bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital
Authors: Razavi Seyd Mansour , Ibrahimpoor Mohammad , Sabouri Kashani Ahmad , Jafarian Ali 
Published: March 2005

Abstract
Background
Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran.

Methods
Patients (n = 802) who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups.

Results
Of the 802 patients, 139 suffered from SSI (17.4%). In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation) hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001.

Conclusion
In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature), this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and approximating the timing of shaving to the operation and substituting cefazolin for cefaluthin when prophylactic antibiotic is to be administered, the SSI may be reduced to a more acceptable level.
Measurement of fractionated plasma metanephrines for exclusion of pheochromocytoma: Can specificity be improved by adjustment for age?
Authors: Sawka Anna M , Thabane Lehana , Gafni Amiram , Levine Mitchell , Young William F 
Published: March 2005

Abstract
Background
Biochemical testing for pheochromocytoma by measurement of fractionated plasma metanephrines is limited by false positive rates of up to 18% in people without known genetic predisposition to the disease. The plasma normetanephrine fraction is responsible for most false positives and plasma normetanephrine increases with age. The objective of this study was to determine if we could improve the specificity of fractionated plasma measurements, by statistically adjusting for age.

Methods
An age-adjusted metanephrine score was derived using logistic regression from 343 subjects (including 33 people with pheochromocytoma) who underwent fractionated plasma metanephrine measurements as part of investigations for suspected pheochromocytoma at Mayo Clinic Rochester (derivation set). The performance of the age-adjusted score was validated in a dataset of 158 subjects (including patients 23 with pheochromocytoma) that underwent measurements of fractionated plasma metanephrines at Mayo Clinic the following year (validation dataset). None of the participants in the validation dataset had known genetic predisposition to pheochromocytoma.

Results
The sensitivity of the age-adjusted metanephrine score was the same as that of traditional interpretation of fractionated plasma metanephrine measurements, yielding a sensitivity of 100% (23/23, 95% confidence interval [CI] 85.7%, 100%). However, the false positive rate with traditional interpretation of fractionated plasma metanephrine measurements was 16.3% (22/135, 95% CI, 11.0%, 23.4%) and that of the age-adjusted score was significantly lower at 3.0% (4/135, 95% CI, 1.2%, 7.4%) (p < 0.001 using McNemar's test).

Conclusion
An adjustment for age in the interpretation of results of fractionated plasma metanephrines may significantly decrease false positives when using this test to exclude sporadic pheochromocytoma. Such improvements in false positive rate may result in savings of expenditures related to confirmatory imaging.
Ethical challenges in surgery as narrated by practicing surgeons
Authors: Torjuul Kirsti , Nordam Ann , Sørlie Venke 
Published: March 2005

Abstract
Background
The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations.

Methods
Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation.

Results
No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues.

Conclusion
The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.
Negative density-distribution relationship in butterflies
Authors: Päivinen Jussi , Grapputo Alessandro , Kaitala Veijo , Komonen Atte , Kotiaho Janne S , Saarinen Kimmo , Wahlberg Niklas 
Published: March 2005

AbstractBackgroundBecause "laws of nature" do not exist in ecology, much of the foundations of community ecology rely on broad statistical generalisations. One of the strongest generalisations is the positive relationship between density and distribution within a given taxonomic assemblage; that is, locally abundant species are more widespread than locally sparse species. Several mechanisms have been proposed to create this positive relationship, and the testing of these mechanisms is attracting increasing attention.ResultsWe report a strong, but counterintuitive, negative relationship between density and distribution in the butterfly fauna of Finland. With an exceptionally comprehensive data set (data includes all 95 resident species in Finland and over 1.5 million individuals), we have been able to submit several of the mechanisms to powerful direct empirical testing. Without exception, we failed to find evidence for the proposed mechanisms creating a positive density-distribution relationship. On the contrary, we found that many of the mechanisms are equally able to generate a negative relationship.ConclusionWe suggest that one important determinant of density-distribution relationships is the geographical location of the study: on the edge of a distribution range, suitable habitat patches are likely to be more isolated than in the core of the range. In such a situation, only the largest and best quality patches are likely to be occupied, and these by definition can support a relatively dense population leading to a negative density-distribution relationship. Finally, we conclude that generalizations about the positive density-distribution relationship should be made more cautiously.
Reduction of motion artifact in pulse oximetry by smoothed pseudo Wigner-Ville distribution
Authors: Yan Yong-sheng , Poon Carmen CY , Zhang Yuan-ting 
Published: March 2005

Abstract

Background
The pulse oximeter, a medical device capable of measuring blood oxygen saturation (SpO2), has been shown to be a valuable device for monitoring patients in critical conditions. In order to incorporate the technique into a wearable device which can be used in ambulatory settings, the influence of motion artifacts on the estimated SpO2 must be reduced. This study investigates the use of the smoothed psuedo Wigner-Ville distribution (SPWVD) for the reduction of motion artifacts affecting pulse oximetry.

