bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of the Efficacy of Sterile Barrier Systems Against Microbial Challenges During Transport and Storage
Authors: Dunkelberg Hartmut , Schmelz Ulrich 
Published: December 2008

Objective.The sterility assurance level of 10−6 is an established standard that defines the quality of sterile products. The aim of the present study was to develop a method that correlated the results from microbial-barrier testing of flexible sterile barrier systems with the estimated microbial challenge that the package encounters during storage and transport.Methods.The effectiveness of microbial-barrier packaging was determined by the use of an exposure chamber test with 20 periodic atmospheric pressure changes of 50 and 70 hPa. Flexible peel pouches were used as sterile barrier systems. The logarithmic reduction value of a sterile barrier system was calculated on the basis of the experimental results and compared with the logarithmic reduction value required for the microbial challenges to maintain sterility during transport and storage.Results.For pouches made of paper and plastic-film material, a logarithmic reduction value of 5.4 was obtained on the basis of 30 of 99 plates becoming nonsterile after being exposed to a 50 hPa difference in periodic atmospheric pressure changes. For pouches made of paper and plastic-film material, a logarithmic reduction value of 5.2 was obtained on the basis of 48 of 100 plates becoming nonsterile after being exposed to a 70 hPa difference in atmospheric pressure. For pouches made of nonwoven and plastic-film material, logarithmic reduction values of 6.38 (ie, 3 of 99 plates became nonsterile after being exposed to a 50 hPa pressure difference) and 6.07 (ie, 3 of the 99 plates became nonsterile after being exposed to a 70 hPa pressure difference) were obtained. Calculating an expected microbial challenge during transport and storage that requires barrier properties corresponding to a logarithmic reduction value of 5.83 and taking the sterility assurance level into account, we found that only the nonwoven pouches fulfilled the European standard EN 556-1.Conclusions.Using the data obtained in a microbial exposure test with a specified flow rate of a bacterial aerosol, we found that the effectiveness of the sterile barrier system against the actual microbial challenge can be examined and evaluated at the sterility assurance level of 10−6.
Expression Profile of Nerve Growth Factor after Muscle Incision in the Rat
Authors: Wu Chaoran , Erickson Mark A. , Xu Jun , Wild Kenneth D. , Brennan Timothy J. 
Published: December 2008

Background
Previous studies have demonstrated that nerve growth factor (NGF) is an important mediator of pathologic pain. Many studies have focused on cutaneous mechanisms for NGF-induced hyperalgesia; few have examined its contribution in deeper tissues like muscle. This study examined pain behaviors and the expression of NGF in incised hind paw flexor digitorum brevis muscle.

Methods
Adult Sprague-Dawley rats were pretreated with anti-NGF peptibody and underwent skin or skin plus deep fascia and muscle incision. Guarding pain behaviors were measured. Muscle NGF messenger RNA (mRNA) was measured by reverse-transcriptase polymerase chain reaction. Changes in NGF protein expression were measured using Western blot, enzyme-linked immunosorbent assay, and immunohistochemistry. In situ hybridization for NGF mRNA was also performed.

Results
Pretreatment with anti-NGF peptibody (100 mg/kg) decreased the guarding behavior caused by deep fascia and muscle incision. Muscle NGF mRNA increased abruptly 2 h after incision and was the same as control by postoperative day 1. NGF protein increased from 4 h after incision and was sustained for several days. NGF was localized in many calcitonin gene-related peptide-positive axons, few N52-positive axons, but not isolectin B4-positive axons in incised muscle. The sources of NGF mRNA included keratinocytes in epidermis and fibroblasts in deeper tissues.

Conclusion
Fibroblasts adjacent to the injury are sources of NGF in incised muscle. NGF is upregulated by incision of muscle and contributes to guarding pain behavior.
Liability Associated with Obstetric Anesthesia
Authors: Davies Joanna M. , Posner Karen L. , Lee Lorri A. , Cheney Frederick W. , Domino Karen B. 
Published: December 2008

Background
Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the American Society of Anesthesiologists Closed Claims database.

Methods
Obstetric anesthesia claims for injuries from 1990 to 2003 (1990 or later claims; n = 426) were compared to obstetric claims for injuries before 1990 (n = 190). Chi-square and z tests compared categorical variables; payment amounts were compared using the Kolmogorov-Smirnov test.

