bluuebunny/crossref_metadata_2025_split huggingface dataset:
The kinematics of Heteroptera in free flight
Authors: Betts C. R. 
Published: September 2010

The kinematics of six species of Heteroptera in free flight are analysed and compared.

Using nested analysis of variance techniques, statistically significant variation was detected between species for several of the flight parameters measured: mean angular velocity; pronation/supination ratio; upstroke/downstroke ratio; and wing beat frequency. In each case this is discussed in terms of variation in flight behaviour.
Beneficial aerodynamic forces are generated during the upstroke and the downstroke, in both fast forward and rising flight.
When the insects change from level, forward flight to near vertical, rising flight, the following parameters are altered in most of the sequences analysed:

the stroke plane angle becomes steeply, negatively inclined, associated with an increase in body angle;
the stroke amplitude is reduced;
wing beat frequency is lowered, associated with a drop in mean angular velocity;
the speed of stroke reversal (rotational velocity) is increased. This may be associated with increased wing torsion and tip flexion which in turn could improve any beneficial unsteady aerodynamic effects generated at stroke reversal.

The reasons for this change in flight performance and the deviations from that seen in other insects are discussed.It is shown that Heteroptera may make use of wing drag in flight, particularly during rising flight.
Clinical trial: the efficacy of open‐label prucalopride treatment in patients with chronic constipation – follow‐up of patients from the pivotal studies
Authors: Camilleri M. , Van Outryve M. J. , Beyens G. , Kerstens R. , Robinson P. , Vandeplassche L. 
Published: September 2010

Aliment Pharmacol Ther 2010; 32: 1113–1123SummaryBackground  Prucalopride is approved in Europe for symptomatic treatment of chronic constipation in women with inadequate relief from laxatives.Aim  To evaluate efficacy of prucalopride during long‐term treatment of patients with chronic constipation.Methods  Patients from three pivotal double‐blind, placebo‐controlled, 12‐week studies with prucalopride could continue treatment in open‐label studies up to 24 months. Efficacy was evaluated every 3 months using the Patient Assessment of Constipation‐Quality of Life (PAC‐QOL) satisfaction scale. Laxative use and reasons for study discontinuation were recorded.Results  Eighty‐six percent of patients who completed the pivotal studies continued prucalopride treatment in the open‐label studies (n = 1455, 90% female). Improvement in average PAC‐QOL satisfaction score observed after 12‐week, double‐blind prucalopride was maintained during open‐label treatment for up to 18 months; in each 3 month period, 40–50% of patients did not use any laxatives. Most frequent adverse events (AEs) resulting in discontinuation were gastrointestinal events (3.3%) and headache (1.0%). Only 10% of patients who had normalized bowel function on prucalopride at the end of pivotal trials discontinued due to insufficient response during open‐label treatment.Conclusion  Satisfaction with bowel function is maintained for up to 18 months of treatment with prucalopride. Gastrointestinal events and headache cause discontinuation of prucalopride treatment in ∼5% of patients (ClinicalTrials.gov identifiers: NCT01070615 and NCT00987844).
Divergent resistance to a monogenean flatworm among three‐spined stickleback populations
Authors: de Roij Job , Harris Philip D. , MacColl Andrew D. C. 
Published: September 2010

Summary1. Given their ubiquity, we might expect parasites to play an important role in the adaptive divergence of host populations. Specifically, adaptation to local parasite communities is predicted to influence the evolution of a number of host traits such as parasite resistance.2. To investigate the possibility that divergent parasite‐mediated selection drives population‐level variation in parasite resistance, we artificially infected lab‐reared three‐spined sticklebacks with the monogenean flatwormGyrodactylus gasterostei. The fish were derived from five populations from North Uist, Scotland, that were chosen because they differed in natural infection levels ofGyrodactylus arcuatus.3. We found substantial differences in resistance toG. gasterosteiamong populations. Resistance was defined largely by the ability to limit the size of the worm population rather than by the timing of the host response.4. Experimental resistance was not significantly correlated with natural infection levels ofG. arcuatus. However, in general, populations with greater exposure toG. arcuatuswere shown to be more resistant toG. gasterostei. Fish from the only naturally unexposed population showed the highest susceptibility, which may be the result of less selection to maintain resistance.5. Taken together, these results suggest that the divergent selection mediated byGyrodactylusmay play a role in driving population‐level variation in resistance to this parasite.
In vivo models for early development of colorectal liver metastasis
Authors: Robertson John H. P. , Sarkar Sandip , Yang Shi Yu , Seifalian Alexander M. , Winslet Marc C. 
Published: September 2010

