bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐platelet therapy and managing ulcer risk
Authors: Chan Francis K L 
Published: December 2011

AbstractLow‐dose aspirin (ASA) has emerged as one of the most important causes of peptic ulcer bleeding in developed countries. Among the risk factors of ASA‐associated ulcer bleeding, Helicobacter pylori infection is one of the few that is treatable. Recent evidence showed that among patients with a history of ASA‐associated ulcer bleeding, the long‐term incidence of recurrent bleeding with ASA use is low after eradication of H. pylori alone. Thus, test‐and‐treat H. pylori is a potentially useful strategy for ASA users with high ulcer risk. However, the risk of bleeding is further increased by combining other anti‐platelet drugs (e.g. clopidogrel) with ASA in acute coronary syndromes and coronary stent placement. There is good evidence that co‐therapy with a proton‐pump inhibitor (PPI) reduces upper gastrointestinal bleeding with ASA alone or dual anti‐platelet therapy. Recently, several meta‐analyses of observational studies found that concurrent use of PPI and clopidogrel was associated with increased risk of major adverse cardiovascular events. Overall, the evidence does not suggest a clinically important interaction between PPIs and clopidogrel. However, there is a subset of patients who have reduced conversion of clopidogrel to its active metabolites due to genetic polymorphism of hepatic P‐450 (carriers of CYP2C19 loss‐of‐function alleles). Since PPIs are also metabolized by similar hepatic enzymes, it is uncertain whether patients carrying CY2C19 loss‐of‐function alleles are susceptible to concomitant PPI use. In the future, management of patients on dual anti‐platelet therapy needs to be individualized according to their thrombotic and bleeding risks.
Effect of endoscopic screening at 1‐year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea
Authors: Yoon Hyuk , Kim Nayoung , Lee Hye Seung , Shin Cheol Min , Park Young Soo , Lee Dong Ho , Park Do Joong , Kim Hyung Ho , Jung Hyun Chae 
Published: December 2011

AbstractBackground and Aim:  The recommended interval of endoscopic screening for gastric cancer (GC) in a general population is 2 years in Korea. However, it has not been determined whether endoscopic screening with a shorter interval is beneficial, especially for high‐risk groups.Methods:  A total of 415 patients with GC were categorized according to whether they had (vigilant screening group) or not (non‐vigilant screening group) undergone endoscopic screening within 1 year before being diagnosed with GC. Clinicopathologic GC characteristics of the two groups were compared. Next, the same analyses were conducted in subgroups of patients with high risk for GC including males, current smokers, first‐degree relatives of GC; and patients with Helicobacter pylori infection, gastric atrophy, or intestinal metaplasia (IM).Results:  The proportion of vigilant screening patients was 36.1%. Early gastric cancer (EGC) was more frequently observed in the vigilant screening group than the non‐vigilant screening group (62.7% vs 49.4%, P = 0.009). In the high‐risk factor analyses, EGC was more frequently detected among patients with severe IM in the vigilant screening group than the non‐vigilant screening group (66.7% vs 35.5%, P = 0.047). In addition, more patients in the vigilant screening group had undergone endoscopic submucosal dissection (ESD; 26.7% vs 0%, P = 0.008) and had stage I (84.6% vs 41.7%, P = 0.012) than in the non‐vigilant screening group.Conclusions:  Endoscopic screening for GC at 1‐year intervals would be beneficial for patients with severe IM in South Korea; this method could detect EGC for which the curative modality would be ESD.
Risk factors for perforation and delayed bleeding associated with endoscopic submucosal dissection for early gastric neoplasms: Analysis of 1123 lesions
Authors: Toyokawa Tatsuya , Inaba Tomoki , Omote Shizuma , Okamoto Akiko , Miyasaka Rika , Watanabe Kazuo , Izumikawa Koichi , Horii Joichiro , Fujita Isao , Ishikawa Shigenao , Morikawa Tamiya , Murakami Takako , Tomoda Jun 
Published: December 2011

