bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicidal Thoughts and Behaviours Among Australian Adults: Findings from the 2007 National Survey of Mental Health and Wellbeing
Authors: Johnston Amy K. , Pirkis Jane E. , Burgess Philip M. 
Published: June 2009

Objectives: To provide an overview of the lifetime and 12 month prevalence of suicidal ideation, suicide plans and suicide attempts for Australian adults as a whole and for particular sociodemographic and clinical population subgroups, and to explore the health service use of people with suicidality. Method: Data came from the 2007 National Survey of Mental Health and Wellbeing (2007 NSMHWB), a nationally, representative household survey of 8841 individuals aged 16–85 years. Results: A total of 13.3% of respondents had suicidal ideation during their lifetime, 4.0% had made a suicide plan and 3.2% had made a suicide attempt. The equivalent 12 month prevalence rates were 2.3%, 0.6% and 0.4%, for ideation, plans and attempts, respectively. In general, suicidality in the previous 12 months tended to be relatively more common in women, younger people, those outside the labour force, and those with mental disorders; and less common in those who were married or in de facto relationships, and those with moderate levels of education. A number of the differences in prevalence rates between sociodemographic and clinical subgroups did not reach statistical significance due to data availability constraints and the conservative tests of significance that were used by necessity. These patterns warrant further exploration. Service use for mental health problems was higher among people with suicidality than it was among the general population, but significant numbers of those experiencing suicidality did not receive treatment. Conclusions: Suicidal thoughts and behaviours are not uncommon among the Australian adult population. These thoughts and behaviours are not only predictive of subsequent fatal suicidal acts, but are significant public health problems in their own right. They are associated with high levels of burden at an individual and societal level. Further analysis is required to assess the effectiveness of the national policy frameworks in reducing the spectrum of suicidal thoughts and behaviours.
Policy Implications of the 2007 Australian National Survey of Mental Health and Wellbeing
Authors: Whiteford Harvey , Groves Aaron 
Published: June 2009

Objectives: To describe some of the policy implications of the Australian National Survey of Mental Health and Wellbeing. Methods: A review of the initial findings from the Survey published by the Australian Bureau of Statistics and the five papers in this issue of the Journal, was done. Results: Mental disorders are highly prevalent with the prevalence essentially unchanged since Australia's 1997 mental health survey. Mental disorders are often comorbid with each other and with physical disorders. Despite the disability they cause, most people with disorders do not seek treatment. This is largely because they do not perceive a need for treatment. Conclusions: National epidemiological surveys are important for service planning. They are especially important in gaining an understanding of the population not accessing services. Innovative strategies, including action on mental health literacy, will be necessary to increase the treatment rates for common mental disorders.
Ecological studies of marine mammals using a seabed-mounted echosounder
Authors: Doksæter Lise , Godø Olav R. , Olsen Erik , Nøttestad Leif , Patel Ruben 
Published: June 2009

Abstract
Doksæter, L., Godø, O. R., Olsen, E., Nøttestad, L., and Patel, R. 2009. Ecological studies of marine mammals using a seabed-mounted echosounder. – ICES Journal of Marine Science, 66: 1029–1036. A seabed-mounted, upward-looking, 38 kHz echosounder (Simrad EK60) was used to monitor cetaceans for 128 d between July 2004 and June 2005. The echosounder was placed at 52°N 30°W at a depth of 910 m, in a frontal area with continuous upwelling creating a hotspot of marine life at all trophic levels. Echo tracks were observed, apparently resulting from one or more animals in close temporal and spatial proximity. The 69 “acoustic detections” were examined with a principal component analysis (PCA) considering mean target strength (TS), group size, and maximum dive depth and duration. The PCA conservatively classified 45 of the acoustic detections as “cetaceans”. Their mean TS values varied between −5 and −36 dB, in agreement with earlier TS measurements of whales and dolphins. Several of the supposed cetaceans were apparently feeding in the “deep-scattering layer” when this ascended at night. This study demonstrates that cetacean behaviour, including swimming, feeding, and vocalizing, can be observed and monitored with stationary active-acoustic instrumentation.
Venous Air Embolism during Total Laparoscopic Hysterectomy
Authors: Kim Chang Seok , Kim Ji Young , Kwon Ja-Young , Choi Seung Ho , Na Sungwon , An Jiwon , Kim Ki Jun 
Published: June 2009

Background
Total laparoscopic hysterectomy (TLH) has become a widely accepted alternative to total abdominal hysterectomy (TAH). The aim of this study was to compare the incidence and grade of venous air embolism (VAE) in TLH to those in TAH using transesophageal echocardiography.

