bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Enterobacter sakazakii from closely related species: The use of Artificial Neural Networks in the analysis of biochemical and 16S rDNA data
Authors: Iversen Carol , Lancashire Lee , Waddington Michael , Forsythe Stephen , Ball Graham 
Published: March 2006

Abstract

Background

Enterobacter sakazakii is an emergent pathogen associated with ingestion of infant formula and accurate identification is important in both industrial and clinical settings. Bacterial species can be difficult to accurately characterise from complex biochemical datasets and computer algorithms can potentially simplify the process.

Results
Artificial Neural Networks were applied to biochemical and 16S rDNA data derived from 282 strains of Enterobacteriaceae, including 189 E. sakazakii isolates, in order to identify key characteristics which could improve the identification of E. sakazakii. The models developed resulted in a predictive performance for blind (validation) data of 99.3 % correct discrimination between E. sakazakii and closely related species for both phenotypic and genotypic data. Three main regions of the partial rDNA sequence were found to be key in discriminating the species. Comparison between E. sakazakii and other strains also constitutively positive for expression of the enzyme α-glucosidase resulted in a predictive performance of 98.7 % for 16S rDNA sequence data and 100% for phenotypic data.

Conclusion
The computationally based methods developed here show a remarkable ability in reducing data dimensionality and complexity, in order to eliminate noise from the system in order to facilitate the speed and reliability of a potential strain identification system. Furthermore, the approaches described are also able to provide valuable information regarding the population structure and distribution of individual species thus providing the foundations for novel assays and diagnostic tests for rapid identification of pathogens.
Methodological quality of systematic reviews of animal studies: a survey of reviews of basic research
Authors: Mignini Luciano E , Khan Khalid S 
Published: March 2006

Abstract

Background
Systematic reviews can serve as a tool in translation of basic life sciences research from laboratory to human research and healthcare. The extent to which reviews of animal research are systematic and unbiased is not known.

Methods
We searched, without language restrictions, Medline, Embase, bibliographies of known reviews (1996–2004) and contacted experts to identify citations of reviews of basic science literature which, as a minimum, performed search of a publicly available resource. From these we identified reviews of animal studies where laboratory variables were measured or where treatments were administered to live animals to examine their effects, and compared them with reviews of bench studies in which human or animal tissues, cell systems or organ preparations were examined in laboratories to better understand mechanisms of diseases.

Results
Systematic reviews of animal studies often lacked methodological features such as specification of a testable hypothesis (9/30, 30%); literature search without language restriction (8/30, 26.6%); assessment of publication bias (5/30, 16.6%), study validity (15/30, 50%) and heterogeneity (10/30, 33.3%); and meta-analysis for quantitative synthesis (12/30, 40%). Compared to reviews of bench studies, they were less prone to bias as they specified the question (96.6% vs. 80%, p = 0.04), searched multiple databases (60% vs. 26.6%, p = 0.01), assessed study quality (50% vs. 20%, p = 0.01), and explored heterogeneity (33.3% vs. 2.2%, p = 0.001) more often.

Conclusion
There seems to be a gradient of frequency of methodological weaknesses among reviews: Attempted systematic reviews of whole animal research tend to be better than those of bench studies, though compared to systematic reviews of human clinical trials they are apparently poorer. There is a need for rigour when reviewing animal research.
Optimal management of adults with pharyngitis – a multi-criteria decision analysis
Authors: Singh Sonal , Dolan James G , Centor Robert M 
Published: March 2006

Abstract

Background
Current practice guidelines offer different management recommendations for adults presenting with a sore throat. The key issue is the extent to which the clinical likelihood of a Group A streptococcal infection should affect patient management decisions. To help resolve this issue, we conducted a multi-criteria decision analysis using the Analytic Hierarchy Process.

Methods
We defined optimal patient management using four criteria: 1) reduce symptom duration; 2) prevent infectious complications, local and systemic; 3) minimize antibiotic side effects, minor and anaphylaxis; and 4) achieve prudent use of antibiotics, avoiding both over-use and under-use. In our baseline analysis we assumed that all criteria and sub-criteria were equally important except minimizing anaphylactic side effects, which was judged very strongly more important than minimizing minor side effects. Management strategies included: a) No test, No treatment; b) Perform a rapid strep test and treat if positive; c) Perform a throat culture and treat if positive; d) Perform a rapid strep test and treat if positive; if negative obtain a throat culture and treat if positive; and e) treat without further tests. We defined four scenarios based on the likelihood of group A streptococcal infection using the Centor score, a well-validated clinical index. Published data were used to estimate the likelihoods of clinical outcomes and the test operating characteristics of the rapid strep test and throat culture for identifying group A streptococcal infections.

