bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With High Levels of Patient Satisfaction With Pain Management
Authors: Shill Jessica , Taylor David McD. , Ngui Bryan , Taylor Simone E. , Ugoni Antony M. , Yeoh Michael , Richardson Joanna 
Published: October 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1212–1215 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to determine, among emergency department (ED) patients, the factors associated with a high level of satisfaction with pain management.Methods:  This was a prospective cohort study in a single ED. Consecutive adult patients, with triage pain scores of ≥4 (numerical rating scale = 0 to 10), were enrolled. Variables examined included demographics, presenting complaint, pain scores, nurse‐initiated analgesia, analgesia administered, time to first analgesia, specific pain communication, and whether “adequate analgesia” was provided (defined as a decrease in pain score to <4 and a decrease from the triage pain score of ≥2). The level of patient satisfaction with their pain management (six‐point scale: very unsatisfied to very satisfied) was determined by a blinded investigator 48 hours post discharge. Logistic regression analyses were undertaken.Results:  Data were complete for 476 patients: mean (±standard deviation [SD]) age was 43.6 (±17.2) years, and 237 were males (49.8%, 95% confidence interval [CI] = 45.2% to 54.4%). A total of 190 (39.9%, 95% CI = 35.5% to 44.5%) patients were “very satisfied” with their pain management, and 207 (43.5%, 95% CI = 39.0% to 48.1%) patients received adequate analgesia. Three variables were associated with the patient being very satisfied: the provision of adequate analgesia (odds ratio [OR] = 7.8, 95% CI = 4.9 to 12.4), specific pain communication (OR = 2.3, 95% CI = 1.3 to 4.1), and oral opioid administration (OR = 2.0, 95% CI = 1.1 to 3.4). Notably, the provision of nurse‐initiated analgesia to 211 patients (44.3%, 95% CI = 39.8% to 48.9%) and the short time to analgesia (median = 11.5 minutes; interquartile range [IQR] = 2.0 to 85.8 minutes) were not associated with being very satisfied.Conclusions:  The receipt of adequate analgesia (as defined) is highly associated with patient satisfaction. This variable may serve as a clinically relevant and achievable target in the pursuit of best‐practice pain management.
Dental age in patients with neurofibromatosis 1
Authors: Jääsaari Päivi , Visnapuu Vivian , Nyström Marjatta , Peltonen Sirkku , Peltonen Juha , Happonen Risto‐Pekka 
Published: October 2012

Neurofibromatosis type 1 (NF1) is a common, hereditary, neurocutaneous skeletal condition with a variety of osseous manifestations. Although NF1 also affects craniofacial structures, the literature has only limited information related to the effect of NF1 on dental development. In this study the dental age of 34 Finnish NF1 patients, 8–17 yr of age, was estimated using the Demirjian & Goldstein method. The dental age of children with NF1 was similar to that of a Finnish control population. The findings suggest that NF1 does not affect the timing of tooth development.
The 20-Year Public Health Impact and Direct Cost of Testosterone Deficiency in U.S. Men
Authors: Moskovic Daniel J. , Araujo Andre B. , Lipshultz Larry I. , Khera Mohit 
Published: October 2012

ABSTRACT

Introduction
Testosterone deficiency (TD) imposes a substantial public health burden in the U.S. We modeled the costs associated with TD-related sequelae including cardiovascular disease (CVD), diabetes mellitus (DM), and osteoporosis-related fractures (ORFs).

Aim
To quantify the incremental cost burden imposed by TD's cardiometabolic sequelae.

Method
Incidence, prevalence, and mortality of these conditions were collected for men ages 45–74 from six national databases and large cross-sectional studies. Relative risk (RR) rates were determined for these sequelae in patients with T &lt; 300 ng/dL. The prevalence of TD was determined for this cohort of men.

Main Outcome Measures
Adjusted incidence and prevalence were determined. Annual costs for the three TD-related sequelae were inflated at a real rate of 3% for 20 years.

Results
Actual and adjusted (normalized for T deficiency) rates of CVD, DM, and ORFs in U.S. men aged 45–74 assuming a TD prevalence of 13.4% were calculated. We determined that, over a 20-year period, T deficiency is projected to be involved in the development of approximately 1.3 million new cases of CVD, 1.1 million new cases of DM, and over 600,000 ORFs. In year 1, the attributed cost burden of these diseases was approximately $8.4 billion. Over the entire 20-year period, T deficiency may be directly responsible for approximately $190–$525 billion in inflation-adjusted U.S. health care expenditures.

