bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leflunomide therapy for BK virus allograft nephropathy after pediatric kidney transplantation
Authors: Jung Young H. , Moon Kyung C. , Ha Jong W. , Kim Sang‐Joon , Ha Il‐Soo , Cheong Hae I. , Kang Hee G. 
Published: December 2012

AbstractThe BK virus (BKV) can be reactivated with immunosuppressive treatment in renal allograft recipients, which can result in interstitial nephritis (BKV‐associated nephropathy, BKVAN) and lead to renal allograft failure. Recently, leflunomide has been reported in some case series of BKVAN with favorable results. Most studies have included only adult patients, we herein report a pediatric case and include a literature review. The patient was a nine‐yr‐old female with end‐stage renal disease due to hypoxic kidney injury. A deceased donor renal transplant was performed and good initial allograft function was achieved following treatment with prednisolone, tacrolimus and mycophenolate mofetil. The serum Cr level increased to 1.6 mg/dL over the following four‐month period. A kidney biopsy revealed pathologic findings of acute cellular rejection and BK nephropathy. After methylprednisolone pulse therapy was administered to control acute rejection, the tacrolimus dose was reduced, and intravenous immunoglobulin treatment and leflunomide therapy were administered to control the BKVAN. Over the following 18 months, the viral load steadily decreased and remained below 100 copies/mL in the plasma. Leflunomide therapy in addition to a reduction of the immunosuppressive therapies resulted in a significant decline in the BK viral load without further deterioration of renal function.
Real-time situation awareness assessment in critical illness management: adapting the situation present assessment method to clinical simulation
Authors: Shelton Clifford Leigh , Kinston Ruth , Molyneux Adrian John , Ambrose Lucy Jane 
Published: December 2012

BackgroundSituation awareness (SA) is a human factor of critical importance to patient safety. Simulation training aims to examine and debrief human factors; however, SA cannot be directly observed. This has led to the development of SA measurement tools. The Situation Present Assessment Method (SPAM) measures SA in real-time without the need to pause the scenario. The SPAM process involves the delivery of queries to the participant who must answer them accurately and quickly. The latency between the query being asked and answer being received represents SA.MethodTwo query delivery procedures are described in the literature: query delivery by telephone and in person. These procedures were piloted in simulation teaching with final-year medical students. The scenarios were videotaped and reviewed by the investigators to evaluate each procedure.Our evaluation of the existing SPAM procedures led us to adapt the method by developing a bespoke application, which delivers queries via a personal digital assistant (PDA), calculates the latency data and presents it to the instructor.ResultsPresented by telephone, queries tended to disrupt the ‘flow’ of the simulation. The ‘in person’ procedure was not disruptive; however, participants found it difficult to distinguish queries from other dialogue. The PDA represented a compromise between these two techniques: generating data without disrupting the scenario.ConclusionsThe use of SPAM is feasible in clinical simulation. By using handheld technology, SA data are made available to the instructor for use in debrief; this expands the utility of SPAM to the field of medical education.
Double balloon enteroscopy in children: a case series highlighting risks, and a review of the literature
Authors: Jensen Melissa , Mysore Krupa , El-Abiad Rami , Rahhal Riad 
Published: December 2012

AimDouble balloon enteroscopy (DBE) is a relatively new endoscopic technique that allows endoscopic access into the small intestine. It has been studied in adults, but the literature remains scarce in the paediatric age group.MethodsWe retrospectively assessed our experience with DBE in children.ResultsWe describe four procedures performed on three patients. The diagnostic yield was high (100%) with one major complication (perforation) encountered. A review of the benefits and risks in this cohort, and the available literature is included.ConclusionsDBE is a promising endoscopic modality in children, but some aspects remain unanswered. There is a great need for a prospective study to better assess benefit and risk in this population.
Evaluation of a new anaesthetist-led propofol sedation service for endoscopy within a UK day-case setting
Authors: Murugesan Senthil V , Davies Mark W , Nicholson Jill , Hughes Mark , Haslam Neil , Smart Howard L , Sarkar Sanchoy 
Published: December 2012