Results
Using the baseline assumptions, no testing and no treatment is preferred for patients with Centor scores of 1; two strategies – culture and treat if positive and rapid strep with culture of negative results – are equally preferable for patients with Centor scores of 2; and rapid strep with culture of negative results is the best management strategy for patients with Centor scores 3 or 4. These results are sensitive to the priorities assigned to the decision criteria, especially avoiding over-use versus under-use of antibiotics, and the population prevalence of Group A streptococcal pharyngitis.

Conclusion
The optimal clinical management of adults with sore throat depends on both the clinical probability of a group A streptococcal infection and clinical judgments that incorporate individual patient and practice circumstances.
HLA-B8 association with late-stage melanoma – an immunological lesson?
Authors: Fensterle Joachim , Trefzer Uwe , Berger Thomas , Andersen Mads Hald , Ugurel Selma , Becker Jürgen C 
Published: March 2006

AbstractBackgroundDifferences in HLA allele frequencies between the diseased and healthy populations may signify efficient immune responses, a notion that has been successfully tested for infectious diseases or for association with genetic elements involved in a distinct type of immunity. This retrospective study is intended to detect differences in MHC class I carrier frequencies of advanced melanoma patients compared to healthy bone marrow donors.MethodsThe HLA-A and -B carrier frequencies of 748 stage IV melanoma patients retrieved from serotyping at 6 different centers in Germany were compared using a chi-square test to 13,386 fully HLA typed bone marrow donors registered in the German national bone marrow donor registry.ResultsThe comparison of HLA carrier frequencies in advanced cancer patients with healthy bone marrow donors revealed a significant decrease in HLA-B8 carrier frequencies, which was also apparent in patients with advanced disease compared to patients with loco-regional disease.ConclusionThe data suggest that protective immune responses restricted to distinct MHC class I molecules may be operational in a subset of melanoma patients, which is the prerequisite for a large scale screen for the corresponding epitopes. Alternatively, the known association of the ancestral haplotype HLA-A1, -B8 and -DR3 with genetic elements such as distinct TNF-α alleles might have a protective effect on disease progression. In any case, identification of the cause of protection within this patient subset might lead to a significant improvement in the efficacy of current immunotherapeutic approaches.
Evaluation of the effect of energy conservation techniques in the performance of activity of daily living tasks
Authors: Ip W M , Woo J , Yue S Y , Kwan M , Sum S MW , Kwok T , Hui S SC 
Published: March 2006

Objective: To determine whether energy conservation techniques during common activity of daily living tasks actually result in lower energy expenditure, and to document subjective comments regarding any differences in the perceived level of effort. Design: Descriptive study comparing energy expenditure in three tasks with and without energy conservation techniques, taking into account the effect of age. Setting: Occupational therapy department of a rehabilitation hospital in Hong Kong. Subjects: One hundred and eight subjects (30 < 60 years; 78 ≥ 60 years) were recruited from staff and members of an elderly social centre in the community. Measurements: Energy expenditure was measured using a portable indirect calorimetry system for three tasks (shopping, washing clothes and hanging laundry) with and without energy conservation techniques. Dyspnoea, fatigue and perceived exertion were measured using visual analogue scales. Results: Reduction in energy expenditure using energy conservation techniques for shopping and hanging laundry was documented in younger subjects only (O2 consumption fell from 13.89&plusmn;3.7 to 12.29&plusmn;3.8 mL/min per kg for shopping, P < 0.001 and 5.9&plusmn;1.2 to 5.0&plusmn;1.2 mL/min per kg, P < 0.001 for hanging laundry), although the older subjects experienced less perceived exertion with the energy conservation techniques. For washing clothes, no reduction in energy expenditure was observed in either age groups. Conclusion: Measurable benefits were observed with use of labour-saving equipment and avoidance of overhead reaching in younger subjects only.
Implicit learning of a motor skill after mild and moderate stroke
Authors: Pohl P S , McDowd J M , Filion D , Richards L G , Stiers W 
Published: March 2006

Objective: To determine if adults in the subacute phase post moderate or mild stroke could learn a motor task under implicit practice conditions. Design: Non-randomized, between-group design. Setting: Subjects' homes. Subjects: Sample of convenience of 15 adults with moderate stroke, 22 adults with mild stroke, and 32 age-matched controls. Stroke severity was determined using the Orpington Prognostic Scale. Intervention: Practice of movements to target switches in two conditions, a repeated series and a random series. Practice was organized into a single session of six blocks of 80 trials such that blocks 1 and 2 were the random series, blocks 3 and 4 the repeated series, block 5 the random series, and block 6 the repeated series. Explicit knowledge of the two conditions was not provided. Main measures: The mean response time and the coefficient of variation were calculated for each block for each group. Results: Regardless of group, participants had a slower response time when practice was unexpectedly switched from the repeated to random condition. The response time and coefficient of variation for those with moderate stroke were persistently greater than those with mild stroke and controls, who were not different from each other. Conclusions: Implicit motor learning is preserved in adults with moderate stroke and may be a viable strategy for teaching motor skills in rehabilitation. The clinician should be aware that subjects with moderate stroke, even when performing with the less affected upper extremity, have significantly slower and more variable movements than those with mild stroke and controls.
Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions
Authors: Toulotte C , Thevenon A , Watelain E , Fabre C 
Published: March 2006

