bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying research priorities for health care priority setting: a collaborative effort between managers and researchers
Authors: Smith Neale , Mitton Craig , Peacock Stuart , Cornelissen Evelyn , MacLeod Stuart 
Published: September 2009

Abstract

Background
To date there has been relatively little published about how research priorities are set, and even less about methods by which decision-makers can be engaged in defining a relevant and appropriate research agenda. We report on a recent effort in British Columbia to have researchers and decision-makers jointly establish an agenda for future research into questions of resource allocation.

Methods
The researchers enlisted decision-maker partners from each of British Columbia's six health authorities. Three forums were held, at which researchers and decision-makers from various levels in the health authorities considered possible research areas related to three key focus areas: (1) generation and use of decision criteria and measurement of 'benefit' against such criteria; (2) identification of so-called 'disinvestment' opportunities; and (3) evaluation of the effectiveness of priority setting procedures. Detailed notes were taken from each forum and synthesized into a set of qualitative themes.

Results
Forum participants suggested that future research into healthcare priority setting would benefit from studies that were longitudinal, comparative, and/or interdisciplinary. As well, participants identified two broad theme areas in which specific research projects were deemed desirable. First, future research might usefully consider how formal priority setting and resource allocation projects are situated within a larger organizational and political context. Second, additional research efforts should be devoted to better understanding and improving the actual implementation of priority setting frameworks, particularly with respect to issues of change management and the resolution of impediments to action on recommendations for resource allocation.

Conclusion
We were able to validate the importance of initial areas posed to the group and observed emergence of additional concerns and directions of critical importance to these decision-makers at this time. It is likely that the results are broadly applicable to other healthcare contexts. The implementation of this research agenda in British Columbia will depend upon the ability of the researchers and decision-makers to develop particular projects that fit within the constraints of existing funding opportunities. The process of engagement itself had benefits in terms of connecting decision-makers with their peers and sparking increased interest in the use and refinement of priority setting frameworks.
The axonal repellent, Slit2, inhibits directional migration of circulating neutrophils
Authors: Tole Soumitra , Mukovozov Ilya M , Huang Yi-Wei , Magalhaes Marco A O , Yan Ming , Crow Min Rui , Liu Guang Ying , Sun Chun Xiang , Durocher Yves , Glogauer Michael , Robinson Lisa A 
Published: September 2009

Abstract
Slit2, a potentially powerful anti-inflammatory agent, inhibits polarization and chemotaxis, but not random movement, of primary neutrophils towards diverse chemoattractants, in vitro and in vivo.
In inflammatory diseases, circulating neutrophils are recruited to sites of injury. Attractant signals are provided by many different chemotactic molecules, such that blockade of one may not prevent neutrophil recruitment effectively. The Slit family of secreted proteins and their transmembrane receptor, Robo, repel axonal migration during CNS development. Emerging evidence shows that by inhibiting the activation of Rho-family GTPases, Slit2/Robo also inhibit migration of other cell types toward a variety of chemotactic factors in vitro and in vivo. The role of Slit2 in inflammation, however, has been largely unexplored. We isolated primary neutrophils from human peripheral blood and mouse bone marrow and detected Robo-1 expression. Using video-microscopic live cell tracking, we found that Slit2 selectively impaired directional migration but not random movement of neutrophils toward fMLP. Slit2 also inhibited neutrophil migration toward other chemoattractants, namely C5a and IL-8. Slit2 inhibited neutrophil chemotaxis by preventing chemoattractant-induced actin barbed end formation and cell polarization. Slit2 mediated these effects by suppressing inducible activation of Cdc42 and Rac2 but did not impair activation of other major kinase pathways involved in neutrophil migration. We further tested the effects of Slit2 in vivo using mouse models of peritoneal inflammation induced by sodium periodate, C5a, and MIP-2. In all instances, Slit2 reduced neutrophil recruitment effectively (P&lt;0.01). Collectively, these data demonstrate that Slit2 potently inhibits chemotaxis but not random motion of circulating neutrophils and point to Slit2 as a potential new therapeutic for preventing localized inflammation.
Sonographic and Electrodiagnostic Evaluations in Patients With Aromatase Inhibitor–Related Arthralgia
Authors: Dizdar Omer , Özçakar Levent , Malas Fevziye Ünsal , Harputluoglu Hakan , Bulut Nilufer , Aksoy Sercan , Ozisik Yavuz , Altundag Kadri 
Published: September 2009

