bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of mode of hydrocortisone administration on glycemic control in patients with septic shock: a prospective randomized trial
Authors: Loisa Pekka , Parviainen Ilkka , Tenhunen Jyrki , Hovilehto Seppo , Ruokonen Esko 
Published: February 2007

Abstract
Introduction
Low-dose hydrocortisone treatment is widely accepted therapy for the treatment of vasopressor-dependent septic shock. The question of whether corticosteroids should be given to septic shock patients by continuous or by bolus infusion is still unanswered. Hydrocortisone induces hyperglycemia and it is possible that continuous hydrocortisone infusion would reduce the fluctuations in blood glucose levels and that tight blood glucose control could be better achieved with this approach.

Methods
In this prospective randomized study, we compared the blood glucose profiles, insulin requirements, amount of nursing workload needed, and shock reversal in 48 septic shock patients who received hydrocortisone treatment either by bolus or by continuous infusion with equivalent dose (200 mg/day). Duration of hydrocortisone treatment was five days.

Results
The mean blood glucose levels were similar in the two groups, but the number of hyperglycemic episodes was significantly higher in those patients who received bolus therapy (15.7 ± 8.5 versus 10.5 ± 8.6 episodes per patient, p = 0.039). Also, more changes in insulin infusion rate were needed to maintain strict normoglycemia in the bolus group (4.7 ± 2.2 versus 3.4 ± 1.9 adjustments per patient per day, p = 0.038). Hypoglycemic episodes were rare in both groups. No difference was seen in shock reversal.

Conclusion
Strict normoglycemia is more easily achieved if the hydrocortisone therapy is given to septic shock patients by continuous infusion. This approach also reduces nursing workload needed to maintain tight blood glucose control.
Trial Registration Number
ISRCTN98820688
Inhalation injury in severely burned children does not augment the systemic inflammatory response
Authors: Finnerty Celeste C , Herndon David N , Jeschke Marc G 
Published: February 2007

Abstract
Introduction
Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children.

Methods
Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in the study. Inhalation injury was diagnosed by bronchoscopy during the first operation. Blood was collected within 24 hours of admission and again at five to seven days following admission. Cytokine expression was profiled using multi-plex antibody-coated beads. Significance was accepted at a p value of less than 0.05.

Results
The mean percentages of total body surface area burned were 67% ± 4% (56% ± 6%, third-degree burns) in the inhalation injury group and 60% ± 3% (45% ± 3%, third-degree burns) in the non-inhalation injury group (p value not significant [NS]). Mean age was 9 ± 1 years in the inhalation injury group and 8 ± 1 years in the non-inhalation injury group (p value NS). Time from burn to admission in the inhalation injury group was 2 ± 1 days compared to 3 ± 1 days in the non-inhalation injury group (p value NS). Mortalities were 40% in the inhalation injury group and 12% in the non-inhalation injury group (p < 0.05). At the time of admission, serum interleukin (IL)-7 was significantly increased in the non-inhalation injury group, whereas IL-12p70 was significantly increased in the inhalation injury group compared to the non-inhalation injury group (p < 0.05). There were no other significant differences between groups. Five to seven days following admission, all cytokines decreased with no differences between the inhalation injury and non-inhalation injury cohorts.

Conclusion
In the present study, we show that an inhalation injury causes alterations in IL-7 and IL-12p70. There were no increased levels of pro-inflammatory cytokines, indicating that an inhalation injury in addition to a burn injury does not augment the systemic inflammatory response early after burn.
A Cost-Effectiveness Analysis of Adjuvant Trastuzumab Regimens in Early HER2/neu–Positive Breast Cancer
Authors: Kurian Allison W. , Thompson Rebecca Newton , Gaw Allison F. , Arai Sally , Ortiz Rafael , Garber Alan M. 
Published: February 2007

