bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective randomized comparison of endobutton versus cross‐pin femoral fixation in hamstring anterior cruciate ligament reconstruction with 2‐year follow‐up
Authors: Price Rohan , Stoney James , Brown Graeme 
Published: December 2009

AbstractBackground:  To determine if there is a different clinical outcome after TransFix versus endobutton femoral fixation in hamstring anterior cruciate ligament (ACL) reconstruction.Methods:  Twenty‐nine patients were randomized into either Endobutton (Smith & Nephew, Andover, MA, USA) (n= 13) or TransFix (Arthrex, Naples, FL, USA) (n= 16) femoral fixation in hamstring ACL reconstruction. The distal fixation was with a bioabsorbable interference screw. The evaluation methods were clinical history and examination, KT1000 arthrometry for laxity as well as the International Knee Documentation Committee (IKDC) scores over a 2‐year time frame.Results:  There were no significant differences between the study groups preoperatively. For the 2‐year follow‐up, 11 patients in the Endobutton group and 13 patients in the TransFix group were available (greater than 80%). No statistical differences between the two groups were found at the 1‐ or 2‐year follow‐up examinations. At the 2‐year follow‐up, 72.7% of the Endobutton and 84.6% of the TransFix group patients were in the IKDC A or B categories. Additional procedures postoperatively occurred more frequently in the TransFix group.Conclusions:  There were no significant differences in the results for either technique of femoral fixation.Level of Evidence:  Level I.
Delays in discharge of vascular surgical patients: a prospective audit
Authors: Edirimanne Senarath , Roake Justin A. , Lewis David R. 
Published: December 2009

AbstractAim:  To quantify delays in discharge for vascular surgical patients and identify causes of such delays.Methods:  A prospective audit of delays in discharge of vascular surgical admissions over a 6‐month period was performed. Expected date and time of discharge was compared with actual date and time of discharge. Day‐case patients, patients who died during admission and patients not under the direct care of the vascular team were excluded.Results:  There were 99 elective and 51 acute admissions accounting for 729 hospital bed days. The median (range) age was 72 years (21–92) and 94% of patients were living independently in the community. Forty‐seven percent of patients were discharged on the planned day and time, 21% on the planned day but at a later‐than‐predicted time and 32% were delayed by more than 1 day. Delays identified in this audit accounted for 135 bed days. Fifteen percent of delays were due to causes that can be improved by internal organization (e.g. delayed paperwork). The majority of the delays (85%) were due to external factors such as lack of rehabilitation beds or lack of placement facilities in nursing homes. Elderly patients and acute admissions were more likely to have long delays in discharge.Conclusion:  Delays in discharge of vascular surgical patients use a lot of acute surgical bed days. Strategies to prevent delays in discharge should include not only improving internal organization and early identification and referral of patients who require rehabilitation/placement but also increased funding for such essential non‐acute services.
Nothing to sneeze at! A study into intra‐operative contamination
Authors: Graham David , Parkinson Benjamin , Evans Meghan , Keijzers Gerben , Derrington Petra 
Published: December 2009

AbstractPurpose:  We performed a prospective study of sneezes from orthopaedic registrars to assess the potential for intra‐operative contamination from a masked surgeon, and to determine if head position can alter the potential for contamination.Type of Study:  Prospective controlled trial.Methods:  Four orthopaedic registrars from the Gold Coast Hospital each inhaled pepper to precipitate a sneeze. Cultures were taken with and without standard Smith & Nephew™ surgical masks, in positions directly in front and to the sides of a masked registrar. The process was repeated three times for each registrar. A control plate was left exposed to the atmosphere. A control plate and sneeze plate was cultured on blood agar. Three masks were subsequently swabbed to exclude contamination from the masks.Results:  2/24 (8.33%) of the side with mask cultures returned significant bacterial growths. Also, 1/12 (8.33%) of the front with mask cultures returned significant growths. In addition, 9/12 (75%) of the direct sneezes resulted in significant bacterial counts. The control plate failed to return any growth. Subsequent culture of the exterior of three surgical masks failed to yield significant growth. There was a statistically significant odds ratio of 0.03 comparing the front and side group with the unmasked direct group. There was no statistically significant difference comparing front and side sneeze growth.Conclusions:  While the use of surgical face masks significantly reduces bacterial counts following a sneeze, it fails to eliminate the potential for surgical field contamination completely. The fact that significant bacterial counts can be returned from direct culture through a mask and to the sides of a mask suggests that head position is irrelevant and contamination is possible in any direction. It is, therefore, suggested that, if possible, a sneezing surgeon distances himself/herself as much as possible from the sterile field. We also recommend following a sneeze; surgeons should re‐gown and glove, given the risk of contamination of the sterile field.Level of evidence:  Level II.
Management of chronic obstructive pulmonary disease in Australia after the publication of national guidelines
Authors: Ta M. , George J. 
Published: December 2009

