bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct costs associated with the appropriateness of hospital stay in elderly population
Authors: Mould-Quevedo Joaquín F , García-Peña Carmen , Contreras-Hernández Iris , Juárez-Cedillo Teresa , Espinel-Bermúdez Claudia , Morales-Cisneros Gabriela , Sánchez-García Sergio 
Published: August 2009

AbstractBackgroundAgeing of Mexican population implies greater demand of hospital services. Nevertheless, the available resources are used inadequately. In this study, the direct medical costs associated with the appropriateness of elderly populations hospital stay are estimated.MethodsAppropriateness of hospital stay was evaluated with the Appropriateness Evaluation Protocol (AEP). Direct medical costs associated with hospital stay under the third-party payer's institutional perspective were estimated, using as information source the clinical files of 60 years of age and older patients, hospitalized during year 2004 in a Regional Hospital from the Mexican Social Security Institute (IMSS), in Mexico City.ResultsThe sample consisted of 724 clinical files, with a mean of 5.3 days (95% CI = 4.9–5.8) of hospital stay, of which 12.4% (n = 90) were classified with at least one inappropriate patient day, with a mean of 2.2 days (95% CI = 1.6 – 2.7). The main cause of inappropriateness days was the inexistence of a diagnostic and/or treatment plan, 98.9% (n = 89). The mean cost for an appropriate hospitalization per patient resulted in US$1,497.2 (95% CI = US$323.2 – US$4,931.4), while the corresponding mean cost for an inappropriate hospitalization per patient resulted in US$2,323.3 (95% CI = US$471.7 – US$6,198.3), (p < 0.001).ConclusionElderly patients who were inappropriately hospitalized had a higher rate of inappropriate patient days. The average of inappropriate patient days cost is considerably higher than appropriate days. In this study, inappropriate hospital-stay causes could be attributable to physicians and current organizational management.
Audience effects in the Atlantic molly (Poecilia mexicana)–prudent male mate choice in response to perceived sperm competition risk?
Authors: Ziege Madlen , Mahlow Kristin , Hennige-Schulz Carmen , Kronmarck Claudia , Tiedemann Ralph , Streit Bruno , Plath Martin 
Published: August 2009

Abstract

Background
Multidirectional interactions in social networks can have a profound effect on mate choice behavior; e.g., Poecilia mexicana males show weaker expression of mating preferences when being observed by a rival. This may be an adaptation to reduce sperm competition risk, which arises because commonly preferred female phenotypes will receive attention also from surrounding males, and/or because other males can copy the focal male's mate choice. Do P. mexicana males indeed respond to perceived sperm competition risk? We gave males a choice between two females and repeated the tests under one of the following conditions: (1) an empty transparent cylinder was presented (control); (2) another ("audience") male inside the cylinder observed the focal male throughout the 2nd part, or (3) the audience male was presented only before the tests, but could not eavesdrop during the actual choice tests (non-specific sperm competition risk treatments); (4) the focal male could see a rival male interact sexually with the previously preferred, or (5) with the non-preferred female before the 2nd part of the tests (specific sperm competition risk treatments).

Results
The strength of individual male preferences declined slightly also during the control treatment (1). However, this decrease was more than two-fold stronger in audience treatment (2), i.e., with non-specific sperm competition risk including the possibility for visual eavesdropping by the audience male. No audience effect was found in treatments (3) and (5), but a weak effect was also observed when the focal male had seen the previously preferred female sexually interact with a rival male (treatment 4; specific sperm competition risk).

Conclusion
When comparing the two 'non-specific sperm competition risk' treatments, a very strong effect was found only when the audience male could actually observe the focal male during mate choice [treatment (2)]. This suggests that focal males indeed attempt to conceal their mating preferences so as to prevent surrounding males from copying their mate choice. When there is no potential for eavesdropping [treatment (3)], non-specific specific sperm competition risk seems to play a minor or no role. Our results also show that P. mexicana males tend to share their mating effort more equally among females when the resource value of their previously preferred mate decreases after mating with a rival male (perceived specific sperm competition risk), but this effect is comparatively weak.
Efficacy and safety of bilateral continuous theta burst stimulation (cTBS) for the treatment of chronic tinnitus: design of a three-armed randomized controlled trial
Authors: Arfeller Carola , Vonthein Reinhard , Plontke Stefan K , Plewnia Christian 
Published: August 2009

