bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Type B Phosphatidylinositol-4-Phosphate 5-Kinase 3 Is Essential for Root Hair Formation inArabidopsis thaliana
Authors: Stenzel Irene , Ischebeck Till , König Sabine , Hołubowska Anna , Sporysz Marta , Hause Bettina , Heilmann Ingo 
Published: January 2008

AbstractRoot hairs are extensions of root epidermal cells and a model system for directional tip growth of plant cells. A previously uncharacterized Arabidopsis thaliana phosphatidylinositol-4-phosphate 5-kinase gene (PIP5K3) was identified and found to be expressed in the root cortex, epidermal cells, and root hairs. Recombinant PIP5K3 protein was catalytically active and converted phosphatidylinositol-4-phosphate to phosphatidylinositol-4,5-bisphosphate [PtdIns(4,5)P2]. Arabidopsis mutant plants homozygous for T-DNA–disrupted PIP5K3 alleles were compromised in root hair formation, a phenotype complemented by expression of wild-type PIP5K3 cDNA under the control of a 1500-bp PIP5K3 promoter fragment. Root hair–specific PIP5K3 overexpression resulted in root hair deformation and loss of cell polarity with increasing accumulation of PIP5K3 transcript. Using reestablishment of root hair formation in T-DNA mutants as a bioassay for physiological functionality of engineered PIP5K3 variants, catalytic activity was found to be essential for physiological function, indicating that PtdIns(4,5)P2 formation is required for root hair development. An N-terminal domain containing membrane occupation and recognition nexus repeats, which is not required for catalytic activity, was found to be essential for the establishment of root hair growth. Fluorescence-tagged PIP5K3 localized to the periphery of the apical region of root hair cells, possibly associating with the plasma membrane and/or exocytotic vesicles. Transient heterologous expression of full-length PIP5K3 in tobacco (Nicotiana tabacum) pollen tubes increased plasma membrane association of a PtdIns(4,5)P2-specific reporter in these tip-growing cells. The data demonstrate that root hair development requires PIP5K3-dependent PtdIns(4,5)P2 production in the apical region of root hair cells.
What Is the Quality of Life for Survivors of Cardiac Arrest? A Prospective Study
Authors: Nichol Graham , Stiell Ian G. , Hebert Paul , Wells George A. , Vandemheen Kathy , Laupacis Andreas 
Published: January 2008

AbstractObjective: To evaluate the quality of life of survivors of in‐hospital and out‐of‐hospital cardiac arrest, and to correlate quality of life with clinically important parameters. Methods: Cohort followed at least six months after hospital discharge. Eligible patients had survived to hospital discharge after sudden cardiac arrest in 1) EDs, wards, and intensive care units of five university hospitals and 2) all locations outside hospitals in two midsized cities. Of 126 patients discharged alive, 30 died before they could be interviewed. Of the 96 patients remaining, 86 (90% of available patients, 68% of survivors to discharge) completed the interview. Quality of life was assessed with the Health Utilities Index Mark 3, which describes health as a utility score on a scale from perfect health (equal to 1.0) to death (equal to 0.) Results: Mean age (±SD) of interviewed survivors was 65 ± 14 years, and 47 (55%) were male; mean time between collapse and initiation of CPR was 2.2 ± 2.6 minutes. Mean utility was 0.72 (±0.22). Utilities were significantly higher among patients who had a shorter duration of resuscitation (mean ? 0.81 for those who received less than 2 minutes of CPR, 0.76 for those who received 3 to 10 minutes, and 0.65 for others, p ? 0.05, r2? 0.07). Mean utilities of survivors were worse than those of the general population (mean ? 0.85 ± 0.16, p < 0.01) and those whose activities were not limited by chronic disease (mean ? 0.91 ± 0.08, p < 0.01). Conclusions: Although overall survival was poor, most survivors had acceptable health‐related quality of life. Therefore, concerns about poor quality of life are not a valid reason to abandon efforts to improve the health care system's response to victims of sudden cardiac arrest. Further research is necessary to identify effective strategies for improving both survival and quality of life after cardiac arrest.
The Evaluation of Cocaine‐induced Chest Pain with Acute Myocardial Perfusion Imaging
Authors: Feldman James A. , Bui Lynn D. , Mitchell Patricia M. , Perera Thomas B. , Lee Victor W. , Bernard Sheilah A. , Fish Susan S. 
Published: January 2008

