bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bedside adherence to clinical practice guidelines for enteral nutrition in critically ill patients receiving mechanical ventilation: a prospective, multi-centre, observational study
Authors: Quenot Jean-Pierre , Plantefeve Gaetan , Baudel Jean-Luc , Camilatto Isabelle , Bertholet Emmanuelle , Cailliod Romain , Reignier Jean , Rigaud Jean-Philippe 
Published: March 2010

Abstract
Introduction
The primary aim was to measure the amount of nutrients required, prescribed and actually administered in critically ill patients. Secondary aims were to assess adherence to clinical practice guidelines, and investigate factors leading to non-adherence.

Methods
Observational, multicenter, prospective study, including 203 patients in a total of 19 intensive care units in France. The prescribed calorie supply was compared with the theoretical minimal required calorie intake (25 Kcal/Kg/day) and with the supply actually delivered to the patient to calculate the ratio of calories prescribed/required and the ratio of calories delivered/prescribed. Clinical factors suspected to influence enteral nutrition were analyzed by univariate and multivariate analysis.

Results
The median ratio of prescribed/required calories per day was 43 [37-54] at day 1 and increased until day 7. From day 4 until the end of the study, the median ratio was > 80%. The median ratio of delivered/prescribed per day was > 80% for all 7 days from the start of enteral nutrition. Among the variables tested (hospital type, use of a local nutrition protocol, sedation, vasoactive drugs, number of interruptions of enteral nutrition and measurement of gastric residual volume), only measurement of residual volume was significant by univariate analysis. This was confirmed by multivariate analysis, where gastric residual volume measurement was the only variable independently associated with the ratio of delivered/prescribed calories (OR = 1.38; 95%CI, 1.12-2.10, p = .024).

Conclusions
The translation of clinical research and recommendations for enteral nutrition into routine bedside practice in critically ill patients receiving mechanical ventilation was satisfactory, but could probably be improved with a multidisciplinary approach.
Immunomodulatory properties of stem cells from human exfoliated deciduous teeth
Authors: Yamaza Takayoshi , Kentaro Akiyama , Chen Chider , Liu Yi , Shi Yufang , Gronthos Stan , Wang Songlin , Shi Songtao 
Published: March 2010

Abstract
Introduction
Stem cells from human exfoliated deciduous teeth (SHED) have been identified as a population of postnatal stem cells capable of differentiating into osteogenic and odontogenic cells, adipogenic cells, and neural cells. Herein we have characterized mesenchymal stem cell properties of SHED in comparison to human bone marrow mesenchymal stem cells (BMMSCs).

Methods
We used in vitro stem cell analysis approaches, including flow cytometry, inductive differentiation, telomerase activity, and Western blot analysis to assess multipotent differentiation of SHED and in vivo implantation to assess tissue regeneration of SHED. In addition, we utilized systemic SHED transplantation to treat systemic lupus erythematosus (SLE)-like MRL/lpr mice.

Results
We found that SHED are capable of differentiating into osteogenic and adipogenic cells, expressing mesenchymal surface molecules (STRO-1, CD146, SSEA4, CD73, CD105, and CD166), and activating multiple signaling pathways, including TGFβ, ERK, Akt, Wnt, and PDGF. Recently, BMMSCs were shown to possess an immunomodulatory function that leads to successful therapies for immune diseases. We examined the immunomodulatory properties of SHED in comparison to BMMSCs and found that SHED had significant effects on inhibiting T helper 17 (Th17) cells in vitro. Moreover, we found that SHED transplantation is capable of effectively reversing SLE-associated disorders in MRL/lpr mice. At the cellular level, SHED transplantation elevated the ratio of regulatory T cells (Tregs) via Th17 cells.

Conclusions
These data suggest that SHED are an accessible and feasible mesenchymal stem cell source for treating immune disorders like SLE.
Identification of Subtypes in Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer Reveals a Gene Signature Prognostic of Outcome
Authors: Staaf Johan , Ringnér Markus , Vallon-Christersson Johan , Jönsson Göran , Bendahl Pär-Ola , Holm Karolina , Arason Adalgeir , Gunnarsson Haukur , Hegardt Cecilia , Agnarsson Bjarni A. , Luts Lena , Grabau Dorthe , Fernö Mårten , Malmström Per-Olof , Johannsson Oskar Th. , Loman Niklas , Barkardottir Rosa B. , Borg Åke 
Published: March 2010

