bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-expiratory lung volume during mechanical ventilation: a comparison with reference values and the effect of positive end-expiratory pressure in intensive care unit patients with different lung conditions
Authors: Bikker Ido G , van Bommel Jasper , Miranda Dinis Reis , Bakker Jan , Gommers Diederik 
Published: November 2008

Abstract
Introduction
Functional residual capacity (FRC) reference values are obtained from spontaneous breathing patients, and are measured in the sitting or standing position. During mechanical ventilation FRC is determined by the level of positive end-expiratory pressure (PEEP), and it is therefore better to speak of end-expiratory lung volume. Application of higher levels of PEEP leads to increased end-expiratory lung volume as a result of recruitment or further distention of already ventilated alveoli. The aim of this study was to measure end-expiratory lung volume in mechanically ventilated intensive care unit (ICU) patients with different types of lung pathology at different PEEP levels, and to compare them with predicted sitting FRC values, arterial oxygenation, and compliance values.

Methods
End-expiratory lung volume measurements were performed at PEEP levels reduced sequentially (15, 10 and then 5 cmH2O) in 45 mechanically ventilated patients divided into three groups according to pulmonary condition: normal lungs (group N), primary lung disorder (group P), and secondary lung disorder (group S).

Results
In all three groups, end-expiratory lung volume decreased significantly (P < 0.001) while PEEP decreased from 15 to 5 cmH2O, whereas the ratio of arterial oxygen tension to inspired oxygen fraction did not change. At 5 cmH2O PEEP, end-expiratory lung volume was 31, 20, and 17 ml/kg predicted body weight in groups N, P, and S, respectively. These measured values were only 66%, 42%, and 34% of the predicted sitting FRC. A correlation between change in end-expiratory lung volume and change in dynamic compliance was found in group S (P < 0.001; R2 = 0.52), but not in the other groups.

Conclusions
End-expiratory lung volume measured at 5 cmH2O PEEP was markedly lower than predicted sitting FRC values in all groups. Only in patients with secondary lung disorders were PEEP-induced changes in end-expiratory lung volume the result of derecruitment. In combination with compliance, end-expiratory lung volume can provide additional information to optimize the ventilator settings.
Mentoring for NHS doctors: perceived benefits across the personal–professional interface
Authors: Steven A , Oxley J , Fleming WG 
Published: November 2008

Summary Objective To investigate NHS doctors' perceived benefits of being involved in mentoring schemes and to explore the overlaps and relationships between areas of benefit. Design Extended qualitative analysis of a multi-site interview study following an interpretivist approach. Setting Six NHS mentoring schemes across England. Main outcome measures Perceived benefits. Results While primary analysis resulted in lists of perceived benefits, the extended analysis revealed three overarching areas: professional practice, personal well-being and development. Benefits appear to go beyond a doctor's professional role to cross the personal–professional interface. Problem solving and change management seem to be key processes underpinning the raft of personal and professional benefits reported. A conceptual map was developed to depict these areas and relationships. In addition secondary analysis suggests that in benefitting one area mentoring may lead to consequential benefits in others. Conclusions Prior research into mentoring has mainly taken place in a single health care sector. This multi-site study suggests that the perceived benefits of involvement in mentoring may cross the personal/professional interface and may override organizational differences. Furthermore the map developed highlights the complex relationships which exist between the three areas of professional practice, personal wellbeing and personal and professional development. Given the consistency of findings across several studies it seems probable that organizations would be strengthened by doctors who feel more satisfied and confident in their professional roles as a result of participation in mentoring. Mentoring may have the potential to take us beyond individual limits to greater benefits and the conceptual map may offer a starting point for the development of outcome criteria and evaluation tools for mentoring schemes.
Incidence and prevalence of multiple allergic disorders recorded in a national primary care database
Authors: Simpson Colin R , Newton John , Hippisley-Cox Julia , Sheikh Aziz 
Published: November 2008

