bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare
Authors: Nicolay C R , Purkayastha S , Greenhalgh A , Benn J , Chaturvedi S , Phillips N , Darzi A 
Published: November 2011

Abstract

Background
The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery.

Methods
MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business™ Elite, the Health Management Information Consortium and PsycINFO® were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically.

Results
Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial.

Conclusion
QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine.
Prognostic significance of peritoneal washing cytology in patients with gastric cancer
Authors: Lee S D , Ryu K W , Eom B W , Lee J H , Kook M C , Kim Y-W 
Published: November 2011

Abstract

Background
Positive peritoneal washing cytology is a poor prognostic factor in patients with gastric cancer. The right therapeutic approach for this condition has not been well documented.

Methods
Patients who underwent surgery for gastric cancer with suspected serosal invasion and peritoneal washing cytology at the Korean National Cancer Centre between May 2001 and December 2009 were included in this retrospective study. Clinicopathological factors and overall survival were analysed with respect to the cytological results and presence of peritoneal metastases. Prognostic factors were analysed in patients with positive cytology but without overt peritoneal metastases.

Results
A total of 1072 patients were included in the analysis, of whom 900 had negative cytology (C0 group) and 172 had positive cytology (C1 group). No peritoneal metastases (P0) were found in 830 patients (92·2 per cent) in the C0 group. Peritoneal metastases (P1) were found in 76 patients (44·2 per cent) in the C1 group. Median overall survival times in the P0 C1, P1 C0 and P1 C1 subgroups were 20·0, 14·0 and 10·0 months respectively. Multivariable analysis of the P0 C1 subgroup revealed that clinical N0–2 category and gastric resection were significantly associated with better prognosis (median survival 24·0 versus 13·0 months for N0–2 versus N3, and 21·0 versus 4·0 months for resected versus non-resected).

Conclusion
Positive washing cytology in patients with gastric cancer is a negative prognostic factor for patients with, as well as those without, overt peritoneal metastases. Resection is an option in patients with clinical stage N0–2 disease without peritoneal metastases but with a positive washing cytology finding.
Highlighting Important Parameters Often Neglected in Numerical Optimization of Preparative Chromatography
Authors: Samuelsson J. , Enmark M. , Forssén P. , Fornstedt T. 
Published: November 2011

AbstractWhen a chromatographic separation process is numerically optimized, a number of input parameters to the column model need to be accurately determined, and the accuracy will affect the reliability of the predicted optimal operational conditions. Furthermore, the numerical accuracy of the solution to the column model will have similar impact. The input parameters holdup volume, injection profiles, and the selection of an algorithm for solving the column model were investigated. Errors in parameters or a numerical error in the solution of the column model were found to lead to a prediction of a product fraction where the set purity and/or yield requirements are not met.
Optimization and Performance of Silica‐Based Media for Industrial‐Scale Antibody Purification
Authors: Miyahara H. , Nakashima R. , Inoue M. , Katsuda T. , Yamaji H. , Katoh S. 
Published: November 2011

AbstractA silica‐based medium with optimized pore size, pore volume, and coupling density was prepared for protein A affinity chromatography, to be used for industrial purification of IgG. Performance and durability of the silica‐based medium were studied during repeated use and compared with other protein A media available on the market. The silica‐based medium provided high dynamic binding capacities for human polyclonal IgG in the superficial liquid velocity range from 150 to 720 cm h–1 because of a high mass transfer coefficient and high mechanical strength. The dynamic binding capacity and IgG recovery were high and varied only slightly during 50–150 cycles of repeated use. The release of protein A ligand was low.
Mathematical Modeling of Protein Chromatograms
Authors: Lienqueo M. E. , Mahn A. , Salgado J. C. , Shene C. 
Published: November 2011

