bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland
Authors: Ebnöther Corina , Tanner Beate , Schmid Flavia , Rocca Vittoria La , Heinzer Ivo , Bregenzer Thomas 
Published: December 2007

Objective.To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center.Methods.Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared with the amount consumed after the intervention. The intervention included additional staff for infection control, repeated instructions for hand hygiene, new guidelines for preoperative antibiotic prophylaxis, and isolation of patients infected or colonized with multidrug-resistant bacteria.Results.The rate of nosocomial infection decreased from approximately 11.7% to 6.8% in 2 years. The rate of hand hygiene compliance increased by 20.0%; it was 59.0% before the intervention and increased to 79.0% afterward. These results correlate with data on the consumption of alcohol-based hand rub, but not with data on the use of antibiotics.Conclusion.Within 2 years, a multimodal infection control program intervention such as this one may reduce the rate of nosocomial infection at a tertiary care center by more than one-third and improve both the quality of care and patient outcomes. It may also generate considerable savings. Therefore, such programs should be promoted not only by hospital epidemiologists but also by hospital administrators.
What's being used to spike your drink? Alleged spiked drink cases in inner city London
Authors: Greene S L , Shiew C M , Streete P , Mustchin S J , Hugget D , Earl B , Dargan P I 
Published: December 2007

Abstract

Objectives
To determine the incidence and character of drink spiking in an urban population of patients within the UK presenting to an emergency department concerned they had consumed a deliberately contaminated drink.

Study design
Prospective case series determining the presence and quantity of sedative and illicit drugs, and ethanol in biological samples (blood and urine) obtained from consenting patients &gt;18 years of age presenting to a large inner city London emergency department alleging they had consumed a spiked drink within the previous 12 h.

Results
Biological samples were obtained from 67 (blood) and 75 (urine) of 78 study participants. 82% of participants were female, mean age 24 years. Mean time from alleged exposure to biological sampling was 5.9 h (range 1–12 h). Ethanol was detected in 89.7% of participants. Mean serum ethanol concentration was 1.65 g/l (range 0.04–3.1 g/l); 60% of participants had a serum ethanol concentration associated with significant intoxication (&gt;1.5 g/l). Illicit drugs were detected in 12 (15%) participants; 7 denied intentional exposure (3 methylenedioxymethamphetamine, 3 cannabis, 1 γ-hydroxybutyrate). Medicinal drugs were detected in 13 participants; only 1 exposure was unexplained (benzodiazepine). Overall illicit or medicinal drugs of unexplained origin were detected in 8 (10%) participants. Unexplained sedative drug exposure was detected in only 2 (3%) participants.

Conclusions
Use of sedative drugs to spike drinks may not be as common as reported in the mainstream media. A large number of study participants had serum ethanol concentrations associated with significant intoxication; the source (personal over-consumption or deliberate drink spiking) is unclear.
Empirical Analysis of Intraseasonal Climate Variability over the Greater Horn of Africa
Authors: Bowden Jared H. , Semazzi Fredrick H. M. 
Published: December 2007

Abstract
This study examines the intraseasonal climate variability over the Greater Horn of Africa (GHA) during the rainy season of October–December (OND). The investigation is primarily based on empirical orthogonal function (EOF) analysis of the pentad Climate Prediction Center Merged Analysis of Precipitation (CMAP) data for the period 1979–2001. The EOF analysis reveals two dominant modes of intraseasonal variability for the OND season: mixed El Niño–Southern Oscillation–Indian Ocean dipole (ENSO-IOD) and a decadal mode.
The leading mode is associated with ENSO–IOD covariability. Case studies of several intraseasonal ENSO–IOD events within the recent decades indicate that during the warm (positive) events pentad rainfall is consistently above normal during the entire season despite fluctuations between pentads. However, case study analyses of negative ENSO–IOD events show that the negative cases are not mirror images of the warm events. The negative events exhibit pronounced wet and dry spells superimposed on the consistent dry anomaly background conditions. There is no large signal regarding the onset for either case, but the withdrawal of the positive (negative) events is anomalously wet (dry).
The second mode of variability is associated with a decadal shift in the rainfall with the northern (southern) GHA becoming wetter (drier) in the recent decade. The decadal change in individual pentads can be quite different across the season and has a tendency to manifest itself through extreme events. The analysis underscores the need to exercise caution when applying seasonal-average-based statistics to infer the long-term behavior on subseasonal time scales. Additional analyses further confirm the decadal rainfall shift using four different rainfall datasets. Averaging the datasets to help aid in removing bias of individual datasets shows that, on average, northern (southern) portions of GHA are 29% (19%) wetter (drier) in the recent decade.
Decadal North Pacific Bred Vectors in a Coupled GCM
Authors: Vikhliaev Yury , Kirtman Ben , Schopf Paul 
Published: December 2007

