bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal distension‐evoked potentials in awake rats: a novel method for studies of visceral sensitivity
Authors: Hultin L. , Nissen T. D. , Kakol‐Palm D. , Lindström E. 
Published: August 2012

AbstractBackground  Quantification of the visceromotor response induced by colorectal distension (CRD) in rodents is commonly used for preclinical studies of visceral pain. The model is well established but does not fully assess the central response to stimulation. The aim of this study was to establish a novel model assessing cerebral evoked potentials (CEPs) in response to CRD in awake rats.Methods  Epidural recording electrodes were chronically implanted in the skull of female Sprague–Dawley rats. Colorectal distension‐induced CEPs were recorded using either rapid balloon distensions (100 ms, 20–80 mmHg) or electric stimulation (1 ms, 1–4 mA) using stimulation probes placed in the distal colon.Key Results  Colorectal distension‐induced CEPs were separated in three partly temporally overlapping components consisting of five prominent peaks. Peak latencies at 80 mmHg were (P1, N1) 23 ± 1 and 55 ± 4 ms, (N2, P2a, P2b) 91 ± 3, 143 ± 5 and 174 ± 3 ms, and (P3) 297 ± 3 ms. Amplitudes and latencies were, except for the early component, intensity dependent. Intrarectal administration of lidocaine significantly reduced the amplitude of N2 (by 42 ± 6%, P < 0.001) and P2 (by 34 ± 6%, P < 0.001). Electrically induced CEPs were intensity dependent and had similar topography and latencies as the mechanical evoked potentials (P1: 26 ± 2 ms; N1: 61 ± 1 ms; P2: 84 ± 6 ms; N2: 154 ± 6 ms; P3: 326 ± 10 ms), but there were large variations in amplitudes in between repeated electrical stimulations.Conclusions & Inferences  Colorectal distension‐induced CEPs can be recorded reliably in awake rats and may serve as a surrogate marker of colonic sensation and be a useful parameter in studies of visceral sensitivity.
Technical Note: Improved implementation of doppler broadening in MCNP5
Authors: Bartol Laura J. , DeWerd Larry A. 
Published: August 2012

Purpose:Incoherent scattering has a substantial effect on spectroscopic measurements and simulations. Many general‐purpose Monte Carlo codes include models that account for the effects of bound electrons on incoherent scattering, including Doppler broadening (DB). This work investigates the DB model used in the Monte Carlo N‐particle transport code (MCNP5).Methods:Simulations were run with three versions of MCNP5: v1.51, v1.60, and a modified form of v1.60 (v1.60m). All simulations used the MCPLIB04 photon data library, which presents the electron subshell data for incoherent scattering in the form of a probability density function. In v1.60m, the source code was altered to sample the electron subshell from a cumulative density function instead. Each version of the code was tested using an identical set of simulations that investigated DB in a slab of silicon at scattering angles of 15°, 30°, and 45°. For each angle, simulations were run for multiple energies between 200 keV and 800 keV. The spectrum of singly‐scattered photons at the exit of the slab was scored. Spectra were analytically calculated for comparison.Results:In v1.51, DB was modeled for incident photon energies below 760 keV, 384 keV, and 260 keV at scattering angles of 15°, 30°, and 45°, respectively. Above these energy thresholds, v1.51 did not model DB. The spectra calculated using v1.60 and v1.60m exhibited DB for all energy‐angle combinations; however, v1.60m, exhibited more energy broadening than did v1.60. The spectra calculated with v1.60m agreed with the analytical calculations.Conclusions:MCNP5 v1.51 and v1.60 model partial broadening when used with the MCPLIB04 data library. MCNP5 v1.60m models DB more accurately due to the form of the electron subshell data. In response to these results, Los Alamos National Laboratory has released a new photon data library, MCPLIB84, that presents the electron subshell data in cumulative distribution form. MCNP5 v1.60 should be used with this library when incoherent scattering has a significant impact on simulation results.
Mannose-Capped Lipoarabinomannan from Mycobacterium tuberculosis Induces Soluble Tumor Necrosis Factor Receptor Production through Tumor Necrosis Factor Alpha-Converting Enzyme Activation
Authors: Richmond Jillian M. , Duffy Elizabeth R. , Lee Jinhee , Kaboli Kavon , Remick Daniel G. , Kornfeld Hardy , Cruikshank William W. 
Published: August 2012

