bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-based policy: What sort of evidence do governments need?
Authors: Nevile Ann 
Published: May 2013

AbstractVery few would dispute the proposition that evidence about the effects of different policy options should inform policy decisions. However, there is less agreement on the nature of the evidence needed. In addition, there may be problems in evaluating that evidence. This is particularly the case when experts offer conflicting advice. This article presents the position held by Professor Nevile that in giving policy advice to the government, it is almost always desirable to draw on a range of different policy instruments. While theoretical input is usually important, it is even more important that theory does not lose contact with the real world. Factual descriptions of the real world and the use of a theoretical toolkit containing more than one theory are essential in achieving this goal. These principles are illustrated by a discussion of a particular category of policy advice – the evaluation of government programmes.
Shared Decision Making for Clients With Mental Illness
Authors: Lukens Jonathan M. , Solomon Phyllis , Sorenson Susan B. 
Published: May 2013

Objective: The goal of this study was to test the degree to which client clinical characteristics and environmental context and social workers’ practice values and experience influenced support for client’s autonomy and willingness to engage in shared decision making (SDM), and whether willingness to engage in SDM was mediated by support for autonomy. Method: A randomized factorial survey of social workers working with adults with severe mental illness was employed. Eighty-seven social workers responded yielding 435 vignettes. Results: Hypotheses were partially supported. Diagnosis, symptomology, threats of harm, treatment adherence, substance use, and social workers’ values and experience predicted support for autonomy and willingness to engage in SDM. Willingness to engage in SDM was modestly mediated by support for autonomy. Conclusion: Helping social workers avoid bias in decision making is critical to the goal of supporting clients’ autonomy, building their capacity, minimizing disempowerment, and promoting recovery.
A Scholar-Practitioner Case Approach
Authors: Scully-Russ Ellen , Lehner Rachelle , Shuck Brad 
Published: May 2013

The Problem Though there is growing interest in the nature of scholarly practice in Human Resource Development (HRD) there is little understanding of how the everyday activities of HRD practitioners are mediated by HRD theories and research. The Solution This preface provides the framework for this special issue on HRD scholar-practitioners. Each article in this issue, with the exception of the final article by Lombardozzi, presents a real-world case on how HRD scholar-practitioners used HRD theory and research to navigate an intractable problem in their practice. This issue explores the wide and varying ways in which scholar-practitioners approach their work, how research and theory were both applied and extended in practice, and the implications for HRD theory, research, and practice. The Stakeholders HRD scholars, researchers, and practitioners who are members of the Academy of Human Resource Development (AHRD), as well managers, educators, and higher education administrators who have a stake in effective organizations may gain insight into the nature of HRD scholarly practice and the role of the HRD scholar-practitioner.
The association of diabetes complications with physical activity in a representative sample of older adults in the United States
Authors: Janevic Mary R , McLaughlin Sara J , Connell Cathleen M 
Published: May 2013

Objective Most adults with diabetes do not engage in the level of physical activity recommended for optimal disease management. Diabetes complications are not generally considered a clinical contraindication to exercise. No prior national studies have examined the associations of these complications with physical activity. Methods Data are from the 2003 Diabetes Supplement to the nationally representative US Health and Retirement Study ( n = 1811; age >50 years). Multiple logistic regression was used to examine the association between diabetes complications and the odds of meeting physical activity guidelines. Results Forty-three percent of the sample met physical activity guidelines. Adjusting for sociodemographic variables, retinopathy (odds ratios (OR) OR = 0.54, 95% confidence intervals (CI) = 0.36–0.81), nephropathy (OR = 0.70, 95% CI = 0.50–0.99), neuropathy (OR = 0.75, 95% CI = 0.59–0.95), and heart disease (OR = 0.69, 95% CI = 0.51–0.94) were all independently associated with reduced odds of meeting guidelines. A borderline significant association was observed for stroke. Discussion Adults with diabetes with complications of the eyes, kidneys, or nerves and those with heart disease are less likely to meet physical activity guidelines compared to those without these complications. These individuals may require additional support from health professionals to achieve recommended amounts of physical activity. More studies are needed to clarify the barriers and benefits to engaging in physical activity in the presence of diabetes complications.
Costs and outcome for serious hand and arm injuries during the first year after trauma – a prospective study
Authors: Rosberg Hans-Eric , Carlsson Katarina Steen , Cederlund Ragnhild I , Ramel Eva , Dahlin Lars B 
Published: May 2013

Abstract

Background
To study costs and outcome for serious hand and arm injuries during the first year after the trauma.

