bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of propofol-related infusion syndrome in critically ill adults: a prospective, multicenter study
Authors: Roberts Russel J , Barletta Jeffrey F , Fong Jeffrey J , Schumaker Greg , Kuper Philip J , Papadopoulos Stella , Yogaratnam Dinesh , Kendall Elise , Xamplas Renee , Gerlach Anthony T , Szumita Paul M , Anger Kevin E , Arpino Paul A , Voils Stacey A , Grgurich Philip , Ruthazer Robin , Devlin John W 
Published: October 2009

Abstract
Introduction
While propofol is associated with an infusion syndrome (PRIS) that may cause death, the incidence of PRIS is unknown. Determining the incidence of PRIS and the frequency of PRIS-related clinical manifestations are key steps prior to the completion of any controlled studies investigating PRIS. This prospective, multicenter study sought to determine the incidence of PRIS and PRIS-related clinical manifestations in a large cohort of critically ill adults prescribed propofol.

Methods
Critically ill adults from 11 academic medical centers administered an infusion of propofol for [>/=] 24 hours were monitored at baseline and then on a daily basis until propofol was discontinued for the presence of 11 different PRIS-associated clinical manifestations and risk factors derived from 83 published case reports of PRIS.

Results
Among 1017 patients [medical (35%), neurosurgical (25%)], PRIS (defined as metabolic acidosis plus cardiac dysfunction and [>/=] 1 of: rhabdomyolysis, hypertriglyceridemia or renal failure occurring after the start of propofol therapy) developed in 11 (1.1%) patients an average of 3 (1-6) [median (range)] days after the start of propofol. While most (91%) of the patients who developed PRIS were receiving a vasopressor (80% initiated after the start of propofol therapy), few received a propofol dose >83 mcg/kg/min (18%) or died (18%). Compared to the 1006 patients who did not develop PRIS, the APACHE II score (25 +/- 6 vs 20 +/- 7, P = 0.01) was greater in patients with PRIS but both the duration of propofol use (P = 0.43) and ICU length of stay (P = 0.82) were similar.

Conclusions
Despite using a conservative definition for PRIS, and only considering new-onset PRIS clinical manifestations, the incidence of PRIS slightly exceeds 1%. Future controlled studies focusing on evaluating whether propofol manifests the derangements of critical illness more frequently than other sedatives will need to be large. These studies should also investigate the mechanism(s) and risk factors for PRIS.
Late initiation of renal replacement therapy is associated with worse outcomes in acute kidney injury after major abdominal surgery
Authors: Shiao Chih-Chung , Wu Vin-Cent , Li Wen-Yi , Lin Yu-Feng , Hu Fu-Chang , Young Guang-Huar , Kuo Chin-Chi , Kao Tze-Wah , Huang Down-Ming , Chen Yung-Ming , Tsai Pi-Ru , Lin Shuei-Liong , Chou Nai-Kuan , Lin Tzu-Hsin , Yeh Yu-Chang , Wang Chih-Hsien , Chou Anne , Ko Wen-Je , Wu Kwan-Dun ,   the National Taiwan University Surgical Intensive Care Unit-Associated Renal Failure (NSARF) Study Group
Published: October 2009

Abstract
Introduction
Abdominal surgery is probably associated with more likelihood to cause acute kidney injury (AKI). The aim of this study was to evaluate whether early or late start of renal replacement therapy (RRT) defined by simplified RIFLE (sRIFLE) classification in AKI patients after major abdominal surgery will affect outcome.

Methods
A multicenter prospective observational study based on the NSARF (N ational Taiwan University S urgical ICU A ssociated R enal F ailure) Study Group database. 98 patients (41 female, mean age 66.4 ± 13.9 years) who underwent acute RRT according to local indications for post-major abdominal surgery AKI between 1 January, 2002 and 31 December, 2005 were enrolled The demographic data, comorbid diseases, types of surgery and RRT, as well as the indications for RRT were documented. The patients were divided into early dialysis (sRIFLE-0 or Risk) and late dialysis (LD, sRIFLE -Injury or Failure) groups. Then we measured and recorded patients' outcome including in-hospital mortality and RRT wean-off until 30 June, 2006.

