bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Confusion Assessment Method—A Tool for Delirium Detection by the Acute Pain Service
Authors: Friedman Zeev , Qin Jing , Berkenstadt Haim , Katznelson Rita 
Published: August 2008

AbstractIntroduction:  Delirium is an acute fluctuating disturbance in cognitive status, linked to increased morbidity and mortality. The purpose of this pilot study was to assess the feasibility in terms of required time and yield of delirium monitoring by the Acute Pain Service (APS) using the Confusion Assessment Method for Intensive Care Unit instrument.Methods:  Patients undergoing surgery requiring more than 2 days of hospital stay were recruited. Each patient was assessed daily for 2 days after surgery using the Confusion Assessment Method for Intensive Care Unit. Patients were also assessed for orientation to person, place, and time. Any notes of confusion or delirium made by physicians or nursing staff were gathered.Results:  145 patients were recruited. Each patient encounter required an average 2.3 ± 0.3 minutes for the assessment (95% CI). The incidence of delirium within 2 days after surgery was 7.6%. Only 18% of the patients diagnosed with delirium by the APS were noted as being confused by the medical or nursing staff.Conclusions:  The use of this tool required little training, and only 2 minutes per patient. It detected more patients with delirium than did the standard nursing assessments or other patient‐clinician interactions. The use of this instrument by the pain service was feasible in terms of time consumption and most likely would be valuable in its yield. Early detection may help in initiating prompt treatment, eliminating known risk factors and thus reducing morbidity.
Eight Hours of Hypotensive versus Normotensive Resuscitation in a Porcine Model of Controlled Hemorrhagic Shock
Authors: Skarda David E. , Mulier Kristine E. , George Mark E. , Beilman Greg J. 
Published: August 2008

AbstractObjectives:  The aim of this study was to compare hypotensive and normotensive resuscitation in a porcine model of hemorrhagic shock.Methods:  This was a prospective, comparative, randomized survival study of controlled hemorrhagic shock using 28 male Yorkshire‐Landrace pigs (15 to 25 kg). In 24 splenectomized pigs, the authors induced hemorrhagic shock to a systolic blood pressure (sBP) of 48 to 58 mm Hg (∼35% bleed). Pigs were randomized to undergo normotensive resuscitation (sBP of 90 mm Hg, n = 7), mild hypotensive resuscitation (sBP of 80 mm Hg, n = 7), severe hypotensive resuscitation (sBP of 65 mm Hg, n = 6), or no resuscitation (n = 4). The authors also included a sham group of animals that were instrumented and splenectomized, but that did not undergo hemorrhagic shock (n = 4). After the initial 8 hours of randomized pressure‐targeted resuscitation, all animals were resuscitated to a sBP of 90 mm Hg for 16 hours.Results:  Animals that underwent severe hypotensive resuscitation were less likely to survive, compared with animals that underwent normotensive resuscitation. Mean arterial pressure (MAP) decreased with hemorrhage and increased appropriately with pressure‐targeted resuscitation. Base excess (BE) and tissue oxygen saturation (StO2) decreased in all animals that underwent hemorrhagic shock. This decrease persisted only in animals that were pressure target resuscitated to a sBP of 65 mm Hg.Conclusions:  In this model of controlled hemorrhagic shock, initial severe hypotensive pressure‐targeted resuscitation for 8 hours was associated with an increased mortality rate and led to a persistent base deficit (BD) and to decreased StO2, suggesting persistent metabolic stress and tissue hypoxia. However, mild hypotensive resuscitation did not lead to a persistent BD or to decreased StO2, suggesting less metabolic stress and less tissue hypoxia.
Effects of cytomegalovirus infection on the mRNA expression of collagens and matrix metalloproteinases in gingival fibroblasts
Authors: Botero J. E. , Contreras A. , Parra B. 
Published: August 2008

