bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissemination of food crops with nutritional benefits: Adoption and disadoption of soybeans in Togo and Benin
Authors: Wendland Kelly J. , Sills Erin O. 
Published: April 2008

Abstract To combat high rates of malnutrition in sub‐Saharan Africa, the UN Millennium Project has called for increased emphasis on technologies that explicitly link agricultural and nutritional components. While there is a large literature on the factors that influence household decisions to adopt new agricultural technologies with economic or environmental benefits, less is known about the factors that determine the uptake and continued use of agricultural technologies promoted exclusively for their health benefits. Using data from a 2004 survey in the Tamberma region of Togo and Benin, we identify factors that influence the adoption and disadoption of soybeans — a crop being promoted throughout West Africa for its high protein content. Similar to the literature on adoption of other sustainable agriculture technologies, we find that household preferences, resource endowments, and risk and uncertainty affect household decisions about soybeans. However, by analyzing decisions about initial uptake and continued cultivation separately, we uncover the importance of intrahousehold dynamics and experience with the soybean crop. To successfully address malnutrition through new agricultural technologies, researchers and rural extension agents should take a disaggregated view of technology adoption, seeking to identify and tailor their outreach to the different factors important at different stages of the dissemination process.
Effects of high‐frequency stimulation on epileptiform activity in vitro: ON/OFF control paradigm
Authors: Su Yuzhuo , Radman Thomas , Vaynshteyn Jake , Parra Lucas C. , Bikson Marom 
Published: April 2008

Summary
Purpose: To determine the effects of high‐frequency electrical stimulation on electrographic seizure activity during and after stimulation (ON‐effect and OFF‐effect).
Methods: The modulation and suppression of epileptiform activity during (ON‐effect) and after (OFF‐effect) high‐frequency electrical stimulation was investigated using the high‐K+ and picrotoxin hippocampal slice epilepsy models. Uniform sinusoidal fields (50 Hz) were applied with various intensity levels for 1 min across brain slices. Extracellular and intracellular activity were monitored during and after stimulation.
Results: The ON‐effects of high‐frequency stimulation were highly variable across individual slices and models; ON‐effects included modulation of activity, pacing, partial suppression, or activity resembling spreading‐depression. On average, epileptic activity, measured as power in the extracellular fields, increased significantly during stimulation. Following the termination of electrical stimulation, a robust poststimulation suppression period was observed. This OFF suppression was observed even at relatively moderate stimulation intensities. The duration of OFF suppression increased with stimulation intensity, independent of ON‐effects. Antagonism of GABA
A
function did not directly effect OFF suppression duration.
Conclusions: The present results suggest that “rational” seizure control protocols using intermittent high‐frequency electrical stimulation should control for both ON and OFF effects.
Granule cell dispersion develops without neurogenesis and does not fully depend on astroglial cell generation in a mouse model of temporal lobe epilepsy
Authors: Nitta Naoki , Heinrich Christophe , Hirai Hisao , Suzuki Fumio 
Published: April 2008

SummaryPurpose:  Granule cell dispersion (GCD) appears as a characteristic morphological feature of the mesial temporal lobe epilepsy (MTLE). It has been suggested that this phenomenon could be due to an increased neurogenesis in the dentate gyrus. However, this hypothesis is still debated and recent clinical and experimental studies have shown that neurogenesis is rather decreased in MTLE. To further determine the role of neural and astroglial cell generation in GCD we examined the consequences of aging and irradiation, which are known to reduce progenitor cells, in a mouse model of MTLE induced by intrahippocampal kainate (KA) injection.Methods:  We injected KA in hippocampus of three different types of mice; (1) young adult, (2) aged, and (3) irradiated mice. Newly generated cells were labeled by Bromodeoxyuridine (BrdU) and were characterized by immunohistochemistry. The extent of GCD was compared among the three animal groups.Results:  In young adult mice, BrdU‐labeled neurons as well as doublecortin‐ and NeuroD‐positive cells decreased progressively after KA injection whereas BrdU‐labeled astrocytes and microglias increased. In aged and irradiated mice, where basal neurogenesis was already strongly reduced, GCD developed after KA injection to the same extent as in young adult mice. However, augmentation of the BrdU‐labeled astrocytes after KA was less than 40% in irradiated mice in comparison to young and aged mice.Conclusions:  Our data show that GCD occurs without neurogenesis. Furthermore GCD developed regardless of the degree of astroglial cell proliferation, suggesting that neural stem cell generation is not crucial for GCD.
Sustained low‐efficiency dialysis with filtration (SLEDD‐f) in the management of acute sodium valproate intoxication
Authors: KHAN Emon , HUGGAN Paul , CELI Leo , MACGINLEY Robert , SCHOLLUM John , WALKER Robert 
Published: April 2008

