bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of foreign bodies in the ear, nose and throat
Authors: Kumar Sashi 
Published: February 2004

AbstractThis article presents a summary of the common foreign bodies (FB) and a practical approach to diagnosis and management. Removal of FB requires good lighting, a cooperative or fully restrained patient and a gentle approach by the clinician. An accurate diagnosis of the FB should be made prior to attempts to remove it and most, if not all FB could be safely removed the following day under better lighting conditions, sedation or anaesthesia in a fasted patient by a more senior clinician.
The Victorian Active Script Programme: promising signs for general practitioners, population health, and the promotion of physical activity
Authors: Sims J , Huang N , Pietsch J , Naccarella L 
Published: January 2004

Background:The Active Script Programme (ASP) aimed to increase the number of general practitioners (GPs) in Victoria, Australia who deliver appropriate, consistent, and effective advice on physical activity to patients. To maximise GP participation, a capacity building strategy within Divisions of General Practice (DGPs) was used. The objectives of the programme were to (a) train and support GPs in advising sedentary patients, and (b) develop tools and resources to assist GPs.Objective:To evaluate the effectiveness of the ASP.Methods:A systems approach was used to promote capacity in Victorian general practice. Economic analyses were incorporated into the programme’s evaluation. Participants were selected DGPs and their GP members. The programme worked with DGPs to train GPs and provide relevant resources. The main outcome measures were (a) changes in GP knowledge and behaviour and (b) cost effectiveness, based on modelled estimates of numbers of patients advised and adopting physical activity and gaining the associated health benefits.Results:GP awareness and provision of physical activity advice increased. Although the programme’s reach was modest, based on actual GP involvement, the cost effectiveness figures ($138 per patient to become sufficiently active to gain health benefits, and $3647 per disability adjusted life year saved) are persuasive.Conclusions:The ASP increased DGPs’ capacity to support GPs to promote physical activity. There is a strong economic argument for governments to invest in such programmes. However, caution is warranted about the maintenance of patients’ activity levels. Programme refinement to encourage GPs to use community supports more effectively will guide future development. Further research on long term patient adherence through a multisectorial approach is warranted.
Effect of prolonged exercise in a hypoxic environment on cardiac function and cardiac troponin T: Table 1
Authors: Shave R E , Dawson E , Whyte G , George K , Gaze D , Collinson P 
Published: January 2004

Background:Exercise induced cardiac fatigue has recently been observed after prolonged exercise. A moderate to high altitude has been suggested as a possible stimulus in the genesis of such cardiac fatigue.Objective:To investigate if exercise induced cardiac fatigue and or cardiac damage occurs after prolonged exercise in a hypoxic environment.Methods:Eight trained male triathletes volunteered for the study. Each completed two 50 mile cycle trials, randomly assigned from normobaric normoxia and normobaric hypoxia (15% Fio2). Echocardiographic assessment and whole blood collection was completed before, immediately after, and 24 hours after exercise. Left ventricular systolic and diastolic functional variables were calculated, and serum was analysed for cardiac troponin T. Results were analysed using a two way repeated measures analysis of variance, with α set at 0.05.Results:No significant differences were observed in either systolic or diastolic function across time or between trials. Cardiac troponin T was detected in one subject immediately after exercise in the normobaric hypoxic trial.Conclusions:A 50 mile cycle trial in either normobaric normoxia or normobaric hypoxia does not induce exercise induced cardiac fatigue. Some people, however, may exhibit minimal cardiac damage after exercise in normobaric hypoxia. The clinical significance of this is yet to be elucidated.
Effect of ultramarathon cycling on the heart rate in elite cyclists
Authors: Neumayr G , Pfister R , Mitterbauer G , Maurer A , Hoertnagl H 
Published: January 2004

