bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multisubunit DNA-Dependent RNA Polymerases from Vaccinia Virus and Other Nucleocytoplasmic Large-DNA Viruses: Impressions from the Age of Structure
Authors: Mirzakhanyan Yeva , Gershon Paul D. 
Published: July 2017

SUMMARY
The past 17 years have been marked by a revolution in our understanding of cellular multisubunit DNA-dependent RNA polymerases (MSDDRPs) at the structural level. A parallel development over the past 15 years has been the emerging story of the giant viruses, which encode MSDDRPs. Here we link the two in an attempt to understand the specialization of multisubunit RNA polymerases in the domain of life encompassing the large nucleocytoplasmic DNA viruses (NCLDV), a superclade that includes the giant viruses and the biochemically well-characterized poxvirus vaccinia virus. The first half of this review surveys the recently determined structural biology of cellular RNA polymerases for a microbiology readership. The second half discusses a reannotation of MSDDRP subunits from NCLDV families and the apparent specialization of these enzymes by virus family and by subunit with regard to subunit or domain loss, subunit dissociability, endogenous control of polymerase arrest, and the elimination/customization of regulatory interactions that would confer higher-order cellular control. Some themes are apparent in linking subunit function to structure in the viral world: as with cellular RNA polymerases I and III and unlike cellular RNA polymerase II, the viral enzymes seem to opt for speed and processivity and seem to have eliminated domains associated with higher-order regulation. The adoption/loss of viral RNA polymerase proofreading functions may have played a part in matching intrinsic mutability to genome size.
Accuracy of the ECG for differential diagnosis between hypertrophic cardiomyopathy and athlete’s heart: comparison between the European Society of Cardiology (2010) and International (2017) criteria
Authors: Zorzi Alessandro , Calore Chiara , Vio Riccardo , Pelliccia Antonio , Corrado Domenico 
Published: July 2017

BackgroundInterpretation of the athlete’s ECG is based on differentiation between benign ECG changes and potentially pathological abnormalities. The aim of the study was to compare the 2010 European Society of Cardiology (ESC) and the 2017 International criteria for differential diagnosis between hypertrophic cardiomyopathy (HCM) and athlete’s heart.MethodsThe study populations included 200 patients with HCM and 563 athletes grouped as follows: ‘group 1’, including normal ECG and isolated increase of QRS voltages, which are considered non-pathologic according to ESC and International criteria; ‘group 2’, including left atrial enlargement or left axis deviation in isolation and Q-waves with an amplitude ≥4 mm but <25% of the ensuing R-wave and a duration <0.04 s which are considered pathologic according to the ESC but not according to the International criteria; and ‘group 3’, including abnormalities which are considered pathologic according to ESC and International criteria.ResultsOverall, the 2010 ESC criteria showed a sensitivity of 95.5% and a specificity of 86.9%. Considering group 2 ECG changes as normal according to the International criteria led to a statistically significant (p<0.001) increase of specificity to 95.9%, associated with a non-significant (p=0.47) reduction of sensitivity to 93%. Among patients with HCM, there was a significant increase of maximal left ventricular wall thickness from group 1 to 3 (p=0.02).ConclusionsThe use of 2017 International criteria is associated with a substantial increase in specificity and a marginal decrease in sensitivity for differential diagnosis between HCM and athlete’s heart.
What outcomes are associated with developing and implementing co-produced interventions in acute healthcare settings? A rapid evidence synthesis
Authors: Clarke David , Jones Fiona , Harris Ruth , Robert Glenn 
Published: July 2017

