bluuebunny/crossref_metadata_2025 huggingface dataset:
Boon of MTA Apexification in Young Permanent Posterior Teeth
Authors: Kumar Vinod , Zameer Mohammed , Prasad Vijaya , Mahantesh T.
Published: October 2014

Single visit apexification using mineral trioxide aggregate (MTA) is a new boon in effective management of nonvital tooth with an open apex which has steadily gained popularity with clinicians; also it shortens the treatment period and improves patient compliance. Importance of this approach lies in expedient cleaning and shaping of the root canal system, followed by its apical seal with MTA. There are several case reports available describing the use of MTA as an apexification agent in incisors and premolar, but presented cases are the unique case reports demonstrating successful apexification procedure using MTA in young permanent mandibular molars. After eight-month follow-up, teeth were without any abnormal clinical symptoms; rather there were radiographic resolution of the periapical lesion and induction of root end closure with new hard tissue formation over MTA.
Dynamics of a Predator-Prey System with a Mate-Finding Allee Effect
Authors: Wu Ruiwen , Liu Xiuxiang
Published: October 2014

We consider a ratio-dependent predator-prey system with a mate-finding Allee effect on prey. The stability properties of the equilibria and a complete bifurcation analysis, including the existence of a saddle-node, a Hopf bifurcation, and, a Bogdanov-Takens bifurcations, have been proved theoretically and numerically. The blow-up method has been applied to investigate the structure of a neighborhood of the origin. Our mathematical results show the mate-finding Allee effect can reduce the complexity of system behaviors by making the complicated equilibrium less complicated, and it can be a destabilizing force as well, which makes the system has a high possibility of being threatened with extinction in ecology.
The Effects of CO2Laser with or without Nanohydroxyapatite Paste in the Occlusion of Dentinal Tubules
Authors: Al-maliky Mohammed Abbood , Mahmood Ali Shukur , Al-karadaghi Tamara Sardar , Kurzmann Christoph , Laky Markus , Franz Alexander , Moritz Andreas
Published: October 2014

The aim of this study was to evaluate a new treatment modality for the occlusion of dentinal tubules (DTs) via the combination of 10.6 µm carbon dioxide (CO2) laser and nanoparticle hydroxyapatite paste (n-HAp). Forty-six sound human molars were used in the current experiment. Ten of the molars were used to assess the temperature elevation during lasing. Thirty were evaluated for dentinal permeability test, subdivided into 3 groups: the control group (C), laser only (L−), and laser plus n-HAp (L+). Six samples, two per group, were used for surface and cross section morphology, evaluated through scanning electron microscope (SEM). The temperature measurement results showed that the maximum temperature increase was 3.2°C. Morphologically groups (L−) and (L+) presented narrower DTs, and almost a complete occlusion of the dentinal tubules for group (L+) was found. The Kruskal-Wallis nonparametric test for permeability test data showed statistical differences between the groups (P<0.05). For intergroup comparison all groups were statistically different from each other, with group (L+) showing significant less dye penetration than the control group. We concluded that CO2laser in moderate power density combined with n-HAp seems to be a good treatment modality for reducing the permeability of dentin.
PulmonaryMycobacterium kansasiiInfection Mimicking Malignancy on the18F-FDG PET Scan in a Patient Receiving Etanercept: A Case Report and Literature Review
Authors: Min Zaw , Amlani Mohan
Published: October 2014

A 66-year-old male presented with chest pain, malaise, generalized weakness, and weight loss. He had been receiving etanercept injection for rheumatoid arthritis. Chest X-ray revealed a right upper lobe mass. Chest computed tomography (CT) showed a right apical mass, highly suggestive of a Pancoast tumor. The thoracic fluorine-18 fluoro-deoxy-glucose (18F-FDG) positron emission tomography (PET) scan demonstrated significantly high metabolic pulmonary lesions with the standardized uptake value (SUV) of 12.5, consistent with lung cancer. The patient underwent bronchoscopy and bronchoalveolar lavage (BAL). BAL cytology was negative for malignant cells. BAL acid fast bacilli (AFB) smears were positive, andMycobacterium kansasiiwas eventually isolated. He received a 12-month course of rifampin, isoniazid, and ethambutol. Interval resolution of pulmonary lesions was noted on follow-up serial CT chest studies. There has been increasing incidence of nontuberculous mycobacterial infections reported in patients treated with the antitumor necrosis factor-alpha (anti-TNF-alpha) agents. Infectious foci have an increased glucose metabolism which potentially causes a high FDG uptake on the18F-FDG PET scan, leading to undue anxiety and cost to the patients. This is the first reported case of pulmonaryM. kansasiiinfection with a positive thoracic18F-FDG PET study mimicking malignancy in a patient on etanercept.
Stereoselective Synthesis of (+)-α-Conhydrine from R-(+)-Glyceraldehyde
Authors: Penumati Nageshwar Rao , Kommu Nagaiah
Published: October 2014

