bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetics of Autoimmune Thyroiditis in Type 1 Diabetes Reveals a Novel Association With DPB1*0201: Data From the Type 1 Diabetes Genetics Consortium
Authors: Kahles Heinrich , Fain Pamela R. , Baker Peter , Eisenbarth George , Badenhoop Klaus 
Published: September 2015

BACKGROUND
Autoimmune thyroiditis occurs in 10–25% of patients with type 1 diabetes (T1D). Most of these patients are also positive for thyroid peroxidase (TPO) antibodies. Thyroid dysfunction complicates T1D metabolic control and is a component of the autoimmune polyglandular syndrome (APS, type 2 or 3). Previous studies of isolated T1D and of T1D combined with other autoimmune disorders showed genetic susceptibility for alleles in HLA-DQB1 and -DRB1 and also CTLA4 and PTPN22.

RESEARCH DESIGN AND METHODS
We analyzed the Type 1 Diabetes Genetics Consortium Autoantibody Workshop data by differentiating those T1D probands with and without TPO antibodies or thyroid disease with respect to polymorphisms in HLA, CTLA4, INS, PTPN22, and VDR, taking into account the ethnic origin. Genotype and clinical/immunogenic phenotype data were analyzed by gene counting methods and logistic regression analysis.

RESULTS
The presence of TPO antibodies (25.2%) and thyroid disease (8.4%) was associated with older age, female sex, and presence of other autoantibodies (GAD65, ATPase, 21-OH) (all P &lt; 0.001). The highest prevalence was in patients of Hispanic ancestry (31%) and the lowest in those of African ancestry (8%). In T1D non-Hispanic whites, HLA-DRB1*0101 is significantly (P &lt; 0.0001) less frequent in TPO-positive than in TPO-negative individuals, whereas HLA-DRB1*0404, -DQB1*0301, and -DPB1*0201 are significantly (P &lt; 0.0001) more frequent. Subjects with a high titer of TPO autoantibodies and with thyroid disease were associated with female sex and older age and negatively associated with DRB1*0401-DQB1*0302 (P &lt; 0.0001). No significant differences were observed for an association of TPO positivity or thyroid disease with single nucleotide polymorphisms in the INS, CTLA4, or VDR loci, with nominal significance (P = 0.01) for PTPN22 R620W variant.

CONCLUSIONS
Thyroid autoimmunity is highly prevalent in T1D patients of non-Hispanic white, Asian, or Hispanic origin. The strongest disease risk is conferred by female sex and older age. This risk is modulated by HLA-DRB1 and HLA-DPB1 loci. The immunogenetic profile for T1D with thyroid autoimmunity may identify distinct pathways regulating polyglandular autoimmunity and disease.
Haematopoietic toxicity of radium-223 in patients with high skeletal tumour burden
Authors: Thomas C. , Beck J. , Hampel C. , Krieger C. , Baqué P. E. , Helisch A. , Schreckenberger M. , Miederer M. 
Published: September 2015

SummaryIn patients with metastasized, castration resistant prostate cancer (mCRPC) treatment with radium-223 (Xofigo) is an attractive therapeutic option. In particular, patients with high tumour load seem to profit from this treatment in regard of survival and quality of live. Aim of this study was to stratify mCRPC patients according to a quantitative imaging marker derived from routine bone scans (EXINI bone) and analyze haematopoietic toxicity of Xofigo in these patients. Patients, methods: Toxicity and oncologic outcome were investigated in a cohort of 14 patients with high tumour load. Additionally, based on a web survey, experience of toxicity in 41 high tumour load patients in Germany in 2014 was collected. Results: In patients with a bone scan index (BSI) greater than 5, significant toxicity occurred in more patients than expected from the ALSYMPCA trial. This was associated with application of fewer cycles. Similar experiences have been made in other centers in Germany. Approximately 7% of these patients will need very long time or will not recover from grade ≥ 3 toxicity. Conclusion: Close follow-up of haematopoietic indices and, in case of toxicity, early termination of therapy is in particular necessary in late stage disease where limited bone marrow reserve is likely.
Face aux suicides au travail : l’action syndicale entre banalisation et déni
Authors: Mühlstein Philippe 
Published: September 2015

