bluuebunny/crossref_metadata_2025_split huggingface dataset:
What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review
Authors: Foy R , Eccles MP , Jamtvedt G , Young J , Grimshaw JM , Baker R 
Published: July 2005

Abstract

Background
Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care.

Methods
We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised.

Results
National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently.

Conclusion
Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward.
Inducible nitric oxide synthase links NF-κB to PGE2 in polyunsaturated fatty acid altered fibroblast in-vitro wound healing
Authors: Jia Yi , Turek John J 
Published: July 2005

AbstractBackgroundThis study investigated mechanisms of altered fibroblast collagen production induced by polyunsaturated fatty acids. 3T3-Swiss fibroblasts were grown in medium containing either eicosapentaenoic or arachidonic acid. The effects of nuclear factor-kappaB activation by lipopolysaccharide on inducible nitric oxide synthase, nitric oxide, prostaglandin E2, collagen production, andin-vitrowound healing were studied.ResultsEicosapentaenoic acid treated cells produced less prostaglandin E2but had increased inducible nitric oxide synthase expression, nitric oxide production, collagen formation, and recoverage area duringin-vitrowound healing than cells treated with arachidonic acid. Activation of nuclear factor-kappaB with lipopolysaccharide increased inducible nitric oxide synthase expression, the production of nitric oxide, prostaglandin E2, collagen, and thein-vitrowound recoverage area. The nitric oxide synthase inhibitor, NG-nitro-L-arginine methyl ester, decreased lipopolysaccharide-induced nitric oxide, but the amount of nitric oxide was greater in eicosapentaenoic acid treated cells. NG-nitro-L-arginine methyl ester plus lipopolysaccharide treatment increased collagen production and cellular recoverage area while treatment with NG-nitro-L-arginine methyl ester alone decreased it in wounded fibroblasts.ConclusionThe activation of the NF-κB pathway and PGE2can be linked by the cross-talk of iNOS and NO in the PUFA altered fibroblast collagen production and wound healing. Additional studies are needed to determine how polyunsaturated fatty acids can be used as adjuvants in combination with other treatments (i.e, drugs) to design therapies to either enhance healthy collagen production or inhibit production and reduce fibrosis.
Smart portable rehabilitation devices
Authors: Mavroidis Constantinos , Nikitczuk Jason , Weinberg Brian , Danaher Gil , Jensen Katherine , Pelletier Philip , Prugnarola Jennifer , Stuart Ryan , Arango Roberto , Leahey Matt , Pavone Robert , Provo Andrew , Yasevac Dan 
Published: July 2005

Abstract

Background
The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s).

Methods
In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device.

Results
Laboratory tests of the devices demonstrated that they were able to meet their design objectives. The prototypes of portable rehabilitation devices presented here did demonstrate that these concepts are capable of the performance their commercially available but non-portable counterparts exhibit.

Conclusion
Smart, portable devices with the ability for real time monitoring and adjustment open a new era in rehabilitation where the recovery process could be dramatically improved.
Engaging with holism in Australian Aboriginal health policy – a review
Authors: Lutschini Mark 
Published: July 2005

Abstract

Background
The ideal concept of Aboriginal holistic health is centrally placed in Australian Aboriginal health policies and strategies. Its effective uptake promises, as advocates suggest, reorienting the complex Australian health system to enable health improvements. However, continual reminders assail us that Aboriginal health is shocking, appalling, disastrous, disgraceful and damning. Could incapacity to engage effectively with the concept undermine health system improvements? The aim of this review of Australian literature was to identify the range of meanings attached to Aboriginal holistic health and engage with their implications for the health system.

Results
In terms of literature synthesis I found that policy makers cannot rely on this approach to provide coherent arguments for meaningful engagement with the concept because authors in general: are uncritical and un-reflexive in the use and interpretation of the concept; often provide no reference for their understandings; tend to alter the concept's definition and constituent elements without justification; ignore the wide range of mainstream literature about holism and health; and fail to acknowledge and examine the range of Aboriginal concepts of health. I used the ten themes from this literature to highlight implications for the health system, and found that a most profound contradiction exists in the acceptance of the English language concept 'holistic' as immutably Aboriginal. Additionally, a range of contradictions and mixed messages within the themes challenge the validity of the concept. Significantly, with the boundary of the concept constructed as diffuse and ethereal, the diverse and uncritical literature, and mixed thematic meanings, it is possible to justify any claim about the health system as holistic.

