bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinetic Comparison among the Fastball, Curveball, Change-up, and Slider in Collegiate Baseball Pitchers
Authors: Fleisig Glenn S. , Kingsley David S. , Loftice Jeremy W. , Dinnen Kenneth P. , Ranganathan Rajiv , Dun Shouchen , Escamilla Rafael F. , Andrews James R. 
Published: November 2005

Background Controversy exists about whether breaking pitches are more stressful than are fastballs. Previous biomechanical studies compared kinematics but not kinetics. Hypothesis Elbow and shoulder forces and torques are statistically different among the fastball, curveball, change-up, and slider. Study Design Descriptive laboratory study. Methods Twenty-one healthy collegiate pitchers were studied with a high-speed automated digitizing system. All subjects threw fastballs (n = 21), most threw curveballs (n = 20) and change-ups (n = 19), and a few threw sliders (n = 6). Wrist, elbow, and shoulder kinetics were calculated using inverse dynamics. Nine kinetic and 26 kinematic parameters were compared among the different pitch types using repeated-measures analysis of variance. Results At the shoulder, internal rotation torque, horizontal adduction torque, abduction torque, and proximal force were significantly less in the change-up than in the other 3 pitches. Shoulder horizontal adduction torque was greater in the fastball than in the curveball and slider. Shoulder proximal force was greater in the slider than in the curveball. Elbow proximal force was less in the change-up than in the other 3 pitches. Elbow varus torque was greater in the fastball and curveball than in the changeup. Elbow flexion torque was greater in the curveball than in the change-up. The curveball and change-up demonstrated kinematic differences from the fastball, consistent with previous studies. Conclusion There were significant kinematic differences between the fastball and curveball but few kinetic differences. The change-up had lower joint kinetics, lower angular velocities, and different body positions than the other 3 pitch types had. Results for the slider were inconclusive because of small sample size. Clinical Relevance Because the resultant joint loads were similar between the fastball and curveball, this study did not indicate that either pitch was more stressful or potentially dangerous for a collegiate pitcher. The low kinetics in the change-up implies that it is the safest.
The Relationship between Quadriceps Muscle Force, Knee Flexion, and Anterior Cruciate Ligament Strain in an in Vitro Simulated Jump Landing
Authors: Withrow Thomas J. , Huston Laura J. , Wojtys Edward M. , Ashton-Miller James A. 
Published: November 2005

Background An instrumented cadaveric knee construct was used to quantify the association between impact force, quadriceps force, knee flexion angle, and anterior cruciate ligament relative strain in simulated unipedal jump landings. Hypothesis Anterior cruciate ligament strain will correlate with impact force, quadriceps force, and knee flexion angle. Study Design Descriptive laboratory study. Methods Eleven cadaveric knees (age, 70.8 [19.3] years; 5 male; 6 female) were mounted in a custom fixture with the tibia and femur secured to a triaxial load cell. Quadriceps, hamstring, and gastrocnemius muscle forces were simulated using pretensioned steel cables (stiffness, 7 kN/cm), and the quadriceps tendon force was measured using a load cell. Mean strain on the anteromedial bundle of the anterior cruciate ligament was measured using a DVRT. With the knee in 25° of flexion, the construct was vertically loaded by an impact force initially directed 4 cm posterior to the knee joint center. Tibiofemoral kinematics was measured using a 3D optoelectronic tracking system. Results The increase in anterior cruciate ligament relative strain was proportional to the increase in quadriceps force (r2 = 0.74; P <. 00001) and knee flexion angle (r2 = 0.88; P <. 00001) but was not correlated with the impact force (r2 = 0.009; P =. 08). Conclusion The increase in knee flexion and quadriceps force during this simulated 1-footed landing strongly influenced the relative strain on the anteromedial bundle of the anterior cruciate ligament. Clinical Relevance These results suggest that even in the presence of knee flexor muscle forces, the increase in quadriceps force required to prevent the knee from flexing during landing can place the anterior cruciate ligament at risk for large strains.
Efficacy of thrombolytic agents in the treatment of pulmonary embolism
Authors: Capstick T. , Henry M. T. 
Published: November 2005

