bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic relevance of disseminated tumor cells in the bone marrow and biological factors of 265 primary breast carcinomas
Authors: Schindlbeck Christian , Kampik Theresa , Janni Wolfgang , Rack Brigitte , Jeschke Udo , Krajewski Stan , Sommer Harald , Friese Klaus 
Published: November 2005

Abstract
Introduction
The prognostic significance of disseminated tumor cells in the bone marrow (DTC-BM) of breast cancer patients has been demonstrated in many studies. Yet, it is not clear which of the primary tumors' biological factors predict hematogenous dissemination. We therefore examined 'tissue micro arrays' (TMAs) of 265 primary breast carcinomas from patients with known bone marrow (BM) status for HER2, Topoisomerase IIα (Top IIa), Ki 67, and p53.

Methods
BM analysis was performed by cytospin preparation and immunocytochemical staining for cytokeratin (CK). TMAs were examined by immunohistochemistry (IHC) for HER2, Top IIa, Ki 67 and p53, and fluorescence in situ hybridization (FISH) for HER2.

Results
HER2 (2+/3+) was positive in 35/167 (21%) cases (FISH 24.3%), Top IIa (>10%) in 87/187 (46%), Ki 67 in 52/184 (28%) and p53 (>5%) in 61/174 cases (34%). Of 265 patients, 68 (25.7%) showed DTC-BM with a median of 2/2 × 106 cells (1 to 1,500). None of the examined factors significantly predicted BM positivity. Significant correlation was seen between HER2 IHC and Top IIa (p = 0.06), Ki 67 (p = 0.031), and p53 (p < .001). Top IIa correlated with Ki 67 and p53, and Ki 67 also with p53 (p = 0.004). After a median follow-up of 60.5 months (7 to 255), the presence of DTC-BM showed prognostic relevance for overall survival (p = 0.03), whereas HER2 (IHC, p = 0.04; FISH, p = 0.03) and Ki 67 (p = 0.04) correlated with disease free survival, and HER2 with distant disease free survival (IHC, p = 0.06; FISH, p = 0.05).

Discussion
The congruence of the examined factors' expression rates indicates a causal line of suppressor, proliferation, and mitosis markers, and growth factor receptors. Hematogenous tumor cell spread seems to be an independent process. The examination of these factors on DTC-BM is the aim of ongoing research.
Correlation of procalcitonin and C-reactive protein to inflammation, complications, and outcome during the intensive care unit course of multiple-trauma patients
Authors: Meisner Michael , Adina Heide , Schmidt Joachim 
Published: November 2005

Abstract
Background
A comparison of the amount of and the kinetics of induction of procalcitonin (PCT) with that of C-reactive protein (CRP) during various types of and severities of multiple trauma, and their relation to trauma-related complications, was performed.

Methods
Ninety adult trauma patients admitted to the intensive care unit of our tertiary care hospital were evaluated in a prospective case study. During the initial 24 hours after trauma the Injury Severity Score, the Sepsis-related Organ Failure Assessment score, and the Acute Physiology and Chronic Health Evaluation II score were evaluated. PCT, CRP, the sepsis criteria (American College of Chest Physicians/Society of Critical Care Medicine definitions), and the Sepsis-related Organ Failure Assessment score were measured at days 1–7, as well as at days 14 and 21, concluding the observation period with the 28-day survival.

Results
The induction of PCT and CRP varied in patients suffering from trauma. PCT increased only moderately in most patients and peaked at day 1–2 after trauma, the concentrations rapidly declining thereafter. CRP ubiquitously increased and its kinetics were much slower. Complications such as sepsis, infection, blood transfusion, prolonged intensive care unit treatment, and poor outcome were more frequent in patients with initially high PCT (>1 ng/ml), whereas increases of CRP showed no positive correlation.

