bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectory tracking for a serial robot manipulator passing through singular configurations based on the adaptive kinematics Jacobian method
Authors: Hasan A T , Hamouda A M S , Ismail N , Aris I , Marhaban M H 
Published: February 2009

This paper discusses the use of artificial neural networks (ANNs) as a method of trajectory tracking control for a robotic system. Using an ANN does not require any prior knowledge of the kinematics model of the system being controlled; the basic idea of this concept is the use of the ANN to learn the characteristics of the robot system rather than to specify an explicit robot system model. In this approach, disadvantages of some schemes such as the fuzzy learning control, for example, have been elevated. Off-line training was performed for a geometric trajectory that is free of obstacles. Studying the kinematics Jacobian of serial manipulators by using ANNs has two problems: one of these is the selection of the appropriate configuration of the network and the other is the generation of a suitable training dataset. In this approach, although this is very difficult in practice, training data were recorded experimentally from sensors fixed on each joint to overcome the effect of kinematics uncertainties present in the real world such as ill-defined linkage parameters, links flexibility, and backlashes in the gear train. Then two network configurations were compared to find the best configuration to be used. Finally, the simulation results were verified experimentally using a general six-degree-of-freedom (DOF) serial robot manipulator.
A genetically trained adaptive neuro-fuzzy inference system network utilized as a proportional-integral-derivative-like feedback controller for non-linear systems
Authors: Lutfy O F , Noor Mohd S B , Marhaban M H , Abbas K A 
Published: February 2009

This paper presents a genetically trained PID (proportional-integral-derivative)-like ANFIS (adaptive neuro-fuzzy inference system) acting as a feedback controller to control non-linear systems. Three important issues are addressed in this paper, which are, first, the evaluation of the ANFIS as a PID-like controller; second, the utilization of the GA (genetic algorithm) alone to train the ANFIS controller, instead of the hybrid learning methods that are widely used in the literature; and, third, the determination of the input and output scaling factors for this controller by the GA. The GA, with real-coding operators, is used to adjust all of the ANFIS parameters, which include the input and output scaling factors, the centres and widths of the input membership functions (MFs), and the consequent parameters. To show the effectiveness of this controller and its learning method, several non-linear plants, including the CSTR (continuous stirred tank reactor), have been selected to be controlled by this controller through simulation. Moreover, this controller's robustness to output disturbances has also been tested and the results clearly indicated the remarkable performance of this controller and its learning algorithm. In addition, the result of comparing the performance of this controller with a genetically tuned classical PID controller has shown the superiority of the PID-like ANFIS controller.
Activity of Novel Antibiotic Lock Solutions in a Model Against Isolates of Catheter-Related Bloodstream Infections
Authors: Bookstaver P Brandon , Williamson John C , Tucker Brian Keith , Raad Issam I , Sherertz Robert J 
Published: February 2009

Background: Catheter-related bloodstream infections (CRBSIs) are a primary concern in patients with indwelling central venous catheters (CVCs). Instillation of an antibiotic lock solution may serve as an adjunctive therapy. Objective: To evaluate the efficacy of novel antibiotic–anticoagulant lock solutions using an in vitro model of CVC infection. Methods: The following lock solutions were evaluated: daptomycin 1 mg/mL (reconstituted with lactated Ringer's [LR]) plus heparin 5000 units/mL, tigecycline 0.5 mg/mL plus ethylenediaminete-traacetate (EDTA) 30 mg/mL, gentamicin 5 mg/mL plus EDTA 30 mg/mL, oefazolin 5 mg/mL plus heparin 5000 units/mL, and phosphate-buffered NaCI 0.9% as the control solution. Analysis was performed on Hickman catheter segments inoculated with the following organisms: methicillin-sensitive Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Staphylococcus epidermidis, and Pseudomonas aeruginosa. The catheters were incubated in the candidate lock, solutions for 0, 2, 4, and 24 hours. Student's t-tests were conducted to evaluate reduction in log10 colony-forming units/milliliter (cfu/mL) of individual lock solutions compared with the control solution. For each organism, analysis of variance and Student's t-tests were performed to determine whether differences existed among the lock solutions. Results: Gentamicin plus EDTA (G+EDTA) and tigecycline plus EDTA (Ti+EDTA) resulted in significant reductions (p < 0.05) of log10 cfu/mL at 24 hours for all organisms tested. Daptomycin, reconstituted in LR, plus heparin (D+LR+H) demonstrated potent activity against all staphylococcal species (p < 0.05). With respect to MRSA, G+EDTA displayed significantly better activity than Ti+EDTA and cefazolin plus heparin (p < 0.05), but there was no significant difference compared with D+LR+H. No antagonism was noted with the addition of anticoagulants to the solutions. Conclusions: Gentamicin, tigecycline, and daptomycin in combination with anticoagulants as lock solutions displayed potent activity against common pathogens responsible for CRBSIs. Each of these lock solutions deserves strong consideration for study in a clinical trial. Further data on compatibility and stability of these solutions are needed before routine clinical use can be recommended.
Trospium Chloride Treatment of Overactive Bladder
Authors: Biastre Kelly , Burnakis Thomas 
Published: February 2009

