bluuebunny/crossref_metadata_2025 huggingface dataset:
Lactate dehydrogenase in hypothermia‐treated newborn infants with hypoxic‐ischaemic encephalopathy
Authors: Thoresen Marianne , Liu Xun , Jary Sally , Brown Emma , Sabir Hemmen , Stone Janet , Cowan Frances , Karlsson Mathias
Published: July 2012

Aims:  We investigated whether plasma lactate dehydrogenase (LDH) predicts outcome in hypothermia (HT)‐treated term infants with moderate/severe hypoxic‐ischaemic encephalopathy (HIE) and additionally whether LDH differs between infants with evidence for acute and nonacute perinatal insults and postnatal collapse (PNC).

Methods:  Data from HT‐treated infants with HIE (n = 39) were analysed retrospectively. Adverse outcome was defined as a Mental and/or Psychomotor Developmental Index (Bayley Scales of Infant Development II), at 18 months <70. The likely timing of insult onset was assessed in infants with an LDH sample obtained within 6 h of birth or PNC (n = 20).

Results:  LDH differed between the favourable/adverse outcome groups at the end of HT treatment (median (IQR) 1540 (1400–1950)U/L vs. 3555 (3003–8705)U/L, (p < 0.01)). All infants (n = 22) with LDH <2085U/L had a favourable outcome while 6 of 11 infants with LDH ≥ 2085U/L had an adverse outcome. LDH in those who died (n = 4) was higher than the favourable outcome group (5090 (2915–12222)U/L, (p < 0.01)) but sampled earlier. Early LDH differed significantly (p < 0.01) between infants with evidence for acute or nonacute insults or PNC.

Conclusion:  These results offer a biomarker, with high negative predictive value in the assessment of outcome in HT‐treated term infants, needing prospective validation.
Long‐term clinical consequences of urinary tract infections during childhood: a review
Authors: Toffolo Antonella , Ammenti Anita , Montini Giovanni
Published: July 2012

Kidney scarring related to urinary tract infection in childhood has been considered the cause of serious long‐term clinical consequences. This assumption is now debated, as the advent of routine antenatal ultrasound in the 1980s has shown that a consistent part of the changes previously attributed to postinfectious scarring is mainly due to congenital malformations. With the aim of determining what is presently known on the long‐term clinical consequences of urinary tract infections (UTIs) in childhood, we performed a review of the literature on the relation between UTIs and blood pressure, renal function, growth and pregnancy‐related complications. By searching Medline/PubMed and Embase from 1980 to 2011, we identified 20 cohorts of children from 23 papers.

Conclusions:  Renal function: there are no clear data to establish long‐term consequences following UTIs during childhood. Most data seem to show that the outcome of renal function can already be delineated at first presentation or in the initial years of follow‐up; only 0.4% of children with normal renal function at start presented a decrease during follow‐up. Hypertension: there is a low risk, associated with renal damage. Growth and pregnancy‐related complications: the few available data seem to exclude a major influence of UTIs.
Heavily obscured quasar host galaxies at z ∼ 2 are discs, not major mergers
Authors: Schawinski Kevin , Simmons Brooke D. , Urry C. Megan , Treister Ezequiel , Glikman Eilat
Published: July 2012

We explore the nature of heavily obscured quasar host galaxies at z ∼ 2 using deep Hubble Space Telescope Wide Field Camera 3/infrared imaging of 28 dust-obscured galaxies (DOGs) to investigate the role of major mergers in driving black hole growth. The high levels of obscuration of the quasars selected for this study act as a natural coronagraph, blocking the quasar light and allowing a clear view of the underlying host galaxy. The sample of heavily obscured quasars represents a significant fraction of the cosmic mass accretion on supermassive black holes as the quasars have inferred bolometric luminosities around the break of the quasar luminosity function. We find that only a small fraction (4 per cent, at most 11–25 per cent) of the quasar host galaxies are major mergers. Fits to their surface brightness profiles indicate that 90 per cent of the host galaxies are either disc dominated, or have a significant disc. This disc-like host morphology, and the corresponding weakness of bulges, is evidence against major mergers and suggests that secular processes are the predominant driver of massive black hole growth. Finally, we suggest that the coincidence of mergers and active galactic nucleus activity is luminosity dependent, with only the most luminous quasars being triggered mostly by major mergers.
Photodynamic Inactivation of Planktonic Cultures and Biofilms of Candida albicans Mediated by Aluminum‐Chloride‐Phthalocyanine Entrapped in Nanoemulsions
Authors: Ribeiro Ana Paula Dias , Andrade Mariana Carvalho , de Fátima da Silva Julhiany , Jorge Janaina Habib , Primo Fernando Lucas , Tedesco Antonio Cláudio , Pavarina Ana Cláudia
Published: July 2012

