bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dealing with Missing Outcomes: Lessons from a Randomized Trial of a Prenatal Intervention to Prevent Early Childhood Caries
Authors: Plutzer Kamila , Mejia Gloria C , Spencer A. John , Keirse Marc J.N.C 
Published: November 2010

Severe early childhood caries (S-ECC) affects 17% of 2-3 year old children in South Australia impacting on their general health and well-being. S-ECC is largely preventable by providing mothers with anticipatory guidance. Randomised controlled trials (RCTs) are the most decisive way to test this, but that approach suffers from near inevitable loss to follow-up that occurs with preventative strategies and distant outcome assessment.We re-examined the results of an RCT to prevent S-ECC using sensitivity analyses and multiple imputation to test different assumptions about violation of random allocation (1%) and major loss to follow-up (32%). Irrespective of any assumptions about missing outcomes, providing expectant mothers with anticipatory guidance during pregnancy and in the child’s first year of life, significantly reduced the incidence of S-ECC at 20 months of age. However, the relative risk of S-ECC varied from 0.18 (95% confidence interval (CI): 0.06 – 0.52) to 0.70 (95% CI: 0.56 – 0.88). Also the ‘number needed to treat’ (NNT) to prevent one case of S-ECC varied 2.5-fold: from 8 to 20 women given anticipatory guidance. Multiple imputation provided a best estimate of 0.25 (95% CI: 0.11 – 0.56) for the relative risk and of 14 (95% CI: 10 – 33) for the number needed to treat.Avoiding loss to follow-up is crucial in any RCT, but is difficult with preventative health care strategies. Instead of abandoning randomisation in such circumstances, sensitivity analyses and multiple imputation can consolidate the findings of an RCT and add extra value to the conclusions derived from it.
Predictor Model of Root Caries in Older Adults: Reporting of Evidence to the Translational Evidence Mechanism
Authors: JG Bauer , S Spackman , J Dong , N Garrett 
Published: November 2010

Compared to younger adults, older adults are at greater risk for root caries. A model of root caries may assist dentists in predicting disease outcomes. OBJECTIVES: Using the Iowa 65+ Oral Health Survey, analysis was done to model the patterns of the root caries development in older adults.Methods:The statistical analysis included Markov chain modeling, model estimation and validation.Results:The model effectively predicts root caries using an 18-month predictive cycle and is validated up to 36 months (two cycles), with no significant differences (Chi-square test p-values >0.1) between predicted and observed distributions. However, we do not have observed data for validation beyond 36 months since the model was designed to perform only at single or multiple 18-month cycles. As expected, the predicted distribution at 54-month (3 cycles) and the observed distribution at 60-month differed significantly (p<0.0001).Conclusions:The model demonstrated a high probability that a sound surface will remain caries free. However, one and multiple-surface lesions aggressively infect adjoining surfaces. Maturing of the carious lesion occurs with the 4-surface lesion, decreasing the probability of tooth loss. Thus, maintaining a sound root surface and early treatment intervention reduces the risk of tooth dysfunction (morphological destruction) and loss.DATABASE FILTERS:P:Tooth/Subject characteristics-Older adults, 65 years of age or more, male and female participants, regional rural Iowa residents, race unspecified, functional status-non-institutionalized level unspecified, risk level unspecifiedI:Root cariesP(C-not applicable): Probability/Statistical significance for decision data only/Clinical significance-dataset over 20 years old/Utility data not included/Cost data not included/Meaning in practice undetermined.O:Each year through a three year cycle, caries progression from a sound root surfaceA:Data attached:■ Published manuscript□ Unpublished manuscript□ Raw dataR:Primary author contact information present
Combined Anterior-Posterior Surgery Versus Posterior Surgery for Thoracolumbar Burst Fractures: A Systematic Review of the Literature
Authors: P. Oprel Pim , Tuinebreijer Wim E , Patka Peter , den Hartog Dennis 
Published: November 2010

Study Design:
A systematic quantitative review of the literature.

Objective:
To compare combined anterior-posterior surgery versus posterior surgery for thoracolumbar fractures in order to identify better treatments.