Objective: To review the pharmacology, pharmacokinetics, safety, and clinical application of trospium chloride for the management of overactive bladder (OAB). Data Sources: Clinical literature including both primary sources and review articles was accessed through MEDLINE, International Pharmaceutical Abstracts, and Cochrane databases from 1980 through January 8, 2009. Search terms included overactive bladder, urge urinary incontinence, muscarinic receptor antagonists, and urinary frequency. Further data sources were identified from bibliographies of selected articles. Study Selection and Data Extraction: Basic pharmacology data were extracted from animal studies and pharmacokinetic data were gathered from human studies. Multicenter, parallel, randomized, double-blind, placebo-controlled studies were included to describe the efficacy and adverse effects of trospium. Data Synthesis: Trospium chloride is an antimuscarinic agent indicated for the treatment of OAB with symptoms of urge urinary incontinence, urgency, and urinary frequency. Trospium has 3 chemical and pharmacokinetic properties unique among antimuscarinic agents: it is a positively charged quaternary ammonium compound with minimal central nervous system penetration; it is not metabolized by the cytochrome P450 system, resulting in a lower tendency for drug interactions; and it is excreted mainly unchanged in the urine as the active parent compound, providing local activity to achieve early onset of clinical effect and prolonged efficacy. In two 12-week, randomized, placebo-controlled clinical studies in adults with OAB, trospium 20 mg twice daily was more effective than placebo in reducing the number of micturitions per 24 hours, reducing the number of urge incontinence episodes per week, and increasing the volume of urine voided per micturition. Placebo-controlled trials report efficacy with trospium in treatment of OAB; comparative trials with other anticholinergic agents are limited. Current therapy of OAB consists primarily of anticholinergic drugs such as oxybutynin, which are associated with therapy-limiting adverse effects. Because the prevalence of OAB is greatest among the elderly, safety considerations regarding renal function must be noted, with dosage adjustment required in patients with severe renal impairment. Conclusions: Whether the pharmacodynamic properties of trospium make it superior to other therapies will require considerable additional experience with the drug. For now, it appears to be a feasible alternative for patients who cannot tolerate oxybutynin.
Promoting Appropriate Drug Use Through the Application of the Spanish Drug-Related Problem Classification System in the Primary Care Setting
Authors: Gómez Marciana Alodia , Villafaina Antonio , Hernández Jesús , Salgado Rosa María , González Miguel Ángel , Rodríguez Jesús , Concha Manuel Martínez de la , Tarriño Alejandra , Gervasini Guillermo , Carrillo Juan Antonio 
Published: February 2009

