bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a patient safety climate survey for Chinese hospitals: cross-national adaptation and psychometric evaluation
Authors: Zhu Junya , Li Liping , Zhao Hailei , Han Guangshu , Wu Albert W , Weingart Saul N 
Published: April 2014

BackgroundExisting patient safety climate instruments, most of which have been developed in the USA, may not accurately reflect the conditions in the healthcare systems of other countries.ObjectivesTo develop and evaluate a patient safety climate instrument for healthcare workers in Chinese hospitals.MethodsBased on a review of existing instruments, expert panel review, focus groups and cognitive interviews, we developed items relevant to patient safety climate in Chinese hospitals. The draft instrument was distributed to 1700 hospital workers from 54 units in six hospitals in five Chinese cities between July and October 2011, and 1464 completed surveys were received. We performed exploratory and confirmatory factor analyses and estimated internal consistency reliability, within-unit agreement, between-unit variation, unit-mean reliability, correlation between multi-item composites, and association between the composites and two single items of perceived safety.ResultsThe final instrument included 34 items organised into nine composites: institutional commitment to safety, unit management support for safety, organisational learning, safety system, adequacy of safety arrangements, error reporting, communication and peer support, teamwork and staffing. All composites had acceptable unit-mean reliabilities (≥0.74) and within-unit agreement (Rwg≥0.71), and exhibited significant between-unit variation with intraclass correlation coefficients ranging from 9% to 21%. Internal consistency reliabilities ranged from 0.59 to 0.88 and were ≥0.70 for eight of the nine composites. Correlations between composites ranged from 0.27 to 0.73. All composites were positively and significantly associated with the two perceived safety items.ConclusionsThe Chinese Hospital Survey on Patient Safety Climate demonstrates adequate dimensionality, reliability and validity. The integration of qualitative and quantitative methods is essential to produce an instrument that is culturally appropriate for Chinese hospitals.
Dual Targeting of Integrin αvβ3 and Matrix Metalloproteinase-2 for Optical Imaging of Tumors and Chemotherapeutic Delivery
Authors: Crisp Jessica L. , Savariar Elamprakash N. , Glasgow Heather L. , Ellies Lesley G. , Whitney Michael A. , Tsien Roger Y. 
Published: April 2014

Abstract
Activatable cell-penetrating peptides (ACPP) provide a general strategy for molecular targeting by exploiting the extracellular protease activities associated with disease. Previous work used a matrix metalloproteinase (MMP-2 and 9)-cleavable sequence in the ACPP to target contrast agents for tumor imaging and fluorescence-guided surgery. To improve specificity and sensitivity for MMP-2, an integrin αvβ3-binding domain, cyclic-RGD, was covalently linked to the ACPP. This co-targeting strategy relies on the interaction of MMP-2 with integrin αvβ3, which are known to associate via the hemopexin domain of MMP-2. In U87MG glioblastoma cells in culture, dual targeting greatly improved ACPP uptake compared with either MMP or integrin αvβ3 targeting alone. In vivo, dual-targeted ACPP treatment resulted in tumor contrast of 7.8 ± 1.6, a 10-fold higher tumor fluorescence compared with the negative control peptide, and increased probe penetration into the core of MDA-MB-231 tumors. This platform also significantly improved efficacy of the chemotherapeutic monomethylauristatin E (MMAE) in both MDA-MB-231 orthotopic human and syngeneic Py230 murine breast tumors. Treatment with cyclic-RGD-PLGC(Me)AG-MMAE-ACPP resulted in complete tumor regression in one quarter of MDA-MB-231 tumor–bearing mice, compared with no survival in the control groups. This rational mechanism for amplified delivery of imaging and potent chemotherapeutic agents avoids the use of antibodies and may be of considerable generality. Mol Cancer Ther; 13(6); 1514–25. ©2014 AACR.
Conserved Oncogenic Behavior of the FAM83 Family Regulates MAPK Signaling in Human Cancer
Authors: Cipriano Rocky , Miskimen Kristy L.S. , Bryson Benjamin L. , Foy Chase R. , Bartel Courtney A. , Jackson Mark W. 
Published: April 2014

