bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the perceived public image of nursing on nurses’ work behaviour
Authors: Takase Miyuki , Maude Phillip , Manias Elizabeth
Published: January 2006

Aim. This paper reports a study comparing nurses’ perceptions of their public image with their self‐image, and examining how the relationship between their perceived public image and self‐image was associated with their job performance and turnover intentions.

Background. The stereotypical public image of nursing is a major concern to nurses. However, it is relatively unknown how this image affects nurses. A few studies have investigated how nurses’ interpretations of their public image affect their self‐image and work behaviour.

Methods. A convenience sample of 346 Australian nurses participated in a questionnaire study in 2003. The results were analysed byt‐test, polynomial regression and response surface analysis. Six participants from the survey participated in a focus group to provide further interpretation of the findings.

Results. Nurses rated their aptitude for leadership more positively than they thought the public viewed them. In contrast, nurses rated their image as being caring less negatively than their perceived public image. Job performance was predicted by self‐image relating to leadership aptitude. On the contrary, the relationship between self‐image and perception of the public image as being caring predicted job performance. When nurses perceived their public image as caring less positively than their self‐image, their job performance tended to improve. As for turnover intention, both self‐image and perceived public images of having an aptitude for leadership and being caring were negatively related to intention to quit the job.

Conclusion. To enhance nurses’ job performance and reduce their turnover intentions, it is important to improve both the public image and self‐image of nurses.
Arabidopsis CYP90B1 catalyses the early C‐22 hydroxylation of C27, C28 and C29 sterols
Authors: Fujita Satomi , Ohnishi Toshiyuki , Watanabe Bunta , Yokota Takao , Takatsuto Suguru , Fujioka Shozo , Yoshida Shigeo , Sakata Kanzo , Mizutani Masaharu
Published: January 2006

Arabidopsis dwf4 is a brassinosteroid (BR)‐deficient mutant, and the DWF4 gene encodes a cytochrome P450, CYP90B1. We report the catalytic activity and substrate specificity of CYP90B1. Recombinant CYP90B1 was produced in Escherichia coli, and CYP90B1 activity was measured in an in vitro assay reconstituted with NADPH‐cytochrome P450 reductase. CYP90B1 converted campestanol (CN) to 6‐deoxocathasterone, confirming that CYP90B1 is a steroid C‐22 hydroxylase. The substrate specificity of CYP90B1 indicated that sterols with a double bond at positions C‐5 and C‐6 are preferred substrates compared with stanols, which have no double bond at the position. In particular, the catalytic efficiency (kcat/Km) of CYP90B1 for campesterol (CR) was 325 times greater than that for CN. As CR is more abundant than CN in planta, the results suggest that C‐22 hydroxylation of CR before C‐5α reduction is the main route of BR biosynthetic pathway, which contrasts with the generally accepted route via CN. In addition, CYP90B1 showed C‐22 hydroxylation activity toward various C27–29 sterols. Cholesterol (C27 sterol) is the best substrate, followed by CR (C28 sterol), whereas sitosterol (C29 sterol) is a poor substrate, suggesting that the substrate preference of CYP90B1 may explain the discrepancy between the in planta abundance of C27/C28/C29 sterols and C27/C28/C29 BRs.
Reorganization of the alternative pathways of the Arabidopsis respiratory chain by nitrogen supply: opposing effects of ammonium and nitrate
Authors: Escobar Matthew A. , Geisler Daniela A. , Rasmusson Allan G.
Published: January 2006

The mitochondrial oxidative phosphorylation system in plants possesses a variety of alternative pathways that decrease respiratory ATP production. These alternative pathways are mediated by three classes of bypass proteins: the type II NAD(P)H dehydrogenases (which circumvent complex I of the electron transport chain), the alternative oxidases (AOXs; which circumvent complexes III and IV) and the uncoupling proteins (which circumvent ATP synthase). We have monitored the expression of all genes encoding respiratory bypass proteins in Arabidopsis thaliana growing with different sources of inorganic nitrogen (N). Resupply of nitrate (NO) to N‐limited seedling cultures caused a decrease in the transcript abundance of several type II NAD(P)H dehydrogenase and AOX genes, while resupply of ammonium (NH) led to broad increases in expression in the same gene families. Similar results were observed upon switching between nitrate and ammonium in the absence of N stress. Nitrate signalling was found to be mediated primarily by the nitrate ion itself, whereas ammonium regulation was dependent upon assimilation and affected by changes in apoplastic pH. Corresponding alterations in alternative respiratory pathway capacities were apparent in seedlings supplied with either nitrate or ammonium as an N source and in mitochondria purified from the seedlings. Specifically, AOX capacity and protein abundance, as well as calcium‐dependent external NADH oxidation, were substantially elevated after growth on ammonium. The increased capacity of respiratory bypass pathways after switching from nitrate to ammonium was correlated to an overall respiratory increase.
Expansins: expanding importance in plant growth and development
Authors: Choi Dongsu , Cho Hyung‐Taeg , Lee Yi
Published: January 2006