Stereoselective synthesis of (+)-α-Conhydrine was accomplished from protected (R)-(+)-glyceraldehyde, a familiar carbohydrate predecessor. Our synthetic strategy featured the following two key reactions. One is Zn-mediated stereoselective aza-Barbier reaction of imine 6 with allyl bromide to afford chiral homoallylic amine 7, and the other is ring-closing metathesis.
Carotid Artery Stenting: Second Consensus Document of the ICCS/ISO-SPREAD Joint Committee
Authors: Lanza Gaetano , Setacci Carlo , Cremonesi Alberto , Ricci Stefano , Inzitari Domenico , de Donato Gianmarco , Castelli Patrizio , Pratesi Carlo , Peinetti Flavio , Lanza Jessica , Zaninelli Augusto , Gensini Gian Franco
Published: October 2014

Background: A major debate in cerebrovascular medicine today is over the choice of the best treatment to implement for stenosis of the carotid artery. Carotid artery stenting is a less invasive technique than endarterectomy for the treatment of carotid stenosis, and is becoming more widely performed, particularly on patients with carotid artery stenosis who present also with comorbidities. To address the aspects related to the use of carotid artery stenting, an Italian multidisciplinary task force comprising the most representative scientific societies concerned with carotid artery disease was set up to provide neurologists, radiologists, cardiologists, vascular surgeons, and all those involved in stroke prevention and treatment with an updated, evidence-based consensus document. Summary: The task force followed a structured methodology to assess the literature on carotid stenosis in order to provide a summary of the main issues related to carotid artery stenting, including the definition of the grade of symptomatic carotid artery stenosis, indications for intervening on the carotid artery stenosis, establishing whether to perform either a surgical or an endovascular procedure, the training, credentialization, and competency needed by physicians to perform carotid artery stenting, acceptable complication rates and risk certification for carotid artery stenting, management of stented patients, durability of carotid artery stenting, and future tasks. Here, we outline the main findings of this effort. Key Messages: As for any guideline or consensus statement, each point is valid as long as the evidence on which it is based remains up to date. In a fast-evolving field of medicine such as that of carotid artery stenosis management, and in particular carotid artery stenting, the stimulation of continuous and fruitful discussion among all professionals involved is mandatory. We hope that this document may provide a standardized basis for the application of carotid artery stenting as implemented today.
Activation of Toll-like Receptor-7 Exacerbates Lupus Nephritis by Modulating Regulatory T Cells
Authors: Gong Li , Wang Yuanzhan , Zhou LiLi , Bai Xiaoyan , Wu Sha , Zhu Fengxin , Zhu Yu Feng
Published: October 2014

Background: Toll-like receptor-7 (TLR7), which recognizes viral single-stranded RNA, can trigger immune complex glomerulonephritis in experimental lupus erythematosus. However, whether it modulates dendritic cells (DCs) phenotype and regulatory T cells (Treg) function is incompletely understood. Method: Splenocytes and bone marrow DCs were obtained from 5- and 20-week-old female MRLlpr/lpr mice and C57BL/6 mice. In addition, to understand the response of Treg and DCs to TLR7 ligation in vivo, 16-week-old female MRLlpr/lpr and C57BL/6 mice were distributed into two groups with or without intraperitoneal injections of TLR7 ligand every other day. Results: After activation with the TLR7 ligand imiquimod in vivo and vitro, DCs from imiquimod-treated MRL/lpr mice showed an altered costimulatory profile, with decreased induction of CD80, CD86, and MHCII expression, comparing to age-matched C57BL/6 control mice. There was no significant difference in the numbers of CD4+CD25+Foxp3+ cells after TLR7 ligation by imiquimod in MRLlpr/lpr and control mice. Immunostaining of kidney sections of nephritic MRL/lpr mice revealed that CD11c was expressed in the infiltrated tubulointerstitial cells, and confocal microscopic analysis of renal CD11c+MHCII+, CD11c+CD80+, and CD11c+​CD86+ cells showed an immature phenotype with low levels of CD80, CD86, and MHCII in imiquimod-treated MRL/lpr mice. There was no difference in the number of Foxp3 positive cells in kidneys between the imiq‑uimod and vehicle-treated groups. Conclusions: Our results suggest that activation of TLR7 exacerbated lupus nephritis by modulating the abnormally costimulatory phenotype of dendritic cells and functions of Treg in MRL/lpr mice.
Chronic Intermittent Low-Level Transcutaneous Electrical Stimulation of Auricular Branch of Vagus Nerve Improves Left Ventricular Remodeling in Conscious Dogs With Healed Myocardial Infarction
Authors: Wang Zhuo , Yu Lilei , Wang Songyun , Huang Bing , Liao Kai , Saren Gaowa , Tan Tuantuan , Jiang Hong
Published: October 2014

Background—

Vagus nerve stimulation attenuates left ventricular (LV) remodeling after myocardial infarction (MI). Our previous study found a noninvasive approach to deliver vagus nerve stimulation by transcutaneous electric stimulation of auricular branch of vagus nerve. So we hypothesize that chronic intermittent low-level tragus stimulation (LL-TS) could attenuate LV remodeling in conscious dogs with healed MI.

