bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinematics of waterfall climbing in Hawaiian freshwater fishes (Gobiidae): vertical propulsion at the aquatic–terrestrial interface
Authors: Schoenfuss Heiko L. , Blob Richard W. 
Published: October 2003

AbstractTo reach adult habitats, juveniles of three species of Hawaiian gobies (fishes under 3 cm long) climb waterfalls up to 350 m high, over 10 000 times their body length. The demands of moving through such an extreme environment could constrain the range of viable locomotor mechanisms that these fishes use. Previous qualitative observations indicated that Lentipes concolor and Awaous guamensis use ‘powerbursts’ of axial undulation to climb, whereas Sicyopterus stimpsoni‘inches up’ vertical surfaces by alternately attaching oral and pelvic suckers to the substrate. To compare these propulsive mechanisms and their physiological requirements, high‐speed video footage of climbing by juveniles from these three species on an artificial waterfall were collected, and climbing kinematics and performance for the two climbing styles were quantified. Bouts of powerburst climbing by L. concolor and A. guamensis typically begin in or near direct water flow and are initiated by a single, rapid adduction of the pectoral fins. Powerburst climbing bouts are rapid (12.4±1.0 body lengths (BL) s−1), but short in duration (0.07±0.02 s) with few continuous locomotor cycles (3.8±1.3 cycles bout−1). Powerburst climbers use high amplitude undulations along the entire body, but minimum resultant velocities of these undulations are high (>6 BL s−1). This suggests that these species may hybridize terrestrial propulsive mechanisms with aquatic mechanisms. In contrast, climbing by inching in S. stimpsoni involves little axial undulation or fin movement. Sicyopterus stimpsoni typically exit the water outside of direct flow and seem to use terrestrial propulsive mechanisms. As the oral disc attaches to the substrate, it expands to almost twice its resting area, after which the posterior body is pulled upwards; once the pelvic disc attaches, the oral disc releases and the anterior body advances. Climbing bouts include several continuous cycles of disc attachment (11.0±1.4 cycles bout−1) and last several seconds at velocities of 0.21±0.01 BL s−1. Before climbing waterfalls during migration to adult habitats, S. stimpsoni undergo a non‐feeding metamorphosis that leads to the development of the mouth as a secondary locomotor organ. The unusual behaviour and ontogenetic strategy of S. stimpsoni seem to be evolutionary novelties, rather than ancestral retentions, suggesting that the evolution of these features may have been closely correlated. The substantial performance and kinematic distinctions between powerburst and inching climbing indicate that considerable locomotor diversity can evolve even in the context of extreme environmental demands.
Rapid ecological and behavioural changes in carnivores: the responses of black bears (Ursus americanus) to altered food
Authors: Beckmann Jon P. , Berger Joel 
Published: October 2003

AbstractMany areas have experienced disproportionate increases in the number of conflicts between large carnivores and humans, and this is especially true in western North America where urban sprawl has encroached into regions that have historically contained large carnivores. Yet, globally there is a paucity of studies of temporal changes in behavioural and ecological parameters of carnivores associated with human‐induced perturbations at the same location. We capitalized on the extent to which human population growth and its coincident food stores offer a quasi‐experimental setting to test hypotheses about the impact of novel food resources. Using black bears Ursus americanus and garbage, measures of behaviour and ecology were contrasted between individuals living in urban–wildland interface (‘experimental’) and in wildland (‘control’) settings at the interface of the Sierra Nevada Range and the Great Basin Desert in the western United States. A temporal dimension was included by comparing our data to those from the same population lacking areas of human encroachment 10–15 years earlier. Specifically, an examination was made of the impacts of garbage on bear time budgets, patterns of activity, and den chronology. Individuals at urban interface areas relative to wildland conspecifics were: (1) active for significantly fewer h per day (8.5 vs 13.3 h; P<0.01); (2) shifted their activities to nocturnal periods (P<0.001); (3) entered dens significantly later and remained in them for significantly fewer days (P<0.05). Our results are contrasted with selected carnivores from sites where attendant changes in behaviour and ecology have accompanied landscape changes associated with human activity. Our findings suggest alterations in carnivore ecology may be rapid and occur within shorter periods than had been previously assumed.
Solitary sclerotic fibroma of skin: a possible link with pleomorphic fibroma with immunophenotypic expression for O13 (CD99) and CD34
Authors: Mahmood Muhammad N. , Salama Mohamed E. , Chaffins Marsha , Ormsby Adrian H. , Ma Chan K. , Linden Michael D. , Lee Min W. 
Published: October 2003