Results
Compared to pre-1990 obstetric claims, the proportion of maternal death (P = 0.002) and newborn death/brain damage (P = 0.048) decreased, whereas maternal nerve injury (P < 0.001) and maternal back pain (P = 0.012) increased in 1990 or later claims. In 1990 or later claims, payment was made on behalf of the anesthesiologist in only 21% of newborn death/brain damage claims compared to 60% of maternal death/brain damage claims (P < 0.001). These payments in both groups were associated with an anesthesia contribution to the injury (P < 0.001) and substandard anesthesia care (P < 0.001). Anesthesia-related newborn death/brain damage claims had an increased proportion of delays in anesthetic care (P = 0.001) and poor communication (P = 0.007) compared to claims unrelated to anesthesia.

Conclusion
Newborn death/brain damage has decreased, yet it remains a leading cause of obstetric anesthesia malpractice claims over time. Potentially preventable anesthetic causes of newborn injury included delays in anesthesia care and poor communication between the obstetrician and anesthesiologist.
CU-2010—A Novel Small Molecule Protease Inhibitor with Antifibrinolytic and Anticoagulant Properties
Authors: Dietrich Wulf , Nicklisch Silke , Koster Andreas , Spannagl Michael , Giersiefen Helmut , van de Locht Andreas 
Published: December 2008

Background
In cardiac surgery, the contact of blood with the artificial surfaces of the cardiopulmonary bypass results in activation of coagulation, fibrinolysis, and platelets, which is recognized as reason for increased bleeding tendency. Antifibrinolytics like tranexamic acid or the broad-spectrum protease inhibitor aprotinin attenuate this response. The marketing of aprotinin has been suspended after a recent clinical trial suggested increased risks associated with aprotinin. Moreover, aprotinin is a protein of animal origin and has antigenic properties. As a result, alternative antifibrinolytic compounds are desirable.

Methods
This in vitro study compared the antifibrinolytic efficacy of the synthetic small molecule CU-2010 with aprotinin and tranexamic acid. Antifibrinolytic activity in plasma and whole blood of ten healthy volunteers was examined with a turbidometric method and with tissue factor-activated thromboelastometry (ROTEM; Pentapharm, Munich, Germany). In addition, anticoagulant effects were assessed through measurement of plasma and whole blood clotting times and thrombin generation.

Results
With its high affinity for plasmin (Ki, 2 nM), CU-2010 inhibited fibrinolysis comparable to aprotinin (Ki, 4 nM) and was ten times more potent than tranexamic acid. CU-2010 also inhibited plasma kallikrein (Ki < 1 nM) and factors Xa (Ki, 45 nM) and XIa (Ki, 18nM), which was reflected in prolongation of coagulation times and an attenuation of thrombin generation.

Conclusion
These findings suggest that CU-2010 has similar antifibrinolytic potency compared to aprotinin, is more potent than tranexamic acid, and possesses some anticoagulant effects.
Arabidopsis Synaptotagmin 1 Is Required for the Maintenance of Plasma Membrane Integrity and Cell Viability
Authors: Schapire Arnaldo L. , Voigt Boris , Jasik Jan , Rosado Abel , Lopez-Cobollo Rosa , Menzel Diedrik , Salinas Julio , Mancuso Stefano , Valpuesta Victoriano , Baluska Frantisek , Botella Miguel A. 
Published: December 2008

Abstract
Plasma membrane repair in animal cells uses synaptotagmin 7, a Ca2+-activated membrane fusion protein that mediates delivery of intracellular membranes to wound sites by a mechanism resembling neuronal Ca2+-regulated exocytosis. Here, we show that loss of function of the homologous Arabidopsis thaliana Synaptotagmin 1 protein (SYT1) reduces the viability of cells as a consequence of a decrease in the integrity of the plasma membrane. This reduced integrity is enhanced in the syt1-2 null mutant in conditions of osmotic stress likely caused by a defective plasma membrane repair. Consistent with a role in plasma membrane repair, SYT1 is ubiquitously expressed, is located at the plasma membrane, and shares all domains characteristic of animal synaptotagmins (i.e., an N terminus-transmembrane domain and a cytoplasmic region containing two C2 domains with phospholipid binding activities). Our analyses support that membrane trafficking mediated by SYT1 is important for plasma membrane integrity and plant fitness.
Determinants of the discrepancy in patient‐ and caregiver‐rated quality of life for persons with dementia
Authors: Huang Hsiu‐Li , Chang Mei Yeh , Tang John Sai‐Hung , Chiu Yi‐Chen , Weng Li‐Chueh 
Published: December 2008

