bluuebunny/crossref_metadata_2025_split huggingface dataset:
NICE recommendations for the assessment of stable chest pain: assessing the early economic and service impact in the rapid-access chest pain service
Authors: Ashrafi Reza , Raga Santosh , Abdool Ali , Disney Andrew , Wong Peter , Davis Gershan K 
Published: February 2013

Abstract

Background
In 2010, guidelines published by the National Institute for Clinical Excellence (NICE) suggested a change in the way patients with stable chest pain of suspected cardiac origin were investigated. These guidelines removed exercise treadmill testing from routine use and introduced cardiac CT to regular use.

Objective
To investigate whether these guidelines had improved our service provision by reducing the number of further investigations required to make a diagnosis, and to see if our costs had increased now that the less expensive exercise treadmill tests were not recommended.

Methods
Clinic letters were used to assess patients pretest likelihood of coronary artery disease for two six-month cohorts of consecutive patients seen in the rapid access chest pain clinic (January–June 2010 and July–December 2011) using NICE published methodology, and to ascertain which investigations patients had. Using NICE modelled costs, we generated comparative hypothetical costs for each cohort and an average cost per patient.

Results
In the January–June 2010 cohort, 435 patients with chest pain were seen, and in July–December 2011, 334 patients were seen. In the pre-NICE guidelines cohort, 23% of patients required two investigations as compared with 11.4% in the post-NICE guidelines cohort, with no patient requiring three investigations as compared with 3% in the original cohort. There was no significant increase in costs per patient in the post-NICE guidance group.

Conclusions
Implementing NICE guidance reduced the number of investigations needed per patient, and did not prove more expensive for our department in the short term.
The Investigational Aurora Kinase A Inhibitor MLN8237 Induces Defects in Cell Viability and Cell-Cycle Progression in Malignant Bladder Cancer Cells In Vitro and In Vivo
Authors: Zhou Ning , Singh Kamini , Mir Maria C. , Parker Yvonne , Lindner Daniel , Dreicer Robert , Ecsedy Jeffrey A. , Zhang Zhongfa , Teh Bin T. , Almasan Alexandru , Hansel Donna E. 
Published: February 2013

Abstract
Purpose: Despite more than 70,000 new cases of bladder cancer in the United States annually, patients with advanced disease have a poor prognosis due to limited treatment modalities. We evaluated Aurora kinase A, identified as an upregulated candidate molecule in bladder cancer, as a potential therapeutic target.
Experimental Design: Gene expression in human bladder cancer samples was evaluated using RNA microarray and quantitative reverse transcriptase PCR. Effects of the Aurora kinase A inhibitor MLN8237 (Millennium) on cell dynamics in malignant T24 and UM-UC-3 and papilloma-derived RT4 bladder cells were evaluated in vitro and in vivo in a mouse xenograft model.
Results: A set of 13 genes involved in the mitotic spindle checkpoint, including Aurora kinases A and B, were upregulated in human urothelial carcinoma compared with normal urothelium. The Aurora kinase A inhibitor MLN8237 induced cell-cycle arrest, aneuploidy, mitotic spindle failure, and apoptosis in the human bladder cancer cell lines T24 and UM-UC-3. MLN8237 also arrested tumor growth when administered orally over 4 weeks in a mouse bladder cancer xenograft model. Finally, in vitro sequential administration of MLN8237 with either paclitaxel or gemcitabine resulted in synergistic cytotoxic effects in T24 cells.
Conclusions: Mitotic spindle checkpoint dysfunction is a common characteristic of human urothelial carcinoma and can be exploited with pharmacologic Aurora A inhibition. Given our demonstration of the ability of the Aurora A inhibitor MLN8237 to inhibit growth of bladder cancer in vitro and in vivo, we conclude that Aurora kinase inhibitors warrant further therapeutic investigation in bladder cancer. Clin Cancer Res; 19(7); 1717–28. ©2013 AACR.
Near-infrared Spectroscopy–mediated Neurofeedback Enhances Efficacy of Motor Imagery–based Training in Poststroke Victims
Authors: Mihara Masahito , Hattori Noriaki , Hatakenaka Megumi , Yagura Hajime , Kawano Teiji , Hino Taro , Miyai Ichiro 
Published: February 2013

Background and Purpose—
Despite the findings that motor imagery and execution are supposed to share common neural networks, previous studies using imagery-based rehabilitation have revealed inconsistent results. In the present study, we investigated whether feedback of cortical activities (neurofeedback) using near-infrared spectroscopy could enhance the efficacy of imagery-based rehabilitation in stroke patients.

