bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial
Authors: Andersen Christoffer H , Andersen Lars L , Gram Bibi , Pedersen Mogens Theisen , Mortensen Ole Steen , Zebis Mette Kreutzfeldt , Sjøgaard Gisela 
Published: June 2012

BackgroundSpecific strength training can reduce neck and shoulder pain in office workers, but the optimal combination of exercise frequency and duration remains unknown. This study investigates how one weekly hour of strength training for the neck and shoulder muscles is most effectively distributed.MethodsA total of 447 office workers with and without neck and/or shoulder pain were randomly allocated at the cluster-level to one of four groups; 1×60 (1WS), 3×20 (3WS) or 9×7 (9WS) min a week of supervised high-intensity strength training for 20 weeks, or to a reference group without training (REF). Primary outcome was self-reported neck and shoulder pain (scale 0–9) and secondary outcome work disability (Disability in Arms, Shoulders and Hands (DASH)).ResultsThe intention-to-treat analysis showed reduced neck and right shoulder pain in the training groups after 20 weeks compared with REF. Among those with pain ≥3 at baseline (n=256), all three training groups achieved significant reduction in neck pain compared with REF (p<0.01). From a baseline pain rating of 3.2 (SD 2.3) in the neck among neck cases, 1WS experienced a reduction of 1.14 (95% CI 0.17 to 2.10), 3WS 1.88 (0.90 to 2.87) and 9WS 1.35 (0.24 to 2.46) which is considered clinically significant. DASH was reduced in 1WS and 3WS only.ConclusionOne hour of specific strength training effectively reduced neck and shoulder pain in office workers. Although the three contrasting training groups showed no statistical differences in neck pain reduction, only 1WS and 3WS reduced DASH. This study suggests some flexibility regarding time-wise distribution when implementing specific strength training at the workplace.
Using systematic change management to improve emergency patients' access to specialist care: the Big Squeeze
Authors: Rafman Heidi , Lim Siang Ngin , Quek Swee Chye , Mahadevan Malcolm , Lim Chanelle , Lim Aymeric 
Published: June 2012

BackgroundDelayed access to specialist care for emergency patients is associated with increased risk of morbidity and mortality, and increased patient anxiety.Objectives(1) To provide timelier access to inpatient and urgent outpatient specialist care for emergency patients. (2) To influence multiple stakeholders to modify their traditional practices and sustain changes.SettingNational University Hospital of Singapore, an academic medical centre with 997 beds in Singapore and over 34 sub-specialties.MethodsA set of six interventions was implemented to meet three goals: (1) provide timely access to urgent outpatient specialist care requested by the emergency department ED; (2) increase early inpatient discharges (in order to better match timing of emergency admissions); and (3) provide earlier defined care by inpatient specialists at the ED. An eight-step organisational change management plan was implemented to ensure all specialties complied with the changes.ResultsThe goals were achieved. (1) Specialist outpatient appointments given within the timeframe requested by the ED doctor increased from 51.7% to 80.8%. (2) Early discharges increased from 11.9% to 26.6% and were sustained at 27.2%. (3) 84% of eligible patients received earlier defined specialist care at the ED. The change management achieved excellent clinician compliance rates ranging from 84% to 100%. However the median wait for admission remained unchanged.ConclusionThe interventions reduced the time for ED patients to access specialist outpatient and inpatient care. The systematic organisational change management approach resulted in sustained compliance.
The epidemiology of adults with severe sepsis and septic shock in Scottish emergency departments
Authors: Gray Alasdair , Ward Kirsty , Lees Fiona , Dewar Colin , Dickie Sarah , McGuffie Crawford ,   On behalf of the STAG steering committee
Published: June 2012

