bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance and consistency of care in admitted trauma patients: our next great opportunity in trauma care?
Authors: Chua Wei Chong , D'Amours Scott K. , Sugrue Michael , Caldwell Erica , Brown Katherine 
Published: June 2009

AbstractFew studies have prospectively analysed the delivery of care in trauma patients. This study undertook a prospective analysis of performance and consistency of care at a Level 1 trauma centre.A 3‐month prospective study was undertaken of all admitted trauma patients at Liverpool Hospital. Data were collected on patient demographics, mechanism of injury, injury severity score (ISS), length of hospital stay, patient outcome and cause of death. Delivery of care was evaluated using 30 performance indicators and assessment of errors.Two hundred and thirty‐six consecutive major trauma patients were studied. 73.3% were male, mean age 39 years. The main mechanism of injury was road trauma in 46.2%. Mean ISS was 12 and 64 patients had an ISS ≥16. Error‐free care was delivered in 145/236 (61.4%). There were 145 errors in 91 patients (38.6%). Errors in judgement and delays in diagnosis accounted for 56/145 (38.6%) and 48/145 (33.1%), respectively. Errors occurred most commonly in the Emergency Department (ED) (48.3%), and trainees from all specialties were responsible for 67.5% of errors. There were 25 near misses detected. Three patients developed major sequelae or complications from errors. One of 13 deaths was deemed potentially preventable.This study has shown that while 61.4% of admitted trauma patients receive optimal care, errors are frequent, resulting in a spectrum of outcomes from near misses to death. The majority of errors result from the activity of unsupervised trainees and relate to errors in judgement and delays in diagnosis. Clearly, there is room for improvement of the delivery of trauma care.
Soluble Human Leukocyte Antigen class I antigen and interleukin‐12 in hepatectomized patients
Authors: Shimura Tatsuo , Morinaga Nobuhiro , Suzuki Hideki , Araki Kenichiro , Kobayashi Tsutomu , Ishizaki Masatoshi , Kuwano Hiroyuki 
Published: June 2009

AbstractBackground:  Interleukin‐12 (IL‐12) has been shown to enhance the cytotoxic activity of NK cells and CTL. IL‐12 also acts as a growth factor for activated NK, T and NKT cells. The soluble HLA class I (sHLA‐I) has been reported to bind a killer‐cell inhibitory receptor, which is expressed on the NK cell, and its signals inhibit NK cell‐mediated cytotoxicity. Effects of fresh frozen plasma (FFP) on post‐operative immune status have not yet been completely examined.Methods:  Thirty consecutive patients taking a hepatectomy were enrolled. The levels of IL‐12 and sHLA‐I were examined by enzyme‐linked immunosorbent assay.Results:  The rate of complication after hepatectomy in the FFP‐administered patients was higher than that in patients without FFP administration (P= 0.0358). Decreased IL‐12 levels after surgery in patients without FFP administration recovered to the preoperative state earlier than those in patients with FFP administration (P < 0.05). The levels of sHLA‐I in the FFP‐administered patients were higher than those in the patients without FFP administration (P < 0.05).Conclusions:  Administration of FFP, which contains sHLA‐I, affected the levels of sHLA‐I after hepatectomy. Both high levels of sHLA‐I and low levels of IL‐12 could attenuate NK activities after hepatectomy, especially when FFP would be administered.
Background luminance affects the detection of microampere currents delivered to macaque striate cortex
Authors: Tehovnik Edward J. , Slocum Warren M. 
Published: June 2009

AbstractMonkeys detect electrical microstimulation delivered to the striate cortex (area V1). We examined whether the ability of monkeys to detect such stimulation is affected by background luminance. While remaining fixated on a spot of light centered on a monitor, a monkey was required to detect a 100 ms train of electrical stimulation delivered to a site within area V1 situated from 1 to 1.5 mm below the cortical surface. A monkey signaled the delivery of stimulation by depressing a lever after which it was rewarded with a drop of apple juice. Control trials were interleaved during which time no stimulation was delivered and the monkey was rewarded for not depressing the lever. Biphasic pulses were delivered at 200 Hz and the current ranged from 2 to 30 μA using 0.2 ms anode‐first biphasic pulses. The background luminance level of the monitor could be varied from 0.005 to 148 cd/m2. It was found that, for monitor luminance levels below 10 cd/m2, the current threshold to evoke a detection response increased. We discuss the significance of this result with regard to phosphenes elicited from human V1 and in relation to visual perception.
A common molecular basis for membrane docking and functional priming of synaptic vesicles
Authors: Siksou Léa , Varoqueaux Frédérique , Pascual Olivier , Triller Antoine , Brose Nils , Marty Serge 
Published: June 2009

