bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of resident and mid-level provider productivity in a high-acuity emergency department setting
Authors: Hamden Khalief , Jeanmonod Donald , Gualtieri Deno , Jeanmonod Rebecca 
Published: January 2013

IntroductionMid-level providers (MLPs) are used in many emergency departments (EDs) to provide care in a low-acuity, high-volume setting, and are able to see more patients and generate more relative value units (RVUs) than residents in this setting. It is unknown if MLPs are as productive as emergency medicine residents in a high-acuity setting.ObjectiveTo determine if there are productivity differences between residents and MLPs, as defined by patients seen (pt/h) and RVUs generated per hour (RVU/h), in a high-acuity area of the ED.MethodsThis is a retrospective review of emergency medicine residents and MLPs assigned to a high-acuity area of a single 45 000 volume community ED. Number of patients seen and RVUs generated were recorded, and pt/h, RVU/h and RVU/pt were calculated. Two-tailed t test was used to compare resident and MLP performance.Results55 MLP and 98 emergency medicine residency shifts were included for comparison. During the study period, MLPs saw 1.56 pt/h (CI±0.14), while residents saw 1.23 pt/h (CI±0.06, p<0.0001). MLPs generated 3.19 RVU/h (CI±0.29), while residents generated 3.33 RVU/h (CI±0.17, p=0.43). Residents generated 2.73 RVU/pt (CI±0.09), while MLPs generated 2.05 RVU/pt (CI±0.09, p<0.0001). In comparing the subgroup of postgraduate year 3 residents (PGY3s) with MLPs, MLPs still saw significantly more patients (1.30 vs 1.56, p=0.003), but PGY3s generated 3.58 RVU/h compared with 3.19 RVU/h for MLPs (p=0.06). PGY3s generated 2.79 RVU/pt compared with 2.05 for MLPs (p<0.0001).ConclusionsIn a high-acuity area of the ED, MLPs see more patients per hour than residents, but generate fewer RVUs per patient. This suggests that residents may document more thoroughly than MLPs. Alternatively, MLPs may elect to see less sick patients even when working in a high-acuity area.
THE FRONTIER OF DECIDABILITY IN PARTIALLY OBSERVABLE RECURSIVE GAMES
Authors: AUGER DAVID , TEYTAUD OLIVIER 
Published: January 2013

The classical decision problem associated with a game is whether a given player has a winning strategy, i.e. some strategy that leads almost surely to a victory, regardless of the other players' strategies. While this problem is relevant for deterministic fully observable games, for a partially observable game the requirement of winning with probability 1 is too strong. In fact, as shown in this paper, a game might be decidable for the simple criterion of almost sure victory, whereas optimal play (even in an approximate sense) is not computable. We therefore propose another criterion, the decidability of which is equivalent to the computability of approximately optimal play. Then, we show that (i) this criterion is undecidable in the general case, even with deterministic games (no random part in the game), (ii) that it is in the jump 0', and that, even in the stochastic case, (iii) it becomes decidable if we add the requirement that the game halts almost surely whatever maybe the strategies of the players.
Phosphorylation of Ribosomal Protein S6 Attenuates DNA Damage and Tumor Suppression during Development of Pancreatic Cancer
Authors: Khalaileh Abed , Dreazen Avigail , Khatib Areej , Apel Roy , Swisa Avital , Kidess-Bassir Norma , Maitra Anirban , Meyuhas Oded , Dor Yuval , Zamir Gideon 
Published: January 2013

Abstract
The signaling pathways that mediate the development of pancreatic ductal adenocarcinoma (PDAC) downstream of mutant Kras remain incompletely understood. Here, we focus on ribosomal protein S6 (rpS6), an mTOR effector not implicated previously in cancer. Phosphorylation of rpS6 was increased in pancreatic acinar cells upon implantation of the chemical carcinogen 7,12-dimethylbenz(a)anthracene (DMBA) or transgenic expression of mutant Kras. To examine the functional significance of rpS6 phosphorylation, we used knockin mice lacking all five phosphorylatable sites in rpS6 (termed rpS6P−/− mice). Strikingly, the development of pancreatic cancer precursor lesions induced by either DMBA or mutant Kras was greatly reduced in rpS6P−/− mice. The rpS6 mutants expressing oncogenic Kras showed increased p53 along with increased staining of γ-H2AX and 53bp1 (Trp53bp1) in areas of acinar ductal metaplasia, suggesting that rpS6 phosphorylation attenuates Kras-induced DNA damage and p53-mediated tumor suppression. These results reveal that rpS6 phosphorylation is important for the initiation of pancreatic cancer. Cancer Res; 73(6); 1811–20. ©2012 AACR.
Genomic and Epigenomic Cross-talks in the Regulatory Landscape of miRNAs in Breast Cancer
Authors: Samantarrai Devyani , Dash Subhra , Chhetri Bini , Mallick Bibekanand 
Published: January 2013