Expansins were originally identified as cell wall‐loosening proteins. The existence and various roles of expansins have been discovered in many plants. Expansins are encoded by a superfamily of genes comprised of subfamilies that evolved from a common ancestor and encode the α‐expansins (EXPAs), the β‐expansins (EXPBs), the expansin‐like A (EXLA), and expansin‐like B (EXLB) proteins. Several expansin‐like genes have also been identified in non‐plant organisms (e.g. a slime mold, fungi, nematodes, and a mollusk). Localization of EXPA and EXPB in the cell wall was confirmed by immunogold electron microscopy. Studies using transgenic plants provided evidence for a broad range of biological roles of expansins in diverse aspects of plant growth and development, such as cell wall extension, fruit softening, abscission, floral organ development, symbiosis, and the response to environmental stresses.
Integration of floral inductive signals by flowering locus T and suppressor of overexpression of Constans 1
Authors: Lee Jeong Hwan , Hong Sung Myun , Yoo Seong Jeon , Park Ohkmae K. , Lee Jong Seob , Ahn Ji Hoon
Published: January 2006

Genetic analyses have identified four major genetic pathways which control the timing of floral transitions in Arabidopsis. The floral promotion or inhibitory signals from these distinct pathways ultimately converge into a subset of genes, commonly known as the floral integrators, such that the plants are compelled either to switch into a flowering phase or to remain in the vegetative stage. In this review, we have discussed the recent findings regarding cross‐talk between floral promotion pathways and flowering locus T and suppressor of overexpression of Constans 1, the major floral integrators within Arabidopsis. The spatial regulation of these integrators has also been discussed, as these spatial patterns may help us to understand the manner in which floral inductive signals are transmitted. We have also discussed conservation and divergence with regard to the regulation of floral integrators between Arabidopsis and rice. Finally, we have provided a series of insights into the complex signaling network which coordinates plant development.
QTL analysis of seed storability in rice
Authors: Zeng D. L. , Guo L. B. , Xu Y. B. , Yasukumi K. , Zhu L. H. , Qian Q.
Published: January 2006

A double haploid population, which consists of 127 lines derived from anther culture of a typical indica and japonica hybrid ‘ZYQ8’/‘JX17’, was used in this study. Seed storability was investigated by using the storage property measured by the difference of seed germination rates before and after treatment of the rice seeds under 40°C and 95% relative humidity for 10 days in a phytotron. Three QTLs related to rice seed storability were detected on chromosomes 9, 11 and 12, with the LOD scores 2.76, 4.83 and 2.54, respectively, together explaining 35.4% of the genetic variation. The ‘JX17’ allele at qLS‐9 and the ‘ZYQ8’ alleles at qLS‐11 and qLS‐12 could enhance the rice seed storability. The effects of the ‘ZYQ8’ alleles of qLS‐11 and qLS‐12 were also verified using chromosome segment substitution lines.
Comparison of a modified assay method for the endopeptidase marker Ep‐D1b with the Sequence Tag Site marker XustSSR2001–7DL for strawbreaker foot rot resistance in wheat
Authors: Santra D. K. , Watt C. , Little L. , Kidwell K. K. , Campbell K. G.
Published: January 2006

The endopeptidase marker Ep‐D1b and Sequence Tag Site (STS) marker XustSSR2001–7DL were reported to be closely associated with the most effective resistance gene (Pch1) in wheat (Triticum aestivum L.) for strawbreaker foot rot [Pseudocercosporella herpotrichoides (Fron) Deighton]. Our objectives were to: (i) develop an efficient assay method for Ep‐D1b in wheat; (ii) correlate endopeptidase zymograms to strawbreaker foot rot reactions of various wheat genotypes; and (iii) compare the utility of Ep‐D1b and XustSSR2001–7DL for predicting disease response. An improved method of assaying for the Ep‐D1b marker using roots from a single seedling was developed, which is a 2.5‐fold improvement over the previous method. Thirty‐eight wheat genotypes with known reactions to strawbreaker foot rot were analysed for Ep‐D1b and the STS marker. Six distinct endopeptidase zymograms were identified among these 38 genotypes tested, and three of these patterns were novel. The endopeptidase marker was 100% accurate for predicting strawbreaker foot rot disease response, whereas the STS marker predicted the correct phenotype with approximately 90% accuracy. The endopeptidase marker Ep‐D1b was more effective and was more economical for use in marker‐assisted selection strategies for Pch1 in our laboratory compared with the STS marker.
Cytological analyses of hybrids and derivatives of hybrids between durum wheat and Thinopyrum bessarabicum, using multicolour fluorescent GISH*
Authors: Jauhar P. P. , Peterson T. S.
Published: January 2006

The wheat progenitors and other wild relatives continue to be important sources of genes for agronomically desirable traits, which can be transferred into durum wheat (Triticum turgidum; 2n = 4x = 28; AABB genomes) cultivars via hybridization. Chromosome pairing in durum × alien species hybrids provides an understanding of genomic relationships, which is useful in planning alien gene introgression strategies. Two durum cultivars, ‘Lloyd’ and ‘Langdon’, were crossed with diploid wheatgrass, Thinopyrum bessarabicum (2n = 2x = 14; JJ), to synthesize F1 hybrids (2n = 3x = 21; ABJ) with Ph1. ‘Langdon’ disomic substitution 5D(5B) was used as a female parent to produce F1 hybrids without Ph1, which resulted in elevation of pairing between durum and grass chromosomes – an important feature from the breeding standpoint. The F1 hybrids were backcrossed to respective parental cultivars and BC1 progenies were raised. ‘Langdon’ 5D(5B) substitution × Th. bessarabicum F1 hybrids were crossed with normal ‘Langdon’ to obtain BC1 progeny. Chromosome pairing relationships were studied in F1 hybrids and BC1 progenies using both conventional staining and fluorescent genomic in situ hybridization (fl‐GISH) techniques. Multicolour fl‐GISH was standardized for characterizing the nature and specificity of chromosome pairing: A–B, A–J and B–J pairing. The A–J and B–J pairing will facilitate gene introgression in durum wheat. Multicolour fl‐GISH will help in characterizing alien chromosome segments captured in the durum complement and in their location in the A and/or B genome, thereby accelerating chromosome engineering research.
Real‐time 3‐D echocardiographic evaluation of the fetal heart using instantaneous volume‐rendered display
Authors: Hata Toshiyuki , Kanenishi Kenji , Tanaka Hirokazu , Kimura Kuniko
Published: January 2006

