bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Prevention After Coronary Artery Bypass Graft Surgery
Authors: Williams Judson B. , DeLong Elizabeth R. , Peterson Eric D. , Dokholyan Rachel S. , Ou Fang-Shu , Ferguson T. Bruce 
Published: December 2010

Background—
Despite evidence supporting the use of aspirin, β-blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering therapies in eligible patients, adoption of these secondary prevention measures after coronary artery bypass grafting has been inconsistent. We sought to rigorously test on a national scale whether low-intensity continuous quality improvement interventions can be used to speed secondary prevention adherence after coronary artery bypass grafting.

Methods and Results—
A total of 458 hospitals participating in the Society of Thoracic Surgeons National Cardiac Database and treating 361 328 patients undergoing isolated coronary artery bypass grafting were randomized to either a control or an intervention group. The intervention group received continuous quality improvement materials designed to influence the prescription of the secondary prevention medications at discharge. The primary outcome measure was discharge prescription rates of the targeted secondary prevention medications at intervention versus control sites, assessed by measuring preintervention and postintervention site differences. Prerandomization treatment patterns and baseline data were similar in the control (n=234) and treatment (n=224) groups. Individual medication use and composite adherence increased over 24 months in both groups, with a markedly more rapid rate of adherence uptake among the intervention hospitals and a statistically significant therapy hazard ratio in the intervention versus control group for all 4 secondary prevention medications.

Conclusions—
Provider-led, low-intensity continuous quality improvement efforts can improve the adoption of care processes into national practice within the context of a medical specialty society infrastructure. The findings of the present trial have led to the incorporation of study outcome metrics into a medical society rating system for ongoing quality improvement.
Civil service pay reforms in Africa
Authors: Olowu Dele 
Published: December 2010

African civil services have been subjected to perpetual rounds of reforms that have in many cases aggravated problems because the core issue of how to pay for quality civil service on a sustained basis has not been given the much-deserved emphasis. Many African countries have lost the capacity to pay for a high quality civil service due in part to the poverty of their economies, the structure of politics and administration, globalization, and wrong-headed reform programmes. A few countries in the region have adopted a strategic performance management approach to civil service reform that aligns the diversity of reform efforts in the public service. This strategy focuses attention on performance and productivity, the attraction and retention of skilled staff and senior management who in turn oversee a new culture of accountable use of resources for results. All of these are core to improving pay and the quantity, quality and performance of the civil service and the state in the region. Points for practitioners New proposals for civil service reform and civil service pay are made after contrasting failed and more successful approaches. These follow a discussion of the key human resource dilemmas presently confronting most of the African civil services.
Redefining political-administrative relationships in South Africa
Authors: Cameron Robert 
Published: December 2010

This article is an overview of shifting political—administrative relationships in South Africa, with particular reference to growing politicization (partisan control of the bureaucracy). Studies of politicization of public services are important because political involvement in management has often led to negative effects on service delivery. The article sets out a theoretical framework for political—administrative relationships, examining the growing politicization of public services, the impact of New Public Management (NPM) and political—administrative relationships in developing countries. It then looks at political—administrative relationships in South Africa, including the apartheid history, the development of a new framework in the democratic South Africa and politicization in the staffing of the public service. It examines three functional areas — the decentralization of powers, contract appointments and performance management — and discusses the implications of this changing framework for service delivery. The methodology consisted of interviews with a number of senior government officials, including three current directors-general and a former Minister for the Public Service and Administration, an analysis of government legislation, Public Service Commission (PSC) data including surveys, unpublished data of the Department of Public Service and Administration (DPSA), policy papers of the African National Congress (ANC) and an Organisation for Economic Co-operation and Development (OECD) study of political involvement in bureaucracies. The article concludes that growing politicization of the public service has contributed to poor service delivery, and that the South African government needs to place greater emphasis on merit as the basis for appointments and promotions. Points for practitioners This article is useful for professionals working in public management and administration because it looks at the following debates and issues, which have practical implications: frameworks for understanding political—administrative relationships in the public service; the impact of the politicization of staff in the public service; and how merit-based appointment can improve government effectiveness. The article also offers lessons to developing countries wishing to create more professional public services.
Comparative public administration and Africa
Authors: Jreisat Jamil 
Published: December 2010

