bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventing the Airborne Spread ofStaphylococcus aureusby Persons With the Common Cold: Effect of Surgical Scrubs, Gowns, and Masks
Authors: Bischoff Werner E. , Tucker Brian K. , Wallis Michelle L. , Reboussin Beth A. , Pfaller Michael A. , Hayden Frederick G. , Sherertz Robert J. 
Published: September 2007

Objective.Transmission ofStaphylococcus aureusvia air may play an important role in healthcare settings. This study investigates the impact of barrier precautions on the spread of airborneS. aureusby volunteers with experimentally induced rhinovirus infection (ie, the common cold).Design.Prospective nonrandomized study.Setting.Wake Forest University School of Medicine (Winston-Salem, NC).Participants.A convenience sample of 10 individuals with nasalS. aureuscarriage selected from 593 students screened for carriage.Intervention.AirborneS. aureusdispersal was studied in the 10 participants under the following clothing conditions: street clothes, surgical scrubs, surgical scrubs and a gown, and the latter plus a face mask. After a 4-day baseline period, volunteers were exposed to a rhinovirus, and their clinical course was followed for 12 days. Daily swabs of nasal specimens, pharynx specimens, and skin specimens were obtained for quantitative culture, and cold symptoms were documented. Data were analyzed by random-effects negative binomial models.Results.All participants developed a common cold. Incidence rate ratios (IRRs) indicated that, compared with airborne levels ofS. aureusduring sessions in which street clothes were worn, airborne levels decreased by 75% when surgical scrubs were worn (P<.001), by 80% when scrubs and a surgical gown were worn (P<.001), and by 82% when scrubs, a gown, and a face mask were worn (P<.001). The addition of a mask to the surgical scrubs and gown did not reduce the airborne dispersal significantly (IRR, 0.92;P>.05). Male volunteers shed twice as muchS. aureusas females (incidence rate ratio, 2.04;P= .013). The cold did not alter the efficacy of the barrier precautions.Conclusions.Scrubs reduced the spread of airborneS. aureus, independent of the presence of a rhinovirus-induced cold. Airborne dispersal of S. aureus during sessions in which participants wore surgical scrubs was not significantly different from that during sessions in which gowns and gowns plus masks were also worn.
Widespread Environmental Contamination Associated With Patients With Diarrhea and Methicillin-ResistantStaphylococcusaureus Colonization of the Gastrointestinal Tract
Authors: Boyce John M. , Havill Nancy L. , Otter Jonathan A. , Adams Nicholas M. T. 
Published: September 2007

Objective.Patients colonized with methicillin-resistantStaphylococcus aureus(MRSA) may contaminate their immediate environment with this organism. However, the extent to which gastrointestinal colonization with MRSA affects environmental contamination is not known. We investigated the frequency of environmental contamination in the rooms of patients with diarrheal stools and heavy gastro-intestinal colonization with MRSA.Design.Prospective observational study.Setting.A 500-bed teaching hospital.Methods.Stool specimens submitted forClostridium difficiletoxin assays were inoculated onto colistin-naladixic acid agar. MRSA was identified with standard methods. Samples from a standardized list of 10 environmental surfaces were cultured, from the rooms of 8 patients who had diarrhea that yielded heavy growth of MRSA (case patients) and from the rooms of 6 MRSA-positive patients with stool cultures negative for MRSA (control patients). MRSA isolates from 13 patients (8 case patients and 5 control patients) and 64 of the environmental isolates recovered from their rooms were compared by pulsed-field gel electrophoresis (PFGE). One clinical isolate from a control patient was excluded because there was no corresponding environmental MRSA isolate with which to compare it.Results.Overall, MRSA were recovered from 47 (58.8%) of 80 surfaces in the rooms of case patients, compared with 14 (23.3%) of 60 surfaces in the rooms of control patients (58.8% [95% CI, 47.8-68.9] vs 23.3% [95% CI, 14.3-35.5];P<.0001). The items most commonly contaminated were bedside rails, blood pressure cuffs, television remote controls, and toilet seats. Seventy-eight percent of the environmental isolates in patients' rooms had PFGE types that were indistinguishable or closely related to those recovered from the patients' clinical specimens.Conclusions.Patients who have diarrheal stools and heavy gastrointestinal colonization with MRSA are associated with significantly greater environmental MRSA contamination than patients without MRSA in their stool, and they are likely to be the source of that contamination.
Impact of a Single Plain Finger Ring on the Bacterial Load on the Hands of Healthcare Workers
Authors: Fagernes Mette , Lingaas Egil , Bjark Per 
Published: September 2007

