bluuebunny/crossref_metadata_2025 huggingface dataset:
Curling Iron‐related Injuries Presenting to U.S. Emergency Departments
Authors: Qazi Khajista , Gerson Lowell W. , Christopher Norman C. , Kessler Eileen , Ida Nathan
Published: January 2008

Abstract. Objective: To describe curling iron‐related injuries reported to the National Electronic Injury Surveillance System (NEISS) between January 1, 1992, and December 31, 1996. Methods: The authors retrospectively reviewed data from NEISS, a weighted probability sample of emergency departments (EDs) developed to monitor consumer product‐related injuries. The information reported includes patient demographics, injury diagnosis, body part injured, incident locale, patient disposition, and a brief narrative description. The authors reviewed the narrative in the hair care products category and abstracted records indicating the injury was caused by contact with a curling iron. Also analyzed were the design features of commonly available curling irons purchased from national discount department stores. Results: There were an estimated 105,081 hair care product‐related injuries in the five‐year period, of which 82,151 (78%) involved a curling iron. Seventy percent of injuries were to females. The patient's median age was 8 years (range 1 month to 96 years). The most commonly occurring injury was thermal burns (97%; 79,912/82,151). Ninety‐eight percent of the injuries occurred in the home and 99% of the patients were discharged home from the ED. In patients <4 years old, 56% of burns occurred by grabbing or touching, while in those ≥10 years the burns occurred by contact while in use. In the older group 69% of burns were of the cornea. Most curling irons use small amounts of power, yet there are no standards for temperature settings or control. The cylinder containing the heating element is mostly exposed, and many irons do not have a power switch. Conclusions: The most common injury resulting from curling irons is thermal burns. The mechanisms and patterns of injury in developmentally distinct age groups suggest that many of these injuries could be prevented by public education and the re‐engineering of curling irons.
Is the ACLS Score a Valid Prediction Rule for Survival after Cardiac Arrest?
Authors: Haukoos Jason S. , Lewis Roger J. , Stratton Samuel J. , Niemann James T.
Published: January 2008

The ACLS (advanced cardiac life support) Score was previously developed to predict survival from out‐of‐hospital cardiac arrest. Whether the arrest was witnessed, initial cardiac rhythm, performance of bystander cardiopulmonary resuscitation (CPR), and the response time of the paramedic unit were determined to be predictive of survival. However, the ACLS Score has not been validated in other emergency medical services systems. Objectives: The purpose of this study was to externally validate the ACLS Score in one patient population. Methods: This was a retrospective cohort study performed at an urban county teaching hospital. The study population consisted of consecutive adult patients treated for out‐of‐hospital, nontraumatic cardiac arrest, and transported to the authors' institution between November 1, 1994, and September 30, 2001. Patient records for all cardiac arrests during the study period were reviewed. Study variables included witnessed arrest, initial arrest rhythm, bystander CPR, paramedic response time, and survival to hospital discharge. Predicted probability of survival to hospital discharge was calculated for each patient using the ACLS Score. The overall predicted and observed survival rates were compared using Flora's Z score. The Hosmer‐Lemeshow test was used to evaluate the model's goodness‐of‐fit over a range of survival probabilities. Results: Of 754 cardiac arrest patients enrolled in the study period, 575 (76%) patients had documentation that allowed scoring using the ACLS Score. Twenty‐five (4%) patients survived to hospital discharge. The predicted number of survivors based on the ACLS Score was 104 (18%), yielding a Flora's Z statistic of −4.46 (p < 0.0001). After categorizing predicted survival probabilities into four categories, the resulting Hosmer‐Lemeshow statistic was 210 (p ≪ 10−6). Both goodness‐of‐fit statistics demonstrated extremely poor fit of the model. A receiver operating characteristic (ROC) curve was created, yielding an area under the ROC curve of 0.33 (95% CI = 0.19 to 0.47), signifying extremely poor discrimination. Conclusions: The previously published ACLS Score was not valid when applied to an external cohort of out‐of‐hospital cardiac arrest patients. An externally valid model is needed to predict survival to hospital discharge following out‐of‐hospital cardiac arrest.
Acute Pain Is Underassessed in Out‐of‐hospital Emergencies
Authors: Luger Thomas J. , Lederer Wolfgang , Gassner Michael , Löckinger Alexander , Ulmer Hanno , Lorenz Ingo H.
Published: January 2008

Objectives: To evaluate the quality of pain assessment by emergency medical services (EMS) in out‐of‐hospital emergencies. Methods: A prospective study was conducted on a convenience sample of patients during a one‐year observation period. Pain ratings assessed by emergency patients were documented at three different intervals during the emergency call, and compared with concomitant assessments by EMS providers. A visual analog scale (VAS) and a verbal pain scale (VPS) were used for pain assessment. Repeated‐measures ANOVA and Dunnett's t‐test were used for data analysis. Results: Fifty‐one out of 70 eligible patients met inclusion criteria. In most emergency patients the intensity of pain was underestimated by EMS, especially when pain was severe (p = 0.0001). During the course of transport, both pain and pain assessment by EMS improved significantly (p = 0.0001). The VAS and VPS were significantly correlated (p = 0.0001). Conclusions: EMS providers significantly underestimate their patients' pain severity. EMS providers should be more attentive to their patients' complaints and comfort.
Site Management of Health Issues in the 2001 World Trade Center Disaster
Authors: Bradt David A.
Published: January 2008

