bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term Stent Use Can Prevent Postoperative Canal Stenosis in Patients with Congenital Aural Atresia
Authors: Moon Il Joon , Cho Yang‐Sun , Park Juyeon , Chung Won‐Ho , Hong Sung Hwa , Chang Sun O 
Published: October 2011

ObjectivePostoperative external auditory canal (EAC) stenosis is the most common complication after congenital aural atresia (CAA) surgery. The authors applied an ear mold or hearing aid as an EAC stent following surgery and analyzed the impact on postoperative EAC stenosis.Study DesignHistorical cohort study.SettingA tertiary hospital.Subjects and MethodsNinety‐six patients who underwent canaloplasty between 1996 and 2010 were included in this study. To discover factors contributing to postoperative EAC stenosis, clinical parameters, including age, sex, Marx grading, Schuknecht classification, Jahrsdoerfer score, surgical approach, triamcinolone injection, and use of stenting with an ear mold or hearing aid, were reviewed and analyzed. Each stent was used for at least 6 months postoperatively. Pure‐tone audiometry was performed preoperatively and 3, 6, and 12 months after canaloplasty.ResultsPostoperative EAC stenosis was the most common postoperative complication, occurring in 8 (8.2%) cases with a mean time interval of 4.1 months. For patients who did not use an ear mold or a hearing aid during the postoperative follow‐up period, the relative risk for the development of postoperative EAC stenosis was 5.125 (95% confidence interval, 1.428‐18.400; P =. 023). Other factors did not show an association with postoperative stenosis. Preoperative air‐bone gap (ABG) was 49.00 dB, and closure of the ABG within 30 dB was obtained in 56.9%, 58.1%, and 48.7% of patients at the 3‐, 6‐, and 12‐month follow‐up, respectively.ConclusionStenting with an ear mold or hearing aid might be a useful method for preventing postoperative EAC stenosis in CAA patients.
A systematic evaluation of the core communication skills expected of a perfusionist
Authors: Melchior RW , Rosenthal T , Schiavo K , Frey T , Rogers D , Patel J , Holt DW 
Published: October 2011

Background: The objective of this systematic evaluation was to identify the sentinel standards necessary to obtain a core level of communication required of a clinical perfusionist during cardiopulmonary bypass (CPB). Once these sentinel standards were identified and a core level of communication was established (via four simulated case scenarios), a team of cardiac healthcare professionals was assembled to interpret both the accuracy of response and the speed of response encountered in each case scenario. Methods: Four simulated case scenarios were utilized in order to replicate the typical patterns of verbal exchange that occur during surgeries using extracorporeal technology. The simulated case scenarios included CPB interactions associated with preparation, initiation, maintenance, termination and post CPB. For all CPB interactions, two variables were measured: accuracy of the perfusionist’s response and speed of the perfusionist’s response. The cases took place in a controlled setting within an empty operating room at The Children’s Hospital of Philadelphia. Four clinical perfusionists each represented the role of the “perfusionist” in all simulated case scenarios. Results: When analyzing the accuracy and speed of the responses, each clinical perfusionist recorded an average score of 96.3% or higher with all case scenarios. Since the clinical perfusionists who participated in the scenarios were primarily pediatric perfusionists, the scores were best during the pediatric case scenario, 99.3% (Case Scenario #4). The lowest scores were captured during Case Scenario #3 (96.3%) which involved a more intense adult patient scenario. Conclusion: The systematic evaluation of both response accuracy and response time (presented in various adult and pediatric patient case scenarios) can be beneficial within the realm of perfusion education. Students will be introduced to core communication concepts within the clinical realm. This study supports the idea that simulation and evaluation may ease the transition for students from the didactic to clinical realm in terms of communication. Further studies need to be developed in order to define “standard” CPB communication guidelines for perfusion students.
Acupuncture versus topiramate in chronic migraine prophylaxis: A randomized clinical trial
Authors: Yang C-P , Chang M-H , Liu P-E , Li T-C , Hsieh C-L , Hwang K-L , Chang H-H 
Published: October 2011

