bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is Overtriage Associated With Increased Mortality? Insights From a Simulation Model of Mass Casualty Trauma Care
Authors: Hupert Nathaniel , Hollingsworth Eric , Xiong Wei 
Published: October 2007

ABSTRACTPurpose: To examine the relationship between overtriage and critical mortality after a mass casualty incident (MCI) using a simulation model of trauma system response.Methods: We created a discrete event simulation model of trauma system management of MCIs involving individual patient triage and treatment. Model variables include triage performance, treatment capability, treatment time, and time-dependent mortality of critically injured patients. We model triage as a variable selection process applied to a hypothetical population of critically and noncritically injured patients. Treatment capability is represented by staffed emergency department trauma bays with associated staffed operating rooms that are recycled after each use. We estimated critical and noncritical patient treatment times and time-dependent mortality rates from the trauma literature.Results: In this simulation model, overtriage, the proportion of noncritical patients among all of those labeled as critical, has a positive, negative, or variable association with critical mortality depending on its etiology (ie, related to changes in triage sensitivity or to changes in the prevalence and total number of critical patients). In all of the modeled scenarios, the ratio of critical patients to treatment capability has a greater impact on critical mortality than overtriage level or time-dependent mortality assumption.Conclusions: Increasing overtriage may have positive, negative, or mixed effects on critical mortality in this trauma system simulation model. These results, which contrast with prior analyses describing a positive linear relationship between overtriage and mortality, highlight the need for alternative metrics to describe trauma system response after MCIs. We explore using the relative number of critical patients to available and staffed treatment units, or the critical surge to capability ratio, which exhibits a consistent and nonlinear association with critical mortality in this model. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S14–S24)
Decadal variations of intense typhoon occurrence in the western North Pacific
Authors: Chan Johnny C.L 
Published: October 2007

The causes of one of the two major oscillation periods, 16–32 years, identified through a wavelet analysis, of the time series of the frequency of intense typhoon (categories 4 and 5 in the Saffir–Simpson scale) occurrence for the period 1960–2005 in the western North Pacific (WNP) is studied in this paper. By dividing this period into sub-periods during which the frequency of intense typhoon occurrence was above or below normal on this time scale, various thermodynamic and dynamic factors in each sub-period are examined.
During the above-normal periods, the sea surface temperature in the southeastern part of the WNP (5–20° N, 150–180° E) is found to be slightly higher. Within this area, the moist static energy (MSE) is also higher and the vertical gradient of saturated MSE in the lower troposphere is more negative. At the same time, the low-level streamfunction anomalies tend to have a negative maximum and the vertical wind shear between 200 and 850 hPa is also relatively small. Thus, both the thermodynamic and dynamic conditions within this area are more conducive to the development of tropical cyclones (TCs). As these cyclones move northwestward, the favourable dynamic conditions continue to be present so that they can intensify further. The steering flow is such that many of these typhoons will stay over water for an extended period of time through low-latitude recurvature. As a result, they can intensify to become category 4 or 5 typhoons. The conditions during the below-normal periods are generally opposite.
A major conclusion from the results of this study is that the frequency of intense typhoon occurrence undergoes a strong multi-decadal (16–32 years) variation due to similar variations in the planetary scale oceanographic and atmospheric conditions that govern the formation, intensification and movement of TCs. These latter variations are largely contributed by the El Niño and the Pacific Decadal Oscillation on similar time scales.
Mining the secretome of the root‐knot nematode Meloidogyne chitwoodi for candidate parasitism genes
Authors: ROZE ERWIN , HANSE BRAM , MITREVA MAKEDONKA , VANHOLME BARTEL , BAKKER JAAP , SMANT GEERT 
Published: October 2007