The terrorist destruction of the World Trade Center led to the greatest loss of life from a criminal incident in the history of the United States. There were 2,801 persons killed or missing at the disaster site, including 147 dead on two hijacked aircraft. Hundreds of buildings sustained direct damage or contamination. Forty different agencies responded with command and control exercised by an incident command system as well as an emergency operations center. Dozens of hazards complicated relief and recovery efforts. Five victims were rescued from the rubble. Up to 1,000 personnel worked daily at the World Trade Center disaster site. These workers collectively made an average of 270 daily presentations to health care providers in the first month post‐disaster. Of presentations for clinical symptoms, leading clinical diagnoses were ocular injuries, headaches, and lung injuries. Mechanical injury accounted for 39% of clinical presentations and appeared preventable by personal protective equipment. Limitations emerged in the site application of emergency triage and clinical care. Notable assets in the site management of health issues include action plans from the incident command system, geographic information system products, wireless application technology, technical consensus among health and safety authorities, and workers' respite care.
Utilization of the emergency department after self‐inflicted injury
Authors: Colman Ian , Dryden Donna M. , Thompson Angus H. , Chahal Anthony M. , Borden Kim , Rowe Brian H. , Voaklander Donald C.
Published: January 2008

Objectives: To compare emergency department (ED) utilization by individuals who present with self‐inflicted injuries with utilization by control populations. Individuals with self‐inflicted injuries commonly present to the ED, yet little research has been conducted on this population in this setting. Methods: Individuals who had an ED presentation in 1995–1996 for a self‐inflicted injury were tracked prospectively for three to four years of follow‐up. This group was matched by age and gender to two groups: individuals who presented with asthma and individuals who presented with other complaints. Data on return visits to the ED were collected from an administrative database. Groups were compared on rates of return visits. Results: There were 478 individuals randomly selected for each group. Individuals in the self‐inflicted injury group had higher rates of return visits to the ED over the follow‐up period: 232.7 visits per 100 person‐years for the self‐inflicted injury group, compared with 117.6 for the asthma group, and 83.0 for the “other” group (p < 0.001). The self‐inflicted injury group had higher rates for many types of diagnoses: self‐inflicted injuries, mental disorders, substance abuse, unintentional injuries, assault, headache pain, and other complaints (all p < 0.001). Patients with more than three repeat visits per year were more common in the self‐inflicted injury group (20.1%) than the asthma or “other” groups (9.2% and 5.6%, respectively). Conclusions: Individuals who harm themselves are chronic users of the ED. The ED represents an opportune setting from which individuals can be directed to appropriate treatment programs.
Emergency Department Patient Satisfaction: Examining the Role of Acuity
Authors: Boudreaux Edwin D. , Friedman Jason , Chansky Michael E. , Baumann Brigitte M.
Published: January 2008

Objectives: To explore the relationships between patient acuity, perceived and actual throughput times, and emergency department (ED) patient satisfaction. The authors hypothesized that high‐acuity patients would be the most satisfied with their throughput times, as well as the overall ED visit. The authors also expected overall ED satisfaction to be more strongly associated with perceived throughput times compared with actual throughput times, regardless of acuity. Methods: This was a prospective survey of 1,865 ED patients at a large, inner‐city hospital during a one‐month period. Data were collected on patient demographics, acuity of patient illness, actual waiting time for evaluation by a physician, and actual overall length of stay. Patient satisfaction with various throughput times (i.e., perceived throughput time) and overall ED visit was assessed by using a seven‐point scale (1 = poor, 7 = excellent). Analysis of variance, analysis of covariance (ANCOVA), and correlations were conducted to explore the hypotheses. Results: Patients with “emergent” acuity perceived their throughput times more favorably and were more satisfied with their overall ED visit compared with “urgent” and “routine” patients (all p < 0.01). Once the effects of perceived throughput time were controlled for by using an ANCOVA, acuity no longer predicted overall ED satisfaction. Correlations showed that overall ED satisfaction was more closely linked to perceived throughput times than to actual throughput times (average r= 0.62 vs. −0.12). Conclusions:“Emergent” patients are more satisfied than “urgent” and “routine” patients with their ED visits. “Emergent” patients perceived their throughput times more favorably than other patients, especially their wait for physician evaluation. Changing perceptions of throughput times may yield larger improvements in satisfaction than decreasing actual throughput times, regardless of patient acuity.
Advanced statistics: Understanding Medical Record Review (MRR) Studies
Authors: Worster Andrew , Haines Ted
Published: January 2008

Medical record review (MRR) studies have been reported to make up 25% of all scientific studies published in emergency medical (EM) journals. However, unlike other study designs, there are no standards for reporting MRRs and very little literature on the methodology for conducting them. The purpose of this article is to provide the reader with methodological guidance regarding the strengths and weaknesses of these types of studies.
Epidemiology of Adult Psychiatric Visits to U.S. Emergency Departments
Authors: Hazlett Sara B. , McCarthy Melissa L. , Londner Michael S. , Onyike Chiadi U.
Published: January 2008

