bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects on management and outcome of severe sepsis and septic shock patients admitted to the intensive care unit after implementation of a sepsis program: a pilot study
Authors: Girardis Massimo , Rinaldi Laura , Donno Lara , Marietta Marco , Codeluppi Mauro , Marchegiano Patrizia , Venturelli Claudia ,   the 'Sopravvivere alla Sepsi 'group of the Modena-University Hospital
Published: September 2009

Abstract
Introduction
The application in clinical practice of evidence-based guidelines for the management of patients with severe sepsis/septic shock is still poor in the emergency department, while little data are available for patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an in-hospital sepsis program on the adherence to evidence-based guidelines and outcome of patients with severe sepsis/septic shock admitted to the ICU.

Methods
This prospective observational cohort study included 67 patients with severe sepsis/septic shock admitted to a multidisciplinary ICU at a University Hospital from January 2005 to June 2007. Compliance to 5 resuscitation and 4 management sepsis interventions and in-hospital mortality were measured following an educational program on sepsis for physician and nurses of all hospital departments and hospital implementation of a specific protocol for recognition and management of patients with severe sepsis/septic shock, including an early consultation by a skilled 'sepsis team'.

Results
During the study period, the compliance to all 9 interventions increased from 8% to 35% of the patients (P < 0.01). The implementation of resuscitation and management interventions was associated with a lower risk of in-hospital mortality (23% vs 68% and 27% vs 68%, P < 0.01). In the latter 2 semesters, after activation of the 'sepsis team', in-hospital mortality of ICU septic shock patients decreased by about 40% compared with the previous period (32% vs 79%, P < 0.01).

Conclusions
In our experience, an in-hospital sepsis program, including education of health-care personnel and process-changes, improved the adherence to guidelines and the survival rate of patients with severe sepsis/septic shock admitted to the ICU.
mRNA expression profiles show differential regulatory effects of microRNAs between estrogen receptor-positive and estrogen receptor-negative breast cancer
Authors: Cheng Chao , Fu Xuping , Alves Pedro , Gerstein Mark 
Published: September 2009

Abstract
Background
Recent studies have shown that the regulatory effect of microRNAs can be investigated by examining expression changes of their target genes. Given this, it is useful to define an overall metric of regulatory effect for a specific microRNA and see how this changes across different conditions.

Results
Here, we define a regulatory effect score (RE-score) to measure the inhibitory effect of a microRNA in a sample, essentially the average difference in expression of its targets versus non-targets. Then we compare the RE-scores of various microRNAs between two breast cancer subtypes: estrogen receptor positive (ER+) and negative (ER-). We applied this approach to five microarray breast cancer datasets and found that the expression of target genes of most microRNAs was more repressed in ER- than ER+; that is, microRNAs appear to have higher RE-scores in ER- breast cancer. These results are robust to the microRNA target prediction method. To interpret these findings, we analyzed the level of microRNA expression in previous studies and found that higher microRNA expression was not always accompanied by higher inhibitory effects. However, several key microRNA processing genes, especially Ago2 and Dicer, were differentially expressed between ER- and ER+ breast cancer, which may explain the different regulatory effects of microRNAs in these two breast cancer subtypes.

Conclusions
The RE-score is a promising indicator to measure microRNAs' inhibitory effects. Most microRNAs exhibit higher RE-scores in ER- than in ER+ samples, suggesting that they have stronger inhibitory effects in ER- breast cancers.
A review of propulsive mechanisms in rowing
Authors: Caplan N , Coppel A , Gardner T 
Published: September 2009

