bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of an evidence based guideline reduces blood tests and length of stay for the limping child in a paediatric emergency department
Authors: McCanny Peter J , McCoy Siobhan , Grant Tim , Walsh Sean , O'Sullivan Ronan 
Published: March 2012

IntroductionAcute non-traumatic limp is a common reason for children to present to the emergency department (ED). There is a wide differential diagnosis for these patients, and there are certain serious conditions which cannot be missed. An evidence based guideline for the ‘limping child’ was designed and the impact of guideline implementation on a number of specific, predefined quantitative outcomes was assessed.MethodsAn initial retrospective chart review over 3 months was carried out for all patients presenting with acute non-traumatic limp. Following guideline introduction and implementation, information was gathered prospectively for a further 3 month period. Data outcomes between the two patient groups were then compared.Results110 patients met the criteria for inclusion: 56 pre-guideline and 54 post-guideline implementation. Baseline characteristics and diagnosis breakdown were similar in both groups. The rate of laboratory investigations was significantly reduced following guideline implementation (68% of patients pre-guideline, vs 48% post-guideline; (χ2), p=0.03). The number of x-rays carried out was similar in each group (74 pre- vs 67 post-guideline, mean 1.32 vs 1.28; (χ2), p=0.53). Length of time spent in the ED was significantly reduced following guideline implementation (median time 150 min pre- vs 82.5 min post-guideline; (χ2), p=0.04). No cases of serious pathology were missed using the guideline.ConclusionImplementation of an evidence based clinical practice guideline for the limping child in a paediatric ED reduced the overall time patients spent in the ED, reduced the need for unnecessary laboratory investigations and ensured that appropriate investigations were carried out on an individual patient basis.
Use of the human dive reflex for the management of supraventricular tachycardia: a review of the literature
Authors: Smith Gavin , Morgans Amee , Taylor David McD , Cameron Peter 
Published: March 2012

BackgroundThe human dive reflex (HDR), a physiological phenomenon similar to the bradycardia reflex used by marine mammals during prolonged submersion, can be employed in managing paroxysmal supraventricular tachycardia (PSVT). This review aims to identify a standardised HDR technique for haemodynamically stable PSVT, to determine the effectiveness of the HDR and to define its usefulness in the prehospital setting.MethodsA review of the Medline, EMBASE and CINAHL databases was conducted. Articles were included if they described the use of the HDR to revert PSVT in the prehospital or emergency medical setting, the nature of the effectiveness of the HDR for PSVT or historically significant developments of HDR techniques for PSVT reversion. Articles not available in English or describing the use of HDR in animal studies only were excluded.Results211 articles were identified, of which 21 were found to be relevant. These included 10 studies of HDR effectiveness in PSVT and three physiological studies of HDR effect. No standardised model of performance exists for the HDR. Elements of performance include: a cold stimulus applied to the entire face, a specific temperature of the cold stimulus, application duration, breath holding during HDR and posture assumed to perform the procedure. There are also safety and logistics issues with using the HDR in prehospital care.ConclusionsThe HDR represents an effective method of terminating PSVT in the hospital emergency department. Its usefulness in prehospital care requires further evaluation of the elements of the manoeuvre to determine appropriateness to this setting.
Nuclear survivin is associated with cell proliferative advantage in uterine cervical carcinomas during radiation therapy
Authors: Chaopotong Pattama , Kajita Sabine , Hashimura Miki , Saegusa Makoto 
Published: March 2012

BackgroundAlthough the anticancer effects of radiation therapy for patients with uterine cervical squamous cell carcinoma (U-SCC) are widely acknowledged, little is known about the resultant morphological alterations in tumour tissue kinetics.AimsTo make a detailed assessment of possible roles of survivin expression in apoptosis and cell proliferation in U-SCC during radiation therapy.Methods181 biopsy specimens from 55 consecutive U-SCCs of patients receiving radiation therapy were studied using a combined morphological (apoptosis) and immunohistochemical (MIB-1 and survivin) approach. The intracellular distribution of various splice variants of thesurvivingene was also examined.ResultsTumour cell proliferation, determined as MIB-1 labelling indices (LIs), as well as nuclear survivin (N-Surv) LIs, were inversely correlated with irradiation dosage, in contrast to relatively minor changes in apoptotic indices, suggesting a shift in tumour tissue kinetics towards a relative predominance of cell deletion. In addition, the low N-Sur LI category showed significant stepwise decrease in MIB-1 LIs during therapy, in contrast to no changes in the high category. Exogenous overexpression of three variants of thesurvivingene resulted in different expression patterns, showing cytoplasmic staining with or without dot formation for survivin and survivin-2B and distinct nuclear accumulation for survivin-deled exon 3 (∆Ex3).ConclusionsResults showed that nuclear survivin, including survivin itself and the survivin-∆Ex3 splice variants, may participate in modulation of altered cell kinetics of U-SCC during radiation therapy.
NILPOTENT ELEMENTS AND NIL-ARMENDARIZ PROPERTY OF MONOID RINGS
Authors: HABIBI M. , MOUSSAVI A. 
Published: March 2012

