bluuebunny/crossref_metadata_2025 huggingface dataset:
Conflict, enactment, empowerment: conditions of independent therapeutic nursing intervention
Authors: Kubsch Sylvia M
Published: May 2006

The purpose of this qualitative study was to describe the use of independent therapeutic nursing interventions by registered nurses in a variety of health care delivery agencies The process used to integrate nursing interventions into the daily routines of agencies that did not formally require their use, the conditions in which they were implemented, and the consequences of their use, were examined Data collection methods included observations and interviews of 36 participant nurses, employed in five health care agencies, for 1 year The organizational culture of each environment was observed and its impact on the enactment of independent therapeutic nursing interventions was evaluated Data analysis, done by using the constant comparative method, generated a proposal of a substantive theory that integrates conditions and consequences of therapeutic nursing intervention Intra‐role conflict, the product of incompatible expectations of the professional conception of nursing and task oriented/medically controlled work environments, served as the motivating force behind strategies of enactment utilized to overcome barriers to implement therapeutic nursing interventions As a consequence of using therapeutic nursing interventions, participants perceived empowerment in relation to clients, peers and other health care professionals
Black hair follicular dysplasia in Large Münsterländer dogs: clinical, histological and ultrastructural features
Authors: Von Bomhard Wolf , Mauldin Elizabeth A. , Schmutz Sheila M. , Leeb Tosso , Casal Margret L.
Published: May 2006

Four Large Münsterländer cross‐bred dogs affected with black hair follicular dysplasia (BHFD) and one unaffected control littermate were observed, and skin was sampled weekly over the first 19 weeks of life. Affected dogs were born with silvery grey hair, a consequence of melanin clumping in the hair shafts. Hair bulb melanocytes were densely pigmented, and contained abundant stage IV melanosomes but adjacent matrix keratinocytes lacked melanosomes. Melanin clumping was not prominent in epidermal melanocytes in the haired skin but occurred in the foot pads. Follicular changes progressed from bulbar clumping, clumping in the isthmus/infundibulum and finally to dysplastic hair shafts. Alopecia developed progressively in pigmented areas.

Silver‐grey hair, melanin clumping, accumulation of stage IV melanosomes within melanocytes and insufficient melanin transfer to adjacent keratinocytes are also classic features of human Griscelli syndrome. The underlying cause in Griscelli syndrome is a defect of melanocytic intracellular transport proteins leading to inadequate and disorganized melanosome transfer to keratinocytes with resultant melanin clumping. In view of the correlation in the phenotype, histology and ultrastructure between both disorders, a defect in intracellular melanosome transport is postulated as the pathogenic mechanism in BHFD.
Biological activity, availability and duration of phytotoxicity for imazamox in four different soils of central Italy
Authors: PANNACCI E , ONOFRI A , COVARELLI G
Published: May 2006

Greenhouse bioassays were carried out from 1999 to 2002 on several types of soils of central Italy to assess the carry‐over risk of imazamox residues to non‐target crops. No observable effect levels (NOELs) were determined on quartz sand; sugar beet showed the highest sensitivity to imazamox (NOEL 0.4–0.8 ng a.i. mL−1 of substrate), followed by spinach, oilseed rape, fennel, cauliflower and lettuce (NOELs from 1 to 5 ng a.i. mL−1 of substrate). Wheat, sunflower, grain sorghum and maize were not very sensitive to this herbicide. Imazamox availability was greatest on sandy soils and decreased in soils with high clay or organic carbon content, where herbicide efficiency was less than 50%, with respect to non‐sorptive media. The decline of herbicide efficiency was quick in sandy soils, where herbicide efficiency dropped to 50% in less than 3 days. In clay‐loam or organic soils, 50% relative efficiency was reached in 15–33 days. Such results suggest that imazamox sprayed at normal field application rates can pose slight risks of carry‐over of residues, which may damage very sensitive species (sugar beet, oilseed rape and spinach) in sandy soils. In these cases, safe recropping intervals of 1–3 months are required, so current label guidelines for imazamox are adequate to protect rotational vegetable crops in central Italy.
Effects of host plant genotype and seedbank density on Striga reproduction
Authors: RODENBURG J , BASTIAANS L , KROPFF M J , VAN AST A
Published: May 2006

Prevention of seed input to the seedbank of Striga hermonthica‐infested fields is an important objective of Striga management. In three consecutive years of field experimentation in Mali, Striga reproduction was studied for 10 sorghum genotypes at infestation levels ranging from 30 000 to 200 000 seeds m−2. Host resistance was identified as an important determinant of Striga reproduction, with the most resistant genotypes (N13, IS9830 and SRN39) reducing Striga reproduction by 70–93% compared with the most susceptible genotype (CK60‐B). Seedbank density had a significant effect on Striga seed production. Higher seedbank density resulted in more Striga plants, which led to increased intra‐specific competition and consequently a reduced level of reproduction per plant. For the most susceptible sorghum genotypes, density dependence also occurred in the earlier belowground stages. Striga reproduction continued beyond harvest. At the high infestation level just 8% of the total reproduction was realised after harvest, whereas at the low infestation level 39% was attained after harvest. Even though host‐plant genotype plays a significant role in Striga reproduction, calculations indicated that only at very low infestation levels the use of the most resistant genotype was able to lower the Striga seedbank.
Fusion of CpG‐ODN‐stimulating dendritic cells with Lewis lung cancer cells can enhance anti‐tumor immune responses
Authors: Du Y.‐C. , Lin P. , Zhang J. , Lu Y.‐R. , Ning Q.‐Z. , Wang Q.
Published: May 2006

