bluuebunny/crossref_metadata_2025_split huggingface dataset:
Borderline femur fracture patients: early total care or damage control orthopaedics?
Authors: Nicholas Ben , Toth Laszlo , van Wessem Karlijn , Evans Julie , Enninghorst Natalie , Balogh Zsolt J. 
Published: December 2010

AbstractBackground:  A recent randomized controlled trial (RCT) favours damage control orthopaedics (DCO) over early total care (ETC) in the management of high‐energy femoral shaft fracture (FSF) patients with borderline physiology. The purpose of this study was to compare the borderline physiology FSF demographics, management and outcomes of a Level‐1 trauma centre, John Hunter Hospital (JHH) with those of the RCT.Methods:  A 41‐month study of the prospective FSF database was performed. FSF patients were categorized according to the Pape system. Stable (JHH‐S) and borderline (JHH‐BL) patients' demographics, injury severity, methods of treatment and outcomes were compared with the corresponding groups of the RCT (RCT‐S and RCT‐BL).Results:  Sixty‐six patients met the inclusion criteria of which 45 (68%) were in JHH‐S and 21 (32%) were in JHH‐BL group. In comparison, there were 121 (73%) RCT‐S and 44 (28%) RCT‐BL patients in the RCT study population. The demographics and injury severity were similar in the borderline groups, while JHH‐S patients were less severely injured. DCO was utilized more frequently in the RCT in both the stable group (JHH‐S: 2% versus RCT‐S: 41%), and the borderline group (JHH‐BL: 14% versus RCT‐BL: 48%). The outcomes between the JHH‐S and RCT‐S groups were comparable, except for intensive care unit (ICU) hours (JHH‐S: 20 ± 64 versus RCT‐S: 165 ± 187, P < 0.0001) and ventilator hours (JHH‐S: 13 ± 46 versus RCT‐S: 98 ± 120, P < 0.0001). Among borderline patients, JHH‐BL had a tendency to show a lower incidence of both acute respiratory distress syndrome (0% versus 14%) and multiple organ failure (4.8% versus 19.6%). JHH‐BL patients had sepsis less frequently (4.8% versus 24.5%, P < 0.05), fewer ICU hours (98 ± 129 versus 436 ± 347, P < 0.0001) and fewer ventilator hours (82 ± 119 versus 337 ± 305, P= 0.0005) compared with the RCT‐BL.Conclusions:  The incidence of S and BL patients, demographics and injury severity (among BL patients) is comparable with the RCT. Our current practice of employing predominantly ETC among S (98%) and BL (86%) patients results in shorter ICU and ventilator days, fewer septic complications and a potentially lower incidence of organ failure than in the RCT which had 57% overall utilization of ETC.
The Relationship Between Incidence of Fractures and Anemia in Older Multiethnic Women
Authors: Chen Zhao , Thomson Cynthia A. , Aickin Mikel , Nicholas J. Skye , Van Wyck David , Lewis Cora E. , Cauley Jane A. , Bassford Tamsen ,   Short list of Women's Health Initiative Investigators
Published: December 2010

OBJECTIVES: To prospectively examine the relationship between anemia and incident fractures of the hip, spine, and all skeletal sites in women from diverse racial and ethnic backgrounds enrolled in the Women's Health Initiative (WHI) Observational Study and Clinical Trials.DESIGN: Prospective cohort study.SETTING: Forty WHI clinical centers across the United States.PARTICIPANTS: Postmenopausal women (n=160,080), mean age 63.2 ± 7.2, were recruited and followed for an average of 7.8 years.MEASUREMENTS: Anemia was defined as hemoglobin levels at baseline less than 12 g/dL. All fractures were self‐reported. Trained physicians further confirmed hip fractures using medical records.RESULTS: Eight thousand seven hundred thirty‐nine of the participants (5.5%) were anemic. The age‐adjusted incidence rate of hip fractures per 10,000 person‐years was 21.4 in women with anemia and 15.0 in women without anemia; higher incidence rates for spine and all fractures were also observed in anemic women. After multiple covariates were included in the Cox proportional hazards models, significantly greater fracture risk associated with anemia still existed, as demonstrated by hazard ratios of fractures associated with anemia of 1.38 (95% confidence interval (CI)=1.13–1.68) for hip, 1.30 (95% CI=1.09–1.55) for spine, and 1.07 (95% CI=1.01–1.14) for all types. No significant racial or ethnic difference was found in these relationships.CONCLUSION: A significantly greater fracture risk was observed in multiethnic postmenopausal women with anemia. Given the high prevalence of anemia in the elderly population, it is important to better understand the relationship and mechanisms linking anemia to fracture risk.
A Randomized Controlled Trial of a Multifactorial Falls Prevention Intervention for Older Fallers Presenting to Emergency Departments
Authors: Russell Melissa A. , Hill Keith D. , Day Lesley M. , Blackberry Irene , Schwartz Jenny , Giummarra Melita J. , Dorevitch Michael , Ibrahim Joseph E. , Dalton Andrew C. , Dharmage Shyamali C. 
Published: December 2010

