bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Effect of Clinical Decision Units on Patient Flow in Seven Canadian Emergency Departments
Authors: Schull Michael J. , Vermeulen Marian J. , Stukel Therese A. , Guttmann Astrid , Leaver Chad A. , Rowe Brian H. , Sales Anne 
Published: July 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:828–836 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  To evaluate the effect of emergency department (ED) clinical decision units (CDUs) on overall ED patient flow in a pilot project funded in 2008 by the Ontario Ministry of Health and Long‐Term Care (MOHLTC).Methods:  A retrospective analysis of unscheduled ED visits at seven CDU pilot and nine control sites was conducted using administrative data. The authors examined trends in CDU utilization and compared outcomes between pilot‐CDU and control sites 1 year prior to implementation, with the first 18 months of CDU operation. Sites that were unsuccessful in their applications for CDU program funding served as controls. Outcomes included ED length of stay (LOS), admission rates, and ED revisit rates.Results:  At CDU sites, roughly 4% of ED patients were admitted to CDUs. The presence of a pilot‐CDU was independently associated with a small reduction in ED LOS for all low‐acuity patients (−0.14 hour, 95% confidence interval [CI] = −0.22 to −0.07) and nonadmitted patients (−0.11 hour, 95% CI = −0.16 to −0.07). A small independent effect on absolute hospital admission rate for all high‐acuity patients (−0.8%, 95% CI = −1.5% to −0.03%) and moderate‐acuity patients (−0.6%, 95% CI = −1.1% to −0.2%) was also observed. Pilot‐CDUs were not associated with changes in ED revisit rates.Conclusions:  With only 4% of ED patients admitted to CDUs, the potential for efficiency gains in these EDs was limited. Nonetheless, these findings suggest small improvements in the operation of the ED through CDU implementation. Although marginal, the observed effects of CDU operation were in the desired direction of reduced ED LOS, reduced admission rate, and no increase in ED revisit rate.
Clinical Pathologic Conference: A 51‐Year‐Old Man With Rash and Joint Pain
Authors: Marinelli Melissa A , McGhee Jonathan 
Published: July 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:e41–e44 © 2012 by the Society for Academic Emergency MedicineAbstractThe authors present a case of a 51‐year‐old male who arrived to the emergency department (ED) with rash and arthralgias. He was not initially forthcoming about all aspects of his history, but ultimately careful clinical evaluation confirmed by laboratory abnormalities revealed the diagnosis. The patient’s clinical presentation is given, a discussion of the differential diagnoses is included, and his clinical course is summarized.
Leukocyte‐Platelet‐Rich Plasma (L‐PRP) Induces an Abnormal Histophenotype in Craniofacial Bone Repair Associated with Changes in the Immunopositivity of the Hematopoietic Clusters of Differentiation, Osteoproteins, and TGF‐β1
Authors: Giovanini Allan Fernando , Grossi João Ricardo Almeida , Gonzaga Carla Castiglia , Zielak João Cesar , Göhringer Isabella , Vieira Juliana de Souza , Kuczera Juliane , de Oliveira Filho Marco Antonio , Deliberador Tatiana Miranda 
Published: July 2012

AbstractBackgroundLeukocyte‐platelet‐rich plasma (L‐PRP) is considered an important source of growth factors, especially Transforming growth factor β 1 (TGF‐β1), which modulates the proliferation and regulation of mesenchymal cells, and also exerts an influence on the hematopoiesis, osteogenesis, and adipogenesis in bone microenvironment. Thus, the aim of this study was to evaluate the effect of L‐PRP on the calvarial bone repair and compare its results on the presence of TGF‐β1, CD34, CD45, bone morphogenetic protein 2 (BMP2), BMPR1B, and Runx2 proteins detected by immunohistochemistry.Material and MethodsFour bone defects were created on the calvaria of 23 rabbits. The defects were treated with autograft, L‐PRP alone, and L‐PRP mixed with autograft. The animals were euthanized at 2, 4, and 6 weeks post‐surgery.ResultsUnlike autograft and sham groups, the defects treated with L‐PRP demonstrated significant positivity to TGF‐β1, while the BMP2 was scarce. These results coincided with the lower bone matrix deposited and larger medullary area, which were composed of fibrosis, when treated with only L‐PRP, or intense adiposity on defects filled with L‐PRP mixed with autograft. The fibrosis that occurred was associated with a minor percentage of osteoproteins, intense presence of CD34+
CD45− cells, and significant expression of TGF‐β1 in all time periods analyzed. The adiposity occurred from the major presence of osteoprogenitor BMPR1B
+ Runx2+ cells simultaneously to BMP2−
TGF‐β1+ and CD34+
CD45+/− expressions predominantly on the earlier period.ConclusionFrom this study, it can be concluded that the L‐PRP used alone or mixed to autograft hindered the osteoneogenesis due to suppression of immunoexpression of BMP2, while the immunopositivity of TGF‐β1 was intense. When used alone, the L‐PRP induced a fibrotic condition associated with TGF‐β1 presence and lack of osteoproteins, but when L‐PRP was mixed to autograft, it induced the presence of the osteolineage cells (BMPR1B
+
Runx2+), but also inhibited the terminal osteoblastic maturation associated with the lack of BMP2 and the presence of TGF‐β1+, a fact that contributed to cellular transdifferentiation into fat cells.
Insights into Lantibiotic Immunity Provided by Bioengineering of LtnI
Authors: Draper Lorraine A. , Deegan Lucy H. , Hill Colin , Cotter Paul D. , Ross R. Paul 
Published: July 2012

