bluuebunny/crossref_metadata_2025_split huggingface dataset:
Muscle disorders: the latest investigations
Authors: Ghaoui R. , Clarke N. , Hollingworth P. , Needham M. 
Published: September 2013

AbstractPatients with muscle disorders can present a diagnostic challenge to physicians because of the different ways they can present and the large number of different underlying causes. Recognition of the ‘myopathic phenotype’ coupled with investigations usually including electrodiagnostic and histological investigations have been essential for diagnosing the underlying cause of a myopathy. Despite these standard investigations, some patients can remain undiagnosed. New tests including more specific antibody tests for immune‐mediated myopathies and the introduction of next‐generation sequencing promise to revolutionise diagnostic approaches for immune and inherited myopathies, but clinical expertise remains essential to choose the most appropriate tests and interpret the results. The aim of this review is to provide an overview of the different presentations to the neuromuscular clinic and the latest investigations that can be helpful in the diagnosis of muscle disorders.
Causes of hospitalisation before and after the 2009 L'Aquila earthquake
Authors: Petrazzi L. , Striuli R. , Polidoro L. , Petrarca M. , Scipioni R. , Struglia M. , Giorgini P. , Necozione S. , Festuccia V. , Ferri C. 
Published: September 2013

AbstractOn 6 April 2009, an earthquake struck L'Aquila. The San Salvatore Hospital was evacuated, and a field hospital was built. The study aimed to assess the epidemiologic impact of the earthquake through the analysis of patient population admitted to the field hospital during a 2‐month period following the disaster. We retrospectively evaluated causes of hospitalisation and demographic data of patients admitted to (i) the Division of Internal Medicine and (ii) the Division of Emergency Medicine of the field hospital from 6 April, 2009 to 29 May, 2009. All data were compared with the admissions made at the same divisions of the San Salvatore Hospital during the same period of previous year. (i) Patient group (n = 102) and comparison group (n = 108). Mean patient age was higher, patients living in L'Aquila were more numerous, while mean length of stay was lower after than before the earthquake. Infectious diseases increased, while ‘other’ diseases decreased after the disaster both in admission and in discharge diagnoses. Gastroenterological diseases decreased with the earthquake but only in admission diagnoses. (ii) Patient group (n = 5255) and comparison group (n = 6564). Triage codes changed with the earthquake. Cardiovascular, psychiatric, gynaecological, infectious and chronic diseases increased, while pneumologic, gastroenterological, traumatic and ‘other’ diseases decreased after the quake. The number of hospitalised patients decreased with the tremor, while those discharged transferred to other hospitals and those who rejected hospitalisation increased. A natural disaster completely changes causes of hospitalisation in the Divisions of Internal and Emergency Medicine. These findings can be useful for the design of specific intervention programmes and for softening the detrimental effects of quakes.
Estimating the Optimal Dynamic Antipsychotic Treatment Regime: Evidence from the Sequential Multiple-Assignment Randomized Clinical Antipsychotic Trials of Intervention and Effectiveness Schizophrenia Study
Authors: Shortreed Susan M. , Moodie Erica E. M. 
Published: September 2013

SummaryTreatment of schizophrenia is notoriously difficult and typically requires personalized adaption of treatment because of lack of efficacy of treatment, poor adherence or intolerable side effects. The Clinical Antipsychotic Trials in Intervention Effectiveness schizophrenia study is a sequential multiple-assignment randomized trial comparing the typical antipsychotic medication perphenazine with several newer atypical antipsychotics. The paper describes the marginal structural modelling method for estimating optimal dynamic treatment regimes and applies the approach to this schizophrenia study. Missing data and valid estimation of confidence intervals are also addressed.
Fast Linked Analyses for Scenario-Based Hierarchies
Authors: Williamson Daniel , Goldstein Michael , Blaker Adam 
Published: September 2013

