bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colonization With Vancomycin-Resistant Enterococcus faecium Comparison of a Long-Term–Care Unit With an Acute-Care Hospital
Authors: Bonilla Hector F. , Zervos Marcus A. , Lyons Michael J. , Bradley Suzanne F. , Hedderwick Sara A. , Ramsey Mary A. , Paul Laura K. , Kauffman Carol A. 
Published: September 2009

AbstractObjective:To compare the epidemiology of vancomycin-resistant Enterococcus faecium (VRE) in a longterm–care unit and an acute-care hospital.Design:Point-prevalence surveys for VRE rectal colonization of patients were carried out over a 21-month period in patients in a long-term–care unit and an acutecare hospital (medical ward and intensive-care units). The environment and hands of healthcare workers also were sampled for VRE. Contour-clamped homogeneous electric field (CHEF) electrophoresis was used to evaluate possible transmission among roommates and the relatedness of patient strains to those in the environment and on the hands of healthcare workers.Setting:A 200-bed Veterans Affairs Medical Center with an attached 90-bed long-term–care unit.Results:From December 1994 to January 1996, rectal VRE colonization of patients in the long-term–care unit increased significantly from 9% to 22%. In contrast, patients on the medical ward rarely were colonized after the first survey in December 1994, and only two intensivecare–unit patients were found to be colonized during the four surveys. The environment was contaminated persistently in the long-term–care unit. In the four surveys, carriage of VRE on hands of healthcare workers varied from 13% to 41%; 65% of healthcare workers with VRE found on their hands worked in the long-term–care unit.Seven different strains were identified by CHEF typing. Although the initial survey found only vanA strains, subsequent surveys showed vanB strains also were present.Conclusions:Residents of a long-term–care unit frequently were colonized with VRE, but infections were uncommon in this population. The environment of the long-term–care unit was contaminated with VRE, and VRE was found frequently on the hands of healthcare workers in this unit. Both vanA and vanB genotypes were found in this setting.
Basics of Surveillance—An Overview
Authors: Pottinger Jean M. , Perl Trish M. 
Published: September 2009

AbstractSurveillance of nosocomial infections is the foundation of an infection control program. This article describes components of a surveillance system, methods for surveillance, methods for case-finding, and data sources. We encourage the epidemiology team to use this background information as they design surveillance systems that meet the goals of their individual institution's infection control program.
The Impact of Affirmative Action: Black Employment in Six Southern Cities*
Authors: Button James W. , Rienzo Barbara A. 
Published: September 2009

Objectives. There have been numerous claims about the current role and impact of affirmative action, one of the most controversial public policies. The purpose of this research is to examine data on affirmative action and black employment in six representative Florida cities.Methods. Data were gathered on 167 randomly selected businesses through personal interviews with employers. OLS regression analysis was performed to explore the independent effects of affirmative action in a multivariate path model of employment‐related predictors.Results. Employer support for affirmative action has a significant and positive influence on black employment, particularly at higher job levels.Conclusions. Affirmative action has developed a constituency among employers who value diversity in employment due to demographic changes that have altered labor and consumer markets.
Chemical Accidents in the United States, 1990–1996*
Authors: Derezinski Daniel D. , Lacy Michael G. , Stretesky Paul B. 
Published: September 2009

Objective. Much of the empirical work on environmental justice centers on the geographic distribution of potential chronic health risks (e.g., planned toxic releases or treatment storage and disposal facilities). Far less attention has been devoted to the geographic distribution of acute health risks that cause immediate harm. The purpose of this work is to examine environmental justice in terms of potential acute health risks by examining the distribution of serious chemical accidents across diverse subpopulations.Methods. We draw upon 1990 census data for the United States to study the relationship between the racial, ethnic, and economic characteristics of census block groups (N=226,398) and the presence or absence of chemical accidents that caused at least one injury, death, or evacuation for the time period of 1990–1996. The data used to map the location of the chemical accidents were obtained from the Environmental Protection Agency's Accidental Release Information Program (ARIP) database.Results. Our results indicate that the acute risk associated with chemical accidents at fixed facilities is greater for individuals living in low‐income census block groups, especially when comparisons are made within the counties where the chemical accidents occur. Our results concerning race and ethnicity are less consistent and somewhat weaker.Conclusions. Although these results do not show large and dramatic effects, as have often been found in the study of the social distribution of chronic environmental risk, they do stand as one of a relatively few social analyses of social variation in exposure to acute environmental risk.
Testing of a measurement model for baccalaureate nursing students’ self‐evaluation of core competencies
Authors: Hsu Li‐Ling , Hsieh Suh‐Ing 
Published: September 2009

