bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of Government policy in supporting nurse‐led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review
Authors: Hoare Karen J. , Mills Jane , Francis Karen
Published: November 2011

hoare k.j., mills j. & francis k. (2011) The role of government policy in supporting nurse‐led care in general practice in the United Kingdom, New Zealand and Australia: an adapted realist review. Journal of Advanced Nursing 68(5), 963–980.

Aim.  This article is a report on a review that examined the role of Government policy in primary care and its association with nurse‐led care in the United Kingdom, New Zealand and Australia between 1998 and 2009.

Background.  The United Kingdom, New Zealand and Australia share a similar model of first point access to the healthcare system via general practitioners. General practice is synonymous with the term primary care.

Data sources.  Medline, CINAHL, EMBASE, Scopus, PsychInfo, Google, Department of Health, England (United Kingdom), Ministry of Health, New Zealand, Department of Health and Ageing, Australia. Searches of electronic databases from 1998 to December 2009 and hand searches of identified leads and key journals. Historical papers accessed to describe the genesis of practice nursing and historical Government policy documents prior to 1998, were examined.

Review methods.  A modified realist review was used to synthesize research and policy documents relating to government policies pertaining to nurse‐led care. In addition, a systematic review was used to identify literature that described practice nurse‐led care.

Results.  Nurse‐led primary care services are well described in the United Kingdom with a total of 45 studies meeting the inclusion criteria for the second review. There are no published studies from New Zealand, and only two from Australia describing nurse‐led primary care.

Conclusion.  New Zealand and Australia lag behind the United Kingdom in practice nurse development. Implementation of clinical governance was fundamental to the development of nurse‐led care in the UK.
Patients of parish nurses experience renewed spiritual identity: a grounded theory study
Authors: Van Dover Leslie , Pfeiffer Jane
Published: November 2011

van dover l. & pfeiffer j. (2011) Patients of parish nurses experience renewed spiritual identity: a grounded theory study. Journal of Advanced Nursing68(6), 1824–1833.

Aim.  This article is a report of a study of the process that patients of parish nurses experience when they are provided spiritual care in Christian churches, a context where patients and nurses share a common set of values.

Background.  Many studies have explored hospitalized patients’ views and experiences of spiritual care. However, little is known about the spiritual changes that patients experience as they receive care from parish nurses.

Methods.  The grounded theory method was used to explore what patients of the parish nurses experienced in spiritual care. Half of the participants were interviewed in 1999–2001 at the time of the parish nurse interviews, and half in 2005. Audiotapes were transcribed verbatim. Constant comparative methods were used to analyse the incidents of receiving spiritual care.

Findings.  Theoretical memos described how the ‘main concern’ of the patients to resolve their health challenge resulted in changes to their spiritual identity. Phases in the change process included: facing a health challenge, finding a safe place, releasing burdens, changing perspectives and joining or rejoining the family of faith. The essence the patients experienced was an enhanced understanding of who they were in God/Christ.

Conclusion.  The patient’s spiritual challenge is to re‐conceptualize the self (as one who is known and loved by God) in the context of a particular health challenge. Spiritual care helps them find a new equilibrium in faith.
Small CAB‐like proteins prevent formation of singlet oxygen in the damaged photosystem II complex of the cyanobacterium Synechocystis sp. PCC 6803
Authors: SINHA RAKESH KUMAR , KOMENDA JOSEF , KNOPPOVÁ JANA , SEDLÁŘOVÁ MICHAELA , POSPÍŠIL PAVEL
Published: November 2011

