bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization patterns of central nervous system drugs: A cross-sectional study among the critically ill patients
Authors: John Lisha Jenny , Devi Padmini , John Jenny , Arifulla Mohamed , Guido Shoba 
Published: August 2011

ABSTRACT
Introduction: Critically ill patients often receive central nervous system drugs due to primary disorder or complications secondary to multiorgan failure. The aim of the study was to evaluate the current utilization pattern of central nervous system drugs among patients in the medical intensive care unit. Materials and Methods: A prospective observational study carried out over a period of 1 year. The relevant data on drug prescription of each patient was collected from the inpatient case record. Drugs were classified into different groups based on WHO–ATC classification. The demographic data, clinical data, and utilization of different classes of drugs as well as individual drugs were analyzed. Results: A total of 325 consecutive patients were included for the analysis; 211 (65%) patients were males; 146 patients (45%) were above 55 years of age. Encephalopathy [63(19.38%)] and stroke [62(19%)] were the common central nervous system diagnoses. In a total of 1237 drugs, 68% of the drugs were prescribed by trade name. Midazolam (N05CD08) 142 (43.69%), morphine (N02AA01) 201 (61.84%), and atracurium (M03AC04) 82 (25.23%) were the most commonly used sedative, analgesic, and neuromuscular blocker, respectively. Phenytoin (N03AB02) 151 (46.46%) had maximum representation among antiepileptic agents. Conclusions: Utilization of drugs from multiple central nervous system drug classes was noticed. Rational use of drugs can be encouraged by prescription by brand name.
Comparison of antinociceptive effect of the antiepileptic drug gabapentin to that of various dosage combinations of gabapentin with lamotrigine and topiramate in mice and rats
Authors: Paudel Keshab Raj , Bhattacharya SK , Rauniar GP , Das BP 
Published: August 2011

ABSTRACT
Introduction: Newer anticonvulsants have a neuromodulatory effect on pain perception mechanisms in a hyperexcitable and damaged nervous system. Aim: This study was designed to study the analgesic effects of gabapentin alone and in combination with lamotrigine and topiramate in experimental pain models. Materials and Methods: Adult albino mice (n = 490) weighing 20–30 g and rats (n = 130) weighing 100–200 g were injected intraperitoneally with gabapentin, lamotrigine, and topiramate alone and in different dose combinations. The hot-plate method, tail-flick method, capsaicin-induced mechanical hyperalgesia, and formalin assay were used to assess the antinociceptive effects. Results: Of the three antiepileptic drugs, when given separately, gabapentin was more efficacious than either topiramate or lamotrigine in all the pain models. Combination of 25 mg/kg gabapentin with 25 mg/kg topiramate was more efficacious (P <.05) than 50 mg/kg gabapentin alone in the capsaicin-induced mechanical hyperalgesia test. Similarly, 50 mg/kg gabapentin with 50 mg/kg topiramate or 5 mg/kg lamotrigine was more efficacious (P <.05) than 50 or 100 mg/kg gabapentin alone in late-phase formalin-induced behaviors. Conclusions: Combination of gabapentin with either lamotrigine or topiramate produced better results than gabapentin alone in capsaicin-induced mechanical hyperalgesia test and in late-phase formalin-induced behaviors.
Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia
Authors: Singla Sanju , Prabhakar Vikram , Singla Rajan Kumar 
Published: August 2011

ABSTRACT
Background: Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients. Aims and Design: The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia. Materials and Methods: The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face. Results: The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients. Conclusions: Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia.
Airway management for occipital encephalocele in neonatal patients: A review of 17 cases
Authors: Yildirim Zeynep Baysal , Avci Emel , Torun Fuat , Cengiz Mustafa , Çigdem Ali , Karabağ Hamza , Karaman Haktan 
Published: August 2011

ABSTRACT
Introduction: Encephalocele, midline defect of cranial bone fusion, occurs most frequently in the occipital region. Airway management in pediatric patients with craniofacial disorders poses many challenges to the anesthesiologist. The purpose of this study is to describe the airway problems encountered for such cases, and describe how these problems were managed. Materials and Methods: We reviewed the charts of occipital encephalocele newborn that were treated by surgical correction in Harran University Hospital during 2006–2008. The collected data were categorized into preoperative, intraoperative, and postoperative data. Results: The mean age of the patients was 5.17 days. Of these 17 patients, eight patients (47.1%) had hydrocephaly, one patient (5.8%) with Dandy Walker syndrome. Micrognathia, macroglossia, restriction in neck movements were recorded as the reasons in six cases each. No major anesthetic complication was found. Conclusions: We reported perioperative management in 17 occipital encephalocele infant. Comprehensive care during peroperative period is essential for successful outcome.
Unusual features in chronic inflammatory demyelinating polyneuropathy: Good outcome after prolonged ventilatory support
Authors: Jha Sanjeev , Ansari MK , Sonkar KK , Paliwal VK 
Published: August 2011