AbstractBackground: Information on the management of chronic obstructive pulmonary disease (COPD) in Australia, especially the extent of adherence to the COPD‐X Plan, is sparse.Aim: To evaluate COPD patient adherence to treatment recommendations and healthcare provider adherence to the COPD‐X Plan.Methods: Cross‐sectional study of patients admitted to a secondary care hospital with an acute exacerbation of COPD over a 6‐month period. Data were collected from patient interviews and medical notes.Results: Participants (n= 45) aged 72 ± 11.5 years (mean ± SD) had a mean FEV1 % predicted 52.2 ± 18.7. At the time 11 (24.4%) patients continued to smoke; 25 (55.6%) had never participated in a pulmonary rehabilitation programme; and 23 (51.1%) self‐reported poor adherence to some COPD medications. Inhaler technique was deemed suboptimal in 25 (55.6%) patients. Only 11 (24.4%) patients had received any instructions from their doctor regarding management of exacerbations. The use of medications not supported by the COPD‐X guidelines were: long‐term prednisolone (11, 24.4%) and prophylactic antibiotics (3, 6.7%).Conclusion: Management of COPD in Australia by both patients and providers remains suboptimal despite the publication and wide dissemination of the COPD‐X Plan, suggesting the need to intensify both patient and provider education in COPD management.
Study of compliance with a clinical pathway for suspected pulmonary embolism
Authors: Ng B. J. H. , Lindstrom S. 
Published: December 2009

AbstractBackground/Aims: Clinical pathways to guide the investigation of suspected pulmonary embolism have been increasingly adopted by emergency departments worldwide. This study evaluated the compliance with a clinical pathway that combines risk assessment (Wells score) with d‐dimer, ventilation–perfusion scanning or computed tomographic pulmonary angiography (CTPA). The aims of this study were to identify factors that contribute to compliance and to assess patient outcomes and resource utilization.Methods: Repeated retrospective chart reviews of 239 patients who underwent investigation for pulmonary embolism through our emergency department extracted patient demographics, pathway parameters and patient outcomes. A phone interview at 3‐month follow up was carried out.Results: Incidence of pulmonary embolism was 8.4% (n= 20). Compliance to the clinical pathway occurred in 120 subjects (50.2%). Non‐compliance occurred in 71 subjects (29.7%). Forty‐eight subjects (20.1%) underwent risk assessments, but subsequent diagnostic tests did not conform to the stated pathway (partial compliance). Compliance was poor in subjects assessed by non‐emergency department doctors (χ2= 27.95, P≤ 0.001). Compliance occurred less in pregnant subjects (χ2= 7.27, P= 0.007) and those with chronic respiratory disease (χ2= 5.31, P= 0.021). Subjects in the compliant group were less likely to undergo CTPA (odds ratio 2.07 (1.16–3.70), P= 0.012).Conclusions: Compliance with this clinical pathway allowed emergency department doctors in an Australian university teaching hospital to complete diagnostic testing for suspected pulmonary embolism appropriately unless non‐emergency department doctors became involved. Compliance with this pathway altered the distribution of diagnostic tests performed with less reliance on CTPA, but was not associated with better patient outcomes.
The bosentan patient registry: long‐term survival in pulmonary arterial hypertension
Authors: Keogh A. , Strange G. , McNeil K. , Williams T. J. , Gabbay E. , Proudman S. , Weintraub R. G. , Wlodarczyk J. , Dalton B. 
Published: December 2009

