bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of pulmonary nodules by C-arm CT using a phantom lung: comparison with CT
Authors: Higashihara Hiroki , Osuga Keigo , Azuma Takeo , Nakazawa Tetsuro , Yanagawa Masahiro , Kikuyama Ayano , Maeda Noboru , Tomiyama Noriyuki 
Published: October 2011

Background Evaluation of detection of lung nodules by C-arm CT (CACT) is important before this procedure can be used to guide percutaneous lung interventions. Purpose To compare the efficacy of CACT with CT in the detection of pulmonary nodules using a phantom lung. Material and Methods A phantom lung containing 12 phantom nodules in four sizes(5mm/8mm/10mm/12mm) and three CT values (one solid nodule, +100 HU; two ground glass nodules, -630 and -800 HU) was used. Six sessions of CACT (slice thickness 4.5 mm) and CT (slice thickness 5 mm) were performed. In each session, the locations of nodules were arbitrarily changed in the phantom. Three radiologists assessed the detection of atotal of 72 nodules. Statistical analysis was performed for the sensitivity and positive predictive value of lung nodules between CACT and CT by the McNemar test and paired t-test ( P < 0.05). Results Sensitivity did not differ between CACT and CT, respectively (reader 1, 82% vs. 88%, P = 0.22; reader 2, 82% vs. 78%, P = 0.37; reader 3, 79% vs. 83%, P = 0.48). For nodules of 8mm or larger, the sensitivity increased for each reader and showed no significant difference between CACT vs. CT. The positive predictive value did not differ between CACT and CT. Conclusion In this phantom study, CT and CACT show similar sensitivity for the detection of pulmonary nodules. CACT could be used in percutaneous interventional procedures in the lungs.
MRI findings of cancers preoperatively diagnosed as pure DCIS at core needle biopsy
Authors: Huang Yu-Ting , Cheung Yun-Chung , Lo Yung-Feng , Ueng Shir-Hwa , Kuo Wen-Ling , Chen Shin-Cheh 
Published: October 2011

Background Under-estimation of invasion components occur occasionally at core needle diagnosed ductal carcinoma in situ (DCIS) that may change the prognosis or treatment planning. Purpose To determine whether enhanced magnetic resonance imaging (MRI) features of biopsy-proven ductal cancers in situ help predict the under-estimation of invasive breast cancers. Material and Methods After a retrospective review of the enhanced MRI features on preoperative proven breast ductal cancers in situ by biopsy, tumor morphology (mass and non-mass), enhancing curve patterns, and non-mass enhanced appearances were compared between pure ductal cancers in situ and invasive ductal cancers (IDCs) after surgery. A statistical analysis was performed, and P values <0.05 were deemed significant. Results Twenty-five breast cancers from 24 women were analyzed. Eleven DCIS remained as DCISs, and 14 were upgraded to IDC after surgery. Eight of 14 IDCs (57%) and one of 11 DCISs (9%) presented as mass lesions; otherwise six (43%) IDCs and 10 (91%) DCISs were non-mass lesions ( P = 0.013). Among the non-mass cancers, six of 10 DCISs (60%) were focally enhanced and six of 6 IDCs (100%) were segmentally enhanced. The overall cancer sizes measured on enhanced MRI were moderately correlated with histopathology, with a Spearman's rank correlation coefficient of 0.656 ( P = 0.001). The mean diameter of the IDCs was larger than that of the pure DCISs on enhanced MRI (2.69 ± 1.42 cm for IDC and 1.62 ± 1.03 cm for DCIS; P = 0.048). The cut-off size was optimally selected at 1.95 cm with a 64% sensitivity and a 77% specificity, using a receiver-operating characteristic curve. The enhancement curves, with washout or persistent rising, were statistically insignificant ( P = 0.085 and 0.93, respectively). Conclusion Enhanced MRI provided informative morphology and size features that might help to predict the underestimation of invasiveness in preoperative biopsy-proven DCIS.
MDCT angiography with 3D image reconstructions in the evaluation of failing arteriovenous fistulas and grafts in hemodialysis patients
Authors: Dimopoulou Angeliki , Raland Hans , Wikström Björn , Magnusson Anders 
Published: October 2011

