bluuebunny/crossref_metadata_2025_split huggingface dataset:
Down‐Modulation of Toll‐Like Receptor 2 Expression on Granulocytes and Suppression of Interleukin‐8 Production Due To In Vitro Treatment With Cellulose Acetate Beads
Authors: Hidaka Mayumi , Fukuzawa Kenji 
Published: November 2011

AbstractThe Adacolumn, which is filled with cellulose acetate beads (CA beads), has been used as a medical device for inflammatory diseases. The CA beads selectively adsorb granulocytes and monocytes and remove them from the peripheral blood. The anti‐inflammatory effects of the Adacolumn are possibly caused by removal of these cells but also due to the functional changes in the processed cells. In this study, we investigated the effects of CA beads treatment on modulation of the expression of innate immunity receptors such as the Toll‐like receptor (TLR) family and production of an inflammatory cytokine, interleukin‐8 (IL‐8). Changes in the expressions of TLR1, 2, 4 and 6 in peripheral leukocytes exposed to CA beads were examined by flow cytometry. TLR2 expression on the surface of granulocytes exposed to CA beads was decreased, but the amount of intracellular TLR2 was increased, possibly by internalization. These changes were not observed in monocytes or lymphocytes. Peptidoglycan (PGN) treatment produced similar changes in TLR2 on granulocytes. We also measured the amounts of IL‐8 in cultured blood treated with lipopolysaccharide (LPS) and PGN, which are known TLR agonists. PGN‐induced IL‐8 production was lower in CA beads‐treated leukocytes than that in non‐treated leukocytes, but LPS did not induce these changes. Based on these findings, we conclude that the down‐modulation of TLR2 and suppression of IL‐8 production on granulocytes by CA beads, may play an important role in the anti‐inflammatory effects of the Adacolumn.
Regional Citrate Anticoagulation Reduces Polymorphonuclear Cell Degranulation in Critically Ill Patients Treated With Continuous Venovenous Hemofiltration
Authors: Tiranathanagul Khajohn , Jearnsujitwimol Onanong , Susantitaphong Paweena , Kijkriengkraikul Narin , Leelahavanichkul Asada , Srisawat Nattachai , Praditpornsilpa Kearkiat , Eiam‐Ong Somchai 
Published: November 2011

AbstractCitrate which chelates ionized calcium can be used as regional anticoagulation in continuous venovenous hemofiltration (CVVH). This is the first study conducted to examine the potentially additive benefit effect of regional citrate anticoagulation (RCA) on polymorphonuclear (PMN) cell degranulation of myeloperoxidase (MPO) and cytokines production in patients with critically acute kidney injury (AKI) undergoing CVVH treatment. This prospective randomized controlled trial was conducted in 20 critically ill patients with AKI who underwent CVVH. The patients were randomized into regional citrate group (n = 10) and heparin group (n = 10). The pre‐dilution CVVH with polyethersulfone dialyzers were utilized in both groups. The levels of pre‐filter and post‐filter MPO as well as inflammatory and anti‐inflammatory cytokines were measured at baseline, 6 h, and 24 h after initiating CVVH. In the heparin group, the post‐filter serum MPO levels were significantly higher than the pre‐filter (median 49.0 vs. 60.5 ng/mL, P < 0.05) at 6 h. There were no significant differences between pre‐ and post‐dialyzer MPO levels in the citrate group. Citrate could significantly decrease systemic pre‐filter serum MPO levels from baseline at 6 h (median 43.5 vs. 17.3 ng/mL, P < 0.01) as well as IL‐8 levels (P < 0.05) whereas heparin provided only significant TNF‐α reduction (P < 0.05). The CVVH circuit survival in the citrate group was longer than the heparin group. In conclusion, citrate, utilized as a regional anticoagulant in CVVH, can reduce both membrane bioincompatibility‐induced and systemic oxidative stress and inflammation, and can prolong CVVH circuit survival time.
Influence of the Assay for Measuring Serum Albumin on Corrected Total Calcium in Chronic Hemodialysis Patients
Authors: Kato Akihiko , Takita Takako , Furuhashi Mitsuyoshi , Fujimoto Taiki , Suzuki Hiroo , Hakamada Masahiro , Maruyama Yukitaka 
Published: November 2011

