bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-polysomnographic assessment using the Pittsburgh Sleep Quality Index questionnaire is not useful in identifying people at higher risk for obstructive sleep apnea
Authors: Scarlata Simone , Pedone Claudio , Curcio Giuseppe , Cortese Livio , Chiurco Domenica , Fontana Davide , Calabrese Mariangela , Fusiello Riccardina , Abbruzzese Gloria , Santangelo Simona , Zito Anna , Incalzi Raffaele Antonelli 
Published: October 2013

Background Polysomnography remains the diagnostic gold standard for obstructive sleep apnea syndrome (OSAS), but it is time consuming and requires dedicated personnel and setting. It may be more useful to plan a polysomnogram based on a preliminary screening. Objective To verify whether a questionnaire of general quality of sleep, the Pittsburgh Sleep Quality Index (PSQI), could outperform a dedicated questionnaire (Epworth Sleep Scale: ESS) in targeting OSAS patients in an at risk population. Methods 254 consecutive subjects attending the outpatient clinic for respiratory diseases were clinically evaluated for sleep apnea and referred to a 12 channel night-time polysomnography. All patients were administered the ESS and the PSQI before the procedure. The correlation between the Apnoea/Hypopnoea Index (AHI) and the global score of the PSQI was calculated; Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), Diagnostic accuracy and the area under the receiver operating characteristic curve (AUC) were calculated. ESS performance was used as a control reference. Results The mean age was 65.8 (standard deviation: 12.1) and the study group was 68.4% male. The mean BMI was 38.5; SD 7.7. Prevalence of OSAS in the study population was 55.5%; OSAS was severe in 60.5% of OSAS patients. ESS was significantly, but weakly, correlated with the AHI (AHI vs ESS: R = 0.308; p < 0.001), whereas PSQI was not (R = 0.037; p = 0.581). Both PSQI and ESS, however, performed unsatisfactorily: sensitivity 37.8% and 69.7%; Specificity 76.1% and 31.0%; Diagnostic Accuracy 57.5% and 49.8%; PPV 60% and 48.7%; NPV 56.3% and 52.2%; AUC 0.589 and 0.509, respectively. Conclusions The PSQI score is not helpful in the pre-polysomnographic assessment of people with suspected OSAS. Further studies are required to provide reliable pre-clinical instruments targeting patients amenable to polysomnography.
Arthroscopic Treatment of Ankle Anterior Bony Impingement
Authors: Parma Alessandro , Buda Roberto , Vannini Francesca , Ruffilli Alberto , Cavallo Marco , Ferruzzi Alberto , Giannini Sandro 
Published: October 2013

Background: Arthroscopic treatment of anterior ankle bony impingement provides good results, with a tendency to decrease over time. The purpose of this study was to analyze the factors affecting long-term results. Methods: Eighty consecutive patients with a mean age of 37.3 years were treated between 2000 and 2004. Impingement lesions were identified according to Scranton-McDermott classification. Preoperative ankle osteoarthritis was documented by van Dijk scale upon the x-rays. Bone spurs were analyzed and classified according to location and size. The associated chondral lesions were classified following the International Cartilage Repair Society (ICRS) criteria. Patient data, foot morphology, and previous traumas were recorded. Patients were evaluated after a mean of 104.6 months follow-up with the American Orthopaedic Foot and Ankle Society (AOFAS) scale. The influence of different factors on outcomes was statistically analyzed. Results: The mean preoperative AOFAS score was 50.9, while at follow-up it was 70.7 ( P < .05). The different grades of Scranton-McDermott impingement classification did not affect the results, but the different grades of van Dijk scale significantly affected the result but not the preoperative stage. Tibial localized spurs had better outcome at follow-up. The grade of the chondral lesions significantly affected the outcome. Other factors negatively affecting the results were age, cavus foot morphology, and history of previous ankle fracture. Conclusion: Arthroscopic treatment provides overall good results, but the long-term presence of associated conditions such as chondral lesions, advanced age, and previous trauma are relevant as prognostic factors. Based on these results, a new classification for bony impingement syndrome system is proposed. Level of Evidence: Level IV, case series.
A novel porcine reproductive and respiratory syndrome virus vector system that stably expresses enhanced green fluorescent protein as a separate transcription unit
Authors: Wang Chengbao , Huang Baicheng , Kong Ning , Li Qiongyi , Ma Yuping , Li Zhijun , Gao Jiming , Zhang Chong , Wang Xiangpeng , Liang Chao , Dang Lu , Xiao Shuqi , Mu Yang , Zhao Qin , Sun Yani , Almazan Fernando , Enjuanes Luis , Zhou En-Min 
Published: October 2013

