bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tailoring intervention procedures to routine primary health care practice; an ethnographic process evaluation
Authors: Jansen Yvonne JFM , de Bont Antoinette , Foets Marleen , Bruijnzeels Marc , Bal Roland 
Published: August 2007

Abstract
Background
Tailor-made approaches enable the uptake of interventions as they are seen as a way to overcome the incompatibility of general interventions with local knowledge about the organisation of routine medical practice and the relationship between the patients and the professionals in practice. Our case is the Quattro project which is a prevention programme for cardiovascular diseases in high-risk patients in primary health care centres in deprived neighbourhoods. This programme was implemented as a pragmatic trial and foresaw the importance of local knowledge in primary health care and internal, or locally made, guidelines. The aim of this paper is to show how this prevention programme, which could be tailored to routine care, was implemented in primary care.

Methods
An ethnographic design was used for this study. We observed and interviewed the researchers and the practice nurses. All the research documents, observations and transcribed interviews were analysed thematically.

Results
Our ethnographic process evaluation showed that the opportunity of tailoring intervention procedures to routine care in a pragmatic trial setting did not result in a well-organised and well-implemented prevention programme. In fact, the lack of standard protocols hindered the implementation of the intervention. Although it was not the purpose of this trial, a guideline was developed. Despite the fact that the developed guideline functioned as a tool, it did not result in the intervention being organised accordingly. However, the guideline did make tailoring the intervention possible. It provided the professionals with the key or the instructions needed to achieve organisational change and transform the existing interprofessional relations.

Conclusion
As tailor-made approaches are developed to enable the uptake of interventions in routine practice, they are facilitated by the brokering of tools such as guidelines. In our study, guidelines facilitated organisational change and enabled the transformation of existing interprofessional relations, and thus made tailoring possible. The attractive flexibility of pragmatic trial design in taking account of local practice variations may often be overestimated.
The influence of lifestyle, menstrual function and oral contraceptive use on bone mass and size in female military cadets
Authors: Ruffing Jamie A , Nieves Jeri W , Zion Marsha , Tendy Susan , Garrett Patricia , Lindsay Robert , Cosman Felicia 
Published: August 2007

Abstract

Purpose
To determine the influence of menstrual irregularity, oral contraceptive use and other factors on bone mineral density (BMD) and bone size at different skeletal sites in 135 college-aged fit women.

Methods
Menstrual history, oral contraceptive use, exercise history, and nutritional factors including calcium, caffeine, and alcohol intake as well as tobacco use were determined by written survey. Height, weight and fitness levels were measured. Spine and hip BMD were measured by dual x-ray absorptiometry (DXA), calcaneus BMD by peripheral DXA, and tibial bone mineral content (BMC) and size by peripheral Quantitative Computed Tomography (p QCT).

Results
The mean age was 18.4 ± 0.8 years. Weight and prior exercise were positively related to BMD at most skeletal sites and to tibial bone size. Milk intake was positively related to calcaneal BMD, tibial BMC and cortical thickness. Fracture history was an important predictor of spine, hip and heel BMD. Women who had ≥ 10 menstrual cycles in the year prior to BMD measurement had higher BMD at all sites as well as a greater tibial mineral content and cortical thickness than women who had oligomenorrhea/amenorrhea (≤ 9 cycles in the prior year; all p < 0.05). Oral Contraceptive (OC) users had significantly lower BMD in the spine (p < 0.02) and calcaneus (p = 0.04), smaller tibial periosteal circumference and lower tibial mineral content (p < 0.02) than non-OC users.

