bluuebunny/crossref_metadata_2025_split huggingface dataset:
An image‐based technique to assess the perceptual quality of clinical chest radiographs
Authors: Lin Yuan , Luo Hui , Dobbins James T. , Page McAdams H. , Wang Xiaohui , Sehnert William J. , Barski Lori , Foos David H. , Samei Ehsan 
Published: November 2012

Purpose:Current clinical image quality assessment techniques mainly analyze image quality for the imaging system in terms of factors such as the capture system modulation transfer function, noise power spectrum, detective quantum efficiency, and the exposure technique. While these elements form the basic underlying components of image quality, when assessing a clinical image, radiologists seldom refer to these factors, but rather examine several specific regions of the displayed patient images, further impacted by a particular image processing method applied, to see whether the image is suitable for diagnosis. In this paper, the authors developed a novel strategy to simulate radiologists’ perceptual evaluation process on actual clinical chest images.Methods:Ten regional based perceptual attributes of chest radiographs were determined through an observer study. Those included lung grey level, lung detail, lung noise, rib‐lung contrast, rib sharpness, mediastinum detail, mediastinum noise, mediastinum alignment, subdiaphragm‐lung contrast, and subdiaphragm area. Each attribute was characterized in terms of a physical quantity measured from the image algorithmically using an automated process. A pilot observer study was performed on 333 digital chest radiographs, which included 179 PA images with 10:1 ratio grids (set 1) and 154 AP images without grids (set 2), to ascertain the correlation between image perceptual attributes and physical quantitative measurements. To determine the acceptable range of each perceptual attribute, a preliminary quality consistency range was defined based on the preferred 80% of images in set 1. Mean value difference (μ1 − μ2) and variance ratio () were investigated to further quantify the differences between the selected two image sets.Results:The pilot observer study demonstrated that our regional based physical quantity metrics of chest radiographs correlated very well with their corresponding perceptual attributes. The distribution comparisons, mean value difference estimations, and variance ratio estimations of each physical quantity between sets of images from two different techniques matched our expectation that the image quality of set 1 should be better than that of set 2.Conclusions:The measured physical quantities provide a robust reflection of perceptual image quality in clinical images. The methodology can be readily applied for automated evaluation of perceptual image quality in clinical chest radiographs.
Brain necrosis after fractionated radiation therapy: Is the halftime for repair longer than we thought?
Authors: Bender Edward T. 
Published: November 2012

Purpose:To derive a radiobiological model that enables the estimation of brain necrosis and spinal cord myelopathy rates for a variety of fractionation schemes, and to compare repair effects between brain and spinal cord.Methods:Sigmoidal dose response relationships for brain radiation necrosis and spinal cord myelopathy are derived from clinical data using nonlinear regression. Three different repair models are considered and the repair halftimes are included as regression parameters.Results:For radiation necrosis, a repair halftime of 38.1 (range 6.9–76) h is found with monoexponential repair, while for spinal cord myelopathy, a repair halftime of 4.1 (range 0–8) h is found. The best‐fit alpha beta ratio is 0.96 (range 0.24–1.73)Conclusions:A radiobiological model that includes repair corrections can describe the clinical data for a variety of fraction sizes, fractionation schedules, and total doses. Modeling suggests a relatively long repair halftime for brain necrosis. This study suggests that the repair halftime for late radiation effects in the brain may be longer than is currently thought. If confirmed in future studies, this may lead to a re‐evaluation of radiation fractionation schedules for some CNS diseases, particularly for those diseases where fractionated stereotactic radiation therapy is used.
Back to the Future for Dermatophyte Genomics
Authors: Rivera Zeyana S. , Losada Liliana , Nierman William C. 
Published: October 2012