SummaryWhen using computer models to provide policy support it is normal to encounter ensembles that test only a handful of feasible or idealized decision scenarios. We present a new methodology for performing multilevel emulation of a complex model as a function of any decision within a predefined class that makes specific use of a scenario ensemble of opportunity on a fast or early version of a simulator and a small, well-chosen, design on our current simulator of interest. The method exploits a geometrical approach to Bayesian inference and is designed to be fast, to facilitate detailed diagnostic checking of our emulators by allowing us to carry out many analyses very quickly. Our motivating application involved constructing an emulator for the UK Met Office Hadley Centre coupled climate model HadCM3 as a function of carbon dioxide forcing, which was part of a ‘RAPID’ programme deliverable to the UK Met Office funded by the Natural Environment Research Council. Our application involved severe time pressure as well as limited access to runs of HadCM3 and a scenario ensemble of opportunity on a lower resolution version of the model.
The Effect of Late Onset, Short-Term Caloric Restriction on the Core Temperature and Physical Activity in Mice
Authors: Golightly Andrew , Boys Richard J. , Cameron Kerry M. , Zglinicki Thomas von 
Published: September 2013

SummaryCaloric restriction (CR) has been shown to delay the onset of cancer and other diseases that are associated with aging. Currently there are very few studies examining the whole-animal physiological response to late onset CR. We study the ways by which mice physiologically compensate for reduced availability of food given exposure to late onset CR and compare these with mice fed ad libitum. The data arise from a 70-day experiment that was undertaken by the authors. A joint model is developed to describe core body temperature and levels of activity and the model parameters assessed for temporal dependence by using dynamic linear models. A Bayesian approach is used throughout. The dynamic parameters are shown to be plausibly constant over time and the constant parameter model is then embedded within a random-effects structure to explore differences between the responses of CR and ad libitum mice. This model is shown to provide a good description of the data.
Dynamic Bradley–Terry Modelling of Sports Tournaments
Authors: Cattelan Manuela , Varin Cristiano , Firth David 
Published: September 2013

SummaryIn the course of national sports tournaments, usually lasting several months, it is expected that the abilities of teams taking part in the tournament will change over time. A dynamic extension of the Bradley–Terry model for paired comparison data is introduced to model the outcomes of sporting contests, allowing for time varying abilities. It is assumed that teams’ home and away abilities depend on past results through exponentially weighted moving average processes. The model proposed is applied to sports data with and without tied contests, namely the 2009–2010 regular season of the National Basketball Association tournament and the 2008–2009 Italian Serie A football season.
Evaluating Joint Effects of Induction–Salvage Treatment Regimes on Overall Survival in Acute Leukaemia
Authors: Wahed Abdus S. , Thall Peter F. 
Published: September 2013

Summary
Typical oncology practice often includes not only an initial front-line treatment but also subsequent treatments given if the initial treatment fails. The physician chooses a treatment at each stage based on the patient's baseline covariates and history of previous treatments and outcomes. Such sequentially adaptive medical decision-making processes are known as dynamic treatment regimes, treatment policies or multistage adaptive treatment strategies. Conventional analyses in terms of front-line treatments that ignore subsequent treatments may be misleading, because they actually are an evaluation of more than front-line treatment effects on outcome. We are motivated by data from a randomized trial of four combination chemotherapies given as front-line treatments to patients with acute leukaemia. Most patients in the trial also received a second-line treatment, which was chosen adaptively and subjectively rather than by randomization, either because the initial treatment was ineffective or the patient's cancer later recurred. We evaluate effects on overall survival time of the 16 two-stage strategies that actually were used. Our methods include a likelihood-based regression approach in which the transition times of all possible multistage outcome paths are modelled, and estimating equations with inverse probability of treatment weighting to correct for bias. Although the two approaches give different numerical estimates of mean survival time, they lead to the same substantive conclusions when comparing the two-stage regimes.
A Multistate Modelling Approach for Pancreatic Cancer Development in Genetically High-Risk Families
Authors: Kolamunnage-Dona Ruwanthi , Vitone L. , Greenhalf W. , Henderson R. , Williamson P. R. 
Published: September 2013