Antoine [Nilpotent elements and Armendariz rings, J. Algebra 319(8) (2008) 3128–3140] studied the structure of the set of nilpotent elements in Armendariz rings and introduced nil-Armendariz rings. For a monoid M, we introduce nil-Armendariz rings relative to M, which is a generalization of nil-Armendariz rings and we investigate their properties. This condition is strongly connected to the question of whether or not a monoid ring R[M] over a nil ring R is nil, which is related to a question of Amitsur [Algebras over infinite fields, Proc. Amer. Math. Soc.7 (1956) 35–48]. This is true for any 2-primal ring R and u.p.-monoid M. If the set of nilpotent elements of a ring R forms an ideal, then R is nil-Armendariz relative to any u.p.-monoid M. Also, for any monoid M with an element of infinite order, M-Armendariz rings are nil M-Armendariz. When R is a 2-primal ring, then R[x] and R[x, x-1] are nil-Armendariz relative to any u.p.-monoid M, and we have nil (R[M]) = nil (R)[M].
Inhibition of OCTN2-Mediated Transport of Carnitine by Etoposide
Authors: Hu Chaoxin , Lancaster Cynthia S. , Zuo Zhili , Hu Shuiying , Chen Zhaoyuan , Rubnitz Jeffrey E. , Baker Sharyn D. , Sparreboom Alex 
Published: March 2012

Abstract
OCTN2 is a bifunctional transporter that reabsorbs filtered carnitine in a sodium-dependent manner and secretes organic cations into urine as a proton antiport mechanism. We hypothesized that inhibition of OCTN2 by anticancer drugs can influence carnitine resorption. OCTN2-mediated transport inhibition by anticancer drugs was assessed using cells transfected with human OCTN2 (hOCTN2) or mouse Octn2 (mOctn2). Excretion of carnitine and acetylcarnitine was measured in urine collected from mice and pediatric patients with cancer before and after administration of etoposide. Five of 27 tested drugs (50–100 μmol/L) inhibited hOCTN2-mediated carnitine uptake by 42% to 85% (P &lt; 0.001). Of these inhibitors, etoposide was itself a transported substrate of hOCTN2 and mOctn2. Etoposide uptake by hOCTN2 was reversed in the presence of excess carnitine. This competitive inhibitory mechanism was confirmed in an in silico molecular docking analysis. In addition, etoposide inhibited the transcellular apical-to-basolateral flux of carnitine in kidney cells. Etoposide was also associated with a significant urinary loss of carnitine in mice (∼1.5-fold) and in patients with cancer (∼2.4-fold). Collectively, these findings indicate that etoposide can inhibit hOCTN2 function, potentially disturb carnitine homeostasis, and that this phenomenon can contribute to treatment-related toxicities. Mol Cancer Ther; 11(4); 921–9. ©2012 AACR.
Auto-Antigenic Protein-DNA Complexes Stimulate Plasmacytoid Dendritic Cells to Promote Atherosclerosis
Authors: Döring Yvonne , Manthey Helga D. , Drechsler Maik , Lievens Dirk , Megens Remco T.A. , Soehnlein Oliver , Busch Martin , Manca Marco , Koenen Rory R. , Pelisek Jaroslav , Daemen Mat J. , Lutgens Esther , Zenke Martin , Binder Christoph J. , Weber Christian , Zernecke Alma 
Published: March 2012

Background—
Inflammation has been closely linked to auto-immunogenic processes in atherosclerosis. Plasmacytoid dendritic cells (pDCs) are specialized to produce type-I interferons in response to pathogenic single-stranded nucleic acids, but can also sense self-DNA released from dying cells or in neutrophil extracellular traps complexed to the antimicrobial peptide Cramp/LL37 in autoimmune disease. However, the exact role of pDCs in atherosclerosis remains elusive.

