bluuebunny/crossref_metadata_2025 huggingface dataset:
New approaches towards the shortening of generation cycles for faster breeding of protein legumeshh
Authors: Ochatt S. J. , Sangwan R. S. , Marget P. , Ndong Y. Assoumou , Rancillac M. , Perney P. , Röbbelen G.
Published: March 2003

In order to shorten generation cycles, a greenhouse strategy was used as control and compared with an in vitro plus in vivo strategy for pea and bambara groundnut, as well as to an in vitro only strategy for pea and grass pea. Using an in vitro plus in vivo system and embryo axis explants, nearly six generations per year for Pisum and over four generations for Vigna were obtained, compared with two generations in the field. Using successive generations from seed to seed in pea, the mean duration for one generation was 67.2 ± 4.6 days in ‘Frisson’, against a mean of 143 ± 3 days in the field. With the in vitro only strategy in pea, 6.87 generations per year were obtained with ‘Frisson’ and 5.24 with ‘Terese’, while with grass pea genotypes over three generations per year were possible. All plants obtained were morphologically normal and fertile. These results show the feasibility of using such strategies to reduce significantly the duration of generation cycles in legumes, thus offering novel approaches for breeding these important crops.
Management and Genetic Factors Affecting Fertility in Sows
Authors: Merks Jwm , Ducro‐Steverink Dwb , Feitsma H
Published: March 2003

Contents The purpose of this article is to summarize the current knowledge on genetic and management methods for improving fertility in sows. Fertilization rate, litter size and the interval between weaning and oestrus are traits that can be monitored on farms. These traits are heritable but can also be influenced by management. Age at puberty and the interval between weaning and oestrus are genetically linked (rg = 0.3) and a shorter weaning‐to‐oestrus interval is related to a longer duration of oestrus. Consequently, selection may be used to simplify detection of oestrus but because of variation in duration of oestrus between lines/breeds, farm‐specific insemination strategies are needed. The direct boar effect on fertilization is small, probably due to the superabundance of sperm cells that is available in each dose of semen. Consequently, the use of a large number of sperm cells per dose is the best management tool for avoiding fertilization problems in sows. Health status of the boars, both for artificial insemination and natural mating, is of importance in order to produce a large number of sperm cells/doses of good quality per ejaculate. It is concluded that factors that influence fertility in sows, particularly prior to and during fertilization, are mainly related to oestrus and the optimal timing of insemination. Selection for adequate symptoms of oestrus, together with farm‐specific insemination strategies are needed.
Validation of the FACSCount AF System for Determination of Sperm Concentration in Boar Semen
Authors: Hansen C , Christensen P , Stryhn H , Hedeboe AM , Rode M , Boe‐Hansen G
Published: March 2003

Contents

A flow cytometric method has been developed for rapid determination of sperm concentration in semen from various mammalian species.* All cells containing DNA are stained with SYBR‐14 or propidium iodide (PI) and sperm concentration is determined in relation to an internal standard of fluorescent microspheres (beads). Satisfactory staining can be achieved within 2–3 min and the following flow cytometric analysis on the FACSCount AF System rapidly provides the user with a precise and accurate assessment of the sperm concentration. In this study, the FACSCount AF System and Sperm Counting Reagent (BD Biosciences) was compared with microscopic counting using a Bürker–Türk haemocytometer. In addition, sperm concentration was determined using the Corning 254 spectrophotometer which is used routinely by Danish artificial insemination stations for boars. The results show that the agreement between flow cytometry and microscopic counting is very high. The slope for the regression line was 1.12 (SE = 0.03) with an estimated intercept with the Y‐axis of 22 × 106sperm/ml (SE = 10 × 106 sperm/ml) and an estimated error of the model of 10 × 106 sperm/ml. For the spectrophotometer, the slope of the regression line was 1.09 (SE = 0.07) with an estimated intercept of 137 × 106 sperm/ml (SE = 25 × 106 sperm/ml). The average error made by the spectrophotometer was 55 × 106 sperm/ml. In addition, the results obtained using flow cytometry was highly repeatable (CV = 2.7%) in comparison with the spectrophotometric method (CV = 6.3%). These results indicate that the FACSCount AF System is a valuable tool for precise and accurate assessment of sperm concentration in boar semen and that use of this system may lead to production of more uniform insemination doses containing a specific number of sperm per dose.
The impact of ward design on the behaviour, occupational satisfaction and well‐being of psychiatric nurses
Authors: Tyson Graham A. , Lambert Gordon , Beattie Lyn
Published: March 2003

ABSTRACT:

Studies have shown that modifications to the physical environment of psychiatric institutions are associated with positive changes in patients’ behaviour, attitudes and perceptions. However, little attention has been paid to the impact such modifications to the physical environment have on the nursing staff. The building of two completely new wards at a rural psychiatric hospital provided an opportunity to examine this issue. Measures of the nursing staffs’ observed behaviour and self‐ratings of burnout and job satisfaction were obtained in both the old and the new wards. The results showed that the new wards were associated with largely positive changes in behaviour and increased burnout, but there was no change in job satisfaction. However, it was clear that a vital component in the success of any environmental manipulation is an appropriate, corresponding change in the organizational climate.
Presentations by youth to Auckland Emergency Departments following a suicide attempt
Authors: Bennett Sara , Coggan Carolyn , Hooper Rhonda , Lovell Cherie , Adams Peter
Published: March 2003