SUMMARYParasite proteins secreted at the interface of nematode and host are believed to play an essential role in parasitism. Here, we present an efficient pipeline of bio‐informatic algorithms and laboratory experiments to identify candidate parasitism genes within nematode secretomes, i.e. the repertoire of secreted proteins in an organism. We performed our approach on 12 218 expressed sequence tags (ESTs) originating from three life stages of the plant parasitic nematode Meloidogyne chitwoodi—a molecularly unexplored root‐knot nematode species. The ESTs from M. chitwoodi were assembled into 5880 contigs and open reading frames translated from the consensus sequences were searched for features of putative signal peptides for protein secretion and trans‐membrane regions, resulting in the identification of 398 secretome members. The products of parasitism genes are secreted by a range of organs, including the oesophageal, amphidial and rectal glands, the intestine, and the hypodermis. To localize the site of expression in M. chitwoodi, we subjected the most abundant secretome members to in situ hybridization microscopy. We found hybridization of one tag in the dorsal oesophageal gland, seven in the two subventral oesophageal glands, two in the intestine and one tag hybridized to the tail tip in the proximity of the phasmids. Four sequences showed similarity to putative parasitism genes from other nematode species, whereas seven represented pioneering sequences. Our approach presents an efficient method to identify candidate parasitism genes, which does not require sophisticated cDNA isolation and selection protocols, and can therefore be used as a powerful starting point for the molecular investigation of parasites.
Mining the genomes of plant pathogenic bacteria: how not to drown in gigabases of sequence
Authors: VINATZER BORIS A. , YAN SHUANGCHUN 
Published: October 2007

SUMMARYHundreds of bacterial genomes including the genomes of dozens of plant pathogenic bacteria have been sequenced. These genomes represent an invaluable resource for molecular plant pathologists. In this review, we describe different approaches that can be used for mining bacterial genome sequences and examples of how some of these approaches have been used to analyse plant pathogen genomes so far. We review how genomes can be mined one by one and how comparative genomics of closely related genomes releases the true power of genomics. Databases and tools useful for genome mining that are publicly accessible on the Internet are also described. Finally, the need for new databases and tools to efficiently mine today's plant pathogen genomes and hundreds more in the near future is discussed.
Bone marrow trephine findings in acute myeloid leukaemia with multilineage dysplasia
Authors: Ngo Nyethane , Lampert Irvin A , Naresh Kikkeri N 
Published: October 2007

SummaryAcute myeloid leukaemia (AML) with multilineage dysplasia (MD) is one of the four main categories of AML in the World Health Organization (WHO) classification. The role of bone marrow trephine biopsy (BMTB) histology and immunohistochemistry in the diagnosis of AML‐MD is currently unclear. BMTBs were studied in 11 cases of AML‐MD and two cases of myelodysplasia that subsequently transformed to AML. Among them, six cases showed trilineage dysplasia and seven showed bilineage dysplasia. With respect to conforming to the WHO definition of AML, documentation of an increased proportion of immature myeloid cells was possible on morphology and counting of immature cells following immunostaining with CD34, CD117 or HLA‐DR antibodies. Recognition and quantification of dysplastic features in the haemopoietic lineages was made easier by immunohistochemistry with antibodies to ret40f (glycophorin C), myeloperoxidase, CD61 and/or CD42b, CD34, CD117 and HLA‐DR. Based on this relatively small series of cases we show the utility of BMTB and immunohistochemistry as an aid to the diagnosis of AML‐MD. This has to be seen not just in light of its utility at diagnosis, but also the role the diagnostic BMTB would play for purposes of comparison when follow‐up BMTBs are submitted in this group of patients.
Retracted: Effect of progestins with different glucocorticoid activity on bone metabolism
Authors: Ishida Yoichiro , Mine Takatomo , Taguchi Toshihiko 
Published: October 2007

