bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress on NICE guideline implementation in mental health trusts: meta-analyses
Authors: Mears Alex , Kendall Tim , Strathdee Geraldine , Sinfield Robert , Aldridge Ian 
Published: September 2008

Aims and MethodTo investigate implementation of National Institute for Health and Clinical Excellence (NICE) guidelines in mental health, focusing on the schizophrenia guideline. Data analyses centred on implementation of the guideline, as well as looking at a set of markers mapped to the NICE principles of implementation and other identified clinical prerequisites. A self-report questionnaire tool was sent to senior executives at mental health trusts containing questions linked to the markers of implementation and clinical prerequisites; responses were analysed with data from the Healthcare Commission audit of implementation of the guideline to show key relationships.ResultsInformation from both data-sets (senior executive data collection and the audit) showed that implementation is patchy, with pockets of good implementation. Findings indicate that higher levels of implementation are linked to corporate commitment and leadership, as well as support from commissioners.Clinical ImplicationsImplementation might be improved by corporate commitment and leadership and better support from commissioners.
Phase I and Pharmacokinetic Study of YM155, a Small-Molecule Inhibitor of Survivin
Authors: Tolcher Anthony W. , Mita Alain , Lewis Lionel D. , Garrett Christopher R. , Till Elizabeth , Daud Adil I. , Patnaik Amita , Papadopoulos Kyri , Takimoto Chris , Bartels Pamela , Keating Anne , Antonia Scott 
Published: September 2008

Purpose To determine the maximum-tolerated dose (MTD) and assess the safety, pharmacokinetics, and preliminary evidence of antitumor activity of YM155, a small-molecule inhibitor of survivin. Patients and Methods Patients with advanced solid malignancies or lymphoma were treated with escalating doses of YM155 administered by 168-hour continuous intravenous infusion (CIVI). Plasma and urine samples were assayed to determine pharmacokinetic parameters and excretion. Results Forty-one patients received 127 cycles of YM155 at doses ranging from 1.8 to 6.0 mg/m2/d by 168-hour CIVI every 3 weeks. Overall, the most common grade 1 to 2 toxicities were stomatitis, pyrexia, and nausea, whereas grade 3 and 4 toxicities were rare. Reversible elevation in serum creatinine in two patients, with one developing acute tubular necrosis, was dose-limiting at 6.0 mg/m2. The MTD was 4.8 mg/m2. At the MTD, the mean steady-state concentration, clearance, volume of distribution at steady-state, and terminal elimination half-life were 7.7 ng/mL, 47.7 L/h, 1,763 L, and 26 hours, respectively. One complete and two partial responses lasting 8, 24+ and 48+ months occurred in three patients with non-Hodgkin's lymphoma, two patients with hormone- and docetaxel-refractory prostate cancer had prostate-specific antigen responses, and one patient with non–small-cell lung cancer had a minor response. Conclusion YM155 can be administered safely at 4.8 mg/m2/d 168 hours CIVI every 3 weeks. The absence of severe toxicities, attainment of plasma concentrations active in preclinical models, and compelling antitumor activity warrant further disease-directed studies of this agent alone and in combination with chemotherapy in a broad array of tumors.
Clinically Applicable Models to CharacterizeBRCA1andBRCA2Variants of Uncertain Significance
Authors: Spearman Andrew D. , Sweet Kevin , Zhou Xiao-Ping , McLennan Jane , Couch Fergus J. , Toland Amanda Ewart 
Published: September 2008

