bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Implications of Preoperative E/e′ Ratio in Patients with Off-pump Coronary Artery Surgery
Authors: Lee Eun-Ho , Yun Sung-Cheol , Chin Ji-Hyun , Choi Dae-Kee , Son Hyo-Jung , Kim Wook-Chong , Choi Seong-Soo , Song Jun-Gol , Hahm Kyung-Don , Sim Ji-Yeon , Choi In-Cheol 
Published: January 2012

Background
The ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e') correlates with left ventricular (LV) filling pressure. In particular, an E/e' ratio more than 15 is an excellent predictor of increased LV filling pressure. The authors evaluated the prognostic implications of preoperative estimated LV filling pressure, assessed by E/e' ratio, in patients undergoing off-pump coronary artery bypass graft surgery.

Methods
This observational study investigated 1,048 consecutive adults undergoing elective off-pump coronary artery bypass graft surgery. The primary outcome was occurrence of major adverse cardiac events (MACE), defined as a composite of death, myocardial infarction, malignant ventricular arrhythmia, cardiac dysfunction, or need for new revascularization. Logistic regression and survival analyses were performed.

Results
An E/e' ratio more than 15 was independently associated with 30-day MACE (odds ratio 2.4, 95% CI 1.4-3.9, P = 0.001) and 1-yr MACE (hazard ratio 2.1, 95% CI 1.4-3.1, P = 0.001), irrespective of underlying LV ejection fraction. MACE free 1-yr survival rate was significantly decreased in patients with E/e' >15, irrespective of underlying LV ejection fraction.

Conclusions
Increased LV filling pressure, assessed by E/e' ratio, is an independent predictor of 30-day and 1-yr MACE in patients who undergo elective off-pump coronary artery bypass graft surgery. These findings indicate that measurements of E/e' may assist in preoperative risk stratification of these patients.
Feasibility of Closed-loop Titration of Propofol and Remifentanil Guided by the Spectral M-Entropy Monitor
Authors: Liu Ngai , Le Guen Morgan , Benabbes-Lambert Fatima , Chazot Thierry , Trillat Bernard , Sessler Daniel I. , Fischler Marc 
Published: January 2012

Background
This randomized controlled trial describes automated coadministration of propofol and remifentanil, guided by M-Entropy analysis of the electroencephalogram. The authors tested the hypothesis that a novel dual-loop controller with an M-Entropy monitor increases time spent within predetermined target entropy ranges.

Methods
Patients scheduled for elective surgery were randomly assigned in this single-blind study using a computer-generated list, to either dual-loop control using a proportional-integral-derivative controller or skilled manual control of propofol and remifentanil using target-controlled-infusion systems. In each group, propofol and remifentanil administration was titrated to a state entropy target of 50 and was subsequently targeted to values between 40 and 60. The primary outcome was the global score, which included the percentage of state entropy or response entropy in the range 40-60, the median absolute performance error and wobble. Data are presented as medians [interquartile range].

Results
Thirty patients assigned to the dual-loop group and 31 assigned to the manual group completed the study. The dual-loop controller was able to provide induction and maintenance for all patients. The Global Score of State Entropy was better maintained with dual-loop than manual control (25 [19-53] vs. 44 [25-110], P = 0.043), and state entropy was more frequently maintained in the range of 40-60 (80 [60-85] vs. 60 [35-82]%, P = 0.046). Propofol (4.1 [2.9-4.9] vs. 4.5 [3.4-6.3] mg · kg(-1) · h(-1)) and remifentanil (0.18 [0.13-0.24] vs. 0.19 [0.15-0.26] μg · kg(-1) · min(-1)) consumptions and the incidence of somatic side effects were similar.

Conclusion
Intraoperative automated control of hypnosis and analgesia guided by M-Entropy is clinically feasible and more precise than skilled manual control.
Ketamine-induced Neuroapoptosis in the Fetal and Neonatal Rhesus Macaque Brain
Authors: Brambrink Ansgar M. , Evers Alex S. , Avidan Michael S. , Farber Nuri B. , Smith Derek J. , Martin Lauren D. , Dissen Gregory A. , Creeley Catherine E. , Olney John W. 
Published: January 2012

Background
Exposure of rhesus macaque fetuses for 24 h or neonates for 9 h to ketamine anesthesia causes neuroapoptosis in the developing brain. The current study clarifies the minimum exposure required for and the extent and spatial distribution of ketamine-induced neuroapoptosis in rhesus fetuses and neonates.

