bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring and managing radiologist workload: A method for quantifying radiologist activities and calculating the full‐time equivalents required to operate a service
Authors: MacDonald Sharyn LS , Cowan Ian A , Floyd Richard A , Graham Rob 
Published: July 2013

AbstractIntroductionAccurate and transparent measurement and monitoring of radiologist workload is highly desirable for management of daily workflow in a radiology department, and for informing decisions on department staffing needs. It offers the potential for benchmarking between departments and assessing future national workforce and training requirements. We describe a technique for quantifying, with minimum subjectivity, all the work carried out by radiologists in a tertiary department.MethodsSix broad categories of clinical activities contributing to radiologist workload were identified: reporting, procedures, trainee supervision, clinical conferences and teaching, informal case discussions, and administration related to referral forms. Time required for reporting was measured using data from the radiology information system. Other activities were measured by observation and timing by observers, and based on these results and extensive consultation, the time requirements and frequency of each activity was agreed on. An activity list was created to record this information and to calculate the total clinical hours required to meet the demand for radiologist services.ResultsDiagnostic reporting accounted for approximately 35% of radiologist clinical time; procedures, 23%; trainee supervision, 15%; conferences and tutorials, 14%; informal case discussions, 10%; and referral‐related administration, 3%. The derived data have been proven reliable for workload planning over the past 3 years.ConclusionsA transparent and robust method of measuring radiologists' workload has been developed, with subjective assessments kept to a minimum. The technique has value for daily workload and longer term planning. It could be adapted for widespread use.
Sleep disturbances and changes in urinary 6‐sulphatoxymelatonin levels in patients with breast cancer undergoing lumpectomy
Authors: HANSEN M. V. , MADSEN M. T. , WILDSCHIØDTZ G. , ROSENBERG J. , GÖGENUR I. 
Published: July 2013

BackgroundSleep disturbances and changes in self‐reported discomfort and melatonin secretion are common in the post‐operative period. We aimed to study the distribution of sleep stages in the perioperative period and evaluate changes in secretion of the melatonin metabolite aMT6s and subjective parameters of sleepiness, pain, general well‐being and fatigue in patients undergoing surgery for breast cancer.MethodsTwelve patients, 30–70 years, undergoing lumpectomy were included. Polysomnography was performed the night before surgery (PREOP), the night after (PO1) and 14 days after (PO14). Recordings were scored as awake, light‐sleep, slow‐wave sleep and rapid‐eye‐movement (REM) sleep. Sleep stages were analysed as % of total sleep time (TST). Self‐reported discomfort was assessed using questions about the level of fatigue, well‐being, pain and sleepiness. Urinary aMT6s was measured by radioimmunoassay.ResultsThere was significantly decreased REM sleep on PO1 (5.9% of TST) compared with PREOP (18.7% of TST) (P < 0.005). An increase in light sleep was observed on PO1 (68.4% of TST) compared with PREOP (55.0% of TST) (P < 0.05). No significant changes in TST, sleep latency, sleep period or total time awake were found. The observed sleep changes were normalised after 2 weeks. No significant changes were found in pain, well‐being, fatigue or sleepiness. Night secretion of aMT6s showed a trend towards a decrease from PREOP to PO1 (P = 0.09) and normalisation on PO14 (P = 0.27 between PREOP and PO14).ConclusionPatients with breast cancer undergoing lumpectomy had significantly disturbed sleep architecture the night after surgery, and these changes were normalised after 2 weeks.
Transcultural validity of the Hypomania Checklist–32 (HCL‐32) in patients with major depressive episodes
Authors: Gamma Alex , Angst Jules , Azorin Jean‐Michel , Bowden Charles L , Perugi Giulio , Vieta Eduard , Young Allan H 
Published: July 2013

