bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic evaluation of drug-eluting stents compared to bare metal stents using a large prospective study in Ontario
Authors: Goeree Ron , Bowen James M. , Blackhouse Gord , Lazzam Charles , Cohen Eric , Chiu Maria , Hopkins Rob , Tarride Jean-Eric , Tu Jack V. 
Published: March 2009

Objectives:To determine the cost-effectiveness (CE) and cost-utility (CU) of drug-eluting stents (DES) compared to bare metal stents (BMS) in Ontario using a large prospective “real-world” cohort study and determine the extent to which results vary by patient risk subgroups.Methods:A field evaluation was conducted based on all stent procedures in the province of Ontario between December 1, 2003, and March 31, 2005, with a minimum subject follow-up of 1 year. Effectiveness data from the study using a propensity-score matched cohort were combined with resource utilization and cost data and quality of life (QOL) data from the published literature in a decision analytic modeling framework to determine 2-year cost-effectiveness (cost per revascularization avoided) and cost-utility (cost per quality-adjusted life-year ([QALY] gained). Stochastic model parameter uncertainty was expressed using probability distributions and analyzed using a probabilistic model. Modeling assumptions were assessed using traditional deterministic sensitivity analysis.Results:Significant differences in revascularization rates were found for patients with two or more high risk factors. Despite these differences, the CE and CU of DES remained high (e.g., $419,000 per QALY gained in the most favorable patient risk subgroup). In sensitivity analysis, the difference in cost between DES and BMS had an impact on the CE and CU results. For example, at a price differential of $500, the CU of DES was $20,000/QALY for one patient subgroup and DES was dominant (i.e., less costly and more effective) in another.Conclusions:At current prices, the CE/CU of DES compared with BMS is high even in patient high risk subgroups. As the relative price of DES decrease, the value for money attractiveness of DES increases, especially for selected high risk patients.
Clinical decision rules for the use of liquor diagnostics in hospitalized neurology patients reduced costs without affecting clinical outcomes
Authors: Haschke-Becher Elisabeth , Totzke Uwe , Afazel Shahrzad , Johansson Tim , Schwarz Markus , Ladurner Gunther , Wild Claudia 
Published: March 2009

Objectives:Excessive use of laboratory diagnostics has been common. This study aimed to evaluate whether clinical decision rules for the use of liquor diagnostics would enable cost containment without affecting medical care.Methods:This was a single-center, retrospective, cost-minimization study based on the records of all 16,319 patients hospitalized and discharged at a Neurology Clinic in Austria between 2004 and 2006. Cost of liquor diagnostics, discharge diagnosis, duration of hospital stay, and mortality were compared along the line before, during, and after implementation of decision rules in mid-2005.Results:There were no significant changes in patient characteristics over time, not in the diagnoses at discharge, nor in the percentage of patients undergoing liquor diagnostics. The average number of tests per patient significantly decreased. Standard tests largely replaced serological tests for infections, regardless of diagnosis. Annual costs for liquor diagnostics decreased by 32.9 percent. Overall, the duration of hospital stay and mortality significantly decreased as well; however, differences were not significant for any single diagnosis-related group.Conclusions:Diagnostic algorithms may allow cost containment without affecting medical care.
In search of the evidentiary foundation of published Canadian economic evaluations (2001–06)
Authors: Tarride Jean-Eric , Lim Morgan E. , Bowen James M. , McCarron Catherine Elizabeth , Blackhouse Gord , Hopkins Robert , O'Reilly Daria , Xie Feng , Goeree Ron 
Published: March 2009

