bluuebunny/crossref_metadata_2025_split huggingface dataset:
A beam model for three-dimensional radiotherapy planning
Authors: Redpath A T 
Published: July 2009

Abstract
A comprehensive beam model for three-dimensional radiotherapy planning is described. Input of patient data is either from an arbitrary spaced set of computed tomography (CT) scans throughout the treatment volume or from outlines traced on a digitizer. Any gantry, head or table rotation is allowed as well as any beam portal shape including internal blocking. Account is taken of beam modification due to the presence of the beam flattening filter, wedges and compensators. Both portal image and beam's eye view displays are readily available. A dose calculation algorithm is presented which uses a differential scatter-air ratio method to calculate the scatter dose in the presence of inhomogeneities. The beam model and algorithm form the basis of an interactive three-dimensional planning system running on a UNIX workstation, and performance times for dose calculation are given.
Ultrasound of the Achilles tendon after surgical repair: morphology and function
Authors: Maffulli N 
Published: July 2009

I read with interest the paper by Rupp et al [1]. I have, however, some concerns about their findings and conclusions.
End-to-end suturing was performed in only four of the operations, while the rest of the patients were treated by a variety of methods. The use of plantaris tendon grafts and of gastrocnemius flaps, alone or in combination, suggests to me that these patients were treated significantly later than the immediate post-injury phase. I have personally repaired 106 Achilles tendon ruptures, and was always able to suture the tendon stumps in an end-to-end fashion in all patients who were operated on within 72 h of the injury.
Display of cross sectional anatomy by nuclear magnetic resonance imaging
Authors: Hinshaw W. S. , Andrew E. R. , Bottomley P. A. , Holland G. N. , Moore W. S. , Worthington B. S. 
Published: July 2009

Abstract
High definition cross-sectional images produced by a new nuclear magnetic resonance (NMR) technique are shown. The images are a series of thin section scans in the coronal plane of the head of a rabbit. The NMR images are derived from the distribution of the density of mobile hydrogen atoms. Various tissue types can be distinguished and a clear registration of gross anatomy is demonstrated. No known hazards are associated with the technique.
Field strength dependence of MRI contrast enhancement: phantom measurements and application to dynamic breast imaging
Authors: Hittmair K , Turetschek K , Gomiscek G , Stiglbauer R , Schurawitzki H 
Published: July 2009

Abstract
Differences in MRI-measured contrast enhancement have been used for tissue characterization, particularly for the characterization of mammary tumours. T 1 weighted spoiled gradient echo sequences have usually been acquired for this purpose and relative signal intensity increase (S rel) has been determined to quantify contrast uptake. The field strength dependence of this technique is evaluated in this paper by phantom measurements. S rel is compared with the recently introduced “enhancement factor” (EF) and “contrast uptake equivalent” (CE) as a quantitative assessment parameter for contrast uptake. Enhancing tissues were simulated with water phantoms doped with increasing concentrations of Gd-DTPA. Spoiled gradients echo images (FLASH-2D) were obtained on a 0.2 T and 1.5 T MR system. S rel, EF and CE were determined and the results of the phantom measurements were applied to typical types of breast tissues.S rel showed a strong dependence on the magnetic field strength and was greater at higher field strengths. This is because S rel correlates positively with the native T 1 which is longer at higher field strengths. Conversely, the EF and CE almost eliminated the distorting influences of the magnetic field strength. CE provided a good approximation of the actual contrast uptake. In practice, the dependence of S rel on the magnetic field strength might cause malignant lesions to be misclassified as benign at low field strengths. Either S rel criteria should be adjusted to magnetic field strength or EF and CE should be used instead of S rel for tissue characterization with dynamic contrast-enhanced MRI.
The potential for dose reduction in diagnostic radiology using low attenuation materials in table tops
Authors: Sutton D , Cranley K 
Published: July 2009