Conclusion
In a population of fit, college-aged women, OC use and oligomenorrhea were associated with reduced BMD and bone size. Weight, as well as prior exercise and milk intake was positively related to bone density and size at some skeletal sites. Understanding these relationships would help improve skeletal health in young women.
Heterogeneity of autoantibodies in 100 patients with autoimmune myositis: insights into clinical features and outcomes
Authors: Koenig Martial , Fritzler Marvin J , Targoff Ira N , Troyanov Yves , Senécal Jean-Luc 
Published: August 2007

AbstractThe objective of this study was to determine the prevalence, mutual associations, clinical manifestations, and diagnoses associated with serum autoantibodies, as detected using recently available immunoassays, in patients with autoimmune myositis (AIM). Sera and clinical data were collected from 100 patients with AIM followed longitudinally. Sera were screened cross-sectionally for 21 autoantibodies by multiplex addressable laser bead immunoassay, line blot immunoassay, immunoprecipitation of in vitro translated recombinant protein, protein A assisted immunoprecipitation, and enzyme-linked immunosorbent assay. Diagnoses were determined using the Bohan and Peter classification as well as recently proposed classifications. Relationships between autoantibodies and clinical manifestations were analyzed by multiple logistic regression. One or more autoantibodies encompassing 19 specificities were present in 80% of the patients. The most common autoantibodies were anti-Ro52 (30% of patients), anti-Ku (23%), anti-synthetases (22%), anti-U1RNP (15%), and anti-fibrillarin (14%). In the presence of autoantibodies to Ku, synthetases, U1RNP, fibrillarin, PM-Scl, or scleroderma autoantigens, at least one more autoantibody was detected in the majority of sera and at least two more autoantibodies in over one-third of sera. The largest number of concurrent autoantibodies was six autoantibodies. Overall, 44 distinct combinations of autoantibodies were counted. Most autoantibodies were unrestricted to any AIM diagnostic category. Distinct clinical syndromes and therapeutic responses were associated with anti-Jo-1, anti-fibrillarin, anti-U1RNP, anti-Ro, anti-Ro52, and autoantibodies to scleroderma autoantigens. We conclude that a significant proportion of AIM patients are characterized by complex associations of autoantibodies. Certain myositis autoantibodies are markers for distinct overlap syndromes and predict therapeutic outcomes. The ultimate clinical features, disease course, and response to therapy in a given AIM patient may be linked to the particular set of associated autoantibodies. These results provide a rationale for patient profiling and its application to therapeutics, because it cannot be assumed that the B-cell response is the same even in the majority of patients in a given diagnostic category.
Reduced selection leads to accelerated gene loss in Shigella
Authors: Hershberg Ruth , Tang Hua , Petrov Dmitri A 
Published: August 2007

Abstract
Background
Obligate pathogenic bacteria lose more genes relative to facultative pathogens, which, in turn, lose more genes than free-living bacteria. It was suggested that the increased gene loss in obligate pathogens may be due to a reduction in the effectiveness of purifying selection. Less attention has been given to the causes of increased gene loss in facultative pathogens.

Results
We examined in detail the rate of gene loss in two groups of facultative pathogenic bacteria: pathogenic Escherichia coli, and Shigella. We show that Shigella strains are losing genes at an accelerated rate relative to pathogenic E. coli. We demonstrate that a genome-wide reduction in the effectiveness of selection contributes to the observed increase in the rate of gene loss in Shigella.

Conclusion
When compared with their closely related pathogenic E. coli relatives, the more niche-limited Shigella strains appear to be losing genes at a significantly accelerated rate. A genome-wide reduction in the effectiveness of purifying selection plays a role in creating this observed difference. Our results demonstrate that differences in the effectiveness of selection contribute to differences in rate of gene loss in facultative pathogenic bacteria. We discuss how the lifestyle and pathogenicity of Shigella may alter the effectiveness of selection, thus influencing the rate of gene loss.
Prognostic and Predictive Value of Centrally Reviewed Expression of Estrogen and Progesterone Receptors in a Randomized Trial Comparing Letrozole and Tamoxifen Adjuvant Therapy for Postmenopausal Early Breast Cancer: BIG 1-98
Authors: Viale Giuseppe , Regan Meredith M. , Maiorano Eugenio , Mastropasqua Mauro G. , Dell'Orto Patrizia , Rasmussen Birgitte Bruun , Raffoul Johnny , Neven Patrick , Orosz Zsolt , Braye Stephen , Öhlschlegel Christian , Thürlimann Beat , Gelber Richard D. , Castiglione-Gertsch Monica , Price Karen N. , Goldhirsch Aron , Gusterson Barry A. , Coates Alan S. 
Published: August 2007