Conclusion
In patients with multiple trauma due to an accident, the PCT level provides more information than the CRP level since only moderate amounts of PCT are induced, and higher concentrations correlate with more severe trauma and a higher frequency of various complications, including sepsis and infection. Most importantly, the moderate trauma-related increase of PCT and the rapidly declining concentrations provide a baseline value near to the normal range at an earlier time frame than for CRP, thus allowing a faster and more valid prediction of sepsis during the early period after trauma.
Bronchoalveolar lavage cytological alveolar damage in patients with severe pneumonia
Authors: Grigoriu Bogdan , Jacobs Frédéric , Beuzen Fabienne , El Khoury Rony , Axler Olivier , Brivet Francois G , Capron Frédérique 
Published: November 2005

Abstract
Introduction
Histological examination of lung specimens from patients with pneumonia shows the presence of desquamated pneumocytes and erythrophages. We hypothesized that these modifications should also be present in bronchoalveolar lavage fluid (BAL) from patients with hospital-acquired pneumonia.

Methods
We conducted a prospective study in mechanically ventilated patients with clinical suspicion of pneumonia. Patients were classified as having hospital-acquired pneumonia or not, in accordance with the quantitative microbiological cultures of respiratory tract specimens. A group of severe community-acquired pneumonias requiring mechanical ventilation during the same period was used for comparison. A specimen of BAL (20 ml) was taken for cytological analysis. A semiquantitative analysis of the dominant leukocyte population, the presence of erythrophages/siderophages and desquamated type II pneumocytes was performed.

Results
In patients with confirmed hospital-acquired pneumonia, we found that 13 out of 39 patients (33.3%) had erythrophages/siderophages in BAL, 18 (46.2%) had desquamated pneumocytes and 8 (20.5%) fulfilled both criteria. Among the patients with community-acquired pneumonia, 7 out of 15 (46.7%) had erythrophages/siderophages and 6 (40%) had desquamated pneumocytes on BAL cytology. Only four (26.7%) fulfilled both criteria. No patient without hospital-acquired pneumonia had erythrophages/siderophages and only 3 out of 18 (16.7%) had desquamated pneumocytes on BAL cytology.

Conclusion
Cytological analysis of BAL from patients with pneumonia (either community-acquired or hospital-acquired) shows elements of cytological alveolar damage as hemorrhage and desquamated type II pneumocytes much more frequently than in BAL from patients without pneumonia. These elements had a high specificity for an infectious cause of pulmonary infiltrates but low specificity. These lesions could serve as an adjunct to diagnosis in patients suspected of having ventilator-associated pneumonia.
A comparison of admission and worst 24-hour Acute Physiology and Chronic Health Evaluation II scores in predicting hospital mortality: a retrospective cohort study
Authors: Ho Kwok M , Dobb Geoffrey J , Knuiman Matthew , Finn Judith , Lee Kok Y , Webb Steven AR 
Published: November 2005

Abstract
Introduction
The Acute Physiology and Chronic Health Evaluation (APACHE) II score is widely used in the intensive care unit (ICU) as a scoring system for research and clinical audit purposes. Physiological data for calculation of the APACHE II score are derived from the worst values in the first 24 hours after admission to the ICU. The collection of physiological data on admission only is probably logistically easier, and this approach is used by some ICUs. This study compares the performance of APACHE II scores calculated using admission data with those obtained from the worst values in the first 24 hours.

Materials and Methods
This was a retrospective cohort study using prospectively collected data from a tertiary ICU. There were no missing physiological data and follow-up for mortality was available for all patients in the database. The admission and the worst 24-hour physiological variables were used to generate the admission APACHE II score and the worst 24-hour APACHE II score, and the corresponding predicted mortality, respectively.

Results
There were 11,107 noncardiac surgery ICU admissions during 11 years from 1 January 1993 to 31 December 2003. The mean admission and the worst 24-hour APACHE II score were 12.7 and 15.4, and the derived predicted mortality estimates were 15.5% and 19.3%, respectively. The actual hospital mortality was 16.3%. The overall discrimination ability, as measured by the area under the receiver operating characteristic curve, of the admission APACHE II model (83.8%, 95% confidence interval = 82.9–84.7) and the worst 24-hour APACHE II model (84.6%, 95% confidence interval = 83.7–85.5) was not significantly different (P = 1.00).

