bluuebunny/crossref_metadata_2025_split huggingface dataset:
General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators
Authors: Zuckerman Randall , Doty Brit , Gold Michael , Bordley James , Dietz Patrick , Jenkins Paul , Heneghan Steven 
Published: September 2006

ABSTRACT:
Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural hospitals and communities. Purpose: To describe hospital administrators’ perceptions regarding the current state of general surgery programs at small rural hospitals in New York State, including the impact that surgical services have on hospital financial viability. Methods: A list of hospitals belonging to the rural hospitals group of the Healthcare Association of New York State was obtained to determine prospective survey recipients. Sixty‐eight administrators at each of the identified hospitals were subsequently surveyed and 38 respondents met all inclusion criteria. Findings: Approximately 87% of hospital administrators perceive that the general surgery program is critical to the hospital’s financial viability. Forty percent of respondents report that they would be forced to close the hospital if the surgical program was lost. Among the 42% of administrators trying to recruit a general surgeon, almost two thirds have been searching for more than 1 year. Conclusions: According to the perceptions of hospital administrators, the financial viability of rural hospitals in New York State depends in large part on their ability to provide surgical services. Additionally, general surgeons appear to be in high demand at a significant number of the surveyed institutions.
Concordance of Patient‐Physician Obesity Diagnosis and Treatment Beliefs in Rural Practice Settings
Authors: Ely Andrea Charbonneau , Greiner K. Allen , Born Wendi , Hall Sandra , Rhode Paula C. , James Aimee S. , Nollen Nicole , Ahluwalia Jasjit S. 
Published: September 2006

ABSTRACT:
Context: Although clinical guidelines recommend routine screening and treatment for obesity in primary care, lack of agreement between physicians and patients about the need for obesity treatment in the primary care setting may be an unexplored factor contributing to the obesity epidemic. Purpose and Methods: To better understand this dynamic, we surveyed 439 obese patients (body mass index ³30) at the time of clinic visits in 2003 at diverse primary care settings in rural Kansas and conducted same‐day interviews with their physicians (N = 28). We used Spearman’s correlation to describe and compare patient and physician responses. Findings: Most patients were women (66%). Their mean age was 55.8 years, and mean body mass index was 37.7. Half (51%) reported discussing their weight on that visit date. Overall, 51% of patients wanted to discuss weight more often with their physician and 54% wanted to discuss weight sooner. Patients and physicians gave similar assessments of the patient’s preference for discussing weight loss, how often weight was discussed at visits, and the patient’s motivation for weight loss. Spearman’s correlations on these variables were .33, .54, and .25, respectively (all P < .001). Conclusions: These patients and their physicians demonstrated a weak to moderate agreement on several variables crucial to initiating and continuing obesity care. Understanding patient and provider beliefs and preferences regarding obesity diagnosis and treatment is essential in designing obesity interventions for primary care.
Combined cytosine arabinoside and prednisone therapy for meningoencephalitis of unknown aetiology in 10 dogs
Authors: Zarfoss M. , Schatzberg S. , Venator K. , Cutter‐Schatzberg K. , Cuddon P. , Pintar J. , Weinkle T. , Scarlett J. , DeLahunta A. 
Published: September 2006

Objectives:The differential diagnosis for young to middle‐aged dogs with progressive neurological signs, focal or multifocal computed tomography/magnetic resonance imaging lesions, mononuclear cerebrospinal fluid pleocytosis and negative infectious titres includes granulomatous meningoencephalomyelitis, breed‐specific meningoencephalitis, infectious meningoencephalitis of unknown origin and central nervous system neoplasia. The terminologymeningoencephalitis of unknown aetiologymay be preferable for cases that lack histopathological diagnoses. The safety and efficacy of a combination of cytosine arabinoside and prednisone protocol is evaluated, in this study, for the treatment of meningoencephalitis of unknown aetiology in 10 dogs.Methods:Cases were selected based on neuroanatomical localisation, negative regional infectious disease titres, cerebrospinal fluid pleocytosis and brain imaging. Clinical response was gauged through follow‐up examinations, owner and referring veterinarian surveys and review of medical records.Results:Partial or complete remission was achieved in all dogs; the median survival time for the 10 dogs was 531 days (range 46 to 1025 days), with five of the 10 dogs alive at the time of writing.ClinicalSignificance:Prednisone/cytosine arabinoside is a safe empirical therapy for dogs with meningoencephalitis of unknown aetiology; this drug combination may prolong survival time.
Trends in Snowfall versus Rainfall in the Western United States
Authors: Knowles Noah , Dettinger Michael D. , Cayan Daniel R. 
Published: September 2006

