bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estradiol Valerate/Dienogest: A Novel Oral Contraceptive
Authors: Whalen Karen L , Rose Renee 
Published: September 2011

Objective: To review the pharmacology, pharmacokinetics, efficacy, and safety of the new oral contraceptive estradiol valerate/dienogest. Data Sources: Searches of PubMed (1966-July 2011) and International Pharmaceutical Abstracts (1970-July 2011) were conducted using the key words estradiol valerate, dienogest, Natazia, and Olaira. Bibliographies of retrieved articles were reviewed to identify additional références. Study Selection and Data Extraction: All identified studies published in English and involving efficacy and safety of estradiol valerate/dienogest as an oral contraceptive were reviewed. Data Synthesis: Estradiol valerate/dienogest is a 4-phasic oral contraceptive approved for the prevention of pregnancy. The 4-phasic design allows for acceptable cycle control with this hormonal combination. In efficacy trials of estradiol valerate/dienogest in women aged 18–35 years, the Pearl Index ranged from 0.40 to 1.64, a range comparable to that of other combination oral contraceptives. The safety profile was also similar to that of other oral contraceptives, with headache, metrorrhagia, breast tenderness, nausea or vomiting, acne, and weight gain reported as the most common adverse effects. Menstrual bleeding patterns and cycle control with estradiol valerate/dienogest were comparable to those of a monophasic oral contraceptive containing ethinyl estradiol/levonorgestrel. Estradiol valerate/dienogest differs from other oral contraceptives in that il necessitates more stringent dosing guidelines for maximum contraceptive efficacy. New starts should be on the first day of menses only, and a back-up method of contraception is required for the first 9 days, as compared to 7 days with other oral contraceptives. Back-up contraception is usually required for any pill taken more than 12 hours later than scheduled. Conclusions: Estradiol valerate/dienogest is an effective oral contraceptive. Because it has more stringent start times and requires a longer duration of back-up contraception and stricter adherence, estradiol valerate/dienogest should be reserved for patients who are intolerant of other combination oral contraceptives.
Probability Machines
Authors: Malley J. D. , Kruppa J. , Dasgupta A. , Malley K. G. , Ziegler A. 
Published: September 2011

SummaryBackground: Most machine learning approaches only provide a classification for binary responses. However, probabilities are required for risk estimation using individual patient characteristics. It has been shown recently that every statistical learning machine known to be consistent for a nonparametric regression problem is a probability machine that is provably consistent for this estimation problem.Objectives: The aim of this paper is to show how random forests and nearest neighbors can be used for consistent estimation of individual probabilities.Methods: Two random forest algorithms and two nearest neighbor algorithms are described in detail for estimation of individual probabilities. We discuss the consistency of random forests, nearest neighbors and other learning machines in detail. We conduct a simulation study to illustrate the validity of the methods. We exemplify the algorithms by analyzing two well-known data sets on the diagnosis of appendicitis and the diagnosis of diabetes in Pima Indians.Results: Simulations demonstrate the validity of the method. With the real data application, we show the accuracy and practicality of this approach. We provide sample code from R packages in which the probability estimation is already available. This means that all calculations can be performed using existing software.Conclusions: Random forest algorithms as well as nearest neighbor approaches are valid machine learning methods for estimating individual probabilities for binary responses. Freely available implementations are available in R and may be used for applications.
A Remote Operating Slit Lamp Microscope System
Authors: Tanabe N. , Go K. , Sakurada Y. , Imasawa M. , Mabuchi F. , Chiba T. , Abe K. , Kashiwagi K. 
Published: September 2011

