bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endometrioid adenocarcinoma of the ovary: MRI findings with emphasis on diffusion-weighted imaging for the differentiation of ovarian tumors
Authors: Kovač Jelena Djokić , Terzić Milan , Mirković Milan , Banko Bojan , Đikić-Rom Aleksandra , Maksimović Ružica 
Published: August 2015

Background Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. Purpose To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. Material and Methods The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b = 800 s/mm2 in solid tumor components. Results The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference ( P = 0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions ( P < 0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79 ± 0.21 vs. 0.90 ± 0.19; P = 0.04) and in all malignant lesions compared with benign tumors (0.88 ± 0.31 vs. 1.33 ± 0.17; P < 0.001). Conclusion DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions.
Feasibility and results of a pilot study of group occupational therapy for fall risk management after stroke
Authors: Schmid Arlene A , Miller Kristine K , Van Puymbroeck Marieke , DeBaun-Sprague Erin , Shively Christine , Peterson Elizabeth , Finlayson Marcia 
Published: August 2015

Introduction This article examines the feasibility and outcomes of a pilot study of Group Occupational Therapy for Falls, a fall risk management program designed for individuals with chronic stroke. Method This was a single-arm pilot study. All 10 participants had chronic stroke (>6 months), self-reported falling or fear of falling, and used a mobility device. Group Occupational Therapy for Falls included six sessions and focused on individual fall risk factor management. Assessments were completed before and after the intervention and assessed management of fall risk factors (five assessments, including the Falls Control Scale and Falls Prevention Strategy Survey), fear of falling (yes/no) question, falls self-efficacy, and activity and participation with the IMPACT (ICF Measure of Participation and ACTivity). Alpha was set at .10 owing to the small sample size and feasibility/pilot-study design. Results Group Occupational Therapy for Falls was feasible and management of fall risk factors improved overall, with significant improvements noted in the Falls Control Scale ( p = .046) and Falls Prevention Strategy Survey (.064). The number of people with FoF significantly decreased ( p = .076). Conclusion Group Occupational Therapy for Falls for fall prevention after stroke should be further developed and assessed in people with stroke as a promising intervention that may manage fall risks and possibly fall rates in the future.
Active inflammatory biomarkers in oral lichen planus
Authors: Santarelli Andrea , Mascitti Marco , Rubini Corrado , Bambini Fabrizio , Zizzi Antonio , Offidani Annamaria , Ganzetti Giulia , Laino Luigi , Cicciù Marco , Muzio Lorenzo Lo 
Published: August 2015

Oral lichen planus (OLP) is a chronic disease, with a central role to cell-mediated autoimmunity. Osteopontin promotes migration and recruitment of immune cells, CD44 is its receptor, and Survivin seems to be important in skin/mucosa homeostasis. The aim of this study was to investigate their expression in biopsy specimens of patients with different OLP clinical types and healthy controls. Biopsy specimens from 30 patients with OLP (15 atrophic and 15 hyperplastic) and 15 healthy controls were subjected to immune-histochemical analysis, to detect the expression of osteopontin, CD44, and Survivin in oral epithelia. The distributions of positively stained cells were evaluated with a quantitative method, while the inflammation degree was evaluated with a semi-quantitative one. Expression of osteopontin and CD44 was higher in OLP than controls, while Survivin expression was lower in OLP patients. There was a greater reduction of Survivin expression in atrophic OLP than hyperplastic OLP. A correlation between osteopontin expression and a high degree of inflammation was found. Furthermore, Survivin expression was higher in cases with low intensity of inflammation. Osteopontin, CD44, and Survivin seem to be involved in OLP pathogenesis, and further investigations are needed for clarifying their role in this oral disease.
Levels of uric acid may predict the future development of pulmonary hypertension in systemic lupus erythematosus: a seven-year follow-up study
Authors: Castillo-Martínez D , Marroquín-Fabián E , Lozada-Navarro A C , Mora-Ramírez M , Juárez M , Sánchez-Muñoz F , Vargas-Barrón J , Sandoval J , Amezcua-Guerra L M 
Published: August 2015

