bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Telephone Call Centers: How Do They Affect Health Care Use and Costs?
Authors: Bunik Maya , Glazner Judith E. , Chandramouli Vijayalaxmi , Emsermann Caroline Bublitz , Hegarty Teresa , Kempe Allison 
Published: February 2007

OBJECTIVES. After-hours call centers have been shown to provide appropriate triage with high levels of parental and provider satisfaction. However, few data are available on the costs and outcomes of call centers from the perspective of the health care system. With this study we sought to determine these outcomes.METHODS. Parents who called the Pediatric After-hours Call Center at the Children's Hospital of Denver from March 19, 2004, to April 19, 2004, were asked an open-ended question before triage: “We would like to know, what you would have done if you could not have called our call center this evening/today?”RESULTS. The response rate for the survey was 77.8% (N = 8980). Parents reported that they would have (1) gone to an emergency department or urgent care facility (46%), (2) treated the child at home (21%), (3) called a physician's office the next day (12%), (4) asked another person for advice (13%), (5) consulted a written source (2%), or (6) other (7%). Of the 46% of callers who would have sought emergent care, only 13.5% subsequently were given an urgent disposition by the call center. Fifteen percent of cases in which the parents would have stayed at home were given an urgent disposition by nurses. Assuming that all callers followed the advice provided, the estimated savings per call, based on local costs, was $42.61 per call. Savings based on Medical Expenditure Panel Survey national payment data were $56.26 per call.CONCLUSIONS. Two thirds of the cases in which parents reported initial intent to go to an emergency department or urgent care facility were not deemed urgent by the call center, whereas 15% of calls from parents who intended to stay home were deemed urgent. If call-center triage recommendations were followed in even half of all cases, then these results would translate into substantial cost savings for the health care system.
Adopting and adapting clinical guidelines for local use
Authors: Penney Gillian C 
Published: February 2007

Key content

Clinical guidelines help to standardise and improve patient care.
Development of a valid clinical guideline requires resources and skills.
Local adaptation of a national guideline provides a cost‐effective approach to guideline introduction.
A formal consensus process allows local stakeholders to adapt a national guideline.
The adapted guideline combines the rigour of national development with the acceptability engendered by local consensus.

Learning objectives

To gain an overview of the fundamental principles of clinical guideline development.
To learn how to adapt national guidelines for use by local NHS organisations or by groups of clinicians in non‐UK settings.

Ethical issues

Guideline introduction diverts scarce resources from direct clinical care.
Evidence indicates that guidelines result in only modest to moderate improvements in patient outcomes.
Clinicians wishing to introduce clinical guidelines should adopt an approach that minimises resource use.

Please cite this article as: Penney GC. Adopting and adapting clinical guidelines for local use. The Obstetrician & Gynaecologist 2007;9:48–52.
Impacts of Early Stages of Salmon Supplementation and Reintroduction Programs on Three Trout Species
Authors: Pearsons Todd N. , Temple Gabriel M. 
Published: February 2007

Abstract
Salmon supplementation and reintroduction programs have the potential to negatively impact other valued fish taxa that are not the targets of enhancement (nontarget taxa (NTT)). Impacts of the supplementation of spring Chinook salmon Oncorhynchus tshawytscha and the reintroduction of coho salmon O. kisutch (hereafter supplementation) on populations of rainbow trout O. mykiss, steelhead (anadromous rainbow trout), cutthroat trout O. clarkii, and bull trout Salvelinus confluentus were evaluated after 5 years of stocking approximately 1 million yearling smolts in the upper Yakima River basin between 1999 and 2003. Field methods included backpack electrofishing and snorkeling in tributaries and drift-boat electrofishing in the main stem. We used three sequential steps in our evaluation: (1) we determined whether spatial overlap occurred between supplemented fish and NTT; (2) if overlap occurred, we determined whether a change in abundance, size, or biomass occurred during supplementation; and (3) if a change occurred, we determined whether the change could be reasonably attributed to supplementation. Salmon rarely overlapped cutthroat trout or bull trout in tributaries, but some overlap with cutthroat trout occurred in relatively high elevations of the main stem and considerable overlap with rainbow trout occurred in tributaries and the main stem. Except in steelhead, the lower 90% confidence limit (CL) of abundance, size, and biomass was above the containment objective for NTT that overlapped significantly with salmon. We used rainbow trout as an analog for steelhead. The lower 90% CL of rainbow trout abundance and size in tributaries and the main stem and biomass in the main stem was below the containment objective for steelhead. However, comparisons of rainbow trout abundance, size, and biomass between tributaries and main-stem sections with relatively high and low salmon abundances revealed that the change was probably not the result of supplementation (before–after control–impact paired site analysis: P &gt; 0.05). Our data indicate that early stages of salmon supplementation have not impacted trout species in the upper Yakima River basin beyond predetermined containment objectives.
Precision of Five Structures for Estimating Age of Common Carp
Authors: Phelps Quinton E. , Edwards Kris R. , Willis David W. 
Published: February 2007

