bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health service pathways for patients with chronic leg ulcers: identifying effective pathways for facilitation of evidence based wound care
Authors: Edwards Helen , Finlayson Kathleen , Courtney Mary , Graves Nick , Gibb Michelle , Parker Christina 
Published: March 2013

Abstract

Background
Chronic leg ulcers cause long term ill-health for older adults and the condition places a significant burden on health service resources. Although evidence on effective management of the condition is available, a significant evidence-practice gap is known to exist, with many suggested reasons e.g. multiple care providers, costs of care and treatments. This study aimed to identify effective health service pathways of care which facilitated evidence-based management of chronic leg ulcers.

Methods
A sample of 70 patients presenting with a lower limb leg or foot ulcer at specialist wound clinics in Queensland, Australia were recruited for an observational study and survey. Retrospective data were collected on demographics, health, medical history, treatments, costs and health service pathways in the previous 12 months. Prospective data were collected on health service pathways, pain, functional ability, quality of life, treatments, wound healing and recurrence outcomes for 24 weeks from admission.

Results
Retrospective data indicated that evidence based guidelines were poorly implemented prior to admission to the study, e.g. only 31% of participants with a lower limb ulcer had an ABPI or duplex assessment in the previous 12 months. On average, participants accessed care 2–3 times/week for 17 weeks from multiple health service providers in the twelve months before admission to the study clinics. Following admission to specialist wound clinics, participants accessed care on average once per week for 12 weeks from a smaller range of providers. The median ulcer duration on admission to the study was 22 weeks (range 2–728 weeks). Following admission to wound clinics, implementation of key indicators of evidence based care increased (p < 0.001) and Kaplan-Meier survival analysis found the median time to healing was 12 weeks (95% CI 9.3–14.7). Implementation of evidence based care was significantly related to improved healing outcomes (p < 0.001).

Conclusions
This study highlights the complexities involved in accessing expertise and evidence based wound care for adults with chronic leg or foot ulcers. Results demonstrate that access to wound management expertise can promote streamlined health services and evidence based wound care, leading to efficient use of health resources and improved health.
The rural - urban divide in ambulatory care of gastrointestinal diseases in Taiwan
Authors: Lin Yi-Hsuan , Tseng Yen-Han , Chen Yi-Chun , Lin Ming-Hwai , Chou Li-Fang , Chen Tzeng-Ji , Hwang Shinn-Jang 
Published: March 2013

Abstract

Background
The utilization of medical care for gastrointestinal diseases increased over the past decade worldwide. The aim of the study was to investigate the difference between rural and urban patients in seeking medical service for gastrointestinal diseases at ambulatory sector in Taiwan.

Methods
From the one-million-people cohort datasets of the National Health Insurance Research Database, the utilization of ambulatory visits for gastrointestinal diseases in 2009 was analyzed. Rural patients were compared with urban and suburban patients as to diagnosis, locality of visits and choice of specialists.

Results
Among 295,056 patients who had ambulatory visits for gastrointestinal diseases in 2009, rural patients sought medical care for gastrointestinal diseases more frequently than urban and suburban patients (1.60 ± 3.90 vs. 1.17 ± 3.02 and 1.39 ± 3.47). 83.4% of rural patients with gastrointestinal diseases were treated by non-gastroenterologists in rural areas. Rural people had lower accessibility of specialist care, especially for hepatitis, esophageal disorders and gastroduodenal ulcer.

Conclusion
The rural–urban disparity of medical care for gastrointestinal diseases in Taiwan highlighted the importance of the well communication between rural physicians and gastroenterologists. Besides the establishment of the referral system, the medical teleconsultation system and the arrangement of specialist outreach clinics in rural areas might be helpful.
An investigation of 125I seed permanent implantation for recurrent carcinoma in the head and neck after surgery and external beam radiotherapy
Authors: Zhu Lihong , Jiang Yuliang , Wang Junjie , Ran Weiqiang , Yuan Huishu , Liu Chen , Qu Ang , Yang Ruijie 
Published: March 2013

Abstract

Background
A preliminary assessment was conducted of the feasibility, efficacy, and morbidity of 125I seed implantation for recurrent head and neck carcinoma after surgery and external beam radiotherapy.