Abstract
The water resources of the western United States depend heavily on snowpack to store part of the wintertime precipitation into the drier summer months. A well-documented shift toward earlier runoff in recent decades has been attributed to 1) more precipitation falling as rain instead of snow and 2) earlier snowmelt. The present study addresses the former, documenting a regional trend toward smaller ratios of winter-total snowfall water equivalent (SFE) to winter-total precipitation (P) during the period 1949–2004.
The trends toward reduced SFE are a response to warming across the region, with the most significant reductions occurring where winter wet-day minimum temperatures, averaged over the study period, were warmer than −5°C. Most SFE reductions were associated with winter wet-day temperature increases between 0° and +3°C over the study period. Warmings larger than this occurred mainly at sites where the mean temperatures were cool enough that the precipitation form was less susceptible to warming trends.
The trends toward reduced SFE/P ratios were most pronounced in March regionwide and in January near the West Coast, corresponding to widespread warming in these months. While mean temperatures in March were sufficiently high to allow the warming trend to produce SFE/P declines across the study region, mean January temperatures were cooler, with the result that January SFE/P impacts were restricted to the lower elevations near the West Coast.
Extending the analysis back to 1920 shows that although the trends presented here may be partially attributable to interdecadal climate variability associated with the Pacific decadal oscillation, they also appear to result from still longer-term climate shifts.
ENSO Modulation of the Interannual and Intraseasonal Variability of the East Asian Monsoon—A Model Study
Authors: Lau Ngar-Cheung , Nath Mary Jo 
Published: September 2006

Abstract
The impacts of ENSO on the evolution of the East Asian monsoon have been studied using output from a general circulation model experiment. Observed monthly variations of the sea surface temperature (SST) field have been prescribed in the tropical eastern and central Pacific, whereas the atmosphere has been coupled to an oceanic mixed layer model beyond this forcing region. During the boreal summer of typical El Niño events, a low-level cyclonic anomaly is simulated over the North Pacific in response to enhanced condensational heating over the equatorial central Pacific. Advective processes associated with the cyclone anomaly lead to temperature tendencies that set the stage for the abrupt establishment of a strong Philippine Sea anticyclone (PSAC) anomaly in the autumn. The synoptic development during the onset of the PSAC anomaly is similar to that accompanying cold-air surges over East Asia.
The air–sea interactions accompanying the intraseasonal variations (ISV) in the model atmosphere exhibit a strong seasonal dependence. During the summer, the climatological monsoon trough over the subtropical western Pacific facilitates positive feedbacks between the atmospheric and oceanic fluctuations. Conversely, the prevalent northeasterly monsoon over this region in the winter leads to negative feedbacks. The onset of the PSAC anomaly is seen to be coincident with a prominent episode of the leading ISV mode. The ENSO events could influence the amplitude of the ISV by modulating the large-scale flow environment in which the ISV are embedded. Amplification of the summer monsoon trough over the western Pacific during El Niño enhances air–sea feedbacks on intraseasonal time scales, thereby raising the amplitudes of the ISV. A weakening of the northeasterly monsoon in El Niño winters suppresses the frequency and strength of the cold-air surges associated with the leading ISV mode in that season.
Many aspects of the model simulation of the relationships between ENSO and the East Asian monsoon are in agreement with observational findings.
On the Connection between Dense Water Formation, Overturning, and Poleward Heat Transport in a Convective Basin*
Authors: Straneo Fiammetta 
Published: September 2006