Abstract
Here we report the rescue of a recombinant porcine reproductive and respiratory syndrome virus (PRRSV) carrying an enhanced green fluorescent protein (EGFP) reporter gene as a separate transcription unit. A copy of the transcription regulatory sequence for ORF6 (TRS6) was inserted between the N protein and 3′-UTR to drive the transcription of the EGFP gene and yield a general purpose expression vector. Successful recovery of PRRSV was obtained using an RNA polymerase II promoter to drive transcription of the full-length virus genome, which was assembled in a bacterial artificial chromosome (BAC). The recombinant virus showed growth replication characteristics similar to those of the wild-type virus in the infected cells. In addition, the recombinant virus stably expressed EGFP for at least 10 passages. EGFP expression was detected at approximately 10 h post infection by live-cell imaging to follow the virus spread in real time and the infection of neighbouring cells occurred predominantly through cell-to-cell-contact. Finally, the recombinant virus generated was found to be an excellent tool for neutralising antibodies and antiviral compound screening. The newly established reverse genetics system for PRRSV could be a useful tool not only to monitor virus spread and screen for neutralising antibodies and antiviral compounds, but also for fundamental research on the biology of the virus.
Perindopril treatment promote left ventricle remodeling in patients with heart failure screened positive for autoantibodies against angiotensin II type 1 receptor
Authors: Du Qian , Wu Jinling , Wang Hua , Wang Xin , Xu Lin , Zhang Zhiyong , Liu Jiamei , Zhang Juan , Chen Jin , Hakonarson Hakon , Hu Aihua , Zhang Lin 
Published: October 2013

Abstract

Background
Autoantibodies specific to the angiotensin II type I receptor (anti-AT1-AR) have been implicated in the pathology of congestive heart failure (CHF). Anti-AT1-AR may be associated with left ventricular function in CHF patients treated with perindopril.

Methods
Synthetic angiotensin II type 1 receptor (AT1-R) peptides served as the target antigen. ELISA was used to screen the sera of 156 CHF patients, which were divided into positive and negative groups based on their anti-AT1-AR reactivity. Echocardiography and a 6-minute walk test were performed at baseline and after one year of perindopril therapy. The end-point events were compared over a 5-year follow-up.

Results
Final analysis covered 138 patients, including 82 positive and 56 negative. The frequency and geometric mean titre of anti-AT1-AR were significantly lower in the positive group after one year of treatment (all P < 0.01, from 100% to 73.2% and from 1:125.3 ± 1.0 to 1:69.2 ± 1.1). Of these, 22 patients showed no antibodies. Both groups showed improvement in left ventricular end-diastole, end-systolic dimensions, ejection fraction, and a 6-minute walk test by perindopril in combination with standard treatment regime for one year (all P < 0.01). However, the 82 patients positive for anti-AT1-AR showed more pronounced improvement than the 56 negative patients (all P < 0.05). However, after 5 years of follow-up, the rate of all causes and cardiovascular mortality attributable to any cause and the re-hospitalisation rate showed no significant differences between the two groups (all P > 0.05).

Conclusions
Perindopril treatment significantly decreased the frequency and geometric mean titre in patients positive for anti-AT1-AR, even to complete ablation. These patients showed greater improvement in left ventricular remodeling and heart function than negative that in patients after one year of perindopril treatment in combination with standard treatment, but no significant differences in endpoint events were observed in the following 5 years. Anti-AT1-AR might be a useful biomarker of over-activation of the renin-angiotensin-aldosterone system for clinical medication.
How confidence intervals become confusion intervals
Authors: McCormack James , Vandermeer Ben , Allan G Michael 
Published: October 2013

Abstract

Background
Controversies are common in medicine. Some arise when the conclusions of research publications directly contradict each other, creating uncertainty for frontline clinicians.