BackgroundThe Surviving Sepsis Campaign (SSC) promotes a bundle approach to the care of septic patients to improve outcome. Some have questioned the capability of delivering the bundle in emergency departments (EDs). The authors report the epidemiology and 6 h bundle compliance of patients with severe sepsis/septic shock presenting to Scottish EDs.MethodsAnalysis of the previously reported Scottish Trauma Audit Group sepsis database was performed including 20 mainland Scottish EDs. A total of 308 910 attendances were screened (between 2 March and 31 May 2009), and 5285 of 27 046 patients were identified after case note review and included on the database. This analysis includes patients who had severe sepsis/septic shock before leaving the ED. Epidemiological, severity of illness criteria, and ED management data were analysed.Results626 patients (median age 73; M/F ratio 1:1; 637 presentations) met entrance criteria. The median number of cases per site was 16 (range 3–103). 561 (88.1%) patients arrived by ambulance. The most common source of infection was the respiratory tract (n=411, 64.5%) The most common physiological derangements were heart rate (n=523, 82.1%), respiratory rate (n=452, 71%) and white cell count (n=432, 67.8%). The median hospital stay was 9 days (IQR 4–17 days). 201 (31.6%) patients were admitted to critical care within 2 days, 130 (20.4%) directly from the ED. 180 patients (28.3%) died. There was poor compliance with all aspect of the SSC resuscitation bundle.ConclusionsSepsis presentations are of variable frequency but have typical epidemiology and clinical outcomes. SSC bundle resuscitation uptake is poor in Scottish EDs.
Emergent stent-assisted angioplasty of extracranial internal carotid artery and intracranial stent-based thrombectomy in acute tandem occlusive disease: technical considerations
Authors: Cohen José E , Gomori Moshe , Rajz Gustavo , Moscovici Samuel , Leker Ronen R , Rosenberg Shai , Itshayek Eyal 
Published: June 2012

ObjectiveTandem occlusions of the internal carotid artery (ICA) and a major intracranial artery respond poorly to intravenous thrombolytic therapy, and are usually managed by endovascular means. This study describes experience with stent-assisted endovascular ICA revascularization and stent-based thrombectomy.MethodsIn patients with tandem ICA–middle cerebral artery (MCA)/distal ICA occlusion, the carotid occlusion was recanalized by primary angioplasty and stent implantation, and the distal occlusion by stent-based thrombectomy. Two variant techniques are described.ResultsSeven consecutive patients, mean age 64.1 years (range 49–75) and mean admission National Institutes of Health Stroke Scale score of 23, were included. Occlusion sites were tandem proximal ICA and MCA trunk (six patients) and tandem proximal left ICA and ICA terminus (one patient). Complete recanalization with complete perfusion (Thrombolysis in Myocardial Infarction [TIMI] 3, Thrombolysis in Cerebral Infarction [TICI] 3) was achieved in six patients and partial recanalization with partial perfusion (TIMI 2, TICI 2A) in one. Mean time to therapy was 4.9 h (range 3–6.5); mean time to recanalization was 55 min (range 38–65 min). CT performed 1 day after recanalization showed cortical sparing (>90% of the cortex at risk) in seven patients. Five patients (72%) presented with good clinical outcome (modified Rankin Scale (mRS) score 0–2) at 1 month; one patient (patient No 7) reached an mRS score of 3 and one patient died.ConclusionsIn selected cases of acute ICA occlusion and concomitant major vessel embolic stroke, angioplasty and stenting of the proximal occlusion and stent-based thrombectomy of the intracranial occlusion may be feasible, effective and safe, and provide early neurological improvement. Further experience and prospective studies are warranted.
Knowledge, attitudes, sexual practices and STI/HIV prevalence in male sex workers and other men who have sex in Tel Aviv, Israel: a cross-sectional study
Authors: Mor Zohar , Dan Michael 
Published: June 2012

