bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study
Authors: Blanco Jesús , Muriel-Bombín Arturo , Sagredo Víctor , Taboada Francisco , Gandía Francisco , Tamayo Luís , Collado Javier , García-Labattut Ángel , Carriedo Demetrio , Valledor Manuel , De Frutos Martín , López María-Jesús , Caballero Ana , Guerra José , Álvarez Braulio , Mayo Agustín , Villar Jesús ,   the Grupo de Estudios y Análisis en Cuidados Intensivos (G.R.E.C.I.A.)
Published: July 2012

Abstract
Introduction
Sepsis is a leading cause of admission to non-cardiological intensive care units (ICUs) and the second leading cause of death among ICU patients. We present the first extensive dataset on the epidemiology of severe sepsis treated in ICUs in Spain.

Methods
We conducted a prospective, observational, multicentre cohort study, carried out over two 3-month periods in 2002. Our aims were to determine the incidence of severe sepsis among adults in ICUs in a specific area in Spain, to determine the early (48 h) ICU and hospital mortality rates, as well as factors associated with the risk of death.

Results
A total of 4,317 patients were admitted and 2,619 patients were eligible for the study; 311 (11.9%) of these presented at least 1 episode of severe sepsis, and 324 (12.4%) episodes of severe sepsis were recorded. The estimated accumulated incidence for the population was 25 cases of severe sepsis attended in ICUs per 100,000 inhabitants per year. The mean logistic organ dysfunction system (LODS) upon admission was 6.3; the mean sepsis-related organ failure assessment (SOFA) score on the first day was 9.6. Two or more organ failures were present at diagnosis in 78.1% of the patients. A microbiological diagnosis of the infection was reached in 209 episodes of sepsis (64.5%) and the most common clinical diagnosis was pneumonia (42.8%). A total of 169 patients (54.3%) died in hospital, 150 (48.2%) of these in the ICU. The mortality in the first 48 h was 14.8%. Factors associated with early death were haematological failure and liver failure at diagnosis, acquisition of the infection prior to ICU admission, and total LODS score on admission. Factors associated with death in the hospital were age, chronic alcohol abuse, increased McCabe score, higher LODS on admission, ΔSOFA 3-1 (defined as the difference in the total SOFA scores on day 3 and on day 1), and the difference of the area under the curve of the SOFA score throughout the first 15 days.

Conclusions
We found a high incidence of severe sepsis attended in the ICU and high ICU and hospital mortality rates. The high prevalence of multiple organ failure at diagnosis and the high mortality in the first 48 h suggests delays in diagnosis, in initial resuscitation, and/or in initiating appropriate antibiotic treatment.
Ventilator-associated pneumonia in patients undergoing major heart surgery: an incidence study in Europe
Authors: Hortal Javier , Muñoz Patricia , Cuerpo Gregorio , Litvan Hector , Rosseel Peter M , Bouza Emilio ,   the European Study Group on Nosocomial Infections,   the European Workgroup of Cardiothoracic Intensivists
Published: July 2012

Abstract
Introduction
Patients undergoing major heart surgery (MHS) represent a special subpopulation at risk for nosocomial infections. Postoperative infection is the main non-cardiac complication after MHS and has been clearly related to increased morbidity, use of hospital resources and mortality. Our aim was to determine the incidence, aetiology, risk factors and outcome of ventilator-associated pneumonia (VAP) in patients who have undergone MHS in Europe.

Methods
Our study was a prospective study of patients undergoing MHS in Europe who developed suspicion of VAP. During a one-month period, participating units submitted a protocol of all patients admitted to their units who had undergone MHS.

