bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of an asthma questionnaire for use in healthcare workers
Authors: Delclos G L , Arif A A , Aday L , Carson A , Lai D , Lusk C , Stock T , Symanski E , Whitehead L W , Benavides F G , Antó J M 
Published: February 2006

Background:Previous studies have described increased occurrence of asthma among healthcare workers, but to our knowledge there are no validated survey questionnaires with which to study this occupational group.Aims:To develop, validate, and refine a new survey instrument on asthma for use in epidemiological studies of healthcare workers.Methods:An initial draft questionnaire, designed by a multidisciplinary team, used previously validated questions where possible; the occupational exposure section was developed by updating health services specific chemical lists through hospital walk-through surveys and review of material safety data sheets. A cross-sectional validation study was conducted in 118 non-smoking subjects, who also underwent bronchial challenge testing, an interview with an industrial hygienist, and measurement of specific IgE antibodies to common aeroallergens.Results:The final version consisted of 43 main questions in four sections. Time to completion of the questionnaire ranged from 13 to 25 minutes. Test–retest reliability of asthma and allergy items ranged from 75% to 94%, and internal consistency for these items was excellent (Cronbach’s α ⩾ 0.86). Against methacholine challenge, an eight item combination of asthma related symptoms had a sensitivity of 71% and specificity of 70%; against a physician diagnosis of asthma, this same combination showed a sensitivity of 79% and specificity of 98%. Agreement between self-reported exposures and industrial hygienist review was similar to previous studies and only moderate, indicating the need to incorporate more reliable methods of exposure assessment. Against the aerollergen panel, the best combinations of sensitivity and specificity were obtained for a history of allergies to dust, dust mite, and animals.Conclusions:Initial evaluation of this new questionnaire indicates good validity and reliability, and further field testing and cross-validation in a larger healthcare worker population is in progress. The need for development of more reliable occupational exposure assessment methods that go beyond self-report is underscored.
Predictors of leaving nursing care: a longitudinal study among Swedish nursing personnel
Authors: Fochsen G , Josephson M , Hagberg M , Toomingas A , Lagerström M 
Published: February 2006

Objectives:Despite extensive research on turnover among nursing personnel very little is known about the impact of physical workload and health on leaving. The aim of this study was to find predictors for leaving nursing care with special reference to physical working conditions and musculoskeletal problems.Methods:This study is based on longitudinal data from a survey of nursing personnel who were employed at various county hospitals in Sweden from 1992–95. A self administrated follow up questionnaire was used to identify their present position in the labour market. The response rate was 73% (n = 1095).Results:The results showed that nursing personnel reporting musculoskeletal problems of the neck/shoulder or knees and those who had limited use of transfer devices were more likely to leave nursing care.Conclusions:The study highlights the importance of taking musculoskeletal problems and use of transfer devices into consideration in order to retain nursing personnel.
HIV-1 STRATEGIES OF IMMUNE EVASION
Authors: CASTIGLIONE F. , BERNASCHI M. 
Published: February 2006

We simulate the progression of the HIV-1 infection in untreated host organisms. The phenotype features of the virus are represented by the replication rate, the probability of activating the transcription, the mutation rate and the capacity to stimulate an immune response (the so-called immunogenicity). It is very difficult to study in-vivo or in-vitro how these characteristics of the virus influence the evolution of the disease. Therefore we resorted to simulations based on a computer model validated in previous studies. We observe, by means of computer experiments, that the virus continuously evolves under the selective pressure of an immune response whose effectiveness downgrades along with the disease progression. The results of the simulations show that immunogenicity is the most important factor in determining the rate of disease progression but, by itself, it is not sufficient to drive the disease to a conclusion in all cases.
Adequacy of Medical Chart Review to Characterize Emergency Care for Asthma: Findings from the Illinois Emergency Department Asthma Collaborative
Authors: McDermott Michael F. , Lenhardt Richard O. , Catrambone Catherine D. , Walter James , Weiss Kevin B. 
Published: February 2006

