bluuebunny/crossref_metadata_2025_split huggingface dataset:
EARLY MRI FOR CLINICAL SCAPHOID FRACTURES IN CHILDREN; A BETTER PATIENT JOURNEY? A 12 YEAR REVIEW FROM BIRMINGHAM CHILDREN'S HOSPITAL
Authors: Cantonsmith B , Stanhope B 
Published: September 2013

Objectives & BackgroundTraditional management of Clinical Scaphoid Fractures has been to immobilise the wrist for 10–21 days and then reassess the injury. Birmingham Children's Hospital (BCH) has offered an Early MRI service for these patients for 12 years. The aim is to MRI the wrist within a few days of injury to get a definitive diagnosis and reduce unnecessary immobilisation. The objective of this review of the Early MRI service, was to analyse:Age, Sex and Hand dominancePercentage of actual scaphoid fractures & other carpal/radial fracturesTime from presentation to MRI scanMethodsData was retrieved for all patients (aged 0–18 years) who had had a Scaphoid Xray or MRI from January 1999 until March 2012 from the Xray reporting system. Patients were included if they had presented to the Emergency Department at BCH, and had normal Scaphoid Xrays followed by an MRI scan.Results137 patients were included. Boys were significantly more likely to actually have a scaphoid fracture (p<0.001) even though the sex distribution of Clinical Scaphoid Fractures was equal. 22.6% had a fractured scaphoid, 18.6% fractured other carpals, 7.3% a fractured radius, 29.1% had another diagnosis and 22.6% were normal. Time from presentation until MRI scan ranged from 1–54 days with a mode of 3 days, median 11 days and mean of 14 days.ConclusionIt is possible to offer Early MRI scanning for Clinical Scaphoid Fractures, and most commonly our patients waited 3 days, reducing the length of immobilisation. A large number of other injuries were identified which were missed on initial Xrays. Half of all subjects have a fracture, however only half of these were scaphoid fractures. Only approximately a quarter of scans were normal, and therefore immobilised unnecessarily. Boys are more likely to actually have a scaphoid fracture on MRI than girls.
RESOURCE ALLOCATION FOR THE TREATMENT OF RARE DISEASES
Authors: Gosain Sheena , Coyle Doug , Clifford Tammy , Jones Barry 
Published: September 2013

IntroductionDrugs for rare diseases are often associated with extremely high costs which can be a barrier to patients' accessibility. Due to scarce healthcare resources, funding for expensive orphan therapies is a predicament for policy-makers and patients. In Canada, funding decisions for drugs for rare diseases are made at the provincial and regional level primarily on an individual basis, and are typically made on the grounds of historical and political factors. In many cases, limited reflection is given to the collective costs or the alternative applications of these resources. To ensure that equitable decisions are made, formal and transparent processes for the reimbursement of orphan drugs are needed.ObjectivesGiven the unique economic and ethical challenges associated with orphan drugs, the applicability of existing approaches used for the priority setting of health care resources may be limited. This study will consider existing priority setting frameworks in order to identify the decision criteria that can be applied for the funding of drugs for rare diseases.MethodsA systematic review will be conducted to identify the available frameworks used when making healthcare resource allocation decisions. A case study of an orphan drug therapy will be used to assess the varying funding decisions that may result from applying different frameworks and decision criteria.ResultsWork in progress.ConclusionsThis research will help establish an understanding of the available priority setting frameworks and the decision criteria that can be applied when making reasonable conclusions related to the reimbursement of orphan drugs. An in depth understanding of the factors to consider when making priority setting decisions may help in the development of a standardized framework for the funding of drugs for rare diseases.
How to Define a Poor Outcome After Transcatheter Aortic Valve Replacement
Authors: Arnold Suzanne V. , Spertus John A. , Lei Yang , Green Philip , Kirtane Ajay J. , Kapadia Samir , Thourani Vinod H. , Herrmann Howard C. , Beohar Nirat , Zajarias Alan , Mack Michael J. , Leon Martin B. , Cohen David J. 
Published: September 2013

Background—
Transcatheter aortic valve replacement (TAVR) has emerged as a less invasive option for valve replacement of patients with severe aortic stenosis. Although it has been recommended that TAVR should not be offered to patients who will not improve functionally or derive meaningful survival benefit from the procedure, no guidance exists on how best to identify such patients. The first step in this process is to define a poor outcome that can then be used as a foundation for subsequent case identification. We sought to evaluate potential definitions of a poor outcome after TAVR that combine both mortality and quality of life components.

