bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effectiveness of Secondary Prevention Lifestyle Interventions Designed to Change Lifestyle Behavior following Stroke: Summary of a Systematic Review
Authors: Lawrence Maggie , Kerr Susan , McVey Caroline , Godwin Jon 
Published: March 2012

Background A feature of stroke is that it recurs (25% within five-years). Risk factors for stroke and recurrent stroke include smoking, alcohol consumption, poor diet, and physical inactivity. Aim To evaluate the effectiveness of secondary prevention lifestyle interventions designed to change lifestyle behavior following stroke. This short paper presents a summary of the systematic review process and findings. Methods Ten major databases were searched using subject headings and key words. Papers were screened using review-specific criteria. Critical appraisal and data extraction were conducted independently by two reviewers. Data were pooled in statistical meta-analysis; where this was not possible findings were presented in narrative form. Results Three studies involving 581 participants were reviewed. Two models of intervention delivery were reported: shared care and nurse-led. Interventions were delivered to groups or in one-to-one consultations. Metaanalyses of the pooled lifestyle data favored the interventions (2 P = 0.02). In terms of physiological outcomes, while overall treatment effect was not significant, pooled results did approach statistical significance (2 P = 0.08), however the test of heterogeneity was significant, suggesting differences in the variables that were pooled. Pooled secondary outcomes, including perceived health status and stroke knowledge, favored the interventions (2 P #< 0.00001), however, the test for heterogeneity was highly significant. Conclusion Stroke secondary prevention lifestyle interventions are effective in terms of effecting positive change in lifestyle behaviors and secondary outcomes, and appear promising in relation to physiological outcomes. There was insufficient evidence to determine the effect of intervention on incidence of stroke recurrence.
Ethnic Entrepreneurship Studies in Geography: A Review1
Authors: Wang Qingfang 
Published: March 2012

AbstractAlthough geographers have profound interests in place and spatial dimensions of entrepreneurship, the social‐spatial process of entrepreneurship is studied as fragmented due to the gaps between sub‐disciplines in geography. While the social identities of entrepreneurs are largely missing from most economic geographic entrepreneurship studies, existing urban and ethnic geographic inquiries are dominated by studies of small‐scale, low‐skilled businesses bounded by ethnic neighborhoods. This paper makes a plea to re‐conceptualize entrepreneurship by incorporating race, ethnicity, and gender. It calls for a broader, non‐elite perspective of entrepreneurship with a multiscaled spatial approach. For the ethnic minority labor force in particular, immigration, which has transformed urban labor markets in many advanced economies of the world, needs to be included in the analytical framework. Both economic and non‐economic dimensions should be examined in the interaction between people and place through ethnic entrepreneurship as a continuous process.
Retinal Photodamage Mediated by All‐trans‐retinal†
Authors: Maeda Tadao , Golczak Marcin , Maeda Akiko 
Published: March 2012

ABSTRACTAccumulation of all‐trans‐retinal (all‐trans‐RAL), reactive vitamin A aldehyde, is one of the key factors in initiating retinal photodamage. This photodamage is characterized by progressive retinal cell death evoked by light exposure in both an acute and chronic fashion. Photoactivated rhodopsin releases all‐trans‐RAL, which is subsequently transported by ATP‐binding cassette transporter 4 and reduced to all‐trans‐retinol by all‐trans‐retinol dehydrogenases located in photoreceptor cells. Any interruptions in the clearing of all‐trans‐RAL in the photoreceptors can cause an accumulation of this reactive aldehyde and its toxic condensation products. This accumulation may result in the manifestation of retinal dystrophy including human retinal degenerative diseases such as Stargardt’s disease and age‐related macular degeneration. Herein, we discuss the mechanisms of all‐trans‐RAL clearance in photoreceptor cells by sequential enzymatic reactions, the visual (retinoid) cycle, and potential molecular pathways of retinal photodamage. We also review recent imaging technologies to monitor retinal health status as well as novel therapeutic strategies preventing all‐trans‐RAL‐associated retinal photodamage.
Small Pheochromocytomas: Significance, Diagnosis, and Outcome
Authors: Yu Run , Pitts Allison , Wei Meng 
Published: March 2012

