bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Instructors’ Perceptions of Behaviors That Comprise Entry-Level Clinical Performance in Physical Therapist Students: A Qualitative Study
Authors: Jette Diane U , Bertoni Alicia , Coots Renee , Johnson Heidi , McLaughlin Catherine , Weisbach Cody 
Published: September 2010

Background and Purpose
The purpose of this study was to qualitatively explore clinical instructors’ (CIs) perceptions of students’ behaviors that comprise entry-level clinical performance, as well as how those perceptions were integrated into their decision making.

Subjects
The participants were 21 physical therapists who were CIs for physical therapist students.

Methods
Using a grounded theory approach, we conducted interviews, asking the question, “What is it about students’ performance that makes you see them as entry-level therapists?” We determined common themes among the interviews and developed a schema to explain the decision-making process.

Results
Participants identified 7 attributes that, when demonstrated to a sufficient degree, illustrated to them students’ ability to practice at the entry level. Those attributes were knowledge, clinical skills, safety, clinical decision making, self-directed learning, interpersonal communication, and professional demeanor. Participants viewed these attributes in concert to form a subjective “gut feeling” that a student demonstrated entry-level performance. A final theme emerged suggesting a definition of entry-level performance as “mentored independence.”

Discussion and Conclusions
Participants reported evaluating students’ performance based on attributes similar to those suggested by the American Physical Therapy Association's Physical Therapist Clinical Performance Instrument and previous research. However, subjectivity also was involved in their decision about whether students were able to practice at the entry level. Participants also concluded that entry-level students need not be independent in all clinical situations.
Determinants of Early Radiographic Progression in Ankylosing Spondylitis
Authors: ATAGUNDUZ PAMIR , AYDIN SIBEL ZEHRA , BAHADIR CENGIZ , ERER BURAK , DIRESKENELI HANER 
Published: September 2010

Objective.To investigate the demographic and clinical characteristics associated with early, extensive radiographic changes in ankylosing spondylitis (AS).Methods.Radiographic severity was assessed cross-sectionally in 235 patients with AS using the Bath AS Radiological Index spine score (BASRI-s). Patients with extensive radiographic changes on the lumbar portion of BASRI-s were defined as the early axial ankylosis (EAA) Group. ANCOVA and logistic regression analyses were used to identify factors affecting EAA.Results.Most study patients were men (139/235, 59.0%). Mean disease duration was 12.4 ± 9.3 years. Fifteen percent of women and 34.8% of men with AS were in the EAA group. HLA-B27-positive men with AS had significantly higher BASRI-lumbar scores, while HLA-B27 had no effect on radiographic progression of axial disease in women with AS. Peripheral joint involvement was associated with slow radiographic progression. Hip involvement had no effect on axial progression but uveitis was more frequent in the male EAA group. The odds for an HLA-B27-positive male patient with AS who did not have peripheral arthritis of having a BASRI-lumbar score of 3 or higher were 3.4 (77% chance to have axially progressive disease). Presence of uveitis increased these odds to 93%. Only 15% of female patients with AS had EAA, and the absence of peripheral arthritis was the only clinical measure associated with EAA in this group.Conclusion.EAA was more frequent in men with AS than in women. Absence of peripheral arthritis, HLA-B27 positivity, and uveitis were associated with multiple syndesmophytes or fusion of multiple vertebrae of the lumbar vertebrae.
Comparative Analysis of Disease Activity Measures, Use of Biologic Agents, Body Mass Index, Radiographic Features, and Bone Density in Psoriatic Arthritis and Rheumatoid Arthritis Patients Followed in a Large U.S. Disease Registry
Authors: REDDY SOUMYA M. , ANANDARAJAH ALLEN P. , FISHER MARK C. , MEASE PHILIP J. , GREENBERG JEFFREY D. , KREMER JOEL M. , REED GEORGE , CHEN RUI , MESSING SUSAN , KAUKEINEN KIMBERLY , RITCHLIN CHRISTOPHER T. 
Published: September 2010

