bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statistical Modeling of Downslope Windstorms in Boulder, Colorado
Authors: Mercer Andrew E. , Richman Michael B. , Bluestein Howard B. , Brown John M. 
Published: May 2008

Abstract
Downslope windstorms are of major concern to those living in and around Boulder, Colorado, often striking with little warning, occasionally bringing clear-air wind gusts of 35–50 m s−1 or higher, and producing widespread damage. Historically, numerical models used for forecasting these events had lower than desired accuracy. This observation provides the motivation to study the potential for improving windstorm forecasting through the use of linear and nonlinear statistical modeling techniques with a perfect prog approach. A 10-yr mountain-windstorm dataset and a set of 18 predictors are used to train and test the models. For the linear model, a stepwise regression is applied. It is difficult to determine which predictor is the most important, although significance testing suggests that 700-hPa flow is selected often. The nonlinear techniques employed, feedforward neural networks (NN) and support vector regression (SVR), do not filter out predictors as the former uses a hidden layer to account for the nonlinearities in the data, whereas the latter fits a kernel function to the data to optimize prediction. The models are evaluated using root-mean-square error (RMSE) and median residuals. The SVR model has the lowest forecast errors, consistently, and is not prone to creating outlier forecasts. Stepwise linear regression (LR) yielded results that were accurate to within an RMSE of 8 m s−1; whereas an NN had errors of 7–9 m s−1 and SVR had errors of 4–6 m s−1. For SVR, 85% of the forecasts predicted maximum wind gusts with an RMSE of less than 6 m s−1 and all forecasts predicted wind gusts with an RMSE of below 12 m s−1. The LR method performed slightly better in most evaluations than NNs; however, SVR was the optimal technique.
Commentary on “Three Years Clinical Experience With Intestinal Transplantation” and the Nutritional Implications
Authors: Janson Douglas D. 
Published: May 2008

Background: After the successful evolution of hepatic transplantation during the last decade, small bowel and multivisceral transplantation remains the sole elusive achievement for the next era of transplant surgeons. Until recently, and for the last thirty years, the results of the sporadic attempts of intestinal transplantation worldwide were discouraging because of unsatisfactory graft and patient survival. The experimental and clinical demonstration of the superior therapeutic efficacy of FK 506, a new immunosuppressive drug, ushered in the current era of small bowel and multivisceral transplantation with initial promising results.Study Design: Forty‐three consecutive patients with short bowel syndrome, intestinal insufficiency, or malignant tumors with or without associated liver disease, were given intestinal (n = 15), hepatic and intestinal (n = 21), or multivisceral allografts that contained four or more organs (n = 7). Treatment was with FK 506‐based immunosuppression. The ascending and right transverse colon was included with the small intestine in 13 of the 43 grafts, almost evenly distributed between the three groups.Results: After 6 to 39 months, 30 of the 43 patients are alive, 29 bearing grafts. The most rapid convalescence and resumption of diet, and the highest three‐month patient survival (100%) and graft survival (88%) were with the isolated intestinal procedure. However, this advantage was slowly eroded during the first two postoperative years, in part because the isolated intestine was more prone to rejection. By the end of this time, the best survival rate (86%) was with the multivisceral procedure. With all three operations, most of the patients were able to resume diet and discontinue parenteral alimentation, and in the best instances, the quality of life approached normal. However, the surveillance and intensity of care required for these patients for the first year, and in most instances thereafter, was very high, being far more than required for patients having transplants of the liver, kidney, or heart.Conclusions: Although intestinal transplantation has gone through the feasibility phase, strategies will be required to increase its practicality. One possibility is to combine intestinal transplantation with contemporaneous autologous bone marrow transplantation.
Acute Pancreatitis: A Review of Pathophysiology and Nutrition Management
Authors: Russell Mary Krystofiak 
Published: May 2008

Acute pancreatitis (AP) is an acute inflammatory process of the pancreas that may involve peripancreatic tissue or remote organs. In its more severe forms, it is a significantly catabolic illness for which specialized nutrition support is required.This review summarizes the pathophysiology of AP, the severity grading systems used in its evaluation, and general treatment strategies, and reviews the value of enteral tube feeding and parenteral nutrition in supporting the patient with this common disease.
Nutrition Issues in Pediatric Crohn's Disease
Authors: Wiskin Anthony E. , Wootton Stephen A. , Beattie Robert M. 
Published: May 2008