Background:  Solitary sclerotic fibroma (SF) presents as a well circumscribed dermal nodule, composed of sparse spindle cells with alternating wavy collagen fibers arranged in a storiform pattern. The histogenesis and nature of this histologically distinct lesion are uncertain. Whether this peculiar tumor represents a true hamartoma or a degenerating end of various fibrous lesions such as pleomorphic fibroma (PF), dermatofibroma, or angiofibroma is still controversial. High proliferating index of spindle cells in SF argues against the possibility of being a degenerating end product of another lesion.Methods:  We studied morphological features and immunoprofile of eight SFs, in comparison with four PFs, one collagenized dermatofibroma, two angiofibromas, and two periungual fibromas. Immunostains for CD34, CD31, O13 (CD99), Factor XIIIa, S‐100, CD68 (KP‐1), and MIB‐1 were carried out using a labeled streptavidin–biotin method with DAKO‐automated immunostainer. Paraffin blocks of two SFs were reprocessed for electron microscopic studies. Clinical data of all patients with SF were also reviewed.Results:  Spindle cells and pleomorphic cells in SF and PF showed diffuse immunoreactivity for CD34 and O13 but were negative for CD31, S‐100, and CD68. Spindle cells in one dermatofibroma and one angiofibroma were positive for Factor XIIIa. Proliferating index (MIB‐1) was very low in all cases of SF, contradicting some previous reports.Conclusions:  SF is a fibrotic lesion with cells positive for CD34 and O13. It shares a common immunoprofile with PF but is distinct from dermatofibroma and other common spindle cell lesions of skin. O13 expression in SF has not been previously described.
Ill‐health reported by schoolchildren during questionnaire surveys in Ghana, Mozambique and Tanzania
Authors: Moestue Helen , Mahumane Bonifacio , Zacher Anna , Issae Wahab , Kihamia Charles M. , Wen Su‐Tung , Adjei Sam , Bundy Donald A. P. , Hall Andrew 
Published: October 2003

SummaryBackground Insufficient attention has been paid to the health problems of school‐age children in sub‐Saharan Africa. A questionnaire administered to schoolchildren about their ill‐health has been developed to identify schools in which urinary schistosomiasis occurs. The data collected during the interviews can also be used to assess other common health problems.Objectives To analyse data collected during health questionnaires in schools to assess how schoolchildren perceive their own health, and to compare the findings between three countries in sub‐Saharan Africa.Methods Questionnaires asking about recent health problems were administered by teachers to schoolchildren in 120 primary schools in Mozambique, 52 primary schools in Tanzania and 298 primary schools in Ghana. A total of 67 002 children aged 8–15 years took part.Results Of the 10 health problems asked about in all questionnaires, the average number reported by each child was 3.9 in Ghana, 3.4 in Mozambique and 3.1 in Tanzania. The distributions of the prevalence of each condition among schools were similar and the prevalence of all conditions showed a similar ranking. For most conditions a greater percentage of girls than boys reported each health problem.Conclusions Schoolchildren in Ghana, Mozambique and Tanzania do not perceive themselves to be healthy. The pattern of reported health problems was similar in each country. School health questionnaires are worthy of further study and validation.
Short communication: Low risk of transmission of severe acute respiratory syndrome on airplanes: the Singapore experience
Authors: Wilder‐Smith Annelies , Paton Nicholas I. , Goh Kee Tai 
Published: October 2003

