bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre‐operative high sensitivity C‐reactive protein and postoperative outcome in patients undergoing elective orthopaedic surgery
Authors: Ackland G. L. , Scollay J. M. , Parks R. W. , De Beaux I. , Mythen M. G. 
Published: August 2007

SummaryHigh‐sensitivity C‐reactive protein (hsCRP) adds important prognostic information, not reflected by traditional risk factors, to the prediction of both the development and outcome of cardiovascular pathology. HsCRP levels also correlate inversely with cardiorespiratory fitness, an important determinant of peri‐operative outcome. We hypothesised that pre‐operative hsCRP should be associated with excess peri‐operative morbidity and longer length of stay. Pre‐operative hsCRP was measured blinded to standardised postoperative outcomes in 129 elective orthopaedic patients. HsCRP levels were divided into high (> 3 mg.l−1) or low (< 3 mg.l−1) groups (Center for Disease Control stratification). High‐CRP patients had significant cardiovascular history, received cardiac medication or steroid therapy (p < 0.05). Higher pre‐operative hsCRP was associated with longer length of stay: mean 7.5 days (95% CI: 6.2–8.8) vs 6.0 days (95% CI: 5.5–6.5; p = 0.03; log rank test). In 21 patients with > 8 days length of stay, high pre‐operative hsCRP patients were over‐represented (p = 0.04). Pre‐operative hsCRP is related to length of stay and delayed postoperative complications.
The effect of screening for cardio‐renal risk factors on drug use in the general population
Authors: Atthobari Jarir , Gansevoort Ron T. , Visser Sipke T. , De Jong Paul E. , De Jong‐van den Berg Lolkje T. W. ,   PREVEND study group
Published: August 2007

What is already know about this subject • Screening of the population may result in medicalization.• There is no report about the effect of a health screening programme on drug prescribing. What this study adds • Screening of the general population for cardiovascular risk factors does not lead to more drug prescribing, for either screening‐related or screening‐unrelated drugs.• The incidence of drug use increases in screened subjects with high risk, but only for drugs related to the purpose of screening.• For screening to be successful, i.e. increased drug use in the detected diseased subjects, it has to be performed in a population expected to be at increased risk.Aim To evaluate the effect of a cardio‐renal screening programme on desired and undue drug use.Methods Data from the PREVEND cohort (Prevention of REnal and Vascular ENd‐stage Disease) were used. The drug use of screened (randomly) selected subjects (n = 2650) was compared with unscreened subjects, matched for age and sex (n = 10 434). Drug use in the overall PREVEND cohort, enriched for albuminuria (n = 6751), was also studied. Screening‐related drugs (antihypertensive, antilipidaemic, antidiabetic and antithrombotic) were selected, as well as screening‐unrelated drugs (benzodiazepines, drugs for acid‐related disorders and painkillers). Time to first prescription after screening is presented as Kaplan–Meier curves.Results After 6.5 years of follow‐up, the incidence of drug use was not significantly different between the screened, randomly selected and unscreened cohorts. Antihypertensives were used by 21.5 and 20.8%, respectively; antilipidaemic 12.8 and 10.2%, antidiabetics 4.0 and 3.9%, and antithrombotic 11.4 and 12.0%. Screening‐unrelated drugs were used at comparable frequencies. Compared with the unscreened cohort, screening‐related drugs were prescribed more frequently for subjects in the enriched cohort (25.8, 15.5, 5.5 and 13.5% for antihypertensive, antilipidaemic, antidiabetic and antithrombotic, respectively), whereas screening‐unrelated drugs were used at comparable frequencies.Conclusions The incidence of drug use did not differ between the screened, randomly selected and unscreened cohorts. Screening does not lead to more drug prescription, thus arguing against the fear of undue medicalization after screening. The data also show that, for screening to be successful, it should be performed in a targeted population, such as one enriched for albuminuria.
A comparison of serum antivenom concentrations after intravenous and intramuscular administration of redback (widow) spider antivenom
Authors: Isbister Geoffrey K. , O'Leary Margaret , Miller Mark , Brown Simon G. A. , Ramasamy Sharmaine , James Rosemary , Schneider Jennifer S. 
Published: August 2007

