bluuebunny/crossref_metadata_2025 huggingface dataset:
Anatomical Reconstruction of Knee Posterolateral Complex with the Tendon of the Long Head of Biceps Femoris
Authors: Zhao Jinzhong , He Yaohua , Wang Jianhua
Published: May 2006

Background

There is no consensus about the best way to reconstruct the knee posterolateral complex.

Hypothesis

Anatomical reconstruction of the knee posterolateral complex with the tendon of the long head of biceps femoris can restore knee posterolateral stability.

Study Design

Case series; Level of evidence, 4.

Methods

Anatomical reconstruction of the fibular collateral ligament, popliteofibular ligament, and popliteus tendon was performed consecutively in 28 patients with chronic posterolateral knee injuries. Two distally pedicled tendon slips more than 16 cm long were created from the tendon of the long head of the biceps femoris. The posterior tendon slip was used to reconstruct the popliteofibular ligament and popliteus tendon, and the anterior slip were doubled to reconstruct the lateral collateral ligament. The patients were followed up for 2 to 4 years.

Results

At the latest follow-up, examinations showed that 96.4% (27/28) of the patients had a normal or nearly normal reconstructed fibular collateral ligament as judged by manual examination. All patients had a normal or nearly normal reconstructed popliteofibular ligament and popliteus tendon as judged by manual examination.

Conclusion

Anatomical reconstruction of the knee posterolateral complex with the tendon of the long head of biceps femoris is effective in restoring knee posterolateral stability.
Anatomical Posterior Cruciate Ligament Transplantation
Authors: Davis Daniel K. , Goltz David H. , Fithian Donald C. , D'Lima Darryl
Published: May 2006

Background

Although current techniques of posterior cruciate ligament reconstruction may successfully stabilize the posterior cruciate ligament-deficient knee, no studies have demonstrated restoration of intact-knee kinematics.

Hypothesis

Posterior cruciate ligament transplantation will successfully restore posterior stability and kinematics to the posterior cruciate ligament-deficient knee.

Study Design

Controlled laboratory study.

Methods

Seven pairs (donor/recipient) of size-matched cadaveric knees underwent a novel technique for posterior cruciate ligament transplantation. The grafts were fixed at the femoral origin and tibial insertion using an inlay technique with rigid fixation. The knees were tested in the intact (intact group), posterior cruciate ligament-deficient (deficient group), and posterior cruciate ligament-transplanted (transplant group) states. A 3-dimensional electromagnetic tracking system during an active knee extension and passive knee flexion maneuver was used to quantify kinematics, specifically looking at femoral rollback. KT ligament arthrometry was used to quantify posterior stability at the quadriceps neutral angle (70°).

Results

For femoral rollback, the intact versus deficient groups was significantly different (P = .045) as was deficient versus transplant groups (P = .008) but not intact versus transplant groups. Similar differences were noted with the measurements of posterior stability (P < .001). Total posterior laxity between the intact versus deficient groups was significantly different (means, 1.32 mm vs 11.1 mm; P < .0001), as was deficient versus transplant groups (means, 11.1 mm vs 2.04 mm; P< .126) but not intact versus transplant groups.

Conclusion

In a posterior cruciate ligament-deficient cadaveric model, we demonstrated the technical feasibility and efficacy of posterior cruciate ligament transplantation for restoring femoral rollback and posterior stability at the quadriceps neutral angle.

Clinical Relevance

Future studies in posterior cruciate ligament reconstruction should not only address stability but also restoration of normal knee kinematics in assessing the success of a given technique.
High-Impact Athletics after Knee Articular Cartilage Repair
Authors: Mithoefer Kai , Williams Riley J. , Warren Russell F. , Wickiewicz Thomas L. , Marx Robert G.
Published: May 2006

Background

Knee articular cartilage injuries in athletes present a therapeutic challenge and have been identified as an important cause of permanent disability because of the high mechanical joint stresses in athletes.

Purpose

To determine whether microfracture treatment of knee articular cartilage injuries can return athletes to high-impact sports and to identify the factors that affect the ability to return to athletic activity.

Study Design

Case series; Level of evidence, 4.

Methods

Thirty-two athletes who regularly participated in high-impact, pivoting sports before articular cartilage injury were treated with microfracture for single articular cartilage lesions of the knee. Functional outcome was prospectively evaluated with a minimum 2-year follow-up by subjective rating, activity-based outcome scores, and the ability for postoperative participation in high-impact, pivoting sports.

Results

At last follow-up, 66% of athletes reported good or excellent results. Activity of daily living, Marx activity rating scale, and Tegner activity scores increased significantly after microfracture. After an initial improvement, score decreases were observed in 47% of athletes. Forty-four percent of athletes were able to regularly participate in high-impact, pivoting sports, 57% of these at the preoperative level. Return to high-impact sports was significantly higher in athletes with age <40 years, lesion size <200 mm2, preoperative symptoms <12 months, and no prior surgical intervention.

