bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia
Authors: Lee Way Seah , Poo Muhammad Izzuddin , Nagaraj Shyamala 
Published: June 2007

Aim:  To estimate the cost of an episode of inpatient care and the economic burden of hospitalisation for childhood rotavirus gastroenteritis (GE) in Malaysia.Methods:  A 12‐month prospective, hospital‐based study on children less than 14 years of age with rotavirus GE, admitted to University of Malaya Medical Centre, Kuala Lumpur, was conducted in 2002. Data on human resource expenditure, costs of investigations, treatment and consumables were collected. Published estimates on rotavirus disease incidence in Malaysia were searched. Economic burden of hospital care for rotavirus GE in Malaysia was estimated by multiplying the cost of each episode of hospital admission for rotavirus GE with national rotavirus incidence in Malaysia.Results:  In 2002, the per capita health expenditure by Malaysian Government was US$71.47. Rotavirus was positive in 85 (22%) of the 393 patients with acute GE admitted during the study period. The median cost of providing inpatient care for an episode of rotavirus GE was US$211.91 (range US$68.50–880.60). The estimated average cases of children hospitalised for rotavirus GE in Malaysia (1999–2000) was 8571 annually. The financial burden of providing inpatient care for rotavirus GE in Malaysian children was estimated to be US$1.8 million (range US$0.6 million−7.5 million) annually.Conclusion:  The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non‐medical and societal costs are included.
COMPARISON OF INFECTION RATE USING DIFFERENT METHODS OF ASSESSMENT FOR SURVEILLANCE OF TOTAL HIP REPLACEMENT SURGICAL SITE INFECTIONS
Authors: Chiew Yoke‐Fong , Theis Jean‐Claude 
Published: June 2007

Background:  The surveillance of surgical site infections (SSI) has been undertaken in many centres worldwide to ascertain the extent of the problem and where possible, to improve the incidence rates, thereby decreasing the undesirable outcomes. The study investigates the processes and outcomes of total hip replacement SSI surveillance carried out in Dunedin Public Hospital in 2004.Methods:  Two hundred and six patients were enlisted in the study and 189 primary replacements and 22 revision replacements were carried out. Four methods of diagnosis of SSI were applied: (i) clinician diagnosis; (ii) ASEPSIS score; (iii) presence of pus cells; and (iv) assessment by a clinical microbiologist. Infection rates were calculated according to the risk indexes.Results:  The incidence of infections varies considerably among these four methods. The infection rates for risk index 0 were 4.35% (method 1), 2.61% (method 2), 0.87% (methods 3 and 4); and for risk indexes 1 and 2 were 4.17% (method 1), 2.08% (method 2), 1.04% (methods 3 and 4).Conclusion:  There is a need for accurate infection data so that the appropriate follow‐up responses, including infection control measures for total hip replacement SSI can be carried out. The preponderance of elderly patients in the study who are frequently on ‘polypharmacy’ regimens adds pressure to the need to obtain true infection rates. This is because when antimicrobials are prescribed to them, drug interactions, adverse effects of the antimicrobials and the selective pressure of antimicrobials causing resistances may occur. More resources and a multidisciplinary approach are required for future studies of similar nature.
Modelling linguistic taxonomic dynamics
Authors: Wichmann Søren , Stauer Dietrich , Lima F. Wellington S. , Schulze Christian 
Published: June 2007

AbstractThis paper presents the results of the application of a bit‐string model of languages (Schulze & Stauffer 2005) to problems of taxonomic patterns. The questions addressed include the following: (1) Which parameters are minimally needed for the development of a taxonomic dynamics leading to the type of distribution of language family sizes currently attested (as measured in the number of languages per family), which appears to be a power‐law? (2) How may such a model be coupled with one of the dynamics of speaker populations leading to the type of language size seen today, which appears to follow a log‐normal distribution?
The present tense with future meaning in the accusative and infinitive construction in Plautus and Terence
Authors: De Melo Wolfgang David Cirilo 
Published: June 2007

