bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a simple computerized tool for measuring spinal and pelvic parameters
Authors: Kim Chi Heon , Chung Chun Kee , Hong Hee Suk , Kim Eun Hyun , Kim Min Jung , Park Byung Joo 
Published: December 2011

Object
Recent studies have emphasized measuring the sagittal vertical axis (SVA) and pelvic parameters (pelvic incidence, sacral slope, and pelvic tilt) when evaluating spinal disorders. An accurate and reproducible measurement is important for a reliable result. Although computerized measurement is more consistent than manual measurement, computerized measurement requires an expensive software program, the need to transfer images to a workstation, and additional education for users. An inexpensive and convenient computerized measurement program is desirable and necessary. The object of this study was to propose a computerized tool for measuring spinal and pelvic parameters and to evaluate the efficacy of this new tool compared with manual measurement.

Methods
The authors devised a tool that provides computerized measurements of the SVA and pelvic parameters in a picture archiving and communication system (PACS) without transferring images to another program. This tool was created by merging functions in the PACS. The resulting tool is easy to implement by merging functions (indicate the center of 2 points, plot a vertical and a horizontal line from a point, and measure the angles between lines) in any image viewer. The tool was made into icons on a toolbar in the PACS. Measurements of distance and angle were computerized by identifying crucial points after selecting the icon. For SVA, 4 points were identified around each corner of the C-7 body and a fifth point at the superior/posterior corner of the S-1 body. For pelvic parameters, 4 points were identified at the centers of each femoral head and at the anterior/superior and posterior/superior corners of S-1. Thirty-three whole-spine lateral radiographs were randomly selected from the radiographic database. To evaluate inter- and intraobserver variability between observers and method, skilled (2 years of experience) and unskilled (1 week of experience) observers measured SVA and pelvic parameters 3 times with a 7-day interval between each time using both computerized and manual measurement methods. The reliability was measured using the intraclass correlation coefficient.

Results
The computerized method showed better congruity than the manual method in both skilled and unskilled observers (p < 0.05), and the intraclass correlation coefficients were > 0.9. The skilled observer showed better agreement than the unskilled observer with both computerized and manual methods, and this difference was prominent in measuring pelvic parameters (p < 0.05). The computerized method required less time than the manual method, especially for the unskilled observer (p < 0.05).

Conclusions
A computerized measurement of pelvic parameters may be a more reliable and efficacious approach than manual measurements. This benefit is more prominent in the unskilled observer, and adding this simple function to an image viewer may be recommended in future studies.
Microsatellite primers for the narrowly endemic shrub Eriogonum giganteum (Polygonaceae)
Authors: Riley Lynn , McGlaughlin Mitchell E. , Helenurm Kaius 
Published: December 2011

• Premise of the study: Microsatellite primers were designed for Eriogonum giganteum var. formosum, an endemic shrub of San Clemente Island, to investigate population structure, genetic diversity, and demographic history.• Methods and Results: Twelve polymorphic microsatellite loci were isolated from the California Channel Island endemic Eriogonum and were screened for variability. The primers amplified one to eight alleles in the target taxon. Many primers also amplified in conspecific and congeneric (E. arborescens, E. fasciculatum, E. grande, E. latifolium, and E. parvifolium) taxa and in the closely related Chorizanthe valida. The total number of alleles per locus for all taxa screened ranged from three to 24.• Conclusions: These primers will be useful for conservation genetic and evolutionary studies within the California Channel Island endemic Eriogonum.
A Dose Schedule for Intraarticular Steroids in Juvenile Arthritis: Table 1.
Authors: EBERHARD B. ANNE , ILOWITE NORMAN T. , SISON CRISTINA 
Published: December 2011