Background and Objective:  The purpose of this in vitro investigation was to study the effects of human cytomegalovirus infection on the mRNA expression for collagens I and III and for matrix metalloproteinases 1 and 2 in gingival fibroblasts.Material and Methods:  Gingival fibroblasts were experimentally infected with the Towne strain of human cytomegalovirus and the kinetics of expression of mRNA for collagens I and III and for matrix metalloproteinases 1 and 2 was studied at different time‐points. Total RNA was isolated at the indicated time, and the reverse transcription–polymerase chain reaction was used to analyze the level of mRNA expression. In addition, gingival specimens were obtained from 14 periodontitis and from three non‐periodontitis subjects and mRNA analysis for collagens and metalloproteinases was carried out. Nested polymerase chain reaction was used to determine the presence or absence of human cytomegalovirus in subgingival samples from each subject.Results:  The infection of gingival fibroblasts with human cytomegalovirus during a 0–72‐h period resulted in progressive reduction in the expression of mRNA for collagens I and III (p < 0.05). A higher concentration of human cytomegalovirus resulted in varying degrees of mRNA reduction, suggesting a virally mediated effect. Biopsies from human cytomegalovirus‐positive individuals with periodontitis had a higher expression of mRNA for collagens I and III than biopsies from human cytomegalovirus‐negative individuals. An up‐regulation in the mRNA expression of matrix metalloproteinases 1 and 2 over time was observed (p < 0.05). Analysis of mRNA expression in gingival biopsies demonstrated higher expression of matrix metalloproteinase‐1 in human cytomegalovirus‐positive periodontitis specimens compared with human cytomegalovirus‐negative periodontitis specimens.Conclusion:  Altered expression of mRNA for collagens and metalloproteinases in human cytomegalovirus‐infected gingival fibroblasts should be considered as possible modifying mechanisms in periodontitis‐infected sites.
The gingipains from Porphyromonas gingivalis do not directly induce osteoclast differentiation in primary mouse bone marrow cultures
Authors: Fitzpatrick R. E. , Campbell P. D. , Sivagurunathan S. , Pagel C. N. , Potempa J. , Mackie E. J. , Pike R. N. 
Published: August 2008

Background and Objective:  Porphyromonas gingivalis is a major aetiological agent in the development of periodontitis, the major clinical hallmark of which is bone resorption. The cysteine proteases (gingipains) produced by P. gingivalis have a critical role in the pathogenesis of the disease, and previous studies on whole bacteria have implicated these enzymes in osteoclastogenesis, a process which serves to upregulate bone resorption. The effects of the gingipains from P. gingivalis on osteoclast differentiation were investigated here to determine whether the enzymes directly contribute to osteoclastogenesis and thus to bone resorption.Material and Methods:  The effects of the gingipains on osteoclast differentiation were investigated in primary mouse bone marrow cultures. The cultures harvested from C57BL6/J mice were incubated in the presence of parathyroid hormone, a known osteoclastogenic factor, or active/inactivated forms of three gingipains. Osteoclast differentiation was quantified by counting the number of multinucleated cells positive for tartrate‐resistant acid phosphatase, an enzyme marker for these cells.Results:  After 10 days of culture, the gingipains, either active or inactive, failed to stimulate osteoclast differentiation in comparison to the parathyroid hormone.Conclusion:  The data presented here demonstrate that the gingipains do not induce osteoclast differentiation in this system, indicating that the bacterium uses other mechanisms to induce bone loss.
Cultural Organizations and the State: Art and State Support in Contemporary Britain
Authors: Alexander Victoria D. 
Published: August 2008

AbstractOnly a small proportion of research in the sociological field of arts and culture is on the state and its effects. Literature which touches on this topic often comes from the policy arena and the wide variety of disciplines interested in public policy. Research tends to focus on two key themes: funding and censorship. But the effects of state actions are much broader. Moreover, state support is often set in opposition to the market, but markets and state systems usually exist together. It is ironic that the effects of the state on cultural organizations are increasingly studied at just this point in time, when states are scaling back their involvement and privatization is coming to the fore. Focusing on cultural organizations usually associated with the fine arts (museums and performing arts organizations), I illustrate some of these themes with a discussion of recent events in the UK.
From C. P. Ellis to School Integration: The Social Psychology of Conflict Reduction
Authors: Kelly Sean , Collett Jessica L. 
Published: August 2008

AbstractIn this article, the authors review social psychological theories of intergroup conflict reduction. Emphasis is placed on three interrelated social conditions which facilitate conflict reduction: intergroup contact, superordinate goals, and shared identities. Bridging experimental research with real‐world studies of schooling, these concepts are applied to understanding the process of school integration. Social contexts which present conflicting parties with a new shared goal and identity, as well as opportunities to become familiar with others beyond stereotypes and anxious reactions, dramatically increase the likelihood of diffusing conflict.
Multiple effects of bevacizumab in angiogenesis: implications for its use in age‐related macular degeneration
Authors: Carneiro Angela , Falcão Manuel , Azevedo Isabel , Falcão Reis Fernando , Soares Raquel 
Published: August 2008

