bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying and screening patients at high risk of colorectal cancer in general practice
Authors: House W. , Sharp D. , Sheridan E. 
Published: May 2013

Objectives To determine the feasibility and acceptability of selecting patients at risk of colorectal cancer by taking family histories by means of a postal questionnaire. To determine if this information could be translated into simple risk categories to guide subsequent management. Setting Patients aged between 30 and 69 years inclusive, registered with a mixed suburban and rural training general practice in south west England. Method A postal questionnaire survey seeking demographic information and family history of colorectal cancer was sent to all eligible patients. Personal risk of colorectal cancer was stratified according to predetermined criteria. Risk assessment was modified if necessary after the general practitioner conferred with a geneticist. Patients were subsequently offered colonoscopy (high risk) or faecal occult blood testing (intermediate risk). Results Response to the questionnaire was 84.7%. 250 patients had a family history of colorectal cancer, of whom 52 were assigned to the high risk group, 104 to the intermediate group, and 94 to the low risk group. The geneticist reassigned five intermediate risk patients to the high risk group. Of 27 patients who had a colonoscopy, two were found to have an adenocarcinoma and a further two adenomatous polyps. In the group given faecal occult blood testing, two patients presented with colorectal cancer before being screened. Conclusions A postal questionnaire is feasible and acceptable for the collection of information about a family history of colorectal cancer from patients in general practice. The personal risk of developing the disease according to standard criteria can be estimated and then managed by a simple protocol.
SOLVING THE US HEALTHCARE PROBLEMS: THE ACTION STRATEGY
Authors: CHANG C. M. 
Published: May 2013

The US healthcare system costs more and delivers less service quality, in comparison with several industrialized nations. This paper describes the critical problems facing the US healthcare system, offers a comprehensive review of various best practices and emerging solutions to address the cost and quality issues, identifies a set of empirical observations from this review, and outlines a rational strategy, the ACTION strategy, to solve some of the noted US healthcare problems. The ACTION strategy, as proposed, takes into account the decision factors, which are important to any healthcare organizations, such as economic viability, technological feasibility, ease of implementation, operational efficiency, as well as being patient-focused, regulatory compliant and risk optimized. When adopted, this strategy should allow a majority of healthcare organizations to achieve steady progress toward cost reduction, quality enhancement, cycle time shortening and patient satisfaction. Practitioners in technology management are well prepared to assist healthcare organizations in implementing the elements of this strategy.
Isentropic Transport within the Antarctic Polar-Night Vortex: Rossby Wave Breaking Evidence and Lagrangian Structures
Authors: Cámara Alvaro de la , Mechoso Carlos R. , Mancho Ana M. , Serrano Encarna , Ide Kayo 
Published: May 2013

Abstract
The trajectories in the lower stratosphere of isopycnic balloons released from Antarctica by Vorcore and Concordiasi field campaigns during the southern springs of 2005 and 2010 showed events of latitudinal transport inside the stratospheric polar vortex, both away from and toward the poleward flank of the polar-night jet. The present paper applies trajectory-based diagnostic techniques to examine mechanisms at work during such events. Reverse domain-filling calculations of potential vorticity (PV) fields from the ECMWF Interim Re-Analysis (ERA-Interim) dataset during the events show irreversible filamentation of the PV fields in the inner side of the polar-night jet, which is a signature of planetary (Rossby) wave breaking. Balloon motions during the events are fairly consistent with the PV filaments. Events of both large (~15° of arc length) and small (~5° of arc length) balloon displacements from the vortex edge are associated, respectively, with deep and shallow penetration into the core of the elongated PV contours. Additionally, the Lagrangian descriptor M is applied to study the configuration of Lagrangian structures during the events. Breaking Rossby waves inside the vortex lead to the presence of hyperbolic points. The geometric configuration of the invariant manifolds associated with the hyperbolic trajectories helps to understand the apparent chaotic behavior of balloons' motions and to identify and analyze balloon transport events not captured by reverse domain-filling calculations.
The Antarctic polar vortex edge is an effective barrier to air parcel crossings. Rossby wave breaking inside the vortex, however, can contribute to tracer mixing inside the vortex and to occasional air crossings of the edge.
An Adjoint-Based Adaptive Ensemble Kalman Filter
Authors: Song Hajoon , Hoteit Ibrahim , Cornuelle Bruce D. , Luo Xiaodong , Subramanian Aneesh C. 
Published: May 2013