J Clin Hypertens (Greenwich). 2012; 14:307–315. ©2012 Wiley Periodicals, Inc.To address the unique challenges in the diagnosis and management of small pheochromocytomas, the authors performed a retrospective study of 24 patients with small pheochromocytomas (≤3 cm) treated between 1995 and 2011, using 51 patients with larger pheochromocytomas (>3 cm) as controls. Patient demographics were similar between the two groups. Small pheochromocytomas presented mainly as adrenal mass and hypertension and their major complication was hypertensive crisis during unrelated procedures in 4 patients (17%). Hypertension was improved in a quarter of the patients after pheochromocytoma resection. The biochemical marker levels in patients with small pheochromocytomas were generally lower than those with larger tumors and half of the patients exhibited modestly elevated or normal levels. The authors conclude that small pheochromocytomas are frequent and may not contribute to baseline hypertension, but can cause hypertensive crisis during unrelated medical procedures. Small pheochromocytomas should be removed to prevent hypertensive crisis and future complications of pheochromocytoma.
Reducing Clinical Inertia in Hypertension Treatment: A Pragmatic Randomized Controlled Trial
Authors: Huebschmann Amy G. , Mizrahi Trina , Soenksen Alyssa , Beaty Brenda L. , Denberg Thomas D. 
Published: March 2012

J Clin Hypertens (Greenwich). 2012; 14:322–329. ©2012 Wiley Periodicals, Inc.Clinical inertia is a major contributor to poor blood pressure (BP) control. The authors tested the effectiveness of an intervention targeting physician, patient, and office system factors with regard to outcomes of clinical inertia and BP control. A total of 591 adult primary care patients with elevated BP (mean systolic BP ≥140 mm Hg or mean diastolic BP ≥90 mm Hg) were randomized to intervention or usual care. An outreach coordinator raised patient and provider awareness of unmet BP goals, arranged BP‐focused primary care clinic visits, and furnished providers with treatment decision support. The intervention reduced clinical inertia (−29% vs −11%, P=.001). Nonetheless, change in BP did not differ between intervention and usual care (−10.1/−4.1 mm Hg vs −9.1/−4.5 mm Hg, P=.50 and 0.71 for systolic and diastolic BP, respectively). Future primary care–focused interventions might benefit from the use of specific medication titration protocols, treatment adherence support, and more sustained patient follow‐up visits.
Hypertension Control Among Newly Treated Patients Before and After Publication of the Main ALLHAT Results and JNC 7 Guidelines
Authors: Krousel‐Wood Marie , Muntner Paul , Carson April , Anderson Amanda H. , Delaune Erin , Cushman William C. , Cutler Jeffrey A. , Piller Linda B. , Goforth Gary A. , Whelton Paul K. 
Published: March 2012

J Clin Hypertens (Greenwich). 2012; 14:277–283. ©2012 Wiley Periodicals, Inc.Medication prescribing practice changed following the publications of the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) in 2002 and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) in 2003. Few data are available on changes in hypertension control rates for patients initiating antihypertensive treatment before and after these publications. The authors compared systolic and diastolic blood pressure (SBP and DBP) levels and hypertension control (SBP <140 mm Hg and DBP <90 mm Hg) rates in patients initiating antihypertensive treatment in a large managed care organization during 2 time periods: July 1, 2001, to June 30, 2002 (n=322); and July 1, 2003, to June 30, 2004 (n=323). The blood pressure reduction associated with antihypertensive medication initiation was similar in 2001–2002 and 2003–2004 (−11.9 and −10.5 mm Hg, respectively, P=.251 for SBP; −6.9 and −5.9 mm Hg, respectively, P=.160 for DBP). The mean SBP and DBP prior to treatment were significantly lower in 2003–2004 vs 2001–2002 (145.4 vs 151.3 mm Hg, P<.001 for SBP; 87.6 vs 90.1 mm Hg, P<.002 for DBP). Hypertension control rates increased from 38.0% to 50.2% (P=.005) from 2001–2002 to 2003–2004. Lower pretreatment SBP and DBP explained hypertension control improvement over time. In this real‐world clinic population, antihypertensive treatment was initiated at lower blood pressure levels following publication of ALLHAT and JNC 7, resulting in substantial improvements in hypertension control rates.
Impact of scanning density on spectral domain optical coherence tomography assessments in neovascular age‐related macular degeneration
Authors: Barañano Anne E. , Keane Pearse A. , Ruiz‐Garcia Humberto , Walsh Alexander C. , Sadda Srinivas R. 
Published: March 2012

