bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of appropriateness of antimicrobial therapy in adults with occult bacteraemia
Authors: Lee Ching-Chi , Hong Ming-Yuan , Chan Tsung-Yu , Hsu Hsiang-Chin , Ko Wen-Chien 
Published: December 2012

PurposeTo investigate the clinical characteristics and outcomes of adults with occult bacteraemia and the clinical impact of appropriate antibiotics.MethodsA case-control study was conducted to retrospectively analyse the bacteraemic adults visiting the emergency department (ED) during the period between January 2005 and August 2006. The patients with occult bacteraemia were the case group. Two control groups (CGs) were selected for comparisons: CG I, those with bacteraemia and the same Pittsburgh bacteremia score who were admitted at the first ED visit temporally near a case patient; and CG II, those with bacteraemia admitted at their first ED visit, irrespective of the Pittsburgh bacteraemia score.ResultsThere were 119 adults composing of the case group, 119 matched adults as the CG I and 293 adults as the CG II. Demographic characteristics, clinical conditions and outcomes were retrieved from chart records. A lower 28-day death rate (5.0% vs 11.9%, p=0.03) and less critical illness (ie, Pittsburgh bacteremia score ≥4 points; 1.7% vs 22.2%; p<0.001) were noted among case patients compared with those in CG II. However, no difference in the 28-day death rate (5.0% vs 5.9%; p=0.77) between the case group and CG I was discovered. Among the case patients, thrombocytopenia (<100 000/mm3; OR, 8.87; p=0.03) and inappropriate antibiotic therapy at the second ED or outpatient-clinic visit (OR 7.59; p=0.045) were the independent factors of 28-day mortality in the multivariate analysis. Moreover, the survival curve revealed a significant difference in the survival rate between those with occult bacteraemia receiving inappropriate and appropriate antibiotic therapy after index bacteraemic-onset (p=0.02).ConclusionsFor adults with occult bacteraemia, a lower severity of illness and death rate than those of bacteraemic patients hospitalised for ED visit could be demonstrated, demonstrating the importance of appropriate antibiotic therapy.
A multidisciplinary team model of caring for patients with perianal Crohn's disease incorporating a literature review, topical therapy and personal practice
Authors: Garrick Vikki , Stenhouse Emily , Haddock Graham , Russell Richard K 
Published: December 2012

BackgroundCrohn's disease (CD) is characterised by periods of relapse and remission. Over time the disease leads almost inevitably to the complications of stricturing, penetration and fistulisation. Perianal CD involves areas of chronic abscess formation, ulceration, skin tags or fistula formation. This can be a particularly challenging and complex problem to manage, and a range of potential treatment modalities exist.MethodsThis review covers the management of perianal CD and provides recommendations for practice for the multidisciplinary team (MDT), including the use of wound management products and relevant clinical images.ResultsCurrent practice focuses predominantly on the use of antibiotic therapy, immunosuppression, immunomodulation and surgery. These therapies are used individually or in combination. The majority of evidence suggests that a combination of medical and surgical management produces the best disease outcomes. However, this treatment regime can be debilitating for the patient and compliance can be difficult. Published work on the use of topical therapy in the management of perianal CD focuses specifically on topical drug therapy; it does not, however, address the basic guiding principles of chronic wound management—in particular, optimal moisture control and the management of bacterial burden on the wound surface. Honey and silver-containing wound management products act as topical antimicrobial agents and therefore address these principles.ConclusionsPerianal CD is the archetypal condition that exemplifies the need for an MDT approach in caring for patients with inflammatory bowel disease. A combination of treatment modalities that includes topical wound management is likely to produce the best patient outcomes.
Improved clinical outcomes and efficacy with a nurse-led dysphagia hotline service
Authors: Murray Iain Alexander , Waters Carolyn , Maskell Giles , Despott Edward J , Palmer Joanne , Dalton Harry R 
Published: December 2012