La prise en compte de la subjectivité au travail par les syndicats a été tardive. Confrontée à des suicides au travail en nombre croissant à la Sncf , la fédération Sud -Rail a, la première, mis en place en 2010 une formation syndicale sur la souffrance au travail, fondée notamment sur les travaux théoriques et cliniques en psychodynamique du travail. Son contenu suscite des controverses, car, contrairement à d’autres formations syndicales mises en œuvre ensuite, celle-ci aborde des questions de philosophie morale : consentement au mal, servitude volontaire et souffrance éthique.
Using Debates to Teach Evidence-Based Practice in Large Online Courses
Authors: Boyd Mary R. , Baliko Beverly , Polyakova-Norwood Vera 
Published: September 2015

Background:
To engage in evidence-based practice (EBP), baccalaureate nursing graduates’ competencies must include locating, interpreting, appraising, and applying research findings. Faculty are challenged to find effective ways to incorporate this content in large online courses.

Method:
Faculty in a thriving college of nursing used interactive debates to teach EBP skills in a large (200+ students) online undergraduate course.

Results:
Students remain highly engaged while practicing critical thinking, team-work, leadership, delegation, communication skills, and peer evaluation through participation in a series of faculty-facilitated online debates.

Conclusion:

Meticulous course organization and use of structured debates allows one instructor to teach skills for EBP, while keeping students engaged with each other, the instructor, and the material. Use of debates and the amount of engagement among students and faculty achieved could not be accomplished in a large face-to-face course. [
J Nurs Educ.
2015;54(10):578–582.]
Differential Roles of Chemokines CCL2 and CCL7 in Monocytosis and Leukocyte Migration during West Nile Virus Infection
Authors: Bardina Susana V. , Michlmayr Daniela , Hoffman Kevin W. , Obara Christopher J. , Sum Janet , Charo Israel F. , Lu Wuyuan , Pletnev Alexander G. , Lim Jean K. 
Published: September 2015

Abstract
West Nile virus (WNV) is a re-emerging pathogen and the leading cause of epidemic encephalitis in the United States. Inflammatory monocytes are a critical component of the cellular infiltrate found in the CNS during WNV encephalitis, although the molecular cues involved in their migration are not fully understood. In mice, we previously showed that WNV infection induces a CCR2-dependent monocytosis that precedes monocyte migration into the CNS. Currently, the relative contribution of the CCR2 ligands, chemokines CCL2 and CCL7, in directing monocyte mobilization and leukocyte migration into the CNS is unclear. In this study, we demonstrate that, although both CCL2 and CCL7 are required for efficient monocytosis and monocyte accumulation in the CNS, only CCL7 deficiency resulted in increased viral burden in the brain and enhanced mortality. The enhanced susceptibility in the absence of CCL7 was associated with the delayed migration of neutrophils and CD8+ T cells into the CNS compared with WT or Ccl2−/− mice. To determine whether CCL7 reconstitution could therapeutically alter the survival outcome of WNV infection, we administered exogenous CCL7 i.v. to WNV-infected Ccl7−/− mice and observed a significant increase in monocytes and neutrophils, but not CD8+ T cells, within the CNS, as well as an enhancement in survival compared with Ccl7−/− mice treated with a linear CCL7 control peptide. Our experiments suggest that CCL7 is an important protective signal involved in leukocyte trafficking during WNV infection, and it may have therapeutic potential for the treatment of acute viral infections of the CNS.
Etiologic factors related to unsatisfactory ThinPrep®cervical cytology: Evaluation and potential solutions to improve
Authors: Kalinicheva Tatyana , Frisch Nora , Giorgadze Tamar , Madan Shashi , Shidham Anushree , Bhalla Amarpreet , Mejias-Badillo Linette , Tranchida Paul , Bandyopadhyay Sudeshna , Dhillon Inderpreet , Shidham Vinod B. 
Published: September 2015

