bluuebunny/crossref_metadata_2025_split huggingface dataset:
MR imaging findings of pilomatricomas: a radiological–pathological correlation
Authors: Kato Hiroki , Kanematsu Masayuki , Watanabe Haruo , Nagano Akihito , Shu En , Seishima Mariko , Miyazaki Tatsuhiko 
Published: August 2015

Background Magnetic resonance imaging (MRI) findings of pilomatricomas have yet to be determined. Purpose To assess the correlation between MRI and pathological findings of pilomatricomas. Material and Methods MR images were obtained on patients with histologically proven pilomatricomas using a 1.5-T MR scanner. The images were retrospectively reviewed for size, signal intensity compared with skeletal muscles, and enhancement patterns. Furthermore, we assessed the presence of a reticular appearance, a ring-like appearance, and peritumoral fat stranding. Results We included 11 consecutive patients with 12 histologically proven pilomatricomas (3 boys/men, 8 girls/women; age range, 4–76 years; mean age, 20 years; median age, 14 years). The tumors were located in the head and neck ( n = 6), upper extremities ( n = 5), and lower extremities ( n = 1). The maximum tumor diameter was in the range of 7–32 mm (mean, 16.5 mm). On T2-weighted (T2W) images, five tumors showed homogeneous hypointensity, whereas six showed reticular hyperintensity and one showed cystic hyperintensity. On fat-suppressed T2W images, nine tumors showed reticular hyperintensity, eight showed ring-like hyperintensity, and five showed peritumoral fat stranding. On fat-suppressed gadolinium-enhanced T1-weighted (T1W) images, one tumor showed no enhancement, whereas three showed reticular enhancement and five showed ring-like enhancement. Histologically, edematous and fibrous stroma was observed in 10 tumors, tumor capsules in 11, and inflammatory cell infiltration of the peritumoral fat tissue in nine. Conclusion MRI features of pilomatricomas included reticular and ring-like hyperintensities on fat-suppressed T2W images and reticular and ring-like enhancement on fat-suppressed gadolinium-enhanced T1W images.
Significance of combined use of MRI and perfusion SPECT for evaluation of multiple system atrophy, cerebellar type
Authors: Miyoshi Fuminori , Kanasaki Yoshiko , Shinohara Yuki , Fujii Shinya , Kaminou Toshio , Tanabe Yoshio , Ogawa Toshihide 
Published: August 2015

Background Multiple system atrophy, cerebellar type (MSA-C) sometimes shows asymmetrical findings on magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). Purpose To assess the frequency and clinical significance of asymmetrical MRI and 99mTc-ethyl cysteinate dimer perfusion (ECD) SPECT findings of the cerebellum, middle cerebellar peduncle (MCP), and pons in MSA-C patients. Material and Methods We retrospectively reviewed 28 patients with MSA-C who underwent MRI and 99mTc-ECD SPECT and evaluated laterality of atrophy and signal changes on MRI, and laterality of perfusion on 99mTc-ECD SPECT transversely and longitudinally. Results Laterality was identified for 64%, 61%, and 21% of atrophy in the cerebellum, MCP, and pons, respectively, on MRI and for 71% of atrophy in the cerebellum on perfusion SPECT. Concerning comparisons between the latest MRI and SPECT findings, laterality of cerebellar/MCP atrophy on MRI and decreased cerebellar perfusion on SPECT was matched in 57%, mismatched in 11%, and absent in 25% of patients. On past images, MRI and SPECT showed matched laterality in 33%, mismatched laterality in 27%, no laterality in 13%, and SPECT precedent laterality in 27% of patients. Including the latest and past images, asymmetrical changes were observed in 75% of patients. We could not identify any correlation between laterality of image findings and cerebellar symptoms in most patients. Conclusion Asymmetrical changes on MRI and perfusion SPECT are common in MSA-C patients. Perfusion SPECT is useful for diagnosing MSA-C in the early stages from a functional perspective.
Glycosaminoglycan chemical exchange saturation transfer at 3T MRI in asymptomatic knee joints
Authors: Schleich Christoph , Bittersohl Bernd , Miese Falk , Schmitt Benjamin , Müller-Lutz Anja , Sondern Malte , Antoch Gerald , Krauspe Rüdiger , Zilkens Christoph 
Published: August 2015

