bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waterborne microbial risk assessment : a population-based dose-response function for Giardia spp. (E.MI.R.A study)
Authors: Zmirou-Navier D , Gofti-Laroche L , Hartemann Ph 
Published: May 2006

Abstract

Background
Dose-response parameters based on clinical challenges are frequently used to assess the health impact of protozoa in drinking water. We compare the risk estimates associated with Giardia in drinking water derived from the dose-response parameter published in the literature and the incidence of acute digestive conditions (ADC) measured in the framework of an epidemiological study in a general population.

Methods
The study combined a daily follow-up of digestive morbidity among a panel of 544 volunteers and a microbiological surveillance of tap water. The relationship between incidence of ADC and concentrations of Giardia cysts was modeled with Generalized Estimating Equations, adjusting on community, age, tap water intake, presence of bacterial indicators, and genetic markers of viruses. The quantitative estimate of Giardia dose was the product of the declared amount of drinking water intake (in L) by the logarithm of cysts concentrations.

Results
The Odds Ratio for one unit of dose [OR = 1.76 (95% CI: 1.21, 2.55)] showed a very good consistency with the risk assessment estimate computed after the literature dose-response, provided application of a 20 % abatement factor to the cysts counts that were measured in the epidemiological study. Doing so, a daily water intake of 2 L and a Giardia concentration of 10 cysts/100 L, would yield an estimated relative excess risk of 12 % according to the Rendtorff model, against 11 % when multiplying the baseline rate of ADC by the corresponding OR. This abatement parameter encompasses uncertainties associated with germ viability, infectivity and virulence in natural settings.

Conclusion
The dose-response function for waterborne Giardia risk derived from clinical experiments is consistent with epidemiological data. However, much remains to be learned about key characteristics that may heavily influence quantitative risk assessment results.
Understandings of reproductive tract infections in a peri-urban pueblo joven in Lima, Peru
Authors: Hernández Lisa Scipioni , Winch Peter J , Parker Kea , Gilman Robert H 
Published: May 2006

Abstract

Background
Control programs for Reproductive Tract Infections (RTIs) typically focus on increasing awareness of risks associated with different forms of sexual contact, and pay little attention to how or why people may link RTIs to other features of their physical or social environments. This paper describes how women in a peri-urban pueblo joven located in the coastal desert surrounding Lima, Peru conceptualize the links between RTIs, sexual behaviour, personal hygiene, and the adverse environment in which they live.

Methods
We combined qualitative interviews and a participatory voting exercise to examine social and physical environmental influences on RTIs and gynaecologic symptom interpretation.

Results
Knowledge of RTIs in general was limited, although knowledge of AIDS was higher. Perceived causes of RTIs fell into three categories: sexual contact with infected persons, personal hygiene and exposure to the contaminated physical environment, with AIDS clearly related to sexual contact. The adverse environment is thought to be a major contributor to vaginal discharge, "inflamed ovaries" and urinary tract infection. The more remote parts of this periurban squatter settlement, characterized by blowing sand and dust and limited access to clean water, are thought to exhibit higher rates of RTIs as a direct result of the adverse environment found there. Stigma associated with RTIs often keeps women from seeking care or obtaining information about gynaecologic symptoms, and favours explanations that avoid mention of sexual practices.

Conclusion
The discrepancy between demonstrated disease risk factors and personal explanations influenced by local environmental conditions and RTI-related stigma poses a challenge for prevention programs. Effective interventions need to take local understandings of RTIs into account as they engage in dialogue with communities about prevention and treatment of RTIs.
The imperative for controlled mechanical stresses in unraveling cellular mechanisms of mechanotransduction
Authors: Anderson Eric J , Falls Thomas D , Sorkin Adam M , Tate Melissa L Knothe 
Published: May 2006

Abstract

Background

In vitro mechanotransduction studies are designed to elucidate cell behavior in response to a well-defined mechanical signal that is imparted to cultured cells, e.g. through fluid flow. Typically, flow rates are calculated based on a parallel plate flow assumption, to achieve a targeted cellular shear stress. This study evaluates the performance of specific flow/perfusion chambers in imparting the targeted stress at the cellular level.

