bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasticity of marrow-derived stem cells
Authors: Herzog Erica L. , Chai Li , Krause Diane S. 
Published: August 2003

AbstractBone marrow (BM) contains hematopoietic stem cells (HSCs), which differentiate into every type of mature blood cell; endothelial cell progenitors; and marrow stromal cells, also called mesenchymal stem cells (MSCs), which can differentiate into mature cells of multiple mesenchymal tissues including fat, bone, and cartilage. Recent findings indicate that adult BM also contains cells that can differentiate into additional mature, nonhematopoietic cells of multiple tissues including epithelial cells of the liver, kidney, lung, skin, gastrointestinal (GI) tract, and myocytes of heart and skeletal muscle. Experimental results obtained in vitro and in vivo are the subject of this review. The emphasis is on how these experiments were performed and under what conditions differentiation from bone marrow to epithelial and neural cells occurs. Questions arise regarding whether tissue injury is necessary for this differentiation and the mechanisms by which it occurs. We also consider which bone marrow subpopulations are capable of this differentiation. Only after we have a better understanding of the mechanisms involved and of the cells required for this differentiation will we be able to fully harness adult stem cell plasticity for clinical purposes. (Blood. 2003; 102:3483-3493)
PECAM-1 negatively regulates GPIb/V/IX signaling in murine platelets
Authors: Rathore Vipul , Stapleton Michelle A. , Hillery Cheryl A. , Montgomery Robert R. , Nichols Timothy C. , Merricks Elizabeth P. , Newman Debra K. , Newman Peter J. 
Published: August 2003

AbstractPlatelet adhesion at sites of vascular injury is mediated, in part, by interaction of the platelet plasma membrane glycoprotein (GP) Ib/V/IX complex with von Willebrand Factor (VWF) presented on collagen-exposed surfaces. Recent studies indicate that GPIb/V/IX may be functionally coupled with the Fc receptor γ (FcRγ)-chain, which, by virtue of its cytoplasmic immunoreceptor tyrosine-based activation motif, sends activation signals into the cell. Platelet endothelial cell adhesion molecule-1 (PECAM-1) is an inhibitory receptor that has previously been shown to negatively regulate platelet responses to collagen, which transduces activation signals via the GPVI/FcRγ-chain complex. To determine whether PECAM-1 might similarly regulate signals emanating from GPIb/FcRγ, we compared activation and aggregation responses to VWF of PECAM-1-positive and PECAM-1-deficient murine platelets. PECAM-1 and the FcRγ-chain became rapidly tyrosine phosphorylated in platelets following botrocetin-induced VWF binding, but FcRγ-chain tyrosine phosphorylation was delayed in PECAM-1-positive, versus PECAM-1-deficient, platelets. PECAM-1-deficient platelets were hyperaggregable to VWF, exhibited enhanced spreading and, under conditions of arterial flow, formed markedly larger thrombi on immobilized VWF than did wild-type platelets. Taken together, these data support the notion that engagement of the GPIb complex, in addition to sending activation signals, also initiates a negative feedback loop involving PECAM-1 that controls the rate and extent of platelet activation. (Blood. 2003;102:3658-3664)
Congenital afibrinogenemia: identification and expression of a missense mutation in FGB impairing fibrinogen secretion
Authors: Vu Dung , Bolton-Maggs Paula H. B. , Parr Jeremy R. , Morris Michael A. , de Moerloose Philippe , Neerman-Arbez Marguerite 
Published: August 2003

