bluuebunny/crossref_metadata_2025 huggingface dataset:
A GRAMMAR-GUIDED GENETIC PROGRAMMING FRAMEWORK CONFIGURED FOR DATA MINING AND SOFTWARE TESTING
Authors: VERGILIO SILVIA REGINA , POZO AURORA
Published: April 2006

Genetic Programming (GP) is a powerful software induction technique that can be applied to solve a wide variety of problems. However, most researchers develop tailor-made GP tools for solving specific problems. These tools generally require significant modifications in their kernel to be adapted to other domains. In this paper, we explore the Grammar-Guided Genetic Programming (GGGP) approach as an alternative to overcome such limitation. We describe a GGGP based framework, named Chameleon, that can be easily configured to solve different problems. We explore the use of Chameleon in two domains, not usually addressed by works in the literature: in the task of mining relational databases and in the software testing activity. The presented results point out that the use of the grammar-guided approach helps us to obtain more generic GP frameworks and that they can contribute in the explored domains.
A Novel Methionine Aminopeptidase-2 Inhibitor, PPI-2458, Inhibits Non–Hodgkin's Lymphoma Cell Proliferation In vitro and In vivo
Authors: Cooper Andrew C. , Karp Russell M. , Clark Edward J. , Taghizadeh Nazbeh R. , Hoyt Jennifer G. , Labenski Matthew T. , Murray Michael J. , Hannig Gerhard , Westlin William F. , Thompson Charles D.
Published: April 2006

Purpose: Fumagillin and related compounds have potent antiproliferative activity through inhibition of methionine aminopeptidase-2 (MetAP-2). It has recently been reported that MetAP-2 is highly expressed in germinal center B cells and germinal center–derived non–Hodgkin's lymphomas (NHL), suggesting an important role for MetAP-2 in proliferating B cells. Therefore, we determined the importance of MetAP-2 in normal and transformed germinal center B cells by evaluating the effects of MetAP-2 inhibition on the form and function of germinal centers and germinal center–derived NHL cells.

Experimental Design: To examine the activity of PPI-2458 on germinal center morphology, spleen sections from cynomolgus monkeys treated with oral PPI-2458 were analyzed. Antiproliferative activity of PPI-2458 was assessed on germinal center–derived NHL lines in culture. A MetAP-2 pharmacodynamic assay was used to determine cellular MetAP-2 inhibition following PPI-2458 treatment. Finally, inhibition of MetAP-2 and proliferation by PPI-2458 was examined in the human SR NHL line in culture and in implanted xenografts.

Results: Oral PPI-2458 caused a reduction in germinal center size and number in lymphoid tissues from treated animals. PPI-2458 potently inhibited growth (GI50 = 0.2-1.9 nmol/L) of several NHL lines in a manner that correlated with MetAP-2 inhibition. Moreover, orally administered PPI-2458 significantly inhibited SR tumor growth, which correlated with inhibition of tumor MetAP-2 (>85% at 100 mg/kg) in mice.

Conclusions: These results show the potent antiproliferative activity of PPI-2458 on NHL lines in vitro and oral antitumor activity in vivo and suggest the therapeutic potential of PPI-2458 as a novel agent for treatment of NHL should be evaluated in the clinical setting.
Protective Effect of Erythropoietin and Its Carbamylated Derivative in Experimental Cisplatin Peripheral Neurotoxicity
Authors: Bianchi Roberto , Brines Michael , Lauria Giuseppe , Savino Costanza , Gilardini Alessandra , Nicolini Gabriella , Rodriguez-Menendez Virginia , Oggioni Norberto , Canta Annalisa , Penza Paola , Lombardi Raffaella , Minoia Claudio , Ronchi Anna , Cerami Anthony , Ghezzi Pietro , Cavaletti Guido
Published: April 2006

Purpose: Antineoplastic drugs, such as cisplatin (CDDP), are severely neurotoxic, causing disabling peripheral neuropathies with clinical signs known as chemotherapy-induced peripheral neurotoxicity. Cotreatment with neuroprotective agents and CDDP has been proposed for preventing or reversing the neuropathy. Erythropoietin given systemically has a wide range of neuroprotective actions in animal models of central and peripheral nervous system damage. However, the erythropoietic action is a potential cause of side effects if erythropoietin is used for neuroprotection. We have successfully identified derivatives of erythropoietin, including carbamylated erythropoietin, which do not raise the hematocrit but retain the neuroprotective action exerted by erythropoietin.

Experimental Design: We have developed previously an experimental chemotherapy-induced peripheral neurotoxicity that closely resembles CDDP neurotoxicity in humans. The present study compared the effects of erythropoietin and carbamylated erythropoietin (50 μg/kg/d thrice weekly) on CDDP (2 mg/kg/d i.p. twice weekly for 4 weeks) neurotoxicity in vivo.

Results: CDDP given to Wistar rats significantly lowered their growth rate (P < 0.05), with slower sensory nerve conduction velocity (P < 0.001) and reduced intraepidermal nerve fibers density (P < 0.001 versus controls). Coadministration of CDDP and erythropoietin or carbamylated erythropoietin partially but significantly prevented the sensory nerve conduction velocity reduction. Both molecules preserved intraepidermal nerve fiber density, thus confirming their neuroprotective effect at the pathologic level. The protective effects were not associated with any difference in platinum concentration in dorsal root ganglia, sciatic nerve, or kidney specimens.