Conclusion
Substitution of the worst 24-hour physiological variables with the admission physiological variables to calculate the admission APACHE II score maintains the overall discrimination ability of the traditional APACHE II model. The admission APACHE II model represents a potential alternative model to the worst 24-hour APACHE II model in critically ill nontrauma patients.
Using simulation for training and to change protocol during the outbreak of severe acute respiratory syndrome
Authors: Abrahamson Simon D , Canzian Sonya , Brunet Fabrice 
Published: November 2005

Abstract
Introduction
During the 2003 severe acute respiratory syndrome (SARS) crisis, we proposed and tested a new protocol for cardiac arrest in a patient with SARS. The protocol was rapidly and effectively instituted by teamwork training using high-fidelity simulation.

Methods
Phase 1 was a curriculum design of a SARS-specific cardiac arrest protocol in three steps: planning the new protocol, repeated simulations of this protocol in a classroom, and a subsequent simulation of a cardiac arrest on a hospital ward. Phase 2 was the training of 275 healthcare workers (HCWs) using the new protocol. Training involved a seminar, practice in wearing the mandatory personal protection system (PPS), and cardiac arrest simulations with subsequent debriefing.

Results
Simulation provided insights that had not been considered in earlier phases of development. For example, a single person can don a PPS worn for the SARS patient in 1 1/2 minutes. However, when multiple members of a cardiac arrest team were dressing simultaneously, the time to don the PPS increased to between 3 1/2 and 5 1/2 minutes. Errors in infection control as well as in medical management of advanced cardiac life support (ACLS) were corrected.

Conclusion
During the SARS crisis, real-time use of a high-fidelity simulator allowed the training of 275 HCWs in 2 weeks, with debriefing and error management. HCWs were required to manage the SARS cardiac arrest wearing unfamiliar equipment and following a modified ACLS protocol. The insight gained from this experience will be valuable for future infectious disease challenges in critical care.
TNF-α-induced chemokine production and apoptosis in human neural precursor cells
Authors: Sheng Wen S , Hu Shuxian , Ni Hsiao T , Rowen Tim N , Lokensgard James R , Peterson Phillip K 
Published: November 2005

AbstractRecent studies have shown that proinflammatory cytokines damage rodent neural precursor cells (NPCs), a source of self-renewing, multipotent cells that play an important role in the developing as well as adult brain. In this study, the effects of tumor necrosis factor α (TNF-α) on cytokine and chemokine production by human NPCs (&gt;98% nestin- and &gt;90% A2B5-positive), obtained from 6- to 8-week-old fetal brain specimens, were evaluated. NPCs stimulated with this proinflammatory cytokine were found to produce abundant amounts of the chemokines monocyte chemoattractant protein 1 (MCP-1)/CC chemokine ligand 2 (CCL2) and interferon-inducible protein 10 (IP-10)/CXC chemokine ligand 10 (CXCL10) in a time- and concentration-dependent manner. TNF-α treatment also induced NPC apoptosis. Receptors for TNF [TNFRI (p55) and TNFRII (p75)] mRNA were constitutively expressed on NPCs. However, only TNFRI was involved in TNF-α-induced chemokine production and apoptosis by NPCs, as anti-TNFRI but not anti-TNFRII antibodies blocked the stimulatory effect. TNF-α treatment induced p38 mitogen-activated protein kinase (MAPK) phosphorylation in NPCs, and SB202190, an inhibitor of p38 MAPK, blocked TNF-α-induced chemokine production. Thus, this study demonstrated that NPCs constitutively express receptors for TNF-α, which when activated, trigger via a p38 MAPK signaling pathway production of two chemokines, MCP-1/CCL2 and IP-10/CXCL10, which are involved in infectious and inflammatory diseases of the brain.
Recent and future advances in roof drainage design and performance
Authors: Arthur S , Wright GB 
Published: November 2005

