bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physician assistants in English general practice: A qualitative study of employers’ viewpoints
Authors: Drennan Vari , Levenson Ros , Halter Mary , Tye Chris 
Published: March 2011

Objective: Effective use of staff is a major aim in all health-care systems both to maximize their impact and to minimize costs. In England, a few general practitioners (GPs) have been recruiting physician assistants (PAs) to work in their practices, independent of any pilot schemes. Our objective was to study the motivation of GPs and practice managers who employed PAs and to understand the factors that sustained their employment. Methods: A qualitative study using semi-structured interviews, analysed thematically, was carried out with 13 GPs and three practice managers from 15 general practices employing PAs in five areas of England. Results: All practices were employing USA-trained PAs. Motivating factors for their employment included increasing the general practice capacity to manage patient demand within government targets for access, broaden the skill-mix in the practice team and financial considerations. The issues that needed to be taken into account in employing PAs included: the requirement for medical supervision; the PAs current lack of a regulatory framework and prescribing authority; and some patients’ lack of familiarity with the concept of the PA. Conclusions: General practice employers view PAs as a positive addition to a mixed skill team for meeting patient demand within a practice's finances. There is a need to develop stronger governance and regulatory frameworks for this emerging profession.
Health Services Use Associated with Emergency Department Closure
Authors: Hansen Kristian Schultz , Enemark Ulrika , Foldspang Anders 
Published: March 2011

Objective To study changes in health services consumption following substantial reduction in the availability of local emergency services in a small municipality population. Method A dynamic cohort (21,000 residents of Viborg County, Denmark, of which 2,300 from Morsø municipality) was followed, 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. Results Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use of substitute health services. By contrast, Morsø women compared to the rest of Viborg county reduced their use of GP services in terms of face-to-face visits (β= -0.08, P = 0.020), telephone consultations (β= -0.11, P = 0.007), home visits (β= -0.48, P = 0.009), and their inpatient hospital utilization (β= -0.12, P = 0.022) during the period when emergeny services were only available in the daytime. Conclusions Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care utilization patterns were observed among local residents that varied by gender.
Back to basics – cutting the cord on umbilical infections
Authors: Sharples Alistair , McArthur David , McNamara Kate , Lengyel John 
Published: March 2011

INTRODUCTION Surgical site infections (SSIs) are a significant cause of postoperative morbidity with laparoscopic surgery associated with lower SSI rates. However, a departmental change in our unit to increased laparoscopic colorectal surgery resulted in increased wound infection rates at umbilical specimen extraction sites, the cause of which we attempted to elucidate. SUBJECTS AND METHODS Prospectively collected data over an 18-month period (April 2008 to September 2009) for laparoscopic colorectal operations in a busy teaching hospital were retrospectively analysed, focusing on operation performed, whether pre-operative skin cleansing was employed, nature of specimen extraction excision, and rate of umbilical wound infection. Comparison was made with open colorectal procedures performed in the preceding year. RESULTS In total, 275 laparoscopic colorectal operations were performed. Over the first 8 months there was a significant increase in infection rates when compared with open procedures over a similar time period (23.5% vs 8.0%; P = 0.0001). Changing practice to use pre-operative skin cleansing and an incision that skirted around, as opposed to traversing, the umbilicus reduced umbilical infection rates significantly from 23.5% to 11.6% (P = 0.01). Patients undergoing right hemicolectomy benefitted more (reduction of 30.0% to 6.9%; P = 0.04) than those undergoing anterior resection (26.8% vs 15.6%, P = 0.13). CONCLUSIONS Umbilical incisions, when extended for specimen extraction, are particularly prone to infection following colorectal surgery but rates can be reduced by simple measures such as pre-operative umbilical cleansing and avoidance of the umbilicus in the incision, without the need for drastic and costly changes in technique or antibiotic prophylaxis.
Diagnostic Potential of Saliva: Current State and Future Applications
Authors: Pfaffe Tina , Cooper-White Justin , Beyerlein Peter , Kostner Karam , Punyadeera Chamindie 
Published: March 2011

BACKGROUND
Over the past 10 years, the use of saliva as a diagnostic fluid has gained attention and has become a translational research success story. Some of the current nanotechnologies have been demonstrated to have the analytical sensitivity required for the use of saliva as a diagnostic medium to detect and predict disease progression. However, these technologies have not yet been integrated into current clinical practice and work flow.