Abstract
It is important to be able to assign priorities to the purchase of radiological equipment. The ability to incorporate potential dose savings into a ranking procedure involving costs is therefore of interest. In this paper we have considered the question of the dose saving made available by the selection of low attenuation table tops and have described how to generate a factor which can be used in a ranking procedure such as cost effectiveness analysis. We describe how data on the expected dose saving can be obtained from measurements of the aluminium equivalent thickness in air used in conjunction with theoretical spectral data. The magnitude of the overestimate when in air measurements alone are used is presented, as is a ready reckoner for determining the true dose saving when changes in table top are considered. Unless the table to be replaced is of some age, the expected dose saving will vary between 6% and 1%.
The use of sodium ironedetate (Sytron) as an MRI rectal contrast agent
Authors: Buxton P J 
Published: July 2009

Abstract
The use of bowel contrast medium in abdominal and pelvic MRI examinations is increasingly being recognized as a useful adjunct. A contrast agent which produces a negative contrast effect with T 2 weighted (T 2W) sequences might help distinguish bowel pathology, which has increased signal intensity, from bowel content. A solution of 7.6 mg ml−1 of sodium ironedetate (Sytron, Link Pharmaceuticals) produces positive contrast on the first (proton density) echo and negative contrast (signal void) on the second (T 2W) echo of a dual echo sequence at 0.5 T. When administered rectally it provides a negative contrast bowel marker for pelvic examinations.
Pleural encasement secondary to acinar adenocarcinoma of the submandibular gland
Authors: Hynes J , Howell A , Johnson R J 
Published: July 2009

Abstract
We present a case of a 42-year-old male with metastatic pleural encasement of the lung with extension into the mediastinum, resulting from an acinar adenocarcinoma of the submandibular gland diagnosed 30 years previously. The radiographic and CT appearances are presented, with a literature review.
A system for remote monitoring of a hospital linear accelerator
Authors: Jennings C S 
Published: July 2009

Abstract
Linear accelerators are complex machines with many parameters affecting the quality of the treatment beam delivered. A high level of technical support is required but this can be difficult to achieve if the linear accelerator is at a centre distant from a medical physics department. This paper describes a solution to this problem whereby a newly installed linear accelerator at the Royal Shrewsbury Hospital is remotely monitored from the Royal Hospital, Wolverhampton. The system enables run-up procedures to be completed by guiding radiographers at Shrewsbury through a series of steps. It consists of electronic hardware connected to the linear accelerator, under the control of a computer. The machine parameters are read and tested against preset tolerances. The monitoring system has been installed and is in routine use. The benefits have been shown to be: a saving in staff time and travel costs, the satisfactory completion of run-up procedures, a higher level of efficiency in the medical physics service provided and effective quality control. Finally, some future developments are presented. These include the development of a real time remote monitoring system that constantly monitors the linear accelerator, allowing the Medical Physics Department access to the machine parameters at any time.
The significance of low grade right iliac fossa uptake on 99Tcm-HMPAO labelled white cell scans
Authors: Small J H , Wraight E P , Freeman A H , Miles K A 
Published: July 2009

Abstract
Technetium-99m HMPAO labelled white cell scanning is now an accepted method for assessing the activity of inflammatory bowel disease. However, false positive results have been demonstrated. This study was conducted to assess the significance of low grade uptake on 99Tcm-HMPAO labelled white cell scans in the right iliac fossa (RIF) in the context of possible inflammatory bowel disease (IBD). 32 patients over a period of 1 year had low grade RIF uptake as the predominant abnormality, 20 of these had no prior diagnosis of inflammatory bowel disease. Only one case in this group was subsequently diagnosed as having Crohn's disease. Nodular lymphoid hyperplasia (NLHP) and non-steroidal anti-inflammatory drugs (NSAIDs) were also associated with low grade RIF uptake. Possible explanations for these findings are discussed.
Calcified pancreas and bile ducts from schistosomiasis
Authors: Fataar S , Al Ansari A G , Bassiony H , Satyanath S , Rudwan M 
Published: July 2009

Abstract
Schistosomiasis is one of the commonest parasitic diseases affecting mankind. Egyptian schistosomiasis (mansoni and haematobium) is capable of producing fibrosis and/or calcification, resulting in striking radiological features in target organs. Our two cases with biliary and pancreatic calcification provide a combination of features not documented previously.
The Impact of Methodological Approach on Cost Findings in Comparison of Epoetin Alfa with Darbepoetin Alfa
Authors: Song Xue , Long Stacey R , Marder William D , Sullivan Sean D , Kallich Joel 
Published: July 2009