AbstractHemodialysis is only infrequently used in drug overdosage situations. The efficacy of hemodialysis to remove the drug depends upon the pharmacokinetics and pharmacodynamics of the drug. At normal therapeutic concentrations, valproic acid is predominantly protein bound and therefore removal by hemodialysis is limited. In an overdose situation, protein binding is rapidly saturated and therefore the substantially larger quantities of the free drug can rapidly cause toxicity. Slow low‐efficient daily diafiltration (SLEDD) has not previously been utilized in a drug overdose situation. We report the effective use of SLEDD to remove high toxic concentrations of valproic acid in an overdose situation. Slow low‐efficient daily diafiltration also prevented the rebound phenomenon that can occur as the excess drug is released from its protein‐bound stores. Hybrid dialysis therapies deserve further evaluation in the management of other poisonings where extra‐corporeal therapy is indicated.
Gustatory sweating recurring on peritoneal dialysis but resolving during periods of hemodialysis
Authors: DISKIN Charles J. , STOKES Thomas J. , DANSBY Linda M. , RADCLIFF Lautrec , CARTER Thomas B. 
Published: April 2008

AbstractGustatory sweating is a rare disorder characterized by profuse sweating on the forehead, face, scalp, and neck occurring soon after ingesting food, which has been reported in diabetic patients. The mechanism is thought to be triggered by taste buds and not gastric stimulation. We report a case where gustatory sweating repeatedly developed on peritoneal dialysis that resolved on periods of hemodialysis. A 32‐year‐old woman with diabetic end‐stage renal disease developed gustatory sweating shortly after beginning continuous ambulatory peritoneal dialysis despite excellent clearances. After 5 months, she changed to hemodialysis for 2 months and noticed complete resolution of her gustatory sweating; however, after her return to peritoneal dialysis 2 months later, her gustatory sweating recurred. While on peritoneal dialysis, she was treated with clonidine, which resulted in improvement but not resolution of her symptoms as had occurred on hemodialysis. Another period on hemodialysis resulted in the resolution of her symptoms that returned again after restarting peritoneal dialysis. Clonidine provided incomplete relief while topical glycopyrrolate was effective and without complications. We report recurrent gustatory sweating on peritoneal dialysis that resolved with hemodialysis. We have no data to suggest that intra‐abdominal stimulation played a role, but rather that despite excellent clearances neuropathy may have played a role. Treatment with topical glycopyrrolate may be safe and effective given every third day if clonidine is ineffective.
Prediction of hemodialysis sorbent cartridge urea nitrogen capacity and sodium release from in vitro tests
Authors: ROSENBAUM Benjamin P. , ASH Stephen R. , WONG Raymond J. , THOMPSON R. Preston , CARR David J. 
Published: April 2008