Abstract
Congenital afibrinogenemia is a rare autosomal recessive disorder characterized by complete absence of detectable fibrinogen. We previously identified the first causative mutations for this disease: a homozygous deletion of approximately 11 kb of the fibrinogen α-chain gene (FGA). Subsequent studies revealed that the great majority of afibrinogenemia mutations are localized in FGA, but mutations were also found in FGG and FGB. Apart from 3 missense mutations identified in the C-terminal portion of FGB, all fibrinogen gene mutations responsible for afibrinogenemia are null. In this study, a young boy with afibrinogenemia was found to be a compound heterozygote for 2 mutations in FGB: an N-terminal nonsense mutation W47X (exon 2) and a missense mutation (G444S, exon 8). Coexpression of the FGB G444S mutant cDNA in combination with wild-type FGA and FGG cDNAs demonstrated that fibrinogen molecules containing the mutant β chain are able to assemble but are not secreted into the media, confirming the pathogenic nature of the identified mutation. (Blood. 2003;102:4413-4415)
Automated Syndromic Surveillance for the 2002 Winter Olympics
Authors: Gesteland Per H. , Gardner Reed M. , Tsui Fu-Chiang , Espino Jessi , Rolfs Robert T. , James Brent C. , Chapman Wendy W. , Moore Andrew W. , Wagner Michael M. 
Published: August 2003

Abstract
The 2002 Olympic Winter Games were held in Utah from February 8 to March 16, 2002. Following the terrorist attacks on September 11, 2001, and the anthrax release in October 2001, the need for bioterrorism surveillance during the Games was paramount. A team of informaticists and public health specialists from Utah and Pittsburgh implemented the Real-time Outbreak and Disease Surveillance (RODS) system in Utah for the Games in just seven weeks. The strategies and challenges of implementing such a system in such a short time are discussed. The motivation and cooperation inspired by the 2002 Olympic Winter Games were a powerful driver in overcoming the organizational issues. Over 114,000 acute care encounters were monitored between February 8 and March 31, 2002. No outbreaks of public health significance were detected. The system was implemented successfully and operational for the 2002 Olympic Winter Games and remains operational today.
Origin of Neuropeptide Y-Containing Afferents to Gonadotropin-Releasing Hormone Neurons in Male Mice
Authors: Turi Gergely F. , Liposits Zsolt , Moenter Suzanne M. , Fekete Csaba , Hrabovszky Erik 
Published: August 2003

Abstract
The origin of neuropeptide Y (NPY) afferents to GnRH neurons was investigated in male mice. Neonatal lesioning of the hypothalamic arcuate nuclei (ARC) with monosodium glutamate markedly reduced the number of NPY fibers in the preoptic area as well as the frequency of their contacts with perikarya and proximal dendrites of GnRH neurons. Dual-label immunofluorescence studies to determine the precise contribution of the ARC to the innervation of GnRH neurons by NPY axons were carried out on transgenic mice in which enhanced green fluorescent protein was expressed under the control of the GnRH promoter (GnRH-enhanced green fluorescent protein mice). The combined application of red Cy3 and blue AMCA fluorochromogenes established that 49.1 ± 7.3% of NPY axons apposed to green GnRH neurons also contained agouti-related protein (AGRP), a selective marker for NPY axons arising from the ARC. Immunoelectronmicroscopic analysis detected symmetric synapses between AGRP fibers and GnRH-immunoreactive perikarya. Additional triple-fluorescence experiments revealed the presence of dopamine-β-hydroxylase immunoreactivity within 25.4 ± 3.3% of NPY afferents to GnRH neurons. This enzyme marker enabled the selective labeling of NPY pathways ascending from noradrenergic/adrenergic cell populations of the brain stem, thus defining a second important source for NPY-containing fibers regulating GnRH cells. The absence of both topographic markers (AGRP and dopamine-β-hydroxylase) within 26% of NPY contacts suggests that additional sources of NPY fibers to GnRH neurons exist. Future studies will address distinct functions of the two identified NPY systems in the afferent neuronal regulation of the GnRH system.
Activation Functions 1 and 2 of Nuclear Receptors: Molecular Strategies for Transcriptional Activation
Authors: Wärnmark Anette , Treuter Eckardt , Wright Anthony P. H. , Gustafsson Jan-Åke 
Published: August 2003