Background: The aim of this study was to investigate the efficacy and tolerability of acupuncture compared with topiramate treatment in chronic migraine (CM) prophylaxis. Methods: A total of 66 consecutive and prospective CM patients were randomly divided into two treatment arms: 1) acupuncture group: acupuncture administered in 24 sessions over 12 weeks (n = 33); and 2) topiramate group: a 4-week titration, initiated at 25 mg/day and increased by 25 mg/day weekly to a maximum of 100 mg/day followed by an 8-week maintenance period (n = 33). Results: A significantly larger decrease in the mean monthly number of moderate/severe headache days (primary end point) from 20.2 ± 1.5 days to 9.8 ± 2.8 days was observed in the acupuncture group compared with 19.8 ± 1.7 days to 12.0 ± 4.1 days in the topiramate group (p < .01) Significant differences favoring acupuncture were also observed for all secondary efficacy variables. These significant differences still existed when we focused on those patients who were overusing acute medication. Adverse events occurred in 6% of acupuncture group and 66% of topiramate group. Conclusion: We suggest that acupuncture could be considered a treatment option for CM patients willing to undergo this prophylactic treatment, even for those patients with medication overuse.
A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. A multicentre European and Latin American study
Authors: Jensen R , Tassorelli C , Rossi P , Allena M , Osipova V , Steiner TJ , Sandrini G , Olesen J , Nappi G ,   the Basic Diagnostic Headache Diary Study Group, Barrientos N , Mulleners WM , Dzagnidze A , Figuerola ML , Filatova EG , Katsarava Z , Koreshkina M , Milanov I , Pereira-Monteiro J , Perrotta A , Ratchin A , Radojicic A , Rezzani C , Sances G , Sretenovic S , Torelli P 
Published: October 2011

Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1:1 randomization list. Those in group 1 were sent the BDHD before their first visit to the headache centre and asked to complete it for at least 1 month. Those in group 2 made their first visit to the headache centre without receiving the BDHD. Results: A total of 626 patients from nine countries and 16 centres completed the study. The BDHD entries were complete in 97.5% of cases. BDHD information and clinical interview were, when taken together, considered complete for diagnosis in 97.7% of cases in group 1 whereas the information obtained by clinical interview alone in group 2 was considered complete in only 86.8% of cases ( p < 0.001). The median number of diagnoses per patient in group 1 was significantly higher than in group 2 ( p = 0.04). The BDHD was very well accepted by both patients and doctors. Conclusions: It is concluded that the BDHD is a useful tool in the diagnostic assessment of the most frequent and disabling forms of primary headache and in headache management.
Predictors of Radiographic Knee Osteoarthritis After Anterior Cruciate Ligament Reconstruction
Authors: Li Ryan T. , Lorenz Stephan , Xu Yan , Harner Christopher D. , Fu Freddie H. , Irrgang James J. 
Published: October 2011

Background: Evidence suggests that single-bundle anterior cruciate ligament (ACL) reconstruction does not reliably prevent the development of knee osteoarthritis (OA). Purpose: This study was conducted to determine the overall prevalence of and risk factors for the development of radiographic knee OA after single-bundle ACL reconstruction. Study Design: Case control study; Level of evidence, 3. Methods: There were 249 individuals who had undergone primary single-bundle ACL reconstruction included in this retrospective cohort study. Follow-up radiographs were scored by a single orthopaedic surgery sports medicine fellow using the Kellgren-Lawrence (KL) scale to determine the degree of OA in the medial, lateral, and patellofemoral compartments. Radiographic OA of the involved knee was considered to be present if, compared with the noninvolved knee, there was at least a 2-grade difference in the KL score in at least 1 compartment or a 1-grade difference in at least 2 compartments. Predictors of OA that were explored included patient age, sex, body mass index (BMI), smoking status activity level, meniscectomy before or concurrent with ACL reconstruction, chondral injury present at the time of ACL reconstruction, graft type and source, tibial and femoral tunnel positions, need for revision, and length of follow-up. Univariable and stepwise multivariable logistic regressions were used to identify factors that were associated with radiographic knee OA. Results: Thirty-nine percent of the patients had radiographic OA an average of 7.8 years after surgery. Female sex, BMI, time from injury to surgery, medial and patellofemoral compartment chondrosis, prior medial or lateral meniscectomy, concurrent medial meniscectomy, and length of follow-up were associated with radiographic knee OA after ACL surgery. Stepwise multivariable logistic regression indicated that prior medial meniscectomy (95% confidence interval [CI], 1.39-6.85), grade 2 or greater medial chondrosis (95% CI, 1.27-6.73), length of follow-up (95% CI, 1.07-1.24), and BMI (overweight 95% CI, 1.08-3.84; obese 95% CI, 1.34-7.80) were the best set of predictors of knee OA. Conclusion: Despite reduced laxity and instability and improved activity and participation, individuals who have undergone ACL reconstruction are still at high risk for developing knee OA compared with the general population. The strongest predictors of knee OA after ACL reconstruction were obesity and grade 2 or greater chondrosis in the medial compartment. These results may aid in identifying patients at risk for OA after ACL reconstruction.
Managing Complexity in Aircraft Design Using Design Structure Matrix
Authors: Shekar B. , Venkataram R. , Satish B.M. 
Published: October 2011

