bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type 1 diabetes and epilepsy: Efficacy and safety of the ketogenic diet
Authors: Dressler Anastasia , Reithofer Eva , Trimmel‐Schwahofer Petra , Klebermasz Katrin , Prayer Daniela , Kasprian Gregor , Rami Birgit , Schober Edith , Feucht Martha 
Published: March 2010

SummaryDiabetes type 1 seems to be more prevalent in epilepsy, and low‐carbohydrate diets improve glycemic control in diabetes type 2, but data on the use of the classic ketogenic diet (KD) in epilepsy and diabetes are scarce. We present 15 months of follow‐up of a 3 years and 6 months old girl with diabetes type 1 (on the KD), right‐sided hemiparesis, and focal epilepsy due to a malformation of cortical development. Although epileptiform activity on electroencephalography (EEG) persisted (especially during sleep), clinically overt seizures have not been reported since the KD. An improved activity level and significant developmental achievements were noticed. Glycosylated hemoglobin (HbA1c) levels improved, and glycemic control was excellent, without severe side effects. Our experience indicates that diabetes does not preclude the use of the KD.
Alterations of intracerebral γ‐aminobutyric acid (GABA) levels by titration with levetiracetam in patients with focal epilepsies
Authors: Doelken Marc T. , Hammen Thilo , Bogner Wolfgang , Mennecke Angelika , Stadlbauer Andreas , Boettcher Uwe , Doerfler Arnd , Stefan Hermann 
Published: March 2010

SummaryPurpose:  The objective of this study was to determine if levetiracetam (LEV) modulates brain γ‐aminobutyric acid (GABA) in patients with epilepsy.Methods:  Occipital GABA was assessed by protein magnetic resonance spectroscopy (1H‐MRS) in 16 patients with focal epilepsy at baseline and following the initiation of oral administration of LEV as monotherapy. Responder profiles were calculated as percentage of baseline seizure frequency. Alterations of GABA/Cr (creatine) of baseline measurements compared to GABA/Cr under LEV therapy were analyzed by Student’s t‐test for paired samples.Results:  After administration of LEV, partial seizure reduction (>50%) was noticed in 5 of 16 patients (31%; 7 of 16 (44%) patients turned out to be free of seizures. Patients with 50–100% seizure reduction under LEV titration were referred to as LEV responders. Of the 32 GABA spectra, only 22 (approximately 70%) yielded a result that met the criteria for spectral quality; therefore, GABA/Cr data from only seven patients were paired. A significant increase of GABA/Cr during titration with LEV was noted in patients responding to LEV (n = 5; p = 0.007). No differences in baseline GABA/Cr levels were detected between patients with and without previous antiepileptic treatment (p = 0.74).Discussion:  The increasing GABA/Cr levels under drug titration only in LEV‐responding epilepsy patients suggest a more complex and indirect influence of LEV on the GABAergic system.
Clinical Comparison of a Novel Extracapsular Stabilization Procedure and Tibial Plateau Leveling Osteotomy for Treatment of Cranial Cruciate Ligament Deficiency in Dogs
Authors: Cook James L. , Luther Jill K. , Beetem Jodi , Karnes Josh , Cook Cristi R. 
Published: March 2010