Objectives: To characterize psychiatric‐related emergency department visits (PREDVs) among adults in the United States for the year 2000 and to analyze PREDV trends from 1992 to 2000. Methods: Emergency department (ED) visit data from the National Hospital Ambulatory Medical Care Survey were used to estimate the number of PREDVs for adults aged 18 years and older. A PREDV was defined as any visit with a psychiatric discharge diagnosis (ICD N290– N312) or a suicide attempt (ICD E950–E959). Results: Approximately 4.3 million PREDVs occurred in the United States in the year 2000, yielding an annual rate of 21 visits per 1,000 adults. The PREDV rates increased 15% between 1992 and 2000. The PREDVs accounted for 5.4% of all ED visits. Substance abuse (27%), neuroses (26%), and psychoses (21%) were the most common conditions. African Americans had significantly higher visit rates (29/1,000; 95% CI = 27/1,000 to 31/1,000) compared with whites (23/1,000; 95% CI = 22/1,000 to 25/1,000). Persons with Medicaid (66/1,000; 95% CI = 64/1,000 to 68/1,000) had double the rate of PREDVs than the uninsured (33/1,000; 95% CI = 31/1,000 to 35/1,000) and almost eight times the rate of those privately insured (8/1,000; 95% CI = 7/1,000 to 10/1,000). Patients with psychiatric diagnoses had a higher admission rate (22%) than those with nonpsychiatric diagnoses (15%). The uninsured were the least likely to be admitted for all major psychiatric conditions except suicide (p < 0.0001). Conclusions: Psychiatric‐related ED visits represent a substantial and growing number of ED visits each year. Patient characteristics influence the likelihood of a PREDV. Further research is needed to better understand the role that hospital EDs play in the delivery of health care services to those with mental illness.
Error Identification, Disclosure, and Reporting: Practice Patterns of Three Emergency Medicine Provider Types
Authors: Hobgood Cherri , Xie Jipan , Weiner Bryan , Hooker James
Published: January 2008

Objectives: To gather preliminary data on how the three major types of emergency medicine (EM) providers, physicians, nurses (RNs), and out‐of‐hospital personnel (EMTs), differ in error identification, disclosure, and reporting. Methods: A convenience sample of emergency department (ED) providers completed a brief survey designed to evaluate error frequency, disclosure, and reporting practices as well as error‐based discussion and educational activities. Results: One hundred sixteen subjects participated: 41 EMTs (35%), 33 RNs (28%), and 42 physicians (36%). Forty‐five percent of EMTs, 56% of RNs, and 21% of physicians identified no clinical errors during the preceding year. When errors were identified, physicians learned of them via dialogue with RNs (58%), patients (13%), pharmacy (35%), and attending physicians (35%). For known errors, all providers were equally unlikely to inform the team caring for the patient. Disclosure to patients was limited and varied by provider type (19% EMTs, 23% RNs, and 74% physicians). Disclosure education was rare, with 15% of any provider type receiving such instruction. Yet, 59% of physicians had observed another provider disclose an error to a patient. Error discussions are widespread, with all providers indicating they discussed their own as well as the errors of others. Conclusions: This study suggests that error identification, disclosure, and reporting challenge all members of the ED care delivery team. Provider‐specific education and enhanced teamwork training will be required to further the transformation of the ED into a high‐reliability organization.
Studies in Emergency Department Data Collection: Shared versus Split Responsibility for Patient Enrollment
Authors: Hollander Judd E. , Sparano Dina M. , Karounos Marianna , Sites Frank D. , Shofer Frances S.
Published: January 2008

Objectives: To compare patient enrollment in six clinical studies using shared coverage (24 emergency department [ED] rooms—two students share enrollment responsibility) with enrollment using split coverage (12 rooms each per student). The academic associate (AA) program uses undergraduate students to collect data for clinical studies in the ED by providing double coverage 16 hours/day, seven days/week. Prior studies have shown that this system captures >85% of eligible patients. Methods to obtain closer to 100% enrollment are desired. Methods: During consecutive 15‐day periods with the same 24 AAs, the daily ED census, hours of AA coverage, and enrollment in each of six studies were evaluated prospectively in the ED. Data are presented as means with 95% confidence intervals (CIs). Results: There was no difference between the shared and split enrollment periods with respect to hours of AA coverage (30.3 vs. 30.7 hours/day; p = 0.7) or average daily ED census (133.7 vs. 141.8; p = 0.15). Overall, the percentages of ED patients recruited for study participation were not different depending on whether the split versus shared recruitment strategy was used (907 patients recruited out of 2,005 ED patients (45.2%; 95% CI = 43.0 to 47.4) vs. 937 of 2,127 (44.0%; 95% CI = 41.9 to 46.1). The 95% CI for the 1.2% difference was −1.8% to 4.2%. Patient enrollments in six individual studies were similar regardless of recruitment strategy. Following the 30‐day trial, AAs were surveyed: 17 of 24 (71%) found the split strategy to be “more helpful in enrolling subjects,” and 20 of 24 (83%) found split strategy helped them “keep better track” of patients. Conclusions: Study subject enrollment was not affected by the use of either the shared or split responsibility strategy for recruitment. Students generally preferred the split strategy because it was more helpful and easier to monitor. Therefore, this may be the best option for similar student‐oriented data collection programs.
Shedding New Light on the “Safe” Club Drug: Methylenedioxymethamphetamine (Ecstasy)‐related Fatalities
Authors: Patel Manish M. , Wright David W. , Ratcliff Jonathan J. , Miller Michael A.
Published: January 2008

