bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of Quantitative D‐dimer Assays in Identifying Pulmonary Embolism: Implications from a Sequential Decision Model
Authors: Duriseti Ram S. , Shachter Ross D. , Brandeau Margaret L. 
Published: May 2006

Objectives:To examine the cost‐effectiveness of a quantitative D‐dimer assay for the evaluation of patients with suspected pulmonary embolism (PE) in an urban emergency department (ED).Methods:The authors analyzed different diagnostic strategies over pretest risk categories on the basis of Wells criteria by using the performance profile of the ELISA D‐dimer assay (over five cutoff values) and imaging strategies used in the ED for PE: compression ultrasound (CUS), ventilation–perfusion (VQ) scan (over three cutoff values), CUS with VQ (over three cutoff values), computed tomography (CT) angiogram (CTA) with pulmonary portion (CTP) and lower‐extremity venous portion, and CUS with CTP. Data used in the analysis were based on literature review. Incremental costs and quality‐adjusted‐life‐years were the outcomes measured.Results:Computed tomography angiogram with pulmonary portion and lower‐extremity venous portion without D‐dimer was the preferred strategy. CUS‐VQ scanning always was dominated by CT‐based strategies. When CTA was infeasible, the dominant strategy was D‐dimer with CUS‐VQ in moderate‐ and high‐Wells patients and was D‐dimer with CUS for low‐Wells patients. When CTP specificity falls below 80%, or if its overall performance is markedly degraded, preferred strategies include D‐dimer testing. Sensitivity analyses suggest that pessimistic assessments of CTP accuracy alter the results only at extremes of parameter settings.Conclusions:In patients in whom PE is suspected, when CTA is available, even the most sensitive quantitative D‐dimer assay is not likely to be cost‐effective. When CTA is not available or if its performance is markedly degraded, use of the D‐dimer assay has value in combination with CUS and a pulmonary imaging study. These conclusions may not hold for the larger domain of patients presenting to the ED with chest pain or shortness of breath in whom PE is one of many competing diagnoses.
Coded Chief Complaints—Automated Analysis of Free‐text Complaints
Authors: Thompson David A. , Eitel David , Fernandes Christopher M.B. , Pines Jesse M. , Amsterdam James , Davidson Steven J. 
Published: May 2006

Objectives:
To describe a new chief‐complaint categorization schema, the development of a computer text‐parsing algorithm to automatically classify free‐text chief complaints into this schema, and use of these coded chief complaints to describe the case mix of a community emergency department (ED).
Methods:
Coded Chief Complaints for Emergency Department Systems (CCC‐EDS) is a new and untested schema of 228 chief complaints, grouped within dimensions of type and system. A computerized text‐parsing algorithm for automatically reading and classifying free‐text chief complaints into 1 of these 228 coded chief complaints was developed by using a consecutive derivation sample of 46,602 patients who presented to a community teaching‐hospital ED in 2004. Descriptive statistics included frequency of patients presenting with the 228 coded chief complaints; percentage of free‐text complaints not categorizable by the CCC‐EDS; and admission rate, age, and gender differences by chief complaint.
Results:
In the derivation sample, the text‐parsing algorithm classified 87.5% of 45,329 ED visits with non‐null free‐text chief complaints into 1 of 194 coded chief complaints. The text‐parsing algorithm successfully classified 87.3% of the free‐text chief complaints in a validation sample. The five most common coded chief complaints were Abdominal Pain (3,734 visits), Fever (2,234), Chest Pain (2,183), Breathing Difficulty (2,030), and Cuts‐Lacerations (2,028).
Conclusions:
The CCC‐EDS is a new comprehensive, granular, and useful classification schema for categorizing chief complaints in an ED. A CCC‐EDS text‐parsing algorithm successfully classified the majority of free‐text chief complaints from an ED computer log. These coded chief complaints were used to describe the case mix of a community teaching‐hospital ED.
Variability of Trauma Transfer Practices among Non–tertiary Care Hospital Emergency Departments
Authors: Newgard Craig D. , McConnell K. John , Hedges Jerris R. 
Published: May 2006