The objectives of this article are to (1) define the contributions of the Comparative Public Administration to knowledge of governance, management of public services, and national development; (2) assess the relevance of these contributions to the African experience; (3) examine how comparative research, despite certain limitations, had steered public administration out of its ethnocentric and provincial mode of analysis into a wider global horizon of search and discovery; and (4) examine the relevance of development administration concepts to practice in Africa, particularly during the formative phase of post-colonial experience. The article offers suggestions for change strategies. Points for practitioners Comparing public administration practices of a country with those of other countries, with past performance, or with benchmarks is vital for administrative improvement and for developing reform strategies. Administrative knowledge, derived through cross-cultural comparative analysis, provides a broader horizon for the practitioner of management and better understanding of the larger context of governance. Also, comparison provides the practitioner with significant insights into policies and actions that work and those that do not work at the local, national, and global levels.
Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement in High-Level Athletes
Authors: Naal Florian D. , Miozzari Hermes H. , Wyss Tobias F. , Nötzli Hubert P. 
Published: December 2010

Background: Midterm outcome studies show that symptomatic femoroacetabular impingement (FAI) can be successfully treated by addressing the underlying pathomorphology with open or arthroscopic surgery. Although athletes may be vulnerable to hip injury from impingement, limited information is available regarding the results of open surgery in this group. Hypothesis: High-level athletes with FAI can resume their sports after surgical hip dislocation and continue professional careers for a significant period. Study Design: Case series; Level of evidence, 4. Methods: Twenty-two professional male athletes (19.7 ± 2.2 years) were evaluated by postal survey at a mean of 45.1 months (range, 12 to 79) after treatment by surgical hip dislocation (30 hips, cam- or mixed-type FAI; mean α angle, 69.3°; 14 ice hockey players). Evaluation included types and level of sports, subjective ratings, and clinical outcomes: Hip Outcome Score, SF-12, UCLA (University of California, Los Angeles) activity scale, Hip Sports Activity Scale, visual analog scale for pain. The primary outcome variable was return to professional sports; the clinical result was the secondary outcome variable. Results: At follow-up, 21 of 22 patients (96%) were still competing professionally: 19 at their previous level and 2 in minor leagues. Eighteen (82%) were satisfied with their hip surgery and 19 (86%) with their sports ability. Mean activity levels were 9.8 per the UCLA scale and 7.6 per the Hip Sports Activity Scale. Mean scores of the Hip Outcome Score–Activities of Daily Living and Sport subscales were 94.5 and 89.1. Mean scores of the SF-12 physical and mental component summaries were 51.1 and 54.3. Pain levels during sports were 1.8 per the visual analog scale. Conclusion: Surgical hip dislocation for the treatment of FAI allows athletes to resume sports and continue professional careers at the same level for several years. Clinical outcomes in terms of subjective ratings and scores were favorable.
Effect of Shoulder Abduction Angle on Biomechanical Properties of the Repaired Rotator Cuff Tendons With 3 Types of Double-Row Technique
Authors: Mihata Teruhisa , Fukuhara Tetsutaro , Jun Bong Jae , Watanabe Chisato , Kinoshita Mitsuo 
Published: December 2010

