bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term dynamics of organic matter and elements exported as coarse particulates from two Caribbean montane watersheds
Authors: Heartsill Scalley T. , Scatena F. N. , Moya S. , Lugo A. E. 
Published: February 2012

Abstract:In heterotrophic streams the retention and export of coarse particulate organic matter and associated elements are fundamental biogeochemical processes that influence water quality, food webs and the structural complexity of forested headwater streams. Nevertheless, few studies have documented the quantity and quality of exported organic matter over multiple years and under a range of conditions that includes both droughts and hurricanes. This study quantifies the export of coarse particulate organic matter (CPOM, > 12.7 mm), over 18 y in two headwater streams in north-east Puerto Rico. Daily exports ranged from 0 to over 170 g ha−1 d−1 and averaged 7.39 g ha−1 d−1, with similar amounts coming from leaves (3.5 g ha−1 d−1) and wood (3.2 g ha−1 d−1). Export of coarse particulate organic carbon was 3.0 g ha−1 d−1 which constitutes only 1.32% of carbon exports. Most litter falling into the streams was processed in place as only 2.3% of the leaf litter falling directly into these perennial channels was exported as CPOM. On average, 6 wk y−1 had no exports while events transporting more than 10 g ha−1 d−1 occurred every 2.8 mo. Instead of a single annual pulse as observed in deciduous systems, there were annual peaks in CPOM exports during May and September and less export during the drier period from December to February. Ratios of C:N in the exported material were highest in the driest month and lowest during rainy months, while leaf fluxes for nitrogen, phosphorus and calcium were highest in rainy months and lowest during February. Although median daily exports and exports during low- and base-flow periods were similar before and after Hugo, after 16 y exports during moderate- and high-flow periods were still less than those in the 2 y prior to the hurricane. Our observations indicate a system with high rates of internal processing that quickly returns to median daily conditions following hurricanes but requires several decades for storm-flow exports to return to pre-disturbance conditions and indicates that the long-term pattern of CPOM export is associated with the level of maturity of watershed vegetation.
Coping with herbivory at the juvenile stage: responses to defoliation and stem browsing in the African savanna tree Colophospermum mopane
Authors: Hartnett David C. , Ott Jacqueline P. , Sebes Kathryn , Ditlhogo Marks K. 
Published: February 2012

Abstract:Responses of plants to herbivory are dependent on the type of damage and the ontogenetic stage of the plant. We compared the effects of stem pruning and defoliation on seedlings of Colophospermum mopane, an ecologically important tree species widely distributed in southern Africa. The growth of 160 greenhouse-grown juveniles were measured for 6-mo after germination and then 6-mo after treatments including 50% defoliation, 100% defoliation, 50% stem pruning and controls. Pruning resulted in 30% reductions in total leaf area, height and biomass. Partial defoliation resulted in 30% reductions in total leaf area and plant biomass. However, complete defoliation resulted in a 30% increase in biomass production, a doubling in leaf and lateral branch number, a 45% reduction in leaf size, and no change in total leaf area. Thus, completely defoliated seedlings showed greater performance than those that were only partially defoliated, indicating that C. mopane has become adapted to the chronic and severe defoliation inflicted by Imbrasia belina caterpillars. Comparison of our results with other studies indicates that C. mopane seedlings are less herbivory-tolerant than adults and that pruning has more negative effects than defoliation. Thus, seedling browsers may constrain recruitment in C. mopane, influencing its population dynamics and abundance.
Leaf nutritional quality as a predictor of primate biomass: further evidence of an ecological anomaly within prosimian communities in Madagascar
Authors: Simmen Bruno , Tarnaud Laurent , Hladik Annette 
Published: February 2012

Abstract:The correlation between the biomass of forest primates and a chemical index of the average nutritional quality of leaves in tropical forests has been repeatedly documented since 1990. We tested the role played by protein : fibre on lemur biomass in a gallery forest in southern Madagascar. Plant species abundance was determined based on transect censuses. We calculated an average ratio of protein-to-fibre in leaves and an abundance-weighted ratio, i.e. the mean weighted by the basal area of tree species, to be compared with the figures available for other forest ecosystems in Madagascar and a number of anthropoid habitats. Lemur densities were evaluated through compilation of previous studies made from prior to 1975 and up until 2011 based on strip censuses and/or identification of all groups supplemented with new censuses. A high mean ratio of protein to fibre (> 0.4) supports high folivore biomass at 390 kg km−2(reaching 630 kg km−2in the closed-canopy forest area) compared with primate communities in other Malagasy forests (protein : fibre: < 0.5; folivore biomass: < 440 kg km−2), as predicted. However, the data corroborate the finding that the total biomass of lemur communities as well as the biomass of folivorous lemur species are low compared with those of African and Asian primate communities for a given protein : fibre ratio. Tree diversity and leaf production do not consistently explain this pattern. In contrast, the extinction of large folivorous lemurs during the past two millennia presumably allowed too little time for smaller-sized species to evolve equally effective morphological and physiological specializations for processing a large range of fibrous foods.
Rationale and design of the NO-PARTY trial: near-zero fluoroscopic exposure during catheter ablation of supraventricular arrhythmias in young patients
Authors: Casella Michela , Dello Russo Antonio , Pelargonio Gemma , Bongiorni Maria Grazia , Del Greco Maurizio , Piacenti Marcello , Andreassi Maria Grazia , Santangeli Pasquale , Bartoletti Stefano , Moltrasio Massimo , Fassini Gaetano , Marini Massimiliano , Di Cori Andrea , Di Biase Luigi , Fiorentini Cesare , Zecchi Paolo , Natale Andrea , Picano Eugenio , Tondo Claudio 
Published: February 2012