This paper reviews the fluid dynamic mechanisms that are fundamental to the rowing stroke. Complex interactions occur between the oar blade and water, and over the last 30 years our understanding of the mechanisms that govern rowing propulsion has developed significantly. The oar blade was once believed to rip through the water, generating a drag force acting normal to the blade. Current research indicates that the oar blade acts as an aerofoil making use of lift forces to propel the boat through the water early and late in the stroke, with drag being the dominant propulsive force when the oar is perpendicular to the boat. Early on-water research showed variations in the fluid dynamic behaviour of different oar blades. Recently, more controlled laboratory tests have isolated the oar blade from the rower—boat—water system to obtain blade characteristics. The isolated nature of recent oar blade studies and the complex nature of the oar blade—water interaction have led to suggestions that computational fluid dynamics (CFD) may be used to advance understanding of oar blade behaviour as a precursor to a more informed design process. By integrating a dynamic CFD model with a mathematical model of rowing mechanics, a full optimization of rower technique, boat rigging, and equipment design could be performed.
Serum total cortisol and free cortisol index give different information regarding the hypothalamus–pituitary–adrenal axis reserve in patients with liver impairment
Authors: Vincent Royce P , Etogo-Asse Frédérique E , Dew Tracy , Bernal William , Alaghband-Zadeh Jamshid , le Roux Carel W 
Published: September 2009

Background The short synacthen test (SST) is used to investigate patients with suspected hypothalamus–pituitary–adrenal (HPA) axis pathology. A rise of serum total cortisol (total cortisol) above 550 nmol/L is accepted as sufficient adrenal reserve. In total, 80% of cortisol is bound to cortisol-binding globulin (CBG) and 10% to albumin. In the acute phase responses CBG concentrations decrease and can influence the interpretation of SST. The free cortisol index (FCI) is a surrogate marker for free cortisol and is defined as total cortisol (nmol/L)/CBG (mg/L) with an FCI > 12 representing sufficient adrenal reserve. The aim of this study was to compare total cortisol and FCI in the interpretation of SST in patients with liver impairment. Method SST was done on 26 patients with liver impairment. Total cortisol was measured on Advia Centaur; serum CBG by radioimmunoassay and FCI calculated. Results Eleven (42%) patients had a total cortisol >550 nmol/L (range 555–2070) and FCI > 12 (12.0–68.9) suggesting sufficient cortisol reserve. Three patients (13%) had total cortisol <550 nmol/L (268–413) and FCI < 12 (3.5–11.6) consistent with cortisol deficiency. Twelve patients (46%) had a total cortisol <550 nmol/L (144–529), but an FCI > 12 (12.0–52.9). None of the patients had a total cortisol >550 nmol/L and FCI < 12. Conclusion When total cortisol alone is used to interpret SST in patients with liver impairment, 46% may have been classified as having adrenal insufficiency because of low CBG. FCI may be better for the evaluation of HPA axis insufficiency in patients with liver impairment.
Women's Experiences with Anal Sex: Motivations and Implications for STD Prevention
Authors: Maynard Emily , Carballo‐Diéguez Alex , Ventuneac Ana , Exner Theresa , Mayer Kenneth 
Published: September 2009

CONTEXT:Heterosexual anal intercourse is a highly efficient mode of HIV transmission, yet little is known about the contexts in which women engage in it, or when and with whom they use condoms. Similarly, sexuality and reproductive health research has paid little attention to female desire and pleasure‐seeking.METHODS:In‐depth interviews were conducted in Boston in 2006 with 28 women who reported having had unprotected anal intercourse in the last year with a man who was HIV‐positive or whose serostatus was unknown. Sexual scripting theory guided analyses of their experiences with and motivations to practice anal intercourse.RESULTS:Participants engaged in anal intercourse for a wide variety of reasons: to experience physical pleasure, enhance emotional intimacy, please their male partners or avoid violence. Male partners usually initiated anal sex. Anal intercourse often occurred in the context of vaginal and oral sex. Among reasons women cited for not using condoms were familiarity with their partner and feeling that condoms made anal sex less pleasurable. Knowledge of HIV and STD risks did not appear to encourage condom use.CONCLUSIONS:Women who perceive condom use during anal sex as limiting their pleasure or intimacy may be at increased risk for acquiring HIV. Consequently, interventions to promote safer anal intercourse must find a way to increase the use of barrier methods without decreasing pleasure or perceived intimacy between sexual partners.
An Illusion of Power: Qualitative Perspectives On Abortion Decision‐Making Among Teenage Women In Sweden
Authors: Ekstrand Maria , Tydén Tanja , Darj Elisabeth , Larsson Margareta 
Published: September 2009