Conclusions: These results widen the spectrum of possible use of erythropoietin and carbamylated erythropoietin as neuroprotectant drugs, strongly supporting their effectiveness.
Targeted Delivery of Tumor Necrosis Factor-α to Tumor Vessels Induces a Therapeutic T Cell–Mediated Immune Response that Protects the Host Against Syngeneic Tumors of Different Histologic Origin
Authors: Balza Enrica , Mortara Lorenzo , Sassi Francesca , Monteghirfo Stefano , Carnemolla Barbara , Castellani Patrizia , Neri Dario , Accolla Roberto S. , Zardi Luciano , Borsi Laura
Published: April 2006

Purpose: We sought to demonstrate that a single systemic administration of L19mTNFα (a fusion protein constituted by the scFv L19 specific for the oncofetal ED-B domain of fibronectin and tumor necrosis factor α, TNFα) in combination with melphalan induced complete and long-lasting tumor eradication in tumor-bearing mice and triggered the generation of a specific T cell–based immune response that protects the animals from a second tumor challenge, as well as from challenges with syngeneic tumor cells of different histologic origin.

Experimental Design and Results: Treatment with L19mTNFα, in combination with melphalan, induced complete tumor regression in 83% of BALB/c mice with WEHI-164 fibrosarcoma and 33% of animals with C51 colon carcinoma. All cured mice rejected challenges with the same tumor cells and, in a very high percentage of animals, also rejected challenges with syngeneic tumor cells of different histologic origin. In adoptive immunity transfer experiments, the splenocytes from tumor-cured mice protected naive mice both from C51 colon carcinoma and from WEHI-164 fibrosarcoma. Similar results were also obtained in adoptive immunity transfer experiments using severely immunodepressed mice. Experiments using depleted splenocytes showed that T cells play a major role in tumor rejection.

Conclusions: The results show that the selective targeting of mTNFα to the tumor enhances its immunostimulatory properties to the point of generating a therapeutic immune response against different histologically unrelated syngeneic tumors. These findings predicate treatment approaches for cancer patients based on the targeted delivery of TNFα to the tumor vasculature.
Identification of a Set of Seven Genes for the Monitoring of Minimal Residual Disease in Pediatric Acute Myeloid Leukemia
Authors: Steinbach Daniel , Schramm Alexander , Eggert Angelika , Onda Masanori , Dawczynski Kristin , Rump Andreas , Pastan Ira , Wittig Susann , Pfaffendorf Nadine , Voigt Astrid , Zintl Felix , Gruhn Bernd
Published: April 2006

Background: Monitoring of minimal residual disease (MRD) has become a strong diagnostic tool in acute lymphoblastic leukemia. It is used for risk-adapted therapy and for the recognition of pending relapses. In acute myeloid leukemia (AML), there is still a need for more suitable MRD markers.

Experimental Design: A stepwise approach which combined genome-wide expression profiling, TaqMan low density arrays, and a TaqMan real-time PCR-based screening was used to identify new markers for the monitoring of MRD in AML. Leukemic cells from 52 children with AML and 145 follow-up samples from 25 patients were analyzed.

Results: Seven genes were identified which are vastly overexpressed in many patients with AML compared with healthy bone marrow: CCL23, GAGED2, MSLN, SPAG6, and ST18 as well as the previously described markers WT1 and PRAME. The expression of all genes decreased to normal levels in patients who achieved a continuous complete remission. Elevated levels of at least one gene were found prior to relapse in 7 out of 10 patients who relapsed.

Conclusions: This set of genes should allow a sensitive and specific monitoring of MRD in AML. Notably, some of these markers could also serve as therapeutic targets or might be involved in leukemogenesis. MSLN is already used as a target for immunotherapy in clinical trials in other malignancies.
Hyperhomocysteinemia Associated With Decreased Renal Transsulfuration Activity in Dahl S Rats
Authors: Li Ningjun , Chen Li , Muh Rachel W. , Li Pin-Lan
Published: April 2006

Elevated plasma homocysteine (Hcys) has been reported to participate in the development of arterial and glomerular sclerosis in Dahl salt-sensitive hypertensive (SS) rats. The mechanism resulting in hyperhomocysteinemia in these animals remains unknown. Disposal of Hcys in the kidneys plays an important role in regulating the plasma Hcys level. We, therefore, examined the activities and expressions of the enzymes involved in the metabolism of Hcys in the kidneys of SS rats, compared with that of Brown Norway rats and SSBN13 rats, a consomic subcolony of SS rats that carries a substituted chromosome 13 from Brown Norway rats. High-performance liquid chromatography analysis demonstrated that plasma Hcys levels were significantly higher in SS rats. The conversion of S-adenosylhomocysteine into Hcys via S-adenosylhomocysteine hydrolase by renal tissue was not different among these 3 rat strains. However, the metabolic rate of Hcys into cysteine was markedly reduced in the SS rat kidneys. The mRNA and protein levels of cystathionine β-synthase (CBS), one of the key enzymes in the transsulfuration pathway in the kidneys, were significantly lower in SS rats. In microdissected nephron segments, CBS mRNA was shown to be mainly present in renal proximal tubules (PTs). The mRNA levels of CBS in the PTs were also significantly decreased in SS rats, accompanied by a reduced CBS activity in PTs. We conclude that hyperhomocysteinemia is associated with a decreased activity and expression of CBS in renal PTs because of the defect of chromosome 13 in SS rats.
Angiotensinogen Modulates Renal Vasculature Growth
Authors: Brand Marcus , Lamandé Noël , Sigmund Curt D. , Larger Etienne , Corvol Pierre , Gasc Jean-Marie
Published: April 2006