Background:In cervical cytology, the unsatisfactory rates for ThinPrep (TP) are slightly higher compared to SurePath. We examined various causes and explored potential for resolution of this discrepancy.Materials and Methods:Totally, 19,422 cases were reviewed and 1000 unsatisfactory specimens were selected and analyzed. 531 specimens were available for wash protocol. Out of 114 unsatisfactory specimens associated with atrophic cellular changes (ACC), 48 were resubmitted by provider and reevaluated.Results:Lubricant and lubricant-like debris/contamination (LUBE) was the most common cause of unsatisfactory specimens (68%; 681/1000) followed by blood (7.5%); ACC only (without other interfering factors) (2.4%); inflammation (3.0%); and combinations thereof (1.9%). 11.5% showed scant cellularity without an identifiable cause. 3.3% were virtually acellular. Wash protocol improved cellularity in 48% (256/531) of cases. However, only 29% (73/256) of those were satisfactory (with more than 5000 cells). Quantitative reduction in LUBE after wash protocol varied with different morphological subtypes. Interpretation patterns on satisfactory specimens after wash protocol were comparable to the results on selected cohort of specimens during the same study period. Out of 114 ACC, wash protocol was performed on 68 ACC specimens leading to satisfactory TP in 24% (16/68). Totally, 48 cases reported as unsatisfactory with ACC, were resubmitted by the providers between 2 weeks and 2 years. 44 (92%) showed increased cellularity, out of which 52% (23/44) did not show ACC.Conclusion:LUBE was the most common cause of unsatisfactory TP in addition to interference by blood and association with atrophic changes. Knowing the morphological spectrum of LUBE would help to identify it as the cause of unsatisfactory TP. Communicating the cause of unsatisfactory TP such as LUBE, ACC, and blood would hint the provider to take appropriate precaution during submission of the repeat specimen, leading to improved patient care.
Trismus
Authors: Poornima C , Poornima G 
Published: September 2015

ABSTRACT
Trismus or jaw hypomobility refers to a sustained, tonic spasm of the masticatory muscles. There are various causes for this common symptom where the patient seeks medical intervention immediately, as it impairs speech and eating; causes social injunction leading to fear, anxiety and anger. Successful treatment of trismus depends on prompt recognition of its cause and immediate initiation of appropriate treatment. A thorough knowledge of this hypomobility is essential for successful treatment and to avoid permanent functional disability. This article gives an insight into etiology, differential diagnosis and treatment of trismus.

How to cite this article
Poornima G, Poornima C. Trismus. J Health Sci Res 2014;5(2):15-20.
A Song of Great Order
Authors: MacKenzie Cameron 
Published: September 2015

Abstract
The real is perhaps the most ambiguous term in critical discourse, and has come to represent a host of investigations into the limit of language as an expressive vehicle in the face of an immaculate silence. As presented in McCarthy's novel, the real in fact works beyond such theological understandings to move through and past Lacanian models and into aesthetic theories of truth and the nature of the artwork. The writings of Alain Badiou allow us to grasp more concretely the deployment of the real in The Crossing, specifically Badiou's understanding of the dialectic in the manufacture of meaning and the role of the poetic enunciation in relationship to the revelation of truth. A close reading of the key structuring element of The Crossing, the Mexican folksong of the corrido, reveals how an artistic act can create the world in which it is performed, and how the resulting work of art may be the only thing, in the end, that can be called real.
Met de wijsheid achteraf
Authors: Eeuwijk Jennifer , van den Bosch Judith , van der Wal Gerrit , Robben Paul 
Published: September 2015

Met de wijsheid achteraf. Hindsight en outcome bias in het toezicht
Als we weten hoe een situatie afloopt, worden we onbewust beïnvloed door die kennis in ons oordeel over de situatie. Het kan de beoordeling van de kwaliteit van de in het verleden genomen beslissingen beïnvloeden (outcome bias), maar ook de beoordeling van de geschatte waarschijnlijkheid van de afloop (hindsight bias). Deze vertekeningen zijn een methodologisch probleem bij het werk van een toezichthouder. Door middel van literatuurstudie, expertinterviews en een focusgroepdiscussie met inspecteurs, is nagegaan wat we onder hindsight en outcome bias verstaan, welke factoren deze vertekening beïnvloeden en hoe deze te verminderen. De kans op vertekening neemt toe, als het eenvoudig lukt om verklaringen te bedenken voor de afloop. Het risico op vertekening kan teruggedrongen worden door, bijvoorbeeld, alternatieve uitkomsten te bedenken. Multidisciplinaire teams en het organiseren van tegenspraak zouden de kwaliteit van het werk van toezichthouders kunnen vergroten.
Real‐time Tissue Elastography for Assessment of Liver Stiffness in Adults Without Known Liver Disease
Authors: Hu Yu , Gong Hai-Yan , Lin Hong-Jun 
Published: September 2015