New drug delivery systems, such as nanoemulsions (NE), have been developed to allow the use of hydrophobic drugs on the antimicrobial photodynamic therapy. This study evaluated the photodynamic potential of aluminum‐chloride‐phthalocyanine (ClAlPc) entrapped in cationic and anionic NE to inactivate Candida albicans planktonic cultures and biofilm compared with free ClAlPc. Fungal suspensions were treated with different delivery systems containing ClAlPc and light emitting diode. For planktonic suspensions, colonies were counted and cell metabolism was evaluated by XTT assay. Flow cytometry evaluated cell membrane damage. For biofilms, the metabolic activity was evaluated by XTT and ClAlPc distribution through biofilms was analyzed by confocal laser scanning microscopy (CLSM). Fungal viability was dependent on the delivery system, superficial charge and light dose. Free ClAlPc caused photokilling of the yeast when combined with 100 J cm−2. Cationic NE‐ClAlPc reduced significantly both colony counts and cell metabolism (P < 0.05). In addition, cationic NE‐ClAlPc and free ClAlPc caused significant damage to the cell membrane (P < 0.05). For the biofilms, cationic NE‐ClAlPc reduced cell metabolism by 70%. Anionic NE‐ClAlPc did not present antifungal activity. CLSM showed different accumulation on biofilms between the delivery systems. Although NE system showed a lower activity for planktonic culture, cationic NE‐ClAlPc showed better results for Candida biofilms.
Greenhouse gas balance due to the conversion of sugarcane areas from burned to green harvest, considering other conservationist management practices
Authors: de Oliveira Bordonal Ricardo , de Figueiredo Eduardo Barretto , La Scala Newton
Published: July 2012

There is a growing need for all productive sectors to develop greenhouse gas (GHG) mitigation techniques to reduce the enhanced greenhouse effect. However, the challenge to the agricultural sector is reducing net emissions while increasing production to meet growing demands for food, fiber, and biofuel. This study focuses on the changes in the GHG balance when sugarcane areas are converted from burned harvest (BH) to green harvest (GH, mechanized harvest), including the changes caused by the adoption of conservationist practices such as reduced tillage and a 4‐month crop rotation with Crotalaria juncea L. during sugarcane replanting. Based on the Intergovernmental Panel on Climate Change (IPCC) (2006) methodologies, the annual emission balance includes both agricultural and mobile sources of GHG, according to the mean annual consumption of supplies per hectare. The potential soil carbon accumulation was also considered in the GH plot. The total amounts of GHG were 2651.9 and 2316.4 kg CO2eq ha−1 yr−1 for BH and GH, respectively. Factoring in a mean annual soil carbon accumulation rate of 888.1 kg CO2 ha−1 yr−1 due to the input from long‐term crop residues associated with the conversion from BH to GH, the emission balance in GH decreased to 1428.3 kg CO2eq ha−1 yr−1. A second decrease occurs when a reduced tillage strategy is adopted instead of conventional tillage during the replanting season in the GH plot, which helps reduce the total emission balance to 1180.3 kg CO2eq ha−1 yr−1. Moreover, the conversion of sugarcane from BH to GH, with the adoption of a crop rotation with Crotalaria juncea L. as well as reduced tillage during sugarcane replanting, would result in a smaller GHG balance of 1064.6 kg CO2eq ha−1 yr−1, providing an effect strategy for GHG mitigation while still providing cleaner sugar and ethanol production in southern Brazil.
Conditional knockout of heparin‐binding epidermal growth factor‐like growth factor in the liver accelerates carbon tetrachloride‐induced liver injury in mice
Authors: Takemura Takayo , Yoshida Yuichi , Kiso Shinichi , Saji Yukiko , Ezaki Hisao , Hamano Mina , Kizu Takashi , Egawa Mayumi , Chatani Norihiro , Furuta Kunimaro , Kamada Yoshihiro , Iwamoto Ryo , Mekada Eisuke , Higashiyama Shigeki , Hayashi Norio , Takehara Tetsuo
Published: July 2012

Aim:  We previously demonstrated that heparin‐binding epidermal growth factor‐like growth factor (HB‐EGF) is induced in response to several liver injuries. Because the HB‐EGF knockout (KO) mice die in utero or immediately after birth due to cardiac defects, the loss of function study in vivo is limited. Here, we generated liver‐specific HB‐EGF conditional knockout mice using the interferon‐inducible Mx‐1 promoter driven cre recombinase transgene and investigated its role during acute liver injury.

Methods:  We induced acute liver injury by a single i.p. injection of carbon tetrachloride (CCl4) in HB‐EGF KO mice and wild‐type mice and liver damage was assessed by biochemical and immunohistochemical analysis. We also used AML12 mouse hepatocyte cell lines to examine the molecular mechanism of HB‐EGF‐dependent anti‐apoptosis and wound‐healing process of the liver in vitro.

Results:  HB‐EGF KO mice exhibited a significant increase of alanine aminotransferase level and also showed a significant increase in the number of apoptotic hepatocytes assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling staining at 24 h after CCl4 injection. We also demonstrated that HB‐EGF treatment inhibited tumor necrosis factor‐α‐induced apoptosis of AML12 mouse hepatocytes and promoted the wound‐healing response of these cells.