Summary of Background Data:
Axial load of the anterior and middle column of the spine can lead to a burst fracture in the vertebral body. The management of thoracolumbar burst fractures remains controversial. The goals of operative treatment are fracture reduction, fixation and decompressing the neural canal. For this, different operative methods are developed, for instance, the posterior and the combined anterior-posterior approach. Recent systematic qualitative reviews comparing these methods are lacking.

Methods:
We conducted an electronic search of MEDLINE, EMBASE, LILACS and the Cochrane Central Register for Controlled Trials.

Results:
Five observational comparative studies and no randomized clinical trials comparing the combined anteriorposterior approach with the posterior approach were retrieved. The total enrollment of patients in these studies was 755 patients. The results were expressed as relative risk (RR) for dichotomous outcomes and weighted mean difference (WMD) for continuous outcomes with 95% confidence intervals (CI).

Conclusions:
A small significantly higher kyphotic correction and improvement of vertebral height (sagittal index) observed for the combined anterior-posterior group is cancelled out by more blood loss, longer operation time, longer hospital stay, higher costs and a possible higher intra- and postoperative complication rate requiring re-operation and the possibility of a worsened Hannover spine score. The surgeons’ choices regarding the operative approach are biased: worse cases tended to undergo the combined anterior-posterior approach.
Development and Validation of an Electronic Health Record–Based Chronic Kidney Disease Registry
Authors: Navaneethan Sankar D. , Jolly Stacey E. , Schold Jesse D. , Arrigain Susana , Saupe Welf , Sharp John , Lyons Jennifer , Simon James F. , Schreiber Martin J. , Jain Anil , Nally Joseph V. 
Published: November 2010

Summary

Background and objectives
Chronic kidney disease (CKD) is increasing, and outcomes-related research from diverse health care settings is needed to target appropriate efforts and interventions. We developed an electronic health record (EHR)-based CKD registry at the Cleveland Clinic and validated comorbid conditions.

Design, setting, participants, & measurements
Patients who had at least one face-to-face outpatient encounter with a Cleveland Clinic health care provider and (1) had two estimated GFR values <60 ml/min per 1.73 m2 >90 days apart as of January 1, 2005 and/or (2) were patients with International Classification of Diseases-9 (ICD-9) diagnosis codes for kidney disease were included.

Results
Our registry includes 57,276 patients (53,399 patients met estimated GFR criteria and 3877 patients met ICD-9 diagnosis code criteria) as of March 2010. Mean age was 69.5 ± 13.4 years, with 55% women and 12% African Americans. Medicare is the primary insurer for more than one half of the study cohort. The κ statistics to assess the extent of agreement between the administrative dataset extracted from the EHR and actual EHR chart review showed substantial agreement (>0.80) for all conditions except for coronary artery disease and hypertension, which had moderate agreement (<0.60).

Conclusions
Development of an EHR-based CKD registry is feasible in a large health system, and the comorbid conditions included in the registry are reliable. In addition to conducting research studies, such a registry could help to improve the quality of care delivered to CKD patients and complement the ongoing nationwide efforts to develop a CKD surveillance project.
Recurrent Deep Intronic Mutations in the SLC12A3 Gene Responsible for Gitelman's Syndrome
Authors: Lo Yi-Fen , Nozu Kandai , Iijima Kazumoto , Morishita Takahiro , Huang Che-Chung , Yang Sung-Sen , Sytwu Huey-Kang , Fang Yu-Wei , Tseng Min-Hua , Lin Shih-Hua 
Published: November 2010

Summary

Background and objectives
Gitelman's syndrome (GS) is an autosomal recessive renal tubular disorder caused by mutations in the SLC12A3 gene encoding the thiazide-sensitive Na+-Cl− cotransporter (NCC). Despite meticulous sequencing of genomic DNA, approximately one-third of GS patients are negative or heterozygotes for the known mutations.

Design, Setting, Participants, & Measurements
Because blood leukocytes express NCC mRNA, we evaluate whether deep intronic mutations contribute to GS patients with uniallelic or undetectable SLC12A3 mutations. Twenty-nine patients with GS (men/women = 16/13), including eight negative and 21 uniallelic SLC12A3 mutations from 19 unrelated families, and normal controls were enrolled in an academic medical center. Analysis of cDNA from blood leukocytes, sequencing of the corresponding introns of genomic DNA for abnormal transcript, and analysis of NCC protein expression from renal biopsy were performed.

