bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Effects of Kidney Donation on Renal Function and Blood Pressure in African Americans
Authors: Budisavljevic Milos N. , Nietert Paul J. , Zhai Yusheng , Dooley Mary J. , Rajagopalan P.R. 
Published: May 2011

Summary

Background and objectives
African Americans (AAs) have four times higher prevalence of ESRD than Caucasians. Therefore, long-term effects of kidney donation are of considerable importance in this patient population.

Design, setting, participants, & measurements
GFR was measured by 125I-iothalamate clearance, 24-hour urine albumin excretion, and 24-hour BP monitoring in 33 AAs and 11 CAs who donated kidneys for transplantation 5 to 23 years previously.

Results
Mean GFRs were 76 ± 13 and 78 ± 11 ml/min per 1.73 m2 for AA and CA donors, respectively. Nine percent of the AA donors and none of the CA donors had GFRs below 60 ml/min per 1.73 m2. AA donors had a tendency for lower prevalence of microalbuminuria compared with CA donors (18.1% versus 36.3%) and a tendency for higher prevalence of macroalbuminuria compared with CAs (12.1% versus 0.0%). Twenty-four percent of the AAs, and 45% of the CAs were hypertensive with mean daytime BP ≥135/85 mmHg. Only 6% of AAs had a decrease in mean nocturnal systolic BP of 10% or more as compared with daytime readings. Older age at time of donation was associated (P = 0.046) with lower GFR values compared with younger ages.

Conclusion
Carefully selected AA kidney donors have well preserved renal function and a low prevalence of hypertension many years after kidney donation. Abnormal albumin excretion and loss of physiologic decrease in nocturnal BP is more prevalent in AA donors than the general AA population. Older age at donation may predict lower GFR after donation.
Inflammatory Markers and Risk of Cerebrovascular Events in Patients Initiating Dialysis
Authors: Sozio Stephen M. , Coresh Josef , Jaar Bernard G. , Fink Nancy E. , Plantinga Laura C. , Armstrong Paige A. , Longenecker J. Craig , Sharrett A. Richey , Powe Neil R. , Parekh Rulan S. 
Published: May 2011

Summary

Background and objectives
Stroke remains a leading cause of morbidity and mortality for patients on dialysis; however, its risk factors in this population and measures to prevent it are not well understood.

Design, setting, participants, & measurements
We investigated whether inflammation was associated with cerebrovascular events in a national US cohort of 1041 incident dialysis patients enrolled from October 1995 to June 1998 and followed until January 31, 2004. Incident cerebrovascular events were defined as nonfatal (hospitalized stroke, carotid endarterectomy) and fatal (stroke death) events after dialysis initiation. With Cox proportional hazards regression analysis accounting for the competing risk of nonstroke death, we assessed the independent event risk associated with baseline levels of multiple inflammatory markers (high-sensitivity C-reactive protein [hsCRP], interleukin-6 (IL-6), matrix metalloproteinase-3 [MMP-3], and P-selectin) and hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) use, which may have pleiotropic inflammatory effects.

Results
165 patients experienced a cerebrovascular event during 3548 person-years of follow-up; overall incidence rate was 4.9/100 person-years. None of the inflammatory markers were associated with cerebrovascular event risk (adjusted hazard ratios [HRs] per log unit [95% confidence interval]: hsCRP, 0.97 [0.85 to 1.11]; IL-6, 1.04 [0.85 to 1.26]; MMP-3, 1.02 [0.70 to 1.48]; P-selectin, 0.98 [0.57 to 1.68]). Statin use was also not associated with significant risk of events in unadjusted (HR 1.07 [0.69 to 1.68]) or propensity-score adjusted analyses (HR 0.98 [0.61 to 1.56]).

Conclusions
In conclusion, neither inflammatory markers nor statin use was associated with risk of cerebrovascular events. Further studies are needed to understand the pathophysiology and prevention of stroke in patients on dialysis.
In vitro evaluation of self-etch bonding in orthodontics using cyclic fatigue
Authors: Mansour Ameerah Yousef , Drummond James L. , Evans Carla A. , Bakhsh Zuhair 
Published: May 2011

Abstract

Objective:
To evaluate the bond strength of a self-etch bonding system using static loading and cyclic fatigue with shear testing. This is a two-part evaluation; the first part will evaluate shear testing, the second part tensile testing.