AbstractThe most used mathematical models with a phenomenological basis for simulating chromatographic curves of proteins in size exclusion chromatography, ion exchange chromatography, affinity chromatography, and hydrophobic interaction chromatography are reviewed. The plate model (PM) and the general rate model (GRM) are briefly described, followed by various applications of these models to the different chromatographic strategies. Based on these examples it is concluded that the GRM is the most complete and informative model, despite it needs several parameters that have to be estimated from theoretical correlations nonspecific for proteins. Additionally, values for the effective pore diffusion coefficient are not generally available. Appropriate calibration leads in most cases to predictions that compare favorably with experimental data. The possibility to predict chromatographic curves under different operational conditions similar to those used at industrial scale by applying mathematical models is still a challenge because it could contribute to the reduction of costs involved in suitable purification processes. In addition, new proteins are continually designed and for each case different conditions are needed.
Threshold Level of Low‐Density Lipoprotein Cholesterol for the Short‐Term Benefit of Statin Therapy in the Acute Phase of Myocardial Infarction
Authors: Lee Jang Hoon , Park Sun Hee , Yang Dong Heon , Park Hun Sik , Cho Yongkeun , Lee Won Kee , Jeong Myung Ho , Kim Young Jo , Jun Jae Eun , Chae Shung Chull ,   for the Korea Acute Myocardial Infarction Registry Investigators
Published: November 2011

AbstractBackground:Little is known about the threshold level of low‐density lipoprotein cholesterol (LDL‐C) for statin therapy in acute myocardial infarction (AMI).Hypothesis:The aim of this study was to investigate the short‐term benefit of the statin in post‐MI patients with low LDL‐C levels.Methods:Between November 2005 and January 2008, 6866 statin‐naive patients were selected from the Korea AMI registry. Major adverse cardiac event (MACE) was defined as a composite of death, recurrent MI, and revascularizations.Results:The 6‐month MACE and mortality showed a U‐shaped curve, with the lowest rate at 114–122 mg/dL. Propensity scores for statin use were calculated for patients with LDL‐C ≤ 113 mg/dL, and they were used to match the patients who received statin (statin user, n = 1031) with those who did not receive it (statin nonuser, n = 1031). The 6‐month MACE was not significantly different between statin users and statin nonusers (9.4% vs 11.0%; hazard ratio [HR]: 0.847, 95% confidence interval [CI]: 0.646‐1.111, P = 0.230), whereas the 6‐month mortality was significantly lower in statin users (7.2% vs 9.7%; HR: 0.728, 95% CI: 0.539–0.984, P = 0.039). However, when the analyses were repeated in the patients with LDL‐C ≤ 105 mg/dL, not only the 6‐month MACE (9.5% vs 9.9%; HR: 0.945, 95% CI: 0.700–1.277, P = 0.713) but also the 6‐month mortality (7.0% vs 8.7%; HR: 0.793, 95% CI: 0.566–1.111, P = 0.177) was not significantly different between statin users and statin nonusers (n = 876 in each group).Conclusions:The beneficial effects of statin therapy seem to vanish when LDL‐C is below a certain level in AMI patients. © 2011 Wiley Periodicals, Inc.Jeong, Kim and Chae received funding from the Korean Society of Cardiology. J.H. Lee, Yang, H.S. Park and Chae received grants from GlaxoSmithKline and Pfizer.
Heterogeneity and dynamics of lateral line afferent innervation during development in zebrafish (Danio rerio)
Authors: Haehnel Melanie , Taguchi Masashige , Liao James C. 
Published: November 2011

AbstractThe lateral line system of larval zebrafish is emerging as a model to study a range of topics in neurobiology, from hair cell regeneration to sensory processing. However, despite numerous studies detailing the patterning and development of lateral line neuromasts, little is known about the organization of their connections to afferent neurons and targets in the hindbrain. We found that as fish grow and neuromasts proliferate over the body surface, the number of afferent neurons increases linearly. The number of afferents innervating certain neuromasts increases over time, while it decreases for other neuromasts. The ratio of afferent neurons to neuromasts differs between the anterior and posterior lateral line system, suggesting potential differences in sensitivity threshold or spatial resolution. A single afferent neuron routinely contacts a group of neuromasts, suggesting that different afferent neurons can convey information about receptive fields along the body. When afferent projections are traced into the hindbrain, where a distinct somatotopy has been previously described, we find that this general organization is absent at the Mauthner cell. We speculate that directional input from the lateral line is less important at an early age, whereas the speed of the escape response is paramount, and that directional responses arise later in development. By quantifying morphological connections in the lateral line system, this study provides a detailed foundation to understand how hydrodynamic information is processed and ultimately translated into appropriate motor behaviors. J. Comp. Neurol. 520:1376–1386, 2012. © 2011 Wiley Periodicals, Inc.
Rearrangement of the cone mosaic in the retina of the rat model of retinitis pigmentosa
Authors: Ji Yerina , Zhu Colleen L. , Grzywacz Norberto M. , Lee Eun‐Jin 
Published: November 2011

