bluuebunny/crossref_metadata_2025_split huggingface dataset:
Notochordal conditioned media from tissue increases proteoglycan accumulation and promotes a healthy nucleus pulposus phenotype in human mesenchymal stem cells
Authors: Purmessur Devina , Schek Rachel M , Abbott Rosalyn D , Ballif Bryan A , Godburn Karolyn E , Iatridis James C 
Published: May 2011

Abstract
Introduction
Notochordal cells (NCs) are influential in development of the intervertebral disc (IVD) and species that retain NCs do not degenerate. IVD repair using bone marrow derived mesenchymal stem cells (MSCs) is an attractive approach and the harsh microenvironment of the IVD suggests pre-differentiation is a necessary first step. The goal of this study was to use soluble factors from NCs in alginate and NCs in their native tissue to differentiate human MSCs to a young nucleus pulposus (NP) phenotype.

Methods
Human MSCs (cultured under micromass conditions for 21 days in hypoxia) were differentiated with conditioned medium derived from porcine notochordal cells in native tissue (NCT) or in alginate beads (NCA), and compared with chondrogenic (TGFβ-3) or basal medium. A PCR array of 42 genes was utilized to screen a large number of genes known to be associated with the healthy NP phenotype and pellet cultures were also evaluated for glycosaminoglycan content, histology and viability. Proteomic analysis was used to assess candidate soluble factors in NCA and NCT.

Results
Notochordal cell conditioned media had diverse effects on MSC phenotype. NCT resulted in the highest levels of glycosaminoglycan (GAG), as well as up-regulation of SOX9 and Collagen II gene expression. NCA demonstrated effects that were catabolic yet also anti-fibrotic and minimally hypertrophic with down-regulation of Collagens I and III and low levels of Collagen X, respectively. Micromass culture and hypoxic conditions were sufficient to promote chondrogenesis demonstrating that both basal and chondrogenic media produced similar phenotypes. Candidate matricellular proteins, clusterin and tenascin were identified by proteomics in the NCA group.

Conclusions
NCs secreted important soluble factors capable of differentiating MSCs to a NP phenotype synthesizing high levels of proteoglycan while also resisting collagen fiber expression and hypertrophy, yet results were sensitive to the conditions in which media was generated (cells in alginate versus cells in their native tissue) so that further mechanistic studies optimizing culture conditions and defining important NC secreted factors are required. Matricellular proteins, such as clusterin and tenascin, are likely to be important to optimize differentiation of MSCs for maximum GAG production and reduced collagen fiber expression.
Goal-directed haemodynamic therapy during elective total hip arthroplasty under regional anaesthesia
Authors: Cecconi Maurizio , Fasano Nicola , Langiano Nicola , Divella Michele , Costa Maria G , Rhodes Andrew , Rocca Giorgio Della 
Published: May 2011

Abstract
Introduction
Total hip replacement is one of the most commonly performed major orthopaedic operations. Goal-directed therapy (GDT) using haemodynamic monitoring has previously demonstrated outcome benefits in high-risk surgical patients under general anaesthesia. GDT has never been formally assessed during regional anaesthesia.

Methods
Patients undergoing total hip replacement while under regional anaesthesia were randomised to either the control group (CTRL) or the protocol group (GDT). Patients in the GDT group, in addition to standard monitoring, were connected to the FloTrac sensor/Vigileo monitor haemodynamic monitoring system, and a GDT protocol was used to maximise the stroke volume and target the oxygen delivery index to > 600 mL/minute/m2.

Results
Patients randomised to the GDT group were given a greater volume of intravenous fluids during the intraoperative period (means ± standard deviation (SD): 6,032 ± 1,388 mL vs. 2,635 ± 346 mL; P < 0.0001), and more of the GDT patients received dobutamine (0 of 20 CTRL patients vs. 11 of 20 GDT patients; P < 0.0003). The GDT patients also received more blood transfused during the intraoperative period (means ± SD: 595 ± 316 mL vs. 0 ± 0 mL; P < 0.0001), although the CTRL group received greater volumes of blood replacement postoperatively (CTRL patients 658 ± 68 mL vs. GDT patients 198 ± 292 mL; P < 0.001). Overall blood consumption (intraoperatively and postoperatively) was not different between the two groups. There were an increased number of complications in the CTRL group (20 of 20 CTRL patients (100%) vs. 16 of 20 GDT patients (80%); P = 0.05). These outcomes were predominantly due to a difference in minor complications (20 of 20 CTRL patients (100%) vs. 15 of 20 GDT patients (75%); P = 0.047).