AbstractNuclear receptors (NRs) comprise a family of ligand inducible transcription factors. To achieve transcriptional activation of target genes, DNA-bound NRs directly recruit general transcription factors (GTFs) to the preinitiation complex or bind intermediary factors, so-called coactivators. These coactivators often constitute subunits of larger multiprotein complexes that act at several functional levels, such as chromatin remodeling, enzymatic modification of histone tails, or modulation of the preinitiation complex via interactions with RNA polymerase II and GTFs. The binding of NR to coactivators is often mediated through one of its activation domains. Many NRs have at least two activation domains, the ligand-independent activation function (AF)-1, which resides in the N-terminal domain, and the ligand-dependent AF-2, which is localized in the C-terminal domain. In this review, we summarize and discuss current knowledge regarding the molecular mechanisms of AF-1- and AF-2-mediated gene activation, focusing on AF-1 and AF-2 conformation and coactivator binding.
The importance of setting and evaluating standards of telemedicine training
Authors: Brebner E M , Brebner J A , Ruddick-Bracken H , Wootton R , Ferguson J 
Published: August 2003

summary The importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established. We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses. Training was delivered on a one-to-one basis. A questionnaire was developed to evaluate user satisfaction and the effectiveness of training. One hundred and two fully completed questionnaires were returned (a 79% response rate). High levels of satisfaction were obtained but the level of user competence reached 100% only when training was supported by a training manual and at least weekly practice. Before establishing a telemedicine service, the following steps appear to be important: identify the required training competencies; deliver a ‘hands on’ training programme based on the required training competencies; back up the training programme with an instruction booklet; ensure that trainees have at least weekly practice; measure the level of user competence.
Evaluation of an Internet-based teledermatology system
Authors: Chao L W , Cestari T F , Bakos L , Oliveira M R , Miot H A , Zampese M , Andrade C B , Böhm G M 
Published: August 2003

summary We established a Website which allowed clinical dermatology cases to be submitted, with digital images, through a simple online form. The case could then be managed within the public health service. A database containing 6000 drug interactions was also available on the Website to help clinical management. The Website was tested by 10 junior doctors, who examined dermatology patients, filled in the electronic form with their clinical observations and descriptions, and forwarded digital images. Five dermatologists then evaluated the 71 cases stored on the Website. The agreement between the virtual evaluation and the definitive diagnosis (on face-to-face examination) was 95%. The Website could be used in national health strategies, as a tool for promoting voluntary medical attendance, and for multicentre epidemiological surveillance.
Rationalizing radio medical advice for maritime emergencies
Authors: Aujla K , Nag R , Ferguson J , Howell M , Cahill C 
Published: August 2003

summary The provision of radio medical advice by the National Health Service for British coastal waters has developed in an ad hoc fashion. In 1999, the closure of one of the two centres providing such advice led to unexpected problems. The demographic characteristics of the offshore population covered by each centre were markedly different and this resulted in a different spectrum of medical emergencies presenting to the sole remaining centre. Subsequent data collection of the details of medical emergencies presenting from offshore allowed an audit to inform the development of training packages for both base and remote practitioners. This has led to an ongoing national rationalization of ship-to-shore radio medical advice for the UK.
Minor injuries telemedicine
Authors: Ferguson J , Rowlands A , Palombo A , Pedley D , Fraser S , Simpson S 
Published: August 2003

summary A minor injuries telemedicine network in Grampian connects 14 accident and emergency departments in community hospitals to a teaching hospital department. In a six-month study, 407 new telemedicine consultations met the inclusion criteria. Rates of transfer for treatment to the base hospital were used as an outcome measure. Fourteen out of a total of 19 members of medical staff gave telemedical advice. They were mainly middle-grade accident and emergency doctors. Transfer rates were 16–48% (median 29%) across staff. The rates did not seem to be affected by the base doctor's seniority, but were a reflection of that doctor's experience of and confidence in using videoconferencing equipment for clinical purposes. Transfer rates decreased as experience increased. Training for doctors undertaking the provision of specialist advice should include the clinical practicalities of making remote diagnoses.
Implementing telemedicine services in northern Norway: Barriers and facilitators
Authors: Larsen F , Gjerdrum E , Obstfelder A , Lundvoll L 
Published: August 2003