Abstract
A number of recent studies done with simple numerical models suggest that the decadal variability in the extratropical North Pacific Ocean is a result of the excitation of low-frequency ocean basin modes. To test this assumption, low-frequency North Pacific variability was examined using a state-of-the-art coupled general circulation model (CGCM). Earlier studies had shown that slowly varying dynamical modes in a CGCM can be effectively isolated using the breeding technique. In this study, the breeding method was applied to the Center for Ocean-Land-Atmosphere Studies (COLA) anomaly coupled GCM (ACGCM), and it was found that several types of slow modes can be isolated depending on the parameters of the breeding cycle.
Tropical bred vector SST and upper-ocean heat content are dominated by the ENSO, which is consistent with the results obtained earlier using other CGCMs. Extratropical bred vector upper-ocean heat content is dominated by oceanic instability localized east of Japan, varying on seasonal-to-interannual time scales, and decadal modes with the large-scale pattern over the central and eastern extratropical North Pacific. Similar to ocean basin modes, the decadal modes have a signature of westward-propagating long baroclinic Rossby waves, but do not exhibit the global imprint typical for global basin modes. The relationship between the decadal bred vectors and the background anomalies is consistent with linear damped dynamics. Presumably, the growth of the decadal bred vectors is due to the atmospheric stochastic forcing, but the existence of extratropical instability on decadal time scales still needs to be verified.
The Darbār, the British, and the Runaway Mahārāja
Authors: Saha Shandip 
Published: December 2007

The Vallabha Sampradāya or Pusti Mārga Hindu devotional community was founded in the sixteenth century by the Vaisnavite philosopher, Vallabha. His successors, known as mahārājas, continued to spread the teachings of the Pusti Mārga and enjoyed much success in Rajasthan and Gujarat. Political and economic patronage by elites of Western India soon transformed these mahārājas into wealthy landlords whose affluent lifestyles would cause much controversy in the nineteenth century. This article uses unpublished documents found in the National Archives of India to detail one of these controversies, revolving around struggles between the Pusti Mārga, the royal house of Mevād., and British authorities for control of the wealth associated with Nāthdvārā, the central focus of Pusti Mārga pilgrimage in Rajasthan. The protracted struggle for the control of Nāthdvārā indicates how Hindu spiritual leaders were far from passive observers of the world who gave themselves purely to the cultivation of spiritual pursuits. On the contrary, this particular controversy is a striking example of how the active engagement of religious leaders in local and regional politics could profoundly affect the existing religious and social structures of their time.
Original Research: Carotid intima-media thickness and plaque volume changes following 2-year angiotensin II-receptor blockade. The Multicentre Olmesartan atherosclerosis Regression Evaluation (MORE) study
Authors: Stumpe Klaus O. , Agabiti-Rosei Enrico , Zielinski Tomasz , Schremmer Dieter , Scholze Jürgen , Laeis Petra , Schwandt Peter , Ludwig Malte 
Published: December 2007

Objective The Multicentre Olmesartan atherosclerosis Regression Evaluation (MORE) study was a double-blind trial in patients with hypertension at increased cardiovascular risk with carotid wall thickening and a defined atherosclerotic plaque that used non-invasive 2- and 3-dimensionaL (D) ultrasound (US), to compare the effects of a 2-year treatment based on either olmesartan medoxomil or atenolol on common carotid (CC) intima-media thickness (IMT) and plaque volume (PV). Methods A total of 165 patients (with systolic/diastolic blood pressure 140—180/ 90—105 mmHg) were randomized to receive either olmesartan (20—40 mg/day) or atenolol (50—100 mg/day). US was performed at baseline and 28, 52 and 104 weeks. The primary efficacy outcome was the change from baseline ( Δ) in CC-IMT assessed by 2D US. Secondary outcomes included Δ PV assessed by 3D US and blood pressure (BP). Results Olmesartan and atenolo produced comparable significant reductions in CC-IMT; mean Δ IMT (SEM) was -0.090 (0.015) mm for oLmesartan and -0.082 (0.014) mm for atenolol. Mean Δ PV was -4.4 (2.3) µl and 0.1 (1.5) µl in the olmesartan and atenolol treated subjects, respectively, without significant between-treatment differences. In the subgroup of patients with baseLine PV ≥ median (33.7 µl), significant between-treatment differences existed in Δ PV ( p = 0 .023), because PV regressed significantly with olmesartan ( Δ PV: -11.5 (4.4) µl) but not with atenolol ( Δ PV: 0.6 (2.5) µl). In these patients BP reductions were comparabLe. Conclusions Carotid IMT and BP decreased similarly with olmesartan and atenolol, but only olmesartan reduced the volume of larger atherosclerotic plaques.
Continuous exposure to Plasmodium results in decreased susceptibility and transcriptomic divergence of the Anopheles gambiae immune system
Authors: Aguilar Ruth , Das Suchismita , Dong Yuemei , Dimopoulos George 
Published: December 2007

Abstract

Background

Plasmodium infection has been shown to compromise the fitness of the mosquito vector, reducing its fecundity and longevity. However, from an evolutionary perspective, the impact of Plasmodium infection as a selective pressure on the mosquito is largely unknown.