BackgroundA nurse practitioner-led dysphagia service was introduced to improve appropriateness of investigations.ObjectiveTo determine the clinical outcomes and efficacy of this service.Design and patientsA 7-year prospective audit of the first 2000 patients referred for investigation of dysphagia.SettingRoyal Cornwall Hospitals NHS Trust.InterventionAn innovative nurse practitioner-led telephone dysphagia hotline (DHL) assessment service for all patients and consultant review following investigation prior to discharge.OutcomesClinical outcomes, service efficiency and cost effectiveness.Results2000 patients (median age 70 years, 48% male) were referred in less than 7 years, 1775 being managed fully through the DHL. 67% patients had gastroscopy only, 13% barium swallow only and 8.8% both and 11.2% had no investigation. Reflux was the commonest cause (41.3%), 9% had peptic stricture, 10% malignancy 1.9% pharyngeal pouches and 0.8% achalasia. The did not attend rate was reduced from 3.9% to 1.1% and 151 patients either refused or did not require investigation saving a potential £53 040. Although some patients with pharyngeal pouches had gastroscopy as initial investigation, no complications resulted.ConclusionsThe nurse practitioner-led DHL service has improved efficiency and resulted in a safe prompt service to patients.
Impact of social and technological distraction on pedestrian crossing behaviour: an observational study
Authors: Thompson Leah L , Rivara Frederick P , Ayyagari Rajiv C , Ebel Beth E 
Published: December 2012

ObjectivesThe objective of the present work was to study the impact of technological and social distraction on cautionary behaviours and crossing times in pedestrians.MethodsPedestrians were observed at 20 high-risk intersections during 1 of 3 randomly assigned time windows in 2012. Observers recorded demographic and behavioural information, including use of a mobile device (talking on the phone, text messaging, or listening to music). We examined the association between distraction and crossing behaviours, adjusting for age and gender. All multivariate analyses were conducted with random effect logistic regression (binary outcomes) and random effect linear regression (continuous outcomes), accounting for clustering by site.ResultsObservers recorded crossing behaviours for 1102 pedestrians. Nearly one-third (29.8%) of all pedestrians performed a distracting activity while crossing. Distractions included listening to music (11.2%), text messaging (7.3%) and using a handheld phone (6.2%). Text messaging, mobile phone use and talking with a companion increased crossing time. Texting pedestrians took 1.87 additional seconds (18.0%) to cross the average intersection (3.4 lanes), compared to undistracted pedestrians. Texting pedestrians were 3.9 times more likely than undistracted pedestrians to display at least 1 unsafe crossing behaviour (disobeying the lights, crossing mid-intersection, or failing to look both ways). Pedestrians listening to music walked more than half a second (0.54) faster across the average intersection than undistracted pedestrians.ConclusionsDistracting activity is common among pedestrians, even while crossing intersections. Technological and social distractions increase crossing times, with text messaging associated with the highest risk. Our findings suggest the need for intervention studies to reduce risk of pedestrian injury.
The role of radiology in the diagnosis and treatment of mesenteric ischaemia
Authors: Upponi Sara , Harvey John Julian , Uberoi Raman , Ganeshan Arul 
Published: December 2012

Abstract
Clinicians working in any acute medical/surgical unit need an understanding of mesenteric ischaemia. Acute mesenteric ischaemia is a life-threatening vascular emergency associated with high morbidity and mortality. However, prompt diagnosis with the use of contrast-enhanced CT, more specifically CT angiography, has replaced catheter angiography as the new standard and is readily available in many emergency departments. Similarly, new hybrid open surgery endovascular treatment can minimise the surgical insult to these often critically ill elderly patients. Together, these changes can change the previously grim prognosis associated with this condition.
By contrast, chronic mesenteric ischaemia (CMI) is an insidious disease and often a diagnosis of exclusion. However, it can cause a significant reduction in a patient's quality of life, due to ‘mesenteric angina’ and food avoidance, yet can potentially be treated simply and effectively. Recognition of the typical clinical history and imaging findings is key to making the diagnosis in a timely fashion.
Radiology plays a significant role in the diagnosis and increasingly in the treatment of mesenteric ischaemia. Other clinicians should have a basic understanding of what radiology can and cannot offer. The advantages and limitations of commonly used imaging modalities—plain films, CT, MRI and ultrasound, are examined. The significance of findings, such as pneumatosis coli and portal gas are explained. Finally, the different endovascular management of both acute and CMI is discussed, which have emerged as minimally invasive options to complement open revascularisation surgery.
Evolution ofNeisseria gonorrhoeaeis a continuing challenge for molecular detection of gonorrhoea: false negative gonococcalporAmutants are spreading internationally
Authors: Ison Catherine A , Golparian Daniel , Saunders Pamela , Chisholm Stephanie , Unemo Magnus 
Published: December 2012