Purpose To evaluate locally versus centrally assessed estrogen (ER) and progesterone (PgR) receptor status and the impact of PgR on letrozole adjuvant therapy compared with tamoxifen in postmenopausal women with early breast cancer. Patients and Methods Breast International Group (BIG) 1-98 randomly assigned 8,010 patients to four arms comparing letrozole and tamoxifen with sequences of each agent. The Central Pathology Office received material for 6,549 patients (82%), of which 79% were assessable (6,291 patients). Prognostic and predictive value of both local and central hormone receptor expression on disease-free survival (DFS) were evaluated among 3,650 assessable patients assigned to the monotherapy arms. Prognostic value and the treatment effect were estimated for centrally assessed ER and PgR expression levels using the Subpopulation Treatment Effect Pattern Plot. Results Central review confirmed 97% of tumors as hormone receptor–positive (ER and/or PgR ≥10%). Of 105 tumors locally ER-negative, 73 were found to have more than 10% positive cells, and eight had 1% to 9%. Of 6,100 tumors locally ER positive, 66 were found to have no staining, and 54 had only 1% to 9%. Discordance was more marked for PgR than ER. Patients with tumors reclassified centrally as ER-negative, or as hormone receptor–negative, had poor DFS. Centrally assessed ER and PgR showed prognostic value. Among patients with centrally assessed ER-expressing tumors, letrozole showed better DFS than tamoxifen, irrespective of PgR expression level. Conclusion Central review changed the assessment of receptor status in a substantial proportion of patients, and should be performed whenever possible in similar trials. PgR expression did not affect the relative efficacy of letrozole over tamoxifen.
Exhaustive, ONE-YEAR FOLLOW-UP OF SUBTHALAMIC NUCLEUS DEEP BRAIN STIMULATION IN A LARGE, SINGLE-CENTER COHORT OF PARKINSONIAN PATIENTS
Authors: Tir Melissa , Devos David , Blond Serge , Touzet Gustavo , Reyns Nicolas , Duhamel Alain , Cottencin Olivier , Dujardin Kathy , Cassim François , Destée Alain , Defebvre Luc , Krystkowiak Pierre 
Published: August 2007

Abstract

OBJECTIVE
To prospectively assess the impact of subthalamic nucleus (STN) deep brain stimulation (DBS) at 12 months after surgery in a series of 100 consecutive patients treated in a single center. The primary objective was to describe the clinical outcome in terms of efficacy and tolerance in STN-DBS patients. A secondary objective was to discuss presurgery clinical characteristics a posteriori as a function of outcome.

METHODS
One hundred and three consecutive patients with severe Parkinson's disease received bilateral STN-DBS in our clinic between May 1998 and March 2003. Clinical assessment was performed before and 12 months after surgery and was based on the Unified Parkinson's Disease Rating Scale, Parts II, III, and IV A; the Schwab and England Scale; and cognitive evaluation. Patient-rated overall improvement was also evaluated.

RESULTS
Twelve months after surgery, the Unified Parkinson's Disease Rating Scale Part III score decreased by 43%, the Unified Parkinson's Disease Rating Scale Part II score (activities of daily living) fell by 34%, and the severity of dyskinesia-related disability decreased by 61%. The main surgical complications after STN-DBS were as follows: infection (n = 7), intracerebral hematoma (n = 5), electrode fracture (n = 4), and incorrect lead placement (n = 8). We observed cognitive decline and depression in 7.7 and 18% of the patients, respectively. The mean patient-rated overall improvement score was 70.7%.