PurposeOne-year adjuvant trastuzumab (AT) therapy, with or without anthracyclines, increases disease-free and overall survival in early-stage HER2/neu-positive breast cancer. We sought to evaluate the cost effectiveness of these regimens, which are expensive and potentially toxic.MethodsWe used a Markov health-state transition model to simulate three adjuvant therapy options for a cohort of 49-year-old women with HER2/neu-positive early-stage breast cancer: conventional chemotherapy without trastuzumab; anthracycline-based AT regimens used in the National Surgical Adjuvant Breast and Bowel Project B-31 and North Central Cancer Treatment Group N9831 trials; and the nonanthracycline AT regimen used in the Breast Cancer International Research group 006 trial. The base case used treatment efficacy measures reported in the randomized clinical trials of AT. We measured health outcomes in quality-adjusted life-years (QALYs) and costs in 2005 United States dollars (US$) and subjected results to probabilistic sensitivity analysis.ResultsIn the base case, the anthracycline-based AT arm has an incremental cost-effectiveness ratio (ICER) of $39,982/QALY, whereas the nonanthracycline AT arm is more expensive and less effective; this result is insensitive to changes in recurrence rates, but if there is no benefit after 4 years, ICERs exceed $100,000/QALY for both AT arms. Results are moderately sensitive to variation in breast cancer survival rates and trastuzumab cost, and less sensitive to variations in cardiac toxicity.ConclusionAT has an ICER comparable to those for other widely used interventions. Longer clinical follow-up is warranted to evaluate the long-term efficacy and toxicity of different AT regimens.
Cost Effectiveness of Adjuvant Trastuzumab in Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer
Authors: Liberato Nicola Lucio , Marchetti Monia , Barosi Giovanni 
Published: February 2007

Purpose To evaluate the cost-effectiveness of 12-month adjuvant trastuzumab therapy in women with high-risk human epidermal growth factor receptor 2 (HER2) –positive early breast cancer. Methods A Markov model tracked quarterly patients’ transitions between five health states: disease free, local relapse, disease free after local relapse, metastatic disease, and death. Patients were allowed to incur symptomatic or asymptomatic transient cardiac dysfunction during trastuzumab administration. Probabilities were derived mainly from the combined report of the National Surgical Adjuvant Breast and Bowel Project B-31 and the North Central Cancer Treatment Group N9831 trials (95% node positive) and a meta-analysis by the Early Breast Cancer Trialists’ Collaborative Group. Costs were estimated from the perspective of the Italian and US health care systems. The analysis was run during a 15-year time horizon. A 3% yearly discount rate was applied to both costs and life-years. Second-order Monte-Carlo and probabilistic sensitivity analyses were performed. Results Adjuvant trastuzumab increases life expectancy by 1.54 (1.18 discounted) quality-adjusted life-years (QALYs). At a cost of €675 and $767 per weekly dose in the Italian and US setting, respectively, trastuzumab achieves its clinical benefit at a cost of €14,861 (95% CI, €3,917 to €44,028) and $18,970 (95% CI, $6,014 to $45,621) per QALY saved. The incremental cost effectiveness was higher than €50,000/QALY (or $60,000/QALY) at time horizons shorter than 7.8 years and for patients older than 76 years or with a 10-year risk of relapse lower than 15%. The results confirmed the cost effectiveness when simulating a Herceptin Adjuvant Trial (HERA) -like scenario at multiway sensitivity analysis. Conclusion In a long-term horizon, adjuvant trastuzumab is a cost-effective therapy for patients with HER2-positive, high-risk, early breast cancer.
Double-Blinded Randomized Study of High-Dose Calcitriol Plus Docetaxel Compared With Placebo Plus Docetaxel in Androgen-Independent Prostate Cancer: A Report From the ASCENT Investigators
Authors: Beer Tomasz M. , Ryan Christopher W. , Venner Peter M. , Petrylak Daniel P. , Chatta Gurkamal S. , Ruether J. Dean , Redfern Charles H. , Fehrenbacher Louis , Saleh Mansoor N. , Waterhouse David M. , Carducci Michael A. , Vicario Daniel , Dreicer Robert , Higano Celestia S. , Ahmann Frederick R. , Chi Kim N. , Henner W. David , Arroyo Alan , Clow Fong W. 
Published: February 2007

