bluuebunny/crossref_metadata_2025_split huggingface dataset:
Area and individual circumstances and mood disorder prevalence
Authors: Wainwright Nicholas W. J. , Surtees Paul G. 
Published: August 2004

BackgroundAssociations have been demonstrated between contextual (area level) factors and a range of physical health outcomes, but their relationship with mental health outcomes is less well understood.AimsTo investigate the relative strength of association between individual and area-level demographic and socioeconomic factors and mood disorder prevalence in the UK.MethodCross-sectional data from 19 687 participants from the European Prospective Investigation into Cancer and Nutrition in Norfolk.ResultsArea deprivation was associated with current (12-month) mood disorders after adjusting for individual-level socio-economic status (OR for top v. bottom quartile of deprivation scores 1.29, 95% C11.1–1.5, P < 0.001). However, this association was small relative to those observed for individual marital and employment status. Significant residual area-level variation in current mood disorders (representing 3.6% of total variation, P=0.04) was largely accounted for by individual-level factors.ConclusionsThe magnitude of the association between socio-economic status and mood disorders is greater at the individual level than at the area level.
Audit of psychiatric discharge summaries: completing the cycle
Authors: Crossan Isabelle , Curtis David , Ong Yong-Lok 
Published: August 2004

Aims and MethodTo examine and attempt to improve the recording of information within psychiatric discharge summaries in an adult psychiatry department, by means of audit and feedback. Psychiatric discharge summaries from an acute adult psychiatric department were examined to determine the recording of ten selected items. Following feedback and discussion, the audit was repeated after 6 months.ResultsFifty-one discharge summaries were examined on the first occasion and 53 on the second. There was considerable variability in the standard of recording across the selected items, but the patterns of recording were similar at both stages. No improvement was found in the recording of information at the second audit.Clinical ImplicationsAudit and feedback alone may have little effect in changing clinical practice. This study examines the experience of undertaking clinical audit from a trainee's perspective, illustrates barriers to change and highlights the possible limitations of audit as a clinical tool.
Phylogenetic conservation of disulfide-linked, dimeric acetylcholine receptor pentamers in southern ocean electric rays
Authors: Tierney M. L. , Osborn K. E. , Milburn P. J. , Stowell M. H. B. , Howitt S. M. 
Published: August 2004

SUMMARY
Intact acetylcholine receptors have been purified on a novel affinity resin from three electric fish endemic to Australian waters. Their binding properties and morphology are compared with those of their northern hemisphere homolog, Torpedo marmorata. All four exhibit apparent dissociation constants, Kd, in the nanomolar range for the snake neurotoxin α-bungarotoxin and have a distinctive rosette-like appearance when viewed in negative stain under the electron microscope. Furthermore,these rosettes are paired, indicating that acetylcholine receptors from southern ocean electric fish exist as dimers, in the same fashion as their northern hemisphere counterparts. The cDNAs of the receptor's four subunits were sequenced from Hypnos monopterigium and the northern hemisphere counterpart, Torpedo marmorata, while cDNAs from only two subunits,α and δ, were able to be sequenced from Narcine tasmaniensis. The penultimate amino acid in the δ subunit of each of the newly sequenced fish species is a cysteine residue. Its conservation suggests that the mechanism for the observed dimerization of acetylcholine receptors is disulfide bond formation between the δ subunit of adjacent receptors, analogous to acetylcholine receptor dimers observed in other electric fish. It appears that this mechanism for receptor clustering is unique to acetylcholine receptors packed and organized in the specialized organs of electric fish. Alignment of the deduced protein sequences with the equivalent sequences from Torpedo californica and humans reveals a high degree of homology.
Multiobjective optimization of a journal bearing using the Pareto optimality concept
Authors: Hirani H 
Published: August 2004

This paper deals with multiobjective optimization (minimization of temperature rise, minimization of oil feed flow, minimization of power loss) and discrete design variables (lubricant viscosity, radial clearance, length-diameter ratio) related to the design of a journal bearing. The aim of this paper is to show the sensitivity of radial clearance, oil viscosity and length-diameter ratio on bearing power loss and oil flow. The paper attempts to remove the difficulty of selecting the weighting factor in multiobjective journal bearing optimization problems. The optimization model is based on a hybrid solution scheme for journal bearings. The objective of bearing optimization is to minimize a linear combination (weighted sum) of power loss and oil flow. Constraints are imposed on the maximum fluid film pressure, minimum film thickness, maximum temperature rise and critical speed. A generic algorithm is used as the optimization tool with a penalty to those solutions that violate constraints. The three-level Taguchi method is used to measure the effect of design variables on the optimum solution. The Pareto-optimal set approach is adapted to segregate the superior design vectors. The results of power loss, oil flow, temperature rise, maximum pressure and minimum film thickness are presented in tabular and graphical form for comparative study. Three journal bearing design examples are included, demonstrating the effectiveness of the proposed method.
A Novel Enantioselective Reaction. Palladium-catalyzed Enantiodistinctive Reaction of Bicyclic Allylic Compounds
Authors: Daimon Hisashi , Ogawa Ryohei , Itagaki Shuichi , Shimizu Isao 
Published: August 2004

