bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception of Radiation Exposure and Risk among Patients, Medical Students, and Referring Physicians at a Tertiary Care Community Hospital
Authors: Ricketts Michelle L. , Baerlocher Mark O. , Asch Murray R. , Myers Andy 
Published: December 2012

Background It is important for physicians to be aware of the radiation doses as well as the risks associated with diagnostic imaging procedures that they are ordering. Methods A survey was administered to patients, medical students, and referring physicians from a number of specialties to determine background knowledge regarding radiation exposure and risk associated with commonly ordered medical imaging tests. Results A total of 127 patients, 32 referring physicians, and 30 medical students completed the survey. The majority of patients (92%) were not informed of the radiation risks associated with tests that they were scheduled to receive and had false perceptions about the use of radiation and its associated risks. Physicians and medical students had misconceptions about the use of ionizing radiation in a number of radiologic examinations; for example, 25% and 43% of physicians and medical students, respectively, were unaware that interventional procedures used ionizing radiation, and 28% of physicians were unaware that mammography used ionizing radiation. Computed tomographies and barium studies were thought to be associated with the least ionizing radiation among physicians. Conclusion There is a need for educating the public, medical students, and referring physicians about radiation exposure and associated risk so that (1) patients receiving multiple medical imaging tests are aware of the radiation that they are receiving and (2) physicians and future physicians will make informed decisions when ordering such tests to limit the amount of radiation that patients receive and to promote informed consent among patients.
The Usefulness of Gadolinium-Enhanced Images on a Follow-up Magnetic Resonance Image in Suspected Multiple Sclerosis
Authors: Moore Fraser G.A. , Levental Mark 
Published: December 2012

Purpose Multiple sclerosis diagnostic criteria include the presence of gadolinium-enhancing lesions when determining dissemination in space and time. Gadolinium is expensive, increases scan time and patient discomfort, and can, rarely, cause serious adverse effects. Our objective was to determine the usefulness of including gadolinium-enhanced images as part of a follow-up brain magnetic resonance imaging (MRI) in patients with a clinically isolated syndrome. Methods Consecutive patients seen between 2008 and 2010 with a clinically isolated syndrome suggestive of multiple sclerosis were prospectively enrolled, had a non–gadolinium-enhanced brain MRI, and consented to a follow-up gadolinium-enhanced brain MRI. The primary outcome was a comparison of the number of patients diagnosed with multiple sclerosis compared with the number who would have been diagnosed without the gadolinium-enhanced images. Results Twenty-one patients enrolled, and 2 withdrew. Follow-up MRIs were performed a median of 241 days after the initial MRI. Eleven patients met the primary outcome and were diagnosed with multiple sclerosis: 6 as a result of a second clinical attack and 5 by using imaging criteria for dissemination in space and time. If the gadolinium-enhanced images had not been obtained, then there would have been no change in the primary outcome. Conclusions In Canadian centers with similar MRI waiting times to those in our study, the routine use of gadolinium as part of a follow-up MRI in patients with suspected multiple sclerosis may not be clinically useful. Gadolinium-enhanced images could still be obtained on an as-needed basis for specific clinical indications.
My Journey to DNA Repair
Authors: Lindahl Tomas 
Published: December 2012

Abstract
I completed my medical studies at the Karolinska Institute in Stockholm but have always been devoted to basic research. My longstanding interest is to understand fundamental DNA repair mechanisms in the fields of cancer therapy, inherited human genetic disorders and ancient DNA. I initially measured DNA decay, including rates of base loss and cytosine deamination. I have discovered several important DNA repair proteins and determined their mechanisms of action. The discovery of uracil-DNA glycosylase defined a new category of repair enzymes with each specialized for different types of DNA damage. The base excision repair pathway was first reconstituted with human proteins in my group. Cell-free analysis for mammalian nucleotide excision repair of DNA was also developed in my laboratory. I found multiple distinct DNA ligases in mammalian cells, and led the first genetic and biochemical work on DNA ligases I, III and IV. I discovered the mammalian exonucleases DNase III (TREX1) and IV (FEN1). Interestingly, expression of TREX1 was altered in some human autoimmune diseases. I also showed that the mutagenic DNA adduct O6-methylguanine (O6mG) is repaired without removing the guanine from DNA, identifying a surprising mechanism by which the methyl group is transferred to a residue in the repair protein itself. A further novel process of DNA repair discovered by my research group is the action of AlkB as an iron-dependent enzyme carrying out oxidative demethylation.
Time Use in Mothers of Children with Cerebral Palsy: A Comparison Study
Authors: Rassafiani Mehdi , Kahjoogh Mina Ahmadi , Hosseini Ali , Sahaf Robab 
Published: December 2012