PurposeTwenty percent of individuals with a strong family and/or personal history of breast and ovarian cancer carry a deleterious mutation in BRCA1 or BRCA2. Identification of mutations in these genes is extremely beneficial for patients pursuing risk reduction strategies. Approximately 7% of individuals who have genetic testing of BRCA1 and BRCA2 carry a variant of uncertain significance (VUS), making clinical management less certain. The majority of identified VUS occur only in one to two individuals; these variants are not able to be classified using current classification models with segregation analysis components.MethodsTo develop a clinically applicable method that can predict the pathogenicity of VUS that does not require familial information or segregation analysis, we identified characteristics of breast or ovarian tumors that distinguished sporadic tumors from tumors with BRCA1 or BRCA2 mutations. Study participants included individuals with known deleterious mutations in BRCA1 or BRCA2 and individuals with classified or unclassified BRCA variants.ResultsWe applied the models to 57 tumors with 43 different deleterious BRCA mutations and 57 tumors with 54 unique classified and unclassified BRCA variants. Of the 33 previously unclassified VUS studied, we found evidence of neutrality for 21.ConclusionOur models showed 98% sensitivity and 76% specificity for predicting classified DNA changes. We classified 64% of unknown variants as neutral. Classification of VUS as neutral will have immediate benefit for those individuals and their family members. These models are adaptable for the clinic and will be useful for individuals with limited available family history.
Total knee replacement for patients with ankylosed knees
Authors: Kim Y.-H. , Kim J.-S. 
Published: September 2008

The purpose of this study was to determine objectively the outcome of total knee replacement in patients with ankylosed knees. There were 82 patients (99 knees) with ankylosed knees who underwent total knee replacement with a condylar constrained or a posterior stabilised prosthesis. Their mean age was 41.9 years (23 to 60) and the mean follow-up was for 8.9 years (6.6 to 14). Pre- and post-operative data included the Hospital for Special Surgery (HSS), the Knee Society (KS) and the Western Ontario and McMaster University Osteoarthritis index (WOMAC) scores. The mean HSS, KS and WOMAC scores improved from 60, 53, and 79 pre-operatively to 81, 85, and 37 at follow-up. These improvements were statistically significant (p = 0.018, 0.001 and 0.014 respectively). The mean physical, social and emotional WOMAC scores also improved significantly (p = 0.032, p = 0.023 and p < 0.001 respectively). The mean satisfaction score was 8.5 (sd 1.5). Total knee replacement gives good mid-term results in patients with ankylosed knees.
Neurolysis of the ulnar nerve for neuropathy following total elbow replacement
Authors: Rispoli D. M. , Athwal G. S. , Morrey B. F. 
Published: September 2008

Ulnar neuropathy presents as a complication in 5% to 10% of total elbow replacements, but subsequent ulnar neurolysis is rarely performed. Little information is available on the surgical management of persistent ulnar neuropathy after elbow replacement. We describe our experience with the surgical management of this problem. Of 1607 total elbow replacements performed at our institution between January 1969 and December 2004, eight patients (0.5%) had a further operation for persistent or progressive ulnar neuropathy. At a mean follow-up of 9.2 years (3.1 to 21.7) six were clinically improved and satisfied with their outcome, although, only four had complete recovery. When transposition was performed on a previously untransposed nerve the rate of recovery was 75%, but this was reduced to 25% if the nerve had been transposed at the time of the replacement.
Effect of Distance from Curing Light Tip to Restoration Surface on Depth of Cure of Composite Resin
Authors: Dunne Stephen M , Millar Brian J 
Published: September 2008

Aims While light-activating composite resins, the light tip may not always be close to the surface of the restoration. This may be intentional in an attempt to create a ramp cure. The aim of this study was to determine the effect of a range of separation distances between the light tip and the restoration surface on the depth of composite cure for different types of light-curing units with a broad range of outputs. Methods Three halogen light units, one plasma arc-curing (PAC) light unit and two light-emitting diode (LED) curing lights in clinical use were tested, and a total of 570 restorations cured in a two-part human tooth model at separations ranging from 0 to 15 mm. The tooth was disassembled and depth of cure determined using the scrape test ISO 4049. Light intensity was also measured at each separation distance for each light. Results The depth of cure was generally found to decrease as the separation distance increased for all lights at the various cure times. However, the effect of increasing the separation distance was less than anticipated. The depth of cure was also related to the light output. Conclusions Depth of composite cure was directly related to intensity and duration of light exposure and inversely related to distance of the light source from the surface for halogen and plasma lights. However, the effect of increasing the separation distance up to 15 mm was less than expected. Altering the separation distance in order to modify the polymerisation characteristics is unlikely to be effective.
Solvation Behaviour of some Copper (I), Silver (I) and Tetraalkylammonium Salts in Actonitrile + Adiponitrile Mixtures
Authors: Gill Dip Singh , Rana Dilbag , Gupta Rahul 
Published: September 2008

