bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subclinical haemostatic activation and current surgeon volume predict bleeding with open radical retropubic prostatectomy
Authors: Tagawa Scott T. , Dorff Tanya B. , Rochanda Leanne , Ye Wei , Boyle Soames , Raghavan Derek , Lieskovsky Gary , Skinner Donald G. , Quinn David I. , Liebman Howard A. 
Published: July 2008

OBJECTIVETo assess subclinical haemostatic activation and clinical variables to predict bleeding during radical retropubic prostatectomy (RP), as haemostatic activation is common in cancer and might be useful for predicting outcomes, but routine coagulation screening does not correlate with bleeding.PATIENTS AND METHODSClinical data and blood samples were collected from 153 patients (median age 63 years; prostate‐specific antigen, PSA, level 5.92 ng/mL) before RP and lymph node dissection. Plasma was assayed for d‐dimer and thrombin‐antithrombin complex (TAT). Univariable then multivariable analyses were used to identify associations between plasma markers and clinical variables for bleeding and thrombosis.RESULTSMost patients (77%) were stage T1c and most (76.5%) had organ‐confined cancer (≤pT2). Pathological Gleason scores were ≤6 in 68 (44.4%) and ≥8 in 14 (9%) of the patients. The median (range) estimated blood loss (EBL) was 400 (50–3000) mL, the median decrease in haemoglobin level 3.5 (−0.1, 6.6) g/dL, and eight men (5.2%) required a transfusion. In the univariable analysis, a lower TAT before RP (P < 0.001) and d‐dimer level (P = 0.023) correlated with a greater decline in haemoglobin level. The platelet count, international normalised ratio, and activated partial thromboplastin time (aPTT) did not predict the EBL nor change in haemoglobin level; the eight transfused patients had lower platelet counts before RP (P = 0.004). Higher surgical volume predicted a lower EBL (P < 0.001) and lower decrease in haemoglobin (P < 0.05). Multivariable linear regression showed that TAT remained significant for the decrease in haemoglobin, and surgical volume for EBL and decrease in haemoglobin.CONCLUSIONSHaemostatic activation before RP was associated with significantly less bleeding when assessed by objective measures, predicting the decrease in haemoglobin level better than prothrombin time, aPTT or platelet counts. Current surgeon volume might also predict both subjective and objective bleeding variables.
Laparoscopic adrenalectomy for pheochromocytoma: evaluation of experience and strategy at a single institute
Authors: Kasahara Takashi , Nishiyama Tsutomu , Takahashi Kota 
Published: July 2008

OBJECTIVETo assess the utility, safety and feasibility of laparoscopic adrenalectomy (LA) for pheochromocytoma. We reviewed our experience, focusing on surgical outcomes compared with our historical open adrenalectomy (OA) and modifications in surgical procedures.PATIENTS AND METHODSBetween 1997 and 2007, 23 patients with pheochromocytoma underwent LA at our institution. As controls, 18 patients undergoing OA were examined retrospectively. In the first cases of LA, we used an abdominal wall‐lifting device with low pneumoperitoneal pressure and initial ligation of the adrenal vein. In subsequent cases, we adopted similar methods to those we perform for other benign adrenal tumours, including a ‘regular’ pneumoperitoneal pressure, and disconnection of the adrenal vein as the last step of tumour dissection.RESULTSRates of hypertension crisis (systolic blood pressure (sBP) of >200 mmHg) and sudden hypotension subsequent to ligation of the adrenal vein (sBP of <80 mmHg) were 17% and 48% in the LA group, and 44% and 72% in the OA group, respectively. Instability of blood pressure was not amplified by the modifications in surgical procedures of laparoscopy. The groups were comparable for operative duration. The intraoperative blood loss among LA patients in whom adrenalectomy was completed laparoscopically was significantly less than that among OA patients, at a median (range) of 70 (10–530) mL vs 400 (10–990) mL (P < 0.001). However, four LA patients with conversion to open surgery had severe blood loss. Regarding postoperative complications and convalescence, the LA group had more favourable outcomes.CONCLUSIONLaparoscopic removal of pheochromocytoma can be safely and feasibly accomplished by surgical approaches similar to those used for other pathological conditions of the adrenal gland. However, conversion to open surgery should be considered in cases with unexpected difficulty in dissection, invasion or adhesion.
MORAL KNOWLEDGE, EPISTEMIC EXTERNALISM, AND INTUITIONISM
Authors: Star Daniel 
Published: August 2008