Methods
Nineteen patients with recurrent head and neck carcinomas underwent 125I seed implantation under ultrasound or computed tomography guidance. The actuarial D90 of 125I seed implantation ranged from 90 to 160 Gy (median, 131 Gy). The follow-up period ranged from 3 to 44 months (median, 11 months).

Results
The median local control was 24 months (95% confidence interval, 10.2 to 37.8). The one- year, two-year and three-year local controls were 73.3%, 27.5% and 27.5%, respectively, whereas the one-year, two-year and three-year survival rates were 53.0%, 18.2% and 18.2%, respectively, and the median survival was 13 months (95% confidence interval, 6.6 to 19.4). A total of 26.3% of patients (5/19) died of local recurrence and 21.1% of patients (4/19) died of metastases. One suffered from a grade 1 skin reaction.

Conclusions

125I seed implantation is feasible and safe as a salvage treatment for patients with recurrent head and neck cancers. The high local control results and low morbidity merits further investigation.
Cancer patient perceptions on the ethical and legal issues related to biobanking
Authors: Master Zubin , Claudio Jaime O , Rachul Christen , Wang Jean CY , Minden Mark D , Caulfield Timothy 
Published: March 2013

Abstract

Background
Understanding the perception of patients on research ethics issues related to biobanking is important to enrich ethical discourse and help inform policy.

Methods
We examined the views of leukemia patients undergoing treatment in clinics located in the Princess Margaret Hospital in Toronto, Ontario, Canada. An initial written survey was provided to 100 patients (64.1% response rate) followed by a follow-up survey (62.5% response rate) covering the topics of informed consent, withdrawal, anonymity, incidental findings and the return of results, ownership, and trust.

Results
The majority (59.6%) preferred one-time consent, 30.3% desired a tiered consent approach that provides multiple options, and 10.1% preferred re-consent for future research. When asked different questions on re-consent, most (58%) reported that re-consent was a waste of time and money, but 51.7% indicated they would feel respected and involved if asked to re-consent. The majority of patients (62.2%) stated they had a right to withdraw their consent, but many changed their mind in the follow-up survey explaining that they should not have the right to withdraw consent. Nearly all of the patients (98%) desired being informed of incidental health findings and explained that the information was useful. Of these, 67.3% of patients preferred that researchers inform them and their doctors of the results. The majority of patients (62.2%) stated that the research institution owns the samples whereas 19.4% stated that the participants owned their samples. Patients had a great deal of trust in doctors, hospitals and government-funded university researchers, moderate levels of trust for provincial governments and industry-funded university researchers, and low levels of trust towards industry and insurance companies.

Conclusions
Many cancer patients surveyed preferred a one-time consent although others desired some form of control. The majority of participants wanted a continuing right to withdraw consent and nearly all wanted to be informed of incidental findings related to their health. Patients had a great deal of trust in their medical professionals and publically-funded researchers as opposed to profit-based industries and insurance companies.
Production of soluble eukaryotic recombinant proteins in E. coli is favoured in early log-phase cultures induced at low temperature
Authors: San-Miguel Teresa , Pérez-Bermúdez Pedro , Gavidia Isabel 
Published: March 2013

Abstract

Background
Producing recombinant plant proteins expressed in Escherichia coli produce in high yields and in a soluble and functional form can be difficult. Under overexpression conditions, proteins frequently accumulate as insoluble aggregates (inclusion bodies) within the producing bacteria. We evaluated how the initial culture density, temperature and duration of the expression stage affect the production of some eukaryotic enzymes in E. coli.