ABSTRACT:

The objective of this study was to describe the population of European youth (15–24 years) presenting to emergency departments (EDs) at one of the three Auckland public hospitals following attempted suicide; and to identify factors associated with presentations to EDs by these youth. A 1‐year medical record review was undertaken. A total of 212 presentations (196 individuals) occurred during the surveillance; alcohol was present for 29%. Attempts involving alcohol were more likely to occur at weekends (P < 0.01); involve cutting and piercing (P < 0.05); be undertaken by employed people (P < 0.05), and be undertaken by those not residing with family (P < 0.01). Two groups of particular concern were identified: those who involved alcohol in their attempt; and those who represented during the study period following multiple suicide attempts. These findings have implications for immediate care within an ED setting, and long‐term follow‐up healthcare options for distressed young people.
Fear and learning in mental health settings
Authors: Fisher Jacklin E.
Published: March 2003

ABSTRACT:

Health‐care students are frequently concerned and anxious about entering the mental health setting for their clinical placement. There are many situations in mental health clinical settings in which the student will witness or become involved in incidents that may challenge existing values, attitudes, ethics and provoke strong emotions in the student. This paper examines clinical critical incidents that have been identified and reflected on by a cohort of second‐year student nurses while undertaking their mental health clinical practicum. Data were gathered from 260 critical incident reports and was sorted into three broad (i) student description of incident; (ii) immediate emotional response of the student to the incident; and (iii) student thoughts and feelings about the incident after the opportunity for structured reflection. The findings demonstrate a wide range of positive, but predominantly, negative experiences. Witnessing psychotic behaviour and incidents involving both actual and threatened violence and verbal abuse dominated the critical incidents with 52% describing one or both of these issues. To illustrate the range of student‐identified critical incidents, verbatim examples of student work are included.
Mycoplasma infection can sensitize host cells to apoptosis through contribution of apoptotic‐like endonuclease(s)
Authors: Sokolova Irina A , Vaughan Andrew TM , Khodarev Nikolai N
Published: March 2003

Mycoplasma infection may lead to various pathologies in a broad range of hosts. It has been shown that Mycoplasma may trigger cell death in cell cultures; however, the mechanism remains unknown. In the present paper we show that Mycoplasma infection of different lymphocyte and epithelial tumour cell lines leads to the inhibition of proliferation, and increased cell death, accompanied by DNA fragmentation and the morphological features of apoptosis. We also showed that this infection leads to an increased sensitivity of cells to various inducers of apoptosis targeting different signalling pathways. Finally, we show that increased apoptosis is associated with overexpression of an endonuclease produced by Mycoplasma. This endonuclease is recovered in the nuclear fraction of host cells, introduces mostly DSB and is active at neutral pH in the presence of divalent cations. Activation of this endonuclease is connected with limited proteolysis, which may be reproduced in vitro by snake venom serine proteinase.
Quantitative analysis of cytokine gene expression in the liver
Authors: Takahashi Megumi , Nishimura Taiji , Yokomuro Kozo
Published: March 2003

The relative levels of cytokine gene expression in the liver were analysed, focusing on IL‐2, IL‐4, IL‐5, IL‐6 and IFN‐γ compared to those in the spleen and Peyer's patch by using the reverse transcriptase polymerase chain reaction (RT‐PCR). The levels of expression of cytokines in the liver mononuclear cells (MNC), especially that of IL‐6, were significantly higher than in other organs when mice were reared under specific pathogen‐free (SPF) or conventional conditions. Both the spleen and Peyer's patch MNC expressed little of any of the cytokines, except for IL‐4 in Peyer's patch MNC. The liver MNC produced significant amounts of IL‐6 in the culture supernatant upon concanavalin A stimulation. These findings suggest that the liver is a potent IL‐6‐ producing organ, which may relate to B cell differentiation, liver regeneration and the induction of acute phase proteins.
Cloning of marsupial T cell receptor α and β constant region cDNAs
Authors: Zuccolotto Peter D , Harrison Gavan A , Deane Elizabeth M
Published: March 2003

Partial cDNAs encoding the tammar wallaby (Macropus eugenii) T cell receptor alpha constant region (TCRαC) and T cell receptor beta constant region (TCRβC) were obtained using reverse transcriptase‐coupled polymerase chain reaction (RT‐PCR). These PCR products were used to screen a brushtail possum (Trichosurus vulpecula) lymph node cDNA library, resulting in the isolation of clones containing the complete coding regions for TCRαC and TCRβC. These constitute the first marsupial T cell receptor sequences to have been elucidated. Sequence analysis of the T. vulpecula constant region revealed a considerable level of sequence identity with TCR of other species, particularly eutherian mammals, at both the nucleic acid and amino acid levels. At the nucleotide level, 65.8% sequence identity was calculated for the T. vulpecula and human TCRαC sequences, with 55.9% identity at the amino acid level. For TCRβC, the T. vulpecula and human β1 sequence identity at the nucleotide level was 75.1% and at the amino acid level, 67.0%. Phylogenetic analyses based on the T. vulpecula sequences indicated that these sequences are basal to, but also most closely related with, TCRαC and TCRβC homologues from eutherian mammals, consistent with the current views of both mammalian and TCR evolution.
Chemokine and cytokine cooperativity: Eosinophil migration in the asthmatic response
Authors: Simson Ljubov , Foster Paul S
Published: March 2003