Results
Overall, 25 hospitals in eight different European countries participated in the study. The number of patients intervened for MHS was 986. Fifteen patients were excluded because of protocol violations. One or more nosocomial infections were detected in 43 (4.4%) patients. VAP was the most frequent nosocomial infection (2.1%; 13.9 episodes per 1000 days of mechanical ventilation). The microorganisms responsible for VAP in this study were: Enterobacteriaceae (45%), Pseudomonas aeruginosa (20%), methicillin-resistant Staphylococcus aureus (10%) and a range of other microorganisms. We identified the following significant independent risk factors for VAP: ascending aorta surgery (odds ratio (OR) = 6.22; 95% confidence interval (CI) = 1.69 to 22.89), number of blood units transfused (OR = 1.08 per unit transfused; 95% CI = 1.04 to 1.13) and need for re-intervention (OR = 6.65; 95% CI = 2.10 to 21.01). The median length of stay in the intensive care unit was significantly longer (P < 0.001) in patients with VAP than in patients without VAP (23 days versus 2 days). Death was significantly more frequent (P < 0.001) in patients with VAP (35% versus 2.3%).

Conclusions
Patients undergoing aortic surgery and those with complicated post-intervention courses, requiring multiple transfusions or re-intervention, constitute a high-risk group probably requiring more active preventive measures.
Cancer of the ampulla of Vater: analysis of the whole genome sequence exposes a potential therapeutic vulnerability
Authors: Demeure Michael J , Craig David W , Sinari Shripad , Moses Tracy M , Christoforides Alexis , Dinh Jennifer , Izatt Tyler , Aldrich Jessica , Decker Ardis , Baker Angela , Cherni Irene , Watanabe April , Koep Lawrence , Lake Douglas , Hostetter Galen , Trent Jeffrey M , Von Hoff Daniel D , Carpten John D 
Published: July 2012

Abstract
Background
Recent advances in the treatment of cancer have focused on targeting genomicaberrations with selective therapeutic agents. In rare tumors, where large-scaleclinical trials are daunting, this targeted genomic approach offers a newperspective and hope for improved treatments. Cancers of the ampulla of Vater arerare tumors that comprise only about 0.2% of gastrointestinal cancers.Consequently, they are often treated as either distal common bile duct orpancreatic cancers.

Methods
We analyzed DNA from a resected cancer of the ampulla of Vater and whole blood DNAfrom a 63 year-old man who underwent a pancreaticoduodenectomy by whole genomesequencing, achieving 37× and 40× coverage, respectively. We determinedsomatic mutations and structural alterations.

Results
We identified relevant aberrations, including deleterious mutations of KRAS and SMAD4 as well as a homozygous focal deletion of the PTEN tumor suppressor gene. These findings suggest that these tumors have adistinct oncogenesis from either common bile duct cancer or pancreatic cancer.Furthermore, this combination of genomic aberrations suggests a therapeuticcontext for dual mTOR/PI3K inhibition.

Conclusions
Whole genome sequencing can elucidate an oncogenic context and expose potentialtherapeutic vulnerabilities in rare cancers.
Symmetry-Itemized Enumeration of Cubane Derivatives as Three-Dimensional Entities by the Partial-Cycle-Index Method of the USCI Approach
Authors: Fujita Shinsaku 
Published: July 2012

Abstract
By placing chiral and achiral proligands on the eight positions of a cubane skeleton of Oh, resulting cubane derivatives are counted as three-dimensional (3D) structural isomers by the partial-cycle-index (PCI) method of the unit-subduced-cycle-index (USCI) approach (S. Fujita, Symmetry and Combinatorial Enumeration in Chemistry, Springer-Verlag, 1991; S. Fujita, Diagrammatical Approach to Molecular Symmetry and Enumeration of Stereoisomers, University of Kragujevac, Kragujevac, 2007), where the numbers of 3D structural isomers with given constitutional formulas are itemized with the subsymmetries of Oh. For this purpose, partial cycle indices with chirality fittingness (PCI-CFs) for respective subgroups of Oh are calculated by using unit subduced cycle indices with chirality fittingness (USCI-CFs) and an inverse matrix of the mark table of Oh. After introducing ligand-inventory functions into the PCI-CFs, expansions of the resulting equations provide us with generating functions for giving the numbers of 3D structural isomers. A Maple program source for counting cubane derivatives as 3D structural isomers is given as an example of practical calculation for listing the resulting data in tabular forms.
Numbering of vertebrae on MRI using a PACS cross-referencing tool
Authors: Paik Nam Chull , Lim Chun Soo , Jang Ho Suk 
Published: July 2012