Methods—
Twenty hemiplegic patients with subcortical stroke received 6 sessions of mental practice with motor imagery of the distal upper limb in addition to standard rehabilitation. Subjects were randomly allocated to REAL and SHAM groups. In the REAL group, cortical hemoglobin signals detected by near-infrared spectroscopy were fed back during imagery. In the SHAM group, irrelevant randomized signals were fed back. Upper limb function was assessed using the finger and arm subscales of the Fugl-Meyer assessment and the Action Research Arm Test.

Results—

The hand/finger subscale of the Fugl-Meyer assessment showed greater functional gain in the REAL group, with a significant interaction between time and group (
F
2,36
=15.5;
P
<0.001). A significant effect of neurofeedback was revealed even in severely impaired subjects. Imagery-related cortical activation in the premotor area was significantly greater in the REAL group than in the SHAM group (
T
58
=2.4;
P
<0.05).

Conclusions—
Our results suggest that near-infrared spectroscopy–mediated neurofeedback may enhance the efficacy of mental practice with motor imagery and augment motor recovery in poststroke patients with severe hemiparesis.
Hydrological Cycles over the Congo and Upper Blue Nile Basins: Evaluation of General Circulation Model Simulations and Reanalysis Products
Authors: Siam Mohamed S. , Demory Marie-Estelle , Eltahir Elfatih A. B. 
Published: February 2013

AbstractThe simulations and predictions of the hydrological cycle by general circulation models (GCMs) are characterized by a significant degree of uncertainty. This uncertainty is reflected in the range of Intergovernmental Panel on Climate Change (IPCC) GCM predictions of future changes in the hydrological cycle, particularly over major African basins. The confidence in GCM predictions can be increased by evaluating different GCMs, identifying those models that succeed in simulating the hydrological cycle under current climate conditions, and using them for climate change studies. Reanalyses are often used to validate GCMs, but they also suffer from an inaccurate representation of the hydrological cycle. In this study, the aim is to identify GCMs and reanalyses' products that provide a realistic representation of the hydrological cycle over the Congo and upper Blue Nile (UBN) basins. Atmospheric and soil water balance constraints are employed to evaluate the models' ability to reproduce the observed streamflow, which is the most accurate measurement of the hydrological cycle. Among the ECMWF Interim Re-Analysis (ERA-Interim), NCEP–NCAR reanalysis, and 40-yr ECWMF Re-Analysis (ERA-40), ERA-Interim shows the best performance over these basins: it balances the water budgets and accurately represents the seasonal cycle of the hydrological variables. The authors find that most GCMs used by the IPCC overestimate the hydrological cycle compared to observations. They observe some improvement in the simulated hydrological cycle with increased horizontal resolution, which suggests that some of the high-resolution GCMs are better suited for climate change studies over Africa.
Improving the Human–Computer Dialogue With Increased Temporal Predictability
Authors: Weber Florian , Haering Carola , Thomaschke Roland 
Published: February 2013

Objective: An experiment was conducted to investigate the impacts of length and variability of system response time (SRT) on user behavior and user experience (UX) in sequential computing tasks. Background: Length is widely considered to be the most important aspect of SRTs in human–computer interaction. Research on temporal attention shows that humans adjust to temporal structures and that performance substantially improves with temporal predictability. Method: Participants performed a sequential task with simulated office software. Duration and variability, that is, the number of different SRTs, was manipulated. Lower variability came at the expense of on average higher durations. User response times, task execution times, and failure rates were measured to assess user performance. UX was measured with a questionnaire. Results: A reduction in variability improved user performance significantly. Whereas task load and failure rates remained constant, responses were significantly faster. Although a reduction in variability came along with, on average, increased SRTs, no difference in UX was found. Conclusion: Considering SRT variability when designing software can yield considerable performance benefits for the users. Although reduced variability comes at the expense of overall longer SRTs, the interface is not subjectively evaluated to be less satisfactory or demanding. Time design should aim not only at reducing average SRT length but also at finding the optimum balance of length and variability. Application: Our findings can easily be applied in any user interface for sequential tasks. User performance can be improved without loss of satisfaction by selectively prolonging particular SRTs to reduce variability.
Combined effects of sensory cueing and limb activation on unilateral neglect in subacute left hemiplegic stroke patients: a randomized controlled pilot study
Authors: Fong Kenneth NK , Yang Nicole YH , Chan Marko KL , Chan Dora YL , Lau Andy FC , Chan Dick YW , Cheung Joyce TY , Cheung Hobby KY , Chung Raymond CK , Chan Chetwyn CH 
Published: February 2013