Objective.To compare disease activity, radiographic features, and bone density in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) matched cohorts.Methods.Disease activity and radiographic data in the Consortium of Rheumatology Researchers of North America database from 2001 to 2008 were compared for 2481 patients with PsA and 17,107 patients with RA subsequently matched for age, gender, and disease duration. Radiographic outcomes included presence of erosions, and joint deformity. In addition, bone mineral density (BMD) scores for lumbar spine (L-spine) and femoral neck were compared using the same matching criteria plus weight and smoking status.Results.Tender (4.5 vs 3.4, p < 0.001) and swollen (4.4 vs 2.9, p < 0.012) joint counts, and modified Health Assessment Questionnaire scores were significantly higher (0.4 vs 0.3, p < 0.001) in patients with RA compared with patients with PsA. Patient general health and pain scores were also higher in patients with RA vs patients with PsA. Joint erosions (47.4% vs 37.6%, p = 0.020) and deformity (25.2% vs 21.6%, p = 0.021) were more prevalent in RA than PsA. In multivariate analysis, a reduced prevalence of erosions in PsA vs RA was noted (OR 0.609, p < 0.001). After matching, T-scores for L-spine (−0.54 vs −0.36, p = 0.077) and femoral neck (−0.88 vs −0.93, p = 0.643) were similar in patients with RA and patients with PsA, although body weight was a major confounder.Conclusion.The level of disease activity and radiographic damage was significantly higher for RA vs PsA subjects, although the magnitude of differences was relatively small. BMD levels were comparable between cohorts. Outcomes in patients with PsA and patients with RA may be more similar than previously reported.
Archaeo‐geophysical methods in the Templo del Escalonado, Cahuachi, Nasca (Peru)
Authors: Rizzo Enzo , Masini Nicola , Lasaponara Rosa , Orefici Giuseppe 
Published: September 2010

ABSTRACTThe application of geophysical prospection methods to detect earthen remains is one of the major challenging issues to be addressed in archaeological investigations. The subtle geophysical contrast between earthen buried remains and the surroundings makes the detection of archaeological features very difficult. In this paper, we address this challenge using a multi‐technique approach. The integration of different geophysical methods has been used to identify archaeological remains in Cahuach, Peru, which is the largest adobe ceremonial centre in the world. The investigations herein presented are focused on two different geophysical campaigns carried out in 2008 in an area of the Templo del Escalonado, which is highly representative of the whole archaeological site. It is a desert environment where the archaeological features are covered by sand and alluvial material.The geophysical prospection, required by the archaeologists to guide excavation planning, was performed using both ground‐penetrating radar (GPR) and geomagnetics with a gradiometer system. The first allowed the detection of significant anomalies, the latter confirmed the presence of these anomalies and also provided additional features not visible from GPR.Trial excavations were carried out in correspondence of some anomalies. The archaeologists unearthed a ceremonial offering in correspondence of an anomaly detected using both GPR and geomagnetic methods. Moreover, an altar and precious archaeological materials were discovered in the area characterized by a magnetic anomaly. From an archaeological perspective, these findings were very significant, because they enabled us to cast new light on the Templo del Escalonado.From a geophysical perspective, our results pointed out the high potentiality of magnetic and GPR techniques to detect, investigate and document adobe archaeological remains in a desert environmental setting.
Best Practices in Clinical Decision Support
Authors: Phansalkar Shobha , Bloomrosen Meryl , Jenders Robert , Bobb Anne , Halamka John , Kuperman Gilad , Payne Thomas , Teasdale S. , Vaida A. J. , Bates D. W. , Wright Adam 
Published: September 2010

Summary
Background: Evidence demonstrates that clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety. However, implementing and maintaining effective decision support interventions presents multiple technical and organizational challenges.
Purpose: To identify best practices for CDS, using the domain of preventive care reminders as an example.
Methods: We assembled a panel of experts in CDS and held a series of facilitated online and in-person discussions. We analyzed the results of these discussions using a grounded theory method to elicit themes and best practices.
Results: Eight best practice themes were identified as important: deliver CDS in the most appropriate ways, develop effective governance structures, consider use of incentives, be aware of workflow, keep content current, monitor and evaluate impact, maintain high quality data, and consider sharing content. Keys themes within each of these areas were also described.
Conclusion: Successful implementation of CDS requires consideration of both technical and socio-technical factors. The themes identified in this study provide guidance on crucial factors that need consideration when CDS is implemented across healthcare settings. These best practice themes may be useful for developers, implementers, and users of decision support.
Cadmium‐Carbonic Anhydrase
Authors: Xu Yan , Supuran Claudiu T , Morel François M M 
Published: September 2010

