bluuebunny/crossref_metadata_2025_split huggingface dataset:
National Estimates of Out-of-Pocket Health Care Expenditure Burdens Among Nonelderly Adults With Cancer: 2001 to 2008
Authors: Bernard Didem S.M. , Farr Stacy L. , Fang Zhengyi 
Published: June 2011

Purpose To compare the prevalence of high out-of-pocket burdens among patients with cancer with other chronically ill and well patients, and to examine the sociodemographic characteristics associated with high burdens among patients with cancer. Methods The sample included persons 18 to 64 years of age who received treatment for cancer, taken from a nationally representative sample of the US population from the 2001 to 2008 Medical Expenditure Panel Survey. We examined the proportion of persons living in families with high out-of-pocket burdens associated with medical spending, including insurance premiums, relative to income, defining high health care (total) burden as spending more than 20% of income on health care (and premiums). Results The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions. Conclusion High burdens may affect treatment choice and deter patients from getting care. Thus, although a detailed patient-physician discussion of costs of care may not be feasible, we believe that an awareness of out-of-pocket burdens among patients with cancer is useful for clinical oncologists.
Beta Blockers and Breast Cancer Mortality: A Population- Based Study
Authors: Barron Thomas I. , Connolly Roisin M. , Sharp Linda , Bennett Kathleen , Visvanathan Kala 
Published: June 2011

Purpose Preclinical studies have demonstrated that antagonism of β2-adrenergic signaling inhibits several pathways necessary for breast tumor progression and metastasis. A series of population-based observational studies were conducted to examine associations between beta blocker use and breast tumor characteristics at diagnosis or breast cancer–specific mortality. Patients and Methods Linked national cancer registry and prescription dispensing data were used to identify women with a diagnosis of stage I to IV invasive breast cancer between January 1, 2001, and December 31, 2006. Women taking propranolol (β1/β2 antagonist; n = 70) or atenolol (β1 antagonist; n = 525), in the year before breast cancer diagnosis were matched (1:2) to women not taking a beta blocker (n = 4,738). Associations between use of propranolol or atenolol and risk of local tumor invasion at diagnosis (T4 tumor), nodal or metastatic involvement at diagnosis (N2/N3/M1 tumor), and time to breast cancer–specific mortality were assessed. Results Propranolol users were significantly less likely to present with a T4 (odds ratio [OR], 0.24, 95% CI, 0.07 to 0.85) or N2/N3/M1 (OR, 0.20; 95% CI, 0.04 to 0.88) tumor compared with matched nonusers. The cumulative probability of breast cancer–specific mortality was significantly lower for propranolol users compared with matched nonusers (hazard ratio, 0.19; 95% CI, 0.06 to 0.60). There was no difference in T4 or N2/N3/M1 tumor incidence or breast cancer–specific mortality between atenolol users and matched nonusers. Conclusion The results provide evidence in humans to support preclinical observations suggesting that inhibiting the β2-adrenergic signaling pathway can reduce breast cancer progression and mortality.
Pathology Review of Outside Material: When Does It Help and When Can It Hurt?
Authors: Smith Lauren B. 
Published: June 2011

Purpose Pathology review is performed for patients when care is transferred to a tertiary care center after diagnostic tissue has been obtained. While it has many benefits, this practice can lead to unforeseen difficulties in doctor-patient communication and patient well-being, especially if a diagnosis is overturned or modified years after treatment. The aim of this analysis is to identify clinical situations in which pathology review can result in challenging discussions between patients and oncologists. Patients Representative case scenarios are presented in the subspecialty area of hematopathology. Analysis of the clinical benefits and possible harm to patients, pathologists, and treating oncologists that may ensue from pathology review is performed. Results Pathology review may result in a valuable second opinion and expert subclassification. However, problematic situations may arise with pathology review, especially if the patient has already undergone definitive treatment and is referred to an academic institution in remission. Difficulties can also arise when patients do not understand the limitations of diagnosing disease on small biopsies. The patient may receive a different diagnosis or it may become apparent that the diagnosis could have been made more expeditiously. These discrepancies must be communicated to the patient and may cause confusion and distress. Conclusion Pathology review can be beneficial or potentially harmful depending on the clinical situation. Preliminary recommendations are provided for selecting patients for review. Limiting pathology review to certain clinical situations and encouraging patients to get second opinions before initial treatment at local referral centers may be helpful in minimizing reassignment of diagnoses after definitive treatment.
Adult Medulloblastoma Comprises Three Major Molecular Variants
Authors: Remke Marc , Hielscher Thomas , Northcott Paul A. , Witt Hendrik , Ryzhova Marina , Wittmann Andrea , Benner Axel , von Deimling Andreas , Scheurlen Wolfram , Perry Arie , Croul Sidney , Kulozik Andreas E. , Lichter Peter , Taylor Michael D. , Pfister Stefan M. , Korshunov Andrey 
Published: June 2011