Methods and Results—
Here we demonstrate that pDCs can be detected in murine and human atherosclerotic lesions. Exposure to oxidatively modified low-density lipoprotein enhanced the capacity of pDCs to phagocytose and prime antigen-specific T cell responses. Plasmacytoid DCs can be stimulated to produce interferon-α by Cramp/DNA complexes, and we further identified increased expression of Cramp and formation of neutrophil extracellular traps in atherosclerotic arteries. Whereas Cramp/DNA complexes aggravated atherosclerotic lesion formation in apolipoprotein E–deficient mice, pDC depletion and Cramp-deficiency in bone marrow reduced atherosclerosis and anti–double-stranded DNA antibody titers. Moreover, the specific activation of pDCs and interferon-α treatment promoted plaque growth, associated with enhanced anti–double-stranded–DNA antibody titers. Accordingly, anti–double-stranded DNA antibodies were elevated in patients with symptomatic versus asymptomatic carotid artery stenosis.

Conclusions—
Self-DNA (eg, released from dying cells or in neutrophil extracellular traps) and an increased expression of the antimicrobial peptide Cramp/LL37 in atherosclerotic lesions may thus stimulate a pDC-driven pathway of autoimmune activation and the generation of anti–double-stranded-DNA antibodies, critically aggravating atherosclerosis lesion formation. These key factors may thus represent novel therapeutic targets.
The Polyphenols Resveratrol and S17834 Prevent the Structural and Functional Sequelae of Diet-Induced Metabolic Heart Disease in Mice
Authors: Qin Fuzhong , Siwik Deborah A. , Luptak Ivan , Hou Xiuyun , Wang Lei , Higuchi Akiko , Weisbrod Robert M. , Ouchi Noriyuki , Tu Vivian H. , Calamaras Timothy D. , Miller Edward J. , Verbeuren Tony J. , Walsh Kenneth , Cohen Richard A. , Colucci Wilson S. 
Published: March 2012

Background—
Diet-induced obesity is associated with metabolic heart disease characterized by left ventricular hypertrophy and diastolic dysfunction. Polyphenols such as resveratrol and the synthetic flavonoid derivative S17834 exert beneficial systemic and cardiovascular effects in a variety of settings including diabetes mellitus and chronic hemodynamic overload.

Methods and Results—
We characterized the structural and functional features of a mouse model of diet-induced metabolic syndrome and used the model to test the hypothesis that the polyphenols prevent myocardial hypertrophy and diastolic dysfunction. Male C57BL/6J mice were fed a normal diet or a diet high in fat and sugar (HFHS) with or without concomitant treatment with S17834 or resveratrol for up to 8 months. HFHS diet–fed mice developed progressive left ventricular hypertrophy and diastolic dysfunction with preservation of systolic function in association with myocyte hypertrophy and interstitial fibrosis. In HFHS diet–fed mice, there was increased myocardial oxidative stress with evidence of oxidant-mediated protein modification via tyrosine nitration and 4-OH-2-nonenol adduction. HFHS diet–fed mice also exhibited increases in plasma fasting glucose, insulin, and homeostasis model assessment of insulin resistance indicative of insulin resistance. Treatment with S17834 or resveratrol prevented left ventricular hypertrophy and diastolic dysfunction. For S17834, these beneficial effects were associated with decreases in oxidant-mediated protein modifications and hyperinsulinemia and increased plasma adiponectin.

Conclusions—
Resveratrol and S17834 administered concurrently with a HFHS diet prevent the development of left ventricular hypertrophy, interstitial fibrosis, and diastolic dysfunction. Multiple mechanisms may contribute to the beneficial effects of the polyphenols, including a reduction in myocardial oxidative stress and related protein modifications, amelioration of insulin resistance, and increased plasma adiponectin. The polyphenols resveratrol and S17834 may be of value in the prevention of diet-induced metabolic heart disease.
Optimal Initial Perturbations for Ensemble Prediction of the Madden–Julian Oscillation during Boreal Winter
Authors: Ham Yoo-Geun , Schubert Siegfried , Chang Yehui 
Published: March 2012