Conclusion

Microfracture is an effective first-line treatment to return young athletes with short symptomatic intervals and small articular cartilage lesions of the knee back to high-impact athletics.
Evaluation of Apparent and Absolute Supraspinatus Strength in Patients with Shoulder Injury Using the Scapular Retraction Test
Authors: Kibler W. Ben , Sciascia Aaron , Dome David
Published: May 2006

Background

Physical examination of patients with shoulder injury not involving actual rotator cuff tears frequently demonstrates decreased rotator cuff strength on manual muscle testing. This decrease has been attributed to supraspinatus muscle weakness, but it may be owing to alterations in scapular position.

Hypothesis

The position of stabilized scapular retraction, by minimizing proximal kinetic chain factors and providing a stable base of muscle origin, positively influences demonstrated supraspinatus strength.

Study Design

Controlled laboratory study.

Methods

Supraspinatus strength was tested in 20 injured patients and 10 healthy controls in both the empty-can arm position and a position of scapular retraction using a handheld dynamometer. Pain in both maneuvers was measured by use of a visual analog scale.

Results

Paired t tests indicated the scapular retraction position resulted in statistically significantly (P =. 001) higher supraspinatus strength values within both groups. There was no significant difference between the 2 positions in visual analog scale scores.

Conclusion

This study shows that demonstrated apparent supraspinatus weakness on clinical examination in symptomatic patients may be dependent on scapular position. The weakness may be owing to other factors besides supraspinatus muscle weakness, such as a lack of a stable base in the kinetic chain or scapula.

Clinical Relevance

The clinical examination that addresses scapular posture and includes scapular retraction will allow more accurate determination of absolute supraspinatus muscle strength and allow efficacious rehabilitation protocols to address the source of the demonstrated weakness.
Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma
Authors: Mishra Allan , Pavelko Terri
Published: May 2006

Background

Elbow epicondylar tendinosis is a common problem that usually resolves with nonoperative treatments. When these measures fail, however, patients are interested in an alternative to surgical intervention.

Hypothesis

Treatment of chronic severe elbow tendinosis with buffered platelet-rich plasma will reduce pain and increase function in patients considering surgery for their problem.

Study Design

Cohort study; Level of evidence, 2.

Methods

One hundred forty patients with elbow epicondylar pain were evaluated in this study. All these patients were initially given a standardized physical therapy protocol and a variety of other nonoperative treatments. Twenty of these patients had significant persistent pain for a mean of 15 months (mean, 82 of 100; range, 60-100 of 100 on a visual analog pain scale), despite these interventions. All patients were considering surgery. This cohort of patients who had failed nonoperative treatment was then given either a single percutaneous injection of platelet-rich plasma (active group, n = 15) or bupivacaine (control group, n = 5).

Results

Eight weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement in control patients (P =. 001). Sixty percent (3 of 5) of the control subjects withdrew or sought other treatments after the 8-week period, preventing further direct analysis. Therefore, only the patients treated with platelet-rich plasma were available for continued evaluation. At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P =. 0001). At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P <. 0001).

Conclusion

Treatment of patients with chronic elbow tendinosis with buffered platelet-rich plasma reduced pain significantly in this pilot investigation. Further evaluation of this novel treatment is warranted. Finally, platelet-rich plasma should be considered before surgical intervention.
Pregnancy outcome following gestational exposure to azithromycin
Authors: Sarkar Moumita , Woodland C Cindy , Koren Gideon , Einarson Adrienne RN
Published: May 2006

Background

Azithromycin is an azalide antibiotic with an extensive range of indications and has become a common treatment option due to its convenient dosing regimen and therapeutic advantages. Human studies addressing gestational use of azithromycin have primarily focused on antibiotic efficacy rather than fetal safety. Our primary objective was to evaluate the possibility of teratogenic risk following gestational exposure to azithromycin.

Methods

There were 3 groups of pregnant women enrolled in our study: 1) women who took azithromycin. 2) women exposed to non-teratogenic antibiotics for similar indications, and 3) women exposed to non-teratogenic agents. They were matched for gestational age at time of call, maternal age, cigarette and alcohol consumption. Rates of major malformations and other endpoints of interest were compared among the three groups.

Results

Pregnancy outcome of 123 women in each group was ascertained. There were no statistically significant differences among the three groups in the rates of major malformations; 3.4% (exposed) versus 2.3% (disease matched) and 3.4% (non teratogen) or any other endpoints that were examined. In the azithromycin group, 88 (71.6%) women took the drug during the first trimester

Conclusion

Results suggest that gestational exposure to azithromycin is not associated with an increase in the rate of major malformations above the baseline of 1–3%. Our data adds to previous research showing that macrolide antibiotics, as a group, are generally safe in pregnancy and provides an evidence-based option for health professionals caring for populations with chlamydia.
The appropriate use of radiography in clinical practice: a report of two cases of biomechanical versus malignant spine pain
Authors: Pringle Roger Kevin , Wyatt Lawrence H
Published: May 2006

Background

To describe the evaluation, treatment, management and referral of two patients with back pain with an eventual malignant etiology, who were first thought to have a non-organic biomechanical disorder.

