bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence‐Based Imaging Guidelines and Medicare Payment Policy
Authors: Sistrom Christopher L. , McKay Niccie L. 
Published: October 2007

Objective. This study examines the relationship between evidence‐based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases.Data Sources. The American College of Radiology Appropriateness Criteria (ACRAC) for neurological imaging, ICD‐9‐CM codes, CPT codes, and payment determinations by the Medicare Part B carrier for Florida and Connecticut.Study Design. Cross‐sectional study of appropriateness criteria and Medicare Part B payment policy for neurological imaging. In addition to descriptive and bivariate statistics, multivariate logistic regression on payment determination (yes or no) was performed.Data Collection Methods. The American College of Radiology Appropriateness Criteria (ACRAC) documents specific to neurological imaging, ICD‐9‐CM codes, and CPT codes were used to create 2,510 medical condition/imaging procedure combinations, with associated appropriateness scores (coded as low/middle/high).Principal Findings. As the level of appropriateness increased, more medical condition/imaging procedure combinations were payable (low = 61 percent, middle = 70 percent, and high = 74 percent). Logistic regression indicated that the odds of a medical condition/imaging procedure combination with a middle level of appropriateness being payable was 48 percent higher than for an otherwise similar combination with a low appropriateness score (95 percent CI on odds ratio=1.19–1.84). The odds ratio for being payable between high and low levels of appropriateness was 2.25 (95 percent CI: 1.66–3.04).Conclusions. Medicare could improve its payment determinations by taking advantage of existing clinical guidelines, appropriateness criteria, and other authoritative resources for evidence‐based practice. Such an approach would give providers a financial incentive that is aligned with best‐practice medicine. In particular, Medicare should review and update its payment policies to reflect current information on the appropriateness of alternative imaging procedures for the same medical condition.
Substrate Characterization of Ventricular Tachycardia in a Porcine Model of Tetralogy of Fallot Using Noncontact Mapping
Authors: KALTMAN JONATHAN R. , GILLESPIE MATTHEW J. , SEYMOUR TRAVIS , KHAN AZEEM , ZELTSER ILANA J. , RHODES LARRY A. , TANEL RONN E. , VETTER VICTORIA L. , WILLIAM GAYNOR J. , SHAH MAULLY J. 
Published: October 2007

Background:

Ventricular tachycardia (VT) in patients following tetralogy of Fallot (TOF) repair is challenging to map because of the presence of scar, patch material, and hemodynamic residua of surgery. This study investigates whether noncontact mapping can identify the arrhythmia substrate in a porcine model that involves a right ventricular outflow tract (RVOT) patch and either chronic volume or pressure load on the right ventricle.
Methods:

Nine infant pigs (3–5 kg) underwent surgery involving an RVOT patch and creation of pulmonary insufficiency (PI, n = 4) or pulmonary stenosis (PS, n = 5). After a mean of 4.2 months, pigs underwent invasive electrophysiology studies (EPS) with noncontact mapping (Ensite, St. Jude Medical, St. Paul, MN USA) of the right ventricle. Automated, unipolar voltage maps (VM) were constructed during sinus rhythm. Threshold for substrate was set at −0.5 mV and incrementally adjusted to higher values until a contiguous region of low voltage was delineated. Programmed stimulation was performed to induce VT. VT activation was correlated to location of VM defined substrate. Three control pigs underwent EPS and VM.
Results:

Free‐wall RVOT substrate was identified in each of the model animals, correlating to location of the patch. The mean voltage threshold was −1.1 mV. VT was induced in 6/9 animals. Diastolic activation approximated the inferior or lateral border of the substrate in all animals. No RVOT substrate was identified in the control pigs.
Conclusion:

Automated voltage mapping of sinus beats identifies substrate for VT in a porcine model of TOF. Consistent diastolic activation of the substrate border was found during VT. Targeting this area may be useful in the ablation of VT after repair of TOF.
QRS Duration Following the Norwood Procedure:
Authors: GRAHAM ERIC M. , SCHEURER MARK A. , PHILIP SAUL J. , BRADLEY SCOTT M. , ATZ ANDREW M. 
Published: October 2007

Background:

To describe the incidence of QRS prolongation, intraventricular conduction delay (IVCD), and presence of ventricular arrhythmias in patients undergoing the Norwood procedure with subsequent superior cavopulmonary anastomosis. Differences between the modified Blalock‐Taussig shunt (BTS) and the right ventricle to pulmonary artery shunt (RV‐PA) on these variables were investigated.
Methods:

Eighty‐two consecutive patients underwent Norwood palliation with a BTS (n = 41) or a RV‐PA (n = 41). Standard 12‐lead surface ECGs were retrospectively reviewed at three separate times: (1) prior to the Norwood procedure, (2) immediately post‐Norwood procedure, and (3) prior to the superior cavopulmonary anastomosis. Groups were compared at these times for the absolute QRS duration, the change in QRS duration from one time interval to the other, and the number of patients with IVCD. The presence of ventricular rhythm abnormalities requiring treatment at any time was recorded.
Results:

Immediately after the Norwood procedure, QRS duration was slightly longer and median QRS change slightly larger for the RV‐PA than the BTS group (P = 0.04). However, there were no differences in these variables at the time of pre superior cavopulmonary anastomosis. Within both groups, there was a significant increase in median QRS duration over time; from both pre‐ and post‐Norwood to presuperior cavopulmonary anastomosis (P < 0.001).
Conclusions:

IVCD is common in patients following a Norwood procedure regardless of the type of shunt received. A ventriculotomy had small effects on QRS duration in the short term, but had no effect on the incidence of treatable ventricular rhythm abnormalities.
Effect of Transvenous Cardiac Resynchronization Therapy Device Implantation on Cardiac Troponin I Release
Authors: ALTIN TIMUCIN , AKYUREK OMER , VURGUN KUTAY , BETON OSMAN , SAYIN TAMER , KILICKAP MUSTAFA , KARAOGUZ REMZI , GULDAL MUHARREM , EROL CETIN 
Published: October 2007

Background: Pacemaker and implantable cardioverter defibrillator (ICD) implantation increases cardiac troponin I (cTnI) levels which indicates myocardial injury. During implantation of a cardiac resynchronization therapy (CRT) device, balloon inflation for coronary sinus (CS) venogram, cannulation of CS side branch, and electrode advancement may interfere with CS drainage and, hence, may decrease the washout of toxic metabolites from the heart. Thus, CRT implantation may further increase cTnI levels. In this study, we investigated the effects of CRT implantation on cTnI release.
Methods: We included 10 patients (mean age = 57 ± 15 years) in whom a successful transvenous CRT system was implanted (CRT group). Twenty patients (mean age = 65 ± 10 years) who underwent a transvenous pacemaker or ICD implantation were included as the control group. Blood samples for cTnI were drawn at baseline and at six, 12, 18, and 24 hours thereafter.
Results: Baseline median cTnI levels were similar in CRT and control groups (0.03 ng/mL vs 0.02 ng/mL, respectively; P = 0.1). Postoperative cTnI levels during 24 hours were significantly higher in the CRT group (P < 0.05) by two‐way repeated measures of analyis of variance. Post hoc analysis revealed that cTnI levels were higher at the 6th, 12th, 18th, and 24th hours compared to baseline levels (P < 0.001, P < 0.001, P < 0.01, and P < 0.01, respectively). There was a significant difference in the area under the curves (AUCs) of cTnI measurements (1.79 hr·ng/mL in the CRT group and 0.78 hr·ng/mL in the control group, P < 0.05).
Conclusion: Postoperative cTnI levels were higher after CRT implantation than simple pacemaker/ICD implantation. This may be due to CS manipulation during CRT implantation.
Cardiac Resynchronization Therapy Response is Associated with Shorter Duration of Atrial Fibrillation
Authors: LELLOUCHE NICOLAS , DE DIEGO CARLOS , VASEGHI MARMAR , BUCH ERIC , CESARIO DAVID A. , MAHAJAN AMAN , WIENER ISAAC , FONAROW GREGG C , BOYLE NOEL G. , SHIVKUMAR KALYANAM 
Published: October 2007

