bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated beam placement for breast radiotherapy using a support vector machine based algorithm
Authors: Zhao Xuan , Kong Dewen , Jozsef Gabor , Chang Jenghwa , Wong Edward K. , Formenti Silvia C. , Wang Yao 
Published: April 2012

Purpose:To develop an automated beam placement technique for whole breast radiotherapy using tangential beams. We seek to find optimal parameters for tangential beams to cover the whole ipsilateral breast (WB) and minimize the dose to the organs at risk (OARs).Methods:A support vector machine (SVM) based method is proposed to determine the optimal posterior plane of the tangential beams. Relative significances of including/avoiding the volumes of interests are incorporated into the cost function of the SVM. After finding the optimal 3‐D plane that separates the whole breast (WB) and the included clinical target volumes (CTVs) from the OARs, the gantry angle, collimator angle, and posterior jaw size of the tangential beams are derived from the separating plane equation. Dosimetric measures of the treatment plans determined by the automated method are compared with those obtained by applying manual beam placement by the physicians. The method can be further extended to use multileaf collimator (MLC) blocking by optimizing posterior MLC positions.Results:The plans for 36 patients (23 prone‐ and 13 supine‐treated) with left breast cancer were analyzed. Our algorithm reduced the volume of the heart that receives >500 cGy dose (V5) from 2.7 to 1.7 cm3 (p = 0.058) on average and the volume of the ipsilateral lung that receives >1000 cGy dose (V10) from 55.2 to 40.7 cm3 (p = 0.0013). The dose coverage as measured by volume receiving >95% of the prescription dose (V95%) of the WB without a 5 mm superficial layer decreases by only 0.74% (p = 0.0002) and the V95% for the tumor bed with 1.5 cm margin remains unchanged.Conclusions:This study has demonstrated the feasibility of using a SVM‐based algorithm to determine optimal beam placement without a physician's intervention. The proposed method reduced the dose to OARs, especially for supine treated patients, without any relevant degradation of dose homogeneity and coverage in general.
Associations between deprivation and rates of childhood overweight and obesity in England, 2007–2010: an ecological study
Authors: Conrad David , Capewell Simon 
Published: April 2012

ObjectivesTo investigate the associations between deprivation and rates of childhood overweight and obesity in England, from 2007 to 2010.DesignAn ecological study using routine data from the National Child Measurement Programme and Indices of Multiple Deprivation (IMD) 2010 scores.SettingLocal authority districts in England.ParticipantsSchoolchildren in Reception year (age 4–5 years) and Year 6 (age 10–11 years) attending non-specialist maintained state schools in England.Primary and secondary outcome measuresPrevalence of overweight in both Reception and Year 6, prevalence of obesity in both Reception and Year 6 and IMD 2010 scores for each local authority.ResultsIn 2009–2010, local authority IMD 2010 scores were strongly correlated with obesity rates among schoolchildren in Reception (r=0.625, p<0.001) and Year 6 (r=0.733, p<0.001). There were no statistically significant changes in association between obesity in Reception or Year 6 and IMD from 2007–2008 to 2009–2010. In contrast, the prevalence of overweight was not statistically significantly correlated with local authority IMD scores in Reception (r=0.095, p=0.092) and only weakly correlated in Year 6 (r=0.184, p=0.001). There were no statistically significant changes in association between overweight in Reception or Year 6 and IMD from 2007–2008 to 2009–2010.ConclusionsChildhood obesity rates in England are strongly associated with deprivation. Given the enormous public health implications of overweight and obesity in the population, these findings suggest that significant effort is required to tackle unhealthy weight in children in all local authorities and that this should be a priority in areas with high levels of deprivation.
A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa
Authors: Mash Rachel , Mash Robert James 
Published: April 2012