Objective: We compared falling and non-falling healthy elderly subjects to identify balance disorders associated with falling. Gait parameters were determined when carrying out single and dual tasks. Design: Case comparison study. Setting: Subjects were studied in the gait laboratory at Hopital Roger Salengro, Lille, France. Subjects: A group of 40 healthy elderly women were assigned to one of two groups according to their falling history: 21 fallers aged 70.4±6.4 years and 19 non-fallers aged 67.0±4.8 years. All subjects performed first a single leg balance test with two conditions (eyes open/closed). Then, gait parameters were analysed under single-task and dual motor-task conditions (walking with a glass of water in the hand). Main measures: Falls, number of times suspended foot touched the floor during the single leg balance test, cadence, speed, stride time, step time, single-support time, stride length and step length during walking under single- and dual-task conditions. Results: During the single leg balance test, fallers placed their feet on the floor three times more often than non-fallers under eyes open conditions (P < 0.05) and twice as often under eyes closed conditions (P < 0.05). In the single-task condition, no significant difference in gait parameters was reported between fallers and non fallers. There was a significant difference (P < 0.05) in the gait parameters (cadence, speed, stride and step time, single-support time) between fallers and non-fallers under dual-task conditions. Conclusions: Dual tasks perturb walking in fallers, who exhibit deteriorated static balance. Consequently, walking under dual-task conditions plus a single leg balance test could be helpful in detecting walking disorders and planning physiotherapy to prevent falls.
Motor relearning programme for stroke patients: a randomized controlled trial
Authors: Chan Dora YL , Chan Chetwyn CH , Au Derrick KS 
Published: March 2006

Objective: To study the efficacy of the motor relearning approach in promoting physical function and task performance for patients after a stroke. Design: Matched-pair randomized controlled trial. Setting: An outpatient rehabilitation centre in Hong Kong. Participants: Fifty-two outpatients with either a thrombotic or haemorrhagic stroke who completed either the study or control group. Interventions: The patients received 18 2-h sessions in six weeks of either the motor relearning programme or a conventional therapy programme. Main outcome measures: The Berg Balance Scale, the Timed Up and Go Test, the Functional Independence Measure (FIM), the modified Lawton Instrumental Activities of Daily Living (IADL) test, and the Community Integration Questionnaire. Results: Patients in the motor relearning group showed significantly better performance on all but the Timed Up and Go Test when compared with the control group ( F(1,150)=6.34-41.86, P ≤ 0.015). The interactions between group and occasion were significant on all five outcome measures, indicating that the rates of change across time between the motor relearning and control groups differed ( F(3,150)=3.60-33.58, P < 0.015). Conclusion: The motor relearning programme was found to be effective for enhancing functional recovery of patients who had a stroke. Both ‘sequential’ and ‘function-based’ concepts are important in applying the motor relearning approach to the rehabilitation of stroke patients.
The effectiveness of a supervised physical training model tailored to the individual needs of patients with whiplash-associated disorders - a randomized controlled trial
Authors: Bunketorp Lina , Lindh Malin , Carlsson Jane , Stener-Victorin Elisabet 
Published: March 2006

Objective: To evaluate the effects of a physical training programme which is supervised and tailored to meet the needs of patients with subacute whiplash-associated disorders. Design: A randomized controlled trial with follow-up at three and nine months after randomization. Setting: An interdisciplinary rehabilitation centre. Subjects: Forty-seven patients with subacute disorders following a whiplash trauma. Interventions: Patients were randomized to a supervised training group or a self-administered home training group. Main measures: Primary outcome measures were the Self-Efficacy Scale, the Tampa Scale for Kinesiophobia and the Pain Disability Index. Secondary outcome measures were neck pain intensity, sensory and affective dimensions of pain, pain location and duration, muscle tenderness, grip strength, cervical mobility, sick leave and analgesic consumption. Results: Forty patients (85%) completed the intervention period, and the drop-outs were followed up by intention-to-treat. The results showed that supervised training was significantly more favourable than home training, with a more rapid improvement in self-efficacy (P=0.03), fear of movement/(re)injury (P=0.03) and pain disability (P=0.03) at three months. Further, supervised training significantly reduced the frequency of analgesic consumption (P=0.03). The improvements were partly maintained at nine months, even though there was no amelioration in pain and physical disorders. Despite the favourable outcome, supervised intervention did not reduce sick leave. Conclusions: The findings indicate a treatment approach that is feasible in the rehabilitation of patients with subacute whiplash-associated disorders in the short term, but additional research is needed to extend these findings and elucidate treatment strategies that also are cost effective.
Effect of compensation procedures for velocity on repeatability and variability of gait parameters in normal subjects
Authors: Shimada Seiichiro , Kobayashi Shigeru , Wada Makoto , Sasaki Shinichi , Kawahara Hideo , Uchida Kenzo , Yayama Takafumi , Baba Hisatoshi 
Published: March 2006

