bluuebunny/crossref_metadata_2025_split huggingface dataset:
Well-differentiated papillary mesothelioma: peritoneal implants are not always metastases in the presence of cancer
Authors: Irwin GW , Ervine A , Kennedy JA 
Published: January 2014

Introduction Well-differentiated papillary mesothelioma is a rare condition that can cause diagnostic uncertainty. Its appearance resembles metastatic deposits and in the presence of a known primary can often be confused for such. Case presentation In this case, we present a patient who had WDPM in the presence of gastric cancer and emphasise the difficulties in making the diagnosis. Conclusion We highlight the need for a high index of suspicion, biopsies at staging laparoscopy and undertake a review of the literature regarding this uncommon condition.
High‐Resolution Microendoscope Images of Middle Ear Cholesteatoma and Surrounding Tissue: Evaluation of Interobserver Concordance
Authors: Bradley James , Jiang Nancy , Levy Lauren , Richards‐Kortum Rebecca , Sikora Andrew , Smouha Eric 
Published: January 2014

ObjectiveInvestigate how accurately otolaryngologists could differentiate between images obtained with high‐resolution microendoscopy (HRME) of ex vivo cholesteatoma specimens and surrounding middle ear epithelium.Study DesignHRME images of surgically resected cholesteatoma and middle ear epithelium were obtained and otolaryngologists classified these images.SettingTertiary medical center.Subjects and MethodsResected cholesteatoma and middle ear epithelium were stained with a contrast agent, proflavine, and HRME images were captured. Specimens were sent for standard histopathology and compared with HRME images. Quality‐controlled images were used to assemble a training set. After viewing training images, otolaryngologists without prior cholesteatoma HRME experience reviewed and classified test images.ResultsTen cholesteatoma and 9 middle ear specimens were collected, of which 17 representative cholesteatoma and 19 middle ear epithelium images were extracted for a testing set. Qualitative analysis for concordance between HRME images and histological images yielded a strong correlation between modalities. The mean accuracy of all reviewers in correctly identifying images was 95% (95% confidence interval [CI], 92%‐98%). The sensitivity to correctly detect cholesteatoma images was 98% (95% CI, 93%‐100%), and the specificity was 92% (95% CI, 87%‐97%). The Fleiss kappa interrater reliability score was 0.83, (95% CI, 0.77‐0.89).ConclusionsMedical professionals can quickly be trained to accurately distinguish between HRME images of cholesteatoma and normal middle ear epithelium, both of which have distinct imaging characteristics. Real‐time HRME optical imaging can potentially improve the results of otologic surgery by allowing for extirpation of cholesteatomas while eliminating residual disease.
A New Computed Tomography Method to Identify Meningitis‐Related Cochlear Ossification and Fibrosis before Cochlear Implantation
Authors: Ichikawa Kazunori , Kashio Akinori , Mori Harushi , Ochi Atushi , Karino Shotaro , Sakamoto Takashi , Kakigi Akinobu , Yamasoba Tatsuya 
Published: January 2014

ObjectiveTo develop a new method to determine the presence of intracochlear ossification and/or fibrosis in cochlear implantation candidates with bilateral profound deafness following meningitis.Study DesignDiagnostic test assessment.SettingA university hospital.Subjects and MethodsThis study involved 15 ears from 13 patients with profound deafness following meningitis who underwent cochlear implantation. These ears showed normal structures, soft tissue, partial bony occlusion, and complete bony occlusion in 4, 3, 2, and 6 ears, respectively. We measured radiodensity in Hounsfield units (HU) using 0.5‐mm‐thick axial high‐resolution computed tomography image slices at 3 different levels in the basal turn, the fenestration, and inferior and ascending segment sites, located along the electrode‐insertion path. Pixel‐level analysis on the DICOM viewer yielded actual computed tomography values of intracochlear soft tissues by eliminating the partial volume effect. The values were compared with the intraoperative findings.ResultsValues for ossification (n = 12) ranged from +547 HU to +1137 HU; for fibrosis (n = 11), from +154 HU to +574 HU; and for fluid (n = 22), from −49 HU to +255 HU. From these values, we developed 2 presets of window width (WW) and window level (WL): (1) WW: 1800, WL: 1100 (200 HU to 2000 HU) and (2) WW: 1500, WL: 1250 (500 HU to 2000 HU). The results using these 2 presets corresponded well to the intraoperative findings.ConclusionOur new method is easy and feasible for preoperative determination of the presence of cochlear ossification and/or fibrosis that develops following meningitis.
Anatomy of the veno-muscular pumps of the lower limb
Authors: Uhl Jean-François , Gillot Claude 
Published: January 2014

