bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosing and Reporting of Central Line–Associated Bloodstream Infections
Authors: Beekmann Susan E. , Diekema Daniel J. , Huskins W. Charles , Herwaldt Loreen , Boyce John M. , Sherertz Robert J. , Polgreen Philip M. ,   on behalf of the Infectious Diseases Society of America Emerging Infections Network
Published: August 2012

Background.The diagnosis of central line-associated bloodstream infections (CLABSIs) is often controversial, and existing guidelines differ in important ways.Objective.To determine both the range of practices involved in obtaining blood culture samples and how central line-associated infections are diagnosed and to obtain members' opinions regarding the process of designating bloodstream infections as publicly reportable CLABSIs.Design.Electronic and paper 11-question survey of infectious-diseases physician members of the Infectious Diseases Society of America Emerging Infections Network (IDSA EIN).Participants.All 1,364 IDSA EIN members were invited to participate.Results.692 (51%) members responded; 52% of respondents with adult practices reported that more than half of the blood culture samples for intensive care unit (ICU) patients with central lines were drawn through existing lines. A sizable majority of respondents used time to positivity, differential time to positivity when paired blood cultures are used, and quantitative culture of catheter tips when diagnosing CLABSI or determining the source of that bacteremia. When determining whether a bacteremia met the reportable CLABSI definition, a majority used a decision method that involved clinical judgment.Conclusions.Our survey documents a strong preference for drawing 1 set of blood culture samples from a peripheral line and 1 from the central line when evaluating fever in an ICU patient, as recommended by IDSA guidelines and in contrast to current Centers for Disease Control and Prevention recommendations. Our data show substantial variability when infectious-diseases physicians were asked to determine whether bloodstream infections were primary bacteremias, and therefore subject to public reporting by National Healthcare Safety Network guidelines, or secondary bacteremias, which are not reportable.
Development of a Modified Surveillance Definition of Central Line–Associated Bloodstream Infections for Patients with Hematologic Malignancies
Authors: DiGiorgio Megan J. , Fatica Cynthia , Oden Mary , Bolwell Brian , Sekeres Mikkael , Kalaycio Matt , Akins Patti , Shane Christina , Bako Jacob , Gordon Steven M. , Fraser Thomas G. 
Published: August 2012

Objective.To develop a modified surveillance definition of central line-associated bloodstream infection (mCLABSI) specific for our population of patients with hematologic malignancies to better support ongoing improvement efforts at our hospital.Design.Retrospective cohort study.Patients.Hematologic malignancies population in a 1,200-bed tertiary care hospital on a 22-bed bone marrow transplant (BMT) unit and a 22-bed leukemia unit.Methods.An mCLABSI definition was developed, and pathogens and rates were compared against those determined using the National Healthcare Safety Network (NHSN) definition.Results.By the NHSN definition the CLABSI rate on the BMT unit was 6.0 per 1,000 central line-days, and by the mCLABSI definition the rate was 2.0 per 1,000 line-days (P < .001). On the leukemia unit, the NHSN CLABSI rate was 14.4 per 1,000 line-days, and the mCLABSI rate was 8.2 per 1,000 line-days (P = .009). The top 3 CLABSI pathogens by the NHSN definition were Enterococcus species, Klebsiella species, and Escherichia coli. The top 3 CLABSI pathogens by the mCLABSI definition were coagulase-negative Staphylococcus (CONS), Pseudomonas aeruginosa, and Staphylococcus aureus. The difference in the incidence of CONS as a cause of CLABSI under the 2 definitions was statistically significant (P < .001).Conclusions.A modified surveillance definition of CLABSI was associated with an increase in the identification of staphylococci as the cause of CLABSIs, as opposed to enteric pathogens, and a decrease in CLABSI rates.
Nanocrystalline Si : H thin films grown at room temperature with plasma-enhanced chemical vapour deposition at a very high pressure
Authors: Gao L , Lu N P , Liao L G , Ji A L , Cao Z X 
Published: August 2012