AbstractIn the accusative and infinitive construction in Archaic Latin, both present and future tense infinitives can be found if there is future meaning; semantic differences cannot be detected. Various scholars have tried to show that the present infinitive is colloquial here or that the alternation between the two tenses has to do with semantic differences in the governing verbs. However, on closer examination of the data such theories cannot be upheld. In this paper, I shall demonstrate that the present infinitive is restricted to telic events. Moreover, it is particularly frequent if the subjects of the superordinate and subordinate verbs are identical. The present infinitive of the verb ‘to give’ occurs more often than present infinitives of other verbs. Finally, we can observe how such present infinitives become less frequent if we compare Plautus and Terence.1
Constituent question formation and focus: a new typological perspective
Authors: Mycock Louise 
Published: June 2007

AbstractAll languages have strategies which enable speakers to ask constituent (‘wh’‐) questions. Of the strategies available, three types based on the notion of movement are usually cited in the literature: in situ, multiple fronting, and simple fronting. However, data reveal that focusing is the defining characteristic of constituent question formation cross‐linguistically. This paper therefore adopts a different approach, presenting a unified analysis within the non‐derivational framework of Lexical‐Functional Grammar which captures the relevant generalisations about focusing and in turn provides a fresh perspective on the typology of constituent question formation strategies.1
The invasive red swamp crayfish as a predictor of Eurasian bittern density in the Camargue, France
Authors: Poulin B. , Lefebvre G. , Crivelli A. J. 
Published: June 2007

AbstractFew data exist on the relationships between food levels and breeding density of the Eurasian bittern Botaurus stellaris, a vulnerable species of high‐priority concern in Europe. Concurrent data were obtained on male bittern density and relative food abundance over a 3‐year period in two wetlands totalling 2500 ha of Mediterranean reed marsh enclosing 25% of the French bittern population. Food abundance was estimated by sampling up to 25 hydrological units using a beach seine in early June of 2002, 2003 and 2004. The density of booming males in each hydrological unit was obtained by point counts and acoustic triangulation in May of the same years. The impact of food abundance on male bittern density was assessed by general regression models using a forward stepwise procedure with mosquitofish Gambusia affinis, carp Cyprinus carpio, other fish species, amphibians, red swamp crayfish Procambarus clarkii and other invertebrates as prey groups. Of these, only to crayfish abundance was bittern density related, contributing to 45% of the variance observed. When the impact of water level was taken into account, the relative abundance of crayfish explained 56% of the inter‐annual differences in bittern density. Because crayfish are rich in calcium and well adapted to fluctuating hydroperiods alternating with drought intervals, they provide a good food source for the bitterns throughout the breeding season at the study sites. The loss of diversity and degradation reported from macrophyte‐dominated marshes following crayfish invasion does not seem to apply to reed‐dominated wetlands. It is further suggested that the recent increase in bittern numbers in the Camargue, while other French populations were decreasing, could in part be related to red swamp crayfish abundance.
Strategy‐switching in the gaffing bat
Authors: Todd V. L. G. , Waters D. A. 
Published: June 2007

AbstractForaging in Daubenton's bats Myotis daubentonii, at two altitudinal locations along a river gradient in North Wales was investigated in relation to aerial insect density and to the density of prey on the water surface. Prey capture in Daubenton's bats consisted of aerial hawking, where prey was taken in the air, and trawling, where bats gaffed invertebrates from the water surface. Aerial hawking accounted for 86% of all prey capture attempts, despite aerial insect availability falling close to zero for much of the night. Conversely, prey density on the water surface was an order of magnitude higher than aerial prey density and increased through the night due to aquatic invertebrate drift. At the higher altitude site, M. daubentonii switched prey capture strategy to gaffing, possibly to reflect this change in prey availability on the water's surface, but at the lower altitude site, they maintained aerial hawking as the preferred strategy. The switch to gaffing may be inhibited by the significant downstream accumulation of large numbers of inedible exuviae of caddis flies, Trichoptera, at the low‐altitude site, which form both acoustic clutter and increase the probability of capturing inedible prey, making foraging less efficient. These small altitudinal differences in foraging strategy should be factored into the design of future altitudinal bat foraging studies and if found to be a widespread strategy, taken into consideration by conservation planners when reviewing the habitat requirements of Daubenton's bats in river valleys within the United Kingdom.
Commentary: Cabanna M et al. (1999). Why don’t physicians follow clinical practice guidelines? A framework for improvement
Authors: Scholes Julie 
Published: June 2007