Objective.To investigate the impact of a single plain finger ring on the number and types of bacteria on the hands of healthcare workers (HCWs).Design.Nonequivalent control groups, posttest only (preexperimental).Methods.A total of 121 HCWs wearing 1 plain ring and 113 HCWs wearing no rings had both hands sampled by the “glove juice” technique. Quantitative culture of the samples was performed and microorganisms were identified.Setting.Two Norwegian acute care hospitals.Participants.A total of 234 HCWs who had physical contact with patients.Results.Total bacterial counts did not differ when hands with rings and hands without rings were compared, both according to nonpaired analysis (which compared the ring-bearing hands of ring-wearing HCWs to the hands of HCWs who did not wear rings [P= .661]) and according to paired analysis (which compared the ring-bearing and ring-free hands of ring-wearing HCWs [P= .071]).Staphylococcus aureuswas recovered from 18.6% of the hands sampled, belonging to 26.9% of the HCWs, but neither paired nor nonpaired analysis showed any association with ring wearing. Gram-negative bacteria were recovered from 20.3% of the hands sampled, belonging to 28.6% of the HCWs. Ring-wearing HCWs were significantly more likely to be carriers of Enterobacteriaceae (P= .006), but paired comparison of the ring-bearing and ring-free hands of these HCWs did not show significant differences (P= .180). Carriage of nonfermentative gram-negative rods did not differ between the 2 groups, by either paired or nonpaired analysis.Conclusions.Wearing a single plain finger ring did not increase the total bacterial load on the hands, nor was it associated with an increased rate of carriage ofS. aureusor nonfermentative gram-negative rods. However, plain rings were associated with an increased rate of Enterobacteriaceae carriage.
Simulating association studies: a data-based resampling method for candidate regions or whole genome scans
Authors: Wright Fred A. , Huang Hanwen , Guan Xiaojun , Gamiel Kevin , Jeffries Clark , Barry William T. , Pardo-Manuel de Villena Fernando , Sullivan Patrick F. , Wilhelmsen Kirk C. , Zou Fei 
Published: September 2007

AbstractMotivation: Reductions in genotyping costs have heightened interest in performing whole genome association scans and in the fine mapping of candidate regions. Improvements in study design and analytic techniques will require the simulation of datasets with realistic patterns of linkage disequilibrium and allele frequencies for typed SNPs.Methods: We describe a general approach to simulate genotyped datasets for standard case-control or affected child trio data, by resampling from existing phased datasets. The approach allows for considerable flexibility in disease models, potentially involving a large number of interacting loci. The method is most applicable for diseases caused by common variants that have not been under strong selection, a class specifically targeted by the International HapMap project.Results: Using the three population Phase I/II HapMap data as a testbed for our approach, we have implemented the approach in HAP-SAMPLE, a web-based simulation tool.Availability: The web-based tool is available at http://www.hapsample.orgContact: fwright@bios.unc.edu; fzou@bios.unc.edu;kirk@med.unc.edu
Factors affecting rule compliance with mesh size regulations in the Baltic cod trawl fishery
Authors: Suuronen Petri , Tschernij Vesa , Jounela Pekka , Valentinsson Daniel , Larsson P-O. 
Published: September 2007

