bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life and Sexual Function of Patients Following Radical Hysterectomy and Vaginal Extension
Authors: Ye Shuang , Yang Jiaxin , Cao Dongyan , Zhu Lan , Lang Jinghe , Chuang Linus T. , Shen Keng 
Published: March 2014

Abstract

Introduction
Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function.

Aim
The aim of this study was to investigate whether vaginal extension can improve sexual function and quality of life and the problem of sexual dysfunction in early-stage cervical cancer survivors (CCSs) in China.

Methods
Case-control and questionnaire-based methods were employed. Thirty-one patients who had undergone vaginal extension following RH and 28 patients with matching factors after RH alone were enrolled in the study.

Main Outcome Measures
Both groups were assessed retrospectively by questionnaires at least 6 months after treatment. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module and the Sexual Function Vaginal Changes Questionnaire are validated measurements for disease- and treatment-specific issues.

Results
Vaginal length was 10.03 ± 1.26 cm and 5.92 ± 1.05 cm in study and control group, respectively (P&lt; 0.05). In the study group, 67.7% patients and 64.3% of control group resumed sexual activity at the time of interview, averaging 6 months between treatment and sexual activity. While difficulty emptying bladder, incomplete emptying, and constipation were the most commonly reported symptoms, no significant difference was observed regarding pelvic floor symptoms. Reduced vagina size and shortened vagina was significantly more prominent in the control group, whereas both group presented with hypoactive sexual desire (88.1%), orgasm dysfunction (71.8%), and low enjoyment or relaxation after sex (51.3%).

Conclusion
Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and should be paid more attention to the CCSs in China.
Efficacy of Omeprazole Powder Paste or Enteric‐Coated Formulation in Healing of Gastric Ulcers in Horses
Authors: Birkmann K. , Junge H.K. , Maischberger E. , Wehrli Eser M. , Schwarzwald C.C. 
Published: March 2014

BackgroundGastroGard, an omeprazole powder paste formulation, is considered the standard treatment for gastric ulcers in horses and is highly effective. Gastrozol, an enteric‐coated omeprazole formulation for horses, has recently become available, but efficacy data are controversial and sparse.ObjectivesTo investigate the efficacy of GastroGard and Gastrozol at labeled doses (4 and 1 mg of omeprazole per kg bwt, respectively,POq24h) in healing of gastric ulcers.Animals40 horses; 9.5 ± 4.6 years; 491 ± 135 kg.MethodsProspective, randomized, blinded study. Horses with an ulcer score ≥1 (Equine Gastric Ulcer Council) were randomly divided into 2 groups and treated for 2 weeks each with GastroGard followed by Gastrozol (A) or vice versa (B). After 2 and 4 weeks, scoring was repeated and compared with baseline. Plasma omeprazole concentrations were measured on the first day of treatment after administration of GastroGard (n = 5) or Gastrozol (n = 5).ResultsCompared with baseline (squamous score (A) 1.65 ± 0.11, (B) 1.98 ± 0.11), ulcer scores at 2 weeks ((A) 0.89 ± 0.11, (B) 1.01 ± 0.11) and 4 weeks ((A) 1.10 ± 0.12, (B) 0.80 ± 0.12) had significantly decreased in both groups (P < .001), independent of treatment (P = .7). Plasma omeprazole concentrations were significantly higher after GastroGard compared with Gastrozol administration (AUCGG = 2856 (1405‐4576) ng/mL × h, AUCGZ = 604 (430‐1609) ng/mL × h;P = .03). The bioavailability for Gastrozol was 1.26 (95% CI 0.56–2.81) times higher than for GastroGard.Conclusions and Clinical ImportanceBoth Gastrozol and GastroGard, combined with appropriate environmental changes, promote healing of gastric ulcers in horses. However, despite enteric coating of Gastrozol, plasma omeprazole concentrations after single labeled doses were significantly higher with GastroGard.
Statistical model based iterative reconstruction (MBIR) in clinical CT systems: Experimental assessment of noise performance
Authors: Li Ke , Tang Jie , Chen Guang‐Hong 
Published: March 2014

