bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Monocyte‐Derived Dendritic Cells and Associated Th2 Skewing in Chronic Rhinosinusitis
Authors: O'Connell Brendan P. , Schlosser Rodney J. , Wentzel Jennifer L. , Nagel Whitney , Mulligan Jennifer K. 
Published: December 2013

IntroductionMonocyte‐derived dendritic cells (moDCs) are antigen‐presenting cells capable of directing immune responses toward T‐helper 1 (Th1) or T‐helper 2 (Th2) phenotypes. The systemic profile of moDCs and their association with Th1/Th2 skewing in chronic rhinosinusitis (CRS) is unclear. The purpose of this study is to characterize circulating moDCs in controls, CRS without nasal polyps (CRSsNP), and CRS with nasal polyps (CRSwNP) and correlate moDCs with Th1/Th2 skewing, mucosal inflammation on computed tomography (CT), and quality of life (QoL).Study DesignCross‐sectional study.SettingTertiary care hospital.SubjectsBlood was drawn from control (n = 12), CRSsNP (n = 18), and CRSwNP (n = 15) patients during endoscopic sinus surgery.MethodsPeripheral blood moDCs were analyzed with flow cytometry for expression of HLA‐DR, CD209, and CD14. Th1 and Th2 cells were identified by CXCR3 and CCR8 expression, respectively. Lund‐Mackay CT scores were assigned by blinded graders. Sino‐Nasal Outcome Test 22 (SNOT‐22) surveys were completed by patients before surgery.ResultsCRSsNP and CRSwNP displayed elevations in systemic moDCs compared with controls. In CRSwNP, systemic Th2 skewing was observed and circulating CD4+ Th2 cells correlated with percent moDCs. MoDCs strongly correlated with higher Lund‐Mackay CT scores in CRSsNP but not in CRSwNP. No relationship between moDCs and SNOT‐22 scores was observed for either subset of CRS.ConclusionThese data support that CRSwNP and CRSsNP display alterations in systemic immune profiles. CRSwNP is characterized by significant elevations in circulating moDCs, which is associated with systemic Th2‐biased inflammation. Circulating moDCs are associated with mucosal inflammation on CT imaging in CRSsNP. No association between moDCs and QoL is evident in either CRS subset.
Diagnostic Variability of Laryngeal Premalignant Lesions: Histological Evaluation and Carcinoma Transformation
Authors: Hu Yanping , Liu Honggang 
Published: December 2013

ObjectiveThis study was to analyze the interobserver histopathological variability and carcinoma transformation of laryngeal premalignant lesions.Study DesignA historical cohort study.SettingDepartment of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.Subjects and Methodsκ‐statistics analysis was performed to estimate interobserver histopathological variability among pathologists by reassessment of 237 cases with laryngeal premalignant lesion according to 2005 WHO classification system. A retrospective follow‐up of 237 patients over 8‐year duration was carried out, and the carcinoma transformation of laryngeal premalignant lesions was analyzed using Kaplan‐Meier survival curve estimation.Resultsκ‐values of 0.5989 concerning interobserver variability indicated a moderate agreement among 3 pathologists. Major source of intergrade diagnostic disagreement between the original and the consensus diagnoses involved 2 grade pairs, namely, mild and moderate dysplasia, severe dysplasia, and carcinoma in situ. In addition, follow‐up study showed that 20 of 237 (8.44%) laryngeal premalignant lesion cases developed into invasive carcinoma. Carcinoma transformation in severe dysplasia group exhibited a similar risk compared to that in carcinoma in situ group (P =. 232).ConclusionSevere dysplasia shows the same carcinoma transformation potential as the carcinoma in situ does. Clinically, more attention to severe dysplasia is needed in comparison with mild and moderate dysplasia.
Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: A retrospective cohort study
Authors: Riolfi Mirko , Buja Alessandra , Zanardo Chiara , Marangon Chiara Francesca , Manno Pietro , Baldo Vincenzo 
Published: December 2013

