bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Bile Duct Carcinoma with Superficial Extension in the Epithelium
Authors: Nanashima Atsushi , Sumida Yorihisa , Tobinaga Syuuichi , Abo Takafumi , Takeshita Hiroaki , Sawai Terumitsu , Hidaka Shigekazu , Fukuoka Hidetoshi , Nagayasu Takeshi 
Published: April 2009

AbstractBackgroundLongitudinal tumor extension from the main tumor involves intramural or superficial spread along the bile duct, which influences surgical curability. Identifying the range of superficial extension is difficult by preoperative imaging. To clarify specific characteristics of bile duct carcinoma (BDC) with superficial extension of epithelium in the bile duct, we examined clinicopathologic features and patient outcomes in BDC patients with or without superficial extension who underwent surgical resection.MethodsBetween 1994 and 2008, we retrospectively examined clinicopathologic findings and outcomes for 42 BDC patients who underwent surgical resection and divided them into two groups: (1) superficial extension (SE) group (n = 10); and (2) non‐SE group (n = 32).ResultsIn terms of macroscopic growth of the main tumor, the papillary type was more common in the SE group than in the non‐SE group, whereas the nodular type was dominant in the non‐SE group. The prevalence of cancer‐positive findings at the cut end of the bile duct was higher in the SE group. Portal vein invasion was not observed in the SE group, and the prevalence of regional lymph node metastasis was significantly greater in the non‐SE group than in the SE group. No patients died of cancer in the SE group, who tended to show better survival than the non‐SE group.ConclusionsThe present results suggest that a good prognosis may be achieved in BDC patients with SE when complete resection is accomplished.
Episiotomy and perineal repair practices among obstetricians in Greece
Authors: Grigoriadis Themos , Athanasiou Stavros , Zisou Antonia , Antsaklis Aris 
Published: April 2009

AbstractObjectiveTo assess current preferences regarding episiotomy and management of obstetric perineal injuries used by obstetricians in Greece, and to assess the impact of evidence‐based information on everyday practices.MethodsA questionnaire survey of obstetricians regarding episiotomy use and the management of obstetric perineal injuries.ResultsFifty‐one percent of obstetricians reported routinely performing an episiotomy during a normal vaginal delivery in primiparous women and 89% reported performing an episiotomy during vacuum‐assisted deliveries. Forty‐two percent of the respondents performed lateral, 44% mediolateral, and 14% midline episiotomies. Following an obstetric anal sphincter tear, half of the respondents recommended a vaginal delivery, regardless of bowel symptoms. There was significant heterogeneity of practices regarding the repair techniques of all obstetric perineal injuries.ConclusionThe majority of obstetricians prefer to perform routine mediolateral and lateral episiotomies, for both normal and operative vaginal deliveries. The adoption of evidence‐based information should be implemented while considering working and cultural backgrounds.
Clinical Survey: Patterns of Utilization of Lumbar Epidural Steroid Injections by a Cohort of Spinal Surgeons
Authors: Lebude Bryan , Wang Dajie , Harrop James S. , Maltenfort Mitchel , Anderson D. Greg , Vaccaro Alexander R. , Ratliff John K. 
Published: April 2009

ObjectiveThere are few data on responses to conservative therapy in the management of lumbar degenerative diseases. To understand the use of epidural steroid injections (ESIs) by spine surgeons in the treatment of 2 distinct lumbar spinal conditions—herniated nucleus pulposus (HNP) and degenerative disk disease (DDD)—a survey of orthopedic and neurosurgical spine surgeons was conducted.DesignParticipants were surveyed via posting of a survey on a commercially maintained Web site. Respondents were queried on individual preferences regarding epidural steroid injections for HNP and DDD.SettingN/A.ParticipantsThe survey was completed by 61 surgeons; not all surgeons completed the entire survey. There was equal representation between orthopedic and neurosurgical spine surgeons; most surgeons reported being in practice for greater than 10 years (41%) and most surgeons reported completing between either 50 and 100 or 100 and 200 spine surgeries each year (26% and 31%).Main Outcome MeasuresResults were tabulated and assessed for variance. Both individual responses to the different ESI treatment protocols offered and difference in use of lumbar epidural steroids between diagnoses were analyzed.ResultsIn treatment of lumbar HNP, the majority of respondents considered ESIs after 6 weeks of noninterventional care (69%). In lumbar DDD, there was no consensus as to overall use, timing, number of ESIs constituting a treatment regimen, number of treatment cycles recommended, and length of treatment before considering other intervention. In comparing treatment of lumbar HNP or DDD, there was no agreement with regard to timing of ESIs, with regard to duration of treatment, nor with regard to number of injections comprising a treatment regimen (κ = ‐0.01, 0.03, and ‐0.02, respectively).ConclusionNo consensus was found as to timing, frequency, and duration of ESI treatment in lumbar HNP and DDD patients in a survey of practicing spine surgeons. These results illustrate one example of lack of consensus in conservative treatment protocols.
Effectiveness of Levetiracetam in the Treatment of Lumbar Radiculopathy: An Open‐Label Prospective Cohort Study
Authors: Hamza Maged S. , Anderson David Greg , Snyder John W. , Deschner Steven , Cifu David X. 
Published: April 2009