AbstractDespite wide promulgation, clinical practice guidelines have had limited effect on changing physician behaviour. Little is known about the process and factors involved in changing physician practices in response to guidelines. The aim is to review barriers to physician adherence to clinical practice guidelines. We searched the MEDLINE, Educational Resources Information Center and Health STAR databases (January 1966 to January 1998), bibliographies; textbooks on health behaviour or public health and references supplied by experts to find English language article titles that describe barriers to guideline adherence. Of 5658 articles initially identified, we selected 76 published studies describing at least one barrier to adherence to clinical practice guidelines, practice parameters, clinical policies or national consensus statements. One investigator screened titles to identify candidate articles, then two investigators independently reviewed the texts to exclude articles that did not match the criteria. Differences were resolved by consensus with a third investigator. Two investigators organized barriers to adherence into a framework according to their effect on physician knowledge, attitudes or behaviour. This organization was validated by three additional investigators. The 76 articles included 120 different surveys investigating 293 potential barriers to physician guideline adherence, including awareness (n = 46), familiarity (n = 31), agreement (n = 33), self‐efficacy (n = 19), outcome expectancy (n = 8), ability to overcome the inertia of previous practice (n = 14), and absence of external barriers to perform recommendations (n = 34). The majority of surveys [70 (58%) of 120] examined only one type of barrier. Studies on improving physician guideline adherence may not be generalizable because barriers in one setting may not be present in another. Our review offers a differential diagnosis for why physicians do not follow practice guidelines, as well as a rational approach towards improving guideline adherence and a framework for future research. Abstract reprinted from the Journal of the American Medical Association volume 282, Cabanna M et al., ‘Why don’t physicians follow clinical practice guidelines? A framework for improvement.’, pages 1458–1465. © 1999, reproduced with permission from the American Medical Association.
Noise levels in a general intensive care unit: a descriptive study
Authors: Christensen Martin 
Published: June 2007

AbstractThe aim of this small‐scale study was to measure, analyse and compare levels of acoustic noise, in a nine‐bedded general intensive care unit (ICU). Measurements were undertaken using the Norsonic 116 sound level meter recording noise levels in the internationally agreed ‘A’ weighted scale. Noise level data were obtained and recorded at 5 min over 3 consecutive days. Results of noise level analysis indicated that mean noise levels within this clinical area was 56·42 dB(A), with acute spikes reaching 80 dB(A). The quietest noise level attained was that of 50 dB(A) during sporadic intervals throughout the 24‐h period. Parametric testing using analysis of variance found a positive relationship (p≤ 0·001) between the nursing shifts and the day of the week. However, Scheffe multiple range testing showed significant differences between the morning shift, and the afternoon and night shifts combined (p≤ 0·05). There was no statistical difference between the afternoon and night shifts (p≥ 0·05). While the results of this study may seem self‐evident in many respects, what it has highlighted is that the problem of excessive noise exposure within the ICU continues to go unabated. More concerning is that the prolonged effects of excessive noise exposure on patients and staff alike can have deleterious effect on the health and well‐being of these individuals.
Cocaine‐induced myocardial infarction
Authors: Coombs Maureen 
Published: June 2007

