bluuebunny/crossref_metadata_2025_split huggingface dataset:
LINKING POETRY, PAINTING, AND PRINTS: THE MODE OF POETIC PICTURES IN LATE MING ILLUSTRATIONS TO THE STORY OF THE WESTERN WING
Authors: Ma Meng-Ching 
Published: January 2008

AbstractThis paper explores a specific mode of illustrations to accompany the most popular dramatic publication in late Ming, The Story of the Western Wing. The visual interpretations of the play will be discussed side by side with the commentaries attributed to contemporary eminent literary figures, in order to examine the common change in reading mentality. Analysis of the image–text relationship for each of the pictures in those editions under discussion reveals that they all relate to the script with the caption taken from the text. Unlike the previous illustrated editions in a narrative mode, the pictures represent the fragmented poetic sentences instead of the narrative text of the play. The caption, a fragmented segment of the text, therefore becomes the key element that relates the image to the text. For the illustrator, it was probably more important to find a key line and a matching scene from the visual repertoire than it was to expound the essence of the script. The emerging mode of “poetic pictures” not only emphasized the poetic quality of the text, but also incorporated visual elements learned from traditional brush painting. The sophisticated integration of poetry and painting into the comparatively popular form of prints attested to the publishers' pursuit of artistic prestige, and the shift in illustrations for narratives during this period.
TAIWANESE STUDIES OF TRADE CERAMICS: AT THE INTERSECTION OF INDIGENOUS AND INTERNATIONAL HISTORIOGRAPHY
Authors: Sakai Takashi 
Published: January 2008

AbstractHsieh Ming-liang. Maoyi taoci yu wenhuashi 貿易陶瓷與文化史 (Trade Ceramics and Cultural History). Taipei: Yunchen Wenhua, 2005. Pp. 399 + 9 colour plates.
Cognitive deficits of schizophrenia: the flower workshop initiative
Authors: Ornellas Pereira Maria Alice , Pereira Alfredo 
Published: January 2008

AbstractAdvancement of research on the neurobiology of the schizophrenic brain has revealed a complex of factors, from genetic tendencies affecting the development of brain structure to functional impairment caused by defective molecular signaling. Recently, the attention of psychiatrists and mental health professionals has been directed to the presence of cognitive deficits, responsible for most of the obstacles to the social insertion of patients.The schizophrenic person has a difficulty to manage the flux of consciousness in social interactions. We address this difficulty with the Flower Arrangement Workshop, a methodology of Psycho-Social Rehabilitation that reduces the vulnerability of the schizophrenic in the social environment. The workshop was offered regularly (18 months) for a group containing 4 schizophrenic subjects.
Early postpartum symptoms in puerperal psychosis
Authors: Heron J , McGuinness M , Blackmore E Robertson , Craddock N , Jones I 
Published: January 2008

Objective To examine the nature of the earliest reported symptoms in women who develop a bipolar affective puerperal psychosis (PP).Design A retrospective interview study.Setting Women were recruited for clinical and molecular genetic studies of PP from a national PP network, articles in the national press and referrals from UK specialist perinatal psychiatry services.Sample One hundred and twenty‐seven women met the criteria for an episode of strictly defined bipolar affective PP developing within 4 weeks of childbirth.Methods Participants were interviewed using the Schedule for clinical assessment in neuropsychiatry and hospital records were reviewed. Lifetime and puerperal episode diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV) based on all the available information. During interview, participants were asked to describe the earliest symptoms they believed to be related to their illness onset. The day of onset for each symptom was recorded.Main outcome measures We present subjectively experienced emotional and behavioural changes occurring within 3 days of childbirth, reported by four or more women.Results Seventy‐three percent of women recalled experiencing an onset of symptoms by day 3. The most commonly recalled symptoms were feeling excited, elated or high (52%), not needing to sleep or not able to sleep (48%), feeling active or energetic (37%) and talking more or feeling very chatty (31%).Conclusions Hypomanic symptoms are particularly characteristic of the early postpartum in women who develop PP. These types of symptoms should be carefully monitored in individuals at high risk of PP episodes.
Severe asphyxia due to delivery‐related malpractice in Sweden 1990–2005
Authors: Berglund S , Grunewald C , Pettersson H , Cnattingius S 
Published: January 2008