Abstract

Cadmium‐carbonic anhydrase (CDCA1) is a ζ‐carbonic anhydrase (CA) isolated from the marine diatom
Thalassiosira weissflogii
, which naturally uses Cd as its metal cofactor. Its homolog gene has been found in a number of diatom species as well as natural assemblages. The expression of
cdca1
gene at both transcript and protein levels is regulated by pH/
p
CO
2
and Cd and Zn availabilities in seawater. The amino acid sequence contains a triple repeat with high identity among repeats, and each single repeat is a functional CA and a structural mimic of a functional β‐CA dimer. CDCA1 incorporates either Zn or Cd at its active site and readily exchanges one with the other. The metal cofactor is tetrahedrally coordinated by two Cys, a His, and a water molecule and an open conformation is adapted at the active site when the metal is absent. The catalytic efficiencies of both the Cd‐ and Zn‐bound CDCA1 are pH dependent and the Zn‐bound CDCA1 is more active than the Cd‐bound CDCA1.
Therapeutic Agents Acting on
RNA
Targets
Authors: Rife Jason P. 
Published: September 2010

Abstract
There are many therapeutics that target RNA, such as streptomycin, gentamicin, and tetracycline; some of them have been in existence for many years. All of them bind to ribosomal RNA and alter normal ribosome function. The modern strategies of drug discovery and design pertain nearly exclusively to protein targets. However, the field of drug discovery for RNA targets is maturing rapidly, largely due to the exciting ribosome/drug complexes that have recently been solved. Potential RNA drug targets abound for bacterial, viral, and cellular systems. Nevertheless, questions remain as to whether or not compounds can be found that simultaneously satisfy RNA binding and pharmacological properties, such as absorption and membrane permeation. The range of interactions observed, from Coulombic to hydrophobic, and the predicted “drug‐like” qualities of several ribosome binding antibiotics, suggest that the discovery of drugs that target RNA can be a general phenomenon.
Thyroid Hormones and Thyromimetics
Authors: Malm Johan , Grover Gary J. 
Published: September 2010

AbstractThis chapter will provide an overview on the recent design principles and structure–activity relationship of thyroid hormones and thyromimetics. The prospects for the treatment of metabolic diseases, hypo‐ and hyperthyroidism, and cardiac disease with pharmacologically selective thyromimetics are considerable if cardiovascular acceleration and other adverse events can be avoided.
Fundamentals of Steroid Chemistry and Biochemistry
Authors: Brueggemeier Robert W. , Li Pui‐Kai 
Published: September 2010

AbstractSteroids are a unique class of chemical compounds found throughout the animal and plant kingdom. This class includes sterols such as cholesterol and ergosterol, bile acids, and steroid hormones. Chemical research on steroids began with isolation and structure determination, and major research efforts focused on total synthesis and on the development of numerous reactions for modifying the steroid scaffold. Methods in microbial transformations of steroids were developed in order to produce large quantities of steroid starting materials at reduced costs. Research in steroid biochemistry first began with studies on the biosynthesis and metabolism of steroids, followed soon thereafter by investigations on the biochemical mechanism of action of steroids. Over the past several decades, steroid biochemistry and molecular biology have focused on steroidogenic enzymes, nuclear steroid receptors, and gene expression. The discovery of the anti‐inflammatory effects of cortisone in the treatment of rheumatoid arthritis and the report of the contraceptive effects of estrogen and progestin preparations illustrated for the first time that steroids could be considered as medicinal agents. As a result, extensive research on the medicinal chemistry, pharmacology, and clinical studies of steroid agonists and antagonists has evolved and continues to provide new insights and new medicinal agents for therapies in many different diseases and chemoprevention strategies.
Agents Acting on Prostanoid and Thromboxane Receptors
Authors: Hall Adrian , Peace Simon , Swarbrick Martin E. 
Published: September 2010