Methods and Results—
Using data from 463 patients who underwent TAVR as part of the Placement of AoRTic TraNscathetER Valve (PARTNER) trial, we evaluated 6-month mortality and quality of life outcomes using the Kansas City Cardiomyopathy Questionnaire to explore potential definitions of a poor outcome. We then compared the strengths and weaknesses of each potential definition by examining the relationship between baseline and 6-month Kansas City Cardiomyopathy Questionnaire scores for each patient. Based on these analyses, we argue that the most appropriate definition of a poor outcome after TAVR is (1) death, (2) Kansas City Cardiomyopathy Questionnaire overall summary score <45, or (3) Kansas City Cardiomyopathy Questionnaire decrease of ≥10 points, which best reflects a failure to achieve the therapeutic goals of TAVR.

Conclusions—
Using empirical data on a large number of patients enrolled in the PARTNER trial, we propose a definition for poor outcome after TAVR that combines both mortality and quality of life measures into a single composite end point. Use of this end point (or other similar end points) in future studies can facilitate development of predictive models that may be useful to identify patients who are poor candidates for TAVR and to provide such patients and their families with appropriate expectations of functional recovery after TAVR.
Limited Evidence for Effects of Intranasal Corticosteroids on Symptom Relief for Recurrent Acute Rhinosinusitis
Authors: van Loon Juliette W. L. , van Harn Rochustina P. , Venekamp Roderick P. , Kaper Nina M. , Sachs Alfred P. E. , van der Heijden Geert J. M. G. 
Published: September 2013

ObjectiveTo systematically review the evidence base on the effectiveness of intranasal corticosteroids in adult patients with recurrent acute rhinosinusitis.Data SourcesPubmed, EMBASE, and the Cochrane Library.Review MethodsA comprehensive search was performed up to March 20, 2013. Two reviewers independently screened publications on title and abstract. Design of selected studies was assessed on directness of evidence and risk of bias. For included studies, risk differences with 95% confidence intervals were extracted or recalculated.ResultsOf 1850 unique records, 3 trials were included. Risk of bias was high and directness of evidence was low for 2 trials, the third trial had low risk of bias with moderate directness of evidence. They found a statistical significant difference for the median number of days to clinical success (defined as patients’ report of symptoms to be cured or much improved) favoring intranasal corticosteroids (6 days) over placebo (9 days), while the difference in proportion of patients reporting clinical success after 21 days of treatment was 20% favoring intranasal corticosteroids over placebo.Conclusion and RecommendationThe evidence for the benefit of intranasal corticosteroids on symptom relief in adult patients with recurrent acute rhinosinusitis is rather limited (ie, 3 trials are available; the best evidence is derived from 1 low risk of bias trial providing moderate directness of evidence that intranasal corticosteroids may speed up relief of symptoms in patients with recurrent acute rhinosinusitis). A large methodologically rigorous randomized trial in antibiotic‐naïve patients is needed to provide a more definite recommendation.
The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial
Authors: Graziano Federica , Calandri Emanuela , Borghi Martina , Bonino Silvia 
Published: September 2013

Objective: To evaluate the effectiveness of a cognitive behavioral group-based intervention aimed at reducing depression and fostering quality of life and psychological well-being of multiple sclerosis patients through the promotion of identity redefinition, sense of coherence, and self-efficacy. Design: A randomized controlled trial. Setting: Non-medical setting, external to the Multiple Sclerosis Clinic Centre. Subjects Eighty-two patients: 64% women; mean age 40.5, SD = 9.4; 95% with relapsing-remitting multiple sclerosis; Expanded Disability Status Scale (EDSS) between 1 and 5.5 were included in the study. Interventions: Patients were randomly assigned to an intervention group (five cognitive behavioral group-based sessions, n = 41) or to a control group (three informative sessions, n = 41). Main measures Depression (CES-D), Quality of life (MSQOL revised), Psychological well-being (PANAS), Identity Motives Scale, Sense of Coherence (SOC), and Self Efficacy in Multiple Sclerosis. Results Quality of life increased in the intervention group compared with the control at 6-months follow-up (mean change 0.72 vs. −1.76, p < 0.05). Well-being in the intervention group increased for males and slightly decreased for females at 6-months follow-up (mean change 6.58 vs. −0.82, p < 0.05). Contrasts revealed an increase in self-efficacy in the intervention group at posttreatment compared with the control (mean change 2.95 vs. −0.11, p < 0.05). Depression tended to lower, while identity and coherence increased in the intervention group compared with the control, though the differences were not significant. Conclusions: Preliminary evidence suggests that intervention promotes patients’ quality of life and has an effect on psychological well-being and self-efficacy.
The effects of resveratrol against trifluralin toxicity in the urinary tract of rats
Authors: Denek Ziya , Erbil Guven , Ozbal Seda , Micili Serap Cilaker , Ozogul Candan 
Published: September 2013