ABSTRACTSevere respiratory muscle paralysis and ventilatory failure is rare in chronic inflammatory demyelinating polyneuropathy (CIDP). We report a 14 year child who presented with respiratory failure, bulbar and multiple cranial nerves involvement along with bilateral phrenic nerve paralysis. He was diagnosed with CIDP after electrophysiological evaluation. He required AMBU ventilation for about 4 months (including domiciliary use), after which he recovered significantly. Along with several unusual features of CIDP, this report highlights good example of steady basic intensive care to save lives and rewarding outcome of prolonged respiratory support, provided by AMBU ventilation which is a rather primitive, but inexpensive device.
Occipital artery occlusion to facilitate transmastoid posterior fossa tumor embolization
Authors: Kumar Subhash , Sharma Rohitash , Goyal Sumit , Husain Shakir 
Published: August 2011

ABSTRACTThe transmastoid branch of the occipital artery is an important supply to posterior fossa vascular malformations and tumors and is often difficult to catheterize due to tortuosity and a transforaminal course. In very difficult situations, we can try to induce spasm of the occipital artery just beyond the origin of the mastoid branch by repeated passages of the microcatheter/wire. This induces a temporary ‘ligation’ like effect so that the microcatheter can then be manipulated into the mastoid branch via the mastoid foramen. Rarely, the occipital artery has to be sacrificed if spasm cannot be induced or is short living, following which particles can be injected from a distance without entering the mastoid foramen. Occluding the occipital artery proximally has no effect on distal perfusion, as collaterals and anastomoses from superficial temporal artery, posterior auricular artery, and opposite occipital artery take over the supply.
Bladder distension: An unusual cause of reflux of blood and hemodynamic changes (autonomic dysreflexia) during endovascular coiling
Authors: Sharma DP , Singh Daljit , Ganjoo P , Tandon M 
Published: August 2011

ABSTRACTAutonomic dysreflexia due to distended bladder is well known. Reflux of blood during endovascular procedure is also a common observation. It happens due to difference in pressure gradient between arterial pressure and that of infusing solution. Generally it happens when the infusion bottle is empty or the pressure in infusion bottles fall. We present an uncommon situation where distended bladder mechanically resulted in reflux of blood into endovascular catheters as well as alteration in hemodynamic parameters. Both settled once the bladder was empty.
Cystic mature teratoma of the thoracic region in a child: An unusual case
Authors: Basmaci Mehmet , Hasturk Askin Esen , Pak Isin 
Published: August 2011

ABSTRACTCystic mature teratomas of the spinal cord are rare lesions. Teratomas account for up to 0.1% of all spinal cord tumors. Teratomas include tissues that originate from the three germ layers. Several congenital disorders may accompany the teratoma. Teratomas are classified as mature, immature or malignant type according to their histological characteristics. Thoracic spinal teratomas are uncommon in the pediatric age group. More than half of the patients are adults. We present herein a five-year-old male patient who was referred to our clinic with cystic mature teratoma at the T12 level.
Mania associated with complicated hereditary spastic paraparesis
Authors: Nayak Raghavendra B , Bhogale Govind S , Patil Nanasaheb M , Pandurangi Aditya A 
Published: August 2011

ABSTRACTHereditary spastic paraparesis (HSP) is an inherited group of neurological disorders with progressive lower limb spasticity. HSP can be clinically grouped into pure and complicated forms. Pure HSP is one without any associated neurological/psychiatric comorbidity. Depression is the most common psychiatric comorbidity. Presence of mania or bipolar affective illness with HSP is a rare phenomenon. We report a case of a 17-year-old boy who presented with classical features of HSP with complaints of excessive happiness, irritability, increased self-esteem and decreased sleep since 1 month. The patient also had complex partial seizure ever since he had features of HSP. The patient’s father and younger sister suffer from pure HSP. The patient was diagnosed to have first episode mania with complicated HSP. The details of treatment and possible neurobiology are discussed in this case report.
Nonprofit Health Insurers: The Story Wall Street Doesn't Tell
Authors: Johnson Susan R. 
Published: August 2011