ABSTRACTPrimaryMycobacterium tuberculosisinfection results in granuloma formation in lung tissue. A granuloma encapsulates mycobacterium-containing cells, thereby preventing dissemination and further infection. Tumor necrosis factor alpha (TNF-α) is a host-protective cytokine duringM. tuberculosisinfection due to its role in promoting and sustaining granuloma formation. TNF activity is regulated through the production of soluble TNF receptors (sTNFRI and sTNFRII). Therefore, we examined the potential production of endogenous sTNFRs duringM. tuberculosisinfection. Using the murine model of aerosolM. tuberculosisinfection, we determined that levels of sTNFR production were elevated in bronchoalveolar lavage fluid 1 month following infection. An investigation ofM. tuberculosiscell wall components identified that the known virulence factor mannose-capped lipoarabinomannan (ManLAM) was sufficient to induce sTNFR production, with sTNFRII being produced preferentially compared with sTNFRI. ManLAM stimulated the release of sTNFRs without TNF production, which corresponded to an increase in TNF-α-converting enzyme (TACE) activity. To determine the relevance of these findings, serum samples fromM. tuberculosis-infected patients were tested and found to have an increase in the sTNFRII/sTNFRI ratio. These data identify a mechanism by whichM. tuberculosisinfection can promote the neutralization of TNF and furthermore suggest the potential use of the sTNFRII/sTNFRI ratio as an indicator of tuberculosis disease.
Participatory healthcare-provider orientation to improve artemether-lumefantrine-based drug treatment of uncomplicated malaria: a cluster quasi-experimental study
Authors: Anyama Norbert G , Tibenderana James K , Kutyabami Paul , Kamba Pakoyo F , Kitutu Freddy E , Adome Richard O 
Published: August 2012

ObjectivesTo assess the effect of participatory healthcare-provider orientation in enhancing patient knowledge, appropriate prescribing and dispensing of artemether-lumefantrine, during drug treatment of uncomplicated malaria.MethodsA cluster quasi-experimental study. The authors developed strategies to address challenges encountered by healthcare providers during clinical management of malaria. The primary outcome was patient knowledge on prescribed malaria drug treatment. Secondary outcomes were appropriate prescribing and provision of adequate drug dispensing information. The authors used generalised estimating equation logistic regression to investigate correlates of appropriate use of artemether-lumefantrine.ResultsThe proportion of patients or caretakers of paediatric patients sufficiently knowledgeable about malaria treatment increased from 16/85 (18.8%) at baseline to 33/96 (34.4%) at evaluation, OR 2.26 (95% CI 1.13 to 4.49), p=0.020, in the intervention, and fell slightly from 49/134 (36.6%) to 35/114 (30.7%), OR 0.77, (95% CI 0.45 to 1.31), p=0.331 in the control district. This was enhanced by the existence of drug-dispensing standard operating procedures (adjusted OR 1.85, 95% CI 0.98 to 3.50; p=0.057). The proportion of appropriate prescriptions increased from 61/87 (70.1%) to 94/112 (83.9%) in the intervention district, OR 2.23 (95% CI 1.13 to 4.40), p=0.020 and reduced from 91/115 (79.1%) to 75/112 (67.0%) in the control district, OR 0.53, (95% CI 0.29 to 0.97), p=0.040. The frequency of adequately dispensed prescriptions increased in the intervention district (34(32.4%) to 53(45.3%), OR 1.73 (95% CI 1.00 to 2.99), p=0.050) but decreased in the control location (94 (69.6%) to 71 (52.6%), OR 0.48 (95% CI 0.29 to 0.80), p=0.004).ConclusionsParticipatory healthcare-provider orientation enhanced patient knowledge, healthcare provider prescribing and dispensing of artemether-lumefantrine, bolstered by adequate medication counselling and use of drug-dispensing standard operating procedures.
Predictors of likelihood of speaking up about safety concerns in labour and delivery
Authors: Lyndon Audrey , Sexton J Bryan , Simpson Kathleen Rice , Rosenstein Alan , Lee Kathryn A , Wachter Robert M 
Published: August 2012

