bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technological diversity management of medical device enterprises
Authors: Shimanuki Seiya , Saiki Tomoko 
Published: October 2012

PurposeThe purpose of this paper is to examine knowledge creation and technological diversity management by medical device manufacturers, to identify strategic directions for innovation in the medical device field.Design/methodology/approachThis paper uses two types of data to assess the importance of multiple technologies and technological diversity in product development: patent applications and approvals of medical devices for sale and use in medical treatment. Additional perspective is provided by the results of a survey of management styles.FindingsWhile knowledge‐creating innovation frequently combines multiple technologies, the scope of technological diversity, the variety of types of technology combined may be wider in low‐risk than in high‐risk innovation.Research limitations/implicationsThe sample size is too small to justify claims of statistical significance. This research should be extended to incorporate more cases and explore the theme in greater depth.Practical implicationsCompanies that choose a high‐risk strategy are likely to be more focused on related multiple technologies with which their researchers are already familiar. Conversely, companies that choose a low‐risk strategy may have more room to experiment since, if something goes wrong, the risk to patient health is lower. Innovative medical device enterprise to seek high‐risk device development is proposed to manage optimal diversity for it.Originality/valueThis paper analyses two case studies relevant to growing interest in technological diversity and knowledge management in knowledge‐driven innovation in the medical device industry in Japan.
Systemic contact dermatitis to corticosteroids
Authors: Baeck M. , Goossens A. 
Published: October 2012

AbstractBackgroundAlthough unexpected and paradoxical, allergic hypersensitivity to corticosteroids is a common finding, delayed‐type reactions being much more frequently encountered than the immediate‐type ones. Although the skin is the main sensitization and elicitation route, other routes, amongst them systemic administration of corticosteroids may exceptionally be involved.ObjectiveTo determine the frequency, clinical presentation and cross‐reactivity patterns for allergic reactions following systemic administration of corticosteroids amongst patients with identified and investigated ‘contact allergy’ to corticosteroids.MethodsWe reviewed clinical data, patch test results and sensitization sources in patients who reacted positively to corticosteroids tested in the K.U. Leuven Dermatology department during an 18‐year period.ResultsSixteen subjects (out of 315 with CS delayed‐type hypersensitivity) presented with allergic manifestations due to systemic administration of corticosteroids. Most patients reacted to molecules from the three groups of the recently reappraised classification.ConclusionThe reactions observed seem to be in most cases ‘systemic contact dermatitis’ due to oral or parenteral re‐exposure of sensitized individuals with the respective corticosteroids previously applied topically. Moreover, most patients seem to be able to react to any corticosteroid molecules and therefore need a systematic individualized evaluation of their sensitization/tolerance profile.
The appropriate cone depth to avoid endocervical margin involvement is dependent on age and disease severity
Authors: BAE HYO SOOK , CHUNG YE WON , KIM TAK , LEE KYU WAN , SONG JAE YUN 
Published: October 2012

AbstractObjective. To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut‐off points to define appropriate cone depth. Main outcome measures. Cone depth to avoid endecervical margin involvement. Results. Ninety‐one women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut‐off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut‐off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut‐off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut‐off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002). Conclusions. Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity.
Diet‐dependent modulation of hippocampal expression of endocannabinoid signaling‐related proteins in cannabinoid antagonist‐treated obese rats
Authors: Rivera Patricia , Luque‐Rojas María Jesús , Pastor Antoni , Blanco Eduardo , Pavón Francisco J. , Serrano Antonia , Crespillo Ana , Vida Margarita , Grondona Jesús M. , Cifuentes Manuel , Bermúdez‐Silva Francisco J. , de la Torre Rafael , de Fonseca Fernando Rodríguez , Suárez Juan 
Published: October 2012