Aims. To determine factors related to the discrepancy in patient‐ and proxy‐rated quality of life for patients with dementia; whether this discrepancy is associated with characteristics of patients, caregivers or the caregiver–patient relationship; and which characteristics best predict this discrepancy.Background. To increase the reliability of quality of life measurements for persons with dementia, many researchers have incorporated proxy reports. However, their investigations have indicated that caregiver‐rated quality of life is not the same as the patient’s own rating. The factors related to this discrepancy have previously been explored, but studies rarely focussed on the quality of the caregiver–patient relationship as a determinant of the discrepancy.Design. A cross‐sectional design was used.Methods. Data were gathered from community‐based interviews with 120 dyads of patients with Alzheimer’s disease or related dementia and their caregivers in Taipei. A structured questionnaire was used to collect data, and the main variable (quality of life–Alzheimer’s disease) was rated separately by patients and caregivers. The data were analysed using intraclass correlation coefficients and multivariate regression methods.Results. The agreement between patients’ and caregivers’ quality of life–Alzheimer’s disease ratings was low. This discrepancy was significantly associated with disturbing dementia behaviour, caregivers’ perceived distress for problem behaviours, caregivers’ overall quality of life and quality of the caregiver–patient relationship.Conclusions. The observed discrepancy between caregiver‐ and patient‐rated quality of life for persons with dementia was largely predicted by the quality of the caregiver–patient relationship.Relevance to clinical practice. Medical professionals should cautiously deliberate when using caregiver‐reported quality of life to substitute for patient‐reported quality of life. When using a proxy report or a combined caregiver–patient rating, medical professionals should assess the quality of the relationship between patient and proxy.
Non‐invasive ventilation during arm exercise and ground walking in patients with chronic hypercapnic respiratory failure
Authors: MENADUE Collette , ALISON Jennifer A. , PIPER Amanda J. , FLUNT Daniel , ELLIS Elizabeth R. 
Published: December 2008

ABSTRACTBackground and objective:  People with chronic hypercapnic respiratory failure (HRF) often have a ventilatory limitation to exercise with difficulty performing activities of daily living. Although non‐invasive ventilation (NIV) appears to reduce the ventilatory limitation and improve exercise performance in people with severe COPD, the effect of NIV during functional activities such as unsupported arm exercise (UAE) and ground walking in people with chronic HRF is unclear.Methods:  Seventeen patients with chronic HRF (PaCO2 52.1 ± 5.3 mm Hg) performed a series of UAE tests, and 15 patients (PaCO2 51.7 ± 3.8 mm Hg) performed a series of endurance shuttle walk tests, with and without NIV in a randomized cross‐over design.Results:  NIV during UAE increased endurance time by a mean of 91 s (95% confidence interval (CI): 10–172, P = 0.031) and reduced dyspnoea by a mean of 2.3 on the Borg scale (95% CI: 1.0–3.7, P = 0.002) compared with exercise without NIV. There was a non‐significant increase in walking endurance time with NIV during exercise (119 s, 95% CI: −17 to 254, P = 0.081); however, isotime dyspnoea was unchanged compared with walking without NIV (−1.0, 95% CI: −3.0 to 1.0, P = 0.29).Conclusion:  NIV during UAE increased endurance time and reduced dyspnoea compared with exercise without NIV in patients with chronic HRF. Investigation of the role of NIV as an adjunct to UAE training is warranted. In contrast, NIV during ground walking did not improve exercise capacity. However, the pressure support provided may have been inadequate as dyspnoea was not reduced.
Changes in lung function and health status in patients with COPD treated with tiotropium or salmeterol plus fluticasone
Authors: KURASHIMA Kazuyoshi , HARA Kenichirou , YONEDA Kouichirou , KANAUCHI Tetsu , KAGIYAMA Naho , TOKUNAGA Daido , TAKAYANAGI Noboru , UBUKATA Mikio , SUGITA Yutaka 
Published: December 2008