Conclusions
GDT applied during regional anaesthesia in patients undergoing elective total hip replacement changes intraoperative fluid management and may improve patient outcomes by decreasing postoperative complications. Larger trials are required to confirm our findings.

Trial registration
SRCTN11616985
Complete Columbian mammoth mitogenome suggests interbreeding with woolly mammoths
Authors: Enk Jacob , Devault Alison , Debruyne Regis , King Christine E , Treangen Todd , O'Rourke Dennis , Salzberg Steven L , Fisher Daniel , MacPhee Ross , Poinar Hendrik 
Published: May 2011

Abstract
Background
Late Pleistocene North America hosted at least two divergent and ecologically distinct species of mammoth: the periglacial woolly mammoth (Mammuthus primigenius) and the subglacial Columbian mammoth (Mammuthus columbi). To date, mammoth genetic research has been entirely restricted to woolly mammoths, rendering their genetic evolution difficult to contextualize within broader Pleistocene paleoecology and biogeography. Here, we take an interspecific approach to clarifying mammoth phylogeny by targeting Columbian mammoth remains for mitogenomic sequencing.

Results
We sequenced the first complete mitochondrial genome of a classic Columbian mammoth, as well as the first complete mitochondrial genome of a North American woolly mammoth. Somewhat contrary to conventional paleontological models, which posit that the two species were highly divergent, the M. columbi mitogenome we obtained falls securely within a subclade of endemic North American M. primigenius.

Conclusions
Though limited, our data suggest that the two species interbred at some point in their evolutionary histories. One potential explanation is that woolly mammoth haplotypes entered Columbian mammoth populations via introgression at subglacial ecotones, a scenario with compelling parallels in extant elephants and consistent with certain regional paleontological observations. This highlights the need for multi-genomic data to sufficiently characterize mammoth evolutionary history. Our results demonstrate that the use of next-generation sequencing technologies holds promise in obtaining such data, even from non-cave, non-permafrost Pleistocene depositional contexts.
Revascularisation and mortality rates following acute coronary syndromes in people with severe mental illness: comparative meta-analysis
Authors: Mitchell Alex J. , Lawrence David 
Published: May 2011

BackgroundHigh levels of comorbid physical illness and excess mortality rates have been previously documented in people with severe mental illness, but outcomes following myocardial infarction and other acute coronary syndromes are less clear.AimsTo examine inequalities in the provision of invasive coronary procedures (revascularisation, angiography, angioplasty and bypass grafting) and subsequent mortality in people with mental illness and in those with schizophrenia, compared with those without mental ill health.MethodSystematic search and random effects meta-analysis were used according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies of mental health and cardiovascular procedures following cardiac events were eligible but we required a minimum of three independent studies to warrant pooling by procedure type. We searched Medline/PubMed and EMBASE abstract databases and ScienceDirect, Ingenta Select, SpringerLink and Online Wiley Library full text databases.ResultsWe identified 22 analyses of possible inequalities in coronary procedures in those with defined mental disorder, of which 10 also reported results in schizophrenia or related psychosis. All studies following acute coronary syndrome originated in the USA. The total sample size was 825 754 individuals. Those with mental disorders received 0.86 (relative risk, RR: 95% CI 0.80–0.92,P<0.0001) of comparable procedures with significantly lower receipt of coronary artery bypass graft (CABG; RR = 0.85, 95% CI 0.72–1.00), cardiac catheterisation (RR = 0.85, 95% CI 0.76–0.95) and percutaneous transluminal coronary angioplasty or percutaneous coronary intervention (PTCA/PCI; RR = 0.87, 95% CI 0.72–1.05). People with a diagnosis of schizophrenia received only 0.53 (95% CI 0.44–0.64,P<0.0001) of the usual procedure rate with significantly lower receipt of CABG (RR = 0.69, 95% CI 0.55–0.85) and PTCA/PCI (RR = 0.50, 95% CI 0.34–0.75). We identified 6 related studies examining mortality following cardiac events: for those with mental illness there was a 1.11 relative risk of mortality up to 1 year (95% CI 1.00–1.24,P= 0.05) but there was insufficient evidence to examine mortality rates in schizophrenia alone.ConclusionsFollowing cardiac events, individuals with mental illness experience a 14% lower rate of invasive coronary interventions (47% in the case of schizophrenia) and they have an 11% increased mortality rate. Further work is required to explore whether these factors are causally linked and whether improvements in medical care might improve survival in those with mental ill health.
Grey matter and social functioning correlates of glutamatergic
metabolite loss in schizophrenia
Authors: Aoyama Naoko , Théberge Jean , Drost Dick J. , Manchanda Rahul , Northcott Sandra , Neufeld Richard W. J. , Menon Ravi S. , Rajakumar Nagalingam , Pavlosky William F. , Densmore Maria , Schaefer Betsy , Williamson Peter C. 
Published: May 2011

