bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stable carbon and nitrogen isotope ratios in muscle and epidermis of arctic whales
Authors: Horstmann‐Dehn Larissa , Follmann Erich H. , Rosa Cheryl , Zelensky Gennady , George Craig 
Published: July 2011

AbstractCollection of minimally invasive biopsy samples has become an important method to establish normal stable isotopes reference ranges in various wildlife species. Baseline data enhance the understanding of feeding ecology, habitat use, and potential food limitation in apparently healthy, free‐ranging cetaceans. Epidermis and muscle were collected from subsistence‐hunted northern Alaskan bowhead (n= 133 epidermis/134 muscle) and beluga whales (n= 42/49) and subsistence‐hunted Russian gray whales (n= 25/17). Additional samples were obtained from gray whales stranded in California (n= 18/11) during mortality events (1999, 2000). Both δ15N and δ13C are trophic position and benthic/pelagic feeding indicators, respectively, in muscle and epidermis. Epidermis is generally enriched in 15N over muscle, while epidermal 13C is more depleted. Lipid extraction does not alter δ15N in either tissue, but affects epidermal δ13C. Nitrogen‐15 is enriched in muscle, but not epidermis of stranded compared to subsistence‐hunted gray whales, indicating probable protein catabolism and nutritional stress in stranded whales. Similarly, epidermal δ13C of harvested whales is lower than in stranded whales, suggesting depleted lipid stores and/or food limitation in stranded animals. Epidermal isotope signatures are similar in both present‐day bowheads and in an ancient sample from the Northern Bering Sea region. Although only one specimen, this suggests trophic level of the ancient whale compares to modern bowheads after a millennium.
A framework for engaging physicians in quality and safety
Authors: Taitz Jonathan M , Lee Thomas H , Sequist Thomas D 
Published: July 2011

BackgroundPhysicians should be engaged in quality-improvement activities to make the systems in which they work safer and more reliable. However, many physicians are still unable to contribute to patient safety initiatives that lead to safer, high-quality care for their patients.ObjectiveTo survey 10 high-performing hospitals in the USA to determine how they engage their physicians in quality and safety.DesignQualitative study that used site visits and a semistructured 20-question interview.SettingTen high-performing US hospitals were chosen from the 2010 US News and World Report Best Hospitals and the Leapfrog Group on Patient Safety.ParticipantsForty two interviews were conducted with forty-six quality leaders including CEO's, Chief Medical Officers, Vice Presidents for Quality and Safety and physicians.MeasurementsSite visits and in-person interviews were conducted during 2010–2011. The interviews were transcribed and coded using the constant comparative method for further analysis by the team.ResultsThe authors developed a six-point framework for physician engagement in quality and safety as a constellation of the best strategies being used across the country. The framework consists of engaged leadership, a physician compact, appropriate compensation, realignment of financial incentives, data plus enablers and promotion.LimitationThe qualitative design and the small number of hospitals surveyed mean that the results may not be generalisable.ConclusionThere remain many ongoing barriers to physician engagement in quality and safety. Some high-performing hospitals in the USA have made significant improvements in engaging their physicians in quality and safety. The proposed framework can assist organisations in the development of strategies to engage physicians in quality-and-safety activities.
Prescribing errors in hospital inpatients: a three-centre study of their prevalence, types and causes
Authors: Franklin Bryony Dean , Reynolds Matthew , Shebl Nada Atef , Burnett Susan , Jacklin Ann 
Published: July 2011

ABSTRACT

Aim
To compare the prevalence and causes of prescribing errors in newly written medication orders and how quickly they were rectified, in three NHS organisations.

Methods
Errors in newly written inpatient and discharge medication orders were recorded in Spring/Summer 2009 by ward pharmacists on medical admissions and surgical wards, as well as the number of erroneous doses administered (or omitted) before errors were corrected. Logistic regression analysis was used to explore the effects of ward (nested within organisation) and clinical specialty, and whether the pharmacist had checked the patient’s medication history during data collection. Causes were explored using semistructured interviews with key informants.

Results
Overall, 1025 prescribing errors were identified in 974 of 6605 medication orders (14.7%, 95% confidence interval (CI) 13.8% to 15.6%). A mean of 0.9 doses were administered (or omitted) before each error was corrected (range 0–11), with differences between specialties and organisations. The error rate on medical admissions wards (16.3%) was significantly higher than that on surgical wards (12.2%), but this was accounted for by the higher proportion of prescribing being on admission, where omission of patients' usual medication was often identified. There were significant differences among wards (and organisations). Contributing factors included lack of feedback on errors, poor documentation and communication of prescribing decisions, and lack of information about patients' medication histories from primary care.

