bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vulval and perianal inflammatory linear verrucous epidermal naevus
Authors: Le Katie , Wong Li‐Chuen , Fischer Gayle 
Published: April 2009

ABSTRACTInflammatory linear verrucous epidermal naevus (ILVEN) is a rare form of epidermal naevus. It occurs as a linear dermatitic or psoriasiform plaque, with onset usually in the first 5 years of life. Lesions are characteristically intensely itchy. We present a case of ILVEN occurring on the vulva and perianal region of a 6‐year‐old girl. The lesion was initially thought to be an area of lichenified dermatitis; however, treatment with even super‐potent topical corticosteroids did not significantly improve the inflammation. A biopsy was performed and histopathological examination showed characteristic features. ILVEN is frequently refractory to topical treatment and surgical excision of lesions may be an option for relief of symptoms. ILVEN occasionally presents in the inguinogenital region and in this area may, like many vulval naevi, be misdiagnosed as vulvitis, psoriasis, genital warts or sexual abuse.
Solitary mastocytoma occurring at a site of trauma
Authors: Tuxen Alana Jane , Orchard David 
Published: April 2009

ABSTRACTWe describe a patient with a solitary mastocytoma arising at a site of trauma. The patient was born with the umbilical cord wrapped around her right thigh and subsequently developed a solitary mastocytoma in the exact site and distribution of this injury. The pathogenesis of mast cell proliferation in solitary mastocytoma is not completely understood. Cytokines released after injury, such as stem cell factor, may stimulate the proliferation of mast cells, as well as fibroblasts and melanocytes to form a mastocytoma. Mast cells in a newborn may be more sensitive to stem cell factor in the presence of cytokines released after injury due to an increased density of c‐kit receptors. We present our patient and review the literature to support a hypothesis that this condition represents a reactive, and not neoplastic, process.
An evaluation of the potential cost‐effectiveness of non‐invasive testing strategies in the diagnosis of significant liver fibrosis
Authors: Carlson Josh J , Kowdley Kris V , Sullivan Sean D , Ramsey Scott D , Veenstra David L 
Published: April 2009

AbstractBackground and Aim: To assess the clinical and economic outcomes of non‐invasive testing strategies in the diagnosis of significant liver fibrosis (Metavir score ≥ 2) compared with liver biopsy.Methods: We developed a decision analytic model of non‐invasive testing strategies in a hypothetical patient population with genotype 1 hepatitis C virus infection, with no contraindications to liver biopsy. The testing strategies included a testing algorithm using the Fibrosure test, a non‐invasive measure of fibrosis, followed by liver biopsy for patients with indeterminate results, Fibrospect II, and Fibroscan. The primary outcomes were sensitivity, specificity, diagnostic accuracy (true positive + true negatives/total patients), and costs, evaluated from the health‐care payer perspective.Results: The testing algorithm using Fibrosure was the most accurate non‐invasive strategy with a sensitivity, specificity, and overall accuracy of 84%, 87%, and 86%, respectively. In comparison with liver biopsy alone, there was a cost savings of approximately $770/person with the Fibrosure testing algorithm, but a net decrease in accuracy of 14%. Fibrospect II and Fibroscan had poorer accuracy (decreases of 12% and 4%, respectively) and lower costs (−$138 and −$357, respectively) compared with the Fibrosure algorithm. In uncertainty analyses in which biopsy sampling error was considered, the Fibrosure algorithm remained consistently less accurate (5–14% decrease).Conclusions: The results of our study suggest that compared with liver biopsy, non‐invasive testing algorithms can result in short‐term cost savings, but the consequences of misdiagnosis in terms of health outcomes and treatment costs might outweigh the short‐term gains in cost and convenience.
Emotional intelligence, reactions and thoughts: Part 2: A pilot study
Authors: Akerjordet Kristin , Severinsson Elisabeth 
Published: April 2009