Clinical features

The study was a retrospective review of the clinical course of two patients seen by a chiropractor in a multi-disciplinary outpatient facility, who presented with what was thought to be non-organic biomechanical spine pain. Clinical examination by both medical and chiropractic physicians did not indicate the need for radiography in the early course of management of either patient. Upon subsequent re-evaluation, it was decided that certain clinical factors required investigation with advanced imaging.

In one instance, the patient responded to conservative care of low back pain for nine weeks, after which she developed severe pain in the pelvis. In the second case, the patient presented with signs and symptoms consistent with uncomplicated musculoskeletal pain that failed to respond to a course of conservative care. He was referred for medical therapy which also failed to relieve his pain. In both patients, malignancy was eventually discovered with magnetic resonance imaging and both patients are now deceased, resulting in an inability to obtain informed consent for the publication of this manuscript.

Conclusion

In these two cases, the prudent use of diagnostic plain film radiography did not significantly alter the appropriate long-term management of patients with neuromusculoskeletal signs and symptoms. The judicious use of magnetic resonance imaging was an effective procedure when investigating recalcitrant neuromusculoskeletal pain in these two patients.
Innovations in mental health services implementation: a report on state-level data from the U.S. Evidence-Based Practices Project
Authors: Magnabosco Jennifer L
Published: May 2006

Background

TheEvidence-Based Practice(EBP)Projecthas been investigating the implementation of evidence-based mental health practices (Assertive Community Treatment, Family Psychoeducation, Integrated Dual Diagnosis Treatment, Illness Management and Recovery, and Supported Employment) in state public mental health systems in the United States since 2001. To date,Projectfindings have yielded valuable insights into implementation strategy characteristics and effectiveness. This paper reports results of an effort to identify and classify state-level implementation activities and strategies employed across the eight states participating in the Project.

Methods

Content analysis and Greenhalgh et al's (2004) definition of innovation were used to identify and classify state-level activities employed during three phases of EBP implementation: Pre-Implementation, Initial Implementation and Sustainability Planning. Activities were coded from site visit reports created from documents and notes from key informant interviews conducted during two periods, Fall 2002 – Spring 2003, and Spring 2004. Frequency counts and rank-order analyses were used to examine patterns of implementation activities and strategies employed across the three phases of implementation.

Results

One hundred and six discreet implementation activities and strategies were identified as innovative and were classified into five categories: 1) state infrastructure building and commitment, 2) stakeholder relationship building and communications, 3) financing, 4) continuous quality management, and 5) service delivery practices and training. Implementation activities from different categories were employed at different phases of implementation.

Conclusion

Insights into effective strategies for implementing EBPs in mental health and other health sectors require qualitative and quantitative research that seeks to: a) empirically test the effects of tools and methods used to implement EBPs, and b) establish a stronger evidence-base from which to plan, implement and sustain such efforts. This paper offers a classification scheme and list of innovative implementation activities and strategies. The classification scheme offers potential value for future studies that seek to assess the effects of various implementation processes, and helps establish widely accepted standards and criteria that can be used to assess the value of innovative activities and strategies.
Differential regulation of chemokine production by Fcγ receptor engagement in human monocytes: association of CCL1 with a distinct form of M2 monocyte activation (M2b, Type 2)
Authors: Sironi Marina , Martinez Fernando O , D’Ambrosio Daniele , Gattorno Marco , Polentarutti Nadia , Locati Massimo , Gregorio Andrea , Iellem Andrea , Cassatella Marco A , Van Damme Jo , Sozzani Silvano , Martini Alberto , Sinigaglia Francesco , Vecchi Annunciata , Mantovani Alberto
Published: May 2006

CC chemokine ligand 1 (CCL1; I-309) is a CC chemokine that interacts with CC chemokine receptor 8, which is preferentially expressed in polarized T helper cell type 2 and Tc2 cells, in eosinophils, and in T regulatory cells. The present study, prompted by transcriptional profiling of human monocytes undergoing different forms of activation, was designed to characterize the production of CCL1 in monocytes compared with the production of other chemokines (CCL2, CCL22, and CCL18) differentially regulated by distinct activation signals. Lipopolysaccharide (LPS), interferon-γ (IFN-γ), interleukin (IL)-1β, tumor necrosis factor α, IL-4, IL-13, IL-10, IL-6, IL-18, and combinations thereof did not induce CCL1 production in monocytes, and some of these signals stimulated production of reference chemokines. Induction of CCL1 in monocytes required engagement of Fc receptor for immunoglobulin G (FcγR)II and exposure to IL-1β or LPS. This combination of stimuli results in a form of M2 (M2b, Type 2) macrophage activation. FcγR engagement also induced CCL22 and amplified its stimulation by IL-4. In contrast, FcγR stimulation inhibited the IL-10- and LPS-mediated induction of CCL18. IL-10, IL-4, and IFN-γ inhibited induction of CCL1 by FcγR ligation and IL-1β. CCL1 was present in synovial fluids and macrophages in juvenile idiopathic arthritis. Thus, regulation of CCL1 in human monocytes is unique, with an obligate requirement of FcγR engagement and costimulation by signals (IL-1β and LPS), which use the myeloid differentiation primary-response protein 88 adaptor protein. Thus, CCL1 is a CC chemokine with a unique pattern of regulation associated with a distinct form of M2 (Type 2, M2b) monocyte activation, which participates in macrophage-dependent regulatory circuits of innate and adaptive immunity.
Industrial firm linkages in a post-Soviet urban economy: implications for development policy and programmes
Authors: Anderson R. Jerome
Published: May 2006