Modern aerospace systems have reached a level of complexity that requires systematic methods for their design. The development of products in aircraft industry involves numerous engineers from different disciplines working on independent components. Routine activities consume a significant part of aircraft development time. To be competitive, aircraft industry needs to manage complexity and readjust the ratio of innovative versus routine work. Thus, the main objective is to develop an approach that can manage complexity in engineering design, reduce the design cycle time, and reduce the product development cost. The design structure matrix (DSM) is a simple tool to perform both analysis and management of complex systems. It enables the user to model, visualize, and analyze the dependencies among the functional group of any system and derive suggestions for the improvement or synthesis of a system. This article illustrates with a case study how DSM can be used to manage complexity in aircraft design process. The result of implementing the DSM approach for Light Combat Aircraft (Navy) at Hindustan Aeronautics Limited, India, (in aircraft design) show primary benefits of 75% reduction in routine activities, 33% reduction in design cycle time, 50% reduction in rework cost, and 30% reduction in product and process development cost of aircraft.
The impact of a pharmacist as a member of healthcare team on facilitating evidenced-based prescribing of innovative drugs in an Italian oncology department
Authors: Cioffi Pasquale , Antonelli Daniela , Belfiglio Maurizio , Melena Stefania , Petrelli Fabio , Grappasonni Iolanda 
Published: October 2011

Aims and background: At the Oncology Department of the Chieti and Ortona Hospitals, the pharmacist designated by the Abruzzo Region to oversee the obligatory monitoring of innovative oncological drugs listed in the database of the Italian Medicines Agency (AIFA) collaborates with oncologists to educate them about evidenced-based prescribing for off-label uses of drugs and to optimize the efficiency of spontaneous reporting of adverse drug reaction (ADR) local system. Methods: The contribution of the pharmacist as a member of the healthcare team was evaluated using the following indices: the percentage of off-label prescriptions of the innovative drugs monitored, the number of reported ADRs, and the percentage of pharmacist suggestions actually implemented by physicians. Results: In the course of 3 years (2008–2010), the pharmacist monitored a total of 843 patients treated with 716 appropriate uses and 127 off-label uses of drugs, oversaw a reduction in the latter from 28.3% in 2008 to 9.6% in 2010, and contributed to almost tripling the number of reported ADRs, from 10 in 2008 to 27 in 2010. In 2010, the pharmacist identified 60 potentially inappropriate prescribing cases, and proposed more appropriate prescriptions for each case: 68.3% (41) of the suggestions were implemented by the physicians and only 31.7% (19) were not. According to answers to a questionnaire administered at the end of the 2010 to evaluate the usefulness of this particular collaboration, physicians are interested in continuous and extensive collaboration. Conclusions: This article demonstrates that a pharmacist, active in the department as part of the heath-care team, can facilitate evidenced-based prescribing for off-label uses of drugs and improve spontaneous reporting of ADRs.
Incidence of fractures in patients with multiple sclerosis: the Danish National Health Registers
Authors: Bazelier Marloes T , de Vries Frank , Bentzen Joan , Vestergaard Peter , Leufkens Hubert GM , van Staa Tjeerd-Pieter , Koch-Henriksen Nils 
Published: October 2011

Background: Patients with multiple sclerosis (MS) are potentially at high risk of fracture due to falls and osteoporosis. Objective: To estimate incidence rates of fractures in MS patients, stratified by fracture type, sex and age, and to compare these rates with controls. Methods: The case population consisted of all patients with an accepted diagnosis of MS in the Danish MS Registry (1949–2007). Data were linked to the National Hospital Discharge Register (1977–2007). Patients with MS ( n = 11,157) were 1:6 matched by year of birth, gender, calendar time and region to persons without MS (controls). Incidence rates of fracture were estimated as the number of fractures per 1000 person-years. Incidence rate ratios (IRRs) were calculated by dividing fracture rates in MS patients by fracture rates in controls. Results: Among patients with MS, the incidence rate of any fracture yielded 22.8 per 1000 person-years. The IRR of any fracture between MS patients and controls was 1.40 (95% CI 1.33–1.46). In particular, IRRs of tibia fracture (3.36 [2.75–4.11]), femur fracture (6.66 [5.06–8.76]) and hip fracture (3.20 [2.83–3.62]) were elevated in MS patients versus controls. Conclusion: Fractures occurred more often in patients with MS, especially fractures of the tibia, hip and femur.
EBV-specific immune responses in patients with multiple sclerosis responding to IFNβ therapy
Authors: Comabella Manuel , Kakalacheva Kristina , Río Jordi , Münz Christian , Montalban Xavier , Lünemann Jan D 
Published: October 2011