ObjectivesThere is mounting evidence that current diagnostic systems inadequately recognize clinically relevant levels of hypomania in depressed patients, thereby leading to an under‐diagnosis of bipolar disorders and the associated risk of treatment that is inappropriate or may actually worsen illness course. The Hypomania Checklist–32 revised version 2 (HCL‐32‐R2) is a self‐rating scale for hypomanic symptoms specifically developed to address this problem. The goal of this study was to assess the transcultural validity of the HCL‐32‐R2.MethodsMeasurement invariance of HCL‐32‐R2 responses from the multinational Bipolar Disorders: Improving Diagnosis, Guidance, and Education (BRIDGE) Study of 5635 patients with major depressive episodes (MDEs) was assessed by exploratory and confirmatory factor analysis across five cultural regions.ResultsTwo previously identified factors were reproduced and explained 60% of the variance in test responses. Only three out of 32 items had cross‐culturally variable factor loadings. Some moderate measurement invariance was also found with regard to age and gender. In discriminating unipolar from bipolar disorder, the HCL‐32‐R2 showed a sensitivity of 82% with a specificity of 57% when current DMS‐IV criteria for bipolar disorder were used, and substantially higher specificity of 73% when evidence‐based modified criteria were applied.ConclusionsThe psychometric properties of the HCL‐32‐R2 were largely culture‐independent. This finding replicates that of our previous international study and is a step towards validating the HCL‐32‐R2 as a broadly applicable screening instrument for hypomanic features, facilitating the detection of hidden bipolarity in depressed patients.
Pre‐modern Islamic Medical Ethics and Graeco‐Islamic‐Jewish Embryology
Authors: Ghaly Mohammed 
Published: July 2013

AbstractThis article examines the, hitherto comparatively unexplored, reception of Greek embryology by medieval Muslim jurists. The article elaborates on the views attributed to Hippocrates (d. ca. 375 BC), which received attention from both Muslim physicians, such as Avicenna (d. 1037), and their Jewish peers living in the Muslim world including Ibn Jumayʽ (d. ca. 1198) and Moses Maimonides (d. 1204). The religio‐ethical implications of these Graeco‐Islamic‐Jewish embryological views were fathomed out by the two medieval Muslim jurists Shihāb al‐Dīn al‐Qarāfī (d. 1285) and Ibn al‐Qayyim (d. 1350). By putting these medieval religio‐ethical discussions into the limelight, the article aims to argue for a two‐pronged thesis. Firstly, pre‐modern medical ethics did exist in the Islamic tradition and available evidence shows that this field had a multidisciplinary character where the Islamic scriptures and the Graeco‐Islamic‐Jewish medical legacy were highly intertwined. This information problematizes the postulate claiming that medieval Muslim jurists were hostile to the so‐called ‘ancient sciences’. Secondly, these medieval religio‐ethical discussions remain playing a significant role in shaping the nascent field of contemporary Islamic bioethics. However, examining the exact character and scope of this role still requires further academic ventures.
Fertility in Turner syndrome
Authors: Hewitt Jacqueline K. , Jayasinghe Yasmin , Amor David J. , Gillam Lynn H. , Warne Garry L. , Grover Sonia , Zacharin Margaret R. 
Published: July 2013

SummaryThere is increasing interest in fertility and use of assisted reproductive technologies for women with Turner syndrome (TS). Current parenting options include adoption, surrogacy, and spontaneous and assisted reproduction. For women with TS, specific risks of pregnancy include higher than usual rates of spontaneous abortion, foetal anomaly, maternal morbidity and mortality. Heterologous fertility assistance using oocytes from related or unrelated donors is an established technique for women with TS. Homologous fertility preservation includes cryopreservation of the patient's own gametes prior to the progressive ovarian atresia known to occur: preserving either mature oocytes or ovarian tissue containing primordial follicles. Mature oocyte cryopreservation requires ovarian stimulation and can be performed only in postpubertal individuals, when few women with TS have viable oocytes. Ovarian tissue cryopreservation, however, can be performed in younger girls prior to ovarian atresia – over 30 pregnancies have resulted using this technique, however, none in women with TS. We recommend consideration of homologous fertility preservation techniques in children only within specialized centres, with informed consent using protocols approved by a research or clinical ethics board. It is essential that further research is performed to improve maternal and foetal outcomes for women with TS.
Progress in understanding the association between high myopia and primary open‐angle glaucoma
Authors: Ma Fei , Dai Jinhui , Sun Xinghuai 
Published: July 2013

AbstractMany clinical and fundamental studies have shown that high myopia (HM) and glaucoma are closely associated. In particular, the occurrence and progression of primary open‐angle glaucoma interact with the progression of HM. Two hypotheses have been proposed to explain the association between the two disorders: the hypertension gene theory and the collagen‐related gene theory. HM and primary open‐angle glaucoma patients show similar collagen changes and hypersensitive responses to glucocorticoids. Consequently, these common features may hold key information regarding their underlying mechanisms. Advances in life sciences, such as molecular genetics, provide opportunities for clarifying their association at the molecular level. This article reviews available research on the association between these two disorders from the perspectives of epidemiology, clinical manifestation, diagnosis and pathogenic mechanisms.
Origins of lacrimal surgery, and evolution of dacryocystorhinostomy to the present
Authors: Harish Varun , Benger Ross S 
Published: July 2013

