bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymph Node Ratio as an Alternative to pN Staging in Node-Positive Breast Cancer
Authors: Vinh-Hung Vincent , Verkooijen Helena M. , Fioretta Gerald , Neyroud-Caspar Isabelle , Rapiti Elisabetta , Vlastos Georges , Deglise Carole , Usel Massimo , Lutz Jean-Michel , Bouchardy Christine 
Published: January 2009

PurposeIn the current pTNM classification system, nodal status of breast cancer is based on the number of involved lymph nodes and does not account for the total number of lymph nodes removed. In this study, we assessed the prognostic value of the lymph node ratio (LNR; ie, ratio of positive over excised lymph nodes) as compared with pN staging and determined its optimal cutoff points.Patients and MethodsFrom the Geneva Cancer Registry, we identified all women diagnosed with node-positive breast cancer between 1980 and 2004 (n = 1,829). The prognostic value of LNRs was calculated for values ranging from 0.05 to 0.95 by Cox regression analysis and validated by bootstrapping. Based on maximum likelihood, we identified cutoff points classifying women into low-, intermediate-, and high-risk LNR groups.ResultsOptimal cutoff points classified patients into low- (≤ 0.20), intermediate- (> 0.20 and ≤ 0.65), and high-risk (> 0.65) LNR groups, corresponding to 10-year disease-specific survival rates of 75%, 63%, and 40%, and adjusted mortality risks of 1 (reference), 1.78 (95% CI, 1.46 to 2.18), and 3.21 (95% CI, 2.54 to 4.06), respectively. In contrast to LNR risk categories, survival curves of pN2 and pN3 crossed after 15 years, and their adjusted mortality risks showed overlapping CIs: 2.07 (95% CI, 1.69 to 2.53) and 2.84 (95% CI, 2.23 to 3.61), respectively.ConclusionLNR predicts survival after breast cancer more accurately than pN classification and should be considered as an alternative to pN staging.
Acute Abnormalities of Sensory Nerve Function Associated With Oxaliplatin-Induced Neurotoxicity
Authors: Park Susanna B. , Goldstein David , Lin Cindy S.-Y. , Krishnan Arun V. , Friedlander Michael L. , Kiernan Matthew C. 
Published: January 2009

Purpose Neurotoxicity is becoming increasingly recognized as the major dose-limiting toxicity of oxaliplatin. Because the mechanism of oxaliplatin-induced neurotoxicity remains unclear, the present study investigated the potential of axonal excitability techniques in identifying pathophysiologic mechanisms and early markers of nerve dysfunction. Patients and Methods Measures of sensory axonal excitability were recorded before and after infusion over 88 treatment cycles in 25 patients with colorectal cancer, who received a total oxaliplatin dose of 766 ± 56 mg/m2. Neurologic assessment, clinical rating scales, and routine nerve conduction studies were performed. Results By completion of treatment, 16% of patients had developed severe (grade 3) neurotoxicity, and oxaliplatin dose reduction or cessation as a result of neurotoxicity was required in 40% of patients. Changes in axonal excitability occurred after infusion and could be explained on the basis of alterations in axonal membrane sodium (Na+) channel function (refractoriness: 7.6% ± 1.7% before infusion v 4.5% ± 1.4% after infusion; P = .03; superexcitability: −22.8% ± 0.8% before infusion v −20.1% ± 1.1% after infusion; P = .0002). Changes became less pronounced in later treatment cycles, suggesting that chronic nerve dysfunction and sensory loss masked acute effects at higher cumulative doses. Importantly, patients who demonstrated reductions in superexcitability in early treatment were subsequently more likely to develop moderate to severe neurotoxicity. The findings suggest that the degree of acute nerve dysfunction may relate to the development of chronic neurotoxicity. Conclusion Sensory axonal excitability techniques may facilitate identification of Na+ channel dysfunction in oxaliplatin-induced neurotoxicity and thereby provide a method to identify patients at risk for neurotoxicity to target those most likely to benefit from future neuroprotective strategies.
Epigenetic Regulation of MicroRNAs in Acute Lymphoblastic Leukemia
Authors: Roman-Gomez Jose , Agirre Xabier , Jiménez-Velasco Antonio , Arqueros Victor , Vilas-Zornoza Amaia , Rodriguez-Otero Paula , Martin-Subero Iñaki , Garate Leire , Cordeu Lucia , San José-Eneriz Edurne , Martin Vanesa , Castillejo Juan Antonio , Bandrés Eva , Calasanz María José , Siebert Reiner , Heiniger Anabel , Torres Antonio , Prosper Felipe 
Published: January 2009