IntroductionThe use of propofol in endoscopy is becoming more prevalent both in Europe and North America. Potential advantages over conscious sedation include controlled deep sedation for therapeutic endoscopy and improved patient satisfaction. A new anaesthetist-led propofol-based day-case sedation service was introduced within the endoscopy unit at the Royal Liverpool University Hospital in April 2011.AimsTo evaluate this new service of anaesthetist-led propofol-based sedation for safety, compliance with current guidelines and satisfaction (patient, anaesthetist and endoscopist).DesignA prospective, service evaluation audit of a new, weekly, anaesthetist-led propofol-based sedation service. Administrative records, anaesthetic notes and satisfaction scores (1=very dissatisfied; 5=very satisfied; patients, anaesthetists, endoscopists) and the ‘patient journey’ were evaluated for 40 consecutive patients treated over 18 weeks. Outcomes were measured against current British Society of Gastroenterology/Royal College of Anaesthetists guidelines.ResultsAll procedures were completed (100% intention-to-treat rate), all patients were discharged on the day of the procedure and none were readmitted within 7 days. Adverse events were minor (10%) and there were no deaths within 30 days. The median satisfaction score was 5 for patients, anaesthetists and endoscopists. The additional cost for provision of such a service included the services of the anaesthetist (one programmed activity) and operating department personnel and for drugs (propofol). The demand for the service rapidly increased.ConclusionsAnaesthetist-led propofol-assisted endoscopy is safe in a day-case endoscopy unit and is associated with high satisfaction scores for patients, anaesthetists and endoscopists. There is a high demand for this service in this UK endoscopy day-case unit.
Graduated driver licensing and motor vehicle crashes involving teenage drivers: an exploratory age-stratified meta-analysis
Authors: Zhu Motao , Cummings Peter , Chu Haitao , Coben Jeffrey H , Li Guohua 
Published: December 2012

ObjectiveGraduated Driver Licensing (GDL) has been implemented in Australia, Canada, New Zealand, USA and Israel. We conducted an exploratory summary of available data to estimate whether GDL effects varied with age.MethodsWe searched MEDLINE and other sources from 1991–2011. GDL evaluation studies with crashes resulting in injuries or deaths were eligible. They had to provide age-specific incidence rate ratios with CI or information for calculating these quantities. We included studies from individual states or provinces, but excluded national studies. We examined rates based on person-years, not license-years.ResultsOf 1397 papers, 144 were screened by abstract and 47 were reviewed. Twelve studies from 11 US states and one Canadian province were selected for meta-analysis for age 16, eight were selected for age 17, and four for age 18. Adjusted rate ratios were pooled using random effects models. The pooled adjusted rate ratios for the association of GDL presence with crash rates was 0.78 (95% CI 0.72 to 0.84) for age 16 years, 0.94 (95% CI 0.93 to 0.96) for 17 and 1.00 (95% CI 0.95 to 1.04) for 18. The difference between these three rate ratios was statistically significant: p<0.001.ConclusionsGDL policies were associated with a 22% reduction in crash rates among 16-year-old drivers, but only a 6% reduction for 17-year-old drivers. GDL showed no association with crashes among 18-year-old drivers. Because we had few studies to summarise, particularly for older adolescents, our findings should be considered exploratory.
Development of a specific exercise programme for professional orchestral musicians
Authors: Chan Cliffton , Driscoll Tim , Ackermann Bronwen 
Published: December 2012