SummaryObjective  Progestins are commonly prescribed for hormone replacement therapy (HRT) and contraception. However, the effects of progestins on bone metabolism remain unclear and are often controversial.Design and patients  This study was conducted to test the hypothesis that progestins with no significant glucocorticoid activity may be a better choice for HRT to achieve increased beneficial effects on bone metabolism than progestins with strong glucocorticoid activity. A total of 104 postmenopausal women aged 50–75 years with osteoporosis were allocated randomly to three groups: (1) conjugated oestrogen plus medroxyprogesterone acetate (HRT‐MPA, with significant glucocorticoid activity); (2) conjugated oestrogen plus norethisterone (HRT‐NET, with no significant glucocorticoid activity); and (3) control (no treatment).Measurements  Vertebral X‐rays and bone mineral density (BMD) at distal 1/3 radius were assessed at baseline and every 6 months during the 2‐year study period, along with markers of bone turnover. The occurrence of new nonvertebral fractures was identified by X‐ray.Results  After the 2‐year treatment, mean BMD changes relative to baseline in the HRT‐MPA, HRT‐NET and control groups were 1·6%, 2·3% and –1·9%, respectively. In addition, the rate of increase in HRT‐NET was significantly greater than that in HRT‐MPA (P = 0·019). The incidence of new fractures during the 2‐year treatment in the control group was 26% (9/34). HRT‐NET treatment significantly inhibited the occurrence of new fractures (RR 0·14, 95% CI 0·02–0·93, P = 0·04), while HRT‐MPA treatment failed to show a statistically significant reduction (RR 0·41, 95% CI 0·14–1·24, P = 0·11). Both HRT‐MPA and HRT‐NET treatments significantly decreased serum osteocalcin levels by 29·4% and 23·5%, respectively, after 6 months of treatment, with the decrease in HRT‐MPA being significantly greater than that in HRT‐NET (P = 0·042).Conclusions  These findings suggest that progestins with no significant glucocorticoid activity may be a better choice for HRT, resulting in increased beneficial effects on bone metabolism compared with progestins with strong glucocorticoid activity.
The management of high‐risk patients with primary hyperparathyroidism – minimally invasive parathyroidectomy vs. medical treatment
Authors: Fang Wen‐Liang , Tseng Ling‐Ming , Chen Jui‐Yu , Chiou See‐Ying , Chou Yi‐Hong , Wu Chew‐Wun , Lee Chen‐Hsen 
Published: October 2007

SummaryObjective  Parathyroidectomy (PTx) for high‐risk primary hyperparathyroidism (PHPT) patients poses a surgical challenge. We hypothesize that a minimally invasive parathyroidectomy (MIP) under local anaesthesia may minimize the perioperative risks and facilitate easier clinical care than medical treatment for these patients.Design and patients  We performed a prospective, nonrandomized, controlled study of 33 PHPT patients evaluated as poor general anaesthesia risks. The outline of the diseased parathyroids and the thyroid were mapped by Tc99m sestamibi scan and focused sonogram. MIPs were performed under local anaesthesia (group 1, 19 patients). Medical treatment with bisphosphonates was continued for patients refusing operation (group 2, 14 patients).Measurements  Serum Ca, PO4, and i‐PTH were measured the following morning, every 6 months in the first postoperative year and then yearly for group 1 patients, or every 3 months for group 2 patients. American Society of Anaesthesiologists (ASA) and New York Heart Association (NYHA) class designations were re‐evaluated every 3 months.Results  In group 1, there were no operative complications, mortality or recurrent hypercalcaemia during a mean follow‐up of 35·5 months. Group 2 patients had a significantly higher incidence of episodes of hypercalcaemic crisis, deteriorating renal function and weight‐bearing bone fractures, while group 1 patients had a higher incidence of improved ASA and NYHA class, better 3‐year overall survival rate (83·1%vs. 60·8%, P = 0·032), and less medical costs.Conclusion  MIP can be safely performed under local anaesthesia and it facilitates clinical care in high‐risk PHPT patients. It is recommended for those selected by image localization.
Inversion of time‐dependent nuclear well‐logging data using neural networks
Authors: Carmine Laura , Aristodemou Elsa , Pain Christopher , Muggeridge Ann , De Oliveira Cassiano 
Published: October 2007