Abstract

Background
Tinnitus, the perception of sound and noise in absence of an auditory stimulus, has been shown to be associated with maladaptive neuronal reorganization and increased activity of the temporoparietal cortex. Transient modulation of tinnitus by repetitive transcranial magnetic stimulation (rTMS) indicated that these areas are critically involved in the pathophysiology of tinnitus and suggested new treatment strategies. However, the therapeutic efficacy of rTMS in tinnitus is still unclear, individual response is variable, and the optimal stimulation area disputable. Recently, continuous theta burst stimulation (cTBS) has been put forward as an effective rTMS protocol for the reduction of pathologically enhanced cortical excitability.

Methods
48 patients with chronic subjective tinnitus will be included in this randomized, placebo controlled, three-arm trial. The treatment consists of two trains of cTBS applied bilaterally to the secondary auditory cortex, the temporoparietal associaction cortex, or to the lower occiput (sham condition) every working day for four weeks. Primary outcome measure is the change of tinnitus distress as quantified by the Tinnitus Questionnaire (TQ). Secondary outcome measures are tinnitus loudness and annoyance as well as tinnitus change during and after treatment. Audiologic and speech audiometric measurements will be performed to assess potential side effects. The aim of the present trail is to investigate effectiveness and safety of a four weeks cTBS treatment on chronic tinnitus and to compare two areas of stimulation. The results will contribute to clarify the therapeutic capacity of rTMS in tinnitus.

Trial registration
The trial was registered with the clinical trials register of http://www.clinicaltrials.gov (NCT00518024).
Salvage of failed free flaps used in head and neck reconstruction
Authors: Novakovic Daniel , Patel Rajan S , Goldstein David P , Gullane Patrick J 
Published: August 2009

Abstract
Free flap success rates are in excess of 95%. Vascular occlusion (thrombosis) remains the primary reason for flap loss, with venous thrombosis being more common than arterial occlusion. The majority of flap failures occur within the first 48 hours. With early recognition and intervention of flap compromise salvage is possible. Successful salvage rates range from 28% to over 90%. Rapid re-exploration in this clinical setting is crucial to maximise the chances of flap salvage. If salvage is not feasible or unsuccessful then non-surgical methods of salvage may be employed with some possibility of success. The purpose of this article is to review the causes of free flap failure and to highlight the available options for salvage.
Community-wide analysis of microbial genome sequence signatures
Authors: Dick Gregory J , Andersson Anders F , Baker Brett J , Simmons Sheri L , Thomas Brian C , Yelton A Pepper , Banfield Jillian F 
Published: August 2009

Abstract
Background
Analyses of DNA sequences from cultivated microorganisms have revealed genome-wide, taxa-specific nucleotide compositional characteristics, referred to as genome signatures. These signatures have far-reaching implications for understanding genome evolution and potential application in classification of metagenomic sequence fragments. However, little is known regarding the distribution of genome signatures in natural microbial communities or the extent to which environmental factors shape them.

Results
We analyzed metagenomic sequence data from two acidophilic biofilm communities, including composite genomes reconstructed for nine archaea, three bacteria, and numerous associated viruses, as well as thousands of unassigned fragments from strain variants and low-abundance organisms. Genome signatures, in the form of tetranucleotide frequencies analyzed by emergent self-organizing maps, segregated sequences from all known populations sharing < 50 to 60% average amino acid identity and revealed previously unknown genomic clusters corresponding to low-abundance organisms and a putative plasmid. Signatures were pervasive genome-wide. Clusters were resolved because intra-genome differences resulting from translational selection or protein adaptation to the intracellular (pH ~5) versus extracellular (pH ~1) environment were small relative to inter-genome differences. We found that these genome signatures stem from multiple influences but are primarily manifested through codon composition, which we propose is the result of genome-specific mutational biases.

