bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to Addressing Adolescent Substance Use: Perceptions of New York School‐Based Health Center Providers
Authors: Harris Brett , Shaw Benjamin , Lawson Hal , Sherman Barry 
Published: January 2016

ABSTRACTBACKGROUNDAdolescent substance use is associated with chronic health conditions, accidents, injury, and school‐related problems, including dropping out. Schools have the potential to provide students with substance use prevention and intervention services, albeit with confidentiality challenges. School‐based health centers (SBHCs) provide confidentiality, positioning them as ideal settings to provide substance use prevention and intervention. This study identified program directors' and clinicians' barriers to addressing adolescent substance use in SBHCs.METHODSBetween May and June 2013, an electronic survey was distributed to all 162 New York State SBHC program directors and clinicians serving middle and high school students.RESULTSThe most prevalent perceived barriers to discussing substance use with students were time constraints (43%), the belief that students are not honest about their use (43%), and clinicians' lack of training (28%). Both directors and clinicians identified challenges in getting students to return for additional sessions to address their use, and they also indicated that confidentiality was a treatment referral barrier.CONCLUSIONSThis study identified timely opportunities that may be leveraged and unique challenges that may be overcome with targeted dissemination, training, and technical assistance efforts to enable directors and clinicians to routinely address substance use in SBHCs.
Disturbed sleep in attention‐deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD presentation
Authors: Virring Anne , Lambek Rikke , Thomsen Per H. , Møller Lene R. , Jennum Poul J. 
Published: January 2016

SummaryAttention‐deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder with three different presentations and high levels of psychiatric comorbidity. Serious sleep complaints are also common, but the role of the presentations and comorbidity in sleep is under‐investigated in ADHD. Consequently, the goal of the study was to investigate sleep problems in medicine‐naive school‐aged children (mean age = 9.6 years) with ADHD compared to controls using objective methods and to examine the role of comorbidity and presentations. Ambulatory polysomnography results suggested that children with ADHD (n = 76) had significantly more sleep disturbances than controls (n = 25), including a larger percentage of rapid eye movement (REM) sleep and more sleep cycles, as well as lower mean sleep efficiency, mean non‐REM (NREM) sleep stage 1 and mean NREM sleep stage 3. No significant between‐group differences were found on the multiple sleep latency test. Stratifying for comorbidity in the ADHD group did not reveal major differences between groups, but mean sleep latency was significantly longer in children with ADHD and no comorbidity compared to controls (36.1 min; SD = 30.1 versus 22.6 min; SD = 15.2). No differences were found between ADHD presentations. Our results support the presence of night‐time sleep disturbances in children with ADHD. Poor sleep does not appear to be attributable to comorbidity alone, nor do sleep disturbances differ within ADHD presentations.
The interpretation of hepatic venous pressure gradient tracings – excellent interobserver agreement unrelated to experience
Authors: Tandon Puneeta , Ripoll Cristina , Assis David , Wongcharatrawee Suchat , Groszmann Roberto J. , Garcia‐Tsao Guadalupe 
Published: January 2016

AbstractBackground and AimsThe hepatic venous pressure gradient (HVPG) plays an important role in the diagnosis, prognosis and therapy of patients with cirrhosis and portal hypertension. One barrier to its widespread use is the potential for a low reproducibility. We aimed to evaluate the interobserver agreement in the interpretation of optimally acquired HVPG tracings from patients with cirrhosis and different degrees of portal hypertension.MethodsTwo hundred and fifteen tracings obtained from 51 patients with cirrhosis in a single centre were interpreted independently by two hepatologists: one experienced observer and one inexperienced observer. Correlation was performed by Pearson linear regression and the intraclass correlation coefficient (ICC). A Bland–Altman plot was constructed to visualize how the differences between observers compared across the range of measurements. Logistic regression was used to identify predictors of ≥10% variation between observers' readings.ResultsThere was a significant linear relationship between observers' readings r = 0.98 (P = 0.001). The ICC between observers (interobserver agreement) was also excellent at 0.991 (P = 0.001). Using the Bland–Altman technique, the mean difference between the observers' readings was 0.2 mmHg (95% CI: −1.2 mmHg to 1.6 mmHg). Thirteen per cent of all readings and 9% of readings with an HVPG of ≥10 mmHg differed by ≥10%. As expected, a lower baseline HVPG was a predictor of this variability.ConclusionsInterobserver reproducibility in the assessment of optimally acquired HVPG tracings is excellent without differences related to experience. The data provide further support that the HVPG can be used accurately in clinical and research settings.
Breast Hypoplasia as a Complication of an Untreated Infantile Hemangioma
Authors: Theiler Martin , Hoffman William Y. , Frieden Ilona J. 
Published: January 2016