Purpose:To reduce radiation dose in CT imaging, the statistical model based iterative reconstruction (MBIR) method has been introduced for clinical use. Based on the principle of MBIR and its nonlinear nature, the noise performance of MBIR is expected to be different from that of the well‐understood filtered backprojection (FBP) reconstruction method. The purpose of this work is to experimentally assess the unique noise characteristics of MBIR using a state‐of‐the‐art clinical CT system.Methods:Three physical phantoms, including a water cylinder and two pediatric head phantoms, were scanned in axial scanning mode using a 64‐slice CT scanner (Discovery CT750 HD, GE Healthcare, Waukesha, WI) at seven different mAs levels (5, 12.5, 25, 50, 100, 200, 300). At each mAs level, each phantom was repeatedly scanned 50 times to generate an image ensemble for noise analysis. Both the FBP method with a standard kernel and the MBIR method (Veo®, GE Healthcare, Waukesha, WI) were used for CT image reconstruction. Three‐dimensional (3D) noise power spectrum (NPS), two‐dimensional (2D) NPS, and zero‐dimensional NPS (noise variance) were assessed both globally and locally. Noise magnitude, noise spatial correlation, noise spatial uniformity and their dose dependence were examined for the two reconstruction methods.Results:(1) At each dose level and at each frequency, the magnitude of the NPS of MBIR was smaller than that of FBP. (2) While the shape of the NPS of FBP was dose‐independent, the shape of the NPS of MBIR was strongly dose‐dependent; lower dose lead to a “redder” NPS with a lower mean frequency value. (3) The noise standard deviation (σ) of MBIR and dose were found to be related through a power law of σ ∝ (dose)−β with the component β ≈ 0.25, which violated the classical σ ∝ (dose)−0.5 power law in FBP. (4) With MBIR, noise reduction was most prominent for thin image slices. (5) MBIR lead to better noise spatial uniformity when compared with FBP. (6) A composite image generated from two MBIR images acquired at two different dose levels (D1 and D2) demonstrated lower noise than that of an image acquired at a dose level of D1+D2.Conclusions:The noise characteristics of the MBIR method are significantly different from those of the FBP method. The well known tradeoff relationship between CT image noise and radiation dose has been modified by MBIR to establish a more gradual dependence of noise on dose. Additionally, some other CT noise properties that had been well understood based on the linear system theory have also been altered by MBIR. Clinical CT scan protocols that had been optimized based on the classical CT noise properties need to be carefully re‐evaluated for systems equipped with MBIR in order to maximize the methodˈs potential clinical benefits in dose reduction and/or in CT image quality improvement.
CHD7 Expression Predicts Survival Outcomes in Patients with Resected Pancreatic Cancer
Authors: Colbert Lauren E. , Petrova Aleksandra V. , Fisher Sarah B. , Pantazides Brooke G. , Madden Matthew Z. , Hardy Claire W. , Warren Matthew D. , Pan Yunfeng , Nagaraju Ganji P. , Liu Elaine A. , Saka Burcu , Hall William A. , Shelton Joseph W. , Gandhi Khanjan , Pauly Rini , Kowalski Jeanne , Kooby David A. , El-Rayes Bassel F. , Staley Charles A. , Adsay N. Volkan , Curran Walter J. , Landry Jerome C. , Maithel Shishir K. , Yu David S. 
Published: March 2014