Findings
A high yield of active soluble proteins was obtained by combining early-log phase cultures and low temperatures for protein induction. When IPTG was added at OD600 = 0.1 and cultures were maintained at 4°C for 48-72 h, the soluble protein yield was 3 fold higher than that obtained in the mid-log phase (OD600 = 0.6). Besides, the target protein expression increased and the endogenous bacterial proteins reduced, thus making the protein purification process easier and more efficient.

Conclusions
The protocol can be widely applied to proteins with a heterologous expression which was limited by loss of activity at high temperatures or by low soluble recombinant protein yield.
Collagen catabolism through Coll2-1 and Coll2-1NO2 and myeloperoxidase activity in marathon runners
Authors: Henrotin Yves , Labasse Alain , Franck Thierry , Bosseloir Alain , Bury Thierry , Deberg Michelle 
Published: March 2013

Abstract
To determine the influence of marathon on the serum levels of two markers of cartilage degradation, Coll2-1 and its nitrated form, Coll2-1NO2, and of a marker of neutrophils activation, the myeloperoxidase (MPO).
Coll2-1, Coll2-1NO2, total and active MPO were measured in 98 marathon runners without joint pain and with an average age of 47 years. Sera were taken at rest right before the departure and within 30 min after the marathon. The subjects were submitted to a questionnaire concerning their physical activity and their life style.
The levels of Coll2-1, Coll2-1NO2 and active MPO were not affected by age, body mass index, sex or performance. The levels of total MPO were higher in female than in male (p < 0.05), but were not affected by the other parameters. After the marathon, Coll2-1 and Coll2-1NO2 concentrations were slightly but systematically decreased. The total and active MPO concentrations were increased by 2 to 3-fold in comparison to the pre-marathon values (p < 0.001 for total and active MPO). The active MPO/total MPO ratio was significantly enhanced after the marathon (p < 0.001). The variation of total MPO during the marathon was negatively correlated with the training time per week (r = −0.34; p = 0.009).
The serum levels of Coll2-1 and Coll2-1NO2 were slightly decreased by marathon, indicating that intensive running could reduce cartilage catabolism. Furthermore, Coll2-1NO2 was not correlated with the total and active MPO indicating that Coll2-1 nitration did not result of a systemic oxidative phenomenon but reflects local changes.
Technical note: proteomic approaches to fundamental questions about neutrophil biology
Authors: McLeish Kenneth R , Merchant Michael L , Klein Jon B , Ward Richard A 
Published: March 2013

ABSTRACTProteomics is one of a group of technologies that generates high-throughput, large-scale datasets that can be used to understand cell or organ functions at a systems level. This review will focus on the application of proteomics to the understanding of neutrophil biology. The strengths and weaknesses of common proteomic methods and their application to neutrophils are reviewed, with the goal of evaluating whether the technology is ready to advance our understanding of neutrophil biology.
Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis
Authors: Fone David , Greene Giles , Farewell Daniel , White James , Kelly Mark , Dunstan Frank 
Published: March 2013

BackgroundCommon mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known.AimsTo investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health.MethodMultilevel analysis of population data from the Welsh Health Survey, 2003/04-2010. A total of 88623 respondents aged 18-74 years were nested within 50587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a ‘case’ of common mental disorder.ResultsHigh neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. =0.33), P=0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88-0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate −1.35 (s.e.=0.54), P=0.012; OR=1.13, 95% CI 1.04-1.22).ConclusionsThe associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level.
A Novel Isoform of Liver Receptor Homolog-1 Is Regulated by Steroidogenic Factor-1 and the Specificity Protein Family in Ovarian Granulosa Cells
Authors: Kawabe Shinya , Yazawa Takashi , Kanno Masafumi , Usami Yoko , Mizutani Tetsuya , Imamichi Yoshitaka , Ju Yunfeng , Matsumura Takehiro , Orisaka Makoto , Miyamoto Kaoru 
Published: March 2013

