bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventional radiological removal of a foreign body from a peripheral bronchus
Authors: Arawwawala D. , Lane C. , Jackson J. , Patel P. 
Published: January 2007

SummaryWe describe the extraction of an impacted tooth from a bronchiole of a ventilated, critically ill patient. Following failed attempts using flexible and rigid bronchoscopy a radiological approach was explored. The successful method described below used guiding catheters, an extraction basket and an occlusion balloon, deployed under fluoroscopic guidance.
Simulators for use in anaesthesia
Authors: Cumin D. , Merry A. F. 
Published: January 2007

SummaryThere are many simulators available for use in anaesthetic‐related education and research. Those who wish to purchase a simulator or to establish a simulation facility face a daunting task in understanding the differences between simulators. Recent reviews have focused on narrower areas of simulation, such as airway management or basic life support, or on the application of simulators. It would be difficult to deal in detail with every simulator ever made for anaesthesia, but in the present review we cover the spectrum of currently available anaesthetic simulators, provide an overview of different types of simulator, and discuss a selection of simulators of particular interest, including some of historical significance and some examples of ‘home made’ simulators. We have found no common terminology amongst authors for describing or classifying simulators, and propose a framework for describing (or classifying) them that is simple, clear and applicable to any simulator.
Correlation between heart rate variability and haemodynamic fluctuation during induction of general anaesthesia: comparison between linear and non‐linear analysis*
Authors: Fujiwara Y. , Kurokawa S. , Asakura Y. , Wakao Y. , Nishiwaki K. , Komatsu T. 
Published: January 2007

SummaryThe objective of this study was to compare linear and non‐linear analysis of heart rate variability (HRV) in terms of correlation with haemodynamic fluctuation during induction of general anaesthesia. Pre‐operatively, HRV was estimated by the MemCalc method in 114 patients scheduled for general anaesthesia. After anaesthesia was induced with propofol, fentanyl and vecuronium bromide, tracheal intubation was performed. Haemodynamic fluctuations during induction of anaesthesia were recorded and the correlation between pre‐operative HRV and haemodynamic fluctuation was examined using logistic regression analysis. As an index of non‐linear analysis of HRV, ultra short‐term entropy (UsEn) correlated better with blood pressure fluctuation than did the ratio of the power of low frequency component of HRV to that of high frequency component (LF/HF). In contrast, although LF/HF significantly correlated with heart rate increase caused by tracheal intubation, the correlation between UsEn and heart rate fluctuation was not significant.
The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*
Authors: Kimberger O. , Illievich U. , Lenhardt R. 
Published: January 2007

SummarySkin surface warming of patients not only improves thermal comfort, but has been shown to reduce anxiety in a pre‐hospital setting. We tested the hypothesis that pre‐operative warming can reduce pre‐operative anxiety as effectively as a conventional dose of intravenous midazolam in patients undergoing neurosurgery. We randomly allocated 80 patients to four groups in the pre‐operative holding area. Treatment was applied for 30–45 min with (1) passive insulation and placebo; (2) passive insulation and intravenous midazolam (30 μg.kg−1); (3) warming with forced‐air and placebo; and (4) warming with forced‐air and intravenous midazolam (30 μg.kg−1). Thermal comfort levels (VAS 0–100 mm) and anxiety levels (VAS 0–100 mm, Spielberger State‐Trait Anxiety Inventory) were assessed twice: before the designated treatment was started and before induction of anaesthesia. In the midazolam and the midazolam/warming groups, anxiety VAS and Spielberger state anxiety scores decreased by − 19 (95% CI: − 29 to − 9, p < 0.01) and − 10 (95% CI: − 14 to − 6, p < 0.01), respectively. In the warming and the combined groups, thermal VAS increased by + 26 (95% CI: 17–34, p < 0.01). Pre‐operative warming did not reduce anxiety VAS (p = 0.11) or Spielberger state anxiety (p = 0.19). The results of our study indicate that pre‐operative warming can be recommended solely to improve thermal comfort, not to replace anxiolytic premedication regimens.
An update on the management of severe idiopathic aplastic anaemia in children
Authors: Davies Jeffrey K. , Guinan Eva C. 
Published: January 2007

