bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Magnetic Resonance Imaging and Stress Radiographs in the Evaluation of Chronic Lateral Ankle Instability
Authors: Jolman Scott , Robbins Justin , Lewis Laura , Wilkes Melissa , Ryan Paul 
Published: January 2017

Background: In patients who develop chronic ankle instability, clinicians often obtain magnetic resonance imaging (MRI) as part of the evaluation prior to operative referral. The purpose of this study was to analyze the diagnostic efficacy of MRI in the diagnosis of chronic lateral ankle instability. Our hypothesis was that magnetic resonance imaging would not be a specific diagnostic tool in the evaluation of chronic lateral ankle instability. Materials and Methods: A retrospective chart review of 187 consecutive patients (190 ankles) was performed. Inclusion criteria for the study group required a primary complaint of instability that required operative repair or reconstruction, a documented clinical evaluation consistent with instability, stress radiographs, and MRI. Stress radiographs and clinical examinations for the study group and a control group were reviewed independently by both a musculoskeletal radiologist and a board-certified orthopaedic foot and ankle surgeon. Predictive values in terms of sensitivity, specificity, and prevalence were performed. In total, 112 patients (115 ankles) were identified who underwent an operative reconstruction of their lateral ligaments with a history, physical examination, and stress radiographs consistent with lateral ankle instability. A control group was selected consisting of 75 patients seen in the foot and ankle clinic with a diagnosis other than lateral ankle instability. Thirty-seven of the patients in the control group had stress radiographs performed in the clinic to rule out instability as part of their evaluation, and this allowed for an evaluation of the efficacy of stress radiographs in addition to MRI. Statistical analysis was performed using predictive values from sensitivity, specificity, and prevalence. Results: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in regards to MRI in the evaluation of patients found to have clinical lateral ankle instability and those who did not had statistical significance. Sensitivity of MRI was 82.6%, specificity was 53.3%, NPV was 66.7%, and PPV was 73%. Since 37 patients in the control group also had stress radiographs, a subanalysis was performed to identify the same values with stress radiographs. Sensitivity, specificity, NPV, and PPV were 66%, 97%, 48%, and 98.7%, respectively. The overall accuracy within this study was 71% for MRI and 74% for stress radiographs. Conclusion: This study demonstrated that MRI has high sensitivity but low specificity in the evaluation of clinical ankle instability. While MRI has value as a screening tool for concomitant ankle pathology, it should not be considered diagnostic in terms of lateral ankle instability. Level of Evidence: Level III, retrospective cohort, comparative series.
Smokers with MS have greater decrements in quality of life and disability than non-smokers
Authors: Briggs Farren BS , Gunzler Douglas D , Ontaneda Daniel , Marrie Ruth Ann 
Published: January 2017

Background: Tobacco smoke plays a pathogenic role in multiple sclerosis (MS) and may accelerate disease progression, yet, some people with MS continue to smoke after disease onset. The average smoker reports diminished health-related quality of life (HRQOL) across many populations. Objectives: To describe the relationships between smoking status and HRQOL, disease activity, and global disability in a US population with MS. Methods: We compared smokers to non-smokers in 950 responders to the Spring 2014 update survey completed by North American Research Committee on Multiple Sclerosis (NARCOMS) registry participants. HRQOL was assessed using Short Form-12 version 2 (SF-12v2), disease activity was investigated using eight Performance Scales (PS) and three Functionality Scales (FS). Global disability was evaluated using Patient Determined Disease Steps (PDDS) and an item response theory (IRT) summed score based on the PS and FS. Results: Smokers had lower HRQOL ( p < 0.0001), reported more disease activity ( p < 0.05) and greater deficits in all PS and FS ( p = 6 × 10−7 to 0.05), except mobility. Smokers and non-smokers did not differ by PDDS but had substantially greater IRT global disability ( p = 2 × 10−7). Conclusion: Active smoking is meaningfully associated with deficits across multiple domains in people with MS and adds to the growing literature of the need for MS-tailored smoking cessation programs.
Clinical characteristics of late-onset neuromyelitis optica spectrum disorder: A multicenter retrospective study in Korea
Authors: Seok Jin Myoung , Cho Hye-Jin , Ahn Suk-Won , Cho Eun Bin , Park Min Su , Joo In-Soo , Shin Ha Young , Kim Sun-Young , Kim Byung-Jo , Kim Jong Kuk , Cho Joong-Yang , Huh So-Young , Kwon Ohyun , Lee Kwang-Ho , Kim Byoung Joon , Min Ju-Hong 
Published: January 2017