Objectives:To analyse the heart rate (HR) response and estimate the ultraendurance threshold—the optimum maintainable exercise intensity of ultraendurance cycling—in ultraendurance elite cyclists competing in the Race across the Alps.Methods:HR monitoring was performed in 10 male elite cyclists during the first Race across the Alps in 2001 (distance: 525 km; cumulative altitude difference: 12 600 m) to investigate the exercise intensity of a cycle ultramarathon and the cardiopulmonary strains involved. Four different exercise intensities were defined as percentages of maximal HR (HRmax) as follows: recovery HR (HRre), <70% of HRmax; moderate aerobic HR (HRma), 70–80%; intense aerobic HR (HRia), 80–90%; and high intensity HR (HRhi), >90%.Results:All athletes investigated finished the competition. The mean racing time was 27 hours and 25 minutes, and the average speed was 18.6 km/h. The mean HRmaxwas 186 beats/min, and the average value of measured HRs (HRaverage) was 126 beats/min resulting in a mean HRaverage/HRmaxratio of 0.68, which probably corresponds to the ultraendurance threshold. The athletes spent 53% (14 hours 32 minutes) of total race time within HRre, 25% (6 hours 51 minutes) within HRma, 19% (5 hours 13 minutes) within HRia, and only 3% (49 minutes) within HRhi, which shows the exercise intensity to be predominantly moderate (HRre+ HRma =  78% or 21 hours 23 minutes). The HR response was influenced by the course profile as well as the duration. In all subjects, exercise intensity declined significantly during the race, as indicated by a decrease in HRaverage/HRmaxof 23% from 0.86 at the start to 0.66 at the end.Conclusions:A substantial decrease (10% every 10 hours) in the HR response is a general cardiovascular feature of ultramarathon cycling, suggesting that the ultraendurance threshold lies at about 70% of HRmaxin elite ultramarathon cyclists.
A comparison of the sports safety policies and practices of community sports clubs during training and competition in northern Sydney, Australia
Authors: Donaldson A , Forero R , Finch C F , Hill T 
Published: January 2004

Objectives:To compare the safety policies and practices reported to be adopted during training and competition by community sports clubs in northern Sydney, Australia.Methods:This cross sectional study involved face to face interviews, using an 81 item extensively validated questionnaire, with representatives of 163 community netball, rugby league, rugby union, and soccer clubs (response rate 85%). The study was undertaken during the winter sports season of 2000. Two separate 14 item scales were developed to analyse the level of safety policy adoption and safety practice implementation during training and competition. The statistical analysis comprised descriptive and inferential analysis stratified by sport.Results:The reliability of the scales was good: Cronbach’s α  =  0.70 (competition scale) to 0.81 (training scale). Significant differences were found between the safety scores for training and competition for all clubs (mean difference 11.2; 95% confidence interval (CI) 10.0 to 12.5) and for each of the four sports: netball (mean difference 14.9; 95% CI 12.6 to 17.2); rugby league (mean difference 10.3; 95% CI 7.1 to 13.6); rugby union (mean difference 9.4; 95% CI 7.1 to 11.7); and soccer (mean difference 8.4; 95% CI 6.5 to 10.3).Conclusions:The differences in the mean competition and training safety scores were significant for all sports. This indicates that safety policies were less often adopted and practices less often implemented during training than during competition. As injuries do occur at training, and sports participants often spend considerably more time training than competing, sporting bodies should consider whether the safety policies and practices adopted and implemented at training are adequate.
Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms
Authors: Cools A M , Witvrouw E E , Declercq G A , Vanderstraeten G G , Cambier D C 
Published: January 2004

Objectives:To determine if the muscle force and electromyographic activity in the scapular rotators of overhead athletes with impingement symptoms showed differences between the injured and non-injured sides.Methods:Isokinetic peak force was evaluated during protraction and retraction of the shoulder girdle, with simultaneous recording of electromyographic activity of the three trapezius muscles and the serratus anterior muscle, in 19 overhead athletes with impingement symptoms.Results:Pairedttests showed significantly lower peak force during isokinetic protraction at high velocity (p<0.05), a significantly lower protraction/retraction ratio (p<0.01), and significantly lower electromyographic activity in the lower trapezius muscle during isokinetic retraction on the injured side than on the non-injured side (p<0.05).Conclusion:These results confirm that patients with impingement symptoms show abnormal muscle performance at the scapulothoracic joint.
CELLULAR OPEN RESOURCE (COR): A PUBLIC CELLML BASED ENVIRONMENT FOR MODELING BIOLOGICAL FUNCTION
Authors: GARNY A. , KOHL P. , NOBLE D. 
Published: January 2004