Objective.To determine whether the intraarticular (IA) dose of triamcinolone hexacetonide (TH) or triamcinolone acetonide (TA) influences time to relapse among patients with juvenile idiopathic arthritis (JIA).Methods.The primary endpoint variable was the time to relapse of arthritis in the affected joint after an intraarticular (IA) injection. A relapse was defined as the reoccurrence of active arthritis in the injected joint. Analysis was carried out including only the first IA joint injection for each patient. Further analysis was conducted including the first knee injection alone. A separate analysis within the IA corticosteroid groups was performed using the Spearman rank coefficient, to determine if dose of IA steroid affected time to relapse.Results.Records from 186 patients with JIA (145 females, 41 males) injected with either TH or TA were collected from January 1995 through December 2003. All subjects were followed for a minimum of 15 months from the time of IA injection. Of the 794 joint injections, 422 (53.1%) were injected with TH and 372 (46.9%) with TA. There were 111 first joint injections (all joints) with TH and 70 with TA. There were 89 first joint injections (knee only) with TH and 56 with TA. TH proved more effective than TA with respect to the time to relapse for first injection into all joints (10.47 ± 0.42 mo vs 8.66 ± 0.59 mo; p < 0.001), and for first injections into knee only (11.04 ± 0.44 vs 8.99 ± 0.65 mo; p < 0.001). IA doses ranged from 0.4 to 4 mg/kg (mean 1.56 ± 0.76) for TH and from 0.5 to 8 mg/kg (mean 2.54 ± 1.74) for TA. There was no correlation between time to relapse and dose of either TH and TA (r = 0.1, p > 0.5). There was no correlation between time to relapse and sex, duration of illness, age of patient, concurrent medications, or subtype of JIA.Conclusion.In a larger dataset (794 injections) we have confirmed our previous findings (227 injections) that TH is a more effective IA corticosteroid than TA. In this much larger data analysis, dose of IA corticosteroid in the range we studied did not significantly influence the duration of response.
Prevalence of Vertebral Compression Fractures and Associated Factors in Children and Adolescents with Severe Juvenile Idiopathic Arthritis
Authors: MARKULA-PATJAS KATI P. , VALTA HELENA L. , KERTTULA LIISA I. , SOINI IRMA H. , HONKANEN VISA E.A. , TOIVIAINEN-SALO SANNA-MARIA , MÄKITIE OUTI M. 
Published: December 2011

Objective.Vertebral fractures occur in patients with juvenile idiopathic arthritis (JIA), but data on their frequency and causes are scarce. Our cross-sectional study evaluated prevalence of compression fractures and associated factors in a high-risk pediatric population with severe JIA.Methods.Children and adolescents with a history of treatment-resistant polyarticular-course JIA for ≥ 5 years or systemic arthritis for ≥ 3 years were recruited. Clinical examination, dietary recall, laboratory measurements, bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry, and spinal radiography were performed.Results.Our study included 50 patients (41 girls), of whom 6 (12%) had systemic arthritis, with a median age of 14.8 years (range 7.0–18.7 yrs) and median disease duration of 10.2 years (range 3.9–16.8 years). Ninety-four percent had used systemic glucocorticoids (GC); the median total duration of GC treatment was 7.1 years (range 0–15.5 yrs). The median weight-adjusted cumulative GC dose for the preceding 3 years was 72 mg/kg (range 0–911 mg/kg). The median bone age-corrected lumbar spine and whole-body areal BMD Z-scores were −0.8 and −1.0, respectively. Twenty-two percent had vertebral fractures, mostly thoracic. Compression fractures were associated with high disease activity, high body mass index (BMI), and high recent cumulative GC dose, but not with disease duration or BMD. Thirty percent had sustained at least 1 peripheral low energy fracture. Twenty-six percent were deemed to have significantly compromised bone health.Conclusion.Severe JIA is associated with a significant risk of vertebral compression fractures. Associated factors include high disease activity, high BMI, and high recent GC exposure. Further studies are needed to establish optimal prevention and treatment guidelines.
Sleep Disturbances and Interleukin 6 Receptor Inhibition in Rheumatoid Arthritis
Authors: FRAGIADAKI KALLIOPI , TEKTONIDOU MARIA G. , KONSTA MARIA , CHROUSOS GEORGE P. , SFIKAKIS PETROS P. 
Published: December 2011