Background: Two erythropoiesis-stimulating agents (ESAs), epoetin alfa and darbepoetin alfa, are approved for the treatment of chemotherapy-induced anemia in patients with cancer. Randomized controlled trials indicate that the drugs are similarly efficacious, but that the duration of clinical benefit (DCB) ranges from 2 to 7 days for epoetin alfa and from 7 to 21 days for darbepoetin alfa, depending on dose. Given equivalent efficacy, payers are increasingly interested in understanding the cost differences for these 2 drugs. Objective: To examine the impact of different methodological approaches on the cost comparison between epoetin alfa and darbepoetin alfa users, with cancer from a payer perspective. Methods: Episodes of care (episode) were constructed for cancer patients treated with ESAs, using MarketScan claims data. Episodes started with the first ESA claim and ended on the last ESA claim or the claim before a 42-day or longer gap in ESA therapy. Each episode was augmented with an estimated DCB based on the last dose in the episode. Cost was reimbursed amount observed in the claims database. Adjusted weekly cost was estimated using generalized linear models to control for difference in clinical and demographic differences across epoetin alfa and darbepoetin alfa episodes. Results: Episodes were created in 324 darbepoetin alfa and 342 epoetin alfa users. Darbepoetin alfa users tended to be younger, had more comorbidities, and had advanced cancer (all p < 0.001). After accounting for DCB, the average weekly cost of darbepoetin alfa was significantly lower than that of epoetin alfa ($619 vs $940; p < 0.001). After multivariate adjustment, darbepoetin alfa had lower costs than epoetin alfa in the base case and all alternative approaches. Conclusions: To reduce the risk of potential bias, DCB and different patient characteristics should be taken into account when using retrospective claims data to conduct cost comparisons between agents that have significant differences in dosing schedule.
The Epothilones: How Pharmacology Relates to Clinical Utility
Authors: Michaud Laura Boehnke 
Published: July 2009

Objective: To review the pharmacologic properties of a novel class of chemotherapeutic agents, the epothilones, and to summarize findings from recent clinical trials investigating the various epothilones in cancer therapy. Data Sources: Literature searches were conducted using MEDLINE, PubMed, and the abstract search engines for the American Society of Clinical Oncology and American Association for Cancer Research annual meetings (all searches through November 2008). Primary search terms included epothilone, BMS-247550, ixabepilone, EPO906, patupilone, sagopilone, and ZK-EPO. Study Selection and Data Extraction: Publications were given priority for inclusion if they discussed structural or pharmacologic properties of the epothilones as a class or if they included preclinical or clinical data for epothilones currently in clinical development. Data Synthesis: The epothilones are a novel class of microtubule-stabilizing agents (MSAs). Epothilones are structurally and pharmacologically distinct from taxanes, but the exact ways in which the pharmacophores of the 2 classes differ has not been firmly established. A number of natural, semisynthetic, and fully synthetic epothilones are in various stages of clinical development. These agents differ from each other and from existing MSAs; these differences influence potency, stability, and solubility. Ixabepilone is currently approved to treat multidrug-resistant metastatic breast cancer and has demonstrated efficacy in earlier stages of breast cancer and in several other tumor types. Patupilone and sagopilone are currently under clinical investigation and have each shown promise in a number of treatment settings and tumor types. All 3 agents appear to be associated with manageable toxicities, but no class-wide toxicity profile exists for the epothilones and dose-limiting toxicities differ among the agents. Conclusions: The epothilones have demonstrated significant potential for addressing the growing therapeutic challenge of taxane resistance, and the ever-increasing pool of information regarding structure–activity relationships of these MSAs will help to optimize microtubule-targeted chemotherapy.
Application of STOPP and START Criteria: Interrater Reliability Among Pharmacists
Authors: Ryan Cristin , O'mahony Denis , Byrne Stephen 
Published: July 2009