Objectives:The aim of this study was to present a review of economic evaluations conducted from a Canadian perspective and to characterize sources of evidence and statistical methods to analyze effectiveness measures, resource utilization, and uncertainty.Methods:A search strategy was developed to identify Canadian economic evaluations published between January 2001 and June 2006. A standardized abstraction form was used to extract key data (e.g., study design, data sources, statistical methods).Results:A total of 153 unique studies were included for review, of which 75 were evaluations of drug therapies and less than half were funded by industry. Cost-effectiveness analysis was the most common type of economic evaluation and 80 percent of the studies used modeling techniques. A single source of evidence for effectiveness measures was used in half of the studies. Statistical methods were commonly reported to compare effectiveness measures when the economic evaluation was conducted alongside a clinical trial but less commonly when determining effectiveness input parameters in model-based economic evaluations, or to analyze resource utilization data. Authors relied mostly on univariate sensitivity analyses to explore uncertainty.Conclusions:This review identifies the need to improve the conduct and reporting of statistical methods for economic evaluations to improve confidence in the results.
Intralesional recombinant α‐interferon for localized prostate cancer: a pilot study with follow‐up of >10 years
Authors: Emerson Laurel , Morales Alvaro 
Published: March 2009

OBJECTIVETo report the long‐term results of the intralesional administration of an immune modifier, interferon‐α (IFN‐α) in men with localized prostate cancer, providing a method for drug delivery within the gland under ultrasonographic control.PATIENTS AND METHODSTen men with localized prostate cancer participated in a study involving the intraprostatic injection of IFN‐α, weekly for 5 weeks. Prostate biopsies were taken and prostate‐specific antigen (PSA) levels were measured bi‐annually or until the men had an alternative treatment.RESULTSThe pretreatment mean Gleason score was 7 and the mean PSA level 11 ng/mL. Biopsies after treatment were negative in three patients. Of the remaining seven, six chose to continue watchful waiting. With time, five went on to alternative treatment; one had radical prostatectomy (at 3 months), two had external beam radiotherapy (at 3 and 6 months), and two had androgen suppression (at 3 and 24 months). Of the three men with initial negative biopsies, one died from unrelated causes 13 years later, with an undetectable PSA level; the second remains asymptomatic 13 years later but has an elevated PSA level. The last patient has a low (<4 ng/mL) PSA level, negative biopsies and had ‘no cancer’ in a resection specimen, 64 months after treatment. These two men remain under active surveillance with no intervention.CONCLUSIONSAfter delivery of IFN‐α directly into the prostate gland, and a long follow‐up, it appears that there was some antitumour activity in some patients. The doses used were small and the schedule of administration short. Further evaluation of this, and other agents alone and in combination, might be worthwhile.
Bladder cancer survivals in New South Wales, Australia: why do women have poorer survival than men?
Authors: Tracey Elizabeth , Roder David , Luke Colin , Bishop James 
Published: March 2009

OBJECTIVETo investigate factors that most influenced survival from bladder cancer in New South Wales, Australia (NSW) and to consider the impact of changes in coding practices on the reporting the of bladder cancer outcomes.PATIENTS AND METHODSAll NSW cases of bladder cancer diagnosed between 1980 and 2003 were followed to the end of 2004 (17 923 cases). Survival analysis was undertaken using Kaplan–Meier unadjusted disease‐specific survival and adjusted disease‐specific survival using Cox proportional hazards regression modelling. This analysis was unique in that it modelled the effect of sex, age, country of birth, socio‐economic status (SES), histological type, extent of disease and period of diagnosis on survival from bladder cancer in NSW.RESULTSAfter adjusting for sex, age, extent of disease, SES, period of diagnosis and histological type, the likelihood of death was 11% (95% confidence interval, CI 5–18%) higher in females than in males, with case fatality most influenced by age at diagnosis, extent of disease, and histological type. When the analysis was repeated for cases with a method 6 (i.e. coding undertaken in the registry after examination of the pathology report, which would enhance accuracy), the likelihood of death was 13% (95% CI 5–21%) higher in females than in males.CONCLUSIONSThe NSW analysis controls for variability in coding, extent of disease at diagnosis and histological type of cancer. The analysis shows significantly lower survival from bladder cancer in NSW women compared with men, with no improvement in survival from 1980 to 2003. Possible reasons for the lower survivals in women, the lack of improvement in survival and coding differences in jurisdictions are discussed.
Relationship between special abilities and autistic‐like traits in a large population‐based sample of 8‐year‐olds
Authors: Vital Pedro M. , Ronald Angelica , Wallace Gregory L. , Happé Francesca 
Published: March 2009

