bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency ablation of colorectal liver metastases downstaged by chemotherapy
Authors: Knudsen Anders Riegels , Kannerup Anne-Sofia , Mortensen Frank Viborg , Nielsen Dennis Tønner 
Published: June 2009

Background: Radiofrequency ablation (RFA) continues to evolve, improving the potentials of this technique. It is now a widely used procedure in the treatment of patients with unresectable colorectal liver metastases, increasing the number of potentially curable patients. Purpose: To evaluate the long-term survival of patients treated by RFA for colorectal liver metastases after downstaging by systemic chemotherapy. Material and Methods: In a retrospective review of our prospective colorectal liver metastasis RFA database, 36 patients (20 males, 16 females; median age 67 years) were identified during an 8-year period (1999–2007). All patients were initially unsuitable for local treatment, and referred to systemic chemotherapy by our multidisciplinary team. Multinodularity and/or location of tumor was the main cause of patients being unsuitable for local treatment. Chemotherapy mainly consisted of 5-fluorouracil and leucovorin combined with oxaliplatin or irinotecan. After downstaging with chemotherapy, patients were treated by RFA. Patients with extrahepatic disease were excluded from RFA treatment. Pre- and posttreatment evaluation was performed with multidetector computed tomography (MDCT) scans. Results: The median time from diagnosis of hepatic metastases to first RFA was 10 months. A total of 158 tumors were treated with RFA during the study period. Median follow-up period was 27 months. The estimated median survival time after diagnosis of hepatic metastasis was 39 months, with a 5-year survival rate of 34%. Conclusion: In selected patients with colorectal liver metastases downstaged by chemotherapy, RFA is an important modality that may contribute to improved survival. Furthermore, all patients responding to systemic chemotherapy should be re-evaluated by a multidisciplinary team.
Retinal Vascular Caliber and Diabetes in a Multiethnic Asian Population
Authors: JEGANATHAN V. SWETHA E. , SABANAYAGAM CHARUMATHI , TAI E. SHYONG , LEE JEANNETTE , LAMOUREUX ECOSSE , SUN CONG , KAWASAKI RYO , WONG TIEN Y. 
Published: June 2009

ABSTRACTObjective: The aim of this study was to examine the relationship of retinal vascular caliber with diabetes and impaired fasting glucose (IFG) in a multiethnic Asian population.Methods: This work was a population‐based cross‐sectional study comprising 3,404 Singaporean Chinese, Indian, and Malay participants. Retinal arteriolar and venular diameters, CRAE and CRVE, respectively were measured from digital retinal photographs. Diabetes was defined as physician‐diagnosis of diabetes, self‐reported use of diabetic medication, or fasting plasma glucose (FPG) ≥ 7 mmol/L; IFG as FPG 6.1–6.9 mmol/L.Results: After adjusting for age, gender, ethnicity, systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking, and vascular caliber (Model 3), participants with diabetes had both larger CRAE and CRVE, compared to those with normal fasting glucose (NFG) or IFG. In a multivariate analysis, including clinical risk factors and CRVE, mean CRAE increased from 143.6 μm in NFG to 145.3 μm with diabetes (P for trend = 0.01). On the other hand, each mmol/L increase in FPG was associated with a 0.51‐μm increase in CRVE (P=0.006). In a subgroup analysis stratified by ethnicity, the association between FPG and larger CRVE was predominantly present among ethnic Indians (0.9‐μm increase in CRVE per mmol/L increase in FPG).Conclusion: Diabetes was associated with larger retinal arteriolar diameters and glucose level was associated with larger retinal venular diameters in this multiethnic Asian population. The magnitude of association between glucose level and venular widening was stronger among ethnic Indians.
Emergency Legal Preparedness for Hospitals and Health Care Personnel
Authors: Hodge James G. , Garcia Andrea M. , Anderson Evan D. , Kaufman Torrey 
Published: June 2009

