bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of triple antithrombotic therapy after percutaneous coronary intervention in patients needing long-term anticoagulation
Authors: Singh Param Puneet , Singh Mukesh , Bedi Updesh , Molnar Janos , Arora Rohit , Khosla Sandeep 
Published: December 2010

Background: Optimal antithrombotic therapy after percutaneous coronary intervention (PCI) is currently undefined in patients requiring long-term anticoagulation. Previous studies comparing triple therapy (TT) of warfarin, aspirin and clopidogrel with standard dual therapy (DT) of aspirin and clopidogrel have yielded conflicting results. Meta-analysis of these studies was performed to evaluate safety and efficacy of TT. Methods: A total of 1482 patients from 6 studies were analyzed using the Mantel–Haenszel random effect model to extract incidence of major bleeding. The secondary end point assessed by three of these studies was major adverse cardiac events (MACEs: cardiovascular death, myocardial infarction and thromboembolic complications). The incidence of MACEs was computed using the Mantel–Haenszel fixed effect model. Combined relative risks (RRs) across all of the studies and the 95% confidence intervals (CIs) were determined. A two-sided alpha error <0.05 was considered statistically significant. Results: Baseline characteristics were similar in both groups. Compared with patients receiving DT, the risk of major bleeding was significantly higher in the TT group (RR: 2.74, CI: 1.08–6.98; p = 0.034). However, risk of MACE was significantly lower in the TT group (RR: 0.72, CI: 0.56–0.98; p = 0.014). Conclusion: In patients requiring long-term anticoagulation after PCI, TT may be superior to DT in reducing the incidence of MACEs, however risk of major bleeding complications is increased significantly.
Endothelial reticulon-4B (Nogo-B) regulates ICAM-1–mediated leukocyte transmigration and acute inflammation
Authors: Di Lorenzo Annarita , Manes Thomas D. , Davalos Alberto , Wright Paulette L. , Sessa William C. 
Published: December 2010

AbstractThe reticulon (Rtn) family of proteins are localized primarily to the endoplasmic reticulum (ER) of most cells. The Rtn-4 family, (aka Nogo) consists of 3 splice variants of a common gene called Rtn-4A, Rtn-4B, and Rtn-4C. Recently, we identified the Rtn-4B (Nogo-B) protein in endothelial and smooth muscle cells of the vessel wall, and showed that Nogo-B is a regulator of cell migration in vitro and vascular remodeling and angiogenesis in vivo. However, the role of Nogo-B in inflammation is still largely unknown. In the present study, we use 2 models of inflammation to show that endothelial Nogo-B regulates leukocyte transmigration and intercellular adhesion molecule-1 (ICAM-1)–dependent signaling. Mice lacking Nogo-A/B have a marked reduction in neutrophil and monocyte recruitment to sites of inflammation, while Nogo-A/B−/− mice engrafted with wild-type (WT) bone marrow still exhibit impaired inflammation compared with WT mice engrafted with Nogo-A/B−/− bone marrow, arguing for a critical role of host Nogo in this response. Using human leukocytes and endothelial cells, we show mechanistically that the silencing of Nogo-B with small interfering RNA (siRNA) impairs the transmigration of neutrophils and reduces ICAM-1–stimulated phosphorylation of vascular endothelial-cell cadherin (VE-cadherin). Our results reveal a novel role of endothelial Nogo-B in basic immune functions and provide a key link in the molecular network governing endothelial-cell regulation of diapedesis.
Transient receptor potential ion channel Trpm7 regulates exocrine pancreatic epithelial proliferation by Mg2+-sensitive Socs3a signaling in development and cancer
Authors: Yee Nelson S. , Zhou Weiqiang , Liang I-Chau 
Published: December 2010