AbstractTo date, cocaine‐induced myocardial infarction (MI) remains an infrequent reason for admission into hospital. However, reports identify rising cocaine usage in the UK. With 7–10% of all patients presenting chest pain having traces of cocaine in their urine, there is an increasing incidence of cardiovascular disease in the under 30s age group. The potential impact on health care resources must cause concern. This report describes the case of a young man admitted to the emergency department after an 18‐h cocaine session. With evidence of an anterolateral MI, left heart studies and thrombectomy were undertaken in cardiac catheters. Admission to critical care was required for ongoing respiratory and cardiac support therapies. Although there are many aspects of patient management that can be explored, specific issues to be discussed in this paper include evidence‐based treatment options, nursing management of inotrope administration and caring for family and friends.
Binding, Uptake, and Metabolism of Chylomicron Remnants by Hepatocytes from Control and Chronic Ethanol‐Fed Rats
Authors: Lakshmanan M. R. , Ezekiel Mildred , Campbell Barbara S. , Muesing Richard A. 
Published: June 2007

Chylomicron remnants, but not lymph chylomicrons, showed a receptor‐dependent high affinity saturable binding to normal rat hepatocytes. The Scatchard analysis of the specific binding data showed a high affinity binding site for the remnants with a dissociation constant of 0.61 nut, assuming a molecular weight of 50 times 10s for chylomicron remnants. Based on the heparin‐releasable bound radioactivity, approximately 80% of the bound remnants seemed to be internalized. The binding process was markedly inhibited by pronase as wen as by protein synthesis inhibitors. Competitive binding studies revealed that the order of competition for the binding of labeled remnants by homologous unlabeled lipoproteins was remnants > chylomicrons > very low density lipoproteins > high density lipoproteins. Human low density lipoproteins showed virtually no competition.Studies on the catabolism of triacylglycerol moiety of the remnants showed that 15.2% of the 14C label in the triacylglycerol moiety of the remnants was catabolized by the hepatocytes to 14CO2 due to specific interaction. This amounted to 93% of the total 14CO2 evolution. This was in sharp contrast to the catabolism of the triacylglycerol moiety of very low density lipoproteins from human and rat, where most of the 14CO2 evolution was due to pathways associated with nonspecific binding.Chronic ethanol feeding caused a 29% (p < 0.02) decrease in the dissociation constant of the high affinity binding site of the liver cell for the remnants, whereas the extent of internalization was decreased by 19% (p < 0.01) as compared to the pair‐fed control animals. In contrast to these small decreases in binding affinity and internalization, the catabolism of both triacylglycerol and cholesterol ester moieties of remnants were markedly inhibited by 58% (p < 0.001) and 44% (p < 0.01), respectively, in hepatocytes from chronic ethanol‐fed animals. These results are compatible with the pathogenesis of fatty liver and defective regulation of hepatic cholesterol synthesis after chronic ethanol abuse.
Prenatal Alcohol Exposure Blunts Interleukin‐1‐Induced ACTH and β‐Endorphin Secretion by Immature Rats
Authors: Lee Soon , Rivier Catherine 
Published: June 2007

The functional relationship between the immune and the hypotha‐lamic‐pituitary‐adrenal (HPA) axis [and in particular the release of pro‐opiomelanocortin (POMC)‐related peptides and corticosteroids induced by interleukins (ILs)] is essential for coordinating the appropriate immune responses to pathogens. Exposure of pregnant mammalian females to alcohol results in abnormal immune functions in the offspring, as well as in altered HPA axis activity. We therefore tested the hypothesis that prenatal alcohol exposure might modify the stimulatory action of ILs on the HPA axis of the pups, thus providing a mechanisms through which this treatment results in increased rate of infectious or inflammatory processes. Pregnant dams were fed a liquid alcohol diet throughout gestation. Dams with free access to food (ad libitum group), or dams fed an isocaloric diet in which sucrose replaced alcohol (pair‐feeding), were also included. At 22‐24 days of age, the pups were injected intraperitoneally with IL‐1β, corticotropin‐releasing factor (CRF), or the vehicle. Blood samples obtained 1‐2 hr later indicated that the alcohol diet resulted in significantly blunted adrenocorticotropic hormone (ACTH) and 0‐endorphin, but not corticosterone release, in response to IL‐1β. Pair‐fed pups also showed some decrease in their pituitary response, although to a lesser degree. In contrast, there was no measurable difference in the ability of CRF to increase plasma ACTH levels.These results suggest that prenatal exposure to alcohol interferes with the stimulatory action of IL‐1β on the secretion of POMC‐related peptides, a phenomenon probably not caused by decreased pituitary responsiveness to CRF. As pups born to pair‐fed dams also exhibited a measurable, although less significant, decrease in IL‐induced ACTH and β‐endorphin release, a possible synergism between caloric restriction and alcohol also needs to be ascertained. We propose that the ability of prenatal alcohol treatment to blunt the release of POMC‐related peptides in response to IL‐1/S may participate in the abnormal immune functions of the offspring.
The cost‐effectiveness of autologous transfusion alternatives: an update and reappraisal
Authors: KARGER RALF , KRETSCHMER VOLKER 
Published: June 2007