Methods
In patients with a Hand Injury Severity Score (HISS) > 50, DASH and EQ-5D scores as well as factors related to costs within the health care sector, costs due to lost production and total costs were evaluated. Cox-regression analysis stratifying for mechanism of injury was used to analyse return to work.

Results
The majority of the 45 included patients (median 42 years 16–64) were men with severe (n = 9) or major (n = 36) injuries with different type of injuries (amputations n = 13; complex injuries n = 18; major nerve injuries/full house n = 13; burn injury n = 1). DASH and EQ-5D decreased and increased, respectively, significantly over time during one year. Total costs (+34%) and costs of lost production were highest for persons injured at work. Factors associated with higher health care costs were age >50 years (+52%), injury at work (+40%) and partial labour market activity (+66%). Costs of lost production had a significant role in total costs of injury. Patients with major injuries had longer duration of sick leave. Patients with severe injuries were more likely to return to work [(RR 3.76 (95% CI 1.38-10.22) from Cox regression, controlling for age, gender and presence of nerve injury].

Conclusions
Despite the fact that work environments have constantly improved over the last decades, we found that hand injuries at work were most costly both in terms of health care and costs of lost production, although the severity, i.e. HISS, did not differ from injuries occurring at home or during leisure.
Optimization and validation of mitochondria-based functional assay as a useful tool to identify BH3-like molecules selectively targeting anti-apoptotic Bcl-2 proteins
Authors: Long Jianting , Liu Liu , Nikolovska-Coleska Zaneta , Shangary Sanjeev , Yi Han , Wang Shenming , Wang Shaomeng 
Published: May 2013

AbstractBackgroundMitochondrial outer membrane permeabilization (MOMP) is a crucial step leading to apoptotic destruction of cancer cells. Bcl-2 family proteins delicately regulate mitochondrial outer membrane integrity through protein-protein interactions, which makes the mitochondrion an ideal cell-free system for screening molecules targeting the Bcl-2 anti-apoptotic proteins. But assay conditions need to be optimized for more reliable results. In this study, we aimed at establishing a reliable functional assay using mitochondria isolated from breast cancer cells to decipher the mode of action of BH3 peptides derived from BH3-only proteins. In this study, high ionic strength buffer was adopted during the initiation of MOMP. Mitochondria isolated from human breast cancer cell lines with distinct expression patterns of Bcl-2 anti-apoptotic proteins were permeabilized by different BH3 peptides alone or in combination, with or without the presence of recombinant anti-apoptotic Bcl-2 family proteins. Cytochrome C and Smac/Diablo were tested in both supernatants and mitochondrial pellets by Western blotting.ResultsSufficient ionic strength was required for optimal release of Cytochrome C. Bad and Noxa BH3 peptides exhibited their bona fide antagonistic effects against Bcl-2/Bcl-xL and Mcl-1 proteins, respectively, whereas Bim BH3 peptide antagonized all three anti-apoptotic Bcl-2 members. Bad and Noxa peptides synergized with each other in the induction of MOMP when mitochondria were dually protected by both Bcl-2/Bcl-xL and Mcl-1.ConclusionsThis method based on MOMP is a useful screening tool for identifying BH3 mimetics with selective toxicity against breast cancer cell mitochondria protected by the three major Bcl-2 anti-apoptotic proteins.
Genome-scale metabolic network guided engineering of Streptomyces tsukubaensis for FK506 production improvement
Authors: Huang Di , Li Shanshan , Xia Menglei , Wen Jianping , Jia Xiaoqiang 
Published: May 2013

Abstract

Background
FK506 is an important immunosuppressant, which can be produced by Streptomyces tsukubaensis. However, the production capacity of the strain is very low. Hereby, a computational guided engineering approach was proposed in order to improve the intracellular precursor and cofactor availability of FK506 in S. tsukubaensis.