Discussion
In this paper, we review how researchers can look at very similar data yet have completely different conclusions based purely on an over-reliance of statistical significance and an unclear understanding of confidence intervals. The dogmatic adherence to statistical significant thresholds can lead authors to write dichotomized absolute conclusions while ignoring the broader interpretations of very consistent findings. We describe three examples of controversy around the potential benefit of a medication, a comparison between new medications, and a medication with a potential harm. The examples include the highest levels of evidence, both meta-analyses and randomized controlled trials. We will show how in each case the confidence intervals and point estimates were very similar. The only identifiable differences to account for the contrasting conclusions arise from the serendipitous finding of confidence intervals that either marginally cross or just fail to cross the line of statistical significance.

Summary
These opposing conclusions are false disagreements that create unnecessary clinical uncertainty. We provide helpful recommendations in approaching conflicting conclusions when they are associated with remarkably similar results.
High prevalence of type 2 diabetes among the urban middle class in Bangladesh
Authors: Saquib Nazmus , Khanam Masuma Akter , Saquib Juliann , Anand Shuchi , Chertow Glenn M , Barry Michele , Ahmed Tahmeed , Cullen Mark R 
Published: October 2013

Abstract

Background
The prevalence of type-2 diabetes and metabolic syndrome are increasing in the developing world; we assessed their prevalence among the urban middle class in Bangladesh.

Methods
In this cross-sectional survey (n = 402), we randomly selected consenting adults (≥ 30 years) from a middle-income neighborhood in Dhaka. We assessed demography, lifestyle, and health status, measured physical indices and blood pressure and obtained blood samples. We evaluated two primary outcomes: (1) type-2 diabetes (fasting blood glucose ≥ 7.0 mmol/L or hemoglobin A1C ≥ 6.5% (48 mmol/mol) or diabetes medication use) and (2) insulin resistance (type-2 diabetes or metabolic syndrome using International Diabetes Federation criteria).

Results
Mean age and Quételet’s (body mass) index were 49.4 ± 12.6 years and 27.0 ± 5.1 kg/m2; 83% were married, 41% had ≥12 years of education, 47% were employed, 47% had a family history of diabetes. Thirty-five percent had type-2 diabetes and 45% had metabolic syndrome. In multivariate models older age and family history of diabetes were significantly associated with type-2 diabetes. Older age, female sex, overweight or obese, high wealth index and positive family history of diabetes were significantly associated with insulin resistance. Participants with type-2 diabetes or insulin resistance had significantly poorer physical health only if they had associated cardiovascular disease.

Conclusions
The prevalence of type-2 diabetes and metabolic syndrome among the middle class in Dhaka is alarmingly high. Screening services should be implemented while researchers focus on strategies to lessen the incidence and morbidity associated with these conditions.
Niños Sanos, Familia Sana: Mexican immigrant study protocol for a multifaceted CBPR intervention to combat childhood obesity in two rural California towns
Authors: de la Torre Adela , Sadeghi Banafsheh , Green Richard D , Kaiser Lucia L , Flores Yvette G , Jackson Carlos F , Shaikh Ulfat , Whent Linda , Schaefer Sara E 
Published: October 2013

Abstract

Background
Overweight and obese children are likely to develop serious health problems. Among children in the U.S., Latino children are affected disproportionally by the obesity epidemic. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a five-year, multi-faceted intervention study to decrease the rate of BMI growth in Mexican origin children in California’s Central Valley. This paper describes the methodology applied to develop and launch the study.

Methods/Design
Investigators use a community-based participatory research approach to develop a quasi-experimental intervention consisting of four main components including nutrition, physical activity, economic and art-community engagement. Each component’s definition, method of delivery, data collection and evaluation are described. Strategies to maintain engagement of the comparison community are reported as well.

Discussion
We present a study methodology for an obesity prevention intervention in communities with unique environmental conditions due to rural and isolated location, limited infrastructure capacity and limited resources. This combined with numerous cultural considerations and an unstable population with limited exposure to researcher expectations necessitates reassessment and adaptation of recruitment strategies, intervention delivery and data collection methods. Trial registration # NCT01900613.