Methods and Results—

Thirty beagle dogs were randomly divided into 3 groups, MI group (left anterior descending artery and major diagonal branches ligation to introduce MI, n=10), LL-TS group (MI plus chronic intermittent LL-TS, n=10), and control group (sham surgery without stimulation, n=10). Tragus stimulation was delivered to bilateral tragus with ear-clips connected to a custom-made stimulator. The voltage slowing sinus rate was used as the threshold for setting LL-TS at 80% below that. LL-TS group was given 4 hours stimulation at 7–9
am
and 4–6
pm
on conscious dogs. At the end of 90-day follow-up, LL-TS group significantly reduced LA and LV dilatation, improved LV contractile and diastolic function, reduced infarct size by ≈50% compared with MI group. LL-TS treatment alleviated cardiac fibrosis and significantly decreased protein expression level of collagen I, collagen III, transforming growth factor β1, and matrix metallopeptidase 9 in LV tissues. The plasma level of high-specific C-reactive protein, norepinephrine, N-terminal pro-B-type-natriuretic peptide in LL-TS group was significantly lower than those in MI group from the 7th day to the end of follow-up.

Conclusions—

Chronic intermittent low-level transcutaneous electric stimulation of auricular branch of vagus nerve can attenuate LV remodeling in conscious dogs with healed MI.
Global Governance Efforts in Tension between Humanitarian Concerns and Statist Sovereignty Rights
Authors: Hofmann Gregor P. , Wisotzki Simone
Published: October 2014

This article focuses on the role of justice claims for issues of global governance. Conflicting justice convictions held by states can become considerable stumbling blocks for multilateral negotiations. Normative claims which call for strengthening individual rights, such as human rights or human security, often collide with statist sovereignty convictions, such as the right of non-intervention, territorial integrity and non-interference. Conflicts between negotiating parties also occur on questions of distribution, recognition and procedural justice. The article argues that such justice conflicts affect the outcome of negotiations. Two recent negotiation processes and governance efforts at the United Nations are examined: the Responsibility to Protect (2005) and the Arms Trade Treaty (2013).
Distributive Justice and Treaty Efficiency: Impact of Dual-use Research Restrictions on bwc Implementation
Authors: Ben Ouagrham-Gormley Sonia
Published: October 2014

This article evaluates the security value of controls over biotechnology transfers and of new restrictions on the spread of scientific results: to what extent do they improve the implementation of the Biological Weapons Convention (bwc)? Although the questions of justice that have plagued thebwcregime since its creation in 1972 have been analyzed extensively, the effects of current controls over dual-use research and the propagation of scientific results on the implementation of thebwchave not been fully addressed. It is argued that although controls over biotechnology transfers increase security because they delay covert programs by creating integration challenges, controls on the spread of scientific results have no security value. They instead may lead to a decreased implementation of thebwc.
A Steady Race towards Better Compliance with International Humanitarian Law? The ICTR 1995–2012
Authors: Steiger Dominik
Published: October 2014

This article reviews the legacy of the International Criminal Tribunal for Rwanda (ICTR) under a specific compliance perspective and asks whether the Tribunal’s jurisprudence furthered the adherence to norms of international criminal and humanitarian law. The Tribunal’s impact on the circulation, emergence and enforcement, of the prohibitions of genocide and other serious violations of international humanitarian law will thus be scrutinised. Furthermore, the legitimacy of the ICTR’s jurisprudence plays a major role as human beings not only follow a logic of consequence but also a logic of appropriateness. This combined approach will show that the ICTR – despite its shortcomings – has furthered compliance by diffusing the norms of international criminal and humanitarian law not only to Rwanda and the Great Lakes Region, but also to the international community.
Amnesty, Revenge, and the Threat of Conflict Relapse
Authors: Childers Jacob
Published: October 2014

Recent decades have witnessed an increase in internal armed conflicts, resulting in significant consequences for affected civilian populations. At the same time, there has been rapid growth in international criminal law and a trend towards accountability. Yet, attempts to mitigate violence may come at the cost of accountability, leading to the commonly referenced to peace-versus-justice dispute. Blanket amnesties are one tool for conflict mitigation, bargaining chips that allow actors to come to the negotiating table. This article examines issues related to blanket amnesties that are absent from the amnesty versus accountability debate. The basis of the analysis is not whether accountability reduces a victim’s desire for revenge. Instead, the analysis examines whether amnesty increases a victim’s desire for revenge, and when combined with other socio-political factors that contribute to conflict relapse, finds that this increased desire may escalate the potential for renewed violence in post-conflict regions.
Saving Lives at Sea: Security, Law and Adverse Effects
Authors: Basaran Tugba
Published: October 2014

In the wake of recent shipwrecks at the Strait of Sicily, the European Union and its Member States have come under renewed pressure to address rescue at sea. Saving lives at sea is not simply a question of enhancing eu rescue efforts, however, but requires eliminating third party sanctions that significantly impede the proper functioning of the international rescue regime. This article focuses on anti-smuggling laws and related instruments and their thorny relation to humanitarian acts. To improve rescue efforts at sea, as a first step all humanitarian acts need to be exempted from criminal sanctions (including the eu Directive 2002/90/ec). This needs to be accompanied by efforts to desecuritize rescue, separating rescue from border security concerns.
Introduction
Authors: Bongmba Elias K. , Olivier Jill
Published: October 2014