ObjectiveTo explore knowledge, attitudes and sexual practices of male sex workers (MSW) in Tel Aviv in comparison with men who have sex with men (MSM) classified by their risk behaviours and to outline attributes related to sexually transmitted infections (STI)/HIV prevalence.MethodsMSW were recruited for this cross-sectional study from designated street venues and gay-dating internet site. MSM were recruited from gay-related venues and divided into high-risk MSM (HRMSM) if they performed unprotected anal intercourse in the last 6 months with an HIV-discordant/unknown partner and to low-risk MSM (LRMSM). Each participant completed a questionnaire and was tested for STI/HIV.ResultsOf 87 MSW and 635 MSM approached, 53 (60.9%) and 235 (37.0%) participated, respectively. Street-MSW (N=32) had more female sex partners and were more drug dependent than internet-MSW (N=21). No differences were found in their knowledge regarding STI/HIV transmission, practices and STI/HIV burden. Compared with HRMSM, MSW had different demographic attributes and demonstrated more realistic perception regarding the risk to getting STI/HIV, while no differences were found in their knowledge and sexual practices. STI burden among MSW, HRMSM (N=119) and LRMSM (N=116) were 28.3%, 23.5% and 10.3% (p=0.009) and HIV burden among MSW, HRMSM and LRMSM were 5.6%, 9.2% and 0%, (p=0.001), respectively. Multivariate models evaluating attributes associated with HIV/STI diagnosis did not find sex work to be significant if the variable used was MSW versus HRMSM, regardless of the adjustments performed. However, when MSW versus LRMSM was used in the model, sex work was associated with STI/HIV diagnosis.ConclusionsStreet-MSW and internet-MSW, similar to all MSW and HRMSM, had comparable sexual practices and had no difference in their STI/HIV prevalence.
Reaching black men who have sex with men: a comparison between respondent-driven sampling and time-location sampling
Authors: Wei Chongyi , McFarland Willi , Colfax Grant N , Fuqua Vincent , Raymond H Fisher 
Published: June 2012

ObjectivesThe authors explored whether respondent-driven sampling (RDS) can generate a more diverse sample of black men who have sex with men (MSM) than time-location sampling (TLS) by comparing sample characteristics accrued by each method in two independent studies.MethodsThe first study exclusively recruited black MSM through RDS (N=256), while the second recruited MSM through TLS including a subsample of black MSM (N=69). Crude and adjusted point estimates and 95% CIs were calculated for socio-demographic and behavioural characteristics, HIV prevalence and prevalence of unrecognised infections, and were compared using the Z-test.ResultsThe samples differed significantly regarding all socio-demographic and some behavioural characteristics. Compared with TLS, RDS estimated higher proportions of older, less educated, poorer, currently homeless and self-identified bisexual black MSM. Participants in RDS were less likely to have a main partner, had fewer male partners, were more likely to have a female partner and have both male and female partners, and reported greater methamphetamine, crack and heroin use. Prevalence of HIV and unrecognised infections were slightly higher among RDS participants.ConclusionsThe RDS sample comprised black MSM who were more diverse with respect to socio-demographic characteristics and may also be at higher risk for HIV. Thus, RDS has advantages in reaching higher risk black MSM who are most hidden from intervention research and service delivery. Future studies of black MSM using RDS could use steering strategies to recruit younger participants and other subgroups of greatest interest to public health and prevention.
Madagascar: A History of Arrivals, What Happened, and Will Happen Next
Authors: Dewar Robert E. , Richard Alison F. 
Published: July 2012

Most of the ancestors of today's human and animal populations reached Madagascar over the last 65 million years, by a variety of routes at a variety of times. Settlers encountered a big, isolated island with an unpredictable climate and a wide array of landscapes. Although patterns of diversification were driven by different mechanisms in humans and animals, the complex interplay between historical contingency and responsiveness to local conditions is evident in both.Global climate change will affect Madagascar, although exactly how remains unclear, and the immediate impact of human activity on the island is overtaking that of gradual global change. Three themes in this review bear on the future: the continuing impact of recent, cataclysmic events on modern communities of people, plants, and animals; Madagascar's long and dynamic environmental history; and the complicated history of how people settled and interacted with the island's landscapes. A deeper understanding of all three can contribute to wise decision making in the coming years.
microRNA Regulatory Network Inference Identifies miR-34a as a Novel Regulator of TGF-β Signaling in Glioblastoma
Authors: Genovese Giannicola , Ergun Ayla , Shukla Sachet A. , Campos Benito , Hanna Jason , Ghosh Papia , Quayle Steven N. , Rai Kunal , Colla Simona , Ying Haoqiang , Wu Chang-Jiun , Sarkar Sharmistha , Xiao Yonghong , Zhang Jianhua , Zhang Hailei , Kwong Lawrence , Dunn Katherine , Wiedemeyer Wolf Ruprecht , Brennan Cameron , Zheng Hongwu , Rimm David L. , Collins James J. , Chin Lynda 
Published: June 2012

