bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public performance and the challenge of local collective action strategies: Quebec’s experience with an Integrated Territorial Approach
Authors: Divay Gérard 
Published: July 2015

Evaluating the performance of local environment activation strategies, set forth in many central policies, is an exercise fraught with challenges. Based on an analysis of 10 Integrated Territorial Approach initiatives, which were rolled out in Quebec’s fight against poverty, this article proposes a framework to better assess their various effects. These strategies are characterised by a partnership process and a collective focus. Performance occurs at micro-, meso- and macro-levels and is observable not only in the production of deliverables, but also on three other process dimensions, which are characteristic of such strategies: fostering the maintenance of local mobilisation drivers; improving the quality of locally productive elements; and learning strategic coherence. This understanding of collective performance takes public managers out of their comfort zone. Beyond having to develop collaborative skills, as is now well-documented in the literature, it leads them to develop an investor mindset and to become logisticians of the collective, not just efficient service providers. Points for practitioners Public managers sometimes feel disadvantaged in local collective action strategies because their performance depends on the contribution of a number of partners whose actions are driven by logics that differ from theirs. By outlining the many possible facets of performance in local collaborative strategies, the statements made in this article could give them greater peace of mind, as well as point out the systemic stumbling blocks that they may face.
Fiscal consolidation and structural reforms in Lithuania in the period 2008–2012: from grand ambitions to hectic firefighting
Authors: Nakrošis Vitalis , Vilpišauskas Ramūnas , Kuokštis Vytautas 
Published: July 2015

This article analyses the inputs, decisions, outputs and outcomes of fiscal consolidation and structural reforms undertaken by the Lithuanian authorities in the period 2008–2012. Our research was based on desk research, which was supplemented by interviews with government decision-makers. The article found that Lithuania successfully pursued fiscal consolidation, which contributed to stabilising its economy and public finances. If economic factors largely explain the timing of fiscal consolidation decisions, political factors are more powerful in accounting for the expenditure-led nature of fiscal consolidation in Lithuania. However, despite bold and ambitious plans, Lithuania's structural reforms proved to be fragmented and incremental due to the absence of a stable base of political support, sustained political attention and persistent political leadership. Points for practitioners First, Lithuania's experience shows the importance of previous policies and the constraints that they impose throughout crises when the speed of decision-making is crucial. Second, it illustrates that an external shock and a reform programme are not sufficient conditions for successful implementation – coalition politics and institutional resistance can derail some initial plans. Third, it demonstrates that even countries that successfully executed a large-scale fiscal consolidation programme may fail to seize the ‘windows of opportunity’ offered by the financial crisis to implement long-term structural reforms.
Survival outcomes for oligometastasis in resected non-small cell lung cancer
Authors: Shimada Yoshihisa , Saji Hisashi , Kakihana Masatoshi , Kajiwara Naohiro , Ohira Tatsuo , Ikeda Norihiko 
Published: July 2015

Background We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancer patients with postoperative distant recurrence, especially oligometastasis. Methods We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011. Results The type of distant recurrence was classified as oligometastasis ( n = 76, 28%) or polymetastasis ( n = 196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis. Conclusions This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.
Operative outcomes of thoracoscopic lobectomy for non-small-cell lung cancer
Authors: Tane Shinya , Nishio Wataru , Okuma Hiromichi , Ogawa Hiroyuki , Hokka Daisuke , Tane Kenta , Tanaka Yugo , Uchino Kazuya , Yoshimura Masahiro , Maniwa Yoshimasa 
Published: July 2015

