bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing the NICE guideline for schizophrenia recommendations for psychological therapies: a qualitative analysis of the attitudes of CMHT staff
Authors: Prytys M. , Garety P. A. , Jolley S. , Onwumere J. , Craig T. 
Published: May 2010

AbstractObjectives. Despite national guidelines recommending cognitive–behavioural therapy (CBT) and family intervention (FI) in the treatment of schizophrenia, levels of implementation in routine care remain low. The present study investigates attitudinal factors amongst community mental health team (CMHT) staff affecting guideline implementation.Design. CMHTs were audited to measure the capacity and delivery of CBT and FI, and semi‐structured interviews were conducted with staff from the teams.Methods. Four CMHTs were audited, and five care coordinators from each team were interviewed. A purposive approach to sampling was used to represent the range of professional training of care coordinating staff. Data were analysed using thematic content analysis.Results. Positive views towards guidelines were evident, although tempered by specific implementation issues. Employing simple psychological interventions and approaches as part of the care coordinating role also emerged as highly valued by staff. Severe workload, time pressure and the need for specialist staff were crucial barriers to implementation. Pessimistic views of recovery for clients with psychosis were also apparent and may affect implementation.Conclusions. Staff attitudes and knowledge are an important area of research when examining guideline implementation and require further study. Key themes that have emerged could inform future training agendas and should be considered when developing guideline implementation strategies for the updated 2009 guidelines. Copyright © 2010 John Wiley & Sons, Ltd.Key Practitioner Message:• There continues to be limited access to psychological therapies for those with a diagnosis of schizophrenia—barriers relate to staff attitudes and knowledge as well as training, resources and organization of services.• A rolling programme of training is required to ensure all clinical staff have a broad understanding of recommended psychological therapies and are competent to discuss these interventions with patients and carers.• Services require access to staff with both the appropriate competencies and dedicated time to deliver CBT for psychosis and FI and ongoing supervision of this work.• Services should regularly and objectively audit eligibility for interventions and offers, uptake and outcome of therapy.
Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial
Authors: Kerr Catherine E. , Josyula Krishnapriya , Littenberg Ronnie 
Published: May 2010

AbstractMindfulness‐based stress reduction (MBSR) is an 8‐week training that is designed to teach participants mindful awareness of the present moment. In randomized clinical trials (RCTs), MBSR has demonstrated efficacy in various conditions including reducing chronic pain‐related distress and improving quality of life in healthy individuals. There have, however, been no qualitative studies investigating participants' descriptions of changes experienced over multiple time points during the course of the programme. This qualitative study of an MBSR cohort (N = 8 healthy individuals) in a larger RCT examined participants' daily diary descriptions of their home‐practice experiences. The study used a two‐part method, combining grounded theory with a close‐ended coding approach. The grounded theory analysis revealed that during the trial, all participants, to varying degrees, described moments of distress related to practice; at the end of the course, all participants who completed the training demonstrated greater detail and clarity in their descriptions, improved affect, and the emergence of an observing self. The closed‐ended coding schema, carried out to shed light on the development of an observing self, revealed that the emergence of an observing self was not related to the valence of participants' experiential descriptions: even participants whose diaries contained predominantly negative characterizations of their experience throughout the trial were able, by the end of the trial, to demonstrate an observing, witnessing attitude towards their own distress. Progress in MBSR may rely less on the valence of participants' experiences and more on the way participants describe and relate to their own inner experience. Copyright © 2010 John Wiley & Sons, Ltd.Key Practitioner Message:This article• Analyses the ways in which participants in a mindfulness‐based stress reduction (MBSR) clinical trial describe their experiences with mindfulness practice.• Carries out qualitative analysis of the ways in which participants' descriptions of home‐based meditation practice contained in their practice diaries change over the course of an 8‐week MBSR trial.• Demonstrates that the participants who successfully completed the 8‐week course show a common developmental trajectory, as each participant used less reactive, judgemental language to describe their home meditative practice‐based experiences by the end of the trial, even when, in the case of some participants, that experience was perceived as negative or distressing.• Suggests that progress in MBSR may rely less on the valence of participants' experience and more on the way participants describe and relate to their own inner experience.
Dynamics of PFC power converters subject to time‐delayed feedback control
Authors: El Aroudi Abdelali , Orabi Mohamed 
Published: May 2010

