bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of colorectal cancer screening in diverse primary care practices
Authors: Zimmerman Richard K , Nowalk Mary Patricia , Tabbarah Melissa , Grufferman Seymour 
Published: September 2006

Abstract

Background
To explain why rates of colorectal cancer (CRC) screening including fecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), colonoscopy (CS), and barium enema (BE), are low, this study assessed determinants of CRC screening from medical records.

Methods
Data were abstracted from patients aged ≥64 years selected from each clinician from 30 diverse primary care practices (n = 981). Measurements included the rates of annual FOBT, ever receiving FOBT, ever receiving FS/CS/BE under a combination variable, endoscopy/barium enema (EBE).

Results
Over five years, 8% had received annual FOBT, 53% had ever received FOBT and 22% had ever received EBE. Annual FOBT was negatively associated with female gender, odds ratio (OR) = .23; 95% confidence interval = .12–.44 and positively associated with routinely receiving influenza vaccine, OR = 2.55 (1.45–4.47); and more office visits: 3 to <5 visits/year, OR = 2.78 (1.41–5.51), and ≥5 visits/year, OR = 3.35 (1.52-7.42). Ever receiving EBE was negatively associated with age ≥75 years, OR = .66 (.46–.95); being widowed, OR = .59 (.38–.92); and positively associated with more office visits: 3 to <5 visits/year, OR = 1.83 (1.18–2.82) and ≥5 visits/year, OR = 2.01 (1.14–3.55).

Conclusion
Overall CRC screening rates were low, but were related to the number of primary care office visits. FOBT was related to immunization status, suggesting the possible benefit of linking these preventive services.
Developing and testing an instrument for identifying performance incentives in the Greek health care sector
Authors: Paleologou Victoria , Kontodimopoulos Nick , Stamouli Aggeliki , Aletras Vassilis , Niakas Dimitris 
Published: September 2006

Abstract

Background
In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity.

Methods
A methodological exploratory design was employed in three phases: a) content development and assessment, which resulted in a 28-item instrument, b) pilot testing (N = 74) and c) field testing (N = 353). Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure.

Results
Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied.

Conclusion
Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger sample of employees in the Greek healthcare system.
Ambulatory measurement of knee motion and physical activity: preliminary evaluation of a smart activity monitor
Authors: Huddleston James , Alaiti Amer , Goldvasser Dov , Scarborough Donna , Freiberg Andrew , Rubash Harry , Malchau Henrik , Harris William , Krebs David 
Published: September 2006

Abstract

Background
There is currently a paucity of devices available for continuous, long-term monitoring of human joint motion. Non-invasive, inexpensive devices capable of recording human activity and joint motion have many applications for medical research. Such a device could be used to quantify range of motion outside the gait laboratory. The purpose of this study was to test the accuracy of the modified Intelligent Device for Energy Expenditure and Activity (IDEEA) in measuring knee flexion angles, to detect different physical activities, and to quantify how often healthy subjects use deep knee flexion in the ambulatory setting.

Methods
We compared Biomotion Laboratory (BML) "gold standard" data to simultaneous IDEEA measures of knee motion and gait, step up/down, and stair descent in 5 healthy subjects. In addition, we used a series of choreographed physical activities outside the BML to confirm the IDEEA's ability to accurately measure 7 commonly-performed physical activities. Subjects then continued data collection during ordinary activities outside the gait laboratory.

Results
Pooled correlations between the BML and IDEEA knee flexion angles were .97 +/- .03 for step up/down, .98 +/- .02 for stair descent, and .98 +/- .01 for gait. In the BML protocol, the IDEEA accurately identified gait, but was less accurate in identifying step up/down and stair descent. During sampling outside the BML, the IDEEA accurately detected walking, running, stair ascent, stair descent, standing, lying, and sitting. On average, subjects flexed their knees >120° for 0.17% of their data collection periods outside the BML.

Conclusion
The modified IDEEA system is a useful clinical tool for evaluating knee motion and multiple physical activities in the ambulatory setting. These five healthy subjects rarely flexed their knees >120°.
Grid technology in tissue-based diagnosis: fundamentals and potential developments
Authors: Görtler Jürgen , Berghoff Martin , Kayser Gian , Kayser Klaus 
Published: September 2006

