bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung recruitment in ARDS patients
Authors: Arnal Jean-Michel , Garnero Aude 
Published: October 2012

Lung recruitment is used to improve oxygenation and decrease the risk of ventilator induced lung injuries. Assessing the potential of recruitability is a pre-requisite for a rational recruitment strategy and setting of PEEP. Using a low flow pressure-volume loop is helpful to assess the potential of recruitability at the bedside. For patients with a high potential of recruitability, recruitment maneuvers are efficient with an appropriate setting of PEEP to maintain the lung recruited. Recruitment maneuvers use pressures from 40 to 60 cmH2O for a short period of time, either with the sustained inflation or the staircase method. PEEP setting after the maneuver is important; a decreasing PEEP trial is a useful practical method.
Acute heart failure: vasoactive agents – does it matter?
Authors: Macas A. , Zinkevičiūtė-Žarskienė G. 
Published: October 2012

Acute heart failure (AHF) is defined as the rapid onset of symptoms se­ condary to abnormal cardiac function. It is a syndrome and has a va­ riety of potential etiologies. AHF is a very polymorphic conception and can be related with abnormalities in cardiac rhythm, systolic or diastolic dysfunction or preload and afterload mismatch. The cornerstone of ma­ nagement includes therapy directed towards the underlying cause of heart failure. On the other hand, if the underlying cause is irreversible – a heart assist device or even heart transplantation may be needed. Therefore, while awaiting their availability, vital organ perfusion remains crucial. In these settings, intravenous cardio-/vaso- active agents are necessary. With few exceptions, most vasopressor and positive inotropic agents are symphatomimetic amines that exert their action by binding and sti­ mulating adrenergic receptors. They are powerful drugs with a considerable potential for toxicity. Vasopressor and inotropic support in case of AHF helps to win the time until a more definitive treatment becomes available. Therefore, AHF management must be directed to establish and eliminate deteriorational factors, however, not the correction of particular hemodynamic parameters.
The 1909 North Carolina Drainage Act and Agricultural Drainage Effects in Eastern North Carolina
Authors: O'Driscoll Michael A. 
Published: October 2012

AbstractOver the last two centuries, agricultural drainage in eastern North Carolina has transformed extensive wetlands to productive croplands. At the start of the drainage movement in the early 1900s, approximately 200,000 hectares (one half million acres) of drained agricultural lands existed in North Carolina. The 1909 North Carolina Drainage Act allowed for more extensive drainage projects. Drainage districts provided effective drainage outlets for farms and reduced flooding for the district. The districts dramatically increased the extent of drained lands during the 20th century. Currently, it is estimated that over 2 million hectares (five million acres) of drained agricultural lands exist in North Carolina, with the majority in the Coastal Plain. Agricultural drainage has contributed to huge gains in agricultural productivity in the region. However, this drainage has contributed to regional stream water quality impairment, altered stream hydrology, and wetland conversion. Over the last three decades, much work has been focused on reducing watershed nutrient exports in eastern North Carolina. Several major strategies have been used to decrease the environmental impacts of agricultural drainage, including: agronomic management practices; controlled drainage; riparian and wetland buffers; and channel alterations. Management of agricultural drainage during the 21st century will play a crucial role in regional stream, wetland, and coastal ecosystem health.
Hybrid Endarterectomy and Endovascular Therapy in Multilevel Lower Extremity Arterial Disease Involving the Femoral Artery Bifurcation
Authors: Zou Junjie , Xia Yongxiang , Yang Hongyu , Ma Hao , Zhang Xiwei 
Published: October 2012