Materials and Methods:
Bovine teeth (n  =  82) were randomly distributed to either a self-etch (Transbond Plus) or total-etch (37% phosphoric-acid + Transbond XT) group. The static shear (SSBS) and cyclic shear (CSBS) bond strengths were measured 24 hours after the bonding of mesh-based brackets. The adhesive remnant index (ARI) and failure sites were evaluated.

Results:
The mean SSBS was 34.25 ± 9.21 and 24.64 ± 9.42 MPa for the total- and self-etch groups, respectively. CSBS was 24.07 ± 0.65 MPa and 18.92 ± 1.08 MPa for the total- and self-etch groups, respectively. Cyclic loading produced lower bond strengths compared to static testing for both adhesives; the difference was only statistically significant for the total-etch system. Comparison of the two materials showed a statistically significant difference between the two techniques. The total-etch had higher bond strengths than the self-etch bonding system. The samples showed a predominance of ARI scored of 2 and 1, and their bonding failure sites were cohesive within the composite.

Conclusion:
Cyclic loading, simulating occlusal forces, reduces the bond strength of both bonding systems. Even though the self-etch bonding system had lower shear bond strength than the total-etch system, both were still clinically acceptable.
Mobile phones and sleep - A review
Authors: Supe Sanjay 
Published: May 2011

Mobile phones and sleep - A review
The increasing use of mobile phones has raised concerns regarding the potential health effects of exposure to the radiofrequency electromagnetic fields. An increasing amount research related to mobile phone use has focussed on the possible effects of mobile phone exposure on human brain activity and function. In particular, the use of sleep research has become a more widely used technique for assessing the possible effects of mobile phones on human health and wellbeing especially in the investigation of potential changes in sleep architecture resulting from mobile phone use. Acute exposure to a mobile phone prior to sleep significantly enhances electroencephalogram spectral power in the sleep spindle frequency range. This mobile phone-induced enhancement in spectral power is largely transitory and does not linger throughout the night. Furthermore, a reduction in rapid eye movement sleep latency following mobile phone exposure was also found, although interestingly, neither this change in rapid eye movement sleep latency or the enhancement in spectral power following mobile phone exposure, led to changes in the overall quality of sleep. In conclusion, a short exposure to the radiofrequency electromagnetic fields emitted by a mobile phone handset immediately prior to sleep is sufficient to induce changes in brain activity in the initial part of sleep. The consequences or functional significance of this effect are currently unknown and it would be premature to draw conclusions about possible health consequences.
Position of effective electron source for shielded electron beams from a therapeutic linear accelerator
Authors: Al Asmary Mohammed , Ravikumar Manickam 
Published: May 2011

Position of effective electron source for shielded electron beams from a therapeutic linear accelerator
The effective electron source positions for the standard electron cones and for the shielded field sizes with cerrobend inserts were measured based on Inverse Square Law (ISL) and the Inverse Slope (IS) method for various electron energies.
The charge measurements were carried out using a 0.6 cc ion chamber (PTW, Type 30001) connected to a PTW Unidos E digital electrometer in a polystyrene phantom for electron beam energies of 6-18 MeV. The resultant charge for 100 MU setting was measured at nominal source to surface distances (SSDs) of 100-120 cm for cone and cerrobend defined field sizes.
The effective SSD (SSDeff) was found to be different for the same field size defined by electron applicator and the cerrobend shield placed in 25×25 cm standard cone. Strong dependency of SSDeff with field size and electron beam energy was noticed.
The results from the ISL and IS method are consistent, hence either of the two methods can be used to determine the effective source position. Whenever treatment is to be given with shielded electron portal, the SSDeff for that field needs to be determined. Same SSDeff as that of the standard cone can be used for minimum shielded electron portals.
Treatment planning system and dose delivery accuracy in extracranial stereotactic radiotherapy using Elekta body frame
Authors: Dawod Tamer , Bremer Michael , Karstens Johann , Werner Martin 
Published: May 2011