Objectives:
To assess both the variability of interhospital trauma transfer practices and nonclinical factors associated with the transfer of injured patients from emergency departments (EDs) of non–tertiary care hospitals.
Methods:
The authors analyzed a retrospective cohort of trauma patients initially presenting to one of 42 non–tertiary care hospitals (Level 3 or 4 hospitals) and requiring admission or transfer from January 1998 to December 2003. Twenty‐one clinical, demographic, and hospital‐level variables were included in multivariable logistic regression models (outcome = ED transfer to a tertiary care hospital), with hospital and year included as fixed effects to adjust for clustering. Classification and regression tree analysis was used to determine the importance of different covariates in predicting whether or not a patient was transferred from the ED.
Results:
Included in the analysis were 10,176 persons, of whom 3,785 (37%) were transferred to a tertiary care hospital from the ED. The hospital of initial presentation was the factor of greatest importance in predicting transfer, and there was substantial variability in transfer practices between hospitals. Several additional nonclinical variables were independently associated with transfer, including type and level of hospital, patient age, increasing distance from the nearest higher‐level hospital (a measure of geographic isolation), and the patient's insurance status (particularly among Level 3 hospitals).
Conclusions:
The non–tertiary care hospital of initial presentation is the strongest predictor for whether an injured patient is transferred to a tertiary center from the ED. There is substantial variability in transfer practices between hospitals after accounting for important clinical factors, and several nonclinical variables are independently associated with transfer.
Optimal Strategy for Cardiopulmonary Resuscitation with Continuous Chest Compression
Authors: Jung Eunok , Babbs Charles F. , Lenhart Suzanne , Protopopescu Vladimir A. 
Published: May 2006

Objectives:
To apply the mathematical techniques of optimal control theory (OCT) to a validated model of the human circulation during cardiopulmonary resuscitation (CPR), so as to discover improved waveforms for chest compression and decompression that maximize the coronary perfusion pressure (CPP).
Methods:
The human circulatory system is represented by seven difference equations that describe the pressure changes in systemic vascular compartments that are caused by chest compression. The forcing term is the intrathoracic pressure that is generated by the external chest compression, which is taken as the control variable for the system. The optimum waveform of this forcing pressure as a function of time, determined from OCT, is that which maximizes the calculated CPP between the thoracic aorta and the superior vena cava over a period of 13.3 seconds of continuous chest compression.
Results:
The optimal waveform included both compression and decompression of the chest to the maximum allowable extent. Compression–decompression waveforms were rectangular in shape. The frequency of optimal compression–decompression that was found by OCT was 90 per minute. The optimal duty cycle (compression duration per cycle time) was 40%. The CPP for the optimum control waveform was 36 mm Hg vs. 25 mm Hg for standard CPR.
Conclusions:
Optimal control theory suggests that both compression and decompression of the chest are needed for best hemodynamics during CPR.
Detection of Individual Microbial Pathogens by Proximity Ligation
Authors: Gustafsdottir Sigrun M , Nordengrahn Ann , Fredriksson Simon , Wallgren Per , Rivera Esteban , Schallmeiner Edith , Merza Malik , Landegren Ulf 
Published: May 2006

Abstract
Background: Nucleic acid amplification allows the detection of single infectious agents. Protein-based assays, although they provide information on ongoing infections, have substantially less detection sensitivity.
Methods: We used proximity ligation reactions to detect proteins on bacteria and virus particles via nucleic acid amplification. Antibodies recognizing viral or bacterial surface proteins were equipped with DNA strands that could be joined by ligation when several antibodies were bound in proximity to surface proteins of individual infectious agents.
Results: Detection sensitivities similar to those of nucleic acid-based detection reactions were achieved directly in infected samples for a parvovirus and an intracellular bacterium.
Conclusions: This method enables detection of ligated DNA strands with good sensitivity by real-time PCR and could be of value for early diagnosis of infectious disease and in biodefense.
Functional and Release Characteristics of Alpine Ski Equipment
Authors: Ettlinger CF , Johnson RJ , Shealy J 
Published: May 2006

