bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural Damage and Chemical Contaminants on Reprocessed Arthroscopic Shaver Blades
Authors: Kobayashi Masahiko , Nakagawa Yasuaki , Okamoto Yukihiro , Nakamura Shinichiro , Nakamura Takashi 
Published: January 2009

Background In response to socioeconomic pressure to cut budgets in medicine, single-use surgical instruments are often reprocessed despite potential biological hazard. Purpose To evaluate the quality and contaminants of reprocessed shaver blades. Hypothesis Reprocessed shaver blades have mechanical damage and chemical contamination. Study Design Controlled laboratory study. Methods Seven blades and 3 abraders were reprocessed 1 time or 3 times and then were assessed. In the first part of the study, structural damage on the blades after 3 reprocessings was compared to that after 1 reprocessing using optical microscopy. In the second part, surface damage was observed using optical microscopy and scanning electron microscopy; elemental and chemical analyses of contaminants found by the microscopy were performed using scanning electron microscopy/energy dispersive x-ray spectroscopy, scanning Auger microscopy, and Fourier transform infrared spectroscopy. Results Optical microscopic examination revealed abrasion on the surface of the inner blade and cracks on the inner tube after 1 reprocessing. These changes were more evident after 3 reprocessings. Scanning electron microscopy/energy dispersive x-ray spectroscopy of the inner cutter of the blade reprocessed once showed contaminants containing calcium, carbon, oxygen, and silicon, and Fourier transform infrared spectroscopy demonstrated biological protein consisting mainly of collagen, some type of salts, and polycarbonate used in plastic molding. Scanning electron microscopy/energy dispersive x-ray spectroscopy of the inner cutter of the reprocessed abrader revealed contaminants containing carbon, calcium, phosphorous, and oxygen, and Fourier transform infrared spectroscopy showed H2O, hydroxyapatite, and hydroxyl proteins. Scanning Auger microscopy showed that the tin-nickel plating on the moving blade and abrader was missing in some locations. Conclusion This is the first study to evaluate both mechanical damage and chemical contaminants containing collagen, hydroxyapatite, and salts on the reprocessed arthroscopic shaver blades. Clinical Relevance Surgeons should keep in mind that mechanical damage and chemical contamination are found on reprocessed arthroscopic blades.
Intramedullary Nailing of Clavicular Midshaft Fractures with the Titanium Elastic Nail
Authors: Frigg Arno , Rillmann Paavo , Perren Thomas , Gerber Martin , Ryf Christian 
Published: January 2009

Background Intramedullary nailing of clavicular midshaft fractures using the titanium elastic nail has been described as a technically easy, minimally invasive operation with few complications and an early return to competitive sports. Hypothesis The results reported thus far have been positive. The titanium elastic nail is associated with multiple intraoperative and postoperative problems. Study Design Case series; Level of evidence, 4. Methods From April 2004 to March 2007, 34 patients at our institution were treated with intramedullary nailing. A standard titanium elastic nail was used in 19 cases and a titanium elastic nail with an end cap in 15 cases. The titanium elastic nail was inserted and advanced under fluoroscopic control. A short incision at the fracture site was made for open reduction if needed. Postoperatively, free range of motion was allowed. Results In 62% of patients, open reduction was necessary independent of fracture type, flattening of the titanium elastic nail, or transverse fragments. Operating time was 44 minutes (range, 10—105 minutes) and fluoroscopy time 9 minutes (range, 2—25 minutes). In 70% of patients, problems or complications occurred (7 medial perforations, 7 lateral penetrations, 1 titanium elastic nail breakage, 1 titanium elastic nail dislocation, 7 hardware irritations). The reoperation rate was 36%. Medial migration and pain were significantly reduced by using an end cap. Conclusion Intramedullary nailing of clavicular midshaft fractures using the titanium elastic nail is a technically demanding operation with various complications in the postoperative phase. This study might explain why the implant has not yet achieved widespread application, despite the fact that other authors have reported good results. Amending the operative technique and postoperative treatment might improve the outcome in the future.
Perinatal HIV transmission and the cost-effectiveness of screening at 14 weeks gestation, at the onset of labour and the rapid testing of infants
Authors: Udeh Belinda , Udeh Chiedozie , Graves Nicholas 
Published: January 2009