Treatment planning system and dose delivery accuracy in extracranial stereotactic radiotherapy using Elekta body frame
The purpose of this study was to measure the photon beam transmission through the Elekta Stereotactic Body Frame (ESBF) and treatment couch, to determine the dose calculations accuracy of the MasterPlan Treatment Planning System (TPS) using Pencil Beam (PBA) and Collapsed Cone (CCA) algorithms during the use of Elekta Stereotactic Body Frame (ESBF), and to demonstrate a simple calculation method to put this transmission into account during the treatment planning dose calculations.
The dose was measured at the center of an in-house custom-built inhomogeneous PMMA thorax phantom with and without ‘the frame + treatment couch’. The phantom was CT-imaged inside the ESBF and planned with multiple 3D-CRT fields using PBA and CCA for photon beams of energies 6 MV and 10 MV. There were two treatment plans for dose calculations. In the first plan, the ‘frame + couch’ were included in the body contour and, therefore, included in the TPS dose calculations. In the second plan, the ‘frame + couch’ were not included in the body contour and, therefore, not included in the calculations. Transmission of the ‘frame + couch’ was determined by the ratio of the dose measurements with the ‘frame + couch’ to the measurements without them. To validate the accuracy of the calculation model, plans with and without the ‘frame + couch’ surrounding the phantoms were compared with their corresponding measurements.
The transmission of the ‘frame + couch’ varies from 90.23-97.54% depending on the energy, field size, the angle of the beams and whether the beams also intercept them. The validation accuracy of the Pencil Beam (PBA) and Collapsed Cone (CCA) algorithms were within 5.33% and 4.04% respectively for the individual measurements for all gantry angles under this study. The results showed that both PBA and CCA algorithms can calculate the dose to the target within 4.25% and 1.95% of the average measured value.
The attenuation caused by the ESBF and couch must be accounted into the planning process. For MasterPlan, the ‘frame + couch’ should be contoured and included in all calculations. This can be done easily and accurately.
Improvement of the quality of effective dose estimation by interlaboratory comparisons
Authors: Katarzyna Ciszewska , Malgorzata Dymecka , Tomasz Pliszczynski , Jakub Osko 
Published: May 2011

Improvement of the quality of effective dose estimation by interlaboratory comparisons
Radiation Protection Measurements Laboratory (RPLM) of the Institute of Atomic Energy POLATOM determines radionuclides in human urine to estimate the effective dose. Being an accredited laboratory, RPLM participated in interlaboratory comparisons in order to assure the quality of services concerning monitoring of internal contamination. The purpose of the study was to examine the effect of interlaboratory comparisons on the accuracy of the provided measurements. The results regarding tritium (3H) and strontium (90Sr) determination, obtained within the radiotoxicological intercomparison exercises, organized by PROCORAD, in 2005-2010, were analyzed and the methods used by the laboratory were verified and improved.
Metachromatic Leucodystrophy: A Case Report
Authors: Karki Subhana , Rai Ganesh Kumar , Kafle Raju 
Published: May 2011

Metachromatic leukodystrophy (MLD) is an autosomal recessive neurodegenerative disorder characterized by deficient activity of the enzyme arylsulfatase-A. Deficiency of this enzyme results in intralysosomal storage of sphingolipid cerebroside 3-sulfates (sulfatides), which are abundant in myelin and neurons. A pathological hallmark of MLD is demyelination and neurodegeneration, causing various and ultimately lethal neurological symptoms. Its frequency is estimated to be 1/40,000 live births. The disease encompasses three clinical subtypes: late infantile (40% of the patients with MLD), juvenile (40%), and adult (20%). DOI: 10.3126/jnps.v31i2.4644 J Nep Paedtr Soc 2010;31(2):143-145
Segmental anatomy of cerebellar arteries: a proposed nomenclature
Authors: Rodríguez-Hernández Ana , Rhoton Albert L. , Lawton Michael T. 
Published: May 2011

Object
The conceptual division of intracranial arteries into segments provides a better understanding of their courses and a useful working vocabulary. Segmental anatomy of cerebral arteries is commonly cited by a numerical nomenclature, but an analogous nomenclature for cerebellar arteries has not been described. In this report, the microsurgical anatomy of the cerebellar arteries is reviewed, and a numbering system for cerebellar arteries is proposed.

