bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conscientious refusals to refer: findings from a national physician survey
Authors: Combs Michael P , Antiel Ryan M , Tilburt Jon C , Mueller Paul S , Curlin Farr A 
Published: February 2011

BackgroundRegarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral.MethodThe authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral.ResultsOf 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4).ConclusionsPhysicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide.
Embolization of intracranial aneurysms with second-generation Matrix-2 detachable coils: mid-term and long-term results
Authors: Ansari Sameer A , Dueweke Eric J , Kanaan Yassine , Chaudhary Neeraj , Gandhi Dheeraj , Thompson B Gregory , Gemmete Joseph J 
Published: February 2011

BackgroundBioactive polyglycolic/polylactic acid (PGLA)-coated Matrix detachable coils were reported to incite intra-aneurysmal inflammation and fibrosis. Multiple large case series with Matrix-1 coils have shown no advantage with respect to aneurysm recurrence. Second-generation Matrix-2 coils were designed with improved platinum support and reduced copolymer friction. We assessed the safety and efficacy of Matrix-2 coil embolization.Methods84 aneurysms were embolized primarily with Matrix-2 coils. Anatomic results were evaluated using a modified Raymond scale with progressive occlusion or recanalization/recurrence strictly defined as any interval change in intra-aneurysmal opacification.ResultsMid-term (8.9±3.4 months) and long-term (23.0±7.4 months) follow-up was available for 65 aneurysms. At mid-term, 55 (85%) aneurysms remained stable (or progressed to occlusion) versus 10 (15%) recurrent aneurysms, 7 (11%) requiring retreatment. At long term, 49 (75%) aneurysms remained stable versus 16 (25%) recurrent aneurysms, 12 (18%) requiring retreatment. Statistically significant factors affecting recanalization included ruptured aneurysms 9/20 (45%), large aneurysms 5/8 (71%), post-procedure residual aneurysms 6/12 (50%) and differential coil packing density of recurrent (21%) versus stable (28%) aneurysms. Patient morbidity (5%) was limited to thromboembolic complications (n=4) or aneurysm rerupture (n=1). Patient mortality (5%) was secondary to subarachnoid hemorrhage complications (n=4) with no procedure-related deaths (0%).ConclusionCoil embolization with Matrix-2 coils is safe and effective, preventing recanalization in small aneurysms at mid-term. Although these aneurysm recurrence rates initially appeared lower than previous reports with Matrix-1 or platinum coils, significant late recanalization was observed on long-term follow-up. We postulate that any derived benefit from Matrix-2 coils is directly dependent on post-procedure outcomes and coil packing density.
‘One cigarette for you and one for me’: children of smoking and non-smoking parents during pretend play
Authors: de Leeuw Rebecca N H , Verhagen Maaike , de Wit Cindy , Scholte Ron H J , Engels Rutger C M E 
Published: February 2011

ObjectiveTo investigate whether perceived parental smoking is related to pretend smoking in young children and whether children influence each other in pretend smoking.MethodsChildren who reported to have at least one smoking parent were coupled with children who had non-smoking parents. Both children were then asked to pretend that they were adults having a barbeque party. During their role playing, the children were observed in order to assess their pretend smoking behaviours and to examine whether children of smoking parents were more likely to initiate pretend smoking. Children were tested at their schools; the sample consisted of 206 children between 4 and 7 years of age (mean age=5.14, SD=0.87), of which 54.4% were girls. The main outcome was whether a child pretended to be smoking and whether the child initiated or followed the other child in this behaviour.ResultsDuring their play, 63.6% (n=131) of the children pretended to smoke. Children of smoking parents were more likely to initiate pretend smoking than to follow.ConclusionsThrough their own smoking, parents appear to be able to influence the way in which their children interact with peers regarding pretend smoking. More specifically, children of smoking parents might instigate smoking among their peers.
Tata Steel: Financing the Corus Acquisition
Authors: Vishwanath S. R. 
Published: February 2011

Tata Steel announced the acquisition of Corus group in October 2006. After a prolonged bidding war with the Brazilian steelmaker CSN, Tata Steel purchased Corus group for about $13b. The case considers the financing package put together by Tata Steel to fund the Corus acquisition. Students are asked to value the different securities offered and evaluate the financing package. This case can be used in a Corporate Finance course in a module on Financing or in a Mergers and Acquisitions course or in a Financial Instruments and Markets course. The case has the following objectives: 1. To introduce students to the characteristics of preferred stocks and convertible instruments. 2. To consider the factors relevant to the selection of different types of securities in financing. 3. To introduce concepts like dilution, leverage, debt capacity. 4. To introduce credit ratings. 5. To introduce valuation of contingent claims. 6. To build skills in designing and implementing an integrated acquisition and financing strategy. Instructors teaching this case could consider teaching Tata Steel (A): The Bid for Corus case first although these cases can be taught independently.
Protein Kinase C δ Is a Downstream Effector of Oncogenic K-ras in Lung Tumors
Authors: Symonds Jennifer M. , Ohm Angela M. , Carter Cristan J. , Heasley Lynn E. , Boyle Theresa A. , Franklin Wilbur A. , Reyland Mary E. 
Published: February 2011