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Widow spider antivenoms, including redback spider antivenom, are often given by the intramuscular route.• No studies have measured widow spider antivenom following intramuscular or intravenous antivenom.WHAT THIS STUDY ADDS• Intramuscular redback spider antivenom is not detectable in serum for at least 3–5 h after treatment. Intravenous antivenom is detectable 30 min after intravenous infusion.• Intramuscular antivenom may not be an effective administration route.AIMSThere are no studies measuring antivenom concentrations following intramuscular administration. This study aimed to compare antivenom concentrations following intravenous and intramuscular administration of redback spider antivenom (RBSAV).METHODSTwenty patients recruited to a controlled trial comparing intramuscular and intravenous administration of antivenom had serial blood samples collected at 30 min intervals for 2 h after the administration of one or two doses of antivenom. Antivenom concentration was measured using an enzyme immunoassay.RESULTSTen patients received intramuscular antivenom but antivenom could not be detected in serum after either one or two vials, at any time point. The median time of the final sample after commencement of antivenom treatment in these patients was 3.2 h (1.8–5 h). Ten patients received intravenous antivenom (three one vial and seven two or more vials) and antivenom was detected in all patients.CONCLUSIONSRBS AV given by the intramuscular route is unlikely to be effective in the treatment of redback (widow) spider bite.
Compressive properties of some Swedish and Danish structured agricultural soils measured in uniaxial compression tests
Authors: Keller T. , Arvidsson J. 
Published: August 2007

SummarySoil compaction is recognized as a threat to long‐term productivity of agricultural soils and as a cause of environmental problems such as flooding. The use of models to establish strategies for prevention of soil compaction is hampered by lack of model input parameters describing soil mechanical properties. This paper presents the compressive properties N (specific volume at σ = 1 kPa on the virgin compression line), Cc (compression index) and Cr (recompression index) obtained from uniaxial compression testing of 69 individual soil layers and investigates the relationships between these properties and readily quantifiable soil parameters. No correlation was found between compressive properties and soil texture. Instead, N, Cc and Cr were positively correlated to the initial specific volume (v0). This suggests that compressive properties are more strongly affected by soil structure than by soil texture. Dependency of compressive properties on v0 could not be expected from classical soil compressive behaviour theory but suggests modifications to the theory of soil unloading‐reloading behaviour. We suggest that the latter is dependent on time between unloading and reloading.
Effects of endotoxaemia on markers of permeability, metabolism and inflammation in the large bowel of healthy subjects
Authors: Jørgensen V. L. , Ibsen M. , Andresen L. , Schulzke J. D. , Perner A. 
Published: August 2007

Background:  Increased permeability and increased luminal concentrations of l‐lactate have previously been shown in the large bowel in septic patients. To advance these observations, a human model of colorectal barrier failure in sepsis is desirable. Therefore, we assessed the effects of endotoxaemia on markers of permeability, metabolism and inflammation in the large bowel in healthy subjects.Methods:  Twelve healthy male subjects received intravenous endotoxin (2 ng/kg body weight) or saline in a paired cross‐over design. Colorectal permeability was assessed after 3, 6, 9 and 12 h by the systemic recovery of luminally instilled 99mTc‐diethylenetriaminepentaacetate. Luminal concentrations of l‐lactate were assessed by equilibrium dialysis. Mucosal biopsies from the large bowel were sampled after 6 and 12 h, and the apoptotic ratio of the epithelium was assessed by terminal deoxynucleotidyl transferase‐mediated desoxyuridinetriphosphate nick end‐labelling (TUNEL) assay and the expression of inducible nitric oxide synthase (iNOS) mRNA by reverse transcriptase‐polymerase chain reaction.Results:  Systemic effects of endotoxaemia were observed, including fever, tachycardia and strongly increased plasma values of tumour necrosis factor‐α. By contrast, the colorectal permeability, luminal lactate concentrations, mucosal infiltration of inflammatory cells, epithelial apoptotic ratio and expression of iNOS were all unaffected by endotoxin.Conclusions:  No effect of a single intravenous dose of endotoxin was observed on markers of large bowel permeability, metabolism and inflammation in healthy subjects. This suggests that this part of the gut is relatively resistant to the systemic inflammation induced by experimental endotoxaemia in humans.
Anaesthesiological considerations in small‐incision and laparoscopic cholecystectomy in symptomatic cholecystolithiasis: implications for pulmonary function. A randomized clinical trial*
Authors: Keus F. , Ahmed Ali U. , Noordergraaf G. J. , Roukema J. A. , Gooszen H. G. , Van Laarhoven C. J. H. M. 
Published: August 2007

