bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Instrument Mixes through Program‐ and Agency‐Level Data: Methodological Issues in Contemporary Implementation Research
Authors: Howlett Michael , Kim Jonathan , Weaver Paul 
Published: February 2006

AbstractTheories of policy instrument choice have gone through several “generations” as theorists have moved from the analysis of individual instruments to comparative studies of instrument selection and the development of theories of instrument choice within implementation “mixes” or “governance strategies.” Current “next generation” theory on policy instruments centers on the question of the optimality of instrument choices. However, empirically assessing the nature of instrument mixes is quite a complex affair, involving considerable methodological difficulties and conceptual ambiguities related to the definition and measurement of policy sector and instruments and their interrelationships. Using materials generated by Canadian governments, this article examines the practical utility and drawbacks of three techniques used in the literature to inventory instruments and identify instrument ecologies and mixes: the conventional “policy domain” approach suggested byBurstein (1991); the “program” approach developed byRose (1988a); and the “legislative” approach used byHosseus and Pal (1997). This article suggests that all three approaches must be used in order to develop even a modest inventory of policy instruments, but that additional problems exist with availability and accessibility of data, both in general and in terms of reconciling materials developed using these different approaches, which makes the analysis of instrument mixes a time‐consuming and expensive affair.
Area Poverty Effects on Local Health Care Costs: An Analysis of Mississippi
Authors: Roberts Brandon 
Published: February 2006

AbstractThis article examines the relationship of area medical costs and poverty in Mississippi. Using a fixed‐effects model and Medicare expenditures, the results indicate that an addition of one percentage point in area poverty increases expected per enrollee expenditures by 0.90%. These figures imply that successful poverty amelioration efforts could yield substantial reductions in medical costs over time. The estimates suggest that a one‐percentage‐point reduction in poverty could accrue to a statewide savings of $510 million in medical costs over a 5‐year time period.
Considering Knowledge Uptake within a Cycle of Transforming Data, Information, and Knowledge
Authors: Michaels Sarah , Goucher Nancy P. , McCarthy Dan 
Published: February 2006

AbstractKnowledge uptake, having decision makers assimilate the ideas of experts, is recognized as an important stimulus to bringing about policy change. This is particularly true in the realm of environmental policymaking, which is characterized by knowledge intensity, complexity, and multifaceted concerns. Using examples from an innovative watershed management organization, this article presents a heuristic for understanding how knowledge uptake occurs within a cycle of organizational reasoning. This cycle is driven by activities that transform data, information, and knowledge and that link specialists with decision makers. The heuristic can be used as a diagnostic tool to identify breaks in the transformation process that impede mandate fulfillment and impair capacity building. Lack of appreciation of the dynamic relationship between data, information and knowledge leads to mistimed and ineffective policy interventions that do not result in the hoped for progress in science intended to underpin policy advances.
Surgical Technique to Maintain Penile Length After Insertion of an Inflatable Penile Prosthesis via Infrapubic Approach
Authors: Borges Fernando , Hakim Lawrence , Kline Cliff 
Published: February 2006

ABSTRACT

Introduction
The aim of this study was to provide an overview of the principal author's experience in maintaining penile length after implantation of a three-piece inflatable penile prosthesis (IPP). For many patients with erectile dysfunction, who choose surgical treatment, loss of penile length after implantation of an IPP is a common concern. In the principal author's experience, release of the suspensory ligament during IPP implant surgery can maintain penile length, alleviating this concern.

Methods
After implantation with an IPP, the principal author released the patient's suspensory ligament.

Main Outcome Measures
The main outcome measure was patient satisfaction with penile length after IPP surgery. A second outcome measure was a substudy measuring the patient's penile length after IPP implantation both before and after suspensory ligament release.

Results
From August 1997 through September 2002, the principal author implanted a total of 303 Alpha 1 IPPs into men who suffered from erectile dysfunction (ED). All had their suspensory ligament released. Postoperative complications were minimal and for the most part transitory. Ninety-three percent reported satisfaction with IPP performance, penile length, and willingness to undergo the IPP surgery again. None of the patients reported penile shortening, with some of them reporting an increase in penile length, as compared with preoperative measurements.