ABSTRACTThe purpose of this work was to investigate a new and fast inversion methodology for the prediction of subsurface formation properties such as porosity, salinity and oil saturation, using time‐dependent nuclear well logging data. Although the ultimate aim is to apply the technique to real‐field data, an initial investigation as described in this paper, was first required; this has been carried out using simulation results from the time‐dependent radiation transport problem within a borehole. Simulated neutron and γ‐ray fluxes at two sodium iodide (NaI) detectors, one near and one far from a pulsed neutron source emitting at ∼14 MeV, were used for the investigation. A total of 67 energy groups from the BUGLE96 cross section library together with 567 property combinations were employed for the original flux response generation, achieved by solving numerically the time‐dependent Boltzmann radiation transport equation in its even parity form. Material property combinations (scenarios) and their correspondent teaching outputs (flux response at detectors) are used to train the Artificial Neural Networks (ANNs) and test data is used to assess the accuracy of the ANNs. The trained networks are then used to produce a surrogate model of the expensive, in terms of computational time and resources, forward model with which a simple inversion method is applied to calculate material properties from the time evolution of flux responses at the two detectors.The inversion technique uses a fast surrogate model comprising 8026 artificial neural networks, which consist of an input layer with three input units (neurons) for porosity, salinity and oil saturation; and two hidden layers and one output neuron representing the scalar photon or neutron flux prediction at the detector. This is the first time this technique has been applied to invert pulsed neutron logging tool information and the results produced are very promising. The next step in the procedure is to apply the methodology to real data.
Varicocelectomy: semen parameters and protamine deficiency
Authors: Nasr‐Esfahani M. H. , Abasi H. , Razavi S. , Ashrafi S. , Tavalaee M. 
Published: October 2007

SummaryDifferent methods have been used to evaluate the beneficial effect of varicocelectomy; these include semen parameters and pregnancy rate. Because of high biological variability of semen parameters, sperm functional tests have been considered as an efficient end point in assessment of fertility. Therefore, the aim of this study was to evaluate the effect of varicocelectomy on semen parameters and sperm protamine deficiency in 192 patients. The results of the present study show that all the three semen parameters and percentage of sperms with normal protamine content have improved post‐surgery. The cumulative pregnancy rate was 34.6%. Comparing the results of the semen parameters and protamine content between patients whose partner became pregnant to those who did not benefit from varicocelectomy before and 6 months after surgery, show that patients may benefit from varicocelectomy that had higher initial semen density and better sperm morphology prior to surgery. Detailed analyses of sperm morphology, along with aforementioned results reveal that the factors which account for pregnancy difference are: (i) improvement in early events of spermatogenesis, possibly during spermatocytogensis and reduction division; and (ii) late spermiogenesis events. Thus, it can be suggested that patients with low initial sperm count may benefit more from assisted reproductive techniques or varicocelectomy followed by assisted reproduction.
Purinergic modulation of human corpus cavernosum relaxation
Authors: Lau D. H. W. , Metcalfe M. J. , Mumtaz F. H. , Mikhailidis D. P. , Thompson C. S. 
Published: October 2007

SummaryThe activation of P2Y6 receptors has been previously reported to cause vascular smooth muscle constriction and relaxation. The aim of our study was to determine the effect of P2Y6 receptor subtype activation on human cavernosal function. Cavernosal tissue was obtained from 23 patients undergoing gender reassignment surgery. Immunohistochemistry (IHC) and Western blotting were used to determine the presence of P2Y6 receptors in corpus cavernosal tissue. The effects of UDP (a selective P2Y6 receptor agonist) before and after the addition of distilled water (control), cibacron blue 3GA (CB, a P2Y6 receptor antagonist; 10−4 m) or N‐nitro‐l‐arginine methyl esther (l‐NAME, a NO synthase inhibitor; 10−4 m) were assessed on phenylephrine (PE; 10−4 m) pre‐contracted cavernosal strips using organ baths. Electrical field stimulation (EFS; 0.5–32 Hz) was performed in the absence and presence of CB to determine neuronal‐mediated P2Y6 receptor responses. IHC and Western blotting revealed the presence of P2Y6 receptors on cavernosal sections. UDP at 10−4 m and 10−3 m induced a 5% and 16% relaxation of the PE‐mediated response (both p < 0.0001), respectively, which was significantly blocked by CB (48% reduction of the UDP 10−3 m response, p < 0.002) but not affected by l‐NAME. EFS‐induced relaxations of pre‐contraction strips were not significantly altered by CB. We have found the presence of P2Y6 receptors in human cavernosal tissues, that when activated induce cavernosal smooth muscle cell relaxation via non‐neuronal and non‐nitric oxide dependent mechanism. Further investigation is needed to establish whether P2Y6 receptors play a physiological role in penile erection.
Bisphenol‐A disruption of the endocrine pancreas and blood glucose homeostasis
Authors: Ropero A. B. , Alonso‐Magdalena P. , García‐García E. , Ripoll C. , Fuentes E. , Nadal A. 
Published: October 2007