Results
We identified nine Taiwan aboriginal patients carrying c.1670–191C→T mutations in intron 13 and 10 nonaboriginal patients carrying c.2548+253C→T mutations in intron 21 from 14 families (14/19). These two mutations undetected in 100 healthy subjects created pseudoexons containing new premature termination codons. Haplotype analysis with markers flanking SLC12A3 revealed that both mutations did not have founder effects. Apical NCC expression in the DCT of renal tissue was markedly diminished in two patients carrying deep intronic mutations.

Conclusions
Deep intronic mutations in SLC12A3 causing defective NCC expression can be identified with the RNA-based approach in patients with GS. c.1670–191C→T and c.2548+253C→T are hot spot mutations that can be screened in GS patients with uniallelic or negative SLC12A3 mutations.
Welsh-Medium Teaching in Psychology
Authors: Thomas Enlli Môn 
Published: November 2010

Teaching psychology through the medium of Welsh is a new development. It raises important issues relating to methods of teaching the subject, and derives from the desire to provide practising psychologists with the training to be able to better serve the Welsh-speaking population of Wales. This paper outlines the problems with Welsh provision that psychologists are able to offer at present. It provides examples of how the Welsh-speaking population is currently at a disadvantage, and proposes that the development of Welsh-medium teaching offers one way of addressing the problem.
Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial
Authors: Field-Fote Edelle C. , Roach Kathryn E. 
Published: November 2010

BackgroundImpaired walking limits function after spinal cord injury (SCI), but training-related improvements are possible even in people with chronic motor incomplete SCI.ObjectiveThe objective of this study was to compare changes in walking speed and distance associated with 4 locomotor training approaches.DesignThis study was a single-blind, randomized clinical trial.SettingThis study was conducted in a rehabilitation research laboratory.ParticipantsParticipants were people with minimal walking function due to chronic SCI.InterventionParticipants (n=74) trained 5 days per week for 12 weeks with the following approaches: treadmill-based training with manual assistance (TM), treadmill-based training with stimulation (TS), overground training with stimulation (OG), and treadmill-based training with robotic assistance (LR).MeasurementsOverground walking speed and distance were the primary outcome measures.ResultsIn participants who completed the training (n=64), there were overall effects for speed (effect size index [d]=0.33) and distance (d=0.35). For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG (d=0.43 and d=0.40, respectively). Effect sizes for speed were the same for TM and TS (d=0.28); there was no effect for LR. The effect size for distance was greater with TS (d=0.16) than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training; walking speed at this time was slower than that at the conclusion of training but remained faster than before training.LimitationsIt is unknown whether the training dosage and the emphasis on training speed were optimal. Robotic training that requires active participation would likely yield different results.ConclusionsIn people with chronic motor incomplete SCI, walking speed improved with both overground training and treadmill-based training; however, walking distance improved to a greater extent with overground training.
Androgen receptor epigenetic variations influence early follicular phase gonadotropin levels
Authors: Laisk Triin , Haller‐Kikkatalo Kadri , Laanpere Margit , Jakovlev Ülle , Peters Maire , Karro Helle , Salumets Andres 
Published: November 2010

AbstractObjective. We examined the influence of the androgen receptor gene (AR) CAG microsatellite (AR‐CAG) repeat polymorphism and X‐chromosome inactivation (XCI) pattern on ovarian reserve markers (follicle stimulating hormone (FSH) and antral follicle count on menstrual cycle day 3–5) and disease etiology in patients with polycystic ovarian syndrome (PCOS) or premature ovarian failure (POF). Design. Case‐control study. Population. In all, 32 women with PCOS, 26 women with POF and 79 controls were investigated. Methods. AR‐CAG and XCI were analyzed using polymerase chain reaction‐based assays following DNA digestion with the methylation‐sensitive restrictase HpaII. Main outcome measures. Distribution of AR‐CAG alleles and XCI patterns. Results. POF patients had shorter AR‐CAG microsatellites than controls. AR‐CAG microsatellite length was negatively associated with serum dehydroepiandrosterone sulfate level. The magnitude of XCI skewing was negatively and positively correlated with luteinizing hormone (LH) and FSH serum levels, respectively, during the early follicular phase, but showed no correlation with the number of early antral follicles. Conclusions. Our results suggest that AR‐CAG variations and XCI pattern exert an effect on FSH and LH values, and also have the potential to influence the etiopathogenesis of POF.
The impact of gestational diabetes mellitus on pregnancy outcome comparing different cut‐off criteria for abnormal glucose tolerance
Authors: Anderberg Eva , Källén Karin , Berntorp Kerstin 
Published: November 2010