Summary Background The co-existence of allergic conditions, food allergy, eczema, allergic rhinitis, asthma and anaphylaxis is thought to be increasing. Analysis of primary healthcare data-sets offers the possibility to advance understanding about the changing epidemiology of multiple allergic disorders. Aim To investigate recent trends in the recorded incidence, lifetime prevalence and consulting behaviour of patients with multiple allergic disorders in England. Methods QRESEARCH is one of the world's largest national aggregated health databases containing the records of over nine million patients (including those who have left or died). Data were extracted on all patients with a recorded diagnosis of multiple allergic disorders, and annual age–sex standardized incidence and lifetime period prevalence rates were calculated for each year from 2001 to 2005. We also analysed the consulting behaviour of these patients when compared with the rest of the QRESEARCH database population. Results The age–sex standardized incidence of multiple allergic disorders was 4.72 per 1000 person-years in 2001 and increased by 32.9% to 6.28 per 1000 patients in 2005 (p<0.001). Lifetime age–sex standardized prevalence of a recorded diagnosis of multiple allergic disorders increased by 48.9% from 31.00 per 1000 in 2001 to 46.16 in 2005 (p<0.001). Over this period, the mean consultation rate to general practitioners for these patients increased from 4.68 to 4.90 consultations per person per year. Conclusions Recorded incidence and lifetime prevalence of multiple allergic disorders in England have increased substantially in recent years.
Concrete and abstract visualizations in history learning tasks
Authors: Prangsma Maaike E. , van Boxtel Carla A. M. , Kanselaar Gellof , Kirschner Paul A. 
Published: November 2008

Background History learning requires that students understand historical phenomena, abstract concepts and the relations between them. Students have problems grasping, using and relating complex historical developments and structures.Aims A study was conducted to determine the effects of tasks with abstract and/or concrete visualizations on the learning of historical developments and structures. The hypothesis was that students receiving visualizations would learn and retain more historical knowledge and concepts than those not receiving visualizations.Sample First‐year pupils in vocational middle school (N = 104) worked in randomly assigned pairs.Methods After reading a text, the pairs were given a learning task in one of four conditions: Textual, Concrete visualized, Abstract visualized, and Combined.Results Post‐test and retention test results showed no significant differences. There were some significant differences on the evaluation questionnaire.Conclusions Combining text and different types of visualizations in learning tasks does not necessarily enhance history learning. Possible explanations given are the ecological setting, the semiotics of the domain of history – that are not defined clearly – and the difficulty of unequivocally visualizing historical concepts.
Intergroup contact, friendship quality and political attitudes in integrated and segregated schools in Northern Ireland
Authors: Stringer Maurice , Irwing P. , Giles M. , McClenahan C. , Wilson R. , Hunter J. A. 
Published: November 2008

BackgroundThis study examines the effects of integrated and segregated schooling on Northern Irish children's self‐reported contact and friendship with members of the other denominational group in school and community settings.AimTo assess the effects of cross group friendships and cross group contacts in school and outside school on children's political attitudes.SampleA cross‐sectional design was employed with 1732 children being assessed at three age levels 11,12 & 14 years in eight‐matched integrated, maintained (Catholic) and controlled (Protestant) schools.MethodLisrel modelling was used to investigate the interrelationships among cross group friendship quality, cross group contacts in school and outside school and children's political attitudes.ResultsIntergroup contact within and outside school was reported frequently in integrated schools but only occasionally in segregated schools. Modelling revealed that cross group contacts in school and outside school were both associated with less extreme political attitudes. Friendship quality with cross group members had no significant effects on political attitudes.ConclusionsThe results provide support for educating Protestants and Catholics together as a means of moderating attitudes and creating cross‐community friendships in a divided society.
The effect of month of birth on the attainments of primary and secondary school pupils
Authors: McPhillips Martin , Jordan‐Black Julie‐Anne 
Published: November 2008

