bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of drug-eluting coronary stents in Quebec, Canada
Authors: Brophy James M. , Erickson Lonny J. 
Published: April 2008

Objectives:The aim of this investigation was to assess the incremental cost-effectiveness of replacing bare metal coronary stents (BMS) with drug-eluting stents (DES) in the Province of Quebec, Canada.Methods:The strategy used was a cost-effectiveness analysis from the perspective of the health-care provider, in the province of Quebec, Canada (population 7.5 million). The main outcome measure was the cost per avoided revascularization intervention.Results:Based on the annual Quebec rate of 14,000 angioplasties with an average of 1.7 stents per procedure and a purchase cost of $2,600 Canadian dollar (CDN) for DES, 100 percent substitution of BMS with DES would require an additional $45.1 million CDN of funding. After the benefits of reduced repeat revascularization interventions are included, the incremental cost would be $35.2 million CDN. The cost per avoided revascularization intervention (18 percent coronary artery bypass graft, 82 percent percutaneous coronary intervention [PCI]) would be $23,067 CDN. If DES were offered selectively to higher risk populations, for example, a 20 percent subgroup with a relative restenosis risk of 2.5 times the current bare metal rate, the incremental cost of the program would be $4.9 million CDN at a cost of $7,800 per avoided revascularization procedure. Break-even costs for the program would occur at DES purchase cost of $1,161 for 100 percent DES use and $1,627 for selective 20 percent DES use for high-risk patients for restenosis (RR = 2.5). Univariate and Monte Carlo sensitivity analyses indicate that the parameters most affecting the analysis are the capacity to select patients at high risk of restenosis, the average number of stents used per PCI, baseline restenosis rates for BMS, the effectiveness ratio of restenosis prevention for DES versus BMS, the cost of DES, and the revascularization rate after initial PCI. Sensitivity analyses suggest little additional health benefits but escalating cost-effectiveness ratios once a DES penetration of 40 percent has been attained.Conclusions:Under current conditions in Quebec, Canada, selective use of DES in high-risk patients is the most acceptable strategy in terms of cost-effectiveness. Results of such an analysis would be expected to be similar in other countries with key model parameters similar to those used in this model. This model provides an example of how to evaluate the cost-effectiveness of selective use of a new technology in high-risk patients.
Cost and health status analysis after autologous chondrocyte implantation and mosaicplasty: A retrospective comparison
Authors: Derrett Sarah , Stokes Elizabeth A. , James Marilyn , Bartlett William , Bentley George 
Published: April 2008

Objectives:Chondral defects of the knee cartilage are prevalent. Autologous chondrocyte implantation (ACI) and mosaicplasty are increasingly used to treat symptomatic knee defects. This study assessed the costs and health status outcomes after ACI and mosaicplasty.Methods:Patients were eligible to participate in this cross-sectional study if they received ACI or mosaicplasty at the Royal National Orthopaedic Hospital between 1997 and 2001 or were on a waiting list for ACI. Secondary-care resource use was collected to 2 years postoperatively using a resource collection proforma. Participants responded to postal questions about sociodemographic characteristics and knee-related (Modified Cincinnati Knee Rating System) and general health status (EQ-5D).Results:Fifty-three ACI, twenty mosaicplasty, and twenty-two patients waiting for ACI participated. The average cost per patient was higher for ACI (£10,600: 95 percent confidence interval [CI], £10,036–£11,214) than mosaicplasty (£7,948: 95 percent CI, £6,957–£9,243). Postoperatively, ACI and mosaicplasty patients (combined) experienced better health status than those waiting for ACI. ACI patients tended to have better health status outcomes than mosaicplasty patients (not statistically significant). Estimated average EQ-5D social tariff improvements for quality-adjusted life year (QALY) calculations were 0.23 (ACI) and 0.06 (mosaicplasty). Average costs per QALY were £23,043 (ACI) and £66,233 (mosaicplasty). The incremental cost effectiveness ratio (ICER) for providing ACI over mosaicplasty was £16,349.Conclusions:Average costs were higher for ACI than mosaicplasty. However, both the estimated cost per QALY and ICER for providing ACI over mosaicplasty fell beneath an implicit English funding threshold of £30,000 per QALY. Prospective studies should include measures of utility to confirm the estimated cost utility ratios of ACI and mosaicplasty.
Diagnosis of appendicitis in adults by ultrasonography or computed tomography: A systematic review and meta-analysis
Authors: Weston Adèle R. , Jackson Terri J. , Blamey Stephen 
Published: April 2008

