bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Influencing Information Seeking by Physical Therapists Providing Stroke Management
Authors: Salbach Nancy M. , Guilcher Sara J.T. , Jaglal Susan B. , Davis David A.
Published: August 2009

Background

Searching and reading the research literature are essential activities for enhancing the use of research and optimizing the quality of physical therapist practice.

Objectives

The objectives of this study were to identify practitioner, organization, and research characteristics that are associated with searching or reading the research literature among physical therapists involved in stroke management.

Design

A cross-sectional study design was used.

Methods

A survey questionnaire was mailed to 1,155 physical therapists in neurological practice in Ontario, Canada. Therapists who treated people with stroke were eligible to participate.

Results

Of the 334 eligible respondents, 270 (80.8%) completed a questionnaire. Among participants with complete data, 37.7% of 265 participants conducted online literature searches and 73.3% of 266 participants read the research literature 2 or more times in a typical month. The following factors were associated with conducting online literature searches 2 or more times in a typical month: participation in research, self-efficacy for implementing evidence-based practice (EBP), being male, perceived facility support of research use, and Internet access to bibliographic databases at work. The following factors were associated with reading the literature 2 or more times in a typical month: participation in research, EBP self-efficacy, membership in a professional organization, perceived facility support of research use, and positive perceptions about the usefulness of the research literature and the relevance of walking interventions evaluated in the stroke rehabilitation research literature. A positive association between searching and reading was observed (odds ratio=16.5, 95% confidence interval=5.8–47.1).

Limitations

The cross-sectional design limited inferences of causality.

Conclusion

Despite a low frequency of searching, the majority of the participating therapists acquired and read the research literature on a monthly basis. Online searching and reading are closely linked behaviors. Modifiable practitioner characteristics, including self-efficacy for implementing EBP and participation in research, appear to be key determinants of EBP.
Brain penetration effects of microelectrodes and deep brain stimulation leads in ventral intermediate nucleus stimulation for essential tremor
Authors: Morishita Takashi , Foote Kelly D. , Wu Samuel S. , Jacobson Charles E. , Rodriguez Ramon L. , Haq Ihtsham U. , Siddiqui Mustafa S. , Malaty Irene A. , Hass Christopher J. , Okun Michael S.
Published: August 2009

Object

Microelectrode recording (MER) and macrostimulation (test stimulation) are used to refine the optimal deep brain stimulation (DBS) lead placement within the operative setting. It is well known that there can be a microlesion effect with microelectrode trajectories and DBS insertion. The aim of this study was to determine the impact of intraoperative MER and lead placement on tremor severity in a cohort of patients with essential tremor.

Methods

Consecutive patients with essential tremor undergoing unilateral DBS (ventral intermediate nucleus stimulation) for medication-refractory tremor were evaluated. Tremor severity was measured at 5 time points utilizing a modified Tremor Rating Scale: 1) immediately before MER; 2) immediately after MER; 3) immediately after lead implantation; 4) 6 months after DBS implantation in the off-DBS condition; and 5) 6 months after implantation in the on-DBS condition. To investigate the impact of the MER and DBS lead placement, Wilcoxon signed-rank tests were applied to test changes in tremor severity scores over the surgical course. In addition, a generalized linear mixed model including factors that potentially influenced the impact of the microlesion was also used for analysis.

Results

Nineteen patients were evaluated. Improvement was noted in the total modified Tremor Rating Scale, postural, and action tremor scores (p < 0.05) as a result of MER and DBS lead placement. The improvements observed following lead placement were similar in magnitude to what was observed in the chronically programmed clinic setting parameters at 6 months after lead implantation. Improvement in tremor severity was maintained over time even in the off-DBS condition at 6 months, which was supportive of a prolonged microlesion effect. The number of macrostimulation passes, the number of MER passes, and disease duration were not related to the change in tremor severity score over time.

Conclusions

Immediate improvement in postural and intention tremors may result from MER and DBS lead placement in patients undergoing DBS for essential tremor. This improvement could be a predictor of successful DBS lead placement at 6 months. Clinicians rating patients in the operating room should be aware of these effects and should consider using rating scales before and after lead placement to take these effects into account when evaluating outcome in and out of the operating room.
The effects of posterior fossa decompressive surgery in adult patients with Chiari malformation and sleep apnea
Authors: Botelho Ricardo Vieira , Bittencourt Lia Rita Azeredo , Rotta José Marcus , Tufik Sérgio
Published: August 2009

Object

One of the feared consequences of craniovertebral junction diseases is apnea. Although several cases of patients with central apnea have been described, obstructive sleep apnea has been identified as the most frequent manifestation of sleep respiratory disorder. Neuronal involvement may be responsible for both central and obstructive apneas. The objective of this work was to study the effect of posterior fossa decompressive surgery on respiratory parameters during sleep in patients with craniovertebral junction malformations and breathing-related sleep disorders.

Methods

In this study, prospectively enrolled consecutive symptomatic adult patients were monitored with full-night polysomnography before and after surgical decompression of the cranial posterior fossa.

