bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of 3D T1-weighted gradient-echo MR imaging for evaluation of the appendix during pregnancy: preliminary results
Authors: Jang Kyung Mi , Kim Seong Hyun , Choi Dongil , Lee Soon Jin , Rhim Hyunchul , Park Min Jung 
Published: August 2011

Background The use of oral contrast has been essential for the identification of a normal appendix on MR imaging during pregnancy. However, stool could be used as a positive oral contrast as it is characterized by a relatively high signal on T1-weighted imaging, and 3D T1-weighted gradient-echo (T1W-GRE) MR imaging has been used to evaluate 3 mm diameter intestines in fetuses. Purpose To evaluate the added value of 3D T1W-GRE MR imaging in combination with T2-weighted imaging (T2WI) compared to T2WI alone for evaluating the appendix during pregnancy. Material and Methods Eighteen consecutive pregnant patients who were clinically suspected of having acute appendicitis underwent appendix MR imaging which included T2WI with or without spectral presaturation attenuated inversion-recovery (SPAIR) fat suppression, and 3D T1W-GRE with SPAIR fat suppression. Two radiologists reviewed the two image sets (the T2WI set and the combined set of T2WI and 3D T1W-GRE images). Pathologic and clinical results served as the reference standard. The differences in the degree of visibility of the appendix and confidence scale for diagnosing acute appendicitis between two image sets were compared by using the paired Wilcoxon signed rank test. Results For both reviewers, the degree of visibility of the appendix using the combined T2WI and 3D T1W-GRE images was significantly higher than using T2WI alone ( P < 0.01), and the confidence levels for acute appendicitis using combined T2WI and 3D T1W-GRE images were significantly different from those using T2WI alone ( P < 0.01). In the 13 patients with a normal appendix, both reviewers showed improved confidence levels for appendicitis using combined T2WI and 3D T1W-GRE images than T2WI alone. Conclusion Adding 3D T1W-GRE images to T2WI is helpful for identification of the appendix, as compared to T2WI alone in pregnant women without ingestion of oral contrast material. This may improve diagnostic confidence for acute appendicitis in pregnant patients.
Preoperative evaluation of neurovascular relationship by using contrast-enhanced and unenhanced 3D time-of-flight MR angiography in patients with trigeminal neuralgia
Authors: Zhou Qin , Liu Zhiling , Li Chuanfu , Qu Chuncheng , Ni Shilei , Zeng Qingshi 
Published: August 2011

Background Microvascular decompression is an etiological strategy for the therapy of trigeminal neuralgia (TN). Preoperative identification of neurovascular compression, therefore, could have an impact on the determination of appropriate treatment for TN. Purpose To evaluate the value of contrast-enhanced and unenhanced three-dimensional (3D) time-of-flight (TOF) MR angiography in the visualization of neurovascular relationship in patients with TN. Material and Methods Thirty-seven patients with unilateral TN underwent unenhanced and contrast-enhanced 3D TOF MR angiography with a 3.0-T MR system. Images were reviewed by a radiologist blinded to clinical details. Vascular contact with the trigeminal nerve was identified, and the nature of the involved vessels (artery or vein) was determined. All patients underwent microvascular decompression. Results In 37 patients with TN, contrast-enhanced 3D TOF MR angiography identified surgically verified neurovascular contact in 35 of 36 symptomatic nerves, and there was no false-positive. Based on surgical findings, the sensitivity of MR imaging was 97.2% and specificity 100%. The nature of the offending vessel was correctly identified in 94.4% of the patients by using the combination of contrast-enhanced and unenhanced MR angiography. Conclusion Contrast-enhanced 3D TOF MR angiography is useful in the detection of vascular contact with the trigeminal nerve in patients with TN, and this MR imaging in combination with unenhanced MR angiography could help in the identification of the nature of the responsible vessels.
Variation of fee-for-service specialist direct care work effort with patient overall illness burden
Authors: Goodman Robert 
Published: August 2011

