bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative ambulation in thoracic surgery patients: standard versus modern ambulation methods
Authors: Nesbitt Jonathan C , Deppen Stephen , Corcoran Richard , Cogdill Shari , Huckabay Sarah , McKnight Drew , Osborne Breanne F , Werking Kristin , Gardner Megan , Perrigo Laurel 
Published: January 2012

Aim:A single‐subject study of two methods of postoperative ambulation of patients recovering from thoracic surgery.Background:During the postoperative setting, patients are often burdened by their condition that reduces their ability to ambulate. This problem is compounded by the addition of devices that make walking more cumbersome. To simplify the process of ambulation during the postoperative period, an intravenous pole/walker (IVPW) was specifically designed to allow all patient devices and attachments to accompany the patient during ambulation, without the need for supplemental caregiver assistance.Methods:The IVPW method of ambulation was compared with standard method of ambulation (SMA) in a single‐subject clinical trial. Thirty‐nine consecutive thoracic surgery patients with at least an IV and chest tube were ambulated using alternatively either the IVPW or the SMA. Immediately following the ambulation periods, the patient and patient's health care worker assessed both methods using satisfaction surveys consisting of several questions about the episodes of ambulation and the number of health care workers needed to assist during ambulation.Results:Patient satisfaction was significantly higher in the ability of the IVPW to provide support and assist in ambulation in comparison with the SMA (p< 0·001). Nurses felt the IVPW both facilitated and provided a safer method for ambulation compared with the SMA (p< 0·001). On average, one less employee was required during ambulation with the IVPW (p< 0·001).Conclusion:The IVPW provided better support and was perceived as a safer method for ambulation compared with the SMA. The IVPW also required one less person to assist with ambulation.Relevance to clinical practice:Facilitation of ambulation in the postoperative setting can impact nursing care and patient satisfaction.
Concomitant Use of Triptan, and SSRI or SNRI After the US Food and Drug Administration Alert on Serotonin Syndrome
Authors: Sclar David A. , Robison Linda M. , Castillo Leigh V. , Schmidt Jennifer M. , Bowen Kurt A. , Oganov Ambartsum M. , Skaer Tracy L. , Kogut Stephen J. 
Published: January 2012

Objective.— The present study was designed to discern the prevalence of concomitant use of a 5‐hydroxytryptamine receptor agonist (triptan), and a selective serotonin reuptake inhibitor (SSRI) or a selective serotonin/norepinephrine reuptake inhibitor (SNRI) after the US Food and Drug Administration issued an alert regarding serotonin syndrome in 2006 and to contrast findings with data published prior to the federal warning.Background.— In July 2006, the US Food and Drug Administration warned patients and health‐care professionals to be aware that use of a triptan in combination with an SSRI or SNRI may result in a potentially life‐threatening problem known as serotonin syndrome. In 2010, the American Headache Society published a position paper noting that there existed conflicting and insufficient information to discern the risk of serotonin syndrome with the use of triptan, and SSRI or SNRI, and that said Class IV data were not to be used as the basis for limiting the prescribing of triptan with SSRI or SNRI (Level U). Clinicians were cautioned as to the seriousness of serotonin toxicity and that monitoring was warranted.Methods.— We used weighted data from the US National Ambulatory Medical Care Survey for years 2007 and 2008 to derive national estimates of the number of office‐based physician–patient encounters (visits), documenting the concomitant use of triptan, and SSRI or SNRI. Results are compared with previously published findings for the years 2003 and 2004.Results.— During the time‐frame 2007‐2008, an annualized mean of 5,256,958 patients were prescribed a triptan (vs 3,874,367 in 2003‐2004, a 35.7% increase), and 68,603,600 patients were prescribed an SSRI or SNRI (vs 50,402,149 in 2003‐2004, a 36.1% increase). An annualized mean of 1,319,763 patients were simultaneously prescribed or continued use of triptan, along with SSRI or SNRI (vs 694,276 in 2003‐2004, a 90.1% increase).Conclusion.— Our study documents that 1.8% (1,319,763/73,860,558) of patients in 2007‐2008 were prescribed triptan, and SSRI or SNRI (vs 1.3% in 2003‐04, an increase of 38.5%). While this is a small fraction overall, the actual number of patients on a nationwide basis is substantial. What remains missing from the literature is documentation as to the number of cases of serotonin syndrome and resulting consequences (clinical and economic) because of the concomitant use of triptan, and SSRI or SNRI in the time‐frame 2007‐2008. Absent in these data, it remains difficult to assess the risk benefit associated with the use of triptan, and SSRI or SNRI.
Nonpharmacological Approaches to the Management of Chronic Pain in Community‐Dwelling Older Adults: A Review of Empirical Evidence
Authors: Park Juyoung , Hughes Anne K. 
Published: January 2012

