bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-emptive swallowing stimulation in long-term intubated patients
Authors: Hwang Chang Ho , Choi Kyoung Hyo , Ko Yoon Suk , Leem Chae Man 
Published: January 2007

Objective: To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Design and subjects: Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.39±17.9 years were stimulated (experimental group) and 18 patients of mean age 61.39±13.5 years were not stimulated (control group). The duration of intubation was 15.59±6.7 days in the experimental group and 15.79±6.5 days in the control group. Duration of stimulation in the experimental group was 7.39±3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study. Results: There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.379±0.07 seconds) was significantly shorter than that of the control group (0.839±0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.39±17.4%/s) was significantly higher than that of the control group (50.19±13.0%/s). Conclusion: Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.
The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain
Authors: Perron Marc , Hébert Luc J , McFadyen Bradford J , Belzile Sylvain , Regnieàre Mario 
Published: January 2007

Objective: To assess the capacity of the Biodex Stability System using a one-leg stance protocol to differentiate between injured and non-injured limbs and between level of disabilities. Design: Cross-sectional study. Setting: Military and civilian clinic. Subjects: Thirty-four individuals with a second-degree lateral ankle sprain and 36 healthy subjects. Methods and measures: Subjects were tested on the Stability System 30 days after injury using a one-leg stance protocol in the dynamic limit-of-stability mode. All subjects also filled out a disability questionnaire (Lower Extremity Functional Scale). The groups were compared based on the overall dynamic limit-of-stability score and its relationship with the score on the disability questionnaire was also examined. Results: The overall dynamic limit-of-stability scores (subjects with a lateral ankle sprain: 13.0% (5.5)-26.0% (9.2); healthy subjects: 16.9% (7.9)-27.9% (9.6)) clustered in the lower end of the theoretical range of 0–100%. Statistically significant differences in the overall dynamic limit-of-stability scores were found between the injured and non-injured limbs but group differences were small and clinically not relevant. No significant relationships were found between the overall dynamic limit-of-stability scores and the Lower Extremity Functional Scale scores (58.2 (11.8)) of the subjects with a lateral ankle sprain. Conclusions: The one-leg stance protocol carried out in the dynamic limit-of-stability mode is very challenging and offers a very limited capacity to differentiate between injured and non-injured limbs. The main outcome of the Stability System does not appear to be a good indicator of the functional capacity of people with a lateral ankle sprain.
The effect of exercise on outcomes for older acute medical inpatients compared with control or alternative treatments: a systematic review of randomized controlled trials
Authors: de Morton Natalie A , Keating Jennifer L , Jeffs Kim 
Published: January 2007

Objective: To determine the effect of exercise interventions for acutely hospitalized older medical patients on functional status and hospital outcomes. Data sources: MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PEDro, Current Contents and Sports Discus were searched until February 2006. Additional studies were identified through reference and citation tracking and contacting authors of eligible trials. Review methods: Eligible studies were prospective randomized or pseudor and omized controlled trials comparing exercise for medical inpatients to alternate or no treatment controls. Of 3138 potentially relevant articles screened by two independent reviewers, seven randomized controlled trials and two pseudorandomized controlled trials were included. Two independent reviewers extracted data relating to patient and hospital outcomes and assessed the method quality. Results: Pooled analysis of multidisciplinary interventions that included exercise indicated a significant increase in the proportion of patients discharged to home at hospital discharge (relative risk 1.08; 95% confidence interval (CI) 1.03 –1.14) and a small but important reduction in acute hospital length of stay (weighted mean difference – / 1.08 days; 95% CI – / 1.93 to – / 0.22) and total hospital costs (weighted mean difference – / US$280; 95% CI – / $493 to – / $65) compared with usual care. Pooled analysis of exercise intervention trials found no effect on the proportion of patients discharged to home or acute hospital length of stay. The effect of exercise on functional outcome measures is unclear. There was no influence of exercise intervention on adverse events. Conclusions: Multidisciplinary intervention that includes exercise improves patient and hospital outcomes for acutely hospitalized older medical patients.
A randomized controlled study of botulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity
Authors: Kong Keng-He , Neo Jong-Jong , Chua Karen SG 
Published: January 2007