Method
Ketamine was administered by IV infusion for 5 h to postnatal day 6 rhesus neonates or to pregnant rhesus females at 120 days' gestation (full term = 165 days). Three hours later, fetuses were delivered by cesarean section, and the fetal and neonatal brains were studied for evidence of apoptotic neurodegeneration, as determined by activated caspase-3 staining.

Results
Both the fetal (n = 3) and neonatal (n = 4) ketamine-exposed brains had a significant increase in apoptotic profiles compared with drug-naive controls (fetal n = 4; neonatal n = 5). Loss of neurons attributable to ketamine exposure was 2.2 times greater in fetuses than in neonates. The pattern of neurodegeneration in fetuses was different from that in neonates, and all subjects exposed at either age had a pattern characteristic for that age.

Conclusion
The developing rhesus macaque brain is sensitive to the apoptogenic action of ketamine at both a fetal and neonatal age, and exposure duration of 5 h is sufficient to induce a significant neuroapoptosis response at either age. The pattern of neurodegeneration induced by ketamine in fetuses was different from that in neonates, and loss of neurons attributable to ketamine exposure was 2.2 times greater in the fetal than neonatal brains.
Natural History of Helicobacter pylori Infection in Mexican Schoolchildren
Authors: Duque Ximena , Vilchis Jenny , Mera Robertino , Trejo‐Valdivia Belem , Goodman Karen J. , Mendoza Maria‐Eugenia , Navarro Fabiola , Roque Victoria , Moran Segundo , Torres Javier , Correa Pelayo 
Published: January 2012

ABSTRACTObjectives:The aim of the present study was to estimate the incidence and spontaneous clearance rate of Helicobacter pylori infection and the effect of some variables on these outcomes in schoolchildren.Methods:From May 2005 to December 2010, 718 schoolchildren enrolled in 3 public boarding schools in Mexico City participated in the follow‐up. At the beginning of the study and every 6 months thereafter, breath samples were taken to detect H pylori infection; blood samples and anthropometric measurements were taken to evaluate nutritional status. Data on sociodemographic characteristics were collected.Results:The prevalence of H pylori infection was 38%. The incidence rate was 6.36%/year. Schoolchildren with anemia or iron deficiency at the beginning of the study (who received iron supplements) showed a higher infection acquisition rate than those with normal iron nutritional status, hazard ratio (HR) 12.52 (95% confidence interval [CI] 4.01%–39.12%), P < 0.001 and HR 2.05 (95% CI 1.09%–3.87%), P = 0.027, respectively. The spontaneous clearance rate of the infection was 4.74%/year. The spontaneous clearance rate was higher in children who had iron deficiency (who received iron supplements), HR 5.02 (95% CI 1.33%–18.99%), P = 0.017, compared with those with normal nutritional iron status. It was lower in schoolchildren with ≥2 siblings compared with schoolchildren with 1 or no siblings, HR 0.23 (95% CI 0.08%–0.63%), P = 0.004.Conclusions:H pylori infection status is dynamic in schoolchildren. Variables related to health status and infection transmission, such as iron status and number of siblings, are important for the incidence and spontaneous clearance of H pylori infection.
Protective Antibody Responses to Influenza A/H1N1/09 Vaccination in Children With Celiac Disease
Authors: Schäppi Michela G. , Meier Sara , Bel Michael , Siegrist Claire‐Anne , Posfay‐Barbe Klara M. ,   H1N1 Study Group
Published: January 2012

ABSTRACTPatients with celiac disease have an increased risk for severe influenza infection and they show less of a response to certain vaccine types. During the influenza A/H1N1/09 pandemic, we prospectively investigated pandemic vaccine responses in 14 pediatric patients with celiac disease and age‐/sex‐matched controls. All of the children with celiac disease reached protective antibody titers (≥40) and showed a geometric mean titer comparable with the control group (530 vs 573).
Feasibility and Efficacy of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Children
Authors: Di Giorgio Angelo , Agazzi Roberto , Alberti Daniele , Colledan Michele , D'Antiga Lorenzo 
Published: January 2012