SUMMARYPower factor correction converters are power electronics circuits used as AC‐DC power supplies. These systems are well known to exhibit nonlinear phenomena such as subharmonic oscillations and chaotic regimes. These undesirable behaviors increase the THD and therefore can jeopardize enormously the system performances. In this paper, time delay feedback control is applied to stabilize a two‐stage power factor correction AC‐DC converter when it exhibits these instabilities under traditional controllers. This control technique introduces many advantages to the most and widely used average current mode control through widening the stability domain of the system. By appropriately selecting the time delay feedback gain and the time delay period, the undesirable subharmonic components are eliminated, whereas the desired ones remain unchanged. A harmonic balance approach is used for studying the dynamics of the system under the new control scheme and to obtain the stabilization domain. Copyright © 2010 John Wiley & Sons, Ltd.
Application of polychromatic flow cytometry to identify novel subsets of circulating cells with angiogenic potential
Authors: Estes Myka L. , Mund Julie A. , Mead Laura E. , Prater Daniel N. , Cai Shanbao , Wang Haiyan , Pollok Karen E. , Murphy Michael P. , An Caroline S. T. , Srour Edward F. , Ingram David A. , Case Jamie 
Published: May 2010

AbstractDefining whether human circulating proangiogenic cells represent a subset of the hematopoietic system and express CD45 or are hematopoietic derivatives that do not express CD45 (and are called endothelial progenitor cells) remains controversial. We have previously developed a polychromatic flow cytometry (PFC) protocol to isolate subsets of hematopoietic cells and we now identify the circulating pool of CD34+CD45dim cells representing functional circulating hematopoietic stem and progenitor cells (CHSPCs) that can be separated on the basis of AC133 expression and report that the AC133+ subset of the CHSPCs enhances the growth of tumor blood vessels in vivo in immunodeficient mice. In addition, the ratio of AC133+ proangiogenic CHSPCs to AC133− nonangiogenic CHSPCs unambiguously correlates with the severity of the clinical state of patients with peripheral arterial disease. In sum, a PFC protocol validated via in vitro and in vivo analyses, can be used to interrogate the roles of human hematopoietic elements in the growth and maintenance of the vasculature. © 2010 International Society for Advancement of Cytometry
Cytohistological correlation of grading in breast carcinoma
Authors: Lingegowda Jyothi B. , MuddeGowda Prakash H. , Ramakantha Chatura K. , Chandrasekar H. R. 
Published: May 2010

AbstractAssigning a tumor grade to breast cancer provides important prognostic information and guides optimal therapy. The present study was undertaken to grade breast carcinoma on aspirates by Robinson grading (RGS) and Scarff–Bloom–Richardson grading system (SBR). Histological grading was done according to Nottingham modification of Scarff–Bloom–Richardson method and the two cytological grading systems were compared.Fifty cases of breast carcinoma with preoperative cytologic diagnosis were assigned tumor grade. Histologic grading was done on corresponding mastectomy or partially resected specimens. Statistical analysis was performed; correlation between cytologic and histologic grading was established using Spearman correlation coefficient. Regression analysis was done to assess the significance of each cytological feature.Univariate analysis showed strong correlation (P < 0.01) for all features except dissociation. Multiple regression analysis of cytologic features revealed cell dissociation nucleoli and nuclear margin as the most influential features. A concordance of 72.5% between RGS (cyto) and SBR (cyto), 64% for RGS (cyto) and SBR (histo), 82% for SBR (cyto) and SBR (histo) was noted. There was a significant association (P < 0.001) between the grades assigned to cytologic and histologic specimens.Cytologic grade could be used to predict histologic grade as significant relationship exists between grades assigned to cytologic and histologic specimens. Diagn. Cytopathol. 2011;39:251–257. © 2010 Wiley‐Liss, Inc.
Follow‐up of women with ASCUS in Chile
Authors: Fanny López , Orlando Quezada , Trinidad Barrios , Estefanía López 
Published: May 2010