BackgroundThalamic glutamine loss and grey matter reduction suggest
neurodegeneration in first-episode schizophrenia, but the duration is
unknown.AimsTo observe glutamine and glutamate levels, grey matter volumes and social
functioning in patients with schizophrenia followed to 80 months after
diagnosis.MethodGrey matter volumes and proton magnetic resonance spectroscopy
metabolites in left anterior cingulate and left thalamus were measured in
17 patients with schizophrenia before medication and 10 and 80 months
after diagnosis. Social functioning was assessed with the Life Skills
Profile Rating Scale (LSPRS) at 80 months.ResultsThe sum of thalamic glutamate and glutamine levels decreased over 80
months, and correlated inversely with the LSPRS. Thalamic glutamine and
grey matter loss were significantly correlated in frontal, parietal,
temporal and limbic regions.ConclusionsBrain metabolite loss is correlated with deteriorated social functioning
and grey matter losses in schizophrenia, consistent with
neurodegeneration.
Dangerous and severe personality disorder
Authors: Duggan Conor 
Published: May 2011

SummaryThe Dangerous and Severe Personality Disorder (DSPD) initiative was introduced a decade ago against overwhelming opposition from psychiatrists and others concerned with the implications of extending the public protection agenda through the use of a questionable medical ‘diagnosis'. As this initiative is now being scaled down, it offers an opportunity to consider the positive and negative aspects of the initiative together with its longer-term legacy.
Mixed anxiety and depressive disorder outcomes: prospective
cohort study in primary care
Authors: Walters Kate , Buszewicz Marta , Weich Scott , King Michael 
Published: May 2011

BackgroundMixed anxiety and depressive disorder (MADD) is common yet ill-defined,
with little known about outcomes.AimsTo determine MADD outcomes over 1 year.MethodWe recruited 250 adults attending seven London general practices with
mild–moderate distress. Three groups were defined using a diagnostic
interview: MADD, other ICD–10 psychiatric diagnosis, no psychiatric
diagnosis. We assessed symptoms of distress (General Health
Questionnaire–28), quality of life (12-item Short Form Health Survey),
general practitioner (GP) diagnosis and consultation rate at baseline, 3
months and 1 year.ResultsTwo-thirds of participants with MADD had no significant psychological
distress at 3 months (61%) or 1 year (69%). However, compared with those
with no diagnosis, individuals had twice the risk of significant distress
(incidence rate ratio 2.39, 95% CI 1.29–4.42) at 3 months but not 1 year,
and persistently lower quality of life (mental health functioning). There
was no significant difference in GP consultation rate/diagnosis.ConclusionsThe majority with MADD improved, but individuals had an increased risk of
significant distress at 3 months and a lower quality of life. As we
cannot currently predict those with a poorer prognosis these patients
should be actively monitored in primary care.
Trends in rates of mental illness in homicide
perpetrators
Authors: Swinson Nicola , Flynn Sandra M. , While David , Roscoe Alison , Kapur Navneet , Appleby Louis , Shaw Jenny 
Published: May 2011

