bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies
Authors: Wang Yi-lun , Zeng Chao , Xie Dong-xing , Yang Ye , Wei Jie , Yang Tuo , Li Hui , Lei Guang-hua 
Published: June 2015

ObjectivesTo evaluate the efficacy and safety of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery.DesignMeta-analysis.Data sources and study eligibility criteriaA comprehensive literature search, using Medline (1966–2014), the Cochrane Central Register of Controlled Trials and Embase databases, was conducted to identify randomised placebo-controlled trials that used a combination of single-dose intra-articular bupivacaine and morphine for postoperative pain relief.Results12 articles were included in this meta-analysis. The mean visual analogue scale (VAS) scores of the bupivacaine plus morphine group were significantly lower than those of the placebo group (weighted mean difference (WMD) −1.75; 95% CI −2.16 to −1.33; p<0.001). The VAS scores at the last follow-up time point (last VAS scores) of the bupivacaine plus morphine group were also significantly lower than those of the placebo group (WMD −1.46; 95% CI −1.63 to −1.29; p<0.001). The number of patients requiring supplementary analgesia was also significantly reduced (RR 0.60; 95% CI 0.39 to 0.93; p=0.02), while there was no significant difference in the time to first analgesic request (WMD 3.46; 95% CI −1.81 to 8.72; p=0.20) or short-term side effects (RR 1.67; 95% CI 0.65 to 4.26; p=0.29).ConclusionsThe administration of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery is effective for pain relief, and its short-term side effects remain similar to saline placebo.
Patient Mutation Directed shRNA Screen Uncovers Novel Bladder Tumor Growth Suppressors
Authors: Hensel Jonathan , Duex Jason E. , Owens Charles , Dancik Garrett M. , Edwards Michael G. , Frierson Henry F. , Theodorescu Dan 
Published: June 2015

Abstract
Next-generation sequencing (NGS) of human bladder cancer has revealed many gene alterations compared with normal tissue, with most being predicted to be “loss of function.” However, given the high number of alterations, evaluating the functional impact of each is impractical. Here, we develop and use a high-throughput, in vivo strategy to determine which alterations are loss of function in tumor growth suppressors. Genes reported as altered by NGS in bladder cancer patients were bioinformatically processed by MutationTaster and MutationAssessor, with 283 predicted as loss of function. An shRNA lentiviral library targeting these genes was transduced into T24 cells, a nontumorigenic human bladder cancer cell line, followed by injection into mice. Tumors that arose were sequenced and the dominant shRNA constructs were found to target IQGAP1, SAMD9L, PCIF1, MED1, and KATNAL1 genes. In vitro validation experiments revealed that shRNA molecules directed at IQGAP1 showed the most profound increase in anchorage-independent growth of T24 cells. The clinical relevance of IQGAP1 as a tumor growth suppressor is supported by the finding that its expression is lower in bladder cancer compared with benign patient urothelium in multiple independent datasets. Lower IQGAP1 protein expression associated with higher tumor grade and decreased patient survival. Finally, depletion of IQGAP1 leads to increased TGFBR2 with TGFβ signaling, explaining in part how reduced IQGAP1 promotes tumor growth. These findings suggest IQGAP1 is a bladder tumor growth suppressor that works via modulating TGFβ signaling and is a potentially clinically useful biomarker.
Implications: This study used gene mutation information from patient-derived bladder tumor specimens to inform the development of a screen used to identify novel tumor growth suppressors. This included identification of the protein IQGAP1 as a potent bladder cancer growth suppressor. Mol Cancer Res; 13(9); 1306–15. ©2015 AACR.
A história que foi usada nos tombamentos e na conservação da Casa do Conselheiro Rodrigues Alves
Authors: Siqueira Lucília Santos 
Published: June 2015

