bluuebunny/crossref_metadata_2025_split huggingface dataset:
44‐55‐66‐PM, a Mnemonic That Improves Retention of the Ottawa Ankle and Foot Rules: A Randomized Controlled Trial
Authors: Gravel Jocelyn , Roy Michel , Carrière Benoit 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:859–864 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Studies have suggested that poor knowledge of the Ottawa Ankle Rules (OAR) limits its clinical impact. This study evaluated the ability of a mnemonic to improve knowledge of the OAR.Methods:  This was a single‐blind randomized controlled trial performed among residents and medical students doing a pediatric emergency medicine rotation. At baseline, all participants were tested for their baseline knowledge of the OAR. The intervention was a standardized information sheet providing a mnemonic of the OAR (44‐55‐66‐PM), while control subjects received its classic description. Block randomization (medical student vs. type of resident) was used. Each participant answered the same questionnaire at the end of rotation (3 weeks later) and via a Web‐based survey 5 to 9 months postrandomization. Main outcome measures were knowledge of the components of the ankle rule based on a 13‐item criterion grid and the foot rule based on a 10‐item criterion grid. All questionnaires were marked at the end of the study by two reviewers blinded to the randomization. Discrepancies in final scores were resolved by consensus. Student’s t‐test was performed to compare mean scores on the evaluation between groups using an intention‐to‐treat approach.Results:  Among the 206 eligible participants, 96 medical students and 94 residents were recruited and agreed to participate. Primary outcomes were measured in 95% of the participants at 3 weeks postrandomization and in 72% on the long‐term follow‐up. Participants in both groups were similar with regard to baseline characteristics and prior knowledge of the OAR. Both groups showed improvement in their knowledge of the rule during the study period. At mid‐term, knowledge of the OAR was similar for the ankle components (score for mnemonic 10.9; control 10.2; 95% confidence interval [CI] for difference = −0.3 to 1.7) and for the foot (mnemonic 7.6 vs. control 7.5; 95% CI for difference = −0.7 to 0.9). On the long term, randomization to the mnemonic was associated with a better knowledge of the OAR as demonstrated by a higher score for the ankle component (mnemonic 10.1 vs. control 8.9; 95% CI for difference = 0.6 to 1.8) and for the foot (mnemonic 7.8 vs. control 6.5; 95% CI for difference = 0.8 to 1.9).Conclusions:  Mid‐term knowledge of the OAR drastically improved for all participants of the study. The use of the mnemonic 44‐55‐66‐PM was associated with a better long‐term knowledge of the OAR among medical students and residents. The improvement in knowledge of the OAR among the control group highlights the importance of using controlled trials for studies evaluating knowledge transfer.
Community‐based Participatory Research: Development of an Emergency Department–based Youth Violence Intervention Using Concept Mapping
Authors: Snider Carolyn E. , Kirst Maritt , Abubakar Shakira , Ahmad Farah , Nathens Avery B. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:1–9 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Emergency departments (EDs) see a high number of youths injured by violence. In Ontario, the most common cause of injury for youths visiting EDs is assault. Secondary prevention strategies using the teachable moment (i.e., events that can lead individuals to make positive changes in their lives) are ideal for use by clinicians. An opportunity exists to take advantage of the teachable moment in the ED in an effort to prevent future occurrences of injury in at‐risk youths. However, little is known about perceptions of youths, parents, and community organizations about such interventions in EDs. The aims of this study were to engage youths, parents, and frontline community workers in conceptualizing a hospital‐based violence prevention intervention and to identify outcomes relevant to the community.Methods:  Concept mapping is an innovative, mixed‐method research approach. It combines structured qualitative processes such as brainstorming and group sorting, with various statistical analyses such as multidimensional scaling and hierarchical clustering, to develop a conceptual framework, and allows for an objective presentation of qualitative data. Concept mapping involves multiple structured steps: 1) brainstorming, 2) sorting, 3) rating, and 4) interpretation. For this study, the first three steps occurred online, and the fourth step occurred during a community meeting.Results:  Over 90 participants were involved, including youths, parents, and community youth workers. A two‐dimensional point map was created and clusters formed to create a visual display of participant ideas on an ED‐based youth violence prevention intervention. Issues related to youth violence prevention that were rated of highest importance and most realistic for hospital involvement included mentorship, the development of youth support groups in the hospital, training doctors and nurses to ask questions about the violent event, and treating youth with respect. Small‐group discussions on the various clusters developed job descriptions, a list of essential services, and suggestions on ways to create a more youth‐friendly environment in the hospital. A large‐group discussion revealed outcomes that participants felt should be measured to determine the success of an intervention program.Conclusions:  This study has been the springboard for the development of an ED‐based youth violence intervention that is supported by the community and affected youth. Using information generated by youth that is grounded in their experience through participatory research methods is feasible for the development of successful and meaningful youth violence prevention interventions.
Educational and Research Advances Stemming from the Academic Emergency Medicine Consensus Conference in Knowledge Translation
Authors: Lang Eddy S. , Wyer Peter , Tabas Jeffrey A. , Krishnan Jerry A. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:865–869 © 2010 by the Society for Academic Emergency MedicineAbstractThe 2007 Academic Emergency Medicine (AEM) consensus conference “Knowledge Translation in Emergency Medicine” yielded a number of initiatives in both education and research that directly reflected the conference’s published objectives and recommendations. One research initiative, CONCERT, is a national consortium of chronic obstructive pulmonary disease (COPD) investigators who set forth an effort designed to optimize COPD care through the identification of gaps between research and practice in diagnosis and management of the chronic and acute care aspects of this disease. In addition to CONCERT, educational programs designed to identify barriers to evidence implementation and to develop solutions to achieve uptake through multidisciplinary collaboration have emerged that reflect the impact of the consensus conference. This article describes these initiatives and highlights the potential for future innovative opportunities.
Enzymatic degradation of adhesive–dentin interfaces produced by mild self‐etch adhesives
Authors: De Munck Jan , Mine Atsushi , Van den Steen Philippe E. , Van Landuyt Kirsten L. , Poitevin André , Opdenakker Ghislain , Van Meerbeek Bart 
Published: July 2010

