bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and cost of stent-assisted coiling of unruptured intracranial aneurysms compared with coiling or clipping
Authors: Frontera Jennifer A , Moatti Joseph , de los Reyes Kenneth M , McCullough Stephen , Moyle Henry , Bederson Joshua B , Patel Aman 
Published: December 2012

ObjectiveStent-assisted coiling (SAC) of unruptured intracranial aneurysms is a treatment alternative to clipping or coiling, although high complication and procedure-related mortality rates have been reported.MethodsA retrospective study was conducted of patients undergoing SAC, coiling or clipping of unruptured intracranial aneurysms between 2003 and 2010. Rates of residual aneurysm, recanalization, complications, cost (adjusted to 2010), length of stay (LOS) and outcome were compared between groups.ResultsOf 116 subjects, 47 underwent SAC, 33 coiling and 36 clipping. The groups were similar in age, gender and aneurysm location, although the SAC group had significantly larger aneurysms with wider necks (p=0.001). Patients who underwent SAC had more residual aneurysm after initial treatment than those treated with coiling or clipping (75%, 52% and 19%, respectively, p<0.0001), but this difference was smaller at follow-up angiography (50%, 50% and 17% residual, respectively) and was not significant after adjusting for baseline aneurysm and neck size. SAC was not associated with increased recanalization, requirement for additional treatment, mortality or complications after adjusting for aneurysm and neck size. Patients who underwent SAC and those who underwent coiling were more likely to have a good discharge disposition than patients treated with clipping (100% vs 91%, p=0.042). LOS was significantly shorter for patients who underwent SAC or coiling compared with those treated with clipping (p<0.0001). The overall direct cost was higher for patients who underwent SAC than for those treated with coiling or clipping (median $22 544 vs $12 933 vs $14 656, p=0.001), even after adjusting for aneurysm and neck size, LOS and retreatment.ConclusionsSAC is a safe alternative to coiling or clipping of unruptured aneurysms but it is currently more expensive.
Plasma catestatin level in patients with acute myocardial infarction and its correlation with ventricular remodelling
Authors: Meng Lei , Wang Jie , Ding Wen-hui , Han Ping , Yang Ying , Qi Li-tong , Zhang Bao-wei 
Published: December 2012

Abstract

Background
The evaluation of ventricular remodelling and functional recovery is essential in predicting the prognosis of patients with acute myocardial infarction (AMI).

Objective
To determine the plasma catestatin level in patients with AMI, and investigate the association between plasma catestatin and heart function, and with left ventricular remodelling (LVR).

Methods
Fifty-eight consecutive patients who were admitted within 12 h of the onset of their ST-segment elevation myocardial infarction symptoms between 1 October 2009 and 30 June 2011 were prospectively recruited. Circulating catestatin was measured by ELISA. All patients underwent an echocardiography examination during the first week; 31 patients had a second echocardiography examination 3 months after the myocardial infarction.

Results
Plasma catestatin at the time of admission was significantly higher in patients than in normal controls. The level increased further in the first week after AMI. Three months after AMI, the plasma catestatin level of patients was comparable to that of normal controls. The plasma level of catestatin correlated with anterior AMI and left ventricular ejection fraction (LVEF) in the acute stage. Compared with patients without LVR, those with LVR had significantly higher level of plasma brain natriuretic peptide on day 7 and a significantly higher level of plasma catestatin on admission and on days 3 and 7 (p=0.033, p=0.001, p=0.006, p=0.021, respectively).