CONTEXT: Swedish law permits abortion at the request of a pregnant woman until the 18th week of gestation. However, the extent to which the decision is truly the woman's own is subject to debate; women are often influenced, directly or indirectly, by the attitudes of their partners, family and friends or by social norms. METHODS: Individual in‐depth interviews about the pregnancy and the abortion decision were conducted 3–4 weeks postabortion with 25 women aged 16–20 at different periods in 2003, 2005 and 2007. Interviews were audio‐taped, transcribed verbatim and analyzed using latent content analysis. RESULTS: The main reasons for unplanned pregnancy were underestimation of pregnancy risk and inconsistent contraceptive use. Pregnancy prevention was perceived as the woman's responsibility. The abortion decision was accompanied by mixed emotions, and was seen as a natural yet difficult choice. Social norms and the negative attitudes of family and friends strongly influenced the decision. Partners and parents were regarded as the most important sources of support. After the abortion, the women felt pressured by contraceptive counselors to use highly effective contraceptives despite their previous negative experiences or worries about side effects. CONCLUSIONS: Swedish teenagers' basic right to decide whether to have an abortion may be limited by societal norms and disapproval of teenage childbearing. Given the perception that women are responsible for contraception, programs need to emphasize that pregnancy prevention is a shared responsibility; greater efforts to include males in prevention practices are needed.
Relationship Dynamics and Consistency of Condom Use Among Adolescents
Authors: Manning Wendy D. , Flanigan Christine M. , Giordano Peggy C. , Longmore Monica A. 
Published: September 2009

CONTEXT: Research on adolescent condom use often focuses on the influence of parents, peers and environmental factors. Although most sexually active teenagers have sex within dating relationships, little is known about associations between the characteristics of these relationships and consistency of condom use. METHODS: Data on 269 participants in Wave 1 of the Toledo Adolescent Relationships Study who had had sex in their current or most recent dating relationship were analyzed in logistic regression models to examine how positive and negative relationship qualities are associated with consistent condom use. RESULTS: Among teenagers who had had sex with their dating partner, both negative relationship dynamics (conflict, partner's controlling behavior, mistrust, jealousy, perceived partner inferiority) and positive qualities (love, enmeshment, salience, self‐disclosure) were negatively associated with consistent condom use (odds ratios, 0.7–0.9). Asymmetries in partners' age, race and school were not related to consistent condom use. Relationship duration was negatively associated with consistency (0.98–0.99), but the association was explained by feelings of relationship importance. Findings for relationship qualities were similar for males and females, with the exception of conflict, which was positively associated with consistent condom use among females but not males. CONCLUSIONS: Although the relationship processes associated with consistent condom use are complex, such processes appeared to be more strongly associated with consistent condom use than were social and demographic characteristics. Programs should focus on relationship qualities and dynamics, recognizing that both negative and positive relationship features are associated with consistent condom use.
An Investigation of Factors Impacting Nitinol Wire Fatigue Life
Authors: Wong S. , Lin Z. C. , Tahran A. , Boylan J. , Pike K. , Kramer-Brown P. 
Published: September 2009

Abstract
The purpose of this study is to identify factors that affect superelastic Nitinol fatigue resistance using a commercially available wire specimen. The study reveals the fatigue resistance of Nitinol wire as functions of surface finish, inclusions, processing, and applied stress applied. Nitinol wires were fatigue tested using the rotating beam fatigue method. The sample strains were verified using a direct strain-measurement method. Wires with outer diameters ranging from 0.127 to 0.343 mm processed with a mechanical and/or electropolished surface finish were compared to one another.
Influence of Test Machine Control Method on Flexural Performance of Fiber Reinforced Concrete Beams
Authors: Bernard E. S. 
Published: September 2009