SummaryThe risk of transmission of severe acute respiratory syndrome (SARS) on airplanes is of major concern to the public and airline industry. We examined data from flights to Singapore with SARS patients on board in order to assess this risk. In‐flight transmission occurred only in one of the three flights with symptomatic SARS patients on board. The incidence was estimated to be 1 out of 156 passengers. The risk of in‐flight transmission of SARS appears to be far lower than that reported for influenza, but may be increased with superspreaders on board.
Pharmacological characteristics and side effects of a new galenic formulation of propofol without soyabean oil*
Authors: Paul M. , Dueck M. , Kampe S. , Fruendt H. , Kasper S. M. 
Published: October 2003

SummaryWe compared the pharmacokinetics, pharmacodynamics and safety profile of a new galenic formulation of propofol (AM149 1%), which does not contain soyabean oil, with a standard formulation of propofol (Disoprivan® 1%). In a randomised, double‐blind, cross‐over study, 30 healthy volunteers received a single intravenous bolus injection of 2.5 mg.kg−1 propofol. Plasma propofol levels were measured for 48 h following drug administration and evaluated according to a three‐compartment model. The pharmacodynamic parameters assessed included induction and emergence times, respiratory and cardiovascular effects, and pain on injection. Patients were monitored for side effects over 48 h. Owing to a high incidence of thrombophlebitis, the study was terminated prematurely and only the data of the two parallel treatment groups (15 patients in each group) were analysed. Plasma concentrations did not differ significantly between the two formulations. Anaesthesia induction and emergence times, respiratory and cardiovascular variables showed no significant differences between the two treatment groups. Pain on injection (80 vs. 20%, p < 0.01) and thrombophlebitis (93.3 vs. 6.6%, p < 0.001) occurred more frequently with AM149 than with Disoprivan®. Although both formulations had similar pharmacokinetic and pharmacodynamic profiles the new formulation is not suitable for clinical use due to the high incidence of thrombophlebitis produced.
Making monitoring ‘work’: human–machine interaction and patient safety in anaesthesia
Authors: Smith A. F. , Mort M. , Goodwin D. , Pope C. 
Published: October 2003

SummaryThis study aimed to explore the use of electronic monitoring within the context of anaesthetic practice. We conducted workplace observation of, and interviews with, anaesthetists and other anaesthetic staff in two UK hospitals. Transcripts were analysed inductively for recurrent themes. Whilst formal sources of knowledge in anaesthesia deal with the issue of monitoring in terms of theoretical principles and performance specifications of devices, anaesthetists in practice often ‘disbelieve’ monitoring information. They call on and integrate other sources of knowledge about the patient, especially from their clinical assessment. The ability to distinguish ‘normal’ and ‘abnormal’ findings is vital. Confidence in electronic information varies with experience, as does the degree to which electronic information may be considered ‘redundant’. We conclude that electronic monitoring brings new dimensions of understanding but also the potential for new ways of misunderstanding. The tacit knowledge underlying the safe use of monitoring deserves greater acknowledgement in training and practice.
A web‐based system for teaching, assessment and examination of the undergraduate peri‐operative medicine curriculum
Authors: Wheeler D. W. , Whittlestone K. D. , Smith H. L. , Gupta A. K. , Menon D. K. ,   on behalf of the East Anglian Peri‐operative Medicine Undergraduate Teaching Forum
Published: October 2003

SummaryToday's students are generally computer literate and have high expectations of university information technology resources. Most United Kingdom medical schools now provide networked computers for learning, research, communication and accessing the worldwide web. We have exploited these advances to augment and improve the teaching of peri‐operative medicine and anaesthesia to medical students in our university, who are taught in several hospitals over a wide geographical area. Course material such as departmental induction information, lecture notes and assessment sheets can be accessed online, contributing to the smooth running of the course. Streamed videos and simulations allow students to familiarise themselves with common practical procedures in advance. Development of a web‐based end of course assessment has resulted in substantially less administration and bureaucracy for course organisers and proved to be a valuable research tool. Students' and teachers' opinions of the new course structure have been overwhelmingly positive.
Assessment of postsurgical recovery after discharge using a pen computer diary*
Authors: Begg A. , Drummond G. , Tiplady B. 
Published: October 2003

