bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary Heart Disease in South-Asian Women
Authors: Gooneratne MDP 
Published: February 2014

ABSTRACT
With the demographic transition in the South-Asian region coronary heart disease in post menopausal women is a major challenge. Women with myocardial infarction often have atypical presentation and have a higher mortality. In South-Asia there is high prevalence of coronary heart disease among women and there is an increasing incidence in both urban and rural areas. While obesity and lack of exercise contribute largely to traditional risk factors in South-Asian women in midlife, nontraditional newer risk factors seem to play a major role in increased prevalence and mortality. Early prevention strategies targeting diet, physical exercise and mental stress are important in preventing further increase of coronary heart disease in South- Asian women.

How to cite this article
Gooneratne MDP. Coronary Heart Disease in South-Asian Women. J South Asian Feder Menopause Soc 2013;1(2):84-87.
Impact and Cost Effectiveness of Routine Intraoperative Transthoracic and Transesophageal Echocardiography on Surgical Decision Making in Pediatric Cardiac Surgery
Authors: Madhavan J Sethu , Ghuman BPS , Mishra Abhi , Arya VK , Kumar Bhupesh , Jayant Aveek , Negi Sunder , Tandon Yamini 
Published: February 2014

ABSTRACTIntroductionCongenital heart diseases (CHD) present with wide spectrum of lesions leading to diagnostic dilemmas and it is quite possible to miss correct diagnosis during preoperative transthoracic echocardiography (TTE) in an inadequately sedated child, especially in a busy outpatient setting. It is a routine practice in our center to do baseline TTE after induction of anesthesia followed by pre and postcardiopulmonary bypass (CPB) transesophageal echocardiography (TEE) in all CHD patients thus helping us review our surgical plan.Materials and methodsAll pediatric patients <18 years undergoing cardiac surgery from January 2013 to December 2013 at our tertiary care center in whom perioperative echocardiograhy was done were included. Appropriate sized TTE and TEE probes were used with the Philips iE33 echocardiography platform (Philips, Andover, MA).ResultsOut of total 352 pediatric cardiac surgical patients, perioperative echocardiography was done in 347(98.5%) patients. Baseline TTE showed new findings leading to change in surgical plan in 11 (3.1%) patients while additional new findings in baseline TEE were seen in 9 (2.6%). Post bypass TEE showed residual lesions requiring a CPB rerun in 19 (5.5%) patients. Intraoperative echocardiography was found to be cost effective with an estimated savings per patient of ₹ 3950 to 5373($61 - 83).ConclusionIntraoperative echocardiography is an important tool in armamentarium of perioperative physician which can be used to review diagnosis and help to formulate an informed surgical plan. Post-bypass transesophageal echocardiography is also useful as it identifies the residual lesions and establishes anatomical correction, which ultimately translates to lesser redo surgeries and a better postoperative outcome.How to cite this articleMishra A, Madhavan JS, Ghuman BPS, Raj R, Kumar A, Dutta V, Negi S, Tandon Y, Kumar A, Arya VK, Kumar B, Jayant A, Puri GD. Impact and Cost Effectiveness of Routine Intraoperative Transthoracic and Transesophageal Echocardiography on Surgical Decision Making in Pediatric Cardiac Surgery. J Perioper Echocardiogr 2014;2(1):3-9.
Neprispôsobiví Rómovia a slušná väčšina? Spravodajský diskurz po násilných udalostiach na severe Českej republiky 2011
Authors: Kluknavská Alena , Zagibová Lenka 
Published: February 2014

The paper analyses the news discourse on Roma minority during the violent incidents and the following anti-Roma protests in the north part of the Czech Republic in 2011. It focuses on news reports relating to the Roma in three most-read Czech newspapers between August 8, 2011 and September 8, 2011. The study adheres to the discourse analysis and is undertaken in three stages. In first step we introduce a general characterization of the news and the context of the unrests as presented by the media. This is followed by the analysis of the extent to which the media emphasize the ethnicity and generalize the “Roma” criminality. In third step a dichotomy in relation to the majority and the Roma minority (us vs. them) is analysed. The analysis points to systematic „othering“ and stereotyping of Roma minority in the selected newspapers. Results show that the media emphasized the ethnicity of Roma actors involved in the attacks and generalized given incidents as continuing „Roma“ criminality. Moreover, the newspapers tended to present the situation either as „the last drop“ of the tensions between two groups (majority population and Roma minority) or as a consequence of the problems with the criminality of „unadaptable“ citizens, meaning the Roma. These discursive practices can lead to deepening of racial stereotypes in the society, but they can also contribute to the formation of favourable discoursive opportunity structure, hence favourable context for parties of the far right, which are characteristic of their nationalistic, racist and xenophobic rhetoric and actions.
Le pilotage par l’État de la formation des enseignants du début des années 1990 à nos jours et ses incidences sur le métier de formateur
Authors: Lapostolle Guy , Grisoni Pascal , Solomon Tsehaye Rachel 
Published: February 2014

