bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Severity of Hazardous Drinking and Related Consequences Among Incarcerated Women
Authors: Strong David R. , Caviness Celeste , Anderson Brad , Brown Richard A. , Stein Michael
Published: March 2010

Background:  Recent epidemiological efforts have demonstrated the utility of measuring individual differences in the severity of alcohol use along a single severity continuum marked by alcohol‐related problems, symptoms of alcohol dependence, and the social consequences of drinking. Translation of this utility to specialized clinical populations is not assured. The expected inter‐relationships among problems, symptoms and consequences, and enhanced sensitivity of combined assessments require confirmation in applied clinical settings.

Method:  Subjects were 245 incarcerated women who met Alcohol Use Disorders Identification Test criteria for hazardous use of alcohol. Participants were recruited from a statewide adult correctional facility for an ongoing clinical trial testing the effectiveness of brief motivational interviewing on alcohol use and HIV risk behaviors. Participants ranged in age from 18 to 56 (M = 34.1, SD = 8.9), 71.4% were Caucasian, and 65.7% reported <12 years of education.

Results:  Analyses suggested that the 6 problems of alcohol abuse, 7 symptoms for alcohol dependence, and 14 alcohol‐related social consequences loaded to a single factor (0.38 to 0.85) that formed a continuum of alcohol severity. Contrary to epidemiological studies, physical fights and being arrested were the most prevalent consequences and were associated with lower alcohol severity in this population. Three of the five items that discriminated best between higher and lower alcohol severity were related to familial and relationship consequences.

Conclusions:  Consistent with epidemiological studies, alcohol severity can be measured among incarcerated hazardously drinking women on a single continuum that includes alcohol problems, symptoms, and social consequences. Replication of the expected alignment of problems and symptoms supports the construct validity of the continuum and further challenges the proposed hierarchical structure of abuse/dependence distinction. Large differences in rates of specific consequences and observed effectiveness of tailored social consequence items suggest the benefits of cross‐sample validation to improve evaluation of clinical outcomes.
The Effect of Data Breaches on Shareholder Wealth
Authors: Gatzlaff Kevin M. , McCullough Kathleen A.
Published: March 2010

Abstract

Many companies face the risk of a data breach exposing stored personal information of customers and employees. The frequency of such incidents has been increasing over time and can result in significant costs for the affected firm. This article examines the stock market's assessment of the cost of data breaches at publicly traded companies in which personal information such as customer and/or employee data are exposed. Using event study methodology on a sample of 77 events between the beginning of 2004 and the end of 2006, we find that the overall effect of a data breach on shareholder wealth is negative and statistically significant. Based on a cross‐sectional analysis of the cumulative abnormal returns, we find a negative association between market reaction and firms that are less forthcoming about the details of the breach. We also find that firms with higher market‐to‐book ratios experience greater negative abnormal returns associated with a data breach. Further, we find that firm size and subsidiary status mitigate the negative effect of a data breach on the firm's stock price and that the negative market reaction to a data breach is more significant in the most recent time periods of the sample.
Left Ventricular Longitudinal Myocardial Function in Overt Hypothyroidism: A Tissue Doppler Echocardiographic Study
Authors: Tiryakioglu Selma Kenar , Tiryakioglu Osman , Ari Hasan , Basel Mehmet Cem , Ozkan Hakan , Bozat Tahsin
Published: March 2010

Background: The aim of this study was to assess left ventricular (LV) myocardial regional function in overt hypothyroidism by use of tissue Doppler imaging and to compare the results to the hormonal profile and standard Doppler echocardiographic examination. Methods: Hypothyroidic (Group 1, n = 25) and euthyroidic patients (Group 2, n = 25) underwent transthorasic echocardiography, strain and strain rate imaging. Results: Standard echocardiography showed that patients with overt hypothyroidism had significantly longer isovolumic contraction time (IVCT) (P < 0.05), deceleration time (DT) (P = 0.014) and isovolumic relaxation time (IVRT) (P = 0.022). Tissue Doppler imaging showed that the mean peak systolic strain (SI) (16.47 ± 1.45 vs. 20.63 ± 1.51, P < 0.001), the mean peak systolic strain rate (SSR) (1.05 ± 0.13 vs. 1.47 ± 0.11, P < 0.001), the mean peak early diastolic strain rate (ESr) (1.72 ± 0.38 vs. 2.03 ± 0.25, P < 0.05) and the mean peak late diastolic strain rate (ASr) (1.22 ± 0.31 vs. 1.46 ± 0.32, P < 0.05) were significantly lower in Group 1 compared to Group 2. For all patients, the systolic strain and systolic strain rate parameters negatively correlated with thyroid stimulating hormone levels and positively correlated with the levels of free triiodothyronine (fT3) and free tetraiodothyronine (fT4). Conclusion: These results indicate that overt hypothyroidism is associated with early impairment in LV longitudinal myocardial function, and that tissue Doppler echocardiography is useful for the grading of disease and detection of early impairment. (ECHOCARDIOGRAPHY 2010;27:505‐511)
Description of a New Planktonic Mixotrophic Dinoflagellate Paragymnodinium shiwhaense n. gen., n. sp. from the Coastal Waters off Western Korea: Morphology, Pigments, and Ribosomal DNA Gene Sequence
Authors: KANG NAM SEON , JEONG HAE JIN , MOESTRUP ØJVIND , SHIN WOONGGHI , NAM SEUNG WON , PARK JAE YEON , DE SALAS MIGUEL F. , KIM KI WOO , NOH JAE HOON
Published: March 2010

