bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cervical ligamentum flavum cyst in an 82-year-old woman presenting with spinal cord compression: a case report and review of the literature
Authors: Brotis Alexandros G , Kapsalaki Eftychia Z , Papadopoulos Evangelos K , Fountas Kostas N 
Published: March 2012

Abstract

Introduction
We report on a very rare case of a cervical ligamentum flavum cyst, which presented with progressive myelopathy and radiculopathy. The cyst was radically extirpated and our patient showed significant recovery. A review of the relevant literature yielded seven cases.

Case presentation
An 82-year-old Greek woman presented with progressive bilateral weakness of her upper extremities and causalgia, cervical pain, episodes of upper extremity numbness and significant walking difficulties. Her neurological examination showed diffusely decreased motor strength in both her upper and lower extremities. Magnetic resonance imaging of her cervical spine demonstrated a large, well-demarcated cystic lesion on the dorsal aspect of her spinal cord at the C3 to C4 level, significantly compressing the spinal cord at this level, in close proximity to the yellow ligament and the C3 left lamina. The largest diameter of this lesion was 1.4 cm, and there was no lesion enhancement after the intravenous administration of a paramagnetic contrast. The lesion was surgically removed after a bilateral C3 laminectomy. The thick cystic wall was yellow and fibro-elastic in consistency, while its content was gelatinous and yellow-brownish. A postoperative cervical-spine magnetic resonance image was obtained before her discharge, demonstrating decompression of her spinal cord and dural expansion. Her six-month follow-up evaluation revealed complete resolution of her walking difficulties, improvement in the muscle strength of her arms (4+/5 in all the affected muscle groups), no causalgia and a significant decrease in her preoperative upper extremity numbness.

Conclusion
Cervical ligamentum flavum cysts are rare benign lesions, which should be included in the list of differential diagnosis of spinal cystic lesions. They can be differentiated from other intracanalicular lesions by their hypointense appearance on T1-weighted and hyperintense appearance on T2-weighted magnetic resonance images, with contrast enhancement of the cystic wall. Surgical extirpation of the cyst is required for symptom alleviation and decompression of the spinal cord. The outcome of these cysts is excellent with no risk of recurrence.
Sample-level enrichment analysis unravels shared stress phenotypes among multiple cancer types
Authors: Gundem Gunes , Lopez-Bigas Nuria 
Published: March 2012

Abstract
Background
Adaptation to stress signals in the tumor microenvironment is a crucial step towards carcinogenic phenotype. The adaptive alterations attained by cells to withstand different types of insults are collectively referred to as the stress phenotypes of cancers. In this manuscript we explore the interrelation of different stress phenotypes in multiple cancer types and ask if these phenotypes could be used to explain prognostic differences among tumor samples.

Methods
We propose a new approach based on enrichment analysis at the level of samples (sample-level enrichment analysis - SLEA) in expression profiling datasets. Without using a priori phenotypic information about samples, SLEA calculates an enrichment score per sample per gene set using z-test. This score is used to determine the relative importance of the corresponding pathway or module in different patient groups.

Results
Our analysis shows that tumors significantly upregulating genes related to chromosome instability strongly correlate with worse prognosis in breast cancer. Moreover, in multiple tumor types, these tumors upregulate a senescence-bypass transcriptional program and exhibit similar stress phenotypes.

Conclusions
Using SLEA we are able to find relationships between stress phenotype pathways across multiple cancer types. Moreover we show that SLEA enables the identification of gene sets in correlation with clinical characteristics such as survival, as well as the identification of biological pathways/processes that underlie the pathology of different cancer subgroups.
Examining Utilization of a Natural Medicine Web-Based Tool Among Non-Primary Care Physicians, Academic Faculty, and Nurses at One Institution
Authors: Karpa Kelly Dowhower , Boehmer Sue 
Published: March 2012