Computer models have proved to be invaluable to experimental and theoretical research in cardiac electrophysiology, and several environments have been designed to aim at easing the development of such models. Recent advances in computing have made the development of graphical user interfaces much simpler, which has lead to the arrival of new software packages that are used primarily for teaching, not research. Here, we introduce Cellular Open Resource (COR), a modeling environment that runs under Microsoft Windows® and that can be used for both research and teaching. It is built around CellMLTM, which provides COR with "out of the box" access to an increasing database of single cell models. Though COR was initially developed to handle cardiac modeling, it may also be applied to other types of reaction (and diffusion) problems. The interface is designed with user friendliness in mind (e.g. an equation viewer can be used to graphically visualize an equation as it would appear in a publication). All the cell models used in a single cell or a multicellular problem are checked for correctness, before being dynamically compiled and converted into machine code, in order to maximize computing efficiency. The computation of a problem is both interactive and event-driven. One can, thus, modify the properties of a problem at any point in time and/or subject to a particular condition. COR is freely available for academic use from .
MODELING OF PROTEIN INTERACTIONS INVOLVED IN CARDIAC TENSION DEVELOPMENT
Authors: SACHSE F. B. , GLÄNZEL K. G. , SEEMANN G. 
Published: January 2004

Modeling of protein interactions responsible for cardiac tension development can enhance the understanding of physiological and pathophysiological phenomena of the heart. Principal components of muscular tension development are the proteins actin, myosin, troponin and tropomyosin. The tension is produced by cross-bridge cycling of actin and myosin using adenosine triphosphate as energy source. The cross-bridge cycling is initiated by binding of intracellular calcium to troponin, resulting in configuration changes of tropomyosin.In this work a hybrid model of protein interactions in cardiac tension development is derived on basis of recent measurements and descriptions on protein level. Dependencies on intracellular calcium concentration, sarcomere stretch and stretch velocity as well as cooperativity mechanisms are incorporated. The model quantifies the tension development by states associated to configurations of the involved proteins. The model enables in conjunction with electrophysiological models of cardiac myocytes the reconstruction of electro-mechanical phenomena. Numerical simulations with the hybrid model were performed, which illustrated the reconstruction of steady state and length switches experiments. The steady state experiments describe the force-cytosolic [ Ca2+] relationship in intact rat cardiac trabeculae. The length switch experiments provide data on the redevelopment of force after sudden stretch in rabbit right ventricular papillary muscles. Results of the numerical simulations show quantitative agreement with experimental studies.The hybrid model of cardiac tension development offers interfaces to further models of cardiac electro-mechanics. The hybrid model can be coupled with models of cellular electrophysiology and passive mechanics of myocardium allowing the inclusion of mechano-electrical feedback mechanisms. The hybrid model can be applied to elucidate cooperativity mechanisms, pathophysiological changes and metabolism of tension development.
COMPARISON OF CARDIAC MAGNETIC FIELD DISTRIBUTIONS DURING DEPOLARIZATION AND REPOLARIZATION
Authors: SMITH F. E. , LANGLEY P. , TRAHMS L. , STEINHOFF U. , BOURKE J. P. , MURRAY A. 
Published: January 2004

