bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous coronary intervention and the use of glycoprotein IIb/IIIa inhibitors in patients with chronic kidney disease on dialysis: A single center experience
Authors: KHAJA Azam , GARG Rajeev , GOVINDARAJAN Gurushanker , MADSEN Richard , AGGARWAL Kul 
Published: October 2008

AbstractPatients on dialysis constitute a major healthcare burden with high prevalence of coronary artery disease frequently requiring coronary revascularization. Prior studies have reported high complications rates with revascularization in patients on dialysis. However, information on the use glycoprotein and direct thrombin inhibitors in this patient population undergoing percutaneous revascularization is limited. We retrospectively analyzed the procedural success and in‐hospital outcomes of percutaneous coronary revascularization in 56 consecutive patients on dialysis compared with 524 patients without renal failure, between January 2001 and August 2007 at our facility. Additionally, we also analyzed the off‐label use of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors during revascularization in this high‐risk group of patients to evaluate for possible increased bleeding complications. In the study group, 7 interventions were performed on peritoneal dialysis and 49 on hemodialysis patients. Sixty‐one percent of these patients had diabetes mellitus. A total of 72 lesions were intervened upon; 12 underwent angioplasty and 60 underwent stenting. Four of 72 interventions were not successful, giving a procedural success rate of 94%. There were 6 immediate complications (10.7%), but no deaths. Thirty‐two patients (57%) received GP IIb/IIIa inhibitors while direct thrombin inhibitors were used during percutaneous coronary intervention in 11(20%) patients. There were no bleeding complications with use of either GP IIb/IIIa inhibitors or direct thrombin inhibitors. In our experience, percutaneous coronary intervention has high procedural success in dialysis patients and concomitant use of GP IIb/IIIa inhibitors is not associated with any major bleeding complications, making this a feasible, safe and effective revascularization option for patients on dialysis; however, this merits further study in a randomized prospective trial.
Orally administrated Juzen‐taiho‐to/TJ‐48 ameliorates erythropoietin (rHuEPO)‐resistant anemia in patients on hemodialysis
Authors: NAKAMOTO Hidetomo , MIMURA Taku , HONDA Nobuko 
Published: October 2008

AbstractMaintenance of the red blood cell volume is a fundamental aspect of ensuring oxygen supply to the tissue. Recombinant human erythropoietin (rHuEPO) was approved for marketing in Japan in 1990 for the treatment of anemia in patients on dialysis. Recombinant human erythropoietin caused a significant increase in hemoglobin (Hb) levels in patients on dialysis. However, not all have a good response to rHuEPO therapy; the causes of rHuEPO failure include iron deficiency, infection, uremia, and interaction of some drugs. Juzen‐taiho‐to (TJ‐48), a mixture of extracts from 10 medicinal herbs, has been used traditionally to treat patients with anemia, anorexia, or fatigue. To clarify the effect of TJ‐48 on erythropoietin‐resistant anemia, we studied the effect of TJ‐48 in patients on hemodialysis with erythropoietin‐resistant anemia. We divided 42 end‐stage renal disease patients on hemodialysis with erythropoietin‐resistant anemia (Hb<10.0 g/dL with rHuEPO 9000 U/wk or 15 U/kg/wk treatment) into 2 groups as follows: a TJ‐48‐treated group (TJ‐48 group, 7.5 g/d, n=22) and a TJ‐48 nontreated (control group, n=20). At the beginning of this study, there was no significant difference between the groups in age, sex, serum creatinine, blood urea nitrogen, serum iron, and ferritin. After 12 weeks of treatment, the Hb level had significantly increased from 8.4 ± 1.1 to 9.5 ± 1.3 g/dL (P=0.0272) in the TJ‐48 group. C‐reactive protein (CRP) had significantly decreased from 1.4 ± 1.7 to 0.6 ± 0.8 mg/dL (P=0.0438). There was a significant negative correlation between Hb and CRP in the TJ‐48 group (r2=0.121, P=0.0066). In contrast, in the control group, Hb and CRP showed no significant changes throughout this study. Nor was there a significant correlation between Hb and CRP in the control group. In conclusion, TJ‐48 was effective in improving erythropoietin‐resistant anemia in end‐stage renal disease patients. This effect was, at least in part, due to the anti‐inflammatory effect of TJ‐48 in patients on hemodialysis.
Hemodialysis access‐related survival and morbidity in an elderly population in South West Thames, UK
Authors: EKBAL Nasirul J. , SWIFT Pauline A. , CHALISEY Anil , STEELE Maggi , MAKANJUOLA David , CHEMLA Eric 
Published: October 2008