AbstractTitle. Testing of a measurement model for baccalaureate nursing students’ self‐evaluation of core competencies.Aim. This paper is a report of a study to test the psychometric properties of the Self‐Evaluated Core Competencies Scale for baccalaureate nursing students.Background. Baccalaureate nursing students receive basic nursing education and continue to build competency in practice settings after graduation. Nursing students today face great challenges. Society demands analytic, critical, reflective and transformative attitudes from graduates. It also demands that institutions of higher education take the responsibility to encourage students, through academic work, to acquire knowledge and skills that meet the needs of the modern workplace, which favours highly skilled and qualified workers.Methods. A survey of 802 senior nursing students in their last semester at college or university was conducted in Taiwan in 2007 using the Self‐Evaluated Core Competencies Scale. Half of the participants were randomly assigned either to principal components analysis with varimax rotation or confirmatory factor analysis.Results. Principal components analysis revealed two components of core competencies that were named as humanity/responsibility and cognitive/performance. The initial model of confirmatory factor analysis was then converged to an acceptable solution but did not show a good fit; however, the final model of confirmatory factor analysis was converged to an acceptable solution with acceptable fit. The final model has two components, namely humanity/responsibility and cognitive/performance. Both components have four indicators. In addition, six indicators have their correlated measurement errors.Conclusion. Self‐Evaluated Core Competencies Scale could be used to assess the core competencies of undergraduate nursing students. In addition, it should be used as a teaching guide to increase students’ competencies to ensure quality patient care in hospitals.
Survey of severe respiratory syncytial virus infection in Kyoto Prefecture from 2003 to 2007
Authors: Ito Hisato , Osamura Toshio , Nakajima Fumiaki , Fujiwara Daisuke , Kuwabara Yasumichi , Yamamoto Toru , Yasuno Tetsuya , Komatsu Hiroshi , Kizaki Zenrou , Kishida Kenji , Akiyama Yuichi , Oomae Tadaki , Nakajima Kouji , Nakamura Akitoshi , Kiyosawa Nobuyuki , Nisikomori Ryuta 
Published: September 2009

AbstractBackground:  Respiratory syncytial virus (RSV) infection in infants can develop into a severe condition.Methods:  A survey of patients with severe RSV infection in hospitals in Kyoto Prefecture was performed from 2003 to 2007. Patients requiring intubation and those with cardiopulmonary arrest on arrival (CPAOA) were considered to have severe RSV infection.Results:  Twenty‐five patients with severe infection were identified and detailed data were available for 21 patients, of whom 18 required intubation and three had CPAOA. The male/female ratio was 12/9 and age ranged from 8 days to 19 years (average, 5.2 months; median: 2 months). At admission white blood cell count, lactate dehydrogenase (P < 0.05), and blood glucose (P < 0.01) were higher and Na was lower (P < 0.01) in the 18 patients with severe infection (excluding the CPAOA cases) compared to 18 sex‐ and age‐matched patients with mild RSV infection. The incidence of bacterial infection was also higher in severe cases (P < 0.05). The outcome was death in four patients (19.0%, including two sudden deaths), aftereffects in two (9.5%), hospital discharge with improvement in 14 (66.7%), and an unclear outcome in one patient. Excluding the two sudden death cases, 14 of 19 patients (73.7%) were extubated within 2 weeks. The period of intubation was longer in older patients (P < 0.05).Conclusion:  Because severe RSV infection led to sudden death in two cases, detection of RSV is important at admission for an infant with CPAOA. Fourteen patients (66.7%), however, had good outcomes and most patients were extubated within 2 weeks.
Environmental determinants correlated to Vibrio harveyi‐mediated death of marine gastropods
Authors: Fukui Youhei , Saitoh Sei‐Ichi , Sawabe Tomoo 
Published: September 2009

