bluuebunny/crossref_metadata_2025_split huggingface dataset:
Navigation-assisted Debridement Arthroplasty for Osteoarthritis of the Elbow: A Preliminary Report
Authors: Ikeda Masayoshi , Kobayashi Yuka , Saito Ikuo , Ishii Takayuki , Shimizu Ayuko , Oka Yoshinori 
Published: October 2011

Background Debridement arthroplasty is a widely accepted operative treatment for elbow osteoarthritis. However, it is sometimes difficult to define the extent of appropriate osteophyte resection. In the present study, a navigation system was used to resect the osteophytes. Methods Eight male patients (mean age, 62 years) were enrolled in the present study. When the osteophytes around the olecranon, coronoid and radial fossae of the distal humerus were removed, the operation was monitored using a navigation system. Pre- and postoperative clinical and radiographical assessments were performed with a mean follow-up of 29 months. Results There were no major complications during the operations. Postoperative computed tomography showed that the osteophytes were properly removed. The mean range of motion of the elbow improved from –21° to 110° pre-operatively to –13° to 130° at the time of follow-up ( p < 0.05). The mean Mayo Elbow Performance Score improved from 75 points to 98 points ( p < 0.05) and the mean Disabilities of the Arm, Shoulder and Hand score improved from 24.2 points to 8.7 points ( p < 0.05). Conclusions The findings of the present study demonstrate that the osteophytes formed at the distal humerus could be precisely visualized using a navigation system. This system effectively defined the region and depth of the morphological configuration for resection.
Evaluation of the cost of therapy for the treatment of sexually transmitted infections in a Nigerian teaching hospital
Authors: Suleiman Ismail A , Tayo Fola 
Published: October 2011

AbstractObjectiveTo determine the cost of therapy to patients of sexually transmitted infections in a Nigerian teaching hospital.MethodsA retrospective drug-utilization evaluation in conjunction with cost-of-illness analysis was used. Two hundred and twenty seven case notes containing 310 prescriptions of patients with sexually transmitted infections were examined over a 1-year period between 2005 and 2006. Relevant data including demographics, diagnosis, prescribed drugs and dosages were extracted and the associated costs, direct and indirect, were evaluated.Key findingsDisease occurrence was higher among the most productive work force group of 21–40 years (59.0%), which had 82.0% of the prescriptions. The overall average cost of antibacterial agents for sexually transmitted infection per patient (n = 227) was NGN977.85 (US$7.52) while the overall average cost per prescription (n = 310) was NGN716.04 ($5.51). The highest average cost of antibacterial agents of NGN2028.00 ($15.60) was obtained for chlamydial infection. The overall average of cost of therapy per patient (n = 227) was NGN2610.65 ($20.08). Chlamydial infection had the highest overall average cost of therapy, at NGN5408.92 ($41.60). The discounted average total cost of therapy for the year 2010 was $48.23 for chlamydial infection. Antibacterial agents constituted the highest cost component (37.5%) followed by indirect costs (26.5%). The average cost of therapy per patient of NGN2610.65 ($20.04) gave a 2010 discounted value of $23.23.ConclusionThe cost of therapy for these infections to patients and the nation as a whole is huge.
Auto‐segmentation of normal and target structures in head and neck CT images: A feature‐driven model‐based approach
Authors: Qazi Arish A. , Pekar Vladimir , Kim John , Xie Jason , Breen Stephen L. , Jaffray David A. 
Published: October 2011