Objectives The main goal of this study was to measure time spent in different activities by mothers who have children with cerebral palsy (CP), in comparison to mothers of healthy children. Methods This study features a descriptive, cross-sectional and matched case control design. Sixty-seven mothers aged between 25 and 50 years based on inclusion and exclusion criteria were selected. The prototype of the Farsi translation of the Mothers’ Time Use Questionnaire was used to measure the time allocations for different activities in both groups. Results Mothers of children with CP spent more time in childcare activities and had a lower level of “satisfaction” in comparison with mothers who have healthy children (p < .05). There were no significant differences in other subtype activities between both groups, namely, paid work, leisure, household chores, and sleeping/resting (p > .05). Conclusion There was an imbalance over time use between childcare activities and other subtype activities in mothers who have children with CP as compared to mothers with healthy children. Mothers with children who have CP require more attention, support, and special assistance from the government to meet their specific roles as mothers.
Advancing obstetric anesthesia practices in Georgia through clinical education and quality improvement methodologies
Authors: Ninidze Nino , Bodin Sarah , Ivester Thomas , Councilman Lisa , Clyne Brittany , Owen Medge 
Published: December 2012

AbstractObjectiveTo determine whether an integrated program of clinical education and improvement methods regarding the safe use of regional anesthesia for obstetrics would result in improved and sustained practice change in Georgia.MethodsBetween 2006 and 2009, intervention teams undertook several visits to 5 Georgian hospitals. Rates of regional anesthesia for labor and cesarean delivery prior to and following the intervention were collected from participating and non‐participating hospitals. There were multifaceted educational activities and quality improvement activities at intervention sites, including protocol development, social marketing, and supply chain logistics. Host hospitals evaluated the program via a questionnaire.ResultsThe use of general anesthesia for cesarean delivery decreased significantly (P < 0.001) and the use of epidural analgesia for labor increased significantly (P < 0.001); there was no change in non‐participating hospitals. Over the course of the program, medication and supply availability improved. Program evaluations were uniformly positive.ConclusionA structured program of education and quality improvement led to an increase in the use of regional anesthesia for vaginal and cesarean deliveries. Achievements were sustained during periods of economic and political turmoil.
Are prophylactic antibiotics necessary for urodynamic study?
Authors: Gürbüz Cenk , Güner Bayram , Atış Gökhan , Canat Lütfi , Caşkurlu Turhan 
Published: December 2012

AbstractThe aim of this study was to assess the efficacy of prophylactic fosfomycin tromethamine (FT) and ciprofloxacin in preventing bacteriuria caused by urodynamic studies (UDS). A total of 426 adult patients presenting for UDS were enrolled the study. A midstream urine sample was taken 72 hours before and 5 days after the procedure. All patients underwent a standard UDS. The 411 patients who had sterile urine before intervention were included in the study. Patients were randomized into three groups. Group1 received no prophylaxis (n = 133), Group 2 (n = 141) received oral ciprofloxacin (500 mg) 1 hour before the procedure, and Group 3 (n = 137) received a single dose of FT approximately 12 hours before the procedure. Bacteriuria was evaluated for each group. Bacteriuria was detected in 3 (2.3%), 6 (4.3%) and 3 patients (1.6%) in Group 1, Group 2, and Group 3, respectively. The most common identified microorganism was Escherichia coli (E coli) in 6 patients (50%). Among the E coli group, extended spectrum beta‐lactamase producing E coli was seen in 2 patients (33.3%). Univariate analysis demonstrated that a history of urogenital operation (p < 0.01) and female gender (p < 0.01) were significant risk factors for bacteriuria. On multiple logistic regression analysis, the past urogenital operation history was the only significant independent risk factor for significant bacteriuria after UDS (OR = 14, 95% CI = 1.82–23.8, p = 0.01). The prevalence of bacteriuria after UDS was relatively low in the current study population. Therefore, for most patients, it may be unnecessary to use preventive prophylactic antibiotics. However, our results suggest that in patients with a previous history of urologic surgery, the risk for significant bacteriuria is increased and the use of prophylaxis should be considered.
Efficacy and tolerability between an olmesartan/amlodipine fixed‐dose combination and an amlodipine double dose in mild to moderate hypertension
Authors: Lin Tsung‐Hsien , Tsai Cheng‐Dao , Pan Ju‐Pin , Hou Charles Jia‐Yin , Hsia Chien‐Hsun , Tsai Jui‐Peng , Lai Wen‐Ter 
Published: December 2012