ABSTRACT. The mixotrophic dinoflagellate Paragymnodinium shiwhaense n. gen., n. sp. is described from living cells and from cells prepared by light, scanning electron, and transmission electron microscopy. In addition, sequences of the small subunit (SSU) and large subunit (LSU) rDNA and photosynthetic pigments are reported. The episome is conical, while the hyposome is hemispherical. Cells are covered with polygonal amphiesmal vesicles arranged in 16 rows and containing a very thin plate‐like component. There is neither an apical groove nor apical line of narrow plates. Instead, there is a sulcal extension‐like furrow. The cingulum is as wide as 0.2–0.3 × cell length and displaced by 0.2–0.3 × cell length. Cell length and width of live cells fed Amphidinium carterae were 8.4–19.3 and 6.1–16.0 μm, respectively. Paragymnodinium shiwhaense does not have a nuclear envelope chamber nor a nuclear fibrous connective (NFC). Cells contain chloroplasts, nematocysts, trichocysts, and peduncle, though eyespots, pyrenoids, and pusules are absent. The main accessory pigment is peridinin. The sequence of the SSU rDNA of this dinoflagellate (GenBank AM408889) is 4% different from that of Gymnodinium aureolum, Lepidodinium viride, and Gymnodinium catenatum, the three closest species, while the LSU rDNA was 17–18% different from that of G. catenatum, Lepidodinium chlorophorum, and Gymnodinium nolleri. The phylogenetic trees show that this dinoflagellate belongs within the Gymnodinium sensu stricto clade. However, in contrast to Gymnodinium spp., cells lack nuclear envelope chambers, NFC, and an apical groove. Unlike Polykrikos spp., which have a taeniocyst–nematocyst complex, P. shiwhaense has nematocysts without taeniocysts. In addition, P. shiwhaense does not have ocelloids in contrast to Warnowia spp. and Nematodinium spp. Therefore, based on morphological and molecular analyses, we suggest that this taxon is a new species, also within a new genus.
Patients Presenting to the Emergency Department With Non‐specific Complaints: The Basel Non‐specific Complaints (BANC) Study
Authors: Nemec Marek , Koller Michael T. , Nickel Christian H. , Maile Silke , Winterhalder Clemens , Karrer Christine , Laifer Gerd , Bingisser Roland
Published: March 2010

Objectives:  Patient management in emergency departments (EDs) is often based on management protocols developed for specific complaints like dyspnea, chest pain, or syncope. To the best of our knowledge, to date no protocols exist for patients with nonspecific complaints (NSCs) such as “weakness,”“dizziness,” or “feeling unwell.” The objectives of this study were to provide a framework for research and a description of patients with NSCs presenting to EDs.

Methods:  Nonspecific complaints were defined as the entity of complaints not part of the set of specific complaints for which evidence‐based management protocols for emergency physicians (EPs) exist. “Serious conditions” were defined as potentially life‐threatening or those requiring early intervention to prevent health status deterioration. During a 6‐month period, all adult nontrauma patients with an Emergency Severity Index (ESI) of 2 or 3 were prospectively enrolled, and serious conditions were identified within a 30‐day period.

Results:  The authors screened 18,261 patients for inclusion. A total of 218 of 1,611 (13.5%) nontrauma ESI 2 and 3 patients presented with NSCs. Median age was 82 years (interquartile range [IQR] = 72 to 87), and 24 of 218 (11%) were nursing home inhabitants. A median of 4 (IQR = 3 to 5) comorbidities were recorded, most often chronic hypertension, coronary artery disease, and dementia. During the 30‐day follow‐up period a serious condition was diagnosed in 128 of 218 patients (59%). The 30‐day mortality rate was 6%.

Conclusions:  Patients with NSC presenting to the ED are at high risk of suffering from serious conditions. Sensitive risk stratification tools are needed to identify patients with potentially adverse health outcomes.

ACADEMIC EMERGENCY MEDICINE 2010; 17:284–292 © 2010 by the Society for Academic Emergency Medicine
Predicting Hospital Admission and Returns to the Emergency Department for Elderly Patients
Authors: LaMantia Michael A. , Platts‐Mills Timothy F. , Biese Kevin , Khandelwal Christine , Forbach Cory , Cairns Charles B. , Busby‐Whitehead Jan , Kizer John S.
Published: March 2010

Objectives:  Methods to accurately identify elderly patients with a high likelihood of hospital admission or subsequent return to the emergency department (ED) might facilitate the development of interventions to expedite the admission process, improve patient care, and reduce overcrowding. This study sought to identify variables found among elderly ED patients that could predict either hospital admission or return to the ED.

Methods:  All visits by patients 75 years of age or older during 2007 at an academic ED serving a large community of elderly were reviewed. Clinical and demographic data were used to construct regression models to predict admission or ED return. These models were then validated in a second group of patients 75 and older who presented during two 1‐month periods in 2008.

Results:  Of 4,873 visits, 3,188 resulted in admission (65.4%). Regression modeling identified five variables statistically related to the probability of admission: age, triage score, heart rate, diastolic blood pressure, and chief complaint. Upon validation, the c‐statistic of the receiver operating characteristic (ROC) curve was 0.73, moderately predictive of admission. We were unable to produce models that predicted ED return for these elderly patients.

Conclusions:  A derived and validated triage‐based model is presented that provides a moderately accurate probability of hospital admission of elderly patients. If validated experimentally, this model might expedite the admission process for elderly ED patients. Our models failed, as have others, to accurately predict ED return among elderly patients, underscoring the challenge of identifying those individuals at risk for early ED returns.

