bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Intraoperative and Postoperative Blood Glucose Concentrations in Predicting Outcomes after Cardiac Surgery
Authors: Duncan Andra E. , Abd-Elsayed Alaa , Maheshwari Ankit , Xu Meng , Soltesz Edward , Koch Colleen G. 
Published: March 2010

Background
Severe hyperglycemia is associated with adverse outcomes after cardiac surgery. Whether intraoperative and postoperative glucose concentrations equally impact outcomes is unknown. The objective of this investigation was to compare the ability of perioperative glucose concentrations and glycemic variability to predict adverse outcomes. Risk associated with decreasing increments of glucose concentrations, hypoglycemia, and diabetic status was also examined.

Methods
This retrospective analysis of prospectively collected data included 4,302 patients who underwent cardiac surgery between October 3, 2005 and May 31, 2007 at the Cleveland Clinic. Time-weighted mean intraoperative (GlcOR) and postoperative (GlcICU) glucose concentrations were calculated. Patients were categorized as follows: Glc more than 200, 171-200, 141-170, and less than or equal to 140 mg/dl. Coefficient of variation was used to calculate glycemic variability. Logistic regression model with backward selection assessed the relationship between glucose concentrations, variability, and adverse outcomes while adjusting for potential confounders. Another model assessed the predictability of GlcOR and GlcICU on adverse outcomes.

Results
Both GlcOR and GlcICU predicted risk for mortality and morbidity. Increased postoperative glycemic variability was associated with increased risk for adverse outcomes. Severe hyperglycemia (GlcOR and GlcICU > 200 mg/dl) was associated with worse outcomes; however, decreasing increments of GlcOR did not consistently reduce risk. GlcOR less than or equal to 140 mg/dl was not associated with improved outcomes compared with severe hyperglycemia, despite infrequent hypoglycemia. Diabetic status did not influence the effects of hyperglycemia.

Conclusion
Perioperative glucose concentrations and glycemic variability are important in predicting outcomes after cardiac surgery. Incremental decreases of intraoperative glucose concentrations did not consistently reduce risk. Despite rare hypoglycemia, intraoperative glucose concentrations closest to normoglycemia were associated with worse outcomes.
Simulation-based Training Improves Physicians' Performance in Patient Care in High-stakes Clinical Setting of Cardiac Surgery
Authors: Bruppacher Heinz R. , Alam Syed K. , LeBlanc Vicki R. , Latter David , Naik Viren N. , Savoldelli Georges L. , Mazer C. David , Kurrek Matt M. , Joo Hwan S. 
Published: March 2010

Background
Simulation-based training is useful in improving physicians' skills. However, no randomized controlled trials have been able to demonstrate the effects of simulation teaching in real-life patient care. This study aimed to determine whether simulation-based training or an interactive seminar resulted in better patient care during weaning from cardiopulmonary bypass (CPB)-a high stakes clinical setting.

Methods
This study was conducted as a prospective, single-blinded, randomized controlled trial. After institutional research board approval, 20 anesthesiology trainees, postgraduate year 4 or higher, inexperienced in CPB weaning, and 60 patients scheduled for elective coronary artery bypass grafting were recruited. Each trainee received a teaching syllabus for CPB weaning 1 week before attempting to wean a patient from CPB (pretest). One week later, each trainee received a 2-h training session with either high-fidelity simulation-based training or a 2-h interactive seminar. Each trainee then weaned patients from CPB within 2 weeks (posttest) and 5 weeks (retention test) from the intervention. Clinical performance was measured using the validated Anesthesiologists' Nontechnical Skills Global Rating Scale and a checklist of expected clinical actions.

Results
Pretest Global Rating Scale and checklist performances were similar. The simulation group scored significantly higher than the seminar group at both posttest (Global Rating Scale [mean +/- standard error]: 14.3 +/- 0.41 vs. 11.8 +/- 0.41, P < 0.001; checklist: 89.9 +/- 3.0% vs. 75.4 +/- 3.0%, P = 0.003) and retention test (Global Rating Scale: 14.1 +/- 0.41 vs. 11.7 +/- 0.41, P < 0.001; checklist: 93.2 +/- 2.4% vs. 77.0 +/- 2.4%, P < 0.001).

