bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival analysis in advanced epithelial ovarian carcinoma in relation to proliferative index of MIB‐1 immunostaining
Authors: Kritpracha Krittaya , Hanprasertpong Jitti , Chandeying Verapol , Dechsukhum Chawaboon , Geater Alan 
Published: May 2005

AbstractAim: To evaluate the survival of patients with advanced epithelial ovarian carcinoma in relation to MIB‐1 immunostaining, to determine the association between MIB‐1 and clinicopathologic variables, and to identify an appropriate cut‐off point for MIB‐1 immunostaining as a prognostic marker.Methods: We retrospectively reviewed the medical records of women diagnosed with advanced epithelial ovarian carcinoma during 1987–1998. The paraffin‐embedded tissue of recruited women was stained with MIB‐1 immunostaining for review.Results: The records of 105 patients were included. The percentage staining of MIB‐1 ranged from 0.3 to 100%, with a median of 11.9%. MIB‐1 staining was generally higher in serous tumors than in other types (P = 0.048), but was not associated with other potential prognostic indicators. The 5‐year survival rate among advanced epithelial ovarian carcinoma patients was 25.7%, while that in the high MIB‐1 (greater than or equal to median) and low MIB‐1 (less than median) patients was 15.1% (95% confidence interval [CI] = 7.1–26.0) and 36.5% (95% CI = 23.8–49.4), respectively. Median survival times in the two groups were 1.8 years and 3.0 years, respectively (P < 0.008). Division of the MIB‐1 staining percentage into quartiles showed that the risk of death increased from the first to the second quartile (≥7.6 to <11.9%, hazard ratio = 2.36, 95% CI = 1.22–4.54) with no further increase in higher quartiles.Conclusion: Among patients with advanced epithelial ovarian carcinoma, MIB‐1 immunostaining was higher in serous than in other histologic types. Levels of MIB‐1 staining above the cut‐off point of 7.6% had significantly poorer survival.
Evaluation of glyceryl trinitrate, misoprostol, and prostaglandin E2 gel for preinduction cervical ripening in term pregnancy
Authors: Sharma Yuthika , Kumar Sunesh , Mittal Sunita , Misra Renu , Dadhwal Vatsla 
Published: May 2005

AbstractAim: To compare the efficacy of glyceryl trinitrate (GTN), dinoprostone and misoprostol for preinduction cervical ripening in primigravida at term.Methods: Sixty‐five term primigravida, each with an unfavorable cervix (Bishop score ≤5), were randomized to receive GTN (0.5 mg perivaginally, n = 21), dinoprostone gel (0.5 mg intracervically, n = 21) and misoprostol (50 µg perivaginally, n = 23) for a maximum of two doses, 6 h apart. Statistical analysis included paired t‐tests to compare pre‐ and post‐treatment Bishop scores, one‐way analysis of variance (anova) tests to compare quantitative variables and chi‐squared tests to compare the proportion of subjects achieving favorable Bishop scores.Results: Baseline Bishop scores were similar in the GTN (3.4 ± 0.9), dinoprostone (3.4 ± 1.0) and misoprostol groups (3.2 ± 1.2). The final outcome was favorable (Bishop score >6) in a greater proportion of subjects in the misoprostol (n = 18, 81.8%) and dinoprostone (n = 14, 66.7%) groups compared with the GTN group (n = 11, 55%). In subjects with a severely unfavorable cervix (Bishop score ≤3), treatment with misoprostol led to a favorable response in 61.6% of patients compared with 45.6% in the misoprostol group and 33.3% in the GTN group. A significant improvement was noted in the Bishop score of all three groups (P < 0.001) but the increase in Bishop score was greater in misoprostol (3.5 ± 2.1) and dinoprostone groups (2.8 ± 1.5), compared with the GTN group (2.0 ± 1.0, anovaF = 4.8, P = 0.01). Hyperstimulation and tachysystole were observed only in the misoprostol  (9%  and  4.3%)  and  dinoprostone  groups  (4.7%  and  16.2%).  The  most  common  adverse  effect  in  the GTN group was headache, which was observed in 47.6% of this group's subjects.Conclusion: The findings of the present study suggest that GTN is safer, but less efficacious, compared with prostaglandins for preinduction cervical ripening at term.
Safe techniques in surgery for hysteroscopic myomectomy
Authors: Murakami Takashi , Tamura Mitsutoshi , Ozawa Yuka , Suzuki Haruka , Terada Yukihiro , Okamura Kunihiro 
Published: May 2005