Purpose Human epidermal growth factor receptor 2 (HER2) gene amplification or protein overexpression (HER2 positivity) defines a clinically challenging subgroup of patients with breast cancer (BC) with variable prognosis and response to therapy. We aimed to investigate the heterogeneous biologic appearance and clinical behavior of HER2-positive tumors using molecular profiling. Patients and Methods Hierarchical clustering of gene expression data from 58 HER2-amplified tumors of various stage, histologic grade, and estrogen receptor (ER) status was used to construct a HER2-derived prognostic predictor that was further evaluated in several large independent BC data sets. Results Unsupervised analysis identified three subtypes of HER2-positive tumors with mixed stage, histologic grade, and ER status. One subtype had a significantly worse clinical outcome. A prognostic predictor was created based on differentially expressed genes between the subtype with worse outcome and the other subtypes. The predictor was able to define patient groups with better and worse outcome in HER2-positive BC across multiple independent BC data sets and identify a sizable HER2-positive group with long disease-free survival and low mortality. Significant correlation to prognosis was also observed in basal-like, ER-negative, lymph node–positive, and high-grade tumors, irrespective of HER2 status. The predictor included genes associated with immune response, tumor invasion, and metastasis. Conclusion The HER2-derived prognostic predictor provides further insight into the heterogeneous biology of HER2-positive tumors and may become useful for improved selection of patients who need additional treatment with new drugs targeting the HER2 pathway.
Psychological Outcomes and Health Beliefs in Adolescent and Young Adult Survivors of Childhood Cancer and Controls
Authors: Kazak Anne E. , DeRosa Branlyn Werba , Schwartz Lisa A. , Hobbie Wendy , Carlson Claire , Ittenbach Richard F. , Mao Jun J. , Ginsberg Jill P. 
Published: March 2010

Purpose The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. Patients and Methods AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. Conclusion AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.
Mapping of the Fibroblast Growth Factors in Human White Adipose Tissue
Authors: Mejhert Niklas , Galitzky Jean , Pettersson Amanda T. , Bambace Clara , Blomqvist Lennart , Bouloumié Anne , Frayn Keith N. , Dahlman Ingrid , Arner Peter , Rydén Mikael 
Published: March 2010

Abstract
Context: Fibroblast growth factors (FGFs) regulate the development of white adipose tissue (WAT). However, the secretion and cellular origin of individual FGFs in WAT as well as the influence of obesity are unknown.
Objective: Our objective was to map FGFs in human sc WAT, the cellular source, and association with obesity.
Design: Secretion, mRNA, and circulatory levels of FGFs in human abdominal sc WAT from nonobese and obese donors were examined by microarray, real-time quantitative PCR, and ELISA. The activity of FGFs in cultured human adipocytes was determined by phosphorylation assays.
Results: Expression of five FGFs (FGF1, FGF2, FGF7, FGF9, and FGF18) and FGF homologous factor (FHF2) was identified in WAT. Only FGF1 was released in a time-dependent manner from sc WAT, and fat cells were the major source of FGF1 secretion. FGF1 expression increased and FGF2 decreased during adipocyte differentiation. Furthermore, FGF1 was not secreted into the circulation. Although FGF1 levels were 2-fold increased in obesity, they were unaltered by weight reduction. Only FGF1 and FGF2 induced a marked concentration-dependent phosphorylation of p44/42 in cultured human adipocytes.
Conclusions: Of the investigated FGFs, only FGF1 is secreted from sc WAT and predominantly so from the adipocyte fraction. The activity in adipocyte cultures and lack of secretion into the circulation suggest that FGF1 acts as an auto- or paracrine factor. FGF1 levels are increased in obesity but unaffected by weight reduction, suggesting a primary defect in obese individuals. In conclusion, FGF1 may play a superior role among the FGFs in sc WAT and obesity development.
Infants of Women with Polycystic Ovary Syndrome Have Lower Cord Blood Androstenedione and Estradiol Levels
Authors: Anderson Helen , Fogel Naomi , Grebe Stefan K. , Singh Ravinder J. , Taylor Robert L. , Dunaif Andrea 
Published: March 2010