AbstractObjective: To use myocardial perfusion imaging to determine the etiology of cocaine‐induced chest pain in patients without ECG evidence of acute cardiac ischemia. Methods: The authors conducted a prospective study of consecutive consenting patients aged 18‐70 years with cocaine‐induced chest pain who reported cocaine use within three days and presented with a chief complaint of chest pain occurring within three hours and lasting longer than 15 minutes with a normal or nondiagnostic ECG. Patients were excluded if they had a clear‐cut noncardiac cause of chest pain, ECG evidence of acute cardiac ischemia, history of myocardial infarction, pregnancy, or lactation, required immediate hospitalization, or were unable to consent. Patients were injected with Tc‐99m tetrofosmin and imaged. Perfusion scans were independently read by two nuclear radiologists. Clinicians blinded to scan results determined patient disposition. Patients with abnormal scans were asked to return for follow‐up resting scans. Results: Fourteen patients were enrolled. Twelve of the 14 patients had chest pain at the time of Tc‐99m tetrofosmin injection. Ten of the 14 [(71%) 95% CI ? 48% to 95%] scans were normal or within normal limits. Four of the 14 [(29%) 95% CI ? 5% to 52%] were abnormal. Of the four patients with abnormal scans, two had follow‐up scans that demonstrated an irreversible perfusion abnormality, and two who did not return for follow‐up reported no subsequent hospitalizations for acute cardiac ischemia. Conclusion: Perfusion imaging did not demonstrate reversible ischemia in most patients (12/14, 86%) with cocaine‐induced chest pain without ECG evidence of ischemia. These results suggest that cocaine‐induced chest pain in most patients without ECG evidence of ischemia is not due to acute ischemia.
Patient and Family Attitudes Regarding the Practice of Procedures on the Newly Deceased
Authors: Manifold Craig A. , Storrow Alan , Rodgers Kevin 
Published: January 2008

AbstractPerformance of emergency lifesaving procedures is an integral part of emergency medicine resident training. Objective: To assess attitudes of ED patients regarding the practice of procedures on the newly deceased. Methods: A descriptive survey was administered to a convenience sample of ED patients and their families at two urban military Level‐1 trauma centers. Subjects were asked about their overall opinions regarding the practice of nontherapeutic procedural skills on themselves or relatives immediately after death in the ED. Subgroup analysis included the issue of advanced permission and opinions regarding procedures defined by the investigators as noninvasive (e.g., laryngeal mask airway) or invasive (e.g., cricothyrotomy). Data were analyzed descriptively and with chi‐square as appropriate. For comparison of proportions, a sample size of at least 140 was chosen for an alpha of 0.05 and a beta of 0.10 to detect an effect size of 0.3. Alpha was corrected for multiple comparisons prior to the study. Results: Three hundred seventeen surveys were collected and 88% (n ? 280) were complete. Seventy‐five percent (n ? 290) and 70% (n ? 273) of the respondents agreed to after‐death procedures on themselves or their relatives, respectively. However, only 40% (n ? 106) and 50% (n ? 131) would allow such procedures without prior permission. Seventy‐one percent (n ? 189) were willing to give permission in a living will, while 85% (n ? 238) indicated support of a wallet card format. There was no significant difference in permission rates when contrasting individual noninvasive and invasive procedures. Conclusion: Most patients are willing to have procedures performed on themselves or relatives shortly after death, yet the majority request that permission be obtained in advance. A living will or carried card would be acceptable for such permission.
The Effects of Graded Doses of Endothelin‐1 on Coronary Perfusion Pressure and Vital Organ Blood Flow during Cardiac Arrest
Authors: DeBehnke Daniel 
Published: January 2008