L’objet de cet article est de questionner, dans une perspective historique, la manière dont l’État a organisé et a fait évoluer la formation des enseignants du début des années 1990 à nos jours. Il s’attache à mettre en lumière les ambitions qui ont présidé aux réformes et tente de montrer la manière dont le métier de formateur d’enseignants s’est constitué et a évolué. Le formateur avait acquis un certain nombre de savoir-faire, et plus généralement une certaine culture, qui pourraient conduire à affirmer qu’un processus de professionnalisation était en cours, et ce jusqu’au milieu des années 2000. Ce processus tendait à rassembler sous une même dénomination, celle de « formateur », des intervenants dans la formation des enseignants, de statuts, d’origines et de compétences diverses. Cette consolidation du métier s’appuyait en partie sur un certain nombre de ruptures, notamment par rapport aux caractéristiques du métier d’enseignant. La masterisation fera voler en éclat ce processus. Il s’agira de tenter d’appréhender les conséquences de cette réforme sur le (s) métier (s) de formateur.
L’accompagnement dans la professionnalisation du métier d’enseignant. Le point de vue des formateurs
Authors: Loizon Denis , Charvy Nathalie , Cartierre Nathalie 
Published: February 2014

La recherche présentée s’intéresse plus particulièrement à un aspect particulier de la professionnalisation : l’accompagnement. Dans les déclarations des formateurs en IUFM, nous avons identifié cinq dimensions de l’accompagnement en relation avec le rapport au savoir : rapport à l’institution, à l’autre, à sa pratique, aux savoirs et à l’expérience antérieure. Si cette dernière dimension revêt un caractère important dans les choix et les pratiques d’accompagnement, nos résultats montrent que les définitions de l’accompagnement sont hétérogènes avec des modalités de mises en oeuvre différentes selon les sujets qui s’appuient bien souvent sur les expériences professionnelles antérieures à la masterisation. Néanmoins, nous avons pu constater des adaptations dans le cadre des masters, notamment l’accompagnement dans les groupes de références.
La formation des bénévoles : une démarche de professionnalisation ?
Authors: Tardif Bourgoin Florence 
Published: February 2014

Les exigences de professionnalisation dans le champ de l’action sociale préoccupent les associations dans un contexte de réduction des financements. Les référentiels de compétences accompagnent ainsi le recrutement des professionnels et les tendances à la sélection des bénévoles ainsi que la formulation d’objectifs en vue de leur qualification. Dans un contexte d’éducation populaire (par exemple dans les centres sociaux) favorisant la transmission des savoirs et des expériences dans un objectif de construction partagée, quelles places occupent la formation et la professionnalisation des bénévoles ?
Prediction of Maximal Surface Electromyographically Based Voluntary Contractions of Erector Spinae Muscles From Sonographic Measurements During Isometric Contractions
Authors: Cuesta-Vargas Antonio I. , González-Sánchez Manuel 
Published: February 2014