AbstractDiet‐induced obesity produces changes in endocannabinoid signaling (ECS), influencing the regulation of energy homeostasis. Recently, we demonstrated that, in high‐fat‐diet‐fed rats, blockade of CB1 receptor by AM251 not only reduced body weight but also increased adult neurogenesis in the hippocampus, suggesting an influence of diet on hippocampal cannabinoid function. To further explore the role of hippocampal ECS in high‐fat‐diet‐induced obesity, we investigated whether the immunohistochemical expression of the enzymes that produce (diacylglycerol lipase alpha and N‐acyl phosphatidylethanolamine phospholipase D) and degrade (monoacylglycerol lipase and fatty acid amino hydrolase) endocannabinoids may be altered in the hippocampus of AM251 (3 mg/kg)‐treated rats fed three different diets: standard diet (normal chow), high‐carbohydrate diet (70% carbohydrate) and high‐fat diet (60% fat). Results indicated that AM251 reduced caloric intake and body weight gain, and induced a modulation of the expression of ECS‐related proteins in the hippocampus of animals exposed to hypercaloric diets. These effects were differentially restricted to either the 2‐arachinodoyl glycerol or anandamide signaling pathways, in a diet‐dependent manner. AM251‐treated rats fed the high‐carbohydrate diet showed a reduction of the diacylglycerol lipase alpha : monoacylglycerol lipase ratio, whereas AM251‐treated rats fed the high‐fat diet showed a decrease of the N‐acyl phosphatidylethanolamine phospholipase D : fatty acid amino hydrolase ratio. These results are consistent with the reduced levels of hippocampal endocannabinoids found after food restriction. Regarding the CB1 expression, AM251 induced specific changes focused in the CA1 stratum pyramidale of high‐fat‐diet‐fed rats. These findings indicated that the cannabinoid antagonist AM251 modulates ECS‐related proteins in the rat hippocampus in a diet‐specific manner. Overall, these results suggest that the hippocampal ECS participates in the physiological adaptations to different caloric diets.
Time‐shift experiments and patterns of adaptation across time and space
Authors: Blanquart François , Gandon Sylvain 
Published: October 2012

AbstractTime‐shift experiments provide measures of the mean fitness of a population in environments of different points in time. Here, we show how to use this type of data to decompose mean fitness into (1) the effect of the environment in which the population is transplanted, (2) the effect of the genetic composition of the population and (3) ‘temporal adaptation’, which measures how the population fits the environment at that time. We derive analytical results for the pattern of ‘temporal adaptation’ and show that it is in general maximal in the recent past. The link between ‘temporal adaptation’ and ‘local adaptation’ is discussed, and we show when patterns of adaptation in time and space are expected to be similar. Finally, we illustrate the potential use of this approach using a data set measuring the adaptation of HIV to the immune response of several recently infected patients.
Climate change reduces offspring fitness in littoral spawners: a study integrating organismic response and long‐term time‐series
Authors: Bartolini Fabrizio , Barausse Alberto , Pörtner Hans‐Otto , Giomi Folco 
Published: October 2012

AbstractIntegrating long‐term ecological observations with experimental findings on species response and tolerance to environmental stress supports an understanding of climate effects on population dynamics. Here, we combine the two approaches, laboratory experiments and analysis of multi‐decadal time‐series, to understand the consequences of climate anomalies and ongoing change for the population dynamics of a eurythermal littoral species,Carcinus aestuarii. For the generation of cause and effect hypotheses we investigated the thermal response of crab embryos at four developmental stages. We first measured metabolic rate variations in embryos following acute warming (16–24 °C) and after incubation at 20 and 24 °C for limited periods. All experiments consistently revealed differential thermal responses depending on the developmental stage. Temperature‐induced changes in metabolic activity of early embryonic stages of blastula and gastrula suggested the onset of abnormal development. In contrast, later developmental stages, characterized by tissue and organ differentiation, were marginally affected by temperature anomalies, indicating enhanced resilience to thermal stress. Then, we extended these findings to a larger, population scale, by analyzing a time‐series ofC. aestuariilandings in the Venice lagoon from 1945 to 2010 (ripe crabs were recorded separately) in relation to temperature. Landings and extreme climatic events showed marked long‐term and short‐term variations. We found negative relationships between landings and thermal stress indices on both timescales, with time lags consistent with an impact on crab early life stages. When quantitatively evaluating the influence of thermal stress on population dynamics, we found that it has a comparable effect to that of the biomass of spawners. This work provides strong evidence that physiological responses to climatic anomalies translate into population‐level changes and that apparently tolerant species may be impacted before the ontogeny of eurythermy. These ontogenetic bottlenecks markedly shape population dynamics and require study to assess the effects of global change.
Influence of tip wear of piezoelectric ultrasonic scalers on root surface roughness at different working parameters. A profilometric and atomic force microscopy study
Authors: Arabaci T , Cicek Y , Dilsiz A , Erdogan İY , Kose O , Kizildağ A 
Published: October 2012