Development strategies as articulated by international financial institutions and bilateral donors appear to omit consideration of urban economies as drivers of economic growth in developing and transition economies. This paper highlights that omission and argues that donor assistance programmes and host government policies should be oriented toward strengthening urban economies by fostering linkages among industrial firms. A study of industrial firms in Yerevan, Armenia seems to indicate linkages among Yerevan′s industrial firms are beginning to form and are associated with growth in the Armenian economy. Policies to strengthen and deepen those linkages should be encouraged.
Second Primary Tumors in Neurofibromatosis 1 Patients Treated for Optic Glioma: Substantial Risks After Radiotherapy
Authors: Sharif Saba , Ferner Rosalie , Birch Jillian M. , Gillespie James E. , Gattamaneni H. Rao , Baser Michael E. , Evans D. Gareth R.
Published: May 2006

Purpose

Optic pathway gliomas (OPGs) are the most common CNS tumor in neurofibromatosis 1 (NF1) patients. We evaluated the long-term risk of second tumors in NF1-related OPGs after radiotherapy.

Patients and Methods

We reviewed 80 NF1 OPG patients from two NF1 clinics to evaluate the long-term risk of developing subsequent nervous system tumors, with or without radiotherapy.

Results

Fifty-eight patients were assessable for second tumors. Nine (50%) of 18 patients who received radiotherapy after their OPGs developed 12 second tumors in 308 person-years of follow-up after radiotherapy. Eight (20%) of 40 patients who were not treated with radiotherapy developed nine tumors in 721 person-years of follow-up after diagnosis of their OPGs. The relative risk of second nervous system tumor after radiotherapy was 3.04 (95% CI, 1.29 to 7.15).

Conclusion

There is a significantly increased risk of second nervous system tumors in those NF1 patients who received radiotherapy for their OPGs, especially when treated in childhood. Thus radiotherapy should only be used if absolutely essential in children with NF1.
Double Induction Containing Either Two Courses or One Course of High-Dose Cytarabine Plus Mitoxantrone and Postremission Therapy by Either Autologous Stem-Cell Transplantation or by Prolonged Maintenance for Acute Myeloid Leukemia
Authors: Büchner Thomas , Berdel Wolfgang E. , Schoch Claudia , Haferlach Torsten , Serve Hubert L. , Kienast Joachim , Schnittger Susanne , Kern Wolfgang , Tchinda Joelle , Reichle Albrecht , Lengfelder Eva , Staib Peter , Ludwig Wolf-Dieter , Aul Carlo , Eimermacher Hartmut , Balleisen Leopold , Sauerland Maria-Cristina , Heinecke Achim , Wörmann Bernhard , Hiddemann Wolfgang
Published: May 2006

Purpose

Intensification by high-dose cytarabine in postremission or induction therapy and prolonged maintenance are established strategies to improve the outcome in patients with acute myeloid leukemia (AML). Whether additional intensification can add to this effect has not yet been determined.

Patients and Methods

A total of 1,770 patients (age 16 to 85 years) with de novo or secondary AML or high-risk myelodysplastic syndrome (MDS) were randomly assigned upfront for induction therapy containing one course with standard dose and one course with high-dose cytarabine, or two courses with high-dose cytarabine, and in the same step received postremission prolonged maintenance or busulfan/cyclophosphamide chemotherapy with autologous stem-cell transplantation.

Results

The complete remission rate in patients younger than 60 and ≥ 60 years of age was 70% and 53%, respectively. The overall survival at 3 years in the two age groups was 42% and 19%, the relapse-free survival was 40% and 19%, and the ongoing remission duration was 48% and 22%, respectively. There were no significant differences in these results between the two randomized induction arms or between the two postremission therapy arms. There was no significant difference in any prognostic subgroup according to secondary AML/MDS, cytogenetics, WBC, lactate dehydrogenase, and early blast clearance.

Conclusion

The regimen of one course with standard-dose cytarabine and one course with high-dose cytarabine for induction, and prolonged maintenance for postremission chemotherapy in patients with AML is not improved by additional escalation in cytotoxic treatment.
Determinants of Skeletal Loss and Recovery in Anorexia Nervosa
Authors: Miller Karen K. , Lee Ellen E. , Lawson Elizabeth A. , Misra Madhusmita , Minihan Jennifer , Grinspoon Steven K. , Gleysteen Suzanne , Mickley Diane , Herzog David , Klibanski Anne
Published: May 2006

Context: Anorexia nervosa (AN) is complicated by severe bone loss. The effects of persistent undernutrition and consequent neuroendocrine dysfunction on bone mass and the factors influencing skeletal recovery have not been well characterized.

Objective: The objective of the study was to determine the rate of bone loss at the spine and hip in women with AN and whether resumption of menstrual function and/or improvement in weight are determinants of skeletal recovery in AN.

Design: The study had a longitudinal design.

Setting: The study was conducted at a clinical research center.

