bluuebunny/crossref_metadata_2025_split huggingface dataset:
Facilitating and evaluating a student‐led seminar series on global health issues as an opportunity for interprofessional learning for health science students
Authors: Cooper Brian A. , MacMillan Beth D. , Beck Ranit A. , Paterson Margo L. 
Published: July 2009

AbstractPre‐licensure interprofessional education (IPE) is often cited as an important foundation in promoting collaboration between healthcare professionals. Due to administrative and attitudinal challenges that can arise in delivering IPE, pre‐licensure healthcare students are rarely given the opportunity to learn together. As a result of the lack of opportunity in the formal curricula, an interprofessional student group developed and coordinated a 10‐week, extracurricular seminar series on global health for medicine, nursing and occupational and physical therapy students at a Canadian university in 2006. This seminar series featured multi‐disciplinary experts in global health and integrated interprofessional problem‐based learning. Using qualitative methods, including focus groups, student reflections and pre‐ and post‐course surveys, specific areas were evaluated as follows: participants’ attitudes towards IPE; the appropriateness of using global health as a vehicle for IPE; and the perceived obstacles and benefits of the IPE experience provided by this seminar series. The evaluation findings highlight the unique benefits and drawbacks of using global health as a vehicle for IPE, the value of sharing a common interest between professions in delivering IPE, perceived practice implications resulting from this seminar series and recommendations in delivering such an initiative. Also, while providing many of the same benefits in the promotion of collaboration between professions as recognized in formal IPE, this student‐run, extracurricular model was shown to limit administrative obstacles, facilitate self‐directed learning and integrate a diverse population of students. Overall, the model and content described was shown to serve as a beneficial and unique means of delivering IPE.
Calorie restriction alters mitochondrial protein acetylation
Authors: Schwer Bjoern , Eckersdorff Mark , Li Yu , Silva Jeffrey C. , Fermin Damian , Kurtev Martin V. , Giallourakis Cosmas , Comb Michael J. , Alt Frederick W. , Lombard David B. 
Published: July 2009

SummaryCalorie restriction (CR) increases lifespan in organisms ranging from budding yeast through mammals. Mitochondrial adaptation represents a key component of the response to CR. Molecular mechanisms underlying this adaptation are largely unknown. Here we show that lysine acetylation of mitochondrial proteins is altered during CR in a tissue‐specific fashion. Via large‐scale mass spectrometry screening, we identify 72 candidate proteins involved in a variety of metabolic pathways with altered acetylation during CR. Mitochondrial acetylation changes may play an important role in the pro‐longevity CR response.
d4eBP acts downstream of both dTOR and dFoxo to modulate cardiac functional aging in Drosophila
Authors: Wessells Robert , Fitzgerald Erin , Piazza Nicole , Ocorr Karen , Morley Samantha , Davies Claire , Lim Hui‐Ying , Elmén Lisa , Hayes Michael , Oldham Sean , Bodmer Rolf 
Published: July 2009

SummarydTOR (target of rapamycin) and dFoxo respond to changes in the nutritional environment to induce a broad range of responses in multiple tissue types. Both dTOR and dFoxo have been demonstrated to control the rate of age‐related decline in cardiac function. Here, we show that the Eif4e‐binding protein (d4eBP) is sufficient to protect long‐term cardiac function against age‐related decline and that up‐regulation of dEif4e is sufficient to recapitulate the effects of high dTOR or insulin signaling. We also provide evidence that d4eBP acts tissue‐autonomously and downstream of dTOR and dFoxo in the myocardium, where it enhances cardiac stress resistance and maintains normal heart rate and myogenic rhythm. Another effector of dTOR and insulin signaling, dS6K, may influence cardiac aging nonautonomously through its activity in the insulin‐producing cells, possibly by regulating dilp2 expression. Thus, elevating d4eBP activity in cardiac tissue represents an effective organ‐specific means for slowing or reversing cardiac functional changes brought about by normal aging.
Soil aggregation and organic carbon in short‐term stockpiles
Authors: Wick A. F. , Stahl P. D. , Ingram L. J. , Vicklund L. 
Published: July 2009

