bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graft Selection in Anterior Cruciate Ligament Reconstruction for Smoking Patients
Authors: Kim Sung-Jae , Lee Su-Keon , Choi Chong Hyuk , Kim Sung-Hwan , Kim Seong-Hun , Jung Min 
Published: October 2013

Background: There has been no previous study regarding graft selection in anterior cruciate ligament (ACL) reconstruction for smoking patients. Purpose: To compare the clinical outcomes of ACL reconstruction between smokers and nonsmokers and to find an optimal graft in ACL reconstruction with regard to clinical outcomes for smoking patients. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 487 patients who underwent unilateral ACL reconstruction were retrospectively reviewed. Included patients were divided into 2 groups according to their history of smoking. Group 1 was composed of patients who had never smoked (n = 322), and group 2 consisted of patients who had reported smoking before ACL reconstruction and during rehabilitation (n = 165). Additionally, each group was divided into 4 subgroups according to the selected graft type (bone–patellar tendon–bone autograft, hamstring [semitendinosus-gracilis] tendon autograft, quadriceps tendon–bone autograft, or Achilles tendon–bone allograft). Patients were assessed for knee instability with the Lachman and pivot-shift tests as well as anterior translation measured by the KT-2000 arthrometer. Functional outcomes were evaluated with the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, and IKDC objective grade. Results: The minimum follow-up period was 24 months. At the final follow-up evaluation, there were significant mean between-group differences regarding the side-to-side difference in anterior translation (group 1, 2.15 ± 1.11 mm; group 2, 2.88 ± 1.38 mm; P < .001), Lysholm knee score (group 1, 90.25 ± 6.18; group 2, 84.79 ± 6.67; P < .001), IKDC subjective score (group 1, 89.16 ± 5.01; group 2, 83.60 ± 7.48; P < .001), and IKDC objective grade (group 1, grade A = 151, B = 130, C = 36, D = 5 patients; group 2, grade A = 48, B = 71, C = 37, D = 9 patients; P < .001). With regard to differences in outcomes between the selected grafts within each group, the Achilles tendon–bone allograft showed the worst outcomes, with statistically significant mean differences for smoking patients in the side-to-side difference in anterior translation (3.59 ± 1.26 mm), Lysholm knee score (81.05 ± 2.82), and IKDC subjective score (79.73 ± 4.29). Conclusion: Unsatisfactory outcomes with regard to stability and functional scores were shown in the smoking group compared with the nonsmoking group. In smokers, the patients receiving an Achilles tendon–bone allograft had poorer outcomes than those with autografts. The bone–patellar tendon–bone autograft is recommendable for ACL reconstruction in a smoking patient.
Should pay-for-performance schemes be locally designed? evidence from the commissioning for quality and innovation (CQUIN) framework
Authors: Kristensen Søren Rud , McDonald Ruth , Sutton Matt 
Published: October 2013

Objectives It is increasingly recognized that the design characteristics of pay-for-performance schemes are important in determining their impact. One important but under-studied design aspect is the extent to which pay-for-performance schemes reflect local priorities. The English Department of Health White Paper High Quality Care for All introduced a Commissioning for Quality and Innovation (CQUIN) Framework from April 2009, under which local commissioners and providers were required to negotiate and implement an annual pay-for-performance scheme. In 2010/2011, these schemes covered 1.5% (£1.0bn) of NHS expenditure. Local design was intended to offer flexibility to local priorities and generate local enthusiasm, while retaining good design properties of focusing on outcomes and processes with a clear link to quality, using established indicators where possible, and covering three key domains of quality (safety; effectiveness; patient experience) and innovation. We assess the extent to which local design achieved these objectives. Methods Quantitative analysis of 337 locally negotiated CQUIN schemes in 2010/2011, along with qualitative analysis of 373 meetings (comprising 800 hours of observation) and 230 formal interviews (audio-recorded and transcribed verbatim) with NHS staff in 12 case study sites. Results The local development process was successful in identifying variation in local needs and priorities for quality improvement but the involvement of frontline clinical staff was insufficient to generate local enthusiasm around the schemes. The schemes did not in general live up to the requirements set by the Department of Health to ensure that local schemes addressed the original objectives for the CQUIN framework. Conclusions While there is clearly an important case for local strategic and clinical input into the design of pay-for-performance schemes, this should be kept separate from the technical design process, which involves defining indicators, agreeing thresholds, and setting prices. These tasks require expertise that is unlikely to exist in each locality. The CQUIN framework potentially offered an opportunity to learn how technical design influenced outcome but due to the high degree of local experimentation and little systematic collection of key variables, it is difficult to derive lessons from this unstructured experiment about the impact and importance of different technical design factors on the effectiveness of pay-for-performance. Balancing the policy goal of localism with the objective of improving patient outcomes leads us to conclude that a somewhat firmer national framework would be preferable to a fully locally designed framework.
Choosing health: qualitative evidence from the experiences of personal health budget holders
Authors: Davidson Jacqueline , Baxter Kate , Glendinning Caroline , Irvine Annie 
Published: October 2013