Objectives:To report the pathology, toxicology, cause, and manner of death in 3,4‐methylenedioxymethamphetamine (MDMA)‐associated fatalities in the United States. Although use trends are increasing, data regarding the hazards of MDMA are limited.Methods:The authors obtained fatality reports from participating medical examiners in the United States. Cases were identified as “drug‐unrelated” when MDMA did not directly cause death (e.g., motor vehicle collision); deaths from drug toxicity were judged “drug‐related.”Results:Thirty‐eight (8%) of the surveyed medical examiners reported 102 deaths associated with MDMA use from 1999 to 2001. Ten percent of fatalities occurred in 1999 and 90% thereafter, representing a 400% relative increase. Victims tended to be young (mean age = 25), white (n= 87 [85%]), male (n= 70 [69%]), and otherwise healthy. Seventy‐one (70%) deaths were drug‐related (DR) and 31 (30%) were drug‐unrelated (DU). Twenty‐four (35%) DR deaths had a mean delay of 6.7 hours (95% CI = 5.1 to 8.2) in activating emergency medical services. Fifty‐five DR cases (81%) were found in asystole and pronounced dead at the scene.Conclusions:The MDMA‐associated fatal events typically occur in young, otherwise healthy individuals. MDMA's impact on the public health and safety of young adults and teenagers needs further assessment.
Use of helical computed tomography for imaging the pediatric cervical spine
Authors: Adelgais Kathleen M. , Grossman David C. , Langer Steve G. , Mann Fred A.
Published: January 2008

Objective: To determine the differences in resource utilization and radiation exposure between conventional radiography (ConvRad) and helical computed tomography (HCT) when used to survey the pediatric cervical spine (CSp). Methods: Patients aged 0–14 years who required CSp radiographic evaluation in addition to cranial CT were prospectively enrolled and assigned to undergo either HCT or ConvRad with adjunctive linear tomography. Outcomes of medication usage, emergency department (ED) length of stay (LOS), cervical spine radiation exposure, and imaging resource use (relative value unit [RVU]) were compared between the two groups. Data were analyzed by regression analysis with adjustment for confounders. Results: Of 136 patients, 64 and 72 patients were assigned to the ConvRad group and HCT group, respectively. At the discretion of the trauma team, 34% of the patients enrolled crossed between the two study arms. Odds ratio (OR), based on original assignment, was 0.8 (95% CI = 0.4 to 1.8) for difference in medication usage between the two groups. Mean LOSs were 259 minutes (95% CI = 124 to 394) and 183 (95% CI = 166 to 200) minutes for HCT and ConvRad, respectively. CSp imaging RVUs were 5.5 (95% CI = 5.1 to 5.8) for HCT and 4.0 (95% CI = 3.3 to 4.6) for ConvRad. Mean CSp radiation doses were 389 mRem (95% CI = 346 to 432) for HCT and 294 mRem (95% CI = 245 to 343) for ConvRad. Adjustment for confounders did not change the direction of the results. Conclusions: As a modality to screen the pediatric CSp for blunt‐force trauma, HCT results in increased radiation exposure and radiology resource use without a reduction in sedation usage or time in the ED.
Emergency Department Management of Acute Pain Episodes in Sickle Cell Disease
Authors: Tanabe Paula , Myers Randall , Zosel Amy , Brice Jane , Ansari Altaf H. , Evans Julia , Martinovich Zoran , Todd Knox H. , Paice Judith A.
Published: January 2008

ObjectivesTo characterize the initial management of patients with sickle cell disease and an acute pain episode, to compare these practices with the American Pain Society Guideline for the Management of Acute and Chronic Pain in Sickle‐Cell Disease in the emergency department, and to identify factors associated with a delay in receiving an initial analgesic.

MethodsThis was a multicenter retrospective design. Consecutive patients with an emergency department visit in 2004 for an acute pain episode related to sickle cell disease were included. Exclusion criteria included age younger than 18 years. A structured medical record review was used to abstract data, including the following outcome variables: analgesic agent and dose, route, and time to administration of initial analgesic. Additional variables included demographics, triage level, intravenous access, and study site. Mann–Whitney U test or Kruskal–Wallis test and multivariate regression were used to identify differences in time to receiving an initial analgesic between groups.

ResultsThere were 612 patient visits, with 159 unique patients. Median time to administration of an initial analgesic was 90 minutes (25th to 75th interquartile range, 54–159 minutes). During 87% of visits, patients received the recommended agent (morphine or hydromorphone); 92% received the recommended dose, and 55% received the drug by the recommended route (intravenously or subcutaneously). Longer times to administration occurred in female patients (mean difference, 21 minutes; 95% confidence interval = 7 to 36 minutes; p = 0.003) and patients assigned triage level 3, 4, or 5 versus 1 or 2 (mean difference, 45 minutes; 95% confidence interval = 29 to 61 minutes; p = 0.00). Patients from study sites 1 and 2 also experienced longer delays.

ConclusionsPatients with an acute painful episode related to sickle cell disease experienced significant delays to administration of an initial analgesic.
Advanced Statistics: Missing Data in Clinical Research—Part 2: Multiple Imputation
Authors: Newgard Craig D. , Haukoos Jason S.
Published: January 2008

In part 1 of this series, the authors describe the importance of incomplete data in clinical research, and provide a conceptual framework for handling incomplete data by describing typical mechanisms and patterns of censoring, and detailing a variety of relatively simple methods and their limitations. In part 2, the authors will explore multiple imputation (MI), a more sophisticated and valid method for handling incomplete data in clinical research. This article will provide a detailed conceptual framework for MI, comparative examples of MI versus naive methods for handling incomplete data (and how different methods may impact subsequent study results), plus a practical user's guide to implementing MI, including sample statistical software MI code and a deidentified precoded database for use with the sample code.
High Rates of Fecal Carriage of Nonenterococcal
vanB
in both Children and Adults
Authors: Graham M. , Ballard S. A. , Grabsch E. A. , Johnson P. D. R. , Grayson M. L.
Published: January 2008