AbstractAn initialization strategy, tailored to the prediction of the Madden–Julian oscillation (MJO), is evaluated using the Goddard Earth Observing System Model, version 5 (GEOS-5), coupled general circulation model (CGCM). The approach is based on the empirical singular vectors (ESVs) of a reduced-space statistically determined linear approximation of the full nonlinear CGCM. The initial ESV, extracted using 10 years (1990–99) of boreal winter hindcast data, has zonal wind anomalies over the western Indian Ocean, while the final ESV (at a forecast lead time of 10 days) reflects a propagation of the zonal wind anomalies to the east over the Maritime Continent—an evolution that is characteristic of the MJO.A new set of ensemble hindcasts are produced for the boreal winter season from 1990 to 1999 in which the leading ESV provides the initial perturbations. The results are compared with those from a set of control hindcasts generated using random perturbations. It is shown that the ESV-based predictions have a systematically higher bivariate correlation skill in predicting the MJO compared to those using the random perturbations. Furthermore, the improvement in the skill depends on the phase of the MJO. The ESV is particularly effective in increasing the forecast skill during those phases of the MJO in which the control has low skill (with correlations increasing by as much as 0.2 at 20–25-day lead times), as well as during those times in which the MJO is weak.
Causal Discovery for Climate Research Using Graphical Models
Authors: Ebert-Uphoff Imme , Deng Yi 
Published: March 2012

AbstractCausal discovery seeks to recover cause–effect relationships from statistical data using graphical models. One goal of this paper is to provide an accessible introduction to causal discovery methods for climate scientists, with a focus on constraint-based structure learning. Second, in a detailed case study constraint-based structure learning is applied to derive hypotheses of causal relationships between four prominent modes of atmospheric low-frequency variability in boreal winter including the Western Pacific Oscillation (WPO), Eastern Pacific Oscillation (EPO), Pacific–North America (PNA) pattern, and North Atlantic Oscillation (NAO). The results are shown in the form of static and temporal independence graphs also known as Bayesian Networks. It is found that WPO and EPO are nearly indistinguishable from the cause–effect perspective as strong simultaneous coupling is identified between the two. In addition, changes in the state of EPO (NAO) may cause changes in the state of NAO (PNA) approximately 18 (3–6) days later. These results are not only consistent with previous findings on dynamical processes connecting different low-frequency modes (e.g., interaction between synoptic and low-frequency eddies) but also provide the basis for formulating new hypotheses regarding the time scale and temporal sequencing of dynamical processes responsible for these connections. Last, the authors propose to use structure learning for climate networks, which are currently based primarily on correlation analysis. While correlation-based climate networks focus on similarity between nodes, independence graphs would provide an alternative viewpoint by focusing on information flow in the network.
Intraseasonal Variability in MERRA Energy Fluxes over the Tropical Oceans
Authors: Robertson Franklin R. , Roberts Jason B. 
Published: March 2012

Abstract
This paper investigates intraseasonal variability as represented by the recent NASA Global Modeling and Assimilation Office (GMAO) reanalysis, the Modern-Era Retrospective analysis for Research and Applications (MERRA). The authors examine the behavior of heat, moisture, and radiative fluxes emphasizing their contribution to intraseasonal variations in heat and moisture balance integrated over the tropical oceans. MERRA successfully captures intraseasonal signals in both state variables and fluxes, though it depends heavily on the analysis increment update terms that constrain the reanalysis to be near the observations. Precipitation anomaly patterns evolve in close agreement with those from the Tropical Rainfall Measuring Mission (TRMM) though locally MERRA may occasionally be smaller by up to 20%. As in the TRMM observations, tropical convection increases lead tropospheric warming by approximately 7 days. Radiative flux anomalies are dominated by cloud forcing and are found to replicate the top-of-the-atmosphere (TOA) energy loss associated with increased convection found by other observationally based studies. However, MERRA’s convectively produced clouds appear to deepen too soon as precipitation increases. Total fractional cloud cover variations appear somewhat weak compared to observations from the Moderate Resolution Imaging Spectroradiometer (MODIS). Evolution of the surface fluxes, convection, and TOA radiation is consistent with the “discharge–recharge” paradigm that posits the importance of lower-tropospheric moisture accumulation prior to the expansion of organized deep convection. The authors conclude that MERRA constitutes a very useful representation of intraseasonal variability that will support a variety of studies concerning radiative–convective–dynamical processes and will help identify pathways for improved moist physical parameterization in global models.
Optoelectrical properties of polymer composite
Authors: Zihlif AM , Faduos Ashraf S , Ragosta G 
Published: March 2012