Background:  The raised incidence of special abilities or ‘savant skills’ among individuals with autism spectrum disorders (ASD) relative to other developmental disorders suggests an association between the traits characteristic of ASD and special abilities. The purpose of this study was to investigate the association between special abilities and ASD‐like traits.Methods:  This study compared the scores of 6,426 8‐year‐olds with and without parent‐reported special abilities on a screening questionnaire for ASD‐like traits in three areas: social interaction, communication, and restricted and repetitive behaviours and interests. Measures of IQ, sex, and socioeconomic status (SES) were also compared.Results:  From parent report, children with special abilities showed significantly more ASD‐like traits than those without such abilities. General intelligence did not mediate this relationship: IQ was found to be positively associated with ability, but negatively associated with ASD‐like traits. Special abilities were more strongly associated with restricted/repetitive characteristics than with social or communication traits.Conclusions:  Results support the association between special abilities and ASD‐like traits, and expand it to traits in the general population. The type of nonsocial traits most strongly associated with parental reports of special abilities suggests a link to a featural information processing style, or ‘weak central coherence’.
High Self‐Reported Prevalence of Diabetes Mellitus, Heart Disease, and Stroke in 11 Counties of Rural Appalachian Ohio
Authors: Schwartz Frank , Ruhil Anirundth , Denham Sharon , Shubrook Jay , Simpson Chris , Boyd Sara L. 
Published: March 2009

ABSTRACT:
Context/Purpose: There is an epidemic of obesity and diabetes in the United States, especially in economically at‐risk populations such as rural Appalachia. This survey determined the self‐reported prevalence of obesity, diabetes mellitus, and associated macrovascular complications in 11 rural counties of Appalachian Ohio. The impacts of lifestyle, cardiovascular risk factors, income, and access to medical care were also determined. Methods: A telephone survey identical to the 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was conducted. Surveys were collected from 3,927 randomly selected residents 18 years of age and older in 11 counties of Appalachian Ohio and compared to published aggregate Ohio and national 2004 BRFSS data. Findings: The self‐reported prevalence of diabetes (11.3%) was markedly higher in Appalachian Ohio counties surveyed compared to aggregate Ohio (7.8%) or national (7.2%) 2004 BRFSS data (P < .044). The prevalence of heart disease (7.6%) and stroke (4.1%) in these counties was slightly higher than aggregate Ohio or national 2004 BRFSS data. In persons with diabetes, the prevalence of heart disease was 2‐fold higher (20.0%) and stroke 3‐fold higher (11.4%) than among nondiabetics (P < .042) in the region and higher than aggregate Ohio and National 2004 BRFSS data. Lower‐income levels and decreased access to medications and glucose monitoring supplies correlated with the increased risk for cardiovascular complications in this rural population (P < .042). Conclusion: The self‐reported prevalence of diabetes mellitus and its associated macrovascular complications are much higher in rural Appalachian Ohio compared to aggregate Ohio and National 2004 BRFSS data.
INTEGRATED PRODUCTION AND THE INVESTMENT–UNCERTAINTY RELATIONSHIP
Authors: Tsai Yingyi , Wu Ching‐tang 
Published: March 2009

AbstractThis paper studies the role of production mode in determining the effects of an increase in uncertainty on the choice of investment outlay. In a continuous‐time model of optimal capital investment with innovative R&D under demand uncertainty, we show that investments in both capital and innovative research decrease with an increase in uncertainty, and that such investments rise with the level of primary demand. Our result sheds light on the mode of production as a source of the negative investment–uncertainty relationship.
Lichtwahrnehmung und Pfingstauffassung im Frühmittelalter
Authors: Kleinschmidt Harald 
Published: March 2009

AbstractThe early medieval exegesis of the Pentecost account in the Acts of the Apostles emphasised the divine origin of the light that some early medieval theologists, specifically Hrabanus Maurus, believed to have descended upon the Apostles (or the congregation) and provided them with special powers. The following article links Hrabanus Maurus's exegetical work with early pictorial representations of Pentecost as well as medieval theories of action.
Implementation and Analysis of Networked Radar Refractivity Retrieval
Authors: Fritz Jason , Chandrasekar V. 
Published: March 2009

