bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved microcalcification visualization using dual-energy digital mammography
Authors: Tsai Chia-Jung , Chen Ran-Chou , Peng Hui-Ling , Hsu Wen-Lin , Lee Jason JS 
Published: April 2013

Background Dual-energy digital mammography (DEDM), involving a combination of high-energy (HE) and low-energy (LE) images, has been investigated as offering a potential improvement in microcalcification detection obscured by overlapping tissue structures. Purpose To explore the possibility to improve detection of microcalcifications using the DEDM technique. Material and Methods Three DEDM protocols were performed by adjusting the effective tube current time product (mAs) of LE image at the same (100%), one half (50%), and one-quarter (25%) of that used in HE image acquisition, named DEDM100%, DEDM50%, and DEDM25%, respectively. A single-energy digital mammography (SEDM) method was also used as a control. A total of 525 regions of interest (ROIs) were used to compare the performance of the DEDM to that of SEDM using free-response receiver-operating characteristic (FROC) and areas under the FROC curve (Az). Results All DEDM protocols ranked significantly higher than the SEDM method ( P < 0.001). The true-positive fraction was 0.90 for an average of 0.017–0.042 false-positive per image using the DEDM100%, 0.017–0.114 using the DEDM50%, 0.021–0.148 using the DEDM25%, and 0.134–0.422 using the SEDM. The estimated Az values were 0.915–0.940, 0.867–0.935, 0.824–0.930, and 0.567–0.673, respectively. Conclusion The DEDM50% protocol provided a trade-off benefit between accurate microcalcification detectability and radiation dose for any tissue density. Therefore, the DEDM50% has the potential to minimize excess radiation dose without a negative impact on image quality which could improve earlier diagnosis of breast cancer.
Thrombophlebitis of the internal jugular vein (Lemierre syndrome): clinical and CT findings
Authors: Kim Bo Yeon , Yoon Dae Young , Kim Hyeong Chul , Kim Eun Soo , Baek Sora , Lim Kyoung Ja , Seo Young Lan , Yun Eun Joo , Choi Chul Soon , Bae Sang Hoon 
Published: April 2013

Background Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9 ± 8.3 years) with thrombophlebitis of the IJV. Results Five patients (50%) had complications, including pneumonia ( n = 3), neck abscess ( n = 1), and thrombophlebitis of cerebral venous sinus ( n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length ( n = 8, 67%), ovoid shape ( n = 7, 58%), complete occlusion of the lumen ( n = 10, 83%), circumferential ( n = 11, 92%), smooth ( n = 8, 67%), and thick (≥4 mm) ( n = 8, 67%) rim enhancement, and adjacent soft tissue swelling ( n = 11, 92%). Conclusion Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis.
Dual time point 18FDG-PET/CT versus single time point 18FDG-PET/CT for the differential diagnosis of pulmonary nodules: a meta-analysis
Authors: Zhang Li , Wang Yinzhong , Lei Junqiang , Tian Jinhui , Zhai Yanan 
Published: April 2013

Background Lung cancer is one of the most common cancer types in the world. An accurate diagnosis of lung cancer is crucial for early treatment and management. Purpose To perform a comprehensive meta-analysis to evaluate the diagnostic performance of dual time point 18F-fluorodexyglucose position emission tomography/computed tomography (FDG-PET/CT) and single time point 18FDG-PET/CT in the diagnosis of pulmonary nodules. Material and Methods PubMed (1966-2011.11), EMBASE (1974-2011.11), Web of Science (1972-2011.11), Cochrane Library (-2011.11), and four Chinese databases — CBM (1978-2011.11), CNKI (1994-2011.11), VIP (1989-2011.11), and Wanfang Database (1994-2011.11) — were searched. Summary sensitivity, summary specificity, summary diagnostic odds ratios (DOR), and summary positive likelihood ratios (LR+) and negative likelihood ratios (LR–) were obtained using Meta-Disc software. Summary receiver-operating characteristic (SROC) curves were used to evaluate the diagnostic performance of dual time point 18FDG-PET/CT and single time point 18FDG-PET/CT. Results The inclusion criteria were fulfilled by eight articles, with a total of 415 patients and 430 pulmonary nodules. Compared with the gold standard (pathology or clinical follow-up), the summary sensitivity of dual time point 18FDG-PET/CT was 79% (95%CI, 74.0–84.0%), and its summary specificity was 73% (95%CI, 65.0–79.0%); the summary LR+ was 2.61 (95%CI, 1.96–3.47), and the summary LR– was 0.29 (95%CI, 0.21–0.41); the summary DOR was 10.25 (95%CI, 5.79–18.14), and the area under the SROC curve (AUC) was 0.8244. The summary sensitivity for single time point 18FDG-PET/CT was 77% (95%CI, 71.9–82.3%), and its summary specificity was 59% (95%CI, 50.6–66.2%); the summary LR+ was 1.97 (95%CI, 1.32–2.93), and the summary LR– was 0.37 (95%CI, 0.29–0.49); the summary DOR was 6.39 (95%CI, 3.39–12.05), and the AUC was 0.8220. Conclusion The results indicate that dual time point 18FDG-PET/CT and single time point 18FDG-PET/CT have similar accuracy in the differential diagnosis of pulmonary nodules. Dual time point 18FDG-PET/CT appears to be more specific than single time point 18FDG-PET/CT.
Efficacy of intralesional triamcinolone injection in the treatment of mammillary fistula: a prospective study
Authors: Berná-Serna Juan D , Berná-Mestre Juan D , Piñero Antonio , Canteras Manuel 
Published: April 2013

