bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies
Authors: Thomas P. , Michelet P. , Barlesi F. , Thirion X. , Doddoli C. , Giudicelli R. , Fuentes P. 
Published: November 2006

The aim of the present study was to determine the risk factors and impact on outcome of blood transfusions following pneumonectomy for thoracic malignancies.A retrospective analysis of 432 consecutive patients was carried out, of whom 183 (42.4%) were transfused post-operatively. The associations between blood transfusions and 20 variables were assessed by univariate and multivariate analysis. Survival analysis included log-rank test and Cox regression model.Patient age, neoadjuvant treatment, completion pneumonectomy and extended procedures were independent predictors of transfusion. It was found that 30-day mortality increased significantly from 2.4% (no transfusion) to 10.9 and 21.9% (≤2 and >2 red blood cell packs, respectively). Blood transfusion was the strongest predictor of 30-day mortality (odds ratio (OR) 10; 95% confidence interval (CI): 3.7–27), respiratory failure (OR 19.2; 95% CI 7.4–49.4) and infectious complications (OR 3; 95% CI 1.5–6.2). In the 367 lung cancer patients, a significantly lower 5-yr survival was observed in univariate analysis of transfused patients (27.8±5.4%versus39.4±4.5%). In a Cox regression analysis, blood transfusion was no longer found to be significant.A dose-related correlation is suggested between blood transfusion and early mortality through an increase of infectious and respiratory complications. In contrast, blood transfusion had no independent adverse impact on long-term survival.
Ultrasound-assisted transthoracic biopsy: fine-needle aspiration or cutting-needle biopsy?
Authors: Diacon A. H. , Theron J. , Schubert P. , Brundyn K. , Louw M. , Wright C. A. , Bolliger C. T. 
Published: November 2006

The present study compared the diagnostic yield of ultrasound-assisted cutting-needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) in chest lesions.A physician performed ultrasound and FNAB with a 22-G spinal needle in all patients, directly followed by a 14-G CNB in patients without contraindication.A total of 155 consecutive lesions arising from the lung (74%), pleura (12%), mediastinum (11%) or chest wall (3%) in patients with a final diagnosis of lung carcinoma (74%), other malignant tumours (12%), non-neoplastic disease (9%) or unknown (5%) were prospectively included. The overall diagnostic yield was 87%. Combined specimens were obtained in 123 lesions (79%). In these, yields of FNAB, CNB and both methods combined were 82, 76 and 89%, respectively. FNAB was significantly better than CNB in lung carcinoma (95versus81%) but CNB was superior in noncarcinomatous tumours and in benign lesions. On-site cytology was 90% sensitive and 100% specific for predicting a positive FNAB. One patient required drainage for pneumothorax (0.6%).Ultrasound-assisted fine-needle aspiration biopsy performed by chest physicians is an accurate and safe initial diagnostic procedure in patients with a high clinical probability of lung carcinoma. All other patients should undergo concurrent fine-needle aspiration biopsy and cutting-needle biopsy.
Exhaled breath condensate pH standardised for CO2partial pressure
Authors: Kullmann T. , Barta I. , Lázár Z. , Szili B. , Barát E. , Valyon M. , Kollai M. , Horváth I. 
Published: November 2006

Exhaled breath condensate (EBC) pH is considered to reflect the acid-base balance of the airways. Current pH measurements do not take into account the effect of CO2. The aim of the present study was to determine the effect of condensate CO2partial pressure on pH and to provide a more precise mode of EBC pH determination.Condensate pH and CO2partial pressure were measured in parallel from 12 healthy volunteers and 12 asthmatics using a blood gas analyser in neat, argon de-aerated and CO2-loaded samples. The regression analysis was used to test the relationship between pH and CO2, and to calculate the pH at a CO2level of 5.33 kPa (physiological alveolar CO2partial pressure). Reproducibility of different pH readings was compared using the Bland–Altman test.Condensate CO2concentration was variable both in neat and argon de-aerated samples. There was a close negative logarithmic relationship between CO2and pH. Calculation of pH at a CO2level of 5.33 kPa provided reproducibility approximately six times as good as that of the currently used measurements.Condensate CO2partial pressure influences pH measurements. Determination of pH at a standard CO2level provides the most reproducible condensate pH values to date.
Vitamin A supplementation in Tanzania: the impact of a change in programmatic delivery strategy on coverage
Authors: Masanja Honorati , Schellenberg Joanna Armstrong , Mshinda Hassan M , Shekar Meera , Mugyabuso Joseph KL , Ndossi Godwin D , de Savigny Don 
Published: November 2006