Trial registration

NCT01900613.
Evaluation of antihyperglycemic and antinociceptive activity of Xanthium indicum stem extract in Swiss albino mice
Authors: Haque Md Ezazul , Rahman Shahnaz , Rahmatullah Mohammed , Jahan Rownak 
Published: October 2013

Abstract

Background

Xanthium indicum stem is used in folk medicine of Bangladesh to control sugar in diabetic patients and to alleviate pain. The objective of the study was to evaluate antihyperglycemic and antinociceptive activity of methanolic extract of Xanthium indicum stems (XISE) in mice.

Methods
Antihyperglycemic activity was measured by oral glucose tolerance tests in glucose-loaded Swiss albino mice. Antinociceptive activity was determined by observed decreases in abdominal constrictions in acetic acid-induced gastric pain model in mice.

Results
The methanol extract of stems showed dose-dependent and statistically significant antihyperglycemic activity at doses of 50, 100, 200 and 400 mg per kg body weight (p values, respectively, < than 0.01, 0.01, 0.005, and 0.01). Highest reduction in blood glucose level (31.2%) was observed with the highest dose (400 mg) of the extract. A standard antihyperglycemic drug, glibenclamide, reduced blood glucose levels by 46.2%, when administered at a dose of 10 mg per kg body weight. In antinociceptive activity tests, the extract when administered at the afore-mentioned four doses, reduced the number of abdominal constrictions in mice, respectively, by 41.7, 50.0, 54.2, and 61.0%. In comparison, a standard antinociceptive drug, aspirin, when administered at a dose of 200 mg per kg body weight, reduced the number of abdominal constrictions by 37.5%.

Conclusion
The experimental results obtained in the present study validate the use of X. indicum stems in folk medicines of Bangladesh to lower blood sugar in diabetic patients and to alleviate pain.
Genomic testing to determine drug response: measuring preferences of the public and patients using Discrete Choice Experiment (DCE)
Authors: Najafzadeh Mehdi , Johnston Karissa M , Peacock Stuart J , Connors Joseph M , Marra Marco A , Lynd Larry D , Marra Carlo A 
Published: October 2013

Abstract

Background
The extent to which a genomic test will be used in practice is affected by factors such as ability of the test to correctly predict response to treatment (i.e. sensitivity and specificity of the test), invasiveness of the testing procedure, test cost, and the probability and severity of side effects associated with treatment.

Methods
Using discrete choice experimentation (DCE), we elicited preferences of the public (Sample 1, N = 533 and Sample 2, N = 525) and cancer patients (Sample 3, N = 38) for different attributes of a hypothetical genomic test for guiding cancer treatment. Samples 1 and 3 considered the test/treatment in the context of an aggressive curable cancer (scenario A) while the scenario for sample 2 was based on a non-aggressive incurable cancer (scenario B).

Results
In aggressive curable cancer (scenario A), everything else being equal, the odds ratio (OR) of choosing a test with 95% sensitivity was 1.41 (versus a test with 50% sensitivity) and willingness to pay (WTP) was $1331, on average, for this amount of improvement in test sensitivity. In this scenario, the OR of choosing a test with 95% specificity was 1.24 times that of a test with 50% specificity (WTP = $827). In non-aggressive incurable cancer (scenario B), the OR of choosing a test with 95% sensitivity was 1.65 (WTP = $1344), and the OR of choosing a test with 95% specificity was 1.50 (WTP = $1080). Reducing severity of treatment side effects from severe to mild was associated with large ORs in both scenarios (OR = 2.10 and 2.24 in scenario A and B, respectively). In contrast, patients had a very large preference for 95% sensitivity of the test (OR = 5.23).

Conclusion
The type and prognosis of cancer affected preferences for genomically-guided treatment. In aggressive curable cancer, individuals emphasized more on the sensitivity rather than the specificity of the test. In contrast, for a non-aggressive incurable cancer, individuals put similar emphasis on sensitivity and specificity of the test. While the public expressed strong preference toward lowering severity of side effects, improving sensitivity of the test had by far the largest influence on patients’ decision to use genomic testing.
The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial
Authors: McGowan Ciara A , Walsh Jennifer M , Byrne Jacinta , Curran Sinead , McAuliffe Fionnuala M 
Published: October 2013

Abstract

Background
Maternal diet is known to impact pregnancy outcome. Following a low glycemic index (GI) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake. We assessed the impact of a low GI dietary intervention on maternal GI, nutritional intake and gestational weight gain (GWG) during pregnancy. Compliance and acceptability of the low GI diet was also examined.