Abstract
An isopycnal, two-layer, idealized model for a convective basin is proposed, consisting of a convecting, interior region and a surrounding boundary current (buoyancy and wind-driven). Parameterized eddy fluxes govern the exchange between the two. To balance the interior buoyancy loss, the boundary current becomes denser as it flows around the basin. Geostrophy imposes that this densification be accompanied by sinking in the boundary current and hence by an overturning circulation. The poleward heat transport, associated with convection in the basin, can thus be viewed as a result of both an overturning and a horizontal circulation. When adapted to the Labrador Sea, the model is able to reproduce the bulk features of the mean state, the seasonal cycle, and even the shutdown of convection from 1969 to 1972. According to the model, only 40% of the poleward heat (buoyancy) transport of the Labrador Sea is associated with the overturning circulation. An exact solution is presented for the linearized equations when changes in the boundary current are small. Numerical solutions are calculated for variations in the amount of convection and for changes in the remotely forced circulation around the basin. These results highlight how the overturning circulation is not simply related to the amount of dense water formed. A speeding up of the circulation around the basin due to wind forcing, for example, will decrease the intensity of the overturning circulation while the dense water formation remains unvaried. In general, it is shown that the fraction of poleward buoyancy (or heat) transport carried by the overturning circulation is not an intrinsic property of the basin but can vary as a result of a number of factors.
Estimates and Implications of Surface Eddy Diffusivity in the Southern Ocean Derived from Tracer Transport
Authors: Marshall John , Shuckburgh Emily , Jones Helen , Hill Chris 
Published: September 2006

Abstract
Near-surface “effective diffusivities” associated with geostrophic eddies in the Southern Ocean are estimated by numerically monitoring the lengthening of idealized tracer contours as they are strained by surface geostrophic flow observed by satellite altimetry. The resulting surface diffusivities show considerable spatial variability and are large (2000 m2 s−1) on the equatorward flank of the Antarctic Circumpolar Current and are small (500 m2 s−1) at the jet axis. Regions of high and low effective diffusivity are shown to be collocated with regions of, respectively, weak and strong isentropic potential vorticity gradients. The maps of diffusivity are used, along with climatological estimates of surface wind stress and air–sea buoyancy flux, to estimate surface meridional residual flows and the relative importance of Eulerian and eddy-induced circulation in the streamwise-averaged dynamics of the Antarctic Circumpolar Current.
Living renal donation
Authors: Crombie Alison K. 
Published: September 2006

‘Saving life’ has become a dominant rhetoric of twentieth-century science-based medicine. One key process through which this is most visible is that associated with the rapidly increasing technologies of transplantation. From the very beginning of transplantation techniques, the possible advantages of ‘live donation’ have been espoused. Such donation has been considered to have a number of advantages. These have related to function — being a better match, for example, and also in many cases to availability. In a further development of this approach, familial living donation in relation to kidney failure has sometimes been seen as ‘the answer’ to organ shortages. This paper describes the use of ethnography in a busy teaching hospital amongst renal clinicians. The methodology has enabled the author to capture the social and cultural context of living donation. The paper highlights how individual medical-value orientations juxtapose rational, technological ways of knowing with interpretative, intuitive and experiential knowledge.
Commonly dysregulated genes in murine APL cells
Authors: Yuan Wenlin , Payton Jacqueline E. , Holt Matthew S. , Link Daniel C. , Watson Mark A. , DiPersio John F. , Ley Timothy J. 
Published: September 2006