AbstractAtypical squamous cells of undetermined significance (ASCUS) is a cytological report that creates a dilemma for the cytologist and the clinician because it does not necessarily represent a pathological entity. To clarify this paradox we propose research into the monitoring of cytological and histological results for a period of 3 years from a cohort of women treated in the Primary Care Health Services of Santiago, Chile, who have received a first Pap ASCUS results in 2005. In the cytological reports, the national nomenclature was used, which is equivalent to the Bethesda System 2001. By applying the selection criteria, a cohort of 154 women was formulated, whereby at the end of the monitoring period, we found: 2 women with invasive carcinoma (1.3%), 33 women with high‐grade squamous intraepithelial lesions HSIL (21.4%), 32 women with low grade squamous intraepithelial lesions LSIL (20.8%), and 87 women with normal results (56.5%). The statistical analysis, by form of the tree of conditional probabilities, shows that when the 2nd smear is repeated within an accelerated time frame (2.7 months), it does not assist in elucidating this cytological entity, and should be repeated only after 6 months from the first ASCUS smear result. Thus, we found that one out of every two women showed no evidence of abnormal results throughout their cytological and histological monitoring. Diagn. Cytopathol. 2011;39:258–263. © 2010 Wiley‐Liss, Inc..
Cytomorphological patterns of M. bovis BCG and M. tuberculosis on fine needle aspiration biopsies: Does HIV make a difference?
Authors: Schubert Pawel T. , Cotton Mark F. , Wright Colleen A. 
Published: May 2010

AbstractTo determine if fine needle aspiration (FNAB) of mycobacterial lymphadenopathy can differentiate infection with M. bovis BCG (BCG) from M. tuberculosis (TB) and whether HIV status affects discriminatory cytological features.A retrospective study of culture positive, fine needle aspiration biopsies of lymph nodes in children (<13 years) between 2003 and 2008.A total of 77 aspirates were available for evaluation with 67 (87%) patients having known HIV status. BCG occurred at a younger age (6 months), predominantly axillary lymph nodes (90%) compared with TB (5 years and 20% axillary lymph nodes). Amorphous necrosis was only seen in aspirates fromTB lymph nodes, while in HIV negative children with TB, foamy macrophages were absent. OnZN staining there were more organisms in the BCG group and in HIV positive patients the organisms were present in both extra‐ and intracellular locations, whereas in the HIV negative patients the organisms were predominantly extracellular in location.Demographic and cytomorphologic features that can assist in distinguishing between thetwo mycobacterial species include: age of patient, location of the lymph node, and presence/absence of amorphous necrosis and foamy macrophages on FNAB. However the only reliable method to identify the mycobacterial species is by mycobacterial culture and/orPCR. Diagn. Cytopathol. 2011;39:264–269. © 2010 Wiley‐Liss, Inc.
Role of brush cytology in the diagnosis of Barrett's esophagus: An analysis of eight cases
Authors: Padmavathy Femila , Siddaraju Neelaiah , Sistla Sarath Chandra 
Published: May 2010

AbstractAlthough debatable, role of cytology in diagnosing Barrett's esophagus has been stressed by some authors. Our brief report analyses the role of brush cytology (BC) in its diagnosis.Eight patients who presented with upper gastrointestinal (GI) manifestations and subsequently diagnosed to have Barrett's esophagus with or without adenocarcinoma on brush cytology (BC) or, endoscopic biopsy (EB) or, a combination of both the techniques were included in the study. In all the cases routine cytologic smears and histologic sections with relevant special stains (when essential) were studied. On cytology, the diagnosis of “Barrett's esophagus” was made when the esophageal brushings obtained from a region beyond 3 cm from the gastroesophageal junction showed closely intermingled clusters of squamous and columnar cells, or when there was evidence of intestinal metaplasia. Adenocarcinoma in Barrett's esophagus was diagnosed by the usual criteria for malignancy with features of adenocarcinoma. Cytologic diagnoses were correlated with the histologic diagnoses.Of the eight cases, seven had histopathologic correlation of which six had evidence of BE on BC; four had cytohistologic concordance, of which three cases revealed adenocarcinoma arising in BE. Two endoscopic biopsies were nonrepresentative. In one case, cytology missed Barrett's esophagus. For two cases in which cytology detected Barrett's mucosa, biopsies were nonrepresentative.Our study showed brush cytology (BC) to be a fairly reliable test for detecting Barrett's esophagus. Owing to its inherent advantage of sampling a wider and circumferential area, a technically well performed brushing procedure is likely to be more representative and superior than multiple endoscopic biopsies. Diagn. Cytopathol. 2011;39:60–64. © 2010 Wiley‐Liss, Inc.
Nonhealing ulcer—A rare initial presentation of chronic myeloid leukemia diagnosed on aspiration cytology
Authors: Wadhwa Neelam , Batra Madhu , Singh Bharat 
Published: May 2010