CONTENT
As a diagnostic fluid, saliva offers advantages over serum because it can be collected noninvasively by individuals with modest training, and it offers a cost-effective approach for the screening of large populations. Gland-specific saliva can also be used for diagnosis of pathology specific to one of the major salivary glands. There is minimal risk of contracting infections during saliva collection, and saliva can be used in clinically challenging situations, such as obtaining samples from children or handicapped or anxious patients, in whom blood sampling could be a difficult act to perform. In this review we highlight the production of and secretion of saliva, the salivary proteome, transportation of biomolecules from blood capillaries to salivary glands, and the diagnostic potential of saliva for use in detection of cardiovascular disease and oral and breast cancers. We also highlight the barriers to application of saliva testing and its advancement in clinical settings.

SUMMARY
Saliva has the potential to become a first-line diagnostic sample of choice owing to the advancements in detection technologies coupled with combinations of biomolecules with clinical relevance.
Bounds on the roots of the Steiner polynomial
Authors: Jetter Madeleine 
Published: March 2011

Abstract
We consider the Steiner polynomial of a C
2 convex body . Denote by ρ
min the minimum value of the principal radii of curvature of ∂K and by ρ
max their maximum. When n ≤ 5, the real parts of the roots are bounded above by –ρ
min and below by –ρ
max. These bounds are valid for any n such that all of the roots of the Steiner polynomial of every convex body in lie in the left half-plane.
Comparison of Brazilian and U.S. Biofuel Demand: The Role of Vehicle Fleets and Prices in Meeting Policy Targets
Authors: Tokgoz Simla , Bhandary Prapti 
Published: March 2011

AbstractThe two largest producers of biofuels in the world, Brazil and U.S., both have various policy initiatives designed to meet a significant portion of their need for transportation fuels from biofuels. However, the structure of bio biofuel demand and vehicle fleets varies widely between these two economies, affecting the level of absorption of biofuels by the refiners and final consumers of each country. The relative prices of biofuels to conventional fuel prices (gasoline and diesel) determine consumers' demand not only for biofuels and but also for alternative fuel vehicles. The vehicle fleet structure, in turn, determines the ability of the transportation sector to absorb biofuels. Brazil, with its low costs of production, can sell ethanol at a competitive level with gasoline, which allows ethanol demand to expand and vehicle fleet to transform. U.S., on the other hand, cannot sell ethanol competitively. This limits market expansion and vehicle fleet transformation in the U.S., which, in turn, hinders its ability to achieve policy targets. With many countries taking initiatives to meet a large share of their transportation fuel needs from biofuels, the experiences of U.S. and Brazil provide valuable lessons for policy makers, where an in-depth analysis of the inter-linkages among relative prices, biofuel demand, and vehicle fleet structure prove to be crucial for successful and effective policy making.
Adenosine 2A receptor: a crucial neuromodulator with bidirectional effect in neuroinflammation and brain injury
Authors: Dai Shuang-Shuang , Zhou Yuan-Guo 
Published: March 2011

AbstractThis review summarizes recent developments that have contributed to our understanding of how adenosine 2A receptors (A2ARs) modulate brain damage in various animal models of acute neurological injuries, including brain ischemia, traumatic brain injury, spinal cord injury and hemorrhage stroke. The main conclusions are: (1) pharmacological, neurochemical and molecular/genetic approaches to the complex actions of A2AR in different cellular elements suggest that A2AR activation exerts bidirectional effect (detrimental or protective) after brain insults; (2) modulation of glutamate excitotoxicity and neuroinflammation are involved in the protection of A2AR agonists or antagonists, but the bidirectional effect of A2AR is largely due to the bidirectional regulation of neuroinflammation (anti-inflammation or proinflammation) by A2AR on immune cells such as microglia cells and peripheral bone marrow cells; and (3) the bidirectional effect of A2AR on neuroinflammation and brain injury depends on the distinct and sometimes opposite actions of A2AR in various cellular elements and on different injury models and associated pathological conditions. The local glutamate level in the brain injury is one of the crucial factors that contribute to the direction of A2AR effect on neuroinflammation and brain injury outcome. These developments presented here clearly highlight the complexity of using A2AR agents therapeutically in acute neuronal injuries and confirm that A2AR ligands have many promising characteristics that encourage the pursuit of their full therapeutic potential.
Unique Calibration Case Study for Predictive Model of Installation Loads for Directional Drilled Fusible PVC Pipe
Authors: Botteicher Richard (Bo) , Ariaratnam Samuel T. 
Published: March 2011