Aim:  Using new real‐time 3‐D fetal echocardiography with instantaneous volume‐rendered display, we evaluated the heart anatomy of a number of normal fetuses during pregnancy.

Methods:  Eighteen normal fetuses in 17 pregnancies (16 singletons and one twin) at 18–38 weeks’ gestation were studied using a transabdominal real‐time 3‐D ultrasound machine. This machine proved capable of providing continuous 3‐D sonographic images every 0.05 and 0.035 s without the need for an external workstation or other additional, costly equipment. For each patient, the fetal heart was first monitored using conventional 2‐D echocardiography and was monitored again within 10 min using real‐time 3‐D echocardiography.

Results:  Consecutive real‐time 3‐D images showing a four‐chamber view, long‐axis view, short‐axis view, and right ventricular outflow tract view were obtained in 100%, 66.6%, 38.8%, and 22.2% of fetuses in the study, respectively. Morphological changes to each atrium or ventricle could be observed clearly and in detail throughout the cardiac cycle. The opening and closing of each valve were clearly visible. Moreover, these observations could be made from any direction.

Conclusions:  Real‐time 3‐D echocardiography provides a novel means for evaluation of the fetal heart in 3‐D in real time in the second and third trimester of pregnancy. Real‐time 3‐D echocardiography may be an important modality in future fetal cardiac research and in evaluation of congenital heart disease in the fetus.
Accurate preoperative diagnosis and laparoscopic removal of the cavitated non‐communicated uterine horn for obstructive Mullerian anomalies
Authors: Takeuchi Hiroyuki , Sato Yuichi , Shimanuki Hiroto , Kikuchi Iwaho , Kumakiri Jun , Kitade Mari , Kinoshita Katsuyuki
Published: January 2006

Obstructive Mullerian anomalies cause severe dysmenorrhea following menarche as a result of disturbed menstrual outflow. Therefore, surgical management such as extirpation of the obstructive uterine horn is required for treatment of these patients. It is necessary to have a detailed understanding of the pathological conditions of the pelvic organs and urinary system prior to surgery. We report three cases of reproductive, nulligravid patients diagnosed as having obstructive Mullerian anomalies. Preoperative accurate diagnosis was obtained by magnetic resonance imaging (MRI) and 3‐D computed tomography (CT) angiography. Laparoscopic resection of the rudimentary uterine horn was performed safely and completely, and resolved all problems. MRI and 3‐D CT angiography are useful tools for diagnosing complex Mullerian anomalies, and operative laparoscopy may be an alternative treatment for these cases.
Preliminary results of neoadjuvant chemotherapy with paclitaxel and cisplatin in patients with advanced epithelial ovarian cancer who are inadequate for optimum primary surgery
Authors: Lee Sun‐Joo , Kim Byoung‐Gie , Lee Jeong‐Won , Park Chang‐Soo , Lee Je‐Ho , Bae Duk‐Soo
Published: January 2006

Aim:  This study was performed to evaluate the efficacy of neoadjuvant chemotherapy (NAC) with paclitaxel and cisplatin in patients with advanced epithelial ovarian cancer who were inadequate for primary optimal surgery.

Methods:  Patients with histologically confirmed epithelial ovarian cancer at International Federation of Gynecology and Obstetrics stages IIIc/IV that was unresectable according to computed tomography findings were eligible for this study. Three cycles of paclitaxel plus cisplatin NAC were administered and the response was evaluated. Patients were then selected for interval debulking surgery or three cycles of additional chemotherapy with the same regimen according to the resectability and response. Interval debulking surgery followed by second‐line chemotherapy was applied to patients with no response to NAC. During the same period, patients who did not agree to the protocol were treated by the conventional method of tumor debulking surgery followed by adjuvant chemotherapy, and served as the control group. A comparison of both groups of patients was carried out.

Results:  A total of 40 patients were involved in the study. All patients were evaluable. Eighteen patients underwent NAC and 22 patients were treated by conventional therapy. Optimal debulking was possible in 14 patients (77.8%) in the NAC group and in 10 patients (45.5%) in the conventional therapy group (P = 0.04). The mean estimated blood loss was 620 cc (range: 300–1500 cc) in the NAC group and 1061 cc (range: 300–3500 cc) in the conventional therapy group (P = 0.04). However, no significant differences were found in the disease‐free and overall survival rates between the two groups (P = 0.48 and P = 0.61, respectively).

