bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of sympathetic stimulation on proximal brachial artery mechanics in humans – differential behaviour within the length of the brachial artery?
Authors: Bjarnegård N. , Rydén Ahlgren Å. , Sonesson B. , Länne T. 
Published: August 2004

AbstractAims:  The mechanical properties of arteries play a major role in the regulation of blood pressure and cardiac performance. The effect of sympathetic stimulation on the mechanical properties of the proximal brachial artery was analysed in 18 healthy volunteers, nine young (25 ± 2 years) and nine elderly (69 ± 2 years).Methods:  A non‐invasive ultrasonic echo‐tracking system for measurement of systolic/diastolic variation of the proximal brachial artery diameter in combination with intra‐arterial pressure measurements was used to determine wall mechanics. The pressure–diameter (P–D) relationship, distensibility coefficient (DC), compliance coefficient (CC) and stiffness(β) were obtained at rest and during sympathetic stimulation induced by lower body negative pressure (LBNP).Results:  The peripheral vascular resistance increased by 100 and 72%, respectively in the young and elderly during LBNP (P < 0.001). Simultaneously, the mechanical properties of the proximal brachial artery remained unaltered, as estimated from both P–D relationship and stiffness in young (β‐index rest: 5.2 ± 0.9, LBNP: 5.5 ± 1.3, NS) as well as elderly (β‐index rest: 13.6 ± 4.6, LBNP: 16.1 ± 4.7, NS).Conclusions:  LBNP‐induced sympathetic activation does not change proximal brachial artery mechanics, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behaviour is within the length of the brachial artery, where the site of transition from elastic to muscular wall structure needs to be specified in future studies.
Muscular adaptations to computer‐guided strength training with eccentric overload
Authors: Friedmann B. , Kinscherf R. , Vorwald S. , Müller H. , Kucera K. , Borisch S. , Richter G. , Bärtsch P. , Billeter R. 
Published: August 2004

AbstractAims:  In order to investigate the muscular adaptations to a novel form of strength training, 18 male untrained subjects performed 4 weeks of low resistance–high repetition knee extension exercise.Methods:  Nine of them trained on a conventional weight resistance device (Leg curler, CON/ECC group), with loads equivalent to 30% of the concentric one‐repetition maximum (1RM) for both the concentric and eccentric phase of movement. The other nine trained on a newly developed computer‐driven device (CON/ECC‐OVERLOAD group) with the concentric load equivalent to 30% of the concentric 1RM and the eccentric load equivalent to 30% of the eccentric 1RM.Results:  Training resulted in significantly (P ≤ 0.05) increased peak torque and a tendency (P = 0.092) to increased muscle cross‐sectional area for the CON/ECC‐OVERLOAD but not the CON/ECC group, while strength endurance capacity was significantly (P ≤ 0.05) increased in the CON/ECC group only. RT‐PCR revealed significantly increased myosin heavy chain (MHC) IIa and lactate dehydrogenase (LDH) A mRNAs, a tendency for increased MHC IIx mRNA (P = 0.056) and high correlations between the changes in MHC IIx and LDH A mRNAs (r = 0.97, P = 0.001) in the CON/ECC‐OVERLOAD group.Conclusions:  These results indicate a shift towards a more type II dominated gene expression pattern in the vasti laterales muscles of the CON/ECC‐OVERLOAD group in response to training. We suggest that the increased eccentric load in the CON/ECC‐OVERLOAD training leads to distinct adaptations towards a stronger, faster muscle.
Endothelial cytochrome P450 contributes to the acetylcholine‐induced cardiodepression in isolated rat hearts
Authors: Pagliaro P. , Penna C. , Rastaldo R. , Mancardi D. , Crisafulli A. , Losano G. , Gattullo D. 
Published: August 2004