SummaryThe current outlook for a child with severe idiopathic aplastic anaemia (AA) is very much better than in previous decades. In part, this may reflect better differentiation of idiopathic and inherited marrow failure. For children with idiopathic AA and a human leucocyte antigen (HLA)‐matched sibling donor (MSD), allogeneic haematopoietic stem‐cell transplantation (AHSCT) is the primary therapy of choice, offering long‐term disease‐free survival of 90%, although graft‐versus‐host disease remains a cause of long‐term morbidity. A greater treatment challenge remains for those children without a MSD. Combination immunosuppressive therapy (IST) is associated with response rates of 70% or more. However, relapse and clonal evolution with transformation to myelodysplasia or acute myeloid leukaemia remain significant problems after IST and long‐term event‐free survival rates are less impressive. For children who do not have a sustained response to IST, alternate donor AHSCT should be considered. New HLA typing technologies, novel stem cell sources, reduced‐intensity conditioning and graft engineering have reduced toxicity and improved the outcome after alternate donor AHSCT. Emerging therapies that capitalise on recent advances in our understanding of the pathophysiology of idiopathic AA and the immunobiology of AHSCT and IST may further improve the long‐term outcome of this disease.
Evaluation of reticulocyte parameters in iron deficiency, vitamin B12 deficiency and β‐thalassemia minor patients
Authors: CEYLAN C. , MISKIOĞLU M. , ÇOLAK H. , KILIÇÇIOĞLU B. , ÖZDEMIR E. 
Published: January 2007

SummaryThe aim of this study was to test the clinical utility of reticulocyte parameters in differential diagnosis in iron deficiency anemia (IDA), vitamin B12 deficiency (B12) and β‐thalassemia minor (TM). We analyzed the percentage of reticulocyte, absolute reticulocyte count, mean content hemoglobin of reticulocyte (CHr), mean corpuscular volume of reticulocyte (MCVr), corpuscular hemoglobin concentration mean of reticulocyte (CHCMr), MCVr/MCV ratio, CHr/CH ratio and CHCMr/CHCM ratio in healthy donors (n = 34), iron deficiency (IDA) (n = 41), vitamin B12 deficiency (B12) (n = 22), and TM (n = 34). This study demonstrates that the cutoff value of CHr was 25.7 as indicative of IDA (85.4% sensitivity, 97.1% specificity). CHr and MCVr may be useful for TM (cutoff value ≤ 24.8 for CHr) and B12 (>102.1, cutoff value for MCVr), respectively. Sensitivity and specificity of these parameters were 90.9, 86.4% and 97.1, 82.4%, respectively. CHCMr is useful to differentiate IDA and TM from B12. While CHr was low value in microcytic groups (mean 21.8 ± 3.3 for IDA, 21.0 ± 2.9 for TM), it was high in B12 (mean 32.1 ± 5.7). However, that of CHr/CH ratio was only significantly in IDA group compared with the control (P < 0.05, mean 0.98). Therefore, there are limitations regarding CHr and CHr/CH ratio differential diagnosis in microcytic and macrocytic groups. CHr, MCVr, and CHCMr are not sufficiently sensitive and specific to differentiate TM from IDA. We conclude that measurement of reticulocyte count and parameters may be a very useful implement in the diagnosis of IDA and TM.
Spontaneous resolution of acquired factor V inhibitor associated with ovarian carcinoma
Authors: MAUGHAN E. O. , WILSON J. , WILDE J. T. 
Published: January 2007

SummaryA 74‐year‐old lady who presented initially with loin pain and haematuria, then melaena was found to have a prothrombin time ratio (PTR) > 10 and activated partial thromboplastin time ratio (APTTR) > 7. A factor V inhibitor was diagnosed. She was managed with supportive care and the FV inhibitor resolved. A few weeks later she developed abdominal swelling and ascites and was found to have an ovarian tumour. This is the first case, as far as we are aware, of a malignancy‐associated FV antibody that has spontaneously remitted before overt presentation of the tumour and illustrates the value of adopting an expectant approach to the management of acquired FV inhibitors.
Comparison of soluble and placental transferrin receptors as standards for the determination of soluble transferrin receptor in humans
Authors: KOGAN A. E. , FILATOV V. L. , KARA A. N. , LEVINA A. A. , KATRUKHA A. G. 
Published: January 2007