Objective: To develop and test a novel extracapsular technique, TightRope CCL technique (TR), and compare its 6‐month clinical outcomes to tibial plateau leveling osteotomy (TPLO) in dogs with cranial cruciate ligament (CCL) deficiency.Study Design: Prospective clinical cohort study.Animals: Medium, large, and giant breed dogs (n=47) with CCL deficiency.Methods: Before clinical use, TR was evaluated by mechanical testing and the surgical technique was developed and evaluated in canine cadavers. For the clinical study, dogs were assigned to either TR (n=24) or TPLO (n=23) groups and the assigned technique performed after arthroscopic assessment and treatment of joint pathology. Postoperative management was standardized for both groups. Outcome measures were performed immediately postoperatively and up to 6 months after surgery and included complication types and rate, subjective measurement of cranial drawer and tibial thrust, subjective assessment of radiographic progression of osteoarthritis (OA), and function using a validated client questionnaire (6 months only).Results: TR with a fiber tape suture had superior mechanical properties for creep, stiffness, yield load, and load at failure. Duration of anesthesia, total surgical time, and stabilization procedure (TR versus TPLO) were all significantly (P<.001) shorter for TR compared with TPLO. Complications requiring further treatment occurred in 12.5% of TR cases and 17.4% of TPLO cases. No significant differences were noted between groups for cranial tibial thrust, but cranial drawer was significantly (P<.05) lower in TR stifles at all postoperative time points. No significant differences were noted between groups for radiographic OA scores. No statistically or clinically significant differences were noted between TR and TPLO for scores for each of the client questionnaire categories.Conclusions: TR resulted in 6‐month outcomes that were not different than TPLO in terms of radiographic progression of OA and client‐evaluated level of function. TR was associated with shorter anesthesia and surgery times as well as a lower complication rate.Clinical Relevance: The TR technique is safe and effective and can be considered an appropriate surgical option as part of the overall treatment plan for CCL deficiency in dogs.
Transfusion medicine knowledge in Postgraduate Year 1 residents
Authors: O'Brien Kerry L. , Champeaux Anne L. , Sundell Zoe E. , Short Matthew W. , Roth Bernard J. 
Published: March 2010

BACKGROUND: Transfusion medicine is a complex important subspecialty of pathology. A transfusion carries measurable risks and benefits. Although fellowship training exists in transfusion medicine, the majority of transfusion decisions are made by clinicians without formal training.STUDY DESIGN AND METHODS: A total of 116 recently graduated medical students entering 10 residency programs at a single medical center over 2 years were evaluated using a standardized patient encounter to determine baseline knowledge. Transfusion medicine knowledge was assessed during the encounter by obtaining verbal consent for red blood cell transfusion, answering patient questions, and completing a written quiz. Final performance was scored using a peer‐reviewed data collection sheet.RESULTS: Scores ranged from 24.0% to 67.1%. Postgraduate Year 1 (PGY‐1) residents graduating from allopathic medical schools had higher scores than those from osteopathic schools (mean, 41.3% vs. 37.5%; p = 0.036). There was no significant difference between PGY‐1 residents entering primary care versus surgical specialties (38.2% and 41.6%; p = 0.10). Although not significant, PGY‐1 residents with previous transfusion medicine education demonstrated a trend toward better performance than those without prior education (47.0% vs. 43.0%; p = 0.057). A total of 17.2% of PGY‐1's could define transfusion‐related acute lung injury, 6.0% knew the transfusion transmission rate of human immunodeficiency virus, 5.2% knew the transfusion transmission rate of hepatitis C virus, and 0% knew the indication for blood product irradiation.CONCLUSIONS: Marked knowledge deficits in transfusion medicine were noted. If the results of this study could be reproduced at other training institutions, medical schools may be willing to donate more resources into transfusion medicine education.
The effect of plasma transfusion on morbidity and mortality: a systematic review and meta‐analysis
Authors: Murad Mohammad Hassan , Stubbs James R. , Gandhi Manish J. , Wang Amy T. , Paul Anu , Erwin Patricia J. , Montori Victor M. , Roback John D. 
Published: March 2010

BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. We systematically reviewed the literature to summarize the available evidence regarding the benefits and harms of plasma transfusion in common clinical settings.STUDY DESIGN AND METHODS: We searched electronic databases from inception through August 2009. Eligible studies enrolled adult patients transfused with plasma and compared to a control group. Paired reviewers independently assessed studies for eligibility and extracted quality and outcome data.RESULTS: Thirty‐seven studies met eligibility criteria, most of which were observational. In patients undergoing massive transfusion, plasma infusion at high plasma : red blood cell ratios was associated with a significant reduction in the risk of death (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.24‐0.60) and multiorgan failure (OR, 0.40; 95% CI, 0.26‐0.60). However, the quality of this evidence was very low due to significant unexplained heterogeneity and several other biases. In a single retrospective study, plasma transfusion was associated with reduced mortality in anticoagulated patients with intracranial hemorrhage (OR, 0.29; 95% CI, 0.09‐0.98). In patients undergoing surgery without massive transfusion, plasma infusion was associated with a trend toward increased mortality (OR, 1.22; 95% CI, 0.73‐2.03). Plasma transfusion was associated with increased risk of developing acute lung injury (OR, 2.92; 95% CI, 1.99‐4.29).CONCLUSIONS: Very‐low‐quality evidence suggests that plasma infusion in the setting of massive transfusion for trauma patients may be associated with a reduction in the risk of death and multiorgan failure. A survival benefit was not demonstrated in most other transfusion populations.
Evidence‐based practice guidelines for plasma transfusion
Authors: Roback John D. , Caldwell Stephen , Carson Jeff , Davenport Robertson , Drew Mary Jo , Eder Anne , Fung Mark , Hamilton Marilyn , Hess John R. , Luban Naomi , Perkins Jeremy G. , Sachais Bruce S. , Shander Aryeh , Silverman Toby , Snyder Ed , Tormey Christopher , Waters John , Djulbegovic Ben 
Published: March 2010

