bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to achieving evidence-based stroke rehabilitation
Authors: Pollock Alexandra S , Legg Lynn , Langhorne Peter , Sellars Cameron 
Published: August 2005

Objective: To determine the perceived barriers to evidence-based practice by health professionals working within the field of stroke rehabilitation. Design: Focus groups were carried out to identify the perceived barriers; these were followed by a postal questionnaire that asked stroke rehabilitation professionals to rate their agreement with the perceived barriers. Subjects: One hundred and five stroke rehabilitation professionals participated in the focus groups and were sent the postal questionnaire. Eighty-six responses were returned, from 27 physiotherapists, 26 occupational therapists, 22 nurses, 6 speech and language therapists, and 5 other professionals. Main outcome measures: Proportion of subjects rating their level of agreement with statements as 1 ‘agree’, 2, 3, 4 or 5 ‘disagree’. Scores of 1 or 2 were classified as ‘agreement’, and scores of 4 or 5 were classified as ‘disagreement’: the percentages of subjects agreeing or disagreeing with each statement were calculated. Results: Twenty barriers were identified, classified under the headings ‘ability’, ‘opportunity’ and ‘implementation’. Seventy-nine (92%) of all respondents agreed that keeping up to date with research findings was important to them, but only 7 (8%) were happy with the time that they had to do this. Fifty-eight (67%) perceived a need for further training. Only 4 (5%) agreed that it was easy to transfer research findings into their daily practice. A number of significant differences were found between the perceived barriers of different disciplines.
A UK general practice database study of prevalence and mortality of people with neural tube defects
Authors: Lawrenson Ross , Wyndaele Jean-Jaques , Vlachonikolis Ioannis , Farmer Christopher , Glickman Scott 
Published: August 2005

Objective: To investigate the prevalence of neural tube defects (NTDs) in the UK and to compare the mortality rate with that of the general population. Methods: A cross-sectional study. The General Practice Research Database (GPRD) contains the prescribing and diagnostic records since 1990 of over 4 million people from throughout the UK. All patients aged 10–69 and registered on the database in the years 1994–1997 were included in the study. Patients with a diagnosis of NTD were identified from the database and prevalence and standardized mortality ratios in each year were calculated. Results: The size of the GPRD reduced during the study period – there were 2 116 452 patients aged 10–69 years on the database in 1994, of whom 1751 had a prior record of NTD. In 1997 there were 998 368 patients, of whom 842 had an NTD. The age standardized prevalence between 1994 and 1997 for NTDs ranged between 7.8 and 8.4 per 10 000 for males and 9.0 and 9.4 per 10 000 for females aged 10–69 years. There were 27 deaths in patients with a record of NTD over the four-year study period. The standardized mortality ratio for the years 1994 to 1997 for NTDs ranged between 1.9 and 2.9. Conclusions: These data give an estimate of the prevalence of NTDs in the general population. They also show that those who have survived to age 10 years still have double the mortality of the general population.
Home-based rehabilitation for people with stroke: a comparative study of six community services providing co-ordinated, multidisciplinary treatment
Authors: Geddes Joanna ML , Chamberlain M Anne 
Published: August 2005

Objective: To describe and compare six community services providing co-ordinated, multidisciplinary rehabilitation to people with stroke. Design: Prospective, descriptive, quantitative study. Setting: England and Northern Ireland. Subjects: Community rehabilitation teams and the patients treated by them. Main outcome measures: Annual numbers treated, Barthel Index, mortality, place of discharge, crude costs. Results: Between mid-1997 and mid-1999, data were collected on 1076 patients who received community-based rehabilitation of whom 48.7% were male. Mean age (SD) was 71 years (13.1); 115 (10.7%) were under 55 years of age and 278 (25.9%) under 65 years of age. Median time between stroke and intervention by the community service was six weeks (25th, 75th percentiles 2.6, 14.4 weeks) and 80.5% had been admitted to hospital. The median Barthel score at the start of community rehabilitation was 15 (11.0, 18.0) and at the end was 18.0 (14.0, 20.0). Median duration of intervention was 12 weeks (6.0, 22.0). At the end of community rehabilitation 912 patients (86.5%) were in the community, 52 (4.9%) had died, 10 (0.9%) were in hospital and 77 (7.3%) in long-term care. Comparative data given here are for one year, 1998, when a total of 519 patients began community rehabilitation. Details of 1855 face-to-face interventions were also recorded from subsets of 10 consecutive patients. Conclusions: Community rehabilitation teams differed in their target populations, in the timing and duration of intervention. A taxonomy of four types of co-ordinated community-based rehabilitation for people with stroke is proposed: (1) Early-supported discharge rehabilitation aimed to reduce length of hospital stay and offered an alternative to hospital rehabilitation. (2) Post-discharge rehabilitation provided additional rehabilitation and aimed for a seamless transfer of patients from hospital to community. (3) General practitioner-oriented post-stroke rehabilitation provided an alternative to hospital admission and rehabilitation. (4) Late community rehabilitation provided patients with the opportunity of an autonomous service, unconnected with hospital or GP referral. Purchasers need to decide for what purpose a team is to be set up. Researchers need to be similarly aware of diversity in community rehabilitation before comparisons are made.
Prospective Validation of an Out‐of‐hospital Decision Rule to Identify Seriously Injured Children Involved in Motor Vehicle Crashes
Authors: Newgard Craig D. , Hui Sai‐Hung Joshua , Griffin Andrew , Wuerstle Melanie , Pratt Franklin , Lewis Roger J. 
Published: August 2005

