bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining the perspectives of midwives and doctors improves risk assessment in early pregnancy
Authors: BERGLUND ANNA , LINDBERG MARIANNE , BERGLUND ANNA , LINDBERG MARIANNE , NYSTRÖM LENNARTH , LINDMARK GUNILLA 
Published: May 2008

AbstractBackground. Traditionally, risk identification in early pregnancy in Swedish antenatal care [ANC] is performed by the midwife at booking, and confirmed by the doctor at a routine visit in early pregnancy, but this extra visit has been questioned. This study compared the risk assessment by the two professions. Methods. In a cluster randomised trial, a planning conference, where midwives reported new mothers to a doctor, replaced the routine consultation with the doctor. Ten ANC‐clinics with the new program (942 mothers) were compared to 10 clinics with standard care (758 mothers). Risk factors were registered independently by midwives and doctors. Degree of agreement in risk identification between midwives and doctors was estimated by the kappa coefficient. Results. The degree of agreement in risk registration was good for previous pregnancy complications (κ = 0.62; CI: 0.55–0.68), and recommendations for doctor's consultation (κ = 0.67; CI: 0.62–0.72); fair for social problems (κ = 0.29; CI: 0.03–0.55), and poor for registration of symptoms and problems in index pregnancy (κ = 0.09; CI: 0.03–0.21) and psychosocial aspects, such as anxiety (κ = 0.09; CI: 0.03–0.21). Significantly more risk factors were registered in the study group. Conclusions: Replacing the routine consultation with the doctor early in pregnancy with a planning conference had no negative impact on risk identification. The results support that the different perspectives of the two professions in combination are important for the safety of surveillance and the psychosocial support expected from antenatal care.
Spontaneous preterm birth, a clinical dilemma: Etiologic, pathophysiologic and genetic heterogeneities and racial disparity
Authors: MENON RAMKUMAR 
Published: May 2008

AbstractPreterm labor leading to preterm delivery (<37 weeks’ gestation) affects approximately 5–7% of live births in developed countries, but significantly higher in developing countries. Prematurity due to preterm birth (PTB) accounts for around 28% of neonatal mortality worldwide. Approximately 45–50% of PTBs are idiopathic or spontaneous, 30% are related to preterm rupture of membranes, and another 15–20% are attributed to medically indicated or elective preterm deliveries. The rate of spontaneous PTB is also increasing and the exact cause is still unclear. Generalized approaches in screening for high risk status of preterm labor and interventions have failed to reduce PTB rates. PTB presents a clinical dilemma due to etiologic, pathophysiologic and genetic heterogeneities. Racial disparity in PTB rates observed in the US further complicates its understanding. PTB is a complex phenotype and is not initiated by a single etiologic agent. Etiologic factors operate through multiple pathophysiologic pathways, and these pathways include highly overlapping biomarkers and molecular factors creating pathophysiologic heterogeneities. In this article, the current understanding of PTB pathophysiology is reviewed and the need for a much broader approach in research, analysis and interpretation of data is explained, where environmental and race/ethnicity specific risk factors may dictate specific pathways leading to PTB. Recent data on amniotic fluid biomarkers and maternal and fetal genetic variants, which indicate huge disparity between races in the US, are also reviewed. These data suggest that gene–gene interactions and gene–environmental interactions produce distinct pathophysiologic pathways with respect to an individual's genetic make‐up and environmental risk exposure. Current strategies of high risk screening and intervention measures may not be generalized, and a more individualized approach may be required to understand PTB and its prevention.
Three‐dimensional endoanal ultrasound assessment of the anal sphincters: Reproducibility
Authors: OLSEN INGRID P. , AUGENSEN KÅRE , WILSGAARD TOM , KISERUD TORVID 
Published: May 2008