Results
The in-hospital mortality was compared as endpoint. Fifty-seven patients (58.2%) died during hospitalization. LD (hazard ratio (HR) 1.846; P = 0.027), old age (HR 2.090; P = 0.010), cardiac failure (HR 4.620; P < 0.001), pre-RRT SOFA score (HR 1.152; P < 0.001) were independent indicators for in-hospital mortality.

Conclusions
The findings of this study support earlier initiation of acute RRT, and also underscore the importance of predicting prognoses of major abdominal surgical patients with AKI by using RIFLE classification.
Clinical implications of neuropsychiatric systemic lupus erythematosus
Authors: Mak Anselm , Ho Roger Chun Man , Lau Chak Sing 
Published: October 2009

SummarySystemic lupus erythematosus (SLE) is a disorder which can affect the central nervous system and result in a broad range of psychiatric syndromes such as psychosis, mood disorders, acute confusion and cognitive dysfunction. Despite the robust nomenclature of neuropsychiatric SLE (NPSLE), psychiatric syndromes in patients are often non-specific and may be secondary to concurrent non-SLE-related conditions and complications of medical therapies. Although the exact immunopathological mechanism for psychiatric presentation remains elusive, prompt exclusion of other factors contributing to the psychiatric symptoms coupled with effective assessment strategies and management with immunosuppression and psychiatric therapy are imperative. Psychiatrists and rheumatologists must work in close liaison to identify, treat and prognosticate patients with psychiatric syndromes in order to improve their quality of life, vocational aptitude and, ultimately, survival.
Article 2 of the Human Rights Act 1998 and the treatment of prisoners
Authors: Curtice Martin , Sandford John 
Published: October 2009

SummaryPeople detained in prisons, psychiatric hospitals, police custody and immigration detention centres remain a cause of concern, particularly to professionals, politicians and the media. As the number of people detained by the state increases, Courts have been taking an increasing interest in cases in which individuals have died in state custody. Such cases are subsumed under Article 2 of the Human Rights Act 1998 – the right to life. Article 2 case law has elucidated key principles that can be applied in practice. Importantly, it imposes on states not only a negative duty not to take life intentionally or negligently, but also a positive duty to safeguard life. The inherent positive obligations have two aspects: first, there is a duty to provide an effective and impartial investigation in cases of death resulting from the activities of state officials, and second, a duty to safeguard and protect life.
Letter from America: acute in-patient psychiatry bed shortages
Authors: Sharfstein Steven S. 
Published: October 2009

SummaryThe number of in-patient beds for psychiatric treatment in America has declined dramatically over the past 40 years. Public and private policies have encouraged an extremely short-term, crisis-stabilisation model of treatment. This is true on both general and subspecialty units. As a result, readmissions have increased, emergency rooms are crowded, and many patients end up homeless or incarcerated in the criminal justice system. These changes have created a public health crisis in America, and are the greatest challenges that American psychiatry faces today.
Metamorphosis by Franz Kafka
Authors: Beveridge Allan 
Published: October 2009

SummaryThis article examines the short story Metamorphosis by the enigmatic Czech writer Franz Kafka, whose work has been the subject of extensive critical discussion. His writings have been seen in the context of existentialism, Jewish mysticism and as a warning of the advent of totalitarianism. Kafka has attracted the attention of psychoanalysts and psychiatrists, who have maintained that his life and work manifest evidence of unresolved Oedipal issues and of schizoid personality. Metamorphosis is open to a multitude of interpretations, but a potentially fruitful approach is to see parallels between the predicament of the story's main character, Gregor Samsa, and that of people with severe mental illness. The story highlights the fate of those who are judged to be different by society and how issues of alienation, impaired communication and rejection arise.
Tumor Infiltrating Lymphocytes But Not Serum Pituitary Antibodies Are Associated with Poor Clinical Outcome after Surgery in Patients with Pituitary Adenoma
Authors: Lupi Isabella , Manetti Luca , Caturegli Patrizio , Menicagli Michele , Cosottini Mirco , Iannelli Aldo , Acerbi Giovanni , Bevilacqua Generoso , Bogazzi Fausto , Martino Enio 
Published: October 2009