Purpose Medulloblastoma is a rare primary brain tumor in adults, whereas it constitutes the most common malignant brain tumor in children. Integrated genomics approaches revealed at least four distinct disease variants in children. The aim of this study was to investigate molecular subtypes and their prognostic implication in a large cohort of adult medulloblastomas as the biology in this age group remains poorly understood. Patients and Methods We combined transcriptome and DNA copy number analyses for 28 adult medulloblastomas. Statistical and bioinformatic tools were applied to discover distinct molecular variants. Clinical and molecular characteristics of each biologic subtype were validated using immunohistochemistry on a tissue microarray derived from an independent patient cohort of adult medulloblastomas (n = 103). Results Gene expression profiles revealed three distinct molecular variants with stable subtype separation using the 300 most varying transcripts. Distinct demographics, genetics, transcriptome, and prognosis were noted for each subtype of adult medulloblastoma. Immunohistochemistry revealed aberrant activation of the sonic hedgehog (SHH) pathway in over half of adult medulloblastomas constituting a promising molecular therapeutic target. In contrast, subtype C tumors, which comprise a robust subtype in childhood medulloblastoma are only exceptionally seen in adult cohorts. Notably, adult subtype D and Wnt/wingless tumors were associated with worse prognosis than pediatric cohorts, whereas survival for SHH tumors was similar for both age groups. Conclusion The transcriptome of adult medulloblastomas differs considerably from pediatric counterparts, both in terms of tumor biology and prognostic impact. Therefore, age-specific classification is required and must be adapted for use in clinical trials of adult medulloblastoma.
Aberrant deep flexor muscles of the forearm associated with the accessory origin of first lumbrical muscle
Authors: Jiji P J , Krishnamurthy Ashwin , Nayak Soubhagya R , D'Costa Sujatha , Pai Mangala M , Prabhu Latha V , Kumar Senthil , Lalitha M K 
Published: June 2011

Objective To find out variations in the deep forearm flexors that are associated with anomalous origin of the first lumbrical muscle. Introduction Muscular anomalies of the upper extremity could cause peripheral nerve disorders. Although variations in the attachments of lumbrical muscles have been commonly studied, muscle with an additional origin in the proximal aspect of the forearm from the deep flexors is not much discussed. Methods Fifty-three formalin-fixed upper limbs were dissected to assess the aberrant origin of the first lumbrical from the deep forearm flexors. The measurement, shape, origin, insertion and innervation of aberrant deep forearm flexors were noted and photographed. Results In two (3.77%) out of 53 upper limbs unilateral aberrant deep forearm flexors were found giving accessory anomalous origin to the first lumbrical muscle. In 11 cases (20.75%) the presence of accessory head of flexor pollicis longus was seen, and found co-existing with the aberrant deep forearm flexor in one (1.89%) limb. Discussion The clinical implication of these muscular anomalies, such as aberrant origins and hypertrophy of the first lumbrical, in nerve entrapments, especially in the aetiology of carpal tunnel syndrome, is considered. The awareness and identification of the muscular variations of the antebrachial and carpal regions will facilitate safe surgery of cases of median nerve entrapment syndromes.
Comparison of the effect of two application methods of self-adherent wrap (Coban™) on range of motion in the hands of healthy subjects
Authors: Glassey Nicole , Phillips Mia 
Published: June 2011