Objective To study the anatomy of the veno-muscular pumps of the lower limb, particularly the calf pump, the most powerful of the lower limb, and to confirm its crucial importance in venous return. Methods In all, 400 cadaveric limbs were injected with green Neoprene latex followed by an anatomical dissection. Results The foot pump is the starter of the venous return. The calf pump can be divided into two anatomical parts: the leg pump located in the veins of the soleus muscle and the popliteal pump ending in the popliteal vein with the unique above-knee collector of the medial gastrocnemial veins. At the leg level, the lateral veins of the soleus are the bigger ones. They drain vertically into the fibular veins. The medial veins of the soleus, smaller, join the posterior tibial veins horizontally. At the popliteal level, medial gastrocnemial veins are the largest veins, which end uniquely as a large collector into the popliteal vein above the knee joint. This explains the power of the gastrocnemial pump: during walking, the high speed of the blood ejection during each muscular systole acts like a nozzle creating a powerful jet into the popliteal vein. This also explains the aspiration (Venturi) effect on the deep veins below. Finally, the thigh pump of the semimembranosus muscles pushes the blood of the deep femoral vein together with the quadriceps veins into the common femoral vein. Conclusion The veno-muscular pumps of the lower limb create a chain of events by their successive activation during walking. They play the role of a peripheral heart, which combined with venous valves serve to avoid gravitational reflux during muscular diastole. A stiffness of the ankle or/and the dispersion of the collectors inside the gastrocnemius could impair this powerful pump and so worsen venous return, causing development of severe chronic venous insufficiency.
Genetic predictors of antidepressant side effects: A grouped candidate gene approach in the Genome-Based Therapeutic Drugs for Depression (GENDEP) study
Authors: Hodgson Karen , Uher Rudolf , Crawford Andrew A , Lewis Glyn , O’Donovan Michael C , Keers Robert , Dernovšek Mojca Z , Mors Ole , Hauser Joanna , Souery Daniel , Maier Wolfgang , Henigsberg Neven , Rietschel Marcella , Placentino Anna , Aitchison Katherine , Farmer Anne , Davis Oliver , McGuffin Peter 
Published: January 2014

Background: The unwanted side effects associated with antidepressants are key determinants of treatment adherence in depression; propensity to experience these adverse drug reactions (ADRs) may be influenced by genetic variation. However, previous work attempting to ascertain the genetic variants involved has had limited success, in part due to the range of ADRs reported with antidepressants. Method: ADRs reported with antidepressant treatment were categorised using their likely pharmacological basis; adrenergic, cholinergic, serotonergic and histaminergic. To identify genetic predictors of susceptibility to each group of ADRs, a candidate gene analysis was performed with data from 431 depressed patients (from a total sample size of 811 patients) enrolled in the Genome-Based Therapeutic Drugs for Depression (GENDEP) project, who were randomly allocated to receive treatment with escitalopram or nortriptyline. Data from 474 patients treated with citalopram or reboxetine in the GenPod project (total sample of 601 patients) were used for replication of significant findings. Results: We found no significant predictors of presumed adrenergic, cholinergic and histaminergic ADRs. Putative serotonergic ADRs were significantly associated with variation in the gene encoding the serotonin 2C receptor ( HTR2C, rs6644093, odds ratio (OR)=1.72, 95% confidence interval (CI)=1.31−2.25, p=7.43×10−5) in GENDEP. However, this finding was not replicated in GenPod. Conclusions: The association between serotonergic side effects and variation in the HTR2C gene in the GENDEP sample supports the hypothesis that serotonin receptor-mediated mechanisms underlie these adverse reactions, however this finding was not replicated in GenPod.
Pain control in patients with hepatocellular carcinoma treated by percutaneous radiofrequency ablation: comparison of the efficacy of one-shot and continuous intravenous fentanyl delivery
Authors: Yokoyama Koichi , Ikeda Osamu , Kawanaka Koichi , Nakasone Yutaka , Inoue Seijiro , Tamura Yoshitaka , Yamashita Yasuyuki 
Published: January 2014