Background Previous research has produced conflicting results regarding the effects of season of birth and age‐position on cognitive attainments. In Northern Ireland the school year divides the summer season into two providing an opportunity to evaluate the relative contribution of season of birth and age‐position effects.Aims To investigate the relationship between attainment in literacy skills and month of birth for primary and secondary school pupils and to determine the relationship between motor skills and month of birth in primary school pupils.Sample One thousand one hundred and twenty four primary school pupils participated, and results for key stage 3 (KS3) English and GCSE English Language, for 3,493 Year 10 and 3,697 Year 12 secondary school pupils, respectively, were obtained.Method Primary school pupils were individually assessed using standardised reading and spelling tests, as well as tests of motor skill. They were also assessed using a standardised group reading test in their class groups. For the secondary school pupils, the results for two year cohorts, in KS3 English and GCSE English language, respectively, were analysed.Results For the primary school pupils there was evidence of both a season of birth and an age‐position effect on all of the cognitive measures, particularly in the early years of schooling. There was, also, evidence of a significant age‐position effect at both KS3 and GCSE in favour of the older pupils. For the younger primary school pupils there was evidence of significant age‐position effects on both motor measures.Conclusions The findings from the present study suggest that month of birth may be related to both season of birth and age‐position effects. These effects may be compounded, particularly in the early years of primary school, when summer born children are youngest in their year, as in England. In Northern Ireland, age‐position effects are also evident in secondary school public examination results, which may have implications for long‐term life choices.
Emphatic stress shift in German
Authors: Berg Thomas 
Published: November 2008

AbstractThis paper presents an analysis of a sample of intentional deviations from the typical stress pattern of German words. These deviations are described as stress shifts in which the main stress is in a different position to the norm. This process is optional, mainly found in media speech and used for emphatic purposes. All stress shifts involve an interchange of primary and secondary stress, thereby demonstrating their sensitivity to a prosodic-similarity constraint. Stress retractions by far outnumber stress advancements, which can be jointly explained by a probabilistic association of the main stress and the word-initial position in language structure and an anticipatory bias in the language production system. Stress shifts show a strong overrepresentation of adjectives because this word class codes evaluative aspects most naturally and it is evaluations that speakers prefer to emphasize. From a social-psychological perspective, stress shifts are claimed to be a means by which speakers may boast their knowledge and, from a rhetorical perspective, a strategy of making the event being talked about more spectacular. Stress shifts are minority patterns in the sense that the constraints on them are so strong that only relatively few lexical items are eligible. This raises the issue of what speakers do with those items which they wish to emphasize but which do not lend themselves readily to stress shifting. Whether they turn to alternative means of expression or whether they leave their intentions unexpressed remains to be determined.
The Effect of Radial Crack Locations on Load Resistance in C1550 Panel Tests
Authors: Bernard E. S. , Xu G. G. 
Published: November 2008

Abstract
ASTM C1550 has been used for post-crack performance assessment of fiber reinforced concrete (FRC) and shotcrete (FRS) for several years and has proven to be an excellent tool for quality control testing due to the very low level of within-batch performance variability typically obtained using this test method. Experience in the field indicates that the positions of the three radial cracks generated in a test vary between specimens and concerns have been raised by users of this test that specimen performance may change as a result of this variation in crack location. The significance of this aspect of specimen behavior has been investigated to determine the characteristic range of crack rotations experienced in C1550 specimens as a result of variations in crack location and the magnitude of their corresponding influence on post-crack load resistance.
A Review of Peripheral Vascular Deformations due to Respiration and Musculoskeletal Influences
Authors: Cheng Christopher P. 
Published: November 2008

Abstract
The vascular system is extremely dynamic with motions generated from cardiac pulsatility, respiration, and musculoskeletal influences. This paper reviews in vivo non-pulsatile, non-radial deformations in the abdominal aorta, and iliac, superficial femoral, renal, and carotid arteries. Medical imaging modalities and geometric modeling and quantification techniques are also briefly outlined. The axial strain, twisting, and bending deformations of these arteries are essential for establishing the boundary conditions by which to evaluate, regulate, and design vascular implants.
Distribution, Abundance, and Population Trends of Bull Trout in Idaho
Authors: High Brett , Meyer Kevin A. , Schill Daniel J. , Mamer Elizabeth R. J. 
Published: November 2008