ObjectivesIdentification of genetic targets specific toNeisseria gonorrhoeaefor use in molecular detection methods has been a challenge. TheporApseudogene inN gonorrhoeaehas been commonly used but recently gonococcal isolates giving a negative result in these PCRs have been reported. Here we describe the characterisation of two such gonococcal isolates received by the reference service at the Health Protection Agency, London, England.MethodsPhenotypic characterisation was achieved using conventional biochemical and immunological tests, matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF-MS), antimicrobial susceptibility testing, serovar determination and detection of meningococcal PorA using monoclonal antibody 4BG4-E7. Genetic species confirmation was determined using commercial and in house PCRs and16S rRNAgene sequencing. Molecular typing using theN gonorrhoeaemulti-antigen sequence typing (NG-MAST) and multilocus sequence typing (MLST) was performed. The DNA sequence of the full-length gonococcalporApseudogene was determined and compared with published sequences.ResultsBoth isolates were confirmed, biochemically and immunologically asN gonorrhoeae, but repeatedly gave negative results with two in house real-time PCR assays for theporApseudogene. Further characterisation of these isolates identified the presence of a meningococcalporAsequence and showed these isolates belong to serovar Bropyst, and to NG-MAST sequence type (ST) 5967 and MLST ST1901.ConclusionsGonococcal isolates that give false negative results withporApseudogene PCR assays have now been identified in four countries, three of which are in Europe, and do not appear clonal. This report highlights the genetic diversity ofN gonorrhoeae, which remains a challenge for the molecular detection methods.
Meta-analyses of the effects of river flow on fish movement and activity
Authors: Taylor Mark K. , Cooke Steven J. 
Published: December 2012

Estimating the timing and magnitude of fish movements relative to environmental factors can provide insight into why fishes behave as they do. To make broad-level inferences about fish movement in lotic environments, we conducted random-effects meta-analyses on the effects of river flow magnitude on (i) non-migratory movements, (ii) upstream migratory movements, (iii) downstream migratory movements, and (iv) fine-scale activity. We found a significant positive effect of river discharge on non-migratory movements ([Formula: see text] = 0.41 (mean) ± 0.07 (SE), Z = 6.06, p < 0.01, k (sample size) = 27); fishes made larger and (or) more frequent movements during periods of elevated discharge. Furthermore, non-salmonids were more affected by river flow than salmonids. River discharge also had a significant positive effect on the rate, frequency, and probability of upstream migratory movements ([Formula: see text] = 0.23 ± 0.10, Z = 2.24, p < 0.05, k = 8). However, the effect of discharge on the rate of downstream migratory movements ([Formula: see text] = –0.05 ± 0.15, Z = –0.35, p > 0.05, k = 5) and fine-scale activity ([Formula: see text] = 0.01 ± 0.11, Z = 0.08, p > 0.05, k = 5) were not significant. Heterogeneity of effect sizes was evident in all meta-analyses as well as inclusion and (or) publication bias. Collectively, our meta-analyses suggested that changes to a river’s flow regime can modulate non-migratory fish behaviour, the consequences of which need to be explored in terms of habitat use and energy budgets. However, more studies are needed to examine potential effect modifiers and improve sample sizes overall.
Transfacial Ultrasound‐Guided Gland‐Preserving Resection of Parotid Sialoliths
Authors: Carroll William W. , Walvekar Rohan R. , Gillespie M. Boyd 
Published: December 2012

ObjectiveReview surgical techniques and outcomes of ultrasound‐guided, transfacial, gland‐preserving removal of difficult parotid stones.Study DesignCase series with chart review.SettingTwo academic tertiary care centers.MethodsPatients who underwent ultrasound‐guided, combined transfacial‐endoscopic operation for symptomatic parotid sialolithiasis from June 2010 through June 2012 at 2 tertiary care university hospitals were evaluated. Outcome measurements included stone size, stone location, complications, symptom relief, and gland preservation rate.ResultsA total of 14 patients underwent ultrasound‐guided, transfacial operation for symptomatic parotid sialolithiasis. Ten of 14 patients (71%) had completely successful therapy defined by no symptoms postoperatively with a preserved, functional gland. Three of the 4 patients without complete symptom resolution did endorse symptom improvement, whereas the fourth patient eventually underwent parotidectomy. Needle localization was used to aid in transfacial stone retrieval in 57% of cases.ConclusionUltrasound‐guided, combined transfacial‐endoscopic removal of certain parotid stones is an alternative to parotidectomy for patients in whom endoscopy or shock wave therapy for stone retrieval is ineffective, unavailable, or contraindicated. Needle localization is a useful adjunct in stone retrieval.
Surface modification of polyurethane towards promoting the ex vivo cytocompatibility and in vivo biocompatibility for hypopharyngeal tissue engineering
Authors: Shen Zhisen , Kang Cheng , Chen Jingjing , Ye Dong , Qiu Shijie , Guo Shanshan , Zhu Yabin 
Published: December 2012