ABSTRACTBackground and objective: The effects of tiotropium, a long‐acting anticholinergic drug, were compared with those of the combination of salmeterol, a long‐acting β2‐agonist, and fluticasone, an inhaled corticosteroid, in patients with COPD.Methods: A 4‐month, randomized, open cross‐over study of tiotropium, 18 µg once daily, versus salmeterol, 50 µg, plus fluticasone, 200 µg, twice daily, was conducted in patients with COPD. Efficacy was assessed by spirometry and responses to the St George's Respiratory Questionnaire (SGRQ). After 4 months, patients were asked to select their subsequent therapy and indicate the reasons for their selection.Results: A total of 78 patients completed the study. There were no significant differences in the improvements in FEV1or SGRQ scores between the therapies. Similar numbers of patients selected tiotropium (42.3%) and salmeterol plus fluticasone (57.7%). However, those who preferred one of the therapies demonstrated greater improvements in SGRQ scores with that therapy. One subgroup of patients (30.8%) showed greater improvements in dyspnoea and FEV1in response to tiotropium, and the other subgroup of patients (35.9%) showed greater improvements in dyspnoea and FEV1in response to salmeterol plus fluticasone. Some patients (14.1%) selected salmeterol plus fluticasone because of positive effects on sputum expectoration.Conclusions: The study was unblinded and the results need to be interpreted with caution. However, tiotropium and salmeterol plus fluticasone had similar overall effects on pulmonary function and SGRQ scores in patients with COPD. Responses to the two therapies were heterogeneous, and the patients who showed greater improvements in FEV1or SGRQ scores with one of the therapies preferred it for their subsequent treatment.
Performance monitoring in children following traumatic brain injury
Authors: Ornstein Tisha J. , Levin Harvey S. , Chen Shirley , Hanten Gerri , Ewing‐Cobbs Linda , Dennis Maureen , Barnes Marcia , Max Jeffrey E. , Logan Gordon D. , Schachar Russell 
Published: December 2008

Background:  Executive control deficits are common sequelae of childhood traumatic brain injury (TBI). The goal of the current study was to assess a specific executive control function, performance monitoring, in children following TBI.Methods:  Thirty‐one children with mild–moderate TBI, 18 with severe TBI, and 37 control children without TBI, of comparable age and sex, performed the stop signal task, a speeded choice reaction time task. On occasion, they were presented with a signal to stop their responses. Performance monitoring was defined as the extent of slowing in go‐task reaction time following failure to stop responses.Results:  The TBI group as a whole demonstrated less post‐error slowing than did controls. This finding suggested impaired error monitoring performance. In addition, time since injury and socioeconomic status predicted less slowing after stopped responses.Conclusions:  We suggest that alterations in performance monitoring expressed as the inability to notice, regulate and adjust behavior to changing situations are an effect of TBI in children.
The structure of the Autism Diagnostic Interview‐Revised: diagnostic and phenotypic implications
Authors: Snow Anne V. , Lecavalier Luc , Houts Carrie 
Published: December 2008

Background:  Multivariate statistics can assist in refining the nosology and diagnosis of pervasive developmental disorders (PDD) and also contribute important information for genetic studies. The Autism Diagnostic Interview‐Revised (ADI‐R) is one of the most widely used assessment instruments in the field of PDD. The current study investigated its factor structure and convergence with measures of adaptive, language, and intellectual functioning.Methods:  Analyses were conducted on 1,861 individuals with PDD between the ages of 4 and 18 years (mean = 8.3, SD = 3.2). ADI‐R scores were submitted to confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Analyses were conducted according to verbal status (n = 1,329 verbal, n = 532 nonverbal) and separately for algorithm items only and for all items. ADI‐R scores were correlated with scores on measures of adaptive, language, and intellectual functioning.Results:  Several factor solutions were examined and compared. CFAs suggested that two‐ and three‐factor solutions were similar, and slightly superior to a one‐factor solution. EFAs and measures of internal consistency provided some support for a two‐factor solution consisting of social and communication behaviors and restricted and repetitive behaviors. Measures of functioning were not associated with ADI‐R domain scores in nonverbal children, but negatively correlated in verbal children.Conclusions:  Overall, data suggested that autism symptomatology can be explained statistically with a two‐domain model. It also pointed to different symptoms susceptible to be helpful in linkage analyses. Implications of a two‐factor model are discussed.
Material Flows in Latin America
Authors: Russi Daniela , Gonzalez‐Martinez Ana C. , Silva‐Macher José Carlos , Giljum Stefan , Martínez‐Alier Joan , Vallejo Maria Cristina 
Published: December 2008