Background: It has been demonstrated that most patients in the terminal stages of cancer would benefit from palliative home-care services. Aim: The aim of this study was to assess the effectiveness of appropriate palliative home-care services in reducing hospital admissions, and to identify factors predicting the likelihood of patients treated at home being hospitalized. Design: Retrospective cohort study. Setting/participants: We enrolled all 402 patients listed by the Local Health Authority No. 5, Veneto Region (North-East Italy), as dying of cancer in 2011. Results: Of the cohort considered, 39.9% patients had been taken into care by a palliative home-care team. Irrespective of age, gender, and type of tumor, patients taken into care by the palliative home-care team were more likely to die at home, less likely to be hospitalized, and spent fewer days in hospital in the last 2 months of their life. Among the patients taken into care by the palliative home-care team, those with hematological cancers and hepatocellular carcinoma were more likely to be hospitalized, and certain symptoms (such as dyspnea and delirium) were predictive of hospitalization. Conclusions: Our study confirms the effectiveness of palliative home care in enabling patients to spend the final period of their lives at home. The services of a palliative home-care team reduced the consumption of hospital resources. This study also provided evidence of some types of cancer (e.g. hematological cancers and hepatocellular carcinoma) being more likely to require hospitalization, suggesting the need to reconsider the pathways of care for these diseases.
Real-time imaging of cerebral infarction in rabbits using electrical impedance tomography
Authors: Yang Bin , Shi Xuetao , Dai Meng , Xu Canhua , You Fushen , Fu Feng , Liu Ruigang , Dong Xiuzhen 
Published: December 2013

Objective To investigate the possible use of electrical impedance tomography (EIT) in monitoring focal cerebral infarction in a rabbit model. Methods A model of focal cerebral infarction was established in eight New Zealand rabbits using a photochemical method without craniectomy. Focal cerebral infarction was confirmed by histopathological examination. Intracranial impedance variation was measured using 16 electrodes placed in a circle on the scalp. EIT images were obtained using a damped least-squares reconstruction algorithm. The average resistivity value (ARV) of the infarct region on EIT images was calculated to quantify relative resistivity changes. A symmetry index was calculated to evaluate the relative difference in resistivity between the two sides of the cerebrum. Results EIT images and ARV curves showed that impedance changes caused by cerebral infarction increased linearly with irradiation time. A difference in ARV was found between measurements taken before and after infarct induction. Conclusions Focal cerebral infarction can be monitored by EIT in the proposed animal model. The results are sufficiently encouraging that the authors plan to extend this study to humans, after further technical improvements.
Combined application of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging in early diagnosis of vulnerable carotid atherosclerotic plaques
Authors: Lei-xing Xie , Jing-jing Gai , Jing-xue Niu , Juan Wang , Juan Li , Chang-zai Liang , Xiao-xi Wang , Da-yi Yin , Jia-jin Liu , Xiong-wei Zhang , Liu-quan Cheng , Yong Wang , Dan-qing Liu , Hong-bin Liu 
Published: December 2013

Objective To assess the correlations between atherosclerotic plaque characteristics and inflammatory activity by combined use of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI). Methods Patients underwent 18F-FDG PET/CT and MRI. Target/background ratios (TBR) of axial sections were determined from mean standard uptake values (SUV). Correlations between TBR and mean vessel wall thickness, total vessel area, lumen area, vessel wall area and normalized wall index were calculated. Plaque types were defined as calcified, collagen, lipid or haemorrhage. Plaques were also classified as thick, thin, or ruptured fibrous cap. Results The study included 31 patients (1178 plaque slices). There was a significant decrease in TBR values across the fibrous cap groups, such that ruptured > thin > thick. Lipid and haemorrhage plaques had significantly higher TBR than calcification and collagen plaques. There were weak positive correlations between TBR and mean vessel wall thickness, vessel wall area and normalized wall index. Conclusions Thin or ruptured plaques, lipid-rich plaques and haemorrhagic plaques possess high inflammatory activity. The combination of 18F-FDG PET/CT and MRI could be useful for qualitative and quantitative diagnosis of carotid atherosclerotic plaques.
Protocadherin-17 promoter methylation in serum-derived DNA is associated with poor prognosis of bladder cancer
Authors: Luo Zhen-Guo , Li Zhi-Gang , Gui Shi-Liang , Chi Bao-Jin , Ma Jian-Guo 
Published: December 2013

