bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making the Stability Pact More Flexible: Does It Lead to Pro‐Cyclical Fiscal Policies?*
Authors: Mackiewicz Michał 
Published: June 2007

AbstractOne of the often‐discussed negative aspects of the Stability and Growth Pact is the rigidity of its deficit rule. Several reform proposals aim currently to alleviate the rule in order to allow the automatic stabilisers to operate freely. However, such a reform is likely to cause even further deterioration of fiscal balances in the EMU member countries. The empirical evidence presented in this paper shows that, in the past, increasing the structural deficit had a strong negative impact on the degree of anti‐cyclical fiscal stabilisation. This suggests that the reform of the Pact, through higher structural deficits, could decrease rather than increase the scope of anti‐cyclical fiscal actions in the EMU member countries.
Mortality Risk in Older Inner‐City African Americans
Authors: Malmstrom Theodore K. , Andresen Elena M. , Wolinsky Fredric D. , Philip Miller J. , Stamps Kathryn , Miller Douglas K. 
Published: June 2007

OBJECTIVES: To investigate mortality risks in a sample of poor, inner‐city‐dwelling, older African Americans.DESIGN: Prospective cohort study.SETTING: St. Louis, Missouri.PARTICIPANTS: Six hundred twenty‐two African Americans aged 68 to 102 at the time of their 1992 to 1994 baseline interviews.MEASUREMENTS: Risk factors previously identified in the literature were examined for seven categories: demographic, socioeconomic, psychosocial, biomedical, disability and physical function, perceived health, and health services utilization. Vital status was ascertained through 2002.RESULTS: Three hundred eighty‐six subjects (62.1%) were deceased and 236 were alive (mortality higher than in matched controls). Significant risks for mortality were older age, male sex, annual income less than $10,000, cancer, cerebrovascular disease, dependencies in lower‐body function, and number of physician visits in the 12 months before baseline.CONCLUSION: In addition to improving the risk factors for stroke and malignant disease in this population, studies focused on improving lower‐body functioning may be warranted as a part of efforts aimed at enhancing longevity in older African‐American adults.
Age‐Varying Association Between Blood Pressure and Risk of Dementia in Those Aged 65 and Older: A Community‐Based Prospective Cohort Study
Authors: Li Ge , Rhew Isaac C. , Shofer Jane B. , Kukull Walter A. , Breitner John C. S. , Peskind Elaine , Bowen James D. , McCormick Wayne , Teri Linda , Crane Paul K. , Larson Eric B. 
Published: June 2007

OBJECTIVES: To assess variation in the association between blood pressure (BP) and risk for dementia across a spectrum of older ages and to examine BP changes before dementia onset.DESIGN: Prospective cohort study.SETTING: A large health maintenance organization in Seattle, Washington.PARTICIPANTS: A cohort of 2,356 members of a large health maintenance organization aged 65 and older who were initially without dementia.MEASUREMENTS: Dementia diagnosis was assessed biennially, and systolic (SBP) and diastolic BP (DBP) were measured at baseline and at four follow‐up assessments. Cox proportional hazards models were used to estimate hazard ratios (HRs) for dementia and Alzheimer's disease (AD) associated with baseline BP in different age groups.RESULTS: Within the youngest age group (65–74 at enrollment) a greater risk for dementia was found in participants with high SBP (≥160 mmHg) (hazard ratio (HR)=1.60, 95% confidence interval (CI)=1.01–2.55) or borderline‐high DBP (80–89 mmHg) (HR=1.59, 95% CI=1.07–2.35) than for those with normal BP (SBP <140 mmHg and DBP <80 mmHg). The dementia risk associated with SBP declined with increasing age (SBP‐by‐age interaction, P=.01). SBP declined similarly with aging in subjects who developed dementia and those who did not. Thus, in this sample, the association between SBP and dementia risk was not dependent on when BP was measured in relation to onset of dementia.CONCLUSION: High SBP was associated with greater risk of dementia in the young elderly (<75) but not in older subjects. Adequate control of hypertension in early old age may reduce the risk for dementia.
Increased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In‐Home Palliative Care
Authors: Brumley Richard , Enguidanos Susan , Jamison Paula , Seitz Rae , Morgenstern Nora , Saito Sherry , McIlwane Jan , Hillary Kristine , Gonzalez Jorge 
Published: June 2007