AbstractSoluble N‐ethylmaleimide‐sensitive factor attachment protein receptor (SNARE) complexes execute synaptic vesicle (SV) fusion. Vesicle fusion is preceded by an obligatory Munc13‐dependent priming process that conveys fusion competence to SVs by facilitating SNARE complex assembly. Ultrastructural studies after chemical fixation indicated that vesicle docking to the plasma membrane is independent of Munc13s but these results may be misleading because aldehyde fixatives modify the localization of SVs with respect to the plasma membrane. To reinvestigate the role of Munc13s in vesicle docking, cultured hippocampal slices were immobilized using high‐pressure freezing, which circumvents aldehyde artifacts. High‐pressure freezing was combined with electron tomography to reach a resolution that allows the characterization of details of SV docking in a close‐to‐native state. In control slices, docked vesicles are not hemifused with the plasma membrane but linked to it and to dense material at the active zone by small strands. In slice cultures from Munc13‐deficient mice, vesicles are not docked to the active zone plasma membrane. These results indicate that SV docking at the plasma membrane and functional priming are respective morphological and physiological manifestations of the same molecular process mediated by SNARE complexes and Munc13s.
Data sharing for pharmacokinetic studies
Authors: ANDERSON BRIAN J. , MERRY ALAN F. 
Published: June 2009

SummaryPooling data from different pediatric studies can provide a single robust pharmacokinetic analysis that allows covariate analysis and hypothesis testing. Data sharing should be driven by the altruistic purpose of improving drug understanding to the clinical benefit of children. Electronic communications have rendered the sharing of data relatively easy, and data sharing within the wider scientific community has become commonplace. Data sharing allows verification of results, save costs and time, allows new interpretation of old data, and can fulfill teaching benefits. It may stimulate cooperative competition between researchers and allow individual researchers to concentrate on unique aspects of the scientific puzzle. However, there is occasionally a reluctance to share, in part because of fear of others stealing the hard work of a research group, which may not be recognized in subsequent publications that reuse data. Providing data may require additional effort for presentation in a suitable format. Data may be abused or used for purposes other than those for which they were collected. Propriety claims may limit access to industry‐sponsored drug research. The question of who has ownership of data is contentious. Investigators often consider data they have collected to be their own property. Reputations and grants may be hinge on ownership of a data set. However, other team members, institutions, funding agencies, and the public also have a stake. The difficulties identified in the general scientific community also apply to data sharing for pediatric pharmacokinetic studies. There are few clearly established rules at present, and consideration of the issues hinges on ethical and philosophical arguments. The development of databases will depend on collaboration and cooperation and greater clarity and consensus over appropriate processes and procedures.
Anesthesia and perioperative medical management of children with spinal muscular atrophy
Authors: GRAHAM ROBERT J. , ATHIRAMAN UMESHKUMAR , LAUBACH ANJOLIE E. , SETHNA NAVIL F. 
Published: June 2009