SummaryThe paper describes a complex multistate modelling approach for the analysis of association between the onset of diabetes and the diagnosis of pancreatic cancer among families with hereditary pancreatitis. The model allows for competing risks, correlated survival times and time-dependent covariates, so taking several interrelated factors into account: the consequences of pancreatic resection, genetic similarities between family members and the possibility that the onset of diabetes is the first symptom of an undiagnosed pancreatic cancer. The model is applied to data on diabetes and cancer outcomes for 593 pancreatitis patients, taken from the world's largest registry of patients with heredity pancreatitis.
Robust Estimation of Economic Indicators from Survey Samples Based on Pareto Tail Modelling
Authors: Alfons Andreas , Templ Matthias , Filzmoser Peter 
Published: September 2013

Summary
Motivated by a practical application, the paper investigates robust estimation of economic indicators from survey samples based on a semiparametric Pareto tail model. Economic performance is typically measured by a set of indicators, which are often estimated from survey data—the motivating example being the European indicators on social exclusion and poverty computed from the well-known European Union statistics on income and living conditions survey. Since economic data typically contain variables with heavily tailed distributions and additional extreme outliers, the idea is to use robust Pareto tail modelling to detect the extreme outliers and to reduce their influence on the indicators. In the survey context, however, sample weights need to be considered when modelling the tail with a Pareto distribution such that the true distribution on the population level is accurately reflected. Therefore, the main methodological contribution is to adapt commonly used robust estimators for the parameters of the Pareto distribution to take sample weights into account. The resulting approach for robust estimation of indicators is then evaluated by means of a simulation study and applied in the context of estimating the Gini coefficient from the survey data.
How to Find an Appropriate Clustering for Mixed-Type Variables with Application to Socio-Economic Stratification
Authors: Hennig Christian , Liao Tim F. 
Published: September 2013

SummaryData with mixed-type (metric–ordinal–nominal) variables are typical for social stratification, i.e. partitioning a population into social classes. Approaches to cluster such data are compared, namely a latent class mixture model assuming local independence and dissimilarity-based methods such as k-medoids. The design of an appropriate dissimilarity measure and the estimation of the number of clusters are discussed as well, comparing the Bayesian information criterion with dissimilarity-based criteria. The comparison is based on a philosophy of cluster analysis that connects the problem of a choice of a suitable clustering method closely to the application by considering direct interpretations of the implications of the methodology. The application of this philosophy to economic data from the 2007 US Survey of Consumer Finances demonstrates techniques and decisions required to obtain an interpretable clustering. The clustering is shown to be significantly more structured than a suitable null model. One result is that the data-based strata are not as strongly connected to occupation categories as is often assumed in the literature.
What If We Voted on the Weights of a Multidimensional Well‐Being Index? An Illustration with Flemish Data*
Authors: Decancq Koen , Van Ootegem Luc , Verhofstadt Elsy 
Published: September 2013

AbstractThere is a widespread consensus that well‐being is a multidimensional notion. To quantify multidimensional well‐being, information on the relative weights of the different dimensions is essential. There is, however, considerable disagreement in the literature on the most appropriate weighting scheme to use. Making use of a recent data set for Flanders, we calculate and compare various common weighting schemes, which are uniformly applied to all individuals. We find that a policymaker would identify different groups of individuals as being worst off depending on the scheme that is chosen. In order to compare and evaluate the weighting schemes, we simulate the support each scheme would get in a voting procedure. Weighting schemes that obtain higher support reflect better the priorities of the respondents and suffer less from the problem of paternalism that is inherent to any common weighting scheme.
Gender, Time Use, and Children's and Adolescents' Well‐Being: Implications for Public Policies*
Authors: Gálvez‐Muñoz Lina , Domínguez‐Serrano Mónica , Rodríguez‐Modroño Paula , Matus‐López Mauricio 
Published: September 2013