ABSTRACTObjectives:Transjugular intrahepatic portosystemic shunt (TIPS) is a valuable tool in managing complications of severe portal hypertension (PH) in adults. In children, TIPS is regarded as a temporary and technically demanding procedure. We report the first paediatric series of TIPS and review its feasibility and efficacy in children.Methods:Children with severe PH that is unresponsive to nonselective β‐blockers and endoscopic treatment were considered candidates for TIPS placement with an expanded polytetrafluoroethylene‐covered Viatorr stent graft. Indications were cirrhotic PH, noncirrhotic PH, and portal vein thrombosis, in both native and transplanted livers.Results:Thirteen children were selected for TIPS between 2005 and 2010. The indications were bleeding in 8 (61.5%) and ascites in 5 (38.5%). TIPS was successfully placed in 11 children, median age 9.8 years (range 2.2–18) and median weight 30 kg (11.5–96). Two patients had a portal cavernoma and 3 had received split liver transplantation. Following TIPS, the portosystemic gradient decreased to 10 mmHg (5–15 mmHg) (P < 0.00001); PH complications resolved in 10 of 11 patients (91%); no patient developed clinical encephalopathy; and 3 patients required a TIPS revision. All of the shunts were patent at last follow‐up (20.4 months, range 0.2–67) in 7 or liver transplantation (6 months, 1.5–33) in 4.Conclusions:Our results suggest that TIPS is feasible and effective in children with ascites or gastrointestinal bleeding unresponsive to medical and endoscopic treatment. TIPS should become part of the armamentarium that is used to manage PH complications in children, both in native livers and in transplanted grafts, as a bridge to transplantation and for long‐term management.
Tolerance to lipopolysaccharide promotes an enhanced neutrophil extracellular traps formation leading to a more efficient bacterial clearance in mice
Authors: Landoni V I , Chiarella P , Martire-Greco D , Schierloh P , van-Rooijen N , Rearte B , Palermo M S , Isturiz M A , Fernández G C 
Published: January 2012

SummaryTolerance to lipopolysaccharide (LPS) constitutes a stress adaptation, in which a primary contact with LPS results in a minimal response when a second exposure with the same stimulus occurs. However, active important defence mechanisms are mounted during the tolerant state. Our aim was to assess the contribution of polymorphonuclear neutrophils (PMN) in the clearance of bacterial infection in a mouse model of tolerance to LPS. After tolerance was developed, we investigated in vivo different mechanisms of bacterial clearance. The elimination of a locally induced polymicrobial challenge was more efficient in tolerant mice both in the presence or absence of local macrophages. This was related to a higher number of PMN migrating to the infectious site as a result of an increased number of PMN from the marginal pool with higher chemotactic capacity, not because of differences in their phagocytic activity or reactive species production. In vivo, neutrophils extracellular trap (NET) destruction by nuclease treatment abolished the observed increased clearance in tolerant but not in control mice. In line with this finding, in vitro NETs formation was higher in PMN from tolerant animals. These results indicate that the higher chemotactic response from an increased PMN marginal pool and the NETs enhanced forming capacity are the main mechanisms mediating bacterial clearance in tolerant mice. To sum up, far from being a lack of response, tolerance to LPS causes PMN priming effects which favour distant and local anti-infectious responses.
Seasonal carbon dynamics and water fluxes in an Amazon rainforest
Authors: Kim Yeonjoo , Knox Ryan G. , Longo Marcos , Medvigy David , Hutyra Lucy R. , Pyle Elizabeth H. , Wofsy Steven C. , Bras Rafael L. , Moorcroft Paul R. 
Published: January 2012