AbstractIn retinitis pigmentosa (RP), the death of cones normally follows some time after the degeneration of rods. Recently, surviving cones in RP have been studied and reported in detail. These cones undergo extensive remodeling in their morphology. Here we report an extension of the remodeling study to consider possible modifications of spatial‐distribution patterns. For this purpose we used S334ter‐line‐3 transgenic rats, a transgenic model developed to express a rhodopsin mutation causing RP. In this study, retinas were collected at postnatal (P) days P5–30, 90, 180, and P600. We then immunostained the retinas to examine the morphology and distribution of cones and to quantify the total cone numbers. Our results indicate that cones undergo extensive changes in their spatial distribution to give rise to a mosaic comprising an orderly array of rings. These rings first begin to appear at P15 at random regions of the retina and become ubiquitous throughout the entire tissue by P90. Such distribution pattern loses its clarity by P180 and mostly disappears at P600, at which time the cones are almost all dead. In contrast, the numbers of cones in RP and normal conditions do not show significant differences at stages as late as P180. Therefore, rings do not form by cell death at their centers, but by cone migration. We discuss its possible mechanisms and suggest a role for hot spots of rod death and the remodeling of Müller cell process into zones of low density of photoreceptors. J. Comp. Neurol., 2012. © 2011 Wiley Periodicals, Inc.
Onecut transcription factors are required for the second phase of development of the A13 dopaminergic nucleus in the mouse
Authors: Espana Agnès , Clotman Frédéric 
Published: November 2011

AbstractThe A13 dopaminergic nucleus belongs to the incerto‐hypothalamic area. It is thought to exert autonomous roles by integrating sensory input to autonomic, neuroendocrine, and motor output. Although its early development has been well characterized, the factors that contribute to later steps of its formation remain unknown. Transcription factors of the Onecut family have been detected in the A13 nucleus, raising the question of possible roles of these factors during A13 development. Using a combination of immunofluorescence analyses on sections and after whole‐mount labeling followed by 3D reconstructions, we further characterized the second phase of development of the A13 nucleus in the mouse, described the distribution of the Onecut proteins throughout A13 development, and analyzed the phenotype of this nucleus in single or compound mutant embryos for the Onecut factors. Here we show that A13 development can be divided into two successive phases. First, during radial migration toward the pial surface the A13 cells differentiate into dopaminergic neurons. Second, these cells gather in the vicinity of the third ventricle. Onecut factors are dynamically and differentially expressed in the A13 nucleus during these two phases of development. In Onecut mutant embryos, the A13 neurons differentiate normally but scatter in the diencephalon and fail to properly gather close to the third ventricle. Hence, Onecut factors are markers of the A13 nucleus throughout embryonic development. They are dispensable for the first phase of A13 development but are required for the second phase of development and for maintenance of this nucleus. J. Comp. Neurol. 520:1424–1441, 2012. © 2011 Wiley Periodicals, Inc.
Expression of delta‐protocadherins in the spinal cord of the chicken embryo
Authors: Lin Juntang , Wang Congrui , Redies Christoph 
Published: November 2011