Conclusions
Plasma catestatin levels were raised after AMI. An early increase of catestatin correlated with anterior AMI and LVEF. Plasma catestatin after the onset of AMI might be associated with the magnitude of progressive ventricular remodelling 3 months after AMI.
The Role of Working Memory and Information Processing Speed on Wisconsin Card Sorting Test Performance in Parkinson Disease Without Dementia
Authors: Liozidou Athanasia , Potagas Constantin , Papageorgiou Sokratis G. , Zalonis Ioannis 
Published: December 2012

Introduction: Wisconsin Card Sorting Test (WCST) performance is often compromised in Parkinson disease (PD). Objective: We aimed to investigate ( a) the role of working memory (WM) and information processing speed (IPS) in the WCST performance of PD without dementia and ( b) the profile of PD without dementia optimal WCST performance. Methods: 73 nondemented patients with PD were examined in WCST, WM (Digit Span Backwards [DSPANB] and Arithmetic subscale, Wechsler Adult Intelligence Scale [WAIS]), and IPS (Digit Symbol subscale-WAIS and Trail Making Test, part A [TMT-A]) and compared to a group of 48 healthy participants. The group with PD was further divided into 2 subgroups on the basis of their WCST performance, number of categories achieved (CAT):0-2 and CAT:3-6, and comparisons were performed. Results: The DSPANB correlated significantly and was the only neuropsychological variable that significantly contributed to the WCST perseverative errors (WPERRORS) performed by the PD group. Differences in the cognitive performance between CAT:3-6 and CAT:0-2 PD subgroups were no longer significant after controlling for age and general level of intelligence (full IQ [FIQ]). Age and FIQ significantly contributed to the WPERRORS performed by CAT:3-6 PD subgroup, while DSPANB was the only variable that significantly contributed to their WCST overall performance. Conclusions: Our findings address the relationship between WM and inflexible behavior exhibited by PD without dementia, argue for the importance of lower age, higher education, and level of intelligence for the successful performance on WCST; yet, the differences in cognitive performance regardless of the duration of illness within our patients with PD provide support to cognitive reserve concept.
Do practitioners managing mood disorders work to a sub-typing or a ‘one size fits all’ model?
Authors: Parker Gordon , Paterson Amelia , McCraw Stacey , Friend Paul , Hong Michael 
Published: December 2012

Objective: To assess whether psychiatrists in the community operate to a sub-typing model of mood disorders when choosing psychotropic medications. Method: Patients assessed through the Black Dog Institute depression clinic provided information on their previously prescribed and current medications, on how effective they found them and whether they had to be ceased due to side-effects. The prevalence of each medication trialled was analysed according to diagnosis (bipolar I, bipolar II, unipolar melancholic depression or unipolar non-melancholic depression). Results: Analyses indicate that psychiatrists prescribe medications differentially in line with diagnosis. This effect was found in both previously prescribed and currently prescribed medications, and was most distinct for mood stabiliser and antipsychotic medications. Several medications, in contrast, appeared to have been trialled by the majority of patients, regardless of diagnosis. Analyses of effectiveness and cessation due to side-effects were compromised by small sub-sample sizes. Conclusions: Psychiatrists in the community appear to operate to a sub-typing model of mood disorders, preferentially prescribing many medications according to mood disorder sub-type.
What makes a hospital-based psychiatry training program successful? The experience of St Vincent’s Hospital, Sydney
Authors: Burke David , Tietze Tad , Chiem Lyn , Boulton Matthew , McGeorge Peter , Andrews Gavin 
Published: December 2012

Objectives: The purpose of this paper is to describe those features that have contributed to the popularity and success of the psychiatry training program at St Vincent’s Hospital, Sydney, and to discuss the factors that potentially weaken the program and how these might be addressed. Conclusions: The strengths of the psychiatry training program at St Vincent’s Hospital are the high rate of recruitment of junior medical officers to psychiatry training, the provision of quality in-house teaching, the in-house provision of psychotherapy supervision and exam preparation, the positive influence of the chief psychiatry registrar, having enough trainees to alleviate the tension between training and service delivery, and the availability of a variety of ‘extra’, high-quality, professional development opportunities.
Trajectory to fellowship: an analysis of the current pathway to becoming a psychiatrist
Authors: Gosbell Andrew , Jurd Stephen , Fletcher Scott 
Published: December 2012