De Munck J, Mine A, Van den Steen PE, Van Landuyt KL, Poitevin A, Opdenakker G, Van Meerbeek B. Enzymatic degradation of adhesive–dentin interfaces produced by mild self‐etch adhesives. Eur J Oral Sci 2010; 118: 494–501. © 2010 Eur J Oral Sci Endogenous matrix metalloproteinases (MMPs) released by adhesive procedures may degrade collagen in the hybrid layer and so compromise the bonding effectiveness of etch‐and‐rinse adhesives. In this study, endogenous enzymatic degradation was evaluated for several simplified self‐etch adhesives. In addition, primers were modified by adding two MMP inhibitors: chlorhexidine, a commonly used disinfectant, but also a non‐specific MMP inhibitor; and SB‐3CT, a specific inhibitor of MMP‐2 and MMP‐9. Gelatin zymography of fresh human dentin powder was used to identify the enzymes released by the adhesives. Micro‐tensile bond strength (μTBS) testing was used to assess the mechanical properties of resin–dentin interfaces over time. In none of the experimental groups treated with the mild self‐etch adhesives was MMP‐2 and/or MMP‐9 identified. Also, no difference in the μTBS was measured for the inhibitor‐modified and the control inhibitor‐free adhesives after 6 months of water storage. It is concluded that in contrast to etch‐and‐rinse adhesives, the involvement of endogenous MMP‐2 and MMP‐9 in the bond‐degradation process is minimal for mild self‐etch adhesives.
Use of antimalarials in dermatology
Authors: Ochsendorf Falk R. 
Published: July 2010