Recent guidelines recommend bolus-dose alteplase for treating massive pulmonary embolism (PE). However, the safest and most effective treatment is as yet unknown.In the present study, a meta-analysis of published studies of alteplase infusion, bolus-dose alteplase and streptokinase was performed. The outcome measures were as follows: objective assessment of thrombolysis; all-cause mortality; deaths due to initial PE, major bleeding episodes and recurrent PE; and morbidity.In total, 26 studies were identified; however, only two comparative studies of alteplase infusionversuseither bolus-dose alteplase or streptokinase were found. Meta-analysis revealed no significant difference between the three regimens, but was compromised by a paucity of data. Crude analysis of summated data on thrombolytic efficacy from all studies revealed that alteplase infusion was more effective than bolus-dose alteplase (relative risk (RR): 1.95; 95% confidence interval (CI): 1.19–3.2), whereas streptokinase was more effective than alteplase infusion (RR: 1.27; 95% CI: 1.09–1.47). Alteplase infusion had a lower mortality due to the initial PE than both bolus-dose alteplase and streptokinase (RR: 0.16; 95% CI: 0.05–0.59 and RR: 0.13; 95% CI: 0.04–0.46, respectively).In conclusion, this evidence suggests that the three thrombolytic agents may vary in efficacy. However, large-scale randomised controlled trials are needed to confirm these results.
α1-Antitrypsin deficiency and lung disease: risk modification by occupational and environmental inhalants
Authors: Senn O. , Russi E. W. , Imboden M. , Probst-Hensch N. M. 
Published: November 2005

Chronic obstructive pulmonary disease (COPD) is a prevalent and preventable disease associated with high morbidity and mortality. Severe and intermediate α1-antitrypsin (AAT) deficiency (serum levels <11 and 11–20 µmol·L−1, respectively) increase the risk of COPD in active smokers. However, little is known about the interaction of severe and intermediate AAT deficiency with modifiable COPD risk factors other than active smoking.In this study, a MEDLINE search was carried out for studies investigating the combined effect of environmental inhalants (occupation and passive smoking) and AAT deficiency in the lung. A total of 18 studies using established methods for the assessment of AAT deficiency were included in this review.Occupational exposures and passive smoking affected lung function decline or prevalence of respiratory symptoms in four out of five studies investigating subjects with severe AAT deficiency, and in eight out of 13 studies with a focus on intermediate AAT deficiency. While study designs mostly prohibited formal assessment of effect modification, an interaction between intermediate AAT deficiency and passive smoking was identified in two studies with children. Additional study limitations included small sample size, poor adjustment for confounding and misclassification of environmental exposure as well as AAT activity.In conclusion, population-based epidemiological studies with associated biobanks are needed to identify gene–environment interactions and population subgroups susceptible to α1-antitrypsin deficiency.
Budesonide/formoterol maintenance and reliever therapy: an effective asthma treatment option?
Authors: Vogelmeier C. , D'Urzo A. , Pauwels† R. , Merino J. M. , Jaspal M. , Boutet S. , Naya I. , Price D. 
Published: November 2005

This 12-month dose-titration study assessed the effectiveness of budesonide/formoterol for maintenance plus relief with a control group using salmeterol/fluticasone for maintenance plus salbutamol for relief.Adolescents and adults (n = 2,143; mean forced expiratory volume in one second (FEV1) 73% predicted; mean inhaled corticosteroid (ICS) 884 µg·day−1) were randomised to budesonide/formoterol 160/4.5 µg two inhalationsb.i.d.plus additional inhalations as needed, or salmeterol/fluticasone 50/250 µgb.i.d.plus salbutamol as needed. Treatment was prescribed open label; after 4 weeks, physicians could titrate maintenance doses in accordance with normal clinical practice.Maintenance plus as-needed budesonide/formoterol prolonged the time to first severe exacerbationversussalmeterol/fluticasone (25% risk reduction). The total number of severe exacerbations was significantly reduced in the budesonide/formoterol group (255versus329). Both regimens provided sustained improvements in symptoms, as-needed use, quality of life and FEV1, with differences in favour of the budesonide/formoterol group for as-needed use (0.58versus0.93 inhalations·day−1) and FEV1(post-β2-agonist values). Mean ICS dose during treatment was similar in both groups (653 µg budesonide·day−1(maintenance plus as-needed)versus583 µg fluticasone·day−1).The simplified strategy using budesonide/formoterol for maintenance and reliever therapy is feasible, safe and at least as effective as salmeterol/fluticasone plus salbutamol.
Use of continuous positive airway pressure during flexible bronchoscopy in young children
Authors: Trachsel D. , Erb T. O. , Frei F. J. , Hammer J. 
Published: November 2005