AbstractInvolvement of skin in hematologic malignancies is rare phenomena as majority of the dermatologic lesions in leukemia patients are nonleukemic. In the absence of preceding history of leukemia, the diagnosis is often a surprise. Chronic nonhealing ulcer on the back of a 65‐years‐old male prompted a fine needle aspiration from its base. Smears showed an unexpected picture comprising of leukocytes in various stages of maturation against a hemorrhagic background. A cytologic diagnosis of leukemia cutis was given. Subsequent hematologic investigations revealed chronic myeloid leukemia in chronic phase. Cutaneous involvement is a rare initial presentation of leukemia in an otherwise asymptomatic patient and also an uncommon cause of nonhealing ulcer. Aspiration cytology scores over biopsy in not only being a rapid and easy diagnostic tool but also allows better appreciation of cellular details like cytoplasmic granules. Diagn. Cytopathol. 2011;39:135–137. © 2010 Wiley‐Liss, Inc.
Prevalence of anal cytological abnormalities in women with positive cervical cytology
Authors: Calore Edenilson E. , Giaccio Claudia Maria Serafim , Nadal Sidney R. 
Published: May 2010

AbstractThe objective of this study was to estimate the prevalence of cytological abnormalities of the anal mucosa in women with positive cervical cytology, but without macroscopic anal lesion. Ultimately we postulated if the anal mucosa may be a reservoir of HPV, which would allow the reinfection of cervix. Forty‐nine patients with abnormal cervical cytology were selected for this work. In a period not exceeding one week of collecting cervix cytology, two swab specimens of the anal canal were also collected. Women diagnosed with cervical HSIL by Pap smear were referred for colposcopy with biopsy of the lesions, to confirm the cytologic diagnosis and ablation of the lesion. We demonstrated a high prevalence of anal squamous intraepithelial lesions in patients with cervical squamous intraepithelial lesions (29 of the total of 49 patients = 59.2%). Of the 20 cases of cervical LSIL, 11 (55%) had abnormal anal cytology. Of the 26 cases with cervical HSIL, 16 (61.5%) had abnormal anal cytology. So, there was a discrete higher prevalence of abnormal anal cytology in cases of high‐grade cervical squamous lesions (cervical HSIL). These results help to support the hypothesis that the anal mucosa is a reservoir of HPV, which can be a source of re‐infection for the cervix. However, there was no significant association between the practice of anal sex and the prevalence of anal cytological abnormalities. These facts are epidemiologically important for future programs for population eradication of cervical lesions related to HPV. Diagn. Cytopathol. 2011;39:323–327. © 2010 Wiley‐Liss, Inc.
Gigantomastia in pregnancy with an accessory axillary mass masquerading as inflammatory carcinoma
Authors: Lokuhetty M. D. S. , Saparamadu P. A. M. , Al‐Sajee D. M. A. , Al‐Ajmi R. 
Published: May 2010

AbstractGiagantomastia is a rare disorder known to occur in pregnancy, causing enlargement of the breasts greater than that of gravid enlargement. The histological features of gigantomastia are glandular hyperplasia and an increase of stromal tissue. Illustrated by one documented case, cytomorphology of gigantomastia was misdiagnosed as a phyllodes tumor. We document the cytomorphology of an axillary mass in a gravid woman of 24 years with gigantomastia. She presented in her first trimester with bilateral mastalgia and swelling, nonresponsive to antibiotics. Imaging excluded mass breast lesions and a pituitary prolactinoma. The breasts progressively enlarged, became warm, tender, and developed skin ulcerations and a peau d'orange appearance. Subsequently she developed a mass in her left axilla. On aspiration of the mass, some of the cytomorphological features were suspicious for a metastasis, which correlated well with her clinical features. Careful evaluation suggested cytomorphology to be compatible with benign accessory breast tissue with possible hormone related changes of pregnancy. Histology of the excised axillary mass confirmed this diagnosis. Thus, awareness of this rare condition and careful evaluation is mandatory to avoid misdiagnosis in a similar clinical context. Diagn. Cytopathol. 2011;39:141–143. © 2010 Wiley‐Liss, Inc.
Retrospective evaluation of instituted standard adequacy criteria for on‐site adequacy assessment of thyroid fine‐needle aspiration
Authors: Jing Xin , Wey Elizabeth , Michael Claire W. 
Published: May 2010