Background: Inappropriate prescribing is a well-documented problem in older people. The new screening tools, STOPP (Screening Tool of Older Peoples' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) have been formulated to identify potentially inappropriate medications (PIMs) and potential errors of omissions (PEOs) in older patients. Consistent, reliable application of STOPP and START is essential for the screening tools to be used effectively by pharmacists. Objective: To determine the interrater reliability among a group of clinical pharmacists in applying the STOPP and START criteria to elderly patients' records. Methods: Ten pharmacists (5 hospital pharmacists, 5 community pharmacists) were given 20 patient profiles containing details including the patients' age and sex, current medications, current diagnoses, relevant medical histories, biochemical data, and estimated glomerular filtration rate. Each pharmacist applied the STOPP and START criteria to each patient record. The PIMs and PEOs identified by each pharmacist were compared with those of 2 academic pharmacists who were highly familiar with the application of STOPP and START. An interrater reliability analysis using the κ statistic (chance corrected measure of agreement) was performed to determine consistency between pharmacists. Results: The median κ coefficients for hospital pharmacists and community pharmacists compared with the academic pharmacists for STOPP were 0.89 and 0.88, respectively, while those for START were 0.91 and 0.90, respectively. Conclusions: Interrater reliability of STOPP and START tools between pharmacists working in different sectors is good. Pharmacists working in both hospitals and in the community can use STOPP and START reliably during their everyday practice to identify PIMs and PEOs in older patients.
Biomechanics, functional patterns, and disparity in Late Devonian arthrodires
Authors: Anderson Philip S. L. 
Published: July 2009

Studies of ecological structure and diversity over time in extinct groups have always been challenged by the inability to observe the behavior of fossil taxa directly. The only available evidence for function, behavior, and interactions between taxa is the morphological characteristics of the preserved fossils. Recent studies on modern groups have shown that morphological analyses may give misleading results in terms of ecological pattern and diversity. An alternative approach is to focus on functionally relevant aspects of morphology through a paleobiomechanical paradigm. The purpose of this research is to examine variation in the lower jaw morphology in Late Devonian arthrodire placoderms and develop biomechanical metrics that can be used to quantify functional diversity among this fossil group. Nine functionally relevant morphological characters were collected for 94 isolated arthrodire inferognathals from the Gogo Formation in Western Australia and the Cleveland Shale in Ohio. These data were used to address aspects of functional morphology, biomechanical disparity, and ecological structure in arthrodire placoderms from the Late Devonian. Results were compared with results from previous morphometric work on the same set of jaws.Statistical tests show a significant difference in functional characters between the two faunas. The differences may be related to phylogenetic differences between faunas, as the two major clades of arthrodire taxa included in this study are almost completely segregated between faunas. Average pairwise disparity analyses of the mechanical characters indicate that there is no significant difference in overall functional diversity between the Cleveland Shale and Gogo Reef arthrodire faunas. This result is at odds with previous results that show overall morphological disparity to be much higher in the Cleveland Shale. Clustering patterns within a multivariate function-space show tightly constrained functional groups of taxa independent of phylogenetic or shape-based morphological similarity. These functional groups illustrate a level of ecological diversity in Late Devonian arthrodires that is comparable to that in certain modern faunas.Further statistical analysis of the morphological and functional disparity of these Late Devonian taxa shows a disjoint between the two measures. Model I regression analysis of and Spearman rank-correlation analysis of average pairwise morphological and functional disparity measures indicate no significant relationship between morphological and functional disparity among the jaws used in this study. Although function is obviously derived from morphology, these results show that morphological shape analysis is not necessarily a good proxy for eco-functional diversity.
Multigenerational exposure of the estuarine sheepshead minnow (Cyprinodon variegatus) to 17β-Estradiol. II. Population-level effects through two life cycles
Authors: Raimondo Sandy , Hemmer Becky L. , Goodman Larry R. , Cripe Geraldine M. 
Published: July 2009

