bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung transthoracic ultrasound elastography imaging and guided biopsies of subpleural cancer: a preliminary report
Authors: Sperandeo Marco , Trovato Francesca M , Dimitri Lucia , Catalano Daniela , Simeone Anna , Martines Giuseppe Fabio , Piscitelli Angela Pamela , Trovato Guglielmo M 
Published: June 2014

Background Despite the usefulness of elastography in assessing the stiffness/elasticity of tissues, and its proven diagnostic accuracy in thyroid, breast, and prostate cancers, among others, it is not yet applied in transthoracic ultrasound (TUS) scans to investigate lung nodules. Purpose To investigate the potential clinical utility of TUS elastography in diagnosing lung cancer proven by fine-needle aspiration biopsy (FNAB). Material and Methods TUS elastography was performed in 95 consecutive patients (71 men, 24 women; age, 62.84 ± 7.37 years) with lesions suspected of involving the chest wall or the pleura detected on chest X-ray or computed tomography (CT). Patients with pleural effusions were not enrolled, but were further evaluated by pleural fluid cytology. Patients were excluded from the study if a diagnosis had already been made based on sputum cytology and/or bronchoscopic histology (making TUS biopsy unnecessary) or if their lung lesions could not be visualized under standard US. Under FNAB, 34 consolidations were ascribed to pneumonia and 65 to cancer. Under TUS, tissue stiffness, detected using a convex multifrequency 2–8-mHz probe and a MyLab™Twice – ElaXto, was scored from 1 (greatest elasticity) to 5 (no elasticity). Subpleural solid masses (2–5 cm) were initially detected by TUS and subsequently assessed by FNAB. Results Histological diagnoses were: small cell lung cancer (4/61), adenocarcinoma (29/61), squamous cell carcinoma (SCC) (12/61), large cell lung carcinoma (12/61), and lymphomas (4/61). Patients’ age and mass sizes (3.06 ± 0.88 cm) were not significantly associated with any histological type. A significant lower elasticity of SCC (4.67 ± 0.492) was observed versus other types of lung cancer ( P < 0.005), and versus pneumonia (2.35 ± 0.48). Conclusion Since only squamous cell lung carcinoma displays the feature of significantly reduced elasticity, and since no clear-cut diagnostic key is yet available, the clinical usefulness of TUS elastography is currently limited with a view to characterizing tumors. Nevertheless, it does enable good non-invasive imaging of lung nodules, providing information on their stiffness, and can improve the accuracy and yield of FNAB.
Effective factors to raise diagnostic performance of breast MRI for diagnosing pathologic complete response in breast cancer patients after neoadjuvant chemotherapy
Authors: Choi Bo Bae , Kim Sung Hun 
Published: June 2014

Background Although MRI is a highly effective tool in evaluating residual disease after neoadjuvant chemotherapy (NAC), there are many reports of discordance between the response of MRI and pathology. To increase MR accuracy, additional methods, which reflect post-NAC changes, should be considered in diagnosis. Purpose To evaluate effective methods that raise the diagnostic performance of MRI for predicting pathologic complete response (pCR) in breast cancer after neoadjuvant chemotherapy (NAC). Material and Methods For 98 invasive breast carcinoma patients, chemotherapeutic response to MRI was evaluated for the following parameters: tumor size, tumor distribution pattern, kinetic curve analysis, and background parenchymal enhancement pattern (BPE). BPE was categorized as “minimal”, “mild”, “moderate”, or “marked”, according to the ACR BI-RADS criteria. Results After NAC, the mean size of tumors decreased by 40% in non-pCR and by 59% in pCR groups, respectively. The sensitivity, specificity, false positive rate and false negative rate of MRI were 96% (78/81), 53% (9/17), 47% (8/17), and 4% (3/81), respectively. At pre-NAC MRI, the most common kinetic curve was delayed washout pattern (68%, 67/98); however, at post-NAC MRI the persistent pattern (55%, 47/86). Grouped lesion was the most common tumor distribution pattern on pre-NAC MRI (28%, 27/98), while on post-NAC solitary mass (40%, 34/86). The most common BPE at pre- and post-NAC MRI was mild and minimal enhancement, respectively. Conclusion To improve the diagnostic accuracy of MRI, we should consider additional factors including: tumor distribution pattern, BPE, kinetic curve analysis, and tumor size.
Migraine and restless legs syndrome: A systematic review
Authors: Schürks Markus , Winter Anke , Berger Klaus , Kurth Tobias 
Published: June 2014