Abstract.Purpose:  To determine the effect of optical coherence tomography (OCT) B‐scan density on the qualitative assessment of neovascular age‐related macular degeneration (AMD).Methods:  Data were collected from 59 patients imaged with Topcon 3D OCT‐1000 (128 B‐scans × 512 A‐scans). Custom software was used to generate less dense subsets of scans: 1/16 (eight B‐scans), 1/8 (16 B‐scans), 1/4 (32 B‐scans) and 1/2 (64 B‐scans). At each B‐scan density, scans were assessed for cystoid spaces, subretinal fluid (SRF), subretinal tissue (SRT) and pigment epithelium detachment (PED). For each sampling density, sensitivity, specificity and predictive values were calculated using the full volume scan (128 B‐scans) as the reference standard.Results:  For cystoid spaces, the detection sensitivity was 76.3% at 1/16 density; this rose to 89.5% with a 1/4 density. For SRF, the detection sensitivity was 75.0% at a 1/16 density; this increased to 91.1% with 1/4 density. For PED, even at the lowest sampling density (1/16) the detection sensitivity was 86.4%; this rose to 94.9% at 1/4 density. For SRT, detection sensitivity at a 1/16 density was 64.7% and only rose above 90% with the densest sampling subset (1/2).Conclusions:  Use of scanning protocols with reduced sampling densities resulted in decreased detection of key features of neovascular AMD; despite this, a sampling density reduced to 1/4 appeared to allow accurate assessment for most features. Current management of neovascular AMD is dependent on qualitative assessment of OCT images; with the recent proliferation of OCT systems, optimization and standardization of scanning protocols may be of value.
Microsatellite instability and loss of fragile histidine triad in gallbladder carcinoma
Authors: Kumari Niraj , Kapoor Vinay K. , Krishnani Narendra , Kumar Kamlesh , Kumar Baitha Dinesh , Behari Anu 
Published: March 2012

ABSTRACTBackground and aim: Microsatellite instability and fragile histidine triad (FHIT) loss have been seen to be involved in gallbladder carcinogenesis. We studied expression loss of mismatch repair (MMR) proteins and loss of FHIT expression in gallbladder cancer by immunohistochemistry using antibodies against MLH1, MSH2 and MSH6 proteins. Methods: One hundred and two consecutive cases of gallbladder cancer were retrospectively collected and expression of MLH1, MSH2 and MSH6 and FHIT protein was studied. The expression pattern was correlated with various clinicopathologic parameters and survival. Results: Expression loss of MMR proteins was found in 52.9% and loss of FHIT expression was found in 45% cases of gallbladder cancer. Loss of FHIT expression was seen in 12% of dysplasia associated with carcinoma. Expression loss of MMR proteins was found in 16% of dysplasia associated with chronic cholecystitis and 32.6% of dysplasia associated with carcinoma. Expression loss of MMR proteins had significant positive correlation with tumor stage and had worse survival compared with patients with intact expression. Loss of FHIT expression was significantly correlated with both tumor grade and stage. Conclusions: Frequency of expression loss of MMR proteins and loss of FHIT expression increased from dysplasia to carcinoma suggesting that both these abnormalities have a role in pathogenesis and occur at an early stage in carcinogenesis of gallbladder. Fifty three percent of gallbladder cancer with expression loss of MMR proteins also showed loss of FHIT expression and were frequent in advanced stage disease suggesting that reduced FHIT expression may be correlated with expression loss of MMR proteins on immunohistochemistry.
Clinical Significance as It Relates to Evidence‐Based Practice
Authors: Bruner Susan , Corbett Cynthia , Gates Brian , Dupler Alice 
Published: March 2012