Conclusion:  NAC provided a higher rate of optimum cytoreduction and equivalent survival with less invasive surgery and reduced morbidity compared with conventional therapy in patients with advanced epithelial ovarian cancer inadequate for primary optimum surgery. Therefore, NAC may be a valuable alternative treatment for these patients.
Comparison of maternal–fetal outcomes in gestational diabetes and lesser degrees of glucose intolerance†
Authors: Nordin Noraihan Mohd , Wei Justen Wong Han , Naing Nyi Nyi , Symonds Edwin Malcolm
Published: January 2006

Aim:  To determine the relationships between maternal and fetal outcomes and gestational diabetes mellitus (GDM), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), respectively.

Methods:  A retrospective cohort study design was used with 149 patients with abnormal oral glucose tolerance test (OGTT) and 149 normal patients. Statistical analysis used was the chi‐squared test, Fisher's exact test or the Student's t‐test, as appropriate. P < 0.05 was considered significant.

Results:  The level of hyperglycemia according to the OGTT (World Health Organization criteria) was associated with pre‐eclampsia, polyhydramnios and macrosomia in GDM patients. There was no increase in the complications of preterm labor and premature rupture of membranes, despite the increased risk of polyhydramnios. Although treated with insulin, macrosomia still occurred in patients with GDM, but there was no shoulder dystocia as there was an increase in the incidence of cesarean section (CS). The IGT group was not associated with adverse fetal or maternal outcomes, but there was an increase in intervention and the incidence of CS. The IFG group was associated with a significantly increased risk of pre‐eclampsia and macrosomia. These findings challenge the concept of IFG being a lesser pathology than GDM. Further prospective studies with a larger number of patients are needed to ascertain the significance of these findings.

Conclusion:  There was an increased risk of pre‐eclampsia and macrosomia in both the GDM and IFG patients, but IGT was not associated with adverse fetal or maternal outcomes.
Development of a Novel Oxidative Hair Color Based on a System with an Optimized Ratio of Higher Alcohol to Cationic Surfactant
Authors: Yamashita T. , Ochiai M. , Shibata K. , Yasuda M. , Noda A.
Published: January 2006

Oxidative hair color, the most commonly used for coloring hair, is characterized by its bleaching effect. This effect enables dark hair to be dyed in various bright colors. In order to enhance this bleaching effect, the concentration of either the alkalizing or oxidizing agent in the hair color base is generally increased. However, this method causes chemical damage to the hair. With the aim of finding methods to obtain an improved bleaching effect without increasing the amount of bleaching ingredients, the authors investigated the permeation mechanism. Cationic bases showed the highest bleaching effect and allowed greater penetration, permitting bleaching ingredients to enter the cortex of the hair more easily and diffuse more quickly. In addition, the molar ratios of higher alcohol (A) to cationic surfactant (C) as a function of the bleaching effect were also evaluated. The results showed an optimum range for this A/C ratio. The smoothness of the hair was also evaluated, revealing an optimum range for the A/C ratio. Based on these findings, a product with an A/C ratio that maximizes the bleaching effect and the smoothness of the hair was successfully developed. Comparison of this newly developed product with a conventional product verified that the new product has a greater bleaching effect and gives a beautiful depth of color while maintaining the silky smoothness of the texture of the hair.

Part of this study was presented at the 23rd IFSCC Congress 2004, Orlando, Florida USA.
N‐Palmitoyl‐4‐Hydroxy‐L‐Proline Palmityl Ester: A Pseudoceramide that Provides Efficient Skin Barrier Repair and Protection
Authors: Vielhaber G. , Lange S. , Ley J. , Koch O.
Published: January 2006

Ceramides are the main constituents of the epidermal permeability barrier, and it has been demonstrated that the application of ceramide enriched creams promotes epidermal barrier repair. However, nature‐identical ceramides are extremely expensive and difficult to formulate. We therefore developed a new pseudoceramide, N‐palmitoyl‐4‐hydroxy‐l‐proline palmityl ester (BIO391). Due to its low melting point of £60°C the pseudoceramide BIO391 can easily be incorporated into cosmetic formulations. In addition, it is very safe for use in cosmetics.

The efficacy of the pseudoceramide BIO391 was investigated in vivo in a model for detergent‐induced barrier disruption. Trans‐epidermal water loss, redness, and skin hydration were recorded before and after barrier disruption as well as during the subsequent 9‐day treatment with the test products.

Barrier repair of skin treated with the pseudoceramide BIO391 was accomplished earlier than that of untreated and vehicle treated skin. Optimum barrier repair was achieved with 1.0% pseudoceramide BIO391 and optimum erythema reduction with 0.5% pseudoceramide BIO391. The optimum dosage could be reduced to 0.1% pseudo‐ceramide by synergistic combination with 0.1% (‐)‐a‐bisabolol. In addition, the pseudoceramide BIO391 proved to be as effective as nature‐identical ceramides 2 and 3. In summary, N‐palmitoyl‐4‐hydroxy‐l‐proline palmityl ester is a highly efficient barrier repair agent with efficacy equivalent to that of nature‐identical ceramides, and it has excellent formulation properties.
Review of Advanced Studies for Sunscreen: Clinical Use and Future Aspect
Authors: Hanada K.
Published: January 2006

