bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insufficient β-lactam concentrations in the early phase of severe sepsis and septic shock
Authors: Taccone Fabio Silvio , Laterre Pierre-François , Dugernier Thierry , Spapen Herbert , Delattre Isabelle , Wittebole Xavier , De Backer Daniel , Layeux Brice , Wallemacq Pierre , Vincent Jean-Louis , Jacobs Frédérique 
Published: July 2010

Abstract
Introduction
Altered pharmacokinetics (PK) in critically ill patients can result in insufficient serum β-lactam concentrations when standard dosages are administered. Previous studies on β-lactam PK have generally excluded the most severely ill patients, or were conducted during the steady-state period of treatment. The aim of our study was to determine whether the first dose of piperacillin-tazobactam, ceftazidime, cefepime, and meropenem would result in adequate serum drug concentrations in patients with severe sepsis and septic shock.

Methods
Open, prospective, multicenter study in four Belgian intensive care units. All consecutive patients with a diagnosis of severe sepsis or septic shock, in whom treatment with the study drugs was indicated, were included. Serum concentrations of the antibiotics were determined by high-pressure liquid chromatography (HPLC) before and 1, 1.5, 4.5 and 6 or 8 hours after administration.

Results
80 patients were treated with piperacillin-tazobactam (n = 27), ceftazidime (n = 18), cefepime (n = 19) or meropenem (n = 16). Serum concentrations remained above 4 times the minimal inhibitory concentration (T > 4 × MIC), corresponding to the clinical breakpoint for Pseudomonas aeruginosa defined by the European Committee on Antimicrobial Susceptibility Testing (EUCAST), for 57% of the dosage interval for meropenem (target MIC = 8 μg/mL), 45% for ceftazidime (MIC = 32 μg/mL), 34% for cefepime (MIC = 32 μg/mL), and 33% for piperacillin-tazobactam (MIC = 64 μg/mL). The number of patients who attained the target PK profile was 12/16 for meropenem (75%), 5/18 for ceftazidime (28%), 3/19 (16%) for cefepime, and 12/27 (44%) for piperacillin-tazobactam.

Conclusions
Serum concentrations of the antibiotic after the first dose were acceptable only for meropenem. Standard dosage regimens for piperacillin-tazobactam, ceftazidime and cefepime may, therefore, be insufficient to empirically cover less susceptible pathogens in the early phase of severe sepsis and septic shock.
Does Mixing Acute Medical Admissions with Burn Patients Increase Infective Complications from Paediatric Thermal Injuries?
Authors: Shaban Fadlo , Stewart Ken , Kalima Pota 
Published: July 2010

Objectives In the winter of 2005-2006 the management at our children's hospital elected to admit ‘overspill’ acute medical admissions to the ward used for plastic surgery and burns for logistical reasons. This study was conducted to assess the effects of that change on the incidence of infective complications in thermally injured patients. Design We conducted a retrospective study by reviewing the case-notes. The data gathered included days on IV fluids and antibiotics, transfer to the Paediatric Intensive Care Unit (PICU), microbiology and a ‘septic signs score’ – based on pyrexia, irritability, diarrhoea/vomiting, wound colonization, bacteraemia. We compared the study winter (when mixed with the medical admissions) to the two preceding winters (control). Setting Royal Hospital of Sick Children in Edinburgh. Participants Seventy-three patients were studied, 23 in the sample winter and 50 in the two preceding control winters. Main outcome measures The outcomes studied were the maximum ‘septic signs score’; patients with a score ≥3; wound colonization; PICU admission; days on antibiotics and IV fluids. Results A statistically significant increase in patients with septic episodes was demonstrated by an increase in the mean septic signs score (0.66 to 1.48, p = 0.044) and the number of patients with a score ≥3 (4% to 22%, p = 0.017). Other analysed variables did not reach statistical significance although the raw data suggested a trend. Conclusion It was concluded that there is an association between mixing acute medical admissions with thermally injured patients and an increase in the incidence of infective complications in the latter group.
The Impact of Article Titles on Citation Hits: An Analysis of General and Specialist Medical Journals
Authors: Jacques Thomas S , Sebire Neil J 
Published: July 2010