OBJECTIVES: To determine whether an in‐home palliative care intervention for terminally ill patients can improve patient satisfaction, reduce medical care costs, and increase the proportion of patients dying at home.DESIGN: A randomized, controlled trial.SETTING: Two health maintenance organizations in two states.PARTICIPANTS: Homebound, terminally ill patients (N=298) with a prognosis of approximately 1 year or less to live plus one or more hospital or emergency department visits in the previous 12 months.INTERVENTION: Usual versus in‐home palliative care plus usual care delivered by an interdisciplinary team providing pain and symptom relief, patient and family education and training, and an array of medical and social support services.MEASUREMENTS: Measured outcomes were satisfaction with care, use of medical services, site of death, and costs of care.RESULTS: Patients randomized to in‐home palliative care reported greater improvement in satisfaction with care at 30 and 90 days after enrollment (P<.05) and were more likely to die at home than those receiving usual care (P<.001). In addition, in‐home palliative care subjects were less likely to visit the emergency department (P=.01) or be admitted to the hospital than those receiving usual care (P<.001), resulting in significantly lower costs of care for intervention patients (P=.03).CONCLUSION: In‐home palliative care significantly increased patient satisfaction while reducing use of medical services and costs of medical care at the end of life. This study, although modest in scope, presents strong evidence for reforming end‐of‐life care.
Energy Requirements in Hospitalized Elderly People
Authors: Alix Emmanuel , Berrut Gilles , Boré Maryvonne , Bouthier‐Quintard Françoise , Buia Jean Marie , Chlala André , Cledat Yves , D'Orsay Geneviève , Lavigne Christian , Levasseur Régis , Mouzet Jean Baptiste , Ombredanne Marie Pierre , Sallé Agnès , Gaillard Cathy , Ritz Patrick 
Published: June 2007

OBJECTIVES: To estimate energy intake and energy expenditure (EE) in elderly hospitalized patients recovering from an acute illness.DESIGN: Cross‐sectional evaluation of the disparity between energy intake and expenditure.PARTICIPANTS: Ninety geriatric patients (mean age±standard deviation 79.7±7.5) admitted to acute care or rehabilitation units.MEASUREMENTS: Patients' energy intake and resting EE (REE) were measured over a 3‐day period. Blood samples were taken to determine C‐reactive protein (CRP), creatinine, and albumin concentrations and to check renal function.RESULTS: Energy intake was higher than REE by a factor of 1.29, but it was lower than the energy requirement. Energy intake, adjusted for differences in body weight, was independent of sex, highest in those who were malnourished (defined as a body mass index (BMI) <21), and lowest in patients who scored poorly on the Mini‐Mental State Examination. Energy intake and REE were independent of plasma CRP, creatinine, and albumin concentrations, as well as the initial diagnosis. REE was similar in men and women, at 18.8 kcal/kg per day. REE was 21.4 kcal/kg per day in patients with a BMI of 21 or less and 18.4 kcal/kg per day in those with a BMI greater than 21 kg/m2. The Harris‐Benedict equation accurately predicted mean REE.CONCLUSION: The mean REE of the geriatric patients studied was 18.8 kcal/kg per day, whereas energy intake was just sufficient to cover minimal requirements. Thus, hospitalized elderly patients are likely to benefit from higher calorie intake.
Preliminary Derivation of a Nursing Home Confusion Assessment Method Based on Data from the Minimum Data Set
Authors: Dosa David , Intrator Orna , McNicoll Lynn , Cang Yuwei , Teno Joan 
Published: June 2007

OBJECTIVES: To develop a Nursing Home Confusion Assessment Method (NH‐CAM) for diagnosing delirium using items found on the Minimum Data Set (MDS) and to compare its performance with that of the delirium Resident Assessment Protocol (RAP) trigger and to an additive score of six of the RAP items.DESIGN: Retrospective cohort study using MDS and Medicare claims data.SETTING: Free‐standing NHs in urban markets in the 48 contiguous U.S. states.PARTICIPANTS: Long‐stay residents who returned to their NHs after acute hospitalizations between April and September 2000 (N=35,721).MEASUREMENTS: Mortality and rehospitalization rates within 90 days of readmission to the NH from the hospital.RESULTS: Almost one‐third (31.8%) of the residents were identified as having delirium according to the RAP; 1.4% had full delirium, 13.2% had Subsyndromal II delirium, and 17.2% had Subsyndromal I delirium. More‐severe NH‐CAM scores were associated with greater risks of mortality and rehospitalization. NH‐CAM levels were strong independent risk factors for survival and rehospitalization in a Cox model (hazard ratios ranging from 1.5 to 1.9 for mortality and 1.1 to 1.3 for rehospitalization) adjusting for cognitive and physical function, diagnoses, inpatient care parameters, care preferences, and sociodemographic factors.CONCLUSION: The NH‐CAM successfully stratified NH residents' risk of mortality and rehospitalization. If validated clinically, the NH‐CAM may be useful in care planning and in further research on the determinants and consequences of delirium in the NH.
Septic Arthritis of the Distal Interphalangeal Joint in Cattle: Comparison of Digital Amputation and Joint Resection by Solar Approach
Authors: STARKE A. , HEPPELMANN M. , BEYERBACH M. , REHAGE J. 
Published: June 2007