OBJECTIVES: To investigate the effect of a referral‐based targeted multifactorial falls prevention intervention on the occurrence of recurrent falls and injuries in older people presenting to an emergency department (ED) after a fall and discharged directly home from the ED.DESIGN: Randomized controlled trial. Assessors of outcomes were unaware of group allocation.SETTING: Seven EDs in metropolitan Melbourne, Australia.PARTICIPANTS: Inclusion criteria were community dwelling, aged 60 and older, presenting to an ED after a fall, and discharged directly home. Exclusion criteria were unable to follow simple instructions or walk independently.INTERVENTION: Targeted referrals to existing community services and health promotion recommendations, based on the falls risk factors found in a baseline assessment.MEASUREMENTS: Primary outcome measures were falls and resultant injuries occurring over the 12‐month follow‐up period. Falls and injury data were collected using falls calendars supported by medical record reviews.RESULTS: Three hundred sixty‐one participants were randomized to the standard care group and 351 to the intervention group. No significant difference was found between the two groups over the 12‐month follow‐up period in number of fallers (relative risk (RR)=1.11, 95% confidence interval (CI)=0.95–1.31] or number of participants sustaining an injury from a fall (RR=1.06, 95% CI=0.86–1.29).CONCLUSION: This study does not support the use of a referral‐based targeted multifactorial intervention program to reduce subsequent falls or fall injuries in older people who present to an ED after a fall.
Cross‐Situational Learning: An Experimental Study of Word‐Learning Mechanisms
Authors: Smith Kenny , Smith Andrew D. M. , Blythe Richard A. 
Published: December 2010

AbstractCross‐situational learning is a mechanism for learning the meaning of words across multiple exposures, despite exposure‐by‐exposure uncertainty as to the word's true meaning. We present experimental evidence showing that humans learn words effectively using cross‐situational learning, even at high levels of referential uncertainty. Both overall success rates and the time taken to learn words are affected by the degree of referential uncertainty, with greater referential uncertainty leading to less reliable, slower learning. Words are also learned less successfully and more slowly if they are presented interleaved with occurrences of other words, although this effect is relatively weak. We present additional analyses of participants’ trial‐by‐trial behavior showing that participants make use of various cross‐situational learning strategies, depending on the difficulty of the word‐learning task. When referential uncertainty is low, participants generally apply a rigorous eliminative approach to cross‐situational learning. When referential uncertainty is high, or exposures to different words are interleaved, participants apply a frequentist approximation to this eliminative approach. We further suggest that these two ways of exploiting cross‐situational information reside on a continuum of learning strategies, underpinned by a single simple associative learning mechanism.
Right‐to‐Left‐Shunt Detected by c‐TCD Using the Orbital Window in Comparison with Temporal Bone Windows
Authors: Kobayashi Kazuto , Kimura Kazumi , Iguchi Yasuyuki , Sakai Kenichirou , Aoki Junya , Iwanaga Takeshi , Shibazaki Kensaku 
Published: December 2010

ABSTRACTPURPOSEThere have been some reports on right‐to‐left shunt as a cause of cryptogenic stroke. Although contrast transcranial Doppler (c‐TCD) can detect RLS, an insufficient temporal window has occasionally restricted its applicability. Thus, we compared the rates of detecting RLS among temporal windows for the middle cerebral arteries (MCAs) and the orbital window for the internal carotid artery (ICA) on c‐TCD.METHODSWe used c‐TCD to detect RLS in patients with suspected ischemic stroke. We enrolled patients who had both sufficient bilateral temporal windows for MCAs and a right orbital window for ICA and performed c‐TCD using all three windows simultaneously.RESULTSWe enrolled 106 consecutive patients and identified microembolic signals (MES) in 30 (28%) of them. Among these 30 patients, 15 had MES from all 3 windows. When these 30 patients were defined as being positive for RLS, the rates of detection were 67%, 73%, and 80% from the right temporal, left temporal, and right orbital windows, respectively (P= .795).CONCLUSIONThe right orbital window as well as the temporal window for c‐TCD could detect RLS. Insonation from the orbital window should be useful for patients who lack temporal windows.
Defective CXCR4 expression in aged bone marrow cells impairs vascular regeneration
Authors: Shao Hongwei , Xu Qiyuan , Wu Qiuling , Ma Qi , Salgueiro Luis , Wang Jian’An , Eton Darwin , Webster Keith A. , Yu Hong 
Published: December 2010