ObjectivesTo investigate normal liver stiffness and its influential factors in adults without liver disease using real‐time tissue elastography. The liver stiffness threshold value for identifying patients with chronic liver disease was also determined.MethodsOne hundred twenty healthy volunteers were examined with real‐time tissue elastography. An integrated quantitative elastographic parameter, defined as the liver fibrosis index, was obtained by tissue dispersion quantitative analysis. Correlations between the liver fibrosis index and age, sex, and body mass index (BMI) were studied. To determine the threshold value for identifying chronic liver disease, 29 patients with chronic hepatitis B who underwent liver biopsy, including patients without fibrosis (fibrosis stage F0; n = 9) and patients with substantial fibrosis (F1–F2; n = 20) were also investigated. A receiver operating characteristic curve analysis for differentiating the F0 from the F1–F2 group was performed.ResultsThere were no significant differences in the mean liver fibrosis index between sexes or among different age groups. There was a positive correlation between BMI and the liver fibrosis index. The mean liver fibrosis index ± SD in healthy participants with a normal BMI was 1.31 ± 0.25. The mean liver fibrosis index values for F0 and F1–F2 patients with a normal BMI were 1.47 ± 0.24 and 2.44 ± 0.49, respectively (P < .001). The optimal liver fibrosis index threshold value for discriminating normal liver from noncirrhotic chronic liver disease was 2.12 in participants with a normal BMI.ConclusionsLiver stiffness determined by real‐time tissue elastography in healthy Chinese adults is not affected by age and sex but has a positive correlation with BMI. Real‐time tissue elastography for assessment of liver stiffness can also be used for identification of substantial fibrosis in patients with chronic liver disease.
Usefulness of Sonography in Evaluating Children Suspected of Malrotation
Authors: Zhou Lu-yao , Li Shu-rong , Wang Wei , Shan Quan-yuan , Pan Fu-shun , Liu Jun-cheng , Xie Xiao-yan 
Published: September 2015

ObjectivesThe purpose of this study was to prospectively evaluate the value of sonography in working up or ruling out malrotation by 3 sonographic features (inversion of the superior mesenteric artery and superior mesenteric vein, the whirlpool sign, and an intraperitoneal transverse duodenum) and comparing it with an upper gastrointestinal (GI) contrast study.MethodsA total of 70 pediatric patients who underwent detailed abdominal sonography to rule out intestinal malrotation were included. Twenty‐three of them also underwent an upper GI contrast study. Surgery or clinical follow‐up was taken as the reference standard. Statistical analysis was performed with the χ2 test.ResultsTwenty‐three patients had a diagnosis of malrotation by surgical findings. With the combination of all 3 sonographic features, the sensitivity, specificity, and accuracy of sonography for determining malrotation were 100% (23 of 23), 97.8% (46 of 47), and 98.6% (69 of 70), respectively, whereas the sensitivity, specificity, and accuracy of the upper GI study were 40% (4 of 10), 64.3% (9 of 14), and 56.5% (13 of 23; P < .001). Combined anomalies in 2 patients and complications in 2 patients were also detected by sonography.ConclusionsBy combining inversion of the superior mesenteric artery and superior mesenteric vein, the whirlpool sign, and an intraperitoneal transverse duodenum, sonography might be more valuable for accurately working up or ruling out pediatric malrotation than an upper GI contrast study. In addition, sonography could provide extra information, such as combined anomalies and intestinal necrosis, to help management.
Impact of an Inexpensive Anatomy‐Based Fetal Pig Simulator on Obstetric Ultrasound Training
Authors: Akoma Ugochi N. , Shumard Kristina M. , Street Linda , Brost Brian C. , Nitsche Joshua F. 
Published: September 2015

ObjectivesThe purpose of this study was to construct an inexpensive anatomy‐based obstetric ultrasound task trainer and investigate whether introduction of this trainer into a hands‐on obstetric ultrasound course improved course participants' ultrasound scanning skills.MethodsThe trainer was created by placing fetal pigs into preservative‐filled heat‐sealed polyethylene bags. Twenty‐four participants in an obstetric ultrasound course at Wake Forest School of Medicine were randomized to receive hands‐on scanning with pregnant women or hands‐on scanning and fetal pig simulation. Biometric scans were performed before and after the course. The time to complete the scans, margin of error of biometric measurements, and number of technically adequate images per scan were compared between groups.ResultsTwelve participants were randomized into each group. Although a direct comparison of postcourse biometric scans demonstrated no difference between groups, participants that received simulation training showed significant improvements in the time to complete the biometric scan (P < .05) and number of technically adequate images obtained (P < .05), whereas those who did not receive simulation training did not show significant improvements.ConclusionsAddition of the fetal pig ultrasound task trainer resulted in improvements in the course participants' scanning efficiency even after very limited exposure. Incorporating the task trainer earlier and more broadly into obstetric ultrasound training may benefit trainees.
A review of electroconvulsive therapy in suicidality
Authors: Oji Chinelo , Moore Troy A. , Gutierrez Cynthia A. 
Published: September 2015

