bluuebunny/crossref_metadata_2025_split huggingface dataset:
Annual Tuberculin Skin Testing of Employees at a University Hospital: A Cost-Benefit Analysis
Authors: Raad Issam , Cusick Janet , Sherertz Robert J. , Sabbagh Mouin , Howell Nora 
Published: September 2009

AbstractThe usefulness of routine annual tuberculin skin testing (purified protein derivative [PPD]) of hospital employees has been questioned. Between 1984 and the end of 1987 the PPD conversion rates of hospital employees at a university and psychiatric hospital in North Florida were compared. The number of employees in both hospitals were almost equal and compliance with the annual testing was more than 95%. In the psychiatric hospital tuberculosis screening of patients was practiced on admission and annually thereafter. Although no unsuspected smear-positive tuberculosis patients were diagnosed in the psychiatric hospital as compared to four in the university hospital, the annual conversion rates of employees were 0.42% and 0.13%, respectively (p>0.001). However, the ratios of these conversion rates to the incidence of tuberculosis in the counties where these hospitals are located respectively were similar (20.0 vs 24.3, p=0.7). The community seems be the major source of the PPD conversion. At the university hospital more than $70,000 was spent on the annual PPD testing to discover 15 converters; nine had no or minimal contact with patients and only two complied with isoniazid (INH) prophylaxis. Annual PPD testing is not cost effective in hospitals with a low annual conversion rate among its employees and with low tuberculosis case rates in the hospital and the surrounding community.
Prevention of Catheter-Associated Urinary Tract Infection: A Cost-Benefit Analysis
Authors: Platt Richard , Frank Polk B. , Murdock Bridget , Rosner Bernard 
Published: September 2009

AbstractA cost-benefit analysis was used to assess four strategies to prevent catheter-associated urinary tract infections in an acute care setting. Routine use of catheters with sealed collection junctions, selective use of these catheters, and oral antibiotic prophylaxis all result in fewer deaths, fewer infections, and lower overall costs than not using any of these. Routine use of sealed junction catheters results in fewer infections and deaths than does selective use. When the cost of a nosocomial urinary tract infection is $500, routine use of sealed junction catheters is also less expensive than selective use in many circumstances. Oral antibiotic prophylaxis would result in the lowest net cost and the fewest deaths and infections, if it were as effective as parenteral prophylaxis, if more than 72% of patients received it, and if important negative factors such as selection of antimicrobial resistance and adverse drug reactions are not considered. When there is no extra cost of sealed junction catheters, their use is less expensive than the oral prophylaxis strategy if the total cost of oral prophylaxis, including the cost of adverse reactions, is greater than $15. If the extra cost of sealed junction catheters is $4 per unit, their use is less expensive than oral prophylaxis when its cost exceeds $35. Prevention of catheter-associated urinary tract infection reduces the overall cost of patient care, even when the prevention itself incurs costs. This analysis supports the routine use of sealed junction catheters in most acute care situations that require indwelling catheter drainage. Currently, we do not recommend routine antibiotic prophylaxis.
Clinical value of minor responses after 4 doses of rituximab in Waldenström macroglobulinaemia: a follow‐up of the Eastern Cooperative Oncology Group E3A98 trial
Authors: Gertz Morie A. , Abonour Rafat , Heffner Leonard T. , Greipp Philip R. , Uno Hajime , Rajkumar S. V. 
Published: September 2009

SummaryWaldenström macroglobulinaemia is a low‐grade, lymphoplasmacytic lymphoma that is responsive to rituximab. We report the role of a minor response in predicting overall outcomes. We extended follow‐up of a previously described cohort (n = 69) treated with 4 weekly doses of rituximab and observed durable responses (median time to progression, 30 months; 5‐year survival rate, 66%). Patients achieving a minor response [25–50% immunoglobulin M (IgM) reduction] appeared to do as well as those achieving an objective response (>50% IgM reduction), which suggests that more aggressive or intensive therapy for minor responders is not required. Future studies of Waldenström macroglobulinaemia should report minor responses because they are associated with clinically meaningful benefits. This trial was registered at http://www.clinicaltrials.gov as #NCT00005609.
Perception and practice of child labour among parents of school‐aged children in Ibadan, southwest Nigeria
Authors: Omokhodion F. O. , Uchendu O. C. 
Published: September 2009

