bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geomatics in injury prevention: the science, the potential and the limitations: Figure 1
Authors: Cusimano M D , Chipman M , Glazier R H , Rinner C , Marshall S P 
Published: February 2007

Background:Geomatics describes the activities involved in acquiring and managing geographical data and producing geographical information for scientific, administrative and technical endeavors. As an emerging science, geomatics has a great potential to support public health. Geomatics provides a conceptual foundation for the development of geographic information systems (GIS), computerized tools that manage and display geographical data for analytical applications. As descriptive epidemiology typically involves the examination of person, place and time in the occurrence of disease or injury, geomatics and GIS can play an important role in understanding and preventing injury.Aim:This article provides a background to geomatics for those in the injury prevention field who are unfamiliar with spatial analysis. We hope to stimulate researchers and practitioners to begin to use geomatics to assist in the prevention of injury.Methods:The authors illustrate the potential benefits and limitations of geomatics in injury prevention in a non-technical way through the use of maps and analysis.Results:By analysing the location of patients treated for fall injuries in Central Toronto using GIS, some demographic and land use variables, such as household income, age, and the location of homeless shelters, were identified as explanatory factors for the spatial distribution.Conclusion:By supporting novel approaches to injury prevention, geomatics has a great potential for efforts to combat the burden of injury. Despite some limitations, those with an interest in injury prevention could benefit from this science.
Attitudes associated with behavioral predictors of serious road traffic crashes: results from the GAZEL cohort
Authors: Nabi Hermann , Rachid Salmi Louis , Lafont Sylviane , Chiron Mireille , Zins Marie , Lagarde Emmanuel 
Published: February 2007

Objectives:To test the hypothesis that behavioral predictors of serious road traffic crashes (RTC) are correlated with unfavorable attitudes towards traffic safety.Design:Prospective and cross-sectional cohort study.Setting:FranceParticipants:13 447 of the 19 894 living members of the GAZEL cohort, workers and recent retirees of a French national utility company followed up since 1989.Main outcomes measures:Driving behavior and attitudes towards traffic safety in 2001 by questionnaire. Serious RTCs were recorded over the subsequent 3 years using the cohort annual questionnaire. Behavioral predictors of serious RTCs were assessed using generalized linear Poisson regression models with time-dependent covariates. Factor scores extracted from the first four attitudinal factors of principal component analysis were saved and then regressed on behavioral predictors as independent variables.Results:After controlling for potential confounders, the best predictors of serious RTCs were: “exceeding speed limits on rural roads”, “risky use of cellular phone”, and “sleepy driving”. The adjusted rate ratio ranged from 1.47 to 2.16. Predictors of contravention of the highway code (the first two predictors) were found to be strongly associated with negative attitudes towards “enforcement” and “speed limitations” with an adjusted odds ratio ranging from 1.31 to 2.02.Conclusion:Our study supports the view that individuals with a high propensity for driving behaviors associated with an increased risk of RTCs were more likely to have negative attitudes towards traffic safety. Changing drivers’ negative or distorted opinions of traffic “enforcement” as well as “speed limitations” and “alcohol prohibition on roads” could improve their compliance with road traffic rules.
Vancomycin administration: the impact of multidisciplinary interventions
Authors: Crowley R K , Fitzpatrick F , Solanki D , FitzGerald S , Humphreys H , Smyth E G 
Published: February 2007

