bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient‐maintained propofol sedation using reaction time monitoring: a volunteer safety study*
Authors: Allam S. , Anderson K. J. , O’Brien C. , Macpherson J. A. , Gambhir S. , Leitch J. A. , Kenny G. N. C. 
Published: November 2012

SummaryPrevious volunteer studies of an effect‐site controlled, patient‐maintained sedation system using propofol have demonstrated a risk of over‐sedation. We have incorporated a reaction‐time monitor into the handset of the patient‐maintained sedation system to add an individualised patient‐feedback mechanism. This study assessed if such reaction‐time feedback modification would reduce the risk of over‐sedation in 20 healthy volunteers deliberately attempting to over‐administer themselves propofol. All the volunteers successfully sedated themselves without reaching any unsafe endpoints. All volunteers maintained verbal contact throughout, in accordance with the definition of conscious sedation. The mean (SD) lowest SpO2 was 97 (1.7) % when breathing room air and no volunteer required supplementary oxygen. The mean (SD) maximum effect‐site propofol concentration reached was 1.7 (0.4) μg.ml−1. The present system was found to be safer than its predecessors, allowing conscious sedation, but preventing over‐sedation.
Maternal mortality in Sweden 1988–2007: more deaths than officially reported
Authors: Esscher Annika , Högberg Ulf , Haglund Bengt , Essën Birgitta 
Published: November 2012

AbstractObjectiveTo obtain more accurate calculations of maternal and pregnancy‐related mortality ratios in Sweden from 1988 to 2007 by using information from national registers and death certificates.DesignA national register‐based study, supplemented by a review of death certificates.SettingSweden, 1988–2007.PopulationThe deaths of 27 957 women of reproductive age (15–49 years).MethodsThe Swedish Cause of Death Register, Medical Birth Register, and National Patient Register were linked. All women with a diagnosis related to pregnancy in at least one of these registers within 1 year prior to death were identified. Death certificates were reviewed to ascertain maternal deaths. Maternal mortality ratio (the number of maternal deaths/100 000 live births, excluding and including suicides), and pregnancy‐related mortality ratio (number of deaths within 42 days after termination of pregnancy, irrespective of cause of death/100 000 live births) were calculated.Main outcome measuresDirect and indirect maternal deaths and pregnancy‐related deaths.ResultsThe maternal mortality ratio in Sweden, based on the current method of identifying maternal deaths, was 3.6. After linking registers and reviewing death certificates, we identified 64% more maternal deaths, resulting in a ratio of 6.0 (or 6.5 if suicides are included). The pregnancy‐related mortality ratio was 7.3. A total of 478 women died within a year after being recorded with a diagnosis related to pregnancy.ConclusionsBy including the 123 cases of maternal death identified in this study, the mean maternal mortality ratio from 1988 to 2007 was 64% higher than reported to the World Health Organization.
Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy
Authors: Kummeling Maxime T.M. , Rietbergen John B.W. , Withagen MariËlla I.J. , Mannaerts Guido H.H. , van der Weiden Robin M.F. 
Published: November 2012

AbstractObjectiveControversial data are available as to whether to perform a simultaneous abdominal or vaginal colposuspension operation in laparoscopic sacrocolpopexy procedures. We wanted to evaluate the effect of a modified laparoscopic operation technique on urodynamic parameters and lower urinary tract symptoms.DesignProspective single center cohort study.SettingTeaching hospital.PopulationForty‐nine consecutive patients who underwent a modified laparoscopic sacrocolpopexy/hysteropexy operation using bone anchor fixation and synthetic mesh, performed by the same laparoscopic surgeons.MethodsPre‐ and postoperative multichannel urodynamic evaluation and validated questionnaires. The same urologist, blinded to the results of the questionnaire survey, interpreted all urodynamic evaluations.Main outcome measuresThe effects of surgery on pelvic anatomy and patient satisfaction, urodynamic observations and diagnoses and symptom scores in validated questionnaires.ResultsForty‐two patients consented to pre‐ and postoperative urodynamic evaluation. Laparoscopic sacrocolpopexy successfully corrected vaginal vault prolapse in all 42 patients with urodynamic evaluation six months after surgery. The bladder volume at first desire to void was significantly increased and the maximal detrusor pressure at voiding phase was significantly decreased. In the questionnaires, irritative and storage voiding symptoms were significantly decreased.ConclusionsThe results of the study demonstrate that there are no adverse urodynamic findings following this modified technique for laparoscopic sacrocolpopexy. The statistically significant urodynamic improvements are in accordance with the scores on the Urogenital Distress Inventory questionnaires. These results do not support a simultaneous routine prophylactic colposuspension procedure.
The beta 1 tubulin R307H single nucleotide polymorphism is associated with treatment failures in immune thrombocytopenia (ITP)
Authors: Basciano Paul A. , Bussel James , Hafeez Zeeshan , Christos Paul J. , Giannakakou Paraskevi 
Published: November 2012