ObjectiveThe purpose of this open‐label study was to assess the effectiveness and tolerability of levetiracetam (LEV) in the treatment of patients with lower lumbar radiculopathy diagnosed by clinical presentation, physical examination, and electrodiagnostics.DesignOpen‐label, forced titration, prospective cohort intent‐to‐treat analysis.SettingMajor teaching hospital.PatientsParticipants were recruited from the university pain clinic and through referrals from the community. Subjects were eligible to participate if they (1) were older than 18 years, (2) had leg pain greater than back pain, (3) had been symptomatic for 6 months and <5 years, (3) had a baseline visual analog scale of at least 6 on the 0‐10 scale, (4) had undergone lumbar spine magnetic resonance imaging within the last 12 months that showed no surgically correctable etiology for their radicular symptoms, and (5) had undergone electrodiagnostics that was positive for lumbar radiculopathy (L4, L5, or S1 nerve roots). Twenty‐six patients were enrolled, and 24 (92.3%) completed the study.InterventionsPatients initially received LEV 500 mg twice a day for 2 weeks. Dosages were then increased to 750 mg twice day for 2 weeks, and then to 1500 mg twice a day for the remainder of the study. Patients were observed for 8 weeks after reaching the maximum dose.Main Outcome MeasurementsTreatment effectiveness was assessed with the use of biweekly brief pain inventory and patient global assessment scales. Frequency and severity of adverse events were recorded.ResultsThe mean biweekly worst and average pain scores decreased from 7.17 and 6.27 at baseline to 4.2 and 3.9, respectively, at week 12 (P ≤ .001). Improvements were reported in general activity, ability to walk, mood, and relationship with people. Side effects consisted of sedation/drowsiness (46%), gastrointestinal upset (23%), headache (19%), blurred vision (15%), weakness/fatigue (11%), and dyscoordination (11%).ConclusionsThis study showed that LEV might be a well‐tolerated and effective treatment for lumbar radiculopathy. A large randomized placebo‐controlled trial is recommended and comparative studies with alternative agents should be sought.
Review of Anatomy, Evaluation, and Treatment of Musculoskeletal Pelvic Floor Pain in Women
Authors: Prather Heidi , Dugan Sheila , Fitzgerald Colleen , Hunt Devyani 
Published: April 2009

ObjectiveThe purpose of this review is 2‐fold. The first is to provide a review for physiatrists already providing care for women with musculoskeletal pelvic floor pain and a resource for physiatrists who are interested in expanding their practice to include this patient population. The second is to describe how musculoskeletal dysfunctions involving the pelvic floor can be approached by the physiatrist using the same principles used to evaluate and treat others dysfunctions in the musculoskeletal system. This discussion clarifies that evaluation and treatment of pelvic floor pain of musculoskeletal origin is within the scope of practice for physiatrists. The authors review the anatomy of the pelvic floor, including the bony pelvis and joints, muscle and fascia, and the peripheral and autonomic nervous systems. Pertinent history and physical examination findings are described. The review concludes with a discussion of differential diagnosis and treatment of musculoskeletal pelvic floor pain in women. Improved recognition of pelvic floor dysfunction by healthcare providers will reduce impairment and disability for women with pelvic floor pain. A physiatrist is in the unique position to treat the musculoskeletal causes of this condition because it requires an expert grasp of anatomy, function, and the linked relationship between the spine and pelvis. Further research regarding musculoskeletal causes and treatment of pelvic floor pain will help validate these concepts and improve awareness and care for women limited by this condition.
Intra‐articular Pressure Profiles of Painful Stiff Shoulders Compared With Those of Other Conditions
Authors: Chung Sun G. , Lee Kyu Jin , Kim Hee Chan , Seo Kwan Sik , Lee Yong‐Taek 
Published: April 2009

