bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of the maximum modified early warning score to predict the need for higher care utilization among admitted emergency department patients
Authors: Heitz Corey R. , Gaillard John P. , Blumstein Howard , Case Doug , Messick Catherine , Miller Chadwick D. 
Published: January 2010

AbstractBACKGROUND:It is uncertain whether ED‐calculated risk scores can predict required intensity of care upon hospital admission. This investigation examines whether versions of the Modified Early Warning Score (MEWS) predict high level of care utilization among patients admitted from the ED.METHODS:A retrospective chart review of 299 admissions was implemented. Exclusions prior to abstraction included pediatrics, cardiology, or trauma admissions. Using a data‐gathering instrument, abstractors recorded physiologic parameters and clinical variables. Risk scores were calculated electronically. In contrast to the original MEWS, the MEWS Max was calculated using data from the entire ED visit. The primary outcome composite included all‐cause mortality and higher care utilization within 24 hours.RESULTS:The final analysis contained 280 participants. 76 (27%) met the composite endpoint of death (n = 1) or higher care utilization (n = 76). The MEWS Max was associated with the composite outcome (OR=l.6 [95% CI 1.3‐1.8] for each one point increase). The MEWS Max had moderate predictive ability (C statistic: MEWS Max 0.73 [0.66‐0.79]) but classified 82% of participants as intermediate (10‐40%) risk. Inclusion of additional variables slightly improved the predictive ability (C statistic 0.76 [0.69–0.82]) and correctly reclassified 17% of patients as <10% risk.CONCLUSIONS:The MEWS Max has moderate ability to predict the need for higher level of care. Addition of ED length of stay and other variables to MEWS Max may identify patients at both low and high risk of requiring a higher level of care. Journal of Hospital Medicine 2010;5:E46–E52. © 2010 Society of Hospital Medicine.
Impact of a restrictive antimicrobial policy on the process and timing of antimicrobial administration
Authors: Winters Bradford D. , Thiemann David R. , Brotman Daniel J. 
Published: January 2010

AbstractBACKGROUND:In‐hospital antimicrobial approval policies are designed to curb the indiscriminant use of antimicrobials. These policies usually require written forms and/or direct requests to an Infectious Disease specialist (or surrogate) prior to release of the antimicrobial. We hypothesized that the approval processes at our institution results in delayed antimicrobial administration.METHODS:We performed a retrospective cohort study examining the time from order to administration for 25 different antimicrobials ordered “stat.” Antimicrobials were classified as restricted (required approval) or unrestricted. We compared these 2 classes to each other both during the daytime (8 AM to 10 PM), when approval is required for restricted antimicrobials, and at night when the first dose of all antimicrobials is exempted. We defined a delay in administration when the medication was given >1 hour from time of order. We separately examined delays of >2 hours.RESULTS:A higher percentage of >1‐hour delays occurred when the antimicrobial was restricted (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.23‐1.82). Similar results were seen for >2‐hour delays (OR = 1.78; 95% CI = 1.39‐2.21). During the exempt‐from‐restriction time period (10 PM to 8 AM), there was no difference between these 2 classes of antimicrobials. Results were unchanged by adjustment for service (medicine vs. surgery vs. other), patient characteristics (age, sex, race), or by weekday vs. weekend.CONCLUSIONS:Statistically significant delays in stat antimicrobial administration occur in our institution when antimicrobials require preapproval. These findings illustrate the importance of considering clinical efficiency when restrictions are put in place for time‐sensitive therapies such as antimicrobials. Journal of Hospital Medicine 2010;5:E41–E45. © 2010 Society of Hospital Medicine.
The temporal and spatial structures of recent and future trends in extreme indices over Korea from a regional climate projection
Authors: Im E. S. , Jung I. W. , Bae D. H. 
Published: January 2010