Background Recurring mammillary fistula (MF) is often difficult to manage. Purpose To evaluate the efficacy of intralesional triamcinolone (ILT) injection versus irrigation with saline solution in the management of MF. Material and Methods A prospective study was conducted including 10 patients with MF. The patients were distributed non-randomly into two groups: saline group ( n = 5) and triamcinolone group ( n = 5). Ultrasound guidance was used for ILT injection. The injection was repeated in the case of no response or recurrence. Results No statistically significant differences were observed between the saline and triamcinolone groups for clinical parameters and ultrasonographic characteristics of the MF and for the outcomes of the two methods of treatment. However, a statistically significant difference was observed between the two groups for recurrence of MF ( P < 0.046). Success of the treatment with ILT injection was observed in 90% of the patients (9/10), and a failure in one case (10%) after three ILT injections, who was referred for surgery. Conclusion ILT injection is an effective, simple, and safe treatment for the management of MF.
Prediction of headache severity (density and functional impact) after traumatic brain injury: A longitudinal multicenter study
Authors: Walker William C , Marwitz Jennifer H , Wilk Amber R , Ketchum Jessica M , Hoffman Jeanne M , Brown Allen W , Lucas Sylvia 
Published: April 2013

Background: Headache (HA) following traumatic brain injury (TBI) is common, but predictors and time course are not well established, particularly after moderate to severe TBI. Methods: A prospective, longitudinal cohort study of HA severity post-TBI was conducted on 450 participants at seven participating rehabilitation centers. Generalized linear mixed-effects models (GLMMs) were used to model repeated measures (months 3, 6, and 12 post-TBI) of two outcomes: HA density (a composite of frequency, duration, and intensity) and HA disruptions to activities of daily living (ADL). Results: Although HA density and ADL disruptions were nominally highest during the first three months post-TBI, neither showed significant changes over time. At all time points, history of pre-injury migraine was by far the strongest predictor of both HA density and ADL disruptions (odds ratio (OR) = 8.0 and OR = 7.2, averaged across time points, respectively). Furthermore, pre-injury non-migraine HA (at three and six months post-TBI), penetrating-type TBI (at six months post-TBI), and female sex (at six and 12 months post-TBI) were each associated with an increase in the odds of a more severe HA density. Severity of TBI (post-traumatic amnesia (PTA) duration) was not associated with either outcome. Conclusion: Individuals with HA at three months after moderate-severe TBI do not improve over the ensuing nine months with respect to HA density or ADL disruptions. Those with pre-injury HA, particularly of migraine type, are at greatest risk for HA post-TBI. Other independent risk factors are penetrating-type TBI and, to a lesser degree and post-acutely only, female sex. Individuals with these risk factors should be monitored and considered for aggressive early intervention.
Reliability of Estimates of ACL Attachment Locations in 3-Dimensional Knee Reconstruction Based on Routine Clinical MRI in Pediatric Patients
Authors: Swami Vimarsha Gopal , Cheng-Baron June , Hui Catherine , Thompson Richard , Jaremko Jacob Lester 
Published: April 2013