AbstractBackground/Aims: The Bosentan Patient Registry (BPR) was a prospective, multicentre, Australian registry funded by Actelion Pharmaceuticals. The primary aim of the registry was to collect survival data in patients with pulmonary arterial hypertension (PAH) treated with bosentan.Methods: The BPR was initiated in 15 specialized PAH centres. All patients on or starting bosentan were invited to enrol. Treating physicians notified the registry if patients discontinued bosentan, because of either a change in therapy, transplantation, intervention or death. Survival data were validated against the Australian Institute of Health and Welfare National Death Index.Results: Between 2004 and 2007, a total of 528 patients (mean age 59 ± 17 years) were enrolled representing 69% of patients either previously taking or initiated on bosentan during that time. The BPR population was generally older with more advanced functional deficit than patients enrolled in randomized, placebo‐controlled trials. Aetiology was idiopathic (iPAH) in 58% and connective tissue disease related (scleroderma (SSc)‐PAH) in 42%. For iPAH patients, World Health Organisation functional classes II, III and IV at enrolment was 8.2%, 66.4% and 20.5%, and for the SSc‐PAH cohort, 3.2%, 75.8% and 17.9% respectively. The observed annual mortality was 11.8% in patients with iPAH and 16.6% in patients SSc‐PAH.Conclusion: This large Australian registry provides ‘real life’ information on the characteristics and management of PAH in clinical practice. Treatment with bosentan improved survival outcomes in both iPAH and SSc‐PAH compared with historical controls. Age, disease severity and aetiology were critical factors in determining clinical outcomes.
Hospital doctors' attitudes towards older people
Authors: Leung S. , LoGiudice D. , Schwarz J. , Brand C. 
Published: December 2009

AbstractBackground: Ageism among health professionals is increasingly recognized, but few studies investigated hospital doctors' attitudes towards older people. The aims of this study were to investigate hospital doctors' attitudes towards older people and to determine whether factors, which were identified in studies on other health professionals, influence hospital doctors' attitudes.Methods: Hospital doctors who worked in General Medicine or Aged Care units in two tertiary public hospitals in metropolitan Victoria, Australia, in 2008 were surveyed with Fraboni's Scale of Ageism (FSA), a validated instrument used to investigate attitudes towards older people. Demographic data from participants were collected.Results: Of the 235 questionnaires distributed, 122 were returned (overall response rate 51.9%). Response rate was highest among consultants (80.4%), followed by registrars (64.1%) and lowest among interns and residents (35.2%). The mean FSA score attained by the respondents was 61.5 (SD 11.0), representing a point between a neutral and a positive disposition. Doctors' characteristics that were associated with more positive attitudes towards older people included age of 30 years or older (P < 0.001), female gender (P= 0.003), more senior in position (P < 0.001), postgraduate years of 10 or more (P < 0.001), previous working experience in Aged Care (P < 0.001), interest in Aged Care (P < 0.001) and more frequent social contacts with healthy older people (P < 0.001).Conclusion: Hospital doctors of different demographic features and background characteristics display different attitudes towards older people. These findings can be used to inform future development of undergraduate and postgraduate medical curricula and form a basis for future studies on the effectiveness of these interventions in improving doctors' attitudes.
Maternal host plant effects on aphid performance: contrasts between a generalist and a specialist species on Brussels sprout cultivars
Authors: Tariq Muhammad , Wright Denis J. , Staley Joanna T. 
Published: December 2009

The performance of the second generation (G2) of alates and apterae of a generalist, Myzus persicae, and a specialist, Brevicoryne brassicae, aphid species reared on Chinese cabbage or cabbage was evaluated on five cultivars of Brussels sprout.
Aphid performance was influenced both by the type of host on which the parent aphid had been reared and by the host on which it was feeding when reproducing.
The fecundity of the G2 of alates of both aphid species reared on Chinese cabbage differed significantly between all the cultivars of Brussels sprout and, on average, was 25% higher than those reared on cabbage. These differences were also apparent for the intrinsic rate of increase of B. brassicae but not for M. persicae.
There was a trend for the G2 of alates from Chinese cabbage to have greater fecundity compared with aphids from cabbage. These differences were significant for the fecundity of the G2 of alates of both aphid species on Brussels sprout cultivars Fillbasket (30% higher), Red Delicious (35% higher) and Winter Harvest (25% higher) than those reared on cabbage.
The intrinsic rate of increase for the G2 of alates of B. brassicae from Chinese cabbage was significantly different on all Brussels sprout cultivars tested. The intrinsic rate of increase differed significantly between aphids reared on either Chinese cabbage or cabbage on cultivars Oliver and Darkmar‐21 (M. persicae) and Red Delicious and Winter Harvest (B. brassicae). The cv. Oliver appeared to be the most consistently good host; Red Delicious was the poorest host overall.
Global warming affects phenology and voltinism of Lobesia botrana in Spain
Authors: Martín‐Vertedor Daniel , Ferrero‐García Juan J. , Torres‐Vila Luis M. 
Published: December 2009