Abstract
Context: Prenatal androgen excess can cause a phenocopy of polycystic ovary syndrome (PCOS) in mammals. Retrospective studies have suggested that girls at risk for PCOS have low birth weight, and prospective studies have suggested an increased prevalence of small-for-gestational-age offspring in women with PCOS.
Objective: The objective of the study was to determine whether infants of women with PCOS have reduced birth weight or increased intrauterine androgen levels.
Design: This was a prospective case-control study.
Participants: Thirty-nine PCOS and 31 control women and their infants participated in the study.
Main Outcome Measures: Birth weight and mixed cord blood testosterone, androstenedione (A), dehydroepiandrosterone, 17-hydroxyprogesterone, estradiol (E2), and dihydrotestosterone levels were measured.
Results: Mean birth weight did not differ, but there was a significant increase in the prevalence of large-for-gestational-age infants in the PCOS group. Cord blood E2 and A levels were lower (P &lt; 0.05), but testosterone to E2 ratios did not differ in female PCOS compared with control offspring. There was no difference in E2 and A levels in the male PCOS and control offspring. There was no difference in 17-hydroxyprogesterone or other androgen levels in either male or female PCOS offspring compared with their respective control group.
Conclusion: Infants of women with PCOS were more likely to be large for gestational age. Female offspring of affected women have lower cord blood A levels; other cord blood androgen levels do not differ compared with female control offspring. Cord blood E2 levels are also significantly decreased in PCOS, without any difference in the testosterone to E2 ratio, suggesting decreased fetal or placental production of steroids.
The UGC Hardness Threshold of the Lp Grothendieck Problem
Authors: Kindler Guy , Naor Assaf , Schechtman Gideon 
Published: March 2010

For p ≥ 2 we consider the problem of, given an n × n matrix A = (aij) whose diagonal entries vanish, approximating in polynomial time the number [Formula: see text] When p = 2 this is simply the problem of computing the maximum eigenvalue of A, whereas for p = ∞ (actually it suffices to take p ≈ log n) it is the Grothendieck problem on the complete graph, which was shown to have a O(log n) approximation algorithm in Nemirovski et al. [Nemirovski, A., C. Roos, T. Terlaky. 1999. On maximization of quadratic form over intersection of ellipsoids with common center. Math. Program. Ser. A 86(3) 463–473], Megretski [Megretski, A. 2001. Relaxations of quadratic programs in operator theory and system analysis. Systems, Approximation, Singular Integral Operators, and Related Topics (Bordeaux, 2000), Vol. 129. Operator Theory Advances and Applications. Birkhäuser, Basel, 365–392], Charikar and Wirth [Charikar, M., A. Wirth. 2004. Maximizing quadratic programs: Extending Grothendieck's inequality. Proc. 45th Annual Sympos. Foundations Comput. Sci., IEEE Computer Society, 54–60] and was used in the work of Charikar and Wirth noted above, to design the best known algorithm for the problem of computing the maximum correlation in correlation clustering. Thus the problem of approximating Optp(A) interpolates between the spectral (p = 2) case and the correlation clustering (p = ∞) case. From a physics point of view this problem corresponds to computing the ground states of spin glasses in a hard-wall potential well. We design a polynomial time algorithm which, given p ≥ 2 and an n × n matrix A = (aij) with zeros on the diagonal, computes Optp(A) up to a factor p/e + 30 log p. On the other hand, assuming the unique games conjecture (UGC) we show that it is NP-hard to approximate Optp(A) up to a factor smaller than p/e + ¼. Hence as p → ∞ the UGC-hardness threshold for computing Optp(A) is exactly (p/e)(1 + o(1)).
On the Power of Robust Solutions in Two-Stage Stochastic and Adaptive Optimization Problems
Authors: Bertsimas Dimitris , Goyal Vineet 
Published: March 2010