Conclusion
Release of the suspensory ligament appears to maintain or even increase penile length, with a minimum of complications, and a high degree of patient satisfaction.
Differences Between Candesartan and Hydralazine in the Protection of Penile Structures in Spontaneously Hypertensive Rats
Authors: Mazza Osvaldo Néstor , Angerosa Margarita , Becher Edgardo , Toblli Jorge Eduardo 
Published: February 2006

ABSTRACT

Introduction
Previous studies indicate that angiotensin type I receptor antagonists present a beneficial effect on penile structures in hypertensive rats. However, at present there is no substantial information concerning the functional aspect of this class of antihypertensive drugs.

Aim
To determine, by in vitro studies, functional effects of Candesartan in comparison with a traditional vasodilating agent, Hydralazine, on penile structures in a rat model of arterial hypertension.

Methods
During 4 months, three groups of male spontaneously hypertensive rats (SHR) and one of Wistar–Kyoto (WKY) rats, as control group, were studied: SHR without treatment; SHR with Candesartan cilexetil 7.5 mg/kg/day; SHR with Hydralazine 50 mg/kg/day; and WKY rats without treatment. Cavernous smooth muscle strips were mounted in an organ bath system for in vitro studies. In addition, cavernous smooth muscle and vascular smooth muscle from cavernous arteries, cavernous tissue fibrosis, and collagen type III were also evaluated by immunohistochemistry.

Results
After 4 months, SHR with Candesartan and Hydralazine showed similar reduction in blood pressure compared with untreated SHR. However, in vitro studies revealed that SHR with Candesartan displayed a better relaxation response to acetylcholine than SHR and SHR with Hydralazine (P &lt; 0.01). Immunostaining indicates that only SHR with Candesartan and control WKY rats showed significantly lower values of: (i) cavernous smooth muscle (P &lt; 0.01); (ii) vascular smooth muscle (P &lt; 0.01); and (iii) collagen type III (P &lt; 0.01) when compared with untreated SHR or SHR with Hydralazine. Additionally, SHR with Candesartan presented a higher endothelial nitric oxide synthase expression in sinusoidal endothelium in comparison with SHR, and SHR with Hydralazine (P &lt; 0.01).

Conclusion
Candesartan presented equivalent blood pressure control compared with Hydralazine. However, only Candesartan showed a significant better response to acetylcholine, in in vitro studies, with a protective role against structural changes in vessels as well as in cavernous spaces of the erectile tissue.
Chocolate and Women's Sexual Health: An Intriguing Correlation
Authors: Salonia Andrea , Fabbri Fabio , Zanni Giuseppe , Scavini Marina , Fantini Gemma Viola , Briganti Alberto , Naspro Richard , Parazzini Fabio , Gori Enzo , Rigatti Patrizio , Montorsi Francesco 
Published: February 2006

ABSTRACT

Introduction
Historically chocolate has been reported to exert several effects on human sexuality, mainly acting as an effective aphrodisiac, increasing sexual desire, and improving sexual pleasure.

Aim
The aim of our study was to assess whether there is an association between daily chocolate intake and sexual function in a convenience sample of Northern Italian women.

Methods
A convenience sample of 163 women (mean ± SD age: 35.3 ± 9.2 years; body mass index [BMI]: 22.5 ± 3.5 kg/m2), recruited through advertising, completed an anonymous semistructured interview on recreational habits and questionnaires to assess sexual function (Female Sexual Function Index [FSFI]), sexual distress (Female Sexual Distress Scale), and depression (Beck Depression Inventory and Center for Epidemiological Survey Depression Scale).

Results
Complete data were available for 153/163 (93.8%) women. Participants who reported daily chocolate intake (Group 1: 120 women) were significantly younger than those (Group 2: 33 women) who did not report to eat chocolate (33.9 ± 0.8 years vs. 40.4 ± 1.6 years, respectively) (P = 0.0003), despite a similar BMI. Participants in Group 1 had significantly higher total (P = 0.002) and desire domain (P = 0.01) FSFI scores than participants in Group 2. No differences between the two groups were observed concerning sexual arousal and satisfaction, sexual distress and depression. Our data also confirm that aging has a high statistically significant impact on women's sexual function.