Conclusions
An important conclusion is that shared environmental pressures and interactions among coevolving organisms do not obscure genome signatures in acid mine drainage communities. Thus, genome signatures can be used to assign sequence fragments to populations, an essential prerequisite if metagenomics is to provide ecological and biochemical insights into the functioning of microbial communities.
System modelling and analysis for design and development of a lean exhaust after-treatment system
Authors: He Y , Narayanaswamy K 
Published: August 2009

A comprehensive system-level modelling methodology for vehicle exhaust and after-treatment system development is presented. Within the constraints required for a development vehicle equipped with a lean-burn direct-injection gasoline engine, system-level analysis was extensively applied to guide the design of the after-treatment system. The size and location of the lean nitrogen oxide (NO x) after-treatment device was determined to achieve the best trade-off between engine back pressure, catalyst light-off, and acceptable thermal ageing under high-speed and high-load conditions. In addition, various after-treatment architecture and layout concepts were efficiently evaluated and screened, requirements for after-treatment components and exhaust thermal management devices were defined, and promising technologies were recommended for further development and testing. Beyond immediate implementation in the development vehicle, several exhaust thermal management strategies (electrically heated converter, lambda split control, engine stop—start, and multiple warm-up) were explored. These technologies have been assessed individually and in combination to formulate effective thermal management strategies under fuel penalty constraints. While the specific applications described in this paper are for a lean-burn gasoline direct-injection development vehicle, the methodology is equally applicable to advanced powertrains with one or more after-treatment devices (diesel engines, alternative fuels, hybrid vehicles, etc.)
A Language for Effective Communication between Surgeons and Radiographers in Trauma Theatre
Authors: Chaganti S , Kumar D , Patil S , Alderman P 
Published: August 2009

INTRODUCTION The advent of the image intensifier has revolutionised trauma surgery since its development in 1955. The manufacturers have given names to various movements of the machine in the operating manual but it has not been popular among orthopaedic surgeons or radiographers. Lack of knowledge of names of various movements and ambiguity in command often leads to confusion between the surgeon and the radiographer regarding which way to move the image intensifier. A questionnaire-based study was conducted to assess the efficacy of communication between orthopaedic surgeons and radiographers while using the image intensifier intra-operatively. SUBJECTS AND METHODS Diagrams depicting the movements of the image intensifier were used in the questionnaire. Fifty questionnaires were given to orthopaedic surgeons and 50 to radiographers to name the various movements. RESULTS Ninety questionnaires were returned, 45 from surgeons and 45 from radiographers. Five questionnaires from surgeons and five from radiographers were returned blank. Of those responding, 97% could name the vertical movement, 68% the horizontal movement, 12% the swivel and 29% the angulation movement. None could name the orbital movement. CONCLUSIONS Even though orthopaedic surgeons do not operate the image intensifier themselves, knowledge of the movements of the image intensifier and their names can improve the efficacy of communication between surgeons and radiographers. A common language and precision in command can avoid confusion and has the potential to improve theatre time utilisation. The nomenclature of various movements of the image intensifier has been described and possible precise commands for various movements have been postulated.
Plasma miR-208 as a Biomarker of Myocardial Injury
Authors: Ji Xu , Takahashi Rie , Hiura Yumiko , Hirokawa Go , Fukushima Yasue , Iwai Naoharu 
Published: August 2009

AbstractBackground: MicroRNAs (miRNAs) are endogenous small RNAs of 21–25 nucleotides that can pair with sites in 3′ untranslated regions in mRNAs of protein-coding genes to downregulate their expression. Recently, circulating miRNAs have been reported as promising biomarkers for various pathologic conditions. We assessed the hypothesis that miRNAs may leak into the circulating blood from injured cells and thereby serve as biomarkers for identifying the injured cell type.Methods: We used isoproterenol-induced myocardial injury in rats as a model and miRNA array analyses to identify candidate miRNAs specifically produced in the ventricles of the heart. Individual miRNA concentrations were measured by real-time reverse-transcription PCR. Plasma cardiac troponin I (cTnI) concentrations were measured with an ELISA.Results: Array analyses revealed miR-208 to be produced exclusively in the heart, and we selected this miRNA as a possible biomarker of myocardial injury. Plasma concentrations of miR-208 increased significantly (P &lt; 0.0001) after isoproterenol-induced myocardial injury and showed a similar time course to the concentration of cTnI, a classic biomarker of myocardial injury.Conclusions: The plasma concentration of miR-208 may be a useful indicator of myocardial injury. Our results suggest that profiling of circulating miRNAs may help identify promising biomarkers of various pathologic conditions.
Posztkondicionálás kísérletes alkalmazása aortakirekesztés kapcsánr
Authors: Szijártó Attila , Gyurkovics Endre , Arányi Péter , Ónody Péter , Stangl Rita , Tátrai Miklós , Lotz Gábor , Mihály Zoltán , Hegedüs Viktor , Blázovics Anna , Kupcsulik Péter 
Published: August 2009

