bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cluster randomized controlled trial of the impact of a computer‐assisted learning package on the learning of musculoskeletal examination skills by undergraduate medical students
Authors: Vivekananda‐Schmidt Pirashanthie , Lewis Martyn , Hassell Andrew B. ,   The Arc Virtual Rheumatology CAL Research Group
Published: October 2005

AbstractObjectiveTo identify whether there was measurable impact of a specific computer‐assisted learning (CAL) package, “Virtual Rheumatology,” on the learning of musculoskeletal examination skills by medical students.MethodsWe conducted 2 parallel, cluster‐randomized controlled trials using undergraduate curricula at 2 locations: Newcastle and London, UK. Medical students attending a musculoskeletal rotation were allocated to the intervention (Virtual Rheumatology CD) or the control arm of the study by placement group. A formative 14‐item objective structured clinical examination (OSCE) assessment on the examination of shoulder and/or knee joints was the main outcome measure at Newcastle. At London, a 17‐item knee station formed part of the summative OSCE. We also used a questionnaire including a 15‐item confidence log (C‐Log) for self assessment of musculoskeletal examination skills and knowledge. Analysis was by intention to teach.ResultsAt Newcastle, there were 112 students in the CD allocated group and 129 in the non‐CD group. The CD allocated group performed significantly better on the OSCE (P = 0.002) and C‐Log (P = 0.005) than the non‐CD group. At London, there were 48 students in the CD allocated group and 65 in the non‐CD group. The CD allocated group performed better on the knee OSCE than the non‐CD group (adjusted P = 0.040), but there was little difference in the change in C‐Log scores from baseline to followup between the 2 groups (P = 0.582).ConclusionThe Virtual Rheumatology CD has a positive impact on the acquisition of musculoskeletal examination skills in medical students. Further study is needed to see if similar advantages could be gained in other clinical specialities and how CAL resources could be effectively integrated into the medical curriculum.
Severely compromised quality of life in women and those of lower socioeconomic status waiting for joint replacement surgery
Authors: Ackerman Ilana N. , Graves Stephen E. , Wicks Ian P. , Bennell Kim L. , Osborne Richard H. 
Published: October 2005

AbstractObjectiveTo determine health‐related quality of life (HRQOL), psychological distress, physical function, and self efficacy in persons waiting for lower‐limb joint replacement surgery.MethodsA total of 214 patients on a waiting list for unilateral primary total knee or hip replacement at a large Australian public teaching hospital completed questionnaires after entry to the list. HRQOL and psychological distress were compared with available population norms.ResultsAverage HRQOL was extremely poor (mean ± SD 0.39 ± 0.24) and much lower (>2 SD) than the population norm. Near death‐equivalent HRQOL or worse than death‐equivalent HRQOL were reported by 15% of participants. High or very high psychological distress was up to 5 times more prevalent in the waiting list sample (relative risk 5.4 for participants ages 75 years and older; 95% confidence interval 3.3, 9.0). Women had significantly lower HRQOL, self efficacy, and physical function scores than men. After adjusting for age and sex, significant socioeconomic disparities were also found. Participants who received the lowest income had the poorest HRQOL; those with the least education or the lowest income had the highest psychological distress. Low self efficacy was moderately associated with poor HRQOL (r = 0.49, P < 0.001) and more strongly associated with high psychological distress (r = −0.55, P < 0.001).ConclusionPatients waiting for joint replacement have very poor HRQOL and high psychological distress, especially women and those from lower socioeconomic backgrounds. Lengthy waiting lists mean patients can experience extended and potentially avoidable morbidity. Interventions to address psychological distress and self efficacy could reduce this burden and should target women and lower socioeconomic groups.
Use of complementary and alternative medicine by persons with arthritis: Results of the National Health Interview Survey
Authors: Quandt Sara A. , Chen Haiying , Grzywacz Joseph G. , Bell Ronny A. , Lang Wei , Arcury Thomas A. 
Published: October 2005

