bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moving Climate Information off the Shelf: Boundary Chains and the Role of RISAs as Adaptive Organizations
Authors: Lemos Maria Carmen , Kirchhoff Christine J. , Kalafatis Scott E. , Scavia Donald , Rood Richard B. 
Published: January 2014

Abstract
While research focusing on how boundary organizations influence the use of climate information has expanded substantially in the past few decades, there has been relatively less attention to how these organizations innovate and adapt to different environments and users. This paper investigates how one boundary organization, the Great Lakes Integrated Sciences and Assessments Center (GLISA), has adapted by creating “boundary chains” to diversify its client base while minimizing transaction costs, increasing scientific knowledge usability, and better meeting client climate information needs. In this approach, boundary organizations connect like links in a chain and together these links span the range between the production of knowledge and its use. Three main chain configurations are identified. In the key chain approach, GLISA has partnered with other organizations in a number of separate projects simultaneously, diversifying its client base without sacrificing customization. In the linked chain approach, GLISA is one of several linked boundary organizations that successively deepen the level of customization to meet particular users’ needs. Finally, by partnering with multiple organizations and stakeholder groups in both configurations, GLISA may be laying the groundwork for enhancing their partners’ own capacity to make climate-related decisions through a networked chain approach that facilitates cooperation among organizations and groups. Each of these approaches represents an adaptive strategy that both enhances the efficiency and effectiveness of participating boundary organizations’ work and improves the provision of climate information that meets users’ needs.
Designed to move? Physical activity lobbying and the politics of productivity
Authors: Piggin Joe 
Published: January 2014

Objectives: Physical inactivity is a major public health concern. At a population level, it is increasingly perceived to be a social problem which is global and multidimensional, and which requires attention by a diverse range of state, private and civil society organisations. Given the increasing attention to physical in/activity by a range of interest groups, this paper explores the political dynamics that are present within physical activity promotion discourse. Specifically, the paper examines the political dynamics associated with a recent physical activity lobby document entitled Designed To Move (DTM). DTM was written and produced by a variety of corporate, government, and health promotion organisations. Method and analysis: This paper uses a critical policy framework to analyse the justifications for, and suggested techniques of, physical activity promotion. It examines the explicit and more subtle reasons used to justify physical activity recommendations, how causes of physical inactivity are conveyed, and who is identified as able to fix the problem. Conclusions: While DTM appears to be a positive and inspirational call to action, several aspects of the document are problematic. Significantly, older adults receive scant attention in the document, and are therefore removed from being potentially important agents in the proposed solution. DTM also frames the workplace milieu in a way that promotes ‘productivity’ and business ‘fortune’ above concern for and consideration of employees’ material conditions of existence. The paper concludes by encouraging health researchers, physical activity students and health promoters to look behind and beyond assumptions about the causes of, and solutions to, physical inactivity.
A randomized controlled trial of the effectiveness of handheld computers for improving everyday memory functioning in patients with memory impairments after acquired brain injury
Authors: Lannin Natasha , Carr Belinda , Allaous Jeanine , Mackenzie Bronwyn , Falcon Alex , Tate Robyn 
Published: January 2014

Objective: To determine the effectiveness of personal digital assistant devices on achievement of memory and organization goals in patients with poor memory after acquired brain injury. Design: Assessor blinded randomized controlled trial. Setting: Specialist brain injury rehabilitation hospital (inpatients and outpatients). Participants: Adults with acquired brain impairments (85% traumatic brain injury; aged ≥17 years) who were assessed as having functional memory impairment on the Rivermead Behavioural Memory Test (General Memory Index). Interventions: Training and support to use a personal digital assistant for eight weeks to compensate for memory failures by an occupational therapist. The control intervention was standard rehabilitation, including use of non-electronic memory aids. Main outcome measures: Goal Attainment Scale which assessed achievement of participants’ daily memory functioning goals and caregiver perception of memory functioning; and General Frequency of Forgetting subscale of the Memory Functioning Questionnaire administered at baseline (pre-randomization) and post intervention (eight weeks later). Results: Forty-two participants with memory impairment were recruited. Use of a personal digital assistant led to greater achievement of functional memory goals (mean difference 1.6 (95% confidence interval (CI) 1.0 to 2.2), P = 0.0001) and improvement on the General Frequency of Forgetting subscale (mean difference 12.5 (95% CI 2.0 to 22.9), P = 0.021). Conclusions: Occupational therapy training in the use of a handheld computer improved patients’ daily memory function more than standard rehabilitation.
Immediate effects of two attention strategies on trunk control on patients after stroke. A randomized controlled pilot trial
Authors: Mückel Simone , Mehrholz Jan 
Published: January 2014