Conclusion
Skills required to wean a patient from CPB can be acquired through simulation-based training. Compared with traditional interactive seminars, simulation-based training leads to improved performance in patient care by senior trainees in anesthesiology.
Lipoproteins and CETP levels as risk factors for severe sepsis in hospitalized patients
Authors: Grion Cintia M. C. , Cardoso Lucienne T. Q. , Perazolo Tatianna F. , Garcia Alexandre S. , Barbosa Décio S. , Morimoto Helena Kaminami , Matsuo Tiemi , Carrilho Alexandre J. F. 
Published: March 2010

Eur J Clin Invest 2010; 40 (4): 330–338AbstractBackground  The magnitude of lipoprotein level reduction during the acute‐phase response may be associated with the severity and mortality of sepsis. However, it remains to be determined whether low lipoprotein levels can be considered a risk factor for developing sepsis. We aimed to investigate lipoprotein levels as risk factors for sepsis in hospitalized patients, and also describe sequential changes in lipoprotein and cholesterol ester transfer protein (CETP) levels during sepsis.Design  This is a prospective cohort study and case–control analysis from selected hospitalized patients. Blood samples were collected at admission, and participants were monitored for severe sepsis. Total cholesterol, high density lipoprotein (HDL), low density lipoprotein, and triglyceride levels were compared between sepsis cases and controls. Cholesterol, apolipoprotein, phospholipid and CETP concentrations were monitored in the case group.Results  Of 1719 enrolled patients, 51 developed severe sepsis and were paired with 71 controls by age, gender, presence of infection at admission and chronic disease. HDL cholesterol level at admission was a risk factor for severe sepsis (OR = 0·969; 95% CI: 0·944–0·995). Mean CETP levels diminished between hospital admission and day 3 of sepsis. The magnitude of this variation (ΔCETP) was more pronounced in non‐survivors (0·78 ± 1·08 μg mL−1) than that in survivors (0·02 ± 0·58 μg mL−1, P = 0·01).Conclusions  HDL cholesterol may have a protective effect against sepsis. Each 1 mg dL−1 increase in HDL decreased the odds of severe sepsis by 3% during hospitalization. The reduction of plasma CETP was associated with mortality.
Circulating levels of osteopontin are closely related to glomerular filtration rate and cardiovascular risk markers in patients with chronic kidney disease
Authors: Lorenzen Johan , Krämer Robert , Kliem Volker , Bode‐Boeger Stefanie M. , Veldink Hendrik , Haller Hermann , Fliser Danilo , Kielstein Jan T. 
Published: March 2010

Eur J Clin Invest 2010; 40 (4): 294–300AbstractBackground  The pleiotropic cytokine osteopontin (OPN) is thought to be involved in the pathogenesis of atherosclerosis. However, the relationship between OPN and renal function, a cardiovascular risk factor itself, is not known. Therefore, we assessed the relationship between OPN plasma levels and renal function in patients at different stages of chronic kidney disease (CKD).Methods  We studied 49 non‐diabetic and non‐smoking patients with primary kidney disease at different CKD stages (K/DOQI 1‐5). True glomerular filtration rate (GFR) in patients was assessed using the inulin‐clearance technique. To examine the role of an abrupt change in GFR on circulating OPN, 15 living related kidney donors were studied before and after unilateral nephrectomy. Twenty matched non‐smoking healthy subjects served as controls.Results  OPN plasma levels in patients with CKD stage 1 (i.e. GFR above 90 mL min−1 1·73 m−2) were comparable with controls. OPN levels increase in a linear fashion with declining GFR (r = −0·9, P < 0·0001), so that the increase in OPN mirrors the severity of renal impairment. After unilateral nephrectomy, circulating OPN increased significantly in parallel to the decrease in GFR. We found a direct association between OPN and other markers of renal function (serum‐creatinine, homocysteine and symmetric dimethylarginine,) as well as with cardiovascular risk factors such as asymmetric dimethylarginine (r = 0·36, P = 0·0213).Conclusion  There is a close inverse association between GFR and circulating OPN in patients with CKD. Furthermore, OPN plasma levels correlate with established cardiovascular risk markers in patients with CKD. Assessment of renal function is important for the interpretation of OPN levels in patients with atherosclerotic disease.
The Haiti Earthquake: a salutary lesson in (non) earthquake engineering
Authors: Styles Peter 
Published: March 2010