AbstractIntroductionRadiofrequency catheter ablation is the mainstay of therapy for supraventricular tachyarrhythmias. Conventional radiofrequency catheter ablation requires the use of fluoroscopy, thus exposing patients to ionising radiation. The feasibility and safety of non-fluoroscopic radiofrequency catheter ablation has been recently reported in a wide range of supraventricular tachyarrhythmias using the EnSite NavX™ mapping system. The NO-PARTY is a multi-centre, randomised controlled trial designed to test the hypothesis that catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system results in a clinically significant reduction in exposure to ionising radiation compared with conventional catheter ablation.MethodsThe study will randomise 210 patients undergoing catheter ablation of supraventricular tachyarrhythmias to either a conventional ablation technique or one guided by the EnSite NavX™ mapping system. The primary end-point is the reduction of the radiation dose to the patient. Secondary end-points include procedural success, reduction of the radiation dose to the operator, and a cost-effectiveness analysis. In a subgroup of patients, we will also evaluate the radiobiological effectiveness of dose reduction by assessing acute chromosomal DNA damage in peripheral blood lymphocytes.ConclusionsNO-PARTY will determine whether radiofrequency catheter ablation of supraventricular tachyarrhythmias guided by the EnSite NavX™ mapping system is a suitable and cost-effective approach to achieve a clinically significant reduction in ionising radiation exposure for both patient and operator.
Impact of Highly Active Antiretroviral Therapy on paediatric Human Immunodeficiency Virus-associated left ventricular dysfunction within the Johannesburg teaching hospital complex
Authors: Pepeta Lungile , Cilliers Antoinette M. 
Published: February 2012

AbstractObjectiveTo analyse the outcome of children with left ventricular dysfunction placed on Highly Active Antiretroviral Therapy.MethodThis study is a retrospective review of records of Human Immunodeficiency Virus-positive children with left ventricular dysfunction. Demographic data were collected. Left ventricular fractional shortening, CD4 percentage, viral load, and nutritional status were compared before and during antiretroviral therapy.ResultsWe reviewed the records of 34 Human Immunodeficiency Virus-positive children with left ventricular dysfunction. In all, 18 patients received antiretroviral therapy (group one) and 16 were antiretroviral therapy naive (group two). The median age of group one at initial visit was 94 months, with a male-to-female ratio of 1:1. Of those, 17 children showed improved left ventricular function on treatment, with an increase in fractional shortening (median: 17–33.5%; p less than 0.0001). There was no significant statistical difference between the groups regarding initial fractional shortening. In group one, the CD4 percentage improved (median: 12% to 30.5%; p less than 0.0001), with viral load suppression (median: 24,900 copies per millilitre to less than 25 copies per millilitre; p less than 0.0001). There was weight gain in group one (median z-score: −1.70 to −1.32; p equal to 0.0083). Proper statistical analysis in group two was not possible because of poor follow-up of patients.ConclusionThe findings are in keeping with other reports that have shown improvement in left ventricular function in patients with Human Immunodeficiency Virus-associated cardiomyopathy treated with Highly Active Antiretroviral Therapy. Recovery of myocardial function is associated with improvement in immunological and nutritional statuses.
Is myocardial performance index useful in differential diagnosis of moderate and severe hypoxic–ischaemic encephalopathy? A serial Doppler echocardiographic evaluation
Authors: Karaarslan Sevim , Alp Hayrullah , Baysal Tamer , Çimen Derya , Örs Rahmi , Oran Bülent 
Published: February 2012