Abstract
The nature of the horizontal directional drilling (HDD) process necessitates the use of pipe products that are capable of being pulled into final alignment via a tensile force, as opposed to being pushed or jacked by segmental means. While steel and high density polyethylene pipes have been historically used with HDD methodology, a fusible polyvinylchloride pipe (FPVCP) product has been one relatively recent addition to the materials available for the installation of water, wastewater, pressure, and non-pressure infrastructure. Maximum safe pull load criteria have been developed for this material, and recent research was focused on aligning current predictive pull force modeling with this material for use in HDD application. Recent work has presented the predictive model and general validation of its use with FPVCP. One particular set of monitored HDD installations that was gathered during the field validation stage of the research provided unique insight into the use of the predictive model to calculate the required pulling force for use in HDD installation methodology. An overview of the model background, field validation study, and specific case study will be reviewed. Specific conclusions regarding this case study relate to the importance of drilling fluid accuracy in the model.
Effect of Gas Pressure on Active Screen Plasma Nitriding Response
Authors: Nishimoto Akio , Nagatsuka Kimiaki , Narita Ryota , Nii Hiroaki , Akamatsu Katsuya 
Published: March 2011

Abstract
An austenitic stainless steel AISI 304 was active screen plasma nitrided using a 304 steel screen to investigate the effect of the gas pressure on the nitriding response. The sample was treated for 18 ks at 723 K in 25 % N2 + 75 % H2. The gas pressure was changed to 100, 600, and 1200 Pa. The distance between the screen and the sample was also changed to 10, 30, and 50 mm. The nitrided samples were characterized by observing their appearance and surface roughness by optical microscopy, X-ray diffraction, and microhardness testing. After nitriding, polygonal particles with a normal distribution were observed at the center and edges of all the nitrided sample surfaces. The particles on the sample surface became finer with an increase in the gas pressure. The nitrided layer with a greater and homogeneous thickness was obtained at a low gas pressure of 100 Pa.
Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome
Authors: Wehr Elisabeth , Trummer Olivia , Giuliani Albrecht , Gruber Hans-Jürgen , Pieber Thomas R , Obermayer-Pietsch Barbara 
Published: March 2011

IntroductionWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances including insulin resistance (IR), which might be related to vitamin D metabolism. We aimed to investigate the association of polymorphisms in the vitamin D receptor (VDR) gene as well as vitamin D level-associated genes with metabolic and endocrine parameters in PCOS women. Moreover, we examined whether there are associations with PCOS susceptibility.MethodsMetabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed in 545 PCOS and 145 control women. Genotyping ofVDR(Cdx2,Bsm-I,Fok-I,Apa-I, andTaq-I),GC,DHCR7, andCYP2R1polymorphisms was performed.Results25-Hydroxyvitamin D (25(OH)D) levels showed significant negative correlation with IR and positive correlation with insulin sensitivity (P<0.05 for all) in PCOS women. In PCOS women, theVDRCdx2‘AA’ genotype was associated with lower fasting insulin (P=0.039) and homeostatic model assessment-IR (P=0.041) and higher quantitative insulin-sensitivity check index (P=0.012) and MATSUDA index (P=0.003). TheVDRApa-I‘AA’ genotype was associated with lower testosterone (P=0.028) levels. In PCOS women, 170 women (31.2%) presented with 25(OH)D levels <20 ng/ml. PCOS women carrying theGC‘GG’ genotype and theDHCR7‘GG’ genotype had a significantly higher risk for 25(OH)D levels <20 ng/ml (OR 2.53 (1.27–5.06),P=0.009, and OR 2.66 (1.08–6.55),P=0.033 respectively) compared with PCOS women carrying theGC‘TT’ genotype andDHCR‘TT’ genotype in multivariate analyses. We observed no association of genetic variations and PCOS susceptibility.ConclusionVDR and vitamin D level-related variants are associated with metabolic and endocrine parameters including 25(OH)D levels in PCOS women.
Time-dependent wave packet theoretical study of femtosecond photoelectron spectra and coupling between the A2Σ+ and B2Π states of the NO molecule in a strong laser field
Authors: Zhu Yonghua , Song Peng , Yang Huan , Ma Fengcai 
Published: March 2011