BackgroundCo-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which they care most. However, little is known regarding the impact of co-production on patient, staff or organisational outcomes in these settings.AimsTo identify and appraise reported outcomes of co-production as an intervention to improve quality of services in acute healthcare settings.DesignRapid evidence synthesis.Data sourcesMedline, Cinahl, Web of Science, Embase, HMIC, Cochrane Database of Systematic Reviews, SCIE, Proquest Dissertation and Theses, EThOS, OpenGrey;CoDesign;The Design Journal;Design Issues.Study selectionStudies reporting patient, staff or organisational outcomes associated with using co-production in an acute healthcare setting.Findings712 titles and abstracts were screened; 24 papers underwent full-text review, and 11 papers were included in the evidence synthesis. One study was a feasibility randomised controlled trial, three were process evaluations and seven used descriptive qualitative approaches. Reported outcomes related to (a) the value of patient and staff involvement in co-production processes; (b) the generation of ideas for changes to processes, practices and clinical environments; and (c) tangible service changes and impacts on patient experiences. Only one study included cost analysis; none reported an economic evaluation. No studies assessed the sustainability of any changes made.ConclusionsDespite increasing interest in and advocacy for co-production, there is a lack of rigorous evaluation in acute healthcare settings. Future studies should evaluate clinical and service outcomes as well as the cost-effectiveness of co-production relative to other forms of quality improvement. Potentially broader impacts on the values and behaviours of participants should also be considered.
Absence of compensatory vasodilation with perfusion pressure challenge in exercise: evidence for and implications of the noncompensator phenotype
Authors: Bentley Robert F. , Walsh Jeremy J. , Drouin Patrick J. , Velickovic Aleksandra , Kitner Sarah J. , Fenuta Alyssa M. , Tschakovsky Michael E. 
Published: July 2017

Compromising oxygen delivery (O2D) during exercise requires compensatory vasodilatory and/or pressor responses to protect O2D:demand matching. The purpose of the study was to determine whether compensatory vasodilation is absent in some healthy young individuals in the face of a sudden reduction in exercising forearm perfusion pressure and whether this affects the exercise pressor response. Twenty-one healthy young men (21.6 ± 2.0 yr) completed rhythmic forearm exercise at a work rate equivalent to 70% of their own maximal exercise vasodilation. During steady-state exercise, the exercising arm was rapidly adjusted from below to above heart level, resulting in a reduction in forearm perfusion pressure of −30.7 ± 0.9 mmHg. Forearm blood flow (ml/min; brachial artery Doppler and echo ultrasound), mean arterial blood pressure (mmHg; finger photoplethysmography), and exercising forearm venous effluent (antecubital vein catheter) measurements revealed distinct compensatory vasodilatory differences. Thirteen individuals responded with compensatory vasodilation (509 ± 128 vs. 632 ± 136 ml·min−1·100 mmHg−1; P < 0.001), while eight individuals did not (663 ± 165 vs. 667 ± 167 ml·min−1·100 mmHg−1; P = 0.6). Compensatory pressor responses between groups were not different (5.5 ± 5.5 and 9.7 ± 9.5 mmHg; P = 0.2). Forearm blood flow, O2D, and oxygen consumption were all protected in compensators (all P > 0.05) but not in noncompensators, who therefore suffered compromises to exercise performance (6 ± 14 vs. −36 ± 29 N; P = 0.004). Phenotypic differences were not explained by potassium or nitric oxide bioavailability. In conclusion, both compensator and noncompensator vasodilator phenotype responses to a sudden compromise to exercising muscle blood flow are evident. Interindividual differences in the mechanisms governing O2D:demand matching should be considered as factors influencing exercise tolerance. NEW & NOTEWORTHY In healthy young individuals, compromising submaximally exercising muscle perfusion appears to evoke compensatory vasodilation to defend oxygen delivery. Here we report the absence of compensatory vasodilation in 8 of 21 such individuals, despite their vasodilatory capacity and increases in perfusion with increasing exercise intensity being indistinguishable from compensators. The absence of compensation impaired exercise tolerance. These findings suggest that interindividual differences in oxygen delivery:demand matching efficacy affect exercise tolerance and depend on the nature of a delivery:demand matching challenge.
Differential Event Rates and Independent Predictors of Long-Term Major Cardiovascular Events and Death in 5795 Patients With Unprotected Left Main Coronary Artery Disease Treated With Stents, Bypass Surgery, or Medication
Authors: Kang Se Hun , Ahn Jung-Min , Lee Cheol Hyun , Lee Pil Hyung , Kang Soo-Jin , Lee Seung-Whan , Kim Young-Hak , Lee Cheol Whan , Park Seong-Wook , Park Duk-Woo , Park Seung-Jung 
Published: July 2017

Background—
Identifying predictive factors for major cardiovascular events and death in patients with unprotected left main coronary artery disease is of great clinical value for risk stratification and possible guidance for tailored preventive strategies.