ObjectivesCurrently, there are no studies combining electromyography (EMG) and sonography to estimate the absolute and relative strength values of erector spinae (ES) muscles in healthy individuals. The purpose of this study was to establish whether the maximum voluntary contraction (MVC) of the ES during isometric contractions could be predicted from the changes in surface EMG as well as in fiber pennation and thickness as measured by sonography.MethodsThirty healthy adults performed 3 isometric extensions at 45° from the vertical to calculate the MVC force. Contractions at 33% and 100% of the MVC force were then used during sonographic and EMG recordings. These measurements were used to observe the architecture and function of the muscles during contraction. Statistical analysis was performed using bivariate regression and regression equations.ResultsThe slope for each regression equation was statistically significant (P < .001) with R2 values of 0.837 and 0.986 for the right and left ES, respectively. The standard error estimate between the sonographic measurements and the regression‐estimated pennation angles for the right and left ES were 0.10 and 0.02, respectively.ConclusionsErector spinae muscle activation can be predicted from the changes in fiber pennation during isometric contractions at 33% and 100% of the MVC force. These findings could be essential for developing a regression equation that could estimate the level of muscle activation from changes in the muscle architecture.
Distribution Pattern of Sonographically Guided Iliopsoas Injections
Authors: Dauffenbach Jason , Pingree Matthew J. , Wisniewski Steve J. , Murthy Naveen , Smith Jay 
Published: February 2014

ObjectivesTo investigate the distribution pattern of sonographically guided iliopsoas (IP) injections in an unembalmed cadaveric model.MethodsA single experienced operator completed 10 sonographically guided IP injections in 5 unembalmed cadaveric pelvic specimens (4 male and 1 female; ages 55–95 years; body mass indices, 15.5–27.5 kg/m2) using a previously described in‐plane, lateral‐to‐medial approach short axis to the tendon. Each injection consisted of 7 mL of a 20% dilution of contrast material injected between the IP tendon and the acetabular rim using a 22‐gauge, 87.5‐mm (3½‐in) needle. To facilitate interpretation of contrast patterns, 2 additional injections were performed on single hips: sonographically guided 14 mL contrast‐latex IP injection and sonographically guided superficial IP “peritendinous” injection with 7 mL of contrast‐latex. Immediately before and after each injection, fluoroscopic images were obtained with a fixed C‐arm equipped with coned beam computed tomography. After each injection, radiographic images were evaluated by a board‐certified, fellowship‐trained musculoskeletal radiologist to determine injectate distribution. Specimens receiving contrast‐latex injections were dissected 48 hours after injection to determine the anatomic location of the injectate.ResultsNine of 10 IP injections (90%) produced characteristic “U‐shaped” flow patterns covering 50% to nearly 100% of the IP tendon circumference and resembling previously published IP bursograms. One injection was excluded because the majority of the latex was within the pectineus muscle, likely due to technical factors. Latex flowed an average of 5.3 cm (range, 0.3–7.9 cm) cephalad and 5.2 cm (range, 1.0–7.5 cm) caudad to the acetabular rim. The large‐volume (14‐mL) IP injection produced a similar flow pattern to the 7 mL injections, whereas the superficial peritendinous injection produced a contrast pattern consistent with intramuscular flow. Subsequent dissection confirmed bursal flow for the 14‐mL injection, whereas the superficial peritendinous injection placed latex within the superficial portion of the IP muscle (ie, intramuscular).ConclusionsSonographically guided IP injections using an in‐plane, lateral‐to‐medial technique place injectate into the IP bursa between the IP tendon and the acetabular rim. Within the limits of this cadaveric investigation, this sonographically guided 7‐mL IP “bursa” injection may provide a minimum of 50% circumferential IP tendon coverage and approximately 5 cm of cephalad and caudad flow. There does not appear to be a peritendinous space deep to the IP tendon at the acetabular rim that is both outside the bursa and amenable to sonographically guided injection. Injections into the superficial aspect of the IP using 7‐mL volumes may not deliver injectate deep to the IP tendon and therefore may represent a fundamentally different injection.
Simple and Complex Fibroadenomas
Authors: Pinto Joana , Aguiar Ana Teresa , Duarte Hálio , Vilaverde Filipa , Rodrigues Ângelo , Krug José Luís 
Published: February 2014