Abstract
Background
Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on Immunization (EPI+) approach to twice-yearly mass distribution campaigns on coverage of vitamin A supplementation in Tanzania

Methods
We investigated disparities in age, sex, socio-economic status, nutritional status and maternal education within vitamin A coverage in children between 1 and 2 years of age from two independent household level child health surveys conducted (1) during a continuous universal targeting scheme based on routine EPI contacts for children aged 9, 15 and 21 months (1999); and (2) three years later after the introduction of twice-yearly vitamin A supplementation campaigns for children aged 6 months to 5 years, a 6-monthly universal targeting scheme (2002). A representative cluster sample of approximately 2,400 rural households was obtained from Rufiji, Morogoro Rural, Kilombero and Ulanga districts. A modular questionnaire about the health of all children under the age of five was administered to consenting heads of households and caretakers of children. Information on the use of child health interventions including vitamin A was asked.

Results
Coverage of vitamin A supplementation among 1–2 year old children increased from 13% [95% CI 10–18%] in 1999 to 76% [95%CI 72–81%] in 2002. In 2002 knowledge of two or more child health danger signs was negatively associated with vitamin A supplementation coverage (80% versus 70%) (p = 0.04). Nevertheless, we did not find any disparities in coverage of vitamin A by district, gender, socio-economic status and DPT vaccinations.

Conclusion
Change in programmatic delivery of vitamin A supplementation was associated with a major improvement in coverage in Tanzania that was been sustained by repeated campaigns for at least three years. There is a need to monitor the effect of such campaigns on the routine health system and on equity of coverage. Documentation of vitamin A supplementation campaign contacts on routine maternal and child health cards would be a simple step to facilitate this monitoring.
Reproducibility of target volumes generated using uncoached 4-dimensional CT scans for peripheral lung cancer
Authors: van der Geld Ylanga G , Lagerwaard Frank J , van Sörnsen de Koste John R , Cuijpers Johan P , Slotman Ben J , Senan Suresh 
Published: November 2006

Abstract

Background
4-dimensional CT (4DCT) scans are increasingly used to account for mobility during radiotherapy planning. As variations in respiratory patterns can alter observed motion, with consequent changes in the generated target volumes, we evaluated the reproducibility of 4D target volumes generated during repeat uncoached quiet respiration.

Methods
A retrospective analysis was performed on two successive scans (4DCT1 and 4DCT2) generated at the same scanning session for 26 patients with peripheral lung cancer treated with stereotactic radiotherapy (SRT). The volume and position of planning target volumes (PTV4DCT1 and PTV4DCT2) contoured on both scans were compared, and a dosimetric analysis performed. A SRT plan optimized for each PTV was sequentially applied to the other PTV, and coverage by the 80% isodose was evaluated. Color intensity projections (CIP) were used to evaluate regions of underdosage.

Results
No significant volumetric differences were observed between the two PTVs (t-Test p = 0.60). The average displacement of the center of mass between corresponding PTVs was 1.4 ± 1.0 mm, but differences in position were 2.0 mm or greater in 5 cases (19%). Coverage of both PTVs by the 80% prescription isodose exceeded 90% for all but one patient. For the latter, the prescription isodose covered only 82.5% of PTV4DCT1. CIP analysis revealed that the region of underdosage was an end-inspiratory position occupied by the tumor for only 10–20% of the respiratory cycle.