We have shown previously that angiotensinogen, like other members of the serine protease inhibitor family, has antiangiogenic properties in vitro on cultured endothelial cells and in ovo in the chick chorioallantoic membrane assay. The aim of this study was to show the effects of angiotensinogen on vascular wall remodeling in vivo. We measured the vessel wall thickness (tunica media) stained with an antibody to α-actin. In the kidney, arterioles were 21.5% thinner in male transgenic mice overexpressing human angiotensinogen than in male control animals. In other vascular beds, the arterial wall thickness was not affected. By using in situ hybridization and Northern blot analysis, human angiotensinogen expression was detected at a high level in the male kidney and at a much lower level in other organs. There is a relationship between the effect of angiotensinogen on arterial wall thickness and the local expression level of angiotensinogen in this model of transgenic mice. Because human angiotensinogen is not cleaved to a significant extent by mouse renin, the reduction in kidney arterial wall thickness is because of angiotensinogen itself and not angiotensin II, and we show that the reduction was not because of hypoplasia or hypotropia. In contrast, a marked difference in the expression of platelet-derived growth factor receptor-β was observed in the kidney arterioles at day 5 when compared with controls. Altogether, these observations provide the first quantitative evidence that a high level of angiotensinogen expression can inhibit the growth of kidney artery walls in vivo.
Dietary Intake of n-6 Fatty Acids Modulates Effect of Apolipoprotein A5 Gene on Plasma Fasting Triglycerides, Remnant Lipoprotein Concentrations, and Lipoprotein Particle Size
Authors: Lai Chao-Qiang , Corella Dolores , Demissie Serkalem , Cupples L. Adrienne , Adiconis Xian , Zhu Yueping , Parnell Laurence D. , Tucker Katherine L. , Ordovas Jose M.
Published: April 2006

Background—

Apolipoprotein A5 gene (
APOA5
) variation is associated with plasma triglycerides (TGs). However, little is known about whether dietary fat modulates this association.

Methods and Results—

We investigated the interaction between
APOA5
gene variation and dietary fat in determining plasma fasting TGs, remnant-like particle (RLP) concentrations, and lipoprotein particle size in 1001 men and 1147 women who were Framingham Heart Study participants. Polymorphisms −1131T>C and 56C>G, representing 2 independent haplotypes, were analyzed. Significant gene–diet interactions between the −1131T>C polymorphism and polyunsaturated fatty acid (PUFA) intake were found (
P
<0.001) in determining fasting TGs, RLP concentrations, and particle size, but these interactions were not found for the 56C>G polymorphism. The −1131C allele was associated with higher fasting TGs and RLP concentrations (
P
<0.01) in only the subjects consuming a high-PUFA diet (>6% of total energy). No heterogeneity by sex was found. These interactions showed a dose-response effect when PUFA intake was considered as a continuous variable (
P
<0.01). Similar interactions were found for the sizes of VLDL and LDL particles. Only in carriers of the −1131C allele did the size of these particles increase (VLDL) or decrease (LDL) as PUFA intake increased (
P
<0.01). We further analyzed the effects of n-6 and n-3 fatty acids and found that the PUFA–APOA5 interactions were specific for dietary n-6 fatty acids.

Conclusions—

Higher n-6 (but not n-3) PUFA intake increased fasting TGs, RLP concentrations, and VLDL size and decreased LDL size in
APOA5
−1131C carriers, suggesting that n-6 PUFA–rich diets are related to a more atherogenic lipid profile in these subjects.
Features of the Metabolic Syndrome and Diabetes Mellitus as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis
Authors: Katz Ronit , Wong Nathan D. , Kronmal Richard , Takasu Junichiro , Shavelle David M. , Probstfield Jeffrey L. , Bertoni Alain G. , Budoff Matthew J. , O’Brien Kevin D.
Published: April 2006

Background—

Calcific aortic valve disease is common in the elderly, is correlated with common cardiovascular risk factors, and is associated with increased cardiovascular event risk; however, whether metabolic syndrome is associated with an increased prevalence of aortic valve calcium (AVC) is not known.

Methods and Results—

The prevalence of AVC, as assessed by computed tomography, was compared in 6780 Multi-Ethnic Study of Atherosclerosis (MESA) participants with metabolic syndrome (n=1550; National Cholesterol Education Program’s Adult Treatment Panel III [ATP III] criteria), diabetes mellitus (n=1016), or neither condition (n=4024). The prevalence of AVC for those with neither condition, metabolic syndrome, or diabetes mellitus was, respectively, 8%, 12%, and 17% in women (
P
<0.001) and 14%, 22%, and 24% in men (
P
<0.001). Compared with those with neither condition, the adjusted relative risks for the presence of AVC were 1.45 (95% CI 1.11 to 1.90) for metabolic syndrome and 2.12 (95% CI 1.54 to 2.92) for diabetes mellitus in women and 1.70 (95% CI 1.32 to 2.19) for metabolic syndrome and 1.73 (95% CI 1.33 to 2.25) for diabetes mellitus in men. There was a graded, linear relationship between AVC prevalence and the number of metabolic syndrome components in both women and men (both
P
<0.001). Similar results were obtained when the International Diabetes Federation metabolic syndrome definition was used.

