bluuebunny/crossref_metadata_2025_split huggingface dataset:
All‐terrain vehicle crashes and associated injuries in north Queensland: Findings from the Rural and Remote Road Safety Study
Authors: O'Connor Teresa , Hanks Heather , Steinhardt Dale 
Published: September 2009

AbstractObjective:  To define characteristics of all‐terrain vehicle (ATV) crashes occurring in north Queensland from March 2004 till June 2007 with the exploration of associated risk factors. Design:  Descriptive analysis of ATV crash data collected by the Rural and Remote Road Safety Study. Setting:  Rural and remote north Queensland. Participants:  Forty‐two ATV drivers and passengers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measures:  Demographics of participants, reason for travel, nature of crash, injuries sustained and risk factors associated with ATV crash. Results:  The majority of casualties were men aged 16–64. Forty‐one per cent of accidents occurred while performing agricultural tasks. Furthermore, 39% of casualties had less than one year's experience riding ATVs. Over half the casualties were not wearing a helmet at the time of the crash. Common injuries were head and neck and upper limb injuries. Rollovers tended to occur while performing agricultural tasks and most commonly resulted in multiple injuries. Conclusions:  Considerable trauma results from ATV crashes in rural and remote north Queensland. These crashes are not included in most general vehicle crash data sets, as they are usually limited to events occurring on public roads. Minimal legislation and regulation currently applies to ATV use in agricultural, recreational and commercial settings. Legislation on safer design of ATVs and mandatory courses for riders is an essential part of addressing the burden of ATV crashes on rural and remote communities.
Pilot study on confocal endomicroscopy for determination of the depth of squamous cell esophageal cancer in vivo
Authors: Iguchi Youichi , Niwa Yasumasa , Miyahara Ryoji , Nakamura Masanao , Banno Kakunori , Nagaya Toshihiko , Nagasaka Tetsuro , Watanabe Osamu , Ando Takafumi , Kawashima Hiroki , Ohmiya Naoki , Itoh Akihiro , Hirooka Yoshiki , Goto Hidemi 
Published: September 2009

AbstractBackground and Aim:  Confocal endomicroscopy is ultra‐high‐magnification endoscopy with histological observation during ongoing endoscopy. We planned a pilot study of the diagnosis of the depth of esophageal cancer using confocal endomicroscopy for treatment strategies.Methods:  Patients had 14 superficial esophageal cancers and one dysplasia. The depth of neoplasms in 15 lesions was confirmed by endoscopic mucosal resection or surgery.We examined the rate of delineation and compared results of confocal imaging with histological findings. We classified two cellular and three microvascular patterns on confocal endomicroscopic images: CP‐N for normal squamous mucosa and CP‐Ca for cancerous lesion; VP‐type A for normal squamous mucosa; VP‐type B for T1a‐EP and T1a‐LPM cancers; and VP‐type C for T1a‐MM or a more invasive cancer pattern. We measured diameters of microvessels for the three patterns of confocal endomicroscopic images and histological specimens.Results:  The rate of delineation was 73.3% (11/15) for esophageal cancer. The results of confocal imaging coincided well with microvessel distribution on horizontal histology. Two endoscopists blindly diagnosed the two types by cellular pattern and the three types by vascular pattern: their overall accuracies were 96% and 89% for the cellular pattern and 85% and 85% for the vascular pattern, respectively. The k value of the cellular pattern and the vascular pattern diagnosis was 0.84 and 0.75, respectively.Conclusion:  Scoring and quantification of confocal endomicroscopic images may be useful for the differential diagnosis and diagnosis of superficial invasion by squamous cell carcinoma.
RIFLE classification as predictive factor of mortality in patients with cirrhosis admitted to intensive care unit
Authors: Cholongitas Evangelos , Calvaruso Vincenza , Senzolo Marco , Patch David , Shaw Steve , O'Beirne James , Burroughs Andrew K. 
Published: September 2009