AbstractBackground and Aim:  Endoscopic submucosal dissection (ESD) is a useful procedure for the treatment of early gastric neoplasms; however, this advanced technique has also resulted in an increase in serious complications such as perforation and delayed bleeding. This study aimed to elucidate the risk factors for these complications.Methods:  A total of 1123 lesions diagnosed with early gastric neoplasms and treated by ESD at three institutions were investigated. Retrospectively, patients with or without these complications were compared on the basis of the patient characteristics and treatment results.Results:  Perforation occurred in 27 lesions (2.4%) and delayed bleeding in 56 lesions (5.0%). Multivariate analysis indicated that lesions located in the upper area of the stomach (odds ratio [OR]: 4.88, 95% confidence interval [CI]: 2.21–10.75) was associated with a significantly higher risk of perforation, and that age ≥ 80 years (OR: 2.15, 95% CI: 1.18–3.90) and a long procedure time (OR: 1.01, 95% CI: 1.001–1.007) were associated with a significantly higher risk of delayed bleeding after ESD. The en bloc resection rate (74% vs 94%) and curative resection rate (48% vs 85%) of lesions with perforation were significantly lower than those without perforation. The rate of residual disease or recurrence after ESD was significantly higher in lesions with delayed bleeding than that without delayed bleeding (5.4% vs 0.84%).Conclusions:  This study demonstrated risk factors for perforation and delayed bleeding associated with ESD. Furthermore, it was clarified that perforation and delayed bleeding influenced post‐procedure results and prognosis after ESD.
T. Philip Ayre and the T Piece
Authors: Brown Thomas C.K. 
Published: December 2011

There are some names that are well known in pediatric anesthesia but who were these people? For 60 years before work stations appeared, the Ayre’s T Piece was widely used. Appropriately initialed, T.P. Ayre (Philip) (Figure 1) was a Newcastle anesthetist who gave several hundred anesthetics as a student, so it was natural that he should become an anesthetist. Ayre’s T Piece was developed about 1937. It allowed fresh gas to be delivered to an endotracheal tube, allowing the anesthetist to be distanced from the operative field. The original T Piece was derived from part of a Phillips airway, which Ayre had been using. It had a bend in the side arm within the lumen of the connecting tube so that the gas could be delivered flowing toward or away from the patient. Ayre soon realized that patients did better when the flow was directed toward the patient. He thought that this aided inspiration. More importantly, although he may not have understood the reason, it kept the airways open preventing alveolar collapse and a reduction in functional residual capacity (FRC). This was unwittingly the first step in the development of the use of positive end expiratory pressure (PEEP). However, when it came to manufacturing the T piece, the makers preferred the simplicity of a tube attached at right angles to the airway (Figure 2), and hence, the advantage was lost until an angled side arm was developed. T. Philip Ayre.image The golden Ayre’s T Piece presented to him on retirement.image
European Union Economies Facing ‘Baumol's Disease’ within the Service Sector*
Authors: FERNANDEZ RAFAEL , PALAZUELOS ENRIQUE 
Published: December 2011

AbstractThis article analyzes the productivity of the service sector within the countries of the European Union during the period 1994–2005. After disaggregating the sector into 11 branches, the article quantifies the relative contribution of each branch to the growth of service sector aggregate productivity. The main conclusion is that the structure of the industry is increasingly dependent on those branches which have lower growth in labour productivity. This conclusion reveals that the EU service sector suffers from ‘Baumol's disease’, which helps to accentuate the slow productivity growth that characterizes this sector.
Modulation of glutamate release from parallel fibers by mGlu4 and pre‐synaptic GABAA receptors
Authors: Antflick Jordan E. , Hampson David R. 
Published: December 2011

J. Neurochem. (2012) 120, 552–563.AbstractThe regulation of pre‐synaptic glutamate release is important in the maintenance and fidelity of excitatory transmission in the nervous system. In this study, we report a novel interaction between a ligand‐gated ion channel and a G‐protein coupled receptor which regulates glutamate release from parallel fiber axon terminals. Immunocytochemical analysis revealed that GABAA receptors and the high affinity group III metabotropic glutamate receptor subtype 4 (mGlu4) are co‐localized on glutamatergic parallel fiber axon terminals in the cerebellum. GABAA and mGlu4 receptors were also found to co‐immunoprecipitate from cerebellar membranes. Independently, these two receptors have opposing roles on glutamate release: pre‐synaptic GABAA receptors promote, while mGlu4 receptors inhibit, glutamate release. However, coincident activation of GABAA receptors with muscimol and mGlu4 with the agonist (2S)‐S‐2‐amino‐4‐phosphonobutanoic acid , increased glutamate release from [3H]glutamate‐loaded cerebellar synaptosomes above that observed with muscimol alone. Further support for an interaction between GABAA and mGlu4 receptors was obtained in the mGlu4 knockout mouse which displayed reduced binding of the GABAA ligand [35S]tert‐butylbicyclophosphorothionate, and decreased expression of the α1, α6, β2 GABAA receptor subunits in the cerebellum. Taken together, our data suggest a new role for mGlu4 whereby simultaneous activation with GABAA receptors acts to amplify glutamate release at parallel fiber‐Purkinje cell synapses.
Leaching of nitrate and phosphorus after autumn and spring application of separated solid animal manures to winter wheat
Authors: Sørensen P. , RubÆk G. H. 
Published: December 2011