AbstractBackground  The problem of child labour has lingered on in many countries because of the complex combination of social, cultural and economic factors involved. Parents play a critical role in child labour as it provides much needed extra income for the family. This study was carried out among parents of school‐aged children in an urban, low‐income community to determine the factors associated with child labour and attitudes to child labour in the community.Methods  A cross‐sectional study was carried out in an urban community in Ibadan, southwest Nigeria. Questionnaires were administered to parents of school‐aged children.Results  A total of 473 parents were interviewed. They were aged between 23 and 56 years, mean 37.9 years. Thirty‐nine per cent of parents indicated that they thought their school‐aged children should work. More women than men, those from polygamous homes and those with lower educational status held this view. Reasons given for wanting their children to work were to supplement family income, 45%, to gain experience, 35% and to help in family business, 10%. In all, 236 (50%) respondents reported that their school‐aged children were working. Parental factors associated with practice of child labour were polygamous marriage, low educational status, unskilled or partly skilled occupation and large family size. Seventeen per cent of parents with working children were not satisfied with their children's work conditions and complained of low earnings, long working hours, work on school days and unsafe work environment. Measures suggested to control child labour include addressing the issue of household poverty, public enlightenment about the ills of child labour and free education up to junior secondary level. Enforcement of child labour laws was the least mentioned.Conclusion  We conclude that control of child labour should be a multifaceted approach involving poverty alleviation, family planning to reduce family size and free, compulsory education up to junior secondary level. Public enlightenment especially for mothers will be of additional benefit.
Evidence of multiple chromosomal inversions in Aedes aegypti formosus from Senegal
Authors: Bernhardt S. A. , Blair C. , Sylla M. , Bosio C. , Black IV W. C. 
Published: September 2009

AbstractChromosomal inversions are prevalent in mosquito species but polytene chromosomes are difficult to prepare and visualize in members of the tribe Aedinii and thus there exists only indirect evidence of inversions. We constructed an F1 intercross family using a P1 female from a laboratory strain of Aedes aegypti aegypti (Aaa) and a P1 male Aedes aegypti formosus (Aaf) from a strain collected from south‐eastern Senegal. Recombination rates in the F2 offspring were severely reduced and genotype ratios suggested a deleterious recessive allele on chromosome 3. The F2 linkage map was incongruent in most respects with the established map for Aaa. Furthermore, no increased recombination was detected in F5 offspring. Recombination rates and gene order were consistent with the presence in Aaf of at least four large inversions on chromosome 1, a single small inversion on chromosome 2 and three inversions on chromosome 3.
Homing endonucleases catalyze double‐stranded DNA breaks and somatic transgene excision in Aedes aegypti
Authors: Traver B. E. , Anderson M. A. E. , Adelman Z. N. 
Published: September 2009

Abstract Aedes aegypti is a major vector of arthropod‐borne viruses such as yellow fever virus and dengue viruses. Efforts to discern the function of genes involved in important behaviours, such as vector competence and host seeking through reverse genetics, would greatly benefit from the ability to generate targeted gene disruptions. Homing endonucleases are selfish elements which catalyze double‐stranded DNA (dsDNA) breaks in a sequence‐specific manner. In this report we demonstrate that the homing endonucleases I‐PpoI, I‐SceI, I‐CreI and I‐AniI are all able to induce dsDNA breaks in adult female Ae. aegypti chromosomes as well as catalyze the somatic excision of a transgene. These experiments provide evidence that homing endonucleases can be used to manipulate the genome of this important disease vector.
Assessment of mitochondrial potential: implications for the correct monitoring of human sperm function
Authors: Amaral A. , Ramalho‐Santos J. 
Published: September 2009