Abstract

Background
Preventing HIV transmission is a worldwide public health issue. Vertical transmission of HIV from a mother can be prevented with diagnosis and treatment, but screening incurs cost. The U.S. Virgin Islands follows the mainland policy on antenatal screening for HIV even though HIV prevalence is higher and rates of antenatal care are lower. This leads to many cases of vertically transmitted HIV. A better policy is required for the U.S. Virgin Islands.

Methods
The objective of this research was to estimate the cost-effectiveness of relevant HIV screening strategies for the antenatal population in the U.S. Virgin Islands. An economic model was used to evaluate the incremental costs and incremental health benefits of nine different combinations of perinatal HIV screening strategies as compared to existing practice from a societal perspective. Three opportunities for screening were considered in isolation and in combination: by 14 weeks gestation, at the onset of labor, or of the infant after birth. The main outcome measure was the cost per life year gained (LYG).

Results
Results indicate that all strategies would produce benefits and save costs. Universal screening by 14 weeks gestation and screening the infant after birth is the recommended strategy, with cost savings of $1,122,787 and health benefits of 310 LYG. Limitations include the limited research on the variations in screening acceptance of screening based on specimen sample, race and economic status. The benefits of screening after 14 weeks gestation but before the onset of labor were also not addressed.

Conclusion
This study highlights the benefits of offering screening at different opportunities and repeat screening and raises the question of generalizing these results to other countries with similar characteristics.
"There's nothing I can't do – I just put my mind to anything and I can do it": a qualitative analysis of how children with chronic disease and their parents account for and manage physical activity
Authors: Fereday Jennifer , MacDougall Colin , Spizzo Marianne , Darbyshire Philip , Schiller Wendy 
Published: January 2009

Abstract

Background
This paper reports the findings of a South Australian qualitative, exploratory study of children and young people living with a chronic disease, and their perceptions and experiences of physical activity. The perceptions and experiences of their parents were also explored. The chronic diseases were type 1 diabetes, asthma and cystic fibrosis.

Methods
Multiple qualitative data collection techniques were used to elicit the children and young people's perspectives and experiences of physical activity, including focus groups, maps, photos and 'traffic light posters'. The children's parents were interviewed separately to ascertain their views of their child's participation in physical activities.

Results
Children and young people described their active participation in a wide variety of physical activities including organised sports and play, but made very little mention of any negative influence or impact due to their disease. Their parents' stories described the diligent background planning and management undertaken to enable their child to participate in a wide range of physical activities.

Conclusion
The results of this study suggest that for these children and young people, having a chronic disease was not perceived as a barrier to participation in organised sport and recreational activities. They were physically active and perceived themselves to be no different from their peers. Their positive beliefs were shared by their parents and the level of participation described was enabled by the high level of parental support and background planning involved in managing their child's health care needs.
Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS): a 24-year clinical experience with 178 patients
Authors: Levandovsky Mark , Harvey Danielle , Lara Primo , Wun Ted 
Published: January 2009

Abstract

Background
Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome (TTP-HUS) are related and uncommon disorders with a high fatality and complication rate if untreated. Plasma exchange therapy has been shown to produce high response rates and improve survival in patients with many forms of TTP-HUS. We performed a retrospective cohort study of 178 consecutively treated patients with TTP-HUS and analyzed whether clinical or laboratory characteristics could predict for important short- and long-term outcome measures.