Abstract
To identify genes that are commonly dysregulated in a murine model of acute promyelocytic leukemia (APL), we first defined gene expression patterns during normal murine myeloid development; serial gene expression profiling studies were performed with primary murine hematopoietic progenitors that were induced to undergo myeloid maturation in vitro with G-CSF. Many genes were reproducibly expressed in restricted developmental “windows,” suggesting a structured hierarchy of expression that is relevant for the induction of developmental fates and/or differentiated cell functions. We compared the normal myeloid developmental transcriptome with that of APL cells derived from mice expressing PML-RARα under control of the murine cathepsin G locus. While many promyelocyte-specific genes were highly expressed in all APL samples, 116 genes were reproducibly dysregulated in many independent APL samples, including Fos, Jun, Egr1, Tnf, and Vcam1. However, this set of commonly dysregulated genes was expressed normally in preleukemic, early myeloid cells from the same mouse model, suggesting that dysregulation occurs as a “downstream” event during disease progression. These studies suggest that the genetic events that lead to APL progression may converge on common pathways that are important for leukemia pathogenesis.
Utility of exhaled nitric oxide as a noninvasive biomarker of lung inflammation in a disease model
Authors: Birrell M. A. , McCluskie K. , Hardaker E. , Knowles R. , Belvisi M. G. 
Published: September 2006

There is a great deal of interest in developing less invasive markers for monitoring airway inflammation and the effect of possible novel anti-inflammatory therapies that may take time to impact on disease pathology. Exhaled nitric oxide (eNO) has been shown to be a reproducible, noninvasive indicator of the inflammatory status of the airway in the clinic.The aim of the present study was to determine the usefulness of measuring eNO as a marker of the anti-inflammatory impact of glucocorticoid and an inhibitor of κB kinase-2 (IKK-2) inhibitor 2-[(aminocarbonyl)amino]-5-(4-fluorophenyl)-3-thiophenecarboxamide (TPCA-1), in a pre-clinical model of airway inflammation. Rats were given vehicle, budesonide or TPCA-1 prior to exposure to lipopolysaccharide, previously shown to induce an increase in eNO and airway neutrophilia/eosinophilia.Comparison of the effect of the two compounds on inflammatory components demonstrated a significant correlation between the impact on eNO and inflammatory cell burden in the airway.The current study demonstrates the usefulness of profiling potential disease-modifying therapies on exhaled nitric oxide levels and the way in which an effect on this noninvasive biomarker relates to effects on pathological parameters such as lung cellularity. Information from studies such as the current one would suggest that the measurement of exhaled nitric oxide has potential for monitoring inflammatory status in lung tissue.
Spacer inhalation technique and deposition of extrafine aerosol in asthmatic children
Authors: Roller C. M. , Zhang G. , Troedson R. G. , Leach C. L. , Le Souëf P. N. , Devadason S. G. 
Published: September 2006

The aim of the present study was to measure airway, oropharyngeal and gastrointestinal deposition of99mTc-labelled hydrofluoroalkane-beclomethasone dipropionate after inhalationviaa pressurised metered-dose inhaler and spacer (Aerochamber PlusTM) in asthmatic children.A group of 24 children (aged 5–17 yrs) with mild asthma inhaled the labelled drug. A total of 12 children took five tidal breaths after each actuation (tidal group). The other 12 children used a slow maximal inhalation followed by a 5–10-s breath-hold (breath-hold group). Simultaneous anterior and posterior planar γ-scintigraphic scans (120-s acquisition) were recorded.For the tidal group, mean±sdlung deposition (% ex-actuator, attenuation corrected) was 35.4±18.3, 47.5±13.0 and 54.9±11.2 in patients aged 5–7 (n = 4), 8–10 (n = 4) and 11–17 yrs (n = 4), respectively. Oropharyngeal and gastrointestinal deposition was 24.0±10.5, 10.3±4.4 and 10.1±6.2. With the breath-hold technique, lung deposition was 58.1±6.7, 56.6±5.2 and 58.4±9.2. Oropharyngeal and gastrointestinal deposition was 12.9±3.2, 20.1±9.5 and 20.8±8.8.Inhalation of the extrafine formulation with the breath-hold technique showed significantly improved lung deposition compared with tidal breathing across all ages. Oropharyngeal and gastrointestinal deposition was markedly decreased, regardless of which inhalation technique was applied, compared with a previous paediatric study using the same formulation deliveredviaa breath-actuated metered-dose inhaler.
Transbronchial needle aspirates: how many passes per target site?
Authors: Diacon A. H. , Schuurmans M. M. , Theron J. , Brundyn K. , Louw M. , Wright C. A. , Bolliger C. T. 
Published: September 2006

