bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Medical Emergency Teams to detect preventable adverse events
Authors: Iyengar Akshai , Baxter Alan , Forster Alan J 
Published: July 2009

Abstract
Introduction
Medical Emergency Teams (METs), also known as Rapid Response Teams, are recommended as a patient safety measure. A potential benefit of implementing an MET is the capacity to systematically assess preventable adverse events, which are defined as poor outcomes caused by errors or system design flaws. We describe how we used MET calls to systematically identify preventable adverse events in an academic tertiary care hospital, and describe our surveillance results.

Methods
For four weeks we collected standard information on consecutive MET calls. Within a week of the MET call, a multi-disciplinary team reviewed the information and rated the cause of the outcome using a previously developed rating scale. We classified the type and severity of the preventable adverse event.

Results
We captured information on all 65 MET calls occurring during the study period. Of these, 16 (24%, 95% confidence interval [CI] 16%–36%) were felt to be preventable adverse events. The most common cause of the preventable adverse events was error in providing appropriate therapy despite an accurate diagnosis. One service accounted for a disproportionate number of preventable adverse events (n = 5, [31%, 95% CI 14%–56%]).

Conclusions
Our method of reviewing MET calls was easy to implement and yielded important results. Hospitals maintaining an MET can use our method as a preventable adverse event detection system at little additional cost.
MotifAdjuster: a tool for computational reassessment of transcription factor binding site annotations
Authors: Keilwagen Jens , Baumbach Jan , Kohl Thomas A , Grosse Ivo 
Published: July 2009

AbstractValuable binding-site annotation data are stored in databases. However, several types of errors can, and do, occur in the process of manually incorporating annotation data from the scientific literature into these databases. Here, we introduce MotifAdjuster http://dig.ipk-gatersleben.de/MotifAdjuster.html, a tool that helps to detect these errors, and we demonstrate its efficacy on public data sets.
Kinin B1 receptor activation turns on exocytosis of matrix metalloprotease-9 and myeloperoxidase in human neutrophils: involvement of mitogen-activated protein kinase family
Authors: Ehrenfeld Pamela , Matus Carola E , Pavicic Francisca , Toledo Cesar , Nualart Francisco , Gonzalez Carlos B , Burgos Rafael A , Bhoola Kanti D , Figueroa Carlos D 
Published: July 2009

AbstractProinflammatory peptides known as kinins activate the human neutrophil and induce the release of its primary and tertiary granules.During neutrophil activation and degranulation, MMP-9 and MPO are released into the extracellular space to propagate inflammatory disorders. As kinin peptides are major participants in acute inflammatory responses, and the G-protein-coupled B1R mediates the chemotaxis of human neutrophils, we examined the release of the neutrophil enzymes MMP-9 and MPO by the B1R agonist LDBK and determined the signaling pathways that may regulate this cellular effect. Cytochalasin-treated and -untreated neutrophils were suspended in HBSS and stimulated with a range concentration of LDBK for 5 min. Zymography and Western blotting revealed that LDBK induced the release of MMP-9 and MPO. The use of specific signaling transduction inhibitors showed that release of MMP-9 depended on ERK1/2 and p38 MAPKs, whereas release of MPO involved only the p38 cascade. Inhibition of the key steps in these pathways showed that the release of both enzymes depended on PKC and PI3K. Stimulation of neutrophils with LDBK produced phosphorylation of ERK1/2 and p38 MAPK, which was inhibited by B1R antagonists. The phosphorylated ERK1/2 MAPK translocated to the neutrophil nucleus, suggesting that transcription of new genes may follow activation of B1R. Our results demonstrate that in human neutrophils, activation of kinin B1R by LDBK initiates separate signaling cascades that trigger the release of MMP-9 and MPO from tertiary and primary granules, respectively, suggesting that the B1R plays a pivotal role in inflammatory disorders.
Seasonal variation in liver function tests: a time-series analysis of outpatient data
Authors: Miyake Kazunori , Miyake Noriko , Kondo Shigemi , Tabe Yoko , Ohsaka Akimichi , Miida Takashi 
Published: July 2009

