bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forced fluid removal in critically ill patients with acute kidney injury
Authors: GANTER C. C. , HOCHULI R. , BOSSARD M. , ETTER R. , TAKALA J. , UEHLINGER D. E. , JAKOB S. M. 
Published: July 2012

PurposeThe aim was to test the feasibility of protocol‐driven fluid removal with continuous renal replacement therapy (CRRT) in patients in whom standard fluid balance prescription did not result in substantial negative fluid balances.Materials and MethodsIn 10 mechanically ventilated patients with sepsis or signs of inflammation and acute kidney injury [age 65 (48–78 years; median, range), simplified acute physiology score II 66 (39–116)], fluid removal was guided by mean arterial pressure (MAP), cardiac index (CI), mixed venous oxygen saturation (SvO
2), lactate/base excess, peripheral circulation, and filling pressures, and adjusted hourly with the goal to maximize volume removal for up to 3 days.ResultsFluid removal rates during the 3 days before and during the study period [66 (36–72) h] were 11 (−30 to +36) ml/kg/day and −59 (−85 to −31) ml/kg/day, respectively (P = 0.002). In 12% of a total of 594 fluid removal rate evaluations, fluid removal had to be decreased or stopped. Most frequent reasons leading to decreasing fluid removal were (n, % of all instances, median lowest value from all patients): SvO
2 (44, 28%, 59%), MAP (36, 23%, 57 mmHg), CI (26, 17%, 2.4 l/min/m2), low peripheral temperature (22, 14%, ‘cold’). Overall, systemic hemodynamics remained stable throughout the study period.ConclusionsIn these patients, protocolized fluid removal with CRRT was associated with large negative fluid balances.
Effect of adductor‐canal‐blockade on established, severe post‐operative pain after total knee arthroplasty: a randomised study
Authors: JÆGER P. , GREVSTAD U. , HENNINGSEN M. H. , GOTTSCHAU B. , MATHIESEN O. , DAHL J. B. 
Published: July 2012

Background:In this proof‐of‐concept study, we investigated the effect of the predominantly sensory adductor‐canal‐blockade on established pain in the early post‐operative period after total knee arthroplasty (TKA). We hypothesised that the adductor‐canal‐blockade would reduce pain during flexion of the knee (primary end point) and at rest, as well as reducing morphine consumption and morphine‐related side effects (secondary outcomes) compared with placebo.Methods:We enrolled patients scheduled for elective TKA into this double‐blind, placebo‐controlled, randomised study. During general anaesthesia, we placed a catheter in the adductor canal, and after obtaining pre‐block pain scores 30 min post‐operatively, we injected 30 ml of ropivacaine 0.75% (n = 21) or saline (n = 20) according to randomisation. Clinicaltrials.gov Identifier: NCT01261897.Results:Forty‐two patients were randomised, and 41 were analysed. Mean (standard deviation) pain scores during flexion of the knee at 1 h post‐operatively were 58 (22) mm and 67 (29) mm, ropivacaine and placebo group, respectively (P = 0.23) but was significantly reduced in the ropivacaine group when calculated as area under the curve for the interval 1–6 h (P = 0.02). There were no statistically significant differences regarding pain at rest (P = 0.08), morphine consumption (P = 0.06), nor morphine‐related side effects, apart from nausea (P = 0.04).Conclusion:This proof‐of‐concept study shows promising results regarding the analgesic efficacy of adductor‐canal‐blockade in post‐operative pain treatment after TKA, with a significant reduction in pain during flexion of the knee in the early post‐operative period compared with placebo. However, the study was not sufficiently powered to permit final conclusions.
Relationship between regional lung compliance and ventilation homogeneity in the supine and prone position
Authors: TANG R. , HUANG Y. , CHEN Q. , HUI X. , LI Y. , YU Q. , ZHAO H. , YANG Y. , QIU H. 
Published: July 2012