Background: Consumer use of herbal and natural products (H/NP) is increasing, yet physicians may be unprepared to provide guidance because of lack of educational training. This knowledge deficit may place consumers at risk of adverse effects. We had previously evaluated the impact of a natural medicine Web-based resource on primary care providers at our institution. Objectives: To ascertain the value of an H/NP Web-based resource to non–primary care physicians, academic faculty, and nurses practicing within a hospital setting. Methods: Non–primary care physicians, academic faculty, and nurses at our medical center were invited to complete an electronic survey 1 year after access to an H/NP clinical decision tool had been obtained. Results: Survey responses were obtained from 226 of 2720 (8%) individuals invited to participate. Overall, respondents indicated a relatively low comfort level (mean 3.5 [2.28] [SD] on a 10-point scale) in discussing H/NP prior to introduction of the electronic H/NP resource. Following a year-long trial subscription to an evidence-based H/NP electronic resource, 29% of physician and nurse survey respondents (60 of 207) reported use of the tool. These individuals ranked their comfort level with H/NP discussions at a 6.96 [1.76] on a 10-point scale. Seventy-six percent of physicians (16 of 21) and 72% of nurses (28 of 39) who had used the tool indicated that because of the resource, they were more likely to ask patients about H/NP use when taking a drug history; 44% (23 of 52) had been able to intervene when a patient was using an H/NP deemed to be unsafe. Conclusions: Our results suggest that an evidence-based H/NP resource boosts physician and nursing comfort in discussing H/NP with patients and enables interventions to be made. Such H/NP clinical decision tools have potential to improve patient care.
Overall and cause-specific mortality in GH-deficient adults on GH replacement
Authors: Gaillard Rolf C , Mattsson Anders F , Åkerblad Ann-Charlotte , Bengtsson Bengt-Åke , Cara José , Feldt-Rasmussen Ulla , Kołtowska-Häggström Maria , Monson John P , Saller Bernhard , Wilton Patrick , Abs Roger 
Published: March 2012

ObjectiveHypopituitarism is associated with an increased mortality rate but the reasons underlying this have not been fully elucidated. The purpose of this study was to evaluate mortality and associated factors within a large GH-replaced population of hypopituitary patients.DesignIn KIMS (Pfizer International Metabolic Database) 13 983 GH-deficient patients with 69 056 patient-years of follow-up were available.MethodsThis study analysed standardised mortality ratios (SMRs) by Poisson regression. IGF1 SDS was used as an indicator of adequacy of GH replacement. Statistical significance was set to P<0.05.ResultsAll-cause mortality was 13% higher compared with normal population rates (SMR, 1.13; 95% confidence interval, 1.04–1.24). Significant associations were female gender, younger age at follow-up, underlying diagnosis of Cushing's disease, craniopharyngioma and aggressive tumour and presence of diabetes insipidus. After controlling for confounding factors, there were statistically significant negative associations between IGF1 SDS after 1, 2 and 3 years of GH replacement and SMR. For cause-specific mortality there was a negative association between 1-year IGF1 SDS and SMR for deaths from cardiovascular diseases (P=0.017) and malignancies (P=0.044).ConclusionsGH-replaced patients with hypopituitarism demonstrated a modest increase in mortality rate; this appears lower than that previously published in GH-deficient patients. Factors associated with increased mortality included female gender, younger attained age, aetiology and lower IGF1 SDS during therapy. These data indicate that GH replacement in hypopituitary adults with GH deficiency may be considered a safe treatment.
The Role of Cation Point Defects and Oxygen Interstitials on Modulations in Undoped and Doped Bi-Sr-Ca-Cu-O Superconductors
Authors: Gai P. L. , Subramanian M. A. , Sleight A. W. 
Published: March 2012

ABSTRACTVariations in superstructure modulations and transition tempeartures (Tc) in undoped and yttrium-doped Bi2Sr2CaCu2O8 (2212) superconductors annealed in different environments have been examined by microstructural analysis. The hole concentration is changed either by annealing the samples in reducing or oxidizing environments, or by partial substitution of Y3+ cations on the Ca-sites. Systematic investigations of the 2212 samples annealed in both the reducing (nitrogen) and oxidizing (oxygen) environments show commensurate and incommensurate modulations, respectively, and a decrease of Tc in oxygen. Commensurate modulations have also been found for samples prepared entirely in nitrogen. High spatial resolution microanalysis reveals that the modulations are insensitive to cation point defects. These results indicate that modulations are intrinsic to the 2212 materials and that they are caused by the lattice mismatch between the perovskite and Bi-O layers. Such periodic variations in interplanar spacings are expected to lead to satellite spots as observed in electron diffraction. The results are consistent with single crystal X-ray diffraction studies reported in the literature. In the Y- doped samples Tc values are similar in Bi2Sr2Ca1-xYxCu2O8 for x=0.2, in both the environments, but decrease with increasing value of x.
Application Study of Vascular Interventional Robotic Mechanism for Remote Steering
Authors: Tian Zengmin , Jia Bo , Lu Wangsheng , Hui Rui 
Published: March 2012

Background:
Recently, robotic systems have been introduced as a useful method for surgical procedures. But in the field of vascular interventional therapy, the development of robotic system is slower.