Conclusions—

In the MESA cohort, the metabolic syndrome and diabetes mellitus are associated with increased risk of AVC, and AVC prevalence is increased with increasing number of metabolic syndrome components.
On the Classification of Vertical Wind Shear as Directional Shear versus Speed Shear
Authors: Markowski Paul , Richardson Yvette
Published: April 2006

Vertical wind shear is commonly classified as “directional” or “speed” shear. In this note, these classifications are reviewed and their relevance discussed with respect to the dynamics of convective storms. In the absence of surface drag, storm morphology and evolution only depend on the shape and length of a hodograph, on which the storm-relative winds depend; that is, storm characteristics are independent of the translation and rotation of a hodograph. Therefore, traditional definitions of directional and speed shear are most relevant when applied to the storm-relative wind profile.
Subtropical Cyclogenesis over the Central North Pacific*
Authors: Caruso Steven J. , Businger Steven
Published: April 2006

The occurrence of subtropical cyclones over the central North Pacific Ocean has a significant impact on Hawaii’s weather and climate. In this study, 70 upper-level lows that formed during the period 1980–2002 are documented. In each case the low became cut off from the polar westerlies south of 30°N over the central Pacific, during the Hawaiian cool season (October–April). The objectives of this research are to document the interannual variability in the occurrence of upper-level lows, to chart the locations of their genesis and their tracks, and to investigate the physical mechanisms important in associated surface development. Significant interannual variability in the occurrence of upper-level lows was found, with evidence suggesting the influence of strong El Niño–Southern Oscillation events on the frequency of subtropical cyclogenesis in this region. Of the 70 upper-level lows, 43 were accompanied by surface cyclogenesis and classified as kona lows. Kona low formation is concentrated to the west-northwest of Hawaii, especially during October and November, whereas lows without surface development are concentrated in the area to the east-northeast of Hawaii. Kona low genesis shifts eastward through the cool season, favoring the area to the east-northeast of Hawaii during February and March, consistent with a shift in the climatological position of the trough aloft during the cool season. Consistent with earlier studies, surface deepening is well correlated with positive vorticity advection by the thermal wind. Static stability and advection of low-level moisture are less well correlated to surface deepening. These results suggest that kona low formation, to first order, is a baroclinic instability that originates in the midlatitudes, and that convection and latent-heat release play a secondary role in surface cyclogenesis.
Reduced Methylprednisolone Clearance Causing Prolonged Pharmacodynamics in a Healthy Subject Was Not Associated WithCYP3A5*3Allele or a Change in Diet Composition
Authors: Lee Su‐Jun , Jusko William J. , Salaita Christine G. , Calis Karim A. , Jann Michael W. , Spratlin Vicky E. , Goldstein Joyce A. , Hon Yuen Yi
Published: April 2006

The influence of diet and genetics was investigated in a healthy white person who had distinctly low methylprednisolone clearance. Pharmacokinetic and pharmacodynamic parameter values were similar on 2 occasions during the consumption of a low‐carbohydrate diet and a Weight Watchers diet, indicating that the decreased clearance was unlikely attributable to a change in diet composition. Although the subject was found to be homozygous forCYP3A5*3,genetic findings were not significant for a number of otherCYP3A4andCYP3A5allelic variants. Because of the high prevalence ofCYP3A5*3/*3in whites and because 5 of 7 white control subjects are also homozygous forCYP3A5*3,this genotype cannot fully explain the reduced metabolism of the drug. Other genetic or contributing factors might have been involved. New polymerase chain reaction‐based genotyping methods for functionally defectiveCYP3A5*6, *8, *9,and*10alleles were developed in this study. These assays will be useful forCYP3A5genotype analysis in future clinical studies.
The Effectiveness of Using a Lipido-Colloid Dressing for Patients With Traumatic Digital Wounds
Authors: Ma K. K. , Chan M. F. , Pang S. M. C.
Published: April 2006

This study compares the effect of a daily gauze dressing with that of a lipidocolloid dressing on the time taken to make up the dressing and efficacy of the management of traumatic digitalwounds. This is a randomized controlled trial of 28 patients (16 experimental and 12 control) with injuries to their fingers and loss of tissue. The patients in the experimental and control groups were given a lipido-colloid dressing and a daily gauze dressing, respectively. The patients'wounds were assessed in terms of the size of thewound and the time it took for thewound to heal. The findings showed that patients in the experimental group had a faster recovery time from the healing of their wound than the control group ( p= .024). The findings can help to establish an evidence-based practice in the management of traumatic digital wounds in clinical settings.
Art Therapy for Children: How It Leads to Change
Authors: Waller Diane
Published: April 2006

The aim of art therapy is to facilitate positive change through engagement with the therapist and the art materials in a safe environment. This article will explore how art therapy is used to help children with emotional, developmental and behavioural problems. It will show how change occurs during the process of physical involvement with the materials; through the making of a significant art object; through sublimation of feelings into the images; and through communication with the therapist via the art object. The article is illustrated with case vignettes which demonstrate how the theories underpinning art therapy are put into practice, drawing attention to the changes that occur as a result.
Mental health and arts participation: the state of the art in England
Authors: Hacking Sue , Secker Jenny , Kent Lyn , Shenton Jo , Spandler Helen
Published: April 2006