Study Participants: Participants included 75 ambulatory women with AN.

Main Outcome Measures: Bone mineral density (BMD) and body composition were measured with dual x-ray absorptiometry.

Results: In women not receiving oral contraceptives, those who did not improve weight or resume menses had a mean annual rate of decline of 2.6% at the spine and 2.4% at the hip. Those who resumed menses and improved weight had a mean annual increase of 3.1% at the posteroanterior spine and 1.8% at the hip. Women who recovered menses demonstrated a mean increase of posteroanterior spine but not hip BMD, independent of weight gain. Women who improved weight, regardless of whether they recovered menstrual function, demonstrated a mean increase of hip, but not spine, BMD. Increase in fat-free mass was a more significant determinant of increased BMD than weight or fat mass gain. In women receiving oral contraceptives, there was no increase in BMD at any site despite a mean 11.7% weight increase.

Conclusions: These data suggest that rapid bone loss, at an average annual rate of about 2.5%, occurs in young women with active AN. Resumption of menstrual function is important for spine BMD recovery, whereas weight gain is critical for hip BMD recovery. We did not observe an increase in BMD with weight gain in women receiving oral contraceptives. Therefore, improvements in reproduction function and weight, with increases in lean body mass a critical component, are both necessary for skeletal recovery in women with AN.
Subcellular translocation of the eGFP-tagged TRPL channel inDrosophilaphotoreceptors requires activation of the phototransduction cascade
Authors: Meyer N. E. , Joel-Almagor T. , Frechter S. , Minke B. , Huber A.
Published: May 2006

Signal-mediated translocation of transient receptor potential (TRP) channels is a novel mechanism to fine tune a variety of signaling pathways including neuronal path finding and Drosophila photoreception. In Drosophila phototransduction the cation channels TRP and TRP-like (TRPL) are the targets of a prototypical G protein-coupled signaling pathway. We have recently found that the TRPL channel translocates between the rhabdomere and the cell body in a light-dependent manner. This translocation modifies the ion channel composition of the signaling membrane and induces long-term adaptation. However, the molecular mechanism underlying TRPL translocation remains unclear. Here we report that eGFP-tagged TRPL expressed in the photoreceptor cells formed functional ion channels with properties of the native channels, whereas TRPL-eGFP translocation could be directly visualized in intact eyes. TRPL-eGFP failed to translocate to the cell body in flies carrying severe mutations in essential phototransduction proteins, including rhodopsin, Gαq, phospholipase Cβ and the TRP ion channel, or in proteins required for TRP function. Our data, furthermore, show that the activation of a small fraction of rhodopsin and of residual amounts of the Gq protein is sufficient to trigger TRPL-eGFP internalization. In addition, we found that endocytosis of TRPL-eGFP occurs independently of dynamin, whereas a mutation of the unconventional myosin III, NINAC, hinders complete translocation of TRPL-eGFP to the cell body. Altogether, this study revealed that activation of the phototransduction cascade is mandatory for TRPL internalization, suggesting a critical role for the light induced conductance increase and the ensuing Ca2+-influx in the translocation process. The critical role of Ca2+ influx was directly demonstrated when the light-induced TRPL-eGFP translocation was blocked by removing extracellular Ca2+.
Transcriptional co-activator p75 binds and tethers the Myc-interacting protein JPO2 to chromatin
Authors: Maertens G. N. , Cherepanov P. , Engelman A.
Published: May 2006

Transcriptional co-activator p75 is implicated in human cancer, autoimmunity and replication of human immunodeficiency virus type 1 (HIV-1) as a dominant integrase-interacting protein. Although characterized as chromatin associated, the normal biological role(s) of p75 remains fairly unclear. To gain insight into p75 function, we have characterized its cellular binding partners and report that JPO2, a recently identified Myc-binding protein, associates with p75 in vitro and in vivo. The pseudo HEAT repeat analogous topology (PHAT) domain of p75, which mediates its interaction with integrase, also mediates the interaction with JPO2, and recombinant integrase protein competes with JPO2 protein for binding to p75 in vitro. JPO2 binds p75 through a 61-residue (amino acids 58-119) region that is distinct from its Myc-interacting domain. In cells, JPO2 and p75 co-localize throughout the cell cycle, and both proteins concentrate on condensed chromosomes during mitosis. Strikingly, the association of JPO2 with chromatin strictly depends upon p75, similar to that of ectopically expressed integrase. Also similar to its effect on integrase, p75 stabilizes intracellular steady-state levels of JPO2 protein. Our results suggest a role for p75 in the Myc regulatory network, and indicate that p75 is a general adaptor protein tethering divergent factors to chromatin through its versatile integrase-binding domain.
A New Bottom-Left-Fill Heuristic Algorithm for the Two-Dimensional Irregular Packing Problem
Authors: Burke Edmund , Hellier Robert , Kendall Graham , Whitwell Glenn
Published: May 2006