Twenty‐five percent of inflammatory bowel disease (IBD) diagnoses present in childhood, with Crohn's disease (CD) being the most common type. Many children have poor nutrition status at presentation of the disease, which may worsen during the clinical course, with a significant number of children having impaired linear growth. The cause of this poor nutrition status is complex, and contributing factors include inadequate intake, malabsorption, altered energy demands, and losses through stool, particularly in colitis. The principal aim of medical management is to induce disease remission, with minimal side effects, thereby enabling normal growth and development. This must include active consideration of the nutrition needs of such children and how they may be best met. However, our understanding of the manner in which the disease process affects the energy demands of children with CD or how poor nutrition, in turn, may affect the disease course is limited. This may constrain the efficacy and effectiveness of standard therapeutic approaches to care.This review explores the many factors of relevance in the delivery of nutrition support to children with inflammatory bowel disease, and explores the role of exclusive enteral nutrition as a corticosteroid‐sparing strategy to induce remission in children with active Crohn's disease.
A “How‐To” Guide in Preparing Abstracts and Poster Presentations
Authors: Boullata Joseph I. , Mancuso Carissa E. 
Published: May 2008

The preparation of an abstract or poster to share information from a project or case report with colleagues is a professional goal for many nutrition support practitioners. This paper provides an approach to help practitioners prepare an abstract for submission and subsequently a poster for presentation at a meeting.A nutrition support question that required collecting and evaluating information, or a unique patient case or case series, can serve as the focus of an abstract and subsequent poster. The professional meeting selected should be appropriate for the abstract topic, and the authors should closely adhere to the organization's abstract submission guidelines. The well‐prepared abstract will then serve as the outline for the poster content; the visual aspect of the poster is also important to effectively communicate the information to colleagues at the meeting. Adequate time is required to prepare both the abstract and the poster in order to fittingly reflect the value of the information. Efforts in preparing the abstract will be worthwhile once the abstract has been accepted by reviewers for a poster session at the meeting. Likewise, the effort in preparing the poster in advance allows the presenter to enjoy the poster session and discuss the project with colleagues.
Obesity, Inflammation, and the Potential Application of Pharmaconutrition
Authors: Cave Matt C. , Hurt Ryan T. , Frazier Thomas H. , Matheson Paul J. , Garrison Richard N. , McClain Craig J. , McClave Stephen A. 
Published: May 2008

Obesity is an emerging problem worldwide. Hospitalized obese patients often have a worse outcome than patients of normal weight, particularly in the setting of trauma and critical care. Obesity creates a low‐grade systemic inflammatory response syndrome (SIRS) that is similar (but on a much smaller scale) to gram‐negative sepsis. This process involves up‐regulation of systemic immunity, is characterized clinically by insulin resistance and the metabolic syndrome, and puts the patient at increased risk for organ failure, infectious morbidity, and mortality. Through lipotoxicity and cytokine dysregulation, obesity may act to prime the immune system, predisposing to an exaggerated subsequent immune response when a second clinical insult occurs (such as trauma, burns, or myocardial infarction).Specialized nutrition therapy for such patients currently consists of a hypocaloric, high‐protein diet. However, this approach does not address the putative pathophysiologic mechanisms of inflammation and altered metabolism associated with obesity. A number of dietary agents such as arginine, fish oil, and carnitine may correct these problems at the molecular level. Pharmaconutrition formulas may provide exciting innovations for the nutrition therapy of the obese patient.
Hyperglycemia Associated With High, Continuous Infusion Rates of Total Parenteral Nutrition Dextrose
Authors: Rosmarin D. Kathryn , Wardlaw Gordon M. , Mirtallo Jay 
Published: May 2008