AbstractObjectiveTo compare the complementary and alternative medicine (CAM) used by adults ages 45 years and older with and without arthritis, and to investigate the prevalence and predictors of CAM use by persons who report being told by a doctor they had arthritis.MethodsData from the 2002 National Health Interview Survey with a supplemental section on CAM use were analyzed. Data on overall use and use by 4 CAM modalities were calculated by arthritis status. CAM use for treatment of any health condition, including arthritis, was calculated and compared by arthritis status. Logistic regression was used to identify predictors of CAM use among persons with arthritis.ResultsOverall use of CAM and use of 3 of 4 major CAM categories were higher for persons who reported doctor‐diagnosed arthritis compared with those without arthritis. Biologically based therapies were the most frequently reported modalities. Although persons with arthritis were more likely than those without arthritis to report using CAM for treatment, most of their CAM use was for conditions other than arthritis. Joint pain and poor functional status were the most common predictors of CAM modalities among persons with arthritis.ConclusionHealth care providers of persons with arthritis should be aware that CAM use is common among their patients. A complete medication history is needed to obtain information on CAM use for all conditions.
Spondyloarthritis research Consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis
Authors: Maksymowych Walter P. , Inman Robert D. , Salonen David , Dhillon Suhkvinder S. , Williams Martin , Stone Millicent , Conner‐spady Barbara , Palsat Janice , Lambert Robert G. W. 
Published: October 2005

AbstractObjectiveTo develop a feasible magnetic resonance imaging (MRI)–based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored.MethodsA scoring method based on the assessment of increased signal denoting bone marrow edema on T2‐weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra‐ and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24‐week response of patients with AS randomized to placebo:infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (Gd‐DTPA)–enhanced MRI sequences.ResultsWe scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd‐DTPA–enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one‐third of patients who received treatment (placebo:infliximab) and inflammation scores were low.ConclusionThe Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.
“It struck me that they didn't understand pain”: The specialist pain clinic experience of patients with chronic musculoskeletal pain
Authors: Harding Geoffrey , Parsons Suzanne , Rahman Anisur , Underwood Martin 
Published: October 2005

AbstractObjectiveTo explore the experiences of diagnosis and management among patients who attended a specialist musculoskeletal pain clinic and the factors influencing their interpretation of these experiences.MethodsA postal questionnaire was sent to potential participants 6–20 months after their first clinic attendance. Data were collected on pain presence, severity, and location; health‐related quality of life; psychological distress; and care‐seeking behavior. Questionnaire data were used to inform combined purposive and theoretical sampling. In‐depth interviews were conducted that probed participants' understanding of their chronic musculoskeletal pain and its management in a specialist musculoskeletal pain clinic.ResultsFifteen patients were interviewed. Four main themes were identified: spoiled identity (pain limited patients' activities so extensively that it affected their sense of self); diminishing faith in medicine (patients were disappointed with aspects of their care‐seeking experience); making sense of pain (patients made sense of their pain by locating their pain within the context of their lives); and learning to live with the pain (an issue for all patients was whether or not their pain would stop or whether they had to learn to live with it).ConclusionDeveloping, implementing, and evaluating approaches to address patients' spoiled identities might allow us to improve patient‐centered outcomes in chronic musculoskeletal pain.
Offering patients the opportunity to choose their hospital for total knee replacement: Impact on satisfaction with the surgery
Authors: Losina Elena , Plerhoples Timothy , Fossel Anne H. , Mahomed Nizar N. , Barrett Jane , Creel Alisha H. , Wright Elizabeth A. , Katz Jeffrey N. 
Published: October 2005