Objective.Interleukin 6 (IL-6)-mediated interactions have been associated with sleep disturbances in healthy subjects. In this pilot study we examined whether administration of the IL-6 receptor antagonist tocilizumab in patients with rheumatoid arthritis (RA) affects sleep disturbances.Methods.Fifteen patients (13 women) with sleep disturbances at baseline received 6 monthly infusions of tocilizumab 8 mg/kg for moderately or severely active RA. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness by Epworth Sleepiness Scale, disease activity by the 28-joint Disease Activity Score-erythrocyte sedimentation rate, functional disability by Health Assessment Questionnaire Disability Index (HAQ-DI), and fatigue by the Functional Assessment of Chronic Illness Therapy (FACIT-Fatigue Scale; FFS) at baseline and first, second, third, and sixth month of treatment. Medications used before enrollment remained unchanged during followup.Results.Sleep quality improved and daytime sleepiness decreased significantly at first-month assessment (p < 0.00001 and p < 0.004, respectively, by repeated measurement analysis) compared to baseline, and these changes became more evident through 6 months. Disease activity decreased, fatigue decreased, and functional status improved significantly. Changes in PSQI score over time were not associated with the corresponding changes in DAS28-ESR (r = 0.37, p = 0.17), but correlated significantly with HAQ-DI changes (r = 0.60, p = 0.02) and marginally with changes in FFS scores (r = −0.46, p = 0.08).Conclusion.Improvement of sleep quality after tocilizumab treatment in patients with RA does not appear to directly result from decreased disease activity, further suggesting that aberrant IL-6 regulation is associated with sleep disturbances.
Projecting Future Medical Care Costs Using Four Scenarios of Lifestyle Risk Rates
Authors: Leutzinger Joseph A. , Ozminkowski Ronald J. , Dunn Rodney L. , Goetzel Ron Z. , Richling Dennis E. , Stewart Maureen , Whitmer R. William 
Published: December 2011

Purpose. This study predicts medical care expenditures over 10 years for Union Pacific Railroad (UPRR) under alternative health risk factor scenarios for the UPRR workforce. Design. This paper describes the development of an economic forecasting model to predict medical care expenditures assuming four different scenarios of population risk. The variables used to predict medical care expenditures are employee demographics and health risk profiles. Setting. UPRR is a transportation company with more than 56,000 employees in 25 states west and south of the Mississippi River. Subjects. Employees of UPRR. Measures. Intermediate outcomes included health risk measures related to exercise patterns, body weight, eating habits, smoking, alcohol consumption, total cholesterol, blood glucose, blood pressure, stress, and depression. Major outcome measures included projected total annual payments by UPRR for medical care services for the decade following 1998. Results. The UPRR work force is projected to grow by 500 employees per year over the 10-year study period. The average age is expected to increase from 44 to 48 years. Without further health promotion intervention, 7 of the 11 risk factors assessed would likely worsen among UPRR's workforce. Medical care cost increases are projected to range from $22.2 million to $99.6 million in constant 1998 dollars over the next decade, depending on the effectiveness of risk factor modification programs. With an expected health promotion budget averaging $1.9 million annually over 10 years, health risks must decline at least 0.09 % per year for the program to pay for itself. Conclusions. Estimating various risk and cost scenarios can facilitate program planning and produce an economic justification for worksite health programs.
The Relationship between Modifiable Health Risks and Future Medical Care Expenditures: The Korea Medical Insurance Corporation (KMIC) Study
Authors: Jee Sun Ha , O'Donnell Michael P. , Suh Il , Kim Il Soon 
Published: December 2011

Context. The relationship between lifestyle risk factors, morbidity, and mortality is well established, but the relationship between lifestyle risk factors and medical care costs is not as well defined. Objectives. To determine the ability of modifiable biometric and lifestyle risk factors to predict future medical care costs. Design. Prospective cohort study. Setting and Participants. Data on modifiable risk factors collected in 1992 and medical care costs collected in 1998 by the Korea Medical Insurance Corporation in South Korea. Data were examined for a final cohort 78 of 728 men and 50,414 women enrolled in the health insurance plan from 1990 through 1998. Main Outcome Measures. Outcome measures included likelihood of any inpatient, outpatient, and total medical care costs and outlier costs; amount of inpatient, outpatient, and total medical care costs; and portion of total medical costs attributable to each risk factor through unadjusted and adjusted multivariate analyses. Results. Baseline modifiable risk factors measured in 1992 (including lifestyle factors such as smoking high body mass index, exercise, and biometric measures such as cholesterol, blood sugar, blood pressure, and urinary sugar) were important predictors of the amount of medical care costs incurred 6 years later in 1998, even after controlling for age, perceived health status, and each of the other modifiable variables. These risk factors were generally better predictors than nonmodifiable demographic risk factors, including income level and type of job. For men, lifestyle risk factors were associated with total costs that were 2.4% (for high blood pressure) to 16.1 % (for former smokers) higher than among men without those risk factors. Biometric risk factors were associated with costs ranging from 9.2% (for cholesterol) to 38.2% (for positive urinary glucose) higher. For women, lifestyle risk factors were associated with total costs that were 2.5% (for exercise) to 6.4% (for current smokers) higher than among those without the risk factors. Biometric risk factors were associated with costs ranging from 10.2% (for cholesterol) to 60.4% (for positive urinary glucose) higher. For men, a cluster of six heart disease risk factors were associated with total costs 54.7% higher, and a cluster of three stroke risk factors were associated with total costs 22.2% higher than in men who had none of these risk factors. Modifiable risk factors accounted for 23.1% of medical costs for men and 8.7% for women. Conclusions. These results suggest that modifiable biometric and lifestyle risk factors can predict a moderate portion of future medical care costs. If these risk factors can be reduced, future medical care costs may be reduced.
Uncertainty and Capacity Constraints: Reconsidering the Aggregate Production Function
Authors: Gracia Eduard 
Published: December 2011