Abstract
Otoliths (asteriscus) have been validated as an accurate structure for estimating age of common carp Cyprinus carpio. However, extraction and processing of common carp otoliths are time consuming and require sacrifice of fish. Therefore, we analyzed age estimation precision of four alternative structures relative to otolith age for 139 common carp collected from five eastern South Dakota lakes. All common carp were collected using daytime electrofishing. Each fish was assigned an identification number and measured to the nearest millimeter total length, after which aging structures were removed. Age was estimated from scales, vertebrae, opercles, pectoral fin rays, and asteriscus otoliths by methods similar to those recommended by previous researchers. Relative to otolith age, average percent error was 6.8% for scales, 15.4% for vertebrae, 9.9% for opercles, and 1.2% for pectoral fin rays. Compared with all other structures, ages from pectoral fin ray sections were nearly as precise as otoliths through age 13 (lowest average percent error); however, fin rays consistently underestimated the ages of fish older than 13 years. In most cases, pectoral fin ray ages matched otolith ages, thereby providing similar age estimates. We conclude that pectoral fin rays provide a precise, economical, and nonlethal alternative for estimating common carp age structure. Accuracy of common carp ages estimated from pectoral fin rays still requires evaluation.
Extending English‐Language Learners' Classroom Interactions Using the Response Protocol
Authors: Mohr Kathleen A.J. , Mohr Eric S. 
Published: February 2007

Despite the need to use and develop their English‐language proficiency, English‐language learners (ELLs) are often quiet during classroom discussions. The Response Protocol was developed to help teachers elicit and support the oral interactions of ELL students.The Response Protocol is a framework consisting of six types of responses that students might make to teacher queries. These response options range from providing accurate information in standard English to saying nothing at all. The tendency for students to disengage from teacher‐initiated interactions can be offset by more skillful management of conversation and instruction. The Response Protocol provides follow‐up prompts teachers can use to elicit, elaborate, and extend questions and answers. Each response category is described and illustrated with authentic classroom examples. The article also includes a list of general language development guidelines that serve to improve classroom talk and support the social, emotional, language, and academic growth of English‐language learners.
Sharing Alphabet Books in Early Childhood Classrooms
Authors: Bradley Barbara A. , Jones Jennifer 
Published: February 2007

To achieve academically, young children need a strong foundation in literacy. Alphabet knowledge is one aspect of early literacy. This article presents the importance of and the components of alphabet knowledge.An exploratory study in which prekindergarten and kindergarten teachers read aloud three different alphabet books to their students in a whole‐class setting is described. Results indicate that teachers do talk about letters when reading alphabet books, but they emphasize letter names over letter–sound knowledge. Further, text features influenced what aspect of the alphabet teachers emphasized, resulting in relatively little talk about letters for one of the alphabet books. Finally, this article describes how various alphabet books may be used to introduce and to teach young children about literacy.
Genome-Wide Reprogramming in Hybrids of Somatic Cells and Embryonic Stem Cells
Authors: Ambrosi Dominic J. , Tanasijevic Borko , Kaur Anupinder , Obergfell Craig , O'Neill Rachel J. , Krueger Winfried , Rasmussen Theodore P. 
Published: February 2007