Methods
Cerebellar arteries were designated by the first letter of the artery's name in lowercase letters, distinguishing them from cerebral arteries with the same first letter of the artery's name. Segmental anatomy was numbered in ascending order from proximal to distal segments.

Results
The superior cerebellar artery was divided into 4 segments: s1, anterior pontomesencephalic segment; s2, lateral pontomesencephalic segment; s3, cerebellomesencephalic segment; and s4, cortical segment. The anterior inferior cerebellar artery was divided into 4 segments: a1, anterior pontine segment; a2, lateral pontine segment; a3, flocculopeduncular segment; and a4, cortical segment. The posterior inferior cerebellar artery was divided into 5 segments: p1, anterior medullary segment; p2, lateral medullary segment; p3, tonsillomedullary segment; p4, telovelotonsillar segment; and p5, cortical segment.

Conclusions
The proposed nomenclature for segmental anatomy of cerebellar artery complements established nomenclature for segmental anatomy of cerebral arteries. This nomenclature is simple, easy to learn, and practical. The nomenclature localizes distal cerebellar artery aneurysms and also localizes an anastomosis or describes a graft's connections to donor and recipient arteries. These applications of the proposed nomenclature with cerebellar arteries mimic the applications of the established nomenclature with cerebral arteries.
Treatment outcomes for patients with glioblastoma multiforme and a low Karnofsky Performance Scale score on presentation to a tertiary care institution
Authors: Marina Ovidiu , Suh John H. , Reddy Chandana A. , Barnett Gene H. , Vogelbaum Michael A. , Peereboom David M. , Stevens Glen H. J. , Elinzano Heinrich , Chao Samuel T. 
Published: May 2011

Object
The object of this study was to determine the benefit of surgery, radiation, and chemotherapy for patients with glioblastoma multiforme (GBM) and a low Karnofsky Performance Scale (KPS) score.

Methods
The authors retrospectively evaluated the records of patients who underwent primary treatment for pathologically confirmed GBM and with a KPS score ≤ 50 on initial evaluation for radiation therapy at a tertiary care institution between 1977 and 2006. Seventy-four patients with a median age of 69 years (range 19–88 years) and a median KPS score of 50 (range 20–50) were retrospectively grouped into the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) Classes IV (11 patients), V (15 patients), and VI (48 patients). Patients underwent biopsy (38 patients) or tumor resection (36 patients). Forty-seven patients received radiation. Nineteen patients also received chemotherapy (53% temozolomide), initiated concurrently (47%) or after radiotherapy.

Results
The median survival overall was 2.3 months (range 0.2–48 months). Median survival stratified by RPA Classes IV, V, and VI was 6.6, 6.6, and 1.8 months, respectively (p < 0.001, log-rank test). Median survival for patients receiving radiation (5.2 months) was greater than that for patients who declined radiation (1.6 months, p < 0.001). Patients in RPA Class VI appeared to benefit from radiotherapy only when tumor resection was also performed. The median survival from treatment initiation was greater for patients receiving chemotherapy concomitantly with radiotherapy (9.8 months) as compared with radiotherapy alone (1.7 months, p = 0.002). Of 20 patients seen for follow-up in the clinic at a median of 48 days (range 24–196 days) following radiotherapy, 70% were noted to have an improvement in the KPS score of between 10 and 30 points from the baseline score. On multivariate analysis, only RPA class (p = 0.01), resection (HR = 0.37, p = 0.001), and radiation therapy (HR = 0.39, p = 0.02) were significant predictors of a decreased mortality rate.