AbstractBackground: Endothelin‐1 (ET‐1) is a potent vasoconstrictor and has been shown to improve coronary perfusion pressure (CPP) during arrest. The effects of ET‐1 on organ blood flow during arrest have not been extensively studied. Objective: To investigate the effects of ET‐1 on myocardial and cerebral blood flow during cardiac arrest. Methods: Sixty immature swine were anesthetized and instrumented. The animals were randomized to receive one of three doses of ET‐1 (50, 150, or 300 μg) or placebo with/without standard‐dose epinephrine (SDE) during cardiac arrest. After a 10‐minute period of no‐flow ventricular fibrillation (VF), cardiopulmonary resuscitation (CPR) was performed for 3 minutes, followed by drug administration. Placebo or SDE was given every 3 minutes. Myocardial and cerebral blood flow was measured using a fluorescent microsphere technique. Results: Prearrest and CPR variables were not different between groups. Beginning 4 minutes after giving 300 μg ET‐1 with or without SDE, CPP was significantly increased compared with SDE alone. Total myocardial blood flow following ET‐1 administration was no different than myocardial blood flow following SDE alone. Cerebral blood flow increased 3.5 minutes after administration of 300 μg ET‐1 with SDE and reached significance 9.5 minutes after drug administration when compared with SDE alone [92.5 (48.8‐117.9) vs 15.6 (7.7‐23) mL/min/100 g]. Conclusions: Three hundred μg ET‐1 with SDE increases CPP and improves cerebral blood flow but does not improve myocardial blood flow during cardiac arrest. The peripheral effects of ET‐1 significantly improve CPP and cerebral blood flow, but myocardial blood flow is not increased due to coronary vasoconstriction.
Post‐resuscitative Hypothermic Bypass Reduces Ischemic Brain Injury in Swine
Authors: Mori Kazuhisa , Itoh Yasushi , Saito Jota , Takeyama Yoshihiro , Kurata Yoshiaki , Kaneko Masamitsu , Asai Yasufumi , Torigoe Toshihiko , Dickson Eric W. 
Published: January 2008

Abstract Objectives: Increasing human and laboratory evidence suggests thatpost‐resuscitative brain hypothermia reduces the pathologic consequences of brain ischemia. Using a swine model of prolonged cardiac arrest, this investigation sought to determine whether unilateral hypothermic carotid bypass was capable of inducing selective brain hypothermia and reducing neurohistologic damage. Methods: Ventricular fibrillation was induced in common swine (n? 12). After 20 minutes of cardiopulmonary arrest (without ventilatory support or cardiopulmonary resuscitation), systemic extracorporeal bypass was instituted to restore coronary and cerebral perfusion, followed by restoration of normal sinus rhythm. Animals randomized to the normal brain temperature (NBT) cohort received mechanical ventilation and intravenous fluids for 24 hours. The selective brain hypothermia (SBH) cohort received 12 hours of femoral/carotid bypass at 32°C. The bypass temperature was then increased one degree per hour until reaching 37°C and continued at this temperature until completion of the protocol (24 hours). Histopathologic damage was evaluated in two areas of the hippocampus. Results: Normal sinus rhythm was restored in all animals after the systemic (femoral/femoral) bypass was initiated. Nasal temperature (surrogate measure of brain temperature) remained higher than 37.0°C throughout the 24‐hour recovery period in the NBT animals. In the SBH cohort, right nasal temperature dropped to the mild hypothermic range (<34°C) two hours after institution of femoral/carotid bypass. This was maintained throughout the 12‐hour cooling period without hemodynamic compromise. There was a significant improvement in the neurohistology scores in the CA1 region of the hippocampus of the SBH treated animals as compared with those of the NBT cohort. Conclusions: Post‐resuscitative selective brain hypothermia reduced regional ischemic brain damage in swine with prolonged ventricular fibrillation.
Dispatcher Assistance and Automated External Defibrillator Performance among Elders
Authors: Ecker Rob , Rea Thomas D. , Meischke Hendrika , Schaeffer Sheri M. , Kudenchuk Peter , Eisenberg Mickey S. 
Published: January 2008