Objective The objective of this paper is to assess whether pulmonary hypertension (PH) may be detected at one point in time or longitudinally predicted by serum uric acid (sUA) levels in systemic lupus erythematosus (SLE). Methods We conducted a post-hoc analysis of a long-term followed cohort of Mexican SLE patients. Echocardiography-based definitions of PH by the ESC/ERS/ISHLT and its associations with clinical and laboratory data on enrollment were studied. Especially, the impact that sUA levels at baseline may have on the future development of PH in patients with normal pulmonary artery systolic pressure (PASP) was explored. Results Out of the 156 SLE patients originally enrolled in the cohort, 44 met the inclusion criteria for the present study and were grouped as having ( n = 10) or not having ( n = 34) PH. At baseline, sUA levels of 5.83 ± 1.79 and 5.82 ± 1.97 mg/dl ( p = ns) were found in patients with and without PH, respectively. No association between PASP and other markers was found. In patients with normal PASP, the presence of sUA ≥ 7 mg/dl at baseline predicted future development of PH (relative risk 8.5, 1.0009 to 72; p = 0.04). Conclusion In SLE, sUA levels at one point in time are useless to detect PH. However, steady hyperuricemia may predict the future development of PH in patients with normal PASP at baseline.
PAP assays in newborn screening for cystic fibrosis: a population-based cost-effectiveness study
Authors: Seror Valerie , Cao Caroline , Roussey Michel , Giorgi Roch 
Published: August 2015

Objectives To compare the cost effectiveness of adding a pancreatitis-associated protein (PAP) assay to common immunoreactive trypsinogen (IRT) and DNA cystic fibrosis (CF) newborn screening strategies. Methods Using data collected on 553,167 newborns, PAP cut-offs were calculated based on non-inferiority of the detection rates of classical forms of CF. Cost effectiveness was considered from the third-party payer's perspective using only direct medical costs, and the unit costs of PAP assays were assessed based on a micro-costing study. Robustness of the cost-effectiveness estimates was assessed, taking the secondary outcomes of screening (ie. detecting mild forms and CF carriers) into account. Results IRT/DNA, IRT/PAP, and IRT/PAP/DNA strategies had similar detection rates for classical forms of CF, but the strategies involving PAP assays detected smaller numbers of mild forms of CF. The IRT/PAP strategy was cost-effective in comparison with either IRT/DNA or IRT/PAP/DNA. IRT/PAP/DNA screening was cost-effective in comparison with IRT/DNA if relatively low value was assumed to be attached to the identification of CF carriers. Conclusions IRT/PAP strategies could be strictly cost-effective, but dropping DNA would mean the test could not detect CF carriers. IRT/PAP/DNA strategies could be a viable option as they are significantly less costly than IRT/DNA, but still allow CF carrier detection.
Effectiveness of a new dietetic weight management food to achieve weight loss in client-owned obese cats
Authors: Christmann Undine , Bečvářová Iveta , Werre Stephen R , Meyer Hein P 
Published: August 2015

Objectives The aim of the study was to evaluate weight loss and maintenance parameters in cats fed a novel weight management food and to assess the owner’s perception of the cat’s quality of life. Methods This study was designed as a prospective, uncontrolled/unmasked clinical trial. One hundred and thirty-two overweight/obese, otherwise healthy, client-owned cats were enrolled. Initial evaluation included physical examination, nutritional assessment, ideal body weight determination and weight-loss feeding guidelines development. Follow-up evaluations (monthly for 6 months) encompassed determination of body weight, body condition score, body fat index, muscle condition score and feeding practices. Quality of life assessment by owners included the cat’s level of energy, happiness, appetite, begging behavior, flatulence, stool volume and fecal score. Results Eighty-three percent of the cats lost weight, with an average ± SEM weight loss of 11.0 ± 1.8% over 6 months and an average ± SE weekly weight loss rate of 0.45 ± 0.02%. The mean ± SEM duration of weight loss was 134.0 ± 4.8 days. Fourteen percent of cats achieved an ideal body weight. Seventy-nine percent of cats ate more calories from novel weight management food than the recommended daily energy requirement for weight loss, and the majority of these cats still lost weight. Body condition score and body fat index decreased over time compared with baseline from weeks 12–24 and from weeks 8–24, respectively. Owners perceived an increase in energy and happiness (>week 12) in the cats that lost weight, without changes in appetite or begging behavior. Conclusions and relevance This study confirmed the effectiveness of the novel weight management food in achieving weight loss in overweight/obese client-owned cats. Owners reported significant improvements in their cat’s quality of life without negative side effects.
A study of grip strength among 20–49-year-old British adults and comparison to existing norms
Authors: Wozny Robyn , Pratt Anna L , Pereira Christine 
Published: August 2015