ACADEMIC EMERGENCY MEDICINE 2010; 17:252–259 © 2010 by the Society for Academic Emergency Medicine
The Effect of Emergency Department Crowding on Analgesia in Patients with Back Pain in Two Hospitals
Authors: Pines Jesse M. , Shofer Frances S. , Isserman Joshua A. , Abbuhl Stephanie B. , Mills Angela M.
Published: March 2010

Objectives:  The authors assessed the association between measures of emergency department (ED) crowding and treatment with analgesia and delays to analgesia in ED patients with back pain.

Methods:  This was a retrospective cohort study of nonpregnant patients who presented to two EDs (an academic ED and a community ED in the same health system) from July 1, 2003, to February 28, 2007, with a chief complaint of “back pain.” Each patient had four validated crowding measures assigned at triage. Main outcomes were the use of analgesia and delays in time to receiving analgesia. Delays were defined as greater than 1 hour to receive any analgesia from the triage time and from the room placement time. The Cochrane‐Armitage test for trend, the Cuzick test for trend, and relative risk (RR) regression were used to test the effects of crowding on outcomes.

Results:  A total of 5,616 patients with back pain presented to the two EDs over the study period (mean ± SD age = 44 ± 17 years, 57% female, 62% black or African American). Of those, 4,425 (79%) received any analgesia while in the ED. A total of 3,589 (81%) experienced a delay greater than 1 hour from triage to analgesia, and 2,985 (67%) experienced a delay more than 1 hour from room placement to analgesia. When hospitals were analyzed separately, a higher proportion of patients experienced delays at the academic site compared with the community site for triage to analgesia (87% vs. 74%) and room to analgesia (71% vs. 63%; both p < 0.001). All ED crowding measures were associated with a higher likelihood for delays in both outcomes. At the academic site, patients were more likely to receive analgesia at the highest waiting room numbers. There were no other differences in ED crowding and likelihood of receiving medications in the ED at the two sites. These associations persisted in the adjusted analysis after controlling for potential confounders of analgesia administration.

Conclusions:  As ED crowding increases, there is a higher likelihood of delays in administration of pain medication in patients with back pain. Analgesia administration was not related to three measures of ED crowding; however, patients were actually more likely to receive analgesics when the waiting room was at peak levels in the academic ED.

ACADEMIC EMERGENCY MEDICINE 2010; 17:276–283 © 2010 by the Society for Academic Emergency Medicine
Palliative Ultrasound for Home Care Hospice Patients
Authors: Mariani Peter J. , Setla Judith A.
Published: March 2010

The evolving relationship between emergency and palliative medicine is expected to benefit patients of each. Two collaborative care encounters involving home hospice patients are discussed. Portable bedside ultrasound was performed in the home to diagnose ascites and to guide palliative paracentesis. Specific interventions and outcomes are reported. The interface of emergency and palliative care and the use of paracentesis in cancer palliation are briefly reviewed. It is concluded that home‐performed ultrasound and ultrasound‐guided procedures are promising palliative modalities for care at the end of life.

ACADEMIC EMERGENCY MEDICINE 2010; 17:293–296 © 2010 by the Society for Academic Emergency Medicine
Amiodarone or Procainamide for the Termination of Sustained Stable Ventricular Tachycardia: An Historical Multicenter Comparison
Authors: Marill Keith A. , DeSouza Ian S. , Nishijima Daniel K. , Senecal Emily L. , Setnik Gary S. , Stair Thomas O. , Ruskin Jeremy N. , Ellinor Patrick T.
Published: March 2010

Objectives:  The objective was to compare the effectiveness of intravenous (IV) procainamide and amiodarone for the termination of spontaneous stable sustained ventricular tachycardia (VT).

Methods:  A historical cohort study of consecutive adult patients with stable sustained VT treated with IV amiodarone or procainamide was performed at four urban hospitals. Patients were identified for enrollment by admissions for VT and treatment with the study agents in the emergency department (ED) from 1993 to 2008. The primary measured outcome was VT termination within 20 minutes of onset of study medicine infusion. A secondary effectiveness outcome was the ultimate need for electrical therapy to terminate the VT episode. Major adverse effects were tabulated, and blood pressure responses to medication infusions were compared.

Results:  There were 97 infusions of amiodarone or procainamide in 90 patients with VT, but the primary outcome was unknown after 14 infusions due to administration of another antidysrhythmic during the 20‐minute observation period. The rates of VT termination were 25% (13/53) and 30% (9/30) for amiodarone and procainamide, respectively. The adjusted odds of termination with procainamide compared to amiodarone was 1.2 (95% confidence interval [CI] = 0.4 to 3.9). Ultimately, 35/66 amiodarone patients (53%, 95% CI = 40 to 65%) and 13/31 procainamide patients (42%, 95% CI = 25 to 61%) required electrical therapy for VT termination. Hypotension led to cessation of medicine infusion or immediate direct current cardioversion (DCCV) in 4/66 (6%, 95% CI = 2 to 15%) and 6/31 (19%, 95% CI = 7 to 37%) patients who received amiodarone and procainamide, respectively.

Conclusions:  Procainamide was not more effective than amiodarone for the termination of sustained VT, but the ability to detect a significant difference was limited by the study design and potential confounding. As used in practice, both agents were relatively ineffective and associated with clinically important proportions of patients with decreased blood pressure.

ACADEMIC EMERGENCY MEDICINE 2010; 17:297–306 © 2010 by the Society for Academic Emergency Medicine
Current Practice, Demographics, and Trends of Critical Care Trained Emergency Physicians in the United States
Authors: Mayglothling Julie A. , Gunnerson Kyle J. , Huang David T.
Published: March 2010

Objectives:  Critical care medicine (CCM) is of growing interest among emergency physicians (EPs), but the number of CCM‐trained EPs and their postfellowship practice is unknown. This study’s purpose was to conduct a descriptive census survey of EPs who have completed or are currently in a CCM fellowship.