SummaryMitochondrial membrane potential (MMP) is an indicator of sperm functionality that can be assessed using specific fluorescent markers. However, the ability of distinct probes to dynamically evaluate sperm MMP has not been determined. In the present study, human sperm samples were independently labelled with MitoTracker Green, MitoTracker Red and JC‐1. The ability of each probe to correctly monitor MMP was determined by incubating sperm with MMP disruptors (KCN, FCCP and valinomycin). Similarly, the effect of distinct fixatives (formaldehyde and methanol) was also tested. The three mitochondrial probes provided similar results, and were able to monitor changes in MMP when sperm had been previously incubated with MMP‐disrupting agents. However, only JC‐1 could, to a small extent, mirror MMP alterations after sperm labelling. Unexpectedly, the three probes were able to stain some pre‐fixed sperm, even though this behaviour was very variable, especially for MitoTrackers. On the other hand, none of the probes was shown to be reliably fixable. Of the three probes tested JC‐1 seems to be the most adequate, nevertheless, the choice of an MMP‐specific probe may depend on the aim of each experimental setting and appropriate controls must always be performed.
Isolation and introgression in the Intermountain West: contrasting gene genealogies reveal the complex biogeographic history of the American pika (Ochotona princeps)
Authors: Galbreath Kurt E. , Hafner David J. , Zamudio Kelly R. , Agnew Kelly 
Published: September 2009

AbstractAim We studied the history of colonization, diversification and introgression among major phylogroups in the American pika,Ochotona princeps(Lagomorpha), using comparative and statistical phylogeographic methods. Our goal was to understand how Pleistocene climatic fluctuations have shaped the distribution of diversity at mitochondrial DNA (mtDNA) and nuclear DNA (nDNA) loci in this alpine specialist.Location North America’s Intermountain West.Methods We accumulated mtDNA sequence data (c. 560–1700 bp) from 232 pikas representing 64 localities, and sequenced two nuclear introns (mast cell growth factor,c. 550 bp,n = 148; protein kinase C iota,c. 660 bp,n = 139) from a subset of individuals. To determine the distribution of major mtDNA lineages, we conducted a phylogenetic analysis on the mtDNA sequence data, and we calculated divergence times among the lineages using a Bayesian Markov chain Monte Carlo approach. Relationships among nuclear alleles were explored with minimum spanning networks. Finally, we conducted coalescent simulations of alternative models of population history to test for congruence between nDNA and mtDNA responses to Pleistocene glacial cycles.Results We found that: (1) all individuals could be assigned to one of five allopatric mtDNA lineages; (2) lineages are associated with separate mountain provinces; (3) lineages originated from at least two rounds of differentiation; (4) nDNA and mtDNA markers exhibited overall phylogeographic congruence; and (5) introgression among phylogroups has occurred at nuclear loci since their initial isolation.Main conclusions Pika populations associated with different mountain systems have followed separate but not completely independent evolutionary trajectories through multiple glacial cycles. Range expansion associated with climate cooling (i.e. glaciations) promoted genetic admixture among populations within mountain ranges. It also permitted periodic contact and introgression between phylogroups associated with different mountain systems, the record of which is retained at nDNA but not mtDNA loci. Evidence for different histories at nuclear and mtDNA loci (i.e. periodic introgression versus deep isolation, respectively) emphasizes the importance of multilocus perspectives for reconstructing complete population histories.
Targeted proteomics using selected reaction monitoring reveals the induction of specific terpene synthases in a multi‐level study of methyl jasmonate‐treated Norway spruce (Picea abies)
Authors: Zulak Katherine G. , Lippert Dustin N. , Kuzyk Michael A. , Domanski Dominik , Chou Tina , Borchers Christoph H. , Bohlmann Jörg 
Published: September 2009

SummaryInduction of terpene synthase (TPS) gene expression and enzyme activity is known to occur in response to various chemical and biological stimuli in several species of spruce (genus Picea). However, high sequence identity between TPS family members has made it difficult to determine the induction patterns of individual TPS at the protein and transcript levels and whether specific TPS enzymes respond differentially to treatment. In the present study we used a multi‐level approach to measure the induction and activity of TPS enzymes in protein extracts of Norway spruce (Picea abies) bark tissue following treatment with methyl jasmonate (MeJA). Measurements were made on the transcript, protein, enzyme activity and metabolite levels. Using a relatively new proteomics application, selective reaction monitoring (SRM), it was possible to differentiate and quantitatively measure the abundance of several known TPS proteins and three 1‐deoxy‐d‐xylulose 5‐phosphate synthase (DXS) isoforms in Norway spruce. Protein levels of individual TPS and DXS enzymes were differentially induced upon MeJA treatment and good correlation was generally observed between induction of transcripts, proteins, and enzyme activities. Most of the mono‐ and diterpenoid metabolites accumulated with similar temporal patterns of induction as part of the coordinated multi‐compound chemical defense response. Protein and enzyme activity levels of the monoTPS (+)‐3‐carene synthase and the corresponding accumulation of (+)‐3‐carene was induced to a higher fold change than any other TPS or metabolite measured, indicating an important role in the induced terpenoid defense response in Norway spruce.
Availability of essential medicines in Ethiopia: an efficiency‐equity trade‐off?
Authors: Carasso Barbara S. , Lagarde Mylene , Tesfaye Addis , Palmer Natasha 
Published: September 2009

