bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survey of Geriatricians on the Effect of Fecal Incontinence on Nursing Home Referral
Authors: Grover Madhusudan , Busby‐Whitehead Jan , Palmer, RN Mary H. , Heymen Steve , Palsson Olafur S. , Goode Patricia S. , Turner Marsha , Whitehead William E. 
Published: May 2010

OBJECTIVES: Determine the effect of fecal incontinence (FI) on healthcare providers' decisions to refer patients for nursing home (NH) placement.DESIGN: Survey.SETTING: Questionnaires were e‐mailed to participants' homes or offices. Participants could also volunteer at the 2008 American Geriatric Society annual meeting in Washington, DC.PARTICIPANTS: Two thousand randomly selected physician members and all 181 nurse practitioner members of the American Geriatrics Society were surveyed.MEASUREMENTS: The survey presented a clinical scenario of a 70‐year‐old woman ready for discharge from a hospital and asked about the likelihood of making a NH referral if the patient had no incontinence, urinary incontinence (UI) alone, or FI. Subsequent questions modified the clinical situation to include other conditions that might affect the decision to refer. A second survey of respondents to Survey 1 addressed possible moderators of the decision to refer (e.g., family caregiver presence, diarrhea or constipation, other physical or psychiatric limitations). Significance of differences in the relative risk (RR) for NH referral was tested using the chi‐square test.RESULTS: Seven hundred sixteen members (24.7% response rate) completed the first survey, and 686 of the 716 (96%) completed the second. FI increased the likelihood of NH referral (RR=4.71, P<.001) more than UI did (RR=1.90, P<.001). Mobility restrictions, cognitive decline, and multiple chronic illnesses increased the likelihood of NH referral more than FI alone (P<.001 for each), but in all scenarios, adding FI further increased the likelihood of referral (P<.001). Having family caregivers willing to help with toileting attenuated the likelihood of referral.CONCLUSION: FI increases the probability that geriatricians will refer to a NH. More‐aggressive outpatient treatment of FI might delay or prevent NH referral, improve quality of life, and reduce healthcare costs.
An Internet‐Based Communication Network for Information Transfer During Patient Transitions from Skilled Nursing Facility to the Emergency Department
Authors: Hustey Fredric M. , Palmer Robert M. 
Published: May 2010

OBJECTIVES: To determine whether the implementation of an Internet‐based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions.DESIGN: Interventional; before and after.SETTING: ED of an urban teaching hospital with approximately 55,000 visits per year and a 55‐bed subacute free‐standing rehabilitation facility (the SNF).PARTICIPANTS: All patients transferred from the SNF to the ED over 16 months.INTERVENTION: An Internet‐based communication network with SNF–ED transfer form for communication during patient care transitions.MEASUREMENTS: Nine elements of patient information assessed before and after intervention through chart review. Secondary outcomes: changes in efficiency of information transfer and staff satisfaction.RESULTS: Two hundred thirty‐four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention.CONCLUSION: The use of an Internet‐based system increased the amount of information communicated during SNF–ED care transitions and significantly reduced the number of pages in which this information was contained.
Randomized Trial of a Delirium Abatement Program for Postacute Skilled Nursing Facilities
Authors: Marcantonio Edward R. , Bergmann Margaret A. , Kiely Dan K. , Orav E. John , Jones Richard N. 
Published: May 2010

