bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness of Targeted Human Immunodeficiency Virus Screening in an Urban Emergency Department
Authors: Dowdy David W. , Rodriguez Robert M. , Bradley Hare C. , Kaplan Beth 
Published: July 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:745–753 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives: Although targeted screening of patients at high risk for human immunodeficiency virus (HIV) infection in the emergency department (ED) improves patient outcomes and may prevent HIV transmission, ED‐based screening programs incur additional costs and have thus not been widely scaled up. The objective of this study was to evaluate the cost‐effectiveness of ED‐based targeted HIV screening as implemented in actual practice.Methods: This was a cost‐utility analysis of a rapid HIV screening program in an urban ED. Physicians were encouraged to screen patients undergoing inpatient admission or who had HIV risk factors. The authors measured costs directly and estimated quality‐adjusted life expectancy using chart review, literature assumptions, and mathematical modeling. Incremental cost utility was evaluated from a societal perspective using a lifetime time horizon.Results: From June 2008 through September 2009, a total of 3,766 HIV tests were ordered (235 tests per month), of which an estimated 2,406 (64%) represented screening in patients without HIV‐related signs or symptoms. Nineteen (0.8%) patients were newly diagnosed through screening during the study period, of whom nine (47%) were eligible for antiretroviral therapy (ART) and maintained consistent outpatient follow‐up. Estimated screening costs were $82,300 per year, or $45.53 per screening test, of which $28.01 (62%) was for program management. Targeted screening prevented an estimated 2.1 HIV transmission events over 16 months. Per patient screened, targeted screening saved $112 (95% uncertainty range [UR] = $20 to $225) and resulted in 2.71 quality‐adjusted life‐days gained (95% UR = 1.71 to 4.01). Cost‐utility was most sensitive to the prevalence of undiagnosed HIV in the screened population.Conclusions: Targeted HIV screening, as implemented in an urban ED, is cost saving and increases quality‐adjusted life expectancy.
Emergency Department Presentation of Children With Tuberculosis
Authors: Cruz Andrea T. , Ong Lydia T. , Starke Jeffrey R. 
Published: July 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:726–732 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  The objectives were to describe emergency department (ED) presentations of children with tuberculosis (TB) disease and assess the utility in children of TB screening tools developed for adults.Methods:  Children at most 18 years old with confirmed or probable TB seen at the Children’s TB Clinic from 2005 to 2009 who were initially evaluated in the ED for symptoms compatible with TB in the preceding month were included. TB was classified as microbiologically confirmed disease or probable TB disease, as defined by the World Health Organization.Results:  Sixty children (29 with confirmed TB and 31 with probable TB) were identified after presentation to the ED, representing 35% of all children diagnosed with TB at the two hospitals during this interval. Eighty‐eight percent were previously healthy. Fifty‐five percent were Hispanic, 30% were black or African American, 12% were Asian, and 3% were white. Forty‐four (73%) had intrathoracic disease (37 pulmonary parenchymal or pleural disease, four miliary disease, two endobronchial, one pericarditis). Sixteen (27%) had extrathoracic disease (eight meningitis, five cervical lymphadenopathy, two gastrointestinal, one interstitial keratitis), 11 of whom also had abnormal chest radiographs, including all eight children with TB meningitis. Most (76.7%) were diagnosed at the time of their first ED visit or during their first hospital admission, 12% after their second ED visit, 10% after their third ED visit, and one patient after six ED visits to various facilities. In 33 case (55%), the diagnosis was suspected in the ED because of epidemiologic risk factors (15), radiographic evaluation (11), or symptoms (7). Hemoptysis (12%) and night sweats (10%) were uncommon. Neither cavitary lesions (seen in two children) nor apical lesions (seen in 42%) predominated. The five screening tools validated for adults with pulmonary disease were 77% to 98% sensitive in identifying children with intrathoracic TB and 50% to 100% sensitive for extrathoracic TB.Conclusions:  The point of entry to health care for many children with TB is the ED. The more protean manifestations of TB in children can decrease the utility of screening tools developed to identify adults with TB. While TB in adults often is a microbiologic diagnosis, childhood TB often is an epidemiologic diagnosis. Therefore, questioning caregivers about TB risk factors in the family may identify a higher percentage of children with possible TB.
Trade liberalization, employment and inequality in India and South Africa
Authors: KUCERA David , RONCOLATO Leanne 
Published: July 2011

