bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Hispanic Americans Baseline Alcohol Survey: Alcoholic Beverage Preference Across Hispanic National Groups
Authors: Caetano Raul , Vaeth Patrice A. C. , Ramisetty‐Mikler Suhasini , Rodriguez Lori A. 
Published: October 2008

Background: U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans.Methods: A sample of 5,224 individuals 18 years of age and older was selected using multistage cluster procedures from the household population in 5 metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Face‐to‐face interviews lasting 1 hour on average were conducted in the respondents’ homes either in English or Spanish.Results: Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00–2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group.Conclusions: Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholic beverages.
Assessment of Emergency Physician Workforce Needs in the United States, 2005
Authors: Camargo Jr Carlos A. , Ginde Adit A. , Singer Ayellet H. , Espinola Janice A. , Sullivan Ashley F , Pearson John F. , Singer Adam J. 
Published: October 2008

AbstractObjectives:  The objective was to estimate emergency physician (EP) workforce needs, taking into account the diversity of U.S. emergency departments (EDs) and various projections of EP supply and demand.Methods:  The 2005 National ED Inventory‐USA (http://www.emnet‐usa.org/) provided annual visit volumes for 4,828 U.S. EDs. The authors calculated annual supply based on existing emergency medicine (EM) board‐certified EPs, adding newly board‐certified EPs, and subtracting board‐certified EPs who died or retired. Demand was estimated at each ED by dividing the number of visits by the average EP volume (based on 2.8 patients/hour, 40 hours/week, and 34% nonclinical time). The models assumed that at least 1 EP should be present 24/7 in each ED, which would require at least 5.35 full‐time equivalents (FTEs) per ED. Based on annual EP attrition estimates, results for best‐case, worst‐case, and intermediate scenarios were calculated.Results:  In 2005, there were approximately 22,000 EM board‐certified EPs, but 40,030 EPs would be needed to staff all 4,828 EDs (55% of demand met). A total of 2,492 (52%) EDs had a visit volume that required the minimum number (5.35) FTEs, of which 47% were rural. In the unrealistic (no attrition), best‐case scenario, it would take until 2019 to staff all EDs with board‐certified EPs. In the worst‐case scenario (12% attrition), supply would never meet demand. Our intermediate scenario (2.5% attrition) suggested that board‐certified EPs would satisfy workforce needs in 2038.Conclusions:  Supply of EM residency‐trained, board‐certified EPs is not likely to meet demand in the near future. Alternative EP staffing arrangements merit further consideration.
International Survey of Emergency Physicians’ Awareness and Use of the Canadian Cervical‐Spine Rule and the Canadian Computed Tomography Head Rule
Authors: Eagles Debra , Stiell Ian G. , Clement Catherine M. , Brehaut Jamie , Taljaard Monica , Kelly Anne‐Maree , Mason Suzanne , Kellermann Arthur , Perry Jeffrey J 
Published: October 2008

AbstractObjectives:  The derivation and validation studies for the Canadian Cervical‐Spine (C‐Spine) Rule (CCR) and the Canadian Computed Tomography (CT) Head Rule (CCHR) have been published in major medical journals. The objectives were to determine: 1) physician awareness and use of these rules in Australasia, Canada, the United Kingdom, and the United States and 2) physician characteristics associated with awareness and use.Methods:  A self‐administered e‐mail and postal survey was sent to members of four national emergency physician (EP) associations using a modified Dillman technique. Results were analyzed using repeated‐measures logistic regression models.Results:  The response rate was 54.8% (1,150/2,100). Reported awareness of the CCR ranged from 97% (Canada) to 65% (United States); for the CCHR it ranged from 86% (Canada) to 31% (United States). Reported use of the CCR ranged from 73% (Canada) to 30% (United States); for the CCHR, it was 57% (Canada) to 12% (United States). Predictors of awareness were country, type of rule, full‐time employment, younger age, and teaching hospital (p < 0.05). Significant differences in use of the CCR by country were observed, but not for the CCHR. Teaching hospitals were more likely to use the CCR than nonteaching hospitals, but less likely to use the CCHR.Conclusions:  This large international study found notable differences among countries with regard to knowledge and use of the CCR and CCHR. Awareness and use of both rules were highest in Canada and lowest in the United States. While younger physicians, those employed full‐time, and those working in teaching hospitals were more likely to be aware of a decision rule, age and employment status were not significant predictors of use. A better understanding of factors related to awareness and use of emergency medicine (EM) decision rules will enhance our understanding of knowledge translation and facilitate strategies to enhance dissemination and implementation of future rules.
Oral versus Intravenous Opioid Dosing for the Initial Treatment of Acute Musculoskeletal Pain in the Emergency Department
Authors: Miner James R. , Moore Johanna , Gray Richard O. , Skinner Lisa , Biros Michelle H. 
Published: October 2008