Methods
To evaluate how well actual flow chambers meet their target stresses (set for 1 and 10 dyn/cm2 for this study) at a cellular level, computational models were developed to calculate flow velocity components and imparted shear stresses for a given pressure gradient. Computational predictions were validated with micro-particle image velocimetry (μ PIV) experiments.

Results
Based on these computational and experimental studies, as few as 66% of cells seeded along the midplane of commonly implemented flow/perfusion chambers are subjected to stresses within ±10% of the target stress. In addition, flow velocities and shear stresses imparted through fluid drag vary as a function of location within each chamber. Hence, not only a limited number of cells are exposed to target stress levels within each chamber, but also neighboring cells may experience different flow regimes. Finally, flow regimes are highly dependent on flow chamber geometry, resulting in significant variation in magnitudes and spatial distributions of stress between chambers.

Conclusion
The results of this study challenge the basic premise of in vitro mechanotransduction studies, i.e. that a controlled flow regime is applied to impart a defined mechanical stimulus to cells. These results also underscore the fact that data from studies in which different chambers are utilized can not be compared, even if the target stress regimes are comparable.
Evaluation of a Pediatric‐sedation Service for Common Diagnostic Procedures
Authors: King Wendalyn K. , Stockwell Jana A. , DeGuzman Michael A. , Simon Harold K. , Khan Naghma S. 
Published: May 2006

Abstract
Background:
Pediatric patients often require sedation for diagnostic procedures such as magnetic resonance imaging and computed tomography scanning. In October 2002, a dedicated sedation service was started at a tertiary care pediatric facility as a joint venture between pediatric emergency medicine and pediatric critical care medicine. Before this service, sedation was provided by the department of radiology by using a standard protocol, with high‐risk patients and failed sedations referred for general anesthesia.
Objectives:
To describe the initial experience with a dedicated pediatric‐sedation service.
Methods:
This was a retrospective analysis of quality‐assurance data collected on all sedations in the radiology department for 23‐month periods before and after sedation‐service implementation. Study variables were number and reasons for canceled or incomplete procedures, rates of referral for general anesthesia, rates of hypoxia, prolonged sedation, need for assisted ventilation, apnea, emesis, and paradoxical reaction to medication. Results are reported in odds ratios (OR) with 95% confidence intervals (95% CI).
Results:
Data from 5,444 sedations were analyzed; 2,148 before and 3,296 after sedation‐service activation. Incomplete studies secondary to inadequate sedation decreased, from 2.7% before the service was created to 0.8% in the post–sedation‐service period (OR, 0.29; 95% CI = 0.18 to 0.47). There also were decreases in cancellations caused by patient illness (3.8% vs. 0.6%; OR, 0.16; 95% CI = 0.10 to 0.27) and rates of hypoxia (8.8% vs. 4.6%; OR, 0.50; 95% CI = 0.40 to 0.63). There were no significant differences between the groups in rates of apnea, need for assisted ventilation, emesis, or prolonged sedation. The implementation of the sedation service also was associated with a decrease in both the number of patients referred to general anesthesia without a trial of sedation (from 2.1% to 0.1%; OR, 0.33; 95% CI = 0.06 to 1.46) and the total number of general anesthesia cases in the radiology department (from 7.5% to 4.4% of all patients requiring either sedation or anesthesia; OR, 0.56; 95% CI = 0.45 to 0.71).
Conclusions:
The implementation of a dedicated pediatric‐sedation service resulted in fewer incomplete studies related to inadequate sedation, in fewer canceled studies secondary to patient illness, in fewer referrals for general anesthesia, and in fewer recorded instances of sedation‐associated hypoxia. These findings have important implications in terms of patient safety and resource utilization.
The Relationship of Plasma Glucose and HbA1c Levels among Emergency Department Patients with No Prior History of Diabetes Mellitus
Authors: Silverman Robert A. , Pahk Raymond , Carbone Michelle , Wells Evelyn , Mitzner Ron , Burris Katy , Kelson James R. , Grella Rosetta , Katzeff Harvey 
Published: May 2006

