bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Physiologically Based, Recirculatory Model of the Kinetics and Dynamics of Propofol in Man
Authors: Upton Richard N. , Ludbrook Guy 
Published: July 2005

Background
The disposition of propofol in man is commonly described using a three-compartment mamillary model. However, these models do not incorporate blood flows as parameters. This complicates the representation of the changes in blood flows that may occur in surgical patients. In contrast, complex physiologically based models are derived from data sets (e.g., tissue:blood partition coefficients) that may not be readily collected in man.

Methods
Alternatively, the authors report a recirculatory model of propofol disposition in a "standard" man that incorporates detailed descriptions of the lungs and brain, but with a lumped description of the remainder of the body. The model was parameterized from data in the literature using a "meta-modeling" approach. The first-pass passage of propofol through the venous vasculature and the lungs was a function of the injected drug mixing with cardiac output and passing through a three-"tank in series" model for the lungs. The brain was represented as a two-compartment model defined by cerebral blood flow and a permeability term. The Bispectral Index was a linear function of the mean brain concentration. The remainder of the body was represented by compartment systems for the liver, fast distribution and slow distribution.

Results
The model was a good fit of the data and was able to predict other data not used in the development of the model.

Conclusions
The model may ultimately find a role in improving the fidelity of patient simulators currently used to train anesthetists and for clinical practice simulation to optimize dosing and management strategies.
Ketamine Inhibits Inspiratory-evoked γ-Aminobutyric Acid and Glycine Neurotransmission to Cardiac Vagal Neurons in the Nucleus Ambiguus
Authors: Wang Xin , Huang Zheng-Gui , Dergacheva Olga , Bouairi Evguenia , Gorini Christopher , Stephens Christopher , Andresen Michael C. , Mendelowitz David 
Published: July 2005

Background
Ketamine can be used for perioperative pain management as well as a dissociative anesthetic agent in emergency situations. However, ketamine can induce both cardiovascular and respiratory depression, especially in pediatric patients. Although ketamine has usually been regarded as sympathoexcitatory, recent work has demonstrated that ketamine has important actions on parasympathetic cardiac vagal efferent activity. The current study tests the hypothesis that ketamine, at clinical relevant concentrations, alters central cardiorespiratory interactions in the brainstem and, in particular, the inspiration-evoked increase in gamma-aminobutyric acid-mediated and glycinergic neurotransmission to parasympathetic cardiac efferent neurons.

Methods
Cardiac vagal neurons were identified by the presence of a retrograde fluorescent tracer. Respiratory evoked gamma-aminobutyric acid-mediated and glycinergic synaptic currents were recorded in cardiac vagal neurons using whole cell patch clamp techniques while spontaneous rhythmic respiratory activity was recorded simultaneously.

Results
: Ketamine, at concentrations from 0.1 to 10 microM, evoked a concentration-dependent inhibition of inspiratory burst frequency. Inspiration-evoked gamma-aminobutyric acid-mediated neurotransmission to cardiac vagal neurons was inhibited at ketamine concentrations of 0.5 and 1 microM. The increase in glycinergic activity to cardiac vagal neurons during inspiration was also inhibited at ketamine concentrations of 0.5 and 1 microM.

Conclusions
At clinically relevant concentrations (0.5 and 1 microM), ketamine alters central respiratory activity and diminishes both inspiration-evoked gamma-aminobutyric acid-mediated and glycinergic neurotransmission to parasympathetic cardiac efferent neurons. This reduction in inhibitory neurotransmission to cardiac vagal neurons is likely responsible for the compromised respiratory sinus arrhythmia that occurs with ketamine anesthesia.
Evidence against Trigger Point Injection Technique for the Treatment of Cervicothoracic Myofascial Pain with Botulinum Toxin Type A
Authors: Ferrante F Michael , Bearn Lisa , Rothrock Robert , King Laurence 
Published: July 2005

Background
Traditional strategies for myofascial pain relief provide transient, incomplete, variable, or unpredictable outcomes. Botulinum toxin is itself an analgesic but can also cause sustained muscular relaxation, thereby possibly affording even greater relief than traditional therapies.