SummaryObjective  To investigate the availability and cost of essential medicines in health centres in rural Ethiopia, and to explore if the fee waiver system protects patients from having to pay for medicines.Methods  The study took place in five health centres in rural Ethiopia. Availability and price of selected key essential medicines was established in the budget and special pharmacy of the health centre, as well as private outlets. Information on availability and cost of prescribed drugs was obtained through patient exit‐interviews.Results  Availability based of essential drugs at facility level was 91% based on a list of selected drugs vs. 84% based on prescriptions filled. However, less than half the prescribed drugs were obtained from the budget pharmacy, and one in six patients was forced to purchase drugs in the private sector, where drugs are roughly twice as expensive. The waiver system did not safeguard against having to pay for medicines.Conclusion  A revolving drug fund system in Ethiopia seems to improve availability of medicines, and can improve affordability by protecting people from purchasing drugs in the private sector. However, it may result in a parallel system, whereby the poor cannot access drugs if these are not available in the budget pharmacy. Equity is a concern in the absence of an adequate mechanism to protect the poor from catastrophic health expenditure.
Management of children with otitis media: A summary of evidence from recent systematic reviews
Authors: Gunasekera Hasantha , Morris Peter S , McIntyre Peter , Craig Jonathan C 
Published: September 2009

AbstractHealth‐care professionals who manage children are regularly confronted with clinical questions regarding the management of the full spectrum of otitis media: acute otitis media; otitis media with effusion; and chronic suppurative otitis media. Given the variety of potential therapies available, the wide spectrum of middle ear disorders, and the lack of consensus about management strategies, clinicians are in a difficult position when managing these children. In this review, we seek to summarise the current best evidence for answering otitis media management questions by collating existing systematic reviews.
Evaluation of a feasibility study addressing risk factors for childhood obesity through home visits
Authors: Wen Li Ming , De Domenico Maria , Elliott Donna , Bindon Jeni , Rissel Chris 
Published: September 2009

Aim:  This pilot study aimed to explore the feasibility of addressing risk factors for childhood obesity through a home‐based early intervention program.Method:  A pilot study was conducted with 56 first‐time mothers, recruited through the antenatal and delivery units of an inner western Sydney hospital. The study offered five home visits by a community early childhood health nurse during the child's first year of life. At each visit, the intervention was tailored to the appropriate developmental stage of the child. One‐to‐one consultation was provided with a focus on sustained breastfeeding, appropriate introduction of solids, avoiding food rewards and promoting the drinking of water and the use of a cup. Both quantitative and qualitative methods were applied to assess the feasibility and acceptability of the program.Results:  The results indicate that the program was very well received by the participating mothers, with a retention rate of 95%. Compared with the state population average, the rate of breastfeeding at 12 months was significantly higher (36% vs. 18%, χ2= 8.21, P < 0.01), there was a lower rate of the introduction of solids before 4 months (2% vs. 13%, χ2= 8.73, P < 0.01), and there was a high rate of cup usage at 12 months (98%).Conclusions:  The early onset of childhood overweight and obesity requires health promotion intervention programs to commence as early as possible. A home‐based intervention through multiple home visits is feasible in addressing the risk factors for childhood obesity.
Immunisation practices in infants born prematurely: Neonatologists' survey and clinical audit
Authors: Crawford Nigel W , Yeo Vivien , Hunt Rod W , Barfield Charles , Gelbart Ben , Buttery Jim P 
Published: September 2009