The cyanobacterial small CAB‐like proteins (SCPs) are single‐helix membrane proteins mostly associated with the photosystem II (PSII) complex that accumulate under stress conditions. Their function is still ambiguous although they are assumed to regulate chlorophyll (Chl) biosynthesis and/or to protect PSII against oxidative damage. In this study, the effect of SCPs on the PSII‐specific light‐induced damage and generation of singlet oxygen (1O2) was assessed in the strains of the cyanobacterium Synechocystis sp. PCC 6803 lacking PSI (PSI‐less strain) or lacking PSI together with all SCPs (PSI‐less/scpABCDE‐ strain). The light‐induced oxidative modifications of the PSII D1 protein reflected by a mobility shift of the D1 protein and by generation of a D1‐cytochrome b‐559 adduct were more pronounced in the PSI‐less/scpABCDE‐ strain. This increased protein oxidation correlated with a faster formation of 1O2 as detected by the green fluorescence of Singlet Oxygen Sensor Green assessed by a laser confocal scanning microscopy and by electron paramagnetic resonance spin‐trapping technique using 2, 2, 6, 6‐tetramethyl‐4‐piperidone (TEMPD) as a spin trap. In contrast, the formation of hydroxyl radicals was similar in both strains. Our results show that SCPs prevent 1O2 formation during PSII damage, most probably by the binding of free Chl released from the damaged PSII complexes.
Chronic cigarette smoking in alcohol dependence: associations with cortical thickness and N‐acetylaspartate levels in the extended brain reward system
Authors: Durazzo Timothy C. , Mon Anderson , Gazdzinski Stefan , Meyerhoff Dieter J.
Published: November 2011

Chronic smoking in alcohol dependence is associated with abnormalities in brain morphology and metabolite levels in large lobar regions (e.g. frontal lobe). Here, we evaluated if these abnormalities are specifically apparent in several cortical and select subcortical components of the extended brain reward system (BRS), a network that is critically involved in the development and maintenance of all forms of addictive disorders. We studied 33 non‐smoking and 43 smoking alcohol‐dependent individuals (ALC) with 1 week of abstinence and 42 non‐smoking Controls. At 1.5 Tesla, we obtained regional measures of cortical thickness and N‐acetylaspartate (NAA; a surrogate marker of neuronal integrity) concentration in major components of the BRS as well as the corresponding measures throughout the cortex. Smoking ALC and non‐smoking ALC demonstrated decreased thickness compared with Controls in the dorsolateral prefrontal cortex (DLPFC), insula, orbitofrontal cortex (OFC), the total BRS, total frontal cortex and global cortex. Smoking ALC had significantly decreased thickness compared to non‐smoking ALC in the ACC, insula, the total BRS and total frontal cortex. Smoking ALC had also lower NAA concentrations than both non‐smoking ALC and Controls in the DLPFC, insula, superior corona radiata and the total BRS. Alcohol consumption and common medical and psychiatric co‐morbidities did not mediate differences between smoking and non‐smoking ALC. This dual modality magnetic resonance (MR) study indicated that chronic smoking in ALC was associated with significant cortical thinning and NAA abnormalities in anterior brain regions that are implicated in the development and maintenance of addictive disorders.
Developing written information on osteoarthritis for patients: facilitating user involvement by exposure to qualitative research
Authors: Grime Janet , Dudley Brian
Published: November 2011

Introduction  In developing a guidebook on osteoarthritis (OA), we collaborated with people who have chronic joint pain (users). But to advise, users need to be aware of and sensitive about their own state of knowledge and educationalists argue that adults sometimes lack such awareness. This paper will report on our experience of providing users with findings from qualitative research to increase awareness of their level of knowledge.

Method  A summary of the results from qualitative research into people’s experiences of living with chronic pain was sent to individual members of two groups of users. It was then used to structure group meetings held to help identify information needed for the guidebook.

Findings  Some users found the summary difficult to read and suggested how to simplify it. Nevertheless, it helped most users to become aware of the experiences and views of others who have OA and thus become more sensitive to their own level of knowledge. It also helped them recall experiences that stimulated practical suggestions for managing joint pain in everyday life and provided a way of gently challenging the views of users when they appeared to assume that their views were widely held. The discussions brought to light gaps in the research literature.