Introduction Hand grip strength is frequently assessed to evaluate interventions or guide treatment. When using calibrated equipment in a standardised method, hand-held dynamometry is a reliable measure for hand grip strength and can be compared to normative data. However, existing British grip strength normative data were published 20 years ago. Methods A non-experimental quantitative study was carried out to establish if existing UK hand grip norms and consolidated multinational norms were representative of today’s 20–49-year-old British adult population. The methodology used was modelled on a previous British study using the mean Jamar dynamometer maximal grip strengths and reported within age bands. Results A total of 135 healthy British citizens of various ethnicities between 20 and 49 years were recruited. Grip strength is decreased in comparison to the existing British normative data for both males and females in all age bands. A significant difference exists ( p < 0.05) for male right hand aged 40–44 years and right and left hands for women 25–29 years and 45–49 years, respectively. Significant differences were also noted in 5 and 8 of the 12 multinational means for men and women respectively. Conclusions Due to small sample size, the ability of this study to demonstrate a significant difference in mean grip strength to the earlier British norms is low. However, a small increase in sample size may have resulted in further significant differences with both studies. A larger study, taking into consideration ethnicity, is recommended to ensure valid and reliable grip strength norms are used in practice.
Comparative assessment of several automatic CPAP devices' responses: a bench test study
Authors: Isetta Valentina , Navajas Daniel , Montserrat Josep M. , Farré Ramon 
Published: August 2015

Automatic continuous positive airway pressure (APAP) devices adjust the delivered pressure based on the breathing patterns of the patient and, accordingly, they may be more suitable for patients who have a variety of pressure demands during sleep based on factors such as body posture, sleep stage or variability between nights. Devices from different manufacturers incorporate distinct algorithms and may therefore respond differently when subjected to the same disturbed breathing pattern. Our objective was to assess the response of several currently available APAP devices in a bench test.A computer-controlled model mimicking the breathing pattern of a patient with obstructive sleep apnoea (OSA) was connected to different APAP devices for 2-h tests during which flow and pressure readings were recorded. Devices tested were AirSense 10 (ResMed), Dreamstar (Sefam), Icon (Fisher & Paykel), Resmart (BMC), Somnobalance (Weinmann), System One (Respironics) and XT-Auto (Apex). Each device was tested twice.The response of each device was considerably different. Whereas some devices were able to normalise breathing, in some cases exceeding the required pressure, other devices did not eliminate disturbed breathing events (mainly prolonged flow limitation). Mean and maximum pressures ranged 7.3–14.6 cmH2O and 10.4–17.9 cmH2O, respectively, and the time to reach maximum pressure varied from 4.4 to 96.0 min.Each APAP device uses a proprietary algorithm and, therefore, the response to a bench simulation of OSA varied significantly. This must be taken into account for nasal pressure treatment of OSA patients and when comparing results from clinical trials.
Genomic analysis of codon usage shows influence of mutation pressure, natural selection, and host features on Marburg virus evolution
Authors: Nasrullah Izza , Butt Azeem M , Tahir Shifa , Idrees Muhammad , Tong Yigang 
Published: August 2015

Abstract
Background
The Marburg virus (MARV) has a negative-sense single-stranded RNA genome, belongs to the family Filoviridae, and is responsible for several outbreaks of highly fatal hemorrhagic fever. Codon usage patterns of viruses reflect a series of evolutionary changes that enable viruses to shape their survival rates and fitness toward the external environment and, most importantly, their hosts. To understand the evolution of MARV at the codon level, we report a comprehensive analysis of synonymous codon usage patterns in MARV genomes. Multiple codon analysis approaches and statistical methods were performed to determine overall codon usage patterns, biases in codon usage, and influence of various factors, including mutation pressure, natural selection, and its two hosts, Homo sapiens and Rousettus aegyptiacus.