A devastating earthquake of magnitude 7 struck very close and almost beneath Port au Prince the capital of Haiti, the western half of the island of Hispaniola, early in the morning of Tuesday, 12 January 2010 (Fig. 1). While in absolute terms this was by no means the largest earthquake recorded this year globally, the death toll is around 230 000, making it one of the world's worst earthquakes in terms of casualties in recorded history, with almost uncountable economic loss to one of the poorest countries in the world.Intensity map of 2010 Haiti earthquake (Image: USGS).image
Assessing the immunopotency of Toll‐like receptor agonists in an in vitro tissue‐engineered immunological model
Authors: Ma Yifan , Poisson Louis , Sanchez‐Schmitz Guzman , Pawar Santosh , Qu Chunfeng , Randolph Gwendalyn J. , Warren William L. , Mishkin Eric M. , Higbee Russell G. 
Published: March 2010

SummaryThe in vitro Peripheral Tissue Equivalent (PTE) module is a three‐dimensional tissue‐engineered endothelial cell/collagen matrix culture system, which has been reported to reproduce in vivo physiological conditions and which generates dendritic cells (DC) autonomously. In the present study, we used the PTE module to investigate the immunopotency of Toll‐like receptor (TLR) agonists, including polyinosine‐polycytidylic acid, Gardiquimod, CpG 2006 and lipopolysaccharide. Application of TLR agonists in the PTE module induced a wide range of cytokines, including interleukins 1α/β, 6, 8 and 10 and tumour necrosis factor‐α. Compared with traditional peripheral blood mononuclear cell (PBMC) cultures, the PTE module produced twofold to 100‐fold higher levels of cytokine secretion, indicating that it can be a highly sensitive assay system. This increased sensitivity is the result of the natural synergy between the leucocytes and the endothelium. Furthermore, the application of TLR agonists, such as lipopolysaccharide and Gardiquimod, to the PTE module enhanced DC differentiation and promoted DC maturation, as indicated by up‐regulated expression of CD83, CD86 and CCR7(CD197). In addition, functional assays indicated PTE‐derived DC treated with Gardiquimod, a TLR‐7 agonist, significantly augmented anti‐tetanus toxoid antibody production. Interestingly, replacing PBMC with purified myeloid cells (CD33+) significantly reduced the responsiveness of the PTE module to TLR stimulation. The reduced sensitivity was partly the result of the removal of plasmacytoid DC that participated in the response to TLR stimulation and sensitization of the PTE module. Overall, the in vitro PTE module clearly demonstrated the effects of TLR agonists on DC generation, maturation and antigen‐presenting capacity, and may serve as a sensitive and predictive test bed for the evaluation of adjuvant candidates.
Beneficial effects of donor‐specific transfusion on renal allograft outcome
Authors: Jovičić Svetlana , Ležaić Visnja , Simonović Ruzica , Djukanović Ljubica 
Published: March 2010

Jovičić S, Ležaić V, Simonović R, Djukanović L. Beneficial effects of donor‐specific transfusion on renal allograft outcome.  Clin Transplant 2011: 25: 317–324. © 2010 John Wiley & Sons A/S.Abstract:  Introduction:  Donor‐specific transfusion (DST) is claimed to improve graft survival in living kidney transplantation. The aim of this study was to determine the influence of DST on the incidence of acute rejection (AR), graft function and survival in the early and late post‐transplantation period in transfusion‐naïve patients.Methods:  Three patient groups were compared: group 1 received DST (n = 18), group 2 patients received no transfusion prior to surgery (n = 13) and group 3 consisted of 132 randomly transfused patients. The DST protocol consisted of infusion of fresh whole donor blood (3 × 150 mL) at two‐wk intervals accompanied by three d of azathioprine. All patients were grafted within one month after the third DST. Triple drug immunosuppression based on cyclosporine A was given to all patients.Results:  DST and polytransfused patients experienced significantly less AR compared with group 2 patients. Two‐yr graft function was significantly better in patients in groups 1 and 3 compared with group 2. Although similar eight‐yr patient and graft survival was found in all the groups, delayed graft function patients had the longest graft half‐life.Conclusion:  DST imposes a significant beneficial effect on the incidence of AR, DGF and graft function during the first post‐transplantation year in transfusion‐naïve patients receiving standard immunosuppression therapy.
Ips typographus population development after a severe storm in a nature reserve in southern Sweden
Authors: Komonen A. , Schroeder L. M. , Weslien J. 
Published: March 2010

