bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteochondral Lesions of the Talus
Authors: Hunt Kenneth J. , Lee Arthur T. , Lindsey Derek P. , Slikker William , Chou Loretta B. 
Published: February 2012

Background: Osteochondral lesions of the talus (OLTs) are a common cause of ankle pain and disability. Current clinical guidelines favor autogenous or allogenic osteochondral grafting procedures for lesions larger than 10 mm in diameter because of increased failure rates in these larger lesions with arthroscopic debridement, curettage, and microfracture. There are currently no biomechanical data nor level I clinical data supporting this size threshold. Purpose: The purpose of this study was to determine the effect of OLT defect size on stress concentration, rim stress, and location of peak stress and whether a threshold defect size exists. Study Design: Descriptive laboratory study. Methods: Progressively larger medial OLTs were created (6, 8, 10, and 12 mm) in 8 fresh-frozen cadaveric ankle joints. With a calibrated Tekscan pressure sensor in the tibiotalar joint, an axial load of 686 N was applied, and pressure was recorded in neutral and 15° of plantar flexion with each defect size. Peak stress, contact area, peak and average rim stresses, and location of peak stress were determined. Results: The distance between peak stress and defect rim was significantly decreased with increasing defect size for lesions of 10 mm and larger. Total tibiotalar contact area was significantly decreased with increasing defect size and with ankle plantar flexion. While peak joint stress and peak rim stress were not affected by defect size or plantar flexion, average rim stress was significantly increased by plantar flexion. Conclusion: Reduction in contact area and shift in the location of peak stress with increasing defect size may contribute to articular cartilage degeneration, pain, and defect enlargement in patients with OLTs. There appears to be a threshold of 10 mm after which the distance between the rim of the defect and the peak stress decreases; however, there is no change in peak stress magnitude with increasing defect size. Clinical Relevance: The location of peak stress in the ankle joint becomes closer to the rim of the defect in OLTs at a threshold of 10 mm and greater in diameter. These data may have implications toward OLT size thresholds for surgical decision making in symptomatic lesions (ie, primary osteochondral transplantation procedure vs curettage and debridement). The ultimate goal is to determine whether there is a threshold defect size for primary osteoarticular graft techniques.
Platelet-Rich Plasma Stimulates Cell Proliferation and Enhances Matrix Gene Expression and Synthesis in Tenocytes From Human Rotator Cuff Tendons With Degenerative Tears
Authors: Jo Chris Hyunchul , Kim Ji Eun , Yoon Kang Sup , Shin Sue 
Published: February 2012

Background: Platelet-rich plasma (PRP) contains various growth factors and appears to have a potential to promote tendon healing, but evidence is lacking regarding its effect on human tenocytes from rotator cuff tendons with degenerative tears. Hypothesis: Platelet-rich plasma stimulates cell proliferation and enhances matrix gene expression and synthesis in tenocytes isolated from human rotator cuff tendons with degenerative tears. Study Design: Controlled laboratory study. Methods: Tenocytes were enzymatically isolated and cultured. To evaluate cell proliferation, tenocytes were cultured with 10% (vol/vol) platelet-poor plasma (PPP), PRP activated with calcium, and PRP activated with calcium and thrombin at platelet concentrations of 100, 200, 400, 800, 1000, 2000, 4000, 8000, and 16,000 × 103/µL for 14 days. Cell number was measured at days 7 and 14. To investigate matrix gene expression and synthesis, cells were cultured with a PPP or PRP gel (10% vol/vol) at a platelet concentration of 1000 × 103/µL for 14 days. Quantitative real-time reverse transcriptase polymerase chain reaction was performed to determine the expressions of type I and III collagen, decorin, tenascin-C, and scleraxis, and measurements of total collagen and glycosaminoglycan (GAG) synthesis were conducted at days 7 and 14. Results: Platelet-rich plasma significantly increased cell proliferation at days 7 and 14 in a dose-dependent manner, and the addition of thrombin moved up the plateau of proliferation. Platelet-rich plasma significantly induced the gene expression of type I collagen at day 7 but not at day 14, while it significantly promoted that of type III both at days 7 and 14. The ratio of type III/I collagens did not change at days 7 and 14. The expressions of decorin and scleraxis significantly increased at day 14, whereas that of tenascin-C significantly increased at days 7 and 14. Platelet-rich plasma significantly increased total collagen synthesis at days 7 and 14 and GAG synthesis at day 14. Conclusion: Platelet-rich plasma promoted cell proliferation and enhanced gene expression and the synthesis of tendon matrix in tenocytes from human rotator cuff tendons with degenerative tears. Clinical Relevance: These findings suggest that PRP might be used as a useful biological tool for regenerative healing of rotator cuff tears by enhancing the proliferation and matrix synthesis of tenocytes from tendons with degenerative tears.
Being Economical with the Evidence
Authors: Haigh Rex 
Published: February 2012