<p>Francisco de Paula Rodrigues Alves (1848-1919) foi Presidente da República do Brasil entre 1902 e 1906. A casa em que morou em Guaratinguetá (SP), construída em taipa nos meados do século XIX, foi tombada nos níveis federal e estadual. Por meio dos processos de tombamento e de alguns eventos relativos à conservação deste bem cultural, examinamos os conteúdos históricos que circularam nos órgãos de patrimônio entre a década de 1960 e o começo do século XXI. </p>
Hospital Variability in Use of Anticoagulant Strategies During Acute Myocardial Infarction Treated With an Early Invasive Strategy
Authors: Arnold Suzanne V. , Li Shu‐Xia , Alexander Karen P. , Spertus John A. , Nallamothu Brahmajee K. , Curtis Jeptha P. , Kosiborod Mikhail , Gupta Aakriti , Wang Tracy Y. , Lin Haiqun , Dharmarajan Kumar , Strait Kelly M. , Lowe Timothy J. , Krumholz Harlan M. 
Published: June 2015

Background
During a myocardial infarction, no single best approach of systemic anticoagulation is recommended, likely due to a lack of comparative effectiveness studies and trade‐offs between treatments.

Methods and Results

We investigated the patterns of use and site‐level variability in anticoagulant strategies (unfractionated heparin [
UFH
] only, low‐molecular‐weight heparin [
LMWH
] only,
UFH
+
LMWH
, any bivalirudin) of 63 796 patients with a principal diagnosis of myocardial infarction treated with an early invasive strategy with percutaneous coronary intervention at 257 hospitals. About half (47%) of patients received
UFH
only, 6%
UFH
+
LMWH
, 7%
LMWH
only, and 40% bivalirudin. Compared with
UFH
, the median odds ratio was 2.90 for
LMWH
+
UFH
, 4.70 for
LMWH
only, and 3.09 for bivalirudin, indicating that 2 “identical” patients would have a 3‐ to 4‐fold greater likelihood of being treated with anticoagulants other than
UFH
at one hospital compared with another. We then categorized hospitals as low‐ or high‐users of
LMWH
and bivalirudin. Using hierarchical, multivariate regression models, we found that low bivalirudin‐using hospitals had higher unadjusted bleeding rates, but the risk‐adjusted and anticoagulant‐adjusted bleeding rates did not differ across the hospital anticoagulation phenotypes. Risk‐standardized mortality and risk‐standardized length of stay also did not differ across hospital phenotypes.

Conclusions
We found substantial site‐level variability in the choice of anticoagulants for invasively managed acute myocardial infarction patients, even after accounting for patient factors. No single hospital‐use pattern was found to be clinically superior. More studies are needed to determine which patients would derive the greatest benefit from various anticoagulants and to support consistent treatment of patients with the optimal anticoagulant strategy.
The Role of Coping Strategies in Psychological Outcomes for Frontotemporal Dementia Caregivers
Authors: Roche, DClinPsy Lauren , Croot Karen , MacCann Carolyn , Cramer Barbara , Diehl-Schmid Janine 
Published: June 2015

Background: Caregiving for a person with frontotemporal dementia (FTD) is related to poor caregiver outcomes. Coping strategies adopted by caregivers are known to influence psychological outcomes in other dementia caregiver populations, however, their influence on psychological outcomes in FTD caregivers is poorly understood at present. Methods: Questionnaire data for 94 German primary caregivers (mean [ M] 59.11 years, 68 females) of FTD care-recipients living in the community ( M 63.94, 30 females) were investigated. Standardized measures completed by the caregiver included the Caregiver Strain Index (CSI), Beck Depression Inventory II (BDI-II), Quality of Life-Alzheimer’s Disease (QoL-AD), and the Brief Coping Orientations to Problems Experienced (COPE). Care-recipients’ nursing care level was collected as a measure of the intensity of their care needs. Results: Mediation analyses showed that the effect of the intensity of care-recipients’ care needs on caregiver well-being depended on caregivers’ experience of strain. High levels of caregiver strain did not predict depression (−0.22, 95% confidence interval CI: [0.16 to 2.04]) but predicted reduced QoL (−0.44, CI: [−1.15 to −.16]). Moreover, caregivers’ experience of strain was exacerbated by their use of dysfunctional coping (β = .21; p = .04), care-recipients’ intensity of care needs (β = .25; p = .01), and fewer financial resources (β = .23; p = .02). In turn, caregivers’ use of dysfunctional coping as a response to their strain increased the levels of depression (0.46, CI: [0.19-0.82]). By contrast, use of problem-focused coping strategies increased caregivers’ QoL (0.10, CI: [0.00 to 0.31]). Significance: This study identifies variables amenable to clinical interventions that can improve caregivers’ well-being: specifically, caregiver strain and coping strategies. For a disease without cure yet increasing prevalence and cost, ameliorating the caregiver experience through targeted interventions is essential.
Improved understanding of rice amylose biosynthesis from advanced starch structural characterization
Authors: Li Enpeng , Wu Alex Chi , Li Juan , Liu Qiaoquan , Gilbert Robert G 
Published: June 2015