AbstractLarge‐scale natural disturbances pose challenges for the management of protected areas and may have undesirable consequences for commercial plantations nearby. A storm, which felled nearly 10 000 m3 of spruce forest in the Osaby nature reserve in southern Sweden, allowed us to study the subsequent population development of the spruce bark beetle (Ips typographus L.). Two summers after the storm, an exceptionally high proportion (74%) of wind‐felled trees had been successfully colonized by the bark beetle, and all living spruce trees had been killed. On standing trees, colonization density was three times higher, and reproductive success one‐fourth, that on wind‐felled trees. The negative relationship between colonization density and reproductive success indicates that intra‐specific competition is one of the main mechanisms reducing I. typographus population growth when the beetles switch from wind‐felled to standing trees after storm disturbances. Indeed, there was no significant difference in beetle production between wind‐felled and standing trees. Furthermore, there were no differences in colonization density, reproductive success or production at different heights in standing trees; however, a higher proportion of the new adults emerged at the tree‐tops rather than lower down before overwintering. Our results also demonstrate that a large proportion (ca. 50%) of the I. typographus population that developed in the storm‐fell area apparently overwintered under the bark of standing trees.
Conflicts between feeding and reproduction in amphibious snakes (sea kraits, Laticauda spp.)
Authors: BRISCHOUX FRANÇOIS , BONNET XAVIER , SHINE RICHARD 
Published: March 2010

AbstractIf reproduction impairs an organism's ability to perform other fitness‐related activities, natural selection may favour behavioural adjustments to minimize these conflicts. This is presumably the reason why many animals are anorexic during the breeding season. We studied amphibious sea snakes, a group whose ecology facilitates teasing apart the causal links between reproduction and feeding. In both Laticauda laticaudata and L. saintgironsi in New Caledonia, adult females cease feeding as their eggs develop. The advantages of foregoing feeding do not relate to thermoregulation (because foraging does not entail lower body temperatures), nor are they attributable to physical constraints on abdominal volume (because in a snake's linear body, there is little overlap between the stomach and the oviducts). Instead, female sea kraits appear to cease feeding because their bodily distension impedes locomotor ability, rendering them less effective at foraging and more vulnerable to aquatic predators.
Familial associations of Alzheimer disease and essential tremor with Parkinson disease
Authors: Costello S. , Bordelon Y. , Bronstein J. , Ritz B. 
Published: March 2010

Background:  We constructed a cohort of first‐degree relatives of participants in a population‐based case–control study of Parkinson disease (PD) and compared the occurrence of Alzheimer disease (AD) and essential tremor (ET) in relatives of PD cases and controls.Methods:  We relied on proband interviews to assess family history in 372 probands with incident PD confirmed by a movement disorder specialist and 404 controls from three rural California counties.Results:  Overall, for the 2980 first‐degree relatives of PD cases, the risk of AD was not increased compared with the 2981 relatives of controls. But relatives of younger onset PD cases (≤60 years of age) were three times more likely to have received an AD diagnosis [hazard ratios (HR): 2.86; 95%CI: 1.44, 5.71]. Our data also suggest that some relatives of PD probands might be at a slightly increased risk of receiving an ET diagnosis, especially relatives of tremor dominant cases (HR: 1.69; 95%CI 0.99, 2.88), younger onset cases (HR: 2.03; 95%CI 0.93, 4.44), and male relatives (HR: 2.31; 95%CI 1.13, 4.73). In addition, fathers of cases were almost 15 years younger than fathers of controls when diagnosed with ET. Results were stable in sensitivity analyses.Conclusion:  Our study suggests a familial susceptibility to AD amongst first‐degree relatives of younger onset PD cases.
Functional magnetic resonance imaging and c‐Fos mapping in rats following a glucoprivic dose of 2‐deoxy‐d‐glucose
Authors: Dodd Garron T. , Williams Steve R. , Luckman Simon M. 
Published: March 2010