Conclusion
TD may be a significant contributor to adverse public health. Further study is needed to definitively describe the whether TD is a modifiable risk factor for CVD, DM, and ORFs. This may represent an opportunity for nationwide public health initiatives aimed at preventive care.
Effect of Different Cornstarch Types in New Formulations of Gluten‐ and Lactose‐Free White Sauces with High Protein Content
Authors: Quiles Amparo , Llorca Empar , Hernández‐Carrión María , Hernando Isabel 
Published: October 2012

AbstractCeliac disease is an immune response to ingestion of gluten in genetically susceptible individuals. As gluten is present in white sauces, the aim of this paper was to obtain new formulations of gluten‐ and lactose‐free sauces with high protein content. The microstructure and several sensory and physical properties were studied. The results showed white sauces maintained good stability and resistance to syneresis during storage. The sauces had a continuous phase consisting of components of starch granules released from gelatinized granules and soy protein, and a dispersed phase consisting of fat globules and swollen starch granules with high amylopectin content. The viscosity of the sauces seems to be related to the number and interaction of starch granules and size of the fat globules. Sensory evaluation revealed the best evaluated sauces were made with cross‐linked starches. Therefore, these starches are recommended for the formulation of gluten‐ and lactose‐free sauces with high protein content.Practical ApplicationsIt is estimated that around 1% of the population suffers from celiac disease. Many of the gluten‐free foods currently available are low quality and have a poor taste and mouthfeel. Sauces are an important part of the human diet. The standard ingredients of a white sauce are milk, oil, flour or starch, and salt. Starch can contain gluten if it is obtained from cereals such as wheat, barley and rye. Moreover, the use of dairy ingredients with high lactose content is unsuitable for celiacs because many also suffer from lactose intolerance. Therefore, it is important to study new formulations of gluten‐ and lactose‐free white sauces with high protein elaborated with different types of cornstarch in order to inform the industry and improve the quality of life of celiacs.
Evaluating the effects of common‐pool resource institutions and market forces on species richness and forest cover in Ecuadorian indigenous Kichwa communities
Authors: Oldekop Johan A. , Bebbington Anthony J. , Hennermann Karl , McMorrow Julia , Springate David A. , Torres Bolier , Truelove Nathan K. , Tysklind Niklas , Villamarín Santiago , Preziosi Richard F. 
Published: October 2012

AbstractWe compare conservation outcomes between a protected area (PA) and four indigenous common‐property regimes (CPRs) under differing degrees of market integration in the Ecuadorian Amazon. We first assess how market forces and common‐pool resource institutions governing processes of forest conversion affect biodiversity and forest cover, and whether institutions mitigate the effect of market forces. We then analyze how biodiversity and forest cover differ between a PA, and communities with different market access. Finally, we link biodiversity and forest cover changes within communities to differences in land‐use practices. While we show similar levels of forest cover and biodiversity between the PA and large CPRs with little access to local markets, institutions appear not to attenuate market effects on conservation outcomes in our case studies. We discuss results within a common‐property theory context and highlight the importance of disentangling how market integration, common‐pool resource institutions, and resource health interact over time.
Soft tissue injuries of the tarsocrural joint: A retrospective analysis of 30 cases evaluated arthroscopically
Authors: Barker W. H. J. , Smith M. R. W. , Minshall G. J. , Wright I. M. 
Published: October 2012