Introduction Coban™ (3M, Berkshire, UK) is a self-adherent dressing frequently used to control oedema in hands. There is a paucity of evidence investigating the effect of different application techniques of Coban™ on range of motion (ROM) of the hand. Method A within-subject design was used to evaluate the effect of two methods of application of Coban™ on the hand ROM of 25 participants. Each participant was tested at baseline, during the two methods of application and after removal of Coban™. Assessments were taken of finger flexion using a goniometer and of thumb ROM using the Kapandji's scale. Results The application of Coban™ reduced active range of joint flexion within the digits. There was also statistically significant difference active joint range of flexion between cylindrical and spiral Coban™ applications at the index finger proximal interphalangeal (PIP) joint (5.2°, P = 0.033), and the middle finger PIP (3.8°, P = 0.003) and distal interphalangeal joints (3.6°, P = 0.018). Discussion The study findings suggest that both cylindrical and spiral Coban™ application to the interphalangeal joint of the thumb and the index and middle fingers reduce range of finger flexion. The cylindrical application limits to a lesser degree than a spiral application. Although the differences were statistically significant, the extent of change may not be of clinical importance.
Mesothelial cells activate the plasma kallikrein-kinin system during pleural inflammation
Authors: Varano della Vergiliana Julius F. , Lansley Sally , Tan Ai Ling , Creaney Jenette , Lee Y.C. Gary , Stewart Geoffrey A. 
Published: June 2011

AbstractPleural inflammation underlies the formation of most exudative pleural effusions and the plasma kallikrein-kinin system (KKS) is known to contribute. Mesothelial cells are the predominant cell type in the pleural cavity, but their potential role in plasma KKS activation and BK production has not been studied. Bradykinin concentrations were higher in pleural fluids than the corresponding serum samples in patients with a variety of diseases. Bradykinin concentrations did not correlate with disease diagnosis, but were elevated in exudative effusions. It was demonstrated, using a range of primary and transformed mesothelial and mesothelioma cell lines, that cells assembled high molecular weight kininogen and plasma prekallikrein to liberate bradykinin, a process inhibited by novobiocin, a heat shock protein 90 (HSP90) inhibitor, cysteine, bradykinin and protamine sulphate. Of the common plasma prekallikrein activators, mesothelial cells expressed HSP90, but not prolylcarboxypeptidase or Factor XII. Calcium mobilisation was induced in some mesothelium-derived cell lines by bradykinin. Des-Arg9-bradykinin was inactive, indicating that mesothelial cells are responsive to bradykinin, mediated via the bradykinin receptor subtype 2. In summary, pleural mesothelial cells support the assembly and activation of the plasma KKS by a mechanism dependent on HSP90, and may contribute to KKS-mediated inflammation in pleural disease.
Characteristic interactions and successive approximations in problems on evaluating coefficients of transport equation and elemental content of a medium
Authors: Khisamutdinov Alfred I. 
Published: June 2011

Abstract
Inversion methods are very important components of nuclear-geophysical technologies. Their main aim is to evaluate the set of parameters of a formation, using measurements data. The parameters describe the properties and the elemental content of it, and they enter into coefficients of the transport equation. In this paper we develop and formalize an approach to problems on mathematical interpretation of the data, we state two inverse problems to the equation and construct successive approximations of the “prime” iteration type to solve a corresponding system of parameters evaluation. The approach is based on concepts defined of “characteristic” interactions, elements, and matrix, it uses the superposition principle for transport processes and linear a priori constraints for the unknowns. Earlier a few concrete problems were examined within this approach.
TLR4 gene polymorphisms: evidence for protection against type 2 diabetes but not for diabetes-associated ischaemic heart disease
Authors: Manolakis A C , Kapsoritakis A N , Tiaka E K , Sidiropoulos A , Gerovassili A , Satra M , Vamvakopoulou D , Tsiopoulos F , Papanas N , Skoularigis I , Potamianos S P , Vamvakopoulos N 
Published: June 2011