Immunogenicity of tumor cells is generally weak. Therefore, dendritic cells (DCs) have been used to boost anti‐tumor responses of DC‐based vaccines. DC function is highly dependent on its subsets and the level of its maturation. Nowadays, DC/tumor cell fusion vaccines are already used in clinical trials, and there are numerous studies discussing the effects of cytidine‐phosphate‐guanosine‐containing oligonucleotides (CpG‐ODN) on various cell types including DC. CpG‐ODN a powerful immuno‐stimulant can drive DCs fully mature, thus improve the efficacy of vaccine therapy. There are two simple ways to help load tumor antigens onto DCs by direct contact with cells themselves: fusion or co‐culture of DCs with whole tumor cells. In this study, we combined these two approaches to improve the efficacy of DC/tumor cell‐based vaccine. Mature DCs are adept at presenting processed Ag to T cells with loss of its capacity to capture Ag, while immature DCs are on the contrary. Our results emphasize the necessity of considering the stage of DC maturation and corresponding choice of tumor antigen delivery when designing approaches for prophylaxis or therapy of tumors using DC‐based immunization protocols. We used CpG‐ODN‐1826‐stimulated mature DCs and non‐CpG‐ODN‐stimulating DCs as sources of tumor antigen carriers to investigate the appropriate Ag‐loading ways between fusion and co‐culture. Our results displayed that DC/tumor vaccine using CpG‐ODN‐stimulating mature DCs fused, not co‐cultured, with tumor cells can generate a consistent and highly effective anti‐tumor immune responses in vivo.
Promoter region ‐318 C/ T and ‐1661 A/G CTLA‐4 single nucleotide polymorphisms and type 1 diabetes in North Indians
Authors: Baniasadi V. , Narain N. , Goswami R. , Das S. N.
Published: May 2006

Single nucleotide polymorphisms (SNPs) of the CTLA‐4 gene have been associated with manifestation of type 1 diabetes in several populations. We assessed the association of five SNPs present in the CTLA‐4 gene [‐318C/T, ‐1661A/G and ‐1722C/T in the promoter region, +49A/G in exon 1 and CT60 in the 3′ untranslated region (UTR) region] with type 1 diabetes in North Indian subjects. Genotyping was performed in the patients (n = 130) and the healthy control (n = 180) subjects by polymerase chain reaction‐fragment length polymorphism analysis using MseI, BbvI, BstEII and NcoI restriction endonucleases for the ‐318, ‐1661, ‐1722, +49 and CT60 SNPs, respectively. The frequency of G alleles at ‐1661 locus was significantly higher in the patient group compared with the control subjects. Although the frequency of T alleles at ‐318 SNP was significantly higher in patients with type 1 diabetes compared with the controls, it did not remain significant after Bonferroni correction for the number of alleles tested. The frequencies of C/T alleles and genotypes at ‐1722C/T and G allele at +49A/G and CT60 SNPs were not significantly different between the patient and the control groups. Of the various possible haplotypes constructed using the five genetic loci tested (‐318, ‐1661, ‐1722, +49, CT60), the frequency of ‘TGTAG’ haplotype was significantly higher in the patients when compared with the controls. The results of the present study indicate that the presence of G allele at ‐1661 locus at the CTLA‐4 gene (IDDM12 locus) is associated with increased susceptibility to type 1 diabetes in North Indians, whereas A allele is protective.
Experimental manipulations of microbial food web interactions in a humic lake: shifting biological drivers of bacterial community structure
Authors: Kent Angela D. , Jones Stuart E. , Lauster George H. , Graham James M. , Newton Ryan J. , McMahon Katherine D.
Published: May 2006

A previous multiyear study observed correlations between bacterioplankton community composition (BCC) and abundance and the dynamics of phytoplankton populations and bacterivorous grazers in a humic lake. These observations generated hypotheses about the importance of trophic interactions (both top‐down and bottom‐up) for structuring bacterial communities in this lake, which were tested using two multifactorial food web manipulation experiments that separately manipulated the intensity of grazing and the composition of the phytoplankton community. Our results, combined with field observations, suggest that a hierarchy of drivers structures bacterial communities in this lake. While other studies have noted links between aggregate measures of phytoplankton and bacterioplankton communities, we demonstrate here correlations between succession of phytoplankton assemblages and BCC as assessed by automated ribosomal intergenic spacer analysis (ARISA). We used a novel approach linking community ARISA data to phylogenetic assignments from sequence analysis of 16S rRNA gene clone libraries to examine the responses of specific bacterial phylotypes to the experimental manipulations. The synchronous dynamics of these populations suggests that primary producers may mediate BCC and diversity through labile organic matter production, which evolves in quality and quantity during phytoplankton succession. Superimposed on this resource‐mediated control of BCC are brief periods of intense bacterivory that impact bacterial abundance and composition.
GENDER AND ETHICS COMMITTEES: WHERE’S THE ‘DIFFERENT VOICE’?
Authors: DICKENSON DONNA
Published: May 2006