Background: According to the Second Consensus of Granada (2002), the term drug-related problem (DRP) is defined as a health problem resulting from pharmacotherapy and is considered a negative clinical outcome (ie, a therapeutic objective is not achieved or adverse effects are reported). DRP classification systems used in primary care settings can be useful tools to detect, evaluate, and resolve DRPs. Objective: To encourage appropriate drug use in the ambulatory clinical setting through DRP detection and evaluation by means of the Spanish DRP classification system, and to document how pharmacists can help resolve DRPs through interventions with both general practitioners (GPs) and patients. Methods: Four pharmacists investigated DRPs in polymedicated patients over a 6-month period. All detected DRPs were grouped into 3 major categories: necessity, effectiveness, and safety. To resolve DRPs, pharmacists performed interventions on GPs and patients. GPs received verbal and written information about DRPs; patient interventions were in the form of private meetings on health education. Results: Four hundred twenty-two patients, 80% of whom were aged 65 years or older, were included in the study. Each patient was taking a mean ± SD of 8.1 ± 2.4 medications. Three hundred four medications were associated with 245 DRPs; medications indicated for digestive/metabolic or cardiovascular pathologies were the most prevalent. Most (60%) of the identified DRPs belonged to the effectiveness category, whereas safety issues accounted for 28.6%. The most frequently reported DRP was pathology resistant to treatment (19.6%), followed by nonadherence (16.3%). Of the 215 interventions carried out to resolve these DRPs, 173 (80.5%) were addressed to GPs, who agreed to change therapy regimens on 90.2% of the occasions. Forty-two (19.5%) interventions were addressed to patients. Furthermore, the interventions accepted by GPs and patients resolved 176 (82%) DRPs. Conclusions: The current Spanish DRP classification system is a useful tool to systematically detect and document DRPs in daily general practice, in addition, the interventions addressed by pharmacists to GPs and patients resolved most of the detected DRPs.
Identification and Evaluation of Pharmacists' Commonly Used Drug Information Sources
Authors: Wong Peck-Sze Jacqueline , Ko Yu , Sklar Grant E 
Published: February 2009

Background: Given the rate at which new medications are introduced to the market, as well as the diversity of existing drugs, pharmacists frequently need to consult drug information (Dl) sources. Currently, there is a lack of information about pharmacists' needs for and sources of DI in Singapore. Objective: To examine where practicing pharmacists in Singapore usually obtain DI and how useful and satisfactory the source is to pharmacists and to determine the kind of drug-related questions pharmacists usually receive. Methods: An online survey was sent to registered hospital and community pharmacists who were members of the Pharmaceutical Society of Singapore. The survey consisted of questions about the pharmacists' demographics, what DI source they used most often, their satisfaction with that DI source, and how frequently they received various DI questions. Results: A total of 156 pharmacists responded to the survey, for a response rate of 27.4%. The majority (82.7%) of the respondents chose reference texts as their most commonly used DI source; of these, 38.0% used the Drug Information Handbook. Reference texts were mostly rated very comprehensive (34.1%) or somewhat comprehensive (54.3%), whereas Web sites or search engines were mostly rated somewhat comprehensive (69.6%) or brief (21.7%). Most pharmacists believed that the information from reference texts could usually (51.2%) or always (48.8%) be trusted. Community pharmacists received questions on over-the-counter drugs and comparisons of drug efficacy more frequently than did hospital pharmacists (p < 0.001 and p = 0.001, respectively), whereas hospital pharmacists more frequently received questions on pharmacokinetics (p = 0.001). Conclusions: Most pharmacists in Singapore use reference texts when searching for general DI, and they find these texts more comprehensive and trustworthy than other available sources. The results also show that pharmacists in different settings receive different types of DI questions and have adequate resources to answer general DI questions.
Clinical Utility of Rituximab in Chronic Graft-Versus-Host Disease
Authors: Bates Jill S , Engemann Ashley Morris , Hammond Julia M 
Published: February 2009