AbstractIntroductionThe aim of this study was to investigate the importance of myocardial performance index as an additive criterion to Sarnat criteria in differential diagnosis of newborn babies with moderate and severe hypoxic–ischaemic encephalopathy.MethodsOur study group included 50 healthy term newborn babies and 20 newborn babies with hypoxic–ischaemic encephalopathy. The 20 newborn babies with hypoxic–ischaemic encephalopathy were scored using Sarnat grades. Left and right ventricular functions were determined on the first day and thereafter in the 1, 3–4, 6–7, and 11–12 months of life by M-Mode and pulsed Doppler.ResultsMyocardial performance indexes of the left ventricle were significantly higher in the severe hypoxic–ischaemic encephalopathy group than in the control group during the first, second, and third analyses (p = 0.01, p = 0.02, p = 0.02, respectively) and only during the first analysis (p = 0.01) in the moderate hypoxic–ischaemic encephalopathy group. In addition, the myocardial performance indexes of the right ventricle were significantly higher during the first, second, and third analyses in both severe and moderate hypoxic–ischaemic encephalopathy groups than in the control group (p = 0.01, all). Hypoxia-induced alterations last longer in the right ventricle than in the left ventricle in the moderate group, as during the second and third analyses myocardial performance index continues to be higher than the control group.ConclusionMyocardial performance indexes for the left and right ventricles were significantly higher in both severe and moderate hypoxic–ischaemic encephalopathy groups than in the control group during the first analysis, and myocardial performance index greater than or equal to 0.5 can be used in order to distinguish moderate and severe hypoxic–ischaemic encephalopathy babies according to Sarnat grades as a discriminative additive criterion.
Free Recall Memory Performance after Aneurysmal Subarachnoid Hemorrhage
Authors: Sheldon Signy , Macdonald R. Loch , Schweizer Tom A. 
Published: February 2012

AbstractMemory deficits for survivors of aneurysmal subarachnoid hemorrhage (SAH) are common, however, the nature of these deficits is not well understood. In this study, 24 patients with SAH and matched control participants were asked to study six lists containing words from four different categories. For half the lists, the categories were presented together (organized lists). For the remaining lists, the related words were presented randomly to maximize the use of executive processes such as strategy and organization (unorganized lists). Across adjoining lists, there was overlap in the types of categories given, done to promote intrusions. Compared to control participants, SAH patients recalled a similar number of words for the organized lists, but significantly fewer words for the unorganized lists. SAH patients also reported more intrusions than their matched counterparts. Separating patients into anterior communicating artery ruptures (ACoA) and ruptures in other regions, there was a recall deficit only for the unorganized list for those with ACoA ruptures and deficits across both list types for other rupture locations. These results suggest that memory impairment following SAH is likely driven by impairment in the executive components of memory, particularly for those with ACoA ruptures. Such findings may help direct future cognitive-therapeutic programs. (JINS, 2012, 18, 334–342)
The role of radiotherapy for large and locally advanced non-melanoma skin carcinoma
Authors: Matthiesen Chance , Forest Christina , Thompson J. Spencer , Ahmad Salahuddin , Herman Terence , Bogardus Carl 
Published: February 2012

AbstractBackground: The role of radiotherapy for large and locally advanced non-melanoma skin cancer is unclear. In this report, we aimed to review our institutional experience with patients treated with radiation therapy for T2–T4 NMSC and analyze outcomes.Methods: Seventy patients and 85 lesions were reviewed who received radiotherapy. Fifty-six lesions (65.9%) were untreated, 17 (20.0%) recurrent, and 12 (14.1%) post-operative. Forty-three (50.6%) were staged T2, 20 (23.5%) T3, and 22 (25.9%) T4. Median follow-up was 20 months.Results: Thirty-nine living patients (59.0%) had no evidence of disease, of which 35 (89.7%) required no therapy following radiotherapy. Twenty-seven patients (41.0%) died, of which 10 deaths were attributed to disease progression. Achievement of complete response (CR) to all therapy and radiotherapy alone was, respectively, 95.3% and 86% for T2, 70% and 65% for T3, and 68.2% and 59.1% for T4. Statistically significant factors for CR included basal cell histology (p = 0.005) and tumour stage T2 (0.01).Conclusions: Radiotherapy for T2–T4 NMSC is effective. Basal cell histology and T2 are statistically favoured to achieve CR to radiotherapy alone.
Selecting indicators for international benchmarking of radiotherapy centres
Authors: van Lent W.A.M. , de Beer R.D. , van Triest B. , van Harten W.H. 
Published: February 2012

