bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated postdischarge transitional care in a hospitalist system to improve discharge outcome: an experimental study
Authors: Shu Chin-Chung , Hsu Nin-Chieh , Lin Yu-Feng , Wang Jann-Yuan , Lin Jou-Wei , Ko Wen-Je 
Published: August 2011

AbstractBackgroundThe postdischarge period is a vulnerable time for patients, with high rates of adverse events that may cause unnecessary readmissions, especially in the elderly. Because postdischarge care continuity is often interrupted after hospitalist care, close follow-up may decrease patient readmission. In this study, we aimed to investigate the impact of a quality improvement program, integrated postdischarge transitional care (PDTC), in Taiwan's hospitalist system.MethodsFrom December 2009 to May 2010, patients admitted to the hospitalist ward of a medical center in Taiwan and later discharged alive to home care were included. Efforts to improve the quality of interventions in the PDTC program, including a disease-specific care plan, telephone monitoring, hotline counseling and referral to a hospitalist-run clinic, were implemented in the latter four months in the intervention group, while the control group was recruited during the first two months of the study period. The primary end point was unplanned readmission or death within 30 days after discharge.ResultsThere were 94 and 219 patients in the control and intervention groups, respectively. Both groups had similar characteristics at the time of admission and at discharge. In the intervention group, 18 patients with worsening disease-specific indicators recorded during telephone monitoring and 21 patients with new or worsening symptoms recorded during hotline counseling had higher rates of unplanned readmission than those without worsening disease-specific indicators (P= 0.031) and worsening symptoms (P= 0.019), respectively. Patients who received PDTC had lower rates of readmission and death than the control group within 30 days after discharge (15% vs. 25%;P= 0.021). Nonuse of a hospitalist-run clinic and presence of underlying malignancy were other independent risk factors for readmission and death within 30 days after discharge.ConclusionIntegrated PDTC using disease-specific care, telephone monitoring, hotline counseling and a hospitalist-run clinic can reduce rates of postdischarge readmission and death.
Sliding and pressure evaluation on conventional and V-shaped seats of reclining wheelchairs for stroke patients with flaccid hemiplegia: a crossover trial
Authors: Huang Hsiu-Chen , Yeh Cheng-Hsin , Chen Chi-Myn , Lin Yu-Sheng , Chung Kao-Chi 
Published: August 2011

Abstract

Background
Reclining wheelchairs are commonly used to transport elderly stroke patients in Taiwan. However, there is concern that the patient's body in the wheelchair often slides forward when they return to a seated position, increasing the sitting pressure. Therefore, a novel reclining wheelchair with an ergonomic "V-Seat" was designed to prevent forward sliding and pressure sores. The use of these reclining chairs by stroke patients has not yet been studied. Thus, we investigated the effects of V-shaped and conventional seats in reclining wheelchairs on the extent of forward sliding and on the sitting pressure of stroke patients with flaccid hemiplegia and of able-bodied elders.

Methods
We recruited 13 able-bodied elders and 11 stroke patients with flaccid hemiplegia and performed 5 reclining cycles in both types of wheelchair. The amount of sliding along the backrest (BS) plane and the seat (SS) plane, the mean sitting pressure (MP), and the sacral peak pressure (SPP) of the subjects were recorded. We used the Wilcoxon signed-rank test to compare the BS, SS, MP, and SPP in wheelchairs with conventional and V-shaped seats, and we used the Wilcoxon rank sum test to compare the differences in BS and SS between stroke patients and able-bodied elders in both types of reclining wheelchair.

Results
The BS, SS, and SPP of stroke patients were significantly lower in the wheelchairs with V-shaped seats than in conventional wheelchairs in most comparisons; however, the BS of able-bodied elders was higher in V-shaped seats than in conventional seats. The SS and SPP of stroke patients were significantly higher than those of able-bodied elders in both types of reclining wheelchair, and the BS of stroke patients was significantly higher than that of able-bodied elders only in conventional reclining wheelchairs.