The herbicide itself and the degradation products are highly toxic on biological systems. The aim of this study is to investigate the potential toxic effects of trifluralin (TRF) on the urinary system of male rats and to investigate the protective effects of resveratrol (RSV) in TRF-induced urinary system damage. A total of 35 male Wistar rats were randomly divided into: (1) control group, (2) sham group, (3) low dose TRF group (0.8 g/kg/day), (4) high dose TRF group (2 g/kg/day) and (5) high dose TRF + RSV group 10 mg/kg/day. RSV was administered for 21 days by intragastric gavage at a dose of 10 mg/kg/day after induction of TRF. Kidney, ureter and urinary bladder tissue was examined using light microscopy and ultrastructurally. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling was performed to detect apoptosis. Superoxide dismutase (SOD), glutathion peroxidase (GPx) and malondialdehyde (MDA) levels were also evaluated biochemically for oxidative stress parameters. Histological evaluation showed that TRF increases apoptosis and oxidative stress, causes histological tissue damages and biochemical changes in the kidneys but does not cause any damage to the ureter and bladder. Treatment with RSV significantly attenuated tissue damage in the urinary system of rats. Apopitotic cells were significantly decreased in the treatment group. Additionally, treatment with RSV decreased SOD and GPx levels and increased MDA levels in the kidney tissue of animals subjected to TRF. These results show that RSV can significantly minimize histological damage and biochemical differences in treating TRF-induced kidney injury in rats.
Observational case-control study of the prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: results from the CoSMo study
Authors: Comi G , Battaglia MA , Bertolotto A , Sette M Del , Ghezzi A , Malferrari G , Salvetti M , Sormani MP , Tesio L , Stolz E , Zaratin P , Mancardi G ,   the CoSMo Collaborative Study Group, Baracchini Claudio , Bergamaschi Roberto , Bertolotto Antonio , Bortolon Franca , Bratina Alessio , Morra Vincenzo Brescia , Buccafusca Maria , Busso Marco , Capra Ruggero , Carraro Nicola , Cavalla Paola , Cecconi Pietro , Centonze Diego , Ciampanelli Domenico , Cirrito Maurilio , Ciuffoli Alessandro , Comi Giancarlo , Coppo Lorenzo , Costantino Gianfranco , Cottone Salvatore , Deboni Antonella , Del Sette Massimo , De Rossi Nicola , Luca Di Maggio , Favaretto Elisabetta , Finocchi Cinzia , Gaeta Roberta , Gallo Paolo , Ghezzi Angelo , Giometto Bruno , Granieri Enrico , Grazioli Silvia , Grimaldi Luigi , Guccione Angelo , Iemolo Francesco , Lochner Piergiorgio , Lugaresi Alessandra , Maimone Davide , Malferrari Giovanni , Mancardi Giovanni L , Mancini Marcello , Mantegazza Renato , Marrosu Maria G , Menci Elisabetta , Monti Lucia , Motti Luisa , Nuzzaco Grazia M , Pascazio Lucia , Patti Francesco , Protti Alessandra , Provinciali Leandro , Rossato Denis , Rovaris Marco , Salvetti Marco , Sanguigni Sandro , Sanzaro Enzo , Sette Giuliano , Spinelli Marica , Stecchi Sergio , Stefanini Matteo , Tezzon Frediano , Tola Maria R , Tonello Simone , Trojano Maria , Ulivelli Monica , Uselli Sebastiano , Viaro Federica , Zaratin Paola , Zedde Maria L 
Published: September 2013