Abstract
Hydrogenated nanocrystalline silicon (nc-Si : H) films were grown using the plasma-enhanced chemical vapour deposition method, with the plasma operated under a gas pressure of up to 30 mbar, i.e. on the verge of plasma instability. The heating effect in determining the crystallite size and crystalline volume fraction can be excluded as the maximum substrate temperature was below 80 °C at the end of growth. Crystallite initiation occurs in the plasma sheath, and Si nanocrystallites appear only when the gas pressure is above 10 mbar. With the pressure increasing to 30 mbar, the volume fraction of the nanocrystalline phase increases steadily, and the crystallite size changes from ∼7.8 to ∼4.5 nm. The optical bandgap of the deposits varies between 2.30 eV (at 15 mbar) and 2.03 eV (at 30 mbar), which can be explained in terms of the reduced hydrogen content and confinement effect. This work opens up the possibility of growing nc-Si : H films with well-controlled crystallite features on substrates held at near room temperature.
Roles of Aldosterone and Oxytocin in Abnormalities Caused by Sevoflurane Anesthesia in Neonatal Rats
Authors: Cao Wengang , Pavlinec Christopher , Gravenstein Nikolaus , Seubert Christoph N. , Martynyuk Anatoly E. 
Published: August 2012

Background
The authors sought to determine whether subjects with pathophysiological conditions that are characterized by increased concentrations of aldosterone have increased susceptibility to the side effects of neonatal anesthesia with sevoflurane.

Methods
Postnatal day 4-20 (P4-P20) rats were exposed to sevoflurane, 6% and 2.1%, for 3 min and 60-360 min, respectively. Exogenous aldosterone was administered to imitate pathophysiological conditions with increased concentrations of aldosterone.

Results
Six hours of anesthesia with sevoflurane on P4-P5 rats resulted in a more than 30-fold increase in serum concentrations of aldosterone (7.02 ± 1.61 ng/dl vs. 263.75 ± 22.31 ng/dl, mean ± SE, n = 5-6) and reduced prepulse inhibition of the acoustic startle response (F(2,37) = 5.66, P < 0.001). Administration of exogenous aldosterone during anesthesia with sevoflurane enhanced seizure-like electroencephalogram patterns in neonatal rats (48.25 ± 15.91 s vs. 222.00 ± 53.87 s, mean ± SE, n = 4) but did not affect electroencephalographic activity in older rats. Exogenous aldosterone increased activation of caspase-3 (F(3,28) = 11.02, P < 0.001) and disruption of prepulse inhibition of startle (F(3,46) = 6.36; P = 0.001) caused by sevoflurane. Intracerebral administration of oxytocin receptor agonists resulted in depressed seizure-like electroencephalogram patterns (F(2,17) = 6.37, P = 0.009), reduced activation of caspase-3 (t(11) = 2.83, P = 0.016), and disruption of prepulse inhibition of startle (t(7) = -2.9; P = 0.023) caused by sevoflurane.

Conclusions
These results suggest that adverse developmental effects of neonatal anesthesia with sevoflurane may involve both central and peripheral actions of the anesthetic. Subjects with increased concentrations of aldosterone may be more vulnerable, whereas intracerebral oxytocin receptor agonists may be neuroprotective.
Geoengineering the climate: an overview and update
Authors: Shepherd J. G. 
Published: August 2012

The climate change that we are experiencing now is caused by an increase in greenhouse gases due to human activities, including burning fossil fuels, agriculture and deforestation. There is now widespread belief that a global warming of greater than 2
°
C above pre-industrial levels would be dangerous and should therefore be avoided. However, despite growing concerns over climate change and numerous international attempts to agree on reductions of global CO
2
emissions, these have continued to climb. This has led some commentators to suggest more radical ‘geoengineering’ alternatives to conventional mitigation by reductions in CO
2
emissions. Geoengineering is deliberate intervention in the climate system to counteract man-made global warming. There are two main classes of geoengineering: direct carbon dioxide removal and solar radiation management that aims to cool the planet by reflecting more sunlight back to space. The findings of the review of geoengineering carried out by the UK Royal Society in 2009 are summarized here, including the climate effects, costs, risks and research and governance needs for various approaches. The possible role of geoengineering in a portfolio of responses to climate change is discussed, and various recent initiatives to establish good governance of research activity are reviewed.