Polymeric substrates with good biocompatibility have been widely employed to create a living construct with the complexities of tissue histology and function in the field of tissue engineering. In this study, poly(ester-urethane) (58213, NAT022) was used to be substrate due to its good physical and chemical properties. Proteins like gelatin or silk fibroin were covalently bonded on its surface using method of diamine aminolysis and glutaraldehyde crosslinking, which had been setup in our group in order to improve poly(ester-urethane)’s hydrophilicity and biocompatibility. The modification was proved by the measurements of static and dynamic contact angles and fluorescence detection. The biological properties were evaluated as in vitro cell culture and in vivo transplantation via cell number counting, morphology observation, immunohistochemistry analysis, etc. The results showed that gelatin or silk fibroin grafted membrane displayed good cytocompatibility, i.e. good proliferation and differentiation of human hypopharynx fibroblast and skeletal muscle cell though the control poly(ester-urethane) indicated low toxicity to cells and good biocompatibility, which was also verified in in vivo experiment. After poly(ester-urethane)–silk fibroin was implanted subcutaneously in rat back, it exhibited a better compatibility to peripheral tissue and faster biodegradation than the control poly(ester-urethane) did. This information supplied us valuable knowledge for poly(ester-urethane) to be used as matrix in situ hypopharynx regeneration study.
Hydroxyapatite/poly(ɛ-caprolactone) double coating on magnesium for enhanced corrosion resistance and coating flexibility
Authors: Jo Ji-Hoon , Li Yuanlong , Kim Sae-Mi , Kim Hyoun-Ee , Koh Young-Hag 
Published: December 2012

Hydroxyapatite was deposited on pure magnesium (Mg) with a flexible poly(ɛ-caprolactone) interlayer to reduce the corrosion rate of Mg and enhance coating flexibility. The poly(ɛ-caprolactone) interlayer was uniformly coated on Mg by a spraying method, followed by hydroxyapatite deposition on the poly(ɛ-caprolactone) using an aerosol deposition method. In scanning electron microscopy observations, inorganic/organic composite-like structure was observed between the hydroxyapatite and poly(ɛ-caprolactone) layers, resulting from the collisions of hydroxyapatite particles into the poly(ɛ-caprolactone) matrix at the initial stage of the aerosol deposition. The corrosion resistance of the coated Mg was examined using potentiodynamic polarization tests. The hydroxyapatite/poly(ɛ-caprolactone) double coating remarkably improved the corrosion resistance of Mg in Hank’s solution. In the in vitro cell tests, the coated Mg showed better cell adhesion compared with the bare Mg due to the reduced corrosion rate and enhanced biocompatibility. The stability and flexibility of hydroxyapatite/poly(ɛ-caprolactone) double coating was investigated by scanning electron microscopy inspections after the coated Mg was deformed. The hydroxyapatite coating on the poly(ɛ-caprolactone) interlayer revealed enhanced coating stability and flexibility without cracking or delamination during bending and stretching compared with the hydroxyapatite single coating. These results demonstrated that the hydroxyapatite/poly(ɛ-caprolactone) double coating significantly improved the surface corrosion resistance of Mg and enhanced coating flexibility for use of Mg as a biodegradable implant.
Evaluation of borate bioactive glass scaffolds with different pore sizes in a rat subcutaneous implantation model
Authors: Deliormanlı Aylin M , Liu Xin , Rahaman Mohamed N 
Published: December 2012