Abstract
Releasable bindings were developed to reduce the risk of lower leg injuries. However, the relationship between the incidence of specific alpine injury groups and the function and calibration of the release system has not been well understood. Over the 32 years between December 1972 and April 2004, the authors conducted a case control study at a northern Vermont ski area involving 17 967 injuries and 3617 uninjured controls. During that time, approximately 6.4 million skier visits were recorded at the area. Injured skiers were treated at clinic in the base lodge and their injuries diagnosed by the clinic staff. Data relating to the accident, the injury, and the equipment used were recorded. The release moments of equipment associated with lower extremity injuries and uninjured controls were measured using a commercially available test device. Case studies of 43 anterior cruciate ligament (ACL) sprains, 79 lower leg injuries, and 99 uninjured controls were conducted using data collected over seven years between December 1997 and April 2004. In terms of quantitative critical defects, 17 % of the control group, 14 % of the ACL group, and 39 % of the lower leg group exhibited release levels more than 30 % above recommended. When qualitative critical defects were considered, 27 % of the control group, 25 % of the ACL group, and 54 % of the lower leg group were found to exhibit one or more defects capable of having a significant effect on equipment function. The authors concluded that sprains, fractures, strains, and contusions of the lower leg among alpine skiers were associated with measurable or observable qualities of the release system. Serious sprains of the knee were not. A substantial reduction of injuries below the knee can be expected if potentially defective equipment can be identified and repaired, or replaced.
Proton Induced Activation in Mercury: Comparison of Measurements and Calculations
Authors: Remec I , Glasgow DC , Haines JR , Johnson JO 
Published: May 2006

Abstract
Measurements and simulations of the proton beam interaction with the mercury target were performed to support Spallation Neutron Source design. Due to the abundance of isotopes produced in mercury, the long delay between the irradiation and the measurements, and the self-shielding of the mercury sample, the measurements were difficult to perform and the activities of several isotopes have large uncertainties. Calculations predicted the activities of the most reliably measured isotopes within 20%–40%; however, some large discrepancies were observed for some isotopes for which the measurements were considered less reliable. Predicted dose rates were in very good agreement with the measurements.
Coarse-Mesh Adjoint Biasing of a Monte Carlo Dose Calculation
Authors: Pevey RE , Miller LF , Marshall WJ , Townsend LW , Alvord B 
Published: May 2006

Abstract
Deep penetration radiation transport calculations have been performed to determine the dose rates at a positron emission tomography (PET) facility in China. The radiation source is a cyclotron that is used for the production of the PET isotopes, with a labyrinthine concrete wall arrangement to minimize dose to operation personnel. Since directionally biased Monte Carlo calculations did not reach an acceptably low standard error after a week of CPU time, approximate adjoint fluxes were calculated for each of four detector locations using coarse-mesh adjoint discrete ordinates calculations and were used to bias the Monte Carlo calculations. This biasing resulted in improved computational efficiency of a factor of one to three orders of magnitude. This result shows the value of even approximate adjoint flux biasing to speed up Monte Carlo calculations.
An Alternative to a 3D Crack Monitor—4-Pin Algorithm
Authors: Tewatia SK , Dhawan AK , Venkatachalam K , Bose PR 
Published: May 2006

Abstract
Cracks may appear in civil engineering structures, such as buildings, the body of a dam, its galleries, adjoining tunnels, and power plants during or after construction. Swelling or poor soils in the foundations, redistribution of stresses in the tunnels, creep of the materials, earthquakes or other vibrations are just a few reasons for cracks. The relative movements of the walls along and across the crack, and perpendicular to the plane of cracking surface or wall, beyond certain limits, may prove to be damaging. For considerations of safety and maintenance, the measurement of the magnitude and time rate of deformation of the cracks is essential. Instrumentation for deformation monitoring is of vital importance, especially in underground excavations in complex geological formations. A 3D crack monitor is used for 3D crack monitoring. The purpose of this paper is to show that by measuring points along and across a crack the same outcome can be determined with less effort and better precision.
The Buried Soul: How Humans Invented Death; Death, Dismemberment, and Memory: Body Politics in Latin America
Authors: ROBBEN ANTONIUS C. G. M. 
Published: May 2006