Abstract
The surface-layer moisture field can be obtained by estimating the refractive index of air, measured in parts per million, and is referred to as refractivity. A technique to estimate the refractivity by using radar has been demonstrated experimentally using the measured change in phase from stationary ground targets. Recently, a new network-based algorithm was proposed within the Center for Collaborative Adaptive Sensing of the Atmosphere (CASA) as an alternative approach, especially when dealing with multiple radars. That work presented the algorithm and applied it to purely simulated data. The research presented here provides more detail and takes the new networked radar approach to the next level by independently validating and demonstrating the output with data collected during a refractivity field experiment in Colorado during the summer of 2006. The practical aspects of implementing the network-based algorithm are presented along with a more complete mathematical representation. The results are then compared with the previously fielded technique starting from the same filtered phase data. From this comparison, the authors conclude that the networked algorithm has potential for providing a good refractivity estimate from a radar network once some of its own shortcomings are addressed.
Transient in utero disruption of Cystic Fibrosis Transmembrane Conductance Regulator causes phenotypic changes in Alveolar Type II cells in adult rats
Authors: Gad Ashraf , Callender Delon L , Killeen Erin , Hudak Joseph , Dlugosz Malgosia A , Larson Janet E , Cohen J Craig , Chander Avinash 
Published: March 2009

Abstract

Background
Mechanicosensory mechanisms regulate cell differentiation during lung organogenesis. We have previously demonstrated that cystic fibrosis transmembrane conductance regulator (CFTR) was integral to stretch-induced growth and development and that transient expression of antisense-CFTR (ASCFTR) had negative effects on lung structure and function. In this study, we examined adult alveolar type II (ATII) cell phenotype after transient knock down of CFTR by adenovirus-directed in utero expression of ASCFTR in the fetal lung.

Results
In comparison to (reporter gene-treated) Controls, ASCFTR-treated adult rat lungs showed elevated phosphatidylcholine (PC) levels in the large but not in the small aggregates of alveolar surfactant. The lung mRNA levels for SP-A and SP-B were lower in the ASCFTR rats. The basal PC secretion in ATII cells was similar in the two groups. However, compared to Control ATII cells, the cells in ASCFTR group showed higher PC secretion with ATP or phorbol myristate acetate. The cell PC pool was also larger in the ASCFTR group. Thus, the increased surfactant secretion in ATII cells could cause higher PC levels in large aggregates of surfactant. In freshly isolated ATII cells, the expression of surfactant proteins was unchanged, suggesting that the lungs of ASCFTR rats contained fewer ATII cells. Gene array analysis of RNA of freshly isolated ATII cells from these lungs showed altered expression of several genes including elevated expression of two calcium-related genes, Ca2+-ATPase and calcium-calmodulin kinase kinase1 (CaMkk1), which was confirmed by real-time PCR. Western blot analysis showed increased expression of calmodulin kinase I, which is activated following phosphorylation by CaMkk1. Although increased expression of calcium regulating genes would argue in favor of Ca2+-dependent mechanisms increasing surfactant secretion, we cannot exclude contribution of alternate mechanisms because of other phenotypic changes in ATII cells of the ASCFTR group.

Conclusion
Developmental changes due to transient disruption of CFTR in fetal lung reflect in altered ATII cell phenotype in the adult life.
Charnley low-frictional torque arthroplasty
Authors: Wroblewski B. M. , Siney P. D. , Fleming P. A. 
Published: March 2009

Of the 11 054 Charnley low-frictional torque arthroplasties carried out at our hospital between 1962 and 1977, 110 (94 patients) had a minimum follow-up of 30 years with a mean of 32.3 years (30.0 to 40.5). The mean age of the patients at operation was 43.3 years (17.0 to 65.0) and 75.7 years (51.0 to 97.0) at follow-up. Overall, 90% of hips (99) were free from pain and activity was reported as normal in 58% of the patients. A total of 13 hips (11.8%) were revised at a mean follow-up of 32.3 years (30.0 to 39.5), with wear and loosening of the acetabular component as the main indications. The clinical results did not reflect the mechanical state of the implant. Follow-up with sequential radiographs of good quality is essential. Revision for radiological changes alone must be accepted if gross loss of bone stock is to be avoided. Improvements in the design, materials and operative technique, based on the long-term outcome, are highlighted.
Ecotoxicological Assessment of an In-Lake Remediation Method
Authors: Soumis-Dugas Gabriel , Triffaut-Bouchet Gaëlle , Galvez Rosa , Martel Louis 
Published: March 2009