Conclusion
In nearly all patients with stage I lung cancer, the PTV derived from a single uncoached 4DCT achieves dosimetric coverage that is similar to that achieved using two such consecutive scans.
Thimerosal induces TH2 responses via influencing cytokine secretion by human dendritic cells
Authors: Agrawal Anshu , Kaushal Poonam , Agrawal Sudhanshu , Gollapudi Sastry , Gupta Sudhir 
Published: November 2006

AbstractThimerosal is an organic mercury compound that is used as a preservative in vaccines and pharmaceutical products. Recent studies have shown a TH2-skewing effect of mercury, although the underlying mechanisms have not been identified. In this study, we investigated whether thimerosal can exercise a TH2-promoting effect through modulation of functions of dendritic cells (DC). Thimerosal, in a concentration-dependent manner, inhibited the secretion of LPS-induced proinflammatory cytokines TNF-α, IL-6, and IL-12p70 from human monocyte-derived DC. However, the secretion of IL-10 from DC was not affected. These thimerosal-exposed DC induced increased TH2 (IL-5 and IL-13) and decreased TH1 (IFN-γ) cytokine secretion from the T cells in the absence of additional thimerosal added to the coculture. Thimerosal exposure of DC led to the depletion of intracellular glutathione (GSH), and addition of exogenous GSH to DC abolished the TH2-promoting effect of thimerosal-treated DC, restoring secretion of TNF-α, IL-6, and IL-12p70 by DC and IFN-γ secretion by T cells. These data suggest that modulation of TH2 responses by mercury and thimerosal, in particular, is through depletion of GSH in DC.
Integrating the Core Competencies: Proceedings from the 2005 Academic Assembly Consortium
Authors: Stahmer Sarah A. , Ellison Stefanie R. , Jubanyik Karen K. , Felten Scott , Doty Christopher , Binder Louis , Jouriles Nicholas J. 
Published: November 2006

AbstractThe Accreditation Council for Graduate Medical Education mandated the integration of the core competencies into residency training in 2001. To this end, educators in emergency medicine (EM) have been proactive in their approach, using collaborative efforts to develop methods that teach and assess the competencies. The first steps toward a collaborative approach occurred during the proceedings of the Council of Emergency Medicine Residency Directors (CORD‐EM) academic assembly in 2002. Three years later, the competencies were revisited by working groups of EM program directors and educators at the 2005 Academic Assembly. This report provides a summary discussion of the status of integration of the competencies into EM training programs in 2005.
Seasonal adjustment of energy budget in a large wild mammal, the Przewalski horse (Equus ferus przewalskii) I. Energy intake
Authors: Kuntz Regina , Kubalek Christina , Ruf Thomas , Tataruch Frieda , Arnold Walter 
Published: November 2006

SUMMARY
Large ruminants respond to changing plant phenology during winter by decreasing voluntary food intake, increasing gut passage time and utilizing body fat reserves. It is uncertain, however, how other large mammals with a non-ruminant digestive physiology cope with winter forage conditions. Therefore, we investigated seasonality of energy intake in a large herbivorous wild mammal, the Przewalski horse (Equus ferus przewalskii). Throughout all seasons we used the n-alkane method to measure daily dry matter intake (DMI), diet composition and digestion, and determined an index of gut passage time in horses living under close to natural conditions.
DMI correlated positively with its content of crude protein and nitrogen-free extract. Independent of these effects, DMI further varied seasonally with a peak in autumn and a nadir in late winter. Fluctuations of DMI corresponded to the annual change in body condition, which decreased during winter while energy reserves were depleted, and increased during the fattening period. Gut passage time varied in the course of the year and was longer during winter when the diet was high in crude fibre. Nevertheless,changes in gut passage time occurred rather independently of changes in forage composition and DMI, suggesting endogenous control for timely adaption of the digestive strategy to meet predictable changes in forage quality.
Excitatory actions of GABA mediate severe-hypoxia-induced depression of neuronal activity in the pond snail (Lymnaea stagnalis)
Authors: Cheung Una , Moghaddasi Mehrnoush , Hall Hannah L. , Smith J. J. B. , Buck Leslie T. , Woodin Melanie A. 
Published: November 2006