Conclusion  We believe this way of involving users by exposing them to qualitative research findings about lay experiences of living with OA effectively facilitated the users’ contributions to the needs of those who have to live with OA, and we believe it has wider applications.
Thoraco‐Omphalopagus Conjoined Twins in Chamois‐Coloured Domestic Goat Kids
Authors: Binanti D. , Riccaboni P.
Published: November 2011

With 2 figures

Conjoined twins have been observed in a wide range of mammalian and non‐mammalian species; they are considered to be more common in bovine, less frequent in sheep and pig and extremely rare in horse and goat. A pair of female conjoined twins was delivered from a 2‐year‐old Chamois‐coloured domestic goat. Post‐mortem examination revealed two identical and symmetrical twins, fused from the manubrium sterni to the region just caudal to the umbilicus. The rib cages were conjoined in the ventral plane with a single set of pericardial, pleural and peritoneal cavities. Internal examination revealed the presence of a common diaphragm and a single enlarged liver. Within a single central pericardium, two malformed hearts were present. Reports on this type of congenital duplication in goats have not been found in the literature. Thoracopagus and thoraco‐omphalopagus are the most common types of conjoined twins in human beings and are associated with the highest mortality because of the frequent incidence of complex cardiac anatomy.
Indirect evidence for microbiota reduction through dietary mannanoligosaccharides in the pigeon, an avian species without functional caeca
Authors: Abd El‐Khalek E. , Kalmar I. D. , De Vroey M. , Ducatelle R. , Pasmans F. , Werquin G. , Janssens G. P. J.
Published: November 2011

A feeding trial was conducted to evaluate the effects of mannanoligosaccharides (MOS) on nutrient digestibility, intestinal pH, gut morphology and faecal bacteriology of pigeons, as model for birds without functional caeca. Sixteen adult pigeons (Columba livia domestica) were randomly allotted to either an extruded pellet diet with or without 0.4% MOS. After an adaptation period of 24 days, excreta were collected during 4 days. Apparent nutrient digestibility coefficients were determined using total collection method. Further, excreta pH was measured and percentage of uric acid determined. Fresh excreta were cultured for measurement of colony‐forming units for Escherichia coli. At the end, the gastrointestinal tract (GIT) was excised and pH measurements performed on the separate GIT sections. Finally, pancreas, liver, gizzard and abdominal fat pad were weighed, and standardised segments of duodenum and jejunum were removed for microscopic measurement of crypt depth, villus height and muscularis thickness. Feed intake and water intake were similar between control diet and MOS diet. Intestinal pH was unaffected by MOS supplementation; however, excreta pH was significantly lower in pigeons on the MOS diet. Although nutrient digestibility was similar between treatments, uric acid content of excreta was significantly higher in the MOS group in relation to the control group. Further, duodenal crypt depth, villus height and muscularis thickness, as well as jejunal muscularis thickness were all significantly reduced by MOS supplementation. No effect of MOS supplementation was seen on the counts of E. coli. Furthermore, despite marked differences on both GIT morphology and uric acid content of excreta, apparent digestibility coefficients, and organ weights, were similar between treatments. It is suggested that the MOS‐induced changes on gut morphology and the reduced excreta pH reflect a reduced bacterial challenge in the intestine of pigeons. Supplementation of MOS, therefore, has potential as prebiotic strategy in birds without functional caeca.
The effect of methyl eugenol exposure on subsequent mating performance of sterile males of Bactrocera dorsalis
Authors: Ji Q. E. , Chen J. H. , McInnis D. O. , Guo Q. L.
Published: November 2011

Methyl eugenol (ME) is ingested and used by several fruit fly species of the genus Bactrocera as a precursor of the sexual pheromone produced by adult males. This can result in an increase in male sexual activity and performance, which is important to the development of an effective sterile insect technique programme in China. The effect of ME on mating competitiveness, multiple mating, and the incidence of female remating were studied in sterile males from a genetic sexing strain of Bactrocera dorsalis (Hendel) irradiated with 100 Gy of 137Cs. The results obtained in field cages showed that feeding on ME did not increase the frequency of multiple mating by sterile males, but significantly increased the mating competitiveness of sterile males against that of semi‐wild males. At the same time, sterile males fed ME did not significantly affect the remating of semi‐wild females 5 days after the initial mating with a semi‐wild male, but the ME‐fed males increased the remating frequency of females 10 and 15 days after the initial mating.
Prenatal high‐dose immunoglobulin treatment for neonatal hemochromatosis: A case report and review of the literature
Authors: Tanaka Hirokazu , Haba Reiji , Itoh Susumu , Sakamoto Haruhiko , Hata Toshiyuki
Published: November 2011