Results

Of the 25 patients who were evaluated, 68% received a diagnosis of sleep apnea. After surgery, the mean number of respiratory events decreased from 180.70 to 69.29 (p = 0.005); the mean number of obstructive events decreased from 107.37 to 60.58 (p = 0.01); and the mean number of central events decreased from 38.45 to 8.05 (p = 0.01). The mean preoperative apnea/hypopnea index decreased from 26.68 to 12.98 (p = 0.06), and the mean central apnea index decreased from 13.81 to 1.68 (p = 0.01).

Conclusions

Decompressive surgery in patients with craniovertebral junction malformations resulted in decreased respiratory events during sleep, lowered sleep fragmentation, and enhanced the sleep apnea index in a significant number of patients. The effect was more pronounced in patients with central apnea.
The role of T helper cell differentiation in promoting nerve allograft survival with costimulation blockade
Authors: Ray Wilson Z. , Kasukurthi Rahul , Papp Esther M. , Moore Amy M. , Yee Andrew , Hunter Daniel A. , Solowski Nancy L. , Mohanakumar Thalachallour , Mackinnon Susan E. , Tung Thomas H.
Published: August 2009

Object

Peripheral nerve allografts provide a temporary scaffold for host nerve regeneration and allow for the repair of significant segmental nerve injuries. Despite this potential, nerve allograft transplantation requires temporary systemic immunosuppression. Characterization of the immunological mechanisms involved in the induction of immune hyporesponsiveness to prevent nerve allograft rejection will help provide a basis for optimizing immunomodulation regimens or manipulating donor nerve allografts to minimize or eliminate the need for global immunosuppression.

Methods

The authors used C57Bl/6 mice and STAT4 and STAT6 gene BALB/c knockout mice. A nonvascularized nerve allograft was used to reconstruct a 1-cm sciatic nerve gap in the murine model. A triple costimulatory blockade of the CD40, CD28/B7, and inducible costimulatory (ICOS) pathways was used. Quantitative assessment was performed at 3 weeks with nerve histomorphometry, walking track analysis, and the enzyme-linked immunospot assay.

Results

The STAT6 −/− mice received 3 doses of costimulation-blocking antibodies and had axonal regeneration equivalent to nerve isografts, while treated STAT4 −/− mice demonstrated moderate axonal regeneration but inferior to the T helper cell Type 2–deficient animals. Enzyme-linked immunospot assay analysis demonstrated a minimal immune response in both STAT4 −/− and STAT6 −/− mice treated with a costimulatory blockade.

Conclusions

The authors' findings suggest that Type 1 T helper cells may play a more significant role in costimulatory blockade–induced immune hyporesponsiveness in the nerve allograft model, and that Type 2 T helper differentation may represent a potential target for directed immunosuppression.
Modulation of physiological hemostasis by irrigation solution: comparison of various irrigation solutions using a mouse brain surface bleeding model
Authors: Fujita Yasutaka , Doi Kazuhisa , Harada Daisuke , Kamikawa Shuji
Published: August 2009

Object

Intraoperative bleeding often obscures the surgical field and may cause neurological damage. The irrigation fluids used during surgery might affect physiological hemostasis because they modulate the extracellular fluid composition of the bleeding area directly. The authors therefore investigated the influence of irrigation fluid on hemostasis in a mouse brain surface bleeding model.

Methods

The cerebral cortices of ddY strain mice were exposed under irrigation with normal saline, lactated Ringer (LR) solution, or artificial CSF (ACF-95). To investigate the influence of electrolytes, calcium, potassium, or both were also added to the saline. After 10 minutes of irrigation at 100 ml/hour, sequential photographs of the surgical area were taken with a microscope, and the number of bleeding points was counted visually. Irrigation and counting were performed in a masked manner.

Results

There were significantly more bleeding points after irrigation with normal saline than with ACF-95; LR solution had a similar effect on physiological hemostasis as ACF-95. Saline augmented with calcium or potassium and calcium was superior to normal saline in terms of hemostasis.

Conclusions

The authors demonstrated that the irrigation fluid used in neurosurgery affects bleeding at the surgical site. To avoid surgical site bleeding, ACF-95 and LR solution should be used as irrigation fluids instead of normal saline. The calcium and potassium content of irrigation solutions seems to be important in hemostasis.
Surgical management of lateral-ventricle metastases: report of 29 cases in a single-institution experience
Authors: Hassaneen Wael , Suki Dima , Salaskar Abhijit L. , Wildrick David M. , Lang Frederick F. , Fuller Gregory N. , Sawaya Raymond
Published: August 2009

Object

The aim of this study was to review the outcome of patients undergoing surgery for treatment of lateral-ventricle metastases.

Methods

Imaging information and chart reviews of operative reports were used to conduct a retrospective analysis in 29 patients who underwent resection of lateral-ventricle metastases at the authors' institution between 1993 and 2007. Clinical and neurosurgical outcomes and recurrence rates were studied.