SummaryThe antimalarials chloroquine and hydroxychloroquine have been used for the treatment of inflammatory diseases for more than 60 years. Even today new indications evolve due to the complex mode of action of these compounds. Due to the fear of side effects, especially irreversible retinopathy, their use is often limited. These side‐effects, however, are a consequence of excessive daily dosages. An effective, safe therapy needs correct dosing, i. e. adherence to maximal daily dosages of 3.5(–4) mg chloroquine or 6(–6.5) mg hydroxychloroquine per kilogram ideal body weight. If the actual body weight is lower than the ideal body weight, this actual weight is used for the calculation of the dosage. Observing these limits allows a rather safe therapy of the diseases like lupus erythematosus, REM syndrome, porphyria cutanea tarda (2 × 125 mg chloroquine/week), cutaneous sarcoidosis and dermatomyositis. If standard therapies fail, then antimalarials can be tried to treat Sjögren syndrome, granu‐loma annulare or erosive lichen planus. If therapy fails, either can be combined with quinacrine to increase their effectiveness. Chloroquine and hydroxychloroquine are indispensable and well‐tolerated essential drugs in dermatology and especially suited as part of a combination scheme, for example with corticosteroids, as they act synergistically and reduce side‐effects.
Omalizumab therapy in atopic dermatitis: depletion of IgE does not improve the clinical course – a randomized, placebo‐controlled and double blind pilot study
Authors: Heil Peter Maximilian , Maurer Dieter , Klein Brigitte , Hultsch Thomas , Stingl Georg 
Published: July 2010

Summary Background: Our understanding of the pathogenic role of IgE in atopic dermatitis is incomplete. We asked whether blocking free IgE would alter the course of the disease. Patients and Methods: We administered either omalizumab, a humanized monoclonal mouse antibody against IgE, or placebo subcutaneously for 16 weeks to 20 atopic dermatitis patients and measured immunological and clinical disease parameters. Results: Omalizumab (I) reduced free serum IgE, (II) lowered surface IgE and FcɛRI expression on different peripheral blood mononuclear cells, (III) reduced the saturation of FcɛRI with IgE, (IV) increased the number of free FcɛRI and (V) lowered the number of IgE+, but not of FcɛRI+ cells in skin. The in vivo relevance of these results is evidenced by the increase in the threshold allergen concentration required to give a type I hypersensitivity reaction in the titrated skin test. While not significantly altering the clinical disease parameters, omalizumab treatment led to an improvement of the atopy patch test results in single patients, i.e. an eczematous reaction upon epicutaneous allergen challenge. Conclusions: The interference with immediate and delayed type skin tests may imply that a therapeutic benefit of omalizumab treatment, if present at all, would be seen in patients with acute rather than chronic forms of the disease.
Occurrence of common and rare δ‐globin gene defects in two multiethnic populations: thirteen new mutations and the significance of δ‐globin gene defects in β‐thalassemia diagnostics
Authors: PHYLIPSEN M. , GALLIVAN M. V. E. , ARKESTEIJN S. G. J. , HARTEVELD C. L. , GIORDANO P. C. 
Published: July 2010

SummaryIntroduction:  The aim of this review is to study the frequency of common and the occurrence of rare and novel mutations of the delta‐globin gene and of Hb Lepore defects that might interfere with thalassemia diagnostics and to report the rationale of HbA2 estimation in the presence of delta‐ or alpha‐gene mutations.Methods:  A total of 135 cases suspected to have a delta‐globin gene defect collected in a diagnostic center in the USA and in a reference laboratory in the Netherlands were characterized by molecular analysis.Results:  Hb B2 was found at a frequency of at least 0.5% in the USA and 0.87% in the Netherlands. Known variants such as Hb A2‐Babinga, Hb A2‐Sphakia, Hb A2‐Fitzroy, Hb A2‐Flatbush, Hb A2‐NYU, Hb A2‐Grovetown, HbA2‐Yialousa, Hb A2‐Indonesia and several delta‐thalassemia mutations were found together with 13 new mutations and two new polymorphisms, while Hb Lepores were regularly observed.Conclusion:  HbA2 mutations either structurally stable and visible or undetectable because of a thalassemia effect or instability are clinically asymptomatic but may compromise the diagnosis of beta‐thalassemia minor. Stable mutations result in two HbA2 fractions of about half of the expected value. Expression defects are undetectable as a protein fraction but reduce the amount of HbA2 by half.
What makes Early Intervention in Psychosis services effective? A Case Study
Authors: Brabban Alison , Dodgson Guy 
Published: July 2010