Conclusions
There were variations among wards, organisations and specialties in error rates and how quickly they were rectified. Exploring reasons for differences between organisations may be useful in identifying best practice and potential solutions.
Describing population dynamics for early life stages of rainbow trout (Oncorhynchus mykiss) using a stock synthesis model1This article is a companion to Korman et al. 2011, published this issue.
Authors: Korman Josh , Martell S.J.D. , Walters Carl 
Published: July 2011

A stock synthesis model was used to assess effects of experimental flows on early life stages of nonnative rainbow trout ( Oncorhynchus mykiss ) in the Colorado River below Glen Canyon Dam (Arizona, USA). The model estimated time-varying survival rates while correcting for entry of new recruits to the age-0 population and changes in vulnerability to capture associated with growth and ontogenetic habitat shifts. A controlled flood, designed in part to enhance native fish habitat, led to an 11-fold increase in early survival rates (fertilization to ~1 month from emergence) of weekly cohorts of trout fertilized after the flood. Effects of increased flow fluctuations during incubation, designed to reduce trout abundance, were not apparent. Age-0 mortality between August and September was over twofold higher in years when there was a 50% reduction in the minimum flow compared with years when flow was stable. There was strong support for models that simulated an ontogenetic shift to deeper habitat in four of five study years. The integration of detailed field information in a stock synthesis model to describe early life history dynamics is a valuable approach that can be applied in a wide range of systems.
Circulating Interleukin-10 and Risk of Cardiovascular Events
Authors: Welsh Paul , Murray Heather M. , Ford Ian , Trompet Stella , de Craen Anton J.M. , Jukema J. Wouter , Stott David J. , McInnes Iain B. , Packard Chris J. , Westendorp Rudi G.J. , Sattar Naveed 
Published: July 2011

Objective—
The goal of this study was to examine the association of the antiinflammatory interleukin-10 (IL-10) with risk of cardiovascular disease (CVD).

Methods and Results—

In the PROSPER (PROspective Study of Pravastatin in the Elderly at Risk) cohort, we related baseline concentrations of circulating IL-10 to risk of CVD events in a nested case (n=819)-control (n=1618) study of 3.2 years of follow-up. Circulating IL-10 showed few strong associations with classical risk factors but was positively correlated with IL-6 and C-reactive protein. IL-10 was positively associated with risk of CVD events (odds ratio [OR] 1.17, 95% CI 1.05 to 1.31 per unit increase in log IL-10) after adjusting for classical risk factors and C-reactive protein. Furthermore, IL-10 was associated more strongly with CVD risk among those with no previous history of CVD (OR 1.42, 95% CI 1.18 to 1.70), compared with those with previous CVD (OR 1.04, 95% CI 0.90 to 1.19;
P
=0.018). Overall, IL-10 showed a modest ability to add discrimination to classical risk factors (C-statistic +0.005,
P
=0.002).

Conclusion—

Baseline circulating levels of the antiinflammatory IL-10 are
positively
associated with risk of CVD among the elderly without prior CVD events, although the association is less evident in those with a history of CVD. Additional epidemiological and mechanistic studies investigating the role of IL-10 in CVD are warranted.
Assessment of Genetic Determinants of the Association of γ′ Fibrinogen in Relation to Cardiovascular Disease
Authors: Lovely Rehana S. , Yang Qiong , Massaro Joseph M. , Wang Jing , D'Agostino Ralph B. , O'Donnell Christopher J. , Shannon Jackilen , Farrell David H. 
Published: July 2011

Objective—
γ′ fibrinogen is a newly emerging biomarker that is associated with cardiovascular disease (CVD). However, the genetic determinants of γ′ fibrinogen levels are unknown. We therefore conducted a genome-wide association study on 3042 participants from the Framingham Heart Study Offspring Cohort.

Methods and Results—

A genome-wide association study with 2.5 million single-nucleotide polymorphisms (SNPs) was carried out for γ′ fibrinogen levels from the cycle 7 examination. Fifty-four SNPs in or near the fibrinogen gene locus demonstrated genome-wide significance (
P
<5.0×10
−8
) for association with γ′ fibrinogen levels. The top-signal SNP was rs7681423 (
P
=9.97×10
−110
) in the fibrinogen gene locus near
FGG
, which encodes the γ chain. Conditional on the top SNP, the only other SNP that remained genome-wide significant was rs1049636. Associations between SNPs, γ′ fibrinogen levels, and prevalent CVD events were examined using multiple logistic regression. γ′ fibrinogen levels were associated with prevalent CVD (
P
=0.02), although the top 2 SNPs associated with γ′ fibrinogen levels were not associated with CVD. These findings contrast those for total fibrinogen levels, which are associated with different genetic loci, particularly
FGB
, which encodes the Bβ chain.