OBJECTIVES: To determine whether a delirium abatement program (DAP) can shorten duration of delirium in new admissions to postacute care (PAC).DESIGN: Cluster randomized controlled trial.SETTING: Eight skilled nursing facilities specializing in PAC within a single metropolitan region.PARTICIPANTS: Four hundred fifty‐seven participants with delirium at PAC admission.INTERVENTION: The DAP consisted of four steps: assessment for delirium within 5 days of PAC admission, assessment and correction of common reversible causes of delirium, prevention of complications of delirium, and restoration of function.MEASUREMENTS: Trained researchers screened eligible patients. Those with delirium defined according to the Confusion Assessment Method were eligible for participation using proxy consent. Regardless of location, researchers blind to intervention status re‐assessed participants for delirium 2 weeks and 1 month after enrollment.RESULTS: Nurses at DAP sites detected delirium in 41% of participants, versus 12% in usual care sites (P<.001), and completed DAP documentation in most participants in whom delirium was detected, but the DAP intervention had no effect on delirium persistence based on two measurements at 2 weeks (DAP 68% vs usual care 66%) and 1 month (DAP 60% vs usual care 51%) (adjusted P≥.20). Adjusting for baseline differences between DAP and usual care participants and restricting analysis to DAP participants in whom delirium was detected did not alter the results.CONCLUSION: Detection of delirium improved at the DAP sites, but the DAP had no effect on the persistence of delirium. This effectiveness trial demonstrated that a nurse‐led DAP intervention was not effective in typical PAC facilities.
Neuropsychological Predictors of Driving Errors in Older Adults
Authors: Dawson Jeffrey D. , Uc Ergun Y. , Anderson Steven W. , Johnson Amy M. , Rizzo Matthew 
Published: May 2010

OBJECTIVES: To identify neuropsychological factors associated with driving errors in older adults.DESIGN: Cross‐sectional observational study.SETTING: Neuropsychological assessment laboratory and an instrumented vehicle on a 35‐mile route on urban and rural roads.PARTICIPANTS: One hundred eleven older adult drivers (aged 65–89; mean age 72.3) and 80 middle‐aged drivers (aged 40–64; mean age 57.2).MEASUREMENTS: Explanatory variables included age, neuropsychological measures (cognitive, visual, and motor), and a composite cognitive score (COGSTAT). The outcome variable was the safety error count, as classified according to video review using a standardized taxonomy.RESULTS: Older drivers committed an average of 35.8 ± 12.8 safety errors per drive, compared with an average of 27.8 ± 9.8 for middle‐aged drivers (P<.001). For older drivers, there was an increase of 2.6 errors per drive observed for each 5‐year age increase (P=.03). After adjustment for age, education, and sex, COGSTAT was a significant predictor of safety errors in older drivers (P=.005), with an approximately 10% increase in safety errors observed for a 10% decrease in cognitive function. Individual significant predictors of more safety errors in older drivers included poorer scores on the Complex Figure Test—Copy, the Complex Figure Test—Recall, Block Design, Near Visual Acuity, and the Grooved Pegboard task.CONCLUSION: Driving errors in older adults tend to increase, even in the absence of neurological diagnoses. Age‐related decline in cognitive abilities, vision, and motor skills can explain some of this increase. Changes in visuospatial and visuomotor abilities appear to be particularly associated with unsafe driving in old age.
Are All Commonly Prescribed Antipsychotics Associated with Greater Mortality in Elderly Male Veterans with Dementia?
Authors: Rossom Rebecca C. , Rector Thomas S. , Lederle Frank A. , Dysken Maurice W. 
Published: May 2010

OBJECTIVES: To estimate mortality risk associated with individual commonly prescribed antipsychotics.DESIGN: Five‐year retrospective study.SETTING: Veterans national healthcare data.PARTICIPANTS: Predominantly male, aged 65 and older, with a diagnosis of dementia and no other indication for an antipsychotic. Subjects who received an antipsychotic were compared with randomly selected controls who did not. Exposed and control cohorts were matched according to their date of dementia diagnosis and time elapsed from diagnosis to the start of antipsychotic therapy.MEASUREMENTS: Mortality during incident antipsychotic use.RESULTS: Cohorts who were exposed to haloperidol (n=2,217), olanzapine (n=3,384), quetiapine (n=4,277), or risperidone (n=8,249) had more comorbidities than their control cohorts. During the first 30 days, there was a significant increase in mortality in subgroups prescribed a daily dose of haloperidol greater than 1 mg (hazard ratio (HR)=3.2, 95% confidence interval (CI)=2.2–4.5, P<.001), olanzapine greater than 2.5 mg (HR=1.5, 95% CI=1.1–2.0, P=.01), or risperidone greater than 1 mg (HR=1.6, 95% CI=1.1–2.2, P=.01) adjusted for demographic characteristics, comorbidities, and medication history using Cox regression analyses. Greater mortality was not seen when a daily dose of quetiapine greater than 50 mg (HR=1.2, 95% CI=0.7–1.8, P=.50) was prescribed, and there was no greater mortality associated with a dose less than 50 mg (HR=0.7, 95% CI=0.5–1.0, P=.03). No antipsychotic was associated with greater mortality after the first 30 days.CONCLUSION: Commonly prescribed doses of haloperidol, olanzapine, and risperidone, but not quetiapine, were associated with a short‐term increase in mortality. Further investigations are warranted to identify patient characteristics and antipsychotic dosage regimens that are not associated with a greater risk of mortality in elderly patients with dementia.
Emergency department blood transfusion predicts early massive transfusion and early blood component requirement
Authors: Nunez Timothy C. , Dutton William D. , May Addison K. , Holcomb John B. , Young Pampee P. , Cotton Bryan A. 
Published: May 2010