AbstractSurface mining is known to drastically reduce soil organic carbon (OC) pools through various mechanisms associated with topsoil salvage, stockpiling and respreading. Stockpiling is an important management practice; however, the effects of this practice on reductions and recovery of soil aggregation and aggregate OC are poorly understood. Objectives of this research were to monitor soil aggregation and aggregate OC in the surface of a short‐term stockpile (<3 yr) followed by a second movement of stockpiled soils to a temporary location. Samples were analysed for aggregate size distribution, aggregate fractions, OC, and organic matter turnover using 13C natural abundance. Macroaggregate proportions increased and microaggregate proportions decreased after 3 yr of storage, possibly indicating recovery of soil structure. Following the removal of the stockpile and placement in a temporary pile, macroaggregation decreased and free silt and clay fractions increased relative to initially stockpiled soils. The second disturbance resulted in greater destruction of aggregate structure than the initial disturbance during topsoil salvage. Aggregate organic matter (as indicated by OC) increased significantly between the early sampling of the stockpiled soils (<1 yr in storage) and the placement of the topsoil in a temporary pile in macroaggregates and remained the same for microaggregates. Organic matter not protected within aggregates decreased with storage time as this material was available for utilization by microbes while aggregate protected organic matter (OM) remained unchanged or slightly increased for macro‐ and microaggregates with stockpile storage time. Aggregate δ13C values did not indicate inclusion of new OM within soil aggregates after 3 yr of topsoil stockpiling. Short‐term stockpiling was beneficial for aggregation in the surface layers where plant roots and microbial communities were active; however, subsequent movement of the topsoil resulted in a greater loss of soil aggregation relative to the initial topsoil salvage without impacting soil OC.
An Animal Study of a Newly Developed Skin‐Penetrating Pad and Covering Material for Catheters to Prevent Exit‐Site Infection in Continuous Ambulatory Peritoneal Dialysis
Authors: Aoyama Masato , Mizuno Toshihide , Tatsumi Eisuke , Taenaka Yoshiyuki , Nemoto Yasushi , Okamoto Yoshihiro , Takemoto Yoshiaki , Naganuma Toshihide , Nakatani Tatsuya 
Published: July 2009

AbstractBecause currently available peritoneal dialysis catheters are not sufficiently biocompatible with the skin and subcutaneous tissue at the site of penetration, exit‐site infection due to pericatheter pocket formation caused by epidermal downgrowth over a long period of time has increasingly become a problem. We developed a new, biocompatible, segmented polyurethane porous material and devised a novel skin‐penetrating pad, the form and material of which we optimized for application in peritoneal dialysis catheters. For the extent of tissue ingrowth into this porous material to be examined, test materials with different pore diameters were inserted into hollow silicone tubes and implanted in the subcutaneous tissue of a goat. Four weeks later, the tubes were extracted, and, after the extent of granulation tissue ingrowth was measured, histopathological evaluation was made. Our novel skin‐penetrating pad has three disklike layers of the segmented polyurethane material with different pore sizes, into the center of which a polyurethane catheter is inserted. These pads were implanted in the skin of a goat and clinically observed over a 2‐year period, after which they were extracted and histopathologically analyzed. In accordance with actual clinical procedures, a commercial CAPD catheter equipped with our skin‐penetrating pad was left indwelling in a goat for 4 months, and the performance of the pad was evaluated after repeated periodic infusion and drainage of the dialysate in and out of the abdominal cavity. There was no inflammation of the ingrown tissue in the pores of the segmented polyurethane material as well as the surrounding tissue, which indicated favorable tissue biocompatibility. The extent of tissue ingrowth was greater as the pore size of the material was larger, and the tissue tended to be mature, mainly consisting of collagenous fibers. The skin‐penetrating pad using the porous material, of which tissue ingrowth was thus optimized, tightly adhered to the goat skin throughout the 2‐year experimental period without any special wound care such as cleansing or disinfection. The performance of the skin‐penetrating pad was similarly favorable when attached to a commercial continuous ambulatory peritoneal dialysis catheter. The newly developed segmented polyurethane porous material had excellent tissue biocompatibility and tissue ingrowth. The skin‐penetrating pad devised by using this porous material did not cause epidermal downgrowth, suggesting that it may be effective for the prevention of exit‐site infection.
Development of an Algorithm to Regulate Pump Output for a Closed Air‐Loop Type Pneumatic Biventricular Assist Device
Authors: Nam Kyoung Won , Lee Jung Joo , Hwang Chang Mo , Choi Jaesoon , Choi Hyuk , Choi Seong Wook , Sun Kyung 
Published: July 2009