Background:  Upper abdominal surgery, including laparoscopic cholecystectomy (LC), is associated with post‐operative pulmonary dysfunction. LC has, by consensus, become the treatment of choice for symptomatic cholecystolithiasis. Small‐incision cholecystectomy (SIC), a procedure that does not require a pneumoperitoneum, threatens to be lost to clinical practice, even though there is evidence of equality. We hypothesized that the SIC technique should be equal, and might even be superior, to LC when considering post‐operative pulmonary function because of the short incision length.Methods:  A single‐centre randomized clinical trial was performed including patients scheduled for elective cholecystectomy. Pulmonary flow‐volume curves were measured pre‐operatively, post‐operatively and at follow‐up. Blood gas analyses were measured pre‐operatively, in the recovery phase and on post‐operative day 1. Anaesthesia, analgesics and peri‐operative care were standardized by protocol. Post‐operatively, patients and caregivers were blind to the procedure.Results:  Two hundred and fifty‐seven patients were analysed. There was one pulmonary complication (pneumonia) in the LC group. In both groups, similar reductions of approximately 20% in pulmonary function parameters occurred, with complete recovery to pre‐operative values. Patients in the SIC group consumed more analgesia when compared with the LC group, without any impact on blood gas analysis. Patients converted to a conventional open technique showed significant differences in six of the eight parameters in pulmonary function tests.Conclusion:  When evaluated with strict methodology and standardization of care, no clinically relevant differences were found between SIC and LC with regard to pulmonary function. Our results suggest that the popularity of the laparoscopic technique cannot be attributed to pulmonary preservation.
Management of nerves during leg amputation – a neglected area in our understanding of the pathogenesis of phantom limb pain
Authors: Rasmussen S. , Kehlet H. 
Published: August 2007

Background:  Chronic neuropathic pain after leg amputation is a significant problem, with a reported incidence during the first year as high as 70%. Intra‐operative handling of the nerves during amputation has not been discussed in the literature on post‐amputation pain and, in major textbooks, it is recommended that the ischial nerve be ligated, despite the fact that the experimental literature uses nerve ligations to produce neuropathic pain. The purpose of this study was to investigate the clinical practice of nerve handling during leg amputation.Methods:  Trainees with at least 2 years of practice received a questionnaire regarding handling of the nerves during leg amputation; 128 of 149 questionnaires sent (86%) were returned.Results:  Ligation of the nerves was used by 31% of surgeons.Conclusion:  There is no consistency in the management of the large nerves during lower leg amputation. The recommendations in major textbooks may not be appropriate when compared with the experimental literature on nerve ligature models to produce neuropathic pain. Future studies on post‐amputation pain should consider intra‐operative nerve management.
Comparison of transmucosal midazolam with inhalation sedation for dental extractions in children. A randomized, cross‐over, clinical trial
Authors: Wilson K. E. , Welbury R. R. , Girdler N. M. 
Published: August 2007

Background:  The transmucosal route for conscious sedation in children has been reported widely in the field of medicine, but less so in dental patients. The aim of this study was to evaluate the efficacy and safety profile of midazolam (0.2 mg/kg) administered by the buccal transmucosal route, in comparison with nitrous oxide/oxygen inhalation sedation, for orthodontic extractions in 10–16‐year‐old dental patients.Methods:  Each patient attended for two visits and was randomly allocated to receive buccal midazolam (0.2 mg/kg) or nitrous oxide/oxygen titrated to 30%/70% at the first visit, the alternative being used at the second visit. The patients’ vital signs, sedation levels and behavioural scores were recorded throughout. Post‐operatively, side‐effects, recall of the visit and satisfaction levels were recorded via questionnaire.Results:  Thirty‐six patients, with a mean age of 12.9 years, completed both arms of the trial. The maximum level of sedation was achieved with buccal midazolam in a mean time of 14.42 min, compared with 7.05 min with inhalation sedation. The vital signs with both types of sedation remained within acceptable limits and the reported side‐effects were of no clinical significance. Buccal midazolam was found to be acceptable by 65.7%. Only 28.6% of cases preferred this technique, the main disadvantage being the taste of the solution.Conclusion:  Buccal midazolam sedation (0.2 mg/kg) seems to be equally as safe and effective as nitrous oxide/oxygen for the extraction of premolar teeth in anxious children. However, further research is required to refine the midazolam vehicle to improve acceptability.
Norepinephrine in low to moderate doses may not increase luminal concentrations of l‐lactate in the gut in patients with septic shock*
Authors: Ibsen M. , Jørgensen V. L. , Perner A. 
Published: August 2007