PurposeTo identify microRNAs (miRNAs) epigenetically regulated in acute lymphoblastic leukemia (ALL).MethodsWe first examined ALL-derived cell lines for the presence of abnormal levels of two different histone modifications (trimethylation of H3 lysine 4 [K4H3me3] and dimethylation of H3 lysine 9 [K9H3me2]) in the 5′UTR regions around CpG islands of 78 miRNAs by chromatin immunoprecipitation (ChIP)-on-ChIP analysis. Methylation status (methylation-specific polymerase chain reaction [PCR]) and expression (quantitative PCR) of miRNAs showing a pattern of histone modifications linked to a closed chromatin structure were analyzed in a panel of six ALL cell lines and in 353 ALL patients.ResultsCpG islands around 13 miRNAs disclosed high levels of K9H3me2 and/or low levels of K4H3me3, a pattern of histone modifications underlying a closed chromatin structure associated with repressive gene expression. Complete consistency in the correlation between both histone marks, the presence of DNA methylation around these miRNAs, and their expression patterns was confirmed in the six ALL cell lines. Treatment with 5-Aza-2′-deoxycytidine upregulated the expression levels of these genes, suggesting that epigenetic mechanisms deregulate the expression of these miRNAs. A total of 65% of the ALL samples had at least one miRNA methylated (methylated group). Estimated disease-free survival (DFS) and overall survival (OS) at 14 years were 78% and 71% for nonmethylated patients and 24% and 28% for methylated patients (P = .00001 for both). Multivariate analysis demonstrated that methylation profile was an independent prognostic factor for predicting DFS (P = .0001) and OS (P = .0001).ConclusionAberrant miRNA methylation is a common phenomenon in ALL that affects the clinical outcome of these patients.
Relationships of Serum 25-Hydroxyvitamin D to Bone Mineral Density and Serum Parathyroid Hormone and Markers of Bone Turnover in Older Persons
Authors: Kuchuk Natalia O. , Pluijm Saskia M. F. , van Schoor Natasja M. , Looman Caspar W. N. , Smit Johannes H. , Lips Paul 
Published: January 2009

Abstract
Context: Serum 25-hydroxyvitamin D [25(OH)D] may influence serum PTH and other parameters of bone health up to a threshold concentration, which may be between 25 and 80 nmol/liter.
Objective: The aim of the study was to assess the threshold serum 25(OH)D with regard to PTH, bone turnover markers, and bone mineral density (BMD).
Design and Setting: This was part of the Longitudinal Aging Study Amsterdam, an ongoing cohort study.
Participants: A total of 1319 subjects (643 men and 676 women) between the ages of 65 and 88 yr participated in the study.
Main Outcome Measures: Serum 25(OH)D, PTH, osteocalcin, urinary deoxypyridinoline/creatinine, quantitative ultrasound of the heel, BMD of lumbar spine and hip, total body bone mineral content, and physical performance. The relationship between the variables was explored by analysis of covariance and the locally weighted regression (LOESS) plots.
Results: Serum 25(OH)D was below 25 nmol/liter in 11.5%, below 50 nmol/liter in 48.4%, below 75 nmol/liter in 82.4%, and above 75 nmol/liter in 17.6% of the respondents. Mean serum PTH decreased gradually from 5.1 pmol/liter when serum 25(OH)D was below 25 nmol/liter to 3.1 pmol/liter when serum 25(OH)D was above 75 nmol/liter (P &lt; 0.001) without reaching a plateau. All BMD values were higher in the higher serum 25(OH)D groups, although only significantly for total hip (P = 0.01), trochanter (P = 0.001), and total body bone mineral content (P = 0.005). A threshold of about 40 nmol/liter existed for osteocalcin and deoxypyridinoline/creatinine, 50 nmol/liter for BMD, and 60 nmol/liter for physical performance.
Conclusions: Low serum 25(OH)D concentrations are common in the elderly. Bone health and physical performance in older persons are likely to improve when serum 25(OH)D is raised above 50–60 nmol/liter.
The effect of repeated questioning on children's accuracy and consistency in eyewitness testimony
Authors: Krähenbühl Sarah , Blades Mark , Eiser Christine 
Published: January 2009