Background: Symptomatic primary infection with the human γ-herpesvirus Epstein–Barr virus (EBV) and elevated immune responses to EBV are associated with the development and progression of multiple sclerosis (MS). Interferon-beta (IFNβ), first-line treatment for relapse-onset MS, exhibits complex immunoregulatory and antiviral activities. Objective: To determine EBV-specific immune responses in patients with MS during IFNβ therapy. Methods: We evaluated cellular and humoral immune responses to EBV- and human cytomegalovirus (HCMV)-encoded antigens in patients with MS before and 1 year after IFNβ treatment by ELISA and flow cytometry. Twenty-eight patients with MS who showed a clinical response to IFNβ as defined by the absence of relapses and lack of progression on the Expanded Disability Status Scale score during the first 2 years of treatment were included. Results: Clinically effective IFNβ-therapy was associated with a downregulation of proliferative T cell responses to the latent EBV nuclear antigen-1 (EBNA1). EBNA1-specific IgG responses as well as cellular and humoral immune responses to MHC class I restricted EBV antigens expressed during lytic replication and viral B cell transformation were similar before and after IFNβ therapy. Although HCMV-specific IgG levels slightly decreased, proliferative T-cell responses towards HCMV antigens remained unchanged during IFNβ therapy. Conclusion: Clinically effective IFNβ therapy is associated with a reduction of proliferative T-cell responses to EBNA1.
Olfactory dysfunction in multiple sclerosis: association with secondary progression
Authors: Silva Ana Martins , Santos Ernestina , Moreira Inês , Bettencourt Andreia , Coutinho Ester , Gonçalves Alexandra , Pinto Claudia , Montalban Xavier , Cavaco Sara 
Published: October 2011

Objective: The Brief Smell Identification Test (B-SIT) was used to explore odour identification capacities in multiple sclerosis (MS). Methods: In total, 153 consecutive patients with MS and 165 healthy controls (HC) participated in the study. All participants were asked to answer the B-SIT and the Hospital Anxiety and Depression Scale (HADS). The Expanded Disability Status Scale (EDSS), the Multiple Sclerosis Severity Scale (MSSS), and the Mini-Mental State Examination (MMSE) were used for patients’ clinical and cognitive characterization. Results: Patients with MS (11.1%) were more impaired on the B-SIT than HC participants (3%). The frequency of impairment was higher for patients with secondary progressive (SPMS; 11/16, 68.8%) than relapsing–remitting (RRMS; 4/121, 3.3%) or primary progressive (2/16, 12.5%) courses. A threshold score of ≤ 8 on the B-SIT provided a sensitivity of 69% and a specificity of 97% in the identification of SPMS among patients with relapsing onset. The association between SPMS and impaired B-SIT remained statistically significant after adjusting for demographic (i.e. age and education), clinical (i.e. disease duration, EDSS, and MSSS), psychopathological (i.e. HADS anxiety and depression scores), and cognitive (i.e. MMSE) variables. Conclusions: A brief odour identification measure provided a good discrimination between SPMS and RRMS courses. A systematic assessment of olfactory functions may contribute to the development of clinical markers of SPMS.
AML1/RUNX1 functions as a cytoplasmic attenuator of NF-κB signaling in the repression of myeloid tumors
Authors: Nakagawa Masahiro , Shimabe Munetake , Watanabe-Okochi Naoko , Arai Shunya , Yoshimi Akihide , Shinohara Akihito , Nishimoto Nahoko , Kataoka Keisuke , Sato Tomohiko , Kumano Keiki , Nannya Yasuhito , Ichikawa Motoshi , Imai Yoichi , Kurokawa Mineo 
Published: October 2011