Abstract
Leveraging The Cancer Genome Atlas (TCGA) multidimensional data in glioblastoma, we inferred the putative regulatory network between microRNA and mRNA using the Context Likelihood of Relatedness modeling algorithm. Interrogation of the network in context of defined molecular subtypes identified 8 microRNAs with a strong discriminatory potential between proneural and mesenchymal subtypes. Integrative in silico analyses, a functional genetic screen, and experimental validation identified miR-34a as a tumor suppressor in proneural subtype glioblastoma. Mechanistically, in addition to its direct regulation of platelet-derived growth factor receptor-alpha (PDGFRA), promoter enrichment analysis of context likelihood of relatedness–inferred mRNA nodes established miR-34a as a novel regulator of a SMAD4 transcriptional network. Clinically, miR-34a expression level is shown to be prognostic, where miR-34a low-expressing glioblastomas exhibited better overall survival. This work illustrates the potential of comprehensive multidimensional cancer genomic data combined with computational and experimental models in enabling mechanistic exploration of relationships among different genetic elements across the genome space in cancer.
Significance: We illustrate here that network modeling of complex multidimensional cancer genomic data can generate a framework in which to explore the biology of cancers, leading to discovery of new pathogenetic insights as well as potential prognostic biomarkers. Specifically in glioblastoma, within the context of the global network, promoter enrichment analysis of network edges uncovered a novel regulation of TGF-β signaling via a Smad4 transcriptomic network by miR-34a. Cancer Discov; 2(8); 736–49. ©2012 AACR.
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Prevalence, Distribution, Predictors, and Outcomes of Patients With Calcified Nodules in Native Coronary Arteries
Authors: Xu Yingjia , Mintz Gary S. , Tam Anthony , McPherson John A. , Iñiguez Andrés , Fajadet Jean , Fahy Martin , Weisz Giora , De Bruyne Bernard , Serruys Patrick W. , Stone Gregg W. , Maehara Akiko 
Published: June 2012

Background—
Pathological studies suggest that calcified coronary nodules are a rare cause of thrombotic events. The frequency, distribution, predictors, and outcomes of calcified nodules have never been described.

Methods and Results—
After successful stenting in 697 patients (167 female; median age, 58.1 years) with acute coronary syndromes, 3-vessel gray-scale and virtual histology intravascular ultrasound was performed in the proximal-mid segments of all 3 coronary arteries as part of a prospective, multicenter study. On the basis of recent histological validation, an independent core laboratory identified calcified nodules as distinct calcification with an irregular, protruding, and convex luminal surface. Patients were followed up for 3 years (median). Overall, 314 calcified nodules were detected in 250 of 1573 analyzable arteries (185 of 623 patients). Thus, the prevalence of calcified nodules was 17% per artery and 30% per patient. Two or more calcified nodules were detected in 48 coronary arteries (3%) in 76 patients (12%). The calcified nodules were located <40 mm from the ostium of the coronary artery in 85% of left anterior descending arteries and 86% of left circumflex arteries, whereas calcified nodules within the right coronary arteries were evenly and more distally distributed. Patients with calcified nodules were significantly older and had more plaque volume, more thick-cap fibroatheroma, but fewer nonculprit lesion major adverse events on follow-up.

Conclusions—
Calcified nodules in untreated nonculprit coronary segments in patients with acute coronary syndromes were more prevalent than previously recognized. Although their distribution mirrored the origin of most thrombotic events, calcified nodules caused fewer major adverse events during 3 years of follow-up.
Noninvasive Magnetic Resonance Imaging Evaluation of Endothelial Permeability in Murine Atherosclerosis Using an Albumin-Binding Contrast Agent
Authors: Phinikaridou Alkystis , Andia Marcelo E. , Protti Andrea , Indermuehle Andreas , Shah Ajay , Smith Alberto , Warley Alice , Botnar René M. 
Published: June 2012

Background—

Endothelial dysfunction promotes atherosclerosis and precedes acute cardiovascular events. We investigated whether in vivo magnetic resonance imaging with the use of an albumin-binding contrast agent, gadofosveset, could detect endothelial damage associated with atherosclerosis in apolipoprotein E–deficient (ApoE
−/−
) mice. Furthermore, we tested whether magnetic resonance imaging could noninvasively assess endothelial function by measuring the endothelial-dependent vasodilation in response to acetylcholine.