Objective:
The purpose of the study is to verify the reliability and safety of vascular interventional robotic system used in angiography, by the way of in vitro preliminary experiments and animal experiments.

Method:
The approach is to employ a proprietary vascular interventional robot system to complete glass vessel models and animal angiogram experiments. This robot system consists of a console port (remote steering system), an assistant port (propelled and rotation system) and a hydraulic fixing device, upon which surgeons control remotely to make go forward and rotate in the glass vessel models and animal vessels, on the 3D operation interface. Consequently, the operation time and success rate are counted and evaluated.

Result:
In the glass vessel model experiments, the Catheter can enter various kinds of vessel models with inside diameter length greater than 3mm and angle less than 90o. In the animal (adult dogs) experiments, surgeons can accomplish smoothly the angiogram of the renal artery, the vertebral renal and the arteria carotis communis, without any complications of surgery.

Conclusion:
The angiogram by using vascular interventional robot system is safe and reliable. Surgeons can finish the angiogram in part by remote operation, and the result of angiogram can meet a number of simple expectations. However without wire control and force feedback systems, the applicability of this kind of robot system is not flexible enough and need to be improved in the future.
The Relationship Between Financial Incentives and Quality of Diabetes Care in Ontario, Canada
Authors: Kiran Tara , Victor J. Charles , Kopp Alexander , Shah Baiju R. , Glazier Richard H. 
Published: March 2012

OBJECTIVE
We assessed the impact of a diabetes incentive code introduced for primary care physicians in Ontario, Canada, in 2002 on quality of diabetes care at the population and patient level.

RESEARCH DESIGN AND METHODS
We analyzed administrative data for 757,928 Ontarians with diabetes to examine the use of the code and receipt of three evidence-based monitoring tests from 2006 to 2008. We assessed testing rates over time and before and after billing of the incentive code.

RESULTS
One-quarter of Ontarians with diabetes had an incentive code billed by their physician. The proportion receiving the optimal number of all three monitoring tests (HbA1c, cholesterol, and eye tests) rose gradually from 16% in 2000 to 27% in 2008. Individuals who were younger, lived in rural areas, were not enrolled in a primary care model, or had a mental illness were less likely to receive all three recommended tests. Patients with higher numbers of incentive code billings in 2006–2008 were more likely to receive recommended testing but also were more likely to have received the highest level of recommended testing prior to introduction of the incentive code. Following the same patients over time, improvement in recommended testing was no greater after billing of the first incentive code than before.

CONCLUSIONS
The diabetes incentive code led to minimal improvement in quality of diabetes care at the population and patient level. Our findings suggest that physicians who provide the highest quality care prior to incentives may be those most likely to claim incentive payments.
Statin Use as a Moderator of Metformin Effect on Risk for Prostate Cancer Among Type 2 Diabetic Patients
Authors: Lehman Donna M. , Lorenzo Carlos , Hernandez Javier , Wang Chen-pin 
Published: March 2012

OBJECTIVE
Metformin and statins have shown promise for cancer prevention. This study assessed whether the effect of metformin on prostate cancer (PCa) incidence varied by statin use among type 2 diabetic patients.

RESEARCH DESIGN AND METHODS
The study cohort consisted of 5,042 type 2 diabetic male patients seen in the Veteran Administration Health Care System who were without prior cancer and were prescribed with metformin or sulfonylurea as the exclusive hypoglycemic medication between fiscal years 1999 and 2005. Cox proportional hazards analyses were conducted to assess the differential hazard ratio (HR) of PCa due to metformin by statin use versus sulfonylurea use, where propensity scores of metformin and statin use were adjusted to account for imbalances in baseline covariates across medication groups.