AbstractAnimal slurry can be separated into solid and liquid manure fractions to facilitate the transport of nutrients from livestock farms. In Denmark, untreated slurry is normally applied in spring whereas the solid fraction may be applied in autumn, causing increased risk of nitrate and phosphorus (P) leaching. We studied the leaching of nitrate and P in lysimeters with winter wheat crops (Triticum aestivum L.) after autumn incorporation versus spring surface application of solid manure fractions, and we compared also spring applications of mineral N fertilizer and pig slurry. Leaching was compared on a loamy sand and a sandy loam soil. The leaching experiment lasted for 2 yr, and the whole experiment was replicated twice. Nitrate leaching was generally low (19–34 kg N/ha) after spring applications of mineral fertilizer and manures. Nitrate leaching increased significantly after autumn application of the solid manures, and the extra nitrate leached was equivalent to 23–35% of total manure N and corresponded to the ammonium content of the manures. After spring application of solid manures and pig slurry, only a slight rise in N leaching was observed during the following autumn/winter (<5% of total manure N). Total P leaching was 40–165 g P/ha/yr, and the application of solid manure in autumn did not increase P leaching. The nitrogen fertilizer replacement value of solid manure N was similar after autumn and spring application (17–32% of total N). We conclude that from an environmental perspective, solid manure fractions should not be applied to winter wheat on sandy and sandy loam soils under humid North European conditions.
The GPCR OGR1 (GPR68) mediates diverse signalling and contraction of airway smooth muscle in response to small reductions in extracellular pH
Authors: Saxena H , Deshpande DA , Tiegs BC , Yan H , Battafarano RJ , Burrows WM , Damera G , Panettieri RA , DuBose Jr TD , An SS , Penn RB 
Published: December 2011

BACKGROUND AND PURPOSEPrevious studies have linked a reduction in pH in airway, caused by either environmental factors, microaspiration of gastric acid or inflammation, with airway smooth muscle (ASM) contraction and increased airway resistance. Neural mechanisms have been shown to mediate airway contraction in response to reductions in airway pH to < 6.5; whether reduced extracellular pH (pHo) has direct effects on ASM is unknown.EXPERIMENTAL APPROACHIntracellular signalling events stimulated by reduced pHo in human cultured ASM cells were examined by immunoblotting, phosphoinositide hydrolysis and calcium mobilization assays. ASM cell contractile state was examined using magnetic twisting cytometry. The expression of putative proton‐sensing GPCRs in ASM was assessed by real‐time PCR. The role of ovarian cancer G protein‐coupled receptor 1 (OGR1 or GPR68) in acid‐induced ASM signalling and contraction was assessed in cultures subjected to siRNA‐mediated OGR1 knockdown.KEY RESULTSASM cells responded to incremental reductions in pHo (from pH 8.0 to pH 6.8) by activating multiple signalling pathways, involving p42/p44, PKB, PKA and calcium mobilization. Coincidently, ASM cells contracted in response to decreased pHo with similar ‘dose’‐dependence. Real‐time PCR suggested OGR1 was the only proton‐sensing GPCR expressed in ASM cells. Both acid‐induced signalling (with the exception of PKB activation) and contraction were significantly attenuated by knockdown of OGR1.CONCLUSIONS AND IMPLICATIONSThese studies reveal OGR1 to be a physiologically relevant GPCR in ASM cells, capable of pleiotropic signalling and mediating contraction in response to small reductions in extracellular pH. Accordingly, ASM OGR1 may contribute to asthma pathology and represent a therapeutic target in obstructive lung diseases.
Factors Associated with Improvement in Guideline‐Based Use of ICDs in Eligible Heart Failure Patients
Authors: MEHRA MANDEEP R. , ALBERT NANCY M. , CURTIS ANNE B. , GHEORGHIADE MIHAI , HEYWOOD J. THOMAS , LIU YANG , O’CONNOR CHRISTOPHER M. , REYNOLDS DWIGHT , WALSH MARY NORINE , YANCY CLYDE W. , FONAROW GREGG C. 
Published: December 2011