AbstractLiver receptor homolog-1 (LRH-1) is a member of the nuclear receptor 5A (NR5A) subfamily. It is expressed in granulosa cells of the ovary and is involved in steroidogenesis and ovulation. To reveal the transcriptional regulatory mechanism of LRH-1, we determined its transcription start site in the ovary using KGN cells, a human granulosa cell tumor cell line. 5′-rapid amplification of cDNA ends PCR revealed that human ovarian LRH-1 was transcribed from a novel transcription start site, termed exon 2o, located 41 bp upstream of the reported exon 2. The novel LRH-1 isoform was expressed in the human ovary but not the liver. Promoter analysis and an EMSA indicated that a steroidogenic factor-1 (SF-1) binding site and a GC box upstream of exon 2o were required for promoter activity, and that SF-1 and specificity protein (Sp)-1/3 bind to the respective regions in ovarian granulosa cells. In KGN cells, transfection of SF-1 increased ovarian LRH-1 promoter activity and SF-1-dependent reporter activity was further enhanced when peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) was cotransfected. In Drosophila SL2 cells, Sp1 was more effective than Sp3 in enhancing promoter activity, and co-transfection of the NR5A-family synergistically increased activity. Infection with adenoviruses expressing SF-1 or PGC-1α induced LRH-1 expression in KGN cells. These results indicate that the expression of human LRH-1 is regulated in a tissue-specific manner, and that the novel promoter region is controlled by the Sp-family, NR5A-family and PGC-1α in ovarian granulosa cells in a coordinated fashion.
How muscle fiber lengths and velocities affect muscle force generation as humans walk and run at different speeds
Authors: Arnold Edith M. , Hamner Samuel R. , Seth Ajay , Millard Matthew , Delp Scott L. 
Published: March 2013

Summary
The lengths and velocities of muscle fibers have a dramatic effect on muscle force generation. It is unknown, however, whether the lengths and velocities of lower limb muscle fibers substantially affect the ability of muscles to generate force during walking and running. We examined this issue by developing simulations of muscle-tendon dynamics that calculate the lengths and velocities of muscle fibers from electromyographic recordings of eleven lower limb muscles and kinematic measurements of the hip, knee, and ankle made as five subjects walked at speeds of 1.0-1.75 m/s and ran at speeds of 2.0-5.0 m/s. We analyzed the simulated fiber lengths, fiber velocities, and forces to evaluate the influence of force-length and force-velocity properties on force generation at different walking and running speeds. The simulations revealed that force generation ability (i.e., the force generated per unit of activation) of eight of the eleven muscles was significantly affected by walking or running speed. Soleus force generation ability decreased with increasing walking speed, but the transition from walking to running increased the force generation ability by reducing fiber velocities. Our results demonstrate the influence of soleus muscle architecture on the walk-to-run transition and the effects of muscle-tendon compliance on the plantarflexors' ability to generate ankle moment and power. The study presents data that permit lower limb muscles to be studied in unprecedented detail by relating muscle fiber dynamics and force generation to the mechanical demands of walking and running.
Modulation of joint moments and work in the goat hindlimb with locomotor speed and surface grade
Authors: Arnold Allison S. , Lee David V. , Biewener Andrew A. 
Published: March 2013