Background For the detection and documentation of numeric variations on spine magnetic resonance imaging (MRI), different techniques have previously been introduced. However, these methods require additional special imaging algorithms, software, or devices. We intend to introduce a vertebral numbering method using the existing picture archiving and communication system (PACS) and MRI system. Purpose To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. Material and Methods This study was a retrospective review of 224 consecutive patients who underwent both lumbar MRI with cervicothoracic scan and whole spine radiographic examinations. A radiologist and a neurosurgeon independently counted the number of presacral vertebrae in a cranial-to-caudal approach with cross-referencing of cervicothoracic and lumbar MRI sagittal series on the PACS workstation. Radiographic numbering from the cervical through the thoracic to the lumbar vertebrae, as a reference standard, was completed independently by the two reviewers. An analysis of the inter-observer and intermodality agreements of radiography and MRI was done. Results In all cases except one, concordant numbering existed between the two modalities of MRI cross-referencing and radiographs combination. Both observers agreed completely, with no inter-observer discordance. Conclusion The number of vertebrae could be identified consistently by counting caudally from C2 with cross-referencing cervicothoracic and lumbosacral sagittal MRI scans on the PACS workstation.
Is the aim of the English health care system to maximize QALYs?
Authors: Shah Koonal , Praet Cecile , Devlin Nancy , Sussex Jonathan , Appleby John , Parkin David 
Published: July 2012

Objectives: To compare the types of benefit considered relevant by the English Department of Health with those included by the National Institute for Health and Clinical Excellence (NICE) when conducting economic evaluations of options for spending limited health care resources. Methods: We analysed all policy Impact Assessments (IAs)carried out by the Department of Health(DH)in 2008 and 2009. The stated benefits of each policy were extracted and thematic analysis was used to categorise these. Results: 51 Impact Assessments were analysed, eight of which mentioned quality-adjusted life year (QALY) gains as a benefit. 18 benefits other than QALY gains were identified. Apart from improving health outcomes, commonly referred to benefits included: reducing costs, improving quality of care, and enhancing patient experience. Many of the policies reviewed were implemented on the basis of benefits unrelated to health outcome. The methods being used to apply a monetary valuation to QALY gains (in cost-benefit calculations) are not consistent across Impact Assessments or with NICE's stated threshold range. Conclusions: The Department of Health and NICE approach resource allocation decisions in different ways, based upon overlapping but not congruent considerations and underlying principles. Given that all these decisions affect the allocation of the same fixed health care budget, there is a case for establishing a uniform framework for option appraisal and priority setting so as to avoid allocative inefficiency. The same applies to any other national health care system.
Evaluating the Quality of Performance of Medication Reconciliation on Hospital Admission
Authors: Miller Daniel F. , Garcia Danielle , Kreys Tiffany-Jade , Phan Stephanie V. , Vandenberg Amy , Garrison Kelli L. 
Published: July 2012

Purpose To assess the quality of the performance of the medication reconciliation process during hospital admission. Methods Subjects were randomized by facility over a 30-day period. Standardized questionnaires were utilized to obtain demographic information, drug allergies, and medication histories. This information was compared with medication reconciliation forms completed upon hospital admission. The primary outcome was the percent of accurate forms completed by the admitting clinician. Secondary outcomes were the accuracy of individual components of the medication order and the time required to accurately reconcile medications. Results One hundred fourteen medication reconciliation forms were audited; over half the subjects were white males with a mean age of 51 years and a median of 7 home medications. Accurate medication reconciliation was documented on 13% of forms. Allergies were consistent among providers in 59% of patients. Of 742 medication orders, the number of inaccuracies was as follows: wrong dose (108, 14.6%), wrong frequency (108, 14.6%), wrong route (54, 7.3%), and wrong medication (25, 3.4%). Omissions (204) and commissions (98) occurred at a rate of 1.79 and 0.86, respectively (114 forms evaluated). The majority of patient/caregiver, outpatient provider, and retail pharmacy interviews required 15 minutes or less to complete. Conclusions Though a national benchmark does not exist for the quality of medication reconciliation performed on hospital admission, there are opportunities to increase the accuracy of medication information obtained during hospital admission.
Parents' Support and Knowledge of Their Daughters' Lives, and Females' Early Sexual Initiation In Nine European Countries
Authors: Madkour Aubrey Spriggs , Farhat Tilda , Halpern Carolyn Tucker , Gabhainn Saoirse nic , Godeau Emmanuelle 
Published: July 2012