Background: Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a possible cause of multiple sclerosis (MS). Objectives: The CoSMo study evaluated the association between CCSVI and MS. Methods: The primary end-point of this multicentric, case-control study was to compare the prevalence of CCSVI between patients with MS, patients with other neurodegenerative diseases (ONDs) and healthy controls (HCs). Color-coded duplex sonography was performed by a sonologist and the images were sent to one of three central sonologists for a second reading. Agreement between local and central sonologists or, in case of disagreement, the predominant judgment among the three central readers, was required for a diagnosis of CCSVI. All readings, data collection and analysis were blinded. Results: The study involved 35 MS centers across Italy and included 1874 subjects aged 18–55. 1767 (94%) were evaluable: 1165 MS patients, 226 patients with ONDs and 376 HCs. CCSVI prevalence was 3.26%, 3.10% and 2.13% for the MS, OND and HC groups, respectively. No significant difference in CCSVI prevalence was found amongst the three cohorts (MS versus HC, OR = 1.55, 95%CI = 0.72–3.36, p = 0.30; OND versus HC, OR = 1.47, 95%CI = 0.53–4.11, p = 0.46; MS versus OND, OR = 1.05, 95%CI = 0.47–2.39, p = 0.99). High negative and low positive agreement was found between the local and centralized readers. Conclusions: CCSVI is not associated with MS.
Assessment of biomarkers for risk prediction with nested case–control studies
Authors: Zhou Qian M , Zheng Yingye , Cai Tianxi 
Published: September 2013

Background Accurate risk prediction plays a key role in disease prevention and disease management; emergence of new biomarkers may lead to an important question about how much improvement in prediction accuracy it would achieve by adding the new markers into the existing risk prediction tools. Purpose In large prospective cohort studies, the standard full-cohort design, requiring marker measurement on the entire cohort, may be infeasible due to cost and low rate of the clinical condition of interest. To overcome such difficulties, nested case–control (NCC) studies provide cost-effective alternatives but bring about challenges in statistical analyses due to complex data sets generated. Methods To evaluate prognostic accuracy of a risk model, Cai and Zheng proposed a class of nonparametric inverse probability weighting (IPW) estimators for accuracy measures in the time-dependent receiver operating characteristic curve analysis. To accommodate a three-phase NCC design in Nurses’ Health Study, we extend the double IPW estimators of Cai and Zheng to develop risk prediction models under time-dependent generalized linear models and evaluate the incremental values of new biomarkers and genetic markers. Results Our results suggest that aggregating the information from both the genetic markers and biomarkers substantially improves the accuracy for predicting 5-year and 10-year risks of rheumatoid arthritis. Conclusions Our method provided robust procedures to evaluate the incremental value of new biomarkers allowing for complex sampling designs.
Protein S levels and the risk of venous thrombosis: results from the MEGA case-control study
Authors: Pintao Maria Carolina , Ribeiro Daniel D. , Bezemer Irene D. , Garcia Andrea A. , de Visser Marieke C. H. , Doggen Carine J. M. , Lijfering Willem M. , Reitsma Pieter H. , Rosendaal Frits R. 
Published: September 2013

Key PointsLow free protein S and low total protein S levels could not identify subjects at risk for venous thrombosis in a population-based study. Protein S testing and subsequent testing on PROS1 mutations should not be considered in unselected patients with venous thrombosis.
Massively parallel sequencing: the new frontier of hematologic genomics
Authors: Johnsen Jill M. , Nickerson Deborah A. , Reiner Alex P. 
Published: September 2013

Abstract
Genomic technologies are becoming a routine part of human genetic analysis. The exponential growth in DNA sequencing capability has brought an unprecedented understanding of human genetic variation and the identification of thousands of variants that impact human health. In this review, we describe the different types of DNA variation and provide an overview of existing DNA sequencing technologies and their applications. As genomic technologies and knowledge continue to advance, they will become integral in clinical practice. To accomplish the goal of personalized genomic medicine for patients, close collaborations between researchers and clinicians will be essential to develop and curate deep databases of genetic variation and their associated phenotypes.
Requirement of epithelial integrin-linked kinase for facilitation of Citrobacter rodentium-induced colitis
Authors: Assi Kiran , Bergstrom Kirk , Vallance Bruce , Owen David , Salh Baljinder 
Published: September 2013

Abstract

Background
Integrin-linked kinase (ILK) is a serine-threonine kinase that transduces extracellular matrix-related cues into intracellular signals, with fundamental roles in cell motility, development and cancer. Recently ILK been shown to have an important role in bacterial epithelial cell attachment, through ILK-bacterial OspE binding. Here we report on the role of epithelial derived ILK in response to Citrobacter rodentium infection.