Abstract
Eutrophication and contaminated sediments are preoccupying issues in aquatic ecosystems and water resources protection. Saint-Augustin Lake (Quebec, Canada) is affected by both problems (eutrophication and contaminated sediment) and the presence of de-icing salts. According to sustainable management principles, Galvez and collaborators are developing an in-lake remediation method to restore eutrophicated lakes which consists of (a) the precipitation of the phosphorus present in the water column by the addition of alum in association with (b) the deposit of an active capping layer (calcite+sand) to isolate P, Al, and the contaminated sediments. The objective of this study is to assess the ecotoxicological impact of this restoration method for the Saint-Augustin Lake. Two ecotoxicological approaches will be used to assess this impact: (a) single-species bioassays using algal (Pseudokirchneriella subcapitata; growth), duckweed (Lemna minor; growth), daphnid (Daphnia magna; survival and reproduction), amphipod (Hyalella azteca; survival and reproduction), and invertebrate (Chironomus riparius; survival, growth, and emergence); and (b) a 2-L microcosm assay using the same organisms for purpose of comparisons. Alum toxicity, calcite impact, and organisms’ recolonization ability will be studied separately: first in artificial conditions, by using formulated sediments and artificial water and by considering de-icing salts impact, and secondly by using the sediments and overlying water of the Saint-Augustin lake. Preliminary results are available and presented here. No effect was measured for salt (NaCl) toxicity on algae, daphnids, chironomids, and amphipods. Alum inhibited algal growth strongly, had no impact on D. magna mobility and survival, but a clear dose-effect response was observed for daphnid reproduction. The global remediation method had almost the same effect as alum on P. subcapitata but stimulated daphnid reproduction at 10 mg/L alum, while it was reduced with 20 mg/L, and completely inhibited with 30 mg/L.
Segmental Duplications Contribute to Gene Expression Differences Between Humans and Chimpanzees
Authors: Blekhman Ran , Oshlack Alicia , Gilad Yoav 
Published: March 2009

AbstractIn addition to specific changes in cis- and trans-regulatory elements, structural changes in the genome are hypothesized to underlie a large number of differences in gene expression between species. Accordingly, we show that species-specific segmental duplications are enriched with genes that are differentially expressed between humans and chimpanzees.
Remission in Rheumatoid Arthritis: Physician and Patient Perspectives
Authors: WOLFE FREDERICK , BOERS MAARTEN , FELSON DAVID , MICHAUD KALEB , WELLS GEORGE A. 
Published: March 2009

Objective.To examine the prevalence of remission in rheumatoid arthritis (RA) as determined by physicians and patients independently, and to determine the degree of agreement among methods, the strength of predictor variables of remission, and the length of remission.Methods.Eight hundred patients with RA completed a remission questionnaire on the day of their rheumatologist visit and their rheumatologists completed a separate questionnaire the same day. The question(s) were: “Given all your experience with disease activity in RA, are you [is your patient] currently in remission?”. Patients also completed 0–10 visual analog scales for RA activity, pain, and functional limitation.Results.The percentage of patients in remission by physician and patient assessment was 34.8% [95% confidence interval (CI) 31.4–38.2] and 30.9% (95% CI 27.7–34.20), respectively. The percentage of patients classified concordantly (full agreement) was 78.6%, and the associated kappa statistic was 0.54 (95% CI 0.45–0.58). The median duration of remission was 2.0 years. The median RA activity, pain, and functional scores were 1.0, 1.5, and 1.25 for patient-determined remission and 1.5, 1.5, and 1.5 for physician-determined remission.Conclusion.Physician and patient estimates of remission in RA are similar (34.8% to 30.9%), and agreement was 78.6% (kappa 0.53). Based on previous data and the observed presence of disease activity, this definition of remission appears to be a measure of minimal disease activity rather than true remission. The problem of remission rates will not be solved until a consensus definition that has relevance in research and the clinic is developed.