Background: There are currently few studies regarding late-onset neuromyelitis optica spectrum disorder (LO-NMOSD). Objective: We aimed to describe the characteristic features of patients with LO-NMOSD in Korea. Methods: Anti-aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder (NMOSD) from nine tertiary hospitals were reviewed retrospectively. The patients were divided into two groups based on age of onset: LO-NMOSD (⩾50 years of age at onset) versus early-onset neuromyelitis optica spectrum disorder (EO-NMOSD) (<50 years of age at onset). Clinical, laboratory, and magnetic resonance imaging (MRI) parameters were investigated. Results: Among a total of 147 patients (125 female; age of onset, 39.4 ± 15.2 years), 45 patients (30.6%) had an age of onset of more than 50 years. Compared to patients with EO-NMOSD, patients with LO-NMOSD had more frequent isolated spinal cord involvement at onset (64.4% vs 37.2%, p = 0.002), less frequent involvement of the optic nerve (40.0% vs 67.7%, p = 0.002), and less frequent brain MRI lesions (31.1% vs 50.0%, p = 0.034). Furthermore, there was a significant positive correlation between age of onset and Expanded Disability Status Scale (EDSS) score at last follow-up ( r = 0.246, p = 0.003). Conclusion: Age of onset could be an important predictor of lesion location and clinical course of patients with NMOSD.
Smoking Habits among Norwegian Doctors 1974
Authors: Aarø Leif-Edvard , Bjartveit Kjell , Vellar Odd D. , Berglund Else-Lill 
Published: January 2017

In the spring of 1974 a representative sample ( N = 1200) of all doctors in Norway (6000) received a mailed questionnaire regarding past and present smoking habits. Close to 95% responded. Among late responders there was a disproportionately high number of smokers. As compared with the general population, both male and female doctors constitute a small proportion of daily smokers and a large proportion of exsmokers. The greatest contrasts are observed in the younger age groups. The percentage of daily smokers in this crossectional study on the medical profession is approximately 50% lower than that found in the 1952–53 study on Norwegian doctors. There is also a shift away from cigarette smoking toward the use of pipe and cigars, which is not found in the general population. Answers to questions regarding reasons for quitting as well as certain attitudinal indicators show that the doctors' reduction in smoking is related to their professional involvement and high level of knowledge concerning the health consequences of smoking.
Review: Optimising the use of Angiotensin Receptor Blockers in the Management of Chronic Heart Failure
Authors: McMurray John 
Published: January 2017

The Candesartan in Heart Failure Assessment of Reduction in Mortality and morbidity (CHARM) trial programme provided clear evidence of the efficacy of candesartan in the management of chronic heart failure (CHF) associated with reduced left ventricular (LV) systolic function. The morbidity and mortality benefits of candesartan were consistent irrespective of age, sex, ethnic origin or baseline heart failure therapy. Extensive safety analyses of the CHARM data have demonstrated that candesartan was well tolerated by patients receiving an angiotensin-converting enzyme (ACE) inhibitor (even at maximal doses) and beta-blocker, and by patients previously intolerant to an ACE inhibitor. They also demonstrated a low incidence of adverse effects, characteristic of drugs that inhibit the renin-angiotensin-aldosterone system CHARM provides conclusive evidence confirming the role of candesartan in the management of CHF patients with LV systolic dysfunction.Treatment should be initiated early to ensure optimum outcome, starting at a low dose (4 mg once daily) and increasing to a target dose of 32 mg once daily. Routine monitoring of blood pressure and of serum creatinine and potassium is warranted.
Review: Effective Implementation of the New ESC Guidelines for the Management of Chronic Heart Failure in Routine Clinical Practice
Authors: Swedberg Karl 
Published: January 2017