Prominent international and national ethics commissions such as the UNESCO International Bioethics Committee rarely achieve anything remotely resembling gender equality, although local research and clinical ethics committees are somewhat more egalitarian. Under‐representation of women is particularly troubling when the subject matter of modern bioethics so disproportionately concerns women’s bodies, and when such committees claim to derive ‘universal’ standards. Are women missing from many ethics committees because of relatively straightforward, if discriminatory, demographic factors? Or are the methods of analysis and styles of ethics to which these bodies are committed somehow ‘anti‐female’? It has been argued, for example, that there is a ‘different voice’ in ethical reasoning, not confined to women but more representative of female experience. Similarly, some feminist writers, such as Evelyn Fox Keller and Donna Haraway, have asked difficult epistemological questions about the dominant ‘masculine paradigm’ in science. Perhaps the dominant paradigm in ethics committee deliberation is similarly gendered? This article provides a preliminary survey of women’s representation on ethics committees in eastern and western Europe, a critical analysis of the supposed ‘masculinism’ of the principlist approach, and a case example in which a ‘different voice’ did indeed make a difference.
LEON GOLDSTEIN AND THE EPISTEMOLOGY OF HISTORICAL KNOWING1
Authors: O'SULLIVAN LUKE
Published: May 2006

Leon Goldstein's critical philosophy of history has suffered a relative lack of attention, but it is the outcome of an unusual story. He reached conclusions about the autonomy of the discipline of history similar to those of R. G. Collingwood and Michael Oakeshott, but he did so from within the Anglo‐American analytic style of philosophy that had little tradition of discussing such matters. Initially, Goldstein attempted to apply a positivistic epistemology derived from Hempel's philosophy of natural science to historical knowledge, but gradually (and partly thanks to his interest in Collingwood) formulated an anti‐realistic epistemology that firmly distinguished historical knowledge of the past not only from the scientific perspective but also from fictional and common‐sense attitudes to the past. Among his achievements were theories of the distinctive nature of historical evidence and historical propositions, of the constructed character of historical events, and of the relationship between historical research and contemporary culture. Taken together, his ideas merit inclusion among the most important twentieth‐century contributions to the problem of historical knowledge.
AGAINST GRANDILOQUENCE
Authors: Dean Carolyn J.
Published: May 2006

Post‐Holocaust: Interpretation, Misinterpretation, and the Claims of History. By Berel Lang
Mitochondrial dysfunction and increased sensitivity to excitotoxicity in mice deficient in DNA mismatch repair
Authors: Francisconi Simona , Codenotti Mara , Toninelli Giulia Ferrari , Uberti Daniela , Memo Maurizio
Published: May 2006

The expression profile in the hippocampus of mice lacking one allele of the MutS homologue (Msh2), gene, which is one of the most representative components of the DNA mismatch repair system, was analysed to understand whether defects in the repair or in response to DNA damage could impact significantly on brain function. The overall results suggested a reduction in mitochondrial function as indicated by gene expression analysis, biochemical and behavioural studies. In the hippocampus of Msh2+/– mice, array data, validated by RT–PCR and western blot analysis, showed reduced expression levels of genes for cytochrome c oxidase subunit 2 (CoxII), ATP synthase subunit β and superoxide dismutase 1. Biochemically, mitochondria from the hippocampus and cortex of these mice show reduced CoxII and increased aconitase activity. Behaviourally, these alterations resulted in mice with increased vulnerability to kainic acid‐induced epileptic seizures and hippocampal neuronal loss. These data suggest that lack of an efficient system involved in recognizing and repairing DNA damage may generate a brain mitochondriopathy.
Abstract no.: 10 DNA fragmentation, but not caspase‐3 activation or PARP‐1 cleavage, combined with macrophage immunostaining as a tool to study phagocytosis of apoptotic cells in situ
Authors: Schrijvers Dorien M. , De Meyer Guido R.Y. , Kockx Mark M. , Herman Arnold G. , Martinet Wim
Published: May 2006

Efficient phagocytosis of cells undergoing apoptosis by macrophages is important to prevent immunological responses and development of chronic inflammatory disorders, such as systemic lupus erythematosus, cystic fibrosis or atherosclerosis. To study phagocytosis of apoptotic cells (AC) by macrophages in tissue, we validated different apoptosis markers (DNA fragmentation, caspase‐3 activation and cleavage of its substrate poly (ADP‐ribose) polymerase‐1) in combination with macrophage immunostaining. Human tonsils were used as a model because they show a high apoptosis frequency under physiological conditions as well as efficient phagocytosis of AC by macrophages. On the other hand, advanced human atherosclerotic plaques were examined since phagocytosis of AC in a plaque is severely impaired. Our results demonstrate that the presence of non‐phagocytized TUNEL‐positive AC represents a suitable marker for poor phagocytosis by macrophages in situ. Other markers for apoptosis, such as cleavage of caspase‐3 or PARP‐1, should not be used to assess phagocytosis efficiency, because activation of the caspase cascade and cleavage of their substrates can occur in AC when they have not yet been phagocytized by macrophages.
Abstract no.: 5 Combined spatiotemporal and motility mapping of the murine small intestine during distension
Authors: Seerden T.C. , Lammers W.J. , Stephen B. , De Man J.G. , De Winter B.Y. , Pelckmans P. A.
Published: May 2006

Background & aim  Since the development of knock out animals, the mouse has emerged as the model species to study GI motility. However, little information is available on the electrical and contractile activities induced by distension in the murine small intestine. In the present study we investigated the electrical and associated motor activity during distension in isolated segments of the murine small intestine.