Objective— To determine in cattle with septic arthritis of the distal interphalangeal joint (SADIJ) the efficacy of resection of the distal interphalangeal joint (JRES) as a digit salvage technique compared with digital amputation (DAMP).Study Design— Prospective, randomized clinical study.Animals— German Holstein–Friesian dairy cattle with SADIJ of 1 hind limb (n=52).Methods— SADIJ diagnosis was based on clinical examination and radiography. Cows were randomly assigned with owner consent to DAMP (n=26) or JRES (n=26). After JRES, a wooden block was fixed to the partner claw in combination with a tipping claw prophylaxis.Results— After surgery, degree of lameness improved significantly faster after DAMP than after JRES. New claw diseases in the opposite limb occurred more frequently after JRES (n=6) than after DAMP (n=1). New claw defects developed in the partner claw on the operated limb in 6 cows after DAMP compared with 1 after JRES. Tipping claw was observed in 50% of JRES cows at day 180. Mean life span between groups was not significantly different (DAMP=13.5 months, JRES=10.9 months).Conclusion— Higher surgical and postsurgical expenditures for JRES were not counterbalanced by a longer productive life; however, frequent disease of the partner claw of cows after DAMP should be considered a critical point, as this generally leads to culling.Clinical Relevance— The higher expenditure for JRES can be justified only for young, valuable cattle.
Custom Total Knee Replacement in a Dog with Femoral Condylar Bone Loss
Authors: LISKA WILLIAM D. , MARCELLIN‐LITTLE DENIS J. , ESKELINEN ESA V. , SIDEBOTHAM CHRISTOPHER G. , HARRYSSON OLA L. A. , HIELM‐BJÖRKMAN ANNA K. 
Published: June 2007

Objective— To report surgical planning, technique, and outcome of custom total knee replacement (TKR) performed to manage a medial femoral condylar nonunion in a dog.Study Design— Clinical case report.Animal— A 3‐year‐old, 20 kg Karelian Bear Hound.Methods— Computed tomographic scan of the left pelvic limb was used to build a stereolithography model of the distal portion of the femur. The model was used to create a custom augment to replace the missing medial femoral condyle and a custom stem for intramedullary condylar cemented fixation. The augment and stem were adapted to femoral and tibial components already available. The model was used to rehearse the surgery and then the custom prosthesis was implanted.Results— Weight bearing returned 8 hours after surgery and improved thereafter. Joint alignment was normal and prosthetic joint motion was 60–165° postoperatively. The dog resumed moose hunting 3 months after surgery. Peak vertical force and impulse of the operated limb measured 17 months after surgery were 65% and 47% of the normal, contralateral limb.Conclusion— Based on short‐term follow‐up, cemented canine TKR was successfully achieved for management of a severely abnormal stifle joint.Clinical Relevance— With further refinement and development of commercially available prostheses, TKR should be possible for canine patients.
Reclassification of Small Intestinal and Cecal Smooth Muscle Tumors in 72 Dogs: Clinical, Histologic, and Immunohistochemical Evaluation
Authors: MAAS CERIEL P.H.J. , TER HAAR GERT , VAN DER GAAG INGRID , KIRPENSTEIJN JOLLE 
Published: June 2007