Aim:  To determine Australian neonatologists' recommendations for the immunisation of ex‐preterm infants and compare their actual immunisation status with recommended Australian guidelines.Methods:  A self‐administered nine‐part questionnaire of current immunisation practices was sent to all Neonatologists in Australia (2006). A complementary retrospective immunisation audit was conducted in two tertiary neonatal units in Melbourne. Hospital records and the Australian Childhood Immunisation Register (ACIR) were reviewed; consenting parents were interviewed and primary care physicians' vaccination records were requested. A random sample of preterm infants born between July 2003 and June 2005 at <32 weeks' gestation were selected.Results:  (i) Neonatologists Survey: The response rate was 68% and the majority of neonatologists (89%) were aware of the current guidelines, but adherence to them varied from 43% to 79%. One‐fifth of neonatologists personally do not receive annual influenza vaccination; and (ii) Immunisation Audit: Conducted between October 2006‐May 2007 it included: 100 hospital records; 97 ACIR records; 47 parent interviews and 43 primary care vaccination records. Overall vaccination coverage was 90% at 12 months of age. Only 20% (10/50) of infants with chronic lung disease received an influenza vaccination. Vaccines were delayed by greater than one month in 15% of participants for the 2 month DTPa vaccine and 43% at 6 months.Conclusions:  The neonatologists survey highlighted variable adherence with immunisation guidelines. The audit confirmed preterm infants are frequently experiencing delayed vaccination and recommended additional vaccinations are often not being received. Formulation of strategies to ensure complete and timely immunisation are required, including better utilisation of the ACIR.
Darbepoetin alfa: A new erythropoietic drug for the treatment of renal anaemia*
Authors:   Amgen Anaemia Advisory Group
Published: September 2009

SUMMARY: Darbepoetin alfa (Aranesp®, Amgen Ltd) is a long‐acting, hyperglycosylated recombinant human erythropoietin (r‐HuEPO; epoetin) analogue, developed for the treatment of anaemia in patients with chronic kidney disease (CKD, i.e. end‐stage renal failure or progressive renal impairment). Based on previously published European guidelines, this review article presents key recommendations for the use of darbepoetin alfa in Australasian clinical practice.Darbepoetin alfa is expected to be a valuable alternative therapeutic agent for the management of renal anaemia. Clinical data demonstrate that: Once‐weekly administration of darbepoetin alfa ‐ whether by subcutaneous (s.c.) or intravenous (i.v.) injection ‐ is as effective as epoetin therapy, administered two or three times per week; patients receiving once‐weekly doses of epoetin can be switched to darbepoetin alfa, once every 2 weeks; target haemoglobin (Hb) concentrations can be successfully maintained in patients switched from epoetin therapy to less frequently administered doses of darbepoetin alfa (administration once every 2 weeks is sufficient for some patients); and darbepoetin alfa has a similar safety profile to epoetin. In addition to addressing a number of practical considerations relating to the use of darbepoetin alfa in clinical practice, this article also highlights principal findings from several key clinical studies.
A NEW THIN ENDOSCOPIC METHOD OF TRANSANAL DRAINAGE TUBE INSERTION FOR ACUTE COLONIC OBSTRUCTION DUE TO COLORECTAL CANCER
Authors: Ohnita Ken , Shikuwa Saburo , Isomoto Hajime , Yamaguchi Naoyuki , Okamoto Kenta , Nishiyama Hitoshi , Fukuda Eiichiro , Nakamura Takashi , Mizuta Yohei , Kohno Shigeru 
Published: September 2009

Aim:  Insertion of a transanal drainage tube is effective in the management of obstructing colorectal cancer. We devised a new method of inserting the transanal drainage tube safely and quickly using a thin endoscope.Methods:  Sixteen patients (seven men and nine women) with obstructive left‐sided colorectal cancer were treated by inserting a transanal drainage tube using a thin endoscope. We inserted a transanal drainage tube for 32 patients (21 men and 11 women) with left‐sided colorectal cancer using the conventional method.Results:  Drainage tube placement by the conventional method was successful in 29 (90.6%) of 32 patients, while via the new method, it was successful in all 16 patients without major complications. Moreover, median insertion time was significantly shortened (34 minutes for the new method compared with 42 minutes for the conventional method).Conclusion:  Management of acute colorectal obstruction by transanal drainage tube insertion using the thin endoscope was effective and safe.