Results
In the present study we have addressed the effect of a continuous Plasmodium berghei infection on the resistance to infection and global gene expression in Anopheles gambiae.
Exposure of A. gambiae to P. berghei-infected blood and infection for 16 generations resulted in a decreased susceptibility to infection, altered constitutive expression levels for approximately 2.4% of the mosquito's total transcriptome and a lower basal level of immune genes expression, including several anti-Plasmodium factors. The infection-responsiveness for several defense genes was elevated in the P. berghei exposed mosquito colonies.

Conclusion
Our study establishes the existence of a selective pressure exerted by the parasite P. berghei on the malaria vector A. gambiae that results in a decreased permissiveness to infection and changes in the mosquito transcriptome regulation that suggest a decreased constitutive immune gene activity but a more potent immune response upon Plasmodium challenge.
Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center
Authors: Tsai Chun-Yen , Wang Mu-Chia , Liao Wei-Tsen , Lu Jui-Heng , Sun Pi-hung , Lin Blossom Yen-Ju , Breen Gerald-Mark 
Published: December 2007

Abstract

Background
This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined.

Method
The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1) Internal Medicine; 2) Surgery; 3) Ophthalmology; 4) Obstetrics-Gynecology and Pediatrics; 5) Chinese Medicine; 6) Otolaryngology; 7) Orthopedics; 8) Family Medicine; and 9) Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1) visual environment; 2) hearing environment; 3) body contact environment; and 4) cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study.

Results
All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness), multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time.

Conclusion
Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal characteristics when redesigning more comfortable and customized physical environments of waiting areas.
Poly(lactic acid) Inverse Opal as Implantable Photonic Bandgap Materials
Authors: Fujishima Musashi , Sakata Syoei , Kikoku Masakazu , Ogawa Daiju , Uchida Kumao 
Published: December 2007

Abstract
Macroporous poly(lactic acid) with inverse opal structure (IoPLA) was fabricated by colloidal crystal templating. IoPLA shows an intense near-infrared (NIR) reflection, which comes from the optical diffraction upon the periodic macroporous structure composed of uniformly sized pores. It is demonstrated that in vivo implantation of IoPLA leads to destruction of the inverse opal structure, causing a notable decrease in the intensity of the NIR reflection peak. IoPLA with this degradation-dependent optical property might become an implantable photonic bandgap material that can report the state of degradation and co-occurring events in a nondestructive, real-time manner.
Three-dimensional custom-designed cementless femoral stem for osteoarthritis secondary to congenital dislocation of the hip
Authors: Flecher X. , Parratte S. , Aubaniac J.-M. , Argenson J.-N. 
Published: December 2007

A clinical and radiological study was conducted on 97 total hip replacements performed for congenital hip dislocation in 79 patients between 1989 and 1998 using a three-dimensional custom-made cementless stem. The mean age at operation was 48 years (17 to 72) and the mean follow-up was for 123 months (83 to 182). According to the Crowe classification, there were 37 class I, 28 class II, 13 class III and 19 class IV hips. The mean leg lengthening was 25 mm (5 to 58), the mean pre-operative femoral anteversion was 38.6° (2° to 86°) and the mean correction in the prosthetic neck was −23.6° (−71° to 13°). The mean Harris hip score improved from 58 (15 to 84) to 93 (40 to 100) points. A revision was required in six hips (6.2%). The overall survival rate was 89.5% (95% confidence interval 89.2 to 89.8) at 13 years when two hips were at risk. This custom-made cementless femoral component, which can be accommodated in the abnormal proximal femur and will correct the anteversion and frontal offset, provided good results without recourse to proximal femoral corrective osteotomy.
The effects of the sympathetic nerves on lumbar radicular pain
Authors: Mizuno S. , Takebayashi T. , Kirita T. , Tanimoto K. , Tohse N. , Yamashita T. 
Published: December 2007