AbstractA number of studies have demonstrated that Early Intervention in Psychosis (EIP) services can produce improved outcomes for service users. However, the essential elements that produce these results remain elusive. This paper considers a number of hypotheses, with a particular focus on one service in the UK, which was designed according to policy guidance. It concludes that the structure of EIP services allows for the effective implementation of evidence based psychosocial interventions, which often fail to be implemented successfully within standard mental health services.
Do Informed Traders Trade More When the Market Is Thick? Evidence from the Nikkei 225 Index Redefinition of April 2000*
Authors: Ahn Hee‐Joon , Cai Jun , Chung Jay M. 
Published: July 2010

AbstractUsing the Nikkei 225 index redefinition that took place in April 2000, we examine whether informed traders strategically trade more when they face increased liquidity trading, as predicted by Admati & Pfleiderer (1988). The significant increase (decrease) in liquidity trading for the new additions (deletions) caused by index trading activities after index redefinition offers a valuable opportunity to empirically test the predictions of Admati and Pfleiderer. The April 2000 index redefinition was not accompanied by any information effects because the event itself was unrelated to changes in firm fundamentals, nor did it involve any information confirmation effects. Our empirical findings support the predictions of the strategic information trader model. We find that informed trading, as measured by the probability of informed trading, increases significantly after additions and decreases significantly after deletions. Further analysis reveals that probability of informed trading changes are associated with changes in investor composition, especially for domestic institutions and foreign shareholders.
Precision of dosimetry‐related measurements obtained on current multidetector computed tomography scanners
Authors: Mathieu Kelsey B. , McNitt‐Gray Michael F. , Zhang Di , Kim Hyun J. , Cody Dianna D. 
Published: July 2010

Purpose:Computed tomography (CT) intrascanner and interscanner variability has not been well characterized. Thus, the purpose of this study was to examine the within‐run, between‐run, and between‐scanner precision of physical dosimetry‐related measurements collected over the course of 1 yr on three different makes and models of multidetector row CT (MDCT) scanners.Methods:Physical measurements were collected using nine CT scanners (three scanners each of GE VCT, GE LightSpeed 16, and Siemens Sensation 64 CT). Measurements were made using various combinations of technical factors, including kVp, type of bowtie filter, and x‐ray beam collimation, for several dosimetry‐related quantities, including (a) free‐in‐air CT dose index; (b) calculated half‐value layers and quarter‐value layers; and (c) weighted CT dose index calculated from exposure measurements collected in both a 16 and 32 cm diameter CTDI phantom. Data collection was repeated at several different time intervals, ranging from seconds (for values) to weekly for 3 weeks and then quarterly or triannually for 1 yr. Precision of the data was quantified by the percent coefficient of variation (%CV).Results:The maximum relative precision error (maximum %CV value) across all dosimetry metrics, time periods, and scanners included in this study was 4.33%. The median observed %CV values for ranged from 0.05% to 0.19% over several seconds, 0.12%–0.52% over 1 week, and 0.58%–2.31% over 3–4 months. For for a 16 and 32 cm CTDI phantom, respectively, the range of median %CVs was 0.38%–1.14% and 0.62%–1.23% in data gathered weekly for 3 weeks and 1.32%–2.79% and 0.84%–2.47% in data gathered quarterly or triannually for 1 yr.Conclusions:From a dosimetry perspective, the MDCT scanners tested in this study demonstrated a high degree of within‐run, between‐run, and between‐scanner precision (with relative precision errors typically well under 5%).
Design and optimization of large area thin‐film CdTe detector for radiation therapy imaging applications
Authors: Parsai E. Ishmael , Shvydka Diana , Kang Jun 
Published: July 2010

Purpose:The authors investigate performance of thin‐film cadmium telluride (CdTe) in detecting high‐energy (6 MV) x rays. The utilization of this material has become technologically feasible only in recent years due to significant development in large area photovoltaic applications.Methods:The CdTe film is combined with a metal plate, facilitating conversion of incoming photons into secondary electrons. The system modeling is based on the Monte Carlo simulations performed to determine the optimized CdTe layer thickness in combination with various converter materials.Results:The authors establish a range of optimal parameters producing the highest DQE due to energy absorption, as well as signal and noise spatial spreading. The authors also analyze the influence of the patient scatter on image formation for a set of detector configurations. The results of absorbed energy simulation are used in device operation modeling to predict the detector output signal. Finally, the authors verify modeling results experimentally for the lowest considered device thickness.Conclusions:The proposed CdTe‐based large area thin‐film detector has a potential of becoming an efficient low‐cost electronic portal imaging device for radiation therapy applications.
A method for optimizing LINAC treatment geometry for volumetric modulated arc therapy of multiple brain metastases
Authors: Kang Jun , Ford Eric C. , Smith Koren , Wong John , McNutt Todd R. 
Published: July 2010