Methods and Results—

The Interventional Research Incorporation Society-Left MAIN Revascularization registry included 5795 patients with unprotected left main coronary artery disease (percutaneous coronary intervention, n=2850; coronary-artery bypass grafting, n=2337; medication alone, n=608). We analyzed the incidence and independent predictors of major adverse cardiac and cerebrovascular events (MACCE; a composite of death, MI, stroke, or repeat revascularization) and all-cause mortality in each treatment stratum. During follow-up (median, 4.3 years), the rates of MACCE and death were substantially higher in the medical group than in the percutaneous coronary intervention and coronary-artery bypass grafting groups (
P
<0.001). In the percutaneous coronary intervention group, the 3 strongest predictors for MACCE were chronic renal failure, old age (≥65 years), and previous heart failure; those for all-cause mortality were chronic renal failure, old age, and low ejection fraction. In the coronary-artery bypass grafting group, old age, chronic renal failure, and low ejection fraction were the 3 strongest predictors of MACCE and death. In the medication group, old age, low ejection fraction, and diabetes mellitus were the 3 strongest predictors of MACCE and death.

Conclusions—
Among patients with unprotected left main coronary artery disease, the key clinical predictors for MACCE and death were generally similar regardless of index treatment. This study provides effect estimates for clinically relevant predictors of long-term clinical outcomes in real-world left main coronary artery patients, providing possible guidance for tailored preventive strategies.

Clinical Trial Registration—

URL:
https://clinicaltrials.gov
. Unique identifier: NCT01341327.
A Conceptual Model of a Shallow Circulation Induced by Prescribed Low-Level Radiative Cooling
Authors: Naumann Ann Kristin , Stevens Bjorn , Hohenegger Cathy , Mellado Juan Pedro 
Published: July 2017

Abstract
A conceptual bulk model for a dry, convective boundary layer with prescribed horizontally homogeneous and heterogeneous low-level radiative cooling rates is developed. For horizontally homogeneous radiative cooling, the response of the system to varying its prescribed parameters is explored and formulated in terms of nondimensional parameters. Large-eddy simulations with prescribed radiative cooling rates match the results of the bulk model well. It is found that, depending on the strength of the surface coupling, the height of the boundary layer (BL) either increases or decreases in response to increasing radiative BL cooling. Another property of the system is that, for increasing surface temperature, the BL temperature decreases if the prescribed radiative BL cooling rates are strong. This counterintuitive behavior is caused by the formulation of the entrainment rate at the inversion. Heterogeneous radiative BL cooling is found to cause a circulation induced by pressure deviations between the area of weak radiative BL cooling and the area of strong radiative BL cooling. Including the feedback of the induced circulation on the BL in a two-column model leads to a modified equilibrium state, in which a weakened horizontal BL flow of about 1 m s−1 is maintained for differences in radiative BL cooling rates larger than 1 K day−1. Such a circulation strength is comparable to a shallow circulation caused by surface temperature differences of a few kelvins. Spatial differences in radiative BL cooling should therefore be considered as a first-order effect for the formation of shallow circulations.
Eddies Observed by Argo Floats. Part II: Form Stress and Streamline Length in the Southern Ocean
Authors: Katsumata Katsuro 
Published: July 2017

AbstractArgo floats measure horizontal current velocities at the parking depth and vertical profiles of temperature and salinity. These data were used to study the roles that eddies play in the dynamics of the Antarctic Circumpolar Current (ACC) in the Southern Ocean. A zonal momentum budget was quantified in a box spanning the latitudes of the Drake Passage and bounded by the sea surface and the 1000-dbar depth. The input of eastward zonal momentum from the wind (17.1 × 1011 N) was approximately twice the downward transfer of eastward momentum across the isopycnal whose mean depth was 1000 dbar, which was mediated via form stress carried by eddies [(8.1 ± 1.9) × 1011 N]. The zonal momentum budget was closed to within uncertainty, meaning that the momentum not accounted for by eddies was explained by the Coriolis term associated with meridional transport. The form stress was spatially concentrated near meridional ridges, particularly on their eastern flanks. The localization was extreme: 7% of the total area contributed about 90% of the form stress. Lengths of streamlines were stretched around steady standing meanders. Seven major meanders were found at large topographic barriers along the ACC, with cyclonic meander collocated with the peaks of the topographic barriers. Eddies were found to lengthen the streamlines mostly on the eastern flanks of the meridional ridges, where the eddy transport was southward. Poleward eddy transport on the eastern flanks of meridional ridges is thus highlighted in the ACC dynamics in transferring eastward zonal momentum downward and in adjusting to wind changes by stretching streamlines.
Long‐Term Follow‐Up of Cartilaginous Tumors of the Larynx
Authors: Thomé Robert , Thomé Daniela Curti , De La Cortina Rodrigo A. C. 
Published: July 2017