IntroductionReligion is important in most African communities, but faith-based HIV prevention programmes are infrequent and very rarely evaluated.ObjectiveThe aim of this study was to evaluate the effectiveness of a church-based peer education HIV prevention programme that focused on youth.DesignA quasi-experimental study design compared non-randomly chosen intervention and control groups.SettingThis study was conducted in the Cape Town Diocese of the Anglican Church of Southern Africa.ParticipantsThe intervention group of 176 teenagers was selected from youth groups at 14 churches and the control group of 92 from youth groups at 17 churches. Intervention and control churches were chosen to be as similar as possible to decrease confounding.InterventionThe intervention was a 20-session peer education programme (Fikelela: Agents of Change) aimed at changing risky sexual behaviour among youth (aged 12–19 years). Three workshops were also held with parents.Primary and secondary outcome measuresThe main outcome measures were changes in age of sexual debut, secondary abstinence, condom use and numbers of partners.ResultsThe programme was successful at increasing condom usage (condom use score 3.5 vs 2.1; p=0.02), OR 6.7 (95% CI 1.1 to 40.7), and postponing sexual debut (11.9% vs 21.4%; p=0.04) absolute difference 9.5%. There was no difference in secondary abstinence (14.6% vs 12.5%; p=0.25) or with the number of partners (mean 1.7 vs 1.4; p=0.67) and OR 2.2 (95% CI 0.7 to 7.4).ConclusionAn initial exploratory quasi-experimental evaluation of the Agents of Change peer education programme in a church-based context found that the age of sexual debut and condom usage was significantly increased. The study demonstrated the potential of faith-based peer education among youth to make a contribution to HIV prevention in Africa. Further evaluation of the effectiveness of the programme is, however, required before widespread implementation can be recommended.
Are neighbourhood food resources distributed inequitably by income and race in the USA? Epidemiological findings across the urban spectrum
Authors: Richardson Andrea S , Boone-Heinonen Janne , Popkin Barry M , Gordon-Larsen Penny 
Published: April 2012

ObjectiveMany recent policies focus on socioeconomic inequities in availability of healthy food stores and restaurants. Yet understanding of how socioeconomic inequities vary across neighbourhood racial composition and across the range from rural to urban settings is limited, largely due to lack of large, geographically and socio-demographically diverse study populations. Using a national sample, the authors examined differences in neighbourhood food resource availability according to neighbourhood-level poverty and racial/ethnic population in non-urban, low-density urban and high-density urban areas.DesignCross-sectional data from an observational cohort study representative of the US middle and high school-aged population in 1994 followed into young adulthood.ParticipantsUsing neighbourhood characteristics of participants in the National Longitudinal Study of Adolescent Health (Wave III, 2001–2002; n=13 995 young adults aged 18–28 years representing 7588 US block groups), the authors examined associations between neighbourhood poverty and race/ethnicity with neighbourhood food resource availability in urbanicity-stratified multivariable linear regression.Primary and secondary outcome measuresNeighbourhood availability of grocery/supermarkets, convenience stores and fast-food restaurants (measured as number of outlets per 100 km roadway).ResultsNeighbourhood race and income disparities were most pronounced in low-density urban areas, where high-poverty/high-minority areas had lower availability of grocery/supermarkets (β coefficient (β)=–1.91, 95% CI –2.73 to –1.09) and convenience stores (β=–2.38, 95% CI –3.62 to –1.14) and greater availability of fast-food restaurants (β=4.87, 95% CI 2.26 to 7.48) than low-poverty/low-minority areas. However, in high-density urban areas, high-poverty/low-minority neighbourhoods had comparatively greater availability of grocery/supermarkets (β=8.05, 95% CI 2.52 to 13.57), convenience stores (β=2.89, 95% CI 0.64 to 5.14) and fast-food restaurants (β=4.03, 95% CI 1.97 to 6.09), relative to low-poverty/low-minority areas.ConclusionsIn addition to targeting disproportionate fast-food availability in disadvantaged dense urban areas, our findings suggest that policies should also target disparities in grocery/supermarket and fast-food restaurant availability in low-density areas.
Structural determinants of food insufficiency, low dietary diversity and BMI: a cross-sectional study of HIV-infected and HIV-negative Rwandan women
Authors: Sirotin Nicole , Hoover Donald , Segal-Isaacson C J , Shi Qiuhu , Adedimeji Adebola , Mutimura Eugene , Cohen Mardge , Anastos Kathryn 
Published: April 2012