AbstractObjectives:  The objective was to compare the time to medication administration, the side effects, and the analgesic effect at sequential time points after medication administration of an oral treatment strategy using oxycodone solution with an intravenous (IV) treatment strategy using morphine sulfate for the initial treatment of musculoskeletal pain in emergency department (ED) patients.Methods:  This was a prospective randomized clinical trial of patients >6 years old who were going to receive IV morphine sulfate for the treatment of musculoskeletal pain but did not yet have an IV. Consenting patients were randomized to have the treating physician order either 0.1 mg/kg morphine sulfate IV or 0.125 mg/kg oxycodone orally in a 5 mg/5 mL suspension as their initial treatment for pain. The time from the placement of the order to the administration of the medication was recorded. Pain was measured using a 100‐mm visual analog scale (VAS) and recorded at 0, 10, 20, 30 and 40 minutes after drug administration.Results:  A total of 405 eligible patients were identified during the study period; 328 (81.0%) patients consented to be in the study. A total of 158 patients were randomized to the IV morphine sulfate treatment group, and 162 were randomized to the oral oxycodone treatment group. Of the patients who were randomized to IV therapy, 34 were withdrawn from the study prior to drug administration; leaving 125 patients in the IV group for analysis. Of the patients who randomized to oral therapy, 22 were withdrawn from the study prior to drug administration, leaving 140 patients for analysis. No serious adverse events were detected. There was a 12‐minute difference between the median time of the order and the administration of oral oxycodone (8.5 minutes) and IV morphine (20.5 minutes). The mean percent change in VAS score was larger for patients in the IV therapy group than those in the oral therapy group at 10 and 20 minutes. At 30 and 40 minutes, the authors could no longer detect a difference. The satisfaction scale score was higher after treatment for the morphine group (median = 4; interquartile range [IQR] = 4 to 5) than for the oxycodone group (median = 4; IQR = 2 to 5; p = 0.008).Conclusions:  The oral loading strategy was associated with delayed onset of analgesia and decreased patient satisfaction, but a shorter time to administration. The oral loading strategy using an oxycodone solution provided similar pain relief to the IV strategy using morphine 30 minutes after administration of the drug. Oral 0.125 mg/kg oxycodone represents a feasible alternative to 0.1 mg/kg IV morphine in the treatment of severe acute musculoskeletal pain when difficult or delayed IV placement greater than 30 minutes presents a barrier to treatment.
Interrater Agreement between Nurses for the Pediatric Canadian Triage and Acuity Scale in a Tertiary Care Center
Authors: Gravel Jocelyn , Gouin Serge , Manzano Sergio , Arsenault Michael , Amre Devendra 
Published: October 2008

