bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human rabies in Iran
Authors: Farahtaj Firouzeh , Fayaz Ahmad , Howaizi Nader , Biglari Peyvand , Gholami Alirez 
Published: March 2014

Background Like most Asian and African countries, Iran is highly endemic for rabies, which is a preventable disease with the timely utilisation of post-exposure prophylaxis (PEP). With the availability of affordable vaccination in Iran, there are still several rabies deaths which are assumed misdiagnosed or received ineffective PEP. Methods We reviewed the files of 16 human rabies deaths, consisting of two groups: 1, ineffective treatment; and 2, erroneous PEP. Results Most of the studied cases were male and were from rural areas. Stray dogs were found to be the common biting animal (68.75%). Of the patients, 10/16 (62.5%) who had injuries on their head and/or face demonstrated shorter incubation periods. The incubation period was longer in a 4-year-old boy who sustained injuries in his abdomen and back. All the patients in group 1 received four doses of vaccine and administration of human rabies immune globulin (HRIG), and death occurred with the mean of 49 days after the bite. This mean was 27 days in three patients in group 2, who received vaccine without administration of HRIG. Conclusion In a total of 1,188,579 cases of PEP given in Iran during: 2002–2011, it is not known whether all PEPs were correctly administered by World Health Organization standards. Extending rabies awareness programmes and timely PEP education in the community in accordance with the implementation of rabies control measures might lead to a decrease in these unfortunate scenarios and heavy financial burden of vaccination required due to the prevalence of rabies.
Evaluating Effects of Developmental Education for College Students Using a Regression Discontinuity Design
Authors: Moss Brian G. , Yeaton William H. 
Published: March 2014

Background: Annually, American colleges and universities provide developmental education (DE) to millions of underprepared students; however, evaluation estimates of DE benefits have been mixed. Objectives: Using a prototypic exemplar of DE, our primary objective was to investigate the utility of a replicative evaluative framework for assessing program effectiveness. Research design: Within the context of the regression discontinuity (RD) design, this research examined the effectiveness of a DE program for five, sequential cohorts of first-time college students. Discontinuity estimates were generated for individual terms and cumulatively, across terms. Subjects: Participants were 3,589 first-time community college students. Measures: DE program effects were measured by contrasting both college-level English grades and a dichotomous measure of pass/fail, for DE and non-DE students. Results: Parametric and nonparametric estimates of overall effect were positive for continuous and dichotomous measures of achievement (grade and pass/fail). The variability of program effects over time was determined by tracking results within individual terms and cumulatively, across terms. Applying this replication strategy, DE’s overall impact was modest (an effect size of approximately .20) but quite consistent, based on parametric and nonparametric estimation approaches. A meta-analysis of five RD results yielded virtually the same estimate as the overall, parametric findings. Subset analysis, though tentative, suggested that males benefited more than females, while academic gains were comparable for different ethnicities. Conclusion: The cumulative, within-study comparison, replication approach offers considerable potential for the evaluation of new and existing policies, particularly when effects are relatively small, as is often the case in applied settings.
Utility of Stepping, Walking, and Head Impulses for Screening Patients for Vestibular Impairments
Authors: Cohen Helen S. , Sangi‐Haghpeykar Haleh , Ricci Natalia A. , Kampangkaew June , Williamson Robert A. 
Published: March 2014

