bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of elastography for differential diagnosis of benign and malignant thyroid nodules
Authors: Kagoya Ryoji , Monobe Hiroko , Tojima Hitoshi 
Published: July 2010

OBJECTIVE1) To classify the appearance of thyroid nodules displayed on ultrasound elastography; 2) to explore the sensitivity and specificity of this examination for differentiating benign and malignant nodules, with histopathologic analysis as the reference standard; and 3) to evaluate its utility for avoiding unnecessary procedures.STUDY DESIGNDiagnostic test assessment.SETTINGCommunity hospital.SUBJECTS AND METHODSForty‐seven thyroid nodules in 44 consecutive patients were examined with ultrasound elastography. The images we obtained were classified into four patterns. In addition, the mean strain index of the thyroid nodule and that of the sternocleidomastoid muscle were measured, and the nodule‐tomuscle strain ratio was calculated. As the reference findings, the presence or absence of calcification, irregular margins, and hypoechogenicity of the thyroid nodules were examined using B‐mode ultrasound.RESULTSElastography patterns 3 and 4 were predictive of malignancy, with 73 percent sensitivity (95% confidence interval [CI]: 39%‐94%) and 64 percent specificity (95% CI: 46%‐79%). Additionally, all nodules without calcification and those that presented with patterns 1 or 2 were benign. A strain ratio greater than 1.5 was set as the predictor of thyroid malignancy. This criterion showed 90 percent sensitivity (95% CI: 59%‐100%) and 50 percent specificity (95% CI: 33%‐67%).CONCLUSIONAlthough elastography can assist in the differential diagnosis of thyroid nodules, its diagnostic performance is not ideal at present. Further improvements in the technique and the diagnostic criteria are necessary for this examination to provide a useful contribution to diagnosis.© 2010 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.
Article Commentary: Response to Commentary on Clinical practice guideline: Hoarseness (Dysphonia)
Authors: Schwartz Seth , Setzen Gavin 
Published: July 2010

The commentary published in this edition of the journal addresses several important issues concerning the clinical practice guideline for hoarseness, which has engendered some controversy since its publication. This response addresses those issues.© 2010 American Academy of Otolaryngology‐Head and Neck Surgery Foundation. All rights reserved.
From shopping to social innovation: Getting public financing right in Canada
Authors: Phillips Susan D , Laforest Rachel , Graham Andrew 
Published: July 2010

AbstractGovernments are an important source of funding for the nonprofit and voluntary sector. Yet, the use of funding instruments is conditioned by the political and institutional context. This paper proposes three financing models – charity, welfare state and citizenship – which capture the link between the choice of public financing and the broader institutional context. The financing models are then used to examine the evolution of funding patterns in Canada. We argue that the evolution of financing models in Canada has gradually constrained instrument choice and more importantly, a market-oriented application of funding instruments has dominated the financing debates at the expense of a broader focus on preconditions of applying the instruments effectively. As a result, funding instruments in Canada are poorly suited for fostering innovation and investing in capacity development in the voluntary sector.
No associations between serum concentrations of 25-hydroxyvitamin D and parathyroid hormone and depression among US adults
Authors: Zhao Guixiang , Ford Earl S. , Li Chaoyang , Balluz Lina S. 
Published: July 2010

Although there is evidence that vitamin D deficiency may play a role in depression, studies done on the associations have yielded mixed results. The present study aimed to examine the associations between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) and the presence of depression among US adults. A cross-sectional, population-based sample (including 3916 participants aged ≥ 20 years) from the 2005–6 National Health and Nutrition Examination Survey was used. Participants' depressive symptoms were assessed using the Patient Health Questionnaire-9 diagnostic algorithm. The associations of 25(OH)D and PTH with depression were explored using multivariate logistic regression models. For all the participants, the age-adjusted prevalence was 5·3 (95 % CI 4·3, 6·5) % for having moderate-to-severe depression, 2·3 (95 % CI 1·7, 3·1) % for having major depression and 3·8 (95 % CI 3·0, 4·6) % for having minor depression. Although the age-adjusted prevalence and the unadjusted OR of having moderate-to-severe depression or major depression decreased linearly with increasing quartiles of 25(OH)D (P < 0·05 for trends), no significant associations remained after adjusting for multiple potential confounders such as demographic variables, lifestyle factors and coexistence of a number of chronic conditions. Neither the age-adjusted prevalence nor the OR (unadjusted or adjusted) of having depression differed significantly by the quartiles of PTH. Thus, in contrast to some of the previous findings, the present results did not show significant associations between serum concentrations of 25(OH)D and PTH and the presence of moderate-to-severe depression, major depression or minor depression among US adults. However, these findings need to be further confirmed in future studies.
Being mobile: electric mobility-scooters and their use by older people
Authors: MAY ESTHER , GARRETT ROBYNE , BALLANTYNE ALISON 
Published: July 2010