AbstractObjectives:  The objective was to measure the interrater agreement between nurses assigning triage levels to children visiting a pediatric emergency departments (EDs) assisted by a computerized version of the Pediatric Canadian Triage and Acuity Scale (PedCTAS).Methods:  This was a prospective cohort study evaluating children triaged from Level 2 (emergent) to Level 5 (nonurgent). A convenience sample of patients triaged during 38 shifts from April to September 2007 in a tertiary care pediatric ED was evaluated. All patients were initially triaged by regular triage nurses using a computerized version of the PedCTAS. Research nurses performed a second evaluation blinded to the first evaluation using the same triage tool. These research nurses were regular ED nurses performing extra hours for research purposes exclusively. The primary outcome measure was the interrater agreement between the two nurses as measured by the linear weighted kappa score. Secondary outcomes included the proportion of patient for which nurses did not apply the triage level suggested by Staturg (override) and agreement for these overrides.Results:  A total of 499 patients were recruited. The overall interrater agreement was moderate (linear weighted kappa score of 0.55 [95% confidence interval {CI} = 0.48 to 0.61] and quadratic weighted kappa score of 0.61 [95% CI = 0.42 to 0.80]). There was a discrepancy of more than one level in only 10 patients (2% of the study population). Overrides occurred in 23.2 and 21.8% for regular and research triage nurses, respectively. These overrides were equally distributed between increase and decrease in triage level.Conclusions:  Nurses using Staturg, which is a computerized version of the PedCTAS, demonstrated moderate interrater agreement for assignment of triage level to children presenting to a pediatric ED.
Patient-Reported Pain with Initial Intracavernosal Injection
Authors: Albaugh Jeffrey , Ferrans Carol Estwing 
Published: October 2008

ABSTRACT

Introduction
Despite the efficacy of intracavernosal injections, one of the greatest impediments to injection therapy is the negative reaction of men to the thought of a needle inserted into the penis.

Aim
To determine the severity of pain associated with the initial intracavernosal self-injections for erectile dysfunction (both pain associated with the needle insertion and the medications).

Methods
This is a descriptive study of self-reported pain associated with intracavernosal self-injections in 65 men with erectile dysfunction. Pain was assessed immediately after needle insertion and again approximately 10–20 minutes postinjection, utilizing a verbal 0–10 pain scale.

Main Outcome Measures
A verbal 0–10 pain rating scale was used to assess pain both for injection pain and medication pain.

Results
For needle insertion, the mean pain rating was 0.80 (standard deviation [SD] = 0.81), with 40% reporting no pain at all. Of the 39 patients who reported pain, the mean pain rating was 1.33 (SD = 0.61). For the medication itself, the mean pain rating was 0.92 (SD = 1.5), with more than half (64.6%) reporting no pain. For those experiencing pain from the medication (N = 23), the mean pain rating was 2.6 (SD = 1.27, range 0.5–5.0). Significantly more patients with radical prostatectomy experienced pain from the medication than other men (51.9% vs. 23.7%, P = 0.02).

Conclusion
The majority of patients experienced little or no pain from either the needle insertion or the medication. Even for men who experienced pain, the severity was relatively low. This study provides information to help diminish fears about injection pain for patients considering penile injections. In addition, this study suggests that medication pain is more common in men postradical prostatectomy, so that it may be advisable to start with lower dosages of prostaglandin alone or in combination with other vasoactive medications for these patients.
Invasive Exotic Plants in the Tropical Pacific Islands: Patterns of Diversity
Authors: Denslow Julie S. , Space James C. , Thomas Philip A. 
Published: October 2008

ABSTRACTOceanic islands are good model systems with which to explore factors affecting exotic species diversity. Islands vary in size, topography, substrate type, degree of isolation, native species diversity, history, human population characteristics, and economic development. Moreover, islands are highly vulnerable to exotic species establishment. We used AICc analyses of data on 1132 vascular plant species for 15 countries and 114 islands from the Pacific Island Ecosystems at Risk (PIER) project to examine biological, geographical, and socioeconomic correlates of exotic species richness. PIER provides data on the distribution of naturalized non‐native plant species thought to pose environmental or economic risk. We hypothesized that the numbers of PIER‐listed species would be positively correlated with island size, habitat diversity, and proximity to major source pools for propagules. Further, we expected numbers of PIER‐listed exotic species to be similar among islands in the same country and to be greater where human populations were larger and where economic activity was high. Most species (908) were found on ≤ 10 islands. Species number was significantly correlated with island and country areas and with native plant species richness. The strongest model revealed by AICc analyses of island data included log (area) and maximum elevation as well as country membership, substrate type, and presence of an airport with paved runway (an index of economic activity). By country, AICc analyses revealed two equivalent models, both of which included log (area) and per capita gross domestic product as well as a measure of population size (either log (population size) or (population density)). Our analyses provide strong evidence of the roles of biogeographic, environmental, and socioeconomic impacts on the distribution and spread of exotic species.
Contrasting Predictors of Fern versus Angiosperm Decomposition in a Common Garden
Authors: Amatangelo Kathryn L. , Vitousek Peter M. 
Published: October 2008