AbstractThis chapter covers recent developments in the prostaglandin and thromboxane research area, with particular focus on the medicinal chemistry aspects. Each of the receptors is discussed in turn with progress and medicinal chemistry strategies discussed for both agonists and antagonists. Clinical development compounds are highlighted.
Retinoids
Authors: Dawson Marcia I. 
Published: September 2010

AbstractRetinoid drugs find major applications in the topical treatment of cutaneous proliferative disorders such as acne, psoriasis, and photoaging and cutaneous cancers such as cutaneous T‐cell lymphoma (CTCL) and Kaposi's sarcoma. Oral retinoids are successfully used to treat nodular/cystic acne, systemic CTCL, and acute promyelocytic leukemia. This overview of available retinoid drugs and those in the preclinical or clinical pipeline covers their development, indications, clinical trial results, adverse effects, and pharmacology/metabolism. Retinoids have been described historically and functionally in the context of interaction with their nuclear receptors—retinoic acid receptors (RARs) and retinoid X receptors (RXRs)—in inducing gene transcription. RAR‐selective retinoids or their prodrugs include first‐generation all‐trans‐retinoic acid (tretinoin) and its 13‐cisisomer (isotretinoin), and second‐generation acitretin and its ethyl ester (etretinate), both having an aromatic 2,3,6‐trimethyl‐4‐methoxyphenyl terminus. Third‐generation more aromatic analogs include ethyl ester tazarotene (Tazorac®) and adapalene (Differin®), both selective for RAR subtypes β and γ, and RARα‐selective pipeline candidates Am80 and NRX 195183, which are in clinical trials. RAR and RXR transcriptional panagonist 9‐cis‐retinoic acid is next and is followed by RXR‐selective bexarotene (Targretin™) and two RXR‐selective clinical trial candidates, 9cUAB and NRX 194204. The fourth generation includes three compounds that may have applications in the treatment or prevention of cancer. While originally considered as retinoids, such asN‐(4‐hydroxyphenyl) retinamide, or as retinoid‐related or derived, such as ST1926 (AHPC) and SHetA2, they subsequently were found to function independently of the RARs and RXRs in inhibiting cancer cell proliferation and inducing apoptosis.
SNPs: Single Nucleotide Polymorphisms and Pharmacogenomics: Individually Designed Drug Therapy
Authors: Maitland‐van der Zee Anke‐Hilse , Puckett Brian J. , Terra Steven G. , Walker Joe 
Published: September 2010

AbstractPharmacogenetics is literally a combination of pharmacology and genetics. Pharmacogenetics is the study of how an individual's genetic makeup may influence response to medications. This chapter describes examples of pharmacogenetic interactions, and the role pharmacogenetics plays and might play in clinical practice.
Synthetic Antibacterial Agents
Authors: Anand Nitya , Remers William A. 
Published: September 2010

AbstractSynthetic antibacterial compounds are divided into topical and systemic agents. Topical agents are called disinfectants or antiseptics depending on how they are used. They show little selectivity between the microbes and the host. Nevertheless, they are indispensable in hospitals, public health, and the home.The development of systemic antibacterial agents had a strong dye connection. Ehrlich's development of selective staining methods led him to propose that dyes may also have selective toxicity for microbes, and to coin the term chemotherapy. Domagk's discovery of antibacterial activity for the azo dye prontosil led to the first effective chemotherapeutic agent, sulfanilamide. This compound provided an excellent lead for structural modification and ushered in the modern era of chemotherapy and drug design. The discovery that sulfonamides act through folate inhibition resulted in the development of dihydrofolate reductase inhibitors such as trimethoprim.The availability of synthetic antibacterials and antibiotics, which were discovered almost concurrently, provided major advances in control of bacterial infections; however, the rise in bacterial resistance prompted the search for newer classes of agents. This search provided fluoroquinolines and oxazolidones.There are also synthetic antibacterials with niche needs, such as nitrofurans and methenamine, which are used for urinary tract infections.
Antidepressants
Authors: Glennon Richard A. , Iversen Leslie 
Published: September 2010