Objectives Most published articles are not cited and citation rates depend on many variables. We hypothesized that specific features of journal titles may be related to citation rates. Design We reviewed the title characteristics of the 25 most cited articles and the 25 least cited articles published in 2005 in general and specialist medical journals including the Lancet, BMJ and Journal of Clinical Pathology. The title length and construction were correlated to the number of times the papers have been cited to May 2009. Setting Retrospective review of a scientific database. Participants None. Main outcome measures Citation rate. Results The number of citations was positively correlated with the length of the title, the presence of a colon in the title and the presence of an acronym. Factors that predicted poor citation included reference to a specific country in the title. Conclusions These data suggest that the construction of an article title has a significant impact on frequently the paper is cited. We hypothesize that this may be related to the way electronic searches of the literature are undertaken.
Comparison of the Application of Low Concentration and 80% Phenol Solution in Pilonidal Sinus Disease
Authors: Sakçak İbrahim , Avşar Fatih Mehmet , Coşgun Erdal 
Published: July 2010

Objectives Many conservative methods have been applied in the treatment of pilonidal sinus disease (PSD). The most commonly used conservative treatment is 80% phenol solution. Our observations demonstrated that 80% phenol solution caused much destruction in the sacrococcygeal region. Design In this study low concentrations of phenol were used with the aim of reducing the unwanted side-effects of high-concentration phenol without reducing the therapeutic effects. Participants We treated 112 patients (18 women, 94 men) with PSD using phenol solution. Patients were divided into two groups: Group A was treated with a 40% solution of phenol solution, and Group B was treated with an 80% solution of phenol solution. Setting All patients were treated on an outpatient basis. One mL of low (40%) or high (80%) concentration phenol solution was injected into the main sinus orifice. During the check it was observed and noted whether there was skin necrosis, fatty tissue necrosis or abscesses. Main outcome measures The mean age was 27.4 years (6-44). The median length of symptoms was seven months (0.5-132). In the 2.8 years (1-6) of mean follow-up period, the disease recurred in 13 (11.6%) patients. Results This treatment procedure was well-tolerated by all the patients except for those who had unwanted results. No patients in group A had skin necrosis, and only one had abscesses. In group B two patients had abscesses, and three had skin necrosis. Fatty tissue necrosis was seen in one patient in Group A and in five patients in Group B. Recurrence rates were four (7.4%) cases in Group A and nine (15.5%) cases in Group B. Conclusions It is possible to treat patients in a shorter time with a considerably smaller loss of working time, since the destruction of peripilonidal adipose tissue and skin is less. Therefore, the use of low-concentration phenol solution is an option to be considered in the treatment of PSD.
Factors Influencing Foundation Programme Choice among Medical Students
Authors: Patel Shelain , Colaco Henry B , Hossain Fahad S 
Published: July 2010

Objectives The advent of Modernising Medical Careers has replaced the traditional pre-registration house officer (PRHO) year and first year of senior house officer (SHO) training with a combined foundation programme. The aim of this study was to find out the factors influencing choice of foundation programme among medical students. Design Prospective survey. Setting Three medical schools based in England. Main outcome measures A questionnaire was formulated containing the reasons for choosing a foundation programme with students asked to rank their choices. Results There were 46 replies. The most important factors identified were geographical location (score 154) and combination of specialties (score 178). The least important factors was the reputation of consultants (score 525) and opportunities for research (score 530). Conclusions The factors influencing choice of foundation programme are not dissimilar to the choice of PRHO year despite the different emphasis in training which it offers.
Smoking Habits and Beliefs About Smoking in Elderly Patients With COPD During Hospitalisation
Authors: Bjarnason Nina H. , Mikkelsen Kim L. , Tønnesen Philip 
Published: July 2010

AbstractTo study beliefs about smoking and COPD, and motivation for smoking discontinuation we recruited 100 COPD patients during admission for exacerbation. They were asked about motivation to quit smoking and about disease understanding. We compared their survival with that of 324 COPD patients and with survival of age-matched Danes. Forty-five smokers, 50 ex-smokers and five never-smokers were included. Mean value of age was 77.5 years, number of years smoking was 51.8, and FEV1 was 0.79 L. Most patients were not certain about the association between smoking and COPD. Only 16% thought that their smoking had caused COPD and 24% thought that they would not suffer from COPD, had they not smoked. Three out of the six motivation questions could be included in a mutual quantitative scale (alpha = 0.76). Thirty per cent (r = 0.55, p = .005) of the variation in the motivation scale score was explained by number of years with smoking (negative association), number of cigarettes smoked per day (positive association) and BMI (negative association). Mortality was lower than in the reference population (RR = 0.63, p = .005), but higher than in age-matched Danes. Many patients are not certain about the association between smoking and COPD. We developed a smoking cessation motivation scale based on three questions.
Smoking Cessation Rates After a Nurse-Led Inpatient Smoking Cessation Intervention
Authors: Meysman Marc , Boudrez Hedwig , Nackaerts Kris , Dieriks Björn , Indemans Rudy , Vermeire Paul 
Published: July 2010

