bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance imaging evaluation of residual tumors in breast cancer after neoadjuvant chemotherapy: surgical implications
Authors: Zhou Juan , Li Gongjie , Sheng Fugeng , Qiao Penggang , Zhang Hongtao , Xing Xudong 
Published: August 2015

Background Magnetic resonance imaging (MRI) can be used to guide breast cancer surgery with breast conservation for large tumors with a substantially reduced size after neoadjuvant chemotherapy (NAC). Purpose To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI) for measuring residual tumor size and enhancement patterns following preoperative NAC. Material and Methods Eighty-nine patients with breast cancer underwent breast DCE-MRI; 38 patients (39 lesions) were treated with NAC and examined for residual disease following therapy. Two patients were excluded because surgery had been performed >2 weeks after the final MR examination. Thus, we correlated the DCE-MRI results of 36 patients (37 lesions) with postoperative histopathological findings. Residual disease was confirmed by more enhancement compared to normal glandular tissue at the initial tumor site. Residual tumor size on DCE-MRI was compared with postoperative pathology findings. Tumor enhancement patterns on DCE-MRI were analyzed and correlated with pathological classification. Results MRI revealed 34 cases of residual tumors, with two false positives and one false negative. Pathological and MR measurements were correlated ( r = 0.793). The correlation of mass enhancement size ( r = 0.87, n = 14) with pathology and DCE-MRI was higher than for non-mass-like enhancement (NME) ( r = 0.735, n = 23). The distribution of pathologic classification was significantly different between different MRI enhancement patterns ( P = 0.006). Mass enhancement had higher cellularity than NME. Conclusion MRI is useful for evaluating residual carcinoma following NAC. Mass enhancement with higher cellularity after NAC can be evaluated more accurately, which is suitable for evaluating lumpectomy. However, other approaches are required for NME, which has lower cellularity.
Differentiation between borderline and benign ovarian tumors: combined analysis of MRI with tumor markers for large cystic masses (≥5 cm)
Authors: Park Sung Yoon , Oh Young Taik , Jung Dae Chul 
Published: August 2015

Background There is overlap in imaging features between borderline and benign ovarian tumors. Purpose To analyze diagnostic performance of magnetic resonance imaging (MRI) combined with tumor markers for differentiating borderline from benign ovarian tumor. Material and Methods Ninety-nine patient with MRI and surgically confirmed ovarian tumors 5 cm or larger (borderline, n = 37; benign, n = 62) were included. On MRI, tumor size, septal number (0; 1–4; 5 or more), and presence of solid portion such as papillary projection or septal thickening 0.5 cm or larger were investigated. Serum tumor markers (carbohydrate antigen 125 [CA 125] and CA 19-9) were recorded. Multivariate analysis was conducted for assessing whether combined MRI with tumor markers could differentiate borderline from benign tumor. The diagnostic performance was also analyzed. Results Incidence of solid portion was 67.6% (25/37) in borderline and 3.2% (2/62) in benign tumors ( P < 0.05). In all patients, without combined analysis of MRI with tumor markers, multivariate analysis revealed solid portion ( P < 0.001) and CA 125 ( P = 0.039) were significant for predicting borderline tumors. When combined analysis of MRI with CA 125 ((i) the presence of solid portion or (ii) CA 125 > 44.1 U/mL with septal number ≥5 for borderline tumor) is incorporated to multivariate analysis, it was only significant ( P = 0.001). The sensitivity, specificity, PPV, NPV, and accuracy of combined analysis of MRI with CA 125 were 89.1%, 91.9%, 86.8%, 93.4, and 90.9%, respectively. Conclusion Combined analysis of MRI with CA 125 may allow better differentiation between borderline and benign ovarian tumor compared with MRI alone.
Laser-evoked potential habituation and central sensitization symptoms in childhood migraine
Authors: de Tommaso Marina , Sciruicchio Vittorio , Ricci Katia , Montemurno Anna , Gentile Francesco , Vecchio Eleonora , Barbaro Maria Grazia Foschino , Simeoni Michele , Goffredo Marvita , Livrea Paolo 
Published: August 2015