ABSTRACT
The lantibiotic lacticin 3147 has been the focus of much research due to its broad spectrum of activity against many microbial targets, including drug-resistant pathogens. In order to protect itself, a lacticin 3147 producer must possess a cognate immunity mechanism. Lacticin 3147 immunity is provided by an ABC transporter, LtnFE, and a dedicated immunity protein, LtnI, both of which are capable of independently providing a degree of protection. In the study described here, we carried out an in-depth investigation of LtnI structure-function relationships through the creation of a series of fusion proteins and LtnI determinants that have been the subject of random and site-directed mutagenesis. We establish that LtnI is a transmembrane protein that contains a number of individual residues and regions, such as those between amino acids 20 and 27 and amino acids 76 and 83, which are essential for LtnI function. Finally, as a consequence of the screening of a bank of 28,000 strains producing different LtnI derivatives, we identified one variant (LtnI I81V) that provides enhanced protection. To our knowledge, this is the first report of a lantibiotic immunity protein with enhanced functionality.
Operative Versus Nonoperative Management of Acute Achilles Tendon Ruptures
Authors: Wilkins Ryan , Bisson Leslie J. 
Published: July 2012

Background: Despite several randomized controlled trials comparing operative to nonoperative management of Achilles tendon ruptures, the optimal management of this condition remains the subject of significant debate. Rerupture is a known complication, but most level I studies have not shown a significant difference in the incidence of reruptures when comparing operative to nonoperative management. Purpose: The goal of this systematic review was to identify all randomized controlled trials comparing operative and nonoperative management of Achilles tendon ruptures and to meta-analyze the data with reruptures being the primary outcome. Secondary outcomes including strength, time to return to work, and other complications were analyzed as well. Study Design: Meta-analysis. Methods: We searched multiple online databases to identify English-language, prospective randomized controlled trials comparing open surgical repair of acute Achilles tendon ruptures to nonoperative management. Rerupture was our primary outcome. Secondary outcomes included strength, time to return to work, deep infections, sural nerve sensory disturbances, noncosmetic scar complaints, and deep venous thrombosis. Coleman methodology scores were calculated for each included study. Data were extracted from all qualifying articles and, when appropriate, pooled and meta-analyzed. Results: Seven level I trials involving 677 patients met inclusion criteria. Coleman scores were 95, 95, 95, 89, 78, 97, and 92. Open repair was associated with a significantly lower rerupture rate compared with nonoperative treatment (3.6% vs 8.8%; odds ratio, 0.425; 95% confidence interval, 0.222-0.815). The incidence of deep infections was significantly higher for patients treated with surgery ( P = .0113). The incidences of noncosmetic scar complaints and sural nerve sensory disturbances were also significantly higher in patients treated with surgery ( P < .001 for each). Strength measurements were not standardized and therefore could not be meta-analyzed. Conclusion: Open surgical repair of acute Achilles tendon ruptures significantly reduces the risk of reruptures when compared with nonoperative management. Several other complications, which are clearly avoided with nonoperative treatment, occur with a significantly higher incidence when surgical repair is performed. The available literature makes it difficult to compare the return of strength in the involved lower extremity after operative or nonoperative management. Future studies may focus on testing strength in a more functional and reproducible manner than isokinetic testing.
Beyond KRAS mutation status: influence of KRAScopy number status and microRNAs on clinical outcome to cetuximab in metastatic colorectal cancer patients
Authors: Mekenkamp Leonie JM , Tol Jolien , Dijkstra Jeroen R , de Krijger Inge , Vink-Börger M Elisa , van Vliet Shannon , Teerenstra Steven , Kamping Eveline , Verwiel Eugène , Koopman Miriam , Meijer Gerrit A , van Krieken J Han JM , Kuiper Roland , Punt Cornelis JA , Nagtegaal Iris D 
Published: July 2012