AbstractObjective: To evaluate the effectiveness of inpatient brief counselling by a smoking cessation nurse compared to usual care (no advice). Methods: The subjects (n = 381, 245 men and 136 women) studied were in-patients, in four Flemish University Hospitals, who were daily smokers. Patients were randomised between 2005 and June 2006. Patients were allocated to an experimental group (EG) or to a control group (CG). Allocation and smoking cessation interventions of patients were stage-matched according to their stage of change as defined by Prochaska and Diclemente. Smoking cessation advice was administered by a qualified smoking cessation nurse. Results: The six-month self-reported continuous abstinence in the EG in 28/178 patients (15.7%) compared to the CG where 14/180 patients were abstinent (7.7%) was significantly better. The effect was most pronounced in the subgroup over 40 years old in the preparation and action stage. In this cohort in the EG, 44% of patients were abstinent at six months compared to 18%in the CG. All patients tended to smoke less after a hospitalisation. Conclusion: The intervention by a smoking cessation nurse during hospitalisation seems effective and is most rewarding in the smokers > 40 years old, and who were well motivated to stop.
Influence of the d3GH receptor polymorphism on the metabolic and biochemical phenotype of GH-deficient adults at baseline and during short- and long-term recombinant human GH replacement therapy
Authors: Giavoli Claudia , Ferrante Emanuele , Profka Eriselda , Olgiati Luca , Bergamaschi Silvia , Ronchi Cristina L , Verrua Elisa , Filopanti Marcello , Passeri Elena , Montefusco Laura , Lania Andrea G , Corbetta Sabrina , Arosio Maura , Ambrosi Bruno , Spada Anna , Beck-Peccoz Paolo 
Published: July 2010

ObjectiveA common polymorphic variant of GH receptor (exon 3 deletion, d3GHR) has been linked with increased response to recombinant human GH (rhGH) in some patients with or without GH deficiency (GHD). The aim of the study was to investigate the impact of the GHR genotype on the phenotype of GHD adults and on the metabolic effect of rhGH therapy.DesignProspective study of GHD patients evaluated before and during short- (1 year,n=100) and long-term (5 years,n=50) rhGH therapy.MethodsEffects of rhGH on IGF1 levels, body composition (body fat percentage, BF%), body mass index, lipid profile, and glucose homeostasis (fasting insulin and glucose, insulin sensitivity indexes) were evaluated according to the presence or the absence of the d3GHR variant.ResultsThe different genotype did not influence basal phenotype of GHD. Short-term rhGH determined normalization of IGF1 levels, decrease in BF%, and worsening of insulin sensitivity, independently from the presence of the d3GHR allele. A significant increase in high-density lipoprotein cholesterol occurred in the d3GHR group. Normalization of IGF1 levels and decrease in BF% were maintained after 5 years. Insulin sensitivity restored to basal values, though in d3GHR patients fasting glucose remained significantly higher than at baseline. After both 1 and 5 years, percentage of subjects with impaired glucose tolerance, similar in the two groups at baseline, decreased in fl/fl while doubled in d3GHR patients. In this last group, a long-term significant reduction in total and low-density lipoprotein cholesterol was also observed.ConclusionThe functional difference of d3GHR may influence some metabolic effects of rhGH on GHD adults.
A Ubiquitin E2 Variant Protein Acts in Axon Termination and Synaptogenesis in Caenorhabditis elegans
Authors: Trujillo Gloriana , Nakata Katsunori , Yan Dong , Maruyama Ichi N , Jin Yishi 
Published: July 2010