AbstractObjective. Volume measurement of the anal sphincter can be a future method for assessing volume loss, muscle atrophy or laceration. Three‐dimensional (3D) endoanal ultrasound is a technique for assessing the volume of the anal sphincters, but the reproducibility of the method is scarcely known. Design. Cross‐sectional, repeated measurements. Sample. Twenty women were recruited for the study after written consent according to an ethically approved protocol, nine 0‐gravida and 11 with traumatic vaginal deliveries. Method. Endoanal 3D‐ultrasound volume was obtained during rest and squeeze. The length of the anal canal and the volume of the external and internal sphincters were determined by two observers. Observer 1 repeated the measurements three times for all 20 women, and observer 2 for the nine 0‐gravida, and intra‐ and inter‐observer variation was assessed. Results. During rest, the anal length measurement had intra‐class correlation coefficients of 0.91 for observer 1 and 0.85 for observer 2. The limits of agreement for inter‐observer measurement were (−0.81 to 1.61) measured in centimeters. For the external anal sphincter volume, the intra‐class correlation coefficients and the limits of agreement were correspondingly: 0.89, 0.78 and (−7.29 to 6.03) measured in cm3, and for the internal anal sphincter volume: 0.85, 0.69 and (−1.72 to 2.95). The variation in identifying the external anal sphincter could rise to a corresponding 30% error in volume measurement. Conclusion. Although intra‐class correlation coefficients showed good reproducibility for endoanal ultrasound measurements, the limits of agreement were less reassuring with sizeable variation in the volume assessment, probably due to uncertainty in landmark identification.
Relationship of perceived stress with depression: Complete mediation by perceived control and anxiety in Iran and the United States
Authors: Ghorbani Nima , Krauss Stephen W. , Watson P. J. , LeBreton Daniel 
Published: May 2008

This study sought to clarify the importance and cross‐cultural relevance of associations between generalized perceived stress and depression. Also tested was the hypothesis that perceived stress would correlate more strongly with anxiety than with depression, whereas control would be more predictive of depression than of anxiety. Relationships between perceived stress, anxiety, depression, and perceived control were examined in samples of Iranian (n = 191) and American (n = 197) undergraduates. Correlations among these variables were generally similar across the two societies. Perceived stress did predict anxiety better than depression, but perceptions of control predicted depression significantly better than anxiety only in the United States. Best fitting structural equation models revealed that anxiety and perceived control completely accounted for the linkage between perceived stress and depression in both societies. An equally acceptable and more parsimonious model described perceived stress as a consequence rather than as an antecedent of anxiety and perceived control. Structural equation models were essentially identical across the two cultures except that internal control displayed a significant negative relationship with anxiety only in Iran. This result seemed to disconfirm any possible suggestion that a supposedly individualistic process like internal control could have no noteworthy role within a presumably more collectivistic Muslim society like Iran. Overall, these data documented the importance of anxiety and perceived control in explaining the perceived stress–depression relationship cross‐culturally and therefore questioned the usefulness of perceived stress in predicting depression. Whether this understanding of the stress–depression relationship deserves general acceptance will require additional studies that measure the frequency of stressful life events and that utilize a longitudinal design.
Managing terror: Differences between Jews and Arabs in Israel
Authors: Somer Eli , Maguen Shira , Or‐Chen Keren , Litz Brett T. 
Published: May 2008

Using telephone surveys, we examined exposure to terror, coping, and mental health response in randomly selected Jewish‐Israelis (n = 100) and Arab‐Israelis (n = 100) living in five Israeli cities affected by terrorism. Jewish‐Israelis and Arab‐Israelis were randomly selected for study participation and completed telephone surveys in May 2002, following an extended string of terror attacks and hostilities. Although terrorism is designed to target Jewish‐Israelis, the rates of exposure were similar in the two groups. Arab‐Israelis reported using a wider array of coping strategies, yet also endorsed more frequent PTSD and more severe depression symptoms than Jewish‐Israelis. We examined a variety of demographic, ethnic, and religious predictors of different coping styles and found varying results. For example, acceptance coping was best predicted by Arab‐Israeli ethnicity, being female, greater religiosity, and lower education. Predictors of mental health response to terror were also examined, with Arab‐Israeli ethnicity, being female, adaptation coping and collaborative coping best predicting PTSD and depression symptoms. Arab‐Israelis may not have the same access to overarching sources of patriotic support that are readily available to their Jewish compatriots, and civilian and economic inequity experienced by the Arab minority may add to a sense of diminished resources. Our findings justify outreach efforts to overlooked minorities at risk for posttraumatic distress. Women seem to be at particular risk for the development of mental health symptoms following terrorism, which should also be noted for outreach purposes.
Values, achievement goals, and individual‐oriented and social‐oriented achievement motivations among Chinese and Indonesian secondary school students
Authors: Liem Arief Darmanegara , Nie Youyan 
Published: May 2008