Methods
Eighty-two American Society of Anesthesiologists physical status I patients scheduled for either TLH or TAH were enrolled. After induction of general anesthesia, a multiplane transesophageal echocardiography probe was inserted. The midesophageal four-chamber or bicaval view was continuously monitored. An independent transesophageal echocardiography-certified anesthesiologist graded VAE.

Results
All patients undergoing TLH showed VAE, and 37.5% of patients had VAE grade higher than III. Fifteen percent of patients undergoing TAH showed VAE, and all of them were grade I. No patient in this study showed hemodynamic instability or electrocardiogram changes at the time of VAE occurrence. Most instances of VAE during TLH occurred during transection of the round ligament and dissection of the broad ligament.

Conclusion
The incidence of VAE in patients undergoing TLH was 100%. VAE grade in TLH was higher compared to that in TAH, especially during transection of the round ligament and dissection of the broad ligament. Although the hemodynamic instability associated with VAE during TLH was not observed in this study, anesthesiologists must be vigilant for detection of VAE during TLH.
LMA-ProSeal™ for Elective Postoperative Care on the Intensive Care Unit
Authors: Russo Sebastian G. , Goetze Benjamin , Troche Stefan , Barwing Jürgen , Quintel Michael , Timmermann Arnd 
Published: June 2009

Background
Compared to an endotracheal tube, laryngeal mask airways are known to cause less hemodynamic alteration during the extubation phase of routine perioperative airway management. This study aims to examine the hypothesis that the LMA-ProSeal (PLMA, The Laryngeal Mask Company Limited, St. Helier, Jersey, Channel Islands) is an adequate tool for elective postoperative care in the intensive care unit (ICU) and potentially associated with less hemodynamic alteration during extubation in the ICU environment compared to an endotracheal tube.

Methods
Forty-eight patients were enrolled for this prospective randomized, controlled trial and were allocated to either control (ICU-T) or study group (ICU-P). In the ICU-P group, the endotracheal tube was replaced by a PLMA at the end of surgery.

Results
Forty-patients completed the study. Cardiovascular parameters increased significantly less in the ICU-P group: systolic blood pressure increased by 18.10 +/- 5.57 mmHg versus 34.65 +/- 5.63 mmHg (P < 0.05), mean arterial blood pressure increased by 11.23 +/- 3.25 mmHg versus 22.65 +/- 3.36 mmHg (P < 0.05), and heart rate increased by 9.3 +/- 2.9 versus 12.9 +/- 2.2 min (P < 0.05). Ventilation via the PLMA during transfer from the operation room to the ICU as well as during ICU stay was successful and without any adverse events.

Conclusions
Removal of the PLMA after recovery from anesthesia was associated with less cardiovascular change compared to the endotracheal tube. Ventilation was possible without reported adverse events during the entire trial. Elective endotracheal tube replacement by the PLMA may be a useful procedure in selected patients.
Chemosensitivity and Mechanosensitivity of Nociceptors from Incised Rat Hindpaw Skin
Authors: Kang Sinyoung , Brennan Timothy J. 
Published: June 2009

Background
The authors have demonstrated a decrease in pH in the incisional wound environment, suggesting a possible contribution of low pH to postsurgical pain. In this study, the authors characterized the acid-responsiveness of nociceptors innervating the plantar aspect of the rat hind paw 1 day after plantar incision and compared this to plantar skin from unincised control rats.

Methods
Using the rat glabrous in vitro skin-tibial nerve preparation, afferent nerve activities from single mechanosensitive nociceptors were recorded. Differences in mechanosensitivity, spontaneous activity, and chemosensitivity of units were evaluated. For chemosensitivity, acid-responsiveness of nociceptors to lactic acid (pH 5.5 to 6.5) was studied.