AbsztraktBevezetés:A posztkondicionálás – amely egy ischaemizált szerven a reperfusio első perceiben alkalmazott több ciklusban ismétlődő, rövid idejű reocclusio – mérsékelni képes az ischaemiás-reperfusiós szervkárosodást. Az aorta és/vagy alsó végtagi verőerek kirekesztése kapcsán a végtag ischaemiás-reperfusiós károsodást szenved, illetve esetenként nagyfokú keringési redistributióhoz vezet. A műtét szövődményei – távoli szervi dysfunctiókban, szisztémás gyulladásos válaszreakcióban, illetve akár shockban megnyilvánuló – ún. reperfusiós syndroma képében jelentkezhetnek. Kísérletünkben a posztkondicionálás hatását vizsgáltuk aortakirekesztéssel járó érsebészeti állatmodellben.Anyagok és módszerek:Hím Wistar-patkányokon 180 perces infrarenalis aortakirekesztést hoztunk létre; az állatok egyharmadánál a reperfusio első 2 percében végzett posztkondicionálással (10 s felengedés + 10 s reocclusio, 6 ciklusban). A haemodynamicai paramétereket invazív artériás nyomásmérővel, a microcirculatiós változásokat lézer-Doppler-áramlásmérővel detektáltuk. A 4. posztoperatív órában vizelet-, plazma-, illetve szövettani mintavétel történt, laboratóriumi és morfológiai vizsgálatok céljából.Eredmények:A reperfusio kezdetekor a 180 perces kirekesztés szignifikáns különbséget okoz a haemodynamicai paraméterekben, posztkondicionálás hatására a microcirculatiót jellemző áramlási görbék karaktere megváltozott, az áramlás hyperaemiával stabilizálódott. A gyulladásos válasz szignifikáns mértékben csökkent (TNF-α, szabadgyök-szintek) a posztkondicionált csoportban. A posztkondicionálás a reperfusiós syndroma részjelenségeként megjelenő távoli szervhatásokat (vese, tüdő) szöveti és laboratóriumi paraméterek tekintetében egyaránt csökkentette.Következtetés:A posztkondicionálás alkalmas módszernek tűnik a hosszú idejű, alsó végtagi keringésleállások okozta szervkárosodások enyhítésére érsebészeti műtétek során.
A “null-biopszia” klinikai értéker
Authors: Szakály Péter 
Published: August 2009

AbsztraktA javuló eredmények ellenére a veseátültetés hosszú távú eredményei elmaradnak a benne rejlő potenciális lehetőségektől. A graftok késői elvesztésének legfőbb oka a cardiovascularis halálozás után, napjainkra a krónikus allograft-nephropathia lett. Ez egy olyan multietiológiás kórkép, melynek megjelenésére időben bármikor számíthatunk. Ha nem találunk időben megfelelő kezelési lehetőséget, akkor elkerülhetetlen az idült veseelégtelenség ismételt kialakulása. Tanulmányom célja annak vizsgálata, hogyan lehetne növelni az átültethető vesék számát, illetve javítani minőségüket.
Visions for Required Postgraduate Year 1 Residency Training by 2020: A Comparison of Actual versus Projected Expansion
Authors: Knapp Katherine K. , Shah Bijal M. , Kim Helen Bo Hyun , Tran Hien 
Published: August 2009