AbstractFixed‐dose combinations (FDCs) are one of the options for improving blood pressure (BP) goal attainment. We enrolled 141 patients and evaluated the efficacy and safety between a fixed dose of olmesartan/amlodipine (OA) and a double dose of amlodipine (DA) for treating mild to moderate hypertension after amlodipine monotherapy failure. After at least 2 weeks of monotherapy failure, the patients were randomized to receive either OA or DA for 8 weeks. We compared the systolic blood pressure (SBP)‐lowering efficacy of the OA and DA using both an office BP and an ambulatory blood pressure monitoring (ABPM) device. The intent‐to‐treat analysis found that the early (2nd week) and final visit (8th week) SBP reductions were significantly greater in those patients receiving OA (n = 70) than DA (n = 71) (17.57 ± 15.49 vs. 10.46 ± 13.36 and 24.89 ± 14.09 vs. 17.03 ± 13.27 mmHg, p = 0.002 and 0.001, respectively). Among those using ABPM, the patients with 8‐week OA had a greater SBP‐lowering effect in comparison with those on DA (14.08 ± 10.74 vs. 6.32 ± 10.21, p = 0.018). Both treatment strategies were well tolerated. This study showed that an OA FDC is more effective than DA in reducing SBP for mild to moderate hypertension after the failure of amlodipine monotherapy.
Complications of urologic laparoscopic surgery: A center surgeon's experience involving 601 procedures including the learning curve
Authors: Akin Yigit , Ates Mutlu , Celik Orcun , Ucar Murat , Yucel Selcuk , Erdogru Tibet 
Published: December 2012

AbstractWhen indications for laparoscopy were expanded to include a variety of urologic diseases, this increased the importance of prevention of complications, especially during the surgeons' learning curve period. Therefore, we evaluated the complications of urologic laparoscopic surgery in the course of one surgeon's experience including the learning curve after completing his long‐term fellowship program. From December 2004 to August 2010, a total of 601 urologic laparoscopic surgical procedures were performed by a single surgeon who had finished a 9‐month fellowship program at an experienced center. The intra‐ and postoperative complications of these cases were documented and graded according to the modified Clavien classification system, and then compared with the first and second 3‐year periods. Of these 601 laparoscopic procedures, 47 complications occurred in 38 patients, resulting in a total complication rate of 7.8%. Conversion to open surgery occurred in four (0.6%) patients. Clavien grades I and II accounted for minor complications and occurred in 36 (5.9%) patients, whereas grades III, IV, and V accounted for major complications, which occurred in 11 (1.8%) patients. The annual complication rates formed a plateau in the 3rd year. Complication rates were significantly lower in the second 3‐year period compared with the first 3 years (p < 0.05). Despite the well‐organized training program and transferability, surgeons must practice caution in the early years until they become more experienced. In spite of the presence of experienced laparoscopic surgeons, the surgical team needs time to gain experience. These factors cause complication rates to form a plateau in terms of time and experience.
Modelling the spatial distribution of Culicoides biting midges at the local scale
Authors: Kluiters Georgette , Sugden David , Guis Helene , McIntyre K. Marie , Labuschagne Karien , Vilar Maria J. , Baylis Matthew 
Published: December 2012