Background: Current techniques of anterior cruciate ligament (ACL) reconstruction focus on the placement of femoral and tibial tunnels at anatomic ACL attachments, which can be difficult to identify intraoperatively. Purpose: To determine whether the 3-dimensional (3D) center of ACL attachments can be reliably detected from routine magnetic resonance imaging (MRI) in patients with intact ACLs and whether the reliability of this technique changes if the ACL is torn. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A computer technique was developed in which users identify points along ACL attachments on routine clinical MRI of preoperative knees. These attachments are then displayed on a 3D MRI reconstruction, which can be used as a visual guide for the surgeon during arthroscopic surgery. Thirty-seven pediatric patients (age range, 10-17 years) with ACL tears and 37 controls with intact ACLs were examined. Two blinded observers identified cruciate ligament attachments on routine clinical 1.5-T MRI of knees. From the resulting 3D model, the location of the center of each ligament attachment site and its area were calculated and reliability assessed. Results: Mean interobserver variation of the centers of ACL attachments for the intact versus torn ACL was 1.7 ± 0.9 mm versus 1.8 ± 1.1 mm (femoral) and 1.4 ± 0.9 mm versus 1.7 ± 1.0 mm (tibial), respectively ( P > .05). The 95% confidence interval for the center location was at most 4 mm. The identified ACL attachment areas were more variable, with interobserver reliability ranging from fair to excellent by the intraclass correlation coefficient. Overlap of ligament areas between observers for the intact versus torn ACL was 70% ± 15% versus 73% ± 12% (femoral) and 79% ± 9% versus 78% ± 10% (tibial), respectively ( P > .05). In all cases, intraobserver reliability was superior to interobserver reliability. Conclusion: The 3D locations of ACL tibial and femoral attachment centers were identified from routine clinical MRI with variability averaging less than 2 mm between 2 observers. The margin of error was at most 4 mm, representing the thickness of a single axial MRI slice, whether the ACL was intact or torn. Remnant tissue at attachments allows a reliable assessment even of torn ligaments. Identification of the ligament attachment areas was more user dependent than was identification of the attachment centers.
Influence d’un contexte de programme triste sur le processus de persuasion publicitaire chez des adultes jeunes et âgés
Authors: Lacoste-Badie Sophie , Malek Faten , Droulers Olivier 
Published: April 2013

Résumé Cette recherche expérimentale examine l’influence de l’âge (adultes jeunes vs. âgés) et du contexte de programme (triste vs. neutre) sur les réactions affectives déclenchées par le programme, sur l’attitude envers les annonces insérées dans le programme et sur l’attitude envers les marques. Les résultats mettent en évidence des effets différenciés chez les adultes jeunes et âgés: le niveau de tristesse déclaré après l’exposition au programme triste est moins fort chez les adultes âgés que chez les adultes jeunes; la tristesse n’influence pas l’attitude envers les annonces (Aad) chez les adultes âgés, alors que son influence est négative chez les adultes jeunes; l’effet de la tristesse sur l’attitude envers les marques (Ab), médiatisé par Aad, n’est pas significatif chez les adultes âgés, alors qu’il est significatif et négatif chez les adultes jeunes. Cette recherche confirme l’existence d’une meilleure régulation émotionnelle chez les adultes âgés (vs. adultes jeunes) dans une situation inductrice d’émotion négative.
La distance temporelle, la simulation mentale et le processus d’adoption d’innovations technologiques complexes
Authors: Jeannot Florence , Jolibert Alain 
Published: April 2013

Résumé Cet article vise à étudier les processus sous-jacents à l’influence de l’interaction entre la distance temporelle et la simulation mentale sur les réactions des consommateurs à l’égard d’innovations technologiques, et à déterminer si les effets bénéfiques de cette interaction, qui ont été démontrés antérieurement avec une innovation semi-continue, se produisent également avec une innovation discontinue. En raison du taux élevé d’échecs lors du lancement d’innovations discontinues et des enjeux que celles-ci représentent pour les entreprises opérant dans le secteur des hautes technologies, il demeure important d’identifier des moyens d’action efficaces pour favoriser leur adoption. Nos résultats indiquent que lorsque l’achat est envisagé à court terme, la simulation orientée vers le processus réduit l’incertitude liée aux coûts d’apprentissage et l’anxiété, et augmente l’intention d’utilisation et l’intention d’achat. A long terme, la simulation orientée vers le résultat diminue l’incertitude envers les bénéfices, et accroît l’optimisme, l’intention d’utilisation et l’intention d’achat.
Evaluation of a New Index of Mechanical Ventilation Weaning
Authors: de Souza Leonardo Cordeiro , Guimarães Fernando Silva , Lugon Jocemir Ronaldo 
Published: April 2013