Background Restless legs syndrome (RLS) is increasingly being reported as a comorbidity of migraine. Methods We conducted a systematic review and meta-analysis of studies investigating RLS in headache/migraine and vice versa. We calculated the prevalence and 95% confidence intervals (CI) of RLS in headache/migraine, of headache/migraine in RLS and controls, and odds ratios (ORs) of the association between the conditions. We then determined pooled effect estimates for the associations. Results We identified 24 studies. RLS prevalence in migraine ranged from 8.7% to 39.0% with no apparent differences based on gender and aura status. Prevalence among controls was compatible with the literature. Migraine prevalence in RLS ranged from 15.1% to 62.6%. We did not pool prevalence data because of high unexplained heterogeneity. High heterogeneity with respect to the association between any migraine and RLS could be explained by study design. Pooled analyses showed substantially higher effect estimates in case-control studies (pooled OR = 4.19, 95% CI 3.07–5.71; I 2 = 0.0%) than in cohort studies (pooled OR = 1.22, 95% CI 1.14–1.30; I 2 = 0.0%). Conclusion Our results support the concept of RLS as an important comorbidity of migraine. However, the degree of association appears to be strongly determined by study design. Potential effects by gender and aura status and the role of RLS in other headache disorders remain unclear.
Religiousness and headache: Is there a relation? Results from a representative sample of adults living in a low-income community
Authors: Lucchetti Giancarlo , Lucchetti Alessandra LG , Peres Mario F Prieto 
Published: June 2014

Background The use of religious behaviors to alleviate the consequences of stressful life circumstances is a frequent strategy employed by pain sufferers. Specifically in the field of headache research, to date, few studies have assessed spiritual and religious beliefs. Objective The objective of this article is to investigate the relation between religiousness (organizational, non-organizational and intrinsic) and headache disorders in a representative sample of adults living in a low-income community. Methods This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 439 people, aged more than 18 years, randomly selected from a low-income community in Brazil. Four regression models were created to explain the relationships between religious involvement and headache, controlling for demographics, depression/anxiety and alcohol use and smoking. Results Of the 439 households contacted, at least one member from 383 (87.2%) households participated. We interviewed more women (74.4%) and more subjects aged 18–39 years. The mean age was 41.7 (SD 8.5) years. Bivariate analysis shows that high religious attendance, non-organizational religiousness and intrinsic religiousness were associated with presence of headache and presence of migraine. After the logistic regression models, only high non-organizational religiousness remained associated with presence of headache (odds ratio (OR): 1.22 (1.01–1.49)). All other religious variables were unrelated to the presence of headache and its types. Conclusion There is a modest relationship between high non-organizational religiousness and presence of headache. Headache sufferers may use coping strategies such as private religious behaviors to try to overcome suffering.
Outcomes of an Open Autologous Osteochondral Plug Graft for Capitellar Osteochondritis Dissecans
Authors: Maruyama Masahiro , Takahara Masatoshi , Harada Mikio , Satake Hiroshi , Takagi Michiaki 
Published: June 2014