Background Biochemical alterations such as glycosaminoglycan (GAG) depletion occur early in the course of osteoarthritis, but cannot be detected with standard magnetic resonance techniques. With glycosaminoglycan chemical exchange saturation transfer (gagCEST), a biochemical imaging technique, it is feasible to detect biochemical components in knee joint cartilage. Purpose To establish baseline values for gagCEST magnetic resonance imaging (MRI) in knee joint cartilage at 3 Tesla (T). Material and Methods Twenty volunteers (8 women, 12 men; mean age, 24.55 ± 2.35 years;age range, 21–29 years) with no history or clinical findings indicative of knee joint pathologies underwent MRI at 3T. The imaging protocol included three-dimensional (3D) double-echo steady-state sequence for morphological cartilage assessment and a prototype 3D CEST pulse sequence to evaluate the CEST effects in six cartilage regions of the knee joint: (i) lateral femoral condyle; (ii) medial femoral condyle; (iii) lateral tibial plateau; (iv) medial tibial plateau; (v) patella; and (vi) trochlea. We used the asymmetry of the magnetization transfer ratio (MTRasym) parameter to quantify the gagCEST effects in these regions. Results Regional differences revealed high MTRasym values in the patellar (1.62% ± 1.19%) and the trochlear (1.17% ± 1.29%) cartilages, and low MTRasym values in the medial femoral condyle (0.41% ± 0.58%) and the lateral tibial plateau (0.52% ± 0.53%) cartilages. Conclusion Regional differences in the gagCEST values must be considered when conducting gagCEST imaging of knee joint cartilage. In the future gagCEST imaging may be an additional feature in the evaluation of the biochemical composition of knee joint cartilage.
Low-cost labour or cultural exchange? Reforming the Working Holiday visa programme
Authors: Reilly Alexander 
Published: August 2015

AbstractThe article considers the place of Working Holiday visas in Australia’s migration policy and socio-economic planning. With the number of Working Holiday visa grants now topping 200,000 annually, Working Holiday Makers are significant participants in low-skilled work in Australia. The article argues that the programme is not adequately regulated to protect Working Holiday Makers in this work. In light of concerns around the exploitation of Working Holiday Makers, the article offers suggestions for reform to the programme. The article argues that the programme should be returned to its original conception of fostering a cultural experience for young migrants coming to Australia. It argues that work entitlements under the Working Holiday visa should be limited to work that is appropriate for young migrants on a brief cultural visit and that labour shortages should otherwise be filled using dedicated temporary labour migration visas which are properly designed to address labour shortages in the economy. Reform is necessary to protect the work conditions of local and migrant workers, to maintain Australia’s reputation as a country with high employment standards and to maintain positive relations with countries in the Working Holiday programme.
MR Imaging Evaluation of the Lisfranc Ligament in Cadaveric Feet and Patients With Acute to Chronic Lisfranc Injury
Authors: Kitsukawa Kaoru , Hirano Takaaki , Niki Hisateru , Tachizawa Natsuki , Nakajima Yasuo , Hirata Kazuaki 
Published: August 2015

Background: Magnetic resonance (MR) imaging is known to be useful to demonstrate Lisfranc ligament injury. There are few studies that report differences in MR imaging findings of acute or chronic Lisfranc ligament injuries. We applied oblique MR imaging planes parallel to the Lisfranc ligament for better visualization of the entire course of the ligament and assessed the detailed MR imaging appearances of the Lisfranc ligament in cadavers and patients with presumed Lisfranc injuries. Methods: Twelve preserved cadaveric feet were examined using a small-diameter surface coil. Long axis, oblique sagittal, and oblique short axis cross sections parallel to the Lisfranc ligament, dorsal ligament, and plantar ligament were obtained. Twenty-six MR examinations from 23 patients with suspected Lisfranc joint injuries were evaluated. Results: In the cadaveric study, the Lisfranc ligament was satisfactorily visible along its entire course in a single slice on long axis and oblique sagittal MR images. The dorsal ligament and the plantar ligament were visible separately from the Lisfranc ligament in oblique sagittal and oblique short axis planes. In the patient study, 11 MR examinations led to diagnoses of complete tears of the Lisfranc ligament that were acute injuries (3-21 days after trauma) mostly associated with disruption of the dorsal and plantar ligaments. Nine studies led to diagnoses of incomplete tears of the Lisfranc ligament that were chronic injuries (2-14 months after trauma). Recovery of the continuity of the disrupted ligament was observed in 3 patients. Conclusion: MR imaging demonstrated the integrity of the ligaments and was useful for diagnosing an acute Lisfranc injury. Fibrous healing of the torn ligament was observed in a chronic injury. Level of Evidence: Level IV, case series.
An evaluation tool for assessing performance in priority setting and resource allocation: multi-site application to identify strengths and weaknesses
Authors: Hall William , Smith Neale , Mitton Craig , Gibson Jennifer , Bryan Stirling 
Published: August 2015