Abstract
MicroRNAs (miRNA) are a class of endogenous, small noncoding RNAs found in animals, plants, and viruses that control their target gene expression posttranscriptionally. They are involved in a wide array of biological processes including cell differentiation, development, cell death and homeostasis, and fine-tune the regulation of these pathways. Their aberrant expressions have been associated with different diseases. These small RNAs are also known to function as oncogenes, oncosupressor genes, modulators of metastatic spread, and regulators of cancer stem cells. Their deregulation is a hallmark of different cancers types including breast cancer. Despite the growing evidence for their involvement in breast cancer, understanding the interplay between miRNAs and their targets leading to the disease remains largely unknown. Here, we provide a comprehensive story on miRNA signatures of breast cancer, miRNAs in breast cancer stem cells, metastamirs (i.e., metastasis regulatory miRNAs), circulating miRNAs as invasive blood-based biomarkers, and oncomiRs and oncosupressor miRNAs associated with breast cancer. Furthermore, we provide biological insights on their regulation by various mechanisms including genomic alterations and demonstration of a complicated feedback network between miRNAs and epigenetic regulators forming an epigenetics–miRNA regulatory circuit whose disruption may underlie the cause of breast cancer. Mol Cancer Res; 11(4); 315–28. ©2013 AACR.
Prognostic Significance of Silent Myocardial Infarction in Newly Diagnosed Type 2 Diabetes Mellitus
Authors: Davis Timothy M.E. , Coleman Ruth L. , Holman Rury R. 
Published: January 2013

Background—
We aimed to determine the prevalence of silent myocardial infarction (SMI) in people with newly diagnosed type 2 diabetes mellitus and its relationships to future myocardial infarction (MI) and all-cause mortality.

Methods and Results—
We examined data from the 5102 patients in the 30-year UK Prospective Diabetes Study (UKPDS) and used Cox proportional hazards regression to examine outcomes by SMI status. Of 1967 patients with complete baseline data, 326 (16.6%) had ECG evidence of SMI (Minnesota codes 1.1 or 1.2) at enrollment. Those with SMI were more likely to be older, female, sedentary, and nonsmokers compared with those without SMI. Their mean blood pressure was greater despite more intensive antihypertensive treatment; they were more likely to be taking aspirin and lipid-lowering therapy; and they had a greater prevalence of microangiopathy. Fully adjusted hazard ratios for those with versus those without SMI in multivariate models that included UKPDS Risk Engine variables were 1.58 (95% confidence interval, 1.22–2.05) for fatal MI and 1.31 (95% confidence interval, 1.10–1.56) for all-cause mortality. Hazard ratios for first fatal or nonfatal MI and for first nonfatal MI were nonsignificant. The net reclassification index showed no improvement when SMI was added to these models, and the integrated discrimination index showed that SMI marginally improved the prediction of fatal MI and all-cause mortality.

Conclusions—
About 1 in 6 UKPDS patients with newly diagnosed type 2 diabetes mellitus had evidence of SMI, which was independently associated with an increased risk of fatal MI and all-cause mortality. However, identification of SMI does not add substantively to current UKPDS Risk Engine predictive variables.