Background: Autologous osteochondral plug grafts have been used for capitellar osteochondritis dissecans (OCD), and good clinical results have been described. However, little is known about the optimal timing of return to sports. Purpose: To investigate the clinical outcomes of open autologous osteochondral plug grafts for capitellar OCD and to address the timing of return to sports. Study Design: Case series; Level of evidence, 4. Methods: Thirty-three male patients with a mean age at the time of surgery of 13.6 years (range, 11-17 years) and with advanced lesions of capitellar OCD underwent a procedure using open autologous osteochondral plug grafts. All patients played baseball, and the lesion affected their throwing side. Thirteen lesions were arthroscopically classified as International Cartilage Repair Society (ICRS) OCD III and 20 lesions as ICRS OCD IV. The mean size of the lesions (sagittal × coronal) was 16 × 14 mm. One to 3 osteochondral plug grafts, with a mean diameter of 7 mm (range, 5-9 mm), were harvested from the lateral femoral condyle and transplanted to the defects. Patients were allowed to begin throwing after 3 months and to return to sports after 6 months. The mean follow-up was 28.4 months (range, 12-76 months), during which elbow pain, Timmerman and Andrews scores, return to sports, and radiographs were evaluated. Results: After surgery, 30 patients (91%) had no elbow pain, and 3 patients (9%) had occasional mild throwing pain. The mean total arc of elbow motion increased significantly from 116° to 133° ( P < .05). The mean Timmerman and Andrews score improved significantly from 143 to 190 ( P < .05). All except 2 patients returned to a competitive level at which they had previously played after a mean of 6.9 months (range, 6-14 months). One patient chose another sport, and another retired from baseball after high school graduation. All patients achieved graft incorporation, and there was no postoperative enlargement of osteophytes on radiographs. One patient had mild anterior knee pain at the donor site during exercise. The remaining patients had no knee pain. The mean Lysholm score was 99.8. Conclusion: The results of this study indicate that an open autologous osteochondral plug graft allows a return to the previous competitive level of throwing by a mean of 7 months postoperatively.
Minimally Invasive Reconstruction of the Lateral Ankle Ligaments Using Semitendinosus Autograft or Tendon Allograft
Authors: Xu Xiangyang , Hu Mu , Liu Jinhao , Zhu Yuan , Wang Bibo 
Published: June 2014

Background: The purpose of the study was to retrospectively compare the therapeutic effect between semitendinosus autograft and tendon allograft for lateral ankle ligaments reconstruction. Methods: From September 2006 to June 2011, 68 patients (41 males, 27 females) with chronic ankle instability underwent anatomical reconstruction of the lateral ligaments using semitendinosus autograft (autograft group, 32 patients) or tendon allograft (allograft group, 36 patients) via a minimally invasive approach. All patients were followed up for at least 12 months. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale score (AOFAS score) and stress tests were used to evaluate the clinical outcomes. Operation time, time to heal and complications were also recorded. Results: Compared with allograft group, the average operation time was significantly increased (85.5 ± 11.5 minutes vs 58.1 ± 10.2 minutes, P < .0001), but the mean time to heal was significantly shorter (11.2 ± 4.1 months vs 13.5 ± 5.2 months, P = .0458) in the autograft group. Although the mean AOFAS score was significantly increased at the final follow-up in the autograft group (95.1 ± 7.5 vs 62.3 ± 8.2, P = .0001) and allograft group (94.8 ± 5.5 vs 60.2 ± 8.4, P < .0001), no significant difference in AOFAS was found between these 2 groups. Similarly, there was no significant difference in talar tilt or shift between autograft and allograft groups. In addition, no patients complained of weakness or disability at the donor site in the autograft group, while incisional swelling was observed in 4 patients in the allograft group, which was resolved via dressing change, oral use of indomethacin or dexamethasone. Conclusion: Reconstruction of the lateral ankle ligaments using a semitendinosus tendon autograft and a minimally invasive approach was safe and effective for ankle instability with a relatively short time for healing and minimal donor site problems. Level of Evidence: Level III, comparative case series.
Toll-Like Receptor 4 Knockout Protects Against Isoproterenol-Induced Cardiac Fibrosis
Authors: Dong Rui-qing , Wang Ze-feng , Zhao Can , Gu Hai-rong , Hu Zhuo-wei , Xie Jing , Wu Yong-quan 
Published: June 2014

