bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a fast-track-pathway including analgo-sedation with local anaesthesia for outpatient varicose vein surgery: a cohort study
Authors: Licker M , Brandao-Farinelli E , Cartier V , Gemayel G , Christenson J T 
Published: December 2012

Objective To evaluate the clinical and economical impact of a fast-track anaesthesia protocol in the management of primary varicose vein (VV) surgery. Methods Over a 10-month period (from 1 December 2009 to 30 September 2011), all patients eligible for open VV surgery ( N = 176) were enrolled in a fast-track clinical pathway including titrated analgo-sedation combined with local anaesthesia. This fast-track cohort was compared with a historical cohort undergoing similar procedures and receiving general anaesthesia (GA) or spinal anaesthesia (SA) (between 1 December 2009 to 30 September 2011, N = 200). The length of stay in the operating facilities and postoperative recovery areas were reported and hospital costs were estimated. In addition, the occurrence of adverse events and unplanned hospital admission were compared between the two consecutive periods. Results Patients characteristics and surgical procedure were not different in the two cohorts. After implementation of the fast-track pathway, the incidence of postoperative adverse events decreased from 41% to 2.3%, with no need for overnight hospital stay (0% versus 7%). The reduction in anaesthesia-controlled time (-47%) and in postoperative recovery time (-61%) were associated with an increased operating capacity (1 extra case per day) and with substantial cost-savings (mean reduction of €312 per case, P < 0.001). Conclusions Implementation of a fast-track pathway for outpatient VV surgery was successful, safe and efficient. Analgo-sedation combined with infiltrative anaesthesia (instead of GA or SA) contributed to increase the operating capacity and to reduce the workload of nursing personnel.
Enhancing Leisure Experiences Post Traumatic Brain Injury: A Pilot Study
Authors: Carbonneau Hélène , Martineau Éric , Andre Melanie , Dawson Deirdre 
Published: December 2012

AbstractUp to 90% of people with severe traumatic brain injury (TBI) report dissatisfaction with the status of their leisure participation and/or social integration. Yet, there are virtually no studies that have investigated the benefits of interventions that target leisure specifically for this population. The purpose of this study was to determine whether the Leisure Education Program (Carbonneau, Fontaine, & Lussier, 2006) designed to assist people with stroke to engage in meaningful leisure activities, build leisure self-efficacy and promote general wellbeing would have similar benefits for survivors of TBI. We recruited three community-dwelling survivors of TBI to participate in a 10-week leisure program. All three participants reported some benefit in leisure satisfaction and self-efficacy. This extended to improvements in general wellbeing and health-related quality of life for two of the three. These findings suggest that further investigations into the benefits of leisure education for adults with TBI should be conducted.
Mitotic Exit and Separation of Mother and Daughter Cells
Authors: Weiss Eric L 
Published: December 2012

Abstract
Productive cell proliferation involves efficient and accurate splitting of the dividing cell into two separate entities. This orderly process reflects coordination of diverse cytological events by regulatory systems that drive the cell from mitosis into G1. In the budding yeast Saccharomyces cerevisiae, separation of mother and daughter cells involves coordinated actomyosin ring contraction and septum synthesis, followed by septum destruction. These events occur in precise and rapid sequence once chromosomes are segregated and are linked with spindle organization and mitotic progress by intricate cell cycle control machinery. Additionally, critical parts of the mother/daughter separation process are asymmetric, reflecting a form of fate specification that occurs in every cell division. This chapter describes central events of budding yeast cell separation, as well as the control pathways that integrate them and link them with the cell cycle.
Mammalian Developmental Genetics in the Twentieth Century
Authors: Artzt Karen 
Published: December 2012

AbstractThis Perspectives is a review of the breathtaking history of mammalian genetics in the past century and, in particular, of the ways in which genetic thinking has illuminated aspects of mouse development. To illustrate the power of that thinking, selected hypothesis-driven experiments and technical advances are discussed. Also included in this account are the beginnings of mouse genetics at the Bussey Institute, Columbia University, and The Jackson Laboratory and a retrospective discussion of one of the classic problems in developmental genetics, the T/t complex and its genetic enigmas.
Diagnostic Imaging Studies Performed in Children Over a Nine-Year Period
Authors: Tompane Trevor , Bush Ruth , Dansky Tanya , Huang Jeannie S. 
Published: December 2012

BACKGROUND AND OBJECTIVE:
Diagnostic imaging procedures (DIPs) producing radiation exposure in children have been associated with increased cancer risk. To develop effective clinical practice interventions that reduce pediatric radiation exposure, a longitudinal assessment of DIP ordering practices in the current clinical climate was performed. Our objective was to determine the prevalence and characteristics of DIPs ordered by physicians in an independent physicians association treating a general pediatric population.