We examined the rate of fecal carriage of
vanB
in the absence of cultivable vancomycin-resistant enterococci in three distinct populations (children, community adults, and hemodialysis patients). Nonenterococcal
vanB
carriage was similarly high in hemodialysis patients (45%) and community adults (63%;
P
= 0.066) and significantly more common among community adults than children (27%;
P
= 0.001).
Induction of the Carrier State in Pigeons Infected with
Salmonella enterica
Subspecies
enterica
Serovar Typhimurium PT99 by Treatment with Florfenicol: a Matter of Pharmacokinetics
Authors: Pasmans Frank , Baert Kris , Martel An , Bousquet-Melou Alain , Lanckriet Ruben , De Boever Sandra , Van Immerseel Filip , Eeckhaut Venessa , de Backer Patrick , Haesebrouck Freddy
Published: January 2008

Paratyphoid caused by
Salmonella enterica
subsp.
enterica
serovar Typhimurium is the main bacterial disease in pigeons. The ability of
Salmonella
serovar Typhimurium to persist intracellularly inside pigeon macrophages results in the development of chronic carriers, which maintain the infection in the flock. In this study, the effect of drinking-water medication with florfenicol on
Salmonella
infection in pigeons was examined. The pharmacokinetics of florfenicol in pigeons revealed a relatively high volume of distribution of 2.02 liters/kg of body weight and maximum concentrations in plasma higher than the MICs for the
Salmonella
strain used (4 μg/ml) but quick clearance of florfenicol due to a short half-life of 1.73 h. Together with highly variable bioavailability and erratic drinking-water uptake, these parameters resulted in the inability to reach a steady-state concentration through the continuous administration of florfenicol in the drinking water. Florfenicol was capable of reducing only moderately the number of intracellular salmonellae in infected pigeon macrophages in vitro. Only at high extracellular concentrations (>16 μg/ml) was a more-than-10-fold reduction of the number of intracellular bacteria noticed. Florfenicol treatment of pigeons via the drinking water from 2 days after experimental inoculation with
Salmonella
serovar Typhimurium until euthanasia at 16 days postinoculation resulted in a reduction of
Salmonella
shedding and an improvement in the fecal consistency. However, internal organs in florfenicol-treated pigeons were significantly more heavily colonized than those in untreated pigeons. In conclusion, the oral application of florfenicol for the treatment of pigeon paratyphoid contributes to the development of carrier animals through sub-MIC concentrations in plasma that do not inhibit intracellular persistency.
Mechanisms of Resistance to Daptomycin in
Enterococcus faecium
Authors: Montero Clemente I. , Stock Frida , Murray Patrick R.
Published: January 2008

In this study, we investigated the clonal emergence of daptomycin-resistant
Enterococcus faecium
strains isolated from a patient with leukocyte adhesion deficiency syndrome. The resistance mechanism in these strains is independent of either equivalent point mutations previously described for
Staphylococcus aureus
or daptomycin inactivation mechanisms identified in soil bacteria.
Population Pharmacokinetics of Piperaquine after Two Different Treatment Regimens with Dihydroartemisinin-Piperaquine in Patients with
Plasmodium falciparum
Malaria in Thailand
Authors: Tarning J. , Ashley E. A. , Lindegardh N. , Stepniewska K. , Phaiphun L. , Day N. P. J. , McGready R. , Ashton M. , Nosten F. , White N. J.
Published: January 2008

The population pharmacokinetics of piperaquine in adults and children with uncomplicated
Plasmodium falciparum
malaria treated with two different dosage regimens of dihydroartemisinin-piperaquine were characterized. Piperaquine pharmacokinetics in 98 Burmese and Karen patients aged 3 to 55 years were described by a two-compartment disposition model with first-order absorption and interindividual random variability on all parameters and were similar with the three- and four-dose regimens. Children had a lower body weight-normalized oral clearance than adults, resulting in longer terminal elimination half-lives and higher total exposure to piperaquine (area under the concentration-time curve from 0 to 63 days [AUC
day 0-63
]). However, children had lower plasma concentrations in the therapeutically relevant posttreatment prophylactic period (AUC
day 3-20
) because of smaller body weight-normalized central volumes of distribution and shorter distribution half-lives. Our data lend further support to a simplified once-daily treatment regimen to improve treatment adherence and efficacy and indicate that weight-adjusted piperaquine doses in children may need to be higher than in adults.
Subacute Toxicity of Colistin Methanesulfonate in Rats: Comparison of Various Intravenous Dosage Regimens
Authors: Wallace Stephanie J. , Li Jian , Nation Roger L. , Rayner Craig R. , Taylor David , Middleton Deborah , Milne Robert W. , Coulthard Kingsley , Turnidge John D.
Published: January 2008

The relative nephro- and neurotoxicity of colistin methanesulfonate (CMS) was investigated with rats during 7 days of intravenous administration in regimens mimicking twice- and once-daily dosing of a clinically relevant dose for humans. Histological examination revealed more-severe renal lesions with the regimen corresponding to once-daily dosing, indicating that the potential for renal toxicity may be greater with extended-interval dosing.
In Vitro Activity of AR-709 against
Streptococcus pneumoniae
Authors: Jansen W. T. M. , Verel A. , Verhoef J. , Milatovic D.
Published: January 2008

We investigated the in vitro activity of AR-709, a novel diaminopyrimidine antibiotic currently in development for treatment of community-acquired upper and lower respiratory tract infections, against 151
Streptococcus pneumoniae
strains from various European countries. AR-709 showed excellent activity against both drug-susceptible and multidrug-resistant pneumococci.
Activity of the Diaminopyrimidine AR-709 against Recently Collected Multidrug-Resistant Isolates of Invasive
Streptococcus pneumoniae
from North America
Authors: Ressner Roseanne A. , Moore Matthew R. , Jorgensen James H.
Published: January 2008