Introduction An evaluation tool should help improve formal priority setting and resource allocation (PSRA) processes in Canada and elsewhere. These are crucial to maximizing value from limited resources. Methods On the basis of case studies, balanced scorecard development protocols and use-focused evaluation principles, an evaluation tool was developed based on an existing framework for high PSRA performance and implemented in two health care organizations in British Columbia, Canada. Results Implementation of the tool identified areas of strength, improvement and weakness in the pilot organizations’ processes for PSRA including: communication, staff engagement and culture. Refinements were identified and incorporated into the tool for future application. Conclusion This is the first documented multi-site application of such an evaluation tool. Broader dissemination should have use both in further refining the basis of the tool and in catalysing improved performance of PSRA practice.
Is drug choice by general practitioners influenced by exposure to specialists? Record-linkage study in Italy
Authors: Formoso Giulio , Lombardi Marco 
Published: August 2015

Objective To investigate whether previous drug prescriptions by, or exposure to, specialists influence general practitioners’ prescribing (using the example of inhibitors of the renin-angiotensin system). Methods Drug prescriptions in GP and specialist care, hospital records and outpatient visits in the Emilia-Romagna region (northern Italy) were linked to assess, among patients who in 2013 had been prescribed Angiotensin Converting Enzyme (ACE)-inhibitors or Angiotensin Receptor Blocker (ARBs) in general practice for the first time, whether those who had been previously prescribed these drugs by specialists (or have been recently exposed to cardiovascular, diabetes or nephrology specialists) were more likely to be prescribed an ARB or a patented ACE-inhibitor/ARB. Results A cohort of 88,926 patients was identified of whom 52,666 had not been exposed to specialists. Of these patients, 77.6% were initially prescribed ACE-inhibitors and 87.2% a non-patented drug. Higher prescription of ACE-inhibitors (82.0%) and of non-patented drugs (95.8%) in general practice were observed in the 10,243 the patients who had already been prescribed these drugs by a specialist compared to unexposed patients ( p < 0.001 in both cases) and in the 14,648 patients exposed to specialists in the 90 days preceding the first prescription in general practice (79.0% and 89.6%, respectively, p < 0.001 in both cases). Conclusions Exposure to specialists was not associated with higher prescription of ARBs and of patented drugs in this Region of Italy. The hypothesis of prescribing induction by specialists is not supported by these data. This kind of analysis can provide help inform local prescribing agreements.
In vivo effects of human adipose-derived stem cells reseeding on acellular bovine pericardium in nude mice
Authors: Wu Qingkai , Dai Miao , Xu Peirong , Hou Min , Teng Yincheng , Feng Jie 
Published: August 2015