Purpose To compare the safety and activity of DN-101, a new high-dose oral formulation of calcitriol designed for cancer therapy, and docetaxel with placebo and docetaxel. Patients and Methods Patients with progressive metastatic androgen-independent prostate cancer and adequate organ function received weekly docetaxel 36 mg/m2 intravenously for 3 weeks of a 4-week cycle combined with either 45 μg DN-101 or placebo taken orally 1 day before docetaxel. The primary end point was prostate-specific antigen (PSA) response within 6 months of enrollment, defined as a 50% reduction confirmed at least 4 weeks later. Results Two hundred fifty patients were randomly assigned. Baseline characteristics were similar in both arms. Within 6 months, PSA responses were seen in 58% in DN-101 patients and 49% in placebo patients (P = .16). Overall, PSA response rates were 63% (DN-101) and 52% (placebo), P = .07. Patients in the DN-101 group had a hazard ratio for death of 0.67 (P = .04) in a multivariate analysis that included baseline hemoglobin and performance status. Median survival has not been reached for the DN-101 arm and is estimated to be 24.5 months using the hazard ratio, compared with 16.4 months for placebo. Grade 3/4 adverse events occurred in 58% of DN-101 patients and in 70% of placebo-treated patients (P = .07). Most common grade 3/4 toxicities for DN-101 versus placebo were neutropenia (10% v 8%), fatigue (8% v 16%), infection (8% v 13%), and hyperglycemia (6% v 12%). Conclusion This study suggests that DN-101 treatment was associated with improved survival, but this will require confirmation because survival was not a primary end point. The addition of weekly DN-101 did not increase the toxicity of weekly docetaxel.
HOXB13-to-IL17BR Expression Ratio Is Related With Tumor Aggressiveness and Response to Tamoxifen of Recurrent Breast Cancer: A Retrospective Study
Authors: Jansen Maurice P.H.M. , Sieuwerts Anieta M. , Look Maxime P. , Ritstier Kirsten , Meijer-van Gelder Marion E. , van Staveren Iris L. , Klijn Jan G.M. , Foekens John A. , Berns Els M.J.J. 
Published: February 2007

Purpose A HOXB13-to-IL17BR expression ratio was previously identified to predict clinical outcome of breast cancer patients treated with adjuvant tamoxifen. However, this ratio may predict a tumor's response to tamoxifen, its intrinsic aggressiveness, or both. Patients and Methods We have measured the HOXB13 and IL17BR expression levels by real-time polymerase chain reaction in 1,252 primary breast tumor specimens. Expression levels were normalized to housekeeper gene levels and related to clinicopathologic factors for all patients. The primary objective of this study was to determine the relationship of a HOXB13-to-IL17BR ratio with tumor aggressiveness and/or with response to tamoxifen therapy in estrogen receptor (ER) -positive disease. We selected ER-positive tumors, and clinical end points for the HOXB13-to-IL17BR ratio were disease-free survival (DFS) in patients with primary breast cancer (N = 619) and progression-free survival (PFS) in patients with recurrent breast cancer treated with first-line tamoxifen monotherapy (N = 193). The odds ratio (OR) and hazard ratio (HR) and their 95% CI were calculated, and all P values were two-sided. Results The HOXB13-to-IL17BR ratio was significantly associated with DFS and PFS. In multivariate analysis, HOXB13-to-IL17BR ratio expression levels were associated with a shorter DFS for node-negative patients only. Corrected for traditional predictive factors, the dichotomized HOXB13-to-IL17BR ratio was the strongest predictor in multivariate analysis for a poor response to tamoxifen therapy (OR = 0.16; 95% CI, 0.06 to 0.45; P < .001) and a shorter PFS (HR = 2.97; 95% CI, 1.82 to 4.86; P < .001). Conclusion High HOXB13-to-IL17BR ratio expression levels associate with both tumor aggressiveness and tamoxifen therapy failure.
Heat transfer evaluation of industrial pneumatic cylinders
Authors: Carneiro J. F. , de Almeida F Gomes 
Published: February 2007