Conclusion:  This study showed that HB‐EGF plays a protective role during acute liver injury.
Humeral stress remodelling locations differ in Thoroughbred racehorses training and racing on dirt compared to synthetic racetrack surfaces
Authors: DIMOCK A. N. , HOFFMAN K. D. , PUCHALSKI S. M. , STOVER S. M.
Published: July 2012

Reasons for performing study: Veterinarians have observed a putative change in the location of humeral stress remodelling in Thoroughbred racehorses with change from dirt to synthetic racetrack surfaces.

Objectives: To determine whether the location and severity of humeral stress remodelling differs between Thoroughbred racehorses exercising on dirt and synthetic racetrack surfaces, the potential significance of different locations of stress remodelling, and the potential usefulness of scintigraphy for prevention of complete humeral fracture.

Methods: Scintigraphic images of humeri from 841 Thoroughbred racehorses at 3 racetracks during 2 years before and after conversion from dirt to synthetic surfaces were evaluated for location and severity of lesions. The effects of surface on lesion distributions were examined using Chi‐square or Fisher's exact tests. Archived fractured humeri were examined to determine the location and severity of stress remodelling associated with complete fracture. Databases were queried to determine whether racehorses with scintigraphic lesions suffered humeral fracture and whether racehorses with a complete humeral fracture had had a scintigraphic examination.

Results: Horses at synthetic racetracks had a greater proportion of distal humeral lesions, whereas horses at dirt racetracks had a greater proportion of caudoproximal lesions (P<0.001). Proximal lesions were more likely to be severe than distal lesions (P<0.001). Most complete fractures were associated with caudoproximal lesions, which were more often severe than distal lesions (P = 0.002). None of the horses with a scintigraphic lesion had a complete humeral fracture. None of the horses with a complete humeral fracture underwent scintigraphic examination.

Conclusions: Race surface affected humeral scintigraphic lesion location and hence the location of stress remodelling. Lesion severity was associated with lesion location. Complete humeral fracture was associated with caudoproximal stress remodelling and lack of scintigraphic examination.

Potential relevance: Risk for complete humeral fracture may be lower on synthetic surfaces than on dirt surfaces, and, by inference, for horses examined using scintigraphy.
Effect of acetylene concentration and thermal ramping rate on the growth of spin-capable carbon nanotube forests
Authors: Lee Kyung H. , Jung Dae Woong , Burk Dorothea , Overzet Lawrence J. , Lee Gil S.
Published: July 2012

Spin-capable multiwalled carbon nanotube (MWCNT) forests that can form webs, sheets, and yarns provide a promising means for advancing various technologies. It is necessary to understand the critical factors to grow spin-capable carbon nanotubes (CNTs) in a repeatable fashion. Here we show how both the spinning capability and morphology of MWCNT forests are significantly changed by controlling the C2H2 concentration and ramp rate of temperature. The acetylene gas flow was varied in the range of 0.25–6.94% by volume. The MWCNTs grown at C2H2 concentrations between 1.47–3.37% are well-aligned and become spin-capable. The well-aligned forests have higher areal density and shorter distance between CNTs. The thermal ramp rate was also changed from 30 °C/min to 70 °C/min. A specific range of thermal ramp rate is also required to have the suitably sized nanoparticles with sufficient density resulting in higher CNT areal density for spinnable MWCNTs. A ramp rate of 50 °C/min forms suitable sized nanoparticles with sufficient density to produce CNT forests with a higher areal density and a shorter tube spacing.
Acoustic and diving behavior of sperm whales (Physeter macrocephalus) during natural and depredation foraging in the Gulf of Alaska
Authors: Mathias Delphine , Thode Aaron M. , Straley Jan , Calambokidis John , Schorr Gregory S. , Folkert Kendall
Published: July 2012

Sperm whales have depredated black cod (Anoplopoma fimbria) from demersal longlines in the Gulf of Alaska for decades, but the behavior has recently spread in intensity and geographic coverage. Over a three-year period 11 bioacoustic tags were attached to adult sperm whales off Southeast Alaska during both natural and depredation foraging conditions. Measurements of the animals’ dive profiles and their acoustic behavior under both behavioral modes were examined for statistically significant differences. Two rough categories of depredation are identified: “deep” and “shallow.” “Deep depredating” whales consistently surface within 500 m of a hauling fishing vessel, have maximum dive depths greater than 200 m, and display significantly different acoustic behavior than naturally foraging whales, with shorter inter-click intervals, occasional bouts of high “creak” rates, and fewer dives without creaks. “Shallow depredating” whales conduct dives that are much shorter, shallower, and more acoustically active than both the natural and deep depredating behaviors, with median creak rates three times that of natural levels. These results suggest that depredation efforts might be measured remotely with passive acoustic monitoring at close ranges.
Automating identification of avian vocalizations using time–frequency information extracted from the Gabor transform
Authors: Connor Edward F. , Li Shidong , Li Steven
Published: July 2012