METHODS:
DIP insurance claims from 2001 to 2009 were obtained from an independent physicians association in a large metropolitan area. Current Procedural Terminology codes, associated International Classification of Diseases, Ninth Revision codes, and patient demographics associated with DIPs were retrieved from insurance claim data and analyzed.

RESULTS:
Overall, 214 538 DIPs were performed on 63 116 children from 2001 to 2009 at a rate of 1 DIP associated with ionizing radiation per 21 patient-months. Over the study period, performance of computed tomography, MRI, ultrasound, and radiography all significantly increased (P &lt; .001 for all). Higher radiation DIPs were most frequently performed in the inpatient and emergency settings on older boy patients for gastrointestinal and congenital disorders. The 3 most common International Classification of Diseases, Ninth Revision codes associated with higher radiation DIPs were abdominal pain, headache, and head injury.

CONCLUSIONS:
DIPs are frequently performed in children and higher radiation DIPs account for an increasing proportion of DIPs performed, especially among children evaluated in the inpatient and emergency department settings and those with gastrointestinal and neurologic symptoms, and congenital anomalies. Our findings may help guide development of clinical practice interventions to reduce DIP-related radiation exposure in youth.
Effect of the Patient's Knowledge on Peritonitis Rates in Peritoneal Dialysis
Authors: Sayed Suheir A.M. , Abu-Aisha Hasan , Ahmed Magda E. , Elamin Sarra 
Published: December 2012

Introduction After a training period, patients maintained on continuous ambulatory peritoneal dialysis (CAPD) assume responsibility for their own treatment. With the aid of appropriate tools, home visits help with ongoing evaluation and training for these patients. Methods We conducted a home visit survey of 50 patients maintained on CAPD in Sudan between April 2009 and June 2010. Housing conditions, home environment, and patient's or caregiver's knowledge about peritoneal dialysis and the exchange procedure were evaluated using structured data collection sheets. Scores were compared with infection rates in the patients before the home visit. Results Patients were maintained on CAPD for a median duration of 11 months. Their mean age was 42 ± 23 years; 70% were male; and 14% had diabetes. Only 34% of patients had suitable housing conditions, and 56% required assisted PD. Of the autonomous patients and assisting family members, 11.6% were illiterate. The median achieved knowledge score was 11.5 of 35 points. The median achieved exchange score was 15 of 20 points. Knowledge and exchange scores were positively and significantly correlated ( R = 0.5, p = 0.00). More patients in the upper quartile than in the middle and lower quartiles of knowledge scores were adherent to daily exit-site care (33.3% vs 5.3%, p = 0.02). Compared with patients in the middle and lower quartiles of knowledge score, patients in the upper quartile had lower rates of peritonitis, exit-site infection, and hospitalization. Conclusions The proposed evaluation form is a valid and reliable assessment tool for the follow-up of CAPD patients. Patients in the upper quartile of knowledge score demonstrated better adherence to the recommended treatment protocols and lower infection rates.
A Cost Evaluation of Peritoneal Dialysis and Hemodialysis in the Treatment of End-Stage Renal Disease in São Paulo, Brazil
Authors: de Abreu Mirhelen Mendes , Walker David R. , Sesso Ricardo C. , Ferraz Marcos B. 
Published: December 2012