The objective of this literature review is to gain insight into the efficacy of nonpharmacological interventions in chronic pain management in community‐dwelling older adults. An extensive search of pertinent databases was performed to identify reports of studies of nonpharmacological (physical and psychosocial) pain interventions. The review identifies intervention studies that used randomized controlled trials (RCTs) and summarizes existing evidence of effectiveness of nonpharmacological interventions. A literature search yielded 28 RCT intervention studies (18 for physical interventions and 10 for psychosocial interventions) that met inclusion criteria and are included in this review. Twenty‐one studies (75%) identified in this review demonstrated statistically significant differences (P < .05) in pain scores between nonpharmacological interventions and no intervention or sham interventions; the intervention groups showed lower pain intensity. More research is needed to determine the best format, intensity, duration, and content of such treatments, as well as their efficacy in the older adult population. Methodological limitations are identified in many of the studies, such as low statistical power due to sample size and imprecise measurement, lack of reliable sham controls, and inadequate blinding. Future intervention studies of nonpharmacological pain therapies may require larger sample sizes, control for comorbidities, and long‐term follow‐up.
Linking Local Food Systems and the Social Economy? Future Roles for Farmers' Markets in Alberta and British Columbia*
Authors: Wittman Hannah , Beckie Mary , Hergesheimer Chris 
Published: January 2012

AbstractOften organized as grassroots, nonprofit organizations, many farmers' markets serve as strategic venues linking producers and consumers of local food while fulfilling multiple social, economic, and environmental objectives. This article examines the potential of farmers' markets to play a catalyst role in linking local food systems to the social economy in western Canada. We used the Delphi method of inquiry to solicit and synthesize perspectives on the future role of farmers' markets within local food systems and the social economy from farmers' market vendors, market managers, and policy and government representatives in each province. We found that negotiations over the definition of local food systems, the dynamics of supply and demand relationships, and perceptions of “authenticity” affect the positionality of farmers' markets in relation to other marketing channels within regional food systems. Stakeholders engaged in this Delphi inquiry strategized ways to scale up local food systems beyond current limits while also maintaining the “authentic experience” offered by farmers' markets that has helped to fuel increased consumer interest, demand, and growth. Results confirm the need for further investigation of the relationship between the social economy, infrastructure, and authenticity in the development of local food systems.
In Search of Housing: Urban Families in Rural Contexts*
Authors: Clark Sherri Lawson 
Published: January 2012

AbstractResearchers have been following a trend posited by the renowned anthropologist Janet Fitchen, which examines the increasing movement of low‐income people to rural communities drawn not necessarily by labor market forces, but by the characteristics and amenities found in rural towns. This study adds to that literature by focusing on the ways in which public housing availability, changes in housing policy, and rural economic restructuring create opportunities for low‐income families to relocate from urban to rural communities in search of affordable housing. Data collected from an ethnographic sample addressed the following questions: (1) what motivates individuals and families to leave their urban neighborhoods and relocate to rural towns and (2) what challenges do individuals and families have in sustaining stable housing in rural communities? Two main sets of literature relevant to this discussion include studies of patterns of residential mobility and explanations of rural economic restructuring. Both form the conceptual approach of this article by offering a framework to better understand the housing choices and behaviors of low‐income families and the contexts in which these actions are situated.
Multicenter Study of Predictors of Suicide Screening in Emergency Departments
Authors: Ting Sarah A. , Sullivan Ashley F. , Miller Ivan , Espinola Janice A. , Allen Michael H. , Camargo Carlos A. , Boudreaux Edwin D. ,   on behalf of the Emergency Department Safety and Follow‐up Evaluation (ED‐SAFE) Investigators
Published: January 2012