Abstract
Tissue-based diagnosis still remains the most reliable and specific diagnostic medical procedure. It is involved in all technological developments in medicine and biology and incorporates tools of quite different applications. These range from molecular genetics to image acquisition and recognition algorithms (for image analysis), or from tissue culture to electronic communication services.
Grid technology seems to possess all features to efficiently target specific constellations of an individual patient in order to obtain a detailed and accurate diagnosis in providing all relevant information and references.
Grid technology can be briefly explained by so-called nodes that are linked together and share certain communication rules in using open standards. The number of nodes can vary as well as their functionality, depending on the needs of a specific user at a given point in time. In the beginning of grid technology, the nodes were used as supercomputers in combining and enhancing the computation power. At present, at least five different Grid functions can be distinguished, that comprise 1) computation services, 2) data services, 3) application services, 4) information services, and 5) knowledge services.
The general structures and functions of a Grid are described, and their potential implementation into virtual tissue-based diagnosis is analyzed. As a result Grid technology offers a new dimension to access distributed information and knowledge and to improving the quality in tissue-based diagnosis and therefore improving the medical quality.
Intravenous nitroglycerin does not preserve gastric microcirculation during gastric tube reconstruction: a randomized controlled trial
Authors: Buise Marc , van Bommel Jasper , Jahn Alexander , Tran Khe , Tilanus Huug , Gommers Diederik 
Published: September 2006

Abstract
Introduction
Complications of oesophagectomy and gastric tube reconstruction include leakage and stenosis, which may be due to compromised microvascular blood flow (MBF) in gastric tissue. We recently demonstrated that decreased MBF could be improved perioperatively by topical administration of nitroglycerin. The aim of the present study was to investigate whether nitroglycerin, administered intravenously during gastric tube reconstruction, could preserve tissue blood flow and oxygenation in the gastric fundus, and reduce the incidence of postoperative leakage.

Methods
In this single-centre, prospective, double-blinded study, we randomized 32 patients scheduled for oesophagectomy into two groups. The intervention group received intravenous nitroglycerin during gastric tube reconstruction, and the control group received normal saline. Baseline values for MBF, microvascular haemoglobin oxygen saturation and microvascular haemoglobin concentration were determined at the gastric fundus before and after gastric tube construction and after pulling up the gastric tube to the neck.

Results
MBF and microvascular haemoglobin oxygen saturation decreased similarly in both groups during gastric tube reconstruction and were comparable. The oesophageal anastomosis was controlled by contrast radiography before discharge from the hospital; leakage was observed in two patients (13%) in the nitroglycerin group and five patients (31 %) in the control group (not significant).

Conclusion
Under stable systemic haemodynamic conditions, continuous intravenous administration of nitroglycerin could not prevent deterioration in gastric microvascular perfusion and microvascular haemoglobin saturation during gastric tube reconstruction. (Trial registration number NCT 00335010.)
Cytolytic cells induce HMGB1 release from melanoma cell lines
Authors: Ito Norimasa , DeMarco Richard A , Mailliard Robbie B , Han Jie , Rabinowich Hannah , Kalinski Pawel , Stolz Donna Beer , Zeh Herbert J , Lotze Michael T 
Published: September 2006

AbstractHigh mobility group box 1 (HMGB1) is one of the recently defined damage-associated molecular pattern molecules, passively released from necrotic cells and secreted by activated macrophage/monocytes. Whether cytolytic cells induce HMGB1 release from tumor cells is not known. We developed a highly sensitive method for detecting intracellular HMGB1 in tumor cells, allowing analysis of the type of cell death and in particular, necrosis. We induced melanoma cell death with cytolytic lymphokine-activated killing (LAK) cells, tumor-specific cytolytic T lymphocytes, TRAIL, or granzyme B delivery and assessed intracellular HMGB1 retention or release to investigate the mechanism of HMGB1 release by cytolytic cells. HMGB1 release from melanoma cells (451Lu, WM9) was detected within 4 h and 24 h following incubation with IL-2-activated PBMC (LAK activity). HLA-A2 and MART1 or gp100-specific cytolytic T lymphocytes induced HMGB1 release from HLA-A2-positive and MART1-positive melanoma cells (FEM X) or T2 cell-loaded, gp100-specific peptides. TRAIL treatment, however, induced HMGB1 release, and it is interesting that this extrinsic pathway-mediated cell death was blocked with the pancaspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone. Conversely, granzyme B delivery did not induce HMGB1 release. HMGB1, along with other intracellular factors released from tumor cells induced by cytolysis, may be important components of the disordered tumor microenvironment. This has important implications for the immunotherapy of patients with cancer. Specifically, HMGB1 may promote healing or immune reactivity, depending on the nature of the local inflammatory response and the presence (or absence) of immune effectors.
Identification and Functional Analysis of the Novel S179R POU1F1 Mutation Associated with Combined Pituitary Hormone Deficiency
Authors: Miyata Ichiro , Vallette-Kasic Sophie , Saveanu Alexandru , Takeuchi Mizuho , Yoshikawa Hideki , Tajima Asako , Tojo Katsuyoshi , Reynaud Rachel , Gueydan Magali , Enjalbert Alain , Tajima Naoko , Eto Yoshikatsu , Brue Thierry 
Published: September 2006