Abstract
Reaction of (±)-2β-acetoxy-4aβ-methyl-2,3,4,4a,5,6,7,8-octahydronaphthalene (4) with dimethyl malonate anion in the presence of a catalytic amount of [(1-Me-allyl)PdCl]2 and (S)-(−)-BINAP proceeded enantiodistinctively to give both the nucleophilic substituted product (2S,4aS)-5 and the diene (R)-6 as the elimination product in considerable enantiomeric excesses.
Rounding Algorithms for a Geometric Embedding of Minimum Multiway Cut
Authors: Karger David R. , Klein Philip , Stein Cliff , Thorup Mikkel , Young Neal E. 
Published: August 2004

Given an undirected graph with edge costs and a subset of k≥3 nodes called terminals, a multiway, or k-way, cut is a subset of the edges whose removal disconnects each terminal from the others. The multiway cut problem is to find a minimum-cost multiway cut. This problem is Max-SNP hard. Recently, Calinescu et al. (Calinescu, G., H. Karloff, Y. Rabani. 2000. An improved approximation algorithm for MULTIWAY CUT. J. Comput. System Sci. 60(3) 564–574) gave a novel geometric relaxation of the problem and a rounding scheme that produced a (3/2−1/k)-approximation algorithm. In this paper, we study their geometric relaxation. In particular, we study the worst-case ratio between the value of the relaxation and the value of the minimum multicut (the so-called integrality gap of the relaxation). For k=3, we show the integrality gap is 12/11, giving tight upper and lower bounds. That is, we exhibit a family of graphs with integrality gaps arbitrarily close to 12/11 and give an algorithm that finds a cut of value 12/11 times the relaxation value. Our lower bound shows that this is the best possible performance guarantee for any algorithm based purely on the value of the relaxation. Our upper bound meets the lower bound and improves the factor of 7/6 shown by Calinescu et al. For all k, we show that there exists a rounding scheme with performance ratio equal to the integrality gap, and we give explicit constructions of polynomial-time rounding schemes that lead to improved upper bounds. For k=4 and 5, our best upper bounds are based on computer-constructed rounding schemes (with computer proofs of correctness). For general k we give an algorithm with performance ratio 1.3438−εk. Our results were discovered with the help of computational experiments that we also describe here.
Use of Verapamil as a Potential P-Glycoprotein Inhibitor in a Patient with Refractory Epilepsy
Authors: Summers Monica A , Moore J Layne , McAuley James W 
Published: August 2004

OBJECTIVE To describe a patient in whom we used adjunctive verapamil therapy was used for its P-glycoprotein inhibitory effects. CASE SUMMARY Verapamil was added to the antiepileptic drug regimen of a 24-year-old woman with intractable epilepsy. The average time interval between hospitalizations for complex partial status doubled. The addition of verapamil greatly improved overall seizure control and subjective quality of life in this pharmacoresistant patient. DISCUSSION The overexpression of P-glycoprotein in the central nervous system may be one mechanism of pharmacoresistance in patients with epilepsy. The calcium-channel blocker verapamil is a known inhibitor of P-glycoprotein and may function to block P-glycoprotein—modulated efflux of antiepileptic drugs in the brain, thereby raising the intracellular concentration of antiepileptic drugs and ultimately decreasing seizure burden in patients with refractory epilepsy. CONCLUSIONS Verapamil may offer pharmacoresistant patients hope of improved seizure control due to its potential P-glycoprotein inhibitory effects.
Anti-Xa Monitoring of Enoxaparin for Acute Coronary Syndromes in Patients with Renal Disease
Authors: Ma Jessica M , Jackevicius Cynthia A , Yeo Erik 
Published: August 2004