SummaryObjectives: To develop a remote-operating slit lamp microscope system (the remote slit lamp) as the core for highly specialized ophthalmology diagnoses, and to compare the utility of this system with the conventional slit lamp microscope system (the conventional slit lamp) in making a diagnosis.Methods: The remote slit lamp system was developed. Three factors were evaluated in comparison to the conventional slit lamp. The ability to acquire skills was investigated using a task loading system among specialists and residents in ophthalmology. Participants repeated a task up to ten times and the time required for each task was analyzed. The consistency of the two systems in making a diagnosis was investigated using eyes of patients with ocular diseases as well as healthy volunteers.Results: The remote slit lamp is composed of a patient’s unit and ophthalmologist’s unit connected by high-speed internet. The two units share images acquired by the slit lamp in addition to the images and voices of patients and ophthalmologists. Both ophthalmology specialists and residents could minimize the completion times after several trials. The remote slit lamp took more time than the conventional slit lamp. Both systems showed a high consistency in evaluations among eyes with healthy eyes or those with ocular diseases.Conclusions: The remote slit lamp has a similar diagnostic ability, but required more examination time in comparison to the conventional slit lamp. The currently developed remote slit lamp has the potential to be employed for telemedicine purposes in the field of ophthalmology.
IMPACT: A Generic Tool for Modelling and Simulating Public Health Policy
Authors: Carruthers E. , Couch P. , Green N. , O’Flaherty M. , Sperrin M. , Williams R. , Asghar Z. , Capewell S. , Buchan I. E. , Ainsworth J. D. 
Published: September 2011

SummaryBackground: Populations are under-served by local health policies and management of resources. This partly reflects a lack of realistically complex models to enable appraisal of a wide range of potential options. Rising computing power coupled with advances in machine learning and healthcare information now enables such models to be constructed and executed. However, such models are not generally accessible to public health practitioners who often lack the requisite technical knowledge or skills.Objectives: To design and develop a system for creating, executing and analysing the results of simulated public health and health-care policy interventions, in ways that are accessible and usable by modellers and policy-makers.Methods: The system requirements were captured and analysed in parallel with the statistical method development for the simulation engine. From the resulting software requirement specification the system architecture was designed, implemented and tested. A model for Coronary Heart Disease (CHD) was created and validated against empirical data.Results: The system was successfully used to create and validate the CHD model. The initial validation results show concordance between the simulation results and the empirical data.Conclusions: We have demonstrated the ability to connect health policy-modellers and policy-makers in a unified system, thereby making population health models easier to share, maintain, reuse and deploy.
A Regional Health Care Network: eHealth.Braunschweig
Authors: Bartkiewicz T. , Bautsch W. , Gerlach A. , Goldapp M. , Haux R. , Heller U. , Kierdorf H. P. , Kleinschmidt T. , Ludwig W. , Markurth U. , Pfingsten-Würzburg S. , Plischke M. , Reilmann H. , Schubert R. , Seidel C. , Warnke R. , Gusew N. 
Published: September 2011

SummaryBackground: Health care network eHealth.Braunschweig has been started in the South-East region of Lower Saxony in Germany in 2009. It composes major health care players, participants from research institutions and important local industry partners.Objectives: The objective of this paper is firstly to describe the relevant regional characteristics and distinctions of the eHealth.Braunschweig health care network and to inform about the goals and structure of eHealth.Braunschweig; secondly to picture and discuss the main concepts and domain fields which are addressed in the health care network; and finally to discuss the architectural challenges of eHealth.Braunschweig regarding the addressed domain fields and defined requirements.Methods: Based on respective literature and former conducted projects we discuss the project structure and goals of eHealth.Braunschweig, depict major domain fields and requirements gained in workshops with participants and discuss the architectural challenges as well as the architectural approach of eHealth.Braunschweig network.Results: The regional healthcare network eHealth.Braunschweig has been established in April 2009. Since then the network has grown constantly and a sufficient progress in network activities has been achieved. The main domain fields have been specified in different workshops with network participants and an architectural realization approach for the transinstitutional information system architecture in the healthcare network has been developed. However, the effects on quality of information processing and quality of patient care have not been proved yet. Systematic evaluation studies have to be done in future in order to investigate the impact of information and communication technology on the quality of information processing and the quality of patient care.Conclusions: In general, the aspects described in this paper are expected to contribute to a systematic approach for the establishment of regional health care networks with lasting and sustainable effects on patient-centered health care in a regional context.
Universal Profiling of HIV-1 Pol for Genotypic Study and Resistance Analysis Across Subtypes
Authors: Nie Ting , Detorio Mervi , Schinazi Raymond F 
Published: September 2011