Results
First, a genome-scale metabolic model of S. tsukubaensis was constructed based on its annotated genome and biochemical information. Subsequently, several potential genetic targets (knockout or overexpression) that guaranteed an improved yield of FK506 were identified by the recently developed methodology. To validate the model predictions, each target gene was manipulated in the parent strain D852, respectively. All the engineered strains showed a higher FK506 production, compared with D852. Furthermore, the combined effect of the genetic modifications was evaluated. Results showed that the strain HT-ΔGDH-DAZ with gdhA-deletion and dahp-, accA2-, zwf2-overexpression enhanced FK506 concentration up to 398.9 mg/L, compared with 143.5 mg/L of the parent strain D852. Finally, fed-batch fermentations of HT-ΔGDH-DAZ were carried out, which led to the FK506 production of 435.9 mg/L, 1.47-fold higher than the parent strain D852 (158.7 mg/L).

Conclusions
Results confirmed that the promising targets led to an increase in FK506 titer. The present work is the first attempt to engineer the primary precursor pathways to improve FK506 production in S. tsukubaensis with genome-scale metabolic network guided metabolic engineering. The relationship between model prediction and experimental results demonstrates the rationality and validity of this approach for target identification. This strategy can also be applied to the improvement of other important secondary metabolites.
Thermodiffusion effects on magneto-nanofluid flow over a stretching sheet
Authors: Awad Faiz G , Sibanda Precious , Khidir Ahmed A 
Published: May 2013

Abstract
We study the effect of thermophoresis on boundary layer magneto-nanofluid flow over a stretching sheet. The model includes the effects of Brownian motion and cross-diffusion effects. The governing partial differential equations are transformed to a system of ordinary differential equations and solved numerically using a spectral linearisation method. The effects of the magnetic influence number, the Prandtl number, Lewis number, the Brownian motion parameter, thermophoresis parameter, the modified Dufour parameter and the Dufour-solutal Lewis number on the fluid properties as well as on the heat, regular and nano mass transfer coefficients are determined and shown graphically.
The clinical relevance of axillary reverse mapping (ARM): study protocol for a randomized controlled trial
Authors: Klompenhouwer Elisabeth G , Gobardhan Paul D , Beek Martinus A , Voogd Adri C , Luiten Ernest JT 
Published: May 2013

Abstract

Background
Axillary lymph node dissection (ALND) in patients with breast cancer has the potential to induce side-effects, including upper-limb lymphedema. Axillary reverse mapping (ARM) is a technique that enables discrimination of the lymphatic drainage of the breast from that of the upper limb in the axillary lymph node (LN) basin. If lymphedema is caused by removing these lymphatics and nodes in the upper limb, the possibility of identifying these lymphatics would enable surgeons to preserve them. The aim of this study is to determine the clinical relevance of selective axillary LN and lymphatic preservation by means of ARM. To minimize the risk of overlooking tumor-positive ARM nodes and the associated risk of undertreatment, we will only include patients with a tumor-positive sentinel lymph node (SLN). Patients who are candidates for ALND because of a proven positive axillary LN at clinical examination can be included in a registration study.

Methods/design
The study will enroll 280 patients diagnosed with SLN biopsy-proven metastasis of invasive breast cancer with an indication for a completion ALND. Patients will be randomized to undergo standard ALND or an ALND in which the ARM nodes and their corresponding lymphatics will be left in situ. Primary outcome is the presence of axillary surgery-related lymphedema at 6, 12, and 24 months post-operatively, measured by the water-displacement method. Secondary outcome measures include pain, paresthesia, numbness, and loss of shoulder mobility, quality of life, and axillary recurrence risk.

Discussion
The benefit of ALND in patients with a positive SLN is a subject of debate. For many patients, an ALND will remain the treatment of choice. This multicenter randomized trial will provide evidence of whether or not axillary LN preservation by means of ARM decreases the side-effects of an ALND. Enrolment of patients will start in April 2013 in five breast-cancer centers in the Netherlands, and is expected to conclude by April 2016.