Abstract

Background
It has been shown from the chain length distributions (CLDs) that amylose chains can be divided into at least two groups: long and short amylose chains. These molecular structures influence some functional properties of starch, such as digestibility and mouth-feel. GBSSI is the key enzyme for the elongation of amylose chains; however, the effect of other starch biosynthesis enzymes in amylose synthesis is still not fully understood. Two advanced starch characterization techniques, size exclusion chromatography (SEC) and fluorophore-assissted carbohydrate electrophoresis (FACE), together with a newly developed starch biosynthesis model, are used to improve understanding of amylose biosynthesis.

Results
SEC and FACE were used to determine the CLD of amylose and amylopectin in various native and mutant rice starches. The types of starch branching enzymes (SBEs) involved in the synthesis of the distinct features seen for shorter degrees of polymerization, DP, < 2000, and longer (DP > 2000) amylose chains are identified by combining these data with a mathematical model of amylopectin biosynthesis. The model enables each feature in the amylopectin CLD to be parameterized in terms of relative SBE activities, which are used to explain differences in the genotypes.

Conclusions
The results suggest that while GBSSI is the predominant enzyme controlling the synthesis of longer amylose chains, some branching enzymes (such as BEI and BEIIb) also play important roles in the synthesis of shorter amylose chains.
Perioperative goal-directed therapy and postoperative outcomes in patients undergoing high-risk abdominal surgery: a historical-prospective, comparative effectiveness study
Authors: Cannesson Maxime , Ramsingh Davinder , Rinehart Joseph , Demirjian Aram , Vu Trung , Vakharia Shermeen , Imagawa David , Yu Zhaoxia , Greenfield Sheldon , Kain Zeev 
Published: June 2015

Abstract
Introduction
Perioperative goal-directed therapy (PGDT) may improve postoperative outcome in high-risk surgery patients but its adoption has been slow. In 2012, we initiated a performance improvement (PI) project focusing on the implementation of PGDT during high-risk abdominal surgeries. The objective of the present study was to evaluate the effectiveness of this intervention.

Methods
This is a historical prospective quality improvement study. The goal of this initiative was to standardize the way fluid management and hemodynamic optimization are conducted during high-risk abdominal surgery in the Departments of Anesthesiology and Surgery at the University of California Irvine. For fluid management, the protocol consisted in standardized baseline crystalloid administration of 3 ml/kg/hour and any additional boluses based on PGDT. The impact of the intervention was assessed on the length of stay in the hospital (LOS) and post-operative complications (NSQIP database).

Results
In the 1 year pre- and post-implementation periods, 128 and 202 patients were included. The average volume of fluid administered during the case was 9.9 (7.1–13.0) ml/kg/hour in the pre-implementation period and 6.6 (4.7–9.5) ml/kg/hour in the post-implementation period (p < 0.01). LOS decreased from 10 (6–16) days to 7 (5–11) days (p = 0.0001). Based on the multiple linear regression analysis, the estimated coefficient for intervention was 0.203 (SE = 0.054, p = 0.0002) indicating that, with the other conditions being held the same, introducing intervention reduced LOS by 18 % (95 % confidence interval 9–27 %). The incidence of NSQIP complications decreased from 39 % to 25 % (p = 0.04).

Conclusion
These results suggest that the implementation of a PI program focusing on the implementation of PGDT can transform fluid administration patterns and improve postoperative outcome in patients undergoing high-risk abdominal surgeries.