Aim We examined the advantages of thoracoscopy over thoracotomy in terms of perioperative outcomes and toleration of adjuvant chemotherapy. Methods Between April 2010 and March 2013, 657 patients with non-small-cell lung cancer who underwent lobectomy were classified into thoracoscopy (308 patients) and thoracotomy (349 patients) groups and compared. Results The thoracoscopy group had less blood loss compared to the thoracotomy group ( p < 0.001). When limiting the analysis to pathological stage I patients, the results were similar ( p < 0.001). In addition, the difference in blood loss between the 2 groups was greater in patients with severe pleural adhesions. The postoperative morbidity of the thoracoscopy group was significantly less than that of the thoracotomy group (13.3% vs. 21.2%, p < 0.001), and this result was similar when analyzing the pathological stage I patients (12.6% vs. 20.6%, p = 0.001). A higher percentage of the thoracoscopy group received both the full planned course and dose of adjuvant chemotherapy compared to the thoracotomy group (84.2% vs. 65.8%, p = 0.032). Conclusions These results indicate that totally thoracoscopic lobectomy is the more beneficial surgical approach with regard to the incidence of postoperative complications and toleration of adjuvant chemotherapy.
The effects of hyperoxaemia on tissue oxygenation in patients with a nadir haematocrit lower than 20% during cardiopulmonary bypass
Authors: Sevuk Utkan , Altindag Rojhat , Baysal Erkan , Yaylak Baris , Adiyaman Mehmet Sahin , Akkaya Suleyman , Ay Nurettin , Alp Vahhac 
Published: July 2015

Excessive haemodilution and the resulting anaemia during CPB is accompanied by a decrease in the total arterial oxygen content, which may impair tissue oxygen delivery. Hyperoxic ventilation has been proven to improve tissue oxygenation in different pathophysiological states of anaemic tissue hypoxia. The aim of this study was to examine the influence of arterial hyperoxaemia on tissue oxygenation during CPB. Records of patients undergoing isolated CABG with CPB were retrospectively reviewed. Patients with nadir haematocrit levels below 20% during CPB were included in the study. Tissue hypoxia was defined as hyperlactataemia (lactate >2.2 mmol/L) coupled with low ScVO2 (ScVO2 <70%) during CPB. One hundred patients with normoxaemia and 100 patients with hyperoxaemia were included in the study. Patients with hyperoxaemia had lower tissue hypoxia incidence than patients with normoxaemia (p<0.001). Compared with patients without tissue hypoxia, patients with tissue hypoxia had significantly lower PaO2 values (p<0.001) and nadir haematocrit levels (p<0.001). Nadir haematocrit levels <18% (OR: 5.3; 95% CI: 2.67–10.6; p<0.001) and hyperoxaemia (OR: 0.28; 95% CI: 0.14–0.56; p<0.001) were independently associated with tissue hypoxia. Conclusions: Hyperoxaemia during CPB may be protective against tissue hypoxia in patients with nadir haematocrit levels <20%.
Veno-arterial extracorporeal membrane oxygenation support for severe cardiac failure in a pediatric patient with intracranial hemorrhage after spontaneous aneurysmatic rupture
Authors: Zant Robert , Melter Michael , Doerfler Christian , Gerling Stephan , Rupprecht Leopold , Philipp Alois , Kunkel Juergen 
Published: July 2015

Introduction: Extracorporeal life support in adult patients with extended intracranial hemorrhage is controversial. In pediatric patients, it has traditionally been considered a contraindication as systemic anticoagulation may worsen the hemorrhage and neurological outcome. Case history: We present a nine-year-old female patient who was admitted with extended intracranial hemorrhage after spontaneous rupture of an aneurysm. On day four after the emergency craniotomy, she required veno-arterial extracorporeal membrane oxygenation for septic shock. Using an adapted anticoagulation protocol aimed at lower activated partial thromboplastin time target values, we did not observe any new bleeding or clotting complications during systemic anticoagulation and the patient had good neurological recovery. Conclusion: Extracorporeal life support with low dose systemic anticoagulation can be considered as a treatment option in pediatric patients after craniotomy for intracranial aneurysmatic hemorrhage.
Peripherally Inserted Central Catheter-Related Vein Thrombosis in Patients With Lung Cancer
Authors: Kang Jun Ren , Long Li Hai , Yan Sun Wen , Wei Wang Wei , Jun Han Zhi , Chen Wei 
Published: July 2015