Although participation in arts activity is believed to have important mental health and social benefits for people with mental health needs, the evidence base is currently weak. This article reports the first phase of a study intended to support the development of stronger evidence. Objectives for the first phase were to map current participatory arts activity, to identify appropriate indicators and to develop measures for use in the second phase of the research. A survey of participatory arts projects for people with mental health needs aged 16 to 65 in England, identified via the Internet and relevant organizations, was carried out to map the scale and scope of activity and to establish the nature of current approaches to evaluation. The results indicate that the scope of activity, in terms of projects’ settings, referral sources, art forms and participation is impressively wide. In terms of scale, however, projects reported low funding and staffing levels that may have implications for the feasibility of routine evaluation in this field. Current approaches to evaluation were limited, but entailed considerable effort and ingenuity, suggesting that projects are keen to demonstrate their benefits. The survey has enabled us to build on the best evaluation practice identified to develop a measure for assessing the mental health, social inclusion and empowerment outcomes of arts participation for people with mental health needs. For the second phase of the study we will work with arts and mental health projects, using the measure alongside qualitative work in a realistic evaluation design, in order to identify the characteristics of effective projects.
Driving SAFE
Authors: Adler Geri , Rottunda Susan , Christensen Kathy , Kuskowski Michael , Thuras Paul
Published: April 2006

The purpose of this study was to develop a screening test of driving knowledge for use with dementia patients and other older drivers. Seventy-five drivers with dementia and 80 non-demented elderly drivers completed a 39-item questionnaire concerning the rules-of-the-road and a Mini-Mental State Examination (MMSE). Using item analysis, 15 items were selected for a screening test.The internal consistency reliability of the test was 0.74, while that of all 39 questions was 0.79. Patient and control means on the test differed significantly ( p < 0.001). MMSE scores accounted for only 16 percent of the variance in driving knowledge scores in the dementia patients. Results suggest that it is possible to develop a knowledge-based driving instrument that can successfully be administered to patients with diagnoses of mild to moderate dementia. Drivers with dementia demonstrated significantly poorer knowledge of driving regulations than the control group. However, the final score on the driving instrument was not well predicted by the MMSE, suggesting that direct assessment of driving knowledge is important to driving assessment.
Outdoor wayfinding in dementia
Authors: Sheehan Bart , Burton Elizabeth , Mitchell Lynne
Published: April 2006

We aimed in this study to investigate (1) outdoor wayfinding performance of people with dementia; and (2) which features of the outdoor built environment are used in wayfinding by people with dementia. We observed 13 older subjects with confirmed dementia and 10 controls on outdoor walks.Two accompanying researchers recorded performance in wayfinding, built environment features and use of these features in wayfinding. Results showed that people with dementia performed worse on wayfinding, even in familiar areas, but that they attended to similar features of the built environment and made equal use of features such as signs in wayfinding. Research that investigates the built environment for people with dementia is feasible and may help guide planning policies likely to enhance independent community living for this group.
The training and development needs of nurses in Indonesia: paper 3 of 3
Authors: Hennessy Deborah , Hicks Carolyn , Hilan Aflah , Kawonal Yoanna
Published: April 2006

Background

Indonesia's recent economic and political history has left a legacy of widespread poverty and serious health problems, and has contributed to marked inequalities in health care. One means of responding to these challenges has been through a reconsideration of the professional roles of nurses, to enable them to deal with the range and complexity of health problems. However, there are currently a number of obstacles to achieving these aims: there is a serious shortfall in trained nurses; the majority of nurses have only limited education and preparation for the role; and there is no central registration of nurses, which means that it is impossible to regulate either the profession or the standards of care. This study aimed to establish the occupational profiles of each grade of nurse, identify their training and development needs and ascertain whether any differences existed between nurses working in different regions or within hospital or community settings.

Methods

An established and psychometrically valid questionnaire was administered to 524 nurses, covering three grades and coming from five provinces.

Results

Significant differences in job profile were found in nurses from different provinces, suggesting that the nature of the role is determined to some degree by the geographical location of practice. The roles of hospital and community nurses, and the different grades of nurse, were fairly similar. All nurses reported significant training needs for all 40 tasks, although these did not vary greatly between grade of nurse. The training needs of nurses from each of the provinces were quite distinct, while those of hospital nurses were greater than those of community nurses.

Conclusion

The results suggest that the role of the nurse is not as diverse as might be expected, given the different levels of preparation and training and the diversity of their work environments. This may reflect the lack of a central registration system and quality framework, which would normally regulate clinical activities according to qualifications. The differences in training needs between subsections of the sample highlight the importance of identifying skills deficits and using this information to develop customized post-registration education programmes. Together, these results provide a rigorous and reliable approach to defining the occupational roles and continuing education needs of Indonesian nurses.
Multimedia Bootcamp: a health sciences library provides basic training to promote faculty technology integration
Authors: Ramsey Ellen C
Published: April 2006

Background

Recent research has shown a backlash against the enthusiastic promotion of technological solutions as replacements for traditional educational content delivery. Many institutions, including the University of Virginia, have committed staff and resources to supporting state-of-the-art, showpiece educational technology projects. However, the Claude Moore Health Sciences Library has taken the approach of helping Health Sciences faculty be more comfortable using technology in incremental ways for instruction and research presentations. In July 2004, to raise awareness of self-service multimedia resources for instructional and professional development needs, the Library conducted a "Multimedia Bootcamp" for nine Health Sciences faculty and fellows.

Methods

Case study.

Results

Program stewardship by a single Library faculty member contributed to the delivery of an integrated learning experience. The amount of time required to attend the sessions and complete homework was the maximum fellows had to devote to such pursuits. The benefit of introducing technology unfamiliar to most fellows allowed program instructors to start everyone at the same baseline while not appearing to pass judgment on the technology literacy skills of faculty. The combination of wrapping the program in the trappings of a fellowship and selecting fellows who could commit to a majority of scheduled sessions yielded strong commitment from participants as evidenced by high attendance and a 100% rate of assignment completion. Response rates to follow-up evaluation requests, as well as continued use of Media Studio resources and Library expertise for projects begun or conceived during Bootcamp, bode well for the long-term success of this program.