Trial registration

TC3698
Drug-eluting stents or coronary artery bypass grafting for unprotected left main coronary artery disease: a meta-analysis of four randomized trials and seventeen observational studies
Authors: Li Qing , Zhang Zhi , Yin Rui-Xing 
Published: May 2013

Abstract

Background
The clinical application of drug-eluting stents (DES) or coronary artery bypass grafting (CABG) for unprotected left main coronary artery disease (ULMCAD) is still controversial. The purpose of this meta-analysis was to compare the safety and efficacy between DES and CABG for ULMCAD.

Methods
Databases of MEDLINE, EMBASE and the Cochrane Library were systematically searched.

Results
Twenty-one studies with 8,413 patients were included in this meta-analysis. The risk was lower in DES than in CABG groups at the early outcomes of death (risk ratio (RR): 0.49, 95% confidence interval (CI): 0.30–0.78), cerebrovascular events (RR: 0.19, 95% CI: 0.08–0.45) and composite endpoint (RR: 0.53, 95% CI: 0.40–0.70); death after 2 years (RR: 0.81, 95% CI: 0.66–0.99), 4 years (RR: 0.69, 95% CI: 0.53–0.90), 5 years (OR: 0.76, 95% CI: 0.61–0.95) and their total effect (RR: 0.79, 95% CI: 0.71–0.87); composite endpoint 1 year (RR: 0.69, 95% CI: 0.58–0.83), 4 years (RR: 0.69, 95% CI: 0.53–0.88), 5 years (RR: 0.74, 95% CI: 0.59–0.92) and their total effect (RR: 0.78, 95% CI: 0.71–0.85). There were no significant differences in the risk for the early outcomes of myocardial infarction (RR: 0.97, 95% CI: 0.68–1.38), death 1 year (OR: 0.81, 95% CI: 0.57–1.15) and 3 years (OR: 0.85, 95% CI: 0.69–1.04), composite endpoint of 2 years (RR: 0.88, 95% CI: 0.72–1.09) and 3 years (RR: 0.87, 95% CI: 0.73–1.04). Nonetheless, there was a lower risk for revascularization associated with CABG from 1 to 5 years and their total effect (RR: 3.77, 95% CI: 3.35–4.26). There was no difference in death, myocardial infarction, cerebrovascular events or revascularization at 1 year between RCT and observational groups.

Conclusions
Our meta-analysis indicates that DES has higher safety but higher revascularization than CABG in patients with ULMCAD in the 5 years after intervention.
Application of failure mode and effects analysis to treatment planning in scanned proton beam radiotherapy
Authors: Cantone Marie Claire , Ciocca Mario , Dionisi Francesco , Fossati Piero , Lorentini Stefano , Krengli Marco , Molinelli Silvia , Orecchia Roberto , Schwarz Marco , Veronese Ivan , Vitolo Viviana 
Published: May 2013

Abstract

Background
A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to the actively scanned proton beam radiotherapy process implemented at CNAO (Centro Nazionale di Adroterapia Oncologica), aiming at preventing accidental exposures to the patient.

Methods
FMEA was applied to the treatment planning stage and consisted of three steps: i) identification of the involved sub-processes; ii) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system, iii) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125.

Results
Thirty-four sub-processes were identified, twenty-two of them were judged to be potentially prone to one or more failure modes. A total of forty-four failure modes were recognized, 52% of them characterized by an RPN score equal to 80 or higher. The threshold of 125 for RPN was exceeded in five cases only. The most critical sub-process appeared related to the delineation and correction of artefacts in planning CT data. Failures associated to that sub-process were inaccurate delineation of the artefacts and incorrect proton stopping power assignment to body regions. Other significant failure modes consisted of an outdated representation of the patient anatomy, an improper selection of beam direction and of the physical beam model or dose calculation grid. The main effects of these failures were represented by wrong dose distribution (i.e. deviating from the planned one) delivered to the patient. Additional strategies for risk mitigation, easily and immediately applicable, consisted of a systematic information collection about any known implanted prosthesis directly from each patient and enforcing a short interval time between CT scan and treatment start. Moreover, (i) the investigation of dedicated CT image reconstruction algorithms, (ii) further evaluation of treatment plan robustness and (iii) implementation of independent methods for dose calculation (such as Monte Carlo simulations) may represent novel solutions to increase patient safety.