SummaryTransferrin receptor is a transmembrane protein that mediates iron transport from blood into cells. The extracellular part of this receptor circulates in blood as soluble transferrin receptor (sTfR) and the immunological determination of this parameter is widely used in clinical practice. This study aimed at comparing the properties of sTfR and placental TfR (pTfR) and to evaluate the validity of pTfR as a standard for the determination of sTfR in human serum. sTfR and pTfR were studied by immunofluorescent assay and fast protein liquid chromatography (FPLC) gel filtration. Serum sTfR levels were calculated using sTfR or pTfR as a standard. The immunological activity of pTfR was lower than that of sTfR in all anti‐TfR monoclonal antibody pairs. Upon FPLC gel filtration, pTfR eluted in a void volume of the column as a protein with a molecular weight (MW) of >1500 kDa, whereas the MW of sTfR corresponded to 237 kDa. This could be a result of micelle formation by pTfR because of its hydrophobic intracellular part. The serum sTfR levels calculated against sTfR were 2.5 times lower than those calculated against pTfR. Serum sTfR levels are overestimated when pTfR is used as the standard.
Carbon dioxide balance of a tropical peat swamp forest in Kalimantan, Indonesia
Authors: HIRANO TAKASHI , SEGAH HENDRIK , HARADA TSUYOSHI , LIMIN SUWIDO , JUNE TANIA , HIRATA RYUICHI , OSAKI MITSURU 
Published: January 2007

AbstractTropical peatlands, which coexist with swamp forests, have accumulated vast amounts of carbon as soil organic matter. Since the 1970s, however, deforestation and drainage have progressed on an enormous scale. In addition, El Niño and Southern Oscillation (ENSO) drought and large‐scale fires, which grow larger under the drought condition, are accelerating peatland devastation. That devastation enhances decomposition of soil organic matter and increases the carbon release to the atmosphere as CO2. This phenomenon suggests that tropical peatlands have already become a large CO2 source, but related quantitative information is limited. Therefore, we evaluated the CO2 balance of a tropical peat swamp forest in Central Kalimantan, Indonesia, using 3 years of CO2 fluxes measured using the eddy covariance technique from 2002 through 2004. The forest was disturbed by drainage; consequently, groundwater level (GL) was reduced. The net ecosystem CO2 production (NEP) measurements showed seasonal variation, which was slightly positive or almost zero in the early dry season, and most‐negative late in the dry season or early the rainy season. This seasonality is attributable to the seasonal pattern of climate, tree phenology and fires. Slightly positive NEP resulted from smaller ecosystem respiration (RE) and larger gross primary production (GPP) under conditions of high photosynthetic photon flux density (PPFD) and large leaf area index (LAI). The most‐negative NEP resulted from smaller GPP and larger RE. The smaller GPP was related to high vapor pressure deficit (VPD), small LAI and low PPFD because of smoke from fires. The larger RE was related to low GL. Annual NEP values were estimated respectively as −602, −382 and −313 g C m−2 yr−1 for 2002, 2003 and 2004. These negative NEP values show that the tropical peat swamp forest, disturbed by drainage, functioned as a CO2 source. That source intensity was highest in 2002, an ENSO year, mainly because of low PPFD caused by dense smoke emitted from large fires.
Climate, food, density and wildlife population growth rate
Authors: HONE JIM , CLUTTON‐BROCK TIM H. 
Published: January 2007

Summary

The aim of this study was to derive and evaluate a priori models of the relationship between annual instantaneous population growth rate (r) and climate. These were derived from the numerical response of annual r and food, and the effect of climate on a parameter in the numerical response. The goodness of fit of a range of such deductive models to data on annual r of Soay sheep and red deer were evaluated using information‐theoretic (AICc‐based) analyses.
The analysis for sheep annual r showed negative effects of abundance and negative effects of the interaction of abundance and climate, measured as March rainfall (and winter NAO) in the best fitting models. The analysis for deer annual r showed a negative effect of deer abundance and a positive effect of climate measured as March rainfall (but a negative effect of winter NAO), but no interaction of abundance and climate in the best fitting models.
There was most support in the analysis of sheep dynamics for the ratio numerical response and the assumption that parameter J (equilibrium food per animal) was influenced by climate. In the analysis of deer dynamics there was most support for the numerical responses assuming effects of food and density (Ivlev and density, food and density, and additive responses) and slightly less support for the ratio numerical response. The evaluation of such models would be aided by the collection of and incorporation of food data into the analyses.
Variability, contingency and rapid change in recent subarctic alpine tree line dynamics
Authors: DANBY RYAN K. , HIK DAVID S. 
Published: January 2007