AbstractThe creation of an alternative pathway from the lacrimal sac into the nose has been practised for over two millennia. Early historical figures who pioneered lacrimal surgery were Celsus and Galen, treating dacryocystitis by plunging a red‐hot cautery iron through the lacrimal bone into the nose. Better understanding of lacrimal physiology and anatomy led to the introduction of more sophisticated techniques in the 18th century. However, despite these approaches, the technique of Celsus continued to be practised well into the eighteenth and nineteenth centuries. Modern lacrimal surgery began when the Italian otolaryngologist, Toti, described his external dacryocystorhinostomy procedure in 1904. Dupuy‐Dutemps and Bourget refined Toti's procedure, and introduced the technique of anastomosing lacrimal and nasal mucosal flaps which remains the foundation of the external dacryocystorhinostomy performed today. The endonasal dacryocystorhinostomy was described before the external approach, but its popularity and success grew only in recent times.
Prostaglandin associated periorbitopathy in patients using bimatoprost, latanoprost and travoprost
Authors: Kucukevcilioglu Murat , Bayer Atilla , Uysal Yusuf , Altinsoy Halil I 
Published: July 2013

AbstractBackgroundTo investigate the frequency of prostaglandin‐associated periorbitopathy among bimatoprost, latanoprost and travoprost users.DesignRetrospective observational case series.ParticipantsThe study group included 105 patients who were using one of the drugs in one eye for more than 1 month, and the other eye was used as a control.Main Outcome MeasuresThe frequency of prostaglandin‐associated periorbitopathy.MethodsSpecial care was taken to detect five prostaglandin‐associated periorbitopathy findings. Hertel exophthalmometry measurements and colour pictures of the periocular area were taken.ResultsStatistically significant differences were found among the groups regarding the presence of all prostaglandin‐associated periorbitopathy findings (P < 0.05). Periorbital fat loss was the most frequent and was observed in nearly all prostaglandin‐associated periorbitopathy patients except those who were relatively young. The overall frequency of prostaglandin‐associated periorbito pathy was 93.3% in the bimatoprost group, 41.4% in the latanoprost group and 70% in the travoprost group. The frequency of deepening of the upper lid sulcus was 80% in the bimatoprost group, 15.7% in the latanoprost group and 45% in the travoprost group. The frequency of milder changes (the presence of either only periorbital fat loss or dermatochalasis involution or the presence of both) was higher in the latanoprost group (62%) than in the travoprost (35.7%) and bimatoprost (7.1%) groups.ConclusionsProstaglandin‐associated periorbitopathy is as common as other adverse effects when careful examinations are performed and is more frequent and more severe in bimatoprost users. The loss of the periorbital fat pad is the first sign to occur during the evolution of prostaglandin‐associated periorbitopathy, especially in older patients.
Prevalence and causes of corneal blindness
Authors: Wang Haijing , Zhang Yaoguang , Li Zhijian , Wang Tiebin , Liu Ping 
Published: July 2013

AbstractBackgroundThe study aimed to assess the prevalence and causes of corneal blindness in a rural northern Chinese population.DesignCross‐sectional study.Participants or SamplesThe cluster random sampling method was used to select the sample.MethodsThis population‐based study included 11 787 participants of all ages in rural Heilongjiang Province, China. These participants underwent a detailed interview and eye examination that included the measurement of visual acuity, slit‐lamp biomicroscopy and direct ophthalmoscopy. An eye was considered to have corneal blindness if the visual acuity was <9/18 because of corneal diseases.Main Outcome MeasuresThe main outcome measure was prevalence rates of corneal blindness and low vision.ResultsAmong the 10 384 people enrolled in the study, the prevalence of corneal blindness is 0.3% (95% confidence interval 0.2–0.4%). The leading cause was keratitis in childhood (40.0%), followed by ocular trauma (33.3%) and keratitis in adulthood (20.0%). Age and illiteracy were found to be associated with an increased prevalence of corneal blindness.ConclusionBlindness because of corneal diseases in rural areas of Northern China is a significant public health problem that needs to be given more attention.
Effectiveness of hand splints in children with cerebral palsy: a systematic review with meta‐analysis
Authors: Jackman Michelle , Novak Iona , Lannin Natasha 
Published: July 2013