AbstractObjectiveTo describe the extent to which patients were offered a choice between 2 or more hospitals for total knee replacement (TKR); to examine the association between having a choice of hospital for TKR and satisfaction with the surgery; and to identify population groups less likely to be offered a choice.MethodsWe studied a population‐based sample of 932 Medicare beneficiaries who underwent elective TKR in 2000. We surveyed patients about their participation in choosing a hospital and their satisfaction with surgery. We examined whether lack of hospital choice influenced satisfaction with surgery after adjusting for age, sex, preoperative function, and socioeconomic status.ResultsAmong 932 TKR recipients (mean age 74 years, 67% women), more than half (53%) reported having a lack of hospital choice. After adjusting for socioeconomic status, patients reporting lack of choice were approximately twice as likely to be dissatisfied with the results of surgery as patients who reported choosing among 2 or more hospitals for TKR (odds ratio [OR] 2.09, 95% confidence interval [95% CI] 1.13–3.87). Results of logistic regression revealed that patients reporting lack of choice were more likely to be women (OR 1.52, 95% CI 1.14–2.04), >80 years of age (as compared with 65–70 years; OR 1.63, 95% CI 1.03–2.57), living in suburban areas (OR 1.68, 95% CI 1.23–2.30), nonwhite (OR 1.57, 95% CI 0.86–2.87), and were less likely to have TKR performed by a high‐volume surgeon (OR 0.71, 95% CI 0.53–0.96).ConclusionMore than half of the patients did not have a choice in selecting the hospital where they had TKR. Patients reporting lack of choice were more likely to be dissatisfied with surgery. Interventions to address preferences for hospital may improve satisfaction with care for patients with advanced knee arthritis.
Maintenance of exercise in women with fibromyalgia
Authors: Dobkin Patricia L. , Abrahamowicz Michal , Fitzcharles Mary‐ann , Dritsa Maria , da Costa Deborah 
Published: October 2005

AbstractObjectiveTo identify predictors of maintenance of exercise for women with fibromyalgia (FM).MethodsWomen with FM who had been randomized to the exercise arm of a clinical trial were studied prospectively during and 3 months following treatment. Subjects completed exercise logs weekly and returned the data via postal mail. Outcome variables were duration of aerobic and stretching exercises. Two separate multivariate models for longitudinal data were built with adjustment for in‐treatment adherence and time. Pretreatment characteristics (self efficacy, pain, disability, stress, exercise barriers and benefits, and age) and changes during treatment (pain, disability, stress, and exercise barriers and benefits) were considered potential predictors of exercise maintenance.ResultsStretching significantly decreased in the 3 months following treatment. High stress at baseline and increases in stress during treatment were associated with poor maintenance of stretching. Disability at baseline (measured with the Fibromyalgia Impact Questionnaire), an increase in barriers to exercise during treatment, and increases in upper‐body pain during treatment were associated with worse maintenance of aerobic exercise in the 3 months following treatment.ConclusionThe maintenance of an exercise program in women with FM appears to be contingent on being able to deal with stress, pain, barriers to exercise, and disability.
Mechanism and Substrate Specificity of tRNA–Guanine Transglycosylases (TGTs): tRNA‐Modifying Enzymes from the Three Different Kingdoms of Life Share a Common Catalytic Mechanism
Authors: Stengl Bernhard , Reuter Klaus , Klebe Gerhard 
Published: October 2005

AbstractTransfer RNA–guanine transglycosylases (TGTs) are evolutionarily ancient enzymes, present in all kingdoms of life, catalyzing guanine exchange within their cognate tRNAs by modified 7‐deazaguanine bases. Although distinct bases are incorporated into tRNA at different positions in a kingdom‐specific manner, the catalytic subunits of TGTs are structurally well conserved. This review provides insight into the sequential steps along the reaction pathway, substrate specificity, and conformational adaptions of the binding pockets by comparison of TGT crystal structures in complex with RNA substrates of a eubacterial and an archaebacterial species. Substrate‐binding modes indicate an evolutionarily conserved base‐exchange mechanism with a conserved aspartate serving as a nucleophile through covalent binding to C1′ of the guanosine ribose moiety in an intermediate state. A second conserved aspartate seems to control the spatial rearrangement of the ribose ring along the reaction pathway and supposedly operates as a general acid/base. Water molecules inside the binding pocket accommodating interaction sites subsequently occupied by polar atoms of substrates help to elucidate substrate‐recognition and substrate‐specificity features. This emphasizes the role of water molecules as general probes to map binding‐site properties for structure‐based drug design. Additionally, substrate‐bound crystal structures allow the extraction of valuable information about the classification of the TGT superfamily into a subdivision of presumably homologous superfamilies adopting the triose‐phosphate isomerase type barrel fold with a standard phosphate‐binding motif.
Safety of adjunctive intracoronary thrombolytic therapy during complex percutaneous coronary intervention: Initial experience with intracoronary tenecteplase
Authors: Kelly Robert V. , Crouch Eron , Krumnacher Heather , Cohen Mauricio G. , Stouffer George A. 
Published: October 2005