Objectives:The use of ultrasonography and computed tomography (CT) in the diagnosis of appendicitis in adult patients was compared.Methods:Systematic review and meta-analysis of current evidence in two clinical situations: unselected nonpregnant, adult patients with symptoms of appendicitis, and more selective use in only those patients who still have an equivocal diagnosis subsequent to routine clinical investigations.Results:Meta-analysis of eligible studies shows CT to have better sensitivity and specificity than ultrasound in both clinical situations.Conclusions:Application of these findings in clinical practice and/or policy would need to evaluate the better diagnostic performance of CT against its cost and availability. In addition, it is imperative that future studies be conducted in patient populations that are well-defined with respect to prior investigations. Sequelae of false-negative and false-positive diagnoses should also be evaluated.
Effects of continuing medical education on improving physician clinical care and patient health: A review of systematic reviews
Authors: Bloom Bernard S. 
Published: April 2008

Objectives:The objective of physician continuing medical education (CME) is to help them keep abreast of advances in patient care, to accept new more-beneficial care, and discontinue use of existing lower-benefit diagnostic and therapeutic interventions. The goal of this review was to examine effectiveness of current CME tools and techniques in changing physician clinical practices and improving patient health outcomes.Methods:Results of published systematic reviews were examined to determine the spectrum from most- to least-effective CME techniques. We searched multiple databases, from 1 January 1984 to 30 October 2004, for English-language, peer-reviewed meta-analyses and other systematic reviews of CME programs that alter physician behavior and/or patient outcomes.Results:Twenty-six reviews met inclusion criteria, that is, were either formal meta-analyses or other systematic reviews. Interactive techniques (audit/feedback, academic detailing/outreach, and reminders) are the most effective at simultaneously changing physician care and patient outcomes. Clinical practice guidelines and opinion leaders are less effective. Didactic presentations and distributing printed information only have little or no beneficial effect in changing physician practice.Conclusions:Even though the most-effective CME techniques have been proven, use of least-effective ones predominates. Such use of ineffective CME likely reduces patient care quality and raises costs for all, the worst of both worlds.
Decision making in general practice: The availability and use of a specific laboratory analysis
Authors: Fauli Siri , Thue Geir 
Published: April 2008

Objectives:The aim of this investigation was to study the effect of general practitioners' (GP's) characteristics on two decisions: whether to have theHelicobacter pylorirapid test (HPRT) in the office laboratory and whether to use this test or a similar hospital-based serological test in a typical clinical situation described in a vignette.Methods:Discrete choice analysis with binary logit models were used to predict the probability that a general practice has the HPRT, as well as the GP's probability of using the HPRT or a similar test in this clinical situation.Results:We found that the number of consultations per week has a positive effect on the probability of having the HPRT, indicating that the size of the practice affects the decision to have such a test in the repertoire. Furthermore, four variables significantly increased the probability of using one of the lab tests: more if located in urban practices, more by solo practitioners, more when the GP stated a high probability forH. pyloriassociated disease, and more when the GP had the rapid test available in the practice. In our analysis, the remuneration system is endogenous and does not have a significant effect on the two decisions.Conclusions:Our study demonstrates that characteristics of the GP affect the availability and use of a specific laboratory analysis.
Cluster randomized trials: Another problem for cost-effectiveness ratios
Authors: Flynn Terry N. , Peters Tim J. 
Published: April 2008