Abstract
FAM83B (family with sequence similarity 83, member B) was recently identified as a novel oncogene involved in activating CRAF/MAPK signaling and driving epithelial cell transformation. FAM83B is one of eight members of a protein family (FAM83) characterized by a highly conserved domain of unknown function (DUF1669), which is necessary and sufficient to drive transformation. Here, it is demonstrated that additional FAM83 members also exhibit oncogenic properties and have significantly elevated levels of expression in multiple human tumor types using a TissueScan Cancer Survey Panel PCR array and database mining. Furthermore, modeling the observed tumor expression of FAM83A, FAM83C, FAM83D, or FAM83E promoted human mammary epithelial cell (HMEC) transformation, which correlated with the ability of each FAM83 member to bind CRAF (RAF1) and promote CRAF membrane localization. Conversely, ablation of FAM83A or FAM83D from breast cancer cells resulted in diminished MAPK signaling with marked suppression of growth in vitro and tumorigenicity in vivo. Importantly, each FAM83 member was determined to be elevated in at least one of 17 distinct tumor types examined, with FAM83A, FAM83B, and FAM83D most frequently overexpressed in several diverse tissue types. Finally, evidence suggests that elevated expression of FAM83 members is associated with elevated tumor grade and decreased overall survival.
Implications: FAM83 proteins represent a novel family of oncogenes suitable for the development of cancer therapies aimed at suppressing MAPK signaling. Mol Cancer Res; 12(8); 1156–65. ©2014 AACR.
p53 Modulates Hsp90 ATPase Activity and Regulates Aryl Hydrocarbon Receptor Signaling
Authors: Kochhar Amit , Kopelovich Levy , Sue Erika , Guttenplan Joseph B. , Herbert Brittney-Shea , Dannenberg Andrew J. , Subbaramaiah Kotha 
Published: April 2014

Abstract
The aryl hydrocarbon receptor (AhR), a client protein of heat shock protein 90 (Hsp90), is a ligand-activated transcription factor that plays a role in polycyclic aromatic hydrocarbon (PAH)-induced carcinogenesis. Tobacco smoke activates AhR signaling leading to increased transcription of CYP1A1 and CYP1B1, which encode proteins that convert PAHs to mutagens. Recently, p53 was found to regulate Hsp90 ATPase activity via effects on activator of Hsp90 ATPase (Aha1). It is possible, therefore, that AhR-dependent expression of CYP1A1 and CYP1B1 might be affected by p53 status. The main objective of this study was to determine whether p53 modulated AhR-dependent gene expression and PAH metabolism. Here, we show that silencing p53 led to elevated Aha1 levels, increased Hsp90 ATPase activity, and enhanced CYP1A1 and CYP1B1 expression. Overexpression of wild-type p53 suppressed levels of CYP1A1 and CYP1B1. The significance of Aha1 in mediating these p53-dependent effects was determined. Silencing of Aha1 led to reduced Hsp90 ATPase activity and downregulation of CYP1A1 and CYP1B1. In contrast, overexpressing Aha1 was associated with increased Hsp90 ATPase activity and elevated levels of CYP1A1 and CYP1B1. Using p53 heterozygous mutant epithelial cells from patients with Li–Fraumeni syndrome, we show that monoallelic mutation of p53 was associated with elevated levels of CYP1A1 and CYP1B1 under both basal conditions and following treatment with benzo[a]pyrene. Treatment with CP-31398, a p53 rescue compound, suppressed benzo[a]pyrene-mediated induction of CYP1A1 and CYP1B1 and the formation of DNA adducts. Collectively, our results suggest that p53 affects AhR-dependent gene expression, PAH metabolism, and possibly carcinogenesis. Cancer Prev Res; 7(6); 596–606. ©2014 AACR.
Institutional Differences in Carotid Artery Duplex Diagnostic Criteria Result in Significant Variability in Classification of Carotid Artery Stenoses and Likely Lead to Disparities in Care
Authors: Arous Edward J. , Baril Donald T. , Robinson William P. , Aiello Francesco A. , Hevelone Nathanael D. , Arous Elias J , Messina Louis M. , Schanzer Andres 
Published: April 2014

Background—
The indications for carotid revascularization are based almost exclusively on the results of carotid duplex ultrasonography. Noninvasive vascular laboratories show large variation in the diagnostic criteria used to classify degree of carotid artery stenosis. We hypothesize that variability of these diagnostic criteria causes significant variation in stenosis classification directly affecting the number of revascularizations and associated costs.