Objective: To compare the effects of contralesional sensory cueing and limb activation with that of sham control in the treatment of unilateral neglect after stroke. Design: A randomized, single-blinded, sham-controlled pilot study. Setting: Two rehabilitation hospitals. Subjects: Forty subacute left hemiplegic stroke inpatients with unilateral neglect. Interventions: Participants were assigned randomly to 1 of 2 groups. The experimental group wore a wristwatch cueing device over the hemiplegic arm for three hours a day, five days per week, for three weeks, and also underwent conventional rehabilitation. Patients were encouraged to move their hemiplegic arm five consecutive times after each prompt. The sham group underwent the same rehabilitation process, except they wore a sham device. Main measures: Neglect, arm motor performance, and overall functioning were assessed pre- and posttraining, and at follow-up. Results: There were no significant differences between groups in outcome measures except the neglect drawing tasks ( p = 0.034) (the mean gain score from baseline to follow-up assessment was 5.2 (3.7) in the experimental group and 1.9 (3.5) in the sham group), across three time intervals. The experimental group showed greater improvement in arm motor performance than did the sham group. Conclusion: The results did not confirm that sensory cueing and limb activation treatment is effective when compared with those receiving placebo to reduce unilateral neglect, but it might be useful for promoting hemiplegic arm performance in stroke patients.
Chronic cerebrospinal venous insufficiency in multiple sclerosis: a highly prevalent age-dependent phenomenon
Authors: Lanzillo Roberta , Mancini Marcello , Liuzzi Raffaele , Di Donato Orlando , Salvatore Elena , Maglio Valentina , Vacca Giovanni , Amato Luca , D’Anna Gennaro , Brunetti Arturo , Brescia Morra Vincenzo 
Published: February 2013

Abstract

Background
This study aimed to investigate the prevalence and clinical relevance of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis (MS) patients and healthy controls using extra- and intracranial colour Doppler sonography.

Methods
We examined 146 MS patients, presenting with a clinically isolated syndrome, relapsing-remitting, secondary progressive, or primary progressive MS, and 38 healthy controls. Sonographic examination was performed according to Zamboni’s protocol and was performed by three independent sonographers. The results of sonographic examination were compared with clinical and demographic characteristics of the patients.

Results
CCSVI, defined as the presence of at least two positive Zamboni’s criteria, was found in 76% of MS patients and 16% of control subjects. B-mode anomalies of internal jugular veins, such as stenosis, malformed valves, annuli, and septa were the most common lesions detected in MS patients (80.8%) and controls (47.4%). We observed a positive correlation between sonographic diagnosis of CCSVI and the patients’ age (p = 0.003). However, such a correlation was not found in controls (p = 0.635). Notably, no significant correlations were found between sonographic signs of CCSVI and clinical characteristics of MS, except for absent flow in the jugular veins, which was found more often in primary (p<0.005) and secondary (p<0.05) progressive patients compared with non-progressive patients. Absent flow in jugular veins was significantly correlated with patients’ age (p < 0.0001).

Conclusions
Sonographically defined CCSVI is common in MS patients. However, CCSVI appears to be primarily associated with the patient’s age, and poorly correlated with the clinical course of the disease.
Spatio-temporal malaria transmission patterns in Navrongo demographic surveillance site, northern Ghana
Authors: Kasasa Simon , Asoala Victor , Gosoniu Laura , Anto Francis , Adjuik Martin , Tindana Cletus , Smith Thomas , Owusu-Agyei Seth , Vounatsou Penelope 
Published: February 2013

Abstract

Background
The relationship between entomological measures of malaria transmission intensity and mortality remains uncertain. This is partly because transmission is heterogeneous even within small geographical areas. Studying this relationship requires high resolution, spatially structured, longitudinal entomological data. Geostatistical models that have been used to analyse the spatio-temporal heterogeneity have not considered the uncertainty in both sporozoite rate (SR) and mosquito density data. This study analysed data from Kassena-Nankana districts in northern Ghana to obtain small area estimates of malaria transmission rates allowing for this uncertainty.

Methods
Independent Bayesian geostatistical models for sporozoite rate and mosquito density were fitted to produce explicit entomological inoculation rate (EIR) estimates for small areas and short time periods, controlling for environmental factors.

Results
Mosquitoes were trapped from 2,803 unique locations for three years using mainly CDC light traps. Anopheles gambiae constituted 52%, the rest were Anopheles funestus. Mean biting rates for An. funestus and An. gambiae were 32 and 33 respectively. Most bites occurred in September, the wettest month. The sporozoite rates were higher in the dry periods of the last two years compared with the wet period. The annual EIR varied from 1,132 to 157 infective bites. Monthly EIR varied between zero and 388 infective bites. Spatial correlation for SR was lower than that of mosquito densities.

