bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Audit of the Quality of Deployed DMICP Records on Operation HERRICK 14
Authors: Batham DR , Wall CM 
Published: March 2013

Background:Troops deploying to remote and hostile environments are exposed to numerous threats to their health and wellbeing. Medical care is provided by dedicated but often inexperienced young doctors, nurses and medics. This audit looks at the quality of medical records that are available to these deployed clinicians and the quality of their record keeping against nationally set guidance for the Summary Care Record (SCR) and Out of Hours record keeping.Methods:The data was collected from consecutive GP and nurse medical consultations at Camp Bastion Primary Health Care Centre during Op HERRICK 14.Results:Only 21.7% of personnel had an imported medical record from the UK and only 1% had a summary fitting the guidance for the SCR. Additionally the quality of record keeping for consultations did not conform to standards set by the Royal College of General Practitioners ‘Out of Hours Clinical Audit Tool’.Conclusions:The low numbers and poor quality of imported medical records into Op HERRICK 14 along with the inexperience of clinicians in keeping medical records compliant with relevant standards is of primary importance in the context of patient safety on operations. This audit highlights a number of areas of potential concern for the Defence Medical Services and areas for enhancement of pre-deployment training.
The Use of Clinical Audit During a Successful Medical Engagement in Afghanistan
Authors: Smith Adam Hewitt 
Published: March 2013

Objectives:To describe a successful medical engagement during counter-insurgency operations in Afghanistan, and to demonstrate that a full audit cycle can be used in this environment to support improvements to local healthcare delivery.Methods:In the district of Nad-e-Ali, Helmand Province, Afghanistan, the management of children under five years of age (under-5s) who presented with diarrhoea to a Ministry of Public Health (MoPH) Basic Health Centre was audited. Staff then attended a training course on the Integrated Management of Childhood Illnesses (IMCI) in Kandahar. After further medical engagement to reinforce this training, the audit was repeated.Results:A lack of knowledge of the Afghan government’s MoPH guidelines during the initial audit resulted in 90% of under- 5s with acute diarrhoea being given unnecessary antibiotics and none receiving zinc as recommended. Following the training course and on-going engagement, there was a 67% reduction in the number of under-5s prescribed antibiotics and a 74% increase in the number who received zinc.Conclusions:Opportunities for successful medical engagement during operations are limited but this example demonstrates that in conjunction with host nation facilities, sustainable improvements in healthcare are possible. Secondly, it shows that use of the audit cycle can provide objective evidence that may help encourage local staff to improve their standards of patient care.
Population-Based Screening of Ophthalmic Disorders in a Cohort of Nigerian Army Personnel
Authors: Eze B I , Okoye O , Hussain NA , Mba CN 
Published: March 2013

Objectives:To assess the burden and spectrum of ophthalmic disorders among army personnel at the 82 Division of the Nigerian Army, Enugu, South Eastern Nigeria.Methods:A population-based screening survey in July 2010 in the 82nd Division, Nigerian Army. Data on participants’ sociodemographics, past medical and ophthalmic history, and findings on ophthalmic examination and refraction were noted according to a defined protocol and analysed statistically using p<0.05 as the level of significance.Results:There were 254 participants (223 males, p<0.05) with a mean age of 36.2 + 9.7 SD years (range 19 -63 years). The prevalence of ophthalmic disorders in the study cohort was 34.6 %. These were mainly refractive abnormalities (22.0%) and anterior segment disorders (13.8%). The refractive abnormalities comprised myopia (51.8%), hypermetropia (28.6%) and astigmatism (16.1%).Conclusions:The prevalence of ophthalmic disorder among army personnel at the 82nd Division, Enugu, is comparatively high. Spherical refractive error and anterior segment disorders are the commonest ophthalmic disorders. These have implications for needs-based and cost-effective provision of eye care services to this military formation and probably to the rest of the Nigerian Army as well. To generate broad-based comparative data, future multi-centre surveys are warranted.
Occupational Accidents In Greek Armed Forces In Evros County
Authors: Malliarou Maria , Sourtzi P , Galanis P , Constantinidis TC , Velonakis E 
Published: March 2013