CONCLUSION
The efficacy and safety of STN-DBS in our center's large cohort of Parkinsonian patients are generally similar to the results obtained by other groups, albeit at the lower limit of the range of reported values. In contrast to efficacy, the occurrence of adverse events cannot be predicted. Younger patients with Parkinson's disease (i.e., those younger than 60 yr) often show an excellent response to levodopa. However, in view of our data on overall patient satisfaction and the occurrence of adverse events, we suggest that older patients (but not those older than 70 yr) and less dopa-sensitive patients (but not those with a response &lt;50%) should still be offered the option of STN-DBS.
Colour perception in a dichromat
Authors: Roth Lina S. V. , Balkenius Anna , Kelber Almut 
Published: August 2007

SUMMARY
Most mammals have dichromatic colour vision based on two different types of cones: a short-wavelength-sensitive cone and a long-wavelength-sensitive cone. Comparing the signal from two cone types gives rise to a one-dimensional chromatic space when brightness is excluded. The so-called `neutral point'refers to the wavelength that the animal cannot distinguish from achromatic light such as white or grey because it stimulates both cone types equally. The question is: how do dichromats perceive their chromatic space? Do they experience a continuous scale of colours or does the neutral point divide their chromatic space into two colour categories, i.e. into colours of either short or long wavelengths?
We trained horses to different colour combinations in a two-choice behavioural experiment and tested their responses to the training and test colours. The horses chose colours according to their similarity/relationship to rewarded and unrewarded training colours. There was no evidence for a categorical boundary at the neutral point or elsewhere.
This study suggests that dichromats perceive their chromatic space as a continuous scale of colours, treating the colour at the neutral point as any other colour they can distinguish.
Life history consequences of temperature transients inDrosophila melanogaster
Authors: Dillon Michael E. , Cahn Liza R. Y. , Huey Raymond B. 
Published: August 2007

SUMMARYThe physiological and life history consequences of chronic temperatures are well studied in ectotherms. However, little is known about the consequences of short-term exposure to unusually high or low temperatures, as would occur during a weather front. What are the immediate life-history effects of such thermal transients? Can ectotherms recover quickly or do they suffer carry-over effects that persist after weather returns to normal? We measured the impact of thermal transients on egg and progeny production of Drosophila melanogaster Meigen from Washington State. We reared flies at 25°C and then transferred 3- to 5-day old adults to one of three transient treatments (1 or 3 days at 18°C, 1 day at 29°C) before returning them to 25°C. We monitored daily egg production and egg-to-adult viability before (as a control), during, and after the transient as well as fecundity and viability of flies held at constant 18°, 25° and 29°C. This population appears particularly heat tolerant as neither constant nor transient exposure to 29°C (usually a stressful temperature for this species) affected female fecundity or the viability of her progeny. However, a 1- or 3-day exposure to 18°C reduced female fecundity by 75–90% relative to controls, and eggs laid during the 3-day exposure had greatly reduced viability. When returned to 25°C after transient exposure to 18°C, females immediately matched the fecundity and viability of females maintained constantly at 25°C. Therefore, these flies do not suffer negative carry-over effects from these moderate thermal transients. Surprisingly, fitness (intrinsic rate of population growth) was not depressed by transient temperature exposure. However, the severity and especially the timing of the transient will probably determine the likelihood of carry-over effects as well as its effect on fitness.
Steaming on Convex Hulls
Authors: Brown Gerald G. , Kline Jeffrey E. , Rosenthal Richard E. , Washburn Alan R. 
Published: August 2007

This is a sea story about using a simple classroom example to save a great deal of money, as well as to convince beginning Postgraduate Naval School operations research students—experienced, skeptical military officers—that mathematical analysis can yield immediate results. The application is planning a ship’s transit from one point to another in a fixed amount of time, given that the ship can operate with one or more of its propulsion plants idled to save fuel. Simple analysis yields nonintuitive results that US Navy shipboard energy-conservation guides overlook. One of the authors (Kline) solved this homework problem as a student and subsequently applied this example when he took command of USS AQUILA, a patrol hydrofoil missile ship. AQUILA achieved results so striking in comparison to her sister ships that the squadron material officer inspected her engineering plant to ensure that no safety settings were being overridden to achieve this record. Kline’s spreadsheet decision-support tool was provided to other hydrofoil commanders. A more general version has been conveyed to the US Navy. Considering that our navy spends about a billion dollars per year on fuel for surface-combatant ships alone, this development promises substantial, long-term returns. “But thou, contracted to thine own bright eyes, Feed'st thy light'st flame with self-substantial fuel.” Shakespeare, Sonnet I
Appraisals of pain from controlled stimuli: Relevance to quantitative sensory testing
Authors: Dannecker Erin A. , Price Donald D. , O'Connor Patrick D. , Robinson Michael E. 
Published: August 2007