For several years, Wall Street investment firms have campaigned for conversion of nonprofit health insurers to investor ownership, arguing that an infusion of equity capital is critical to insurers' survival. However, closer examination of the financial performance and capital position of not-for-profit health plans shows that: □ The lower operating margins reported by not-for-profit health plans very likely reflect the organizations' corporate missions to serve their communities by minimizing the cost of coverage and their ability to invest all gains back into the company for the future benefit of their customers. Their investor-owned counterparts must generate higher margins to give shareholders a return on their investment. □ Compared with investor-owned insurers, not-for-profit health plans use a significantly higher percentage of the customers' premium dollar to pay health care claims. A lower percentage goes for administrative expenses. □ Over the past 10 years, not-for-profit health plans have succeeded in using operational and investment gains to build and retain a strong capital position—stronger than that of investor-owned companies—while investing heavily in infrastructure, product development, and market growth.
Aspects of Health Reform: Contributions from the Economic Research Initiative on the Uninsured. Aspects of Health Reform: Introduction
Authors: McLaughlin Catherine , Levy Helen , Quinn Brian 
Published: August 2011

From 2001 to 2008, the Robert Wood Johnson Foundation funded the Economic Research Initiative on the Uninsured (ERIU), housed at the University of Michigan. The goals of ERIU were to increase, diversify, and improve the quality and quantity of economics research on the uninsured, and to translate that research into the type of resources that are useful to policymakers, policy analysts, researchers, and members of the media. One of the primary objectives of ERIU was to fund research projects that explored economic issues about the uninsured in new, yet rigorous and interesting ways. ERIU began by commissioning six critical syntheses of the existing research. These syntheses were intended to inform researchers of what we know and what we don't know about the uninsured. In eight years, ERIU funded more than 50 new research projects on a variety of coverage topics aimed at addressing the gaps in knowledge highlighted in these syntheses. These projects, involving more than 100 researchers, resulted in over 70 conference and seminar presentations worldwide and approximately 40 articles published in peer-reviewed journals.
Growing Interest in Meditation in the United States
Authors: Burke Adam , Gonzalez Autumn 
Published: August 2011

Meditation is a self-regulatory, mind-body process used to help engage attention and awareness, and to produce a state of inner quiescence. It has been used as a self-transformative practice for millennia, most notably in the Far East. Interest in meditation was evident in the United States in the late 19th century, and began to flourish during the early 1960s as Transcendental Meditation, Zen, and other traditions grew significantly in popularity. Over the ensuing decades a large body of scientific literature has also emerged. One factor contributing to this growth in publications is an increasingly sophisticated ability to measure brain activity using functional magnetic resonance imaging (fMRI) and advance EEG and MEG technologies. National surveys, including the National Health Interview Survey's (NHIS), also show clear evidence of growing consumer interest in meditation. The NHIS shows use of meditation to be in the top ten most commonly used complementary and alternative medicine (CAM) therapies. The most recent 2007 NHIS compared findings of meditation use with reported use in the 2002 survey. A statistically significant increase in mediation practice among adults in the previous 12 months was noted, up from 7.6% in 2002 to 9.4% in 2007.
Interfuel Substitution and Energy Use in the U.K. Manufacturing Sector
Authors: Steinbuks Jevgenijs 
Published: August 2011

This paper investigates interfuel substitution, separately accounting for different types of energy use in the U.K. manufacturing sector. Econometric models of interfuel substitution are applied to aggregate energy use, as well as to a specific energy use process—thermal heating—where interfuel substitution is technologically feasible. Compared to the aggregate data, the estimated own-price elasticities for all fuels and the cross-price elasticities for fossil fuels are considerably higher for thermal heating processes. Nonetheless, electricity is found to be a poor substitute for other fuels based on both aggregate data and, separately, for the heating process. An increase in real fuel prices from the Climate Change Levy in 2001 resulted in higher substitution elasticities based on aggregate data, and lower substitution elasticities for the thermal heating process. The results of a counterfactual decomposition of change in the estimated elasticities indicate that technological change was the major determinant of the differences in observed elasticities before and after the energy price increase.doi: 10.5547/ISSN0195-6574-EJ-Vol33-No1-1
The Impact of State Level Building Codes on Residential Electricity Consumption
Authors: Aroonruengsawat Anin , Auffhammer Maximilian , Sanstad Alan H. 
Published: August 2011

This paper studies the impacts of state level residential building codes on per capita residential electricity consumption. We construct a timeline of when individual states first implemented residential building codes. Using panel data for 48 US states from 1970-2006, we exploit the temporal and spatial variation of building code implementation and issuance of building permits to identify the effect of the regulation on residential electricity consumption. Controlling for the effect of prices, income, and weather, we show that states that adopted building codes followed by a significant amount of new construction have experienced detectable decreases in per capita residential electricity consumption—ranging from 0.3-5% in the year 2006. Estimates are larger in states where codes are more stringent and more strictly enforced.doi: 10.5547/ISSN0195-6574-EJ-Vol33-No1-2
Willingness to Pay for a Climate Backstop: Liquid Fuel Producers and Direct CO2Air Capture
Authors: Nemet Gregory F. , Brandt Adam R. 
Published: August 2011