BackgroundDespite widespread emphasis on promoting ‘assertive communication’ by care givers as essential to patient-safety-improvement efforts, little is known about when and how clinicians speak up to address safety concerns. In this cross-sectional study, the authors use a new measure of speaking up to begin exploring this issue in maternity care.MethodsThe authors developed a scenario-based measure of clinician's assessment of potential harm and likelihood of speaking up in response to perceived harm. The authors embedded this scale in a survey with measures of safety climate, teamwork climate, disruptive behaviour, work stress, and personality traits of bravery and assertiveness. The survey was distributed to all registered nurses and obstetricians practising in two US Labour & Delivery units.ResultsThe response rate was 54% (125 of 230 potential respondents). Respondents were experienced clinicians (13.7±11 years in specialty). A higher perception of harm, respondent role, specialty experience and site predicted the likelihood of speaking up when controlling for bravery and assertiveness. Physicians rated potential harm in common clinical scenarios lower than nurses did (7.5 vs 8.4 on 2–10 scale; p<0.001). Some participants (12%) indicated they were unlikely to speak up, despite perceiving a high potential for harm in certain situations.DiscussionThis exploratory study found that nurses and physicians differed in their harm ratings, and harm rating was a predictor of speaking up. This may partially explain persistent discrepancies between physicians and nurses in teamwork climate scores. Differing assessments of potential harms inherent in everyday practice may be a target for teamwork intervention in maternity care.
Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study
Authors: Hogan Helen , Healey Frances , Neale Graham , Thomson Richard , Vincent Charles , Black Nick 
Published: August 2012

IntroductionMonitoring hospital mortality rates is widely recommended. However, the number of preventable deaths remains uncertain with estimates in England ranging from 840 to 40 000 per year, these being derived from studies that identified adverse events but not whether events contributed to death or shortened life expectancy of those affected.MethodsRetrospective case record reviews of 1000 adults who died in 2009 in 10 acute hospitals in England were undertaken. Trained physician reviewers estimated life expectancy on admission, to identified problems in care contributing to death and judged if deaths were preventable taking into account patients' overall condition at that time.ResultsReviewers judged 5.2% (95% CI 3.8% to 6.6%) of deaths as having a 50% or greater chance of being preventable. The principal problems associated with preventable deaths were poor clinical monitoring (31.3%; 95% CI 23.9 to 39.7), diagnostic errors (29.7%; 95% CI 22.5% to 38.1%), and inadequate drug or fluid management (21.1%; 95% CI 14.9 to 29.0). Extrapolating from these figures suggests there would have been 11 859 (95% CI 8712 to 14 983) adult preventable deaths in hospitals in England. Most preventable deaths (60%) occurred in elderly, frail patients with multiple comorbidities judged to have had less than 1 year of life left to live.ConclusionsThe incidence of preventable hospital deaths is much lower than previous estimates. The burden of harm from preventable problems in care is still substantial. A focus on deaths may not be the most efficient approach to identify opportunities for improvement given the low proportion of deaths due to problems with healthcare.
‘Tempos’ management in primary care: a key factor for classifying adverse events, and improving quality and safety
Authors: Amalberti R , Brami J 
Published: August 2012

BackgroundThe role of time management in safe and efficient medicine is important but poorly incorporated into the taxonomies of error in primary care. This paper addresses the lack of time management, presenting a framework integrating five time scales termed ‘Tempos’ requiring parallel processing by GPs: the disease's tempo (unexpected rapid evolutions, slow reaction to treatment); the office's tempo (day-to-day agenda and interruptions); the patient's tempo (time to express symptoms, compliance, emotion); the system's tempo (time for appointments, exams, and feedback); and the time to access to knowledge. The art of medicine is to control all of these tempos in parallel and simultaneously.MethodTwo qualified physicians reviewed a sample of 1046 malpractice claims from one liability insurer to determine whether a medical injury had occurred and, if so, whether it was due to one or more tempo-related problems. 623 of these reports were analysed in greater detail to identify the prevalence and characteristics of claims and related time management errors.ResultsThe percentages of contributing factors were as follows: disease tempo, 37.9%; office tempo, 13.2%; patient tempo, 13.8%; out-of-office coordination tempo, 22.6%; and GP's access to knowledge tempo, 33.2%.ConclusionAlthough not conceptualised in most error taxonomies, the disease and patient tempos are cornerstones in risk management in primary care. Traditional taxonomies describe events from an analytical perspective of care at the system level and offer opportunities to improve organisation, process, and evidence-based medicine. The suggested classification describes events in terms of (unsafe) dynamic control of parallel constraints from the carer's perspective, namely the GP, and offers improvement on how to self manage and coordinate different contradictory tempos and day-to-day activities. Further work is needed to test the validity and usefulness of this approach.
Visualising differences in professionals' perspectives on quality and safety
Authors: Travaglia Joanne Francis , Nugus Peter Ivan , Greenfield David , Westbrook Johanna Irene , Braithwaite Jeffrey 
Published: August 2012