This study examined how values related to achievement goals and individual‐oriented and social‐oriented achievement motivations among secondary school students in China (N = 355) and Indonesia (N = 356). Statistical comparisons showed the Chinese students endorsed more strongly than the Indonesian students on self‐direction and hedonism values, individual‐oriented achievement motivation, and mastery‐approach goals. Conversely, the Indonesian students endorsed more strongly than their Chinese counterparts on security, conformity, tradition, universalism and achievement values, social‐oriented achievement motivation, and performance‐approach and mastery‐avoidance goals. Values explained a significant amount of the variance in almost all of the dimensions of motivation. Etic and emic relationships between values and achievement motivations were found.
Multidetector computed tomography arthrography of the shoulder: diagnostic accuracy and indications
Authors: De Filippo M. , Bertellini A. , Sverzellati N. , Pogliacomi F. , Costantino C. , Vitale M. , Zappia M. , Corradi D. , Garlaschi G. , Zompatori M. 
Published: May 2008

Background: The presence of subcutaneous implants, such as permanent defibrillators, is an absolute contraindication to the use of magnetic resonance imaging (MRI). Moreover, MRI is unadvisable in subjects with metallic hardware near the area of study, as artifacts generated by such materials distort image quality. Purpose: To evaluate the diagnostic accuracy and indications of arthrography with multidetector computed tomography arthrography (arthro-MDCT) of the shoulder in patients with absolute or relative contraindications to MRI and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. Material and Methods: After intraarticular injection of iodixanol and volumetric acquisition, 70 shoulders in 70 patients (30 females, 40 males, age range 32–60 years) were examined with a 16-detector-row CT scanner. The patients had arthralgia but no radiologically detected fractures. They could not be studied by MRI because of absolute contraindications (subcutaneous electronic implants), surgical metal implants, or claustrophobia. In 28 of the 70 patients who had had previous shoulder surgery, the arthro-CT examination was preceded by an MRI on the same day. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. Results: In the 42 non-operated patients, the comparison between arthro-MDCT and arthroscopy showed sensitivity and specificity ranging between 87% and 100%. In the 28 operated shoulders, arthro-MDCT had an accuracy of 94% compared with 25% with MRI. Interobserver agreement was almost perfect (κ=0.95) in the evaluation of all types of lesions, both on MDCT and MRI. When arthro-MDCT was compared with MRI in the postoperative patients by a McNemar test, a significant difference ( P<0.05) was found between these two techniques. Conclusion: Arthro-MDCT of the shoulder is a safe technique that provides accurate diagnosis in identifying chondral, fibrocartilaginous, and intraarticular ligamentous lesions in patients who cannot be evaluated by MRI, and in patients after surgery.
A comparison of esophagography and esophageal transit scintigraphy in the evaluation of usefulness of endoscopic pneumatic dilatation in achalasia
Authors: Chung J-J. , Park H. J. , Yu J. S. , Hong Y. J. , Kim J. H. , Kim M.-J. , Lee S. I. 
Published: May 2008