RESULTS
Mean follow-up was ∼5 years, and 7.5% had a PCa diagnosis. Statin use modified the effect of metformin on PCa incidence (P &lt; 0.0001). Metformin was associated with a significantly reduced PCa incidence among patients on statins (HR 0.69 [95% CI 0.50–0.92]; 17 cases/533 metformin users vs. 135 cases/2,404 sulfonylureas users) and an increased PCa incidence among patients not on statins (HR 2.15 [1.83–2.52]; 22 cases/175 metformin users vs. 186 cases/1,930 sulfonylureas users). The HR of PCa incidence for those taking metformin and statins versus those taking neither medication was 0.32 (0.25–0.42).

CONCLUSIONS
Among men with type 2 diabetes, PCa incidence among metformin users varied by their statin use. The potential beneficial influence on PCa by combination use of metformin and statin may be due to synergistic effects.
Socially Assistive Robotics for Guiding Motor Task Practice
Authors: Wade Eric , Parnandi Avinash , Mead Ross , Matarić Maja 
Published: March 2012

Abstract
Due to their quantitative nature, robotic systems are useful tools for systematically augmenting human behavior and performance in dynamic environments, such as therapeutic rehabilitation settings. The efficacy of human-robot interaction (HRI) in these settings will depend on the robot’s coaching style. Our goal was to investigate the influence of robot coaching styles designed to enhance motivation and encouragement on post-stroke individuals during motor task practice. We hypothesized that coaching styles incorporating user performance and preference would be preferred in a therapeutic HRI setting. We designed an evaluation study with seven individuals post stroke. A socially assistive robotics (SAR) system using three different coaching styles guided participants during performance of an upper extremity practice task. User preference was not significantly affected by the different robot coaching styles in our participant sample (H(2) = 2.638, p = 0.267). However, trends indicated differences in preference for the coaching styles. Our results provide insights into the design and use of SAR systems in therapeutic interactions aiming to influence user behavior.
Isolation and characterization of microsatellite loci in the endangered tree Diplopanax stachyanthus (Araliaceae)
Authors: Wang Li , Wu Min , Wen Zhi , Xia Qiu‐Ping , Yan Hai‐Fei , Luo Zhi‐Yong 
Published: March 2012

• Premise of the study: Microsatellite markers were developed in Diplopanax stachyanthus to investigate the population genetics of this endangered tree.• Methods and Results: Using the Fast Isolation by AFLP of Sequences Containing repeats (FIASCO) protocol, 15 microsatellite markers were developed in D. stachyanthus and evaluated for their variability in 25 samples from a natural population. For the 11 polymorphic loci, the number of alleles ranged from two to eight, while the observed and expected heterozygosities ranged from 0.5200 to 0.7600 and 0.4200 to 0.7813, respectively. Their cross‐taxa transferability was also examined in Acanthopanax gracilistylus, Tetrapanax papyrifer, Cornus controversa, and Dendrobenthamia japonica var. chinensis, and four to 15 loci proved amplifiable in these species.• Conclusions: These microsatellite markers could be employed to investigate the population genetics of D. stachyanthus, and may potentially be applicable to other related species.
Microsatellites in Aureliana fasciculata var. fasciculata (Solanaceae), a shrub that inhabits the Atlantic Rainforest
Authors: Zamberlan Priscilla M. , da Silva Michele S. , Ramos‐Fregonezi Aline M. C. , Bonatto Sandro L. , Freitas Loreta B. 
Published: March 2012

• Premise of the study: Microsatellite primers were developed in Aureliana fasciculata var. fasciculata, a shrub that inhabits the Atlantic Rainforest, to investigate the intraspecific genetic structure of the species.• Methods and Results: Nine pairs of microsatellite primers were designed that were based on a simple sequence repeat (SSR)–enriched library. Seven loci were amplified successfully. Two populations of A. fasciculata var. fasciculata were genotyped and all loci were polymorphic, with two to five alleles per locus per population detected. Cross‐species amplification was achieved in other members of the genus and members of the sister genus Athenaea.• Conclusions: The development of these microsatellite markers will contribute to future population genetic studies in A. fasciculata var. fasciculata. Cross‐amplification among other species in the genus and in the sister genus Athenaea might be a useful tool to establish patterns of genetic variability within the Atlantic Rainforest.
Habitat Use of Woodpeckers in the Big Woods of Eastern Arkansas
Authors: Krementz David G. , Lehnen Sarah E. , Luscier Jason D. 
Published: March 2012