Background Long-term physiological variations, such as seasonal variations, affect the screening efficiency at medical checkups. This study examined the seasonal variation in liver function tests using recently described data-mining methods. Methods The ‘latent reference values’ of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase ( γGT), cholinesterase (ChE) and total bilirubin (T-Bil) were extracted from a seven-year database of outpatients (aged 20–79 yr; comprising approximately 1,270,000 test results). After calculating the monthly means for each variable, the time-series data were separated into trend and seasonal components using a local regression model (Loess method). Then, a cosine function model (cosinor method) was applied to the seasonal component to determine the periodicity and fluctuation range. A two-year outpatient database (215,000 results) from another hospital was also analysed to confirm the reproducibility of these methods. Results The serum levels of test results tended to increase in the winter. The increase in AST and ALT was about 6% in men and women, and was greater than that in ChE, ALP (in men and women) and γGT (in men). In contrast, T-Bil increased by 3.6% (men) and 5.0% (women) in the summer. The total protein and albumin concentrations did not change significantly. AST and ALT showed similar seasonal variation in both institutions in the comparative analysis. Conclusions The liver function tests were observed to show seasonal variations. These seasonal variations should therefore be taken into consideration when establishing either reference intervals or cut-off values, which are especially important regarding aminotransferases.
Measurement of immunoglobulin A in saliva by particle-enhanced nephelometric immunoassay: sample collection, limits of quantitation, precision, stability and reference range
Authors: Booth Christine K , Dwyer Dan B , Pacque Paul F , Ball Madeleine J 
Published: July 2009

Background Total immunoglobulin A in saliva (s-IgA) is normally assayed using an enzyme-linked immunosorbent assay. We have investigated methodological issues relating to the use of particle-enhanced nephelometric immunoassay (PENIA) to measure s-IgA in whole unstimulated saliva and determine its reference range. Methods Whole unstimulated resting saliva was collected to determine sample stability (temperature, time, effect of a protease inhibitor), limit of quantitation (LOQ), assay precision and analytical variation. The reference range for 134 healthy adults was determined. Results Linearity was excellent (4–10.3 mg L−1, P < 0.001; R2 = 0.997) and without significant bias (mean of −0.7%). The lowest intra- and inter-analytical coefficients of variation were 1.8% and 7.5% and LOQ was 1.4 mg L−1. The concentration of s-IgA is stable at room temperature for up to 6 h, at 4°C for 48 h, at −4°C for two weeks and at −80°C for up to 1.3 yr. There is no evidence that a protease inhibitor increases the stability or that repeated freeze–thawing cycles degrade sample quality. The reference ranges for s-IgA concentration, s-IgA secretion, s-IgA:albumin and s-IgA:osmolality were 15.9–414.5 mg L−1, 7.2–234.9 μg min−1, 0.4–19 and 0.6–8.9, respectively. Conclusion Automated PENIA assay of s-IgA is precise and accurate. High stability of collected saliva samples and the ease and speed of the assay make this an ideal method for use in athletic and military training situations. The convenience of measuring albumin and IgA on the same analytical platform adds to the practicability of the test.
An audit of oral glucose tolerance tests at a large teaching hospital: indications, outcomes and confounding factors
Authors: Ryan Joshua , Siriwardhana Deepani , Vasikaran Samuel D 
Published: July 2009

Background Australian guidelines on the diagnosis of diabetes mellitus (DM) recommend performing an oral glucose tolerance test (OGTT) in people with fasting plasma glucose (FPG) values of 5.5–6.9 mmol/L. Aim To evaluate indications, outcomes and confounding factors of OGTTs performed at a large teaching hospital and to compare them with Australian DM guidelines. Method A retrospective audit of OGTTs performed over an 18-month period in a teaching hospital in a major Australian city. Information gathered included co-morbidities; medications; risk factors for type 2 DM; indication for OGTT; results of OGTT and previous glucose tests. Results All 129 OGTTs identified were included in the audit. Eighty-nine (69%) were male, with a median age of 57 years (range 19–86), and 3% were of Australian Aboriginal ethnicity. An indication for OGTT was identified in 93%, including FPG 5.5–6.9 mmol/L (36%) and random plasma glucose (RPG) 5.5–11.0 mmol/L (19%). Other indications for OGTT identified included polycystic ovary syndrome or metabolic syndrome (8%), peripheral neuropathy (3%) and as part of a research protocol (12%). Forty-two (35%) were inpatients at the time of OGTT, of which 35 (30%) were admitted for acute medical or surgical illnesses such as stroke. Nineteen percent were taking medications known to affect plasma glucose (e.g. oral corticosteroids). Conclusion Only 55% of OGTTs had a previous FPG or RPG value warranting OGTT using current Australian DM guidelines. Other valid indications for OGTT were identified in the majority of the remainder. In addition, 41% were performed in the presence of confounding factors (such as acute illness or medications known to affect plasma glucose). Many of the OGTTs that are currently being performed are in the presence of confounding factors that could cause misleading results.
Evaluation of redox statuses in patients with hepatitis B virus-associated hepatocellular carcinoma
Authors: Tsai Shih-Meng , Lin Shu-Kai , Lee King-The , Hsiao Jen-Kuei , Huang Jung-Chih , Wu Szu-Hsien , Ma Hsu , Wu Szu-Hwa , Tsai Li-Yu 
Published: July 2009