Results

The mean patient age was 56 years (range 20–69 years); 66% of patients were male. Single intraventricular metastases occurred in 69% of patients, and 55% of them had systemic metastases. The 30-day postoperative mortality rate was 7%. There was intracerebral tumor recurrence in 41% of patients, with 1 patient undergoing a second operation for this. The median postoperative survival duration for 28 patients (excluding 1 patient with preoperative leptomeningeal disease) was 11.7 months; the 3- and 5-year survival rates were 17 and 11%, respectively. Univariate analysis identified factors significantly influencing survival, including the preoperative Karnofsky Performance Scale (KPS) score (p = 0.02), the number of cerebral metastases (p = 0.02), the presence of primary renal cell carcinoma (RCC) (p = 0.02), and the resection method (en bloc vs piecemeal; p = 0.05). The presence of extracranial metastases did not significantly influence survival. Multivariate analysis showed that the preoperative KPS score (p = 0.002), the presence of primary RCC (p = 0.039), and the resection method (en bloc vs piecemeal; p = 0.008) correlated significantly with survival time.

Conclusions

Surgery is an important component in the management of intraventricular metastases. To the authors' knowledge, this is the first study focusing totally on resection of lateral-ventricle metastases. The authors found that patients with primary RCC, those with a favorable preoperative KPS score, and those who underwent en bloc resection had a better outcome than others.
Emergency reversal of anticoagulation and antiplatelet therapies in neurosurgical patients
Authors: Beshay Joseph E. , Morgan Howard , Madden Christopher , Yu Wengui , Sarode Ravindra
Published: August 2009

Intracranial hemorrhage (ICH) is a common problem encountered by neurosurgeons. Patient outcomes are influenced by hematoma size, growth, location, and the timing of evacuation, when indicated. Patients may have abnormal coagulation due to pharmacological anticoagulation or coagulopathy due to underlying systemic disease or blood transfusions. Strategies to reestablish the integrity of the clotting cascade and platelet function assume a familiarity with these processes. As patients are increasingly treated with anticoagulants and antiplatelet agents, it is essential that the physicians who care for patients with ICH understand these pathways and recognize how they can be manipulated to restore hemostasis.
Functional outcome after complete surgical removal of giant vestibular schwannomas
Authors: Samii Madjid , Gerganov Venelin M. , Samii Amir
Published: August 2009

Object

The authors evaluated the outcome of radical surgery in a consecutive series of patients with giant vestibular schwannomas (VSs).

Methods

Fifty patients with VSs > 4.0 cm in maximal extrameatal diameter were included in this retrospective study (Group A). The group was compared with a matched group of 167 patients with VSs < 3.9 cm (Group B). In all cases the retrosigmoid approach was used. Outcome measures included completeness of tumor removal, facial nerve function, hearing, and the surgery-related complication rate.

Results

The mean tumor size in Group A was 4.4 cm and that in Group B was 2.3 cm. Total removal was achieved in all Group A patients and in 97.6% of Group B patients. The anatomical integrity of the facial nerve was preserved in 92% in Group A and in 98.8% in Group B. At last follow-up 75% of the patients with giant VSs had excellent or good facial nerve function, 19% had fair function, and 6% had poor function. In 33% of patients (3 cases) with good preoperative hearing level, it was preserved. Newly developed lower cranial nerve dysfunction occurred in 3 patients but proved to be temporary in 2 of them. A CSF leak developed in 6% of those who not previously undergone surgery. Compared with Group B, a significant difference was found only in the rates of the following parameters: excellent facial nerve function, useful and good hearing, lower cranial nerve dysfunction, and blood collection (p < 0.05). The perioperative mortality rate in both groups was 0%.

Conclusions

In patients with a giant VS, total tumor removal can be achieved via the retrosigmoid approach with a 0% mortality rate and low morbidity rate, especially with regards to facial nerve function. In selected cases even hearing preservation is possible. Tumor size significantly correlates with postoperative outcome.
The Influence of Remote Substituents on the Amine-Catalysed Solvolysis Reaction of Some Para-Substituted Oxazolinones in Water–Dmso Mixtures
Authors: Ismail Amel M. , El-Sadany Samir K.
Published: August 2009

The kinetics of the morpholine-catalysed solvolysis of some p-substituted (Z)-4-benzylidene-2-phenyloxazolin-5-one in water- dimethylsulfoxide mixtures (20-90% V/V) at different temperatures in the range (40-60°C) have been studied. There is an electronic effect in the predicted direction for para-substitution in the benzylidene moiety in different percentage compositions of binary aqueous solvent mixtures. An electron-withdrawing substituent in the benzylidene ring leads to rate enhancement while an electron-donating substituent retarded the rate. A good linear relationship was obtained from plots of log kobs against the σ-Hammett parameter with a positive slope (ρ) at the various experimental temperatures and solvent compositions. Plots of the reaction rate constant ρ against the dielectric constant and the reciprocal temperature gave straight lines. The thermodynamic parameters Δ H≠, Δ S≠ and Δ G≠ have been determined; Δ G≠ increases gradually as the mole fraction of the cosolvent increase, due to a complex quasi-mirror image compensation of Δ H≠ and Δ S≠. A plot of Δ H≠ versus Δ S≠ for the reaction in water–solvent mixtures gave good straight lines with isokinetic temperatures which are higher than the experimental temperature. The higher negative values of the entropy suggest selective solvation by the more polar water molecules.
Kinetics and Mechanism of the Oxidation of Dl-Methionine by Benzimidazolium Dichromate
Authors: Pandey Dinesh , Kothari Seema
Published: August 2009