Objectives—To reclassify canine small intestinal and cecal leiomyoma (LM) and leiomyosarcoma (LMS) into smooth muscle and gastrointestinal stromal tumors (GIST) using histologic and immunohistochemical (IH) analysis and to report clinical findings and survival data.Study Design—Retrospective review of cases.Animals—Dogs (n=47) with small intestinal (40 LMS; 7 LM) and 25 dogs with cecal tumors (23 LMS; 2 LM).Methods—Clinical and survival data were reviewed. Tissue sections were reevaluated for light‐microscopic malignancy criteria and examined for expression of SMA, desmin, vimentin, S‐100, and CD117 (KIT) by immunohistochemistry.Results—Reclassification resulted in 2 LM, 9 LMS, 19 GIST, and 17 GIST‐like tumors in the small intestine and 23 GIST and 2 GIST‐like tumors in the cecum. GIST‐like tumors were morphologic and IH identical to GIST but lacked KIT expression. No significant difference in survival was observed for tumor type, location, histologic, or IH characteristics; however, dogs with cecal tumors were significantly older in age, presented more commonly with intestinal perforation and peritonitis, and less commonly with weight loss. Cecal tumors had more histologic malignancy criteria than small intestinal tumors. After excision, 1 and 2 year recurrence‐free periods were 80.1% and 67.2% for small intestinal and 83.3% and 61.9% for cecal tumors.Conclusion—Prognosis for intestinal tumors with histologic smooth muscle appearance is good after excision and not related to tumor type, location, histologic, or IH characteristics.Clinical Relevance—Clinical importance could not be demonstrated for reclassification, but may be for future treatment, of intestinal smooth muscle or stromal tumors.
Effect of 9 mm Tibial Tuberosity Advancement on Cranial Tibial Translation in the Canine Cranial Cruciate Ligament‐Deficient Stifle
Authors: MILLER JONATHAN M. , SHIRES PETER K. , LANZ OTTO I. , MARTIN ROBERT A. , GRANT J. WALLACE 
Published: June 2007

Objective— To assess the effect of 9 mm tibial tuberosity advancement (TTA) on cranial tibial translation (CTT) in a cranial cruciate ligament (CCL)‐deficient canine stifle model.Study Design— In vitro cadaveric study.Animals— Canine pelvic limbs (n=12).Methods— Each stifle was placed in a jig at 135° with a simulated quadriceps force and tibial axial force. CTT distance was measured with the CCL intact (iCCL), transected (tCCL), and after performing TTA using a 9 mm cage.Results— Mean CTT for iCCL was 0.42 mm, 1.58 mm after severing the CCL, and 1.06 mm post‐TTA. The tCCL CTT measured without any quadriceps force was 2.59 mm. Differences between the intact and tCCL (P<.0001) and tCCL and TTA (P=.0003) were significant. The difference between the tCCL with and without the quadriceps force was not significant (P=.0597).Conclusions— These data confirm that TTA does reduce CTT in tCCL stifles in this model. The CTT noted was less than that noted clinically. The addition of a simulated quadriceps force to a CCL‐deficient stifle before a TTA, by itself, may not significantly lessen CTT.Clinical Relevance— Whereas this in vitro model demonstrated that TTA reduced CTT in canine stifles with CCL transected, the model limitations preclude extrapolation to the effect of TTA in a live dog.
Surgical Stapling Devices in Veterinary Medicine: A Review
Authors: TOBIAS KAREN M. 
Published: June 2007

Objectives—To review indications, benefits, and complications of surgical stapling in animals.Study Design—Literature review.Results—Benefits and complications of surgical stapling depend on the procedure performed. Use of surgical staplers does not improve wound strength but may decrease surgical time.Clinical Relevance—In patients at significant risk for intraoperative contamination or morbidity from prolonged anesthesia time, use of stapling devices should be considered.
Evaluation of Agreement Between Numerical Rating Scales, Visual Analogue Scoring Scales, and Force Plate Gait Analysis in Dogs
Authors: QUINN MARGARET M. , KEULER NICHOLAS S. , LU YAN , FARIA MARIA L. E. , MUIR PETER , MARKEL MARK D. 
Published: June 2007