Trial registration
Clinicaltrials.gov NCT02057653. Registered 17 December 2013.
TLR2, but not TLR4, plays a predominant role in the immune responses to cholera vaccines
Authors: Yang Jae Seung , Kim Hye Jin , Kang Seok-Seong , Kim Kyoung Whun , Kim Dong Wook , Yun Cheol-Heui , Park Soon-Jung , Seo Ho Seong , Finlay B Brett , Han Seung Hyun 
Published: June 2015

Abstract
Vibrio cholerae can cause severe diarrhea and dehydration leading to high mortality and morbidity. Current cholera vaccines are formulated with KVC. Although the innate immune responses following vaccination deeply influence the induction of adaptive immunity, the initial recognition of cholera vaccines by the host innate immune system is not well characterized. In this study, the ability of KVC to induce innate immune responses was investigated. Unlike typical Gram-negative bacteria stimulating TLR2 and TLR4, KVC activated TLR2 but hardly TLR4. However, purified V. cholerae LPS preferentially stimulated TLR4, although not as potently as LPS of other Gram-negative bacteria, implying that LPS is not a major immunostimulatory component of KVC. Instead, MPFs were similar to KVC in the capacity to activate TLR2, transcription factors, and cytokine expression. Furthermore, OmpU is an abundant membrane protein of V. cholerae and could interact with TLR2 for inducing cytokine expression. Notably, cholera vaccine-induced immune responses are impaired in TLR2−/− mice. Conclusively, TLR2 is essential for the immune responses to cholera vaccination, and OmpU is the major immunostimulatory component of cholera vaccines.
Strong Interaction of Bovine Brain Calmodulin with Bisphenol A: Effects on Secondary Structure, Conformation, Ca2+-Binding Affinity, Gibbs Energy, and Domain Cooperativity
Authors: Murayama Koichi , Sonoyama Masashi , Matsuda Sadayuki 
Published: June 2015

Abstract
Calmodulin (CaM) is a major member of the family of Ca2+-binding proteins. In this study, effects on Ca2+-binding affinity and conformation of CaM by bisphenol A (BPA) were investigated by using circular dichroism and UV absorbance spectroscopy, domain-specific fluorescence spectroscopy, and isothermal titration calorimetry. It was revealed that the existence of a strongly perturbed chirality arose from four BPA molecules binding to CaM by hydrogen bonding, and that the conformation of CaM was modified for binding with BPA. Consequently, the interaction CaM with BPA elicits reduction of Ca2+-binding affinity and the deterioration of domain cooperativity.
The Ancient Hippocrates: Galen and the Apology of Medicin in the Proprepticus
Authors: Komorowska Joanna 
Published: June 2015

Ancient Hippocrates: Galen and the Apology of Medicin in the Proprepticus
Easy as it is to consider Galen’s Protrepticus a straightforward exercise in the art of hortative rhetorics, it seems advisable to consider the ramifications and the role played by the philosophical hypotext: given the details of the argument, one may easily be reminded of certain passages of the Platonic Gorgias, as well as the importance of the actual imagery exploited in the course of exposition. In doing so, the essay seeks to reevaluate the Galenic work and put it in the wider context of philosophizing discourses of the era.
Elocutio in Quintilian's Institutio Oratoria, Book Eight
Authors: Śnieżewski Stanisław 
Published: June 2015

Elocutio in Quintilian's Institutio Oratoria, Book Eight
The rhetorical art is the skill of speaking well, it is useful, it is an art, and it has virtus. The Greek concept of fra;sivj is rendered by Roman authors as elocutio, i.e. style. Quintilian believes clarity of speech is the basic element of good style. Words should be apt, order – direct, conclusion – not too distant, and everything should have adequate proportions. Words should be selected depending on the context. The words used in a metaphorical sense gain appreciation only in a specific context. Ability to present facts clearly and vividly is a great asset. Even the natural and unsophisticated simplicity, which the Greeks call afeleia, contains some decorativeness, while punctilious scrupulosity in adhering to grammatical correctness gives the impression of sophistication and subtlety. The real power of the speaker lies in his ability to strengthen or weaken the power of words. The last, sixth chapter of book eight contains Quintilian’s thoughts on the rhetorical tropes. A trope (tro;povj) is an artistic (cum virtute) change of a word or an expression from the original and proper one to another.
Differential effects of focused and unfocused recasts on EFL learners’ oral accuracy
Authors: Ansarin Ali Akbar , Chehrazad Mohammad Hassan 
Published: June 2015