SummaryReasons for performing the studyIntra‐articular soft tissue injuries of the equine tarsocrural joint have been poorly defined.MethodsAll horses that underwent arthroscopic surgery of a tarsocrural joint over a 10 year period were identified. Those with primary intra‐articular soft tissue injuries were selected for inclusion and the cases evaluated retrospectively.ResultsTwo hundred and eighty‐one horses underwent tarsocrural joint arthroscopy during the study period, 30 of which met the inclusion criteria (30 joints). A combination of soft tissue lesions was more common than injury to a single structure. Injuries involved the joint capsule (n = 25), collateral ligaments (n = 20), dorsal plica (n = 8) and open communication between the tarsocrural joint and extensor bundle (n = 7). Following arthroscopic surgery and rehabilitation, 81% of horses were able to return to their previous function.ConclusionIntra‐articular soft tissue injuries of the tarsocrural joint may be associated with localising clinical signs of inflammation. This series represented 11% of the total number of arthroscopic procedures undertaken on that joint in a single referral hospital. Arthroscopic surgery allows accurate definition of the injuries and facilitates lesion management. Case outcome following arthroscopic debridement and a subsequent period of rehabilitation is favourable.Potential relevanceIn lame horses with clinical signs localised to the tarsocrural joint, disrupted intra‐articular soft tissues should be considered in the list of differential diagnoses. Attending clinicians should consider arthroscopic evaluation in cases where primary intra‐articular soft tissue injuries are suspected to be causative.
Leaf Gas Exchange Characteristics of Jatropha as Affected by Nitrogen Supply, Leaf Age and Atmospheric Vapour Pressure Deficit
Authors: Rajaona A. M. , Brueck H. , Asch F. 
Published: October 2012

AbstractFacing a steadily increasing world energy demand, jatropha, among other energy crops, has been reported to potentially contribute to biofuel production. A basic characterisation of plant responses to abiotic environmental factors is important for assessing the model‐assisted potential of this plant in view of the many agro‐ecological zones in which jatropha is presently cultivated. Two pot experiments and two field studies were used to record gas exchange parameters in response to light, nitrogen supply, atmospheric vapour pressure deficit (VPD), leaf age and time of measurements. Variation of N supply from 0 to 16 mm resulted in lower rates of photosynthesis (A) and stomatal conductance (gs) of treatment 0 mm N compared with other N levels, whereas the light compensation point (IC), quantum yield (QY) and dark respiration rates (Rd) were similar in all treatments. In the field, diurnal effects were evident with higher light‐saturated photosynthetic rate (Amax) and QY and lower IC and Rd in the morning than in the afternoon. Considering leaf age effects, fully expanded leaves had a lower Amax compared with expanding leaves and this variation in leaf gas exchange was not related to changes in the chlorophyll index value (SPAD) which steadily increased with leaf age. QY of field and greenhouse plants varied from 0.023 to 0.037 and was substantially lower than in C3 plants. A was positively correlated with gs in a hyperbolic function. A varied from 0.64 to 21.13 μmol m−2 s−1 and gs varied from 12 to 469 mmol m−2 s−1. With increasing VPD, gs decreased, but this response differed between the field experiments and the two pot experiments which contrasted each other distinctively. Applying the inverse logistic function of Webb (Ecological Modeling, 56 (1991), 81), the maximal stomatal conductance of jatropha was in the range of 382 mmol m−2 s−1 and gs is predicted to be close to zero at 5 kPa. These data altogether indicate that light absorption characteristics of single leaves and carbohydrate status parameters should be investigated further to explain the low QY and the pronounced diurnal variation.
Melatonin levels in periodontal health and disease
Authors: Almughrabi O. M. , Marzouk K. M. , Hasanato R. M. , Shafik S. S. 
Published: October 2012

Background and ObjectiveThe aim of this study was to measure melatonin levels in the gingival crevicular fluid and saliva of subjects with healthy periodontal tissues, plaque‐induced gingival inflammation, chronic periodontitis and aggressive periodontitis.Material and MethodsA total of 70 subjects were examined and assigned to four groups: healthy periodontium (10 subjects); plaque‐induced gingival inflammation (20 subjects); chronic periodontitis (20 subjects); and aggressive periodontitis (20 subjects). Gingival crevicular fluid and saliva samples were collected from each subject and analyzed usingELISAs.ResultsThe melatonin levels in both gingival crevicular fluid and saliva were lower in patients with chronic periodontitis (10.4 and 12.8 pg/mL, respectively) and aggressive periodontitis (8.4 and 8.8 pg/mL, respectively) than in patients with gingivitis (13.9 and 17.6 pg/mL, respectively) and in healthy subjects (16.6 and 22.9 pg/mL, respectively). The mean melatonin levels in both gingival crevicular fluid and saliva were statistically significantly higher in healthy patients compared with patients with chronic periodontitis and aggressive periodontitis; however, there was no significant difference in the plaque‐induced gingival inflammation between the study groups.ConclusionsThe melatonin levels in gingival crevicular fluid and saliva are decreased in diseased periodontal tissues, especially periodontitis. The melatonin level was lowest in the aggressive periodontitis group.
Low Body Mass Index Is Associated with a Positive Response during a Head‐Up Tilt Test
Authors: LUIZ LUZ LEIRIA TIAGO , BARCELLOS SÔNIA REGINA , MORAES MARIA ANTONIETA , LIMA GUSTAVO GLOTZ DE , KUS TERESA , BARBISAN JUAREZ NEHAUS 
Published: October 2012