BackgroundMusculoskeletal problems are common in professional orchestral musicians, and little is known about effective prevention strategies. Exercise is suggested to help in reducing work-related upper limb disorders and accordingly a trial of a specific exercise programme for this population was planned. Formative and process evaluation procedures were undertaken during the development of the programme to ensure high methodological credibility.MethodsLiterature reviews on exercise interventions for musicians as well as for neck, shoulder, abdominal, lower back and hip/pelvic body regions were undertaken. Current preventative and rehabilitation models were reviewed including undergraduate curriculums, postgraduate training programmes, and opinion from academic and clinical physiotherapists. Five series of progressive exercises were developed as a result. These were reviewed by expert physiotherapists who were blinded to the proposed progression difficulty of the exercises. A revised draft was produced for further review. This final programme was pilot trialed and feedback from the participants and physiotherapist instructors were obtained.ResultsNo evidence-based literature regarding an exercise programme for professional orchestral musicians was found. An exercise programme was subsequently developed with progressive stages that followed an adapted exercise prevention and rehabilitation model. The blinded ranking of each exercise series produced varied results particularly in the abdominal and shoulder series. Feedback from the participants and instructors in the pilot study resulted in changes to the exercise difficulty, and the class format and structure.ConclusionsUsing available evidence on exercise prescription in collaboration with clinical consensus and current best practice, a specific exercise programme was developed to prevent and/or reduce occupational injuries in professional orchestral musicians.
Smoking and intention to quit in deprived areas of Glasgow: is it related to housing improvements and neighbourhood regeneration because of improved mental health?
Authors: Bond Lyndal , Egan Matt , Kearns Ade , Clark Julie , Tannahill Carol 
Published: December 2012

BackgroundPeople living in areas of multiple deprivation are more likely to smoke and less likely to quit smoking. This study examines the effect on smoking and intention to quit smoking for those who have experienced housing improvements (HI) in deprived areas of Glasgow, UK, and investigates whether such effects can be explained by improved mental health.MethodsQuasi-experimental, 2-year longitudinal study, comparing residents’ smoking and intention to quit smoking for HI group (n=545) with non-HI group (n=517), adjusting for baseline (2006) sociodemographic factors and smoking status. SF-12 mental health scores were used to assess mental health, along with self-reported experience of, and General Practitioner (GP) consultations for, anxiety and depression in the last 12 months.ResultsThere was no relationship between smoking and HI, adjusting for baseline rates (OR=0.97, 95% CI 0.57 to 1.67, p=0.918). We found an association between intention to quit and HI, which remained significant after adjusting for sociodemographics and previous intention to quit (OR 2.16, 95% CI 1.12 to 4.16, p=0.022). We found no consistent evidence that this association was attenuated by improvement in our three mental health measures.ConclusionsProviding residents in disadvantaged areas with better housing may prompt them to consider quitting smoking. However, few people actually quit, indicating that residential improvements or changes to the physical environment may not be sufficient drivers of personal behavioural change. It would make sense to link health services to housing regeneration projects to support changes in health behaviours at a time when environmental change appears to make behavioural change more likely.
A FORMALIZATION OF RECORD LINKAGE AND ITS APPLICATION TO DATA PROTECTION
Authors: TORRA VICENÇ , STOKES KLARA 
Published: December 2012

Re-identification and record linkage are tools used to measure disclosure risk in data privacy. Given two data files, record linkage establishes links between those records that correspond to the same individual. These links are often expressed in terms of probability distributions. This paper presents a review of a formalization of re-identification in terms of compatible belief functions. This formalization makes it possible to define the set of methods for re-identification that are relevant for the estimation of disclosure risk in privacy protection. Any re-identification method that does not fulfill the criteria for being in this set, may be discarded in a theoretical disclosure risk analysis. The focus in this paper is on providing examples of how this formalization can be applied in a few different scenarios in data privacy
Melody Valve Implant Within Failed Bioprosthetic Valves in the Pulmonary Position
Authors: Gillespie Matthew J. , Rome Jonathan J. , Levi Daniel S. , Williams Ryan J. , Rhodes John F. , Cheatham John P. , Hellenbrand William E. , Jones Thomas K. , Vincent Julie A. , Zahn Evan M. , McElhinney Doff B. 
Published: December 2012

Background—
Transcatheter pulmonary valve implantation using the Melody valve has emerged as an important therapy for the treatment of postoperative right ventricular outflow tract dysfunction. Melody-in-bioprosthetic valves (BPV) is currently considered an off-label indication. We review the combined experience with transcatheter pulmonary valve implantation within BPVs from 8 centers in the United States and discuss technical aspects of the Melody-in-BPV procedure.