Based on the Gabor transform, a metric is developed and applied to automatically identify bird species from a sample of 568 digital recordings of songs/calls from 67 species of birds. The Gabor frequency–amplitude spectrum and the Gabor time-amplitude profile are proposed as a means to characterize the frequency and time patterns of a bird song. An approach based on template matching where unknown song clips are compared to a library of known song clips is used. After adding noise to simulate the background environment and using an adaptive high-pass filter to de-noise the recordings, the successful identification rate exceeded 93% even at signal-to-noise ratios as low as 5 dB. Bird species whose songs/calls were dominated by low frequencies were more difficult to identify than species whose songs were dominated by higher frequencies. The results suggest that automated identification may be practical if comprehensive libraries of recordings that encompass the vocal variation within species can be assembled.
Acoustic energy density distribution and sound intensity vector field inside coupled spaces
Authors: Meissner Mirosław
Published: July 2012

In this paper, the modal expansion method supported by a computer implementation has been used to predict steady-state distributions of the potential and kinetic energy densities, and the active and reactive sound intensities inside two coupled enclosures. The numerical study was dedicated to low-frequency room responses. Calculation results have shown that the distribution of energetic quantities in coupled spaces is strongly influenced by the modal localization. Appropriate descriptors of the localization effect were introduced to identify localized modes. As was evidenced by numerical data, the characteristic objects in the active intensity field are vortices positioned irregularly inside the room. It was found that vortex centers lie exactly on the lines corresponding to zeros of the eigenfunction for a dominant mode. Finally, an impact of the wall impedance on the quantitative relationship between the active and reactive intensities was analyzed and it was concluded that for very small sound damping the behavior of the sound intensity inside the room space is essentially only oscillatory.
Radial and translational oscillations of an acoustically levitated bubble in aqueous ethanol solutions
Authors: Cui Weicheng , Chen Weizhong , Qi Shuibao , Zhou Chao , Tu Juan
Published: July 2012

The radial and translational oscillations of a single cavitation bubble in a standing ultrasound wave were investigated experimentally at various driving acoustic pressures for aqueous ethanol solutions with different bulk molar fractions of ethanol range of 0–1.3×10−3. The results show that both the lower and upper stability thresholds of the acoustic driving pressure decreased as the concentration of ethanol was increased. At a given driving pressure the ambient and maximum bubble sizes increased with increasing ethanol concentration. In addition, as the ethanol was increased, the sonoluminescence intensity decreased while the bubble dynamics remained largely unchanged. The translational oscillation of the levitated bubble, however, became increasingly violent with increasing ethanol concentration. The displacement of the bubble reached 0.7 mm at the highest concentration studied (1.3×10−3) and the maximum bubble size was found to change as the bubble jumped up and down. This bubble translation may be responsible for the decrease of the acoustic driving pressure threshold and suggests that repetitive injection of ethanol molecules into the bubble takes place. These results may account for the different sensitivities of single bubble and multi-bubble sonoluminescence to the presence of volatile additives.
Characterization of mechanical properties of a hollow cylinder with zero group velocity Lamb modes
Authors: Cès M. , Royer D. , Prada C.
Published: July 2012

Hollow cylinders used in the industry must be regularly inspected. Elastic guided waves, similar to Lamb modes in a plate, can propagate in the axial direction or around the circumference. They are sensitive to geometrical and mechanical parameters of the cylindrical shell. The objective of this paper is to show that zero group velocity (ZGV) Lamb modes can be used to bring out anisotropy and to measure elastic constants of the material. This study provides experimental and numerical investigations on a Zirconium alloy tube extensively used by the nuclear industry in reactor core components. A non-contact method, based on laser ultrasound techniques and ZGV Lamb modes, demonstrates that the difference observed between axial and circumferential guided waves cannot be explained by an isotropic model. Then, a transverse isotropic model is used for the Zircaloy tube. Four of the five elastic constants are directly extracted from ZGV resonance frequencies. The last one is deduced from the measured dispersion spectra. With this complete set of constants, a good agreement is obtained between theoretical and experimental dispersion curves for both axially and circumferentially propagating guided waves.
Characterizing dusky dolphin sounds from Argentina and New Zealand
Authors: Vaughn-Hirshorn Robin L. , Hodge Kristin B. , Würsig Bernd , Sappenfield Rebecca H. , Lammers Marc O. , Dudzinski Kathleen M.
Published: July 2012

Dusky dolphin (Lagenorhynchus obscurus) acoustic sounds were characterized by analyzing narrowband recordings [0–16 kHz in New Zealand (NZ) and 0–24 kHz in Argentina], and sounds in broadband recordings (0–200 kHz) were compared to their counterparts in down-sampled narrowband recordings (0–16 kHz). The most robust similarity between sounds present in broadband recordings and their counterparts in the down-sampled narrowband recordings was inter-click interval (ICI); ICI was therefore primarily used to characterize click sounds in narrowband recordings. In NZ and Argentina, distribution of ICIs was a continuum, although the distribution of ICIs in NZ had a somewhat bimodal tendency. In NZ, sounds that had smaller mean ICIs were more likely to have constant ICIs, and less likely to have increasing or decreasing ICIs. Similar to some other delphinids, dusky dolphins may use single, short duration sounds that have a constant ICI and closely spaced clicks for communication. No whistles were documented at either study site. Temporally structured sequences of burst pulses (i.e., sounds with ICI < about 10 ms) also occurred at both study sites, and these sequences contained 2–14 burst pulses that appeared closely matched aurally and in spectrograms and waveforms.
Reproducible Quantification of Cancer-Associated Proteins in Body Fluids Using Targeted Proteomics
Authors: Hüttenhain Ruth , Soste Martin , Selevsek Nathalie , Röst Hannes , Sethi Atul , Carapito Christine , Farrah Terry , Deutsch Eric W. , Kusebauch Ulrike , Moritz Robert L. , Niméus-Malmström Emma , Rinner Oliver , Aebersold Ruedi
Published: July 2012