Objectives Few studies have addressed central sensitization symptoms and pain processing in childhood migraine. Our aims were to examine pain sensitivity and responses, including habituation, evoked by CO2 laser stimuli (laser-evoked potentials (LEPs)) in a cohort of children with migraine compared to non-migraine controls and to determine the correlation between LEP features and signs of central sensitization. Methods Thirty-five patients 8–15 years of age with migraines without aura were evaluated during the inter-critical phase and were compared to 17 controls. LEPs were analyzed, and their main features were correlated with clinical symptoms including allodynia and pericranial tenderness. Results The laser-evoked pain threshold was lower and the N2P2 vertex complex amplitude was higher in children with migraines. Furthermore, habituation of vertex waves of LEPs clearly showed a tendency toward progressive amplitude enhancement in the migraine group. Acute allodynia and inter-critical pericranial tenderness correlated with trigeminal LEP features, particularly with the abnormal habituation pattern. Discussion Abnormalities of pain processing and symptoms of central sensitization appear to be characteristics of children with migraine. Reduced habituation and progressive amplification of cortical responses to laser stimuli indicate an overactive nociceptive system at the onset of migraine, and this hyperactivity may subtend allodynia and pericranial tenderness. Future prospective trials may aid in the early identification of clinical phenotypes that display a tendency to develop into the chronic form of migraine, warranting a timely therapeutic approach.
Autonomic Nervous System Dysfunction in Patients With Parkinson Disease Having Depression
Authors: Park Hyung-Eun , Kim Joong-Seok , Oh Yoon-Sang , Park In-Seok , Park Jeong-Wook , Song In-Uk , Lee Kwang-Soo 
Published: August 2015

Background and Aim: Both depression and cardiovascular autonomic dysfunctions, such as orthostatic hypotension, supine hypertension, and the absence of normal nocturnal blood pressure (BP) fall (“nondipping”), occur relatively commonly in Parkinson disease (PD); however, the relationship between depression and cardiovascular autonomic abnormalities has not been established. In this study, we sought to determine whether the cardiovascular autonomic abnormalities found in PD are associated with depression. Methods: Among 129 nondemented, levodopa-naive patients with mild PD, 44 had depression. Orthostatic vital signs and ambulatory 24-hour BP monitoring were recorded, and geriatric depressive scales were obtained in all patients. Associations between orthostatic hypotension, supine hypertension, nocturnal hypertension, nondipping, and depression were analyzed. The ratio of the standard deviation of 24-hour heart rate to that of systolic BP (SBP) was utilized as an index of baroreflex–cardiovagal function. Results: Depression was associated with orthostatic hypotension, and patients with depression had higher SBP change during orthostasis and attenuated cardiovagal dysfunction as observed during ambulatory BP monitoring. Across individuals, values for orthostatic changes in BP were correlated with values for geriatric depressive scale. Conclusion: Depression is associated with neurocirculatory abnormalities—especially orthostatic hypotension—in early PD. Although the association does not imply causation, this result suggests that depression in PD might be associated with functional impairment of the autonomic nervous system and its pathologic substrate.
Reactive angioendotheliomatosis as a presenting cutaneous manifestation of Hughes syndrome
Authors: Nikam B , Shah S , Kale M , Jamale V 
Published: August 2015

Background Antiphospholipid antibody syndrome is an autoimmune disorder associated with pregnancy complications, venous and/or arterial thrombosis and the presence of antiphospholipid antibodies. This syndrome is known to present with various cutaneous features, but association with reactive angioendotheliomatosis has been described rarely in the literature. Results A woman in her thirties with a past history of three consecutive abortions developed purpuric, ulcerative plaque over the plantar aspect of the foot. Her biopsy showed marked expansion of dermal vasculature due to intravascular cellular proliferation suggestive of reactive angioendotheliomatosis. The intravascular cells stained positive for CD31. Her blood investigations showed positive lupus anticoagulant, antiphospholipid antibodies and anticardiolipin antibodies, leading to a diagnosis of antiphospholipid syndrome also known as Hughes syndrome. Conclusion We suggest that a hypercoagulable state caused the formation of intravascular thrombi leading to reactive angioendotheliomatosis. We report a case of Hughes syndrome with reactive angioendotheliomatosis as the first clinical cutaneous manifestation and treated satisfactorily with anticoagulants and immunomodulators.
System Dynamics and Simulation/Gaming
Authors: Alessi Stephen , Kopainsky Birgit 
Published: August 2015