Conclusions
FMEA is a useful tool for prospective evaluation of patient safety in proton beam radiotherapy. The application of this method to the treatment planning stage lead to identify strategies for risk mitigation in addition to the safety measures already adopted in clinical practice.
Recent cancer incidence trends in an observational clinical cohort of HIV-infected patients in the US, 2000 to 2011
Authors: Yanik Elizabeth L , Tamburro Kristen , Eron Joseph J , Damania Blossom , Napravnik Sonia , Dittmer Dirk P 
Published: May 2013

Abstract

Background
In HIV-infected populations in developed countries, the most recent published cancer incidence trend analyses are only updated through 2008. We assessed changes in the distribution of cancer types and incidence trends among HIV-infected patients in North Carolina up until 2011.

Methods
We linked the University of North Carolina Center for AIDS Research HIV Clinical Cohort, an observational clinical cohort of 3141 HIV-infected patients, with the North Carolina Cancer registry. Cancer incidence rates were estimated across calendar years from 2000 to 2011. The distribution of cancer types was described. Incidence trends were assessed with linear regression.

Results
Across 15,022 person-years of follow-up, 202 cancers were identified (incidence rate per 100,000 person-years [IR]: 1345; 95% confidence interval [CI]: 1166, 1544). The majority of cancers were virus-related (61%), including Kaposi sarcoma (N = 32) (IR: 213; 95%CI: 146, 301), non-Hodgkin lymphoma (N = 34) (IR: 226; 95%CI: 157, 316), and anal cancer (N = 16) (IR: 107; 95%CI: 61, 173). Non-Hodgkin lymphoma was observed to decrease from 2000 to 2011 (decline of 15 cases per 100,000 person-years per calendar year, 95%CI: -27, -3). No other changes in incidence or changes in incidence trends were observed for other cancers (all P > 0.20).

Conclusions
We observed a substantial burden of a variety of cancers in this population in the last decade. Kaposi sarcoma and non-Hodgkin lymphoma were consistently two of the greatest contributors to cancer burden across calendar time. Cancer rates appeared stable across calendar years, except for non-Hodgkin lymphoma, which appeared to decrease throughout the study period.
Altered microRNA expression profile in amyotrophic lateral sclerosis: a role in the regulation of NFL mRNA levels
Authors: Campos-Melo Danae , Droppelmann Cristian A , He Zhongping , Volkening Kathryn , Strong Michael J 
Published: May 2013

Abstract

Background
Amyotrophic Lateral Sclerosis (ALS) is a progressive, adult onset, fatal neurodegenerative disease of motor neurons. There is emerging evidence that alterations in RNA metabolism may be critical in the pathogenesis of ALS. MicroRNAs (miRNAs) are small non-coding RNAs that are key determinants of mRNA stability. Considering that miRNAs are increasingly being recognized as having a role in a variety of neurodegenerative diseases, we decided to characterize the miRNA expression profile in spinal cord (SC) tissue in sporadic ALS (sALS) and controls. Furthermore, we performed functional analysis to identify a group of dysregulated miRNAs that could be responsible for the selective suppression of low molecular weight neurofilament (NFL) mRNA observed in ALS.

Results
Using TaqMan arrays we analyzed 664 miRNAs and found that a large number of miRNAs are differentially expressed in ventral lumbar SC in sALS compared to controls. We observed that the majority of dysregulated miRNAs are down-regulated in sALS SC tissues. Ingenuity Pathway Analysis (IPA) showed that dysregulated miRNAs are linked with nervous system function and cell death. We used two prediction algorithms to develop a panel of miRNAs that have recognition elements within the human NFL mRNA 3′UTR, and then we performed functional analysis for these miRNAs. Our results demonstrate that three miRNAs that are dysregulated in sALS (miR-146a*, miR-524-5p and miR-582-3p) are capable of interacting with NFL mRNA 3′UTR in a manner that is consistent with the suppressed steady state mRNA levels observed in spinal motor neurons in ALS.

Conclusions
The miRNA expression profile is broadly altered in the SC in sALS. Amongst these is a group of dysregulated miRNAs directly regulate the NFL mRNA 3′UTR, suggesting a role in the selective suppression of NFL mRNA in the ALS spinal motor neuron neurofilamentous aggregate formation.