Methods
The study goal was to determine whether direct injection of botulinum toxin type A (BoNT-A) into trigger points was efficacious for cervicothoracic myofascial pain, and if so, to determine the presence or absence of a dose-response relation. One hundred thirty-two patients with cervical or shoulder myofascial pain or both and active trigger points were enrolled in a 12-week, randomized, double-blind, placebo-controlled trial. After a 2-week washout period for all medications, patients were injected with either saline or 10, 25, or 50 U BoNT-A into up to five active trigger points. The maximum doses in each experimental group were 0, 50, 125, and 250 U per patient, respectively. Patients subsequently received myofascial release physical therapy and amitriptyline, ibuprofen, and propoxyphene-acetaminophen napsylate. Follow-up visits occurred at 1, 2, 4, 6, 8, and 12 weeks. Outcome measures included visual analog pain scores, pain threshold as measured by pressure algometry, and rescue dose use of propoxyphene-acetaminophen napsylate.

Results
No significant differences occurred between placebo and BoNT-A groups with respect to visual analog pain scores, pressure algometry, and rescue medication.

Conclusions
Injection of BoNT-A directly into trigger points did not improve cervicothoracic myofascial pain. The role of direct injection of trigger points with BoNT-A is discussed in comparison to other injection methodologies in the potential genesis of pain relief.
Use of Anesthesia Induction Rooms Can Increase the Number of Urgent Orthopedic Cases Completed within 7 Hours
Authors: Torkki Paulus M. , Marjamaa Riitta A. , Torkki Markus I. , Kallio Pentti E. , Kirvelä Olli A. 
Published: July 2005

Background
Mean turnover times and the time spent in the operating room (OR) can be reduced by concurrent induction of anesthesia. Previous studies of anesthesia induction outside the OR have concentrated either on anesthesia-controlled time or turnover time. The goal of this study was to investigate the impact of an induction room model on the whole surgical process, its phases and delays between the phases, and the number of cases performed during the 7-h working day.

Methods
A prospective analysis of OR times was conducted for 5 weeks with the traditional induction-in-the-OR model followed by 4 weeks with a new model: A team of two nurses and one anesthesiologist was added to one OR to perform parallel anesthesia induction in a separate induction room. The durations of phases of surgical process, number of completed cases between 7:45 am and 3:00 pm, and daily raw utilization of the OR were assessed. Results were compared to those measured before the intervention.

Results
The mean nonoperative time was reduced by 45.6%, whereas surgery time remained unchanged. The time savings contributed to the concurrent anesthesia induction and the cut down in delays between the phases. The new model allowed one additional case to be performed during the 7-h working day.

Conclusions
Anesthesia induction outside the OR can increase the number of surgical cases performed during a regular workday.
Breath Hydrogen Test After a Bean Meal Demonstrates Delayed Oro‐Cecal Transit Time in Children with Chronic Constipation
Authors: Soares Ana Cristina Fontenele , Lederman Henrique Manoel , Fagundes‐Neto Ulysses , de Morais Mauro Batista 
Published: July 2005

ABSTRACTObjective:To evaluate oro‐cecal transit time in children with chronic constipation.Methods:34 patients with chronic functional constipation age 3 to 13 years and 15 controls without constipation. Oro‐cecal transit time was evaluated using the hydrogen breath test after ingestion of lactulose and after a standard meal of cooked beans. Total and segmental colonic transit times were measured with radiopaque markers.Results:Of 34 patients with chronic constipation 61.8% had increased total colonic transit time (>62 hours). Oro‐cecal transit time measured with lactulose as substrate was similar (p = 0.727) in constipated patients with increased colonic transit time (63.8 ± 16.3 minutes), in constipated patients with normal colonic transit time (66.9 ± 22.9 minutes), and in controls (65.3 ± 15.5 minutes). Using a test meal of beans, the hydrogen breath test showed that oro‐cecal transit time of constipated patients with increased total colon transit time was higher (252.4 ± 23.2 minutes) than oro‐cecal transit time of constipated patients with normal colonic transit time (227.7 ± 39.6 minutes) or controls (205.3 ± 23.3 minutes) (p < .05).Conclusion:Hydrogen excretion in breath after a bean test meal showed delayed oro‐cecal transit time in children with chronic constipation with abnormal total colonic transit time.
Induced Growth and Maturation of the Gastrointestinal Tract After Phaseolus vulgaris Lectin Exposure in Suckling Rats
Authors: Linderoth Ann , Biernat Marzena , Prykhodko Olena , Kornilovska Iryna , Pusztai Arpad , Pierzynowski Stefan G , Björn Weström R 
Published: July 2005