Background Excess reactive oxygen species related to neoplasia of liver has been established. Essentially, the human body has developed different antioxidant systems for defence against these attacks. To evaluate the redox status in hepatocellular carcinoma (HCC) induced by hepatitis B virus (HBV), the most important aetiological factor in Taiwan, changes in O2. generation, lipid peroxidation as well as antioxidant status in the blood of HCC patients with HBV carriers for more than 20 years were measured. Methods Superoxide anion radical (O2.−) generation and the levels of malondialdehyde (MDA) served as an index of lipid peroxidation along with the analyses of activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GRx); also, glutathione status, including reduced glutathione (GSH) and oxidized glutathione (GSSG), and the levels of vitamins A, C and E were determined. Results In 54 patients, the levels of O2.−, MDA and GSSG, and the activities of SOD and GRx of blood were significantly higher than those of 57 controls. Conversely, the levels of GSH and total GSH, and GSH/GSSG ratio, and vitamins A and C were significantly decreased. Additionally, there were no significant changes in the activity of GPx and the levels of vitamin E. Conclusions Our data suggest that the redox statuses in patients with HBV-associated HCC were elevated or decreased in certain parameters. However, the increased activities of antioxidant enzymes may be a compensatory up-regulation and the decrease antioxidant statuses were responses to the enhanced oxidative stress in those patients.
Serum free light chain assay reduces the need for serum and urine immunofixation electrophoresis in the evaluation of monoclonal gammopathy
Authors: Fulton Richard B , Fernando Suran L 
Published: July 2009

Background The potential for serum free light chain (sFLC) assay measurements to replace urine electrophoresis (uEPG) and to also diminish the need for serum immunofixation (sIFE) in the screening for monoclonal gammopathy was assessed. A testing algorithm for monoclonal protein was developed based on our data and cost analysis. Methods Data from 890 consecutive sFLC requests were retrospectively analysed. These included 549 samples for serum electrophoresis (sEPG), 447 for sIFE, and 318 for uEPG and urine immunofixation (uIFE). A total of 219 samples had sFLC, sEPG, sIFE and uEPG + uIFE performed. The ability of different test combinations to detect the presence of monoclonal proteins was compared. Results The sFLC κ/ λ ratio (FLC ratio) indicated monoclonal light chains in 12% more samples than uEPG + uIFE. The combination of sEPG and FLC ratio detected monoclonal proteins in 49% more samples than the combination of sEPG and sIFE. Furthermore, the sEPG + FLC ratio combination detected monoclonal protein in 6% more samples than were detected by the combined performance of sEPG, sIFE, uEPG and uIFE. However, non-linearity of the assay, the expense of repeat determinations due to the narrow measuring ranges, and frequent antigen excess checks were found to be limitations of the sFLC assay in this study. Conclusion The FLC ratio is a more sensitive method than uIFE in the detection of monoclonal light chains and may substantially reduce the need for onerous 24 h urine collections. Our proposed algorithm for the evaluation of monoclonal gammopathy incorporates the sFLC assay, resulting in a reduction in the performance of labour intensive sIFE and uEPG + uIFE while still increasing the detection of monoclonal proteins.
Design, implementation and results of the quality control program for the Australian government's point of care testing in general practice trial
Authors: Shephard Mark , Shephard Anne , Watkinson Les , Mazzachi Beryl , Worley Paul 
Published: July 2009