Key findings include the following.

— Geoengineering is not a magic bullet and not an alternative to emissions reductions.

— Cutting global greenhouse gas emissions must remain our highest priority.
(i) But this is proving to be difficult, and geoengineering may be useful to support it.

— Geoengineering is very likely to be technically possible.
(i) However, there are major uncertainties and potential risks concerning effectiveness, costs and social and environmental impacts.

— Much more research is needed, as well as public engagement and a system of regulation (for both deployment and for possible large-scale field tests).

— The acceptability of geoengineering will be determined as much by social, legal and political issues as by scientific and technical factors.

Some methods of both types would involve release of materials to the environment, either to the atmosphere or to the oceans, in areas beyond national jurisdiction. The intended impacts on climate would in any case affect many or all countries, possibly to a variable extent. There are therefore inherent international implications for deployment of such geoengineering methods (and possibly also for some forms of research), which need early and collaborative consideration,
before
any deployment or large-scale experiments could be undertaken responsibly.
Gastric carcinoids after long‐term use of a proton pump inhibitor
Authors: Jianu C. S. , Fossmark R. , Viset T. , Qvigstad G. , Sørdal Ø. , Mårvik R. , Waldum H. L. 
Published: August 2012

SummaryBackgroundProton pump inhibitors (PPIs) are potent inhibitors of gastric acid secretion and give hypergastrinemia secondary to gastric hypoacidity. PPI treatment therefore induces enterochromaffin‐like (ECL) cell hyperplasia. Long‐term hypergastrinemia in rodents and man also leads to ECL cell neoplasia. Whether long‐term PPI treatment will induce ECL cell neoplasia in man has been disputed.AimTo describe gastric carcinoids in two patients with a history of long‐term PPI use.ResultsTwo patients had been taking PPI for 12–13 years due to gastro‐oesophageal reflux disease. At routine upper gastrointestinal endoscopy a solitary tumour was found in the oxyntic mucosa of both patients. Histology from the tumours showed in both cases a well‐differentiated neuroendocrine tumour. Biopsies from flat oxyntic mucosa showed no signs of atrophic gastritis and a normal presence of parietal cells in both cases, but hyperplasia of ECL cells. The tumour in patient 1 was resected endoscopically. After cessation of PPI treatment the tumour regressed in patient 2 and the ECL cell hyperplasia regressed in both patients. In patient 2 serum gastrin and chromogranin A were elevated during PPI treatment, and normalised after cessation of treatment. In patient 1, unfortunately, we had serum only after treatment, and at that time both parameters were normal.ConclusionThese cases show that hypergastrinemia secondary to proton pump inhibitors treatment, like other causes of hypergastrinemia, may induce enterochromaffin‐like cell carcinoids in man.
‘She is Too Young for These Chores’ — Is Housework Taking a Back Seat in Urban Chinese Childhood?
Authors: Goh Esther Chor Leng , Kuczynski Leon 
Published: August 2012

The child in contemporary urban China is experiencing an increasingly exclusive focus on academic achievement at the expense of non‐academic activities, particularly housework. In‐depth interviews with caregivers (including grandparents and parents) from 9 three‐generational families (n = 34) and parents from 10 nuclear families (n = 20) were conducted. Results show that although children from both family types were low in housework participation, children in three‐generational families were perceived by their caregivers to be less competent in performing self‐care and family‐care tasks. They were also less frequently assigned regular tasks as compared with children from nuclear families. Unlike caregivers from western societies, where children's participation in housework is seen as either a means of socialisation or a source of domestic labour, Chinese caregivers consider housework as a distraction, at best an addendum to academic work.
How to generalize efficacy results of randomized trials: recommendations based on a systematic review of possible approaches
Authors: Post Piet N. , de Beer Hans , Guyatt Gordon H. 
Published: August 2012