Methods
The SPWVD approach is compared with two techniques currently used in this field, i.e. the weighted moving average (WMA) and the fast Fourier transform (FFT) approaches. SpO2 and pulse rate were estimated from a photoplethysmographic (PPG) signal recorded when subject is in a resting position as well as in the act of performing four types of motions: horizontal and vertical movements of the hand, and bending and pressing motions of the finger. For each condition, 24 sets of PPG signals collected from 6 subjects, each of 30 seconds, were studied with reference to the PPG signal recorded simultaneously from the subject's other hand, which was stationary at all times.

Results and Discussion
The SPWVD approach shows significant improvement (p < 0.05), as compared to traditional approaches, when subjects bend their finger or press their finger against the sensor. In addition, the SPWVD approach also reduces the mean absolute pulse rate error significantly (p < 0.05) from 16.4 bpm and 11.2 bpm for the WMA and FFT approaches, respectively, to 5.62 bpm.

Conclusion
The results suggested that the SPWVD approach could potentially be used to reduce motion artifact on wearable pulse oximeters.
Dendritic cells are defective in breast cancer patients: a potential role for polyamine in this immunodeficiency
Authors: Gervais Alban , Levêque Jean , Bouet-Toussaint Françoise , Burtin Florence , Lesimple Thierry , Sulpice Laurent , Patard Jean-Jacques , Genetet Noelle , Catros-Quemener Véronique 
Published: March 2005

Abstract
Introduction
Dendritic cells (DCs) are antigen-presenting cells that are currently employed in cancer clinical trials. However, it is not clear whether their ability to induce tumour-specific immune responses when they are isolated from cancer patients is reduced relative to their ability in vivo. We determined the phenotype and functional activity of DCs from cancer patients and investigated the effect of putrescine, a polyamine molecule that is released in large amounts by cancer cells and has been implicated in metastatic invasion, on DCs.

Methods
The IL-4/GM-CSF (granulocyte–macrophage colony-stimulating factor) procedure for culturing blood monocyte-derived DCs was applied to cells from healthy donors and patients (17 with breast, 7 with colorectal and 10 with renal cell carcinoma). The same peroxide-treated tumour cells (M74 cell line) were used for DC pulsing. We investigated the effects of stimulation of autologous lymphocytes by DCs pulsed with treated tumour cells (DC-Tu), and cytolytic activity of T cells was determined in the same target cells.

Results
Certain differences were observed between donors and breast cancer patients. The yield of DCs was dramatically weaker, and expression of MHC class II was lower and the percentage of HLA-DR-Lin- cells higher in patients. Whatever combination of maturating agents was used, expression of markers of mature DCs was significantly lower in patients. Also, DCs from patients exhibited reduced ability to stimulate cytotoxic T lymphocytes. After DC-Tu stimulation, specific cytolytic activity was enhanced by up to 40% when DCs were from donors but only up to 10% when they were from patients. IFN-γ production was repeatedly found to be enhanced in donors but not in patients. By adding putrescine to DCs from donors, it was possible to enhance the HLA-DR-Lin- cell percentage and to reduce the final cytolytic activity of lymphocytes after DC-Tu stimulation, mimicking defective DC function. These putrescine-induced deficiencies were reversed by treating DCs with all-trans retinoic acid.

Conclusion
These data are consistent with blockade of antigen-presenting cells at an early stage of differentiation in patients with breast cancer. Putrescine released in the microenvironmement of DCs could be involved in this blockade. Use of all-trans retinoic acid treatment to reverse this blockade and favour ex vivo expansion of antigen-specific T lymphocytes is of real interest.
Randomised controlled trials relevant to aggressive and violent people, 1955–2000: a survey
Authors: Cure Sharon , Chua Wan Lian , Duggan Lorna , Adams Clive 
Published: March 2005