Abstract
Broad-scale declines in populations of bull trout Salvelinus confluentus over the past century or more led the Idaho Department of Fish and Game to implement statewide no-harvest regulations on bull trout in 1994 and ultimately led to a threatened listing under the U.S. Endangered Species Act in 1998. Despite this listing, quantitative evaluations of trends in abundance and estimates of population size over most of the species' historical range have not been made. We evaluated bull trout distribution, abundance, and trends in abundance using stratified sampling extrapolations of fish surveys (snorkeling and electrofishing) conducted at 2,521 survey sites (most distributed nonrandomly) across 77,447 km of stream. Bull trout were captured at 887 (35%) of the sites. Within the 262 local populations designated by the U.S. Fish and Wildlife Service within seven Idaho recovery units, the number of 70-mm total length and larger bull trout was estimated at 1.13 million; this estimate was most likely biased low due to sampling limitations. Long-term (&gt;20 years) intrinsic rates of change (r) were negative for 10 of 16 bull trout populations up to 1994 (3 were significantly negative; 1 was significantly positive) and were positive for 14 of 17 populations after 1994 (1 was significantly negative; 5 were significantly positive). Over the entire period of record and all trend data sets, r averaged 0.01 ± 0.01 (mean ± 90% confidence interval), suggesting stability at a broad scale. During these same time periods, trends for other salmonids in much of the study area experienced similar declines through 1994 and increases after 1994, suggesting that environmental factors with influence over large geographical areas produced the recent positive trends. Once bull trout populations were detrended by use of linear regression residuals, there was little evidence of synchrony between populations. Our results suggest that despite declines from historical levels, bull trout in Idaho are presently widely distributed, relatively abundant, and apparently stable.
Field-Based Evaluations of Horizontal Flat-Plate Fish Screens
Authors: Rose Brien P. , Mesa Matthew G. , Barbin-Zydlewski Gayle 
Published: November 2008

Abstract
Diversions from streams are often screened to prevent the loss of or injury to fish. Hydraulic criteria meant to protect fish that encounter screens have been developed, but primarily for screens that are vertical to the water flow rather than horizontal. For this reason, we measured selected hydraulic variables and released wild rainbow trout Oncorhynchus mykiss over two types of horizontal flat-plate fish screens in the field. Our goal was to assess the efficacy of these screens under a variety of conditions in the field and provide information that could be used to develop criteria for safe fish passage. We evaluated three different inverted-weir screens over a range of stream (0.24–1.77 m3/s) and diversion flows (0.10–0.31 m3/s). Approach velocities (AVs) ranged from 3 to 8 cm/s and sweeping velocities (SVs) from 69 to 143 cm/s. We also evaluated a simple backwatered screen over stream flows of 0.23–0.79 m3/s and diversion flows of 0.08–0.32 m3/s. The mean SVs for this screen ranged from 15 to 66 cm/s and the mean AVs from 1 to 5 cm/s. The survival rates of fish held for 24 h after passage over these screens exceeded 98%. Overall, the number of fish–screen contacts was low and the injuries related to passage were infrequent and consisted primarily of minor fin injuries. Our results indicate that screens of this type have great potential as safe and effective fish screens for small diversions. Care must be taken, however, to avoid operating conditions that produce shallow or no water over the screen surface, situations of high AVs and low SVs at backwatered screens, and situations producing a localized high AV with spiraling flow.
Comparison of Opioid Requirements and Analgesic Response in Opioid‐Tolerant versus Opioid‐Naïve Patients After Total Knee Arthroplasty
Authors: Patanwala Asad E. , Jarzyna Donna L. , Miller Michael D. , Erstad Brian L. 
Published: November 2008