SummaryIn this article we compare the resource flows of Chile, Ecuador, Mexico, and Peru between 1980 and 2000. Our objective is to analyze the structure of social metabolism of extractive countries and the consequences of the neoliberal economic structural reforms on the use of natural resources. In two decades, the domestic extraction of materials increased considerably in the four countries, mainly due to the mining sector in Chile and Peru, biomass and oil in Ecuador, and construction minerals in Mexico. Imports and exports also increased, because of the increasingly deeper integration in international markets, prompted by liberalization policies implemented in the four countries between the late 1970s and the late 1990s. All four countries had a negative physical trade balance for most of the period analyzed, with exports exceeding imports in terms of weight. However, parallel growth of imports reduced the physical deficit in Chile, Mexico, and Peru. Ecuador's physical deficit was the highest and did not decrease during the last two decades. A diversification of exports away from bulk commodities could be observed in Chile and Mexico and to a lesser extent in Peru, whereas in Ecuador the export sector remained mainly based on oil and biomass. More research is needed to explore the environmental and social impacts of the neoliberal economic reforms. Also, the indirect flows associated with direct physical imports and exports deserve to be subjected to further analysis.
Australia's Resource Use Trajectories
Authors: Schandl Heinz , Poldy Franzi , Turner Graham M. , Measham Thomas G. , Walker Daniel H. , Eisenmenger Nina 
Published: December 2008

SummaryAustralia's export‐oriented large natural resources sectors of agriculture and mining, the ways large‐scale services, such as nutrition, water, housing, transport and mobility, and energy are organized, and the consumption patterns of Australia's wealthy urban households, create a unique pattern of overall resource use in Australia. In an attempt to contribute to a new environmental information system compatible with economic accounts, we represent Australia's resource use by employing standard biophysical indicators for resource use developed within the Organisation for Economic Co‐operation and Development (OECD) context. We look at the last 3 decades of resource use and the economic, social, and environmental implications. We also discuss scenarios of future resource use patterns based on a stocks and flows model of the Australian economy. We argue that current extractive economic patterns have contributed to the recent economic boom in Australia but will eventually lead to negative social and environmental outcomes. Although there is currently little evidence of political support for changing the economic focus on export‐oriented agriculture and mining industries, there is significant potential for improvements in socio‐technological systems and room for more sustainable household consumption.
Industrialization, Fossil Fuels, and the Transformation of Land Use
Authors: Erb Karl‐Heinz , Gingrich Simone , Krausmann Fridolin , Haberl Helmut 
Published: December 2008

SummaryHuman‐induced changes in global stocks and flows of carbon are major drivers of global climate change. This article presents a comprehensive and systemic account of a nation's carbon budget, comprising socioeconomic as well as ecological carbon flows in a historic time series. The example of Austria 1830–2000, for which excellent databases facilitate a comprehensive assessment, suggests that changes in socioeconomic metabolism during the agrarian−industrial transition are intimately linked with changes in land use and natural carbon flows. In the preindustrial agrarian colonization of Austria (during the thousands of years before 1830), a huge amount of carbon was released due to the expansion of agricultural land. At the dawn of Austria's industrialization (1830–1880), this process was terminated, and carbon inflows and outflows of ecosystems were approximately balanced. With rising fossil fuel consumption, Austria's socioeconomic system added growing amounts of carbon to the atmosphere each year. At the same time, fossil‐fuel‐powered surges in the productivity of agro‐ecosystems facilitated the production of growing amounts of agricultural biomass on shrinking agricultural areas. This greatly enhanced ecological carbon flows and, together with decreasing pressures on forests, allowed ecosystems to recover from past depletion and absorb increasing amounts of carbon. The systematic interlinkage between the socioeconomic energy system and carbon flows in ecosystems, as documented in this study, underlines the need for comprehensive and consistent analyses of society−nature interaction to develop monitoring tools and support strategies aimed at a more sustainable future.