Background Arteriovenous fistulas and grafts are the methods of choice for vascular access in renal failure patients in need of hemodialysis. Their major complication, however, is stenosis, which might lead to thrombosis. Purpose To demonstrate the usefulness of 16-MDCTA with 3D image reconstructions, in long-term hemodialysis patients with dysfunctional arteriovenous fistulas and grafts (AVF and AVG). Material and Methods During a 17-month period, 31 patients with dysfunctional AVF and AVG (24 AVF and seven AVG) were examined with MDCTA with 3D image postprocessing. Parameters such as comprehension of the anatomy, quality of contrast enhancement, and pathological vascular changes were measured. DSA was then performed in 24 patients. Results MDCTA illustrated the anatomy of the AVF/AVG and the entire vascular tree to the heart, in a detailed and comprehensive manner in 93.5% of the evaluated segments, and depicted pathology of AVF/ AVG or pathology of the associated vasculature. MDCTA demonstrated a total of 38 significant stenoses in 25 patients. DSA verified 37 stenoses in 24 patients and demonstrated two additional stenoses. MDCTA had thus a sensitivity of 95%. All 24 patients were treated with percutaneous transluminal angioplasty (PTA) with good technical results. Conclusion MDCTA with 3D reconstructions of dysfunctioning AVFs and AVGs in hemodialysis patients is an accurate and reliable diagnostic method helping customize future intervention.
Climate for Evidence-Informed Health Systems: A Profile of Systematic Review Production in 41 Low- and Middle-Income Countries, 1996-2008
Authors: Law Tyler , Lavis John , Hamandi Ali , Cheung Andrew , El-Jardali Fadi 
Published: October 2011

Objective To describe systematic review production in 41 countries in Africa, the Americas, Asia and the eastern Mediterranean to understand one dimension of the climate for evidence-informed health systems and to provide a baseline for an evaluation of knowledge translation initiatives. Methods Our focus was systematic reviews published between 1996 and 2008 that had a corresponding author based in, or that appeared to target, one of the countries in these regions. We searched both Medline and Embase using validated search strategies, identified citations with a country name in the corresponding author's institutional affiliation or as a textword (i.e., an explicit mention in the title or abstract) or keyword, and coded articles describing a systematic review. We followed the same citation identification procedure for Health Systems Evidence, a database containing systematic reviews about health systems. Results Systematic review production increased between three-fold (for Africa in Medline) and 110-fold (for Asia in Embase) between the first period (1996-2002) and second period (2003-2008). In the second period, China was more often the home of corresponding authors and the target of reviews than any other country. No systematic reviews were produced by a corresponding author based in nine countries, or appeared to target five countries. Only 48 reviews identified through Medline and Embase addressed health systems, and 35 health systems reviews identified through Health Systems Evidence addressed these countries. Conclusion In many countries, those seeking to support evidence-informed health systems cannot turn to experienced local systematic reviewers to help them to find and use systematic reviews or to conduct reviews on high priority topics when none exists. These findings suggest the need for local capacity-building initiatives.
Which Experiences of Health Care Delivery Matter to Service Users and Why? A Critical Interpretive Synthesis and Conceptual Map
Authors: Entwistle Vikki , Firnigl Danielle , Ryan Mandy , Francis Jillian , Kinghorn Philip 
Published: October 2011

Objective Patients' experiences are often treated as health care quality indicators. Our aim was to identify the range of experiences of health care delivery that matter to patients and to produce a conceptual map to facilitate consideration of why they matter. Methods Broad-based review and critical interpretive synthesis of research literature on patients' perspectives of health care delivery. We recorded experiences reported by a diverse range of patients on ‘concept cards’, considered why they were important, and explored various ways of organizing them, including internationally recognized health care quality frameworks. We developed a conceptual map that we refined with feedback from stakeholders. Results Patients identify many health care experiences as important. Existing health care quality frameworks do not cover them all. Our conceptual map presents a rich array of experiences, including health care relationships (beyond communication) and their implications for people's valued capabilities (e.g. to feel respected, contribute to their care, experience reciprocity). It is organized to reflect our synthesis argument, which links health care delivery to what people are enabled (or not) to feel, be and do. The map highlights the broad implications of the social dynamics of health care delivery. Experiences are labelled from a patient's perspective, rendering the importance of responsiveness to individuals axiomatic. Conclusions Our conceptual map identifies and helps explain the importance of diverse experiences of health care delivery. It challenges and helps policy-makers, service providers and researchers to attend to the range of experiences that matter, and to take seriously the need for responsiveness to individuals.
Failure Mode and Effects Analysis: Views of Hospital Staff in the UK
Authors: Shebl Nada , Franklin Bryony , Barber Nick , Burnett Susan , Parand Anam 
Published: October 2011