SummaryIn Europe, colorectal cancer is the second most prevalent form of cancer diagnosed. Globally each year, almost one million cases of colorectal cancer are registered and almost half a million deaths are attributed to this disease. This high mortality is associated with the development of liver metastases. For oncological advances to occur, accurate in vivo models are required to study colorectal cancer metastasis development. These models, by increasing our understanding of the early stages of colorectal liver establishment, will facilitate the development of novel therapeutic interventions and allow the clinical effects of these interventions to be studied. By analysis of current in vivo models for early development of colorectal liver metastasis, this review examines available methods of the tumour cell preparation, introduction and monitoring in vivo. An insight into the technical problems which can occur will be discussed. The implications of these different techniques on the resulting metastasis picture will be analysed. Existing in vivo models are assessed regarding the accuracy of the metastatic picture they portray.
Turbulent blood flow plays an essential localizing role in the development of atherosclerotic lesions in experimentally induced hypercholesterolaemia in rats
Authors: Prado Cibele M. , Ramos Simone G. , Elias Jorge , Rossi Marcos A. 
Published: September 2010

SummaryTaking into account that atherosclerosis is a focal disease and high levels of plasma cholesterol are closely correlated with its pathogenesis, it is a challenge to explain how equal concentrations of cholesterol bathing the endothelium can produce local, rather than global, effects on arteries. The focal distribution of atherosclerotic lesions has been considered to be dependent, at least in part, on hydrodynamic factors. The present study was carried out to further test the hypothesis that these forces are an important localizing factor in rats feeding a hypercholesterolaemic diet and submitted to infra‐diaphragmatic aortic constriction. These animals develop a normotensive prestenotic region with laminar blood flow that serves as control for a normotensive poststenotic region with turbulent blood flow. Our findings clearly demonstrated that the combination of turbulent blood flow and low wall shear stress (WSS) in the presence of hypercholesterolaemia and oxidative stress creates conditions to the formation of focally distributed incipient atherosclerotic lesions observed in the poststenotic segment. In contrast, only diffuse fatty streaks could be observed in the normotensive prestenotic segment with laminar blood flow and normal WSS in the presence of hypercholesterolaemia and oxidative stress. Although haemodynamic forces are not by themselves responsible for the pathogenesis of atherosclerosis, they prime the local vascular wall in which the lesion develop. Further studies are required to establish how haemodynamic forces are detected and transduced into chemical signalling by the cells of the artery wall and then converted into pathophysiologically relevant phenotypic changes.
Improving the organization of consultation departments in university hospitals
Authors: Dechartres Agnès , Mazeau Valérie , Grenier‐Sennelier Catherine , Brézin Antoine P. , Vidal‐Trecan Gwenaelle M. 
Published: September 2010