SUMMARYGenetic analysis of pancreatic development has provided new insights into the mechanisms underlying the formation of exocrine pancreatic neoplasia. Zebrafish sweetbread (swd) mutants develop hypoplastic acini and dysmorphic ducts in the exocrine pancreas, with impeded progression of cell division cycle and of epithelial growth. Positional cloning and allelic complementation have revealed that the swd mutations affect the transient receptor potential melastatin-subfamily member 7 (trpm7) gene, which encodes a divalent cation-permeable channel with kinase activity. Supplementary Mg2+ partially rescued the exocrine pancreatic defects of the trpm7 mutants by improving cell-cycle progression and growth and repressing the suppressor of cytokine signaling 3a (socs3a) gene. The role of Socs3a in Trpm7-mediated signaling is supported by the findings that socs3a mRNA level is elevated in the trpm7 mutants, and antisense inhibition of socs3a expression improved their exocrine pancreatic growth. TRPM7 is generally overexpressed in human pancreatic adenocarcinoma. TRPM7-deficient cells are impaired in proliferation and arrested in the G0-G1 phases of the cell division cycle. Supplementary Mg2+ rescued the proliferative defect of the TRPM7-deficient cells. Results of this study indicate that Trpm7 regulates exocrine pancreatic development via the Mg2+-sensitive Socs3a pathway, and suggest that aberrant TRPM7-mediated signaling contributes to pancreatic carcinogenesis.
Bocmodifies the holoprosencephaly spectrum ofCdomutant mice
Authors: Zhang Wei , Hong Mingi , Bae Gyu-un , Kang Jong-Sun , Krauss Robert S. 
Published: December 2010

SUMMARYHoloprosencephaly (HPE) is caused by a failure to form the midline of the forebrain and/or midface. It is one of the most common human birth defects, but clinical expression is extremely variable. HPE is associated with mutations in the sonic hedgehog (SHH) pathway. Mice lacking the Shh pathway regulator Cdo (also called Cdon) display HPE with strain-dependent penetrance and expressivity, implicating silent modifier genes as one cause of the variability. However, the identities of potential HPE modifiers of this type are unknown. We report here that whereas mice lacking the Cdo paralog Boc do not have HPE, Cdo;Boc double mutants on a largely Cdo-resistant genetic background have lobar HPE with strong craniofacial anomalies and defects in Shh target gene expression in the developing forebrain. Boc is therefore a silent HPE modifier gene in mice. Furthermore, Cdo and Boc have specific, selective roles in Shh signaling in mammals, because Cdo;Boc double-mutant mice do not display the most severe HPE phenotype seen in Shh-null mice, nor do they have major defects in digit patterning or development of vertebrae, which are also Shh-dependent processes. This is in contrast to reported observations in Drosophila, where genetic removal of the Cdo and Boc orthologs Ihog and Boi results in a complete loss of response to the hedgehog ligand. Therefore, there is evolutionary divergence between mammals and insects in the requirement of the hedgehog pathway for Cdo/Ihog family members, with mammalian development involving additional factors and/or distinct mechanisms at this level of pathway regulation.
Synthesis of Cyclophane Dimer Using Cyclophane-tethered Fmoc-amino Acid Derivatives as a Multivalent Host
Authors: Hayashida Osamu , Nakashima Tomomi 
Published: December 2010

Abstract
Water-soluble cyclophane dimer was synthesized by Fmoc-chemistry of cyclophane-tethered Fmoc-lysine derivative, as a multivalent host. The host showed enhanced guest binding affinity relative to that by monocyclic cyclophane, as confirmed by fluorescence spectroscopy as well as surface plasmon resonance measurements.
Organocatalyst-mediated Aldol–Robinson Cascade Reactions: A Convenient Synthesis of Substituted Cyclohex-2-enones
Authors: Wang Li , Gong Qing-Ping , Liu Xiao-Jun , Li Yong-Hong , Huang Ping , Wang Bi-Qin , Zhao Ke-Qing 
Published: December 2010

Abstract
A convenient organocatalytic process for the chemoselective synthesis of substituted cyclohex-2-enones was developed. The cascade reaction involves a remarkable Michael addition of an acyclic ketone-based enamine onto unmodified enones. The enamine-mediated aldol–Robinson cascade reactions of aromatic and aliphatic aldehydes with acetone produced substituted cyclohex-2-enones in moderate to high yields under mild reaction conditions.
Preparation of (Sr0.5Ba0.5)Si2N2O2:Eu2+ Phosphor and Its Luminescence Properties
Authors: Lei Bingfu , Machida Ken-ichi , Horikawa Takashi , Hanzawa Hiromasa 
Published: December 2010

Abstract
Eu2+ ion-doped oxynitride phosphor, (Sr0.5Ba0.5)Si2O2N2:Eu2+, was prepared by solid-state reaction using metal alloy as precursor. Owing to the relatively high activity of the metal alloy precursor compared with the inert Si3N4, a single phase of solid solution phosphor (Sr0.5Ba0.5)Si2O2N2:Eu2+ was easily obtained at 1400 °C under atmospheric pressure. It showed a broad excitation band originating from the 4f7 → 4f65d transition of Eu2+ ion, extending to 520 nm, and centering at 460 nm and a strong emission band peaking at 565 nm. The high emission and small thermal quenching allow this material to be used for phosphor-converted white LEDs.
What Evidence is There That a Physiotherapy Service in the Emergency Department Improves Health Outcomes? A Systematic Review
Authors: Kilner Emily 
Published: December 2010