Objective To explore health care professionals' experiences and perceptions of Failure Mode and Effects Analysis (FMEA), a team-based, prospective risk analysis technique. Methods Semi-structured interviews were conducted with 21 operational leads (20 pharmacists, one nurse) in medicines management teams of hospitals participating in a national quality improvement programme. Interviews were transcribed, coded and emergent themes identified using framework analysis. Results Themes identified included perceptions and experiences of participants with FMEA, validity and reliability issues, and FMEA's use in practice. FMEA was considered to be a structured but subjective process that helps health care professionals get together to identify high risk areas of care. Both positive and negative opinions were expressed, with the majority of interviewees expressing positive views towards FMEA in relation to its structured nature and the use of a multidisciplinary team. Other participants criticised FMEA for being subjective and lacking validity. Most likely to restrict its widespread use were its time consuming nature and its perceived lack of validity and reliability. Conclusion FMEA is a subjective but systematic tool that helps identify high risk areas, but its time consuming nature, difficulty with the scores and perceived lack of validity and reliability may limit its widespread use.
Is There Common Duct Enlargement Present Ultrasonically: How do you Measure Yours? (Survey of Departmental Practice)
Authors: Fitzgerald Tom 
Published: October 2011

A departmental survey of personal methodology in the measurement of bile duct diameter was carried out by means of a representative diagram of a typical bile duct image configuration. The results revealed considerable differences in measurement practice, and factors that may explain the patterns of interobserver variation, among 20 respondents in this task, were postulated. There was considerable scope for error, by a factor of three times between the smallest and largest diameter selected noted within current practice variation. This reflects similar disparity found in the literature. Within the setting of the development of current therapeutic strategies, there may be a need for confirmation and/or re-establishment of contemporary normal ranges for biliary tree diameter. A study of reasonable magnitude would be required to clarify the many and complex common and special causes of variation in ultrasonic evaluation outlined towards enhancing the utility of this useful and hitherto important ultrasonic sign.
Assessment of androgen concentration in women: liquid chromatography–tandem mass spectrometry and extraction RIA show comparable results
Authors: Janse Femi , Eijkemans Martinus J C , Goverde Angelique J , Lentjes Eef G W M , Hoek Annemieke , Lambalk Cornelius B , Hickey Theresa E , Fauser Bart C J M , Norman Robert J 
Published: October 2011

ObjectiveThe measurement of serum testosterone in women is challenging due to lack of trueness, precision, and sensitivity of various available testosterone assays. Accurate assessment of testosterone in women is crucial especially in conditions associated with alleged over- or under-production of testosterone, such as in polycystic ovary syndrome (PCOS) or primary ovarian insufficiency (POI). The aim of this study was to measure and compare androgen concentrations in women with PCOS, POI, and female controls and to evaluate the performance of extraction RIA and liquid chromatography–tandem mass spectrometry (LC–MS/MS) in these women.DesignCross-sectional study.MethodsCarefully phenotyped women with POI (n=208) or PCOS (n=200) and 45 healthy, regularly cyclic female controls were included. Method comparison analyses were performed for total testosterone, androstenedione (AD), and DHEA, as measured by LC–MS/MS and extraction RIA.ResultsAll androgen levels were significantly elevated in women with PCOS compared with POI patients (P<0.05) and controls (P<0.05). Women with POI presented with similar androgen concentrations as controls, except for AD. Compared with measurements by extraction RIA, testosterone, DHEA, and AD concentrations measured by LC–MS/MS were systematically lower. However, using extraction RIA and LC–MS/MS, testosterone, DHEA, and AD measurements were shown to have good agreement as assessed by Bland–Altman analysis and intraclass correlation coefficient: 0.95 (95% confidence interval 0.94–0.91), 0.83 (0.79–0.86), and 0.96 (0.95–0.97) respectively.ConclusionsLC–MS/MS, compared with a labor-intensive extraction RIA, shows good precision, sensitivity, and high accuracy for measuring female testosterone, DHEA, and AD concentrations under various clinical conditions. LC–MS/MS, therefore, represents a convenient and reliable assay for both clinical and research purposes, where androgen measurement in women is required.
Environment-Sensitive Epigenetics and the Heritability of Complex Diseases
Authors: Furrow Robert E , Christiansen Freddy B , Feldman Marcus W 
Published: October 2011