Objective: To evaluate the effects of a mathematical procedure that adjusts for gait velocity on the variability seen in gait analysis. Design: Evaluation before and after compensation. Setting: Gait laboratory, Fukui University Hospital, Japan. Subjects: Fourteen normal volunteers. Outcome measures: A computerized gait analysis system with two forceplates and a light source spot measuring device was used. Gait measurement in each subject was performed on three different days. Results: The gait parameters measured on three different days were significantly different, particularly step length, stride length, velocity, the components of floor-reaction forces and hip motion. In these parameters, intraclass correlation coefficient, ICC (1,1) was not high (range 0.05-0.71). However, there was a high correlation between these parameters and velocity and high repeatability was obtained following compensation for velocity (ICC (1,1), range 0.73-0.97). In contrast, compensation of parameters whose measurement was not significantly different before compensation did not improve ICC (1,1). Variability of all parameters was acceptable, however CV (an index of variability) improved significantly after compensation compared with that before compensation in six of 15 parameters. Conclusions: Our findings suggest that low repeatability in gait parameters should be considered even when the gait of normal subjects is measured on different days. A high repeatability and more acceptable variability were obtained when the data were compensated for velocity.
Constraint-induced movement therapy in patients with stroke: a pilot study on effects of small group training and of extended mitt use
Authors: Brogårdh Christina , Sjölund Bengt H 
Published: March 2006

Objective: (1) To evaluate constraint-induced movement therapy for chronic stroke patients modified into group practice to limit the demand on therapist resources. (2) To explore whether extended mitt use alone may enhance outcome. Design: A combined case-control and randomized controlled study with pre- and post-treatment measures by blinded observers. Setting: A university hospital rehabilitation department. Participants: Sixteen stroke patients (nine men and seven women; mean age 56.7 years; on average 28.9 months post stroke, five of whom were 6-9 months post stroke) with moderate motor impairments in the contralateral upper limb. Intervention: Constraint-induced therapy (mitt on the less affected hand 90% of waking hours for 12 days) with 2-3 patients per therapist and 6 h of group training per day. After the training period, the patients were randomized either to using the mitt at home every other day for two-week periods for another three months (in total 21 days) or to no further treatment. Outcome measures: Modified Motor Assessment Scale, Sollerman Hand Function Test, Two-Point Discrimination test and Motor Activity Log. Results: The mean motor performance improved significantly after two weeks of constraint-induced group therapy on Motor Assessment Scale (1.44 (95% confidence interval (95% CI) 0.59-2.28) points; P = 0.003) and on Sollerman Hand Function Test (3.81 (95% CI 0.26-7.36) points; P = 0.037) but showed no sensory change in the Two-Point Discrimination Test (P = 0.283). The median difference in self-reported motor ability (Motor Activity Log) also improved (P B=0.001). However, no additional effect was seen from wearing a mitt for another three months. Conclusion: Constraint-induced group therapy, allowing several patients per therapist, seems to be a feasible alternative to improve upper limb motor function. The restraint alone, extended in time, did not enhance the treatment effect.
Intrathecal baclofen therapy improves functional intelligibility of speech in cerebral palsy
Authors: Leary S M , Gilpin P , Lockley L , Rodriguez L , Jarrett L , Stevenson V L 
Published: March 2006

Objective: To assess the effect of intrathecal baclofen on spastic dysarthia in cerebral palsy. Design: Single case study. Methods: Functional outcome measures, including the Assessment of Intelligibility of Dysarthric Speech, were performed before and after a trial of intrathecal baclofen in an adult patient with spastic dysarthria due to cerebral palsy. The patient proceeded to intrathecal baclofen pump implantation and was reassessed after six months of continuous intrathecal baclofen therapy. Results: Improvement in function including speech intelligibility was seen following the intrathecal baclofen trial. The improvement was sustained at six months post pump implantation. Conclusions: Intrathecal baclofen improved functional intelligibility of speech in a carefully selected subject. The Assessment of Intelligibility of Dysarthric Speech was found to be a useful quantitative tool to assess the effect of intrathecal baclofen on spastic dysarthria.