AbstractElderly patients form the most rapidly expanding group of hemodialysis (HD) patients in Europe and the United States. There are initiatives to promote an increase in arteriovenous fistula (AVF) formation. There are concerns that elderly patients may have lower rates of surgical vascular access compared with younger patients due to risks of higher co‐morbidities, surgical complications, and higher AVF nonuse rates. The aim of this study was to compare access‐related survival and morbidity for dialysis catheters and AVFs and to evaluate the AVF nonuse rate in an elderly population. We have performed a retrospective analysis of access survival and morbidity in patients ≥70 years of age, either on maintenance HD or predialysis with preemptive formation of surgical access. One hundred and forty‐six patients had permanent HD access created during the 18‐month study period, from 1 January 2006 to June 2007. There were 89 male and 57 female patients in whom 78 AVFs and 137 tunneled venous catheters were inserted. There was a significantly greater loss of vascular access due to infection in the catheter group compared with the AVF group (P<0.016). Access survival was also significantly prolonged in the AVF group (446 days, 95% confidence interval 405–487) compared with the catheter group (276 days, 95% confidence interval 240–313), P=0.001. The rate of nonuse of AVFs was low (16%). We conclude that an AVF is the preferred form of vascular access in elderly HD patients.
Correlation between physical functioning and sleep disturbances in hemodialysis patients
Authors: SABBAGH Ramsey , IQBAL Sameena , VASILEVSKY Murray , BARRÉ Paul 
Published: October 2008

AbstractThe study set out to investigate the relationship between physical functioning, inflammatory status, and sleep disturbance in a chronic hemodialysis (HD) population. Forty‐six maintenance HD patients from the McGill University Health Centre were enrolled in this study between October 2005 and 2006. The well‐validated Human Activity Profile (HAP) questionnaire and the RAND 36‐item survey were used to assess physical functioning. Subjects were given the Pittsburgh Sleep Quality Index (PSQI) survey to evaluate the degree of sleep disturbance. Inflammatory status was assessed with the average value of serial C‐reactive protein (CRP) levels for each patient, over a period of 12 months before their enrollment in the study. A multivariate logistic regression model was created for these analyses to control for potential confounders, including dialysis adequacy, inflammation, and hemoglobin. Seventy‐six percent of the study population had poor sleep as per the Pittsburgh Sleep Quality Index (PSQI score ≥5). In addition, 65% of subjects had high CRP values (>5 mg/L). On univariate analysis, both a CRP >5 mg/L and a lower adjusted activity score (AAS) on the HAP were significantly associated with poor sleep (PSQI score ≥5). Multivariate logistic analysis demonstrated that the AAS remained significantly associated with poor sleep, with a 6% decrease in the odds of poor sleep for each score increase in the AAS of the HAP. Poor physical functioning in chronic HD patients, as measured by the HAP, is associated with sleep disturbance, after controlling for inflammation and dialysis adequacy.
Low‐molecular‐weight heparin for routine hemodialysis
Authors: DAVENPORT Andrew 
Published: October 2008