Objective Sensory testing has been advocated for the diagnosis, prognosis, and outcome evaluation of pain patients, but responses to controlled stimuli have not been well correlated to clinical pain. As an initial step for improving the clinical relevance of sensory testing, this investigation compared appraisals of and responses to controlled pain stimuli.Design A prospective within subjects design was used.Methods Heat, ischaemic, and delayed‐onset muscle pain were induced in the upper extremity of 44 participants (47.7% women) during four experimental sessions.Results The threat of heat and ischaemic pain was higher than delayed‐onset muscle pain (F2, 86=5.30, p<.01, η2=.11). Threat, challenge, predictability, and controllability were related to heat pain most consistently. The affective‐sensory ratios of ischaemic and delayed‐onset muscle pain resembled those of clinical pain and were higher than heat pain (F2, 84=11.64, p<.01, η2=.22). Delayed‐onset muscle pain meaningfully affected daily activities, which correlated to delayed‐onset muscle pain ratings (rs=.60–.68, ps <.001).Conclusions Heat stimuli may be well suited for instructional manipulations of appraisals to improve the clinical relevance of quantitative sensory testing and delayed‐onset muscle pain's effects on daily activities are clinically relevant.
Suction Equilibration Time for a High Capacity Tensiometer
Authors: Oliveira O. M. , Marinho F. A. M. 
Published: August 2007

Abstract
It is well established, the importance of the measurement of soil suction for the assessment of mechanical and hydraulic behavior of unsaturated soils. Among the methods to obtain the soil suction, the tensiometer is one of the most convenient and reliable. However conventional tensiometer has a limitation related to the maximum suction it is capable of measure. This limitation was overcome by Ridley and Burland (1993), with the development of a high capacity tensiometer, which is capable of measure suction well above 100 kPa. The equipment has a quick response time, allowing the determination of suction in minutes. This paper presents a study about the factors that affect the equilibrium time for high capacity tensiometers in the laboratory. Soil specimens were prepared at three different conditions, creating different soil structures. In addition to that an investigation about the characteristic of the interface that is required between the soil sample and the porous ceramic of the tensiometer was carried out; showing the role of the paste on the technique. The results also suggested that it is possible to infer the hydraulic conductivity function using the equilibrium curve obtained during the measurement of the soil suction using the high capacity tensiometer.
Nonoperative Management of Perianal Abscess in Infants Is Associated With Decreased Risk for Fistula Formation
Authors: Christison-Lagay Emily R. , Hall Jason F. , Wales Paul W. , Bailey Karen , Terluk Andrew , Goldstein Allan M. , Ein Sigmund H. , Masiakos Peter T. 
Published: August 2007

OBJECTIVE. We sought to determine the frequency of progression in infants of perianal abscess with and without surgical drainage to fistula in ano to optimize a treatment plan for these children.
METHODS. A retrospective cohort study was conducted of all patients who were ≤1 year of age and presented with perianal abscess to 2 pediatric tertiary care institutions during a 10-year period (January 1995 to February 2005, inclusive). Patients were divided into those who underwent surgical drainage and those who did not, and the rate of subsequent fistula formation was determined.
RESULTS. Of 165 children initially identified, follow-up was available for 140. Ninety-four percent of children were male. Mean age was 4.2 ± 3.1 months. Of the 140 patients, 83 abscesses were drained and 57 were not drained. Of patients who underwent surgical drainage, 50 developed a fistula, whereas of those who did not undergo drainage only 9 developed a fistula. Synchronous administration of antibiotics (intravenous or oral) used in 57 of 58 patients from 1 institution was associated with an even greater decrease in fistula formation (12.5%) in the undrained population.
CONCLUSIONS. Perianal abscess formation in infants who are younger than 12 months is a separate entity from abscess formation in older age groups. In this largest study to date, a combined center series of patients who presented to 2 academic pediatric hospitals with infantile perianal abscess, local hygiene and systemic antibiotics without surgical drainage minimized formation of fistula in ano.