Objective  To describe possible causes of delivery‐related severe asphyxia due to malpractice.Design and setting  A nationwide descriptive study in Sweden.Population  All women asking for financial compensation because of suspected medical malpractice in connection with childbirth during 1990–2005.Method  We included infants with a gestational age of ≥33 completed gestational weeks, a planned vaginal onset of delivery, reactive cardiotocography at admission for labour and severe asphyxia‐related outcomes presumably due to malpractice. As asphyxia‐related outcomes, we included cases of neonatal death and infants with diagnosed encephalopathy before the age of 28 days.Main outcome measure  Severe asphyxia due to malpractice during labour.Results  A total of 472 case records were scrutinised. One hundred and seventy‐seven infants were considered to suffer from severe asphyxia due to malpractice around labour. The most common events of malpractice in connection with delivery were neglecting to supervise fetal wellbeing in 173 cases (98%), neglecting signs of fetal asphyxia in 126 cases (71%), including incautious use of oxytocin in 126 cases (71%) and choosing a nonoptimal mode of delivery in 92 cases (52%).Conclusion  There is a great need and a challenge to improve cooperation and to create security barriers within our labour units. The most common cause of malpractice is that stated guidelines for fetal surveillance are not followed. Midwives and obstetricians need to improve their shared understanding of how to act in cases of imminent fetal asphyxia and how to choose a timely and optimal mode of delivery.
Vaginal surgery for pelvic organ prolapse using mesh and a vaginal support device
Authors: Carey M , Slack M , Higgs P , Wynn‐Williams M , Cornish A 
Published: January 2008

Objectives  To describe a new surgical procedure for pelvic organ prolapse using mesh and a vaginal support device (VSD) and to report the results of surgery.Design  A prospective observational study.Setting  Two tertiary referral Urogynaecology practices.Population  Ninety‐five women with International Continence Society pelvic organ prolapse quantification stage 2 or more pelvic organ prolapse who underwent vaginal surgery using mesh augmentation and a VSD.Methods  Surgery involved a vaginal approach with mesh reinforcement and placement of a VSD for 4 weeks. At 6 and 12 months, women were examined for prolapse recurrence, and visual analogue scales for satisfaction were completed. Women completed quality‐of‐life (QOL) questionnaires preoperatively and at 6 and 12 months.Main outcome measures  Objective success of surgery at 6 and 12 months following surgery. Secondary outcomes were subjective success, complications, QOL outcomes and patients’ satisfaction.Results  Objective success rate was 92 and 85% at 6 and 12 months, respectively. Subjective success rate was 91 and 87% at 6 and 12 months, respectively. New prolapse in nonrepaired compartments accounted for 7 of 12 (58%) failures at 12 months. Two of 4 mesh exposures required surgery. Sexual dysfunction was reported by 58% of sexually active women preoperatively and 23% at 12 months. QOL scores significantly improved at 12 months compared with baseline (P < 0.0001).Conclusion  Vaginal surgery using mesh and a VSD is an effective procedure for pelvic organ prolapse. However, further studies are required to establish the role of the surgery described in this study.
Inappropriate Use of Emergency Medical Services Transport: Comparison of Provider and Patient Perspectives
Authors: Richards John R. , Ferrall Stephen J. 
Published: January 2008