AbstractThis paper explores the generally overlooked relevance of an important contemporary debate in mainstream epistemology to philosophers working within ethics on questions concerning moral knowledge. It is argued that this debate, between internalists and externalists about the accessibility of epistemic justification, has the potential to be both significantly influenced by, and have a significant impact upon, the study of moral knowledge. The moral sphere provides a particular type of strong evidence in favour of externalism, and mainstream epistemologists might benefit from paying attention to this fact. At the same time, the terrain of moral epistemology (approached as a sub‐field of metaethics) needs to be reshaped by the realisation that externalists can steal the thunder of intuitionists when it comes to knowledge constituted by seemingly self‐evident beliefs.1
Modulation of basal and stress‐induced amygdaloid substance P release by the potent and selective NK1 receptor antagonist L‐822429
Authors: Singewald Nicolas , Chicchi Gary G. , Thurner Clemens C. , Tsao Kwei‐Lan , Spetea Mariana , Schmidhammer Helmut , Sreepathi Hari Kishore , Ferraguti Francesco , Singewald Georg M. , Ebner Karl 
Published: July 2008

AbstractIt has been shown that anxiety and stress responses are modulated by substance P (SP) released within the amygdala. However, there is an important gap in our knowledge concerning the mechanisms regulating extracellular SP in this brain region. To study a possible self‐regulating role of SP, we used a selective neurokinin‐1 (NK1) receptor antagonist to investigate whether blockade of NK1 receptors results in altered basal and/or stress‐evoked SP release in the medial amygdala (MeA), a critical brain area for a functional involvement of SP transmission in enhanced anxiety responses induced by stressor exposure.In vitrobinding and functional receptor assays revealed that L‐822429 represents a potent and selective rat NK1 receptor antagonist. Intra‐amygdaloid administration of L‐822429 via inverse microdialysis enhanced basal, but attenuated swim stress‐induced SP release, while the low‐affinity enantiomer of L‐822429 had no effect. Using light and electron microscopy, synaptic contacts between SP‐containing fibres and dendrites expressing NK1 receptors was demonstrated in the medial amygdala. Our findings suggest self‐regulatory capacity of SP‐mediated neurotransmission that differs in the effect on basal and stress‐induced release of SP. Under basal conditions endogenous SP can serve as a signal that tonically inhibits its own release via a NK1 receptor‐mediated negative feedback action, while under stress conditions SP release is further facilitated by activation of NK1 receptors, likely leading to high local levels of SP and activation of receptors to which SP binds with lower affinity.
Dopamine receptors regulate NMDA receptor surface expression in prefrontal cortex neurons
Authors: Gao Can , Wolf Marina E. 
Published: July 2008

AbstractInteractions between dopamine (DA) and glutamate systems in the prefrontal cortex (PFC) are important in addiction and other psychiatric disorders. Here, we examined DA receptor regulation of NMDA receptor surface expression in postnatal rat PFC neuronal cultures. Immunocytochemical analysis demonstrated that surface expression (synaptic and non‐synaptic) of NR1 and NR2B on PFC pyramidal neurons was increased by the D1 receptor agonist SKF 81297 (1 μM, 5 min). Activation of protein kinase A (PKA) did not alter NR1 distribution, indicating that PKA does not mediate the effect of D1 receptor stimulation. However, the tyrosine kinase inhibitor genistein (50 μM, 30 min) completely blocked the effect of SKF 81297 on NR1 and NR2B surface expression. Protein cross‐linking studies confirmed that SKF 81297 (1 μM, 5 min) increased NR1 and NR2B surface expression, and further showed that NR2A surface expression was not affected. Genistein blocked the effect of SKF 81297 on NR1 and NR2B. Surface‐expressed immunoreactivity detected with a phospho‐specific antibody to tyrosine 1472 of NR2B also increased after D1 agonist treatment. Our results show that tyrosine phosphorylation plays an important role in the trafficking of NR2B‐containing NMDA receptors in PFC neurons and the regulation of their trafficking by DA receptors.
Does a solitary lobar collapse give pressure–lung volume relationship similar to that found in acute respiratory distress syndrome? A porcine experimental study
Authors: Koefoed‐Nielsen Jacob , Hansen Lars Kjærsgaard , Larsson Anders 
Published: July 2008