Purpose. In police interviews children may be asked the same question many times. We investigated how the number of repetitions and the interval between those repetitions affected the accuracy and consistency of children's responses.Methods. 156 children aged 4–9 years watched a staged event and were interviewed individually 1 week later. Children were asked eight open‐ended questions, which were each repeated a further four times (making a total of forty questions). Half these open‐ended questions could be answered from information in the event, and half were unanswerable (so children should have said ‘don't know’ in response to these questions). The questions were repeated in gist form. The interval between an initial question and its repetitions was varied by use of other questions and twenty non‐repeated filler questions. The intervals between repetitions were immediate repetition, repetition after a delay of three intervening questions, after a delay of six intervening questions, and after ten or more intervening questions.Results. Over a quarter of children's responses to repeated questions changed, usually resulting in a decline in accuracy, particularly after the first repetition. Subsequently, the number of repetitions and delay interval had little effect on responses to answerable questions although accuracy to unanswerable questions continued to decline.Conclusions. Question repetition had a negative affect on children's consistency and accuracy. For unanswerable questions in particular, the more often a question was repeated the more likely children were to invent a response.
Relative Resistance of Silicone and Si-Hybrid Based Sealants to Alternating Periods of Accelerated Weathering and Thermo-Mechanical Movements
Authors: Longo D. , Vandereecken P. 
Published: January 2009

Abstract
Sealants used in weatherseal applications are subject to both environmental and mechanical aging during their service life. Environmental aging consists of interaction with sunlight, rain, or moisture, and other atmospheric agents such as ozone. Mechanical aging is linked to the expansion and contraction of the different substrates (glass, concrete…) due to temperature variations. In order to assess the durability of sealants, the ISO 11600 norm includes separate tests for movement capability (ISO 9047) and UV irradiation (ISO 11431) but no combinations of those tests. In 1991, the RILEM TC139-DBS “Durability of Building Sealants” was created to develop new and more adapted testing. The testing proposed by this comity, was a combination of accelerated weathering (humidity and UV) combined with thermo-mechanical cycling. This study compares the durability of silicone sealants and newly developed Si-modified organic based sealants using alternated cycles of ISO 11431 and ISO 9047 during a one year period. Results show that most Si-modified organic will show limited durability in weatherseal applications mostly because of poor UV resistance. Newly developed Si-organic based sealants tested during this work show excellent UV resistance but poor elastic recovery after compression at high temperature (70 °C). This poor elastic recovery limits their long term movement capability. However, good durability can be expected with designs leading to lower movement capability than those obtained from the ISO 11600 testing.
Quenchant Characterization by Cooling Curve Analysis
Authors: Canale Lauralice C. F. , Luo Xinmin , Yao Xin , Totten G. E. 
Published: January 2009

Abstract
Currently, ASTM cooling curve analysis standards ASTM D6200 “Standard Test Method for Determination of Cooling Characteristics of Quench Oils by Cooling Curve Analysis,” D6482 “Standard Test Method for Determination of Cooling Characteristics of Aqueous Polymer Quenchants by Cooling Curve Analysis with Agitation,” and D6549 “Standard Test Method for Determination of Cooling Characteristics of Quenching by Cooling Curve Analysis with Agitation (Drayton Unit),” describe the experimental methodology for cooling curve data acquisition but leave the analysis of the resulting time-temperature cooling data up to the user. Therefore, it is of interest to provide an overview of the various methodologies that may be used by the user of these standards for data analyses and reporting. This is important in order to assess the impact of quench severity on resulting metallurgical properties of various steel alloys. The objective of this paper is to provide a general overview of approaches used to quantify not only the time-temperature behavior, but also a general quantitative assessment of relative quench severity exhibited by the various quenching media being analyzed. Methods for characterizing and interpreting cooling time-temperature curves are reviewed and the reasons for their utilization are discussed.
Obesity: impact on obstetric practice and outcome
Authors: Stewart Frances M , Ramsay Jane E , Greer Ian A 
Published: January 2009

Prepregnancy obesity is increasingly common.
More than half of all women who died from direct or indirect causes in the 2003–05 report, Saving Mothers’ Lives, were overweight or obese.
Obese mothers have an increased risk of complications.