The world of study and engagement on religion and public life has become rather colorful and crowded of late, filled with all sorts of disciplinary specialists and actors. Working in this multi- and interdisciplinary space can be engaging or terrifying, given its opportunities and absence of clear boundaries and definitions. The papers in this edition examine the interdisciplinary space between “religion” and “the public” in Africa – with a focus on the intersection of religion, development and public health. The authors argue that achieving genuine dialogue, collaboration or transdisciplinarity in this space is elusive, but worthwhile.
Interannual Coupling between Summertime Surface Temperature and Precipitation over Land: Processes and Implications for Climate Change*
Authors: Berg Alexis , Lintner Benjamin R. , Findell Kirsten , Seneviratne Sonia I. , van den Hurk Bart , Ducharne Agnès , Chéruy Frédérique , Hagemann Stefan , Lawrence David M. , Malyshev Sergey , Meier Arndt , Gentine Pierre
Published: October 2014

Widespread negative correlations between summertime-mean temperatures and precipitation over land regions are a well-known feature of terrestrial climate. This behavior has generally been interpreted in the context of soil moisture–atmosphere coupling, with soil moisture deficits associated with reduced rainfall leading to enhanced surface sensible heating and higher surface temperature. The present study revisits the genesis of these negative temperature–precipitation correlations using simulations from the Global Land–Atmosphere Coupling Experiment–phase 5 of the Coupled Model Intercomparison Project (GLACE-CMIP5) multimodel experiment. The analyses are based on simulations with five climate models, which were integrated with prescribed (noninteractive) and with interactive soil moisture over the period 1950–2100. While the results presented here generally confirm the interpretation that negative correlations between seasonal temperature and precipitation arise through the direct control of soil moisture on surface heat flux partitioning, the presence of widespread negative correlations when soil moisture–atmosphere interactions are artificially removed in at least two out of five models suggests that atmospheric processes, in addition to land surface processes, contribute to the observed negative temperature–precipitation correlation. On longer time scales, the negative correlation between precipitation and temperature is shown to have implications for the projection of climate change impacts on near-surface climate: in all models, in the regions of strongest temperature–precipitation anticorrelation on interannual time scales, long-term regional warming is modulated to a large extent by the regional response of precipitation to climate change, with precipitation increases (decreases) being associated with minimum (maximum) warming. This correspondence appears to arise largely as the result of soil moisture–atmosphere interactions.
Evolving Ensembles
Authors: Roebber Paul J.
Published: October 2014

An ensemble forecast method using evolutionary programming, including various forms of genetic exchange, disease, mutation, and the training of solutions within ecological niches, is presented. A 2344-member ensemble generated in this way is tested for 60-h minimum temperature forecasts for Chicago, Illinois.

The ensemble forecasts are superior in both ensemble average root-mean-square error and Brier skill score to those obtained from a 21-member operational ensemble model output statistics (MOS) forecast. While both ensembles are underdispersive, spread calibration produces greater gains in probabilistic skill for the evolutionary program ensemble than for the MOS ensemble. When a Bayesian model combination calibration is used, the skill advantage for the evolutionary program ensemble relative to the MOS ensemble increases for root-mean-square error, but decreases for Brier skill score. Further improvement in root-mean-square error is obtained when the raw evolutionary program and MOS forecasts are pooled, and a new Bayesian model combination ensemble is produced.

Future extensions to the method are discussed, including those capable of producing more complex forms, those involving 1000-fold increases in training populations, and adaptive methods.
Has the Study of Public Service Motivation Addressed the Issues That Motivated the Study?
Authors: Prebble Mark
Published: October 2014

The study of Public Service Motivation (PSM) has achieved considerable academic momentum with increasingly subtle research appearing each year. It is now opportune to look back at decades of work to see whether the concerns that initiated this area of study have been addressed. This article uses seminal articles that have shaped the field to find three main topics of interest: a concern about the way that theories of public choice characterized human nature, an ambition to crystallize and measure long-held understandings about a public service ethos, and a wish to promote a practical basis for incentivizing staff in the public sector. The application of PSM to these goals is examined, with the conclusion that PSM studies have made little progress in addressing any of those concerns. The implications of that conclusion are briefly considered.
Adolescent Bariatric Surgery
Authors: Nogueira Isadora , Hrovat Kathleen
Published: October 2014