Background:The clinical microbiology team observed that patients were not receiving all prescribed doses of vancomycin. Ward staff was confused about ordering and interpreting vancomycin therapeutic drug monitoring (TDM) levels.Aim:To audit the incidence of vancomycin dose omission. To implement a series of interventions to improve vancomycin dose administration, and to repeat the audit process to assess these interventions.Methods:Three prospective audits were conducted to assess the impact of vancomycin TDM on administration of vancomycin. After the first audit, a number of changes in the TDM process were undertaken. After review of the second audit, a senior pharmacist coordinated ward-based pharmacists in assisting staff to interpret levels, and TDM interpretative charts were designed for drug charts. Following the third audit, feedback to hospital management and a plan for ongoing education were undertaken.Results:There was a significant reduction in the number of vancomycin doses held inappropriately in the third (10% (78/782) of prescribed doses) when compared to the first audit (16% (161/1007) of doses) (p<0.01). Of doses that were held inappropriately, there was a significant decrease in doses held for no apparent reason in audit 3 (16% (27/170) of prescribed doses) when compared to audit 1 (25% (69/282) of doses) (p<0.05).Conclusions:The interventions resulted in a 37.5% reduction in inappropriately held vancomycin doses over a one-year period; 10% of doses are still being held inappropriately. This study highlights the difficulties in identifying barriers to change and changing healthcare worker behaviour.
Frequency of epithelioid granulomas in colonoscopic biopsy specimens from paediatric and adult patients with Crohn’s colitis
Authors: Rubio C A , Orrego A , Nesi G , Finkel Y 
Published: February 2007

Aims:To test the assumption that epithelioid granulomas found in colonoscopic biopsy specimens in patients with Crohn’s colitis are markers of a different clinical behaviour.Methods:Sections from colonoscopic biopsy specimens from 352 consecutive patients (119 children and 233 adults) were investigated.Results:A total of 1117 colonoscopies were performed: 293 in children (mean 2.46 per patient) and 824 in adults (mean 3.53 per patient) (p<0.05). Granulomas at initial colonoscopy were recorded in 67.2% (43/64) of children and 65.9% (27/41) of adults (p>0.6), and at subsequent colonoscopies in 53.8% (64/119) of children and 17.6% (41/233) of adults (p<0.05). Surgical intervention was required in 6.3% (4/64) of the children having previous granuloma, but also in 14.5% (8/55) of those without previous granuloma, the rate for operated adults being 26.8% (11/41) and 24.5% (47/192), respectively (p>0.6).Conclusions:Granulomas in entry and/or in subsequent colonoscopic biopsy specimens in patients with Crohn’s colitis did not predict the need for subsequent surgical intervention. The fact that the frequency of granulomas was significantly higher in children than in adults with Crohn’s colitis (despite a higher mean number of colonoscopic biopsies in adults), and that granulomas were present in colonoscopic biopsy specimens but not in the subsequent surgical specimens from 50% of the paediatric and 36% of the adult patients strengthen the conviction that granulomas in Crohn’s colitis might evolve or regress at different time intervals during the course of the disease. This behaviour would reflect a particular immunological reaction, an epiphenomenon from immature tissues—as in children—when challenged by the so far elusive aetiological agent responsible for Crohn’s disease.
Targeting HER-2/neuin Early Breast Cancer Development Using Dendritic Cells with Staged Interleukin-12 Burst Secretion
Authors: Czerniecki Brian J. , Koski Gary K. , Koldovsky Ursula , Xu Shuwen , Cohen Peter A. , Mick Rosemarie , Nisenbaum Harvey , Pasha Terry , Xu Min , Fox Kevin R. , Weinstein Susan , Orel Susan G. , Vonderheide Robert , Coukos George , DeMichele Angela , Araujo Louis , Spitz Francis R. , Rosen Mark , Levine Bruce L. , June Carl , Zhang Paul J. 
Published: February 2007