Methods:  The authors created a Web‐based survey, and requests to participate were sent to EPs who have completed or are currently in a CCM fellowship. Responses were collected over a 12‐month period. Physicians were located via multiple whom electronic mailing lists, including the Emergency Medicine Section of the Society of Critical Care Medicine, Critical Care Section of the American College of Emergency Physicians, and the Emergency Medicine Residents’ Association. The authors also contacted CCM fellowship coordinators and used informal networking. Data were collected on emergency medicine (EM) and other residency training; discipline, duration, and year of CCM fellowship; current practice setting; and board certification status, including the European Diploma in Intensive Care (EDIC).

Results:  A total of 104 physicians completed the survey (97% response rate), of whom 73 had completed fellowship at the time of participation, and 31 of whom were in fellowship training. Of those who completed fellowship, 36/73 (49%) practice both EM and CCM, and 45/73 (62%) practice in academic institutions. Multiple disciplines of fellowship were represented: multidisciplinary (39), surgical (28), internal medicine (16), anesthesia (14), and other (4). Together, the CCM fellowships at the University of Maryland R Adams Cowley Shock Trauma Center and the University of Pittsburgh have trained 42% of all EM‐CCM physicians, with 38 other institutions training from one to four fellows each. The number of EPs completing CCM fellowships has risen: from 1974 to 1989, 12 EPs; from 1990 to 1999, 15 EPs; and from 2000 to 2007, 43 EPs.

Conclusions:  Emergency physicians are entering CCM fellowships in increasing numbers. Almost half of these EPs practice both EM and CCM.

ACADAEMIC EMERGENCY MEDICINE 2010; 17:325–329 © 2010 by the Society for Academic Emergency Medicine
REVIEW ARTICLE: Chlamydia trachomatis, a Hidden Epidemic: Effects on Female Reproduction and Options for Treatment
Authors: Carey Alison J. , Beagley Kenneth W.
Published: March 2010

Citation Carey AJ, Beagley KW. Chlamydia trachomatis, a hidden epidemic: effects on the female reproduction and options for treatment. Am J Reprod Immunol 2010

The number of genital tract Chlamydia trachomatis infections is steadily increasing worldwide, with approximately 50–70% of infections asymptomatic. There is currently no uniform screening practice, current antibiotic treatment has failed to prevent the increased incidence, and there is no vaccine available. We examined studies on the epidemiology of C. trachomatis infections, the effects infections have on the female reproductive tract and subsequent reproductive health and what measures are being taken to reduce these problems. Undetected or multiple infections in women can lead to the development of severe reproductive sequelae, including pelvic inflammatory disease and tubal infertility. There are two possible paradigms of chlamydial pathogenesis, the cellular and immunological paradigms. While many vaccine candidates are being extensively tested in animal models, they are still years from clinical trials. With no vaccine available and antibiotic treatment unable to halt the increased incidence, infection rates will continue to increase and cause a significant burden on health care systems.
Genetic Variation in the Indoleamine 2,3‐Dioxygenase Gene in Pre‐eclampsia
Authors: Nishizawa Haruki , Kato Takema , Ota Sayuri , Nishiyama Sachie , Pryor‐Koishi Kanako , Suzuki Machiko , Tsutsumi Makiko , Inagaki Hidehito , Kurahashi Hiroki , Udagawa Yasuhiro
Published: March 2010

Citation Nishizawa H, Kato T, Ota S, Nishiyama S, Pryor‐Koishi K, Suzuki M, Tsutsumi M, Inagaki H, Kurahashi H, Udagawa Y. Genetic variation in the indoleamine 2,3‐Dioxygenase gene in pre‐eclampsia. Am J Reprod Immunol 2010; 64: 68–76

Problem  To investigate the contribution of genomic variations in the indoleamine 2,3‐dioxygenase (IDO) gene to the onset of pre‐eclampsia.

Method of study  We examined sequence variations in the IDO1 gene using placental genomic DNA from 35 pre‐eclamptic patients and 32 normotensive pregnant women.

Results  A case–control study revealed that none of the common variants influences the risk of disease. Sequencing of each IDO1 exon in diseased subjects revealed rare variants. This variation, c.‐147_150delGAAA, was located within the 5′‐untranslated region of the IDO1 gene, and its homozygote was identified only in pre‐eclamptic subjects. However, despite the low levels of IDO expression and enzyme activity in the c.‐147_150delGAAA homozygote, reporter assays indicated that this variation does not affect gene expression.

Conclusion  Our findings indicate that genetic alteration of fetal IDO gene does not appear to be a primary cause of pre‐eclampsia.
Hormonal alterations in adolescent chronic fatigue syndrome
Authors: Wyller Vegard Bruun , Evang Johan Arild , Godang Kristin , Solhjell Kari K. , Bollerslev Jens
Published: March 2010

Aim:  The chronic fatigue syndrome is associated with alterations in the hypothalamus‐pituitary‐adrenal axis and cardiovascular autonomic nervous activity, suggesting a central dysregulation. This study explored differences among adolescent chronic fatigue syndrome patients and healthy controls regarding antidiuretic hormone, the renin‐angiotensin‐aldosterone‐system, sex hormones and cardiac peptides.