summary Telemedicine is not simply a technology – it also involves processes. The use of telemedicine is influenced by many factors. Our intention was to examine what conditions promote the use of telemedicine between general practitioners (GPs) and hospitals. Qualitative interviews were undertaken with 16 GPs in northern Norway. The extent to which GPs were using the services was limited, although some used them fairly frequently. The most widely used service was teledermatology. The GPs saw advantages of the services in general and saw clear benefits for their patients. The services were considered to be time-consuming, and the lack of adequate government remuneration for the time involved in teleconsultations was seen as a barrier to their use. The GPs focused on their own ability to handle new technology and expressed a need to practise more.
An evaluation of a telemedicine fracture review clinic
Authors: Palombo A , Ferguson J , Rowlands A , Pedley D , Fraser S 
Published: August 2003

summary Telemedicine is being widely used in the treatment of patients with minor injuries in north-east Scotland. A telemedicine fracture review clinic has been developed. During a one-month study period there were a total of 67 review appointments and 88 new patients. Fifty individual patients were reviewed and 10 were seen on more than one occasion. The mean number of reviews for all patients was 2.3. Thirty-six patients had initially been seen by telemedicine, six of whom (17%) had to come to Aberdeen for part of their treatment. Fourteen patients reviewed by telemedicine had initially been seen in person. All patients were safely managed and normal guidelines were followed. There is scope for significant expansion of this service, since 131 patients were seen in a fracture clinic in Aberdeen who lived close to a minor injury unit with telemedicine and X-ray facilities. The majority of these patients were likely to have had injuries suitable to be followed up using telemedicine.
A role for tele-education in the centralization of accident and emergency services
Authors: Pedley D , Brebner E , Rowlands A , Palombo A , Ferguson J 
Published: August 2003

summary We evaluated the use of tele-education to provide an induction programme for accident and emergency senior house officers (SHOs) in three remote locations, and compared their performance with that of SHOs receiving the same induction programme in the conventional manner. Both groups of doctors performed similarly in a pre-course multiple-choice question (MCQ) paper, and showed comparable improvement following the induction programme lectures. Sound quality and levels of interactivity were identified as areas for improvement in the tele-education programme. Tele-education might allow doctors based in peripheral units similar access to high-quality teaching to that enjoyed by those in larger hospitals. Further experience and evaluation are required to optimize this method of education delivery.
An evaluation of the west Surrey telemedicine monitoring project
Authors: Dale Jeremy , Connor Sarah , Tolley Kim 
Published: August 2003

summary We conducted a three-month pilot study of a home monitoring service for patients with chronic obstructive pulmonary disease. Fifty-five patients were recruited. They transmitted physiological data to a monitoring centre once a day. During the period of the study, 36 escalations were reported to have occurred. Of these, 29 (81%) were managed at home; the other 7 (19%) resulted in acute admission after emergency telephone calls. Although only a small number of patients were involved for a relatively short period of time, there was evidence of a substantial (approximately 50%) decrease in rates of hospital admission. The service was highly acceptable to the patients.
An empirical analysis of a telehealth system in terms of cost-sharing
Authors: Tsuji Masatsugu , Suzuki Wataru , Taoka Fumio 
Published: August 2003

summary We interviewed 348 users of a home telemonitoring system and asked questions about their willingness to pay (WTP). Assuming that the functional form of demand was logistic, the best estimate of the WTP was ¥4519 per user per month. We also analysed how the benefits of the system (expressed in terms of WTP) were attributed to four factors: stabilizing illness; enhancement of health consciousness; less anxiety in day-to-day life; and a decrease in medical expenditures. All except the last were significant. According to the resulting model, individual users should bear ¥2763 in costs, while society should reimburse ¥349. Surprisingly, the value of ¥2763 obtained here is very close to the amount (¥2500) actually charged by Kamaishi City.
Design and implementation of an automatic message-routing system for low-cost telemedicine
Authors: Wootton Richard 
Published: August 2003