Background From 2005 to 2007 the Australian Government funded a multicentre, clustered randomized controlled trial to determine the clinical effectiveness, cost-effectiveness, satisfaction and safety of point of care testing (PoCT) in general practice (GP). PoC tests measured (and devices used) in the trial were haemoglobin A1c and urine albumin:creatinine ratio (DCA 2000), lipids (Cholestech LDX) and international normalized ratio (CoaguChek S). Methods An internal quality control (QC) program was developed as part of a quality management framework for the trial. PoCT device operators were provided with a colour-coded QC Result Sheet and QC Action Sheet for on-site recording and interpreting of their results. Within-practice imprecision for QC testing was calculated and compared with the analytical goals for imprecision set prior to the trial. Results The average participation rate for QC testing was 91% or greater. Median within-practice imprecision met the analytical goals for all PoC tests, except for high-density lipoprotein-cholesterol (HDL-C) where observed performance was outside the minimum goal for one level and one lot number of QC. Most practices achieved the imprecision goals for all analytes, with the principal exception of HDL-C. Conclusions Results from QC testing indicate that PoCT in the GP trial met the analytical goals set for the trial, with the exception of HDL-C.
Autism, “Recovery (to Normalcy),” and the Politics of Hope
Authors: Broderick Alicia A. 
Published: July 2009

Abstract
This article draws on the traditions of critical discourse analysis (N. Fairclough, 1995, 2001; M. Foucault, 1972, 1980; J. P. Gee, 1999) in critically examining the discursive formation of “recovery” from autism in applied behavioral analysis (ABA) discourse and its relationship to constructs of hope. Constituted principally in the work of O. I. Lovaas (1987) and C. Maurice (1993), and central to ABA discourse on recovery, has been the construction of a particular vision of hope that has at least 2 integral conceptual elements: (a) Hope for recovery within ABA discourse is constructed in binary opposition to hopelessness, and (b) recovery within ABA discourse is discursively constructed as “recovery (to normalcy).” The author analyzes these 2 pivotal ABA texts within the context of an analysis of other uses of the term recovery in broader bodies of literature: (a) within prior autism-related literature, particularly autobiography, and (b) within literature emanating from the psychiatric survivors' movement. If, indeed, visions of hope inform educational policy and decision making, this analysis addresses S. Danforth's (1997) cogent query, “On what basis hope?”, and asserts that moral and political commitments should be central sources of visions of hope and, therefore, inform educational policy and decision making for young children with labels of autism.
Implications of Increased C-Reactive Protein for Cardiovascular Risk Stratification in Black and White Men and Women in the US
Authors: Cushman Mary , McClure Leslie A , Howard Virginia J , Jenny Nancy S , Lakoski Susan G , Howard George 
Published: July 2009

Abstract
Background: We evaluated prevalence and correlates of increased high-sensitivity C-reactive protein (hsCRP) in a large population of blacks and whites, and the impact of hsCRP measurement on coronary heart disease risk reclassification.
Methods: We studied 19 080 participants of the REGARDS (REasons for Geographic And Racial Differences in Stroke) study (age &gt;45 years, without vascular diagnoses, and living dispersed across the US). A total of 8309 nondiabetic participants not using lipid-lowering medications were classified into 4 risk categories based on the Framingham vascular disease risk score. Participants with hsCRP &lt;1 mg/L were reclassified to the next lower risk group, and those with hsCRP &gt;3 mg/L to the next higher risk group. We also assessed reclassification of risk based on the Reynolds vascular risk score, incorporating hsCRP and family history.
Results: Overall, 40% of participants had hsCRP &gt;3 mg/L. Blacks, women, and obese people were at highest risk for increased hsCRP. Among nondiabetic women at 5%–20% Framingham vascular predicted risk, hsCRP data led to reclassification of 48% to a higher risk group and 19% to a lower risk group. For men, these percentages were 24% and 40%. Blacks were more often reclassified to a higher risk group than whites. Reynolds vascular risk score data led to reclassification of 85% of women and 67% of men, almost exclusively to a lower risk group than the Framingham vascular score.
Conclusions: In this national study, a majority of participants, especially blacks and women, were reclassified to a different 10-year vascular risk category on the basis of hsCRP testing after risk assessment. With the inclusion of hsCRP testing data, the Reynolds risk score classified the population differently than the new Framingham vascular score. .
Mechanisms of liver disease: cross-talk between the NF-κB and JNK pathways
Authors: Papa Salvatore , Bubici Concetta , Zazzeroni Francesca , Franzoso Guido 
Published: July 2009

