PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “data commons”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources

Comparison of bootstrap approaches for estimation of uncertainties of DTI parameters.

Bootstrap is an empirical non-parametric statistical technique based on data resampling that has been used to quantify uncertainties of diffusion tensor MRI (DTI) parameters, useful in tractography and in assessing DTI methods. The current bootstrap method (repetition bootstrap) used for DTI analysis performs resampling within the data sharing common diffusion gradients, requiring multiple acquisitions for each diffusion gradient. Recently, wild bootstrap was proposed that can be applied without multiple acquisitions. In this paper, two new approaches are introduced called residual bootstrap and repetition bootknife. We show that repetition bootknife corrects for the large bias present in the repetition bootstrap method and, therefore, better estimates the standard errors. Like wild bootstrap, residual bootstrap is applicable to single acquisition scheme, and both are based on regression residuals (called model-based resampling). Residual bootstrap is based on the assumption that non-constant variance of measured diffusion-attenuated signals can be modeled, which is actually the assumption behind the widely used weighted least squares solution of diffusion tensor. The performances of these bootstrap approaches were compared in terms of bias, variance, and overall error of bootstrap-estimated standard error by Monte Carlo simulation. We demonstrate that residual bootstrap has smaller biases and overall errors, which enables estimation of uncertainties with higher accuracy. Understanding the properties of these bootstrap procedures will help us to choose the optimal approach for estimating uncertainties that can benefit hypothesis testing based on DTI parameters, probabilistic fiber tracking, and optimizing DTI methods.

Brain↗

Compensatory arterial enlargement is a common pathobiologic response in early atherosclerosis.

BACKGROUND: Human arteries are dynamic conduits that respond to different stimuli by remodeling their structure and size. Arterial dilatation has been shown to occur in moderate and advanced atherosclerosis in studies that evaluated only one artery, either coronary, carotid, or superficial femoral artery (SFA). The purpose of this study was to quantify and compare compensatory arterial enlargement throughout the peripheral vascular system in early atherosclerosis. METHODS: Seventy-two patients (40 male, 32 female, mean age 67 +/- 12 years) underwent transcutaneous B-mode ultrasound imaging during routine examinations. Thirty-nine carotid, 19 aorta, 19 iliac, 23 common femoral (CFA), 21 SFA, and 23 popliteal arteries were longitudinally imaged. Eight healthy volunteers (6 male, 2 female, mean age 27 +/- 2.2 years) had the same arteries evaluated (n = 48). Internal diameter (ID) and external diameter (ED) were measured in disease-free areas and in paired adjacent areas exhibiting increased intima-media thickening (IMT) and small atherosclerotic plaques. The percent change in ID, ED, IMT, and plaque thickness were calculated. RESULTS: There was no observed change in ID or ED in all arteries of the healthy volunteers. When compared with normal vessel segments, all arteries demonstrated a marked decrease in ID and increase in ED in areas of small, hemodynamically insignificant plaque. The aorta had a 6.00% +/- 1.92% increase in ED, which was significantly less than the percent increase in ED observed in carotid (8.14 +/- 4.5%. P = 0.05), CFA (9.73 +/- 3.54%, P = 0.0001), SFA (9.15 +/- 4.25%, P = 0.005), and popliteal arteries (9.67 +/- 4.34, P = 0.002). In all arteries there was a strong correlation between plaque thickness and percent change in ED with the best correlation observed in the popliteal artery (R2 = 0.823, P < 0.0001). IMT was significantly increased in all normal vessel segments of the patients when compared with the healthy volunteers (P < 0.001). CONCLUSION: All peripheral arteries dilate in response to intima-media thickening and early atherosclerotic plaque formation. This adaptive response occurs at the site of the lesion to preserve luminal area. The percent change in ED is strongly related to plaque thickness and is greatest in the more distal arteries.

Adult↗

Regional cerebral blood flow correlated with flashback intensity in patients with posttraumatic stress disorder.