Objective To explore whether a common industry measure of overall patient illness burden, used to assess the total costs of members in a health plan, would be suitable to describe variation in a summary metric of utilization that assesses specialist physician direct patient care services not grouped into clinical episodes, but with exclusion criteria applied to reduce any bias in the data. Data sources/study setting Calendar year 2006 administrative data on 153,557 commercial members enrolled in a non-profit single-state statewide Health Maintenance Organization (HMO) and treated by 4356 specialists in 11 specialties. The health plan's global referral process and specialist fee-for-service reimbursement likely makes these results applicable to the non-managed care setting, as once a global referral was authorized there was no required intervention by the HMO or referring primary care provider for the majority of any subsequent specialist direct clinical care. Study design Specialty-specific correlations and ordinary least-squares regression models to assess variations in specialist direct patient care work effort with patient overall illness burden, after the application of exclusion criteria to reduce potential bias in the data. Principle findings Statistically significant positive correlations exist between specialist direct patient care work effort and patient overall illness burden for all studied specialties. Regression models revealed a generally monotonic increasing relationship between illness burden categories and aggregate specialist direct patient care work effort. Almost all regression model differences from the reference category across specialties are statistically significant ( P ≤ 0.012). Assessment of additional results demonstrates the relationship has more substantive significance in some specialties and less in others. The most substantive relationships in this study were found in the specialties of orthopaedic surgery, general surgery and interventional cardiology. Conclusions For many specialties, specialists do vary physician direct patient care utilization with patient overall illness burden. Accounting for patient overall health status is important to fairly compare specialists of certain specialties on utilization for health plan specialist network management. Additional study is required to evaluate health plan application of this methodology.
Association of Cognitive Impairment with Combinations of Vitamin B12–Related Parameters
Authors: Lildballe Dorte L , Fedosov Sergey , Sherliker Paul , Hin Harold , Clarke Robert , Nexo Ebba 
Published: August 2011

BACKGROUNDLow vitamin B12 concentrations have been associated with higher risks of cognitive impairment, but whether these associations are causal is uncertain. The associations of cognitive impairment with combinations of vitamin B12, holotranscobalamin, methylmalonic acid, and total homocysteine, and with the vitamin B12 transport proteins transcobalamin and haptocorrin, have not been previously studied.METHODSWe performed a population-based cross-sectional study of 839 people 75 years old or older. We examined the association of cognitive function as measured by mini–mental state examination scores, with markers of vitamin B12 status. Spearman correlations as well as multivariate-adjusted odds ratios and 95% CIs for cognitive impairment were calculated for extreme thirds of serum concentrations of vitamin B12, holotranscobalamin, methylmalonic acid, total homocysteine, combination of these markers in a wellness score, heaptocorrin, and transcobalamin for all data and with B12 analogs in a nested case-control study.RESULTSCognitive impairment was significantly associated with low vitamin B12 [odds ratio 2.3 (95% CI 1.2–4.5)]; low holotranscobalamin [4.1 (2.0–8.7)], high methylmalonic acid [3.5 (1.8–7.1)], high homocysteine [4.8 (2.3–10.0)] and low wellness score [5.1 (2.61–10.46)]. After correction for relevant covariates, cognitive impairment remained significantly associated with high homocysteine [4.85 (2.24–10.53)] and with a low wellness score [5.60 (2.61–12.01)] but not with transcobalamin, haptocorrin, or analogs on haptocorrin.CONCLUSIONSCognitive impairment was associated with the combined effects of the 4 biomarkers of vitamin B12 deficiency when included in a wellness score but was not associated with binding proteins or analogs on haptocorrin.
Determination of Hemolysis Thresholds by the Use of Data Loggers in Pneumatic Tube Systems
Authors: Streichert Thomas , Otto Benjamin , Schnabel Claudia , Nordholt Gerhard , Haddad Munif , Maric Mario , Petersmann Astrid , Jung Roman , Wagener Christoph 
Published: August 2011