Summary

Boundaries between forest and tundra ecosystems, tree lines, are expected to advance in altitude and latitude in response to climate warming. However, varied responses to 20th century warming suggest that in addition to temperature, tree line dynamics are mediated by species‐specific traits and environmental conditions at landscape and local scales.
We examined recent tree line dynamics at six topographically different, but climatically similar, sites in south‐west Yukon, Canada. Dendroecological techniques were used to reconstruct changes in density of the dominant tree species, white spruce (Picea glauca), and to construct static age distributions of willow (Salix spp.), one of two dominant shrub genera. Data were analysed to identify periods and rates of establishment and mortality and to relate these to past climate.
Tree line elevation and stand density increased significantly during the early to mid 20th century. However, this change was not uniform across sites. Spruce advanced rapidly on south‐facing slopes and tree line rose 65–85 m in elevation. Tree line did not advance on north‐facing slopes, but stand density increased 40–65%. Differences observed between aspects were due primarily to the differential presence of permafrost. Additional variability among sites was related to slope and vegetation type. Results were less conclusive for willow, but evidence for an advance was found at two sites.
Increases in stand density were strongly correlated with summer temperatures. The period of rapid change coincided with a 30‐year period of above average temperatures, beginning in 1920. The highest correlations were obtained using a forward average of 30–50 years, supporting the hypothesis that tree line dynamics are controlled more by conditions influencing recruitment than by establishment alone.
The changes observed at several sites are suggestive of a threshold response and challenge the notion that tree lines respond gradually to climate warming. Overall, the results provide further evidence to support the idea that the pattern and timing of change is contingent on local, landscape, and regional‐scale factors, as well as species’ biology.
A model‐based framework for the phenotypic characterization of the flowering of Medicago truncatula
Authors: MOREAU DELPHINE , SALON CHRISTOPHE , MUNIER‐JOLAIN NATHALIE 
Published: January 2007

ABSTRACTTo facilitate the phenotypic characterization of Medicago truncatula, our aim was to provide a framework of analysis of flowering in response to environmental factors. The flowering of the line A17 was analysed in different conditions of temperature, duration of vernalization and photoperiod. Flowering was characterized using three descriptors at the axis level: the position of the first reproductive node (1RN), the date of beginning of flowering (DBF) and the florochron (RFa−1) corresponding to the reciprocal of the rate of progression of flowering along each axis. As for vegetative development, it was found that flowering could be analysed as a function of thermal time using a base temperature (Tb) of 5 °C. Vernalization displayed a sound impact on the flowering. For all the studied axes, increasing the duration of vernalization lowered the 1RN and hastened the DBF. By contrast, for most of the studied axes, RFa−1 was only slightly affected by vernalization. For the branch B0, RFa−1 was a genotypic constant when thermal time was used. Considering B0 as a reference axis, an ecophysiological model was developed to simulate the impact of environmental factors on the three components of flowering. Concrete practical applications of the model‐based framework presented herein are proposed for helping the genetic and genomic studies of M. truncatula.
Long‐term effects of a structured intensive diabetes education programme (SIDEP) in patients with Type 2 diabetes mellitus—a 4‐year follow‐up study
Authors: Ko S.‐H. , Song K.‐H. , Kim S.‐R. , Lee J.‐M. , Kim J.‐S. , Shin J.‐H. , Cho Y.‐K. , Park Y.‐M. , Jeong J.‐H. , Yoon K.‐H. , Cha B.‐Y. , Son H.‐Y. , Ahn Y.‐B. 
Published: January 2007