AbstractRoughness on tooth surfaces is reported to facilitate the reestablishment of microbial dental plaque. Hence, the main goal of dental scaling is to remove bacterial plaque and obtain smoother tooth surfaces. This study was aimed to assess the influence of tip wear of ultrasonic scaler inserts on root surface roughness at different working parameters. Twenty piezoelectric ultrasonic scaler inserts (10 worn/10 new) were selected to examine the erosion ratio (ER) on the scaler tips and to assess the influence of tip wear on root surface roughness. Erosion on the tip surfaces was evaluated under atomic force microscopy (AFM). Root samples were prepared and instrumented by new (Group I) and worn (Group II) inserts at different working parameters. Roughness change (Rc) on root surfaces after instrumentation was examined under profilometer and compared between and within the groups. Statistically significant differences were found between the mean ERs of new and worn tips (P < 0.01). The results of this study showed that tip angulation and instrument power strongly influenced the Rc values on instrumented samples (P < 0.05). It was also revealed that tip wear influenced the Rc values on root surfaces especially at 45° tip angulation (P < 0.05). Therefore, tip wear should also be considered as much as the other parameters to minimize the surface roughness during ultrasonic treatment.
Erythrocyte and reticulocyte indices in the assessment of erythropoiesis activity and iron availability
Authors: Urrechaga E. , Borque L. , Escanero J. F. 
Published: October 2012

SummaryIntroductionConsequence of the imbalance between the erythroid marrow iron requirements and the actual supply is a reduction in red cell hemoglobin content, which causes hypochromic mature red cells and reticulocytes. Sysmex XE 5000 analyzer (Sysmex Corporation, Kobe, Japan) reports reticulocyte hemoglobin equivalent (Ret‐He) and the percentages of erythrocyte subsets, including the hypochromic fraction (%Hypo‐He). We study the value of these parameters of hemoglobinization in the evaluation of erythropoiesis and iron availability.MethodsNinety healthy subjects, 85 patients with chronic kidney disease (CKD) and 65 patients on dialysis (HD) receiving therapy and 91 patients with iron deficiency (IDA) were analyzed. Pearson's correlation, t‐test for independent, and receiver operating characteristic (ROC) curve analysis were utilized.ResultsThe results in the IDA group reflected the state of iron depletion (low ferritin), low iron availability (low MCH and high percentage of hypochromic red cells (%Hypo‐He)), and iron‐restricted erythropoiesis (low Ret‐He). In the HD and CKD, the reticulocyte percentage showed the increased erythropoiesis, maintained due to treatment (Ret‐He over 30 pg) and good iron availability, MCH within reference range and %Hypo‐He slightly increased. The results of ROC curves analysis for the diagnosis of iron deficiency (gold standard sTfR > 21 nm) were as follows: Ret‐He area under curve (AUC) 0.935 cutoff 29.8 pg, sensitivity 90.7%, specificity 83.1%. % Hypo‐He AUC 0.925 cutoff 3.5%, sensitivity 87.3%, specificity 88.0%.ConclusionsPercentage of hypochromic red cells and Ret‐He provide information about individual cell characteristics, so the hypochromic cells are detected and quantitated improving the evaluation of erythropoiesis and iron status.
Double balloon enteroscopy can be safely done in elderly patients with significant co‐morbidities
Authors: Byeon Jeong‐Sik , Mann Neel K. , Jamil Laith H. , Lo Simon K. 
Published: October 2012