For understanding the clinical significance of sunscreen, representative photodermatoses including xeroderma pigmentosa, polymorphous light eruption, chronic actinic dermatitis and porphyria were explained. In addition, several topics concerning strategy of sunscreen use were reviewed. Finally, new strategies of sun‐protection with metallothionein protein and NF‐κB decoy were introduced.
Spectroscopic Characterization of Color Polymorphism in the Orbital Skin
Authors: Fukuda Y. , Soga H. , Satoh H. , Kitahara T. , Yoshizuka N. , Takema Y.
Published: January 2006

The color and shape of the orbital skin have specific properties, differing from those of the cheek and forehead. Changes in the properties of the orbital skin are recognized as so‐called “dark circles.” To understand the variety in the color and shape of the orbital skin, we previously observed the orbital skin in 180 healthy females, and found color tone characteristics (brown, red, and blue) and various morphological characteristics. We also established a photographic scale for their scoring and reported the results of the analysis of their correlation with age at the 48th Conference of the SCCJ. In this study, to clarify the association of skin color tone with melanin and regional blood flow, analysis of skin properties by non‐invasive spectroscopy and assessment by scoring using the photographic scale were performed in 60 healthy females. The brown tone score was positively correlated with the melanin index. This suggested that the brown tone in the orbital skin is due to melanin. The red tone score was positively correlated with the Hb value and negatively correlated with the blood flow rate. These results suggested that the red tone in the orbital skin is due to increased Hb and blood flow stagnation. The blue tone score was negatively correlated with oxygen saturation and blood flow, suggesting that the blue tone in the orbital skin reflects blood flow stagnation and decreased skin circulation. These results suggested the important role of regional blood flow, and changes in melanin content play important roles in changes in the color tone of the orbital skin.
Penetration of cationic conditioning compounds into hair fibers: A TOF‐SIMS approach
Authors: Ruetsch S. B. , Kamath Y. K.
Published: January 2006

Cationic conditioning compounds protect against hair damage caused by cosmetic chemical treatments and grooming practices. They also enhance the retention of moisture. However, the question as to whether they do this superficially by residing on the hair surface or by penetrating into the fiber remains unanswered. In this work, an attempt has been made to show the penetration of a low‐molecular‐weight cationic conditioning compound into the hair cortex using the time‐of‐flight secondary ion mass spectrometry (TOF SIMS) method, applied in earlier research to show the penetration of oils into hair. An example of the practical benefit of such penetration into the cortex in greatly improving the fatigue resistance of hair has been discussed.
The dynamic adjustment towards target capital structures of firms in transition economies*
Authors: de Haas Ralph , Peeters Marga
Published: January 2006

We examine the capital structure dynamics of Central and Eastern European firms to get a better understanding of the quantitative and qualitative development of the financial systems in this region. The dynamic model used endogenizes the target leverage as well as the adjustment speed. It is applied to microeconomic data for ten countries. We find that during the transition process, firms generally increased their leverage, lowering the gap between the actual and the target leverage. Profitability and age are the most robust determinants of capital structure targets. Although banking system development has in general enabled firms to get closer to their leverage targets, information asymmetries between firms and banks are still relatively large. As a result, firms prefer internal finance above bank debt and adjust leverage only slowly.
User profiling on the Web based on deep knowledge and sequential questioning
Authors: Mussi Silvano
Published: January 2006

Abstract: User profiling on the Web is a topic that has attracted a great number of technological approaches and applications. In most user profiling approaches the website learns profiles from data implicitly acquired from user behaviours, i.e. observing the behaviours of users with a statistically significant number of accesses. This paper presents an alternative approach. In this approach the website explicitly acquires data from users, user interests are represented in a Bayesian network, and user profiles are enriched and refined over time. The profile enrichment is achieved through a sequential asking algorithm based on the value‐of‐information theory using the Shannon entropy concept. However, what mostly characterizes the approach is the fact that the user is involved in a collaborative process of profile building. The approach has been tried out for over a year in a real application. On the basis of the experimental results the approach turns out to be particularly suitable for applications where the website is strongly based on deep domain knowledge (as for example is the case for scientific websites) and has a community of users that share the same domain knowledge of the website and produce a ‘low’ number of accesses (‘low’ compared to the high number of accesses of a typical commercial website). After presenting the technical aspects of the approach, we discuss the underlying ideas in the light of the experimental results and the literature on human–computer interaction and user profiling.
An expert system for the selection of software design patterns
Authors: Moynihan Gary P. , Suki Abhijit , Fonseca Daniel J.
Published: January 2006

Abstract: This paper describes the development of a prototype expert system for the selection of design patterns that are used in object‐oriented software. Design patterns provide one method of software reuse, which supports the goal of improved software development productivity. The prototype system represents an initial step towards providing an automated solution regarding the design pattern application problem, i.e. leading a designer to a suitable design pattern which is applicable to the problem at hand. The feasibility of using expert system technology to aid in the selection problem is demonstrated.
Frequency and distribution pattern of melanocytic naevi in Estonian children and the influence of atopic dermatitis
Authors: Kallas M , Rosdahl I , Fredriksson M , Synnerstad I
Published: January 2006

Background  There is a strong correlation between naevus number and prospective melanoma risk. Melanoma is one of the most rapidly increasing cancers in Estonia and primary prevention programmes for melanoma that target risk behaviour in the sun have so far not been launched.