BackgroundThe safety-and-quality movement is now two decades old. Errors persist despite best efforts, indicating that there are entrenched overt and perhaps less explicit barriers limiting the success of improvement efforts.Objectives and hypothesesTo examine the perspectives of five groups of healthcare workers (administrative staff, nurses, medical practitioners, allied health and managers) and to compare and contrast their descriptions of quality-and-safety activities within their organisation. Differences in perspectives can be an indicator of divergence in the conceptualisation of, and impetus for, quality-improvement strategies which are intended to engage healthcare professions and staff.Design, setting and participantsStudy data were collected in a defined geographical healthcare jurisdiction in Australia, via individual and group interviews held across four service streams (aged care and rehabilitation; mental health; community health; and cancer services). Data were collected in 2008 and analysed, using data-mining software, in 2009.ResultsClear differences in the perspectives of professional groups were evident, suggesting variations in the perceptions of, and priorities for, quality and safety.ConclusionsThe visual representation of quality and safety perspectives provides insights into the conceptual maps currently utilised by healthcare workers. Understanding the similarity and differences in these maps may enable more effective targeting of interprofessional improvement strategies.
Role for MicroRNA-21 in Atrial Profibrillatory Fibrotic Remodeling Associated With Experimental Postinfarction Heart Failure
Authors: Cardin Sophie , Guasch Eduard , Luo Xiaobin , Naud Patrice , Le Quang Khaï , Shi YanFen , Tardif Jean-Claude , Comtois Philippe , Nattel Stanley 
Published: August 2012

Background—
Atrial tissue fibrosis is often an important component of the atrial fibrillation (AF) substrate. Small noncoding microRNAs are important mediators in many cardiac remodeling paradigms. MicroRNA-21 (miR-21) has been suggested to be important in ventricular fibrotic remodeling by downregulating Sprouty-1, a protein that suppresses fibroblast proliferation. The present study examined the potential role of miR-21 in the atrial AF substrate resulting from experimental heart failure after myocardial infarction (MI).

Methods and Results—

Large MIs (based on echocardiographic left ventricular wall motion score index) were created by left anterior descending coronary artery ligation in rats. Changes induced by MI versus sham controls were first characterized with echocardiography, histology, biochemistry, and in vivo electrophysiology. Additional MI rats were then randomized to receive anti–miR-21 (KD21) or scrambled control sequence (Scr21) injections into the left atrial myocardium. Progressive left ventricular enlargement, hypocontractility, left atrial dilation, fibrosis, refractoriness prolongation, and AF promotion occurred in MI rats versus sham controls. Atrial tissues of MI rats showed upregulation of miR-21, along with dysregulation of the target genes Sprouty-1, collagen-1, and collagen-3. KD21 treatment reduced atrial miR-21 expression levels in MI rats to values in sham rats, decreased AF duration from 417 (69–1595; median [Q1–Q3]) seconds to 3 (2–16) seconds (8 weeks after MI;
P
<0.05), and reduced atrial fibrous tissue content from 14.4±1.8% (mean±SEM) to 4.9±1.2% (8 weeks after MI;
P
<0.05) versus Scr21 controls.

Conclusions—
MI-induced heart failure leads to AF-promoting atrial remodeling in rats. Atrial miR-21 knockdown suppresses atrial fibrosis and AF promotion, implicating miR-21 as an important signaling molecule for the AF substrate and pointing to miR-21 as a potential target for molecular interventions designed to prevent AF.
Impact of Different ENSO Regimes on Southwest Pacific Tropical Cyclones
Authors: Chand Savin S. , L. McBride John , Tory Kevin J. , Wheeler Matthew C. , Walsh Kevin J. E. 
Published: August 2012