Aim:The purpose of this study was to investigate risk factors for occupational accidents and the relationship between perceived and actual risk of occupational accidents in Greek soldiers.Method:A case-control study was conducted of military personnel in Evros county in Greece. Cases (n=250) were defined as enlisted personnel having had an accident at work and the control series (n=300) comprised of a simple random sample, stratified by age from the army population.Results:Conscripted soldiers (OR=3.8, 2.21 to 6.58, p<0.001) and professional soldiers (OR=2.2, 1.28-3.75, p=0.004) had higher frequency of occurrence of accidents in comparison to army officers. The degree of risk perception due to electrical hazards (OR=2.8, 1.81-4.18, p<0.001), lighting (OR=2.6, 1.74-3.97, p<0.001), falls (OR=2.9, 1.61-5.13, p<0.001) and inadequate safety signs (OR=3.3, 1.99-5.49, p<0.001) were associated with increased occurrence of accident. Regression analysis demonstrated a significant relationship between the accident and the age, time of service in the present unit, specialty, level of education, years of service and the overall military training.Conclusion:This study highlights the increased likelihood of occupational accidents among military personnel with lower rank and lower level of education, less working experience (fewer years of service) and less military training (conscripted and professional soldiers). The existence of occupational accidents in the workplace, civilian or military, creates the need for the adoption of policies for the protection of workers and the organization of occupational preventive services.
Energy expenditure and changes in body composition during exercise-based rehabilitation
Authors: Kristensen Jakob 
Published: March 2013

IntroductionExercise-based rehabilitation programmes have formed the cornerstone of the treatment currently delivered at the Defence Medical Rehabilitation Centre (DMRC) based at Headley Court.Increased operational activity in recent years has meant a concomitant increase in the pressure on Defence rehabilitation resources and a greater need for effective rehabilitation strategies. The aim of this research was to assess the effects of exercise-based rehabilitation on energy expenditure and body composition.MethodsA group of nine male volunteers (30±2.4 years) serving with the Armed Forces and suffering from a variety of musculoskeletal lower limb injuries underwent 17 days of exercise-based rehabilitation. Total daily energy expenditure (TEE) was assessed using a portable combined heart rate monitor/accelerometer (Actiheart).Changes in body composition were assessed using dual energy x-ray absorptiometry (DEXA).ResultsMeanTEE over the entire admission period was 2915±53 kcal/day with no significant difference in TEE observed between training week 1 (W1) and 2 (W2). However, a strong trend towards increased TEE in W1 was observed (p=0.06). No significant change was observed in fat mass (FM), lean body mass (LBM) or body-fat percentage despite the exercise-based rehabilitation programme.ConclusionsThese results suggest that 17 days of exercise-based rehabilitation is insufficient to observe significant changes in body composition, despite high energy expenditure.
Potential Role of BNIP3 in Cardiac Remodeling, Myocardial Stiffness, and Endoplasmic Reticulum
Authors: Chaanine Antoine H. , Gordon Ronald E. , Kohlbrenner Erik , Benard Ludovic , Jeong Dongtak , Hajjar Roger J. 
Published: March 2013

Background—
We have shown that BNIP3 expression is significantly increased in heart failure (HF). In this study, we tested the effects of BNIP3 manipulation in HF.