BACKGROUND: There is little systematically derived evidence‐based guidance to inform plasma transfusion decisions. To address this issue, the AABB commissioned the development of clinical practice guidelines to help direct appropriate transfusion of plasma.STUDY DESIGN AND METHODS: A systematic review (SR) and meta‐analysis of randomized and observational studies was performed to quantify known benefits and harms of plasma transfusion in common clinical scenarios (see accompanying article). A multidisciplinary guidelines panel then used the SR and the GRADE methodology to develop evidence‐based plasma transfusion guidelines as well as identify areas for future investigation.RESULTS: Based on evidence ranging primarily from moderate to very low in quality, the panel developed the following guidelines: 1) The panel suggested that plasma be transfused to patients requiring massive transfusion. However, 2) the panel could not recommend for or against transfusion of plasma at a plasma : red blood cell ratio of 1:3 or more during massive transfusion, 3) nor could the panel recommend for or against transfusion of plasma to patients undergoing surgery in the absence of massive transfusion. 4) The panel suggested that plasma be transfused in patients with warfarin therapy–related intracranial hemorrhage, 5) but could not recommend for or against transfusion of plasma to reverse warfarin anticoagulation in patients without intracranial hemorrhage. 6) The panel suggested against plasma transfusion for other selected groups of patients.CONCLUSION: We have systematically developed evidence‐based guidance to inform plasma transfusion decisions in common clinical scenarios. Data from additional randomized studies will be required to establish more comprehensive and definitive guidelines for plasma transfusion.
Pricing and Capital Allocation for Multiline Insurance Firms
Authors: Ibragimov Rustam , Jaffee Dwight , Walden Johan 
Published: March 2010

AbstractWe study multiline insurance companies with limited liability. Insurance premiums are determined by no‐arbitrage principles. The results are developed under the realistic assumption that the losses created by insurer default are allocated among policyholders following an ex post, pro rata, sharing rule. In general, the ratio of default costs to expected claims, and thus the ratio of premiums to expected claims, vary across insurance lines. Moreover, capital and related costs are allocated across lines in proportion to each line's share of a digital default option on the insurer. Our results expand and generalize those derived elsewhere in the literature.
NAGPRA's Effects on Anthropology Education: Views from a College Serving Native American Communities
Authors: Fine‐Dare Kathleen , Charles Mona , Mulhern Dawn , Riggs Charles 
Published: March 2010

Abstract:“Promoting Native American Scholarship,” by Kathleen Fine‐Dare“Focus on Professional Responsibility,” by Mona Charles“Repatriation Laws Impact Osteological Training,” by Dawn Mulhern“Providing Background in Ethics and Law,” by Charles Riggs
The role of microRNAs in ovarian cancer initiation and progression
Authors: Li Shuang‐Di , Zhang Jia‐Rong , Wang Yan‐Qiu , Wan Xiao‐Ping 
Published: March 2010

Abstract

Introduction
Aberrant expression of miRNAs in ovarian cancer
Regulation of microRNAs in ovarian cancer
Biological function of miRNAs in epithelial ovarian cancer
miRNA as diagnostic and prognostic tools in ovarian cancer
Therapeutic potential of miRNAs in ovarian cancer
Conclusions