Abstract
Suuronen, P., Tschernij, V., Jounela, P., Valentinsson, D., and Larsson, P-O. 2007. Factors affecting rule compiance with mesh size regulations in the Baltic cod trawl fishery. – ICES Journal of Marine Science, 64: 1603–1606. In this study, we evaluate the efficiency and applicability of a series of gear-based management measures, enforced since 1990, whose purpose was to improve size selectivity in the trawl fishery for Baltic cod (Gadus morhua). In general, our study revealed that these measures had no marked effect on the capture and discard of young cod. Legal and illegal manipulation of selective codends was widespread. The adoption of a codend design that offered a modest increase in selectivity, but had a good match with the legislated minimum landing size (MLS), led to greater compliance, demonstrating that a mismatch between MLS and selectivity should be avoided. It was also obvious that, generally, the fishing industry did not tolerate large short-term losses. Our evaluation is that overly ambitious rules will be circumvented, and frequent and incoherent changes in the regulations represent bad management practice. A gradual introduction of restrictions and participation by fishers in the decision-making process will increase compliance.
Acoustic and stiffness properties of gillnets as they relate to small cetacean bycatch
Authors: Mooney T. Aran , Au Whitlow W. L. , Nachtigall Paul E. , Trippel Edward A. 
Published: September 2007

AbstractMooney, T. A., Au, W. W. L., Nachtigall, P. E., and Trippel, E. A. 2007. Acoustic and stiffness properties of gillnets as they relate to small cetacean bycatch. – ICES Journal of Marine Science, 64: 1324–1332. Small cetaceans are incidental bycatch in gillnet fisheries. Dolphin and porpoise bycatch has been reduced by the use of barium sulphate-enhanced gillnets. This decreased entanglement is likely the result of either higher acoustic reflectivity or greater stiffness for barium nets. To address these variables, our study quantified the acoustic reflectivity and stiffness of six net types including barium sulphate, iron oxide-enhanced and control demersal gillnets of sizes which typically target cod (Gadus morhua) and monkfish (Lophius americanus). Acoustic reflectivity, or target strength (TS), was assessed using dolphin and porpoise-like sonar signals from 0° to 40°. TS values were used to calculate likely detection ranges. Barium sulphate- and iron oxide-enhanced nets showed increased reflectivity compared with control nets, with the barium sulphate nets generating the highest TS values. Dolphins should detect these nets in time to avoid contact, but porpoises, with typically lower source levels, may not detect nets at a range great enough to avoid entanglement. Barium sulphate line was significantly stiffer than comparable nylon line. All lines lost stiffness when soaked in seawater for 24 h. Barium sulphate nets proved stiffer and more acoustically reflective, and both factors are likely important in reducing harbour porpoise bycatch.
Controlling urban car parking – an exemplar for public management?
Authors: Kerley Richard 
Published: September 2007

PurposeThis paper aims to analyse the management of urban on street car parking as an example of the dilemmas of understanding and improving the performance of public management.Design/methodology/approachA conceptual paper that assesses empirical practice against different theoretical frameworks and suggests new management and policy directions.FindingsThe management of regulatory services such as urban on street car parking are little examined in the literature of public management, though the economic literature does review some aspects of parking behaviour. This paper analyses car parking as an exemplar site for empirical confirmation of the difficulties of reconciling multiple stakeholder interests when addressing a “wicked problem”. The paper further argues that public management theory can be developed from examination of such routine minutiae of day‐to‐day life.Originality/valueThe paper provides a fresh theoretical perspective on an every day social activity and suggests that such analysis can aid theory building for public management.
Population pharmacokinetic analysis of carboxyhaemoglobin concentrations in adult cigarette smokers
Authors: Cronenberger Carol , Mould Diane R. , Roethig Hans‐Juergen , Sarkar Mohamadi 
Published: September 2007