Abstract
Oncogenic activation of K-ras occurs commonly in non–small cell lung cancer (NSCLC), but strategies to therapeutically target this pathway have been challenging to develop. Information about downstream effectors of K-ras remains incomplete, and tractable targets are yet to be defined. In this study, we investigated the role of protein kinase C δ (PKCδ) in K-ras–dependent lung tumorigenesis by using a mouse carcinogen model and human NSCLC cells. The incidence of urethane-induced lung tumors was decreased by 69% in PKCδ-deficient knockout (δKO) mice compared with wild-type (δWT) mice. δKO tumors are smaller and showed reduced proliferation. DNA sequencing indicated that all δWT tumors had activating mutations in KRAS, whereas only 69% of δKO tumors did, suggesting that PKCδ acts as a tumor promoter downstream of oncogenic K-ras while acting as a tumor suppressor in other oncogenic contexts. Similar results were obtained in a panel of NSCLC cell lines with oncogenic K-ras but which differ in their dependence on K-ras for survival. RNA interference–mediated attenuation of PKCδ inhibited anchorage-independent growth, invasion, migration, and tumorigenesis in K-ras–dependent cells. These effects were associated with suppression of mitogen-activated protein kinase pathway activation. In contrast, PKCδ attenuation enhanced anchorage-independent growth, invasion, and migration in NSCLC cells that were either K-ras–independent or that had WT KRAS. Unexpectedly, our studies indicate that the function of PKCδ in tumor cells depends on a specific oncogenic context, as loss of PKCδ in NSCLC cells suppressed transformed growth only in cells dependent on oncogenic K-ras for proliferation and survival. Cancer Res; 71(6); 2087–97. ©2011 AACR.
Helicobacter hepaticus–Induced Liver Tumor Promotion Is Associated with Increased Serum Bile Acid and a Persistent Microbial-Induced Immune Response
Authors: García Alexis , Zeng Yu , Muthupalani Sureshkumar , Ge Zhongming , Potter Amanda , Mobley Melissa W. , Boussahmain Chakib , Feng Yan , Wishnok John S. , Fox James G. 
Published: February 2011

Abstract
Chronic microbial infection influences cancer progression, but the mechanisms that link them remain unclear. Constitutive androstane receptor (CAR) is a nuclear receptor that regulates enzymes involved in endobiotic and xenobiotic metabolism. CAR activation is a mechanism of xenobiotic tumor promotion; however, the effects of chronic microbial infection on tumor promotion have not been studied in the context of CAR function. Here, we report that CAR limits the effects of chronic infection–associated progression of liver cancer. CAR knockout (KO) and wild-type (WT) male mice were treated with or without the tumor initiator diethylnitrosamine (DEN) at 5 weeks of age and then orally inoculated with Helicobacter hepaticus (Hh) or sterile media at 8 weeks of age. At approximately 50 weeks postinoculation, mice were euthanized for histopathologic, microbiological, molecular, and metabolomic analyses. Hh infection induced comparable hepatitis in WT and KO mice with or without DEN that correlated with significant upregulation of Tnfα and toll receptor Tlr2. Notably, DEN-treated Hh-infected KO mice exhibited increased numbers of liver lobes with dysplasia and neoplasia and increased multiplicity of neoplasia, relative to similarly treated WT mice. Enhanced tumor promotion was associated with decreased hepatic expression of P450 enzymes Cyp2b10 and Cyp3a11, increased expression of Camp, and increased serum concentrations of chenodeoxycholic acid. Together, our findings suggest that liver tumor promotion is enhanced by an impaired metabolic detoxification of endobiotics and a persistent microbial-induced immune response. Cancer Res; 71(7); 2529–40. ©2011 AACR.
Immunoglobulin A Defines Secretions from Salivary Tissue in Post–Sistrunk Procedure Drainage
Authors: Baig Samir M. , Martinez‐Alvernia Efrain A. , Mankarious Leila A. 
Published: February 2011