Aim:  To investigate the effect of different doses of norepinephrine (noradrenaline) on luminal concentrations of l‐lactate in the rectum and stomach in patients with fluid‐resuscitated septic shock.Methods:  This was a paired cross‐over study in which the dose of norepinephrine was titrated to mean arterial blood pressures (MAPs) of 65 and 85 mmHg in random sequence. It was performed in a mixed intensive care unit at a university hospital. Eight patients with fluid‐resuscitated septic shock requiring norepinephrine (>0.1 μg/kg/min) were included. Patients were treated with norepinephrine to a MAP of either 65 or 85 mmHg for 2 h. After a ‘washout’ period of 2 h, the dose of norepinephrine was titrated to the other endpoint of MAP for another 2 h. The concentrations of l‐lactate in the rectal and gastric lumen were estimated by 1‐h equilibrium dialysis during the second hour of the treatment periods.Results:  MAP and central venous oxygen saturation were increased by increasing the dose of norepinephrine [median (range) (μg/kg/min): 0.07 (0.00–0.60) and 0.18 (0.11–1.00) at MAPs of 65 and 85 mmHg, respectively], whereas the metabolic markers were unaffected [luminal concentrations (mmol/l) of l‐lactate in the rectum of 1.9 (0.8–6.4) and 1.8 (0.9–5.7) (P =0.94) and in the stomach of 1.1 (0.1–10.0) and 1.3 (0.3–9.7) (P =0.88) at MAPs of 65 and 85 mmHg, respectively].Conclusion:  In this small study, luminal concentrations of l‐lactate in the rectum and stomach were unaffected by norepinephrine at low to moderate doses. These data suggest that norepinephrine may not increase luminal concentrations of l‐lactate in the gut in patients with fluid‐resuscitated septic shock.
Recreation Nonparticipation as Choice Behavior Rather Than Statistical Outcome
Authors: English Eric 
Published: August 2007

AbstractIn recreation demand models nonparticipation is usually estimated as the probability mass on zero demand given a positive level of expected demand and a discrete distribution of demand outcomes. Researchers have attempted to improve predictions of nonparticipation by modifying the parameters of the demand distribution. This study departs from previous approaches by explicitly incorporating nonparticipation into the behavioral model. The choice to participate is described by a distribution of preferences combined with a choke price on individual demands to distinguish participants from nonparticipants. The model is found to accurately predict nonparticipation and the size of the user group.
Voting for Environmental Policy Under Income and Preference Heterogeneity
Authors: Eerola Essi , Huhtala Anni 
Published: August 2007

AbstractWe examine the design of policies for promoting the consumption of green products under preference and income heterogeneity using organic food as an example. Two instruments are considered: a price subsidy for organic food products and a tax on conventional products. When the income differences and social benefits of organic farming are large, these factors dominate in shaping the policy preferences of the majority. In this case, the environmental policies preferred by the majority tend to be stricter than socially optimal policies. However, when income differences are small, policy preferences are more directly determined by tastes for organic products and the majority may prefer no intervention.
Cross‐subsidization Due to Inframarginal Support in Agriculture: A General Theory and Empirical Evidence
Authors: de Gorter Harry , Just David R. , Kropp Jaclyn D. 
Published: August 2007

AbstractA general theory of cross‐subsidization due to inframarginal support is developed. Two sources of output distortion are identified: exit deterrence and extramarginal output. Some firms would not be in business without the subsidy. Cost savings due to declining average costs are always greater than the losses incurred where price equals marginal cost. Moreover, it is theoretically possible for inframarginal subsidies to expand output more than equivalent fully coupled subsidies. Empirical analysis of U.S. dairy subsidies isolates these components of cross‐subsidization and finds distortions from inframarginal support to be substantial, with implications for trade negotiations, dispute settlement, and policy formulation.
Food Stamp Program Participation and Food Insecurity: An Instrumental Variables Approach
Authors: Yen Steven T. , Andrews Margaret , Chen Zhuo , Eastwood David B. 
Published: August 2007