The past 10 years have witnessed significant changes in the way roof drainage systems are understood and designed. In particular, there has been a stepchange in the confidence with which siphonic roof drainage systems may be specified and expected to perform. These changes have occurred whilst urban drainage design in general has been revolutionized by wider acceptance of Sustainable Urban Drainage Systems and greater public concern regarding pluvial flooding within the context of climate change. This text considers, in detail, both how roof drainage systems are designed and how they should be expected to perform. Particular attention is drawn to weaknesses in accepted design methods. Consideration is also given to ‘innovative’ roof drainage related approaches such as green roofs and rainwater harvesting. Practical application: Over the past few years there have been many changes in how roof drainage systems are specified and designed. On large buildings, technologies such as ‘siphonic roof drainage’ are now commonplace and there is an ever increasing demand for ‘green roofs’ to be specified due to their potential to ‘green’ developments. Based on ongoing research, this paper details how these different types of roof drainage solutions can be efficiently designed and what levels of performance can be expected.
A simplified radiosity algorithm for general urban radiation exchange
Authors: Robinson D , Stone A 
Published: November 2005

The radiant external environment may be described by two hemispheres, above and below the horizontal plane, which are discretized into a number of patches of known solid angle. Occlusions to these patches may be combined and represented as some patch fraction for which the radiant characteristics are defined by the dominant occlusion. By solving for radiant exchanges between each surface in a scene and its associated (un)occluded patches, we have a simplified radiosity algorithm (SRA). This paper describes the application of this SRA to solve for urban scale predictions of: (i) solar radiation; (ii) interior daylight; and (iii) longwave radiation. Comparisons of solar and daylight predictions with the ray-tracing program RADIANCE show that accurate results are achieved at a computational cost several orders of magnitude lower. Practical application: This paper describes a new model for predicting external irradiance (shortwave and longwave) and internal illuminance in an accurate and very efficient way, in a single computational module. This module may be incorporated into existing software to improve the quality of predictions from single building thermal simulations as well as emerging software for urban scale predictions of integrated resource (energy, water, waste) flows, for which the model was developed.
Dwelling temperatures and comfort during the August 2003 heat wave
Authors: Wright AJ , Young AN , Natarajan S 
Published: November 2005

More frequent hot summers in the UK under climate change could lead to increased discomfort in dwellings, but there is little published field data on internal summer temperatures. Temperatures were measured in four dwellings around south Manchester and five dwellings in London during the August 2003 heat wave. Resultant statistics and various comfort metrics indicated a high level of discomfort in most dwellings, particularly in London. Daily internal temperatures were shown to correlate strongly with a time-decaying function of daily outside temperatures. Day and night temperatures were shown to relate to the type of structure. It is concluded that if heat waves become more common, this would lead to increased discomfort, with implications for health, mortality and housing design. Practical application: The results presented in this paper show what actually happens to a sample of dwelling temperatures during a severe UK heat wave, and the consequences for comfort. Little has been published on this previously. The correlations between time-averaged outside temperatures, and internal temperatures, provide a method for predicting dwelling temperatures in the future in a warming climate, without the need for detailed simulation and including real occupancy effects such as window opening, which are difficult to simulate reliably. Since there were many excess deaths during the August 2003 heat wave, health is an important concern. Work by others on this issue has shown that mortality rate is correlated with a three-day moving average of outside temperature above a threshold. This moving average correlates closely with the type of time-averaged outside temperature used in the paper. It seems quite possible that a 3-day moving average is a good predictor of excess mortality because it is also a good predictor of internal building temperatures, due to the mediation of thermal mass. This provides an alternative, or additional, explanation to that which explains the mortality as the cumulative result of high external temperatures acting on the human body over a few days, without considering the effects of buildings.
A steady-state model for predicting hygrothermal conditions in beds in relation to house dust mite requirements
Authors: Pretlove SEC , Oreszczyn T , Ridley I , Wilkinson T , Crowther D 
Published: November 2005