Abstract
Solvation behaviour of some copper (I), silver (I) and tetrabutylammonium salts has been investigated in binary mixtures of acetonitrile and adiponitrile containing 100, 90, 80, 70, 60 and 50 mol % AN at 298 K using molar conductance and viscosity measurements. The conductance data have been analyzed by using the Shedlovsky method to calculate limiting molar conductance (Λo) of the electrolytes. The solvated radii for various ions indicate that tetrabutylammonium (Bu4N+) and tetraphenylborate (BPh4
–) are not solvated in all AN+ADN mixtures. The anions are poorly solvated but Cu+ and Ag+ are highly solvated in AN+ADN mixtures. The extent of solvation of Cu+ is greater then that of Ag+. The solvation of these both ions increases in ADN rich region of the mixtures. The viscosity data have been analyzed by using the Jones-Dole equation to calculate viscosity B-coefficients of electrolytes. The ionic B± coefficients for individual ions have been evaluated. The results show that anions are weakly solvated in whole composition range of AN + ADN mixtures. The B+ coefficients for Cu+ and Ag+ increase with increase in ADN composition i.e. these are better solvated in ADN rich region of binary mixtures. The viscosity results are in good agreement with the results obtained from the conductance studies.
Clinical Investigation: Determinants of Blood Cell Omega-3 Fatty Acid Content
Authors: Block Robert C. , Harris William S. , Pottala James V. 
Published: September 2008

Background:
Although red blood cell eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) content
(the Omega-3 Index) predicts cardiovascular death, the factors determining the Index are unknown.

Methods:
In 704 outpatients, we undertook an investigation of the clinical determinants of the Index.

Results:
Factors associated with the Index in decreasing order were: EPA+DHA supplement use, fish consumption
frequency, triglyceride level, age, high cholesterol history, and smoking. These factors explained 59% of Index variability,
with capsules/fish intake together accounting for 47%. The Index increased by 13% (p< 0.0001) for each serving level
increase in fish intake and EPA+DHA supplementation correlated with a 58% increase (p< 0.0001) regardless of
background fish intake (p=0.25; test for interaction). A 100 mg/dL decrease in serum triglycerides was associated with a
15% higher (p<0.0001) Index.

Conclusions:
The intake of EPA+DHA-rich foods and supplements principally determined the Omega-3 Index, but
explained only about half of the variability.
The Effect of Trade Facilitation on Sectoral Trade
Authors: Martinez-Zarzoso Inma , Márquez-Ramos Laura 
Published: September 2008

Abstract
This paper aims to analyse the effect of trade facilitation on sectoral trade flows. We use data from the World Bank's Doing Business Database on the fees associated with completing the procedures to export or import goods in a country, on the number of documents needed and on the required time to complete all the administrative procedures to import and export. An augmented gravity equation is estimated for 13 exporters and 167 importers using a number of estimation techniques, namely OLS, PPML and the Harvey model. A common result is that trade flows increase by lowering transport costs and the number of days required to trade. The outcome supports multilateral initiatives, as that in the WTO, which encourages countries to assess their trade facilitation needs and priorities and to improve them. The measures adopted will not only benefit the country that improves trade facilitation, but also it's trading partners.
The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures: cadaveric feasibility study
Authors: Tubbs R. Shane , Loukas Marios , Shoja Mohammadali M. , Shokouhi Ghaffar , Wellons John C. , Oakes W. Jerry , Cohen-Gadol Aaron A. 
Published: September 2008

Object
Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors' knowledge, not been previously explored.

Methods
In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of nerve was then tunneled subcutaneously and contralaterally across the neck to a supra- and infraclavicular exposure of the suprascapular and musculocutaneous nerves. Measurements were made of the length and diameter of the LTN.

Results
All specimens were found to have a LTN that could be brought to the aforementioned contralateral nerves. Neural connections remained tension free with left and right neck rotation of ~ 45°. The mean length of the LTN was 22 cm with a range of 18–27 cm. The overall mean diameter of this nerve was 3.0 mm. No gross evidence of injury to surrounding neurovascular structures was identified in any specimen.