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The pharmacokinetics of carboxyhaemoglobin have been reported previously, primarily with regard to poisoning and toxicity.• Most of these reports have involved noncompartmental analysis of data obtained where the actual dose of carbon monoxide was not known. WHAT THIS STUDY ADDS • This study presents a comprehensive population pharmacokinetic model for carboxyhaemoglobin in adult cigarette smokers.• Since carboxyhaemoglobin is a marker of cigarette smoke exposure, model‐based evaluations can be used for simulation and other evaluations of the kinetics of this agent.AIMSTo develop a population‐based model to describe and predict the pharmacokinetics of carboxyhaemoglobin (COHb) in adult smokers.METHODSData from smokers of different conventional cigarettes (CC) in three open‐label, randomized studies were analysed using NONMEM (version V, Level 1.1). COHb concentrations were determined at baseline for two cigarettes [Federal Trade Commission (FTC) tar 11 mg; CC1, or FTC tar 6 mg; CC2]. On day 1, subjects were randomized to continue smoking their original cigarettes, switch to a different cigarette (FTC tar 1 mg; CC3), or stop smoking. COHb concentrations were measured at baseline and on days 3 and 8 after randomization. Each cigarette was treated as a unit dose assuming a linear relationship between the number of cigarettes smoked and measured COHb percent saturation. Model building used standard methods. Model performance was evaluated using nonparametric bootstrapping and predictive checks.RESULTSThe data were described by a two‐compartment model with zero‐order input and first‐order elimination with endogenous COHb. Model parameters included elimination rate constant (k10), central volume of distribution (Vc/F), rate constants between central and peripheral compartments (k12 and k21), baseline COHb concentrations (c0), and relative fraction of carbon monoxide absorbed (F1). The median (range) COHb half‐lives were 1.6 h (0.680–2.76) and 30.9 h (7.13–367) (α and β phases, respectively). F1 increased with increasing cigarette tar content and age, whereas k12 increased with ideal body weight.CONCLUSIONA robust model was developed to predict COHb concentrations in adult smokers and to determine optimum COHb sampling times in future studies.
Effect of theophylline on the rate of moderate to severe exacerbations among patients with chronic obstructive pulmonary disease
Authors: Cyr Marie‐Christyne , Beauchesne Marie‐France , Lemière Catherine , Blais Lucie 
Published: September 2007

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Despite active research, none of the existing medications used to treat chronic obstructive pulmonary disease (COPD) has been shown to modify the long‐term decline in lung function.• Theophyllines have been recognized for their bronchodilating effects and anti‐inflammatory properties, but at the same time they are associated with the risk of adverse events due to their narrow therapeutic range and potential for drug interactions.• To our knowledge, no study has investigated the effects of theophylline on outcomes that can reflect the overall morbidity of COPD patients. WHAT THIS STUDY ADDS • The use of theophyllines is associated with a reduction in the rate of COPD exacerbations compared with long‐acting β2‐agonists among COPD patients.• Theophyllines could be seen as an interesting alternative in the treatment of COPD, because they are much less expensive than long‐acting β2‐agonists, and, from the patient's perspective, an oral formulation might be easier to take than an inhaled formulation.AIMTo determine the effectiveness of theophyllines in real clinical practice on moderate to severe exacerbations.METHODSA cohort of 36 492 chronic obstructive pulmonary disease (COPD) patients aged ≥50 years was reconstructed from the health administrative databases of the province of Quebec, Canada, between 1 January 1995 and 31 December 2002 to compare users of theophyllines with users of inhaled corticosteroids (ICS) and users of long‐acting β2‐agonists (LABA) on their rate of moderate to severe COPD exacerbations.RESULTSUsers of theophyllines were found to be less likely than users of LABA [crude rates 84 vs. 91 per 100 patient‐years, adjusted rate ratio (RR) 0.89, 95% confidence interval (CI) 0.84, 0.95] and users of theophyllines plus ICS were found to be less likely than users of LABA plus ICS (crude rates 114 vs. 112 per 100 patient‐years, adjusted RR 0.89, 95% CI 0.87, 0.92) to have moderate to severe COPD exacerbations. Users of theophyllines were found to be more likely than users of ICS to have a COPD exacerbation (crude rates 84 vs. 77 per 100 patient‐years, adjusted RR 1.07, 95% CI 1.04, 1.10), and this association was even stronger among patients who had at least three exacerbations in the year prior to cohort entry (crude rates 273 vs. 213 per 100 patient‐years, adjusted RR 1.28, 95% CI 1.19, 1.38).CONCLUSIONThe use of theophyllines was found to be associated with a reduction in the rate of COPD exacerbations among all COPD patients, but to be less effective than ICS among patients with frequent exacerbations.
The effect of exercise on the absorption of inhaled human insulin in healthy volunteers
Authors: Petersen Astrid H. , Köhler Gerd , Korsatko Stefan , Wutte Andrea , Wonisch Manfred , Mautner Agnes , Rønn Birgitte B. , Clauson Per , Laursen Torben , Wollmer Per , Pieber Thomas R. 
Published: September 2007