Objective: To investigate the prognostic value of protocadherin 17 ( PCDH17) promoter methylation in serum-derived DNA of patients with bladder cancer. Methods: DNA was isolated from serum of patients with bladder cancer and from age- and sex-matched controls. Methylation-specific polymerase chain reaction was used to examine the methylation status of the PCDH17 promoter. The correlations between methylation status and clinicopathological characteristics and overall survival were examined. Results: PCDH17 promoter methylation was detected in 79/151 (52.3%) of patients with bladder cancer, and none of the 43 control subjects. Methylation was significantly associated with larger tumour diameter (>3 cm), high grade (G3) and advanced stage (T2–T4). Patients with PCDH17 promoter methylation had significantly shorter overall survival than those with unmethylated PCDH17 promoter. Methylation was an independent predictor of overall survival. Conclusions: PCDH17 promoter methylation was significantly associated with malignant behaviour and poor prognosis of bladder cancer. The detection of PCDH17 promoter methylation in serum-derived DNA may be a convenient and noninvasive predictive biomarker in routine clinical practice.
Relationship of bispectral index to minimum alveolar concentration during isoflurane, sevoflurane or desflurane anaesthesia
Authors: Kim Jin-Kyoung , Kim Duk-Kyung , Lee Myeong-Jin 
Published: December 2013

Objective To determine bispectral index (BIS) values produced by equipotent concentrations of commonly used volatile anaesthetics. Methods Female patients undergoing thyroidectomy were randomly assigned to receive isoflurane, sevoflurane or desflurane anaesthesia. After induction, anaesthesia was maintained by the volatile agent at 1 minimum alveolar concentration and supplemented with remifentanil infusion. BIS values were recorded during 1 h surgical anaesthesia after a 15 min equilibrium phase. Results Time-averaged BIS value during the study period was significantly lower in the desflurane group ( n = 29) than the sevoflurane group ( n = 27) (37.0 ± 4.9 vs 41.5 ± 5.9). Duration of deep hypnosis (BIS < 40) was significantly longer in the desflurane group than the sevoflurane group (40.2 ± 20.7 vs 24.3 ± 22.5 min). There were no significant differences in any parameter between the isoflurane group ( n = 27) and any other group. Conclusions Desflurane produces a greater hypnotic effect than sevoflurane during equipotent anaesthesia. Management of volatile anaesthesia using predetermined minimum alveolar concentration targets can lead to an unnecessarily long duration of deep hypnosis.
Sleep quality, arousal and pain thresholds in tension-type headache: A blinded controlled polysomnographic study
Authors: Engstrøm M , Hagen K , Bjørk M , Stovner LJ , Stjern M , Sand T 
Published: December 2013

Introduction We aimed to compare subjective and objective sleep quality in tension-type headache (TTH) patients and to evaluate the relationship between sleep quality and pain thresholds (PT) in controls and TTH patients. Methods A blinded cross-sectional study where polysomnography (PSG) and PT (to pressure, heat and cold) measurements were done in 20 patients with TTH (eight episodic (ETTH) and twelve chronic (CTTH) TTH) and 29 healthy controls. Sleep diaries and questionnaires were applied. Results TTH patients had more anxiety ( p = 0.001), insomnia ( p < 0.0005), daytime tiredness ( p < 0.0005) and reduced subjective sleep quality ( p < 0.0005) compared to healthy controls. Sleep diaries revealed more long awakenings in TTH ( p = 0.01) but no total sleep-time differences. TTH patients had more slow-wave sleep ( p = 0.002) and less fast arousals ( p = 0.004) in their PSGs. CTTH subjects had lower pressure PT ( p = 0.048) and more daytime sleepiness than the controls ( p = 0.039). Among TTH lower cold PT (CPT) correlated inversely with light sleep (N1) ( r = −0.49, p = 0.003) while slow arousals correlated inversely with headache-frequency ( r = −0.64, p = 0.003). Conclusions We hypothesize that TTH patients need more sleep than healthy controls and might be relatively sleep deprived. Inadequate sleep may also contribute to increased pain sensitivity and headache frequency in TTH.
Effects of CGRP receptor antagonism in nitroglycerin-induced hyperalgesia
Authors: Greco R , Mangione AS , Siani F , Blandini F , Vairetti M , Nappi G , Sandrini G , Buzzi MG , Tassorelli C 
Published: December 2013