Results
Nucleotide composition and relative synonymous codon usage (RSCU) analysis revealed that MARV shows mutation bias and prefers U- and A-ended codons to code amino acids. Effective number of codons analysis indicated that overall codon usage among MARV genomes is slightly biased. The Parity Rule 2 plot analysis showed that GC and AU nucleotides were not used proportionally which accounts for the presence of natural selection. Codon usage patterns of MARV were also found to be influenced by its hosts. This indicates that MARV have evolved codon usage patterns that are specific to both of its hosts. Moreover, selection pressure from R. aegyptiacus on the MARV RSCU patterns was found to be dominant compared with that from H. sapiens. Overall, mutation pressure was found to be the most important and dominant force that shapes codon usage patterns in MARV.

Conclusions
To our knowledge, this is the first detailed codon usage analysis of MARV and extends our understanding of the mechanisms that contribute to codon usage and evolution of MARV.
Adequate antibiotic therapy prior to ICU admission in patients with severe sepsis and septic shock reduces hospital mortality
Authors: Garnacho-Montero José , Gutiérrez-Pizarraya Antonio , Escoresca-Ortega Ana , Fernández-Delgado Esperanza , López-Sánchez José María 
Published: August 2015

Abstract
Introduction
In patients with severe sepsis and septic shock as cause of Intensive Care Unit (ICU) admission, we analyze the impact on mortality of adequate antimicrobial therapy initiated before ICU admission.

Methods
We conducted a prospective observational study enrolling patients admitted to the ICU with severe sepsis or septic shock from January 2008 to September 2013. The primary end-point was in-hospital mortality. We considered two groups for comparisons: patients who received adequate antibiotic treatment before or after the admission to the ICU.

Results
A total of 926 septic patients were admitted to ICU, and 638 (68.8%) had available microbiological isolation: 444 (69.6%) received adequate empirical antimicrobial treatment prior to ICU and 194 (30.4%) after admission. Global hospital mortality in patients that received treatment before ICU admission, between 0-6h ICU, 6–12h ICU, 12–24h ICU and after 24 hours since ICU admission were 31.3, 53.2, 57.1, 50 and 50.8% (p<0.001). The multivariate analysis showed that urinary focus (odds ratio (OR) 0.20; 0.09–0.42; p<0.001) and adequate treatment prior to ICU admission (OR 0.37; 0.24–0.56; p<0.001) were protective factors whereas APACHE II score (OR 1.10; 1.07–1.14; p<0.001), septic shock (OR 2.47; 1.57–3.87; p<0.001), respiratory source (OR 1.91; 1.12–3.21; p=0.016), cirrhosis (OR 3.74; 1.60–8.76; p=0.002) and malignancy (OR 1.65; 1.02–2.70; p=0.042) were variables independently associated with in-hospital mortality. Adequate treatment prior to ICU was a protective factor for mortality in patients with severe sepsis (n=236) or in septic shock (n=402).

Conclusions
The administration of adequate antimicrobial therapy before ICU admission is decisive for the survival of patients with severe sepsis and septic shock. Our efforts should be directed to assure the correct administration antibiotics before ICU admission in patients with sepsis.
Impact of an Automatically Generated Cancer Survivorship Care Plan on Patient-Reported Outcomes in Routine Clinical Practice: Longitudinal Outcomes of a Pragmatic, Cluster Randomized Trial
Authors: Nicolaije Kim A.H. , Ezendam Nicole P.M. , Vos M. Caroline , Pijnenborg Johanna M.A. , Boll Dorry , Boss Erik A. , Hermans Ralph H.M. , Engelhart Karin C.M. , Haartsen Joke E. , Pijlman Brenda M. , van Loon-Baelemans Ingrid E.A.M. , Mertens Helena J.M.M. , Nolting Willem E. , van Beek Johannes J. , Roukema Jan A. , Zijlstra Wobbe P. , Kruitwagen Roy F.P.M. , van de Poll-Franse Lonneke V. 
Published: August 2015