Abstract
The objective of this study was to evaluate the feasibility and efficacy of hybrid therapy (combined endarterectomy-endovascular) in patients with complex peripheral multifocal steno-obstructive vascular disease involving the femoral artery bifurcation. Forty-one combined procedures were performed on 40 patients. Although the common femoral artery was usually treated with endarterectomy, endoluminal procedures were performed proximally in 12 patients (group 1), distally in 18 patients (group 2), and both upward and downward in 11 patients (group 3). Patients underwent clinical assessment and ankle-brachial index measurement thereafter. Primary, assisted-primary, and secondary patency rates at 24 months were 59%, 66%, and 72%, respectively. Primary patency rates were lower in group 3 compared with groups 1 and 2 (P  =  0.015). The limb salvage rate was 86.4% at the end of the follow-up period. Hybrid procedures provide feasible and effective treatment management of selected patients with multilevel lower extremity arterial disease involving the femoral artery bifurcation.
Giant Neurofibroma in the Right Lower Limb of a 26-Year-Old Woman: Report of a Case
Authors: Zhou Jianda , Li Ming , Luo Chengqun , He Quanyong , Yin Zhaoqi , Peng Hao , Chen Zizi , Chen Jiye , Zhong Shi , Huiqing Xie 
Published: October 2012

Abstract
Neurofibromatosis (NF) is a genetically inherited, autosomal-dominant disease with an incidence of 1 in 3000 live births. There are two types of NF, NF 1 and NF 2, and NF 1 is the most common. This study reports on the diagnosis, treatment, and related family medical history of a rare case with NF-1 in the right lower limb.
Instrumented Outpatient Anterior Cervical Discectomy and Fusion: Is it Safe?
Authors: Sheperd Courtney S , Young William F 
Published: October 2012

Abstract
Anterior cervical discectomy and fusion procedures are one of the most common procedures performed in spinal surgery. Increasingly they are being performed on an outpatient basis. The primary impetus for performing procedures as an outpatient is potential cost savings. However, there are few studies discussing the safety of performing the procedure in an ambulatory setting. This is a retrospective review of our initial experience in performing anterior cervical discectomy and fusion procedures with instrumentation (ACDFI) in an ambulatory surgery center dedicated to spine surgery. Patients were selected for outpatient surgery if they had limited co-morbidities and the surgery involved only 1 or 2 levels. One hundred fifty-two patients underwent outpatient ACDFI during the study period (2007–2009). Six patients returned to the hospital emergency room after discharge. The reasons for evaluation included 2 for neck pain, 1 for dysphagia, 1 for vocal cord paralysis and dysphagia, 1 for nausea, and 1 for cervical swelling. Only 1 of the 6 patients required admission to the hospital. None of the 6 suffered any long-term sequelae. The overall complication rate was 3.9%. A self-reported survey was completed by 75 patients within 6 months of surgery, and there was a 100% satisfaction rate among responders. ACDFI can be performed safely on an outpatient in selected patients with a high degree of patient satisfaction. Our experience is consistent with those of previous investigators.
Three-Dimensional Stereoscopic Volume Rendering of Malignant Pleural Mesothelioma
Authors: Mollberg Nathan M , Parsad Nigel M , Armato Samuel G , Vigneswaran Janani , Kindler Hedy L , Sensakovic William F , Salgia Ravi , Silverstein Jonathan C , Vigneswaran Wickii T 
Published: October 2012

Abstract
Our objective was to investigate the application of three-dimensional (3D) stereoscopic volume rendering with perceptual colorization on preoperative imaging for malignant pleural mesothelioma. At present, we have prospectively enrolled 6 patients being considered for resection of malignant pleural mesothelioma that have undergone a multidetector-row computed tomography (CT) scan of the chest. The CT data sets were volume rendered without preprocessing. The resultant 3D rendering was displayed stereoscopically and used to provide information regarding tumor extent, morphology, and anatomic involvement. To demonstrate this technique, this information was compared with the corresponding two-dimensional CT grayscale axial images from two of these patients. Three-dimensional stereoscopic reconstructions of the CT data sets provided detailed information regarding the local extent of tumor that could be used for preoperative surgical planning. Three-dimensional stereoscopic volume rendering for malignant pleural mesothelioma is a novel approach. Combined with our innovative perceptual colorization algorithm, stereoscopic volumetric analysis potentially allows for the accurate determination of the extent of pleural mesothelioma with results difficult to duplicate using grayscale, multiplanar CT images.
Usefulness of Steroid Administration for Diagnosis of IgG4-Related Sclerosing Cholangitis
Authors: Kubo Norio , Suzuki Hideki , Kobayashi Tsutomu , Araki Kenichiro , Sasaki Shigeru , Wada Wataru , Kuwano Hiroyuki 
Published: October 2012