Background: Atrial fibrillation (AF) is commonly associated with heart failure. The benefit of cardiac resynchronization therapy (CRT) on atrial remodeling has been demonstrated. However, biventricular pacing did not reduce the global incidence of AF. We evaluated the relationship between CRT response and AF duration.
Methods: We retrospectively analyzed data from 96 patients (59 ± 15 years; 78% male) who underwent CRT. All patients had class III–IV New York Heart Association (NYHA) symptoms despite maximal medical therapy, left ventricular ejection fraction (LVEF) ≤ 35%, QRS >130 ms, and sinus rhythm before implantation. CRT response in patients who survived at six months of follow‐up was defined as: (1) no hospitalization for heart failure and (2) improvement of one or more grades in the NYHA classification.
Results: CRT responders (n = 54) and non‐responders (n = 42) had similar baseline characteristics, including the incidence of persistent AF within six months before implantation. Six months after implantation, when compared to baseline, CRT responders exhibited a significant decrease in left atrial size (47.5 ± 7.1 mm vs 44.6 ± 7.7 mm, P < 0.01) and in the incidence of persistent AF (17% vs 2%, P = 0.02). At six months, CRT responders demonstrated shorter mean AF duration (7.5 ± 43.3 hours vs 48.8 ± 129.0 hours, P = 0.03) and lower incidence of persistent AF (2% vs 19%, P = 0.004) compared to nonresponders.
Conclusion: CRT response is associated with a reversal of atrial remodeling and a shorter AF duration.
Electrocardiographic Patterns during:
Authors: GIUDICI MICHAEL C. , TIGRETT DARRYN W. , CARLSON JACQUELINE I. , LORENZ TERRI D. , PAUL DEBORAH L. , BAROLD S. SERGE 
Published: October 2007

Background: The electrocardiogram (ECG) patterns during pacing from the great cardiac vein (GCV) and the middle cardiac vein (MCV) are not well known.
Methods: We recorded 12‐lead ECGs during GCV and MCV pacing in 26 patients undergoing implantation of a cardiac resynchronization device. The left ventricular (LV) lead was passed down the GCV (n = 19) or MCV (n = 7) prior to moving it to a lateral or posterolateral vein for permanent implantation.
Results and Conclusions: Pacing within the GCV resulted in a left bundle branch block (LBBB) morphology with no or minimal R‐wave in V1 in 14 patients and a right bundle branch block (RBBB) pattern (R > S in lead V1) in four patients. In one patient, lead V1 during GCV pacing was isoelectric (R = S). A more distal pacing site in the GCV yielded a LBBB pattern in all the patients. All leads placed in the MCV resulted in a LBBB configuration. An ECG pattern with a RBBB pattern was invariably recorded during LV pacing in 125 consecutive outpatients with biventricular pacemakers and LV leads in the posterolatral and lateral coronary veins. Knowledge of the ECG patterns from various pacing sites in the coronary venous system may be helpful for troubleshooting all types of pacing systems, especially those where the coronary venous pacing site is unintentional.
Clinical and neurocognitive correlates of insight in patients with bipolar I disorder in remission
Authors: Dias V. V. , Brissos S. , Carita A. I. 
Published: October 2007

Objective:  The relationship between insight and neurocognition in bipolar disorder has not been clearly established.Method:  A neuropsychological battery assessing attention, mental control, perceptual‐motor skills, executive functions, verbal fluency and abstraction, and visuo‐spatial attention was administered to 50 bipolar remitted patients and 50 healthy controls. Insight was assessed with the Scale to Assess Unawareness of Mental Disorder.Results:  Patients presented significantly worse neurocognitive performance. Insight was impaired in 60% of patients, and age, educational level, manic symptoms, age of disease onset, number of admissions, and performance on several neurocognitive tests correlated significantly with insight. A regression model revealed that age and Trail Making Test part B (TMT‐B) performance accounted for 32% of the variance in overall illness awareness, while performance on the TMT‐B alone accounted for 28% of the variance.Conclusion:  Impaired insight and neurocognitive dysfunction seem to be present in euthymic bipolar patients. Insight in bipolar disorder may be partially dependent on intact neurocognition.
Influence of facial convexity on facial attractiveness in Japanese
Authors: Ioi H , Nakata S , Nakasima A , Counts AL 
Published: October 2007

