bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a Best‐Practice Perioperative Governance Structure to Implement Better Block Scheduling
Authors: Heiser Randy 
Published: December 2012

AbstractAchieving, developing, and maintaining a well‐functioning OR scheduling system requires a well‐designed perioperative governance structure. Traditional OR/surgery committees, consisting mainly of surgeons, have tried to provide this function but often have not succeeded. An OR governance model should be led by an OR executive committee that functions as a board of directors for the surgery program and works closely with the surgery department medical director and an OR advisory committee. Ideally, the OR executive committee should develop a block schedule that includes a mix of block, open, and urgent or emergent OR access, because this combination is most effective for improving OR use and adapting to changes in surgical procedure volume.
Hybrid OR 101: A Primer for the OR Nurse
Authors: Schaadt Jennifer , Landau Bruce 
Published: December 2012

AbstractA hybrid OR incorporates fixed imaging in a sterile OR setting. Because demand for procedures that can be performed in a hybrid OR is increasing, many institutions are considering or are in the process of building a hybrid OR. Currently, no standards exist relative to a hybrid OR's location, design, procedure volumes, patient types, staffing requirements, skill sets, or workflow. The unique technology and equipment inherent to a hybrid OR affects the OR workflow. The ability to successfully plan, design, and implement a hybrid OR program requires strategic vision and the cohesive efforts of a multidisciplinary team, of which the OR nurse is a key member.
Meta‐analysis of the effectiveness of cryotherapy in the treatment of cervical intraepithelial neoplasia
Authors: Sauvaget Catherine , Muwonge Richard , Sankaranarayanan Rengaswamy 
Published: December 2012

AbstractBackgroundCryotherapy can be used for the ablation of cervical intraepithelial neoplasia (CIN).ObjectivesTo provide an updated and comprehensive estimate of the efficacy of cryotherapy for CIN.Search strategyA literature search identified original studies (randomized controlled trials and clinical reports).Selection criteriaStudies reporting cure rates, acceptability, and safety of cryotherapy were included in the analysis.Data collection and analysisNumber of persistent or recurrent lesions at follow‐up, adverse events, and complications were recorded. Quality of the methodology was also assessed. Meta‐analyses were performed according to CIN thresholds, geographic region, study year, setting, study design, presence of endocervical involvement, freezing method, duration of follow‐up, and status of the cryotherapy provider.Main resultsA total of 146 articles were retrieved; 77 papers—equivalent to 28 827 cases of treated CIN—were included in the meta‐analysis. Cryotherapy achieved cure rates of 94.0% (CIN1), 92.0% (CIN2), and 85.0% (CIN3). Use of the double‐freeze method and absence of endocervical involvement significantly increased cure rates. Minimal complications were reported as adverse effects.ConclusionsCryotherapy is an effective, safe, and acceptable treatment for CIN. It has been shown to be successful in low‐resource settings, enabling availability and accessibility of early detection services.
Comparative accuracies of two common screening instruments for classification of Alzheimer's disease, mild cognitive impairment, and healthy aging
Authors: Roalf David R. , Moberg Paul J. , Xie Sharon X. , Wolk David A. , Moelter Stephen T. , Arnold Steven E. 
Published: December 2012

AbstractBackgroundThe aim of this study was to compare the utility and diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) and Mini‐Mental State Examination (MMSE) in the diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) in a clinical cohort.MethodsThree hundred twenty‐one AD, 126 MCI, and 140 older adults with healthy cognition (HC) were evaluated using the MMSE, the MoCA, a standardized neuropsychologic battery according to the Consortium to Establish a Registry of Alzheimer's Disease (CERAD‐NB), and an informant‐based measure of functional impairment, the Dementia Severity Rating Scale (DSRS). Diagnostic accuracy and optimal cut‐off scores were calculated for each measure, and a method for converting MoCA to MMSE scores is presented.ResultsThe MMSE and MoCA offer reasonably good diagnostic and classification accuracy as compared with the more detailed CERAD‐NB; however, as a brief cognitive screening measure, the MoCA was more sensitive and had higher classification accuracy for differentiating MCI from HC. Complementing the MMSE or the MoCA with the DSRS significantly improved diagnostic accuracy.ConclusionThe findings support recent data indicating that the MoCA is superior to the MMSE as a global assessment tool, particularly in discerning earlier stages of cognitive decline. In addition, we found that overall diagnostic accuracy improves when the MMSE or MoCA is combined with an informant‐based functional measure. Finally, we provide a reliable and easy conversion of MoCA to MMSE scores. However, the need for MCI‐specific measures is still needed to increase the diagnostic specificity between AD and MCI.
Neoadjuvant chemotherapy improves survival rate in advanced urothelial carcinoma
Authors: Tsai Chia‐Chun , Huang Chun‐Hsiung , Huang Chun‐Nung , Wu Wen‐Jeng , Yeh Hsin‐Chih , Li Wei‐Ming , Li Ching‐Chia , Lee Mei‐Hui 
Published: December 2012