J. Neurochem.(2010)113, 1123–1132.AbstractThe glucose analogue, 2‐deoxy‐d‐glucose (2‐DG) is an inhibitor of glycolysis and, when administered systemically or centrally, induces glucoprivation leading to counter‐regulatory responses, including increased feeding behaviour. Investigations into how the brain responds to glucoprivation could have important therapeutic potential, as disruptions or defects in the defence of the brain’s ‘glucostatic’ circuitry may be partly responsible for pathological conditions resulting from diabetes and obesity. To define the ‘glucostat’ brain circuitry further we have combined blood‐oxygen‐level‐dependent pharmacological‐challenge magnetic resonance imaging (phMRI) with whole‐brain c‐Fos functional activity mapping to characterise brain regions responsive to an orexigenic dose of 2‐DG [200 mg/kg; subcutaneous (s.c.)]. For phMRI, rats were imaged using a T2*‐weighted gradient echo in a 7T magnet for 60 min under α‐chloralose anaesthesia, whereas animals for immunohistochemistry were unanaesthetised and freely behaving. These complementary methods demonstrated functional brain activity in a number of previously characterised glucose‐sensing brain regions such as those in the hypothalamus and brainstem following administration of 2‐DG compared with vehicle. As the study mapped whole‐brain functional responses, it also identified the orbitofrontal cortex and striatum (nucleus accumbens and ventral pallidum) as novel 2‐DG‐responsive brain regions. These regions make up a corticostriatal connection with the hypothalamus, by which aspects of motivation, salience and reward can impinge on the hypothalamic control of feeding behaviour. This study, therefore, provides further evidence for a common integrated circuit involved in the induction of feeding behaviour, and illustrates the valuable potential of phMRI in investigating central pharmacological actions.
Differential vulnerability of neurons in Huntington’s disease: the role of cell type‐specific features
Authors: Han Ina , You YiMei , Kordower Jeffrey H. , Brady Scott T. , Morfini Gerardo A. 
Published: March 2010

J. Neurochem.(2010)113, 1073–1091.AbstractAbnormal expansion of a polyglutamine tract in huntingtin (Htt) protein results in Huntington’s disease (HD), an autosomal dominant neurodegenerative disorder involving progressive loss of motor and cognitive function. Contrasting with the ubiquitous tissue expression of polyglutamine‐expanded Htt, HD pathology is characterized by the increased vulnerability of specific neuronal populations within the striatum and the cerebral cortex. Morphological, biochemical, and functional characteristics of neurons affected in HD that might render these cells more vulnerable to the toxic effects of polyglutamine‐Htt are covered in this review. The differential vulnerability of neurons observed in HD is discussed in the context of various major pathogenic mechanisms proposed to date, and in line with evidence showing a ‘dying‐back’ pattern of degeneration in affected neuronal populations.
Rarest of the rare: advances in combining evolutionary distinctiveness and scarcity to inform conservation at biogeographical scales
Authors: Cadotte Marc W. , Jonathan Davies T. 
Published: March 2010

AbstractAim In an era of global habitat loss and species extinction, conservation biology is increasingly becoming a science of triage. A key approach has been the designation of global biodiversity hotspots – areas of high species richness and endemism – prioritizing regions that are disproportionately valuable. However, traditional hotspot approaches leave absent information on species evolutionary histories. We argue that prioritizing the preservation of evolutionary diversity is one way to maximize genotypic and functional diversity, providing ecosystems with the greatest number of options for dealing with an uncertain future.Location Global.Methods We review methods for encapsulating phylogenetic diversity and distinctiveness and provide an illustration of how phylogenetic metrics can be extended to include data on geographical rarity and inform conservation prioritization at biogeographic scales.Results Abundance‐weighted metrics of evolutionary diversity can be used to simultaneously prioritize populations, species, habitats and biogeographical regions.Main conclusion Policy makers need to know where scarce conservation funds should be focused to maximize gains and minimize the loss of biological diversity. By incorporating these evolutionary diversity metrics into prioritization schemes, managers can better quantify the valuation of different regions based on evolutionary information.