bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Medicine in the Developing World: A Delphi Study
Authors: Hodkinson Peter W. , Wallis Lee A. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:765–774 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Emergency medicine (EM) as a specialty has developed rapidly in the western world, but remains largely immature in developing nations. There is an urgent need for emergency services, but no clear guidelines are available on the priorities for establishing EM in the developing world. This study seeks to establish consensus on key areas of EM development in developing world settings, with respect to scope of EM, staffing needs, training requirements, and research priorities.Methods:  A three‐round Delphi study was conducted via e‐mail. A panel was convened of 50 EM specialists or equivalent, with experience in or interest in EM in the developing world. In the first round, panelists provided free‐text statements on scope, staffing, training, and research priorities for EM in the developing world. A five‐point Likert scale was used to rate agreement with the statements in Rounds 2 and 3. Consensus statements are presented as a series of synopsis statements for each of the four major themes.Results:  A total of 168 of 208 statements (81%) had reached consensus at the end of the study. Key areas in which consensus was reached included EM being a specialist‐driven service, with substantial role for nonphysicians. International training courses should be adapted to local needs. EM research in developing countries should be clinically driven and focus on local issues of importance.Conclusions:  The scope and function of EM and relationships with other specialties are defined. Unambiguous principles are laid out for the development of the specialty in developing world environments. The next step required in this process is translation into practical guidelines for the development of EM in developing world settings where they may be used to drive policy, protocols, and research.
Intestinal‐FABP and Liver‐FABP: Novel Markers for Severe Abdominal Injury
Authors: Relja Borna , Szermutzky Maika , Henrich Dirk , Maier Marcus , De Haan Jacco‐Juri , Lubbers Tim , Buurman Wim A. , Marzi Ingo 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:729–735 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  Fatty acid–binding proteins (FABPs) have relatively high tissue concentrations and low plasma concentrations and are released into the circulation following organ injury. We explored the utility of intestinal‐(I)‐FABP and liver‐(L)‐FABP for the diagnosis of abdominal injury in patients with multiple trauma.Methods:  This prospective study included 102 trauma patients and 30 healthy volunteers. Plasma I‐FABP and L‐FABP levels were measured in the emergency department (ED) by enzyme‐linked immunosorbent assay (ELISA). Forty‐one patients suffered from serious or severe abdominal trauma (Abbreviated Injury Score [AIS] code “ai” for abdominal injury, AISai ≥ 3) and nine were moderately abdominally injured (AISai < 3). Fifty‐two had no abdominal injury.Results:  Median I‐FABP and L‐FABP levels in the AISai ≥ 3 group (516 pg/mL and 135 ng/mL, respectively) were significantly higher compared to the AISai < 3 group (154 pg/mL and 13 ng/mL, respectively) or those without abdominal injury (207 pg/mL and 21 ng/mL, respectively) or normal controls (108 pg/mL and 13 ng/mL, respectively). The cutoff to distinguish the ai ≥ 3 is 359 pg/mL for I‐FABP and 54 ng/mL for L‐FABP, with 93% specificity and 75% sensitivity for I‐FABP and 93% and 82% for L‐FABP, respectively.Conclusions:  High I‐FABP and L‐FABP levels correlate with relevant severity of abdominal tissue damage in patients with multiple trauma. I‐FABP and L‐FABP could be useful as markers for the early detection of significant abdominal injury in acute multiple trauma and identify patients who require rapid intervention.
Core Curricular Elements for Fellowship Training in International Emergency Medicine
Authors: Bayram Jamil , Rosborough Stephanie , Bartels Susan , Lis Julian , VanRooyen Michael J. , Bobby Kapur G. , Anderson Philip D. 
Published: July 2010