AbstractRadical surgery (RS) with adjuvant chemotherapy (AC) or radiotherapy has been conventionally used for patients with advanced urothelial carcinoma (AUC). Recent research has indicated that systemic neoadjuvant chemotherapy (NC) with RS yields better outcomes than RS alone for patients with locally advanced bladder cancer. However, there are no reports indicating whether NC or AC would be beneficial for patients with AUC. The present study compared the survival rate for AUC patients receiving NC or AC. A retrospective analysis was conducted using data for 64 patients with AUC who underwent RS and systemic chemotherapy at our institution between March 2002 and March 2011. Of the 64 patients, 30 received NC before RS and 34 received RS followed by systemic AC. Pathologic stages (p = 0.002), grades (p = 0.018) and lymphovascular invasion (p = 0.047) were significantly lower in the patients who received NC first than in those who received RC first. Furthermore, analysis of the surgical specimens revealed that 26.7% of patients who received NC before RS had complete remission. There were no significant differences in demographic data, surgical complications, and chemotoxicity between the two patient groups. The progression‐free survival (PFS) and overall survival (OS) of patients who received initial NC were significantly better than those of patients who received initial RC (p = 0.002 and 0.018, respectively). Our results indicate that NC administration before RS significantly improved the PFS and OS of AUC patients, without increasing surgical complications and chemotoxicity. Further prospectively controlled trials need to be conducted to confirm the effectiveness of NC for AUC patients.
Relationship between low‐density lipoprotein levels on admission and 1‐year outcome in patients with acute ST‐segment‐elevation myocardial infarction
Authors: Sun Yu‐Jiao , Li Yu‐Ze , Jiang Da‐Ming , Zhang Bo , Gao Yuan , Zhang Zhi‐Hong , Qi Guo‐Xian 
Published: December 2012

AbstractThis study assessed the relationship between low‐density lipoprotein cholesterol (LDL‐C) levels on admission and the incidence of major adverse cardiovascular events (MACE) in patients with acute ST‐segment‐elevation myocardial infarction (ASTEMI). Patients with ASTEMI who had a lipid profile tested within 24 hours of symptom onset were enrolled. They were stratified into high and low LDL‐C groups according to whether their LDL‐C was above (n = 501) or below (n = 575) the median level, respectively. The incidence of MACE, cardiovascular death, non‐fatal MI, revascularization, and stroke was compared between the groups at 1 month, 6 months, and 1 year. Survival analysis and Cox proportional hazard analysis were performed. In‐hospital use of beta blockers was better in the high than in the low LDL‐C group (76.6% vs. 69.7%, p = 0.01). Statin use was significantly higher in the high than in the low LDL‐C group during follow‐up (86.8% vs. 80.0%, p = 0.003 at1 month; 71.6% vs. 62.4%, p = 0.002 at 6 months; 67.8% vs. 61.2%, p = 0.03 at 1 year). The incidence of MACE on follow‐up at 1 month was higher in the low than in the high LDL‐C group (12.0% vs. 8.1%, p = 0.04). At 1 year, survival was not significantly different between the groups. Cox proportional hazards analysis indicated that the incidence of MACE was significantly associated with hypertension, current smoking, high‐density lipoprotein cholesterol (HDL‐C), in‐hospital use of beta blockers, and statin use on follow‐up (p < 0.01). LDL‐C levels on admission in patients with ASTEMI had no significant effect on the 6‐month and 1‐year incidence of MACE, but the incidence of MACE was significantly higher in the low LDL‐C group at 1 month. It would be relevant to further investigate the HDL‐C level on admission, in‐hospital use of beta blockers, and statin use during follow‐up in relation to MACE.
Mechanisms of apple polyphenols‐induced proliferation inhibiting and apoptosis in a metastatic oral adenoid cystic carcinoma cell line
Authors: Zheng Chao‐Qun , Qiao Bin , Wang Miao , Tao Qian 
Published: December 2012