This paper describes the development, testing and validation of a simple steady-state hygrothermal bed model (BED) which predicts conditions of temperature and relative humidity within the bed core (the occupied space between mattress and covering), given the temperature and relative humidity of the bedroom. BED is the second of three simple steady-state models that in combination allow the impact of modifying bedroom hygrothermal conditions on dust mite populations to be assessed. The first of the trio is Condensation Targeter II, an existing validated model that predicts average monthly conditions of temperature and relative humidity within the bedroom. These conditions are then used as boundary conditions for the BED model which predicts hygrothermal conditions within the bed core. Finally, these outputs are in turn used as inputs to a simple Mite Population Index (MPI) model (to be described elsewhere) that predicts their likely effect on house dust mite population growth in the bed. As reported here, BED has been validated using monitored bedroom and bed data for a full year in three dwellings and the results show that the steady state model predicts monthly bed hygrothermal conditions with a reasonable degree of accuracy. Using Condensation Targeter II and BED in combination, a sensitivity study has been carried out to assess the impact of changes in input parameters of both models on hygrothermal conditions in the bed core. This highlights the importance that the design of the fabric and services of the building has on the hygrothermal conditions in a bed. The impact of climate change has also been assessed using future climate change scenarios. Practical application: This paper describes in detail a simple steady-state model, (BED) which is used to predict the monthly average temperature and relative humidity within a bed, given the ambient conditions within the bedroon. The input parameters, output parameters and the model formulae are provided so that the model can be easily implemented. BED is the second of three simple models that are used to predict, first the bedroon conditions (Condensation Targeter II), second the bed conditions (BED) and finally the likely effect on house dust mite population growth using a simple Mite Population Index (MPI).
Use of an expert system rating for the energy performance of a building
Authors: de Santoli L , Felici G 
Published: November 2005

In this paper we present an expert system for the energy performance evaluation of buildings. The system is obtained from the integration of different evaluation methodologies in a unified framework and results in a friendly tool made available to internet users, who can obtain, in real time, good quality performance certificates. The scope of the project is to develop a performance assessment of buildings that is both complete and flexible, and that could be extended to different environmental conditions. The project has been originated from the official European procedure EPBD 2002/91/CE which states the essential requirements in a performance-based building strategy. The expert system designed in the first stage of the project has been embedded in a software tool named BEEPS (Building Environment and Energy Performance System), where a Life Cycle Analysis technique is implemented to provide a material and energy balance over the entire life of the material, product or service. This embodies the knowledge of experts in energy evaluations and makes such knowledge available to users in a comprehensible and concise way. A dynamic set of rules processes the data on the building, draws the proper conclusions and constructs a certificate in textual form combining analysis, motivations and suggestions to improve the energetic efficiency of the considered building. The system has been customized for the production of energy performance certificates of buildings in Italy, taking into account climatic conditions, indoor environment requirements, and cost-effectiveness. Residential premises and winter have been considered in a first stage. In the paper we also describe the validation of the proposed tool on 120 case-studies related to residential real estate built in Rome during the last century. Additional components of the project that strongly contribute to the effectiveness of BEEPS are also described, such as the analysis of the building typology and the use of the Geographical Information System for data gathering. The full system is currently available on-line at www.beepsitalia.it. Practical application: In this paper an expert system for the energy performance evaluation of buildings is presented. The scope of the study is to develop a tool for the performance assessment of buildings that is both complete and flexible, and that could be extended to different environmental conditions which matchesthe European Directive EPBD 2002/91/CE. The expert system designed has been embedded in a software tool named BEEPS (Building Environment and Energy Performance System), this is available on-line at www.beepsitalia.it.