Abstract
Context: The pituitary-specific transcription factor 1 plays a key role in the development and differentiation of three pituitary cell types: somatotrophs, lactotrophs, and thyrotrophs. Several mutations of the human gene (called POU1F1) have been shown to be responsible for a phenotype of combined pituitary hormone deficiency involving GH, prolactin (PRL), and TSH.
Objective: We have identified a novel homozygous C to G mutation in exon 4 of the POU1F1 gene (S179R) in a patient with this rare phenotype. We analyzed the functional consequences of this S179R mutation associated with a single-amino acid change in the POU-specific domain.
Methods: Consequences of this mutation on transcriptional activities by transfection studies in αT3 cells, DNA binding ability by EMSA, structural properties, and nuclear accumulation of POU1F1 were investigated.
Results: The transactivation capacity of this mutant was markedly decreased on the GH1, PRL, TSHβ, and POU1F1 genes. Interestingly, this mutation abolished the functional interaction of POU1F1 on the PRL promoter with the coactivator cAMP response element-binding protein-binding protein but not with the transcription factor LIM homeodomain transcription factor 3. The S179R mutant displayed normal nuclear accumulation but a markedly decreased binding to a DNA response element in keeping with crystallographic data, suggesting that the S179R mutation might interfere with DNA binding.
Conclusions: Together with previous data, our study indicates that both DNA binding and interaction with cofactors like cAMP response element-binding protein-binding protein are critical for POU1F1 function and that functional and structural properties of abnormal POU1F1 proteins are variously influenced by the type of mutations.
Hook Needle-Guided Excision of Recurrent Differentiated Thyroid Cancer in Previously Operated Neck Compartments: A Safe Technique for Small, Nonpalpable Recurrent Disease
Authors: Triponez Frederic , Poder Liina , Zarnegar Rasa , Goldstein Ruth , Roayaie Kayvan , Feldstein Vickie , Lee James , Kebebew Electron , Duh Quan-Yang , Clark Orlo H. 
Published: September 2006

Abstract
Context: As a result of more sensitive techniques to detect recurrent thyroid cancer, the number of patients presenting with small, nonpalpable recurrent thyroid cancer in cervical lymph nodes is increasing. Surgical excision of nonpalpable recurrent thyroid cancer can be difficult, particularly in a previously operated area.
Objective: The objective of this study was to investigate whether preoperative insertion of a hook needle under ultrasound guidance is useful in neck reoperations for recurrent thyroid cancer.
Patients: Ten consecutive patients presenting over a 4-month period with nonpalpable, ultrasound-visible, fine needle biopsy-proven recurrent thyroid cancer in previously operated neck compartment(s) were studied.
Main Outcome Measures: We measured whether it was technically possible to insert a hook needle preoperatively, rate of negative neck exploration, and complication rate.
Results: The hook needle was inserted in seven patients. In three patients, the hook needle was not inserted; one patient had palpable disease 4 months after the preoperative clinic visit, one patient had a tumor too close to the carotid artery, and one patient had multiple bilateral foci of recurrent disease in the central neck. One patient had bleeding after insertion of the needle due to a penetration of an anterior jugular vein that was easily managed at neck reexploration. No other complication occurred during the hook needle insertion, and the only surgical complication was a transient recurrent nerve palsy. All pathology reports showed malignant disease.
Conclusion: Hook needle-guided excision of recurrent thyroid cancer is feasible and appears to be a promising tool for safe and successful reoperation of patients with small recurrent thyroid cancer in cervical lymph nodes.
Salivary α-Amylase Levels after Yohimbine Challenge in Healthy Men
Authors: Ehlert Ulrike , Erni Katja , Hebisch Gundula , Nater Urs 
Published: September 2006

Abstract
Context: We and others have previously shown that standardized psychosocial stress significantly increases salivary α-amylase (sAA), but it remains unclear whether sAA reflects autonomic nervous system activation.
Objective: The aim of this study was to assess cardiovascular effects and sAA and catecholamine secretion after iv injection of yohimbine.
Design and Setting: We conducted a randomized double-blind placebo-controlled study at an academic research unit.
Participants: Thirteen healthy males (aged 20–28 yr) were examined.
Intervention: Participants received iv injection of yohimbine (0.4 μg/kg) or placebo (0.9% NaCl).
Main Outcome Measures: Eight saliva and blood samples were taken before and after injection for the assessment of salivary flow rate and sAA and catecholamine concentrations. In addition, blood pressure, mood, and anxiety were assessed repeatedly.
Results: Yohimbine induced increases of sAA activity and output in comparison to placebo (P = 0.034). Blood pressure (P &lt; 0.001), salivary flow rate (P = 0.007), and catecholamines (P &lt; 0.001) were also significantly increased. No significant correlations between α-amylase parameters and catecholamines were observed.
Conclusions: The results indicate that yohimbine administration activates not only autonomic parameters but also sAA via adrenergic mechanisms, suggesting that sAA might be an indirect indicator of the central sympathetic system.
Impaired Caspase-3 Expression by Peripheral T Cells in Chronic Autoimmune Thyroiditis and in Autoimmune Polyendocrine Syndrome-2
Authors: Vendrame Francesco , Segni Maria , Grassetti Daniele , Tellone Valeria , Augello Giovanni , Trischitta Vincenzo , Torlontano Massimo , Dotta Francesco 
Published: September 2006