AbstractRationale  Changes in the demography of doctors require changes in care practices.Objectives  The aim of this study was to identify factors associated with doctors’ workload in the ophthalmology consultation department of a university hospital, with a view to developing methods to improve the organization of hospital outpatient clinics.Methods  A 10‐day cross‐sectional survey was carried out in an ophthalmology outpatient clinic (in‐ and outpatient consultations, including emergencies) specializing in the uveitis care. Demographic and management data for each patient were collected on a structured form. The doctor’s workload was assessed, using a scale taking into account the duration of the consultation and the number of diagnostic tests performed, as a function of management complexity.Results  Of the 861 consultations studied, 39.7% were highly complex. The level of complexity of consultations was correlated with the type of referral (phi = 0.602), consultation duration (phi = 0.545), the number of consultations in the previous year (phi = 0.499), and the number of diagnostic tests performed (phi = 0.445). Consultations were longer and diagnostic tests were more frequently performed if patients had been referred by an ophthalmologist, consulted a faculty doctor or a fellow, or presented with uveitis. Consultations were also more complex for patients with at least four previous consultations in the past year.Conclusions  Type of referral, status of the attending doctor and number of consultations within the course of 1 year were associated with doctors’ workload and could be taken into account to predict the duration of complexity of consultations when scheduling appointments.
Validation of the German Glasgow children’s benefit inventory
Authors: Schwentner Ilona , Schwentner Christian , Schmutzhard Joachim , Radmayr Christian , Grabher Gudrun , Sprinzl Georg , Höfer Stefan 
Published: September 2010

AbstractObjective  The aim of this study was to validate the German Glasgow Children’s Benefit Inventory (GCBI) in children with different surgical interventions.Material and methods  The GCBI was translated by using accepted forward–backward translation techniques and mailed to 741 parents whose children underwent either an otorhinolaryngological (n = 641) or an urological intervention (n = 100). The assessment was performed in a retrospective manner at the Medical University Innsbruck, Austria between January and March 2006. An exploratory principal component factor analysis with varimax rotation using factor loadings of ≥0.40 to allocate items to a scale was performed. Frequencies, means and standard deviations were used to describe patient, clinical, sociodemographic, and scale characteristics.Results  The questionnaire was completed and returned by 325 patients (43.9%). The GCBI showed a high internal consistency (α = 0.84). The four‐factor solution, emotional, vitality, learning and physical health explained 55.7% of variance.Conclusion  The German version of the GCBI was proven to be valid and reliable. It is suitable for subjective outcome analysis of different paediatric interventions from infants to adolescents.
Evaluating effectiveness of preoperative testing procedure: some notes on modelling strategies in multi‐centre surveys
Authors: Gregori Dario , Lusa Lara , Rosato Rosalba , Silvestri Luciano 
Published: September 2010

AbstractRationale  In technology assessment in health‐related fields the construction of a model for interpreting the economic implications of the introduction of a technology is only a part of the problem. The most important part is often the formulation of a model that can be used for selecting patients to submit to the new cost‐saving procedure or medical strategy. The model is usually complicated by the fact that data are often non‐homogeneous with respect to some uncontrolled variables and are correlated. The most typical example is the so‐called hospital effect in multi‐centre studies.Aims and objectives  We show the implications derived by different choices in modelling strategies when evaluating the usefulness of preoperative chest radiography, an exam performed before surgery, usually with the aim to detect unsuspected abnormalities that could influence the anaesthetic management and/or surgical plan.Method  We analyze the data from a multi‐centre study including more than 7000 patients. We use about 6000 patients to fit regression models using both a population averaged and a subject‐specific approach. We explore the limitations of these models when used for predictive purposes using a validation set of more than 1000 patients.Results  We show the importance of taking into account the heterogeneity among observations and the correlation structure of the data and propose an approach for integrating a population‐averaged and subject specific approach into a single modeling strategy. We find that the hospital represents an important variable causing heterogeneity that influences the probability of a useful POCR.Conclusions  We find that starting with a marginal model, evaluating the shrinkage effect and eventually move to a more detailed model for the heterogeneity is preferable. This kind of flexible approach seems to be more informative at various phases of the model‐building strategy.
The uptake of technologies designed to influence medication safety in Canadian hospitals
Authors: Saginur Michael , Graham Ian D. , Forster Alan J. , Boucher Michel , Wells George A. 
Published: September 2010