BACKGROUND There are limited data on dosing of enoxaparin in patients with renal disease due to the routine exclusion of this population in clinical trials. To account for the potentially delayed drug elimination in these patients, we developed guidelines for adjusting enoxaparin dosing based on anti-Xa monitoring. OBJECTIVE To evaluate anti-Xa level monitoring, resulting from the standards of practice as set out by our hospital's guidelines for enoxaparin dosing in renally impaired patients. METHODS A total of 72 separate acute coronary syndrome patient admissions were retrospectively reviewed. All patients had anti-Xa levels taken and creatinine clearance values <30 mL/min during enoxaparin therapy. RESULTS The average trough anti-Xa level at the once- and twice-daily doses was 0.40 and 0.72 IU/mL, respectively. With twice-daily dosing, only 6% of the trough concentrations were in the target range of 0.2–0.3 IU/mL compared with 36% with once-daily dosing. Of the 22 patients who had a change of dosing frequency from twice to once daily, 5% of trough anti-Xa levels were ≤0.5 IU/mL with twice-daily versus 68% with once-daily dosing. CONCLUSIONS Although the relationship between anti-Xa activity, efficacy, and adverse effects has not been definitively established, anti-Xa levels can assist with dosing of enoxaparin in renally impaired patients. Our hospital guidelines are effective in adjusting dosing to reach target anti-Xa levels.
Physical and Chemical Compatibility of Daptomycin with Nine Medications
Authors: Lai Jan-Ji , Brodeur Stephanie K 
Published: August 2004

BACKGROUND Hospitalized patients with serious gram-positive infections tend to require concomitant therapy. Unfortunately, a number of antimicrobial agents have demonstrated incompatibility with other agents commonly administered intravenously. OBJECTIVE To evaluate the physical compatibility and chemical stability of the novel lipopeptide antibiotic daptomycin, at 20 mg/mL, with 9 commonly administered intravenous medications: aztreonam, ceftazidime, ceftriaxone, dopamine, gentamicin, fluconazole, heparin, levofloxacin, and lidocaine to support simultaneous Y-site administration. METHODS Daptomycin was admixed with each medication separately in NaCl 0.9%, incubated at room temperature, and assayed at 30, 60, and 120 minutes. Physical stability was assessed by visual inspection and by turbidity measurements. Chemical stability was assessed by HPLC analysis using standard methods. RESULTS All 9 daptomycin admixtures remained clear solutions, free of visible particulates. There were also few changes in turbidity (range 0 to −0.7 nephelometric turbidity units) during the study. In general, pH changes were within ± 0.06 of baseline readings for all admixtures. HPLC analysis indicated no significant reduction (<4%) in daptomycin potency after 120 minutes at room temperature compared with baseline values in all 9 admixtures tested. In addition, there was no significant reduction (<5%) in potency compared with baseline values of the 9 medications tested in the daptomycin admixtures. CONCLUSIONS The results of this study indicate that solutions of 9 commonly administered intravenous medications simultaneously Y-site administered with daptomycin are stable and compatible, based on both physical and chemical potency analyses.
Effect of 24-Hour Intravenous Tubing Set Change on the Sterility of Repackaged Fat Emulsion in Neonates
Authors: Reiter Pamela D , Robles Janie , Dowell Elaine B 
Published: August 2004

BACKGROUND Duration of intravenous fat emulsion (IVFE) infusions, precise method of administration (manufactured bottle vs repackaged syringe), and interval for administration set change continue to be debated. OBJECTIVE To determine the contamination rate associated with replacing IVFE administration sets every 24 hours in newborn infants receiving fat emulsion repackaged into unit-of-use syringes. METHODS This was a prospective, microbiologic study of 90 administration sets used in 19 neonates. IVFE samples were obtained from administration sets at the end of a 19– to 23–hour infusion and prior to daily tubing set change from infants who received repackaged IVFE. Samples of IVFE (1–3 mL) were aseptically removed at the catheter connection site proximal to the patient, transferred into BACTEC PEDSPlus culture media, and continuously monitored for 5 days to detect gram-positive and gram-negative organisms, as well as yeast. RESULTS Two samples (2.27%) grew coagulase-negative Staphylococcus. Both samples were from the same asymptomatic patient and were obtained on consecutive days. A blood sample obtained through this infant's central catheter grew the same organism and suggested catheter hub colonization as the primary site of microbe origin. CONCLUSIONS Microbial contamination of IVFE infusion sets changed at 24–hour intervals, using unit-of-use syringes in neonates, was low at 2.2%.
Celecoxib-Induced Methemoglobinemia
Authors: Kaushik Prashant , Zuckerman Steven J , Campo Nicholas J , Banda Venkatramana R , Hayes Scott D , Kaushik Richa 
Published: August 2004