Abstract.This article uses social accounting matrices in a Leontief multiplier model to estimate the effects of trade expansion on employment and incomes in India and South Africa. The evaluation focuses on a period of rapid trade liberalization beginning in the early 1990s, distinguishing between trade with developed and developing countries. Employment results identify winning and losing industries and examine sex and skill biases. Income results examine inequality measured by household income distribution (rural and urban). Results are presented in the context of trade theory as regards adjustment mechanisms for bringing trade into balance and implications of specialization for economic development.
HMGB‐1 induces c‐kit+ cell microvascular rolling and adhesion via both toll‐like receptor‐2 and toll‐like receptor‐4 of endothelial cells
Authors: Furlani Dario , Donndorf Peter , Westien Ingeborg , Ugurlucan Murat , Pittermann Erik , Wang Weiwei , Li Wenzhong , Vollmar Brigitte , Steinhoff Gustav , Kaminski Alexander , Ma Nan 
Published: July 2011

AbstractHigh‐mobility group box 1 (HMGB‐1) is a strong chemo‐attractive signal for both inflammatory and stem cells. The aim of this study is to evaluate the mechanisms regulating HMGB‐1–mediated adhesion and rolling of c‐kit+ cells and assess whether toll‐like receptor‐2 (TLR‐2) and toll‐like receptor‐4 (TLR‐4) of endothelial cells or c‐kit+ cells are implicated in the activation of downstream migration signals to peripheral c‐kit+ cells. Effects of HMGB‐1 on the c‐kit+ cells/endothelial interaction were evaluated by a cremaster muscle model in wild‐type (WT), TLR‐2 (−/−) and Tlr4 (LPS‐del) mice. The mRNA and protein expression levels of endothelial nitric oxide synthase were determined by quantitative real‐time PCR and immunofluorescence staining. Induction of crucial adhesion molecules for rolling and adhesion of stem cells and leukocytes were monitored in vivo and in vitro. Following local HMGB‐1 administration, a significant increase in cell rolling was detected (32.4 ± 7.1% in ‘WT’ versus 9.9 ± 3.2% in ‘control’, P < 0.05). The number of firmly adherent c‐kit+ cells was more than 13‐fold higher than that of the control group (14.6 ± 5.1 cells/mm2 in ‘WT’ versus 1.1 ± 1.0 cells/mm2 in ‘control’, P < 0.05). In knockout animals, the fraction of rolling cells did not differ significantly from control levels. Firm endothelial adhesion was significantly reduced in TLR‐2 (−/−) and Tlr4 (LPS‐del) mice compared to WT mice (1.5 ± 1.4 cells/mm2 in ‘TLR‐2 (−/−)’ and 2.4 ± 1.4 cells/mm2 in ‘Tlr4 (LPS‐del)’ versus 14.6 ± 5.1 cells/mm2 in ‘WT’, P < 0.05). TLR‐2 (−/−) and Tlr4 (LPS‐del) stem cells in WT mice did not show significant reduction in rolling and adhesion compared to WT cells. HMGB‐1 mediates c‐kit+ cell recruitment via endothelial TLR‐2 and TLR‐4.
Cardiomyocyte death induced by ischaemic/hypoxic stress is differentially affected by distinct purinergic P2 receptors
Authors: Cosentino Simona , Banfi Cristina , Burbiel Joachim C. , Luo Haijian , Tremoli Elena , Abbracchio Maria P. 
Published: July 2011

AbstractBlood levels of extracellular nucleotides (e.g. ATP) are greatly increased during heart ischaemia, but, despite the presence of their specific receptors on cardiomyocytes (both P2X and P2Y subtypes), their effects on the subsequent myocardial damage are still unknown. In this study, we aimed at investigating the role of ATP and specific P2 receptors in the appearance of cell injury in a cardiac model of ischaemic/hypoxic stress. Cells were maintained in a modular incubator chamber in a controlled humidified atmosphere of 95% N2 for 16 hrs in a glucose‐free medium. In this condition, we detected an early increase in the release of ATP in the culture medium, which was followed by a massive increase in the release of cytoplasmic histone‐associated‐DNA‐fragments, a marker of apoptosis. Addition of either apyrase, which degrades extracellular ATP, or various inhibitors of ATP release via connexin hemichannels fully abolished ischaemic/hypoxic stress‐associated apoptosis. To dissect the role of specific P2 receptor subtypes, we used a combined approach: (i) non‐selective and, when available, subtype‐selective P2 antagonists, were added to cardiomyocytes before ischaemic/hypoxic stress; (ii) selected P2 receptors genes were silenced via specific small interfering RNAs. Both approaches indicated that the P2Y2 and P2χ7 receptor subtypes are directly involved in the induction of cell death during ischaemic/hypoxic stress, whereas the P2Y4 receptor has a protective effect. Overall, these findings indicate a role for ATP and its receptors in modulating cardiomyocyte damage during ischaemic/hypoxic stress.
Fetal death in twins
Authors: MAHONY RHONA , MULCAHY CELIA , MCAULIFFE FIONNUALA , HERLIHY COLM O , CARROLL STEPHEN , FOLEY MICHAEL E. 
Published: July 2011