AbstractThis article, the second in a series of four, focuses on new mothers' perceptions of emotional intelligence, reactions and thoughts by means of a descriptive design. The study included 250 postnatal mothers (a response rate of 80%). The data were analyzed using descriptive and inferential statistics. The results show that, from a health promotion perspective, emotional intelligence might be an important component in relation to stress management and mental health. However, emotionally perceptive women seem to be affected by stress and depression to a greater extent. The relative strength of the associations between the scales also provides a valid and useful overall measure of new mothers' perceptions. Further validity scores for the scales must be obtained before any conclusions can be drawn.
The efficacy and effect of opioid analgesia in undifferentiated abdominal pain in children: a review of four studies
Authors: SHARWOOD LISA N. , BABL FRANZ E. 
Published: April 2009

SummaryIntroduction:  The question of whether opioid analgesia should be given in patients with undifferentiated acute abdominal pain has been characterized by concerns about its efficacy and that signs used to determine accurate diagnosis may be masked by the drug. The objective of this review is to critically analyze pertinent pediatric randomized controlled studies considering this issue.Methods:  A comprehensive literature search was conducted via Medline in October 2007, using the terms ‘abdominal pain’, ‘physical examination’, ‘analgesics’, ‘opioid’ and ‘appendicitis’. Other articles were identified using the bibliographies of papers found through Medline; alternate databases were searched but did not reveal additional studies.Results:  A total of four trials were identified, and their validity and applicability were reviewed. In all studies, randomization to the analgesia group was associated with significant reduction in pain; one study showing no greater effect with opioid than placebo. All studies used a 10 cm Visual Analogue Scale to assess pain. All studies were only sufficiently powered to consider the primary outcome of opioid efficacy in abdominal pain vs placebo rather than diagnostic accuracy, although they all reported on diagnostic accuracy. Meta‐analysis of results for efficacy and accuracy was not possible due to the heterogeneity of study populations.Conclusions:  A large, probably multi‐centred trial is needed to answer with sufficient power the question of whether opioid analgesia impairs diagnostic accuracy in children with undifferentiated acute abdominal pain.
Comparison of propofol‐fentanyl with propofol‐fentanyl‐ketamine combination in pediatric patients undergoing interventional radiology procedures
Authors: AYDIN ERDEN I. , GULSUN PAMUK A. , AKINCI SEDA B. , KOSEOGLU AYHAN , AYPAR ULKU 
Published: April 2009

SummaryBackground:  With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation.Methods and materials:  Sixty consenting American Society of Anesthesia physical status I–III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double‐blinded, institutional review board approved protocol. Group 1 received propofol 0.5 mg·kg−1 + fentanyl 1 μg·kg−1 + ketamine 0.5 mg·kg−1, and group 2 received propofol 0.5 mg·kg−1 + fentanyl 1 μg·kg−1 + same volume of %0.9 NaCl intravenously.Results:  While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation (P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure (P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus.Conclusions:  In conclusion, addition of low dose ketamine to propofol‐fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.
National survey of pediatric breathing systems use in the UK*
Authors: MARSH DEBORAH FRANCES , MACKIE POPPY 
Published: April 2009

SummaryAims:  To determine current practice in the use of pediatric breathing systems in the UK.Background:  Whilst the Ayres T‐Piece has been used extensively in pediatric anesthesia for nearly six decades, the circle system has undergone recent modifications. These have enhanced its suitability for pediatric use.Methods:  A postal questionnaire was sent to all consultant members of the Association of Paediatric Anaesthetists (APA). This asked about standard breathing systems for induction, maintenance, and ventilation during anesthesia in three groups of children (neonates, infants, and older children less than 20 kg). Additional questions included if anesthetic rooms were used and scavenging routinely employed.Results:  Replies were received from 337 members, giving a response rate of 75%. The T‐Piece was the predominant breathing system for induction in all age groups but the circle appears popular for maintenance, particularly in older children. Anesthetic rooms were used by 97% for induction and scavenging used by only 60% when using a T‐Piece.Conclusions:  Despite significant improvements to the pediatric circle system and its practical advantages, the T‐Piece remains the commonest breathing system used in smaller children by UK members of the APA.
Validation of a theoretically derived model for the management of massive blood loss in pediatric patients – a case report
Authors: PATERSON NEIL A. 
Published: April 2009