AimThe aim of this review was to determine the effectiveness of hand splinting for improving hand function in children with cerebral palsy (CP) and brain injury.MethodA systematic review with meta‐analyses was conducted. Only randomized and quasi‐randomized controlled trials in which all participants were children aged 0 to 18 years withCPor brain injury and a hand splint (cast, brace, or orthosis) were included.ResultsSix studies met the inclusion criteria. No study included participants with a brain injury; therefore, the results relate only toCP. Five studies investigated ‘non‐functional hand splints’ and one investigated a ‘functional hand splint’. Moderate‐quality evidence indicated a small benefit of non‐functional hand splints plus therapy on upper limb skills over therapy alone (standard mean difference [SMD]=0.81, 95% confidence interval [CI]=0.03–1.58), although benefits were diminished 2 to 3 months after splint wearing stopped (SMD=0.35,CI−0.06 to 0.77).InterpretationIn children withCP, hand splints may have a small benefit for upper limb skills. However, results are diminished after splint wearing stops. Given the costs – potential negative cosmesis and discomfort for the child – clinicians must consider whether hand splinting is clinically worthwhile. Further methodologically sound research regarding hand splinting combined with evidence‐based therapy is needed to investigate whether the small clinical effect is meaningful.
C‐reactive protein and incident diabetes in patients with arterial disease
Authors: Verhagen Sandra N. , Wassink Annemarie M. J. , van der Graaf Yolanda , Visseren Frank L. J. ,   SMART Study Group
Published: July 2013

AbstractIntroductionSystemic low‐grade inflammation, as measured by high‐sensitive C‐reactive protein (hsCRP), may contribute to the risk of type 2 diabetes in patients with manifest arterial disease.MethodsCohort study in 4072 patients with manifest arterial disease without diabetes. The relation between quartiles of hsCRP and type 2 diabetes was assessed with Cox regression analyses, taking age, smoking and blood pressure–lowering medication and lipid‐lowering medication into account. Insulin resistance was estimated with homeostasis model of insulin resistance (HOMA‐IR). In exploratory models, adjustments were performed for body mass index (BMI) and visceral and subcutaneous adipose tissue thickness.ResultsDuring a median follow‐up of 5·0 (IQR 2·5–8·2) years, 288 subjects developed diabetes. High hsCRP was independently associated with incident diabetes (Q4 vs. Q1 males: HR 1·62; 95% CI 1·06–2·48; females: HR 3·12; 95% CI 1·57–6·21). HOMA‐IR at baseline is related to hsCRP plasma levels (Q4 vs. Q1: males: β 0·27; 95% CI 0·19–0·36; females: β 0·35; 95% CI 0·22–0·48). The risk of diabetes associated with hsCRP was abolished in males (Q4 vs. 1 HR 1·23; 95% CI 0·80–1·88) and attenuated in females (Q4 vs. 1 HR 2·32; 95% CI 1·14–4·75) after adding BMI to the model, but not modified by statin use (P for interaction: 0·61).ConclusionsPatients with manifest arterial disease with high hsCRP plasma levels are at increased risk to develop type 2 diabetes and are more insulin resistant as compared to those with low hsCRP levels. This increase in risk is more pronounced in females than in males and is not modified by statin use.
Integrating multi‐receiver electromagnetic induction measurements into the interpretation of the soil landscape around the school of gladiators atCarnuntum
Authors: Saey T. , Van Meirvenne M. , De Smedt P. , Neubauer W. , Trinks I. , Verhoeven G. , Seren S. 
Published: July 2013