ObjectiveTo determine if some common screening tests predict scores on detailed, objective diagnostic tests of the vestibular system.Study DesignSixty patients with vestibular disorders were compared with 60 asymptomatic controls.SettingVestibular diagnostic laboratory, tertiary care center.Subjects and MethodsSubjects were screened with head impulse tests, Fukuda stepping tests while walking and marching in place, and tandem walking tests with eyes open and closed. All subjects underwent bithermal caloric tests and Dix‐Hallpike maneuvers; patients underwent low‐frequency sinusoidal tests of the vestibulo‐ocular reflex in darkness and cervical vestibular evoked myogenic potentials.ResultsOn tandem walking tests, patients differed significantly from controls, but receiver operating characteristic scores were < 0.80. On Fukuda tests, patients turned significantly more than controls for walking but not marching, but receiver operating characteristic values were considerably less than 0.80. On head impulse tests, patients with bithermal caloric weakness (≥20% and <60%) did not differ from controls, but patients with severe bithermal caloric weakness (≥60%) differed significantly from controls. Receiver operating characteristic values were >0.80 only for subjects with severe bithermal caloric weakness and were highest, at 0.88, for subjects with severe weakness and age ≥ 60 years.ConclusionsThe Fukuda test is a poor screening test because it does not correlate well with objective test findings. Tandem walking is best used for screening older patients for vestibular disorders. Positive findings on a head impulse test are probably consistent with severe peripheral vestibular impairment and may be most useful in older patients. In younger patients with vertigo, negative results on head impulse tests may not be informative.
The ‘surprise’ question in advanced cancer patients: A prospective study among general practitioners
Authors: Moroni Matteo , Zocchi Donato , Bolognesi Deborah , Abernethy Amy , Rondelli Roberto , Savorani Giandomenico , Salera Marcello , Dall’Olio Filippo G , Galli Giulia , Biasco Guido ,   on behalf of the SUQ-P group, Balduzzi Antonio , Bandi Giulio , Baraldini Laura , Bauleo Salvatore , Bertini Luigi , Borghi Paolo , Calzoni Paolo , Camanzi Maurizio , Cammarata Antonino , Casarini Piero , Cau Roberto , Deni Cecilia , Ehrlich Shirley , Ermini Giuliano , Franco Livio , Furlò Giancarlo , Grandi Marina , Luigi Lalli Antonio , Maccaferri Marco , Marzo Carla , Masi Angelo , Matrà Annunzio , Mazzetti Gaito Piero , Montanari Federico , Oggianu Massimo , Ognibene Gianluca , Palasciano Maria , Palestini Saida , Perrone Fernando , Quadrelli Stefano , Rappacciolo Antonino , Rubini Stefano , Salera Marcello , Santi Sandra , Savorani Giandomenico , Serio Alberto , Maria Severino Anna , Siena Matteo , Speziali Pietro , Spinnato Luigi , Tosetti Cesare , Velonà Pietro , Verri Andrea , Zocchi Donato 
Published: March 2014

Background: Using the ‘surprise’ question ‘Would you be surprised if this patient died in the next year?’ may improve physicians’ prognostic accuracy and identify people appropriate for palliative care. Aim: Determine the prognostic accuracy of general practitioners asking the ‘surprise’ question about their patients with advanced (stage IV) cancer. Design: Prospective cohort study. Setting/participants: Between December 2011 and February 2012, 42 of 50 randomly selected general practitioners (Bologna area, Italy) prospectively classified 231 patients diagnosed with advanced cancer according to the ‘surprise’ question and supplied the status of each patient 1 year later. Results: Of the 231 patients, general practitioners responded ‘No’ to the ‘surprise’ question for 126 (54.5%) and ‘Yes’ for 105 (45.5%). After 12 months, 104 (45.0%) patients had died; 87 (83.7%) were in the ‘No’ group. The sensitivity of the ‘surprise’ question was 69.3%; the specificity was 83.6%. Positive predictive value was 83.8%; negative predictive value was 69.0%. The answer to the ‘surprise’ question was significantly correlated with survival at 1 year. Patients in the ‘No’ group had an odds ratio of 11.55 (95% confidence interval: 5.83–23.28) and a hazard ratio of 6.99 (95% confidence interval: 3.75–13.03) of being dead in the next year compared to patients in the ‘Yes’ group ( p = 0.000 for both odds ratio and hazard ratio). Conclusion: When general practitioners used the ‘surprise’ question for their patients with advanced cancer, the accuracy of survival prognosis was very high. This has clinical potential as a method to identify patients who might benefit from palliative care.
Biomechanical Comparison of the Interval Throwing Program and Baseball Pitching
Authors: Slenker Nicholas R. , Limpisvasti Orr , Mohr Karen , Aguinaldo Arnel , ElAttrache Neal S. 
Published: March 2014