Abstract
In this work, the femtosecond time-resolved photoelectron spectra and the coupling between the A2Σ+ and B2Π states of the NO molecule in a strong laser field have been investigated by the time-dependent wave packet method. We demonstrate that the weak coupling between the A2Σ+ and B2Π states of NO plays a key role on the peak centered at 0.37 eV of the photoelectron spectra in the 2+1’ channel.
Rho kinase inhibitors stimulate the migration of human cultured osteoblastic cells by regulating actomyosin activity
Authors: Zhang Xuejiao , Li Cheng , Gao Huiling , Nabeka Hiroaki , Shimokawa Tetsuya , Wakisaka Hiroyuki , Matsuda Seiji , Kobayashi Naoto 
Published: March 2011

AbstractWe investigated the effects of Rho-associated kinase (ROCK) on migration and cytoskeletal organization in primary human osteoblasts and Saos-2 human osteosarcoma cells. Both cell types were exposed to two different ROCK inhibitors, Y-27632 and HA-1077. In the improved motility assay used in the present study, Y-27632 and HA-1077 significantly increased the migration of both osteoblasts and osteosarcoma cells on plastic in a dose-dependent and reversible manner. Fluorescent images showed that cells of both types cultured with Y-27632 or HA-1077 exhibited a stellate appearance, with poor assembly of stress fibers and focal contacts. Western blotting showed that ROCK inhibitors reduced myosin light chain (MLC) phosphorylation within 5 min without affecting overall myosin light-chain protein levels. Inhibition of ROCK activity is thought to enhance the migration of human osteoblasts through reorganization of the actin cytoskeleton and regulation of myosin activity. ROCK inhibitors may be potentially useful as anabolic agents to enhance the biocompatibility of bone and joint prostheses.
Human dirofilariosis: The report of subcutaneous Dirofilaria repens infection in the Slovak Republic
Authors: Nováková E. , Kinčeková J. , Adamicová K. , Kompaníková J. , Švihrová V. , Šimeková K. , Krause J. , Pavlinová J. , Dvorožňáková E. 
Published: March 2011

Abstract
Dirofilariosis is a vector-borne disease that is spreading in Europe from the southern endemic regions to the northern countries, including Slovakia. The dog parasites Dirofilaria immitis and D. repens are zoonotic agents, responsible for the development of human pulmonary and subcutaneous dirofilariosis, respectively. The present paper reports the third case of human dirofilariosis in Slovakia caused by D. repens. The pacient, a 41-year-old woman, was referred with tumour process in the subcutaneous area of the right forearm. Within 14 days the USG confirmed the rapid increase of the nodule from 20 × 10 mm to 30 × 25 mm. The surgical extirpation of the tumour was indicated. Histological examination revealed the formation with eosinofilic rime and the presence of a worm in the centre, detected as D. repens.
Helminth infection in Mugil incilis from Cartagena de Indias, Colombian Caribbean coast
Authors: Iglesias L. , Benítez R. , Adroher F. , Valero A. 
Published: March 2011