Results
Overall 30-day mortality was 16% (n = 27). 171 patients (96%) received plasma exchange as the principal treatment, with a mean of 8 exchanges and a mean cumulative infused volume of 42 ± 71 L of fresh frozen plasma. The rate of complete response was 65% or 55% depending on whether this was defined by a platelet count of 100,000/μl or 150,000/μl, respectively. The rate of relapse was 18%. The Clinical Severity Score did not predict for 30-day mortality or relapse. The time to complete response did not predict for relapse. Renal insufficiency at presentation was associated with a decreased risk of relapse, with each unit increase in serum creatinine associated with a 40% decreased odds of relapse. 72% of our cohort had an idiopathic TTP-sporadic HUS, while 17% had an underlying cancer, received a solid organ transplant or were treated with a mitomycin-based therapy. The estimated overall 5-year survival was 55% and was significantly better in those without serious underlying conditions.

Conclusion
Plasma exchange therapy produced both high response and survival rates in this large cohort of patients with TTP-HUS. The Clinical Severity Score did not predict for 30-day mortality or relapse, contrary to our previous findings. Interestingly, the presence of renal insufficiency was associated with a decreased risk of relapse. The most important predictor of mortality was the presence or absence of a serious underlying disorder.
A forensic aspect of age characteristics of dentine using transversal microradiography: a case report
Authors: Vasiliadis Leonidas , Stavrianos Christos , Kafas Panagiotis 
Published: January 2009

Abstract

Background
Translucency of dentine is the result of occlusion of the corresponding dentinal tubules by a mineral substance which has a refractive index similar to that of the rest of the dentine.

Case presentation
This case report describes the microradiographic features of an upper cadaveric canine. Transverse microradiograph is one of the methods assessing apical dentine translucency for various dental and medical reasons.

Conclusion
Estimation of age using teeth structures may be of primary value in forensic dentistry, especially when soft tissues are severely destructed.
Assaying the regulatory potential of mammalian conserved non-coding sequences in human cells
Authors: Attanasio Catia , Reymond Alexandre , Humbert Richard , Lyle Robert , Kuehn Michael S , Neph Shane , Sabo Peter J , Goldy Jeff , Weaver Molly , Haydock Andrew , Lee Kristin , Dorschner Michael , Dermitzakis Emmanouil T , Antonarakis Stylianos E , Stamatoyannopoulos John A 
Published: January 2009

Abstract
Background
Conserved non-coding sequences in the human genome are approximately tenfold more abundant than known genes, and have been hypothesized to mark the locations of cis-regulatory elements. However, the global contribution of conserved non-coding sequences to the transcriptional regulation of human genes is currently unknown. Deeply conserved elements shared between humans and teleost fish predominantly flank genes active during morphogenesis and are enriched for positive transcriptional regulatory elements. However, such deeply conserved elements account for <1% of the conserved non-coding sequences in the human genome, which are predominantly mammalian.

Results
We explored the regulatory potential of a large sample of these 'common' conserved non-coding sequences using a variety of classic assays, including chromatin remodeling, and enhancer/repressor and promoter activity. When tested across diverse human model cell types, we find that the fraction of experimentally active conserved non-coding sequences within any given cell type is low (approximately 5%), and that this proportion increases only modestly when considered collectively across cell types.

Conclusions
The results suggest that classic assays of cis-regulatory potential are unlikely to expose the functional potential of the substantial majority of mammalian conserved non-coding sequences in the human genome.
Problems across care pathways in specialist adult eating disorder services
Authors: Waller Glenn , Schmidt Ulrike , Treasure Janet , Murray Katie , Aleyna Joana , Emanuelli Francesca , Crockett Jo , Yeomans Maria 
Published: January 2009

Aims and MethodDespite considerable knowledge of outcomes for patients who complete treatment for eating disorders, less is known about earlier stages in the treatment journey. This study aimed to map the efficiency of the anticipated patient journey along care pathways. Referrals to specialist eating disorder services (n=1887) were tracked through the process of referral, assessment, treatment and discharge.ResultsThe patient mortality rate was low. However, there were serious problems of attrition throughout the care pathways. of the original referrals where a meaningful conclusion could be reached, in approximately 35% the person was never seen, only half entered treatment and only a quarter reached the end of treatment.Clinical ImplicationsThis study demonstrates considerable inefficiency of resource utilisation. Suggestions are made for reducing this inefficiency, to allow more patients the opportunity of evidence-based care.
Benzodiazepine and hypnotic prescribing in an acute adult psychiatric in-patient unit
Authors: Hallahan Brian P. , Murray Ivan T. , McDonald Colm 
Published: January 2009