AbstractIntracoronary thrombus is associated with increased risk of in‐laboratory vessel closure, recurrent myocardial infarction (MI), urgent vessel revascularization, and death. There is a lack of consensus on what represents the ideal treatment for patients with thrombotic complications during percutaneous coronary intervention (PCI), but the development of newer thrombolytic agents with increased fibrin specificity and longer half‐life provides a potentially useful treatment option. In this study, the safety and efficacy of intracoronary tenecteplase (TNK) was evaluated in 34 patients (22 with acute ST elevation MI, 4 with rescue PCI, 6 with non‐ST elevation MI, and 2 during elective PCI) who developed no‐reflow, distal embolization, or visible intracoronary thrombus during PCI. The mean age was 57 years, 76% were Caucasian, and there were 14 women and 20 men. Cardiogenic shock was present in seven (21%) patients at baseline. All patients were being treated with aspirin and either unfractionated heparin (33 patients) or bivalrudin. Glycoprotein IIb/IIIa inhibitors were used in 76% of patients. Intracoronary TNK was used at a mean dose of 10.2 ± 5.2 mg (median, 10 mg; range, 5–25 mg). There was one TIMI major bleeding event and three TIMI minor bleeding events. The mean hematocrit measured the morning following PCI was 35.5% ± 4.9% in patients receiving TNK and 36.5% ± 4.4% in a randomly selected sample of 150 consecutive patients undergoing PCI (P = 0.25). In conjunction with mechanical intervention, TNK was successful at dissolving angiographic thrombus and/or improving flow in 91% of patients. In conclusion, intracoronary TNK is safe and well tolerated in patients who develop thrombotic complications during complex PCI. © 2005 Wiley‐Liss, Inc.
Guidewire‐induced coronary artery perforation treated with transcatheter delivery of subcutaneous tissue
Authors: Oda Hirotaka , Oda Masato , Makiyama Yashiro , Kashimura Takeshi , Takahashi Kazuyoshi , Miida Tsutomu , Higuma, Norio 
Published: October 2005

AbstractIn three cases of small coronary artery perforation by guidewires during percutaneous coronary intervention, coronary leakage continued despite prolonged balloon inflation and reversal of heparin. Subcutaneous tissue was selectively delivered to perforated vessels by means of microcatheters in a successful attempt to stop leakage. This method appears to be extremely effective for treating guidewire‐induced perforations of distal coronary arteries. © 2005 Wiley‐Liss, Inc.
Clostridium botulinum sagt “no” zu NO'
Authors: Jaenicke Lothar 
Published: October 2005

AbstractEs ist seit bald hundert Jahren bekannt, dass NO'‐Bildner wie Nitrat und Nitrit das Keimen und Auswachsen der Hitze‐resistenten Sporen von “Wurstvergiftungsbazillen” hemmen und nicht nur das Fleisch durch Methämoglobin‐Bildung schön und dauernd rot färben – wobei sich auch mikrobielle Zersetzung eine Zeitlang verdecken lässt. Es ist erlaubter Zusatzstoff im Pökelsalz. Aber man weiß erst jetzt, welche molekulare Strategie das Bakterium benutzt, um NO' in seiner Wirtsumgebung zu erkennen und zu vermeiden.
Race modifies the association between breast carcinoma pathologic prognostic indicators and the positive status for HER‐2/neu
Authors: Stark Azadeh T. , Claud Sarah , Kapke Alissa , Lu Mei , Linden Michael , Griggs Jennifer 
Published: October 2005