BackgroundRandomised trials remain the gold standard for evaluating health interventions. This applies to the criminal justice system as well as to health.AimsTo identify and survey randomised trials relevant to forensic mental health services.MethodWe searched 29 electronic bibliographic databases and acquired randomised trials involving sex offenders, arsonists or people clearly and actively aggressive, or abusive of children or spouse. Two researchers reliably extracted data.ResultsOf 409 studies found, we were able to acquire 300 for further inspection. They all involved particularly violent people (totaln=28 669), mostly adult men; the mean study size was 197 (median 52, mode 60, range 1–1200). In these 300 randomised trials over 700 interventions were evaluated and short-term outcomes were recorded on 345 different scales.ConclusionsWider collaboration, rationalising treatments and simplifying outcomes could further strengthen the tradition of trialling in forensic psychiatry. Systematic reviews of these studies are overdue.
Personality and comorbidity of common psychiatric disorders
Authors: Khan Amir A. , Jacobson Kristen C. , Gardner Charles O. , Prescott Carol A. , Kendler Kenneth S. 
Published: March 2005

BackgroundWe know little about the degree to which comorbidity, so commonly seen among psychiatric disorders, arises from variation in normal personality.AimsTo study the degree to which variation in normal personality accounts for the comorbidity of eight common psychiatric and substance use disorders.MethodInternalising disorders (major depression, generalised anxiety and panic disorders, phobias), externalising disorders (alcohol and drug dependence, anti-social personality and conduct disorders) and personality dimensions of neuroticism, extraversion and novelty seeking were assessed in 7588 participants from a population-based twin registry. The proportion of comorbidity explained by each personality dimension was calculated using structural equation modelling.ResultsNeuroticism accounted for the highest proportion of comorbidity within internalising disorders (20–45%) and between internalising and externalising disorders (19–88%). Variation in neuroticism and novelty seeking each accounted for a modest proportion (10–12% and 7–14%, respectively) of the comorbidity within externalising disorders. Extraversion contributed negligiblyConclusionsHigh neuroticism appears to be a broad vulnerability factor for comorbid psychiatric disorders. Novelty seeking is modestly important for comorbid externalising disorders.
Neural correlates of syntax production in schizophrenia
Authors: Kircher Tilo T. J. , Oh Tomasina M. , Brammer Michael J. , McGuire Philip K. 
Published: March 2005

BackgroundThe production of grammatically complex sentences is impaired in schizophrenia. It has been suggested that impaired syntax processing reflects a risk for the disorder.AimsTo examine the neural correlates of syntax production in people with schizophrenia using functional magnetic resonance imaging (fMRI).MethodSix patients with schizophrenia and six healthy volunteers spoke about seven Rorschach inkblots for 3 min each while correlates of brain activation were measured with fMRI. Participants produced varying amounts of syntactically simple and complex sentences during each 3 min run. The number of simple and complex sentences was correlated separately with the BOLD contrast.ResultsIn the comparison between the control group and the patient group, the number of complex sentences produced was correlated with activation in the posterior portion of the right middle temporal (Brodmann area 21) and left superior frontal (BA 10) gyri in the control group but not in the patients.ConclusionsThe absence of activation in the right posterior temporal and left superior frontal cortex in patients with schizophrenia might contribute to the articulation of grammatically more simple speech in people with this disorder.
Repeated self-poisoning: increasing severity of self-harm as a predictor of subsequent suicide
Authors: Carter Greg , Reith David M. , Whyte Ian M. , McPherson Michelle 
Published: March 2005

BackgroundPrediction of suicide risk is difficult in clinical practice.AimsTo identify changes in clinical presentation predictive of suicide in patients treated for repeated episodes of self-poisoning.MethodA nested case–control study used the Hunter Area Toxicology Service database to identify exposure variables and the National Death Index to identify suicide. Cases were patients who had hospital treatment on more than one occasion between 15 January 1987 and 31 December 2000.ResultsThere were 31 cases, for which 93 controls were selected. Study variables associated with an increased risk of subsequent suicide were an increase in the number of drugs ingested (odds ratio 2.59, 95% CI 1.48–4.51), an increase in the dose ingested (OR1.33, 95% CI 1.01–1.76), an increase in coma score (OR 1.71, 95% CI 1.11–2.66), a decrease in Glasgow Coma Score (OR 1.21, 95% CI 1.03–1.43) and an increase in drug or alcohol misuse (OR 2.33, 95% CI 1.06–5.10).ConclusionsPatients who have escalating severity of self-poisoning episodes are at high risk of completed suicide.
Suicide by hanging: multicentre study based on coroners' records in England
Authors: Bennewith Olive , Gunnell David , Kapur Navneet , Turnbull Pauline , Simkin Sue , Sutton Lesley , Hawton Keith 
Published: March 2005