Methods and Results—
In a rat model of pressure overload HF, BNIP3 knockdown significantly decreased left ventricular (LV) volumes with significant improvement in LV diastolic and systolic function. There were significant decreases in myocardial apoptosis and LV interstitial fibrosis. Ultrastructurally, BNIP3 knockdown attenuated mitochondrial fragmentation and restored mitochondrial morphology and integrity. On the molecular level, there were significant decreases in endoplasmic reticulum (ER) stress and mitochondrial apoptotic markers. One of the mechanisms by which BNIP3 mediates mitochondrial dysfunction is via the oligomerization of the voltage-dependent anion channels causing a shift of calcium from the ER to mitochondrial compartments, leading to the decrease in ER calcium content, mitochondrial damage, apoptosis, and LV interstitial fibrosis, and hence contributes to both systolic and diastolic myocardial dysfunction, respectively. In systolic HF, the downregulation of SERCA2a (sarcoplasmic-endoplasmic reticulum calcium ATPase), along with an increased BNIP3 expression, further worsen myocardial diastolic and systolic function and contribute to the major remodeling seen in systolic HF as compared with diastolic HF with normal SERCA2a expression.

Conclusions—
The increase in BNIP3 expression contributes mainly to myocardial diastolic dysfunction through mitochondrial apoptosis, LV interstitial fibrosis, and to some extent to myocardial systolic dysfunction attributable to the shift of calcium from the ER to the mitochondria and to the decrease in ER calcium content. However, SERCA2a downregulation remains a prerequisite for the major LV remodeling seen in systolic HF.
Duration of Ventilations During Cardiopulmonary Resuscitation by Lay Rescuers and First Responders
Authors: Beesems Stefanie G. , Wijmans Lizzy , Tijssen Jan G.P. , Koster Rudolph W. 
Published: March 2013

Background—
The 2010 guidelines for cardiopulmonary resuscitation allow 5 seconds to give 2 breaths to deliver sufficient chest compressions and to keep perfusion pressure high. This study aims to determine whether the recommended short interruption for ventilations by trained lay rescuers and first responders can be achieved and to evaluate its consequence for chest compressions and survival.

Methods and Results—
From a prospective data collection of out-of-hospital cardiac arrest, we used automatic external defibrillator recordings of cardiopulmonary resuscitation by rescuers who had received a standard European Resuscitation Council basic life support and automatic external defibrillator course. Ventilation periods and total compressions delivered per minute during each 2 minutes of cardiopulmonary resuscitation cycle were measured, and the chest compression fraction was calculated. Neurological intact survival to discharge was studied in relation to these factors and covariates. We included 199 automatic external defibrillator recordings. The median interruption time for 2 ventilations was 7 seconds (25th–75th percentile, 6–9 seconds). Of all rescuers, 21% took <5 seconds and 83% took <10 seconds for a ventilation period; 97%, 88%, and 63% of rescuers were able to deliver >60, >70, and >80 chest compressions per minute, respectively. The median chest compression fraction was 65% (25th–75th percentile, 59%–71%). Survival was 25% (49 of 199), not associated with long or short ventilation pauses when controlled for covariates.

Conclusions—
The great majority of rescuers can give 2 rescue breaths in <10 seconds and deliver at least 70 compressions in a minute. Longer pauses for ventilations are not associated with worse outcome. Guidelines may allow longer pauses for ventilations with no detriment to survival.
Your Hero Is a Ghost, 2010
Authors: Lovett/Codagnone  , Zook Tom 
Published: March 2013

Stainless steel, wood, conduit, black paint, speakers, sound. Photo by Jason Mandella, courtesy Sculpture Center, New York, and the artists Lovett/Codagnone, an artist team based in New York, have worked together since 1995 using photography, performance, video, sound, and installation. Their ongoing exploration of relations of power, as manifested in explicit cultural signifiers as well as clandestine or unconscious practices, investigates the way power comes to play within social structures (relationships, family) to focus on intimacy and the construction of desire. Recent solo exhibitions: Museo Marino Marini, Florence, 2012; LA><ART, Los Angeles, 2012; September Galerie, Berlin, 2011; Sculpture Center, New York, 2010; Sara Meltzer Gallery, New York, 2009; MoMA PS1, New York, 2007–2008. Their performances have been presented at the ICA Philadelphia (2010); Judson Memorial Church, New York (2010); and the ICA Boston (2007). Their work has been shown in galleries and museums in France, Germany, Italy, and The Netherlands. Supplemental media related to this piece can be found at www.mitpressjournals.org/doi/suppl/10.1162/DRAM_a_00205
Improving well-being through community health improvement: a service evaluation
Authors: Eden Angela , Lowndes Janice 
Published: March 2013