Aims and MethodWe examined the prescribing practices concerning benzodiazepine and hypnotic medications at a university teaching hospital. Retrospective data from 74 consecutively admitted in-patients were analysed.ResultsBenzodiazepines were prescribed to 51% of individuals on a routine basis and to 66% of individuals on an ‘as required’ basis. An indication was documented for 70% of individuals prescribed benzodiazepines routinely and for 29% of patients prescribed benzodiazepines ‘as required’. Hypnotic agents were administered to 24% of patients on a routine basis and 23% of individuals on an ‘as required’ basis. An indication was documented for 39% of patients prescribed hypnotic agents routinely and 12% of patients prescribed hypnotics ‘as required’.Clinical ImplicationsBenzodiazepine and hypnotic agents are frequently prescribed without any clear reason provided in the patients' medical notes or prescription card.
Micro-tectonic constraints on the evolution of the Barles half-window (Digne nappe, southern Alps). Implications for the timing of folding in the Valensole foreland basin
Authors: Fournier Marc , Agard Philippe , Petit Carole 
Published: January 2009

AbstractThe “Vélodrome” overturned syncline, at the northern margin of the Cenozoic foreland basin of Valensole in SE France, was formed during the Late Cenozoic at the front of the Digne nappe. Microstructural analyses reveal that mesoscale faulting in the molassic series, from the Oligocene “Molasse Rouge” at the base to the middle to late Miocene “Valensole Conglomerates” at the top, partly occurred before the folding, as layer-parallel shortening: the NNE-SSW-directed compression is recorded by two systems of reverse and strike-slip faults, which formed when the strata were still horizontal and were passively tilted as folding occurred. These data suggest that the Vélodrome folding postdates the deposition of the Valensole Conglomerates and occurred in late Miocene-Pliocene times during the emplacement of the Digne nappe. These results are difficult to reconcile with the interpretation of the Vélodrome as a growth fold progressively formed in 10–15 m.y. during the deposition of the Miocene molasses. Structural data collected in the Barles tectonic half-window enable to reconstruct the evolution of the deformation since the Jurassic. The two main phases of shortening, the pre-Oligocene Pyrenean-Provençal and the Mio-Pliocene Alpine phases, are almost homoaxial with a direction of compression trending N-S for the former and NNE-SSW for the later. A late Eocene-basal Oligocene N-S extensional episode is documented between these two phases, probably in relation with the formation of the western European rift system. The direction of extension of the Liassic rifting of the Alpine Tethys is roughly constrained in the NW-SE quadrant. Paleo-stress field reconstruction brings consistent results at the regional scale and proves to be a powerful tool to decipher the evolution of the deformation in a remarkably complicated tectonic setting.
Early Ordovician volcanism in the Iberian Chains (NE Spain) and its influence on the preservation of shell concentrations
Authors: Álvaro Jose Javier , Ezzouhairi Hassan , Ribeiro M. Luisa , Ramos J. Farinha , Solá A. Rita 
Published: January 2009

AbstractResearch is described to evaluate the influence of volcanic activity on studies of shell-concentration taphonomy and biodiversity patterns in strata that commonly display poor densities of skeletal debris. Two volcanic episodes are recorded in the Lower Ordovician of the Iberian Chains: (i) a succession of Tremadocian-earliest “Arenig”, eruptive felsic products, expelled explosively and characterized by the onset of rhyolitic and dacitic tuffs embedded in the Borrachón and Santed formations; and (ii) an “Arenig”, effusive basaltic volcanic episode, represented by a single lava flow embedded in the Armorican Quartzite. The volcanic activity reflects a change from sub-alkaline to alkaline geochemical affinities, related to the Early Ordovician magmatism recorded in southwestern Europe that is commonly attributed to the opening of the Rheic Ocean.The felsic explosive tuffs are associated with two ecosystem disturbance events: (i) a short-term colonization event of opportunistic linguliformean brachiopods that proliferated in the aftermath of a multi-event rhyolitic pyroclastic surge deposit; and (ii) several single-event mass-mortality horizons associated with dacitic pyroclastic flows responsible for the preservation of high-diverse allochthonous coquinas. Our knowledge of the biodiversity patterns achieved by the benthic communities preserved in the poorly fossiliferous, siliciclastic strata of the Iberian Chains is, as a result, strongly biased by the presence of skeletal tuffs, directly controlled by the onset of neighbouring eruptive explosions.
Mineralogy of agglutinated benthic foraminifera; implications for paleo-environmental reconstructions
Authors: Armynot du Chatelet Eric , Recourt Philippe , Chopin Vincent 
Published: January 2009