Abstract Objectives: Automated external defibrillators (AEDs) provide an opportunity to improve survival in out‐of‐hospital, ventricular fibrillation (VF) cardiac arrest by enabling laypersons not trained in rhythm recognition to deliver lifesaving therapy. The potential role of emergency dispatchers in the layperson use of AEDs is uncertain. This study was performed to examine whether dispatcher telephone assistance affected AED skill performance during a simulated VF cardiac arrest among a cohort of older adults. The hypothesis was that dispatcher assistance would increase the proportion who were able to correctly deliver a shock, but might require additional time. Methods: One hundred fifty community‐dwelling persons aged 58‐84 years were recruited from eight senior centers in King County, Washington. All participants had received AED training approximately six months previously. For this study, the participants were randomized to AED operation with or without dispatcher assistance during a simulated VF cardiac arrest. The proportions who successfully delivered a shock and the time intervals from collapse to shock were compared between the two groups. Results: The participants who received dispatcher assistance were more likely to correctly deliver a shock with the AED during the simulated VF cardiac arrest (91% vs 68%, p ? 0.001). Among those who were able to deliver a shock, the participants who received dispatcher assistance required a longer time interval from collapse to shock [median (25th, 75th percentile) ? 193 seconds (165, 225) for dispatcher assistance, and 148 seconds (138, 166) for no dispatcher assistance, p ? 0.001]. Conclusions: Among older laypersons previously trained in AED operation, dispatcher assistance may increase the proportion who can successfully deliver a shock during a VF cardiac arrest.
Access to Care A Review of the Emergency Medicine Literature
Authors: Richardson Lynne D. , Hwang Ula 
Published: January 2008

AbstractThe authors review the evolution of the emergency medicine literature regarding emergency department (ED) use and access to care over the past 20 years. They discuss the impact of cost containment and the emergence of managed care on prevailing views of ED utilization. In the 1980s, the characterization of “nonurgent ED visits” as “inappropriate” and high ED charges led to the targeting of non‐emergency ED care as a potential source of savings. During the 1990s the literature reveals multiple attempts to identify “inappropriate” ED visits and to develop strategies to triage these visits away from the ED. By the late 1990s, demonstration of the risks of denying emergency care and more sophisticated analyses of actual costs led to reconsideration of initiatives to limit access to ED care and renewed focus on the critical role of the ED as a safety net provider. In recent years, “de facto” denials of emergency care due to long ED waiting times and other adverse consequences of ED crowding have begun to dominate the emergency medicine health services literature.
Rationing and the Role of the Emergency Department as Society's Safety Net
Authors: Glauser Jonathan 
Published: January 2008

AbstractEmergency medicine has an integral role in the establishment of universal access to health care for all persons living in the United States. Currently, emergency departments provide the only unfunded mandate available to millions of American residents who otherwise have no access to health care coverage. Any effort to establish universal care must accept health care rationing as a basic principle, and establish a minimum standard of benefits to which all human beings are entitled in this country. People and employers should be allowed to purchase additional care based on their willingness and ability to pay, but under no circumstances should anyone be denied a basic package of health care benefits. Emergency care must be part of those basic benefits. Emergency medicine charges should be structured so that they are not unduly onerous to society, and should reflect true expenses, including marginal costs for nonurgent care. Emergency physicians (EPs) and hospital administrations should recognize their critical role in serving society in roles that are not strictly medical, and allocate resources to benefit the general population in the greatest way. This role will be expanded to include preventive care, to provide for basic pharmacologic coverage as needed, and to provide necessary immunizations when traditional primary care has failed. We have a moral obligation to recognize that resources are limited and to allocate them so as to benefit the greatest number of patients in the greatest way. As members of the medical profession best equipped to assume such a task, it is incumbent upon EPs to act as advocates to the public to enable us to fulfill this mission.
Neurotensin Analog NT69L Induces Rapid and Prolonged Hypothermia after Hypoxic Ischemia
Authors: Katz Laurence M. , Wang Yuanfan , McMahon Beth , Richelson Elliott 
Published: January 2008

Abstract Objective: To determine whether the neurotensin analog NT69L, administered systemically, could induce mild brain hypothermia after asphyxial cardiac arrest (ACA) in rats. Methods: The study design was experimental, blinded, randomized, and approved by the animal use committee. All rats had continuous monitoring of brain temperature and sustained 8 minutes of ACA, resuscitation, and either saline or NT69L intravenously afterreturn of spontaneous circulation (ROSC). Rats surviving 14 days after ACA had a neurological deficit score (NDS) and a Morris Water Maze (MWM) test. Results: Seven of eight rats in each group survived 14 days. Brain temperature was less than 35°C 13.1 ± 3 minutes (mean ± standard deviation) after NT69L vs controls that remained 37.5°C at the same ambient temperature (p < 0.05 ANOVA). The NT69L group remained below 35°C for 300 ± 100 minutes while the controls remained at 37.5 ± 0.5°C. The NDS in the NT69L rats was 3 ± 3% vs controls 26 ± 8% (p < 0.05, Kruskal‐Wallis, 0%= normal, 100%= brain dead). The NT69L rats performed better on the MWM vs the controls (22 ± 8 sec vs 45 ± 26 sec, respectively, p < 0.05 ANOVA). Conclusions: NT69L induced rapid and prolonged mild brain hypothermia after ACA in this ratmodel and reduced neurological deficits.
Snowmobile Injuries in Utah
Authors: Guenther Skokan Elisabeth , Olson Lenora M. , Cook Lawrence J. , Corneli Howard M. 
Published: January 2008