Objectives:
To assess the intermethod reliability of medical chart review compared with directly observed care in patients presenting to emergency departments (EDs) for asthma care.
Methods:
ED care practices for persons with asthma were evaluated by comparing chart review with trained observers. Fifty‐one patients from five EDs participating in the Illinois Emergency Department Asthma Collaborative were studied. Practices in assessment, treatment, education, and referral were measured. Eighteen elements of care were assessed. Concordance between chart and observation was measured by using the kappa statistic.
Results:
Of 51 subjects studied, nine were children. Kappa values varied depending on content. Kappa values ranged from 0.22 to 0.91 for items reflecting asthma assessment. Good concordances (κ= 0.50 to 0.82) were found for items reflecting treatment practices. The lowest concordances were for items assessing educational activities (κ= 0.04 to 0.34). Referral practices had fair to moderate concordances (κ= 0.21 to 0.45).
Conclusions:
Intermethod reliability of medical chart review and directly observed care varied depending on the element of care being measured. The use of chart review to measure quality of ED‐based asthma care may only be appropriate for a limited number of care processes that are reliably and validly captured from chart review.
Interobserver Agreement for the Diagnosis of Venous Thromboembolism on Computed Tomography Chest Angiography and Indirect Venography of the Lower Extremities in Emergency Department Patients
Authors: Richman Peter B. , Dominguez Shari , Kasper David , Chen Frederick , Friese Jeremy , Wood Joseph , Collins Joseph , Kline Jeffrey A. 
Published: February 2006

Objectives:
To determine interobserver agreement between radiologists for computed tomography (CT) angiography and venography. CT venography of the lower extremities combined with standard CT angiography of the chest may result in an increased overall diagnosis rate of venous thromboembolism (pulmonary embolism or deep venous thrombosis).
Methods:
The study had a retrospective cohort design. The population consisted of emergency department patients who were evaluated for suspected pulmonary embolism. A random sample of 50 patients diagnosed and treated for venous thromboembolism and 50 age‐ and gender‐matched patients whose CT angiograms and venograms were read as negative were enrolled. The original reading (R1) was compared with readings of two study radiologists: R2, a general radiologist, and R3, a radiologist with fellowship training in cross‐sectional imaging. All readers were blinded to each other.
Results:
Both R2 and R3 found both CT angiogram and venogram components technically adequate in 95% (95% CI = 89% to 98%) and 86% (95% CI = 78% to 92%) of studies, respectively. The agreement was very good for CT angiography (lowest agreement = 92%; lowest κ= 0.83) and was good for CT venography (85%, κ= 0.65). In nine cases, R1 read the CT angiogram as negative but the venogram as positive for DVT, whereas both R2 and R3 read both components as negative in four of these nine, suggesting a false‐positive isolated DVT rate of 44% (95% CI = 19% to 73%). In no case did R1 read both scan components as negative when R2 and R3 agreed on presence of pulmonary embolism or DVT.
Conclusions:
Diagnosis of pulmonary embolism on CT angiography is more reliable than diagnosis of isolated DVT on CT venography.
Depression among Emergency Medicine Residents over an Academic Year
Authors: Katz Eric D. , Sharp Lydia , Ferguson Edward 
Published: February 2006