SummaryPredictive biomarkers are needed in immune thrombocytopenia (ITP). Single nucleotide polymorphisms (SNPs) in beta 1 tubulin are potential candidates, as beta 1 tubulin is integral for platelet production and function, and SNPs in beta 1 tubulin have been associated with distinct phenotypes in platelets. We investigated the most prevalent beta 1 tubulin SNP (R307H) as a biomarker in patients with ITP via a retrospective chart review. Allelic frequencies between a group of 191 ITP patients and a healthy control group showed no difference, suggesting no direct aetiological role for the SNP in ITP. However, over similar periods of follow‐up, both heterozygote and homozygote minor allele ITP patients were treated with significantly more treatment modalities and had significantly higher risk of failure to immune‐modulatory therapies [relative risk (RR) = 1·5, 95% confidence interval (CI) = 1·1–2·1; P = 0·01]; with rituximab, in particular, ITP patients with the SNP experienced a 58% failure rate (RR = 1·6, 95%CI = 1·03–2·5; P = 0·04). Analysis of the absolute immature platelet fraction (A‐IPF) as a marker of platelet production showed that SNP patients had significantly higher median A‐IPFs compared to non‐SNP patients when complete responses were achieved using immune modulatory therapies. The data suggest that the beta 1 tubulin R307H SNP has potential for use as a biomarker in ITP and may affect platelet turnover.
Stability of human mesenchymal stem cells during in vitro culture: considerations for cell therapy
Authors: Binato R. , de Souza Fernandez T. , Lazzarotto‐Silva C. , Du Rocher B. , Mencalha A. , Pizzatti L. , Bouzas L. F. , Abdelhay E. 
Published: November 2012

AbstractEx vivo expansion and manipulation of human mesenchymal stem cells are important approaches to immunoregulatory and regenerative cell therapies. Although these cells show great potential for use, issues relating to their overall nature emerge as problems in the field. The need for extensive cell quantity amplification in vitro to obtain sufficient cell numbers for use, poses a risk of accumulating genetic and epigenetic abnormalities that could lead to sporadic malignant cell transformation. In this study, we have examined human mesenchymal stem cells derived from bone marrow, over extended culture time, using cytogenetic analyses, mixed lymphocyte reactions, proteomics and gene expression assays to determine whether the cultures would retain their potential for use in subsequent passages. Results indicate that in vitro cultures of these cells demonstrated chromosome variability after passage 4, but their immunomodulatory functions and differentiation capacity were maintained. At the molecular level, changes were observed from passage 5 on, indicating initiation of differentiation. Together, these results lead to the hypothesis that human mesenchymal stem cells cultures can be used successfully in cell therapy up to passage 4. However, use of cells from higher passages would have to be analysed case by case.
Living vs. deceased donor liver transplantation for hepatocellular carcinoma: a systematic review and meta‐analysis
Authors: Grant Robert C. , Sandhu Lakhbir , Dixon Peter R. , Greig Paul D. , Grant David R. , McGilvray Ian D. 
Published: November 2012