Conclusions
The use of V-shaped seats in reclining wheelchairs can help reduce the forward sliding and sacral peak pressure of stroke patients with flaccid hemiplegia. The back displacement of able-bodied subjects when using both conventional and V-shape seats in reclining positions differs from the back displacement of stroke patients with flaccid hemiplegia when using such seats. These results are of paramount value and should be considered when prescribing the use of reclining wheelchairs to subjects with flaccid hemiplegia.
SUrgical versus PERcutaneous Bypass: SUPERB-trial; Heparin-bonded endoluminal versus surgical femoro-popliteal bypass: study protocol for a randomized controlled trial
Authors: Lensvelt Mare MA , Holewijn Suzanne , Fritschy Wilbert M , Wikkeling Otmar RM , van Walraven Laurens A , Wallis de Vries Bas M , Zeebregts Clark J , Reijnen Michel MPJ 
Published: August 2011

Abstract

Background
Endovascular treatment options for the superficial femoral artery are evolving rapidly. For long lesions, the venous femoropopliteal bypass considered to be superior above the prosthetic bypass. An endoluminal bypass, however, may provide equal patency rates compared to the prosthetic above knee bypass. The introduction of heparin-bonded endografts may further improve patency rates. The SUrgical versus PERcutaneous Bypass (SuperB) study is designed to assess whether a heparin-bonded endoluminal bypass provides equal patency rates compared to the venous bypass and to prove that it is associated with improved quality of life, related to a decreased complication rate, or not.

Methods/design
Two-hundred-twenty-two patients with peripheral arterial occlusive disease, category 3-6 according to Rutherford, will be randomized in two treatment arms; 1. the surgical femoro-popliteal bypass, venous whenever possible, and 2. the heparin-bonded endoluminal bypass. The power analysis was based on a non-inferiority principle, with an effect size of 90% and 10% margins (alpha 5%, power 80%). Patients will be recruited from 5 teaching hospitals in the Netherlands during a 2-year period. The primary endpoint is primary patency and quality of life evaluated by the RAND-36 questionnaire and the Walking Impairment Questionnaire. Secondary endpoints include secondary patency, freedom-from-TLR and complications.

Discussion
The SuperB trial is a multicentre randomized controlled trial designed to show non-inferiority in patency rates of the heparin-bonded endograft compared to the surgical bypass for treatment of long SFA lesions, and to prove a better quality of life using the heparin bonded-endograft compared to surgically treatment, related to a reduction in complications.
Trial Registration
Clinicaltrials: NCT01220245
Mechanisms of increased risk of tumorigenesis in Atm and Brca1 double heterozygosity
Authors: Wang Jufang , Su Fengtao , Smilenov Lubomir B , Zhou Libin , Hu Wentao , Ding Nan , Zhou Guangming 
Published: August 2011

AbstractBackgroundBoth epidemiological and experimental studies suggest that heterozygosity for a single gene is linked with tumorigenesis and heterozygosity for two genes increases the risk of tumor incidence. Our previous work has demonstrated thatAtm/Brca1double heterozygosity leads to higher cell transformation rate than single heterozygosity. However, the underlying mechanisms have not been fully understood yet. In the present study, a series of pathways were investigated to clarify the possible mechanisms of increased risk of tumorigenesis inAtmandBrca1heterozygosity.MethodsWild type cells,AtmorBrca1single heterozygous cells, andAtm/Brca1double heterozygous cells were used to investigate DNA damage and repair, cell cycle, micronuclei, and cell transformation after photon irradiation.ResultsRemarkable high transformation frequency was confirmed inAtm/Brca1double heterozygous cells compared to wild type cells. It was observed that delayed DNA damage recognition, disturbed cell cycle checkpoint, incomplete DNA repair, and increased genomic instability were involved in the biological networks. Haploinsufficiency of either ATM or BRCA1 negatively impacts these pathways.ConclusionsThe quantity of critical proteins such as ATM and BRCA1 plays an important role in determination of the fate of cells exposed to ionizing radiation and double heterozygosity increases the risk of tumorigenesis. These findings also benefit understanding of the individual susceptibility to tumor initiation.
Limb salvage after gas gangrene: a case report and review of the literature
Authors: Aggelidakis John , Lasithiotakis Konstantinos , Topalidou Anastasia , Koutroumpas John , Kouvidis Georgios , Katonis Paulos 
Published: August 2011