Abstract
Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is one of the IgG4-related systemic sclerosing diseases and responds well to steroid therapy. A 58-year-old male was admitted with hilar bile duct stenosis revealed by computed tomography. We performed percutaneous transhepatic right portal vein embolization (PTPE) and scheduled a right hepatectomy because a hilar cholangiocarcinoma was first suspected. However, there was no cytologic evidence of malignancy and serum IgG4 was elevated. Steroid therapy was initiated after PTPE. There was no evidence of bile duct stenosis after 4 weeks. Improving diagnostic technique, IgG4-SC was diagnosed and treated with steroid therapy. In some cases, we couldn't deny the malignancy and performed unnecessary resection. We recommend that steroid administration while waiting for the liver volume to increase after PTPE is useful. The therapy aids in the diagnosis of bile duct stenosis, which has value for a hilar bile duct limit type of IgG4-SC, as in the case reported here.
Cost Analysis of Establishing a Relationship Between a Surgical Program in the US and Vietnam
Authors: Chu Quyen D. , Nguyen Thu , Nguyen Phuong , Ho Hung S. 
Published: October 2012

Abstract
“Twinning” refers to a constructive partnership between hospitals in developed and developing nations. Such an effort may contribute immensely to capacity building for the developing nation, but one of the reasons given for the lack of sustainability is cost. We share a detailed operating cost analysis of our recent experience with an institution in Vietnam. We were awarded a 1-year $54,000 grant from the Vietnam Education Foundation (VEF) to conduct a live tele-video conferencing course on the “Fundamentals of Clinical Surgery” with Thai Binh Medical University (TBMU). In-country lectures as well as an assessment of the needs at TBMU were performed. Total financial assistance and expenditures were tabulated to assess up-front infrastructure investment and annual cost required to sustain the program. The total amount of direct money ($66,686) and in-kind services ($70,276) was $136,962. The initial infrastructure cost was $41,085, which represented 62% of the direct money received. The annual cost to sustain the program was approximately $11,948. We concluded that the annual cost to maintain a “twinning” program was relatively low, and the efforts to sustain a “twinning” program were financially feasible and worthwhile endeavors. “Twinning” should be a critical part of the surgical humanitarian volunteerism effort.
Abdominal Trauma in Durban, South Africa: Factors Influencing Outcome
Authors: Mnguni M.N. , Muckart D.J.J. , Madiba T.E. 
Published: October 2012

Abstract
Abdominal injury as a result of both blunt and penetrating trauma has an appreciable mortality rate from hemorrhage and sepsis. In this article, we present our experience with the management of abdominal trauma in Durban and investigate factors that influence outcome. We performed a prospective study of patients with abdominal trauma in one surgical ward at King Edward VIII Hospital in Durban over a period of 7 years, from 1998 through 2004. Demographic details, cause of injury, delay before surgery, clinical presentation, findings at surgery, management and outcome were documented. There were 488 patients with abdominal trauma with a mean age of 29.2 ± 10.7 years. There were 440 penetrating injuries (240 firearm wounds; 200 stab wounds) and 48 blunt injuries. The mean delay before surgery was 11.7 ± 16.4 hours, and 55 patients (11%) presented in shock. Four hundred and forty patients underwent laparotomy, and 48 were managed nonoperatively. The Injury Severity Score was 11.1 ± 6.7, and the New Injury Severity Score was 17.1 ± 11.1. One hundred and thirty-seven patients (28%) were admitted to the intensive care unit (ICU), with a mean ICU stay of 3.6 ± 5.5 days. One hundred and thirty-two patients developed complications (28%), and 52 (11%) died. Shock, acidosis, increased transfusion requirements, number of organs injured, and injury severity were all associated with higher mortality. Delay before surgery had no influence on outcome. Hospital stay was 9.2 ± 10.8 days. The majority of abdominal injuries in our environment are due to firearms. Physiological instability, mechanism of injury, severity of injury, and the number of organs injured influence outcome.
A Prospective Randomized Study to Assess the Optimal Duration of Intravenous Antimicrobial Prophylaxis in Elective Gastric Cancer Surgery
Authors: Haga Norihiro , Ishida Hideyuki , Ishiguro Toru , Kumamoto Kensuke , Ishibashi Keiichiro , Tsuji Yoshitaka , Miyazaki Tatsuya 
Published: October 2012