AbstractIntroduction: Benchmarking can be used to improve hospital performance. It is however not easy to develop a concise and meaningful set of indicators on aspects related to operations management. We developed an indicator set for managers and evaluated its use in an international benchmark of radiotherapy centres. The indicator set assessed the efficiency, patient-centeredness and timeliness of the services delivered.Methods: We identified possible indicators from literature and professionals. Stakeholders’ feedback helped to produce a shortlist of indicators. For this indicator set, data were obtained in a pilot that included four European radiotherapy centres. With these data, the indicators were evaluated on definition clarity, data availability, reliability and discriminative value.Results: Literature produced a gross list of 81 indicators. Based on stakeholder feedback, 33 indicators were selected and evaluated in the benchmark. Six negatively evaluated indicators were adapted, together with eight positively evaluated indicators 14 indicators seemed feasible. Examples of indicators concerned utilisation, waiting times, patient satisfaction and risk analysis.Conclusions: This study provides a pragmatic indicator development process for international benchmarks on operations management. The presented indicators showed to be feasible for use in international benchmarking of radiotherapy centres. The pilot identified attainable performance levels and provided leads for improvements.
Heightened vulnerabilities and better care for all: Disability and end-of-life care
Authors: Stienstra Deborah , D'Aubin April , Derksen Jim 
Published: February 2012

AbstractObjective:The purpose of this study was to assess the extent to which vulnerability was present or heightened as a result of either disability or end-of-life policies, or both, when people with disabilities face end of life.Method:People with disabilities and policy makers from four Canadian provinces and at the federal level were interviewed or participated in focus groups to identify interactions between disability policies and end-of-life policies. Relevant policy documents in each jurisdiction were also analyzed. Key theme analysis was used on transcripts and policy documents. Fact sheets identifying five key issues were developed and shared in the four provinces with policy makers and people with disabilities.Results:Examples of heightened vulnerability are evident in discontinuity from formal healthcare providers with knowledge of conditions and impairments, separation from informal care providers and support systems, and lack of coordination with and gaps in disability-related supports. When policies seek to increase the dignity, autonomy, and capacity of all individuals, including those who experience heightened vulnerability, they can mitigate or lessen some of the vulnerability.Significance of results:Specific policies addressing access to community-based palliative care, coordination between long-standing formal care providers and new care providers, and support and respect for informal care providers, can redress these heightened vulnerabilities. The interactions between disability and end-of-life policies can be used to create inclusive end-of-life policies, resulting in better end-of-life care for all people, including people with disabilities.
“In pain waiting to die”: Everyday understandings of suffering
Authors: Schwartz Karen D. , Lutfiyya Zana Marie 
Published: February 2012

AbstractObjective:The notion of “suffering” is understood in very different ways in a variety of contexts. In palliative care, the relief and prevention of suffering is considered to be a fundamental goal (Pastrana et al., 2008). However, the avoidance of suffering has also been used as an argument by those campaigning for the legalization of euthanasia and assisted suicide (Finlay, 2009). In reflecting upon suffering in these two contexts, we were intrigued by Finlay's (2009) contention that to laypeople, the phrase “‘unbearable suffering’ conjures up images of patients on their deathbeds wracked with uncontrolled pain” (p. 1841).Method:This article explores how suffering is used and understood in an “everyday” discourse, by analyzing comments posted to a website debating assisted suicide in the context of the Canadian case of Sue Rodriguez.Results:Using a broad social approach to discourse analysis (Tonkiss, 2004), three themes emerged in our analysis: (1) when people suffer, (2) how people are understood to suffer, and (3) how suffering should be dealt with. We also examined what was not said in this discussion: there was little consideration of the more holistic goals of palliative care and how suffering might be understood and managed in ways other than within the frame of assisted suicide.Significance of results:Paying attention to the everyday discourse of suffering is important because, as members of society, we all play a role in negotiating the meaning of suffering. Such meaning has a significant impact upon patients and palliative care professionals alike.
Palliative care for vulnerable populations
Authors: Stienstra Deborah , Chochinov Harvey Max 
Published: February 2012

AbstractObjective:The purpose of this article is to identify how inclusive and accessible palliative care can be achieved for all, including those labelled as vulnerable populations.Method:Drawing on a review of existing literature as well the research of the Vulnerable Persons and End-of-Life New Emerging Team (VP-NET), this article reflects on what changes can be made within palliative care to make it more inclusive.Results:Experiences of marginalization often result, intentionally or unintentionally, in differential treatment in healthcare. This increased vulnerability may result from attitudes of healthcare providers or from barriers as a result of “normal” care practices and policies that may exclude or stigmatize certain populations. This may include identifying when palliative care is necessary, who receives palliative care and where, and what is necessary to complement palliative care.Significance of results:Inclusive and accessible palliative care can become possible through building on the existing strengths in palliative care, as well as addressing existing barriers. This may include treating the whole person and that person's support team, including paid support workers, as part of the unit of care. It involves ensuring physically accessible hospice and palliative care locations, as well as thinking creatively about how to include those excluded in traditional locations. Inclusive palliative care also ensures coordination with other care services. Addressing the barriers to access, and inclusion of those who have been excluded within existing palliative care services, will ensure better palliative and end-of-life care for everyone.