AbstractBackground and Aim:  To evaluate the association of the Risk, Injury, Failure, Loss and End‐stage renal failure (RIFLE) score on mortality in patients with decompensated cirrhosis admitted to intensive care unit (ICU).Methods:  A cohort of 412 patients with cirrhosis consecutively admitted to ICU was classified according to the RIFLE score. Multivariable logistic regression analysis was used to evaluate the factors associated with mortality. Liver‐specific, Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) and RIFLE scores on admission, were compared by receiver–operator characteristic curves.Results:  The overall mortality during ICU stay or within 6 weeks after discharge from ICU was 61.2%, but decreased over time (76% during first interval, 1989–1992 vs 50% during the last, 2005–2006, P < 0.001). Multivariate analysis showed that RIFLE score (odds ratio: 2.1, P < 0.001) was an independent factor significantly associated with mortality. Although SOFA had the best discrimination (area under receiver–operator characteristic curve = 0.84), and the APACHE II had the best calibration, the RIFLE score had the best sensitivity (90%) to predict death in patients during follow up.Conclusions:  RIFLE score was significantly associated with mortality, confirming the importance of renal failure in this large cohort of patients with cirrhosis admitted to ICU, but it is less useful than other scores.
Ease of early gastric cancer demarcation recognition: A comparison of four magnifying endoscopy methods
Authors: Kadowaki Shigenori , Tanaka Kyosuke , Toyoda Hideki , Kosaka Ryo , Imoto Ichiro , Hamada Yasuhiko , Katsurahara Masaki , Inoue Hiroyuki , Aoki Masatoshi , Noda Tomohiro , Yamada Tomomi , Takei Yoshiyuki , Katayama Naoyuki 
Published: September 2009

AbstractBackground and Aim:  Various techniques using magnifying endoscopy (ME) have been developed to enhance images of early gastric cancer (EGC) demarcations, which are often obscure. We investigated four ME methods to determine which is most effective in enhancing the recognition of EGC demarcations: conventional ME (CME), ME with narrow band imaging (NBI‐ME), enhanced‐magnification endoscopy with acetic acid (EME), and ME with NBI and acetic acid (NBI‐EME).Methods:  Thirty‐seven successive patients having a total of 40 EGCs participated in the investigation. The endoscope was fixed and magnification images of EGC demarcations in each patient were recorded using four different ME methods (CME, NBI‐ME, EME and NBI‐EME). Eight experts and eight non‐experts scored each of the four images of each lesion for ease of recognition of demarcation (1 to 4, with 4 being easiest).Results:  The mean scores of expert and non‐expert judges, respectively, for images acquired using each technique were: CME 1.23, 1.24; NBI‐ME 2.61, 2.95; EME 2.62, 2.32 and NBI‐EME 3.54, 3.50. There were significant differences between the mean scores for the four techniques (P < 0.0001) using one‐way repeated‐measures anova. In a Bonferroni's multiple comparison, the average scores (expert and non‐expert) of images acquired using NBI‐EME were significantly higher than those acquired using other methods; images acquired by NBI‐ME or EME also scored significantly higher than those by CME. Non‐experts also scored NBI‐ME images significantly higher than CME and EME images.Conclusions:  Early gastric cancer demarcations were recognized most easily using NBI‐EME, and more easily using EME or NBI‐ME than CME.
Lymph node staging in esophageal squamous cell carcinoma: A comparative study of endoscopic ultrasonography versus computed tomography
Authors: Takizawa Kohei , Matsuda Takahisa , Kozu Takahiro , Eguchi Takako , Kato Hoichi , Nakanishi Yukihiro , Hijikata Atsushi , Saito Daizo 
Published: September 2009

AbstractBackground and Aim:  Endoscopic ultrasonography (EUS) is established as a standard approach for locoregional staging of esophageal cancer. However, only a few published studies have attempted to correlate the station of the abnormal lymph nodes detected by EUS with the definitive histology. We compared EUS and computed tomography (CT) in the initial staging of esophageal squamous cell carcinoma.Methods:  Consecutive patients with esophageal cancer undergoing EUS were evaluated. EUS findings and patient data including histopatology were collected prospectively and analyzed retrospectively. Lymph node locations were divided into three groups; abdominal (A), paraesophageal (B), and thoracic paratracheal (C).Results:  A total of 365 consecutive patients underwent EUS and 159 patients underwent esophagectomy without neoadjuvant chemotherapy. Thirty‐eight patients were excluded (insufficient EUS, etc.), and 121 patients were enrolled. The overall accuracy of EUS was 64% (sensitivity 68%, specificity 58%, positive predictive value [PPV] 68%), CT was 51% (sensitivity 33%, specificity 75%, PPV 64%), and CT + EUS was 64% (sensitivity 74%, specificity 50%, PPV 66%). The accuracy of EUS was higher than CT in Groups A and C. Sensitivity of CT was lower than that of EUS alone and CT + EUS.Conclusions:  This study has demonstrated that EUS is a more accurate technique than contrast‐enhanced CT for detecting abnormal lymph nodes. Sensitivity of CT was lower than that of EUS alone and CT + EUS. But some metastatic lymph nodes in neck and abdominal fields are only detectable by CT. Therefore, both EUS and CT should be undertaken for routine examination prior to treatment of esophageal cancer.
Feasibility of individualized treatment for hepatitis C patients in the real world
Authors: Chen Tsung‐Ming , Huang Pi‐Teh , Lin Ching‐Heng , Tsai Ming‐Hung , Lin Lien‐Fu , Liu Chung‐Cheng , Ho Ka‐Sic , Tung Jai‐Nien 
Published: September 2009