AbstractThe relationship between Food Stamp Program (FSP) participation and household food insecurity (FI) is investigated using data from the 1996–1997 National Food Stamp Program Survey. Endogeneity of FSP participation is accommodated with an instrumental variables approach. In contrast to other findings reported in the literature, results suggest participation in the FSP reduces the severity of FI. Sociodemographic variables play important roles in FSP participation and FI. Underreporting of FSP participation and limited observations of food‐insecure households in previous studies may have also been factors.
The Role of Patent Rights in Mergers: Consolidation in Plant Biotechnology
Authors: Marco Alan C. , Rausser Gordon C. 
Published: August 2007

AbstractFew empirical studies have addressed the impact of the patent system on industry structure. Using firm‐level patent data for firms in plant biotechnology, we develop a measure of patent enforceability. Duration models show that patent statistics are useful predictors of the timing of consolidation and that patent enforceability is an important factor influencing the likelihood of consolidation. Acquisitions in plant biotechnology may be motivated by the enforcement of patent rights when firms have overlapping technologies; some merger activity may be explained by attempts to avoid mutually blocking technology, as exemplified by the case of Roundup Ready corn.
THEOLOGICAL ETHICS, THE CHURCHES, AND GLOBAL POLITICS
Authors: Cahill Lisa Sowle 
Published: August 2007

ABSTRACTSeveral discourses about theology, church, and politics are occurring among Christian theologians in the United States. One influential strand centers on the communitarian theology of Stanley Hauerwas, who calls on Christians to witness faithfully against liberalism in general and war in particular. Jeffrey Stout, in his widely discussed Democracy and Tradition (2004), responds that religious people ought precisely to endorse those democratic and liberal American traditions that join religious and secular counterparts to battle injustice. Hauerwas, Stout, and many of their interlocutors envision liberal U.S. culture as the context of Christian social ethics. The ensuing debate rarely incorporates Catholic scholars, feminist scholars, scholars of color, or international and liberationist voices. Their inclusion could enhance an understanding of the role of the church in society, and support a common morality in the face of global pluralism. More importantly, it could broaden the scope of discourse on religion and politics to envision global Christian social ethics.
AQUINAS ON ATTACHMENT, ENVY, AND HATRED IN THE SUMMA THEOLOGICA
Authors: Green Keith 
Published: August 2007

ABSTRACTThis essay examines Aquinas's discussions of hatred in Summa Theologica I‐II, Q. 29 and II‐II, Q. 34, in order to retrieve an account of what contemporary theorists of the emotions call its cognitive contents. In Aquinas's view, hatred is constituted as a passion by a narrative pattern that includes its intentional object, beliefs, perceptions of changes in bodily states, and motivated desires. This essay endorses Aquinas's broadly “cognitivist” account of passional hatred, in line with his way of treating passions in general. I suggest that Aquinas's account of hatred's arising out of attachment is compelling. However, I also argue that if Aquinas's treatment of hatred is to help us understand the phenomenon of hate, where classes of people are abominated for an identity they bear, and to avoid equating an oppressor's hatred with that of the oppressed for the oppressor, the cognitive pathway to hatred must be broader than through envy.
GOD, WAR, AND CONSCIENCE
Authors: Eberle Christopher J. 
Published: August 2007

ABSTRACTMany military officers believe that they morally ought to obey legal orders to fight even in unjust wars: they have a moral obligation to exercise indiscriminate obedience to legal orders to fight. I argue that officers should not be required to exercise indiscriminate obedience: certain theistic commitments to which many citizens and officers adhere prohibit indiscriminate obedience to legal orders to fight. This theistic argument constitutes adequate reason not to require officers to exercise indiscriminate obedience. However, this raises a further question: namely, whether it is appropriate to rely on such a theistic argument when shaping the moral requirements of military officership. I argue that citizens and officers have good reason to make public decisions solely on religious grounds and so are free to follow my theistic argument when shaping the requirements of military officership.