ObjectiveSeveral factors either predisposing or protecting from the onset of diabetes mellitus type 2 (DM2) have been proposed. Two specific polymorphisms of toll-like receptor 4 (TLR4; Asp299Gly and Thr399Ile) have recently been identified either as candidate protector genes against DM2 and associated neuropathy or risk alleles for the manifestation of diabetic retinopathy. The impact of these alleles on the risk for ischaemic heart disease (IHD) is controversial while their role in diabetes-associated IHD has never been studied.Design and methodsIn order to clarify the potential impact of TLR4 polymorphisms on the predisposition for DM2 as well as on diabetes-related IHD vulnerability, the distribution of the mutant TLR4 Asp299Gly and Thr399Ile alleles in 286 DM2 patients and 413 non-DM2 controls with or without IHD, was examined.ResultsMutant alleles were predominantly detected in 79/413 non-diabetic individuals versus 15/286 DM2 patients (P<0.0001). The rates of positivity for mutant alleles were similar among diabetic patients with or without IHD (7/142 vs 8/144, P>0.1), whereas they proved different among non-diabetic individuals with or without IHD (39/145 vs 40/268, P=0.004). Following multivariate analysis, the difference between diabetic and non-diabetic subjects, with regard to TLR4 mutations alone, remained significant (P=0.04).ConclusionsMutant TLR4 alleles confer protection against DM2. However, their presence does not seem to play any role, protective or aggravating, in the manifestation of IHD either in diabetic or in non-diabetic individuals.
A Public‐Private Partnership Model for National Cybersecurity
Authors: Shore Malcolm , Du Yi , Zeadally Sherali 
Published: June 2011

AbstractMany governments have established public‐private partnerships to manage critical infrastructure protection, one element of which is telecommunications. However, in New Zealand these collaborative efforts have had limited success and the rapid increase in use of the Internet to support both society and commerce has led to the need for a more specific focus in this area. While regulation is an effective means of forcing action by industry, it can lead to significant unintended consequences and undesirable behaviours. This article explores how governments can have confidence in the safety and protection of their critical national infrastructures through a model of assured public‐private partnership that is based on an incentivised adoption approach to drive optimal outcomes within the New Zealand context.
Adolescents and Cybercrime: Navigating between Freedom and Control
Authors: van der Hof Simone , Koops Bert‐Jaap 
Published: June 2011

AbstractOnline safety for children and adolescents as a policy issue finds itself in a turbulent arena: emerging new mobile and online technologies and applications carry opportunities and risks and constantly bring new challenges. This article explores particularly the field of adolescents and cybercrime against a background of a culture of control combined with an increasing use of new media by youngsters. Based on two particular cases, i.e. ‘grooming’—a new development in criminal law where children and adolescents are treated as (potential) victims in need of protection—and ‘sexting’—a new development in online risk‐taking where adolescents are framed as (potential) offenders in need of repression—we argue that public policy with respect to adolescent behaviour and online risks is tilting towards more control. These developments in cybercrime policy that focus on criminal law as a policy instrument disturb the balance between the freedom of adolescents to develop into responsible and independent adults and controlling online risks. Other, more promising avenues, such as encouraging digital literacy of citizens and protecting those children who are particularly vulnerable, should rather be at the forefront of public policy.
Overcoming the Warez Paradox: Online Piracy Groups and Situational Crime Prevention
Authors: Basamanowicz Jonathan , Bouchard Martin 
Published: June 2011

