bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human and animal bites and venomous stings
Authors: MacFarlane C , van Loggerenberg CJ 
Published: January 2007

Human and animal bites and venomous stings demand careful handling. Immediate resuscitation may be necessary. Severe tissue damage from larger animals frequently requires urgent haemorrhage control, followed by debridement. Subsequent reconstruction is commonly necessary. Smaller bites, and particularly human bites, may easily be underestimated, and can have significant infective sequellae, with particular attention being paid to the potential finger joint injury. Surgical exploration is frequently indicated, debridement, irrigation and antimicrobial therapy being required. Viral transmission, as well as bacterial infection, can result from bites. With regard to envenomation, often a great deal of time and effort is directed at identifying the offending animal and focusing on a specific toxin. It is important to ensure effective general resuscitation first. Thereafter, specific antivenom and antianaphylaxis measures may be taken. A description of the three common envenomation symptom complexes -cyto-complex, neuro-complex and haemo-complex - is presented, along with some causative sources. Principles of resuscitation, wound care and general treatment measures are indicated, and then appropriate specific treatments are recommended. Bites and envenomations vary in different parts of the world and it is important that emergency departments develop appropriate protocols relevant to their locations. Common poisonous animal sources should be identified and symptom complexes anticipated. Specific antivenom therapy, appropriate to the area, should be available. However, the general principles of resuscitation and wound care have pride of place.
Mediastinal trauma
Authors: Salim Ali , Demetriades Demetrios 
Published: January 2007

The evaluation of mediastinal trauma has undergone some important changes in the last few years. Electrocardiography (ECG) combined with troponin measurements have become the standard of evaluation of suspected blunt cardiac trauma. Spiral computerized tomography (CT) scan has largely replaced angiography for suspected blunt aortic rupture. There is good evidence that with a suspicious mechanism of injury the thoracic aorta should be evaluated irrespective of chest X-ray findings. In penetrating trauma the introduction of trauma ultrasound in the emergency room has revolutionized the early diagnosis of cardiac tamponade. Most mediastinal gunshot wounds in haemodynamically stable patients can safely be managed non-operatively. Evaluation of the direction of the bullet tract by means of spiral CT scan has replaced angiography and oesophageal studies in about 75% of patients with mediastinal gunshot wounds who are haemodynamically stable.
Current concepts in the management of patients with so-called ‘minor’ or ‘mild’ head injury
Authors: Swann IJ , Teasdale GM 
Published: January 2007

‘Mild’ head injury is increasingly recognized as a potential source of physical and psychological disability, but there is a lack of consistency about the definition and management of these patients. We discuss and define the terms ‘mild’ and ‘minor’, the assessment of post-traumatic amnesia, and the relevance of other signs and symptoms. Previous guidelines and recent evidence that a ‘mild’ injury may be followed by an intracranial complication are reviewed as a basis for recommendations for investigation and management in accident and emergency departments, for in-patient observation and for discharge planning.
Elder abuse
Authors: Dyer Christopher , Rowe Jed 
Published: January 2007

Accident and emergency departments are often the first point of contact for an abused older person. Elder abuse is common and can take many forms, including physical, psychological, financial and sexual abuse, or neglect. The stereotypical victim of abuse as a frail roleless female is probably not accurate, as there appears to be little correlation between the degree of physical and mental disability of the victim and subsequent physical abuse. Elder abuse is most often domestic violence that has graduated into old age. Identifying physical abuse is not always easy - the key feature is the incongruity between the signs of injury and the account of the process that led to it. While accident and emergency departments have well-established mechanisms to deal with suspected cases of child abuse, very few have procedures for handling elder abuse. Raising the awareness of healthcare workers in this area is seen as a vital goal in tackling this problem.
Clinical evaluation of the child: injury to the chest and abdomen
Authors: Ramenofsky Max L , Cash Susan 
Published: January 2007