Eosinophils play a central role in the pathophysiology of allergic disease. The mechanisms that regulate eosinophil migration are complex; however, chemokines and cytokines produced in both the early and late phases of the asthmatic response appear to cooperate in eosinophil recruitment. In particular, there exists a unique synergy between eotaxin and IL‐5. The role of chemokine/cytokine cooperativity has been investigated in the extracellular matrix, adhesion molecule/integrin interactions, receptor polarization and aggregation and the convergence and divergence of intracellular signalling pathways. Understanding the mechanisms whereby eosinophils migrate will allow the development of specific therapeutic strategies aimed at attenuating specific components of the allergic response.
Cellular function of p70S6K: A role in regulating cell motility
Authors: Berven Leise A , Crouch Michael F
Published: March 2003

The 70 kDa ribosomal S6 kinase (p70S6K) is activated by numerous mitogens, growth factors and hormones. Activation of p70S6K occurs through phosphorylation at a number of sites and the primary target of the activated kinase is the 40S ribosomal protein S6, a major component of the machinery involved in protein synthesis in mammalian cells. In addition to its involvement in regulating translation, p70S6K activation has been implicated in cell cycle control and neuronal cell differentiation. Recent data obtained in this laboratory suggests that p70S6K may also function in regulating cell motility, a cellular response that is important in tumour metastases, the immune response and tissue repair. The present paper reviews the regulation and cellular function of p70S6K and proposes a novel function of p70S6K in regulating cell motility.
Life on the inside: Probing Mycobacterium tuberculosis gene expression during infection
Authors: Triccas James A , Gicquel Brigitte
Published: March 2003

The identification of Mycobacterium tuberculosis genes specifically expressed during infection is a key step in understanding mycobacterial pathogenesis. Such genes most likely encode products required for survival within the host and for progressive infection. Recent advances in mycobacterial genetics have permitted the development of new techniques and the adaptation of existing methods to analyse mycobacterial in vivo gene expression and virulence. This has revealed a subset of M. tuberculosis genes that are differentially expressed during infection and has demonstrated that a number of components contribute to the virulence of the organism. This information is expected to provide new strategies to prevent tuberculosis infection, new targets for antimicrobial therapy and new insights into the infectious process.
Murine histidine‐rich glycoprotein: Cloning, characterization and cellular origin
Authors: Hulett Mark D , Parish Christopher R
Published: March 2003

Histidine‐rich glycoprotein (HRG) is a plasma protein of vertebrates that has been implicated in the regulation of several important biological functions, including the immune response and blood clotting. In the present study, we have isolated and determined the sequence of the cDNAs for both mouse and rat HRG. The deduced amino acid sequences of mouse and rat HRG are 525 and 510 amino acids, respectively, and they show the same three‐domain structure that has been predicted for human HRG, with which they share high amino acid identity. Northern blot analysis indicates that the mouse HRG mRNA is 1.7 kb and is localized specifically to the liver. It has been suggested, somewhat controversially, that some immune cells, such as monocytes and megakaryocytes, also synthesize HRG. Reverse transcriptase–polymerase chain reaction analysis has failed to show any HRG mRNA in immune tissues of the mouse, including the spleen, thymus, lymph node, bone marrow and peripheral blood leucocytes. These data suggest that HRG expression by immune cells is due to the acquisition of plasma HRG derived from the liver. Finally, genomic Southern blot analysis of the mouse HRG gene suggests that it is a single copy gene.
New approaches in the treatment of asthma
Authors: Ramshaw HS , Woodcock JM , Bagley CJ , McClure BJ , Hercus TR , Lopez AF
Published: March 2003

Asthma is a common and complex inflammatory disease of the airways that remains incurable. Current forms of therapy are long term and may exhibit associated side‐effect problems. Major participants in the development of an asthma phenotype include the triggering stimuli such as the allergens themselves, cells such as T cells, epithelial cells and mast cells that produce a variety of cytokines including IL‐5, GM‐CSF, IL‐3, IL‐4 and IL‐13 and chemokines such as eotaxin. Significantly, the eosinophil, a specialized blood cell type, is invariably associated with this disease. The eosinophil has long been incriminated in the pathology of asthma due to its ability to release preformed and unique toxic substances as well as newly formed pro‐inflammatory mediators. The regulation of eosinophil production and function is carried out by soluble peptides or factors. Of these IL‐5, GM‐CSF and IL‐3 are of paramount importance as they control eosinophil functional activity and are the only known eosinophilopoietic factors. In addition they regulate the eosinophil life span by inhibiting apoptosis. While one therapeutic approach in asthma is directed at inhibiting single eosinophil products such as leukotrienes or single eosinophil regulators such as IL‐5, we believe that the simultaneous inhibition of more than one component is preferable. This may be particularly important with eosinophil regulators in that not only IL‐5, but also GM‐CSF has been repeatedly implicated in clinical studies of asthma. The fact that GM‐CSF is produced by many cells in the body and in copious amounts by lung epithelial cells highlights this need further. Our approach takes advantage of the fact that the IL‐5 and GM‐CSF receptors (as well as IL‐3 receptors) utilize a shared subunit to bind, with high affinity, to these cytokines and the same common subunit mediates signal transduction culminating in all the biological activities mentioned. By generating the monoclonal antibody BION‐1 to the cytokine binding region of the common subunit (βc) we have shown that the approach of inhibiting IL‐5, GM‐CSF and IL‐3 binding and the resulting stimulation of eosinophil production and function with a single agent is feasible. Furthermore we have used BION‐1 as a tool to crystallize and define the structure of the cytokine binding domain of βc. This knowledge and this approach may lead to the generation of novel therapeutics for the treatment of asthma.
A novel system for convenient detection of low‐affinity receptor–ligand interactions: Chelator‐lipid liposomes engrafted with recombinant CD4 bind to cells expressing MHC class II
Authors: Van Broekhoven Christina L , Altin Joseph G
Published: March 2003