Summary

Culicoides midges (Diptera: Ceratopogonidae) are ubiquitous on farms in the United Kingdom (UK), but little research has explored their abundance, an important determinant of disease risk. Models to explain and predict variation in their abundance are needed for effective targeting of control methods against bluetongue virus (BTV) and other Culicoides‐borne diseases. Although models have been attempted at the national scale (e.g. Scotland), no investigations have taken place at a finer spatial scale.
Midge abundances were estimated using light traps on 35 farms in Bala, north Wales. Culicoides catches were combined with remotely sensed ecological correlates, and on‐farm host and environmental data, within a GLM model. Drivers of local‐scale variation were determined at the 1‐km resolution.
Local‐scale variation in abundance exhibited an almost 500‐fold difference (74–33 720) between farms in maximum Obsoletus Group catches. The Obsoletus Group model explained 81% of this variance and was dominated by normalized difference vegetation index (NDVI). This is consistent with previous studies suggesting strong impacts of forest cover and vegetation activity on distribution, as well as shaded breeding site requirements.
The variance explained was consistently high for the Pulicaris Group, C. pulicaris and C. punctatus (80%, 73% and 74%), the other probable BTV vector species in the United Kingdom. The abundance of all vector species increased with the number of sheep on farms, but this relationship was missing from any of the non‐vector models. This is particularly interesting given that none of the species concerned are known to utilize sheep‐associated larval development sites. Performance of the non‐vector models was also high (65–87% variance explained), but species differed in their associations with satellite variables.
Synthesis and application. At a large spatial scale, there is significant variation in Culicoides Obsoletus Group abundance, which undermines attempts to record their nationwide distribution in larger‐scale models. Satellite data can be used to explain a high proportion of this variation and, if shown to be generalizable, they may produce effective predictive models of disease vector abundance. We recommend undertaking a prior survey for farms with high Culicoides catches within the sampling area and checking stability in catch size between seasons and years.
Changes in hepatic lipogenic and oxidative enzymes and glucose homeostasis induced by an acetyl‐l‐carnitine and nicotinamide treatment in dyslipidaemic insulin‐resistant rats
Authors: Ferreira Maria R , Camberos Maria del C , Selenscig Dante , Martucci Lucía C , Chicco Adriana , Lombardo Yolanda B , Cresto Juan C 
Published: December 2012

Summary

Normal rats fed a sucrose‐rich diet (SRD) develop dyslipidaemia and insulin resistance. The present study examined whether administration of the mitochondrial nutrients nicotinamide and acetyl‐l‐carnitine reversed or improved these metabolic abnormalities.

Male Wistar rats were fed an SRD for 90 days. Half the rats then received daily injections of nicotinamide (25 mg/kg, i.p.) and acetyl‐ l‐carnitine (50 mg/kg, i.p.) for a further 90 days. The remaining rats in the SRD‐fed group and those in a normal chow‐fed control group were injected with an equal volume of saline solution for the same period. The following parameters were determined in all groups: (i) liver activity of fatty acid synthase (FAS), acetyl‐CoA carboxylase (ACC) and carnitine‐palmitoyl transferase‐1 (CPT‐1); (ii) hepatic and skeletal muscle triacylglycerol content, plasma glucose, insulin, free fatty acid (FFA) and triacylglycerol levels and pancreatic insulin content; and (iii) glucose tolerance.

Administration of nicotinamide and acetyl‐l‐carnitine to the SRD‐fed rats reduced dyslipidaemia, liver steatosis, muscle triacylglycerol content and hepatic FAS and ACC activities and increased CPT‐1 activity. In addition nicotinamide and acetyl‐l‐carnitine improved the glucose disappearance rate (Kg), normalized plasma glucose levels and moderately increased insulinaemia without altering pancreatic insulin content. Finally, nicotinamide and acetyl‐l‐carnitine administration reduced bodyweight gain and visceral adiposity.

The results of the present study suggest that altering key hepatic lipogenic and fatty acid oxidative enzymatic activity could improve dyslipidaemia, liver steatosis and visceral adiposity. Indeed, administration of nicotinamide and acetyl‐l‐carnitine improved glucose intolerance and normalized plasma glucose levels.
Metastasis associated protein 1 correlates with Hypoxia inducible‐factor 1 alpha expression and lymphangiogenesis in esophageal cancer
Authors: Guo Xufeng , Chen Yongbing , Fang Wentao , Yang Wentao , Shi Li , Zhu Rongying 
Published: December 2012