BackgroundThe prone position (PP) improves ventilation homogeneity in acute respiratory distress syndrome. The aim of this study was to investigate whether the alleviation of ventilation inhomogeneity in PP was due to changes in regional lung compliance.MethodsTen lung‐lavaged piglets were mechanically ventilated in supine position (SP) and in PP. In each position, positive end‐expiratory pressure (PEEP) was reduced from 20 to 6 cmH2O in steps of 2 cmH2O every 10 min after full lung recruitment. Respiratory mechanics, blood gas, haemodynamic data and whole‐lung computed tomography scans were recorded at each PEEP. The compliances of normally aerated (C
normal) and newly recruited (C
recruited) lung regions were calculated. Open lung PEEP (OL‐PEEP) was defined as the lowest PEEP to maintain full lung recruitment.ResultsAt OL‐PEEP, PP significantly increased normally aerated lung regions, decreased poorly aerated and hyperinflated lung regions and decreased tidal recruitment and hyperinflation. C
normal was significantly reduced in PP compared with SP (12.8 ± 4.2 ml/cmH2O vs. 20.1 ± 6.2 ml/cmH2O, P < 0.001), whereas C
recruited was increased in PP (13.9 ± 3.9 ml/cmH2O vs. 9.4 ± 2.4 ml/cmH2O, P < 0.001). C
normal was correlated with hyperinflated lung regions at end‐expiration (rho = 0.67) and end‐inspiration (rho = 0.56) at OL‐PEEP. C
recruited was correlated with normally (r2 = 0.36) and poorly aerated lung regions (rho = –0.58) at OL‐PEEP.ConclusionThis surfactant‐depleted model shows that the improvement of ventilation homogeneity in PP is related to an increase in C
recruited and a decrease in C
normal.
Scent‐Marking Behaviour in a Pack of Free‐Ranging Domestic Dogs
Authors: Cafazzo Simona , Natoli Eugenia , Valsecchi Paola 
Published: July 2012

AbstractMost mammals scent‐mark, and a variety of hypotheses have been put forward to explain this behaviour. Most of our knowledge about scent marking in domestic dogs comes from studies carried out on laboratory or companion dogs, while few studies have been carried out on free‐ranging dogs. Here, we explored the functional significance of different scent‐marking behavioural patterns in a pack of free‐ranging domestic dogs by testing two non‐exclusive hypotheses: the indirect territorial defence and the dominance/threat hypotheses. Through direct observation, we recorded the locations of dog scent marks (urination, defecation and ground scratching) and information regarding the identity and posture of the marking animal. We found evidence that markings are used by dogs to form a ‘property line’ and to threaten rivals during agonistic conflicts. Both males and females utilized scent marking to assert dominance and probably to relocate food or maintain possession over it. Raised‐leg urination and ground scratching probably play a role in olfactory and visual communication in both males and females. Urinations released by females, especially through flexed‐leg posture, may also convey information about their reproductive state. Finally, our observations suggest that defecation does not play an essential role in olfactory communication among free‐ranging dogs and that standing and squat postures are associated with normal excretion. Our results suggest that many of the proposed functions of marking behaviours are not mutually exclusive, and all should be explored through detailed field and laboratory studies.
Assessment of Different Functional Parameters of Frozen–Thawed Buffalo Spermatozoa by Using Cytofluorimetric Determinations
Authors: Minervini F , Guastamacchia R , Pizzi F , Dell’Aquila ME , Barile VL 
Published: July 2012

ContentsFlow cytometry is a useful tool that provides an accurate, objective and rapid evaluation of semen quality. The use of this technique could significantly improve the quality of buffalo semen samples used in artificial insemination. This study was carried out to evaluate, by flow cytometry, frozen–thawed buffalo spermatozoa quality parameters such as sperm viability by SYBR‐14/propidium iodide staining; mitochondrial function by JC‐1 potentiometric probe; sperm chromatin stability (SCSA) by acridine orange; and acrosome reaction (AR) by FITC‐PNA staining. Semen samples from five Italian Mediterranean buffalo bulls were used. Sperm viability was not different between bulls and ranged from 33.4% to 43.6%. A consistent rate (55.1 ± 10.8%) of sperm cells showed high mitochondrial membrane potential (Δψhigh), with no significant differences between subjects. Sperm chromatin structure assay differed significantly between the five buffalo bulls; moreover, data showed high stability within each buffalo. DNA fragmentation indexes (DFI), such as %‐DFI,‐DFI, SD‐DFI, were 11.2 ± 8.6, 153.3 ± 24.6 and 81.6 ± 21.2, respectively. Regarding AR, the percentage of acrosome‐reacted live (ARL) and acrosome‐reacted dead (ARD) spermatozoa was 0.3 ± 0.2 and 15.3 ± 5.5, respectively. This functional parameter differed significantly between buffalo bulls and showed high stability. Following to Ca2+ionophore A23187 for 3 h, AR significantly differed between subjects and was characterized by an increase in both ARL (10.8%) and ARD population (22.0%). This study indicates that flow cytometry could be a useful tool for a quick multiparametric evaluation of sperm quality in buffalo. In particular, SCSA and AR resulted in sperm functional parameters sensitive enough for the diagnosis of frozen‐thawed semen fertilizing potential.
Clinical implications of the transversus abdominis plane block in pediatric anesthesia
Authors: Mai Christine L. , Young Mark J. , Quraishi Sadeq A. 
Published: July 2012