Purpose To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal sonography, and electromyography (EMG) in these patients. Patients and Methods Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92). Patients who were not receiving hormone treatment were included as a control group (n = 28). Musculoskeletal sonography and EMG were applied to the patients and the controls along with markers of autoimmunity. Results Thirty patients (32.6%) reported to have AI-related new-onset or worsening arthralgia. The most commonly affected joints were knee (70%), wrist (70%), and small joints of the hand (63%). Patients taking AIs had increased tendon thicknesses compared with those who never received AIs (P < .001). Patients with AI-related arthralgia had higher rates of effusion in hand joints/tendons than those without arthralgia (P = .033). More patients with AI-related arthralgia had EMG findings consistent with carpal tunnel syndrome (CTS) than those without arthralgia (P = .024). No significant difference was observed in erythrocyte sedimentation rates, C-reactive protein, antinuclear antibody, antidouble stranded DNA antibody, rheumatoid factor, or anticyclic citrullinated peptide levels between patients and controls or between those with and without arthralgia. Conclusion Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component. Our finding of increased CTS frequency also supports this hypothesis.
Immunophenotypic Analysis of AIDS-Related Diffuse Large B-Cell Lymphoma and Clinical Implications in Patients From AIDS Malignancies Consortium Clinical Trials 010 and 034
Authors: Chadburn Amy , Chiu April , Lee Jeannette Y. , Chen Xia , Hyjek Elizabeth , Banham Alison H. , Noy Ariela , Kaplan Lawrence D. , Sparano Joseph A. , Bhatia Kishor , Cesarman Ethel 
Published: September 2009

PurposeDiffuse large B-cell lymphoma (DLBCL) represents a clinically heterogeneous disease. Models based on immunohistochemistry predict clinical outcome. These include subdivision into germinal center (GC) versus non-GC subtypes; proliferation index (measured by expression of Ki-67), and expression of BCL-2, FOXP1, or B-lymphocyte-induced maturation protein (Blimp-1)/PRDM1. We sought to determine whether immunohistochemical analyses of biopsies from patients with DLBCL having HIV infection are similarly relevant for prognosis.Patients and MethodsWe examined 81 DLBCLs from patients with AIDS in AMC010 (cyclophosphamide, doxorubicin, vincristine, and prednisone [CHOP] v CHOP-rituximab) and AMC034 (etoposide, doxorubicin, vincristine, prednisone, and dose-adjusted cyclophosphamide plus rituximab concurrent v sequential) clinical trials and compared the immunophenotype with survival data, Epstein-Barr virus (EBV) positivity, and CD4 counts.ResultsThe GC and non-GC subtypes of DLBCL did not differ significantly with respect to overall survival or CD4 count at cancer presentation. EBV could be found in both subtypes of DLBCL, although less frequently in the GC subtype, and did not affect survival. Expression of FOXP1, Blimp-1/PRDM1, or BCL-2 was not correlated with the outcome in patients with AIDS-related DLBCL.ConclusionThese data indicate that with current treatment strategies for lymphoma and control of HIV infection, commonly used immunohistochemical markers may not be clinically relevant in HIV-infected patients with DLBCL. The only predictive immunohistochemical marker was found to be Ki-67, where a higher proliferation index was associated with better survival, suggesting a better response to therapy in patients whose tumors had higher proliferation rates.
Myeloperoxidase Genotypes and Enhanced Efficacy of Chemotherapy for Early-Stage Breast Cancer in SWOG-8897
Authors: Ambrosone Christine B. , Barlow William E. , Reynolds Wanda , Livingston Robert B. , Yeh I-Tien , Choi Ji-Yeob , Davis Warren , Rae James M. , Tang Li , Hutchins Laura R. , Ravdin Peter M. , Martino Silvana , Osborne C. Kent , Lyss Alan P. , Hayes Daniel F. , Albain Kathy S. 
Published: September 2009