CONTEXTAssociations between early sexual initiation and parental support and knowledge have not been uniformly tested in multiple European population‐based samples. Understanding such associations is important in efforts to discourage females’ early sex.METHODSData were compiled for 7,466 females aged 14–16 who participated in the 2005–2006 Health Behaviors in School‐Aged Children survey in nine countries (Austria, Finland, Greece, Hungary, Iceland, Lithuania, Romania, Spain and Ukraine). Univariate, bivariate and multivariable analyses were run with standard error corrections and weights to assess how sexual initiation before age 16 was related to maternal and paternal support and knowledge of daily activities.RESULTSPrevalence of early sexual initiation ranged from 7% (in Romania) to 35% (in Iceland). In bivariate analyses, maternal and paternal support were significantly negatively related to adolescent females’ early sexual initiation in most countries. In models with demographic controls, parental support was negatively associated with early sexual initiation (odds ratio, 0.8 for maternal and 0.7 for paternal). After parental knowledge was added, early sexual initiation was no longer associated with parental support, but was negatively associated with maternal and paternal knowledge (0.7 for each). These patterns held across countries.CONCLUSIONSParental knowledge largely explained negative associations between parental support and early initiation, suggesting either that knowledge is more important than support or that knowledge mediates the association between support and early sex.
Digital Signal Processor based Performance Investigation of Indirect Current Controlled Active Power Filter for Power Quality Improvement
Authors: Gupta Nitin , Singh S. P. , Dubey S. P. , Palwalia D. K. 
Published: July 2012

Abstract
This paper presents a novel Digital Signal Processor (DSP) based control algorithm for 3-phase shunt active power filter (APF) using neural network and indirect current control strategy to eliminate current harmonics and reactive power compensation under ideal and distorted supply voltage. The compensation process is based on sensing of source current instead of filter current, and thus differs from conventional techniques for elimination of switching ripples. Fundamental frequency signal extraction is done using adaptive linear neuron (ADALINE) network from distorted voltage signal without using low-pass filter or phase-locked-loop block. ADALINE gives simple, robust and accurate design for selected frequency extraction. Instead of calculating oscillating and reactive power, the reference generation is used to calculate average active power component. Various simulation results are presented to study the performance of proposed design during steady-state and transient conditions of non-linear loads using MATLAB/ Simulink tool under sinusoidal and distorted supply voltage conditions. Simulated response has been validated with a laboratory prototype using a Texas make floating-point TMS320F28335 DSP. Based on the simulated and experimental results it can be concluded that the spectral performance of the input current are in compliance with the harmonic limits imposed by IEEE-519 standard.
Design and Performance Evaluation of STATCOM Supplementary Modulation Controller in Power Systems
Authors: Tummala Trjyothsna , K VAISAKH 
Published: July 2012

Abstract
Damping of low-frequency electro-mechanical oscillations is essential for reliable operation of power systems. The fast acting, power electronics based FACTS controllers which are capable of improving both steady state and dynamic performance permit enhanced approaches to system stabilization. This paper presents the control laws and location index proposed for a static synchronous compensator (STATCOM) based on a circuit analogy of the electro-mechanical system. The signals which are used can be synthesized using locally available measurements. A detailed study of small signal analysis is carried out to study the effectiveness of the control law and strategic location of the damping controller. With the objective of damping oscillations, a nonlinear constrained optimization technique has been presented for tuning the controller parameters with and without phase compensation. Transient stability analysis has then been performed with STATCOM for a multimachine power system. Comparison of the optimization technique with that of the classical root locus method shows improvement of stability obtained with the former. Case studies on a single machine infinite bus system, three machine system and ten machine systems illustrate the effect of STATCOM on transient stability and its accurate prediction.
Micro-optics: a micro-tutorial
Authors: Zappe Hans 
Published: July 2012