Young children are at increased risk for hypoxaemia and hypercapnia during flexible bronchoscopy due to the small size and increased collapsibility of their airways. Various strategies are used to prevent hypoventilation and to provide oxygen during the procedure. The aim of this study was to assess the impact of continuous positive airway pressure (CPAP) on ventilation during flexible bronchoscopy in infants and young children.Tidal breathing was measured in 16 spontaneously breathing and deeply sedated children, aged 3–25 months, by ultrasound spirometryviaan airway endoscopy mask. Measurements were made with the tip of the bronchoscope positioned in the pharynx with no CPAP, and in mid-trachea with 0, 5 and 10 cmH2O of CPAP.Transition of the bronchoscope through the vocal cords was associated with significant decreases of tidal volumes (5.0±0.5versus3.4±0.5 mL·kg−1), peak tidal expiratory flows (78±12versus52±10 mL·s−1) and peak tidal inspiratory flows (98±15versus66±12 mL·kg−1). CPAP (5–10 cmH2O) induced almost complete reversal of these changes.In conclusion, it is shown here that flexible bronchoscopy in spontaneously breathing young children is associated with significant decreases in tidal volume and respiratory flow. These changes are largely reversible with continuous positive airway pressure.
Risk factors of frequent exacerbations in difficult-to-treat asthma
Authors: ten Brinke A. , Sterk P. J. , Masclee A. A. M. , Spinhoven P. , Schmidt J. T. , Zwinderman A. H. , Rabe K. F. , Bel E. H. 
Published: November 2005

Recurrent exacerbations are a major cause of morbidity and medical expenditure in patients with asthma. Various exogenous and endogenous factors are thought to influence the level of asthma control, but systematical data on the involvement of these factors in the recurrence of asthma exacerbations are scarce.In this study, 13 clinical and environmental factors potentially associated with recurrent exacerbations were investigated in 136 patients with difficult-to-treat asthma. Patients with more than three severe exacerbations (n = 39) in the previous year were compared with those with only one exacerbation per year (n = 24). A systematic diagnostic protocol was used to assess 13 potential risk factors.Factors significantly associated with frequent exacerbations included: severe nasal sinus disease (adjusted odds ratio (OR) 3.7); gastro-oesophageal reflux (OR 4.9); recurrent respiratory infections (OR 6.9); psychological dysfunctioning (OR 10.8); and obstructive sleep apnoea (OR 3.4). Severe chronic sinus disease and psychological dysfunctioning were the only independently associated factors (adjusted OR 5.5 and 11.7, respectively). All patients with frequent exacerbations exhibited at least one of these five factors, whilst 52% showed three or more factors.In conclusion, the results show that recurrent exacerbations in asthma are associated with specific co-morbid factors that are easy to detect and that are treatable. Therapeutic interventions aimed at correcting these factors are likely to reduce morbidity and medical expenditure in these patients.
Airway narrowing in porcine bronchi with and without lung parenchyma
Authors: Noble P. B. , Sharma A. , McFawn P. K. , Mitchell H. W. 
Published: November 2005