The oxidation of DL-methionine (MT) by benzimidazolium dichromate (BIDC), in dimethyl sulfoxide, leads to the formation of the corresponding sulfoxide. The reaction is first order with respect to BIDC. Michaelis - Menten type kinetics were observed with respect to MT. The reaction is catalysed by hydrogen ions and the dependence is of the form kobs = k‘[H+]. The rate of oxidation of MT was determined in 19 organic solvents. An analysis of the solvent effect by solvatochromic equations indicated that though both the anion- and cation-solvating powers of the solvent contribute to the observed solvent effect, the role of cation-solvation is much the major. A suitable mechanism has been proposed.
Theoretical Study, An Efficient Synthesis Route to, and Kinetic Investigation of, Stable Phosphorus Ylides Derived from Benzamide
Authors: Habibi-Khorassani Sayyed Mostafa , Ebrahimi Ali , Maghsoodlou Malek Taher , Saravani Hamideh , Zakarianezhad Mohammad , Ghahramaninezhat Mahbobe , Kazemian Mohammad Amin , Nassiri Mahmoud , Khajehali Zohreh
Published: August 2009

The synthesis, theoretical study and a kinetics and mechanistic investigation are described as a one-pot condensation reaction between benzamide and acetylenic esters in the presence of triphenyphosphine to generate a novel stable phosphorus ylides. For the first time, theoretical calculations have been employed to assign the most stable isomers ( Z or E) of phosphorus ylides 4a-c by AIM and NBO theory, in which Z-4(a,b) are the more stable forms, whereas Z-4c appears as a single isomer. In these cases, the 1H, 13C and 31P NMR spectra of these ylides are consistent with the results obtained from theoretical calculations. Kinetic investigation of the new ylides was undertaken by UV. Useful information was obtained from studies of the effect of solvent, structure of reactants (different alkyl groups within the acetylenic esters), and also the concentration of reactants on the rate of reactions. The proposed mechanism was consistent with the results obtained; from the steady-state approximation, the first step ( k2) of the reaction was recognized as the rate-determining step on the basis of the experimental data.
Andrew Melville, sacred chronology and world history: the Carmina Danielis 9 and the Antichristus
Authors: John Reid Steven
Published: August 2009

The accepted view of the ecclesiastical reformer Andrew Melville (1545–1622) as the dynamic leader of the Presbyterian movement in Jacobean Scotland has been severely eroded in recent years, with particular criticism of the actual importance of his contribution to the Kirk and to Scottish higher education. While this reductionism has been necessary, it has resulted in an inversion of the overwhelmingly positive traditional image of Melville, and does not give us a rounded assessment of his life and works. This article attempts to partially redress this balance by looking at a neglected aspect of Melville's Latin writings, which showcase his talents as a humanist intellectual and biblical commentator. It focuses on two long poems that are both commentaries and paraphrases of Daniel and Revelation: the Carmina Danielis and the Antichristus. Through these poems, we see how Melville engaged with two problems exercising reformed theologians across Europe: the dating of key biblical events and the historicised meaning of prophecies within these texts. We also find evidence that Melville read widely among both contemporary and ancient commentators on both these issues.
‘They must have their children educated some way’: the education of Catholics in eighteenth-century Scotland
Authors: Prunier Clotilde
Published: August 2009

This paper examines the provision of schooling to Catholics in eighteenth-century Scotland. In the first half of the century, schools established in the Highlands by the SSPCK mainly served a religious purpose, because Protestants were convinced that education was both a preservative against and an antidote to popery. As for the Catholic Church in Scotland, it concentrated its efforts on providing education to those boys intended for the priesthood. However, as the century wore on, there was a clear shift in the attitude of Scottish Catholics towards education. This paper presents evidence which suggests that Catholics came to regard education as an asset rather than as a threat, and that the changing perception of the uses of education mirrors the evolution of the standing of Scottish Catholics in British society.
Sifting through the archive: an epistolary sketch of the elusive Reverend William McLeod
Authors: MacHardy Carolyn
Published: August 2009

The focus of this article is on compiling a biography of Reverend William McLeod, a secular priest who served Corgarff from 1800 to 1804 and Braemar from 1804 until his death in 1809. This task is complicated by the fact that he was known by some as McLeod, and by others as McHardy, while Dom Odo Blundell in his 1909 \textit{The Catholic Highlands of Scotland} referred to him as McLeod alias McHardy. This article makes use of documents that have come to light, during the course of the last century, which not only assist in explaining who this enigmatic priest was, but also suggest possible reasons for the confusion surrounding his name. Although his service to the Church was interrupted by the tuberculosis which caused his death, the details of his life, including his presence in Braemar during a particularly turbulent period in this Mission's history, help to expand our knowledge of Catholicism in the north-east Highlands during the late eighteenth and early nineteenth centuries.
Synthesis and Characterization of a Novel 2-Pyrazoline
Authors: Singh Pramod , Negi Jagmohan , Nee Pant Geeta , Rawat Mohan S. , Budakoti Asha
Published: August 2009