Methods and Results—
The diagnostic criteria to interpret carotid duplex ultrasounds were obtained from 10 New England institutions. All carotid duplex scans performed at our institution were reviewed from 2008 to 2012. Using the diagnostic criteria from each institution, the degree of stenosis that would have been reported was classified as 70% to 99% asymptomatic, 80% to 99% asymptomatic, and 50% to 99% symptomatic. We then calculated the theoretical number of carotid revascularization procedures that this cohort would be offered using each institution’s diagnostic criteria and the costs of these procedures based on reimbursement rates. Among 10 614 patients who underwent 15 534 carotid duplex scans, 31 025 arteries were reviewed. Application of the 10 institutions’ criteria to the patients from our institution yielded marked variation in the number classified as 70% to 99% asymptomatic (range, 186–2201), 80% to 99% asymptomatic (range, 78–426), and 50% to 99% symptomatic (range, 157–781). If revascularizations were based on these results, costs would range from $2.2 to $26 million, $0.9 to $5.0 million, and $1.9 to $9.2 million, respectively.

Conclusions—
Differences in diagnostic criteria to interpret carotid ultrasound result in significant variation in classification of carotid artery stenosis, likely leading to differences in the number and subsequent costs of revascularizations. This theoretical model highlights the need for standardization of carotid duplex criteria.
The Temporal Evolution of Coarse Location Coding of Objects: Evidence for Feedback
Authors: Chakravarthi Ramakrishna , Carlson Thomas A. , Chaffin Julie , Turret Jeremy , VanRullen Rufin 
Published: April 2014

Abstract
Objects occupy space. How does the brain represent the spatial location of objects? Retinotopic early visual cortex has precise location information but can only segment simple objects. On the other hand, higher visual areas can resolve complex objects but only have coarse location information. Thus coarse location of complex objects might be represented by either (a) feedback from higher areas to early retinotopic areas or (b) coarse position encoding in higher areas. We tested these alternatives by presenting various kinds of first- (edge-defined) and second-order (texture) objects. We applied multivariate classifiers to the pattern of EEG amplitudes across the scalp at a range of time points to trace the temporal dynamics of coarse location representation. For edge-defined objects, peak classification performance was high and early and thus attributable to the retinotopic layout of early visual cortex. For texture objects, it was low and late. Crucially, despite these differences in peak performance and timing, training a classifier on one object and testing it on others revealed that the topography at peak performance was the same for both first- and second-order objects. That is, the same location information, encoded by early visual areas, was available for both edge-defined and texture objects at different time points. These results indicate that locations of complex objects such as textures, although not represented in the bottom–up sweep, are encoded later by neural patterns resembling the bottom–up ones. We conclude that feedback mechanisms play an important role in coarse location representation of complex objects.
EEG Frequency Tagging to Dissociate the Cortical Responses to Nociceptive and Nonnociceptive Stimuli
Authors: Colon Elisabeth , Legrain Valéry , Mouraux André 
Published: April 2014

Abstract
Whether the cortical processing of nociceptive input relies on the activity of nociceptive-specific neurons or whether it relies on the activity of neurons also involved in processing nonnociceptive sensory input remains a matter of debate. Here, we combined EEG “frequency tagging” of steady-state evoked potentials (SS-EPs) with an intermodal selective attention paradigm to test whether the cortical processing of nociceptive input relies on nociceptive-specific neuronal populations that can be selectively modulated by top–down attention. Trains of nociceptive and vibrotactile stimuli (Experiment 1) and trains of nociceptive and visual stimuli (Experiment 2) were applied concomitantly to the same hand, thus eliciting nociceptive, vibrotactile, and visual SS-EPs. In each experiment, a target detection task was used to focus attention toward one of the two concurrent streams of sensory input. We found that selectively attending to nociceptive or vibrotactile somatosensory input indistinctly enhances the magnitude of nociceptive and vibrotactile SS-EPs, whereas selectively attending to nociceptive or visual input independently enhances the magnitude of the SS-EP elicited by the attended sensory input. This differential effect indicates that the processing of nociceptive input involves neuronal populations also involved in the processing of touch, but distinct from the neuronal populations involved in vision.
Supersaturation Variability and Cirrus Ice Crystal Size Distributions
Authors: Kärcher B. , Dörnbrack A. , Sölch I. 
Published: April 2014