This paper presents a new heuristic algorithm for the two-dimensional irregular stock-cutting problem, which generates significantly better results than the previous state of the art on a wide range of established benchmark problems. The developed algorithm is able to pack shapes with a traditional line representation, and it can also pack shapes that incorporate circular arcs and holes. This in itself represents a significant improvement upon the state of the art. By utilising hill climbing and tabu local search methods, the proposed technique produces 25 new best solutions for 26 previously reported benchmark problems drawn from over 20 years of cutting and packing research. These solutions are obtained using reasonable time frames, the majority of problems being solved within five minutes. In addition to this, we also present 10 new benchmark problems, which involve both circular arcs and holes. These are provided because of a shortage of realistic industrial style benchmark problems within the literature and to encourage further research and greater comparison between this and future methods.
Warfarin Exposure and the Risk of Thromboembolic and Major Bleeding Events Among Medicaid Patients with Atrial Fibrillation
Authors: Boulanger Luke , Hauch Ole , Friedman Mark , Foster Talia , Dixon Deirdre , Wygant Gail , Menzin Joseph
Published: May 2006

Background:

Outcomes of anticoagulation have been assessed in commercially insured populations, but similar data do not exist for Medicaid populations.

Objective:

To assess the association between warfarin exposure and rates of thromboembolic and bleeding events among patients with nonvalvular atrial fibrillation (NVAF) enrolled in California Medicaid.

Methods:

Using a retrospective cohort design based on administrative claims data, we selected Medicaid enrollees aged 50 years and older based on their first claim with a diagnosis of AF between January 1, 1998, and March 31, 2002. Patients were excluded if they had selected contraindications to warfarin, claims for valve replacement procedures, or evidence that AF resulted from transient or reversible causes. Pharmacy claims and prothrombin time tests were used to define subsequent periods of warfarin use (exposure) and nonuse (nonexposure) by all patients. The relative rates of hospitalization for thromboembolic and bleeding events associated with periods of warfarin exposure versus nonexposure were estimated.

Results:

The 4355 study patients had a mean age of 74 years, and 65% were female. Fifty-nine percent filled any prescriptions for warfarin following AF diagnosis. Across all patients, warfarin exposure occurred during 37% of days after diagnosis. Thromboembolic events were 27% less frequent during periods of warfarin exposure relative to periods of non-exposure (p < 0.01). Major bleeding events were not significantly more common during periods of warfarin exposure (p = 0.55).

Conclusions:

In this Medicaid population with NVAF, warfarin use was low and was associated with a relatively modest reduction in thromboembolic events, with no increase in major bleeding risk.
Pediatrics Efficacy and Safety of Naltrexone Use in Pediatric Patients with Autistic Disorder
Authors: Eichaar Gladys M , Maisch Nicole M , Augusto Laura M Gianni , Wehring Heidi J
Published: May 2006

Objective:

To review the efficacy and safety of naltrexone in pediatric patients with autistic disorder (AD).

Data Sources:

Using the terms pediatric, child, naltrexone, autism, and autistic disorder, a literature search was performed using MEDLINE (1966–May 18, 2006) and the International Pharmaceutical Abstracts (1971–May 18, 2006) database. The references of these articles were scanned for additional relevant literature.

Study Selection and Data Extraction:

All articles describing or evaluating the efficacy and/or safety of naltrexone in pediatric patients with AD were included in this review. Three case reports, 8 case series, and 14 clinical studies were identified as pertinent.

Data Synthesis:

Naltrexone has been used most commonly at doses ranging from 0.5 to 2 mg/kg/day and found to be predominantly effective in decreasing self-injurious behavior. Naltrexone may also attenuate hyperactivity, agitation, irritability, temper tantrums, social withdrawal, and stereotyped behaviors. Patients may also exhibit improved attention and eye contact. Transient sedation was the most commonly reported adverse event. Small sample size, short duration, and inconsistent evaluative methods characterize the available research.

Conclusions:

A child affected by AD may benefit from a trial of naltrexone therapy, particularly if the child exhibits self-injurious behavior and other attempted therapies have failed. Serious adverse effects have not been reported in short-term studies.
Deferasirox—An Oral Agent for Chronic Iron Overload
Authors: VanOrden Heidi E , Hagemann Tracy M
Published: May 2006

Objective:

To review the available literature on the pharmacology, pharmacokinetics, efficacy, toxicology, adverse effects, drug interactions, and dosage guidelines for deferasirox, an oral iron chelator, in Phase III trials.

Data Sources:

Reviewers searched the following databases for English-language studies: MEDLINE (1966—April 2006), International Pharmaceutical Abstracts (1970–April 2006), and the Cochrane Library Database. Key search terms included iron chelation, chelation, iron overload, deferasirox, and ICL670.

Study Selection and Data Extraction:

Data on efficacy, toxicology, adverse effects, and pharmacokinetics for deferasirox were obtained from randomized, open-label, blinded clinical trials. Other information was obtained from the manufacturer, including unpublished studies in abstract form as well as available data on deferasirox.

Data Synthesis:

Deferasirox is an orally active iron chelator. In clinical trials, deferasirox demonstrated efficacy at dosages of 20 and 30 mg/kg/day in treating iron overload in patients with β-thalassemia. Deferasirox has been studied in patients older than 2 years and appears to be safe, with the most common adverse effects reported being mild, transient nausea, gastrointestinal disturbances, and rash. There were no reports of serious adverse effects in trials to date.