Broth microdilution was used to determine the MICs of AR-709 and comparator antimicrobial agents for 224 invasive multidrug-resistant isolates of
Streptococcus pneumoniae
. AR-709 was highly active, with a MIC
50
of 0.25 μg/ml, a MIC
90
of 0.5 μg/ml, and a range of ≤0.008 μg/ml to 1 μg/ml.
Synergistic Effect of Calcineurin Inhibitors and Fluconazole against
Candida albicans
Biofilms
Authors: Uppuluri Priya , Nett Jeniel , Heitman Joseph , Andes David
Published: January 2008

Calcineurin is a Ca
2+
-calmodulin-activated serine/threonine-specific protein phosphatase that governs multiple aspects of fungal physiology, including cation homeostasis, morphogenesis, antifungal drug susceptibility, and virulence. Growth of
Candida albicans
planktonic cells is sensitive to the calcineurin inhibitors FK506 and cyclosporine A (CsA) in combination with the azole antifungal fluconazole. This drug synergism is attributable to two effects: first, calcineurin inhibitors render fluconazole fungicidal rather than simply fungistatic, and second, membrane perturbation by azole inhibition of ergosterol biosynthesis increases intracellular calcineurin inhibitor concentrations.
C. albicans
cells in biofilms are up to 1,000-fold more resistant to fluconazole than planktonic cells. In both in vitro experiments and in an in vivo rat catheter model,
C. albicans
cells in biofilms were resistant to individually delivered fluconazole or calcineurin inhibitors but exquisitely sensitive to the combination of FK506-fluconazole or CsA-fluconazole.
C. albicans
strains lacking FKBP12 or expressing a dominant FK506-resistant calcineurin mutant subunit (Cnb1-1) formed biofilms that were resistant to FK506-fluconazole but susceptible to CsA-fluconazole, demonstrating that drug synergism is mediated via direct calcineurin inhibition. These findings reveal that calcineurin contributes to fluconazole resistance of biofilms and provide evidence that synergistic drug combinations may prove efficacious as novel therapeutic interventions to treat or prevent biofilms.
Antimicrobial Activity of Omiganan Pentahydrochloride against Contemporary Fungal Pathogens Responsible for Catheter-Associated Infections
Authors: Fritsche Thomas R. , Rhomberg Paul R. , Sader Helio S. , Jones Ronald N.
Published: January 2008

Omiganan, a bactericidal and fungicidal cationic peptide being developed as a topical gel for prevention of catheter-associated infections, inhibited commonly occurring fungal pathogens including
Candida
spp. (106 isolates) at ≤256 μg/ml and molds (including 10
Aspergillus
isolates) at ≤1,024 μg/ml. All fungi were inhibited by omiganan at concentrations well below the 1% (10,000 μg/ml) clinical formulation, including species with reduced susceptibility to azoles and echinocandins.
Role of rhizobitoxine in protecting soybean roots from Macrophomina phaseolina infection
Authors: Chakraborty Usha , Purkayastha R. P.
Published: January 2008

Bacterization of soybean seeds or roots with Rhizobium japonicum significantly reduced charcoal rot disease caused by Macrophomina phaseolina. Rhizobium japonicum inhibited the growth of M. phaseolina on both liquid and solid media. Replacement of nutrient medium with culture filtrate of R. japonicum significantly reduced mycelial growth of M. phaseolina. Whole culture extracts of R. japonicum yielded a toxic substance which was identified as rhizobitoxine after chromatographic, ultraviolet, and infrared spectrophotometric analyses. This compound also was detected in the roots of soybean inoculated with either R. japonicum alone or in combination of R. japonicum and M. phaseolina. Dosage response curves with rhizobitoxine showed it to be antifungal. The possible role of rhizobitoxine in protecting soybean roots from M. phaseolina infection is discussed.
Cell surface characteristics of Mortierella species and their interaction with a mycoparasite
Authors: Manocha M. S.
Published: January 2008

Cell surface characteristics of three Mortierella species differing in their response to a mycoparasite, Piptocephalis virginiana, were examined. Their cell wall composition was typical of mucoraceous fungi with chitin and chitosan as major polysaccharides. Electron microscopy revealed that the mycoparasite penetrated and formed haustoria in the hyphae of susceptible hosts, M. pusilla and M. isabellina. The failure of the parasite to establish contact and penetrate a hypha of the nonhost, M. candelabrum, was not due to cell wall thickness, rigidity, or chitin contents. Markedly different protein patterns obtained from crude alkali extracts of host and nonhost cell walls by sodium dodecyl sulfate – polyacrylamide gel electrophoresis might explain the difference in host and nonhost response to the mycoparasite. Whereas most of the bands differed only in intensity after staining with either Coomassie blue or periodic acid – Schiff reagent, there were two distinct bands of glycoproteins (76 000 and 74 000) observed in the host species which were absent in the nonhost species.
The effects of the insecticide acephate on the growth and nutrient uptake of an aquatic bacterium
Authors: Williams G. L. , Albright L. J.
Published: January 2008

The effects of high (1000 ppm) and low (1 ppm) concentrations of acephate on the rate of growth and nutrient uptake by an aquatic bacterium (identified as Chromobacterium lividum) were investigated. This insecticide increased doubling time, decreased maximum cellular yield, and reduced cell size when C. lividum was grown in the presence of high acephate concentrations. Total [14C]glucose and 14C-labeled amino acids uptake rates were reduced by the high acephate concentration. The high acephate concentration did not affect active uptake of [14C]cycloleucine, a nonmetabolized amino acid analogue. Low concentration of acephate had little apparent influence upon these metabolic processes.
Spheroplasts of Rhizobium japonicum
Authors: Berry James O. , Atherly Alan G.
Published: January 2008