The prevalence of obesity in adolescents has dramatically increased over the past 3 decades in the United States. Weight loss surgery is becoming a viable treatment option for obese adolescents. The number of surgeries being performed yearly is rising, and this trend is likely to continue. Adolescent patients present a unique challenge to clinicians. There are currently best‐practice recommendations and evidence‐based nutrition guidelines for the treatment of the adolescent bariatric patient. A review of the current literature was performed to discuss bariatric surgery and nutrition for the adolescent patient. Studies show that most adolescents with obesity will become obese adults, thus increasing their risk of developing serious and debilitating health conditions. It is recommended that the candidates for surgery be referred to a practice that has a multidisciplinary team experienced in meeting the distinct physical and psychological needs of adolescents. Specific nutrition concerns for the adolescent bariatric patient include preoperative educational pathway, postoperative dietary progression, female reproduction, compliance with vitamin/supplementation recommendations, laboratory tests, and long‐term monitoring. The medical literature has reported positive outcomes of bariatric surgery in adolescents with severe obesity. Before surgery is offered as an option, unique factors to adolescents must be addressed. The multidisciplinary clinical team must consider the adolescents' cognitive, social, and emotional development when considering their candidacy for surgery. As the number of adolescent bariatric surgery programs increases, continued research and long‐term outcome data need to be collected and shared to base future treatment decisions.
Further evidence of tetragonality in bainitic ferrite
Authors: Hulme-Smith C. N. , Peet M. J. , Lonardelli I. , Dippel A. C. , Bhadeshia H. K. D. H.
Published: October 2014

There is growing evidence that bainitic ferrite which retains a substantial amount of carbon in solid solution does not have cubic symmetry. We provide additional data on a different nanostructured bainitic steel to support this evidence, based on synchrotron X-ray diffraction experiments. The data are consistent only with a displacive transformation mechanism for bainite.
The complete alk sequences of Rhodococcus erythropolis from Lake Baikal
Authors: Likhoshvay Alexander , Lomakina Anna , Grachev Mihail
Published: October 2014

Background

Rhodococci are bacteria able to degrade a wide range of hydrocarbons, including the alkanes present in crude oil, due to alk genes in their genomes.

Findings

Genome sequencing of DNA from Rhodococcus erythropolis strain 4 (obtained from a deep-water bitumen mound) revealed four alk genes, and the predicted amino acid sequences coded by these genes were highly conserved, having sections up to 11 amino acid residues.

Conclusions

Obtained four genes from Rhodococcus erythropolis were similar to corresponding genes from other bacteria collected from other environments, including marine sources. This indicated a large-scale horizontal alk gene transfer between bacteria from different subgenera.
Integrative Analysis of FOXP1 Function Reveals a Tumor-Suppressive Effect in Prostate Cancer
Authors: Takayama Ken-ichi , Suzuki Takashi , Tsutsumi Shuichi , Fujimura Tetsuya , Takahashi Satoru , Homma Yukio , Urano Tomohiko , Aburatani Hiroyuki , Inoue Satoshi
Published: October 2014

The transcriptional network of the androgen receptor (AR), a key molecule of prostate cancer, is frequently modulated by interactions with other transcriptional factors such as forkhead box protein A1 (FOXA1). However, global regulatory mechanisms of AR signaling mediated by such factors have not been well investigated. Here we conducted a chromatin immunoprecipitation sequence analysis, which revealed that another FOX family, FOXP1, is specifically regulated by both AR and FOXA1. We also found that FOXP1 acts as a tumor suppressor in prostate cancer through inhibiting cell proliferation and migration. We generated an extensive global map of FOXP1 binding sites and found that FOXP1 is directly involved in AR-mediated transcription. We demonstrated that FOXP1 has a repressive effect on AR-induced transcriptional activity or histone modification in enhancer regions. Moreover, by a global analysis of androgen-mediated transcriptional networks, we observed enrichment of FOXP1 binding genes in the gene cluster negatively regulated by FOXP1. Evaluation of FOXP1 expression in clinical samples indicated that the decreased expression of FOXP1 is another prognostic factor of prostate cancer. Taken together, our results suggest a novel mechanism in which AR-induced FOXP1 functions as a direct modulator of the AR and FOXA1 centric global transcriptional network.
Hard-to-heal venous–lymphatic leg ulcers: a special case
Authors: Silva José António , Filipe Rosário , Cardoso Manuel Esteves , Andriessen Anneke
Published: October 2014

In the treatment of this 56-year-old male, the aim was to attend to his multiple pathologies, reducing his venous-lymphatic oedema on both legs, closing the extended ulcers and improving his quality of life. The patient received treatment in a community-based wound healing clinic. After various local therapies were not successful, the wounds were cleansed with saline and covered with a biocellulose dressing (BWD) and polyhexanide (PHMB), after which a short-stretch bandage system was applied. Compression was then switched to a tubular compression system. At day 0, both lower legs had significant oedema and circumferential venous-lymphatic ulcers, and the left leg showed signs of inflammation. However, at day 8, inflammation, oedema and ulcer area had reduced. After 2 months, the ulcers were almost closed and the oedema had reduced to a level where the tubular compression system could be applied. Treatment using BWD and compression and good adherence to this regimen led to ulcer closure. This improved the patients’ quality of life significantly.
Enhanced recovery and nurse-led telephone follow-up post surgery
Authors: Burch Jennie
Published: October 2014

Aim:

Nurse-led telephone follow-up was undertaken for patients after major colorectal surgery on the enhanced recovery programme following their discharge, with the aim of ensuring they were provided with adequate advice and information to enable their recovery at home.