AbstractThis paper has two main goals. The first is to analyse and measure gender differences in children's and adolescents' well‐being by using a capability approach. The second aim is to identify the parameters that can help design policies to improve children's and adolescents' well‐being. The econometric model used is a multiple indicator multiple causes (MIMIC) model, belonging to the class of structural equation models. The estimation is done on a sample of 10‐ to 17‐year‐old girls and boys and uses micro‐data from the Spanish Time Use Survey (2002–03). Results show that parents' working time, both paid and unpaid, is a determinant of children's well‐being. Gender differences are also especially significant, consequently posing important policy implications.
Hygienic and Sanitary Conditions in the Hospital Foodservice: Relationship between Good Practices and Microbiological Quality
Authors: Gonçalves Juliana Macedo , Rodrigues Kelly Lameiro , Demoliner Fernanda , Rossales Roseméri , Almeida Ângela Teresinha Santiago , Buchweitz Márcia Rúbia Duarte 
Published: September 2013

AbstractThis study evaluated the hygienic and sanitary conditions of hospital kitchens, assessing good practices through a checklist and comparing the results to microbiological analyses. The good practices that were implemented in the hospital foodservices were evaluated through a checklist based on the current Brazilian legislation. Microbiological analyses of the air, water, utensils, surfaces and food handlers' hands were conducted. The air and water quality were adequate according to the checklist; however, the microbiological analyses of the water detected the presence of coliform bacteria in almost all tested samples. The air quality was also unsatisfactory based on the counts of aerobic mesophilic bacteria, mold and yeast. Even though the checklist assigned a “regular” in the hygienic classification, the utensils and surfaces had satisfactory hygienic results based on the aerobic mesophilic bacteria, mold and yeast counts. The hands of the food handlers tested positive for staphylococcus coagulase, suggesting flaws in their personal hygienic techniques, although the checklist indicated that these professionals were trained on a regular basis. The analysis of good practices in hospital meal preparation through checklists was not sufficiently sensitive for identifying microbiological risks.Practical ApplicationsThe importance of this study is in control of sanitary hygienic meals produced in hospitals. Because of the importance of proper meals in the recovery of patients, the objective of this study was to assess the hygiene and sanitation in hospital kitchens, relating the analysis of good practices through a checklist with microbiological analyses.
Information needs among patients with chronic obstructive pulmonary disease at their first hospital admission: priorities and correlates
Authors: Guo Su‐Er , Huang Chiung‐Yu , Hsu Hsin‐Tien 
Published: September 2013

Aims and objectivesTo better understand chronic obstructive pulmonary disease patients' informational needs and associated factors using the Predisposing, Reinforcing and Enabling Causes in Educational Diagnosis and Evaluation model.BackgroundDespite the increase in the incidence of chronic obstructive pulmonary disease, little research has been carried out on the information needs from a patient perspective.DesignA cross‐sectional, correlational design was used.MethodsA convenience sample of 107 subjects was recruited from four Taiwanese hospitals. Multiple regression analyses were conducted to identify the total informational needs and related factors.ResultsMajor findings were that (1) patients' top informational need was daily care, and (2) variables associated with the total information needs were younger age, greater health internal locus of control, less dyspnoea severity and greater social support.ConclusionsPatients' perceived chronic obstructive pulmonary disease informational needs are not congruent with the information received from healthcare professionals.Relevance to clinical practiceHealthcare professionals need to be sensitive to the fact that treatment‐related information was not the top priority of patients with chronic obstructive pulmonary disease. Healthcare professionals also need to target the special subpopulation of chronic obstructive pulmonary disease patients with greater total informational need to maximise educational impact.
Analysis of factors affecting the life quality of the patients with late stomach cancer
Authors: Ma Yan‐Mei , Ba Cai‐Feng , Wang Yu‐Bin 
Published: September 2013