Abstract Objective: To describe the epidemiology of snowmobile injuries in Utah. Methods: Analysis of probabilistically linked statewide emergency department (ED), hospital admission, and death certificate data for 1996 and 1997. Results: There were 625 cases of snowmobile‐related injuries. The majority (83%) were evaluated in the ED only. Median ED patient age was 29 years (range 3‐74 years), and 66% were male. The leading diagnoses were open wounds to the head (7.8%), back strains (5.4%), and contusions of the trunk and lower extremities (5.2% and 5.0%, respectively). An Injury Severity Score (ISS) of ≥4 (range 1‐75) was found in 37% of the ED patients. The median charge was $373 per patient, with two‐year cumulative charges of $266,283. One hundred seven patients required inpatient hospital care. Median inpatient age was 32 years (range 4‐92 years), and 60% were male. Leading inpatient diagnoses were fracture of the vertebral column (9.3%), lower extremity fracture (9.3%), upper extremity fracture (6.5%), and pelvis fracture (3.7%). An ISS of ≥4 (range 1‐38) was found in 70% of the hospitalized patients. Average length of stay was 3 days, with a range of 1 to 68 days. Median inpatient charge was $6,003 per patient, with two‐year cumulative charges of $1,333,218. Ten inpatients required transfer for rehabilitation or skilled nursing care. There were a total of six fatalities, three of which occurred in the ED, one in the inpatient population, and two identified from the death certificate database. Conclusions: By combining ED, inpatient, and death certificate data sets, probabilistic linkage provides a comprehensive description of snowmobile‐related injuries and a baseline evaluation of morbidity, mortality, and financial burden.
Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department
Authors: Miner James R. , Fish Sara J. , Smith Stephen W. , Biros Michelle H. 
Published: January 2008

Abstract Objective: To compare the efficacy of droperidol with that of prochlorperazine for the treatment of benign headaches in emergency department (ED) patients. Methods: Prospective, randomized clinical trial in an urban ED. Patients were given either droperidol, 5 mg intramuscular (IM) or 2.5 mg intravenous (IV), or prochlorperazine, 10 mg IM or 10 mg IV. Measurements included side effects and the patient's pain perception as measured on a 100‐mm visual analog scale (VAS) at baseline, 30, and 60 minutes after the medication was given. Data were analyzed using chi‐square, two‐tailed t‐tests, and two‐way analysis of variance (ANOVA) when appropriate. Results: During an eight‐month period, 168 patients were enrolled. Eighty‐two (48.8%) of the patients received droperidol; 86 (51.2%) received prochlorperazine. In the droperidol group, 49 (59.6%) received IM administration and 33 (40.4%) IV. In the prochlorperazine group, 57 (66.3%) received IM administration and 29 (33.7%) IV. Sixty minutes after the medication, the mean decrease in the VAS scores was 81.4% for droperidol and 66.9% for prochlorperazine (p ? 0.001). At 30 minutes, 60.9% of the patients receiving droperidol and 44.2% of the patients receiving prochlorperazine had obtained at least a 50% reduction in their VAS scores (p ? 0.09). At 60 minutes, 90.2% of the patients receiving droperidol and 68.6% of the patients receiving prochlorperazine had at least a 50% reduction in their VAS scores (p ? 0.017). No difference between IM dosing and IV dosing was detected. Side effects, including dystonia, akathisia, and decreased level of consciousness, were seen in 15.2% of the patients receiving droperidol and 9.61% of the patients receiving prochlorperazine. No significant or persisting morbidity was detected. Conclusions: Droperidol was more effective than prochlorperazine in relieving pain associated with benign headaches.