AbstractThe closed air space‐type of extracorporeal pneumatic ventricular assist device (VAD) developed by the Korea Artificial Organ Center utilizes a bellows‐transforming mechanism to generate the air pressure required to pump blood. This operating mechanism can reduce the size and weight of the driving unit; however, the output of the blood pump can be affected by the pressure loading conditions of the blood sac. Therefore, to guarantee a proper pump output level, regardless of the pressure loading conditions that vary over time, automatic pump output regulation of the blood pump is required. We describe herein a pump output regulation algorithm that was developed to maintain pump output around a reference level against various afterload pressures, and verified the pump performance in vitro. Based on actual operating conditions in animal experiments, the pumping rate was limited to 40–84 beats per minute, and the afterload pressure was limited to 80–150 mm Hg. The tested reference pump output was 4.0 L/min. During experiments, the pump output was successfully and automatically regulated within the preset area regardless of the varying afterload conditions. The results of this preliminary experiment can be used as the basis for an automatic control algorithm that can enhance the stability and reliability of the applied VAD.
Early Responses in Randomized Clinical Trials of Triptans in Acute Migraine Treatment. Are They Clinically Relevant? A Comment
Authors: Tfelt‐Hansen Peer 
Published: July 2009

(Headache 2010;50:1198‐1200)One can question the clinical relevance of early headache responses after oral and intranasal triptans. Thus, for pain‐free the early responses were significant but in absolute values they were only a few percentages: the therapeutic gains (TGs) were 1.8% (95% CI = 0.3‐3%) for oral almotriptan 12.5 after 30 minutes and 1.0% (95% CI = 0‐2%) after intranasal zolmitriptan 5 mg after 15 minutes. These results are compared with subcutaneous sumatriptan 6 mg which has TGs of 11% (95% CI = 7‐15%) to 14% (95% CI = 11‐17%) for pain‐free after 30 minutes. Subcutaneous sumatriptan has a 2 times higher response rate than intranasal zolmitriptan and is 5 times more effective than oral almotriptan at these early time points. It is concluded that if a very early and clinically relevant effect is desired then the migraine patient should use the subcutaneous administration form of sumatriptan.
Nontraumatic Headaches in the Emergency Department: Evaluation of a Clinical Pathway
Authors: Dutto Luca , Meineri Piero , Melchio Remo , Bracco Christian , Lauria Giuseppe , Sciolla Andrea , Pomero Fulvio , Sturlese Ugo , Grasso Enzo , Tartaglino Bruno 
Published: July 2009

Objective.— To determine the impact and efficacy of a clinical pathway in the management of patients with nontraumatic and afebrile headache (NTAH) in the emergency department (ED).Background.— Nontraumatic and afebrile headache is one of the most common neurological symptoms in the ED. However, data about the application of an evidence‐based operative protocol are lacking.Methods.— A before–after intervention study comparing adult patients presenting to the ED with atraumatic headache was conducted during a 6‐month period from April to September 2005 and with the same type of patients in the same period in 2006 after a clinical pathway had been implemented. According to their clinical presentations, patients of the 2006 group were divided into 3 subgroups and managed following the established protocol.Study results were based on analysis of 6 months of clinical outcome, the number of CT head scans in the ED, number of neurological consultations in the ED, number of admissions, and length of stay in the ED.Results.— A total of 686 patients were enrolled in the study, of which 374 were those presenting to our ED with NTAH in 2006 and managed with the aid of the study protocol; the other 312 patients were those who presented in 2005, before the intervention.The study protocol was strictly applied to 247 patients (66%) of the 2006 group. There were fewer neurological consultations after the intervention (41.2% vs 52.5%, difference: −11.3%, 95% confidence intervals [CI]: −18.7% to −3.9%; P = .003); likewise, admissions were significantly reduced after the intervention (9.0% vs 14.7%, difference: −5.7%, 95% CI: −10.6% to −0.8%; P = .02). No significant differences were found between the 2 groups for number of CT head scans (42.2% vs 38.4%, difference: 3.7%, 95% CI: −3.5% to 11%; P = .3).Mean length of stay in the ED was lower after the intervention, though not significantly (170.6 ± 102 minutes vs 180.5 ± 105 minutes, difference: −9.8 minutes, 95% CI: −20.3 to 5.7; P = .09). A 6‐month follow‐up was completed involving 302 (96.7%) patients in the first group and 370 (98.9%) in the second group. There was only one misdiagnosis after the intervention while 2 incorrect diagnoses were made before the intervention (0.27% vs 0.6%, difference: −0.33%, 95% CI: −2.1% to 0.9%; P = .5).Conclusions.— Our diagnostic protocol for NTAH appears to be safe and sensitive in diagnosing malignant headaches. In addition, it may improve use of resources by reducing the need for neurological consultations and admissions without increasing the number of CT scans or prolonging length of stay in the ED. Furthermore, when using the protocol ED physicians seem more confident in their evaluations of headache resulting in fewer requests for specialist input.
Post‐Traumatic External Nasal Pain Syndrome (a Trigeminal Based Pain Disorder)
Authors: Rozen Todd 
Published: July 2009