AbstractThe chemokine stromal cell‐derived factor‐1 (SDF‐1) plays a critical role in mobilizing precursor cells in the bone marrow and is essential for efficient vascular regeneration and repair. We recently reported that calcium augments the expression of chemokine receptor CXCR4 and enhances the angiogenic potential of bone marrow derived cells (BMCs). Neovascularization is impaired by aging therefore we suggested that aging may cause defects of CXCR4 expression and cellular responses to calcium. Indeed we found that both the basal and calcium‐induced surface expression of CXCR4 on BMCs was significantly reduced in 25‐month‐old mice compared with 2‐month‐old mice. Reduced Ca‐induced CXCR4 expression in BMC from aged mice was associated with defective calcium influx. Diminished CXCR4 surface expression in BMC from aged mice correlated with diminished neovascularization in an ischemic hindlimb model with less accumulation of CD34+ progenitor cells in the ischemic muscle with or without local overexpression of SDF‐1. Intravenous injection of BMCs from old mice homed less efficiently to ischemic muscle and stimulated significantly less neovascularization compared with the BMCs from young mice. Transplantation of old BMCs into young mice did not reconstitute CXCR4 functions suggesting that the defects were not reversible by changing the environment. We conclude that defects of basal and calcium‐regulated functions of the CXCR4/SDF‐1 axis in BMCs contribute significantly to the age‐related loss of vasculogenic responses.
Addressing loneliness in a retirement village community: A pilot test of a print‐delivered intervention
Authors: Gracia Natalie , Moyle Wendy , Oxlade Deborah , Radford Katrina 
Published: December 2010

Aim:  To explore perceptions of a self‐help print‐delivered intervention aimed at encouraging social well‐being and addressing loneliness in a retirement village community.Method:  A total of 58 residents of an Australian retirement village received a series of five factsheets addressing various dimensions of loneliness.Results:  The factsheets raised awareness of the importance of social well‐being and loneliness. However, the approach was considered difficult to update and was not appropriate for those from a non‐English speaking background or with vision impairments. The non‐face‐to‐face approach also was unable to address issues of loneliness associated with bereavement.Conclusion:  This form of intervention offers a cost‐effective way to raise awareness of loneliness and social well‐being in a retirement village community when issues of updating and presentation of information are taken into consideration.
Development and testing of a questionnaire to measure older people's experience of the Transition Care Program in Australia
Authors: Masters Stacey , Giles Lynne , Halbert Julie , Crotty Maria 
Published: December 2010

Aim:  Transition Care (TC) is a new program for older adults in Australia. At present, program quality is assessed using provider reports of compliance with key requirements established by the Australian Government Department of Health and Ageing. As part of the National Evaluation of the Transition Care Program, the authors developed a questionnaire to measure recipient experience of TC.Method:  Validity and reliability were assessed via interviews with 582 recipients or proxies 3 months after discharge from TC.Results:  Concordance between test–retest observations was high. Principal component analysis suggested three subscales were important: restoration, continuity of care and patient involvement. Recipients of TC in a residential care setting had lower mean scores on the restoration subscale compared to those who received services in the community.Conclusion:  This study found that a standardised measure of recipient experience could inform quality improvement in TC and is feasible to administer via questionnaire.
Retrospective case note review of patients brought to Ipswich emergency department under mental health emergency examination orders: Does intoxication alter outcome?
Authors: Brierley Stephen , Baker Kylie , Brack Janet , Cunningham Sgt Peter 
Published: December 2010