OBJECTIVE To report a case of acute methemoglobinemia in a patient treated with celecoxib for osteoarthritis. CASE SUMMARY A 72-year-old African American man developed an acute confusional state (ACS) one month after receiving celecoxib for osteoarthritis of his knee joints. There was no other identifiable cause of ACS such as any recognized cause of metabolic encephalopathy, meningoencephalitis, cerebrovascular accident, or drug intoxication. He was found to have severe methemoglobinemia (serum methemoglobin fraction 9%; reference range 0–0.2). His symptoms improved substantially, and serum methemoglobin levels decreased to 0.7% after the initiation of methylene blue therapy. He was discharged on oral riboflavin and ascorbic acid and was advised not to restart celecoxib therapy. He had not shown any recurrence of the symptoms at a follow-up visit 2 months after the withdrawal of celecoxib. DISCUSSION Celecoxib is a nonsteroidal antiinflammatory drug that selectively inhibits cyclooxygenase-2. Acute methemoglobinemia can present as a syndrome of nonspecific symptoms such as headache, nausea, fatigue, dyspnea, and lethargy; these may progress to respiratory depression, coma, shock, seizures, and death. Although acute methemoglobinemia has been reported with the use of several drugs, including sulfonamides, as of August 13, 2004, this is the first case report of severe methemoglobinemia manifesting as ACS with celecoxib therapy. Use of the Naranjo probability scale indicated a probable relationship between the clinical manifestations of methemoglobinemia and celecoxib therapy in this patient. CONCLUSIONS Celecoxib can be associated with acute methemoglobinemia. Prompt diagnosis of this condition, withdrawal of celecoxib, and treatment with the antagonists (methylene blue, ascorbic acid, riboflavin) can reverse this potentially serious condition.
Increased serum maternal levels of the HER2 oncoprotein p105 ectodomain in preeclampsia
Authors: Tse Chantal , Lefevre Guillaume , Berkane Nadia , Flahault Antoine , Toumi Karine , Brault Didier , Capeau Jacqueline , Uzan Serge 
Published: August 2004

AbstractHER2/ERBB2 protein is a 185 kDa transmembrane growth factor receptor whose extracellular domain, a 105 kDa fragment (p105), can be released from cell surfaces by proteolytic cleavage. The aim of our study was to compare serum p105 concentrations in normal and pathological pregnancies and to determine whether any correlation exists between preeclampsia and p105 levels. Serum p105 was assayed in 96 nonpregnant women and 89 pregnant women (26 normotensive, 14 normotensive with a history of preeclampsia or fetal hypotrophy, 10 with chronic hypertension, 10 with gestational hypertension and 29 with preeclampsia). Median serum p105 levels (median; 95% confidence interval) were higher in the preeclampsia group (13.9 μg/l; 12.8–16.1 μg/l) than in the normotensive (11.7 μg/l; 10.6μ13.3 μg/l; p<0.05) or non-pregnant groups (9.3 μg/l; 8.9–9.6 μg/l; p<0.001). There were no significant differences between the other pregnancy groups. In the normotensive group, serum p105 was correlated with the number of gestations (r=0.46; p<0.05), parity (r=0.39; p<0.05) and placenta weight (r=0.61; p<0.05). In preeclamptic women, serum p105 correlated with parity (r=0.46; p<0.05). Serum p105 concentrations above 11.9 μg/l were associated with a high odds ratio (OR) for onset of preeclampsia (after adjustment for parity OR=9.0; 95% CI=2.3–36.0; p<0.005). Preeclampsia is associated with increased serum p105 concentrations, which may be related to increased fetomaternal cell traffic.
Determination of urinary glyoxal and methylglyoxal by high-performance liquid chromatography
Authors: Akira Kazuki , Matsumoto Yui , Hashimoto Takao 
Published: August 2004

AbstractCarbonyl stress compounds such as glyoxal and methylglyoxal have been recently attracting much attention because of their possible clinical significance in chronic and age-related diseases. A high-performance liquid chromatographic procedure has been developed for the simultaneous quantitation of glyoxal and methylglyoxal in human urine. The assay is based on the reaction of these compounds with 1,2-diamino-4,5-dimethoxybenzene to form fluorescent adducts, which are separated by reversed-phase highperformance liquid chromatography in a total run time of 45 minutes and quantitated fluorometrically using 2,3-pentanedione as an internal standard. Derivatization is performed for diluted urine (100–120 mOsm/kg H
Antioxidants in patients with hyperthyroidism
Authors: Mayer Ljiljana , Romic Željko , Škreb Franjo , Bačic-Vrća Vesna , Čepelak Ivana , Žanic-Grubišić Tihana , Kirin Marijan 
Published: August 2004