AbstractWe report the case of a mixed infantile hemangioma (IH) involving the right breast that resulted in pronounced hypoplasia of the affected breast, which became apparent after breast development at puberty. No treatment had been performed in infancy or childhood. This case demonstrates that the presence of an IH may affect development of the mammary gland bud and that systemic therapy should be considered in an attempt to minimize this adverse sequela.
Penile and Scrotal Swelling: An Underrecognized Presentation of Crohn's Disease
Authors: Barrick Benjamin J. , Tollefson Megha M. , Schoch Jennifer J. , McEvoy Marian T. , Hand Jennifer L. , Wieland Carilyn N. , Davis Dawn M. R. 
Published: January 2016

AbstractBackground: Penile and scrotal swelling can occur as an extraintestinal manifestation of Crohn's disease (CD) and is thought to be an uncommon form of metastatic CD (MCD). Because of the rarity of this manifestation, much is unknown concerning the presentation, treatment, and response to therapy in children with genital MCD. Methods: Boys ages 1 to 17 years presenting with genital edema and a confirmed diagnosis or strong suspicion of CD who were evaluated at the Mayo Clinic between 1996 and 2014 were included for review. We sought to characterize the clinical and pathologic features of genital MCD and response to treatment in our cohort of patients. Results: Eight patients with genital MCD were identified from our institution (mean age 11.4 yrs, range 7–16yrs). Seven (88%) patients experienced cutaneous symptoms before a formal diagnosis of CD was made, and two of the seven had no adverse gastrointestinal symptoms at that time. Patients were prescribed an average of 3.4 medications (topical and systemic) for management of their gastrointestinal CD and MCD. Conclusions: Penile and scrotal swelling can occur as an extraintestinal manifestation of CD and is thought to be an uncommon form of MCD. In boys, genital swelling typically precedes intestinal CD. Treatment of the underlying CD with systemic medications was most helpful in this series. An evaluation for CD is necessary in all patients presenting with unexplained genital swelling.
Orofacial amyloidosis—unusual ­presentation of a rare condition: A case report
Authors: Kaushik Rachna , Pushpanshu Kumar , Punyani Silky R. 
Published: January 2016

ABSTRACTOrofacial amyloidosis is an extremely rare and generally a benign condition. In contrast to systemic amyloidosis, other organs are not involved; however, extensive investigations are recommended to intercept any systemic involvement. Diagnosis is confirmed by histological examination and Congo red staining. This condition does not have a known etiology, and hence no general consensus exists regarding its management. We are presenting a case of a 65‐year‐old female patient with orofacial amyloidosis having ocular and extensive oral involvement.
Implicit Bias and Policing
Authors: Spencer Katherine B. , Charbonneau Amanda K. , Glaser Jack 
Published: January 2016

AbstractIn a time when racial prejudice is generally taboo and decision makers, including law enforcement officials, strenuously disavow the use of group‐based stereotypes to make judgments that affect others, one might expect discriminatory outcomes to be unusual. However, research repeatedly indicates that discrimination is pervasive across many domains, and specifically in policing. A major cause of biased policing is likely the implicit biases that operate outside of conscious awareness and control but nevertheless influence our behaviors. Implicit biases (e.g., stereotypes linking Blacks with crime or with related traits like violence or hostility) influence judgments through processes of misattribution and disambiguation. Although psychological science gives us good insight into the causes of racially biased policing, there are as yet no known, straightforward, effective intervention programs. Nevertheless, there are several strands of research that represent promising avenues for further exploration, including intergroup contact, exposure to counter‐stereotypic exemplars, and stereotype negation. Meanwhile, many police departments are adjusting their policies, trainings, and procedures to try to address biased policing and community complaints. Several common themes among those changes include banning racial profiling, collecting data, training officers, reducing discretion, and adopting new technologies. These adjustments are more likely to be successful if they incorporate the understanding that biased policing occurs in the absence of explicitly “racist” thoughts because of well‐documented, pernicious stereotypes that operate largely outside of conscious awareness and control.
The canine prostate cancer cell line CHP‐1 shows over‐expression of the co‐chaperone small glutamine‐rich tetratricopeptide repeat‐containing protein α
Authors: Azakami D. , Nakahira R. , Kato Y. , Michishita M. , Kobayashi M. , Onozawa E. , Bonkobara M. , Kobayashi M. , Takahashi K. , Watanabe M. , Ishioka K. , Sako T. , Ochiai K. , Omi T. 
Published: January 2016