Purpose:Intensity modulated radiation therapy (IMRT) allows greater control over dose distribution, which leads to a decrease in radiation related toxicity. IMRT, however, requires precise and accurate delineation of the organs at risk and target volumes. Manual delineation is tedious and suffers from both interobserver and intraobserver variability. State of the art auto‐segmentation methods are either atlas‐based, model‐based or hybrid however, robust fully automated segmentation is often difficult due to the insufficient discriminative information provided by standard medical imaging modalities for certain tissue types. In this paper, the authors present a fully automated hybrid approach which combines deformable registration with the model‐based approach to accurately segment normal and target tissues from head and neck CT images.Methods:The segmentation process starts by using an average atlas to reliably identify salient landmarks in the patient image. The relationship between these landmarks and the reference dataset serves to guide a deformable registration algorithm, which allows for a close initialization of a set of organ‐specific deformable models in the patient image, ensuring their robust adaptation to the boundaries of the structures. Finally, the models are automatically fine adjusted by our boundary refinement approach which attempts to model the uncertainty in model adaptation using a probabilistic mask. This uncertainty is subsequently resolved by voxel classification based on local low‐level organ‐specific features.Results:To quantitatively evaluate the method, they auto‐segment several organs at risk and target tissues from 10 head and neck CT images. They compare the segmentations to the manual delineations outlined by the expert. The evaluation is carried out by estimating two common quantitative measures on 10 datasets: volume overlap fraction or the Dice similarity coefficient (DSC), and a geometrical metric, the median symmetric Hausdorff distance (HD), which is evaluated slice‐wise. They achieve an average overlap of 93% for the mandible, 91% for the brainstem, 83% for the parotids, 83% for the submandibular glands, and 74% for the lymph node levels.Conclusions:Our automated segmentation framework is able to segment anatomy in the head and neck region with high accuracy within a clinically‐acceptable segmentation time.
Radiochromic EBT2 film dosimetry for low‐energy protontherapy
Authors: Angellier G. , Gautier M. , Hérault J. 
Published: October 2011

Purpose:In protontherapy, accessories are used in order to adapt the beam to the surface and to the depth of the target. They are positioned close to the patient in order to avoid perturbation effects related to proton scattering. The level of contamination of the beam caused by these accessories may be assessed by examining the dose maps in parallel planes to the beam incidence. The EBT2 radiochromic film is a suitable tool for this task, as it can be cut into small pieces and immersed in water. Prior to use the EBT2 film for dose measurements, its response when exposed to a proton beam must be analysed.Methods:The measurements were performed at the Centre Antoine Lacassagne, using the hospital‐based MEDICYC isochronous cyclotron which provides 65 MeV protons. Monoenergetic as well as polyenergetic beams were used. Small pieces of EBT2 films were irradiated with proton beams in a small water phantom. Films were exposed at various angles close to the beam incidence and received doses ranging from 0.25 to 500 Gy. The optical density (OD) was studied as a function of angle, dose and linear energy transfer (LET).Results:The effective atomic number of the active layer of the film is close to that of water which prevents disturbances of the measurement. However, the high density and the significant thickness of the Mylar substrate surrounding the active layer affect the use of the film in a parallel orientation to the beam. Therefore, the substrate layer may totally or partially slow down the protons. The measurement is then no longer representative to what happens in water. The measurement errors can be corrected by applying a tilt angle of at least 5° between the film and the beam. The dose analysis reveals that the green channel is the most sensitive in the dose range from 1 to 100 Gy. The OD is accurately described by a Weibull function of the dose with four free parameters. The Weibull function is valid for both monoenergetic and polyenergetic beams if the LET is limited to values below 15 MeV g− 1 cm2. When using a film orientation close to the beam incidence angle, increasing LET values are encountered throughout the film axis gradually with the protons slowing down in water. The EBT2 films show an underestimated response for higher LET values. The comparison of data from the present study to data obtained by other authors for EBT films allows modelling the underestimated response as a function of the LET. The definition improvement of the link between OD and LET requires to integrate more closely the beam energy characteristics.Conclusions:The EBT2 film is a suitable dosimeter for analysing dose plans in planes nearly parallel to the beam orientation by compensating the underestimated dose response due to LET.
Assessment of three methods for detection of ultrasound artifacts
Authors: King Deirdre M. , Hangiandreou Nicholas J. , Tradup Donald J. , Stekel Scott F. 
Published: October 2011