Methodology:

A total of 200 patients were prospectively called within 4 weeks of discharge home from hospital by the enhanced recovery nurse.

Results:

Diet was generally tolerated and mobility was continued at home. Many of the patients had seen a health professional since their discharge home for issues such as wound care or stoma review. Readmission rates were low and most concerns that patients reported were addressed during the telephone call.

Discussion:

It is reassuring that the majority of patients were coping well and many of the concerns reported were simply addressed over the telephone with advice. After the first 100 patients were telephoned, improvements were made to the discharge advice provided to the second 100 patients. The responses suggest that there were less community nurse visits in the second half of the patient cohort and this may be associated with changes made to discharge advice.

Conclusion:

Patients continue to recover well once discharged home following colorectal surgery on the enhanced recovery pathway. Nurse-led telephone follow-up may be a suitable method for short-term follow-up and, potentially, it is also suitable for long-term follow-up of select groups of cancer patients.
Breast nurse practitioner training and assessment: a proposed model
Authors: Hassell Karen , Cheung Kwok Leung
Published: October 2014

The role of the breast nurse practitioner has been expanding in recent years and many breast units in the UK employ nurse practitioners to carry out a variety of clinical duties. Most of these involve diagnostic assessment of breast diseases and clinical breast examination. While most nurse practitioners have been trained by shadowing breast surgeons, working under supervision, and demonstrating a satisfactory concordance, in terms of clinical opinion with their clinical supervisors, there is a lack of literature describing a training programme that includes assessment. A proposed model including induction, training, assessment (using established tools from a medical school and Royal Surgical Colleges) and audit, with a competency-based ‘sign-off’, is described in this article and supported by the experience of a nurse practitioner who has been successfully trained in this way. The model can instil confidence and credibility to employers and the public, and can also be adapted and extended to other areas of clinical practice.
Patient perspective: journey of a breast cancer survivor and her use of person-centered thinking tools
Authors: George Amanda
Published: October 2014

Amanda George is Training & Development Supervisor in the disability sector and leads the person-centered thinking website for people with cancer and chronic illnesses, Think About Your Life (TAYL). As she prepares to celebrate her 11th year as a cancer survivor during Breast Cancer Awareness Month, Amanda tells us how person-centered thinking has helped her on her personal breast cancer journey.
An overview of male intermittent self-catheterisation
Authors: Logan Karen
Published: October 2014

Since the early 1970s intermittent self-catheterisation (ISC) has become increasingly popular and is now considered the method of choice for draining retained urine from the bladder and to treat urethral strictures in men. It is the preferred option for this kind of bladder dysfunction management instead of an indwelling urinary catheter. Learning ISC can be a challenging time for men, but with the support of knowledgeable experienced nurses in teaching ISC it can be successfully achieved. This article outlines the anatomy of the male urinary tract, offers practical tips for nurses who teach it, and highlights issues important to men when learning and living with ISC.
A randomised trial of honey barrier cream versus zinc oxide ointment
Authors: Nijhuis WA , Houwing RH , Van der Zwet WC , Jansman FGA
Published: October 2014

In this single-blind multicentre, intervention study, 31 patients with symmetrical intertrigo in large skin folds were included to study the clinical effect of two topical treatments, i.e. standard therapy with zinc oxide ointment versus honey barrier cream. Patients were treated twice daily for 21 days, and the severity of intertrigo was scored in an observation period of 21 days. Patients were used as their own controls by treating symmetrical skin folds, on the left and right side. There was no significant difference in treatment effect between intervention groups. For the majority of patients, both treatments were effective. However, the use of honey barrier cream showed lower pruritus complaints (12.9% versus 29.0%). Honey barrier cream is a suitable alternative in the treatment of intertrigo, and promotes patient comfort.
Painful dressing changes for chronic wounds: assessment and management
Authors: Solowiej Kazia , Upton Dominic
Published: October 2014

Wound pain can arise from the wound itself, continuing wound treatment and anticipatory pain, which occurs in some patients as a consequence of negative experiences of care. Specifically, pain caused by the removal and application of dressings has been identified as a major contributor to wound pain, from both patient and health professional perspectives. This article reviews literature on the impact of pain at dressing change, and provides practical suggestions for assessment and management of pain during wound care.
Seven years of zero central-line-associated bloodstream infections
Authors: Harnage Sophie
Published: October 2014

Many hospitals feel they have adequately addressed the issue of bloodstream infection prevention if they mandate a conventional central-line bundle. Yet central-line-associated bloodstream infections (CLABSIs) persist as a major problem in health care today. Sutter Roseville Medical Center (SRMC) in Roseville, California has achieved unprecedented success in eliminating CLABSIs by approaching the issue more broadly than most institutions. The SRMC bundle is more comprehensive and innovative than conventional bundles. It is applied by a dedicated vascular access team, and the team's efforts are supported by a safety-first culture enforced by senior leadership. All of this is accomplished without losing sight of the financial implications of infection prevention. SRMC is committed to substantial up-front investments in patient safety to realise long-term cost-effectiveness.
A snapshot of innovation: chemotherapy delivery in the UK
Authors: Lennan Elaine , McPhelim John
Published: October 2014