Background Hepatic percutaneous radiofrequency ablation (RFA) is usually performed with the patient under deep intravenous (i.v.) sedation or general anesthesia. Nonetheless, many patients report pain during and/or after the procedure. Purpose To perform a prospective study of pain control obtained by the i.v. one-shot delivery and the continuous i.v. infusion of fentanyl in patients with hepatocellular carcinoma (HCC) treated by RFA. Material and Methods Between April 2007 and March 2010, 83 patients with 106 HCCs underwent percutaneous RFA. All HCCs were addressed by computed tomography (CT)-guided percutaneous RFA performed within 5 h of embolization of the tumor vessels with iodized oil and gelatin sponges. Standard anesthesia consisted of 10 mL of 1% lidocaine injected locally. For conscious sedation, group one patients ( n = 41) were injected i.v. with 100 µg of fentanyl before and 100 µg of fentanyl 30 min after percutaneous RFA. In group two ( n = 42) we delivered fentanyl by continuous i.v. infusion at 100 µg/h during RFA. Upon request, patients in both groups also received 5 mg of diazepam i.v. for pain during the RFA procedure. The severity of pain experienced by all patients was evaluated on a visual analogue scale (VAS) and complications elicited by the anesthesia regimens were recorded. We also assessed the effectiveness of the treatment on sequential follow-up CT and/or magnetic resonance imaging (MRI) at 3-month intervals. Results Percutaneous RFA was technically successful in all 83 patients. Two patients in group one (4.8%) and one patient in group two (2.4%) manifested residual enhancement 3 months post RFA. There was no significant difference in the local recurrence rate between the two groups. At 4.0 ± 1.8 for group one and 3.4 ± 1.9 for group two, the VAS score was not significantly different. Major fentanyl or diazepam toxicity was recorded in 11 patients (24.4%) in group one and two patients (4.8%) in group two; the difference was statistically significant ( P < 0.01). Conclusion The continuous infusion of fentanyl provided effective and safe analgesia in HCC patients undergoing percutaneous RFA.
Flow artifact in the anterior communicating artery resembling aneurysm on the time of flight MR angiogram
Authors: Takhtani Deepak , Dundamadappa Sathish , Puri Ajit S , Wakhloo Ajay 
Published: January 2014

Background Magnetic resonance angiogram (MRA) of the brain is a widely employed non-invasive test to diagnose aneurysms. However, its overall accuracy is less than digital subtraction angiography and is prone to give false-positive or false-negative results. False-negative results can be seen with hemorrhage, lipoma, dermoid, posterior lobe of the pituitary gland, and the flow artifacts. Purpose To describe the findings associated with false aneurysms in the anterior communicating artery on the time of flight MRA and review the physical principles behind this artifact. Material and Methods This short series comprises of four patients whose MRA showed suspicious aneurysms in the region of the anterior communicating artery (ACOM) on time of flight MRA. Results Two patients underwent catheter angiogram and the other two patients had computed tomography angiogram. None of these cases proved to have aneurysms and normal anterior communicating arteries were seen in all the patients. The findings on the MR angiograms were considered artifacts. All of the pseudoaneurysm had tapered appearance. Conclusion MR angiogram can result in artifacts at ACOM which may be mistaken for aneurysm. Such pseudoaneurysms have characteristic appearance and should be followed up with non-invasive tests.
A Comparative, Prospective, and Randomized Study of Two Conservative Treatment Protocols for First-episode Lateral Ankle Ligament Injuries
Authors: Prado Marcelo Pires , Mendes Alberto Abussamra Moreira , Amodio Daniel Tasseto , Camanho Gilberto Luis , Smyth Niall A. , Fernandes Tulio Diniz 
Published: January 2014

Background: The objective of this study was to investigate functional results, the amount of time that patients missed from regular working activities, and the incidence of residual mechanical ankle instability following conservative treatment of a first episode of severe lateral ankle ligament sprain (with articular instability). Methods: This prospective and randomized study included 186 patients with severe lateral ankle ligament injuries, who were randomly assigned into 2 conservative treatment groups. In group A, participants were treated with a walking boot with weight-bearing allowed, pain management, ice, and elevation with restricted joint mobilization for 3 weeks. In group B, patients were treated with a functional brace for 3 weeks. After this period, patients from both groups were placed in a short, functional brace for an additional 3 weeks, during which they also started a rehabilitation program. Results: No statistically significant difference was found in pain intensity score between the 2 groups; however, functional evaluations based on the AOFAS ankle and hindfoot score system showed a statistically significant improvement in the group treated with the functional brace. In addition, the average recovery period necessary for patients of group B to resume their duties was shorter than that for patients in group A. No significant difference was detected in residual mechanical ankle instability between the 2 groups. Conclusion: Patients with severe lateral ankle ligament lesions treated with a functional brace were shown to exhibit somewhat better results than those treated with a walking boot, and both methods presented a very low incidence of residual chronic instability. We found adequate conservative treatment was sufficient to reestablish ankle stability and that functional treatment had a marginally better clinical short-term outcome with a shorter average recovery period. Level of Evidence: Level I, prospective randomized study.
Effect of Supramalleolar Osteotomy and Total Ankle Replacement on Talar Position in the Varus Osteoarthritic Ankle
Authors: Colin Fabrice , Bolliger Lilianna , Horn Lang Tamara , Knupp Markus , Hintermann Beat 
Published: January 2014

