bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomic Characteristics and Radiographic References of the Anterolateral and Posteromedial Bundles of the Posterior Cruciate Ligament
Authors: Osti Michael , Tschann Peter , Künzel Karl Heinz , Benedetto Karl Peter 
Published: April 2012

Background: Anatomic graft tunnel placement is reported to be essential in double-bundle posterior cruciate ligament (PCL) reconstruction. A measurement system that correlates anatomy and radiographs is lacking so far. Purpose: To define the femoral and tibial attachments of the anterolateral (AL) and posteromedial (PM) bundles and to correlate them with digital and radiographic images to establish a radiographic anatomy based on anatomic landmarks and evaluate whether radiographs can serve as an accurate method for intraoperative and postoperative assessments of tunnel placement. Study Design: Descriptive laboratory study. Methods: Fifteen human cadaveric knee specimens were used. After preparation, the insertion areas of the 2 fiber bundles were marked with colorants, and high-definition digital images were obtained. With radiopaque tubes placed in the center of each bundle’s footprint, anteroposterior and lateral radiographs were created. A measurement grid system was superimposed to determine the position of the AL and PM bundles’ femoral and tibial insertion areas on both digital images and radiographs. The measurement zones were numbered 1 to 16, starting in the anterosuperior corner and ending in the posteroinferior corner. Results: On radiographs and digital images, the femoral centers of the AL and PM bundles were found in zones 2 and 7, respectively. The tibial centers of the AL and PM bundles were found at 47.88% and 50.93%, respectively, of the total mediolateral diameter, 83.09% and 92.29%, respectively, of the total anteroposterior diameter, and 3.53 mm and 8.57 mm, respectively, inferior from the tibial plateau on radiographs. Conclusion: This study provides a geometric characterization of the AL and PM bundles of the PCL and establishes a reliable and feasible correlation system between anatomy and radiography based on anatomic landmarks. Clinical Relevance: Accurate definition of the insertion sites of the PCL is essential for anatomic double-bundle reconstruction. The results of our study may be used as a reference for intraoperative and postoperative assessments of correct femoral and tibial tunnel placements.
A Model Infant Feeding Policy for Baby-Friendly Designation in the USA
Authors: Feldman-Winter Lori , Procaccini Diane , Merewood Anne 
Published: April 2012

Background: In June 2010, the Communities Putting Prevention to Work program (Centers for Disease Control and Prevention) funded a New Jersey (NJ) Office on Nutrition and Fitness, Department of Health and Senior Services project to reduce obesity and increase exclusive breastfeeding by increased implementation of the Baby-Friendly Hospital Initiative in the state of NJ. At baseline, NJ had no Baby-Friendly hospitals and no hospital was using an infant feeding policy that conformed to standards required by Baby-Friendly USA for designation. Goal: To create a model infant feeding policy that would be adaptable for use at multiple NJ hospitals preparing for Baby-Friendly designation. Methods: Project consultants created a policy based on existent policies from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, certified Baby-Friendly hospitals, and guidance from Baby-Friendly USA. This policy was submitted to Baby-Friendly USA, the US body responsible for Baby-Friendly designation. Results: Baby-Friendly USA requested changes; after adaptations, the policy was made available to targeted NJ hospitals via a statewide portal. The hospitals made relevant adaptations for their setting, and those that were ready submitted the policy during the Baby-Friendly designation process. The policy was acceptable to Baby-Friendly USA. Conclusion: A collaborative initiative can use a single breastfeeding policy template as an aid toward Baby-Friendly designation. Such work streamlines the process and saves time and resources.
Biplanar MRI for the assessment of the spinal cord in multiple sclerosis
Authors: Weier Katrin , Mazraeh Jilla , Naegelin Yvonne , Thoeni Alain , Hirsch Jochen G , Fabbro Thomas , Bruni Nicole , Duyar Hüseyin , Bendfeldt Kerstin , Radue Ernst-Wilhelm , Kappos Ludwig , Gass Achim 
Published: April 2012