AbstractThe temporal and spatial characteristics of trends in extreme indices over Korea between 1971 and 2100 are investigated using daily minimum (Tmin) and maximum (Tmax) temperature and precipitation data from a regional climate projection at 20 km grid spacing. Five temperature–based indices and five precipitation–based indices are selected to comprehensively consider the frequency, intensity, and persistence of extreme events. In addition, Mann–Kendall tests are used to detect the statistical significance of trends in these indices. For validation during the reference period (1971–2000), the model reasonably simulates the temporal and spatial pattern of the trend. The model captures observed direction and magnitude well in various types of extremes. Indices based on Tmin show a considerable change towards warmer climate conditions while indices based on Tmax do not reveal any distinct trend, implying an asymmetric response of Tmin and Tmax to global warming. Indices of the frequency and intensity of heavy precipitation show a significant increase, whereas the duration of dry and wet consecutive days shows no change. For future projections, the temperature–based indices exhibit a much more significant and consistent trend than the precipitation–based indices, with statistical significance at the 95% confidence level for all indices. The frequency and intensity of heavy precipitation are projected to increase in the 21st century, continuing the trend of the reference climate. Although the future projected changes in the duration of consecutive dry and wet days are not statistically significant, the signal becomes more pronounced with respect to the reference simulation. Copyright © 2010 Royal Meteorological Society
Variability in the summer season hydrological cycle over the Atlantic‐Europe region 1979–2007
Authors: Allan Richard P. , Zveryaev Igor I. 
Published: January 2010

AbstractVariability in aspects of the hydrological cycle over the Europe‐Atlantic region during the summer season is analysed for the period 1979–2007, using observational estimates, reanalyses and climate model simulations. Warming and moistening trends are evident in observations and models although decadal changes in water vapour are not well represented by reanalyses, including the new European Centre for Medium Range Weather Forecasts (ECMWF) Interim reanalysis. Over the north Atlantic and northern Europe, observed water vapour trends are close to that expected from the temperature trends and Clausius–Clapeyron equation (7% K−1), larger than the model simulations. Precipitation over Europe is dominated by large‐scale dynamics with positive phases of the North Atlantic Oscillation coinciding with drier conditions over north Europe and wetter conditions over the Mediterranean region. Evaporation trends over Europe are positive in reanalyses and models, especially for the Mediterranean region (1–3% per decade in reanalyses and climate models). Over the north Atlantic, declining precipitation combined with increased moisture contributed to an apparent rise in water vapour residence time. Maximum precipitation minus evaporation over the north Atlantic occurred during summer 1991, declining thereafter. Copyright © 2010 Royal Meteorological Society
BMP‐7–induced ectopic bone formation and fracture healing is impaired by systemic NSAID application in C57BL/6‐mice
Authors: Spiro Alexander S. , Timo Beil F. , Baranowsky Anke , Barvencik Florian , Schilling Arndt F. , Nguyen Khoa , Khadem Shahram , Seitz Sebastian , Rueger Johannes M. , Schinke Thorsten , Amling Michael 
Published: January 2010

AbstractNonsteroidal antiinflammatory drugs (NSAIDs) are known to potentially impair the fracture healing process. The aim of the present study was to determine if the impairment of bone healing by systemic NSAID application is, at least in part, due to an interaction of NSAIDs with the bone anabolic BMP‐7 pathway. Therefore, we first analyzed fracture healing in control and diclofenac‐treated mice, where we not only found a significant impairment of fracture healing due to diclofenac treatment as assessed by biomechanical testing and µCT imaging, but also found high coexpression of bone morphogenetic protein‐7 (BMP‐7) and cyclooxygenase‐2 (COX‐2) within the fracture callus of both groups. To experimentally address the possible interaction between BMP‐7 and COX‐2, we then induced ectopic bone formation in control (n = 10) and diclofenac‐treated mice (n = 10) by application of BMP‐7 (recombinant human OP‐1, rhOP‐1) into the hamstring muscles. After 20 days of treatment, each ectopic bone nodule was analyzed by contact‐radiography, µCT, histology, and histomorphometry. Diclofenac application decreased the trabecular number and bone mass in the ectopic bone nodules significantly due to reduced osteoblast number and activity. These data demonstrate that the bone anabolic effect of BMP‐7 and fracture healing is impaired by diclofenac application, and suggest that the potential negative impact of NSAIDs on fracture healing is, at least in part, due to interference with BMP‐7 signaling. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:785–791, 2010
Modulation of Wnt signaling influences fracture repair
Authors: Komatsu David E. , Mary Michelle N. , Schroeder Robert Jason , Robling Alex G. , Turner Charles H. , Warden Stuart J. 
Published: January 2010