ABSTRACTDuring the past decade, hospital emergency preparedness has become a focus of local, state, and federal governments seeking to address emergencies or disasters that affect the public health. Integral to hospital emergency preparedness are numerous legal challenges that hospitals and their health care personnel face during declared states of emergencies. In this article, we evaluate legal requirements for hospital emergency preparedness, key legal concerns that hospitals should consider in emergency preparedness activities, and how the changing legal landscape during emergencies necessitates real-time decision making. We then analyze legal issues including negligence, discrimination, and criminal culpability that may arise during or after medical triage. Finally, we examine the legal risks of evading preparedness, specifically asking how a hospital and its personnel may be held liable for failing to plan or prepare for an emergency. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S37–S44)
Health Care Emergency Management: Establishing the Science of Managing Mass Casualty and Mass Effect Incidents
Authors: Macintyre Anthony G. , Barbera Joseph A. , Brewster Peter 
Published: June 2009

ABSTRACTParticularly since 2001, the health care industry has witnessed many independent and often competing efforts to address mitigation and preparedness for emergencies. Clinicians, health care administrators, engineers, safety and security personnel, and others have each developed relatively independent efforts to improve emergency response. A broader conceptual approach through the development of a health care emergency management profession should be considered to integrate these various critical initiatives. When based on long-standing emergency management principles and practices, health care emergency management provides standardized, widely accepted management principles, application concepts, and terminology. This approach could also promote health care integration into the larger community emergency response system. The case for a formally defined health care emergency management profession is presented with discussion points outlining the advantages of this approach. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S52–S58)
Major Influences on Hospital Emergency Management and Disaster Preparedness
Authors: Sauer Lauren M. , McCarthy Melissa L. , Knebel Ann , Brewster Peter 
Published: June 2009

ABSTRACTThe role of hospitals in the community response to disasters has received increased attention, particularly since the terrorist attacks of September 11, 2001. Hospitals must be prepared to respond to and recover from all-hazards emergencies and disasters. There have been several initiatives to guide hospitals’ role in these events and to assist hospitals in their effort to prepare for them. This article focuses on the efforts of 4 distinct groups: The Joint Commission (TJC), the executive branch of the US government, the US Congress, and the Department of Health and Human Services (DHHS). Despite the different approach each group uses to assist hospitals to improve their emergency management capabilities, the initiatives reinforce one another and have resulted in increased efforts by hospitals to improve their disaster preparedness and response capabilities and community integration. The continued progress of our medical response system in all-hazard emergencies and disasters depends in large part on the future guidance and support of these 4 key institutions. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S68–S73)
Consensus and Tools Needed to Measure Health Care Emergency Management Capabilities
Authors: McCarthy Melissa L. , Brewster Peter , Hsu Edbert B. , Macintyre Anthony G. , Kelen Gabor D. 
Published: June 2009

ABSTRACTThere is no widely accepted, validated framework of health care emergency management capabilities (HEMCs) that can be used by facilities to guide their disaster preparedness and response efforts. We reviewed the HEMCs and the evaluation methods used by the Veterans Health Administration, The Joint Commission, the Institute of Medicine Metropolitan Medical Response System committee, the Department of Homeland Security, and the Department of Health and Human Services to determine whether a core set of HEMCs and evaluative methods could be identified.Despite differences in the conceptualization of health care emergency management, there is considerable overlap among the agencies regarding major capabilities and capability-specific elements. Of the 5 agencies, 4 identified occupant safety and continuity of operations as major capabilities. An additional 5 capabilities were identified as major by 3 agencies. Most often the differences were related to whether a capability should be a major one versus a capability-specific element (eg, decontamination, management of resources). All of the agencies rely on multiple indicators and data sources to evaluate HEMCs. Few performance-based tools have been developed and none have been fully tested for their reliability and validity. Consensus on a framework and tools to measure HEMCs is needed. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S45–S51)
Access to Health Services and Care-seeking Behaviors After the 2007 Ica Earthquake in Peru
Authors: Daniels Amy , Chapin Erica , Aspilcueta Daniel , Doocy Shannon ,   With The Instituto Peruano de Paternidad Responsable-Johns Hopkins Bloomberg School of Public Health-City University of New York Study Team
Published: June 2009