AbstractContext: Activation-induced cell death (AICD) is a major mechanism in the regulation of peripheral tolerance, and caspase-3 represents its major executioner. AICD impairment contributes to the persistence of autoreactive T cells, and defective AICD has been reported in autoimmune thyroiditis as well as in type 1 diabetes mellitus.Objective: The objective of this study was to evaluate the involvement of caspase-3 in the regulation of AICD resistance in thyroid and polyendocrine autoimmunity.Design/Settings/Patients/Intervention: Caspase-3 expression was analyzed in peripheral blood lymphocytes from 26 adults (A-AT) and 25 children (Y-AT) affected by autoimmune thyroiditis and 13 individuals affected by chronic autoimmune thyroiditis plus Addison’s disease [autoimmune polyendocrine syndrome-2 (APS-2)] in comparison with 32 age-matched normal control subjects (NC).Outcome Measures: Caspase-3 mRNA expression in peripheral T cells was evaluated by quantitative real-time PCR; protein expression of both procaspase-3 and activated caspase-3 by Western blot analysis was followed by scanning densitometry.Results: Caspase-3 mRNA expression was significantly reduced in resting lymphocytes from both A-AT (P = 0.001) and Y-AT (P = 0.016) compared with NC. After lymphocyte activation, protein levels of caspase-3 active form were significantly reduced in A-AT (P = 0.023) and Y-AT (P = 0.001) compared with NC. The APS-2 group displayed characteristics similar to the A-AT group because both caspase-3 mRNA and protein active form levels were significantly reduced compared with NC (P = 0.004 and 0.002, respectively).Conclusion: Our data show that peripheral lymphocytes of subjects affected by thyroid autoimmunity or APS-2 show defective expression of the major executioner of AICD, thus potentially contributing to AICD resistance and to the development of autoimmunity.
Influences of Age, Gender, Smoking, and Family History on Autoimmune Thyroid Disease Phenotype
Authors: Manji N. , Carr-Smith J. D. , Boelaert K. , Allahabadia A. , Armitage M. , Chatterjee V. K. , Lazarus J. H. , Pearce S. H. S. , Vaidya B. , Gough S. C. , Franklyn J. A. 
Published: September 2006

Abstract
Context: Both genetic and environmental factors contribute to susceptibility to Graves’ disease (GD) and Hashimoto’s thyroiditis (HT), as well as disease manifestations.
Objective: The objective of the study was to define how endogenous/environmental factors contribute to variation in phenotype.
Design/Setting: This was a multicenter cohort study.
Patients/Outcome Measures: We prospectively collected clinical/biochemical data as part of the protocol for a United Kingdom DNA collection for GD and HT. We investigated, in 2805 Caucasian subjects, whether age at diagnosis, gender, family history (FH), smoking history, and presence of goiter influenced disease manifestations.
Results: For 2405 subjects with GD, the presence of goiter was independently associated with disease severity (serum free T4 at diagnosis) (P &lt; 0.001). Free T4 (P &lt; 0.05) and current smoking (P &lt; 0.001) were both independent predictors of the presence of ophthalmopathy. Approximately half of those with GD (47.4% of females, 40.0% of males) and HT (n = 400) (56.4% of females, 51.7% of males) reported a FH of thyroid dysfunction. In GD, a FH of hyperthyroidism in any relative was more frequent than hypothyroidism (30.1 vs. 24.4% in affected females, P &lt; 0.001). In HT, a FH of hypothyroidism was more common than hyperthyroidism (42.1 vs. 22.8% in affected females, P &lt; 0.001). For GD (P &lt; 0.001) and HT (P &lt; 0.05), a FH was more common in maternal than paternal relatives. The reporting of a parent with thyroid dysfunction (hyper or hypo) was associated with lower median age at diagnosis of both GD (mother with hyperthyroidism, P &lt; 0.001) and HT (father with hypothyroidism, P &lt; 0.05). In GD and HT, there was an inverse relationship between the number of relatives with thyroid dysfunction and age at diagnosis (P &lt; 0.01).
Conclusions: Marked associations among age at diagnosis, disease severity, goiter, ophthalmopathy, smoking, and FH provide evidence for interactions between genetic and environmental/endogenous factors; understanding these may allow preventive measures or better tailoring of therapies.