Background: IMPROVE HF, a 24‐month performance improvement initiative for outpatient cardiology and multispecialty practices, demonstrated significant improvement in guideline‐based use of implantable cardioverter‐defibrillators (ICDs) for patients with heart failure (HF). We investigated patient, physician, and practice factors associated with improvements in ICD use.
Methods: Patients with HF or postmyocardial infarction (MI) left ventricular systolic dysfunction who met eligibility criteria for ICDs at baseline and 24 months were analyzed. Multivariate analyses were performed to identify patient, physician, and practice characteristics associated with greater improvement in ICD therapy rates from baseline to 24 months.
Results: There were 4,058 patients eligible for ICD therapy at baseline and 24 months, with 2,600 (64.1%) treated at baseline and 3,361 (82.8%) treated at 24 months (+18.7%, P < 0.001). Practice heterogeneity in ICD use was significantly decreased after implementation of the performance improvement initiative. Characteristics independently associated with improvement in use of ICD therapy included race, history of MI, presence of edema, QRS duration, months since last measured left ventricular ejection fraction, and number of physicians in the practice. Improvement in ICD use was independent of other patient, physician, and practice characteristics, including age and sex.
Conclusions: The IMPROVE HF performance improvement initiative was associated with substantially improved adherence to guideline‐recommended ICD therapy. Certain patient and practice characteristics, including race, history of MI, edema, QRS duration, and number of physicians in the practice, were independently associated with improvement in ICD use. These findings highlight the need for ongoing quality improvement monitoring and performance improvement activities. (PACE 2012; 35:135–145)
Spectrophotometric assessment of peri‐implant mucosa after restoration with zirconia abutments veneered with fluorescent ceramic: a controlled, retrospective clinical study
Authors: Happe Arndt , Schulte‐Mattler Verena , Fickl Stefan , Naumann Michael , Zöller Joachim E , Rothamel Daniel 
Published: December 2011

AbstractObjectivesThe purpose of this study was to investigate the optical appearance of the soft tissue labial to dental implants restored with fluorescent ceramic‐veneered zircona abutments. It was hypothesized that the tested abutment design leads to an increased brightness in the marginal peri‐implant tissue, which does not differ from that of natural teeth. Moreover, a reduction of the color difference that has been reported from other abutment materials was expected.Materials and methodsA total of 12 patients with single titanium implants in the maxillary anterior region were recruited. All implants (N = 12) were restored with zirconia abutments veneered with fluorescent ceramic and full‐ceramic crowns. Color measurements of the peri‐implant mucosa at the test sites were made of the facial aspect of the teeth using a Spectroshade‐spectrophotometer. The gingiva of a contralateral or adjacent natural tooth served as a control.Color data (CIE‐L*a*b*color coordinates) were obtained in five incremental areas of 1 × 2 mm in both test and control sites.∆E‐values were calculated from theΔL*,Δa*andΔb*values for each patient.ResultsData acquisition from the test site demonstrated lower mean values ofL*,a*andb*than the control site. Statistical significance between the test site and control site was reached in theL*values only in the second of the five incremental areas (P < 0.05, Wilcoxon test). However, discrepancies ina*‐andb*‐values reached a statistically significant difference in the incremental areas 1, 2 and 4, and inb* in area 5 (P < 0.05, Wilcoxon test). Medians of the∆E‐values in all five increments were found to be higher than the clinical perceptual threshold of 3.7. However, considering the original data, five individual patients did not reach the threshold in increment 1 and 2, two in increment 3 and three in increment 4. None of the patients showed lower∆E‐values than the perceptual threshold of 3.7 in increment 5, which had the largest distance from the gingival margin.ConclusionThe tested abutment design leads to a peri‐implant soft tissue color that, in the critical marginal area, in five of 12 patients did not statistically differ from the tissue of the gingiva of natural teeth. Particularly, the brightness of the peri‐implant soft‐tissue seemed to be more adapted to the natural situation using a fluorescent abutment design.
Synergistic induction of periodontal tissue regeneration by binary application of human osteogenic protein‐1 and human transforming growth factor‐β3 in Class II furcation defects of Papio ursinus
Authors: Teare J. A. , Petit J.‐C. , Ripamonti U. 
Published: December 2011