Methods  The naevus profile was examined in 549/700 9‐year‐old Estonian children (282 boys and 267 girls) and the presence of active atopic dermatitis (AD) was registered.

Results  There was a wide range of naevi (4–121) and a median total body count of 26. There was no difference in naevus count between boys and girls. No dysplastic naevi were found. Thirty‐nine of 549 children (7%) had at least one lesion clinically diagnosed as a congenital naevus.

 Boys had more naevi on the face (median 4) and trunk (median 12) than girls (median 3 and 9, respectively, P < 0.001). Girls had more naevi on the legs compared with boys (median 4 and 3, respectively, P < 0.01). Fifty‐four out of 549 (9.8%) had naevi on the palms and 18/549 (3.3%) on the soles. Children with fair skin, freckles and light hair and eye colours had significantly more naevi than those with darker colours. Thirty‐one of 549 (6%) children had AD diagnosed on the examination day and they had a lower total naevus count (median 20) compared with children with no AD (median 27, n = 518, P < 0.05).

Conclusions  The naevus situation in Estonian children today might constitute a starting point for evaluating the efficiency of coming preventive measures as a change of naevus number in children might serve as an early marker for a change in melanoma incidence.
Psoralen cream plus ultraviolet A photochemotherapy (PUVA cream): our experience
Authors: Pozo‐Román T , González‐López A , Velasco‐Vaquero ME , Núñez‐Cabezón M
Published: January 2006

Background  Psoralen ultraviolet A (PUVA) bath photochemotherapy has been proved highly effective in the treatment of various dermatoses without potential side‐effects of systemic therapy. Another form of topical PUVA therapy (PUVA cream) without the logistical requirements for bath tubs has recently been developed.

Objective  We sought to develop preparation and treatment standards to PUVA cream and to confirm its clinical efficacy in the treatment of various dermatoses.

Methods  In the first phase, the safety of a novel cream containing 0.002% 8‐methoxypsoralen (8‐MOP) was determined in six healthy volunteers. In a second phase, 40 patients with different dermatoses were treated with a minor concentration (0.001% 8‐MOP), following the guidelines for topical PUVA of the British Photodermatology Group.

Results  Plasma levels of psoralen after the application of the novel cream containing 0.002% 8‐MOP, were less than 34 ng/mL, the maximum 8‐MOP concentration reported for topical PUVA. With a minor concentration (0.001% 8‐MOP), important improvement or healing was found in 53.3% of the cycles, generally with a good response since the first month of treatment. Only mild side‐effects were detected in 14 patients.

Conclusions  Based on our data, PUVA cream photochemotherapy is well accepted by patients and may be a highly effective treatment even if previous therapy was unsuccessful. In addition, PUVA cream is easier to use than PUVA bath.
What defines the quality of patient care in tinea pedis?
Authors: Mistik S , Ferahbas A , Koc AN , Ayangil D , Ozturk A
Published: January 2006

Objectives  The aim of this study has been to evaluate patients with tinea pedis for their demographic data and attitudes affecting the treatment of disease, and to compare the in vitro activity of 10 antifungal agents and to relate them to their in vivo activity.

Methods  Patients with positive mycological examination were enrolled in the study, and a questionnaire comprised of 22 questions was administered. A mycological culture was carried out for each specimen. The antifungal susceptibility of the subcultured species was determined for griseofulvin, terbinafine, ciclopiroxolamine, fluconazole, ketoconazole, itraconazole, bifonazole, sulconazole, oxiconazole and miconazole with microdilution.

Results  Mycological cultures were carried out from 59 patients and there were 35 positive cultures (59.3%). The dermatophytes were Trichophyton rubrum (n = 25) and Trichophyton mentagrophytes (n = 3). The yeasts were Candida albicans (n = 7), Candida glabrata (n = 1) and Trichosporon (n = 2). In the minimum inhibitory concentration (MIC) study, the mean ± standard error of the mean (SEM) MICs of the antifungals for T. rubrum were as follows: terbinafine 0.01 ± 0.003, oxiconazole 0.16 ± 0.05, sulkonazole 0.31 ± 0.05, miconazole 0.45 ± 0.15, itraconazole 0.74 ± 0.01, ketokonazole 1.03 ± 0.17, ciclopiroxolamine 1.30 ± 0.12, bifonazole 1.94 ± 0.51, griseofulvin 4.87 ± 0.61, and fluconazole 17.91 ± 3.67 µg/mL.

Conclusion  Our study supports that azoles could be used as first‐line treatment, as oxiconazole is very effective for both dermatophytes and C. albicans. Correlation between in vitro results and clinical outcomes of cases of dermatophytes is still to be established and interpretive breakpoints defined, in order to increase the quality of patient care in tinea pedis.
Metastatic malignant melanoma presenting with hypercalcaemia and bone marrow involvement
Authors: Batsis JA , Barry MJ
Published: January 2006

We report a 75‐year‐old female patient with a background of malignant melanoma who presented with hypercalcaemia to our institution. She was aggressively treated but declined clinically. Computed tomography head and X‐ray studies were suggestive of multiple myeloma, but bone marrow examination was significant for metastatic malignant melanoma. Very few patients with melanoma present with these features, and it further exemplifies the importance of close follow‐up and the aggressive nature of this disease process.
Nursing Home Capabilities and Decisions to Hospitalize: A Survey of Medical Directors and Directors of Nursing
Authors: Buchanan Joan L. , Murkofsky Rachel L. , O'Malley Alistair James , Karon Sarita L. , Zimmerman David , Caudry Daryl J. , Marcantonio Edward R.
Published: January 2006

OBJECTIVES: To obtain information from decision makers about attitudes toward hospitalization and the factors that influence their decisions to hospitalize nursing home residents.