Objectives: To determine the extent of inappropriate ambulance use from the perspectives of both emergency medical services (EMS) providers and patients utilizing EMS transport, assess level of agreement, and identify variables associated with inappropriate ambulance use. Methods: A prospective cross‐sectional study was done of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban university hospital ED. EMS providers and patients completed a survey with questions regarding their perceptions of whether the need for ambulance transport was an emergency or a nonemergency. Patient demographic information and availability of alternate means of transportation to the hospital were also evaluated.Results: Eight hundred eighty‐seven patients were included in the study. EMS providers thought that 501 patient transports were appropriate and represented true emergencies, whereas 689 patients believed their medical problems were true emergencies. A significant number of patients (n = 415, 47%) had access to alternative transportation to the hospital. Blunt traumatic injury and altered mental status were the most common reasons for EMS transport. Patient characteristics significantly associated with EMS provider perception of a true emergency were male gender, age >51 years, higher education, chest pain/cardiac complaints, shortness of breath/respiratory complaints, and Medicare insurance. Characteristics significantly associated with patients who perceived themselves to have true emergencies were black ethnicity, higher education, shortness of breath/respiratory complaints, and Medicare insurance. There was 75% agreement between EMS providers and patients on appropriateness of ambulance transport (kappa = 0.84). Conclusion: Inappropriate ambulance use is a significant problem from both EMS provider and patient perspectives. Certain patient characteristics are associated with a higher probability of appropriate and inappropriate uses of EMS transport. A large number of patients transported by ambulance have alternative means of transportation but elect not to use them.
Minor Head Trauma in Anticoagulated Patients
Authors: Garra Gregory , Nashed Ashraf H. , Capobianco Leo 
Published: January 2008

AbstractObjective: To determine the incidence of clinically significant intracranial injury in the anticoagulated patient suffering minor head trauma without loss of consciousness (LOC) or acute neurologic abnormality. Methods: A retrospective chart review was performed based on a computerized search of electronic patient records from six community hospital EDs, one of which is a trauma center. Patients taking warfarin who sustained minor head trauma without LOC having no acute neurologic abnormalities treated from January 1994 to January 1996 were identified using a search of electronic ED records. Charts were reviewed for mechanism of injury, physical examination findings of head injury, and concomitant injury. Prothrombin time and head CT results were recorded if obtained. For those patients not receiving a head CT on ED evaluation, telephone follow‐up was performed to determine outcome. Results: There were 65 patients meeting inclusion criteria. Thirty‐eight patients had prothrombin times obtained, with ranges from 12.0 sec to 30.7 sec. There was no intracranial injury found in any of the 39 patients having a head CT. Additionally, follow‐up on the 26 patients who did not undergo CT scanning revealed no evidence of complications related to their head injuries. Conclusions: The incidence of clinically significant intracranial injury is extremely low in the anticoagulated patient suffering minor blunt head trauma without LOC or acute neurologic abnormality. CT scanning may not be necessary in these patients. Larger prospective studies are needed to confirm these findings.
Proposed Fellowship Training Program in International Emergency Medicine
Authors: VanRooyen Michael J. , Clem Kathleen J. , Holliman C. James , Wolfson Allan B. , Green Gary , Kirsch Thomas D. 
Published: January 2008

AbstractInterest in international emergency medicine (EM) has grown steadily over the last ten years. This growth has been fueled by increased demand for emergency services abroad and the proliferation of emergency physicians (EPs) working in international relief and development. As a response, several academic EM programs have developed international EM fellowships for the purpose of providing formal training to EPs interested in international health. Although there have been preliminary articles describing fellowship curricula, to the authors' knowledge no recommendations have been proposed by national consensus that suggest emphasis or required components of a fellowship program. Therefore, a group of EPs interested in fellowship training convened for the purpose of developing goals and objectives for a postgraduate training program in international EM. To that end, this article proposes guidelines for a fellowship training program for international EM.
Octylcyanoacrylate for the Treatment of Contaminated Partial‐thickness Burns in Swine A Randomized Controlled Experiment
Authors: Singer Adam J. , Mohammad Mazhar , Tortora George , Thode Henry C. , McClain Steve A. 
Published: January 2008