Learning objectives:

To learn about the increased incidence of miscarriage, congenital malformation and metabolic complications.
To learn about the increased risks of intrapartum complications.

Ethical issues:

Should medical assistance to conceive be withheld until BMI ≤35?
More of the healthcare budget should be spent on prevention rather than treatment of obesity.

Please cite this article as: Stewart FM, Ramsay JE, Greer IA. Obesity: impact on obstetric practice and outcome. The Obstetrician & Gynaecologist 2009;11:25–31.
NICE guidelines on urinary incontinence: implications for training and practice in urogynaecology
Authors: Freeman Robert M , Monga Ashwani 
Published: January 2009

NICE have produced the most comprehensive guidelines so far on the management of urinary incontinence in women.
Thirteen key recommendations relate to initial assessment in primary care; investigations; and conservative and surgical treatments.
NICE discuss the implications for training and practice and recommend methods of implementation.

Learning objectives:

To learn how to assess symptoms.
To appreciate how to use investigations appropriately.
To understand how to choose appropriate treatment.

Ethical issues:

Do we have to follow national guidelines?
Is it appropriate for the medical profession to focus on cost?
Should decisions on funding to implement these guidelines rest with primary care trusts?

Please cite this article as: Freeman RM, Monga A. NICE guidelines on urinary incontinence: implications for training and practice in urogynaecology. The Obstetrician & Gynaecologist 2009;11:33–39.
Adenomyosis uteri: an update
Authors: Mehasseb Mohamed K , Habiba Marwan A 
Published: January 2009

Adenomyosis uteri is defined by the presence of endometrium in the myometrium.
The prevalence in asymptomatic women remains unknown.
It is commonly associated with other pathologies.
Hysterectomy remains the main surgical option for women whose families are complete.

Learning objectives:

To understand the theories regarding the aetiology.
To appreciate the clinical picture and complications.
To learn about current treatment modalities.

Ethical issues:

Counselling women with adenomyosis uteri is challenging when the clinical significance of the condition is uncertain.
Are more expensive diagnostic tests, such as magnetic resonance imaging, justifiable?
Is the risk–benefit weighted against invasive investigation?

Please cite this article as: Mehasseb MK and Habiba MA. Adenomyosis uteri: an update. The Obstetrician & Gynaecologist 2009;11:41–47.
Geochemistry of the Panjal Traps basalts (NW Himalaya): records of the Pangea Permian break-up
Authors: Chauvet François , Lapierre Henriette , Bosch Delphine , Guillot Stéphane , Mascle Georges , Vannay Jean-Claude , Cotten Jo , Brunet Pierre , Keller Francine 
Published: January 2009

AbstractThe late Lower to Middle Permian Panjal Traps (NW Himalaya, India-Pakistan) represent the greatest magmatic province erupted on the northern Indian platform during the Neotethys opening. New geochemical and isotopic analyses were performed on basalts from the eastern borders of the traps (SE Zanskar-NW Spiti area) in order to characterize this volcanism, to discuss its compositional variations in comparison to Panjal counterparts and its relationships with the opening of Neotethys. Lavas show features of tholeiitic low-Ti (&lt; 1.6%) continental flood basalts with LREE, Th enrichments and Nb-Ta negative anomalies. Trace element ratios combined with εNdi values (−3.6 to +0.9) and high Pb isotopic ratios suggest that these tholeiitic basalts were derived from an OIB-like mantle contaminated at various degrees by a continental crust component. Previous geochemical features are broadly similar to those of the coeval Panjal volcanic sequences identified westwards (Ladakh, Kashmir and Pakistan). Present geochemical constraints obtained for the Panjal Traps basalts suggest they originated from rapid effusion of tholeiitic melts during opening of the Neotethys Ocean. Similar magmatism implying an OIB-type reservoir is contemporaneously recognized on and along the adjacent Arabian platform. Both Indian and Arabian Permian volcanics were emplaced during coeval syn-rift to post rift transition. These Lower to Middle Permian south Neotethyan continental flood magmatism are regarded as associated to a passive rifting. In this scheme, OIB-type isotopic signature would be related either to a melting episode of syn-rift up-welling mantle plumes or to a melting of a regional abnormally hot and enriched mantle.
A Ringed Non-Uniform Network: How to Raise its Efficiency
Authors: Survilo J. 
Published: January 2009