Objective: To investigate the entire spinal cord (SC) of multiple sclerosis (MS) patients with biplanar MRI and to relate these MRI findings to clinical functional scores. Methods: Two hundred and two patients (140 women, 62 men 24–74 years, Expanded Disability Status Scale (EDSS) scores 0–7.5) were investigated clinically and with biplanar MRI. Sagittal and axial proton density weighted (PDw) and T2 weighted (T2w) images of the whole SC were obtained employing parallel imaging. Data were analyzed by consensus reading using a standardized reporting scheme. Different combinations of findings were compared to EDSS scores with Spearman’s rank correlation coefficient (ρ). Results: The combined analysis of sagittal and axial planes demonstrated slightly differing results in 97/202 (48%) patients. There were 9% additional lesions identified, leading to a higher lesion count in 28% of these patients, but also rejection of equivocal abnormality leading to a lower lesion count in 11% of patients. Considering both sagittal and axial images, SC abnormalities were found in 167/202 (83%) patients. When compared with EDSS scores, the combination of focal lesions, signs of atrophy and diffuse abnormalities showed a moderate correlation (ρ=0.52), that precludes its use for individual patient assessment. Conclusion: Biplanar MRI facilitates a comprehensive identification, localization, and grading of pathological SC findings in MS patients. This improves the confidence and utility of SC imaging.
The relationship between three well-characterized polymorphisms of the angiotensin converting enzyme gene and lung cancer risk: a case-control study and a meta-analysis
Authors: Gao Min , Wang Yuli , Shi Yuzhi , Liu Dan , Liang Yin , Yu Yan , Zhaobin Jiahui , Zhu Lili , Jin Shoude 
Published: April 2012

Background and objective: The gene encoding angiotensin converting enzyme (ACE) is a promising candidate for lung cancer. We aimed to assess three well-characterized polymorphisms of the ACE gene (A-240T, I/D, A2350G) and lung cancer in Chinese people, and complete a meta-analysis of the association of I/D polymorphism with lung cancer. Methods and results: In our case-control study, a total of 684 patients with lung cancer and 602 age-matched controls were recruited. Genotyping was performed using polymerase chain reaction (PCR) and ligase detection reactions (LDR) techniques. Single-locus analysis indicated that carriers of the A-240T allele had a significantly increased risk for lung cancer under additive (odds ratio (OR)=1.2; 95% confidence interval (CI): 1.02–1.42; P=0.027) and recessive (OR=1.8; 95% CI: 1.24–2.63; P=0.002) models, and that DD genotype carriers were 1.97 times more likely to develop lung cancer (95% CI: 1.25–3.11; P=0.004) compared with those with the I allele under the recessive model. However, no significance was observed in further haplotype analysis ( P>0.05). In a meta-analysis of ACE gene insertion-deletion (I/D) polymorphism from six studies with 1183 lung cancer patients and 1065 controls, we failed to detect any significant association (overall OR=1.09; 95% CI: 0.84–1.41). A low probability of publication bias was observed. Conclusions: Our results suggest that ACE gene A-240T polymorphism might be a genetic marker for the development of lung cancer in Chinese people.
Positive conversion of negative signaling of CTLA4 potentiates antitumor efficacy of adoptive T-cell therapy in murine tumor models
Authors: Shin Jae Hun , Park Hyung Bae , Oh Yu Mi , Lim Dong Pyo , Lee Ji Eun , Seo Hae Hyun , Lee Sang Jin , Eom Hyeon Seok , Kim In-Hoo , Lee Seung Hoon , Choi Kyungho 
Published: April 2012