A compendium of SRM assays for cancer-associated proteins provides a resource for accelerating and planning biomarker verification studies.
Hair Growth in Action
Authors: Frisk Megan L.
Published: July 2012

Real-time imaging in vivo reveals cellular mechanisms of hair growth.
Complete Genome Sequence of Bluetongue Virus Serotype 16 of Goat Origin from India
Authors: Minakshi Prasad , Singh Ravinder , Ranjan Koushlesh , Kumar Pawan , Joshi Chaitanya G. , Reddy Y. Krishna Mohan , Prasad Gaya
Published: July 2012

In this article, we document the first complete genome sequence of an isolate of bluetongue virus serotype 16 (BTV16) from a goat in India. The virus was isolated from an in-contact goat from an animal farm in Chennai where clinical disease occurs in sheep. The total size of the genome is 19,185 bp. The information provided for full-length sequences of all 10 segments will help in understanding the geographical origin and transmission of the Indian isolate of BTV16 as well as its comparison with global isolates of BTV16 of sheep, cattle, and other host species origins.
The Triple Threat of Cryptococcosis: It’s the Body Site, the Strain, and/or the Host
Authors: Perfect John R.
Published: July 2012

Cryptococcosis is the leading invasive fungal infection in the world today. Over the past century, the causative agents,
Cryptococcus neoformans
and
Cryptococcus gattii
, have risen from the status of medical curiosities to common but life-threatening central nervous system pathogens. In an elegant experimental pathobiology study of these two organisms carried out by Ngamskulrungroj et al., there are three matters that merit further discussion. First is the question of whether there is a variable specific pathobiology for each yeast strain. Does it make biological and clinical sense to designate
C. neoformans
and
C. gattii
as two separate species? Second is the matter of how the organisms differ pathologically at the site of infection. Finally, there is the possibility that the human immune system responds differently to each species. Although no single study can provide definitive mechanistic answers to the important questions, this experimental pathology study and its discussion clearly frame the issues to be dissected.
Limitations of serum values to estimate glomerular filtration rate during exercise
Authors: Poortmans Jacques R , Gulbis Béatrice , De Bruyn Edward , Baudry Stéphane , Carpentier Alain
Published: July 2012

Objective

Glomerular filtration rate (GFR) is part of routine medical practice for clinical assessment of kidney function in health and disease conditions, and is determined by measuring the clearance of creatinine (Cl-Crn) or estimated (eGFR) from equations using serum creatinine (Crn) or cystatin C (Cyst C). Crn and Cyst C methods obviate the need for urine collection but their reliability under non-resting conditions is uncertain. This study compared GFR determined by Cl-Crn, Crn and Cyst C methods under the conditions of rest and after exercise.

Methods

Twelve young male subjects performed a 30 min treadmill exercise at 80% of the maximal oxygen capacity. Venous blood samples and urine collections were collected before and after exercise and after recovery period. GFR rates were calculated from serum Crn and Cyst C equations, and Cl-Crn measured from serum and urine Crn output. Albumin was also determined for all samples.

Results

Under resting conditions, eGFR from Crn and Cyst C did not differ from Cl-Crn (p=0.39). Immediately after exercise, GFR decreased significantly, regardless of the method, but more so for Cl-Crn (−30.0%; p<0.05) compared with Crn (−18.2%) and Cyst C (−19.8%). After the recovery period, GFR determined by Cl-Crn was returned to initial values whereas Crn and Cyst C remained reduced. Although eGFR methods accurately estimate GFR at rest, those methods underestimated the change in GFR after acute exercise.

Conclusions

These results indicate that exercise-induced changes in GFR should be determined by Cl-Crn method.
Diagnostic accuracy of clinical tests of the hip: a systematic review with meta-analysis
Authors: Reiman Michael P , Goode Adam P , Hegedus Eric J , Cook Chad E , Wright Alexis A
Published: July 2012

Background

Hip Physical Examination (HPE) tests have long been used to diagnose a myriad of intra-and extra-articular pathologies of the hip joint. Useful clinical utility is necessary to support diagnostic imaging and subsequent surgical decision making.

Objective

Summarise and evaluate the current research and utility on the diagnostic accuracy of HPE tests for the hip joint germane to sports related injuries and pathology.

Methods

A computer-assisted literature search of MEDLINE, CINHAL and EMBASE databases (January 1966 to January 2012) using keywords related to diagnostic accuracy of the hip joint. This systematic review with meta-analysis utilised thePreferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines for the search and reporting phases of the study. Der-Simonian and Laird random effects models were used to summarise sensitivities (SN), specificities (SP), likelihood ratios and diagnostic OR.