BackgroundThe rise in homicides by those with serious mental illness is of concern,
although this increase may not be continuing.AimsTo examine rates of mental illness among homicide perpetrators.MethodA national consecutive case series of homicide perpetrators in England
and Wales from 1997 to 2006. Rates of mental disorder were based on data
from psychiatric reports, contact with psychiatric services, diminished
responsibility verdict and hospital disposal.ResultsOf the 5884 homicides notified to the National Confidential Inquiry into
Suicide and Homicide by People with Mental Illness between 1997 and 2006,
the number of homicide perpetrators with schizophrenia increased at a
rate of 4% per year, those with psychotic symptoms at the time of the
offence increased by 6% per year. The number of verdicts of diminished
responsibility decreased but no change was found in the number of
perpetrators receiving a hospital order disposal. The likeliest
explanation for the rise in homicide by people with psychosis is the
misuse of drugs and/or alcohol, which our data show increased at a
similar magnitude to homicides by those with psychotic symptoms. However,
we are unable to demonstrate a causal association. Although the Poisson
regression provides evidence of an upward trend in homicide by people
with serious mental illness between 1997 and 2006, the number of
homicides fell in the final 2 years of data collection, so these findings
should be treated with caution.ConclusionsThere appears to be a concomitant increase in drug misuse over the
period, which may account for this rise in homicide. However, an increase
in the number of people in contact with mental health services may
suggest that access to mental health services is improving. Previous
studies have used court verdicts such as diminished responsibility as a
proxy measure of mental disorder. Our data indicate that this does not
reflect accurately the prevalence of mental disorder in this
population.
Preventive psychiatry: a paradigm to improve population mental
health and well-being
Authors: Bhui Kamaldeep , Dinos Sokratis 
Published: May 2011

SummaryThe government's Public Health White Paper for England sets out a utopian
vision of how to prevent and remedy mental health problems. The public
health approach relies on primary prevention, promoting individual
responsibilities and resilience, while also sustaining existing services and
tackling inequalities. These ambitions are consistent with the preventive
psychiatric paradigm, and with the best of evidence-based psychiatric
practice. Although the evidence on cost-effectiveness of public mental
health interventions is growing, the challenge is to ensure that specialist
knowledge informs policy, practice and research so that inequalities are not
compounded. Specialist mental health professionals are needed to inform and
lead public health reforms.
Doctors' experience of a bespoke physician consultation service: cross-sectional investigation
Authors: Meerten Maja , Bland Julia , Gross Samantha R. , Garelick Antony I. 
Published: May 2011

Aims and methodOur aim was to follow-up on a cohort of self-referred doctors who attended MedNet. We used a two-point cross-sectional design. Measures included three standardised self-report questionnaires administered before and after consultation. Doctors were also asked to complete a service user questionnaire, and data regarding engagement and onward referrals were gathered through case-note review.ResultsA statistically significant improvement in scores on all three questionnaires was found after intervention; however, scores on one subscale, the risk domain of the Clinical Outcomes in Routine Evaluation – Outcome Measure, did not change significantly. Of the doctors at no risk of suicide at intake, nearly two-thirds (n = 41/70, 59%) were sufficiently helped by the consultations provided to not need further treatment. Of the doctors at some risk of suicide at intake, two-thirds (n = 34/51, 67%) did need an onward referral. Only one doctor required hospital admission, an outcome that suggests the approach used is containing and clinically responsive.Clinical implicationsThis paper highlights the efficacy, need and importance of specialist services for doctors in difficulty. We found that the bespoke consultation model provided at MedNet is valued highly by the doctors as service users.
Case-based discussion: a useful tool for revalidation
Authors: Mynors-Wallis Laurence , Cope Denise , Brittlebank Andrew , Palekar Fauzan 
Published: May 2011

Aims and methodRevalidation is the process by which doctors demonstrate that they are up to date and fit to practise. Case-based discussion has been identified by both psychiatrists and service users and carers as a potentially useful tool for revalidation. The aim of this study was to examine the feasibility of case-based discussion for assessments to use in revalidation. A pilot using case-based discussion as an assessment/developmental technique for revalidation was undertaken in six trusts involving 86 consultant psychiatrists.ResultsThe average time taken for each case-based discussion including preparation and reflection was 48 min. All but one of the doctors involved in the case-based discussion pilot described the process as useful or very useful in improving clinical practice. In total 87% of the assessed doctors and all of the assessors reported that they considered case-based discussion to be a useful part of the revalidation process assessed. The majority of doctors assessed believed that cases should be chosen at random (91%).Clinical implicationsCase-based discussions have the potential to be a useful quality improvement tool for revalidation.
General practitioners' attitudes on who should manage metabolic dysregulations associated with antipsychotics
Authors: Bainbridge Emma , Gallagher Anne , McDonald Gary , McDonald Colm , Ahmed Mohamed 
Published: May 2011