European guidelines for the management of chronic heart failure (CHF) have been recently updated. Key changes include emphasis on CHF with preserved ejection fraction, and recognition of the role of angiotensin receptor blockers (ARBs) in the management of CHF patients with left ventricular systolic dysfunction who remain symptomatic despite optimal therapy, or who are intolerant to angiotensin-converting enzyme (ACE) inhibitors. Recent trials that clearly demonstrated significant mortality and morbidity benefits were integral to these new recommendations. Additionally, a high dose of an ARB, as demonstrated in the Candesartan in Heart Failure Assessment of Reduction in Mortality and morbidity (CHARM) programme, can significantly reduce hospitalisation for heart failure in these settings. The guidelines recommend that only those ARBs and doses used in clinical trials should be considered, taking into account current licensed indications. Clinicians who are directly involved in the management of CHF must play a key role in the dissemination of these guidelines to colleagues to ensure that optimal CHF management is integrated into standard practice.
A prospective clinical trial to compare the performance of dried blood spots prenatal screening for Down’s syndrome with conventional non-invasive testing technology
Authors: Hu Huiying , Jiang Yulin , Zhang Minghui , Liu Shanying , Hao Na , Zhou Jing , Liu Juntao , Zhang Xiaojin , Ma Liangkun 
Published: January 2017

To evaluate, side by side, the efficiency of dried blood spots (DBSs) against serum screening for Down’s syndrome, and then, to construct a two-tier strategy by topping up the fetal cell-free DNA (cfDNA) secondary screening over the high-risk women marked by the primary blood testing to build a practical screening tactic to identify fetal Down’s syndrome. One thousand eight hundred and thirty-seven low-risk Chinese women, with singleton pregnancy, were enrolled for the study. Alpha-fetoprotein and free beta human chorionic gonadotropin were measured for the serum as well as for the parallel DBS samples. Partial high-risk pregnant women identified by primary blood testing (n = 38) were also subject to the secondary cfDNA screening. Diagnostic amniocentesis was utilized to confirm the screening results. The true positive rate for Down’s syndrome detection was 100% for both blood screening methods; however, the false-positive rate was 3.0% for DBS and 4.0% for serum screening, respectively. DBS correlated well with serum screening on Down’s syndrome detection. Three out of 38 primary high-risk women displayed chromosomal abnormalities by cfDNA analysis, which were confirmed by amniocentesis. Either the true detection rate or the false-positive rate for Down’s syndrome between DBS and the serum test is comparable. In addition, blood primary screening aligned with secondary cfDNA analysis, a “before and after” two-tier screening strategy, can massively decrease the false-positive rate, which, then, dramatically reduces the demand for invasive diagnostic operation.Impact statementChildren born with Down’s syndrome display a wide range of mental and physical disability. Currently, there is no effective treatment to ease the burden and anxiety of the Down’s syndrome family and the surrounding society. This study is to evaluate the efficiency of dried blood spots against serum screening for Down’s syndrome and to construct a two-tier strategy by topping up the fetal cell-free DNA (cfDNA) secondary screening over the high-risk women marked by the primary blood testing to build a practical screening tactic to identify fetal Down’s syndrome. Results demonstrate that fetal cfDNA can significantly reduce false-positive rate close to none while distinguishing all true positives. Thus, we recommend that fetal cfDNA analysis to be utilized as a secondary screening tool atop of the primary blood protein screening to further minimize the capacity of undesirable invasive diagnostic operations.
Hepatitis B X-interacting protein promotes cisplatin resistance and regulates CD147 via Sp1 in ovarian cancer
Authors: Zou Wei , Ma Xiangdong , Yang Hong , Hua Wei , Chen Biliang , Cai Guoqing 
Published: January 2017