AbstractAlthough androgen therapy resistance and poor clinical outcomes are seen in most canine prostate cancer cases, there are only a few tools for analysing canine prostate cancer by using a cell biological approach. Therefore, to evaluate androgen‐independent neoplastic cell growth, a new canine prostate cancer cell line (CHP‐1) was established in this study. CHP‐1 over‐expressed the co‐chaperone small glutamine‐rich tetratricopeptide repeat‐containing protein α (SGTA), which is over‐expressed in human androgen‐independent prostate cancer. The CHP‐1 xenograft also showed SGTA over‐expression. Although CHP‐1 shows poor androgen receptor (AR) signalling upon dihydrotestosterone stimulation, forced expression of AR enabled evaluation of AR signalling. Taken together, these results suggest that CHP‐1 will be a useful model for investigating the pathogenesis of androgen‐dependent and androgen‐independent canine prostate cancer.
Experimental verification of gain drop due to general ion recombination for a carbon‐ion pencil beam
Authors: Tansho Ryohei , Furukawa Takuji , Hara Yousuke , Mizushima Kota , Saotome Naoya , Saraya Yuichi , Shirai Toshiyuki , Noda Koji 
Published: January 2016

Purpose:Accurate dose measurement in radiotherapy is critically dependent on correction for gain drop, which is the difference of the measured current from the ideal saturation current due to general ion recombination. Although a correction method based on the Boag theory has been employed, the theory assumes that ionized charge density in an ionization chamber (IC) is spatially uniform throughout the irradiation volume. For particle pencil beam scanning, however, the charge density is not uniform, because the fluence distribution of a pencil beam is not uniform. The aim of this study was to verify the effect of the nonuniformity of ionized charge density on the gain drop due to general ion recombination.Methods:The authors measured the saturation curve, namely, the applied voltage versus measured current, using a large plane‐parallel IC and 24‐channel parallel‐plate IC with concentric electrodes. To verify the effect of the nonuniform ionized charge density on the measured saturation curve, the authors calculated the saturation curve using a method which takes into account the nonuniform ionized charge density and compared it with the measured saturation curves.Results:Measurement values of the different saturation curves in the different channels of the concentric electrodes differed and were consistent with the calculated values. The saturation curves measured by the large plane‐parallel IC were also consistent with the calculation results, including the estimation error of beam size and of setup misalignment. Although the impact of the nonuniform ionized charge density on the gain drop was clinically negligible with the conventional beam intensity, it was expected that the impact would increase with higher ionized charge density.Conclusions:For pencil beam scanning, the assumption of the conventional Boag theory is not valid. Furthermore, the nonuniform ionized charge density affects the prediction accuracy of gain drop when the ionized charge density is increased by a higher dose rate and/or lower beam size.
Influence of pre-existing inflammation on the outcome of acute coronary syndrome: a cross-sectional study
Authors: Odeberg Jacob , Freitag Michael , Forssell Henrik , Vaara Ivar , Persson Marie-Louise , Odeberg Håkan , Halling Anders , Råstam Lennart , Lindblad Ulf 
Published: January 2016