Abstract
Micro-optics represents a rich discipline with many features not found in classical optics. Yet micro-optics is not merely ‘small optics’. Using the technologies of microfabrication, entirely new fabrication processes, new materials and new types of optical devices have been conceived. Here, we provide a brief introduction to the field, discussing a variety of miniaturized optical components, as well as the materials from which they are made and the novel technologies used to fabricate them. Designed as a tutorial, this brief précis includes adequate literature references to guide the interested reader to more in-depth treatments.
Hybrid hyperchromats for chromatic confocal sensor systems
Authors: Hillenbrand Matthias , Mitschunas Beate , Wenzel Christian , Grewe Adrian , Ma Xuan , Feßer Patrick , Bichra Mohamed , Sinzinger Stefan 
Published: July 2012

Abstract
The combination of diffractive and refractive elements in hybrid optical systems allows for precise control of the longitudinal chromatic aberration. We provide comprehensive design strategies for hybrid hyperchromatic lenses that maximise the longitudinal chromatic aberrations. These lenses are mainly used in chromatic confocal sensor systems for efficient non-contact profilometry as well as for measurements of distances and wall thicknesses of transparent materials. Our design approach enables the tailoring of the sensor properties to the specific measurement problem and assists designers in finding optimised solutions for industrial applications. We, for example, demonstrate a hybrid system that significantly exceeds the longitudinal chromatic aberration of purely diffractive elements.
Current state of diagnostic technologies in the autoimmunology laboratory
Authors: Tozzoli Renato , Bonaguri Chiara , Melegari Alessandra , Antico Antonio , Bassetti Danila , Bizzaro Nicola 
Published: July 2012

Abstract
The methods for detecting and measuring autoantibodies have evolved markedly in recent years, encompassing three generations of analytical technologies. Many different immunoassay methods have been developed and used for research and laboratory practice purposes, from the early conventional (or monoplex) analytical methods able to detect single autoantibodies to the more recent multiplex platforms that can quantify tens of molecules. Although it has been in use for over 50 years, indirect immunofluorescence remains the standard method for research on many types of autoantibodies, due to its characteristics of diagnostic sensitivity and also to recent technological innovations which permit it a greater level of automation and standardization. The recent multiplex immunometric methods, with varying levels of automation, present characteristics of higher diagnostic accuracy, but are not yet widely diffused in autoimmunology laboratories due to the limited number of autoantibodies that are detectable, and due to the high cost of reagents and systems. Technological advancement in autoimmunology continues to evolve rapidly, and in the coming years new proteomic techniques will be able to radically change the approach to diagnostics and possibly also clinical treatment of autoimmune diseases. The scope of this review is to update the state of the art of technologies and methods for the measurement of autoantibodies, with special reference to innovations in indirect immunofluorescence and in multiple proteomic methods.
Measurement of wood shrinkage in jack pine using three dimensional digital image correlation (DIC)
Authors: Peng Mingkai , Ho Yi-Chieh , Wang Wei-Chung , Chui Ying Hei , Gong Meng 
Published: July 2012

Abstract
Dimensional stability is one of the most important properties of lumber. Shrinkage is especially critical in this regard. In this study, longitudinal, radial and tangential shrinkages in jack pine (Pinus banksiana) have been found to be 0.4, 3.3 and 5.7%, respectively, by means of three dimensional digital image correlation (3D DIC). Full field shrinkage data were extracted from two types of specimen. It was demonstrated that the 3D DIC method is a suitable method of providing localized shrinkage values. The shrinkages in the three anatomical dimensions exhibit different variation patterns from pith to bark. Detailed shrinkage measurements provided data for a better understanding and modeling of shrinkage within a tree stem, which could be useful for lumber distortion simulation.