Little has been written about persistent external nasal pain after injury to the nose in the neurologic or headache literature. In clinical practice, this can be a disabling and treatment refractory condition. The external portion of the nose is highly innervated by branches of the ophthalmic and maxillary divisions of the trigeminal nerve including the nasociliary nerve, external nasal nerve, infratrochlear nerve, anterior ethmoidal nerve, and infraorbital nerve. As these nerves are located on the external portion of the nose just deep enough to the skin they can be easily traumatized with any impact to the nose.Four patients with what is termed the post‐traumatic external nasal pain syndrome are reported in this paper, describing the clinical presentation of the disorder and providing treatment options. Post‐traumatic external nasal pain syndrome appears to be a novel form of trigeminal‐based pain not previously reported in the neurologic literature.
Catastrophe Risk Financing in the United States and the European Union: A Comparative Analysis of Alternative Regulatory Approaches
Authors: Klein Robert W. , Wang Shaun 
Published: July 2009

AbstractThe regulation of insurance companies in the United States and the European Union (EU) continues to evolve in response to market forces and the changing nature of risk but with somewhat different philosophies and at different rates. One important area where both economic realities and markets are changing is catastrophe risk and its financing. This article examines and compares regulatory and other government policies in the United States and the EU generally and their approaches to the financing of catastrophe risk specifically. It is important to understand the fundamental differences between the two systems to gain insights into their disparate treatment of catastrophe risk financing. Although policies could be improved in both jurisdictions, we argue that the much greater reform is needed in the United States relative to the EU regulatory policies that are being developed. We offer recommendations on how U.S. policies could be significantly improved as well as comment on issues facing the EU. We conclude with some observations on the needs for further progress in the U.S. and EU regulatory systems.
Modeling Mortality With Jumps: Applications to Mortality Securitization
Authors: Chen Hua , Cox Samuel H. 
Published: July 2009

AbstractIn this article, we incorporate a jump process into the original Lee–Carter model, and use it to forecast mortality rates and analyze mortality securitization. We explore alternative models with transitory versus permanent jump effects and find that modeling mortality via transitory jump effects may be more appropriate in mortality securitization. We use the Swiss Re mortality bond in 2003 as an example to show how to apply our model together with the distortion measure approach to value mortality‐linked securities. Pricing the Swiss Re mortality bond is challenging because the mortality index is correlated across countries and over time. Cox, Lin, and Wang (2006) employ the normalized multivariate exponential tilting to take into account correlations across countries, but the problem of correlation over time remains unsolved. We show in this article how to account for the correlations of the mortality index over time by simulating the mortality index and changing the measure on paths.
Correlation of Mechanical Dyssynchrony with QRS Duration Measured by Signal‐Averaged Electrocardiography
Authors: Andrikopoulos George K. , Tzeis Stylianos , Kolb Christof , Sakellariou Dimitrios , Avramides Dimosthenes , Alexopoulos Evangelos C. , Triantafyllou Konstantinos , Manolis Antonis S. 
Published: July 2009