Purpose. This article summarizes the nine contributions to the symposium on system dynamics. The goal of the symposium is to investigate how research in system dynamics is contributing to simulation-gaming, and how the more general field of simulation-gaming is influencing work in system dynamics. Summary of articles. We summarize the nine contributions. They include five articles on basic research in learning and teaching principles for system dynamics, three articles on interactive learning environments, and a final critical reflection article which summarizes the other eight and suggests future research needs. Conclusion. The main problem still to be addressed is improvement in and measurement of learning and performance.
Critical Reflections on System Dynamics and Simulation/Gaming
Authors: Davidsen Pål I. , Spector J. Michael 
Published: August 2015

Purpose. This article critically discusses the contributions in this symposium and the progress in the fields of system dynamics and interactive learning environments. Two Perspectives. For this purpose, the article uses two different perspectives. One perspective is system dynamics or model-based policy analysis and design. The other perspective is the learning sciences, that is, the theories and principles of learning. Commentaries. With these two perspectives in mind, this article reflects on each of the eight contributions to this symposium and gives critiques and suggestions. Recommendation. The results and insights generated by these contributions suggest that the greatest need for future research on system dynamics and its contribution to simulation-gaming is demonstration of improvements in learning and performance.
Validity and Reliability of the Teamwork Scale for Youth
Authors: Lower Leeann M. , Newman Tarkington J. , Anderson-Butcher Dawn 
Published: August 2015

The teamwork life skill is a critical outcome desired in many positive youth development interventions; however, limited versatile, user-friendly measures of this construct exist. Purpose: This study examines the psychometric properties of the Teamwork Scale for Youth, an assessment designed to measure youths’ perceptions of their teamwork competency. Methods: The Teamwork Scale for Youth was administered to a sample of 460 youths. Confirmatory factor analyses examined the factor structure and measurement invariance of the scale across time. Correlations between teamwork and perceived social competence and commitment scores were also examined. Results: The revised 8-item Teamwork Scale for Youth was found to demonstrate acceptable factorial validity and measurement invariance across time. Additionally, strong reliability and concurrent and predictive validity of the scale were established. Discussion: The Teamwork Scale for Youth is a brief, easily administered, psychometrically sound tool that can be used with confidence in social work research and practice.
Replication of a Continuing Education Workshop in the Evidence-Based Practice Process
Authors: Gromoske Andrea N. , Berger Lisa K. 
Published: August 2015

Objective: To replicate the results of Parrish and Rubin’s continuing education workshop in the evidence-based practice (EBP) process utilizing different workshop facilitators with participants in a different geographic location. Methods: We used a replicated, one-group pretest–posttest design with 3-month follow-up to evaluate the effectiveness of a 7-hr, continuing education workshop. Social workers’ ( N = 45) knowledge of, attitudes toward, views of feasibility, intentions to use, and current use of the EBP process were assessed. Results: Three of four cohorts of participants showed significant improvement from pretest to posttest in the overall measure of the EBP process ( p < .05). Participants’ scores significantly improved over time regarding their familiarity with, attitudes about, and intentions to use and current use of the EBP process ( p < .001). Conclusions: Parrish and Rubin’s continuing education workshop in the EBP process appears to be an effective means to train social workers in the EBP process.
Safe Zone for Neural Structures in Medial Displacement Calcaneal Osteotomy
Authors: Talusan Paul G. , Cata Ezequiel , Tan Eric W. , Parks Brent G. , Guyton Gregory P. 
Published: August 2015