Background: Toll-like receptor 4 participates in the process of acute heart injury. The underlying mechanisms of its protection are multifactorial, but we hypothesized that toll-like receptor-mediated autophagy control plays a vital role. The purpose of this study was to clarify the effect of autophagy on cardiac fibrosis. Methods: Cardiac fibrosis was induced by subcutaneous isoproterenol (ISO) injection, and rapamycin was simultaneously administered orally for 14 days. Animal echocardiography was then used to evaluate the success of the cardiac fibrosis model, and the mice were killed after the echocardiography examination. Results: Toll-like receptor 4 knockout (TLR4 KO) mice had better heart function than did wild-type (WT) mice ( P < .05). Rapamycin treatment reduced the left ventricular ejection fraction to 23.5% ( P < .05), and the collagen volume fraction of the ISO and ISO plus rapamycin groups was 5.9% and 25.9%, respectively, in TLR4 KO mice. Compared with the WT mice, Beclin 1 and autophagy were downregulated in TLR4 KO mice ( P < .05); however, the ISO plus rapamycin group had higher autophagy activity than did the ISO group in TLR4 KO mice ( P < .05). Conclusions: Our results suggest that TLR4 KO-induced cardioprotection against ISO-induced cardiac fibrosis is associated with reduced autophagy induction. Cardiac fibroblast autophagy participates in its own activation. The moderate inhibition of autophagic activity may be a new strategy for treating cardiac fibrosis.
A non-participant observational study of health and social care waste disposal behaviour in the South West of England
Authors: Manzi Sean , Nichols Andrew , Richardson Janet 
Published: June 2014

Introduction The National Health Service in England has a large carbon footprint. Waste production and disposal contributes to this carbon footprint and costs the National Health Service England over £82 million per annum. This study builds on existing work regarding health care waste management in the United Kingdom where the potential for recycling has begun to be studied. The study focuses on a private hospital and social care organizations, and provides a more detailed study of the behaviour of individuals across a variety of waste management systems. Methods The study was an overt observational study at four health and social care sites in the South West of England. Systematic observations were made of the waste disposed of by employees in which the observer recorded: a description of the waste item; the bin into which the waste was placed; the type of employee who disposed of the waste; the material the waste comprised and the appropriateness of the disposal behaviour. Results The domestic waste bin was found to be most commonly used by employees to dispose of waste (51%), and the materials observed being disposed of most often were paper (26%), organic wastes (19%) and plastic (19%). There were significant differences between the four sites indicating that the activities performed at each site may have been influencing the waste being disposed of. Conclusion It was concluded that the transfer of waste from the domestic waste stream to the recycling waste stream should be a central focus for the design of new health and social care waste management systems. Employees will require guidance and training in identifying and classifying waste materials for recycling.
The influence of immersion in the L2 culture on perception of the L1 culture-specific emotion of tęsknota
Authors: Ożańska-Ponikwia Katarzyna 
Published: June 2014