Epithelial ovarian cancer (EOC) has the highest mortality rate of all gynaecological cancers. One of the greatest impediments to improving outcome is an incomplete understanding of the molecular underpinnings of EOC pathogenesis and progression. Recent studies suggest that microRNAs (miRNAs) are involved in ovarian tumorigenesis and cancer development. Several miRNA profiling studies have identified some consensus aberrantly expressed miRNAs in EOC tissues, and these EOC‐related miRNAs may play critical roles in the pathogenesis and progression of EOC. Moreover, some of the miRNAs may have diagnostic or prognostic significance. In this review, recent progress to reveal the role of miRNAs in EOC will be addressed, and a model for miRNA functions in ovarian cancer initiation and progression will be proposed.
The embryonic morphogen, Nodal, is associated with channel‐like structures in human malignant melanoma xenografts
Authors: McAllister Josephine C. , Zhan Qian , Weishaupt Carsten , Hsu Mei‐Yu , Murphy George F. 
Published: March 2010

Formation of channel‐like structures, also termed vasculogenic mimicry (VM), describes the ability of aggressive melanoma cells to form PAS‐positive anastomosing structures that correlate with tumor virulence. This phenomenon may indicate differentiation plasticity, a feature melanoma cells may share with stem cells in the developing embryo. Recent studies have indicated that VM and tumorigenicity of human malignant melanoma may depend on the signaling pathways of an embryonic morphogen, Nodal. However, given the secretory nature of Nodal protein and melanoma cell heterogeneity, it remains unclear whether the Nodal‐expressing cells participate directly or indirectly in VM that is potentially related to tumorigenic growth. We have developed a humanized murine xenograft model in which developing human melanomas may be sequentially studied during early stages of tumorigenic growth within a physiological human dermal microenvironment. Nodal protein localized diffusely to melanoma cell membranes, with occasional foci of accentuated reactivity in patterns suggestive of channel formation. Similar findings were detected in a limited number of patient‐derived tumors. In situ hybridization confirmed Nodal mRNA to be restricted to tumor cells within xenografts that formed arborizing networks in patterns consistent with VM. These data indicate that Nodal gene expression is associated with formation of VM‐like structures in a physiologically relevant model of human melanoma tumorigenesis, and further support a key role for Nodal expression in the formation of channel‐like structures. The humanized xenograft model should be useful in future studies to define the mechanistic pathways responsible for VM and melanoma progression.McAllister JC, Zhan Q, Weishaupt C, Hsu M‐Y, Murphy GF. The embryonic morphogen, Nodal, is associated with channel‐like structures in human malignant melanoma xenografts.
Melanoma biomarker expression in melanocytic tumor progression: a tissue microarray study
Authors: Nazarian Rosalynn M. , Prieto Victor G. , Elder David E. , Duncan Lyn M. 
Published: March 2010

Background: The elucidation of protein biomarkers that are differentially expressed in human melanocytic tumors during tumor progression may lead to the identification of therapeutic targets and novel diagnostic tests. In a meeting chaired by Dr Mihm, a list of biomarkers of interest in melanoma was compiled. The specialized programs of research excellence (SPORE) in skin cancer developed a melanocytic tumor progression tissue microarray (TMA) to evaluate these candidate biomarkers. In addition to markers reported elsewhere, we evaluated c‐Kit, MITF, MART1, HMB‐45 and bcl‐2. Methods: The TMA contains 480 cores of benign nevi, primary cutaneous melanoma and melanoma metastases. Immunohistochemical detection of melanoma biomarkers, including c‐Kit, MITF, MART‐1, HMB‐45 and bcl‐2 was performed. Results: Intense nuclear staining for MITF protein was observed in 83% of nevi, 56% of primary melanomas and 23% of metastases. Bcl‐2 expression was reduced with progression to metastasis (detected in 86, 89 and 52% of nevi, primaries and metastases, respectively), contrary to MART‐1, which showed no differential expression (74, 85 and 84%). HMB‐45 was observed in 18% of nevi and most (72 and 75%) primary melanomas and metastases. c‐Kit protein increased with progression from nevi to primary tumor (10 and 77% of cases, respectively) and was decreased in metastases (26% of cases). Conclusions: Through a collaboration of the Skin SPOREs sponsored by the Organ Systems Branch of the National Cancer Institute (NCI), we identified a list of melanoma biomarkers of interest, developed a melanocytic tumor progression TMA and completed a coordinated analysis of these biomarkers. This TMA has served as a powerful validation tool for newly identified and known melanoma biomarkers by revealing trends in expression during tumor progression and by confirming the heterogeneity of biomarker expression in cutaneous melanocytic tumors.Nazarian RM, Prieto VG, Elder DE, Duncan LM. Melanoma biomarker expression in melanocytic tumor progression: a tissue microarray study.
The biologic importance of tumor‐infiltrating lymphocytes
Authors: Hodi F. Stephen , Dranoff Glenn 
Published: March 2010