Objective: To compare the immediate effects of an external focus to enhance lateral body weight shift after stroke. Design: Randomized controlled trial. Setting: Inpatient rehabilitation hospital. Subjects: Twenty patients after stroke (11 males; mean (SD) age 72.2 (7.4) years; duration of illness 56 (14) days; there were 9 (45%) left-sided strokes) with impaired sitting balance were randomly allocated into two groups either external focus ( n = 10) or internal focus ( n = 10). Intervention: Patients in the external focus group, while sitting, were instructed to shift as much weight as they could sidewards to an external point next to their hip. Patients in the internal focus group were instructed to shift as much weight as they could sidewards to their hip. Main outcome measures: Immediate lateral body weight shift as well as anterior–posterior deviation was measured in centimetres with a sensor mat. Results: Patients in the external focus group achieved greater lateral body weight shift than those in the internal focus group (mean shift (SD) 8.7 (2.6) cm vs. 4.5 (3.3) cm, respectively; P = 0.006). However, there were no significant differences in anterior–posterior deviation (mean shift (SD) 2.3 (1.3) cm vs. 1.2 (1.2) cm, respectively; P = 0.08). Conclusion: Using an external focus may lead immediately to an enhanced lateral body weight shift while sitting, without increasing anterior–posterior deviation.
Does botulinum toxin injection site determine outcome in post-stroke plantarflexion spasticity? Comparison study of two injection sites in the gastrocnemius muscle: a randomized double-blind controlled trial
Authors: Im Sun , Park Joo Hyun , Son Seong Kon , Shin Jae-Eun , Cho Sae Hoon , Park Geun-Young 
Published: January 2014

Objective: To determine if botulinum toxin type A injection at the proximal 2/10 and 3/10 of calf length, where the intramuscular nerve endings of the gastrocnemius muscle are densely distributed, is more efficacious in controlling plantarflexion spasticity than injection at distant sites within the same muscle. Design: A double-blind randomized controlled trial. Settting: Two rehabilitation centres. Subjects: Forty stroke patients were randomly allocated to two groups. Group A received injection at the proximal 2/10 and 3/10 of calf length, group B at and below the midbelly of the muscle. Both groups received 200 IU of botulinum toxin A and were followed up to eight weeks. Main measures: Primary variables were the surface electromyography values recorded during plantarflexion; secondary variables were the Modified Ashworth Scale, Modified Tardieu Scale, clonus scale, 10-metre walking test, ABILOCO and Functional Ambulation Categories. Results: At baseline, the median Modified Ashworth Scale was 2.0 (range,1+ −3.0), and there were no significant differences between the two groups in all the parameters, including spasticity. Compared to baseline, no significant differences between the two groups were detected in all the surface electromyography and clinical parameters at week 8 (P > 0.05). Both groups showed significant improvement of spasticity with a median Modified Ashworth Scale of 1+ (range, 0.0–2.0) at eight weeks. Conclusions: Botulinum toxin A injection was associated with a significant improvement from baseline to week 8 in both treatment groups, however, no significant difference between the 2 groups was observed, based on the electrophysiological and clinical parameters employed in this study.
Anatomic Variance of the Iliopsoas Tendon
Authors: Philippon Marc J. , Devitt Brian M. , Campbell Kevin J. , Michalski Max P. , Espinoza Chris , Wijdicks Coen A. , LaPrade Robert F. 
Published: January 2014

Background: The iliopsoas tendon has been implicated as a generator of hip pain and a cause of labral injury due to impingement. Arthroscopic release of the iliopsoas tendon has become a preferred treatment for internal snapping hips. Traditionally, the iliopsoas tendon has been considered the conjoint tendon of the psoas major and iliacus muscles, although anatomic variance has been reported. Hypothesis: The iliopsoas tendon consists of 2 discrete tendons in the majority of cases, arising from both the psoas major and iliacus muscles. Study Design: Descriptive laboratory study. Methods: Fifty-three nonmatched, fresh-frozen, cadaveric hemipelvis specimens (average age, 62 years; range, 47-70 years; 29 male and 24 female) were used in this study. The iliopsoas muscle was exposed via a Smith-Petersen approach. A transverse incision across the entire iliopsoas musculotendinous unit was made at the level of the hip joint. Each distinctly identifiable tendon was recorded, and the distance from the lesser trochanter was recorded. Results: The prevalence of a single-, double-, and triple-banded iliopsoas tendon was 28.3%, 64.2%, and 7.5%, respectively. The psoas major tendon was consistently the most medial tendinous structure, and the primary iliacus tendon was found immediately lateral to the psoas major tendon within the belly of the iliacus muscle. When present, an accessory iliacus tendon was located adjacent to the primary iliacus tendon, lateral to the primary iliacus tendon. Conclusion: Once considered a rare anatomic variant, the finding of ≥2 distinct tendinous components to the iliacus and psoas major muscle groups is an important discovery. It is essential to be cognizant of the possibility that more than 1 tendon may exist to ensure complete release during endoscopy. Clinical Significance: Arthroscopic release of the iliopsoas tendon is a well-accepted surgical treatment for iliopsoas impingement. The most widely used site for tendon release is at the level of the anterior hip joint. The findings of this novel cadaveric anatomy study suggest that surgeons should be mindful that more than 1 tendon may be present and require release for curative treatment.
Exploring Competitiveness of the Indian Health Sector
Authors: Bhardwaj Siddharatha S. , Chawla Komal 
Published: January 2014