Conclusions
It is alluring to hypothesize that chocolate can have either a psychological or a biological positive impact on women's sexuality. In our sample women reporting chocolate consumption have higher FSFI scores than women who do not eat chocolate. However, when data are adjusted for age FSFI scores are similar, regardless of chocolate consumption.
Influence of intermittent anaerobic exercise on mouse physical endurance and antioxidant components
Authors: Qiao D , Hou L , Liu X 
Published: February 2006

Objective:To determine the effect of intermittent anaerobic exercise on physical endurance, antioxidant capacity, and lipid peroxidation of brain, heart, and skeletal muscles in mice.Methods:Mice were made to perform intermittent (with short or long rest intervals) anaerobic swimming on six consecutive days. Body weight was monitored. Tissue total antioxidant capacity (T-AOC), superoxide dismutase (SOD), and thiobarbituric acid reaction substance (TBARS) were determined on the 2nd, 4th, and 6th day. Physical endurance was determined on day 7 by using an exhaustive swimming test and a static grasping test.Results:The intermittent anaerobic exercise resulted in decreased growth rate and physical endurance capacity, as indicated by less weight gain and shorter time to exhaustion during the exhaustive swimming and static grasping test (p<0.05). It also led to a higher T-AOC in muscle, heart, and brain, higher SOD activity in muscle and heart, and higher TBARS content in muscle (p<0.05). This type of exercise had no effect on brain SOD and TBARS. The changes in T-AOC in brain, muscle, and heart were all more pronounced the longer the experiment continued (p<0.05).Conclusion:Intermittent anaerobic exercise reduced growth and physical endurance and increased tissue antioxidant capacity and lipid peroxidation.
Neuromuscular fatigue and recovery dynamics following prolonged continuous run at anaerobic threshold
Authors: Škof B , Strojnik V 
Published: February 2006

Objective:The aim of this study was to determine the influence of intensive aerobic running on some muscle contractile characteristics and the dynamics of their recovery during a 2 hour period afterwards.Methods:Seven well trained runners performed a 6 km run at anaerobic threshold (VOBLA). Knee torque during single twitch, low and high frequency electrical stimulation (ES), maximum voluntary knee extension, and muscle activation level test of the quadriceps femoris muscles were measured before and immediately after the run, and at several time points during a 120 minute interval that followed the run.Results:After exercise, the mean (SE) maximum twitch torque (TTW) and torque at ES with 20 Hz (low frequency ES; TF20) dropped by 14.1 (5.1)% (p<0.05) and 20.6 (7.9)% (p<0.05) respectively, while torque at stimulation with 100 Hz (high frequency ES; TF100), maximum isometric knee extension torque (maximum voluntary contraction torque; TMVC), and activation level did not change significantly. Twitch contraction time was shortened by 8 (2)% (p<0.05). Ten minutes after the run, TTWwas 40% higher than immediately after the run and 10% (p<0.05) higher than before the run. TF20, TF100, and TMVCremained lower for 60 minutes (p<0.05) than before the run.Conclusions:A 6 km continuous run at VOBLAcaused peripheral fatigue by impairing excitation–contraction coupling. Twitch torque recovered very quickly. However, the process of torque restoration at maximum isometric knee extension torque and at high and low frequency ES took much longer.
Aprotinin in the management of Achilles tendinopathy: a randomised controlled trial
Authors: Brown R , Orchard J , Kinchington M , Hooper A , Nalder G 
Published: February 2006

Background:Achilles tendinopathy is a common condition, which can become chronic and interfere with athletic performance. The proteinase inhibitor aprotinin (as injection) has been found to improve recovery in patellar tendinopathy1 (evidence level 1b2) and Achilles tendinopathy.3 Internationally this therapy is being used based on this limited knowledge base.Aim:To evaluate whether aprotinin injections decrease time to recovery in Achilles tendinopathy.Method:A prospective, randomised, double blind, placebo controlled trial was performed comparing saline (0.9%) plus local anaesthetic injections and eccentric exercises with aprotinin (30 000 kIU) plus local anaesthetic injection and eccentric exercise. Three injections were given, each a week apart. In total, 26 patients, with 33 affected tendons, were enrolled for this study.Results:At no follow up point (2, 4, 12, or 52 weeks) was there any statistically significant difference between the treatment group and placebo. This included VISA-A scores4 and secondary outcome measures. However, a trend for improvement over placebo was noted.Conclusion:In this study on Achilles tendinopathy, aprotinin was not shown to offer any statistically significant benefit over placebo. Larger multicentre trials are needed to evaluate the efficacy of aprotinin in Achilles tendinopathy.
Sodium supplementation is not required to maintain serum sodium concentrations during an Ironman triathlon
Authors: Hew-Butler T D , Sharwood K , Collins M , Speedy D , Noakes T 
Published: February 2006