SummaryBackground:  The underlying pathophysiology causing different shapes of static pressure–lung volume (PV) curves is not fully elucidated. In this study the aim was to examine the influence of a solitary lobar collapse on inflation–deflation PV curves. The hypothesis was that a lobar collapse would induce the same changes in the PV‐curve as those found in experimental acute lung injury (ALI) and in acute respiratory distress syndrome (ARDS).Methods:  In four mechanically ventilated, anaesthetized pigs, the right lower lobe was collapsed by selective lavage and exsufflation. End‐expiratory lung volume and static inflation–deflation PV curves of the respiratory system, the chest wall and the lung were obtained before formation of the collapse. After creation of the collapse, the same measurements were performed in the non‐collapsed lung and in the whole lung including the lobar collapse. In two animals computed tomography was performed to verify the lobar collapse.Results:  The solitary lobar collapse changed the PV curve by inducing a significant hysteresis and a right shift of lower inflexion point (LIP) on the inflation limb, but had minimal influence on the deflation limb. After creation of the lobar collapse, LIP was found at the pressure at which the collapse started to expand.Conclusions:  PV curves of lungs with solitary lobar collapse are similar to those found in ALI/ARDS. Inspiratory LIP indicated start of recruitment, and expiratory curves did not indicate the pressure at which collapse occurred.
Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome
Authors: Patrick Neary J. , Roberts Andy D. W. , Leavins Nina , Harrison Michael F. , Croll James C. , Sexsmith James R. 
Published: July 2008

SummaryThis study examined the effects of maximal incremental exercise on cerebral oxygenation in chronic fatigue syndrome (CFS) subjects. Furthermore, we tested the hypothesis that CFS subjects have a reduced oxygen delivery to the brain during exercise. Six female CFS and eight control (CON) subjects (similar in height, weight, body mass index and physical activity level) performed an incremental cycle ergometer test to exhaustion, while changes in cerebral oxy‐haemoglobin (HbO2), deoxy‐haemoglobin (HHb), total blood volume (tHb = HbO2 + HHb) and O2 saturation [tissue oxygenation index (TOI), %)] was monitored in the left prefrontal lobe using a near‐infrared spectrophotometer. Heart rate (HR) and rating of perceived exertion (RPE) were recorded at each workload throughout the test. Predicted VO2peak in CFS (1331 ± 377 ml) subjects was significantly (P ≤ 0·05) lower than the CON group (1990 ± 332 ml), and CFS subjects achieved volitional exhaustion significantly faster (CFS: 351 ± 224 s; CON: 715 ± 176 s) at a lower power output (CFS: 100 ± 39 W; CON: 163 ± 34 W). CFS subjects also exhibited a significantly lower maximum HR (CFS: 154 ± 13 bpm; CON: 186 ± 11 bpm) and consistently reported a higher RPE at the same absolute workload when compared with CON subjects. Prefrontal cortex HbO2, HHb and tHb were significantly lower at maximal exercise in CFS versus CON, as was TOI during exercise and recovery. The CFS subjects exhibited significant exercise intolerance and reduced prefrontal oxygenation and tHb response when compared with CON subjects. These data suggest that the altered cerebral oxygenation and blood volume may contribute to the reduced exercise load in CFS, and supports the contention that CFS, in part, is mediated centrally.
Revealing and Resolving Patient Safety Defects: The Impact of Leadership WalkRounds on Frontline Caregiver Assessments of Patient Safety
Authors: Frankel Allan , Grillo Sarah Pratt , Pittman Mary , Thomas Eric J. , Horowitz Lisa , Page Martha , Sexton Bryan 
Published: July 2008