AbstractThe Big Woods of eastern Arkansas contain some of the highest densities of woodpeckers recorded within bottomland hardwood forests of the southeastern United States. A better understanding of habitat use patterns by these woodpeckers is a priority for conservationists seeking to maintain these high densities in the Big Woods and the Lower Mississippi Alluvial Valley as a whole. Hence, we used linear mixed-effects and linear models to estimate the importance of habitat characteristics to woodpecker density in the Big Woods during the breeding seasons of 2006 and 2007 and the winter of 2007. Northern flicker Colaptes auratus density was negatively related to tree density both for moderate (&gt;25 cm diameter at breast height) and larger trees (&gt;61 cm diameter at breast height). Red-headed woodpeckers Melanerpes erythrocephalus also had a negative relationship with density of large (&gt;61 cm diameter at breast height) trees. Bark disfiguration (an index of tree health) was negatively related to red-bellied woodpecker Melanerpes carolinus and yellow-bellied sapsucker Sphyrapicus varius densities. No measured habitat variables explained pileated woodpecker Dryocopus pileatus density. Overall, the high densities of woodpeckers observed in our study suggest that the current forest management of the Big Woods of Arkansas is meeting the nesting, roosting, and foraging requirements for these birds.
Change in Density of Duck Nest Cavities at Forests in the North Central United States
Authors: Denton John C. , Roy Charlotte L. , Soulliere Gregory J. , Potter Bradly A. 
Published: March 2012

AbstractDuring the past century, clear-cut hardwood forests of the north central United States have regenerated, and trees have matured into size classes increasingly capable of producing cavities suitable for nesting ducks. We determined the density of natural cavities suitable for cavity-nesting ducks, compared suitable cavity-tree distribution by size class and species, and assessed how forest maturation impacted suitable cavity density and distribution over time at four sites in the north central United States. During 2006–2008, cavities suitable for nesting ducks occurred at densities of 1.76, 1.40, 1.84, and 0.92/ha at Mingo National Wildlife Refuge (NWR) in Missouri, Shiawassee NWR in Michigan, Muscatatuck NWR in Indiana, and a study site including Mead State Wildlife Area in Wisconsin, respectively. Suitable nest-cavity densities increased at Mingo NWR (+300%) since 1965 and Shiawassee NWR (+900%) since 1973, but they remained similar at study sites examined during the mid-1980s (Muscatatuck NWR and Mead Wildlife Area) when previous site-specific cavity-suitability criteria were applied to our cavity data. Differences among sites were due to variation in tree species composition, stage of forest maturation, and potentially forest harvest regimes. Comparison of size distributions of all trees and those with suitable nest cavities indicated these forests have yet to mature into the most prolific cavity-producing size classes. Our findings suggest nest sites are not limiting duck populations at these four sites and hardwood forests with similar composition and structure. Rather than using the traditional practice of supplementing duck nest sites, wildlife managers in the North Central region should assess actual limiting factors before developing habitat management prescriptions for local cavity-nesting duck populations.
The male genital tract of Axymyiidae and Tanyderidae (Diptera)
Authors: Borkent Art , Sinclair Bradley J. 
Published: March 2012

AbstractThe male genital tract of Axymyiidae and Tanyderidae, represented by Axymyia furcata McAtee and Protoplasa fitchii Osten Sacken, respectively, are described and illustrated for the first time. The tract of A. furcata is foreshortened, with relatively short, thick vasa deferentia that meet medially at the ejaculatory duct, which empties dorsal to the ejaculatory apodeme. The accessory glands are large and either firmly appressed or fused medially. The tract of P. fitchii has elongate vasa deferentia that curve ventrally and enter the ejaculatory duct separately. The short accessory glands are separate but their exit is uncertain. Neither of these male genital tracts shed further light on the phylogenetic position of these families within the nematocerous Diptera, although Tanyderidae do lack the synapomorphic multi-chambered accessory glands grouping Ptychopteridae + Culicomorpha + Bibionomorpha.