ObjectiveTo test two questions raised by a previous study: whether high and steeply rising intra‐articular (IA) pressure achieved by controlled fluid infusion would be specific to the painful stiff shoulder (PSS) and whether rupture occurs immediately after the appearance of the third phase so that it could be considered as a preruptural sign.DesignCase series.SettingUniversity Outpatient Clinic of Physical Medicine and Rehabilitation.ParticipantsFourteen PSS patients who had limited range of motion of the shoulder in at least 2 directions for more than a month were participants, and 6 shoulders of 5 people with other conditions including 2 healthy shoulders served as controls.Intervention and Main Outcome MeasuresReal‐time pressure monitoring was done with fluid infusion in a constant‐volume rate. For PSS patients, fluid was infused until rupture occurred. More than 25 mL of fluid was instilled in the shoulders of the control group. The pressure‐volume (P‐V) profiles, number of phases, maximal volume (Vmax) and pressure (Pv_max) at Vmax, stiffness of the capsule (Kph2), and the fluid volume (Vph3) infused from the appearance of the triphasic curve to the rupture were evaluated.ResultsAmong the 14 PSS patients, 12 demonstrated steeply increasing pressure (8 triphasic, 4 biphasic), but 2 showed flat and low‐pressure profiles. In contrast, the entire control group revealed flat pressure profiles. The PSS subjects showed far higher Pv_max at lower Vmax than the control subjects. The Kph2 was significantly higher in the PSS group. The Vph3 was 5.03 ± 3.18 mL ranging from 2.33 to 10.99 mL.ConclusionsThe steeply rising, high IA pressure can be considered as a predominant characteristic of the PSS compared with other conditions that showed flat, low‐pressure profiles, suggesting the P‐V profiles might be used in evaluation of the capsular tightness of various shoulder problems. The triphasic curve appears to be a preruptural sign; however, there are several practical limitations to terminating hydraulic distension before rupture occurs.
Design and Implementation of a Home‐Based Exercise Program Post‐Hip Fracture: The Baltimore Hip Studies Experience
Authors: Yu‐Yahiro Janet A. , Resnick Barbara , Orwig Denise , Hicks Gregory , Magaziner Jay 
Published: April 2009

ObjectiveThe objectives are to describe for the first time a home‐based exercise intervention for frail elderly hip fracture patients and to describe the feasibility of this exercise program.DesignA home‐based exercise program was used in a randomized controlled trial in which the authors investigated exercise intervention versus no exercise intervention in patients after hip fracture.SettingThis program was implemented at the patients' own home or place of residence after discharge.ParticipantsWomen 65 years of age or older were recruited within 15 days of hip fracture. Eligible patients were those with a nonpathologic fracture who were admitted within 72 hours of injury, had surgical repair of the hip fracture, and met medical inclusion criteria. Participants initially were randomized to exercise groups and then assigned to exercise trainers.InterventionThe exercise contained strength training and aerobic components. Participants were expected to exercise 5 days per week by performing a combination of supervised and independently performed exercise sessions. Intensity and duration were increased gradually by trainers in a standardized way. The frequency of the supervised sessions decreased as participants became more independent. Treatment fidelity visits ensured that the intervention was being delivered as intended across trainers and across participants.Main Outcome MeasurementThis work describes the feasibility and challenges of administering an intensive home‐based exercise program in this population of older adults.ResultsOf those patients randomized to exercise, 82% were followed by a trainer and almost all advanced to higher levels in both aerobic and strength programs. Overall, participants received an average of 44 (78.5%) of the prescribed visits by the trainer.ConclusionsThis study showed that it was possible to engage a frail older population of post‐hip fracture patients in a program of aerobic and strength training exercise with a high rate of participation.
Pure ovarian choriocarinoma mimicking ectopic pregnancy in true hermaphroditism
Authors: WANG DANQING , HU YAYI , HE YING , XIE CONG , YIN RUTIE 
Published: April 2009