PurposeMyeloperoxidase (MPO) generates reactive oxygen species and also activates xenobiotics . In a rigorous clinical trial (Southwest Oncology Group SWOG-8897), we examined relationships between genotypes and disease-free survival (DFS) among women treated for breast cancer, as well as those who did not receive adjuvant chemotherapy.Patients and MethodsPatients were assigned to risk groups according to standard prognostic features; the low-risk group (n = 753 genotyped) received follow-up only, and the high-risk group (n = 401 genotyped) was randomly assigned to adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) or cyclophosphamide, doxorubicin, and fluorouracil (CAF), with or without tamoxifen. DNA from archived normal lymph node tissue was genotyped, and Cox proportional hazard models were used to calculate DFS associated with MPO genotypes.ResultsAmong women in the treatment arm, those with MPO G alleles had more than a two-fold reduction in hazard of recurrence (adjusted hazard ratio [HR] for GA genotypes, 0.51; 95% CI, 0.21 to 0.99; HR for GG genotypes, 0.41; 95% CI, 0.21 to 0.77). Effects were greatest among women who were further randomly assigned to tamoxifen (HR for GA genotypes, 0.28; 95% CI, 0.12 to 0.69; HR for GG genotypes, 0.19; 95% CI, 0.08 to 0.45). There were no significant associations between genotypes and DFS among women in the untreated arm, and relationships between genotypes and DFS did not differ by CAF or CMF.ConclusionThese results, observed in two independent study populations, indicate that high-activity MPO genotypes are associated with better survival among women receiving cyclophosphamide-containing therapy, particularly when followed by tamoxifen therapy. MPO can be inhibited and/or upregulated by commonly used drugs; thus, our findings merit further investigation for optimization of therapeutics for breast cancer.
Aromatase Inhibitor–Induced Carpal Tunnel Syndrome: Results From the ATAC Trial
Authors: Sestak Ivana , Sapunar Francisco , Cuzick Jack 
Published: September 2009

Purpose Carpal tunnel syndrome (CTS) is a condition in which the median nerve is compressed, leading to pain and muscle weakness in the fingers and hand. Aromatase inhibitors lead to profound estrogen suppression and may be expected to increase the risk of CTS in postmenopausal women receiving adjuvant therapy for early breast cancer. Patients and Methods The current analyses were based on the 100-month median follow-up data in postmenopausal women in the two monotherapy arms (anastrozole, n = 3,092; tamoxifen, n = 3,094). Here, we investigate the natural history of patients who presented with CTS during adjuvant treatment for breast cancer and the relative importance of a range of known risk factors for CTS. Results After 100 months of follow-up, 80 cases (2.6%) of CTS were reported in the anastrozole arm, compared with 23 cases (0.7%) in the tamoxifen arm (P < .0001). The majority of CTS cases were reported as mild to moderate intensity and occurred early. None of the women stopped treatment medication as a result of CTS. CTS was significantly increased for women who used prior hormone replacement therapy (P = .007) or received prior chemotherapy (P = .01). Those who were 60 years of age or older at entry were at lower risk of CTS compared with their counterparts (P = .002). Conclusion Although the use of anastrozole is associated with a greater incidence of CTS, it is rare, and most cases were of mild to moderate intensity and short duration. CTS has little impact on the overall risk-to-benefit ratio for the use of anastrozole in postmenopausal women with early breast cancer.
Altered consciousness in Ugandan hospital admissions
Authors: Rwebembera Joselyn , Wilson Tony 
Published: September 2009