Background The increased use of anti-HIV-1 treatments in developing countries primarily infected by non-B subtypes necessitates development of novel tools to assess susceptibility and resistance. HIV-1 genomes are highly polymorphic and present challenges for the development of universal protocols capable of screening across subtypes. Currently available viral genotyping methods are useful for viral quantification, but are inadequate for sequence profiling or comprehensive mutation detection in the variable regions of HIV polymerase ( pol). Methods A novel set of universal primers within pol, with consensus among a variety of HIV-1 subtypes, was developed. One-round amplification was performed by one-step reverse transcription PCR on 79 samples from HIV-1 subtypes. Using a second set of primers, the amplified fragment was sequenced and assembled to produce a profile database per sample. Results First-round amplification using universal primers generated a unique amplicon encompassing the major pol regions in all tested HIV-1 subtype samples. Sequence analysis of the amplified fragment not only confirmed the subtype of each HIV-1 isolate but also identified resistance mutations in the pol genes of HIV-1, including protease, reverse transcriptase, connection, RNase H, and integrase. Last, some of these primers were used to develop a viral load test using quantitative real time-PCR. Conclusions A novel protocol was produced to effectively identify and simultaneously generate extensive sequence profiles of pol genes across HIV-1 subtypes. This protocol allows for expeditious and cost-effective mutation detection, genotypic evaluation and viral load determination in multiple HIV-1 subtypes.
Etravirine and Rilpivirine Resistance in HIV-1 Subtype Crf01_Ae-Infected Adults Failing Non-Nucleoside Reverse Transcriptase Inhibitor-Based Regimens
Authors: Bunupuradah Torsak , Ananworanich Jintanat , Chetchotisakd Ploenchan , Kantipong Pacharee , Jirajariyavej Supunnee , Sirivichayakul Sunee , Munsakul Warangkana , Prasithsirikul Wisit , Sungkanuparph Somnuek , Bowonwattanuwong Chureeratana , Klinbuayaem Virat , Petoumenos Kathy , Hirschel Bernard , Bhakeecheep Sorakij , Ruxrungtham Kiat 
Published: September 2011

Background We studied prevalence of etravirine (ETR) and rilpivirine (RPV) resistance in HIV-1 subtype CRF01_AE infection with first-line non-nucleoside reverse transcriptase inhibitor (NNRTI) failure. Methods A total of 225 adults failing two nucleoside reverse transcriptase inhibitors (NRTIs) plus 1 NNRTI in Thailand with HIV RNA>1,000 copies/ml were included. Genotypic resistance results and HIV-1 subtype were interpreted by Stanford DR database. ETR resistance was calculated by the new Monogram weighted score (Monogram WS; ≥4 indicating high-level ETR resistance) and by DUET weighted score (DUET WS; 2.5–3.5 and ≥4 resulted in intermediate and reduce ETR response, respectively). RPV resistance interpretation was based on previous reports. Results Median (IQR) age was 38 (34–42) years, 41% were female and CDC A:B:C were 22%:21%:57%. HIV subtypes were 96% CRF01_AE and 4% B. Antiretrovirals at failure were lamivudine (100%), stavudine (93%), nevirapine (90%) and efavirenz (10%) with a median (IQR) duration of 3.4 (1.8–4.5) years. Median (IQR) CD4+ T-cell count and HIV RNA were 194 (121–280) cells/mm3 and 4.1 (3.6–4.6) log10 copies/ml, respectively. The common NNRTI mutations were Y181C (41%), G190A (22%) and K103N (19%). The proportion of patients with Monogram WS score ≥4 was 61.3%. By DUET WS, 49.8% and 7.5% of patients were scored 2.5–3.5 and ≥4, respectively. Only HIV RNA≥4 log10 copies/ml at failure was associated with both Monogram WS≥4 (OR 2.3, 95% CI 1.3–3.9; P=0.003) and DUET WS≥2.5 (OR 1.9, 95% CI 1.1–3.3; P=0.02). The RVP resistance-associated mutations (RAMs) detected were K101P (1.8%), Y181I (2.7%) and Y181V (3.6%). All patients with RPV mutation had ETR resistance. No E138R/E138K mutations were detected. Conclusions Approximately 60% of patients had high-level ETR resistance. The role of ETR in second-line therapy is limited in late NNRTI failure settings. RVP RAMs were uncommon, but cross-resistance between ETR and RVP was high.
In utero exposure to tenofovir disoproxil fumarate does not impair growth and bone health in HIV-uninfected children born to HIV-infected mothers
Authors: Viganò Alessandra , Mora Stefano , Giacomet Vania , Stucchi Sara , Manfredini Valeria , Gabiano Clara , Salvini Filippo , Cellini Monica , Tamburrini Enrica , Puzzovio Maria , Zuccotti Gian Vincenzo 
Published: September 2011