AbstractOvarian choriocarinoma is a rare tumor and has not been described before in a true hermaphrodite condition. A 23‐year‐old karyotype 46XX parous female was admitted to hospital because of amenorrhea, irregular vaginal bleeding, an adnexal mass, and an increased β‐hCG serum level. Ectopic pregnancy was suspected three times and exploratory laparoscopy done each time removing the right ovarian mass and local pelvic and omental spread. Final pathology revealed a true hermaphrodite state with testicular tissue with distinct tubules, ovarian tissue with follicles, and ovarian choriocarinoma with necrosis and hemorrhage. She received chemotherapy followed by radical pelvic surgery.
Improved confinement with internal electron transport barriers in RFX-mod
Authors: Carraro L. , Alfier A. , Bonomo F. , Fassina A. , Gobbin M. , Lorenzini R. , Piovesan P. , Puiatti M.E. , Spizzo G. , Terranova D. , Valisa M. , Zuin M. , Canton A. , Franz P. , Innocente P. , Pasqualotto R. , Auriemma F. , Cappello S. , Guo S.C. , Marrelli L. , Martines E. , Spolaore M. , Zanotto L. 
Published: April 2009

RFX-mod reliably operates at 1.5 MA, the highest current ever achieved on a reversed field pinch device thanks to the the feedback control on multiple magnetohydrodynamic modes.
In these high current discharges magnetic topology spontaneously self-organizes in an Ohmic helical symmetry, the quasi single helicity (QSH) state, in which the magnetic dynamics is dominated by the innermost resonant mode, with the new magnetic axis helically twisting around the geometrical axis of the torus.
Inside the helical structure energy confinement is enhanced and electron temperatures exceeding 1 keV are measured, with steep gradients, which identify an internal transport barrier. Separatrix expulsion and symmetric electron temperature profiles with high gradients are obtained for ratios between the dominant mode and total B above about 4%. The measured electron temperature peak involves a large fraction of the plasma cross section, corresponding to an improvement in the global electron energy confinement up to a factor 2. The steep temperature profiles obtained in QSH conditions correspond to an electron thermal diffusivity reduced by more than one order of magnitude.
Perturbative experiments (pellets and impurity laser blow off injections) have been performed to study particle confinement inside and outside the thermal island. Inside the helical structure experimental evidence of main gas confinement increase has been obtained, while for impurities there is no evidence of confinement increase.
A graphical algorithm for fast computation of identity coefficients and generalized kinship coefficients
Authors: Abney Mark 
Published: April 2009

Abstract
Summary: Computing the probability of identity by descent sharing among n genes given only the pedigree of those genes is a computationally challenging problem, if n or the pedigree size is large. Here, I present a novel graphical algorithm for efficiently computing all generalized kinship coefficients for n genes. The graphical description transforms the problem from doing many recursion on the pedigree to doing a single traversal of a structure referred to as the kinship graph.
Availability: The algorithm is implemented for n = 4 in the software package IdCoefs at http://home.uchicago.edu/abney/Software.html.
Contact: abney@bsd.uchicago.edu
Supplementary Information: Supplementary data are available at Bioinformatics online.
Adiponectin is increased in cardiac cachexia irrespective of body mass index
Authors: Paulo Araújo José , Lourenço Patrícia , Rocha‐Gonçalves Francisco , Ferreira António , Bettencourt Paulo 
Published: April 2009

AimsCardiac cachexia (CC) is a complication of chronic heart failure (CHF). Little is known about the mechanisms leading to CC. Adiponectin, leptin, and ghrelin are important regulators of energy metabolism and body weight. Previous studies of CHF and CC had great differences in body mass index (BMI) between cachectic and non‐cachectic patients. To assess serum adiponectin, leptin, and ghrelin concentrations in cachectic and non‐cachectic patients.Methods and resultsWe conducted a case–control study in CHF patients matched for BMI. Cases (n = 33) were cachectic patients with unintentional weight loss of ≥7.5% of the previous baseline weight. Controls (n = 33) had no history of weight loss and were individually matched with cases for age, sex, and BMI. Cachectic patients had significantly higher adiponectin levels than controls: 25.0 ± 12.3 vs. 14.7 ± 8.8 µg/mL (P = 0.002). Leptin concentration was lower in the cachectic group: 7.5 (IQR 4.0–10.8) vs. 8.0 (IQR 7.1–10.5) ng/mL. Differences in leptin lost significance once adjusted for fat mass. Adiponectin remained higher in cachectics after such adjustment. Ghrelin was not significantly different between groups. Adiponectin correlated positively with weight loss and BNP.ConclusionCachexia in CHF was associated with an increase in adiponectin, irrespective of BMI. This suggests a role of adiponectin in the wasting process of cachectic patients.
The impact of a self‐management group programme on health behaviour and healthcare utilization among congestive heart failure patients
Authors: Smeulders Esther S.T.F. , van Haastregt Jolanda C.M. , Ambergen Ton , Janssen‐Boyne Josiane J.J. , van Eijk Jacques Th.M. , Kempen Gertrudis I.J.M. 
Published: April 2009