Tissue-engineered biologic products may be a viable option in the reconstruction of pelvic organ prolapse (POP). This study was based on the hypothesis that human adipose-derived stem cells (hASCs) are viable in acellular bovine pericardium (ABP), when reseeded by two different techniques, and thus, aid in the reconstruction. To investigate the reseeding of hASCs on ABP grafts by using non-invasive bioluminescence imaging (BLI), and to identify the effective hASCs–scaffold combinations that enabled regeneration. Thirty female athymic nude mice were randomly divided into three groups: In the VIVO group, ABPs were implanted in the subcutaneous pockets and enhanced green fluorescent protein luciferase (eGFP·Luc)-hASCs (1 × 106 cells/50 µL) were injected on the ABP at the same time. In the VITRO group, the mice were implanted with grafts that ABP were co-cultured with eGFP·Luc-hASCs in vitro. The BLANK group mice were implanted with ABP only. The eGFP·Luc-hASCs reseeded on ABP were analyzed by BLI, histology, and immunohistochemistry. The eGFP·Luc-hASCs reseeded on ABP could be visualized at 12 weeks in vivo. Histology revealed that the VIVO group displayed the highest cell ingrowths, small vessels, and percent of collagen content per unit area. Desmin and α-smooth muscle actin were positive at the same site in the VIVO group cells. However, few smooth muscles were observed in the VITRO and BLANK groups. These results suggest that hASCs reseeded on ABP in vivo during surgery may further enhance the properties of ABP and may promote regeneration at the recipient site, resulting in a promising treatment option for POP.
Comprendre l’influence des facteurs contextuels sur la participation communautaire à la santé : une étude de cas dans le district sanitaire de Tenkodogo, au Burkina Faso
Authors: Sombié Issa , Ilboudo David O. S. , Soubeiga André Kamba , Samuelsen Helle 
Published: August 2015

Le Burkina Faso met en œuvre depuis plusieurs années la stratégie de la participation communautaire. Des comités de gestion (CoGes) ont été mis en place dans les centres de santé de la première ligne et doivent participer aux prises de décisions. L’objectif principal de cette stratégie est de favoriser l’utilisation des services de santé et une adhésion massive des communautés aux activités de promotion de la santé. Seulement, on constate que les résultats escomptés par les autorités sanitaires tardent à se réaliser. Le présent article convoque les facteurs liés au contexte socioculturel du district sanitaire, pour analyser le phénomène de la participation communautaire. L’étude s’est déroulée dans le district sanitaire de Tenkodogo, situé dans la région administrative du Centre-est, à environ 190 km de la capitale. Cette étude exclusivement qualitative, a utilisé deux méthodes de collecte : les entretiens individuels et les focus groups. Les participants à l’étude sont les chefs de ménage ( n = 48), les membres des CoGes ( n = 10), les agents de santé ( n = 8) et les agents de santé communautaire ( n = 24). La méthode de l’analyse de contenu a été utilisée pour l’analyse des données. Les résultats de l’étude montrent que plusieurs facteurs socioculturels influencent la dynamique de la participation communautaire dans le district. Ce sont les conditions économiques, la perception négative des services de santé, les inégalités sociales de sexe et d’âge, le faible ancrage social des organisations communautaires, les rivalités inter-villages et les conflits coutumiers. L’étude relève également que les communautés ne perçoivent pas leur implication dans le processus décisionnel des services de santé comme une priorité. Leurs principales attentes s’orientent vers la disponibilité de soins de qualité et à coût réduit.
A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care
Authors: Dickson Jennifer L. , Alsweiler Jane , Gunn Cameron A. , Pretty Christopher G. , Chase J. Geoffrey 
Published: August 2015

Background: Model-based glycemic control relies on sufficiency of underlying models to describe underlying patient physiology. In particular, very preterm infant glucose-insulin metabolism can differ significantly from adults, and is relatively unstudied. In this study, C-peptide concentrations are used to develop insulin-secretion models for the purposes of glycemic control in neonatal intensive care. Methods: Plasma C-peptide, insulin, and blood glucose concentrations (BGC) were retrospectively analyzed from a cohort of 41 hyperglycemic very preterm (median age 27.2 [26.2-28.7] weeks) and very low birth-weight infants (median birth weight 839 [735-1000] g). A 2-compartment model of C-peptide kinetics was used to estimate insulin secretion. Insulin secretion was examined with respect to nutritional intake, exogenous and plasma insulin concentration, and BGC. Results: Insulin secretion was found to be highly variable between patients and over time, and could not be modeled with respect to age, weight, or protein or dextrose intake. In 13 of 54 samples exogenous insulin was being administered, and insulin secretion was lower. However, low data numbers make this result inconclusive. Insulin secretion was found to increase with BG, with a stronger association in female infants than males ( R2 = .51 vs R2 = .13, and R2 = .26 for the combined cohort). Conclusions: A sex-based insulin secretion model was created and incorporated into a model-based glycemic control framework. Nutritional intake did not predict insulin secretion, indicating that insulin secretion is a complex function of a number of metabolic factors.
An Automatic Assessment System of Diabetic Foot Ulcers Based on Wound Area Determination, Color Segmentation, and Healing Score Evaluation
Authors: Wang Lei , Pedersen Peder C. , Strong Diane M. , Tulu Bengisu , Agu Emmanuel , Ignotz Ron , He Qian 
Published: August 2015

