bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sudden death in patients receiving drugs tending to prolong the QT interval
Authors: Jolly Kate , Gammage Michael D. , Cheng Kar Keung , Bradburn Peter , Banting Miriam V. , Langman Michael J. S. 
Published: July 2009

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Drugs slowing electocardiographic QT conduction can cause tachyarrhythmias, torsades de pointes (TdP) and cardiac arrest.• Associated risks of sudden death have been consistently found for older, typical, antipsychotic drugs, but epidemiological evidence of risks for other drugs are poorly defined. WHAT THIS STUDY ADDS • In a population‐based study risk of sudden death with noncardiac drug treatment was mainly posed by antipsychotics both typical and atypical, and by antidepressants, particularly selective serotonin reuptake inhibitors.• Results could not be accounted for by confounding.• No significant risk was associated with use of other noncardiac or psychiatric drugs.• A published general categorization of risk of drug‐induced TdP corresponded poorly with these findings.AIMSTo examine risks of sudden death in the community associated with drugs grouped by their risk of causing torsades de pointes (TdP) and to explore the risks for individual drugs.METHODSCase–control study comparing prior drug intakes and morbidities, using the Arizona classification of drugs causing TdP. Participants included 1010 patients dying suddenly where post‐mortem examination did not identify a clear cause of death, and 3030 matched living controls from primary care.RESULTSNoncardiac drug risk was posed by antipsychotics and antidepressants. Significantly raised odds ratios (ORs) were found for takers of typical and atypical antipsychotics, ORs [95% confidence interval] 3.94 (2.05, 7.55) and 4.36 (2.54, 7.51), and of selective serotonin reuptake inhibitors [SSRIs] rather than tricyclic antidepressants, ORs 2.21 (1.61, 3.05) and 1.44 (0.96, 2.13). No significant risk was associated with other, noncardiac or psychiatric drugs, OR 1.09 (0.85, 1.41). Arizona classified drugs considered to raise risk of TdP were associated with raised risk of sudden death, as were those only weakly associated with TdP and not considered to pose a risk in normal use, ORs 2.08 (1.45, 3.00) and 1.74 (1.33, 2.28), respectively.CONCLUSIONSAtypical and typical antipsychotic drug use were both strongly associated with raised risks, as were SSRIs. Tricyclic antidepressants were not associated with raised risks. The Arizona classification of risk of TdP was a poor predictor of likelihood of noncardiac drug‐associated sudden death.
Effects of an experimental drought on the functioning of a cacao agroforestry system, Sulawesi, Indonesia
Authors: SCHWENDENMANN LUITGARD , VELDKAMP EDZO , MOSER GERALD , HÖLSCHER DIRK , KÖHLER MICHAEL , CLOUGH YANN , ANAS ISWANDI , DJAJAKIRANA GUNAWAN , ERASMI STEFAN , HERTEL DIETRICH , LEITNER DANIELA , LEUSCHNER CHRISTOPH , MICHALZIK BEATE , PROPASTIN PAVEL , TJOA AIYEN , TSCHARNTKE TEJA , Van STRAATEN OLIVER 
Published: July 2009

AbstractAgroforestry systems may play a critical role in reducing the vulnerability of farmers' livelihood to droughts as tree‐based systems provide several mechanisms that can mitigate the impacts from extreme weather events. Here, we use a replicated throughfall reduction experiment to study the drought response of a cacao/Gliricidia stand over a 13‐month period. Soil water content was successfully reduced down to a soil depth of at least 2.5 m. Contrary to our expectations we measured only relatively small nonsignificant changes in cacao (−11%) and Gliricidia (−12%) sap flux densities, cacao leaf litterfall (+8%), Gliricidia leaf litterfall (−2%), soil carbon dioxide efflux (−14%), and cacao yield (−10%) during roof closure. However, cacao bean yield in roof plots was substantially lower (−45%) compared with control plots during the main harvest following the period when soil water content was lowest. This indicates that cacao bean yield was more sensitive to drought than other ecosystem functions. We found evidence in this agroforest that there is complementary use of soil water resources through vertical partitioning of water uptake between cacao and Gliricidia. This, in combination with acclimation may have helped cacao trees to cope with the induced drought. Cacao agroforests may thus play an important role as a drought‐tolerant land use in those (sub‐) tropical regions where the frequency and severity of droughts is projected to increase.
Host–parasite interactions and vectors in the barn swallow in relation to climate change
Authors: MØLLER A. P. 
Published: July 2009