AbstractGas gangrene is a necrotic infection of soft tissue associated with high mortality, often necessitating amputation in order to control the infection. Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. The patient was early treated with surgery and antibiotics rendering possible the preservation of the limb and some of its function. Additionally, a review of the literature regarding case reports of limb salvage after gas gangrene is presented.
Prolapsed sigmoid intussusception per anus in an elderly man: a case report
Authors: Teyha Penn S , Chandika Alphonce , Kotecha Vihar R 
Published: August 2011

Abstract

Background
Intussusception in pediatrics is widely documented and well described. On the basis of the literature, however, adult intussusception is a rare entity with a prevalence of from 1% to 5%. The majority of adult patients with intussusception have an underlying pathology that needs to be identified by performing a proper physical examination and a wide array of investigations.

Case presentation
We present a case of a 66-year-old African man who presented to our emergency department with a mass protruding per anus with obstipation. During laparotomy, we found that the sigmoid colon had intussuscepted into the rectum and out from the anus. Other abdominal viscera were normal and without any obvious mesenteric lymphadenopathy. Sigmoid colectomy and spectacle colostomy were performed. Grossly, the excised bowel looked normal, but the histologic results showed features of necrosis and chronic inflammation.

Conclusion
While 70% to 90% of cases of adult intussusception have an identifiable cause or lesion, most pediatric intussusceptions are idiopathic. The presentation in an adult described herein was of an uncommon idiopathic type with no identifiable cause found on the basis of the history, physical examination, or histological findings.
Detection of synthetic glucocorticoids by liquid chromatography-tandem mass spectrometry in patients being investigated for Cushing's syndrome
Authors: Djedovic N K , Rainbow S J 
Published: August 2011

Background We report a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the detection of four commonly prescribed steroid drugs (prednisolone, dexamethasone, betamethasone and beclomethasone dipropionate) while simultaneously measuring 24-h urine free cortisol and cortisone in patients. Methods Two hundred and fifty microlitre aliquots of urine were spiked with internal standard and extracted with dichloromethane. The MS instrument was operated with positive electrospray and multiple reaction monitoring. Two transitions were monitored for each analyte of interest and the ratio of the intensities of the product ion fragments was established. Results The LC-MS/MS method for the measurement of urine free cortisol and cortisone was established. The assay was linear up to 788 nmol/L for cortisol and 777 nmol/L for cortisone, with a limit of quantitation of 5.0 nmol/L for both. Analysis time per sample was seven minutes. Transitions for four synthetic glucocorticoids were included, and they were identified based on the ratio of the intensities of product ion fragments. Analysis of 219 samples collected from 154 patients (55 male and 99 female) revealed the presence of prednisolone in five samples from three patients. Dexamethasone was detected in samples from four patients, and betamethasone was detected in one sample. Conclusion This is the first LC-MS/MS method in routine use to combine quantification of urinary cortisol and cortisone and detection of synthetic glucocorticoids in patients being investigated for Cushing's syndrome. Since the most common quoted cause of Cushing's syndrome is steroid treatment, this is a valuable diagnostic tool.
“Forward to Haydn!”: Schenker's Politics and the German Revival of Haydn
Authors: Proksch Bryan 
Published: August 2011

Abstract
While Heinrich Schenker consistently espoused the superiority of the German masterworks, his biases toward Haydn's works laid the groundwork for a reversal of nearly a century of neglect toward that composer's music in German-speaking lands. The circumstances of Schenker's personal life together with his reaction to the socioeconomic and political pressures created by the harsh terms imposed on Germany and Austria by the Treaties of Versailles and Saint-Germain led him to make the restoration of Haydn's stature as a compositional genius a crucial battle in his fight to reclaim German identity in the wake of the First World War. His mentorship of Anthony van Hoboken, who in turn underwrote Schenker's publications, created a partnership that redefined the cultural significance of Haydn's music and provided for the preservation of numerous Haydn autographs. Schenker's writings on Haydn refuted popular myths on the composer and replaced them with detailed arguments rooted in analysis in an effort to demonstrate the composer's musical significance to a nation in crisis specifically and the world at large.
The Value of Microbiological Screening in Cleft Lip and Palate Surgery
Authors: Thomas Gregory P.L. , Sibley Jane , Goodacre Timothy E.E. , Cadier Michael M. 
Published: August 2011