Abstract Objectives: To prospectively validate a previously published out‐of‐hospital clinical decision rule to identify seriously injured children involved in motor vehicle crashes (MVCs). Methods: The authors selected 20 Los Angeles County Fire Department fire stations, based on pediatric MVC call volume and geographic diversity, and 21 associated hospitals for participation in the study. Immediately following an MVC call involving a pediatric patient aged 0–14 years, each engine/paramedic squad completed a data form (15 variables, including vital signs, Glasgow Coma Scale score, and vehicular and crash characteristics). This study was conducted over a 24‐month period. Outcomes included: 1) “serious injury” as defined by an Injury Severity Score (ISS) ≥ 16 (primary outcome), and 2) need for specialized trauma care (emergent intubation, major nonorthopedic operative intervention or death in the first 24 hours, or pediatric intensive care unit stay longer than 48 hours), as assessed by retrospective chart review. Accuracy measures and binominal confidence intervals (CIs) were calculated for the decision rule validation. Results: One hundred seventy‐five children were prospectively enrolled in the study; 36 children were excluded due to lack of hospital participation or missing hospital charts. There were four children with ISS ≥ 16 (3%) and six children requiring specialized trauma care (4%). The sensitivities and specificities of the rule were: 100% (95% CI = 40% to 100%) and 73% (95% CI = 65% to 81%) for serious injury, and 83% (95% CI = 36% to 100%) and 74% (95% CI = 65% to 81%) for specialized trauma care, respectively. Conclusions: Although definitive conclusions are limited by the sample size, the decision rule identified all seriously injured children involved in MVCs and had moderate specificity. The decision rule was less sensitive for identifying children requiring specialized trauma care. Larger validation studies are needed to adequately assess the utility of this rule before implementation.
Research Opportunities in the Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Authors: Smithline Howard A. , Rowe Brian H. , Radeos Michael S. , Cydulka Rita K. , Camargo Carlos A. 
Published: August 2005

AbstractAcute exacerbations of chronic obstructive pulmonary disease are a common problem in the emergency department. Despite considerable research involving the management of this disease over the past decade, much remains unclear from an emergency medicine perspective. Increased research would better guide the management of these complex patients from the perspectives of the patient, the caregiver, and society. The major areas of research can be divided into diagnosis, therapy, and education. The reliability and validity of different definitions of acute exacerbations of chronic obstructive pulmonary disease need to be assessed. The utility and performance characteristics of diagnostic testing need to be determined for this difficult patient population. Specific diagnostic tests include measures of dyspnea, spirometry and exercise tolerance, measures of gas exchange, airway inflammation, and chest imaging. It remains unclear which patient‐specific therapies (oxygen, bronchodilators, corticosteroids, antibiotics, noninvasive positive pressure ventilation, and methylxanthines) should be used and monitored. Finally, the utility of education of both health care providers and patients and how it may be applied to the acute setting need to be addressed.
Infant Contingency/Extinction Performance After Observing Partial Reinforcement
Authors: Weir Catherine , Toland Cynthia , King Rose Ann , Martin Lisa Maas 
Published: August 2005