AbstractSmall-scale dynamical variability affects atmospheric supersaturation and therefore the development of ice clouds via uptake of water vapor on ice crystals. This variability and its implications for ice growth are difficult to capture experimentally and theoretically. By interpreting supersaturation as a stochastic variable, the authors examine the average temporal behavior of, and the link between, supersaturation fluctuations and ice crystal size distributions in upper-tropospheric cirrus clouds. The authors classify cirrus types according to their ability to dampen supersaturation fluctuations owing to depositional growth of cloud ice and study how size distributions in them respond to supersaturation variability, investigating the possibility of the occurrence of ice-supersaturated states within cirrus. Typical time scales for growth and damping impacts on supersaturation are minutes and minutes to hours, respectively, and are highly variable among cirrus types and within single clouds. Transient deviations from saturated equilibrium states can occur depending on the ice crystal number concentration and size and on the strength of the small-scale dynamical forcing. Supersaturation preferentially occurs in cloud regions with few small ice crystals. The authors demonstrate that supersaturation fluctuations in very thin tropical tropopause cirrus create long-lived supersaturated states. Furthermore, they potentially generate few large ice crystals, broadening size distributions, and significantly enhance water mass fluxes due to sedimentation. Although not studied here, they may also allow new ice crystals to nucleate. Implications of these findings for those clouds to dehydrate air entering the lower stratosphere are discussed and future research needs are outlined.
Comparison of Next-Day Convection-Allowing Forecasts of Storm motion on 1- and 4-km Grids
Authors: VandenBerg Michael A. , Coniglio Michael C. , Clark Adam J. 
Published: April 2014

Abstract
This study compares next-day forecasts of storm motion from convection-allowing models with 1- and 4-km grid spacing. A tracking algorithm is used to determine the motion of discrete storms in both the model forecasts and an analysis of radar observations. The distributions of both the raw storm motions and the deviations of these motions from the environmental flow are examined to determine the overall biases of the 1- and 4-km forecasts and how they compare to the observed storm motions. The mean storm speeds for the 1-km forecasts are significantly closer to the observed mean than those for the 4-km forecasts when viewed relative to the environmental flow/shear, but mostly for the shorter-lived storms. For storm directions, the 1-km forecast storms move similarly to the 4-km forecast storms on average. However, for the raw storm motions and those relative to the 0–6-km shear, results suggest that the 1-km forecasts may alleviate some of a clockwise (rightward) bias of the 4-km forecasts, particularly for those that do not deviate strongly from the 0–6-km shear vector. This improvement in a clockwise bias also is seen for the longer-lived storms, but is not seen when viewing the storm motions relative to the 850–300-hPa mean wind or Bunkers motion vector. These results suggest that a reduction from 4- to 1-km grid spacing can potentially improve forecasts of storm motion, but further analysis of closer storm analogs are needed to confirm these results and to explore specific hypotheses for their differences.
Intraoperative motive for performing a laparoscopic appendectomy on a postoperative histological proven normal appendix
Authors: Slotboom T. , Hamminga J. T. H. , Hofker H. S. , Heineman E. , Haveman J. W. ,   For the Apple Study Group; Appendicitis and Laparoscopic evaluation
Published: April 2014

Background: Diagnostic laparoscopy is the ultimate tool to evaluate the appendix. However, the intraoperative evaluation of the appendix is difficult, as the negative appendectomy rate remains 12%–18%. The aim of this study is to analyze the intraoperative motive for performing a laparoscopic appendectomy of an appendix that was proven to be noninflamed after histological examination. Methods: In 2008 and 2009, in five hospitals, operation reports of all negative laparoscopic appendectomies were retrospectively analyzed in order to assess the intraoperative motive for removing the appendix. Results: A total of 1,465 appendectomies were analyzed with an overall negative appendectomy rate of 9% (132/1,465). In 57% (841/1,465), a laparoscopic appendectomy was performed, with 9% ( n = 75) negative appendectomies. In 51% of the negative appendectomies, the visual assessment of the appendix was decisive in performing the appendectomy. In 33%, the surgeon was in doubt whether the appendix was inflamed or normal. In 4%, the surgeon was aware he removed a healthy appendix, and in 9%, an appendectomy was performed for different reasons. Conclusion: In more than half of the microscopic healthy appendices, the surgeon was convinced of the diagnosis appendicitis during surgery. Intraoperative laparoscopic assessment of the appendix can be difficult.
Trauma-Related Critical Care
Authors: Matsushima K. , Khan M. , Frankel H. L. 
Published: April 2014