AbstractHysteroscopic myomectomy is regarded as the best treatment for patients with submucous myomata. However, this procedure has a number of associated complications, including uterine perforation, cervical laceration, hyponatremia and hemorrhage, especially in cases of sessile submucous myomata. To avoid these problems, it is important to make well‐advised preparations and manipulations both pre‐ and intraoperatively. The main surgical considerations for safe hysteroscopic myomectomy are shortening the operating time and avoiding cutting too deeply into the myometrium. With these requirements in mind, a combination of techniques using vaporization and a powerful oxytocic agent, such as prostaglandin F‐2α, appears to be the safest method of carrying out hysteroresectoscopy for unpedunculated sessile submucous myomata.
Tension‐free vaginal tape procedure with manual‐tapping method: A potentially useful technique
Authors: Matsuo Koji , Koyama Masayasu , Yoshida Susumu , Koyama Shinsuke , Tsutsui Tateki , Shimoya Koichiro , Kimura Tadashi , Murata Yuji 
Published: May 2005

AbstractAim: Stress urinary incontinence (SUI) is accompanied by pelvic organ prolapse (POP) in many cases. We investigate a procedure to adjust the level of suspension of the mid‐urethra using tension‐free vaginal tape (TVT) under general anesthesia at the time of POP repair surgery.Methods: Preliminary examination carried out prior to this study showed that the pressure stress applied by a surgeon is less than half of that induced using the cough‐stress method: the manual‐tapping method (MTM) showed an average intravesical urinary leak point pressure (IULPP) of 21.4 mmHg (range 19–23 mmHg), when the cough‐stress method demonstrated an average IULPP >52.4 mmHg (range 45–58 mmHg; n = 3). An attempt was made to predict postoperative SUI by packing sponge gauze into the manually replaced vagina preoperatively. If SUI appeared, TVT was added to the repair operation for POP in those patients (n = 11). Lastly, the MTM was used to decide the level of urethral suspension during the TVT procedure following POP repair surgery under general anesthesia (n = 11).Results: Eleven patients underwent the TVT procedure combined with POP repair surgery. The mean postoperative follow‐up period was 23.8 months (range 9–40 months). There was no case of post‐surgical ischuria. One patient showed a cystocele during the postoperative course. However, all other patients were relieved from the symptoms of POP, and none complained of SUI following the procedure.Conclusion: The MTM seems to be a more appropriate indicator by which to adjust the level of urethral suspension during the TVT procedure than the conventional method, particularly under general anesthesia. To prevent and cure perioperative SUI, the MTM as a TVT procedure combined with POP repair surgery under general anesthesia is a useful procedure.
Functional relationship between human rolandic oscillations and motor cortical excitability: an MEG study
Authors: Tamura Yohei , Hoshiyama Minoru , Nakata Hiroki , Hiroe Nobuo , Inui Koji , Kaneoke Yoshiki , Inoue Kiyoharu , Kakigi Ryusuke 
Published: May 2005