Reaction of dibenzalacetone with hydrazine hydrate and formic acid yielded a novel 2-pyrazoline 1, characterized by ESI-MS, FT-IR, UV, 1HNMR and 13CNMR data and microanalysis.
Semi‐blind fast equalization of QAM channels using concurrent gradient‐Newton CMA and soft decision‐directed scheme
Authors: Chen S.
Published: August 2009

This contribution considers semi‐blind adaptive equalization for communication systems that employ high‐throughput quadrature amplitude modulation signalling. A minimum number of training symbols, approximately equal to the dimension of the equalizer, are first utilized to provide a rough initial least‐squares estimate of the equalizer's weight vector. A novel gradient‐Newton concurrent constant modulus algorithm and soft decision‐directed scheme are then applied to adapt the equalizer. The proposed semi‐blind adaptive algorithm is capable of converging fast and accurately to the optimal minimum mean‐square error equalization solution. Simulation results obtained demonstrate that the convergence speed of this semi‐blind adaptive algorithm is close to that of the training‐based recursive least‐square algorithm. Copyright © 2009 John Wiley & Sons, Ltd.
Less conservative criteria for fault accommodation of time‐varying delay systems using adaptive fault diagnosis observer
Authors: Jiang Bin , Zhang Ke , Shi Peng
Published: August 2009

This paper studies the problem of fault accommodation of time‐varying delay systems using adaptive fault diagnosis observer. Based on the proposed fast adaptive fault estimation (FAFE) algorithm using only a measured output, a delay‐dependent criteria is first established to reduce the conservatism of the design procedure, and the FAFE algorithm can enhance the performance of fault estimation. On the basis of fault estimation, the observer‐based fault‐tolerant tracking control is then designed to guarantee tracking performance of the closed‐loop systems. Furthermore, comprehensive analysis is presented to discuss the calculation steps using linear matrix inequality technique. Finally, simulation results of a stirred tank reactor model are presented to illustrate the efficiency of the proposed techniques. Copyright © 2009 John Wiley & Sons, Ltd.
Interpreting longitudinal spirometry: Weight gain and other factors affecting the recognition of excessive FEV1 decline
Authors: Wang Mei Lin , Avashia Bipin H. , Petsonk Edward L.
Published: August 2009

Background

Excessive FEV1 loss in an individual or a group can reflect hazardous exposures and development of lung disease. However, multiple factors may affect FEV1 measurements.

Methods

Using medical screening data collected in 1884 chemical plant workers between 1973 and 2003, the influence of multiple factors on repeated measurements of FEV1 was examined.

Results

The FEV1 level was associated with age, height, race, sex, cigarette smoking, changes in body weight, and spirometer model. After controlling for these factors, longitudinal FEV1 decline averaged 23.8 ml/year for white males; an additional loss of 8.3 ml was associated with one pack‐year smoking and 5.4 ml with a one pound weight gain. Depending on the spirometer model, FEV1 differed by up to 95 ml.

Conclusions

The study results provide quantitative estimates of the effect of specific factors on FEV1, and should be useful to health professionals in the evaluation of accelerated lung function declines. Am. J. Ind. Med. 52:782–789, 2009. © 2009 Wiley‐Liss, Inc.
Impact of publicly sponsored interventions on musculoskeletal injury claims in nursing homes
Authors: Park Robert M. , Bushnell P. Timothy , Bailer A. John , Collins James W. , Stayner Leslie T.
Published: August 2009

Background

The rate of lost‐time sprains and strains in private nursing homes is over three times the national average, and for back injuries, almost four times the national average. The Ohio Bureau of Workers' Compensation (BWC) has sponsored interventions that were preferentially promoted to nursing homes in 2000–2001, including training, consultation, and grants up to $40,000 for equipment purchases.

Methods

This study evaluated the impact of BWC interventions on back injury claim rates using BWC data on claims, interventions, and employer payroll for all Ohio nursing homes during 1995–2004 using Poisson regression. A subset of nursing homes was analyzed with more detailed data that allowed estimation of the impact of staffing levels and resident acuity on claim rates. Costs of interventions were compared to the associated savings in claim costs.

Results

A $500 equipment purchase per nursing home worker was associated with a 21% reduction in back injury rate. Assuming an equipment life of 10 years, this translates to an estimated $768 reduction in claim costs per worker, a present value of $495 with a 5% discount rate applied. Results for training courses were equivocal. Only those receiving below‐median hours had a significant 19% reduction in claim rates. Injury rates did not generally decline with consultation independent of equipment purchases, although possible confounding, misclassification, and bias due to non‐random management participation clouds interpretation. In nursing homes with available data, resident acuity was modestly associated with back injury risk, and the injury rate increased with resident‐to‐staff ratio (acting through three terms: RR = 1.50 for each additional resident per staff member; for the ratio alone, RR = 1.32, 95% CI = 1.18–1.48). In these NHs, an expenditure of $908 per resident care worker (equivalent to $500 per employee in the other model) was also associated with a 21% reduction in injury rate. However, with a resident‐to‐staff ratio greater than 2.0, the same expenditure was associated with a $1,643 reduction in back claim costs over 10 years per employee, a present value of $1,062 with 5% discount rate.