Objectives:This work has investigated under what conditions cost-effectiveness data from a cluster randomized trial (CRT) are suitable for analysis using a cluster-adjusted nonparametric bootstrap. The bootstrap's main advantages are in dealing with skewed data and its ability to take correlations between costs and effects into account. However, there are known theoretical problems with a commonly used cluster bootstrap procedure, and the practical implications of these require investigation.Methods:Simulations were used to estimate the coverage of confidence intervals around incremental cost-effectiveness ratios from CRTs using two bootstrap methods.Results:The bootstrap gave excessively narrow confidence intervals, but there was evidence to suggest that, when the number of clusters per treatment arm exceeded 24, it might give acceptable results. The method that resampled individuals as well as clusters did not perform well when cost and effectiveness data were correlated.Conclusions:If economic data from such trials are to be analyzed adequately, then there is a need for further investigations of more complex bootstrap procedures. Similarly, further research is required on methods such as the net benefit approach.
Validity of original studies in health technology assessment reports: Significance of standardized assessment and reporting
Authors: Porzsolt Franz , Kajnar Hana , Awa Aziz , Fässler Margrit , Herzberger Barbara 
Published: April 2008

Objectives:As health technology assessments (HTA) may have considerable impact on health-care decisions, it is essential to guarantee the expected quality of these assessments. Variations in the methods used or lack of transparency can affect the important role of HTA reports.Methods:In our study, we analyzed the methods used in two corresponding HTA reports to assess the validity of two key papers, which were included in both reports. Also the discussions and the final conclusions of both reports were compared.Results:The authors of the two HTA reports used different instruments to assess the validity of the original studies. A minor problem is differences that were found in the assessments of identical validity aspects of the included studies and in the information provided in the HTA reports. A more serious problem was found in both HTA reports which identified the weakness of the key papers and expressed these limitations in the discussions (read mainly by scientists) but not in the conclusions (read mainly by policy-makers).Conclusions:The results of this study may be important for any institution that prepares recommendations for policy-makers. In the case of HTA reports, no new checklists are necessary as the checklist offered by the INAHTA contains the needed information. It may be necessary, however, to consider an “intramural quality board,” which helps the member organizations guarantee both the transparency of the original studies included in HTA reports and the transparency of the HTA report itself.
N3Logic: A logical framework for the World Wide Web
Authors: BERNERS-LEE TIM , CONNOLLY DAN , KAGAL LALANA , SCHARF YOSI , HENDLER JIM 
Published: April 2008

AbstractThe Semantic Web drives toward the use of the Web for interacting with logically interconnected data. Through knowledge models such as Resource Description Framework (RDF), the Semantic Web provides a unifying representation of richly structured data. Adding logic to the Web implies the use of rules to make inferences, choose courses of action, and answer questions. This logic must be powerful enough to describe complex properties of objects but not so powerful that agents can be tricked by being asked to consider a paradox. The Web has several characteristics that can lead to problems when existing logics are used, in particular, the inconsistencies that inevitably arise due to the openness of the Web, where anyone can assert anything. N3Logic is a logic that allows rules to be expressed in a Web environment. It extends RDF with syntax for nested graphs and quantified variables and with predicates for implication and accessing resources on the Web, and functions including cryptographic, string, math. The main goal of N3Logic is to be a minimal extension to the RDF data model such that the same language can be used for logic and data. In this paper, we describe N3Logic and illustrate through examples why it is an appropriate logic for the Web.
Comparison Between the Original Rorschach Plates and the Parisi-Pes Parallel Series in Argentina
Authors: Passalacqua Alicia Martha , Pestana Lelia Sandra 
Published: April 2008

Le texte présenté est la synthèse serrée d'une étude menée par le Département du Rorschach de la Faculté de Psychologie de l'université de Buenos Aires et d'autres universités en Argentine. Nous y soulignons l'importance de valider une série parallèle de planches de Rorschach dans notre environnement, afin de disposer d'une série alternative en cas de besoin. Cette nécessité vient de la grande diffusion de la technique dans les champs de la psychologie communautaire qui pourrait produire un effet d'apprentissage et gêner l'utilisation psychodiagnostique de cet instrument. Le Rorschach lui-même s'est montré un instrument d'évaluation particulièrement pertinent et valide, ce qui en a rendu l'usage indispensable dans différents secteurs de la pratique, tels qu'en psychologie légale, psychologie du travail, clinique et en éducation. La série parallèle de Parisi-Pes pourrait constituer une alternative, et il est donc nécessaire d'en établir l'équivalence sur la population locale. Notre analyse s'est centrée sur les indicateurs du fonctionnement du moi (adaptation, jugement et testing de la réalité), en raison de leur importance dans le diagnostic différentiel, ainsi que sur les réponses réputées banales en Italie. Nous avons aussi mené une étude pilote sur le fonctionnement affectif et l'influence du sexe.
Cerebral Metabolism and Personality in Patients with Epilepsy of the Temporal Lobe
Authors: de Felipe-Oroquieta J. , Ortega F. , Maldonado A. , Pozo M. A. , Sola R. G. 
Published: April 2008