Speroplasts of Rhizobium japonicum strains 61A76, USDA 31, and 110 were prepared by culturing cells in the presence of glycine, followed by treatment with lysozyme. The cells were examined by scanning electron microscopy before, during, and after becoming spheroplasts and found to be morphologically similar to the bacteroid forms found in soybean root nodules. Some similarities of spheroplast and bacteroid formation are discussed.
A convenient and efficient protocol for the synthesis of symmetrical N,N′-alkylidine bisamides by sulfamic acid under solvent-free conditions
Authors: Selvam Nagarajan Panneer , Saranya Sundar , Perumal Paramasivan T
Published: January 2008

A simple and convenient approach to the synthesis of symmetrical N,N′-alkylidine bisamides is described. Aromatic and aliphatic nitriles react with aromatic aldehydes in the presence of sulfamic acid to give the corresponding bisamides in moderate yields.Key words: alkylidine bisamides, nitrile, sulfamic acid.
New diformyldihydroxyaromatic precursors for luminescent Schiff base macrocycles: Synthesis, characterization, and condensation studies
Authors: Boden Britta N , Abdolmaleki Amir , Ma Cecily T.-Z , MacLachlan Mark J
Published: January 2008

With the goal of preparing luminescent, fully conjugated Schiff base macrocycles, a series of precursors based on benzene, phenanthrene, and triphenylene with formylhydroxy functionalization have been prepared and characterized. The condensation of these compounds with substituted phenylenediamines to afford conjugated [2+2] or [3+3] Schiff base macrocycle has been investigated. Although the [3+3] Schiff base macrocycles could not be isolated, two new soluble and luminescent [2+2] Schiff base macrocycles with N2O2 binding pockets have been prepared and characterized.Key words: Schiff base, macrocycle, condensation, salicylaldehyde, conjugated.
Differential growth response to atmospheric carbon dioxide enrichment in seedlings of Cedrusatlantica and Pinusnigra ssp. Laricio var. Corsicana
Authors: Kaushal P. , Guehl J. M. , Aussenac G.
Published: January 2008

Nine-month-old seedlings of Cedrusatlantica Manetti and Pinusnigra Arn. ssp. Laricio var. Corsicana were transplanted in parallelepipedal containers permitting root growth observations (minirhizotrons) and in 6 L pots and were then transferred into two polyethylene tunnels in a greenhouse, where they were submitted to atmospheric CO2 concentrations of 350 (normal) and 800 μmol•mol−1 (enriched) for their 2nd growth year. At the end of the enrichment period, the biomass of the enriched plants was 66 (C. atlantica) and 30% (P. nigra) higher than those of the plants grown at normal CO2 concentrations. The root:shoot biomass ratio remained unaffected by enrichment in both species. Height and diameter growth were 20 (C. atlantica) and 10% (P. nigra) higher in the enriched treatment. At the end of the enrichment period, the CO2 assimilation rate was no longer stimulated in the enriched C. atlantica plants as compared with the normal treatment, but remained slightly stimulated in the P. nigra seedlings. The differential growth response to elevated CO2 appears to be related to the distinct genetic growth pattern of the two species, namely to their different patterns of root growth before bud break and during early aerial growth.
Sapwood volume for three subalpine conifers: predictive equations and ecological implications
Authors: Ryan Michael G.
Published: January 2008

Xylem conducting tissue or sapwood is an important storage organ for water, carbohydrates, and nutrients, but the living ray parenchyma cells require energy for maintenance. I examined sapwood volume for three subalpine conifers (Engelmann spruce, subalpine fir, and lodgepole pine) in relation to tree size and leaf area. Sapwood volume increases exponentially as leaf area increases, with the rate of increase determined by the ratio of leaf area to sapwood cross-sectional area. Increase in the cost of sapwood maintenance respiration relative to photosynthetic production may explain lower relative growth rates reported for large trees and older stands. Lodgepole pine showed the most rapid increase in sapwood volume with increasing leaf area, suggesting storage capacity and sapwood maintenance are important processes for this species. I also present simple equations for estimating sapwood volume.
Effects of potassium deficiency and simulated acid rain, alone and in combination, on the ultrastructure of Scots pine needles
Authors: Holopainen Toini , Nygren Pekka
Published: January 2008

The effects of potassium deficiency and artificial acid precipitation, alone and in combination, on Scots pine (Pinussilvestris L.) needles were studied using transmission electron microscopy. The seedling material was grown in quartz sand culture and watered with nutrient solution containing 45, 20, 10, or 5 mg of potassium/L; the concentration of other nutrients was constant and equally available for all seedlings. A portion of the seedlings from each group received consecutive acidified water spraying of pH 4.5, 4.0, 3.5, and 3.0, each for 4 days with a 3-day resting period between applications. The potassium deficiency caused an increase in the proportional vacuolar space and severe vesiculation of the tonoplast. Irregularly shaped lipid structures increased in number in the cytoplasm, and lipid bodies also appeared in the vacuoles and occasionally in the chloroplasts. The symptoms related to potassium deficiency were more severe in the transfusion parenchyma cells than in the mesophyll. The lowest level of potassium produced almost complete disorganization of the cellular structures in the transfusion parenchyma tissue, but severe changes were also seen in the mesophyll. The simulated acid rain treatment caused the formation of protrusions in the chloroplasts and an increase in irregularly shaped lipid structures in the cytoplasm throughout the mesophyll tissue, but no clear symptoms were observed inside the bundle sheath. In general, the changes caused by acid rain in the chloroplasts were slight and did not cause serious disorganization of these organelles. When the seedlings were exposed to combination treatment, the typical symptoms of both exposures were observable. The results suggest that the stresses caused by potassium deficiency and short-term foliar acid rain treatment can be distinguished in the needle ultrastructure.
Host response to inoculation and behaviour of introduced and indigenous ectomycorrhizal fungi of jack pine grown on oil-sands tailings
Authors: Danielson R. M. , Visser S.
Published: January 2008