AbstractObjective. To examine pregnancy outcomes in relation to different categories of glucose tolerance during pregnancy. Design. Prospective observational cohort study. Setting. Patient recruitment and data collection were performed in four delivery departments in southern Sweden. Population. Women delivering during 2003–2005; 306 with gestational diabetes mellitus, 744 with gestational impaired glucose tolerance and 329 randomly selected controls. Methods. All women were offered a 75 g oral glucose tolerance test during pregnancy. On the basis of their capillary 2‐hour plasma glucose concentrations, three groups were identified: gestational diabetes mellitus (>10.0 mmol/l), gestational impaired glucose tolerance (8.6–9.9 mmol/l) and controls (<8.6 mmol/l). Data for the groups were compared using a population‐based database. Main outcome measures. Maternal and fetal outcomes. Results. For the gestational diabetes mellitus group, adjusted odds ratios (95% confidence intervals) for hypertensive disorders during pregnancy and induction of labor and emergency cesarean section were 2.7 (1.3–5.8), 3.1 (1.8–5.2) and 2.5 (1.5–4.4), respectively; and for Apgar score <7 at 5 minutes, need for neonatal intensive care >1 day and large‐for‐gestational age infant were 9.6 (1.2–78.0), 5.2 (2.8–9.6) and 2.5 (1.3–5.1), respectively. The increases in odds ratios for the gestational impaired glucose tolerance group were less pronounced but still significant for hypertension during pregnancy, induction of labor, large‐for‐gestational age infant and use of neonatal intensive care >1 day, with odds ratios (95% confidence interval) 2.0 (1.0–4.1), 1.8 (1.1–3.0), 2.1 (1.1–3.9) and 2.1 (1.1–3.8), respectively. Conclusions. These data indicate that even limited degrees of maternal hyperglycemia may affect the outcome of pregnancy.
Prevalence of postpartum urinary incontinence: a systematic review
Authors: Thom David H. , Rortveit Guri 
Published: November 2010

AbstractObjective. To investigate the prevalence of urinary incontinence within the first year postpartum. Design. A systematic review of population‐based studies. Population. General female populations up to 1 year postpartum. Methods. Studies on incontinence in population‐based sample defined as from one or more district hospitals or from multiple clinics covering a defined geographic area. Studies of women from a single outpatient clinic or who were referred for care (e.g. for being high risk) were excluded. In addition, studies had to have a sample size of over 100 participants and a response rate 50% or over. Main outcome measures. Prevalence from individual studies as well as mean prevalence is given. Pooled prevalence is estimated for non‐heterogenous studies. Results. During the first 3 months postpartum, the pooled prevalence of any postpartum incontinence was 33% (95% confidence interval (CI) 32–36%) in all women. The mean prevalence of weekly and daily incontinence was 12% (95% CI 11–13%) and 3% (95% CI 3–4%), respectively. The mean prevalence was double in the vaginal delivery group (31%, 95% CI 30–33%) compared to the cesarean section group (15%, 95% CI 11–18%). Longitudinal studies within the first year postpartum showed small changes in prevalence over time. Conclusions. The prevalence of postpartum incontinence was high. Prevalence was substantially less for more frequent incontinence. Urinary incontinence after cesarean section was half the prevalence after vaginal delivery.
Intraoperative high-resolution ultrasound: a new technique in the management of peripheral nerve disorders
Authors: Koenig Ralph W. , Schmidt Thomas E. , Heinen Christian P. G. , Wirtz Christian R. , Kretschmer Thomas , Antoniadis Gregor , Pedro Maria T. 
Published: November 2010

Object
Surgical treatment of nerve lesions in continuity remains difficult, even in the most experienced hands. The regenerative potential of those injuries can be evaluated by intraoperative electrophysiological studies and/or intraneural dissection. The present study examines the value of intraoperative high-frequency ultrasound as an imaging tool for decision making in the management of traumatic nerve lesions in continuity.