AbstractThe Japanese Society for Dialysis Therapy guideline for secondary hyperparathyroidism recommends the use of albumin‐corrected serum Ca as a therapeutic target in chronic hemodialysis patients; however, the assay used for albumin measurement may affect the corrected Ca level. In this study, we examined the impact of the albumin assay on corrected Ca levels in hemodialysis patients. We measured serum albumin using bromocresol green (BCG) and modified bromocresol purple (BCP) assays, and corrected Ca for albumin using Payne's formula in 422 hemodialysis patients (age 66 ± 13 years; time on hemodialysis 116 ± 111 months). Serum albumin values were 3.7 ± 0.4 (1.4–4.6) g/dL by BCG and 3.3 ± 0.4 (1.0–4.3) g/dL by modified BCP, with the differences between the two assays ranging from 0.0 to 0.6 with a mean of 0.35 ± 0.09 g/dL. Serum C‐reactive protein and globulin values were significantly higher in patients with differences in albumin greater than 0.5 g/dL (P < 0.01). Based on the BCG method, 71 patients (16.8%) were classified with hypocalcemia, 51 (12.1%) with hypercalcemia, and 300 (70.0%) as normocalcemic. In contrast, when using modified BCP, 33 patients (7.9%) were labeled as hypocalcemic, while 92 (21.8%) were hypercalcemic. Depending on the use of either BCG or modified BCP, a discrepancy of classification was observed in 79 patients (18.7%): 41 patients were re‐classified from normocalcemic to hypercalcemic, and 38 patients were re‐classified from hypocalcemic to normocalcemic by selecting the modified BCP assay. These findings suggest that the type of assay used for albumin measurement has an impact on albumin‐corrected Ca levels.
Role of Plasma Exchange in the Thyroid Storm
Authors: Muller Clotilde , Perrin Peggy , Faller Bernadette , Richter Sarah , Chantrel Francois 
Published: November 2011

AbstractInadequately treated thyroid storm can lead to death. Therapeutic plasma exchange (TPE) is a suggested treatment when conventional treatments fail, but its indication is not well codified. We report our experience through three explicit cases. Three elderly patients were admitted to our hospital for cardiac or neurologic symptoms due to thyroid storm. After initiation of conventional therapy, TPE was performed with clinical and biological improvement. The speed of symptom resolution varies depending on the severity. This technique must be carried out by experienced medical staff as many complications can occur; nevertheless, in our patients with severe comorbidities, no complications occurred. The action of TPE mainly results from plasma removal of cytokines, putative antibodies, and thyroid hormones and their bound proteins. TPE has a transitory effect and thus should be associated with other thyroid blockers. When there are threatening symptoms, TPE should be done early, without waiting for the efficiency of conventional treatment, since it is the fastest method known for the improvement of the clinical condition. We also suggest starting TPE in case of neurologic symptoms because of very slow and incomplete regression. The Burch and Wartofsky score seems to be a helpful tool in establishing the diagnosis of thyroid storm and for deciding on when to initiate TPE.
Differences in social support of caregivers living with partners suffering from COPD or dementia
Authors: Nordtug Bente , Krokstad Steinar , Sletvold Olav , Holen Are 
Published: November 2011

nordtug b., krokstad s., sletvold o. & holen a. (2013) Differences in social support of caregivers living with partners suffering from COPD or dementia. International Journal of Older People Nursing 8, 93–103  doi: 10.1111/j.1748‐3743.2011.00302.xBackground.  Future patients with chronic diseases will probably remain longer in their homes. To enable family caregivers to meet these challenges, public services and informal support are essential.Objectives.  This study compared social support between home‐dwelling caregivers of partners with chronic obstructive pulmonary disease or dementia.Methods.  A cross‐sectional study of 206 caregivers. Professional aid was quantified by the services utilised. Informal support from family and friends was rated by the number of helping persons and the degree of social withdrawal. The Medical Outcomes Study Social Support Survey Form captured perceived social support.Results.  For both diseases, increased severity correlated with more utilisation of professional aid. The chronic obstructive pulmonary disease group perceived more social support, reported less social withdrawal and higher numbers of helping persons. Ill partners’ aggressive behaviour reduced perceived support. The use of professional aid was negatively associated with the ill partner’s level of self‐care, and positively correlated with social withdrawal. Professional aid was more utilised by the dementia group and by men.Conclusions.  Differences in caregivers’ needs for social support were related to their partner’s disease.Implications for practice.  Counteracting social withdrawal, considering type of illness and gender differences may increase the quality of informal care.
A combined project of prawns and poultry: a dynamical system
Authors: Sana Shib Sankar , Chaudhuri Kripasindhu 
Published: November 2011