Automatic positioning devices are used worldwide in tasks such as handling or assembly, making them key components of modern manufacturing systems. Pneumatic solutions are usually less expensive than their electrical counterparts, are more reliable, and require less maintenance. However, the complex non-linear nature and high model order of pneumatic systems lead to a very difficult control task. These problems make model order reductions and simplifications a common practice in servopneumatics. The heat transfer between air inside the cylinder and its environment is usually neglected or only indirectly accounted for, since it varies with the pressure, temperature, and speed of the actuator, which makes its experimental assessment difficult. In this work a simple and yet accurate procedure is presented on the basis of a thermal time constant, enabling its evaluation. The procedure is validated by simulation studies, and furthermore the heat conductance of three industrial actuators is experimentally determined.
Disability Management Strategies: A Preliminary Investigation of Perceptions, Policies and Return-to-Work Outcomes
Authors: Harder Henry G. , McHugh Gabrielle , Wagner Shannon L. , Harder Kari A. 
Published: February 2007

AbstractThe objectives of this retrospective study were to (1) examine the predictive value of employer's disability management (DM) perceptions and DM policies in return-to-work outcomes for the injured worker, (2) examine factors that influence employer's DM perceptions, polices and return-to-work outcomes, and (3) examine the relationship between demographic factors of the individual and return-to-work outcomes. Employers from a northern British Columbia, Canada community were randomly selected to participate. The findings of the study supported the hypothesis that company perception towards DM is a significant contributing factor to the presence of DM policies in the workplace and that DM polices are predictive of return-to-work outcomes for injured workers.
Reliability and Validity of Functional Capacity Evaluations: An Update
Authors: Innes Ev 
Published: February 2007

AbstractFunctional capacity evaluations (FCEs) and other work-related assessments continue to be used in occupational rehabilitation to determine the capacity of injured and disabled workers to either return to their preinjury jobs, or to determine what they are capable of doing in a work context. New instruments have been developed and others refined. There is a continuing call however for these systems to demonstrate acceptable reliability and validity. Comprehensive reviews of reliability and validity of work-related assessments were published and included information up to the end of 1997. This study updates that information by examining research conducted on five FCEs over the subsequent 8-year period (January 1998–March 2006). The Isernhagen Work Systems (IWS) FCE had the most comprehensive coverage of all aspects of reliability and validity, while the Progressive Isoinertial Lifting Evaluation (PILE) was also extensively researched. Newer FCEs show promise and should continue to be investigated. Clinicians and others are encouraged to be informed consumers of the evidence that exists for the reliability and validity of FCEs and other work-related assessments.
Disability Management Best Practices and Joint Labour–Management Collaboration
Authors: Shrey Don , Hursh Norman , Gallina Paul , Slinn Sara , White Anthony 
Published: February 2007

AbstractThe purpose of this article is to discuss the rationale for labour involvement in the management of injury and disability at the workplace. The authors discuss the importance of joint labour–management collaboration in the development and implementation of disability management and return-to-work programs. Best practices in disability management are reviewed, with a focus on important implications for joint labour–management committees. An overview of the key elements of formal return-to-work programs is discussed, including established benchmarks for return-to-work program development and implementation. This article also provides an overview of a proposed pioneering research project to analyse collective bargaining agreements, to review evidence of a joint commitment to best practices in worksite disability management, and to determine the extent to which disability management best practices are evident within unionised worksites.
Developing an Occupational Rehabilitation System for Workplace Stress
Authors: Randall Christine , Buys Nicholas , Kendall Elizabeth 
Published: February 2007

AbstractThe costs of occupational stress are rising and employers increasingly need to address occupational stress, prevention and rehabilitation issues. However, there is a relative lack of understanding about implementing strategies within specific organisational contexts. Extant literature indicates a need for integrated prevention and rehabilitation strategies that address specific organisational climates that contribute to stress. The Queensland Police Service (QPS) is one policing organisation facing significant occupational stress issues requiring organisational solutions. This article describes a Participatory Action Research case study, the aim of which is to develop an occupational rehabilitation system within the QPS to address identified stress issues. A combination of background information, interview and focus group data is being used to determine stress issues and provide potential solutions to specifically address the needs of the QPS. The findings of this study emphasise the importance of participant involvement in identifying issues and generating solutions, as well as demonstrating the value of taking a systemic approach. The findings suggest that the use of the Participatory Action Research approach is invaluable in promoting the long-term success of the QPS change process.
Posttrauma Employability of People With Symptoms of PTSD and the Contribution of Work Environments
Authors: Matthews Lynda R. 
Published: February 2007