Structured AbstractAuthors –  Ioi H, Nakata S, Nakasima A, Counts ALObjective –  The purpose of this study was to assess and determine the range of the top three most‐favored facial profiles for each sex from a series of varying facial convexity, and to evaluate the clinically acceptable facial profiles for Japanese adults.Design –  Questionnaire‐based study.Subjects and methods –  Silhouettes of average male and female profiles were constructed from the profiles of 30 Japanese males and females with normal occlusions. Chin positions were protruded or retruded by 2°, 4°, 6°, 8° and 10°, respectively, from the average profile. Forty‐one orthodontists and 50 dental students were asked to select the three most‐favored profiles for each sex, and they were also asked to indicate whether they would seek surgical orthodontic treatment if that image represented their own profile.Results –  For males, both the orthodontists and dental students chose the average profile as the most‐favored profile. For females, both the orthodontists and dental students chose a slightly more retruded chin position as the most‐favored profile. Japanese raters tended to choose class II profiles as more acceptable profiles than class III profiles for both males and females.Conclusions –  These findings suggest that Japanese patients with class III profiles tend to seek surgical orthodontic treatment more often.
Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents
Authors: Ristic M , Svabic M Vlahovic , Sasic M , Zelic O 
Published: October 2007

Structured AbstractAuthors –  Ristic M, Vlahovic Svabic M, Sasic M, Zelic OObjective– –  To determine the effects of fixed orthodontic appliances on periodontal health and microbiological composition of subgingival dental plaque.Material and methods –  This prospective longitudinal self‐controlled study was conducted on 32 adolescents (13 males, 19 females), who were scheduled for fixed orthodontic treatment between 2002 and 2005. Dental plaque accumulation, gingival inflammation and pocket probing depth were measured at the mesio‐vestibular angle of the examined group of teeth followed by collection of subgingival dental plaque samples in the same points. These periodontal indices and microbiological parameters were determined prior to the placement of fixed appliances and 1, 3 and 6 months after the beginning of orthodontic treatment.Results –  All values of both clinical and microbiological parameters started to increase after the placement of fixed appliances. Maximum values were reached 3 months after fixed appliance placement followed by their decrease in the last registration period of 6 months after the placement of fixed appliances.Conclusions –  Treatment with fixed appliances in adolescents may transitionally increase the values of all periodontal indices and stimulate the growth of periodontopathogenic bacteria, but without destructive effects on deep periodontal tissues.
Anthropometric and cephalometric measurements in X‐linked hypohidrotic ectodermal dysplasia
Authors: Lexner MO , Bardow A , Bjorn‐Jorgensen J , Hertz JM , Almer L , Kreiborg S 
Published: October 2007

Structured AbstractAuthors – Lexner MO, Bardow A, Bjorn‐Jorgensen J, Hertz JM, Almer L, Kreiborg S.Objective – To describe the somatic development and craniofacial morphology in males affected with hypohidrotic ectodermal dysplasia (HED) and female carriers and to find clinical markers for early clinical diagnosis of possible female carriers.Design – A clinical and radiographic examination of the affected males and the female carriers.Setting and sample population – Twenty‐four affected males and 43 female carriers with a known mutation in theED1gene were examined in a dental clinic in either Copenhagen or Aarhus, Denmark.Experimental variables – Height, body mass index (BMI) and head circumference. Cephalometric analysis of the craniofacial morphology.Outcome measure – Data on the somatic and craniofacial development in the affected males and female carriers.Results – No difference was observed regarding body height in the affected males and female carriers, BMI values were lower than the mean in most affected boys and adolescence and head circumference was somewhat decreased in both groups compared to normative data. The cephalometric analysis showed a reduced maxilla length and prognathism, a normal size and shape of the mandible and a reduced sagittal jaw relationship in both HED groups. Furthermore, affected males had a retroclined nasal bone and a more anteriorly inclined maxilla. A short nose, protruding lips, reduced facial convexity and facial height, characterized the soft tissue profile of the affected males. In female carriers, the lips were significantly retruded when compared with controls.Conclusion – No specific somatic or cephalometric markers could be observed, in the female carrier group.
Changes in cranial base morphology in different malocclusions
Authors: Polat ÖÖ , Kaya B 
Published: October 2007