Summary Vibrio harveyi is an emerging pathogen that causes mass mortality in a wide variety of marine animal species; however, it is still unclear which environmental determinants correlate V. harveyi dynamics and the bacterium‐mediated death of marine animal life. We conducted a correlation analysis over a 5‐year period (2003–2007) analysing the following data: V. harveyi abundance, marine animal mortality and environmental variables (seawater temperature, salinity, pH, chlorophyll a, rainfall and total viable bacterial counts). The samples were collected from a coastal area in northern Japan, where deaths of a marine gastropod species (Haliotis discus hannai) have been reported. Our analysis revealed significant positive correlations between average seawater temperature and average V. harveyi abundance (R = 0.955; P < 0.05), and between average seawater temperature and V. harveyi‐mediated abalone death (R = 0.931; P < 0.05). Based on the regression model, n°C rise in seawater temperature gave rise to a 21n‐fold increase in the risk of mortality caused by V. harveyi infection. This is the first report providing evidence of the strong positive correlation between seawater temperature and V. harveyi‐mediated death of marine species.
Weight and blood pressure response to weight management and sibutramine in diabetic and non‐diabetic high‐risk patients: an analysis from the 6‐week lead‐in period of the sibutramine cardiovascular outcomes (SCOUT) trial
Authors: Van Gaal L. F. , Caterson I. D. , Coutinho W. , Finer N. , Maggioni A. P. , Sharma A. M. , Torp‐Pedersen C. , Ge H. , Moran S. A. , Shepherd G. M. , James W. P. T. ,   on behalf of the SCOUT Investigators
Published: September 2009

Objective: To assess treatment responses to sibutramine and weight management in diabetic patients during the lead‐in period of the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Methods: SCOUT is an ongoing, prospective, randomized, double‐blind, placebo‐controlled outcome trial in cardiovascular high‐risk overweight/obese patients. A total of 10 742 patients received single‐blind sibutramine and individualized weight management during the 6‐week lead‐in period; 84% had a history of type 2 diabetes mellitus and additional co‐morbidities. Post‐hoc analyses assessed anthropomorphic and vital sign responses between patients with and without diabetes. Results: Concomitant antidiabetic medication use was reported by 86% of the diabetic patients (approximately 30% required insulin–alone or in combination). Body weight and waist circumference decreased in diabetic patients: median 2.1 kg; 2.0 cm (both men and women); for those on insulin: 1.9 kg; 1.5/2.0 cm (men/women); without insulin: 2.3 kg; 2.0 cm (both men and women); blood pressure (BP) was also reduced (median systolic/diastolic 3.5/1.0 mmHg) with larger reductions in diabetic patients who were hypertensive and/or lost the most weight (>5%). In diabetic patients who entered with BP at target (<130/<85 mmHg) but did not lose weight (N = 245), increases of 3.5/2.0 mmHg were observed. Non‐diabetic patients had greater weight losses (2.5 kg) but smaller reductions in BP (systolic/diastolic −2.5/−0.5 mmHg). Pulse rate increases were less in diabetic vs. non‐diabetic patients (1.5 vs. 2.0 bpm). Conclusion: In these high‐risk diabetic patients, sibutramine and lifestyle modifications for 6 weeks resulted in small, but clinically relevant, median reductions in body weight, waist circumference and BP. A small median increase in pulse rate was recorded.
Treating mineral metabolism disorders in patients undergoing long hemodialysis: A search for an optimal strategy
Authors: JEAN Guillaume , VANEL Thierry , TERRAT Jean‐Claude , HUROT Jean‐Marc , LORRIAUX Christie , MAYOR Brice , CHAZOT Charles 
Published: September 2009