AbstractWe assessed patients after their return home following gynaecological surgery, using a daily electronic diary. Thirty‐two females aged 27–77 years took part. After a hospital stay of 1–6 days (mean 2.3), they were given a pen‐based electronic diary and asked to record symptoms and other data over one month. They also completed a questionnaire at the end of the study. Substantial effects on quality and duration of sleep, pain during both the night and day, interference with daily activities, energy, and ability to concentrate were recorded, mostly during the first week of treatment. Symptoms reported in the final questionnaire correlated significantly with diary data. Most patients found the electronic diary easy to use, and none found it difficult. Daily electronic diaries are an acceptable method of obtaining better information on the extent and duration of symptoms and other difficulties after discharge following surgery.
A clinical evaluation of the Bonfils Intubation Fibrescope*
Authors: Halligan M. , Charters P. 
Published: October 2003

SummaryThe Bonfils Intubation Fibrescope is a rigid optical instrument for performing orotracheal intubation. We describe its introduction into our clinical practice in 60 patients with normal airways who required orotracheal intubation for elective surgery. Two anaesthetists each performed 30 attempts to intubate, in turn, in patients who received a standard general anaesthetic with neuromuscular blockade. Intubation was successful in 59 out of 60 cases. The median (IQR [range]) time to intubation was 33 s (24–50 [13–180] s). Median (IQR [range]) verbal rating score for difficulty was 2 (1–3 [0–10]). There was a significant correlation between the intubation times and the verbal rating score (p < 0.01). There was evidence of airway trauma in the single patient in whom intubation failed. The Bonfils Intubation Fibrescope is an effective instrument for orotracheal intubation in normal subjects.
Prediction of difficult laryngoscopy in obese patients by ultrasound quantification of anterior neck soft tissue*
Authors: Ezri T. , Gewürtz G. , Sessler D. I. , Medalion B. , Szmuk P. , Hagberg C. , Susmallian S. 
Published: October 2003

SummaryIn 50 morbidly obese patients, we quantified the soft tissue of the neck from the skin to the anterior aspect of the trachea at the vocal cords using ultrasound. Thyromental distance, mouth opening, limited neck mobility, modified Mallampati score, abnormal upper teeth, neck circumference and sleep apnoea were assessed as predictors of difficult laryngoscopy. Of the nine (18%) cases of difficult laryngoscopy, seven (78%) had a history of obstructive sleep apnoea, compared with two of the 41 patients (5%) in whom laryngoscopy was easy (p < 0.001). Patients in whom laryngoscopy was difficult had more pretracheal soft tissue (mean (SD) 28 (2.7) mm vs. 17.5 (1.8) mm; p < 0.001) and a greater neck circumference (50 (3.8) vs. 43.5 (2.2) cm; p < 0.001). None of the other predictors correlated with difficult laryngoscopy. We conclude that an abundance of pretracheal soft tissue at the level of the vocal cords is a good predictor of difficult laryngoscopy in obese patients.
Post‐splenectomy thrombocytopenia: implications for regional analgesia
Authors: McLure H. A. , Trenfield S. , Quereshi A. , Williams J. 
Published: October 2003

SummaryHospital computerised records were reviewed to identify patients who had undergone splenectomy, then chart their platelet count before and for the 5 days after the operation. A pre‐operative platelet count less than 100 × 109.l−1 occurred in 66% of leukaemia (n = 35), 56% of lymphoma (n = 41) and 5% of solid tumour (n = 39) patients. Platelet supplementation prior to epidural catheter insertion may reduce the risks of spinal bleeding. However, accidental catheter removal during a postoperative period of thrombocytopenia may lead to formation of an epidural haematoma. The lowest postoperative platelet count was less than 100 × 109.l−1 in 66% of leukaemia, 27% of lymphoma and 13% of solid tumour patients. Platelet counts varied considerably, so predicting an individual patient's postoperative nadir from the pre‐operative count would be impossible. Consequently, placement of an epidural catheter in many of these patients could expose them to an increased risk of spinal bleeding if the catheter is removed accidentally.
Anaesthetic considerations in a parturient with varicella presenting for Caesarean section
Authors: Brown N. W. , Parsons A. P. R. , Kam P. C. A. 
Published: October 2003