The systematic review undertaken for the Group Analytic Community by Sheffield University is an excellent piece of work ‘of its time’, but it may not speak to everybody in the field. Some of the reasons for this are the precise methodology of such reviews, concerned with an exclusively rationalist model for selecting and appraising evidence in a framework, which excludes other schools of thought (particularly the social sciences, including critical theory, anthropology and economics). As many of those who work in group analysis have backgrounds in these and allied disciplines, rather than biomedical science, there is a risk of excluding much useful and scholarly collaboration with adjacent disciplines unless we hold an open mind about such methodologies. As group analysts, we are in a strong position to observe and criticize the ‘evidence-based hegemony’ when it becomes closer to dogma than science. This article is based on a talk given to a Group Analytic Society conference entitled ‘Can Group Therapy Survive NICE?’ held in London on 29 January 2010.
A Review of the Use of Antiepileptic Drugs in High-Grade Central Nervous System Tumors
Authors: Wallace Elaine M. , O'Reilly Maeve , Twomey Marie 
Published: February 2012

Background: Seizures are a common complication in patients with central nervous system (CNS) tumors. Optimal management is unclear with no defined guidelines and pharmacological management poses many controversies. Due to a hypothesized lack of consistency, we aimed to retrospectively review seizure management in patients with high-grade CNS tumors in our institution. Methods: The medical records of patients with high-grade CNS tumors referred to the specialist palliative medicine service in our institution from January-June 2008 were retrospectively reviewed. Seizure incidence, antiepileptic drug (AED) choice, neurology input, medication interactions, and appropriate drug level monitoring were assessed. Results: Twenty-seven patients were included for analysis. Fifteen (56%) were female. The mean age was 58.8 years (range 31-82 years). Three (11%) patients presented with seizures and 8 (30%) developed seizures subsequently. Eight (73% of those with seizures) were on monotherapy AED. Six different agents were used as first-line agents. Phenytoin was the most common AED used (n = 4). Three (27%) patients were on combination AEDs. Five (45.5%) patients had been seen by neurology and 6 (54.5%) had appropriate drug level monitoring performed. Six (55%) patients had potential AED-non-AED interactions. None of the patients had instructions documented in the clinical notes against driving. Conclusion: Seizure management in patients with CNS tumors is not consistent and remains very much a neglected area. Appropriate choice of AED is crucial. Physicians should be aware of potential drug interactions. Ownership and regular follow-up of this group is required to ensure optimum patient management.
Outcomes of Critically Ill Gynecological Cancer Patients Admitted to Intensive Care Unit
Authors: Ñamendys-Silva Silvio A. , González-Herrera María O. , Texcocano-Becerra Julia , Herrera-Gómez Angel 
Published: February 2012

Purpose: To assess the characteristics of critically ill patients with gynecological cancer, and to evaluate their prognosis. Methods: Fifty-two critically ill patients with gynecological cancer admitted to intensive care unit (ICU) were included. Univariate and multivariate logistic regressions were used to identify factors associated with hospital mortality. Results: Thirty-five patients (67.3%) had carcinoma of the cervix uteri and 11 (21.2%) had ovarian cancer. The mortality rate in the ICU was 17.3% (9 of 52) and hospital mortality rate were 23%(12 of 52). In the multivariate analysis, independent prognostic factors for hospital mortality were vasopressor use (odds ratio [OR] = 8.60, 95% confidence interval [CI] 2.05-36; P = .03) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.43, 95% CI 1.01-2.09; P = .048). Conclusions: The independent prognostic factors for hospital mortality were the need for vasopressors and the APACHE II score.
Early urinary aldosterone excretion in very low birth weight infants
Authors: Costa Simonetta , Cota Francesco , Romagnoli Costantino , Latella Caterina , Maggio Luca , Tesfagabir Mikael Ghennet , Gallini Francesca 
Published: February 2012