Results

The employed search strategy revealed 25 potential articles, with 10 demonstrating high quality. Fourteen articles qualified for meta-analysis. The meta-analysis demonstrated that most tests possess weak diagnostic properties with the exception of the patellar-pubic percussion test, which had excellent pooled SN 95 (95% CI 92 to 97%) and good specificity 86 (95% CI 78 to 92%).

Conclusion

Several studies have investigated pathology in the hip. Few of the current studies are of substantial quality to dictate clinical decision-making. Currently, only the patellar-pubic percussion test is supported by the data as a stand-alone HPE test. Further studies involving high quality designs are needed to fully assess the value of HPE tests for patients with intra- and extra-articular hip dysfunction.
Stroke and mortality in patients with incident heart failure: the Diet, Cancer and Health (DCH) cohort study
Authors: Lip Gregory Y H , Rasmussen Lars Hvilsted , Skjøth Flemming , Overvad Kim , Larsen Torben Bjerregaard
Published: July 2012

Objective

The objective was to test the hypothesis that the risk of stroke, death and the composite of ‘stroke and death’ would be increased among patients with incident heart failure (HF). While HF increases the risk of mortality, stroke and thromboembolism in general, the ‘extreme high-risk’ nature of incident HF is perhaps under-recognised in everyday clinical practice.

Design

Prospective cohort study.

Setting

Large Danish prospective epidemiological cohort.

Participants

Subjects in the Diet, Cancer and Health study.

Outcome measures

Stroke, death and the composite of ‘stroke and death’ among patients with incident cases of HF, without concomitant atrial fibrillation.

Results

From the original cohort, 1239 patients with incident HF were identified. Incidence rates show a higher incidence in the initial period following the diagnosis of HF, with a markedly higher rate of death and stroke (ischaemic or haemorrhagic) in the initial 30 days following the diagnosis of incident HF. While lower than the risk at 0–30 days, the higher risk did not return to normal at 6+ months after the diagnosis of incident HF. This risk increase was apparent for the end points of stroke (ischaemic or haemorrhagic or both) whether or not a vitamin K antagonist (VKA) was used. With VKA use, there was a lower adjusted HR for death and the composite of ‘death or stroke’ compared to non-VKA use at the three time intervals following diagnosis of HF, whether 0–30 days, 30 days to 6 months and 6+ months. On multivariate analysis, previous stroke/transient ischaemic attack/thromboembolism was a predictor of higher risk of stroke, death and the composite of ‘stroke and death’, while VKA treatment was a highly significant predictor of a lower risk for death (adjusted HR 0.46, 95% CI 0.28 to 0.74, p<0.001) and the combined end point of death or stroke (adjusted HR 0.64, 95% CI 0.43 to 0.96, p=0.003).

Conclusions

Based on relative hazards, incident HF is clearly a major risk factor for stroke, death and the composite of ‘stroke and death’, especially in the initial 30 days following initial diagnosis. The use of VKA therapy was associated with a lower risk of these end points. These findings would have major implications for the approach to management of patients presenting with incident HF, given the high risk of this population for death and stroke, which may be ameliorated by VKA therapy.
Exposure to hot and cold temperatures and ambulance attendances in Brisbane, Australia: a time-series study
Authors: Turner Lyle R , Connell Des , Tong Shilu
Published: July 2012

Objectives

To investigate the effect of hot and cold temperatures on ambulance attendances.

Design

An ecological time-series study.

Setting and participants

The study was conducted in Brisbane, Australia. The authors collected information on 783 935 daily ambulance attendances, along with data of associated meteorological variables and air pollutants, for the period of 2000–2007.

Outcome measures

The total number of ambulance attendances was examined, along with those related to cardiovascular, respiratory and other non-traumatic conditions. Generalised additive models were used to assess the relationship between daily mean temperature and the number of ambulance attendances.

Results

There were statistically significant relationships between mean temperature and ambulance attendances for all categories. Acute heat effects were found with a 1.17% (95% CI 0.86% to 1.48%) increase in total attendances for 1°C increase above threshold (0–1 days lag). Cold effects were delayed and longer lasting with a 1.30% (0.87% to 1.73%) increase in total attendances for a 1°C decrease below the threshold (2–15 days lag). Harvesting was observed following initial acute periods of heat effects but not for cold effects.