ACADEMIC EMERGENCY MEDICINE 2010; 17:748–757 © 2010 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to describe the common educational goals, curricular elements, and methods of evaluation used in international emergency medicine (IEM) fellowship training programs currently. IEM fellowship programs have been developed to provide formal training for emergency physicians (EPs) interested in pursuing careers in IEM. Those fellowships are variable in scope, objectives, and duration. Previously published articles have suggested a general curriculum structure for IEM fellowships.Methods:  A search of MEDLINE, EMBASE, and CINAHL databases from 1950 to June 2008 was performed, combining the terms international, emergency medicine, and fellowship. Online curricula and descriptive materials from IEM fellowships listed by the Society for Academic Emergency Medicine (SAEM) were reviewed. Knowledge and skill areas common to multiple programs were organized in discrete categories. IEM fellowship directors were contacted for input and feedback.Results:  Eight articles on IEM fellowships were identified. Two articles described a general structure for fellowship curriculum. Sixteen of 20 IEM fellowship programs had descriptive materials posted online. These information sources, plus input from seven fellowship program directors, yielded the following seven discrete knowledge and skill areas: 1) emergency medicine systems development, 2) humanitarian relief, 3) disaster management, 4) public health, 5) travel and field medicine, 6) program administration, and 7) academic skills.Conclusions:  While IEM fellowships vary with regard to objectives and structure, this article presents an overview of the current focus of IEM fellowship training curricula that could serve as a resource for IEM curriculum development at individual institutions.
Myocardial telocytes: a specific new cellular entity
Authors: Kostin Sawa 
Published: July 2010

Abstract

Introduction
Cellular compartments of telocytes
Distribution of telocytes in the heart
Possible functions of telocytes in the myocardium
Telocytes and myocardial remodelling
Unresolved issues regarding myocardial telocytes

The existence of a new type of interstitial cells in the heart namely, interstitial Cajal‐like cells (ICLC), has been described for the first time by Hinescu and Popescu in 2005. This study was then followed by an ascending trend of publications regarding the morphology, phenotype and distribution of myocardial ICLC in diverse species including human patients. Recently the new term ‘telocytes’ has been proposed for cells formerly known as ICLC, and the term ‘telopodes’ has been proposed for the prolongations of these cells. The identification of these cells is based on ultrastructural criteria. In addition, telocyters/telyopodes can be identified by several complementary approaches including methylene blue vital staining, silver impregnation and immunoreactivity against CD117/c‐kit, vimentin, etc. This point of view presents critical data existing in literature, as well as own results, which unequivocally provide compelling evidence that telocytes are a new distinct cellular entity of myocardial interstitium. Several presumable functions of the myocardial telocytes are discussed: (i) intercellular signalling, (ii) cardiac repair/remodelling and (iii) stem cell nursing in cardiac renewal.
Groundwater contribution to baseflow maintains habitat connectivity forTandanus bostocki(Teleostei: Plotosidae) in a south‐western Australian river
Authors: Beatty S. J. , Morgan D. L. , McAleer F. J. , Ramsay A. R. 
Published: July 2010

Beatty SJ, Morgan DL, McAleer FJ, Ramsay AR. Groundwater contribution to baseflow maintains habitat connectivity forTandanus bostocki(Teleostei: Plotosidae) in a south‐western Australian river. Ecology of Freshwater Fish 2010: 19: 595–608. © 2010 John Wiley & Sons A/SAbstract – A global biodiversity hotspot, south‐western Australia is characterised by a highly endemic freshwater fish fauna that is severely impacted by habitat alterations. As is the case with many rivers in this region, the Blackwood River is secondarily salinised as a consequence of agricultural practices and this has caused population depletions of halo‐intolerant fishes. This study is the first to examine the role that groundwater intrusion has in maintaining habitat connectivity for an obligate freshwater fish in a secondarily salinised river. We determined the significance of nonsaline groundwater intrusion in maintaining habitat and migratory routes of the freshwater cobbler,Tandanus bostockiduring prolonged annual dry periods; characteristic of Mediterranean climatic zones.Tandanus bostockiundertook large, yet spatially and temporally variable, localised movements through riffles. During baseflow, the period of major groundwater influence, movements were significantly associated with discharge. Analysis of gonadal development suggested that such movements were not strictly related to reproduction and were probably for foraging purposes. The study reveals groundwater is crucial in maintaining migratory routes through riffles and suggestsT. bostockimay be reliably used as an indicator of aquatic habitat connectivity in light of groundwater extractions and also continued rainfall reductions in this region due to climate change.
Individual growth and its implications for the recruitment dynamics of stream‐dwelling marble trout (Salmo marmoratus)
Authors: Vincenzi S. , Crivelli A. J. , Jesensek D. , De Leo G. A. 
Published: July 2010