AbstractSynchronization and desynchronization of the neural rhythm in the brain play an important role in the orchestration of perception, motor action and conscious experience. Based on the results of electrocorticographic and magnetoencephalographic (MEG) recordings, it has been considered that human rolandic oscillations originate in the anterior bank of the central sulcus (20‐Hz rhythm) and the postcentral cortex (10‐Hz rhythm): the 20‐Hz oscillation is closely related to motor function, while the 10‐Hz rhythm is attributed mainly to sensory function. To test whether the rolandic oscillations are functionally relevant to the motor cortical excitability, we examined effects of 1‐Hz repetitive transcranial magnetic stimulation (rTMS) of the left primary motor cortex (M1) on movement‐related changes of the rolandic oscillations in 12 normal subjects. MEG data recorded during brisk extension of the right index finger in two different sessions (with and without rTMS conditioning) were compared. Motor‐evoked potential (MEP) of the right hand muscle was also measured before and after rTMS to assess the motor cortical excitability. We found that 1‐Hz rTMS over M1 significantly reduced the movement‐related rebound of the 20‐Hz oscillation in association with decreased motor cortical excitability. In particular, movement‐related rebound of the 20‐Hz rhythm was closely tied with motor cortical excitability. These findings further strengthen the notion of functional relevance of 20‐Hz cortical oscillation to motor cortical excitability. In the framework of previous studies, the decrease in movement‐related rebound may be regarded as a compensatory reaction to the inhibited cortical activity.
Anesthetic management of a 9‐year‐old child undergoing resection of a tracheal tumor
Authors: KAWARAGUCHI YOSHITAKA , TANIGUCHI AKIHIRO 
Published: May 2005

SummaryPrimary tracheal tumors in children are rare. We report the anesthetic management of a 9‐year‐old child undergoing resection of a midtracheal tumor obstructing approximately 73% of the tracheal lumen. To prepare for any possible airway emergency during the induction and maintenance of anesthesia, we ascertained preoperatively that a mini‐tracheotomy tube could be inserted at the distal portion of the tracheal lesion. Oxygenation and ventilation were adequately maintained throughout the period of anesthesia. Anesthetic management for tracheal tumor resection should reflect the location of the tumor and the degree of tracheal obstruction.
Geometric Representation of High Dimension, Low Sample Size Data
Authors: Hall Peter , Marron J. S. , Neeman Amnon 
Published: May 2005

SummaryHigh dimension, low sample size data are emerging in various areas of science. We find a common structure underlying many such data sets by using a non-standard type of asymptotics: the dimension tends to ∞ while the sample size is fixed. Our analysis shows a tendency for the data to lie deterministically at the vertices of a regular simplex. Essentially all the randomness in the data appears only as a random rotation of this simplex. This geometric representation is used to obtain several new statistical insights.
Making information easier for people with learning disabilities
Authors: Rodgers Jackie , Namaganda Syson 
Published: May 2005

Accessible summary

Researchers worked with people with learning disabilities to make guidance on how to make information easier. They looked at books and papers and talked to people who had worked at making information easier.
One of the most important things they found out was that everyone who makes information for people with learning disabilities should work with people with learning disabilities to do it.
Everyone needs to keep working to find better ways to make information easier. Information is important for people with learning disabilities to make changes that will make their lives better.

SummaryThis paper begins with a discussion of what we mean by easy information. It then describes the methods employed in a project to create guidance on making information easier for people with learning disabilities. Researchers and people with learning disabilities worked together to interview information providers about approaches they had used and to carry out a literature review. Draft guidance was written and tested with a range of groups and individuals. Key findings from the project were the necessity of a clear aim when planning information, the need to consider carefully the best format or media for sharing your message and most importantly, to work with your intended audience when creating information. The paper goes on to discuss the importance of making information appropriate for all sections of the community, including people from Black and minority ethnic groups.
The information needs and behaviour of clinical researchers: a user‐needs analysis
Authors: Korjonen‐Close Helena 
Published: May 2005

AbstractAims:  As part of the strategy to set up a new information service, including a physical Resource Centre, the analysis of information needs of clinical research professionals involved with clinical research and development in the UK and Europe was required. It also aimed to identify differences in requirements between the various roles of professionals and establish what information resources are currently used.Methods:  A user‐needs survey online of the members of The Institute. Group discussions with specialist subcommittees of members.Results:  Two hundred and ninety members responded to the online survey of 20 questions. This makes it a response rate of 7.9%. Members expressed a lack of information in their particular professional area, and lack the skills to retrieve and appraise information.Discussion:  The results of the survey are discussed in more detail, giving indications of what the information service should collect, what types of materials should be provided to members and what services should be on offer.Recommendation:  These were developed from the results of the needs analysis and submitted to management for approval. Issues of concern, such as financial constraint and staff constraints are also discussed.Conclusions:  There is an opportunity to build a unique collection of clinical research material, which will promote The Institute not only to members, but also to the wider health sector. Members stated that the most physical medical libraries don't provide what they need, but the main finding through the survey and discussions is that it's pointless to set up ‘yet another medical library’.
Undertaking an information‐needs analysis of the emergency‐care physician to inform the role of the clinical librarian: a Greek perspective
Authors: Lappa E. 
Published: May 2005