Abstract

Background

KRAS mutation is a negative predictive factor for treatment with anti-epidermal growth factor receptor (EGFR) antibodies in metastatic colorectal cancer (mCRC). Novel predictive markers are required to further improve the selection of patients for this treatment. We assessed the influence of modification of KRAS by gene copy number aberration (CNA) and microRNAs (miRNAs) in correlation to clinical outcome in mCRC patients treated with cetuximab in combination with chemotherapy and bevacizumab.

Methods
Formalin-fixed paraffin-embedded primary tumour tissue was used from 34 mCRC patients in a phase III trial, who were selected based upon their good (n = 17) or poor (n = 17) progression-free survival (PFS) upon treatment with cetuximab in combination with capecitabine, oxaliplatin, and bevacizumab. Gene copy number at the KRAS locus was assessed using high resolution genome-wide array CGH and the expression levels of 17 miRNAs targeting KRAS were determined by real-time PCR.

Results
Copy number loss of the KRAS locus was observed in the tumour of 5 patients who were all good responders including patients with a KRAS mutation. Copy number gains in two wild-type KRAS tumours were associated with a poor PFS. In KRAS mutated tumours increased miR-200b and decreased miR-143 expression were associated with a good PFS. In wild-type KRAS patients, miRNA expression did not correlate with PFS in a multivariate model.

Conclusions
Our results indicate that the assessment of KRAS CNA and miRNAs targeting KRAS might further optimize the selection of mCRC eligible for anti-EGFR therapy.
Porous silicon nanocrystals in a silica aerogel matrix
Authors: Amonkosolpan Jamaree , Wolverson Daniel , Goller Bernhard , Polisski Sergej , Kovalev Dmitry , Rollings Matthew , Grogan Michael D W , Birks Timothy A 
Published: July 2012

Abstract
Silicon nanoparticles of three types (oxide-terminated silicon nanospheres, micron-sized hydrogen-terminated porous silicon grains and micron-size oxide-terminated porous silicon grains) were incorporated into silica aerogels at the gel preparation stage. Samples with a wide range of concentrations were prepared, resulting in aerogels that were translucent (but weakly coloured) through to completely opaque for visible light over sample thicknesses of several millimetres. The photoluminescence of these composite materials and of silica aerogel without silicon inclusions was studied in vacuum and in the presence of molecular oxygen in order to determine whether there is any evidence for non-radiative energy transfer from the silicon triplet exciton state to molecular oxygen adsorbed at the silicon surface. No sensitivity to oxygen was observed from the nanoparticles which had partially H-terminated surfaces before incorporation, and so we conclude that the silicon surface has become substantially oxidised. Finally, the FTIR and Raman scattering spectra of the composites were studied in order to establish the presence of crystalline silicon; by taking the ratio of intensities of the silicon and aerogel Raman bands, we were able to obtain a quantitative measure of the silicon nanoparticle concentration independent of the degree of optical attenuation.
High performance surface-enhanced Raman scattering substrates of Si-based Au film developed by focused ion beam nanofabrication
Authors: Gao Tingting , Xu Zongwei , Fang Fengzhou , Gao Wenlong , Zhang Qing , Xu Xiaoxuan 
Published: July 2012