Abstract
Context: Serum pituitary antibodies (Pit Abs) and tumor-infiltrating lymphocytes (TILs) have been described in pituitary adenomas, but their clinical significance remains unknown.
Objective: The objective of the study was to assess Pit Abs and TILs prevalence in pituitary adenomas and their influence on clinical outcome.
Design: This was a prevalence case-control study.
Patients and Setting: Two hundred ninety-one pituitary adenoma cases (110 non-secreting, 30 ACTH-69 GH-71 prolactin- and 13 TSH-secreting adenoma; 177 operated and 114 untreated), 409 healthy controls, and 14 autoimmune hypophysitis were enrolled in a tertiary referral center.
Intervention: Pit Abs were measured using immunofluorescence in all cases and controls (n = 714). The presence of TILs was evaluated using CD45 staining in a subset of adenomas surgically treated (n = 72).
Main Outcome Measure: Clinical response of pituitary adenoma after surgery was evaluated.
Results: Pit Abs prevalence was higher in adenomas (5.1%) than healthy subjects (0.7%, P &lt; 0.0001) and lower than in autoimmune hypophysitis patients (57%, P &lt; 0.0001). Similarly, TILs prevalence was higher in adenomas than normal pituitary (P = 0.01) and lower than in autoimmune hypophysitis (P &lt; 0.0001). No correlation between Pit Abs and TILs was found (P = 0.78). A poor clinical outcome was more common in adenoma patients with TILs (11 of 18, 61%) than in those without (17 of 54, 31%, P = 0.026). Multivariate regression analysis identified the presence of TILs as independent prognostic factor for persistence/recurrence of pituitary adenoma.
Conclusions: TILs and Pit Abs are present in a significant number of pituitary adenoma patients. Cell-mediated immunity appears to be predictive of a less favorable clinical outcome.
The importance of color in mate choice of the blue crab Callinectes sapidus
Authors: Baldwin Jamie , Johnsen Sönke 
Published: October 2009

SUMMARY
Visual displays often play a large role in animal communication,particularly in sexual interactions. The blue crab Callinectes sapidus is both colorful and highly visually responsive, yet almost all studies of their courtship have focused on chemical cues. In the blue crab's underwater environment, however, visual cues may function more rapidly and over a longer distance than chemical cues. Given that blue crabs are aggressive and cannibalistic, visual cues may therefore allow blue crabs to quickly evaluate potential mates from safer distances. In the present study we show that courtship and mate choice behavior in C. sapidus can be stimulated by visual cues alone. Further, we show that males have a preference for females with red claw dactyls. In binary choice experiments, males displayed more often to photographs of females with red claws than to those with white claws or to those with black claws that were isoluminant to the red ones. This strongly suggests that male blue crabs made their choices based on the hue of the red claws, further suggesting that blue crabs are capable of color vision and use color in mate choice.
Symbiotic bacteria living in the hoopoe's uropygial gland prevent feather degradation
Authors: Ruiz-Rodríguez M. , Valdivia E. , Soler Juan J. , Martín-Vivaldi M. , Martín-Platero A. M. , Martínez-Bueno M. 
Published: October 2009

SUMMARY
Among potential agents that might damage bird feathers are certain microorganisms which secrete enzymes that digest keratin, as is the case of the ubiquitous bacterium Bacillus licheniformis, present in both the feathers and skin of wild birds. It is therefore a good candidate for testing the effects of bird defences against feather-degrading microorganisms. One of these defences is the oil secreted by the uropygial gland, which birds use to protect their feathers against parasites. In previous studies we have shown how Enterococcus faecalis strains isolated from nestling hoopoes exert antagonistic effects against B. licheniformis, mediated by the production of bacteriocins. Consequently we hypothesized that this enterococcus and the bacteriocins it engenders might act as a defence against feather-degrading microorganisms in hoopoes. We investigated this hypothesis in a series of laboratory experiments and evaluated the extent to which the keratinolytic effects caused by B. licheniformis were reduced by the E. faecalis MRR10-3 strain, isolated from hoopoes, and its bacteriocins. In different treatments, feathers or pure keratin was incubated with B. licheniformis, B. licheniformis together with E. faecalis MRR10-3, and B. licheniformis together with the bacteriocins produced by E. faecalis MRR10-3. Our results were in accordance with the predicted effects on hoopoe feathers. There was a significant decrease both in pure keratin loss and in feather degradation in the presence of the symbiotic bacterium or its bacteriocin. These results suggest that by preening their feathers hoopoes benefit from their symbiotic relationship with bacteriocin-producing enterococci, which constitute a chemical defence against feather degradation.
Transectional heat transfer in thermoregulating bigeye tuna (Thunnus obesus) – a 2D heat flux model
Authors: Boye Jess , Musyl Michael , Brill Richard , Malte Hans 
Published: October 2009