Hypothesis/Introduction: In the neonatal period, many factors may interfere with aldosterone production but data currently available are few and controversial. In this study we aim to assess the early urinary aldosterone excretion (UAE) in very low birth weight (VLBW) infants and to identify some possible clinical and biochemical variables that may influence this excretion. Materials and methods: We conducted a prospective study in 30 VLBW infants. Aldosterone was measured in the first 72 hours of life in the urine and plasma and urinary electrolytes were determined. Demographic and clinical data were also recorded. Results: The exploratory analysis showed that a significant positive correlation exists between UAE and gestational age and birth weight and that infants with respiratory distress syndrome have higher urinary aldosterone levels than infants without respiratory distress, but only plasma sodium resulted a significant independent factor that negatively influenced UAE at linear regression analysis (coefficient −0.02, 95% confidence interval [−0.03; −0.004]; adjusted R2 0.33). Conclusions: The renin–angiotensin–aldosterone system of VLBW infants seems to be able, even immediately after birth, to respond to variations of plasma sodium concentrations; measurement of UAE constitutes an interesting method to determine aldosterone production, avoiding blood sampling in neonates so small and frail as VLBW infants.
An evaluation of a therapeutic garden's influence on the quality of life of aged care residents with dementia
Authors: Edwards Christine Anne , McDonnell Colin , Merl Helga 
Published: February 2012

To evaluate whether a therapeutic garden can improve the quality of life of aged care residents with dementia and their carers, objective instruments as well as interviews with residents, staff, and family members were employed. Residents' mean quality of life scores increased by just over 10%, mean depression scores decreased similarly and mean agitation scores decreased by almost half. Resident, staff and family member interviews elicited positive feedback including observations that it had improved the quality of life for residents and decreased staff and family stress levels. In sum, qualitative and quantitative pre and post findings indicate that an environmental change such as a therapeutic garden can improve the lives of aged care residents with dementia, and their formal and informal carers.
24-h duration of the novel LABA vilanterol trifenatate in asthma patients treated with inhaled corticosteroids
Authors: Lötvall Jan , Bateman Eric D. , Bleecker Eugene R. , Busse William W. , Woodcock Ashley , Follows Richard , Lim Jessica , Stone Sally , Jacques Loretta , Haumann Brett 
Published: February 2012

Current guidelines recommend adding a long-acting inhaled β2-agonist (LABA) to inhaled corticosteroids (ICS) in patients with uncontrolled asthma. This study evaluated the novel, once-daily LABA vilanterol trifenatate (VI) in asthma patients who remained symptomatic despite existing ICS therapy.The study involved a randomised, double-blind, placebo-controlled trial of VI (3, 6.25, 12.5, 25 and 50 μg), administered once daily in the evening by dry powder inhaler for 28 days, in asthma patients aged ≥12 yrs symptomatic on current ICS therapy. The primary end-point was trough (24 h post-dose) forced expiratory volume in 1 s (FEV1); secondary end-points were weighted mean FEV1, peak expiratory flow (PEF), symptom-/rescue-free 24-h periods, and safety.A significant relationship was observed between VI dose and improvements in trough FEV1(p=0.037). Statistically significant increases in mean trough FEV1, relative to placebo, were documented for VI 12.5–50 μg (121–162 mL; p≤0.016). Dose-related effects of VI were observed on weighted mean (0–24 h) FEV1, morning/evening PEF, and symptom-/rescue-free 24-h periods. All doses of VI were well tolerated with low incidences of recognised LABA-related adverse events (tremor 0–2%; palpitations 0–2%; glucose effects 0–1%; potassium effects 0–<1%).Once-daily VI 12.5–50 μg resulted in prolonged bronchodilation of at least 24 h with good tolerability in asthma patients receiving ICS. Based on the overall efficacy and adverse event profile from this study, the optimum dose of VI appears to be 25 μg.
Occlusion pressure analysis role in partitioning of pulmonary vascular resistance in CTEPH
Authors: Toshner Mark , Suntharalingam Jay , Fesler Pierre , Soon Elaine , Sheares Karen K. , Jenkins David , White Paul , Morrell Nicholas W. , Naeije Robert , Pepke-Zaba Joanna 
Published: February 2012