Aims and objectivesTo provide a theoretical basis for the clinical care of patients with late stomach cancer, we investigated the life quality and analysed its related factor in the patients with late stomach cancer.BackgroundDue to the lack of effective screening methods, stomach cancer usually has been in the advanced stage when patients are diagnosed. However, the treatment for late stomach cancer is a tough problem in today's medicine. Chemotherapy or radiotherapy brings patients physiological and psychological distress and heavy financial burden, affecting patients' therapeutic effects, prognosis and life quality.DesignThe patients with late stomach cancer were included, and then, questionnaires about the life quality were completed.MethodsQuestionnaires including European Organisation for Research on Treatment of Cancer Quality of Life Questionnaire‐Core 30, Social Support Rating Scale, Medical Coping Modes Questionnaire and Self‐rating Anxiety Scale were completed by 173 patients with late stomach cancer who received treatment in our hospital between May 2010 and May 2011. Correlation analyses were performed.ResultsThe overall score of the life quality of the patients with late stomach cancer was only 29·54 ± 12·21. The social support, medical coping modes, anxiety and patients' clinical data (except radiotherapy) markedly affected the overall life quality of the patients with late stomach cancer (p < 0·05).ConclusionThe life quality of the patients with late stomach cancer is poor and is associated with many factors.Relevance to clinical practiceThis study provides a theoretical basis for better nursing the patients with late stomach cancer and improving their life quality.
Single or repeated gonadotropin‐releasing hormone agonist treatment avoids hysterectomy in premenopausal women with large symptomatic fibroids with no effects on sexual function
Authors: Perrone Anna Myriam , Pozzati Federica , Di Marcoberardino Barbara , Rossi Martina , Procaccini Martina , Pellegrini Alice , Santini Donatella , De Iaco Pierandrea 
Published: September 2013

AbstractAimThe aim of our study was to explore the effects on symptoms and female sexual function of the medical management with gonadotropin‐releasing hormone agonist (GnRHa) in women of more than 45 years old compared to surgical management.MethodsWomen with symptomatic uterine fibroids were enrolled to participate to the present open‐label study. We offered two different treatment options: medical with GnRHa for 6 months (group A) or hysterectomy (group B). The patients were reviewed in follow‐up for 24 months. The impact of medical or surgical therapy on sexual life was evaluated.ResultsNo significant differences were found in population characteristics between the two groups. GnRHa treatment was efficient in reducing symptoms in 88% of patients but 22% of patients needed adjunctive cycles of medical therapy. After 24 months, 16% of the patients did not complete the study. The failure percentage of the medical treatment was 12%. No severe side‐effects were recorded, and eight patients had reached menopause. No significant differences were observed in the Female Sexual Function Index score in each domain between the medical and surgical groups, with total scores of 18.94 ± 10.16 and 22.00 ± 8.86, respectively (mean ± standard deviation), and the prevalence of dysfunction was 12% and 22%, respectively, similar to the general population of the same age.ConclusionWe found that medical therapy with GnRHa is a satisfactory alternative to surgery for fibroids in women of more than 45 years old.
Humoral hypercalcemia caused by uterine corpus carcinosarcoma consisting of squamous cell carcinoma in its epithelial component
Authors: Takamatsu Shiro , Matsumura Noriomi , Baba Tsukasa , Mandai Masaki , Mikami Yoshiki , Konishi Ikuo 
Published: September 2013

AbstractHumoral hypercalcemia of malignancy (HHM) is a paraneoplastic syndrome primarily caused by a tumor‐producing parathyroid hormone‐related protein (PTH‐rP). We describe the first reported case of a uterine carcinosarcoma causing HHM. A 70‐year‐old patient was transferred to our hospital for a uterine tumor accompanied by impaired consciousness. The laboratory tests indicated anemia, malnutrition, elevated serum calcium and elevated PTH‐rP. Emergency surgery, including abdominal hysterectomy and bilateral salpingo‐oophorectomy, was performed due to uncontrollable uterine bleeding. The pathological diagnosis was carcinosarcoma consisting of pure squamous cell carcinoma in its epithelial component. Postoperatively, chemotherapy with paclitaxel and carboplatin was performed. The patient had recurrent tumors at the para‐aortic lymph nodes 11 months after the initial surgery and underwent a pelvic and para‐aortic lymphadenectomy, which removed all of the recurrent tumors.