ObjectivesComplex fibroadenomas are fibroadenomas harboring 1 or more complex pathologic features: epithelial calcifications, apocrine metaplasia, sclerosing adenosis, and cysts larger than 3 mm. No sonographic features have been clearly defined for the distinction of simple fibroadenomas from complex ones, which are associated with an increased cancer risk. We aimed to evaluate the accuracy of sonographic features for the prediction of complexity in fibroadenomas.MethodsA total of 252 fibroadenomas were found at consecutive percutaneous needle or excisional surgical biopsy. Sixty‐three were excluded because their respective imaging examinations were not recorded on digital support and consequently were not available. According to histologic diagnoses, fibroadenomas (n = 189) were classified into simple (n = 159) and complex (n = 30). The size, number, and sonographic features were assessed, and their respective accuracy rates for prediction of complexity were analyzed.ResultsAll patients were women. Complex fibroadenomas presented more frequently as solitary nodules (n = 21 [70%]) and were significantly larger than simple fibroadenomas (1.9 versus 1.3 cm; P = .009). Image predictors of complexity were an irregular shape (P< .001), noncircumscribed contours (indistinct, angular, microlobulated, or spiculated; P < .001), a complex echo structure (P < .001), the presence of microcalcifications (P = .002), and posterior acoustic enhancement (P < .001). By logistic multivariate regression, a complex echo structure (odds ratio [OR], 9.5; 95% confidence interval [CI], 2.8–32.3), noncircumscribed contours (OR, 3.7; 95% CI, 1.1–12.8), and posterior acoustic enhancement (OR, 4.0; 95% CI, 1.1–14.6) were independent predictors of complexity. Receiver operating characteristic curve analysis showed that a complex echo structure was the most accurate sonographic finding for identification of complex fibroadenomas (area under the curve, 0.74).ConclusionsCertain sonographic features are associated with complex fibroadenomas and can help the radiologist decide which ones require biopsy.
Reproducibility of Renal Volume Measurement in Adults Using 3‐Dimensional Sonography
Authors: de Amorim Paiva Camila Caroline , de Mello Junior Carlos Fernando , Guimarães Filho Helio Antonio , de Brito Gomes Camila Albuquerque , Junior Lusimário Rodrigues Silva , Junior Gilberto Moura Brito , Paiva Cláudio Sérgio Medeiros 
Published: February 2014

ObjectivesThe purpose of this study was to determine the interobserver reproducibility of renal volume measurement performed by 3‐dimensional (3D) sonography.MethodsWe conducted an exploratory, quantitative, observational, and descriptive cross‐sectional study. We calculated ranges, means, and standard deviations of the renal volumes obtained with 3D sonography by 2 different examiners from a sample of 30 patients. The interobserver reproducibility was assessed by calculating intraclass correlation coefficients (ICCs) and by construction of Bland‐Altman plots.ResultsThe ICC between the right 3D renal volumes obtained by examiners 1 and 2 was 0.8552 (95% confidence interval, 0.7153–0.9292), showing excellent reproducibility (P < .0001). For the left 3D renal volumes obtained by examiners 1 and 2, the ICC was 0.6411 (95% confidence interval, 0.3652–0.8135), showing average to good reproducibility (P = .0001). The Bland‐Altman plots showed mean differences ± SD of −4.8% ± 23.9% between the right renal volumes obtained by examiners 1 and 2 and −2.2% ± 38% between the left renal volumes. The 95% limits of agreement between the right renal volumes obtained by examiners 1 and 2 were −28.7% to 19%, whereas those between the left renal volumes were −40.2% to 35.7%.ConclusionsThree‐dimensional sonography showed good interobserver reproducibility, which was better for the right kidney. It appears necessary to establish standardized techniques for acquisition of sonographic renal volumes.
Shear Wave Elastography for Liver Stiffness Measurement in Clinical Sonographic Examinations
Authors: Yoon Jeong Hee , Lee Jeong Min , Han Joon Koo , Cho Byung Ihn 
Published: February 2014

ObjectivesThe purpose of this study was to determine the optimal minimum number of liver stiffness measurements on shear wave elastography (SWE) and to evaluate the frequency of technical failures and unreliable stiffness measurements and the intraobserver reproducibility of SWE.MethodsThis retrospective study was approved by our Institutional Review Board, and informed consent was waived. From August 2011 to January 2013, 540 patients underwent abdominal sonography, including SWE. In 86 patients (group 1), the minimum number of examinations was determined by comparing the intraclass correlation coefficient (ICC) of subsets of the first 2 to 14 measurements with that from 15 measurements. In 454 patients (group 2), 2 SWE sessions were performed in the right lobe within 1 day. Technical failure was defined as when no or little signal was obtained in the elastogram during the first 5 acquisitions; unreliable SWE results were defined as when the interquartile range/median liver stiffness value exceeded 30%. Intraobserver reproducibility was assessed using ICCs and Bland‐Altman plots.ResultsIn group 1, the ICCs did not significantly increase after the first 6 measurements. In group 2, there were technical failures and unreliable results in 47 patients (10.35%) and 74 patients (16.29%), respectively. In 407 patients, after excluding technical failures, there was no significant difference in the median liver stiffness values between the 2 sessions (6.95 versus 6.86 kPa; P > .05). The overall intraobserver reproducibility was excellent (ICC, 0.95).ConclusionsIn this study, the optimal minimum number of SWE measurements was 6, and SWE using 6 measurements showed excellent intraobserver reproducibility.
Three‐Dimensional Sonographic Assessment of Placental Volume and Vascularization in Pregnancies Complicated by Hypertensive Disorders
Authors: de Almeida Pimenta Eduardo Jorge , Silva de Paula Carla Fagundes , Duarte Bonini Campos Juliana Alvares , Fox Karin Anneliese , Francisco Rossana , Ruano Rodrigo , Zugaib Marcelo 
Published: February 2014