An awareness of diseases causing altered mental status (AMS) in particular localities could greatly facilitate patient management. This cross-sectional study evaluated 100 consecutive patients with AMS admitted to a hospital in Uganda. Patients were assessed by the Confusion Assessment Method. History, examination, available laboratory tests and patients' response to treatment were used to identify aetiologies. Our study included 58 males and 42 females: 82% were 16–50 years old and 38% were HIV-infected. The most common cause of AMS was infection (51.3%), with cerebral malaria and meningitis predominating. The aetiology was unidentified in 12%. The in-hospital mortality rate was 44%, with HIV infection being positively associated. As infections and metabolic derangements, the most common causes of AMS in our setting, are mostly treatable with a relatively favourable outcome, critical evaluation, early intervention and improved investigative capacity would greatly improve patient outcome.
The Assessment of Specimens Procured by Endoscopic Ampullectomy
Authors: Bellizzi Andrew M. , Kahaleh Michel , Stelow Edward B. 
Published: September 2009

Abstract
Endoscopic ampullectomy (EA) is increasingly used in the management of ampullary neoplasia. Although studies on the safety and efficacy of this procedure exist, no study has specifically addressed the histopathologic features of the specimens. We review our experience with 45 EA specimens assessed for the following: diagnosis, high-grade dysplasia (HGD), submucosal ampullary gland/ductule involvement, specimen integrity, and margin status. Familial adenomatous polyposis (FAP) status and the endoscopist’s impression of completeness of removal were also ascertained. Previous biopsy diagnoses were compared with ampullectomy diagnoses, and histologic and clinical features were correlated with disease persistence. The histologic features of the ampullectomy specimens were as follows: diagnosis (no diagnostic abnormality, 3; reactive, 8; adenoma, 26; adenocarcinoma, 7; other, 1); HGD, 1; submucosal ampullary gland/ductule involvement, 20; specimen integrity (intact, 22; fragmented, 23); and margin status (positive, 20; negative, 2; could not be assessed, 12). Five patients had FAP, and EA was deemed complete in 21 (47%). The diagnostic agreement between preampullectomy biopsy and ampullectomy was 64%. Of the patients, 33 (73%) had documented persistent disease. None of the histologic or clinical features had a statistically significant relationship with disease persistence.
Validation of a Miniature Tensile Strength Measurement System
Authors: Roebuck B , Lord JD , Orkney LP 
Published: September 2009

Miniature strength test systems are of use for several reasons. For example, many advanced materials are often in limited supply and the use of small testpieces can accelerate the production of useful data. Also, small sections can be taken from working components and tested to assess material degradation without affecting performance. An important criteria for choice of testpiece size is such that the microstructure within the testpiece is representative of the structure as a whole. However, strain measurement becomes more of a challenge as the testpiece size diminishes. Typically extensometers are used on gauge lengths of 10–25 mm, thus smaller testpieces present some problems in the use of conventional extensometers. Because of these difficulties an alternative method of strain measurement, based on changes in resistance, was used in the current work.
A miniature test system, the ETMT (ElectroThermoMechanical Test), developed at the National Physical Laboratory, was used to measure the stress/strain characteristics, particularly at elevated temperatures, of two material types, paniculate reinforced aluminium alloy composites and a Ni-based superalloy, Nimonic 901. The testpiece dimensions were typically 30 × 2 × 1 mm, with a grip separation of 16–20 mm. Elevated temperatures were achieved using a DC heating current. Strain was measured using changes in electrical resistance of a central gauge length of the testpiece, about 2–3 mm in length. Because the strain measurement method was nonstandard the stress/strain data were compared with measurements made from conventional tensile tests using rectangular dogbone testpieces, with a 6 × 3 mm gauge length cross section.
The comparison between the ETMT results and those obtained from elevated temperature conventional tests showed that the effects of deformation rate were very important. Thus the use of miniature testpieces can be a cost effective and rapid technique for obtaining material property data, but it is important to report values for all the parameters that can effect the measurement of strength.
Environmentally Friendly Bearing Steel With Reduced Hardening Distortion
Authors: Lund TB , Ölund LJP 
Published: September 2009