ABSTRACTObjectives:In mammals, the postnatal development of the gastrointestinal tract is characterized by vast structural and functional changes. Using a suckling rat model, we investigated whether red kidney bean lectin, phytohemagglutinin (PHA), a potent gut mitogen in adult rats, can accelerate the growth and maturation of the gastrointestinal tract.Methods:At either 10 or 14 days of age, suckling rats were daily gavage fed with PHA (0.05 mg/g body weight) or saline for 3 days. At 1 or 3 days after this treatment, gastrointestinal organ growth, intestinal morphology, disaccharidase pattern, macromolecular absorption capacity, and pancreatic enzyme contents were studied.Results:After PHA exposure, increased small intestinal growth and number of crypt cells were observed, whereas the proportion of enterocytes with supranuclear vacuoles in the distal intestine was decreased. The macromolecular absorption of the markers bovine immunoglobulin (Ig)G and bovine serum albumin and plasma levels of maternal IgG decreased, and intestinal disaccharidases switched toward an adult‐like pattern. The pancreas weight and pancreatic protein and trypsin contents increased. These changes were partly reversible when the PHA treatment began at 10 days of age, but they persisted when the treatment began at 14 days of age.Conclusions:PHA induced enhanced growth and precocious functional maturation of the gastrointestinal tract in suckling rats. The effects persisted if the PHA treatment started at 14 days of age, but not before, suggesting an age dependent mechanism. These findings may lead to a better understanding of gastrointestinal maturation and constitute a basis for the treatment of mammals having an immature gut.
Acidic Oligosaccharides from Pectin Hydrolysate as New Component for Infant Formulae: Effect on Intestinal Flora, Stool Characteristics, and pH
Authors: Fanaro S , Jelinek J , Stahl B , Boehm G , Kock R , Vigi V 
Published: July 2005

ABSTRACTObjectives:To come even closer to the functional composition of human milk, acidic oligosaccharides (AOS) from pectin were added to well known neutral prebiotics (galacto‐oligosaccharides (GOS) and long‐chain fructo‐oligosaccharides (FOS)). The effect of AOS and GOS/FOS/AOS on intestinal flora, stool characteristics as well as acceptance and tolerance was investigated.Methods:Human milk contains 75% to 85% neutral and 15% to 25% acidic oligosaccharides. In this prospective, randomized, double blind study, a mixture of 80% neutral oligosaccharides (from long‐chain galacto‐ and long‐chain fructo‐oligosaccharides) with 20% acidic oligosaccharides derived from pectin hydrolysis was investigated. Forty‐six term infants were fed a standard formula supplemented with either maltodextrin as control (n = 15), or with 0.2 g acidic oligosaccharides (n = 16), or with the latter plus 0.6 g neutral oligosaccharides (mixture of galacto‐ and fructo‐oligosaccharides; n = 15). Fecal flora using plating technique and pH were measured. Stool characteristics and possible side effects (crying, vomiting, and regurgitation) were recorded.Results:There was no difference in the bifidobacteria counts between the control and the group supplemented with acidic oligosaccharides alone (8.75 ± 0.50 vs. 8.58 ± 0.94 log colony forming units [CFU]/g stool). In infants fed the combination of acidic and neutral oligosaccharides, bifidobacteria were increased (9.61 ± 0.70 log CFU/g stool; P < 0.01). The same pattern was observed with lactobacilli. Stool consistency was softest in infants fed the complete oligosaccharide mixture, but also in those fed formula supplemented with acidic oligosaccharides alone, the stool consistency was significantly softer compared with the control group. Fecal pH increased in the controls, remained constant in acidic oligosaccharides alone, and decreased in the complete mixture of oligosaccharides group.Conclusion:There was no difference in growth, crying, vomiting, and regurgitation patterns between the groups. In summary, acidic oligosaccharides from pectin hydrolysate are well tolerated as ingredient in infant formulae but do not affect intestinal microecology.
The basic elliptic equations in an equilateral triangle
Authors: Dassios G , Fokas A.S 
Published: July 2005