Clinical Trial Registration—

URL:
http://www.controlled-trials.com
. Identifier: ISRCTN number 75451837.
Common Variants Within Oxidative Phosphorylation Genes Influence Risk of Ischemic Stroke and Intracerebral Hemorrhage
Authors: Anderson Christopher D. , Biffi Alessandro , Nalls Michael A. , Devan William J. , Schwab Kristin , Ayres Alison M. , Valant Valerie , Ross Owen A. , Rost Natalia S. , Saxena Richa , Viswanathan Anand , Worrall Bradford B. , Brott Thomas G. , Goldstein Joshua N. , Brown Devin , Broderick Joseph P. , Norrving Bo , Greenberg Steven M. , Silliman Scott L. , Hansen Björn M. , Tirschwell David L. , Lindgren Arne , Slowik Agnieszka , Schmidt Reinhold , Selim Magdy , Roquer Jaume , Montaner Joan , Singleton Andrew B. , Kidwell Chelsea S. , Woo Daniel , Furie Karen L. , Meschia James F. , Rosand Jonathan 
Published: January 2013

Background and Purpose—
Previous studies demonstrated association between mitochondrial DNA variants and ischemic stroke (IS). We investigated whether variants within a larger set of oxidative phosphorylation (OXPHOS) genes encoded by both autosomal and mitochondrial DNA were associated with risk of IS and, based on our results, extended our investigation to intracerebral hemorrhage (ICH).

Methods—
This association study used a discovery cohort of 1643 individuals, a validation cohort of 2432 individuals for IS, and an extension cohort of 1476 individuals for ICH. Gene-set enrichment analysis was performed on all structural OXPHOS genes, as well as genes contributing to individual respiratory complexes. Gene-sets passing gene-set enrichment analysis were tested by constructing genetic scores using common variants residing within each gene. Associations between each variant and IS that emerged in the discovery cohort were examined in validation and extension cohorts.

Results—

IS was associated with genetic risk scores in OXPHOS as a whole (odds ratio [OR], 1.17;
P
=0.008) and complex I (OR, 1.06;
P
=0.050). Among IS subtypes, small vessel stroke showed association with OXPHOS (OR, 1.16;
P
=0.007), complex I (OR, 1.13;
P
=0.027), and complex IV (OR, 1.14;
P
=0.018). To further explore this small vessel association, we extended our analysis to ICH, revealing association between deep hemispheric ICH and complex IV (OR, 1.08;
P
=0.008).

Conclusions—
This pathway analysis demonstrates association between common genetic variants within OXPHOS genes and stroke. The associations for small vessel stroke and deep ICH suggest that genetic variation in OXPHOS influences small vessel pathobiology. Further studies are needed to identify culprit genetic variants and assess their functional consequences.
Histological Features of Carotid Plaque in Patients With Ocular Ischemia Versus Cerebral Events
Authors: Howard Dominic P.J. , van Lammeren Guus W. , Redgrave Jessica N. , Moll Frans L. , de Vries Jean-Paul P.M. , de Kleijn Dominique P.V. , de Borst Gert Jan , Pasterkamp Gerard , Rothwell Peter M. 
Published: January 2013

Background and Purpose—
Patients with carotid artery stenosis and ocular ischemic events have a much lower risk of future ipsilateral ischemic stroke on medical treatment and lower procedural risks for endarterectomy and stenting than patients with cerebral ischemic events, and are closer in risk to patients with asymptomatic stenosis. The reasons for this difference in prognosis are not fully understood, but may reflect differences in carotid plaque pathology.

Methods—
In consecutive patients undergoing carotid endarterectomy for recently symptomatic stenosis (Oxford Plaque Study, Athero-Express Study), we compared carotid plaque histology (using validated semiquantitative scales) in those who had cerebral events within the last 6 months (n=1317) versus those with ocular events only (n=323).

Results—

Compared with plaques from patients with ocular events only, those from patients with cerebral events had significantly more large lipid core (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.05–1.82;
P
=0.02), inflammation (OR, 1.32; 95% CI, 1.02–1.72;
P
=0.04) and overall plaque instability (OR, 1.37; 95% CI, 1.05–1.80;
P
=0.02), and less fibrous content (OR, 0.71; 95% CI, 0.54–0.92;
P
=0.01), and calcification (OR, 0.70; 95% CI, 0.54–0.91;
P
=0.008). The overall number of histological features known to be associated with vulnerable plaque was greater in patients with cerebral events than in those with ocular events (
P
=0.002).