SummaryOptimal perioperative analgesia for infants and children after major abdominal surgery poses a challenge when central neuraxial techniques are contraindicated. As a regional anesthesia technique, the transversus abdominis plane (TAP) block has been shown to reduce opioid consumption and improve pain scores compared to traditional perioperative pain strategies. Accordingly, TAP blocks may be considered as an alternative to central neuraxial analgesia to optimize perioperative pain control. Advancements in ultrasound technology have further improved the reliability and safety profile of this technique. Despite growing recognition of the diverse clinical scenarios where TAP blocks may be of benefit, its use among pediatric anesthesiologists remains limited. This article describes the history, anatomy, and a review of the current literature on TAP blocks with an emphasis on outcomes in pediatric patients.
The effect of zinc limitation on the transcriptome ofPseudomonas protegens Pf‐5
Authors: Lim Chee Kent , Hassan Karl A. , Penesyan Anahit , Loper Joyce E. , Paulsen Ian T. 
Published: July 2012

SummaryZinc is an important nutrient but can be lacking in some soil environments, influencing the physiology of soil‐dwelling bacteria. Hence, we studied the global effect of zinc limitation on the transcriptome of the rhizosphere biocontrol strainPseudomonas protegens Pf‐5 (formerlyPseudomonas fluorescens). We observed that the expression of the putative zinc uptake regulator (Zur) gene was upregulated, and we mapped putativeZur binding sites in thePf‐5 genome using bioinformatic approaches. In line with the need to regulate intracellular zinc concentrations, an array of potential zinc transporter genes was found to be zinc‐regulated. To adapt to low‐zinc conditions, a gene cluster encoding non‐zinc‐requiring paralogues of zinc‐dependent proteins was also significantly upregulated. Similarly, transcription of genes encoding non‐zinc‐requiring paralogues of ribosomal proteinsL31 andL36 was increased by zinc limitation. A strong transcriptional downregulation of the putative copper chaperone gene (copZ) was also observed, suggesting interplay between zinc and copper homeostasis. Importantly, zinc also affected biocontrol attributes inPf‐5, most notably reducing the expression of the gene cluster responsible for biosynthesis of the antibiotic 2,4‐diacetylphloroglucinol (DAPG) under zinc limitation. This study clearly defines changes to the molecular physiology ofPf‐5 that enable it to survive under zinc limitation.
Acanthamoeba feature a unique backpacking strategy to trap and feed on Listeria monocytogenes and other motile bacteria
Authors: Doyscher Dominik , Fieseler Lars , Dons Lone , Loessner Martin J. , Schuppler Markus 
Published: July 2012

SummaryDespite its prominent role as an intracellular human pathogen, Listeria monocytogenes normally features a saprophytic lifestyle, and shares many environmental habitats with predatory protozoa. Earlier studies claimed that Acanthamoeba may act as environmental reservoirs for L. monocytogenes, whereas others failed to confirm this hypothesis. Our findings support the latter and provide clear evidence that L. monocytogenes is unable to persist in Acanthamoeba castellanii and A. polyphaga. Instead, external Listeria cells are rapidly immobilized on the surface of Acanthamoeba trophozoites, forming large aggregates of densely packed bacteria that we termed backpacks. While the assembly of backpacks is dependent on bacterial motility, flagellation alone is not sufficient. Electron micrographs showed that the aggregates are held together by filaments of likely amoebal origin. Time‐lapse microscopy revealed that shortly after the bacteria are collected, the amoeba can change direction of movement, phagocytose the backpack and continue to repeat the process. The phenomenon was also observed with avirulent L. monocytogenes mutants, non‐pathogenic Listeria, and other motile bacteria, indicating that formation of backpacks is not specific for L. monocytogenes, and independent of bacterial pathogenicity or virulence. Hence, backpacking appears to represent a unique and highly effective strategy of Acanthamoeba to trap and feed on motile bacteria.
FixedbSubsampling and the Block Bootstrap: Improved Confidence Sets based onp-Value Calibration
Authors: Shao Xiaofeng , Politis Dimitris N. 
Published: July 2012