Purpose The Indian health care industry, on account of its cost advantage, is fast emerging as the first choice of patients throughout the globe. The modern day Indian health care industry, as a matter of fact, has a dual role to play. First, coming up to the expectations of global and elite Indian patients. Second, fulfilling its social obligations by catering to the needs of a huge lower-middle class of people suffering from various ailments. The litmus test for the Indian health care industry is the way in which strikes a balance in between its commercial and social obligations. The best way under the prevailing situation is to keep patients’ faith intact by rendering quality services without bothering too much about the profit. Service quality, in fact, is dependent upon the service performance and how far it is able to satisfy customers. The present study makes an endeavour to gauge the service quality in selected multi-specialty hospitals of India by garnering the views of the patients/observers pertaining to their expectations and actual perception about the services being rendered to them. The study assumes a greater importance as the players chosen for the study represent both public as well as private sector. Research Type Empirical Findings There exists a difference in the perception and expectations of the patients/observers as far as their evaluation of the hospitals on various dimensions of service quality is concerned. Both the selected hospitals have been found to be struggling on the service quality dimensions such as accessibility, promptness and timeliness. The public hospital enjoys an edge over its private counterpart on the security, accuracy and reliability aspects. The private hospital, meanwhile, has a better rating on the impressiveness front. Both hospitals have done reasonably well on the competence, customization and ambience fronts. Practical Implications The administrative wing of the hospitals may start viewing service quality from the clients’ perspective and make necessary changes in their service quality endeavours. Research Limitations Technicalities involved in understanding of the concept of service quality might have acted as a handicap for the patients/observers in giving prompt and accurate answers to the questions in hand.
Impact of 2011 Resident Duty Hour Requirements on Neurology Residency Programs and Departments
Authors: George Benjamin P. , Probasco John C. , Dorsey E. Ray , Venkatesan Arun 
Published: January 2014

Objective: In 2011, the Accreditation Council on Graduate Medical Education (ACGME) redefined resident duty hour requirements by reducing in-hospital duty hour requirements for residents in an effort to improve patient care, resident well-being, and resident education. We sought to determine the cost of adoption based on changes made by neurology residency programs and departments due to these requirements. Methods: We surveyed department chairs or residency program directors at 123 ACGME-accredited US adult neurology training programs on programmatic changes and resident expansion, hiring practices, and development of new computer-based resources in direct response to the 2011 ACGME duty hour requirements. Using data from publicly available resources, we estimated respondents’ financial cost of adoption. Results: In all, 63 responded (51% response rate); 76% were program directors. The most common changes implemented by programs were adding night float systems (n = 31; 49%) and increasing faculty responsibility (n = 26; 41%). In direct response to the requirements, 21 programs applied to ACGME for 40 additional residents, 29 of which were fully covered by institutional funds. In direct response to the requirements, nearly half of the departments (n = 26) hired individuals for a total of 80 hires (or 64 full-time equivalents), most commonly mid-level practitioners. The total estimated cost to responding departments was US $12.7 million or US $201,000 per department annually. When projecting expenses of planned changes for the following year, costs increased to US $360,000 per department, with 5-year costs exceeding US $1 million. Conclusions: The most recent restriction on resident duty hours comes at substantial cost to neurology departments and residency programs.
Surgical Time of Day Does Not Affect Outcome Following Hip Fracture Fixation
Authors: Switzer Julie A. , Bennett Ryan E. , Wright David M. , Vang Sandy , Anderson Christopher P. , Vlasak Andrea J. , Gammon Steven R. 
Published: January 2014