AbstractExperimental studies suggest that the regenerating liver provides a “fertile field” for the growth of hepatocellular carcinoma (HCC). However, clinical studies report conflicting results comparing living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) for HCC. Thus, disease‐free survival (DFS) and overall survival (OS) were compared after LDLT and DDLT for HCC in a systematic review and meta‐analysis. Twelve studies satisfied eligibility criteria for DFS, including 633 LDLT and 1232 DDLT. Twelve studies satisfied eligibility criteria for OS, including 637 LDLT and 1050 DDLT. Altogether, there were 16 unique studies; 1, 2, and 13 of these were rated as high, medium, and low quality, respectively. Studies were heterogeneous, non‐randomized, and mostly retrospective. The combined hazard ratio was 1.59 (95% confidence interval [CI]: 1.02–2.49; I2 = 50.07%) for DFS after LDLT vs. DDLT for HCC, and 0.97 (95% CI: 0.73–1.27; I2 = 5.68%) for OS. This analysis provides evidence of lower DFS after LDLT compared with DDLT for HCC. Improved study design and reporting is required in future research to ascribe the observed difference in DFS to study bias or biological risk specifically associated with LDLT.
Impaired induction of long‐term potentiation‐like plasticity in patients with high‐functioning autism and Asperger syndrome
Authors: JUNG NIKOLAI H , JANZARIK WIBKE G , DELVENDAHL IGOR , MÜNCHAU ALEXANDER , BISCALDI MONICA , MAINBERGER FLORIAN , BÄUMER TOBIAS , RAUH REINHOLD , MALL VOLKER 
Published: November 2012

Aim  We aimed to investigate the induction of long‐term potentiation (LTP)‐like plasticity by paired associative stimulation (PAS) in patients with high‐functioning autism and Asperger syndrome (HFA/AS).Method  PAS with an interstimulus interval between electrical and transcranial magnetic stimulation of 25 ms (PAS25) was performed in patients with HFA/AS (n=9; eight males, one female; mean age 17y 11mo, SD 4y 5mo) and in typically developing age‐matched volunteers (n=9; five males, four females; mean age 22y 4mo, SD 5y 2mo). The amplitude of motor‐evoked potentials was measured before PAS25, immediately after stimulation, and 30 minutes and 60 minutes later. A PAS protocol adapted to individual N20 latency (PASN20+2) was performed in six additional patients with HFA/AS. Short‐interval intracortical inhibition was measured using paired‐pulse stimulation.Results  In contrast to the typically developing participants, the patients with HFA/AS did not show a significant increase in motor‐evoked potentials after PAS25. This finding could also be demonstrated after adaptation for N20 latency. Short‐interval intracortical inhibition of patients with HFA/AS was normal compared with the comparison group and did not correlate with PAS effect.Interpretation  Our results show a significant impairment of LTP‐like plasticity induced by PAS in individuals with HFA/AS compared with typically developing participants. This finding is in accordance with results from animal studies as well as human studies. Impaired LTP‐like plasticity in patients with HFA/AS points towards reduced excitatory synaptic connectivity and deficits in sensory‐motor integration in these patients.
Symptomatology of autism spectrum disorder in a population with neurofibromatosis type 1
Authors: WALSH KARIN S , VÉLEZ JORGE I , KARDEL PETER G , IMAS DANIEL M , MUENKE MAXIMILIAN , PACKER ROGER J , CASTELLANOS FRANCISCO X , ACOSTA MARIA T 
Published: November 2012

Aim  Difficulties in neurocognition and social interaction are the most prominent causes of morbidity and long‐term disability in children with neurofibromatosis type 1 (NF1). Symptoms of attention‐deficit–hyperactivity disorder (ADHD) have also been extensively recognized in NF1. However, systematic evaluation of symptoms of autism spectrum disorder (ASD) in children with NF1 has been limited.Method  We present a retrospective, cross‐sectional study of the prevalence of symptoms of ASD and ADHD and their relationship in a consecutive series of 66 patients from our NF1 clinic. The Social Responsiveness Scale and the Vanderbilt ADHD Diagnostic Parent Rating Scale were used to assess symptoms of ASD and ADHD.Results  Sixty‐six participants (42 males, 24 females) were included in this study. Mean age at assessment was 10 years 11 months (SD 5y 4mo). Forty percent of our NF1 sample had raised symptom levels reaching clinical significance on the Social Responsiveness Scale (T ≥ 60), and 14% reached levels consistent with those seen in children with ASDs (T ≥ 75). These raised levels were not explained by NF1 disease severity or externalizing/internalizing behavioral disorders. There was a statistically significant relationship between symptoms of ADHD and ASD (χ2=9.11, df=1, p=0.003, φ=0.56). Particularly salient were the relationships between attention and hyperactivity deficits, with impairments in social awareness and social motivation.Interpretation  We found that symptoms of ASD in our NF1 population were raised, consistent with previous reports. Further characterization of the specific ASD symptoms and their impact on daily function is fundamental to the development and implementation of effective interventions in this population, which will probably include a combination of medical and behavioral approaches.
Influence of estuary conditions on the recovery rate of coded‐wire‐tagged Chinook salmon (Oncorhynchus tshawytscha) in an ocean fishery
Authors: Zeug Steven C. , Cavallo Bradley J. 
Published: November 2012