Purpose:The purpose of this work is to measure the performance (sensitivity and specificity) of three different visually based methods of detecting ultrasound artifacts using dynamic clips obtained with a liquid phantom. It is important to detect the presence of these non uniformities as early as possible, so they can be assessed, tracked, and addressed well before clinical image quality is impacted.Methods:A total of 28 transducers of varying models containing a single artificial artifact created by stretching thin filaments across the transducer face were prepared. A second set of 28 matching transducers contained no artifacts. A 10 s clip was recorded of a dynamic speckle pattern from a custom liquid phantom (“dynamic clip”). A single‐frame image was obtained by computing the median values at each pixel location over all frames of the clip (“median image”). This single‐frame median image was then subtracted from a baseline image previously obtained with no induced artifact (“subtracted median”). All images were evaluated by six observers. The mean sensitivity and specificity with 95% exact binomial confidence intervals for the three artifact detection methods were estimated. Evaluation time and observer confidence were recorded.Results:Both single‐frame median and subtracted median images had a higher sensitivity than the dynamic clip. Overall the subtracted median images had the highest sensitivity of 97%, while maintaining a high specificity of 92%. Observers identified artifacts in the shortest time and with the highest confidence with this method. The subtracted median method removed the original structural variations and non‐uniformities, and reduced the likelihood of false‐positives.Conclusions:From the three methods assessed in this study, subtracted median images allow detection of artifacts with very good sensitivity and specificity, low image evaluation times, and a high degree of observer confidence, making these ideal for routine QC. For acceptance testing, where there are no previous baseline images available for subtraction, the use of median images is useful, although comparison with median images from different transducers of the same model and/or comparison of impressions from multiple observers should be made to decrease the incidence of false‐positive findings. If median and subtracted median images are not available, direct inspection of the dynamic B‐mode clips is useful for acceptance testing and quality control, but with lower sensitivity and somewhat longer evaluation time.
Novel Vaginal Microflora Colonization Model Providing New Insight into Microbicide Mechanism of Action
Authors: Fichorova Raina N. , Yamamoto Hidemi S. , Delaney Mary L. , Onderdonk Andrew B. , Doncel Gustavo F. 
Published: October 2011

ABSTRACTSeveral broad-spectrum microbicides, including cellulose sulfate (CS), have passed conventional preclinical and phase I clinical safety evaluation and yet have failed to protect women from acquiring HIV-1 in phase II/III trials. Concerns have been raised that current preclinical algorithms are deficient in addressing the complexity of the microflora-regulated vaginal mucosal barrier. We applied a novel microflora-colonized model to evaluate CS and hydroxyethylcellulose (HEC), which is used as a “universal placebo” in microbicide trials. Cervicovaginal epithelial cultures were colonized with normal vaginal microflora isolates representing commonLactobacillusspecies used as probiotics (L. acidophilusandL. crispatus) orPrevotella biviaandAtopobium vaginae, most prevalent in the disturbed microflora of bacterial vaginosis (BV). At baseline, all strains maintained constant epithelium-associated CFUs without inducing cytotoxicity and apoptosis. CS selectively reduced epithelium-associated CFUs and (to a lesser extent) planktonic CFUs, most significantly affectingL. crispatus. Inducing only minor changes in sterile epithelial cultures, CS induced expression of innate immunity mediators (RANTES, interleukin-8 [IL-8], and secretory leukocyte protease inhibitor [SLPI]) in microflora-colonized epithelia, most significantly potentiating effects of bacteria causing BV. In the absence of CS, all bacterial strains exceptL. acidophilusactivated NF-κB, although IL-8 and RANTES levels were increased by the presence of BV-causing bacteria only. CS enhanced NF-κB activation in a dose-dependent manner under all conditions, includingL. acidophiluscolonization. HEC remained inert. These results offer insights into possible mechanisms of CS clinical failure. The bacterially colonized cervicovaginal model reveals unique aspects of microflora-epithelium-drug interactions and innate immunity in the female genital tract and should become an integral part of preclinical safety evaluation of anti-HIV microbicides and other vaginal formulations.IMPORTANCEThis report provides experimental evidence supporting the concept that the vaginal microflora regulates the epithelial innate immunity in a species- and strain-specific manner and that topically applied microbicides may alter both the bacterial and epithelial components of this homeostatic interaction. Our data also highlight the importance of differentiating the effects of biomedical interventions on epithelium-associated versus conventional planktonic bacterial growth when assessing vaginal mucosal health and immunity.
Membrane and Core Periplasmic Agrobacterium tumefaciens Virulence Type IV Secretion System Components Localize to Multiple Sites around the Bacterial Perimeter during Lateral Attachment to Plant Cells
Authors: Aguilar Julieta , Cameron Todd A. , Zupan John , Zambryski Patricia 
Published: October 2011