Methods:  We included a consecutive sample of 67 adolescents aged 12–18 years with chronic fatigue syndrome diagnosed according to a thorough and standardized set of investigations, and a volunteer sample of 55 healthy control subjects of equal gender and age distribution. Hormones were assayed with standard laboratory methods.

Results:  Among patients, plasma antidiuretic hormone was significantly decreased and serum osmolality and plasma renin activity were significantly increased (p ≤ 0.001). Serum concentration of aldosterone, cortisol, NT‐proBNP and sex hormones were not significantly different in the two groups.

Conclusion:  Chronic fatigue syndrome in adolescents is associated with alterations in hormonal systems controlling osmolality and blood volume, possibly supporting a theory of central dysregulation.
Above‐ and below‐ground plant biomass response to experimental warming in northern Alaska
Authors: Hollister Robert D. , Flaherty Kathryn J.
Published: March 2010

Question:Does experimental warming, designed to simulate future warming of the Arctic, change the biomass allocation and mycorrhizal infection of tundra plants?

Location:High Arctic tundra near Barrow, Alaska, USA (71°18′N 156°40′W).

Methods:Above and below ground plant biomass of all species was harvested following 3–4 yr of 1‐2°C of experimental warming. Biomass allocation and arbuscular mycorrhizal infection were also examined in the two dominant species,Salix rotundifoliaandCarex aquatilis.

Results:Above‐ground biomass of graminoids increased in response to warming but there was no difference in total plant biomass or the ratio of above‐ground to below‐ground biomass for the community as a whole.Carex aquatilisincreased above‐ground biomass and proportionally allocated more biomass above ground in response to warming.Salix rotundifoliaincreased the amount of above‐ and below‐ground biomass allocated per leaf in response to warming. Mycorrhizal infection rates showed no direct response to warming, but total abundance was estimated to have likely increased in response to warming owing to increased root biomass ofS. rotundifolia.

Conclusions:The community as a whole was resistant to short‐term warming and showed no significant changes in above‐ or below‐ground biomass despite significant increases in above‐ground biomass of graminoids. However, the patterns of biomass allocation forC. aquatilisandS. rotundifoliadid change with warming. This suggests that long‐term warming may result in changes in the above‐ground to below‐ground biomass ratio of the community.
Aberrant muscle syndrome: Hypertrophy of the hand and arm due to aberrant muscles with or without hypertrophy of the muscles
Authors: Ogino Toshihiko , Satake Hiroshi , Takahara Masatoshi , Kikuchi Noriaki , Watanabe Tadayosi , Iba Kousuke , Ishii Seiichi
Published: March 2010

Five patients were reported in our congenital anomaly registry who had six hands in total with muscular hyperplasia, aberrant muscles, ulnar drift of the fingers in the metacarpophalangeal (MP) joints, flexion contractures of the MP joints, and enlargement of the metacarpal spaces. Thirty patients with unilateral involvement of this condition have been reported previously. We reviewed these cases and found that the condition varied in severity and that it was reported using different names. However, this condition seems different from true macrodactyly and multiple camptodactyly, including windblown hand, and seems to be an isolated entity of congenital upper limb anomaly. The authors recommend ‘aberrant muscle syndrome’ or ‘accessory muscle syndrome’ as a diagnostic name, because this seems to be the most common pathological finding in this condition.
Transfers from residential aged care facilities to the emergency department are reduced through improved primary care services: An intervention study
Authors: Codde Jim , Arendts Glenn , Frankel Jackie , Ivey Mary , Reibel Tracy , Bowen Shirley , Babich Paul
Published: March 2010

Aim:  To assess the impact of an enhanced primary care service for residential aged care facilities (RACF) on the transfer of patients from RACF to a hospital emergency department (ED).

Methods:  A before–after study of an enhanced primary care service provided by experienced ED‐based nurses under the governance of general practitioners. The intervention was analysed comparatively using standardised normal deviates and seasonal autoregressive integrated moving average models, complemented by qualitative assessment.

Results:  There was a statistically significant reduction (17%, P < 0.001) in the number of transfers during the intervention period. This finding held when adjusting for the seasonality of ED referrals over a 4‐year period. The intervention was highly valued by clinicians in RACF and ED.

Conclusion:  Enhanced primary care services reduce the number of transfers to ED from RACF.
Purification of three aminotransferases from Hydrogenobacter thermophilus TK‐6 – novel types of alanine or glycine aminotransferase
Authors: Kameya Masafumi , Arai Hiroyuki , Ishii Masaharu , Igarashi Yasuo
Published: March 2010

Aminotransferases catalyse synthetic and degradative reactions of amino acids, and serve as a key linkage between central carbon and nitrogen metabolism in most organisms. In this study, three aminotransferases (AT1, AT2 and AT3) were purified and characterized from Hydrogenobacter thermophilus, a hydrogen‐oxidizing chemolithoautotrophic bacterium, which has been reported to possess unique features in its carbon and nitrogen anabolism. AT1, AT2 and AT3 exhibited glutamate:oxaloacetate aminotransferase, glutamate:pyruvate aminotransferase and alanine:glyoxylate aminotransferase activities, respectively. In addition, both AT1 and AT2 catalysed a glutamate:glyoxylate aminotransferase reaction. Interestingly, phylogenetic analysis showed that AT2 belongs to aminotransferase family IV, whereas known glutamate:pyruvate aminotransferases and glutamate:glyoxylate aminotransferases are members of family Iγ. In contrast, AT3 was classified into family I, distant from eukaryotic alanine:glyoxylate aminotransferases which belong to family IV. Although Thermococcus litoralis alanine:glyoxylate aminotransferase is the sole known example of family I alanine:glyoxylate aminotransferases, it is indicated that this alanine:glyoxylate aminotransferase and AT3 are derived from distinct lineages within family I, because neither high sequence similarity nor putative substrate‐binding residues are shared by these two enzymes. To our knowledge, this study is the first report of the primary structure of bacterial glutamate:glyoxylate aminotransferase and alanine:glyoxylate aminotransferase, and demonstrates the presence of novel types of aminotransferase phylogenetically distinct from known eukaryotic and archaeal isozymes.
ORIGINAL RESEARCH—PEYRONIE’S DISEASE: Peyronie’s Disease Following Radical Prostatectomy: Incidence and Predictors
Authors: Tal Raanan , Heck Matthias , Teloken Patrick , Siegrist Timothy , Nelson Christian J. , Mulhall John P.
Published: March 2010