Conclusion

An incremental approach to integrating technology with current practices in instruction and presentation provided a supportive yet energizing environment for Health Sciences faculty. Keys to this program were its faculty focus, traditional hands-on instruction, unrestricted access to technology tools and support, and inclusion of criteria for evaluating when multimedia can augment pedagogical aims.
Resuscitation fluids in trauma 1: why give fluid and how to give it
Authors: Levett Denny , Vercueil Andre , Grocott Michael
Published: April 2006

Fluid resuscitation following trauma is necessary to restore compromised organ perfusion and hypoxic tissue damage. The activation of the Systemic Inflammatory Response Syndrome in response to both traumatic and subsequent hypoxic insults has implications for what represents the optimal fluid resuscitation strategy. There is no single resuscitation strategy that can be applied to all patients with traumatic injury. This article reviews the evidence available to help guide fluid therapy.

A number of studies have suggested that timing of fluid therapy with respect to surgical intervention is crucial. Prior to definitive treatment of injury permissive hypotension confers advantage, particularly in the setting of penetrating trauma. The situation is less clear in cases of blunt trauma, where further studies comparing restrictive with liberal fluid regimes are required. The site of injury will also influence the strategy to be adopted. Following traumatic brain injury, maintenance of cerebral perfusion pressure is likely to be of overriding importance.

Once definitive surgical control of haemorrhage has been achieved, fluid therapy to maximise stroke volume and cardiac output is advised. Following the development of established critical illness, goal-directed therapy may increase mortality.
11C-Acetate Positron Emission Tomography Imaging and Image Fusion With Computed Tomography and Magnetic Resonance Imaging in Patients With Recurrent Prostate Cancer
Authors: Wachter Stefan , Tomek Sandra , Kurtaran Amir , Wachter-Gerstner Natascha , Djavan Bob , Becherer Alexander , Mitterhauser Markus , Dobrozemsky Georg , Li Shuren , Pötter Richard , Dudczak Robert , Kletter Kurt
Published: April 2006

Purpose

To assess the clinical value of computed tomography (CT) and magnetic resonance imaging (MRI) image fusion with 11C-acetate (AC) positron emission tomography (PET) imaging for detection and exact location of clinically occult recurrences.

Patients and Methods

Fifty prostate cancer patients with elevated/increasing serum prostate-specific antigen levels after radical therapy underwent whole-body AC PET. Uptake was initially interpreted as normal, abnormal, or equivocal. In case of abnormal or equivocal uptake, additional conventional imaging techniques, such as CT, MRI, and bone scans, were performed. To precisely define the anatomic location of abnormal uptake and to improve characterization of equivocal lesions, a software-assisted image fusion (CT-PET, MRI-PET) was performed and evaluated as site-by-site analysis of 51 abnormal (n = 37) or equivocal (n = 14) sites of all 50 patients. In 17 patients, additional histopathologic evaluation was available.

Results

In five (10%), 13 (26%), and 32 (64%) of the 50 patients, AC PET studies demonstrated AC uptake judged as normal, equivocal, and abnormal, respectively. Image fusion changed characterization of equivocal lesions as normal in five (10%) of 51 sites and abnormal in nine (18%) of 51 sites. It precisely defined the anatomic location of abnormal uptake in 37 (73%) of 51 sites. AC PET findings did influence patient management in 14 (28%) of 50 patients.

Conclusion

Retrospective fusion of AC PET and CT/MRI is feasible and seems to be essential for final diagnosis. This is particularly true in patients with AC uptake in the prostate region.
Phase II Placebo-Controlled Randomized Discontinuation Trial of Sorafenib in Patients With Metastatic Renal Cell Carcinoma
Authors: Ratain Mark J. , Eisen Tim , Stadler Walter M. , Flaherty Keith T. , Kaye Stan B. , Rosner Gary L. , Gore Martin , Desai Apurva A. , Patnaik Amita , Xiong Henry Q. , Rowinsky Eric , Abbruzzese James L. , Xia Chenghua , Simantov Ronit , Schwartz Brian , O'Dwyer Peter J.
Published: April 2006

Purpose

This phase II randomized discontinuation trial evaluated the effects of sorafenib (BAY 43-9006), an oral multikinase inhibitor targeting the tumor and vasculature, on tumor growth in patients with metastatic renal cell carcinoma.

Patients and Methods

Patients initially received oral sorafenib 400 mg twice daily during the initial run-in period. After 12 weeks, patients with changes in bidimensional tumor measurements that were less than 25% from baseline were randomly assigned to sorafenib or placebo for an additional 12 weeks; patients with ≥ 25% tumor shrinkage continued open-label sorafenib; patients with ≥ 25% tumor growth discontinued treatment. The primary end point was the percentage of randomly assigned patients remaining progression free at 24 weeks after the initiation of sorafenib.

Results

Of 202 patients treated during the run-in period, 73 patients had tumor shrinkage of ≥ 25%. Sixty-five patients with stable disease at 12 weeks were randomly assigned to sorafenib (n = 32) or placebo (n = 33). At 24 weeks, 50% of the sorafenib-treated patients were progression free versus 18% of the placebo-treated patients (P = .0077). Median progression-free survival (PFS) from randomization was significantly longer with sorafenib (24 weeks) than placebo (6 weeks; P = .0087). Median overall PFS was 29 weeks for the entire renal cell carcinoma population (n = 202). Sorafenib was readministered in 28 patients whose disease progressed on placebo; these patients continued on sorafenib until further progression, for a median of 24 weeks. Common adverse events were skin rash/desquamation, hand-foot skin reaction, and fatigue; 9% of patients discontinued therapy, and no patients died from toxicity.