Abstract.Purpose:  This study aimed to elucidate the precise effects of bevacizumab in all steps in the neovascularization process in endothelial cells.Methods:  Human umbilical vein endothelial cells (HUVECs) were incubated with bevacizumab at concentrations within the clinically established range or with identical amounts of excipient. Cell cytotoxicity (evaluated by MTT assay), proliferation (by BrdU incorporation assay), apoptosis (by TUNEL assay), migration (by double‐chamber assay) and vessel assembly in matrigel‐coated plates were assessed in vitro. Mouse plug matrigel assays were performed to confirm in vitro results.Results:  Incubation of HUVECs with bevacizumab did not present cytotoxicity. Concentrations comparable with those after intravitreal doses of bevacizumab significantly reduced proliferation and migration capacity, and increased apoptotic rates in these cells. In addition, bevacizumab led to a significant decrease in the assembly of capillary‐like structures on matrigel assay in comparison with excipient‐treated cells. Further substantiating these in vitro findings, bevacizumab also inhibited angiogenesis in a mouse plug matrigel assay, as evaluated by haemoglobin content levels.Conclusions:  These results demonstrate that clinical doses of bevacizumab are able to prevent several steps of the angiogenic process. Bevacizumab is thus currently recommended for treating disorders that present augmented angiogenesis.
Comparison of Two PCR-Based Human Papillomavirus Genotyping Methods
Authors: Castle Philip E. , Porras Carolina , Quint Wim G. , Rodriguez Ana Cecilia , Schiffman Mark , Gravitt Patti E. , González Paula , Katki Hormuzd A. , Silva Sandra , Freer Enrique , Van Doorn Leen-Jan , Jiménez Silvia , Herrero Rolando , Hildesheim Allan ,   for the CVT Group
Published: August 2008

ABSTRACT

We compared two consensus primer PCR human papillomavirus (HPV) genotyping methods for the detection of individual HPV genotypes and carcinogenic HPV genotypes as a group, using a stratified sample of enrollment cervical specimens from sexually active women participating in the NCI/Costa Rica HPV16/18 Vaccine Efficacy Trial. For the SPF
10
method, DNA was extracted from 0.1% of the cervical specimen by using a MagNA Pure LC instrument, a 65-bp region of the HPV L1 gene was targeted for PCR amplification by using SPF
10
primers, and 25 genotypes were detected by reverse-line blot hybridization of the amplicons. For the Linear Array (LA) method, DNA was extracted from 0.5% of the cervical specimen by using an MDx robot, a 450-bp region of the HPV L1 gene was targeted for PCR amplification by using PGMY09/11 L1 primers, and 37 genotypes were detected by reverse-line blot hybridization of the amplicons. Specimens (
n
= 1,427) for testing by the LA method were randomly selected from strata defined on the basis of enrollment test results from the SPF
10
method, cytology, and Hybrid Capture 2. LA results were extrapolated to the trial cohort (
n
= 5,659). The LA and SPF
10
methods detected 21 genotypes in common; HPV16, -18, -31, -33, -35, -39, -45, -51, -52, -56, -58, -59, -66, -68, and -73 were considered the carcinogenic HPV genotypes. There was no difference in the overall results for grouped detection of carcinogenic HPV by the SPF
10
and LA methods (35.3% versus 35.9%, respectively;
P
= 0.5), with a 91.8% overall agreement and a kappa value of 0.82. In comparisons of individual HPV genotypes, the LA method detected significantly more HPV16, HPV18, HPV39, HPV58, HPV59, HPV66, and HPV68/73 and less HPV31 and HPV52 than the SPF
10
method; inclusion of genotype-specific testing for HPV16 and HPV18 for those specimens testing positive for HPV by the SPF
10
method but for which no individual HPV genotype was detected abrogated any differences between the LA and SPF
10
methods. The LA method detected more carcinogenic-HPV-genotype infections per specimen than the SPF
10
method (
P
< 0.001). In conclusion, the LA method and the SPF
10
method with HPV16 and HPV18 genotype-specific detection among ungenotyped HPV-positive specimens were comparable for detection of HPV16 and HPV18, the two HPV genotypes targeted by current prophylactic HPV vaccines. Both approaches are suitable for monitoring the impact of HPV16/18 vaccines in clinical trials.
Haemorrhagic transformation in acute ischaemic stroke following thrombolysis therapy: classification, pathogenesis and risk factors
Authors: Thanvi B R , Treadwell S , Robinson T 
Published: August 2008