We consider a two-stage mixed integer stochastic optimization problem and show that a static robust solution is a good approximation to the fully adaptable two-stage solution for the stochastic problem under fairly general assumptions on the uncertainty set and the probability distribution. In particular, we show that if the right-hand side of the constraints is uncertain and belongs to a symmetric uncertainty set (such as hypercube, ellipsoid or norm ball) and the probability measure is also symmetric, then the cost of the optimal fixed solution to the corresponding robust problem is at most twice the optimal expected cost of the two-stage stochastic problem. Furthermore, we show that the bound is tight for symmetric uncertainty sets and can be arbitrarily large if the uncertainty set is not symmetric. We refer to the ratio of the optimal cost of the robust problem and the optimal cost of the two-stage stochastic problem as the stochasticity gap. We also extend the bound on the stochasticity gap for another class of uncertainty sets referred to as positive. If both the objective coefficients and right-hand side are uncertain, we show that the stochasticity gap can be arbitrarily large even if the uncertainty set and the probability measure are both symmetric. However, we prove that the adaptability gap (ratio of optimal cost of the robust problem and the optimal cost of a two-stage fully adaptable problem) is at most four even if both the objective coefficients and the right-hand side of the constraints are uncertain and belong to a symmetric uncertainty set. The bound holds for the class of positive uncertainty sets as well. Moreover, if the uncertainty set is a hypercube (special case of a symmetric set), the adaptability gap is one under an even more general model of uncertainty where the constraint coefficients are also uncertain.
Pediatric Lead Exposure From Imported Indian Spices and Cultural Powders
Authors: Lin Cristiane Gurgel , Schaider Laurel Anne , Brabander Daniel Joseph , Woolf Alan David 
Published: March 2010

BACKGROUND:
Significant lead poisoning has been associated with imported nonpaint products.

OBJECTIVES:
To describe cases of pediatric lead intoxication from imported Indian spices and cultural powders, determine lead concentrations in these products, and predict effects of ingestion on pediatric blood lead levels (BLLs).

PATIENTS AND METHODS:
Cases and case-study information were obtained from patients followed by the Pediatric Environmental Health Center (Children's Hospital Boston). Imported spices (n = 86) and cultural powders (n = 71) were analyzed for lead by using x-ray fluorescence spectroscopy. The simple bioaccessibility extraction test was used to estimate oral bioavailability. The integrated exposure uptake biokinetic model for lead in children was used to predict population-wide geometric mean BLLs and the probability of elevated BLLs (&gt;10 μg/dL).

RESULTS:
Four cases of pediatric lead poisoning from Indian spices or cultural powders are described. Twenty-two of 86 spices and foodstuff products contained &gt;1 μg/g lead (for these 22 samples, mean: 2.6 μg/g [95% confidence interval: 1.9–3.3]; maximum: 7.6 μg/g). Forty-six of 71 cultural products contained &gt;1 μg/g lead (for 43 of these samples, mean: 8.0 μg/g [95% confidence interval: 5.2–10.8]; maximum: 41.4 μg/g). Three sindoor products contained &gt;47% lead. With a fixed ingestion of 5 μg/day and 50% bioavailability, predicted geometric mean BLLs for children aged 0 to 4 years increased from 3.2 to 4.1 μg/dL, and predicted prevalence of children with a BLL of &gt;10 μg/dL increased more than threefold (0.8%–2.8%).

CONCLUSIONS:
Chronic exposure to spices and cultural powders may cause elevated BLLs. A majority of cultural products contained &gt;1 μg/g lead, and some sindoor contained extremely high bioaccessible lead levels. Clinicians should routinely screen for exposure to these products.
Clinical Genetic Testing for Patients With Autism Spectrum Disorders
Authors: Shen Yiping , Dies Kira A. , Holm Ingrid A. , Bridgemohan Carolyn , Sobeih Magdi M. , Caronna Elizabeth B. , Miller Karen J. , Frazier Jean A. , Silverstein Iris , Picker Jonathan , Weissman Laura , Raffalli Peter , Jeste Shafali , Demmer Laurie A. , Peters Heather K. , Brewster Stephanie J. , Kowalczyk Sara J. , Rosen-Sheidley Beth , McGowan Caroline , Duda Andrew W. , Lincoln Sharyn A. , Lowe Kathryn R. , Schonwald Alison , Robbins Michael , Hisama Fuki , Wolff Robert , Becker Ronald , Nasir Ramzi , Urion David K. , Milunsky Jeff M. , Rappaport Leonard , Gusella James F. , Walsh Christopher A. , Wu Bai-Lin , Miller David T. ,   on behalf of the Autism Consortium Clinical Genetics/DNA Diagnostics Collaboration
Published: March 2010