BACKGROUND: Nuclear imaging studies have examined cerebral blood flow (rCBF) in subjects with posttraumatic stress disorder (PTSD) using symptom evocation paradigms. To date, no such studies have investigated rCBF as related to subjects' reports of flashback intensity. METHODS: Subjects with varying traumatic histories and longstanding PTSD were studied using [15O]-H2O positron emission tomography with an auditory script of their traumatic event. Eight subjects had three resting scans followed by their script and additional scans. Heart rate responses as well as the presence of flashbacks and their intensity were recorded. rCBF was correlated with flashback intensity in each subject's scan. Combined analysis of all subjects' data yielded common regions related to the flashback experience. RESULTS: rCBF correlated directly with flashback intensity in the brainstem, lingula, bilateral insula, right putamen and left hippocampal and perihippocampal, somatosensory and cerebellar regions. Inverse correlations with rCBF were found in bilateral dorsolateral prefrontal, right fusiform and right medial temporal cortices. CONCLUSIONS: This study correlated flashback intensity and rCBF in a group of patients with chronic PTSD suggesting involvement of brainstem, and areas associated with motor control, complex visual/spatial cues and memory.

Adult↗

The International Endogene Study: a collection of families for genetic research in endometriosis.

OBJECTIVE: The aim of the International Endogene Study is to discover genes that influence susceptibility to endometriosis. DESIGN: The study brings together two research groups based in Australia and the United Kingdom that independently have been collecting families for linkage analysis and candidate gene studies. Both groups used similar methods to recruit families, obtain clinical notes, assign disease status based on the operative records and available histology, and collect common clinical data including age at onset of symptoms, age at diagnosis, and symptoms experienced. SETTING: Recruitment has been mainly from Australia, the United Kingdom, and the United States. PATIENT(S): All affected participants have surgically confirmed disease. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical and epidemiological data. RESULT(S): To date, >1,100 families with affected sisters have been recruited, and >1,200 triads (affected women and both parents), for case-control studies. CONCLUSION(S): We have created the largest resource yet assembled of clinical data and DNA for linkage and association studies in endometriosis. The increase in power to detect susceptibility genes vindicates the decision to merge the two studies and demonstrates the value of large-scale international collaboration.

Australia↗

Hierarchical logistic regression models for clustered binary outcomes in studies of IVF-ET.

OBJECTIVE: To describe a hierarchical logistic regression model for clustered binary data, apply it to data from a study on the effect of hydrosalpinx on embryo implantation, and compare the results with analyses that do not account for clustering. DESIGN: Observational study. SETTING: Academic research environment. PATIENT(S): Women undergoing IVF-ET for tubal disease. MAIN OUTCOME MEASURE(S): Odds of per embryo implantation. RESULT(S): Although regression estimates are largely similar between the models, the hierarchical model properly reflects the added variation due to clustering. Standard errors are higher, confidence intervals are wider, and P values indicate fewer "statistically significant" effects. CONCLUSION(S): Ignoring important sources of variation in any analysis can lead to incorrect confidence intervals and P values. In studies of IVF-ET, where clustered data are common, unexplained heterogeneity can be substantial. In this setting, hierarchical logistic regression is an appropriate alternative to standard logistic regression.

Adult↗

Sexual function in patients treated for benign prostatic hyperplasia.

CONTEXT: What is the effect of different treatment options for benign prostatic hyperplasia (BPH) on sexual function or dysfunction? With increasing age, sexual dysfunction and BPH become more prevalent. Some treatments for BPH can affect sexual function. Different surgical treatments have different effects on sexual function depending on how much the internal involuntary sphincter is affected. The same is true for medical therapies, each class of drug having a unique affect on sexual function. STARTING POINT: In the past, many articles suggested a causal relation between BPH and sexual dysfunction. But a recent report by H Leliefeld and colleagues (BJU International 2002; 89: 208-13) confirms the idea that the relation is coincidental. Prospectively, these investigators examined patients at baseline and 9 months after various treatments for BPH with questionnaires on voiding symptoms, related complications, and sexual function. 84% of patients reported no change in sexual function. All treatments showed both improvement and deterioration in 3-14% and 0-16% of patients, respectively. As expected, age was the most important determinant of sexual function. In addition, the effect of severe irritative symptoms or the presence of urological comorbidity, such as bladder stones, increased the rate of sexual dysfunction. In this study, most patients underwent surgical therapy or watchful waiting while fewer had medical therapy. Too few patients had minimally invasive procedures to comment on their effect on sexual function. WHRE NEXT? Thus the relation between treatment of BPH (or watchful waiting) and sexual dysfunction is usually coincidental, unless symptoms become severe or complications (such as bladder stones or urinary retention) develop. More prospective studies are needed to assess the effect of BPH and its treatment on sexual function. Medical therapy is now more common than surgery in developed countries and treatment of BPH is commonly advocated for improvement in quality of life. Therefore any effects on sexual function become even more important. As minimally invasive surgical operations become more common, more data will be required for such interventions. The difficulty will be in keeping up with the rapidly evolving techniques of minimally invasive therapies.