AbstractObjective: To compare infection and reepithelialization rates of contaminated second‐degree burns treated with octylcyanoacrylate (OCA), silver sulfadiazine (SSD), polyurethane (PU) film, and dry gauze (control; C) in swine. Methods: Eighty standardized burns were created by applying an aluminum bar preheated to 80°C to the backs and flanks of young pigs for 20 seconds. All burns were immediately contaminated with 0.1 mL of Staphylococcus aureus 105/mL and randomly treated with OCA spray, SSD, PU, or dry gauze (C). Full‐thickness biopsies were taken at 3, 7, and 14 days for blinded histopathologic evaluation using hematoxylin and eosin (H&E)‐stained slides. Burns were considered infected in the presence of interstitial reticular dermal neutrophils containing bacteria (intraobserver agreement, κ= 1.00). Quantitative wound cultures were performed on a second day‐3 specimen. Results: At day 3, wound infection rates were 30% (OCA), 50% (SSD), 55% (PU), and 50% (C); p = 0.40 (Kruskal‐Wallis test). At day 7, infection rates were 35% (OCA), 85% (SSD), 70% (PU), and 65% (C); p = 0.01. Median bacterial counts at day 3 were 6,500 (OCA), 20,000 (SSD), 1,000,000 (PU), and 650,000 (C); p = 0.29. The proportion of completely reepithelialized wounds at day 14 were 75% (OCA), 90% (SSD), 85% (PU), and 90% (C); p = 0.50. Conclusions: Treatment of contaminated partial‐thickness burns with OCA spray resulted in fewer infections at one week than with the other three treatments.
A Combination of Midazolam and Ketamine for Procedural Sedation and Analgesia in Adult Emergency Department Patients
Authors: Chudnofsky Carl R. , Weber James E. , Stoyanoff Peter J. , Colone Pino D. , Wilkerson Mark D. , Hallinen Diane L. , Jaggi F. Michael , Boczar Michael E. , Perry Marcia A. 
Published: January 2008

AbstractObjective: To describe the clinical characteristics of a combination of midazolam and ketamine for procedural sedation and analgesia in adult emergency department (ED) patients. Methods: This was a prospective, observational trial, conducted in the ED of an urban level II trauma center. Patients ≥ 18 years of age requiring procedural sedation and analgesia were eligible, and enrolled patients received 0.07 mg/kg of intravenous midazolam followed by 2 mg/kg of intravenous ketamine. Vital signs were recorded at regular intervals. The adequacy of sedation, adverse effects, patient satisfaction, and time to reach discharge alertness were determined. Descriptive statistics were calculated using statistical analysis software. Results: Seventy‐seven patients were enrolled. Three were excluded due to protocol violations, three due to lack of documentation, and one due to subcutaneous infiltration of ketamine, leaving 70 patients for analysis. The average age was 31 years, and 41 (59%) were female. Indications for procedural sedation and analgesia included abscess incision and drainage (66%), fracture/joint reduction (26%), and other (8%). The mean dose of midazolam was 5.6 ± 1.4 mg and the mean dose of ketamine was 159 ± 42 mg. The mean time to achieve discharge criteria was 64 ± 24 minutes. Fivepatients experienced mild emergence reactions, but there were no episodes of hallucinations, delirium, or other serious emergence reactions. Eighteen (25%) patients recalled dreaming while sedated; twelve (17%) were described as pleasant, two (3%) unpleasant, three (4%) both pleasant and unpleasant, and one (1%) neither pleasant nor unpleasant. There were four (6%) cases of respiratory compromise, two (3%) episodes of emesis, and one (1%) case of myoclonia. All of these were transient and did not result in a change in the patient's disposition. Only one (1%) patient indicated that she was not satisfied with the sedation regimen. Conclusions: The combination of midazolam and ketamine provides effective procedural sedation and analgesia in adult ED patients, and appears to be safe.
Prospective Confirmation of Low Arrest Rates among Intoxicated Drivers in Motor Vehicle Crashes
Authors: Lahn Michael , Gallagher E. John , Li Siu Fai , Touger Michael , Olmedo Ruben 
Published: January 2008