Abstract
The liver plays a central role in the transformation and degradation of endogenous and exogenous chemicals, and in the removal of unwanted cells such as damaged, genetically mutated and virus-infected cells. Because of this function, the liver is susceptible to toxicity caused by the products generated during these natural occurrences. Hepatocyte death is the major feature of liver injury. In response to liver injury, specific intracellular processes are initiated to maintain liver integrity. Inflammatory cytokines including tumor necrosis factor (TNF)α and interleukin-6 (IL-6) are key mediators of these processes and activate different cellular response such as proliferation, survival and death. TNFα induces specific signaling pathways in hepatocytes that lead to activation of either pro-survival mediators or effectors of cell death. Whereas activation of transcription factor NF-κB promotes survival, c-Jun N-terminal kinases (JNKs) and caspases are strategic effectors of cell death in the TNFα-mediated signaling pathway. This review summarizes recent advances in the mechanisms of TNFα-induced hepatotoxicity and suggests that NF-κB plays a protective role against JNK-induced hepatocyte death. Identification of the mechanisms regulating interplay between the NF-κB and JNK pathways is required in the search for novel targets for the treatment of liver disease, including hepatitis and hepatocellular carcinoma.
Immunologic hurdles of therapeutic stem cell transplantation
Authors: Utermöhlen Olaf , Baschuk Nikola , Abdullah Zeinab , Engelmann Afra , Siebolts Udo , Wickenhauser Claudia , Stocking Carol , Krönke Martin 
Published: July 2009

Abstract
Detailed knowledge of the immunologic properties of embryonic stem (ES) cells is a prerequisite for safe applications of ES cell-based regenerative medicine. Recently, the long-standing assumption that ES cells are ignored by immunocompetent hosts was disproved. Instead, it is becoming increasingly clear that ES cells actively protect themselves via several immunomodulatory and immunoevasive mechanisms against cytotoxic T-lymphocytes and natural killer cells. Here we review current knowledge about the immunologic properties of ES cells and discuss the implications for ES cell-based regenerative medicine, for the immunobiology of the embryo as a semi-allogeneic graft, and for the regenerative capacity of adult stem cells.
Dissection of gene regulatory networks in embryonic stem cells by means of high-throughput sequencing
Authors: Beisel Christian , Paro Renato 
Published: July 2009

Abstract
Transcription factor regulation of gene expression and chromatin-controlled epigenetic memory systems are closely cooperating in establishing the pluripotent state of embryonic stem (ES) cells and maintaining cell fate decisions throughout development of an organism. A thorough understanding of the regulatory transcriptional circuitry that rules the underlying plastic yet heritable gene expression programs in ES cells is of great importance. With the advent of next-generation sequencing technologies facilitating the quantitative assessment of functional genomics assays it is now feasible to interrogate transcription networks at a genome-wide scale. Here, we discuss the application of next-generation sequencing in elucidating the molecular mechanisms underlying ES cell function.
Interplay between host cell and hepatitis C virus in regulating viral replication
Authors: Bode Johannes G. , Brenndörfer Erwin D. , Karthe Juliane , Häussinger Dieter 
Published: July 2009

Abstract
Viral life cycle as that of the hepatitis C virus (HCV) completely relies on host cell infrastructure, presupposing that the virus has evolved mechanisms to utilize and control all cellular molecules or pathways required for viral life cycle. Hence, HCV must have acquired the ability to gain access to key pathways controlling processes, such as cell growth, apoptosis and protein synthesis, which are all considered to also be crucial for liver regeneration. This occurs in a balanced way permitting persistent replication of viral genomes and production of infectious particles without endangering host cell viability and survival. In particular during the last decade, accumulating evidence indicates that HCV utilizes signaling pathways of the host with major impact on cellular growth, viability, cell cycle or cellular metabolism, such as epidermal growth factor-receptor mediated signals, the PI3K/Akt cascade or the family of Src kinases. Furthermore, HCV specifically interacts with parts of the cellular machinery involved in protein translation, processing, maturation and transport, such as components of the translation complex, the heat shock protein family, the immunophilins or the vesicle-associated membrane protein-associated proteins A and B. The present review focuses on the interplay between viral proteins and these factors of the host cell enabling the virus to utilize host cell infrastructure.