AbstractObjective.To examine the pattern and prospective risk of intrauterine fetal death (IUFD) in twin pregnancy by chorionicity.Design.Retrospective cohort analysis.Setting.Large national tertiary referral center.Population.All consecutive twin deliveries (1997–2006) ≥24 weeks.Methods. Retrospective review of all consecutive twin deliveries over 10 years to identify patterns of IUFD in twins and calculate gestation‐specific prospective risks of IUFD. Fetal death was defined as intrauterine demise of a fetus ≥24weeks, intertwin birthweight discordance as ≥20% difference and growth restriction as birthweight <5thcentile. Chorionicity was confirmed by postnatal placental examination.Main outcome measures.Fetal death.Results.1094 twin pairs including 276 monochorionic‐diamniotic (MCDA) (25.3%) and 818 dichorionic‐diamniotic (DCDA) twin pregnancies (74.7%) were studied. Twenty‐nine fetal deaths occurred affecting 22 twin pregnancies. The incidence of IUFD (death of one or both fetuses) in MCDA twin pregnancies was three times that in DCDA pregnancies [11/276 (3.9)% vs. 11/818 (1.3%)p<0.001]. The majority of deaths in MCDA twins were associated with twin–twin transfusion syndrome (TTTS) prior to 30 weeks. In normally grown twins the prospective risk of IUFD was similarly low in MCDA and DCDA pregnancies after 34 weeks but in pregnancies complicated by abnormal growth, the prospective risk of IUFD was 3.4 in MCDA and 2.0 in DCDA pregnancies.Conclusion.Twin pregnancies complicated by growth restriction or growth discordance were associated with a high risk of IUFD, particularly in affected MCDA twins. Conversely, in normally grown twins the risk was similarly low in MCDA and DCDA pregnancies after 34 weeks.
Weight gain in infancy and post‐bronchiolitis wheezing
Authors: Nuolivirta Kirsi , Koponen Petri , Helminen Merja , Korppi Matti 
Published: July 2011

AbstractAim:  Low birth weight, high birth weight and excessive weight gain after birth may be risk factors for asthma in childhood, but their associations with wheezing in early childhood are poorly studied. The aim of the study was to evaluate birth weight, weight gain in early infancy and overweight in infancy assessed by weight for length (WFL) as risk factors for wheezing after hospitalization for bronchiolitis in early infancy.Methods:  In all, 127 full‐term infants hospitalized for bronchiolitis at age <6 months have been followed up until the mean age of 1.5 years. The weights and lengths of the infants were measured on admission to hospital and at the control visit. Birth weights were obtained from the hospital records.Results:  Both occurrence and recurrence of post‐bronchiolitis wheezing were associated with birth weight >4000 g and the recurrence of post‐bronchiolitis wheezing with WFL >110% at age 1.5 years. The associations were robust to adjustments with gender and allergy. Higher weight gain from birth to hospitalization at age <6 months was associated with wheezing in the subgroup of children with birth weight >4000 g.Conclusion:  High birth weight and the development of overweight may be associated with post‐bronchiolitis wheezing in infancy.
The Evolution of a Holocene Estuarine Barrier on the Coromandel Coast, New Zealand
Authors: WOODS J.L.D. 
Published: July 2011