AbstractAims:  Acetylcholine (ACh) is known to reduce the contractility of the heart by acting on myocardial muscarinic M2 receptors. ACh induces also an endothelial‐dependent vasodilatation by causing the release of nitric oxide (NO), prostacyclin and endothelium‐derived hyperpolarizing factors from the vascular endothelium. It has been proposed that ACh elicits a hyperpolarization of the coronary endothelial cells which may be accompanied by the activation of cytochrome P450 (CYP) and the resulting release of epoxyeicosatrienoic acids (EETs). The study aims at investigating whether endothelial CYP is involved in the cardiodepression by ACh.Methods and results:  In isolated rat hearts, cardiodepression by ACh (i.e. 25–30% reduction of developed left ventricular pressure) was partially attenuated either by inhibition of CYP with 1‐aminobenzotriazole (ABT) or by endothelial dysfunction obtained with Triton X‐100. No attenuation of cardiodepression was seen after nitric oxide synthase and cyclooxygenase inhibition by l‐nitro‐arginine methyl ester and indomethacin, respectively.Conclusion:  The results suggest that the negative inotropic effect of ACh depends not only on a direct myocardial effect but also on the endothelial CYP activation.
Foraging ecology and interactions with fisheries of wandering albatrosses (Diomedea exulans) breeding at South Georgia
Authors: Xavier J. C. , Trathan P. N. , Croxall J. P. , Wood A. G. , Podestá G. , Rodhouse P. G. 
Published: August 2004

AbstractKnowledge about the areas used by the foraging wandering albatross, Diomedea exulans, its prey and overlap with longline fisheries is important information not only for the conservation of this species but also for furthering our understanding of the ecology of its prey. We attached satellite‐tracking devices and activity recorders to wandering albatrosses between May and July of 1999 and 2000 (years of differing food availability around South Georgia) in order to assess inter‐annual variation in the main foraging areas, association with oceanographic features (i.e. fronts, bathymetry), diet and interactions with fisheries. The overall foraging patterns of the tracked birds were similar in 1999 and 2000, ranging between southern Brazil (28°S) and the Antarctic Peninsula (63°S) and between the waters off Tristan da Cunha (19°W) and the Patagonian Shelf and oceanic waters south of Cape Horn (68°W) in the South Atlantic. In 1999, wandering albatrosses spent most time in sub‐Antarctic oceanic waters, their trip durations were significantly longer and they fed on fish and cephalopods (53 and 42% by mass, respectively). In contrast, in 2000, they spent more time in Antarctic waters, foraging trips were shorter and the diet was predominantly fish (84% by mass). Wandering albatrosses were associated with the sub‐Antarctic Front (SAF; both years), Subtropical Front (STF; in 1999) and the Tropical Front (TF; in 2000) suggesting that this species exploits prey concentrated at oceanic fronts. Fisheries discards also seemed to provide a very good source of food. Several fish species that are targeted (e.g. Patagonian toothfish, Dissostichus eleginoides) or are available as offal/discards from commercial fisheries (e.g. the macrourids, Antimora rostrata and Macrourus holotrachys) were mainly associated with the South Georgia shelf and the Patagonian Shelf, respectively. Wandering albatross foraging areas overlapped with longline fisheries in three different regions: around South Georgia, at the Patagonian Shelf and in oceanic waters north of 40°S. Females commuted more frequently to the Patagonian Shelf and to oceanic areas where longline fisheries were operating. Males, on the other hand, spent more time on the shelf/shelf slope of South Georgia where they were more at risk from the local Patagonian toothfish fishery, particularly in 2000. These results emphasize that inter‐annual variation in foraging preferences could lead to increased incidental mortality of this vulnerable species. Potential evidence for this is provided by a satellite‐tracked wandering albatross (male; 1.8‐day trip), whose diet contained a Patagonian toothfish head and a longline hook, and who spent extensive time in the water (44% of the time wet; 0.3 days of the trip) where a Patagonian toothfish longline fishing vessel was operating.
Direct pulp capping with mineral trioxide aggregate in a primary molar: a case report
Authors: BODEM O. , BLUMENSHINE S. , ZEH D. , KOCH M. J. 
Published: August 2004

Summary. A case is presented in which pulp capping was performed on a right first mandibular primary molar in a 7‐year‐old male patient. An alkaline cement powder based on mineral trioxide aggregate (MTA) was used for pulp capping. There were no pathological findings either on a radiograph taken after one year or on clinical examination after 18 months, and the right first mandibular primary molar remained vital after capping with MTA. Further clinical investigation of MTA for direct pulp capping of primary teeth should be performed.
Dental caries experience and its relationship to social and behavioural factors among 3–5‐year‐old children in Uganda
Authors: KIWANUKA S. N. , ÅSTRØM A. N. , TROVIK T. A. 
Published: August 2004