Objective: To evaluate the use of rituximab in the clinical management of steroid-refractory chronic graft-versus-host disease (GVHD). Data Sources: Literature was accessed through MEDLINE and International Pharmaceutical Abstracts (1990–September 2008), both indexed and nonindexed citations, using the terms rituximab, graft-versus-host disease, monoclonal antibodies, and CD20. In addition, reference citations from the publications identified were reviewed. Study Selection and Data Extraction: All articles discussing rituximab as a therapeutic option in the treatment of GVHD that were published in English and enrolled human study participants were evaluated. Data Synthesis: Rituximab is a genetically engineered chimeric murine monoclonal antibody that binds to the CD20 differentiation antigen found on B-lymphocytes. GVHD is the leading cause of procedural-related morbidity and mortality following allogeneic hematopoietic stem cell transplantation (HSCT). Chronic GVHD (cGVHD) occurs in up to 70% of individuals undergoing HSCT, and approximately 40% of those patients are refractory to conventional T-lymphocyte–directed therapies. Limited treatments are available for individuals with steroid-refractory cGVHD. Rituximab therapy in individuals with extensive cGVHD has demonstrated clinical efficacy with manageable toxicities in retrospective and prospective studies. Conclusions: Available data suggest that rituximab is a treatment option for patients with extensive steroid-refractory cGVHD. Rituximab may be particularly effective for individuals with steroid-refractory cGVHD manifesting as thrombocytopenia or with sclerodermatous, cutaneous, and rheumatologic involvement.
Use of Hormone Replacement Therapy, 1998–2007: Sustained Impact of the Women's Health Initiative Findings
Authors: Silverman Barbara G , Kokia Ehud S 
Published: February 2009

Background: Trials of hormone replacement therapy (HRT) for prevention of chronic disease in postmenopausal women have suggested that the risks of treatment outweigh the benefits. The publication in 2002 of the Women's Health Initiative (WHI) study sparked a rapid decline in HRT purchases among American women. Objective: To examine the impact of the WHI findings on patterns of HRT use in Israeli women. Methods: We linked purchases of estrogen preparations from 1998 to 2007 by female Israeli health maintenance organization members aged 45 years and older to membership data. For each year, we calculated total annual purchases and rate of HRT utilization, characterized new users by age and mode of therapy, and examined rates of switching between modes of therapy. Results: Twenty percent of women aged 45 years and older purchased estrogen products in 2001, versus 10% in 2007 (p < 0.001; χ2). Vaginally administered products accounted for a rising percentage of purchases, from 5% in 1999 to 18% in 2007. An increasing percentage of new users aged 55 years and older started with a vaginal product (62% in 1999, 82% in 2007). After 2002, new users of oral therapy discontinued use more quickly than those who started oral therapy before 2002. Tibolone accounted for an increasing percentage of oral drugs purchased (12% in 2003, 29% in 2007). Conclusions: The WHI findings had a rapid and sustained impact on HRT utilization in a large population of Israeli women, including a sharp decrease in the rate of use, particularly of oral preparations, as well as reduced duration of therapy and increased use of vaginal preparations and tibolone as first choices for treatment.
Geriatrics: Is There an Association Between Inappropriate Prescription Drug use and Adherence in Discharged Elderly Patients?
Authors: Mansur Nariman , Weiss Avraham , Beloosesky Yichayaou 
Published: February 2009

Background: Inappropriate prescription drug (IPD) use is very common among older patients. However, its impact on medication continuity and adherence after hospitalization has not been researched, with little known regarding readmissions and mortality. Objective: To investigate the prevalence and clinical characteristics of patients discharged with IPDs and examine whether use of these drugs is related to medication continuity and adherence 1 month postdischarge as well as to readmissions and mortality 3 months postdischarge. Methods: Clinical and demographic data, postdischarge medication modification, and adherence were prospectively obtained on interview of 212 unselected elderly (aged ≥65 y) patients or, if necessary, their caregivers. Nonadherence was defined as the percentage of drug doses less than or equal to 70% or greater than or equal to 110%. Medication appropriateness was assessed retrospectively using the Beers' criteria, Results: Use of IPDs occurred in 43.5% and 44.4% of patients on admission and discharge, respectively. At discharge, the numbers of IPDs and prescribed drugs were correlated (R = 0.39; p < 0.01). No relationship was found between IPDs at discharge and age, sex, functional and cognitive status, number of chronic diseases, and reason for admission. Sixty percent of patients who were nonadherent to at least one drug had at least one IPD, compared with 37.4% of the adherent patients (p = 0.008). Nonadherence to at least one drug increased as the number of IPDs on discharge increased (p = 0.004). No relationship was found between IPD use and postdischarge medication modifications, readmissions, and mortality. Conclusions: A high number of hospitalized elderly patients are discharged with IPDs that are directly correlated with the number of prescribed drugs at discharge and postdischarge nonadherence. Further studies are needed to assess the impact of postdischarge IPD use on health outcome, and healthcare providers should work to decrease its prevalence.
Allergic Cross-Sensitivity Between Penicillin, Carbapenem, and Monobactam Antibiotics: What are the Chances?
Authors: Frumin Jane , Gallagher Jason C 
Published: February 2009