SummarySubsampling and block-based bootstrap methods have been used in a wide range of inference problems for time series. To accommodate the dependence, these resampling methods involve a bandwidth parameter, such as the subsampling window width and block size in the block-based bootstrap. In empirical work, using different bandwidth parameters could lead to different inference results, but traditional first-order asymptotic theory does not capture the choice of the bandwidth. We propose to adopt the fixed b approach, as advocated by Kiefer and Vogelsang in the heteroscedasticity–auto-correlation robust testing context, to account for the influence of the bandwidth on inference. Under the fixed b asymptotic framework, we derive the asymptotic null distribution of the p-values for subsampling and the moving block bootstrap, and further propose a calibration of the traditional small-b-based confidence intervals (regions or bands) and tests. Our treatment is fairly general as it includes both finite dimensional parameters and infinite dimensional parameters, such as the marginal distribution function. Simulation results show that the fixed b approach is more accurate than the traditional small b approach in terms of approximating the finite sample distribution, and that the calibrated confidence sets tend to have smaller coverage errors than the uncalibrated counterparts.
Comparison between CHADS2 and CHA2DS2‐VASc score in a stroke cohort with atrial fibrillation
Authors: Giralt‐Steinhauer E. , Cuadrado‐Godia E. , Ois Á. , Jiménez‐Conde J. , Rodríguez‐Campello A. , Soriano C. , Roquer J. 
Published: July 2012

Background and purposeIn patients with atrial fibrillation (AF), stroke risk stratification schemes have been developed to optimize antithrombotic treatment. The CHADS2 score is frequently used but has limitations. The CHA2DS2‐VASc score improves risk prediction. Our objectives are to describe CHADS2 and CHA2DS2‐VASc score distribution in a cohort of patients with AF and first‐ever ischaemic stroke (FIS) and to identify differences in embolic risk stratification.MethodsOur cohort included 589 patients with FIS, previous modified Rankin score ≤ 3, and non‐valvular AF. We recorded demographic data, vascular risk factors, and antithrombotic pre‐treatment. The CHADS2 and CHA2DS2‐VASc scores were calculated according to clinical status before stroke onset.ResultsIn 186 (31.6%) patients, AF was previously unknown. Of patients with known AF and CHADS2 ≥2 (n = 320), only 103 (32.2%) were taking anticoagulants; more than half of these patients had an INR <2. The CHADS2 score placed 142 (24.1%) patients in the low–intermediate risk (score ≤ 1) category compared with 21 (3.6%) with CHA2DS2‐VASc, P < 0.001. Applying CHA2DS2‐VASc reclassified 121 (85.2%) subjects in the CHADS2 low–intermediate risk category as high risk (≥2), an indication for anticoagulants. Of the 21 patients who suffered a stroke despite their low CHA2DS2‐VASc score (≤1), seven (33.3%) reported alcohol overuse, and six (28.5%) had a concomitant stroke etiology.ConclusionsAbout 25% of FIS patients with AF had a CHADS2 score ≤ 1. Despite the high CHADS2 score of our population, few patients received the recommended antithrombotic treatment according to their thromboembolic risk. Using the CHA2DS2‐VASc schema significantly increased the percentage of patients indicated for anticoagulation.
PTX3 Genetic Variation and Dizygotic Twinning in The Gambia: Could Pleiotropy with Innate Immunity Explain Common Dizygotic Twinning in Africa?
Authors: Sirugo Giorgio , Edwards Digna R. Velez , Ryckman Kelli K. , Bisseye Cyrille , White Marquitta J. , Kebbeh Bunja , Morris Gerard A. J. , Adegbola Richard A. , Tacconelli Alessandra , Predazzi Irene M. , Novelli Giuseppe , Vannberg Fredrik O. , Odunsi Kunle , Page Grier P. , Williams Scott M. 
Published: July 2012

SummaryDizygotic (DZ) twinning has a genetic component and is common among sub‐Saharan Africans; in The Gambia its frequency is up to 3% of live births. Variation in PTX3, encoding Pentraxin 3, a soluble pattern recognition receptor that plays an important role both in innate immunity and in female fertility, has been associated with resistance to Mycobacterium tuberculosis pulmonary disease and to Pseudomonas aeruginosa infection in cystic fibrosis patients. We tested whether PTX3 variants in Gambian women associate with DZ twinning, by genotyping five PTX3 single nucleotide polymorphisms (SNPs) in 130 sister pairs (96 full sibs and 34 half sibs) who had DZ twins. Two, three and five SNP haplotypes differed in frequency between twinning mothers and those without a history of twinning (from P= 0.006 to 3.03e‐06 for two SNP and three SNP haplotypes, respectively). Twinning mothers and West African tuberculosis‐controls from a previous study shared several frequent haplotypes. Most importantly, our data are consistent with an independently reported association of PTX3 and female fertility in a sample from Ghana. Taken together, these results indicate that selective pressure on PTX3 variants that affect the innate immune response to infectious agents, could also produce the observed high incidence of DZ twinning in Gambians.
Do quality improvement systems improve health library services? A systematic review
Authors: Gray Hannah , Sutton Gary , Treadway Victoria 
Published: July 2012