Background: The interval throwing progression has been part of baseball rehabilitation and conditioning for decades, yet little is known about the upper extremity loads an athlete is subjected to during this progression. Hypothesis: A biomechanical comparison of fastball pitching, variable-effort pitching, and throwing various flat-ground distances will show significant torque differences in the throwing shoulder and elbow. Study Design: Descriptive laboratory study. Methods: Twenty-nine healthy college baseball pitchers were analyzed using a quantitative motion analysis system. The participants threw from flat ground at distances of 18, 27, 37, and 55 m, having been instructed to throw “hard, on a horizontal line.” The participants then threw fastballs 18.4 m from a mound at 3 different effort levels: 60%, 80%, and full effort. The kinetic values for humeral internal rotational torque (HIRT) and elbow valgus load (EVL) were extracted for each throw. Repeated-measures analyses of variance (ANOVAs) were used to compare all 7 throwing conditions within pitchers. The kinetic data were also compared against ball velocity to evaluate throwing efficiency. A separate analysis was conducted using a 3-level repeated-measures ANOVA with post hoc paired t tests comparing just the variable-effort throws from the mound. Results: No statistically significant differences were found in either HIRT or EVL between any of the flat-ground distances and throwing from the mound ( P > .05). Despite similar biomechanical loads compared with the mound, throwing from flat ground showed significantly decreased ball velocity (82% of maximum). Statistically significant differences were found in humeral internal rotational torque and elbow valgus load between fastball pitching off the mound at 60% and 100%, as these parameters increased with throwing effort ( P < .05). At 60% perceived effort from the mound, pitchers generated forces of 76% and ball speeds approaching 84% of maximum. Conclusion: Partial-effort pitching demonstrates significantly lower loads on the shoulder and elbow. Flat-ground throwing at even the shortest distances had similar biomechanical loads compared with pitching from the mound, yet at significantly lower ball velocity. This illustrates the mechanical advantage and increased efficiency of throwing from a mound. No increase in shoulder or elbow loads was seen with increasing distances from flat ground, as pitchers began using a “crow hop” for the longer distances, facilitating the throw with their lower extremity. The mechanical advantage of throwing from a mound or using the crow hop is likely protective during rehabilitation and training throws. Clinical Relevance: The findings of this study may be used to improve rehabilitation programs designed for baseball players returning from shoulder or elbow injury.
Scapulothoracic Bursitis and Snapping Scapula Syndrome
Authors: Warth Ryan J. , Spiegl Ulrich J. , Millett Peter J. 
Published: March 2014

Background: Symptomatic scapulothoracic disorders, such as painful scapular crepitus and/or bursitis, are uncommon; however, they can produce significant pain and disability in many patients. Purpose: To review the current knowledge pertaining to snapping scapula syndrome and to identify areas of further research that may be helpful to improve clinical outcomes and patient satisfaction. Study Design: Systematic review. Methods: We performed a preliminary search of the PubMed and Embase databases using the search terms “snapping scapula,” “scapulothoracic bursitis,” “partial scapulectomy,” and “superomedial angle resection” in September 2013. All nonreview articles related to the topic of snapping scapula syndrome were included. Results: The search identified a total of 167 unique articles, 81 of which were relevant to the topic of snapping scapula syndrome. There were 36 case series of fewer than 10 patients, 16 technique papers, 11 imaging studies, 9 anatomic studies, and 9 level IV outcomes studies. The level of evidence obtained from this literature search was inadequate to perform a formal systematic review or meta-analysis. Therefore, a critical review of current evidence is presented. Conclusion: Snapping scapula syndrome, a likely underdiagnosed condition, can produce significant shoulder dysfunction in many patients. Because the precise origin is typically unknown, specific treatments that are effective for some patients may not be effective for others. Nevertheless, bursectomy with or without partial scapulectomy is currently the most effective primary method of treatment in patients who fail nonoperative therapy. However, many patients experience continued shoulder disability even after surgical intervention. Future studies should focus on identifying the modifiable factors associated with poor outcomes after operative and nonoperative management for snapping scapula syndrome in an effort to improve clinical outcomes and patient satisfaction.
An Analysis of Group Avoidance Following a Rare Group Event: A Contribution to Understanding a ‘Near Death Experience’ in Analytic Group Therapy
Authors: Roth Bennett 
Published: March 2014

A patient with a compulsive need to act out a near death wish (Joseph, 1982) was asked to join a therapy group as a last resort to a blocked treatment. While in the group, following an interpretation (during a co-joint session) of his violent wish, he acted out by nearly putting himself in a coma towards the end of a group session. The effects of the rare event are discussed in terms of the precipitating interpretation and the group tolerance for primitive regression in an empty and emptied state of indifference. A theoretical discussion follows the clinical material.
Does gastric acid suppression affect sunitinib efficacy in patients with advanced or metastatic renal cell cancer?
Authors: Ha Vincent H , Ngo Margaret , Chu Michael P , Ghosh Sunita , Sawyer Michael B , Chambers Carole R 
Published: March 2014