Method
Eight hundred women were randomised in early pregnancy to receive low GI and healthy eating dietary advice or to receive standard maternity care. The intervention group received dietary advice at a group education session before 22 weeks gestation. All women completed a 3 day food diary during each trimester of pregnancy. Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis.

Results
Maternal GI was significantly reduced in the intervention group at trimester 2 and 3. The numbers of women within the lowest quartile of GI increased from 37% in trimester 1 to 52% in trimester 3 (P < 0.001) among the intervention group. The intervention group had significantly lower energy intake (P < 0.05), higher protein (% TE) (P < 0.01) and higher dietary fibre intake (P < 0.01) post intervention. Consumption of food groups with known high GI values were significantly reduced among the intervention group. Women in the intervention low GI group were less likely to exceed the Institute of Medicine’s GWG goals.

Conclusion
A dietary intervention in early pregnancy had a positive influence on maternal GI, food and nutrient intakes and GWG. Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy.

Trial registration
Current Controlled Trials Registration Number: ISRCTN54392969.
Digital breast tomosynthesis image reconstruction using 2D and 3D total variation minimization
Authors: Ertas Metin , Yildirim Isa , Kamasak Mustafa , Akan Aydin 
Published: October 2013

Abstract

Background
Digital breast tomosynthesis (DBT) is an emerging imaging modality which produces three-dimensional radiographic images of breast. DBT reconstructs tomographic images from a limited view angle, thus data acquired from DBT is not sufficient enough to reconstruct an exact image. It was proven that a sparse image from a highly undersampled data can be reconstructed via compressed sensing (CS) techniques. This can be done by minimizing the l1 norm of the gradient of the image which can also be defined as total variation (TV) minimization. In tomosynthesis imaging problem, this idea was utilized by minimizing total variation of image reconstructed by algebraic reconstruction technique (ART). Previous studies have largely addressed 2-dimensional (2D) TV minimization and only few of them have mentioned 3-dimensional (3D) TV minimization. However, quantitative analysis of 2D and 3D TV minimization with ART in DBT imaging has not been studied.

Methods
In this paper two different DBT image reconstruction algorithms with total variation minimization have been developed and a comprehensive quantitative analysis of these two methods and ART has been carried out: The first method is ART + TV2D where TV is applied to each slice independently. The other method is ART + TV3D in which TV is applied by formulating the minimization problem 3D considering all slices.

Results
A 3D phantom which roughly simulates a breast tomosynthesis image was designed to evaluate the performance of the methods both quantitatively and qualitatively in the sense of visual assessment, structural similarity (SSIM), root means square error (RMSE) of a specific layer of interest (LOI) and total error values. Both methods show superior results in reducing out-of-focus slice blur compared to ART.

Conclusions
Computer simulations show that ART + TV3D method substantially enhances the reconstructed image with fewer artifacts and smaller error rates than the other two algorithms under the same configuration and parameters and it provides faster convergence rate.
Automatic Cryptosporidium and Giardia viability detection in treated water
Authors: Badsha Shahriar , Mokhtar Norrima , Arof Hamzah , Lim Yvonne Ai Lian , Mubin Marizan , Ibrahim Zuwairie 
Published: October 2013

Abstract
In the automatic detection of Cryptosporidium and Giardia (oo)cysts in water samples, low contrast and noise in the microscopic images can adversely affect the accuracy of the segmentation results. An improved partial differential equation (PDE) filtering that achieves a better trade-off between noise removal and edge preservation is introduced where the compass operator is utilized to attenuate noise while retaining edge information at the cytoplasm wall and around the nuclei of the (oo)cysts. Then the anatomically important information is separated from the unwanted background noise using the Otsu method to improve the detection accuracy. Once the (oo)cysts are located, a simple technique to classify the two types of protozoans using area, roundness metric and eccentricity is implemented. Finally, the number of nuclei in the cytoplasm of each (oo)cyst is counted to check the viability of individual parasite. The proposed system is tested on 40 microscopic images obtained from treated water samples, and it gives excellent detection and viability rates of 97% and 98%, respectively.