Adult↗

High frequency (200 Hz) oscillations and firing patterns in the basolateral amygdala and dorsal endopiriform nucleus of the behaving rat.

The known repertoire of rhythms in the amygdala and paleocortex includes a range of oscillations from slow waves (<1 Hz) to fast gamma (40-100 Hz). In the present report, we show approximately 200 Hz oscillations in the basolateral nucleus of the amygdala (BL) and the adjacent dorsal endopiriform nucleus (EPN) of the behaving rat. Microwire techniques were applied for recording single units and field activity from these structures and EEG from the dorsal or temporal CA1 subfields of the hippocampus. Units from both EPN and BL exhibited similar irregular firing patterns with bursts. The mean firing rates in EPN were <1 Hz, whereas units in the BL fired in a range of <1-17 Hz. Neuronal activity in both BL and EPN was phase-locked with high-frequency field oscillations (HFO, approximately 200 Hz). Amygdaloid/EPN HFO displayed on average lower numbers of cycles and smaller amplitudes than hippocampal ripples. Neuronal firing and HFO in the BL and EPN were state dependent with a maximal occurrence during slow-wave sleep (SWS), being lower during waking and paradoxical sleep. Cross-correlation between hippocampal ripples and EPN or BL units and field HFO did not reveal any synchrony. These data suggest common principles of temporal coding in BL and EPN in certain behavioural states via short scale population synchrony though they convey signals of different modalities.

Amygdala↗

The marrow homing efficiency of murine hematopoietic stem cells remains constant during ontogeny.

OBJECTIVE: Several recent studies have established the potential clinical utility of hematopoietic stem cells (HSCs) not only for marrow rescue but also for regenerating diseased or damaged nonhematopoietic tissues. These findings have focused renewed interest in understanding the in vivo trafficking patterns of HSCs from different sources. Previous experiments have suggested that the half-life of HSCs in the circulation is short, although the actual proportion that return to the bone marrow (BM) following transplantation has not been previously quantitated. The present study was undertaken to measure this fraction and compare the values obtained for functionally defined HSCs from adult murine BM and day-14 fetal liver (FL). METHODS: The number of HSCs that could be recovered from the BM of lethally irradiated mice 24 hours after intravenous injection of Ly-5 congenic BM or FL cells was determined by limiting-dilution competitive repopulating unit (CRU) assays in secondary mice. RESULTS: The marrow seeding efficiency of both adult BM- and FL-CRU able to produce lymphoid and myeloid progeny for 5-26 weeks posttransplant was approximately 10%. FL-CRU generated clones that were approximately threefold larger than those produced by BM-CRU. Interestingly, clones produced by "homed" HSCs were approximately twofold smaller than those produced by freshly isolated HSCs. Differences were also seen in the proportions of lymphoid vs myeloid progeny generated by fresh and homed HSCs. CONCLUSIONS: These data suggest common mechanisms regulating the BM homing of long-term repopulating HSCs throughout ontogeny despite subtle differences in the size and composition of the clones they generate.

Animals↗

Rescue angioplasty after failed thrombolysis: technical and clinical outcomes in a large thrombolysis trial. GUSTO-1 Angiographic Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.