Conclusion

Sorafenib has significant disease-stabilizing activity in metastatic renal cell carcinoma and is tolerable with chronic daily therapy.
ESR Study of Intramolecular Magnetic Interactions in Bis(nitrenophenyl) Sulfides
Authors: Nimura Shigeaki , Kikuchi Osamu , OHANA Tsuguyori , Yabe Akira , Kaise Masahiro
Published: April 2006

In photolysis of 4,4′-diazidodiphenyl sulfide quintet ESR peaks were observed and the plots of these signal intensities vs. temperature obeyed the Curie law, although no quintet signals were observed in the photolysis of 4,4′-diazidodiphenyl ether. The ESR spectrum upon the irradiation of 3,4′-diazidodiphenyl sulfide showed quintet resonances of 3,4′-dinitrenodiphenyl sulfide. Both Curie analysis and PM3-CI calculations indicated that the quintet state is a ground-state.
A Novel Blue Light Emitting Material Prepared from 2-(o-Hydroxyphenyl)benzoxazole
Authors: Nakamura Norikazu , Wakabayashi Shinichi , Miyairi Keiichi , Fujii Tsuneo
Published: April 2006

A new organozinc compound, zinc bis-2-(o-hydroxyphenyl)benzoxazolate, was prepared from 2-(o-hydroxyphenyl)benzoxazole and electroluminescent properties of the compound was investigated. An electroluminescent device was composed of glass substrate/indium-tin-oxide/hole transporting layer/zinc benzoxazolate/Al thin films. The electroluminescence of blue light was observed with the electric field of over 90 MV/m.
Preparation and Binding Affinity of New Porphyrin Host Molecule for Ubiquinone Analogues
Authors: Hayashi Takashi , Miyahara Takashi , Aoyama Yasunori , Nonoguchi Masanori , Ogoshi Hisanobu
Published: April 2006

αααα-meso-Tetra(7-hydroxy-1-naphthyl)porphyrin (1) is prepared as a host molecule for ubiquinone analogue, 2,3,5,6-tetramethoxy-p-benzoquinone (2). The affinity and thermodynamic aspects in porphyrin 1- quinone 2 pairing were determined by titrimetric measurement of electronic absorption and fluorescence spectra. The binding constant of 1 for 2 at 298 K is obtained; Ka = 7.9 × 102 M−1 in toluene. The fashion of this porphyrin-quinone pairing was large different from that of previous host, αααα-meso-tetra(2-hydroxy-1-naphthyl)porphyrin (3), -quinone 2 pairing.
Synthesis of Z-1,1-Dichloro-2-[4-(2-dimethylaminoethoxy)phenyl]-2-(4-hydroxyphenyl)-3-phenyl Cyclopropane and Z-1,1-Dichloro-2-[4-(2-dimethylaminoethoxy)phenyl]-2-(4-chlorophenyl)-3-phenyl Cyclopropane
Authors: Singh Satendra , Magarian Robert A
Published: April 2006

The synthesis of title compounds is described. The key steps in the synthesis are the preparation of the pure Z-ethene, the stereospecific addition of dichlorocarbene, amino-dehalogenation and deprotection of the phenol. Heptafluorotolyl protecting group is used in the synthesis of pure Z-ethene which is stable under basic heterogenous cyclopropanation reaction conditions.
Synthesis and Characterization of (μ-Alkoxo)bis(μ-carboxylato)diruthenium Complexes, Na[Ru2(dhpta)(μ-O2CR)2] (dhptaH5 = 1,3-diamino-2-hydroxypropane tetraacetic acid). A Ruthenium Analogue of Model Systems for Iron-oxo Proteins
Authors: Tanase Tomoaki , Kato Masako , Yamada Yasuko , Tanaka Keiko , Lee Keomil , Sugihara Yoshikazu , Ichimura Akio , Kinoshita Isamu , Haga Masaaki , Sasaki Yoichi , Yamamoto Yasuhiro , Nagano Tetsuo , Yano Shigenobu
Published: April 2006

The first ruthenium analogue of hemerythrin models with μ-alkoxo bridging, Na[Ru(dhpta)(μ-O2CR)2] (1: R = CH3, 2: R = C6H5, 3: R = C6H4-p-OH, 4: R = C6H4-p-NH2) have been prepared and characterized, and the crystal structure of 1 has been determined; these compounds undergo two one-electron reductions to the RuIIRuIII and RuIIRuII states with large separations (∼0.6 V) between the successive redox potentials, allowing the formation of stable mixed-valence species.
Selective Oxidation of Methane to Methanol over FePO4 Using N2O and H2 at Low Temperatures
Authors: Wang Ye , Otsuka Kiyoshi
Published: April 2006

Methane could selectively be converted to methanol with N2O over iron phosphate (FePO4) catalyst. Addition of hydrogen enhanced the conversion of methane and the yield of methanol. The formation of CH3OH initiated at ≥523 K and the one-pass yield for the sum of CH3OH and HCHO reached 5.3% at 723 K in the presence of hydrogen. A monoatomic oxygen species formed on FePO4 surface was suggeted to be responsible for this active and selective oxidation of methane.
[6,6-Di(5-methylthiophen-2-yl)-2,5-dimethylene-2,5-dihydrothiophene] diylium Derivatives. Stable Trimethylenemethane Dications Extended with Thiophenes
Authors: Kawase Takeshi , Wei Chuanxi , Ueno Nobuhiko , Oda Masaji
Published: April 2006