Conclusions
Based on the results of this cadaveric study, the use of the contralateral LTN may be considered for neurotization of the proximal musculocutaneous and suprascapular nerves.
Direct epidural electrical stimulation of the optic nerve: a new method for intraoperative assessment of function
Authors: Bošnjak Roman , Benedièiè Mitja 
Published: September 2008

Intraoperative visual system monitoring of lesions with a close relationship to the optic apparatus by using light flashes reportedly is difficult to perform, and the results are too unreliable to interpret. The authors used direct epidural electrical stimulation of the optic nerve (ON) during surgery instead of light flashes.
Four patients were included in this feasibility study. In 3 patients—1 each harboring a planum sphenoidale meningioma, a tuberculum sellae meningioma, and an intraorbital ON sheath meningioma—2 stimulating needle electrodes were placed on each side of the ON just anterior to the optic canal, before unroofing the optic canal and an extradural anterior clinoidectomy. In the fourth patient, who harbored a frontotemporal astrocytoma, stimulation was applied at the exit of the ON from the canal. The electrically induced visual evoked potentials (eVEPs) were recorded from the scalp before, during, and after tumor removal.
A typical eVEP consisted of N20 and N40 waves. The amplitude of the N40 wave varied up to 25% prior to tumor removal. In the patient with a symptomatic tuberculum sellae meningioma, the decompressive effect of opening the optic canal and the impact of manipulation during piecemeal tumor removal were detected by the eVEPs. In the patient with an ON sheath meningioma and light sensation, only the N20 wave was observed.
Epidural electrical stimulation of the ON is a safe means of providing a stable signal and real-time information on nerve conduction during surgery. It may be a useful adjunct in improving visual outcomes postoperatively. Further clinical studies are necessary.
Surface dialysis after experimental brain injury: modification of edema fluid flow in the rat model
Authors: Shulyakov Alexander V. , Benour Mahmoud , Del Bigio Marc R. 
Published: September 2008

Object
This study was undertaken to determine if dialysis of damaged brain surface can reduce cerebrospinal fluid (CSF) pressure and progressive brain edema. The authors secondarily determined if local brain cooling was simultaneously possible.

Methods
Telemetric pressure transmitters were implanted into the lumbar subarachnoid space of 58 young adult male rats. Cryogenic brain injury was created and 2 hours later decompressive craniectomy was performed. An osmotic cell with a semipermeable dialysis membrane placed on the damaged brain surface was perfused with dextran 15% solution for 2 or 4 hours. Water content was determined in the cerebral hemispheres using the wet-dry weight method. Evans blue–albumin spread was measured morphometrically. Brain temperature was measured bilaterally.

Results
The CSF pressure increased after cryogenic injury and decreased after craniotomy. Two hours of brain dialysis significantly reduced CSF pressure in comparison with craniotomy alone and sham dialysis. Injured brain had higher water content, but this was not affected by dialysis. Spread of Evans blue–albumin, however, was significantly reduced by the treatment. Cooling of the dialysis solution caused significant local brain cooling.

Conclusions
Surface dialysis of cryogenically injured rat brain controls CSF pressure and reduces intraparenchymal spread of edema fluid in the acute period after injury. The authors postulate that edema fluid moves into the osmotic cell rather than spreading through the uninjured brain. Long-term experiments will be needed to prove that this combination therapy is effective.
Brain cortex regeneration affected by scaffold architectures
Authors: Wong Darice Y. , Krebsbach Paul H. , Hollister Scott J. 
Published: September 2008

Object
The aim of this study was to compare designed scaffolds with a random-pored sponge scaffold to determine what role scaffold architecture plays in a cortical injury model.