Purpose: The performance of most indices used to predict ventilator weaning outcomes remains below expectation. The purpose of this study was to evaluate a new weaning index, the timed inspiratory effort (TIE) index, which is based on the maximal inspiratory pressure and the occlusion time required to reach it. Methods: This observational prospective study included patients undergoing mechanical ventilation. Patients ready to be weaned had their TIE index and 6 previously reported indices recorded. The primary end point was the overall predictive performance of the studied weaning indices (area under the receiver operating characteristic curves [AUCs]). The secondary end points were sensitivity, specificity, positive predictive value, and negative predictive value. P values <.05 were considered significant. Results: From the 128 initially screened patients, the 103 patients selected for the study included 45 women and 58 men (mean age 60.8 ± 19.8 years). In all, 60 patients were weaned, 43 were not weaned, and 32 died during the study period. Tracheotomy was necessary in 61 patients. The mean duration of mechanical ventilation was 17.5 ± 17.3 days. The AUC of 3 weaning predictors (the TIE index, the integrative weaning index, and the frequency-to-tidal volume [ f/Vt] ratio index) was higher than the other indices. The TIE index had the largest AUC. Conclusion: The TIE index performed better than the best weaning indices used in clinical practice.
Diminished Appetite Predicts Mortality of Chinese Peritoneal Dialysis Patients
Authors: Huang Baoyan , Zhou Zijuan , Xu Hong , Wang Haiyun , Liu Bingyan , Cui Ying , Yang Wei , Li Xuemei , Chen Limeng 
Published: April 2013

Background: Many maintenance dialysis patients experience a common cluster of symptoms, including diminished appetite (anorexia). This symptom has been associated with reduced quality of life and increased mortality in this population. Aim: The aim of this study was to determine whether diminished appetite is a significant predictor of negative clinical outcomes in patients on peritoneal dialysis (PD). Method: A longitudinal prospective study was conducted in 98 patients receiving PD in Beijing, China. Clinical characteristics, nutritional and inflammatory marker levels, and related peritoneal treatment information were collected. The appetite status and serum albumin levels were assessed initially and reevaluated monthly during the first year of follow-up. All patients were followed for nearly 5 years or until death. Data were collected about mortality, hospitalization, and peritonitis. Results: The mean age of participants was 60.3 ± 14.4, and 22.8% reported diminished appetite. At baseline, female sex, cardiovascular disease, and prealbumin level were the significant predictors of appetite. The average length of follow-up was 39 (range: 2–57) months. The Kaplan–Meier survival curve showed the survival rate was lower in patients reporting diminished appetite than for patients reporting normal appetite. Multivariate analysis indicated that diminished appetite, diabetes, ferritin, and serum albumin levels were independent predictors of mortality. Conclusion: Self-reported appetite was a predictor of clinical characteristics and outcome for patients receiving PD. Conducting appetite evaluation periodically is recommended as a nursing strategy to improve care for these patients.
Achieving valid patient-reported outcomes measurement: a lesson from fatigue in multiple sclerosis
Authors: Hobart Jeremy , Cano Stefan , Baron Rachel , Thompson Alan , Schwid Steven , Zajicek John , Andrich David 
Published: April 2013

Background: The increasing influence of patient-reported outcome (PRO) measurement instruments indicates their scrutiny has never been more crucial. Above all, PRO instruments should be valid: shown to assess what they purport to assess. Objectives: To evaluate a widely used fatigue PRO instrument, highlight key issues in understanding PRO instrument validity, demonstrate limitations of those approaches and justify notable changes in the validation process. Methods: A two-phase evaluation of the 40-item Fatigue Impact scale (FIS): a qualitative evaluation of content and face validity using expert opinion ( n=30) and a modified Delphi technique; a quantitative psychometric evaluation of internal and external construct validity of data from 333 people with multiple sclerosis using traditional and modern methods. Results: Qualitative evaluation did not support content or face validity of the FIS. Expert opinion agreed with the subscale placement of 23 items (58%), and classified all 40 items as being non-specific to fatigue impact. Nevertheless, standard quantitative psychometric evaluations implied, largely, FIS subscales were reliable and valid. Conclusions: Standard quantitative ‘psychometric’ evaluations of PRO instrument validity can be misleading. Evaluation of existing PRO instruments requires both qualitative and statistical methods. Development of new PRO instruments requires stronger conceptual underpinning, clearer definitions of the substantive variables for measurement and hypothesis-testing experimental designs.
Pillcam ESO® is more accurate than clinical scoring systems in risk stratifying emergency room patients with acute upper gastrointestinal bleeding
Authors: Gutkin Ellen , Shalomov Albert , Hussain Syed A. , Kim Sang H. , Cortes Rafael , Gray Sondra , Judeh Hani , Pollack Simcha , Rubin Moshe 
Published: April 2013