AbstractPancreatic ductal adenocarcinoma (PDAC) is a devastating disease with poor outcomes with current therapies. Gemcitabine is the primary adjuvant drug used clinically, but its effectiveness is limited. In this study, our objective was to use a rationale-driven approach to identify novel biomarkers for outcome in patients with early-stage resected PDAC treated with adjuvant gemcitabine. Using a synthetic lethal screen in human PDAC cells, we identified 93 genes, including 55 genes linked to DNA damage responses (DDR), that demonstrated gemcitabine sensitization when silenced, including CHD7, which functions in chromatin remodeling. CHD7 depletion sensitized PDAC cells to gemcitabine and delayed their growth in tumor xenografts. Moreover, CHD7 silencing impaired ATR-dependent phosphorylation of CHK1 and increased DNA damage induced by gemcitabine. CHD7 was dysregulated, ranking above the 90th percentile in differential expression in a panel of PDAC clinical specimens, highlighting its potential as a biomarker. Immunohistochemical analysis of specimens from 59 patients with resected PDAC receiving adjuvant gemcitabine revealed that low CHD7 expression was associated with increased recurrence-free survival (RFS) and overall survival (OS), in univariate and multivariate analyses. Notably, CHD7 expression was not associated with RFS or OS for patients not receiving gemcitabine. Thus, low CHD7 expression was correlated selectively with gemcitabine sensitivity in this patient population. These results supported our rationale-driven strategy to exploit dysregulated DDR pathways in PDAC to identify genetic determinants of gemcitabine sensitivity, identifying CHD7 as a novel biomarker candidate to evaluate further for individualizing PDAC treatment. Cancer Res; 74(10); 2677–87. ©2014 AACR.
Evidence of Clinical Utility: An Unmet Need in Molecular Diagnostics for Patients with Cancer
Authors: Parkinson David R. , McCormack Robert T. , Keating Susan M. , Gutman Steven I. , Hamilton Stanley R. , Mansfield Elizabeth A. , Piper Margaret A. , DeVerka Patricia , Frueh Felix W. , Jessup J. Milburn , McShane Lisa M. , Tunis Sean R. , Sigman Caroline C. , Kelloff Gary J. 
Published: March 2014

Abstract
This article defines and describes best practices for the academic and business community to generate evidence of clinical utility for cancer molecular diagnostic assays. Beyond analytical and clinical validation, successful demonstration of clinical utility involves developing sufficient evidence to demonstrate that a diagnostic test results in an improvement in patient outcomes. This discussion is complementary to theoretical frameworks described in previously published guidance and literature reports by the U.S. Food and Drug Administration, Centers for Disease Control and Prevention, Institute of Medicine, and Center for Medical Technology Policy, among others. These reports are comprehensive and specifically clarify appropriate clinical use, adoption, and payer reimbursement for assay manufacturers, as well as Clinical Laboratory Improvement Amendments–certified laboratories, including those that develop assays (laboratory developed tests). Practical criteria and steps for establishing clinical utility are crucial to subsequent decisions for reimbursement without which high-performing molecular diagnostics will have limited availability to patients with cancer and fail to translate scientific advances into high-quality and cost-effective cancer care.
See all articles in this CCR Focus section, “The Precision Medicine Conundrum: Approaches to Companion Diagnostic Co-development.”
Clin Cancer Res; 20(6); 1428–44. ©2014 AACR.
High-Sensitivity C-Reactive Protein and Interleukin-6–Dominant Inflammation and Ischemic Stroke Risk
Authors: Luna Jorge M. , Moon Yeseon P. , Liu Khin M. , Spitalnik Steven , Paik Myunghee C. , Cheung Keun , Sacco Ralph L. , Elkind Mitchell S.V. 
Published: March 2014

Background and Purpose—
Interleukin-6 (IL-6) is a proinflammatory cytokine with known autoregulatory feedback mechanisms. We hypothesized that elevated high-sensitivity C-reactive protein (hsCRP) relative to IL-6 confers an increased risk of ischemic stroke (IS), and low hsCRP relative to IL-6 a decreased risk, for individuals in the prospective, multiethnic, population-based Northern Manhattan Study (NOMAS).

Methods—
Serum hsCRP and IL-6 were measured in NOMAS participants at baseline. We created a trichotomized predictor based on the dominant biomarker in terms of quartiles: hsCRP-dominant, IL-6–dominant, and codominant groups. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for the association between inflammatory biomarker group status and risk of incident IS.

Results—
Of 3298 participants, both hsCRP and IL-6 were available in 1656 participants (mean follow-up, 7.8 years; 113 incident IS). The hsCRP-dominant group had increased risk of IS (adjusted hazard ratio, 2.62; 95% confidence interval, 1.56–4.41) and the IL-6–dominant group had decreased risk (adjusted hazard ratio, 0.38; 95% confidence interval, 0.18–0.82) when compared with the referent group, after adjusting for potential confounders. Model fit was improved using the inflammation-dominant construct, over either biomarker alone.