BACKGROUND:Cartilaginous tumors of the larynx are uncommon. A literature review disclosed approximately 250 cases since 1816; the cricoid cartilage is the most common site. The rarity of these tumors has made for limited experience and, as a consequence, our knowledge is incomplete.OBJECTIVE:To report surgical results as well as long‐term follow‐up on 6 patients with cartilaginous tumors of the larynx.DESIGN:A 28‐year retrospective study with the patients followed‐up from 6 to 28 years (average, 17.8 years).METHODS:Six adult white male patients with cartilaginous tumors of the larynx: 4 low‐grade chondrosarcoma (1 of the thyroid and 3 of the cricoid) and 2 chondroma of the cricoid. Surgical treatment included total laryngectomy of the thyroid and 1 of the cricoid chondrosarcoma, and conservation surgery of the other 4 cricoid tumors: the 2 patients with chondrosarcoma had total resection of the cricoid cartilage with thyrotracheal anastomosis, and the 2 patients with chondroma had local tumor resection using a laryngofissure approach.RESULTS:The margins of the specimen were negative for tumor in the 6 patients. On follow‐up, none of the patients had regional or distant metastasis or tumor‐related death. One of the patients with cricoid chondrosarcoma developed recurrence 8 years after conservation surgery, and required a total laryngectomy for salvage. Survival rate rumor‐free at S years was 100% and at 10 years 67%, co‐morbidity being responsible for the decrease in survival rate.CONCLUSIONS:Based on this small series of patients, the long‐term follow‐up of benign and low‐grade malignant tumors suggests that the surgical approach and prognosis does not depend on histologic distinction and, importantly, underdiagnosed malignancy on tumor sampling and recurrent chondrosarcoma, managed with salvage surgery, have no adverse impact on patient survival. Total resection of the cricoid cartilage with thyrotracheal anastomosis over a stent proved an alternative surgical technique in chondrosarcoma who otherwise would have been treated by total laryngectomy.
Pentoxifylline Effects on Acute and Late Complications after Radiotherapy in Rabbit
Authors: Aygenc Erdinc , Celikkanat Serdar , Bilgili Hasan , Aksaray Ferdi , Orhun Sibel , Kaymakci Mustafa , Ozdem Cafer 
Published: July 2017

Soft tissue damages after radiotherapy are an uncommon but serious complication. Late damage after radiation is the principal dose‐limiting factor in radiation therapy today and is dependent on vascular pathology as a result of radiation. Pentoxifylline is a methylxanthine derivative that produces dose‐related improvement in blood flow, lower blood viscosity, improved erythrocyte flexibility, and increased tissue oxygen levels. An agent that increases blood flow and tissue oxygen content may contribute to enhanced healing of soft tissue pathology. Sixteen adult New Zealand rabbits were separated into 2 groups and inspected for 30 weeks after radiation. We noted acute and chronic reactions and pathologic changes in different regions of the head and neck of rabbits. The prophylactic administration of pentoxifylline in the postirradiation period can reduce late soft tissue pathology, but it does not affect acute radiation reactions.
Retrolabyrinthine Vestibular Neurectomy with Simultaneous Monitoring of Eighth Nerve and Brain Stem Auditory Evoked Potentials
Authors: Silverstein Herbert , McDaniel Alan , Wazen Jack , Norrell Horace 
Published: July 2017

