bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a Preclinical Spinal Safety Model
Authors: Westin B. David , Walker Suellen M. , Deumens Ronald , Grafe Marjorie , Yaksh Tony L. 
Published: June 2010

Background
Preclinical studies demonstrate increased neuroapoptosis after general anesthesia in early life. Neuraxial techniques may minimize potential risks, but there has been no systematic evaluation of spinal analgesic safety in developmental models. We aimed to validate a preclinical model for evaluating dose-dependent efficacy, spinal cord toxicity, and long-term function after intrathecal morphine in the neonatal rat.

Methods
Lumbar intrathecal injections were performed in anesthetized rats aged postnatal day (P) 3, 10, and 21. The relationship between injectate volume and segmental spread was assessed postmortem and by in vivo imaging. To determine the antinociceptive dose, mechanical withdrawal thresholds were measured at baseline and 30 min after intrathecal morphine. To evaluate toxicity, doses up to the maximum tolerated were administered, and spinal cord histopathology, apoptosis, and glial response were evaluated 1 and 7 days after P3 or P21 injection. Sensory thresholds and gait analysis were evaluated at P35.

Results
Intrathecal injection can be reliably performed at all postnatal ages and injectate volume influences segmental spread. Intrathecal morphine produced spinally mediated analgesia at all ages with lower dose requirements in younger pups. High-dose intrathecal morphine did not produce signs of spinal cord toxicity or alter long-term function.

Conclusions
The therapeutic ratio for intrathecal morphine (toxic dose/antinociceptive dose) was at least 300 at P3 and at least 20 at P21 (latter doses limited by side effects). These data provide relative efficacy and safety for comparison with other analgesic preparations and contribute supporting evidence for the validity of this preclinical neonatal safety model.
Thoracic Epidural Anesthesia Attenuates Endotoxin-induced Impairment of Gastrointestinal Organ Perfusion
Authors: Schäper Jörn , Ahmed Raees , Perschel Frank Holger , Schäfer Michael , Habazettl Helmut , Welte Martin 
Published: June 2010

Background
Systemic inflammation can be associated with a redistribution of organ blood flow and a decrease in gastrointestinal perfusion. Regional sympathetic blockade by means of thoracic epidural anesthesia (TEA) has been shown to improve intestinal microcirculation during systemic inflammation. This study tests the hypothesis that during systemic inflammation, TEA attenuates the impairment of gastrointestinal organ perfusion without compromising blood flow to vital organs.

Methods
Eighteen rats were anesthetized, hemodynamically monitored, and mechanically ventilated with room air. By using fluorescent microspheres, organ perfusion was quantified at baseline, 30 min after the start of epidural infusion of either 2% lidocaine (TEA) or normal saline (control), and after 60 and 120 min of intravenous Escherichia coli lipopolysaccharide infusion in TEA and control animals.

Results
Blood pressure initially was lower in TEA animals, but it was comparable to controls during endotoxemia. Gastrointestinal organ perfusion significantly decreased after 120 min of endotoxemia in the controls but not in the TEA animals (-23 +/- 27% vs. -6 +/- 26%, mean +/- SD, P < 0.05). Perfusion of the vital organs such as the heart, brain, liver, and kidneys was comparable between controls and TEA after 120 min of endotoxemia.

Conclusions
TEA attenuates the impairment of gastrointestinal organ perfusion during endotoxemia. Hence, the protective effects of TEA on intestinal microcirculation during endotoxemia may be due to a higher total organ blood flow compared with endotoxemic control animals. Furthermore, in the course of endotoxemia, TEA provides hemodynamic stability and does not compromise blood flow to vital organs.
Skin Conductance Fluctuations Correlate Poorly with Postoperative Self-report Pain Measures in School-aged Children
Authors: Choo Eugene K. , Magruder William , Montgomery Carolyne J. , Lim Joanne , Brant Rollin , Ansermino J. Mark 
Published: June 2010

Background
The number of fluctuations of skin conductance per second (NFSC) has been shown to correlate with induced pain and self-report pain scales. This study aimed to evaluate the validity and feasibility of NFSC as an objective measurement of nociception intensity in school-aged children after surgery.