ABSTRACTWe evaluated differences in the rates and correlates of decomposition among 32 fern and angiosperm litter types collected in Hawai'i. Leptosporangiate ferns were separated into groups based on phylogeny: ‘polypod’ ferns, a monophyletic clade of ferns that diversified in the Cretaceous, and all other (‘non‐polypod’) ferns that diversified earlier. We measured initial litter chemistry (nutrients and carbon chemistry), and mass loss and nitrogen (N), phosphorus (P), and calcium (Ca) of litter tissue during a 1‐yr incubation in a common garden. Nutrient concentrations and carbon (C) chemistry differed significantly among litter types, and litter turnover (k‐values) ranged from 0.29 to 8.31. Decomposition rates were more closely correlated with nutrient concentration than is typically observed. Lignin:N was the best predictor of decomposition across all litter types combined; however, among plant groups different predictors of decomposition were important. Nitrogen and P concentrations best predicted fern decomposition, whereas C chemistry, particularly lignin concentration, was more important for angiosperm (monocot and dicot) decomposition. Among native plants, non‐polypod ferns decomposed significantly more slowly than both polypod ferns and angiosperms. Contrary to our hypothesis, fern litter did not decompose more slowly than angiosperm litter overall. Nutrient dynamics in litter were affected by initial litter concentration more than phylogeny; low‐nutrient litter immobilized more nutrients than high‐nutrient litter. Systematic differences in rates of decomposition, and the importance of nutrients in predicting fern decomposition, imply that changes in species composition within ferns and between ferns and angiosperms could influence the functioning of ecosystems where ferns are important forest components.
Beyond Reserves: A Research Agenda for Conserving Biodiversity in Human‐modified Tropical Landscapes
Authors: Chazdon Robin L. , Harvey Celia A. , Komar Oliver , Griffith Daniel M. , Ferguson Bruce G. , Martínez‐Ramos Miguel , Morales Helda , Nigh Ronald , Soto‐Pinto Lorena , Van Breugel Michiel , Philpott Stacy M. 
Published: October 2008

ABSTRACTTo truly understand the current status of tropical diversity and to forecast future trends, we need to increase emphasis on the study of biodiversity in rural landscapes that are actively managed or modified by people. We present an integrated landscape approach to promote research in human‐modified landscapes that includes the effects of landscape structure and dynamics on conservation of biodiversity, provision of ecosystem services, and sustainability of rural livelihoods. We propose research priorities encompassing three major areas: biodiversity, human–environment interactions, and restoration ecology. We highlight key areas where we lack knowledge and where additional understanding is most urgent for promoting conservation and sustaining rural livelihoods. Finally, we recommend participatory and multidisciplinary approaches in research and management. Lasting conservation efforts demand new alliances among conservation biologists, agroecologists, agronomists, farmers, indigenous peoples, rural social movements, foresters, social scientists, and land managers to collaborate in research, co‐design conservation programs and policies, and manage human‐modified landscapes in ways that enhance biodiversity conservation and promote sustainable livelihoods.
Regional Fragmentation of Rain Forest in West Africa and Its Effect on Local Dung Beetle Assemblage Structure
Authors: Davis Adrian L. V. , Philips T. Keith 
Published: October 2008