The interactions of cell surface receptors with their ligands, crucial for initiating many immunological responses, are often stabilized by receptor dimerization/oligomerization, and by multimeric interactions between receptors on one cell with their ligands or cognate receptors on the apposing cell. Current techniques for studying receptor–ligand interactions, however, do not always allow receptors to move laterally to enable dimerization/ oligomerization, or to interact multimerically with ligands on cell surfaces. For these reasons detection of low‐ affinity receptor–ligand interactions has been difficult. Utilizing a novel chelator‐lipid, nitrilotriacetic acid di‐tetradecylamine (NTA‐DTDA), we have developed a convenient liposome system for directly detecting low‐affinity receptor–ligand interactions. Our studies using recombinant soluble forms of murine CD40 and B7.1, and murine and human CD4, each possessing a hexhistidine tag, showed that these proteins can be anchored or ‘engrafted’ directly onto fluorescently labelled liposomes via a metal‐chelating linkage with NTA‐DTDA, permitting them to undergo dimerization/oligomerization and multimeric binding with ligands on cells. Fluorescence‐ activated cell sorter (FACS) analyses demonstrated that while there is little if any binding of soluble forms of murine CD40 and B7.1, and murine and human CD4 to cells, engrafted liposomes bind specifically to cells expressing the appropriate cognate receptor, often giving a fluorescence 4–6‐fold above control cells. Such liposomes could detect directly the low‐affinity interaction of murine CD40 and B7.1 with CD154‐ and CD28‐expressing cells, respectively, and the interaction of CD4 with MHC Class II, which has hitherto defied direct detection except through mutational analysis and mAb blocking studies.
Ultraviolet light induced injury: Immunological and inflammatory effects
Authors: Clydesdale Gavin J , Dandie Geoffrey W , Muller H Konrad
Published: March 2003

This article reviews many of the complex events that occur after cutaneous ultraviolet (UV) exposure. The inflammatory changes of acute exposure of the skin include erythema (sunburn), the production of inflammatory mediators, alteration of vascular responses and an inflammatory cell infiltrate. Damage to proteins and DNA accumulates within skin cells and characteristic morphological changes occur in keratinocytes and other skin cells. When a cell becomes damaged irreparably by UV exposure, cell death follows via apoptotic mechanisms. Alterations in cutaneous and systemic immunity occur as a result of the UV‐induced inflammation and damage, including changes in the production of cytokines by keratinocytes and other skin‐associated cells, alteration of adhesion molecule expression and the loss of APC function within the skin. These changes lead to the generation of suppressor T cells, the induction of antigen‐specific immunosuppression and a lowering of cell‐mediated immunity. These events impair the immune system's capacity to reject highly antigenic skin cancers. This review gives an overview of the acute inflammatory and immunological events associated with cutaneous UV exposure, which are important to consider before dealing with the complex interactions that occur with chronic UV exposure, leading to photocarcinogenesis.
CD8+CD28– T cells: Certainties and uncertainties of a prevalent human T‐cell subset
Authors: Arosa Fernando A
Published: March 2003

Human peripheral blood CD8+ T cells comprise cells that are in different states of differentiation and under the control of complex homeostatic processes. In a number of situations ranging from chronic inflammatory conditions and infectious diseases to ageing, immunodeficiency, iron overload and heavy alcohol intake, major phenotypic changes, usually associated with an increase in CD8+ T cells lacking CD28 expression, take place. CD8+CD28– T cells are characterized by a low proliferative capacity to conventional stimulation in vitro and by morphological and functional features of activated/memory T cells. Although the nature of the signals that give origin to this T‐cell subset is uncertain, growing evidence argues for the existence of an interplay between epithelial cells, molecules with the MHC‐class I fold and CD8+ T cells. The possibility that the generation of CD8+CD28– T cells is the combination of TCR/CD3ζ‐ and regulatory factor‐mediated signals as a result of the sensing of modifications of the internal environment is discussed.
Manipulation of immune responses to Mycobacterium bovis by vaccination with IL‐2‐ and IL‐18‐secreting recombinant bacillus Calmette Guerin
Authors: Young Sarah , O'Donnell Michael , Lockhart Euan , Buddle Bryce , Slobbe Lynn , Luo Yi , De Lisle Geoff , Buchan Glenn
Published: March 2003