Ovarian cancer is the highest mortality rate of all female reproductive malignancies. Drug resistance is a major cause of treatment failure in malignant tumors. Hepatitis B X-interacting protein acts as an oncoprotein, regulates cell proliferation, and migration in breast cancer. We aimed to investigate the effects and mechanisms of hepatitis B X-interacting protein on resistance to cisplatin in human ovarian cancer cell lines. The mRNA and protein levels of hepatitis B X-interacting protein were detected using RT-PCR and Western blotting in cisplatin-resistant and cisplatin-sensitive tissues, cisplatin-resistant cell lines A2780/CP and SKOV3/CP, and cisplatin-sensitive cell lines A2780 and SKOV3. Cell viability and apoptosis were measured to evaluate cellular sensitivity to cisplatin in A2780/CP cells. Luciferase reporter gene assay was used to determine the relationship between hepatitis B X-interacting protein and CD147. The in vivo function of hepatitis B X-interacting protein on tumor burden was assessed in cisplatin-resistant xenograft models. The results showed that hepatitis B X-interacting protein was highly expressed in ovarian cancer of cisplatin-resistant tissues and cells. Notably, knockdown of hepatitis B X-interacting protein significantly reduced cell viability in A2780/CP compared with cisplatin treatment alone. Hepatitis B X-interacting protein and cisplatin cooperated to induce apoptosis and increase the expression of c-caspase 3 as well as the Bax/Bcl-2 ratio. We confirmed that hepatitis B X-interacting protein up-regulated CD147 at the protein expression and transcriptional levels. Moreover, we found that hepatitis B X-interacting protein was able to activate the CD147 promoter through Sp1. In vivo, depletion of hepatitis B X-interacting protein decreased the tumor volume and weight induced by cisplatin. Taken together, these results indicate that hepatitis B X-interacting protein promotes cisplatin resistance and regulated CD147 via Sp1 in ovarian cancer cell lines. Impact statement We found that hepatitis B X-interacting protein (HBXIP) was able to activate the CD147 promoter through Sp1. In vivo, depletion of HBXIP decreased the tumor volume and weight induced by CP. Taken together, these results indicate that HBXIP promotes cisplatin resistance and regulated CD147 via Sp1 in ovarian cancer cell lines.
Quercetin and the ocular surface: What we know and where we are going
Authors: McKay Tina B , Karamichos Dimitrios 
Published: January 2017

Flavonoids are a class of plant and fungus secondary metabolites that serve functional roles in protecting against UV-induced oxidative stress, mediating auxin signaling, and promoting microbial defense. Flavonoids are extremely abundant in nature where their potent antioxidant capacity and very low toxicity makes them highly attractive as potential therapeutic agents. In terms of clinical applications, neither the Food and Drug Administration (FDA) nor the European Food Safety Authority (EFSA) has approved any health claims or drugs related to the use of flavonoids for therapeutic purposes. Quercetin is a common flavonol that has been shown to have potent antioxidant, anti-inflammatory, and anti-fibrotic activities both in vitro and in vivo in various tissues. Recently, the application of quercetin as a therapeutic has been gaining attention in the ocular surface scientific community in the study of dry eye, keratoconus, inflammation, and neovascularization of the cornea. This review will discuss the latest findings and the use of quercetin for the treatment of dystrophies of the ocular surface. Impact statement The eye represents a small portion of the human body, accounting for one decimal fraction of the anterior body surface. The cornea is an avascular, transparent tissue that acts as a primary barrier against mechanical and infectious damaging agents, protecting the internal structures of the eye. Corneal survival and function are affected by a number of factors including but not limited to injury, trauma, infection, genetics, and environment. Corneal injury, or trauma, often leads to loss of corneal transparency and even blindness. The concept of “curing” corneal opacity has been discussed in published form for over 200 years. Currently, full corneal transplant is the only treatment option. There is a strong interest in developing natural therapeutic products that come with minimum side effects. A novel antioxidant flavonoid, quercetin, has been gaining traction as a potential therapeutic to prevent the injured cornea. This review discusses the potential of this antioxidant.
Soy protein isolate inhibits hepatic tumor promotion in mice fed a high-fat liquid diet
Authors: Mercer Kelly E , Pulliam Casey F , Pedersen Kim B. , Hennings Leah , Ronis Martin JJ 
Published: January 2017