ABSTRACT

Dermatophytes are a uniquely pathogenic group of fungi that cause most common fungal infections globally. The major cause of athlete’s foot is
Trichophyton rubrum
, a pathogen of human skin. A recent paper in this journal reported the sequencing and analysis of five additional genome sequences, including that of
Trichophyton rubrum
. These five join the existing two additional genome sequences to bring the total to seven dermatophyte genome sequences, a notable milestone in the study of these fungi. These additional genomes set the stage for future genome-supported studies on the biology, pathogenicity, and host specificity of this important group of pathogens. To predict how this future might play out, we review the history of
Aspergillus
genomics since the initial publication of the first three
Aspergillus
genome sequences in 2005, an event that stimulated important studies of the pathogenic
Aspergillus
species. From these 7 years of
Aspergillus
history, we offer some speculation on the future of dermatophyte studies supported by the genome sequences given the similarities, differences, and relative levels of support for studies in these two groups of fungi and the diseases they cause.
Long-Term Changes of Diffusion Tensor Imaging and Behavioural Status after Acupuncture Treatment in Rats with Transient Focal Cerebral Ischaemia
Authors: Wu Zhiyuan , Hu Jinqing , Du Fang , Zhou Xiaoyan , Xiang Qiongyao , Miao Fei 
Published: October 2012

Background The effect of acupuncture treatment in cerebral ischaemia is controversial. A study was undertaken to assess its effects in rats with transient middle cerebral artery occlusion (tMCAO) and discuss its mechanisms. Methods 21 Sprague–Dawley rats were divided into three groups. Group 1 underwent tMCAO and subsequently received acupuncture treatment, Group 2 underwent tMCAO without treatment and Group 3 only underwent sham operation. The evolution of diffusion tensor imaging (DTI) features in ischaemic lesions from acute to chronic periods was assessed and the correlations with behavioural tests and histopathological changes were examined. Results tMCAO rats displayed side-specific sensorimotor deficits after occlusion. Behavioural scores of rats in group 1 reduced gradually with acupuncture treatment. No significant difference in lesion size on T2-weighted imaging was found between the two tMCAO groups. Relative apparent diffusion coefficient (rADC) and relative fractional anisotropy (rFA) values in the centre and at the edge of the ischaemic lesions reduced at first and then increased to varying degrees. Only changes in the rFA value at the edge of the ischaemic lesions were significantly different between the two tMCAO groups. A more significant increase in growth-associated protein B-50 and synaptophysin protein expression was found in group 1 than in the other groups. No significant correlations were found between behavioural scores, DTI appearances and immunohistochemical results. Conclusions The acupuncture points applied were effective, and improving neuronal regeneration may have a role in the mechanism of acupuncture treatment of post-stroke paralysis of the limbs in rats. MRI, particularly the fractional anisotropy value of DTI, is an appropriate parameter to evaluate the recovery status.
Emergence of pneumococcal 19A empyema in UK children
Authors: Thomas Matthew F , Sheppard Carmen L , Guiver Malcolm , Slack Mary P E , George Robert C , Gorton Russell , Paton James Y , Simmister Clare , Cliff David , Elemraid Mohamed A , Clark Julia E , Rushton Stephen P , Spencer David Anthony 
Published: October 2012

IntroductionInvasive pneumococcal disease due to serotype 19A has become a major concern, particularly in the USA and Asia. We describe the characteristics of pneumococcal serotype 19A related empyema and changes in its incidence in the UK.MethodsData from paediatric empyema patients between September 2006 and March 2011 were collected from 17 respiratory centres in the UK. Pneumococcal serotypes were identified as part of the Health Protection Agency enhanced paediatric empyema surveillance programme.ResultsFour serotypes accounted for over 80% of 136 cases (Serotype 1 : 43%, 3 : 21%, 7 : 11% and 19A:10%). The incidence of empyema due to serotype 19A quadrupled from 0.48 (0.16–1.13) cases per million children in 2006/2007 to 2.02 (1.25–3.09) in 2010/2011. Severity of disease was significantly increased in children with 19A infection when compared to other serotypes.ConclusionsThe incidence of empyema due to pneumococcal serotype 19A infection has increased significantly and is associated with substantial morbidity.
Thirty-years of screening for cystic fibrosis in East Anglia
Authors: Calvin Jacqui , Hogg Sarah L , McShane Donna , McAuley Sharon Anne , Iles Richard , Ross-Russell Robert , MacLean Fiona M , Heeley Mary E , Heeley Anthony F 
Published: October 2012