This paper describes the establishment of a health improvement service delivered in a socio-economically deprived region of the UK. Recent service reorganisation has provided the opportunity to consider new outcome measures. Results from a service evaluation conducted during integration into local council services are presented. Individuals living in socially excluded communities may require support to feel involved in their local community and to develop supportive networks. In turn, this support could be protective to their health and well-being. This paper will explore how community development activities delivered by Salford Health Improvement Service (SHIS) can support measurable improvements in well-being. Data are drawn from a validated structured questionnaire that measured well-being before and after involvement in a range of community-based interventions based upon established community development principles. The questionnaire was completed by 404 individuals. The paper is UK focused and as such is situated within the context of predominantly UK-based community development literature. The findings indicate that the community development interventions delivered by SHIS do produce positive outcomes in terms of increasing participants’ level of well-being. Self-reported well-being improved in 75% of participants. Community development approaches may be an effective approach in supporting people to become engaged in activities that facilitate healthy lifestyles.
Bone morphogenetic proteins enhance an epithelial-mesenchymal transition in normal airway epithelial cells during restitution of a disrupted epithelium
Authors: McCormack Natasha , Molloy Emer L , O’Dea Shirley 
Published: March 2013

Abstract

Background
Mechanisms of airway repair are poorly understood. It has been proposed that, following injury, progenitor populations such as club cells (Clara) become undifferentiated, proliferate and re-differentiate to re-epithelialise the airway. The exact phenotype of such cells during repair is unknown however. We hypothesised that airway epithelial cells (AECs) undergo some degree of epithelial-mesenchymal transition (EMT) in order to migrate over a denuded airway and effect re-epithelialisation. Furthermore, based on our previous findings that BMP signalling is an early event in AECs following injury in vivo and that BMP4 down-regulates E-cadherin expression and enhances migration in AECs in vitro, we hypothesised that BMPs could play a role in inducing such a phenotypic switch.

Methods
Normal AECs were isolated from mouse lungs and analysed in a model of a disrupted epithelium. EMT marker expression and BMP signalling were examined by immunofluorescence, Western blotting and RT-PCR.

Results
Following generation of a wound area, AECs at the wound edge migrated and acquired a mesenchymal-like morphology. E-cadherin expression was reduced in migrating cells while vimentin and α-smooth muscle actin (α-SMA) expression was increased. Re-expression of membrane E-cadherin was subsequently observed in some cells in the wound area following re-establishment of the monolayer. A transient increase in the incidence of nuclear phosphorylated Smad1/5/8 was observed in migrating cells compared with confluent cells, indicating active BMP signalling during migration. BMP antagonists noggin and gremlin inhibited cell migration, confirming the involvement of BMP signalling in migration and indicating autocrine signalling, possibly involving BMP7 or BMP4 which were expressed in AECs. Exogenous BMP2, BMP4 and BMP7 induced a mesenchymal-like morphology in AECs, enhanced the rate of cell migration and increased α-SMA protein expression in AECs.

Conclusions
Following disruption of an intact epithelium, migrating AECs at the wound edge acquire an EMT-like phenotype involving altered expression of E-cadherin, vimentin and α-SMA. BMP signalling is involved in AEC migration and is likely to mediate the switch towards an EMT-like phenotype by altering protein expression to facilitate cell migration and wound closure. We propose therefore that acquisition of an EMT-like phenotype by AECs is a normal aspect of wound repair. Furthermore, we suggest that diseases involving fibrosis may arise because the EMT phase of repair is prolonged by chronic injury/inflammation, rather than being caused by it, as is the current paradigm.
Gene expression profiling of breast cancer survivability by pooled cDNA microarray analysis using logistic regression, artificial neural networks and decision trees
Authors: Chou Hsiu-Ling , Yao Chung-Tay , Su Sui-Lun , Lee Chia-Yi , Hu Kuang-Yu , Terng Harn-Jing , Shih Yun-Wen , Chang Yu-Tien , Lu Yu-Fen , Chang Chi-Wen , Wahlqvist Mark L , Wetter Thomas , Chu Chi-Ming 
Published: March 2013