Background The release of calcitonin gene-related peptide (CGRP) from trigeminal nerves plays a central role in the pathophysiology of migraine and clinical evidence shows an antimigraine effect for CGRP receptor antagonists. Systemic administration of nitroglycerin (NTG), a nitrovasodilator, consistently provokes spontaneous-like migraine attacks in migraine sufferers; in the rat, systemic NTG induces a condition of hyperalgesia, probably through the activation of cerebral/spinal structures involved in nociceptive transmission. Aim The aim of this article is to test the analgesic effect of the CGRP receptor antagonist MK-8825 in two animal models of pain that may be relevant for migraine: the tail flick test and the formalin test performed during NTG-induced hyperalgesia. Results MK-8825 showed analgesic activity when administered alone at both the tail flick test and the formalin test. Furthermore, the CGRP antagonist proved effective in counteracting NTG-induced hyperalgesia in both tests. MK-8825 indeed reduced the nociceptive behavior when administered either simultaneously or prior to (30–60 minutes before) NTG. Conclusion These data suggest that MK-8825 may represent a potential therapeutic tool for the treatment of migraine.
Identifying predictors of high sodium excretion in patients with heart failure: A mixed effect analysis of longitudinal data
Authors: Masterson Creber Ruth , Topaz Maxim , Lennie Terry A , Lee Christopher S , Puzantian Houry , Riegel Barbara 
Published: December 2013

Background:A low-sodium diet is a core component of heart failure self-care but patients have difficulty following the diet.Aim:The aim of this study was to identify predictors of higher than recommended sodium excretion among patients with heart failure.Methods:The World Health Organization Five Dimensions of Adherence model was used to guide analysis of existing data collected from a prospective, longitudinal study of 280 community-dwelling adults with previously or currently symptomatic heart failure. Sodium excretion was measured objectively using 24-hour urine sodium measured at three time points over six months. A mixed effect logistic model identified predictors of higher than recommended sodium excretion.Results:The adjusted odds of higher sodium excretion were 2.90, (95% confidence interval (CI): 1.15–4.25, p<0.001) for patients who were obese; 2.80 (95% CI: 1.33–5.89, p=0.007) for patients with diabetes; and 2.22 (95% CI: 1.09–4.53, p=0.028) for patients who were cognitively intact.Conclusion:Three factors were associated with excess sodium excretion and two factors, obesity and diabetes, are modifiable by changing dietary food patterns.
Factors related to bowel cleansing failure before colonoscopy: Results of the PACOME study
Authors: Hautefeuille Gaëlle , Lapuelle Jean , Chaussade Stanislas , Ponchon Thierry , Molard B Richard , Coulom Pierre , Laugier René , Henri Franck , Cadiot Guillaume 
Published: December 2013

BackgroundThe factors associated with inadequate bowel cleansing leading to colonoscopy failure are not well known.ObjectiveWe conducted a multicentre, prospective, observational case–control study in order to identify these factors.MethodsInvestigators included one patient with colonoscopy failure due to inadequate bowel cleansing (failure group) and the following patient with complete colonoscopy (success group). Data related to demographics, medical history, and preparation were collected and compared. Factors associated with bowel cleansing failure were identified by multivariate logistical regression analysis.ResultsA total of 101 gastroenterologists included 202 patients from 1 November 2009 to 15 January 2010. There was no difference between both groups with regards to baseline characteristics. In univariate analysis, factors significantly associated with bowel cleansing failure were vomiting during preparation (p  = 0.0007), incomplete intake of the preparation (p  = 0.002), and constipation (p  = 0.02). Type and timing of preparation were not significantly different between groups. In multivariate analysis, incomplete intake of the preparation (OR 4.5, 95% CI 1.2–17.3), constipation (OR 4.2, 95% CI 1.2–14.9), and treatment with neuroleptics or antidepressants (OR 9.9 (95% CI 1.4–71.0) were independent predictors of colonoscopy failure.ConclusionsFactors associated with bowel cleansing failure were incomplete intake of the preparation, constipation, and treatment with psychotropic drugs. Interventions to reduce poor colonoscopy preparations should be targeted at these at‐risk patients.
JAK2 or CALR mutation status defines subtypes of essential thrombocythemia with substantially different clinical course and outcomes
Authors: Rumi Elisa , Pietra Daniela , Ferretti Virginia , Klampfl Thorsten , Harutyunyan Ashot S. , Milosevic Jelena D. , Them Nicole C. C. , Berg Tiina , Elena Chiara , Casetti Ilaria C. , Milanesi Chiara , Sant’Antonio Emanuela , Bellini Marta , Fugazza Elena , Renna Maria C. , Boveri Emanuela , Astori Cesare , Pascutto Cristiana , Kralovics Robert , Cazzola Mario 
Published: December 2013