Results
C-fibers showed dose-dependent, sustained responses to lactic acid. A greater proportion of C-fibers from 2 mm or less from the incision was activated by pH 6.0 lactic acid (52.9%) compared to control (14.3%). Total evoked potentials during acid exposure were greater in C-fibers innervating 2 mm or less from the incision compared to those in unincised skin. The prevalence of acid responses and total evoked potentials during acid exposure in C-fibers innervating more than 2 mm from the incision were not different from control. Few A-fibers responded to lactic acid, with a range of pH 5.5 to 6.5 in both incision and control groups. Increased spontaneous activity and mechanosensitivity were also evident.

Conclusions
C-fibers in the vicinity of the incision showed qualitatively and quantitatively greater chemosensitivity to pH 6.0 lactic acid compared to control. This change was localized to 2 mm or less from the incision, suggesting increased chemosensitivity of nociceptive C-fibers 1 day after plantar incision.
Propofol Activates and Allosterically Modulates Recombinant Protein Kinase Cϵ
Authors: Wickley Peter J. , Yuge Ryo , Martin Brad A. , Meyer Jacob S. , Damron Derek S. 
Published: June 2009

Background
Myocardial protection by anesthetics is known to involve activation of protein kinase C epsilon (PKC epsilon). A key step in the activation process is autophosphorylation of the enzyme at serine 729. This study's objectives were to identify the extent to which propofol interacts with PKC epsilon and to identify the molecular mechanism(s) of interaction.

Methods
Immunoblot analysis of recombinant PKC epsilon was used to assess autophosphorylation of PKC epsilon at serine 729 before and after exposure to propofol. An enzyme-linked immunosorbant assay kit was used for measuring PKC epsilon activity. Spectral shifts in fluorescence emission maxima of the C1B subdomain of PKC epsilon in combination with the fluorescent phorbol ester, sapintoxin D, was used to identify molecular interactions between propofol and the phorbol ester/diacylglycerol binding site on the enzyme.

Results
Propofol (1 microM) caused a sixfold increase in immunodetectable serine 729 phosphorylated PKC epsilon and increased catalytic activity of the enzyme in a dose-dependent manner. Dioctanoylglycerol-induced or phorbol myristic acetate-induced activation of recombinant PKC epsilon activity was enhanced by preincubation with propofol. Both propofol and phorbol myristic acetate quenched the intrinsic fluorescence spectra of the PKC epsilon C1B subdomain in a dose-dependent manner, and propofol caused a further leftward-shift in the fluorescence emission maxima of sapintoxin D after addition of the C1B subdomain.

Conclusions
These results demonstrate that propofol interacts with recombinant PKC epsilon causing autophosphorylation and activation of the enzyme. Moreover, propofol enhances phorbol ester-induced catalytic activity, suggesting that propofol binds to a region near the phorbol ester binding site allowing for allosteric modulation of PKC epsilon catalytic activity.
Crossover Comparison of the Laryngeal Mask Supreme™ and the i-gel™ in Simulated Difficult Airway Scenario in Anesthetized Patients
Authors: Theiler Lorenz G. , Kleine-Brueggeney Maren , Kaiser Dagmar , Urwyler Natalie , Luyet Cedric , Vogt Andreas , Greif Robert , Unibe M M. E. 
Published: June 2009

Background
The single-use supraglottic airway devices LMA-Supreme (LMA-S; Laryngeal Mask Company, Henley-on-Thames, United Kingdom) and i-gel (Intersurgical Ltd, Wokingham, Berkshire, United Kingdom) have a second tube for gastric tube insertion. Only the LMA-S has an inflatable cuff. They have the same clinical indications and might be useful for difficult airway management. This prospective, crossover, randomized controlled trial was performed in a simulated difficult airway scenario using an extrication collar limiting mouth opening and neck movement.

Methods
Sixty patients were included. Both devices were placed in random order in each patient. Primary outcome was overall success rate. Other measurements were time to successful ventilation, airway leak pressure, fiberoptic glottic view, and adverse events.