In the paediatric age group (under 18 years) injury continues to be the dominant cause of mortality, being more common than all other causes combined. Disability resulting from injury represents a major expenditure in financial and emotional terms. The child’s anatomy and physiology are such that directly applying the principles of adult trauma care to the child can result in a less than optimal outcome and can add to long-term and/or permanent disability. Chest and abdominal injuries are the second and third most common causes of death, respectively, in childhood and when combined represent the second leading cause of death in this age group due to injury. There are six life-threatening injuries seen in paediatric injuries: airway obstruction, tension pneumothorax, massive haemothorax, open pneumothorax, flail chest and cardiac tamponade. There are six other potentially life-threatening injuries: simple pneumothorax, pulmonary contusion, tracheobronchial disruption, blunt cardiac injury, aortic disruption and haemothorax. These entities are discussed in terms of identification and treatment. Abdominal injuries are generally well recognized by trauma surgeons. The difference in the paediatric age group involves the diagnosis of intra-abdominal injuries. The principle of diagnosis is that the injured organ should be specifically identified, not just left at the impression that something is bleeding, perforated or otherwise disrupted. The main diagnostic modality is the spiral or helical computerized tomography scan. This is an appropriate diagnostic method in all but the most severely injured and haemodynamically abnormal children. Care in initial assessment and management and in specific diagnosis has great potential to decrease the mortality in a country’s youngest citizens.
Management of complex violent trauma to the upper urinary tract
Authors: Safir Michael H , McAninch Jack W 
Published: January 2007

Since abdominal and retroperitoneal trauma may endanger both the kidney and ureter, urologists are frequently called upon to evaluate an injured patient in the emergency department or in the operating room. In this setting, the suspicion of urological injury begins a clinical cascade of decision making and diagnostic testing. The recognized injury, if appropriately managed, usually heals without incident. The unrecognized injury may jeopardize the recovery of the trauma patient, such as the patient who has sustained an occult ureteral laceration and continues to have an ‘unexplained’ ileus or fever. Although urinary injury is not usually the sole compelling event in severe trauma, thoughtful consideration and treatment of renal and ureteral injuries, collectively referred to as upper urinary tract injuries, will help the surgeon to avoid troublesome management complications. As urological surgeons, we owe a debt to early pioneers in surgical traumatology who provided the groundwork for acute care management and the management of solid and hollow organ injuries. Upon this framework, the management of urological trauma has blossomed through experience and introspection. Advances in imaging modalities, improvements and renovations of surgical technique, and critical review of outcomes data have influenced the management of genito-urinary trauma and will certainly alter the way we treat trauma patients in the next millennium. This paper illustrates some important concepts in acute genito-urinary trauma and helps towards an improved understanding of acute urological care.
A novel role for PECAM-1 in megakaryocytokinesis and recovery of platelet counts in thrombocytopenic mice
Authors: Dhanjal Tarvinder S. , Pendaries Caroline , Ross Ewan A. , Larson Mark K. , Protty Majd B. , Buckley Chris D. , Watson Steve P. 
Published: January 2007

AbstractDuring thrombopoiesis, maturing megakaryocytes (MKs) migrate within the complex bone marrow stromal microenvironment from the proliferative osteoblastic niche to the capillary-rich vascular niche where proplatelet formation and platelet release occurs. This physiologic process involves proliferation, differentiation, migration, and maturation of MKs before platelet production occurs. In this study, we report a role for the glycoprotein PECAM-1 in thrombopoiesis. We show that following induced thrombocytopenia, recovery of the peripheral platelet count is impaired in PECAM-1–deficient mice. Whereas MK maturation, proplatelet formation, and platelet production under in vitro conditions were unaffected, we identified a migration defect in PECAM-1–deficient MKs in response to a gradient of stromal cell–derived factor 1 (SDF1), a major chemokine regulating MK migration within the bone marrow. This defect could be explained by defective PECAM-1−/− MK polarization of the SDF1 receptor CXCR4 and an increase in adhesion to immobilized bone marrow matrix proteins that can be explained by an increase in integrin activation. The defect of migration and polarization was confirmed in vivo with demonstration of altered spatial localization of MKs within the bone marrow in PECAM-1–deficient mice, following immune-induced thrombocytopenia. This study identifies a novel role for PECAM-1 in regulating MK migration and thrombopoiesis.
Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation
Authors: Armand Philippe , Kim Haesook T. , Cutler Corey S. , Ho Vincent T. , Koreth John , Alyea Edwin P. , Soiffer Robert J. , Antin Joseph H. 
Published: January 2007