AbstractFunctional deregulation of transcription factors has been found in many types of tumors. Transcription factor AML1/RUNX1 is one of the most frequent targets of chromosomal abnormalities in human leukemia and altered function of AML1 is closely associated with malignant transformation of hematopoietic cells. However, the molecular basis and therapeutic targets of AML1-related leukemia are still elusive. Here, we explored immediate target pathways of AML1 by in vitro synchronous inactivation in hematopoietic cells. We found that AML1 inhibits NF-κB signaling through interaction with IκB kinase complex in the cytoplasm. Remarkably, AML1 mutants found in myeloid tumors lack the ability to inhibit NF-κB signaling, and human cases with AML1-related leukemia exhibits distinctly activated NF-κB signaling. Furthermore, inhibition of NF-κB signaling in leukemic cells with mutated AML1 efficiently blocks their growth and development of leukemia. These findings reveal a novel role for AML1 as a cytoplasmic attenuator of NF-κB signaling and indicate that NF-κB signaling is one of the promising therapeutic targets of hematologic malignancies with AML1 abnormality.
Evidence for the divergence of innate and adaptive T-cell precursors before commitment to the αβ and γδ lineages
Authors: Kisielow Jan , Tortola Luigi , Weber Jacqueline , Karjalainen Klaus , Kopf Manfred 
Published: October 2011

AbstractIn addition to adaptive T cells, the thymus supports the development of unconventional T cells such as natural killer T (NKT) and CD8αα intraepithelial lymphocytes (IELs), which have innate functional properties, particular antigenic specificities, and tissue localization. Both conventional and innate T cells are believed to develop from common precursors undergoing instructive, TCR-mediated lineage fate decisions, but innate T cells are proposed to undergo positive instead of negative selection in response to agonistic TCR signals. In the present study, we show that, in contrast to conventional αβT cells, innate αβT cells are not selected against functional TCRγ rearrangements and express TCRγ mRNA. Likewise, in contrast to the majority of γδT cells, thymic innate γδT cells are not efficiently selected against functional TCRβ chains. In precursors of conventional T cells, autonomous TCR signals emanating from the pre-TCR or γδTCR in the absence of ligand mediate selection against the TCR of the opposite isotype and αβ/γδ lineage commitment. Our data suggest that developing innate T cells ignore such signals and rely solely on agonistic TCR interactions. Consistently, most innate T cells reacted strongly against autologous thymocytes. These results suggest that innate and adaptive T-cell lineages do not develop from the same pool of precursors and potentially diverge before αβ/γδ lineage commitment.
The role of maintenance thalidomide therapy in multiple myeloma: MRC Myeloma IX results and meta-analysis
Authors: Morgan Gareth J. , Gregory Walter M. , Davies Faith E. , Bell Sue E. , Szubert Alexander J. , Brown Julia M. , Coy Nuria N. , Cook Gordon , Russell Nigel H. , Rudin Claudius , Roddie Huw , Drayson Mark T. , Owen Roger G. , Ross Fiona M. , Jackson Graham H. , Child J. Anthony ,   on behalf of the National Cancer Research Institute Haematological Oncology Clinical Studies Group
Published: October 2011

Abstract
Thalidomide maintenance has the potential to modulate residual multiple myeloma (MM) after an initial response. This trial compared the effect of thalidomide maintenance and no maintenance on progression-free survival (PFS) and overall survival (OS) in MM patients. After intensive or nonintensive induction therapy, 820 newly diagnosed MM patients were randomized to open-label thalidomide maintenance until progression, or no maintenance. Interphase FISH (iFISH) analysis was performed at study entry. Median PFS was significantly longer with thalidomide maintenance (log-rank P < .001). Median OS was similar between regimens (log-rank P = .40). Patients with favorable iFISH showed improved PFS (P = .004) and a trend toward a late survival benefit. Patients with adverse iFISH receiving thalidomide showed no significant PFS benefit and worse OS (P = .009). Effective relapse therapy enhanced survival after progression, translating into a significant OS benefit. Meta-analysis of this and other studies show a significant late OS benefit (P < .001, 7-year difference hazard ratio = 12.3; 95% confidence interval, 5.5-19.0). Thalidomide maintenance significantly improves PFS and can be associated with improved OS. iFISH testing is important in assessing the clinical impact of maintenance therapy. Overview analysis demonstrated that thalidomide maintenance was associated with a significant late OS benefit. This trial was registered at www.isrctn.org as #ISRCTN68454111.