We conduct a sensitivity analysis to describe conditions under which liquid fuel producers would fund the development of a climate backstop. We estimate (1) the cost to develop competitively priced direct CO2air capture technology, a possible climate backstop and (2) the effect of this technology on the value of liquid fuel reserves by country and fuel. Under most assumptions, development costs exceed individual benefits. A particularly robust result is that carbon prices generate large benefits for conventional oil producers—making a climate backstop unappealing for them. Unilateral investment does become more likely under: stringent carbon policy, social discount rates, improved technical outcomes, and high price elasticity of demand for liquid fuels. Early stage investment is inexpensive and could provide a hedge against such developments, particularly for fuels on the margin, such as tar sands and gas-to-liquids. Since only a few entities benefit, free riding is not an important disincentive to investment, although uncertainty about who benefits probably is.doi: 10.5547/ISSN0195-6574-EJ-Vol33-No1-3
Precisely Designed Gold Nanoparticles by Surface Polymerization – Artificial Molecules as Building Blocks for Novel Materials
Authors: Bokern Stefan , Gries Katharina , Görtz Hans‐Helmut , Warzelhan Volker , Agarwal Seema , Greiner Andreas 
Published: August 2011

AbstractThe synthesis of gold nanoparticles (2–4 nm) carrying a single functional polystyrene chain and its characterization by gel permeation chromatography are reported. This has been achieved by a new type of macromolecular azo‐initiator based on telechelic polystyrene with containing α,ω‐methylcoumarin endgroups and an azo group in the middle of the polystyrene. The structure and the near‐quantitative functionality of the initiator have been verified by performing NMR, GPC, and UV–vis measurements. This macroinitiator has been used to initiate a surface polymerization of 4‐vinylthiophenol molecules immobilized on the surface of gold nanoparticles. As a product, gold nanoparticles carrying exactly one polystyrene chain have been synthesized with functionalization degrees of up to 90% (crude yield). Proof and quantification of the functionalization degree have been demonstrated by application of a GPC setup with a diode array detector for online UV–vis spectra.
A tubular PLGA‐sandwiched cell/hydrogel fabrication technique based on a step‐by‐step mold/extraction process
Authors: WANG Xiaohong , Mäkitie Antti A. , Paloheimo Kaija‐stiina , Tuomi Jukka , Paloheimo Markku , Sui Shaochun 
Published: August 2011

AbstractFor successful blood vessel and organ manufacturing, it is critical to maintain the cell survival rate in an environment suitable for the appropriate inducement of regeneration. Mechanical properties and cell compatibilities of artificial grafts are equally critical for the long‐term structural and biological stabilization. By combining the advantages of both synthetic and natural polymers, a hybrid poly(dl‐lactic‐co‐glycolic acid) (PLGA) sandwiched adipose stem cell (ADSC)/fibrin construct is proposed in this study. A step‐by‐step mold/extraction method was developed for generating the smooth muscle tissue in vitro. Through the predesigned molds, two different material systems were arranged in a predefined space to act as different roles. The organic solvent in the PLGA/tetraglycol was easily extracted during the fabrication process, and no harmful effects were observed to the seeding cells. The technique holds the promise for wide use in complex organ manufacturing. © 2011 Wiley Periodicals, Inc. Adv Polym Techn 30: 163–173, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/adv.20213
Preparation and characterization of grafted cellophane membranes for affinity separation of His‐tag Chitinase
Authors: Eldin M. S. Mohy , Rahman S. Abdel , Fawal G. F. El 
Published: August 2011

AbstractImmobilized Cu2+ ions affinity cellophane membranes for affinity separation of His‐tag Chitinase were prepared. Cellophane membranes were first grafted with polymethacrylic acid, and the impacts of various grafting conditions on grafting process parameters were evaluated. Fourier transform infrared analysis and thermal gravimetric analysis provided evidences of grafting occurrence. The grafted membranes were then immobilized with copper ions as the last step before being tested in separation of chitinase enzyme from an equal protein mixture with bovine serum albumin (BSA). The membranes show high affinity toward the separation of chitinase enzyme, which adsorbed 80% of chitinase and only 28% of BSA from the 0.25% protein mixture solution. At lower concentrations, 0.025%–0.05%, the membranes show complete selectivity toward chitinase. No leakage of Cu2+ ions was detected in the elution solution, whereas 95% of chitinase and 90% of BSA were eluted. © 2011 Wiley Periodicals, Inc. Adv Polym Techn 30: 191–202, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/adv.20216