AbstractObjectives:  The objective was to provide estimates and predictors of screening for suicide in emergency departments (EDs).Methods:  Eight geographically diverse U.S. EDs each performed chart reviews of 100 randomly selected patients, ages 18 years or older, with visits in October 2009. Trained chart abstractors collected information on patient demographics, presentation, discharge diagnosis, suicide screening, and other mental health indicators. Univariate logistic regression was used to determine factors associated with suicide screening.Results:  The cohort of 800 patients had a median age of 41 years (interquartile range = 27 to 53 years) with 57% female, 16% Hispanic, 58% white, 23% black or African American, and 10% other race. Suicide screenings were documented for 39 patients (4.9%; 95% confidence interval [CI] = 3.4% to 6.4%). Of those screened, 23 (2.9% of total sample; 95% CI = 1.7% to 4.0%) were positive for suicidal ideation or behavior. Approximately 90% of those screened had documented complaints of a psychiatric nature at triage. About one‐third had either documentation of alcohol abuse (33%) or intentional illegal or prescription drug misuse (36%).Conclusions:  The presence of known psychiatric problems and substance use had the strongest associations with suicide screening, yet even patients presenting with these indicators were not screened for suicide. Understanding factors that currently influence suicide screening in the ED will guide the design and implementation of improved suicide screening protocols and related interventions.ACADEMIC EMERGENCY MEDICINE 2012; 1–5 © 2012 by the Society for Academic Emergency Medicine
Emergency Medical Services Education in Emergency Medicine Residency Programs: A National Survey
Authors: Katzer Robert , Cabanas Jose G. , Martin‐Gill Christian ,   for the SAEM Emergency Medical Services Interest Group
Published: January 2012

AbstractObjectives:  Emergency medical services (EMS) was recently approved as a subspecialty by the American Board of Medical Specialties, highlighting the core content of knowledge that encompasses prehospital emergency patient care. This study aimed to describe the current state of EMS education at emergency medicine (EM) residency programs in the United States.Methods:  The authors distributed an online survey containing multiple‐choice and free‐response questions pertaining to resident EMS education to the directors of EM residency programs in the United States between July 21 and September 10, 2010.Results:  Of 154 programs, 117 (75%) responded to the survey, and 108 (70%) completed the survey by answering all required questions. Of completed surveys, 82 programs (76%) reported the cumulative time devoted to EMS didactic education during the course of residency training, a median of 20 hours (range = 3 to 300 hours; interquartile range [IQR] = 12 to 36 hours). There is a designated EMS rotation in 89% of programs, with a median duration of 3 weeks (range = 1 to 9 weeks; IQR = 2 to 4 weeks). Most programs involve residents on EMS rotations strictly as in‐field observers (63%), some as in‐field providers (20%), and the rest with some combination of the two roles. Ground ride‐along is required in 94% of programs, while air ride‐along is mandatory in 4% and optional in 81% of programs. Direct medical oversight (DMO) certification is required in 41% of residency programs, but not available in 26% of program jurisdictions. Residents in 92% of programs provide DMO. In those programs, most residents (77%) provide DMO primarily while working in the emergency department (ED), 13% during dedicated EMS or medical oversight shifts, and 4% during a combination of these shifts. Disaster‐preparedness was most frequently listed as the component programs would like to add to their EMS curricula.Conclusions:  There is a wide range in the didactic, online, and in‐field EMS educational experiences provided as part of EM training. Most residents participate in ground ride‐along activities, provide DMO, and have a dedicated EMS rotation. Disaster‐preparedness is the most common desired addition to existing EMS rotations.ACADEMIC EMERGENCY MEDICINE 2012; 19:1–6 © 2012 by the Society for Academic Emergency Medicine
Influence of epigenetic modifications of the interleukin‐10 promoter on IL10 gene expression
Authors: Larsson Lena , Thorbert‐Mros Sara , Rymo Lars , Berglundh Tord 
Published: January 2012