AbstractBackground and Aim:  Individualized treatment with a combination of peg‐interferon and ribavirin for patients with hepatitis C virus (HCV) infection has been validated in randomized controlled clinical trials, but its usefulness in the real world is unknown. The aim of the present study was to assess the feasibility of individualized treatment for HCV patients compared with standard therapy in a real‐life clinical setting.Methods:  A total of 253 naïve patients with HCV infection who received peg‐interferon and ribavirin combination treatment were analyzed and grouped into one of three clinical settings: (i) infection with genotype non‐1 (HCV non‐1) and treatment for standard 24 weeks (n = 105; none received an abbreviated therapy); (ii) genotype 1 (HCV‐1) and standard therapy for either 24 weeks (n = 71) or 48 weeks (n = 21); and (iii) HCV‐1 and individualized treatment (n = 56). The individualized therapy used was an abbreviated 24‐week treatment for HCV‐1 patients who achieved a rapid virological response, otherwise patients received a 48‐week course of treatment. Early termination of treatment at week 16 was recommended for non‐responders.Results:  A sustained virological response (SVR) was achieved in 83.8% of patients with HCV non‐1 infection. Among the HCV‐1‐infected patients, 53.5% of patients who underwent standard 24‐week treatment, 66.7% of patients who underwent standard 48‐week treatment, and 64.3% of patients treated by individualized therapy achieved SVR. Patients infected with HCV‐1 and treated by individualized therapy had a similar efficacy response compared with the standard 48‐week therapy (adjusted odds ratio [OR] 0.765, 95% confidence interval [CI], 0.220–2.659, P = 0.673). Both individualized therapy (adjusted OR 2.855, 95% CI 1.189–6.855, P = 0.019) or standard 48‐week treatment (adjusted OR 3.733, 95% CI 1.073–12.986, P = 0.038) had significantly higher odds of SVR compared with HCV‐1 patients treated by standard 24‐week course.Conclusion:  Individualized therapy is feasible in the real world, especially for patients with HCV‐1 infection.
N‐Acetylcysteine improves disturbed ileal contractility following partial hepatectomy in rats
Authors: Okay Erdem , Mutlu Oguz , Gocmez Semil S , Oz Sarpkaya , Utkan Tijen 
Published: September 2009

AbstractBackground and Aims:  It is well known that disturbed intestinal motility and bacterial overgrowth may occur following partial hepatectomy. These events have been followed by the translocation of enteric bacteria that play a major role in the development of infections. We designed the present study to evaluate the effect of N‐acetylcysteine (NAC) on ileal muscle contractility as an indication of intestinal motility.Methods:  Sprague–Dawley rats were divided into four groups (n = 6): sham, sham plus preoperative intraperitoneal NAC injection, hepatectomy, and hepatectomy plus preoperative intraperitoneal NAC injection. Contractile and relaxant responses in isolated ileal smooth muscle strips were determined using an in vitro muscle technique. Statistical analyses were performed by Kruskal–Wallis and Mann–Whitney U‐tests.Results:  Contractile responses to KCl and carbachol were significantly decreased in the ileal strips of the hepatectomy group when compared to the sham‐operated control group. The impaired contraction of strips was markedly improved by preoperative NAC treatment. However, neither the electrical field stimulation nor the sodium nitroprusside‐mediated relaxant responses changed in any of the groups.Conclusions:  Our data indicated that disturbed ileal contractility after partial hepatectomy was remedied by preoperative NAC treatment, which in turn might cause attenuation of bacterial translocation.
Evaluation of esophageal function in patients with gastroesophageal reflux disease using transnasal endoscopy
Authors: Yasaka Shigeaki , Murakami Kazunari , Abe Takashi , Anan Juro , Mizukami Kazuhiro , Tanahashi Jin , Okimoto Tadayoshi , Kodama Masaaki , Kudo Yoshikuni , Kawasaki Hisanori , Fujioka Toshio 
Published: September 2009