Conclusions

This study shows that both hot and cold temperatures led to increases in ambulance attendances for different medical conditions. Our findings support the notion that ambulance attendance records are a valid and timely source of data for use in the development of local weather/health early warning systems.
Automated electronic reminders to prevent miscommunication among primary medical, surgical and anaesthesia providers: a root cause analysis
Authors: Freundlich Robert E , Grondin Louise , Tremper Kevin K , Saran Kelly A , Kheterpal Sachin
Published: July 2012

In this case report, the authors present an adverse event possibly caused by miscommunication among three separate medical teams at their hospital. The authors then discuss the hospital's root cause analysis and its proposed solutions, focusing on the subsequent hospital-wide implementation of an automated electronic reminder for abnormal laboratory values that may have helped to prevent similar medical errors.
Uncharted territory: measuring costs of diagnostic errors outside the medical record
Authors: Schwartz Alan , Weiner Saul J , Weaver Frances , Yudkowsky Rachel , Sharma Gunjan , Binns-Calvey Amy , Preyss Ben , Jordan Neil
Published: July 2012

Context

In a past study using unannounced standardised patients (USPs), substantial rates of diagnostic and treatment errors were documented among internists. Because the authors know the correct disposition of these encounters and obtained the physicians' notes, they can identify necessary treatment that was not provided and unnecessary treatment. They can also discern which errors can be identified exclusively from a review of the medical records.

Objective

To estimate the avoidable direct costs incurred by physicians making errors in our previous study.

Design

In the study, USPs visited 111 internal medicine attending physicians. They presented variants of four previously validated cases that jointly manipulate the presence or absence of contextual and biomedical factors that could lead to errors in management if overlooked. For example, in a patient with worsening asthma symptoms, a complicating biomedical factor was the presence of reflux disease and a complicating contextual factor was inability to afford the currently prescribed inhaler. Costs of missed or unnecessary services were computed using Medicare cost-based reimbursement data.

Setting

Fourteen practice locations, including two academic clinics, two community-based primary care networks with multiple sites, a core safety net provider, and three Veteran Administration government facilities.

Main outcome measures

Contribution of errors to costs of care.

Results

Overall, errors in care resulted in predicted costs of approximately $174 000 across 399 visits, of which only $8745 was discernible from a review of the medical records alone (without knowledge of the correct diagnoses). The median cost of error per visit with an incorrect care plan differed by case and by presentation variant within case.

Conclusions

Chart reviews alone underestimate costs of care because they typically reflect appropriate treatment decisions conditional on (potentially erroneous) diagnoses. Important information about patient context is often entirely missing from medical records. Experimental methods, including the use of USPs, reveal the substantial costs of these errors.
Failures in communication and information transfer across the surgical care pathway: interview study
Authors: Nagpal Kamal , Arora Sonal , Vats Amit , Wong Helen W , Sevdalis Nick , Vincent Charles , Moorthy Krishna
Published: July 2012

Background and Objectives

Effective communication is imperative to safe surgical practice. Previous studies have typically focused upon the operating theatre. This study aimed to explore the communication and information transfer failures across the entire surgical care pathway.

Methods

Using a qualitative approach, semi-structured interviews were conducted with 18 members of the multidisciplinary team (seven surgeons, five anaesthetists and six nurses) in an acute National Health Service trust. Participants' views regarding information transfer and communication failures at each phase of care, their causes, effects and potential interventions were explored. Interviews were recorded, transcribed verbatim, and submitted to emergent theme analysis. Sampling ceased when categorical and theoretical saturation was achieved.

Results

Preoperatively, lack of communication between anaesthetists and surgeons was the most common problem (13/18 participants). Incomplete handover from the ward to theatre (12/18) and theatre to recovery (15/18) were other key problems. Work environment, lack of protocols and primitive forms of information transfer were reported as the most common cause of failures. Participants reported that these failures led to increased morbidity and mortality. Healthcare staff were strongly supportive of the view that standardisation and systematisation of communication processes was essential to improve patient safety.

Conclusions

This study suggests communication failures occur across the entire continuum of care and the participants opined that it could have a potentially serious impact on patient safety. This data can be used to plan interventions targeted at the entire surgical pathway so as to improve the quality of care at all stages of the patient's journey.
The unmet needs of partners and caregivers of adults diagnosed with cancer: a systematic review
Authors: Lambert Sylvie D , Harrison James D , Smith Ellen , Bonevski Billie , Carey Mariko , Lawsin Catalina , Paul Chris , Girgis Afaf
Published: July 2012

Objectives

The recognition that a partner or caregiver is typically the patient's primary support person and is also deeply affected by the cancer diagnosis has prompted efforts to document their unmet supportive care needs. This review aimed to: (1) quantify the prevalence of unmet needs reported by partners and caregivers, (2) categorise their unmet needs by domain and (3) identify the main variables associated with reporting more unmet needs.

Methods

Manuscripts were identified through systematically searching electronic databases, checking the reference lists of retrieved publications, online searching of key journals and contacting researchers in this field.

Results

Unmet need items across 29 manuscripts were clustered into six domains: comprehensive cancer care (prevalence 1.1%–96%), emotional and psychological (3%–93.2%), partner or caregiver impact and daily activities (2.8%–79%), relationship (3.7% and 58%), information (2.2%–86%) and spiritual (2%–43%). Studies of caregivers of palliative care or terminal patients often reported a higher prevalence of unmet needs than studies of caregivers of cancer survivors. Variables associated with higher unmet needs included being female, not being the spouse of the patient, having lower social support or reporting distress.