ABSTRACTA retrospective study was performed to determine whether there is an increased incidence of hyperglycemia in patients not predisposed to hyperglycemia (n = 102) who receive total parenteral nutrition (TPN) dextrose in excess of 4 to 5 mg/kg/min. Of the 37 subjects administered dextrose at >5 mg/kg/min, 18 exhibited hyperglycemia. None did so who received dextrose at ≤4 mg/kg/min (n = 19). TPN dextrose infusion rate was positively correlated with blood glucose concentration, over and above other variables considered in a multiple regression, including kcal/kg administered, furosemide or dopamine use, gender, age, or diagnosis. Thus, TPN dextrose infusion rates > 4 to 5 mg/kg/min increase risk of hyperglycemia.
Observations on Possible Effects of Daily Vitamin K Replacement, Especially Upon Warfarin Therapy
Authors: Bern Murray 
Published: May 2008

Daily parenteral vitamin K supplement is now recommended by the US Food and Drug Administration (FDA) for patients receiving IV hyperalimentation. This is considered as preferable to the previous recommendations of weekly parenteral or oral supplement, or as in some cases no supplement at all. Supplemental vitamin K1 will ensure adequate supplies for hepatic saturation and thus the production of clotting factors II, VII, IX, and X, plus the anticoagulants protein C, protein S, and protein Z. But this is not the entire story. This recommended supplement will affect other physiologic systems that also use vitamin K‐dependent γ‐carboxylation.Vitamin K is not 1 molecule but rather 2 natural substances, vitamin K1 and K2, and the synthetic K3's. It is not understood, what, if any, effect may occur because of the saturation or competition from the vitamin K1 upon the functioning of vitamins K2 and the derivatives of K3 in vivo upon bone mineralization, cell growth, and blood vessel health, all known to be influenced by the vitamins K. There are probably other physiologic systems yet to be studied relative to vitamins K and γ‐carboxylation.This review also considers the available research upon warfarin when given to patients receiving hyperalimentation and what effects the vitamin K supplements may have. Because studies to date have not controlled for vitamin K intake, consideration is given to whether one should expect any change in previously reported outcomes when using low‐dose warfarin for prophylaxis against central vein thrombosis. Also considered are possible positive or negative effects that chronic warfarin therapy may have upon the other vitamin K‐dependent systems under discussion.This review offers a platform for further discussion and derived clinical research provoked by this new FDA recommendation.
Evaluation of Possible Causes of Delayed Hypersensitivity Impairment in Cancer Patients
Authors: Dominioni Lorenzo , Dionigi Renzo , Dionigi Paolo , Nazari Stefano , Fossati Giun S. , Prati Ubaldo , Tibaldeschi Carlo , Pavesi Franco 
Published: May 2008

The separate roles of malnutrition, advanced age, and stage of tumor growth as causes of impairment of delayed hypersensitivity response (DHR) was studied in 111 patients with solid tumors and in 56 nonneoplastic control patients matched for age, anatomical site of disease, degree of illness, and nutritional status. Pretreatment DHR to recall antigens (tuberculin, Candida, streptokinase‐streptodornase, trichophyton) and to dinitrochlorobenzene in cancer patients was 9% anergic, 43% hypoergic, and 48% normoergic; the distribution of DHR in controls was not significantly different.In cancer patients, the serum albumin level showed an inverse correlation with the stage of tumor (p < 0.01) and a positive correlation with the DHR (p < 0.001); the serum albumin level was also in the controls positively correlated with the DHR (p < 0.01), indicating that malnutrition in neoplastic or benign disease may cause depression of DHR. In well‐nourished controls, age was inversely correlated with DHR (p < 0.05), showing that aging itself may be another relevant cause of depression of DHR. The results of this study indicate that DHR in patients with solid tumors is similar to the DHR of nonneoplastic patients if matched for age, sex, and nutritional status. DHR impairment in cancer patients appears to be caused mainly by aging and by malnutrition due to the advanced progression of cancer.
Long‐Term Nutritional Support as an Adjunct to Chemotherapy for Breast Cancer
Authors: Elkort Richard J. , Baker Frances L. , Vitale Joseph J. , Cordano Angel 
Published: May 2008