Abstract

Background
Microarray technology can acquire information about thousands of genes simultaneously. We analyzed published breast cancer microarray databases to predict five-year recurrence and compared the performance of three data mining algorithms of artificial neural networks (ANN), decision trees (DT) and logistic regression (LR) and two composite models of DT-ANN and DT-LR. The collection of microarray datasets from the Gene Expression Omnibus, four breast cancer datasets were pooled for predicting five-year breast cancer relapse. After data compilation, 757 subjects, 5 clinical variables and 13,452 genetic variables were aggregated. The bootstrap method, Mann-Whitney U test and 20-fold cross-validation were performed to investigate candidate genes with 100 most-significant p-values. The predictive powers of DT, LR and ANN models were assessed using accuracy and the area under ROC curve. The associated genes were evaluated using Cox regression.

Results
The DT models exhibited the lowest predictive power and the poorest extrapolation when applied to the test samples. The ANN models displayed the best predictive power and showed the best extrapolation. The 21 most-associated genes, as determined by integration of each model, were analyzed using Cox regression with a 3.53-fold (95% CI: 2.24-5.58) increased risk of breast cancer five-year recurrence…

Conclusions
The 21 selected genes can predict breast cancer recurrence. Among these genes, CCNB1, PLK1 and TOP2A are in the cell cycle G2/M DNA damage checkpoint pathway. Oncologists can offer the genetic information for patients when understanding the gene expression profiles on breast cancer recurrence.
Diversification of Quiescin sulfhydryl oxidase in a preserved framework for redox relay
Authors: Limor-Waisberg Keren , Ben-Dor Shifra , Fass Deborah 
Published: March 2013

Abstract

Background
The enzyme family Quiescin Sulfhydryl Oxidase (QSOX) is defined by the presence of an amino-terminal thioredoxin-fold (Trx) domain and a carboxy-terminal Erv family sulfhydryl oxidase domain. QSOX enzymes, which generate disulfide bonds and transfer them to substrate proteins, are present in a wide variety of eukaryotic species including metazoans and plants, but are absent from fungi. Plant and animal QSOXs differ in their active-site amino acid sequences and content of non-catalytic domains. The question arises, therefore, whether the Trx-Erv fusion has the same mechanistic significance in all QSOX enzymes, and whether shared features distinguish the functional domains of QSOX from other instances in which these domains occur independently. Through a study of QSOX phylogeny and an analysis of QSOX sequence diversity in light of recently determined three-dimensional structures, we sought insight into the origin and evolution of this multi-domain redox alliance.

Results
An updated collection of QSOX enzymes was used to confirm and refine the differences in domain composition and active-site sequence motif patterns of QSOXs belonging to various eukaryotic phyla. Beyond the expected phylogenetic distinction of animal and plant QSOX enzymes, trees based on individual redox-active QSOX domains show a particular distinction of the Trx domain early in plant evolution. A comparison of QSOX domains with Trx and Erv domains from outside the QSOX family revealed several sequence and structural features that clearly differentiate QSOXs from other enzymes containing either of these domains. Notably, these features, present in QSOXs of various phyla, localize to the interface between the Trx and Erv domains observed in structures of QSOX that model interdomain redox communication.

Conclusions
The infrastructure for interdomain electron relay, previously identified for animal and parasite QSOXs, is found broadly across the QSOX family, including the plant enzymes. We conclude that the conserved three-dimensional framework of the QSOX catalytic domains accommodates lineage-specific differences and paralog diversification in the amino acid residues surrounding the redox-active cysteines. Our findings indicate that QSOX enzymes are characterized not just by the presence of the two defining domain folds but also by features that promote coordinated activity.