Conclusions:

Deferasirox represents a new approach to the management of chronic iron overload in patients with chronic anemias who require blood transfusions. The available literature suggests that deferasirox is safe and as effective as the current standard of therapy at dosages of 20–30 mg/kg/day for β-thalassemia. Further studies are needed to confirm its efficacy in other chronic transfusion-requiring diseases.
Development and Validation of the Self-Administration of Medication Tool
Authors: Manias Elizabeth , Beanland Christine J , Riley Robin G , Hutchinson Alison M
Published: May 2006

Background:

Consumer participation in planning and implementing health care is actively encouraged as a means of improving patient outcomes. In assessing the ability of patients to self-medicate, health professionals can identify areas in which patients need assistance, education, and intervention to optimize their health outcomes after discharge.

Objective:

To develop and validate a tool to quantify the ability of patients to administer their regularly scheduled medications while they are hospitalized.

Methods:

Past research enabled us to develop the Self-Administration of Medication (SAM) tool. Using a Delphi technique of 3 rounds, a panel of expert health professionals established the content validity of the tool. For determining level of agreement in using the SAM tool, 56 patients were selected; for each patient, 2 randomly selected nurses completed an assessment. Construct validity and internal consistency were examined by testing the tool in 50 patients and comparing with other validated scales.

Results:

The 29-item SAM tool had high content validity scores for clarity, representation, and comprehensiveness, with content validity index values ranging from 0.95–1.0. In testing the level of agreement between 2 nurses, out of 43 valid cases, 95.3% of nurses overwhelmingly agreed about the patients’ competence to self-administer their drugs. The intraclass correlation coefficient was 0.819 (95% Cl 0.666 to 0.902). Internal consistency for the SAM tool was high, with a Cronbach's alpha of 0.899. A moderate to strong correlation was obtained when comparing the SAM tool with other validated measures.

Conclusions:

The SAM tool is valid and reliable for quantifying patients’ ability to manage their regularly scheduled medications in the hospital setting.
Pharmaceutical Care in Community Pharmacies: Practice and Research in Sweden
Authors: Westerlund LO Tommy , Björk H Thony
Published: May 2006

Objective:

To describe the organization and delivery of community pharmacy and medical care, as well as pharmaceutical care practice and research, in Sweden.

Findings:

The Swedish retail pharmacy system of 800 community pharmacies and nearly 80 hospital pharmacies is unique in that it is organized into one single, government-owned chain, known as Apoteket AB. The pharmacy staff consists of pharmacists, prescriptionists, and pharmacy technicians. Some activities related to pharmaceutical care have been directed toward specific patient groups during annual theme campaigns. In the past few years, there has been a growing emphasis on the identification, resolution, and documentation of drug-related problems (DRPs) in Swedish pharmacy practice. A classification system for documenting DRPs and pharmacy interventions was developed in 1995 and incorporated into the software of all community pharmacies in 2001. A national DRP database (SWE-DRP) was established in 2004 to collect and analyze DRPs and interventions on a nationwide basis. Recently, a new counseling technique composed of key questions to facilitate the detection of DRPs has been tested successfully. Patient medication profiles are kept in 160 pharmacies, and a new national register of drugs dispensed to patients became available in 2006. Most pharmaceutical care studies in Sweden have focused on DRPs and resulting pharmacy interventions.

Discussion:

Swedish community pharmacy DRP work is in the international forefront but there is a potential for further developing cognitive services, given the beneficial organization of the country's pharmacies into one single pharmacy chain. The introduction of patient medication profiles has been both late and slow and has only had a marginal effect on pharmaceutical care practice so far. The universities do not appear to have any desire to influence the practice of pharmacy and could potentially take on a more active role in preparing pharmacy students for patient-oriented services. Current threats to pharmaceutical care practice and research include organizational changes, budget cuts, and reduced manpower of Apoteket AB.

Conclusions:

The identification, resolution, and documentation of DRPs are central to community pharmacy practice in Sweden, resulting in a number of research studies. A national DRP database, patient medication profiles, and a new national register of drugs dispensed to patients provide opportunities for growth in pharmaceutical care practice and research in the country.
A Case of Streptococcus intermedius Empyema
Authors: Wargo Kurt A , McConnell Victoria J , Higginbotham Steven A
Published: May 2006

Objective:

To report a case of empyema caused by Streptococcus intermedius as a complication of community-acquired pneumonia (CAP).

Case Summary:

An 85-year-old woman with a history of chronic obstructive pulmonary disease, asthma, heart failure, and hypothyroidism developed empyema as a result of 2 episodes of CAP and an acute exacerbation of chronic bronchitis within the past 2 months. Therapy with intravenous levofloxacin 750 mg every 48 hours was initiated. Culture results of the empyema fluid yielded pure growth of a rarely encountered microorganism, S. intermedius. Intravenous piperacillin/tazobactam 3.375 g every 6 hours was added to the antimicrobial therapy at that time. However, cultures continued to show S. intermedius. Surgical decortication was unsuccessful, and the patient died after a 30 day hospital stay.