Summary.Objective. The aim of this study was to assess the socio‐demographic and behavioural correlates of caries experience and sugar intake patterns among pre‐school children in Uganda.Methods. Five hundred and eighty‐nine, 3–5‐year‐old children (51% boys, response rate = 85%), attending nursery schools in urban and peri‐urban settings in central Kampala and Nakawa, respectively, were clinically examined for dental caries using the dmft index. Visible plaque on the labial surfaces of their maxillary incisors was recorded as a proxy for oral hygiene habits. A questionnaire designed to assess socio‐demographic factors and sugar habits was completed by their caregivers in face‐to‐face interviews.Results. The mean dmft scores were 1·7, 2·4 and 3·1, and 42%, 44% and 42% had visible plaque among 3‐, 4‐ and 5‐year‐olds, respectively. In Nakawa, a total of 64%, 62% and 22% of the subjects had dmft > 0, decayed teeth (dt) > 0 and missing teeth > 0, respectively. The corresponding rates in central Kampala were 56%, 55% and 17%. Multivariate analyses revealed that attending school in Nakawa, having a mother with a lower level of education, reporting the intake of cough syrup, visiting a dentist and scoring positively for plaque were associated with higher odds (1·6, 1·5, 3·7 and 2·7) for having dmft > 0. The adjusted mean frequency sugar scores varied systematically between mothers with low and high levels of education (mean scores = 11·0 vs. 10·4), and for children with negative and positive plaque scores (mean scores = 10·6 vs. 10·9).Conclusion. The caries experience was highest among children attending nursery schools in Nakawa and those who had had longer periods of cough syrup consumption, whereas children from the two locations were equally exposed to sugar consumption generally. Both caries experience and frequency of sugar consumption was highest among children of less‐well‐educated mothers.
Pupillary reflex dilation and skin temperature to assess sensory level during combined general and caudal anesthesia in children*
Authors: Emery John , Ho David , MacKeen Leslie , Héon Elise , Bissonnette Bruno 
Published: August 2004

SummaryBackground:  Regional anesthesia causes sympathetic blockade, vasodilation and higher skin temperature in anesthetized dermatomes. Measurement of skin temperature changes might provide a useful estimate of the level of caudal anesthesia in children. Pupillary reflex dilation (PRD) allows estimation of the sensory level during combined general/epidural anesthesia in adults, but has not been assessed in children. This study was designed to evaluate skin temperature and PRD as methods of estimating sensory level in children receiving combined general/caudal epidural anesthesia.Methods:  Twenty ASA I and II children aged 10 months–5 years were enrolled. Anesthesia was induced with sevoflurane and N2O in O2 and maintained with 1 MAC isoflurane and air in O2. Caudal epidural anesthesia was achieved by injection of 1 ml·kg−1 0.25% bupivacaine. Skin temperature was measured by rapid response infrared thermometry. PRD was measured using an ophthalmic ultrasound biomicroscope (UBM). The three criteria used to estimate sensory level were a drop in skin temperature of 0.5°C between dermatomes, PRD of 50% and PRD of 0.2 mm.Results:  A drop in skin temperature of 0.5°C between dermatomes allowed estimation of the sensory level in only 20% of patients. PRD of 50%, and PRD of 0.2 mm allowed estimation of the sensory level in 45 and 100% of patients, respectively. PRD was significantly greater above the T10 dermatome compared with L2 (P < 0.01). The maximum pupillary dilation was significantly greater in children over 2 years of age [1.3 ± 0.8 mm sd)] compared with children less than two years of age [0.6 ± 0.3 mm sd)].Conclusions:  Skin temperature cannot be used to estimate sensory level during combined general/caudal epidural anesthesia. PRD of 0.2 mm is sensitive to the loss of analgesia but is not clinically useful. PRD may be useful above 2 years of age.
Potentially Inappropriate Medication Prescriptions among Elderly Nursing Home Residents: Their Scope and Associated Resident and Facility Characteristics
Authors: Lau Denys T. , Kasper Judith D. , Potter D. E. B. , Lyles Alan 
Published: August 2004