AbstractUnfractionated heparin (UFH) is a series of molecules, and as such has variable pharmacodynamics. Low‐molecular‐weight heparins were developed to improve both drug pharmacokinetics and dynamics, so as to provide a reliable clinical effect. These are potent agents, but have an increased half‐life compared with UFH in dialysis patients, and also require special laboratory monitoring. We switched our chronic hemodialysis patients from unfractionated to low‐molecular‐weight heparins. Low‐molecular‐weight heparins proved to be effective in preventing extracorporeal circuit clotting, and safe with fewer bleeding episodes and heparin‐induced thrombocytopenia than standard UFH. Indeed, we stopped routine laboratory monitoring because of the lack of side effects, and simply dosed by clinical inspection of the extracorporeal circuit for thrombus, and the time for fistula needle sites to stop bleeding. These agents have become the anticoagulants of choice in Europe for routine outpatient hemodialysis sessions, not only due to reduced drug costs but also due to the reliability of their clinical effect and ease of administration.
Defining Team Performance for Simulation‐based Training: Methodology, Metrics, and Opportunities for Emergency Medicine
Authors: Shapiro Marc J. , Gardner Roxane , Godwin Steven A , Jay Gregory D. , Lindquist David G. , Salisbury Mary L. , Salas Eduardo 
Published: October 2008

AbstractAcross health care, teamwork is a critical element for effective patient care. Yet, numerous well‐intentioned training programs may fail to achieve the desired outcomes in team performance. Hope for the improvement of teamwork in health care is provided by the success of the aviation and military communities in utilizing simulation‐based training (SBT) for training and evaluating teams. This consensus paper 1) proposes a scientifically based methodology for SBT design and evaluation, 2) reviews existing team performance metrics in health care along with recommendations, and 3) focuses on leadership as a target for SBT because it has a high likelihood to improve many team processes and ultimately performance. It is hoped that this discussion will assist those in emergency medicine (EM) and the larger health care field in the design and delivery of SBT for training and evaluating teamwork.
Maintaining Naval Combatants in ABS Classification In‐Service
Authors: ASHE GLENN M. 
Published: October 2008

AbstractThe American Bureau of Shipping and the Naval Sea Systems Command have been working together over the last several years in a measured initiative to develop and apply classification Rules for naval vessels, and currently both littoral combat ship (LCS) programs and the DDG‐1000 program require that the vessels be built and delivered in class to the Naval Vessel Rules. In addition, the JHSV platform will be delivered in class with ABS. It has been decided that the LCS platforms will be retained in class as a part of their maintenance philosophy. If this is successful, then DD‐1000 will also be retained in class. The JHSV, as are all Military Sealift Command ships, will be retained in class in‐service. This paper reviews the background supporting this initiative, describes the concept of retention in class, outlines the approach adopted, and reviews the current status of application.
Drydock Service Life Cost Reduction by Use of Finite Element Analysis
Authors: ASHLEY ADAM R. , LAROCK FRANCIS J. , MANN CHARLES E. 
Published: October 2008

AbstractMilitary Standard 1625 (SH) is currently the principal governing document for certification of floating drydocks which service US Navy ships. In order to maintain their certification, drydock owners must periodically document, evaluate, and repair corroded structural elements according to this standard's specifications. This evaluation and repair process is frequently cost‐prohibitive for some docks that have sustained significant corrosion. As an alternative, a finite element analysis (FEA) may be performed to isolate areas that require repair to maintain the safe operating capacity of the vessel. First, a finite element model of the drydock is created based on corrosion data from ultrasonic testing (UT). The corroded model is then analyzed to evaluate the global strength of the drydock and to isolate specific areas of corrosion that require repair. By isolating structurally critical areas, unnecessary repairs otherwise required, may be avoided. This process may result in considerable cost savings for drydock owners. In addition, wastage rates from historic ultrasonic survey data may be used to predict future corrosion. This paper will summarize the FEA conducted of the floating drydock ADEPT, a US Navy‐owned dock that is leased by Gulf Copper Ship Repair Inc. of Corpus Christi, TX. During the drydock's service life, significant corrosion has developed throughout the vessel's structure. Ultrasonic surveys were conducted to document the existing levels of corrosion and MAESTRO, a FEA program developed by Proteus Engineering, was used to develop a finite element model of the vessel based on the scantlings reported from the surveys. MAESTRO was then used to perform a FEA to isolate areas that require repair. Additionally, results from this analysis were used to calculate wastage rates and predict future corrosion. The FEA was then modified to analyze the future condition of the vessel in order to evaluate the need for future repairs.
Identification of Supplementary Metrics to Sustain Fleet Readiness from a Maintenance Perspective
Authors: DEAN ANTHONY W. , REINA JERRY J. , BAO HAN P. 
Published: October 2008