Objectives:
Patients without a history of diabetes mellitus may be incidentally found to be hyperglycemic in the emergency department (ED). If the hyperglycemia is due to undiagnosed diabetes, then an opportunity for detection exists. Hemoglobin A1c (HbA1c) provides a weighted average of blood glucose levels over the past several months; high HbA1c levels could indicate diabetes. The objective of this study was to determine whether hyperglycemia in ED patients without a history of diabetes was associated with higher HbA1c levels.
Methods:
This was a prospective nonconsecutive case series of adults aged 18 years or older presenting to the ED with acute illness for whom a plasma glucose sample was drawn for clinical management. A history of diabetes/hyperglycemia or current symptoms of diabetes excluded patients. HbA1c levels were analyzed for a glucose cutoff of 110 mg/dL; the data were further analyzed using additional glucose cutoffs. Based on the Third National Health and Nutrition Examination Survey outpatient screening data, an HbA1c level ≥6.2% was considered elevated (sensitivity of 63% and specificity of 97% for identifying diabetes).
Results:
There were 541 patients enrolled; the glucose level correlated with the HbA1c level (r= 0.60, p < 0.001). Among the 331 patients with a glucose level ≥110 mg/dL, 22.4% had an elevated HbA1c level; among the 210 patients with a glucose level < 110 mg/dL, 7.6% had an elevated HbA1c level. There were few patients (n= 13) with a glucose level ≥200 mg/dL, but most (85%) had an elevated HbA1c level. Among the 140 patients with a mildly elevated glucose level (110–125 mg/dL), 16.4% had an elevated HbA1c level.
Conclusions:
Elevated HbA1c levels are found in ED patients with elevated random plasma glucose values. ED patients with hyperglycemia may warrant referral for diabetes testing.
Heritability of Serum Resistin and Its Genetic Correlation with Insulin Resistance-Related Features in Nondiabetic Caucasians
Authors: Menzaghi Claudia , Coco Angelo , Salvemini Lucia , Thompson Ryan , De Cosmo Salvatore , Doria Alessandro , Trischitta Vincenzo 
Published: May 2006

Abstract
Context: Serum levels of resistin are believed to modulate insulin resistance in humans.
Objective: The aim of this study was to investigate whether serum resistin levels are genetically controlled and whether this control is shared with other insulin resistance traits.
Design and Methods: The study cohort included 264 nondiabetic probands, Caucasian from Italy, and their 473 adult family members. Phenotypic characterization included anthropometric variables, blood pressure, fasting glucose and insulin, lipid profile, and resistin levels. Genotypes were determined at position g.−420C→G (rs1862513), IVS2+181G→A (rs3745367), and GAT(n) polymorphisms of the resistin (RETN) gene.
Results: In the 264 unrelated probands, resistin levels were significantly (P &lt; 0.01) correlated with adiposity, blood pressure, C-reactive protein, and the metabolic syndrome score. In a variance component analysis of the 264 probands and their 473 relatives, about 70% of the observed variation of serum resistin levels was heritable (P &lt; 0.0001). A small, but significant (P = 0.004) proportion of this variance was explained by the G→A variation at position IVS2+181 of the RETN gene. Significant genetic correlations (P &lt; 0.05) were observed between resistin and body mass index (ρg = 0.30), waist circumference (ρg = 0.32), the insulin resistance index HOMAIR (ρg = 0.28), and the metabolic syndrome score (ρg = 0.35).
Conclusions: These data indicate that serum resistin is highly heritable and has some common genetic background with traits related to insulin resistance, reinforcing the hypothesis that this adipokine may play a pathogenic role in insulin resistance-related abnormalities, including type 2 diabetes and cardiovascular disease.
A Convenient Synthesis of γ-Alkyl-α-hydroxy-γ-lactones as a Food Intake-Control Substance
Authors: Nakano Taichi , Ino Yurika , Nagai Yoichiro 
Published: May 2006