Objectives: To assess the effects of botulinum toxin A (BT-A) on hemiplegic shoulder pain associated with spasticity. Design: Randomized, double-blind, placebo-controlled study. Setting: Outpatient clinic of a rehabilitation department. Participants: Patients, more than three months post stroke, with hemiplegic shoulder pain associated with shoulder adductor and elbow flexor spasticity, randomly assigned to BT-A or placebo. Intervention: One-time injection of BT-A (500 units) into the pectoralis major and biceps brachii on the hemiplegic side. Main measures: Visual analogue scale of shoulder pain (0 –10), shoulder adductor and elbow flexor tone using the Ashworth Scale and passive range of shoulder abduction. These were assessed at baseline, four weeks, eight weeks and 12 weeks post injection. Results: Seventeen patients were enrolled, eight in the BT-A group and nine in the placebo group. At baseline, the median visual analogue scale score for shoulder pain was 6, the median Ashworth Scale shoulder adductor and elbow flexor spasticity score was 2 and the median range of shoulder abduction 76 degrees. Subjects who received BT-A showed significantly greater improvements in median shoulder adductor and elbow flexor Ashworth Scale scores than placebo at week 4 (P B / 0.01) but not at week 8 and 12. For shoulder pain and passive shoulder abduction range, all subjects showed postinjection improvements and no difference could be demonstrated between the two groups. Discussion: Possible reasons for the negative finding in this study include the small sample size and the presence of causes of shoulder pain not related to spasticity which could have confounded outcome.
Goal-directed training: linking theories of treatment to clinical practice for improved functional activities in daily life
Authors: Mastos M , Miller K , Eliasson A C , Imms C 
Published: January 2007

Background: Goal-directed training is an activity-based approach to therapy. Meaningful, client-selected goals are used to provide opportunities for problem solving and to indirectly drive the movements required to successfully meet the task demands. This is in contrast to interventions that focus on changing body functions. Here, the principles of goal-directed training will be studied through two case studies with the aim of linking theories of treatment to clinical practice. Principles illustrated: The approach is based on the dynamic systems motor control theory and occupation-based therapy models, which suggest that movement patterns emerge from the interaction between the person's abilities, environment and the goal. Motor learning principles are applied to structure and schedule practice. Theory in practice: Four components provide the basis for goal-directed training: (1) selection of a meaningful goal; (2) analysis of baseline performance; (3) intervention/ practice regime; and (4) evaluation of outcome. Two individuals with acquired brain injury practised self-care tasks: eating and tying hair into a ponytail. Intensive training was undertaken over four weeks and the intervention outcome measured using the Goal Attainment Scale. Conclusions: The positive achievements in the self-care tasks illustrated that theories of motor control and motor learning can be applied to goal-directed training. The examples demonstrated that the approach could be applied to individuals with a range of abilities.
Tradeoffs Between Directed and Autonomous Driving on the Mars Exploration Rovers
Authors: Biesiadecki Jeffrey J. , Leger P. Chris , Maimone Mark W. 
Published: January 2007

NASA’s Mars Exploration Rovers (MER) have collected a great diversity of geological science results, thanks in large part to their surface mobility capabilities. The six wheel rocker/bogie mobility system provides driving capabilities in a range of terrain types, while the onboard IMU measures actual rover attitude changes (roll, pitch and yaw, but not position) quickly and accurately. Four stereo camera pairs provide accurate position knowledge and/or terrain assessment. Solar panels generally provide enough energy to drive the vehicle for at most four hours each day, but drive time is often restricted by other planned activities. Driving along slopes in nonhomogeneous terrain injects unpredictable amounts of slip into each drive. These restrictions led to the creation of driving strategies that alternately use more or less onboard autonomy, to maximize drive speed and distance at the cost of increased complexity in the sequences of commands built by human Rover Planners each day. Commands to the MER vehicles are typically transmitted at most once per day, so mobility operations are encoded as event-driven sequences of individual motion commands. Motions may be commanded using quickly-executing Directed commands which perform only reactive motion safety checks (e.g., real-time current limits, maximum instantaneous vehicle tilt limit), slowly-executing position measuring Visual Odometry (VisOdom) commands, which use images to accurately update the onboard position estimate, or slow-to-medium speed Autonomous Navigation (AutoNav) commands, which use onboard image processing to perform predictive terrain safety checks and optional autonomous Path Selection. In total, the MER rovers have driven more than 10 kilometers over Martian terrain during their first 21 months of operation using these basic modes. In this paper we describe the strategies adopted for selecting between human-planned Directed drives versus rover-adaptive Autonomous Navigation, Visual Odometry and Path Selection drives.
Wave Haptics: Building Stiff Controllers from the Natural Motor Dynamics
Authors: Diolaiti Nicola , Niemeyer Günter , Tanner Neal A. 
Published: January 2007

Haptics, like the fields of robotics and motion control, relies on high stiffness position control of electric motors. Traditionally, DC motors are driven by current amplifiers designed to hide their electrical dynamics. Meanwhile encoder-based position feedback creates virtual springs. Unfortunately this cancellation-replacement approach experiences performance limits due to sensor quantization, discretization, and amplifier bandwidths. An alternate approach is presented, noting the inherent inductor-resistor dynamics of the motor are beneficial to the haptic task. Two main insights are followed, which may be utilized independently or preferably in combination. First, the electrical inductance L can serve as a stiffness, providing a natural sensorless coupling between the virtual environment and the user. Second, the electrical resistance R can create a natural wave transformation, providing a robust computer interface between the discrete and continuous time domains. The resulting analog circuit implements a simple voltage drive and can achieve higher stiffness than traditional approaches, especially in the frequency range where human users are most sensitive. A prototype 1-DOF system has been implemented and confirms the promise of this novel paradigm.
Look before you leap and don’t put all your eggs in one basket
Authors: Pryjmachuk Steven , Richards David A. 
Published: January 2007