AbstractRecent climate change has affected the phenology of numerous species, and such differential changes may affect host–parasite interactions. Using information on vectors (louseflies, mosquitoes, blackflies) and parasites (tropical fowl miteOrnithonyssus bursa, the louseflyOrnithomyia avicularia, a chewing louseBrueeliasp., two species of feather mitesTrouessartia cruciferaandTrouessartia appendiculata, and two species of blood parasitesLeucozytozoon whitworthiandHaemoproteus prognei) of the barn swallowHirundo rusticacollected during 1971–2008, I analyzed temporal changes in emergence and abundance, relationships with climatic conditions, and changes in the fitness impact of parasites on their hosts. Temperature and rainfall during the summer breeding season of the host increased during the study. The intensity of infestation by mites decreased, but increased for the lousefly during 1982–2008. The prevalence of two species of blood parasites increased during 1988–2008. The timing of first mass emergence of mosquitoes and blackflies advanced. These temporal changes in phenology and abundance of parasites and vectors could be linked to changes in temperature, but less so to changes in precipitation. Parasites had fitness consequences for hosts because intensity of the mite and the chewing louse was significantly associated with delayed breeding of the host, while a greater abundance of feather mites was associated with earlier breeding. Reproductive success of the host decreased with increasing abundance of the chewing louse. The temporal decrease in mite abundance was associated with advanced breeding of the host, while the increase in abundance of the lousefly was associated with earlier breeding. Virulence by the tropical fowl mite decreased with increasing temperature, independent of confounding factors. These findings suggest that climate change affects parasite species differently, hence altering the composition of the parasite community, and that climate change causes changes in the virulence of parasites. Because the changing phenology of different species of parasites had both positive and negative effects on their hosts, and because the abundance of some parasites increased, while that of other decreased, there was no consistent temporal change in host fitness during 1971–2008.
At work or play: A comparison of private property vehicle crashes with those occurring on public roads in north Queensland
Authors: Blackman Ross , Cheffins Tracy , Veitch Craig , O'Connor Teresa 
Published: July 2009

AbstractObjective:  To define characteristics of vehicle crashes occurring on rural private property in north Queensland with an exploration of associated risk factors. Design:  Descriptive analysis of private property crash data collected by the Rural and Remote Road Safety Study. Setting:  Rural and remote north Queensland. Participants:  A total of 305 vehicle controllers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measure:  A structured questionnaire completed by participants covering crash details, lifestyle and demographic characteristics, driving history, medical history, alcohol and drug use and attitudes to road use. Results:  Overall, 27.9% of interviewees crashed on private property, with the highest proportion of private road crashes occurring in the North West Statistical Division (45%). Risk factors shown to be associated with private property crashes included male sex, riding off‐road motorcycle or all‐terrain vehicle, first‐time driving at that site, lack of licence for vehicle type, recreational use and not wearing a helmet or seatbelt. Conclusions:  Considerable trauma results from vehicle crashes on rural private property. These crashes are not included in most crash data sets, which are limited to public road crashes. Legislation and regulations applicable to private property vehicle use are largely focused on workplace health and safety, yet work‐related crashes represent a minority of private property crashes in north Queensland.
Otitis media in Aboriginal children: The discordance between burden of illness and access to services in rural/remote and urban Australia
Authors: Gunasekera Hasantha , Morris Peter S , Daniels John , Couzos Sophie , Craig Jonathan C 
Published: July 2009