Chemotherapy is a major part of NHS care. Aroud 200 hospitals deliver chemotherapy services within their facilities, in community clinics and in the patients' homes. The safety of such services has attracted attention resulting in the production of a service template for the future by the National Chemotherapy Advisory Board in 2009. Its report recognized opportunities for redesigning services and recommended optimising the development of non-medical staff. The UK chemotherapy partnership was established to help professionals involved in chemotherapy share their experiences of improving and developing services and roles. This short article places the need for the UK Chemotherapy Partnership website in context and describes the origins of the Partnership as well as future plans.
An overview of drug development for metastatic breast cancer
Authors: Stebbing Justin , Ellis Paul
Published: October 2014

The prevalence of breast cancer is increasing as more women are living with the disease. Outcomes have improved as a result of progress in all major aspects of multidisciplinary care. These include surgery, radiotherapy, hormonal therapy, chemotherapy and newer targeted drugs. Two aspects merit particular attention here. First, there is an understanding now that cancer is a heterogenous disease and a ‘one-size-fits-all’ approach is becoming redundant, albeit slowly. Second, basic science and an appreciation of cellular molecular targets in those different types of breast cancer is being translated into the clinic and has led to the development of exciting new drugs for both triple negative and HER2-positive relapsed disease. An improved understanding of endocrine resistance remains an unmet need in drug development and here, it appears worthwhile to adopt less conventional approaches. Better trial design with a focus on biomarkers should lower barriers to regulatory approval as well as increase cost effectiveness.
Advanced prostate cancer: treatment and patient-centred care
Authors: Peate Ian
Published: October 2014

There have been many significant advances in the treatment of prostate cancer, yet it remains a growing problem for men's health. Many men die from prostate cancer each year and many more live with non-cancerous, but debilitating, prostate disorders. This article discusses advanced (metastatic) prostate cancer, provides nurses with an overview of treatment options available to men with this condition, and offers a starting point from which to examine further evidence. It aims to encourage nurses to ensure that the patient is involved in making any decisions that could potentially impact on his health and wellbeing. In line with current thinking, the patient must be at the heart of every decision and be provided with greater choice and control (Department of Health, 2010).
Obstetric perineal wound infection: is there underreporting?
Authors: Johnson Adeyemi , Thakar Ranee , Sultan Abdul H
Published: October 2014

Obstetric perineal wound infection is a complication of perineal trauma during vaginal delivery; however, it is difficult to establish its true incidence as women present for treatment to their GP or the hospital.

Aim:

To establish the incidence and risk factors of wound infection in postpartum women with sutured tears.

Method:

A 3-month prospective audit was carried out on all women who sustained sutured tears. Wound infection was defined as the presence of any two of the following markers: perineal pain, wound dehiscence, or purulent vaginal discharge. A total of 341 women were contacted by telephone 21 days post-delivery and asked about markers for perineal wound infection and antibiotic use.

Results:

In total, 409 women sustained sutured perineal tears, including episiotomies, and first, second, third and fourth degree tears. Of the 341 (83%) women contacted, 39 (11%) had a perineal wound infection based on the criteria of any two infection markers. Sixteen (5%) women had all three markers of wound infection. Prolonged rupture of membranes and instrumental delivery was a significant risk factor for women with two and three markers of wound infection, respectively.

Conclusion:

One in ten women who sustained a perineal tear at vaginal delivery that required suturing developed perineal wound infection. Instrumental deliveries and prolonged rupture of membranes predispose women to perineal wound infection.
Maggot therapy: a literature review of methods and patient experience
Authors: Menon Jane
Published: October 2014

Used in wound-bed preparation, larval therapy can be effective both clinically and financially, if used appropriately. In this article, the author reviews contemporary literature and key research on the benefits and challenges of using this therapy for wound care. The article focuses on debridement, as well as associated antimicrobial effects and psychological issues. Considerations and cautions that may affect clinical practice, such as pain management, peri-wound skin care, different methods of application and preparing the patient both physically and psychologically are also explored.
An algorithm for the use of intravenous salbutamol in children
Authors: Clayton Sadie , Gilchrist Francis , Alexander John , Enberby Beth , Lenney Warren
Published: October 2014

the evidence base for the management of severe or life-threathening exacerbations of asthma is not as strong as that for mild or moderate exacerbations. Despite this information deficit, intravenous (IV) salbutamol has become an accepted treatment option for children not responding to inhaled bronchodilator and corticosteroid therapy. Studies have shown that it is used in many centres in the UK replacing IV aminophylline, however, there is wide variation in dosing regimens and inconsistencies in practice. The authors audited their own prescribing practice and developed an algorithm-based approach to the use of IV salbutamol that includes patient selection and all aspects of prescribing, preparation, administration, monitoring and the requirements of the environment where care is delivered. It includes details of the IV salbutamol bolus and the infusion process, incorporating all available evidence. The algorithm provides guidance on IV salbutamol usage in children up to and including 18 years. The authors hope it will promote standardised practice, limit the opportunity for prescribing errors and highlight the need for a national paediatric study comparing IV salbutamol and IV aminophylline. It may also stimulate discussion on the IV salbutamol dosage used in adult practice.
Cabazitaxel for prostate cancer: patient preparation and ongoing care
Authors: Hardwick Julia
Published: October 2014