Objective: This study sought to examine the pathway and barriers to attaining The Royal Australian and New Zealand College of Psychiatrists’(RANZCP) Fellowship for those undergoing the current training program, which was implemented in November 2003. This program involved a new training structure, with basic (years 1–3) and advanced (years 4–5) requirements. All formal assessments occur during Basic Training, while either generalist or sub-specialty streams are available during Advanced Training. We assessed 3 years’ intake of trainees who had commenced with the current program and have reached the minimum time to attain RANZCP Fellowship. Methods: Data were extracted from the College’s database for all trainees who commenced training between December 2003 and February 2006; we analysed data on assessments, rotations, breaks in training, part-time status, and other items. The key elements evaluated were the time to complete mandatory training requirements and outcomes. Conclusions: For those attaining RANZCP Fellowship within this cohort, the median Training time was consistent with the structure of the 5-year training program. It was clear that the RANZCP Fellowship Training Program is flexible, because 43% of the trainees studied undertook periods of part-time training and/or breaks in training, plus a range of sub-speciality programs were commenced in the Advanced Training.
Evaluating Leadership Development Needs in a Health Care Setting Through a Partnership Approach
Authors: Grandy Gina , Holton Judith 
Published: December 2012

The Problem Strategic HRD contributes to creating an environment in which objectives and improved performance can be realized through leadership development (LD). Despite considerable investment in LD by public and private sector organizations in North America and Europe, these efforts often fail to produce significant changes in leaders’ behaviors, organizational culture, or organizational performance. As a result, too often leadership development programs (LDPs) are “one size fits all” or a prepackaged competency model without paying attention to individual and contextual differences. A more collaborative approach in the design and delivery of LD has been advocated; however, to date little research has documented or evaluated this at the pre-LDP or needs assessment stage. The Solution This research argues that LD should be a collaborative process involving all stakeholders and that such a partnership approach starts at the needs assessment phase. The research documents and evaluates a three-phase LD needs assessment process in a health care setting. Adopting a case study methodology, it draws primarily upon qualitative data collected from focus groups, written submissions, and interviews with senior and middle managers employed in a provincial health authority, Horizon Health Network, located in Atlantic Canada. The Stakeholders HRD researchers and practitioners in health care responsible for designing, delivering, and evaluating LDPs will find the approach described here insightful and practical. Middle and senior managers working in health care settings who seek to find practical and effective means of addressing leadership gaps and building and sustaining leadership competence across organizations under the pressures of persistent and complex change will also find this research relevant and valuable.
Comparison of co-expression measures: mutual information, correlation, and model based indices
Authors: Song Lin , Langfelder Peter , Horvath Steve 
Published: December 2012

AbstractBackgroundCo-expression measures are often used to define networks among genes. Mutual information (MI) is often used as a generalized correlation measure. It is not clear how much MI adds beyond standard (robust) correlation measures or regression model based association measures. Further, it is important to assess what transformations of these and other co-expression measures lead to biologically meaningful modules (clusters of genes).ResultsWe provide a comprehensive comparison between mutual information and several correlation measures in 8 empirical data sets and in simulations. We also study different approaches for transforming an adjacency matrix, e.g. using the topological overlap measure. Overall, we confirm close relationships between MI and correlation in all data sets which reflects the fact that most gene pairs satisfy linear or monotonic relationships. We discuss rare situations when the two measures disagree. We also compare correlation and MI based approaches when it comes to defining co-expression network modules. We show that a robust measure of correlation (the biweight midcorrelation transformed via the topological overlap transformation) leads to modules that are superior to MI based modules and maximal information coefficient (MIC) based modules in terms of gene ontology enrichment. We present a function that relates correlation to mutual information which can be used to approximate the mutual information from the corresponding correlation coefficient. We propose the use of polynomial or spline regression models as an alternative to MI for capturing non-linear relationships between quantitative variables.ConclusionThe biweight midcorrelation outperforms MI in terms of elucidating gene pairwise relationships. Coupled with the topological overlap matrix transformation, it often leads to more significantly enriched co-expression modules. Spline and polynomial networks form attractive alternatives to MI in case of non-linear relationships. Our results indicate that MI networks can safely be replaced by correlation networks when it comes to measuring co-expression relationships in stationary data.
Meta-analytical biomarker search of EST expression data reveals three differentially expressed candidates
Authors: Wu Timothy H , Chu Lichieh J , Wang Jian-Chiao , Chen Ting-Wen , Tien Yin-Jing , Lin Wen-Chang , Ng Wailap V 
Published: December 2012