Results
Success rate for the LMA-S was 95% versus 93% for the i-gel (P = 1.000). LMA-S needed shorter insertion time (34 +/- 12 s vs. 42 +/- 23 s, P = 0.024). Tidal volumes and airway leak pressure were similar (LMA-S 26 +/- 8 cm H20; i-gel 27 +/- 9 cm H20; P = 0.441). Fiberoptic view through the i-gel showed less epiglottic downfolding. Overall agreement in insertion outcome was 54 (successes) and 1 (failure) or 55 (92%) of 60 patients. The difference in success rate was 1.7% (95% CI -11.3% to 7.6%).

Conclusions
Both airway devices had similar insertion success and clinical performance in the simulated difficult airway situation. The authors found less epiglottic downfolding and better fiberoptic view but longer insertion time with the i-gel. Our study shows that both devices are feasible for emergency airway management in patients with reduced neck movement and limited mouth opening.
Lipid Emulsion Combined with Epinephrine and Vasopressin Does Not Improve Survival in a Swine Model of Bupivacaine-induced Cardiac Arrest
Authors: Hicks Shawn D. , Salcido David D. , Logue Eric S. , Suffoletto Brian P. , Empey Philip E. , Poloyac Samuel M. , Miller Donald R. , Callaway Clifton W. , Menegazzi James J. 
Published: June 2009

Background
This study sought to evaluate the efficacy of lipid emulsion in reversing bupivacaine-induced cardiovascular collapse when added to a resuscitation protocol that included the use of epinephrine and vasopressin.

Methods
After induction of general anesthesia and instrumentation, 19 mixed-breed domestic swine had cardiovascular collapse induced by an intravenous bolus of 10 mg/kg bupivacaine. After 5 min of resuscitation including chest compressions, epinephrine (100 microg/kg) and vasopressin (1.5 U/kg), animals were randomized to receive either a bolus of 20% lipid emulsion (4 ml/kg) followed by a continuous infusion (0.5 ml x kg(-1) x min(-1)) or an equal volume of saline. Investigators were blinded to the treatment assignment. The primary endpoint was return of spontaneous circulation (mean arterial pressure of at least 60 mmHg for at least 1 min).

Results
Treatment groups were similar with respect to baseline measurements of weight, sex, and hemodynamic and metabolic variables. The rates of return of spontaneous circulation were similar between groups: (3 of 10) in the lipid group and 4 of 9 in the saline group (P = 0.65). Total serum bupivacaine concentrations were higher in the lipid group at the 10-min timepoint (mean +/- SEM: 23.13 +/- 5.37 ng/ml vs. 15.33 +/- 4.04 ng/ml, P = 0.004). More norepinephrine was required in the lipid group compared to the saline group to maintain a mean arterial pressure above 60 mmHg during the 60-min survival period (mean +/- SEM: 738.6 +/- 94.4 vs.. 487.3 +/- 171.0 microg).

Conclusions
In this swine model, lipid emulsion did not improve rates of return of spontaneous circulation after bupivacaine-induced cardiovascular collapse.
Success of Spinal and Epidural Labor Analgesia
Authors: Grondin Lydia S. , Nelson Kenneth , Ross Vernon , Aponte Orlando , Lee Sherman , Pan Peter H. 
Published: June 2009

Background
Comparison of air versus saline for loss of resistance technique (LORT) in combined spinal epidural labor analgesia (CSE) has not been evaluated, and neither has the relation between CSE characteristics (the presence/absence of initial spontaneous clear fluid return or upon aspiration) and spinal/epidural analgesia outcomes. The authors hypothesized that there is no difference in the spinal analgesia success or epidural catheter efficacy between using air versus saline LORT for CSE.

Methods
A total of 360 patients were randomized to air or saline LORT for CSE. Primary outcome was spinal analgesia success as defined by verbal pain score of no more than 3 at 15 min after spinal dose administration. Secondary outcomes were CSE characteristics, catheter replacement, and average hourly epidural drug consumption.

Results
Results from 345 patients were analyzed. Spinal analgesia success, epidural catheter replacement, and drug consumption were not different between using air or saline LORT and were also independent of the presence/absence of fluid return on aspiration if initial spontaneous fluid returned to the spinal needle. However, epidural catheters inserted in absence of initial fluid return had a significantly higher catheter replacement rate (28.6%) than the 4.1% among those with initial fluid return (P < 0.03).