Conclusions
Patients with a KPS score ≤ 50 appear to have increased survival and functional status following tumor resection and radiation. The extent of benefit from concomitant chemotherapy is unclear. Future studies may benefit from reporting that utilizes a prognostic classification system such as the RTOG RPA class, which has been shown to be effective at separating outcomes even in patients with low performance status. Patients with GBMs and low KPS scores need to be evaluated in prospective studies to identify the extent to which different therapies improve outcomes.
Cost-effectiveness of transforaminal lumbar interbody fusion for Grade I degenerative spondylolisthesis
Authors: Adogwa Owoicho , Parker Scott L. , Davis Brandon J. , Aaronson Oran , Devin Clinton , Cheng Joseph S. , McGirt Matthew J. 
Published: May 2011

Object
Transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis-associated back and leg pain is associated with improvement in pain, disability, and quality of life. However, given the rising health care costs associated with spinal fusion procedures and varying results of recent cost-utility studies, the cost-effectiveness of TLIF remains unclear. The authors set out to assess the comprehensive costs of TLIF at their institution and to determine its cost-effectiveness in the treatment of degenerative spondylolisthesis.

Methods
Forty-five patients undergoing TLIF for Grade I degenerative spondylolisthesis–associated back and leg pain after 6–12 months of conservative therapy were included. The authors assessed the 2-year back pain visual analog scale (VAS) score, leg pain VAS score, Oswestry Disability Index, and total back-related medical resource utilization, missed work, and health-state values (quality-adjusted life years [QALYs], calculated from EQ-5D with US valuation). Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost), and patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). The mean total 2-year cost per QALY gained after TLIF was assessed.

Results
Compared with preoperative health states reported after at least 6 months of medical management, a significant improvement in back pain VAS score, leg pain VAS score, and Oswestry Disability Index was observed 2 years after TLIF, with a mean 2-year gain of 0.86 QALYs. The mean ± SD total 2-year cost of TLIF was $36,836 ± $11,800 (surgery cost, $21,311 ± $2800; outpatient resource utilization cost, $3940 ± $2720; indirect cost, $11,584 ± $11,363). Transforaminal lumbar interbody fusion was associated with a mean 2-year cost per QALY gained of $42,854.

Conclusions
Transforaminal lumbar interbody fusion improved pain, disability, and quality of life in patients with degenerative spondylolisthesis–associated back and leg pain. The total cost per QALY gained for TLIF was $42,854 when evaluated 2 years after surgery with Medicare fees, suggesting that TLIF is a cost-effective treatment of lumbar spondylolisthesis.
Incidence of postoperative symptomatic epidural hematoma in spinal decompression surgery
Authors: Aono Hiroyuki , Ohwada Tetsuo , Hosono Noboru , Tobimatsu Hidekazu , Ariga Kenta , Fuji Takeshi , Iwasaki Motoki 
Published: May 2011

Object
Neurological deterioration due to spinal epidural hematoma (SEH) is a rare but significant complication of spinal surgery. The frequency of hematoma evacuation after spinal surgery is reportedly 0.1%–3%. The objective of this study was to investigate the symptomatology of SEH and the frequency of evacuation for each surgical procedure after spinal decompression surgery.

Methods
This is a retrospective study of 26 patients who underwent SEH evacuation after spinal decompression surgery between 1986 and 2005. During this period, 6356 spinal decompression surgeries were performed. The factors studied were the frequency of SEH evacuation for each surgical procedure, symptoms, time to SEH evacuation, comorbidities, and neurological recovery.

Results
The frequency of SEH evacuation was 0.41% (26 of 6356) for all operations. The frequency for each surgical procedure was 0% (0 of 1568) in standard lumbar discectomy, 0.50% (8 of 1614) in lumbar laminectomy, 0.67% (8 of 1191) in posterior lumbar interbody fusion, 4.46% (5 of 112) in thoracic laminectomy, 0.44% (4 of 910) in cervical laminoplasty, and 0.21% (1 of 466) in cervical anterior spinal fusion. Nine patients had comorbidities involving hemorrhage. Spinal epidural hematoma evacuation was performed between 4 hours and 8 days after the initial operation. Whereas severe paralysis was observed within 24 hours in most patients undergoing cervical and/or thoracic surgery, half of the patients undergoing lumbar surgery had symptoms of SEH such as leg pain or bladder dysfunction after suction drain removal. The shorter the period to evacuation, the better were the results of neurological recovery.

Conclusions
Postoperative SEH was most frequent after thoracic laminectomy. In cervical and thoracic surgeries, symptoms of SEH were noted within 24 hours, mostly severe paralysis, and almost half of the lumbar surgery patients had symptoms after suction drain removal.