One of the limitations of the meaning-focused instruction in an EFL context is that a communicative approach isn’t sufficient enough to ensure higher levels of oral accuracy. The purpose of the current study was to investigate the effects of two different focus on form techniques, extensive and intensive recasts, on the EFL learners’ oral accuracy. Three pre-intermediate intact classes were randomly selected as the intensive recast, extensive recast, and the control groups. In the intensive recast group the focus of correction was on the simple past tense errors. In the extensive recast group the recast was provided for all errors. In the control group, there was no corrective feedback. Learners’ oral accuracy as the number of Error-free T-units per T-units was measured. One-way ANOVAs indicated that the differences among groups were only significant in sessions five and six. Tukey HSD indicated that intensive recast group outperformed both the extensive and the control groups in these sessions and there were no significant differences between the other two groups. These findings suggest that focus on form can be an effective tool for the development of the oral accuracy in the EFL situations. In addition, recasting learners’ oral errors could enhance the oral accuracy.
Segmentación y conteo de las líneas de la nariz del feto en imágenes ecográficas de las 11-13+6 semanas de gestación
Authors: Ballesteros Maldonado Angee Paola , López Alza Laura Catalina , Herrera Garcia Rodrigo Javier 
Published: June 2015

<p><span>Este documento presenta un método para la segmentación de la nariz y el posterior conteo de las líneas correspondientes a la piel, el hueso nasal y la punta de la nariz en imágenes de ultrasonido fetales 2D del primer trimestre de gestación, de 11 a 13 semanas y 6 días (11-13</span><span><sup>+6 </sup></span><span>semanas). La presencia de las tres líneas del área nasal es una de las características que debe cumplir el feto en la ecografía para garantizar la confiabilidad de la medición del grosor traslucencia nucal. Dicha medición se emplea para identificar la posible existencia de síndromes o anomalías cromosómicas. El método se aplica a la región correspondiente al corte sagital medio de la cabeza donde se han resaltado las regiones con mayor intensidad. La segmentación es jerarquica: primero, se identifica la región de la nariz a través de máximos regionales y alta excentricidad; posteriormente las líneas ya mencionadas son extraídas con agrupamiento basado en K-medias y morfología matemática. </span></p><p><span>Dada la incertidumbre entre las imágenes con respecto a posición fetal, resolución, nivel de ruido y rango dinámico, los resultados obtenidos van desde casos en los que no se encuentra la región de interés, hasta otros en los que son claramente identificables las líneas.</span></p>
Development of a topology-based current-flux characteristic approximation in a Hamiltonian model of a reluctance machine
Authors: Burlikowski Wojciech , Kowalik Zygmunt 
Published: June 2015

Abstract
The paper presents an algorithm for the construction of an approximation of a highly nonlinear current-flux characteristic of a synchronous reluctance machine. Such an approximation is required in a Hamiltonian model of an electric machine and the constructed approximation is suited to be used in such a model. It employs a simplicial approximation based on irregular points sets in the spaces of currents and fluxes. The sets are constructed by the iterative insertion of new points. Initially the sets contain an arbitrarily small number of elements. The insertion is based on an approximation error calculation. Based on the sets containing possibly small number of elements, the proposed procedure leads to smooth and precise approximation. Due to the nonlinearity of the approximated characteristics, ambiguities can occur. A method for the triangulation refinement of the sets of currents and fluxes that eliminates them is also presented. In the paper, a reluctance machine model using the constructed approximation is described and compared with a model using the approximation based on regular sets
Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives
Authors: Russu C. , Copotoiu C. , Bud V. , Saracut C. , Gherghinescu M. , Molnar Varlam C. , Molnar C. 
Published: June 2015

Abstract
Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results.
Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared.
Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made.
Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.