AbstractThe role of work environments in employability was examined at approximately 8 months postaccident in a sample of 69 trauma-exposed, injured adults with and without PTSD. Results showed that participants with PTSD reported significantly lower employability than those without PTSD and this translated into significantly poorer return-to-work rates. Two work environment dimensions, low work support and poor organisational structure, were significantly associated with low employability in the sample. Low levels of work support were significantly related to high PTSD symptom severity. A combination of 3 variables, PTSD symptom severity, physical functioning, and workplace organisational structure, accounted for 60% of variation in employability. Interventions in the workplace should aim to minimise and accommodate PTSD symptomatology and physical dysfunction. In addition, this study has also shown that workplace-based interventions should be aimed at clarifying expectations about job tasks, and promoting moderate managerial control in the workplace. These factors should be considered for inclusion as standard disability management practices for this population.
The ovoidal hyperplanes of a dual polar space of rank 4
Authors: Pralle Harm , Shpectorov Sergey 
Published: February 2007

Abstract
Let π be a thick polar space of rank 4 over a field 𝕂 such that the generalised quadrangle Res+(α) of a line α of π which consists of the planes and 3-spaces of π containing α, admits a spread. Let

be a line-spread of π with the following property: Let

be the set of 3-spaces of π in which

induces spreads. For every point Σ of π, the 3-spaces of

containing Σ all contain the spread line λ ∈

covering Σ and form a spread of the generalised quadrangle

. Then

is a generalised quadrangle. The polar spaces Sp8 (𝕂) and

admit such spreads for both finite and infinite fields 𝕂. They are the only finite classical polar spaces admitting such spreads. If π ≅ Sp8(q), respectively

, then Γ ≅ Sp4(q
2), respectively H5(q
2). If π ≅ Sp8(𝕂) for some infinite field 𝕂, then Γ ≅ Sp4(ℍ) for some field ℍ. In the infinite case, there exists an example of a spread

in H8(ℂ) over the complex numbers ℂ with

over the quaternions.
Dualizing π, the point set

of the dual polar space Δ dual to π is a hyperplane of Δ intersecting each symp Σ, i.e. an element of maximal type of Δ, in the set of neighbours of an ovoid of a quad of Σ.
Evaluation of primary re-excision after recent inadequate resection of soft tissue sarcomas in dogs: 41 cases (1999–2004)
Authors: Bacon Nicholas J. , Dernell William S. , Ehrhart Nicole , Powers Barbara E. , Withrow Stephen J. 
Published: February 2007

Abstract
Objective—To determine the efficacy of primary re-excision alone for treatment of soft tissue sarcomas after recent incomplete resection, the frequency and clinical importance of detecting residual tumor in resected scars, and prognostic factors associated with the procedure.
Design—Retrospective case series.
Animals—41 dogs.
Procedures—Medical records of dogs that had undergone recent incomplete excision of a soft tissue sarcoma at a referring veterinary practice and subsequent re-excision of the scar at the Colorado State University Veterinary Medical Center were reviewed.Owners and referring veterinarians were contacted for follow-up information.Slides from re-excised specimens were reviewed.Dogs that underwent radiation therapy after the re-excision procedure were excluded.
Results—41 dogs met the inclusion criteria, and long-term follow-up information was available for 39 dogs.Median follow-up time was 816 days.Local recurrence of tumor developed in 6 of 39 (15%) dogs, and distant metastasis occurred in 4 of 39 (10%) dogs.Healthy tis sue margins of 0.5 to 3.5 cm were achieved at re-excision. Residual tumor was identified in 9 of 41 (22%) resected scars.No tumor-, patient-, or treatment-related variables were associated with local recurrence except for the presence of liposarcoma or fibrosarcoma or whether fine-needle aspiration had been performed prior to surgery.
Conclusions and Clinical Relevance—After incomplete resection of soft tissue sarcomas, resection of local tissue should be performed, even if excisable tissue margins appear narrow.A long-term favorable prognosis is achievable without radiation therapy or amputation. The presence of residual tumor in resected scar tissue should not be used to predict local recurrence.