Conclusions—
In this multiethnic cohort, when hsCRP-quartile was higher than IL-6 quartile, IS risk was increased, and conversely when IL-6 quartiles were elevated relative to hsCRP, IS risk was decreased. Construct validity requires confirmation in other cohorts.
Improving Foot Examinations in Patients With Diabetes
Authors: Szpunar Susan M. , Minnick Steven E. , Dako Imhoitsemeh , Saravolatz Louis D. 
Published: March 2014

Purpose The purpose of this project was to determine if a Performance-Improvement Continuing Medical Education (PI-CME) project, using the American Medical Association’s methodology, would help improve the timeliness and comprehensiveness of foot examinations in patients with diabetes. Methods A PI-CME project was conducted with the Internal Medicine faculty staff physicians (n = 8) and residents (n = 45). Following the 3 steps of PI-CME, participants received baseline reports about their performance defined by the American Diabetes Association’s guidelines for foot examinations (stage A). Each group received an educational intervention (stage B) and a reminder tool for use in the practice. Participants received individualized reports about their performance post intervention (stage C) for comparison with preintervention data and reflection on any changes in compliance. Results In the faculty and resident clinics, the percentage of patients who received an annual foot examination when due increased significantly. Both clinics also showed improvements in the percentage of patients who received all 3 components of the exam, with the greatest improvement in the resident clinic. Conclusions The PI-CME approach can be successfully used both with faculty staff physicians (who receive CME credits) and residents (who do not receive credits) to improve performance on diabetes quality measures.
Early onset of Chanarin-Dorfman syndrome with severe liver involvement in a patient with a complex rearrangement of ABHD5 promoter
Authors: Missaglia Sara , Valadares Eugenia Ribeiro , Moro Laura , Faguntes Eleonora Druve Tavares , quintão Roque Raquel , Giardina Bruno , Tavian Daniela 
Published: March 2014

Abstract

Background
α/β-hydrolase domain-containing protein 5 (ABHD5) plays an important role in the triacylglycerols (TAG) hydrolysis. Indeed, ABHD5 is the co-activator of adipose triglyceride lipase (ATGL), that catalyses the initial step of TAG hydrolysis. Mutations in ABHD5 gene are associated with the onset of Chanarin-Dorfman syndrome (CDS), a rare autosomal recessive lipid storage disorder, characterized by non-bullous congenital ichthyosiform erythroderma (NCIE), hepatomegaly and liver steatosis.

Case presentation
We describe here a 5-years-old Brazilian child who presented with NCIE at birth and diffuse micro and macro-vesicular steatosis on liver biopsy since she was 2 years old. Molecular analysis of coding sequence and putative 5′ regulatory region of ABHD5 gene was performed. A homozygous novel deletion, affecting the promoter region and the exon 1, was identified, confirming the suspected diagnosis of CDS for this patient. RT-PCR analysis showed that the genomic rearrangement completely abolished the ABHD5 gene expression in the patient, while only a partial loss of expression was detected in her parents. This is the first report describing the identification of a large deletion encompassing the promoter region of ABHD5 gene. The total loss of ABHD5 expression may explain the early onset of CDS and the severe liver involvement. After molecular diagnosis, the patient started a special diet, poor in fatty acids with medium chain triglycerides (MCT), and showed hepatic and dermatologic improvement in spite of severe molecular defect.

Conclusions
This case report extends the spectrum of disease-causing ABHD5 mutations in CDS providing evidence for a novel pathogenic mechanism for this rare disorder. Moreover, our preliminary data show that early diagnosis and prompt treatment of neutral lipid accumulation might be useful for CD patients.
Nanoscale changes in chromatin organization represent the initial steps of tumorigenesis: a transmission electron microscopy study
Authors: Cherkezyan Lusik , Stypula-Cyrus Yolanda , Subramanian Hariharan , White Craig , Dela Cruz Mart , Wali Ramesh K , Goldberg Michael J , Bianchi Laura K , Roy Hemant K , Backman Vadim 
Published: March 2014

Abstract

Background
Nuclear alterations are a well-known manifestation of cancer. However, little is known about the early, microscopically-undetectable stages of malignant transformation. Based on the phenomenon of field cancerization, the tissue in the field of a tumor can be used to identify and study the initiating events of carcinogenesis. Morphological changes in nuclear organization have been implicated in the field of colorectal cancer (CRC), and we hypothesize that characterization of chromatin alterations in the early stages of CRC will provide insight into cancer progression, as well as serve as a biomarker for early detection, risk stratification and prevention.