Background Growth impairment and bone toxicity due to tenofovir disoproxil fumarate (TDF) fetal exposure has been described mainly in animals. We evaluated growth pattern and bone health in TDF-exposed HIV-uninfected children born to HIV-infected mothers, defined as seroreverters (SR). Methods This was a multicentre observational cross-sectional cohort study enrolling 68 SR who were in utero exposed to an antiretroviral regimen including (TDF+) or not including (TDF-) tenofovir. Neonatal data and duration of antiretroviral exposure were recorded. At enrolment, anthropometric measures, tibial speed of sound (SOS) by quantitative ultrasound and several parameters of bone metabolism were assessed. Results Gestational age and median in utero antiretroviral exposure were similar in subjects exposed to TDF ( n=33) and those non-exposed ( n=35). Age at enrolment was comparable in the two groups (TDF-exposed range 11.8–76.2 months and TDF non-exposed range 11.8–77.9 months). The incidence of low weight and length measurements (<10th percentiles) at birth was similar in TDF-exposed and TDF non-exposed. Normal growth development was found in both groups of subjects at enrolment. The median (0.6; range -2.4–2.6) SOS z-score of TDF-exposed was similar to the median (0.8; range -2.2–4.4) SOS z-score of TDF non-exposed (Student's t=0.84; P=0.40). Parameters of bone metabolism were similar in the two groups. Conclusions Exposure to TDF during pregnancy does not impair growth patterns, bone health and markers of bone metabolism in SR infants and young children born to HIV-infected women.
Sir James Berry (1860-1946) (To the 150th Anniversary)
Authors: Romanchishen Anatoly F , Vabalayte Kristina V , Tovbina Marina H 
Published: September 2011

ABSTRACTJames Berry was born at Kingston, Ontario, where his father had business interests, but was educated at Whitgift School, South Croydon, London. He spent his student time at St Bartholomew's Hospital and became a fellow of the Royal College of Surgeons. Later, he became consultant surgeon and emeritus lecturer for clinical surgery at the Royal Free Hospital in London. He retired from praxis in 1927. Berry pioneered thyroid surgery in England and wrote a textbook on the subject . With his first wife he assembled and led a medical team to Serbia in World War I. They were captured by the Hungarians and repatriated through Switzerland, only to return to continue their work in Romania.
Use of Retroauricular Temporal Flap for Large Post Oncosurgical Glabellar and Forehead Defects
Authors: Saraiya Hemant 
Published: September 2011

ABSTRACTIntroductionReconstruction of large defect in glabellar and forehead areas poses a perplexing problem for a reconstructive surgeon. Although coverage of small defect can be straight forward, few options are available for the coverage of large area.Materials and methodsTwo patients were operated for recurrent basal cell carcinoma and dermatofibrosarcoma respectively. Excision left very large defect which was reconstructed by retroauricular temporal flap.ResultsBoth flaps survived completely. Flap cutting and final insetting was done on 21st day. The postoperative result was very satisfactory.ConclusionsRetroauricular temporal (Washio) flap is a robust and reliable flap. It satisfactorily caters the need of the recipient area. The scars are oncologically and esthetically acceptable. We believe that this technique is a simple and effective solution to a difficult problem.
Therapeutic Monoclonal Antibodies: Current Perspectives and Applications for the Treatment of Head and Neck Cancer
Authors: Blein Stanislas , Hou Sam 
Published: September 2011