We have used retrolabyrinthine vestibular neurectomy In 36 of 49 cases as the primary surgical procedure to relieve vertigo. Most of the patients (46 of 49) had Meniere's disease. Results indicate that 71% (35 of 49) of the patients had no vertigo after the operation, while 22% (11 of 49) had much Improvement. Hearing was maintained within 20 dB of the preoperative level in 78% (38 of 49) of the patients. During surgery in the last 23 patients, direct nerve potentials were recorded from the middle ear promontory and the intracranial cochlear nerve. Brain stem auditory evoked responses were simultaneously recorded in the last 10 patients. It appears that the intraoperative direct cochlear nerve potentials can be used as a sensitive monitor of trauma to the cochlear nerve during and after vestibular neurectomy. If the latency of the eighth nerve action potential changes less than 0.3 msec and the waveform does not change after vestibular neurectomy, there is an excellent chance that hearing at 1 month after surgery will be within 15 dB of the level before surgery. The retrolabyrinthine vestibular neurectomy has replaced the middle fossa vestibular neurectomy and the endolymphatic subarachnoid shunt procedure in our clinic.
Intraoperative Electrocochleography during Endolymphatic Sac Surgery: Clinical Results
Authors: Bojrab Dennis I. , Bhansali Sanjay A. , Andreozzi Mark P. 
Published: July 2017

Thirty‐eight patients who underwent endolymphatic shunt surgery with intraoperative electrocochleography were questioned regarding control of symptoms. The average follow‐up period was 2 years (range, 7 to 40 months). Sixteen (42%) patients showed improvement in the intraoperative electrocochleography potential, 12 (32%) showed worsening, and 10 (26%) showed no change. Complete or substantial control of dizziness was achieved in 36 (95%) patients, and insignificant control in only 2 (5%) patients. Hearing Improvement was noted in 4 (11%) patients, and hearing loss in 13 (34%). No correlation was found between intraoperative electrocochleography improvement and dizziness control. However, three of the four patients who had hearing improvement also had the greatest improvement in intraoperative electrocochleography recording. Intraoperative electrocochleography may help the surgeon more accurately identify the true endolymphatic sac and duct.
Effect of Anemia on Survival of Myocutaneous Flaps in the Pig
Authors: Kim Kun Z. , Thompson David H. , George Thomas F. , McQuillan Patrick M. , Kao Tzu‐Cheg 
Published: July 2017

The decision to transfuse patients after major head and neck reconstructive surgery has been influenced by the dictum that a hematocrit level of 30% or more is necessary for the survival of surgical flaps. Pedicled myocutaneous flaps are among the most frequently used methods of reconstruction after major head and neck oncologic surgery. No studies have addressed the survival of myocutaneous pedicied flaps in anemic animals. In this study survival of latissimus dorsi myocutaneous flaps in pigs was evaluated in anemic and control groups. A total of 26 pigs were randomly divided into two groups. The pigs in the anemic group were exsanguinated to normovolemic anemia (average hematocrit, 19%), followed by elevation of a latissimus dorsi myocutaneous flap. In the control group the same operation was performed without exsanguination. All other variables were kept constant. The flap survival was judged on postoperative3 days 7, and 14 by two evaluators. Ten pigs from each group were found to have 100% flap survival on postoperative day 14. There was no significant difference in mean flap survival rates between two groups for postoperative3 days 7, and 14. It is concluded that normovolemic anemia does not adversely affect the survival of the myocutaneous flaps. This finding may save unnecessary transfusions in postoperative patients.
Nasopharyngeal Radium Irradiation: Fundamental Considerations
Authors: Royal Henry D. 
Published: July 2017

This article discusses the potential carcinogenic effects of radiation exposure from nasopharyngeal radium irradiation exposure and issues to consider when deciding whether to recommend screening for asymptomatic patients who have been treated by nasopharyngeal radium irradiation. The radiation exposure from the radium is primarily the result of γ‐rays, which are very penetrating. β‐Particles would affect only the tissues located within 1 cm of the eustachian tube orifice. On the basis of a quantitative risk assessment, the lifetime risk of brain cancer developing was estimated to be approximately 3 per 1000 persons, and the lifetime risk of a fatal cancer 5.6 per 1000 persons. When the medical benefits of screening asymptomatic patients are assessed, several factors, including the medical risks and benefits and cost‐effectiveness of follow‐up, should be considered.