BACKGROUND: The purpose of this study was to evaluate the ability of uncrossmatched transfusions in the emergency department (ED) to predict early (<6 hr) massive transfusion (MT) of red blood cells (RBCs) and blood components.STUDY DESIGN AND METHODS: All patients admitted to a Level 1 trauma center between July 2005 and June 2007 who received any transfusions and were transported directly from the scene of injury were included. Early MT was defined as the need for 10 U or more or RBCs in the first 6 hours. Early MT plasma was defined as 6 U or more of plasma in the first 6 hours. Early MT platelets (PLTs) were defined as two or more apheresis transfusions in the first 6 hours. Univariate and multivariate analyses were performed.RESULTS: A total of 485 patients (34%) received ED transfusions (ED RBC+) and 956 (66%) did not receive ED transfusions (ED RBC–). ED RBC+ patients were younger, were more likely to be male, and arrived with more severe injuries. Multivariate regression identified ED transfusion of uncrossmatched RBC as an independent predictor of requiring early MT of RBCs (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.36‐7.59; p = 0.001), plasma (OR, 2.7; 95% CI, 1.66‐4.39; p < 0.001), and PLTs (OR, 1.9; 95% CI, 1.08‐3.41; p = 0.025).CONCLUSION: Patients receiving uncrossmatched RBCs in the ED are more than three times more likely to receive early MT of RBCs. Additionally, patients transfused with ED RBCs are more likely to receive 6 units or more of plasma and two or more apheresis PLT transfusions. Given these findings, ED transfusion of uncrossmatched RBCs should be considered a potential trigger for activation of an institution's MT protocol.
Information and Incentives Inside the Firm: Evidence from Loan Officer Rotation
Authors: HERTZBERG ANDREW , LIBERTI JOSE MARIA , PARAVISINI DANIEL 
Published: May 2010

ABSTRACTWe present evidence that reassigning tasks among agents can alleviate moral hazard in communication. A rotation policy that routinely reassigns loan officers to borrowers of a commercial bank affects the officers' reporting behavior. When an officer anticipates rotation, reports are more accurate and contain more bad news about the borrower's repayment prospects. As a result, the rotation policy makes bank lending decisions more sensitive to officer reports. The threat of rotation improves communication because self‐reporting bad news has a smaller negative effect on an officer's career prospects than bad news exposed by a successor.
Gesturing Saves Cognitive Resources When Talking About Nonpresent Objects
Authors: Ping Raedy , Goldin‐Meadow Susan 
Published: May 2010

AbstractIn numerous experimental contexts, gesturing has been shown to lighten a speaker’s cognitive load. However, in all of these experimental paradigms, the gestures have been directed to items in the “here‐and‐now.” This study attempts to generalize gesture’s ability to lighten cognitive load. We demonstrate here that gesturing continues to confer cognitive benefits when speakers talk about objects that are not present, and therefore cannot be directly indexed by gesture. These findings suggest that gesturing confers its benefits by more than simply tying abstract speech to the objects directly visible in the environment. Moreover, we show that the cognitive benefit conferred by gesturing is greater when novice learners produce gestures that add to the information expressed in speech than when they produce gestures that convey the same information as speech, suggesting that it is gesture’s meaningfulness that gives it the ability to affect working memory load.
A Computational Account of the Development of the Generalization of Shape Information
Authors: Doumas Leonidas A. A. , Hummel John E. 
Published: May 2010