Abstract

Background
Researches have been conducted for the identification of differentially expressed genes (DEGs) by generating and mining of cDNA expressed sequence tags (ESTs) for more than a decade. Although the availability of public databases make possible the comprehensive mining of DEGs among the ESTs from multiple tissue types, existing studies usually employed statistics suitable only for two categories. Multi-class test has been developed to enable the finding of tissue specific genes, but subsequent search for cancer genes involves separate two-category test only on the ESTs of the tissue of interest. This constricts the amount of data used. On the other hand, simple pooling of cancer and normal genes from multiple tissue types runs the risk of Simpson's paradox. Here we presented a different approach which searched for multi-cancer DEG candidates by analyzing all pertinent ESTs in all categories and narrowing down the cancer biomarker candidates via integrative analysis with microarray data and selection of secretory and membrane protein genes as well as incorporation of network analysis. Finally, the differential expression patterns of three selected cancer biomarker candidates were confirmed by real-time qPCR analysis.

Results
Seven hundred and twenty three primary DEG candidates (p-value < 0.05 and lower bound of confidence interval of odds ratio ≧ 1.65) were selected from a curated EST database with the application of Cochran-Mantel-Haenszel statistic (CMH). GeneGO analysis results indicated this set as neoplasm enriched. Cross-examination with microarray data further narrowed the list down to 235 genes, among which 96 had membrane or secretory annotations. After examined the candidates in protein interaction network, public tissue expression databases, and literatures, we selected three genes for further evaluation by real-time qPCR with eight major normal and cancer tissues. The higher-than-normal tissue expression of COL3A1, DLG3, and RNF43 in some of the cancer tissues is in agreement with our in silico predictions.

Conclusions
Searching digitized transcriptome using CMH enabled us to identify multi-cancer differentially expressed gene candidates. Our methodology demonstrated simultaneously analysis for cancer biomarkers of multiple tissue types with the EST data. With the revived interest in digitizing the transcriptomes by NGS, cancer biomarkers could be more precisely detected from the ESTs. The three candidates identified in this study, COL3A1, DLG3, and RNF43, are valuable targets for further evaluation with a larger sample size of normal and cancer tissue or serum samples.
MicroRNA-centric measurement improves functional enrichment analysis of co-expressed and differentially expressed microRNA clusters
Authors: Lee Su Yeon , Sohn Kyung-Ah , Kim Ju Han 
Published: December 2012

Abstract

Background
Functional annotations are available only for a very small fraction of microRNAs (miRNAs) and very few miRNA target genes are experimentally validated. Therefore, functional analysis of miRNA clusters has typically relied on computational target gene prediction followed by Gene Ontology and/or pathway analysis. These previous methods share the limitation that they do not consider the many-to-many-to-many tri-partite network topology between miRNAs, target genes, and functional annotations. Moreover, the highly false-positive nature of sequence-based target prediction algorithms causes propagation of annotation errors throughout the tri-partite network.

Results
A new conceptual framework is proposed for functional analysis of miRNA clusters, which extends the conventional target gene-centric approaches to a more generalized tri-partite space. Under this framework, we construct miRNA-, target link-, and target gene-centric computational measures incorporating the whole tri-partite network topology. Each of these methods and all their possible combinations are evaluated on publicly available miRNA clusters and with a wide range of variations for miRNA-target gene relations. We find that the miRNA-centric measures outperform others in terms of the average specificity and functional homogeneity of the GO terms significantly enriched for each miRNA cluster.