Methods and Results—

A total of 104 patients underwent Melody-in-BPV in the pulmonary position at 8 US centers from April 2007 to January 2012. Ten different types of BPVs were intervened on, with Melody valve implantation at the intended site in all patients. Following Melody valve implant, the peak right ventricle-to-pulmonary artery gradient decreased from 38.7±16.3 to 10.9±6.7 mm Hg (
P
<0.001), and the right ventricular systolic pressure fell from 71.6±21.7 to 46.7±15.9 mm Hg (
P
<0.001). There was no serious procedural morbidity, and no deaths related to the catheterization or implant. At a median follow-up of 12 months (1–46 months), no patients had more than mild regurgitation, and 4 had a mean right ventricular outflow tract gradient ≥30 mm Hg. During follow-up, there were 2 stent fractures, 3 cases of endocarditis (2 managed with surgical explant), and 2 deaths that were unrelated to the Melody valve.

Conclusions—
Transcatheter pulmonary valve implantation using the Melody valve within BPVs can be accomplished with a high rate of success, low procedure-related morbidity and mortality, and excellent short-term results. The findings of this preliminary multicenter experience suggest that the Melody valve is an effective transcatheter treatment option for failed BPVs.
Phosphorylation and Assembly of Glutamate Receptors After Brain Ischemia
Authors: Zhang Fan , Guo Ailan , Liu Chunli , Comb Micheal , Hu Bingren 
Published: December 2012

Background and Purpose—
Overassembly of synaptic glutamate receptors leads to excitotoxicity. The goal of this study is to investigate phosphorylation and assembly of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid and N-methyl-D-aspartate receptors after brain ischemia with reperfusion (I/R).

Methods—
Rats were subjected to 15 minutes of global ischemia followed by 0.5, 4, and 24 hours of reperfusion. Phosphotyrosine peptides of glutamate receptors in synaptosomal fraction after I/R were identified and quantified by state-of-the-art immuno-affinity purification of phosphotyrosine peptides followed by liquid chromatography/mass spectrometry/mass spectrometry analysis (immunoaffinity purification-coupled liquid chromatography/mass spectrometry/mass spectrometry). Glutamate receptor phosphorylation and synaptic assembly after I/R were studied by biochemical methods.

Results—
Numerous phosphotyrosine-sites of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid and N-methyl-D-aspartate were upregulated by approximately 2- to 37-fold after I/R. A core glutamate receptor kinase, Src kinase, was significantly activated. GluR2/3 and NR2A/B were rapidly clustered from extrasynaptic to synaptic membrane fractions after I/R. GluR2/3 was then translocated into the intracellular pool, whereas NR2A/B remained in the synaptic fraction for as long as 24 hours. Consistently, trafficking-related phosphorylation of GluR2/3-S880 was significantly but transiently upregulated, whereas NR2A/B-Y1246 and NR2A/B-Y1472 were significantly and persistently upregulated after I/R.

Conclusions—
Phosphorylation of glutamate receptors at synapses may lead to overassembly of glutamate receptors, probably via activation of Src family kinases, after I/R. This study provides global proteomic information about glutamate receptor tyrosine phosphorylation after brain ischemia.
Remarkable Decline in Ischemic Stroke Mortality is Not Matched by Changes in Incidence
Authors: Vaartjes Ilonca , O’Flaherty Martin , Capewell Simon , Kappelle Jaap , Bots Michiel 
Published: December 2012

Background and Purpose—
In Western Europe, mortality from ischemic stroke (IS) has declined over several decades. Age–sex-specific IS mortality, IS incidence, 30-day case fatality, and 1-year mortality after hospital admission are essential for explaining recent trends in IS mortality in the new millennium.