AbstractObjective:  To alter staff perceptions, and to examine alternative management processes for intoxicated patients brought to Ipswich ED under mental health emergency examination orders by comparing disposition outcomes with non‐intoxicated patients.Methods:  Consultation‐Liaison mental health nursing staff completed surveys on all patients assessed under emergency examination orders over a 6 month period in 2008. Patients were classified as intoxicated if they recorded alcometer readings of greater than 0.05%, or self‐reported drug use during the events leading to their transport to the ED. Outcomes were retrospectively collated with entries in Clinical Liaison nursing logbooks. Outcome measures recorded were rates of admission, outpatient referrals to the Integrated Mental Health Service, follow up by other community services or no follow up. Differences in outcomes for intoxicated and non‐intoxicated patient groups were tested for significance using χ2 or Fisher's exact test.Results:  One hundred and sixty‐eight cases were included in the audit. No cases were excluded. Sixty patients were identified as intoxicated. The age and sex distributions were similar between intoxicated and non‐intoxicated patients. There were no significant differences in admission or referral rates. The average length of assessment time in the ED was longer in the intoxicated group.Discussion:  This audit showed similar outcomes for both patient groups contrary to the perceptions expressed by ED staff in informal surveys. The admission and referral rate for both groups indicate they are an at‐risk population. The admission rate of 16% has led to this department negotiating alternative accommodation for patients while they sober up.
The comparative pharmacokinetics of modified‐release and immediate‐release paracetamol in a simulated overdose model
Authors: Chiew Angela , Day Peter , Salonikas Chris , Naidoo Daya , Graudins Andis , Thomas Rebecca 
Published: December 2010

AbstractBackground:  Panadol Extend (PEx) is an over‐the‐counter, modified‐release formulation of paracetamol. Each 665 mg tablet contains 69% slow‐release and 31% immediate‐release paracetamol. In simulated human overdose, PEx exhibits lower and later peak serum concentrations and a lower area‐under‐the‐curve (AUC) than comparable doses of immediate‐release paracetamol (APAP‐IR). The lower AUC might result from incomplete absorption of paracetamol or simultaneous metabolism with absorption.Objective:  Do differences in pharmacokinetics (PK) between PEx and APAP‐IR result from incomplete absorption or simultaneous absorption and metabolism of paracetamol?Methods:  Cross‐over study of 80 mg/kg of PEx or APAP‐IR in nine volunteers. Serial plasma paracetamol, glucuronide, sulphate and cysteine metabolite estimates performed over 24 h. Peak plasma concentration (Cmax), AUC(0–∞), time to peak concentration (Tmax) and elimination half‐life (t1/2) were compared.Results:  PEx exhibited significantly lower paracetamol Cmax (252.33 µmol/L vs 565.56 µmol/L, P= 0.0421), AUC(0–∞) (2133 µmol/h/L vs 2637 µmol/h/L, P= 0.0004) and delayed Tmax (2.889 h vs 1.389 h, P= 0.0189) than APAP‐IR. Sulphate metabolite PK parameters for both preparations, PEx vs APAP‐IR, showed similar AUC(0–∞) (1369 µmol/h/L vs 1089 µmol/h/L), Tmax (3.889 h vs 4.444 h), Cmax (95.889 µmol/L vs 95.889 µmol/L) and t1/2 (3.895 h vs 3.810 h). Glucuronide metabolite concentrations revealed that PEx produced a lower Cmax (257.44 µmol/L vs 335.22 µmol/L, P= 0.0239) than APAP‐IR. All other pharmacokinetic parameters were similar. Cysteine metabolite was not detected.Conclusion:  There were minor differences between the PK parameters of the two major paracetamol metabolites of these two preparations in simulated overdose. The variability in paracetamol AUC seen between the two preparations in moderate overdose might be explained by concurrent metabolism of paracetamol during slower absorption with PEx.
Spontaneous pneumoperitoneum: Diagnostic and management difficulties
Authors: Mann Caroline M , Bhati Chandra S , Gemmell David , Doyle Peter , Gupta Vibhore , Gorman David F 
Published: December 2010

AbstractAcute abdominal pain is a common presentation to the ED. Most patients undergo a chest radiograph as part of their initial investigations, which occasionally reveals pneumoperitoneum. Pneumoperitoneum on imaging suggests a perforated hollow abdominal viscus and therefore often constitutes a surgical emergency. However, if the patient is neither peritonitic nor septic a management dilemma is faced. Some cases of pneumoperitoneum might be managed conservatively thus avoiding unnecessary laparotomy. We present a case of recurrent spontaneous pneumoperitoneum with abdominal pain that was managed conservatively and discuss the possible aetiologies and management issues of spontaneous pneumoperitoneum.
Monitoring standing herbage on granitic soils in the Big Horn Mountains, Wyoming, USA
Authors: Uresk Daniel W. , Juntti Tom , Javersak Jody 
Published: December 2010