Larsson L, Thorbert‐Mros S, Rymo L, Berglundh T. Influence of epigenetic modifications of the interleukin‐10 promoter on IL10 gene expression. Eur J Oral Sci 2012; 120: 14–20. © 2012 Eur J Oral SciEpigenetic modifications of DNA and its associated proteins influence gene expression. The ‐1087 interleukin‐10 (IL10) gene polymorphism is associated with differences in IL10 expression. The objectives of this study were to analyze the effect of DNA methylation and histone modifications on IL10 gene expression, the differences in epigenetic modifications between GG and AA genotypes of the ‐1087 IL10 gene polymorphism, and the methylation pattern in the region close to the ‐1087 position. Using B cells obtained from subjects with GG and AA genotypes we demonstrated that treatment with histone deacetylase inhibitors and 5‐aza‐2‐deoxycytidine resulted in an increase in the production of IL10 mRNA. The chromatin immunoprecipitation assay revealed that stimulation with lipopolysaccharide resulted in a higher fold increase in the acetylation of histone H4 and in the methylation of histone H3 for GG genotype cells than for AA genotype cells. The increase in acetylation of histone H3 was larger for AA genotype cells than for GG genotype cells. For unstimulated cells the acetylation and methylation of histone H3 were higher for GG genotype cells than for AA genotype cells, while AA genotype cells had a higher increase in acetylation of histone H4. DNA methylation assays revealed that the three CpG sites distal to the ‐1087 site were methylated in blood cells and gingival tissues.
Peptidoglycan and lipopolysaccharide synergistically enhance bone resorption and osteoclastogenesis
Authors: Kishimoto T. , Kaneko T. , Ukai T. , Yokoyama M. , Ayon Haro R. , Yoshinaga Y. , Yoshimura A. , Hara Y. 
Published: January 2012

Kishimoto T, Kaneko T, Ukai T, Yokoyama M, Ayon Haro R, Yoshinaga Y, Yoshimura A, Hara Y. Peptidoglycan and lipopolysaccharide synergistically enhance bone resorption and osteoclastogenesis. J Periodont Res 2012; 47: 446–454. © 2012 John Wiley & Sons A/SBackground and Objective:  Peptidoglycan (PGN) and lipopolysaccharide (LPS) are bacterial cell wall constituents that are able to induce bone resorption by stimulating Toll‐like receptor (TLR) 2 and TLR4, respectively. The fragments of PGN also stimulate inflammatory responses via nucleotide‐binding oligomerization domain (NOD) 1 and NOD2, although there are differences in the NOD‐stimulatory activities between gram‐positive and gram‐negative PGNs. The TLR and NOD signaling pathways are known to engage in cross‐talk to enhance the production of inflammatory cytokines. In the present study, we investigated the effects of gram‐negative and gram‐positive PGNs on bone resorption and osteoclastogenesis in the presence or absence of LPS.Material and Methods:  We injected Escherichia coli PGN or Staphylococcus aureus PGN with or without LPS into mouse gingiva, and histopathologically assessed alveolar bone resorption by tartrate‐resistant acid phosphatase staining. We also stimulated osteoclast precursors from mouse bone marrow macrophages with these PGNs in vitro and assessed osteoclastogenesis. The cells were also stimulated with synthetic ligands for NOD1; γ‐D‐glutamyl‐meso‐DAP NOD2; muramyl dipeptide or TLR2; Pam3CSK4 with or without LPS to analyse the signaling cross‐talk.Results:  S. aureus PGN, but not E. coli PGN, induced alveolar bone resorption, as did LPS. However, PGN from both sources significantly enhanced the bone resorption in the mice co‐injected with LPS. Both types of PGNs induced osteoclastogenesis and accelerated osteoclastogenesis when the cells were co‐stimulated with LPS in vitro. All synthetic ligands synergistically induced osteoclastogenesis by co‐stimulation with LPS.Conclusion:  Gram‐positive or gram‐negative PGN worked synergistically with LPS to induce bone resorption and osteoclastogenesis, possibly by co‐ordinating the effects of TLR2, NOD1, NOD2 and TLR4 signaling.
The long‐term outcomes of four alternative treatment strategies for primary open‐angle glaucoma
Authors: van Gestel Aukje , Webers Carroll A. , Severens Johan L. , Beckers Henny J. , Jansonius Nomdo M. , Hendrikse Fred , Schouten Jan S. 
Published: January 2012