AbstractThe evaluation of multigeneration, population-level impacts is particularly important in the risk assessment of endocrine-disrupting compounds, because adverse effects may not be evident during the first generation of exposure. Population models were developed for the sheepshead minnow (Cyprinodon variegatus) exposed to 17β-estradiol (E2) for two complete generations (F1 and F2) to determine population-level effects of multigenerational exposure to a model estrogen. Stage-structured matrix models were used to determine interactions between treatment and the number of generations exposed. Reproduction was significantly reduced in both the 0.08 and 0.2 μg E2/L treatments in both generations, and embryo and larval stages experienced reduced survival at 0.2 μg/L in the second generation only. However, increased female to male sex ratio in these treatments compensated for the loss in reproductive output, and significant population-level effects only occurred in the 0.2 μg E2/L treatment of the F2 population. The F2 population in the 0.2 μg E2/L treatment also had an altered, stable stage distribution relative to the control population of both generations and the F1 population in the 0.2 μg E2/L treatment, resulting in additional population-level effects. These results demonstrate that continued exposure to E2 had compounding effects on sheepshead minnow populations and that long-term exposures may be necessary to understand the risk that exposures to environmental estrogens pose to native populations. Although population-level effects did not occur in the F1 generation, a risk decision based on F1 organism-level effects would be protective of the population exposed for two generations.
Foxo1 Links Hyperglycemia to LDL Oxidation and Endothelial Nitric Oxide Synthase Dysfunction in Vascular Endothelial Cells
Authors: Tanaka Jun , Qiang Li , Banks Alexander S. , Welch Carrie L. , Matsumoto Michihiro , Kitamura Tadahiro , Ido-Kitamura Yukari , DePinho Ronald A. , Accili Domenico 
Published: July 2009

OBJECTIVE
Atherosclerotic cardiovascular disease is the leading cause of death among people with diabetes. Generation of oxidized LDLs and reduced nitric oxide (NO) availability because of endothelial NO synthase (eNOS) dysfunction are critical events in atherosclerotic plaque formation. Biochemical mechanism leading from hyperglycemia to oxLDL formation and eNOS dysfunction is unknown.

RESEARCH DESIGN AND METHODS
We show that glucose, acting through oxidative stress, activates the transcription factor Foxo1 in vascular endothelial cells.

RESULTS
Foxo1 promotes inducible NOS (iNOS)-dependent NO-peroxynitrite generation, which leads in turn to LDL oxidation and eNOS dysfunction. We demonstrate that Foxo1 gain-of-function mimics the effects of hyperglycemia on this process, whereas conditional Foxo1 knockout in vascular endothelial cells prevents it.

CONCLUSIONS
The findings reveal a hitherto unsuspected role of the endothelial iNOS-NO-peroxynitrite pathway in lipid peroxidation and eNOS dysfunction and suggest that Foxo1 activation in response to hyperglycemia brings about proatherogenic changes in vascular endothelial cell function.
Neurological mortality among U.S. veterans of the Persian Gulf War: 13‐year follow‐up
Authors: Barth Shannon K. , Kang Han K. , Bullman Tim A. , Wallin Mitchell T. 
Published: July 2009

AbstractBackgroundThis study focuses on long‐term mortality, specifically brain cancer, amyotrophic lateral sclerosis (ALS), Parkinson's disease, and multiple sclerosis (MS) of 621,902 veterans who served in the 1990–1991 Persian Gulf War (GW), and 746,248 non‐GW veterans.MethodsFollow‐up began with the date the veteran left the GW theater or May 1, 1991 and ended with the date of death or December 31, 2004. Cox proportional hazard models were used for analyses.ResultsAdjusted mortality rate ratios (aRR) of GW veterans compared to non‐GW veterans were not statistically significant for brain cancer (aRR = 0.90, 95% confidence interval (CI): 0.73, 1.11), MS (aRR = 0.61, 95% CI: 0.23, 1.63), Parkinson's disease (aRR = 0.71, 95% CI: 0.17, 2.99), or ALS (aRR = 0.96, 95% CI: 0.56, 1.62). GW veterans potentially exposed to nerve agents for 2 or more days and GW veterans exposed to oil well fire smoke were at increased risk for brain cancer mortality (aRR = 2.71, 95% CI: 1.25, 5.87; aRR = 1.81, 95% CI: 1.00, 3.27; respectively).ConclusionsThe risk of death due to ALS, MS, Parkinson's disease, and brain cancer was not associated with 1991 GW service in general. However, GW veterans potentially exposed to nerve agents at Khamisiyah, Iraq, and to oil well fire smoke had an increased risk of mortality due to brain cancer. Am. J. Ind. Med. 52:663–670, 2009. © 2009 Wiley‐Liss, Inc.