In recent years, the concept of nutritional support as a part of a comprehensive cancer management program has gained increasing acceptability. However, little data is available in regard to the effect of nutritional support programs on the chronic disease state represented by recurrent or persistent cancer that characterizes patients undergoing systemic chemotherapy.In 1977 we undertook to study this problem in a randomized prospective study designed to evaluate the effects of long‐term (12 months) enteral nutritional support in a group of ambulatory breast cancer patients undergoining a standard cytotoxic chemotherapy treatment program, in an adjuvant or therapeutic setting.The results of this study suggest that patients with breast cancer are overweight as compared to the general population and that any significant change in initial body weight, either a gain or a loss, is associated with an increased risk of recurrent disease.Data are presented which show little or no correlation between standard parameters of nutritional assessment and risk of disease recurrence and/or response to chemotherapy.These data also suggest that until we better understand the relationship between tumor and host in breast cancer patients, we offer nutritional support programs only in situations where there are specific clinical indications for such interventions.
Hemodynamic Effects of Intravenous Fat Emulsions in Patients with Heart Disease
Authors: Fisch Daniel , Abel Ronald M. 
Published: May 2008

Two intravenous fat emulsions (Liposyn 10%, Abbott Laboratories, North Chicago, IL, and Intralipid 10%, Cutter Laboratories, Berkeley, CA) were evaluated in 13 adult patients following cardiopulmonary bypass procedures in a randomized, prospective, double‐blind study to determine their overall hemodynamic effects. The fat emulsions were administered for 30 minutes, and each patient was his own control.Neither intravenous fat emulsion was observed to exert significant changes in left ventricular stroke work, left ventricular filling pressure, cardiac output, systemic vascular resistance, mean systemic arterial blood pressure, central venous pressure, or mean pulmonary artery pressure. This study confirms that the administration of 10% fat emulsions available in the United States does not exert significant untoward hemodynamic changes, even in patients with severe cardiac impairment recovering from recent open heart surgery.
Changes in Body Protein, Body Potassium, and Lean Body Mass During Total Parenteral Nutrition
Authors: McNeill Kenneth G. , Harrison Joan E. , Mernagh John R. , Stewart Sandra , Jeejeebhoy Khursheed N. 
Published: May 2008

Lean body mass by anthropometry (AMLBM), total body potassium (TBK), and total body nitrogen (TBN) by prompt gamma analysis, are reported in 38 malnourished patients during total parenteral nutrition. Over long periods (>2 months) TBN increased 32% while AMLBM and TBK rose only by 9.2 and 9.5%, respectively. Changes in AMLBM and in K were significantly correlated, but changes in nitrogen were not correlated with either. From short‐term studies, the same conclusions can be obtained; although there are changes in lean body mass and in potassium, there is no correlation with such changes in nitrogen.With repletion, changes in body protein are not necessarily related to changes in AMLBM or to TBK: the latter two reflecting total and intracellular water, respectively, but not protein content.
Rapidly Declining Serum Albumin Values in Newly Hospitalized Patients: Prevalence, Severity, and Contributory Factors
Authors: Courtney Mary E. , Greene Harry L. , Folk Cathy C. , Helinek Gerard L. , Dmitruk Andrea 
Published: May 2008

We had noted that a number of hospitalized patients showed abnormally low serum albumin levels within a few days of admission, although the albumin had been normal at admission. Since this rapid decline in albumin could not be accounted for on the basis of starvation, we hypothesized that the changes were due to the increase in intravascular fluid volume which normally occurs with assumption of the recumbent position. Since albumin is often a nutritional screening parameter in hospitalized patients, it is important to ascertain the incidence of such profound changes in albumin as well as to identify possible causes for this change.A survey of 34 concurrent hospital admissions showed that 28 out of 34 (82%) patients had a decline in serum albumin within 5 days of hospitalization. These 28 patients had a decrease of 0.5 ± 0.09 g/dl. Twenty‐five additional patients were studied in order to elucidate causative factors. Twenty out of the 25 showed a decrease in serum albumin within 5 days of admission (mean decrease 0.5 ± 0.05 g/dl). Hemoglobins in these patients decreased by a mean of 1.1 ± 0.34 g/dl (p < 0.01), but BUN and uric acid levels did not change significantly. The one factor common to all patients with declining albumin values was change in posture. All patients were ambulatory at the time of the initial albumin determination but were on bedrest for at least 6 1/2 hours before the second determination.The findings indicate that most hospitalized patients have significant changes in serum albumin levels which occur with change in posture. If the albumin level is to be used as a nutritional indicator, the patient's position at the time of phlebotomy is essential for accurate interpretation of results.
Continuous Elemental Enteral Alimentation in the Treatment of Children and Adolescents with Crohn's Disease
Authors: Morin Claude L. , Roulet Michel , Roy Claude C. , Weber Andrée , Lapointe Normand 
Published: May 2008