Abstract
The Cobb–Douglas function is today one of the most widely adopted assumptions in economic modeling, yet both its theoretical and empirical bases have long been under question. This paper builds an alternative function on very different (albeit also neoclassical) microfoundations aimed at both addressing those theoretical drawbacks and providing a better empirical fit than the Cobb–Douglas formula. The new model, unlike the Cobb–Douglas function, does not portray installed capacity as aggregate capital but as a sunk cost generating economic rents. An analysis of 1949–2008 annual U.S. growth data suggest this alternative model explains nearly 85 percent of GDP fluctuations and is empirically more robust than the Cobb–Douglas, whilst both contemporary and lagged aggregate capital are statistically rejected as explanatory variables. This lends support to the old “Cambridge Critique”, according to which using value-weighted capital aggregates to explain production simply makes no sense. At face value, these results not only pose a question on any macroeconomic model assuming a Cobb–Douglas function but also point towards an alternative interpretation of phenomena such as the way monetary policy impacts productivity.
Fabrication of Silk Microneedles for Controlled‐Release Drug Delivery
Authors: Tsioris Konstantinos , Raja Waseem K. , Pritchard Eleanor M. , Panilaitis Bruce , Kaplan David L. , Omenetto Fiorenzo G. 
Published: December 2011

AbstractMicroneedles are emerging as a minimally invasive drug delivery alternative to hypodermic needles. Current material systems utilized in microneedles impose constraints hindering the further development of this technology. In particular, it is difficult to preserve sensitive biochemical compounds (such as pharmaceuticals) during processing in a single microneedle system and subsequently achieve their controlled release. A possible solution involves fabricating microneedles systems from the biomaterial silk fibroin. Silk fibroin combines excellent mechanical properties, biocompatibility, biodegradability, benign processing conditions, and the ability to preserve and maintain the activity of biological compounds entrained in its material matrix. The degradation rate of silk fibroin and the diffusion rate of the entrained molecules can be controlled simply by adjusting post‐processing conditions. This combination of properties makes silk an ideal choice to improve on existing issues associated with other microneedle‐based drug delivery system. In this study, a fabrication method to produce silk biopolymer microstructures with the high aspect ratios and mechanical properties required to manufacture microneedle systems is reported. Room temperature and aqueous‐based micromolding allows for the bulk loading of these microneedles with labile drugs. The drug release rate is decreased 5.6‐fold by adjusting the post‐processing conditions of the microneedles, mainly by controlling the silk protein secondary structure. The release kinetics are quantified in an in vitro collagen hydrogel model, which allows tracking of the model drug. Antibiotic loaded silk microneedles are manufactured and used to demonstrate a 10‐fold reduction of bacterial density after their application. The processing strategies developed in this study can be expanded to other silk‐based structural formats for drug delivery and biologicals storage applications.
Consensus recommendations for current treatments and accelerating clinical trials for patients with neurofibromatosis type 2
Authors: Blakeley Jaishri O. , Evans D. Gareth , Adler John , Brackmann Derald , Chen Ruihong , Ferner Rosalie E. , Hanemann C. Oliver , Harris Gordon , Huson Susan M. , Jacob Abraham , Kalamarides Michel , Karajannis Matthias A. , Korf Bruce R. , Mautner Victor‐Felix , McClatchey Andrea I. , Miao Harry , Plotkin Scott R. , Slattery William , Stemmer‐Rachamimov Anat O. , Welling D. Bradley , Wen Patrick Y. , Widemann Brigitte , Hunter‐Schaedle Kim , Giovannini Marco 
Published: December 2011