ABSTRACTThere is increasing use of electric mobility-scooters by older people in South Australia, the fourth largest state in Australia. Although various issues about their use have been raised by users, carers, urban planners and legislators, to date they have received little research attention. The purpose of the study reported in this paper was to explore the factors that influence and impact upon older people who use mobility-scooters, particularly from their own perspectives. Data were collected through a survey of 67 current electric mobility-scooter older users, and through two focus groups with other older South Australian people who were users. The data showed that more than 71 per cent of the participants had owned their scooter for more than two years, most had purchased the scooter as new, and 80 per cent owned a four-wheel scooter. The scooter was used predominantly for getting to and from shops, visiting friends and family, and to go for rides. Most respondents used their scooters three to five times each week and travelled between two and five kilometres from their home. The key findings from the focus groups were categorised into three major themes of ‘obtaining a scooter’, ‘the meaning of mobility’ and ‘issues around sharing spaces’. Each is exemplified. The implications for environmental and building design, for the better training of users, and for public education are discussed.
Being physically active in old age: relationships with being active earlier in life, social status and agents of socialisation
Authors: CASTILLO JESUS MARTÍNEZ DEL , NAVARRO JOSÉ EMILIO JIMÉNEZ-BEATTY , SANZ JOSÉ LUIS GRAUPERA , RODRÍGUEZ MARÍA MARTÍN , IZQUIERDO ANTONIO CAMPOS , PINÉS DAVID DEL HIERRO 
Published: July 2010

ABSTRACTCritical reviews of the literature on the factors that influence physical activity among older adults have argued that existing theoretical frameworks should be extended by integrating those that deal with the complex processes of socialisation and social learning. This paper explores some of the social processes that influence older people's participation in physical activity (beyond that associated with everyday domestic tasks). A questionnaire with items on personal, social and environmental characteristics was completed by a random sample of older adults in the Madrid Autonomous Region (Spain). Significant relationships were found between the type of physical activity participation and: being physically active at earlier life stages, socio-economic status, the encouragement of others or social support in being active, and the knowledge and availability of local facilities. Some cases were observed of re-socialisation into physical activity among those who had been inactive earlier in life, and both appropriate environmental and supportive social conditions appeared instrumental. The findings could usefully inform the design of future social programmes to promote active lifestyles in later life, but given the complexity of the socialisation processes, it would be advisable for future studies to examine other than the four factors featured in the presented analysis, such as the role of cultural differences.
Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the Single Assessment Process in England
Authors: CHALLIS DAVID , ABENDSTERN MICHELE , CLARKSON PAUL , HUGHES JANE , SUTCLIFFE CAROLINE 
Published: July 2010

ABSTRACTThe quality of assessment of older people with health and social care needs has for some time been a concern of policy makers, practitioners, older people and carers in the United Kingdom and internationally. This article seeks to address a key aspect of these concerns, namely whether sufficient expertise is deployed when, as a basis for a care plan and service allocation, an older person's eligibility for local authority adult social-care services requires a comprehensive needs assessment of their usually complex and multiple problems. Is an adequate range of professionals engaged, and is a multi-disciplinary approach applied? The Single Assessment Process (SAP) was introduced in England in 2004 to promote a multi-disciplinary model of service delivery. After its introduction, a survey in 2005–06 was conducted to establish the prevalence and patterns of comprehensive assessment practice across England. The reported arrangements for multi-disciplinary working among local authority areas in England were categorised and reviewed. The findings suggest, first, that the provision of comprehensive assessments of older people that require the expertise of multiple professionals is limited, except where the possibility arose of placement in a care-home-with-nursing, and second that by and large a systematic multi-disciplinary approach was absent. Policy initiatives to address the difficulties in assessment need to be more prescriptive if they are to produce the intended outcomes.
Optimal cut-off values and population means of waist circumference in different populations
Authors: Wang Zhiqiang , Ma Jun , Si Damin 
Published: July 2010

Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define ‘optimal’ cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify individuals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.
Attentional Regulation in Young Twins With Probable Stuttering, High Nonfluency, and Typical Fluency
Authors: Felsenfeld Susan , van Beijsterveldt Catharina Eugenie Maria , Boomsma Dorret Irene 
Published: July 2010

Purpose
Using a sample of 20,445 Dutch twins, this study examined the relationship between speech fluency and attentional regulation in children. A secondary objective was to identify etiological overlap between nonfluency and poor attention using fluency-discordant twin pairs.

Method

Three fluency groups were created at age 5 using a parent questionnaire: (a) probable stuttering (PS;
N
= 826; 4.0%), highly nonfluent (HNF;
N
= 547; 2.7%), and typically fluent (TF;
N
= 19,072; 93%). Multiple scales assessing attention, primarily self-regulation/inhibition, were obtained from both parents when children were ages 5 and 7 and from teachers when children were age 7.