Purpose:Volumetric modulated arc therapy (VMAT) is a rotational delivery technique in which MLC shapes, dose rate, and gantry rotation speed are optimized to produce conformal dose distributions. The aim of this work is to develop a beam projection method for deriving the optimal table and collimator angles for multilesion treatment planning.Methods:The method consists of four steps. The first step is to define the vector of beam‐eye‐view (BEV)‐‐axis in the treatment planning CT coordinates. The second step is to project each target onto the BEV‐‐axis vector. In the third step, the best table and collimator angle are found with a brute‐force optimization technique that minimizes MLC leaf sharing between lesions. The fourth step is to generate an optimized VMAT plan with appropriate table/collimator angles and evaluate the plan quality.Results:The authors tested the method on three example cases with targets of various locations in the brain and sizes ranging from 1.18 to. Applying the optimized geometric parameter to generate VMAT plan, a reduction of the 12 Gy volume was more than 6.1% for all cases; the plan homogeneity was improved from to vs a VMAT plan with the manufacturer recommended table and collimator angles.Conclusions:The authors conclude that the use of the projection method minimizes the sharing of MLC leaves between lesions and improves the plan quality for multilesion VMAT delivery.
An improved Bayesian tensor regularization and sampling algorithm to track neuronal fiber pathways in the language circuit
Authors: Mishra Arabinda , Anderson Adam W. , Wu Xi , Gore John C. , Ding Zhaohua 
Published: July 2010

Purpose:The purpose of this work is to design a neuronal fiber tracking algorithm, which will be more suitable for reconstruction of fibers associated with functionally important regions in the human brain. The functional activations in the brain normally occur in the gray matter regions. Hence the fibers bordering these regions are weakly myelinated, resulting in poor performance of conventional tractography methods to trace the fiber links between them. A lower fractional anisotropy in this region makes it even difficult to track the fibers in the presence of noise. In this work, the authors focused on a stochastic approach to reconstruct these fiber pathways based on a Bayesian regularization framework.Methods:To estimate the true fiber direction (propagation vector), thea priori and conditional probability density functions are calculated in advance and are modeled as multivariate normal. The variance of the estimated tensor element vector is associated with the uncertainty due to noise and partial volume averaging (PVA). An adaptive and multiple sampling of the estimated tensor element vector, which is a function of the pre‐estimated variance, overcomes the effect of noise and PVA in this work.Results:The algorithm has been rigorously tested using a variety of synthetic data sets. The quantitative comparison of the results to standard algorithms motivated the authors to implement it forin vivo DTI data analysis. The algorithm has been implemented to delineate fibers in two major language pathways (Broca's to SMA and Broca's to Wernicke's) across 12 healthy subjects. Though the mean of standard deviation was marginally bigger than conventional (Euler's) approach [P. J. Basser et al., “In vivo fiber tractography using DT‐MRI data,” Magn. Reson. Med. 44(4), 625–632 (2000)], the number of extracted fibers in this approach was significantly higher. The authors also compared the performance of the proposed method to Lu's method [Y. Lu et al., “Improved fiber tractography with Bayesian tensor regularization,” Neuroimage 31(3), 1061–1074 (2006)] and Friman's stochastic approach [O. Friman et al., “A Bayesian approach for stochastic white matter tractography,” IEEE Trans. Med. Imaging 25(8), 965–978 (2006)]. Overall performance of the approach is found to be superior to above two methods, particularly when the signal‐to‐noise ratio was low.Conclusions:The authors observed that an adaptive sampling of the tensor element vectors, estimated as a function of the variance in a Bayesian framework, can effectively delineate neuronal fibers to analyze the structure‐function relationship in human brain. The simulated andin vivo results are in good agreement with the theoretical aspects of the algorithm.