ObjectivesThe purpose of this study was to evaluate the association between placental volumes, placental vascularity, and hypertensive disorders in pregnancy.MethodsA prospective case‐control study was conducted between April 2011 and July 2012. Placental volumes and vascularity were evaluated by 3‐dimensional sonographic, 3‐dimensional power Doppler histographic, and 2‐dimensional color Doppler studies. Pregnant women were classified as normotensive or hypertensive and stratified by the nature of their hypertensive disorders. The following variables were evaluated: observed‐to‐expected placental volume ratio, placental volume‐to‐estimated fetal weight ratio, placental vascular indices, and pulsatility indices of the right and left uterine and umbilical arteries.ResultsSixty‐six healthy pregnant women and 62 pregnant women with hypertensive disorders were evaluated (matched by maternal age, gestational age at sonography, and parity). Placental volumes were not reduced in pregnancy in women with hypertensive disorders (P > .05). Conversely, reduced placental vascularization indices (vascularization index and vascularization‐flow index) were observed in pregnancies complicated by hypertensive disorders (P < .01; P < .01), especially in patients with superimposed preeclampsia (P = .04; P = .02). A weak correlation was observed between placental volumes, placental vascular indices, and Doppler studies of the uterine and umbilical arteries.ConclusionsPregnancies complicated by hypertensive disorders are associated with reduced placental vascularity but not with reduced placental volumes. These findings are independent of changes in uterine artery Doppler studies. Future studies of the prediction of preeclampsia may focus on placental vascularity in combination with results of Doppler studies of the uterine arteries.
Real‐time Ultrasound Elastography for Differentiation of Benign and Malignant Thyroid Nodules
Authors: Sun Jiasi , Cai Jingyu , Wang Xuemei 
Published: February 2014

ObjectivesThe clinical challenge of managing thyroid nodules nowadays is to diagnose the minority of malignant disease. Real‐time ultrasound elastography, which can measure tissue elasticity, is used as a complement to conventional sonography for improving the diagnosis of thyroid tumors. There are 2 common criteria for evaluating an elastogram: the elasticity score and strain ratio. This meta‐analysis was performed to expand on a previous meta‐analysis to assess the diagnostic power of ultrasound elastography in differentiating benign and malignant thyroid nodules for elasticity score and strain ratio assessment.MethodsThe MEDLINE, EMBASE, PubMed, and Cochrane Library databases up to January 31, 2013, were searched. The pooled sensitivity, specificity, and summary receiver operating characteristic curve were obtained from individual studies with a random‐effects model. The extent and sources of heterogeneity were explored.ResultsA total of 5481 nodules in 4468 patients for elasticity score studies and 1063 nodules in 983 patients for strain ratio studies were analyzed. The overall mean sensitivity and specificity of ultrasound elastography for differentiation of thyroid nodules were 0.79 (95% confidence interval [CI], 0.77–0.81) and 0.77 (95% CI, 0.76–0.79) for elasticity score assessment and 0.85 (95% CI, 0.81–0.89) and 0.80 (95% CI, 0.77–0.83) for strain ratio assessment, respectively. The areas under the curve for the elasticity score and strain ratio were 0.8941 and 0.9285.ConclusionsThese results confirmed those obtained in the previous meta‐analysis. Ultrasound elastography has high sensitivity and specificity for identification of thyroid nodules. It is a promising tool for reducing unnecessary fine‐needle‐aspiration biopsy.