ABSTRACTOver the past two decades, monoclonal antibodies have emerged as a versatile class of therapeutics with unique properties. More than 30 therapeutic antibodies are now approved in the United States and European Union, with numerous candidates filling the preclinical and clinical pipeline of every major pharmaceutical companies and biotechnology firms. Monoclonal antibodies have the advantage over traditional medicines in that they are able to specifically bind to the desired targets with little to no associated toxicity. In the recent years, monoclonal antibodies approved for oncology treatments have gained in notoriety and are now used as adjuvants or neo-adjuvants to radiotherapy, chemotherapy and surgery. In the field of head and neck cancer, the anti-EGF receptor antibody Erbitux has paved the way for new targeted treatments to SCCHN. This review introduces some basic concepts and recent perspectives on monoclonal antibodies with a focus on head and neck cancer treatments.
Parapharyngeal Space Tumors
Authors: Khandawala Pratima S 
Published: September 2011

ABSTRACTParapharyngeal space is a potential space in the neck extending from skull base to the greater cornu of hyoid bone. It is divided in prestyloid and poststyloid compartment by the fascia joining styloid process to tensor veli palatini. Tumors of parapharyngeal space are uncommon, comprising of less than 1% of all head and neck neoplasms. CT Scanning and MRI investigations is complimentary and both studies should be performed for evaluation of lesions in this area. Complete surgical excision is the mainstay of treatment.
Oncogenic Osteoblastoma: A Rare Clinical Entity in the PNS Arising from Ethmoidal Sinus
Authors: Srinivas Champion Venkateshalu , Jhon Stanley , Kailash N , Savithri L , Jyothi Divya 
Published: September 2011

ABSTRACTOncogenic osteoblastoma is a rare clinical entity in the peripheral nervous system (PNS). Its presentation is like a nasal polyp. One should keep the diagnosis of oncogenic osteoblastoma in mind as a differential diagnosis for mass in nasal cavity. Excessive bleeding during surgery should arouse the suspicion and the pathologist has to be sounded. A preliminary biopsy of the mass is to be considered. Immunohistochemistry (IHC) should be done, if the suspicion is strong.
A Rare Anatomical Relationship of Spinal Accessory Nerve to Internal Jugular Vein
Authors: Duggal Prahlad , Dhawan Amit , Sandhu Sumeet 
Published: September 2011

ABSTRACTA patient with a squamous cell carcinoma of right retromolar area of the mandible and undergoing a staging neck dissection was noted to have a unique relationship of the internal jugular vein and spinal accessory nerve. At the upper end of the dissection (level II, Memorial Sloan-Kettering classification), the spinal accessory nerve was observed to pass directly through the internal jugular vein. Although previously described only once in the literature, this finding may be encountered by other surgeons who operate in this area and it is important that these anatomical variations are borne in mind to prevent inadvertent injury. To our knowledge, this must be the first case reported from India.
Recent Trends in the Epidemiology of HIV in Antenatal Women at a Tertiary Care Center
Authors: Nanda Smiti , Grover Sonal , Dahiya Krishna , Sangwan Roopa 
Published: September 2011

ABSTRACT

Introduction
Globally, women and children are the fastest growing group of HIV-positive individuals. As 90% of the pediatric HIV infection is due to mother to child transmission, determination of the seroprevalence in pregnancy will also enable us to take some measures to decrease the transmission to the newborn.

Objective
To study the seroprevalance of HIV among pregnant women.

Methods
Data of 31,328 women attending the antenatal clinic from January 2006 to December 2009 was analyzed. The pregnant women attending the antenatal clinic for consultation were counseled for HIV testing, informed consent was obtained and blood samples collected for HIV testing. Seropositive women were questioned regarding their awareness of AIDS, personal habits, blood transfusion, drug abuse and methods of contraception. Spouses of the seropositive pregnant women were also counseled and similarly tested for HIV.

Results
Acceptability of the test after patient counseling was 72.85%, and 95.3% women attended post-test counseling and collected reports.

Conclusion
There is no definite treatment for HIV/AIDS; however, the pandemic can be controlled by education and behavioral modification.