AbstractAim of study:  The primary focus of this pilot study was to gain a better understanding of the information needs of emergency‐care clinicians. The secondary focus was to compare the traditional current practice of information provision within other emergency departments in Greek hospitals, with the new model of clinical librarianship (CL).Rationale:  Clinical staff in the emergency department deal with a variety of cases, they have no time to visit the library, but need information instantly in their place of work. Clinical decision making in the emergency department setting frequently requires the clinician to obtain additional sources of information and clinical librarians may facilitate this.Study design:  The present study focused on two professional groups: medical librarians (group A) and clinicians (consultants, senior registrars, registrars, nurses (group B), working in the emergency departments of two Greek hospitals. The study was organized through a questionnaire survey and some in‐depth interviews.Results:  This study showed that, for 100% of the clinicians in daily practice, the main information needs arise while treating patients, and that information would help in making patient‐care decisions. Clinicians made little use of hospital libraries because they are usually under tremendous time pressure. The main outcome of the study was the use of a clinical librarian as an information provider. Clinical librarians supply information to assist decisions, based on this model. This extends the librarian's role in evidence‐based medicine, giving much stronger attention to the relevant evidence in clinical practice.Conclusions:  Nowadays, health services are facing organizational change. The introduction of new technology, and rapid growth of medical knowledge creates a demand for new ways of providing information. Clinical librarian programmes may deliver patients specific information in a timely manner. The mission of the clinical librarian is to facilitate access to quality information which is necessary for improving health, and to act as an informationist in the emergency department.
Information needs of specialist healthcare professionals: a preliminary study based on the West of Scotland Colorectal Cancer Managed Clinical Network
Authors: Thain Annette , Wales Ann 
Published: May 2005

AbstractObjectives:  Funded by Research in the Workplace Award (RIWA) 2001, the study investigated the information needs and use of NHS library services by members of the West of Scotland Colorectal Cancer Managed Clinical Network (MCN), a single subject, cross boundary, multi‐professional organization.Method:  A postal questionnaire sent out in October 2002 was returned by 100 members and follow‐up interviews were held in March 2003 with 11 of the respondents. The questions related to access to resources, library services such as literature searches, current awareness and training. They also explored the use of electronic resources and the Internet.Results:  Respondents were mainly hospital doctors and a few nurses from across five health boards. Most had access to a library, although not all made use of it, possibly an indication of the need for improved communications between librarians and health‐care staff. Generally, research and professional development were reported as reasons for needing cancer information, but on further investigation the motivation to conduct literature searches was more related to patient care. Examples included treatment of unusual cases, locating information for patients and identifying guidelines. There are indications of unmet needs for local contact information and evaluated patient information.Conclusion:  Development of a cancer portal within the NHS Scotland e‐Library available from May 2004 based on the Managed Knowledge Network (MKN) concept is attempting to address many of the issues raised in the survey, including inequities of access to services and signposting to a variety of types of information.
Managing knowledge to support the patient journey in NHS Scotland: strategic vision and practical reality
Authors: Wales Ann 
Published: May 2005

AbstractBackground:  The strategy for NHS Scotland Knowledge Services is set in the context of a global transition to a networked model of management within health services.Objectives:  Development planning for NHS Scotland aims to establish strategic vision and operational delivery systems which meet the needs of this changing health environment.Methods:  Analysis of knowledge needs at strategic organizational level and through consultation with healthcare staff form the basis of a vision of seamless knowledge support throughout all stages of the patient journey, based on a hybrid model of complementary human‐ and technology‐based knowledge networks.Results:  The central role of the NHS Scotland e‐library as a system‐wide technology infrastructure facilitating management of both explicit and tacit knowledge is described. The implementation pathway and approaches to evaluation are outlined, based on practical steps to translate the concept of knowledge networks into a working reality.Conclusions:  The model emerging is that of a knowledge matrix, with the primary delivery system comprising inter‐dependent human, organizational and technology‐based networks focused on the overriding common purpose of improving patient care.
Characteristics of Medical Practices in Three Developed Managed Care Markets
Authors: Landon Bruce E. , Normand Sharon‐Lise T. , Frank Richard , McNeil Barbara J. 
Published: May 2005