OBJECTIVES: We sought to assess the angiographic outcome, complication rates and clinical features of percutaneous transluminal coronary angioplasty (PTCA) after failed thrombolysis for acute myocardial infarction. BACKGROUND: "Rescue angioplasty" refers to mechanical reopening of an occluded infarct-related artery (IRA) after failed intravenous thrombolysis. Although the procedure is commonly performed, data describing its technical and clinical outcome are sparse. Early reports suggested that rescue PTCA is less often successful and produces more complications than primary PTCA. Other reports have described beneficial effects of successful rescue PTCA but adverse outcomes when PTCA is unsuccessful. METHODS: Using data from the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-1) angiographic substudy, we compared clinical and angiographic outcomes of 198 patients selected for a rescue PTCA attempt with those of 266 patients with failed thrombolysis but managed conservatively and, for reference, with those of 1,058 patients with successful thrombolysis. RESULTS: Patients offered rescue PTCA had more impaired left ventricular function than those in whom closed vessels were managed conservatively. Rescue successfully opened 88.4% of closed arteries, with 68% attaining Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow. The interventions did not increase catheterization laboratory or postprocedural complication rates. Multivariate analysis identified severe heart failure to be a determinant of a failed rescue attempt. Successful rescue PTCA resulted in superior left ventricular function and 30-day mortality outcomes, comparable to outcomes in patients with closed IRAs managed conservatively, but less favorable than in patients in whom thrombolytic therapy was initially successful. The mortality rate after a failed rescue attempt was 30.4%; however, five of the seven patients who died after failed rescue PTCA were in cardiogenic shock before the procedure. CONCLUSIONS: Rescue PTCA tends to be selected for patients with clinical predictors of a poor outcome. It is effective in restoring patency. Patients who die after a failed rescue attempt are often already in extremis before the angioplasty attempt.

Aged↗

The Women's Ischemia Syndrome Evaluation (WISE) study: protocol design, methodology and feasibility report.

OBJECTIVES: The Women's Ischemia Syndrome Evaluation (WISE) is a National Heart, Lung and Blood Institute-sponsored, four-center study designed to: 1) optimize symptom evaluation and diagnostic testing for ischemic heart disease; 2) explore mechanisms for symptoms and myocardial ischemia in the absence of epicardial coronary artery stenoses, and 3) evaluate the influence of reproductive hormones on symptoms and diagnostic test response. BACKGROUND: Accurate diagnosis of ischemic heart disease in women is a major challenge to physicians, and the role reproductive hormones play in this diagnostic uncertainty is unexplored. Moreover, the significance and pathophysiology of ischemia in the absence of significant epicardial coronary stenoses is unknown. METHODS: The WISE common core data include demographic and clinical data, symptom and psychosocial variables, coronary angiographic and ventriculographic data, brachial artery reactivity testing, resting/ambulatory electrocardiographic monitoring and a variety of blood determinations. Site-specific complementary methods include physiologic and functional cardiovascular assessments of myocardial perfusion and metabolism, ventriculography, endothelial vascular function and coronary angiography. Women are followed for at least 1 year to assess clinical events and symptom status. RESULTS: In Phase I (1996-1997), a pilot phase, 256 women were studied. These data indicate that the WISE protocol is safe and feasible for identifying symptomatic women with and without significant epicardial coronary artery stenoses. CONCLUSIONS: The WISE study will define contemporary diagnostic testing to evaluate women with suspected ischemic heart disease. Phase II (1997-1999) is ongoing and will study an additional 680 women, for a total WISE enrollment of 936 women. Phase III (2000) will include patient follow-up, data analysis and a National Institutes of Health WISE workshop.

Adult↗

A proposed method to estimate premorbid intelligence utilizing group achievement measures from school records.