Conclusion—
γ′ fibrinogen is associated with prevalent CVD and with SNPs exclusively in and near the fibrinogen gene locus.
JAGGED1 Signaling Regulates Hemangioma Stem Cell–to–Pericyte/Vascular Smooth Muscle Cell Differentiation
Authors: Boscolo Elisa , Stewart Camille L. , Greenberger Shoshana , Wu June K. , Durham Jennifer T. , Herman Ira M. , Mulliken John B. , Kitajewski Jan , Bischoff Joyce 
Published: July 2011

Objective—
The aim of our study is to determine the cellular and molecular origin for the pericytes in infantile hemangioma (IH) and their functional role in the formation of pathological blood vessels.

Methods and Results—

Here we show that IH-derived stem cells (HemSCs) form pericyte-like cells. With in vitro studies, we demonstrate that HemSC-to-pericyte differentiation depends on direct contact with endothelial cells. JAGGED1 expressed ectopically in fibroblasts was sufficient to induce HemSCs to acquire a pericyte-like phenotype, indicating a critical role for JAGGED1. In vivo, we blocked pericyte differentiation with recombinant JAGGED1, and we observed reduced formation of blood vessels, with an evident lack of pericytes. Silencing
JAGGED1
in the endothelial cells reduced blood vessel formation and resulted in a paucity of pericytes.

Conclusion—
Our data show that endothelial JAGGED1 controls HemSC-to-pericyte differentiation in a murine model of IH and suggests that pericytes have a fundamental role in formation of blood vessels in IH.
Haploinsufficiency of Target of Rapamycin Attenuates Cardiomyopathies in Adult Zebrafish
Authors: Ding Yonghe , Sun Xiaojing , Huang Wei , Hoage Tiffany , Redfield Margaret , Kushwaha Sudhir , Sivasubbu Sridhar , Lin Xueying , Ekker Stephen , Xu Xiaolei 
Published: July 2011

Rationale:
Although a cardioprotective function of target of rapamycin (TOR) signaling inhibition has been suggested by pharmacological studies using rapamycin, genetic evidences are still lacking. We explored adult zebrafish as a novel vertebrate model for dissecting signaling pathways in cardiomyopathy.

Objective:
We generated the second adult zebrafish cardiomyopathy model induced by doxorubicin. By genetically analyzing both the doxorubicin and our previous established anemia-induced cardiomyopathy models, we decipher the functions of TOR signaling in cardiomyopathies of different etiology.

Methods and Results:

Along the progression of both cardiomyopathy models, we detected dynamic TOR activity at different stages of pathogenesis as well as distinct effects of TOR signaling inhibition. Nevertheless, cardiac enlargement in both models can be effectively attenuated by inhibition of TOR signaling through short-term rapamycin treatment. To assess the long-term effects of TOR reduction, we used a zebrafish target of rapamycin (
ztor
) mutant identified from an insertional mutagenesis screen. We show that TOR haploinsufficiency in the
ztor
heterozygous fish improved cardiac function, prevented pathological remodeling events, and ultimately reduced mortality in both adult fish models of cardiomyopathy. Mechanistically, these cardioprotective effects are conveyed by the antihypertrophy, antiapoptosis, and proautophagy function of TOR signaling inhibition.

Conclusions:
Our results prove adult zebrafish as a conserved novel vertebrate model for human cardiomyopathies. Moreover, we provide the first genetic evidence to demonstrate a long-term cardioprotective effect of TOR signaling inhibition on at least 2 cardiomyopathies of distinct etiology, despite dynamic TOR activities during their pathogenesis.
An Economic Analysis of Robot-Assisted Therapy for Long-Term Upper-Limb Impairment After Stroke
Authors: Wagner Todd H. , Lo Albert C. , Peduzzi Peter , Bravata Dawn M. , Huang Grant D. , Krebs Hermano I. , Ringer Robert J. , Federman Daniel G. , Richards Lorie G. , Haselkorn Jodie K. , Wittenberg George F. , Volpe Bruce T. , Bever Christopher T. , Duncan Pamela W. , Siroka Andrew , Guarino Peter D. 
Published: July 2011

Background and Purpose—
Stroke is a leading cause of disability. Rehabilitation robotics have been developed to aid in recovery after a stroke. This study determined the additional cost of robot-assisted therapy and tested its cost-effectiveness.