Conclusions

Expenditures for ergonomic equipment in nursing homes by the Ohio BWC were associated with fewer worker injuries and reductions in claim costs that were similar in magnitude to expenditures. Un‐estimated benefits and costs also need to be considered in assessing full health and financial impacts. Am. J. Ind. Med. 52:683–697, 2009. © 2009 Wiley‐Liss, Inc.
Some alternatives in the statistical analysis of sickness absence
Authors: Navarro Albert , Reis Ricardo J. , Martin Miguel
Published: August 2009

Purpose

Sickness absence (SA) is a commonly used outcome in occupational health cohort studies. Without the use of statistical techniques that take into account that SA is a recurrent event, the probability of obtaining biased estimates of the effects related to SA is very high. The objective of this article is to examine the application of marginal models, comparing them to count‐based models, when the outcome of interest is SA.

Methods

By re‐sampling the data of a reference study, 1,000 samples of 1,200 individuals were generated. In each of these samples, the coefficients of two factors were estimated by fitting various models: Poisson, Negative Binomial, standard Cox model for a first occurrence, Andersen–Gill and Prentice–Williams–Peterson.

Results

In general, differences among the models are observed in the estimates of variances and coefficients, as well as in their distribution. Specifically, the Poisson model estimates the greatest effect for both coefficients (IRR = 1.17 and IRR = 1.60), and the Prentice–Williams–Peterson the least effect (HR = 1.01 and HR = 1.26).

Conclusions

Whenever possible, the instantaneous form of analysis should be used for occurrences of a recurrent event. Collection of study data should be organized in order to permit recording of the most complete information possible, particularly regarding event occurrences. This should allow the presence of within‐individual heterogeneity and/or occurrence dependency to be studied, and would further permit the most appropriate model to be chosen. When there is occurrence dependence, the choice of a model using the specific baseline hazard seems to be appropriate. Am. J. Ind. Med. 52:811–816, 2009. © 2009 Wiley‐Liss, Inc.
Die Anwendung von Viren in Chemo‐ und Biosensoren
Authors: Mao Chuanbin , Liu Aihua , Cao Binrui
Published: August 2009

Viren haben sich in jüngster Zeit als einzigartige Hilfsmittel für den empfindlichen und selektiven Nachweis von Analyten wie Explosivstoffen, Proteinen, Bakterien, Viren, Sporen und Toxinen erwiesen. Auf Bakterien spezialisierte Viren, die Bakteriophagen – oder kurz Phagen –, wurden dabei am intensivsten untersucht: Zielspezifische nichtlysierende Phagen (sowie von diesen präsentierte Peptide und Proteine) können mithilfe hoch entwickelter Phagendisplaytechniken identifiziert werden, und lysierende Phagen können gezielt Bakterien aufbrechen und spezifische Zellmarker wie Enzyme ausschütten, die analysiert werden können. Darüber hinaus sind Phagen chemisch wie thermisch hinreichend stabil, und sie lassen sich mit Molekülen kuppeln und mit Nanomaterialien kombinieren und auf der Oberfläche eines Signalwandlers in einem Analysesystems verankern. Im Mittelpunkt dieses Aufsatzes stehen Fortschritte bei der Verwendung von Phagen in Chemo‐ und Biosensoren durch Kombination mit etablierten analytischen Techniken. Überdies werden aktuelle Entwicklungen bei der Verwendung von Virus‐Nanomaterial‐Kompositen und anderen Viren in Sensoranwendungen vorgestellt.
Virus‐Based Chemical and Biological Sensing
Authors: Mao Chuanbin , Liu Aihua , Cao Binrui
Published: August 2009

Viruses have recently proven useful for the detection of target analytes such as explosives, proteins, bacteria, viruses, spores, and toxins with high selectivity and sensitivity. Bacteriophages (often shortened to phages), viruses that specifically infect bacteria, are currently the most studied viruses, mainly because target‐specific nonlytic phages (and the peptides and proteins carried by them) can be identified by using the well‐established phage display technique, and lytic phages can specifically break bacteria to release cell‐specific marker molecules such as enzymes that can be assayed. In addition, phages have good chemical and thermal stability, and can be conjugated with nanomaterials and immobilized on a transducer surface in an analytical device. This Review focuses on progress made in the use of phages in chemical and biological sensors in combination with traditional analytical techniques. Recent progress in the use of virus–nanomaterial composites and other viruses in sensing applications is also highlighted.
Habitat suitability analysis for lacustrine brown trout (Salmo trutta) in Lake Walchensee, Germany: implications for the conservation of an endangered flagship species
Authors: Denic Marco , Geist Juergen
Published: August 2009

The lacustrine brown trout (Salmo trutta) is endangered and of high conservation importance. In the only spawning habitat of the population in the Bavarian Lake Walchensee, the River Obernach, a substantial decrease in spawning runs has been reported. In this study, the present ecological state of the spawning stream was analysed with the objective of identifying life‐stage specific limitations to successful recruitment attributable to deficiencies in (i) spawning migration, (ii) spawning habitat quality, and (iii) habitat quality for juveniles.