ObjectivesIn Sub-Saharan Africa, the overlapping epidemics of undernutrition and HIV infection affect over 200 and 23 million people, respectively, and little is known about the combined prevalence and nutritional effects. The authors sought to determine which structural factors are associated with food insufficiency, low dietary diversity and low body mass index (BMI) in HIV-negative and HIV-infected Sub-Saharan women.Study designCross-sectional analysis of a longitudinal cohort.SettingCommunity-based women's organisations.Participants161 HIV-negative and 514 HIV-infected Rwandan women.Primary and secondary outcome measuresPrimary outcomes included food insufficiency (reporting ‘usually not’ or ‘never’ to ‘Do you have enough food?’), low household dietary diversity (Household Dietary Diversity Score ≤3) and BMI <18.5 (kg/m2). The authors also measured structural and behavioural factors including: income, household size, literacy and alcohol use.ResultsFood insufficiency was prevalent (46%) as was low dietary diversity (43%) and low BMI (15%). Food insufficiency and dietary diversity were associated with low income (adjusted odds ratio (aOR)=2.14 (95% CI 1.30 to 3.52) p<0.01), (aOR=6.51 (95% CI 3.66 to 11.57) p<0.001), respectfully and illiteracy (aOR=2.00 (95% CI 1.31 to 3.04) p<0.01), (aOR=2.10 (95% CI 1.37 to 3.23) p<0.001), respectfully and were not associated with HIV infection. Alcohol use was strongly associated with food insufficiency (aOR=3.23 (95% CI 1.99 to 5.24) p<0.001). Low BMI was inversely associated with HIV infection (aOR≈0.5) and was not correlated with food insufficiency or dietary diversity.ConclusionsRwandan women experienced high rates of food insufficiency and low dietary diversity. Extreme poverty, illiteracy and alcohol use, not HIV infection alone, may contribute to food insufficiency in Rwandan women. Food insufficiency, dietary diversity and low BMI do not correlate with one another; therefore, low BMI may not be an adequate screening tool for food insufficiency. Further studies are needed to understand the health effects of not having enough food, low food diversity and low weight in both HIV-negative and HIV-infected women.
A retrospective cohort study assessing patient characteristics and the incidence of cardiovascular disease using linked routine primary and secondary care data
Authors: Payne Rupert A , Abel Gary A , Simpson Colin R 
Published: April 2012

ObjectivesData linkage combines information from several clinical data sets. The authors examined whether coding inconsistencies for cardiovascular disease between components of linked data sets result in differences in apparent population characteristics.DesignRetrospective cohort study.SettingRoutine primary care data from 40 Scottish general practitioner (GP) surgeries linked to national hospital records.Participants240 846 patients, aged 20 years or older, registered at a GP surgery.OutcomesCases of myocardial infarction, ischaemic heart disease and stroke (cerebrovascular disease) were identified from GP and hospital records. Patient characteristics and incidence rates were assessed for all three clinical outcomes, based on GP, hospital, paired GP/hospital (similar diagnoses recorded simultaneously in both data sets) or pooled GP/hospital records (diagnosis recorded in either or both data sets).ResultsFor all three outcomes, the authors found evidence (p<0.05) of different characteristics when using different methods of case identification. Prescribing of cardiovascular medicines for ischaemic heart disease was greatest for cases identified using paired records (p≤0.013). For all conditions, 30-day case fatality rates were higher for cases identified using hospital compared with GP or paired data, most noticeably for myocardial infarction (hospital 20%, GP 4%, p=0.001). Incidence rates were highest using pooled GP/hospital data and lowest using paired data.ConclusionsDifferences exist in patient characteristics and disease incidence for cardiovascular conditions, depending on the data source. This has implications for studies using routine clinical data.
Effects of the Great East Japan Earthquake and huge tsunami on glycaemic control and blood pressure in patients with diabetes mellitus
Authors: Ogawa Susumu , Ishiki Mikihito , Nako Kazuhiro , Okamura Masashi , Senda Miho , Sakamoto Takuya , Ito Sadayoshi 
Published: April 2012