Abstract
Iron overload could be a significant contributor to treatment-related mortality (TRM) for patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT). We studied 590 patients who underwent myeloablative allogeneic HSCT at our institution, and on whom a pretransplantation serum ferritin was available. An elevated pretransplantation serum ferritin level was strongly associated with lower overall and disease-free survival. Subgroup multivariable analyses demonstrated that this association was restricted to patients with acute leukemia or myelodysplastic syndrome (MDS); in the latter group, the inferior survival was attributable to a significant increase in TRM. There was also a trend toward an increased risk of veno-occlusive disease in patients with high ferritin. Our results argue that iron overload plays an important role in transplantation outcome for patients with acute leukemia or MDS, as it does in thalassemia. They also suggest future prospective trials to examine the potential benefit of chelation therapy in this setting.
The molecular basis of IL-21–mediated proliferation
Authors: Zeng Rong , Spolski Rosanne , Casas Esther , Zhu Wei , Levy David E. , Leonard Warren J. 
Published: January 2007

AbstractInterleukin-21 (IL-21) is a type I cytokine that modulates functions of T, B, natural killer (NK), and myeloid cells. The IL-21 receptor (IL-21R) is closely related to the IL-2 receptor β chain and is capable of transducing signals through its dimerization with the common cytokine receptor γ chain (γc), the protein whose expression is defective in humans with X-linked severe combined immunodeficiency. To clarify the molecular basis of IL-21 actions, we investigated the role of tyrosine residues in the IL-21R cytoplasmic domain. Simultaneous mutation of all 6 tyrosines greatly diminished IL-21–mediated proliferation, whereas retention of tyrosine 510 (Y510) allowed full proliferation. Y510 efficiently mediated IL-21–induced phosphorylation of Stat1 and Stat3, but not of Stat5, and CD8+ T cells from Stat1/Stat3 double knock-out mice exhibited decreased proliferation in response to IL-21 + IL-15. In addition, IL-21 weakly induced phosphorylation of Shc and Akt, and consistent with this, specific inhibitors of the MAPK and PI3K pathways inhibited IL-21–mediated proliferation. Collectively, these data indicate the involvement of the Jak-STAT, MAPK, and PI3K pathways in IL-21 signaling.
Fgf-dependent otic induction requires competence provided by Foxi1 and Dlx3b
Authors: Hans Stefan , Christison Joe , Liu Dong , Westerfield Monte 
Published: January 2007

Abstract

Background
The inner ear arises from a specialized set of cells, the otic placode, that forms at the lateral edge of the neural plate adjacent to the hindbrain. Previous studies indicated that fibroblast growth factors (Fgfs) are required for otic induction; in zebrafish, loss of both Fgf3 and Fgf8 results in total ablation of otic tissue. Furthermore, gain-of-function studies suggested that Fgf signaling is not only necessary but also sufficient for otic induction, although the amount of induced ectopic otic tissue reported after misexpression of fgf3 or fgf8 varies among different studies. We previously suggested that Foxi1 and Dlx3b may provide competence to form the ear because loss of both foxi1 and dlx3b results in ablation of all otic tissue even in the presence of a fully functional Fgf signaling pathway.