Methods  Short segments of the murine small intestine were mounted in a Tyrode‐superfused organ bath. Upon distension to 3.0 cmH20 periods of oscillations were generated. The electrical and contractile activities of these oscillations were recorded with a longitudinal row of 16 extracellular electrodes and a digital video camera. The electrodes recorded the slow wave and spike activities. The video camera monitored changes in intestinal configuration. Both signals were analyzed with custom‐developed software. In addition the effect of verapamil (3 × 10−5) and atropine (10−5) were examined.

Results  Distension induced the appearance of oscillatory contractions. Motility analyses revealed that these oscillations propagated. The majority propagated aborally (50%), while others propagated in the oral (33%) or in both directions (17%). The frequencies, velocities and directions of the propagating oscillations were strongly correlated with the frequencies (R = 0.81), velocities (R = 0.83) and directions (R = 1.0) of the electrical slow wave. Atropine (n = 4) and verapamil (n = 4) abolished the propagating oscillations.

Conclusion  The distension induced propagating oscillations are caused by propagating slow waves and its accompanying action potentials. Frequency, direction and velocity of these propagating oscillations are determined by the underlying slow wave activity. These propagating oscillation are cholinergic and calcium‐dependent.
Abstract no.: 6 Gender‐dependent contractile behaviour of aortic segments of apolipoprotein E‐deficient (apoE‐/‐) mice
Authors: Van Assche T. , Fransen P. , Guns P.‐J. , Van Hove C. , Herman A.G. , Bult H.
Published: May 2006

The present study investigated whether the higher contractile behaviour of apoE‐/‐ compared with wild type (wt) C57Bl/6J aortic segments is due to an increased contractile status of the smooth muscle cells or a lower basal relaxant effect of the endothelium. Endothelium‐intact or ‐denuded aortic strips or rings were mounted in a myograph and loaded with fura2‐AM to measure internal calcium (Ca2+i) simultaneously with isometric force. In endothelium‐intact segments, basal Ca2+i was significantly lower in apoE‐/‐ females (n = 7) than in wt females (n = 8), wt males (n = 8) or apoE‐/‐ males (n = 7), i.e. 0.40 ± 0.04 vs. 0.73 ± 0.06, 0.77 ± 0.07 and 0.66 ± 0.09 relative units (340/380 excitation emission ratio). Remarkably, isometric force evoked by 1 μM phenylephrine (PE) was significantly higher in apoE‐/‐ females than in wt females, wt males or apoE‐/‐ males, i.e. 0.59 ± 0.06 vs. 0.18 ± 0.04, 0.20 ± 0.05, and 0.20 ± 0.06 mN/mm, whereas the concomitant PE‐induced Ca2+i increase was similar in all groups. Incubation of apoE‐/‐ strips with NOsynthase inhibitors (300 μM L‐NNA + L‐NAME) increased force in females from 0.61 ± 0.19 to 0.80 ± 0.22 (n = 5) mN/mm (+131%) and in males from 0.37 ± 0.09 to 0.78 ± 0.12 (n = 4) mN/mm (+210%). Experiments in endothelium‐denuded aortic rings revealed that the contractile status of smooth muscle cells in wt and apoE‐/‐ females was not altered, whereas contractility of apoE‐/‐ male rings was even reduced in comparison with wt males. It is concluded that in comparison with wt mice, reduced basal NO levels and not a higher contractile status of the smooth muscle cells is responsible for the higher contractile behaviour of apoE‐/‐ females. In males, the contractile status of the smooth muscle cells seemed to be compromised, but not the basal endothelial cell function.
Abstract no.: 7 Endothelium‐dependent relaxation evoked by ATP and UTP in the aorta of P2Y2‐deficient mice
Authors: Guns P.‐J. D.F. , Van Assche T. , Fransen P. , Robaye B. , Boeynaems J.‐M. , Bult H.
Published: May 2006

Based on pharmacological criteria, we previously suggested that in the mouse aorta endothelium‐dependent relaxation by nucleotides is mediated by P2Y1 (ADP), P2Y2 (ATP) and P2Y6 (UDP) receptors. For UTP it was unclear whether P2Y2, P2Y6 or yet another subtype was involved. Therefore, in view of the lack of selective purinergic agonists and antagonists we used P2Y2‐deficient mice to clarify the action of UTP. Thoracic aorta segments (width 2 mm) of P2Y2‐deficient and wild type (WT) mice were mounted in organ baths to measure isometric force development and intracellular calcium signalling. Relaxations evoked by ADP, UDP and acetylcholine were identical in knockout and WT mice indicating that the receptors for these agonists function normally. P2Y2‐deficient mice showed impaired ATP‐ and ATPγS‐evoked relaxation, suggesting that in WT mice ATP and ATPγS activate predominantly the P2Y2‐subtype. The ATP/ATPγS‐evoked relaxation and calcium signals in the knockout mice were partially rescued by P2Y1, since they were sensitive to 2′‐deoxy‐N6‐methyladenosine3′,5′‐bisphosphate (MRS2179), a P2Y1 selective antagonist. In contrast to ATP, the UTP‐evoked relaxation was not different among knockout and WT mice. Moreover, the action of UTP was not sensitive to MRS2179. Therefore, the action of UTP is probably mediated mainly by a P2Y6 (like) receptor subtype. In conclusion, we demonstrated that ATP‐evoked relaxation of the murine aorta is mainly mediated by P2Y2. But this P2Y2 receptor has apparently no major role in UTP‐evoked relaxation. The vasodilator effect of UTP is probably mediated mainly by a P2Y6 (like) receptor.
Use of Public Health Nurse Competencies to Develop a Childcare Health Consultant Workforce
Authors: Wold Judith Lupo , Gaines Sherry K. , Leary Janie M.
Published: May 2006

ABSTRACT
The purpose of this article is to describe the efforts in the state of Georgia to train public health nurse‐childcare health consultants (PHN‐CCHCs) using the framework of the “Core competencies for public health practice.”