AbstractBackground  There are many technologies designed to improve medication safety. Although limited evidence supports their use, there are pressures to implement them.Objective  To determine the uptake of technologies designed to improve medication safety, plans for adopting technologies, attitudes towards technology use, and perceptions of medication error.Methods  We performed a cross‐sectional survey of pharmacy directors at Canada’s 100 largest acute‐care hospitals.Results  Seventy‐eight per cent of surveyed hospitals responded. Responding hospitals averaged 499 beds and 29% were teaching facilities. Hospital frequently used clinical pharmacy services (97% of hospitals), pharmacy‐based intravenous admixture services (81%), computerized decision support modules for pharmacy order entry systems (77%), unit‐dose drug distribution systems (75%) and computerized medication administration records (67%). Hospitals infrequently used bar‐coding (9% of hospitals) and computerized physician order entry (9%). A majority of respondents and hospitals favoured expanded use of new technologies and planned for increased uptake. Respondents chose as their hospital’s next investment: automated dispensing (33%), bar‐coding (25%) and computerized physician order entry (12%).Conclusion  Canadian hospitals appear poised to make sizeable investments in poorly evaluated technologies that address medication safety.
Project management can help to reduce costs and improve quality in health care services
Authors: Sa Couto Joaquim 
Published: September 2010

AbstractRationale, aims and objectives  Health care spending has increased steadily over the last 50 years, but there is a consensus that this trend cannot continue indefinitely. The ideal solution would bring about cost reductions coupled with improvements in quality, but this has remained an elusive goal. In this article, a novel idea is proposed that consists of adopting a project type of production in health care, instead of the current mass production methods used in the modern ‘health care factories’.Methods  The author demonstrates that health care services in general, and medical services in particular, fit the category of projects. This is accomplished through a comprehensive study of the main features of projects and medical services and a comparative analysis.Results and Conclusion  The author infers that the productivity gains brought by project management to so many other human endeavours can be brought to health care. It is also claimed that if project management is adopted in health care, then physicians would be the natural project managers because of their proficiency with the casuistic method (one‐off, non‐repetitive production) and because of their experience in ‘managing’ their patient’s cases that is indeed what doctors have been doing for as long as their profession exists.
Illness severity and total visits in family medicine
Authors: Rohrer James E. , Rasmussen Norman , Adamson Steven A. 
Published: September 2010

AbstractObjective  The purpose of this study was to estimate the independent effect of clinical severity on visit utilization by family medicine patients so that disease management programmes can be targeted accurately and immediately towards patients most likely to benefit from them.Design  A convenience sample of 698 primary care patients was analysed. All patients had been referred to a medical specialist. Utilization of all types of medical services including laboratory, radiology and ancillary services was used to classify patients as high‐utilizers (the top 20%) or not high‐utilizers. Patients were stratified into three severity categories based on point scores assigned to specific diseases. The diagnoses included in the Charlson severity index were used to score each patient and the Charlson point scores were used to measure severity. The odds of being a high‐utilizer were adjusted for severity category and demographic variables.Results  Severity was independently related to the odds of being a high‐user (adjusted odds ratio = 2.7 for severity = 1 and 5.7 for severity = 2, with the reference category being severity = 0). Age was related to high‐use in univariate analyses but not in multivariate analyses.Conclusions  Case management programmes in primary care practices should consider using disease severity to identify cases. Severity data can be abstracted by medical secretaries who review narrative problem lists as well as billing codes.
Patient‐based evaluations of primary care for cardiovascular diseases: a comparison between conventional and complementary medicine
Authors: Matter‐Walstra Klazien , Schoeni‐Affolter Franziska , Widmer Marcel , Busato André 
Published: September 2010