SummaryObjective:  To describe the perioperative medical care, anesthetic considerations, and the risk of postanesthetic respiratory failure in patients with pediatric spinal muscular atrophy (SMA).Methods:  There is a retrospective chart review carried out at an urban, tertiary care pediatric hospital. All patients with ICD‐9 codes corresponding to SMA diagnoses were identified, and records screened for anesthetic and perioperative medical management. Medical records were reviewed for demographic, clinical, and outcome data.Main results:  Twenty‐five children with SMA (10 type I, 8 type II, 7 type III) accounted for 56 general and regional anesthetic cases. Twenty‐one (38%) cases had preexisting ventilator dependence. Total intravenous anesthesia with nitrous oxide was provided in 14 (25%) cases, balanced anesthesia with inhalational agents and epidural or systemic opioids were used in 41 (84%) cases, and one infant received a spinal anesthesia. Intraoperative and postoperative complications occurred in 2 (4%) and 2 (4%) cases respectively. One case required an unplanned postanesthetic intensive care unit admission, and there were two late deaths with redirection of care.Conclusions:  Perioperative care can be provided for children with SMA safely and effectively with total intravenous or inhaled anesthetics along with the judicious use of opioids to improve patient comfort without increased morbidity. Further prospective studies of standardized anesthetic and perioperative respiratory medical management in this population are required to minimize the decompensation of tenuous preoperative respiratory function.
Anesthetic management of a neonate with type IV laryngotracheo‐esophageal cleft
Authors: TAGAWA TSUYOSHI , OKUDA MASAHIRO , SAKURABA SHIGEKI 
Published: June 2009

SummaryLaryngotracheo‐esophageal cleft is a rare congenital anomaly that occurs when the trachea and esophagus fail to separate during fetal development. Clinical severity varies greatly in anatomic cleft extent. We report the successful management of the airway of a neonate with type IV laryngotracheo‐esophageal cleft for the gastric division surgery by dividing the esophagogastric continuity between the esophageal orifice and the stomach using the balloon catheter and remaining spontaneous breathing through the large cuffed tracheal tube inserted into the esophageal orifice.
Metagenomic analysis of viruses in reclaimed water
Authors: Rosario Karyna , Nilsson Christina , Lim Yan Wei , Ruan Yijun , Breitbart Mya 
Published: June 2009

SummaryReclaimed water use is an important component of sustainable water resource management. However, there are concerns regarding pathogen transport through this alternative water supply. This study characterized the viral community found in reclaimed water and compared it with viruses in potable water. Reclaimed water contained 1000‐fold more virus‐like particles than potable water, having approximately 108 VLPs per millilitre. Metagenomic analyses revealed that most of the viruses in both reclaimed and potable water were novel. Bacteriophages dominated the DNA viral community in both reclaimed and potable water, but reclaimed water had a distinct phage community based on phage family distributions and host representation within each family. Eukaryotic viruses similar to plant pathogens and invertebrate picornaviruses dominated RNA metagenomic libraries. Established human pathogens were not detected in reclaimed water viral metagenomes, which contained a wealth of novel single‐stranded DNA and RNA viruses related to plant, animal and insect viruses. Therefore, reclaimed water may play a role in the dissemination of highly stable viruses. Information regarding viruses present in reclaimed water but not in potable water can be used to identify new bioindicators of water quality. Future studies will need to investigate the infectivity and host range of these viruses to evaluate the impacts of reclaimed water use on human and ecosystem health.
Nodulation of Sesbania species by Rhizobium (Agrobacterium) strain IRBG74 and other rhizobia
Authors: Cummings Stephen P. , Gyaneshwar Prasad , Vinuesa Pablo , Farruggia Frank T. , Andrews Mitchell , Humphry David , Elliott Geoffrey N. , Nelson Andrew , Orr Caroline , Pettitt Deborah , Shah Gopit R. , Santos Scott R. , Krishnan Hari B. , Odee David , Moreira Fatima M. S. , Sprent Janet I. , Young J. Peter W. , James Euan K. 
Published: June 2009