AbstractBackgroundA turbulent financial and political climate requires health libraries to be more accountable than ever. Quality improvement systems are widely considered a ‘good thing to do’, but do they produce useful outcomes that can demonstrate value?ObjectivesTo undertake a systematic review to identify which aspects of health libraries are being measured for quality, what tools are being used and what outcomes are reported following utilisation of quality improvement systems.ResultsMany health libraries utilise quality improvement systems without translating the data into service improvements. Included studies demonstrate that quality improvement systems produce valuable outcomes including a positive impact on strategic planning, promotion, new and improved services and staff development. No impact of quality improvement systems on library users or patients is reported in the literature.ConclusionsThe literature in this area is sparse and requires updating. We recommend further primary research is conducted in health libraries focusing upon the outcomes of utilising quality improvement systems. An exploration of quality improvement systems in other library sectors may also provide valuable insight for health libraries.
Patient perceptions of epinephrine auto‐injectors: exploring barriers to use
Authors: Money Arthur G. , Barnett Julie , Kuljis Jasna , Lucas Jane 
Published: July 2012

Scand J Caring Sci; 2013; 27; 335–344

Patient perceptions of epinephrine auto‐injectors: exploring barriers to use
Background:  In recent years, government initiatives have proposed that patient self‐care should serve as a key resource in response to the anticipated increase in global demand for health care. However, if patients are to be empowered as self‐carers, barriers to engagement must be identified and overcome. Anaphylaxis is an increasingly common life‐threatening allergic reaction. Patients at risk of anaphylaxis are prescribed epinephrine auto‐injectors and play a crucial role in delivering their own care and management of this condition. One key recommendation is that patients routinely carry an epinephrine auto‐injector with them and deploy the device when needed. However, only a small proportion of patients that require epinephrine actually receive it.Objective:  To explore the reasons why patients who have been prescribed epinephrine auto‐injectors fail to adhere to self‐care and management recommendations.Methods:  In‐depth interviews with 15 adults who have been prescribed epinephrine auto‐injectors were carried out to explore the barriers that exist in the provision of effective self‐care and management of anaphylaxis.Results:  Inconsistent health professional advice, perceived stigma of carrying a ‘weapon‐like’ device, poor device design and limited patient training were identified as barriers to carriage or use. Patients were reluctant to carry devices in public because of perceived and observed stigma and suspicion. They were happy to ignore expiry dates, and some participants were confident that the emergency services would provide them with the appropriate care they needed, and therefore, did not carry the device in urban areas.Conclusions and clinical implications:  Improved training of patients, the public and health professionals around both the carriage and use of auto‐injectors are areas for urgent attention if improved levels of self‐care are to be attained. The design of epinephrine auto‐injectors should also receive attention as patients often fail to carry them owing to size and aesthetics.
Soil organic‐C accumulation and N availability under improved pastures established in Mediterranean oak woodlands
Authors: Gómez‐Rey M. X. , Garcês A. , Madeira M. 
Published: July 2012

AbstractLong‐term effects of improved pasture establishment (with high proportion of legumes) on soil organic‐C status and N availability in Mediterranean cork oak (Quercus suberL.) woodlands were assessed. Soils were sampled beneath scattered crowns and in open areas, considering two systems: unmanaged and managed woodlands where improved pastures were installed 26 and 32 years ago. Total and labile C and N pools were measured and C and N mineralization were determined over 24 weeks laboratory incubation. Soils under improved pastures showed higher organic‐C, total‐N and net N mineralization than those under unmanaged pasture, mainly when established beneath trees. Potentially mineralizable C, C mineralization rate and microbial C were not statistically different between the unmanaged and improved pasture sites, but were higher closer to the tree than in the open area (1.8, 1.2 and 1.2 times, respectively). TheqCO2was higher in improved pastures (1.7 times). Labile pool of C and N extracted with hot water increased under improved pasture (3.4 and 1.7 times, respectively). Results indicate that soil quality amelioration by improved pastures is stronger in the presence of oak trees. Management systems that favour oak tree maintenance and regeneration should be taken into account to reverse soil degradation.