Background: Upper gastrointestinal bleeding (UGIB) accounts for 400,000 hospital admissions in the US each year. Despite advances, mortality rates remain high and are estimated to be 5–10%. Early therapeutic endoscopy is widely recommended as a means of reducing morbidity and mortality. The Rockall and Blatchford scores are clinical scoring systems devised to assist in risk stratifying patients with UGIB. In a prior study we found that rapid live bedside video capsule endoscopy (VCE) utilizing Pillcam ESO® correctly identified patients with high-risk stigmata of bleeding seen on upper endoscopy. In this study, we compare the accuracy of the Rockall and Blatchford scores with Pillcam ESO® in predicting high-risk endoscopic stigmata. Methods: Pre-endoscopy Blatchford and Rockall scores were calculated for 25 patients (14 males, 11 females) presenting to the emergency room with acute UGIB. The average patient was 66 years of age. A total of 24 out of 25 patients underwent upper endoscopy within 24 hours. One patient did not undergo endoscopy due to clinical instability. The timing of endoscopy was based on clinical parameters in 12 patients, and on live view VCE with Pillcam ESO® in the other 13 patients. Positive VCE was defined as red blood, clot or coffee grounds. Mean Rockall and Blatchford scores for all 24 patients were compared to determine potential differences between high- and low-risk patients. Rockall and Blatchford scores were also compared with VCE findings. Results: Of 24 patients, 13 had high-risk stigmata on upper endoscopy. The mean Rockall and Blatchford scores were 3 and 13, respectively. In the 11 patients without stigmata, the mean Rockall and Blatchford scores were 2 and 11, respectively. There was no statistically significant difference between the Blatchford scores of the two groups (95% confidence interval [CI] −5.1 to 1.3; p = 0.22). There was no statistically significant difference between the Rockall scores of the two groups (95% CI −2.3 to 0.3; p = 0.11). In the subgroup of 12 patients who underwent VCE prior to endoscopy, 8/12 had positive findings, which were all confirmed at endoscopy. All 4 patients with negative VCE had no high-risk stigmata at endoscopy. Conclusion: In emergency room patients with acute UGIB, neither the Rockall nor the Blatchford scores were able to differentiate high- and low-risk patients identified at endoscopy. Live view VCE, however, was accurate in predicting high-risk endoscopic stigmata, and may be better suited as a risk stratification tool. Additional studies with a larger cohort will be required to validate these findings.
A survey of UK hand therapists' confidence in the interpretation of hand radiographs
Authors: McMullen Emily 
Published: April 2013

Objective To describe current practice among hand therapists in the UK when ordering and interpreting radiographs in clinical practice, in order to define confidence and establish national baselines. To highlight, promote discussion and propose the possible requirement for standardized education and a formal systematic assessment protocol for radiographic interpretation. Methods All British Association Hand Therapist (BAHT) registered centres in the UK were sent questionnaires and data collections sheets in order to ascertain current practice. Results The data suggest that of the 75 hand therapy centres in the UK who participated in this study 50.6% have therapists ordering radiographs. Of these 36% have formalized teaching and only 5.3% use a formal systematic assessment protocol for hand radiograph interpretation. The average confidence level on a visual analogue scale (VAS) was 5 (some confidence) with only four centres demonstrating above 6 (confident). Increased confidence levels were found to be associated with the availability of formal training and systematic assessment tools. Conclusion Centres using formalized training demonstrated a higher level of confidence than those without. The highest levels of confidence were in those centres whose therapists used a formal systematic assessment tool. The data collected suggests an education programme and standardized assessment protocol may assist the confidence of hand therapists in the radiographic assessment of hands.