Summary
Goats and other quadrupeds must modulate the work output of their muscles to accommodate the changing mechanical demands associated with locomotion in their natural environments. This study examined which hindlimb joint moments goats use to generate and absorb mechanical energy on level and sloped surfaces over a range of locomotor speeds. Ground reaction forces and the three-dimensional locations of joint markers were recorded as goats walked, trotted, and galloped over 0°, +15°, and -15° sloped surfaces. Net joint moments, powers, and work were estimated at the goats' hip, knee, ankle and metatarsophalangeal joints throughout the stance phase via inverse dynamics calculations. Differences in locomotor speed on the level, inclined, and declined surfaces were characterized and accounted for by fitting regression equations to the joint moment, power and work data plotted versus non-dimensionalized speed. During level locomotion, the net work generated by moments at each of the hindlimb joints was small (less than 0.1 J/kg body mass) and did not vary substantially with gait or locomotor speed. During uphill running, by contrast, mechanical energy was generated at the hip, knee, and ankle, and the net work at each of these joints increased dramatically with speed (p &lt; 0.05). The greatest increases in positive joint work occurred at the hip and ankle. During downhill running, mechanical energy was decreased in two main ways: goats generated larger knee extension moments in the first half of stance, absorbing energy as the knee flexed, and goats generated smaller ankle extension moments in the second half of stance, delivering less energy. The goats' hip extension moment in mid-stance was also diminished, contributing to the decrease in energy. These analyses offer new insight into quadrupedal locomotion, clarifying how the moments generated by hindlimb muscles modulate mechanical energy at different locomotor speeds and grades, as needed to accommodate the demands of variable terrain.
High thermal sensitivity of blood enhances oxygen delivery in the high-flying bar-headed goose
Authors: Meir Jessica U. , Milsom William K. 
Published: March 2013

Summary
The bar-headed goose (Anser indicus) crosses the Himalayan Mountains twice a year at altitudes where oxygen (O2) levels are less than half those at sea-level and temperatures are below -20°C. Although it has been known for over three decades that the major hemoglobin (Hb) component of bar-headed geese has an increased affinity for O2, enhancing O2 uptake, the effects of temperature and interactions of temperature and pH on bar-headed goose Hb-O2 affinity have not previously been determined. An increase in breathing of the hypoxic and extremely cold air experienced by a bar-headed goose at altitude (due to the enhanced hypoxic ventilatory response in this species) could result in both reduced temperature and reduced levels of CO2 at the blood/gas interface in the lungs, enhancing O2 loading. In addition, given the strenuous nature of flapping flight, particularly in thin air, blood leaving the exercising muscle should be warm and acidotic, facilitating O2 unloading. To explore the possibility that features of blood biochemistry in this species could further enhance O2 delivery, we determined the P50 (PO2 at which Hb is 50% saturated) of whole blood from bar-headed geese under conditions of varying temperature and [CO2]. We found that blood-O2 affinity was highly temperature sensitive in bar-headed geese compared to other birds and mammals. Based on our analysis, temperature and pH effects acting on blood-O2 affinity (cold alkalotic lungs and warm acidotic muscle) could increase O2 delivery by 2 fold during sustained flapping flight at high-altitudes compared to what would be delivered by blood at constant temperature and pH.
Estimating physiological tolerances - a comparison of traditional approaches to nonlinear regression techniques
Authors: Marshall Dustin , Bode Michael , White Craig R. 
Published: March 2013

SummaryTraditionally, physiologists have estimated the ability of organisms to withstand lower partial pressures of oxygen by estimating the partial pressure at which oxygen consumption begins to decrease (known as the 'critical Po2' or 'Pc'). For almost 30 years, the principal way in which Pc has been estimated has been via piecewise 'broken stick' regression. Broken stick regression (BSR) was a useful approach when more sophisticated analyses were less available, but BSR makes a number of unsupported assumptions about the underlying form of the relationship between the rate of oxygen consumption and oxygen availability. The BSR approach also distils a range of values into a single point with no estimate of error. In accordance with more general calls to fit functions to continuous data, we propose the use of nonlinear regression (NLR) to fit various curvilinear functions to oxygen consumption data in order to estimate Pc. Importantly, our approach is back-compatible so that data collected using traditional methods in earlier studies can be compared to data collected using our technique. When we compared the performance of our approach relative to the traditional BSR approach for real world and simulated data, we found that under realistic circumstances, the NLR was more accurate and provided more powerful hypothesis tests. We recommend that future studies make use of NLR to estimate Pc, and also suggest that this approach might be more appropriate for a range of physiological studies that use BSR currently.