ObjectivesInflammation is a well-established risk factor for the development of coronary artery disease (CAD) and acute coronary syndrome (ACS). However, less is known about its influence on the outcome of ACS. The aim of this study was to determine if blood biomarkers of inflammation were associated specifically with acute myocardial infarction (MI) or unstable angina (UA) in patients with ACS.DesignCross-sectional study.SettingPatients admitted to the coronary care unit, via the emergency room, at a central county hospital over a 4-year period (1992–1996).ParticipantsIn a substudy of Carlscrona Heart Attack Prognosis Study (CHAPS) of 5292 patients admitted to the coronary care unit, we identified 908 patients aged 30–74 years, who at discharge had received the diagnosis of either MI (527) or UA (381).Main outcome measuresMI or UA, based on the diagnosis set at discharge from hospital.ResultsWhen adjusted for smoking, age, sex and duration of chest pain, concentrations of plasma biomarkers of inflammation (high-sensitivity C reactive protein>2 mg/L (OR=1.40 (1.00 to 1.96) and fibrinogen (p for trend=0.035)) analysed at admission were found to be associated with MI over UA, in an event of ACS. A strong significant association with MI over UA was found for blood cell markers of inflammation, that is, counts of neutrophils (p for trend<0.001), monocytes (p for trend<0.001) and thrombocytes (p for trend=0.021), while lymphocyte count showed no association. Interestingly, eosinophil count (p for trend=0.003) was found to be significantly lower in patients with MI compared to those with UA.ConclusionsOur results show that, in patients with ACS, the blood cell profile and degree of inflammation at admission was associated with the outcome. Furthermore, our data suggest that a pre-existing low-grade inflammation may dispose towards MI over UA.
Comparative study of linear and curvilinear ultrasound probes to assess quadriceps rectus femoris muscle mass in healthy subjects and in patients with chronic respiratory disease
Authors: Mandal S , Suh E , Thompson A , Connolly B , Ramsay M , Harding R , Puthucheary Z , Moxham J , Hart N 
Published: January 2016

IntroductionUltrasound measurements of rectus femoris cross-sectional area (RFCSA) are clinically useful measurements in chronic obstructive pulmonary disease (COPD) and critically ill patients. Technical considerations as to the type of probe used, which affects image resolution, have limited widespread clinical application. We hypothesised that measurement of RFCSAwould be similar with linear and curvilinear probes.MethodsFour studies were performed to compare the use of the curvilinear probe in measuring RFCSA.Study 1investigated agreement of RFCSAmeasurements using linear and curvilinear probes in healthy subjects, and in patients with chronic respiratory disease.Study 2investigated the intra-rater and inter-rater agreement using the curvilinear probe.Study 3investigated the agreement of RFCSAmeasured from whole and spliced images using the linear probe.Study 4investigated the applicability of ultrasound in measuring RFCSAduring the acute and recovery phases of an exacerbation of COPD.ResultsStudy 1showed demonstrated no difference in the measurement of RFCSAusing the curvilinear and linear probes (308±104 mm2vs 320±117 mm2, p=0.80; intraclass correlation coefficient (ICC)>0.97).Study 2demonstrated high intra-rater and inter-rater reliability of RFCSAmeasurement with ICC>0.95 for both.Study 3showed that the spliced image from the linear probe was similar to the whole image RFCSA(308±103.5 vs 263±147 mm2, p=0.34; ICC>0.98).Study 4confirmed the clinical acceptability of using the curvilinear probe during an exacerbation of COPD. There were relationships observed between admission RFCSAand body mass index (r=+0.65, p=0.018), and between RFCSAat admission and physical activity levels at 4 weeks post-hospital discharge (r=+0.75, p=0.006).ConclusionsThese studies have demonstrated that clinicians can employ whole and spliced images from the linear probe or use images from the curvilinear probe, to measure RFCSA. This will extend the clinical applicability of ultrasound in the measurement of muscle mass in all patient groups.
Successful diagnosis and treatment of Orthohalarachne attenuata nasal mites utilising voluntary rhinoscopy in three Pacific walrus (Odobenus rosmarus divergens)
Authors: Fravel Vanessa , Procter Diana 
Published: January 2016

A 17‐year‐old adult female walrus presented with copious nasal discharge for one week duration despite a normal appetite and attitude. Antibiotic treatment was initiated based on culture results from the nasal discharge. The amount of nasal discharge decreased dramatically during antibiotic treatment but returned soon after the treatment ended. The walrus had a mild leucocytosis, normal thoracic ultrasound and normal skull radiographs. After four weeks of training, voluntary endoscopy of the anterior nasal cavity was performed revealing mucus surrounding nasal mites, which were collected. The nasal mites were examined microscopically and determined to be Orthohalarachne attenuata nasal mites. The patient was successfully treated with ivermectin 0.2 mg/kg by mouth two weeks apart. This report highlights the importance of medical husbandry training to perform diagnostic procedures without the risk of anaesthesia.
Formation of Renal Cysts and Tumors in Vhl/Trp53-Deficient Mice Requires HIF1α and HIF2α
Authors: Schönenberger Désirée , Harlander Sabine , Rajski Michal , Jacobs Robert A. , Lundby Anne-Kristine , Adlesic Mojca , Hejhal Tomas , Wild Peter J. , Lundby Carsten , Frew Ian J. 
Published: January 2016