Abstract
A new hybrid ensemble Kalman filter/four-dimensional variational data assimilation (EnKF/4D-VAR) approach is introduced to mitigate background covariance limitations in the EnKF. The work is based on the adaptive EnKF (AEnKF) method, which bears a strong resemblance to the hybrid EnKF/three-dimensional variational data assimilation (3D-VAR) method. In the AEnKF, the representativeness of the EnKF ensemble is regularly enhanced with new members generated after back projection of the EnKF analysis residuals to state space using a 3D-VAR [or optimal interpolation (OI)] scheme with a preselected background covariance matrix. The idea here is to reformulate the transformation of the residuals as a 4D-VAR problem, constraining the new member with model dynamics and the previous observations. This should provide more information for the estimation of the new member and reduce dependence of the AEnKF on the assumed stationary background covariance matrix. This is done by integrating the analysis residuals backward in time with the adjoint model. Numerical experiments are performed with the Lorenz-96 model under different scenarios to test the new approach and to evaluate its performance with respect to the EnKF and the hybrid EnKF/3D-VAR. The new method leads to the least root-mean-square estimation errors as long as the linear assumption guaranteeing the stability of the adjoint model holds. It is also found to be less sensitive to choices of the assimilation system inputs and parameters.
Varied spectrum of clinical presentation and mortality in a prospective registry of visceral leishmaniasis in a low endemicity area of Northern Italy
Authors: Cenderello Giovanni , Pasa Ambra , Dusi Andrea , Dentone Chiara , Toscanini Federica , Bobbio Nicoletta , Bondi Elisabetta , Del Bono Valerio , Izzo Manuela , Riccio Giovanni , Anselmo Marco , Giacchino Raffaella , Marazzi Maria Grazia , Pagano Gabriella , Cassola Giovanni , Viscoli Claudio , Ferrea Giuseppe , De Maria Andrea 
Published: May 2013

Abstract

Background
Visceral Leishmaniasis (VL) is endemic in 88 countries, in areas of relatively low incidence with a relevant proportion of immune suppressed patients clinical presentation, diagnosis and management may present difficulties and pitfalls.

Methods
Demographic data, clinical, laboratory features and therapeutic findings were recorded in patients identified by a regional VL disease registry from January 2007 to December 2010.

Results
A total of 55 patients (36 adults mean age 48.7 years, 19 children median age 37.5 months) were observed presenting with 65 episodes. All childen were immunocompetent, whereas adults affected by VL included both immunocompetent (n°17) and immunesuppressed (n°19) patients. The clinical presentation was homogeneous in children with predominance of fever and hepato-splenomegaly. A wider spectrum of clinical presentations was observed in immunocompromised adults. Bone marrow detection of intracellular parasites (Giemsa staining) and serology (IFAT) were the most frequently used diagnostic tools. In addition, detection of urinary antigen was used in adult patients with good specificity (90%). Liposomal amphotericin B was the most frequently prescribed first line drug (98.2% of cases) with 100% clinical cure. VL relapses (n°10) represented a crucial finding: they occurred only in adult patients, mainly in immunocompromised patients (40% of HIV, 22% of non-HIV immunocompromised patients, 5,9% of immunocompetent patients). Furthermore, three deaths with VL were reported, all occurring in relapsing immunocompromised patients accounting for a still high overall mortality in this group (15.8%).

Conclusions
The wide spectrum of clinical presentation in immunesuppresed patients and high recurrence rates still represent a clinical challenge accounting for high mortality. Early clinical identification and satisfactory treatment performance with liposomal amphotericin B are confirmed in areas with low-level endemicity and good clinical standards. VL needs continuing attention in endemic areas where increasing numbers of immunocompromised patients at risk are dwelling.
Functional abnormalities in the cortical processing of sound complexity and musical consonance in schizophrenia: evidence from an evoked potential study
Authors: Wu Kuan-Yi , Chao Ching-Wen , Hung Ching-I , Chen Wei-Hong , Chen Yung-Ting , Liang Sheng-Fu 
Published: May 2013

Abstract

Background
Previous studies have demonstrated functional and structural temporal lobe abnormalities located close to the auditory cortical regions in schizophrenia. The goal of this study was to determine whether functional abnormalities exist in the cortical processing of musical sound in schizophrenia.