Methods
For this study we used transmission electron microscopy (TEM) images of nuclei harboring pre-neoplastic CRC alterations in two models: a carcinogen-treated animal model of early CRC, and microscopically normal-appearing tissue in the field of human CRC. We quantify the chromatin arrangement using approaches with two levels of complexity: 1) binary, where chromatin is separated into areas of dense heterochromatin and loose euchromatin, and 2) grey-scale, where the statistics of continuous mass-density distribution within the nucleus is quantified by its spatial correlation function.

Results
We established an increase in heterochromatin content and clump size, as well as a loss of its characteristic peripheral positioning in microscopically normal pre-neoplastic cell nuclei. Additionally, the analysis of chromatin density showed that its spatial distribution is altered from a fractal to a stretched exponential.

Conclusions
We characterize quantitatively and qualitatively the nanoscale structural alterations preceding cancer development, which may allow for the establishment of promising new biomarkers for cancer risk stratification and diagnosis. The findings of this study confirm that ultrastructural changes of chromatin in field carcinogenesis represent early neoplastic events leading to the development of well-documented, microscopically detectable hallmarks of cancer.
Dynamic constrained coalition formation among electric vehicles
Authors: de O Ramos Gabriel , Burguillo Juan C , Bazzan Ana LC 
Published: March 2014

Abstract

Background
The use of electric vehicles (EVs) and vehicle-to-grid (V2G) technologies have been advocated as an efficient way to reduce the intermittency of renewable energy sources in smart grids. However, operating on V2G sessions in a cost-effective way is not a trivial task for EVs. The formation of coalitions among EVs has been proposed to tackle this problem.

Methods
In this paper we introduce Dynamic Constrained Coalition Formation (DCCF), which is a distributed heuristic-based method for constrained coalition structure generation (CSG) in dynamic environments. In our approach, coalitions are formed observing constraints imposed by the grid. To this end, EV agents negotiate the formation of feasible coalitions among themselves.

Results
Based on experiments, we show that DCCF is efficient to provide good solutions in a fast way. DCCF provides solutions whose quality approaches 98% of the optimum. In dynamically changing scenarios, DCCF also shows good results, keeping the agents payoff stable along time.

Conclusions
Essentially, DCCF’s main advantage over traditional CSG algorithms is that its computational effort is very lower. On the other hand, unlike traditional algorithms, DCCF is suitable only for constraint-based problems.
The classification of Crithidia luciliae immunofluorescence test (CLIFT) using a novel automated system
Authors: Buzzulini Francesca , Rigon Amelia , Soda Paolo , Onofri Leonardo , Infantino Maria , Arcarese Luisa , Iannello Giulio , Afeltra Antonella 
Published: March 2014

Abstract
Introduction
In recent years, there has been an increased demand for computer-aided diagnosis (CAD) tools to support clinicians in the field of indirect immunofluorescence. To this aim, academic and industrial research is focusing on detecting antinuclear, anti-neutrophil, and anti-double-stranded (anti-dsDNA) antibodies. Within this framework, we present a CAD system for automatic analysis of dsDNA antibody images using a multi-step classification approach. The final classification of a well is based on the classification of all its images, and each image is classified on the basis of the labeling of its cells.

Methods
We populated a database of 342 images—74 positive (21.6%) and 268 negative (78.4%)— belonging to 63 consecutive sera: 15 positive (23.8%) and 48 negative (76.2%). We assessed system performance by using k-fold cross-validation. Furthermore, we successfully validated the recognition system on 83 consecutive sera, collected by using different equipment in a referral center, counting 279 images: 92 positive (33.0%) and 187 negative (67.0%).

Results
With respect to well classification, the system correctly classified 98.4% of wells (62 out of 63). Integrating information from multiple images of the same wells recovers the possible misclassifications that occurred at the previous steps (cell and image classification). This system, validated in a clinical routine fashion, provides recognition accuracy equal to 100%.

Conclusion
The data obtained show that automation is a viable alternative for Crithidia luciliae immunofluorescence test analysis.