AbstractA wide variety of programs and schemes are in place (and many programs are in continuous development by organizations such as the Office of Naval Research) that address the sustainability of the Navy's Fleet. Newly developed technologies are allowing for the continued design and development of much more complex ships with a host of innovative concepts and requirements. The cost of construction of these next‐generation ships, budgetary restraints, and other factors have also made it so necessary to maintain, adapt, and extend the life of the legacy fleet to meet operational requirements and maintain our maritime dominance. As we extend and adapt technology to become implemented across the wide variety of vessel platforms in existence in the legacy fleet, manning reductions are being implemented across the various ship‐type classes. As more and more maintenance is being shifted from the sailors on the ships to various off‐ship organizations, this brings into question the level of training necessary for ship's personnel in the maintenance area that is required when manning the ship from a tactical or operational perspective. Decision tools need to be developed for senior Navy management for use in evaluating and determining the optimal balance in manning ships from not only the operational perspective but also from the maintainability/survivability perspective. It is believed evaluation of the requirements, benchmarking, and the development of assessment metrics for determining the requirements of the Fleet for capable maintainers are of vital importance and will have far‐reaching impact on the Sea Warrior, Sea Trial, and Sea Enterprise programs in support of the “Sea Power 21” strategic concept of the Navy. This paper explores the necessity of benchmarking current ship's force capabilities, establishing manning requirement metrics, and evaluation of current maintenance policies.
Bond Strength and Etching Pattern of Adhesive Systems to Enamel: Effects of Conditioning Time and Enamel Preparation
Authors: PIVETTA MARCELA RIGUERA , MOURA SANDRA KISS , BARROSO LUCIA PEREIRA , LASCALA ANTONIO CARLOS , REIS ALESSANDRA , LOGUERCIO ALESSANDRO DOURADO , GRANDE ROSA HELENA MIRANDA 
Published: October 2008

ABSTRACTStatement of the problem:  The performance of self‐etch systems on enamel is controversial and seems to be dependent on the application technique and the enamel preparation.Purpose of the Study:  To examine the effects of conditioning time and enamel surface preparation on bond strength and etching pattern of adhesive systems to enamel.Materials and Methods:  Ninety‐six teeth were divided into 16 conditions (N = 6) in function of enamel preparation and conditioning time for bond strength test. The adhesive systems OptiBond FL (Kerr, Orange, CA, USA), OptiBond SOLO Plus (Kerr), Clearfil SE Bond (Kuraray, Osaka, Japan), and Adper Prompt L‐Pop (3M ESPE, St. Paul, MN, USA) were applied on unground or ground enamel following the manufacturers’ directions or doubling the conditioning time. Cylinders of Filtek Flow (0.5‐mm height) were applied to each bonded enamel surface using a Tygon tube (0.7 mm in diameter; Saint‐Gobain Corp., Aurora, OH, USA). After storage (24 h/37°C), the specimens were subjected to shear force (0.5 mm/min). The data were treated by a three‐way analysis of variance and Tukey's test (α = 0.05). The failure modes of the debonded interfaces and the etching pattern of adhesives were observed using scanning electron microscopy.Results:  Only the main factor “adhesive” was statistically significant (p < 0.001). The lowest bond strength value was observed for OptiBond FL. The most defined etching pattern was observed for 35% phosphoric acid and for Adper Prompt L‐Pop. Mixed failures were observed for all adhesives, but OptiBond FL showed cohesive failures in resin predominantly.Conclusions:  The increase in the conditioning time as well as the enamel pretreatment did not provide an increase in the resin–enamel bond strength values for the studied adhesives.CLINICAL SIGNIFICANCEThe surface enamel preparation and the conditioning time do not affect the performance of self‐etch systems to enamel.
Hydrocolloid dressings in the management of acute wounds: a review of the literature
Authors: Thomas Stephen 
Published: October 2008