Abstract
Recent experiments demonstrate that somatic nuclei can be reprogrammed to a pluripotent state when fused to ESCs. The resulting hybrids are pluripotent as judged by developmental assays, but detailed analyses of the underlying molecular-genetic control of reprogrammed transcription in such hybrids are required to better understand fusion-mediated reprogramming. We produced hybrids of mouse ESCs and fibroblasts that, although nearly tetraploid, exhibit characteristics of normal ESCs, including apparent immortality in culture, ESC-like colony morphology, and pluripotency. Comprehensive analysis of the mouse embryonic fibroblast/ESC hybrid transcriptome revealed global patterns of gene expression reminiscent of ESCs. However, combined analysis of variance and hierarchical clustering analyses revealed at least seven distinct classes of differentially regulated genes in comparisons of hybrids, ESCs, and somatic cells. The largest class includes somatic genes that are silenced in hybrids and ESCs, but a smaller class includes genes that are expressed at nearly equivalent levels in hybrids and ESCs that contain many genes implicated in pluripotency and chromatin function. Reprogrammed genes are distributed throughout the genome. Reprogramming events include both transcriptional silencing and activation of genes residing on chromosomes of somatic origin. Somatic/ESC hybrid cell lines resemble their pre-fusion ESC partners in terms of behavior in culture and pluripotency. However, they contain unique expression profiles that are similar but not identical to normal ESCs. ESC fusion-mediated reprogramming provides a tractable system for the investigation of mechanisms of reprogramming.
Disclosure of potential conflicts of interest is found at the end of this article.
Sonic Hedgehog and Other Soluble Factors from Differentiating Embryoid Bodies Inhibit Pancreas Development
Authors: Mfopou Josué K. , De Groote Véronique , Xu Xiabo , Heimberg Harry , Bouwens Luc 
Published: February 2007

Abstract
Success of cell-replacement therapy for diabetes will largely depend on the establishment of alternative sources of pancreatic islet grafts. Embryonic stem (ES) cell differentiation toward pancreatic insulin-producing cells offers such perspectives, but there are still many challenges to overcome. Our previous studies suggested that the limited amount of insulin-positive cells derived from ES cells is related to the activation of pancreas inhibitory signals. To confirm this hypothesis, we report here that exposure of mouse embryonic pancreas explants to soluble factors from embryoid bodies (EBs) inhibits growth, morphogenesis, and endocrine and exocrine differentiation as evaluated by explant size and mRNA and protein expression. Sonic Hedgehog (Shh), an established pancreas repressor both at early and late developmental stages, was produced and secreted by EBs, and participated in the inhibitory effect by inducing its target Gli1 in the explants. Inhibition of Hedgehog pathway rescued the differentiation of Insulin-positive cells in the explants. In contrast to pancreatic cells, hepatic progenitors exposed to EB-conditioned medium showed improved differentiation of albumin-positive cells. In a model system of ES cell differentiation in vitro, we found that definitive endoderm induction by serum removal or activin A treatment further increased Hedgehog production and activity in EBs. Concomitantly, downregulation of the pancreas marker Pdx1 was recorded in activin-treated EBs, a phenomenon that was prevented by antagonizing Hedgehog signaling with Hedgehog interacting protein. These data strongly suggest that Hedgehog production in EBs limits pancreatic fate acquisition and forms a major obstacle in the specification of pancreatic cells from ES-derived definitive endoderm.
Disclosure of potential conflicts of interest is found at the end of this article.
Tannerella forsythensis prtH Genotype and Association With Periodontal Status
Authors: Hamlet Stephen M. , Taiyeb‐Ali Tara B. , Cullinan Mary P. , Westerman Bill , Palmer Janet E. , Seymour Gregory J. 
Published: February 2007