AbstractBackground and Aims:  To investigate the utility of a new method of carrying out esophageal manometry using a narrow gauge manometry catheter via a transnasal endoscope.Methods:  The Frequency Scale for the Symptoms of gastroesophageal reflux disease (GERD) (FSSG), a GERD‐specific questionnaire, was given to 45 subjects. Subjects underwent transnasal endoscopy with three dry and three wet (3 mL water) swallows. Direct observations of the primary peristaltic wave and peristaltic pressure measurement were conducted simultaneously.Results:  Endoscopic observation of lower esophageal motility associated with swallowing revealed dilatation of the esophageal lumen after swallowing, followed by contraction in association with the primary peristaltic wave. The peristaltic pressure was significantly lower with increased FSSG scores for dry swallows (r = −0.347, P = 0.0212), but no significant correlation was seen for wet swallows.Conclusions:  The significant negative correlation between reflux symptoms and peristaltic pressure in dry swallows was thought to be that reduced pressure immediately rostral to the lower esophageal sphincter leads to decreased clearance following gastric acid reflux, playing a large part in the onset of symptoms.
Roles of adipose restriction and metabolic factors in progression of steatosis to steatohepatitis in obese, diabetic mice
Authors: Larter Claire Z , Yeh Matthew M , Van Rooyen Derrick M , Teoh Narci C , Brooling John , Hou Jing Yun , Williams Jacqueline , Clyne Matthew , Nolan Christopher J , Farrell Geoffrey C 
Published: September 2009

AbstractBackground and Aims:  We previously reported that steatohepatitis develops in obese, hypercholesterolemic, diabetic foz/foz mice fed a high‐fat (HF) diet for 12 months. We now report earlier onset of steatohepatitis in relation to metabolic abnormalities, and clarify the roles of dietary fat and bodily lipid partitioning on steatosis severity, liver injury and inflammatory recruitment in this novel non‐alcoholic steatohepatitis (NASH) model.Methods:  Foz/foz (Alms1 mutant) and wild‐type (WT) mice were fed a HF diet or chow, and metabolic characteristics and liver histology were studied at 2, 6, 12 and 24 weeks.Results:  After 12 weeks HF‐feeding, foz/foz mice were obese and diabetic with approximately 70% reduction in serum adiponectin. Hepatomegaly developed at this time, corresponding to a plateau in adipose expansion and increased adipose inflammation. Liver histology showed mild inflammation and hepatocyte ballooning as well as steatosis. By 24 weeks, HF‐fed foz/foz mice developed severe steatohepatitis (marked steatosis, alanine aminotransferase elevation, ballooning, inflammation, fibrosis), whereas dietary and genetic controls showed only simple steatosis. While steatosis was associated with hepatic lipogenesis, indicated by increased fatty acid synthase activity, steatohepatitis was associated with significantly higher levels of CD36, indicating active fatty acid uptake, possibly under the influence of peroxisome proliferator‐activated receptor‐γ.Conclusion:  In mice genetically predisposed to obesity and diabetes, HF feeding leads to restriction of adipose tissue for accommodation of excess energy, causing lipid partitioning into liver, and transformation of simple steatosis to fibrosing steatohepatitis. The way in which HF feeding ‘saturates’ adipose stores, decreases serum adiponectin and causes hepatic inflammation in steatohepatitis may provide clues to pathogenesis of NASH in metabolic syndrome.
Bone marrow stem cells and the liver: Are they relevant?
Authors: Eckersley‐Maslin Mélanie A , Warner Fiona J , Grzelak Candice A , McCaughan Geoffrey W , Shackel Nicholas A 
Published: September 2009