Conclusions—
Carotid plaques from patients undergoing endarterectomy for previous ocular ischemic events have fewer vulnerable plaque features than those from patients with recent cerebral ischemic events, possibly explaining some of the differences in risk of stroke between these groups.
What We Think before a Voluntary Movement
Authors: Schneider Logan , Houdayer Elise , Bai Ou , Hallett Mark 
Published: January 2013

Abstract
A central feature of voluntary movement is the sense of volition, but when this sense arises in the course of movement formulation and execution is not clear. Many studies have explored how the brain might be actively preparing movement before the sense of volition; however, because the timing of the sense of volition has depended on subjective and retrospective judgments, these findings are still regarded with a degree of scepticism. EEG events such as beta event-related desynchronization and movement-related cortical potentials are associated with the brain's programming of movement. Using an optimized EEG signal derived from multiple variables, we were able to make real-time predictions of movements in advance of their occurrence with a low false-positive rate. We asked participants what they were thinking at the time of prediction: Sometimes they were thinking about movement, and other times they were not. Our results indicate that the brain can be preparing to make voluntary movements while participants are thinking about something else.
The Culture of Negotiation in the European Union: Reviewing Trends and Predicting Patterns of Multilateral Decision-Making
Authors: Guggenbühl Alain 
Published: January 2013

Summary
This article looks into the formal and informal facets of inter-state deliberation and negotiation among the 27 member states of the European Union. Its aim is twofold: on one hand to capture and consolidate the view of the ‘Brussels’ inter-state negotiation routine; on the other, to anticipate the evolution of the negotiation modes among member states in their daily collective decision-making. The article reviews some of the essential trends and occurrences that feature the multilateral processes of negotiation in the Council of the EU. With the support of negotiation literature, it derives from these trends a few patterns to help predict whether the culture of negotiation among the 27 member states will be positively impacted or impinged by the latest EU Treaty, which was signed in Lisbon in December 2007. The article frames and qualifies the EU culture of negotiation, while also offering a predictive lens on the future practice of negotiations among member states, which is absent from the traditional theoretical perspectives.
Analysis of Tropical Cyclone Precipitation Using an Object-Based Algorithm
Authors: Skok Gregor , Bacmeister Julio , Tribbia Joseph 
Published: January 2013

Abstract
A recently developed object identification algorithm is applied to multisensor precipitation estimates from the Tropical Rainfall Measuring Mission (TRMM 3B42) to detect and quantify the contribution of tropical cyclone precipitation (TCP) to total precipitation between 1998 and 2008. The study period includes 1144 storms. Estimates of TCP derived here are similar in pattern and seasonal variation to earlier estimates but are somewhat higher in magnitude. Annual-mean TCP fractions of over 20% are diagnosed over large swaths of tropical ocean, with seasonal means in some regions of more than 50%. Interannual variability of TCP is examined, and a small but significant downward trend in global TCP from 1998 to 2008 is found, consistent with results from independent studies examining accumulated cyclone energy (ACE). Relationships between annual-mean ACE and TCP in each major tropical cyclone basin are examined. High correlations are found in almost every basin, although different linear relationships exist in each. The highest ACE/TCP ratios are obtained in the North Atlantic and northeast Pacific basins, with lower ratios present in the northwest Pacific and South Pacific basins.
Awakening from the nightmarish slumber of phantasmagoria
Authors: Panfilio Kenneth Michael 
Published: January 2013

Walter Benjamin is discussed in this article to speak to the character of our experiences in the world as we try to animate our freedom in the midst of phantasmagoria. While we may indeed be trapped in the slumber of phantasmagoria and its many nightmares of despair, it is still possible to blast away the sands of sleep and awaken to a morally redeemed world fashioned through our engagement with various dreams of freedom. First, this article will explore the concept of phantasmagoria, which is a symbolically rich term used by Benjamin to speak to the complex ways in which we are mired within the combined material and aesthetic trappings of an advanced capitalist world. Such an exploration will consider three archetypes of character (the gambler, the flâneur and the collector) and their corresponding experiences (fashion, boredom and interiority) in an attempt to unite various convolutes from The Arcades Project to consider freedom in a world spectrally haunted by such phantasmagoria. Second, we will consider the possibility of becoming dialectically startled before the angel of history and its potential to animate our weak Messianic power. Such an act must involve the building-up of a redemptive imagination as a means to speak the truth of our place as the makers of value in the world challenged to destine our own journey in the ongoing project of justice.
Novel HIF2A mutations disrupt oxygen sensing, leading to polycythemia, paragangliomas, and somatostatinomas
Authors: Yang Chunzhang , Sun Michael G. , Matro Joey , Huynh Thanh T. , Rahimpour Shervin , Prchal Josef T. , Lechan Ronald , Lonser Russell , Pacak Karel , Zhuang Zhengping 
Published: January 2013