Borate bioactive glass has been shown to convert faster and more completely to hydroxyapatite and enhance new bone formation in vivo when compared to silicate bioactive glass (such as 45S5 and 13-93 bioactive glass). In this work, the effects of the borate glass microstructure on its conversion to hydroxyapatite (HA) in vitro and its ability to support tissue ingrowth in a rat subcutaneous implantation model were investigated. Bioactive borate glass scaffolds, designated 13-93B3, with a grid-like microstructure and pore widths of 300, 600, and 900 µm were prepared by a robocasting technique. The scaffolds were implanted subcutaneously for 4 weeks in Sprague Dawley rats. Silicate 13-93 glass scaffolds with the same microstructure were used as the control. The conversion of the scaffolds to HA was studied as a function of immersion time in a simulated body fluid. Histology and scanning electron microscopy were used to evaluate conversion of the bioactive glass implants to hydroxyapatite, as well as tissue ingrowth and blood vessel formation in the implants. The pore size of the scaffolds was found to have little effect on tissue infiltration and angiogenesis after the 4-week implantation.
Novel optically active poly(amide-thioester-imide)s containing l-α-amino acids and thiadiazol anticorrosion group
Authors: Mallakpour Shadpour , Zadehnazari Amin 
Published: December 2012

Here, for the first time, we report the synthesis of a new class of optically active polymers, poly(amide-thioester-imide)s (PATEI)s, containing flexible and anticorrosion linkages. Step growth polymerization of a novel diamine with diacids containing amino acid and trimellitylimide groups in tetrabutylammonium bromide, in the molten state, which acts as a molten ionic salt medium, was carried out. The obtained polymeric materials were of the nanoscale size and were assembled by filamentary particles as shown by field-emission scanning electron microscopy micrographs, which were distributed uniformly and randomly, with an average nanosize diameter of about 40 nm. The polymeric samples were readily soluble in a variety of common organic solvents and formed low-colored and flexible thin films via solution casting. The values of absorption edge wavelength ( λ0) were determined by ultraviolet–visible spectroscopy, and all of the resulting PATEI films exhibited high-optical transparency. According to x-ray diffraction patterns, all the PATEIs were amorphous. The structure of PATEIs were also characterized by Fourier-transform infrared spectroscopy, Proton-nuclear magnetic resonance, elemental, and thermogravimetric analysis techniques. The effect of ultrasound on the morphology of polymers was also investigated. This study confirmed that the size of polymer particles decreased and there was a change in their morphology.
Investigation of physical properties and structure–property relationship in new poly(azo-sulfone-amide)s
Authors: Kausar Ayesha , Hussain Syed Tajammul 
Published: December 2012

Series of aromatic polyamides containing azo groups have been synthesized by the phosphorylation polycondensation of a new dicarboxylic acid ( E)-1-(4-(4-(3-carboxypyridylazo)thiocarbamoylaminophenyl-sulfonyl)phenyl)-3-(3-carboxypyridylazo)-thiourea and various diamines. Poly(azo-sulfone-amide)s (PASAs) were characterized using spectroscopic techniques, solubility, molar mass, electrical conductivity, mechanical strength, nonflammability, thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) studies. PASAs possessed fine solubility in polar solvents and high molar mass 70 × 103–75 × 103 gmol−1. These polyamides showed fibrous structure according to field-emission scanning electron microscopy (FESEM). Thermal and nonflammability data indicated that PASAs were fairly stable above 500°C having initial weight loss of around 525–531°C, 10% of gravimetric loss in the range of 542–563°C, own high glass transition temperature 257–267°C and limiting oxygen index (LOI) values (35–47%). The polymers also demonstrated higher tensile strength (61.10–74.29 MPa) and elongation at break (1.49–1.57). FESEM images displayed fibrous morphology of the PASAs. Moreover, polyamides showed superior electrical conductivity (1.45–1.92 S cm−1). Fine balance of the properties render the new PASAs potential engineering plastics for a number of aerospace relevance.
A novel finite element model incorporating rotary inertia in thin circular rods
Authors: Ranganathan Shivakumar I 
Published: December 2012

In this article, we extend the finite element formulation proposed by Buckham et al.2 to include the effects of rotary inertia in isotropic circular rods (or cables). In developing our model, we first express the angular velocities in terms of the time derivatives of the Frenet frame and use this definition to determine the contributions of rotary inertia. A salient feature of this model is that only six variables representing the absolute position vectors are used as nodal coordinates. Galerkin’s weighted residual approach is used to complete the discretization.