Results
Using a transgenic line that allows us to misexpress fgf8 under the control of the zebrafish temperature-inducible hsp70 promoter, we readdressed the role of Fgf signaling and otic competence during placode induction. We find that misexpression of fgf8 fails to induce formation of ectopic otic vesicles outside of the endogenous ear field and has different consequences depending upon the developmental stage. Overexpression of fgf8 from 1-cell to midgastrula stages leads to formation of no or small otic vesicles, respectively. Overexpression of fgf8 at these stages never leads to ectopic expression of foxi1 or dlx3b, contrary to previous studies that indicated that foxi1 is activated by Fgf signaling. Consistent with our results we find that pharmacological inhibition of Fgf signaling has no effect on foxi1 or dlx3b expression, but instead, Bmp signaling activates foxi1, directly and dlx3b, indirectly. In contrast to early activation of fgf8, fgf8 overexpression at the end of gastrulation, when otic induction begins, leads to much larger otic vesicles. We further show that application of a low dose of retinoic acid that does not perturb patterning of the anterior neural plate leads to expansion of foxi1 and to a massive Fgf-dependent otic induction.

Conclusion
These results provide further support for the hypothesis that Foxi1 and Dlx3b provide competence for cells to respond to Fgf and form an otic placode.
Factor structure of the Singapore English version of the KINDL® children quality of life questionnaire
Authors: Wee Hwee-Lin , Ravens-Sieberer Ulrike , Erhart Michael , Li Shu-Chuen 
Published: January 2007

Abstract

Background
Quality of life (QoL) outcomes are useful in the assessment of physical, mental and social well-being and for informed healthcare decision making. However, few studies have evaluated QoL issues among Asian children due largely to the lack of culturally valid and reliable QoL questionnaires. Hence, we aimed to report the psychometric properties, in particular factor structure, of KINDL (Singapore) questionnaires among school-going children.

Methods
Students aged 8–16 years from participating schools were selected by convenience sampling. Subjects self-completed KINDL-Kid (Singapore) and KINDL-Kiddo (Singapore) questionnaires, which were cross-culturally adapted from KINDL (Germany English) for use in Singapore. We evaluated floor and ceiling effects, internal consistency and performed factor analysis.

Results
A total of 328 respondents (mean (SD) age: 9.6 (1.31) years; 67% female; 75% Chinese, 16% Malays, 9% Indians and others) completed KINDL-Kid while 1,026 respondents (mean (SD) age: 14.0 (1.00) years; 82% female; 82% Chinese, 12% Malays; 6% Indians and others) completed KINDL-Kiddo. Mean (SD) TOTAL QoL score was 65.5 (12.76) and 56.6 (11.92) for KINDL-Kid and KINDL-Kiddo, respectively. Floor and ceiling effects were important in five of six KINDL-Kid and two of six KINDL-Kiddo subscales. Reliability coefficients ranged from 0.40 to 0.71 (KINDL-Kid) and 0.44 to 0.84 (KINDL-Kiddo). Factor analysis generated eight and seven factors in KINDL-Kid and KINDL-Kiddo, respectively.

Conclusion
KINDL-Kiddo exhibited good psychometric properties and may be used to assess QoL in this multi-ethnic English-speaking Asian population. However, psychometric properties of KINDL-Kid may need to be improved either by developing new items or modifying existing items.
Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients
Authors: Dunnwald Lisa K , Rossing Mary Anne , Li Christopher I 
Published: January 2007

Abstract
Background
Breast cancer patients with tumors that are estrogen receptor (ER)-positive and/or progesterone receptor (PR)-positive have lower risks of mortality after their diagnosis compared to women with ER- and/or PR-negative disease. However, few studies have evaluated variations in the risks of breast cancer-specific mortality across ER/PR status by either demographic or clinical characteristics.

Methods
Using data from 11 population-based cancer registries that participate in the SEER (Surveillance, Epidemiology, and End Results) program, 155,175 women at least 30 years old with a primary diagnosis of invasive breast carcinoma from 1990 to 2001 were included in the study. Associations between joint hormone receptor status and breast cancer mortality risk within categories of diagnosis age, diagnosis year, race/ethnicity, histologic tumor type, stage, grade, size, and axillary lymph node status were evaluated using the Cox proportional hazards model.