AbstractProtocadherins constitute the largest subfamily of cadherin genes and are widely expressed in the nervous system. In the present study, we cloned eight members of the delta‐protocadherin subfamily of cadherins (Pcdh1, Pcdh7, Pcdh8, Pcdh9, Pcdh10, Pcdh17, Pcdh18, and Pcdh19) from the chicken, and investigated their expression in the developing chicken spinal cord by in situ hybridization. Our results showed that each of the investigated delta‐protocadherins exhibits a spatially restricted and temporally regulated pattern of expression. Pcdh1, Pcdh8, Pcdh18, and Pcdh19 are expressed in restricted dorsoventral domains of the neuroepithelial layer at early developmental stages (E2.5–E4). In the differentiating mantle layer, specific expression profiles are observed for all eight delta‐protocadherins along the dorsoventral, mediolateral, and rostrocaudal dimensions at intermediate stages of development (E6–E10). Expression profiles are especially diverse in the motor column, where different pools of motor neurons exhibit signal for subsets of delta‐protocadherins. In the dorsal root ganglion, subpopulations of cells express combinations of Pcdh1, Pcdh7, Pcdh8, Pcdh9, Pcdh10, and Pcdh17. The ventral boundary cap cells are positive for Pcdh7, Pcdh9, and Pcdh10. Signals for Pcdh8, Pcdh18, and Pcdh19 are found in the meninges. Surrounding tissues, such as the notochord, dermomyotome, and sclerotome also exhibit differential expression patterns. The highly regulated spatiotemporal expression patterns of delta‐protocadherins suggest that they have multiple and diverse functions during development of the spinal cord and its surrounding tissues. J. Comp. Neurol. 520:1509–1531, 2012. © 2011 Wiley Periodicals, Inc.
Age‐related changes in the morphology of cerebral capillaries do not correlate with cognitive decline
Authors: Peters Alan , Sethares Claire 
Published: November 2011

AbstractThe effects of age on cerebral capillaries have been examined in area 46 of the prefrontal cortices of sixteen rhesus monkeys, ranging in age from 5 to 35 years. Fourteen of the monkeys had been behaviorally tested prior to their brains being prepared for electron microscopic examination. It was found that whereas the thickness of the outer basal lamina adjacent to the glial limiting membrane increased with age and showed increasing numbers of splits, the inner basal lamina between endothelial cells and pericytes did not become thicker with age, and did not show splitting. There were also no age‐related changes in the extent of the coverage of endothelial cells by pericytes and no change in the frequency of mitochondria in endothelial cells. The factors that did change with age, namely, the thickness of the outer basal lamina and the increased numbers of splits in this lamina showed no correlations with the cognitive status of the monkeys, suggesting that thickening of the outer basal lamina does not contribute to cognitive decline. J. Comp. Neurol. 520:1339–1347, 2012. © 2011 Wiley Periodicals, Inc.
Higher brain centers for social tasks in worker ants, Camponotus japonicus
Authors: Nishikawa Michiko , Watanabe Hidehiro , Yokohari Fumio 
Published: November 2011

AbstractAnts, eusocial insects, have highly elaborate chemical communication systems using a wide variety of pheromones. In the carpenter ant, Camponotus japonicus, workers and queens have the female‐specific basiconic sensilla on antennae. The antennal lobe, the primary processing center, in female carpenter ants contains about 480 glomeruli, which are divided into seven groups (T1–T7 glomeruli) based on sensory afferent tracts. The axons of sensory neurons in basiconic sensilla are thought to project to female‐specific T6 glomeruli. Therefore, these sensilla and glomeruli are thought to relate to female‐specific social tasks in the ants. By using dye filling into local neurons (LNs) and projection neurons (PNs) in the antennal lobe, we neuroanatomically revealed the existence of an isolated processing system for signals probably relating to social tasks in the worker ant. In the antennal lobe, two categories of glomeruli, T6 glomeruli and non‐T6 glomeruli, are clearly segregated by LNs. Furthermore, axon terminals of uniglomerular PNs from the respective categories of glomeruli (T6 uni‐PNs and non‐T6 uni‐PNs) are also segregated in the secondary olfactory centers, the calyces of the mushroom body and the lateral horn: T6 uni‐PNs terminate in the outer layers of the basal ring and lip of mushroom body calyces and in the posterior region of the lateral horn, whereas non‐T6 uni‐PNs terminate in the middle and inner layers of the basal ring and lip and in the anterior region of the lateral horn. These findings suggest that information probably relating to social tasks might be isolated from other olfactory information and processed in a separate subsystem. J. Comp. Neurol. 520:1584–1598, 2012. © 2011 Wiley Periodicals, Inc.
Frequency and prognostic impact of the aberrant CD8 expression in 5,523 patients with chronic lymphocytic leukemia
Authors: Kern Wolfgang , Bacher Ulrike , Haferlach Claudia , Alpermann Tamara , Dicker Frank , Schnittger Susanne , Haferlach Torsten 
Published: November 2011