Vincenzi S, Crivelli AJ, Jesensek D, De Leo GA. Individual growth and its implications for the recruitment dynamics of stream‐dwelling marble trout (Salmo marmoratus). Ecology of Freshwater Fish 2010: 19: 477–486. © 2010 John Wiley & Sons A/SAbstract – The role of density‐dependent individual growth in the recruitment dynamics of fish populations has rarely been analysed in a quantitative framework. Variations of mean size of juveniles in response to changes in population densities have frequently been observed in salmonids and it has been shown that body‐size differences at the juvenile stage can persist through the sub‐adult and adult stage. As fecundity and sexual maturation are often a function of body size, inter‐cohort variations in individual growth may ultimately affect the reproductive output and, consequently, the amount of yearly recruitment. Here, we present a simulation analysis investigating the effects of density‐dependent growth on the reproductive output and, ultimately, on the population dynamics of stream‐dwelling salmonids. The demographic model used for the numerical analysis was parameterised using marble troutSalmo marmoratusas a reference species and explicitly accounted for the occurrence of major floods events causing the population to collapse to very low densities. Our simulations showed that density‐dependent individual growth is a powerful mechanism to foster population resilience through compensatory recruitment. In addition, we argue that density‐dependent growth also helps regulate recruitment at high population densities. We show that even slight variations in the growth trajectories of fish substantially affect the size and the dynamics of the population.
Use of Raman spectroscopy for the early detection of filaggrin‐related atopic dermatitis
Authors: González F. J. , Alda J. , Moreno‐Cruz B. , Martínez‐Escanamé M. , Ramírez‐Elías M. G. , Torres‐Álvarez B. , Moncada B. 
Published: July 2010

Background: Filaggrin (FLG) gene mutations, which result in complete or incomplete loss of proFLG/FLG peptides, have been reported as an important predisposing factor for atopic dermatitis (AD) and secondary atopic phenotypes such as atopic asthma.Method: The presence of the protein FLG in the skin was evaluated at birth on 12 infants using Raman spectroscopy; these 12 infants were monitored for 1 year to see whether they developed AD. Three different statistical analysis procedures, two of which involved principal component analysis (PCA), were performed on the Raman spectra in order to determine the FLG content.Results: The infants who had a lower FLG content, determined using any of the three statistical analysis procedures proposed, were also the ones that clinically developed AD.Conclusion: The results suggest that Raman spectroscopy and statistical analysis such as PCA could be used as an early detection procedure for FLG ‐related AD and as a possible quantitative marker for FLG gene mutations.
Continuous intrathecal baclofen therapy in children with cerebral palsy – when does improvement emerge?
Authors: Ramstad K , Jahnsen R , Lofterod B , Skjeldal OH 
Published: July 2010

AbstractAim:  The aim of the study was to explore the timing of effects of intrathecal baclofen therapy in children with cerebral palsy.Methods:  Thirty five children with severe disabilities with cerebral palsy who started continuous intrathecal baclofen therapy (CITB) were followed for 18 months. Pain, number of awakenings during night, spasticity, GMFM‐66 scores and PEDI scores were recorded the day before pump implantation and after 6 and 18 months of treatment respectively.Results:  Introduction of CITB was associated with changes across all ICF dimensions. Reduced pain and improved sleep occurred within 6 months of treatment. Social function improved within 6 months and continued to improve until 18 months of CITB. Mobility also improved, but with a latency.Conclusion:  There seems to be a sequence of changes after introduction of continuous intrathecal baclofen in a child with cerebral palsy that may guide the multidisciplinary team in their timing of therapy during post‐surgical follow‐up.
Low Apgar score and mortality in extremely preterm neonates born in the United States
Authors: Lee Henry Chong , Subeh Mohammad , Gould Jeffrey B. 
Published: July 2010