In his deep and prolific investigations of heat diffusion, Lamé was led to the investigation of the eigenvalues and eigenfunctions of the Laplace operator in an equilateral triangle. In particular, he derived explicit results for the Dirichlet and Neumann cases using an ingenious change of variables. The relevant eigenfunctions are a complicated infinite series in terms of his variables.Here we first show that boundary-value problems with simple boundary conditions, such as the Dirichlet and the Neumann problems, can be solved in an elementary manner. In particular, the unknown Neumann and Dirichlet boundary values can be expressed in terms of a Fourier series for the Dirichlet and the Neumann problems, respectively. Our analysis is based on the so-called global relation, which is an algebraic equation coupling the Dirichlet and the Neumann spectral values on the perimeter of the triangle.As Lamé correctly pointed out, infinite series are inadequate for expressing the solution of more complicated problems such as mixed boundary-value problems. In this paper we show, further utilizing the global relation, that such problems can be solved in terms ofgeneralized Fourier integrals.
TV Weather Forecast or Look through the Window? Expert and Consumer Expectations about Macroeconomic Conditions
Authors: Roos Michael W. M. 
Published: July 2005

SummaryThis paper investigates the empirical relation between consumer and expert expectations about macroeconomic conditions in Germany. Using data from the EU Consumer Confidence Survey and the ZEW business expectations, static models and error‐correction models are estimated explaining consumer expectations as functions of expert expectations, consumer retrospections, and lagged consumer expectations. It's found that consumer expectations are only weakly related to expert expectations, but strongly influenced by consumers' retrospections. Consumers primarily extrapolate perceptions about current economic conditions in the future. However, during national election campaigns, the relation between consumer and expert expectations is stronger.
Hospital admissions for ‘drug‐induced’ disorders in England: a study using the Hospital Episodes Statistics (HES) database
Authors: Waller Patrick , Shaw Mary , Ho Davidson , Shakir Saad , Ebrahim Shah 
Published: July 2005

AimsTo review Hospital Episode Statistics (HES) data for England coded as being ‘drug induced’ during 1996–2000 and to consider their potential utility for assessing the public health burden of adverse drug reactions (ADRs) and studying drug safety.MethodsICD‐10 codes including the words ‘drug‐induced’ or ‘due to’ a medicine or which are recognized to be invariably caused by a drug were extracted along with external cause codes indicating that a drug was implicated (i.e. Y40‐59 in ICD‐10). We also calculated the proportions of patients with each ‘drug‐induced’ code for whom an external cause code had been applied.ResultsDuring the 5‐year study period there were almost 53.8 million hospital admissions in England, of which 44 411 (0.083%) were coded as ‘drug‐induced’ and 168 958 (0.314%) were associated with a relevant external cause code. The numbers of patients with ‘drug‐induced’ codes used were generally stable during the study period (range 7454–8860 per year) but the application of external cause codes increased in each year and by 40% overall (from 24 786 in 1996 to 34 843 in 2000). The overall proportion of ‘drug‐induced’ codes associated with a relevant external cause code was quite low (12–15%) but there was considerable variation between codes.ConclusionsComparisons with published studies indicate that HES data grossly underestimate the burden of drug‐induced disorders as a cause of hospital admission. There are likely to be multiple underlying reasons including under‐recognition, under‐recording and limitations of the coding system. The potential of these data for identifying previously unrecognized serious ADRs is limited by constraints on the availability of detailed data regarding individual cases.
Parents’ perspectives on coping with Duchenne muscular dystrophy
Authors: Webb C. L. 
Published: July 2005

AbstractBackground  The author, who has a grown son with Duchenne Muscular Dystrophy (DMD), has personally experienced a lack of available information for parents about coping with DMD. Therefore, as a longtime personal goal, she developed this study to address that lack of information.Methods  Fifteen semi‐structured interviews were conducted with 23 parents (n = 7 with both parents; n = 1 with two sisters; n = 6 with mothers only; n = 1 with father only). The purpose of the interviews was to examine the strategies parents use to cope when their sons have DMD. The interviews were conducted in 12 states, taped and transcribed.Results  Grounded theory analysis of the interview data indicated the willingness of these parents to share information to empower others like themselves.Conclusions  Parents want to be heard and valued as experts on DMD by medical and other professionals who interact with their sons. In addition, they want to proactively participate in their sons’ lives and to encourage other parents to do the same.
Development of a measure of the health‐related quality of life of children in public care
Authors: Upton P. , Maddocks A. , Eiser C. , Barnes P. M. , Williams J. 
Published: July 2005