AbstractA review of the literature suggests that the application of self‐adhesive hydrocolloid dressings, most commonly associated with the treatment of ulcerative conditions such as pressure ulcers and leg ulcers, may also offer benefits in the management of acute wounds of all types, for example decreasing healing times of donor sites by about 40% compared with traditional treatments. Healing times of superficial traumatic injuries and surgical wounds are similarly enhanced but in the treatment of burns, the principal benefit appears to be a reduction in wound pain, an effect that has also been reported in virtually all other wound types. The impermeable nature of hydrocolloids provides a protective covering to the wound, permitting washing or showering while helping to prevent the spread of pathogenic microorganisms. There also appear to be significant cost–benefits associated with the use of hydrocolloids. In recent years, hydrocolloid dressings have been replaced by other products such as foams for the treatment of more heavily exuding wounds but for more lightly exuding wounds they still offer many practical advantages and as such will undoubtedly continue to meet an important need in wound management practice.
Toward representative protection of the world's coasts and oceans—progress, gaps, and opportunities
Authors: Spalding Mark D. , Fish Lucy , Wood Louisa J. 
Published: October 2008

AbstractMarine conservation lags behind terrestrial in the establishment of protected areas. This was recognized by the Convention on Biological Diversity, whose members, in 2004, agreed to establish “comprehensive, effectively managed, and ecologically representative” systems of marine protected areas (MPAs) by 2012. Halfway toward this target date, we look at the coverage of the world's 5045 MPAs from a biogeographic perspective. Only 4.09% of continental shelf areas are incorporated within MPAs, although coverage rises to 12.1% in a narrow coastal belt. Approximately half of all marine ecoregions have less than 1% MPA coverage across the shelf, but this is highly variable, and (8%) of ecoregions have >30% protection. Protection is greatest in the tropical realms, while temperate realms remain poorly represented. Given that that many sites lack effective management, even these low estimates of coverage are an optimistic measure of the extent of effective marine conservation.
Comparison of Extraintestinal Pathogenic
Escherichia coli
Strains from Human and Avian Sources Reveals a Mixed Subset Representing Potential Zoonotic Pathogens
Authors: Johnson Timothy J. , Wannemuehler Yvonne , Johnson Sara J. , Stell Adam L. , Doetkott Curt , Johnson James R. , Kim Kwang S. , Spanjaard Lodewijk , Nolan Lisa K. 
Published: September 2008

ABSTRACT

Since extraintestinal pathogenic
Escherichia coli
(ExPEC) strains from human and avian hosts encounter similar challenges in establishing infection in extraintestinal locations, they may share similar contents of virulence genes and capacities to cause disease. In the present study, 1,074 ExPEC isolates were classified by phylogenetic group and possession of 67 other traits, including virulence-associated genes and plasmid replicon types. These ExPEC isolates included 452 avian pathogenic
E. coli
strains from avian colibacillosis, 91 neonatal meningitis
E. coli
(NMEC) strains causing human neonatal meningitis, and 531 uropathogenic
E. coli
strains from human urinary tract infections. Cluster analysis of the data revealed that most members of each subpathotype represent a genetically distinct group and have distinguishing characteristics. However, a genotyping cluster containing 108 ExPEC isolates was identified, heavily mixed with regard to subpathotype, in which there was substantial trait overlap. Many of the isolates within this cluster belonged to the O1, O2, or O18 serogroup. Also, 58% belonged to the ST95 multilocus sequence typing group, and over 90% of them were assigned to the B2 phylogenetic group typical of human ExPEC strains. This cluster contained strains with a high number of both chromosome- and plasmid-associated ExPEC genes. Further characterization of this ExPEC subset with zoonotic potential urges future studies exploring the potential for the transmission of certain ExPEC strains between humans and animals. Also, the widespread occurrence of plasmids among NMEC strains and members of the mixed cluster suggests that plasmid-mediated virulence in these pathotypes warrants further attention.