AbstractThis review examines a joint project involving prawns and broilers. The growth rates of both species vary with available nutrients. The nutrients for both species are functions of the biomasses of the two species. The harvesting rates of prawns and broilers depend non‐linearly on effort functions. The existence of steady states and their stability (local and global) are investigated analytically. The joint profit of the project is maximized using Pontryagin’s maximum principle. The model is also illustrated using suitable numerical examples and demonstrated graphically.
Cardiopulmonary resuscitation before defibrillation in the out-of-hospital setting: a literature review: Table 1
Authors: Winship Christian , Williams Brett , Boyle Malcolm J 
Published: November 2011

BackgroundMany studies over the past decade have investigated delaying initial defibrillation to perform cardiopulmonary resuscitation (CPR), as it has been associated with increased rates of restoration of spontaneous circulation and/or survival. Since 2006, a number of studies have investigated these procedures. The objective of this study was to undertake a literature review examining the commencement of CPR before defibrillation in the out-of-hospital setting.MethodsA literature review was undertaken using the electronic medical databases Ovid Medline, EMBASE, CINHAL Plus, Cochrane Systematic Review and Meditext, from their commencement to the end of June 2011. Keywords used in the search included: CPR, defibrillation, ventricular fibrillation, VF, EMS, EMT, paramedic, emergency medical service, emergency medical technician, prehospital, out-of-hospital and ambulance. References of relevant articles were also reviewed.FindingsOf the 3079 articles located, 10 met the inclusion criteria. The results of these studies showed conflicting results. All retrospective studies (n=6) indicated a benefit in performing pre-shock CPR on patients with ventricular fibrillation for durations between 90 and 180 s. Conversely, all randomised controlled trials demonstrated no benefit from providing CPR before defibrillation compared with immediate defibrillation for return of spontaneous circulation, neurological outcome and/or survival to hospital discharge. However, none of the studies reported evidence that CPR before defibrillation is harmful.ConclusionConflicting evidence remains regarding the benefit of CPR before defibrillation. The establishment of a consistent timeframe of chest compressions before defibrillation in the out-of-hospital setting will provide uniformity in standards in clinical practice and education and training.
High-sensitivity troponin T for early rule-out of myocardial infarction in recent onset chest pain
Authors: Aldous Sally , Pemberton Chris , Richards A Mark , Troughton Richard , Than Martin 
Published: November 2011

ObjectiveTo investigate whether a high-sensitivity troponin assay, shown to improve early detection of acute myocardial infarction (AMI), permits accelerated rule-in/rule-out of AMI.MethodsPatients who presented to the emergency department within 4 h of the onset of chest pain suggestive of acute coronary syndrome were prospectively recruited from November 2007 to April 2010. Blood samples were taken at 0, 1, 2 and 12–24 h after presentation and were analysed for clinically applied troponin I and for high-sensitivity troponin T (hsTnT). The dynamic change in hsTnT levels between time points was measured. The primary outcome was admission diagnosis of AMI.ResultsOf the 385 patients recruited, 82 (21.3%) had AMI. The sensitivity of hsTnT by 2 h was 95.1% (88.7–98.1%), specificity 75.6% (73.8–76.5%), positive predictive value 53.8% (50.2–55.5%) and negative predictive value 98.3% (96.0–99.3%). The sensitivity was not statistically different between peak values at 2 h and 24 h. Adding ECG results reduced the false negative rate to 1.2%. The additional application of ≥20% delta criterion over the 2 h period for 0–2 h samples increased specificity to 92.4% (90.2–94.3%) but reduced sensitivity to 56.1% (48.0–63.2%).ConclusionhsTnT taken at 0 and 2 h after presentation, together with ECG results, could identify patients suitable for early stress testing with a false negative rate for AMI of 1.2%. Further trials of such an approach are warranted. The specificity of hsTnT for diagnosing AMI could be improved by the use of a delta of ≥20%, but at the cost of major reductions in sensitivity.
Proportion of out-of-hospital adult non-traumatic cardiac or respiratory arrest among calls for seizure
Authors: Dami Fabrice , Rossetti Andrea O , Fuchs Vincent , Yersin Bertrand , Hugli Olivier 
Published: November 2011