Background: Preimplantation left ventricular dyssynchrony is considered a prerequisite for a beneficial response to cardiac resynchronization therapy (CRT). However, electrical dyssynchrony estimated by QRS duration (QRSd) on ECG has not been proven to be an optimal surrogate of mechanical dyssynchrony. We evaluated the correlation of mechanical dyssynchrony with QRSd as measured by signal‐averaged electrocardiography (SAECG) in comparison with measurements based on conventional surface ECG and with onscreen measurements based on digital ECG. Methods: We included 49 consecutive patients with decompensated heart failure (40 men, aged 66.8 ± 9.5 years), New York Heart Association (NYHA) class II–IV, and LVEF ≤ 40%. QRSd was calculated by manual measurement of 12‐lead ECG, on‐screen measurement of computer‐based ECG, and calculation of total ventricular activation time on SAECG. Results: Only 60.4% of the studied patients had QRS ≥ 120 ms based on measurements derived by SAECG compared to 69.4% by using on‐screen measurement of computer‐based ECG and 73.5% based on surface ECG (P = 0.041). Interventricular but not intraventricular delay was correlated with QRSd. The correlation of interventricular dyssynchrony with QRSd was stronger when measured by SAECG than by surface ECG (r = 0.45, P = 0.001 vs r = 0.35, P < 0.01). Among patients with ischemic cardiomyopathy, no significant correlation was demonstrated between mechanical dyssynchrony and QRSd. In nonischemic patients, interventricular delay was significantly correlated with QRSd measured by surface ECG (r = 0.45, P < 0.05) and SAECG (r = 0.46, P < 0.05). Conclusions: The use of SAECG results in different patient classification in wide QRS complex category as compared to surface ECG. Furthermore, QRSd measured by SAECG is correlated with interventricular but not intraventricular dyssynchrony in heart failure patients.
Correction for QT/RR Hysteresis in the Assessment of Drug‐Induced QTc Changes—Cardiac Safety of Gadobutrol
Authors: Malik Marek , Hnatkova Katerina , Schmidt Anna , Smetana Peter 
Published: July 2009

Background: The so‐called thorough QT/QTc (TQT) studies required for every new pharmaceutical compound are negative if upper single‐sided 95% confidence interval (CI) of placebo and baseline corrected QTc prolongation is <10 ms. This tight requirement has many methodological implications. If the investigated drug has a fast action and ECGs cannot be obtained at stable heart rates, QT/RR hysteresis correction is needed. Methods: This was used in a TQT study of gadobutrol. The TQT study was a randomized double‐blind five‐times crossover study of three doses of gadobutrol (0.1, 0.3, and 0.5 mmol/kg) that was placebo and positive effect controlled (moxifloxacin 400 mg). The study enrolled 50 healthy subjects with data of all periods. QT/RR hysteresis was assessed from prestudy exercise test ECGs. Among others, comparisons were made between population heart rate correction without hysteresis considerations and combined population heart rate and hysteresis correction. Results: The highest heart rate increase (placebo and baseline controlled) of 13.1 beats per minute (90% CI 9.9–16.4) occurred 1 minute after the administration of the highest dose of gadobutrol. Without hysteresis consideration, the highest ΔΔQTc were 9.91 ms (90% CI 8.01–11.81) while with hysteresis correction, these values were 7.62 ms (90% CI 6.37–8.87), thus turning a marginally positive TQT study into a negative finding. Conclusion: Hence, omitting hysteresis correction from episodes of fast heart rate changes may lead to incorrect conclusions. Despite substantial rate acceleration, accurate hysteresis correction confirms that gadobutrol does not have any effects on cardiac repolarization that would be within the limits of regulatory relevance.
Atrial Fibrillation in Patients with Constrictive Pericarditis: The Significance of Pericardial Calcification
Authors: Rezaian Gholam R. , Poor‐Moghaddas Masoud , Kojuri Javad , Rezaian Shahed , Liaghat Lida , Zare Najaf 
Published: July 2009

Background: Although atrial fibrillation (AF) is commonly encountered in patients with constrictive pericarditis (CP), little has been done to clarify its associated predisposing factors. Our aim was to evaluate the association of age, gender, disease duration, and pericardial calcification with AF in these patients. Methods: The medical records of 44 patients with CP were reviewed. There were 13 (29.5%) with AF and 31 (70.5%) with sinus rhythm. The two groups were compared for demographic variables, disease duration, and the presence of pericardial calcification. Results: The male‐to‐female ratio was 3.4:1. Calcification was seen in 11 (25%) of the entire group. AF was much more common in those with calcification than those with sinus rhythm (odds ratio, 7.87 [95% CI, 1.73–35.78], P = 0.008). There was no association between the presence of AF and the age (P = 0.156) or gender (P ≈ 1.00). Logistic regression, however, showed that the chance of developing AF increased by 27% by each year of increase in disease duration (P = 0.025). Conclusion: It seems that in patients with CP, the presence of pericardial calcification and the increasing disease duration are associated with a higher chance of developing AF.