Structured AbstractAuthors –  Polat ÖÖ, Kaya BObjectives –  To evaluate the differences in cranial base flexure between skeletal and dental Class I, Class II and Class III malocclusions.Design –  Lateral cephalometric radiographs, matched for age, of skeletal Class I, Class II and Class III patients with an average vertical growth pattern were analyzed and compared.Setting and sample population –  A total of 75 patients having skeletal Class I (n = 25), Class II (n = 25) and Class III (n = 25) malocclusions of Baskent University.Experimental variable –  Anterior (SN) and posterior (SBa) cranial base lengths, cranial base angle (N‐S‐Ba, N‐S‐Ar) and both anterior (SN‐FH) and posterior (SBa‐FH) cranial base inclinations were measured on the pretreatment lateral cephalograms.Outcome measure –  Size and shape differences in cranial base between different malocclusions.Results –  Anterior and posterior cranial base lengths, and cranial base angles did not show statistically significant differences between the three groups studied. Both anterior and posterior cranial base inclinations were increased significantly in the Class III group compared with Class I and Class II groups.Conclusions –  No differences were observed in anterior and posterior cranial base lengths, and cranial base angles between the three malocclusions. However, cranial base inclinations were increased in Class III malocclusions.
Can There Be a Just War Without a Just Peace?
Authors: Pabst Adrian 
Published: October 2007

AbstractThis essay explores the political and legal problem of legitimate wars in relation to the theological question of justice and peace. It begins by charting a brief genealogical account of how in the modern era the Christian ‘just war’ tradition was formalised and thus drained of much of its substantive and practical context.The essay also examines and rejects a number of contemporary attempts to use ‘just war’ theory in order to legitimate modern warfare. The argument is that both neoconservative realism and political liberalism instrumentalise the ‘just war’ tradition to defend and extend central state power. Christian pacifism has a compelling critique of realism and liberalism, but it fails to offer a genuinely transformative ontology and politics.The essay concludes by calling for a metaphysics of peace that can resist the modern primacy of violence and make real the divine promise of a harmoniously ordered cosmos.
A Feminist Appraisal of Augustine
Authors: Duran Jane 
Published: October 2007

AbstractEmploying several major lines of argument, I claim that Augustine exhibits styles of thought, literary methods and modes of inquiry that are not only accessible to feminist scholarship, but that are genuinely feminist‐friendly. I first examine the Confessions, and then proceed with analyses of Augustine's style, a comparison of his work to that of another major thinker in the Christian tradition, an analysis of his use of the notion of unity, and a final look at City of God. The work of commentators such as Chadwick, Clark, McMahon and Mallard is used in order to support the argument. Augustine's standing as one of the founding Church Fathers may make it difficult for us to mention him in the same breath as the concept of “feminism.”1 Yet in our attempts to try to come to grips with thinkers as diverse as Nietzsche, Kierkegaard, and Quine, we have frequently noticed that concepts useful to feminists are where one finds them.
Role of slow delayed rectifier K+‐current in QT prolongation in the alloxan‐induced diabetic rabbit heart
Authors: Lengyel Cs. , Virág L. , Kovács P. P. , Kristóf A. , Pacher P. , Kocsis E. , Koltay Zs. M. , Nánási P. P. , Tóth M. , Kecskeméti V. , Papp J. Gy. , Varró A. , Jost N. 
Published: October 2007

AbstractAim:  In diabetes mellitus, several cardiac electrophysiological parameters are known to be affected. In rodent experimental diabetes models, changes in these parameters were reported, but only limited relevant information is available in other species, having cardiac electrophysiological properties more resembling the human, including the rabbit. The present study was designed to analyse the effects of experimental type 1 diabetes on ventricular repolarization and the underlying transmembrane potassium currents in rabbit hearts.Methods:  Diabetes was induced by a single injection of alloxan (145 mg kg−1 i.v.). After the development of diabetes (3 weeks), electrophysiological studies were performed using whole cell voltage clamp and ECG measurements.Results:  The QTc interval in diabetic rabbits was moderately but statistically significantly longer than measured in the control animals (155 ± 1.8 ms vs. 145 ± 2.8 ms, respectively, n = 9–10, P < 0.05). This QTc‐lengthening effect of diabetes was accompanied by a significant reduction in the density of the slow delayed rectifier K+ current, IKs (from 1.48 ± 0.35 to 0.86 ± 0.17 pA pF−1 at +50 mV, n = 19–21, P < 0.05) without changes in current kinetics. No differences were observed either in the density or in the kinetics of the inward rectifier K+ current (IK1), the rapid delayed rectifier K+ current (IKr), the transient outward current (Ito) and the L‐type calcium current (ICaL) between the control and alloxan‐treated rabbits.Conclusion:  It is concluded that type 1 diabetes mellitus, although only moderately, lengthens ventricular repolarization. Diabetes attenuates the repolarization reserve by decreasing the density of IKs current, and thereby may enhance the risk of sudden cardiac death.