Abstract
Flexural testing of fiber reinforced concrete (FRC) and shotcrete using beams has undergone a steady evolution over the past 30 years to the point where complex servo-controlled test machines are now required to undertake these tests. These machines have been found necessary in order to impose stable and reproducible test conditions on beams. Servo-controlled machines utilize closed-loop strain feedback mechanisms in an attempt to maintain stability throughout the post-crack deformation history of a brittle FRC specimen. However, some standard test methods for flexural performance assessment of FRC require displacement-control of the loading piston rather than strain-control based on the measured deformation of the beam. Displacement-control has frequently been found to result in unstable unloading of brittle FRC. Anecdotal evidence suggests that differences in the method of machine control may lead to changes in the apparent performance of specimens. An investigation was therefore instigated to examine the apparent performance of FRC beams tested using strain-controlled loading compared to displacement-control.
Separability Property and Load Normalization in AA 6061-T6 Aluminum Alloy
Authors: Cassanelli AN , Ortiz H , Wainstein JE , deVedia LA 
Published: September 2009

In the present work, a study of the separability property, experimental ηpl factor determination, and load normalization AA 6061-T6 aluminum alloy is described. The separability property has been studied using the Sij parameter with Standard ASTM E 1820-96 SE(B) blunt notch specimens with 8 and 24% side grooving.
The deformation property function H, from variable separability property, was written in terms of plastic and total displacement. The ηpl factor was determined using the Sharobeam and Landes methodology with two side grooves and the two H functions. The ηpl factor values obtained with the H function evaluated in terms of the total and plastic displacement differed by less than 1.4%. The values obtained were close to that suggested in ASTM E 1820-96.
In order to estimate crack length from the test record, the unloading and normalization load methodologies were used. Special attention was paid to the point where the domain of definition of the separability property in plastic displacement started and the influence it had on the estimated crack length. The normalization load was described by means of a standard and a modified power law, and calibration curves were obtained for blunt notched and fatigue precracked specimens.
The degree of restraint introduced by different side-grooving ratios had an influence on the resulting J-R curve, and the three methods employed were sensitive to this change. The toughness obtained with the geometry, dimensions, constraints, test conditions, and material used in this work with different estimation methodologies were in relatively good agreement.
Scanning Atomic-Force Microscopy on Initiation and Growth Behavior of Fatigue Slip-Bands in α-Brass
Authors: Nakai Y , Kusukawa T , Hayashi N 
Published: September 2009

Slip-band formation and fatigue crack-initiation processes in α-brass were observed by means of atomic force microscopy (AFM), and the effects of the grain size and the stress amplitude were discussed. In a fine grain material, fatigue cracks were initiated only from slip-bands. In a coarse grain material, however, they were initiated either from slip-bands or grain boundaries. The depth of an intrusion drastically increased with its outgrowth to a crack, and with coalescence of cracks, the width of cracks increased rapidly.
The depth of an intrusion increased with the number of loading cycles, and when the depth reaches a critical value, a transgranular crack was initiated from the intrusion. The critical value was given as a function of the slip-band angle relative to the stress axis. From the AFM observations, it was found that the critical value of the slip distance was independent of the slip-band angle relative to the stress axis, the stress amplitude, and the grain-size. For crack-initiations from grain boundaries, however, the value of the grain boundary depth at the crack initiation was not a unique function of the grain boundary angle relative to the stress axis.
An X-Specimen Test for Determination of Thin-Walled Tube Fracture Toughness
Authors: Hsu HH , Chien KF , Chu HC , Kuo RC , Liaw PK 
Published: September 2009

A new fracture toughness measurement method, named an X-specimen test that is based on the curved compact-tension test, was proposed to assess the fracture toughness of thin-walled tubing materials like Zircaloy fuel cladding. This technique offers applications of fracture mechanics for testing thin-walled tubes, which do not meet the requirements of the American Society for Testing and Materials standards in terms of the specimen configuration and loading state. The finite-element analysis was conducted to evaluate the feasibility of applying the X-specimen test to the measurement of cladding fracture toughness and to develop a relationship between the stress intensity factor and crack extension. Then fracture and fatigue tests were performed employing a hydraulic mechanical testing machine. The J-integral value was evaluated using the experimental results of the applied load, loadline displacement, and crack extension.
By means of a backtracking method, the stress intensity solutions were computed using fatigue results. A J-integral value of about 82 kN/m was obtained for Zircaloy fuel cladding. A comparison of the present test results and literature data shows that the X-specimen test is suitable for a quantitative evaluation of the fracture behavior of thin-walled tubing materials.
Fatigue and Fracture Mechanics: 32nd Volume
Authors: Chona R 
Published: September 2009