Extratension and introversion are stable personality styles in adult subjects. Mental functioning of the former is especially influenced by the emotions and of the latter by ideation. The aim of the present work is to analyze, using positron emission tomography with [18F]fluorodeoxyglucose (18FDG-PET), possible differences in cerebral metabolism in patients with intractable temporal lobe epilepsy (TLE) in relation to different personality styles assessed with the Rorschach test.Twenty-eight drug-resistant TLE patients with complex partial seizures were assessed by means of FDG-PET and the Rorschach test. According to location of the epileptogenic area in the dominant hemisphere and the personality style of the subject, a table of contingencies was drawn up (χ² and contingency coefficient). Finally, an analysis was made of the personality changes in patients that had received neurosurgical treatment.The results show a clear differentiation with FDG-PET as regards location of the temporal lobe affected. In 80% of subjects personality style coincided with a cerebral metabolic pattern: introversives had predominant hypometabolism in the left hemisphere and extratensives in the right. The tendency toward introversion or extratension in ambitents showed this metabolic pattern only in 38% of subjects, with 54% presenting the opposite pattern. The Rorschach test was carried out for a second time after surgical temporal resection (n = 13), and it was observed that some patients maintained their personality style while others modified it.These results suggest the existence of different hemispheric metabolic patterns in the personality styles assessed by the Rorschach test in TLE patients.
Defying the economists: a decrease in heart rate improves not only cardiac but also endothelial function
Authors: Triggle C R 
Published: April 2008

Ivabradine has proven therapeutic efficacy for cardiac ischaemia and, until proved otherwise, is a very specific inhibitor of the cardiac sinoatrial node If current. In the current issue of the British Journal of Pharmacology, Drouin et al. demonstrated that chronic treatment of the human apoB‐100 transgene dyslipidaemic mouse with ivabradine significantly improved endothelium‐dependent vasodilatation to ACh in renal and cerebral arteries and that the beneficial effects of ivabradine result secondarily to the lowering of heart rate. These data suggest that drugs that target the If current have potential benefits not only as anti‐ischaemics but also as agents for the treatment of endothelial dysfunction.British Journal of Pharmacology (2008) 154, 727–728; doi:10.1038/bjp.2008.116; published online 28 April 2008
Calsenilin and CALP interact with the cytoplasmic tail of UDP-Gal:GA2/GM2/GD2 β-1,3-galactosyltransferase
Authors: Quintero Cristián A. , Valdez-Taubas Javier , Ferrari Mariana L. , Haedo Sergio D. , Maccioni Hugo J. F. 
Published: April 2008