Abstract
A novel method with high flexibility and efficiency for developing SERS substrates is proposed by patterning nanostructures on Si substrates using focused ion beam direct writing (FIBDW) technology following with precise thermal evaporation of gold film on the substrate. The effect of SERS on the substrate was systematically investigated by optimizing the processing parameters and the gold film thickness. The results proved that small dwell time could improve the machining accuracy and obtain smaller nanogap. The Raman-enhanced performance of the substrate was investigated with 10−6mol/L Rhodamine 6 G solution. It was indicated that the elliptic nanostructures with 15-nm spacing on Si substrates, coated with approximately 15-nm thick gold film, have exhibited a high-enhanced performance, but dramatic performance degradation was found as the gold film thickness further increased, which most probably resulted from changes of the nanostructures’ morphology such as elliptical tip and spacing. To avoid the morphological changes effectively after depositing gold film, optimization design of the nanostructures for FIBDW on Si substrates was proposed. Besides, a similar phenomenon was found when the gold film was less than 15nm because there was little gold remaining on the substrate. The method proposed in this paper shows a great potential for the higher performance SERS substrates development, which can further reduce the spacing between hot spots.
Growth and characterization of ZnO/ZnTe core/shell nanowire arrays on transparent conducting oxide glass substrates
Authors: Lin YuWei , Chen Wei-Jen , Lu Jiun You , Chang Yuan Huei , Liang Chi-Te , Chen Yang Fang , Lu Jing-Yu 
Published: July 2012

Abstract
We report the growth and characterization of ZnO/ZnTe core/shell nanowire arrays on indium tin oxide. Coating of the ZnTe layer on well-aligned vertical ZnO nanowires has been demonstrated by scanning electron microscope, tunneling electron microscope, X-ray diffraction pattern, photoluminescence, and transmission studies. The ZnO/ZnTe core/shell nanowire arrays were then used as the active layer and carrier transport medium to fabricate a photovoltaic device. The enhanced photocurrent and faster response observed in ZnO/ZnTe, together with the quenching of the UV emission in the PL spectra, indicate that carrier separation in this structure plays an important role in determining their optical response. The results also indicate that core/shell structures can be made into useful photovoltaic devices.
Optimizing cell arrays for accurate functional genomics
Authors: Fengler Sven , H Bastiaens Philippe I , Grecco Hernán E , Roda-Navarro Pedro 
Published: July 2012

Abstract

Background
Cellular responses emerge from a complex network of dynamic biochemical reactions. In order to investigate them is necessary to develop methods that allow perturbing a high number of gene products in a flexible and fast way. Cell arrays (CA) enable such experiments on microscope slides via reverse transfection of cellular colonies growing on spotted genetic material. In contrast to multi-well plates, CA are susceptible to contamination among neighboring spots hindering accurate quantification in cell-based screening projects. Here we have developed a quality control protocol for quantifying and minimizing contamination in CA.

Results
We imaged checkered CA that express two distinct fluorescent proteins and segmented images into single cells to quantify the transfection efficiency and interspot contamination. Compared with standard procedures, we measured a 3-fold reduction of contaminants when arrays containing HeLa cells were washed shortly after cell seeding. We proved that nucleic acid uptake during cell seeding rather than migration among neighboring spots was the major source of contamination. Arrays of MCF7 cells developed without the washing step showed 7-fold lower percentage of contaminant cells, demonstrating that contamination is dependent on specific cell properties.

Conclusions
Previously published methodological works have focused on achieving high transfection rate in densely packed CA. Here, we focused in an equally important parameter: The interspot contamination. The presented quality control is essential for estimating the rate of contamination, a major source of false positives and negatives in current microscopy based functional genomics screenings. We have demonstrated that a washing step after seeding enhances CA quality for HeLA but is not necessary for MCF7. The described method provides a way to find optimal seeding protocols for cell lines intended to be used for the first time in CA.
Activation of NK cell cytotoxicity by the natural compound 2,3-butanediol
Authors: Lai Hsin-Chih , Chang Chih-Jung , Yang Chun-Hung , Hsu Ya-Jing , Chen Chang-Chieh , Lin Chuan-Sheng , Tsai Yu-Huan , Huang Tsung-Teng , Ojcius David M , Tsai Ying-Huang , Lu Chia-Chen 
Published: July 2012

Abstract2,3-BTD activates NK cells cytotoxicity by NKG2D/NCRs pathways.The natural compound 2,3-BTD has diverse physiological effects in a range of organisms, including acting as a detoxifying product of liver alcohol metabolism in humans and ameliorating endotoxin-induced acute lung injury in rats. In this study, we reveal that 2,3-BTD enhances NK cell cytotoxic activity in human pNK cells and NK92 cells. Treatment of NK cells with 2,3-BTD increased perforin expression in a dose-dependent manner. This was accompanied by elevated JNK and ERK1/2 MAPK activities and enhanced expression of NKG2D/NCRs, upstream signaling molecules of the MAPK pathways. The 2,3-BTD effect was inhibited by pretreatment with inhibitors of JNK (SP) or ERK1/2 (PD) or by depleting NKG2D/NCRs or JNK1 or ERK2 with siRNA. These results indicate that 2,3-BTD activates NK cell cytotoxicity by NKG2D/NCR pathways and represent the first report of the 2,3-BTD effect on activation of innate immunity cells.
Dental Composite Restorations and Psychosocial Function in Children
Authors: Maserejian Nancy N. , Trachtenberg Felicia L. , Hauser Russ , McKinlay Sonja , Shrader Peter , Tavares Mary , Bellinger David C. 
Published: July 2012