Abstract
The duration of antimicrobial prophylaxis in gastric cancer surgery is not yet established. This prospective randomized study was performed to confirm the noninferiority of single-dose versus multiple-dose antimicrobial prophylaxis in terms of the incidence of surgical-site infection in gastric cancer surgery. Three hundred twenty-five patients undergoing elective resection for gastric cancer were randomized to receive only single-dose cefazolin (1 g) during surgery (single-dose group) or an additional 5 doses every 12 hours postoperatively (multiple-dose group). The overall incidence of surgical-site infections was 9.1% in the single-dose group and 6.2% in the multiple-dose group [difference (95% confidence interval): −2.9% (−5.9%–0.0%)]. Multivariate logistic regression analysis identified blood loss, being overweight, and advanced age as significant independent risk factors for surgical-site infection. Single-dose antimicrobial prophylaxis seemed to be acceptable, and choosing multiple-dose prophylaxis may have little impact on the prevention of surgical-site infections in elective gastric cancer surgery.
The validity of multiple choice practical examinations as an alternative to traditional free response examination formats in gross anatomy
Authors: Shaibah Hassan Sami , van der Vleuten Cees P. M. 
Published: October 2012

AbstractTraditionally, an anatomy practical examination is conducted using a free response format (FRF). However, this format is resource‐intensive, as it requires a relatively large time investment from anatomy course faculty in preparation and grading. Thus, several interventions have been reported where the response format was changed to a selected response format (SRF). However, validity evidence from those interventions has not proved entirely adequate for the practical anatomy examination, and thus, further investigation was required. In this study, the validity evidence of SRF was examined using multiple choice questions (MCQs) constructed according to different levels of Bloom's taxonomy in comparison with the traditional free response format. A group of 100 medical students registered in a gross anatomy course volunteered to be enrolled in this study. The experimental MCQ examinations were part of graded midterm and final steeplechase practical examination. Volunteer students were instructed to complete the practical examinations twice, once in each of two separate examination rooms. The two separate examinations consisted of a traditional free response format and MCQ format. Scores from the two examinations (FRF and MCQ) displayed a strong correlation, even with higher level Bloom's taxonomy questions. In conclusion, the results of this study provide empirical evidence that the SRF (MCQ) response format is a valid method and can be used as an alternative to the traditional FRF steeplechase examination. Anat Sci Educ. © 2013 American Association of Anatomists.
Elastin signaling in wound repair
Authors: Almine Jessica F. , Wise Steven G. , Weiss Anthony S. 
Published: October 2012

AbstractSkin is an important organ to the human body as it functions as an interface between the body and environment. Cutaneous injury elicits a complex wound healing process, which is an orchestration of cells, matrix components, and signaling factors that re‐establishes the barrier function of skin. In adults, an unavoidable consequence of wound healing is scar formation. However, in early fetal development, wound healing is scarless. This phenomenon is characterized by an attenuated inflammatory response, differential expression of signaling factors, and regeneration of normal skin architecture. Elastin endows a range of mechanical and cell interactive properties to skin. In adult wound healing, elastin is severely lacking and only a disorganized elastic fiber network is present after scar formation. The inherent properties of elastin make it a desirable inclusion to adult wound healing. Elastin imparts recoil and resistance and induces a range of cell activities, including cell migration and proliferation, matrix synthesis, and protease production. The effects of elastin align with the hallmarks of fetal scarless wound healing. Elastin synthesis is substantial in late stage in utero and drops to a trickle in adults. The physical and cell signaling advantages of elastin in a wound healing context creates a parallel with the innate features of fetal skin that can allow for scarless healing. Birth Defects Research (Part C) 96:248–257, 2012. © 2012 Wiley Periodicals, Inc.
Scarless fetal skin wound healing update
Authors: Lo David D. , Zimmermann Andrew S. , Nauta Allison , Longaker Michael T. , Lorenz H. Peter 
Published: October 2012