ABSTRACTObjective: To assess care-seeking behaviors, perceptions of quality, and access to health services among populations affected by the 2007 Peruvian earthquake.Methods: A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural populations of the 4 provinces most affected by the earthquake. Forty-two clusters of 16 households (n = 672) were interviewed approximately 6 months after the earthquake.Results: Of all of the respondents, 38% reported that a household member sought medical care within 2 weeks after the earthquake. Earthquake-related injury, presence of a chronic medical condition, and residence in temporary housing were significantly associated with care seeking in adjusted models. Individuals experiencing earthquake-related injuries and those with chronic medical conditions, respectively, were 7.1 times (95% confidence interval [CI] 3.7–13.7) and 1.9 times (95% CI 1.3–2.9) more likely to seek medical care; temporary housing residents were 1.7 times (95% CI 1.0–2.8) more likely to seek care than those residing in permanent housing.Conclusions: Earthquake-related injury and chronic medical conditions were associated with care seeking in the first 2 weeks after the 2007 Ica earthquake. Households living in temporary housing were more likely to seek medical care than those residing in permanent structures, suggesting that displaced people are more likely to need medical attention. (Disaster Med Public Health Preparedness. 2009;3:97–103)
Update on Mortality in the Democratic Republic of Congo: Results From a Third Nationwide Survey
Authors: Coghlan Benjamin , Ngoy Pascal , Mulumba Flavien , Hardy Colleen , Bemo Valerie Nkamgang , Stewart Tony , Lewis Jennifer , Brennan Richard J. 
Published: June 2009

ABSTRACTBackground:The humanitarian crisis in the Democratic Republic of Congo (DRC) has been among the world’s deadliest in recent decades. We conducted our third nationwide survey to examine trends in mortality rates during a period of changing political, security, and humanitarian conditions.Methods:We used a 3-stage, household-based cluster sampling technique to compare east and west DRC. Sixteen east health zones and 15 west zones were selected with a probability proportional to population size. Four east zones were purposely selected to allow historical comparisons. The 20 smallest population units were sampled in each zone, 20 households in each unit. The number and distribution of households determined whether they were selected using systematic random or random walk sampling. Respondents were asked about deaths of household members during the recall period: January 2006–April 2007.Findings:In all, 14,000 households were visited. The national crude mortality rate of 2.2 deaths per 1000 population per month (95% confidence interval [CI] 2.1–2.3) is almost 70% higher than that documented for DRC in the 1984 census (1.3) and is unchanged since 2004. A small but significant decrease in mortality since 2004 in the insecure east (rate ratio: 0.96,P= .026) was offset by increases in the western provinces and a transition area in the center of the country. Nonetheless, the crude mortality rate in the insecure east (2.6) remains significantly higher than in the other regions (2.0 and 2.1, respectively). Deaths from violence have declined since 2004 (rate ratio 0.7,P= .02).Conclusions:More than 4 years after the official end of war, the crude mortality rate remains elevated across DRC. Slight but significant improvements in mortality in the insecure east coincided temporally with recent progress on security, humanitarian, and political fronts. (Disaster Med Public Health Preparedness. 2009;3:88–96)
A Novel Approach to Multihazard Modeling and Simulation
Authors: Smith Silas W. , Portelli Ian , Narzisi Giuseppe , Nelson Lewis S. , Menges Fabian , Rekow E Dianne , Mincer Joshua S. , Mishra Bhubaneswar , Goldfrank Lewis R. 
Published: June 2009

ABSTRACTObjective:To develop and apply a novel modeling approach to support medical and public health disaster planning and response using a sarin release scenario in a metropolitan environment.Methods:An agent-based disaster simulation model was developed incorporating the principles of dose response, surge response, and psychosocial characteristics superimposed on topographically accurate geographic information system architecture. The modeling scenarios involved passive and active releases of sarin in multiple transportation hubs in a metropolitan city. Parameters evaluated included emergency medical services, hospital surge capacity (including implementation of disaster plan), and behavioral and psychosocial characteristics of the victims.Results:In passive sarin release scenarios of 5 to 15 L, mortality increased nonlinearly from 0.13% to 8.69%, reaching 55.4% with active dispersion, reflecting higher initial doses. Cumulative mortality rates from releases in 1 to 3 major transportation hubs similarly increased nonlinearly as a function of dose and systemic stress. The increase in mortality rate was most pronounced in the 80% to 100% emergency department occupancy range, analogous to the previously observed queuing phenomenon. Effective implementation of hospital disaster plans decreased mortality and injury severity. Decreasing ambulance response time and increasing available responding units reduced mortality among potentially salvageable patients. Adverse psychosocial characteristics (excess worry and low compliance) increased demands on health care resources. Transfer to alternative urban sites was possible.Conclusions:An agent-based modeling approach provides a mechanism to assess complex individual and systemwide effects in rare events. (Disaster Med Public Health Preparedness. 2009;3:75–87)
Human leukocyte antigen profile in HIV‐1 infected individuals and AIDS patients from Chongqing, China
Authors: Huang Xia , Ling Hua , Feng Liangui , Ding Xianbin , Zhou Quanhua , Han Mei , Mao Wei , Xiong Hongyan 
Published: June 2009