AbstractChinook salmon (Oncorhynchus tschawytscha) populations within the highly modified San Francisco Estuary, California, have seen precipitous declines in recent years. To better understand this decline, a decade of coded‐wire tag release and recovery data for juvenile salmon was combined with physicochemical data to construct models that represented alternative hypotheses of estuarine conditions that influence tag recovery rate in the ocean. An information theoretic approach was used to evaluate the weight of evidence for each hypothesis and model averaging was performed to determine the level of support for variables that represented individual hypotheses. A single best model was identified for salmon released into the Sacramento River side of the estuary, whereas two competitive models were selected for salmon released into the San Joaquin River side of the estuary. Model averaging found that recovery rates were greatest for San Joaquin River releases when estuary water temperatures were lower, and salmon were released at larger sizes. Recovery rate of Sacramento releases was greatest during years with better water quality. There was little evidence that large‐scale water exports or inflows influenced recovery rates in the ocean during this time period. These results suggest that conceptual models of salmon ecology in estuaries should be quantitatively evaluated prior to implementation of recovery actions to maximise the effectiveness of management and facilitate the recovery of depressed Chinook populations.
Positive climate feedbacks of soil microbial communities in a semi‐arid grassland
Authors: Nie Ming , Pendall Elise , Bell Colin , Gasch Caley K. , Raut Swastika , Tamang Shanker , Wallenstein Matthew D. 
Published: November 2012

AbstractSoil microbial communities may be able to rapidly respond to changing environments in ways that change community structure and functioning, which could affect climate–carbon feedbacks. However, detecting microbial feedbacks to elevated CO2 (eCO2) or warming is hampered by concurrent changes in substrate availability and plant responses. Whether microbial communities can persistently feed back to climate change is still unknown. We overcame this problem by collecting microbial inocula at subfreezing conditions under eCO2 and warming treatments in a semi‐arid grassland field experiment. The inoculant was incubated in a sterilised soil medium at constant conditions for 30 days. Microbes from eCO2 exhibited an increased ability to decompose soil organic matter (SOM) compared with those from ambient CO2 plots, and microbes from warmed plots exhibited increased thermal sensitivity for respiration. Microbes from the combined eCO2 and warming plots had consistently enhanced microbial decomposition activity and thermal sensitivity. These persistent positive feedbacks of soil microbial communities to eCO2 and warming may therefore stimulate soil C loss.
Chronic catchment nitrogen enrichment and stoichiometric constraints on the bioavailability of dissolved organic matter from leaf leachate
Authors: MINEAU MADELEINE M. , RIGSBY CHAD M. , ELY DAMON T. , FERNANDEZ IVAN J. , NORTON STEPHEN A. , OHNO TSUTOMU , VALETT H. MAURICE , SIMON KEVIN S. 
Published: November 2012

Summary1. Chronic nitrogen (N) deposition may alter the bioavailability of dissolved organic matter (DOM) in streams by multiple pathways. Elevated N deposition may alter the nutrient stoichiometry of DOM as well as nutrient availability in stream water.2. We evaluated the influence of a decadal‐scale experimental N enrichment on the relative importance of DOM nutrient content and inorganic nutrient availability on the bioavailability of DOM. We measured the consumption of dissolved organic carbon (DOC) and changes in nutrient concentration, DOM components and enzyme activity in a bottle incubation assay with different DOM and nutrient treatments. To evaluate the effect of DOM stoichiometry, we used leaf leachates of different carbon/N/phosphorus (C : N :P) ratio, made from leaf litter sourced in the reference and N‐enriched catchments at the Bear Brook Watershed in Maine (BBWM). We also manipulated the concentration of inorganic N and P to compare the effect of nutrient enrichment with DOM stoichiometry.3. DOC from the N‐enriched catchment was consumed 14% faster than that from the reference catchment. However, mean DOC consumption for both leachates was more than doubled by the simultaneous addition of N and P, compared to controls, while the addition of N or P alone increased consumption by 42 and 23%, respectively. The effect of N and/or P enrichment consistently had a greater effect than DOM source for all response variables considered.4. We subsequently conducted DOC uptake measurements using leaf leachate addition under ambient and elevated N and P in the streams draining the reference and N‐enriched catchments at BBWM. In both streams, DOC uptake lengths were shorter when N and P were elevated.5. Although both DOM stoichiometry and inorganic nutrient availability affect DOM bioavailability, N and P co‐limitation appears to be the dominant driver of reach‐scale processing of DOM.
Climate‐induced shift in hydrological regime alters basal resource dynamics in a wilderness river ecosystem
Authors: DAVIS J. M. , BAXTER C. V. , MINSHALL G. W. , OLSON N. F. , TANG C. , CROSBY B. T. 
Published: November 2012