SummaryWe present the case of a 5‐year‐old girl who was brought to hospital having suffered an intracranial bleed. She was found to have a large cerebral arteriovenous malformation which was unsuitable for coiling. Uncontrollable raised intracranial pressure refractory to all therapies necessitated surgery as a last resort. Massive hemorrhage eventuated during the procedure with the estimated loss of between five and six blood volumes, the majority occurring within the space of an hour and a half. We describe management using a locally developed protocol and correlate this with laboratory findings.
Ultrasound (US) guided transversus abdominis plane (TAP) block for paediatric inguinal hernia surgery – a pilot study
Authors: Fredrickson M.J. 
Published: April 2009

Aim:  To assess the effectiveness of ultrasound guided TAP block compared to ilioinguinal block for inguinal hernia surgery.Background:  The transversus abdominis plane block has been shown to provide effective intra‐ and postoperative analgesia following lower abdominal surgery [1‐3] and may be an acceptable alternative to the ilioinguinal block in the setting of inguinal surgery [4,5]. It has been suggested that the TAP block is easier to perform than the ilioinguinal block, while also facilitating in‐plane needle imaging [4].Methods:  Subjects scheduled for inguinal hernia surgery were prospectively randomized to US guided ilioinguinal or TAP block using a total volume of 0.3 ml kg‐1 of 50 : 50 lignocaine 1%/ ropivacaine 1%. A single operator experienced in US guided regional anaesthesia performed all blocks. Muscle images were graded on a 4‐point scale (vivid or barely visible, 2 or 3 muscles). Surgery commenced 5 mins following block placement. Fentanyl 0.25 mcg kg‐1 was given PRN during surgery for an increase in heart rate, mean arterial pressure or respiratory rate >20% from postinduction values. Intravenous morphine was given in the PACU for nurse‐assessed moderate to severe pain or emergence agitation. Ibuprofen was given at home for parent‐assessed pain nonresponsive to paracetamol. Blinded observers assessed age appropriate pain score (0–10) in the PACU, day stay unit and during the first 24 h.

Results
Ilioinguinal
TAP

n
12
8

Images: ‘vivid + 3 muscles’ (n%)
58
100

Block time, s (mean)
91
48

Intraoperative fentanyl (n%)
66
63

Worst PACU pain score (median)
2.5
0

PACU morphine required (n%)
17
25

Worst day stay unit pain score (median)
1
5

Doses paracetamol/ibuprofen /24 he (mean)
2.2/0.4
1.5/0.8

Conclusions:  Interim results support ongoing evaluation of the TAP block for inguinal hernia surgery.References1 Shibata Y, Sato Y, Fujiwara Y, Komatsu T. Transversus abdominis plane block. Anesth Analg 2007; 105: 883; author reply 883.2 McDonnell JG, O’Donnell B, Curley G, Heffernan A, Power C, Life JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg 2007; 104: 193–197.3 Hubbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound‐guided transversus abdominis plane (TAP) block. Anaesth Intensive Care 2007; 35: 616–6174 Fredrickson MJ. Early experience with the transversus abdominis plane block in children. Pediatric Anesthesia 2008; 18: 891.5 Banal V. The efficacy of transversus abdominis plane after inguinal surgery. http://www.asra.com/abstracts/spring2008: A59 2008.
LANDSAT Sub‐pixel Analysis in Mapping Impact of Climatic Variability on Prairie Pothole Changes
Authors: Zhang Bo , Schwartz Franklin W , Tong Daoqin 
Published: April 2009