Estimating premorbid cognitive functioning is an important part of any neuropsychological evaluation. This estimate is the benchmark against which current cognitive functioning is compared to establish the existence, degree, and rate of cognitive decline. Typically methods used to estimate premorbid cognitive functioning are based on; (1) demographic information, (2) combined current test performance with demographics, and (3) current reading (word recognition) ability. These approaches each have drawbacks including difficulty estimating premorbid abilities of people close to the extremes of intellectual functioning (i.e., estimating the premorbid ability of individuals in the gifted or borderline intellectual ranges). The current study reviewed the existing data comparing commonly used group administered achievement and college board tests with the Wechsler IQ tests. It is proposed that clinicians may predict premorbid cognitive functioning by applying the well-known predicted-difference method to estimate IQ from group administered achievement test scores. The correlations between group administered achievement and college board tests with the Wechsler IQ tests are reviewed and the descriptive statistics of selected group administered achievement and college board tests are presented.

Adolescent↗

Interactive ERP recording increases the amplitude of the endogenous P300 peak in schizophrenia.

The P300 is a long-latency cognitive event-related potential (ERP) elicited by the presentation of relevant target stimuli. Unfortunately, the standard ERP recording technique takes no account of the background EEG during stimulus presentation. However, a recently developed technique (interactive recording) controls for variability in the EEG by applying stimuli only when the background EEG is in a predetermined state. The use of the interactive technique has led to significant changes in the P300 amplitude in control studies. Since P300 amplitude data are commonly used in schizophrenia research, and have previously been associated with cognitive deficits in schizophrenia, we studied the effects of interactive recording in a schizophrenia population. The same ERP paradigm was implemented twice for each subject, using both standard ERP and the interactive recording techniques. There was a significant increase in the amplitude of the P300 peak with interactive recording, although no significant change in latency. The results indicate that the effect of background EEG may need to be taken into account when conducting general ERP-based studies in schizophrenia. The results also indicate that the method may be used to investigate the effects of EEG variation on ERP values and, by implication, on cognitive processes. In particular, the recognition of EEG states that lead to a higher amplitude ERP value may aid in the further development of EEG investigations of schizophrenia. A similar development is indicated between cognitive research in schizophrenia and the sub-second brain-states in which cognitive function may be reflected.

Adult↗

Blood supply to the oral and maxillofacial tissues following radiation therapy: a prospective ultrasonographic study.

In this prospective clinical study of the early radiation effects on blood supply to the mouth and face, 44 patients (31 men-13 women, mean age 63.4 yrs) with oral tumors underwent surgery and adjuvant postoperative radiotherapy with conventional fractionation (mean dose at the neck approximately equal to 50 Gy). Blood flow parameters 1 cm below the bifurcation of the common carotid artery (mean velocity time averaged, lumen diameter, resistivity index-RI) as well as perivascular reaction, were recorded on Color Doppler Imaging video tapes in a series of five consecutive examinations up to six months postirradiation. There were no statistically significant changes shown between the initial and follow-up examinations for any of the parameters investigated. There was no difference in blood flow between the ipsilateral (operated-irradiated) and contralateral side of the neck. Results did not seem to correlate with known vascular disease risk factors such as sex, arterial pressure, cholesterol levels, smoking and diabetes. After the effect of age was controlled, flow measurements remained statistically stable. Radiation dosage did not appear to influence carotid flow parameters. Perivascular reaction had the highest peak immediately postirradiation but regressed with time. This study suggests that therapeutic radiation of the neck at this dose level may not have important effects on the maxillofacial region blood supply for approximately eight months postoperatively; however, these patients should be closely evaluated for symptoms or signs of carotid artery lesions on a long-term basis.

Adenocarcinoma↗

Relative survival in elderly European cancer patients: evidence for health care inequalities. The EUROCARE Working Group.