During bronchoconstriction elastic after-loads arise due to distortion of lung parenchyma by the narrowing airway. In the present study, the functional effect of parenchymal elastic after-load on airway narrowing was determined.Airway narrowing was measuredin vivoover a range of transpulmonary pressures and compared within vitronarrowing measured at corresponding transmural pressures. Bronchi were generation 10 with internal diameters of ∼4 mm.In vivoluminal narrowing was measured by videobronchoscopy in anaesthetised and ventilated pigs.In vitroluminal narrowing was measured by videoendoscopy in isolated bronchial segments. Airways were activated by maximum vagal nerve stimulation and maximum electrical field stimulationin vivoandin vitro, respectively.At 5 cmH2O, stimulation produced a 35.9±3.2% (n = 6) and a 36.5±2.4% (n = 11) decrease in lumen diameterin vivoandin vitro, respectively. At 30 cmH2O, luminal narrowing fell to 23.7±2.0%in vivoand 23.4±2.5%in vitro. There was no difference between luminal narrowingin vivoandin vitroat any pressure.In conclusion, these findings suggest that in mid-sized, cartilaginous bronchi, parenchymal elastic after-loads do not restrict airway narrowing.
Goal-oriented treatment and combination therapy for pulmonary arterial hypertension
Authors: Hoeper M. M. , Markevych I. , Spiekerkoetter E. , Welte T. , Niedermeyer J. 
Published: November 2005

Combination therapy may improve outcome in patients with severe pulmonary arterial hypertension (PAH).PAH patients were treated according to a goal-oriented therapeutic strategy. Patients who did not reach the treatment goals with monotherapy received combination treatment according to a predefined strategy, including bosentan, sildenafil and inhaled iloprost. Intravenous iloprost and lung transplantation were reserved for treatment failures. End points were overall survival, transplantation-free survival, and survival free from transplantation and intravenous prostanoid treatment.Between January 2002 and December 2004, 123 consecutive patients with PAH were treated according to the novel approach. Survival at 1, 2 and 3 yrs was 93.0, 83.1 and 79.9%, respectively, which was significantly better than the survival of a historical control group, as well as the expected survival. Compared to the historical control group, the use of combination treatment also significantly improved the combined end point of death, lung transplantation and need for intravenous iloprost treatment.In conclusion, a therapeutic approach utilising combinations of bosentan, sildenafil and inhaled iloprost in conjunction with a goal-oriented treatment strategy provides acceptable long-term results in patients with severe pulmonary arterial hypertension, and reduces the need for intravenous prostaglandin treatment and lung transplantation.
A genome-wide survey of Major Histocompatibility Complex (MHC) genes and their paralogues in zebrafish
Authors: Sambrook Jennifer G , Figueroa Felipe , Beck Stephan 
Published: November 2005

AbstractBackgroundThe genomic organisation of the Major Histocompatibility Complex (MHC) varies greatly between different vertebrates. In mammals, the classical MHC consists of a large number of linked genes (e.g. greater than 200 in humans) with predominantly immune function. In some birds, it consists of only a small number of linked MHC core genes (e.g. smaller than 20 in chickens) forming a minimal essential MHC and, in fish, the MHC consists of a so far unknown number of genes including non-linked MHC core genes. Here we report a survey of MHC genes and their paralogues in the zebrafish genome.ResultsUsing sequence similarity searches against the zebrafish draft genome assembly (Zv4, September 2004), 149 putative MHC gene loci and their paralogues have been identified. Of these, 41 map to chromosome 19 while the remaining loci are spread across essentially all chromosomes. Despite the fragmentation, a set of MHC core genes involved in peptide transport, loading and presentation are still found in a single linkage group.ConclusionThe results extend the linkage information of MHC core genes on zebrafish chromosome 19 and show the distribution of the remaining MHC genes and their paralogues to be genome-wide. Although based on a draft genome assembly, this survey demonstrates an essentially fragmented MHC in zebrafish.
Epidural abscess caused by Streptococcus milleri in a pregnant woman
Authors: Lampen Russell , Bearman Gonzalo 
Published: November 2005

Abstract

Background
Bacteria in the Streptococcus milleri group (S. anginosus, S. constellatus, and S. intermedius) are associated with bacteremia and abscess formation. While most reports of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions, SMG infections during pregnancy have been documented. However, SMG infections in pregnant women are associated with either neonatal or maternal puerperal sepsis. Albeit rare, S. milleri spinal-epidural abscess in pregnancy has been reported, always as a complication of spinal-epidural anesthesia. We report a case of spinal-epidural abscess caused by SMG in a young, pregnant woman without an antecedent history of spinal epidural anesthesia and without any underlying risk factors for invasive streptococcal disease.