Background: Peripherally inserted central venous catheters (PICCs) are widely used in patients with cancer. Catheter usage is one of the risk factors for venous thromboembolism. We aimed to scrutinize the incidence and risk factors for PICC-related upper extremity venous thrombosis (UEVT) in patients with lung cancer receiving chemotherapy. Patients and Methods: We performed a retrospective cohort study of patients with lung cancer with PICC insertion undergoing chemotherapy. Symptomatic PICC-UEVT was diagnosed by ultrasound. The relationship between chemotherapeutic agent exposure and PICC-UEVT was evaluated. Patient-, catheter-, and insertion-related factors were analyzed in univariable and multivariable logistic regression to identify significant independent risk factors for PICC-UEVT in patients with lung cancer. Results: A total of 328 patients with lung cancer having PICC undergoing chemotherapy were included, for a total of 34 895 catheter days. Seventeen (5.2%) patients developed PICC-related UEVT, with an incidence of 0.49 per 1000 catheter days. In multivariable logistic analysis, advanced disease was shown to be a significant risk factor for PICC-UEVT (odds ratio [OR]: 4.9; 95% confidence interval [CI]: 1.4-16.7; P = .011). Patients treated with etoposide had a higher risk of PICC-related UEVT (OR: 3.6; 95% CI: 1.1-12.1; P = .042). Patients were followed up after PICC removal for a median duration of 246 days. None of the patients developed pulmonary embolism. Conclusion: Patients with lung cancer harboring an advanced disease or treating with etoposide were at higher risk of PICC-UEVT.
Why Are Some Institutions Replaced while Others Persist? Evidence from State Constitutions
Authors: Cayton Adam 
Published: July 2015

AbstractWhy are some institutions quickly replaced while others endure for more than a century? Majority cycling over institutions is theoretically unavoidable, but politics provides few opportunities to study it empirically. Using data on state constitutional characteristics and legislative composition from 1834 to 2012, this article advances the theory that institutions are more likely to be endogenously replaced when the society of actors differs from the time of enactment, and that institutional characteristics can exacerbate or mitigate these risks. Results show that political change interacts with institutional particularism to preserve or undermine state constitutions. More particularistic constitutions have shorter life spans because they are more vulnerable to changes in the political environment.
Unicortical fixation of metacarpal fractures: is it strong enough?
Authors: Dickson J. K. , Bhat W. , Gujral S. , Paget J. , O’Neill J. , Lee S. J. 
Published: July 2015

Unicortical fixation has some practical and theoretical advantages over bicortical fixation. Questions have been raised to its adequacy for post-operative mobilization. We hypothesized that fixation using a plate and eight unicortical screws would be as strong as using a plate and four bicortical screws. A total of 40 unicortical and 40 bicortical fixations were compared using a cadaveric metacarpal model. Unicortical fixation was performed using an eight-hole parallel plate and bicortical fixation with a four-hole straight plate. Fixations were tested to failure using four-point bending load. The mean load to failure was 414 N SD 38(SE) for the unicortical group and 296 N SD 29(SE) for the bicortical group. Significant differences between these two constructs were observed. The mean stiffness of the fixation was higher for the bicortical group than the unicortical, although this difference did not reach significance. Unicortical fixation alone is sufficient to enable early post-operative mobilization in a live model. Level of evidence: 2
Tumefactive multiple sclerosis lesions in two patients after cessation of fingolimod treatment
Authors: Faissner Simon , Hoepner Robert , Lukas Carsten , Chan Andrew , Gold Ralf , Ellrichmann Gisa 
Published: July 2015

Background: Fingolimod (FTY) is the first oral medication approved for multiple sclerosis therapy. Until now, little has been known about the effects of FTY withdrawal regarding disease activity and development of tumefactive demyelinating lesions (TDLs), as already described in patients who discontinue natalizumab. Methods: In this study we present the clinical and radiological findings of two patients who had a severe rebound after FTY withdrawal and compare these with patients identified by a PubMed data bank analysis using the search term ‘fingolimod rebound’. In total, 10 patients, of whom three developed TDLs, are presented. Results: Patients suffering from TDLs were free of clinical and radiological signs of disease activity under FTY therapy (100% versus 57%, compared with patients without TDLs) and had rebounds after a mean of 14.6 weeks (standard deviation 11.5) [patients without TDLs 11.7 (standard deviation 3.4)]. Conclusion: We propose that a good therapeutic response to FTY might be predisposing for a severe rebound after withdrawal. Consequently, therapy switches should be planned carefully with a short therapy free interval.
Effect and Mechanism of Virechana Karma (Therapeutic Purgation) Over Fructose-Induced Metabolic Syndrome
Authors: Chaturvedi Ashutosh , Rao Prasanna N. , Kumar M. Ashvini , Ravishankar B. , Rao Niranjan , Ravi M. 
Published: July 2015