BACKGROUNDPneumatic tube systems (PTSs) for the transport of blood samples are regaining popularity in medical centers after earlier reports that their use could introduce preanalytical distortions such as hemolysis and changes in blood gases.METHODSWe drew duplicate blood samples from 30 volunteers. One sample was hand transported, and the other sample was transported through a PTS together with a mini–data logger that provided continuous measurements of temperature, humidity, pressure, and acceleration. After transport the samples were analyzed at the same time. We looked for possible relationships of the transport method and the parameters measured by the data loggers with differences in hematological parameters, standard clinical chemistry analyses, blood coagulation, erythrocyte sedimentation rate, and blood gas analysis.RESULTSThere were no significant differences in temperature, humidity, and pressure between the methods of transport, but we observed significant differences in 3-axis accelerations. The combined effect of these forces could be described by the right-tailed area under the vector sum acceleration distribution. Our data show that this area correlated with PTS speed and that PTS speed and the area under the curve exhibited a direct relation to the degree of hemolysis.CONCLUSIONSAssessment of 3-axis acceleration by use of data loggers can be used to identify preanalytical deviations that result from the transportation of blood samples in PTSs. Our approach could be used for the evaluation and regular control of PTSs without the need for repeated blood drawing and laboratory analyses.
Identification of Recent Cannabis Use: Whole-Blood and Plasma Free and Glucuronidated Cannabinoid Pharmacokinetics following Controlled Smoked Cannabis Administration
Authors: Schwope David M , Karschner Erin L , Gorelick David A , Huestis Marilyn A 
Published: August 2011

BACKGROUNDΔ9-Tetrahydrocannabinol (THC) is the most frequently observed illicit drug in investigations of accidents and driving under the influence of drugs. THC-glucuronide has been suggested as a marker of recent cannabis use, but there are no blood data following controlled THC administration to test this hypothesis. Furthermore, there are no studies directly examining whole-blood cannabinoid pharmacokinetics, although this matrix is often the only available specimen.METHODSParticipants (9 men, 1 woman) resided on a closed research unit and smoked one 6.8% THC cannabis cigarette ad libitum. We quantified THC, 11-hydroxy-THC (11-OH-THC), 11-nor-9-carboxy-THC (THCCOOH), cannabidiol (CBD), cannabinol (CBN), THC-glucuronide and THCCOOH-glucuronide directly in whole blood and plasma by liquid chromatography/tandem mass spectrometry within 24 h of collection to obviate stability issues.RESULTSMedian whole blood (plasma) observed maximum concentrations (Cmax) were 50 (76), 6.4 (10), 41 (67), 1.3 (2.0), 2.4 (3.6), 89 (190), and 0.7 (1.4) μg/L 0.25 h after starting smoking for THC, 11-OH- THC, THCCOOH, CBD, CBN, and THCCOOH-glucuronide, respectively, and 0.5 h for THC-glucuronide. At observed Cmax, whole-blood (plasma) detection rates were 60% (80%), 80% (90%), and 50% (80%) for CBD, CBN, and THC-glucuronide, respectively. CBD and CBN were not detectable after 1 h in either matrix (LOQ 1.0 μg/L).CONCLUSIONSHuman whole-blood cannabinoid data following cannabis smoking will assist whole blood and plasma cannabinoid interpretation, while furthering identification of recent cannabis intake.
Informationsinfrastrukturen gestern, heute, morgen. Anmerkungen zu Empfehlungen des Wissenschaftsrates
Authors: Dugall Berndt 
Published: August 2011

Zusammenfassung
Mit den „Empfehlungen zu Forschungsinfrastrukturen“ hat der Wissenschaftsrat im Frühjahr 2011 umfängliche Hinweise und Vorschläge zur Neuordnung insbesondere der Informationsinfrastrukturen in Deutschland unterbreitet. Dabei spielen die gravierenden Veränderungen der letzten Jahre in diesem Bereich eine wesentliche Rolle. In dem vorliegenden Beitrag werden die Vorschläge und Thesen auf der Basis der Entwicklung und Herausbildung von Informationsinfrastrukturen in den letzten 50 Jahren in Deutschland unter besonderer Berücksichtigung der jeweils dazu ergangenen früheren Empfehlungen des Wissenschaftsrats diskutiert.
Uniqueness of lattice packings and coverings of extreme density
Authors: Gruber Peter M. 
Published: August 2011