Background: We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively to minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy. Methods: Forty cadaveric specimens were used. In 20 specimens, the sural, medial plantar (MP), and lateral plantar (LP) nerves were sutured to radiopaque wire, and a lateral ankle radiograph was obtained. On the radiograph, a line was drawn from the posterior superior apex of the calcaneal tuberosity to the origin of the plantar fascia and labeled as the “landmark line.” A parallel line was drawn 2 mm posterior to the most posterior nerve, and the area between these lines was defined as the safe zone. In 20 additional specimens, an osteotomy was performed 1 cm anterior to the landmark line using a percutaneous or open technique. Dissection was performed to assess for laceration of the sural, MP, LP, medial calcaneal (MC), or lateral calcaneal (LC) nerves. Results: The safe zone was determined to be within the area 11.2 ± 2.7 mm anterior to the landmark line. After open osteotomy, lacerations were found in 3 of 10 MC nerves and 3 of 10 LC nerves. After percutaneous osteotomy, lacerations were found in 2 of 10 MC nerves and 1 of 10 LC nerves. No lacerations of the sural, MP, or LP nerves were found with either osteotomy. Conclusions: The safe zone extended 11.2 ± 2.7 mm anterior to the described landmark line. The MC and LC nerves were always at risk during medial displacement calcaneal osteotomy. Clinical Relevance: Nerve injury to both major and minor sensory nerves is likely underrecognized as a source of morbidity after calcaneal osteotomy. The current study provides a ready intraoperative guideline for minimizing this risk.
Total Ankle Arthroplasty Following Prior Infection About the Ankle
Authors: Shi Glenn G. , Huh Jeannie , Gross Christopher E. , Adams Samuel B. , Easley Mark E. , DeOrio James K. , Nunley James A. 
Published: August 2015

Background: We evaluated whether a history of prior infection about the native ankle joint, bone, or soft tissues was associated with a higher rate of infection following total ankle arthroplasty (TAA) when compared with that of primary TAA in the general population. Methods: This is a retrospective review of our institution’s TAA registry to identify all patients who reported a prior history of ankle joint sepsis or osteomyelitis and who were subsequently treated with TAA with at least 1-year follow-up. The primary outcome measure was re-infection rate. Secondary outcome measures were patient-reported outcome scores, implant survival, and complications. Twenty-two TAAs were performed in 22 patients, consisting of 9 men and 13 women, with a mean age of 58.4 years (range = 30-80 years). Patients were followed for a mean of 29.3 months (range = 11.4-83.8 months). The length of complete symptom-free interval between the index infection to time of TAA was 8.8 years (range = 0-44 years). These patients had a mean 2.7 (range = 0-13) procedures involving the ipsilateral ankle joint prior to TAA. Results: No deep infection was observed in this series. Eleven patients were followed for more than 2 years, with postoperative visual analog scale scores decreasing from 53.1 (range = 12-90) to 20.6 (range = 0-89) of 100. Ten of the 11 ankles also had AOFAS ankle-hindfoot and SF-36 scores. Their AOFAS ankle-hindfoot score increased from 38.9 (range = 10-61) to 70.1 (range = 29-90), and SF-36 score improved from 40.6 (range = 3.3-76.4) to 67.6 (range = 36.4-85.4). Conclusion: Single-stage TAA can be a viable option to treat arthritic ankle pain for those patients with resolved bone or ankle joint infection, producing improved outcomes in pain and function. Level of Evidence: Level IV, case series.
Effect of Arthroscopic Evaluation of Acute Ankle Fractures on PROMIS Intermediate-Term Functional Outcomes
Authors: Fuchs Daniel J. , Ho Bryant S. , LaBelle Mark W. , Kelikian Armen S. 
Published: August 2015

Background: Following open reduction internal fixation (ORIF) of unstable ankle fractures, some patients have persistent pain and poor outcomes. This may be secondary to intra-articular injuries that occur at the time of fracture, which occur in up to 88% of fractures. Ankle arthroscopy at the time of ORIF has been proposed to address these intra-articular injuries. This study compared patient-reported functional outcomes in patients who underwent ankle ORIF with and without ankle arthroscopy. Methods: An institutional database was used to retrospectively identify 93 patients who underwent ORIF for an unstable ankle fracture with an intact medial malleolus between 2002 and 2013. Forty-two patients had ankle arthroscopy at the time of ORIF and 51 did not. Functional outcomes between groups were compared using Patient Reported Outcomes Measurement Information System (PROMIS) physical function and pain interference computerized adaptive tests at a minimum follow-up of 1 year. Outcomes were also measured with the visual analog scale (VAS) pain score and the Olerud and Molander ankle fracture outcome scale. Average patient follow-up was 67 months (n = 51). Results: PROMIS physical function and pain interference scores were not significantly different between groups (physical function, 57.8 vs 54.5, P = .23; pain interference, 45.6 vs 46.9, P = .56). Operative time was increased in the arthroscopy group (74 minutes vs 59 minutes, P = .027). Overall, 60% (25/42) had chondral lesions of the talus, 7% (3/42) had chondral lesions of the tibial plafond, and 21% (9/42) had loose bodies requiring removal. There was no significant difference in complication rates between groups. Conclusion: At intermediate-term follow-up of patients with unstable ankle fractures and intact medial malleoli, functional outcomes were not significantly improved in patients who underwent ankle arthroscopy. However, there were no increased complications attributable to ankle arthroscopy, and average total operative time was increased by only 15 minutes. Level of Evidence: Level III, retrospective cohort study.
The Chalder Fatigue Questionnaire is a valid and reliable measure of perceived fatigue severity in multiple sclerosis
Authors: Chilcot Joseph , Norton Sam , Kelly Maedhbh Etain , Moss-Morris Rona 
Published: August 2015