BACKGROUND:Multiple lines of evidence indicate a strong genetic contribution to autism spectrum disorders (ASDs). Current guidelines for clinical genetic testing recommend a G-banded karyotype to detect chromosomal abnormalities and fragile X DNA testing, but guidelines for chromosomal microarray analysis have not been established.PATIENTS AND METHODS:A cohort of 933 patients received clinical genetic testing for a diagnosis of ASD between January 2006 and December 2008. Clinical genetic testing included G-banded karyotype, fragile X testing, and chromosomal microarray (CMA) to test for submicroscopic genomic deletions and duplications. Diagnostic yield of clinically significant genetic changes was compared.RESULTS:Karyotype yielded abnormal results in 19 of 852 patients (2.23% [95% confidence interval (CI): 1.73%–2.73%]), fragile X testing was abnormal in 4 of 861 (0.46% [95% CI: 0.36%–0.56%]), and CMA identified deletions or duplications in 154 of 848 patients (18.2% [95% CI: 14.76%–21.64%]). CMA results for 59 of 848 patients (7.0% [95% CI: 5.5%–8.5%]) were considered abnormal, which includes variants associated with known genomic disorders or variants of possible significance. CMA results were normal in 10 of 852 patients (1.2%) with abnormal karyotype due to balanced rearrangements or unidentified marker chromosome. CMA with whole-genome coverage and CMA with targeted genomic regions detected clinically relevant copy-number changes in 7.3% (51 of 697) and 5.3% (8 of 151) of patients, respectively, both higher than karyotype. With the exception of recurrent deletion and duplication of chromosome 16p11.2 and 15q13.2q13.3, most copy-number changes were unique or identified in only a small subset of patients.CONCLUSIONS:CMA had the highest detection rate among clinically available genetic tests for patients with ASD. Interpretation of microarray data is complicated by the presence of both novel and recurrent copy-number variants of unknown significance. Despite these limitations, CMA should be considered as part of the initial diagnostic evaluation of patients with ASD.
A comparative approach to the study of behaviour: The effect of Darwin’s intellectual legacy on psychology
Authors: Topál József 
Published: March 2010

Darwin születésének 200. és A fajok eredete című mű megjelenésének 150. évfordulója kapcsán érdemes röviden áttekinteni azt, milyen szerepet játszottak az evolúciós gondolat és a belőle következő állítások az állati és emberi viselkedés kutatásának kialakulásában, fejlődésében, és hogyan hat ez a viselkedéstudományok mai állapotára. E szempontból különös jelentősége van annak a darwini gondolatnak, miszerint az állatvilágban nemcsak a jól megfigyelhető és könnyen megismerhető morfológiai bélyegekre vonatkoztatható a törzsfejlődési-evolúciós folytonosság, hanem ugyanez érvényes a viselkedésre és annak rejtett, kognitív (pszichológiai) mechanizmusaira is. A kontinuitás elvének ebben a formában való merész és Darwin korában valójában minden tudományos-empirikus alapot nélkülöző kiterjesztése egy nagyon fontos, máig érvényes üzenetet hordoz. Nem hagy ugyanis kétséget afelől, hogy az állati viselkedés sokszempontú, összehasonlító tanulmányozása nélkülözhetetlen eszköze annak, hogy megismerhessük a saját fajunk viselkedésének és elmeműködésének titkait. Bár ez az elképzelés csak meglehetősen felemás sikerrel tudott gyökeret verni a pszichológiai tudományok különböző diszciplínáiban, alapvető szerepe volt a természettudományos alapokon szerveződő összehasonlító pszichológia megjelenésében és széles körű elfogadtatásában. Manapság azt látjuk, hogy a modern kognitív pszichológiai kutatások különböző irányvonalai egyre kifejezettebben kötődnek a darwini valamint a lorenzi-tinbergeni hagyományokhoz és ezen keresztül az összehasonlító viselkedésbiológiai kutatások különböző területeihez. Az a hagyományos megosztottság ugyanis, amelyet a viselkedés- és elmekutatás biológiai és pszichológiai ágai, mint egymás alternatívái évtizedeken keresztül megjelenítettek, egy új szintézisben lassanként eltűnni látszik. A modern összehasonlító viselkedéskutatás hatékonysága nemcsak abban rejlik, hogy sokoldalú módszertani eszköztárral rendelkezve a viselkedés hagyományos elemzése mellett képes az endofenotípus (élettani és genetikai korrelátumok, idegi aktivációk) mérésére is, hanem hogy képes a megfigyelt jelenség differenciált és sokoldalú megközelítésére, a törzs- és egyedfejlődési szempontok, valamint a környezeti adaptációk kérdésének egységes keretben való tárgyalására.