AbstractIn hemodialysis (HD) patients, mineral metabolism (MM) disorders have been associated with an increased mortality rate. We report the evolution of MM parameters in a stable HD population undergoing long hemodialysis by performing an annual cross‐sectional analysis for every year from 1994 to 2008. The therapeutic strategy has changed: the dialysate calcium concentration has decreased from a mean of 1.7 ± 0.1 to 1.5 ± 0.07 mmol/L and has been adapted to parathyroid hormone serum levels (from 1 to 1.75 mmol/L). The use of calcium‐based and aluminum‐based phosphate binders has decreased and they have been replaced by sevelamer; alfacalcidol has partly been replaced by native vitamin D. The percentage of patients with a parathyroid hormone serum level between 150 and 300 pg/mL has increased from 9% to 67% (P<0.001); the percentage of patients with phosphataemia between 1.15 and 1.78 mmol/L has increased from 39% to 84% (P<0.001). The percentage of those with albumin‐corrected calcemia between 2.1 and 2.37 mmol/L has increased from 29% to 61% (P<0.001), and that of patients with a calcium‐phosphorous product (Ca × P) level >4.4 mmol/L decreased from 8.8% to 2% (P=0.02). Although patients undergo long and intensive HD treatment, MM disorders are common. However, an appropriate strategy, mostly consisting of native vitamin D supplementation, progressive replacement of calcium‐based phosphate binders with non–calcium‐based ones, and individualization of dialysis session duration and dialysate calcium concentration, would result in a drastic improvement.
Acquired perforating dermatoses in patients with diabetic kidney disease on hemodialysis
Authors: Hari KUMAR K. V. S. , PRAJAPATI Jayaram , PAVAN G. , PARTHASARATHY A. , JHA Ratan , MODI K. D. 
Published: September 2009

AbstractAcquired perforating dermatoses (APD) is an uncommon skin disorder seen in patients with diabetes mellitus, chronic kidney disease, or both together. We present the clinicopathological features of APD in patients with diabetic kidney disease and discuss the recent advances in management. We retrospectively analyzed the data of 8 patients with APD presenting to our center. All patients were known cases of Type 2 diabetes and chronic kidney disease requiring maintenance dialysis. Acquired perforating dermatoses was diagnosed based on clinical presentation of itchy, keratotic papulonodular lesions, and characteristic histopathological features of transepithelial elimination on skin biopsy. The patients were subdivided into 4 types of APD based on the biopsy features. All our patients had Type 2 diabetes over 5 years duration and were on maintenance dialysis for more than 6 months before presentation. Acquired perforating dermatoses symptoms appeared 2 to 6 months before presentation. The majority of patients (6/8) had a subtype of reactive perforating collagenosis. All the patients showed significant resolution with topical glucocorticoid therapy. Acquired perforating dermatoses is a skin complication seen in Type 2 diabetes, chronic kidney disease, or when both are present together. Early identification and therapy prevents the associated morbidity.
Unions without Borders: Organizing and Enlightening Immigrant Farm Workers
Authors: Griffith David 
Published: September 2009

AbstractFarm workers pose special problems for union organizing due to their legal status, their high rates of turnover, their employment through subcontracts, and the temporary and seasonal dimensions of farm work. Yet by organizing farm workers, unions have developed and refined strategies that point to methods of meeting the challenges of contemporary work environments in and out of agriculture. This includes organizing workers across fragmented space, whether transnational or transregional, and organizing workers who are sifted into production regimes via subcontractual relationships. This paper examines two farm worker unions – the Farm Labor Organizing Committee and the Coalition of Immokalee Workers – in terms of their successes and failures with farm labor organizing. It finds that boycotts, the use of fine arts, balancing local and transnational interests, and building relationships based on confianza (trust) are critical to the formation and maintenance of effective union organization.
Topical calcitriol protects from UV‐induced genetic damage but suppresses cutaneous immunity in humans
Authors: Damian Diona L. , Kim Young Jin , Dixon Katie M. , Halliday Gary M. , Javeri Arash , Mason Rebecca S. 
Published: September 2009