Context:Critical assessment of recommendations that athletes consume additional sodium during athletic events.Objective:To evaluate if sodium supplementation is necessary to maintain serum sodium concentrations during prolonged endurance activity and prevent the development of hyponatraemia.Design:Prospective randomised trial of athletes receiving sodium (620 mg table salt), placebo (596 mg starch), or no supplementation during a triathlon. The sodium and placebo tablets were taken ad libitum, with the suggested range of 1–4 per hour.Setting:The 2001 Cape Town Ironman triathlon (3.8 km swim, 180 km cycle, 42.2 km run).Subjects:A total of 413 triathletes completing the Ironman race.Main outcome measures:Sodium supplementation was not necessary to maintain serum sodium concentrations in athletes completing an Ironman triathlon nor required to prevent hyponatraemia from occurring in athletes who did not ingest supplemental sodium during the race.Results:Subjects in the sodium supplementation group ingested an additional 3.6 (2.0) g (156 (88) mmol) sodium during the race (all values are mean (SD)). There were no significant differences between the sodium, placebo, and no supplementation groups with regard to age, finishing time, serum sodium concentration before and after the race, weight before the race, weight change during the race, and rectal temperature, systolic and diastolic blood pressure after the race. The sodium supplementation group consumed 14.7 (8.3) tablets, and the placebo group took 15.8 (10.1) tablets (p  =  0.55; NS).Conclusions:Ad libitum sodium supplementation was not necessary to preserve serum sodium concentrations in athletes competing for about 12 hours in an Ironman triathlon. The Institute of Medicine’s recommended daily adequate intake of sodium (1.5 g/65 mmol) seems sufficient for a healthy person without further need to supplement during athletic activity.
Effectiveness of post-match recovery strategies in rugby players: Figure 1
Authors: Gill N D , Beaven C M , Cook C 
Published: February 2006

Objectives:To examine the effectiveness of four interventions on the rate and magnitude of muscle damage recovery, as measured by creatine kinase (CK).Methods:23 elite male rugby players were monitored transdermally before, immediately after, 36 hours after, and 84 hours after competitive rugby matches. Players were randomly assigned to complete one of four post-match strategies: contrast water therapy (CWT), compression garment (GAR), low intensity active exercise (ACT), and passive recovery (PAS).Results:Significant increases in CK activity in transdermal exudate were observed as a result of the rugby match (p<0.01). The magnitude of recovery in the PAS intervention was significantly worse than in the ACT, CWT, and GAR interventions at the 36 and 84 hour time points (p<0.05).Conclusions:An enhanced rate and magnitude of recovery was observed in the ACT, CWT, and GAR treatment groups when compared with the PAS group. Low impact exercise immediately post-competition, wearing compression garments, or carrying out contrast water therapy enhanced CK clearance more than passive recovery in young male athletes.
Video analysis of falls experienced by paediatric iceskaters and roller/inline skaters
Authors: Knox C L , Comstock R D 
Published: February 2006

Objectives:To evaluate differences in the way iceskaters and roller/inline skaters fall.Methods:Children’s falls related to skating were videotaped and categorised based on type of skating activity, child’s estimated age, direction of fall, whether the child attempted to break the fall, and whether the head struck the skating surface.Results:In total, 216 iceskating and 201 roller/inline skating falls were captured on videotape. In both iceskating and roller/inline skating, the majority of falls were forward in direction. The skaters attempted to break the falls with their arms or hands in over 90% of falls in both iceskating (93.1%) and roller/inline skating (94.5%). A greater proportion of falls in iceskating resulted in the head striking the skating surface (13.0%) than did those in roller/inline skating (3.0%) (odds ratio = 4.8; 95% confidence interval 1.9 to 13.3; p<0.001).Conclusions:This study found that paediatric iceskaters and roller/inline skaters fall similarly and that both types of skaters try to break their falls with their arms or hands; however, because iceskating takes place on a low friction surface, attempts to break falls with the arms or hands are often unsuccessful, leading to head and face injuries. The development of a new type of protective gear, a wrist guard with a non-slip palm, should stop iceskaters from striking the head, protect against upper extremity fractures, and unlike a bulky helmet, should not discourage children from skating.
Prognosis and morphometrical features of non-bronchioloalveolar cell adenocarcinoma: an assessment of the non-alveolar replacing area and high grade atypical area
Authors: Tajiri M , Kameda Y , Nakayama H , Sakamoto K 
Published: February 2006