This paper examines the survival of elderly European cancer patients, on the basis of the EUROCARE II results. Using Hakulinen and Abeywickrama's method, the relative survival rates at 1 and 5 years from diagnosis were computed by sex and quinquennial age group for the elderly (65-99 years old). Age-standardised rates for the whole elderly group were also calculated. The analysis covered: all malignancies combined, stomach, colon, rectum, pancreas, lung, melanoma, bladder, kidney and non-Hodgkin's lymphomas for both sexes; prostate and larynx for men; and breast, ovary, uterine cervix and corpus for women. Data relating to 701521 cancer patients came from 44 population-based cancer registries in 16 European countries. The relative risks of death (RRs) of older patients (65-99) with respect to middle-aged adults (55-64) were computed by sex and country, for all malignancies only. The most prominent finding was the decrease in survival rates with increasing age for almost all cancer sites. The age-curves of survival rates at 1 year from diagnosis usually had a steeper slope than those at 5 years, particularly in women. This suggests that disease stage at presentation plays an important role in determining survival, particularly in the elderly. Thus, all factors which influence timing diagnosis in the elderly and cause a delay in tumour detection, such as psycho-social factors, access to care, co-morbidities and other clinical features affecting performance status, are very important predictors of prognosis. Very large geographic variations in relative survival rates were found among European countries. The ordering of countries was similar for almost all cancer sites. Western and Central Europe generally had the best survival, followed by Northern countries and by Southern ones (the latter with survival around the European average: 39% in men, 47% in women). The UK had survival rates unexpectedly lower than rates of nearest nations, often below the European average. Eastern countries usually had the lowest rates. In the very elderly patients (over 85 years), an apparent rise in the survival rates was noted, particularly at 5 years from diagnosis and in men. This 'too good' survival is unlikely to be due to real better prognosis, but rather to a selection bias. Countries with this unusual rise are also those registering a high proportion of DCO cases (those cases retrieved by death certificate only) (around 10%) or DCO unavailable. Another 'natural' bias has also to be taken into account: in elderly patients with a very bad prognosis, who are often suffering from other serious co-morbid conditions, cancer diagnoses could be under-notified and not reach at all the data sources commonly monitored by cancer registries.

Age Factors↗

Magnetic resonance imaging using hyperpolarized 3He-Gas.

RATIONALE AND OBJECTIVES: Current imaging procedures of the lung concentrate on visualization of morphology. Computed tomography is the imaging method of choice for the majority of pulmonary diseases. Functional data are commonly obtained from arterial blood gas analysis, spirometry, and body plethysmography, which all suffer from lack of regional information. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) of the lung has been advanced recently by the use of hyperpolarized 3He as a new contrast mechanism. Four different image acquisition modes are performed during a typical patient study. RESULTS: 3He-MRI yields functional information about the lung with a high spatial and temporal resolution, avoiding the risks of ionizing radiation. The method is currently limited by high costs and restricted availability of the gas. CONCLUSION: In this article, the experience obtained at the University of Mainz, being Europe's most experienced center performing 3He-MRI in humans, is reviewed against the international background.

Contrast Media↗

Linking commercial burglaries by modus operandi: tests using regression and ROC analysis.

This paper uses statistical models to test directly the police practice of utilising modus operandi to link crimes to a common offender. Data from 86 solved commercial burglaries committed by 43 offenders are analysed using logistic regression analysis to identify behavioural features that reliably distinguish between linked and unlinked crime pairs. Receiver operating characteristic analysis is then used to assign each behavioural feature an overall level of predictive accuracy. The results indicate that certain features, in particular the distances between burglary locations, lead to high levels of predictive accuracy. This study therefore reveals some of the important consistencies in commercial burglary behaviour. These have theoretical value in helping to explain criminal activity. They also have practical value by providing the basis for a diagnostic tool that could be used in comparative case analysis.

Crime↗

Effective drug-allergy checking: methodological and operational issues.

Adverse drug events cause a large number of injuries, and adverse events caused by medications administered in the face of known allergies represent an important preventable cause of patient harm. Computerized systems can effectively prevent reactions due to known allergies, but building an effective allergy prevention feature is challenging and presents many interesting informatics issues that have both methodological and operational implications. In this paper, we present the experiences from one large delivery system in delivering allergy-related decision support, discuss some of the different approaches that we have used, and then propose a future approach. We also discuss the methodological, behavioral, and operational issues that have arisen which have a major impact on success. Key factors in drug-allergy checking include storing patient allergy data in a single common repository, representing allergy data using suitable terminologies and creating groups of allergies for inferencing purposes, being judicious about which allergy warnings to display, conveying the reaction that the patient has experienced when exposed to the drug to inform the provider of the importance of the warning, and perhaps most important, implementing strategies to optimize the likelihood that allergy information will be entered.

Database Management Systems↗