Objective:  To compare the burden of otitis media (OM) managed by Aboriginal Medical Service (AMS) practitioners and the availability of specialist ear health services in rural/remote versus urban Australian settings.Design, Setting and Participants:  We mailed questionnaires to all Australian AMS medical practitioners managing children in December 2006. Questions addressed the frequency of childhood OM cases seen, and the availability and waiting times for audiology; ear, nose and throat (ENT); and hearing‐aid services. We compared rural/remote and urban practitioner's responses using the χ2 test with clustering adjustments.Results:  Questionnaires were returned by 63/87 (72%) AMSs and by 131/238 (55%) eligible practitioners. Rural/Remote practitioners reported managing a greater number of children with OM per week than urban practitioners (1 df, P= 0.02) and a larger proportion of the children they managed having OM (1 df, P= 0.009). More rural/remote than urban practitioners reported relevant services were not available locally: audiology (11.1 vs. 0%, P= 0.038), ENT (33.3 vs. 3.9%, P= 0.0004) and hearing‐aid provision (37.7 vs. 1.9%, P < 0.0001). More rural/remote practitioners reported audiology waiting times longer than the recommended 3 months (18.3 vs. 1.9%, P= 0.007). Equal proportions reported ENT waiting times longer than the recommended 6 months (13.9 vs. 11.3%, P= 0.7).Conclusions:  Rural/Remote AMS practitioners manage a greater OM burden than urban AMS practitioners, but affected children have less access to specialist ear health services and longer waiting times. One in five rural/remote Aboriginal children wait longer than recommended for audiology testing, and one in eight Aboriginal children nationwide wait longer than recommended for ENT services.
Assessment of the burden of paediatric empyema in Australia
Authors: Strachan Roxanne , Jaffé Adam 
Published: July 2009

Aims:  To investigate the change in incidence of childhood empyema and pneumonia in Australia, and ascertain the management trends in all hospitals caring for children with empyema.Methods:  The incidences of empyema and pneumonia were calculated for each year between 1993/1994 and 2004/2005 using retrospective primary diagnostic coding from ICD‐9 and 10 comprising the Australian National Hospital Morbidity Database for five age groups in patients less than 20 years of age. Hospitals with allocated paediatric beds were surveyed on referral pattern and treatment preferences.Results:  In this study, 145 562 patients with pneumonia were admitted with a mean (range) incidence of 2306 (1846–2652) per million. The trend towards an overall increase was not statistically significant. Only the 1–4 years old age group demonstrated a significant increase (P < 0.01, r2= 0.61). A total of 469 cases of empyema were identified with a mean incidence of 7.35 (4–10.2) per million. There was an overall increase in incidence (P < 0.05, r2= 0.51) reflecting an increase in the 1‐ to 4‐year‐olds (P < 0.005, r2= 0.60) and 15‐ to 19‐year‐olds (P < 0.05, r2= 0.37). The overall percentage of empyema as a proportion of pneumonia increased from 0.27 to 0.70% (0.48% (0.27–0.70%), P < 0.05, r2= 0.38). The survey response rate was 75%. Ninety‐nine of 121 (82%) hospitals referred children with empyema to a more appropriate centre with wide variations in treatments provided.Conclusions:  The rise in incidence of empyema reflects that seen in other countries. Furthermore, there are diverse management practices suggesting a clear need for national guidelines.
Emergency management of paediatric status epilepticus in Australia and New Zealand: Practice patterns in the context of clinical practice guidelines
Authors: Babl Franz E , Sheriff Nisa , Borland Meredith , Acworth Jason , Neutze Jocelyn , Krieser David , Ngo Peter , Schutz Jacquie , Thomson Fiona , Cotterell Elizabeth , Jamison Sarah , Francis Peter 
Published: July 2009

Aims:  To establish current acute seizure management through a review of clinical practice guidelines (CPGs) and reported physician management in the 11 largest paediatric emergency departments in Australia (n= 9) and New Zealand (n= 2) within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network, and to compare this with Advanced Paediatric Life Support (APLS) guidelines and existing evidence.Methods:  (i) Review of CPGs for acute seizure management at PREDICT sites. (ii) A standardised anonymous survey of senior emergency doctors at PREDICT sites investigating management of status epilepticus (SE).Results:  Ten sites used seven different seizure CPGs. One site had no seizure CPG. First line management was with benzodiazepines (10 sites). Second line and subsequent management included phenytoin (10), phenobarbitone (10), thiopentone (9), paraldehyde (6) and midazolam infusion (5). Of 83 available consultants, 78 (94%) responded. First line management of SE without intravenous (IV) access included diazepam per rectum (PR) (49%), and midazolam intramuscular (41%) and via the buccal route (9%). First line management of SE with IV access included midazolam IV (50%) and diazepam IV (44%). The second line agent was phenytoin (88%); third line agents were phenobarbitone (33%), thiopentone and intubation (32%), paraldehyde PR (22%) and midazolam infusion (6%). Fourth line agents were thiopentone and intubation (60%), phenobarbitone (16%), midazolam infusion (13%) and paraldehyde (9%).Conclusions:  Initial seizure management by CPG recommendations and reported physician practice was broadly similar across PREDICT sites and consistent with APLS guidelines. Practice was variable for second/third line SE management. Areas of controversy would benefit from multi‐centred trials.
The web‐building spider Theridion impressum (Araneae: Theridiidae) is not adversely affected by Bt maize resistant to corn rootworms
Authors: Meissle Michael , Romeis Jörg 
Published: July 2009