Abstract
The influence of different types of ENSO on tropical cyclone (TC) interannual variability in the central southwest Pacific region (5°–25°S, 170°E–170°W) is investigated. Using empirical orthogonal function analysis and an agglomerative hierarchical clustering of early tropical cyclone season Pacific sea surface temperature, years are classified into four separate regimes (i.e., canonical El Niño, canonical La Niña, positive-neutral, and negative-neutral) for the period between 1970 and 2009. These regimes are found to have a large impact on TC genesis over the central southwest Pacific region. Both the canonical El Niño and the positive-neutral years have increased numbers of cyclones, with an average of 4.3 yr−1 for positive-neutral and 4 yr−1 for canonical El Niño. In contrast, during a La Niña and negative-neutral events, substantially fewer TCs (averages of ~2.2 and 2.4 yr−1, respectively) are observed in the central southwest Pacific. The enhancement of TC numbers in both canonical El Niño and positive-neutral years is associated with the extension of favorable low-level cyclonic relative vorticity, and low vertical wind shear eastward across the date line. Relative humidity and SST are also very conducive for genesis in this region during canonical El Niño and positive-neutral events. The patterns are quite different, however, with the favorable conditions concentrated in the date line region for the positive-neutral, as compared with conditions farther eastward for the canonical El Niño regime. A significant result of the study is the demonstration that ENSO-neutral events can be objectively clustered into two separate regimes, each with very different impacts on TC genesis.
Sensitivity of Western Boundary Transport at the Mean North Equatorial Current Bifurcation Latitude to Wind Forcing
Authors: Zhang Xuebin , Cornuelle Bruce , Roemmich Dean 
Published: August 2012

Abstract
The bifurcation of the North Equatorial Current (NEC) plays an important role in the heat and water mass exchanges between the tropical and subtropical gyres in the Pacific Ocean. The variability of western boundary transport (WBT) east of the Philippine coast at the mean NEC bifurcation latitude (12°N) is examined here. A tropical Pacific regional model is set up based on the Massachusetts Institute of Technology general circulation model and its adjoint, which calculates the sensitivities of a defined meridional transport to atmospheric forcing fields and ocean state going backward in time. The adjoint-derived sensitivity of the WBT at the mean NEC bifurcation latitude to surface wind stress is dominated by curl-like patterns that are located farther eastward and southward with increasing time lag. The temporal evolution of the adjoint sensitivity of the WBT to wind stress resembles wind-forced Rossby wave dynamics but propagating with speeds determined by the background stratification and current, suggesting that wind-forced Rossby waves are the underlying mechanism. Interannual-to-decadal variations of the WBT can be hindcast well by multiplying the adjoint sensitivity and the time-lagged wind stress over the whole model domain and summing over time lags. The analysis agrees with previous findings that surface wind stress (especially zonal wind stress in the western subtropical Pacific) largely determines the WBT east of the Philippines, and with a time lag based on Rossby wave propagation. This adjoint sensitivity study quantifies the contribution of wind stress at all latitudes and longitudes and provides a novel perspective to understand the relationship between the WBT and wind forcing over the Pacific Ocean.
Small interfering RNA-producing loci in the ancient parasitic eukaryote Trypanosoma brucei
Authors: Tschudi Christian , Shi Huafang , Franklin Joseph B , Ullu Elisabetta 
Published: August 2012

Abstract

Background
At the core of the RNA interference (RNAi) pathway in Trypanosoma brucei is a single Argonaute protein, Tb AGO1, with an established role in controlling retroposon and repeat transcripts. Recent evidence from higher eukaryotes suggests that a variety of genomic sequences with the potential to produce double-stranded RNA are sources for small interfering RNAs (siRNAs).

Results
To test whether such endogenous siRNAs are present in T. brucei and to probe the individual role of the two Dicer-like enzymes, we affinity purified Tb AGO1 from wild-type procyclic trypanosomes, as well as from cells deficient in the cytoplasmic (Tb DCL1) or nuclear (Tb DCL2) Dicer, and subjected the bound RNAs to Illumina high-throughput sequencing. In wild-type cells the majority of reads originated from two classes of retroposons. We also considerably expanded the repertoire of trypanosome siRNAs to encompass a family of 147-bp satellite-like repeats, many of the regions where RNA polymerase II transcription converges, large inverted repeats and two pseudogenes. Production of these newly described siRNAs is strictly dependent on the nuclear DCL2. Notably, our data indicate that putative centromeric regions, excluding the CIR147 repeats, are not a significant source for endogenous siRNAs.

Conclusions
Our data suggest that endogenous RNAi targets may be as evolutionarily old as the mechanism itself.