Introduction

Both prostate cancer and Peyronie’s disease (PD) are prevalent in men after their fifth decade of life. The evidence to support or refute a link between radical prostatectomy (RP) and PD is limited.

Aims

To define the incidence of PD in men who had RP and determine possible predictors of PD development after RP.

Methods

A review of a prospectively built sexual medicine database, years 2002–2008, looking at subjects who had RP as a monotherapy for localized prostate cancer. We identified and characterized subjects who developed PD within 3 years after RP and compared them with subjects who did not.

Main Outcome Measures

The incidence of PD among men who attended a sexual medicine clinic after they had RP, predictors of PD development after RP.

Results

The study population included 1,011 subjects, and PD incidence in this population was 15.9%. Mean time to develop PD after RP was 13.9 ± 0.7 months. Mean curvature magnitude was 31+17 degrees. On univariate analysis, younger age (mean age of 59+7 in men with PD vs. 60+7 years in men without PD, P = 0.006) and white race (vs non-white, 18% vs. 7%, P <0.001) were predictive of PD development after RP, but post-op erectile function was not a predictor of PD development. On multivariate analysis, younger age (odds ratio (OR)=1.3, for 5-year decrease in age) and white race (OR=4.1, vs. non-white) remained independent significant predictors.

Conclusions

Men presenting with sexual dysfunction after RP have higher PD incidence then the general population. Therefore, they should be routinely evaluated for PD. Younger men and men of white race are at increased risk for PD. Prospective controlled studies are needed to elucidate the incidence of PD following RP and to conclude if RP has a causative role in the pathogenesis of PD.
Cancer vaccines: Where are we going?
Authors: CEBON Jonathan
Published: March 2010

The discovery that the immune system can distinguish molecular targets on cancer cells has led to efforts to develop cancer immunotherapeutics that can improve the recognition and effective elimination of tumor cells. Several types of tumor antigens are recognized by T lymphocytes, which are classified according to patterns of gene expression or protein distribution. Of particular interest is the group of molecules known as cancer‐germline or cancer‐testis antigens. As the relationship between the immune system and cancer has become clearer, so too have the challenges in designing effective cancer immunotherapeutics: (i) antigens need to be specifically selected based on ideal characteristics, such as tissue distribution that is restricted to tumors; (ii) selected antigens need to be combined with adjuvant agents that enhance their immunogenicity and yield robust responses; (iii) vaccination should be timed to pre‐empt the development of regulatory suppressive immune mechanisms; and (iv) if suppressive regulatory mechanisms do arise, specific antagonists may be needed to enhance pro‐immune outcomes. These challenges are shaping current and future research in this area.
Is evaluation of a faecal smear a useful technique in the diagnosis of canine pulmonary angiostrongylosis?
Authors: Humm K. , Adamantos S.
Published: March 2010

Objectives: To describe a method of faecal smear production and to determine the sensitivity and specificity of faecal smear for detection of parasitic larvae using Baermann sedimentation as a gold standard

Methods: Faecal smears were produced from samples submitted to the Royal Veterinary College Diagnostic Laboratory Service for Baermann sedimentation. An inexperienced and an experienced assessor each examined the smear for larvae for a maximum of five minutes.

Results: One hundred and eighty six samples were analysed of which 28 were positive for Angiostrongylus vasorum on Baermann sedimentation. The experienced assessor had a faecal smear sensitivity of 61% and a specificity of 100%. The inexperienced assessor had a faecal smear sensitivity of 54% and a specificity of 95%.

Clinical Significance: Faecal smear is an effective and cheap aid to diagnosis of canine angiostrongylosis which can be readily performed in general practice. Its use leads to a rapid detection of infection compared to other available methods. This could lead to swifter treatment of the disease and a decrease in inappropriate diagnostics. A further diagnostic method, such as Baermann sedimentation, is recommended whether the faecal smear result is positive or negative.
Muscle potentials evoked by magnetic stimulation of the sciatic nerve in unilateral sciatic nerve dysfunction
Authors: Van Soens I. , Struys M. M. R. F. , Van Ham L. M. L.
Published: March 2010

Magnetic stimulation of the sciatic nerve and subsequent recording of the muscle‐evoked potential (MEP) was performed in eight dogs and three cats with unilateral sciatic nerve dysfunction. Localisation of the lesion in the sciatic nerve was based on the history, clinical neurological examination and on results of electromyography examination. Aetiology of the sciatic nerve lesion was diverse. A significant difference was found in MEP between the normal and the affected limbs. In addition, absence of conscious pain sensation, absence of voluntary motor function and a poor outcome seemed associated with the inability to evoke an MEP in the affected limb.
In situ Raman and X‐ray spectroscopies to monitor microbial activities under high hydrostatic pressure
Authors: Oger Phil M. , Daniel Isabelle , Picard Aude
Published: March 2010