ABSTRACTData from Ghana and Côte d'Ivoire, for local dung beetle assemblages of rain forest, plantations, and savanna, suggest that a subset of the savanna fauna has expanded its range across the Eastern Guinean Forest ecoregion, presumably in response to its conversion from continuous rain forest into an archipelago of forest fragments within a disturbance matrix of less shady plantation and farmland vegetation that more resembles moist savanna.
Invasive Ants Disrupt Gecko Pollination and Seed Dispersal of the Endangered Plant Roussea simplex in Mauritius
Authors: Hansen Dennis M. , Müller Christine B. 
Published: October 2008

ABSTRACTIn Mauritius, the endemic blue‐tailed day‐gecko Phelsuma cepediana is currently the sole pollinator and seed disperser of the critically endangered endemic plant Roussea simplex (Rousseaceae). The flowers and fruits are often visited by the invasive ant Technomyrmex albipes, which forages on the nectar and fruit pulp, and tends honeydew‐producing mealybugs on the fruits. Here, we experimentally explore how the presence of this alien ant species influences geckos foraging at flowers and fruits of R. simplex by removing and excluding ants from flowers and fruits. Gecko visitation rates to ant‐free control flowers and fruits, and flowers and fruits where ants had been removed and excluded, were higher than those to ant‐infested flowers and fruits. The resulting seed set of ant‐infested flowers was greatly reduced, compared to ant‐free control flowers. Similarly, for fruits with ants, very few seeds were likely to be ingested and dispersed by the geckos. Thus, T. albipes monopolizes flowers and fruits of R. simplex, and prevents access of pollinating and seed‐dispersing P. cepediana geckos by aggressive interference competition. For a critically endangered plant like R. simplex, this double‐disruption of two vital mutualistic interactions is of urgent conservation concern.
Loss of Histone H4K20 Trimethylation Occurs in Preneoplasia and Influences Prognosis of Non–Small Cell Lung Cancer
Authors: Van Den Broeck Arnaud , Brambilla Elisabeth , Moro-Sibilot Denis , Lantuejoul Sylvie , Brambilla Christian , Eymin Beatrice , Khochbin Saadi , Gazzeri Sylvie 
Published: October 2008

Abstract
Purpose: Epigenetic modifications of histone have crucial roles in the control of gene activity, nuclear architecture, and genomic stability. In this respect, they may contribute to the development and progression of cancer. We investigated whether epigenetic changes of histone H4 are involved in lung carcinogenesis.
Experimental Design: Epigenetic modifications of histone H4 were studied by immunohistochemistry in normal lung and 157 lung carcinoma using antibodies specifically recognizing the acetylated (Ac) lysines 5 (K5), K8, K12, K16, and trimethylated (me3) K20 residues of histone H4. Western blotting was used to validate the immunohistochemistry results. H4K20me3 was also studied in 17 preneoplastic lesions. Expression of the Suv4-20h1/2 trimethyltransferases was analyzed by quantitative reverse transcription-PCR in a subset of tumor samples.
Results: As compared with normal lung, cancer cells displayed an aberrant pattern of histone H4 modifications with hyperacetylation of H4K5/H4K8, hypoacetylation of H4K12/H4K16, and loss of H4K20 trimethylation. Alteration of H4K20 trimethylation was frequent in squamous cell carcinoma (67%) and was observed in early precursors lesions in which the level of H4K20me3 staining strongly decreased with disease progression. In adenocarcinoma, the down-regulation of H4K20me3 was less frequent (28%) but allowed the identification of a subgroup of stage I adenocarcinoma patients with reduced survival (P = 0.007). Loss of H4K20 trimethylation was associated with decreased expression of Suv4-20h2, a specific H4K20 trimethyltransferase involved in telomere length maintenance.
Conclusions: Our findings indicate an important role of histone H4 modifications in bronchial carcinogenesis and highlight H4K20me3 as a candidate biomarker for early detection of and therapeutic approaches to lung cancer.