Bacillus Calmette Guerin (BCG) has been reported to show variable efficacy as a vaccine against tuberculosis. We demonstrated that the secretion of biologically active IL‐2 (rBCG/IL‐2), but not IL‐18 (rBCG/IL‐18), by BCG improves its ability to induce and maintain a strong type 1 immune response in BALB/c mice. rBCG/IL‐2 induced significantly higher Ag‐specific proliferative responses, high IFN‐γ production and serum titres of IgG2a 16 weeks after vaccination. This immune profile was correlated to an increased rate of clearance of non‐pathogenic mycobacteria (live BCG delivered intranasally). Surprisingly, however, this strong type 1 immune profile induced no greater protective immunity against aerosol challenge with virulent Mycobacterium bovis than that induced by normal BCG (nBCG). By comparison, vaccination with rBCG/IL‐18 was found to induce significantly less IFN‐γ production in splenic lymphocytes than nBCG. This impaired induction of IFN‐γ was correlated to a significantly lower protective efficacy against M. bovis challenge, as compared to nBCG. The data suggest that manipulation of the immune response to tuberculosis and tuberculosis vaccines will require a more complete understanding of the factors that are important in generating a protective immune response.
The good, the bad and the relative, part two: Goodness and the criterion problem in qualitative research
Authors: Rn Carolyn Emden , Rn Margarete Sandelowski
Published: March 2003

This (part two) paper finds ‘the problem of the criterion’ at the heart of disputes about what constitutes goodness in qualitative research, an ancient philosophic conundrum as to how best represent reality. Ways around the problem are considered, including conceiving criteria as open‐ended ‘lists’, and ‘enabling conditions’. Discussion principally concerns the impact of postmodernist thinking on the topic, and how qualitative researchers might usefully juxtapose the rationality of a modern world (in which notions such as reliability and validity are prized) with a mounting postmodern sensibility that acknowledges irrationality, fragmentation, and uncertainty. Part one of the paper traced efforts to define ‘goodness’ in qualitative research within various fields, including nursing. Disputes were found to centre on how the traditional concepts of reliability and validity related to qualitative research. In reviewing various sets of criteria of goodness, these concepts were consequently conceived as being championed, translated, exiled, redeemed, and surpassed.
Chronic pain and distress in older people: A cluster analysis
Authors: Hall‐Lord Marie Louise , Larsson Gerry , Steen Bertil
Published: March 2003

Chronic pain represents a major health problem among older people. The aims of the present study were to: (i) identify various profiles of pain and distress experiences among older patients; and (ii) compare whether background variables, sense of coherence, functional ability and experiences of interventions aimed at reducing pain and distress varied among the patient profiles. Interviews were carried out with 42 older patients. A cluster analysis yielded three clusters, each representing a different profile of patients. Case illustrations are provided for each profile. There were no differences between the clusters, regarding intensity and duration of pain. One profile, with subjects of advanced age, showed a decreased functional ability and favourable scores in most of the categories of pain and distress. Another profile of patients showed favourable mean scores in all categories. The third cluster of patients showed unfavourable scores in most categories of pain and distress. There appears to be a need to treat the three groups of patients in different ways in the caring situation.
The future of palliative care nursing research in Australia
Authors: Wilkes Lesley , Tracy Sally , White Kate
Published: March 2003

Nursing research in palliative care is becoming more important as cost effectiveness and evidence‐based practice are becoming mandatory. Fifty‐nine published and unpublished projects relating to nursing research on palliative care in Australia between 1990 and 1996 were reviewed. Findings indicated that nurses working in palliative care in Australia are interested in researching a range of topics using varied methods. The nurses’ primary interests appear to be their own professional issues and management of the patient’s pain. Little research on families/carers of palliative care patients was evident. There is a need for future research to focus on projects that justify the nurse’s role in the palliative care team, show that nursing interventions for symptom control affect patient outcomes and prove nurses are integral to the psychosocial and spiritual wellbeing of the patient and family during the palliative care journey.
Elements of a systematic review
Authors: Magarey Judith M
Published: March 2003

This paper examines the subject of systematic reviews from a nursing viewpoint. The history of the evidence‐based health‐care movement and the major differences between systematic reviews and traditional literature reviews are discussed. The steps of the process used by those conducting reviews are examined in detail. These include structuring a research question, searching and appraising the literature, data extraction, analysis and synthesis, and reporting the results. It is this process that ensures reviews can be considered as a legitimate form of nursing research.
Critical thinking in nursing education: Literature review
Authors: RN Elaine Simpson , RN Mary Courtney
Published: March 2003

The need for critical thinking in nursing has been accentuated in response to the rapidly changing health‐care environment. Nurses must think critically to provide effective care while coping with the expansion in role associated with the complexities of current health‐care systems. This literature review will present a history of inquiry into critical thinking and research to support the conclusion that critical thinking is necessary not only in the clinical practice setting, but also as an integral component of nursing‐education programmes to promote the development of nurses’ critical‐thinking abilities. The aims of this paper are to: (i) review the literature on critical thinking; (ii) examine the dimensions of critical thinking; (iii) investigate the various critical thinking strategies for their appropriateness to enhance critical thinking in nurses; and (iv) examine issues relating to the evaluation of critical‐thinking skills in nursing.
Nurses’ and patients’ perceptions of dignity
Authors: Walsh Ken , Kowanko Inge
Published: March 2003