Objective. To estimate the scope of potentially inappropriate medication prescriptions (PIRx) among elderly residents in U.S. nursing homes (NHs), and to examine associated resident and facility characteristics.Data Sources. The 1996 Medical Expenditure Panel Survey Nursing Home Component (MEPS NHC), a survey of a nationally representative sample of NHs and residents.Study Design. The PIRx, defined by Beers's consensus criteria (1991, 1997), was identified using up to a year's worth of NH prescribed medicine data for each resident. The study sample represented 1.6 million NH residents (n=3,372).Results. At a minimum, 50 percent of all residents aged 65 or older, with an NH stay of three months or longer received at least one PIRx in 1996. The most common PIRx involved propoxyphene, diphenhydramine, hydroxyzine, oxybutynin, amitriptyline, cyproheptadine, iron supplements, and ranitidine. Resident factors associated with greater odds of PIRx were Medicaid coverage, no high school diploma, and nondementia mental disorders. Facility factors were more beds and lower RN‐to‐resident ratio. Factors associated with lower odds of PIRx were fewer medications, residents with communication problems, and being in an accredited NH. Onsite availability of pharmacists or mental health providers was not related.Implications. With quality of care and patient safety as major public health concerns, effective policies are needed to avoid PIRx occurrences and improve the quality of prescribing among elderly residents in NHs. Additional studies are needed to determine the impact of PIRx on this NH population.
Socioeconomic Disparities in the Use of Home Health Services in a Medicare Managed Care Population
Authors: Freedman Vicki A. , Rogowski Jeannette , Wickstrom Steven L. , Adams John , Marainen Jonas , Escarce José J. 
Published: August 2004

Objective. To investigate socioeconomic disparities in access to home health visits and durable medical equipment by persons enrolled in two Medicare managed care health plans.Data Sources. A telephone survey of 4,613 Medicare managed care enrollees conducted between April and October of 2000 and linked to administrative claims for a subsequent 12‐month period.Study Design. We estimated a series of logistic regression models to determine which socioeconomic factors were related to home health visits and the use of durable medical equipment (DME) among Medicare managed care enrollees.Principal Findings. Controlling for health and demographic differences, Medicare managed care enrollees in the lowest tertile for nonhousing assets had 50 percent greater odds than those in the highest tertile of having one or more home health visits. All else equal, enrollees with less than a high school education had 30 percent lower odds than those who had graduated from high school of using durable medical equipment.Conclusions. Medicare managed care enrollees of low socioeconomic status do not appear to have reduced access to home health visits; however, use of durable medical equipment is considerably lower for enrollees with less than a high school education. Physicians and therapists working with Medicare managed care enrollees may want to actively target DME prescriptions to those with educational disadvantages.
Physical Rehabilitation following Medicare Prospective Payment for Skilled Nursing Facilities
Authors: Wodchis Walter P. 
Published: August 2004

Objective. To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents.Data Sources. Resident‐level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents admitted to SNFs in Michigan and Ohio in 1998 and 1999 form the study population (n=99,952).Study Design. A differences‐in‐differences identification strategy is used to compare rehabilitation therapy for SNF residents before and after a change in Medicare SNF payment. Logistic and linear regression analyses are used to examine the effect of PPS on receipt of physical, occupational, or speech therapy and total therapy time.Data Extraction. Data for the present study were extracted from the University of Michigan Assessment Archive Project (UMAAP). One assessment was obtained for each resident admitted to nursing facilities during the study period.Principal Findings. The introduction of PPS for all U.S. Medicare residents in July of 1998 was associated with specific targeting of rehabilitation treatment time to the most profitable levels of therapy. The PPS was also associated with increased likelihood of therapy but less rehabilitation therapy time for Medicare residents.Conclusions. The present results indicate that rehabilitation therapy is sensitive to the specific payment incentives associated with PPS.
Associations of Race, Education, and Patterns of Preventive Service Use with Stage of Cancer at Time of Diagnosis
Authors: Gornick Marian E. , Eggers Paul W. , Riley Gerald F. 
Published: August 2004