Background: Post-trauma resuscitation has evolved based on civilian and wartime experiences over the last decade. Similarly, data from large multicenter randomized trials have changed the management of critically ill trauma patients in the intensive care unit. Methods: This is a review of the literature focusing on areas relevant to the management of trauma patients in the intensive care unit. Results: The following topics are included: (1) ventilator management, (2) trauma sepsis, (3) use of vasopressors in hemorrhage, (4) glucose control, (5) nutrition, and (6) hemodynamic monitoring. Conclusion: This review demonstrated the most recent data of trauma-related critical care. Further studies will be needed to settle growing controversies in the management of critically injured patients.
Management of Bleeding Pelvic Fractures
Authors: Marzi I. , Lustenberger T. 
Published: April 2014

Introduction: In patients with severe pelvic fractures, exsanguinating hemorrhage represents the major cause of death within the first 24 h. Despite advances in management, the mortality rate in these patients remains significantly high. Recently, multiple treatment algorithms have been proposed for patients with severe pelvic fractures; however, the optimal modalities in particular in the hemodynamically unstable patient are still a matter of lively debate.This review article focuses on the recent body of knowledge on the different treatment options in patients with severe pelvic fractures and proposes the possible role of each modality in the management of these patients. Methods: The MEDLINE database was searched for medical literature addressing the management of severe pelvic fractures with specific attention given to recent, clinically relevant publications. Results: Angiography and embolization have emerged as excellent methods for addressing arterial bleeding. Mechanical pelvic stabilization and surgical hemostasis by pelvic packing, on the other hand, may effectively control venous bleeding and bleeding from the fractured bony surface. However, since there is no precise way to determine the major source of bleeding that is responsible for the hemodynamic instability, controversy remains over the timing and optimal order of angiography, mechanical pelvic stabilization, and packing. Conclusions: The author’s own approach to these patients includes angiographic embolization as a first-line treatment only in hemodynamically stable patients with an arterial blush seen in the computed tomography scan, indicating acute arterial bleeding. Hemodynamically unstable patients are immediately transferred to the operating room, where pelvic packing and mechanical stabilization of the pelvic ring are carried out. Optionally, a subsequent postoperative angio-embolization is performed if signs of further bleeding remain present.
Genetic variants of ACE (Insertion/Deletion) and AGT (M268T) genes in patients with diabetes and nephropathy
Authors: Shaikh Rozeena , Shahid Syed M , Mansoor Qaisar , Ismail Muhammad , Azhar Abid 
Published: April 2014

Introduction: Diabetes mellitus (DM) has been a growing epidemic worldwide and poses a major socio-economic challenge. The leading cause of DM death is nephropathy due to end-stage renal disease (ESRD). This study aims to identify the possible association of I/D variants of the ACE gene and M268T (rs699) of the AGT gene of renin–angiotensin–aldosterone system (RAAS). Materials and methods: Study subjects include 115 patients with DM, 110 with diabetic nephropathy (DN) and 110 controls. Fasting blood samples were collected for biochemical analyses and PCR amplification of specific regions of the ACE and AGT genes using primers. Results: The distribution of ACE (I/D) II 28.8%, ID 35.6% and DD 35.6% while in DN II 24.5%, ID 41% and DD 34.5%. The AGT (M268T) genotypes were distributed in DM as TT 30.4%, MT 66.9% and MM 2.6% while in DN subjects TT 56.4%, MT 42.7% and MM 0.9%. Conclusion: Significant differences were observed in the DD genotype and D allele of the ACE gene and the TT genotype and T allele of AGT genes between diabetic patients with and without nephropathy. The study may conclude that the D allele polymorphism in the ACE gene and the T allele polymorphism in AGT gene may be considered as genetic risk factors for the development of nephropathy in diabetes.