AbstractBackgroundMetastasis to regional lymph nodes represents the first step of dissemination in esophageal cancer and serves as an unfavorable prognostic indicator for disease progression. The formation of tumor lymphatic microvessels is dependent on the production of lymphangiogenic growth factors by tumor cells, such as vascular endothelial growth factor C (VEGF‐C), metastasis‐associated gene 1 (MTA1), and hypoxia inducible‐factor l alpha (HIF‐1α). The degree of intratumoral lymphatic microvessel density (LMVD) by immunohistochemistry is thought to influence tumor lymph node metastasis (LNM) and prognosis in various solid tumors. The aim of this study was to investigate the expression of MTA1 and HIF‐1α in human esophageal cancer and to explore the relationship between their expression and lymphangiogenesis.MethodThe expression of MTA1 and HIF‐1α, and LMVD marked by D2‐40 were detected using immunohistochemical staining in eighty‐two human esophageal cancer cases.ResultsThe positive rates of MTA1 and HIF‐1α expression were 69.5% and 59.8%, respectively. The expression of MTA1 and HIF‐1α were both correlated with LNM. In addition, MTA1 and HIF‐1α expression has a positive correlation in human esophageal cancer; LMVD correlated significantly with LNM. LMVD in MTA1 and HIF‐1α over‐expression cases was higher than that in none or weak cases, and this difference has statistical significance.ConclusionOur findings suggest that MTA1 plays an important role in lymphangiogenesis and LNM by stabilizing HIF‐1α in esophageal cancer. The inhibition of lymphangiogenesis, MTA1, or HIF‐1α activity may have an important therapeutic benefit in the control of esophageal cancer.
Dopamine D1 Receptor Signaling System Regulates Ryanodine Receptor Expression in Ethanol Physical Dependence
Authors: Kurokawa Kazuhiro , Mizuno Koji , Ohkuma Seitaro 
Published: December 2012

BackgroundRyanodine receptors (RyRs) amplifying activity‐dependent calcium influx via calcium‐induced calcium release play an important role in central nervous system functions including learning, memory, and drug abuse. In this study, we investigated the role and the regulatory mechanisms of RyR expression under continuous exposure of mice to ethanol (EtOH) vapor for 9 days.MethodsThe model of EtOH physical dependence was prepared as follows: 8‐week‐old male ddY mice were exposed to EtOH vapor for 9 days. Protein and mRNA of RyR‐1, RyR‐2, and RyR‐3 in the frontal cortex and limbic forebrain were determined by Western blot and real‐time RT‐PCR analysis, respectively.ResultsExposure of mice to EtOH vapor for 9 days induced significant withdrawal signs when estimated with withdrawal score, which was dose‐dependently suppressed by intracerebroventricular administration of dantrolene, an RyR antagonist. Protein levels of RyR‐1 and RyR‐2 in the frontal cortex and limbic forebrain significantly increased during EtOH vapor exposure for 9 days with increased expression of their mRNA, whereas that of RyR‐3 in these 2 brain regions showed no changes. Increased proteins and mRNA of RyR‐1 and RyR‐2 were completely abolished by SCH23390, a selective antagonist of dopamine D1 receptors (D1DRs), but not by sulpiride, a selective antagonist of D2DRs.ConclusionsRyRs play a critical role in the development of EtOH physical dependence and that the up‐regulation of RyRs in the brain of mouse, showing EtOH physical dependence is regulated by D1DRs.
Actual and Perceived Units of Alcohol in a Self‐Defined “Usual Glass” of Alcoholic Drinks in England
Authors: Boniface Sadie , Kneale James , Shelton Nicola 
Published: December 2012

BackgroundSeveral studies have found participants pour more than 1 standard drink or unit as their usual glass. This is the first study to measure actual and perceived amounts of alcohol in a self‐defined usual glass of wines and spirits in the general population.MethodsParticipants were a convenience sample of adults who drink alcohol or who pour drinks for other people (n = 283, 54% women) at 6 sites in South East England. The survey was face to face and comprised a self‐completion questionnaire and pouring task. Estimation accuracy, categorised as correct (±0.5 units), underestimate (>0.5 units), or overestimate (>0.5 units) was the main outcome.ResultsThe mean number of units poured was 1.90 (SD 0.80; n = 264) for wine and 1.93 (SD 0.78; n = 201) for spirits. The amount of alcohol in a self‐defined usual glass was estimated in 440 glasses (248 wine and 192 spirits). Overestimation took place in 42% glasses of spirit poured and 29% glasses of wine poured, and underestimation in 17 and 19%, respectively. Multinomial logistic regression found volume poured to be significantly associated with underestimating both wines and spirits, and additionally for wine only, belonging to a non‐white ethnic group and being unemployed or retired. Not having a university degree was significantly associated with overestimating both drink types.ConclusionsThis study is the first in the general population and did not identify systematic underestimation of the amount of alcohol in a self‐defined usual glass. Underestimation is significantly associated with volume poured for both drink types; therefore, advocating pouring smaller glasses could reduce underestimation of alcohol consumption.