DESIGN: Cross‐sectional survey.

SETTING: Four hundred forty‐eight nursing homes, 76% of which were nonprofit, from 25 states.

PARTICIPANTS: Medical directors and directors of nursing (DONs).

MEASUREMENTS: Participants were surveyed about resource availability, determinants of hospitalization, causes of overhospitalization, and nursing home practice.

RESULTS: The survey response rate was 81%, with at least one survey from 93% of the facilities. Medical directors and DONs agreed that resident preference was the most important determinant in the decision to hospitalize, followed by quality of life. Although both groups ranked on‐site doctor/nurse practitioner evaluation within 4 hours as the least accessible resource, they did not rank doctors not being quickly available as an important cause of overhospitalization. Rather, medical directors perceived the lack of information and support to residents and families around end‐of‐life care and the lack of familiarity with residents by covering doctors as the most important causes of overhospitalization. DONs agreed but reversed the order. Medical directors and DONs expressed confidence in provider and staff ability, although DONs were significantly more positive.

CONCLUSION: Medical directors and DONs agree about most factors that influence decisions to hospitalize nursing home residents. Patient‐centered factors play the largest roles, and the most important causes of overhospitalization are potentially modifiable.
Bone Density Testing in Older Women and Its Association with Patient Age
Authors: Neuner Joan M. , Binkley Neil , Sparapani Rodney A. , Laud Purushottam W. , Nattinger Ann B.
Published: January 2006

OBJECTIVES: To measure the early adoption of bone density testing and examine the association between older age and such testing.

DESIGN: Retrospective study of Medicare administrative claims.

SETTING: Five states and six urban regions in the United States.

PARTICIPANTS: Female Medicare recipients aged 66 to 90.

MEASUREMENTS: Bone density testing in women without prior osteoporosis or fracture (osteoporosis screening) was evaluated. The association between age and osteoporosis screening was then examined while controlling for other demographic and health factors.

RESULTS: Of 43,802 women eligible for osteoporosis screening, 22.9% were tested between 1999 and 2001, the first 3 full years of Medicare coverage. Receipt of bone density tests decreased with increasing age, from 27.2% of women aged 66 to 70 to fewer than 10% of women aged 86 to 90. After adjustment for race, comorbidity, fracture risk, and socioeconomic factors, bone density testing decreased significantly with each age category, so that women aged 71 to 75 were slightly less likely than (adjusted odds ratio (AOR) =0.91, 95% confidence interval (CI) =0.86–0.96), women aged 76 to 80 were less likely than (AOR =0.71, 95% CI =0.67–0.76), and women aged 81 to 85 were half as likely as (AOR =0.50, 95% CI =0.46–0.55) women aged 66 to 70 to receive a bone density test.

CONCLUSION: In the 3 years after Medicare reimbursement for osteoporosis screening began, adoption of bone density testing was lowest in women in age groups at highest fracture risk.
Modulation of clinical expression of plaque‐induced gingivitis: response in aggressive periodontitis subjects
Authors: Trombelli Leonardo , Scapoli Chiara , Tatakis Dimitris N. , Minenna Luigi
Published: January 2006

Aim: The aim of this study was to characterize the gingival inflammatory response to de novo plaque accumulation in subjects treated for aggressive periodontitis (AP). The gingival inflammatory response of the AP subjects was retrospectively compared with that of periodontally healthy individuals (PH) matched for exposure to plaque and of periodontally healthy subjects previously identified as “high responders” (HR) and “low responders” (LR).

Materials and Methods: 13 AP subjects and 26 matched PH subjects participated in a 21‐day experimental gingivitis trial. Plaque index (PlI), Gingival index (GI), gingival crevicular fluid volume (GCF) and angulated bleeding score (AngBS) were recorded at days 0, 7, 14 and 21. Cumulative plaque exposure (CPE), i.e. PlI over time, was also calculated.

Results: GCF was significantly higher in AP compared with PH group at each observation interval (p0.001). In addition, GCF was significantly higher in AP group compared with either LR or HR groups at each observation interval (p<0.001).

Conclusions: These results suggest that susceptibility to gingival inflammation in response to de novo plaque accumulation may be related to susceptibility to periodontitis.
Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12 month randomized, controlled, single masked pilot study
Authors: McColl E. , Patel K. , Dahlen G. , Tonetti M. , Graziani F. , Suvan J. , Laurell L.
Published: January 2006

Objective: To compare the short‐term performance of subgingival local delivery of 2% minocycline gel and conventional subgingival debridement in supportive periodontal therapy (SPT) patients.

Methods: Forty adult patients having completed active treatment for moderate to advanced chronic periodontitis were included in a randomized, controlled, single masked maintenance care pilot study. Sites with residual pocket probing depths 5 mm and bleeding on probing were treated with either minocycline gel (minocycline‐group) or scaling and root planing only (debridement‐group) at baseline, 3, 6, and 9 months. Clinical and microbiological examinations were performed at baseline, 3, 6, 9, and 12 months.