Conclusion
It seems not so much incapacity to engage, but incapacity to coherently articulate Aboriginal concepts of health, which prevents advisory bodies such as the National Indigenous Council to imbue whole-of-government approaches in accordance with Aboriginal values.
Association of ENPP1gene polymorphisms with hand osteoarthritis in a Chuvasha population
Authors: Suk Eun-Kyung , Malkin Ida , Dahm Stefan , Kalichman Leonid , Ruf Nico , Kobyliansky Eugene , Toliat Mohammad , Rutsch Frank , Nürnberg Peter , Livshits Gregory 
Published: July 2005

AbstractPeriarticular calcification is a common attendant symptom of generalized arterial calcification of infancy, a rare Mendelian disorder caused by mutations of the gene coding for ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1). This prompted us to perform a family-based association study to test the hypothesis that genetic variation at the ENPP1 locus is involved in the etiology of osteoarthritis of the hand. The study population comprised 126 nuclear families with 574 adult individuals living in small villages in the Chuvasha and Bashkirostan autonomies of the Russian Federation. The extent of osteoarthritis was determined by analyzing plain hand radiographs. The outcome of a principal component analysis of osteoarthritis scores of a total of 28 joints of both hands was used as a primary phenotype in this study. Maximum likelihood estimates of the variance component analysis revealed a substantial contribution of genetic factors to the overall trait variance of about 25% in this homogeneous population. Three short tandem repeat (STR) polymorphisms – one intragenic and two flanking markers – and four single-nucleotide polymorphisms were tested. The markers tagged the ENPP1 locus at nearly equal intervals. We used three different transmission disequilibrium tests and obtained highly significant association signals. Alleles of the upstream microsatellite marker as well as several single-nucleotide polymorphism haplotypes consistently revealed the association. Thus, our data highlights variability of ENPP1 as an important genetic factor in the pathogenesis of idiopathic osteoarthritis.
Microanatomy of the Intrachoroidal Vasculature of the Lateral Ventricle
Authors: Marinković Slobodan , Gibo Hirohiko , Milisavljević Milan , Djulejić Vuk , Jovanović Vladimir T. 
Published: July 2005

Abstract

OBJECTIVE:
Intraventricular surgery requires a detailed knowledge of the microanatomy of the choroid plexus vasculature.

METHODS:
Twenty choroid plexuses were microdissected, and two additional plexuses were prepared for microscopic examination.

RESULTS:
The choroid plexus was perfused primarily by the anterior choroidal artery (AChA) and the lateral posterior choroidal artery (LPChA). The AChA, which averaged 650 μm in diameter, most often (in 75% of cases) divided into the medial and lateral trunks, which averaged 450 μm in diameter. The medial trunk gave off the bush-like intrachoroidal branches, whereas the lateral trunk divided into the parallel arteries. The inferior LPChA was present in 50% of the hemispheres, both the inferior and superior LPChAs in 40%, and their common trunk in 10%. In 40%, the LPChA, which averaged 670 μm in diameter, divided into the terminal trunks, with a mean diameter of 490 μm. The anastomoses involving the trunks of the LPChA and other choroidal arteries averaged 310 μm in diameter. All primary intrachoroidal branches of the AChA and LPChA were divided into three groups. The parallel branches, which averaged from 220 to 230 μm in diameter, coursed along the lateral part of the choroid plexus. The tortuous glomus vessels, which averaged 310 μm in size, originated from the AChA (45%), the LPChA (15%), or both (40%). The bush-like vessels, with a mean diameter between 155 and 190 μm, ramified into smaller twigs, up to the intrachoroidal capillaries.

CONCLUSION:
The data obtained on the microanatomy of the intrachoroidal vasculature may have certain neurosurgical implications.
Localized Transcranial Electrical Motor Evoked Potentials for Monitoring Cranial Nerves in Cranial Base Surgery
Authors: Akagami Ryojo , Dong Charles C.J. , Westerberg Brian D. 
Published: July 2005

Abstract

OBJECTIVE:
To describe a novel monitoring technique that allows “functional” assessment of cranial nerve continuity during cranial base surgery.

METHODS:
Facial motor evoked potentials (MEP) in 71 consecutive patients were obtained by localized transcranial electrical stimulation in all patients requiring facial nerve monitoring during the period from November 2002 to August 2004. With transcranial electrical stimulation localized to the contralateral cortex, facial nerve MEPs are obtained through stimulation of more proximal intracranial structures.

RESULTS:
Logistic regression revealed that the final-to-baseline facial MEP ratio predicted satisfactory (House-Brackmann Grade 1 and 2 function) immediate postoperative facial function (0.005 &gt; P &gt; 0.0005). Contingency table analysis showed high correlation (χ2, P ≤ 2 × 108) and acceptable test characteristics using a 50% final-to-baseline MEP ratio.