This paper’s aim is to draw attention to the pitfalls that novice and, sometimes, experienced researchers fall into when undertaking quantitative data analysis in the health and social sciences, and to offer some guidance as to how such pitfalls might be avoided. Many health and social science students are routinely instructed that the procedure for undertaking data analysis in quantitative research is as follows: specify hypotheses; collect data and enter it into a computerised statistical package; run various statistical procedures; examine the computer outputs for p-values that are statistically significant. If significant differences are found, jubilation often exists because statistically significant results are deemed to be a clear indicator that something worthwhile (and publishable) has been discovered. This paper argues that this approach has two major oversights: a failure to explore the raw data prior to analysis and an overdependence on p-values. Both of these oversights are routinely present in much health and social-science research, and both create problems for scientific rigour. Researchers need to exercise caution (‘look before you leap’) and prudence (‘don’t put all your eggs in one basket’) when undertaking quantitative data analyses. Caution demands that, prior to full data analysis, researchers employ procedures such as data cleaning, data screening and exploratory data analysis. Prudence demands that researchers see p-values for their true worth, which exists only within the context of statistical theory, confidence intervals, effect sizes and the absolute meaning of statistical significance.
Researching the implementation of pioneering roles in nursing and midwifery
Authors: Lathlean Judith 
Published: January 2007

This paper presents research on the implementation of pioneering roles in nursing and midwifery in the United Kingdom—namely lecturer practitioners, consultant nurses and nurse registrars. It seeks to critique the empirical insights gained from studying new roles aimed at better integrating distinct aspects of nursing and midwifery, at solving long-standing ‘problems’ in nursing and midwifery, at extending traditional roles and at improving and advancing practice, education and research. The paper draws upon knowledge derived from three empirical projects—an ethnographic study and survey of the role of lecturer practitioners, conducted in one setting in the UK (Lathlean, 1997), a study of the role of consultant nurses within healthcare Trusts (Lathlean and Masterson, 2004) and an action-based evaluation of an innovative work based pilot training programme for the development of nurse registrars as aspiring consultant nurses (Surridge and Lathlean, 2006). The paper sets these within the context of an extensive literature on lecturer practitioners and consultant nurses, and encompasses both a national and international perspective through the inclusion of UK, North American and Australian experiences. The theoretical understandings gleaned from these studies include the apparent inevitability of certain challenges in new roles such as role ambiguity and role overload, the need for organisational commitment to establish and sustain such roles, the variability of roles and the uncertainty as to the achievements of these posts or, at the very least, the extent to which these achievements can be measured. Conclusions drawn include the value of longitudinal studies over short-term cross-sectional research, incorporating approaches that reflect the diversity of the roles; the complexity of ascertaining role impact; and the value of undertaking a qualitative meta-analysis or meta-ethnography of existing studies.
Evaluating prescribing competencies and standards used in nurse independent prescribers’ prescribing consultations
Authors: Latter Sue , Maben Jill , Myall Michelle , Young Amanda , Baileff Anne 
Published: January 2007

Background Independent prescribing of medicines by nurses is widely considered to be part of advanced nursing practice, and occurs within an episode of patient care that can be completed independently by a nurse. Nurse prescribers therefore require the competencies necessary to manage a consultation—such as history taking and diagnostic skills—and subsequently need to decide on any appropriate medicine to be prescribed. Safe prescribing should also involve an accurate, legible and comprehensive written prescription and documentation of the consultation in the patient’s records. However, the extent to which nurse independent prescribers use prescribing competencies and standards in practice had not been researched prior to this study. Aim To describe the frequency with which nurses use a range of prescribing competencies in their prescribing consultations, in order to provide a measure of the quality and safety of nurses’ independent prescribing practices. Design and methods Across 10 case study sites, 118 nurse independent prescribers’ prescribing consultations were analysed using non-participant observation and a structured checklist of prescribing competencies. Documentary analysis was also undertaken of a) prescriptions written ( n =132) by nurses and b) the record of the prescribing episode in patient records ( n =118). Sample and setting 118 prescribing consultations of 14 purposively selected nurse independent prescribers working in primary and secondary care trust case study sites in England. Findings Nurse independent prescribers were issuing a prescription every 2.82 consultations; nurses used a range of assessment and diagnosis competencies in prescribing consultations, but some were employed more consistently than others; nurses almost universally wrote full and accurate prescription scripts for their patients; nurses recorded each of their prescribing consultations, but some details of the consultation and the prescription issued were not always consistently recorded in the patient records. Conclusion The findings from this observation study provide evidence about the quality and safety of nurses’ prescribing consultations in England.
Progression to end-stage liver disease in patients with inherited bleeding disorders and hepatitis C: an international, multicenter cohort study
Authors: Posthouwer Dirk , Makris Michael , Yee Thynn T. , Fischer Kathelijn , van Veen Joost J. , Griffioen Anja , van Erpecum Karel J. , Mauser-Bunschoten Eveline P. 
Published: January 2007