Methods
After approval by the research ethics board and obtaining consent, 100 subjects participated in this prospective observational study. Preoperatively, NFSC was measured for 60 s at rest and during response to a self-report pain scale (numeric rating scale [NRS], Faces Pain Scale-Revised) and anxiety scoring (NRS). Postoperative measurements were repeated every 10 min for 30 min or until NRS pain score was <or= 4 for two consecutive scores. Spearman rank correlation coefficients were calculated to investigate the relationship between NFSC and NRS pain, Faces Pain Scale-Revised, and NRS anxiety. The clinical utility of using NFSC in determining NRS pain threshold was investigated using receiver operator characteristics analysis. For clinical relevance, a cutoff NFSC was chosen that optimizes both specificity and sensitivity. Although selecting a low cutoff value increases the sensitivity of the NFSC in diagnosing pain, it does so at the expense of specificity.

Results
Data from 90 subjects (64.4% male) aged 7-17 yr (median age 13 yr) were analyzed (217 postoperative datasets). NFSC correlated weakly with NRS pain scores (P = 0.21; P < 0.002). NFSC did not correlate with NRS anxiety scores (P = 0.15, P < 0.03). NRS pain scores correlated strongly with Faces Pain Scale-Revised (P = 0.89, P < 0.0001) and weakly with NRS anxiety scores (P = 0.34, P < 0.0001). A threshold of 0.23 NFSC predicted severe pain (NRS >or= 7) with 56.3% sensitivity (95% CI = 37.7-73.6%) and 78.4% specificity (95% CI = 71.7-84.1%). The area under receiver operator characteristic curve for NFSC was 69.1%.

Conclusions
NFSC measurement is feasible in a perioperative setting but was not specific for postoperative pain intensity and was unable to identify analgesia requirements when compared with self-report measures.
Management of visceral leishmaniasis in rural primary health care services in Bihar, India
Authors: Hasker E. , Singh S. P. , Malaviya P. , Singh R. P. , Shankar R. , Boelaert M. , Sundar S. 
Published: June 2010

SummaryObjective  In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent, with early diagnosis based on a rapid diagnostic test and treatment with the oral drug miltefosine as its main strategy. Several recent studies have signaled underreporting of VL cases in the region. Information on treatment outcomes is scanty. Our aim was to document VL case management by the primary health care services in India.Methods  We took a random sample of all VL patients registered in rural primary health care (PHC) facilities of Muzaffarpur district, Bihar, India during 2008. Patients were traced at home for an interview and their records were reviewed. We recorded patient and doctor delay, treatment regimens, treatment outcomes and costs incurred by patients.Results  We could review records of all 150 patients sampled and interview 139 patients or their guardian. Most patients (81%) had first presented to unqualified practitioners; median delay before reaching the appropriate primary healthcare facility was 40 days (IQR 31–59 days). Existing networks of village health workers were under‐used. 48% of VL patients were treated with antimonials; 40% of those needed a second treatment course. Median direct expenditure by patients was 4000 rupees per episode (IQR 2695–5563 rupees), equivalent to almost 2 months of household income.Conclusion  In 2008 still critical flaws remained in VL case management in the primary health care services in Bihar: obsolete use of antimonials with high failure rates and long patient delay. To meet the target of the VL elimination, more active case detection strategies are needed, and village health worker networks could be more involved. Costs to patients remain an obstacle to early case finding.
Climate Optimum rejuvenates the Mediterranean marine world
Authors: POR Francis D. 
Published: June 2010

AbstractThe Mediterranean, a sea with an already eventful history, is again undergoing an extreme change. A combination of general warming of the Mediterranean Sea and contact with the Indopacific world through the Suez Canal has set the stage for massive changes in the biota that inhabit this sea. For over a century, tropical species of all taxa have been migrating back into the Mediterranean, suggesting a duplication or restoration of a mid‐Pliocene Piacenzian or late Miocene Tortonian situation. Test cases are presented in three major taxa. It is not a serial invasion by individual rogue exotic and damaging species, as often wrongly assumed and asserted. Despite its unique biogeographic magnitude being recognized, an opportunity to study the progress of this phenomenon is being missed. This is because of the changed priorities in research, the acute taxonomic impediment and to the geopolitical difficulties in cooperation. Nonetheless, the limitations of the restoration process are defined and a careful future outlook is presented.
IFRS within the Multi‐GAAP Canadian Reality: A Teaching and Learning Imperative for Intermediate Financial Accounting
Authors: CONROD JOAN E. D. 
Published: June 2010