Introduction: Renal cell cancer is a chemotherapy-insensitive cancer treated by vascular endothelial growth factor receptor antagonists. Recently, a question has arisen on whether there is an interaction between tyrosine kinase inhibitors, such as sunitinib, and acid suppressing agents. Methods: A retrospective chart review was conducted for patients at two tertiary care centers who received sunitinib between 1 January 2006 and 31 March 2013. Using electronic systems and a province-wide electronic health records database, medication dispensing records were obtained. A univariate Cox’s proportional hazard model determined if acid suppression had effects on progression-free survival and overall survival. Results: Of 383 patient charts reviewed, 231 were included in the study. Patients on intermittent acid suppression, lost to follow-up or received sunitinib for less than one week were excluded from the study. The median age of the study population was 65. Patients who received no acid suppression (n = 186) had a median progression-free survival of 23.6 weeks (95% CI, 19.0–31.9 weeks) and patients who received continuous acid suppression (n = 45) had a median progression-free survival of 18.9 weeks (95% CI, 11.0–23.7  p = 0.04). A median overall survival of 62.4 weeks (95% CI, 42.0–82.7 weeks) was observed in the group with no acid suppression, while a median overall survival of 40.9 weeks (95% CI, 26.1–74.4 weeks) was observed in the continuous acid suppression group ( p = 0.02). Conclusion: There was a significant difference in progression-free survival and overall survival between the acid suppressed and no acid suppression groups. Further research is required to confirm this potential interaction.
Comprendre l’adaptation de l’hôpital de Logo en République Démocratique du Congo à un programme sanitaire exogène
Authors: Karemere Hermès , Macq Jean 
Published: March 2014

Introduction : L’évaluation d’un programme sanitaire est souvent réalisée de manière linéaire, associant moyens mis en place et performance réalisée. Nous avons pris une autre perspective : celle d’analyser l’hôpital en tant qu’un système adaptatif complexe, partant des effets du programme santé 9ème Fond Européen de Développement sur la production hospitalière, en vue de comprendre l’adaptation de l’hôpital au changement apporté par le programme. Méthodologie : Étude de cas rétrospective (2006 à 2010) ciblant l’hôpital de Logo en Ituri couvrant 208 716 habitants en 2010. L’approche a été mixte, combinant des données quantitatives issues des statistiques hospitalières de routine et des informations qualitatives collectées au travers de la revue documentaire et des entrevues. La triangulation des données a permis de générer des théories explicatives sur le lien entre l’évolution de la production des soins et deux activités importantes du programme. Résultats : Quinze événements et interventions ont été identifiés et validés lors des entrevues. La variation ou la stabilité de la production n’a pas été systématiquement associée aux interventions du programme. Discussion : La stabilité de la production de l’hôpital de Logo ne dépendait pas seulement des interventions du programme mais également d’autres facteurs comme des arrangements institutionnels préexistants ou la nature de l’interaction entre acteurs. L’analyse de l’hôpital en tant qu’un Système complexe adaptatif permet de mieux comprendre son adaptation à un contexte changeant et offre des perspectives de mieux améliorer sa gouvernance.
Pediatric Applications of Surgical Patch Angioplasty of the Main Coronary Trunks
Authors: Sepehripour Amir H. , Harling Leanne , Ashrafian Hutan , Athanasiou Thanos 
Published: March 2014