AbstractGenome-wide association studies have thus far failed to explain the observed heritability of complex human diseases. This is referred to as the “missing heritability” problem. However, these analyses have usually neglected to consider a role for epigenetic variation, which has been associated with many human diseases. We extend models of epigenetic inheritance to investigate whether environment-sensitive epigenetic modifications of DNA might explain observed patterns of familial aggregation. We find that variation in epigenetic state and environmental state can result in highly heritable phenotypes through a combination of epigenetic and environmental inheritance. These two inheritance processes together can produce familial covariances significantly higher than those predicted by models of purely epigenetic inheritance and similar to those expected from genetic effects. The results suggest that epigenetic variation, inherited both directly and through shared environmental effects, may make a key contribution to the missing heritability.
PPM-1, a PP2Cα/β phosphatase, Regulates Axon Termination and Synapse Formation in Caenorhabditis elegans
Authors: Tulgren Erik D , Baker Scott T , Rapp Laramie , Gurney Allison M , Grill Brock 
Published: October 2011

Abstract
The PHR (Pam/Highwire/RPM-1) proteins are evolutionarily conserved ubiquitin ligases that regulate axon guidance and synapse formation in Caenorhabditis elegans, Drosophila, zebrafish, and mice. In C. elegans, RPM-1 (Regulator of Presynaptic Morphology-1) functions in synapse formation, axon guidance, axon termination, and postsynaptic GLR-1 trafficking. Acting as an E3 ubiquitin ligase, RPM-1 negatively regulates a MAP kinase pathway that includes: dlk-1, mkk-4, and the p38 MAPK, pmk-3. Here we provide evidence that ppm-1, a serine/threonine phosphatase homologous to human PP2Cα(PPM1A) and PP2Cβ(PPM1B) acts as a second negative regulatory mechanism to control the dlk-1 pathway. We show that ppm-1 functions through its phosphatase activity in a parallel genetic pathway with glo-4 and fsn-1 to regulate both synapse formation in the GABAergic motorneurons and axon termination in the mechanosensory neurons. Our transgenic analysis shows that ppm-1 acts downstream of rpm-1 to negatively regulate the DLK-1 pathway, with PPM-1 most likely acting at the level of pmk-3. Our study provides insight into the negative regulatory mechanisms that control the dlk-1 pathway in neurons and demonstrates a new role for the PP2C/PPM phosphatases as regulators of neuronal development.
Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease
Authors: Topol Gastón Andrés , Podesta Leandro Ariel , Reeves Kenneth Dean , Raya Marcelo Francisco , Fullerton Bradley Dean , Yeh Hung-wen 
Published: October 2011