Objective. To describe physician practices, ranging from solo and two‐physician practices to large medical groups, in three geographically diverse parts of the country with strong managed care presences.Data Sources/Study Design. Surveys of medical practices in three managed care markets conducted in 2000–2001.Study Design. We administered questionnaires to all medical practices affiliated with two large health plans in Boston, MA, and Portland, OR, and to all practices providing primary care for cardiovascular disease patients admitted to five large hospitals in Minneapolis, MN. We offer data on how physician practices are structured under managed care in these geographically diverse regions of the country with a focus on the structural characteristics, financial arrangements, and care management strategies adopted by practices.Data Collection. A two‐staged survey consisting of an initial telephone survey that was undertaken using CATI (computerized assisted telephone interviewing) techniques followed by written modules triggered by specific responses to the telephone survey.Principal Findings. We interviewed 468 practices encompassing 668 distinct sites of care (overall response rate 72 percent). Practices had an average of 13.9 member physicians (range: 1–125). Most (80.1 percent) medium‐ (four to nine physicians) and large‐size (10 or more physicians) groups regularly scheduled meetings to discuss resource utilization and referrals. Almost 90 percent of the practices reported that these meetings occurred at least once per month. The predominant method for paying practices was via fee‐for‐service payments. Most other payments were in the form of capitation. Overall, 75 percent of physician practices compensated physicians based on productivity, but there was substantial variation related to practice size. Nonetheless, of the practices that did not use straight productivity methods (45 percent of medium‐sized practices and 54 percent of large practices), most used arrangements consisting of combinations of salary and productivity formulas.Conclusions. We found diversity in the characteristics and capabilities of medical practices in these three markets with high managed care involvement. Financial practices of most practices are geared towards rewarding productivity, and care management practices and capabilities such as electronic medical records remain underdeveloped.
Welfare Reform and Health Insurance of Immigrants
Authors: Kaushal Neeraj , Kaestner Robert 
Published: May 2005

Objective. To investigate the effect of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) on the health insurance coverage of foreign‐ and U.S.‐born families headed by low‐educated women.Data Source. Secondary data from the March series of the Current Population Surveys for 1994–2001.Study Design. Multivariate regression methods and a pre‐ and post‐test with comparison group research design (difference‐in‐differences) are used to estimate the effect of welfare reform on the health insurance coverage of low‐educated, foreign‐ and U.S.‐born unmarried women and their children. Heterogenous responses by states to create substitute Temporary Aid to Needy Families or Medicaid programs for newly arrived immigrants are used to investigate whether the estimated effect of PRWORA on newly arrived immigrants is related to the actual provisions of the law, or the result of fears engendered by the law.Principal Findings. PRWORA increased the proportion of uninsured among low‐educated, foreign‐born, unmarried women by 9.9–10.7 percentage points. In contrast, the effect of PRWORA on the health insurance coverage of similar U.S.‐born women is negligible. PRWORA also increased the proportion of uninsured among foreign‐born children living with low‐educated, single mothers by 13.5 percentage points. Again, the policy had little effect on the health insurance coverage of the children of U.S.‐born, low‐educated single mothers. There is some evidence that the fear and uncertainty engendered by the law had an effect on immigrant health insurance coverage.Conclusions. This research demonstrates that PRWORA adversely affected the health insurance of low‐educated, unmarried, immigrant women and their children. In the case of unmarried women, it may be partly because the jobs that they obtained in response to PRWORA were less likely to provide health insurance. The research also suggests that PRWORA may have engendered fear among immigrants and dampened their enrollment in safety net programs.