Description
23 peer-reviewed papers detail the latest advances in all aspects of fatigue and fracture mechanics, related technologies, and innovative applications. Topics range from:
• New analytical approaches to applications for tried and true methods
• Life assessment issues facing critical engineering components and structures
• Fracture behavior under dynamic loading
• Failure mechanics in ceramics and composites.
Effects of Radiation on Materials: 23rd International Symposium
Authors: Lott Randy G. , Busby Jeremy T. 
Published: September 2009

Description
Eighteen peer-reviewed papers focus on the irradiation embrittlement of reactor pressure vessel steels. This new publication provides a broad perspective on the development and application of trend curves used to predict fracture toughness transition temperatures in irradiated reactor pressure vessel steels. Papers cover materials ranging from erbium-tritide films to oxide dispersion strengthened (ODS) ferritic steels.
Lateral Tests on Full-Scale Lumber- and Plywood-Sheathed Roof Diaphragms
Authors: Stillinger JR 
Published: September 2009

During 1952 and 1953, the Timber Mechanics Section of the Oregon Forest Products Laboratory built and tested eight lumber-sheathed and two plywood-sheathed roof diaphragms 20 by 60-ft in size, in order to determine the strength and stiffness at various load levels when the following structural elements were investigated: (1) ⅜-in. plywood sheathing; (2) 1.-in. lumber sheathing used green and dry and applied in a longitudinal or diagonal orientation; (3) different nailing patterns; (4) variations in boundary member construction; (5) presence or absence of bridging and blocking; (6) different corner connections; (7) use of metal corrugated fasteners; and (8) presence or absence of skylight openings.
A pin-connected steel-and-timber truss was used in testing the diaphragms. Loads were applied by two 30-ton hydraulic jacks connected in unison. The load was applied in steps to a predetermined level, then released to a zero load; the same procedure was followed for each new load level. In some of the diaphragms, a repetitive loading procedure was employed to determine the load level where permanent set occurred.
In addition to deflection readings, buckling in the framing members, sheathing movement, and strains across joints and within members of the tension chord and endposts were measured.
The summary of test results indicates that the strength and stiffness of roof diaphragms can be appreciably influenced by altering any of the test variables included in this testing program.
Effect of Calcination on Natural Pozzolans
Authors: Mielenz RC , Witte LP , Glantz OJ 
Published: September 2009

Calcination will improve the quality of some pozzolans, reduce the quality of others, and induce pozzolanic properties in some otherwise essentially non-reactive-substances. Natural pozzolans or natural materials in which pozzolanic properties can be induced by calcination at temperatures less than 2000 F. owe their activity to One or more of five kinds of substances. Consequently, natural pozzolans can be classified by their essential active ingredient as follows: Activity type Essential active constituent 1....................:...............Volcanic glass 2....................... Opal 3a...................................Kaolinite-type clay 3b...................................Montmorillonite-type clay 3c...................................Illite-type clay 3d...................................Mixed clay with vermiculite 4....................................Zeolites 5....................................Hydrated oxides of aluminum 6....................................Nonpozzolan
Water requirement, setting time of lime-pozzolan paste, strength development of portland-pozzolan mortar, and control of alkali-aggregate reaction are affected significantly by calcination at temperatures up to 2000 F. Calcination of clayey materials, activity type 3, is essential to develop satisfactory pozzolanic activity. The quality of activity types 1, 2, and 4 frequently can be improved considerably by calcination. No materials of activity type 5 were included in the investigations.
Pozzolans of activity types 1, 2, 3a, and 3b are the most promising from the standpoints of strength development and control of alkali-aggregate reaction in mortar and concrete, opaline cherts of activity type 2 being superior to all others. For these materials, calcination in the range from 1200 F. to 1600 F. will induce optimum activity.