Transbronchial needle aspiration is a bronchoscopic sampling method for a variety of bronchial and pulmonary lesions. The present study investigated whether and how serial needle passes contribute to the yield of transbronchial needle aspiration at specific target sites.A total of 1,562 needle passes, performed at 374 target sites in 245 patients with neoplastic disease (82%), non-neoplastic disease (15%) or undiagnosed lesions (3%), were prospectively recorded and rated for anatomical location, size, bronchoscopic appearance and underlying disease.Positive aspirates were obtained in 75% of patients and at 68% of target sites. A diagnosis was established with the first, second, third and fourth needle pass at 64, 87, 95 and 98% of targets, respectively. The absolute yield varied strongly with target site features, but the stepwise increment to the maximum yield provided by serial passes was similar across target sites.In conclusion, three transbronchial needle passes per site are appropriate when only a tissue diagnosis is sought and when alternative sites or sampling modalities are available. At least four or five passes should be carried out at lymph node stations critical for the staging of lung cancer.
Standard anti-tuberculosis treatment and hepatotoxicity: do dosing schedules matter?
Authors: Chang K. C. , Leung C. C. , Yew W. W. , Tam C. M. 
Published: September 2006

A nested case–control study was conducted in order to examine whether dosing schedules of standard pyrazinamide-containing anti-tuberculosis (TB) treatment (standard treatment) might affect hepatotoxicity.The present authors retrospectively identified all patients with hepatitis using biochemical criteria from a cohort of 3,007 clinic patients who commenced anti-TB treatment from January 1 to June 30, 2001. Each case with hepatitis between 1–9 weeks post-TB treatment was compared using conditional logistic regression analysis with two controls selected randomly from patients without hepatitis in the same period and matched by sex, age and standard treatment. Impacts of sex and age were examined by logistic regression analysis of cases and patients without hepatitis.Hepatitis occurred in 167 patients, of whom 96 qualified as cases. A conditional logistic risk model identified hepatitis B surface antigen carriage as the only risk factor (odds ratio (95% confidence interval (CI)) 1.8 (1.1–3.1)). Logistic regression analysis showed that sex was nonsignificant but ageing increased the odds of hepatitis. The risk of hepatitis increased from 2.6% (1.9–3.5%) to 4.1% (3.2–5.3%) as age exceeded 49 yrs.Dosing schedules in the first 9 weeks have little impact on hepatotoxicity. If patients at risk of both hepatitis and relapse receive standard treatment, daily dosing is preferable.
Inhibitory effects of repeated hyperoxia on breathing in newborn mice
Authors: Lofaso F. , Dauger S. , Matrot B. , Vardon G. , Gaultier C. , Gallego J. 
Published: September 2006

Brief oxygen therapy is commonly used for resuscitation at birth or prevention of hypoxaemia before procedures during the neonatal period. However, O2may severely depress breathing, especially when administered repeatedly. The aim of the present study was to test the effects of repeated hyperoxia on breathing control in newborn mice.A total of 97 Swiss mouse pups were assigned to O2or air on post-natal day 0, 1 or 2. Each pup in the O2group was subjected to four hyperoxic tests (100% O2for 3 min followed by 12 min normoxia), whereas pups in the air group were maintained in normoxia. Breathing variables were measured using flow-through barometric plethysmography.O2significantly decreased minute ventilation as seen in a decrease in respiratory rate. This decrease became significantly larger with repeated exposure and ranged -17– -26% for all ages combined. Furthermore, hyperoxia increased total apnoea duration, as compared with the baseline value.In newborn mice, repeated hyperoxia increasingly depressed breathing. This finding further supports a need for stringent control of oxygen therapy, most notably repeated oxygen administration in the neonatal period for premature newborn infants and those carried to term.