Abstract
For d = 2, 3 a generic convex body in has a unique lattice packing and for d ≥ 4 at most a(d) lattice packings of maximum density, where a(d) ≥ 1 is a constant. If in a certain connectedness property holds, one may take a(d) = 1. Dually, for d = 2 a generic convex body has a unique lattice covering of minimum density and for d ≥ 3 there is a constant b(d) ≥ 1 such that it has at most b(d) such coverings.
Impact of New Chemotherapeutic and Targeted Agents on Survival in Stage IV Non-Small Cell Lung Cancer
Authors: Yu Joanne L. , Simmons Christine , Victor J. Charles , Han Dolly , Hogeveen Sophie , Leighl Natasha , Verma Sunil 
Published: August 2011

Abstract

Purpose.
Significant advances in the systemic management of metastatic non-small cell lung cancer (NSCLC) have occurred over the past decade, with options now including multiple lines of chemotherapy, epidermal growth factor receptor inhibitors, and antiangiogenic agents. Improvements in overall survival have been demonstrated in randomized controlled trials comparing these newer agents with best supportive care or standard therapy. This study examined uptake of these therapies in general practice and their impact on survival.

Methods.
This retrospective cohort study compared demographic, treatment, and survival data among 987 patients diagnosed with stage IV NSCLC at two institutions in 1998, 2003, and 2008. Cohorts were selected based on intervals when doublet chemotherapy, second-line chemotherapy, and targeted agents were incorporated into the standard treatment regimen.

Results.
The proportion of patients receiving systemic therapy increased over time (20% in 1998, 42% in 2008). Overall survival improved significantly across cohorts (p &lt; .001), with 2-year survival rates of 0.3% in 1998, 4% in 2003, and 15% in 2008. In a multivariate survival analysis, the 2003 and 2008 cohorts were independently associated with longer survival, as was the use of one or more lines of systemic therapy. Elderly patients (aged ≥70 years) were also more likely to receive systemic therapy over time, with longer overall survival (p &lt; .001).

Conclusion.
Over the past decade, there has been an increasing use of systemic therapy in stage IV NSCLC patients, including the elderly. This has been associated with significantly longer overall survival.
Prognostic Role of Vitamin D Status and Efficacy of Vitamin D Supplementation in Cancer Patients: A Systematic Review
Authors: Buttigliero Consuelo , Monagheddu Chiara , Petroni Paola , Saini Andrea , Dogliotti Luigi , Ciccone Giovannino , Berruti Alfredo 
Published: August 2011

Abstract

Background.
Whether or not hypovitaminosis D can influence the prognosis of cancer patients and whether or not vitamin D (vitD) supplementation improves outcome remain controversial.

Design.
Studies evaluating the prognostic role of vitD and vitD receptor (VDR) in cancer patients and trials evaluating the efficacy of vitD administration on patient outcome were identified by a search of MEDLINE, EMBASE, ISI Web of Knowledge, and the Cochrane Library through June 2010.

Results.
Twenty-five studies were included. A negative prognostic role for low serum vitD level was observed in five cohort studies including patients with breast cancer (one study), colon cancer (two studies), prostate cancer (one study), and melanoma (one study), but not in two studies on non-small cell lung cancer and one study on breast cancer. Three of four studies showed that VDR+ tumors carry a better prognosis than VDR− tumors, whereas VDR polymorphisms were significantly associated with prognosis in five of 10 studies. A significant interaction between serum vitD level and VDR polymorphism was observed in one study. Three randomized trials involving advanced prostate cancer patients explored the prognostic role of vitD supplementation. A meta-analysis of these trials showed no effect on survival (pooled risk ratio, 1.07; 95% confidence interval, CI, 0.93–1.23), with strong heterogeneity among studies.