SummaryA parturient with varicella (chickenpox) presented for an elective Caesarean section and spinal anaesthesia was employed for surgery. A review of the literature is presented and the anaesthetic issues are discussed.
Pre‐operative hepatitis in a woman treated with Chinese medicines
Authors: Critchley L. A. H. , Chen D. Q. , Chu T. T. , Fok B. S. , Yeung C. 
Published: October 2003

SummaryA 37‐year‐old Hong Kong Chinese female with cervical cancer was scheduled for radical hysterectomy and lymphadenectomy. Her past health was good. Pre‐operatively, she was found to have a fatty liver, prolonged prothrombin time and abnormal liver function tests. Surgery was not postponed and she was anaesthetised uneventfully, using a general anaesthetic technique. The procedure lasted 4 h. Postoperatively, she developed a large pelvic haematoma and a wound infection. Her coagulation and liver function tests gradually returned to normal. No obvious medical cause for her liver dysfunction could be found. However, it emerged that she had received a 6‐week course of traditional Chinese medicines prior to admission. The prescriptions contained over 60 different ingredients, some of which were known to be hepatotoxic, cytotoxic or to cause bleeding. This was the most likely explanation for her liver dysfunction.
The provision and practice of renal replacement therapy on adult intensive care units in the United Kingdom
Authors: Wright S. E. , Bodenham A. , Short A. I. K. , Turney J. H. 
Published: October 2003

SummaryThis study surveyed the availability and current practice of renal replacement therapy on adult general intensive care units in the United Kingdom. Questionnaires were returned from 236 units (89%). Renal replacement therapy was provided by 212 (90%) of responding units, treating 9442 patients per year. Renal physicians were involved in the initiation and prescription of treatment in 22 (11%) units. Ninety‐one units (43%) had no step down facility on‐site for those patients still requiring renal replacement therapy but no longer requiring intensive care. Continuous techniques are used by the majority of units, most commonly, continuous veno‐venous haemofiltration, with an ultrafiltration rate of 2000 ml.h−1. Fifty‐eight units (28%) use haemofiltration as adjuvant treatment in septic shock. The provision and practice of renal replacement therapy is now an integral part of intensive care medicine in the United Kingdom.
Effect of the second‐generation antihistamine, fexofenadine, on cough reflex sensitivity and pulmonary function
Authors: Dicpinigaitis Peter V. , Gayle Yvonne E. 
Published: October 2003

Aims  Current guidelines recommend the use of first‐generation antihistamines for the treatment of cough due to rhinitis/postnasal drip syndrome. The antitussive activity of the second‐generation antihistamine, fexofenadine, has not been investigated. Therefore, we evaluated the effect of fexofenadine on capsaicin‐induced cough in healthy volunteers and in subjects with acute viral upper respiratory tract infection (URI).Methods  Twelve healthy volunteers and 12 subjects with URI underwent pulmonary function testing and capsaicin cough challenge on two separate days, 2 h after ingesting 180 mg fexofenadine or matched placebo. Subjects inhaled single, vital‐capacity breaths of capsaicin aerosol, administered in incremental doubling concentrations, until the concentration inducing five or more coughs (C5) was determined.Results  In both subject groups, C5 was not significantly different after fexofenadine compared to placebo. In subjects with URI, pulmonary function studies were also similar. In healthy volunteers, however, FEV1 and FEF25−75, pulmonary function parameters reflecting the degree of airway dilatation, were significantly increased after fexofenadine. Mean (95% CI) values for FEV1(L) after fexofenadine and placebo were 3.16 (2.77, 3.55) and 3.08 (2.69, 3.47), respectively (P = 0.017). Mean values for FEF25−75(L/s) were 3.49 (3.10, 3.88) and 3.26 (2.79, 3.72), respectively (P = 0.029).Conclusions  Fexofenadine demonstrated no antitussive activity against capsaicin‐induced cough in healthy volunteers and subjects with URI. The ineffectiveness of fexofenadine in suppressing cough probably reflects the lack of anticholinergic activity and central nervous system penetrance that is characteristic of first‐generation antihistamines. The mild bronchodilation induced by fexofenadine in healthy volunteers is of unclear clinical significance and requires further investigation.