AbstractIntroductionSuicidal thoughts and behaviors are highly associated with major psychiatric illnesses, including depression, schizophrenia, and substance related disorders.1 Suicide is a major cause of death in individuals with mood disorders, and mortality rates are markedly higher in this patient cohort compared with those without mental illness.2,3 The estimated lifetime rate of suicide in those with schizophrenia, major depressive disorder, and bipolar disorder are 6.0%, 14.6%, and 15.5%, respectively, as compared with 0.72% in the general population.4MethodsA literature search was conducted for empirical evidence of affect of suicidality with electroconvulsive therapy.ResultsAvailable evidence suggests electroconvulsive therapy may reduce the risk of suicide in various patient populations.DiscussionThis review seeks to summarize a selection of the pertinent literature describing electroconvulsive therapy's effects on suicidality.
A review of suicide risk assessment instruments and approaches
Authors: Lotito Megan , Cook Emmeline 
Published: September 2015

Abstract

Introduction:
Conducting an accurate suicide risk assessment (SRA) is no simple task as there are a number of factors that influence an individual's level of suicidality and his/her willingness to share this information. Therefore, it is imperative that practitioners adopt a systematic approach to conducting and documenting the foreseeability that a patient will commit suicide.

Methods
PubMed was used to search for articles published in MEDLINE journals using the following keywords: suicide, risk assessment, measure, scale. Randomized trials and pilot, proof-of-concept publications investigating the use of specific SRA measurements were included in the review. The scales are described based on the prevailing opinions in psychiatry from the American Psychiatric Association's Textbook of Suicide Assessment and Management (2nd ed., 2012).

Results
Although various SRA scales exist, experts in the field have repeatedly concluded that there is not any one scale that can predict who will commit suicide to any useful degree. However, when used along with the clinical interview, standardized suicide risk factor components of clinical and research scales remain crucial to gaining information often omitted by patients regarding thoughts and preparation for suicide. A summary of the most widely cited scales and approaches used in SRA is provided.

Discussion
SRA remains a challenge largely due to the fact that suicidal behavior is multifactorial. As a result, risk formulation is a process that should involve both standardized measures and detailed clinical interviews repeated over time.
Modeling interstellar pickup ion distributions in corotating interaction regions inside 1 AU
Authors: Chen J. H. , Schwadron N. A. , Möbius E. , Gorby M. 
Published: September 2015

AbstractWe present a modeling study of interstellar pickup ion (PUI) distributions in corotating interaction regions (CIRs). We consider gradual compressions associated with CIRs formed when fast speed streams overtake slower streams in the inner heliosphere. For the analysis, we adopt a simplified magnetohydrodynamic model of a CIR. The Energetic Particle Radiation Environment Module, a parallelized particle numerical kinetic code, is used to model PUI distributions using the focused transport equation, including adiabatic cooling/heating, adiabatic focusing, and parallel and perpendicular diffusion. The continuous injection of PUIs is handled as a source term with a ring distribution in velocity space that is produced from the local neutral density obtained from a hot model of the interstellar neutral gas. The simulated distributions exhibit a harder spectrum in the compression region and a softer spectrum in the rarefaction region than that in undisturbed solar wind. As an additional result, a v−5 power law tail distribution above the PUI cutoff speed (a knee in the distribution) emerges for a particular velocity gradient in the CIR. The tail above the PUI cutoff is sensitive to the CIR velocity gradient, and in one observational case studied, this relationship adequately explains the observed spectrum from 2 to 4 times the solar wind speed. This suggests that the velocity gradient associated with the CIR formation can efficiently create a seed population of PUIs before a shock forms even without stochastic acceleration. Thus, local CIR compressions without shocks may play a significant role in the acceleration process as suggested previously.