Study Objectives. To compare opioid requirements in opioid‐tolerant and opioid‐naïve patients after total knee arthroplasty, and to compare pain scores, sedation scores, and adverse effects between the groups.Design. Prospective, observational study.Setting. Academic medical center.Patients. Twenty‐nine patients aged 18 years or older who underwent elective total knee arthroplasty between October 1, 2005, and June 31, 2007.Measurements and Main Results. Patients were classified on the basis of their daily opioid consumption during the week before surgery: those who required 10 mg or less of oral morphine equivalent were considered opioid naïve (20 patients), and those who required at least 30 mg of oral morphine equivalent were opioid tolerant (nine patients). Postoperative opioid consumption, pain scores, sedation scores, and adverse effects were compared between the two groups up to 48 hours after discharge from the postanesthesia care unit (PACU). Postoperative opioid consumption (in intravenous morphine equivalents) was significantly greater in the opioid‐tolerant group than in the opioid‐naïve group in the PACU (median 56 vs 8.2 mg, p=0.0013), during the first 24 hours after discharge from the PACU (108 vs 20.5 mg, p=0.0004), and 24–48 hours after discharge from the PACU (152.3 vs 25 mg, p=0.0001). Pain scores, assessed by using a verbal numeric scale from 0–10, were significantly greater in the opioid‐tolerant group than in the opioid‐naïve group during the first 24 hours after discharge from the PACU (5.9 vs 4.1, p=0.03). We observed no significant difference in pain scores during the other time periods studied. Sedation scores and adverse effects were similar between groups.Conclusion. After total knee arthroplasty, patients tolerant to opioids required significantly more opioids in the PACU and up to 48 hours after discharge from the PACU than did opioid‐naïve patients. Opioid‐tolerant patients also experienced greater pain during the first 24 hours after discharge from the PACU; however, sedation scores and adverse effects did not appear to be significantly different at any of the time periods studied. Clinicians need to be aggressive with pain management immediately after surgery and ensure that patients restart any opioid treatment at home as soon as possible.
Pharmacokinetics of Ibutilide in Patients with Heart Failure Due to Left Ventricular Systolic Dysfunction
Authors: Tisdale James E. , Overholser Brian R. , Sowinski Kevin M. , Wroblewski Heather A. , Amankwa Kwadwo , Borzak Steven , Kingery Joanna R. , Coram Rita , Zipes Douglas P. , Flockhart David A. , Kovacs Richard J. 
Published: November 2008

Study Objective.To assess whether the increased risk of ibutilide‐induced torsade de pointes in patients with heart failure may be due to increased ibutilide exposure, we sought to determine if the pharmacokinetics of ibutilide are altered in patients with heart failure due to left ventricular systolic dysfunction.Design.Multicenter, prospective pharmacokinetic study.Setting.Four academic medical centers in the United States.Patients.Sixteen adult patients with atrial fibrillation or atrial flutter requiring conversion to normal sinus rhythm: six patients who had New York Heart Association (NYHA) class II or III heart failure due to left ventricular dysfunction (mean ± SD left ventricular ejection fraction [LVEF] 30 ± 9%); 10 patients who did not have left ventricular dysfunction (mean ± SD LVEF 54 ± 5% in six of these 10 patients) served as controls.Intervention.All patients received a single dose of ibutilide 1.0 mg administered intravenously over 10 minutes. Blood samples were obtained through an indwelling catheter in the contralateral arm before ibutilide administration, at the end of the infusion, and at 5, 15, 30, 45 minutes and 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, and 48 hours after the infusion.Measurements and Main Results.Serum ibutilide concentrations were determined by using high‐performance liquid chromatography and mass spectrometry. No significant differences were noted between the heart failure and normal left ventricular function groups in the following parameters: maximum serum ibutilide concentration (median [interquartile range] 3.8 [2.3–5.7] vs 5.8 [3.1–14.4] μg/L, p=0.31), area under the serum concentration‐time curve from time zero extrapolated to infinity (mean ± SD 11.0 ± 9.4 vs 13.2 ± 10.6 μg * hr/L, p=0.88), steady‐state volume of distribution (1380 ± 334 vs 1390 ± 964 L, p=0.99), systemic clearance (129 ± 60 vs 125 ± 81 L/hr, p=0.92), or half‐life (12.5 ± 10.7 vs 12.4 ± 8.6 hrs, p=0.99).Conclusion.The pharmacokinetics of ibutilide do not appear to be altered in patients with NYHA class II or III heart failure due to left ventricular systolic dysfunction. Therefore, the increased risk of ibutilide‐induced torsade de pointes in patients with heart failure does not appear to be due to increased ibutilide exposure.