Conclusion.
Hypovitaminosis D seems to be associated with a worse prognosis in some cancers, but vitD supplementation failed to demonstrate a benefit in prostate cancer patients. The currently available evidence is insufficient to recommend vitD supplementation in cancer patients in clinical practice.
If I Am in the Mood, I Enjoy It: An Exploration of Cancer-Related Fatigue and Sexual Functioning in Women with Breast Cancer
Authors: Webber Kate , Mok Kelly , Bennett Barbara , Lloyd Andrew R. , Friedlander Michael , Juraskova Ilona , Goldstein David ,   FolCan study group
Published: August 2011

Abstract

Learning Objectives
After completing this course, the reader will be able to: Explain the relationship between cancer-related fatigue and sexual function.Identify the presence of mood disorder as a key determinant of sexual problems after adjuvant breast cancer therapy.
This article is available for continuing medical education credit at CME.TheOncologist.com

Background.
We recently reported that cancer-related fatigue (CRF) after adjuvant breast cancer therapy was prevalent and disabling, but largely self-limiting within 12 months. The current paper describes sexual functioning (SF) and its relationship to CRF, mood disorder, and quality of life (QOL) over the first year after completion of adjuvant therapy.

Methods.
Women were recruited after surgery, but prior to commencing adjuvant treatment, for early-stage breast cancer. Self-reported validated questionnaires assessed SF, CRF, mood, menopausal symptoms, disability, and QOL at baseline, completion of therapy, and at 6 months and 12 months after treatment.

Results.
Of the 218 participants, 92 (42%) completed the SF measure (mean age, 50 years). They were significantly younger, more likely to be partnered, and less likely to be postmenopausal than nonresponders. At baseline, 40% reported problems with sexual interest and 60% reported problems with physical sexual function. SF scores declined across all domains at the end of treatment, then improved but remained below baseline at 12 months, with a significant temporal effect in the physical SF subscale and a trend for overall satisfaction. There were significant correlations between the SF and QOL domains (physical and emotional health, social functioning, and general health) as well as overall QOL. The presence of mood disorder, but not fatigue, demographic, or treatment variables, independently predicted worse overall sexual satisfaction.

Conclusions.
Sexual dysfunction is common after breast cancer therapy and impacts QOL. Interventions should include identification and treatment of concomitant mood disorder.
Disproportionate Proximity to Environmental Health Hazards: Methods, Models, and Measurement
Authors: Chakraborty Jayajit , Maantay Juliana A. , Brender Jean D. 
Published: August 2011

We sought to provide a historical overview of methods, models, and data used in the environmental justice (EJ) research literature to measure proximity to environmental hazards and potential exposure to their adverse health effects. We explored how the assessment of disproportionate proximity and exposure has evolved from comparing the prevalence of minority or low-income residents in geographic entities hosting pollution sources and discrete buffer zones to more refined techniques that use continuous distances, pollutant fate-and-transport models, and estimates of health risk from toxic exposure.We also reviewed analytical techniques used to determine the characteristics of people residing in areas potentially exposed to environmental hazards and emerging geostatistical techniques that are more appropriate for EJ analysis than conventional statistical methods.We concluded by providing several recommendations regarding future research and data needs for EJ assessment that would lead to more reliable results and policy solutions.
Moving Environmental Justice Indoors: Understanding Structural Influences on Residential Exposure Patterns in Low-Income Communities
Authors: Adamkiewicz Gary , Zota Ami R. , Fabian M. Patricia , Chahine Teresa , Julien Rhona , Spengler John D. , Levy Jonathan I. 
Published: August 2011

Objectives. The indoor environment has not been fully incorporated into the environmental justice dialogue. To inform strategies to reduce disparities, we developed a framework to identify the individual and place-based drivers of indoor environment quality. Methods. We reviewed empirical evidence of socioeconomic disparities in indoor exposures and key determinants of these exposures for air pollutants, lead, allergens, and semivolatile organic compounds. We also used an indoor air quality model applied to multifamily housing to illustrate how nitrogen dioxide (NO2) and fine particulate matter (PM2.5) vary as a function of factors known to be influenced by socioeconomic status. Results. Indoor concentrations of multiple pollutants are elevated in low-socioeconomic status households. Differences in these exposures are driven by the combined influences of indoor sources, outdoor sources, physical structures, and residential activity patterns. Simulation models confirmed indoor sources’ importance in determining indoor NO2 and PM2.5 exposures and showed the influence of household-specific determinants. Conclusions. Both theoretical models and empirical evidence emphasized that disparities in indoor environmental exposure can be significant. Understanding key determinants of multiple indoor exposures can aid in developing policies to reduce these disparities.