AbstractScar formation, a physiologic process in adult wound healing, can have devastating effects for patients; a multitude of pathologic outcomes, affecting all organ systems, stems from an amplification of this process. In contrast to adult wound repair, the early‐gestation fetal skin wound heals without scar formation, a phenomenon that appears to be intrinsic to fetal skin. An intensive research effort has focused on unraveling the mechanisms that underlie scarless fetal wound healing in an attempt to improve the quality of healing in both children and adults. Unique properties of fetal cells, extracellular matrix, cytokine profile, and gene expression contribute to this scarless repair. Despite the great increase in knowledge gained over the past decades, the precise mechanisms regulating scarless fetal healing remain unknown. Herein, we describe the current proposed mechanisms underlying fetal scarless wound healing in an effort to recapitulate the fetal phenotype in the postnatal environment. Birth Defects Research (Part C) 96:237–247, 2012. © 2012 Wiley Periodicals, Inc.
Optimizing websites in the post panda world
Authors: Sweeny Marianne 
Published: October 2012

AbstractEDITOR'S SUMMARYWebmasters' traditional approach to search engine optimization was long based on matching query terms with word tokens. The result was a machine‐oriented reflection of presumed relevance among retrieved items. Yet humans interpret content differently, focusing more on meaning than match, prompting programmers to focus on semantics, applied ontologies and predictive machine learning. Google Panda upended tradition with a focus on internal content quality and user engagement as well as the external influences of social media interaction, comments and reviews. Information architects can support a better search user experience through page layout, a flatter architecture, simpler site navigation and strong semantic connections between content and external authority resources.
A metaphor for content strategy
Authors: Dennison Carrie Hane 
Published: October 2012

AbstractEDITOR'S SUMMARYThe planning, building and furnishing of a house create an illustrative metaphor for developing a website and handling its content. A construction blueprint demands consideration of how a building will be used, the total space, subdivision of space into rooms, intended uses for separate spaces, location and maintenance plans. Similarly, information architecture for a website requires understanding of who the users will be and how they will use the site, what options should be provided, maintenance and expansion plans and budget. Like furniture in a house, website content must be suited to user needs and to the subspaces, layout and functions of the site. Content should be actively managed, enhanced and pruned as needed without hoarding unnecessary material.
How to start sketchnoting
Authors: Erb Veronica 
Published: October 2012

AbstractEDITOR'S SUMMARYSketchnoting is a graphic method for putting thoughts on paper, whether for taking notes or presenting a design process. Figures, scribbles, boxes and arrows provide the raw materials, with no need for artistic ability. Erb presents her process for sketchnoting, starting with preliminary elements to plan the sketch including title, speaker style, description of the talk and any other useful information. Content is captured as boxes holding main points, which can then be refined and connected to reflect flow and hierarchical organization. With these enhancements, the sketchnote gains focus, and personal flair can be added for visual pizazz. The process improves with practice, and the end product, mixing verbal and nonverbal, presents information in an innovative way.
Sustainability: Scholarly repository as an enterprise
Authors: Rieger Oya Yildirim 
Published: October 2012

AbstractEDITOR'S SUMMARYThe expanding need for an open information sharing infrastructure to promote scholarly communication led to the pioneering establishment of arXiv.org, now maintained by the Cornell University Library. To be sustainable, the repository requires careful, long term planning for services, management and funding. The library is developing a sustainability model for arXiv, based on voluntary contributions and the ongoing participation and support of 200 libraries and research laboratories around the world. The sustainability initiative is based on a membership model and builds on arXiv's technical, service, financial and policy infrastructure. Five principles for sustainability drive development, starting with deep integration into the scholarly community. Also key are a clearly defined mandate and governance structure, a stable yet innovative technology platform, systematic creation of content policies and strong business planning strategies. Repositories like arXiv must consider usability and lifecycle alongside values and trends in scholarly communication. To endure, they must also support and enhance their service by securing and managing resources and demonstrating responsible stewardship.