Conclusions
Spinal analgesia success rate and epidural efficacy are independent of whether air or saline is used for LORT during CSE. Practice of aspiration for fluid after observing initial fluid return may be unnecessary because this practice does not alter spinal/epidural analgesia outcomes. However, epidural catheters inserted with the absence of initial fluid returned to spinal needle may pose a high failure risk.
Effects of Sevoflurane and Propofol on the Nociceptive Withdrawal Reflex and on the H Reflex
Authors: Baars Jan H. , Mager René , Dankert Katharina , Hackbarth Mark , von Dincklage Falk , Rehberg Benno 
Published: June 2009

Background
The predominant target of anesthetics to suppress movement responses to noxious stimuli is located in the spinal cord. Although volatile anesthetics appear to produce immobility by actions on the ventral rather than the dorsal horn, the site of action of propofol remains unclear.

Methods
In a crossover design, the authors compared in 13 volunteers the effects of sevoflurane and propofol on the amplitudes of the H reflex, which is mediated exclusively in the ventral horn and a withdrawal reflex (RIII Reflex), which integrates dorsal and ventral horn function. The concentrations were adjusted according to a Dixon up-and-down approach, depending on movement responses to tetanic stimulation.

Results
Sevoflurane and propofol concentrations ranged from 1.2 to 1.6 Vol% and 3 to 6 mg/l, respectively. Sevoflurane reduced the H reflex amplitude significantly to 66 +/- 17% (mean +/- SD) of its control values. Propofol did not significantly reduce the H reflex. The reductions under the two drugs differed significantly. The RIII reflex amplitude was significantly reduced to 19 +/- 10% and 27 +/- 12% (mean +/- SD) of the control values by sevoflurane and propofol, respectively. The reductions did not differ between the drugs.

Conclusions
Probably because of the polysynaptic relay, the attenuation of the withdrawal reflex exceeds the attenuation of the H reflex. Sevoflurane produces a larger inhibitory effect on the H reflex than propofol, which confirms that the ventral horn is a more important target for volatile anesthetics, whereas effects of propofol on this site of action are rather limited. Our findings indirectly suggest for propofol a relatively stronger effect within the dorsal horn.
Reversal of Neuromuscular Blockade by Sugammadex after Continuous Infusion of Rocuronium in Patients Randomized to Sevoflurane or Propofol Maintenance Anesthesia
Authors: Rex Christopher , Wagner Stefanie , Spies Claudia , Scholz Jens , Rietbergen Henk , Heeringa Marten , Wulf Hinnerk 
Published: June 2009

Background
Sugammadex rapidly reverses neuromuscular blockade induced by bolus rocuronium doses, but it has not been investigated after continuous rocuronium infusion in surgical patients. We therefore examined the clinical effect of sugammadex for neuromuscular blockade induced by continuous rocuronium infusion in adults undergoing surgery under maintenance anesthesia with sevoflurane or propofol.

Methods
This four-center, comparative, parallel-group study, randomly assigned 52 adult patients (American Society of Anesthesiologists Class I-III) to maintenance anesthesia with sevoflurane or propofol. Neuromuscular blockade was induced by bolus injection of 0.6 mg/kg rocuronium followed by continuous infusion of 7 microg x kg(-1) x min(-1) rocuronium adjusted to maintain a neuromuscular blockade depth of zero response to train-of-four and a posttetanic count of no more than 10 responses. A single dose of 4 mg/kg sugammadex was administered at first twitch (T1) 3-10%. The primary clinical effect variable was recovery time to a train-of-four ratio of 0.9.

Results
Median recovery time from start of sugammadex administration to a train-of-four ratio of 0.9 in the sevoflurane and propofol groups was 1.3 and 1.2 min, respectively. The estimated difference in recovery time between groups was 9 s (95% confidence interval -6 to 20 s), entirely within the predefined equivalence interval. Median plasma rocuronium concentration just before sugammadex administration was 33% lower during maintenance anesthesia with sevoflurane than with propofol. Sugammadex was well tolerated. One adverse event (procedural hypotension) was considered to be probably related to sugammadex.

Conclusions
Single-dose sugammadex (4 mg/kg) after continuous rocuronium infusion is equally effective and well tolerated during maintenance anesthesia with sevoflurane or propofol.