Flow-directed pulmonary artery occlusion is posited to enable partitioning of vascular resistance into small and large vessels. As such it may have a role in assessment for pulmonary endarterectomy.To test if the occlusion technique distinguished small from large vessel disease we studied 59 subjects with chronic thromboembolic pulmonary hypertension (CTEPH), idiopathic pulmonary arterial hypertension (IPAH), and connective tissue disease (CTD)-associated PAH. At right heart catheterisation, occlusion pressures were recorded. With fitting of the pressure decay curve, pulmonary vascular resistance was partitioned into downstream (small vessels) and upstream (large vessels, Rup).47 patients completed the study; 14 operable CTEPH, 15 inoperable CTEPH, 13 idiopathic or CTD-PAH and five post-operative CTEPH. There was a significant difference in mean Rupin the proximal operable CTEPH group 87.3 (95% CI 84.1–90.5); inoperable CTEPH mean 75.8 (95% CI 66.76–84.73), p=0.048; and IPAH/CTD, mean 77.1 (95% CI 71.86–82.33), p=0.003. Receiver operating characteristic curves to distinguish operable from inoperable CTEPH demonstrated an area under the curve of 0.75, p=0.0001. A cut-off of 79.3 gave 100% sensitivity (95% CI 73.5–100%) but 57.1% specificity (95% CI 28.9–82.3%). In a subgroup analysis of multiple lobar sampling there was demonstrable heterogeneity.Rupis significantly increased in operable proximal CTEPH compared with non-operable distal CTEPH and IPAH/CTD-PAH. Rupvariability in patients with CTEPH and PAH is suggestive of pathophysiological heterogeneity.
Leptin and regulatory T-lymphocytes in idiopathic pulmonary arterial hypertension
Authors: Huertas Alice , Tu Ly , Gambaryan Natalia , Girerd Barbara , Perros Frédéric , Montani David , Fabre Dominique , Fadel Elie , Eddahibi Saadia , Cohen-Kaminsky Sylvia , Guignabert Christophe , Humbert Marc 
Published: February 2012

Immune mechanisms and autoimmunity seem to play a significant role in idiopathic pulmonary arterial hypertension (IPAH) pathogenesis and/or progression, but the pathophysiology is still unclear. Recent evidence has demonstrated a detrimental involvement of leptin in promoting various autoimmune diseases by controlling regulatory T-lymphocytes. Despite this knowledge, the role of leptin in IPAH is currently unknown. We hypothesised that leptin, synthesised by dysfunctional pulmonary endothelium, might play a role in the immunopathogenesis of IPAH by regulating circulating regulatory T-lymphocytes function.First, we collected serum and regulatory T-lymphocytes from controls, and IPAH and scleroderma-associated pulmonary arterial hypertension (SSc-PAH) patients; secondly, we recovered tissue samples and cultured endothelial cells after either surgery or transplantation in controls and IPAH patients, respectively.Our findings indicate that serum leptin was higher in IPAH and SSc-PAH patients than controls. Circulating regulatory T-lymphocyte numbers were comparable in all groups, and the percentage of those expressing leptin receptor was higher in IPAH and SSc-PAH compared with controls, whereas their function was reduced in IPAH and SSc-PAH patients compared with controls, in a leptin-dependent manner. Furthermore, endothelial cells from IPAH patients synthesised more leptin than controls.Our data suggest that endothelial-derived leptin may play a role in the immunopathogenesis of IPAH.
High inhaled corticosteroids adherence in childhood asthma: the role of medication beliefs
Authors: Klok Ted , Kaptein Adrian A. , Duiverman Eric J. , Brand Paul L. 
Published: February 2012

Our aim was to study determinants of adherence in young asthmatic children over a 3-month period, including the role of parental illness and medication perceptions as determinants of adherence.Consecutive 2–6-yr-old children with asthma, using inhaled corticosteroids (ICS), followed-up at our paediatric asthma clinic (where patients are being extensively trained in self-management, and are followed-up closely) were enrolled. Adherence was measured electronically using a Smartinhaler® and calculated as a percentage of the prescribed dose. We examined the association of adherence to a range of putative determinants, including clinical characteristics and parental perceptions about illness and medication.Median (interquartile range) adherence, measured over 3 months in 93 children, was 92 (76–97)%, and most children had well controlled asthma. 94% of parents expressed the view that giving ICS to their child would protect him/her from becoming worse. Adherence was significantly associated with asthma control and with parental perceptions about medication.The high adherence rate observed in our study was associated with parental perceptions about ICS need. The high perceived need of ICS may probably be ascribed to the organisation of asthma care (with repeated tailored education and close follow-up).
Diagnostic accuracy of a urine lipoarabinomannan strip-test for TB detection in HIV-infected hospitalised patients
Authors: Peter Jonathan G. , Theron Grant , van Zyl-Smit Richard , Haripersad Asheen , Mottay Lynelle , Kraus Sarah , Binder Anke , Meldau Richard , Hardy Anneli , Dheda Keertan 
Published: February 2012