AbstractRationale, aims and objectivesRandomized controlled trials (RCTs) are the preferred source for evidence for the effect of treatment. However, patients participating inRCTs often manifest important differences from patients seen in practice. Therefore, guideline developers have to decide whether the results are generalizable to the target population not represented inRCTs.MethodA systematic review of the literature was undertaken to identify methods to decide whether to generalize the results fromRCTs to patients who were not represented in these trials.ResultsOne approach is to examine the in‐ and exclusion criteria of trials and infer from these whether the trial population was sufficiently representative. Other authors suggest, because of the inclusion of a broader range of patients, reliance on observational studies if no direct evidence for the target population is available.Another approach is to apply the relative effect of treatment found in trials to patients in practice unless there is a compelling reason to believe the results would differ substantially as a function of particular characteristics of those patients. Although there are exceptions, this approach is supported by empirical evidence that, in general, relative effect of treatment on benefit outcomes seldom differs to an important extent across subgroups of patients.ConclusionWe propose this last approach: focusing onRCTs unless there is a compelling reason not to do so. Compelling reasons will most often be found with respect to issues of rare adverse effects, for which observational studies are likely to provide the best estimates.
Simple questionnaire and urine reagent strips compared to microscopy for the diagnosis of Schistosoma haematobium in a community in northern Ghana
Authors: Bogoch Isaac I. , Andrews Jason R. , Dadzie Ephraim Richard K. , Utzinger Jürg 
Published: August 2012

AbstractObjectives  To evaluate the utility of a simple questionnaire and urine reagent strip testing for the rapid diagnosis of Schistosoma haematobium in rural northern Ghana.Methods  Cross‐sectional parasitological and questionnaire survey in a community in northern Ghana. Participants provided two urine specimens that were examined under a microscope using a centrifugation method. The first urine sample was additionally subjected to reagent strip testing. A short questionnaire was administered to all participants.Results  Microscopy of urine samples obtained from 208 individuals aged 1–77 years revealed an S. haematobium prevalence of 6.8%. The presence of any blood or protein on a urine reagent strip was 100% and 42% sensitive, and 93% and 80% specific for S. haematobium diagnosis. Questionnaires were completed by 198 individuals. Self‐reported haematuria showed a sensitivity of 53% and a specificity of 85%. A dichotomous two‐question panel was helpful in S. haematobium diagnosis, with working and playing near the river significantly associated with S. haematobium infection (P < 0.001).Conclusion  The use of urine reagent strips, coupled with questions pertaining to water contact patterns, might be considered for point‐of‐contact diagnosis of S. haematobium where microscopy is unavailable.
Clinical issues in oesophageal adenocarcinoma: could DNA copy number hold the key?
Authors: Frankel Adam , Nancarrow Derek , Wayte Nicola , Barbour Andrew 
Published: August 2012

AbstractWhile not being considered a common cancer, since 1975 oesophageal adenocarcinoma (OAC) has had the fastest‐rising incidence of any malignancy in Caucasian Western populations. In the absence of major improvements in treatment since this rise began, the number of deaths has also increased rapidly. In contrast, there have been significant advances in basic science in this period. One such advance is the discovery of DNA copy number aberrations (CNAs), and their potential role in carcinogenesis. The study of CNAs offers the potential to answer fundamental clinical questions in OAC, which in turn may lead to improved diagnosis, staging and treatment. This review outlines current clinical dilemmas in OAC, discusses the role that CNAs have been shown to play to date and highlights potential future applications.
Anterior segment fluorescein angiography of the normal feline eye using a dSLR camera adaptor
Authors: Alario Anthony F. , Pirie Christopher G. , Pizzirani Stefano 
Published: August 2012