summary Email has been used for some years as a low-cost telemedicine medium to provide support for developing countries. However, all operations have been relatively small scale and fairly labour intensive to administer. A scalable, automatic message-routing system was constructed which automates many of the tasks. During a four-month study period in 2002, 485 messages were processed automatically. There were 31 referrals from eight hospitals in three countries. These referrals were handled by 25 volunteer specialists from a panel of 42. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 1.0 days (interquartile range 0.7–2.4). The median interval between allocation and first reply was 0.7 days (interquartile range 0.3–2.3). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.
Guidelines for teleradiology practice: Results of the Tyrolean teleradiology pilot project
Authors: Soegner P , Rettenbacher Th , Smekal A , Nedden D Zur 
Published: August 2003

summary The Tyrolean telemedicine pilot project linked the University Clinic of Innsbruck and the district hospital in Reutte. Five medical specialties were investigated: teleradiology, telepathology, teledermatology, tele-ophthalmology and tele-oncology. A Tyrolean ‘four-column model of quality management in telemedicine’ was introduced to ensure a global view of the project and to avoid mistakes. In teleradiology, a 12-step workflow was developed, which described the medical responsibilities at each stage. We found that the defined teleradiology workflow and the technical equipment for data security and data exchange worked without problems in over 79% of a total of 424 cases. To ensure continuous quality assurance, the whole teleradiology workflow was ISO 9001:2000 certified.
Lessons from the implementation of a home telecare service
Authors: Hibbert D , Mair F S , Angus R M , May C , Boland A , Haycox A , Roberts C , Shiels C , Capewell S 
Published: August 2003

summary We conducted a qualitative evaluation of the introduction of a telenursing service. The service used an analogue videophone linked with a physiological monitoring device, which allowed the transmission of data between the patient's home and the hospital. A researcher kept a detailed diary of day-to-day activity for the first year of the project. Computer software for qualitative data analysis was used to code the text and the analysis followed the principles of constant comparison. The diary entries documented how the commercially available equipment was adapted to suit the organization and content of the nurses’ work. The nurses made a number of suggestions to improve the user-friendliness of the equipment. The technology, the existing home care service (the comparison arm of the study) and the randomized controlled trial itself all underwent continuous change. The traditionalrandomized control design of trial has limitations in this situation, and there is a need for more realistic trial designs.
How has NHS Direct changed primary care provision?
Authors: Mark Annabelle L , Shepherd Ifan D H 
Published: August 2003

summary We studied a general practice cooperative in west London that served 900,000 patients. The telephone triage service subsequently became a pilot for the national service, NHS Direct. Both quantitative and qualitative data were used for the study. The quantitative data consisted of the (anonymized) patient computer records available on the telephone triage service for the first two weeks in December 1998, December 1999 and December 2000. Two significant events were identified. The first, which emerged principally from analysis of the quantitative call data, were changes in patient outcomes during the period that spanned the arrival of NHS Direct. The second, revealed mainly through analysis of the qualitative data, were changes in the behaviour, perceptions and work experience of the triage nurses. Significant behavioural and attitudinal transitions occur when primary care organizations are modified.
Determining clinician satisfaction with telemedicine
Authors: Kennedy C , Johnston K , Taylor P , Murdoch I E 
Published: August 2003

summary We compared two methods of assessing clinician satisfaction with telemedicine. Clinicians completed a self-administered questionnaire with a preference ranking scale and a discrete choice method. Sixty-three clinicians completed the questionnaire (a 78% response rate). The preference ranking method showed that clinicians ranked the level of skill of the other clinician as the most important (55%) attribute of a teleconsultation and the completeness of the history as the second most important attribute (42%). The discrete choice method showed that clinicians ranked completeness of the patient's history as the most important attribute and risk of receiving wrong advice as the second most important. The use of discrete choice preferences provides an alternative and more objective method for collecting data about preferences in telemedicine. However, its use is not simple and requires the participants to be engaged in person rather than sent a questionnaire by post.