Ten pediatric patients, aged 8.5–19 years, with active symptomatic Crohn's disease, received a three‐week period of continuous elemental enteral alimentation with no other form of treatment. All patients in this study were selected according to the following criteria, which were applied consecutively : (1) newly diagnosed patients with no previous treatment for Crohn's disease, (2) disease activity index over 200, and (3) no complication requiring surgery.All patients experienced a clinical remission and improved their immunologic and nutritional status during the elemental enteral alimentation. The mean disease activity index for the whole group was 307.0 ± 23.6 (range: 203 to 413) before and 69.2 ± 11.4 (range: 15 to 114) after the feeding period. Significant increases in body weight, triceps skinfold, mid‐arm circumference, serum transferrin and mean percentage of T lymphocytes were also observed. Following cessation of enteral alimentation, a small declining dose of prednisone was used during a one‐year follow‐up period. Eight of the ten patients were still in clinical remission three months after the feeding period and their nutritional status had continued to improve during that period of time.
Prealbumin: A Parameter of Visceral Protein Levels During Albumin Infusion
Authors: Vanlandingham Sam , Spiekerman A. Michael , Newmark Stephen R. 
Published: May 2008

Prealbumin estimations were obtained to determine nutritional states in a group of patients supported with total parenteral nutrition and exogenous albumin infusions. Patients who were in positive nitrogen balance demonstrated an increase in prealbumin levels (11.0 ± 1.6 milligram percent versus 20.3 ± 3.3 milligram percent), whereas patients who were in negative nitrogen balance demonstrated a decrease in prealbumin levels (13.1 ± 5.3 milligram percent versus 9.8 ± 2.2 milligram percent).Prealbumin can be utilized as a test to reflect visceral protein states in patients receiving exogenous albumin infusions.
Free Amino Acids in Plasma and Muscle in Fulminant Hepatic Coma During an Extracorporeal Liver Perfusion
Authors: Roth E. , Muhlbacher F. , Rauhs R. , Huk I. , Soderland K. , Funovics J. 
Published: May 2008

A 21‐year‐old female patient suffering from fulminant hepatic failure was treated with extracorporeal normothermic baboon's liver perfusion for 60 hours. The amino acids (AA) uptake of the extracorporeal organ and the ratio of plasma and muscle AA at the end of the perfusion were measured.The AA uptake of the extracorporeal liver was 414 millimoles per 60 hours and even greater during hemodialysis treatment.In spite of this AA uptake, the plasma AA pattern was not normalized. At the end of the perfusion, the free AA concentration in muscle tissue was 86.25 millimoles per liter of intracellular water, an increase of 62% compared to healthy volunteers. In the patient, the ratio of glutamine to glutamine in muscle tissue was 20 to 1 compared to 5 to 1 in normals.It is concluded that (1) the extracorporeal baboon liver cannot extract the quantities of AA released by endogenous protein catabolism in hepatic failure, and (2) the muscular ammonia detoxification system gets overloaded as indicated by the increase ratio of glutamine to glutamate.
Perforation of Intrathoracic Great Veins by Parenteral Nutrition Catheters
Authors: Jebson Peter J. , Rempe Lynn E. 
Published: May 2008

Perforation of intrathoracic great veins by parenteral nutrition catheters has been previously reported as an unusual complication. The following three case reports illustrate the varied clinical picture that may appear following perforation. The differential diagnosis may be difficult to clarify so early recognition is essential if rapid deterioration in the patient's condition is to be avoided.Each patient in this report provides a useful example for diagnosing this complication. Included are some basic suggestions to help the clinician in early detection.