Background: For individuals with type 2 diabetes, foot ulcers represent a significant health issue. The aim of this study is to design and evaluate a wound assessment system to help wound clinics assess patients with foot ulcers in a way that complements their current visual examination and manual measurements of their foot ulcers. Methods: The physical components of the system consist of an image capture box, a smartphone for wound image capture and a laptop for analyzing the wound image. The wound image assessment algorithms calculate the overall wound area, color segmented wound areas, and a healing score, to provide a quantitative assessment of the wound healing status both for a single wound image and comparisons of subsequent images to an initial wound image. Results: The system was evaluated by assessing foot ulcers for 12 patients in the Wound Clinic at University of Massachusetts Medical School. As performance measures, the Matthews correlation coefficient (MCC) value for the wound area determination algorithm tested on 32 foot ulcer images was .68. The clinical validity of our healing score algorithm relative to the experienced clinicians was measured by Krippendorff’s alpha coefficient (KAC) and ranged from .42 to .81. Conclusion: Our system provides a promising real-time method for wound assessment based on image analysis. Clinical comparisons indicate that the optimized mean-shift-based algorithm is well suited for wound area determination. Clinical evaluation of our healing score algorithm shows its potential to provide clinicians with a quantitative method for evaluating wound healing status.
Excision of Morton’s Neuroma Using a Longitudinal Plantar Approach
Authors: Kundert Hans-Peter , Plaass Christian , Stukenborg-Colsman Christina , Waizy Hazibullah 
Published: August 2015

Background. Operative procedures are indicated in the treatment of Morton’s neuroma (MN) when conservative therapies have been unsuccessful. A dorsal approach for neurolysis or neurectomy was strongly recommended. The aim of this case series study was to prospectively analyze the midterm clinical outcome and complications following the excision of a MN using a plantar longitudinal approach. Methods. Between September 2000 and January 2009, we included 44 patients (51 feet, 56 neuromas) in a prospective study treated by excision of a primary MN using a plantar longitudinal approach. The MN diagnosis was based on clinical symptoms, magnetic resonance imaging findings, and pain relief after infiltration of local anesthetics. Histological examinations were performed in all resected specimens. The patients returned for final follow-up at a mean of 54 (range = 12 to 99) months, comparing preoperative and postoperative perception of pain on a Visual Analogue Scale (VAS) and assessing clinical findings. Results. The average amount of pain, according to VAS, was 8 (range = 6-9) points preoperatively and 0.4 (range = 0-5) points at final follow-up. Complications occurred in 7.1% of interventions and scar problems in 5.2%, including delayed wound healing, hypertrophic scar formation, and inclusion cyst. Conclusion. The present study shows a strong relief of pain after MN resection using a plantar longitudinal incision, coupled with a low rate of local complications. This surgical procedure seems to be a reliable choice for the excision of MN, even in cases with MN in adjacent webspaces, because it is technically simple and the plantar scar is not bothersome if properly located. Levels of Evidence: Therapeutic, Level IV: Prospective, Case series
Retrocalcaneal Pain After Open Reduction and Internal Fixation of Avulsion Fracture of the Achilles Tendon Treated by Endoscopic Adhesiolysis and Endoscopic Calcaneoplasty
Authors: Lui Tun Hing 
Published: August 2015

Avulsion fracture of the Achilles tendon is uncommon. Open reduction and internal fixation is indicated for displaced fracture in order to restore the normal function of the Achilles tendon. We present a patient with avulsion fracture of Achilles tendon that was complicated by the development of secondary Haglund’s deformity and fibrous adhesion between the Achilles tendon and the calcaneus. He was successful treated by endoscopic calcaneoplasty and endoscopic adhesiolysis. Levels of Evidence: Therapeutic, Level IV: Case report