AbstractAims  Patient education is a very important part of diabetes care. However, until now, little data has been presented about the long‐term effectiveness of structured intensive diabetes education programmes (SIDEP) for people with Type 2 diabetes mellitus.Methods  People with Type 2 diabetes (n = 547) hospitalized from December 1999 to December 2000 were randomly assigned to two groups. Two hundred and nineteen patients undertook an inpatient SIDEP and the remaining patients received conventional glycaemic control without intensive education. After discharge, all patients were monitored regularly. Laboratory data were obtained, and adherence to self‐care behaviour was determined on a five‐point scale by questionnaires completed annually.Results  Of the patients who completed the SIDEP, 160 (73.1%) were followed up for more than 4 years. The mean HbA1c (7.9 ± 1.2 vs. 8.7 ± 1.6%; P < 0.05) and the frequency of hospitalization related to diabetes per patient per year (0.3 ± 0.6 vs. 0.8 ± 0.9; P < 0.05) was significantly lower in the SIDEP group than in the control group. The SIDEP group adhered more closely to self‐care behaviour than the control group over 4 years (P < 0.05). People with Type 2 diabetes mellitus of longer duration and those treated with insulin had poorer HbA1c at follow‐up.Conclusions  A well‐designed, intensive patient education programme is necessary for people with diabetes. However, regular and sustained reinforcement with encouragement is also required to maintain optimal glycaemic control, especially in insulin‐treated patients.
Experiences of patients with insulin‐treated diabetes in conscript military service
Authors: Sane T. , Rautuoja A. , Mäkelä M. , Westerberg J. , Lehesjoki M. 
Published: January 2007

AbstractAims  To determine how young adults with insulin therapy manage daily care of diabetes during the physically demanding conditions of conscript military service, and to evaluate the effects of military service on glycaemic control and on the incidence of acute diabetic complications.Methods  An observational study of 47 young male volunteer conscripts receiving insulin therapy was carried out at the Signal Regiment in Riihimäki from January 2001 to July 2005. Outcome measures were drop‐out rate from service, management of diabetes care, glycaemic control, and occurrence of severe hypoglycaemia or ketoacidosis during service.Results  Forty (85%) diabetic conscripts completed service, with service time ranging from 180 to 362 days, and seven (15%) interrupted service. One‐third of conscripts reported difficulties during military training with insulin injections and blood glucose testing. The mean HbA1c during service increased by 0.6% units (P = 0.007) from baseline. Five events of severe hypoglycaemia in three conscripts (overall incidence rate 0.15 per patient‐year) and one ketoacidosis event occurred. Diabetic conscripts were chosen for leadership training more often than non‐diabetic conscripts.Conclusions  Our data suggest that selected and motivated adolescents on insulin therapy can manage the daily care of diabetes and maintain appropriate glycaemic control during service, although the risk of severe hypoglycaemia exists.
Insulin detemir compared with NPH insulin in children and adolescents with Type 1 diabetes
Authors: Robertson K. J. , Schoenle E. , Gucev Z. , Mordhorst L. , Gall M.‐A. , Ludvigsson J. 
Published: January 2007

AbstractAims  This study compared the effect of insulin detemir on glycaemic control (HbA1c, fasting plasma glucose and variability thereof) with that of Neutral Protamine Hagedorn human isophane (NPH) insulin, both combined with insulin aspart, in children with Type 1 diabetes mellitus, and compared the safety of these treatments.Methods  In this 26‐week, open‐label, randomized (2 : 1), parallel‐group study, 347 (140 prepubertal and 207 pubertal) children with Type 1 diabetes, aged 6–17 years, received insulin detemir (n = 232) or NPH insulin (n = 115) once or twice daily, according to the prestudy regimen, plus premeal insulin aspart.Results  The mean HbA1c decreased by ∼0.8% with both treatments. After 26 weeks, the mean difference in HbA1c was 0.1% (95% confidence interval −0.1, 0.3) (insulin detemir 8.0%, NPH insulin 7.9%). Within‐subject variation in self‐measured fasting plasma glucose was significantly lower with insulin detemir than with NPH insulin (SD 3.3 vs. 4.3, P < 0.001), as was mean fasting plasma glucose (8.4 vs. 9.6 mmol/l, P = 0.022). The risk of nocturnal hypoglycaemia (22.00–07.00 h) was 26% lower with insulin detemir (P = 0.041) and the risk of 24‐h hypoglycaemia was similar with the two treatments (P = 0.351). The mean body mass index (BMI) Z‐score was lower with insulin detemir (P < 0.001).Conclusions  Basal‐bolus treatment with insulin detemir or NPH insulin and premeal insulin aspart in children and adolescents with Type 1 diabetes mellitus improved HbA1c to a similar degree. The lower and more predictable fasting plasma glucose, lower risk of nocturnal hypoglycaemia and lower BMI observed with insulin detemir are clinically significant advantages compared with NPH insulin.