AbstractUS federal law enforcement operations occurring between 2001 and 2005 attempted to disrupt the online piracy scene, targeting copyright piracy rings known as ‘warez groups’. Previous work on warez groups has demonstrated a paradoxical situation where attempts to curtail warez group activities through policing and advancements in DRM only further encourage such groups to crack and distribute content. This study collected data on 93 convictions from these policing operations to construct a crime script of these groups' motivations and modus operandi in the release process. The results confirm previous findings that attempts to disrupt the activities of warez groups are counterproductive. To avoid the paradox, this study suggests that industry account for the motivations and modus operandi of these groups by creating DRM technologies which allow un‐cracked content to seep through the testing step of the script, thereby placing a group's ability to obtain prestige at risk. Law enforcement should focus on apprehending crackers, as they are the most significant step in the release process.
Public Policy Responses to Cybercrime
Authors: Fafinski Stefan 
Published: June 2011

AbstractBreaches of the ethics, confidence and trust that are embedded in the information society give rise to a range of risks that are of concern to individuals, industry and public administration. This special issue of Policy & Internet is concerned with the policy implications of cybercrimes that result from the abuse of networked technologies. It provides a range of multidisiciplinary views that are actively being sought by policymaking communities and which impact on national and supra‐national legislation, public‐private cooperation, and international coordination against transnational crime.
Sole depth and weight-bearing characteristics of the palmar surface of the feet of feral horses and domestic Thoroughbreds
Authors: Hampson Brian A. , Connelley Alexandra D. , de Laat Melody A. , Mills Paul C. , Pollitt Chris C. 
Published: June 2011

Abstract
Objective—To determine solar load-bearing structures in the feet of feral horses and investigate morphological characteristics of the sole in feral horses and domestic Thoroughbreds.
Sample—Forelimbs from cadavers of 70 feral horses and 20 domestic Thoroughbreds in Australia.
Procedures—Left forefeet were obtained from 3 feral horse populations from habitats of soft substrate (SS [n = 10 horses]), hard substrate (HS [10]), and a combination of SS and HS (10) and loaded in vitro. Pressure distribution was measured with a pressure plate. Sole depth was measured at 12 points across the solar plane in feet obtained from feral horses from SS (n = 20 horses) and HS (20) habitats and domestic Thoroughbreds (20).
Results—Feet of feral horses from HS habitats loaded the periphery of the sole and hoof wall on a flat surface. Feral horses from HS or SS habitats had greater mean sole depth than did domestic Thoroughbreds. Sole depth was greatest peripherally and was correlated with the loading pattern.
Conclusions and Clinical Relevance—The peripheral aspect of the sole in the feet of feral horses had a load-bearing function. Because of the robust nature of the tissue architecture, the hoof capsule of feral horses may be less flexible than that of typical domestic horses. The application of narrow-web horseshoes may not take full advantage of the load-bearing and force-dissipating properties of the peripheral aspect of the sole. Further studies are required to understand the effects of biomechanical stimulation on the adaptive responses of equine feet.
Effect of topical vapocoolant spray on response to arthrocentesis and intravenous catheterization in unsedated horses
Authors: Fjordbakk Cathrine T. , Haga Henning A. 
Published: June 2011

Abstract
Objective—To assess the efficacy of a commercially available topical vapocoolant spray in reducing responses to arthrocentesis of the middle carpal (MC) and metacarpophalangeal (MCP) joints and jugular vein catheterization in unsedated horses.
Animals—8 healthy research horses.
Procedures—Arthrocentesis of both MC and MCP joints and bilateral jugular vein catheterization were performed in each horse. Immediately prior to skin penetration, 1 randomly selected MC joint, MCP joint, and jugular vein were sprayed with a vapocoolant liquid (intervention product), and the contralateral MC joint, MCP joint, and jugular vein were sprayed with water (placebo). An observer blinded to the type of spray treatment used evaluated the horses' responses to needle or catheter placement procedures by use of a 6-point categorical scale and a 100-mm visual analog scale.
Results—Responses evaluated via the visual analog scale were significantly reduced after application of the intervention product, compared with responses after application of the placebo, for the MC and MCP joints; no difference in responses to jugular vein catheterization was detected between the 2 treatments.
Conclusions and Clinical Relevance—Vapocoolant spray was safe and effective in reducing horses' responses to arthrocentesis. The use of such products prior to joint injections may reduce procedural nociception and pain anticipation in unsedated horses and may improve the safety of personnel performing such procedures.