The Buried Soul: How Humans Invented Death. Timothy Taylor. Boston, MA: Beacon Press, 2002. 353 pp. Death, Dismemberment, and Memory: Body Politics in Latin America. Lyman L. Johnson, ed. Albuquerque: University of New Mexico Press, 2004. 354 pp.
Frozen Negotiations: The Peace Process in Chiapas
Authors: Manaut Raúl Benítez , Selee Andrew , Arnson Cynthia J. 
Published: May 2006

Mexico's democratic transition has helped reduce, if not eliminate, the threat of renewed armed conflict in Chiapas. However, absent more active measures from the government and the Ejército Zapatista de Liberación Nacional (EZLN) to seek a permanent peace agreement and come to terms with the legacies of the past, the conflict will linger on in an unstable détente, which we term “armed peace.” While this situation is far better than the open hostilities of the past, it also belies the promise of a fully democratic society in which all citizens are equally included in the political process.
La transición democrática en México ha contribuido a reducir, si no eliminar, la posibilidad de que el conflicto armado en Chiapas se reanude. Sin embargo, sin esfuerzos mas activos por parte del gobierno y del Ejército Zapatista de Liberación Nacional (EZLN) para buscar un acuerdo de paz permanente y saldar cuentas con el pasado, el conflicto permanecerá en un estado inestable que llamamos “paz armada”. Aunque esta situación es mucho mejor que las tensiones y agresiones del pasado, no cumple los requisitos de una sociedad plenamente democrática en que todos los ciudadanos participan en condiciones de igualdad en el proceso político.
Democracy in Mexico City: The Impacts of Structural Reforms
Authors: Wirth Clifford J. 
Published: May 2006

In the 1980s and 1990s, the Mexican Congress instituted reforms to provide for democratic governance in the Distrito Federal (DF). The reform's impacts are examined through longitudinal surveys of DF city council members and the public, elite interviews, and elections analysis. DF governance provides for democratic elections for mayor, district administrators, and the city council, but government corruption undermines the fairness of elections. The mayor retains a great deal of formal policymaking authority relative to the weak city council. DF citizens are denied democratic rights to influence public policies through the city council. The mayor has thwarted the council's democratic initiatives and advanced populist policies at the expense of long-term policies.
En las décadas de 1980s y 1990s, el Congreso de México instituyó reformas para proporcionar un gobierno democrático en el Distrito Federal (DF). Los impactos de las reformas están examinados por encuestas longitudinales de los diputados locales y el público, entrevistas con las élites y análisis de las elecciones. El gobierno del DF provee elecciones democráticas para jefe de gobierno del DF, jefes delegacionales y la Asamblea Legislativa del DF (ALDF), pero la corrupción mina la limpieza de las elecciones. El jefe de gobierno del DF conserva una autoridad muy grande para hacer políticas en comparación de una ALDF débil. A los ciudadanos del DF les faltan derechos democráticos para influir en las políticas públicas a través de la ALDF. El jefe de gobierno del DF ha frustrado las iniciativas de la ALDF y, en cambio, introduce políticas populares en vez de hacer política a largo plazo.
Vicente Fox's Presidential Style and the New Mexican Presidency
Authors: Loaeza Soledad 
Published: May 2006

Arguing that throughout his campaign and the first half of his presidency Vicente Fox focused on personal style at the expense of issues and policies, this article explores the effects of Fox's plebiscitarian approach on the institution of the Mexican presidency. After describing the plebiscitarian presidency formula, this article considers some of the differences that distinguish President Fox from his predecessors and identifies as definitive features of the foxista presidency its personalization of authority and fortification of a relationship (established via public opinion) between presidential performance and personal qualities. It then looks at constraints opposing the development of a plebiscitarian presidency, and concludes by assessing the potential impact of Vicente Fox's personal style on the Mexican presidency.
Argumentando que a lo largo de su campaña y la primera mitad de su presidencia Vicente Fox centró su atención en su estilo personal a expensas de asuntos de gobierno y políticas, este artículo explora los efectos del enfoque plebiscitario de Fox y sus efectos en la institución presidencial de México. Después de describir la fórmula de la presidencia plebiscitaria, este artículo reflexiona acerca de las diferencias que distinguen al presidente Fox de sus predecesores e identifica como un aspecto definitorio de la presidencia foxista la personalización de la autoridad y el impulso a la relación (establecido por medio de la opinión pública) entre el desempeño presidencial y las cualidades personales. Posteriormente, se detallan las restricciones existentes al desarrollo de la presidencia plebiscitaria y se concluye el impacto potencial del estilo personalista de gobierno de Vicente Fox en la presidencia mexicana.
Democratization and the Dynamics of Candidate Selection Rule Change in Mexico, 1991–2003
Authors: Wuhs Steven T. 
Published: May 2006