BACKGROUND AND OBJECTIVE:
Resin-based dental materials may intraorally release their chemical components and bisphenol A. The New England Children’s Amalgam Trial found that children randomized to amalgam had better psychosocial outcomes than those assigned to composites for posterior tooth restorations. The objective of this study was to examine whether greater exposure to dental composites is associated with psychosocial problems in children.

METHODS:
Analysis of treatment-level data from the New England Children’s Amalgam Trial, a 2-group randomized safety trial comparing amalgam with the treatment plan of bisphenol A-glycidyl methacrylate (bisGMA)-based composite and urethane dimethacrylate–based polyacid-modified composite (compomer), among 534 children aged 6 to 10 years at baseline. Psychosocial function at follow-up (n = 434) was measured by using the self-reported Behavior Assessment System for Children (BASC-SR) and parent-reported Child Behavior Checklist (CBCL).

RESULTS:
Children with higher cumulative exposure to bisGMA-based composite had poorer follow-up scores on 3 of 4 BASC-SR global scales: Emotional Symptoms (β = 0.8, SE = 0.3, P = .003), Clinical Maladjustment (β = 0.7, SE = 0.3, P = .02), and Personal Adjustment (β = –0.8, SE = 0.2, P = .002). Associations were stronger with posterior-occlusal (chewing) surfaces, where degradation of composite was more likely. For CBCL change, associations were not statistically significant. At-risk or clinically significant scores were more common among children with greater exposure for CBCL Total Problem Behaviors (16.3% vs 11.2%, P-trend = .01) and numerous BASC-SR syndromes (eg, ≥13 vs 0 surface-years, Interpersonal Relations 13.7% vs 4.8%, P-trend = .01). No associations were found with compomer, nor with amalgam exposure levels among children randomized to amalgam.

CONCLUSIONS:
Greater exposure to bisGMA-based dental composite restorations was associated with impaired psychosocial function in children, whereas no adverse psychosocial outcomes were observed with greater urethane dimethacrylate–based compomer or amalgam treatment levels.
The Impact of Macromastia on Adolescents: A Cross-Sectional Study
Authors: Cerrato Felecia , Webb Michelle L. , Rosen Heather , Nuzzi Laura , McCarty Erika R. , DiVasta Amy D. , Greene Arin K. , Labow Brian I. 
Published: July 2012

OBJECTIVE:
To determine the physical and psychosocial impact of macromastia on adolescents considering reduction mammaplasty in comparison with healthy adolescents.

METHODS:
The following surveys were administered to adolescents with macromastia and control subjects, aged 12 to 21 years: Short-Form 36v2, Rosenberg Self-Esteem Scale, Breast-Related Symptoms Questionnaire, and Eating-Attitudes Test-26 (EAT-26). Demographic variables and self-reported breast symptoms were compared between the 2 groups. Linear regression models, unadjusted and adjusted for BMI category (normal weight, overweight, obese), were fit to determine the effect of case status on survey score. Odds ratios for the risk of disordered eating behaviors (EAT-26 score ≥20) in cases versus controls were also determined.

RESULTS:
Ninety-six subjects with macromastia and 103 control subjects participated in this study. Age was similar between groups, but subjects with macromastia had a higher BMI (P = .02). Adolescents with macromastia had lower Short-Form 36v2 domain, Rosenberg Self-Esteem Scale, and Breast-Related Symptoms Questionnaire scores and higher EAT-26 scores compared with controls. Macromastia was also associated with a higher risk of disordered eating behaviors. In almost all cases, the impact of macromastia was independent of BMI category.

CONCLUSIONS:
Macromastia has a substantial negative impact on health-related quality of life, self-esteem, physical symptoms, and eating behaviors in adolescents with this condition. These observations were largely independent of BMI category. Health care providers should be aware of these important negative health outcomes that are associated with macromastia and consider early evaluation for adolescents with this condition.