AbstractAim:  To investigate the relationship between low Apgar score and neonatal mortality in preterm neonates.Methods:  Infant birth and death certificate data from the US National Center for Health Statistics for 2001–2002 were analysed. Primary outcome was 28‐day mortality for 690 933 neonates at gestational ages 24–36 weeks. Mortality rates were calculated for each combination of gestational age and 5‐min Apgar score. Relative risks of mortality, by high vs. low Apgar score, were calculated for each age.Results:  Distribution of Apgar scores depended on gestational age, the youngest gestational ages having higher proportions of low Apgar scores. Median Apgar score ranged from 6 at 24 weeks, to 9 at 30–36 weeks gestation. The relative risk of death was significantly higher at Apgar scores 0–3 vs. 7–10, including at the youngest gestational ages, ranging from 3.1 (95% confidence interval 2.9, 3.4) at 24 weeks to 18.5 (95% confidence interval 15.7, 21.8) at 28 weeks.Conclusion:  Low Apgar score was associated with increased mortality in premature neonates, including those at 24–28 weeks gestational age, and may be a useful tool for clinicians in assessing prognosis and for researchers as a risk prediction variable.
Facilitated tucking as a non‐pharmacological intervention for neonatal pain relief: is it clinically feasible?
Authors: Cignacco E , Axelin A , Stoffel L , Sellam G , Anand KJS , Engberg S 
Published: July 2010

AbstractThere is an impressive body of knowledge on pain management in infants hospitalized in neonatal intensive care units. However, deficits in the clinical management of pain in these infants remain. One reason is the gap between research evidence and translation of this knowledge into the clinical setting. This is particularly true for non‐pharmacological pain‐relieving methods. Effective performance of some of these methods requires additional staffing and time. This viewpoint articles describes the clinical challenges associated with implementing ‘facilitated tucking’. Although ‘facilitated tucking’ is described as an efficient method for acute pain relief, the clinical facilitators required to successfully implement such a resource consuming‐intervention remain unclear.Conclusion:  Translational research on the feasibility of using ‘facilitated tucking’ in the management of neonatal pain is warranted, including the economic impact of this intervention. Increased manpower costs need to be weighed against the possible long‐term economical consequences of pain exposure in infants.
The Genetic Inactivation of Inducible Nitric Oxide Synthase (iNOS) Intensifies Fibrosis and Oxidative Stress in the Penile Corpora Cavernosa in Type 1 Diabetes
Authors: Ferrini Monica G. , Rivera Steve , Moon Joanne , Vernet Dolores , Rajfer Jacob , Gonzalez-Cadavid Nestor F. 
Published: July 2010

ABSTRACT

Introduction
Endogenously elicited inducible nitric oxide synthase (iNOS) induction counteracts fibrosis and oxidative stress in penile tissues in rat models of Peyronie’s disease and erectile dysfunction.

Aim
The current study aimed to determine whether the genetic blockade of iNOS expression in the iNOS knock out (iNOS KO) mouse intensifies fibrosis and oxidative stress in the penile corpora cavernosa, and this is exacerbated by streptozotocin (STZ)-induced diabetes and counteracted by insulin.

Main Outcomes Measures
Quantitative assessment of histological and biochemical markers in mouse corporal tissue.

Methods
Male iNOS KO and wild type (WT) mice were left untreated or injected with STZ, with or without insulin treatment. At 8 weeks, glycemia, glucosuria, and proteinuria were determined, and corporal tissue sections were obtained and subjected to Masson trichrome staining for smooth muscle (SM)/collagen ratio, and immunostaining for α-smooth muscle actin (ASMA) for, SM content, proliferating cell nuclear antigen (PCNA) for cell replication, TGFβ1 as profibrotic factor, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay for apoptosis, and xanthine oxidoreductase (XOR) for oxidative stress. Collagen was estimated by the hydroxyproline reaction.

Results
The corporal SM/collagen ratio and SM content were reduced, and collagen content increased in iNOS KO mice as compared with WT mice, but apoptosis was decreased and cell replication increased, whereas TGFβ1 and XOR did not vary. Severe hyperglycemia caused in the WT a reduction of the corporal SM/collagen ratio and SM content and an increase in apoptosis without changes in PCNA, TGFβ1, or XOR. In the iNOS KO mouse the hyperglycemia-induced alterations were exacerbated, with additional increases in oxidative stress and TGFβ1. Insulin normalized glycemia and partially protected the SM in both the WT and the iNOS KO mice.