Structural stream analysis showed that discharge and several migration barriers — particularly near the river outlet into the lake — prevent successful spawning migrations at normal water levels. Migration barriers are probably the main limiting factor for reproduction of lacustrine brown trout, whereas structural variability of the Obernach meets the habitat requirements of both spawners and juveniles.

Spawning site quality was suitable for trout, as indicated by stream substratum texture and high exchange rates between free‐flowing water and the interstitial zone in physico‐chemical parameters (redox potential, dissolved oxygen, pH, temperature and conductivity).

Analyses of fish community structure revealed dominance of lithophilic species, in particular of riverine brown trout (Salmo trutta). Its density and intact demographic population structure suggest that spawning and juvenile habitat quality for salmonids is not limiting. Recapture of stocked lacustrine trout juveniles also indicates habitat suitability for the juvenile stage.

In conclusion, the results show that the methodology used in this study is suitable for the identification of life‐stage specific habitat deficiencies in lacustrine brown trout and other fish species. Availability of habitat data throughout the species' distribution range is a first crucial step for the development of an effective recovery plan. Copyright © 2009 John Wiley & Sons, Ltd.
Clinical competencies and the basic sciences: An online case tutorial paradigm for delivery of integrated clinical and basic science content
Authors: DiLullo Camille , Morris Harry J. , Kriebel Richard M.
Published: August 2009

Understanding the relevance of basic science knowledge in the determination of patient assessment, diagnosis, and treatment is critical to good medical practice. One method often used to direct students in the fundamental process of integrating basic science and clinical information is problem‐based learning (PBL). The faculty facilitated small group discussion format traditionally used for PBL is a significant challenge for faculty and facilities with a large class. To provide inductive learning to a large class early in the preclerkship curriculum, a series of online, case‐based tutorials was created using the method of inquiry‐based learning. The tutorial paradigm is designed to challenge students through a guided inquiry process in which clinical skills and basic science information are seamlessly joined. The psychosocial dimension of patient care is added to the documented case presentation of the tutorials in the form of patient/physician history taking and physical examination videos. These videos augment the written case with additional information providing the student with visual exposure in methods of patient communication and appropriate professional patient/physician interactions that address competencies of patient care, communication, and professionalism. The tutorials were made available via learning management system course sites. The study tracked usage of the tutorials by 270 first‐year medical students. Anat Sci Educ 2:238–243, 2009. © 2009 American Association of Anatomists.
Emergence of terminological conventions as a searcher–indexer coordination game
Authors: Bodoff David
Published: August 2009

In the traditional model of information retrieval, searchers and indexers choose query and index terms, respectively, and these term choices are ultimately compared in a matching process. One of the main challenges in information science and information retrieval is that searchers and indexers often do not choose the same term even though the item is relevant to the need whereas at other times they do choose the same term even though it is not relevant. But if both searchers and indexers have the opportunity to review feedback data showing the success or failure of their previous term choices, then there exists an evolutionary force that, all else being equal, will lead to helpful convergence in searchers' and indexers' term usage when the information is relevant, and helpfuldivergence of term usage when it is not. Based on learning theory, and new theory presented here, it is possible to predict which terms will emerge as the terminological conventions that are used by groups of searchers and the indexers of relevant and nonrelevant information items.
Exhaustive in vivo labelling of plasmid DNA with BrdU for intracellular detection in non‐viral transfection of mammalian cells
Authors: Jérôme Valérie , Heider Andreas , Schallon Anja , Freitag Ruth
Published: August 2009

The study of the non‐viral gene delivery process at the molecular level, e.g. during the transfection of mammalian cells, is currently limited by the difficulties of specifically detecting the transfected plasmid DNA within the cells. Here we describe the in vivo production of 5‐bromodeoxyuridine (BrdU)‐labelled plasmid DNA by a thymine‐requiring Escherichia coli strain leading to 92 ± 15% BrdU incorporation while minimizing plasmid structure alteration. The labelled plasmid is produced on the milligram scale in a two‐stage cultivation process. The relevance of this approach for plasmid DNA visualisation in the field of gene delivery is demonstrated by localising the BrdU‐labelled plasmid DNA via immunodetection/fluorescence microscopy in CHO‐K1 cells after electroporation with naked, BrdU‐labelled plasmid DNA and after polyfection with polyethylenimine/BrdU‐labelled plasmid complexes.
Mitochondria‐Penetrating Peptides: Sequence Effects and Model Cargo Transport
Authors: Yousif Lema F. , Stewart Kelly M. , Horton Kristin L. , Kelley Shana O.
Published: August 2009

A class of mitochondria‐penetrating peptides (MPPs) was studied in an effort to optimize their applications in the delivery of bioactive cargo to this therapeutically important organelle. The sequence requirements for mitochondrial entry were monitored, and it was discovered that while an alternating cationic/hydrophobic residue motif is not required, the inclusion of a stretch of adjacent cationic amino acids can impede access to the organelle. In addition, a variety of N‐ and C‐terminal cargo were tested to determine if there are limitations to the lipophilicity, charge, or polarity of compounds that can be transported to mitochondria by MPPs. The results reported demonstrate that these peptide sequences are versatile transporters that will have a range of biological applications.
Deciphering Pactamycin Biosynthesis and Engineered Production of New Pactamycin Analogues
Authors: Ito Takuya , Roongsawang Niran , Shirasaka Norifumi , Lu Wanli , Flatt Patricia M. , Kasanah Noer , Miranda Cristobal , Mahmud Taifo
Published: August 2009