AbstractObjective: Several states have legally sanctioned or mandated physician reporting of drivers who were driving while intoxicated (DWI). Valid prospective evidence demonstrating extremely poor performance of the criminal justice system seems ethically and scientifically essential if overriding public health considerations are to abrogate the fundamental principles of patient—physician confidentiality. No such evidence is available. The authors reasoned that poor performance of the judicial system would be most evident if drivers who were DWI were not arrested under conditions selected to optimize legal intervention. The authors therefore wished to estimate the unbiased proportion of DWI drivers brought to an emergency department (ED) under these optimized conditions who escape detection by law enforcement officials. Methods: Prospective, consecutive cohort of drivers transported to an urban ED following a motor vehicle crash (MVC). Conditions selected to optimize legal intervention included: police at scene; inebriation of driver clinically evident to out‐of‐hospital personnel; and confirmatory blood ethanol level ≥100 mg/dL (≥22 mmol/L). Main outcome measure was arrest for DWI. Results: Of 294 drivers in MVCs, 270 had ethanol levels, of whom 18 met criteria for optimum likelihood of legal intervention. Of these, 22% were arrested for DWI (95% CI = 6% to 48%). Adjustment for missing data, under assumptions designed to maximize arrest frequency for DWI, did not materially alter these findings. No patients were lost to follow‐up. Conclusion: These findings prospectively confirm that, even under conditions selected to optimize detection by law enforcement officials, only about one of every five drivers who were DWI and were brought to an ED following an MVC—and almost certainly no more than a minority—comes to the attention of the criminal justice system.
Do Diabetic Patients Have Higher In‐hospital Complication Rates When Admitted from the Emergency Department for Possible Myocardial Ischemia?
Authors: Richman Peter B. , Brogan Gerard X. , Nashed Ashraf H. , Hollander Judd E. , Thode Henry C. 
Published: January 2008

AbstractObjective: To compare in‐hospital complication rates for diabetic and nondiabetic patients admitted from the emergency department (ED) for possible myocardial ischemia. Methods: This was a prospective, observational study of consecutive consenting patients presenting to a suburban university hospital ED during study hours with typical and atypical symptoms consistent with cardiac ischemia. Demographic, historical, and clinical data were recorded by trained research assistants using a standardized, closed‐question, data collection instrument. Inpatient records were reviewed by trained data abstractors to ascertain hospital course and occurrence of complications. Final discharge diagnosis of acute myocardial infarction (AMI) was assigned by World Health Organization criteria. Categorical and continuous data were analyzed by chi‐square and t‐tests, respectively. All tests were two‐tailed with alpha set at 0.05. Results: There were 1,543 patients enrolled who did not have complications at initial presentation; 283 were diabetic. The rule‐in rate for AMI was 13.8% for nondiabetic patients and 17.7% for diabetic patients (p = 0.09). Times to presentation were similar for nondiabetic vs diabetic patients [248 minutes (95% CI = 231 to 266) vs 235 minutes (95% CI = 202 to 269); p = 0.32]. Nondiabetic patients tended to be younger [56.6 years (95% CI = 55.8 to 57.4) vs 61.6 years (95% CI = 60.2 to 63.1); p = 0.001] and were less likely to be female (34.3% vs 48.1%; p = 0.001). The two groups had similar prevalences for initial electrocardiograms diagnostic for AMI (5.5% vs 7.4%; p = 0.21). There was no significant difference between nondiabetic and diabetic patients for the occurrence of the following complications after admission to the hospital: congestive heart failure (1.3% vs 1.1%, p = 0.77); nonsustained ventricular tachycardia (VT) (1.3% vs 1.2%, p = 0.93); sustained VT (1.2% vs 1.1%, p = 0.85); supraventricular tachycardia (1.7% vs 3.2%, p = 0.12); bradydysrhythmias (1.9% vs 1.1%, p = 0.33); hypotension necessitating the use of pressors (0.9% vs 1.1%, p = 0.76); cardiopulmonary resuscitation (0.2% vs 0.7%, p = 0.10); and death (0.3% vs 0.7%, p = 0.34). One or more complications occurred with similar frequencies for patients in the two groups (6.3% vs 5.7%; p = 0.70). Conclusions: No statistically significant difference was found in the post‐admission complication rates for initially stable diabetic vs nondiabetic patients admitted for possible myocardial ischemia. Based on these results, the presence or absence of diabetes as a comorbid condition does not indicate a need to alter admitting decisions with respect to risk for inpatient complications.