AbstractAdenoid cystic carcinoma (ACC) is characterized by intensive local invasion and high incidence of distant metastases. Conventional chemotherapy for ACC produces a poor result. We aimed to evaluate the effect of apple polyphenols (APs), a novel nutraceutical agent, on the proliferation and apoptosis levels in a metastatic oral ACC cell line. A metastatic ACC (ACC‐M) cell line and control cells (MRC‐5 cells derived from normal lung tissue) were treated with APs at different concentrations. MTT assay was used to determine the in vitro cytotoxicity. The cell cycle distribution and apoptosis levels were measured by flow cytometry. To evaluate the mechanism of APs, vascular endothelial growth factor receptor‐2 (VEGFR‐2) and caspase‐3 messenger ribonucleic acid (mRNA) and protein levels were evaluated by reverse transcription‐polymerase chain reaction and Western blots, respectively. After cells were cultured for 24 hours or 48 hours, the critical concentration of cytotoxicity of APs in MRC‐5 cells was found to be 250 μg/mL. In contrast, in the concentration range of 100–250 μg/mL, the cytotoxicity of APs in ACC‐M cells was time‐ and dose‐dependent: ACC‐M cell proliferation declined at 100 μg/mL when cultured for 48 hours, whereas growth was not inhibited at the concentrations of APs below 200 μg/mL when cultured for 24 hours. In selected time and dose patterns (ACC‐M cells cultured at the concentrations of 150 and 250 μg/mL for 48 hours), the flow cytometry performance showed that apoptosis and necrosis occurred in APs‐treated ACC‐M cells. Also, in these patterns, VEGFR‐2 mRNA and protein levels decreased whereas the levels of caspase‐3 increased. In summary, APs could inhibit proliferation and induce apoptosis in ACC‐M cells in vitro. These effects may be related to the downregulation of VEGFR‐2 expression and the activation of caspase‐3 expression.
Essential concepts necessary to consider when evaluating the efficacy of quantitative easing
Authors: Putnam Bluford H. 
Published: December 2012

AbstractThe economic impact from quantitative easing (QE) may be much less than assumed by the Federal Reserve. One focus is on the effectiveness of QE to stabilize a failing banking system, and the judgment here is largely positive. A second focus, especially in the US, is on evaluating subsequent rounds of QE that were implemented after the economy had resumed growth and after the banking sector had recapitalized and returned to profitability. For these subsequent rounds of QE, the reviews are decidedly mixed and heavily dependent on the assumptions embedded in the economic models used by the researchers. Researchers willing to assume that the US is a closed domestic economy tend to find a large impact on long‐term interest rates from QE. If the US is part of a highly integrated global economy, a smaller effect is presumed. Then there is the more important and controversial evaluation of whether there is any impact on real GDP growth and job creation from QE once the economy is growing again, even if unemployment rates remain historically elevated. What one chooses to ignore or assume does not exist can be more important to the conclusions of QE evaluations than may meet the eye. Inappropriate assumptions can lead to poor decisions.
Depositional processes of reworked tephra from the Late Pleistocene Youngest Toba Tuff deposits in the Lenggong Valley, Malaysia
Authors: Gatti Emma , Saidin Mokhtar , Talib Khairunnisa , Rashidi NurAsikin , Gibbard Philip , Oppenheimer Clive 
Published: December 2012

AbstractTwo fundamental issues for tephrostratigraphic work are the differentiation of primary from reworked tephra and the characterization of reworking mechanisms. We study the depositional processes of four deposits of Youngest Toba Tuff in the Lenggong valley, Malaysia. We focus on site stratigraphy, particle-size distributions, magnetic susceptibility and mineralogical associations. Reworked tephra display variable sedimentological characteristics including polymodal and unimodal, very fine to coarse-grained distributions, and variable concentrations of ash. Particle-size distributions from this study are similar to published analyses for primary deposits, demonstrating that particle size alone cannot distinguish primary from secondary tephra. The tephra sequences are associated with fluvial and colluvial deposition. Three facies are identified: flood flow, mudflow and slumping. The ash accumulated rapidly, over a period of a few days to months. In this valley the ideal site for paleoenvironmental reconstructions is Kampung Luat 3, where ash accumulated at least in two distinct phases. Despite the rapid accumulation, the Lenggong sites are not well-suited for paleoenvironmental studies of the YTT impact. The time lag between the primary deposition and the floods is unknown and the records could have been modified by site-specific characteristics. Such variables should be considered when proposing paleo-environmental reconstructions based on reworked tephra.
Assessment of Risk of Bleeding From Esophageal Varices During Management of Biliary Atresia in Children
Authors: Wanty Catherine , Helleputte Thibault , Smets Françoise , Sokal Etienne M. , Stephenne Xavier 
Published: December 2012