BackgroundNewborn screening for cystic fibrosis (CF) relies on the measurement of immunoreactive trypsinogen (IRT) originating from the pancreas. The Norfolk, Suffolk and Cambridgeshire screening programme initially exploited the persistent increase in IRT seen in CF (IRT-IRT protocol) and later changed to include mutation analysis as a second tier test (IRT-DNA-IRT protocol).ResultsDuring a 30 year period 582 966 babies have been screened by IRT-IRT and 147 764 by IRT-DNA-IRT (total 730730), resulting in 296 screen positive cases of CF and 29 false negatives (including 10 false negatives with meconium ileus). Ten missed CF cases were pancreatic insufficient, however all were diagnosed before their first birthday, suggesting that a false negative result did not forestall appropriate clinical investigation. The IRT-DNA-IRT protocol had a much improved positive predictive value (PPV) of 85.9% compared to 67.3% for IRT-IRT, excluding CF babies with meconium ileus. The PPVs increased to 82.2% and 98.2% respectively if only well, term babies were considered. The main factor to account for this improvement in PPV has probably been the incorporation of DNA analysis in the second tier testing.ConclusionsThe diagnosis of screen-positive babies proved difficult in a minority of cases with the classification of some patients changing with evolving phenotype. Our results illustrate the importance of collecting outcome data over a long time period for accurate assessment of the screening programme. This study provides evidence that newborn screening for CF is a valid undertaking that detects 95% of unsuspected CF cases presenting before 3 years of age.
Cost-effectiveness of a European preventive cardiology programme in primary care: a Markov modelling approach
Authors: Mistry Hema , Morris Stephen , Dyer Matthew , Kotseva Kornelia , Wood David , Buxton Martin 
Published: October 2012

ObjectiveTo investigate the longer-term cost-effectiveness of a nurse-coordinated preventive cardiology programme for primary prevention of cardiovascular disease (CVD) compared to routine practice from a health service perspective.DesignA matched, paired cluster-randomised controlled trial.SettingSix pairs of general practices in six countries.Participants1019 patients were randomised to the EUROACTION intervention programme and 1005 patients to usual care (UC) and who completed the 1-year follow-up.Outcome measuresEvidence on health outcomes and costs was based on patient-level data from the study, which had a 1-year follow-up period. Future risk of CVD events was modelled, using published risk models based on patient characteristics. An individual-level Markov model for each patient was used to extrapolate beyond the end of the trial, which was populated with data from published sources. We used an 11-year time horizon and investigated the impact on the cost-effectiveness of varying the duration of the effect of the intervention beyond the end of the trial. Results are expressed as incremental cost per quality-adjusted life-year gained.ResultsUnadjusted results found the intervention to be more costly and also more effective than UC. However, after adjusting for differences in age, gender, country and baseline risk factors, the intervention was dominated by UC, but this analysis was not able to take into account the lifestyle changes in terms of diet and physical activity.ConclusionsAlthough the EUROACTION study achieved healthier lifestyle changes and improvements in management of blood pressure and lipids for patients at high risk of CVD, compared to UC, it was not possible to show, using available risk equations which do not incorporate diet and physical activity, that the intervention reduced longer-term cardiovascular risk cost-effectively. Whether or not an intervention such as that offered by EUROACTION is cost-effective requires a longer-term trial with major cardiovascular events as the outcome.Trial Registration numberISRCTN 71715857.
Alu and LINE-1 methylation and lung function in the normative ageing study
Authors: Lange Nancy E , Sordillo Joanne , Tarantini Letizia , Bollati Valentina , Sparrow David , Vokonas Pantel , Zanobetti Antonella , Schwartz Joel , Baccarelli Andrea , Litonjua Augusto A , DeMeo Dawn L 
Published: October 2012