Background: The prtH gene of Tannerella forsythensis encodes for a cysteine protease possessing virulent properties. Subgingival colonization by T. forsythensis with this genotype has been suggested to be a discriminator between periodontal health and disease. This study examined the prevalence of T. forsythensis prtH genotype in subgingival plaque and its association with periodontal disease progression and current disease status.Methods: Subjects harboring T. forsythensis in their subgingival plaque were identified using real‐time polymerase chain reaction (PCR). The presence or absence of the prtH genotype was assessed by conventional PCR. Probing depths and relative attachment levels were also assessed.Results: The prtH genotype was detected in 13 of 56 (23.2%) subjects harboring T. forsythensis in their subgingival plaque. Periodontal disease progression was defined as two or more sites with ≥2 mm attachment loss in the previous 2‐year period; current disease was defined as four or more sites with probing depths ≥4 mm. The odds of periodontal disease (progression and/or current disease) were 1.55 times greater in subjects harboring prtH genotype T. forsythensis than in subjects in whom prtH was not detected. The prtH genotype was associated with higher numbers of T. forsythensis. In subjects with high levels of T. forsythensis, prtH genotype was associated with an increased extent of periodontal disease 2 years subsequently.Conclusions: These results show that T. forsythensis prtH genotype is associated with high levels of T. forsythensis. However, further work is needed to determine whether it also is a useful marker of periodontal disease progression in T. forsythensis–infected subjects.
Extracellular Signal‐Regulated Kinase 1/2 Is Involved in Ascorbic Acid–Induced Osteoblastic Differentiation in Periodontal Ligament Cells
Authors: Mimori Kaori , Komaki Motohiro , Iwasaki Kengo , Ishikawa Isao 
Published: February 2007

Background: Periodontal ligament (PDL) cells possess osteoblast‐like properties and play key roles in periodontal regeneration. Previously, we have reported that ascorbic acid promotes the osteoblastic differentiation of PDL cells by modulating the type I collagen–integrin interaction. However, the signaling pathway activated following collagen–integrin interaction is still unclear. In this study, we examined the involvement of extracellular signal‐regulated kinase (ERK)1/2 in the expression of osteoblastic marker genes such as the osteoblast‐specific transcriptional factor runt‐related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and osteocalcin (OCN) in PDL cells.Methods: PDL cells were cultured on a conventional or type I collagen–coated dish in the presence or absence of ascorbic acid and examined for ALP activity and osteoblastic marker genes. For detection of ERK1/2, cells were plated on a petri (non‐adhesive) dish or type I collagen–coated dish, and Western blot analysis was performed. The effect of the ERK1/2 inhibitor on osteoblastic marker gene expression was examined.Results: Ascorbic acid increased gene expression of Runx2, ALP, and OCN. A combination of ascorbic acid and type I collagen remarkably upregulated Runx2, ALP, and OCN gene expression and ALP activity. Western blot analysis revealed an increased level of ERK1/2 phosphorylation in cells plated on type I collagen. An ERK1/2 inhibitor suppressed ascorbic acid–induced ALP and OCN gene expression, whereas Runx2 was not affected in PDL cells.Conclusion: These results indicate that ERK1/2 is involved in ascorbic acid–induced osteoblastic differentiation during PDL cell attachment to type I collagen.
Body Mass Index in Urban Canada: Neighborhood and Metropolitan Area Effects
Authors: Ross Nancy A. , Tremblay Stephane , Khan Saeeda , Crouse Daniel , Tremblay Mark , Berthelot Jean-Marie 
Published: February 2007