Objective The nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care staff, though it is unclear how such a service affects health outcomes. The objective was to identify the effect an emergency department physiotherapy service has on health outcomes. Method Systematic searches were carried out on the following databases: CINAHL, Medline, Web of Knowledge, Scopus, PEDro, PubMed, Cochrane and Academic Search Premier. Selection criteria included full-text English primary studies published in peer-reviewed journals, investigating physiotherapy services based directly in the emergency department. Papers were appraised using a researcher-developed appraisal of bias tool. Results Eleven eligible primary studies were identified. For most, the likelihood of methodological bias was high or unknown due to inadequate detail provided. Three studies were judged to have introduced little bias. At system and provider levels, there is insufficient evidence to support benefits of an emergency department physiotherapy service. At patient level, there is high-level evidence of benefits in terms of improved pain control and reduced disability in the short term. Conclusions Research evidence does not support the use of physiotherapists in emergency departments.
Identifying Poorly Performing General Practices in England: A Longitudinal Study Using Data from the Quality and Outcomes Framework
Authors: Ashworth Mark , Schofield Peter , Seed Paul , Durbaba Stevo , Kordowicz Maria , Jones Roger 
Published: December 2010

Objective To determine the characteristics of general practices which perform poorly in terms of Quality and Outcome (QOF) performance indicators in England's NHS. Method Retrospective, four year longitudinal study, 2005 to 2008. Data were obtained from 8515 practices (99% of practices in England) in year 1, 8264 (98%) in year 2, 8192 (98%) in year 3 and 8256 (99%) in year 4. Outcome measures: QOF performance scores; social deprivation (IMD-2007) and ethnicity from the 2001 national census; general practice characteristics. Results We identified a cohort of 212 (2.7%) practices which remained in the lowest decile for total QOF scores in the four years following the introduction of the QOF. A total of 705,386 patients were registered at these practices in year 4. These practices were more likely to be singlehanded (odds ratio [OR], 13.8), non-training practices (OR, 3.9) and located in deprived areas (OR, 2.6; most vs least deprived quintiles). General practitioners (GPs) in these practices were more often aged ≥65 years or more (OR, 7.3; mean GP age ≥65 years vs <45 years), male (OR 2.0), UK qualified (OR 2.0) with small list sizes (OR 3.2; list size <1000 vs 1500-2000 patients). We identified individual QOF indicators which were poorly achieved. The reported prevalence of most chronic diseases was lower in the poorly performing cohort. Conclusions A small minority of practices have remained poor performers in terms of measurable performance indicators over a four-year period. The strongest predictors of poor QOF performance were singlehanded and small practices, and practices staffed by elderly GPs.
Open Access Research
Authors: Wright Kath , Light Kate , Stirk Lisa 
Published: December 2010

Open access makes research results available via the Internet without the user needing to have a subscription or to make a one-off payment to a publisher. This model of publication has resulted in the creation of both digital repositories and open access electronic journals. Material published using either of these routes is often free of restrictions in terms of both copyright and licensing. This edition of ‘What's on the web’ reviews three websites that look at different aspects of open access: developing open access repositories in universities, academic publishing and communication, and an example of an open access publisher. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:
Role of laparoscopic nephrectomy for refractory hypertension in poorly functioning kidneys
Authors: Elhage Oussama , Sahai Arun , Challacombe Ben , Murphy Declan , Scoble John , Dasgupta Prokar 
Published: December 2010

INTRODUCTION Hypertension is a common medical problem mainly treated by effective antihypertensive drugs. Persistent hypertension can be difficult to manage and have detrimental effect on vital organs. Nephrectomy of poorly functioning kidneys may be indicated in a minority of such cases. PATIENTS AND METHODS We performed laparoscopic nephrectomy on 12 patients with refractory hypertension. RESULTS Eight had complete response, three had partial response and one had no response. CONCLUSIONS Laparoscopic nephrectomy has a role in carefully selected adult patients with refractory hypertension due to non-functioning kidney. Patients need to understand the surgical risks as well as the small risk of failure to treat hypertension.
Bare below elbows: does this policy affect handwashing efficacy and reduce bacterial colonisation?
Authors: Burger A , Wijewardena C , Clayson S , Greatorex RA 
Published: December 2010