AbstractObjectives  To validate PedsQLTM for children in public care and develop an ‘in‐care’ module.Design and setting  Questionnaire development and validation. Questionnaires were completed in placement. A total of 69 children in public care (aged 8–18 years) and their carers were recruited through routine paediatric assessments, and 662 children not in public care were recruited from local schools.Measures  Self‐ and proxy‐report versions of PedsQLTM generic module and the ‘in‐care’ module.Results  Cronbach's alpha for the generic module ranged from 0.66 to 0.88 and from 0.74 to 0.90 for self‐ and proxy‐report respectively. Lower scores were reported for children in care compared with peers living at home for proxy‐ and self‐report. Proxy‐ and self‐report correlation ranged from 0.43 to 0.60 (P < 0.001).Cronbach's alpha for the in‐care module was 0.87 and 0.91 for self‐ and proxy‐report respectively. Proxy‐ and self‐report scores showed significant correlation with generic module scores. The highest correlations were seen with sub‐scales measuring Psychosocial Functioning (e.g. Emotional Functioning: Pearson's r = 0.67 and 0.59, P < 0.001 for self‐ and proxy‐report respectively). Proxy‐ and self‐report correlation was 0.45 (P < 0.001).Conclusions  We found PedsQLTM generic module and the newly developed ‘in‐care’ module to have excellent internal reliability for self‐ and proxy‐report. Validity was established for both measures and significant correlation found between child and proxy ratings. Although further testing of the measures is recommended, both have potential value in assessing the success of placements and could provide a reliable and valid tool for individual patient analysis in clinical practice and for research with this group.
Three‐year follow‐up of a family support service cohort of children with behavioural problems and their parents
Authors: Anderson L. , Vostanis P. , O'Reilly M. 
Published: July 2005

AbstractBackground  The aim of this study was to establish the medium‐term (three‐year) psychosocial outcome of children with behavioural problems and their parents, who had received an intervention from a family support service.Methods  Forty families were traced at the three‐year follow‐up and agreed to participate. Pre‐ and post‐intervention and follow‐up measures were the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the Strengths and Difficulties Questionnaire (SDQ).Results  The primary HoNOSCA outcome items (i.e. those initially targeted by the parenting intervention) of aggression/antisocial behaviour and family relationships were not found to have changed significantly from the baseline (but had not sustained the sort‐term improvement following the intervention). Deterioration was found in other HoNOSCA items such as overactivity, self‐harm, scholastic/language skills, emotional, and poor school attendance. When we compared pre‐intervention with follow‐up SDQ scores, there was no significant change on any scales, i.e. these had returned to the level reported at the time of the original referral to the family support service.Conclusions  Following the intervention from a family support service, children and families reported a significant improvement in most outcome measures, predominantly child behaviour and family relationships. However, these improvements were either not sustained or there were additional difficulties at three‐year follow‐up. These could be related to various external and developmental factors. This lack of sustainable treatment effects for children with behavioural problems is consistent with previous research findings on parenting programmes.
Developmental differences in understanding the causes, controllability and chronicity of disabilities
Authors: Smith L. A. , Williams J. M. 
Published: July 2005

AbstractObjective  The present study explored typically developing children's (n = 77) understanding of the causes, controllability and chronicity of disabilities.Design  Children in each of four age groups (4–5 years, 6–7 years, 9–10 years and 11–12 years) were interviewed to explore their ideas about children with physical disabilities (minor: missing thumb; major: wheel‐chair bound), sensory disabilities (blindness and hearing loss), learning disabilities (non‐specific and Down syndrome) and emotional/behavioural difficulties (attention deficit hyperactivity disorder and lack of social skills).Results  Significant age differences were found in children's understandings of the causes, controllability and chronicity of disabilities. Furthermore, children showed a greater understanding of salient disabilities.Conclusions  Findings are discussed in terms of developmental changes and the role of experience in shaping children's understanding of disabilities.