Objectives: Obstruction of the main coronary trunks, although rare among the general pediatric population, remains an important complication of the arterial switch operation (ASO). Surgical patch angioplasty (SPA) is a technique whereby myocardial revascularization is achieved through direct ostial enlargement, restoring antegrade coronary flow, avoiding competitive flow, and preserving conduit material. This study investigates the indications, techniques, and outcomes of SPA in the pediatric population. Methods: A systematic literature review identified 15 studies incorporating 92 patients. The primary outcome of interest was 30-day mortality. Secondary outcomes included 30-day major adverse cardiac and cerebrovascular events, mortality at last follow-up, reintervention rate, symptomatic status, angiographic patency, and myocardial perfusion status at last follow-up. Results: The SPA was most frequently performed to treat ostial occlusion as a complication of the ASO (73.9%). Of the procedures, 77.2% involved the left main stem, 8.7% the left anterior descending artery, and 14.1% the right coronary artery. Saphenous vein was the commonest patch type (60.9%) followed by autologous pericardium (23.9%). Of the procedures, 96.7% were considered successful with an uneventful postoperative recovery. Overall hospital mortality was 2.2%. At a mean of 39 months of follow-up, 84.8% of the patients were asymptomatic, 51.1% of the repairs were angiographically patent, 9.8% had myocardial perfusion defects, and 6.5% required repeat revascularization. Conclusion: Current evidence suggests that SPA shows encouraging outcomes in a pediatric population and, with increasing experience, may provide a definitive solution to coronary artery occlusion.
Transcriptome analysis identifies Bacillus anthracis genes that respond to CO2through an AtxA-dependent mechanism
Authors: McKenzie Andrew T , Pomerantsev Andrei P , Sastalla Inka , Martens Craig , Ricklefs Stacy M , Virtaneva Kimmo , Anzick Sarah , Porcella Stephen F , Leppla Stephen H 
Published: March 2014

AbstractBackgroundUpon infection of a mammalian host,Bacillus anthracisresponds to host cues, and particularly to elevated temperature (37°C) and bicarbonate/CO2concentrations, with increased expression of virulence factors that include the anthrax toxins and extracellular capsular layer. This response requires the presence of the pXO1 virulence plasmid-encoded pleiotropic regulator AtxA. To better understand the genetic basis of this response, we utilized a controlledin vitrosystem and Next Generation sequencing to determine and compare RNA expression profiles of the parental strain and an isogenic AtxA-deficient strain in a 2 × 2 factorial design with growth environments containing or lacking carbon dioxide.ResultsWe found 15 pXO1-encoded genes and 3 chromosomal genes that were strongly regulated by the separate or synergistic actions of AtxA and carbon dioxide. The majority of the regulated genes responded to both AtxA and carbon dioxide rather than to just one of these factors. Interestingly, we identified two previously unrecognized small RNAs that are highly expressed under physiological carbon dioxide concentrations in an AtxA-dependent manner. Expression levels of the two small RNAs were found to be higher than that of any other gene differentially expressed in response to these conditions. Secondary structure and small RNA-mRNA binding predictions for the two small RNAs suggest that they may perform important functions in regulatingB. anthracisvirulence.ConclusionsA majority of genes on the virulence plasmid pXO1 that are regulated by the presence of either CO2or AtxA separately are also regulated synergistically in the presence of both. These results also elucidate novel pXO1-encoded small RNAs that are associated with virulence conditions.
The impact of COX-2 on invasion of osteosarcoma cell and its mechanism of regulation
Authors: Wu Xing , Cai Ming , Ji Fang , Lou Lie-ming 
Published: March 2014

Abstract

Background
Recently, cyclooxygenase-2 (COX-2) has become an important new target in the field of tumor metastasis. However, the relationship between COX-2 gene expression and the behavior of osteosarcoma metastasis is largely unknown. The study is to investigate how antisense oligonucleotides (ODNs) of COX-2 inhibit the invasion of human osteosarcoma cell line OS-732 and their mechanism of regulation.

Methods
A COX-2 antisense oligonucleotide was designed, synthesized, and transfected into OS-732 human osteosarcoma cells. RT-PCR and western blotting were performed to determine the transfection efficiency. A modified Boyden-transwell assay was used to measure the inhibition rate of tumor cell invasion. In OS-732 cells transfected with COX-2 antisense ODNs, RT-PCR was used to examine the mRNA expression of urokinase-type plasminogen activator (uPA) and that of its receptor, uPAR.

Results
Both the mRNA and protein expression levels of COX-2 were significantly reduced when cells were transfected with COX-2 antisense ODNs, which significantly reduced the invasive ability of OS-732 cells in a dose-dependent manner. The expression levels of uPA and uPAR were also significantly reduced (p < 0.01).

Conclusion
COX-2 antisense ODNs significantly inhibited the invasion of OS-732 cells, primarily by decreasing the mRNA expression of uPA and uPAR.