Pinusbanksiana Lamb, seedlings were inoculated with nine mycorrhizal fungi and outplanted on an oil-sands containment dyke that had been amended with muskeg peat. After one growing season, E-strain (Complexipes), Hebeloma sp., Thelephoraterrestris Ehrh.:Fr., and Laccariaproximo Boudier each formed mycorrhizae with greater than 40% of the new short roots within 10 cm of the stem. Cenococcumgeophilum Fr., Pisolithustinctorius (Pers.) Coker & Couch, Astraeushygrometricus (Pers.) Morgan, Lactariusparadoxus Beardslee & Burlingham, and Sphaerosporellabrunnea (Alb. & Schw.:Fr.) Svrcek & Kubika each formed mycorrhizae with less than 6% of the short roots on egressed laterals. Of the introduced fungi, only E-strain was present in substantial quantities after 3 years. The quantity of short roots converted to mycorrhizae by indigenous fungi was 4, 33, and 72% after 1, 2, and 3 years, respectively. The change in mycorrhizal fungi appeared to be a noncompetitive replacement process, in which the original short root resident fungus died in the near absence of mycorrhizal fungi. At the end of the 3rd year, the major indigenous fungi converting short roots to mycorrhizae were E-strain, Tuber sp., Suillus-like spp., Myceliumradicisatrovirens Melin, and an unidentified basidiomycete. Inoculation with E-strain and Thelephoraterrestris resulted in a 2- to 3-fold increase in shoot weight after 2 years compared with uninoculated seedlings.
Green lumber grade yields from black cherry and red maple factory grade logs sawed at band and circular mills
Authors: Yaussy Daniel A.
Published: January 2008

Multivariate regression models were developed to predict green board-foot yields (1 board ft. = 2.360 dm3) for the standard factory lumber grades processed from black cherry (Prunusserotina Ehrh.) and red maple (Acerrubrum L.) factory grade logs sawed at band and circular sawmills. The models use log measurements of grade, scaling diameter, length, and proportion of scaling defect. They can be used in computer programs related to sawmill simulations, economic modeling, or log-yard inventory systems.
Variation in leaf quality of two oak species: implications for stand susceptibility to gypsy moth defoliation
Authors: Kleiner Karl W. , Montgomery Michael E. , Schultz Jack C.
Published: January 2008

Variation in phenolic leaf traits was measured for red oaks (Quercusrubra L.) and chestnut oaks (Quercusprinus L.) growing in a resistant stand (on a mesic lowland) and in a susceptible stand (on a xeric ridgetop). Chestnut oak foliage had significantly greater measures of protein binding capacity, total phenolics, and hydrolyzable tannins than red oak, regardless of stand location. Foliage from both species in the susceptible stand had significantly greater measures of condensed tannin than did foliage from the resistant stand. Seasonal changes in phenolic content were the largest sources of intraspecific variation. Chestnut oak was more abundant in the susceptible stand than in the resistant stand. Species and site factors thus result in high tannin levels in oak foliage in susceptible stands compared with resistant stands. The significance of this in relation to gypsy moth population dynamics is discussed.
Site patterns of natural regeneration following clear-cutting in northwestern Quebec
Authors: Harvey B. D. , Bergeron Y.
Published: January 2008

Pre- and post-harvest regeneration levels were compared for Abiesbalsamea (L.) Mill. –Betulapapyrifera Marsh. –Picea spp. forests in an area of the southern clay belt of northwestern Quebec. Results revealed abundant advance softwood regeneration (mean = 65 000 stems/ha), almost entirely of Abies prior to harvest. The survey following mechanical and manual whole-tree harvesting suggested a 92% reduction of softwood regeneration and a shift from softwood to a mixed or hardwood-shrub dominated regeneration. Ninety percent of softwood seedlings collected after harvest were pre-established. Destruction of advance regeneration was generally greater on fine-textured soils. Hierarchic cluster analysis of ecological types based on softwood, hardwood, and shrub tree regeneration data as variables, revealed nine groups that could serve as a basis for operational silvicultural decision making. In general, Salix spp. and Alnusrugosa (Du Roi) Spreng. are the major competitors on poorly drained sites; Betula sp., Acerspicatum Lam., and Prunuspensylvanica L.f. dominate on thin organic deposits and coarse deposits, whereas Populustremuloides Michx. and Acerspicatum dominate on fine-textured deposits. These findings suggest that a good understanding of physical site factors can provide useful information for harvesting and silvicultural planning.
JET-CORRELATIONS FROM STAR
Authors:   for the STAR Collaboration (For the full author list of the collaboration, see Ref. 1.), VAN LEEUWEN M.
Published: January 2008

We present recent results on particle spectra and azimuthal di-hadron correlations at intermediate and high pT in p + p , d + Au and Au + Au collisions at [Formula: see text] from the STAR collaboration. The implications for parton energy loss and hadronisation in hot and dense QCD matter are discussed.