Key Points
Newly identified mutations in HIF2A result in polycythemia and neuroendocrine tumors. Disruption of the hydroxylation domain in HIF-2α results in protein stabilization, pseudohypoxia, and tumorigenesis.
Triptans in prevention of menstrual migraine: a systematic review with meta-analysis
Authors: Hu Yong , Guan Xiaofei , Fan Lin , Jin Lingjing 
Published: January 2013

Abstract
Randomized clinical trials (RCT) assessing the efficacy and tolerability of triptans compared with placebo as short-term prophylaxis of menstrual migraine (MM) were systematically reviewed in this study. Triptans, which interfere with the pathogenesis of migraine and are effective in relieving associated neurovegetative symptoms, have been extensively proposed for prevention of menstrual migraine attacks. We searched Cochrane CENTRAL, MEDLINE and EMBASE for randomized, double-blind, placebo-controlled trials on triptans for MM until 1 Oct, 2012. A total of six RCTs were identified. Two authors independently assessed trial’s quality and extracted data. Numbers of participants free from MM per perimenstrual period (PMP), requiring rescue medication, suffering from headache-associated symptoms and experiencing adverse events in treatment and control groups were used to calculate relative risk (RR) and number needed to treat (NNT) with their corresponding 95% confidence interval (CI). A total of 633 participants received frovatriptan 2.5 mg QD, 584 received frovatriptan 2.5 mg BID, 392 received naratriptan 1 mg BID, 70 received naratriptan 2.5 mg BID, 80 received zolmitriptan 2.5 mg BID, 83 received zolmitriptan 2.5 mg TID and 1104 received placebo. Overall, triptans is an effective, short-term, prophylactic treatment of choice for MM. Considering MM frequency, severity and adverse events, frovatriptan 2.5 mg BID and zolmitriptan 2.5 mg TID tend to be the preferred regimens.
Deep sequencing uncovers commonality in small RNA profiles between transgene-induced and naturally occurring RNA silencing of chalcone synthase-A gene in petunia
Authors: Kasai Megumi , Matsumura Hideo , Yoshida Kentaro , Terauchi Ryohei , Taneda Akito , Kanazawa Akira 
Published: January 2013

AbstractBackgroundIntroduction of a transgene that transcribes RNA homologous to an endogenous gene in the plant genome can induce silencing of both genes, a phenomenon termed cosuppression. Cosuppression was first discovered in transgenic petunia plants transformed with theCHS-Agene encoding chalcone synthase, in which nonpigmented sectors in flowers or completely white flowers are produced. Some of the flower-color patterns observed in transgenic petunias havingCHS-Acosuppression resemble those in existing nontransgenic varieties. Although the mechanism by which white sectors are generated in nontransgenic petunia is known to be due to RNA silencing of theCHS-Agene as in cosuppression, whether the same trigger(s) and/or pattern of RNA degradation are involved in these phenomena has not been known. Here, we addressed this question using deep-sequencing and bioinformatic analyses of small RNAs.ResultsWe analyzed short interfering RNAs (siRNAs) produced in nonpigmented sectors of petal tissues in transgenic petunia plants that haveCHS-Acosuppression and a nontransgenic petunia variety Red Star, that has naturally occurringCHS-ARNA silencing. In both silencing systems, 21-nt and 22-nt siRNAs were the most and the second-most abundant size classes, respectively.CHS-AsiRNA production was confined to exon 2, indicating that RNA degradation through the RNA silencing pathway occurred in this exon. Common siRNAs were detected in cosuppression and naturally occurring RNA silencing, and their ranks based on the number of siRNAs in these plants were correlated with each other. Noticeably, highly abundant siRNAs were common in these systems. Phased siRNAs were detected in multiple phases at multiple sites, and some of the ends of the regions that produced phased siRNAs were conserved.ConclusionsThe features of siRNA production found to be common to cosuppression and naturally occurring silencing of theCHS-Agene indicate mechanistic similarities between these silencing systems especially in the biosynthetic processes of siRNAs including cleavage ofCHS-Atranscripts and subsequent production of secondary siRNAs in exon 2. The data also suggest that these events occurred at multiple sites, which can be a feature of these silencing phenomena.