Summary1. We integrated a 20‐year ecological data set from a sparsely inhabited, snowmelt‐dominated catchment with hydrologic models to predict the effects of hydrologic shifts on stream biofilm.2.  We used a stepwise multiple regression to assess the relationship between hydrology and biofilm ash‐free dry mass (AFDM) and chlorophyll‐a (chl‐a) under recent climate conditions. Biofilm AFDM was significantly related to the timing of peak streamflow, and chl‐a was significantly related to the timing of median streamflow. We applied these results to output from the variable infiltration capacity hydrologic model, which predicted hydrology under a baseline scenario (+0 °C) and a range of warming scenarios expected with climate change (+1, +2 or +3 °C).3.  When compared to the baseline, the results indicated that earlier peakflows predicted under warming scenarios may lead to earlier initiation of biofilm growth. This may increase biofilm AFDM during the summer by up to 103% (±29) in the +3 °C scenario. Moreover, interannual variability of AFDM was predicted to increase up to 300%. Average chl‐a during the summer increased by up to 90% (±15) in the +3 °C scenario; however, its response was not significantly different from baseline in most years.4.  Because hydrologic change may alter the temporal dynamics of biofilm growth, it may affect the seasonal dynamics of biofilm quality (i.e. chl‐a‐to‐AFDM ratio). The results indicated that hydrologic shifts may increase biofilm quality during the spring, but may decrease it during the summer. Thus, we provide evidence that predicted hydrologic shifts in snowmelt‐dominated streams may alter the quantity and quality of an important basal resource. However, the magnitudes of these predictions are likely to be affected by other environmental changes that are occurring with climate change (e.g. increased wildfire activity and stream warming).
Canada's Housing Bubble Story: Mortgage Securitization, the State, and the Global Financial Crisis
Authors: Walks Alan 
Published: November 2012

AbstractCanada's experience during and after the financial crisis appears to distinguish it from its international peers. Canadian real estate sales and values experienced record increases since the global financial crisis emerged in 2008, rather than declines, and Canada did not witness any bank failures. The dominant trope concerning Canada's financial and housing markets is that they are sound, prudent, appropriately regulated and ‘boring but effective’. It is widely assumed that Canadian banks did not need, nor receive, a ‘bailout’, that mortgage lending standards remained high, and that the securitization of mortgages was not widespread. The truth, however, does not accord with this mainstream view. In fact, the Canadian financial and housing markets reveal marked similarities with their international peers. Canada's banks needed, and received, a substantial ‘bailout’, while federal policies before and after the financial crisis resulted in the massive growth of mortgage securitization and record household indebtedness. This article documents the growth of Canada's housing bubble, the history of mortgage securitization, and of government policies implemented before and after the crisis. Instead of making the Canadian financial and housing sectors more resilient and sustainable, the outcomes of state responses are best understood as regressively redistributive.
Euroscepticism at the Supranational Level: The Case of the ‘Untidy Right’ in the European Parliament*
Authors: BRACK NATHALIE 
Published: November 2012

AbstractFor the last 20 years, Euroscepticism has become a stable component of European politics and has attracted much attention. European elections have provided Eurosceptic parties with an opportunity to get parliamentary representation. While there is a burgeoning literature on the Eurosceptic stances of these parties, there remains relatively little research on their strategies once inside the European Parliament. This article analyzes how Eurosceptic MEPs from the ‘untidy right’ conceive and carry out their representative mandate in an institution they despise. First, it takes an historical perspective to show that despite the persistence of Euroscepticism in the European Union's elected chamber, the body of research remains comparatively limited. Second, it examines the institutional constraints faced by Eurosceptic representatives resulting from the institutional environment and the ideological heterogeneity of these actors. The final part proposes a typology of parliamentary roles to account for their attitudes and behaviours inside the chamber.