SummaryRecently, the unique foundations of a school of gladiators were discovered in theRoman town ofCarnuntum (40 km southeast ofVienna,Austria) by applying a combination of non‐invasive archaeological prospection techniques such as magnetometry, ground penetrating radar, aerial photography, airborne laser scanning and airborne imaging spectroscopy. Although the well‐preserved remains of the building complex were revealed down to a depth of 1.8 m by high‐resolution near‐surface geophysics, some questions about the surrounding soil landscape remained unanswered. Therefore, a proximal soil sensing procedure based on a survey with a multi‐receiver electromagnetic induction (EMI) instrument was conducted to interpret the surroundings of the school, covering an area of 5.6 ha. We investigated the usefulness of integrating the complementary apparent electrical conductivity (ECa) and apparent magnetic susceptibility (MSa) measurements for the mapping and investigation of this soil landscape. The multipleECameasurements allowed the identification of zones with low‐conductive gravel outcrops, and zones where silty‐clayey soils were deposited on top of the underlying gravel. AnEC‐depth slicing procedure enhanced the contrast between small soil features, such as frost‐wedge pseudomorphs and drainage gullies, and their background, and provided indications about the depth extent of these features. TheMS‐depth slices showed the foundations of the school of gladiators, an aqueduct and grave monuments. After combining these results with the topography, an integrated visualization of the school in its soil landscape was obtained. This study demonstrated the potential of multi‐receiverEMIsoil surveys to map and interpret the soil landscape and to discern small natural as well as archaeological features.
Prognostic value of insular lobe involvement in temporal lobe epilepsy: A stereoelectroencephalographic study
Authors: Blauwblomme Thomas , David Olivier , Minotti Lorella , Job Anne‐Sophie , Chassagnon Serge , Hoffman Dominique , Chabardes Stéphan , Kahane Philippe 
Published: July 2013

SummaryPurposeFailure of anterior temporal lobectomy for temporal lobe epilepsy has raised the question of insular cortex involvement in these seizures. Because of difficulties in exploring the insula with invasive electroencephalography (EEG) recordings, only few studies have been performed and this question remains unanswered.MethodsHere, we studied 17 patients who underwent surgery for drug‐resistant temporal lobe epilepsy, explored with intracerebral electrodes, with at least one electrode coplanar to the insula. We analyzed seizure propagation patterns from temporal lobe structures to the insula, and their effect on outcome. We used an objective measure of the epileptogenicity of the insula for individual cases and group analysis between patients who were seizure‐free after surgery and the others.Key FindingsAll temporal lobe seizures propagated to the insular cortex, with a shorter propagation delay in the case of mesiolateral temporal lobe seizures, thus supporting the existence of a perilimbic network. Epileptogenicity of the insular cortex was not a prognostic factor for outcome after surgery.SignificanceInsular involvement in temporal lobe seizure is not per se a prognostic factor for surgical outcome. Prognosis may be correlated with larger epileptogenic zones that our stereoelectroencephalography spatial sampling could have underestimated.
Electroencephalography monitoring in critically ill children: Current practice and implications for future study design
Authors: Sánchez Sarah M. , Arndt Daniel H. , Carpenter Jessica L. , Chapman Kevin E. , Cornett Karen M. , Dlugos Dennis J. , Gallentine William B. , Giza Christopher C. , Goldstein Joshua L. , Hahn Cecil D. , Lerner Jason T. , Loddenkemper Tobias , Matsumoto Joyce H. , McBain Kristin , Nash Kendall B. , Payne Eric , Sánchez Fernández Iván , Shults Justine , Williams Korwyn , Yang Amy , Abend Nicholas S. 
Published: July 2013

SummaryPurposeSurvey data indicate that continuous electroencephalography (EEG) (CEEG) monitoring is used with increasing frequency to identify electrographic seizures in critically ill children, but studies of current CEEG practice have not been conducted. We aimed to describe the clinical utilization of CEEG in critically ill children at tertiary care hospitals with a particular focus on variables essential for designing feasible prospective multicenter studies evaluating the impact of electrographic seizures on outcome.MethodsEleven North American centers retrospectively enrolled 550 consecutive critically ill children who underwent CEEG. We collected data regarding subject characteristics, CEEG indications, and CEEG findings.Key FindingsCEEG indications were encephalopathy with possible seizures in 67% of subjects, event characterization in 38% of subjects, and management of refractory status epilepticus in 11% of subjects. CEEG was initiated outside routine work hours in 47% of subjects. CEEG duration was <12 h in 16%, 12–24 h in 34%, and >24 h in 48%. Substantial variability existed among sites in CEEG indications and neurologic diagnoses, yet within each acute neurologic diagnosis category a similar proportion of subjects at each site had electrographic seizures. Electrographic seizure characteristics including distribution and duration varied across sites and neurologic diagnoses.SignificanceThese data provide a systematic assessment of recent CEEG use in critically ill children and indicate variability in practice. The results suggest that multicenter studies are feasible if CEEG monitoring pathways can be standardized. However, the data also indicate that electrographic seizure variability must be considered when designing studies that address the impact of electrographic seizures on outcome.