AbstractBackground and AimPerformance of double balloon enteroscopy (DBE) on older patients with comorbidities is a matter of safety. We aimed to investigate the utility and safety of DBE in older patients.MethodsWe retrospectively reviewed the medical records of patients 75 years or older who underwent DBE in our open‐access endoscopy unit in a tertiary center. We analyzed the diagnostic yield, therapeutic intervention, and safety including complications of DBE.ResultsFour scheduled DBEs were canceled because of poor conditions. Two hundred and fourteen DBEs were performed in 167 elderly patients. All DBEs were performed under monitored anesthesia care using intravenous propofol administered by anesthesiologists. One half of the patients were male (female : male = 80:87). The mean age of patients was 80.1 ± 3.7 years. Co‐morbidity of significant chronic diseases was noted in 208 (97.2%) DBEs. Fifty‐one (23.8%) DBEs were performed in patients with American Society of Anesthesiologists (ASA) physical status II, 151 (70.6%) DBEs with ASA class III, and 12 (5.6%) DBEs with ASA class IV. The most common indication was obscure gastrointestinal bleeding. The mean DBE procedure time was 131 ± 51 min. Abnormalities were detected in 129 (60.3%) DBEs with therapeutic interventions performed in 83 (38.8%) cases. Pancreatitis, hypoxia, and aspiration pneumonia developed after three (1.4%), three (1.4%), and two (0.9%) DBEs, respectively, all of which resolved with conservative care.ConclusionsDouble balloon enteroscopy can be done with acceptable safety in the elderly with high ASA class. DBE shows a high diagnostic yield and can deliver many therapeutic applications.
Identification of a high risk gastric cancer group using serum pepsinogen after successful eradication of Helicobacter pylori
Authors: Haneda Masahira , Kato Mototsugu , Ishigaki Saori , Suzuki Mio , Takahashi Masakazu , Nakagawa Manabu , Ono Shouko , Mori Yasuaki , Mabe Katsuhiro , Nakagawa Shouichi , Kudo Takahiko , Shimizu Yuichi , Asaka Masahiko 
Published: October 2012

AbstractBackground and AimPepsinogen (PG) method is widely used to identify high risk groups of gastric cancer. It is very useful before Helicobacter pylori eradication, but after eradication the method becomes useless because the PGI, PGII, PGI/II ratios change. Therefore, we aimed to identify a high risk group for gastric cancer using serum pepsinogen after successful eradication of H. pylori.MethodsA total of 261 participants were enrolled after successful eradication of H. pylori in Hokkaido University Hospital from 1995 to 2010. Participants with renal failure, taking proton pump inhibitors, and those with advanced gastric cancer were excluded. Serum levels of PGI and II were measured using chemiluminescent immunoassay method.ResultsReceiver operating characteristic curves using cancerous and non‐cancerous data in post‐eradication determined the optimal cut‐off value of PGI/II as 4.5. The sensitivity and the specificity were 65.9% and 79.3%, respectively. The usual PG method includes 48.9% of cancer cases, and the PGI/II ≤ 4.5 in post‐eradication includes 65.9% of them, and it includes approximately half of the high risk group of diffuse type cancer. PGI/II ≤ 4.5 in post‐eradication included many gastric cancer cases detected after eradication (12/16 = 75%).ConclusionIn the identification of a high risk group for gastric cancer, we suggest that the optimal cut‐off value of PGI/II after successful eradication of H. pylori is 4.5. PGI/II ≤ 4.5 in post‐eradication includes more gastric cancer cases compared with the traditional PG method, and 75% of gastric cancer cases detected after eradication.
Alternative investigations for irritable bowel syndrome
Authors: Philpott Hamish , Nandurkar Sanjay , Lubel John , Gibson Peter R 
Published: October 2012