Abstract
This survey records the occurrence of larvae of Contracaecum multipapillatum sensu lato (Von Drasche, 1882) Lucker, 1941 (Nematoda, Anisakidae) and adults of Floridosentis mugilis (Machado Filho, 1951) Ward, 1953 (Acanthocephala, Neoechinorhynchidae) in mullet Mugil incilis Hancock, 1830 caught in La Boquilla, Cartagena de Indias (Colombian Caribbean coast). The prevalence of F. mugilis was 45.7 % and of C. multipapillatum s.l. 58.6 %, while 28.6 % of the fish were parasitized by both species. The smallest hosts presented the lowest prevalence of F. mugilis but the highest prevalence of C. multipapillatum s.l.. Prevalence, mean abundance and mean intensity of C. multipapillatum s.l. in M. incilis were all highest in viscera. The prevalence in fish muscle tissue was low (2.9 %).
Dendritic Cells and CD28 Costimulation Are Required To Sustain Virus-Specific CD8+ T Cell Responses during the Effector Phase In Vivo
Authors: Dolfi Douglas V. , Duttagupta Priyanka A. , Boesteanu Alina C. , Mueller Yvonne M. , Oliai Caspian H. , Borowski Annie B. , Katsikis Peter D. 
Published: March 2011

Abstract
Although much is known about the initiation of immune responses, much less is known about what controls the effector phase. CD8+ T cell responses are believed to be programmed in lymph nodes during priming without any further contribution by dendritic cells (DCs) and Ag. In this study, we report the requirement for DCs, Ag, and CD28 costimulation during the effector phase of the CD8+ T cell response. Depleting DCs or blocking CD28 after day 6 of primary influenza A virus infection decreases the virus-specific CD8+ T cell response by inducing apoptosis, and this results in decreased viral clearance. Furthermore, effector CD8+ T cells adoptively transferred during the effector phase fail to expand without DC, CD28 costimulation, and cognate Ag. The absence of costimulation also leads to reduced survival of virus-specific effector cells as they undergo apoptosis mediated by the proapoptotic molecule Bim. Finally, IL-2 treatment restored the effector response in the absence of CD28 costimulation. Thus, in contrast to naive CD8+ T cells, which undergo an initial Ag-independent proliferation, effector CD8+ T cells expanding in the lungs during the effector phase require Ag, CD28 costimulation, and DCs for survival and expansion. These requirements would greatly impair effector responses against viruses and tumors that are known to inhibit DC maturation and in chronic infections and aging where CD28−/− CD8+ T cells accumulate.
Functional Plasticity of Antigen-Specific Regulatory T Cells in Context of Tumor
Authors: Addey Caroline , White Matthew , Dou Lang , Coe David , Dyson Julian , Chai Jian-Guo 
Published: March 2011

Abstract
Although polyclonal regulatory T cells (Tregs) that once expressed Foxp3 (ex-Tregs) derived from Foxp3+ Tregs have been described in homeostatic and autoimmune settings, little is known regarding the influence of the tumor environment on ex-Treg development. After adoptive transfer of HY-specific green Tregs (peripheral or thymic) to Rag2−/− B6 female mice bearing syngeneic HY-expressing MB49 tumors, a significant fraction rapidly lost expression of Foxp3. On the second transfer to a Rag2−/− B6 male environment, these ex-Tregs expanded strongly, whereas Tregs that maintained expression of Foxp3 expression did not. Both FACS and quantitative real-time-PCR analysis revealed that ex-Tregs upregulated genes characteristic of a Th1 effector-memory phenotype including IFN-γ and downregulated a panel of Treg-specific genes. Peripheral HY-specific green Tregs were adoptively transferred to Rag2−/− B6 male mice, to dissect the factors regulating ex-Treg differentiation. Development of ex-Tregs was more efficient in the mesenteric lymph node (mLN) than peripheral lymph node environment, correlating with a much greater level of IL-6 mRNA in mLN. In addition, the preferential development of ex-Tregs in mLN was significantly impaired by cotransfer of HY-specific naive CD4 T cells. Collectively, our study not only demonstrates the plasticity of Ag-specific Tregs in the context of the tumor environment, but also defines key molecular and cellular events that modulate ex-Treg differentiation.