Background: Due to the need for medical optimization and congested operating room schedules, surgical repair is often performed at night. Studies have shown that work done at night increases complications. The primary aim of our study is to compare the rates of complications and 30-day mortality between 2 surgical times of day, daytime group (DTG, 07:00-15:59) and nighttime group (NTG, 16:00-06:59). Methods: Retrospective chart review from 2005 through 2010. Setting: Level 1 Trauma Center. Participants: 1443 patients with hip fracture, age ≥50 years with isolated injury and surgical treatment of the fracture. Main Outcomes and Measures: Thirty-day mortality and complications: myocardial infarction, cardiac event, stroke, central nervous system event, pneumonia, urinary tract infection, postoperative wound infection, and bleeding requiring transfusion of 3 or more red blood cell units. Results: A total of 859 patients met the inclusion criteria; 668 patients in the DTG and 191 patients in the NTG. The 30-day mortality was 7.8%. The complication rate was 28%. No difference was found in 30-day mortality or complication rate based on the time of day the surgery was performed ( P = 1.0 and P = .92, respectively). This remained unchanged when controlling for health status and surgical complexity. Age (odds ratio = 1.03/year), Charlson Comorbidity Index (CCI; odds ratio = 1.21), and American Society of Anesthesiologists (ASA; odds ratio = 1.85) score were predictive of adverse outcomes. Conclusion: Surgical time of day did not affect 30-day mortality or total number of complications. Age, ASA score, and CCI were associated with adverse outcomes.
The Epidemiology of Injuries in Mixed Martial Arts
Authors: Lystad Reidar P. , Gregory Kobi , Wilson Juno 
Published: January 2014

Background: Mixed martial arts (MMA) has experienced a surge in popularity since emerging in the 1990s, but the sport has also faced concomitant criticism from public, political, and medical holds. Notwithstanding the polarized discourse concerning the sport, no systematic review of the injury problems in MMA has been published to date. Purpose: To systematically review the epidemiologic data on injuries in MMA and to quantitatively estimate injury incidence and risk factor effect sizes. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Electronic searching of PubMed, Scopus, CINAHL, EMBASE, AMED, and SPORTDiscus databases to identify studies reporting on the epidemiology of injuries in MMA. Random-effects models were used to obtain pooled summary estimates of the injury incidence rate per 1000 athlete-exposures (IIRAE) and rate ratios with 95% confidence intervals (CIs). Heterogeneity was evaluated with the I2 statistic. Results: A total of 6 studies were eligible for inclusion in this review. The IIRAE summary estimate was found to be 228.7 (95% CI, 110.4-473.5). No studies reported injury severity. The most commonly injured anatomic region was the head (range, 66.8%-78.0%) followed by the wrist/hand (range, 6.0%-12.0%), while the most frequent injury types were laceration (range, 36.7%-59.4%), fracture (range, 7.4%-43.3%), and concussion (range, 3.8%-20.4%). The most notable risk factors pertained to the outcome of bouts. Losers incurred 3 times as many injuries as winners, and fighters in bouts ending with knockout or technical knockout incurred more than 2 times as many injuries as fighters in bouts ending with submission. Conclusion: Notwithstanding the paucity of data, the injury incidence in MMA appears to be greater than in most, if not all, other popular and commonly practiced combat sports. In general, the injury pattern in MMA is very similar to that in professional boxing but unlike that found in other combat sports such as judo and taekwondo. More epidemiologic research is urgently needed to improve the accuracy of the injury incidence estimate, to determine the injury severity, and to identify more risk factors for injury in MMA.
Intracellular growth of Mycobacterium avium subspecies and global transcriptional responses in human macrophages after infection
Authors: Agdestein Angelika , Jones Anya , Flatberg Arnar , Johansen Tone B , Heffernan Inger Austrheim , Djønne Berit , Bosco Anthony , Olsen Ingrid 
Published: January 2014

Abstract

Background

Mycobacterium avium subsp. avium (Maa) and M. avium subsp. hominissuis (Mah) are environmental mycobacteria and significant opportunistic pathogens. Mycobacterium avium infections in humans and pigs are mainly due to Mah. It is not known whether this is caused by a difference in virulence or difference in exposure to the two subspecies. The aim of the present study was to investigate the ability of the M. avium subspecies to replicate intracellularly and to characterise the gene expression program triggered by infection of human primary macrophages.

Results
All isolates were able to invade and persist within human macrophages. However, intracellular replication was only evident in cells infected with the two Maa isolates. Transcriptional responses to the isolates were characterized by upregulation of genes involved in apoptosis, immune- and inflammatory response, signal transduction and NF-kB signaling, cell proliferation and T-cell activation. Although similar pathways and networks were perturbed by the different isolates, the response to the Maa subspecies was exaggerated, and there was evidence of increased activation of type I and II interferon signaling pathways.

Conclusion

Mycobacterium avium isolates of different genetic characteristics invaded monocytes and induced different degree of macrophage activation. Isolates of Maa were able to replicate intracellularly suggesting that differences in exposure, uptake or induction of adaptive immunity are more likely explanations for the difference in prevalence between M. avium subspecies.