ABSTRACTHIV/AIDS is currently the leading cause of infectious disease mortality around the world. Since many alleles and/or haplotypes of HLA have been reported to be associated with progressive HIV infection, more detailed information on the HLA profile in HIV‐1 infected individuals in Chongqing, southwest China would facilitate further understanding of HIV‐1 infection, help AIDS vaccine design and the planning of effective preventive strategies. In this study, we performed 4‐digit resolution HLA‐A, B, DRB1 genotyping of 759 HIV‐1 seropositive individuals using PCR‐SSO methods. Six alleles were found at more than 10% high frequency: A*1101, A*0201, A*2402, B*4601, B*4001 and DRB1*0901. The most common 2‐ and 3‐locus haplotypes were A*0201‐B*4601, A*1101‐B*4001, A*1101‐B*4601, A*3303/1‐B*5801, A*0201‐B*4601‐DRB1*0901, A*1101‐B*4601‐DRB1*0901 and A*3303/1‐B*5801‐DRB1*0301.690 HIV‐1 seropositive individuals with records of CD4 counts were divided into two groups: an AIDS patient group comprising 216 subjects with AIDS‐defining symptoms and CD4 counts below 200 cells/mm3 and an asymptomatic, HIV seropositive group of 474 subjects with a stable CD4 count of no less than 200 individuals. In the AIDS patient group, A*3303/1 and B*5801 alleles and the A*3303/1‐B*5801 haplotype were significantly underrepresented as compared to the HIV‐infected group, whereas A*1101‐B*4001, A*1101‐B*1502, A*2402‐B*4801 haplotypes and five common haplotypes from two groups were significantly overrepresented. HLA‐A or B and HLA‐Bw6‐Bw6 homozygotes were also overrepresented in the AIDS patients group. Our observations suggest that the presence of the B*3501 allele, A*2402‐B*4801, common 2‐locus and 3‐locus haplotypes, HLA‐A or B and Bw6‐Bw6 homozygosity may predict a poor disease outcome in HIV‐1 infection. However, HIV‐1 infected individuals who have B*5801 alleles, A*3303/1‐B*5801 haplotype and are heterozygous for Bw4‐Bw6 are more likely to be resistant to progression of AIDS in this Chinese population.
Mechanisms of action of acriflavine: electron microscopic study of cell wall changes induced in Staphylococcus aureus by acriflavine
Authors: Kawai Mako , Yamagishi Jun‐ichi 
Published: June 2009

ABSTRACTThe antimicrobial action of acriflavine, a quaternary ammonium compound, on Staphylococcus aureus was studied by electron microscopic observation. The bactericidal activity of acriflavine was dose‐dependent over the 4 hr of exposure time. Scanning electron micrographs showed a wavy wrinkled cell surface following treatment with acriflavine. Transmission electron micrographs showed thickened cell walls following treatment with acriflavine. Acriflavine‐induced cell wall thickness seemed to affect both the peripheral and cross walls, but was reversible after treatment removal. These findings indicate that cell wall thickness is a characteristic phenotype of S. aureus exposed to acriflavine. It is therefore believed that cell wall thickness plays an important role in the mechanism of action of acriflavine.
Development of a broadly reactive nested reverse transcription‐PCR assay to detect murine noroviruses, and investigation of the prevalence of murine noroviruses in laboratory mice in Japan
Authors: Kitajima Masaaki , Oka Tomoichiro , Tohya Yukinobu , Katayama Hiroyuki , Takeda Naokazu , Katayama Kazuhiko 
Published: June 2009