GalT2 (UDP-Gal:GA2/GM2/GD2 β-1,3-galactosyltransferase) is a Golgi-resident type II membrane protein that participates in the synthesis of glycosphingolipids. The molecular determinants for traffic and localization of this and other glycosyltransferases are still poorly characterized. Considering the possibility that interactions with other proteins may influence these processes, in the present study we carried out a yeast two-hybrid screening using elements of the N-terminal domain of GalT2 as bait. In this screening, we identified calsenilin and its close homologue CALP (calsenilin-like protein), both members of the recoverin-NCS (neuronal calcium sensor) family of calcium-binding proteins. In vitro, GalT2 binds to immobilized recombinant CALP, and CALP binds to immobilized peptides with the GalT2 cytoplasmic tail sequence. GalT2 and calsenilin interact physically when co-expressed in CHO (Chinese-hamster ovary)-K1 cells. The expression of CALP or calsenilin affect Golgi localization of GalT2, and of two other glycosyltransferases, SialT2 (CMP-NeuAc:GM3 sialyltransferase) and GalNAcT (UDP-GalNAc:lactosylceramide/GM3/GD3 β1-4 N-acetylgalactosaminyltransferase), by redistributing them from the Golgi to the ER (endoplasmic reticulum), whereas the localization of the VSV-G (G-protein of the vesicular stomatitis virus) or the Golgin GM130 was essentially unaffected. Conversely, the expression of GalT2 affects the localization of calsenilin and CALP by shifting a fraction of the molecules from being mostly diffuse in the cytosol, to clustered structures in the perinuclear region. These combined in vivo and in vitro results suggest that CALP and calsenilin are involved in the trafficking of Golgi glycosyltransferases.
swissPIT: a novel approach for pipelined analysis of mass spectrometry data
Authors: Quandt Andreas , Hernandez Patricia , Masselot Alexandre , Hernandez Céline , Maffioletti Sergio , Pautasso Cesare , Appel Ron D. , Lisacek Frederique 
Published: April 2008

Abstract
The identification and characterization of peptides from tandem mass spectrometry (MS/MS) data represents a critical aspect of proteomics. Today, tandem MS analysis is often performed by only using a single identification program achieving identification rates between 10–50% (Elias and Gygi, 2007). Beside the development of new analysis tools, recent publications describe also the pipelining of different search programs to increase the identification rate (Hartler et al., 2007; Keller et al., 2005).
The Swiss Protein Identification Toolbox (swissPIT) follows this approach, but goes a step further by providing the user an expandable multi-tool platform capable of executing workflows to analyze tandem MS-based data. One of the major problems in proteomics is the absent of standardized workflows to analyze the produced data. This includes the pre-processing part as well as the final identification of peptides and proteins. The main idea of swissPIT is not only the usage of different identification tool in parallel, but also the meaningful concatenation of different identification strategies at the same time. The swissPIT is open source software but we also provide a user-friendly web platform, which demonstrates the capabilities of our software and which is available at http://swisspit.cscs.ch upon request for account.
Contact: andreas.quandt@isb-sib.ch
A novel PRKAR1A mutation associated with hepatocellular carcinoma in a young patient and a variable Carney complex phenotype in affected subjects in older generations
Authors: Gennari Monia , Stratakis Constantine A. , Hovarth Anelia , Pirazzoli Piero , Cicognani Alessandro 
Published: April 2008

SummaryContext  Carney complex (CNC) is an autosomal dominant multiple endocrine neoplasia syndrome (OMIM 160980). About 70% of cases are familiar; most have mutations of the PRKAR1A gene on chromosome 17q22–24. There is little phenotype–genotype correlation known to date.Objective  To study the genotype–phenotype correlation in a family with newly diagnosed CNC and three generations of subjects bearing the same PRKAR1A mutation. The proband was diagnosed with hepatocellular carcinoma, a tumour that appears to be associated with CNC.Design  The study consisted of clinical and genetic analysis of a total of 10 individuals belonging to a large Italian family.Patients  The index case was referred for PRKAR1A gene mutation analysis because he met the diagnostic criteria for a clinical diagnosis of CNC.Results  The PRKAR1A‐inactivating mutation c.502 +1G > A in the intron 5 splice‐donor site was detected after bidirectional sequencing of germline DNA. The mutation causes a frameshift in the transcribed sequence and a nonsense mRNA that was shown to be degraded; this leads to PRKAR1A haploinsufficiency in all tissues. All available relatives were screened first by DNA testing and, if the latter was positive, by clinical, biochemical and imaging means.Conclusions  A novel PRKAR1A mutation with an apparently low penetrance and variable expression is reported; the same mutation is also associated with a hepatocellular carcinoma. This is the first time a PRKAR1A mutation is reported in individuals who were diagnosed with CNC after retrospective family screening and following the identification of a proband; the finding has implications for genetic counselling on PRKAR1A and/or CNC.