Purpose This study was conducted to longitudinally assess the impact of an automatically generated survivorship care plan (SCP) on patient-reported outcomes in routine clinical practice. Primary outcomes were patient satisfaction with information and care. Secondary outcomes included illness perceptions and health care use. Methods Twelve hospitals were randomly assigned to SCP care or usual care in a pragmatic, cluster randomized trial. Newly diagnosed patients with endometrial cancer completed questionnaires after diagnosis (n = 221; 75% response), 6 months (n = 158), and 12 months (n = 147). An SCP application was built in the Web-based ROGY (Registration System Oncological Gynecology). By clicking the SCP button, a patient-tailored SCP was generated. Results In the SCP care arm, 74% of patients received an SCP. They reported receiving more information about their treatment (mean [M] = 57, standard deviation [SD] = 20 v M = 47, SD = 24; P = .03), other services (M = 35, SD = 22 v M = 25, SD = 22; P = .03), and different places of care (M = 27, SD = 25 v M = 23, SD = 26; P = .04) than the usual care arm (scales, 0 to 100). However, there were no differences regarding satisfaction with information or care. Patients in the SCP care arm experienced more symptoms (M = 3.3, SD = 2.0 v M = 2.6, SD = 1.6; P = .03), were more concerned about their illness (M = 4.4, SD = 2.3 v M = 3.9, SD = 2.1; P = .03), were more affected emotionally (M = 4.0, SD = 2.2 v M = 3.7, SD = 2.2; P = .046), and reported more cancer-related contact with their primary care physician (M = 1.8, SD = 2.0 v M = 1.1, SD = 0.9; P = .003) than those in the usual care arm (scale, 1 to 10). These effects did not differ over time. Conclusion The present trial showed no evidence of a benefit of SCPs on satisfaction with information and care. Furthermore, SCPs increased patients' concerns, emotional impact, experienced symptoms, and the amount of cancer-related contact with the primary care physician. Whether this may ultimately lead to more empowered patients should be investigated further.
Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial
Authors: Murphy Daniel R. , Wu Louis , Thomas Eric J. , Forjuoh Samuel N. , Meyer Ashley N.D. , Singh Hardeep 
Published: August 2015

Purpose We tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. Methods We performed a cluster randomized controlled trial of primary care providers (PCPs) at two sites to test whether triggers that prospectively identify patients with potential delays in diagnostic evaluation for lung, colorectal, or prostate cancer can reduce time to follow-up diagnostic evaluation. Intervention steps included queries of the electronic health record repository for patients with abnormal findings and lack of associated follow-up actions, manual review of triggered records, and communication of this information to PCPs via secure e-mail and, if needed, phone calls to ensure message receipt. We compared times to diagnostic evaluation and proportions of patients followed up between intervention and control cohorts based on final review at 7 months. Results We recruited 72 PCPs (36 in the intervention group and 36 in the control group) and applied the trigger to all patients under their care from April 20, 2011, to July 19, 2012. Of 10,673 patients with abnormal findings, the trigger flagged 1,256 patients (11.8%) as high risk for delayed diagnostic evaluation. Times to diagnostic evaluation were significantly lower in intervention patients compared with control patients flagged by the colorectal trigger (median, 104 v 200 days, respectively; n = 557; P < .001) and prostate trigger (40% received evaluation at 144 v 192 days, respectively; n = 157; P < .001) but not the lung trigger (median, 65 v 93 days, respectively; n = 19; P = .59). More intervention patients than control patients received diagnostic evaluation by final review (73.4% v 52.2%, respectively; relative risk, 1.41; 95% CI, 1.25 to 1.58). Conclusion Electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up. Similar interventions could improve timeliness of diagnosis of other serious conditions.