AbstractCytotoxic T lymphocyte–associated antigen 4 (CTLA4) has been known to be a strong tolerance-inducing inhibitory receptor on T-cell surface. Systemic blocking of CTLA4 function with blocking antibodies has been regarded as an attractive strategy to enhance antitumor immunity. However, this strategy accompanies systemic autoimmune side effects that are sometimes problematic. Therefore, we developed a novel CTLA4 mutant that could be expressed in tumor antigen-specific T cells to enhance antitumor effect without systemic autoimmunity. This mutant, named CTLA4-CD28 chimera, consists of extracellular and transmembrane domains of CTLA4, linked with cytoplasmic CD28 domain. Overexpression of CTLA4-CD28 chimera in T cells delivered stimulatory signals rather than inhibitory signals of CTLA4 and significantly enhanced T-cell reactivity. Although this effect was observed in both CD4 and CD8 T cells, the effect on CD4 T cells was predominant. CTLA4-CD28 chimera gene modification of CD4 T cells significantly enhanced antitumor effect of unmodified CD8 T cells. Nonetheless, the gene modification of CD8 T cells along with CD4 T cells further maximized antitumor effect of T cells in 2 different murine tumor models. Thus, CTLA4-CD28 chimera gene modification of both tumor antigen-specific CD4 and CD8 T cells would be an ideal way of modulating CTLA4 function to enhance tumor-specific T-cell reactivity.
Identification and expansion of highly suppressive CD8+FoxP3+ regulatory T cells after experimental allogeneic bone marrow transplantation
Authors: Robb Renee J. , Lineburg Katie E. , Kuns Rachel D. , Wilson Yana A. , Raffelt Neil C. , Olver Stuart D. , Varelias Antiopi , Alexander Kylie A. , Teal Bianca E. , Sparwasser Tim , Hammerling Gunter J. , Markey Kate A. , Koyama Motoko , Clouston Andrew D. , Engwerda Christian R. , Hill Geoffrey R. , MacDonald Kelli P. A. 
Published: April 2012

AbstractFoxP3+ confers suppressive properties and is confined to regulatory T cells (Treg) that potently inhibit autoreactive immune responses. In the transplant setting, natural CD4+ Treg are critical in controlling alloreactivity and the establishment of tolerance. We now identify an important CD8+ population of FoxP3+ Treg that convert from CD8+ conventional donor T cells after allogeneic but not syngeneic bone marrow transplantation. These CD8+ Treg undergo conversion in the mesenteric lymph nodes under the influence of recipient dendritic cells and TGF-β. Importantly, this population is as important for protection from GVHD as the well-studied natural CD4+FoxP3+ population and is more potent in exerting class I–restricted and antigen-specific suppression in vitro and in vivo. Critically, CD8+FoxP3+ Treg are exquisitely sensitive to inhibition by cyclosporine but can be massively and specifically expanded in vivo to prevent GVHD by coadministering rapamycin and IL-2 antibody complexes. CD8+FoxP3+ Treg thus represent a new regulatory population with considerable potential to preferentially subvert MHC class I–restricted T-cell responses after bone marrow transplantation.
Prognostic irrelevance of ring sideroblast percentage in World Health Organization–defined myelodysplastic syndromes without excess blasts
Authors: Patnaik Mrinal M. , Hanson Curtis A. , Sulai Nanna H. , Hodnefield Janice M. , Knudson Ryan A. , Ketterling Rhett P. , Lasho Terra L. , Tefferi Ayalew 
Published: April 2012

Abstract
The presence of ≥ 15% bone marrow (BM) ring sideroblasts (RS) and < 5% blasts is required for a diagnosis of refractory anemia with ring sideroblasts. We examined the phenotypic and prognostic relevance of this “15%” RS threshold in 200 patients with myelodysplastic syndromes (MDS) without excess blasts and with ≥ 1% RS. The impact of RS% was assessed both as a continuous and categorical variable: < 5% (n = 56), 5%-14% (n = 32), 15%-50% (n = 79), and > 50% (n = 33). RS% correlated (P < .05) directly with age, platelet count, transfusion dependency, BM cellularity, and mutant SF3B1 and inversely with hemoglobin level, multilineage dysplasia, and high-risk karyotype; but did not correlate with IDH mutations. At a median follow-up of 33 months, 156 (73%) deaths and 24 (12%) leukemic transformations were documented. Neither univariate nor multivariable analysis showed significant effect for RS% on overall or leukemia-free survival, suggesting the limited prognostic value of quantifying BM RS in MDS.
Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study
Authors: Celebi Nora , Tsouraki Rodoula , Engel Corinna , Holderried Friederike , Riessen Reimer , Weyrich Peter 
Published: April 2012

Abstract

Background
Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students.