AbstractNeurofibromatosis type 2 (NF2) is a tumor suppressor syndrome characterized by bilateral vestibular schwannomas (VS) which often result in deafness despite aggressive management. Meningiomas, ependymomas, and other cranial nerve and peripheral schwannomas are also commonly found in NF2 and collectively lead to major neurologic morbidity and mortality. Traditionally, the overall survival rate in patients with NF2 is estimated to be 38% at 20 years from diagnosis. Hence, there is a desperate need for new, effective therapies. Recent progress in understanding the molecular basis of NF2 related tumors has aided in the identification of potential therapeutic targets and emerging clinical therapies. In June 2010, representatives of the international NF2 research and clinical community convened under the leadership of Drs. D. Gareth Evans (University of Manchester) and Marco Giovannini (House Research Institute) to review the state of NF2 treatment and clinical trials. This manuscript summarizes the expert opinions about current treatments for NF2 associated tumors and recommendations for advancing therapies emerging from that meeting. The development of effective therapies for NF2 associated tumors has the potential for significant clinical advancement not only for patients with NF2 but for thousands of neuro‐oncology patients afflicted with these tumors. © 2011 Wiley Periodicals, Inc.
The 8th international research symposium on the Marfan Syndrome and related conditions
Authors: Pyeritz Reed E. , Loeys Bart 
Published: December 2011

AbstractIn the nearly quarter‐century since the first international symposium on Marfan syndrome, enormous progress has been achieved in clinical, translational, and basic research. The 8th symposium, at the end of 2010, provides a useful summary of the current status of investigations, reveals why life‐expectancy has improved so markedly during the past 30 years, and lays out a clear path for future endeavors, not only in Marfan syndrome, but in the expanding array of conditions related either through phenotype or pathogenesis. © 2011 Wiley Periodicals, Inc.
A 16q12 microdeletion in a boy with severe psychomotor delay, craniofacial dysmorphism, brain and limb malformations, and a heart defect
Authors: Shoukier Moneef , Wickert Julia , Schröder Julia , Bartels Iris , Auber Bernd , Zoll Barbara , Salinas‐Riester Gabriela , Weise Dagmar , Brockmann Knut , Zirn Birgit , Burfeind Peter 
Published: December 2011

AbstractInterstitial deletions of the proximal chromosome 16q are rare. To date, only six cases with molecularly well‐characterized microdeletions within this chromosomal region have been described. We report on a patient with severe psychomotor delay, dysmorphic features, microcephaly and hypoplasia of the corpus callosum, epilepsy, a heart defect, and pronounced muscular hypotonia. Array comparative genomic hybridization (aCGH) revealed that the patient's features were likely caused by a 4.7 Mb de novo deletion on chromosome 16q12.1q12.2, which was confirmed by quantitative real‐time PCR (qPCR). The psychomotor delay and craniofacial dysmorphism are more severe in our patient than previously reported patients. Unmasked recessive mutations in the ZNF423 and FTO genes on the remaining allele were excluded as the putative cause for this severe phenotype. In conclusion, the phenotypic spectrum of microdeletions in 16q12 is broad and comprises variable degrees of psychomotor delay and intellectual disability, craniofacial anomalies, and additional features, including heart defects, brain malformations, and limb anomalies. © 2011 Wiley Periodicals, Inc.
Mild nasal malformations and parietal foramina caused by homozygous ALX4 mutations
Authors: Kayserili Hülya , Altunoglu U. , Ozgur H. , Basaran S. , Uyguner Z.O. 
Published: December 2011

AbstractWe report on a boy born to consanguineous parents, who had hypertelorism, a broad nasal bridge, ridge and tip, bifid nasal tip, cleft alae nasi, broad columella, unilateral preauricular tag, shallow labiogingival sulcus, and bilateral large parietal foramina. Cranial MRI revealed a kinked corpus body and small cerebellar vermis. Molecular analysis uncovered a homozygous c.673C > G (p.Q225E) mutation in ALX4 gene. We compare the relatively mild phenotype in the patient to the more marked phenotype described in other patients with homozygous ALX4 mutations, and to the phenotypes in patients with mutations in other ALX genes. © 2011 Wiley Periodicals, Inc.