Abstract
The von Hippel–Lindau (VHL) tumor suppressor gene is inactivated in the majority of clear cell renal cell carcinomas (ccRCC), but genetic ablation of Vhl alone in mouse models is insufficient to recapitulate human tumorigenesis. One function of pVHL is to regulate the stability of the hypoxia-inducible factors (HIF), which become constitutively activated in the absence of pVHL. In established ccRCC, HIF1α has been implicated as a renal tumor suppressor, whereas HIF2α is considered an oncoprotein. In this study, we investigated the contributions of HIF1α and HIF2α to ccRCC initiation in the context of Vhl deficiency. We found that deleting Vhl plus Hif1a or Hif2a specifically in the renal epithelium did not induce tumor formation. However, HIF1α and HIF2α differentially regulated cell proliferation, mitochondrial abundance and oxidative capacity, glycogen accumulation, and acquisition of a clear cell phenotype in Vhl-deficient renal epithelial cells. HIF1α, but not HIF2α, induced Warburg-like metabolism characterized by increased glycolysis, decreased oxygen consumption, and decreased ATP production in mouse embryonic fibroblasts, providing insights into the cellular changes potentially occurring in Vhl mutant renal cells before ccRCC formation. Importantly, deletion of either Hif1a or Hif2a completely prevented the formation of renal cysts and tumors in Vhl/Trp53 mutant mice. These findings argue that both HIF1α and HIF2α exert protumorigenic functions during the earliest stages of cyst and tumor formation in the kidney. Cancer Res; 76(7); 2025–36. ©2016 AACR.
Endometrial Carcinomas with POLE Exonuclease Domain Mutations Have a Favorable Prognosis
Authors: McConechy Melissa K. , Talhouk Aline , Leung Samuel , Chiu Derek , Yang Winnie , Senz Janine , Reha-Krantz Linda J. , Lee Cheng-Han , Huntsman David G. , Gilks C. Blake , McAlpine Jessica N. 
Published: January 2016

Abstract
Purpose: The aim of this study was to confirm the prognostic significance of POLE exonuclease domain mutations (EDM) in endometrial carcinoma patients. In addition, the effect of treatment on POLE-mutated tumors was assessed.
Experimental Design: A retrospective patient cohort of 496 endometrial carcinoma patients was identified for targeted sequencing of the POLE exonuclease domain, yielding 406 evaluable tumors. Univariable and multivariable analyses were performed to determine the effect of POLE mutation status on progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS). Combining results from eight studies in a meta-analysis, we computed pooled HR for PFS, DSS, and OS.
Results: POLEEDMs were identified in 39 of 406 (9.6%) endometrial carcinomas. Women with POLE-mutated endometrial carcinomas were younger, with stage I (92%) tumors, grade 3 (62%), endometrioid histology (82%), and frequent (49%) lymphovascular invasion. In univariable analysis, POLE-mutated endometrial carcinomas had significantly improved outcomes compared with patients with no EDMs for PFS, DSS, and OS. In multivariable analysis, POLE EDMs were only significantly associated with improved PFS. The effect of adjuvant treatment on POLE-mutated cases could not be determined conclusively; however, both treated and untreated patients with POLE EDMs had good outcomes. Meta-analysis revealed an association between POLE EDMs and improved PFS and DSS with pooled HRs 0.34 [95% confidence interval (CI), 0.15–0.73] and 0.35 (95% CI, 0.13–0.92), respectively.
Conclusions: POLE EDMs are prognostic markers associated with excellent outcomes for endometrial carcinoma patients. Further investigation is needed to conclusively determine if treatment is necessary for this group of women. Clin Cancer Res; 22(12); 2865–73. ©2016 AACR.