Lack of point-of-care tests for tuberculosis (TB) result in diagnostic delay, and increased mortality and healthcare-related costs.The urine DetermineTMTB-LAM point-of-care strip-test was evaluated in 335 prospectively-recruited hospitalised patients with suspected TB-HIV co-infection (group 1) and from 88 HIV-infected hospitalised patients with non-TB diagnoses (group 2). Cut-off point-specific analyses were performed using: 1) a microbiological reference standard (culture positiveversusnegative); and 2) a composite reference standard (exclusion of patients with clinical-TB from the culture-negative group).Using the microbiological reference and the manufacturer-recommended grade-1 cut-off point, LAM sensitivity and specificity was 66% (95% CI 57–74%). By contrast, using the composite reference sensitivity was 60% (95% CI 53–67%) and specificity improved to 96% (95% CI 89–100%) (p=0.001). The same pattern was seen when the grade-2 cut-off point was used (specificity 75%versus96%; p=0.01). In group two patients specificity was poor using the grade-1 cut-off point, but improved significantly when the grade-2 cut-off point was used (90%versus99%; p=0.009). The grade-2 cut-off point also offered superior inter-reader reliability (p=0.002). Sensitivity was highest in those with a CD4 <200 cells per mL. LAM combined with smear-microscopy was able to rule-in TB in 71% ofMycobacterium tuberculosisculture-positive patients.This preliminary study indicates that the LAM strip-test may be a potentially useful rapid rule-in test for TB in hospitalised patients with advanced immunosuppression. The grade 2, but not the manufacturer-recommended grade 1 cut-off point, offered superior rule-in utility and inter-reader reliability. Larger studies to evaluate cut-off points and diagnostic accuracy are urgently required.
Boundedness of (k + 1)-linear fractional integral with a multiple variable kernel
Authors: Zhang Huihui , Ruan Jianmiao , Yu Xiao 
Published: February 2012

Abstract
In this article, we discuss the boundedness of (k + 1)-linear fractional integrals with variable kernels on product L

p
spaces. Our results improved some known results.

2000 Mathematics Subject Classification: 42B20; 42B25.
REGγ is associated with multiple oncogenic pathways in human cancers
Authors: He Jing , Cui Long , Zeng Yu , Wang Guangqiang , Zhou Ping , Yang Yuanyuan , Ji Lei , Zhao Yanyan , Chen Jiwu , Wang Zhuo , Shi Tieliu , Zhang Pei , Chen Rui , Li Xiaotao 
Published: February 2012

Abstract

Background
Recent studies suggest a role of the proteasome activator, REGγ, in cancer progression. Since there are limited numbers of known REGγ targets, it is not known which cancers and pathways are associated with REGγ.

Methods
REGγ protein expressions in four different cancers were investigated by immunohistochemistry (IHC) analysis. Following NCBI Gene Expression Omnibus (GEO) database search, microarray platform validation, differential expressions of REGγ in corresponding cancers were statistically analyzed. Genes highly correlated with REGγ were defined based on Pearson's correlation coefficient. Functional links were estimated by Ingenuity Core analysis. Finally, validation was performed by RT-PCR analysis in established cancer cell lines and IHC in human colon cancer tissues

Results
Here, we demonstrate overexpression of REGγ in four different cancer types by micro-tissue array analysis. Using meta-analysis of publicly available microarray databases and biological studies, we verified elevated REGγ gene expression in the four types of cancers and identified genes significantly correlated with REGγ expression, including genes in p53, Myc pathways, and multiple other cancer-related pathways. The predicted correlations were largely consistent with quantitative RT-PCR analysis.

Conclusions
This study provides us novel insights in REGγ gene expression profiles and its link to multiple cancer-related pathways in cancers. Our results indicate potentially important pathogenic roles of REGγ in multiple cancer types and implicate REGγ as a putative cancer marker.