AbstractThis chapter reviews the antidepressant drugs currently available in Europe and/or the United States from the perspectives of their clinical efficacy, pharmacokinetics, pharmacology, structure–activity relationships, metabolism, and mechanisms of action. The older nonselective monoamine oxidase inhibitors (e.g., phenelzine, tranylcypromine) have largely been replaced by agents that selectively inhibit monoamine oxidase A (e.g., moclobemide) or by inhibitors of norepinephrine/serotonin monoamine transporter reuptake mechanisms. The first generation of such drugs, the tricyclic antidepressants, suffered from a number of dangerous and unpleasant adverse side effects caused by their many other pharmacological actions on the heart and on cholinergic and other monoamine receptors in the brain. Most of the current generation of antidepressants are serotonin‐selective reuptake inhibitors or mixed norepinephrine/serotonin reuptake inhibitors that possess a safer side‐effect profile. These drugs have gained widespread use in the treatment of depression and a number of related psychiatric conditions, including phobias and the treatment of generalized anxiety disorder (GAD). Some agents that act as norepinephrine‐selective reuptake inhibitors (e.g., reboxetine) are also clinically effective and there is considerable overlap between noradrenergic and serotonergic mechanisms in the CNS. Monoamine selectivity can also be altered by the formation of active metabolitesin vivo. All antidepressants require several weeks of treatment before the maximum clinical benefit is seen. This may be attributable to drug‐induced alterations in the expression of receptors in brain (e.g., downregulation of 5‐HT1Areceptors) and/or alterations in the expression of neurotrophic factors (e.g., brain‐derived neurotrophic factor, vascular endothelial growth factor) associated with changes in neurogenesis in certain brain regions. New approaches to future antidepressant drug discovery include antagonists for glutamate NMDA receptors, substance P NK1 receptors, corticotrophin releasing factor receptors, or agonists/antagonists for galanin receptors.
New Strategies for Natural Products Lead Generation
Authors: Carter Guy T. , Bernan Valerie S. , Koehn Frank E. 
Published: September 2010

Abstract
Microbial sources of natural products are increasingly valued for their chemical diversity and access to biosynthetic pathways. It appears that an incredible repository of untapped microbial life and associated chemical diversity remain to be exploited. Molecular techniques such as “metagenomics” are beginning to provide access to cryptic biosynthetic pathways, which are also revealing new chemistry. Refined libraries of natural products with well‐characterized components provide enhanced value as screening sources. These libraries continue to provide new chemical entities that inform biological processes and provide leads for therapeutic agents. There is a renaissance of phenotypic screening that promises to uncover numerous new links between secondary metabolites and their roles in biology. Genomic methods are growing in value as our understanding of biosynthetic processes at the molecular level expands. Screening of DNA sequences for pathways that yield particular chemistries is now a reality for certain types of biosynthetic processes, especially type I polyketide synthases and nonribosomally produced peptides.
ADMETIn VitroProfiling: Utility and Applications in Lead Discovery
Authors: Kerns Edward H. , Di Li , Carter Guy T. 
Published: September 2010

AbstractADMET properties are a vital integral part of drug discovery because they determine the pharmacokinetics and safety of clinical development candidates. Diverse ADMET profiling assays have been developed and implemented to provide property data for drug discovery team decision making. Their utility and applications in lead discovery include the following: lead selection, diagnosis of poor PK, guidance for structure modification, solving specific project team property issues, providing accurate biological data for SAR, selecting compounds forin vivoPK and PD studies, and improving dosing for optimum exposurein vivo. ADMET properties are discussed along with case studies and assays.
Structural Alerts for Toxicity
Authors: Blagg Julian 
Published: September 2010

AbstractThis chapter summarizes structural alerts where there is a significant weight of evidence that their incorporation into a drug candidate molecule is likely to result in a higher than average incidence of attrition due to adverse safety/or toxicity findings. The mechanism of formation of reactive metabolites from each structural alert is summarized. The structure–toxicity relationships and the boundary of definition for each structural alert are discussed. The benefits of low exposure and alternative routes of metabolism are highlighted along with screening methods to manage the risks associated with structural alerts.