Party leaders in Mexico face the challenge of maintaining party unity while remaining competitive in a democratizing context. Candidate selection rules are central to achieving both objectives. I argue that leaders must decide between “open” rules that nominate electable candidates and “closed” rules that build strong party organizations, and suggest that strategic interests are the most powerful determinant of rule choice. Despite an evident trend toward greater openness, however, party leaders have taken advantage of Mexico's mixed electoral system to preserve their own influence and placate party activists, while reaping the benefits of open rules.Los líderes de los partidos políticos en México se enfrentan al reto de mantener la cohesión de sus partidos mientras buscan seguir ganando las elecciones. Los procesos de selección de los candidatos son cruciales para lograr los dos objetivos. Planteo que los líderes deben elegir entre procesos “abiertos” que producen candidatos atractivos y procesos “cerrados” que fortalecen los partidos mismos, y que las metas estratégicas de los partidos tienen la mayor influencia en la selección de las reglas. A pesar de una tendencia hacia mayor apertura, los líderes, por medio del sistema electoral “mixto” de México, han conservado su propia influencia, conciliando con los activistas, mientras se aprovechan de los beneficios electorales de los procesos abiertos.
Perceptions and Attitudes about Corruption and Democracy in Mexico
Authors: Bailey John , Paras Pablo 
Published: May 2006

Corruption is one of the most significant challenges confronting processes of democratic governability in Mexico. This article brings a methodological focus to bear on three sets of topics: (1) In what activities or instances of daily life do respondents claim to encounter corruption? (2) Who cares about corruption? That is, what is the salience of corruption to various groups? (3) What are the effects of perceptions of corruption on satisfaction with/support for democracy? Based on a secondary analysis of three data sets, our principal findings are that (1) the term, “corruption,” has several different meanings for respondents; (2) government is viewed as only slightly more corrupt than society; (3) if we include bribes as corruption, a rather small subset of the samples (about a quarter) claim to have directly experienced bribery; and (4) perceptions of corruption negatively influence satisfaction with democracy, and those who perceive corruption to be a significant problem are less likely to trust institutions or individuals. In addition to these findings, we speculate about a puzzle: If rather few respondents claim direct experience with corruption in their daily lives, why do so many express such firm and pessimistic views about corruption in so many distant spheres of political and social life?
La corrupción es uno de los retos más importantes que enfrenta el proceso de gobernabilidad democrática en México. El artículo presenta un enfoque metodológico para abordar tres preguntas: (1) según los entrevistados, ¿en qué actividades de la vida diaria se experimenta corrupción?; (2) ¿a quién le importa la corrupción?; es decir, ¿cuál es la prominencia de la corrupción para diferentes grupos?; y ¿cuáles son los efectos de las percepciones de corrupción en la apoyo y satisfacción democrática? Basados en investigación secundaria de tres bases de datos nuestros hallazgos son los siguientes: (1) la palabra, “corrupción,” tiene diferentes significados entre los entrevistados; (2) el gobierno es percibido sólo ligeramente más corrupto que la sociedad; (3) si incluimos las ‘mordidas’ como corrupción, un subgrupo de la muestra (un cuarto aproximadamente) dice haber participado directamente en los sobornos; y (4) las percepciones sobre la corrupción afectan negativamente la satisfacción con la democracia y aquellos que perciben que la corrupción es un problema grave son menos propensos a confiar en las instituciones y en los individuos. Además, especulamos sobre un enigma: si son pocos quienes afirman tener una experiencia directa con la corrupción, por qué tantos expresan un firme y marcado pesimismo sobre la corrupción en diversas esferas de la vida política y social?