Methods
A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question.

Results
A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward specific workload and number of medical activities could be shown.

Conclusions
There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.
Temporal trends of sulphadoxine-pyrimethamine (SP) drug-resistance molecular markers in Plasmodium falciparum parasites from pregnant women in western Kenya
Authors: Iriemenam Nnaemeka C , Shah Monica , Gatei Wangeci , van Eijk Anna M , Ayisi John , Kariuki Simon , Vanden Eng Jodi , Owino Simon O , Lal Ashima A , Omosun Yusuf O , Otieno Kephas , Desai Meghna , ter Kuile Feiko O , Nahlen Bernard , Moore Julie , Hamel Mary J , Ouma Peter , Slutsker Laurence , Shi Ya Ping 
Published: April 2012

Abstract

Background
Resistance to sulphadoxine-pyrimethamine (SP) in Plasmodium falciparum parasites is associated with mutations in the dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes and has spread worldwide. SP remains the recommended drug for intermittent preventive treatment for malaria in pregnancy (IPTp) and information on population prevalence of the SP resistance molecular markers in pregnant women is limited.

Methods
Temporal trends of SP resistance molecular markers were investigated in 489 parasite samples collected from pregnant women at delivery from three different observational studies between 1996 and 2009 in Kenya, where SP was adopted for both IPTp and case treatment policies in 1998. Using real-time polymerase chain reaction, pyrosequencing and direct sequencing, 10 single-nucleotide polymorphisms (SNPs) of SP resistance molecular markers were assayed.

Results
The prevalence of quintuple mutant (dhfr N51I/C59R/S108N and dhps A437G/K540E combined genotype) increased from 7 % in the first study (1996–2000) to 88 % in the third study (2008–2009). When further stratified by sample collection year and adoption of IPTp policy, the prevalence of the quintuple mutant increased from 2.4 % in 1998 to 44.4 % three years after IPTp policy adoption, seemingly in parallel with the increase in percentage of SP use in pregnancy. However, in the 1996–2000 study, more mutations in the combined dhfr/dhps genotype were associated with SP use during pregnancy only in univariable analysis and no associations were detected in the 2002–2008 and 2008–2009 studies. In addition, in the 2008–2009 study, 5.3 % of the parasite samples carried the dhps triple mutant (A437G/K540E/A581G). There were no differences in the prevalence of SP mutant genotypes between the parasite samples from HIV + and HIV- women over time and between paired peripheral and placental samples.

Conclusions
There was a significant increase in dhfr/dhps quintuple mutant and the emergence of new genotype containing dhps 581 in the parasites from pregnant women in western Kenya over 13 years. IPTp adoption and SP use in pregnancy only played a minor role in the increased drug-resistant parasites in the pregnant women over time. Most likely, other major factors, such as the high prevalence of resistant parasites selected by the use of SP for case management in large non-pregnant population, might have contributed to the temporally increased prevalence of SP resistant parasites in pregnant women. Further investigations are needed to determine the linkage between SP drug resistance markers and efficacy of IPTp-SP.
A two-stage cluster sampling method using gridded population data, a GIS, and Google EarthTM imagery in a population-based mortality survey in Iraq
Authors: Galway LP , Bell Nathaniel , SAE Al Shatari , Hagopian Amy , Burnham Gilbert , Flaxman Abraham , Weiss Wiliam M , Rajaratnam Julie , Takaro Tim K 
Published: April 2012

AbstractBackgroundMortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.ResultsWe present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google EarthTMimagery and sampling grids to select households in the second sampling stage. The sampling method is implemented in a household mortality study in Iraq in 2011. Factors affecting feasibility and methodological quality are described.ConclusionSampling is a challenge in retrospective population-based mortality studies and alternatives that improve on the conventional approaches are needed. The sampling strategy presented here was designed to generate a representative sample of the Iraqi population while reducing the potential for bias and considering the context specific challenges of the study setting. This sampling strategy, or variations on it, are adaptable and should be considered and tested in other conflict settings.
Factors predictive of papillary thyroid micro-carcinoma with bilateral involvement and central lymph node metastasis: a retrospective study
Authors: Zhou Yi-Li , Gao Er-li , Zhang Wei , Yang Han , Guo Gui-Long , Zhang Xiao-Hua , Wang Ou-Chen 
Published: April 2012

Abstract

Background
The optimal resection extent for papillary thyroid microcarcinoma (PTMC) remains controversial. The objective of the study was to investigate risk factors of bilateral PTMC and central lymph node metastasis (CLNM) to guide surgical strategies for PTMC patients.

Methods
We retrospectively reviewed 211 PTMC patients who underwent total thyroidectomy (TT) and 122 clinical lymph node-negative (cN0) cases that underwent prophylactic central lymph node dissection (CLND) between 2010 and 2011. The frequency, pattern, and predictive factors for bilateral PTMC and CLNM in these patients were studied using univariate and multivariate analysis with respect to the following variables: age, gender, extrathyroidal extension (ETE), T stage, with Hashimoto thyroiditis (HT), tumor size and multifocality based on final pathology, and preoperative evaluation using ultrasonography (US).

Results
Fifty-four of 211 (25.6%) patients had bilateral PTMC. In multivariate analysis, multifocality (P < 0.001, OR = 23.900) and tumor size ≥7 mm (P = 0.014, OR = 2.398) based on US were independent predictive factors for bilateral PTMC which was also independently associated with multifocality (P < 0.001, OR = 29.657) and tumor size ≥7 mm (P = 0.005, OR = 2.863) based on final pathology. Among 122 cN0 patients who underwent prophylactic CLND, we found 49.2% of patients had CLNM. CLNM was independently associated with men, age <50 years and tumor size ≥7 mm based on final pathology or preoperative US.

Conclusions
TT should be considered for PTMC patients who are found multifocality and tumor size ≥7 mm based on preoperative US. CLND need be considered in cN0 patients who are men, aged <50 years or tumor size ≥7 mm based on preoperative US.
Prognostic significance of tumor markers in T4a gastric cancer
Authors: Liu Xiaowen , Cai Hong , Wang Yanong 
Published: April 2012

AbstractBackgroundThe clinical importance of preoperative tumor markers remain elusive in gastric cancer. The aim of this study was to evaluate the prognostic value of AFP, CEA, CA19-9, and CA50 in T4a stage gastric cancer.MethodsTwo hundred and seventy-three T4a gastric cancer patients who underwent curative D2 gastrectomy between 1996 and 2005 were evaluated. The correlation between tumor markers and clinicopathologic characteristics and prognostic value of preoperative tumor markers were investigated.ResultsCorrelation analysis showed that AFP was associated with Borrmann type (P = 0.010); CEA with sex (P = 0.029), tumors site (P = 0.014), and N stage (P = 0.001); CA19-9 with age (P = 0.047), tumor site (P = 0.011), lymphovascular invasion (P = 0.004), and N stage (P = 0.000); CA50 with age (P = 0.017), tumor site (P = 0.004), tumor size (P = 0.014), and N stage (P = 0.000). Multivariate analysis showed that the positivity of preoperative CEA, CA19-9, and CA50 were major independent poor prognostic factors of patients with T4a stage gastric cancer.ConclusionsPreoperative serum tumor marker might be a candidate for the staging system in addition to conventional factors.