Background: After rotator cuff repair, the shoulder is immobilized in various abduction positions. However, there is no consensus on the proper abduction angle. Purpose: To assess the effect of shoulder abduction angle on the biomechanical properties of the repaired rotator cuff tendons among 3 types of double-row techniques. Study Design: Controlled laboratory study. Methods: Thirty-two fresh-frozen porcine shoulders were used. A simulated rotator cuff tear was repaired by 1 of 3 double-row techniques: conventional double-row repair, transosseous-equivalent repair, and a combination of conventional double-row and bridging sutures (compression double-row repair). Each specimen underwent cyclic testing followed by tensile testing to failure at a simulated shoulder abduction angle of 0° or 40° on a material testing machine. Gap formation and failure loads were measured. Results: Gap formation in conventional double-row repair at 0° (1.2 ± 0.5 mm) was significantly greater than that at 40° (0.5 ± 0.3mm, P = .01). The yield and ultimate failure loads for conventional double-row repair at 40° were significantly larger than those at 0° ( P < .01), whereas those for transosseous-equivalent repair ( P < .01) and compression double-row repair ( P < .0001) at 0° were significantly larger than those at 40°. The failure load for compression double-row repair was the greatest among the 3 double-row techniques at both 0° and 40° of abduction. Conclusion: Bridging sutures have a greater effect on the biomechanical properties of the repaired rotator cuff tendon at a low abduction angle, and the conventional double-row technique has a greater effect at a high abduction angle. Clinical Relevance: Proper abduction position after rotator cuff repair differs between conventional double-row repair and transosseous-equivalent repair. The authors recommend the use of the combined technique of conventional double-row and bridging sutures to obtain better biomechanical properties at both low and high abduction angles.
Rosuvastatin Treatment is Associated with a Decrease of Serum Oxidised Low-Density Lipoprotein/Beta2-Glycoprotein I Complex Concentration in Type 2 Diabetes
Authors: Ames Paul RJ , Ortiz-Cadenas Alfredo , Torre Ignacio Garcia-De La , Nava Arnulfo , Oregon-Miranda Aldo , Batuca Joana R , Kojima Kazuo , Lopez Luis R , Matsuura Eiji 
Published: December 2010

Aims To evaluate the effect of rosuvastatin on oxidised low-density lipoprotein/beta2-glycoprotein I (oxLDL/β2GPI) complex concentration in type 2 diabetes mellitus. Methods Open label 2:1 assignment of consecutive diabetic patients into oral rosuvastatin (10 mg daily for six weeks) arm or observational arm with measurements of serum oxLDL/|β2GPI complexes, nitric oxide metabolites, asymmetric dimethyl arginine, nitrotyrosine alongside routine biochemistry at baseline and end of study in all patients. Results After rosuvastatin treatment the mean serum concentration of oxLDL/β2GPI decreased from 0.79±0.49 units/mL to 0.53±0.36 units/mL (p<0.001). The decrease was statistically independent from the decrements of mean cholesterol, LDL and triglyceride concentrations (p<0.001) but probably dependent on the decrement of nitrate (p<0.001). Conclusion In type 2 diabetes, treatment with rosuvastatin was associated with a significant reduction of serum concentrations of oxLDL/β2GPI complexes, which is in further support of the already proposed effects of the drug on the oxidative metabolism of lipids and/or LDL. The oxLDL/β2GPI complex may represent a surrogate marker of oxidative stress in type 2 diabetes.
A Prospective, Observational Study of the Management of Hyperglycaemia in Acute Stroke. What is the Optimum Level of Blood Glucose at which to Intervene?
Authors: Grant Paul S , Ali Khalid 
Published: December 2010

Background It is well known that blood glucose levels are increased in the first 12 hours after the onset of acute stroke. The magnitude of the rise is supposedly related to the severity of the stroke and this is in turn associated with a worse prognosis. Several guidelines advocate the use of insulin sliding scales in the acute stroke setting but these are only implemented with varying degrees of success. There is no clear evidence base as to the glycaemic level at which to intervene and the significance of the intervention on outcomes. Methods We prospectively reviewed the treatment of 229 patients admitted to a stroke unit and compared admission blood glucose results with stroke prognostic/neurological deficit score (National Institutes of Health Stroke Scale) at 30 days. Inter-physician practice variability allowed us to observe the outcomes when different levels for intervention were used (and allowed us to calculate an optimum level of glucose at which insulin sliding scale treatment would lead to most benefit). Results We showed that glucose is a modifiable factor that has implications for long-term stroke outcomes. Conclusion The suggested level for intervention with insulin (admission blood glucose of ≥ 10.1 mmol/L) is lower than previously thought.
Natural killer–cell differentiation by myeloid progenitors
Authors: Grzywacz Bartosz , Kataria Nandini , Kataria Niketa , Blazar Bruce R. , Miller Jeffrey S. , Verneris Michael R. 
Published: December 2010