AbstractSatellite‐based observations indicate that seasonal patterns in canopy greenness and productivity in the Amazon are negatively correlated with precipitation, with increased greenness occurring during the dry months. Flux tower measurements indicate that the canopy greening that occurs during the dry season is associated with increases in net ecosystem productivity (NEP) and evapotranspiration (ET). Land surface and terrestrial biosphere model simulations for the region have predicted the opposite of these observed patterns, with significant declines in greenness, NEP, and ET during the dry season. In this study, we address this issue mainly by developing an empirically constrained, light‐controlled phenology submodel within the Ecosystem Demography model version 2 (ED2). The constrained ED2 model with a suite of field observations shows markedly improved predictions of seasonal ecosystem dynamics, more accurately capturing the observed patterns of seasonality in water, carbon, and litter fluxes seen at the Tapajos National Forest, Brazil (2.86°S, 54.96°W). Long‐term simulations indicate that this light‐controlled phenology increases the resilience of Amazon forest NEP to interannual variability in climate forcing.
Can mechanism help explain insect host choice?
Authors: CUNNINGHAM J. P. 
Published: January 2012

AbstractEvolutionary theory predicts that herbivorous insects should lay eggs on plants in a way that reflects the suitability of each plant species for larval development. Empirical studies, however, often fail to find any relationship between an adult insect’s choice of host–plant and offspring fitness, and in such cases, it is generally assumed that other ‘missing’ factors (e.g. predation, host–plant abundance, learning and adult feeding sites) must be contributing to overall host suitability. Here, I consider an alternative theory – that a fitness cost inherent in the olfactory mechanism could constrain the evolution of insect host selection. I begin by reviewing current knowledge of odour processing in the insect antennal lobe with the aid of a simple schematic: the aim being to explain the workings of this mechanism to scientists who do not have prior knowledge in this field. I then use the schematic to explore how an insect’s perception of host and non‐host odours is governed by a set of processing rules, or algorithm. Under the assumptions of this mechanistic view, the perception of every plant odour is interrelated, and seemingly bad host choices can still arise as part of an overall adaptive behavioural strategy. I discuss how an understanding of mechanism can improve the interpretation of theoretical and empirical studies in insect behaviour and evolution.
Abdominal Exploration in Captive Collared Peccaries (Tayassu tajacu) by Ultrasonography
Authors: Peixoto G. C. X. , Oliveira I. R. S. , Alves N. D. , Oliveira M. F. , Silva A. R. 
Published: January 2012

SummaryThis study determines the morphology and ultrasound features of the abdominal organs in male, nestling and healthy collared peccaries. The bladder wall is hyperechogenic, with a thickness of 0.2 ± 0.08 cm. The kidneys present a well‐defined cortex, medulla and pelvis, and the dimensions are 2.56 ± 0.3 × 4.6 ± 0.8 cm for the left and 2.51 ± 0.4 × 4.86 ± 1.1 cm for the right kidney. The spleen has a uniform echotexture over its entire surface. The largest dimensions of the liver are 2.0 ± 0.57 cm for the left lobe and 1.42 ± 0.66 cm for the caudate lobe. The liver presents a homogeneous echotexture in the majority of cases, but sometimes some hyperechoic spots are present. The stomach wall has a thickness of 0.42 ± 0.28 cm. The bowel loops show alternate hyperechoic and hypoechoic layers with a uniform diameter and a wall thickness of 0.19 ± 0.07 cm.
Pilot study on the acceptance of mobile teledermatology for the home monitoring of high‐need patients with psoriasis
Authors: Frühauf Julia , Schwantzer Gerold , Ambros‐Rudolph Christina M , Weger Wolfgang , Ahlgrimm‐Siess Verena , Salmhofer Wolfgang , Hofmann‐Wellenhof Rainer 
Published: January 2012