SummaryConcatenated sequence analysis with 16S rRNA, rpoB and fusA genes identified a bacterial strain (IRBG74) isolated from root nodules of the aquatic legume Sesbania cannabina as a close relative of the plant pathogen Rhizobium radiobacter (syn. Agrobacterium tumefaciens). However, DNA:DNA hybridization with R. radiobacter, R. rubi, R. vitis and R. huautlense gave only 44%, 5%, 8% and 8% similarity respectively, suggesting that IRBG74 is potentially a new species. Additionally, it contained no vir genes and lacked tumour‐forming ability, but harboured a sym‐plasmid containing nifH and nodA genes similar to those in other Sesbania symbionts. Indeed, IRBG74 effectively nodulated S. cannabina and seven other Sesbania spp. that nodulate with Ensifer (Sinorhizobium)/Rhizobium strains with similar nodA genes to IRBG74, but not species that nodulate with Azorhizobium or Mesorhizobium. Light and electron microscopy revealed that IRBG74 infected Sesbania spp. via lateral root junctions under flooded conditions, but via root hairs under non‐flooded conditions. Thus, IRBG74 is the first confirmed legume‐nodulating symbiont from the Rhizobium (Agrobacterium) clade. Cross‐inoculation studies with various Sesbania symbionts showed that S. cannabina could form fully effective symbioses with strains in the genera Rhizobium and Ensifer, only ineffective ones with Azorhizobium strains, and either partially effective (Mesorhizobium huakii) or ineffective (Mesorhizobium plurifarium) symbioses with Mesorhizobium. These data are discussed in terms of the molecular phylogeny of Sesbania and its symbionts.
Complete clinical response to neoadjuvant chemoradiotherapy in patients with rectal cancer: opinions of British and Irish specialists
Authors: Wynn G. R. , Bhasin N. , Macklin C. P. , George M. L. 
Published: June 2009

AbstractIntroduction  Advances in neoadjuvant treatment have highlighted the phenomenon of complete clinical response (CCR) in a proportion of patients with rectal cancer. Radical surgery may be associated with a poor functional outcome and quality of life and has a small but significant risk of mortality. This study aimed to assess opinion of colorectal surgeons on issues surrounding the question of nonoperative management in patients who demonstrate complete response after neoadjuvant therapy.Method  A questionnaire was sent to members of the Association of Coloproctology of Great Britain and Ireland regarding investigations, clinical management, pathological assessment and oncological outcome in rectal cancer patients with a complete response to neoadjuvant chemoradiotherapy.Results  A total of 122 consultants responded (26% response rate). Most surgeons (58%) would not consider conservative management of patients with a complete response and even more (69%) expressed that they would never discuss nonoperative management in patients with rectal cancer who are fit for curative surgery. Over 70 different combinations of investigations and imaging modalities were suggested to define a CCR. Eighty‐six per cent of consultants felt that a pathology report stating no evidence of residual adenocarcinoma did not rule out the presence of tumour cells and all respondents estimated the percentage of patients with pathological complete response as < 20%.Conclusions  No consensus exists as to what defines a complete response and at present there is resistance to offering nonoperative management in selected patients. With improvements in neoadjuvant treatment modalities, it will be increasingly important to consider nonoperative management in the future.
Meta‐analysis of the colon J‐Pouch vs transverse coloplasty pouch after anterior resection for rectal cancer
Authors: Liao C. , Gao F. , Cao Y. , Tan A. , Li X. , Wu D. 
Published: June 2009

AbstractPurpose  To evaluate the outcome of colonic J‐pouches (CJP) and transverse colonic pouches (TCPs) after anterior resection for rectal cancer.Method  Trials were located through Medline, Embase, the Cochrane Central Register of Controlled Trials, VIP and CNKI. Main end‐points included functional outcomes, postoperative complications and anorectal physiological outcomes.Results  Of 120 articles, 34 compared CJP and TCP. Of these only six were randomized controlled trials (RCT), which fulfilled the inclusion criteria. These six included 648 patients, including 326 in the CJP group and 322 in the TCP group. There were no differences in the incidences of anastomotic leak [odds ratio 0.50, 95% confidence interval (CI) 0.21–1.18], chest infection (0.43, 0.09–2.00), wound infection (0.87, 0.33–2.30), anastomotic stricture (1.30, 0.44–3.84), fistula (0.64, 0.18–2.31).There were no difference in functional outcomes such as stool frequency [weighted mean difference (WMD) of −0.01, −0.30–0.27 at 6 months].There was no difference for anorectal physiology but heterogeneity existed: resting pressure (0.39, −1.76 to 2.55; 3.09, −0.04 to 6.23; 4.15, 2.21–6.094, at preoperation, 6 and 12 months,); squeeze pressure (−15.02, −46.14 to 16.10; −15.04, −37.04 to 6.97;0.83, −7.70 to 9.37 at preoperation, 6 and 12 months);(Neo)rectal threshold volume(8.49, 5.18–11.81; 27.13, −5.08 to 59.35, at preoperation and 6 months); Maximal (neo) rectal volume (−14.05, −36.60 to 8.50; 23.37, 2.65–44.09; −0.54, −0.91 to −0.18, at preoperation, 6 and at 12 months).Conclusions  Transverse colonic pouch has similar results as CJP. As it is a safe, feasible, simple, technically easy and time‐saving surgical procedure, TCP is a good candidate for wider clinical application.
The endoscopic spectrum of segmental colitis associated with diverticulosis
Authors: Tursi A. , Elisei W. , Brandimarte G. , Giorgetti G. M. , Lecca P. G. , Di Cesare L. , Inchingolo C. D. , Aiello F. 
Published: June 2009