AbstractAbecassis, Sera, Yonas, and Schwade (2001)showed that young children represent shapes more metrically, and perhaps more holistically, than do older children and adults. How does a child transition from representing objects and events as undifferentiated wholes to representing them explicitly in terms of their attributes? According to RBC (Recognition‐by‐Components theory;Biederman, 1987), objects are represented as collections of categorical geometric parts (“geons”) in particular categorical spatial relations. We propose that the transition from holistic to more categorical visual shape processing is a function of the development of geon‐like representations via a process of progressive intersection discovery. We present an account of this transition in terms of DORA (Doumas, Hummel, & Sandhofer, 2008), a model of the discovery of relational concepts. We demonstrate that DORA can learn representations of single geons by comparing objects composed of multiple geons. In addition, as DORA is learning it follows the same performance trajectory as children, originally generalizing shape more metrically/holistically and eventually generalizing categorically.
Correlation between immature platelet fraction and reticulated platelets. Usefulness in the etiology diagnosis of thrombocytopenia
Authors: Pons Issac , Monteagudo Manuel , Lucchetti Gianni , Muñoz Luz , Perea Granada , Colomina Isabel , Guiu Joaquim , Obiols Joaquima 
Published: May 2010

AbstractBackground:  Reticulated platelets (RP) are a surrogate marker for megakaryocytic activity, but the limitation of this determination is the lack of standardization of methodology. The determination of the immature platelet fraction (IPF) is performed in a simple, automated, and reproducible way between laboratories. We analyzed the correlation between IPF and RP, and usefulness of IPF in patients with thrombocytopenia.Methods:  RP were determined by flow cytometry using double staining with thiazole orange and CD61 PerCP®. IPF was performed with Sysmex XE2100 analyzer. We used a control group with normal platelets, and thrombocytopenic patients were classified into three groups: Group 1. Central thrombocytopenia, Group 2. Thrombocytopenia as a result of enhanced peripheral platelet destruction, and Group 3. Peripheral non‐immune thrombocytopenia by abnormal distribution.Results:  Fourteen controls and 66 patients were analyzed. Group 1: 25 patients, they had mean and confidence interval 95% (95% CI) for IPF 8.67% (6.49–10.46%) and RP 4.08% (2.86–5.30%). Group 2: 20 patients, they had mean and 95%CI for IPF 16.80% (12.20–21.39%) and RP 16.14% (9.89–22.40%). Group 3: 21 patients, they had mean and 95% CI for IPF 9.04% (6.95–11.14%) and RP 5.23% (3.41–7.05%). The overall Pearson linear correlation between IPF and RP was r: 0.65. There were statistically significant differences in values of IPF and RP between Group 2 and the other two groups (P < 0.01).Conclusion:  There is a good correlation between IPF and RP mainly in thrombocytopenia by peripheral destruction. Determination of IPF is an easy technique in their implementation, standardized and reproducible, so it could be a useful screening technique in patients with thrombocytopenia.
Organ transplantation and skin cancer: basic problems and new perspectives
Authors: Hofbauer Günther F.L. , Bavinck Jan Nico Bouwes , Euvrard Sylvie 
Published: May 2010