CONCLUSION:
Facial nerve MEPs recorded intraoperatively during cranial base surgery using the proposed technique predicts immediate postoperative facial nerve outcome. This technique can also be used to monitor other motor cranial nerves in cranial base surgery.
Preserving Olfactory Function in Anterior Craniofacial Surgery through Cribriform Plate Osteotomy Applied in Selected Patients
Authors: Feiz-Erfan Iman , Han Patrick P. , Spetzler Robert F. , Horn Eric M. , Klopfenstein Jeffrey D. , Kim Louis J. , Porter Randall W. , Beals Stephen P. , Lettieri Salvatore C. , Joganic Edward F. 
Published: July 2005

AbstractOBJECTIVE:Olfaction is often sacrificed to gain access to the cranial base in anterior craniofacial surgery. We describe the long-term results of olfactory function in patients who underwent anterior craniofacial surgery and a cribriform plate osteotomy to preserve olfaction.METHODS:Between 1992 and 2004, 28 patients underwent 29 cribriform plate osteotomies in an attempt to preserve olfaction during anterior craniofacial surgery performed through modified extended transbasal approaches. Patients' charts and office notes were reviewed retrospectively. Formal olfactory testing was available in 5 patients, but most data were based on patients' subjective reports of olfaction. Olfactory preservation was defined by the subjective ability to detect fumes such as coffee, chocolate, roses, and orange juice regardless of the intensity of the sensation. Follow-up was based on phone calls to patients.RESULTS:Four patients were lost to follow-up and excluded. Therefore, follow-up was available in 24 patients after 25 procedures. On the basis of patients' subjective reports, olfaction was spared in 22 patients after 23 procedures (92%) and was confirmed objectively in the five patients formally tested. After surgery, only two patients were anosmic.CONCLUSION:Olfaction can be preserved in selected patients undergoing anterior craniofacial surgery. At least 1 cm of nasal mucosa should remain attached to the cribriform plate, which can be achieved by including the nasal bone in the osteotomy of the orbital bar. A medial orbital canthopexy is therefore necessary after these procedures.
MacCarty Keyhole and Inferior Orbital Fissure in Orbitozygomatic Craniotomy
Authors: Shimizu Satoru , Tanriover Necmettin , Rhoton Albert L. , Yoshioka Nobutaka , Fujii Kiyotaka 
Published: July 2005

Abstract

OBJECTIVE:
This study had two objectives. The first was to define the ideal position of the MacCarty keyhole, a commonly used craniotomy entry site into which three of the bone cuts in orbitozygomatic craniotomy extend. The second objective was to examine the relationships in the inferior orbital fissure, a site into which two of the bone cuts in orbitozygomatic craniotomy extend.

METHODS:
Twenty frontotemporal regions from adult skulls were examined to delineate the relationships between the surface anatomy of the fronto-orbitozygomatic region and the underlying frontal fossa and orbit. Drill holes placed along, above, and below the frontosphenoid suture were made beginning anteriorly at an area referred to as the three-suture junction, located at the junction of the frontozygomatic, sphenozygomatic, and frontosphenoid sutures. The site of the deep end of each hole was recorded to clarify the ideal position of the keyhole. The relationships in the inferior orbital fissure, the site of the lower end of the bone cut that begins in the orbital portion of the keyhole and extends along the lateral orbital wall, were also examined.

CONCLUSION:
Placing the MacCarty keyhole on the frontosphenoid suture 5 to 6 mm behind the three-suture junction results in greater preservation of the lateral wall and roof of the orbit than when the hole is placed at a more anterior site, as previously recommended. The anterolateral part of the inferior orbital fissure, which faces the temporal fossa and into which the bone cuts in the orbitozygomatic craniotomy extend, has a lower density of vascular and neural structures than the middle and posteromedial parts, which are related to the infratemporal and pterygopalatine fossa.
Contralateral Approaches to Multiple Cerebral Aneurysms
Authors: Clatterbuck Richard E. , Tamargo Rafael J. 
Published: July 2005

Abstract
NOT INFREQUENTLY, PATIENTS with bilateral cerebral aneurysms are encountered. In such patients, the ability to treat bilateral aneurysms through a unilateral approach spares the patient the risk and inconvenience associated with a separate craniotomy. The contralateral approach for aneurysm repair is technically feasible and safe in appropriately selected patients. Herein, we review our technique for maximizing contralateral exposure and clipping contralateral aneurysms through the four anatomic triangles that serve as corridors in this approach.
New Endoscope Shaft for Endoscopic Transsphenoidal Pituitary Surgery
Authors: van Lindert Erik J. , Grotenhuis J. André 
Published: July 2005

Abstract

OBJECTIVE:
To describe a new endoscope shaft developed for suction-aspiration during endoscopic transsphenoidal pituitary surgery.

METHODS:
A custom-made shaft for a Wolf endoscope (Richard Wolf GmbH, Knittlingen, Germany) was developed with a height of 10 mm and a width of 5 mm, allowing an additional working channel for the endoscope for flexible suction tubes with a diameter of up to 10-French.