Objectives Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. Method Over 2000 people from 20 pilot sites were recruited to a multi-method evaluation of the personal health budget pilots. A sub-sample of 58 people was selected for qualitative interviews three months after the offer of a budget; 52 were re-interviewed six months later. The purposively selected sample reflected a range of health conditions, locality, age and gender. Results Personal health budgets were reported to have positive impacts on health, health care and relatives/family. Benefits often extended beyond the condition for which the budget had been awarded. However, interviewees rarely knew the level of their budget; some reported difficulty in agreeing acceptable uses for their budget; and delays could occur in procuring chosen services or equipment. Conclusion Patients’ experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.
Characterization of the heart transcriptome of the white shark (Carcharodon carcharias)
Authors: Richards Vincent P , Suzuki Haruo , Stanhope Michael J , Shivji Mahmood S 
Published: October 2013

Abstract

Background
The white shark (Carcharodon carcharias) is a globally distributed, apex predator possessing physical, physiological, and behavioral traits that have garnered it significant public attention. In addition to interest in the genetic basis of its form and function, as a representative of the oldest extant jawed vertebrate lineage, white sharks are also of conservation concern due to their small population size and threat from overfishing. Despite this, surprisingly little is known about the biology of white sharks, and genomic resources are unavailable. To address this deficit, we combined Roche-454 and Illumina sequencing technologies to characterize the first transciptome of any tissue for this species.

Results
From white shark heart cDNA we generated 665,399 Roche 454 reads (median length 387-bp) that were assembled into 141,626 contigs (mean length 503-bp). We also generated 78,566,588 Illumina reads, which we aligned to the 454 contigs producing 105,014 454/Illumina consensus sequences. To these, we added 3,432 non-singleton 454 contigs. By comparing these sequences to the UniProtKB/Swiss-Prot database we were able to annotate 21,019 translated open reading frames (ORFs) of ≥ 20 amino acids. Of these, 19,277 were additionally assigned Gene Ontology (GO) functional annotations. While acknowledging the limitations of our single tissue transcriptome, Fisher tests showed the white shark transcriptome to be significantly enriched for numerous metabolic GO terms compared to the zebra fish and human transcriptomes, with white shark showing more similarity to human than to zebra fish (i.e. fewer terms were significantly different). We also compared the transcriptome to other available elasmobranch sequences, for signatures of positive selection and identified several genes of putative adaptive significance on the white shark lineage. The white shark transcriptome also contained 8,404 microsatellites (dinucleotide, trinucleotide, or tetranucleotide motifs ≥ five perfect repeats). Detailed characterization of these microsatellites showed that ORFs with trinucleotide repeats, were significantly enriched for transcription regulatory roles and that trinucleotide frequency within ORFs was lower than for a wide range of taxonomic groups including other vertebrates.

Conclusion
The white shark heart transcriptome represents a valuable resource for future elasmobranch functional and comparative genomic studies, as well as for population and other biological studies vital for effective conservation of this globally vulnerable species.
Poly-L-glutamate/glutamine synthesis in the cell wall of Mycobacterium bovisis regulated in response to nitrogen availability
Authors: Tripathi Deeksha , Chandra Harish , Bhatnagar Rakesh 
Published: October 2013

Abstract

Background
The cell wall of pathogenic mycobacteria is known to possess poly-L-glutamine (PLG) layer. PLG synthesis has been directly linked to glutamine synthetase (GS) enzyme. glnA1 gene encodes for GS enzyme in mycobacteria. PLG layer is absent in cell wall of avirulent Mycobacterium smegmatis, although M. smegmatis strain expressing GS enzyme of pathogenic mycobacteria can synthesize PLG layer in the cell wall. The role of GS enzyme has been extensively studied in Mycobacterium tuberculosis, however, little is known about GS enzyme in other mycobacterial species. Mycobacterium bovis, as an intracellular pathogen encounters nitrogen stress inside macrophages, thus it has developed nitrogen assimilatory pathways to survive in adverse conditions. We have investigated the expression and activity of M. bovis GS in response to nitrogen availability and effect on synthesis of PLG layer in the cell wall. M. smegmatis was used as a model to study the behaviour of glnA1 locus of M. bovis.