Abstract
In the developing nervous system, cohorts of events regulate the precise patterning of axons and formation of synapses between presynaptic neurons and their targets. The conserved PHR proteins play important roles in many aspects of axon and synapse development from C. elegans to mammals. The PHR proteins act as E3 ubiquitin ligases for the dual-leucine-zipper-bearing MAP kinase kinase kinase (DLK MAPKKK) to regulate the signal transduction cascade. In C. elegans, loss-of-function of the PHR protein RPM-1 (Regulator of Presynaptic Morphology-1) results in fewer synapses, disorganized presynaptic architecture, and axon overextension. Inactivation of the DLK-1 pathway suppresses these defects. By characterizing additional genetic suppressors of rpm-1, we present here a new member of the DLK-1 pathway, UEV-3, an E2 ubiquitin-conjugating enzyme variant. We show that uev-3 acts cell autonomously in neurons, despite its ubiquitous expression. Our genetic epistasis analysis supports a conclusion that uev-3 acts downstream of the MAPKK mkk-4 and upstream of the MAPKAPK mak-2. UEV-3 can interact with the p38 MAPK PMK-3. We postulate that UEV-3 may provide additional specificity in the DLK-1 pathway by contributing to activation of PMK-3 or limiting the substrates accessible to PMK-3.
A Principled Approach to Deriving Approximate Conditional Sampling Distributions in Population Genetics Models with Recombination
Authors: Paul Joshua S , Song Yun S 
Published: July 2010

Abstract
The multilocus conditional sampling distribution (CSD) describes the probability that an additionally sampled DNA sequence is of a certain type, given that a collection of sequences has already been observed. The CSD has a wide range of applications in both computational biology and population genomics analysis, including phasing genotype data into haplotype data, imputing missing data, estimating recombination rates, inferring local ancestry in admixed populations, and importance sampling of coalescent genealogies. Unfortunately, the true CSD under the coalescent with recombination is not known, so approximations, formulated as hidden Markov models, have been proposed in the past. These approximations have led to a number of useful statistical tools, but it is important to recognize that they were not derived from, though were certainly motivated by, principles underlying the coalescent process. The goal of this article is to develop a principled approach to derive improved CSDs directly from the underlying population genetics model. Our approach is based on the diffusion process approximation and the resulting mathematical expressions admit intuitive genealogical interpretations, which we utilize to introduce further approximations and make our method scalable in the number of loci. The general algorithm presented here applies to an arbitrary number of loci and an arbitrary finite-alleles recurrent mutation model. Empirical results are provided to demonstrate that our new CSDs are in general substantially more accurate than previously proposed approximations.
The Effective Size of Populations Infected With Cytoplasmic Sex-Ratio Distorters
Authors: Engelstädter Jan 
Published: July 2010

Abstract
Many arthropod species are infected with maternally inherited endosymbionts that induce a shift in the sex ratio of their hosts by feminizing or killing males (cytoplasmic sex-ratio distorters, or SRDs). These endosymbionts can have profound impacts on evolutionary processes of their hosts. Here, I derive analytical expressions for the coalescent effective size Ne of populations that are infected with SRDs. Irrespective of the type of SRD, Ne for mitochondrial genes is given by the number of infected females. For nuclear genes, the effective population size generally decreases with increasing prevalence of the SRD and can be considerably lower than the actual size of the population. For example, with male-killing bacteria that have near perfect maternal transmission, Ne is reduced by a factor that is given to a good approximation by the proportion of uninfected individuals in the population. The formulae derived here also yield the effective size of populations infected with mutualistic endosymbionts or maternally inherited bacteria that induce cytoplasmic incompatibility, although in these cases, the reduction in Ne is expected to be less severe than for cytoplasmic SRDs.
Development and Validity of a 2-Item Screen to Identify Families at Risk for Food Insecurity
Authors: Hager Erin R. , Quigg Anna M. , Black Maureen M. , Coleman Sharon M. , Heeren Timothy , Rose-Jacobs Ruth , Cook John T. , de Cuba Stephanie A. Ettinger , Casey Patrick H. , Chilton Mariana , Cutts Diana B. , Meyers Alan F. , Frank Deborah A. 
Published: July 2010