Conclusions
We propose novel miRNA-centric functional enrichment measures in a conceptual framework that connects the spaces of miRNAs, genes, and GO terms in a unified way. Our comprehensive evaluation result demonstrates that functional enrichment analysis of co-expressed and differentially expressed miRNA clusters can substantially benefit from the proposed miRNA-centric approaches.
Barriers and facilitators to the implementation of clinical practice guidelines: A cross-sectional survey among physicians in Estonia
Authors: Taba Pille , Rosenthal Marika , Habicht Jarno , Tarien Helvi , Mathiesen Mari , Hill Suzanne , Bero Lisa 
Published: December 2012

Abstract

Background
In an era when an increasing amount of clinical information is available to health care professionals, the effective implementation of clinical practice guidelines requires the development of strategies to facilitate the use of these guidelines. The objective of this study was to assess attitudes towards clinical practice guidelines, as well as the barriers and facilitators to their use, among Estonian physicians. The study was conducted to inform the revision of the clinical practice guideline development process and can provide inspiration to other countries considering the increasing use of evidence-based medicine.

Methods
We conducted an online survey of physicians to assess resource, system, and attitudinal barriers. We also asked a set of questions related to improving the use of clinical practice guidelines and collected free-text comments. We hypothesized that attitudes concerning guidelines may differ by gender, years of experience and practice setting. The study population consisted of physicians from the database of the Department of Continuing Medical Education of the University of Tartu. Differences between groups were analyzed using the Kruskal-Wallis non-parametric test.

Results
41% (497/1212) of physicians in the database completed the questionnaire, comprising more than 10% of physicians in the country. Most respondents (79%) used treatment guidelines in their daily clinical practice. Lack of time was the barrier identified by the most physicians (42%), followed by lack of medical resources for implementation (32%). The majority of physicians disagreed with the statement that guidelines were not accessible (73%) or too complicated (70%). Physicians practicing in outpatient settings or for more than 25 years were the most likely to experience difficulties in guideline use. 95% of respondents agreed that an easy-to-find online database of guidelines would facilitate use.

Conclusions
Use of updated evidence-based guidelines is a prerequisite for the high-quality management of diseases, and recognizing the factors that affect guideline compliance makes it possible to work towards improving guideline adherence in clinical practice. In our study, physicians with long-term clinical experience and doctors in outpatient settings perceived more barriers, which should be taken into account when planning strategies in improving the use of guidelines. Informed by the results of the survey, leading health authorities are making an effort to develop specially designed interventions to implement clinical practice guidelines, including an easily accessible online database.
Probing the applicability of autotransporter based surface display with the EstA autotransporter of Pseudomonas stutzeri A15
Authors: Nicolay Toon , Lemoine Lynn , Lievens Elke , Balzarini Sam , Vanderleyden Jos , Spaepen Stijn 
Published: December 2012

Abstract

Background
Autotransporters represent a widespread family of secreted proteins in Gram-negative bacteria. Their seemingly easy secretion mechanism and modular structure make them interesting candidates for cell surface display of heterologous proteins. The most widely applied host organism for this purpose is Escherichia coli. Pseudomonas stutzeri A15 is an interesting candidate host for environmentally relevant biotechnological applications. With the recently characterized P. stutzeri A15 EstA autotransporter at hand, all tools for developing a surface display system for environmental use are available. More general, this system could serve as a case-study to test the broad applicability of autotransporter based surface display.

Results
Based on the P. stutzeri A15 EstA autotransporter β-domain, a surface display expression module was constructed for use in P. stutzeri A15. Proof of concept of this module was presented by successful surface display of the original EstA passenger domain, which retained its full esterase activity. Almost all of the tested heterologous passenger domains however were not exposed at the cell surface of P. stutzeri A15, as assessed by whole cell proteinase K treatment. Only for a beta-lactamase protein, cell surface display in P. stutzeri A15 was comparable to presentation of the original EstA passenger domain. Development of expression modules based on the full-length EstA autotransporter did not resolve these problems.

Conclusions
Since only one of the tested heterologous passenger proteins could be displayed at the cell surface of P. stutzeri A15 to a notable extent, our results indicate that the EstA autotransporter cannot be regarded as a broad spectrum cell surface display system in P. stutzeri A15.