AbstractBecause lymphoid progenitors can give rise to natural killer (NK) cells, NK ontogeny has been considered to be exclusively lymphoid. Here, we show that rare human CD34+ hematopoietic progenitors develop into NK cells in vitro in the presence of cytokines (interleukin-7, interleukin-15, stem cell factor, and fms-like tyrosine kinase-3 ligand). Adding hydrocortisone and stromal cells greatly increases the frequency of progenitor cells that give rise to NK cells through the recruitment of myeloid precursors, including common myeloid progenitors and granulocytic-monocytic precursors to the NK-cell lineage. WNT signaling was involved in this effect. Cells at more advanced stages of myeloid differentiation (with increasing expression of CD13 and macrophage colony-stimulating factor receptor [M-CSFR]) could also differentiate into NK cells in the presence of cytokines, stroma, and hydrocortisone. NK cells derived from myeloid precursors (CD56−CD117+M-CSFR+) showed more expression of killer immunoglobulin-like receptors, a fraction of killer immunoglobulin–like receptor-positive–expressing cells that lacked NKG2A, a higher cytotoxicity compared with CD56−CD117+M-CSFR− precursor-derived NK cells and thus resemble the CD56dim subset of NK cells. Collectively, these studies show that NK cells can be derived from the myeloid lineage.
Identification of Patients With Acute Myeloblastic Leukemia Who Benefit From the Addition of Gemtuzumab Ozogamicin: Results of the MRC AML15 Trial
Authors: Burnett Alan K. , Hills Robert K. , Milligan Donald , Kjeldsen Lars , Kell Jonathan , Russell Nigel H. , Yin John A.L. , Hunter Ann , Goldstone Anthony H. , Wheatley Keith 
Published: December 2010

Purpose Antibody-directed chemotherapy for acute myeloid leukemia (AML) may permit more treatment to be administered without escalating toxicity. Gemtuzumab ozogamicin (GO) is an immunoconjugate between CD33 and calicheamicin that is internalized when binding to the epitope. We previously established that it is feasible to combine GO with conventional chemotherapy. We now report a large randomized trial testing the addition of GO to induction and/or consolidation chemotherapy in untreated younger patients. Patients and Methods In this open-label trial, 1,113 patients, predominantly younger than age 60 years, were randomly assigned to receive a single dose of GO (3 mg/m2) on day 1 of induction course 1 with one of the following three induction schedules: daunorubicin and cytarabine; cytarabine, daunorubicin, and etoposide; or fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin. In remission, 948 patients were randomly assigned to GO in course 3 in combination with amsacrine, cytarabine, and etoposide or high-dose cytarabine. The primary end points were response rate and survival. Results The addition of GO was well tolerated with no significant increase in toxicity. There was no overall difference in response or survival in either induction of consolidation. However, a predefined analysis by cytogenetics showed highly significant interaction with induction GO (P = .001), with significant survival benefit for patients with favorable cytogenetics, no benefit for patients with poor-risk disease, and a trend for benefit in intermediate-risk patients. An internally validated prognostic index identified approximately 70% of patients with a predicted benefit of 10% in 5-year survival. Conclusion A substantial proportion of younger patients with AML have improved survival with the addition of GO to induction chemotherapy with little additional toxicity.
Breastfeeding Duration and Academic Achievement at 10 Years
Authors: Oddy Wendy H. , Li Jianghong , Whitehouse Andrew J. O. , Zubrick Stephen R. , Malacova Eva 
Published: December 2010

INTRODUCTION:
The aim of this study was to examine the relationship between duration of breastfeeding and educational outcomes. We hypothesized that longer periods of breastfeeding would predict better educational outcomes in middle childhood.

METHODS:
The Western Australian Pregnancy Cohort (Raine) Study used a cohort of 2900 women who were enrolled at 18 weeks' gestation; with 2868 live-born children were followed prospectively. At ∼10 years of age, data from 1038 children were linked to standardized mathematics, reading, writing, and spelling scores. Associations between breastfeeding duration and educational outcomes were estimated by using linear models with adjustment for gender, family income, maternal factors, and early stimulation at home through reading.

RESULTS:
Ten-year-old children who were predominantly breastfed for 6 months or longer in infancy had higher academic scores than children who were breastfed for less than 6 months. The effect of breastfeeding on educational outcomes differed according to gender; boys were particularly responsive (in mathematics, spelling, reading, and writing) to a longer duration of breastfeeding.