SUMMARYWe developed a 2D heat flux model to elucidate routes and rates of heat transfer within bigeye tuna Thunnus obesus Lowe 1839 in both steady-state and time-dependent settings. In modeling the former situation, we adjusted the efficiencies of heat conservation in the red and the white muscle so as to make the output of the model agree as closely as possible with observed cross-sectional isotherms. In modeling the latter situation, we applied the heat exchanger efficiencies from the steady-state model to predict the distribution of temperature and heat fluxes in bigeye tuna during their extensive daily vertical excursions. The simulations yielded a close match to the data recorded in free-swimming fish and strongly point to the importance of the heat-producing and heat-conserving properties of the white muscle. The best correspondence between model output and observed data was obtained when the countercurrent heat exchangers in the blood flow pathways to the red and white muscle retained 99% and 96% (respectively) of the heat produced in these tissues. Our model confirms that the ability of bigeye tuna to maintain elevated muscle temperatures during their extensive daily vertical movements depends on their ability to rapidly modulate heating and cooling rates. This study shows that the differential cooling and heating rates could be fully accounted for by a mechanism where blood flow to the swimming muscles is either exclusively through the heat exchangers or completely shunted around them, depending on the ambient temperature relative to the body temperature. Our results therefore strongly suggest that such a mechanism is involved in the extensive physiological thermoregulatory abilities of endothermic bigeye tuna.
Adjustments of wingbeat frequency and air speed to air density in free-flying migratory birds
Authors: Schmaljohann H. , Liechti F. 
Published: October 2009

SUMMARYBirds adjust their flight behaviour to the physical properties of the air. Lift and drag, the two major properties in aerodynamics, are highly dependent on air density. With decreasing air density drag is reduced and lift per wingbeat decreases. According to flight mechanical theory, wingbeat frequency and air speed should increase with decreasing air density, i.e. increasing flight altitude. Although wind tunnel experiments have shed light on many aspects of avian flight, the effect of air density remained ambiguous, because air density could not be adjusted in wind tunnels, until now. By means of radar we recorded tracks of several thousand free-flying individual birds during nocturnal migration. From these tracks we derived wingbeat frequencies and air speeds covering air densities from 0.84 kg m–3 to 1.13 kg m–3, corresponding to an altitudinal range of about 3000 m. We demonstrate here with this sample of nocturnal migrants that: (1)wingbeat frequency decreases with air density (which corresponds to an increase in flap-gliding flyers by 0.4 Hz km–1 and in bounding flyers by 1.1 Hz km–1), (2) reducing wingbeat frequency to equivalent sea level values did not abolish the dependency on air density, as expected by flight mechanical theory, and (3) bounding flyers show a higher response in their flight behavioural adjustments to changes in air density than flap-gliding flyers. With respect to air speed flap-gliding flyers increase their air speed by 1.0 m s–1km–1 and bounding flyers by 1.4 m s–1km–1.
Effects of serotonergic agents on survival and hemolymph composition of the larval mosquitoAedes aegypti(Diptera: Culicidae, L.)in vivo: does serotonin regulate hemolymph acid–base homeostasis?
Authors: Clark T. M. , Lawecki J. L. , Shepherd J. J. , Hirschler A. N. , Samandu T. R. 
Published: October 2009