Conclusion
This study confirms the presence of spatio-temporal heterogeneity in malaria transmission within a small geographical area. Spatial variance was stronger than temporal especially in the SR. The estimated EIR will be used in mortality analysis for the area.
The impact of serological features in Chinese children with primary or past Epstein–Barr virus infections
Authors: Huang Yuan , Wei Cong , Zheng Kun , Zhao Dongchi 
Published: February 2013

Abstract

Background
Epstein–Barr virus (EBV) is a primary cause of infectious mononucleosis (IM) throughout the world, and the positive serology rate changes over time in infected individuals. The aim of this study was to explore the serological and clinical features among Chinese children with EBV infections. A retrospective study of children suspected of having IM was conducted. Peripheral blood samples were analyzed by indirect immunofluorescence to detect any EBV-specific antibodies. Samples were classed as positive (+) or negative (−) to immunoglobulins M (IgM) or G (IgG) to the viral capsid antigen (VCA) or EBV nuclear antigen (EBNA). A standard medical history was taken, including epidemiological data and noting any clinical manifestations.

Results
Of 317 children, 37 were aged <8 months; 10 of these were VCA-IgM+, and the youngest was aged 1 month; 280 were aged >8 months. The EBV infection rate ranged from 21.4% among subjects aged 8–12 months to 84.2% in those aged >9 years. Serologically, children who tested as VCA-IgM+ together with VCA-IgG and EBNA-IgG– had longer hospital stays with more palatal petechiae and lymphadenopathy, especially among those with an atypical lymphocyte count of >10%. Children with the serological patterns [VCA-IgM–, VCA-IgG+ and EBNA-IgG–] and [VCA-IgM+ VCA-IgG+ and EBNA-IgG+] did not show specific clinical features.

Conclusions
Infants aged <8 months could be infected with EBV. About 84% of these Chinese children aged >9 years had serological evidence of EBV infection, whereas IM peaked in patients aged 2–3 years.
Chicken faecal microbiota and disturbances induced by single or repeated therapy with tetracycline and streptomycin
Authors: Videnska Petra , Faldynova Marcela , Juricova Helena , Babak Vladimir , Sisak Frantisek , Havlickova Hana , Rychlik Ivan 
Published: February 2013

Abstract

Background
In this study, we characterised the microbiota present in the faeces of 15- and 46-week-old egg laying hens before and after tetracycline or streptomycin therapy. In the first experiment, the layers were subjected to 7 days of therapy. In the second experiment, the hens were subjected to two days of therapy, which was repeated for an additional two days after 12 days of antibiotic withdrawal. This enabled us to characterise dynamics of the changes after antibiotic administration and withdrawal, and to identify genera repeatedly resistant to tetracycline and streptomycin.

Results
Real-time PCRs specific for Enterobacteriales, Lactobacillales, Clostridiales and Bifidobacteriales showed that changes in the microbiota in response to antibiotic therapy and antibiotic withdrawal were quite rapid and could be observed within 24 hours after the change in therapy status. Pyrosequencing of PCR amplified V3/V4 variable regions of 16S rRNA genes showed that representatives of the orders Clostridiales, Lactobacillales, Bacteroidales, Bifidobacteriales, Enterobacteriales, Erysipelotrichales, Coriobacteriales, Desulfovibrionales, Burkholderiales, Campylobacterales and Actinomycetales were detected in the faeces of hens prior to the antibiotic therapy. Tetracycline and streptomycin therapies decreased the prevalence of Bifidobacteriales, Bacteroidales, Clostridiales, Desulfovibrionales, Burkholderiales and Campylobacterales in faecal samples in both experiments. On the other hand, Enterobacteriales and Lactobacillales always increased in prevalence in response to both therapies. Within the latter two orders, Escherichia and Enterococcus were the genera prevalence of which increased after all the antibiotic treatments.

Conclusions
The changes in microbiota composition induced by the antibiotic therapy were rapid and quite dramatic and only representatives of the genera Enterococcus and Escherichia increased in response to the therapy with both antibiotics in both experiments.
Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan
Authors: Mannan Hasheem , ElTayeb Shahla , MacLachlan Malcolm , Amin Mutamad , McVeigh Joanne , Munthali Alister , Van Rooy Gert 
Published: February 2013

Abstract

Background
One of the most crucial steps towards delivering judicious and comprehensive mental health care is the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a high-quality mental health system are considerable: the provision of mental health services to all who need them, in an equitable way, in a mode that promotes human rights and health outcomes.

Method

EquiFrame, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi, Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of High, Moderate, or Low quality.

Results
Substantial variability was identified across EquiFrame’s summary indices for the mental health policies of Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage. Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored 33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary Ranking of Low accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was High; for the Sudanese Mental Health Policy was Moderate; and for the Malawian Mental Health Policy was Low.

Conclusions
If human rights and equity underpin policy formation, it is more likely that they will be inculcated in health service delivery. EquiFrame may provide a novel and valuable tool for mental health policy analysis in relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful realization of the Millennium Development Goals.