Objective This study was performed to investigate whether nasal and oropharyngeal microbiological swabs taken prior to cleft lip and palate surgery correlated with the oronasal flora at the time of surgery and whether specific culture results affected surgical outcome. Methods Prospective audit set in two designated U.K. cleft centers each with a single surgeon. Nasal and oropharyngeal microbiological swabs were taken within 2 weeks prior to surgery and again on the operating table. Adverse outcome measures included postoperative pyrexia, wound dehiscence, or fistula formation. Results One hundred forty-four cases were recruited over 12 months. Nasal swabs cultured organisms significantly more often than oropharyngeal swabs (p < .0001). No significant difference was detected in the number of cases with a positive microbiology culture preoperatively compared with perioperative sampling (48% and 50%). The specific organisms cultured from preoperative swabs were the same as those cultured at surgery in only half of cases. Preoperative microbiology swabs were poorly predictive of the oronasal flora at surgery. Antibiotic treatment of patients with positive preoperative microbiology did not significantly reduce the incidence of bacterial colonization or significantly alter clinical outcome. Conclusion Preoperative microbiological investigation is not helpful in predicting the nasal and oropharyngeal flora at the time of surgery. Further, culture results did not correlate with postoperative outcome, regardless of whether pre- or perioperative antibiotic therapy was instigated. This evidence suggests that microbiology screening swabs are an unnecessary investigation.
Parameters of Care for Craniosynostosis
Authors: McCarthy Joseph G. , Warren Stephen M. , Bernstein Joseph , Burnett Whitney , Cunningham Michael L. , Edmond Jane C. , Figueroa Alvaro A. , Kapp-Simon Kathleen A. , Labow Brian I. , Peterson-Falzone Sally J. , Proctor Mark R. , Rubin Marcie S. , Sze Raymond W. , Yemen Terrance A. ,   other members of the Craniosynostosis Working Group
Published: August 2011

Background A multidisciplinary meeting was held from March 4 to 6, 2010, in Atlanta, Georgia, entitled “Craniosynostosis: Developing Parameters for Diagnosis, Treatment, and Management.” The goal of this meeting was to create parameters of care for individuals with craniosynostosis. Methods Fifty-two conference attendees represented a broad range of expertise, including anesthesiology, craniofacial surgery, dentistry, genetics, hand surgery, neurosurgery, nursing, ophthalmology, oral and maxillofacial surgery, orthodontics, otolaryngology, pediatrics, psychology, public health, radiology, and speech-language pathology. These attendees also represented 16 professional societies and peer-reviewed journals. The current state of knowledge related to each discipline was reviewed. Based on areas of expertise, four breakout groups were created to reach a consensus and draft specialty-specific parameters of care based on the literature or, in the absence of literature, broad clinical experience. In an iterative manner, the specialty-specific draft recommendations were presented to all conference attendees. Participants discussed the recommendations in multidisciplinary groups to facilitate exchange and consensus across disciplines. After the conference, a pediatric intensivist and social worker reviewed the recommendations. Results Consensus was reached among the 52 conference attendees and two post hoc reviewers. Longitudinal parameters of care were developed for the diagnosis, treatment, and management of craniosynostosis in each of the 18 specialty areas of care from prenatal evaluation to adulthood. Conclusions To our knowledge, this is the first multidisciplinary effort to develop parameters of care for craniosynostosis. These parameters were designed to help facilitate the development of educational programs for the patient, families, and health-care professionals; stimulate the creation of a national database and registry to promote research, especially in the area of outcome studies; improve credentialing of interdisciplinary craniofacial clinical teams; and improve the availability of health insurance coverage for all individuals with craniosynostosis.
17β-Estradiol promotes cell proliferation in rat osteoarthritis model chondrocytes via PI3K/Akt pathway
Authors: Huang Jia , Xia Chun , Zheng Xin , Yi Ting , Wang Xiao , Song Gang , Zhang Bing 
Published: August 2011