ABSTRACT

Type IV secretion systems (T4SS) transfer DNA and/or proteins into recipient cells. Here we performed immunofluorescence deconvolution microscopy to localize the assembled T4SS by detection of its native components VirB1, VirB2, VirB4, VirB5, VirB7, VirB8, VirB9, VirB10, and VirB11 in the C58 nopaline strain of
Agrobacterium tumefaciens
, following induction of virulence (
vir
) gene expression. These different proteins represent T4SS components spanning the inner membrane, periplasm, or outer membrane. Native VirB2, VirB5, VirB7, and VirB8 were also localized in the
A. tumefaciens
octopine strain A348. Quantitative analyses of the localization of all the above Vir proteins in nopaline and octopine strains revealed multiple foci in single optical sections in over 80% and 70% of the bacterial cells, respectively. Green fluorescent protein (GFP)-VirB8 expression following
vir
induction was used to monitor bacterial binding to live host plant cells; bacteria bind predominantly along their lengths, with few bacteria binding via their poles or subpoles.
vir
-induced attachment-defective bacteria or bacteria without the Ti plasmid do not bind to plant cells. These data support a model where multiple
vir-
T4SS around the perimeter of the bacterium maximize effective contact with the host to facilitate efficient transfer of DNA and protein substrates.

IMPORTANCE
Transfer of DNA and/or proteins to host cells through multiprotein type IV secretion system (T4SS) complexes that span the bacterial cell envelope is critical to bacterial pathogenesis. Early reports suggested that T4SS components localized at the cell poles. Now, higher-resolution deconvolution fluorescence microscopy reveals that all structural components of the
Agrobacterium tumefaciens vir
-T4SS, as well as its transported protein substrates, localize to multiple foci around the cell perimeter. These results lead to a new model of
A. tumefaciens
attachment to a plant cell, where
A. tumefaciens
takes advantage of the multiple
vir-
T4SS along its length to make intimate lateral contact with plant cells and thereby effectively transfer DNA and/or proteins through the
vir-
T4SS. The T4SS of
A. tumefaciens
is among the best-studied T4SS, and the majority of its components are highly conserved in different pathogenic bacterial species. Thus, the results presented can be applied to a broad range of pathogens that utilize T4SS.
Chlamydia infection, pelvic inflammatory disease, ectopic pregnancy and infertility: cross-national study
Authors: Bender Nicole , Herrmann Björn , Andersen Berit , Hocking Jane S , van Bergen Jan , Morgan Jane , van den Broek Ingrid VF , Zwahlen Marcel , Low Nicola 
Published: October 2011

ObjectivesTo describe, using routine data in selected countries, chlamydia control activities and rates of chlamydia infection, pelvic inflammatory disease (PID), ectopic pregnancy and infertility and to compare trends in chlamydia positivity with rates of PID and ectopic pregnancy.MethodsCross-national comparison including national data from Australia, Denmark, the Netherlands, New Zealand, Sweden and Switzerland. Routine data sources about chlamydia diagnosis and testing and International Classification of Disease-10 coded diagnoses of PID, ectopic pregnancy and infertility in women aged 15–39 years from 1999 to 2008 were described. Trends over time and relevant associations were examined using Poisson regression.ResultsOpportunistic chlamydia testing was recommended in all countries except Switzerland, but target groups differed. Rates of chlamydia testing were highest in New Zealand. Chlamydia positivity was similar in all countries with available data (Denmark, New Zealand and Sweden) and increased over time. Increasing chlamydia positivity rates were associated with decreasing PID rates in Denmark and Sweden and with decreasing ectopic pregnancy rates in Denmark, New Zealand and Sweden. Ectopic pregnancy rates appeared to increase over time in 15–19-year-olds in several countries. Trends in infertility diagnoses were very variable.ConclusionsThe intensity of recommendations about chlamydia control varied between countries but was not consistently related to levels of chlamydia diagnosis or testing. Relationships between levels of chlamydia infection and complication rates between or within countries over time were not straightforward. Development and validation of indicators of chlamydia-related morbidity that can be compared across countries and over time should be pursued.
Urinary Levels of Cigarette Smoke Constituent Metabolites Are Prospectively Associated with Lung Cancer Development in Smokers
Authors: Yuan Jian-Min , Gao Yu-Tang , Murphy Sharon E. , Carmella Steven G. , Wang Renwei , Zhong Yan , Moy Kristin A. , Davis Andrew B. , Tao Li , Chen Menglan , Han Shaomei , Nelson Heather H. , Yu Mimi C. , Hecht Stephen S. 
Published: October 2011