SUMMARYThere is still an ongoing debate whether autologous transfusion methods (ATM) are cost‐effective when compared with each other or with other medical interventions. A search on MEDLINE and in the British National Health Service Economic Evaluation Database was conducted to retrieve cost‐effectiveness analyses focusing on preoperative autologous blood donation (PABD), acute normovolemic hemodilution (ANH) or perioperative blood salvage (PBS). The search covered the years from 1991 to 2006. The quality of retrieved papers was assessed using published criteria for the evaluation of economic analyses of health‐care measures. Twenty‐six studies were identified: ten for PABD, four for ANH, seven for PBS and five which evaluated strategies combining different ATM. Nineteen studies were conducted in the USA, including most of the PABD studies. Only one study included indirect costs in its cost estimates. The majority of analyses were based on suboptimal study designs. Only six studies employed randomized controlled trials, in most of which avoidance of allogeneic transfusion was chosen as the effectiveness parameter. Ten studies used decision analysis models, calculating cost‐effectiveness ratios based on quality‐adjusted life‐years. These included eight PABD studies and two PBS studies. The assumptions needed for the models were often either outdated or derived from unsystematic reviews of the pertinent literature. In conclusion, economic analyses of ATM are heterogeneous with respect to several aspects of study design. The currently available scientific evidence is of limited quality because of considerable uncertainties in estimates of several key variables thought to substantially affect the results of economic analyses.
An Observing System Simulation Experiment for the Indian Ocean
Authors: Vecchi Gabriel A. , Harrison Matthew J. 
Published: June 2007

AbstractAn integrated in situ Indian Ocean observing system (IndOOS) is simulated using a high-resolution ocean general circulation model (OGCM) with daily mean forcing, including an estimate of subdaily oceanic variability derived from observations. The inclusion of subdaily noise is fundamental to the results; in the mixed layer it is parameterized as Gaussian noise with an rms of 0.1°C; below the mixed layer a Gaussian interface displacement with an rms of 7 m is used. The focus of this assessment is on the ability of an IndOOS—comprising a 3° × 3° Argo profiling float array, a series of frequently repeated XBT lines, and an array of moored buoys—to observe the interannual and subseasonal variability of subsurface Indian Ocean temperature. The simulated IndOOS captures much of the OGCM interannual subsurface temperature variability.A fully deployed Argo array with 10-day sampling interval is able to capture a significant part of the Indian Ocean interannual temperature variability; a 5-day sampling interval degrades its ability to capture variability. The proposed moored buoy array and frequently repeated XBT lines provide complementary information in key regions, particularly the Java/Sumatra and Somali upwelling and equatorial regions. Since the subdaily noise is of the same order as the subseasonal signal and since much of the variability is submonthly, a 5-day sampling interval does not drastically enhance the ability of Argo to capture the OGCM subseasonal variability. However, as sampling intervals are decreased, there is enhanced divergence of the Argo floats, diminished ability to quality control data, and a decreased lifetime of the floats; these factors argue against attempting to resolve subseasonal variability with Argo by shortening the sampling interval. A moored array is essential to capturing the subseasonal and near-equatorial variability in the model, and the proposed moored buoy locations span the region of strong subseasonal variability. On the whole, the proposed IndOOS significantly enhances the ability to capture both interannual and subseasonal variability in the Indian Ocean.