OBJECTIVES:To develop a brief screen to identify families at risk for food insecurity (FI) and to evaluate the sensitivity, specificity, and convergent validity of the screen.PATIENTS AND METHODS:Caregivers of children (age: birth through 3 years) from 7 urban medical centers completed the US Department of Agriculture 18-item Household Food Security Survey (HFSS), reports of child health, hospitalizations in their lifetime, and developmental risk. Children were weighed and measured. An FI screen was developed on the basis of affirmative HFSS responses among food-insecure families. Sensitivity and specificity were evaluated. Convergent validity (the correspondence between the FI screen and theoretically related variables) was assessed with logistic regression, adjusted for covariates including study site; the caregivers' race/ethnicity, US-born versus immigrant status, marital status, education, and employment; history of breastfeeding; child's gender; and the child's low birth weight status.RESULTS:The sample included 30 098 families, 23% of which were food insecure. HFSS questions 1 and 2 were most frequently endorsed among food-insecure families (92.5% and 81.9%, respectively). An affirmative response to either question 1 or 2 had a sensitivity of 97% and specificity of 83% and was associated with increased risk of reported poor/fair child health (adjusted odds ratio [aOR]: 1.56; P &lt; .001), hospitalizations in their lifetime (aOR: 1.17; P &lt; .001), and developmental risk (aOR: 1.60; P &lt; .001).CONCLUSIONS:A 2-item FI screen was sensitive, specific, and valid among low-income families with young children. The FI screen rapidly identifies households at risk for FI, enabling providers to target services that ameliorate the health and developmental consequences associated with FI.
Technique for Indexing an Immediate Loading Implant Position for a Provisional Restoration
Authors: Mazaro José Vitor Quinelli , Pellizzer Eduardo Piza , Verri Fellippo Ramos , Falcón-Antenucci Rosse Mary , Zavanelli Adriana Cristina 
Published: July 2010

Abstract
The transfer of an intraoral implant position to the cast for an immediate loading implant is an important step and may be difficult to achieve with commonly used transfer and impression methods. Thus, the purpose of this report is to describe a technique for the use of a surgical template to transfer the implant position for fabrication of a provisional restoration. This technique simplifies the procedure, eliminates the need for taking an impression, avoids surgical site contamination, and maintains an adequate emergence profile during fabrication of the definitive restoration. An indexing technique for transferring the position of the implant from the treated surface after extraction is described.
Reconstruction of Posterior Mandibular Alveolar Ridge Deficiencies With the Piezoelectric Hinge–Assisted Ridge Split Technique: A Retrospective Observational Report
Authors: Holtzclaw Dan J. , Toscano Nicholas J. , Rosen Paul S. 
Published: July 2010

Background: Reconstruction of alveolar defects in the posterior edentulous mandible can be a difficult task. In addition to complicating anatomic features, such as the inferior alveolar nerve, mental foramen, oblique ridge, and lingual undercut of the mylohyoid ridge, edentulous ridges in the posterior mandible have thicker cortices and decreased volumes of vascular trabecular bone than their maxillary counterparts. Traditionally, these areas have been treated with autogenous block grafts. Significant resorption of these grafts, in combination with patient morbidity at secondary donor sites, has led clinicians to seek alternatives for augmenting the edentulous posterior mandible. The aim of this retrospective consecutive case series is to report on both the technique of the piezoelectric hinge–assisted ridge split procedure for augmenting these sites and the results that were achieved.Methods: Thirteen patients with 17 horizontal alveolar ridge deficiencies of the posterior mandible were treated with the piezoelectric hinge–assisted ridge split procedure. After an average healing period of 14 weeks, dental implants were placed into the augmented sites. Intrasurgical alveolar ridge measurements taken at the initial surgery and subsequently at the time of implant placement documented the horizontal gains achieved by this procedure.Results: Overall mean gain in horizontal width was 4.03 mm (± 0.67). For single implant–site augmentations, the mean gain was 3.38 mm (± 0.25). For multiple adjacent implant–site augmentations, mean gain was 4.25 mm (± 0.62). A total of 31 dental implants were successfully placed in all sites and none required additional augmentation procedures. There were no instances of adverse outcomes, such as neurosensory deficits or sequestration of mobilized buccal plates. After a minimum of 6 months of loading, all dental implants have been successful.Conclusions: This retrospective observational report demonstrates that the piezoelectric hinge–assisted ridge split procedure can achieve substantial gains in horizontal ridge width of the edentulous posterior mandible without associated morbidity. Further prospective and larger observational studies are warranted to see if this is true over a larger patient population and to compare this technique to other more traditionally used approaches.