Alcoholic and nonalcoholic fatty liver diseases are risk factors for development of hepatocellular carcinoma, but the underlying mechanisms are poorly understood. On the other hand, ingestion of soy-containing diets may oppose the development of certain cancers. We previously reported that replacing casein with a soy protein isolate reduced tumor promotion in the livers of mice with alcoholic liver disease after feeding a high fat ethanol liquid diet following initiation with diethylnitrosamine. Feeding soy protein isolate inhibited processes that may contribute to tumor promotion including inflammation, sphingolipid signaling, and Wnt/β-catenin signaling. We have extended these studies to characterize liver tumor promotion in a model of nonalcoholic fatty liver disease produced by chronic feeding of high-fat liquid diets in the absence of ethanol. Mice treated with diethylnitrosamine on postnatal day 14 were fed a high-fat liquid diet made with casein or SPI as the sole protein source for 16 weeks in adulthood. Relative to mice fed normal chow, a high fat/casein diet led to increased tumor promotion, hepatocyte proliferation, steatosis, and inflammation. Replacing casein with soy protein isolate counteracted these effects. The high fat diets also resulted in a general increase in transcripts for Wnt/β-catenin pathway components, which may be an important mechanism, whereby hepatic tumorigenesis is promoted. However, soy protein isolate did not block Wnt signaling in this nonalcoholic fatty liver disease model. We conclude that replacing casein with soy protein isolate blocks development of steatosis, inflammation, and tumor promotion in diethylnitrosamine-treated mice fed high fat diets. Impact statement The impact of dietary components on cancer is a topic of great interest for both the general public and the scientific community. Liver cancer is currently the second leading form of cancer deaths worldwide. Our study has addressed the effect of the protein source on hepatic tumor promotion in a mouse model reflecting aspects of non-alcoholic fatty liver disease (NAFLD). A high-fat liquid diet with casein as the protein source promotes hepatic injury and tumor promotion in diethylnitrosamine-treated mice. Replacing casein with a soy protein isolate led to a pronounced diminishment of tumor promotion and associated hepatic injury and inflammation. The study thus demonstrates that a dietary protein source can have beneficial, preventative effects on hepatic tumor promotion.
Using Hermeneutic Phenomenology to Elicit a Sense of Body at Mid-Life
Authors: Shin Kyung Rim 
Published: January 2017

In this article, the author demonstrates how a phenomenological approach may be used to describe the changes of women's bodies at menopause. In Korea, the middle age of Korean women has been referred as the golden age and autumn season, and which means Korean thing highly of internal mature rather than external facts. When Korean women experience menopausal, they feel they are in the middle of storm, and just have passed by in the time. They can expert and feel tomorrow's weather by the changes of their body. While the experience menopausal, they can extremely perceive changes of their body, and at the same time, incidence rate of breast cancer is no the increase. Mastectomy has serious effects on both women's body and spirit. Phenomenological analysis on the changes of body shows that the middle age women of Korea feel “Evidently visible scratches of years”, “My body is a live weather forecaster”, “Khi is getting weaker”, “Being fearful suddenly but too late”, “The more aged, the more precious life becomes”, “Being comfortable is better than being beautiful”, “Wish to go back to their past”, “Intense desire for re- challenging life”, “Better friends than husband”. In conclusion, there of no way to fully understand someone without knowing one's lived experience within the cultural context. To understand artificial changes by surgery as well as natural ones, and even to do holistic nursing, qualitative research is essentially required.
Advancing Uncertainty: Untangling and Discerning Related Concepts
Authors: Penrod Janice 
Published: January 2017

Methods of advancing concepts within the qualitative paradigm have been developed and articulated. In this section, I describe methodological perspectives of a project designed to advance the concept of uncertainty using multiple qualitative methods. Through a series of earlier studies, the concept of uncertainty arose repeatedly in varied contexts, working its way into prominence, and warranting further investigation. Processes of advanced concept analysis were used to initiate the formal investigation into the meaning of the concept. Through concept analysis, the concept was deconstructed to identify conceptual components and gaps in understanding. Using this skeletal framework of the concept identified through concept analysis, subsequent studies were carried out to add ‘flesh’ to the concept. First, a concept refinement using the literature as data was completed. Findings revealed that the current state of the concept of uncertainty failed to incorporate what was known of the lived experience. Therefore, using interview techniques as the primary data source, a phenomenological study of uncertainty among caregivers was conducted. Incorporating the findings of the phenomenology, the skeletal framework of the concept was further fleshed out using techniques of concept correction to produce a more mature conceptualization of uncertainty. In this section, I describe the flow of this qualitative project investigating the concept of uncertainty, with special emphasis on a particular threat to validity (called conceptual tunnel vision) that was identified and addressed during the phases of concept correction. Though in this article I employ a study of uncertainty for illustration, limited substantive findings regarding uncertainty are presented to retain a clear focus on the methodological issues.