Please cite this paper as: Organ transplantation and skin cancer: basic problems and new perspectives. Experimental Dermatology 2010; 19: 473–483.Abstract:  Solid organ transplant and subsequent graft survival have increased worldwide, while immunosuppression has prevented rejection with increasing success. Side effects of cutaneous infection and neoplasm, however, affect the majority of solid organ transplant recipients (OTRs). Squamous cell carcinoma of the skin (SCC) is the most common neoplasm overall following organ transplant with a risk that is 60–100 times greater than for the immunocompetent population. This review focuses on questions of ongoing debate about SCC formation in OTRs such as viral carcinogenesis, systemic photoprotection, photosensitization by drugs, the impact of immunosuppressive drugs and inflammation as a driver of carcinogenesis.
A novel Chlamydiaceae‐like bacterium found in faecal specimens from sea birds from the Bering Sea
Authors: Christerson Linus , Blomqvist Maria , Grannas Karin , Thollesson Mikael , Laroucau Karine , Waldenström Jonas , Eliasson Ingvar , Olsen Björn , Herrmann Björn 
Published: May 2010

SummaryThe family Chlamydiaceae contains several bacterial pathogens of important human and veterinary medical concern, such as Chlamydia trachomatis and Chlamydophila psittaci. Within the order Chlamydiales there are also an increasing number of chlamydia‐like bacteria whose biodiversity, host range and environmental spread seem to have been largely underestimated, and which are currently being investigated for their potential medical relevance. In this study we present 16S rRNA, rnpB and ompA gene sequence data congruently indicating a novel chlamydia‐like bacterium found in faecal specimens from opportunistic fish‐eating sea birds, belonging to the Laridae and Alcidae families, from the Bering Sea. This novel bacterium appears to be closer to the Chlamydiaceae than other chlamydia‐like bacteria and is most likely a novel genus within the Chlamydiaceae family.
Sovereign Wealth Funds: An Assessment
Authors: Bahgat Gawdat 
Published: May 2010

AbstractHigh oil prices and impressive economic performance in emerging markets have led to the accumulation of massive financial assets. These nations have created sovereign wealth funds (SWFs) to manage their growing assets. SWFs have provided significant liquidity to American and European financial institutions. The rise of SWFs in number and size has raised concern about their objectives and strategies. This study examines the role these state‐owned funds play in the global markets and the efforts to regulate their activities. I argue that capital exporting and importing nations share common interests and reciprocal responsibility in ensuring global financial prosperity.Policy Implications

Sovereign wealth funds are currently important players in the international financial system and are projected to become even more influential in the future.
Sovereign wealth funds investments are driven more by commercial interests and less by political objectives.
The interests of capital exporting and capital importing nations are not mutually exclusive. Rather, both seek economic prosperity and political stability.
Too much regulation of sovereign wealth funds’ activities is likely to weaken cross‐border trade and investment.
Sovereign wealth funds should gain the confidence of host countries by accepting a high level of transparency.
Disruption of the Putative Cell Surface Polysaccharide Biosynthesis Gene SO3177 in
Shewanella oneidensis
MR-1 Enhances Adhesion to Electrodes and Current Generation in Microbial Fuel Cells
Authors: Kouzuma Atsushi , Meng Xian-Ying , Kimura Nobutada , Hashimoto Kazuhito , Watanabe Kazuya 
Published: May 2010

ABSTRACT

A microbial fuel cell (MFC) was inoculated with a random transposon insertion mutant library of
Shewanella oneidensis
MR-1 and operated with lactate as the sole fuel to select for mutants that preferentially grew in it. Agar plate cultivation of the resultant MFC enrichment culture detected an increased number of colonies exhibiting rough morphology. One such isolate, strain 4A, generated 50% more current in an MFC than wild-type MR-1. Determination of the transposon insertion site in strain 4A followed by deletion and complementation experiments revealed that the SO3177 gene, encoding a putative formyltransferase and situated in a cell surface polysaccharide biosynthesis gene cluster, was responsible for the increased current. Transmission electron microscopy showed that a layered structure at the cell surface, stainable with ruthenium red, was impaired in the SO3177 mutant (ΔSO3177), confirming that SO3177 is involved in the biosynthesis of cell surface polysaccharides. Compared to the wild type, ΔSO3177 cells preferentially attached to graphite felt anodes in MFCs, while physicochemical analyses revealed that the cell surface of ΔSO3177 was more hydrophobic. These results demonstrate that cell surface polysaccharides affect not only the cell adhesion to graphite anodes but also the current generation in MFCs.