PURPOSE.  This paper analyzes the concept of clinical significance (CS) in relation to evidence‐based practice (EBP). The purpose is to show that CS terminology is inconsistent in the nursing literature. It is argued that nursing outcomes and interventions that include findings of CS are difficult to interpret due to lack of an operational definition. It is further argued that the absence of a consistent operational definition is incompatible with EBPs which require standardization of terminology.DATA SOURCES.  The current literature and research studies, particularly from the electronic databases Cumulative Index to Nursing and Allied Health Literature, ISI Web of Knowledge, PubMed, and Cochrane Database of Systematic Reviews.DATA SYNTHESIS.  The disparate uses of CS negatively impact standardizing and quantifying research outcomes to discern EBPs. The authors propose a definition of CS inclusive of the multifarious uses that were revealed in the literature, and conclude that there is a need for professional nursing consensus to define the term. A standard operational definition of CS would enable consistency as clinicians interpret research findings and facilitate translating research to practice.CONCLUSIONS.  Given the centrality of CS to interpreting research findings and applying them to practice, there is a need to solidify the terminology of and measurements for CS in nursing. National nursing agencies, including The National Institute for Nursing Research and Sigma Theta Tau International, should make standardizing CS a high priority for targeted funding. One method of doing so would be to support a consensus convergence to review and select the optimal measures of CS for nursing research. Research to increase knowledge about what constitutes measurement and change, or CS from the patient perspective is needed. Editors and peer reviewers should encourage authors to include a discussion of CS. Discussions of CS should receive greater emphasis in research journals. It is hoped that the preliminary findings from the concept analysis presented in this article will facilitate the work of such a consensus forum.IMPLICATIONS FOR NURSING PRACTICE.  The most immediate and tangible advantages to a common conceptual definition and meaning of CS terminologies by nursing, regardless of which definition is selected, are less confusion and more clarity. Ultimately, the most enduring benefit of a common conceptual definition and measurement for CS is the bridge it provides between research and practice, and the facility with which it promotes the integration of research into EBP.
Branded food references in children's magazines: ‘advertisements’ are the tip of the iceberg
Authors: Jones S. C. , Gregory P. , Kervin L. 
Published: March 2012

SummaryObjectiveWhile children's magazines ‘blur the lines’ between editorial content and advertising, this medium has escaped the calls for government restrictions that are currently associated with food advertisements aired during children's television programming. The aim of this study was to address significant gaps in the evidence base in relation to commercial food messages in children's magazines by systematically investigating the nature and extent of food advertising and promotions over a 12‐month period.MethodAll issues of Australian children's magazines published in the calendar year 2009 were examined for references to foods or beverages.ResultsApproximately 16% of the 1678 food references identified were portrayals of branded food products (or food brands). However, only 83 of these 269 were clearly identified as advertisements. Of these 269 branded food references, 86% were for non‐core (broadly, less healthy) foods, including all but seven of the advertisements.ConclusionsIt appears that recent reductions in televised promotions for non‐core foods, and industry initiatives to reduce the targeting of children, have not carried through to magazine advertising. This study adds to the evidence base that the marketing of unhealthy food to children is widespread, and often covert, and supports public health calls for the strengthening of advertising regulation.
Frequency split metal artifact reduction (FSMAR) in computed tomography
Authors: Meyer Esther , Raupach Rainer , Lell Michael , Schmidt Bernhard , Kachelrieß Marc 
Published: March 2012