AbstractBackground:In patients with chronic lymphocytic leukemia (CLL), aberrant expression of the T‐lineage antigen CD8 was reported in low frequencies. The clinical impact of this phenomenon remains in discussion.Methods:We analyzed 5,523 patients with CLL (21–97 years) by multiparametric flow cytometry and performed fluorescence in situ hybridization (FISH), immunoglobulin heavy chain variable (IGHV) region mutational status analysis, and clinical outcome studies.Results:CD8 was positive in 61/5,523 (1.1%) patients. ZAP‐70 expression amounted to a mean of 25.4% in CD8‐positive vs. 28.2% in CD8‐negative cases (n.s.), CD38 expression to a mean of 38.6% vs. 34.0% (n.s.). Cytogenetic alterations did not differ significantly [CD8‐positive vs. CD8‐negative: 13q deletion: 24/36 (66.7%) vs. 2,015/3,368 (59.8%); trisomy 12:7/35 (20.0%) vs. 487/3,357 (14.5%); 11q deletion: 6/35 (17.1%) vs. 360/3,354 (10.7%)]. A mutated IGHV status showed similar frequency in CD8‐positive and CD8‐negative cases (31/44; 70.5% vs. 1,700/2,816; 60.4%; n.s.). CD8‐positive patients had a shorter median time to treatment compared with CD8‐negative patients (12.0 vs. 77.1 months, P = 0.008). In univariable Cox analysis, CD8‐positivity adversely influenced median TTT (P = 0.011). In multivariable analysis, the strongest parameters were hemoglobin level and mutated IGHV status (P < 0.001 for both) but CD8‐positivity was still relevant (P = 0.074).Conclusions:This study confirms that CD8 expression is a recurrent albeit rare phenomenon in patients with CLL and suggests that CD8 expression has an adverse prognostic impact. Therefore, CD8 expression should be further investigated for its potential to contribute to risk stratification in patients with CLL. © 2011 International Clinical Cytometry Society
Medullary thyroid carcinoma in a patient with Hashimoto's thyroiditis diagnosed by calcitonin washout from a thyroid nodule
Authors: Mousa Umut , Gursoy Alptekin , Ozdemir Handan , Moray Gokhan 
Published: November 2011

AbstractSerum calcitonin is a tumor marker used in the diagnosis and follow‐up of medullary thyroid carcinoma. Calcitonin washout evaluation is a new method used for suspicious thyroid nodules and lymph nodes. Limited clinical data are present about the efficacy of this method. A 61‐year‐old female patient with known Hashimoto's thyroditis and an 8‐mm hypoechoic nodule was presented with one previously benign fine‐needle aspiration cytology (FNAC). On referral to our department, she had a moderately high‐serum calcitonin level, and we repeated the FNAC that was reported as nondiagnostic. We performed FNAC for the third time together with calcitonin washout evaluation from the thyroid nodule. The FNAC was again nondiagnostic, but the calcitonin washout level from the thyroid nodule was 152.569 pg/mL. Total thyroidectomy was performed, and the diagnosis was confirmed as medullary thyroid carcinoma. Calcitonin washout evaluation may be a useful method in the differential diagnosis of patients with thyroid nodules having moderately high‐serum calcitonin levels. Diagn. Cytopathol. 2013. © 2011 Wiley Periodicals, Inc.