Results

When compared with the TF controls, both the PS and HNF children received higher (i.e., more problematic) scores on parental attention ratings at both ages (
p
< .002). Effect sizes were moderate for both groups. Teacher and parent ratings were generally comparable. The discordant co-twin analyses suggested that nonfluency and attention were influenced by potentially overlapping genetic and shared environmental factors.

Conclusions
The liability to express both high nonfluency and problems with self-regulation/inhibition may arise from a common set of pathogenic mechanisms. This supports emerging models of stuttering, which propose that poor fluency may be part of a broader network of impaired self-regulatory processes.
Classification of Speech and Language Profiles in 4-Year-Old Children With Cerebral Palsy: A Prospective Preliminary Study
Authors: Hustad Katherine C. , Gorton Kristin , Lee Jimin 
Published: July 2010

PurposeIn this study, the authors proposed and tested a preliminary speech and language classification system for children with cerebral palsy.MethodSpeech and language assessment data were collected in a laboratory setting from 34 children with cerebral palsy (CP; 18 male, 16 female) with a mean age of 54 months (SD= 1.8). Measures of interest were vowel area, speech rate, language comprehension scores, and speech intelligibility ratings.ResultsCanonical discriminant function analysis showed that 3 functions accounted for 100% of the variance among profile groups, with speech variables accounting for 93% of the variance. Classification agreement varied from 74% to 97% based on 4 different classification paradigms.ConclusionsThe results of this study provide preliminary support for the classification of speech and language abilities of children with CP into 4 initial profile groups. Further research is necessary to validate the full classification system.
Determinants of Nosocomial Infection in 6 Neonatal Intensive Care Units: An Italian Multicenter Prospective Cohort Study
Authors: Auriti Cinzia , Ronchetti Maria Paola , Pezzotti Patrizio , Marrocco Gabriella , Quondamcarlo Anna , Seganti Giulio , Bagnoli Francesco , De Felice Claudio , Buonocore Giuseppe , Arioni Cesare , Serra Giovanni , Bacolla Gianfranco , Corso Giovanna , Mastropasqua Savino , Mari Annibale , Corchia Carlo , Di Lallo Domenico , Ravà Lucilla , Orzalesi Marcello , Di Ciommo Vincenzo 
Published: July 2010

Background.Nosocomial infections are still a major cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs).Objective.To describe the epidemiology of nosocomial infections in NICUs and to assess the risk of nosocomial infection related to the therapeutic procedures performed and to the clinical characteristics of the neonates at birth and at admission to the NICU, taking into account the time between the exposure and the onset of infection.Design.A multicenter, prospective cohort study.Patients and Setting.A total of 1,692 neonates admitted to 6 NICUs in Italy were observed and monitored for the development of nosocomial infection during their hospital stay.Methods.Data were collected on the clinical characteristics of the neonates admitted to the NICUs, their therapeutic interventions and treatments, their infections, and their mortality rate. The cumulative probability of having at least 1 infection and the cumulative probability of having at least 1 infection or dying were estimated. The hazard ratio (HR) for the first infection and the HR for the first infection or death were also estimated.Results.A total of 255 episodes of nosocomial infection were diagnosed in 217 neonates, yielding an incidence density of 6.9 episodes per 1,000 patient-days. The risk factors related to nosocomial infection in very-low-birth-weight neonates were receipt of continuous positive airway pressure (HR, 3.8 [95% confidence interval {CI}, 1.7-8.1]), a Clinical Risk Index for Babies score of 4 or greater (HR, 2.2 [95% CI, 1.4-3.4]), and a gestational age of less than 28 weeks (HR, 2.1 [95% CI, 1.2-3.8]). Among heavier neonates, the risk factors for nosocomial infection were receipt of parenteral nutrition (HR, 8.1 [95% CI, 3.2-20.5]) and presence of malformations (HR, 2.3 [95% CI, 1.5-3.5]).Conclusions.Patterns of risk factors for nosocomial infection differ between very-low-birth-weight neonates and heavier neonates. Therapeutic procedures appear to be strong determinants of nosocomial infection in both groups of neonates, after controlling for clinical characteristics.
Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies
Authors: El‐Serag H. , Becher A. , Jones R. 
Published: July 2010