ObjectiveTo examine the effects of a huge tsunami resulting from the Great East Japan Earthquake on blood pressure (BP) control and glycaemic control in diabetic patients.DesignA retrospective study.SettingTohoku University, Japan.Participants63 patients were visiting Rikuzentakata Hospital for diabetic treatment before the earthquake and returned to the clinic in July after the earthquake, and they were analysed in the present study. The subjects were divided into two groups: those who were hit by the tsunami, the Tsunami (+) group (n=28), and those who were not, the Tsunami (−) group (n=35), and the groups' parameters and their changes were compared.Primary outcome measureChanges of HbA1c.Secondary outcome measuresChanges of BP, body mass index.ResultsHbA1c and both BP increased, while the numbers of most drugs taken decreased in both groups. Parameter changes were significantly greater in the Tsunami (+) group. All medical data stored at the hospital was lost in the tsunami. The Tsunami (+) patients also had their own records of treatment washed away, so it was difficult to replicate their pre-earthquake drug prescriptions afterwards. In comparison, the Tsunami (−) patients kept their treatment information, making it possible to resume the treatment they had been receiving before the earthquake. The BP rose only slightly in men, whereas it rose sharply in women, even though they had not been directly affected by the tsunami. BP rose markedly in both genders affected by the tsunami.ConclusionsAll medical information was lost in the tsunami, and glycaemic and BP controls of the tsunami-affected patients worsened more than those of patients who had been affected by the earthquake alone. Women may be more sensitive to changes in the living environment that result from a major earthquake than are men.
Unsatisfactory rates vary between cervical cytology samples prepared using ThinPrep and SurePath platforms: a review and meta-analysis
Authors: Fontaine Daniel , Narine Nadira , Naugler Christopher 
Published: April 2012

ObjectiveTo compare unsatisfactory rates between the two major liquid-based cytology (LBC) platforms, namely ThinPrep (Hologic) and SurePath (Becton Dickinson).DesignThe authors performed both a systematic review and a meta-analysis. Inclusion criteria were English language, data presented on unsatisfactory rates for either ThinPrep or SurePath, utilising actual patient samples (ie, not laboratory manipulated samples) and no manipulation using acetic acid to increase the satisfactory rate. The authors searched PubMed for articles using the keywords ‘SurePath’ or ‘ThinPrep’ and ‘unsatisfactory’. References of retrieved studies were searched for additional articles. Key researchers in the field were also contacted.Participants and interventionsEligible studies were reviewed for rates of unsatisfactory cervical cytology smears processed on either the ThinPrep or SurePath platforms (compared with a general linear model) or data on unsatisfactory rates for both platforms for the same laboratory and the same patient population (compared with a meta-analysis using a random effects model and pooled RR).Primary Outcome MeasureUnsatisfactory rate of cervical cytology smears.ResultsA total of 1 120 418 cervical cytology smears were reported in 14 different studies using the SurePath platform for an overall unsatisfactory rate (weighted average) of 0.3%. 28 studies reported on 1 148 755 smears prepared using the ThinPrep platform for an overall unsatisfactory rate (weighted average) of 1.3%. The general linear model did not show a difference between LBC platforms when other variables were controlled for; however, the power to detect a difference (0.087) was very low. The meta-analysis performed on four studies where both ThinPrep and SurePath results were reported from the same laboratory showed fewer unsatisfactory tests from the SurePath platform (RR 0.44, 95% CI 0.25 to 0.77, p=0.004).ConclusionsMultiple factors affect LBC unsatisfactory rates. In a meta-analysis, cervical cytology samples prepared on the SurePath platform show significantly fewer unsatisfactory smears than those prepared on the ThinPrep platform.
Observational cohort study of the safety of digoxin use in women with heart failure
Authors: Flory James H , Ky Bonnie , Haynes Kevin , M Brunelli Steve , Munson Jeffrey , Rowan Christopher , Strom Brian L , Hennessy Sean 
Published: April 2012

ObjectivesThis study aims to assess whether digoxin has a different effect on mortality risk for women than it does for men in patients with heart failure (HF).DesignThis study uses the UK-based The Health Information Network population database in a cohort study of the impact of digoxin exposure on mortality for men and women who carry the diagnosis of HF. Digoxin exposure was assessed based on prescribing data. Multivariable Cox proportional hazards models were used to assess whether there was an interaction between sex and digoxin affecting mortality hazard.SettingThe setting was primary care outpatient practices.ParticipantsThe study cohort consisted of 17 707 men and 19 227 women with the diagnosis of HF who contributed only time without digoxin exposure and 9487 men and 10 808 women with the diagnosis of HF who contributed time with digoxin exposure.Main outcome measuresThe main outcome measure was all-cause mortality.ResultsThe primary outcome of this study was the absence of a large interaction between digoxin use and sex affecting mortality. For men, digoxin use was associated with a HR for mortality of 1.00, while for women, the HR was also 1.00 (p value for interaction 0.65). The results of sensitivity analyses were consistent with those of the primary analysis.ConclusionObservational data do not support the concern that there is a substantial increased risk of mortality due to the use of digoxin in women. This finding is consistent with previous observational studies but discordant with results from a post hoc analysis of a randomised controlled trial of digoxin versus placebo.
Comparison of a digital and an optical analogue hand‐held refractometer for the measurement of canine urine specific gravity
Authors: Paris J. K. , Bennett A. D. , Dodkin S. J. , Gunn‐Moore D. A. 
Published: April 2012