INTRODUCTION UK Department of Health guidelines recommend that clinical staff are ‘bare below the elbows’. There is a paucity of evidence to support this policy. One may hypothesise that absence of clothing around wrists facilitates more effective handwashing: this study aims to establish whether dress code affects bacterial colonisation before and after handwashing. SUBJECTS AND METHODS Sixty-six clinical staff volunteered to take part in the study, noting whether they were bare below the elbows (BBE) or not bare (NB). Using a standardised technique, imprints of left and right fingers, palms, wrists and forearms were taken onto mini agar plates. Imprints were repeated after handwashing. After incubation, colonies per plate were counted, and subcultures taken. RESULTS Thirty-eight staff were BBE and 28 were not. A total of 1112 plates were cultured. Before handwashing there was no significant difference in number of colonies between BBE and NB groups (Mann–Whitney, P < 0.05). Handwashing reduced the colony count, with greatest effect on fingers, palms and dominant wrists (t-test, P < 0.05). Comparing the two groups again after handwashing revealed no significant difference (Mann–Whitney, P < 0.05). Subcultures revealed predominantly skin flora. CONCLUSIONS There was a large variation in number of colonies cultured. Handwashing resulted in a statistically significant reduction in colony count on fingers, palms and dominant wrist regardless of clothing. We conclude that handwashing produces a significant reduction in number of bacterial colonies on staff hands, and that clothing that is not BBE does not impede this reduction.
Impact of organisational changes on fracture neck of femur management
Authors: Mallick Emad , Gulihar Abhinav , Taylor Grahame , Furlong Andrew , Pandey Radhakant 
Published: December 2010

INTRODUCTION In 2005, University Hospitals of Leicester formed a Fracture Neck of Femur (#NOF) project group to improve care of this group of patients. SUBJECTS AND METHODS The salient changes effected by the group were the appointment of designated orthogeriatricians, trauma co-ordinators, clinical aides, and discharge nurses. RESULTS As a result of these measures, the number of patients going to theatre within 48 h of admission rose from 38.5% in 2005/6 to 90% in 2007/8. In-hospital mortality decreased from 16.5% in 2005/6 to 10.9% in 2007/8. The 30-day mortality dropped from 13% in 2005/6 to 10.9% in 2007/8. Hospital stay reduced from 29 days in 2005/06 to 17 days in 2007/8. CONCLUSIONS Re-organisation of available resources has a positive impact on reducing mortality and in-hospital stay of fracture neck of femur patients.
Today or tomorrow? A retrospective analysis of the clinical indications used to request urgent magnetic resonance imaging of the spine
Authors: Thangarajah Tanujan , O’Donoghue Donal , Pillay Robin 
Published: December 2010

INTRODUCTION The finite resources available to National Health Service institutions require clinicians to order investigations that are not readily available appropriately. This is particularly true for the radiological assessment of patients presenting with features pertaining to acute spinal cord dysfunction. Such cases conventionally require urgent magnetic resonance imaging (MRI) which is sometimes performed ‘out-of-hours’. There is evidence to suggest, however, that a high proportion of patients do not have a structural abnormality on MRI to account for their clinical findings, and consequently the majority of scans that are requested urgently are normal. The primary aim of this study was to determine whether any clinical feature(s) could accurately predict the presence of a structural abnormality on MRI. As a secondary objective, the ability of such features to predict the need for spinal surgery was assessed. PATIENTS AND METHODS A retrospective analysis of consecutive patients who warranted urgent MRI was conducted. Eighty-one patients were eligible for study. The Fisher’s test was used for statistical analysis of all data. A P-value of less than 0.05 was considered to be significant. RESULTS MRI was performed within 24 h of admission in 16 patients, and of these, seven had surgery within 24–48 h. Only two patients were found to have significant neurological compromise. Despite both a history and examination suggesting otherwise, MRI was normal in 10 patients (12%). CONCLUSIONS We were unable to elucidate any clinical features that were able to predict the presence of an abnormal MRI. We did find, however, that patients with a combination of both subjective neurological findings and positive neurological signs (P = 0.02), saddle anaesthesia and/or decreased anal tone (P = 0.03) or sciatica (P = 0.02) had pathology on MRI that warranted surgical intervention. The authors recommend that the aforementioned features formulate the basis of guidelines used to request and/or perform MRI urgently since they are highly suggestive of surgical intervention. Conversely, patients who do not exhibit the above examination findings might not require either an urgent or ‘out-of-hours’ scan, but could potentially be investigated less expediently and/or wait until ‘normal working hours’.
Urinary Catalytic Iron in Obesity
Authors: Thethi Tina K , Parsha Kaushik , Rajapurkar Mohan , Mukhopadhyay Banibrata , Shah Sudhir , Yau C Lillian , Japa Shanker , Fonseca Vivian 
Published: December 2010