Objective: To evaluate the literature on the allergic cross-reactivity between penicillin, carbapenem, and monobactam antibiotics. Data Sources: A MEDLINE search (1950–June 2008) of the English literature was performed using the search terms β-lactam, penicillin, monobactam, carbapenem, allergy, and cross-reactivity. References of review articles were also screened for inclusion. Study Selection and Data Extraction: All articles in English from the data source were identified. Studies whose primary goal was to evaluate drug hypersensitivity and the potential for cross-reactivity were evaluated. Data Synthesis: Many patients have reported penicillin allergies that have not been verified by skin testing; many healthcare providers avoid the use of other β-lactam antibiotics, namely carbapenems, in these patients due to fear of the potential for immunoglobulin E-mediated allergic cross-reactivity. A wide range of cross-reactivity between penicillins and carbapenems has been reported in various studies; however, more recent prospective studies have shown the incidence of cross-reactivity between penicillin and carbapenem skin tests to be around 1%. Additionally, many prescribers freely use the monobactam aztreonam in penicillin-allergic patients, believing there is no cross-reactivity between the 2 drugs. Although data support the lack of cross-reactivity between aztreonam and penicillins, immunology and some clinical data support an interaction between ceftazidime and aztreonam due to the similarity of their side chains. Conclusions: Although variability in cross-reactivity rates between β-lactam classes exists in the literature, the practice of avoiding carbapenems in penicillin-allergic patients should be reconsidered. With regard to monobactams, the administration of aztreonam in a patient with a ceftazidime allergy may carry an increased risk of type 1 hypersensitivity reactions and should be considered with caution. Additionally, the importance of obtaining a thorough patient history regarding the previous allergic event, proper documentation, and penicillin skin testing is re emphasized.
Cocaine-Related Vasculitis Causing Scrotal Gangrene
Authors: Chen Szu-Chia , Jang Mei-Yu , Wang Chuan-Sheng , Tsai Kun-Bow , Chuang Shu-Hui , Chen Huang-Chi , Chang Jer-Ming 
Published: February 2009

Objective: To describe a case of possible cocaine-related vasculitis resulting in gangrene of the scrotum and review the literature on cocaine-related vascular complications. Case Summary: A 22-year-old male presented with fever, painful swelling of the right scrotum, and a blackened ulcerated lesion on the right scrotum 3 hours after smoking crack cocaine. Blood and urine cultures and serologic tests were negative, and the D-dimer level was normal. Echocardiogram showed no evidence of vegetation and results of a chest X-ray were normal. Despite treatment for presumptive orchitis with intravenous levofloxacin 750 mg/day, the ulcerated lesion of the right scrotum progressed the next day. The patient received debridement of the necrotic tissue and pathology revealed some degenerated vessels with fibrinoid deposits and inflammatory infiltrates, suggestive of vasculitis. No further tenderness and swelling of the scrotum occurred and the patient was discharged after 10 days. When he returned for follow-up, the wound had healed completely. Discussions: Cocaine-related vascular complications, including ischemic stroke, myocardial infarction, and peripheral occlusive disease, all of which have various possible mechanisms, are of clinical importance. Vasculitis is one of the mechanisms of vascular complications associated with cocaine use. According to the Naranjo probability scale, cocaine was the possible causative agent of the patient's vasculitis, which led to scrotum gangrene. To our knowledge, this is the first report in the literature of scrotum gangrene developing after crack cocaine was smoked. Conclusions: This case report describes a rare occurrence of gangrene of the scrotum associated with cocaine smoking, which is consistent with cocaine's potent vasoconstrictive activity. Cocaine abuse has the potential to cause clinically significant ischemic events anywhere in the body, independent of the method of administration.