Methods
Twelve schizophrenic patients and twelve age- and sex-matched healthy controls were recruited, and participants listened to a random sequence of two kinds of sonic entities, intervals (tritones and perfect fifths) and chords (atonal chords, diminished chords, and major triads), of varying degrees of complexity and consonance. The perception of musical sound was investigated by the auditory evoked potentials technique.

Results
Our results showed that schizophrenic patients exhibited significant reductions in the amplitudes of the N1 and P2 components elicited by musical stimuli, to which consonant sounds contributed more significantly than dissonant sounds. Schizophrenic patients could not perceive the dissimilarity between interval and chord stimuli based on the evoked potentials responses as compared with the healthy controls.

Conclusion
This study provided electrophysiological evidence of functional abnormalities in the cortical processing of sound complexity and music consonance in schizophrenia. The preliminary findings warrant further investigations for the underlying mechanisms.
In-vitro evaluation of selected Egyptian traditional herbal medicines for treatment of alzheimer disease
Authors: Ali Shereen K , Hamed Ahmed R , Soltan Maha M , Hegazy Usama M , Elgorashi Esameldin E , El-Garf Ibrahim A , Hussein Ahmed A 
Published: May 2013

AbstractBackgroundEgyptians recognized the healing power of herbs and used them in their medicinal formulations. Nowadays, “Attarin” drug shops and the public use mainly the Unani medicinal system for treatment of their health problems including improvement of memory and old age related diseases. Numerous medicinal plants have been described in old literature of Arabic traditional medicine for treatment of Alzheimer’s disease (AD) (or to strengthen memory).MethodsIn this study, some of these plants were evaluated against three different preliminary bioassays related to AD to explore the possible way of their bio-interaction. Twenty three selected plants were extracted with methanol and screenedin vitroagainst acetylcholinesterase (AChE) and cycloxygenase-1 (COX-1) enzymes. In addition, anti-oxidant activity using DPPH was determined.ResultsOf the tested plant extracts;Adhatoda vasicaandPeganum harmalashowed inhibitory effect on AChE at IC50294 μg/ml and 68 μg/ml respectively. Moreover,A. vasicainteracted reversibly with the enzyme whileP. harmalashowed irreversible inhibition.Ferula assafoetida(IC503.2 μg/ml),Syzygium aromaticum(34.9 μg/ml) andZingiber officinalis(33.6 μg/ml) showed activity against COX-1 enzyme. Potent radical scavenging activity was demonstrated by three plant extractsTerminalia chebula(EC502.2 μg/ml),T. arjuna(3.1 μg/ml) andEmblica officinalis(6.3 μg/ml).ConclusionInterestingly, differential results have been obtained which indicate the variability of the mode of actions for the selected plants. Additionally, the reversible interaction ofA. vasicaagainst AChE and the potent activity ofF. assafoetidaagainst COX-1 make them effective, new and promising agents for treatment of AD in the future, either as total extracts or their single bioactive constituents.
Hydroxycamptothecin induces apoptosis and inhibits tumor growth in colon cancer by the downregulation of survivin and XIAP expression
Authors: Fei Bojian , Chi Alfred L , Weng Yuan 
Published: May 2013

Abstract

Background
10-Hydroxycamptothecin (10-HCPT), isolated from a Chinese tree Camptotheca acuminate, inhibits the activity of topoisomerase I and has a broad spectrum of anticancer activity in vitro and in vivo. It has been shown that HCPT is more active and less toxic than conventional camptothecins and can induce cancer cell apoptosis. However, the mechanisms of HCPT-induced apoptosis in colon cancer cells remain unclear. In this study, we investigated the effects of HCPT on apoptosis of colon cancer and underlying mechanism.

Methods
Cell proliferation was measured by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay, and apoptosis was measured using terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. Expression of genes was detected using real-time reverse transcription-polymerase chain reaction (real time-PCR) and Western blot. Tumor growth in vivo was evaluated using a nude mouse xenograft model.