Multichannel magnetocardiography measures the magnetic field distribution of the human heart noninvasively from many sites over the body surface. Multichannel magnetocardiogram (MCG) analysis enables regional temporal differences in the distribution of cardiac magnetic field strength during depolarization and repolarization to be identified, allowing estimation of the global and local inhomogeneity of the cardiac activation process. The aim of this study was to compare the spatial distribution of cardiac magnetic field strength during ventricular depolarization and repolarization in both normal subjects and patients with cardiac abnormalities, obtaining amplitude measurements by magnetocardiography. MCGs were recorded at 49 sites over the heart from three normal subjects and two patients with inverted T-wave conditions. The magnetic field intensity during depolarization and repolarization was measured automatically for each channel and displayed spatially as contour maps. A Pearson correlation was used to determine the spatial relationship between the variables. For normal subjects, magnetic field strength maps during depolarization (R-wave) showed two asymmetric regions of magnetic field strength with a high positive value in the lower half of the chest and a high negative value above this. The regions of high R-wave amplitude corresponded spatially to concentrated asymmetric regions of high magnetic field strength during repolarization (T-wave). Pearson-r correlation coefficients of 0.7 (p<0.01), 0.8 (p<0.01) and 0.9 (p<0.01) were obtained from this analysis for the three normal subjects. A negative correlation coefficient of -0.7 (p<0.01) was obtained for one of the subjects with inverted T-wave abnormalities, suggesting similar but inverted magnetic field and current distributions to normal subjects. Even with the high correlation values in these four subjects, the MCG was able to identify differences in the distribution of magnetic field strength, with a shift in the T-wave relative to the R-wave. The measurement of cardiac magnetic field distribution during depolarization and repolarization of normal subjects and patients with clinical abnormalities should enable the improvement of theoretical models for the explanation of the cardiac depolarization and repolarization processes.
Regionalism and Free Trade Agreements in East Asia
Authors: Cheong Inkyo 
Published: February 2004

This paper gives an overview of the progress of regionalism in East Asia and examines the background of the recent embrace of trade agreements by China, Japan, and South Korea. It discusses the progress toward free trade agreements (FTAs) within East Asia and offers reasons for their slow development. The impacts of eight hypothetical East Asian FTAs are estimated using a computable generalized equilibrium model. The model predicts that countries will benefit from both bilateral FTAs and regional FTAs (such as a Northeast Asian FTA and an East Asian FTA); however, greater economic benefits would be gained under regional FTAs than under bilateral FTAs. Although the simulation used in the study estimates that a Northeast Asian FTA and an East Asian FTA would bring a similar level of economic benefits, results indicate that greater benefits would accrue under an East Asian FTA. Discussions of a Japan–ASEAN FTA are under way, after talks of an FTA between ASEAN and China blossomed in late 2000. China and Japan are competitively promoting bilateral FTAs with ASEAN. As discussions of an FTA with ASEAN heat up in China and Japan, South Korea has also begun reviewing the economic feasibility of an FTA with ASEAN. If China, Japan, and South Korea competitively pursue bilateral FTAs with ASEAN, this may result in several important problems, including spaghetti bowl effects, a hub-and-spoke dilemma, or struggles for regional leadership. This paper tries to show that an East Asian FTA covering the whole region is economically desirable and stresses that East Asian countries should introduce a regionwide FTA, rather than multiple bilateral or subregional FTAs. An East Asian FTA can be realized only in the long term because of economic, political, and social obstacles. East Asia, which already lags behind other regions in terms of regionalism, should not passively wait for the establishment of an East Asian FTA, which is likely to take some time to be established.
Biomechanical Properties of Patellar and Hamstring Graft Tibial Fixation Techniques in Anterior Cruciate Ligament Reconstruction
Authors: Adam Frank , Pape Dietrich , Schiel Karin , Steimer Oliver , Kohn Dieter , Rupp Stefan 
Published: February 2004