SUMMARY
To characterize the effect of severe hypoxia on neuronal activity,long-term intracellular recordings were made from neurones in the isolated central ring ganglia of Lymnaea stagnalis. When a neurone at rest in normoxia was subjected to severe hypoxia, action potential firing frequency decreased by 38% (from 2.4-1.5 spikes s-1), and the resting membrane potential hyperpolarized from -70.3 to -75.1 mV. Blocking GABAA receptor-mediated synaptic transmission with the antagonist bicuculline methiodide (100 μmol l-1) decreased neuronal activity by 36%, and prevented any further changes in response to severe hypoxia, indicating that GABAergic neurotransmission mediates the severe hypoxia-induced decrease in neuronal activity. Puffing 100 μmol l-1 GABA onto the cell body produced an excitatory response characterized by a transient increase in action potential (AP) firing, which was significantly decreased in severe hypoxia. Perturbing intracellular chloride concentrations with the Na+/K+/Cl-(NKCC1) cotransporter antagonist bumetanide (100 μmol l-1)decreased AP firing by 40%, consistent with GABA being an excitatory neurotransmitter in the adult Lymnaea CNS. Taken together, these studies indicate that severe hypoxia reduces the activity of NKCC1, leading to a reduction in excitatory GABAergic transmission, which results in a hyperpolarization of the resting membrane potential (Vm)and as a result decreased AP frequency.
Epiglottic reconstruction and subtotal laryngectomy
Authors: Schbchter Gary L. 
Published: November 2006

AbstractVertical hemilaryngectomy has been expanded aggressively in recent years so that, in some cases, the term subtotal laryngectomy would be more appropriate. Reconstruction after these extended resections is a problem. Intraluminal stenting has not been successful in cases where resection has been aggressive. The resulting lumen is inadequate. As a means of overcoming this problem, the epiglottic reconstruction procedure has been promoted.This paper presents experiences with 12 patients who underwent epiglottic reconstruction after subtotal laryngectomy. Indications, anatomic details, and overall results using this reconstructive technique are outlined. It is the conclusion of the author that epiglottic reconstruction is an effective procedure for preservation of function after subtotal laryngectomy.
Warthin's tumor: A review indicating no male predominance.
Authors: Kennedy Thomas L. 
Published: November 2006

AbstractThere is probably no other head and neck group of tumors as those found in the parotid gland that constitute such a diversity of growths, both benign and malignant. Warthin's or papillary cystadenoma lymphomatosum is the second most common benign tumor of the parotid gland. One universally held clinical characteristic of this tumor is its high male ratio. Because of a high frequency of female Warthin's tumor seen at Geisinger Medical Center, a review of all primary parotid gland tumors from 1971 to 1981 was carried out. Sixty‐two cases out of 204 primary neoplasms were classified as Warthin's. There was no significant difference in the number of male and female cases with 32 males and 30 females. The clinical characteristics of Warthin's tumor and this unusually high female occurrence are discussed.
Vestibular function testing: Where are we in 1983?
Authors: Rubin Wallace 
Published: November 2006

AbstractConceptual, technological, electronic and computer revolutions have transformed the methodology for evaluating the patient with dysequilibrium. What has been said and written for the past 25 years is not currently applicable.Present day, cost effective, clinical evaluation format is presented, including changes and deletions in the conventional ENG test battery. It also includes the addition of computer technology in the rotation and ocular tracking tests. These deletions and additions in technique provide the clinician with more useful practical data for diagnosis. There is also capability for patient follow‐up and monitoring. These concepts are presented from the clinical vantage point and are supported with patient evaluation examples.
Complications of pectoralis myocutaneous flaps.
Authors: Maisel Robert H. , Liston Stephen L. , Adams George L. 
Published: November 2006