Results
We observed that GS expression and activity decreased significantly in high nitrogen grown conditions. In high nitrogen conditions, the amount of PLG in cell wall was drastically reduced (below detectable limits) as compared to low nitrogen condition in M. bovis and in M. smegmatis strain complemented with M. bovis glnA1. Additionally, biofilm formation by M. smegmatis strain complemented with M. bovis glnA1 was increased than the wild type M. smegmatis strain.

Conclusions
The physiological regulation of GS in M. bovis was found to be similar to that reported in other mycobacteria but this data revealed that PLG synthesis in the cell wall of pathogenic mycobacteria occurs only in nitrogen limiting conditions and on the contrary high nitrogen conditions inhibit PLG synthesis. This indicates that PLG synthesis may be a form of nitrogen assimilatory pathway during ammonium starvation in virulent mycobacteria. Also, we have found that M. smegmatis complemented with M. bovis glnA1 was more efficient in biofilm formation than the wild type strain. This indicates that PLG layer favors biofilm formation. This study demonstrate that the nitrogen availability not only regulates GS expression and activity in M. bovis but also affects cell surface properties by modulating synthesis of PLG.
Trophic and proliferative effects of Shh on motor neurons in embryonic spinal cord culture from wildtype and G93A SOD1 mice
Authors: Ma Xiaoxing , Turnbull Patrick , Peterson Randy , Turnbull John 
Published: October 2013

Abstract

Background
The developmental morphogen sonic hedgehog (Shh) may continue to play a trophic role in the support of terminally-differentiated motor neurons, of potential relevance to motor neuron disease. In addition, it may support the proliferation and differentiation of endogenous stem cells along motor neuronal lineages. As such, we have examined the trophic and proliferative effects of Shh supplementation or Shh antagonism in embryonic spinal cord cell cultures derived from wildtype or G93A SOD1 mice, a mouse model of amyotrophic lateral sclerosis.

Results
Shh supported survival, and stimulated growth of motor neurons, neurite outgrowth, and neurosphere formation in primary culture derived from both G93A SOD1 and WT mice. Shh increased the percentage of ciliated motor neurons, especially in G93A SOD1 culture. Shh-treated cultures showed increased neuronal proliferation compared to controls and especially cyclopamine treated cultures, from G93A SOD1 and WT mice. Moreover, Shh enhanced cell survival and differentiation of motor neuron precursors in WT culture.

Conclusions
Shh is neurotrophic to motor neurons and has mitogenic effects in WT and mSOD1 G93A culture in vitro.
Cardiovascular screening in rheumatoid arthritis: a cross-sectional primary care database study
Authors: Monk Helen L , Muller Sara , Mallen Christian D , Hider Samantha L 
Published: October 2013

Abstract

Background
Patients with rheumatoid arthritis (RA) are known to be at increased risk of vascular disease. It is not known whether screening for vascular risk factors occurs in primary care. The aim of this study was to determine whether guidance advocating cardiovascular screening in RA patients is being implemented in primary care.

Methods
This study was undertaken in a UK primary care consultation database. All patients with a diagnosis of RA between 2000 and 2008, and still registered with the GP practice in 2009 were matched by age, gender and GP practice to three non-RA patients. Evidence of screening for five traditional vascular risk factors (blood pressure, lipids, glucose, weight, smoking) was compared in those with and without RA using logistic regression models. A comparison was also made with diabetes.

Results
401 RA patients were identified and matched to 1198 non-RA patients. No differences in the overall rates of screening were found (all five risk factors: RA 24.9% vs no RA 25.6%), but RA patients were more likely to have a smoking status recorded (67% versus 62%). In contrast, those with diabetes were up to 12 times as likely to receive vascular screening.

Conclusions
Despite the excess risk of vascular disease in patients with RA being of a similar magnitude to that seen in diabetes, patients with RA did not receive additional CVD screening in primary care, although this was achieved in patients with diabetes. More emphasis needs to be placed on ensuring those with RA are actively screened for cardiovascular disease in primary care.
Association of interleukin-33 gene single nucleotide polymorphisms with ischemic stroke in north Chinese population
Authors: Guo Liang , Zhou Xinghu , Guo Xiaofan , Zhang Xingang , Sun Yingxian 
Published: October 2013

Abstract

Background
IL-33, an IL-1-like cytokine, is a ligand for IL1RL1, which is an important effector molecule of type 2 T helper responses. Although IL-33/IL1RL1 interaction has been suggested to be important in the development of atherosclerosis, genetic influences of the polymorphisms of IL33 in human ischemic stroke are unclear. The aim of this study was to examine whether the single nucleotide polymorphisms in IL33 are associated with ischemic stroke in Northern Chinese population.