AimsThe ‘Chronic Disease Self‐Management Programme’ (CDSMP) emphasizes patients’ responsibility for the day‐to‐day management of their condition(s) and has shown favourable effects on health behaviour and healthcare utilization among various groups of patients with chronic conditions. However, the effects of the CDSMP among congestive heart failure (CHF) patients are unknown. We therefore aimed to assess the effects of the CDSMP on health behaviour and healthcare utilization in patients with CHF.Methods and resultsThis randomized, controlled trial with 12 months of follow‐up included 317 CHF patients with a slight to marked limitation of physical activity. Control patients (n = 131) received usual care, consisting of regular checkups at an outpatient clinic. Intervention group patients (n = 186) received usual care and participated in a 6‐week self‐management group programme. Favourable effects on walking for exercise and other physical activities such as aerobic, stretching, and strength exercises, sports, and gardening were reported in the intervention group immediately after completion of the programme. The effect of the programme on other physical activities extended to 6 months of follow‐up. No favourable effects were found for the other outcomes.ConclusionThe CDSMP significantly improved physical activity among CHF patients for up to 6 months after the end of the programme; however, it did not affect other health behaviour outcomes or healthcare utilization.
Upregulated expression of cardiac ankyrin repeat protein in human failing hearts due to arrhythmogenic right ventricular cardiomyopathy
Authors: Wei Ying‐Jie , Cui Chuan‐Jue , Huang Yin‐Xia , Zhang Xiao‐Lling , Zhang Hao , Hu Sheng‐Shou 
Published: April 2009

AimsExpression of cardiac ankyrin repeat protein (CARP) is augmented in heart failure due to dilated or ischaemic cardiomyopathy. It is unclear whether CARP is upregulated in heart failure due to arrhythmogenic right ventricular cardiomyopathy (ARVC). In the present study, we investigated the expression pattern of CARP and the correlation between CARP and the well‐known heart failure marker pro‐atrial natriuretic peptide (proANP) in ARVC failing hearts.Methods and resultsGene microarray analysis demonstrated increased CARP expression in ARVC failing hearts compared with non‐failing control hearts, which was further validated by real‐time RT–PCR, western blot, and ELISA at the mRNA and protein levels. Fractionation experiments revealed that the upregulation of CARP expression is restricted to the nuclei of residual cardiac cells in ARVC failing hearts. Regression analysis showed a positive correlation between CARP and proANP in ARVC failing hearts.ConclusionAugmented CARP expression may be a common molecular event in failing hearts regardless of cardiomyopathic aetiology. The upregulation of nuclear CARP expression and positive correlation between cardiac CARP and proANP suggests that CARP may be used as a genetic marker existing in the nuclei in contrast to proANP existing in the cytosol of cardiac cells in heart failure patients.
The use of an adaptive acoustic-survey design to estimate the abundance of highly skewed fish populations
Authors: Harbitz Alf , Ona Egil , Pennington Michael 
Published: April 2009

Abstract
Harbitz, A., Ona, E., and Pennington, M. 2009. The use of an adaptive acoustic-survey design to estimate the abundance of highly skewed fish populations. – ICES Journal of Marine Science, 66: 1349–1354. The uncertainty (relative root-mean-square error) of abundance estimates based on a simple and easily implemented adaptive design for an acoustic survey is examined. The study is limited to surveys with parallel transects and independent observations with extremely skewed distributions. The adaptive approach defines a stratum for each conventional observation and how to take additional observations in that stratum when the acoustic density exceeds a predetermined threshold. The cost (sailing distance) of each added observation is about three times that of a conventional observation. This method was demonstrated using high-resolution transect data from a herring (Clupea harengus) acoustic survey conducted in 2006 off the north coast of Norway. The primary sampling unit for this winter survey was 5 nautical miles, and the usual distance between transects was 20 nautical miles. The results indicate that an adaptive survey design would substantially reduce the root-mean-square error of the abundance estimates compared with that of the conventional survey design.