AbstractPurpose  To describe anterior segment fluorescein angiography (ASFA) of the normal feline eye using a digital single‐lens reflex (dSLR) camera adaptor.Animals  Ten cats free of ocular and systemic disease were evaluated.Methods  All cats received maropitant citrate (1.0 mg/kg SQ) and diphenhydramine (2.0 mg/kg SQ) 20 min prior to anesthesia using propofol (4 mg/kg IV bolus, 0.2 mg/kg/min CRI). Standard color and red‐free images were obtained prior to the administration of 10% sodium fluorescein (20 mg/kg IV). Imaging was performed using a dSLR camera (Canon 7D), dSLR camera adaptor, camera lens (Canon EF‐S 60 mm f/2.8 macro), and an accessory flash (Canon 580EXII). Imaging occurred at a rate of 1/second immediately following IV bolus of sodium fluorescein for a total of 30 s, then at 1, 2, 3, 4, 5, and 10 min.Results  Ten cats with an average age of 3.7 ± 0.9 years and various iris colors were imaged. Arterial, capillary, and venous phases occurred 4.6, 7.8, and 8.9 s postinjection, respectively. Visibility of the vasculature was not impaired by the degree of iris pigmentation. Patency of a persistent pupillary membrane was noted in one cat. Vessel leakage was common, as well as, leakage into the aqueous humor. Proper patient positioning and restricted ocular movements were critical. No adverse events were noted.Conclusions  This study demonstrates ASFA findings in normal feline eyes using a cost‐effective dSLR camera adaptor. Fluorescein leakage from vessels and into the aqueous humor was a common finding. Visibility of iris vasculature was not impaired by the degree of iris pigmentation.
EFNS‐ENS guidelines for the use of PCR technology for the diagnosis of infections of the nervous system
Authors: Steiner I. , Schmutzhard E. , Sellner J. , Chaudhuri A. , Kennedy P. G. E. 
Published: August 2012

BackgroundPolymerase chain reaction (PCR) as a means to amplify nucleic acids has become an essential element in diagnosis of infections. It has evolved into a simple and rapid, easy‐ to‐ use approach. At present there are no published guidelines for the usage of PCR technology for the diagnosis of infections of the nervous system.MethodsWe reviewed the advantages and pitfalls of PCR in order to guide neurologists and infectious diseases experts in its application for the diagnosis of infections of the nervous system. Medical reference systems were searched, and original papers, meta‐analyses, review papers, book chapters and guidelines recommendations were reviewed. The final literature search was performed in May 2012. Recommendations were reached by consensus.RecommendationsThe reliability of PCR technology for the diagnosis of neurological infections is currently based on the pathogens. The main contribution of PCR is to the diagnosis of viral infections followed by bacterial CNS infections with the notable exception of tuberculous meningitis. Efficacy for the diagnosis of protozoal infections and helminthic infestations has also been established in many instances. Unfortunately, current molecular PCR technology is far from becoming routine in resource‐poor countries where such infections are prevalent. Despite the importance of fungal infections in the context of the immune‐compromised host, there is not enough data to recommend the routine use of PCR.ConclusionsPCR technology is currently a reliable method for the diagnosis of viral and bacterial (except tuberculosis) infections, and only for some protozoal infections and helminthic infestations.
Practitioner Review: Children in foster care – vulnerabilities and evidence‐based interventions that promote resilience processes
Authors: Leve Leslie D. , Harold Gordon T. , Chamberlain Patricia , Landsverk John A. , Fisher Philip A. , Vostanis Panos 
Published: August 2012

Background:  An increasing number of children are placed in foster care (i.e., a kin or nonkin family home other than the biological parent) due to experiences of physical, sexual, emotional, or psychological abuse, and/or neglect. Children in foster care are at increased risk for a host of negative outcomes encompassing emotional, behavioral, neurobiological, and social realms.Methods:  Areas of risk and vulnerability among foster children are described, including emotional and behavioral deficits, impaired neurobiological development, and social relationship deficits. Evidence suggesting the significance of family placement changes and prenatal exposure to substances as contributing mechanisms is presented. Based on a systematic search of the PsycINFO database (to March 2012), eight efficacious evidence‐based interventions for foster families are summarized.Findings:  Although the development of evidence‐based interventions that improve outcomes for foster children has lagged behind the delivery of interventions in other service sectors (e.g., mental health and educational sectors), several interventions across childhood and adolescence offer promise. Service system constraints offer both challenges and opportunities for more routine implementation of evidence‐based interventions.Conclusions:  Given the increased likelihood of poor outcomes for foster children, increased efforts to understand the pathways to vulnerability and to implement interventions shown to be effective in remediating risks and improving outcomes for this population are indicated. Evaluation of efficacious interventions in countries outside of the United States is also needed.