SummaryThe link between endocrine disruptors and altered blood glucose homeostasis has been recently suggested. Epidemiological studies have correlated levels of phthalates, dioxins and persistent organic pollutants with alterations of blood glucose homeostasis in humans. Environmentally relevant doses of the ubiquitous endocrine disruptor bisphenol‐A (BPA) have profound effects on mice endocrine pancreas – an essential tissue involved in glucose metabolism. BPA exerts rapid non‐genomic effects on insulin releasing β‐cells and glucagon releasing α‐cells within freshly isolated islets of Langerhans. In vivo, a single BPA injection of 10μg/kg rapidly increases plasma insulin and concomitantly decreases glycaemia. When mice were treated with BPA 100μg/kg/day for 4 days, the environmental oestrogen produced an increase in β‐cell insulin content along with a post‐prandial hyperinsulinaemia and insulin resistance. The results reviewed here demonstrate that doses well below the current lowest observed adverse effect level considered by the US‐EPA, disrupt pancreatic β‐cell function producing insulin resistance in male mice. Therefore, this altered blood glucose homeostasis by BPA exposure may enhance the risk of developing type II diabetes.
The KiSS‐1/GPR54 system: putative target for endocrine disruption of reproduction at hypothalamic–pituitary unit?
Authors: Navarro Victor M. , Tena‐Sempere Manuel 
Published: October 2007

SummaryThe hypothalamic–pituitary (HP) unit, key element in the control of development and function of the reproductive axis, is highly sensitive to the organizing and activational effects of endogenous and exogenous compounds with sex steroid activity. Thus, inappropriate sex steroid input during early critical periods of their maturation can induce immediate or delayed defects in the neuroendocrine systems governing reproduction, which might eventually lead to alterations in the timing of puberty onset and/or infertility. Similarly, later inadequate exposures can cause dysfunctions of the gonadotropic axis. In recent years, kisspeptins (the products of KiSS‐1 gene that operate through the G protein‐coupled receptor 54) have emerged as fundamental regulators of puberty onset and gonadotropin secretion, and neurons in the hypothalamus expressing KiSS‐1 have been demonstrated as essential conduits for the dynamic control of the gonadotropic axis by a number of hormonal factors. In this context, the hypothalamic KiSS‐1 system has been proven sensitive to the early organizing effects, as well as to the acute regulatory actions, of gonadal steroids: phenomena which are likely to play fundamental roles in the sexual differentiation of gonadotropin secretion, and its feedback regulation by androgen and oestrogen. These observations raise the question on whether the hypothalamic KiSS‐1 system might constitute a potential target for endocrine disruption of puberty onset and reproductive function at the HP unit by compounds with oestrogenic, androgenic or anti‐androgenic activity. We review herein the physiological basis and initial, albeit so far scarce, experimental evidence supporting such possibility.
Neoplasia as development gone awry: the role of endocrine disruptors
Authors: Soto Ana M. , Maffini Maricel V. , Sonnenschein Carlos 
Published: October 2007

SummaryThe hypothesis that prenatal exposure to endocrine disruptors might cause cancer arose from challenging two well‐accepted notions: (i) mammalian development is merely the unfolding of a genetic programme and (ii) only mutagenic agents can cause cancer. This hypothesis required challenging genetic determinism. The ecological developmental biology (eco‐devo) movement revitalized the concept of developmental plasticity through the occurrence of polyphenisms (a single genotype produces diverse phenotypes which are determined by environmental cues). Based on the principles of eco‐devo and the tissue organization field theory of carcinogenesis and neoplasia, we tested the hypothesis that exposure to xenoestrogens during foetal development in rats increased the propensity to develop mammary cancer during adulthood. We chose exposure to bisphenol A (BPA) as a model for environmental oestrogen exposure. This endocrine disruptor induced the development of ductal hyperplasias and carcinoma in situ. These highly proliferative lesions contained an increased number of oestrogen receptor α‐positive cells. Thus, foetal BPA exposure was sufficient to induce the development of oestrogen‐sensitive pre‐neoplastic and neoplastic lesions in the mammary gland in the absence of any additional treatment aimed at increasing tumour incidence.