Background: In varus osteoarthritic ankles, joint congruency is usually lost leading to progressive wear of the medial tibiotalar joint. Recent studies have shown that balancing the hindfoot with the aid of supramalleolar osteotomy (SMOT) is an effective method to decrease symptoms and to delay progression of osteoarthritis of the ankle joint. Resurfacing the articular surfaces with total ankle replacement (TAR), in contrast, may compensate for the lost joint congruency and lost stability of the talus at the peritalar joint. However, no literature exists with regard to the overall correction of talar position in all 3 planes when using these 2 treatment modalities. The purpose of this study was to determine the effect of SMOT and TAR on talar position in all 3 planes, and to compare the efficiency of both procedures in restoring overall hindfoot geometry. Methods: Out of 104 ankles with a varus-tilted ankle, 52 patients were treated with SMOT and 52 with TAR. Weight-bearing radiographs were analyzed to measure the talar position in all 3 planes, including the talar tilt angle (TT), the sagittal talocalcaneal inclination angle (TCI), and the talometatarsal 1 angle (TMT1) pre- and postoperatively. Results: Although after TAR the talar position was corrected in all the 3 planes, SMOT on the other hand did not fully correct the TT, and furthermore TMT1 remained unchanged. Conclusions: Resurfacing of the worn-out articular surface and tensioning of ligaments, as is the case in TAR, radiographically restores the hindfoot geometry in the neutral position better than SMOT does. Level of Evidence: Level III, retrospective comparative study.
Characterization of the Adenosine Pharmacology of Ticagrelor Reveals Therapeutically Relevant Inhibition of Equilibrative Nucleoside Transporter 1
Authors: Armstrong Duncan , Summers Claire , Ewart Lorna , Nylander Sven , Sidaway James E. , van Giezen J. J. J. 
Published: January 2014

Introduction: Studies have shown that ticagrelor has a further adenosine-mediated mechanism of action in addition to its potent inhibition of the P2Y12 receptor, which may explain some of ticagrelor’s clinical characteristics. This study aimed to further characterize the adenosine pharmacology of ticagrelor, its major metabolites, and other P2Y12 receptor antagonists. Methods: Inhibition of nucleoside transporter-mediated [3H]adenosine uptake by ticagrelor, its major metabolites, and alternative P2Y12 antagonists was examined in recombinant Madin-Darby canine kidney (MDCK) cells. The pharmacology of ticagrelor and its major metabolites at adenosine A1, A2A, A2B, and A3 receptor subtypes was examined using in vitro radioligand binding and functional assays and ex vivo C-fiber experiments in rat and guinea pig vagus nerves. Results: Ticagrelor (and less effectively its metabolites) and the main cangrelor metabolite inhibited [3H]adenosine uptake in equilibrative nucleoside transporter (ENT) 1-expressing MDCK cells, whereas cangrelor and the active metabolites of prasugrel or clopidogrel had no effect. No significant inhibitory activity was observed in MDCK cells expressing ENT2 or concentrative nucleoside transporters 2/3. Ticagrelor demonstrated high affinity (inhibition constant [Ki] = 41 nmol/L) for ENT1. In adenosine receptor-binding experiments, ticagrelor and its major circulating metabolite, AR-C124910XX, had low affinity (Ki > 6 µmol/L) for each of the adenosine A1, A2A, and A2B receptors, whereas ticagrelor had a submicromolar (Ki = 190 nmol/L) affinity for the adenosine A3 receptor. However, in functional assays, at high concentrations (10 µmol/L) ticagrelor only partially inhibited 3 mmol/L adenosine-induced depolarizations in the guinea pig and rat vagus nerve preparations (by 35% and 49%, respectively). Conclusions: Ticagrelor inhibits cellular adenosine uptake selectively via ENT1 inhibition at concentrations of clinical relevance. However, the low-binding affinity and functional inhibition of adenosine receptors observed with ticagrelor or its metabolites indicate that they possess a negligible adenosine-like activity at clinically relevant concentrations.
Sun exposure and multiple sclerosis risk in Norway and Italy: The EnvIMS study
Authors: Bjørnevik Kjetil , Riise Trond , Casetta Ilaria , Drulovic Jelena , Granieri Enrico , Holmøy Trygve , Kampman Margitta T , Landtblom Anne-Marie , Lauer Klaus , Lossius Andreas , Magalhaes Sandra , Myhr Kjell-Morten , Pekmezovic Tatjana , Wesnes Kristin , Wolfson Christina , Pugliatti Maura 
Published: January 2014