A rat model of lumbar root constriction with an additional sympathectomy in some animals was used to assess whether the sympathetic nerves influenced radicular pain. Behavioural tests were undertaken before and after the operation. On the 28th post-operative day, both dorsal root ganglia and the spinal roots of L4 and L5 were removed, frozen and sectioned on a cryostat (8 μm to 10 μm). Immunostaining was then performed with antibodies to tyrosine hydroxylase (TH) according to the Avidin Biotin Complex method. In order to quantify the presence of sympathetic nerve fibres, we counted TH-immunoreactive fibres in the dorsal root ganglia using a light microscope equipped with a micrometer graticule (10 x 10 squares, 500 mm x 500 mm). We counted the squares of the graticule which contained TH-immunoreactive fibres for each of five randomly-selected sections of the dorsal root ganglia. The root constriction group showed mechanical allodynia and thermal hyperalgesia. In this group, TH-immunoreactive fibres were abundant in the ipsilateral dorsal root ganglia at L5 and L4 compared with the opposite side. In the sympathectomy group, mechanical hypersensitivity was attenuated significantly. We consider that the sympathetic nervous system plays an important role in the generation of radicular pain.
The effect of metal ions in solution on bacterial growth compared with wear particles from hip replacements
Authors: Anwar H. A. , Aldam C. H. , Visuvanathan S. , Hart A. J. 
Published: December 2007

The biological significance of cobalt-chromium wear particles from metal-on-metal hip replacements may be different to the effects of the constituent metal ions in solution. Bacteria may be able to discriminate between particulate and ionic forms of these metals because of a transmembrane nickel/cobalt-permease. It is not known whether wear particles are bacteriocidal. We compared the doubling time of coagulase negative staphylococcus, Staphylococcus aureus and methicillin resistant S. aureus when cultured in either wear particles from a metal-on-metal hip simulator, wear particles from a metal-on-polyethylene hip simulator, metal ions in solution or a control. Doubling time halved in metal-on-metal (p = 0.003) and metal-on-polyethylene (p = 0.131) particulate debris compared with the control. Bacterial nickel/cobalt-transporters allow metal ions but not wear particles to cross bacterial membranes. This may be useful for testing the biological characteristics of different wear debris. This experiment also shows that metal-on-metal hip wear debris is not bacteriocidal.
Buspirone for Autistic Disorder in a Woman with an Intellectual Disability
Authors: Brahm Nancy C , Fast Gary A , Brown Robert C 
Published: December 2007

Objective: To describe a case of an intellectually disabled patient who was diagnosed with autistic disorder (AD) and responded positively to buspirone, demonstrated by a reduction in target behaviors of self-injury, property destruction, and physical aggression. Case Summary: A 33-year-old, white, nonverbal, profoundly intellectually impaired woman (IQ <20–25), residing in a state-run facility, exhibited worsening aggressive behaviors associated with AD. These behaviors were characterized by a history of self-injurious behavior (eg, slapping and scratching herself); property destruction, including breaking windows: and head butting of staff and peers. Additional diagnoses included a seizure disorder, hyperprolactinemia, and osteoporosis. At the time of admission, her drug regimen included 3 atypical antipsychotic agents: risperidone, clozapine, and aripiprazole. Antipsychotic agents have been reported to lower the seizure threshold, and elevated prolactin levels have been associated with risperidone use. Aripiprazole and clozapine were discontinued on admission, and risperidone was discontinued one month later following increased behavioral deterioration. Buspirone was considered an appropriate replacement medication, as it has not been associated with elevated prolactin levels or a lowered seizure threshold, and was initiated at 15 mg/day. Significant reductions in aggression were noted following titration to a total dairy dose of 90 mg. Discussion: Buspirone is approved for treatment of generalized anxiety disorder in adults. Dopaminergic agonist/antagonist actions have been reported with use of higher doses. These receptor effects have been beneficial for aggressive behaviors in the AD population that were exhibited by our patient, but effectiveness for aggression in the intellectually disabled population is uncertain. In our patient, problematic behaviors associated with AD responded positively to buspirone. Conclusions: The reduction in target aggressive behaviors achieved with buspirone therapy allowed other treatment interventions to proceed more effectively in our patient. Clinicians may wish to consider use of buspirone in patients with AD who do not respond to or have risk factors (or use of other therapy.
The social character of parental and adolescent television viewing: An event history analysis
Authors: Westerik Henk , Renckstorf Karsten , Lammers Jan , Wester Fred 
Published: December 2007

Abstract
The amount of time that people spend on watching television is a matter of social concern. In the past, several approaches have been developed explaining why people expose themselves to television, most notably the Uses and Gratifications approach. Building on an action theoretical framework, it is argued that the influence of routinization and situational context of television viewing (including the role played by others) should receive more attention. This approach is then applied to media use in households, with an emphasis on how adolescents and parents influence each other's television viewing. Event history on data from 55 Dutch households (including 86 adolescents and their parents) show that the influence of parents and their adolescent children is reciprocal, that is, not only do parents influence their children, but children also influence their parents. This influence does, however, not increase during the teenage years, nor does parental influence diminish during those years.