Abstract
Haemorrhagic transformation of cerebral infarction is a common and potentially serious occurrence following acute ischaemic stroke. Though often a “natural” evolution, particularly in acute embolic stroke, haemorrhagic transformation is a prime concern with the use of thrombolytic therapy for acute ischaemic stroke. The severity of haemorrhage may range from a few petechiae to a large haematoma with space occupying effect. The pathogenesis of haemorrhagic transformation is not well established, though ischaemia and reperfusion have been proposed to cause disruption of the blood–brain barrier leading to extravasation of blood. At the molecular level, free radicals and proteolotic enzymes (metalloproteinases) may cause tissue injury. Studies have identified a number of clinical, radiological, and biochemical parameters that may serve as potential predictors of increased risk for haemorrhagic transformation. The knowledge of these factors may help in improving patient selection for thrombolytic therapy.
The inter-operator variability in measuring waist circumference and its potential impact on the diagnosis of the metabolic syndrome
Authors: Panoulas V F , Ahmad N , Fazal A A , Kassamali R H , Nightingale P , Kitas G D , Labib M 
Published: August 2008

Abstract

Objective
The International Diabetes Federation (IDF) has proposed ethnicity specific cut-off values for waist circumference, as an essential criterion for the diagnosis of the metabolic syndrome (MetS). However, before introducing waist circumference measurement as part of the clinical examination, or an obligatory criterion for MetS, it is important to ensure that the measurement is reliable and reproducible.

Study design
The inter- and intra-operator variability in measuring waist circumference was assessed in a preliminary study of 10 health professionals and the inter-operator variability in clinical practice was assessed in a study of 102 patients. Repeated measures analysis of variance (ANOVA) was used to assess the significance of the inter- and intra-operator variability.

Results
Intra-operator variability was not found to be significant in the preliminary study (F = 0.15, p = 0.764). However, the inter-operator variability was significant in both studies (preliminary: F = 4.16, p&lt;0.001, clinical practice study: F = 14.06, p&lt;0.001). In clinical practice, this could lead to disagreement among operators regarding the presence of central obesity in 9% of the patients. After giving written instructions on how to measure waist circumference, the coefficient of variation was not significantly altered (p = 0.202) but the inter-operator variability lost significance (F = 2.34, p = 0.11), suggesting a reduction in systematic error.

Conclusions
Measuring waist circumference is subject to significant inter-operator variability and could potentially lead to misclassifying patients as having the MetS, or not. Better training of health professionals on how to measure waist circumference properly is needed in order to ensure that patients are not misclassified and that international comparisons of the prevalence of the MetS are reliable.
Paleoclimate Reconstructions of Tropical Sea Surface Temperatures from Precipitation Proxies: Methods, Uncertainties, and Nonstationarity
Authors: Furtado Jason C. , Di Lorenzo Emanuele , Cobb Kim M. , Bracco Annalisa 
Published: August 2008

AbstractProxy-based paleoclimate reconstructions of tropical sea surface temperature (SST) fields may lead to better constraints of tropical climate variability in climate model projections. In this study, the authors quantify uncertainties associated with two popular SST anomaly reconstruction methods that have been applied over the last millennium. The first reconstruction method exploits the high correlation between the leading modes of variability of global precipitation and SSTs; the second method uses a multiregression model that exploits the multiple modes of covariability between precipitation and SSTs. Regardless of the proxy network density, the first method has skill only in the tropical eastern Pacific and misses some ENSO events. By contrast, the multiregression approach demonstrates high skill throughout the tropical Indo-Pacific region and predicts all ENSO events correctly. The advantage of the multiregression method lies in the second mode of covariability between SSTs and precipitation, which explains nearly 15% of the covariability between the two variables. However, when the period 1950–2000 is considered, the authors find that the nonstationarity in the second mode of covariability between SST and precipitation leads to a significant reduction of skill in the Indian Ocean and the warm pool region. This change suggests that the underlying stationarity assumption common in most climate field reconstruction methods needs to be treated more carefully, particularly in the tropics.
The Summer North Atlantic Oscillation: Past, Present, and Future
Authors: Folland Chris K. , Knight Jeff , Linderholm Hans W. , Fereday David , Ineson Sarah , Hurrell James W. 
Published: August 2008