AbstractObjective  An endoscopic classification of ‘Segmental colitis associated with diverticulosis’ (SCAD) is lacking. Our aim was therefore to assess the endoscopic spectrum of SCAD, comparing it with the histological and clinical features.Method  A prospective study was performed from January 2004 to October 2007. Diagnosis of SCAD was made on the basis of specific endoscopic and histological patterns.Results  A total of 6230 consecutive colonoscopies were performed during the study period. SCAD was diagnosed in 92 (1.48%) patients, with four endoscopic patterns: pattern A, ‘crescentic fold disease’ (52.20%); pattern B, ‘Mild‐to moderate ulcerative colitis‐like’ pattern (30.40%); pattern C, ‘Crohn’s disease colitis‐like’ pattern (10.90%); pattern D, ‘Severe ulcerative colitis‐like’ pattern (6.50%).Most patients with patterns A (58.33%, P < 0.018) and B (89.29%, P < 0.00001) showed histological alterations resembling moderate ulcerative colitis (UC). In pattern C, larger histological variability was found (P < 0.01). All patients showing pattern D showed the typical histological alteration changes of severe UC (P < 0.0001).In pattern A (60.42%, P = n.s.) and pattern B (46.43%, P = n.s.), diarrhoea was the most common symptom whilst abdominal pain was the most frequent in pattern C (50%, P = n.s.) and pattern D (83.33%, P = n.s.) patients.Conclusions  Endoscopic patterns of SCAD may range from mild to severe inflammation. The histopathological findings but not clinical features showed a statistically significant association with the degree of endoscopic severity.
Nāgārjuna and the Tathāgatagarbha: A Closer Look at Some Peculiar Features in the Niraupamyastava
Authors: MITRIKESKI DRASKO 
Published: June 2009

This article examines several verses from the Niraupamyastava, where Nāgārjuna makes explicit references to the non‐empty aspects of the doctrine of emptiness—a topic systematized and crystallized in the doctrine of Tathāgatagarbha, thought to have appeared later than his date and to have been unknown to him.Establishing the authenticity of the hymn, in addition to the criteria utilized by Lindtner, the article analyses the style and the relationship of the text with texts belonging to other schools, thus locating Nāgārjuna in his historical and temporal context. The article also brings into focus the overlooked or marginalized topics present in Nāgārjuna's texts such as the practice of devotion and visualization of the Buddha as method for realizing emptiness.
Immunocryosurgery for basal cell carcinoma: results of a pilot, prospective, open‐label study of cryosurgery during continued imiquimod application
Authors: Gaitanis G , Nomikos K , Vava E , Alexopoulos EC , Bassukas ID 
Published: June 2009

AbstractBackground/aim  Theoretical considerations support the combination of cryosurgery and topical imiquimod to treat basal cell carcinomas (BCC). The aim of the present study was to test the feasibility and efficacy of ‘cryosurgery during continued imiquimod application’ (‘immunocryosurgery’) to treat ‘high‐risk‐for‐recurrence’ BCCs.Methods  Thirteen patients with 21 biopsy‐proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N2 cryosurgery (spray, two cycles, 10–20 s) and imiquimod was continued for additional 2–12 weeks (median, 4). The outcome after at least 18 months of follow‐up (18–24 months) is currently reported.Results  Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow‐up (cumulative efficacy: 95%).Conclusions  ‘Immunocryosurgery’ is a promising non‐surgical combination modality to treat ‘high‐risk‐for‐recurrence BCCs’. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results.