AbstractBACKGROUNDInferences about the variations in the biology of breast carcinoma between African‐Americans and Caucasians have been reported. The difference in the prevalence of positive HER‐2/neu breast carcinoma was evaluated and the race‐specific risk was assessed for positive HER‐2/neu among a cohort of women diagnosed with their first primary breast carcinoma, given the accepted prognostic pathologic indicators for positive HER‐2/neu status.METHODSDemographic, clinical, and pathologic data were collected from existing databases. The status of HER‐2/neu was considered positive if the immunohistochemistry score was 3+ or if the fluorescent in situ hybridization indicated a ratio greater than 2. Multivariable logistic regression was used to determine the race‐specific risk for HER‐2/neu positive breast carcinoma.RESULTSThe difference in the prevalence of HER‐2/neu‐positive status between African‐American and Caucasian women was not statistically significant (P = 0.46). For Caucasian women the likelihood for positive HER‐2/neu was statistically significant and increased almost linearly within each stage with nuclear grade dedifferentiation relative to the reference group, women with Stage 1, Grade 1 carcinomas. For African‐American women, this risk was not significantly associated with stage, nuclear grade, their interaction term, or other pathologic prognostic indicators.CONCLUSIONSThe findings suggest that race modifies the association between the pathologic prognostic indicators of breast carcinoma and the likelihood of HER‐2/neu‐positive carcinoma. So far, clinical correlative studies of HER‐2/neu have not included race as an independent variable. Concerns about the limited generalizability and the need for validation of the findings across racial lines have been expressed previously. Cancer 2005. © 2005 American Cancer Society.
Use of the Radiation Therapy Oncology Group recursive partitioning analysis classification system and predictors of survival in 19 women with brain metastases from ovarian carcinoma
Authors: Chen Philip G. , Lee Shih‐Yuan , Barnett Gene H. , Vogelbaum Michael A. , Saxton Jerrold P. , Fleming Peter A. , Suh John H. 
Published: October 2005

AbstractBACKGROUNDBrain metastases are an uncommon complication in women with primary ovarian carcinoma; thus, little is known about whether the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) prognostic classification system is valid in this patient population.METHODSFrom September 1985 to June 2002, 19 patients with brain metastases resulting from primary ovarian carcinoma underwent treatment at the Cleveland Clinic Foundation. The medical records of these patients were retrospectively reviewed.RESULTSAt the time of data analysis, all 19 women had died. The median age at diagnosis of primary ovarian carcinoma and brain metastasis was 51 and 54 years of age, respectively. Fifteen patients presented with a Karnofsky performance status (KPS) of 70 or higher. Seven patients had a single brain lesion and 12 had multiple lesions. All RTOG RPA prognostic classes were represented, with median survivals of 24.7, 8.9, and 2.6 months for Classes I, II, and III, respectively (P = 0.31). Patients who underwent surgical resection survived longer than those who did not (33.7 vs. 7.4 mos). The presence of multiple lesions was adversely related to survival on multivariate analysis (P = 0.03). Primary control was an important predictor of survival on multivariate analysis as well (P = 0.01) and was achieved in 15 of the 19 women.CONCLUSIONSThis is the first study to support the prognostic usefulness of the RTOG RPA classification for ovarian carcinoma patients with metastasis to the brain. The number of metastatic intracranial lesions should be included when determining the prognosis. Cancer 2005. © 2005 American Cancer Society.
On the shape of the ground state eigenvalue density of a random Hill's equation
Authors: Cambronero Santiago , Rider Brian , Ramírez José 
Published: October 2005

AbstractConsider the Hill's operator Q = −d2/dx2 + q(x) in which q(x), 0 ≤ x ≤ 1, is a white noise. Denote by f(μ) the probability density function of −λ0(q), the negative of the ground state eigenvalue, at μ. We prove the detailed asymptotics

as μ → + ∞. This result is based on a precise Laplace analysis of a functional integral representation for f(μ) established by S. Cambronero and H. P. McKean in 5. © 2005 Wiley Periodicals, Inc.