SummaryThe growth of genetically engineered maize that produces the insecticidal protein Cry3Bb1 from Bacillus thuringiensis (Bt) is an effective method to control corn rootworms (Diabrotica spp.), which are threatening maize production in North America and Europe. In this study, the risk of Cry3Bb1‐expressing maize for the predatory spider Theridion impressum, a common species in European maize fields, was assessed. Quantification of Cry3Bb1 in potential prey species collected in Bt maize plots and prey spectrum analysis revealed that T. impressum ingests Cry3Bb1 in the field. Exposure to the Bt protein, however, was highly variable because some potential prey species, such as phloem‐feeding herbivores and predators, contained little or no Cry3Bb1, whereas leaf‐feeding herbivores contained high concentrations. Adult and juvenile T. impressum spiders were fed with Cry3Bb1‐containing food (prey or maize pollen) for 8 weeks in the laboratory to examine the toxicity of the Bt protein. No differences in mortality, weight development or offspring production were observed between spiders provided with food containing or not containing Cry3Bb1. Retrospective power analysis indicated that the bioassays were sufficiently sensitive to detect meaningful differences if present. Although Cry3Bb1 is ingested by the spider in the field, our data provide no evidence for toxicity. Consequently, the growth of corn rootworm‐resistant Bt maize appears to pose no risk for T. impressum.
Ancient DNA perspective on the failed introduction of mongooses in Italy during the XXth century
Authors: Gaubert P. , Zenatello M. 
Published: July 2009

AbstractWe used ancient DNA techniques to amplify mitochondrial DNA fragments [cytochrome b (cyt b) and control region (CR)] from four museum specimens that represent, to our knowledge, the last testimony of the introduction of – now extinct – mongooses in Italy. We assessed the identity, origin and genetic variability of Italian mongooses using a species‐level assignation Bayesian approach and haplotype network analysis. The genetic diversity (cyt b and CR) among Italian individuals was null. The cyt b sequences from the four museum specimens clearly established the Indian grey mongoose Herpestes edwardsii as the species having been introduced in Italy in the mid‐XXth century. The latter had at least been released twice within a period of 10 years (Circeo NP and Capalbio, c. 200 km northward), probably from the same captive stock of the Giardino Zoologico di Roma. Assessment of genetic variability and haplotype network including native representatives of H. edwardsii suggested that the introduced pool likely originated from Pakistan or India. It appears that a combination of deleterious factors including low genetic diversity, restricted range and nonadaptation to western Palaearctic winter conditions is responsible for the extinction of the species in Italy. However, the lack of knowledge on the life‐history traits and population dynamics of H. edwardsii prevents from further discussion of the factors that likely promoted its extinction process.
Estimating the Quantity and Economic Value of Family Caregiving for Community‐Dwelling Older Persons in the Last Year of Life
Authors: Rhee YongJoo , Degenholtz Howard B. , Lo Sasso Anthony T. , Emanuel Linda L. 
Published: July 2009