AbstractIn sorbent‐based hemodialysis, factors limiting a treatment session are urea conversion capacity and sodium release from the cartridge. In vitro experiments were performed to model typical treatment scenarios using various dialyzers and 4 types of SORB™ sorbent cartridges. The experiments were continued to the point of column saturation with ammonium. The urea nitrogen removed and amount of sodium released in each trial were analyzed in a multi‐variable regression against several variables: amount of zirconium phosphate (ZrP), dialysate flow rate (DFR), simulated blood flow rate (BFR), simulated patient whole‐body fluid volume (V), initial simulated patient urea concentration (BUNi), dialyzer area permeability (KoA) product, initial dialysate sodium and bicarbonate (HCO3i) concentrations, initial simulated patient sodium (Nai), pH of ZrP, creatinine, breakthrough time, and average urea nitrogen concentration in dialysate. The urea nitrogen capacity (UNC) of various new SORB™ columns is positively related to ZrP, BFR, V, BUNi, and ZrP pH and negatively to DFR with an R2adjusted=0.990. Two models are described for sodium release. The first model is related positively to DFR and V and negatively to ZrP, KoA product, and dialysate HCO3i with an R2adjusted=0.584. The second model incorporates knowledge of initial simulated patient sodium (negative relationship) and urea levels (negative relationship) in addition to the parameters in the first model with an R2adjusted=0.786. These mathematical models should allow for prediction of patient sodium profiles and the time of column urea saturation based on simple inputs relating to patient chemistries and the dialysis treatment.
Statins are associated with a reduced risk of bone fracture in hemodialysis (HD) patients
Authors: NICHOLS Robert , HOPMAN Wilma M. , MORTON Alexander R. , HARMAN Gavin J. , HOLDEN Rachel M. 
Published: April 2008

AbstractThe Dialysis Outcomes and Practice Patterns Study reported a statistically non‐significant protective effect of HMG‐co reductase inhibitors (statins) on bone fracture risk in hemodialysis (HD) patients. We sought to determine whether statin exposure was associated with reduced risk of bone fracture in our HD population. This was a retrospective cohort study of 174 prevalent HD patients. Fracture data are abstracted from the medical record. Subjects were considered to be on a statin if they were exposed at any time since the date of dialysis initiation. The subjects were 174 HD patients (68.4% male) with a median age of 69.1 and age range from 25.2 to 96.3 years. The median age at initiation of HD was 62.5, ranging from 15.2 to 90.5 years. The mean (SD) dialysis vintage was 7.3 (4.5) years. Seventy‐seven subjects (44.3%) had statin exposure. There were a total of 54 first bone fractures. There was a positive correlation between bone fracture and dialysis vintage (p=0.023) and a negative association between bone fracture and statin exposure (p=0.044). Those with statin exposure had a higher prevalence of CAD (p=0.030) compared with those not exposed. Logistic regression analysis (stepwise, α=0.05) was performed with dependent variable bone fracture and independent variables age at HD initiation (forced), dialysis vintage, gender (forced), prednisone use (forced), and statin exposure. The significant predictors of bone fracture (R2=0.14, p=0.004) were age at HD initiation (p=0.016), dialysis vintage (p=0.007), and absence of statin exposure (p=0.019). Statin exposure appears to be associated with a reduced frequency of bone fracture in HD patients. Future studies evaluating the potential anabolic effect of statins on bone are required.
Understanding Smoking Cessation in Rural Communities
Authors: Hutcheson Tresza D. , Greiner K. Allen , Ellerbeck Edward F. , Jeffries Shawn K. , Mussulman Laura M. , Casey Genevieve N. 
Published: April 2008

ABSTRACT:
Context:

Rural communities are adversely impacted by increased rates of tobacco use. Rural residents may be exposed to unique communal norms and other factors that influence smoking cessation. Purpose: This study explored facilitating factors and barriers to cessation and the role of rural health care systems in the smoking‐cessation process. Methods: Focus groups were conducted with smokers (N = 63) in 7 Midwestern rural communities. Qualitative analysis and thematic coding of transcripts was conducted. Findings: Three levels of pertinent themes—intrinsic, health‐system resource, and community/social factors—were identified. Intrinsic factors facilitating cessation included willingness to try various cessation methods, beliefs about consequences of continuing smoking (eg, smoking‐related illnesses), and benefits of quitting (eg, saving money). Intrinsic barriers included skepticism about resources, low self‐efficacy and motivation for smoking cessation, concern about negative consequences of quitting (eg, weight gain), and perceived benefits of continued smoking (eg, enjoyment). Key health‐system resource facilitators were pharmacotherapy use and physician visits. Resource barriers included infrequent physician visits, lack of medical/financial resources, limited local smoking‐cessation programs, and lack of knowledge of existing resources. In terms of community/social factors, participants acknowledged the negative social impact/image of smoking, but also cited a lack of alternative activities, few public restrictions, stressors, and exposure to other smokers as barriers to cessation. Conclusions: Smokers in rural communities face significant challenges that must be addressed. A multilevel model centered on improving access to health care system resources while addressing intrinsic and community/social factors might enhance smoking‐cessation interventions and programs in rural communities.
Medicare Hospital Charges in the Last Year of Life: Distribution by Quarter for Rural and Urban Nursing Home Decedents With Cognitive Impairment
Authors: Gessert Charles E. , Haller Irina V. 
Published: April 2008