Methods
We used a nested case–control study involving 90 ischemic stroke patients and 270 age-matched, sex-matched and blood pressure-matched non-ischemic stroke controls from a rural population and determined the genotypes of four polymorphisms (rs1929992, rs10975519, rs4742170, rs16924159) in IL33 by Snapshot SNP genotyping assays to assess any links with ischemic stroke.

Results
Univariate analysis showed two single nucleotide polymorphisms (rs1929992, rs4742170) in IL33 were associated with ischemic stroke in additive, dominant, and recessive model. Binary Logistic Regression shows that rs4742170 variation is the most important factor associated with ischemic stroke (adjusted odds ratio (OR) = 1.880, 95% confidence interval (CI) = 1.316-2.686 in an additive model; OR = 2.091, CI = 1.249-3.498 in a dominant model; OR = 2.623, CI = 1.366-5.036 in a recessive model).

Conclusion
In this sample of patients, genetic variation of rs4742170 in IL33 is significantly associated with the developing of ischemic stroke.
Optimising the accuracy of blood pressure monitoring in chronic kidney disease: the utility of BpTRU
Authors: Brothwell Shona , Dutton Mary , Ferro Charles , Stringer Stephanie , Cockwell Paul 
Published: October 2013

Abstract

Background
Accurate blood pressure monitoring is critical for the management of chronic kidney disease, but changes in management in secondary care clinics may be based on a single blood pressure reading, with a subsequent lack of accuracy. The aim of this study was to evaluate a fully automated sphygmomanometer for optimising the accuracy of blood pressure measurements in the setting of secondary care renal clinics.

Methods
Patients had routine blood pressure measurements with a calibrated DINAMAP PRO400 monitor in a clinical assessment room. Patients then underwent repeat assessment with a DINAMAP PRO400 monitor and BpTRU device and subsequent 24 hour ambulatory blood pressure monitoring (ABPM).

Results
The BpTRU systolic (± SD) reading (117.3 ± 14.1 mmHg) was significantly lower than the routine clinic mean systolic blood pressure (143.8 ± 15.5 mmHg; P < 0.001) and the repeat blood pressure taken with a DINAMAP PRO400 monitor in a quiet room (129.9 ± 19.9 mmHg; P < 0.001). The routine clinic mean diastolic (82.4 ± 11.2 mmHg) was significantly higher than the BpTRU reading (78.4 ± 10.0 mmHg; P < 0.001). Clinic BpTRU measurements were not significantly different to the daytime mean or overall mean of 24 hour ABPM.

Conclusions
In patients with CKD, routine clinic blood pressure measurements were significantly higher than measurements using a BpTRU machine in a quiet room, but there was no significant difference in this setting between BpTRU readings and 24 hour ABPM. Adjusting clinic protocols to utilise the most accurate blood pressure technique available is a simple manoeuvre that could deliver major improvements in clinical practice.
Clinical instability of breast cancer markers is reflected in long-term in vitro estrogen deprivation studies
Authors: Milosevic Jelena , Klinge Johanna , Borg Anna-Lena , Foukakis Theodoros , Bergh Jonas , Tobin Nicholas P 
Published: October 2013

Abstract

Background
Long-term estrogen deprivation models are widely employed in an in vitro setting to recapitulate the hormonal milieu of breast cancer patients treated with endocrine therapy. Despite the wealth information we have garnered from these models thus far, a comprehensive time-course analysis of the estrogen (ER), progesterone (PR), and human epidermal growth factor 2 (HER-2/neu) receptors on the gene and protein level, coupled with expression array data is currently lacking. We aimed to address this knowledge gap in order to enhance our understanding of endocrine therapy resistance in breast cancer patients.

Methods
ER positive MCF7 and BT474 breast cancer cells were grown in estrogen depleted medium for 10 months with the ER negative MDA-MB-231 cell line employed as control. ER, PR and HER-2/neu expression were analysed at defined short and long-term time points by immunocytochemistry (ICC), and quantitative real-time RT-PCR (qRT-PCR). Microarray analysis was performed on representative samples.

Results
MCF7 cells cultured in estrogen depleted medium displayed decreasing expression of ER up to 8 weeks, which was then re-expressed at 10 months. PR was also down-regulated at early time points and remained so for the duration of the study. BT474 cells generally displayed no changes in ER during the first 8 weeks of deprivation, however its expression was significantly decreased at 10 months. PR expression was also down-regulated early in BT474 samples and was absent at later time points. Finally, microarray data revealed that genes and cell processes down-regulated in both cell lines at 6 weeks overlapped with those down-regulated in aromatase inhibitor treated breast cancer patients.

Conclusions
Our data demonstrate that expression of ER, PR, and cell metabolic/proliferative processes are unstable in response to long-term estrogen deprivation in breast cancer cell lines. These results mirror recent clinical findings and again emphasize the utility of LTED models in translational research.