AbstractSummer climate in the North Atlantic–European sector possesses a principal pattern of year-to-year variability that is the parallel to the well-known North Atlantic Oscillation in winter. This summer North Atlantic Oscillation (SNAO) is defined here as the first empirical orthogonal function (EOF) of observed summertime extratropical North Atlantic pressure at mean sea level. It is shown to be characterized by a more northerly location and smaller spatial scale than its winter counterpart. The SNAO is also detected by cluster analysis and has a near-equivalent barotropic structure on daily and monthly time scales. Although of lesser amplitude than its wintertime counterpart, the SNAO exerts a strong influence on northern European rainfall, temperature, and cloudiness through changes in the position of the North Atlantic storm track. It is, therefore, of key importance in generating summer climate extremes, including flooding, drought, and heat stress in northwestern Europe. The El Niño–Southern Oscillation (ENSO) phenomenon is known to influence summertime European climate; however, interannual variations of the SNAO are only weakly influenced by ENSO. On interdecadal time scales, both modeling and observational results indicate that SNAO variations are partly related to the Atlantic multidecadal oscillation. It is shown that SNAO variations extend far back in time, as evidenced by reconstructions of SNAO variations back to 1706 using tree-ring records. Very long instrumental records, such as central England temperature, are used to validate the reconstruction. Finally, two climate models are shown to simulate the present-day SNAO and predict a trend toward a more positive index phase in the future under increasing greenhouse gas concentrations. This implies the long-term likelihood of increased summer drought for northwestern Europe.
Observations of Tidal Internal Wave Beams at Kauai Channel, Hawaii
Authors: Cole S. T. , Rudnick D. L. , Hodges B. A. , Martin J. P. 
Published: August 2008

Abstract
To observe the across-ridge structure of internal tides, density and velocity were measured using SeaSoar and a Doppler sonar over the upper 400–600 m of the ocean extending 152 km on each side of the Hawaiian Ridge at Kauai Channel. Eighteen sections were completed in about 18 days with sampling intentionally detuned from the lunar semidiurnal (M2) tide so that averaging over all sections was equivalent to phase averaging the M2 tide. Velocity and displacement variance and several covariances involving velocity and displacement showed one M2 internal wave beam on each side of the ridge and reflection of the beams off of the surface. Theoretical ray slopes aligned with the observed beams and originated from the sides of the ridge. Energy flux was in agreement with internal wave generation at the ridge. Inferred turbulent dissipation was elevated relative to open ocean values near tidal beams. Energy flux was larger than total dissipation almost everywhere across the ridge. Internal wave energy flux and dissipation at Kauai Channel were 1.5–2.5 times greater than at the average location along the Hawaiian Ridge. The upper 400–600 m was about 1/3 to 1/2 as energetic as the full-depth ocean. Tidal beams interact with each other over the entire length of the beams causing gradients along beams in almost all covariances, momentum flux divergences, and mean flows. At Kauai Channel, momentum flux divergences corresponded to mean flows of 1–4 cm s−1.
Participation in Decision Making: A Multidimensional Perspective
Authors: Mohrman Allan M. , Cooke Robert A. , Mohrman Susan Albers 
Published: August 2008

The purpose of this paper is to illustrate the importance of treating participation in decision making in a multidimensional manner. Ques tionnaire results indicate that participation in different decision domains is differentially related to teacher satisfaction. A practical implication is that efforts to increase teacher influence should focus on particular kinds of decisions. Allan M. Mohrman, Jr., is on the Faculty of Management Science, College of Administrative Science, The Ohio State University; Robert A. Cooke is a Study Director at the Survey Research Center of the Institute for Social Research, The University of Michigan; Susan Albers Mohrman is a graduate student in the Organization Behavior Depart ment of the Graduate School of Management, Northwestern University.