Aims/objectives/purpose/ research questions: This study focuses on the relationship between the immersion in the L2 culture and changes in the perception of the L1 culture-specific emotion of tęsknota. It was designed to research the possible influence of such variables as immersion in the L2 culture, emotional intelligence (EI), frequency of the L1/L2 use and self-perceived L2 proficiency on the perception of emotion of tęsknota. Design/methodology/approach: Mixed methods were used in the present study. The qualitative method was used in order to elicit Polish culture-specific emotion of tęsknota by means of presenting the description of the given emotion in the participants’ L1 and L2. Three questionnaires (Personal background questionnaire; L1 and L2 use questionnaire, Trait Emotional Intelligence questionnaire) were used to gather sociobiographical and EI data. The quantitative method was used to gather sociobiographical and EI data. Data and analysis: Data from 97 Polish–English late bilinguals and Polish L2 users of English was analysed qualitatively and quantitatively. Findings/conclusions: Data analysis showed that clear linguistic differences in the perception of L1 culture-specific emotion of tęsknota emerged between Polish L2 users of English who had never been abroad and Polish–English bilinguals/L2 users who had lived in an English-speaking country, even if both groups were similar as far as age, gender, educational level, EI and self-perceived L2 proficiency is concerned. Originality: This is the first study to the best of our knowledge that researches possible changes in the perception of culture-specific Polish emotion of tęsknota among Polish–English bilinguals and Polish L2 users of English. Significance/implications: The present research shows that in the case of the participants of this study, proficiency in a foreign language might lead to the conceptual shift in the perception of L1 emotion only while accompanied by immersion/socialisation into L2 culture.
An Ambient Assisted Living Approach in Designing Domiciliary Services Combined With Innovative Technologies for Patients With Alzheimer’s Disease
Authors: Cavallo Filippo , Aquilano Michela , Arvati Marco 
Published: June 2014

Background: Alzheimer’s disease (AD) is one of the most disabling diseases to affect large numbers of elderly people worldwide. Because of the characteristics of this disease, patients with AD require daily assistance from service providers both in nursing homes and at home. Domiciliary assistance has been demonstrated to be cost effective and efficient in the first phase of the disease, helping to slow down the course of the illness, improve the quality of life and care, and extend independence for patients and caregivers. In this context, the aim of this work is to demonstrate the technical effectiveness and acceptability of an innovative domiciliary smart sensor system for providing domiciliary assistance to patients with AD which has been developed with an Ambient Assisted Living (AAL) approach. Methods: The design, development, testing, and evaluation of the innovative technological solution were performed by a multidisciplinary team. In all, 15 sociomedical operators and 14 patients with AD were directly involved in defining the end-users’ needs and requirements, identifying design principles with acceptability and usability features and evaluating the technological solutions before and after the real experimentation. Results: A modular technological system was produced to help caregivers continuously monitor the health status, safety, and daily activities of patients with AD. During the experimentation, the acceptability, utility, usability, and efficacy of this system were evaluated as quite positive. Conclusion: The experience described in this article demonstrated that AAL technologies are feasible and effective nowadays and can be actively used in assisting patients with AD in their homes. The extensive involvement of caregivers in the experimentation allowed to assess that there is, through the use of the technological system, a proven improvement in care performance and efficiency of care provision by both formal and informal caregivers and consequently an increase in the quality of life of patients, their relatives, and their caregivers.
Using physiologically-based pharmacokinetic-guided “body-on-a-chip” systems to predict mammalian response to drug and chemical exposure
Authors: Sung Jong Hwan , Srinivasan Balaji , Esch Mandy Brigitte , McLamb William T , Bernabini Catia , Shuler Michael L , Hickman James J 
Published: June 2014

The continued development of in vitro systems that accurately emulate human response to drugs or chemical agents will impact drug development, our understanding of chemical toxicity, and enhance our ability to respond to threats from chemical or biological agents. A promising technology is to build microscale replicas of humans that capture essential elements of physiology, pharmacology, and/or toxicology (microphysiological systems). Here, we review progress on systems for microscale models of mammalian systems that include two or more integrated cellular components. These systems are described as a “body-on-a-chip”, and utilize the concept of physiologically-based pharmacokinetic (PBPK) modeling in the design. These microscale systems can also be used as model systems to predict whole-body responses to drugs as well as study the mechanism of action of drugs using PBPK analysis. In this review, we provide examples of various approaches to construct such systems with a focus on their physiological usefulness and various approaches to measure responses (e.g. chemical, electrical, or mechanical force and cellular viability and morphology). While the goal is to predict human response, other mammalian cell types can be utilized with the same principle to predict animal response. These systems will be evaluated on their potential to be physiologically accurate, to provide effective and efficient platform for analytics with accessibility to a wide range of users, for ease of incorporation of analytics, functional for weeks to months, and the ability to replicate previously observed human responses.