Detailed pathologic analysis has delineated a close association between intratumoral CD 8+ cytotoxic T cells and favorable clinical outcomes in diverse cancers. Conversely, the presence at tumor sites of negative immune regulatory elements, such as FoxP 3+ T cells (Tregs) and PD‐1/PD‐L1 co‐stimulatory molecules, is closely associated with inferior patient survival. Together, these results indicate the importance of the balance between cytotoxic and regulatory pathways in the tumor microenvironment as a critical determinant of prognosis. This immune index also provides a framework for devising therapeutic strategies to enlarge the population of antitumor cytotoxic T cells and attenuate immune regulation. Among these approaches, vaccination with irradiated, autologous tumor cells engineered to secrete granulocyte–macrophage colony‐stimulating factor (GM‐CSF) followed by antibody blockade of cytotoxic T‐lymphocyte associated antigen‐4 (CTLA‐4) provides clinical benefits for some advanced‐course melanoma patients. The extent of tumor necrosis in post‐treatment biopsies is linearly related to the natural logarithm of the ratio of CD 8+ T cells to FoxP 3+ Tregs. These findings show a concordance between the immune signature of tumor protection in endogenous and therapy‐induced responses, strongly supporting Martin Mihm's original insights.Hodi FS, Dranoff G. The biologic importance of tumor‐infiltrating lymphocytes.
Drug‐associated reversible granulomatous T cell dyscrasia: a distinct subset of the interstitial granulomatous drug reaction
Authors: Magro Cynthia M. , Cruz‐Inigo Andres E. , Votava Henry , Jacobs Michael , Wolfe David , Crowson A. Neil 
Published: March 2010

Background: A cutaneous T‐cell infiltrate exhibiting cytologic and architectural atypia, an aberrant phenotypic profile and clonal restriction would fall under the rubric of a T‐cell dyscrasia. Although such an infiltrate could represent a lymphoma, this constellation of findings can also be seen in drug‐associated pseudolymphoma. Methods: In 2001, two of the authors (CMM and AEC) proposed the term reversible T‐cell dyscrasia to describe atypical T‐lymphocytic infiltrates that manifest a light microscopic, phenotypic and molecular profile that closely parallels cutaneous T‐cell lymphoma but regress when the causal drug is withdrawn. Results: Herein we report our 10 cases of drug‐associated pseudolymphoma resembling granulomatous mycosis fungoides. Conclusions: We term this reaction pattern drug‐associated reversible granulomatous T‐cell dyscrasia and consider it a distinct subset of the interstitial granulomatous drug reactionMagro CM, Cruz‐Inigo AE, Votava H, Jacobs M, Wolfe D, Crowson A N Neil. Drug‐associated reversible granulomatous T cell dyscrasia: a distinct subset of the interstitial granulomatous drug reaction.
ASSOCIATIVE COMMUNITY BANKS IN BRAZIL
Authors: De Melo Neto Segundo João Joaquim 
Published: March 2010

The fundamentals of capitalism lie not only in the private ownership of capital but also in its concentration in the hands of a minority. Because they do not have capital, those who need to work for a living—the vast majority—are forced to sell their ability to produce to those who control the means of production. Therefore, capitalists have at their disposal an abundant supply of labor force that usually outnumbers labor demand. If workers had access to credit, many of them would open their own businesses instead of being someone else's employees.1The bigger the number of new businesses established, the more likely they would be to succeed because the insertion of small fractions of capital into the market would expand demand and allow these businesses to find buyers for their goods. In 2003, Brazil had 10 million small and micro entrepreneurs, 1 million families in rural settlements from land‐based reform programs, and over 11 million households depending on the Bolsa Família2 government program, along with a huge mass of unemployed, all in need of access to funds. Despite several credit democratization measures adopted by the current government, among which the sixfold increase in funds from Pronaf (Brazilian National Programme to Strengthen Family Agriculture) stands out, the great majority of those mentioned have not been aided as yet.3