Teare JA, Petit J‐C, Ripamonti U. Synergistic induction of periodontal tissue regeneration by binary application of human osteogenic protein‐1 and human transforming growth factor‐β

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in Class II furcation defects of Papio ursinus. J Periodont Res 2012; 47: 336–344. © 2011 John Wiley & Sons A/SBackground and Objective:  Binary applications of recombinant human osteogenic protein‐1 (hOP‐1) and transforming growth factor‐β3 (hTGF‐β3) synergize to induce pronounced bone formation. To induce periodontal tissue regeneration, binary applications of hOP‐1 and hTGF‐β3 were implanted in Class II furcation defects of the Chacma baboon, Papio ursinus.Material and Methods:  Defects were created bilaterally in the furcation of the first and second mandibular molars of three adult baboons. Single applications of 25 μg hOP‐1 and 75 μg hTGF‐β3 in Matrigel® matrix were compared with 20:1 binary applications, i.e. 25 μg hOP‐1 and 1.25 μg hTGF‐β3. Morcellated fragments of autogenous rectus abdominis striated muscle were added to binary applications. Sixty days after implantation, the animals were killed and the operated tissues harvested en bloc. Undecalcified sections were studied by light microscopy, and regenerated tissue was assessed by measuring volume and height of newly formed alveolar bone and cementum.Results:  The hOP‐1 and hTGF‐β3 induced periodontal tissue regeneration and cementogenesis. Qualitative morphological analysis of binary applications showed clear evidence for considerable periodontal tissue regeneration. Quantitatively, the differences in the histomorphometric values did not reach statistical significance for the group size chosen for this primate study. The addition of morcellated muscle fragments did not enhance tissue regeneration. Binary applications showed rapid expansion of the newly formed bone against the root surfaces following fibrovascular tissue induction in the centre of the treated defects.Conclusion:  Binary applications of hOP‐1and hTGF‐β3 in Matrigel® matrix in Class II furcation defects of P. ursinus induced substantial periodontal tissue regeneration, which was tempered, however, by the anatomy of the furcation defect model, which does not allow for the rapid growth and expansion of the synergistic induction of bone formation, particularly when additionally treated with responding myoblastic stem cells.
Visual and confocal microscopic interpretation of patch tests to benzethonium chloride and benzalkonium chloride
Authors: Benjamin Bohaty , Chris Fricker , Salvador González , Melissa Gill , Susan Nedorost 
Published: December 2011

BackgroundQuaternary ammonium compounds (Quats), such as benzalkonium chloride (BAC) and benzethonium chloride (BEC), are widely used as antibacterial active ingredients and preservatives in personal care products, disinfectants, and ophthalmic preparations. BAC is known to be a marginal irritant when patch tested at 0.15% aq. Data on BEC are limited.ObjectiveTo differentiate irritant from allergic patch test reactions to quaternary ammonium compounds.MethodsEight subjects who were considered likely to react based on history of rash after exposure to disinfectants or a history of prior positive patch test to BAC were recruited, as well as two patients undergoing routine patch testing. BAC (0.15% aq), BAC (0.15% pet), BEC (0.05% aq), BEC (0.15% pet), BEC (0.15% aq), BEC (0.5% aq), sodium lauryl sulfate (2.0%), and deionized water were applied under Finn chambers for 48 h. Four days and 7 days after application, the sites were examined visually and then by in vivo reflectance confocal microscopy (RCM) which was interpreted by blinded experts.ResultsTwo patients with definite allergic reactions according to visual patch test reads and RCM were clinically relevant. Cross‐reaction between BEC and BAC was demonstrated in one patient. RCM imaging correlated well with clinical scoring and interpretation of patch test reactions in terms of irritancy vs. allergy for BEC and BAC.ConclusionRelevant allergic reactions to quats occur in humans. Possible cross‐reaction was noted to occur between BAC and BEC. RCM appears to be a useful tool in distinguishing between irritancy and sensitization during patch testing to BAC and BEC. Further study of prevalence and best test concentration and vehicle is needed.