AbstractOverexpression of HER-2/neu (c-erbB2) is associated with increased risk of recurrent disease in ductal carcinoma in situ (DCIS) and a poorer prognosis in node-positive breast cancer. We therefore examined the early immunotherapeutic targeting of HER-2/neu in DCIS. Before surgical resection, HER-2/neupos DCIS patients (n = 13) received 4 weekly vaccinations of dendritic cells pulsed with HER-2/neu HLA class I and II peptides. The vaccine dendritic cells were activated in vitro with IFN-γ and bacterial lipopolysaccharide to become highly polarized DC1-type dendritic cells that secrete high levels of interleukin-12p70 (IL-12p70). Intranodal delivery of dendritic cells supplied both antigenic stimulation and a synchronized preconditioned burst of IL-12p70 production directly to the anatomic site of T-cell sensitization. Before vaccination, many subjects possessed HER-2/neu–HLA-A2 tetramer-staining CD8pos T cells that expressed low levels of CD28 and high levels of the inhibitory B7 ligand CTLA-4, but this ratio inverted after vaccination. The vaccinated subjects also showed high rates of peptide-specific sensitization for both IFN-γ–secreting CD4pos (85%) and CD8pos (80%) T cells, with recognition of antigenically relevant breast cancer lines, accumulation of T and B lymphocytes in the breast, and induction of complement-dependent, tumor-lytic antibodies. Seven of 11 evaluable patients also showed markedly decreased HER-2/neu expression in surgical tumor specimens, often with measurable decreases in residual DCIS, suggesting an active process of “immunoediting” for HER-2/neu–expressing tumor cells following vaccination. DC1 vaccination strategies may therefore have potential for both the prevention and the treatment of early breast cancer. [Cancer Res 2007;67(4):1842–52]
APC Mutations and Other Genetic and Epigenetic Changes in Colon Cancer
Authors: Samowitz Wade S. , Slattery Martha L. , Sweeney Carol , Herrick Jennifer , Wolff Roger K. , Albertsen Hans 
Published: February 2007

Abstract
Relationships between adenomatous polyposis coli (APC) mutations, BRAF V600E mutations, and the CpG island methylator phenotype (CIMP) in colon cancer have not been explored. In addition, controversies exist about the proportion of tumors with APC mutations in the mutation cluster region (MCR); how commonly APC, Ki-ras, and p53 mutations occur in the same tumor; and whether APC mutations occur in sporadic microsatellite-unstable tumors. The APC gene was therefore sequenced in 90 colonic adenocarcinomas previously evaluated for CIMP, microsatellite instability, BRAF, Ki-ras, and p53. APC mutations were inversely related to BRAF mutations (P = 0.0003) and CIMP (P = 0.02) and directly related to p53 and Ki-ras mutations (P = 0.04). Slightly more than half of APC mutations occurred outside of the MCR, and frameshift mutations were more likely than nonsense mutations to occur in the MCR (21 of 28 versus 12 of 40, P = 0.0003). APC mutations were found in sporadic microsatellite-unstable tumors and were more likely to be frameshifts in short nucleotide repeats (P = 0.007). The occurrence of APC, Ki-ras, and p53 mutations together in the same tumor was uncommon (11.1%). In conclusion, an analysis restricted to the MCR will miss more than half of APC mutations as well as mischaracterize their mutational spectrum. The conventional wisdom that most colon cancers contain APC, Ki-ras, and p53 mutations is incorrect. Microsatellite instability may precede acquisition of APC mutations in sporadic microsatellite-unstable tumors. The relationships of APC mutations to other genetic and epigenetic alterations add to the already impressive genetic heterogeneity of colon cancer. (Mol Cancer Res 2007;5(2):165–70)
Pattern of Care for Schizophrenia Patients in Granada (Spain): A Case Register Study
Authors: Moreno B. , Cervilla J. , Luna J. D. , Torres F. 
Published: February 2007

Aims: This study sets out to explore the use flow of mental health services by a cohort of patients with schizophrenia located in Granada (Spain). Methods: All cases (N = 844) included in the analysis were users of the community mental healthcare public service provided in the area. The Markov chain model was used to calculate the probability of transition from one type of contact with mental health services resources to another type of contact in the next month, over a three-year follow-up. Results: For a given one-month period, for each level of service contact, most patients continued to use the same level of care. Conclusions: Our results can be interpreted as a reflection of adequate continuity of mental health care provided by the Andalusian community service.
Case Management for Individuals with a Severe Mental Illness: A 6-Year Follow-Up Study
Authors: Björkman Tommy , Hansson Lars 
Published: February 2007