Abstract
A series of new γ-alkyl-α-hydroxy-γ-lactones which are promising as excellent food intake-control substances was synthesized in high yields by the hydrolysis of γ-alkyl-α-chloro-γ-lactones.
Estimation of Bulkiness of a Highly Sterically Demanding 2,4,6-Tris[bis(trimethylsilyl)methyl]phenyl Group
Authors: Okazaki Renji , Unno Masafumi , Inamoto Naoki 
Published: May 2006

Abstract
In two different types of reactions the title group behaves as a bulkier group than 2,4,6-tri-t-butylphenyl which has often been used for kinetic stabilization of highly reactive compounds.
Clozapine-Induced Systemic Lupus Erythematosus
Authors: Rami Abu Fanne , Barkan Daniel , Mevorach Dror , Leitersdorf Eran , Caraco Yoseph 
Published: May 2006

Objective: To report a case of classic clozapine-induced systemic lupus erythematosus that also developed on rechallenge. Case Summary: A 32-year-old white woman diagnosed with schizophrenia presented in 1996 with clinical characteristics and laboratory markers consistent with drug-induced lupus (DIL). Clozapine, started 1 year prior, was withdrawn, with complete biological and clinical remission within 3 months. In 2004, 1 week after rechallenge with clozapine for uncontrolled schizophrenia, the patient developed clinical and biological signs and symptoms consistent with the diagnosis of DIL. Again, discontinuation of clozapine was followed by full remission within 2–3 months. Discussion: DIL was first described more than 50 years ago, with multiple drugs implicated in the causation. Clozapine-induced lupus was reported recently, but does not meet the usual criteria for a diagnosis of DIL. We report a classic case of clozapine-induced lupus that, according to the Naranjo probability scale, demonstrates a highly probable relationship between DIL and clozapine. Conclusions: DIL demands a high index of suspicion for diagnosis. Although clozapine has an extensive safety profile, DIL must be considered as one of its serious adverse effects.
Nuclear fusion in finite semifield planes
Authors: Jha Vikram , Johnson Norman L. 
Published: May 2006

Abstract
We study the subplanes of finite semifield planes that are coordinatizable by subfields F of some semifield D such that F lies in at least two of the three seminuclear fields N
ℓ(D), Nm
(D), and Nr
(D). Our main results determine completely the combinatorial configurations associated with such subplanes, and enables, for example, a computational method to determine the number of nuclear planes of order q in semifield planes of order qt
.
The results have a number of applications. Firstly, they imply ‘fusion’ theorems. The most basic one is that if two or more seminuclear subfields, of a semifield D coordinatizing a translation plane π, are each isomorphic to GF(q), then π may be recoordinatized by a semifield E such that the indicated seminuclear fields, of order q, coincide. The most important case is nuclear fusion: if all three seminuclei of D are isomorphic to GF(q) then the nucleus N(E) ≅ GF(q).
Further applications are concerned with semifield spreads π of order q
2. We classify all such π that admit three homology groups of order q – 1 with dierent axis (the shears axis, the infinite line, and any other component), thus generalizing a theorem of D. E. Knuth, who proved an algebraic version of the result.
Victimization, Substance Use, and HIV Risk Behaviors Among Gay/Bisexual/Two-Spirit and Heterosexual American Indian Men in New York City
Authors: Simoni Jane M. , Walters Karina L. , Balsam Kimberly F. , Meyers Seth B. 
Published: May 2006

Objectives.secondary aims included describing condom-use attitudes, beliefs about HIV/AIDS in the Indian community, HIV knowledge, HIV status, and preference for and access to HIV prevention services in this population. Methods. A survey was mailed to all members of an American Indian community organization in New York City. Results. The 20 men self-identifying as gay, two-spirit, or bisexual (hereafter, “two-spirit”) were more likely to report being victimized and engaging in HIV risk behaviors than the 51 heterosexual respondents, although they reported comparable levels of recent substance use. Overall, victimization was associated with lifetime HIV risk behaviors (even after control for sexual orientation) but not with substance use or unsafe sex in the past 12 months. The percentage of HIV infection was surprisingly high (10% of two-spirit men and 6% of heterosexual men). Conclusions. Two-spirit men are a vulnerable population whose victimization must be understood within an appropriate historical and political context.
Blood Transfusions in the Early Years of AIDS in Sub-Saharan Africa
Authors: Schneider William H. , Drucker Ernest 
Published: May 2006

Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990. By 1955, 19 African colonies and countries reported transfusion programs—with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950–1970, when all epidemic strains of HIV first emerged in this region.
Longitudinal Relationships Between Use of Highly Active Antiretroviral Therapy and Satisfaction With Care Among Women Living With HIV/AIDS
Authors: Burke-Miller Jane K. , Cook Judith A. , Cohen Mardge H. , Hessol Nancy A. , Wilson Tracey E. , Richardson Jean L. , Williams Pete , Gange Stephen J. 
Published: May 2006

Objectives. We used longitudinal data to examine the roles of 4 dimensions of patient satisfaction as both predictors and outcomes of use of highly active antiretroviral therapy (HAART) among women in the United States with HIV/AIDS. Methods. Generalized estimating equations were used to analyze time-lagged satisfaction–HAART relationships over 8 years in the Women’s Interagency HIV Study. Results. Multivariate models showed that, over time, HAART use was associated with higher patient satisfaction with care in general, with providers, and with access/convenience of care; however, patient satisfaction was not associated with subsequent HAART use. Symptoms of depression and poor health-related quality of life were associated with less satisfaction with care on all 4 dimensions assessed, whereas African American race/ethnicity, illegal drug use, and fewer primary care visits were associated with less HAART use. Conclusions. Our findings suggest that dissatisfaction with care is not a reason for underuse of HAART among women with HIV and that providers should not be discouraged from recommending HAART to dissatisfied patients. Rather, increasing women’s access to primary care could result in both increased HAART use and greater patient satisfaction.
HIV Testing Among Young Adults in the United States: Associations with Financial Resources and Geography
Authors: Nguyen Trang Quyen , Ford Carol A. , Kaufman Jay S. , Leone Peter A. , Suchindran Chirayath , Miller William C. 
Published: May 2006

We estimated prevalence and odds ratios for self-reported HIV testing among sexually experienced young adults using nationally representative data obtained from Wave III of the National Longitudinal Study of Adolescent Health (Add Health). The prevalence of testing in the past year was 18.8%. Young adults who had private or no health insurance were less likely to report testing than were young adults who had public health insurance, particularly in the South. Respondents with functional income were less likely to report testing than were those without functional income, particularly in the South and Northeast. Variable HIV testing based on finances and insurance should be addressed.
Perpetration of Intimate Partner Violence Associated With Sexual Risk Behaviors Among Young Adult Men
Authors: Raj Anita , Santana M. Christina , La Marche Ana , Amaro Hortensia , Cranston Kevin , Silverman Jay G. 
Published: May 2006

Objective. We assessed the association between intimate partner violence (IPV) perpetration and sexual risk behaviors and fatherhood (having fathered children) among young men. Methods. Sexually active men aged 18 to 35 years who visited an urban community health center and who reported having sexual intercourse with a steady female partner during the past 3 months (N = 283) completed a brief self-administered survey about sexual risk behaviors, IPV perpetration, and demographics. We conducted logistic regression analyses adjusted for demographics to assess associations between IPV and sexual risk behaviors and fatherhood. Results. Participants were predominantly Hispanic (74.9%) and Black (21.9%). Participants who reported IPV perpetration during the past year (41.3%) were significantly more likely to report (1) inconsistent or no condom use during vaginal and anal sexual intercourse, (2) forcing sexual intercourse without a condom, (3) having sexual intercourse with other women, and (4) having fathered 3 or more children. Conclusion. IPV perpetration was common among our sample and was associated with increased sexual risk behaviors. Urban community health centers may offer an important venue for reaching this at-risk population.