AbstractThe myocutaneous pectoralis major flap has recently caught the attention of head and neck surgeons. Over the last 12 months, our service has used this flap in 14 patients. Reconstruction in the oral cavity and larynx as well as closure of large areas of skin necrosis of the neck have been the indications. Our complications occurred in 4 of the 14 patients and included neck abscess and fistula, flap necrosis, and chest wall hematoma or abscess. The flap is an eminently useful and successful flap when designed and performed as indicated in the body of the paper.
Angioleiomyoma of the larynx. Report of a case and review of the literature
Authors: Nuutinen Juhani , Syrjänen Kari 
Published: November 2006

AbstractA rare case of angioleiomyoma in a 76‐year‐old man is presented. The main symptoms were hoarseness and dyspnea. The tumor originated in the subglottic surface of the right vocal cord and there was only 3 mm of the laryngeal inlet free of the tumor. Histopathologically it was well circumscribed and composed of proliferating smooth muscle fibers and dilated blood vessels. The tumor was partially removed endoscopically, and subsequent cryotherapy was instituted. After two courses of cryotherapy the tumor had completely disappeared. Laryngeal function was restored to normal, and no signs of recurrence were observed after follow‐up of 8 months.
New Approaches in Investigation of Removal Mechanisms during Copper Chemical-Mechanical Polishing
Authors: Kulkarni M , Greisen D , Ng D , Liang H 
Published: November 2006

Abstract
This paper discusses new techniques for elucidating removal mechanisms of copper during chemical-mechanical polishing. Two new approaches were used in this research. One is the linkage between electrochemical, passivation, and wear for removal mechanisms. The other is to use an atomic force microscope to analyze polished copper surfaces at a nanometer length scale. Effects of pH, concentration of oxidizer, cathodic current, and amount of abrasive particles on surface materials removal were studied. Our investigation indicates that a balance between passivation and removal is needed to achieve a good localized planarization.
The Association of Child and Household Food Insecurity With Childhood Overweight Status
Authors: Casey Patrick H. , Simpson Pippa M. , Gossett Jeffrey M. , Bogle Margaret L. , Champagne Catherine M. , Connell Carol , Harsha David , McCabe-Sellers Beverly , Robbins James M. , Stuff Janice E. , Weber Judith 
Published: November 2006

CONTEXT. The prevalence of childhood overweight status is increasing. Some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food.OBJECTIVES. The purpose of this work was to assess the association of household and child food insecurity with childhood overweight status.METHODS. The National Health and Nutrition Examination Survey 1999–2002 uses a stratified multistaged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children 3 to 17 years old in this sample are included in these analyses. We measured BMI categorized as at risk for overweight or greater (≥85%) or overweight (≥95%) and household and child food security/insecurity using the US Food Security Scale.RESULTS. When compared with children from food-secure households, children from food-insecure households were more likely to demonstrate significant associations with being at risk for overweight or greater in the following demographic categories: 12 to 17 years, girls, white, and in households with income &lt;100% and &gt;4 times the federal poverty level. Household food insecurity is associated with child overweight status in children aged 12 to 17, girls, and children who live in households with incomes &gt;4 times the federal poverty level. Child food insecurity demonstrated the same associations with being at risk for overweight or greater, as did household food insecurity, but associations were also seen in 3- to 5-year-old children, boys, and Mexican American children. Child food insecurity is significantly associated with child overweight status for children aged 12 to 17, girls, white children, and children in families with income ≤100% poverty level. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated with a child being at risk for overweight status or greater, but not overweight status.CONCLUSIONS. Household and child food insecurity are associated with being at risk for overweight and overweight status among many demographic categories of children. Child food insecurity is independently associated with being at risk for overweight status or greater while controlling for important demographic variables. Future longitudinal research is required to determine whether food insecurity is causally related to child overweight status.