Abstract
Polycyclic aromatic hydrocarbons (PAH) are believed to be among the principal causative agents for lung cancer in smokers, but no epidemiologic studies have evaluated the relationship of PAH uptake and metabolism to lung cancer. In this study, we quantified prediagnostic urinary levels of r-1,t-2,3,c-4-tetrahydroxy-1,2,3,4-tetrahydrophenanthrene (PheT), a validated biomarker of PAH uptake and metabolism, as well as 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), and cotinine and its glucuronides (total cotinine), validated biomarkers of uptake of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, and nicotine, respectively, in relation to lung cancer risk among current smokers in a nested case–control study within a cohort of 18,244 Chinese men in Shanghai, China. Urinary levels of PheT, total NNAL, and total cotinine were significantly higher in cases than controls (N = 476 matched pairs). ORs (95% confidence intervals) for lung cancer in the second, third, fourth, and fifth quintiles of PheT were 1.70 (1.00–2.88), 1.07 (0.62–1.84), 1.48 (0.86–2.53), and 2.34 (1.33–4.11), respectively, relative to the lowest quartile (Ptrend = 0.023) after adjustment for self-reported smoking intensity and duration and urinary total NNAL and total cotinine. This study also confirmed that urinary total NNAL and total cotinine are independently related to lung cancer risk. Cancer Res; 71(21); 6749–57. ©2011 AACR.
Smad7 Expression in T cells Prevents Colitis-Associated Cancer
Authors: Rizzo Angelamaria , Waldner Maximilian J. , Stolfi Carmine , Sarra Massimiliano , Fina Daniele , Becker Christoph , Neurath Markus F. , Macdonald Thomas T. , Pallone Francesco , Monteleone Giovanni , Fantini Massimo C. 
Published: October 2011

AbstractPatients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer due to chronic inflammation. In IBD, chronic inflammation relies upon a TGFβ signaling blockade, but its precise mechanistic relationship to colitis-associated colorectal cancer (CAC) remains unclear. In this study, we investigated the role of the TGFβ signaling inhibitor Smad7 in CAC pathogenesis. In human colonic specimens, Smad7 was downregulated in CD4+ T cells located in the lamina propria of patients with complicated IBD compared with uncomplicated IBD. Therefore, we assessed CAC susceptibility in a transgenic mouse model where Smad7 was overexpressed specifically in T cells. In this model, Smad7 overexpression increased colitis severity, but the mice nevertheless developed fewer tumors than nontransgenic mice. Protection was associated with increased expression of IFNγ and increased accumulation of cytotoxic CD8+ and natural killer T cells in the tumors and peritumoral areas. Moreover, genetic deficiency in IFNγ abolished the Smad7-dependent protection against CAC. Taken together, our findings defined a novel and unexpected role for Smad7 in promoting a heightened inflammatory response that protects against CAC. Cancer Res; 71(24); 7423–32. ©2011 AACR.
Is Co-option a Prevailing Mechanism during Cancer Progression?
Authors: Billaud Marc , Santoro Massimo 
Published: October 2011

AbstractCancer progression results from the accumulation of genetic and epigenetic alterations that provide tumor cells with a selective advantage. The consecutive cycles of mutations, selections, and clonal expansions generate, over time, descendant cells with increasing malignant properties. Although this conception of tumor development rests on solid experimental foundations, it has also raised several persisting questions. Does the succession of mutations dictate the progression of each cancer type or does the disturbance of an invariant set of regulatory circuits govern tumor evolution regardless of the linear order of genetic events? Is the ability of malignant cells to disseminate and spawn metastasis a property acquired at late stages of tumor development or is the proclivity to metastasize implanted early during cancer formation? Considering these issues, we elaborate here on the concept of co-option that refers to the emergence of novel functions from ancestral characters during episodes of organismal evolution. As discussed in this Perspective, co-option seems to be a key mechanism propelling the molecular engine that drives malignant transformation. Hence, this notion may constitute a unifying principle that connects a large body of experimental results to clinical observations. Cancer Res; 71(21); 6572–5. ©2011 AACR.