Key Points
JAK2 (V617F)-mutated essential thrombocythemia and polycythemia vera are different phenotypes in the evolution of a single neoplasm. CALR-mutated essential thrombocythemia is a distinct disease entity not only at the molecular level, but also with respect to clinical outcomes.
Effect of facemasks on empathy and relational continuity: a randomised controlled trial in primary care
Authors: Wong Carmen Ka Man , Yip Benjamin Hon Kei , Mercer Stewart , Griffiths Sian , Kung Kenny , Wong Martin Chi-sang , Chor Josette , Wong Samuel Yeung-shan 
Published: December 2013

Abstract

Background
There is limited evidence to support the use of facemasks in preventing infection for primary care professionals. Negative effects on communication has been suggested when the physician wears a facemask. As communication skills and doctor patient relationship are essential to primary care consultations, the effects of doctor’s facemask wearing were explored.

Method
A randomised controlled study was conducted in primary care to explore the effects of doctors wearing facemasks on patients’ perception of doctors’ empathy, patient enablement and patient satisfaction. Primary care doctors were randomized to mask wearing and non mask wearing clinical consultations in public primary care clinics in Hong Kong. Patients’ views were gathered using the Consultation and Relational Empathy (CARE) Measure, Patient Enablement Instrument (PEI) and an overall satisfaction rating scale. The effects of face mask wearing were investigated using multilevel (hierarchical) modelling.

Results
1,030 patients were randomised to doctor-mask wearing consultations (n = 514) and non mask wearing consultations (n = 516). A significant and negative effect was found in the patients’ perception of the doctors’ empathy (CARE score reduction -0.98, p-value = 0.04). In the more established doctor-patient relationship, the effect of doctors’ mask wearing was more pronounced (CARE score reduction -5.67, p-value = 0.03).

Conclusion
This study demonstrates that when doctors wearing a facemask during consultations, this has a significant negative impact on the patient’s perceived empathy and diminish the positive effects of relational continuity. Consideration should be taken in planning appropriate use of facemasks in infectious disease policy for primary care and other healthcare professionals at a national, local or practice level.

Clinical trial registration
This trial was registered on Chinese Clinical Trial Register (ChiCTR). Registration no.: ChiCTR-TTRCC-12002519. URL: http://www.chictr.org/en/proj/show.aspx?proj=3486. Due to administrative error, registration of trial did not take place until after the trial started on 1st August 2011 and registration number was released on 21st September 2012.
Determination of French influenza outbreaks periods between 1985 and 2011 through a web-based Delphi method
Authors: Debin Marion , Souty Cécile , Turbelin Clément , Blanchon Thierry , Boëlle Pierre-Yves , Hanslik Thomas , Hejblum Gilles , Le Strat Yann , Quintus Flavien ,   the DelFluWeb study group, Falchi Alessandra 
Published: December 2013

AbstractBackgroundAssessing the accuracy of influenza epidemic periods determined by statistical models is important to improve the performance of algorithms used in real-time syndromic surveillance systems. This is a difficult problem to address in the absence of a reliable gold standard. The objective of this study is to establish an expert-based determination of the start and the end of influenza epidemics in France.MethodsA three-round international web-based Delphi survey was proposed to 288 eligible influenza experts. Fifty-seven (20%) experts completed the three-rounds of the study. The experts were invited to indicate the starting and the ending week of influenza epidemics, on 32 time-series graphs of influenza seasons drawn using data from the FrenchSentinellesNetwork (Influenza-like illness incidence rates) and virological data from the WHO-FluNet. Twenty-six of 32 time-series graphs proposed corresponded to each of the French influenza seasons observed between 1985 and 2011. Six influenza seasons were proposed twice at each round to measure variation among expert responses.ResultsWe obtained consensual results for 88% (23/26) of the epidemic periods. In two or three rounds (depending on the season) answers gathered around modes, and the internal control demonstrated a good reproducibility of the answers. Virological data did not appear to have a significant impact on the answers or the level of consensus, except for a season with a major mismatch between virological and incidence data timings.ConclusionsThanks to this international web-based Delphi survey, we obtained reproducible, stable and consensual results for the majority of the French influenza epidemic curves analysed. The detailed curves together with the estimates from the Delphi study could be a helpful tool for assessing the performance of statistical outbreak detection methods, in order to optimize them.