Please cite this paper as: Topical calcitriol protects from UV‐induced genetic damage but suppresses cutaneous immunity in humans. Experimental Dermatology 2010; 19: e23‐e30.Abstract:  Calcitriol, the biologically active form of vitamin D, has been reported to cause both suppressive and protective immune effects in mice. Its immune effects in vivo in humans are unclear. We investigated the in vivo effects of topical calcitriol on minimal erythema dose and skin immune responses in healthy volunteers. We found that calcitriol did not protect from ultraviolet (UV)‐induced erythema (sunburn) when applied either 24 h before or immediately after irradiation, although it decreased the density of sunburn cells and thymine dimers seen on biopsy when applied 24 h before and again immediately after irradiation. Using the Mantoux reaction as a model of skin immunity, we found that topical calcitriol applied at high total doses reduced the Mantoux responses of nearby untreated, unirradiated skin, suggesting a para‐local or systemic immunosuppressive effect not observed with lower calcitriol doses. We then measured UV‐induced suppression of Mantoux reactions at vehicle‐treated sites and sites treated with low‐dose calcitriol, and found that calcitriol neither reduced nor enhanced UV‐induced immunosuppression. Despite calcitriol reducing UV‐induced DNA damage, which should protect the immune system, it has immunosuppressive effects in our model which may help to explain the efficacy of analogues such as calcipotriol in the treatment of psoriasis.
Increased subcutaneous adipose tissue impairs dermal function in diet‐induced obese mice
Authors: Ezure Tomonobu , Amano Satoshi 
Published: September 2009

Please cite this paper as: Increased subcutaneous adipose tissue impairs dermal function in diet‐induced obese mice. Experimental Dermatology 2010; 19: 878–882.Abstract:  Increment of subcutaneous adipose tissue is a risk factor for facial morphological changes, such as sagging, which may be at least partly because of the increased weight burden of accumulated fat. However, it is not clear how the increase of subcutaneous adipose tissue affects dermal structure and function. We examined this issue in HR‐1 hairless mice given a high‐fat diet (HFD). After having been fed with HFD for 12 weeks, the mice became obese and the subcutaneous adipose tissue layer was significantly thickened, while the dermal layer became significantly thinner than that of control mice fed normal diet. However, the thickness of the dermal layer was not changed in the ear pinna, which lacks a subcutaneous adipose layer, suggesting that increase of subcutaneous adipose tissue may induce dermal changes. The number of dermal fibroblasts in the dermis was significantly reduced in obese mice, although there was no change in gene expression levels of extracellular matrix components, including collagen, hyaluronic acid synthase, fibulin5, fibrillin‐1, laminin β1, matrix metalloproteinases and tissue inhibitor of metalloproteinases. Dermal elasticity was significantly decreased in obese hairless mice. These results suggest that subcutaneous adipose cells in obese mice may reduce the proliferation of dermal fibroblasts and induce a decrease of dermal thickness and elasticity. Therefore, the increment of the subcutaneous adipose layer in obese subjects may induce impairment of dermal biomechanical characteristics and promote the appearance of sagging.
Reader performance in radiographic diagnosis of signs of mitral regurgitation in cavalier King Charles spaniels
Authors: Hansson K. , Häggström J. , Kvart C. , Lord P. 
Published: September 2009

Objectives:To measure accuracy and variability of diagnosis by radiography of heart enlargement (HE) and heart failure (HF) in mitral regurgitation (MR).Methods:Sixteen readers representing four levels of experience evaluated 50 sets of radiographs with varying severity of MR for presence or absence of HE, left atrial enlargement (LAE) and HF. The performance of the readers was compared with a reference standard, using area under the curve (AUC) of receiver operating characteristic (ROC) curves. The interreader agreement value kappa (K) was calculated. A subset of difficult cases of HF was analysed before and after removing an outlying reader from each group.Results:AUC for HE was 0·89, for LAE it was 0·93 and for HF it was 0·92. Experience increased certainty of diagnosis but not accuracy. K ranges were HE, 0·53 to 0·67; LAE, 0·61 to 0·69 and HF, 0·49 to 0·58. When only difficult cases of HF were read, accuracy decreased and experienced readers performed better than inexperienced. When outlying readers were excluded, the differences between experienced and inexperienced readers increased.ClinicalSignificance:LAE, not HE, should be used to evaluate the heart size and indirectly the severity of MR on radiographs. For HF, agreement among individual readers was only moderate. Studies of reader accuracy should consider the effects of interreader variability.