SUMMARYThe role of serotonin in the regulation of larval Aedes aegyptihemolymph composition was investigated in vivo using two reuptake inhibitors (SSRIs), alaproclate HCl and 6-nitroquipazine maleate, and the receptor antagonist methiothepin mesylate. Larvae were placed in media differing in pH and salinity in the presence and absence of serotonergic agents. The toxicity of each agent was strongly influenced by ambient pH. For each agent, toxicity was negligible in acidic media, intermediate in neutral media and greatest in alkaline media. By contrast, toxicity of all agents was independent of salinity. No effects on mass-specific body water or hemolymph volume were observed whereas hemolymph osmotic pressure, Na+concentrations and pH differed significantly among treatments. 6-nitroquipazine caused a decrease in Na+ from 115±1.7 to 103±0.9 mmol l–1, and alaproclate caused alkalosis of the hemolymph from pH 7.55±0.026 to pH 7.72±0.044. Methiothepin decreased hemolymph osmotic pressure from 329±9.9 to 304±8.8 and showed the greatest overall toxicity. Control larvae excreted net base in pH 4 media (1.4 μmol g–1 h–1) and net acid in pH 7 (1.2 μmol g–1 h–1) and pH 11 (5.1μmol g–1 h–1) media. In pH 4 media,alaproclate and methiothepin caused a shift to net H+ excretion(1.1 and 1.5 μmol g–1 h1, respectively) whereas these agents did not influence acid excretion rates in pH 7 or pH 11 media. The hypothesis that serotonin is involved in hemolymph acid–base balance is discussed.
State-changes in the swimmeret system: a neural circuit that drives locomotion
Authors: Tschuluun N. , Hall W. M. , Mulloney B. 
Published: October 2009

SUMMARYThe crayfish swimmeret system undergoes transitions between a silent state and an active state. In the silent state, no patterned firing occurs in swimmeret motor neurons. In the active state, bursts of spikes in power stroke motor neurons alternate periodically with bursts of spikes in return stroke motor neurons. In preparations of the isolated crayfish central nervous system(CNS), the temporal structures of motor patterns expressed in the active state are similar to those expressed by the intact animal. These transitions can occur spontaneously, in response to stimulation of command neurons, or in response to application of neuromodulators and transmitter analogues. We used single-electrode voltage clamp of power-stroke exciter and return-stroke exciter motor neurons to study changes in membrane currents during spontaneous transitions and during transitions caused by bath-application of carbachol or octopamine (OA). Spontaneous transitions from silence to activity were marked by the appearance of a standing inward current and periodic outward currents in both types of motor neurons. Bath-application of carbachol also led to the development of these currents and activation of the system. Using low Ca2+–high Mg2+ saline to block synaptic transmission, we found that the carbachol-induced inward current included a direct response by the motor neuron and an indirect component. Spontaneous transitions from activity to silence were marked by disappearance of the standing inward current and the periodic outward currents. Bath-application of OA led promptly to the disappearance of both currents, and silenced the system. OA also acted directly on both types of motor neurons to cause a hyperpolarizing outward current that would contribute to silencing the system.
Skeletal muscle atrophy occurs slowly and selectively during prolonged aestivation inCyclorana alboguttata(Günther 1867)
Authors: Mantle Beth L. , Hudson Nicholas J. , Harper Gregory S. , Cramp Rebecca L. , Franklin Craig E. 
Published: October 2009

SUMMARYWe investigated the effect of prolonged immobilisation of six and nine months duration on the morphology and antioxidant biochemistry of skeletal muscles in the amphibian aestivator Cyclorana alboguttata. We hypothesised that, in the event of atrophy occurring during aestivation,larger jumping muscles were more likely to be preserved over smaller non-jumping muscles. Whole muscle mass (g), muscle cross-sectional area (CSA)(μm2), water content (%) and myofibre number (per mm2) remained unchanged in the cruralis muscle after six to nine months of aestivation; however, myofibre area (μm2) was significantly reduced. Whole muscle mass, water content, myofibre number and myofibre CSA remained unchanged in the gastrocnemius muscle after six to nine months of aestivation. However, iliofibularis dry muscle mass, whole muscle CSA and myofibre CSA was significantly reduced during aestivation. Similarly,sartorius dry muscle mass, water content and whole muscle CSA was significantly reduced during aestivation. Endogenous antioxidants were maintained at control levels throughout aestivation in all four muscles. The results suggest changes to muscle morphology during aestivation may occur when lipid reserves have been depleted and protein becomes the primary fuel substrate for preserving basal metabolic processes. Muscle atrophy as a result of this protein catabolism may be correlated with locomotor function, with smaller non-jumping muscles preferentially used as a protein source during fasting over larger jumping muscles. Higher levels of endogenous antioxidants in the jumping muscles may confer a protective advantage against oxidative damage during aestivation; however, it is not clear whether they play a role during aestivation or upon resumption of normal metabolic activity.