AbstractWhile the importance of Wnt signaling in skeletal development and homeostasis is well documented, little is known regarding its function in fracture repair. We hypothesized that activation and inactivation of Wnt signaling would enhance and impair fracture repair, respectively. Femoral fractures were generated in Lrp5 knockout mice (Lrp5−/−) and wild‐type littermates (Lrp5+/+), as well as C57BL/6 mice. Lrp5−/− and Lrp5+/+ mice were untreated, while C57BL/6 mice were treated 2×/week with vehicle or anti‐Dkk1 antibodies (Dkk1 Ab) initiated immediately postoperatively (Day 0) or 4 days postoperatively (Day 4). Fractures were radiographed weekly until sacrifice at day 28, followed by DXA, pQCT, and biomechanical analyses. Lrp5−/− mice showed impaired repair compared to Lrp5+/+ mice, as evidenced by reduced callus area, BMC, BMD, and biomechanical properties. The effects of Dkk1 Ab treatment depended on the timing of initiation. Day 0 initiation enhanced repair, with significant gains seen for callus area, BMC, BMD, and biomechanical properties, whereas Day 4 initiation had no effect. These results validated our hypothesis that Wnt signaling influences fracture repair, with prompt activation enhancing repair and inactivation impairing it. Furthermore, these data suggest that activation of Wnt signaling during fracture repair may have clinical utility in facilitating fracture repair. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:928–936, 2010
Increased morbidity rates in patients with heart disease or chronic liver disease following radical gastric surgery
Authors: Jeong Sang‐Ho , Ahn Hye Sung , Yoo Moon‐Won , Cho Jae‐Jin , Lee Hyuk‐Joon , Kim Hyung‐Ho , Lee Kuhn‐Uk , Yang Han‐Kwang 
Published: January 2010

AbstractBackgroundThe aim of this study was to investigate possible associations between (i) comorbid disease and (ii) perioperative risk factors and morbidity following radical surgery for gastric cancer.Materials and MethodsConsecutive patients (759) undergoing radical gastrectomy and D2 level lymph node dissection for gastric cancer were included. Clinical data concerning patient characteristics, operative methods, and complications were collected prospectively.ResultsThe morbidity rate for radical gastrectomy was 14.2% (108/759). The most significant comorbid risk factors for postoperative morbidity were heart disease [anticoagulant medication: OR = 1.5 (95% CI = 0.35–6.6, P = 0.53); history without medication: OR = 4.0 (95% CI = 1.1–14.6, P = 0.03); history with current medication: OR = 6.7 (95% CI = 1.5–29.9, P = 0.01)] and chronic liver disease [chronic hepatitis: OR = 2.4 (95% CI = 0.9–6.5, P = 0.07); liver cirrhosis class A: OR = 8.4 (95% CI = 2.8–25.3, P = 0.00); liver cirrhosis class B: OR = 9.38 (95% CI = 0.7–115.5, P = 0.08)]. The most significant perioperative risk factors for postoperative morbidity were high TNM stage and combined organ resection (P < 0.05), and there was no association between increased postoperative morbidity and well controlled hypertension, anticoagulant therapy, diabetes mellitus, pulmonary disease, tuberculosis, or thyroid disease (P > 0.05).ConclusionPatients with heart disease or chronic liver disease are at a higher risk of morbidity following radical surgery for gastric cancer. J. Surg. Oncol. 2010; 101:200–204. © 2010 Wiley‐Liss, Inc.
Axillary reverse mapping with indocyanine fluorescence imaging in patients with breast cancer
Authors: Noguchi Masakuni , Yokoi Miki , Nakano Yasuharu 
Published: January 2010

AbstractBackgroundThe ARM technique was proposed to prevent arm lymphedema after ALND and/or SLN biopsy. However, several problems remain to be resolved in the practical application of this technique.MethodsThe fluorescent ARM nodes and/or lymphatics were identified using a fluorescence imaging system with subdermal injection of indocyanine green into the upper limb. ALND was performed in patients with clinically involved nodes, and the ARM nodes were separately removed during ALND. SLN biopsy was performed in patients with clinically uninvolved nodes. If SLN was positive, ALND was performed with removal of ARM nodes. Otherwise, identified ARM nodes were preserved unless they were the same as SLN.ResultsARM nodes and/or lymphatics were identified in 7 (88%) of 8 patients who underwent ALND, whereas they were identified in 9 (75%) of 12 patients who underwent SLN biopsy alone. ARM nodes were involved with tumors in 3 (43%) of the former patients, and SLN was the same as the ARM node in 2 (14%) of 14 patients who underwent SLN biopsy.ConclusionsFluorescence imaging was sensitive for identification of ARM nodes and/or lymphatics. However, further studies are needed before efforts to preserve these nodes can be safely implemented. J. Surg. Oncol. 2010; 101:217–221. © 2010 Wiley‐Liss, Inc.
A bio‐analytical hydrophilic interaction LC‐MS/MS method for the simultaneous quantification of omeprazole and lansoprazole in human plasma in support of a pharmacokinetic omeprazole study in children
Authors: De Smet Julie , Boussery Koen , De Cock Pieter , De Paepe Peter , Remon Jean‐Paul , Van Winckel Myriam , Van Bocxlaer Jan 
Published: January 2010