RESULTS:
The new shaft was used in 30 consecutive endoscopic transsphenoidal procedures for pituitary adenomas. It allowed true bimanual manipulation without having to fixate the endoscope. Tumor removal was facilitated, technical problems were not encountered, and operation time was reduced. There were no instrumentation-related complications.

CONCLUSION:
The new shaft improves the ergonomics of endoscopic transsphenoidal pituitary surgery in cases in which the endoscope is handheld.
Aggressive Cranial Vault Decompression for Cranial Hyperostosis: Technical Case Report of Two Cases
Authors: Mocco J. , Komotar Ricardo J. , Zacharia Brad E. , Feldstein Neil A. , Bruce Jeffrey N. 
Published: July 2005

AbstractOBJECTIVE AND IMPORTANCE:Camurati-Engelmann's disease, also known as progressive diaphysial dysplasia, is a disorder of the bone metabolism. Neurological manifestations of progressive diaphysial dysplasia include cranial nerve dysfunction, generalized weakness, cerebellar herniation, and increased intracranial pressure. In the past, surgical intervention has been of limited and temporary benefit. We present two patients with cranial hyperostosis secondary to Camurati-Engelmann's disease who were treated successfully with a single surgery involving a combination of multiple craniotomies for cranial vault decompression.CLINICAL PRESENTATION:Two patients presented with signs and symptoms of increased intracranial pressure secondary to Camurati-Engelmann's syndrome. Radiological workup revealed marked cranial hyperostosis.INTERVENTION:The patients underwent aggressive cranial vault decompression. Multiple craniotomies were performed, and the inner table was then drilled down until the bone was 1 cm thick.CONCLUSION:Effective surgical options are needed for clinically significant cranial hyperostosis. In an effort to further define operative management in these patients, we describe a single, aggressive surgical procedure that may be used for successful cranial decompression.
Remote Cerebellar Hemorrhage after a Spinal Surgery Complicated by Dural Tear: Case Report and Literature Review
Authors: Karaeminogullari Oguz , Atalay Basar , Sahin Orcun , Ozalay Metin , Demirors Huseyin , Tuncay Cengiz , Ozen Ozlem , Tandogan Reha 
Published: July 2005

Abstract

OBJECTIVE AND IMPORTANCE:
This report presents a case in which cerebellar hemorrhage occurred after lumbar decompression surgery that was complicated by dural tear and prolonged cerebrospinal fluid leakage. Remote cerebellar hemorrhage after spinal surgery is extremely rare. Our objective is to describe this unusual complication, discuss the possible mechanisms of remote cerebellar hemorrhage, and review the literature.

CLINICAL PRESENTATION:
A 73-year-old woman underwent surgery for lumbar spinal stenosis. A dural tear occurred during decompression, and the patient developed remote cerebellar hemorrhage on postoperative Day 2.

INTERVENTION:
The cerebellar hemorrhage was treated surgically, and a biopsy of hemorrhagic brain parenchyma revealed an arteriovenous malformation.

CONCLUSION:
Although it is an extremely rare complication, remote cerebellar hemorrhage should be kept in mind as a possible complication of spinal surgery, especially in operations complicated by dural tears.
Volumetric Image Guidance for Motor Cortex Stimulation: Integration of Three-dimensional Cortical Anatomy and Functional Imaging
Authors: Gharabaghi Alireza , Hellwig Dieter , Rosahl Steffen Klaus , Shahidi Ramin , Schrader Christoph , Freund Hans-Joachim , Samii Madjid 
Published: July 2005

Abstract

OBJECTIVE:
Epidural electrical stimulation of the motor cortex is a promising treatment option in patients with intractable pain. Varying rates of success in long-term pain relief have been attributed to inaccurate positioning of the electrode array, partly because the sulcal landmarks are not directly visualized. We describe an integrated protocol for precise electrode placement, combining functional image guidance and intraoperative electrical stimulation in the awake patient.

METHODS:
Volumetric rendering of a three-dimensional (3-D) magnetic resonance data set was used to visualize the cortical surface and to superimpose functional magnetic resonance imaging data in six patients with refractory chronic pain. The intraoperative positioning of the quadripolar electrode array was monitored by functional 3-D image guidance. Continuous electrophysiological monitoring and clinical assessment of the motor effects complemented the procedure.

RESULTS:
Volumetrically rendered 3-D images were advantageous for the location of the burr hole over the perirolandic area by revealing individual cortical morphological features (e.g., the hand knob) and function at the same time. The exact position of the electrodes was verified reliably by cortical stimulation. No complications were observed throughout the procedures.

CONCLUSION:
The combination of 3-D functional neuronavigation, intraoperative electrical stimulation, and continuous motor output monitoring in awake patients provides optimal information for the identification of the appropriate somatotopic area of motor cortex. This combined imaging and stimulation approach for electrode positioning offers a safe and minimal invasive strategy for the treatment of intractable chronic pain in selected patients.