AbstractBenthic foraminifera of recent salt marsh environments are often dominated by species with an agglutinated test. The grains used for test construction by these foraminifera are collected from their surrounding environment. In this study we investigate the role of sediment grain size and mineralogical composition for richness, population density and taxonomic composition of agglutinating foraminifera. Foraminifera from 15 stations of the tidal marsh of the Canche estuary (Pas-de-Calais, France) were studied.The species richness depends on the grain size of the sediment, whereas the density is not related to sediment grain size. The distribution of foraminifera species throughout the tidal marsh may depend on many environmental parameters such as OM as well as tidal elevation, already largely discussed in literature. The mineralogical composition of the agglutinated grains in Trochammina inflata and Arenoparrella mexicana is very different from that of sediment; the composition of Jadammina macrescens is generally different from that of the sediment with some exceptions, and in Miliammina fusca, Paratrochammina haynesi and Remaneica plicata the mineralogical compositions are similar to those of the sediment. The studied species may be able to select their preferred grains based upon composition even if a particular mineral is scarce in the sediment.
A new species of Argillochelys (Testudines: Cryptodira: Cheloniidae) from the Ouled Abdoun phosphate basin, Morocco
Authors: Tong Haiyan , Hirayama Ren 
Published: January 2009

AbstractA new species of Argillochelys (Testudines: Cryptodira: Cheloniidae), A. africana n. sp. is described on the basis of three skulls and a lower jaw from the Lower Tertiary beds of the Ouled Abdoun phosphate basin, Morocco. It differs from A. cuneiceps, A. antiqua and A. athersuchi essentially in the frontal well retracted from the orbital margin, with a broad prefrontal/postorbital contact, a more developed secondary palate, and the anterior part of the lower jaw more dorsoventrally flattened, with a wider triturating surface and a longer symphysis, without lingual ridge. This is the first record of Argillochelys from Africa.
The Misperception of Norms: The Psychology of Bias and the Economics of Equilibrium
Authors: Cooter Robert D , Feldman Michal , Feldman Yuval 
Published: January 2009

Abstract
This study combines the psychology of bias and the economics of equilibrium. We focus on two of the most discussed perceptual biases found by psychologists who studied the role social norms in ethical decision making. First, psychologists found a general tendency of people to over-estimate how many other people engage in unethical behavior. We show that this bias causes more people to violate the norm than if the bias were corrected. Second, psychologists found a general tendency of a person to over-estimate how many other people act the same as he does. We show that this bias does not change the number of people who violate the norm, contrary to the predictions of some psychologists. When a person suffers from both biases, they can augment or undermine each other. In either case, we show that supplying accurate information will cause more people to conform to the norm. In general, we show that applying the equilibrium concept to psychological studies improves public policy recommendations by increasing precision in predicting aggregate behavior over time.
Psychology and Institutional Design
Authors: Tyler Tom 
Published: January 2009

Abstract
I argue for the usefulness of a value-based approach to legal regulation. The value-based approach designs institutions in ways that promote the development of values such as legitimacy. Such a development of values encourages people to follow the rules because they believe they ought to, rather than out of fear of punishment. I suggest that the deterrence approach has limits and that the values-based model is a more efficient and effective basis for encouraging people to bring their behavior into line with law and legal institutions.