AbstractA hydrophilic interaction LC method with MS/MS was developed and validated for the simultaneous quantification of omeprazole and lansoprazole in human plasma. Chromatographic separation was achieved on a Betasil silica column using a high organic mobile phase (eluent A: ACN/formic acid 997.5:2.5 v/v; eluent B: water/formic acid 997.5:2.5 v/v) and gradient elution. The mass spectrometer was operated in the Multiple Reaction Monitoring mode. Prior to chromatography, liquid–liquid extraction with ethyl acetate was used and the organic layer was diluted with ACN, allowing direct injection on column. The method showed acceptable linearity, high precision (RSD%<10.5%), accuracy (88.9–109.3%) and selectivity in the two concentration ranges studied: 1.5–100 and 5–2000 ng/mL. The LOQ was established at 1.5 and 5 ng/mL for the two concentration ranges. Lack of variability in matrix effects was demonstrated and mean extraction recovery for omeprazole and lansoprazole was determined in the low (56.3–67.7%) and high (45.3–44.3%) concentration range, respectively. Additionally, plasma samples were found to be stable after three freeze–thaw cycles and for at least 15 h after extraction. This assay was successfully applied to a pharmacokinetic omeprazole study in children with cerebral palsy and mental retardation.
Preparation of sub‐micron skeletal monoliths with high capacity for liquid chromatography
Authors: Yao Chunhe , Qi Li , Yang Gengliang , Wang Fuyi 
Published: January 2010

AbstractA novel kind of poly(glycidyl methacrylate‐co‐ethylene glycol dimethacrylate)‐based monolithic column was developed for LC by directing supramolecular self‐assembly of high internal phase emulsion. Mercury intrusion porosimetry characterization and scanning electron microscope pictures showed that these monoliths presented micrometer‐sized throughpores, unique sub‐micron skeletons and relatively large specific surface area. Additionally, porosity of monoliths could be adjusted while skeletons remained in the size range of 100.0–1000.0 nm. The new monoliths demonstrated not only better column efficiency, but also larger binding capacity. Dynamic binding capacity for protein (BSA) was evaluated to be 42.5 mg/mL, above two times higher than that of the general monoliths (19.1 mg/mL) and higher than that of commercial “Convective Interaction Media” monolithic columns (30.0 mg/mL). Moreover, their chromatographic behaviors were also evaluated in detail by chemical stability and swelling characterization of the monolithic column. Separation of proteins mixture (cytochrome c, myoglobin, ribonuclease A, lysozyme and BSA) on the monolith was achieved within 4 min at velocity of 1440.0 cm/h. Those unique properties made the novel monolithic column a promising alternative to commercially available monolithic supports in LC applications.
Influence of stationary phase chemistry and mobile‐phase composition on retention, selectivity, and MS response in hydrophilic interaction chromatography
Authors: Fountain Kenneth J. , Xu Jane , Diehl Diane M. , Morrison Damian 
Published: January 2010

AbstractA comprehensive retention and selectivity characterization of several hydrophilic interaction chromatography (HILIC) stationary phases was performed with 28 test probes in order to study the influence of particle type, surface chemistry, and mobile‐phase pH on chromatographic retention, selectivity, and MS response. Selectivity differences were compared for columns operated at both low and high pH, while ESI‐MS was used to study the effects of mobile‐phase pH on signal response. Additionally, acetone was explored as a potential alternative to ACN as the weak HILIC solvent. Moderate differences in selectivity were observed on the same column operated at different pH, mostly due to acidic compounds. In addition, the MS response increased when a high pH mobile phase was used, particularly for analytes that were ionized with negative ESI‐MS. Even larger selectivity differences were observed for different stationary phases evaluated with the same mobile phase. Acetone was not a suitable replacement for ACN in routine HILIC separations due to differences in selectivity and MS response. Finally, the data from this study were used to establish guidelines for rapid HILIC method development of polar compounds, which is demonstrated with a mixture of histidine dipeptides and organophosphonate nerve agent metabolites.
Kinetics and mechanisms of OH‐initiated oxidation of small unsaturated alcohols
Authors: Takahashi Kenshi , Hurley Michael D. , Wallington Timothy J. 
Published: January 2010