Objectives:
To describe the frequency of depression among emergency medicine (EM) residents by month, gender, rotation type, postgraduate year (PGY), and number of hours worked.
Methods:
This was a prospective, nonblinded, cohort study of consenting EM residents in a four‐year, 51‐resident EM residency program from July 2003 to June 2004. Participants received an anonymous monthly survey via Web site that consisted of the Center for Epidemiologic Studies Depression Scale (CESD) and the resident's gender, PGY, number of hours worked in the previous week (≤40, 41–60, 61–80 and >80), and rotation type (EM, intensive care unit, non‐EM clinical, or other). Residents were excluded from analysis if they did not complete at least one survey during each season. For each resident, the peak score for each three‐month period was recorded and analyzed with a mixed‐model analysis of variance to account for a repeated‐measures effect.
Results:
Fifty of 51 (98.0%) residents consented for participation. Nineteen (38%) were excluded because of incomplete data. The prevalence of depression was 12.1% (95% confidence interval [95% CI] = 7.5% to 19.0%; 15 of 124 scores). The women had numerically, but not statistically, significantly lower mean ± standard deviation CESD scores than the men (6.4 ± 6.8 vs. 8.7 ± 8.6, p = 1.0). There was no significant difference in mean CESD score by month, PGY, rotation type, or number of hours worked.
Conclusions:
Season, number of hours worked, rotation type, PGY, and gender all failed to predict depression among EM residents in this single‐center trial. The prevalence of depression was comparable to that of the general population.
How Well are Cardiopulmonary Resuscitation and Automated External Defibrillator Skills Retained over Time? Results from the Public Access Defibrillation (PAD) Trial
Authors: Riegel Barbara , Nafziger Sarah D. , McBurnie Mary Ann , Powell Judy , Ledingham Robert , Sehra Ruchir , Mango LynnMarie , Henry Mark C. 
Published: February 2006

Background:
The current standard for cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) retraining for laypersons is a four‐hour course every two years. Others have documented substantial skill deterioration during this time period.
Objectives:
To evaluate 1) the retention of core CPR and AED skills among volunteer laypersons and 2) the time required to retrain laypersons to proficiency as a function of time since initial training.
Methods:
This was an observational follow‐up study evaluating CPR and AED skill retention and testing/retraining time up through 17 months after initial training. The study took place at 1,260 facilities recruited by 24 North American clinical research centers, and included 6,182 volunteer laypersons participating in the Public Access Defibrillation (PAD) Trial. Training to proficiency in either CPR only (N= 2,426) or CPR+AED (N= 3,756) was followed by testing/retraining provided three to 17 months later. Retraining was done in brief, one‐on‐one, individualized, interactive sessions. The outcome studied was instructors' global assessments of performance of CPR and AED skill adequacy, i.e., whether CPR actions would likely result in perfusion (yes/no) and whether AED actions would result in a shock through the heart (yes/no).
Results:
For global CPR performance, 79%, 73%, and 71% of volunteers tested for the first time since initial training three to five, six to 11, and 12 to 17 months after initial training, respectively, were judged by their instructors as having adequate performance (p < 0.001, chi‐square for linear trend). For global AED performance, 91%, 86%, and 84% of volunteers, respectively, were judged as having adequate performance (p < 0.001). The mean (± standard deviation) times required to test and retrain volunteers to proficiency were 5.7 (± 4.0) minutes for CPR skills and 7.7 (± 4.6) minutes for CPR+AED skills.
Conclusions:
Among PAD Trial volunteer laypersons participating in a simulated resuscitation, the proportions of volunteers judged by instructors to have adequate CPR and AED skills demonstrated small declines associated with longer intervals between initial training and subsequent testing. However, based on instructors' judgment, large majorities of volunteers still retained both CPR and AED core skills through 17 months after initial training. Furthermore, individual testing and retraining for CPR and AED skills were usually accomplished in less than 10 minutes per volunteer. Additional research is essential to identify training and evaluation techniques that predict adequate CPR and AED skill performance of laypersons when applied to an actual cardiac arrest.
Methods to assess drug permeability across the blood-brain barrier
Authors: Nicolazzo Joseph A , Charman Susan A , Charman William N 
Published: February 2006