AbstractThe Prairie Pothole Region in the United States contains millions of seasonal, semi‐permanent, or permanent lakes and wetlands that typically range in size from 0.1 to 10 ha. These lakes and wetlands are vulnerable to climate change, especially in our study area in South Dakota, in which a period of deluge following a sharp drought considerably expanded the areal extent of prairie pothole lakes during the last decade of the twentieth century. Preliminary estimates of lake areas, determined using LANDSAT 5 and 7 images, had appreciable errors especially for the smallest of these lakes. This article describes a new sub‐pixel approach integrated with a CART (Classification and Regression Tree) model using a GIS (Geographical Information System) to quantify mixed water pixels along lake boundaries to improve area estimations for pothole lakes. Errors in estimated area were typically 10% or less for lakes greater than 1 ha in size. An analysis of lakes in our study area demonstrates how lake area changed with the transition from drought to deluge. Small lakes exhibited a distinct seasonal variation in contrast to large lakes that tended to follow precipitation trends more broadly. The total water area of lakes is consistent with broad variation in rainfall.
Girls with honour‐related problems in a comparative perspective
Authors: Schlytter Astrid , Linell Hanna 
Published: April 2009

Schlytter A, Linell H. Girls with honour‐related problems in a comparative perspective Int J Soc Welfare 2010: 19: 152–161 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.The aim of this study was to learn to perceive the indicators of honour‐related problems in a girl's everyday life. Our investigation included all girls aged 13–18 years who were about to be taken into care in 2006. The comparative analysis was based on 37 County Court cases in Stockholm County. The girls' exposure to harm in 13 of the 37 cases could be coupled to the demands and values of the honour culture. All the girls in the ‘honour’ group had been victims of mental abuse; they were more isolated than the girls in the ‘other reason’ group and none of the girls in the ‘honour’ group chose to meet their parents in court. We found that the honour culture life situation is new to the social services, which for these girls can mean that they do not have access to the same legal protection as other girls.
Social expenditures and public administration: are local social assistance costs in Sweden a matter of organisation?
Authors: Minas Renate 
Published: April 2009

Minas R. Social expenditures and public administration: are local social assistance costs in Sweden a matter of organisation? Int J Soc Welfare 2010: 19: 215–224 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.This study examines the connection between organisational factors and local social assistance expenditures in Swedish municipalities. The organisation of social assistance units, particularly those for the intake of social assistance inquirers, and the possible implications for local social assistance costs are highlighted. The study is based on interview data from medium‐sized Swedish municipalities combined with register data covering the years from 1997 to 2001. The results show that socioeconomic factors have an overall dominant effect, but also that organisational factors co‐vary with local social assistance expenditures. The results show a cost‐reducing effect for special intake units: firstly, when these units are analysed together with other forms of specialisation and secondly, when staff resources are taken into account. Thus, specialised intake organisation by itself does not play a cost‐reducing role, but does so in combination with certain other factors that characterise the internal organisation of the social welfare office.
Intervening in youth problem behavior in Sweden: a pragmatic cost analysis of MST from a randomized trial with conduct disordered youth
Authors: Olsson Tina M. 
Published: April 2009

Olsson TM. Intervening in youth problem behavior in Sweden: a pragmatic cost analysis of MST from a randomized trial with conduct disordered youthInt J Soc Welfare 2010: 19: 194–205 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.Within the context of a randomized trial, this study assessed the costs of treating conduct disorder with multisystemic therapy (MST) or treatment as usual (TAU) for 156 youth in Sweden. From the perspective of the municipal Social Welfare Administration, all intervention costs were collected for the 6‐month period starting at randomization. MST was found to cost, on average, US$8,847 per youth. A course of intervention including MST was found to cost significantly more (US$5,038 per youth) than TAU. Although MST was found to reduce the use of and costs associated with non‐placement interventions, MST was not found to reduce the use of or costs associated with placement interventions. This is contrary to findings reported from studies undertaken in the USA. Intent‐to‐treat (ITT) and treatment‐of‐treated (TOT) analyses are presented.
Implicit regularization of the incomplete oblique projections method
Authors: Scolnik H. D. , Echebest N. E. , Guardarucci M. T. 
Published: April 2009