Background: To describe the association between body mass index (BMI) and a positive response during a head‐up tilt test (HUT) in patients referred for an investigation of syncope.Methods: Observational study of patients referred for the diagnostic evaluation of syncope. Patients were divided into four groups according to their BMI: <18.5 kg/m2, 18.5–24.9 kg/m2, 25–29.9 kg/m2, and > 30 kg/m2.Results: A total of 419 patients were evaluated. The mean age was 43 ± 22 years, and 62% were female. The prevalence of a positive tilt test was different between groups when stratified by BMI (P = 0.01), with a higher proportion of patients with positive tests among those with BMI <18.5 kg/m2 compared with other groups (P = 0.05). Multivariate analysis also showed that underweight patients had a 3.9 times higher risk for a positive HUT response (P = 0.01); additionally, the use of contraceptive drugs was associated with a protective effect during HUT (odds ratio: 0.35, confidence interval:0.19–0.45, P = 0.001).Conclusion: In our sample, changes in BMI are associated with a positive response for HUT, and oral contraceptives seemed to protect against this response. Further studies are needed with larger numbers of patients to corroborate this finding.(PACE 2013; 36:37–41)
ECG Criteria for Accurate Localization of Left Anterolateral and Posterolateral Accessory Pathways
Authors: MOSS JOSHUA D. , GERSTENFELD EDWARD P. , DEO RAJAT , HUTCHINSON MATHEW D. , CALLANS DAVID J. , MARCHLINSKI FRANCIS E. , DIXIT SANJAY 
Published: October 2012

Background
: Left lateral accessory pathway (AP) location along the mitral annulus (MA) can influence ablation strategy, including choice of a transseptal or retrograde aortic approach and the use of deflectable sheaths and/or bidirectional catheters. We aimed to develop electrocardiographic (ECG) criteria to accurately localize a left lateral AP, hypothesizing that the relationship of QRS amplitudes in limb leads II and III could be used to differentiate left anterolateral (LAL) from left posterolateral (LPL) AP locations.
Methods
: The ECGs from patients who underwent ablation of a left‐sided AP between 2001 and 2008 were evaluated for the relationship of QRS amplitudes in limb leads II and III. A LAL‐AP was defined by successful ablation between 12 and 3 o’clock on the MA, as seen in left anterior oblique (LAO) fluoroscopic projection. A LPL‐AP was defined by successful ablation between 3 and 6 o’clock in the LAO projection.
Results
: In 249 consecutive patients undergoing AP ablation, 23 met the prespecified inclusion criteria: manifest preexcitation due to single AP, ablated successfully in a LAL or LPL location. The ratio of dominant QRS amplitude in lead II to lead III was ≥1 in 10/11 patients with LAL‐AP, compared with 3/12 patients with a LPL‐AP (P = 0.002). Using these criteria, two blinded reviewers predicted a LAL or LPL location with 87% accuracy and 100% interobserver agreement.
Conclusions
: We report new ECG criteria that can be used to accurately predict the anterior and posterior location of a left lateral AP. Such localization may facilitate procedural planning. (PACE 2012;35:1444–1450)
Succinate dehydrogenase assembly factor 2 is needed for assembly and activity of mitochondrial complex II and for normal root elongation in Arabidopsis
Authors: Huang Shaobai , Taylor Nicolas L. , Ströher Elke , Fenske Ricarda , Millar A. Harvey 
Published: October 2012