AbstractOsteoarthritis (OA) is the most common cause of musculoskeletal pain and disability. The importance of chondrocytes in the pathogenesis of OA is unequivocal. 17β-estradiol (E2) has a potential protective effect against OA. However, the mechanism of E2 in OA chondrocytes remains unclear. In this study, we investigated the regulative effect of E2 on cell growth and the relationship between E2 and the PI3K/Akt pathway in rat OA model chondrocytes (pretreated with interleukin-1β). We found that E2 induced chondrocyte proliferation, and increased the expression level of Akt simultaneously, especially the expression level of P-Akt. Furthermore, the inhibition of P-Akt could block chondrocyte proliferation induced by E2. These results suggest that PI3K/Akt activation induced by E2 may be an important factor in the mechanism of E2 in cell proliferation in rat OA model chondrocytes, and help further understanding the role of E2 in OA progression.
Generalized stern models of the electric double layer considering the spatial variation of permittvity and finite size of ions in saturation regime
Authors: Gongadze Ekaterina , Rienen Ursula , Iglič Aleš 
Published: August 2011

AbstractThe interaction between a charged metal implant surface and a surrounding body fluid (electrolyte solution) leads to ion redistribution and thus to formation of an electrical double layer (EDL). The physical properties of the EDL contribute essentially to the formation of the complex implant-biosystem interface. Study of the EDL began in 1879 by Hermann von Helmholtz and still today remains a scientific challenge. The present mini review is focused on introducing the generalized Stern theory of an EDL, which takes into account the orientational ordering of water molecules. To ascertain the plausibility of the generalized Stern models described, we follow the classical model of Stern and introduce two Langevin models for spatial variation of the relative permittivity for point-like and finite sized ions. We attempt to uncover the subtle interplay between water ordering and finite sized ions and their impact on the electric potential near the charged implant surface. Two complementary effects appear to account for the spatial dependency of the relative permittivity near the charged implant surface — the dipole moment vectors of water molecules are predominantly oriented towards the surface and water molecules are depleted due to the accumulation of counterions. At the end the expressions for relative permittivity in both Langevin models were generalized by also taking into account the cavity and reaction field.
Preparation and characterization of V2O5 doped SiO2-TiO2 thin films
Authors: Nocuń Marek , Kwaśny Sławomir 
Published: August 2011

Abstract
In our investigation, V doped SiO2/TiO2 thin films were prepared on glass substrates by dip coating sol-gel technique. Chemical composition of the samples was studied by X-ray photoelectron spectroscopy (XPS). Transmittance of the samples was characterized using UV-VIS spectrophotometry. Subsequently band-gap energy (Eg) was estimated for these films. Powders obtained from sols were characterized by FTIR spectroscopy. It was found that vanadium decreases optical band gap of SSiO2/TiO2 films.
Staff Experience, Knowledge and Attitudes Regarding the Management of Adolescent Patients in Adult Mental Health Units
Authors: Curran Genevieve , Walter Garry , Soh Nerissa , Herman Michael , Baker Martin , Paton Michael , Newton Liz , Byrne Simon 
Published: August 2011

Objective: Inpatient psychiatric care of adolescents should, where possible, be provided in specialized units. However, admission of adolescent patients to adult mental health units does occur. There is a paucity of data about this practice. This study collates information about the experience, attitudes and knowledge of clinical staff regarding the care of adolescent patients in adult psychiatry units within Northern Sydney Central Coast Area Health Service (NSCCHS). Method: A survey was emailed to all clinical staff with employer accessible email addresses in NSCCHS. Results: The response rate was 29% (n = 108). The majority of respondents believed their wards were “not at all” (30.7%) or “only a little” (57.4%) equipped to care for adolescent patients. The majority felt “moderately” (39.6%) or “very” (16.8%) confident to care for these patients; however, a significant proportion (43.2%) lacked confidence. There was no significant difference across the responses of psychiatrists, psychiatry registrars and nursing staff to these questions. The majority felt the objectives of these admissions were met “only a little” (47.4%) or “not at all” (16.5%). Many concerns regarding the admission of adolescents to adult wards were reported. Conclusions: Generally, staff were not in favour of admitting adolescent patients to adult mental health units apart from in exceptional circumstances. Staff harboured concerns about several aspects of care for adolescents in adult wards.