AbstractHyperthyroidism is a hypermetabolic state accompanied by increased oxygen utilization, increased production of reactive oxygen species and consequentially measurable changes in antioxidative factors. Therefore, the activities of whole blood glutathione peroxidase (GPx) and erythrocyte superoxide dismutase (SOD), total antioxidant status (TAS) in serum and erythrocytes, and serum urate and transferrrin concentrations were determined in 70 women: 14 with newly diagnosed Graves' disease (group A); 28 with hyperthyroidism on therapy with methimazole (group B, divided into two subgroups, B1 and B2) and 28 healthy women (group C).In comparison with control group C, GPx activity was significantly decreased in all patient groups (p<0.05), whereas SOD activity was significantly decreased in group A (p<0.01) and significantly increased in group B (p<0.01). In comparison with the control group, serum TAS activity was significantly decreased in group A, and erythrocyte TAS activity in all patient groups.Study results suggest that the impaired antioxidative factor balance leads to the development and presence of oxidative stress in women with hyperthyroidism. The severity of these alterations, considered contradictory by some authors, appears to depend on the use of therapy.
Biochemical diagnosis of impaired left ventricular ejection fraction - comparison of the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP)
Authors: Mueller Thomas , Gegenhuber Alfons , Poelz Werner , Haltmayer Meinhard 
Published: August 2004

AbstractThe aim of the present investigation was to evaluate the diagnostic accuracy of brain natriuretic peptide (BNP) and amino terminal proBNP (NT-proBNP) for the detection of mild/moderate and severe impairment of left ventricular ejection fraction (LVEF). In 180 subjects BNP and NT-proBNP were measured by two novel fully automated chemiluminescent assays (Bayer and Roche methods). LVEF as determined by echocardiography was categorized as normal (>60%), mildly/moderately reduced (35–60%) and severely diminished (<35%). Discriminating between patients with LVEF<35% (n=32) and subjects with LVEF ≥35% (n=148), receiver-operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) of 0.912 for BNP and of 0.896 for NT-proBNP (difference 0.016, p=0.554). In contrast, BNP displayed an AUC of 0.843and NT-proBNP an AUC of 0.927 (difference of 0.084, p=0.034) when comparing patients with LVEF 35–60% (n=37) and individuals with LVEF >60% (n=111). Evaluation of discordant false classifications at cut-off levels with the highest diagnostic accuracy showed advantages for BNP in the biochemical diagnosis of LVEF<35% (4 misclassifications by BNP and 25 by NT-proBNP, p<0.001) and for NT-proBNP in the detection of LVEF 35–60% (25 misclassifications by BNP and 7 by NT-proBNP, p=0.002). In conclusion, the present study indicates a different diagnostic accuracy of BNP and NT-pro-BNP for the detection of mildly/moderately reduced LVEF and severely diminished LVEF. Advantages of BNP may be advocated for the biochemical diagnosis of more severely impaired LVEF, while NT-proBNP might be a more discerning marker of early systolic left ventricular dysfunction.
Urine albumin excretion in acute ischaemic stroke is related to serum interleukin-6
Authors: Dziedzic Tomasz , Slowik Agnieszka , Szczudlik Andrzej 
Published: August 2004

AbstractBackground and purpose: Several studies show a link between microalbuminuria and markers of inflammation. Increased urine albumin excretion accompanies acute ischaemic stroke. The mechanisms responsible for microalbuminuria in acute stroke patients remain unclear. The goal of this study was to determine if there is a relationship between urine albumin excretion and interleukin-6, a key mediator of acute phase reaction. Methods: Nineteen acute ischaemic stroke patients and 13 controls matched for age, sex and cardiovascular risk factors were included. Serum interleukin-6 level was measured on the 2nd day of stroke at 06:00 am, 10:00 am, 06:00 pm and 10:00 pm using ELISA method. Urine albumin excretion was determined using immunonephelometric method. Results: Interleukin-6 level and urine albumin excretion were significantly higher in stroke patients than in controls. There was a significant correlation between interleukin-6 level and urine albumin excretion in stroke patients (R=−0.60 at 06:00 am; R=−0.49 at 10:00 am; R=−0.64 at 06:00 pm; R=−0.54 at 10:00 pm) but not in controls. Conclusions: Urine albumin excretion in acute ischaemic stroke is related to serum interleukin-6.