Conclusions

Despite the ability to classify unmet needs within broad domains, quantification of unmet needs was challenging. This was mainly due to the diversity in methods used across studies (eg, different measures, variability in conceptualisation of unmet needs, etc). Rigorous, context-specific, longitudinal studies that use validated measures are needed to benefit future intervention research.
Impact of population density on collision rates in a rapidly developing rural, exurban area of Los Angeles County
Authors: Fischer Kelly , Sternfeld Isabelle , Melnick Douglas Sloan
Published: July 2012

Objectives

To determine if the commonly acknowledged relationships between population density and traffic collisions are found at the subcounty level and to describe how collision characteristics may vary substantially at a local level, with a particular emphasis on exurban areas.

Design

Los Angeles County collision data were obtained from the California Highway Patrol and the census tract and service planning area (SPA) for each collision were determined. The correlation between population density and collision rates by census tract was calculated within each SPA and for the entire county. Primary collision factors were compared for geographic areas of different population densities within one exurban SPA in Los Angeles County.

Results

An inverse relationship was found between collision rates and population density within Los Angeles County. Primary collisions factors were different in areas of the county with different population densities, with driving or biking under the influence particularly common in the most rural area.

Conclusions

Subcounty analyses are very important to the study of traffic collisions. Traffic problems in rapidly developing exurban areas may be quite different from those in older, more established areas.
Attitudes towards requiring ignition interlocks for all driving while intoxicated offenders: findings from the 2010 HealthStyles Survey
Authors: Shults Ruth A , Bergen Gwen
Published: July 2012

Ignition interlocks are effective in reducing recidivism among driving while intoxicated (DWI) offenders while installed on their vehicles. However, the devices are not widely used in the USA. This survey gauged public support for requiring ignition interlocks for all convicted DWI offenders including first-time offenders. 69% of respondents supported such a policy. Support was lowest (38%) among persons who reported drinking and driving in the past 30 days. Multivariate regression analysis indicated that support varied little by region, community size or most measured individual characteristics. Persons who did not drink and drive were 80% more likely to support the requirement than those who drink and drive. These findings suggest that laws requiring ignition interlocks for all convicted DWI offenders may face the most opposition in communities with high levels of drinking and driving.
Retrospective review of diagnostic histopathology samples in research projects: transparency should be the practice with respect to diagnostic discordance
Authors: Bjugn Roger , Casati Bettina
Published: July 2012

Retrospective review of diagnostic histopathology samples in secondary research projects may generate cases with discordance in diagnosis between the pathologist originally signing out the sample and the reviewer. In this article the authors discuss ethical and legal issues involved in secondary review and propose how diagnostic discrepancies in research projects can be handled. Research participants have the right to know about and control the handling of personal data. Researchers have a duty to inform research participants about research findings of relevance to the current or future health or quality of life. Such feedback is to be provided within a healthcare framework. The authors recommend that pathology laboratories should require researchers to provide feedback on diagnostic discrepancies of potentially clinical significance in secondary research projects using retrospective review of diagnostic histopathology material. The pathology laboratory in charge of the archival material should be responsible for the follow-up on such cases.
Death certification: do consultant pathologists do it better?
Authors: Fernando Dinesh , Oxley Jon D , Nottingham John
Published: July 2012

The completion of the medical certificate of cause of death is required for registration of a death, and this data helps plan healthcare services for the country. Many audits have shown them to be inaccurately completed by junior doctors, but the authors examined whether advice from consultant pathologists could improve this. Using the Office for National Statistics guidelines, the authors found that only 56% of the certificates were appropriately completed. The planned introduction of medical examiners to England and Wales is aimed at improving this situation, but consultant pathologists will still issue causes of death following postmortems, and it would seem prudent to train pathologists as well.
Quantitative health impact assessment: taking stock and moving forward
Authors: Fehr Rainer , Hurley Fintan , Mekel Odile Cecile , Mackenbach Johan P
Published: July 2012

Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents.
Analysis of utilization patterns of vertebroplasty and kyphoplasty in the Medicare population
Authors: Manchikanti Laxmaiah , Pampati Vidyasagar , Hirsch Joshua A
Published: July 2012

Objective

To determine the pattern of utilization of vertebral augmentation procedures including vertebroplasty and kyphoplasty of the lumbar and thoracic spine in the Medicare population in the USA.

Methods

This analysis was performed using a standard 5% national sample of the Centers for Medicare and Medicaid Services physician outpatient billing claims from 2001 to 2008 and the Physician/Supplier Procedure Summary Master File for 2009 and 2010. Overall characteristics of utilization patterns for vertebral augmentation procedures were evaluated using multiple variables.

Results

From 2002 to 2010, vertebroplasty procedures decreased overall by 24.6% with an average annual decrease of 3.5% per 100 000 Medicare population; from 2006 to 2010 the declines were 42.4% overall and 12.9% annually. From 2006 to 2010, kyphoplasty procedures increased overall by 0.8% with an annual average increase of 0.2% per 100 000 Medicare population.

Conclusion

Analysis of growth patterns of vertebroplasty and kyphoplasty in the Medicare population from 2002 to 2010 illustrates a lack of growth of kyphoplasty and a decline in vertebroplasty procedures.