ABSTRACTBackground/Objectives:  The willingness to be educated is one of the highest desires among patients with psoriasis. Therefore, a collaborative model of management would appear to be essential in enhancing patient satisfaction in this challenging condition. The present study aimed at examining the applicability of a mobile teledermatology service in this regard and assessing the association between patient acceptance and perceived health‐related quality of life.Methods:  High‐need patients with psoriasis performed visits over 12 weeks transmitting clinical images together with some relevant clinical information via mobile phones to teledermatologists, who provided treatment instructions. Ten patients and two teledermatologists completed 20‐item patient (weeks 6 and 12) and 10‐item physician (at week 12) acceptance questionnaires. In addition, patients answered the dermatology life quality index (DLQI) at weeks 0, 6 and 12.Results:  Both patients and teledermatologists were pleased with the service with high acceptance rates (patients: 81.0% at week 6 and 82.9% at week 12; teledermatologists: 74.0%). In addition, 80% of the patients considered the service an alternative to in‐person consultation and 90% felt they were in good hands but had achieved a more flexible and empowered lifestyle. No significant correlations were found between patient acceptance and DLQI. Both teledermatologists found the service a convenient and reliable tool for patient monitoring. Neither patients nor teledermatologists thought further in‐person consultations necessary.Conclusion:  Mobile teledermatology is a valuable tool for the home monitoring of patients with psoriasis that makes a meaningful difference in their lives. It is well accepted by both patients and the physicians involved.
Differential responses of plants, reptiles and birds to grazing management, fertilizer and tree clearing
Authors: DORROUGH J. , MCINTYRE S. , BROWN G. , STOL J. , BARRETT G. , BROWN A. 
Published: January 2012

AbstractThe relative effects of tree clearing, increased livestock densities and nutrient enrichment have rarely been compared across markedly different organism types, but negative effects are generally predicted. In contrast, adoption of rotational grazing is thought to benefit biodiversity in pastures but there are few supporting data. We examined the response of native plants, birds and reptiles to livestock management in south‐eastern Australia. We selected 12 pairs of rotationally and continuously grazed farms. Two 1‐ha plots were established in native pastures on each farm, one cleared and the second still retaining woodland tree cover. Stocking rates, fertilizer histories and landscape tree cover varied among farms. The abundance and richness of all taxa was lower in cleared pastures. The less mobile organisms (reptiles and plants) were positively correlated with tree cover at landscape scales, but only when trees were present at the plot scale. This pattern was driven by a few observations in landscapes with approximately 50% tree canopy cover. Neither bird abundance nor richness was correlated with stocking rates or nutrient enrichment, but plant richness responded negatively to both. The response of reptiles varied, declining with nutrient enrichment but positively correlated with livestock densities. These responses may be partly interpreted within the context of prior filtering of species pools through long‐term grazing pressure. No taxa responded positively to rotational grazing management. We predict that reductions in livestock density and soil nutrients will directly benefit plants and less so reptiles, but not birds. Indirect benefits are predicted for birds and reptiles if management increases persistence of trees within paddocks. Although some forms of rotational grazing can increase woodland tree recruitment, rotational grazing in itself is unlikely to enhance diversity.
General anesthesia without intravenous access in children – a survey of current practice among members of the APAGBI and UK regional representatives of the APAGBI and the AAGBI
Authors: Pettigrew Tom , Adewale Lola , Morton Neil S. 
Published: January 2012

SummaryBackground:  The establishment of intravenous (IV) access should be considered for all adults and children undergoing general anesthesia. Inhalational induction prior to the establishment of IV access remains a popular technique in pediatric practice, and most practitioners will subsequently obtain IV access at the earliest opportunity. Previous surveys have indicated that some anesthetists may elect to omit IV access for the duration of anesthesia and surgery; however, the extent of this practice is unclear. A survey of pediatric anesthetists (members of the APAGBI and regional representatives of both the APAGBI and the AAGBI) was conducted to determine the prevalence of anesthesia without IV access in children, together with the circumstances in which this would be considered by practitioners.Method:  A web‐based survey was distributed via email to members of the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) and regional representatives of both the APAGBI and the Association of Anesthetists of Great Britain and Ireland (AAGBI). In total, 1419 invitations to complete the survey were sent.Results:  Seven hundred and twenty seven completed surveys were returned, indicating a response rate of 51%. Twenty‐eight respondents reported that they did not anesthetize children age <16 years. Of the remaining 699 respondents, 295 (42%) described circumstances where intravenous access was omitted during general anesthesia. The vast majority (84.7%) indicated that this was a rare occurrence. Only 44 (6.3%) respondents indicated they would always or usually undertake procedures under general anesthesia in children without IV access. Respondents suggested that short procedures, including dental extractions and myringotomy, were circumstances in which this practice was acceptable.Conclusion:  The majority of respondents to this survey reported that they would usually establish IV access in children undergoing general anesthesia except in specific circumstances.