Study Objective. To explore the feasibility of expanding postgraduate year (PGY) 1 residency training as proposed by the American College of Clinical Pharmacy and American Society of Health‐System Pharmacists (ASHP).Design. Prospective survey analysis.Data Source. The ASHP Online Residency Directory was used to obtain PGY1 residency program data from June 2007‐June 2008. A four‐item questionnaire was developed to survey future residency growth in identified PGY1 programs.Measurements and Main Results. Survey data were aggregated to project future residency growth in the “next few years” (range 2–4 yrs). Estimates of Doctor of Pharmacy (Pharm.D.) graduates to 2020 were used to calculate PGY1 residency positions and average annual growth rates required if 24% (scenario 1), 75% (scenario 2), and 100% (scenario 3) of pharmacy graduates pursue PGY1 residencies. Projected growth from the survey was compared with required growth under the scenarios, as well as with actual PGY1 growth from June 2007‐June 2008. A subset analysis of college‐affiliated and Veterans Affairs (VA) PGY1 programs was performed. The survey response rate was 57%. The PGY1 positions were projected to increase by 8.3%/year in the next few years or 4193 positions by 2020 if 8.3% growth is sustained. Required average annual growth rates for scenarios 1–3, respectively, were 4.8%, 14.4%, and 17%. Projected growth rates were sufficient to achieve only scenario 1 in which 24% (percentage of pharmacists estimated to practice in health systems) of graduates pursue PGY1 residencies. The actual PGY1 growth rate from 2007–2008 was 9.9%. The VA positions actually grew at 12.5% and college‐affiliated positions grew at 8.3% over this period, whereas VA projection for growth was 4.8% and college‐affiliated projection was 9.6%.Conclusion. Having sufficient PGY1 residency positions available for all Pharm.D. graduates by 2020 would require at least a 17% average annual growth rate, whereas survey respondents predicted 8.3%. Actual residency growth in 2008 (9.9%) exceeded survey projections. Study data suggest that the ASHP aspiration to have all graduates who pursue health‐system pharmacy careers complete a PGY1 residency is achievable. Higher percentages, 75% or 100%, are only partially achievable. Continued growth of college‐affiliated residencies and sustained growth in the VA system are important to achieving residency growth goals.
The Health of Older Mexican Americans in the Long Run
Authors: González Hector M. , Ceballos Miguel , Tarraf Wassim , West Brady T. , Bowen Mary E. , Vega William A. 
Published: August 2009

Objectives. We compared risk for several medical illnesses between immigrant and US-born older Mexican Americans to determine the relationship between functional health and years of US residency among immigrants. Methods. Cross-sectional, multistage probability sample data for 3050 Mexican Americans aged 65 years or older from 5 US southwestern states were analyzed. Self-rated health, medical illnesses, and functional measures were examined in multivariate regression models that included nativity and years of US residency as key predictors. Results. Self-rated health and medical illnesses of immigrant and US-born groups did not differ significantly. Immigrants with longer US residency had significantly higher cognitive functioning scores and fewer problems with functional activities after adjustment for predisposing and medical need factors. Conclusions. Among older Mexican Americans, immigrant health advantages over their US-born counterparts were not apparent. Immigrants had better health functioning with longer US residency that may derive from greater socioeconomic resources. Our findings suggest that the negative acculturation–health relationship found among younger immigrant adults may become a positive relationship in later life.
Differential Trends in Weight-Related Health Behaviors Among American Young Adults by Gender, Race/Ethnicity, and Socioeconomic Status: 1984–2006
Authors: Clarke Philippa J. , O'Malley Patrick M. , Johnston Lloyd D. , Schulenberg John E. , Lantz Paula 
Published: August 2009

Objectives. We investigated temporal patterns from 1984 to 2006 in 6 weight-related health behaviors by using longitudinal data for multiple cohorts of young adults (aged 19–26 years) from the nationally representative Monitoring the Future Study. Methods. We used growth curve models to examine historical trends in 6 health behaviors: frequency of eating breakfast, eating green vegetables, eating fruit, exercising, watching television, and sleeping 7 hours each night. Variations across gender, race/ethnicity, and socioeconomic status were investigated. Results. Frequency of exercising was consistently lower among young adult women than young adult men over this 23-year period. Compared with White women, Hispanic women, and women from other race/ethnic groups, Black women showed declines in the frequency of exercise since 1984. In general, young adult women showed a marked increase in the frequency of eating breakfast over this period, although Black women did not show any net gains. Conclusions. Social disparities in body weight may increase because Black women, Hispanic women, and men with lower socioeconomic status show declining trends in positive weight-related health behaviors compared with White young adults with higher socioeconomic status.