Case presentation
A 25 year old pregnant woman developed neurological symptoms consistent with spinal cord compression at 20 weeks gestation. She underwent emergency laminectomy for decompression and was treated with ceftriaxone 2 gm IV daily for 28 days. She was ambulatory at the time of discharge from the inpatient rehabilitation unit with residual lower extremity weakness.

Conclusion
To our knowledge, this is the first reported case of a Streptococcus milleri epidural abscess in a healthy, pregnant woman with no history of epidural anesthesia or invasive procedures. This report adds to the body of literature on SMG invasive infections. Treatment of SMG spinal-epidural abscess with neurologic manifestations should include prompt and aggressive surgical decompression coupled with targeted anti-infective therapy.
Disseminated tuberculosis presenting with finger swelling in a patient with tuberculous osteomyelitis: a case report
Authors: Agarwal Shradha , Caplivski Daniel , Bottone Edward J 
Published: November 2005

Abstract

Background
Extrapulmonary manifestations of tuberculosis have become increasingly important in the era of HIV/AIDS.

Case presentation
We describe a case of tuberculosis (TB) dactylitis in a patient with AIDS who originated from the Ivory Coast. The diagnosis was established by direct visualization of acid-fast bacilli on joint fluid and bone biopsy of the proximal phalanx. Imaging of the chest revealed multiple bilateral nodules. Confirmation of the diagnosis was made by isolation of Mycobacterium tuberculosis from sputum and bone cultures.

Conclusion
Tuberculosis should be considered in patients with unusual soft tissue or skeletal lesions, especially when an immunosuppressive condition is present. Ziehl-Neelsen staining and culture of tissue obtained via surgical biopsy offer the most direct approach to diagnosis.
Psychiatric problems of detainees under the Anti-Terrorism Crime and Security Act 2001
Authors: Robbins Ian , MacKeith James , Davison Sophie , Kopelman Michael , Meux Clive , Ratnam Sumi , Somekh David , Taylor Richard 
Published: November 2005

Aims and MethodTo provide a composite view of the impact of indefinite detention under the Anti-Terrorism Crime and Security Act 2001. Until recently, a number of detainees had been detained under this legislation since December 2001. The impact of this on eight detainees and three of their spouses is examined through qualitative analysis of 48 reports and documents compiled by 11 psychiatrists and 1 psychologist.ResultsDetention has had a severe adverse impact on the mental health of all detainees and the spouses interviewed. All were clinically depressed and a number had post-traumatic stress disorder. The indefinite nature of detention was a major factor in their deterioration.Clinical ImplicationsThe use of indefinite detention without trial has severe adverse consequences that may pose insurmountable problems for the prison healthcare system.
Assessing risk and emotional disturbance using the CORE–OM and HoNOS outcome measures at the interface between primary and secondary mental healthcare
Authors: Leach Chris , Lucock Mike , Barkham Michael , Noble Rachael , Clarke Linda , Iveson Steve 
Published: November 2005

Aims and MethodThere is interest in how outcome measures routinely used in mental health settings compare with each other in assessing risk and emotional disturbance. The relation between the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE–OM), a client-completed measure, and the Health of the Nation Outcome Scale (HoNOS), a clinician-completed measure, was explored using data from 297 clients referred to secondary services by a primary care mental health liaison team.ResultsThe correlation between CORE–OM and HoNOS was 0.50, with cluster and factor analyses revealing overlap between the measures in assessing risk to self and others and general emotional issues.Clinical ImplicationsAlthough the measures are typically used in different settings, the overlap suggests that both might be useful in any setting where assessment for mental health problems and risk is needed.