ObjectivesTo measure the proportion of adult non-traumatic cardiac or respiratory arrest among calls for seizure to an emergency medical dispatch centre and to record whether known epileptic patients present cardiac or respiratory arrest together with seizure.MethodsThis 2-year prospective observational investigation involved the collection of tape recordings of all incoming calls to the emergency medical dispatch centre, in which an out-of-hospital non-traumatic seizure was the chief complaint in patients >18 years, in addition to the paramedics' records of all patients who presented with respiratory or cardiac arrest. The authors also recorded whether the bystander spontaneously mentioned to the dispatcher that the victim was known to have epilepsy.ResultsDuring the 24-month period, the call centre received 561 incoming calls for an out-of-hospital non-traumatic seizure in an adult. Twelve cases were classified as cardiac or respiratory arrest by paramedics. In one case, the caller spontaneously mentioned that the victim had a history of epilepsy. The proportion of cardiac or respiratory arrest among calls for seizure was 2.1%.ConclusionAlthough these cases are rare, dispatchers should closely monitor seizure patients with the help of bystanders to exclude an out-of-hospital cardiac or respiratory arrest, in which case the dispatcher can offer telephone cardiopulmonary resuscitation advice until the paramedics arrive. Whenever the activity of the centre allows it and no new incoming call is on hold, this can be achieved by staying on the line with the caller or by calling back. A history of epilepsy should not modify the type of monitoring performed by the dispatcher as those patients may also have an arrest together with seizure.
Doctors' working conditions in emergency care units in Germany: a real-time assessment
Authors: Mache Stefanie , Vitzthum Karin , Klapp Burghard F , Groneberg David A 
Published: November 2011

Background and objectivesAs interest in doctors' work in Germany has increased over the last few years, this study determines how doctors spend their work time in emergency departments. The study also provides information on patient load and working conditions in emergency units.Methods and materialAn observational time-and-motion study was carried out at three emergency departments. A single investigator followed emergency doctors and recorded the time spent on various work activities. Job activities were classified into 12 different main categories, including direct or indirect patient care.ResultsThe data showed that doctors in emergency departments had to work overtime (M=09.17 h). They performed more than 80 tasks per day and were forced to handle multitasking situations. Indirect patient care and administrative duties were the main tasks doctors spent time on during the day. Direct patient care and contact represented only a small proportion of work time.ConclusionDoctors working in emergency care units have to deal with highly unpredictable workloads and overtime work, and simultaneously should also care for patients and interact with a large number of different persons during each work shift. The findings of this study are useful in efforts to improve emergency medical care and doctors' working conditions.
Patch dynamics and the development of structural and spatial heterogeneity in Pacific Northwest forests
Authors: Kane Van R. , Gersonde Rolf F. , Lutz James A. , McGaughey Robert J. , Bakker Jonathan D. , Franklin Jerry F. 
Published: November 2011

Over time, chronic small-scale disturbances within forests should create distinct stand structures and spatial patterns. We tested this hypothesis by measuring the structure and spatial arrangement of gaps and canopy patches. We used airborne LiDAR data from 100 sites (cumulative 11.2 km2) in the Pacific Northwest, USA, across a 643 year chronosequence to measure canopy structure, patch and gap diversity, and scales of variance. We used airborne LiDAR’s ability to identify strata in canopy surface height to distinguish patch spatial structures as homogeneous canopy structure, matrix–patch structures, or patch mosaics. We identified six distinct stand structure classes that were associated with the canopy closure, competitive exclusion, maturation, and three patch mosaics stages of late seral forest development. Structural variance peaked in all classes at the tree-to-tree and tree-to-gap scales (10–15 m), but many sites maintained high variance at scales >30 m and up to 200 m, emphasizing the high patch-to-patch heterogeneity. The time required to develop complex patch and gap structures was highly variable and was likely linked to individual site circumstances. The high variance at larger scales appears to be an emergent property that is not a simple propagation of processes observed at smaller spatial scales.
Optimal structure and development of uneven-aged Norway spruce forests
Authors: Tahvonen Olli 
Published: November 2011