Objective Conventional hemodialysis (HD) predominates over peritoneal dialysis (PD) around the world. Prospective and comparative studies comparing the costs of these modalities are scarce. In the present prospective assessment, we describe the resources used and total patient costs for both HD and PD. Methodology We assessed 249 patients on HD and 228 on PD. All patients were 18 years of age or older and on stable dialysis. The information was collected at three points over 1 year, using standard questionnaires. The sources for costs were the Brazilian public and private health care systems. Societal perspective was considered. Statistical Analysis Core trends and dispersions were measured. Regression models assessed the impact of modality on the average total cost per patient per year. Results Of the 249 HD patients and 228 PD dialysis patients, 189 (74%) and 160 (70%) respectively completed follow-up. The mean age for women was 55.8 years; for men, it was 59.8 years ( p = 0.001). The average total cost per patient–year was US$28 570 for HD and US$27158 for PD. By category, the costs consisted of direct medical–hospital costs (82.3% for HD, 86.5% for PD), direct nonmedical costs (5.3% for HD, 3.7% for PD), and indirect costs (12.4% for HD, 9.8% for PD). Overall costs were less for PD patients than for their HD counterparts ( p = 0.025). Conclusions Maintenance dialysis represented the most important source of costs for both modalities; loss of productivity incurred significant costs. Future studies should contemplate the social consequences arising from each modality.
Prevalence of 25(OH) Vitamin D Insufficiency and Deficiency in Pediatric Patients on Chronic Dialysis
Authors: Cho Hee Yeon , Hyun Hye Sun , Kang Hee Gyung , Ha Il Soo , Cheong Hae Il 
Published: December 2012

Background 25(OH) Vitamin D [25(OH)D] is the major circulating form of vitamin D and the parameter used to reflect vitamin D status. Patients with chronic kidney disease (CKD) are likely to have low levels of 25(OH)D, and recent observations have linked suboptimal vitamin D status with adverse cardiovascular outcomes, inflammation, insulin resistance, and the rate of progression of renal insufficiency. Little is known about the magnitude of vitamin D deficiency in pediatric patients with stage 5 CKD on chronic dialysis. Objectives The aim of the present cross-sectional study was to assess the prevalence of abnormal vitamin D status in children on chronic dialysis. Methods Serum 25(OH)D, 1,25(OH)2 vitamin D [1,25(OH)2D], calcium, phosphorus, and parathyroid hormone (PTH) were evaluated in 59 pediatric patients on chronic dialysis. Weekly renal Kt/V and creatinine clearance (CCr) were evaluated as parameters reflecting residual renal function. In these patients, serum 25(OH)D concentrations less than 10 ng/mL were considered deficiency and concentrations of 10 – 30 ng/mL were considered insufficiency. Results Of the 59 pediatric patients (mean age: 14.4 ± 5.1 years), 51 (86.4%) were on peritoneal dialysis (PD), and 8 (13.6%) were on hemodialysis. Vitamin D deficiency was found in 32.2% of the patients ( n = 19), and vitamin D insufficiency, in 50.8% ( n = 30). Patients with serum 25(OH)D concentrations less than 30 ng/mL were older than those with normal 25(OH)D concentrations (15.4 ± 4.5 years vs 9.2 ± 5.1 years, p = 0.000). Patients with 25(OH) D concentrations less than 30 ng/mL had higher PTH levels than did those with normal 25(OH)D concentrations (349.5 ± 318.3 pg/mL vs 142.5 ± 116.9 pg/mL, p = 0.001). In the univariate analysis, there was no correlation between serum 25(OH)D and serum 1,25(OH)2D ( r = 0.242, p = 0.064), calcium ( r = 0.108, p = 0.415), phosphorus ( r = –0.050, p = 0.706), or body mass index ( r = –0.046, p = 0.729). In PD patients, serum 25(OH)D was positively correlated with weekly renal Kt/V ( r = 0.385, p = 0.005) and CCr ( r = 0.443, p = 0.001). In addition, serum 25(OH)D and serum albumin were positively correlated ( r = 0.297, p = 0.035) in the PD patients. Conclusions The present study found a high prevalence of 25(OH)D deficiency and insufficiency in children on chronic dialysis. Serum 25(OH)D was associated with residual renal function in children on PD. Further studies to evaluate the consequences of vitamin D deficiency and the impact of therapeutic interventions are needed in pediatric CKD patients.
Who Needs Direct-Acting Antivirals for HCV? Challenges Faced in Advancing HCV Therapy for HIV–HCV-Coinfected Individuals
Authors: Klein Marina B , Rollet Kathleen C , Hull Mark , Cooper Curtis , Walmsley Sharon , Conway Brian , Pick Neora ,   the Canadian Co-infection Cohort Study (CTN222) Investigators
Published: December 2012