Methods
Intraoperative high-frequency ultrasound was applied to 19 traumatic or iatrogenic nerve lesions of differing extents. The information obtained was correlated with intraoperative electrophysiological, microsurgical intraneural dissection, and histopathological findings in resected nerve segments.

Results
The intraoperative application of high-resolution, high-frequency ultrasound enabled morphological examination of nerve lesions in continuity, with good image quality. The assessment of the severity of the underlying nerve injury matched perfectly with the judgment obtained from intraoperative electrophysiological studies. Both intraneural nerve dissection and neuropathological examination of the resected nerve segments confirmed the sonographic findings. In addition, intraoperative ultrasound proved to be very time efficient.

Conclusions
With intraoperative ultrasound, the extent of traumatic peripheral nerve lesions can be examined morphologically for the first time. It is a promising, noninvasive method that seems capable of assessing the type (intraneural/perineural) and grade of nerve fibrosis. Therefore, in combination with intraoperative neurophysiological studies, intraoperative high-resolution ultrasound may represent a major tool for noninvasive assessment of the regenerative potential of a nerve lesion.
FDG uptake in primary squamous cell carcinoma of the head and neck
Authors: Vangestel C. , Goethals I. , De Potter A. , Peeters M. , Vermeersch H. , Van de Wiele C. , Deron P. 
Published: November 2010

Summary
Aim: This study aimed at assessing the relationship between over-expression of glucose transporters and hexokinases, tumour proliferation and apoptosis corrected for cellularity and partial volume corrected (pvc) FDG SUV values in primary squamous cell carcinoma of the head and neck (pSCCHN). Patients, methods: In 27 consecutive patients suffering from pSCCHN, FDG SUVmax and mean pvc values of the primary tumour were derived from a pre-surgical routine staging FDG PET/CT examination. GLUT-1, GLUT-3, HK-1, HK-3 expression, tumour proliferation (Ki-67 staining) and the number of apoptotic cells (cleaved caspase-3 staining), corrected for tumour cellularity, were subsequently assessed on the corresponding post-surgically obtained biopsies and tumour specimens. FDG SUVmax and mean pvc values of pSCCHN were correlated with the corresponding histological findings. Results: FDG SUV max and mean pvc values correlated significantly: with GLUT-1 scores r = 0.408 (p = 0.04) and r = 0.439 (p = 0.03) as well as with the number of apoptotic cells r = 0.529 (p = 0.008) and r = 0.484 (p = 0.017). The number of apoptotic cells also correlated to GLUT-3 scores: r = 0.62 (p = 0.001) and GLUT-1 scores r = 0.528 (p = 0.008). Conclusion: FDG SUV pvc proved significantly related to GLUT-1 expression by tumour cells and to the absolute number of apoptotic cells. The latter finding warrants further exploration and confirmation by additional studies.
Effect of a Preceptor Education Workshop: Part 2. Qualitative Results of a Hospital-Wide Study
Authors: Sandau Kristin E. , Halm Margo 
Published: November 2010

Background:
This study examined the hospital-wide effect of a mandatory 8-hour nurse preceptor workshop on preceptors and orientees.

Methods:
A mixed-methods approach was used. The quantitative surveys were augmented with qualitative short-answer questions (QUAN + qual) to identify the perceptions of preceptorship experiences for both preceptors and orientees.

Results:
Findings from the narrative portions of the survey are presented. Orientees were able to distinguish between poor and excellent quality in precepting, were concerned that orientation was not tailored to the needs of experienced nurses, and described three to four preceptors as being the ideal number to be assigned to an orientee. Preceptors postintervention described “being more open” to the orientee’s view, “slowing down,” and increasing the promotion of critical thinking strategies.

Conclusion:
According to the quantitative results, orientees postintervention did not report increased satisfaction with preceptors. Qualitative findings suggested that this was likely related to a high number of preceptors, heavy patient loads, and lack of tailoring of orientation to the needs of experienced nurses. The quantitative results showed that preceptors postintervention reported increased satisfaction and confidence for precepting in all five preceptor roles assessed quantitatively; qualitative findings further supported these findings. However, narrative findings indicated that a primary barrier to positive changes in a preceptor’s practice was a heavy patient load while precepting.