SummaryWe studied 162 cases of hanging by suicide occurring in 24 coroners' jurisdictions in England within a 6-month period in 2001. Prison and psychiatric ward suicides accounted for only 6% of these. The most frequently used ligatures (ropes, belts and cable) and ligature points (beams, girders, lofts and trees) are commonly available in community settings, limiting opportunities for prevention. In only half the cases (52%) were victims fully suspended with both feet off the ground. Four per cent had also taken an overdose.
Zoledronic Acid Significantly Reduces Skeletal Complications Compared With Placebo in Japanese Women With Bone Metastases From Breast Cancer: A Randomized, Placebo-Controlled Trial
Authors: Kohno Norio , Aogi Kenjiro , Minami Hironobu , Nakamura Seigo , Asaga Taro , Iino Yuichi , Watanabe Toru , Goessl Carsten , Ohashi Yasuo , Takashima Shigemitsu 
Published: March 2005

Purpose To investigate the efficacy and safety of zoledronic acid for the treatment of bone metastases from breast cancer. Patients and Methods Women with bone metastases (N = 228) were randomly assigned to receive 4 mg zoledronic acid (n = 114) or placebo (n = 114) via 15-minute infusions every 4 weeks for 1 year. The primary efficacy end point was the skeletal-related event (SRE) rate ratio between treatment groups. An SRE was defined as pathologic fracture, spinal cord compression, and radiation or surgery to bone. Secondary end points included percentage of patients with at least one SRE, time-to-first SRE, and Andersen-Gill multiple-event analysis. Results The SRE rate ratio at 1 year (excluding HCM and adjusted for prior fracture) was 0.61 (permutation test; P = .027), indicating that zoledronic acid reduced the rate of SRE by 39% compared with placebo. The percentage of patients with at least one SRE (excluding HCM) was significantly reduced by 20% by zoledronic acid (29.8% v 49.6% for placebo; P = .003). Zoledronic acid significantly delayed time-to-first SRE (median not reached v 364 days; Cox regression; P = .007) and reduced the risk of SREs by 41% in multiple event analysis (risk ratio = 0.59; P = .019) compared with placebo. Zoledronic acid was well tolerated with a safety profile similar to placebo. No patient treated with zoledronic acid had grade 3 or 4 serum creatinine increase. Conclusion Zoledronic acid significantly reduced skeletal complications compared with placebo across multiple end points in Japanese women with bone metastases from breast cancer.
Protective role of Coptidis Rhizoma alkaloids against peroxynitrite-induced damage to renal tubular epithelial cells
Authors: Yokozawa Takako , Satoh Akiko , Cho Eun Ju , Kashiwada Yoshiki , Ikeshiro Yasumasa 
Published: March 2005

Abstract
A study was conducted to elucidate and compare the protective activity of alkaloids from Coptidis Rhizoma (berberine, coptisine, palmatine, epiberberine, jatrorhizine, groenlandicine and magnoflorine) using an LLC-PK1 cell under peroxynitrite (ONOO−) generation model. Treatment with 3-morpholino-sydnonimine (SIN-1) led to an increase in cellular ONOO− generation in comparison with non-treated cells. However, Coptidis Rhizoma extract and its alkaloids, except for berberine, reduced the cellular ONOO− level. In addition, DNA fragmentation induced by SIN-1 was significantly decreased by the extract, and also by coptisine, epiberberine, jatrorhizine, groenlandicine and magnoflorine. Moreover, treatment with berberine, coptisine, palmatine and epiberberine exerted a protective effect against G0/G1 phase arrest of cell cycle induced by SIN-1. The increase in cellular ONOO− generation, DNA damage and disturbance of the cell cycle by SIN-1 resulted in a decrease in cell viability. However, Coptidis Rhizoma extract, epiberberine, jatrorhizine, groenlandicine and magnoflorine significantly increased cell viability even at a concentration as low as 10μg mL−1. These findings demonstrate that Coptidis Rhizoma extract and its alkaloids can ameliorate the cell damage associated with ONOO− generation in renal tubular LLC-PK1 cells, and that the various alkaloids have distinctive mechanisms of action, such as ONOO− scavenging, protection from DNA damage and control of the cell cycle. Furthermore, the data suggest that among the Coptidis Rhizoma alkaloids, coptisine is the most effective for protection against SIN-1-induced cellular injury in terms of its potency and content.