Abstract
Prior to 1990, many patients with inherited bleeding disorders were infected with hepatitis C virus (HCV). This study assessed the risk of end-stage liver disease (ESLD) in patients with hemophilia with chronic hepatitis C. Patients were infected between 1961 and 1990 and were followed up to August 2005. Of 847 anti-HCV+ patients, 160 (19%) spontaneously cleared HCV and 687 (81%) developed chronic hepatitis C. Coinfection with HIV was present in 210 patients. After 35 years of infection the cumulative incidence of ESLD was 11.5% (95% CI, 8.2%-14.8%) in HIV− patients and 35.1% (95% CI, 29.2%-41.0%; P < .001) in patients coinfected with HIV. Independent risk factors of ESLD were HIV coinfection (hazard ratio 13.8; 95% CI, 7.5-25.3), older age at infection (hazard ratio 2.3 per 10 years; 95% CI, 2.0-2.8), alcohol abuse (hazard ratio 4.9; 95% CI, 2.5-9.6), and presence of HCV genotype 1 (hazard ratio 2.2; 95% CI, 1.1-4.2). With longer duration of HCV infection, the risk of developing ESLD is emerging in patients with inherited bleeding disorders. Risk factors for rapid progression to ESLD are alcohol abuse, coinfection with HIV, older age at infection, and presence of HCV genotype 1.
SIVSM/HIV-2 Vpx proteins promote retroviral escape from a proteasome-dependent restriction pathway present in human dendritic cells
Authors: Goujon Caroline , Rivière Lise , Jarrosson-Wuilleme Loraine , Bernaud Jeanine , Rigal Dominique , Darlix Jean-Luc , Cimarelli Andrea 
Published: January 2007

Abstract

Background
Vpx is a non-structural protein coded by members of the SIVSM/HIV-2 lineage that is believed to have originated by duplication of the common vpr gene present in primate lentiviruses. Vpx is incorporated into virion particles and is thus present during the early steps of viral infection, where it is thought to drive nuclear import of viral nucleoprotein complexes. We have previously shown that Vpx is required for SIVMAC-derived lentiviral vectors (LVs) infection of human monocyte-derived dendritic cells (DCs). However, since the requirement for Vpx is specific for DCs and not for other non-dividing cell types, this suggests that Vpx may play a role other than nuclear import.

Results
Here, we show that the function of Vpx in the infection of DCs is conserved exclusively within the SIVSM/HIV-2 lineage. At a molecular level, Vpx acts by promoting the accumulation of full length viral DNA. Furthermore, when supplied in target cells prior to infection, Vpx exerts a similar effect following infection of DCs with retroviruses as divergent as primate and feline lentiviruses and gammaretroviruses. Lastly, the effect of Vpx overlaps with that of the proteasome inhibitor MG132 in DCs.

Conclusion
Overall, our results support the notion that Vpx modifies the intracellular milieu of target DCs to facilitate lentiviral infection. The data suggest that this is achieved by promoting viral escape from a proteasome-dependent pathway especially detrimental to viral infection in DCs.
Structure-based engineering of papillomavirus major capsid L1: controlling particle assembly
Authors: Bishop Brooke , Dasgupta Jhimli , Chen Xiaojiang S 
Published: January 2007

Abstract
The outer shell of the papillomavirus particle is comprised of 72 pentamers of the major capsid L1 protein arranged on a T = 7 icosahedral lattice. The recombinant L1 can form T = 7 virus-like particles in vitro. The crystal structure of a T = 7 papilloma virion has not yet been determined; however, the crystal structure of a T = 1 particle containing 12 pentamers is known. The T = 1 structure reveals that helix-helix interactions, through three helices–h2, h3, and h4–near the C-terminus of L1, mediate the inter-pentameric bonding that is responsible for T = 1 assembly. Based on the T = 1 crystal structure, we have generated a set of internal deletions to test the role of the three C-terminal helices in T = 7 assembly. We have demonstrated that the h2, h3, and h4 near the C-terminal end of L1 are important for the L1 structure and particle assembly. In particular, we found that h2 and h3 are essential for L1 folding and pentamer formation, whereas h4 is indispensable for the assembly of not only T1, but also of the T7 virus-like particle.