Pactamycin is an aminocyclopentitol‐derived natural product that has potent antibacterial and antitumor activities. Sequence analysis of an 86 kb continuous region of the chromosome from Streptomyces pactum ATCC 27456 revealed a gene cluster involved in the biosynthesis of pactamycin. Gene inactivation of the Fe‐S radical SAM oxidoreductase (ptmC) and the glycosyltransferase (ptmJ), individually abrogated pactamycin biosynthesis; this confirmed the involvement of the ptm gene cluster in pactamycin biosynthesis. The polyketide synthase gene (ptmQ) was found to support 6‐methylsalicylic acid (6‐MSA) synthesis in a heterologous host, S. lividans T7. In vivo inactivation of ptmQ in S. pactum impaired pactamycin and pactamycate production but led to production of two new pactamycin analogues, de‐6‐MSA‐pactamycin and de‐6‐MSA‐pactamycate. The new compounds showed equivalent cytotoxic and antibacterial activities with the corresponding parent molecules and shed more light on the structure–activity relationship of pactamycin.
Treatment of pulmonary vein stenosis with expanded polytetrafluoroethylene covered stents
Authors: Gordon Brent M. , Moore John W.
Published: August 2009

Atrium expanded polytetrafluoroethylene covered stents were implanted in the stenotic pulmonary veins (n = 5) of three patients. Use of this device was feasible in infants and the procedure was well‐tolerated without major complications. The majority (4/5) of covered stents remained patent for at least 3 months after implantation. Stents remain patent in the two surviving patients 6 months after deployment.
Long‐term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS
Authors: Jakabčin Jozef , Špaček Radim , Bystroň Marian , Kvašňák Martin , Jager Jiri , Veselka Josef , Kala Petr , Červinka Pavel
Published: August 2009

Objective: To assess the role of the intravascular ultrasound (IVUS) during implantation of Drug‐eluting stents (DES) on long‐term outcome in patients with complex coronary artery disease and high clinical risk profile with special attention to the development of late stent thrombosis (LST). Methods: Two hunderd and ten patients were randomly assigned to receive DES either with (N = 105) or without (N = 105) the IVUS guidance. Dual antiplatelet treatment was administered for 6 months in all patients. At 18‐month follow‐up, the rates of Major adverse cardiac events (MACEs) (death, myocardial infarction, and reintervention) were assessed in both groups with special attention to possible LST. Stent thrombosis was classified according to Academic Research Consortium (ARC). Results: At the 18‐month follow‐up, there was no significant difference between both groups regarding MACE (11% vs. 12%; P = NS). Stent thrombosis has occurred in four patients (3.8%) in the group with and in 6 patients (5.7%; P = NS) in the group without the IVUS guidance. Conclusions: In our randomized trial we failed to demonstrate the superiority of the IVUS guidance during DES implantation over standard high‐pressure postdilatation. However we confirmed worrisome results concerning DES thrombosis after discontinuation of dual antiplatelet‐treatment with documented stent thrombosis related events in almost 5% of patients with 50% of mortality in this high‐risk clinical scenario. © 2009 Wiley‐Liss, Inc.
Economic analysis of angiography and preemptive angioplasty to prevent hemodialysis‐access thrombosis
Authors: Bittl John A. , Cohen David J. , Seek Melvin M. , Feldman Robert L.
Published: August 2009

Objectives:

We sought to determine the economic value of early angiography and prophylactic angioplasty to prevent hemodialysis‐access thrombosis.

Background:

End stage renal disease consumes more than 6% of the Medicare budget. There is a need to understand the financial impact of each component of care.

Methods:

We conducted an observational economic analysis of a closed cohort of 818 hemodialysis patients, of whom 560 were referred for 1437 consecutive radiographic procedures during an 8‐year period. Patient‐level, bottom‐up microcosting methods provided supply and personnel costs before and after expansion of an angiographic referral program.

Results:

The rate of referral for malfunctioning but nonthrombosed hemodialysis accesses increased from 18.8 ± 8.8 to 48.3 ± 11.9 angiographic procedures per 100 patient‐years (P < 0.001), which was associated with a decline in access thrombosis from 27.6 to 22.0 events per 100 patient‐years (P = 0.029) and a net cost of $34,586 per 100 patient‐years. The incremental cost‐effectiveness ratio for invasive surveillance was $6,177 per thrombosis event avoided. The angiographic program expanded at the same time that the proportion of autogenous fistulas increased from 28.3% ± 11.3% to 59.7% ± 10.7% of total referrals (P = 0.0001). On multivariable logistic regression analysis, the expanded angiography program (P = 0.001) and the proportion of autogenous fistulas (P = 0.0001) were both independently associated with the reduction in access thrombosis.

Conclusions:

Given the incremental costs and the relatively modest benefits in preventing access thrombosis, preemptive angiographic management may represent a less efficient use of healthcare resources than increasing the number of patients with autogenous fistulas. © 2009 Wiley‐Liss, Inc.