Methods

C. rodentium was administered to both control and intestinal epithelial cell ILK knockout mice. Histological inflammatory scores were assessed, and cytokines measured by ELISA as well as RT-PCR, in mouse colons. Bacterial colonization was determined by plating homogenates onto MacConkey agar, and immunofluorescence microscopy performed using anti-LPS and anti-Tir antibodies.

Results
ILK-ko mice exhibited reduced weight loss at 15 days post-infection (p < 0.01) and demonstrated reduced histological inflammatory scores (p < 0.01), reduced CCL2 and pro-inflammatory cytokines. This was not due to reduced colonization, but was associated with an altered pattern of C. rodentium bacterial migration. Attenuated fibronectin expression was found in the ILK-ko mice. C. rodentium exposure was shown to increase ILK expression in cell lines, and in murine epithelium in vivo. In ILK-ko mice reduced activation of ser473Akt and reduced crypt proliferation, together with reduced cyclin D1 expression were observed.

Conclusions
ILK influences the host response to C. rodentium -induced infection, independently of reduced colonization in the ILK knockout mice. The reduced inflammation and dramatically attenuated hyperplastic cryptal response to infection in this group, are at least in part the result of, the reduction in CCL2 and cyclin D1 expression respectively.
Feasibility study on full closed-loop control ventilation (IntelliVent-ASV™) in ICU patients with acute respiratory failure: a prospective observational comparative study
Authors: Arnal Jean-Michel , Garnero Aude , Novonti Dominik , Demory Didier , Ducros Laurent , Berric Audrey , Donati Stéphane Yannis , Corno Gaëlle , Jaber Samir , Durand-Gasselin Jacques 
Published: September 2013

Abstract
Introduction
IntelliVent-ASV™ is a full closed-loop ventilation mode that automatically adjusts ventilation and oxygenation parameters in both passive and active patients. This feasibility study compared oxygenation and ventilation settings automatically selected by IntelliVent-ASV™ among three predefined lung conditions (normal lung, acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD)) in active and passive patients. The feasibility of IntelliVent-ASV™ use was assessed based on the number of safety events, the need to switch to conventional mode for any medical reason, and sensor failure.

Method
This prospective observational comparative study included 100 consecutive patients who were invasively ventilated for less than 24 hours at the time of inclusion with an expected duration of ventilation of more than 12 hours. Patients were ventilated using IntelliVent-ASV™ from inclusion to extubation. Settings, automatically selected by the ventilator, delivered ventilation, respiratory mechanics, and gas exchanges were recorded once a day.

Results
Regarding feasibility, all patients were ventilated using IntelliVent-ASV™ (392 days in total). No safety issues occurred and there was never a need to switch to an alternative ventilation mode. The fully automated ventilation was used for 95% of the total ventilation time. IntelliVent-ASV™ selected different settings according to lung condition in passive and active patients. In passive patients, tidal volume (VT), predicted body weight (PBW) was significantly different between normal lung (n = 45), ARDS (n = 16) and COPD patients (n = 19) (8.1 (7.3 to 8.9) mL/kg; 7.5 (6.9 to 7.9) mL/kg; 9.9 (8.3 to 11.1) mL/kg, respectively; P 0.05). In passive ARDS patients, FiO2 and positive end-expiratory pressure (PEEP) were statistically higher than passive normal lung (35 (33 to 47)% versus 30 (30 to 31)% and 11 (8 to 13) cmH2O versus 5 (5 to 6) cmH2O, respectively; P< 0.05).

Conclusions
IntelliVent-ASV™ was safely used in unselected ventilated ICU patients with different lung conditions. Automatically selected oxygenation and ventilation settings were different according to the lung condition, especially in passive patients.

Trial Registration
ClinicalTrials.gov: NCT01489085