Purpose: The problem of metal artifact reduction (MAR) is almost as old as the clinical use of computed tomography itself. When metal implants are present in the field of measurement, severe artifacts degrade the image quality and the diagnostic value of CT images. Up to now, no generally accepted solution to this issue has been found. In this work, a method based on a new MAR concept is presented: frequency split metal artifact reduction (FSMAR). It ensures efficient reduction of metal artifacts at high image quality with enhanced preservation of details close to metal implants.Methods: FSMAR combines a raw data inpainting‐based MAR method with an image‐based frequency split approach. Many typical methods for metal artifact reduction are inpainting‐based MAR methods and simply replace unreliable parts of the projection data, for example, by linear interpolation. Frequency split approaches were used in CT, for example, by combining two reconstruction methods in order to reduce cone‐beam artifacts. FSMAR combines the high frequencies of an uncorrected image, where all available data were used for the reconstruction with the more reliable low frequencies of an image which was corrected with an inpainting‐based MAR method. The algorithm is tested in combination with normalized metal artifact reduction (NMAR) and with a standard inpainting‐based MAR approach. NMAR is a more sophisticated inpainting‐based MAR method, which introduces less new artifacts which may result from interpolation errors. A quantitative evaluation was performed using the examples of a simulation of the XCAT phantom and a scan of a spine phantom. Further evaluation includes patients with different types of metal implants: hip prostheses, dental fillings, neurocoil, and spine fixation, which were scanned with a modern clinical dual source CT scanner.Results: FSMAR ensures sharp edges and a preservation of anatomical details which is in many cases better than after applying an inpainting‐based MAR method only. In contrast to other MAR methods, FSMAR yields images without the usual blurring close to implants.Conclusions: FSMAR should be used together with NMAR, a combination which ensures an accurate correction of both high and low frequencies. The algorithm is computationally inexpensive compared to iterative methods and methods with complex inpainting schemes. No parameters were chosen manually; it is ready for an application in clinical routine.
Characteristics of optically stimulated luminescence dosimeters in the spread‐out Bragg peak region of clinical proton beams
Authors: Kerns James R. , Kry Stephen F. , Sahoo Narayan 
Published: March 2012

Purpose:Optically stimulated luminescent detectors (OSLDs) have a number of advantages in radiation dosimetry making them excellent dosimeters for quality assurance and patient dose verification. Although the dosimeters have been investigated in several modalities, relatively little work has been done in examining the dosimeters for use in clinical proton beams. This study examined a number of characteristics of the response of the dosimeters in the spread‐out Bragg peak (SOBP) region of clinical proton beams.Methods:Optically stimulated luminescence (OSL) dosimeters from Landauer, Inc., specifically the nanoDot dosimeter, were investigated. These dosimeters were placed in a special phantom with a recess to fit the dosimeters without an air gap. Beams with nominal energies of 160, 200, and 250 MeV were used in the passively‐scattered proton beam at the MD Anderson Cancer Center Proton Therapy Center. Dosimetric properties including linearity, field size dependence, energy dependence, residual signal as a function of cumulative dose, and postirradiation fading were investigated by taking measurements at the center of SOBPs.Results:The dosimeters showed 1% supralinearity at 200 cGy and 5% supralinearity at 1000 cGy. No noticeable field size dependence of the detector was found for field sizes from 2 × 2 cm2 to 18 × 18 cm2. Residual signal as a function of cumulative dose showed a small increase for measurements up to 1000 cGy. Readout signal depletion of the dosimeters after consecutive readings showed a slightly larger depletion in protons for doses up to 500 cGy but not by a clinically significant amount. Within the center of various SOBP widths and proton energies the variation in response was less than 2%. An average beam quality factor of 1.089 with experimental standard deviation of 0.007 was determined and applied to the data such that the results were within 1.2% of ion chamber data.Conclusions:The nanoDot OSL dosimeter characteristics were studied in the SOBP region of clinical proton beams. To achieve accurate dosimetric readings, corrections to the dosimeter response were applied. Corrections tended to be minimal or broadly consistent. The nanoDot OSLD was found to be an acceptable dosimeter for measurement in the SOBP region for a range of clinical proton beams.