Background Reliable fixation of the soft hamstring grafts in ACL reconstruction has been reported as problematic. Hypothesis The biomechanical properties of patellar tendon (PT) grafts fixed with biodegradable screws (PTBS) are superior compared to quadrupled hamstring grafts fixed with BioScrew (HBS) or Suture-Disc fixation (HSD). Study Design Controlled laboratory study with roentgen stereometric analysis (RSA). Methods Ten porcine specimens were prepared for each group. In the PT group, the bone plugs were fixed with a 7 · 25 mm BioScrew. In the hamstring group, four-stranded tendon grafts were anchored within a tibial tunnel of 8 mm diameter either with a 7 · 25 mm BioScrew or eight polyester sutures knotted over a Suture-Disc. The grafts were loaded stepwise, and micromotion of the graft inside the tibial tunnel was measured with RSA. Results Hamstring grafts failed at lower loads (HBS: 536 N, HSD 445 N) than the PTBS grafts (658 N). Stiffness in the PTBS group was much greater compared to the hamstring groups (3500 N/mm versus HBS = 517 N/mm and HSD = 111 N/mm). Irreversible graft motion after graft loading with 200 N was measured at 0.03 mm (PTBS), 0.38mm (HBS), and 1.85mm (HSD). Elasticity for the HSD fixation was measured at 0.67 mm at 100 N and 1.32 mm at 200 N load. Conclusion Hamstring graft fixation with BioScrew and Suture-Disc displayed less stiffness and early graft motion compared to PTBS fixation. Screw fixation of tendon grafts is superior to Suture-Disc fixation with linkage material since it offers greater stiffness and less graft motion inside the tibial tunnel. Clinical Relevance Our results revealed graft motion for hamstring fixation with screw or linkage material at loads that occur during rehabilitation. This, in turn, may lead to graft laxity.
A Clinical and Roentgenographic Study of Little League Elbow
Authors: Hang David Wei , Chao Chien Ming , Hang Yi-Shiong 
Published: February 2004

Background Comparisons of medial elbow injury rate and the incidence of clinical and radiographic findings among Little League baseball players have not been documented. Hypothesis Injury rate and clinical and radiographic findings in Little Leaguers of different positions may be similar. Study Design Survey and retrospective review. Methods Altogether, 343 Little Leaguers (120 pitchers, 40 catchers, and 183 fielders) participated in the study. The survey (including age, playing position, playing experience, and symptoms), clinical examination, and roentgenogram of both elbows were obtained for analysis using Pearson's chi-square test. Results Clinically, 58% of the pitchers presented with soreness compared to 63% in catchers and 47% in fielders. Radiographic examination revealed hypertrophy of the medial humeral epicondyle in all pitchers and catchers and 90% of the fielders. Separation of the medial epicondyle was found in 63% of pitchers, 70% of catchers, and 50% of fielders, while fragmentation was found in 19% of pitchers, 40% of catchers, and 15% of fielders. In subjects with separation or fragmentation, 49% and 56% complained of elbow soreness, respectively. Conclusion Similar rates of medial elbow changes in Little Leaguers may imply that the roentgenological changes of the medial epicondyle could be an adaptive yet physiological reaction to the excessive valgus stress of throwing. The higher incidence of medial epicondylar separation and fragmentation in catchers that has not been reported before may be secondary to the increased stress placed on the elbow when throwing from the squatting position.
Prospective Evaluation of Thermal Capsulorrhaphy for Shoulder Instability
Authors: D'Alessandro Donald F. , Bradley James P. , Fleischli James E. , Connor Patrick M. 
Published: February 2004

Background Thermal shrinkage of capsular tissue has recently been proposed as a means to address the capsular redundancyassociated with shoulder instability. Although this procedure has become very popular, minimal peer-reviewed literature isavailable to justify its widespread use. Purpose To prospectively evaluate the efficacy of arthroscopic electrothermal capsulorrhaphy for the treatment of shoulderinstability. Study Design This nonrandomized prospective study evaluated the indications and results of thermal capsulorrhaphy in 84shoulders with an average follow-up of 38 months. Methods Patients were divided into three clinical subgroups: traumatic anterior dislocation (acute or recurrent), recurrent anterioranterior/inferior subluxation without prior dislocation, and multidirectional instability. Patients underwent arthroscopic thermalcapsulorrhaphy after initial assessment, radiographs, and failure of a minimum of 3 months of nonoperative rehabilitation. Results Outcome measures included pain, recurrent instability, return to work/sports, and the American Shoulder and ElbowSurgeons (ASES) Shoulder Assessment score. Overall results were excellent in 33 participants (39%), satisfactory in 20 (24%),and unsatisfactory in 31 (37%). Conclusions The high rate of unsatisfactory overall results (37%), documented with longer follow-up, is of great concern. Theauthors conclude that enthusiasm for thermal capsulorrhaphy should be tempered until further studies document its efficacy.