OBJECTIVE:To examine the potential of dextrose injection versus lidocaine injection versus supervised usual care to reduce sport alteration and sport-related symptoms in adolescent athletes with Osgood-Schlatter disease.PATIENTS AND METHODS:Girls aged 9 to 15 and boys aged 10 to 17 were randomly assigned to either therapist-supervised usual care or double-blind injection of 1% lidocaine solution with or without 12.5% dextrose. Injections were administered monthly for 3 months. All subjects were then offered dextrose injections monthly as needed. Unaltered sport (Nirschl Pain Phase Scale &lt; 4) and asymptomatic sport (Nirschl Pain Phase Scale = 0) were the threshold goals.RESULTS:Sixty-five knees in 54 athletes were treated. Compared with usual care at 3 months, unaltered sport was more common in both dextrose-treated (21 of 21 vs 13 of 22; P = .001) and lidocaine-treated (20 of 22 vs 13 of 22; P = .034) knees, and asymptomatic sport was more frequent in dextrose-treated knees than either lidocaine-treated (14 of 21 vs 5 of 22; P = .006) or usual-care–treated (14 of 21 vs 3 of 22; P &lt; .001) knees. At 1 year, asymptomatic sport was more common in dextrose-treated knees than knees treated with only lidocaine (32 of 38 vs 6 of 13; P = .024) or only usual care (32 of 38 vs 2 of 14; P &lt; .0001).CONCLUSIONS:Our results suggest superior symptom-reduction efficacy of injection therapy over usual care in the treatment of Osgood-Schlatter disease in adolescents. A significant component of the effect seems to be associated with the dextrose component of a dextrose/lidocaine solution. Dextrose injection over the apophysis and patellar tendon origin was safe and well tolerated and resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than usual care.
Incidence and Descriptive Epidemiologic Features of Traumatic Brain Injury in King County, Washington
Authors: Koepsell Thomas D. , Rivara Frederick P. , Vavilala Monica S. , Wang Jin , Temkin Nancy , Jaffe Kenneth M. , Durbin Dennis R. 
Published: October 2011

OBJECTIVE:
Traumatic brain injury (TBI) is a major cause of disability among US children. Our goal was to obtain population-based data on TBI incidence rates.

METHODS:
We conducted surveillance through a stratified random sample of hospital emergency departments in King County, Washington, to identify children 0 to 17 years of age with medically treated TBIs during an 18-month study period in 2007–2008. Additional cases were identified through hospital admission logs and the medical examiner's office. For a sample of nonfatal cases, parents were interviewed to verify TBIs, and medical record data on severity and mechanisms were obtained.

RESULTS:
The estimated incidence of TBIs in this setting was 304 cases per 100 000 child-years. The incidence was highest for preschool-aged children and lowest for children aged 5 to 9 years. Rates were uniformly higher for boys than for girls; there was a larger gender gap at older ages. Falls were the main mechanism of injury, especially among preschool-aged children, whereas being struck by or against an object and motor vehicle–related trauma were important contributors for older children. Approximately 97% of TBI cases were mild, although moderate/severe TBI incidence increased with age.

CONCLUSIONS:
TBIs led to many emergency department visits involving children, but a large majority of the cases were clinically mild. Incidence rates for King County were well below recent national estimates but within the range reported in previous US studies. Because mechanisms of injury varied greatly according to age, prevention strategies almost certainly must be customized to each age group for greatest impact.
Improvement in Survival of Older Adults with Multiple Myeloma: Results of an Updated Period Analysis of SEER Data
Authors: Pulte Dianne , Gondos Adam , Brenner Hermann 
Published: October 2011

Abstract

Background.
Treatment of multiple myeloma has changed significantly over the past several years with clinical trials reporting superior survival results using newer agents. Previous work has shown that the survival rate has improved for younger, but not older, patients with myeloma. Here, we update survival estimates for patients with myeloma in the early 21st century to determine whether continued improvement can be seen on a population level and whether or not it now extends to older patients.

Methods.
Using period analysis to examine data from the Surveillance, Epidemiology, and End Results database, we estimate changes in the 5- and 10-year relative survival rates (RSRs) from 1998–2002 to 2003–2007.

Results.
The 5- and 10-year RSRs have improved for patients with myeloma overall, from 32.8% and 15% in 1998–2002 to 40.3% and 20.8%, respectively, in 2003–2007. The greatest improvements were observed for patients aged 15–44 years, with 5- and 10-year RSRs reaching &gt;70% and ∼50%, respectively, but improvements were also seen for patients aged &gt;70 years.

Conclusion.
Overall, survival continues to improve for patients with myeloma, including older patients, suggesting that newer treatment options continue to make a population-wide impact.