Methods—
We estimated the intervention costs and tracked participants' healthcare costs. We collected quality of life using the Stroke Impact Scale and the Health Utilities Index. We analyzed the cost data at 36 weeks postrandomization using multivariate regression models controlling for site, presence of a prior stroke, and Veterans Affairs costs in the year before randomization.

Results—

A total of 127 participants were randomized to usual care plus robot therapy (n=49), usual care plus intensive comparison therapy (n=50), or usual care alone (n=28). The average cost of delivering robot therapy and intensive comparison therapy was $5152 and $7382, respectively (
P
<0.001), and both were significantly more expensive than usual care alone (no additional intervention costs). At 36 weeks postrandomization, the total costs were comparable for the 3 groups ($17 831 for robot therapy, $19 746 for intensive comparison therapy, and $19 098 for usual care). Changes in quality of life were modest and not statistically different.

Conclusions—
The added cost of delivering robot or intensive comparison therapy was recuperated by lower healthcare use costs compared with those in the usual care group. However, uncertainty remains about the cost-effectiveness of robotic-assisted rehabilitation compared with traditional rehabilitation.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT00372411.
Dual-Enhanced Cardiac CT for Detection of Left Atrial Appendage Thrombus in Patients With Stroke
Authors: Hur Jin , Kim Young Jin , Lee Hye-Jeong , Nam Ji Eun , Ha Jong-Won , Heo Ji Hoe , Chang Hyuk-Jae , Kim Hua Sun , Hong Yoo Jin , Kim Hee Yeong , Choe Kyu Ok , Choi Byoung Wook 
Published: July 2011

Background and Purpose—
A noninvasive method with high reliability and accuracy comparable to transesophageal echocardiography for identification of left atrial appendage thrombus would be of significant clinical value. The aim of this study was to assess the diagnostic performance of a dual-enhanced cardiac CT protocol for detection of left atrial appendage thrombi and for differentiation between thrombus and circulatory stasis in patients with stroke.

Methods—
We studied 83 consecutive patients with stroke (56 men and 27 women; mean age, 62.6 years) who had high risk factors for thrombus formation and had undergone both dual-source CT and transesophageal echocardiography within a 3-day period. CT was performed with prospective electrocardiographic gating, and scanning began 180 seconds after the test bolus.

Results—

Among the 83 patients, a total of 13 thrombi combined with spontaneous echo contrast and 14 spontaneous echo contrasts were detected by transesophageal echocardiography. All 13 thrombi combined with spontaneous echo contrast were correctly diagnosed on CT. Using transesophageal echocardiography as the reference standard, the overall sensitivity and specificity of CT for the detection of thrombi and circulatory stasis in the left atrial appendage were 96% (95% CI, 78% to 99%), and 100% (95% CI, 92% to 100%), respectively. On CT, the mean left atrial appendage/ascending aorta Hounsfield unit ratios were significantly different between thrombus and circulatory stasis (0.15 Hounsfield unit versus 0.27 Hounsfield unit,
P
=0.001). The mean effective radiation dose was 3.11 mSv.

Conclusions—
Dual-enhanced cardiac CT with prospective electrocardiographic gating is a noninvasive and sensitive modality for detecting left atrial appendage thrombus with an acceptable radiation dose.
Differential Association of Docosahexaenoic and Eicosapentaenoic Acids With Carotid Intima-Media Thickness
Authors: Sekikawa Akira , Kadowaki Takashi , El-Saed Aiman , Okamura Tomonori , Sutton-Tyrrell Kim , Nakamura Yasuyuki , Evans Rhobert W. , Mitsunami Ken-ichi , Edmundowicz Daniel , Nishio Yoshihiko , Nakata Katsumi , Kadota Aya , Otake Teruo , Miura Katsuyuki , Choo Jina , Abbott Robert D. , Kuller Lewis H. , Curb J. David , Ueshima Hirotsugu ,   for the ERA JUMP Study group
Published: July 2011

Background and Purpose—
Recent studies reported the differential effect of docosahexaenoic (DHA) and eicosapentaenoic acids (EPA). We examined the differential association of DHA and EPA with carotid intima-media thickness (IMT) in Japanese individuals in Japan and in U.S. white individuals and explored whether DHA or EPA contributes to the difference in IMT between the two groups.

Methods—
A population-based cross-sectional study in 608 Japanese and U.S. white men aged 40 to 49 was conducted to assess IMT, serum DHA, EPA, and other cardiovascular risk factors.