AbstractIntermediate accounting instructors need to be engaged in the specific complexities and challenges of the new international financial reporting standards (IFRS) reality within the Canadian multi‐GAAP environment. Intermediate accounting courses are directly affected because they represent substantive coverage of the corporate reporting environment. In this article I make the case that these courses should primarily reflect IFRS standards in order to entrench IFRS competencies in students who wish to pursue a professional designation, to prepare students for the global environment, and to concentrate IFRS expertise issues in a robust instructor group. The competency maps of each of the three Canadian professional accounting bodies clearly reflect IFRS. Students can analyze the implications of major areas of policy differences between IFRS and private enterprise GAAP (PEGAAP) through specific targeted course coverage, but also through active learning elements, particularly research elements. This commentary reflects some of the active debate occurring regarding postsecondary curriculum as Canada adapts to IFRS and PEGAAP, and encourages action.
Applying XBRL in an Accounting Information System Design Using the REA Approach: An Instructional Case*
Authors: PENG JACOB , JANIE CHANG C. 
Published: June 2010

AbstractThe Church in Somewhere (CIS) is a small community church which uses an Excel spreadsheet to keep its financial records. The church administrator is considering moving from a spreadsheet accounting system to a relational database system that can easily be expanded to include more information in the future. In this paper we examine the transforming process in this hypothetical case by following a resource‐event‐agent (REA) modeling paradigm to create a database. We then link the REA model to financial reporting using Microsoft Access. In addition, using the financial report in the database, students prepare and validate an eXtensible Business Reporting Language (XBRL) document for CIS. Instead of applying the complex U.S. Generally Accepted Accounting Principles (GAAP) Taxonomies, Release 2009, the case uses a dedicated CIS Taxonomy to complete the mapping and tagging processes.
Impaired Immunogenicity of a Meningococcal Factor H-Binding Protein Vaccine Engineered To Eliminate Factor H Binding
Authors: Beernink Peter T. , Shaughnessy Jutamas , Ram Sanjay , Granoff Dan M. 
Published: June 2010

ABSTRACT
Meningococcal factor H-binding protein (fHbp) is a promising antigen that is part of two vaccines in clinical development. The protein specifically binds human complement factor H (fH), which downregulates complement activation on the bacterial surface and enables the organism to evade host defenses. In humans, the vaccine antigen forms a complex with fH, which may affect anti-fHbp antibody repertoire and decrease serum bactericidal activity by covering important fHbp epitopes. In a recent study, fHbp residues in contact with fH were identified from a crystal structure. Two fHbp glutamate residues that mediated ion-pair interactions with fH were replaced with alanine, and the resulting E218A/E239A mutant no longer bound the fH fragment. In the present study, we generated the E218A/E239A mutant recombinant protein and confirmed the lack of fH binding. By enzyme-linked immunosorbent assay (ELISA), the mutant fHbp showed similar respective concentration-dependent inhibition of binding of four bactericidal anti-fHbp monoclonal antibodies (MAbs) to fHbp, compared with inhibition by the soluble wild-type protein. In two mouse strains, the mutant fHbp elicited up to 4-fold-lower IgG anti-fHbp antibody titers and up to 20-fold-lower serum bactericidal titers than those elicited by the wild-type fHbp vaccine. Thus, although introduction of the two alanine substitutions to eliminate fH binding did not appear to destabilize the molecule globally, the mutations resulted in decreased immunogenicity in mouse models in which neither the mutant nor the wild-type control vaccine bound fH. These results cast doubt on the vaccine potential in humans of this mutant fHbp.
Virulence of
Escherichia coli
B2 Isolates from Meat and Animals in a Murine Model of Ascending Urinary Tract Infection (UTI): Evidence that UTI Is a Zoonosis
Authors: Jakobsen Lotte , Hammerum Anette M. , Frimodt-Møller Niels 
Published: June 2010