CONCLUSIONS:
Predominant breastfeeding for 6 months or longer was positively associated with academic achievement in children at 10 years of age. However, the effectiveness of breastfeeding differed according to gender; the benefits were only evident for boys.
Pandemic H1N1 in Children Requiring Intensive Care in Australia and New Zealand During Winter 2009
Authors: Yung Michael , Slater Anthony , Festa Marino , Williams Gary , Erickson Simon , Pettila Ville , Alexander Janet , Howe Belinda D. , Shekerdemian Lara S. ,   on behalf of the Australia and New Zealand Intensive Care Influenza Investigators and the Paediatric Study Group and the Clinical Trials Group of the Australia New Zealand Intensive Care Society
Published: December 2010

OBJECTIVE:
To describe in detail the pediatric intensive care experience of influenza A, particularly pandemic H1N1-09, in Australia and New Zealand during the 2009 Southern Hemisphere winter and to compare the pediatric experience with that of adults.

METHOD:
This was an inception-cohort study of all children who were admitted to intensive care with confirmed influenza A during winter 2009 at all general ICUs and PICUs in Australia and New Zealand.

RESULTS:
From June 1 through August 31, 2009, 107 children (20.0 per million [95% confidence interval: 16.1–23.8]) with influenza A, including 83 (15.5 per million [95% confidence interval: 12.1–18.9]) with H1N1-09 were admitted to ICUs. Fifty-two percent (39 of 75) of children with H1N1-09 had 1 or more comorbidity, most commonly neurologic (20%). Most (48 of 83 [58%]) presented with pneumonia. Thirteen of 83 (16%) had neurologic presentations. Eighty percent of the children with H1N1-09 required ventilation. Mortality was lower than in adults: 6 of 83 (7%) vs 114 of 668 (17%) (P = .02). The median length of stay for children with H1N1-09 was 5 days. Children with H1N1-09 occupied 773 bed-days (147 per million children) and 5.8% of specialist PICU beds. Presentation with septic shock or after cardiac arrest and the presence of 1 or more comorbidities were risk factors for severe disease.

CONCLUSIONS:
H1N1-09 caused a substantial burden on pediatric intensive care services in Australia and New Zealand. Compared with adults, children more commonly had nonrespiratory presentations and required ventilation more often but had a lower mortality rate.
Economic Evaluation of Caffeine for Apnea of Prematurity
Authors: Dukhovny Dmitry , Lorch Scott A. , Schmidt Barbara , Doyle Lex W. , Kok Joke H. , Roberts Robin S. , Kamholz Karen L. , Wang Na , Mao Wenyang , Zupancic John A. F. ,   for the Caffeine for Apnea of Prematurity Trial Group
Published: December 2010

OBJECTIVE:
To determine the cost-effectiveness of treatment with caffeine compared with placebo for apnea of prematurity in infants with birth weights less than 1250 g, from birth through 18 to 21 months' corrected age.

METHODS:
We undertook a retrospective economic evaluation of the cost per survivor without neurodevelopmental impairment by using individual-patient data from the Caffeine for Apnea of Prematurity clinical trial (N = 1869). We included direct medical costs either to the insurance payer or the hospital but excluded costs to parents and society, such as lost productivity. We used a price of $0.21/mg of generic caffeine citrate for our base-case analysis. All costs were expressed in 2008 Canadian dollars and discounted at 3%. The time horizon for this analysis extended through 18 to 21 months' corrected age to match the clinical trial.

RESULTS:
The mean cost per infant was $124 466 in the caffeine group and $133 505 in the placebo group (difference: $9039 [−14 749 to −3375]; adjusted P = .014). Cost-effectiveness analysis showed caffeine to be a dominant or “win-win” therapy: in &gt;99% of 1000 bootstrap replications of the analysis, caffeine-treated infants had simultaneously better outcomes and lower mean costs. These results were robust to a 1000% increase in the individual resource items, including the price of caffeine citrate.

CONCLUSIONS:
In comparison with placebo, caffeine therapy for apnea of prematurity in infants weighing less than 1250 g is economically appealing for infants up to 18 to 21 months' corrected age.