AbstractBackground  Patients with chronic diseases, including cardiovascular conditions, increasingly rely on complementary and alternative medical (CAM) therapies.Objectives  The Swiss Program for Complementary Medicine Evaluation offers a unique opportunity to analyse cardiovascular patients’ satisfaction with CAM and conventional medical (COM) therapies. The treatment choices of doctors certified in conventional as well as complementary therapies also could be studied.Methods  A national observational evaluation on treatment satisfaction of patients consulting COM or CAM doctors. Out of this evaluation project, data related to patients with cardiovascular diseases were specifically analysed for patient satisfaction with treatment and outcome when treated by COM or CAM doctors.Results  Of 199 included doctors (78 COM, 121 CAM) treating cardiovascular patients, COM doctors treated twice as many cardiovascular patients per doctor than CAM doctors. CAM doctors treated less than 1/3 of their cardiovascular patients solely by CAM, while they treated 42% exclusively by COM therapies. Patients seeing a CAM doctor had a significantly longer consultation and were more likely to be highly satisfied with overall treatment outcome and patient‐practitioner communication. Moreover, patients seeing a CAM doctor and being treated solely by a CAM therapy more often report ‘complete fulfilment of outcome expectation’ and ‘high overall satisfaction with treatment’, although their symptoms less often disappear totally than those of COM therapy‐treated patients.Conclusion  CAM therapies are not the first treatment choice for cardiovascular diseases. However, even though CAM doctors preferentially apply COM therapies, cardiovascular patients treated by CAM doctors are more likely to be satisfied with the overall treatment outcome, possibly because of the longer and better patient–practitioner interaction.
Our genes are not our destiny: incorporating molecular medicine into clinical practice
Authors: Genuis Stephen J. 
Published: September 2010

AbstractIn many developed nations, the state of publicly administered health care is increasingly precarious as a result of escalating numbers of chronically ill patients, inadequate medical personnel and hospital facilities, as well as sparse funding for ongoing upgrades to state‐of‐the‐art diagnostic and therapeutic technology – an increased emphasis on aetiology‐centred medicine should be considered in order to achieve improved health for patients and populations. Medical practice patterns which are designed to provide quick and effective amelioration of signs and symptoms are frequently not an enduring solution to many health afflictions and chronic disease states. Recent scientific discovery has rendered the drug‐oriented algorithmic paradigm commonly found in contemporary evidence‐based medicine to be a reductionist approach to clinical practice. Unfolding evidence appears to support a genetic predisposition model of health and illness rather than a fatalistic predestination construct – modifiable epigenetic and environmental factors have enormous potential to influence clinical outcomes. By understanding and applying fundamental clinical principles relating to the emerging fields of molecular medicine, nutrigenomics and human exposure assessment, doctors will be empowered to address causality of affliction when possible and achieve sustained reprieve for many suffering patients.
Optimizing the design of visual analogue scales for assessing quality of life: a semi‐qualitative study among Chinese‐speaking Singaporeans
Authors: Wee Hwee‐Lin , Fong Kok‐Yong , Tse Connie , Machin David , Cheung Yin‐Bun , Luo Nan , Thumboo Julian 
Published: September 2010

AbstractObjectives  Current recommendations for visual analogue scale (VAS) design are largely derived from studies on pain assessment. We evaluated respondent preferences for VAS design for health‐related quality of life (HRQoL) assessment.Methods  In‐depth interviews were conducted among Chinese‐speaking rheumatology outpatients and caregivers (age ≥ 21 years) to determine preferences for the following: (1) VAS orientation (horizontal/vertical); (2) length of instructions (long/intermediate/short); (3) scale range (0–10/0–100 points); (4) indicator for computerized touchscreen VAS (bar/column). Responses in subjects expressing a preference were compared using tests of proportions.Results  Among 101 subjects, more subjects preferred a horizontal over a vertical format (48 vs. 37, P = 0.23; 16 no preference), and intermediate length over long/short instructions (44 vs. 14 vs. 31, P = 0.004; 12 no preference). A scale range of 0–10 was preferred over 0–100 (62 vs. 21, P < 0.001; 18 no preference). A bar indicator was preferred over a column for computerized touchscreen VAS (54 vs. 44, P = 0.31; 3 no preference). Only presence of chronic medical conditions influenced subject preference [odds ratio (95% confidence interval): 3.9 (1.6–9.6), P = 0.002].Conclusion  Chinese‐speaking subjects preferred a 0–10‐point VAS with intermediate length instructions for HRQoL assessment. Thus, a 0–10‐point VAS with intermediate length instructions may be more useful for HRQoL assessment among Chinese subjects.