Results
Compared to ER+/PR+ cases, elevations in risk of mortality were observed across all subcategories of age at diagnosis, ranging from 1.2- to 1.5-fold differences for ER+/PR- cases, 1.5- to 2.1-fold differences for ER-/PR+ cases, and 2.1- to 2.6-fold differences for ER-/PR- cases. Greater differences were observed in analyses stratified by grade; among women with low-grade lesions, ER-/PR- patients had a 2.6-fold (95% confidence interval [CI] 1.7 to 3.9) to 3.1-fold (95% CI 2.8 to 3.4) increased risk of mortality compared to ER+/PR+ patients, but among women with high-grade lesions, they had a 2.1-fold (95% CI 1.9 to 2.2) to 2.3-fold (95% CI 1.8 to 2.8) increased risk.

Conclusion
Compared to women with ER+/PR+ tumors, women with ER+/PR-, ER-/PR+, or ER-/PR- tumors experienced higher risks of mortality, which were largely independent of the various demographic and clinical tumor characteristics assessed in this study. The higher relative mortality risks identified among ER-/PR- patients with small or low-grade tumors raise the question of whether there may be a beneficial role for adjuvant chemotherapy in this population.
Comparative genomics reveals a constant rate of origination and convergent acquisition of functional retrogenes in Drosophila
Authors: Bai Yongsheng , Casola Claudio , Feschotte Cédric , Betrán Esther 
Published: January 2007

Abstract
Background
Processed copies of genes (retrogenes) are duplicate genes that originated through the reverse-transcription of a host transcript and insertion in the genome. This type of gene duplication, as any other, could be a source of new genes and functions. Using whole genome sequence data for 12 Drosophila species, we dated the origin of 94 retroposition events that gave rise to candidate functional genes in D. melanogaster.

Results
Based on this analysis, we infer that functional retrogenes have emerged at a fairly constant rate of 0.5 genes per million years per lineage over the last approximately 63 million years of Drosophila evolution. The number of functional retrogenes and the rate at which they are recruited in the D. melanogaster lineage are of the same order of magnitude as those estimated in the human lineage, despite the higher deletion bias in the Drosophila genome. However, unlike primates, the rate of retroposition in Drosophila seems to be fairly constant and no burst of retroposition can be inferred from our analyses. In addition, our data also support an important role for retrogenes as a source of lineage-specific male functions, in agreement with previous hypotheses. Finally, we identified three cases of functional retrogenes in D. melanogaster that have been independently retroposed and recruited in parallel as new genes in other Drosophila lineages.

Conclusion
Together, these results indicate that retroposition is a persistent mechanism and a recurrent pathway for the emergence of new genes in Drosophila.
Massive, sustained γδ T cell migration from the bovine skin in vivo
Authors: Van Rhijn Ildiko , Rutten Victor P M G , Charleston Bryan , Smits Mieke , van Eden Willem , Koets Ad P 
Published: January 2007

AbstractIn all species studied so far, γδ T cells are abundantly present in epithelia. The functions of these cells are largely unknown. Using a lymph duct cannulation method, which is only possible in large animals such as cattle, we show that large numbers of γδ T cells, but not αβ T cells, are constitutively present in pseudoafferent lymph draining bovine skin. The γδ T cells, which are present in pseudoafferent lymph, use Vγ segments that are characteristic for bovine dermal γδ T cells, suggesting that these cells migrated from the skin. Further supporting the origin of these cells is the fact that fluorescent latex beads injected in the skin could be recovered in cells in the pseudoafferent lymph. The cannulation method is minimally invasive, and the lymph flow, which was sustained and remained essentially unaltered during 14 days, closely represents the in vivo situation. The γδ T cells could not be induced to produce IFN-γ, TNF-α, and IL-10, and they did not express costimulatory molecules, IL-2 receptor, and MHC Class II molecules. The level of γδ T cell egress was 6.7 × 103 γδ T cells per cm2 skin per hour, which is enough to deplete all γδ T cells from the skin within 46 h. As this massive γδ T cell migration was observed during 14 days, constant replenishment of these cells must take place. Our data suggest that γδ T cells in tissues fulfill more than exclusively local functions.