Conclusions
The antifibrotic, antioxidative, and SM-protective roles of iNOS in the penile corpora cavernosa were confirmed in the iNOS KO/STZ mouse model. These findings support the importance of endogenously-elicited iNOS induction in protecting the penile corpora cavernosa from the pro-fibrotic effects of hyperglycemia.
Relationship between Serum Lipid Values and Atherosclerotic Burden in the Proximal Thoracic Aorta
Authors: Kohsaka Shun , Jin Zhezhen , Rundek Tatjana , Homma Shunichi , Sacco Ralph L. , Tullio Marco R. Di 
Published: July 2010

Background We conducted a cross-sectional analysis in a population-based cohort to compare the strength of the associations among various lipid parameters and the presence of atherosclerotic plaque in the proximal thoracic aorta. Methods As part of Aortic Plaques and Risk of Ischemic Stroke (APRIS) study, 464 subjects were studied (mean age 69.1±9.0, 251 males and 213 females), including 255 patients with first ischaemic stroke and 209 stroke-free controls. Presence and thickness of atherosclerotic plaque were assessed by transoesophageal echocardiography. Measured lipid parameters included total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, and non-high-density lipoprotein cholesterol, lipoprotein (a), apolipoprotein (Apo) B and A-I levels with their ratio. Results Overall, atherosclerotic plaque was detected in 326 subjects (70.4%) and 37.6% of these subjects ( n = 174) had atherosclerotic plaque ≥ ***4 mm. After adjusting for other significant predictors of atherosclerosis, high-density lipoprotein cholesterol level and Apo B/A-I ratio emerged as the strongest predictors of any atherosclerotic plaque ( P<0.001 and P = 0.004, respectively), followed by individual Apo B ( P = 0.015) and A-I ( P = 0.016) levels, triglycerides ( P = 0.027) and non-high-density lipoprotein cholesterol level ( P = 0.021). Total and low-density lipoprotein cholesterol levels were not significant predictors for any atherosclerotic plaque ( P = 0.273 and P = 0.081, respectively). High-density lipoprotein cholesterol level ( P = 0.008) and Apo A-I ( P = 0.006) were also significant predictors of atherosclerotic plaque ≥ 4 mm. Similar trends were observed after exclusion of subjects on cholesterol lowering drugs. Conclusion High-density lipoprotein cholesterol level and Apo B/A-I ratio, but not total or low-density lipoprotein cholesterol levels, were strongly associated with degree of proximal aortic atherosclerosis.
The Prevalence of Peripheral Arteriopathy is Higher in Ischaemic Stroke as Compared with Transient Ischaemic Attack and Intracerebral Haemorrhage
Authors: Huttner Hagen B. , Köhrmann Martin , Mauer Christoph , Lücking Hannes , Kloska Stephan , Doerfler Arnd , Schwab Stefan , Schellinger Peter D. 
Published: July 2010

Background: There is little data on the association of peripheral arterial disease and stroke. We aimed to assess the prevalence of peripheral arterial disease in acute stroke and to identify the predisposing factors for peripheral arterial disease in a stroke cohort. Methods: We enrolled all consecutive patients who were admitted to our stroke- and neurocritical care units with the diagnosis of a transient ischaemic attack, ischaemic or haemorrhagic stroke over a period of 5 months. As controls, we analysed 50 nonvascular neurological patients who were matched to age. Upon admission, assessment of the ankle brachial index was performed in all patients. The only exclusion criteria was decompensated congestive heart failure. Results: Altogether, we compared 374 stroke patients (95 transient ischaemic attack, 231 ischaemic, and 48 haemorrhagic strokes) and 50 nonstroke controls. The prevalence of peripheral arterial disease in the control group was 14%. There was a trend towards a higher prevalence of peripheral arterial disease in stroke patients (χ2-test: P = 0.051; prevalence peripheral arterial disease in transient ischaemic attack: 16.8%, ischaemic stroke: 32%, and haemorrhagic stroke: 20.8%). A higher proportion of ischaemic stroke patients were peripheral arterial disease-positive, compared with transient ischaemic attack patients ( P = 0.005) and controls ( P = 0.011), respectively. Multivariate regression analyses identified the parameters age, arterial hypertension, current or former smokers and a history of cardiovascular events to be predisposing factors of peripheral arterial disease. Conclusion: This study represents the first systematic investigation of the prevalence of peripheral arterial disease in stroke. By now, it is clear that: • peripheral arterial disease is more commonly found in stroke than in nonstroke patients • ischaemic stroke patients show the highest prevalence of peripheral arterial disease, and • peripheral arterial disease in stroke is related to common vascular risk factors.