SummaryMitochondria complex II (succinate dehydrogenase, SDH) plays a central role in respiratory metabolism as a component of both the electron transport chain and the tricarboxylic acid cycle. We report the identification of an SDH assembly factor by analysis of T‐DNA insertions in At5g51040, a protein with unknown function that was identified by mass spectrometry analysis as a low abundance mitochondrial protein. This gene is co‐expressed with a number of genes encoding mitochondrial proteins, including SDH1‐1, and has low partial sequence similarity to human SDHAF2, a protein required for flavin‐adenine dinucleotide (FAD) insertion into SDH. In contrast to observations of other SDH deficient lines in Arabidopsis, the sdhaf2 line did not affect photosynthetic rate or stomatal conductance, but instead showed inhibition of primary root elongation with early lateral root emergence, presumably due to the low SDH activity caused by the reduced abundance of SDHAF2. Both roots and leaves showed succinate accumulation but different responses in the abundance of other organic acids and amino acids assayed. Isolated mitochondria showed lowered SDH1 protein abundance, lowered maximal SDH activity and less protein‐bound flavin‐adenine dinucleotide (FAD) at the molecular mass of SDH1 in the gel separation. The short root phenotype and SDH function of sdhaf2 was fully complemented by transformation with SDHAF2. Application of the SDH inhibitor, malonate, phenocopied the sdhaf2 root architecture in WT. Whole root respiratory assays showed no difference between WT and sdhaf2, but micro‐respirometry of the tips of roots clearly showed low oxygen consumption in sdhaf2 which could explain a metabolic deficit responsible for root tip growth.
Identification of Streptococcus intermedius Central Nervous System Infection by Use of PCR and Electrospray Ionization Mass Spectrometry
Authors: Bhatia Nisha S. , Farrell John J. , Sampath Rangarajan , Ranken Raymond , Rounds Megan A. , Ecker David J. , Bonomo Robert A. 
Published: October 2012

ABSTRACT

We describe the utility of PCR and electrospray ionization with mass spectrometry (PCR/ESI-MS) of culture-negative cerebrospinal fluid (CSF) in order to identify Gram-positive cocci noted on a Gram stain of CSF from a previously healthy 26-year-old man with community-acquired pneumonia (CAP) and multiple brain abscesses. CSF samples were obtained 2 weeks apart, first by lumbar puncture and 2 weeks later from an external ventricular drain that was inserted into the right ventricle. Both CSF cultures were negative. A Gram stain of bronchoalveolar lavage (BAL) fluid was notable for many Gram-positive cocci (GPC), but cultures of BAL fluid and subcarinal lymph node biopsy tissue were negative. PCR/ESI-MS detected
Streptococcus intermedius
, a common cause of brain abscesses, in both CSF samples as well as in the fixed tissue from the biopsy. This unique case confirms
S. intermedius
pulmonary infection as the source of metastatic CNS infection and reveals the potential of PCR/ESI-MS to detect a streptococcal pathogen not captured by conventional cultures.
Comparison of SpectraCell RA Typing and Multilocus Sequence Typing for Extended-Spectrum-β-Lactamase-Producing Escherichia coli
Authors: Overdevest I. T. M. A. , Heck M. , van der Zwaluw K. , Willemsen I. , van de Ven J. , Verhulst C. , Kluytmans J. A. J. W. 
Published: October 2012

ABSTRACT

Multilocus sequence typing (MLST) is one of the most reliable methods for typing of
Escherichia coli
, including extended-spectrum-β-lactamase-producing
E. coli
(ESBL-EC). We investigated the performance of a new typing method, SpectraCell RA (River Diagnostics, Madison, WI), in comparison on MLST on a well-defined collection of ESBL-EC isolates obtained from chicken meat and humans. Ninety-two ESBL-EC isolates obtained from meat and 59 ESBL-EC isolates obtained from human rectal swabs and clinical blood cultures were typed using MLST and SpectraCell RA. The sensitivity and specificity of SpectraCell RA were calculated, using MLST as a reference method. Subsequently, the results of SpectraCell RA were used to determine the relatedness of ESBL-EC isolates from chicken and humans. Using MLST as the gold standard, the performance of SpectraCell RA was evaluated for 3 different cutoff values: 0.99975, 0.99955, and 0.99935. Depending on the cutoff value, the sensitivity was mediocre to unacceptably low, with values of 9.4%, 43.9%, and 66.7%, respectively. When sensitivity increased, the specificity decreased rapidly, from 95.6% to 69.8% and 34.4%, respectively. Also, the number of clusters containing both human and meat samples varied from 0 (0.0%) to 14 (38.9%). Our study shows that SpectraCell RA is not a suitable typing method for ESBL-EC when evaluating relationships of ESBL-EC at the population level.