Objectives: The goal of the training was twofold: (1) to prepare a statewide cadre of PHNs as the primary workforce for Georgia's emerging childcare health consultation (CCHC) system and (2) to prepare their district nurse directors to lead and support CCHCs.

Design: Administrators attended a 2‐day workshop followed by access to executive coaching for their management teams. PHNs participated in a three‐phase training program, with phases 1 and 3 offered as 3‐day workshops with field experiences, and phase 2 offered online and as a practicum.

Sample: Forty‐four administrators and over 85 PHN‐CCHCs completed the training.

Results: Graduates of the program reported satisfaction with training and reported the use of PHN core competencies in CCHC. Graduates also found enhanced skills in using core competencies to be applicable to a variety of population‐based practices. Beyond CCHC being instituted in selected health districts, interest in CCHC has occurred statewide.

Conclusions: The PHN‐CCHC program enhanced the knowledge and use of core competencies and heightened interest in CCHC statewide.
Evaluation of a Community‐Based Outreach Worker Program for Children With Asthma
Authors: Primomo Janet , Johnston Sandra , DiBiase Frank , Nodolf Jocelyn , Noren Leanne
Published: May 2006

ABSTRACT
Objective: An asthma outreach worker (AOW) can provide home‐based education about asthma management and methods to minimize home environmental asthma triggers. A theory‐based AOW program was implemented by a community partnership and its effectiveness was evaluated.

Design: Baseline and follow‐up surveys were used to evaluate the effectiveness of the AOW.

Sample: The convenience sample consisted of 60 caregivers whose children received AOW services.

Measures: Quality of life, use of asthma management plans, medication use, health care utilization, home environmental behavior changes to reduce triggers, and satisfaction with AOW services were self‐reported by caregivers.

Results: Caregivers reported significantly higher quality of life at follow‐up than at baseline. At follow‐up, 93% of the children had asthma management plans as compared with 31% at baseline. Self‐reported hospitalizations were significantly reduced. All of the families made changes to minimize household asthma triggers. Caregivers reported high satisfaction with the AOW and 90% of them felt that the home environmental assessment conducted by the AOW helped improve their child's asthma.

Conclusion: Short‐term community‐based AOW services for children can be effective in enhancing self‐management capabilities, improving the quality of life, increasing the use of asthma management plans, and helping families reduce asthma triggers in the home environment.
Replicating the Hospital Elder Life Program in a Community Hospital and Demonstrating Effectiveness Using Quality Improvement Methodology
Authors: Rubin Fred H. , Williams Jennifer T. , Lescisin Dianne A. , Mook William J. , Hassan Shuja , Inouye Sharon K.
Published: May 2006

OBJECTIVES: To evaluate a replication of the Hospital Elder Life Program (HELP), a quality‐improvement model, in a community hospital without a research infrastructure, using administrative data.

DESIGN: A pretest/posttest quality‐improvement study.

SETTING: A 500‐bed community teaching hospital in western Pennsylvania.

PARTICIPANTS: Four thousand seven hundred sixty‐three hospitalized patients aged 70 and older admitted to one nursing unit over 3.5 years.

INTERVENTION: Application of the HELP multicomponent intervention targeting patients at risk for delirium.

MEASUREMENTS: A proxy measure for delirium was developed using administrative data to calculate delirium rate and differences in variable costs of care and length of stay for patients before and after the intervention. Similar calculations were used in delirious patients for variable costs and length of stay before and after the intervention. Satisfaction surveys were administered to nursing staff and patient families before and after the intervention.

RESULTS: The intervention reduced the absolute rate of delirium according to proxy report 14.4% from baseline, which represented a relative reduction in risk of 35.3% (P=.002). Total costs on this 40‐bed nursing unit were reduced $626,261 over 6 months. Satisfaction of nursing staff and families was high in the intervention group. In addition, the intervention showed sustained benefits over time and remains funded by the hospital.

CONCLUSION: HELP can be successfully replicated in a community hospital, yielding clinical and financial benefits.
Identification of a novel A1v‐O1v hybrid allele with G829A mutation in a chimeric individual of AelBel phenotype
Authors: Sun Chien‐Feng , Chen Ding‐Ping , Tseng Ching‐Ping , Wang Wei‐Ting , Liu Jui‐Ping
Published: May 2006

BACKGROUND:  Many A and B suballeles responsible for ABO subgroup formation have been identified. Some of these minor alleles have mutations in the ABO gene coding sequence. Most of these mutations are due to single‐nucleotide substitution and lead to amino acid alteration. Several alleles at the ABO locus appear to be caused by crossing over between dissimilar alleles.

STUDY DESIGN AND METHODS:  Blood samples were collected from an individual with AelBel phenotype and her family members. Sequencing of the seven ABO exons was performed on these samples. The following was performed for the samples from the AelBel proposita: cloning and sequencing of the genomic DNA of the ABO gene, reverse transcription–polymerase chain reaction (PCR) analysis of cDNA transcript of the ABO gene, sequence‐specific priming (SSP)‐PCR analysis and direct sequencing of the ABO gene, SSP‐PCR DNA typing of generic HLA‐ABC and HLA‐DRB, and short‐tandem repeat (STR)‐PCR typing on 15 autosomal, 2 X‐chromosomal, and 6 Y‐chromosomal loci.