AbstractMuch research has focussed on the development of novel therapeutic agents to target various central nervous system disorders, however less attention has been given to determining the potential of such agents to permeate the blood-brain barrier (BBB), a factor that will ultimately govern the effectiveness of these agents in man. In order to assess the potential for novel compounds to permeate the BBB, various in-vitro, in-vivo and in-silico methods may be employed. Although in-vitro models (such as primary cell culture and immortalized cell lines) are useful as a screening method and can appropriately rank compounds in order of BBB permeability, they often correlate poorly to in-vivo brain uptake due to down-regulation of some BBB-specific transporters. In-vivo models (such as the internal carotid artery single injection or perfusion, intravenous bolus injection, brain efflux index and intracerebral microdialysis) provide more accurate information regarding brain uptake, and these can be complemented with novel imaging techniques (such as magnetic resonance imaging and positron emission tomography), although such methods are not suited to high-throughput permeability assessment. This paper reviews current methods used for assessing BBB permeability and highlights the particular advantages and disadvantages associated with each method, with a particular focus on methods suitable for moderate- to high-throughput screening.
In-vitro and in-vivo evaluation of oligoethylene esters as dermal prodrugs of 18β-glycyrrhetic acid
Authors: Puglia Carmelo , Bonina Francesco , Ostacolo Carmine , Sacchi Antonia , Laneri Sonia 
Published: February 2006

Abstract
Novel polyoxyethylene esters of 18 β-glycyrrhetic acid (GA) were synthesized and evaluated as potential dermal prodrugs. The permeation of these prodrugs (1a-e) was studied in-vitro, using excised human skin membranes (SCE; stratum corneum/epidermis) mounted in Franz type cells, and in-vivo, evaluating the ability of these compounds to inhibit methyl nicotinate (MN)-induced skin erythema in healthy human subjects. All the esters synthesized showed a good water stability, while the enzymatic hydrolysis rate was significantly affected by the length of the polyoxyethylenic chain used as promoiety. In in-vitro percutaneous absorption studies, only esters 1b and 1c (respectively triethylen- and tetraethylenglycol derivatives) showed an increased flux through SCE membranes compared with GA. Furthermore, we observed an appreciable and sustained in-vivo topical anti-inflammatory activity of esters 1b and 1c compared with the parent drug.
Development and characterization of emulsomes for sustained and targeted delivery of an antiviral agent to liver
Authors: Vyas S P , Subhedar Rasika , Jain Sanyog 
Published: February 2006

Abstract
In this study we developed emulsomes, a novel lipoidal vesicular system with an internal solid fat core surrounded by a phospholipid bilayer. Plain emulsomal formulations composed of solid lipid (trilaurin or tristearin), cholesterol and soya phosphatidylcholine and stearylamine containing cationic emulsomes loaded with an antiviral drug (zidovudine) were prepared by a simple cast film method followed by sonication to produce emulsomes of nanometric size range. All different types of formulations were optimized for lipid ratios and characterized in-vitro for shape, morphology, size and in-vitro drug release profile. Emulsomal formulations displayed a sufficiently slow drug release profile (12–15% after 24 h). In-vivo organ distribution studies in rats demonstrated better uptake of emulsomal formulations by the liver cells. Further, a significantly higher (P &lt; 0.05) liver concentration of drug was estimated over a period of 24 h for cationic emulsomes than for plain neutral emulsomes. We concluded that cationic emulsomes could fuse with the endosomal membrane due to charge-charge interaction and were released in the cytoplasm before lysosomal degradation and could sustain drug release over a prolonged period. The proposed cationic emulsome-based system showed excellent potential for intracellular hepatic targeting and the strategy could play a vital role in the effective treatment of life-threatening viral infections, such as hepatitis, HIV and Epstein-Barr virus infection.
Anti-cancer effect of celecoxib and aerosolized docetaxel against human non-small cell lung cancer cell line, A549
Authors: Fulzele Suniket V , Shaik Madhu Sudhan , Chatterjee Abhijit , Singh M 
Published: February 2006