Results—

Japanese compared to U.S. whites had significantly lower IMT (mean±SD, 618±81 and 672±94 μm for Japanese and whites, respectively;
P
<0.001) and had >2-fold higher levels of DHA and EPA. DHA, but not EPA, had an inverse association with IMT in both Japanese and U.S. whites. The inverse association remained only in Japanese men after adjusting for risk and other factors. The significant difference in multivariable-adjusted IMT became nonsignificant after further adjusting for DHA (mean difference, 17 μm; 95% CI, −8 to 43;
P
=0.177) but not EPA. In this multivariable-adjusted model, DHA but not EPA was a significant predictor of IMT (
P
=−0.032 versus 0.863, respectively).

Conclusions—
These data suggest that DHA may have a more potent antiatherogenic effect than EPA, especially in levels observed in the Japanese, independent of risk factors.
Relationship Between C-Reactive Protein, Systemic Oxygen Consumption, and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
Authors: Badjatia Neeraj , Carpenter Amanda , Fernandez Luis , Schmidt J. Michael , Mayer Stephan A. , Claassen Jan , Lee Kiwon , Connolly E. Sander , Seres David , Elkind Mitchell S.V. 
Published: July 2011

Background and Purpose—

Subarachnoid hemorrhage (SAH) is known to result in elevated systemic oxygen consumption (V
o
2
) and increases in high-sensitivity C-reactive protein (hsCRP), although the relationship among hsCRP, V
o
2
, and delayed cerebral ischemia (DCI) after SAH remains unknown. We hypothesized that hsCRP is directly associated with V
o
2
and that elevated V
o
2
is a predictor of DCI after SAH.

Methods—

Prospective serial assessments of V
o
2
and hsCRP over 4 prespecified time periods during the first 14 days after bleed in consecutive SAH patients admitted to a single academic medical center for a 2-year period.

Results—

One hundred ten SAH patients met study criteria (mean age, 55±16 years; 62% women), with a median admission Hunt Hess grade of 3 (interquartile range, 2–4). In multivariate generalized estimating equation model of the first 14 days after bleed, V
o
2
was associated with younger age (
P
=0.01), male gender (
P
=0.01), and hsCRP levels (
P
=0.03). Twenty-four (22%) patients had DCI develop, with a median onset on day 7 after bleed (interquartile range, 5–11). The mean V
o
2
(291±65 mL/min versus 226±55 mL/min;
P
=0.003) was higher in DCI patients. In a multivariable Cox proportional hazards model, younger age (hazard ratio, 1.2 per 5 years; 95% CI, 1.1–1.3), a higher modified Fisher scale score (hazard ratio, 3.4 per 1-point increase; 95% CI, 1.7–6.9), and higher V
o
2
(HR, 1.2 per 50-mL/min increase; 95% CI, 1.1–1.3) were predictive of DCI.

Conclusions—
Systemic oxygen consumption is associated with hsCRP levels in the first 14 days after SAH and is an independent predictor of DCI.
Short-Term Outcomes After Symptomatic Internal Carotid Artery Occlusion
Authors: Burke Matthew J. , Vergouwen Mervyn D.I. , Fang Jiming , Swartz Rick H. , Kapral Moira K. , Silver Frank L. , Casaubon Leanne K. 
Published: July 2011

Background and Purpose—
Previous studies concerning internal carotid artery (ICA) occlusion have focused on long-term prognosis. The purpose of the present study was to evaluate short-term outcomes of patients with symptomatic ICA occlusion.

Methods—
We used data from the Registry of the Canadian Stroke Network on consecutive patients presenting to 11 stroke centers in Ontario. We included patients with noncardioembolic ischemic stroke or transient ischemic attack within the anterior circulation. The resulting cohort was divided into 4 groups based on vascular imaging of the ipsilateral extracranial ICA: occlusion, severe stenosis, moderate stenosis, and mild/no stenosis. Logistic regression modeling was used to evaluate the association between the degree of stenosis/occlusion of the symptomatic ICA and a series of short-term outcome measures.

Results—
Of the 4144 patients who met study criteria, 283 patients had a symptomatic ICA occlusion. Compared with patients with ICA occlusion, patients with all other degrees of stenosis had a lower risk of in-hospital death, neurological worsening, and poor functional outcome. Particularly, severe stenosis was associated with a lower risk of in-hospital death (adjusted OR, 0.40; 95% CI, 0.20 to 0.79), neurological worsening (adjusted OR, 0.52; 95% CI, 0.34 to 0.78), and poor functional outcome (adjusted OR, 0.62; 95% CI, 0.41 to 0.94) compared with the ICA occlusion group.

Conclusions—
The results of our study showed that patients with symptomatic ICA occlusion are at a high risk of adverse outcomes that is as severe, if not worse, than any other degree of ICA stenosis in the short term. Thus, more aggressive management may be warranted for patients with acute, symptomatic ICA occlusion.