A Ringed Non-Uniform Network: How to Raise its Efficiency
As distinct from radial electric power lines, in closed loops the consumers are fed from two sides. This is advantageous from the viewpoint of supply reliability, power quality and its losses; however, these are the least only when a loop is uniform, which is not always met in practice. In a non-uniform loop a circulating current flows, and the losses increase proportionally to its square. To reduce losses in such a non-uniform loop, the circulating current should be eliminated. For this purpose a booster transformer can be used. The voltage of such a transformer is known to be in quadrature to the phase voltage; the present consideration has shown that such orientation of the opposing voltage gives the best results only when all loads in the loop are active, otherwise the angle of opposing voltage should be regulated. The voltage value should also be regulated depending on the load. Another technique consists in introducing a complementary reactance into the terminal branches. Such reactance should be regulated if loads are changing in time disproportionately with respect to each other. The best results are achieved when all loop node loads have the same cosφ. If the complementary reactance calculated at one end of the loop is positive, then that calculated at the second end of the loop will be negative, and vice versa. The appropriate choice can be made, in particular, involving both loop terminals.
Applying Resource Utilization Groups (RUG-III) in Hong Kong Nursing Homes
Authors: Chou Kee-Lee , Chi Iris , Leung Joe C.B. 
Published: January 2009

RÉSUMÉLe système de classification des malades Resource Utilization Groups III (RUG-III) est un indice de composition de la clientèle élaboré aux États-unis pour classer les pensionnaires des maisons de soins infirmiers et le financement des services de soins en établissement. À Hong Kong, RUG III est basé sur plusieurs groupes de pensionnaires. Le but de la présente étude était d'examiner la fiabilité et la validité de RUG III dans les maisons de soins infirmiers de Hong Kong. Une enquête transversale a été effectuée dans sept établissements de soins de longue durée exploités par une seule agence. Les pensionnaires (n=1 127) ont été évalués selon un ensemble minimal de données et aussi de soins, et le temps passé par le personnel auxiliaire à la dispense des soins a été consigné durant deux semaines avant ou après la fin de l'évaluation de l'ensemble minimal des données. Un évaluateur indépendant a rencontré de nouveau 45 des 1 127 résidents afin d'évaluer le coefficient d'objectivité. Le coefficient d'objectivité de l'évaluation de l'ensemble minimal des données était excellent (Kappa=0,76) et le RUG III initial a compté pour quelque 30 pour cent du temps du personnel infirmier. Les résultats apportent une preuve préliminaire permettant d'étayer que RUG III est un indice fiable et valide de la composition de la clientèle des maisons de soins infirmiers de Hong Kong, mais il faudra effectuer d'autres études afin de réduire la variance de l'utilisation des ressources expliquée par cet indice de composition de la clientèle.
Chitosan Hydrogel‐Capped Porous SiO2 as a pH Responsive Nano‐Valve for Triggered Release of Insulin
Authors: Wu Jianmin , Sailor Michael J. 
Published: January 2009

AbstractA pH responsive, chitosan‐based hydrogel film is used to cap the pores of a porous SiO2 layer. The porous SiO2 layer is prepared by thermal oxidation of an electrochemically etched Si wafer, and the hydrogel film is prepared by reaction of chitosan with glycidoxypropyltrimethoxysilane (GPTMS). Optical reflectivity spectroscopy and scanning electron microscopy (SEM) confirm that the bio‐polymer only partially infiltrates the porous SiO2 film, generating a double layer structure. The optical reflectivity spectrum displays Fabry–Pérot interference fringes characteristic of a double layer, which is characterized using reflective interferometric Fourier transform spectroscopy (RIFTS). Monitoring the position of the RIFTS peak corresponding to the hydrogel layer allows direct, real‐time observation of the reversible volume phase transition of the hydrogel upon cycling of pH in the range 6.0–7.4. The swelling ratio and response time are controlled by the relative amount of GPTMS in the hydrogel. The pH‐dependent volume phase transition can be used to release insulin trapped in the porous SiO2 layer underneath the hydrogel film. At pH 7.4, the gel in the top layer effectively blocks insulin release, while at pH 6.0 insulin penetrates the swollen hydrogel layer, resulting in a steady release into solution.