SummaryBackground  Persistent gastro‐oesophageal reflux disease (GERD) symptoms can occur despite proton pump inhibitor (PPI) therapy.Aim  To assess the prevalence and potential determinants of persistent GERD symptoms in primary care and community‐based studies.Methods  Studies were identified by systematic PubMed and Embase searches; pooled prevalence data are shown as sample‐size weighted means and 95% confidence intervals.Results  Nineteen studies in individuals with GERD taking a PPI were included. In interventional, nonrandomized primary care trials, the prevalence of persistent troublesome heartburn and regurgitation was 17% (6–28%) and 28% (26–30%) respectively; in randomized trials, it was 32% (25–39%) and 28% (26–30%), respectively. In observational primary care and community‐based studies, 45% (30–60%) of participants reported persistent GERD symptoms. Overall, persistent GERD symptoms despite PPI treatment were more likely in studies with a higher proportion of female participants [>60% vs. <50%, risk ratio (RR): 3.66; P < 0.001], but less likely in studies from Europe than in those from the USA (RR: 0.71; P < 0.001), and were associated with decreased psychological and physical well‐being.Conclusions  Persistent GERD symptoms despite PPI treatment are common in the primary care and community setting. Alternative approaches to management are required.
Tumour lysis syndrome: an unusual presentation
Authors: Chubb E. A. , Maloney D. , Farley‐Hills E. 
Published: July 2010

SummaryWe report a case of spontaneous tumour lysis syndrome that developed postoperatively in a patient with undiagnosed Burkitt’s lymphoma. The former diagnosis was made, unusually, following the development of white emulsion‐like urine in the catheter bag whilst the patient was being managed in the intensive care unit. After laboratory analysis, the urine was found to contain large quantities of uric acid crystals which were the key to the prompt diagnosis. Spontaneous tumour lysis syndrome is rare and this case highlights the difficulties in making an early diagnosis when the presence of a predisposing tumour has not yet been identified. Untreated tumour lysis syndrome can be fatal due to severe biochemical disturbances causing cardiac dysfunction and multi‐organ failure. Early recognition and treatment are crucial to prevent morbidity and mortality. The unusual presentation of this case in association with an undiagnosed Burkitt’s lymphoma emphasises how vigilant anaesthetists and intensivists must be in recognising this potentially life‐threatening condition. We believe that the triggering factor in this case was laparotomy and handling of the tumour.
Shelf life extension of durum semolina‐based fresh pasta
Authors: Costa Cristina , Lucera Annalisa , Mastromatteo Marcella , Conte Amalia , Del Nobile Matteo Alessandro 
Published: July 2010

SummaryIn this work, the combined effects of chitosan, modified atmosphere packaging (MAP) and packaging barrier properties on shelf life of fresh pasta is presented. In particular, all pasta samples were packaged under active and passive MAP in two different polymeric films with high and low barrier properties. In order to assess the influence of the variables described beforehand on the shelf life of pasta, the sensorial and microbiological quality has been monitored during storage. Results confirmed the antimicrobial properties of chitosan. Moreover, the findings recorded in this study suggest that the shelf life of fresh pasta is limited by the sensorial characteristics. Statistically significant differences between the shelf life of pasta packaged in low barrier and high barrier films were found. The best result was obtained for samples packaged in high barrier film, due to the ability of the packaging to maintain the gas headspace conditions during the storage.
Supercritical CO2 and N2O pasteurisation of peach and kiwi juice
Authors: Spilimbergo Sara , Ciola Lara 
Published: July 2010

SummaryThe microbial inactivation and qualitative parameters (pH, sugar content, titratable acidity, absorbance at 420 nm and turbidity) of peach and kiwi juices treated at 35 °C with supercritical carbon dioxide (SC‐CO2) and nitrous oxide (SC‐N2O) were determined as a function of pressure and treatment time. Total inactivation of both naturally occurring microorganisms and Saccharomyces cerevisiae strain (105 cfu mL−1) was obtained after 15 min of SC‐CO2/N2O treatment, 10 MPa and 35 °C, for both juices. No significant changes in chemical‐physical or in sensorial characteristics between untreated and treated juice were detected. The results obtained demonstrate the feasibility and the potential of SC‐CO2/N2O treatment as an alternative low temperature pasteurisation process for peach and kiwi juices.
Determination of biochemical properties of foam‐mat dried mango powder
Authors: Kadam Dattatreya M. , Wilson Robin A. , Kaur Sumandeep 
Published: July 2010

SummaryInvestigations were carried out to see the impact of drying air temperature (65, 75 and 85 °C) and milk as foaming agent in different concentration levels (0%, 10%, 15%, 20% and 25%) on the chemical properties of foam‐mat dried mango juice powder. Chemical properties such as total sugars, ascorbic acid, total carotenes, minerals, total acid, pH, total soluble solids (TSS) and microbial load (fungal and bacterial) of foam‐mat dried mango powder were determined. Data were analysed as per two‐way anova, Duncan’s multiple range test and l.s.d. of AgRes Software statistical package. Almost all chemical properties show decreasing trend with increase in drying air temperature. Microbial load was not detected in foam‐mat dried mango powder. It was found that addition of 10% milk as foaming agent and drying at 65 °C temperature gave better results.