AbstractThis retrospective study was conducted to investigate the impact of using instituted standard criteria for on‐site assessment of specimen adequacy on fine‐needle aspiration (FNA) diagnosis of thyroid nodules. The study included a total of 1,031 thyroid FNAs that were performed and assisted with on‐site adequacy assessment using instituted standard criteria from July 2006 to March 2009. Adequate specimens require the presence of at least six groups of follicular cells in total on Diff–Quik stained smears with a minimum of 10 cells in each group. Agreement on specimen adequacy between on‐site and final assessment, nondiagnostic rate, distribution of cytologic diagnoses, and cytohistologic concordance for cases with surgical follow‐up was evaluated. Implementing the instituted standard criteria resulted in 93% level of agreement on specimen adequacy between on‐site and final assessment. Nondiagnostic rate upon final assessment was 10.7%. Cytohistologic concordant rate reached 93.9% and 82.3% for nonneoplastic and neoplastic lesions, respectively. Most importantly, this approach to standardization not only provided diagnostic consistency among cytopathologists, but also minimized confusions and enhanced effective communication. Thus, high satisfactions have been achieved from endocrinologists/radiologists who utilized our on‐site assessment service and/or participated in the management of thyroid nodules. Diagn. Cytopathol. 2011;39:391–394. © 2010 Wiley‐Liss, Inc.
Pleomorphic hyalinizing angiectatic tumor: Cytomorphologic features on fine‐needle aspiration
Authors: Cimino‐Mathews Ashley , Ali, Syed Z. 
Published: May 2010

AbstractPleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low‐grade neoplasm occurring predominantly in the subcutaneous tissue of the lower extremity, which is characterized histologically by intermixed bland spindle cells and larger pleomorphic cells, ectatic blood vessels with fibrin, and prominent hyalinization. Here we describe the cytologic features of PHAT seen on fine‐needle aspiration of a right calf mass in a 46‐year‐old man. The smears were cellular, composed predominantly of bland spindle cells dispersed singly as well as in tissue fragments and characterized by open chromatin and small nucleoli. A second population of pleomorphic spindle cells with coarse chromatin, prominent nucleoli, and occasional intranuclear pseudoinclusions was also present. Many of the pleomorphic cells surrounded hyalizined vessels. No mitotic figures were identified. The cytologic diagnosis was a “spindle cell lesion, NOS” with the differential diagnosis including benign lesions and low‐grade neoplasms, including PHAT and schwannoma. Diagn. Cytopathol.2011;39:214–217. © 2010 Wiley‐Liss, Inc.
Sensitivity of fine‐needle aspiration for papillary carcinoma of the thyroid correlates with tumor size
Authors: Renshaw Andrew A. 
Published: May 2010

AbstractFine‐needle aspiration (FNA) of the thyroid for papillary carcinomas is highly sensitive. We sought to determine if the sensitivity of FNA for papillary carcinoma is correlated with the size of the tumor.We reviewed the results of thyroid resections for the last 12 years and correlated the findings with clinical and cytologic information.During the time period, a total of 1,331 resections were performed, and a total of 501 papillary carcinomas were identified, including 291 classic tumors, 65 follicular variants, and 145 “incidental” tumors. Sensitivity for all tumors was strongly correlated with tumor size and ranged from a sensitivity of 0–3% for tumors 2 mm or less, 90% for tumors 1–3 cm (220/244, P < 0.001) and 83% for tumors above 3 cm (47/59, P = 0.02). Abnormal FNAs of classic tumors were always recognized as papillary (262/262) compared to only 49% of follicular variants (32/65, P < 0.001).The sensitivity of FNA for papillary thyroid carcinoma is strongly correlated with tumor size. Tumors smaller than 0.5 cm and tumors larger than 3 cm may be more difficult to successfully aspirate on FNA, and the follicular variant may be more difficult to recognize as papillary. Diagn. Cytopathol., 2011. © 2010 Wiley‐Liss, Inc.