Aim:It has become obvious that the prognosis of bronchioloalveolar cell carcinoma (BAC) in small peripheral adenocarcinoma of the lung is good, but most cases actually treated as pulmonary adenocarcinoma in hospitals tend to be non-bronchioloalveolar cell carcinoma (non-BAC). The prognoses of non-BAC are greatly varied. We studied the relationships between the morphometrical features and the prognoses of non-BAC.Methods:In total, 69 cases of non-BAC measuring ⩽20 mm in diameter across their greatest dimension were evaluated. We considered that the non-alveolar replacing area and the high grade atypical area were related to the prognosis, and therefore defined the ratio of both areas to the total area at the maximum face of the tumours as the non-alveolar replacing area ratio (NAAR) and the high grade atypical area ratio (HAAR), respectively. We thereafter analysed the relationships between both ratios and the prognosis.Results:The NAAR and HAAR were significantly higher in the recurrent cases than in the recurrence free cases. We divided the non-BAC cases at the centre of both ratios into two groups, high and low. The 5 year survival rate of the high NAAR and high HAAR group was 48.3%, while that of the low NAAR and low HAAR group was 72.2%. The groups showing high rates for both ratios had significantly worse prognoses. A multivariate analysis indicated that the HAAR contributes most to the prognosis.Conclusions:These results suggest that the NAAR and HAAR are closely associated with the prognosis of non-BAC.
An unusual case of systemic mastocytosis associated with chronic lymphocytic leukaemia (SM-CLL)
Authors: Horny H-P , Sotlar K , Stellmacher F , Valent P , Grabbe J 
Published: February 2006

Aims:Whereas focal accumulations of reactive lymphocytes around mast cell (MC) infiltrates are often seen in indolent systemic mastocytosis (ISM) involving the bone marrow, an association of systemic mastocytosis (SM) with malignant lymphoma/lymphatic leukaemia is very rare. This report contributes to the differential diagnosis of ISM by demonstrating that such lymphocytic aggregates may be neoplastic.Methods:Biopsy specimens (bone marrow and gastrointestinal mucosa) of a 69 year old woman with mild blood lymphocytosis and a history of urticaria pigmentosa-like skin lesions that had disappeared a few years earlier, were investigated immunohistochemically using antibodies against CD3, CD5, CD20, CD23, CD25, CD34, CD117, chymase, and tryptase. Rearrangements of theIgHandTCRygenes were studied by seminested PCR. Mutation analysis of c-kitwas performed by melting point analysis of nested PCR using amplified DNA from pooled microdissected single cells (MC and B cells) of both sites.Results:The histomorphological features of the bone marrow corresponded to that of ISM with multifocal accumulations of MC surrounded by clusters of lymphocytes of mature appearance. However, these lymphocytes revealed an aberrant immunophenotype with coexpression of CD5, CD20, and CD23, thus enabling the final diagnosis of SM with an associated clonal haematological non-MC lineage disease, in particular SM with associated B cell chronic lymphocytic leukaemia (SM-CLL). Monoclonality for both ISM and B-CLL could be confirmed by demonstrating the typical activatingc-kitpoint mutation D816V in bone marrow MC, and a monoclonal IgH rearrangement in bone marrow B cells.Conclusions:Usually, focal accumulations of lymphocytes around MC infiltrates in the bone marrow of patients with SM are reactive in nature (lymphocytosis). However, a low grade malignant lymphoma should also be included in the differential diagnosis. We describe here the first case, to our knowledge, with synchronous diagnosis of SM and associated B-CLL. This diagnosis could only be established by application of appropriate immunohistochemical and molecular techniques, as the bone marrow histology on first investigation resembled that of typical ISM.