ObjectivesThis was a pilot study to establish a protein difference between thyroglossal duct cyst fluid relative to oral saliva, in order to differentiate patients with residual thyroglossal cyst from those with salivary fistula in the case of post–Sistrunk procedure incisional drainage. Past immunohistochemistry studies on archived tissue blocks from post–Sistrunk procedure patients have shown MUC5AC to have elevated concentrations in thyroglossal duct relative to salivary tissue; secretory immunoglobulin A (IgA) was also chosen as a candidate protein based on previously published reports of its increased concentration in saliva relative to respiratory secretions.DesignDiagnostic tests were assessed. Thyroglossal duct cyst fluid and oral saliva were obtained from 12 patients. Enzyme‐linked immunosorbent assay (ELISA) was then performed on the samples to identify the presence of MUC5AC and IgA.SettingTertiary care hospital.SubjectsPatient fluid samples were taken immediately postoperatively for patients undergoing Sistrunk procedure at one institution. Presence of thyroglossal duct cyst was confirmed in all cases by pathology.ResultsSeven of 12 thyroglossal duct cyst fluid samples were shown to have elevated absorbance with ELISA for MUC5AC. In experiments for IgA, 10 of the 12 saliva samples had elevated absorbance compared with thyroglossal duct fluid samples obtained from the same patient.ConclusionsIgA is an accurate identifier of saliva compared with thyroglossal duct fluid in secreted samples obtained from the same patient.
Distinct Epigenetic Profiling in Head and Neck Squamous Cell Carcinoma Stem Cells
Authors: Furusawa Jun , Zhang Haihong , Vural Emre , Stone Annjanette , Fukuda Satoshi , Oridate Nobuhiko , Fang Hong , Ye Yanbin , Suen James Y. , Fan Chun‐Yang 
Published: February 2011

ObjectiveTo identify unique epigenetic signature in cancer stem cells (CSCs) in head and neck squamous cell carcinoma (HNSCC).Study DesignMolecular and microarray studies.SettingTertiary referral center.Subjects and MethodsHead and neck CSCs were isolated in HNSCC cells by CD44 staining and flow cytometry sorting. CSCs with highest CD44 expression (CD44hi) and non–stem cells (non‐SCs) with lowest CD44 expression (CD44low) were then characterized for stemness gene expression and their responses to chemotherapeutic agents, followed by high‐throughput epigenetic profiling using the Illumina BeadChip Array, targeting 28,544 CpG sites covering more than 14,956 genes.ResultsCD44hi CSCs expressed higher levels of stem cell markers and were more resistant to chemotherapeutic agents as compared to CD44low non‐SCs. By DNA methylation microarray analysis, 17 hypomethylated and 9 hypermethylated genes were identified in CD44hi CSCs as compared to non‐SCs in most HNSCC cell lines. Cluster analysis using these 26 genes showed that CD44hi CSCs were epigenetically distinct from the CD44low non‐SCs in all 5 HNSCC cell lines.ConclusionA unique epigenetic profile consisting of 17 hypomethylated and 9 hypermethylated genes was seen in HNSCC CSCs. These genes may be critically required in maintaining the stemness or pluripotency of CSCs and may represent novel molecular targets for anticancer therapies aimed at eradicating CSCs in HNSCC.
Assessing the Efficacy of Tragal Pumping
Authors: Boyd Nathan H. , Gottschall Joshua A. 
Published: February 2011

ObjectiveTragal pumping is the practice of pushing on the tragus to raise pressure in the external auditory canal. This is a study to determine if tragal pumping improves middle ear penetration of ototopical medications via a patent pressure equalization tube.Study DesignProspective, randomized controlled trial.SettingTertiary referral center.Subjects and MethodsChildren with chronic otitis media scheduled for routine placement of bilateral pressure equalization tubes were offered enrollment in the study. After pressure equalization tube insertion, an otic preparation of 0.3% ofloxacin solution dyed with methylene blue was applied sequentially to both ear canals by the operating surgeon. Tragal pumping was performed on the experimental ear, and the opposite ear served as a control. A second operator, blinded to the randomization process, used an operating microscope to determine if otic drops had entered the middle ear as demonstrated by methylene blue staining of the promontory mucosa.ResultsTwenty‐four patients with a mean age of 3.6 years were enrolled in the study. Middle ear penetration of otic drops was present in 33% (8/24) of control ears and in 75% (18/24) of experimental ears, resulting in a statistically significant difference (P =. 0094).ConclusionTragal pumping improves the middle ear penetration of ototopical medications via a patent pressure equalization tube.
Tracing neural connections to pain pathways with relevance to primary headaches
Authors: Edvinsson Lars 
Published: February 2011