Results
HCPT could significantly inhibit cell proliferation and induce apoptosis in colon cancer SW1116 and Colo 205 cells in dose- and time-dependent manners. HCPT treatment activated the activities of caspase 3, 7, 8 and 9, downregulated the expression of survivin, survivinΔEx3, survivin-3B and XIAP, and upregulated expression of surviving 2B. Moreover, the combination of HCPT and 5-fluorouracial (5-FU) synergistically induced apoptosis and downregulated the expression of survivin and XIAP. Knockdown of survivin and XIAP by siRNA sensitized colon cancer to HCTP-induced apoptosis. Furthermore, HCPT treatment significantly inhibited SW1116 xenograft tumor growth.

Conclusions
Our results elucidate new mechanisms of HCPT antitumor by the downregulation of survivin and XIAP expression. The combination of HCPT with 5-FU or IAP inhibitors may be a potential strategy for colon cancer treatment.
Loss of Pten promotes angiogenesis and enhanced vegfaa expression in zebrafish
Authors: Choorapoikayil Suma , Weijts Bart , Kers Rianne , de Bruin Alain , den Hertog Jeroen 
Published: May 2013

Summary
Angiogenesis, the emergence of vessels from an existing vascular network, is pathologically associated with tumor progression and is of great interest for therapeutic intervention. PTEN is a frequently mutated tumor suppressor and has been linked to the progression of many types of tumors, including hemangiosarcomas in zebrafish. Here, we report that mutant zebrafish embryos lacking functional Pten exhibit enhanced angiogenesis, accompanied by elevated levels of phosphorylated Akt (pAkt). Inhibition of phosphoinositide 3-kinase (PI3K) by LY294002 treatment and application of sunitinib, a widely used anti-angiogenic compound, suppressed enhanced angiogenesis in Pten mutants. Vegfaa has a crucial role in angiogenesis and vegfaa expression was upregulated in embryos lacking functional Pten. Interestingly, vegfaa expression was also upregulated in hemangiosarcomas from haploinsufficient adult zebrafish Pten mutants. Elevated vegfaa expression in mutant embryos lacking functional Pten was suppressed by LY294002. Surprisingly, sunitinib treatment dramatically enhanced vegfaa expression in Pten mutant embryos, which might account for tumor relapse in human patients who are treated with sunitinib. Combined treatment with suboptimal concentrations of sunitinib and LY294002 rescued enhanced angiogenesis in pten mutant embryos without the dramatic increase in vegfaa expression, suggesting a new approach for therapeutic intervention in VEGFR-signaling-dependent tumors.
Heteroleptic Palladium(II) Complexes with Mixed Thiol- and Sulfide-containing Amino Acids: Self-assembly of Novel Heptanuclear Coordination Oligomers
Authors: Yokoi Anzu , Yoshinari Nobuto , Konno Takumi 
Published: May 2013

Abstract
Treatment of a cyclic tripalladium(II) complex, [Pd3(d-pen)3] (d-H2pen: d-penicillamine), with l-methionine (l-Hmet) gave a novel open-chain-type S-bridged heptapalladium(II) complex, [Pd7(d-pen)8(l-met)2]4−, besides a monopalladium(II) complex, [Pd(d-pen)(l-met)]−. A similar reaction using S-methyl-l-cysteine (l-Hsmc) instead of l-Hmet produced an analogous heptapalladium(II) complex, [Pd7(d-pen)8(l-smc)2]4−.
A prospective study comparing conservative with operative treatment in patients with a ‘floating shoulder’ including assessment of the prognostic value of the glenopolar angle
Authors: Yadav V. , Khare G. N. , Singh S. , Kumaraswamy V. , Sharma N. , Rai A. K. , Ramaswamy A. G. , Sharma H. 
Published: May 2013