ABSTRACTObjectives:The management of esophageal varices (EV) in children experiencing biliary atresia (BA) remains controversial. Recent studies in children proposed initiating a prophylactic treatment in patients with severe (grade III) EV and/or EV associated with red color signs. Our study was aimed at assessing the risk of bleeding from EV in a series of patients with BA, identifying risk factors for bleeding to develop a predictive model of bleeding.Methods:This was a retrospective study including 83 eligible patients with BA. Clinical, ultrasonographic, endoscopic, and laboratory parameters were studied from the beginning of medical management up to the occurrence of upper gastrointestinal bleeding. In patients not presenting any bleeding, data were analyzed until liver transplantation, endoscopic treatment of EV was performed, or last follow‐up. Risk factors were investigated using univariate and multivariate statistical analyses.Results:Seventeen of 83 patients (20%) presented gastrointestinal bleeding, with a median age of 9.5 months (6–50 months). In univariate and multivariate analyses, high‐grade EV, red color signs on endoscopic examination, and low fibrinogen levels, at first endoscopy, were identified as risk factors for bleeding. When tested in >10,000 different models, these 3 variables appeared to play the most significant role in predicting bleeding.Conclusions:Our study confirmed that grade III EV and red color signs are risk factors for bleeding in patients followed up for BA. We identified low fibrinogen levels as an additional risk factor. The relevance of these 3 factors to predict bleeding from EV requires validation in a prospective study.
miR156 and miR390 Regulate tasiRNA Accumulation and Developmental Timing in Physcomitrella patens
Authors: Cho Sung Hyun , Coruh Ceyda , Axtell Michael J. 
Published: December 2012

Abstract
microRNA156 (miR156) affects developmental timing in flowering plants. miR156 and its target relationships with members of the SQUAMOSA PROMOTER BINDING PROTEIN-LIKE (SPL) gene family appear universally conserved in land plants, but the specific functions of miR156 outside of flowering plants are unknown. We find that miR156 promotes a developmental change from young filamentous protonemata to leafy gametophores in the moss Physcomitrella patens, opposite to its role as an inhibitor of development in flowering plants. P. patens miR156 also influences accumulation of trans-acting small interfering RNAs (tasiRNAs) dependent upon a second ancient microRNA, miR390. Both miR156 and miR390 directly target a single major tasiRNA primary transcript. Inhibition of miR156 function causes increased miR390-triggered tasiRNA accumulation and decreased accumulation of tasiRNA targets. Overexpression of miR390 also caused a slower formation of gametophores, elevated miR390-triggered tasiRNA accumulation, and reduced level of tasiRNA targets. We conclude that a gene regulatory network controlled by miR156, miR390, and their targets controls developmental change in P. patens. The broad outlines and regulatory logic of this network are conserved in flowering plants, albeit with some modifications. Partially conserved small RNA networks thus influence developmental timing in plants with radically different body plans.
A MAPK Cascade Downstream of ERECTA Receptor-Like Protein Kinase Regulates Arabidopsis Inflorescence Architecture by Promoting Localized Cell Proliferation
Authors: Meng Xiangzong , Wang Huachun , He Yunxia , Liu Yidong , Walker John C. , Torii Keiko U. , Zhang Shuqun 
Published: December 2012