AbstractWhitianga Harbour on the Coromandel Peninsula, North Island, New Zealand is fronted by a broad sandy barrier composed of linear beach ridges. The barrier developed through a process of rollover as sea level rose in the early Holocene with shelly sandy sediment washed inland over estuarine muds. These overwash deposits are present to 3 m below sea level in the back barrier area. Once sea level stabilised and barrier rollover had ceased the barrier continued to prograde in a series of beach ridges. The back barrier area is characterised by estuarine muds, overlain by splay and overwash deposits that are reworked by fluvial and tidal channels. The initial flooding of the estuary occurred at around 7350–7225 years cal BP, reaching modern levels by 6894–6729 years cal BP at the earliest. Infill was rapid as evidenced by estuarine species (crustaceans and bivalves) preserved in life position. From ∼6000 years BP to present, the estuary is characterised by tidal and fluvial reworking, suggesting that modern sediment inputs are bypassing the estuary.
Ecological factors influencing group sizes of river dolphins (Inia geoffrensisandSotalia fluviatilis)
Authors: Gomez‐Salazar Catalina , Trujillo Fernando , Whitehead Hal 
Published: July 2011

AbstractLiving in groups is usually driven by predation and competition for resources. River dolphins do not have natural predators but inhabit dynamic systems with predictable seasonal shifts. These ecological features may provide some insight into the forces driving group formation and help us to answer questions such as why river dolphins have some of the smallest group sizes of cetaceans, and why group sizes vary with time and place. We analyzed observations of group size forIniaandSotaliaover a 9 yr period. In the Amazon, largest group sizes occurred in main rivers and lakes, particularly during the low water season when resources are concentrated; smaller group sizes occurred in constricted waters (channels, tributaries, and confluences) that receive an influx of blackwaters that are poor in nutrients and sediments. In the Orinoco, the largest group sizes occurred during the transitional water season when the aquatic productivity increases. The largest group size ofIniaoccurred in the Orinoco location that contains the influx of two highly productive whitewater rivers. Flood pulses govern productivity and major biological factors of these river basins. Any threats to flood pulses will likely have an effect on the functionality of these ecosystems and the species living in them.
Whistle characteristics of common dolphins (Delphinus sp.) in the Hauraki Gulf, New Zealand
Authors: Petrella Vincenzo , Martinez Emmanuelle , Anderson Michael G. , Stockin Karen A. 
Published: July 2011

AbstractQuantifying the vocal repertoire of a species is critical for subsequent analysis of signal functionality, geographic variation, and social relevance. However, the vocalizations of free‐ranging common dolphins (Delphinus sp.) have not previously been described from New Zealand waters. We present the first quantitative analysis of whistle characteristics to be undertaken on the New Zealand population. Acoustic data were collected in the Hauraki Gulf, North Island from 28 independent dolphin group encounters. A total of 11,715 whistles were collected from 105.1 min of recordings. Seven whistle contours were identified containing 29 subtypes. Vocalizations spanned from 3.2 to 23 kHz, with most whistles occurring between 11 and 13 kHz. Whistle duration ranged from 0.01 to 4.00 s (mean ± SD; 0.27 ± 0.32). Of the 2,663 whistles analyzed, 82% have previously been identified within U.K. populations. An additional six contours, apparently unique to New Zealand Delphinus were also identified. Data presented here offer a first insight into the whistle characteristics of New Zealand Delphinus. Comparisons with previously studied populations reveal marked differences in the whistle frequency and modulation of the New Zealand population. Interpopulation differences suggest behavior and the local environment likely play a role in shaping the vocal repertoire of this species.
Food partitioning among three sympatric odontocetes (Grampus griseus, Lagenodelphis hosei, and Stenella attenuata)
Authors: Wang Ming‐Chih , Shao Kwang‐Tsao , Huang Shiang‐Lin , Chou Lien‐Siang 
Published: July 2011

AbstractFood is one of the most important dimensions of resource partitioning for species coexistence. In this study, we investigated the dietary composition and foraging habits of three sympatric odontocetes in order to identify their levels of food niche overlap and ecological separation. Stomach content analysis was performed on samples collected from carcasses confiscated by police or entangled in gill nets from 1994 to 2001, including 27 Risso's dolphins (GG) (Grampus griseus), 27 Fraser's dolphins (LH) (Lagenodelphis hosei), and 45 pantropical spotted dolphins (SA) (Stenella attenuata). GG consumed only cephalopods, with Enoploteuthis chunii accounting for 90.5% of total prey consumed, LH fed on mesopelagic fishes and cephalopods, dominated by hatchetfish, Polyipnus stereope (50.2%), and SA ate both mesopelagic and epipelagic preys, primarily fishes of Myctophum asperum (20.3%) and squids of E. chunii (25.8%). Among the three odontocetes, GG had the narrowest dietary niche width, while SA had the widest width. Both the niche overlap index and the analysis of similarities (ANOSIM) showed significant diet differentiation among these three dolphin species. The depth distribution of their principal prey items further suggests that LH feeds in the deepest waters while SA utilizes prey resources near surface.
The systematics of right whales (Mysticeti: Balaenidae)
Authors: Churchill Morgan , Berta Annalisa , Deméré Thomas 
Published: July 2011