AbstractBackground and AimAlternative and complementary medical practitioners have long advocated alternative treatments for irritable bowel syndrome. A more recent development has been the use of alternative investigations by these practitioners and, in the era of internet advertising, directly by patients themselves. The aim of the present study was to examine the alternative investigations that are advocated for the assessment of gastrointestinal disease and that are available through mainstream laboratories in Australia.MethodsA comprehensive literature review was undertaken for each investigation, which was then evaluated on the basis of ACCE criteria for diagnostic tests. The ACCE criteria consider the analytical and clinical validity, clinical utility and ethical implications of the test.ResultsSerum immunoglobulin G (IgG) to food antigens, salivary IgA, intestinal permeability, fecal short‐chain fatty acids and fecal microbial analysis were identified as readily available. None of the investigations satisfied the ACCE criteria. The tests were deficient in one or more areas of analytical validity, clinical application, validity and ethical usage standards.ConclusionAlternative investigations lack reliability and direct clinical applications, and should not be recommended for the investigation of gastrointestinal symptoms.
Clinical features of autoimmune hepatitis and comparison of two diagnostic criteria in Korea: A nationwide, multicenter study
Authors: Kim Bo Hyun , Kim Yoon Jun , Jeong Sook‐Hyang , Tak Won Young , Ahn Sang Hoon , Lee Youn Jae , Jung Eun Uk , Lee Jung Il , Yeon Jong Eun , Hwang Jae Seok , Um Soon Ho , Seo Yeon Seok , Kim Young Seok , Song Byung Cheol , Kim Ju Hyun , Jung Young Kul , Park Choong Kee , Kim Kyung‐Ah , Min Hyun Ju , Cho Eun Young , Lee Eom Seok , Kwon So Young , Chae Hee Bok , Kim Dong Joon , Shin Su Rin 
Published: October 2012

AbstractBackground and AimAs a rare liver disease, little is known about autoimmune hepatitis (AIH). This study investigated the clinical features and compared two diagnostic criteria of AIH in Korea.MethodsA nationwide, multicenter, retrospective analysis was done of data of adult patients diagnosed with AIH from January 2005 to December 2009.ResultsThe enrolled patients (n = 343; mean age, 52.8 years; range, 19–87 years; 12% male, 88% female) met diagnostic criteria of AIH according to the revised original criteria (n = 311) or the simplified criteria (n = 250). At diagnosis, 30.6% were asymptomatic, 22.7% were cirrhotic, and 4.3% displayed hepatic decompensation. The positive results for anti‐nuclear antibody, smooth muscle antibody, and anti‐liver/kidney microsomal antibody were 94.2%, 23.0%, and 2.9%, respectively. Definite AIH and probable AIH according to the revised original criteria were 24.8% and 65.3%, respectively, while those according to the simplified criteria were 34.4% and 38.5%, respectively. The diagnostic sensitivity and positive predictive value of simplified criteria in comparison with the revised original criteria were 69.9% and 86.4%, respectively. As an initial therapy, corticosteroid (37.7%) or corticosteroid with azathioprine (36.8%) was administered. Remission, incomplete response, and treatment failure were noted with 85.7%, 10.5%, and 3.9% of patients, respectively.ConclusionsAutoimmune hepatitis in Korea is mostly type I, showing a mean age of 53 years with comparable clinical features to other countries. The concordant rate of the two diagnostic criteria was rather low with modest sensitivity of the simplified criteria. Further studies on the validation of the diagnostic criteria are warranted.
Autoimmune pulmonary alveolar proteinosis: Treatment options in year 2013
Authors: LETH STEFFEN , BENDSTRUP ELISABETH , VESTERGAARD HANNE , HILBERG OLE 
Published: October 2012

ABSTRACTPulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by accumulation of a periodic acid Schiff (PAS)‐positive eosinophilic material in the distal airways. For decades, the standard treatment of PAP has been whole lung lavage (WLL), where large quantities of saline are instilled into the lungs to remove the proteinaceous material. However, not all patients respond to this treatment. Thus, new treatment modalities, such as subcutaneous or inhaled granulocyte macrophage colony‐stimulating factor (GM‐CSF), and the CD20 antibody rituximab and plasmapheresis, have been investigated. Based on the current literature, a stepwise treatment plan is suggested starting with WLL, continuing to inhaled GM‐CSF, and then to rituximab if the former treatment regimes are unsuccessful.