AbstractSocial information gathering by infants 6 and 12 months old was examined as a foundation for later social learning that may be uniquely human. Infant performance on a contingency/extinction task was studied following a caregiver demonstration of the contingency on varied reinforcement schedules. Infants who observed caregivers receive any reinforcing stimulation in pretraining decreased responding over their own acquisition period, possibly because they began to habituate to the reinforcer. In extinction, infants who observed caregivers receive partial reinforcement in pretraining were more persistent in responding than others. This suggested that direct experience with partial reinforcement is not needed for greater persistence in extinction. These studies revealed details of social learning in the 1st year.
Spironolactone for Hirsutism in Polycystic Ovary Syndrome
Authors: Christy Natalie A , Franks Andrea S , Cross L Brian 
Published: August 2005

OBJECTIVE: To evaluate the level of evidence for treatment of hirsutism associated with polycystic ovary syndrome (PCOS) with spironolactone. DATA SOURCES: Studies and reports were located in MEDLINE (1966–January 2005%), EMBASE, and International Pharmaceutical Abstracts through the second week of January 2005. DATA SYNTHESIS: Hirsutism is a common clinical problem and is often associated with PCOS. Research has been performed to assess the efficacy of spironolactone therapy in patients with hirsute characteristics. Five studies that evaluated the effectiveness of spironolactone for hirsutism in PCOS were identified and reviewed. CONCLUSIONS: The effects of multiple treatment options on the subjective and objective measures of hirsutism have displayed varying results. The outcomes reported to date have shown a positive trend toward using spironolactone in women with PCOS and hirsutism.
Pathophysiology of Mifepristone-Induced Septic Shock Due to Clostridium sordellii
Authors: Miech Ralph P 
Published: July 2005

OBJECTIVE: To explain the role of mifepristone in medical abortions that results in fulminant and lethal septic shock due to Clostridium sordellii. DATA SOURCES: MEDLINE, PubMed, and Google Scholar databases were searched (1984–March 2005%). Key search terms were mifepristone, RU38486, RU486, Mifeprex, medical abortion, septic shock, innate immune system, cytokines, and Clostridium sordellii. STUDY SELECTION AND DATA EXTRACTION: All articles identified from the data sources were evaluated and all information deemed relevant was included for the information related to the development of the understanding of the pathophysiology of mifepristone-induced septic shock due to C. sordellii. DATA SYNTHESIS: The mechanisms of action of mifepristone were incorporated into the pathophysiology of septic shock due to C. sordellii. Mifepristone, by blocking both progesterone and glucocorticoid receptors, interferes with the controlled release and functioning of cortisol and cytokines. Failure of physiologically controlled cortisol and cytokine responses results in an impaired innate immune system that results in disintegration of the body's defense system necessary to prevent the endometrial spread of C. sordellii infection. The abnormal cortisol and cytokine responses due to mifepristone coupled to the release of potent exotoxins and an endotoxin from C. sordellii are the major contributors to the rapid development of lethal septic shock. CONCLUSIONS: Theoretically, it appears that the mechanisms of mifepristone action favor the development of infection that leads to septic shock and intensifies the actions of multiple inflammatory cytokines, resulting in fulminant, lethal septic shock.
A Computer Program for Age–Length Keys Incorporating Age Assignment to Individual Fish
Authors: Isermann Daniel A. , Knight Carey T. 
Published: August 2005

Abstract
We provide a computer program (AGEKEY) that quickly implements an age–length key approach for estimating fish population age structure and mean lengths at age. The program's approach to age assignment differs from previous approaches in that ages are explicitly assigned to individual unaged fish. Because individual age assignment is necessary to describe the variation around estimates of mean catch per effort (CPE) at age and to compare these estimates through standard statistical procedures, the number of fish of a specified age captured in each unit of effort must be known or estimated. Individual age assignment can be confounded by instances of fractionality, where ages cannot be evenly assigned to fish within individual length intervals. Program AGEKEY resolves the problem of fractionality by applying an integer-based approach to age assignment. When we tested the validity of the program with two sample data sets, AGEKEY yielded estimates of age frequency and mean lengths at age that were very similar to estimates calculated through spreadsheet approaches. Program AGEKEY can quickly derive estimates of age frequency and mean lengths at age using an age–length key approach that will provide users with the data necessary to describe the precision associated with estimates of CPE at age and allow for statistical comparisons of CPE at age across surveys.
Evaluation of Supplemental Walleye Stocking in Northern Wisconsin Lakes
Authors: Jennings Martin J. , Kampa Jeffrey M. , Hatzenbeler Gene R. , Emmons Edward E. 
Published: August 2005