Cabazitaxel, a new-generation taxane that fulfils a hitherto unmet need for second-line chemotherapy in metastatic castrate-resistant prostate cancer, has received approval from the European Medicines Agency. In a recent phase III clinical trial, this drug showed a survival benefit over mitoxantrone; however, it was associated with significant side effects, most notably neutropenia, diarrhoea, nausea/ vomiting, peripheral neuropathy and fatigue. Careful patient selection for cabazitaxel is essential, as is a robust management plan for the detection, assessment and prompt treatment of any side effects. This article examines the nurse's role in patient preparation, education, ongoing monitoring and support throughout cabazitaxel treatment.
Promoting male urinary continence
Authors: Pellatt Glynis Collis
Published: October 2014

Urinary incontinence is a common problem among men of all ages, and can have a major impact on quality of life. Although incontinence rates in men could be as high as 24%, there is far less published information about male than female continence problems. Nurses have an important role to play in promoting continence by working with patients to identify appropriate incontinence management options. Incontinence can often be treated by non-invasive or minimally invasive means. Incontinence management should be considered before containment. However, nurses do need knowledge about management options to be able to support and advise patients. This article discusses a range of non-invasive and minimally invasive incontinence options. Although catheterisation should not be the first choice for most patients, it is discussed as it may be the most suitable option for some, particularly men with neurogenic bladders.
Give them time to ponder
Authors: Hilary White
Published: October 2014

The narrative of picture books provides a safe place from which children can explore relationships and the wider world. In her second article, Hilary White balances adult and child-led activities.
Enhanced Near-Infrared Emission from Holmium–Ytterbium Co-Doped Phosphate Glasses Containing Silver Nanoparticles
Authors: Hernandez Miguel A. Vallejo , Gámez M. Alejandrina Martínez , Martínez José L. Lucio , Kir'yanov Alexander V.
Published: October 2014

The fabrication and spectroscopic characterization of Ho3+ and Yb3+ co-doped phosphate glasses, also containing silver nanoparticles (SNPs), is reported. The nucleation and formation of nanoparticle structures in the samples are confirmed using transmission electron microscopy analyses. It is found that the Ho3+-Yb3+-SNP phosphate glasses exhibit an enhancement of both the resonant-absorption and the fluorescence properties when the SNP concentration is increased.
Spectroscopic Characterization of Supramolecular Chiral Porphyrin Homoassociates at the Air–Water Interface
Authors: Harada Takunori , Moriyama Hiroshi , Takahashi Hiromi , Umemura Kazuo , Yokota Haruo , Kawakami Ryo , Mishima Kenji
Published: October 2014

The water-soluble 4-sulfonatophenyl meso-substituted porphyrin (TPPS) dye exhibits a transformation to a chiral self-aggregate from the non-aggregated species (diprotonated H4TPPS2–) at low concentration (no more than 1 × 10−5 M). Immobilization of supramolecular chiral porphyrin homoassociates was mediated by the electrostatic interaction between the anionic TPPS molecule and cationic surfactant monolayer at the air–water interface. With the immobilization, a reversible transformation from monomeric TPPS to J-aggregate ( M→J) could be changed into an irreversible ( M→J), which is desirable for stabilization of aggregation structure for a long period. The novel finding was achieved using a fine-tuned specialized solid-state circular dichroism (CD) spectrophotometer and derived analytical procedure to obtain artifact-free CD signals. To our knowledge, this is the first report achieving the chiral control of a homoassociate induced by a chiral surfactant at the air–water interface, indicating that the handedness of the formed homoassociate could be determined.
Evidence in a different form: The search conference process
Authors: Varney Helen , Rumbold Bruce , Sampson Alison
Published: October 2014

Arts and health practitioners, policy-makers and researchers were invited to a two-day search conference to talk about the nature of arts-based evidence, and ways of researching the impact of arts on health. Using a participatory enquiry process, participants shared stories of specific projects, discussed the aims, forms and politics of arts-based evidence, developed creative responses and practical strategies, and noted areas for further conversation and action. Two dominant themes emerged. First, the arts are particularly powerful in health generation; second, the most important evidence is that which shows how the arts can be a catalyst for change.
Evidence requirements for the development of the National Australian Arts and Health Framework
Authors: Zigmond Helen
Published: October 2014

This article outlines the work undertaken to provide evidence required to support the development of the National Arts and Health Framework endorsed by the Australian health ministers in November 2013. The Institute For Creative Health was charged with being the sector’s reference organization and supplied the evidence required throughout the Framework’s development, as well as moderating the sector’s response to draft proposals. A two-phase process of assembling the evidence required to support government action was identified. With Finland, Australia leads the world in having the health jurisdictions create a National Arts and Health Framework, and appropriate evidence was critical at all stages of its development.
Editorial
Authors: Arroyo Arq. Julio
Published: October 2014

Nota editorial N°4