Aims and methodTo assess attitudes of general practitioners (GPs) on who should be responsible for managing metabolic dysregulations associated with the use of antipsychotics prescribed by psychiatrists. A total of 121 GPs in West Galway catchment area were surveyed using a simple questionnaire.ResultsA total of 104 GPs responded (86% response rate). The vast majority of responders (82%) believed that medical management should be provided within primary care. However, 46% indicated that initial screening and simple non-pharmacological management should be provided by mental health services.Clinical implicationsThe vast majority of GPs appear willing to take over the medical management of metabolic dysregulations emerging from antipsychotic prescribing in secondary care. Clearly defined roles for mental health services and primary care in the management of metabolic complications are of paramount importance, and individual mental health services should implement protocols for screening, non-pharmacological management and referral to primary care.
Stability of the diagnosis of first-episode drug-induced psychosis
Authors: Komuravelli Aravind , Poole Rob , Higgo Robert 
Published: May 2011

Aims and methodTo assess the stability of the diagnosis of first-episode drug-induced psychosis over a follow-up period of at least 2 years. Patients with no psychiatric history who had been discharged from in-patient care between January 2002 and April 2006 with a firm diagnosis of drug-induced psychosis were identified. Follow-up information for at least the next 2 years or until discharge from mental health services was collected retrospectively from psychiatric records.ResultsNearly all of the patients who remained under psychiatric follow-up had a change in diagnosis, most commonly to a schizophreniform disorder. Those who were retained in follow-up had significantly longer index admissions than those discharged to primary care (P = 0.05).Clinical implicationsThis study suggests that many individuals diagnosed with drug-induced psychosis are further diagnosed as having a functional psychosis, usually schizophreniform in nature. This is compatible with the suggestion that individuals diagnosed with drug-induced psychosis are experiencing either the effects of drug intoxication or an ordinary functional psychosis complicated by incidental drug use.
Entwurf von Ausgangsrückführungen für nichtlineare Systeme mittels Sum-of-Squares-Programmierung
Authors: Bäuml Markus , Deutscher Joachim 
Published: May 2011

Zusammenfassung
Dieser Beitrag stellt den Entwurf von Ausgangsrückführungen für Systeme mit nicht-polynomialen Nichtlinearitäten mittels SOS-Programmierung vor. Dazu wird eine polynomiale Approximation des Systems durchgeführt und der zugehörige Approximationsfehler bestimmt. Diese Fehlerabschätzung wird im SOS-Programm benutzt, um eine stabilisierende Ausgangsrückführung und eine Lyapunov-Funktion so zu bestimmen, dass ein möglichst großer Einzugsbereich der Ruhelage der Regelung mit dem tatsächlichen System resultiert. Um auf die sich ergebende Regelkreisdynamik Einfluss zu nehmen, wird der lineare Anteil des Reglers vorgegeben, mit dem eine gewünschte Eigenwertverteilung für die Linearisierung des geregelten Systems eingestellt wird. Die für die Stabilisierbarkeit nötigte dynamische Ausgangsrückführung kann dabei durch Erweiterung des Systems um die Dynamik des Reglers auf den Entwurf eines statischen Reglers zurückgeführt werden. Anhand eines einfachen Beispiels wird die vorgestellte Entwurfsmethodik veranschaulicht.
Strukturelle und streng strukuturelle Steuerbarkeit: Übersicht und neue Ergebnisse
Authors: Svaricek Ferdinand , Jarczyk Jan Cristian , Alt Benedikt 
Published: May 2011

Zusammenfassung
Der Beitrag bietet einen Überblick über die Konzepte der strukturellen und streng strukturellen Steuerbarkeit von strukturierten linearen Systemen und diskutuiert einige neue Ergebnisse zur strengen strukturellen Steuerbarkeit. Ein System wird streng strukturell steuerbar genannt, wenn die Steuerbarkeitsbedingungen für beliebige von Null verschiedene Systemparameter erfüllt sind.