Abstract
Direct delivery of chemotherapeutic agents to the lung can increase both the drug concentration and exposure period to lung tumours. The objective of this study was to formulate docetaxel (DOC) into a metered dose inhaler (MDI), assess its aerodynamic characteristics and to evaluate the effect of celecoxib (CXB), a cyclooxygenase-2 (COX-2) inhibitor, on the in-vitro cytotoxicity and apoptotic response of aerosolized DOC against human lung adenocarcinoma cell line A549. A stable solution-type MDI formulation was developed with 0.25% DOC and 15% w/w ethyl alcohol using HFA 134a propellant. The formulation was evaluated for medication delivery, mass median aerodynamic diameter (MMAD), geometric standard deviation (GSD), percent throat deposition, respirable mass and respirable fraction. A six-stage viable impactor was used to assess the in-vitro cytotoxicity of DOC-MDI alone or in combination with CXB. Induction of apoptosis in A549 cells by DOC (non-aerosolized and aerosolized) in combination with CXB was evaluated by established techniques, such as caspase-3 estimation and terminal deoxynucleotidyl transferase-mediated nick end labelling (TUNEL) staining. The influence of different treatments on the expression of COX-2 and peroxisome proliferator-activated receptor-γ (PPAR-γ) in A549 cells was studied by RT-PCR. The DOC-MDI formulation had a MMAD of 1.58 μm, (GSD = 3.2) and a medication delivery of 80 μg/shot. DOC-MDI (one shot) in combination with CXB (10 μg mL−1) had a cell kill of more than 80% as determined by in-vitro cytotoxicity assay. The specific caspase-3 activity in A549 cells treated with DOC (0.01 μg mL−1) and CXB (10.0 μg mL−1) combination was 4 times higher than CXB and untreated control group, respectively. Further, TUNEL staining showed significant apoptosis of A549 cells treated with aerosolized DOC alone or in combination with CXB when compared with CXB and untreated cells. The RT-PCR experiments showed similar expression of COX-2 in both control and treated groups. PPAR-γ expression was increased in the combination treatment (0.01 μg mL−1 DOC and 10 μg mL−1 CXB) as compared with control (untreated), DOC (0.01 μg mL−1) and CXB (10 μg mL−1) treatments. Our results indicate the potential of inhalation delivery of DOC in the treatment of lung cancer.
Novel depots of buprenorphine have a long-acting effect for the management of physical dependence to morphine
Authors: Kuel Chun-Hsiung , Liu Kuo-Sheng , Kao Cheng-Hsiung , Liu Shyun-Yeu , Wang Jhi-Joung , Sung K C 
Published: February 2006

Abstract
Buprenorphine is a promising new pharmacotherapy for the management of physical dependence to opioids. The aim of the study was to evaluate the duration of action of several novel depots of buprenorphine in the treatment of physical dependence to morphine in mice. Following intramuscular injection, the duration of action of several novel oil-based depots of buprenorphine base in morphine-dependent mice were evaluated. The traditional dosage form of buprenorphine hydrochloride in saline was used as control. We found that the depot of buprenorphine base in sesame oil produced a dose-related long-lasting effect. On an equimolar basis of 6 μmol kg−1, its effect was 5.7-fold longer than that of buprenorphine hydrochloride in saline. When prepared in several other oleaginous vehicles (castor oil, cottonseed oil, peanut oil and soybean oil), buprenorphine base also produced a long-lasting effect, which was similar to buprenorphine base in sesame oil. In conclusion, buprenorphine base, when prepared in oleaginous vehicles and injected intramuscularly in mice, produced a long-lasting effect on physical dependence to morphine.
Effects of tamsulosin on resting urethral pressure and arterial blood pressure in anaesthetized female dogs
Authors: Ohtake Akiyoshi , Sato Shuichi , Sasamata Masao , Miyata Keiji 
Published: February 2006

AbstractThe purposes of the present study were to investigate the effects of the α1-adrenoceptor antagonists tamsulosin, prazosin and urapidil on resting urethral pressure in anaesthetized female dogs, and to compare the results with their effects on arterial blood pressure. Tamsulosin decreased resting maximal urethral pressure in the urethral pressure profile in a dose-dependent fashion, whereas it had almost no effect on mean arterial blood pressure. Prazosin and urapidil also dose-dependently decreased resting maximal urethral pressure, but these effects were accompanied by decreases in mean arterial blood pressure. Thus, of these three compounds, tamsulosin dose-dependently decreased resting maximal urethral pressure with negligible effect on mean arterial blood pressure in female dogs. These results suggest that tamsulosin will be useful in the treatment of voiding dysfunction associated with bladder outlet obstruction in women, with little hypotensive effect.