AbstractThe contribution of bone marrow stem cell responses to liver homeostasis, injury and malignancy is discussed in this review. Pluripotent stem cells or their more committed progenitor progeny are essential to tissue development, regeneration and repair and are widely implicated in the pathogenesis of malignancy. Stem cell responses to injury are the focus of intense research efforts in the hope of future therapeutic manipulation. Stem cells occur within tissues, such as the liver, or arise from extrahepatic sites, in particular, the bone marrow. As the largest reservoir of stem cells in the adult, the bone marrow has been implicated in the stem cell response associated with liver injury. However, in liver injury, the relative contribution of bone marrow stem cells compared to intrahepatic progenitor responses is poorly characterized. Intrahepatic progenitor responses have been recently reviewed elsewhere. In this review, we have summarized liver‐specific extrahepatic stem cell responses originating from the bone marrow. The physiological relevance of bone marrow stem cell responses to adult liver homeostasis, injury and malignancy is discussed with emphasis on mechanisms of bone marrow stem cell recruitment to sites of liver injury and its contribution to intrahepatic malignancy.
Rapid risk assessment using probability of fracture nomographs
Authors: PENMETSA R. , TUEGEL E. , SHANMUGAM V. 
Published: September 2009

ABSTRACTTraditional risk‐based design process involves designing the structure based on risk estimates obtained during several iterations of an optimization routine. This approach is computationally expensive for large‐scale aircraft structural systems. Therefore, this paper introduces the concept of risk‐based design plots that can be used for both structural sizing and risk assessment for fracture strength when maximum allowable crack length is available. In situations when crack length is defined as a probability distribution the presented approach can only be applied for various percentiles of crack lengths. These plots are obtained using normalized probability density models of load and material properties and are applicable for any arbitrary load and strength values. Risk‐based design plots serve as a tool for failure probability assessment given geometry and applied load or they can determine geometric constraints to be used in sizing given allowable failure probability. This approach would transform a reliability‐based optimization problem into a deterministic optimization problem with geometric constraints that implicitly incorporate risk into the design. In this paper, cracked flat plate and stiffened plate are used to demonstrate the methodology and its applicability.
Some issues on structural integrity analysis of P91 welds in power plants subjected to high temperature creep*
Authors: HYDE T. H. , SUN W. , YAGHI A. H. , LEEN S. B. 
Published: September 2009

ABSTRACTWelds are metallurgically complex, with heterogeneous structures within the weld metal and heat‐affected zones. In order to carry out a structural integrity assessment, it is important to have knowledge of the initial metallurgical features and the associated material property variations so that it is possible to accurately model all the possible failure modes of welds using, for example, numerical techniques. This paper describes some fundamental issues concerning a holistic process for high temperature performance and failure prediction assessment of power plant welds. This includes welding process simulation and residual stress determination, microstructural evolution and the formulation of creep damage mechanics constitutive equations including weld metal anisotropy. Typical examples, from specific case studies for P91 welds, are used to illustrate the application. Future requirements for development of high temperature assessment methods for welds are suggested.
Multiple molecular targets underlie the antidiabetic effect of Nigella sativa seed extract in skeletal muscle, adipocyte and liver cells
Authors: Benhaddou‐Andaloussi A. , Martineau L. C. , Vallerand D. , Haddad Y. , Afshar A. , Settaf A. , Haddad P. S. 
Published: September 2009

Aim:
Nigella sativa (N. sativa) is a plant widely used in traditional medicine of North African countries. During the last decade, several studies have shown that extracts from the seeds of N. sativa have antidiabetic effects. Methods: Our group has recently demonstrated that N. sativa seed ethanol extract (NSE) induces an important insulin‐like stimulation of glucose uptake in C2C12 skeletal muscle cells and 3T3‐L1 adipocytes following an 18 h treatment. The purpose of the present study was to elucidate the pathways mediating this insulin‐like effect and the mechanisms through which these pathways are activated. Results: Results from western immunoblot experiments indicate that in C2C12 cells as well as in H4IIE hepatocytes, but not in 3T3‐L1 cells, NSE increases activity of Akt, a key mediator of the effects of insulin, and activity of AMP‐activated protein kinase (AMPK), a master metabolic regulating enzyme. To test whether the activation of AMPK resulted from a disruption of mitochondrial function, the effects of NSE on oxygen consumption were assessed in isolated liver mitochondria. NSE was found to exhibit potent uncoupling activity. Conclusion: Finally, to provide an explanation for the effects of NSE in adipocytes, PPARγ stimulating activity was tested using a reporter gene assay. Results indicate that NSE behaves as an agonist of PPARγ. The data supports the ethnobotanical use of N. sativa seed oil as a treatment for diabetes, and suggests potential uses of this product, or compounds derived thereof, against obesity and the metabolic syndrome.