Background. Panchakarma (biopurification methods) is one of the modes of ayurveda to treat disorders of the body. Virechana karma (therapeutic purgation), one among the Panchakarma, is a purification process that is commonly used to treat metabolic disorders like obesity and diabetes mellitus. Hence this study was planned to provide evidence through animal experiments. Methods. Albino rats were subject to Virechana karma (therapeutic purgation) to evaluate the influence of therapy and its mechanism over fructose-induced metabolic syndrome. Results. Results show that Virechana is effective in the management of the metabolic syndrome with decrease in the fecal fat content, fasting blood glucose, serum triglyceride, and reduced fatty changes in liver, heart, and kidney in comparison with the positive control group. Conclusion. Experimental evaluation showed decrease in fatty acid in the storage like liver, kidney, heart, and muscle adipose tissue can indirectly increase the insulin sensitivity in insulin receptor present at skeletal muscles.
PKR inhibits the DNA damage response, and is associated with poor survival in AML and accelerated leukemia in NHD13 mice
Authors: Cheng Xiaodong , Byrne Michael , Brown Kevin D. , Konopleva Marina Y. , Kornblau Steven M. , Bennett Richard L. , May W. Stratford 
Published: July 2015

Key Points
Nuclear PKR activity represses DNA damage response signaling and DNA repair in primary hematopoietic cells. Increased PKR promotes genomic instability and inferior outcomes in both AML and the NHD13 mouse model of leukemia.
Low urinary indoxyl sulfate levels early after transplantation reflect a disrupted microbiome and are associated with poor outcome
Authors: Weber Daniela , Oefner Peter J. , Hiergeist Andreas , Koestler Josef , Gessner André , Weber Markus , Hahn Joachim , Wolff Daniel , Stämmler Frank , Spang Rainer , Herr Wolfgang , Dettmer Katja , Holler Ernst 
Published: July 2015

Key Points
Urinary 3-IS levels predict outcome after ASCT and are associated with antibiotics and NOD2/CARD15 variants.
Targeting IL13Ralpha2 activates STAT6-TP63 pathway to suppress breast cancer lung metastasis
Authors: Papageorgis Panagiotis , Ozturk Sait , Lambert Arthur W. , Neophytou Christiana M. , Tzatsos Alexandros , Wong Chen K. , Thiagalingam Sam , Constantinou Andreas I. 
Published: July 2015

Abstract
Introduction
Basal-like breast cancer (BLBC) is an aggressive subtype often characterized by distant metastasis, poor patient prognosis, and limited treatment options. Therefore, the discovery of alternative targets to restrain its metastatic potential is urgently needed. In this study, we aimed to identify novel genes that drive metastasis of BLBC and to elucidate the underlying mechanisms of action.

Methods
An unbiased approach using gene expression profiling of a BLBC progression model and in silico leveraging of pre-existing tumor transcriptomes were used to uncover metastasis-promoting genes. Lentiviral-mediated knockdown of interleukin-13 receptor alpha 2 (IL13Ralpha2) coupled with whole-body in vivo bioluminescence imaging was performed to assess its role in regulating breast cancer tumor growth and lung metastasis. Gene expression microarray analysis was followed by in vitro validation and cell migration assays to elucidate the downstream molecular pathways involved in this process.

Results
We found that overexpression of the decoy receptor IL13Ralpha2 is significantly enriched in basal compared with luminal primary breast tumors as well as in a subset of metastatic basal-B breast cancer cells. Importantly, breast cancer patients with high-grade tumors and increased IL13Ralpha2 levels had significantly worse prognosis for metastasis-free survival compared with patients with low expression. Depletion of IL13Ralpha2 in metastatic breast cancer cells modestly delayed primary tumor growth but dramatically suppressed lung metastasis in vivo. Furthermore, IL13Ralpha2 silencing was associated with enhanced IL-13-mediated phosphorylation of signal transducer and activator of transcription 6 (STAT6) and impaired migratory ability of metastatic breast cancer cells. Interestingly, genome-wide transcriptional analysis revealed that IL13Ralpha2 knockdown and IL-13 treatment cooperatively upregulated the metastasis suppressor tumor protein 63 (TP63) in a STAT6-dependent manner. These observations are consistent with increased metastasis-free survival of breast cancer patients with high levels of TP63 and STAT6 expression and suggest that the STAT6-TP63 pathway could be involved in impairing metastatic dissemination of breast cancer cells to the lungs.