OBJECTIVES: To estimate the quantity and economic value of informal care provided to older persons during their final year of life in the community.DESIGN: Retrospective analysis of publicly available nationally representative survey data.SETTING: This retrospective study used data from the Health and Retirement Study, a nationally representative, longitudinal study of community‐dwelling older people.PARTICIPANTS: Older people who died between 2000 and 2002.MEASUREMENTS: Data were extracted from the 2002 “exit survey” and linked with characteristics of caregivers from the helper file. Ordinary least squares regression was used to estimate hours of informal caregiving for community‐dwelling older people (N=990). Adjusted hours were multiplied by the 2002 national average home aide wage ($9.16 per hour). Sensitivity tests were performed using the 10th percentile wage rate ($6.56) and 90th percentile wage rate ($12.34).RESULTS: Older people who died in the community received on average 65.8 hours per week of informal care in the last year of life. The estimated economic value ranges from $22,514 to $42,351, which is equivalent to the annual direct replacement cost with a home aide in 2002.CONCLUSION: Family members provide substantial assistance during the last year of life for older people who die in the community. If the informal care provided in the last year of life is replaced with a home aide, the total economic value for the United States would be approximately $1.4 billion (in 2002).
The Effects of Dehydroepiandrosterone (DHEA)/DHEA-Sulfate (DHEAS) on the Contraction Responses of the Clitoral Cavernous Smooth Muscle from Female Rabbits
Authors: Lee Shin Young , Myung Soon Chul , Lee Moo Yeol , Kim Tae Hyoung , Kim Sae Chul , Kim Kyung Do , Park Soo Hyun , Kim Won Yong 
Published: July 2009

ABSTRACTIntroductionDehydroepiandrosterone (DHEA) is a multifunctional steroid that is increasingly available as a supplement aimed at improving libido and well-being in postmenopausal women in the recent times. Together with its sulfate version, DHEA-sulfate (DHEAS), it is the most abundant steroid in humans. The clitoris is an important component of the female sexual response, with its increased vascular response during sexual arousal that results in erection.AimsTo elucidate the direct effects of DHEA/DHEAS on the vasomotor reactivity of the rabbit clitoral cavernosum.MethodsTwenty New Zealand white female rabbits weighing approximately 2.5–3 kg were used in the study.Main Outcome MeasuresThe contractile response of clitoral cavernous smooth muscle strips in response to phenylephrine (PE; 10−9–10−4 M) were observed in rabbits. Additionally, DHEA/DHEAS effects on phenylephrine-induced contraction and/or acetylcholine-induced relaxation of phenylephrine-induced contraction were measured.ResultsDHEA/DHEAS did not elicit any remarkable response in the resting state. However, both DHEA and DHEAS evoked dose-dependent relaxations of PE-induced contraction. The contractile responses to high potassium were significantly decreased in the DHEA/DHEAS-pretreated strips, compared with the DHEA/DHEAS-nontreated strips. Additionally, contractions by Bay K 8644 (10−7–10−6 M) treatment were also significantly inhibited by DHEA/DHEAS. DHEA-induced relaxation responses were stronger than DHEAS-induced relaxation responses. Various K channel blockers, tetraethylammonium (TEA; 1 mM, 10 mM), 4-aminopyridine (10 µM) and glibenclamide (10 µM) did not affect the DHEA/DHEAS-induced relaxation on muscle strips contracted by PE. Relaxation responses by acetylcholine or sodium nitroprusside (SNP) were not changed after DHEA/DHEAS pretreatment.ConclusionsDHEA/DHEAS was found to induce a relaxation response in rabbit clitoral cavernosal smooth muscle, and this is thought to be mediated by direct inhibition of a voltage-dependent calcium channel.
Helping a Man with Leprosy: A Case Study
Authors: Guimarães Heloísa C. Q. C. P. , Barros Alba L. B. L. , Bassoli Sidinéia R. B. , Salotti Selma R. A. , Oda Roseli M. , Lunney Margaret 
Published: July 2009

PURPOSE.  This case study illustrates nursing diagnoses and interventions for a man with leprosy.DATA SOURCES.  Data sources were published literature on the disease of leprosy, and the experience and expertise of the authors in working with people with leprosy.DATA SYNTHESIS.  Data were synthesized using the standardized nursing languages of North American Nursing Diagnosis Association International and the Nursing Interventions Classification. The accuracy of the diagnoses and the appropriateness of the nursing interventions were supported by the positive health outcomes of the patient.CONCLUSIONS.  Although leprosy has been eradicated in some countries, the risk of new cases is present anywhere that Mycobacterium leprae still exists. The recommended treatment of multibacilar polychemotherapy has lowered the rate of new cases in Brazil.IMPLICATIONS FOR NURSING PRACTICE.  Nurses need to incorporate evidence‐based practice interventions for leprosy‐based wound care, and nurses should encourage persons with leprosy to maintain regular medical care with multibacilar polychemotherapy.