Climate change is promoting alterations of a very diverse nature in the life cycle of an array of insect species, including changes in phenology and voltinism. In Spain, there is observational evidence that the moth Lobesia botrana Den. & Schiff. (Lep.: Tortricidae), a key vine pest that is usually trivoltine in Mediterranean latitudes, tends to advance spring emergence, displaying a partial fourth additional flight, a fact that is potentially attributable to global warming.
To verify this hypothesis, local temperatures were correlated with L. botrana phenology in six vine‐growing areas of southwestern Spain during the last two decades (1984–2006) by exploiting the database of flight curves obtained with sexual pheromone traps. The dates of second and third flight peaks of the moth were calculated for each area and year and then correlated with both time (years) and local temperatures.
The results obtained demonstrated a noteworthy trend towards local warming (as a result of global warming) in the last two decades, with mean increases in annual and spring temperatures of 0.9 and 3.0°C, respectively. Therefore, L. botrana phenology has significantly advanced by more than 12 days. Moreover, the phenological advance contributed to increased moth voltinism in 2006 by promoting a complete fourth additional flight, a fact that has never been reported previously to our knowledge in the Iberian Peninsula.
The potential impact of an earlier phenology and increased voltinism in L. botrana is discussed from an agro‐ecological perspective.
Crenarchaeota affiliated with group 1.1b are prevalent in coastal mineral soils of the Ross Sea region of Antarctica
Authors: Ayton J. , Aislabie J. , Barker G. M. , Saul D. , Turner S. 
Published: December 2009

SummaryThe objective of this study was to examine the presence and diversity of Archaea within mineral and ornithogenic soils from 12 locations across the Ross Sea region. Archaea were not abundant but DNA sufficient for producing 16S rRNA gene clone libraries was extracted from 18 of 51 soil samples, from four locations. A total of 1452 clones were analysed by restriction fragment length polymorphism and assigned to 43 operational taxonomic units from which representatives were sequenced. Archaea were primarily restricted to coastal mineral soils which showed a predominance of Crenarchaeota belonging to group 1.1b (> 99% of clones). These clones were assigned to six clusters (A through F), based on shared identity to sequences in the GenBank database. Ordination indicated that soil chemistry and water content determined archaeal community structure. This is the first comprehensive study of the archaeal community in Antarctic soils and as such provides a reference point for further investigation of microbial function in this environment.
An α‐amylase is a novel receptor for Bacillus thuringiensis ssp. israelensis Cry4Ba and Cry11Aa toxins in the malaria vector mosquito Anopheles albimanus (Diptera: Culicidae)
Authors: Fernandez‐Luna Maria Teresa , Lanz‐Mendoza Humberto , Gill Sarjeet S. , Bravo Alejandra , Soberon Mario , Miranda‐Rios Juan 
Published: December 2009

Summary Bacillus thuringiensis ssp. israelensis (Bti) produces four Cry toxins (Cry4Aa, Cry4Ba, Cry10Aa and Cry11Aa), and two Cyt proteins (Cyt1Aa and Cyt2Ba), toxic to mosquito‐larvae of the genus Aedes, Anopheles and Culex, important human disease vectors that transmit dengue virus, malaria and filarial parasites respectively. Previous work showed that Bti is highly toxic to Anopheles albimanus, the main vector for transmission of malaria in Mexico. In this work, we analysed the toxicity of isolated Cry proteins of Bti and identified an An. albimanus midgut protein as a putative Cry4Ba and Cry11Aa receptor molecule. Biossays showed that Cry4Ba and Cry11Aa of Bti are toxic to An. albimanus larvae. Ligand blot assays indicated that a 70 kDa glycosylphosphatidylinositol‐anchored protein present in midgut brush border membrane vesicles of An. albimanus interacts with Cry4Ba and Cry11Aa toxins. This protein was identified as an α‐amylase by mass spectrometry and enzymatic activity assays. The cDNA that codes for the α‐amylase was cloned by means of 5′‐ and 3′‐RACE experiments. Recombinant α‐amylase expressed in Escherichia coli specifically binds Cry4Ba and Cry11Aa toxins.
Phenotypic and genomic diversity of Lactobacillus plantarum strains isolated from various environmental niches
Authors: Siezen Roland J. , Tzeneva Vesela A. , Castioni Anna , Wels Michiel , Phan Hoa T. K. , Rademaker Jan L. W. , Starrenburg Marjo J. C. , Kleerebezem Michiel , Molenaar Douwe , Van Hylckama Vlieg Johan E. T. 
Published: December 2009