Background: Esophageal transit scintigraphy and barium esophagography have been used for evaluation of therapeutic results in patients with achalasia. It remains to be determined which method is most useful, and whether both studies are necessary before and after treatment for achalasia. Purpose: To evaluate the usefulness of both esophagography and esophageal transit scintigraphy (ETS) to determine the efficacy of endoscopic pneumatic dilatation (EPD) in patients with achalasia. Material and Methods: Seventeen patients (6 M, 11 F) with achalasia underwent both esophagography and ETS before and after EPD. Esophagographic findings were reviewed to determine the length and caliber of stenosis in the esophagogastric channel. Dynamic images of ETS were evaluated on time–activity curves. Changes in the clinical symptom score were evaluated. Statistical analyses of esophagography and ETS before and after EPD were performed. Results: After EPD, the mean symptom score improved ( P<0.05). The mean residue of radioisotope in ETS also improved after EPD, with a statistically significant correlation ( P<0.05). There was a statistically significant correlation between the improved symptom scores and the change in ETS after EPD ( P<0.05). There was no statistical correlation between clinical symptom scores and esophageal caliber, regardless of EPD ( P>0.05). With an 8-mm diameter of the esophagogastric channel as a benchmark for successful treatment, there was no statistical correlation between esophagography and ETS at 15 s after EPD ( P>0.05). Conclusion: Esophagography was useful for the evaluation of morphology and caliber of the esophagogastric channel, while ETS was useful for the functional evaluation of esophageal emptying. Both studies may therefore be considered necessary to evaluate the efficacy of EPD in patients with achalasia.
Improvement in respiratory function by percutaneous vertebroplasty
Authors: Tanigawa N. , Kariya S. , Kojima H. , Komemushi A. , Shomura Y. , Tokuda T. , Ueno Y. , Kuwata S. , Fujita A. , Terada J. , Sawada S. 
Published: May 2008

Background: Percutaneous vertebroplasty (PVP) improves back pain and corrects spinal misalignment to some extent, and thus may improve respiratory function. Purpose: To retrospectively investigate changes in respiratory function after PVP. Material and Methods: 41 patients (mean age 72.0 years, range 59–86 years; 39 women, two men) who had undergone PVP for vertebral compression fractures (37 thoracic vertebral bodies [Th6–Th12] and 50 lumbar vertebral bodies [L1–L5]) caused by osteoporosis visited our hospital for follow-up consultation between January and June 2005. At this follow-up consultation, respiratory function testing, including percent forced vital capacity (FVC%) and percent forced expiratory volume in 1 s (FEV1%), was performed. We retrospectively compared these values with those taken before PVP using a Wilcoxon signed-rank test. Results: FVC% was 85.2±30.3% before PVP and 91.5±16.8% at follow-up (mean 10 months after PVP), which represented a significant difference ( P<0.003). No significant difference in FEV1% was detected. Regarding the number of treatment levels, that is, single vertebroplasty versus multiple vertebroplasty, no significant difference in improvement of FVC% was confirmed ( P=0.1). FVC% was abnormally low (≤79%) before PVP in 16 patients and improved to within normal range postoperatively in six of these patients (38%). Conclusion: PVP improves preoperatively decreased lung function, but this improvement takes time.
Comparison of diagnostic accuracy of breast masses using digitized images versus screen-film mammography
Authors: Liang Zhigang , Du Xiangying , Liu Jiabin , Yao Xinyu , Yang Yanhui , Li Kuncheng 
Published: May 2008

Background: Medical film digitizers play an important transitory role as digital–analogue bridges in radiology. Digitized mammograms require evaluation of performance to assure medical image quality. Purpose: To compare the diagnostic accuracy in the interpretation of breast masses using original screen-film mammograms versus digitized images. Material and Methods: A total of 72 female patients between 55 and 81 years of age suspected of having breast cancer were selected by two non-observing radiologists. Of these, 31 cases were benign lesions and 41 cases were cancer. The mammography films were digitized using a laser film digitizer. Three radiologists, each with more than 10 years of experience in mammography, interpreted the screen-film mammograms and digitized images respectively. The time interval was 4 weeks. A four-point malignancy scale was used, with 1 defined as definitely not malignant, 2 as probably not malignant, 3 as probably malignant, and 4 as definitely malignant. Receiver operating characteristic (ROC) curves, sensitivity, and specificity were compared. Results: The average area-under-the-curve (Az) value of the original screen-film mammograms was 0.921, and the average Az value of the digitized images was 0.859. This difference was not statistically significant ( P=0.131). The detection specificity of extremely dense breasts was lower than that for other breast compositions for both digitized images and screen-film mammograms. No statistical significance in sensitivity and specificity was observed between digitized images and mammograms for each breast composition. Original screen-film mammograms were observed to perform better than digitized images. Conclusion: Digitized images with a spatial resolution of 175 µm can be used instead of screen-film mammograms in the diagnosis of breast cancer.
Impact of fdg-pet/ct fused imaging on tumor volume assessment of head-and-neck squamous cell carcinoma: intermethod and interobserver variations
Authors: Murakami R. , Uozumi H. , Hirai T. , Nishimura R. , Katsuragawa S. , Shiraishi S. , Toya R. , Tashiro K. , Kawanaka K. , Oya N. , Tomiguchi S. , Yamashita Y. 
Published: May 2008