Optimal harvesting of Norway spruce ( Picea abies (L.) Karst.) forests is studied applying an individual-tree model for uneven-aged management. Optimization is carried out by gradient-based, large-scale interior point methods. Assuming volume maximization and natural regeneration, it is optimal to apply uneven-aged management. Under artificial regeneration, the result is the reverse. Economically optimal solutions with a 20-year harvesting interval produce an annual sawn timber output of 4.4–2.4 m3·ha–1 depending on thermal zone and interest rate. Before harvest basal area varies between 18 and 12 m2·ha–1 and the diameter of harvested trees between 15 and 33 cm. In contrast with the classic inverted J-structure, optimal steady-state size structure resembles a serrate form. Profitability of even- and uneven-aged management is compared assuming that the initial stand state represents an optimal uneven-aged steady state. A switch to even-aged management is optimal given the most favorable growth conditions and interest rate below 1%–2%. In other cases, it is economically optimal to continue uneven-aged management although volume output remains lower than under even-aged management.
Butt rot incidence, causal fungi, and related yield loss in Picea abies stands of Latvia
Authors: Arhipova N. , Gaitnieks T. , Donis J. , Stenlid J. , Vasaitis R. 
Published: November 2011

Root and butt rot is the most destructive disease of conifers in the Northern Hemisphere, but little is known about the dynamics of yield loss in stands of different ages, site types, and species composition. This study aimed to estimate butt rot incidence, causal fungi, and related wood yield loss in Picea abies (L.) H. Karst. stands in Latvia. A total of 24 745 stumps were examined on 318 forest sites, and 21.8% of them contained rot. There was a positive correlation between stand age and butt rot frequency. Proportion of other tree species in a stand had no influence on incidence of the rot, but significant differences were observed among different forest site types. The length of decay columns in 114 stems analysed was 6.6 ± 2.6 m on average. Based on the observed butt rot frequencies in Latvian P. abies stands of different age classes, volumes of decay-degraded wood in a fully stocked stand would comprise about 19.7 m3·ha–1 at the age of 40 years, 57.4 m3·ha–1 at 60 years, 54.9 m3·ha–1 at 80 years, 63.1 m3·ha–1 at 100 years, and 91.8 m3·ha–1 at 120 years, corresponding to 6%–16% of a total standing volume.
Blockade of prostaglandin E2 signaling through EP1 and EP3 receptors attenuates Flt3L-dependent dendritic cell development from hematopoietic progenitor cells
Authors: Singh Pratibha , Hoggatt Jonathan , Hu Peirong , Speth Jennifer M. , Fukuda Seiji , Breyer Richard M. , Pelus Louis M. 
Published: November 2011

AbstractDendritic cell (DC) homeostasis, like all mature blood cells, is maintained via hierarchal generation from hematopoietic precursors; however, little is known about the regulatory mechanisms governing DC generation. Here, we show that prostaglandin E2 (PGE2) is required for optimal Flt3 ligand–mediated DC development and regulates expression of the Flt3 receptor on DC-committed progenitor cells. Inhibition of PGE2 biosynthesis reduces Flt3-mediated activation of STAT3 and expression of the antiapoptotic protein survivin, resulting in increased apoptosis of DC-committed progenitor cells. Reduced DC development caused by diminished PGE2 signaling is reversed by overexpression of Flt3 or survivin in DC progenitors and conversely is mimicked by STAT3 inhibition. PGE2 regulation of DC generation is specifically mediated through the EP1 and EP3 G protein PGE2 receptors. These studies define a novel DC progenitor regulatory pathway in which PGE2 signaling through EP1/EP3 receptors regulates Flt3 expression and downstream STAT3 activation and survivin expression, required for optimal DC progenitor survival and DC development in vivo.