Objective—To evaluate the accuracy of numerical rating (NRS) and visual analogue (VAS) scoring scales compared with force plate gait analysis and agreement between observers for each scoring scale.Study Design—Experimental study.Animals—Mixed breed dogs (n=21) with a right limb tibial osteotomy repaired with an external fixator.Methods—Three small‐animal veterinarians with orthopedic training scored lameness using NRS and VAS before surgery, and at 4 and 8 weeks after surgery. Peak force and impulse were determined at the same time points using a force plate. Agreement between observers and with force plate data was assessed. Significance was set atP≤.05.Results—Agreement was generally low among observers for both NRS and VAS scores. When evaluated at each time point, an acceptable level of agreement was present only at 4 weeks after surgery. Only impulse had a significant relationship with some of the observers' subjective scores. No significant relationships between any observer's scores and force plate data existed if very lame dogs were omitted.Conclusions—Subjective scoring scales do not replace force plate gait analysis. Agreement is low unless lameness is severe, and each observer uses an individually unique scale. Subjective scoring scales most accurately reflect force plate gait analysis when lameness is severe.Clinical Relevance—Subjective lameness scoring scales may not accurately reflect lameness and do not replace force plate gait analysis. Observers must stay the same during the duration of a study for accurate analyses.
In Vitro Mechanical Comparison of Screwed, Bolted, and Novel Interlocking Nail Systems to Buttress Plate Fixation in Torsion and Mediolateral Bending
Authors: LANSDOWNE JENNIFER L. , SINNOTT MICHAEL T. , DÉJARDIN LOIC M. , TING DENNIS , HAUT ROGER C. 
Published: June 2007

Objective—To compare standard interlocking nails (ILN) with a newly designed ILN featuring an angle‐stable locking mechanism (ILNn).Study design—Six experimental groups.Sample population—Bone models (n=48) treated with 6 and 8 mm nails locked with screws or bolts (ILN6s, ILN8s, ILN6b, ILN8b, respectively), ILNn, and a 3.5 mm broad‐DCP (br‐DCP); n=4/testing mode.Methods—Specimens were tested in torsion or 4‐point bending. Construct compliance, deformation, and slack were statistically compared (P<.05).Results—Regardless of testing mode, construct compliance was greater with smaller ILN. Screwed constructs were more compliant than bolted ones, with a significant difference between ILN6s and ILN6b in torsion. Plated constructs were significantly more compliant than the ILNn. Angular deformation was consistently greater with smaller ILN. Screwed ILN constructs sustained ∼2 × the torsional deformation of the bolted ones (∼36° [ILN6s] versus ∼18° [ILN6b]). Comparatively, ILNn constructs had significantly less torsional (∼8°) and bending (∼4°) deformation than other constructs. Whereas standard ILN constructs had slack in both modes, ILNn and br‐DCP construct deformations consistently occurred without slack.Conclusions—Use of bolts rather than screws improved ILN mechanical behavior, but neither locking mechanism completely counteracted torsion and bending forces. Conversely, the ILNn angle‐stable locking system eliminated torsional and bending slack, resulting in comparable mechanical performances between ILNn and plated constructs.Clinical Relevance—The angle‐stable locking mechanism of the new ILN eliminates all slack in the system; thus, interfragmentary motion will likely be reduced compared with standard ILN, which may improve the local environment for fracture healing.
Effective molecular RHD typing strategy for blood donations
Authors: Polin Helene , Danzer Martin , Hofer Katja , Gassner Waltraud , Gabriel Christian 
Published: June 2007

BACKGROUND: More than 50 weak D alleles and numerous partial D alleles have been described to date that can be identified by molecular methods as polymerase chain reaction (PCR) and DNA sequencing of the RHD gene. A real time–based RHD typing scheme was developed and tested during an 8‐month period.STUDY DESIGN AND METHODS: A total of 53,347 blood donors and patients were tested with standardized immunohematologic methods. A total of 201 DNA samples with weak D reactions underwent molecular characterization by weak D real‐time PCR, exon‐screening real‐time PCR, and nucleotide sequencing of RHD Exons 1 through 10. A total of 2,427 samples with D– phenotype were tested for the presence of RHD markers.RESULTS: Molecular typing of 201 samples with weak D expression revealed 15 different known aberrant alleles as well as one new weak D type dubbed weak D Type 49. Approximately 60 percent of the alleles were determined as weak D Types 1 through 3 and detected by only one amplification run. Weak D Type 1 represented the most frequent allele (n = 72). Three samples with D– phenotype showed amplification of RHD‐specific markers. Sequence‐based typing (SBT) of these samples revealed a DEL allele, RHD(IVS3+1G>A), in two samples and one weak D Type 4.3.CONCLUSIONS: The presented scheme for RHD genotyping of weak D red blood cell units was reliable for detection of aberrant alleles. Testing of D– blood samples as quality control seems to overcome limitations of standard serology by detection of samples with weak D or DEL phenotype.