RESULTS:  The proposita with AelBel phenotype has blood group chimerism with a major group of A1v‐O1v/O1(O01) and a minor group of B(B101)/O1v(O02). Additional haplotypes on HLA‐ABC, HLA‐DR‐B, STR loci, and Y‐chromosome STR loci were present on the proposita. The paternal genotype is B(B101)/O1(O01) and the maternal genotype is A1v(A102)/O1v(O02). No other siblings have the A1v‐O1v hybrid allele. Parentage was confirmed with the paternity STR‐PCR test. Full‐length cDNA transcripts of the B(B101) allele and alternately spliced cDNA transcripts of the hybrid A1v‐O1v, O1, and O1v alleles were cloned from the proposita. The A1v‐O1v hybrid gene contains two missense mutations: C467T and G829A, resulting in Pro156Leu and Val277Met substitution.

CONCLUSION:  Formation of the A1v‐O1v hybrid allele appears to result from de novo recombination in the germ line of the mother during meiosis. G829A with Val277Met appears to be responsible for the decrease in A‐transferase activity and Ael phenotypic expression in the proposita. The chimeric minor population of B(B101)/O1v is responsible for Bel phenotypic expression in the proposita.
Overexpression of transforming growth factor‐β1 in teeth results in detachment of ameloblasts and enamel defects
Authors: Haruyama Naoto , Thyagarajan Tamizchelvi , Skobe Ziedonis , Wright J. Tim , Septier Dominique , Sreenath Taduru L. , Goldberg Michel , Kulkarni Ashok B.
Published: May 2006

Transforming growth factor‐β1 (TGF‐β1) is a key regulator of many cellular processes, including cell adhesion, the immune response and synthesis of extracellular matrix proteins. In the present study, we report the characterization of enamel defects in a transgenic mouse model overexpressing TGF‐β1 in odontoblasts and ameloblasts, its expression being driven by the promoter sequences of the dentin sialophosphoprotein gene. As reported earlier, these mice develop distinct dentin defects similar to those seen in human dentin dysplasia and dentinogenesis imperfecta. A further detailed examination of enamel in these mice revealed that from the early secretory stage, ameloblasts began to detach from dentin to form cyst‐like structures. A soft X‐ray analysis revealed that this cyst‐like structure had a disorganized and partially mineralized matrix with an abnormal mineralization pattern and a globular appearance. In the molars, the enamel was not only pitted and hypoplastic, but enamel rods were completely lost. Thus, altered TGF‐β1 expression in the tooth seems to trigger detachment of ameloblasts and abnormal secretion and deposition of minerals in the cyst‐like structures adjoining the dentin. We speculate that the altered expression of TGF‐β1 in teeth impacts the adhesion process of ameloblasts to dentin.
Mutational analysis of candidate genes in 24 amelogenesis imperfecta families
Authors: Kim Jung‐Wook , Simmer James P. , Lin Brent P.‐L. , Seymen Figen , Bartlett John D. , Hu Jan C.‐C.
Published: May 2006

Amelogenesis imperfecta (AI) is a heterogeneous group of inherited defects in dental enamel formation. The malformed enamel can be unusually thin, soft, rough and stained. The strict definition of AI includes only those cases where enamel defects occur in the absence of other symptoms. Currently, there are seven candidate genes for AI: amelogenin, enamelin, ameloblastin, tuftelin, distal‐less homeobox 3, enamelysin, and kallikrein 4. To identify sequence variations in AI candidate genes in patients with isolated enamel defects, and to deduce the likely effect of each sequence variation on protein expression and structure, families with isolated enamel defects were recruited. The coding exons and nearby intron sequences were amplified for each of the AI candidate genes by using genomic DNA from the proband as template. The amplification products for the proband were sequenced. Then, other family members were tested to determine their genotype with respect to each sequence variation. All subjects received an oral examination, and intraoral photographs and dental radiographs were obtained. Out of 24 families with isolated enamel defects, only six disease‐causing mutations were identified in the AI candidate genes. This finding suggests that many additional genes potentially contribute to the etiology of AI.
Proteomic analysis of enamel matrix using a two‐dimensional protein fractionation system
Authors: Yamakoshi Yasuo , Hu Jan C.‐C. , Zhang Hengming , Iwata Takanori , Yamakoshi Fumiko , Simmer James P.
Published: May 2006

Our objectives in this study were to perform separate proteomic analyses of porcine soft and hard enamel matrices, using the ProteomeLab PF‐2D System, to compare the contents of the hard and soft enamel and to identify matrix constituents that are absent from the early maturation stage. Developing first permanent molars were dissected from 6‐month‐old pigs. Both immature and mature enamel samples were obtained by scraping the secretory‐stage (soft) and maturation‐stage (hard) enamel, respectively. Enamel matrix samples were sequentially extracted and fractionated with 50 mM phosphate buffer (pH 7.4) and then with 50 mM carbonate buffer (pH 10.8). The neutral enamel extract was separated into four fractions by successive ammonium sulfate precipitations. The alkaline enamel extract was separated into four fractions by ion‐exchange chromatography. These eight extracts from both the soft and hard enamel were injected for chromatofocusing. Soft enamel fractions containing constituents absent from the hard enamel were further separated by reverse‐phase high‐performance liquid chromatography. The major soft enamel constituents absent from the hard enamel were acidic glycoproteins, corresponding to the 32‐kDa enamelin, and the 29‐, 27‐, 15‐, 13‐, 8‐ and 6‐kDa C‐terminal fragments of ameloblastin. Loss of these glycoproteins is associated with a post‐transition increase in enamel mineralization.
Porcine SPARC: isolation from dentin, cDNA sequence, and computer model
Authors: Chun Yong‐Hee P. , Yamakoshi Yasuo , Kim Jung‐Wook , Iwata Takanori , Hu Jan C‐C. , Simmer James P.
Published: May 2006