ABSTRACT

In vivo
evidence of a connection between urinary tract infections (UTI) and foods is lacking. The virulence of 13
Escherichia coli
B2 isolates from healthy animals and fresh meat was investigated in a murine model of ascending UTI. All isolates produced positive bladder cultures (10
2
to 10
7
CFU), and nine isolates produced positive kidney cultures (10
2
to 10
5
CFU).
Genetic Diversity and Virulence Profiles of
Escherichia coli
Isolates Causing Spontaneous Bacterial Peritonitis and Bacteremia in Patients with Cirrhosis
Authors: Bert Frédéric , Johnson James R. , Ouattara Bénédicte , Leflon-Guibout Véronique , Johnston Brian , Marcon Estelle , Valla Dominique , Moreau Richard , Nicolas-Chanoine Marie-Hélène 
Published: June 2010

ABSTRACT

Among patients with cirrhosis, infections caused by
Escherichia coli
organisms that translocate from the gut are a frequent and severe complication. One hundred ten
E. coli
isolates from 110 cirrhotic patients with spontaneous bacterial peritonitis and/or spontaneous bacteremia were characterized for their phylogenetic group and virulence genotype (34 extraintestinal virulence factor genes). Genetic relatedness was investigated by enterobacterial repetitive intergenic consensus sequence type 2 (ERIC-2) PCR typing and multilocus sequence typing. Phylogenetic groups A, B1, B2, and D accounted for 24%, 4%, 48%, and 24% of the population, respectively. Overall, 68 distinct ERIC-2 profiles were encountered. Eleven clonal groups, represented by multiple isolates (2 to 11) from the same sequence type (ST) or sequence type complex, were identified. These clonal groups accounted for 54 (49%) isolates overall. Membership in one of these clonal groups was more frequent among B2 isolates than non-B2 isolates (67% versus 32%,
P
< 0.001). The most frequent sequence types were ST95 (
n
= 13) and ST73 (
n
= 8), followed by the ST14 and ST10 complexes (
n
= 7). ST131 and ST69 were represented by three isolates each. Clonal group-associated isolates exhibited a greater prevalence of 11 virulence genes, including
pap
elements, than the other isolates. However, no association between clonal groups and host factors, type of infection, or mortality was observed. In conclusion,
E. coli
isolates causing spontaneous bacterial peritonitis and bacteremia in cirrhotic patients are genetically diverse. However, approximately half of the isolates belong to familiar clonal groups and exhibit extensive virulence profiles that may be associated with greater invasive potential.
In Situ Molecular Diagnosis and Histopathological Characterization of EnteroadherentEnterococcus hiraeInfection in Pre-Weaning-Age Kittens
Authors: Nicklas Jodi L. , Moisan Peter , Stone Maria R. , Gookin Jody L. 
Published: June 2010

ABSTRACTThe bacterial causes of diarrhea can be frustrating to identify, and it is likely that many remain undiagnosed. The pathogenic potential of certain bacteria becomes less ambiguous when they are observed to intimately associate with intestinal epithelial cells. In the present study we sought to retrospectively characterize the clinical,in situmolecular, and histopathological features of enteroadherent bacteria in seven unrelated kittens that were presumptively diagnosed with enteropathogenicEscherichia coli(EPEC) on the basis of postmortem light microscopic and, in some cases, microbiological examination. Characterization of the enteroadherent bacteria in each case was performed by Gram staining,in situhybridization using fluorescence-labeled oligonucleotide probes, PCR amplification of species-specific gene sequences, and ultrastructural imaging applied to formalin-fixed paraffin-embedded sections of intestinal tissue. In only two kittens was EPEC infection confirmed. In the remaining five kittens, enteroadherent bacteria were identified asEnterococcusspp. The enterococci were further identified asEnterococcus hiraeon the basis of PCR amplification of DNA extracted from the formalin-fixed, paraffin-embedded tissue and amplified by using species-specific primers. Transmission electron microscopy of representative lesions fromE. coli- andEnterococcusspp.-infected kittens revealed coccobacilli adherent to intestinal epithelial cells without effacement of microvilli or cup-and-pedestal formation. Enterococci were not observed, nor were DNA sequences amplified from intestinal tissue obtained from age-matched kittens euthanized for reasons unrelated to intestinal disease. These studies suggest thatE. hiraemay be a common cause of enteroadherent bacterial infection in pre-weaning-age kittens and should be considered in the differential diagnosis of bacterial disease in this population.
Ecological Temporal Stability of
Staphylococcus aureus
Nasal Carriage
Authors: Sakwinska Olga , Blanc Dominique S. , Lazor-Blanchet Catherine , Moreillon Martine , Giddey Marlyse , Moreillon Philippe 
Published: June 2010