Objectives: The objective of this paper is to estimate the association between multiple sclerosis (MS) and measures of sun exposure in specific age periods in Norway and Italy. Methods: A total of 1660 MS patients and 3050 controls from Italy and Norway who participated in a multinational case-control study (EnvIMS) reported sun habits during childhood and adolescence. Results: A significant association between infrequent summer outdoor activity and increased MS risk was found in Norway and in Italy. The association was strongest between the ages of 16 and 18 years in Norway (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.30–2.59), and between birth and age 5 years in Italy (OR 1.56, 95% CI 1.16–2.10). In Italy a significant association was also found during winter (OR 1.42, 95% CI 1.03–1.97). Frequent sunscreen use between birth and the age of 6 years was associated with MS in Norway (OR 1.44, 95% CI 1.08–1.93) after adjusting for outdoor activity during the same period. Red hair (OR 1.67, 95% CI 1.06–2.63) and blonde hair (OR 1.36, 95% CI 1.09–1.70) were associated with MS after adjusting for outdoor activity and sunscreen use. Conclusion: Converging evidence from different measures underlines the beneficial effect of sun exposure on MS risk.
The 60 most highly cited articles published in the Journal of Telemedicine and Telecare and Telemedicine Journal and E-health
Authors: Askari Azam , Khodaie Mahdieh , Bahaadinbeigy Kambiz 
Published: January 2014

Summary We analysed the most highly cited articles in two specialist telemedicine journals, the Journal of Telemedicine and Telecare (JTT) and Telemedicine Journal and E-health (TJEH). Articles were extracted from the Science Citation Index Expanded in September 2012. A total of 1810 articles were listed for the JTT and 1550 for TJEH. In the JTT, the mean number of citations was 43 (SD 13); in TJEH the mean number of citations was 30 (SD 11). The average number of citations for the JTT was significantly higher than for TJEH ( P < 0.001). In each journal, the 60 articles which had the most citations were identified as highly cited publications (HCPs). The 60 HCPs in the JTT originated from 16 countries; the 60 HCPs in TJEH originated from 10 countries. Considering both journals together, the majority of HCPs came from the US, UK, Australia and Canada. In the JTT, the mean number of authors for each HCP was 4.6 (SD = 3.1); in TJEH, the mean number of authors for each HCP was 4.5 (SD = 2.3). There was no difference between the two journals ( P = 0.84) and the characteristics of the HCPs published in the JTT and TJEH were broadly similar. Although HCPs are not a direct method of measuring quality, they are an indicator of the scientific impact of the articles.
Investing in HRD in Uncertain Times Now and in the Future
Authors: Cascio Wayne F. 
Published: January 2014

The Problem We live in uncertain times, exacerbated by many direct and indirect effects of the global financial crisis. However, there is a lack of understanding about how human resource development (HRD) is responding to the global financial crisis or how HRD scholars and practitioners can best respond to these new realities and thus successfully ensure the future of HRD. The Solution To appreciate the future, it is critical to understand the past. Thus, this reflective piece outlines several factors that have caused, and continue to cause, uncertainty in the global economy, including structural changes in labor markets and developments in technology. A literature review revealed several HRD responses of firms to these new realities. These include technology-delivered instruction and social-learning tools. The article concludes by identifying characteristics of effective training and examines some distinctive practices of three firms that have been recognized as the global best in class for their leadership-development efforts. The Stakeholders Scholars and practitioners interested in the HRD, technology-delivered instruction, and social-learning fields.