Genes encoding the major enamel matrix proteins and non‐collagenous proteins of bone and dentin are members of the secretory calcium‐binding phosphoprotein (SCPP) family, which originated from ancestral SPARC (secreted protein, acidic and rich in cysteine; BM‐40/osteonectin). To better understand the role of SPARC in mineralizing systems, we isolated SPARC from developing pig teeth, deduced its primary structure from the cDNA sequence, and determined its quaternary structure by homology modelling with reference to human SPARC crystal structures. The guanidine/EDTA extract from porcine dentin was fractionated by anion‐exchange and size‐exclusion chromatography. Stains‐all positive bands at 38 and 35 kDa gave the N‐terminal sequences APQQEALPDETEV and DFEKNYNMYIFPV, which corresponded to the SPARC N terminus and an internal region of the protein. Porcine SPARC contains 300 amino acids, including the 17‐amino acid signal peptide, and shares 96.2% amino acid sequence identity with human SPARC. Without post‐translational modifications, the 283‐amino acid secreted protein has a molecular mass of 32.3 kDa. The three‐dimensional model revealed that porcine SPARC contains a single N‐linked glycosylation at N113, seven intramolecular disulfide bridges, and assembles into dimers. SPARC is composed of three structural/functional domains: an acidic Ca2+‐binding, a follistatin‐like, and an extracellular calcium‐binding domain.
Formation of the dentino–enamel interface in enamelysin (MMP‐20)‐deficient mouse incisors
Authors: Beniash Elia , Skobe Ziedonis , Bartlett John D.
Published: May 2006

An anomalous dentino–enamel junction (DEJ), manifested by delamination of the enamel layer, was reported in enamelysin [matrix metalloproteinase‐20 (MMP‐20)] knockout (KO) mice. To better understand the possible role of MMP‐20 in the formation of the DEJ, we performed transmission electron microscopy (TEM) studies of the DEJ at early stages of tooth morphogenesis in KO mice. Our TEM analysis revealed that in the incisors from KO mice the mantle dentin is hypomineralized at the onset of enamel mineralization. At this early stage, TEM revealed no apparent differences in nascent aprismatic enamel between the KO mice and the controls. Hypomineralized mantle dentin was also observed in the incisors from KO mice, as assessed by back‐scattered SEM at the secretory and early maturation stages, but not in the late‐maturation stage, suggesting that the mineralization of mantle dentin is not completely arrested, but rather postponed. Histological studies indicate that the organic content in the initial enamel layer remains very high throughout amelogenesis. These results imply that MMP‐20 is involved in the regulation of mineralization in mantle dentin and demonstrate the complex nature of DEJ formation. They also suggest that the structural and functional properties of the DEJ are determined during the initial mineralization stages.
The amelogenin story: origin and evolution
Authors: Sire Jean‐Yves , Delgado Sidney , Girondot Marc
Published: May 2006

Genome sequencing and gene mapping have permitted the identification of HEVIN (SPARC‐Like1) as the probable ancestor of the enamel matrix proteins (EMPs), amelogenin (AMEL), ameloblastin (AMBN) and enamelin (ENAM). We have undertaken a phylogenetic analysis to elucidate their relationships. AMEL genes available in databases, and new sequences obtained in blast searching genomes or expressed sequence tags, were compiled (22 full‐length sequences), aligned, and the ancestral sequence calculated and used to search for similarities using psi‐blast. Hits were obtained with the N‐terminal region of AMBN, ENAM, and HEVIN. We retrieved all available AMBN (n = 8), ENAM (n = 3), and HEVIN (n = 4) sequences. The sequences of the four proteins were aligned and analyzed phylogenetically. AMEL and AMBN are sister genes, which diverged after duplication of a common ancestor issued from ENAM. The latter derived from a copy of HEVIN. Comparisons of gene organization, amino acid sequences and location of ENAM and AMBN, adjacent on the same chromosome, suggest that AMBN is closer to ENAM than AMEL. This supports AMEL as being derived from AMBN duplication. This duplication occurred long before tetrapod differentiation, probably in an ancestral osteichthyan. The story of AMEL origin is completed as follows: SPARC→HEVIN→ENAM→AMBN→AMEL.
Developmental movements of the inner enamel epithelium as derived from micromorphological features
Authors: Radlanski Ralf J. , Renz Herbert
Published: May 2006