It is generally agreed in the nursing literature that the maintenance of patient dignity is an important element of nursing care that is highly valued by patients. Despite this, dignity is seldom defined and there are few guidelines that nurses may use in their practice to safeguard individual patients’ dignity. This phenomenological study aimed to uncover patients’ and nurses’ perceptions of dignity, formulate a definition of dignity based on the experience of patients and nurses, and identify nursing practices that maintain or compromise patient dignity. The study found that the characteristics nurses associated with dignity were many and varied. Important elements in the meaning the nurses ascribed to the notion of patient dignity were the elements of respect, privacy, control, advocacy and time. The themes which emerged from the patient interviews were similar to those which emerged from the interviews with nurses. The characteristics that patients attributed to dignity and its maintenance included respect, privacy, control, choice, humour and matter‐of‐factness.
Analysis of sharps injury occurrences at a hospital in Singapore
Authors: Ng Leng Nee , Lim Hui Li , Chan Yiong Huak , Bin Bachok Dzulazwan
Published: March 2003

Relatively little attention has been directed to investigating the risks of sharps injuries in Singapore. This study examines the epidemiology and causes of sharps injuries at a university teaching hospital. The type of instruments, site of injuries and personnel involved in each sharps injury were determined retrospectively by reviewing the Incident Reports forms and Infection Control records between 1997 and 2000. Descriptive information on the forms and records were extracted and collected on standard charts. The data were then analysed using spss Windows software. The rates of sharps injuries were 11.0 per 100 medical staff and 6.9 per 100 nursing staff. Medical staff yielded highest proportion of sharps injuries rendering 33 cases (40.2%), followed by 24 cases involving nursing staff (29.3%) and 12 cases of nursing students (14.6%). In total, 62.2% of injuries were caused by hollow bore needles (51 cases). Non‐hollow bore needle injuries only accounted for 17.1% of total injuries (14 cases). Hollow bore needles accounted for the highest proportion of sharps injuries in this study, corresponding to findings in other studies. Rates of injuries were similar to the rates found at another local hospital. At the hospital studied, sharps with safety features had effectively produced no reported cases of sharps injuries.
Nursing management of fever in children: A systematic review
Authors: Watts Robin , Robertson Jeanette , Thomas Gail
Published: March 2003

Objectives:  The aim of the present review was to determine whether the best available evidence supports the types and timing of the various nursing interventions that are commonly used to reduce fever in non‐critically‐ill children, and to what extent the outcomes are influenced by these nursing actions.

Methods:  Studies included were randomised or quasi‐randomised controlled trials that involved non‐critically‐ill children with a fever aged between 3 months and 16 years.

The search strategy sought to identify both published and unpublished research reports in the English language and covered all major databases up to 1998.

The methodological quality of each study was assessed by two independent reviewers using a piloted critical appraisal checklist.

Despite all studies being randomised, heterogeneity precluded conduction of a meta‐analysis; therefore, evidence was synthesised using narrative summaries.

Results: Ten studies were assessed as being of sufficient quality to be included in the review. These studies addressed two of the intervention categories identified in the protocol: (i) administration of antipyretics (paracetamol); and (ii) direct cooling measures on the outcome measure (reduction of or prevention of increase in fever).

The review found little benefit from sponging in temperate climates and usually at the expense of the child's comfort. There may be situations in high environmental temperatures and high humidity, or where there is a need for immediate temperature reduction, in which sponging may be warranted. Risks were identified when paracetamol was administered on a sustained basis over even a short period of time and above a relatively low total daily dosage. There was a lack of evidence to support the administration of antipyretics to reduce the incidence of febrile convulsions.

There is a need for parental education that focuses on knowledge of the body's protective physiological responses and how to support these responses.

Conclusion: The primary purpose for intervening when a child has a fever is to increase the child's comfort. This consideration should be weighed against any harm that might result from intervening. There was a lack of evidence to support the routine use of sponging. The administration of paracetamol should be used selectively and with caution. In summary, care needs to be individualised, based on current knowledge of the effectiveness and risks of interventions.
Biogeochemical contrasts between mid‐Cretaceous carbonate platforms and Cenozoic reefs
Authors: Iryu Yasufumi , Yamada Tsutomu
Published: March 2003

Carbonate sediments of mid‐Cretaceous platforms on Allison and Resolution Guyots, Mid‐Pacific Mountains (ODP Leg 143, Sites 865, 866, 867 and 868) and those of upper Oligocene to Pliocene reefs of the Kita‐daito‐jima Borehole were studied. The mid‐Cretaceous platforms abound with abiotic (?) precipitates (ooids) and microbial carbonate grains/sediments (oncoids and ‘algal’ laminites), whereas the Cenozoic reefs consist mainly of coral and non‐geniculate coralline algae, major frame‐builders, benthic foraminifers and codiacean alga (Halimeda). There exists a remarkable difference in a mode of calcification between the mid‐Cretaceous platforms and Cenozoic reefs. The major reef‐builders of Cenozoic reefs precipitated carbonates within closed to semiclosed spaces within their bodies. In contrast, the mid‐Cretaceous platforms contain abundant grains/sediments formed by chemical (?) precipitations and biotic extracellular calcification. This contrasting feature reflects different modes of biogeochemical cycles between the mid‐Cretaceous and Cenozoic. Increased CO2 (degassed by active volcanism) and resultant high temperature and intensive weathering may have brought high concentration of Ca2+ and HCO3− into the mid‐Cretaceous sea, which enhanced abiotic and extracellular calcification. Inverse processes are true for the Cenozoic.
Hepatic fibrosis: From bench to bedside
Authors: SCHUPPAN DETLEF , POROV YURY
Published: March 2003