ObjectivesTo investigate the association between methylation of transposable elementsAluand long-interspersed nuclear elements (LINE-1) and lung function.DesignCohort study.SettingOutpatient Veterans Administration facilities in greater Boston, Massachusetts, USA.ParticipantsIndividuals from the Veterans Administration Normative Aging Study, a longitudinal study of aging in men, evaluated between 1999 and 2007. The majority (97%) were white.Primary and secondary outcome measuresPrimary predictor was methylation, assessed using PCR-pyrosequencing after bisulphite treatment. Primary outcome was lung function as assessed by spirometry, performed according to American Thoracic Society/European Respiratory Society guidelines at the same visit as the blood draws.ResultsIn multivariable models adjusted for age, height, body mass index (BMI), pack-years of smoking, current smoking and race,Aluhypomethylation was associated with lower forced expiratory volume in 1 s (FEV1) (β=28 ml per 1% change inAlumethylation, p=0.017) and showed a trend towards association with a lower forced vital capacity (FVC) (β=27 ml, p=0.06) and lower FEV1/FVC (β=0.3%, p=0.058). In multivariable models adjusted for age, height, BMI, pack-years of smoking, current smoking, per cent lymphocytes, race and baseline lung function, LINE-1 hypomethylation was associated with more rapid decline of FEV1(β=6.9 ml/year per 1% change in LINE-1 methylation, p=0.005) and of FVC (β=9.6 ml/year, p=0.002).ConclusionsIn multiple regression analysis,Aluhypomethylation was associated with lower lung function, and LINE-1 hypomethylation was associated with more rapid lung function decline in a cohort of older and primarily white men from North America. Future studies should aim to replicate these findings and determine ifAluor LINE-1 hypomethylation may be due to specific and modifiable environmental exposures.
Access to facility delivery and caesarean section in north-central Liberia: a cross-sectional community-based study
Authors: Gartland Matthew G , Taryor Victor D , Norman Andy M , Vermund Sten H 
Published: November 2012

ObjectiveRural north-central Liberia has one of the world's highest maternal mortality ratios. We studied health facility birthing service utilisation and the motives of women seeking or not seeking facility-based care in north-central Liberia.DesignCross-sectional community-based structured interviews and health facility medical record review.SettingA regional hospital and the surrounding communities in rural north-central Liberia.ParticipantsA convenience sample of 307 women between 15 and 49 years participated in structured interviews. 1031 deliveries performed in the regional hospital were included in the record review.Primary outcomesDelivery within a health facility and caesarean delivery rates were used as indicators of direct utilisation of care and as markers of availability of maternal health services.ResultsOf 280 interview respondents with a prior childbirth, only 47 (16.8%) delivered their last child in a health facility. Women who did not use formal services cited cost, sudden labour and family tradition or religion as their principal reasons for home delivery. At the regional hospital, the caesarean delivery rate was 35.5%.ConclusionsThere is an enormous unmet need for maternal health services in north-central Liberia. Greater outreach and referral services as well as community-based education among women, family members and traditional midwives are vital to improve the timely utilisation of care.
Trends in population mental health before and after the 2008 recession: a repeat cross-sectional analysis of the 1991–2010 Health Surveys of England
Authors: Katikireddi Srinivasa Vittal , Niedzwiedz Claire L , Popham Frank 
Published: October 2012