Conclusion
Our findings indicate that IL13Ralpha2 could be used as a promising biomarker to predict patient outcome and provide a rationale for assessing the efficacy of anti-IL13Ralpha2 therapies in a subset of highly aggressive basal-like breast tumors as a strategy to prevent metastatic disease.
ROCK activity and the Gβγ complex mediate chemotactic migration of mouse bone marrow-derived stromal cells
Authors: Ryan Caroline M. , Brown James A. L. , Bourke Emer , Prendergast Áine M. , Kavanagh Claire , Liu Zhonglin , Owens Peter , Shaw Georgina , Kolch Walter , O’Brien Timothy , Barry Frank P. 
Published: July 2015

Abstract
Introduction
Bone marrow-derived stromal cells (BMSCs), also known as mesenchymal stem cells, are the focus of intensive efforts worldwide to elucidate their function and biology. Despite the importance of BMSC migration for their potential therapeutic uses, the mechanisms and signalling governing stem cell migration are still not fully elucidated.

Methods
We investigated and detailed the effects of MCP-1 activation on BMSCs by using inhibitors of G protein-coupled receptor alpha beta (GPCR αβ), ROCK (Rho-associated, coiled-coil containing protein kinase), and PI3 kinase (PI3K). The effects of MCP-1 stimulation on intracellular signalling cascades were characterised by using immunoblotting and immunofluorescence. The effectors of MCP-1-mediated migration were investigated by using migration assays (both two-dimensional and three-dimensional) in combination with inhibitors.

Results
We established the kinetics of the MCP-1-activated signalling cascade and show that this cascade correlates with cell surface re-localisation of chemokine (C motif) receptor 2 (CCR2) (the MCP-1 receptor) to the cell periphery following MCP-1 stimulation. We show that MCP-1-initiated signalling is dependent on the activation of βγ subunits from the GPCR αβγ complex. In addition, we characterise a novel role for PI3Kγ signalling for the activation of both PAK and ERK following MCP-1 stimulation. We present evidence that the Gβγ complex is responsible for PI3K/Akt, PAK, and ERK signalling induced by MCP-1 in BMSCs. Importantly, we found that, in BMSCs, inhibition of ROCK significantly inhibits MCP-1-induced chemotactic migration, in contrast to previous reports in other systems.

Conclusions
Our results indicate differential chemotactic signalling in mouse BMSCs, which has important implications for the translation of in vivo mouse model findings into human trials. We identified novel components and interactions activated by MCP-1-mediated signalling, which are important for stem cell migration. This work has identified additional potential therapeutic targets that could be manipulated to improve BMSC delivery and homing.
Deeply sequenced metagenome and metatranscriptome of a biogas-producing microbial community from an agricultural production-scale biogas plant
Authors: Bremges Andreas , Maus Irena , Belmann Peter , Eikmeyer Felix , Winkler Anika , Albersmeier Andreas , Pühler Alfred , Schlüter Andreas , Sczyrba Alexander 
Published: July 2015

Abstract

Background
The production of biogas takes place under anaerobic conditions and involves microbial decomposition of organic matter. Most of the participating microbes are still unknown and non-cultivable. Accordingly, shotgun metagenome sequencing currently is the method of choice to obtain insights into community composition and the genetic repertoire.

Findings
Here, we report on the deeply sequenced metagenome and metatranscriptome of a complex biogas-producing microbial community from an agricultural production-scale biogas plant. We assembled the metagenome and, as an example application, show that we reconstructed most genes involved in the methane metabolism, a key pathway involving methanogenesis performed by methanogenic Archaea. This result indicates that there is sufficient sequencing coverage for most downstream analyses.

Conclusions
Sequenced at least one order of magnitude deeper than previous studies, our metagenome data will enable new insights into community composition and the genetic potential of important community members. Moreover, mapping of transcripts to reconstructed genome sequences will enable the identification of active metabolic pathways in target organisms.