Objective. To go beyond the documentation of disparities by race and SES by analyzing health behaviors regarding preventive and cancer screening services and determining if these behaviors are associated with stage of cancer when first diagnosed.Data. Stage of cancer for Medicare patients diagnosed in 1995 with breast, colorectal, uterine, ovarian, prostate, bladder, or stomach cancer; and use of influenza and pneumonia immunization, mammography, pap smear, colon cancer screening, and the prostate specific antigen test during the two years preceding diagnosis of cancer.Study Design. Hypothesis tested: health behaviors regarding use of preventive and cancer screening services are associated with stage of cancer when first diagnosed.Data Collection/Extraction Methods. Information was extracted from the database formed by the linkage of Surveillance, Epidemiology, and End Results (SEER) cancer registries with Medicare files.Principal Findings. Black and white patients (of higher and lower SES) who used more of the preventive and cancer screening services were at a lower risk of having late stage cancer for six cancers studied (breast, colorectal [male and female], prostate, uterine, and male bladder cancer) than their counterparts who used fewer of these services.Conclusions. The use of preventive and cancer screening services is a health behavior associated with better health outcomes for the elderly diagnosed with cancer. The lack of preventive service use can serve as a marker for identifying persons at risk of late stage cancer when first diagnosed. Strategies that encourage the use of preventive services by low users of these services are likely to reinforce a range of healthy behaviors that help to ameliorate disparities in health outcomes.
Posthospital Care Transitions: Patterns, Complications, and Risk Identification
Authors: Coleman Eric A. , Min Sung‐joon , Chomiak Alyssa , Kramer Andrew M. 
Published: August 2004

Objectives. To (1) describe patterns of posthospital care transitions; (2) characterize these patterns as uncomplicated or complicated; (3) identify those at greatest risk for complicated transitions.Data Sources/Study Setting. The Medicare Current Beneficiary Survey was used to identify beneficiaries aged 65 and older who were discharged from an acute care hospital in 1997–1998.Study Design. Patterns of posthospital transfers were described over a 30‐day time period following initial hospital discharge. Uncomplicated posthospital care patterns were defined as a sequence of transfers from higher‐to lower‐intensity care environments without recidivism, while complicated posthospital care patterns were defined as the opposite sequence of events. Indices were developed to identify patients at risk for complicated transitions.Principal Findings. Forty‐six distinct types of care patterns were observed during the 30 days following hospital discharge. Among these patterns, 444 episodes (61.2 percent) were limited to a single transfer, 130 episodes (17.9 percent) included two transfers, 62 episodes (8.5 percent) involved three transfers, and 31 episodes (4.3 percent) involved four or more transfers. Fifty‐nine episodes (8.1 percent) resulted in death. Between 13.4 percent and 25.0 percent of posthospital care patterns in the 1998 sample were classified as complicated. The area under the receiver operating curve was 0.771 for a predictive index that utilized administrative data and 0.833 for an index that used a combination of administrative and self‐reported data.Conclusions. Posthospital care transitions are common among Medicare beneficiaries and patterns of care vary greatly. A significant number of beneficiaries experienced complicated care transitions—a finding that has important implications for both patient safety and cost‐containment efforts. Patients at risk for complicated care patterns can be identified using data available at the time of hospital discharge.
Plan, Geographical, and Temporal Variation of Consumer Assessments of Ambulatory Health Care
Authors: Zaslavsky Alan M. , Zaborski Lawrence B. , Cleary Paul D. 
Published: August 2004

Objective. To quantify contributions of health plans and geography to variation in consumer assessments of health plan quality.Data Sources. Responses of beneficiaries of Medicare managed care plans to the Consumer Assessment of Health Plans Study (CAHPS®) survey. Our data included more than 700,000 survey responses assessing 381 Medicare managed care (MMC) contracts over a period of five years.Study Design. The survey was administered to a nationally representative sample of beneficiaries of Medicare managed care plans.Principal Findings. Member assessments of their health plans, customer service functions, and prescription drug benefits varied most across health plans; these also varied the most over time. Assessments of direct interactions with doctors and their practices were more affected by geographical location, and these assessments were quite stable over time. A health plan's global rating often changed significantly between consecutive years, but only rarely were there such changes in ratings of care or doctor. Nationally, mean assessments tended to decrease over the study period.Conclusions. Our findings suggest that ratings of plans and reports about customer service and prescription access are affected by plan policies, benefits design, and administrative structures that can be changed relatively quickly. Conversely, assessments of other aspects of care are largely determined by characteristics of provider networks that are relatively stable. A consumer survey is unlikely to detect meaningful changes in quality of care from year to year unless quality improvement measures are developed that have substantially larger effects, possibly through area‐wide initiatives, than historical temporal variations in quality.