Objectives. We investigated the influence of neighborhood and metropolitan area characteristics on body mass index (BMI) in urban Canada in 2001. Methods. We conducted a multilevel analysis with data collected from a cross-sectional survey of men and women nested in neighborhoods and metropolitan areas in urban Canada during 2001. Results. After we controlled for individual sociodemographic characteristics and behaviors, the average BMIs of residents of neighborhoods in which a large proportion of individuals had less than a high school education were higher than those BMIs of residents in neighborhoods with small proportions of such individuals (P< .01). Living in a neighborhood with a high proportion of recent immigrants was associated with lower BMI for men (P<.01), but not for women. Neighborhood dwelling density was not associated with BMI for either gender. Metropolitan sprawl was associated with higher BMI for men (P=.02), but the effect was not significant for women (P= .09). Conclusions. BMI is strongly patterned by an individual’s social position in urban Canada. A neighborhood’s social condition has an incremental influence on the average BMI of its residents. However, BMI is not influenced by dwelling density. Metropolitan sprawl is associated with higher BMI for Canadian men, which supports recent evidence of this same association among American men. Individuals and their environments collectively influence BMI in urban Canada.
Advancing Health and Environmental Disease Tracking: A 5-Year Follow-Up Study
Authors: Litt Jill S. , Wismann Andrea , Resnick Beth , Dawson Rebecca Smullin , Hano Mary , Burke Thomas A. 
Published: February 2007

Objectives. Our goal was to gain an understanding of the extent to which environmental public health tracking (EPHT) has progressed since the release of the 2000 Pew Environmental Health Commission report examining the nation’s EPHT infrastructure. Methods. As a follow-up to the Pew Commission report, we conducted a telephone survey of state practitioners in an effort to assess EPHT trends and changes in state-level capacities and activities over the past several years. Results. We found that new and enhanced federal–state partnerships; improved surveillance, data analysis, and communication capacities; and enhanced support of tracking personnel have provided a foundation for progress in the area of EPHT. Also, the Centers for Disease Control and Prevention’s support of EPHT has strengthened the national environmental public health infrastructure and capacity to track environmental hazards, exposures, and health. Conclusions. Improved funding, data access, and translation of data to prevention activities are critical to sustaining progress in EPHT and developing the evidence base necessary for assessing the longer-term impacts and efficacy of EPHT and related environmental health improvements.
“The Death of the ‘New Poete’: Virgilian Ruin and Ciceronian Recollection in Spenser’sThe Shepheardes Calender”
Authors: Helfer Rebeca 
Published: February 2007

AbstractThis essay explores Virgil's influence in Renaissance poetry through the literature's most common trope, that of ruin; specifically, it examines the complexity of Virgilian imitation in Spenser'sThe Shepheardes Calenderthrough an exploration of its introduction by his anonymous first critic, E.K. Through thetoposof ruin, this essay reconsiders Virgil's legacy in theCalender, suggesting that critics have underestimated Spenser's criticism of Virgil's authorial pattern. Rather than reconstructing Virgil's model of cultural transmission — that of ruin and repair—Spenser presents the Ciceronian art of memory as a competing model for the architecture of immortality, for building upon the ruins of the past.
Appropriating the Instruments of Worship: The 1512 Medici Restoration and the Florentine Cathedral Choirbooks*
Authors: Tacconi Marica S. 
Published: February 2007

AbstractThis study examines the impact of the 1512 Medici restoration on the antiphonaries and graduals of the Florentine cathedral. Seven choirhooks are recognizably Medicean in their artistic and, in one significant case, in their liturgical and musical content. Whether through depictions of the family's most distinguished members — notably Lorenzo il Magnifico and Pope Leo X — or the detailed representations of contemporary events in which the Medici were the protagonists, or whether through the creation of a new Office for Florentine bishop-saint Zenobius, these lavish manuscripts reflect the themes of control and propaganda central to the years of the Medici restoration.
The Sorbonnic Trots: Staging the Intestinal Distress of the Roman Catholic Church in French Reform Theater
Authors: Persels Jeff 
Published: February 2007

AbstractThis essay surveys the use of metaphors of illness, specifically those of constipation and diarrhea, in vernacular French Evangelical and Calvinist polemical theater of the 1520s and 30s (Berquin, Malingre, Marguerite d'Angoulême) through the 1560s (Badius). It considers the relatively frequent reference to staging of diagnosis, treatment, and cure in the context of contemporary medical belief and practice, and observes a shift in emphasis from optimistic prognosis and successful therapy of the earlier Evangelical period to negative pronouncement of imminent (and deserved) death in the later Calvinist or Huguenot period at the start of the Wars of Religion.