Until recently, monitoring of cells and cellular activities at high hydrostatic pressure (HHP) was mainly limited to ex situ observations. Samples were analyzed prior to and following the depressurization step to evaluate the effect of the pressure treatment. Such ex situ measurements have several drawbacks: (i) it does not allow for kinetic measurements and (ii) the depressurization step often leads to artifactual measurements. Here, we describe recent advances in diamond anvil cell (DAC) technology to adapt it to the monitoring of microbial processes in situ. The modified DAC is asymmetrical, with a single anvil and a diamond window to improve imaging quality and signal collection. Using this novel DAC combined to Raman and X‐ray spectroscopy, we monitored the metabolism of glucose by baker's yeast and the reduction of selenite by Agrobacterium tumefaciens in situ under HHP. In situ spectroscopy is also a promising tool to study piezophilic microorganisms.
High hydrostatic pressure processing of tropical fruits
Authors: Lopes Maria Lúcia M. , Valente Mesquita Vera L. , Chiaradia Ana Cristina N. , Fernandes Antônio Alberto R. , Fernandes Patricia M. B.
Published: March 2010

Interest in the nonthermal method of high hydrostatic pressure (HHP) for food preservation has increased recently due to the possibility of inactivating microorganisms and enzymes while maintaining product sensorial and nutritional properties. This work deals with HHP use for the preservation of tropical fruit products. HHP is shown to be a practical approach to obtaining high‐quality tropical fruit products that are both nutritive and safe.
Fluorescent probe dyes for metabolic‐ion sensing under high hydrostatic pressures
Authors: Urayama Paul , Frey Eric W. , Savage Sara R.
Published: March 2010

Fluorescence spectroscopy and microscopy imaging are widely used at ambient pressure for analytical studies on biological systems. Before using fluorescence‐based methods at high pressures, biochemical and metabolic probes need to be characterized under pressure to ensure valid quantitative results. In this review, we describe the principles behind the use of fluorescent probe dyes for ion sensing and provide models for interpreting the dye spectrum under pressure. We then review results from three studies using the excited‐state emission from probe dyes sensitive to pH and calcium‐ion concentration, demonstrating some ways pressure may affect probe operation.
Recovery of tobacco BY‐2 cells after high hydrostatic pressure treatment
Authors: Kusube Masataka , Nishino Takumi , Nishikawa Yuki , Goto Masaki , Matsuki Hitoshi , Iwahashi Hitoshi
Published: March 2010

The recovery of Nicotiana tabacum L. cv. Bright Yellow 2 (BY‐2) cells in Linsmaire and Skoog medium after treatment at high hydrostatic pressure was investigated using an Evans Blue staining method to discriminate live from dead cells. The survival of BY‐2 cells just after the high‐pressure treatment at 5° C and 25° C decreased abruptly at pressures higher than 50 MPa and 100 MPa, respectively. Furthermore, almost all of the BY‐2 cells treated at 5° C and 25° C recovered pressures below 25 MPa and 75 MPa, respectively. However, no BY‐2 cells recovered at pressures above 100 MPa at either temperature.
Water content influence on thermal and volumetric properties of wheat starch gelatinization under 10 MPa
Authors: Orlowska Marta , Randzio Stanislaw L.
Published: March 2010

A transitiometric in situ analysis of wheat starch aqueous suspensions heated over a temperature range from 285 K to 415 K under isobaric conditions of 10 MPa is presented. Measurements were performed at four selected water concentrations: 56.0%, 64.7%, 73.5%, and 82.4% weight/water. Thermal and volumetric properties and their water content dependencies have been determined for three successive starch phase transformations occurred during wheat starch gelatinization.
L'effet redistributeur des programmes sociaux publics et privés: une analyse empirique basée sur plusieurs pays
Authors: Goudswaard Kees , Caminada Koen
Published: March 2010

L'une des fonctions de nombreux systèmes nationaux de protection sociale consiste à redistribuer le revenu dans d'importantes proportions. Mais la taille et la nature des programmes de protection sociale sont en pleine évolution. Dans un certain nombre de pays, l'on a assistéà une réorientation du public vers le privé en matière de dispositions de protection sociale, les dispositions privées venant remplacer ou compléter les programmes publics. En s'appuyant sur des travaux antérieurs, le présent article analyse l'impact redistributeur du revenu des programmes publics de protection sociale par opposition aux programmes privés. En utilisant des données récentes de l'Organisation de coopération et de développement économiques (OCDE), nous constatons l'existence, dans plusieurs pays, d'une relation positive très forte entre les dépenses sociales publiques et la redistribution du revenu. S'agissant des dépenses sociales privées, on observe une relation négative faible, mais statistiquement significative, avec le niveau de redistribution. Dans les pays dans lesquels une plus grande part des dépenses sociales totales est attribuée aux dispositions privées, il y a moins de redistribution du revenu. Nous concluons que le choix entre poids relatif des dispositions publiques et dispositions privées en matière de protection sociale a une incidence sur l'impact redistributeur de l'Etat protecteur.
Extension de la couverture de sécurité sociale: un examen des faits récents
Authors: Van Ginneken Wouter
Published: March 2010

Cet article présente les résultats de treize études menées dans le cadre du Projet d'examen des connaissances actuelles sur l'extension de la couverture de l'Association internationale de la sécurité sociale (AISS). Il examine des faits récents qui font ressortir la façon dont les prestations en espèces et la couverture des soins de santé, financées soit par des cotisations soit par l'impôt ou par les deux, peuvent être étendues et maintenues dans des pays à revenu faible, moyen et élevé. L'article signale également un certain nombre de domaines prioritaires, ainsi que des questions liées à l'extension de la couverture, notamment l'amélioration de la protection des travailleurs migrants et informels.
Faire des soins de santé une prestation de sécurité sociale: approches institutionnelles de l'extension de la couverture
Authors: Ron Aviva
Published: March 2010