Summary Lactobacillus plantarum is a ubiquitous microorganism that is able to colonize several ecological niches, including vegetables, meat, dairy substrates and the gastro‐intestinal tract. An extensive phenotypic and genomic diversity analysis was conducted to elucidate the molecular basis of the high flexibility and versatility of this species. First, 185 isolates from diverse environments were phenotypically characterized by evaluating their fermentation and growth characteristics. Strains clustered largely together within their particular food niche, but human fecal isolates were scattered throughout the food clusters, suggesting that they originate from the food eaten by the individuals. Based on distinct phenotypic profiles, 24 strains were selected and, together with a further 18 strains from an earlier low‐resolution study, their genomic diversity was evaluated by comparative genome hybridization against the reference genome of L. plantarum WCFS1. Over 2000 genes were identified that constitute the core genome of the L. plantarum species, including 121 unique L. plantarum‐marker genes that have not been found in other lactic acid bacteria. Over 50 genes unique for the reference strain WCFS1 were identified that were absent in the other L. plantarum strains. Strains of the L. plantarum subspecies argentoratensis were found to lack a common set of 24 genes, organized in seven gene clusters/operons, supporting their classification as a separate subspecies. The results provide a detailed view on phenotypic and genomic diversity of L. plantarum and lead to a better comprehension of niche adaptation and functionality of the organism.
Property Derivatives for Managing European Real‐Estate Risk
Authors: Fabozzi Frank J. , Shiller Robert J. , Tunaru Radu S. 
Published: December 2009

Abstract Although property markets represent a large proportion of total wealth in developed countries, the real‐estate derivatives markets are still lagging behind in volume of trading and liquidity. Over the last few years there has been increased activity in developing derivative instruments that can be utilised by asset managers. In this paper, we discuss the problems encountered when using property derivatives for managing European real‐estate risk. We also consider a special class of structured interest rate swaps that have embedded real‐estate risk and propose a more efficient way to tailor these swaps.
Use of a prescription‐based measure of antiretroviral therapy adherence to predict viral rebound in HIV‐infected individuals with viral suppression
Authors: Cambiano V , Lampe FC , Rodger AJ , Smith CJ , Geretti AM , Lodwick RK , Holloway J , Johnson M , Phillips AN 
Published: December 2009

ObjectiveThe aim of the study was to assess whether a simple, routinely available measure of antiretroviral therapy (ART) adherence predicts viral rebound at the next HIV viral load (VL) measurement in virally suppressed patients.MethodsThe analysis was performed on the Royal Free HIV Cohort, London, UK. Each ‘drug coverage–viral load episode’ (DCVL episode) was defined as a 6‐month period immediately prior to a VL ≤50 HIV‐1 RNA copies/mL (time‐zero), during which the patient had been continuously on HAART, with all measured VLs ≤50 copies/mL. The next VL after time‐zero was used to assess whether VL rebound (defined as >200 copies/mL) had occurred. Drug coverage, our measure of adherence, was calculated as the proportion of days in the 6‐month period covered by a valid prescription for at least three antiretroviral drugs.ResultsA total of 376 (2.4%) VL rebounds occurred in 15 660 DCVL episodes among 1632 patients. Drug coverage was 100% for 32% of episodes, 95–99% for 16% of episodes and ≤60% for 10% of episodes. The risk ratio of rebound associated with a 10% increase in drug coverage, adjusted for potential confounding variables, was 0.93 (95% confidence interval 0.88–0.98).ConclusionsAntiretroviral drug coverage assessed at the time of VL measurement in patients with undetectable VL is potentially clinically useful for predicting VL rebound at the next VL measurement.