Abstract Antifibrotic therapies are preferentially targeted to the activated mesenchymal cells in the liver that synthesize an excess of matrix proteins and resemble the myofibroblasts of healing wounds. These cells derive from normally quiescent hepatic stellate cells and (myo‐) fibroblasts. Their activation is triggered and maintained by several fibrogenic modulators and cytokines, but also by mechanical stress. Whereas many agents inhibit stellate cell/myofibroblast proliferation and collagen synthesis in vitro, only few of them are tolerable or effective in suitable animal models in vivo. An antifibrotic effect was demonstrated for silymarin, a defined mixture of flavonoids, sho‐saiko‐to which contains the related compound baicalein, for halofuginone, another plant‐derived agent, for the phosphodiesterase inhibitor pentoxifylline and for LU135252, an oral inhibitor of the endothelin‐A‐receptor. The retrospective finding that interferon‐α therapy for hepatitis C may halt or even reverse fibrosis, has to be confirmed in prospective randomized trials. Strategies to inhibit the profibrogenic cytokines transforming growth factor (TGF)‐β or connective tissue growth factor (e.g. by soluble decoy receptors) are evolving, but have not been convincing yet. Drug targeting to the fibrogenic liver cells is now possible by use of cyclic peptides that bind to receptors which are specifically up‐regulated on activated stellate cells, for example those for platelet‐derived growth factors or collagen type VI. In addition, blockade of such activation receptors can induce stress‐relaxation which reverts the fibrogenic cells to a fibrolytic, collagen degrading phenotype. Combined with the evolving validation of serological markers of fibrogenesis and fibrolysis an effective and individualized treatment of liver fibrosis can be anticipated.

© 2002 Blackwell Publishing Asia Pty Ltd
Distal colonic neoplasms predict proximal neoplasia in average‐risk, asymptomatic subjects
Authors: Collett Judith , Platell Cameron , Fletcher David , Aquilia Sina , Olynyk John
Published: March 2003

Flexible sigmoidoscopy has been recommended as a screening method to reduce the incidence of colorectal cancer in asymptomatic, average‐risk subjects through the early detection and removal of polyps. However, the association between distal and proximal colonic neoplasia and, hence, the requirement for colonoscopic follow up of screen‐detected distal neoplasms is unclear. Our aims were: (i) to evaluate the risk of having proximal neoplasms in those with distal colonic neoplasms; and (ii) to determine whether the risk was dependent on the number, size, histology or morphology of the distal lesions. We prospectively evaluated asymptomatic subjects in a flexible sigmoidoscopy based screening programme. Those with rectosigmoid neoplasia underwent colonoscopy. The number, size, histology and morphology of the polyps were recorded. Advanced lesions were defined as adenomas > 1 cm or with a villous component or severe dysplasia, carcinoma in situ or cancer. Adenomatous polyps were found in 17% (135) of screening flexible sigmoidoscopies. At colonoscopy, up to 30% of subjects with distal colonic neoplasms had synchronous proximal lesions at colonoscopy and up to 20% had advanced proximal lesions. The risk of proximal colonic neoplasia was increased in those with distal sessile colonic neoplasms but appeared independent of distal lesion size, number or morphology. In conclusion, distal colonic neoplasia predicts proximal neoplasia in up to 30% of subjects and these were advanced lesions in up to 20%. We recommend that all subjects with biopsy proven distal colonic neoplasia undergo colonoscopy.
Apolipoprotein A‐I in bile inhibits cholesterol crystallization and modifies transcellular lipid transfer through cultured human gall‐bladder epithelial cells
Authors: Secknus Roger , Darby Gwendolyn , Chernosky Ann , Juvonen Tatu , Moore Edward , Holzbach R Thomas
Published: March 2003

Background: Apolipoprotein A‐I (Apo A‐I), conventionally purified by several steps including organic solvent‐delipidation from plasma, inhibits cholesterol crystallization in bile. To observe a significant effect in vitro, however, supraphysiological concentrations above 100 μg/mL are required. For this reason, this protein has not been considered to play a physiological role in vivo. In the present study, we examined the cholesterol crystal growth‐inhibiting effect of biliary Apo A‐I at its physiological concentration, the modification of transcellular transfer of biliary lipids through cultured human gall‐bladder epithelial cells (GBEC) by Apo A‐I at its physiological concentration and the binding and secretion of Apo A‐I by GBEC.

Methods and Results: We purified biliary Apo A‐I to near homogeneity using immobilized artificial membrane chromatography. At 5 μg/mL, biliary Apo A‐I reduced cholesterol crystal mass by 50%, whereas plasma‐derived, solvent‐delipidated Apo A‐I had no effect. Using an antibody‐capture enzyme‐linked immunosorbent assay, we found reduced Apo A‐I concentrations in bile samples from gallstone patients when compared with bile samples from gallstone‐free controls (medians, 2.35 and 9.4 μg/mL, respectively). In a GBEC line, Apo A‐I (5 μg/mL) enhanced transfer of phospholipid and cholesterol from the mucosal to the serosal side of cell monolayers by approximately 50%. These cells appear to bind Apo A‐I reversibly in a dose‐ and time‐dependent manner, compatible with receptor‐type binding. Cultured human gall‐bladder epithelial cells also showed basal secretion of Apo A‐I, which was greatly increased by exposure to model bile solutions.