Background: As a part of a set of reforms launched in 1995, 10 pilot case management services were established in Sweden, which have been subject to an evaluation with regard to outcome and changes in use of services. The present study was designed to provide information about client outcomes over a 6-year follow-up period. Aims: The aim of the study was to investigate changes during the follow-up period with regard to symptoms, needs for care, psychosocial functioning, quality of life and social network. Methods: The study used a time series design with 6-year follow-up of client outcomes. Results: Of the original 176 clients, 92 clients participated in the 6-year follow-up. Improvements were found in a number of clinical aspects, quality of life and social network, and a decrease in use of psychiatric services during the follow-up period. Conclusions: The findings support results from earlier studies showing a decrease in use of psychiatric services and sustained improvements in social functioning. The study also supports the findings that client outcomes change over time and that certain outcomes do not appear in a short-term perspective.
Effects of a Novel Sterilization Process on Soft Tissue Mechanical Properties for Anterior Cruciate Ligament Allografts
Authors: Schimizzi Aimee , Wedemeyer Michelle , Odell Tim , Thomas Walter , Mahar Andrew T. , Pedowitz Robert 
Published: February 2007

Background Allograft anterior cruciate ligament reconstruction provides benefits such as earlier return to activities and less pain, but concerns remain regarding potential infection and biomechanical stability. Hypothesis There is no difference in biomechanical properties of soft tissue allografts treated with the Biocleanse tissue sterilization process compared with irradiated and fresh-frozen allografts. Study Design Controlled laboratory study. Methods Thirty-six tibialis anterior allografts were equally divided between Biocleanse, irradiated, and fresh-frozen groups. Grafts were measured for cross-sectional area and looped over a smooth rod with the free sutured ends of the graft fixed in custom clamps. Specimens were tensioned to 10 N for 2 minutes and then loaded between 50 and 300 N for 1000 cycles followed by a failure test. Data for creep (mm); stiffness (N/mm) at cycles 1, 10, 100, and 1000; failure load (N); and failure stress (MPa) were compared with a one-way analysis of variance (P < .05). Results There were no statistically significant differences in creep between groups. Sterilized groups (irradiated = 144.7 ± 17.7 N/mm and Biocleanse = 146.5 ± 28.2N/mm) were significantly stiffer during the first cycle than the fresh-frozen group (117.8 ± 15.7 N/mm, P < .005) without statistically significant differences for subsequent cycles. There were no differences between groups for either failure load (fresh-frozen = 1665 ± 291.3 N, irradiated = 1671.9 ± 290.2 N, Biocleanse = 1651.6 ± 377.4 N) or failure stress. Conclusion Data for “time-zero” physiologic stiffness and failure loads indicate that the Biocleanse process does not adversely affect the biomechanical properties of the allograft material. Clinical Relevance This novel sterilization technique may provide surgeons with potential allograft material with similar biomechanical properties to native tissue.
Reconstruction of Chronic Achilles Tendon Rupture with the use of Interposed Tissue between the Stumps
Authors: Yasuda Toshito , Kinoshita Mitsuo , Okuda Ryuzo 
Published: February 2007

Background The gap between the tendon stumps in chronic Achilles tendon rupture has reportedly been filled with interposed scar tissue. In the authors’ clinical experience, this interposed tissue is often thick and resists tension, so they considered it was possible to use the interposed tissue for reconstruction of Achilles tendon rupture. Hypothesis Scar tissue interposed between the tendon stumps has the capacity to form tendon-like repair tissue in patients with chronic Achilles tendon rupture. Study Design Case series; Level of evidence, 4. Methods Six patients with chronic rupture of the Achilles tendon underwent tendon reconstruction with the use of interposed tissue between the stumps. The average time from the primary injury to surgery was 22 weeks (range, 9 to 30 weeks). Preoperative magnetic resonance imaging (MRI), histology of the interposed tissue, and clinical results were evaluated. The average postoperative follow-up period was 31 months (range, 24 to 43 months). Results Preoperative T2-weighted MRI in all cases revealed that chronically ruptured Achilles tendons were thickened and fusiform-shaped with diffuse intratendinous high-signal alterations throughout. Longitudinal high-signal bands were seen throughout the tendon, except at the musculotendinous junction and insertion on the calcaneus. Histologically, scar tissue interposed between the tendon stumps consisted of dense collagen fibers, and degenerative changes were not seen. After surgery, no patient had difficulty in walking or stair climbing, and all were able to perform a single-limb toe raise. The mean preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores were 88.2 and 98.3 points, respectively; the difference was statistically significant (P = .0277). Conclusion Interposed tissue between the tendon stumps is suitable for repair of chronic Achilles tendon rupture if preoperative MRI shows a thickened fusiform-shaped Achilles tendon with diffuse intratendinous high-signal alterations throughout.
Matrix Metalloproteinase Inhibitors Prevent a Decrease in the Mechanical Properties of Stress-Deprived Tendons
Authors: Arnoczky Steven P. , Lavagnino Michael , Egerbacher Monika , Caballero Oscar , Gardner Keri 
Published: February 2007