Background The recent availability of new direct-acting antivirals (DAAs) for HCV treatment, which significantly increase sustained virological response rates for genotype 1 HCV infection, has brought new optimism with respect to curative HCV treatment for HIV–HCV-coinfected patients. We describe the characteristics of coinfected patients who could be eligible for DAAs to determine potential challenges facing clinicians and patients hoping to take advantage of these new therapies. Methods We evaluated the sociodemographic and clinical characteristics of the genotype 1 HCV–HIV-infected participants in a Canadian prospective multicentre cohort study at their most recent visit to assess potential eligibility for combination HCV treatment with boceprevir or telaprevir. Results Of the 1,020 coinfected participants enrolled in the cohort, 707 (85%) had evidence of chronic HCV infection (HCV-RNA-positive), of whom 497 (70%) were infected with genotype 1; 375 (75%) were naive to HCV treatment and 122 (25%) had previously received therapy and failed. Only 143 (38%) of HCV treatment-naive and 39 (32%) of treatment-experienced participants had no absolute contraindications for treatment. Alcohol abuse, active depression and decompensated liver disease were the most frequent reasons for treatment ineligibility. The majority would require alterations in antiretroviral regimens to avoid important drug–drug interactions. Conclusions Although the need for curative HCV therapy in HIV–HCV coinfection is great, the actual number of patients who could be eligible for DAAs at the present time may be quite low. There remains an urgent need to develop safe, simple and interferon-sparing treatments for coinfected individuals.
Comment la contractualisation dans les administrations fiscales peut-elle limiter la corruption et la fraude ? Le cas des douanes camerounaises
Authors: Cantens Thomas , Raballand Gaël , Bilangna Samson , Djeuwo Marcellin 
Published: December 2012

Résumé Cet article examine les effets de l’introduction de « contrats de performance » au sein des administrations fiscales, à partir d’une expérience lancée dans les douanes camerounaises en 2008. Cet exemple original de réforme transpose des éléments de la Nouvelle Gestion Publique dans le contexte particulier d’une administration qui fait de la lutte contre la corruption son premier objectif pour augmenter son efficacité. L’analyse s’appuie sur des données quantitatives pour étudier les changements de comportement individuel et leurs effets macroéconomiques sur l’efficacité de l’administration. Des données qualitatives ont également été recueillies de 2008 à 2011. Si leurs résultats mesurables sont positifs sur la collecte des recettes, la réduction des mauvaises pratiques et la célérité du traitement des dossiers, l’évaluation et la contractualisation soulèvent néanmoins des questionnements sur les rapports des fonctionnaires à leur institution et à la loi. Classification JEL : D73, H11, H20
Modernisation de l'administration fiscale dans les pays en développement : impact de la TVA
Authors: Bodin Jean-Paul 
Published: December 2012

Résumé Depuis plus d’une vingtaine d’années, la TVA a permis de renforcer la mobilisation des ressources dans les pays en développement et de lancer des réformes importantes en matière d’administration fiscale. Les performances de cette taxe sont toutefois en deçà des potentialités dans beaucoup de pays. L’amélioration de ces performances et la modernisation du système fiscal passent par une accélération de la réforme de l’administration fiscale qui exige des investissements conséquents en matière de ressources humaines et d’informatisation. Elle implique également une plus grande efficacité dans l’organisation et l’utilisation de l’assistance technique qui est indispensable pour appuyer ces réformes. Classification JEL : H26, H29
Rho-Family GTPase Cdc42 Controls Migration of Langerhans Cells In Vivo
Authors: Luckashenak Nancy , Wähe Anna , Breit Katharina , Brakebusch Cord , Brocker Thomas 
Published: December 2012