Background: Symptoms associated with primary headaches are linked to cranial vascular activity and to the central nervous system (CNS). Review: The central projections of sensory nerves from three cranial vessels are described in order to further understand pain mechanisms involved in primary headaches. Tracers that label small and large calibre primary afferent fibres revealed similar distributions for the central terminations of sensory nerves in the superficial temporal artery, superior sagittal sinus and middle meningeal artery. The sensory nerve fibres from the vessels pass through both the trigeminal and rostral cervical spinal nerves and terminate in the ventrolateral part of the C1-C3 dorsal horns and the caudal and interpolar divisions of the spinal trigeminal nucleus. The C-fibre terminations were located mainly in the superficial layers (Rexed laminae I and II), and the Aδ-fibres terminated in the deep layers (laminae III and IV). The rostral projections from the ventrolateral C1-C2 dorsal horn revealed terminations in the medial and lateral parabrachial nuclei, the cuneiform nucleus, the periaqueductal gray, the deep mesencephalic nucleus, the thalamic posterior nuclear group and its triangular part, and the thalamic ventral posteromedial nucleus. The terminations in the pons and midbrain were predominately bilateral, whereas those in the thalamus were confined to the contralateral side. Conclusions: The observations, done in rats with the understanding that similar trigeminovascular organization exists in man, reveal vascular projections into the brainstem and some aspects of the central regions putatively involved in the central processing of noxious craniovascular signals.
Knee Rotational Stability During Pivoting Movement Is Restored After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
Authors: Lam Mak-Ham , Fong Daniel Tik-Pui , Yung Patrick Shu-Hang , Ho Eric Po-Yan , Fung Kwai-Yau , Chan Kai-Ming 
Published: February 2011

Background: The restoration of knee rotational stability after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction has been demonstrated in the cadaveric model and with passive stress tests on humans but not yet with dynamic functional biomechanical tests performed by human participants. Purpose: To prospectively investigate the range of tibial rotation of ACL-deficient and ACL-reconstructed knees during a pivoting task. The authors hypothesized that there would be a significant increase in tibial internal rotation in the ACL-deficient knee compared with the contralateral knee and that the increased rotation would return to normal after anatomic double-bundle ACL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Ten men with unilateral ACL injury performed a high-demand jump-landing and pivoting task before and after ACL reconstruction with mean follow-up of 11 months. The range of tibial rotation of the injured, reconstructed, and intact knees during the pivoting movement was measured by an optical motion analysis system. Paired t tests were performed to investigate any significant difference between the 2 limbs preoperatively and postoperatively and within the injured limb before and after the surgical treatment. Statistical significance was set at P < .05. Results: The range of tibial rotation was higher in the ACL-deficient knee (12.6° ± 4.5°) than in the intact knee (7.9° ± 3.1°) preoperatively ( P < .05). The increased rotation was reduced in the reconstructed knee (8.9° ± 3.0°) after ACL reconstruction versus the intact knee postoperatively (8.2° ± 2.6°) ( P < .05). There was no significant difference in the tibial rotation between the intact knee and the reconstructed knee postoperatively ( P > .05). Conclusion: As assessed with a dynamic functional pivoting movement, the anatomic double-bundle ACL reconstruction successfully restores knee rotational stability from an impaired level.
Hamstring Muscle Strains in Professional Football Players
Authors: Elliott Marcus C. C. W. , Zarins Bertram , Powell John W. , Kenyon Charles D. 
Published: February 2011

Background: Investigations into hamstring strain injuries at the elite level exist in sports such as Australian Rules football, rugby, and soccer, but no large-scale study exists on the incidence and circumstances surrounding these injuries in the National Football League (NFL). Hypothesis: Injury rates will vary between different player positions, times in the season, and across different playing situations. Study Design: Descriptive epidemiology study. Methods: Between 1989 and 1998, injury data were prospectively collected by athletic trainers for every NFL team and recorded in the NFL’s Injury Surveillance System. Data collected included team, date of injury, activity the player was engaged in at the time of injury, injury severity, position played, mechanism of injury, and history of previous injury. Injury rates were reported in injuries per athlete-exposure (A-E). An athlete-exposure was defined as 1 athlete participating in either 1 practice or 1 game. Results: Over the 10-year study period 1716 hamstring strains were reported for an injury rate (IR) of 0.77 per 1000 A-E. More than half (51.3%) of hamstring strains occurred during the 7-week preseason. The preseason practice IR was significantly elevated compared with the regular-season practice IR (0.82/1000 A-E and 0.18/1000 A-E, respectively). The most commonly injured positions were the defensive secondary, accounting for 23.1% of the injuries; the wide receivers, accounting for 20.8%; and special teams, constituting 13.0% of the injuries in the study. Conclusion: Hamstring strains are a considerable cause of disability in football, with the majority of injuries occurring during the short preseason. In particular, the speed position players, such as the wide receivers and defensive secondary, as well as players on the special teams units, are at elevated risk for injury. These positions and situations with a higher risk of injury provide foci for preventative interventions.