Abstract
Supplemental stocking of walleye Sander vitreus is an important component of fishery management programs in North America. We conducted an experimental study in 23 northern Wisconsin lakes over a 4-year period to assess differences in year-class strength with and without supplemental stocking. These study lakes all hosted walleye fisheries targeting mixed-recruitment populations (i.e., ones with both natural reproduction and supplemental stocking). We tested for differences in catch per effort (CPE) between stocked and nonstocked years using a general linear mixed model. Catch per effort of age-0 walleyes was 2.3 greater per shoreline mile when lakes were stocked, suggesting that stocking increases year-class strength by about 0.13 age-0 walleyes/ acre. Catch per effort values approximated a Poisson distribution, most lakes showing low CPE of age-0 walleyes whether or not they were stocked. Stocked fingerlings were marked with oxytetracycline as fry to determine the percent contribution of stocked fish to the year-class and to estimate 3-month survival. The mean survival of stocked fingerlings until autumn was 3.4%. Results for individual lakes varied, and these differences may be useful for managers in prioritizing waters for stocking. One lake showed strong survival of stocked fish and increases over nonstocked year-classes during both stocking events; this is consistent with literature reports documenting successful supplemental stocking in 5% of case histories.
The Red Queen and the environment: reconciling public regulation and business strategy
Authors: Søgaard Villy , Madsen Svend Ole 
Published: August 2005

AbstractUntil the late 1980s, environmental regulation in Denmark was often carried out in an intensely politicized and confrontational climate marked by strong tensions between authorities and polluting firms. In recent years, however, the general spirit of regulation seems to have improved significantly. During this same period, ‘generic’ measures such as general discharge limits have been supplemented with more specific demands, tailored for individual companies. The present paper presents a case study based on the environmental regulation of TripleNine, a West Jutland fishmeal factory. In response to major changes in its market and regulatory environment, the firm has revised its general strategy and taken a more pro‐active stance on environmental issues, pursuing a policy of active co‐operation with local environmental authorities. Informed by this and other case studies, a theoretical model is developed to account for the incorporation of ecological concerns into firms' general business strategy. Against the background of this model, the paper addresses the long‐term possibilities of reconciling business strategy and public regulation in the future. Copyright © 2005 John Wiley & Sons, Ltd and ERP Environment.
High‐Temperature, High‐Pressure Hydrothermal Synthesis, Crystal Structure, and Solid‐State NMR Spectroscopy of Cs2(UO2)(Si2O6) and Variable‐Temperature Powder X‐Ray Diffraction Study of the Hydrate Phase Cs2(UO2) (Si2O6)×0.5H2O.
Authors: Chen Chih‐Shan , Chiang Ray‐Kuang , Kao Hsien‐Ming , Lii Kwang‐Hwa 
Published: August 2005

AbstractFor Abstract see ChemInform Abstract in Full Text.
New Zeotype Borophosphates with Chiral Tetrahedral Topology: (H)0.5M1.25(H2O)1.5 [BP2O8]×H2O (M: Co(II) and Mn(II)).
Authors: Yilmaz A. , Yildirim L. Tatar , Bu X. , Kizilyalli M. , Stucky G. D. 
Published: August 2005

AbstractFor Abstract see ChemInform Abstract in Full Text.
Bis‐paracyclophane N‐Heterocyclic Carbene—Ruthenium Catalyzed Asymmetric Ketone Hydrosilylation.
Authors: Song Chun , Ma Changqin , Ma Yudao , Feng Wenhua , Ma Shutao , Chai Qiang , Andrus Merritt B. 
Published: August 2005

AbstractFor Abstract see ChemInform Abstract in Full Text.
Dosimetric parameters that predict late rectal complications after curative radiotherapy in patients with uterine cervical carcinoma
Authors: Hyun Kim Tae , Choi Jinho , Park Sung‐Yong , Lee Seok‐Ho , Lee Kyu‐Chan , Yang Dae Sik , Shin Kyung Hwan , Cho Kwan Ho , Lim Hyun‐Sun , Kim Joo‐Young 
Published: August 2005