Abstract
Epidermal Langerhans cells (LCs) of the skin represent the prototype migratory dendritic cell (DC) subtype. In the skin, they take up Ag, migrate to the draining lymph nodes, and contribute to Ag transport and immunity. Different depletion models for LCs have revealed contrasting roles and contributions of this cell type. To target the migratory properties of DCs, we generated mice lacking the Rho-family GTPase Cdc42 specifically in DCs. In these animals, the initial seeding of the epidermis with LCs is functional, resulting in slightly reduced Langerhans cell numbers. However, Cdc42-deficient LCs fail to leave the skin in steady state as well as upon stimulation, as they do not enter the skin-draining afferent lymph vessels. Similarly, also other Cdc42-deficient migratory DC subsets fail to home properly to the corresponding draining lymph nodes. We used this novel mouse model, in which LCs are locked out, to demonstrate that these cells contribute substantially to priming of Ag-specific CD4 and CD8 T cell responses upon epicutaneous immunization, but could not detect a role in the induction of contact hypersensitivity to various doses of hapten.
In Vivo Blockade of the PD-1 Receptor Suppresses HIV-1 Viral Loads and Improves CD4+ T Cell Levels in Humanized Mice
Authors: Palmer Brent E. , Neff C. Preston , LeCureux Jonathan , Ehler Angelica , DSouza Michelle , Remling-Mulder Leila , Korman Alan J. , Fontenot Andrew P. , Akkina Ramesh 
Published: December 2012

Abstract
The programmed death-1 (PD-1) pathway limits the function of virus-specific T cells during chronic infection. We previously showed that blockade of the PD-1 pathway increases HIV-1–associated T cell function in vitro. However, the effect of PD-1 blockade on HIV-1 disease progression in vivo has not been examined. As in humans, HIV-1–infected humanized BALB/c-Rag2−/−γc−/− (Rag-hu) mice express elevated levels of PD-1 on T cells during chronic infection. To examine the effect of PD-1 blockade on disease progression, Rag-hu mice with chronic HIV-1 infection were treated with a blocking mAb directed against programmed cell death-1 ligand-1, the ligand for PD-1. Programmed cell death-1 ligand-1–treated Rag-hu mice exhibited a progressive decrease in the HIV-1 plasma viral load, with a 7-fold decrease by day 7, a 20-fold decrease by day 14, a 178-fold decrease by day 21, and a 269-fold decrease by day 28 postinitiation of treatment. By day 7, the percentage of CD4+ T cells was statistically higher in the treated compared with the untreated group, and this trend was sustained throughout the 28-d treatment period. Moreover, there was a strong inverse correlation between plasma viral load and the percentage of both CD4+ (r = −0.66; p &lt; 0.0001) and CD8+ (r = −0.64; p &lt; 0.0001) T cells in the treated mice but not the untreated mice. This study provides “proof of concept” that humanized mice can be used to examine the effects of immunotherapeutic interventions on HIV-1 infection. Furthermore, to our knowledge, these data demonstrate for the first time that blockade of the PD-1 pathway reduces HIV-1 viral loads.
A Phospholipase C-γ1–Independent, RasGRP1-ERK–Dependent Pathway Drives Lymphoproliferative Disease in Linker for Activation of T Cells–Y136F Mutant Mice
Authors: Kortum Robert L. , Rouquette-Jazdanian Alexandre K. , Miyaji Michihiko , Merrill Robert K. , Markegard Evan , Pinski John M. , Wesselink Amelia , Nath Nandan N. , Alexander Clayton P. , Li Wenmei , Kedei Noemi , Roose Jeroen P. , Blumberg Peter M. , Samelson Lawrence E. , Sommers Connie L. 
Published: December 2012

Abstract
Mice expressing a germline mutation in the phospholipase C-γ1–binding site of linker for activation of T cells (LAT) show progressive lymphoproliferation and ultimately die at 4–6 mo age. The hyperactivated T cells in these mice show defective TCR-induced calcium flux but enhanced Ras/ERK activation, which is critical for disease progression. Despite the loss of LAT-dependent phospholipase C–γ1 binding and activation, genetic analysis revealed RasGRP1, and not Sos1 or Sos2, to be the major Ras guanine exchange factor responsible for ERK activation and the lymphoproliferative phenotype in these mice. Analysis of isolated CD4+ T cells from LAT-Y136F mice showed altered proximal TCR-dependent kinase signaling, which activated a Zap70- and LAT-independent pathway. Moreover, LAT-Y136F T cells showed ERK activation that was dependent on Lck and/or Fyn, protein kinase C–θ, and RasGRP1. These data demonstrate a novel route to Ras activation in vivo in a pathological setting.