ABSTRACT

We described the colonization dynamics of
Staphylococcus aureus
in a group of 266 healthy carriers over a period of approximately 1 year. We used precise genotyping methods, i.e., amplified fragment length polymorphism (AFLP),
spa
typing, and double-locus sequence typing (DLST), to detect changes in strain identity. Strain change took place rather rarely: out of 89 carriers who had initially been colonized, only 7 acquired a strain different from the original one. Approximately one-third of the carriers eliminated the colonization, and a similar number became newly colonized. Some of these events probably represent detection failure rather than genuine colonization loss or acquisition. Lower bacterial counts were associated with increased probability of eliminating the colonization. We have confirmed a high mutation rate in the
spa
locus: 6 out of 53 strains underwent mutation in the
spa
locus. There was no overall change in
S. aureus
genotype composition.
Diversity of
Escherichia coli
Strains Producing Extended-Spectrum β-Lactamases in Spain: Second Nationwide Study
Authors: Díaz Miguel A. , Hernández-Bello José R. , Rodríguez-Baño Jesús , Martínez-Martínez Luis , Calvo Jorge , Blanco Jorge , Pascual Alvaro 
Published: June 2010

ABSTRACT

The prevalence of extended-spectrum β-lactamase (ESBL)-producing
Escherichia coli
(ESBLEC) in Spain increased 8-fold from 2000 to 2006. ESBL type, clonal relationship, antimicrobial susceptibility, and clinical data about infections caused by ESBLEC are evaluated in a second nationwide study developed in 2006. From 1008 clinical isolates obtained over 2 months from 44 hospitals, 254 were used for further analysis. ESBL production was evaluated by synergy testing, PCR, and sequencing. Antimicrobial activity was evaluated by microdilution. The clonal relationship was evaluated by repetitive extragenic palindromic-PCR (REP-PCR). The O25b subtype and the new
afa
operon FM955459 were determined by triplex PCR in isolates producing CTX-M-15. Multilocus sequence typing was performed on these isolates. A total of 72% of all ESBLs were of the CTX-M type, 26.8% were of the SHV type, and 1.2% were of the TEM type. The most prevalent ESBLs were CTX-M-14 (119 isolates), SHV-12 (68 isolates), CTX-M-15 (37 isolates), and CTX-M-9 (21 isolates). By REP-PCR, 214 clones were detected. All but five CTX-M-15 ESBLEC isolates corresponded to the international O25b/ST131 clone. This clone had not been detected in the first study (published in 2000). Epidemiological and clinical features were studied in 304 representative patients. A total of 60% of the patients were older than 60 and had nonfatal underlying diseases, and 55% had recently received antibiotics. Urinary tract infections accounted for 71% of cases, and 9% were bacteremic. There has been a significant increase in the prevalence of ESBLEC in Spain, with most of these strains being CTX-M-producing isolates, including the pandemic O25b-ST131. SHV-12-producing
E. coli
remains an important cause of community-acquired infection.
Evaluation of
mupA
Evigene in Comparison to Disk Diffusion for Detection of High-Level Mupirocin Resistance in Clinical Isolates of
Staphylococcus aureus
Authors: Acuna-Villaorduna Carlos , Hardwick Matthew J. , Goucher Suzanne , Waga Masashi , Shoham Shmuel 
Published: June 2010

ABSTRACT

High-level mupirocin resistance (H-Mu
r
) in
S. aureus
is associated with the
mupA
gene. The
mupA
Evigene test rapidly identifies this gene. This study assessed the performance of
mupA
Evigene compared to that of susceptibility disk testing.
mupA
Evigene detected H-Mu
r
in 6/179
S. aureus
isolates, and the results were concordant with those of susceptibility disk testing.