Methods and Results—

ApoE
−/−
mice were imaged at 4, 8, and 12 weeks after commencement of a high-fat diet. Statin-treated ApoE
−/−
mice were scanned after 12 weeks of a high-fat diet. Wild-type mice were imaged before and 48 hours after injection of Russell's viper venom, an endothelial toxin. Delayed enhancement magnetic resonance imaging and T1 mapping of the brachiocephalic artery, 30 minutes after injection of gadofosveset, showed increased vessel wall enhancement and relaxation rate (R
1
) with progression of atherosclerosis in ApoE
−/−
(R
1
[s
−1
]: R
4 weeks
2.42±0.35, R
8 weeks
3.45±0.54, R
12 weeks
3.83±0.52) and Russell's viper venom–injected wild-type mice (R
1
=4.57±0.86). Conversely, wild-type (R
1
=2.15±0.34) and statin-treated ApoE
−/−
(R
1
=3.0±0.65) mice showed less enhancement. Uptake of gadofosveset correlated with Evans blue staining, morphological changes of endothelial cells, and widening of the cell-cell junctions, suggesting that uptake occurs in regions of increased vascular permeability. Endothelial-dependent vasomotor responses showed vasoconstriction of the arteries of the ApoE
−/−
(−22.22±7.95%) and Russell's viper venom–injected (−10.37±17.60%) mice compared with wild-type mice (32.45±12.35%). Statin treatment improved endothelium morphology and function (−8.12±8.22%).

Conclusions—
We demonstrate the noninvasive assessment of endothelial permeability and function with the use of an albumin-binding magnetic resonance contrast agent. Blood albumin leakage could be a surrogate marker for the in vivo evaluation of interventions that aim to restore the endothelium.
Cyclin-Dependent Kinase 5–Mediated Hyperphosphorylation of Sirtuin-1 Contributes to the Development of Endothelial Senescence and Atherosclerosis
Authors: Bai Bo , Liang Yan , Xu Cheng , Lee Mary Y.K. , Xu Aimin , Wu Donghai , Vanhoutte Paul M. , Wang Yu 
Published: June 2012

Background—
Endothelial senescence represents one of the major characteristics of vascular aging and promotes the development of atherosclerosis. Sirtuin-1 (SIRT1) is an NAD-dependent deacetylase possessing antiaging activities. During the occurrence of endothelial senescence, both the expression and activity of SIRT1 are downregulated. The present study was designed to investigate the molecular mechanisms contributing to the loss-of-SIRT1 function in senescent endothelial cells.

Methods and Results—
After repetitive passages, primary cultures of porcine aortic endothelial cells exhibited a severe senescence phenotype. Western blotting revealed that phosphorylation of SIRT1 at serine 47 (S47) was significantly enhanced in senescent endothelial cells. S47 phosphorylation was stimulated by agents promoting senescence and attenuated by drugs with antisenescence properties. Mutation of S47 to nonphosphorable alanine (S47A) enhanced whereas replacing S47 with phospho-mimicking aspartic acid (S47D) abolished the antisenescent, growth-promoting, and LKB1-downregulating actions of SIRT1. Phosphorylation at S47 was critically involved in the nuclear retention of SIRT1 but abolished its association with the telomeric repeat-binding factor 2–interacting protein 1. Cyclin-dependent kinase 5 (CDK5) was identified as an SIRT1 kinase modulating S47 phosphorylation. Knockdown or inhibition of CDK5 reduced the number of senescent endothelial cells, promoted nuclear exportation of SIRT1, and attenuated the expression of inflammatory genes in porcine aortic endothelial cells. The truncated regulatory subunit of CDK5, P25, accumulated in senescent porcine aortic endothelial cells and atherosclerotic aortas. Long-term treatment with roscovitine, a CDK5 inhibitor, blocked the development of cellular senescence and atherosclerosis in aortas of hypercholesterolemic apolipoprotein E–deficient mice.

Conclusion—
CDK5-mediated hyperphosphorylation of SIRT1 facilitates the development of endothelial senescence and atherosclerosis.