INTRODUCTION
Obesity precedes the development of many cardiovascular disease risk factors, including type 2 diabetes mellitus (DM), hypertension, and chronic kidney disease. Catalytic iron, which has been associated with these chronic diseases, may be one of the links between obesity and these multifactorial diverse disorders.

OBJECTIVE
We investigated whether urinary catalytic iron is increased in obese individuals without DM and overt kidney disease.

STUDY DESIGN
We measured urinary catalytic iron using established methods in 200 randomly selected individuals without DM [100 who were obese (body mass index ≥30 kg/m2) and 100 who were nonobese (body mass index ≤27)]. Participants were selected from an outpatient clinic and community setting and were part of an ongoing cross-sectional study of obesity in individuals between the ages of 18 and 70 years.

RESULTS
There was a significant difference in mean (95% CI) urinary catalytic iron excretion between the obese participants and the nonobese participants, 463 (343–582) nmol/mg [52.3 (38.8–65.8) nmol/μmol] vs 197 (141–253) nmol/mg [22.3 (15.9–28.6) nmol/μmol]; P &lt; 0.001. The significant predictors of increased urinary catalytic iron were obesity (P = 0.001) and waist-to-hip ratio (P = 0.03).

CONCLUSIONS
Our study results demonstrate that obesity and waist-to-hip ratio are associated with increased urinary catalytic iron, which may be a useful marker of oxidative stress. Additional studies are needed to determine the role of catalytic iron in increased cardiovascular disease and chronic kidney disease associated with obesity.
Polymorphisms at the regulatory regions of the CASR gene influence stone risk in primary hyperparathyroidism
Authors: Vezzoli Giuseppe , Scillitani Alfredo , Corbetta Sabrina , Terranegra Annalisa , Dogliotti Elena , Guarnieri Vito , Arcidiacono Teresa , Paloschi Vera , Rainone Francesco , Eller-Vainicher Cristina , Borghi Loris , Nouvenne Antonio , Guerra Angela , Meschi Tiziana , Allegri Franca , Cusi Daniele , Spada Anna , Cole David E C , Hendy Geoffrey N , Spotti Donatella , Soldati Laura 
Published: December 2010

Background and objectiveSingle nucleotide polymorphisms (SNPs) of the calcium-sensing receptor (CASR) gene at the regulatory region were associated with idiopathic calcium nephrolithiasis. To confirm their association with nephrolithiasis, we tested patients with primary hyperparathyroidism (PHPT).DesignA genotype–phenotype association study.MethodsIn all, 332 PHPT patients and 453 healthy controls were genotyped for the rs7652589 (G>A) and rs1501899 (G>A) SNPs sited in the noncoding regulatory region of the CASR gene. Allele, haplotype, and diplotype distribution were compared between PHPT patients and controls, and in stone forming and stone-free PHPT patients.ResultsThe allele frequency at rs7652589 and rs1501899 SNPs was similar in PHPT patients and controls. The A minor alleles at these two SNPs were more frequent in stone forming (n=157) than in stone-free (n=175) PHPT patients (rs7652589: 36.9 vs 27.1%, P=0.007; rs1501899: 37.1 vs 26.4%, P=0.003). Accordingly, homozygous or heterozygous PHPT patients for the AA haplotype (n=174, AA/AA or AA/GG diplotype) had an increased stone risk (odds ratio 1.83, 95% confidence interval 1.2–2.9, P=0.008). Furthermore, these PHPT patients had higher serum concentrations of ionized calcium and parathyroid hormone (1.50±0.015 mmol/l and 183±12.2 pg/ml) than patients with the GG/GG diplotype (n=145, 1.47±0.011 mmol/l (P=0.04) and 150±11.4 pg/ml (P=0.049)). Using a logistic regression model, the increase in stone risk in PHPT patients was predicted by AA/AA or AA/GG diplotype, the highest tertile of serum ionized calcium values and the lowest tertile of age.ConclusionsPolymorphisms located in the regulatory region of the CASR gene may increase susceptibility of the PHPT patients to kidney stone production.