Both conservative and operative forms of treatment have been recommended for patients with a ‘floating shoulder’. We compared the results of conservative and operative treatment in 25 patients with this injury and investigated the use of the glenopolar angle (GPA) as an indicator of the functional outcome. A total of 13 patients (ten male and three female; mean age 32.5 years (24.7 to 40.4)) were treated conservatively and 12 patients (ten male and two female; mean age 33.67 years (24.6 to 42.7)) were treated operatively by fixation of the clavicular fracture alone. Outcome was assessed using the Herscovici score, which was also related to changes in the GPA at one year post-operatively.The mean Herscovici score was significantly better three months and two years after the injury in the operative group (p < 0.001 and p = 0.003, respectively). There was a negative correlation between the change in GPA and the Herscovici score at two years follow-up in both the conservative and operative groups, but neither were statistically significant (r = -0.295 and r = -0.19, respectively). There was a significant difference between the pre- and post-operative GPA in the operative group (p = 0.017).When compared with conservative treatment, fixation of the clavicle alone gives better results in the treatment of patients with a floating shoulder. The GPA changes significantly with fixation of clavicle alone but there is no significant correlation between the pre-injury GPA and the final clinical outcome in these patients.Cite this article: Bone Joint J 2013;95-B:815–19.
Instability of the sternoclavicular joint
Authors: Sewell M. D. , Al-Hadithy N. , Le Leu A. , Lambert S. M. 
Published: May 2013

The sternoclavicular joint (SCJ) is a pivotal articulation in the linked system of the upper limb girdle, providing load-bearing in compression while resisting displacement in tension or distraction at the manubrium sterni. The SCJ and acromioclavicular joint (ACJ) both have a small surface area of contact protected by an intra-articular fibrocartilaginous disc and are supported by strong extrinsic and intrinsic capsular ligaments. The function of load-sharing in the upper limb by bulky periscapular and thoracobrachial muscles is extremely important to the longevity of both joints. Ligamentous and capsular laxity changes with age, exposing both joints to greater strain, which may explain the rising incidence of arthritis in both with age. The incidence of arthritis in the SCJ is less than that in the ACJ, suggesting that the extrinsic ligaments of the SCJ provide greater stability than the coracoclavicular ligaments of the ACJ.Instability of the SCJ is rare and can be difficult to distinguish from medial clavicular physeal or metaphyseal fracture-separation: cross-sectional imaging is often required. The distinction is important because the treatment options and outcomes of treatment are dissimilar, whereas the treatment and outcomes of ACJ separation and fracture of the lateral clavicle can be similar. Proper recognition and treatment of traumatic instability is vital as these injuries may be life-threatening. Instability of the SCJ does not always require surgical intervention. An accurate diagnosis is required before surgery can be considered, and we recommend the use of the Stanmore instability triangle. Most poor outcomes result from a failure to recognise the underlying pathology.There is a natural reluctance for orthopaedic surgeons to operate in this area owing to unfamiliarity with, and the close proximity of, the related vascular structures, but the interposed sternohyoid and sternothyroid muscles are rarely injured and provide a clear boundary to the medial retroclavicular space, as well as an anatomical barrier to unsafe intervention.This review presents current concepts of instability of the SCJ, describes the relevant surgical anatomy, provides a framework for diagnosis and management, including physiotherapy, and discusses the technical challenges of operative intervention.Cite this article: Bone Joint J 2013;95-B:721–31.
Early revisions of the Femoro-Patella Vialla joint replacement
Authors: Williams D. P. , Pandit H. G. , Athanasou N. A. , Murray D. W. , Gibbons C. L. M. H. 
Published: May 2013

The aim of this study was to review the early outcome of the Femoro-Patella Vialla (FPV) joint replacement. A total of 48 consecutive FPVs were implanted between December 2007 and June 2011. Case-note analysis was performed to evaluate the indications, operative histology, operative findings, post-operative complications and reasons for revision. The mean age of the patients was 63.3 years (48.2 to 81.0) and the mean follow-up was 25.0 months (6.1 to 48.9). Revision was performed in seven (14.6%) at a mean of 21.7 months, and there was one re-revision. Persistent pain was observed in three further patients who remain unrevised. The reasons for revision were pain due to progressive tibiofemoral disease in five, inflammatory arthritis in one, and patellar fracture following trauma in one. No failures were related to the implant or the technique. Trochlear dysplasia was associated with a significantly lower rate of revision (5.9% vs 35.7%, p = 0.017) and a lower incidence of revision or persistent pain (11.8% vs 42.9%, p = 0.045). Focal patellofemoral osteoarthritis secondary to trochlear dysplasia should be considered the best indication for patellofemoral replacement. Standardised radiological imaging, with MRI to exclude overt tibiofemoral disease should be part of the pre-operative assessment, especially for the non-dysplastic knee. Cite this article: Bone Joint J 2013;95-B:793–7.