Objective. To evaluate the impact of rigorous WalkRounds on frontline caregiver assessments of safety climate, and to clarify the steps and implementation of rigorous WalkRounds.Data Sources/Study Setting. Primary outcome variables were baseline and post WalkRounds safety climate scores from the Safety Attitudes Questionnaire (SAQ). Secondary outcomes were safety issues elicited through WalkRounds. Study period was August 2002 to April 2005; seven hospitals in Massachusetts agreed to participate; and the project was implemented in all patient care areas.Study Design. Prospective study of the impact of rigorously applied WalkRounds on frontline caregivers assessments of safety climate in their patient care area. WalkRounds were conducted weekly and according to the seven‐step WalkRounds Guide. The SAQ was administered at baseline and approximately 18 months post‐WalkRounds implementation to all caregivers in patient care areas.Results. Two of seven hospitals complied with the rigorous WalkRounds approach; hospital A was an academic teaching center and hospital B a community teaching hospital. Of 21 patient care areas, SAQ surveys were received from 62 percent of respondents at baseline and 60 percent post WalkRounds. At baseline, 10 of 21 care areas (48 percent) had safety climate scores below 60 percent, whereas post‐WalkRounds three care areas (14 percent) had safety climate scores below 60 percent without improving by 10 points or more. Safety climate scale scores in hospital A were 62 percent at baseline and 77 percent post‐WalkRounds (t=2.67, p=.03), and in hospital B were 46 percent at baseline and 56 percent post WalkRounds (t=2.06, p=.06). Main safety issues by category were equipment/facility (A [26 percent] and B [33 percent]) and communication (A [24 percent] and B [18 percent]).Conclusions. WalkRounds implementation requires significant organizational will; sustainability requires outstanding project management and leadership engagement. In the patient care areas that rigorously implemented WalkRounds, frontline caregiver assessments of patient safety increased. SAQ results such as safety climate scores facilitate the triage of quality improvement efforts, and provide consensus assessments of frontline caregivers that identify themes for improvement.
COOLIA CANARIENSIS SP. NOV. (DINOPHYCEAE), A NEW NONTOXIC EPIPHYTIC BENTHIC DINOFLAGELLATE FROM THE CANARY ISLANDS1
Authors: Fraga Santiago , Penna Antonella , Bianconi Irene , Paz Beatriz , Zapata Manuel 
Published: July 2008

A new photosynthetic dinoflagellate species, Coolia canariensis S. Fraga sp. nov., is described based on samples taken from tidal ponds on the rocky shore of the Canary Islands, northeast Atlantic Ocean. Its morphology was studied by LM and SEM. It is almost spherical and has a thick smooth theca with many scattered pores. Plate 1′ is the biggest of the epithecal plates, and 7″ is twice as wide as it is long. Phylogeny inferred from the D1/D2 regions of the LSU nuclear rDNA of three strains of C. canariensis and several strains of other Coolia species, C. monotis, C. sp., showed that C. canariensis strains clustered in a well‐supported clade distinct from the other species. No toxins were detected using mouse bioassay, liquid chromatography with Fluorescence detection (LC‐FLD) or liquid chromatography‐mass spectrometry (LC‐MS). Its pigment composition is of the peridinin type of dinoflagellates. Together with this new species, many other strains of C. monotis from the Atlantic Ocean and Mediterranean Sea have been analyzed for toxin presence, and no evidence of toxin production related to yessotoxins (YTXs) was found, as was previously suggested for C. monotis from Australia.
Brain Diffusion Abnormalities in Children With Fetal Alcohol Spectrum Disorder
Authors: Lebel Catherine , Rasmussen Carmen , Wyper Katy , Walker Lindsay , Andrew Gail , Yager Jerome , Beaulieu Christian 
Published: July 2008

Background:  Children with fetal alcohol spectrum disorder (FASD) have a variety of cognitive, behavioral, and neurological impairments, including structural brain damage. Despite the importance of white matter connections for proper brain function, little is known about how these connections, and the deep gray matter structures that act as relay stations, are affected in children with FASD. The purpose of this study was to use diffusion tensor imaging, an advanced magnetic resonance imaging technique, to examine microstructural differences of white and deep gray matter in children with FASD.Methods:  Subjects were 24 children aged 5–13 years previously diagnosed with FASD and 95 healthy children over the same age range. Diffusion tractography was used to delineate 10 major white matter tracts in each individual, and region‐of‐interest analysis was used to assess 4 deep gray matter structures. Fractional anisotropy, an indicator of white matter integrity, and mean diffusivity, a measure of the average water diffusion, were assessed in all 14 brain structures.Results:  Diffusion tensor imaging revealed significant differences of diffusion parameters in several areas of the brain, including the genu and splenium of the corpus callosum, cingulum, corticospinal tracts, inferior fronto‐occipital fasciculus, inferior and superior longitudinal fasciculi, globus pallidus, putamen, and thalamus. Reduced white and gray matter volumes, as well as total brain volume, were observed in the FASD group.Conclusions:  These results demonstrate diffusion abnormalities in FASD beyond the corpus callosum and suggest that several specific white matter regions, particularly commissural and temporal connections, and deep gray matter areas of the brain are sensitive to prenatal alcohol exposure.
Errors in patient specimen collection: application of statistical process control
Authors: Dzik Walter Sunny , Beckman Neil , Selleng Kathleen , Heddle Nancy , Szczepiorkowski Zbigniew , Wendel Silvano , Murphy Michael 
Published: July 2008