Conclusions: Apolipoprotein A‐I in bile, thus, has both a direct effect on cholesterol crystal formation and enhances lipid removal from gall‐bladder bile by GBEC. This effect may be specific and receptor mediated. These observations support two separate roles for human biliary Apo A‐I and suggest that this protein may be important in preventing the formation of cholesterol crystals (the initial step in gallstone formation) in supersaturated bile.
Molecular aspects of organic compound transport across the plasma membrane of hepatocytes
Authors: Kamisako Toshinori , Gabazza Esteban , Ishihara Tomoaki , Adachi Yukihiko
Published: March 2003

Many organic compounds are taken up from the blood by membrane transporters, taken across the sinosuidal membrane of hepatocytes and then excreted into bile via the bile canalicular membrane. The hepatic uptake of conjugated bile acids is mediated by the sodium taurocholate cotransporting polypeptide. Many organic anions and bulky organic cations are incorporated into hepatocytes by the organic anion transporting polypeptide, while small organic cations are transported by the organic cation transporter. At the canalicular membrane, organic compounds are excreted into bile by ATP‐binding cassette transporters which hydrolyse ATP to ADP. Excretion of monovalent bile acids is mediated by the canalicular bile salt transporter and that of organic anions, including divalent bile acid conjugates, are mediated by the multi‐drug resistance‐associated protein 2, also termed canalicular multi‐specific organic anion transporter. Organic cations are excreted into bile by the multi‐drug resistance gene product (MDR) 1 and phospholipids are excreted by MDR3 (mdr2 in mice and rats). The clinical syndromes associated with alterations of these transporters are also discussed.
CASE REPORT: Two cases of biliary papillomatosis with unusual associations
Authors: Cheng Ming Shiaw , Ahchong Ah Kian , Mak Kong Ling , Yip Andrew Wai Chun
Published: March 2003

Papillomatosis arising from the biliary tree is a well recognized but rare entity. We encountered two patients with this condition. However, one of them had associated hepatocellular carcinoma and cirrhosis and the other had concomitant recurrent pyogenic cholangitis. To our knowledge, these associations have not been reported before. We, therefore, present these clinical problems and highlight the added difficulty in the management of these patients.
Acquisition of resistance to apoptosis and necrosis by Bcl‐xL over‐expression in rat hepatoma McA‐RH8994 cells
Authors: Fukuda Kazunori , Yamamoto Masahiro
Published: March 2003

Background: Bcl‐xL is the predominant anti‐apoptotic Bcl‐2 family member in the liver. Suppression of cell death promotes carcinogenesis and contributes to resistance to radiation and chemotherapeutic agents.

Methods: Direct effects of Bcl‐xL protein on apoptosis and necrosis were investigated in rat hepatoma cells. Rat hepatoma cell line McA‐RH8994 cells were transfected with expression plasmids containing a whole coding sequence of rat bcl‐xL cDNA of sense orientation. Stable transfectant cell lines expressing bcl‐xL cDNA (designated as RH8994/Bcl‐xL‐S), or control plasmid DNA (designated as RH8994/pT) were established.

Results: Cellular amounts of Bcl‐xL in RH8994/Bcl‐xL‐S cells were demonstrated to be more than 20‐fold that of RH8994/pT and parental cells. Three independent clones of RH8994/Bcl‐xL‐S were isolated and their susceptibility to various cell death stimuli was compared with that of the control cells. Transforming growth factor‐β1 and tumour necrosis factor‐α induced apoptosis dose dependently in these cells, but the 50% cytotoxicity concentrations of these factors in RH8994/Bcl‐xL‐S cells were more than 10‐fold higher than those in RH8994/pT and parental cells. Similarly, RH8994/Bcl‐xL‐S cells were shown to be significantly less susceptible to necrotic cell death induced by a calcium ionophore, A23187; a mutagen, N‐methyl‐N′‐nitro‐N‐nitrosoguanidine; and UV‐irradiation when compared with the control cells.

Conclusions: Over‐expression of Bcl‐xL was shown to provide protection against apoptotic and necrotic cell death in rat hepatoma cells.
C ASE R	EPORT: Lamivudine therapy for submassive hepatic necrosis due to reactivation of hepatitis B following chemotherapy
Authors: Maguire Cliona M , Crawford Darrell Hg , Hourigan Luke F , Clouston Andrew D , Walpole Euan T , Powell Elizabeth E
Published: March 2003

This report describes the case of a 53‐year‐old woman who developed severe hepatitis following chemotherapy for breast carcinoma. The patient was hepatitis B surface antigen positive, e antigen negative and e antibody positive and had high levels of hepatitis B virus‐DNA. Liver biopsy revealed submassive hepatic necrosis, consistent with reactivation of hepatitis B. Treatment with lamivudine resulted in rapid loss of hepatitis B virus‐DNA, resolution of hepatitis and clinical recovery.