Methods
Cylindrical scaffolds (3 × 3 mm) were made of a poly-(ε-caprolactone) polymer with 2 different molds from a 3D printer and had either: 1) unidirectional channels and microgrooves oriented longitudinally within the cylinder or 2) orthogonally intersecting channels and axial microgrooves within the cylinder. Additional randomized porosity was imparted using a salt-leaching method. A control scaffold without channels or microgrooves but containing random pores was also made. Scaffolds were implanted for 1, 4, and 8 weeks in a cylindrical defect created 3 mm posterior to the bregma in rat cortex. Control animals had tissue removed but received no implant. Brains were coronally cryosectioned and sections were stained. Antibodies for nestin, glial fibrillary acidic protein (GFAP), and TUJ1 were used to identify neural progenitors, activated astrocytes, and neuronal axons. Tissue ingrowth (H & E), astrocytic infiltration (GFAP), parenchymal inflammation (GFAP), and defect width (H & E) were quantified from images.

Results
Defect widths grew and parenchymal inflammation decreased over time with no statistical difference between groups. Total tissue ingrowth and astrocytic infiltration increased over time and was greatest in the orthogonal design group. Specific cell ingrowth, which was aligned with microgrooves interiorly in the orthogonal group and exteriorly in the longitudinal channel group, was qualitatively assessed from nestin and TUJ1 labeling.

Conclusions
Scaffold architecture can benefit brain tissue regeneration by integrating the following design principles: 1) large (100s of micrometers) pores or channels oriented toward the parenchyma for increased astrocytic infiltration; 2) microgrooves oriented in the desired direction of cellular migration and neuronal alignment; and 3) fully interconnecting channels for cellular migration and tissue integration.
Mesencephalic ependymal cysts: treatment under pure endoscopic or endoscope–assisted keyhole conditions
Authors: Conrad Jens , Welschehold Stefan , Charalampaki Patra , van Lindert Erik , Grunert Peter , Perneczky Axel 
Published: September 2008

Object
Primary intracranial ependymal cysts are extremely rare. Similar to congenital intraparenchymal cysts in the mesencephalon they usually occur with symptoms of an occlusive hydrocephalus or symptoms like Parinaud syndrome, dizziness, or gait disturbance. The objective of this study was to evaluate the surgical methods for the treatment of these cysts and the clinical outcome of the patients.

Methods
The authors present the clinical records of 8 patients who were treated in their department for symptomatic mesencephalic ependymal cysts in the past 10 years. The patient age ranged from 22 to 60 years with a mean age of 44 years. In 4 cases the authors performed a suboccipital infratentorial supracerebellar approach by using endoscope-assisted microsurgery. The other 4 patients underwent a pure endoscopic procedure over a frontal bur hole trepanation.

Results
Four patients became symptom free, and the remaining 4 improved significantly after a mean follow-up duration of 38.5 months (range 5–119 months). One patient underwent 2 operations: first a ventriculocystostomy and 4 months later endoscopic third ventriculostomy because of recurrent hydrocephalus. In 1 case a second surgery was necessary because of a wound infection. In all of the patients an adequate fenestration of the cyst was achieved.

Conclusions
A symptomatic mesencephalic ependymal cyst is an indication for neurosurgical intervention. These cysts can be treated successfully and most likely definitively by a pure endoscopic or endoscope-assisted keyhole neurosurgical technique. There were no morbid conditions or death due to the procedures in this group of 8 patients. Therefore, the authors regard these surgical procedures to be good alternatives to treatments such as shunt placement or stereotactic aspiration of the cysts.
Drawing facilitates children's reports of factual and narrative information: implications for educational contexts
Authors: Gross Julien , Hayne Harlene , Drury Tanya 
Published: September 2008

AbstractIn the present study, we examined the effect of drawing on children's reports of an educational event. Five‐ and 6‐year‐old children visited a local museum and were interviewed either 1–2 days or 7 months later. After each delay, half of the children were asked to tell about what they had learned during their visit to the museum and the other half were given the opportunity to draw while telling. All children were also given a standard comprehension test, covering material that the museum staff considered to be most relevant to the visit. When tested after a short delay, children who drew while talking reported more factual and more narrative information than children who did not draw. When tested after a long delay, drawing only enhanced children's reports of narrative information. After both delays, children's verbal descriptions of the event exceeded their scores on the comprehension test. These data have important practical implications for the educational value of museum visits and suggest a new method of assessing children's learning in educational contexts. Copyright © 2008 John Wiley & Sons, Ltd.