Abstract.Purpose: To evaluate the long‐term effects and costs of four treatment strategies for primary open‐angle glaucoma compared to usual care.Methods: Cost‐effectiveness analyses with a lifelong horizon were made from a societal perspective. Data were generated with a patient‐level model based on discrete event simulation. The model structure and parameter estimates were based on literature, particularly clinical studies on the natural course of glaucoma and the effect of treatment. We simulated heterogeneous cohorts of 3000 patients and explored the impact of uncertainty with sensitivity analyses.Results: The incremental cost‐effectiveness ratio (ICER) of initial treatment with a prostaglandin analogue compared with a β‐blocker was €12.931 per quality‐adjusted life year (QALY) gained. A low initial target pressure (15 mmHg) resulted in 0.115 QALYs gained and €1550 saved compared to a gradual decrease from 21 to 15 mmHg upon progression. Visual field (VF) measurements every 6 rather than 12 months lead to health gains at increased costs (ICER €173 486 per QALY gained), whereas measurements every 24 months lead to health losses at reduced costs (ICER €21 516 per QALY lost). All treatment strategies were dominant over ‘withholding treatment’.Conclusions: From a cost‐effectiveness point of view, it seems advantageous to aim for a low intraocular pressure in all glaucoma patients. The feasibility of this strategy should therefore be investigated. Additionally, the cost‐effectiveness outcomes of initiating monotherapy with a prostaglandin analogue and reducing the frequency of VF testing may be acceptable.
Association of CiaRH with resistance of Streptococcus mutans to antimicrobial peptides in biofilms
Authors: Mazda Y. , Kawada‐Matsuo M. , Kanbara K. , Oogai Y. , Shibata Y. , Yamashita Y. , Miyawaki S. , Komatsuzawa H. 
Published: January 2012

SummaryStreptococcus mutans is a cariogenic pathogen in humans. To persist in the oral cavity, S. mutans is resistant against several antibacterial factors derived from the host. In this study, we investigated the mechanism of resistance to cationic antimicrobial peptides (AMPs), which are innate immune factors in humans. Because dltA‐D (teichoic acid biosynthesis) was reported to affect the susceptibility to AMPs in other bacterial species, we evaluated the susceptibility of a dltC knockout mutant of S. mutans to the AMPs human beta‐defensin‐1 (hBD1), hBD2, hBD3 and LL37. The dltC mutant exhibited significantly increased susceptibility to AMPs. Regulation of dltC expression involved CiaRH, a two‐component system. Expression of dltC in the wild‐type strain was significantly increased in biofilm cells compared with that in planktonic cells, whereas expression was not increased in a ciaRH knockout mutant. In biofilm cells, we found that susceptibility to LL37 was increased in the ciaRH mutant compared with that in the wild type. From these results, it is concluded that Dlt is involved in the susceptibility of S. mutans to AMPs and is regulated by CiaRH in biofilm cells.
How Do Spatial Learning and Memory Occur in the Brain? Coordinated Learning of Entorhinal Grid Cells and Hippocampal Place Cells
Authors: Pilly Praveen K. , Grossberg Stephen 
Published: January 2012

AbstractSpatial learning and memory are important for navigation and formation of episodic memories. The hippocampus and medial entorhinal cortex (MEC) are key brain areas for spatial learning and memory. Place cells in hippocampus fire whenever an animal is located in a specific region in the environment. Grid cells in the superficial layers of MEC provide inputs to place cells and exhibit remarkable regular hexagonal spatial firing patterns. They also exhibit a gradient of spatial scales along the dorsoventral axis of the MEC, with neighboring cells at a given dorsoventral location having different spatial phases. A neural model shows how a hierarchy of self-organizing maps, each obeying the same laws, responds to realistic rat trajectories by learning grid cells with hexagonal grid firing fields of multiple spatial scales and place cells with unimodal firing fields that fit neurophysiological data about their development in juvenile rats. The hippocampal place fields represent much larger spaces than the grid cells to support navigational behaviors. Both the entorhinal and hippocampal self-organizing maps amplify and learn to categorize the most energetic and frequent co-occurrences of their inputs. Top–down attentional mechanisms from hippocampus to MEC help to dynamically stabilize these spatial memories in both the model and neurophysiological data. Spatial learning through MEC to hippocampus occurs in parallel with temporal learning through lateral entorhinal cortex to hippocampus. These homologous spatial and temporal representations illustrate a kind of “neural relativity” that may provide a substrate for episodic learning and memory.