BACKGROUND: Errors in the collection and labeling of blood samples for pretransfusion testing increase the risk of transfusion‐associated patient morbidity and mortality. Statistical process control (SPC) is a recognized method to monitor the performance of a critical process. An easy‐to‐use SPC method was tested to determine its feasibility as a tool for monitoring quality in transfusion medicine.STUDY DESIGN AND METHODS: SPC control charts were adapted to a spreadsheet presentation. Data tabulating the frequency of mislabeled and miscollected blood samples from 10 hospitals in five countries from 2004 to 2006 were used to demonstrate the method. Control charts were produced to monitor process stability.RESULTS: The participating hospitals found the SPC spreadsheet very suitable to monitor the performance of the sample labeling and collection and applied SPC charts to suit their specific needs. One hospital monitored subcategories of sample error in detail. A large hospital monitored the number of wrong‐blood‐in‐tube (WBIT) events. Four smaller‐sized facilities, each following the same policy for sample collection, combined their data on WBIT samples into a single control chart. One hospital used the control chart to monitor the effect of an educational intervention.CONCLUSION: A simple SPC method is described that can monitor the process of sample collection and labeling in any hospital. SPC could be applied to other critical steps in the transfusion processes as a tool for biovigilance and could be used to develop regional or national performance standards for pretransfusion sample collection. A link is provided to download the spreadsheet for free.
Survival after blood transfusion
Authors: Kamper‐Jørgensen Mads , Ahlgren Martin , Rostgaard Klaus , Melbye Mads , Edgren Gustaf , Nyrén Olof , Reilly Marie , Norda Rut , Titlestad Kjell , Tynell Elsa , Hjalgrim Henrik 
Published: July 2008

BACKGROUND: Long‐term survival of transfusion recipients has rarely been studied. This study examines short‐ and long‐term mortality among transfusion recipients and reports these as absolute rates and rates relative to the general population.STUDY DESIGN AND METHODS: Population‐based cohort study of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all‐cause mortality.RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first registered transfusion. Three months after the first transfusion, 84.3 percent of recipients were alive. One‐, 5‐, and 20‐year posttransfusion survival was 73.7, 53.4, and 27.0 percent, respectively. Survival was slightly poorer in men than in women, decreased with increasing age, and was worst for recipients transfused at departments of internal medicine. The first 3 months after the first transfusion, the standardized mortality ratio (SMR) was 17.6 times higher in transfusion recipients than in the general population. One to 4 years after first transfusion, the SMR was 2.1 and even after 17 years the SMR remained significantly 1.3‐fold increased.CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion‐transmitted disease as well as for cost‐benefit estimation of new blood safety interventions.
Priority setting for research on aquatic resources: an application of modified economic surplus analysis to natural resource systems
Authors: Briones Roehlano M. , Dey Madan M. , Ahmed A. K. M. Mahfuzuddin , Prein Mark , Stobutzki Ilona 
Published: July 2008

AbstractIn contrast to research on farming systems, research on natural resource systems seldom applies rigorous priority setting techniques, mainly due to difficulties associated with estimating research impact ex ante for such systems. This article presents a replicable approach to priority setting that addresses these difficulties. Assessment is based on multiple criteria, combining economic surplus analysis with subjective scoring, based on information drawn from a cross‐country survey of expert opinion. The approach is applied to the WorldFish Center, a global agricultural research organization focusing on living aquatic resources, both farmed and wild. The exercise demonstrates the relevance of conventional evaluation techniques to fisheries research based on a practical application of its impact pathways.