ObjectiveTo assess short-term differences in population mental health before and after the 2008 recession and explore how and why these changes differ by gender, age and socio-economic position.DesignRepeat cross-sectional analysis of survey data.SettingEngland.ParticipantsRepresentative samples of the working age (25–64 years) general population participating in the Health Survey for England between 1991 and 2010 inclusive.Main outcome measuresPrevalence of poor mental health (caseness) as measured by the general health questionnaire-12 (GHQ).ResultsAge–sex standardised prevalence of GHQ caseness increased from 13.7% (95% CI 12.9% to 14.5%) in 2008 to 16.4% (95% CI 14.9% to 17.9%) in 2009 and 15.5% (95% CI 14.4% to 16.7%) in 2010. Women had a consistently greater prevalence since 1991 until the current recession. However, compared to 2008, men experienced an increase in age-adjusted caseness of 5.1% (95% CI 2.6% to 7.6%, p<0.001) in 2009 and 3% (95% CI 1.2% to 4.9%, p=0.001) in 2010, while no statistically significant changes were seen in women. Adjustment for differences in employment status and education level did not account for the observed increase in men nor did they explain the differential gender patterning. Over the last decade, socio-economic inequalities showed a tendency to increase but no clear evidence for an increase in inequalities associated with the recession was found. Similarly, no evidence was found for a differential effect between age groups.ConclusionsPopulation mental health in men has deteriorated within 2 years of the onset of the current recession. These changes, and their patterning by gender, could not be accounted for by differences in employment status. Further work is needed to monitor recessionary impacts on health inequalities in response to ongoing labour market and social policy changes.
Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers
Authors: Hesselink Gijs , Flink Maria , Olsson Mariann , Barach Paul , Dudzik-Urbaniak Ewa , Orrego Carola , Toccafondi Giulio , Kalkman Cor , Johnson Julie K , Schoonhoven Lisette , Vernooij-Dassen Myrra , Wollersheim Hub ,   on behalf of the European HANDOVER Research Collaborative
Published: November 2012

BackgroundAdvocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients.ObjectiveThe aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process.MethodsA qualitative study using purposive sampling of 192 individual interviews and 26 focus group interviews was conducted in five European Union countries with patients and/or family members, hospital physicians and nurses, and community general practitioners and nurses. A modified Grounded Theory approach was used to analyse the data.ResultsThe barriers and facilitators were classified into 15 categories from which four themes emerged: (1) healthcare providers do not sufficiently prioritise discharge consultations with patients and family members due to time restraints and competing care obligations; (2) discharge communication varied from instructing patients and family members to shared decision-making; (3) patients often feel unprepared for discharge, and postdischarge care is not tailored to individual patient needs and preferences; and (4) pressure on available hospital beds and community resources affect the discharge process.ConclusionsOur findings suggest that involvement of patients and families in the preparations for discharge is determined by the extent to which care providers are willing and able to accommodate patients’ and families’ capabilities, needs and preferences. Future interventions should be directed at healthcare providers’ attitudes and their organisation's leadership, with a focus on improving communication among care providers, patients and families,andbetween hospital and community care providers.
Perceived causes of prescribing errors by junior doctors in hospital inpatients: a study from the PROTECT programme
Authors: Ross Sarah , Ryan Cristín , Duncan Eilidh M , Francis Jillian J , Johnston Marie , Ker Jean S , Lee Amanda Jane , MacLeod Mary Joan , Maxwell Simon , McKay Gerard , McLay James , Webb David J , Bond Christine 
Published: October 2012

IntroductionPrescribing errors are a major cause of patient safety incidents. Understanding the underlying factors is essential in developing interventions to address this problem. This study aimed to investigate the perceived causes of prescribing errors among foundation (junior) doctors in Scotland.MethodsIn eight Scottish hospitals, data on prescribing errors were collected by ward pharmacists over a 14-month period. Foundation doctors responsible for making a prescribing error were interviewed about the perceived causes. Interview transcripts were analysed using content analysis and categorised into themes previously identified under Reason's Model of Accident Causation and Human Error.Results40 prescribers were interviewed about 100 specific errors. Multiple perceived causes for all types of error were identified and were categorised into five categories of error-producing conditions, (environment, team, individual, task and patient factors). Work environment was identified as an important aspect by all doctors, especially workload and time pressures. Team factors included multiple individuals and teams involved with a patient, poor communication, poor medicines reconciliation and documentation and following incorrect instructions from other members of the team. A further team factor was the assumption that another member of the team would identify any errors made. The most frequently noted individual factors were lack of personal knowledge and experience. The main task factor identified was poor availability of drug information at admission and the most frequently stated patient factor was complexity.ConclusionsThis study has emphasised the complex nature of prescribing errors, and the wide range of error-producing conditions within hospitals including the work environment, team, task, individual and patient. Further work is now needed to develop and assess interventions that address these possible causes in order to reduce prescribing error rates.