Background An increase in matrix metalloproteinases (MMPs) and the resulting degradation of the extracellular matrix have been implicated in the pathogenesis of tendinopathy. Studies have documented the beneficial effects of MMP inhibitors used to treat pathologic conditions in which MMP activity has had a negative effect on connective tissues. Hypothesis Matrix metalloproteinase inhibitors will prevent the decrease in material properties associated with tendon stress deprivation by inhibiting MMP activity. Study Design Controlled laboratory study. Methods Rat tail tendons were subjected to 7 days of in vitro stress deprivation with and without the addition of 1 of 2 broad-spectrum MMP inhibitors (doxycycline and ilomastat). The material properties (ultimate tensile stress, strain, and tensile modulus) of the tendons were compared with each other and with fresh control tendons. In addition, tendons from each group were evaluated for MMP-13 messenger RNA expression, MMP-13 protein synthesis, MMP-13 activity, and pericellular matrix morphology. Results Both MMP inhibitors resulted in a statistically significant reduction in MMP activity in 7 day stress-deprived tendons when compared with nontreated, stress-deprived tendons. Similarly, tendons treated with either ilomastat or doxycycline had significantly improved material properties. MMP-13 messenger RNA expression and protein synthesis were not significantly affected by either MMP inhibitor. Both MMP inhibitors were able to maintain the integrity of the pericellular matrix when compared with nontreated, stress-deprived tendons. Conclusion Matrix metalloproteinase inhibitors prevented the activation of MMP-13 and significantly inhibited pericellular matrix degeneration and the loss of material properties associated with stress deprivation. Clinical Relevance Matrix metalloproteinase inhibitors may play a supportive role in the treatment of tendinopathy by limiting the MMP-mediated degradation of the extracellular matrix.
Glenohumeral Internal Rotation Deficits in Professional Pitchers Enrolled in an Internal Rotation Stretching Program
Authors: Lintner David , Mayol Magdiel , Uzodinma Obinna , Jones Rex , Labossiere David 
Published: February 2007

Background Repetitive throwing motion creates increased external rotation and decreased internal rotation in the glenohumeral joint. There is controversy regarding the contribution of osseous and soft tissue adaptations to these changes in rotation. Objective To evaluate internal rotation deficits in the professional baseball thrower's shoulder and determine the impact of an internal rotation stretch program on that deficit. Study Design Cross-sectional study; Level of evidence, 3. Methods Eighty-five male professional pitchers were evaluated in this study. Players were divided into 2 groups based on length of participation in an appropriate internal rotation stretch program. Data were collected on internal and external rotations and total range of motion in both dominant and nondominant arms using a goniometer. Internal rotation deficit (the lack of internal rotation relative to the opposite side) was calculated. Generalized comparative statistical tests were used. Results Pitchers with 3 or more years in a stretch program (group 1) had greater internal rotation (74.3° vs 54.3°) and greater total range of motion (217.0° vs 194.2°) in dominant shoulders than did pitchers with less than 3 years (group 2). Total range of motion was greater in the dominant than in the nondominant arm for group 1. Internal rotation deficit in dominant arms was significantly greater for group 2 than for group 1. The analysis of dominant arm rotation relative to years in an internal rotation stretching program for pitchers in both groups showed a progressive increase in both internal rotation and total arc of motion with the number years in such a program plateauing after year 3. Conclusion The throwing motion shifts the total arc of motion toward external rotation and diminishes internal rotation. The increased external rotation may be attributable to increased humeral retroversion. The internal rotation deficit, however, is caused by soft tissue adaptations that can be addressed by consistent participation in a stretching program focused on internal rotation.