It was the purpose of this article to analyze the (micro) morphological structure of enamel at different stages of development in order to deduce movement patterns of ameloblasts during formation of the human dental primordium. Developing enamel and overlying ameloblasts were dried and fractured for scanning electron microscopy (SEM) and sectioned for transmission electron microscopy (TEM). Specimens of human permanent enamel were either fractured and/or ground and etched to visualize the enamel rods. All specimens were viewed by SEM. Moreover, three‐dimensional reconstructions were made from serial ground sections of enamel blocks to follow the enamel rods for a longer distance. In addition, the outline of the dentino–enamel junction was analyzed under the SEM after removal (using nitric acid) of the enamel cap, and in serial histological sections. Two basic movements of the inner enamel epithelium can be derived from the micromorphological features: (i) the scalloped dentino–enamel junction may be a consequence of a bulged inner enamel epithelium owing to initial spatial impediment; and (ii) the undulating path of the enamel rods may be a consequence of unequal growth of the cells in the cervical loop.
Identification of secreted and membrane proteins in the rat incisor enamel organ using a signal‐trap screening approach
Authors: Moffatt Pierre , Smith Charles E. , Sooknanan Roy , St‐Arnaud René , Nanci Antonio
Published: May 2006

The secretome represents the subset of proteins that are targeted by signal peptides to the endoplasmic reticulum. Among those, secreted proteins play a pivotal role because they regulate determinant cell activities such as differentiation and intercellular communication. In calcified tissues, they also represent key players in extracellular mineralization. This study was carried out to establish a secretome profile of rat enamel organ (EO) cells. A functional genomic technology, based on the signal trap methodology, was applied, starting with a library of 5′‐enriched cDNA fragments prepared from rat incisor EOs. A total of 2,592 clones were analyzed by means of macroarray hybridizations and DNA sequencing. Ninety‐four unique clones encoding a signal peptide were retrieved. Among those were 84 matched known genes, many not previously reported to be expressed by the EO. Most importantly, 10 clones were classified as being novel, with EO‐009 identified as the rat homolog of human APin protein. These data indicate that many secreted and membrane‐embedded EO proteins still remain to be identified, some of which may play crucial roles in regulating processes that create an optimal environment for the formation and organization of apatite crystals into a complex three‐dimensional calcified matrix.
Dynamic light scattering study of an amelogenin gel‐like matrix in vitro
Authors: Petta Vassiliki , Moradian‐Oldak Janet , Yannopoulos Spyros N. , Bouropoulos Nikolaos
Published: May 2006

Amelogenin self‐assembly is critical for the structural organization of apatite crystals during enamel mineralization. The aim of the present study was to investigate the influence of temperature and protein concentration on the aggregation of amelogenin nanospheres at high protein concentrations (> 4.4 mg ml−1) in order to obtain an insight into the mechanism of amelogenin self‐assembly to form higher‐order structures. Amelogenins were extracted from enamel scrapings of unerupted mandibular pig molars. The dynamics of protein solutions were measured using dynamic light scattering (DLS) as a function of temperature and at acidic pH. At pH 4–5.5, three kinds of particles were observed, ranging in size from 3 to 80 nm. At pH 6, heating the solution above ≈ 30°C resulted in a drastic change in the solution transparency, from clear to opaque. Low pH showed no aggregation effect, whilst solutions at a slightly acidic pH exhibited diffusion dynamics associated with the onset of aggregation. In addition, at the same temperature range, the hydrodynamic radii of the aggregates increased drastically, by almost one order of magnitude. These observations support the view that hydrophobic interactions are the primary driving force for the pH‐ and temperature‐sensitive self‐assembly of amelogenin particles in a ‘gel‐like’ matrix. The trend of self‐assembly in a ‘gel‐like matrix’ is similar to that in solution.
Influence of rotating–oscillating, sonic and ultrasonic action of power toothbrushes on abrasion of sound and eroded dentine
Authors: Wiegand A. , Lemmrich F. , Attin T.
Published: May 2006

Objective:  This in vitro study aimed to evaluate the susceptibility of sound and eroded dentine to brushing abrasion performed by different rotating–oscillating, sonic and ultrasonic toothbrushes.

Methods:  Toothbrushing abrasion (20 cycles, each 30 s) was applied to bovine dentine samples (each subgroup n = 10) exhibiting both a demineralized (each cycle: 1% citric acid, pH: 2.3, 60 s; 30 min remineralization in artificial saliva) and a sound surface area. Toothbrushing was performed in an automatic brushing machine with the rotating–oscillating, sonic and ultrasonic toothbrushes either (a) activated, supplemented by 20 strokes/min of the brushing machine, (b) inactivated, supplemented by 20 strokes/min of the brushing machine or (c) inactivated, supplemented by 80 strokes/min of the brushing machine. A manual toothbrush was applied with 20, 80 or 100 linear strokes/min. Specimens of the control group were not brushed after erosion. After each cycle, the samples were stored in artificial saliva for 4 h. After 20 cycles, loss of sound and softened dentine was determined by profilometry. Mann–Whitney–Wilcoxon test and Bonferroni corrections were applied to the data (p < 0.05).

Results:  For all groups, demineralized dentin areas exhibited significantly higher abrasion values than the respective sound dentine surfaces. However, mean dentine loss of both softened and sound dentine was higher after use of the rotating–oscillating, sonic and ultrasonic brushes with the activated regime [(a) eroded dentine: 9.94–16.45 µm; sound dentine: 3.31–5.47 µm] than after brushing with the inactivated regimes [(b) eroded dentine: 5.10–5.62 µm; sound dentine: 1.16–1.81 µm; (c) eroded dentin: 7.64–8.89 µm; sound dentine: 1.38–1.69 µm].

Conclusion:  The results indicate that rotating–oscillating, sonic or ultrasonic action of the power toothbrushes leads to an increased loss of demineralized and sound dentine.