Trimethylenemethane dication derivatives extended with thiophenes are synthesized as stable substances by acid treatment of the precursor diols, showing highly tetrapolar properties and four-stage redox properties with two-electron transfer for each stage.
Facile Reduction of Dichloro(phthalocyaninato)antimony(V) Cation
Authors: Kagaya Yutaka , Isago Hiroaki
Published: April 2006

Antimony(V)-phthalocyanine, [Sb(pc)Cl2]+ (where pc2− = phthalocyaninate, C32H16N82−), has been prepared and characterized for the first time. Of the metallophthalocyanines without any substituent groups so far reported, it has the Q-band at the longest wavelength and the smallest first ring-reduction potential.
Construction of Functionalized Dolabellane Framework via the Stereocontrolled Cope Rearrangement of a 1,3,2-Dioxasilacycloheptane Derivative
Authors: Kato Nobuo , Higo Atsushi , Nakanishi Kohji , Wu Xue , Takeshita Hitoshi
Published: April 2006

Dolabellane, a biogenetic precursor of fusicoccane and dolastane diterpenoids, was constructed stereoselectively via Cope rearrangement of an appropriately functionalized 1,3,2-dioxasilacycloheptane derivative to generate the trans-geometry at C-1 and C-12.
A New Series of Water-Soluble Platinum(II) Complexes Stabilized with Trimethylarsane. Their Synthesis, Crystal Structures, and Solution Equilibria
Authors: Miyamoto T Ken
Published: April 2006

A series of water-soluble platinum(II) complexes stabilized with trimethylarsane were synthesized for the first time. Crystal structures of the complexes, e.g., cis-[Pt(NO3)2(AsMe3)2], cis-[Pt(OH)(AsMe3)2]2(NO3)2, cis-[Pt(OH)2(AsMe3)2]·5H2O (where Me = methyl; ox = oxalato), were determined by X-ray diffraction method. The 13C NMR spectroscopy demonstrated the solution equilibria among these species.
Fabrication of Non-woven Mats of Gelatin/Poly(l-lactic acid) Composites by Electrospinning and Their Application for Scaffold of Cell Proliferation
Authors: Moon Young Sun , Uyama Hiroshi , Inoue Sachiko , Tabata Yasuhiko
Published: April 2006

Nanofiber non-woven mats of gelatin/poly(l-lactic acid) composites were fabricated by electrospinning. The mechanical strength of the composite mats was much larger than that of the gelatin nanofiber mat. Mesenchymal stem cells adhered and proliferated well on the present composite mats.
The productive performance of public hospital clinics in Greece: a case study
Authors: Lyroudi K , Glaveli N , Koulakiotis A , Angelidis D
Published: April 2006

One of the most important and crucial issues for political and social reasons in Greece is the reorganization of the public sector health system - more precisely, the improvement of public hospital operations, both in terms of the resources they use and the quality and quantity of the services they provide. This study focuses on investigating the productivity performance of 10 clinics in a public hospital located in Thessaloniki. The methodology applied is the data envelopment analysis (DEA) to measure the Malmquist productivity index. The results indicated that the efficiency of the hospital clinics has improved. However, clinics' efficiency varies a lot from month to month. In a competitive environment, these differences need to be addressed, investigated and reduced in order to improve total efficiency.
Hospital responses to pay-for-performance incentives
Authors: Reiter Kristin L , Nahra Tammie A , Alexander Jeffrey A , Wheeler John RC
Published: April 2006

Not-for-profit hospitals are complex organizations and, therefore, may face unique challenges in responding to financial incentives for quality. In this research, we explore the types of behavioural changes made by not-for-profit Michigan hospitals in response to a pay-for-performance system for quality. We also identify factors that motivate or facilitate changes in effort. We apply a conceptual framework based on agency theory to motivate our research questions. Using data derived from structured interviews and surveys administered to 86 hospitals participating in a pay-for-performance system, we compare hospitals reporting and not reporting behavioural changes. Separate analyses are performed for hospitals reporting structure-related changes and hospitals reporting process-related changes. Our findings confirm that hospitals respond to incentive payments; however, our findings also reveal that hospital responses are not universal. Rather, involvement by boards of trustees, willingness to exert leverage with physicians, and financial and competitive motivations are all associated with hospitals' behavioural responses to incentives. Results of this research will help inform payers and hospital managers considering the use of incentives about the nature of hospitals' responses.
Developing the electronic health record: what about patient safety?
Authors: Boaden Ruth , Joyce Paul
Published: April 2006

This paper examines the development of electronic health records within the National Health Service (NHS) by an analysis of a series of pilot projects funded by the Electronic Record Development and Implementation Project (ERDIP), one aspect of the work of the NHS Information Authority (NHSIA) (As of 1 April 2005, the NHSIA ceased to operate. Much of its work is continued by Connecting for Health and the Health and Social Care Information Centre.) The focus of the analysis is on the extent to which identifying and correcting error within health records was explored through these projects. The inherent potential for error and resultant impact on patient safety is highlighted, by considering the context of the record, the content of the record and the process of change from paper-based or piecemeal electronic health records to integrated electronic health records. While the process of change highlights issues of data security and access, it is the variability in starting points for different organizations that possibly poses most risk to patient safety. Issues relating to the content of the record can to some extent be minimized by the effective use of technology, but the tension between coding and qualitative data requires further consideration in terms of its impact on patient safety. This paper concludes that the development of electronic health records has to be viewed within the context of governance and patient safety, and the implications articulated.