AbstractThe aim of this paper is to improve the performance of the incomplete oblique projections method (IOP), previously introduced by the authors for solving inconsistent linear systems, when applied to image reconstruction problems. That method employs incomplete oblique projections onto the set of solutions of the augmented system Ax−r=b, and converges to a weighted least squares solution of the system Ax=b. Many tomographic image reconstruction problems are such that the limitation of the range of rays makes the model underdetermined, the discretized linear system is rank‐deficient, the nullspace is non‐trivial, and the minimal norm least squares solution may be far away from the true image. In a previous paper, we have added a quadratic term reflecting neighboring pixel information to the standard least squares model for improving the quality of the reconstructed images. In this paper we replace the quadratic function by a more general regularizing function avoiding the modification of the original system. The key idea is to perform a joint optimization of the norm of the residual and of the regularizing function in each iteration. The theoretical properties of this new algorithm are analyzed, and numerical experiments are presented comparing its performance with other well‐known methods. They show that the new approach improves the quality of the reconstructed images.
A survey on vertex coloring problems
Authors: Malaguti Enrico , Toth Paolo 
Published: April 2009

AbstractThis paper surveys the most important algorithmic and computational results on the Vertex Coloring Problem (VCP) and its generalizations. The first part of the paper introduces the classical models for the VCP, and discusses how these models can be used and possibly strengthened to derive exact and heuristic algorithms for the problem. Computational results on the best performing algorithms proposed in the literature are reported. The second part of the paper is devoted to some generalizations of the problem, which are obtained by considering additional constraints [Bandwidth (Multi) Coloring Problem, Bounded Vertex Coloring Problem] or an objective function with a special structure (Weighted Vertex Coloring Problem). The extension of the models for the classical VCP to the considered problems and the best performing algorithms from the literature, as well as the corresponding computational results, are reported.
Transient occult hepatitis B virus infection in a blood donor with high viremia
Authors: Bremer Corinna M. , Saniewski Mona , Wend Ulrike C. , Torres Pilar , Lelie Nico , Gerlich Wolfram H. , Glebe Dieter 
Published: April 2009

BACKGROUND: Screening of blood donors for viral nucleic acids has recently been introduced in several countries. With the use of transcription‐mediated amplification, a blood donor was detected who had 90,000 copies of hepatitis B virus (HBV) DNA/mL but no hepatitis B surface antigen (HBsAg) or antibody to hepatitis B core antigen (anti‐HBc). One month later, anti‐HBc and hepatitis B surface antibody (anti‐HBs) appeared; HBV DNA disappeared after 2 months. This study asked why HBsAg was undetectable in this rare case of transient occult HBV infection.STUDY DESIGN AND METHODS: The HBV DNA in the first sample was cloned and sequenced to identify mutations. The physical nature of the virus was examined by polyethylene glycol precipitation, DNase digestion, density gradient centrifugation, and immunoprecipitation.RESULTS: Several mutations were found all over the genome, but the HBs antigen loop was unchanged. A stop mutation in the precore region led to loss of hepatitis B e antigen (HBeAg) expression. No HBV DNA–containing immune complexes were present. The plasma did not contain nonencapsidated HBV DNA that could explain the absence of HBsAg. The virus was immune precipitated by antibodies against HBsAg or preS1 antigen. The ratio of HBV to HBsAg subviral particles was estimated to be 1 in less than 20 whereas in overt cases the ratio is 1 in more than 1000.CONCLUSION: The acute resolving occult HBV infection was caused by an HBeAg‐negative variant, which otherwise was almost normal. The negative HBsAg result was probably due to an unusually low production of surplus HBsAg. The absence of the viral immunomodulator HBeAg and the early appearance of anti‐HBs suggested a rapid noncytolytic HBsAg‐specific T‐cell response leading to low expression of HBsAg.