ABSTRACT:
Background:

Medicare beneficiaries incur 27%‐30% of lifetime charges in the last year of life; most charges occur in the last quarter. Factors associated with high end‐of‐life Medicare charges include less advanced age, non‐white race, absence of advance directive, and urban residence. Methods: We analyzed Medicare hospital charges in the last year of life for nursing home residents with severe cognitive impairment, focusing on rural–urban differences. The study population consisted of 3,703 nursing home residents (1,882 rural, 1,821 urban) in Minnesota and Texas who died in 2000‐2001. Data on Medicare hospital charges were obtained from 1998‐2001 Centers for Medicare and Medicaid Services MedPAR files. Results: During the last year of life, unadjusted charges averaged $12,448 for rural subjects; $31,780 for urban. The charges were distributed across the last 4 quarters similarly for the 2 populations, with 15%‐20% of charges incurred in each of the first 3 quarters, and 47% (rural) and 52% (urban) in the last quarter. At the individual level, a higher percentage of hospital charges were incurred in the last 90 days by urban than by rural residents (P < .001). A larger proportion of urban (43%) than rural (37%) residents were hospitalized in the final quarter. The charges for hospitalized residents (N = 1,994) were distributed similarly to those of the entire study population. Discussion: Medicare hospital charges during the last year of life were lower for rural nursing home residents with cognitive impairment than for their urban counterparts. Charges tend to be more concentrated in the last 90 days of life for urban residents.
Rural–Urban Differences in Primary Care Physicians' Practice Patterns, Characteristics, and Incomes
Authors: Weeks William B. , Wallace Amy E. 
Published: April 2008

ABSTRACT:
Context:

Low salaries and difficult work conditions are perceived as a major barrier to the recruitment of primary care physicians to rural settings. Purpose: To examine rural–urban differences in physician work effort, physician characteristics, and practice characteristics, and to determine whether, after adjusting for any observed differences, rural primary care physicians' incomes were lower than those of urban primary care physicians. Methods: Using survey data from actively practicing office‐based general practitioners (1,157), family physicians (1,378), general internists (2,811), or pediatricians (1,752) who responded to the American Medical Association's annual survey of physicians between 1992 and 2002, we used linear regression modeling to determine the association between practicing in a rural (nonmetropolitan) or urban (standard metropolitan statistical area) setting and physicians' annual incomes after controlling for specialty, work effort, provider characteristics, and practice characteristics. Findings: Rural primary care physicians' unadjusted annual incomes were similar to their urban counterparts, but they tended to work longer hours, complete more patient visits, and have a much greater proportion of Medicaid patients. After adjusting for work effort, physician characteristics, and practice characteristics, primary care physicians who practiced in rural settings made $9,585 (5%) less than their urban counterparts (95% confidence intervals: −$14,569, −$4,602, P < .001). In particular, rural practicing general internists and pediatricians experienced lower incomes than did their urban counterparts. Conclusions: Addressing rural physicians' lower incomes, longer work hours, and greater dependence on Medicaid reimbursement may improve the ability to ensure that an adequate supply of primary care physicians practice in rural settings.
Expanding the Role of Nurse Practitioners: Effects on Rural Access to Care for Injured Workers
Authors: Sears Jeanne M. , Wickizer Thomas M. , Franklin Gary M. , Cheadle Allen D. , Berkowitz Bobbie 
Published: April 2008

ABSTRACT:
Context:

A 3‐year pilot program to expand the role of nurse practitioners (NPs) in the Washington State workers' compensation system was implemented in 2004 (SHB 1691), amid concern about disparities in access to health care for injured workers in rural areas. SHB 1691 authorized NPs to independently perform most functions of an attending physician. Purpose: The aims of this study were to (1) describe the contribution by NPs to Washington's workers' compensation provider workforce, (2) evaluate change in provider availability attributable to SHB 1691, and (3) evaluate the effect of SHB 1691 on timely accident report filing. Methods: Administrative data were used to evaluate this natural experiment, using a pre‐post design with primary care physicians (PCPs) as a nonequivalent comparison group. Findings: NPs served injured workers with characteristics similar to those served by PCPs, but 22.0% of NPs were rural, compared with 17.3% of PCPs. Of claimants with NPs as their attending provider, 53.3% were injured in a rural county, compared with 24.7% for those with PCP attending providers. The number of NPs participating in the workers' compensation system rose after SHB 1691 implementation, more so in rural areas. SHB 1691 implementation was associated with a 16 percentage point improvement in timely accident report filing by NPs in both rural and urban areas. Conclusions: Authorizing NPs to function as attending providers for injured workers may improve provider availability (especially in rural areas) and timely accident report filing, which in turn may improve worker outcomes and system costs.
Nonemergency Medicine‐Trained Physician Coverage in Rural Emergency Departments
Authors: Peterson Lars E. , Dodoo Martey , Bennett Kevin J. , Bazemore Andrew , Phillips Robert L. 
Published: April 2008

ABSTRACT:
Context: Rural areas have fewer physicians compared to urban areas, and rural emergency departments often rely on community or contracted providers for staffing. The emergency department workforce is composed of a variety of physician specialties and clinicians. Purpose: To determine the distribution of emergency department clinicians and the proportion of care they provide across the rural‐urban continuum. Methods: Cross‐sectional analysis of secondary data. The distribution of clinicians who provide emergency department care by county was determined using the 2003 Area Resource File. The percentage of emergency department care provided by clinician type was determined using 2003 Medicare claims data. Logistic regression analyses assessed the odds of being seen by different clinicians with a patient's rurality when presenting to the emergency department. Findings: Board‐certified emergency physicians provide 75% of all emergency department care, but only 48% for Medicare beneficiaries of the most rural of counties. The bulk of the remainder of emergency department care is largely provided by family physicians and general internists, with the percentage increasing with rurality. The likelihood of being seen by an emergency physician in the emergency department decreases 5‐fold as rurality increases, while being seen by a family physician increases 7‐fold. Conclusion: Nonemergency physicians provide a significant portion of emergency department care, particularly in rural areas. Medical specialties must cooperate to ensure the availability of high‐quality emergency department care to all Americans regardless of physician specialty.
Ten new microsatellite markers for the buttonwood mangrove (Conocarpus erectus L., Combretaceae)
Authors: NETTEL ALEJANDRO , DODD RICHARD S. , CID‐BECERRA JORGE A. , DE LA ROSA‐VELEZ JORGE 
Published: April 2008

AbstractWe present 10 microsatellite markers for the buttonwood mangrove, Conocarpus erectus, a wide‐range mangrove associate species. Polymorphism was assessed among individuals from six different populations along the Pacific Coast of Mexico and Costa Rica, as well as in two individuals from the Yucatan Peninsula in the Atlantic. The number of alleles detected in the Pacific ranged from two to five. All loci amplified in the Yucatan samples and seven loci revealed a unique Atlantic allele. These markers will be useful for studies in the conservation of the species and to study the basic biology of C. erectus.
Isolation and characterization of microsatellite loci from the endangered New Zealand takahe (Gruiformes; Rallidae; Porphyrio hochstetteri)
Authors: GRUEBER CATHERINE E , KING TANIA M , WATERS JONATHAN M , JAMIESON IAN G 
Published: April 2008

AbstractNineteen polymorphic microsatellite loci were characterized from the endangered takahe (Porphyrio hochstetteri). Like many of New Zealand's other native avian species, levels of polymorphism were low, with variation detected at only 19 of 110 (17.3%) loci, and most polymorphic loci (78.9%) were diallelic (mean number of alleles = 2.3). Despite these low levels of variation, the microsatellites developed here will be useful for parentage assignment for confirming pedigrees, and investigating relationships between genetic variation, pedigree‐based inbreeding and reproductive success in this highly endangered species.