Urine specific gravity (USG) is used clinically as a measure of urine concentration, and is routinely assessed by refractometry. A comparison between optical analogue and digital refractometers for evaluation of canine urine has not been reported. The aim of this study was to compare a digital and an optical analogue hand‐held refractometer for the measurement of canine USG, and to assess correlation with urine osmolality. Prospective study. Free‐catch urine samples were collected from 285 hospitalised adult dogs, and paired USG readings were obtained with a digital and an optical analogue refractometer. In 50 dogs, urine osmolality was also measured using a freezing point depression osmometer. There was a small but statistically significant difference between the two refractometers (P<0.001), with the optical analogue refractometer reading higher than the digital refractometer (mean difference 0.0006, sd 0.0012). Paired refractometer measurements varied by <0.002 in 91.5 per cent of cases. The optical analogue and digital refractometer readings showed excellent correlation with osmolality (r=0.980 and r=0.977, respectively, P<0.001 in both cases). Despite statistical significance, the difference between the two refractometers is unlikely to be clinically significant. Both instruments provide an accurate assessment of USG in dogs.
Visual cleanliness scores of cattle at slaughter and microbial loads on the hides and the carcases
Authors: Blagojevic B. , Antic D. , Ducic M. , Buncic S. 
Published: April 2012

In two abattoirs, visual cleanliness of 100 cattle was assessed before slaughter (on a scale of 1 to 4). From each animal, two sponge swabs (approximately 2000 cm2 area, each) were taken: (a) from hide, immediately after sticking, and (b) from final carcase, but before chilling. In each swab sample, total viable count (TVC), Enterobacteriaceae count (EC) and the presence of Escherichia coli O157 were determined. The mean TVC/EC status of hides and final carcases differed significantly only between very dirty cattle (category 4) and all other less dirty or clean cattle (categories 1, 2 and 3), but not between the less dirty and clean cattle (between categories 1, 2 and 3). However, no clear relationship between the visual cleanliness of the hide and the occurrence of E coli O157 on hide or dressed carcases was observed. The study indicated the possibility that visual categorisation of cattle into only two main categories – one containing very dirty animals (category 4 in this work, corresponding to categories 4 + 5 in The UK Food Standards Agency system) and another containing all the other less dirty or clean animals (categories 1 + 2 + 3) – could be sufficient in practice
Hematopoietic Progenitor Cells and Restenosis After Carotid Endarterectomy
Authors: Patel Sanjay D. , Humphries Julia , Mattock Katherine , Wadoodi Ashar , Modarai Bijan , Ahmad Anwar , Burnand Kevin G. , Waltham Matthew , Smith Alberto 
Published: April 2012

Background and Purpose—
Hematopoietic progenitor cells (HPCs) may attenuate the response to vascular injury by maintaining endothelial integrity and function. Our aim was to determine whether circulating HPC number and function correlate with restenosis after carotid endarterectomy.

Methods—

HPC number (CD34
+
/CD133
+
cells), early colony-forming units, migratory capacity, and senescence were analyzed in blood collected preoperatively, 1 day, and 6 weeks postoperatively. Mobilizing cytokine levels were also measured. Stenosis was assessed by duplex scanning.

Results—

HPC numbers (
P
<0.001) and early colony-forming unit count (
P
=0.001) fell rapidly 24 hours postoperatively. Restenosis at 6 months correlated negatively with the magnitude of postoperative falls in HPC numbers (
R
=−0.38,
P
=0.013) and early colony-forming unit counts (
R
=−0.42,
P
=0.008). The migratory capacity of preoperative HPCs correlated negatively with restenosis (
R
=−0.48,
P
=0.007). Preoperative SDF1 levels correlated with falls in HPC number (
R
=0.42,
P
=0.044) and early colony-forming unit counts (
R
=0.56,
P
=0.004).

Conclusions—
HPC function appears to be linked to the development of carotid artery restenosis after endarterectomy. These data support the concept that HPCs have a role in regulating remodeling of the injured arterial wall.