Results: Full‐mouth plaque and bleeding scores remained <10% and <20%, respectively, for both groups throughout the study. In both groups there was a persistent reduction in number of teeth and sites with probing pocket depths 5 mm (p<0.05) with no significant differences between the groups. The prevalence of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Prevotella nigrescens, remained at levels 105 in the majority of patients and sites in both groups.

Conclusion: This pilot study failed to show a difference between local delivery of 2% minocycline gel as mono‐therapy and traditional subgingival debridement in patients on SPT.
Hyper‐reactive mononuclear cells and neutrophils in chronic periodontitis
Authors: Gustafsson A. , Ito H. , Åsman B. , Bergström K.
Published: January 2006

Objectives: Stimulated mono‐ and polymorphonuclear cells from patients with periodontitis have shown increased release of interleukin‐1β (IL‐1β) and oxygen radicals, respectively. The aim was to study whether this hyper‐reactivity could be found both in mono‐ and polymorphonuclear cells from the same patient, and whether there was a relation to the gene coding for IL‐1β (IL‐1β+3953).

Material and Methods: Peripheral mononuclear cells from 14 non‐smoking and well‐treated patients and pair‐matched controls were incubated with opsonized Staphylococcus aureus and lipopolysaccharide (LPS). Released IL‐1β and tumour necrosis factor (TNF)‐α were determined with ELISA. Generation of oxygen radicals from the Fcγ‐receptor‐stimulated neutrophils was measured with chemiluminescence and the polymorphism at IL‐1β+3953 was measured with polymerase chainreaction.

Results: The mononuclear cells from the patients released more IL‐1β after incubation with LPS (p<0.001) and with bacteria (p<0.05). The release of TNF‐α tended to be higher in the patient group. The peripheral neutrophils from the patients generated more oxygen radicals (p<0.06). We found no differences between the study groups regarding the IL‐1β+3953 polymorphism.

Conclusion: The similarity in systemic inflammation between patients and controls suggests that the increased release/generation of IL‐1β and oxygen radicals from peripheral leukocytes in periodontitis patients is of a constitutional nature and of pathogenic relevance.
The relationship between maternal periodontitis, adverse pregnancy outcome and miscarriage in never smokers
Authors: Farrell (née Moore) S. , Ide M. , Wilson R. F.
Published: January 2006

Background: It has been postulated that associations between periodontal disease and systemic conditions may be because of the confounding effects of smoking. In addition, studies of this type rarely investigate the adverse pregnancy outcome of miscarriage.

Aim: The aim of this prospective study was to investigate a relationship between periodontal disease in pregnancy and subsequent adverse pregnancy outcomes in a population of never smokers.

Materials and Methods: Pregnant women were recruited at 12 weeks gestation. Demographic, behavioural and medical data were collected. A periodontal examination was performed and data on each subjects' pregnancy outcome were collected.

Results: A total of 1793 women reported never previously smoking. Of these, 7.3% had a pre‐term birth and 0.9% a late miscarriage. As expected in this population, we found no associations between poorer periodontal health and either pre‐term birth or low birth weight (LBW). In contrast, the subjects who experienced a late miscarriage had a higher mean probing depth at mesial sites compared with the subjects that gave birth at term (2.69 mm versus 2.41 mm, p=0.006).

Conclusions: There was an association between some measures of periodontal disease and late miscarriage; however, there was no association between periodontitis and pre‐term birth or LBW in this population.
Evaluating the quality of active‐control trials in periodontal research
Authors: Tu Yu‐Kang , Maddick Ian , Kellett Margaret , Clerehugh Valerie , Gilthorpe Mark S.
Published: January 2006

Aim: The increasing popularity of randomized‐controlled trials (RCTs) has raiseed the issue of their quality. Frequently overlooked are the differences between superiority and equivalence trials. The purpose of this study was to apply specific methodological criteria to evaluate the quality of active‐control trials using studies that compared guided tissue regeneration (GTR) with enamel matrix derivatives (EMD).

Materials and Methods: Seven RCTs were identified in the literature. Standard methodological criteria and seven additional criteria for trials using active‐control groups were used to evaluate the quality of the seven RCTs.

Results: Two trials were considered as superiority trials. The remaining five provided no clear statement of their research aim. However, two claimed that EMD and GTR were equally effective, because their results failed to show a significant difference between EMD and GTR. Most trials did not meet the majority of the design criteria.

Conclusions: The general lack of compliance with quality criteria might place doubt on the value of these trials and may render any conclusions questionable. It is therefore important to distinguish clearly between superiority trials and equivalence trials, and to incorporate appropriate additional criteria in the design of future RCTs with active‐control groups.
Confounding and effect modification: possible explanation for variation in the results on the association between oral and systemic diseases
Authors: Ylöstalo P. V. , Knuuttila M. L.
Published: January 2006

Objectives: There is large variation in the results of studies on the association between periodontitis and systemic diseases. The variation might be explained by the fact that the association between periodontitis and systemic diseases is confounded, or the association might be modified by extraneous factors. In this article, we show, using simple examples, how confounding and effect modification may cause variation in results. In addition, these examples show that uncontrolled or partially controlled confounders can induce spurious associations.

Conclusion: Confounding and effect modification may explain the variation in the results of studies on the association between periodontitis and systemic diseases.