What is already known about this subject • Exercise is known to affect absorption of other inhaled substances, but so far there are no reports on the effect of exercise on the absorption of inhaled insulin in humans. What this paper adds • This report is the first to investigate the effect of exercise on the absorption of inhaled insulin.• In this study in healthy volunteers we found that exercise early after dosing increased absorption (15–20%) of inhaled insulin over the first 2 h after start of exercise, with an approximately 30% increase in maximal insulin concentration, and unchanged overall absorption.AimsTo investigate the effect of moderate exercise on the absorption of inhaled insulin.MethodsA single‐centre, randomized, open‐label, three‐period cross‐over trial was carried out in 12 nonsmoking healthy subjects. A dose of 3.5 mg inhaled human insulin was administered via a nebulizer and followed in random order by either 1) no exercise (NOEX), 2) 30 min exercise starting immediately after dosing (EX0), or 3) 30 min exercise starting 30 min after dosing (EX30). The study was carried out as a 10 h euglycaemic glucose clamp (90 mg dl−1 (5.0 mmol l−1)).ResultsThe absorption of insulin over the first 2 h after start of exercise was 16% increased for EX0 (ratio (95%CI) 1.16 (1.04, 1.30), P = 0.01) and 20% increased for EX30 (1.20 (1.05, 1.36), P < 0.01), both compared with NOEX; the overall insulin absorption during 6 h and 10 h after dosing was not influenced by exercise. The maximum insulin concentration (Cmax) increased by 32% for EX0 and 35% for EX30 (both P < 0.01) compared with NOEX, while the time to Cmax was 31 min faster for EX0 (P < 0.01), but not significantly different after EX30, compared with NOEX.ConclusionsA significant and clinically relevant increase of insulin absorption over the first 2 h after the beginning of exercise was observed. Until data from studies using the specific insulin inhalers exists, patients using inhaled insulin should be made aware of a potential increased absorption and higher concentration of insulin in connection with exercise.
The contribution of observational studies to the knowledge of drug effectiveness in heart failure
Authors: Dobre Daniela , Van Veldhuisen Dirk J. , DeJongste Mike J. L. , Van Sonderen Eric , Klungel Olaf H. , Sanderman Robbert , Ranchor Adelita V. , Haaijer‐Ruskamp Flora M. 
Published: September 2007

AimsRandomized controlled trials (RCTs) are the golden standard for the assessment of drug efficacy. Little is known about the add‐on value of observational studies in heart failure (HF). We aimed to assess the contribution of observational studies to actual knowledge regarding the effectiveness of angiotensin‐converting enzyme inhibitors (ACEI), and β‐blockers (BB) in HF.MethodsObservational studies that assessed the effectiveness of ACEI and BB in HF were identified by searching Medline, Embase, Cochrane Database (1990–2005) and the bibliographies of published articles. Cohort, case–control and time‐series analysis studies were considered for inclusion. Studies with <100 patients and those who did not perform a multivariate analysis were excluded.ResultsA total of 23 cohort studies met the inclusion criteria. Studies of ACEI and BB showed a decrease in mortality with drug use in elderly patients with a broad range of ejection fraction (EF), and in those with depressed EF. Additionally, they showed a decrease in mortality in patients with renal insufficiency. The effect of ACEI and BB in HF with preserved EF was not clear, although last evidence suggests a potential benefit. Low‐dose ACEI and BB may have beneficial effects. Target doses of ACEI seemed superior to low doses, but there was no clear dose–response relationship.ConclusionsObservational studies in HF validate the effectiveness of ACEI and BB in populations underrepresented or excluded from RCTs. Observational studies of drug effectiveness provide relevant additional information for clinical practice.