AbstractBACKGROUNDLate rectal complication (LRC) was a major late complication in patients with uterine cervical carcinoma who were treated with a combination of external beam radiotherapy (EBRT) and high‐dose‐rate intracavitary irradiation (HDR‐ICR). For the current study, the authors retrospectively evaluated dosimetric parameters that were correlated with LRC ≥ Grade 2 in patients with uterine cervical carcinoma who were treated with curative radiotherapy, and they analyzed the appropriate dose estimates to the rectum that were predictive for LRC ≥ Grade 2.METHODSBetween July 1994 and September 2002, 157 patients who were diagnosed with Stage IB–IIIB cervical carcinoma and were treated with definitive radiotherapy were included. EBRT (41.4–66 grays [Gy] in 23–33 fractions) to the whole pelvis was delivered to all patients, with midline shielding performed after a 36–50.4 Gy external dose. HDR‐ICR (21–39 Gy in 6–13 fractions to Point A) was administered at a rate of 2 fractions weekly after midline shielding of EBRT. LRC was scored using Radiation Therapy Oncology Group criteria. The total biologically effective dose (BED) at specific points, such as Point A (BEDPoint A), rectal point (BEDRP), and maximal rectal point (BEDMP), was determined by a summation of the EBRT and HDR‐ICR components, in which the α/β ratio was set to 3. Analyzed parameters included patient age, tumor size, stage, concurrent chemotherapy, ICR fraction size, RP ratio (dose at the rectal point according to the Point A dose), MP ratio (dose at the maximal rectal point according to the Point A dose), EBRT dose, BEDPoint A, BEDRP, and BEDMP.RESULTSThe 5‐year actuarial overall rate of LRC ≥ Grade 2 in all patients was 18.4%. Univariate analysis showed that the RP ratio, MP ratio, EBRT dose, BEDPoint A, BEDRP, and BEDMP were correlated with LRC ≥ Grade 2 (P < 0.05). Multivariate analysis showed that, of all clinical and dosimetric parameters evaluated, only BEDRP was correlated with LRC ≥ Grade 2 (P = 0.009). The 5‐year actuarial rate of LRC ≥ Grade 2 was 5.4% in patients with a BEDRP < 125 Gy3 and 36.1% in patients with a BEDRP ≥ 125 Gy3 (P < 0.001).CONCLUSIONSBEDRP was a useful dosimetric parameter for predicting the risk of LRC ≥ Grade 2 and should be limited to < 125 Gy3 whenever possible to minimize the risk of LRC ≥ Grade 2 in patients with uterine cervical carcinoma who are treated with a combination of EBRT and HDR‐ICR. Cancer 2005. © 2005 American Cancer Society.
Short‐term plasticity of Bergmann glial cell extrasynaptic currents during parallel fiber stimulation in rat cerebellum
Authors: Bellamy Tomas C. , Ogden David 
Published: August 2005

AbstractBergmann glial cells (BGC) enclose the synapses of Purkinje neurons (PN) and interneurons in the molecular layer of the cerebellar cortex. During synaptic transmission, glutamate evokes inward currents in the glia by activation of Ca2+‐permeable aminohydroxymethylisoxazole propionic acid receptors (AMPAR) and electrogenic transporters. We describe the plasticity of BGC currents during paired‐pulse and repetitive stimulation of parallel fibers in cerebellar slices. Paired‐pulse facilitation (PPF) of BGC AMPAR currents was 4‐fold, twice that of PN PPF. Experiments with a low‐affinity AMPAR antagonist showed an increase in extrasynaptic glutamate concentration during the second pulse of the pair. PPF of glial transporter currents was 1.8‐fold, similar to synaptic PPF. Tetanic stimulation revealed that facilitation of BGC AMPAR currents is not sustained during high‐frequency stimulation, and substantial depression is observed after a few pulses. Consequently, Ca2+ influx through glial AMPARs would initially be facilitated but subsequently depressed, generating a transient Ca2+ influx in response to a sustained tetanus. This pattern of plasticity may be important in enabling Bergmann glial cell processes to detect and support synapses with high‐frequency input. Finally, a new current was observed in BGC during repetitive stimulation. It was blocked by NBQX and intracellular GDP‐β‐S, increased by glutamate uptake inhibition, had PPF similar to synaptic PPF, and was unaffected by an inhibitor of fast glial AMPAR currents. The evidence suggests that activation of neuronal AMPARs causes the release of a paracrine messenger to activate a G‐protein coupled receptor in the BGC. © 2005 Wiley‐Liss, Inc.