Methods—
Data for all IS deaths (1980–2010) in the Netherlands were grouped by year, sex, and age. A joinpoint regression was fitted to detect points in time at which significant changes in the trends occur. By linking nationwide registers, a cohort of patients first admitted for IS between 1997 and 2005 was constructed and age–sex-specific 30-day case fatality and 1-year mortality were computed. IS incidence (admitted IS patients and out-of-hospital IS deaths) was computed by age and sex. Mann–Kendall tests were used for trend evaluation.

Results—
IS mortality declined continuously between1980 and 2000 with an attenuation of decline in the 1990s in some of the age–sex groups. A remarkable decline in IS mortality after 2000 was observed in all age–sex groups, except for young men. An improved decline in 30-day case fatality and in 1-year mortality was also observed in almost all age–sex groups. In contrast, IS incidence remained stable between 1997 and 2005 or even increased slightly.

Conclusions—
The recent remarkable decline in IS mortality was not matched by a decline in the number of incident nonfatal IS events. This is worrying, because IS is already a leading cause of adult disability, claiming a heavy human and economic burden. Prevention of IS is therefore now of the greatest importance.
A Modeling Study of Stratospheric Waves over the Southern Andes and Drake Passage
Authors: Jiang Qingfang , Doyle James D. , Reinecke Alex , Smith Ronald B. , Eckermann Stephen D. 
Published: December 2012

Abstract
Large-amplitude stratospheric gravity waves over the southern Andes and Drake Passage, as observed by the Atmospheric Infrared Sounder (AIRS) on 8–9 August 2010, are modeled and studied using a deep (0–70 km) version of the Coupled Ocean–Atmosphere Mesoscale Prediction System (COAMPS) model. The simulated tropospheric waves are generated by flow over the high central Andes ridge and the Patagonian peaks in the southern Andes. Some waves emanating from Patagonia propagate southeastward across Drake Passage into the stratosphere over a horizontal distance of more than 1000 km. The wave momentum flux is characterized by a tropospheric maximum over Patagonia that splits into two comparable maxima in the stratosphere: one located directly over the terrain and the other tilting southward with altitude.
Using spatial ray-tracing techniques and flow conditions derived from the numerical simulation, the authors find that waves that originate from the high ridge in the Central Andes are absorbed by a critical level in the lower stratosphere. The three-dimensional waves originating from Patagonia could be separated into three families—namely, a northeast-propagating family, which is absorbed by a critical level between 15 and 20 km; a localized family, which breaks down in the stratosphere and lower mesosphere directly above Patagonia; and a southeast-propagating family, which forms the observed linear stratospheric wave patterns oriented across Drake Passage. The southward group propagation, assisted by lateral wave refraction due to persistent meridional shear of the zonal winds, leads to stratospheric wave breaking and drag near 60°S, well south of the parent orography.
Challenges in Forecasting the 2011 Runoff Season in the Colorado Basin
Authors: Werner Kevin , Yeager Kristen 
Published: December 2012

Abstract
Historically large snowpack across the upper Colorado basin and the Great Basin in 2011 presented the potential for widespread and severe flooding. While widespread flooding did occur, its impacts were largely moderated through a combination of sustained cool weather during the melt season and mitigation measures based on forecasts. The potential for more severe flooding persisted from April through the first part of July as record-high snowpacks slowly melted. NOAA's Colorado Basin River Forecast Center (CBRFC) is the primary office responsible for generating river forecasts in support of emergency and water management within the Colorado River basin. This paper describes the 2011 runoff season in the basin and examines the skill of CBRFC forecasts for that season. The primary goal of this paper is to raise awareness of the research and development areas that could, if successfully integrated into the CBRFC river forecasting system, improve forecasts in similar situations in the future. The authors identify three areas of potential forecast improvement: 1) improving week two to seasonal weather and climate predictions, 2) incorporation of remotely sensed snow-covered area, and 3) improving coordination between reservoir operations and forecasts.