Background: Fatigue is one of the most distressing symptoms of multiple sclerosis (MS). Measuring MS fatigue poses a number of challenges. Many measures confound definitions of severity and impact of fatigue and/or lack psychometric validation in MS. Objective: To evaluate the psychometric properties of an 11-item fatigue severity measure, the Chalder Fatigue Questionnaire (CFQ) in MS including validity of the factor structure, internal reliability, discriminant validity and sensitivity to change. Methods: Data were pooled from four previous studies investigating MS fatigue using the CFQ ( n=444). Data analysis included confirmatory factor analysis to determine the factor structure and model fit, correlations to assess discriminant validity and effects sizes to determine sensitivity to change. Results: A bi-factor model with one general fatigue factor, incorporating two smaller group factors (mental and physical fatigue) had good model fit and appeared the most appropriate factor structure underlying the CFQ scale. The CFQ had high internal consistency, showed small to moderate correlations with impact of fatigue and mood, and was sensitive to change across low and high intensity behavioural interventions. Conclusions: The CFQ measuring a composite of physical and mental fatigue severity (i.e. a total score) is a psychometrically sound measure of fatigue severity in MS.
Palliative Surgery for Pseudomyxoma Peritonei
Authors: Funder J. A. , Jepsen K. V. , Stribolt K. , Iversen L. H. 
Published: August 2015

Introduction: Pseudomyxoma peritonei is a rare disease causing peritoneal carcinomatosis. In patients with extensive carcinomatosis, curative treatment is unachievable. Palliative debulking therapy is the only treatment in relieving symptoms. We report our results from palliative debulking surgery at a national pseudomyxoma peritonei center in Denmark. Methods: From January 2007 to October 2012, we performed 27 palliative operations for pseudomyxoma peritonei with debulking at our institution. All patients were evaluated and found eligible for palliative treatment only. Patients were prospectively registered, while perioperative data were collected retrospectively from patient records. Results: The majority of patients ( n = 25) received an omentectomy (93%) as the primary procedure. In total, 17 (63%) received additional surgery. Median operative time was 88 min (range: 33–160 min). Median stay at the recovery ward was 6 h (2–288 h). Median hospital stay was 8 days (4–105 days). In all, 23 (85%) patients had no in-hospital complications, whereas 4 patients experienced complications (15%). Two of the complications were mild (Clavien-Dindo grade II), and two experienced severe complications (grade III and IV). Thirty-day mortality was 0%. Median survival was 3.0 years (0.2–6.2 years). Conclusion: Palliative debulking is a safe procedure with an acceptable morbidity and mortality offering immediate disease control.
Party Competition and Conflict in State Legislatures
Authors: Hinchliffe Kelsey L. , Lee Frances E. 
Published: August 2015

AbstractThis article examines the relationship between party competition for control of governing institutions and legislative party polarization. Although the competition/cohesion thesis dates to the 1940s, it has never before been subject to a test with data from the 50 states. Drawing upon newly available data, we take stock of the evidence. Five measures of party competition are used: (1) the number of recent shifts of party control, (2) an index of party competition for state offices, (3) the closeness of presidential elections in the state, (4) the effective number of political parties in the state, and (5) the ratio of Republicans to Democrats in the electorate. Nearly all of these measures correlate with higher levels of party polarization in both the lower and upper chambers, and none are associated with a lower level of polarization.