Environmental issues are becoming increasingly important as the costs of waste disposal increase and global climate effects of petroleum product usage become more evident. A major problem in the manufacturing of bearing components today is the distortion generated in the heat treatment quenching operation. The quenching is difficult to control and is a polluting fire and health risk due to the quenching media used. The hardening distortion causes excessive grinding, and large efforts have been made to reduce distortion and the excessive grinding costs caused by this. Major efforts have been made to develop gas quenching, but as the standard steels used for component manufacturing today have very limited hardenability, only a minor share of the component range can be effectively gas quenched.
By utilizing modern tools for material development, a family of low-alloyed steel has been designed which combine environmental friendliness, minimum hardening distortion and improved product performance for industrial components. The steels also have been designed in such a way that standard, high volume production routes can be utilized, and -with the advances in hard machining — in many cases can be used to design new and very cost efficient ways of component production with a minimal environmental impact.
This paper presents a concept where components can be martensitically hardened in a simple air cooling, even directly on cooling from a hot forming operation. These steels significantly reduce hardening distortion, improve working environment and are environmentally friendly. They also offer the potential to change component production routes drastically and as well provide high performance components for large volume production.
Higher Macro-Cleanliness of Bearing Steels Needs More Accurate Measuring-Methods
Authors: Thiery D , Delhaes C 
Published: September 2009

Increasing requirements of trendsetter-industry (automotive and railway) on the performance of bearings demand also an improvement of the applied materials. That means principally to reduce macroscopic, non-metallic inclusions. Therefore, steel works need new targets to optimize metallurgical and casting techniques.
For this reason, ultrasonic examination methods are more and more applied to test bigger volumes instead of plains. Especially the immersion ultrasonic testing allows to detect smaller inhomogenities.
To get optimal testing conditions, SAARSTAHL AG and FhG-IZfP made pretests.
Then, the german steel industry in the VDEh made a circle examination to optimize and standardize the test conditions. The reproducible limit size of detectable defects seems to be an equivalent flat bottom hole of 300 to 400 μm for the chosen conditions.
All results of the circle examination were used to prepare detailed prescriptions for a test in form of a german standard (SEP 1927), presented in this paper.
Rolling Contact Fatigue Tests to Investigate Surface Initiated Damage and Tolerance to Surface Dents
Authors: Girodin D , Ville F , Guers R , Dudragne G 
Published: September 2009

The improvement in steel cleanliness has resulted in a large reduction of subsurface damage initiated on inclusions. As a consequence surface initiated failure related to lubricant contamination has become the main cause of damage in most commercial applications. Debris contaminants can produce dents on the raceways, which generate stress concentrations, leading to failure.
This paper describes experimental procedures developed to study the surface initiated damage mechanisms using two types of pre-damaging processes to simulate debris contaminant effects. - dents printed on the raceway using a diamond indenter, - natural dents obtained using a lubricant contaminated by fine hard particles
Three-dimensional surface topography was used to characterise dent morphology and to compare the influence of materials. The test results show that the pre-denting method using hard powder is more efficient to reproduce surface morphology and damage mechanisms observed under practical operating conditions.
A Comparison of the Mechanical and Physical Properties of Contemporary and New Alloys for Aerospace Bearing Applications
Authors: Ragen MA , Anthony DL , Spitzer RF 
Published: September 2009

This paper presents the results of several contributing sources in establishing the mechanical and physical properties of various new candidate alloys for aerospace bearing applications. The alloys evaluated included the high Nitrogen steels Cronidur 30 and XD15NW, the carburizing stainless steels Pyrowear 675 and CSS-42L, and the nitrided steel 32CDV13. The properties evaluated included hot hardness, recovery hardness, fracture toughness, corrosion resistance, abrasive wear resistance, and structural (rotating beam) fatigue strength. Elemental testing was performed independently of the material suppliers to evaluate these properties for the candidate alloys.
This paper is not intended to promote any one alloy as the best solution to all bearing needs, but rather to provide a data base to assist in the selection of the optimum solution to a specific bearing application. The test results obtained confirmed that each candidate material has unique strengths and weaknesses. For example, Cronidur 30 and XD15NW demonstrated very good corrosion resistance, but do not have good fracture toughness or wear resistance. Conversely, Pyrowear 675 and CSS-42L have very good fracture toughness, but are more susceptible to corrosion problems. The 32CDV13 nitrided steel also had very good fracture toughness and relatively good wear resistance, but demonstrated poor corrosion resistance.