Pour parvenir à la couverture maladie universelle, il faut associer de manière appropriée des régimes d'assurance sociale contributifs obligatoires. Ces régimes doivent comporter des mécanismes pour intégrer à la couverture la population du secteur informel et des systèmes d'aide sociale financés par l'impôt pour ceux qui perçoivent des revenus trop faibles pour payer des cotisations. Il existe une tendance qui consiste à instaurer des systèmes d'assurance maladie sociale distincts placés sous la tutelle d'autorités de la santé distinctes. Cet article plaide en faveur d'une inversion de cette tendance. Il propose d'étendre la couverture santé en s'appuyant sur les régimes de sécurité sociale du secteur formel existants, notamment parce qu'ils disposent du soutien politique et des structures institutionnelles nécessaires. Il examine les raisons pour lesquelles l'extension de la couverture a été lente jusqu'à présent et souligne l'intérêt qu'il y a à intégrer les soins de santé aux prestations de sécurité sociale. Il n'en reconnaît pas moins l'importance de préserver des liens entre les régimes légaux et des régimes communautaires et de micro‐assurance santé bien encadrés.
Das Rentensystem für den öffentlichen Dienst in Taiwan: Gerechtigkeitsprobleme innerhalb und zwischen Systemen
Authors: Shao Ai Ju
Published: March 2010

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Dieser Artikel analysiert die Probleme desNew Public Service Pension Fund Systemin Taiwan, China. Weniger als zwei Jahrzehnte nach seiner Gründung ist dieses junge Rentensystem für den öffentlichen Dienst mit einem finanziellen Ungleichgewicht und einer Kontroverse über die Großzügigkeit seiner Leistungen konfrontiert. Der Artikel liefert zuerst einen Überblick über die unterschiedlichen Systeme für die Altersvorsorge mit Schwerpunkt auf dem System für Bedienstete im allgemeinen öffentlichen Sektor. Anschließend wird auf die finanziellen Probleme des Rentensystems für den allgemeinen öffentlichen Sektor eingegangen, einschließlich der steigenden Kosten seiner Leistungen für alle Steuerzahler. Schließlich wird eine Reihe möglicher Reformoptionen beschrieben, die der öffentliche Sektor prüfen sollte. Dazu zählen die Senkung der Leistungsniveaus, strengere Bezugskriterien und die Einrichtung eines neuen Systems. Was Letzteres betrifft, muss jedes neue System die Bedingung längerfristiger finanzieller Tragfähigkeit erfüllen und gleichzeitig optimale Fairness für alle Betroffenen einschließlich der Steuerzahler gewährleisten.
Die Ratifizierung von IAO‐Übereinkommen und Arbeitslosenleistungen: Eine empirische Analyse
Authors: Kim Wonik
Published: March 2010

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Dieser Artikel untersucht die Beziehung zwischen der Ratifizierung von Übereinkommen der Internationalen Arbeitsorganisation (IAO) und der Bereitstellung von Arbeitslosenleistungen. Zwei Fragen werden mit statistischen Analysen geprüft: weshalb Länder IAO‐Übereinkommen zu Arbeitslosenleistungen ratifizieren und ob die Ratifizierung die Staatsausgaben für Arbeitslosenprogramme beeinflusst. Die wichtigsten Ergebnisse sind, dass Demokratisierung, Weltregion, Einkommen und Globalisierung die Hauptfaktoren sind, welche die Länder bei der Ratifizierung von IAO‐Übereinkommen zu Arbeitslosenleistungen beeinflussen. Die Ratifizierung von IAO‐Übereinkommen ist außerdem systematisch mit höheren Ausgaben gekoppelt, falls die Länder mehr als zwei Übereinkommen ratifiziert haben.
Die Gesundheitsversorgung als Leistung der sozialen Sicherheit: Institutionelle Ansätze zur Ausdehnung der Deckung
Authors: Ron Aviva
Published: March 2010

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Um eine universelle Deckung durch die Gesundheitsversorgung zu erreichen, ist eine angemessene Mischung aus obligatorischen beitragsgestützten Sozialversicherungssystemen mit Mechanismen erforderlich, welche die Bevölkerung im informellen Wirtschaftssektor einschließen, und einer aus Steuern finanzierten Sozialhilfe für jene, deren Einkommen keine eigenen Beitragszahlungen zulässt. Dieser Beitrag fordert eine Umkehrung des aktuellen Trends, der eine gesonderte Entwicklung der sozialen Krankenversicherung durch separate Gesundheitsbehörden begünstigt, und setzt sich für eine Ausdehnung der Deckung durch die Gesundheitsversorgung über bestehende Systeme der sozialen Sicherheit im formalen Sektor ein, nicht zuletzt deshalb, weil diese über die notwendige politische Unterstützung und eine entsprechende institutionelle Strukturen verfügen. Der Artikel erörtert die Ursachen für die bisher langsam erfolgte Ausdehnung der Deckung und betont die Vorteile einer Integration der Gesundheitsversorgung in das Leistungssystem der sozialen Sicherheit, wobei auch die Bedeutung von Verknüpfungen zwischen gesetzlichen und gut regulierten, auf Gemeinschaftsebene oder einer Mikrokrankenversicherung beruhenden Systemen gebührend berücksichtigt wird.