Abstract
Spatiotemporal-specific cell proliferation and cell differentiation are critical to the formation of normal tissues, organs, and organisms. The highly coordinated cell differentiation and proliferation events illustrate the importance of cell–cell communication during growth and development. In Arabidopsis thaliana, ERECTA (ER), a receptor-like protein kinase, plays important roles in promoting localized cell proliferation, which determines inflorescence architecture, organ shape, and size. However, the downstream signaling components remain unidentified. Here, we report a mitogen-activated protein kinase (MAPK; or MPK) cascade that functions downstream of ER in regulating localized cell proliferation. Similar to an er mutant, loss of function of MPK3/MPK6 or their upstream MAPK kinases (MAPKKs; or MKKs), MKK4/MKK5, resulted in shortened pedicels and clustered inflorescences. Epistasis analysis demonstrated that the gain of function of MKK4 and MKK5 transgenes could rescue the loss-of-function er mutant phenotype at both morphological and cellular levels, suggesting that the MPK3/MPK6 cascade functions downstream of the ER receptor. Furthermore, YODA (YDA), a MAPKK kinase, was shown to be upstream of MKK4/MKK5 and downstream of ER in regulating inflorescence architecture based on both gain- and loss-of-function data. Taken together, these results suggest that the YDA-MKK4/MKK5-MPK3/MPK6 cascade functions downstream of the ER receptor in regulating localized cell proliferation, which further shapes the morphology of plant organs.
Analysis of tryptophan‐rich region in Clostridium septicum alpha‐toxin involved with binding to glycosylphosphatidylinositol‐anchored proteins
Authors: Mukamoto Masafumi , Kimura Ryota , Hang'ombe Mudenda B. , Kohda Tomoko , Kozaki Shunji 
Published: December 2012

AbstractClostridium septicum alpha‐toxin has a unique tryptophan‐rich region (302NGYSEWDWKWV312) that consists of 11 amino acid residues near the C‐terminus. Using mutant toxins, the contribution of individual amino acids in the tryptophan‐rich region to cytotoxicity and binding to glycosylphosphatidylinositol (GPI)‐anchored proteins was examined. For retention of maximum cytotoxic activity, W307 and W311 are essential residues and residue 309 has to be hydrophobic and possess an aromatic side chain, such as tryptophan or phenylalanine. When residue 308, which lies between tryptophans (W307 and W309) is changed from an acidic to a basic amino acid, the cytotoxic activity of the mutant is reduced to less than that of the wild type. It was shown by a toxin overlay assay that the cytotoxic activity of each mutant toxin correlates closely with affinity to GPI‐anchored proteins. These findings indicate that the WDW_W sequence in the tryptophan‐rich region plays an important role in the cytotoxic mechanism of alpha‐toxin, especially in the binding to GPI‐anchored proteins as cell receptors.
Aquatic ecosystem functions of an isolated floodplain and their implications for flood retention and management
Authors: Reckendorfer Walter , Funk Andrea , Gschöpf Christine , Hein Thomas , Schiemer Fritz 
Published: December 2012

Summary

We used an isolated floodplain of the river Danube as a model system to gain an understanding on the functioning of retention areas to predict future developments and to sustain their ecological services.
We applied correlation analysis and spline regression models to assess the effects of geomorphology, hydraulics, and seasonality on sediment characteristics, suspended solids, hydrochemistry and primary producers.
The spatio‐temporal connection to the river is the primary factor influencing the hydrochemical characteristics and sediments. Allochthonous processes such as nutrient and sediment input during high waters dominate in connected parts of the floodplain, whereas autochthonous processes, for example, the release of phosphorus from the sediments and internally driven eutrophication, dominate in isolated parts. These conditions also affect the dominating primary producers, biodiversity, the degree of floodplain aggradation and thus the potential life span of aquatic habitats.
Measures to improve the functional basis for ecological services may use both allochthonous and autochthonous processes as a starting point, that is, minimizing sediment storage and nutrient input and improving the water balance to prolong the life span of isolated waters, and thus maximizing water body diversity and associated biodiversity.
Based on the results of our analysis and literature, eight alternative management measures have been evaluated. As a result, we propose a stepwise adaptive approach beginning with a controlled water supply with low sediments and nutrient loads. If these measures prove insufficient to sustain ecological functions and conservation value, more radical steps must be considered.
Synthesis and applications The increasing problems with catastrophic flooding have forced decision makers to seek basin‐wide solutions with focus on ‘more room for the river’ and the reintegration of former floodplains as retention basins. Such reintegrations also represent opportunities to improve the ecological conditions for nature development in addition to their principal function, that is, the storage of water during floods. The results of our study can serve as an effective tool to predict the effects of alternative management options and to establish and define the design criteria of water retention areas with regard to their ecological functions, life spans and biodiversity.