Discussion:

Early, appropriate antimicrobial therapy is the mainstay of CAP treatment. Although rare, empyema or thoracic abscess can occur despite this therapy, due to mucosal changes caused by CAP. Historically, antimicrobial therapy used to treat organisms that typically cause CAP also has activity against S. intermedius. However, growth of this microorganism and failure to respond to therapy should alert clinicians to the possibility of empyema or abscess formation.

Conclusions:

Despite historical in vitro susceptibility data of S. intermedius, antimicrobial therapy may be ineffective, and more extreme measures may be needed to achieve a successful outcome. Early, appropriate antimicrobial therapy needs to remain the mainstay of the treatment of CAP in an attempt to prevent fatal complications such as this from occurring.
A special gift we bestow on you for being representative of us: Considering leader charisma from a self‐categorization perspective
Authors: Platow Michael J. , van Knippenberg Daan , Haslam S. Alexander , van Knippenberg Barbara , Spears Russell
Published: May 2006

Two experiments tested hypotheses, derived from social identity and self‐categorization theories, regarding the attribution of charisma to leaders. In Experiment 1 (N = 203), in‐group prototypical leaders were attributed greater levels of charisma and were perceived to be more persuasive than in‐group non‐prototypical leaders. In Experiment 2 (N = 220), leaders described with in‐group stereotypical characteristics were attributed relatively high levels of charisma regardless of their group‐oriented versus exchange rhetoric. Leaders described with out‐group stereotypical characteristics, however, had to employ group‐oriented rhetoric to be attributed relatively high levels of charisma. We conclude that leadership emerges from being representative of ‘us’; charisma may, indeed, be a special gift, but it is one bestowed on group members by group members for being representative of, rather than distinct from, the group itself.
Assessment of implicit personality self‐concept using the implicit association test (IAT): Concurrent assessment of anxiousness and angriness
Authors: Schnabel Konrad , Banse Rainer , Asendorpf Jens B.
Published: May 2006

This study explored the psychometric properties of the Implicit Association Test (IAT) when it is employed for the assessment of two personality traits within one sample. The sequence of an anxiousness and an angriness IAT was counterbalanced across 100 participants and the IATs' predictive validity for anxious versus angry behaviour after emotion inductions was examined and compared to direct self‐report measures. The anxiousness IAT added incremental validity over direct measures for the prediction of anxious behaviour. The angriness IAT was affected by an order effect. When the angriness IAT was completed after the anxiousness IAT both tests correlated withr= .46 whereas they were not significantly correlated when the angriness IAT was completed first. Direct anxiousness and angriness measures were uncorrelated. Implications for the assessment of multiple implicit personality self‐concept dimensions are discussed.
Race and willingness to cooperate with the police: The roles of quality of contact, attitudes towards the behaviour and subjective norms
Authors: Viki G. Tendayi , Culmer Michelle J. , Eller Anja , Abrams Dominic
Published: May 2006

Black individuals are usually reluctant to co‐operate with the police (Smith, 1983a). We propose that a history of unpleasant interactions with the police generates hostile attitudes towards the institution (Jefferson & Walker, 1993). Using a sample of 56 black and 64 white participants, we examined whether quality of contact predicts black people's attitudes and subjective norms concerning co‐operating with the police. Our findings indicated that the Contact Hypothesis (Pettigrew, 1998) and Theory of Planned Behaviour (Ajzen, 1991) jointly provide some insight into the disinclination of black individuals to co‐operate with the police. We found that the relationship between race and attitudes or subjective norms concerning co‐operation with police investigations was mediated by quality of previous contact with the police. In turn, the relationship between quality of contact and willingness to co‐operate with police investigations was mediated by both attitudes and subjective norms. Theoretical and practical implications are discussed.
Characterizing the Asphalt-Aggregate Mixtures Using Rheological Properties of Asphalt Binders
Authors: Zeng M , Huang S-C
Published: May 2006

Modeling techniques were employed to establish the relationship between the rheological properties (G* and δ) of asphalt binders and asphalt-aggregate mixtures. Results of this study indicate that the complex modulus and phase angle of the mixture can be represented by the same parameters obtained from the binder under the conditions of material linearity. This relationship is independent of frequency (or loading time) and temperature. For typical dense graded asphalt mixtures, the relationship is not significantly affected by the characteristics of both the asphalt binder and the aggregate. The relationship between the complex moduli of the asphalt binder and mixture can be mathematically modeled by the generalized power function. This function is more precise than the Heukelom and Klomp model (HK expression) and bilogarithm linear model (BL approximation), particularly at low and high modulus values. The generalized power function can differentiate asphalt binder as a viscoelastic liquid and asphalt mixture as a viscoelastic solid under the action of shear loading. The relationship of the phase angles, as an integrated part of rheological property of a viscoelastic material, between asphalt binders and mixtures can be modeled by a modified haversine function. This function completes the modeling of rheological properties as a whole for the first time and also reflects the fundamental material difference between the binder and the mixture in viscoelastic theory. Characterizing the asphalt mixture properties through the binder properties not only can save tremendous efforts in testing an asphalt mixture, but also can simplify the pavement performance prediction.