AbstractSmog chamber relative rate techniques were used to measure rate coefficients of (5.00 ± 0.54) × 10−11, (5.87 ± 0.63) × 10−11, and (6.49 ± 0.82) × 10−11cm3molecule−1s−1in 700 Torr air at 296 ± 1 K for reactions of OH radicals with allyl alcohol, 1‐buten‐3‐ol, and 2‐methyl‐3‐buten‐2‐ol, respectively; the quoted uncertainties encompass the extremes of determinations using two different reference compounds. The OH‐initiated oxidation of allyl alcohol in the presence of NOxgives glycolaldehyde in a molar yield of 0.85 ± 0.08; the quoted uncertainty is two standard deviations. Oxidation of 2‐methyl‐3‐buten‐2‐ol gives acetone and glycolaldehyde in molar yields of 0.66 ± 0.06 and 0.56 ± 0.05, respectively. The reaction of OH radicals with allyl alcohol, 1‐buten‐3‐ol, and 2‐methyl‐3‐buten‐2‐ol proceeds predominately via addition to the >CCH2double bond with most of the addition occurring to the terminal carbon. © 2010 Wiley Periodicals, Inc. Int J Chem Kinet 42: 151–158, 2010
The relationship between trusting beliefs and Web site loyalty: The moderating role of consumer motives and flow
Authors: Gupta Reetika , Kabadayi Sertan 
Published: January 2010

AbstractThis research (1) examines how specific consumer motives (i.e., goal‐directed: searching for information, experiential: browsing for recreation) influence the trusting belief–loyalty relationship at a Web site in a distinct manner and (2) investigates how the online flow experience in each of the motive states strengthens or weakens the trusting belief–loyalty relationship. The results suggest that for consumers with an experiential motive, benevolence‐ and integrity‐related beliefs are the key drivers of loyalty, while ability‐related beliefs do not drive loyalty. On the other hand, for consumers with a goal‐directed motive, the ability‐ and integrity‐related beliefs are the key drivers of loyalty, while benevolence‐related beliefs are not influential. Further, this research illustrates that when consumers with an experiential motive experience a high level of flow, the impact of trusting beliefs on loyalty weakens. However, for consumers with a goal‐directed motive, trusting beliefs continue to exert the same impact on loyalty across both high and low levels of flow. ©2010 Wiley Periodicals, Inc.
Long‐term follow‐up of DYT1 dystonia patients treated by deep brain stimulation: An open‐label study
Authors: Cif Laura , Vasques Xavier , Gonzalez Victoria , Ravel Patrice , Biolsi Brigitte , Collod‐Beroud Gwenaelle , Tuffery‐Giraud Sylvie , Elfertit Hassan , Claustres Mireille , Coubes Philippe 
Published: January 2010

AbstractLong‐term efficacy of internal globus pallidus (GPi) deep‐brain stimulation (DBS) in DYT1 dystonia and disease progression under DBS was studied. Twenty‐six patients of this open‐label study were divided into two groups: (A) with single bilateral GPi lead, (B) with a second bilateral GPi lead implanted owning to subsequent worsening of symptomatology. Dystonia was assessed with the Burke Scale. Appearance of new symptoms and distribution according to body region were recorded. In the whole cohort, significant decreases in motor and disability subscores (P < 0.0001) were observed at 1 year and maintained up to 10 years. Group B showed worsening of the symptoms. At 1 year, there were no significant differences between Groups A (without subsequent worsening) and B; at 5 years, a significant difference was found for motor and disability scores. Within Group B, four patients exhibited additional improvement after the second DBS surgery. In the 26 patients, significant difference (P = 0.001) was found between the number of body regions affected by dystonia preoperatively and over the whole follow‐up. DBS efficacy in DYT1 dystonia can be maintained up to 10 years (two patients). New symptoms appear with long‐term follow‐up and may improve with additional leads in a subgroup of patients. © 2009 Movement Disorder Society