AbstractMonitoring annual herbage use in rangelands is desirable for scientific management but problematic due to the difficulty and expense of making direct measurements of sufficient precision. We used a Robel pole with 1.27 cm alternating white and gray bands to indirectly measure standing herbage. This technique enables a smooth transition in the basis of annual use monitoring from percent use to residual herbage and overcomes the difficulties alluded to above. Our study was conducted in the southern Bighorn National Forest, Wyoming on granitic soils and within the Idaho fescue (Festuca idahoensis Elmer) vegetation type. The objectives were to develop and validate the relationship between Robel pole visual obstruction readings and clipped standing herbage, and develop guidelines for monitoring and estimation of optimum sample size. Clipped standing herbage ranged from 134 to 3792 kg dry matter (DM) ha−1 with a mean of 1558 kg DM ha−1. Visually obstructed bands (band = 1.27 cm) averaged 6.1 and ranged from 0.2 to 19.5. Approximately 75% of the variation in standing herbage was explained by linear regression on visual obstruction measurements. Both intercept and slope of the regression were highly significant (P = 0.001). The standard error of the estimate for a single observation was 458 kg DM ha−1. Cluster analyses grouped the visual obstruction readings into four management categories. This monitoring tool provides pertinent information for managers to develop guidelines based on band and/or standing herbage for natural areas, wildlife and livestock use.
Testing genetic algorithm as a tool to select relevant wavebands from field hyperspectral data for estimating pasture mass and quality in a mixed sown pasture using partial least squares regression
Authors: Kawamura Kensuke , Watanabe Nariyasu , Sakanoue Seiichi , Lee Hyo‐Jin , Inoue Yoshio , Odagawa Shinya 
Published: December 2010

AbstractIt is now accepted that partial least squares (PLS) regression with waveband selection might improve their predictive accuracy in multivariate calibration of models to describe pasture mass and quality. Recently, genetic algorithm (GA) has been shown to be a suitable method for selecting wavebands in the laboratory calibrations. This study aimed to investigate the performance of genetic algorithms PLS (GA‐PLS) regression analyses for estimating green forage biomass (GBM), neutral detergent fiber (NDF), acid detergent fiber (ADF), acid detergent lignin (ADL) and crude protein (CP) concentrations of herbage and herbage mass in CP (CPm) from field hyperspectral data at canopy scale. The predictive ability of GA‐PLS was compared with that of iterative stepwise elimination PLS (ISE‐PLS) and standard full‐spectrum PLS (FS‐PLS), using first derivative reflectance (FDR) spectra data. Canopy reflectance measurements and plant sampling were obtained from 50 selected sites in each of two seasons; spring (May) and summer (July) 2007. For all parameters, cross‐validated coefficients of determination (R2) increased and root mean square error values decreased, respectively, with GA wavebands selection. The number of wavebands selected in the GA‐PLS model ranged between 63 (4.0% of all 1563 available wavebands) and 167 (10.7%), suggesting that over 89% of wavebands were redundant. Between ISE‐PLS and GA‐PLS models, higher R2 values and lower root mean squared errors of prediction were obtained from GA‐PLS prediction for all parameters except CP concentration. Particularly, GA based waveband selection greatly improved ADF (R2 = 0.68–0.77) and ADL (R2 = 0.47–0.59) predictions. These results suggest that pasture quality and GBM can be predicted from field hyperspectral measurements using a GA‐PLS model, and that the GA‐PLS has the advantage of tuning the optimum bands for PLS regression, giving better predictive ability.
Determination of serum biochemistry reference intervals in a large sample of adult greyhounds
Authors: Dunlop M. M. , Sanchez‐Vazquez M. J. , Freeman K. P. , Gibson G. , Sacchini F. , Lewis F. 
Published: December 2010

Background: As large breed, highly muscled dogs, greyhounds are regarded as physiologically different to other breeds. Biochemistry reference intervals have previously been determined using small numbers of greyhounds or based on the observations from racing dogs. Objectives: The purpose of this study was to develop statistically defined reference intervals for biochemical analytes in healthy non‐racing greyhounds. Partitioning according to gender was also examined. Methods: Biochemical analytes from a population of non‐racing healthy greyhounds, including 269 males, 202 females and 28 dogs where gender had not been recorded, were examined using a non‐parametric statistical approach. The dogs were aged between one and nine years old. Results: Total protein, albumin, globulin and creatinine reference intervals differed from generic reference intervals used for dogs. The reference intervals for greyhounds in this study are similar to those obtained by other studies of greyhounds, but often had a narrower range of values, likely reflecting more accurate estimation associated with larger numbers of reference individuals. Recommended methods for assessment of partitioning do not indicate a need to partition according to gender.