ABSTRACTA broadly reactive nested RT‐PCR assay to detect MNV was developed and subsequently used to investigate the prevalence of MNV in laboratory mice in Japan. MNV were detected in 8 (22%) of 37 murine stool specimens by second‐round PCR, although no positive band was obtained from any specimen by first‐round PCR. Genetic analysis of the second round PCR products showed that MNV sequences detected in this study were closely matched (97.2 ∼ 99.1%) to that of MNV‐3 (DQ223042). This is the first report demonstrating the prevalence of MNV in Japan.
Novel pharmacogenetic markers for treatment outcome in azathioprine‐treated inflammatory bowel disease
Authors: SMITH M. A. , MARINAKI A. M. , ARENAS M. , SHOBOWALE‐BAKRE M. , LEWIS C. M. , ANSARI A. , DULEY J. , SANDERSON J. D. 
Published: June 2009

SummaryBackground Azathioprine (AZA) pharmacogenetics are complex and much studied. Genetic polymorphism in TPMT is known to influence treatment outcome. Xanthine oxidase/dehydrogenase (XDH) and aldehyde oxidase (AO) compete with TPMT to inactivate AZA.Aim To assess whether genetic polymorphism inAOX1,XDHandMOCOS(the product of which activates the essential cofactor for AO and XDH) is associated with AZA treatment outcome in IBD.Methods Real‐time PCR was conducted for a panel of single nucleotide polymorphism (SNPs) inAOX1, XDHandMOCOSusing TaqMan SNP genotyping assays in a prospective cohort of 192 patients receiving AZA for IBD.Results Single nucleotide polymorphismAOX1c.3404A > G (Asn1135Ser, rs55754655) predicted lack of AZA response (P = 0.035, OR 2.54, 95%CI 1.06–6.13) and when combined with TPMT activity, this information allowed stratification of a patient’s chance of AZA response, ranging from 86% in patients where both markers were favourable to 33% where they were unfavourable (P < 0.0001). We also demonstrated a weak protective effect against adverse drug reactions (ADRs) from SNPsXDHc.837C > T (P = 0.048, OR 0.23, 95% CI 0.05–1.05) andMOCOSc.2107A > C, (P = 0.058 in recessive model, OR 0.64, 95%CI 0.36–1.15), which was stronger where they coincided (P = 0.019).Conclusion These findings have important implications for clinical practice and our understanding of AZA metabolism.
Genetic structure of a wide‐spectrum chicken gene pool
Authors: Granevitze Z. , Hillel J. , Feldman M. , Six A. , Eding H. , Weigend S. 
Published: June 2009

SummaryThe genetic structure of 65 chicken populations was studied using 29 simple sequence repeat loci. Six main clusters which corresponded to geographical origins and histories were identified: Brown Egg Layers; predominantly Broilers; native Chinese breeds or breeds with recent Asian origin; predominantly breeds of European derivation; a small cluster containing populations with no common history and populations that had breeding history with White Leghorn. Another group of populations that shared their genome with several clusters was defined as ‘Multi‐clusters’. Gallus gallus gallus (Multi‐clusters), one of the subspecies of the Red Jungle Fowl, which was previously suggested to be one of the ancestors of the domesticated chicken, has almost no shared loci with European and White Egg layer populations. In a further sub‐clustering of the populations, discrimination between all the 65 populations was possible, and relationships between each were suggested. The genetic variation between populations was found to account for about 34% of the total genetic variation, 11% of the variation being between clusters and 23% being between populations within clusters. The suggested clusters may assist in future studies of genetic aspects of the chicken gene pool.
Mapping of quantitative trait loci affecting eggshell quality on chromosome 9 in an F2 intercross between two chicken lines divergently selected for eggshell strength
Authors: Takahashi H. , Yang D. , Sasaki O. , Furukawa T. , Nirasawa K. 
Published: June 2009

SummaryBroken and cracked eggshells are major causes of significant economic losses to the egg production industry. The quantitative trait loci (QTL) on chromosome 9 influencing the quality of eggshells were identified by analysing an intercross between two parent lines developed from the same founder population by a two‐way selection for eggshell strength with non‐destructive deformation conducted over 14 generations. Chromosome‐wide highly significant (P < 0.01) QTL associated with egg weight (EW), short length of egg (SLE), long length of egg (LLE) and eggshell weight were mapped to the distal region of chromosome 9. Among the QTL affecting EW, SLE and LLE, ovocalyxin‐32 was identified as a potential candidate gene influencing eggshell traits. Marker‐assisted selection based on these QTL could be used to develop strategies for reducing the breakage and cracking of eggs in commercial layer houses.