AbstractBalaenidae (right whales) are large, critically endangered baleen whales represented by four living species. The evolutionary relationships of balaenids are poorly known, with the number of genera, relationships to fossil taxa, and position within Mysticeti in contention. This study employs a comprehensive set of morphological characters to address aspects of balaenid phylogeny. A sister‐group relationship between neobalaenids and balaenids is strongly supported, although this conflicts with molecular evidence, which may be an artifact of long‐branch attraction (LBA). Monophyly of Balaenidae is supported, and three major clades are recognized: (1) extinct genus Balaenula, (2) extant and extinct species of the genus Eubalaena, and (3) extant and extinct species of the genus Balaena plus the extinct taxon, Balaenella. The relationships of these clades to one another, as well as to the early Miocene stem balaenid, Morenocetus parvus, remain unresolved. Pliocene taxa, Balaenula astensis and Balaenula balaenopsis, form a clade that is the sister group to the Japanese Pliocene Balaenula sp. Eubalaena glacialis and Pliocene Eubalaena belgica, are in an unresolved polytomy with a clade including E. japonica and E. australis. Extant and fossil species of Balaena form a monophyletic group that is sister group to the Dutch Pliocene Balaenella, although phylogenetic relationships within Balaena remain unresolved.
Individual variation in pup vocalizations and absence of behavioral signs of maternal vocal recognition in Weddell seals (Leptonychotes weddellii)
Authors: Opzeeland Ilse C. Van , Parijs Sofie M. Van , Frickenhaus Stephan , Kreiss Cornelia M. , Boebel Olaf 
Published: July 2011

AbstractIndividually stereotyped vocalizations often play an important role in relocation of offspring in gregarious breeders. In phocids, mothers often alternate between foraging at sea and attending their pup. Pup calls are individually distinctive in various phocid species. However, experimental evidence for maternal recognition is rare. In this study, we recorded Weddell seal (Leptonychotes weddellii) pup vocalizations at two whelping patches in Atka Bay, Antarctica, and explored individual vocal variation based on eight vocal parameters. Overall, 58% of calls were correctly classified according to individual. For males (n= 12) and females (n= 9), respectively, nine and seven individuals were correctly identified based on vocal parameters. To investigate whether mothers respond differently to calls of familiar vs. unfamiliar pups, we conducted playback experiments with 21 mothers. Maternal responses did not differ between playbacks of own, familiar, and unfamiliar pup calls. We suggest that Weddell seal pup calls may need to contain only a critical amount of individually distinct information because mothers and pups use a combination of sensory modalities for identification. However, it cannot be excluded that pup developmental factors and differing environmental factors between colonies affect pup acoustic behavior and the role of acoustic cues in the relocation process.
2,4,6‐Octatrienoic acid is a novel promoter of melanogenesis and antioxidant defence in normal human melanocytes via PPAR‐γ activation
Authors: Flori Enrica , Mastrofrancesco Arianna , Kovacs Daniela , Ramot Yuval , Briganti Stefania , Bellei Barbara , Paus Ralf , Picardo Mauro 
Published: July 2011

SummaryGiven the importance of the tanning response in protecting human skin from the harmful effects of UV radiation, one important research priority is to identify novel molecules that are capable of promoting pigmentation and/or antioxidant defence. Parrodienes share some structural features with carotenoids and retinoids, stimulate cell antioxidant defence and counteract senescence‐like phenotype in fibroblasts. We selected the parrodiene‐derivative 2,4,6‐octatrienoic acid (Octa) to study its impact on key parameters of melanogenesis and antioxidant defence in organ‐cultured human skin and in normal human melanocytes. Octa promoted melanogenesis by up‐regulating tyrosinase and microphthalmia‐associated transcription factor expression. This correlated with an increase of melanin content in both human epidermis in situ and cultured human epidermal melanocytes. Moreover, Octa increased the biological antioxidant potential content and the expression and activity of catalase. Activation of peroxisome proliferator‐activated receptor (PPAR)‐γ was necessary to evoke these effects. These data strongly encourage the systematic study of Octa as a novel candidate promoter of human skin photoprotection.