The physical properties of polystyrene composites containing different concentrations of iron (0, 5, 10, 20 and 30 wt.%) were studied as a function of ultraviolet (UV) wavelength, iron concentration, temperature, and applied field frequency. The absorption spectra were collected using the UV-spectrophotometry, and the electrical results were determined using the alternating current (AC) impedance method. Analysis of the optical absorption spectra results showed that the transition of energy electrons is direct in k-space and the optical energy gap decreases with iron content. The impedance was measured in the frequency range 50 kHz–1 MHz and temperature range 30–110 C. It was found that the dielectric constant and the dielectric loss of the composites increase with iron concentration and decrease with the applied frequency. The AC conductivity of the composites increases with frequency, temperature, and iron concentration. The low value of the activation energies indicates that the composite of 30 wt.% of iron nearly becomes a conductive material.
Actin-dependent activation of serum response factor in T cells by the viral oncoprotein tip
Authors: Katsch Kristin , de Jong Sarah Jill , Albrecht Jens-Christian , Steger Julia , Genth Harald , Posern Guido , Biesinger Brigitte 
Published: March 2012

Abstract
Serum response factor (SRF) acts as a multifunctional transcription factor regulated by mutually exclusive interactions with ternary complex factors (TCFs) or myocardin-related transcription factors (MRTFs). Binding of Rho- and actin-regulated MRTF:SRF complexes to target gene promoters requires an SRF-binding site only, whereas MAPK-regulated TCF:SRF complexes in addition rely on flanking sequences present in the serum response element (SRE). Here, we report on the activation of an SRE luciferase reporter by Tip, the viral oncoprotein essentially contributing to human T-cell transformation by Herpesvirus saimiri. SRE activation in Tip-expressing Jurkat T cells could not be attributed to triggering of the MAPK pathway. Therefore, we further analyzed the contribution of MRTF complexes. Indeed, Tip also activated a reporter construct responsive to MRTF:SRF. Activation of this reporter was abrogated by overexpression of a dominant negative mutant of the MRTF-family member MAL. Moreover, enrichment of monomeric actin suppressed the Tip-induced reporter activity. Further upstream, the Rho-family GTPase Rac, was found to be required for MRTF:SRF reporter activation by Tip. Initiation of this pathway was strictly dependent on Tip's ability to interact with Lck and on the activity of this Src-family kinase. Independent of Tip, T-cell stimulation orchestrates Src-family kinase, MAPK and actin pathways to induce SRF. These findings establish actin-regulated transcription in human T cells and suggest its role in viral oncogenesis.
Current status and future directions in the management of chronic hepatitis C
Authors: Aman Wosen , Mousa Shaymaa , Shiha Gamal , Mousa Shaker A 
Published: March 2012

Abstract
Hepatitis C virus (HCV) is endemic worldwide, and it causes cirrhosis and other complications that often lead to death; nevertheless, our knowledge of the disease and its mechanisms is limited. HCV is most common in underdeveloped nations, including many in Africa and Asia. The virus is usually transmitted by parenteral routes, but sexual, perinatal, and other types of transfer have been known to occur. Approximately 80% of individuals who contract hepatitis C develop a chronic infection, and very few are able to spontaneously clear the virus. Because hepatitis C is asymptomatic in the majority of patients, the presence of HCV RNA in the serum is the best diagnostic tool. Although serious complications from hepatitis C may not occur for 20 years, 1/5 of chronic patients eventually develop life - threatening cirrhosis. More research is needed on the different therapy options for the disease, and many factors, most importantly the genotype of the virus, must be taken into account before beginning any treatment. As there is no vaccine against HCV at present, the most effective and recommended therapy is pegylated-interferon-α-2a plus ribavirin. While interferon is marginally effective as a monotherapy, both adding the moiety and combining it with ribavirin have been shown to dramatically increase its potency. While there are numerous alternative and complementary medicines available for patients with hepatitis C, their efficacy is questionable. Currently, research is being done to investigate other possible treatments for hepatitis C, and progress is being made to develop a vaccine against HCV, despite the many challenges the virus presents. Until such a vaccination is available, prevention and control methods are important in containing and impeding the spread of the virus and mitigating its deleterious effects on the health of people and communities worldwide.