Background: Although gross tumor volume (GTV) at the primary site can predict local control of head-and-neck squamous cell carcinoma (SCC) in patients who are treated with organ-preservation therapy, GTV assessment does not eliminate substantial interobserver variation. Purpose: To evaluate whether F-18-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) fused imaging provides additional information for GTV assessment. Material and Methods: We obtained FDG-PET/CT fused images on 20 patients with head-and-neck SCC. All had undergone preoperative conventional workup, including contrast-enhanced CT and magnetic resonance imaging (MRI). The GTV of the primary tumors was designed by two independent observers who used routine clinical data. Observer A was a radiologist and observer B a radiation oncologist. GTV1 and GTV2 were designed without and with FDG-PET/CT, respectively. For geometric interobserver comparison, we calculated the concordance rate as the ratio of the intersection (A⋂B) of the GTVs to their union (A⋃B). Intermethod (GTV1 vs. GTV2) and interobserver (A vs. B) differences in the GTVs were assessed by Bland-Altman analysis and the Spearman rank-correlation test. The interobserver concordance rates for GTV1 and GTV2 were compared using a two-tailed paired-samples t test. Results: On FDG-PET/CT, all primary tumors were visualized. There was no systemic trend for a volume difference between GTV1 and GTV2. Although the 95% limits of agreement were wider for interobserver than intermethod differences, the 95% limits of interobserver agreement were narrower for GTV2 than GTV1. The mean interobserver concordance rate for GTV2 was higher than for GTV1 (54.5% vs. 39.1%, P=0.0002). Conclusion: FDG-PET/CT is a useful modality for consistent GTV assessment, which should not be used as a single modality but rather to obtain supplemental information in patients with head-and-neck SCC.
Gender equality in university sportspeople's drinking
Authors: O'BRIEN KERRY S. , HUNTER JACKIE , KYPRI KYPROS , ALI AJMOL 
Published: May 2008

AbstractIntroduction and Aims. In large population‐based alcohol studies males are shown consistently to drink more, and more hazardously, than females. However, research from some countries suggests that gender differences in drinking are converging, with females drinking more than in the past. Large population‐based research may miss gender‐based changes in drinking behaviours that occur in sub‐populations most at risk of hazardous drinking. We examine gender differences in a sub‐population where hazardous drinking is common and endorsed, namely university sportspeople. Design and Methods. The Alcohol Use Disorders Identification Test (AUDIT) and a drinking motives measure were used to assess hazardous drinking behaviours and drinking motives in 631 university sportspeople (females = 331, 52%). Results. There were no gender differences in AUDIT scores. However, drinking motives differed between genders, with coping motives being a significant predictor of hazardous drinking in females but not males. Hazardous drinking, including binge drinking (46.3%) and frequent binge drinking (35%), in New Zealand university sportspeople is high for both males and females. Discussion and Conclusions. New Zealand university sportspeople are one population where gender differences in drinking are not apparent and run counter to European population based research and research in US sporting populations. Gender role equality in the university systems, and endorsement of drinking in sporting culture, may account for the lack of gender differences in this New Zealand sporting population. Future research on gender differences in drinking should examine sub‐populations where gender role differentiation is low, and socio‐cultural/structural factors supporting gender equality are high.