Neonatal hemochromatosis is a difficult disorder to cure, and it has a high rate of recurrence. High‐dose immunoglobulin treatment is very effective as prenatal treatment for recurrent neonatal hemochromatosis. A 34‐year‐old pregnant Japanese woman underwent high‐dose immunoglobulin treatment for recurrent neonatal hemochromatosis. High‐dose non‐specific intravenous immunoglobulin (1 g/kg bodyweight) was administered to the mother intravenously every week from 18 until 36 gestational weeks. A male infant was delivered at 37 weeks of gestation, and his condition was favorable, including hepatic function. The use of γ‐globulin for neonatal hemochromatosis appears adequately validated by experience.
Acne: prevalence and relationship with dietary habits in Eskisehir, Turkey
Authors: Koku Aksu A.E. , Metintas S. , Saracoglu Z.N. , Gurel G. , Sabuncu I. , Arikan I. , Kalyoncu C.
Published: November 2011

Background  Acne vulgaris is a common disease affecting adolescents. There is not comprehensive data on acne prevalence in the Central Anatolia Region in particular. Etiology of acne is not clarified yet. Acne might be related to environmental factors. There is increasing evidence supporting acne and diet relationship.

Objectives  The aim of the study was to determine the acne prevalence in adolescents in the city of Eskisehir, located in the Central Anatolia, Turkey in addition to evaluate factors affecting acne and its relationship with dietary habits.

Methods  A cross‐sectional study was conducted on 2300 participants aged 13–18 years. The participants were asked to complete a questionnaire form consisting information about acne and a questionnaire form consisting information about dietary habits (The Adolescent Food Habits Checklist). In addition an objective evaluation of acne was determined.

Results  The mean age of students with acne was 15.10 ± 1.53. The current acne prevalence was 60.7%. Although 21% of the participants had severe acne (grade 3–4) and 25% developed sequelaes, only 11.5% of all participants consulted a doctor. The participants without acne had healthier dietary habits than participants with acne (P < 0.05). Frequent fat intake (OR = 1.39, 95% CI: 1.06–1.82), frequent sugar intake (OR = 1.30, 95% CI: 1.05–1.60), frequent eating sausages, burgers (OR = 1.24, 95% CI: 1.03–1.48), frequent eating pastries, cakes (OR = 1.20, 95% CI: 1.01–1.43) were associated with increased risk for acne.

Conclusions  Acne prevalence is high among adolescents in Eskisehir but the rate of consulting doctor is low. Increasing public awareness is critical for convincing adolescents to seek medical help earlier. Acne was related with dietary habits. Fat, sugar and fast food consumption is found to be positively correlated with acne prevalence.
Atherosclerotic plaques in the internal carotid artery and associations with lung function assessed by different methods
Authors: Frantz Sophia , Nihlén Ulf , Dencker Magnus , Engström Gunnar , Löfdahl Claes‐Göran , Wollmer Per
Published: November 2011

Background:  Previous studies on associations between reduced lung function and cardiovascular disease (CVD) have mainly been based on forced expiratory volume in 1‐s (FEV1) and vital capacity (VC). This study examined potential associations between five different lung function variables and plaques in the internal carotid artery (ICA).

Methods:  Subjects (n = 450) from a previous population‐based respiratory questionnaire survey [current smokers without lower respiratory symptoms, subjects with a self‐reported diagnosis of chronic obstructive pulmonary disease (COPD) and never‐smokers without lower respiratory symptoms] were examined using spirometry, body plethysmography and measurements of diffusing capacity for CO (DL,CO). Plaques in the ICA were assessed by ultrasonography.

Results:  Two hundred and twenty subjects were current smokers, 139 ex‐smokers and 89 never‐smokers. COPD was diagnosed in 130 subjects (GOLD criteria). Plaques in the ICA were present in 231 subjects (52%). General linear analysis with adjustment for established risk factors for atherosclerosis, including C‐reactive protein, showed that DL,CO was lower [77·4% versus 83·7% of predicted normal (PN), P = 0·014] and residual volume (RV) was higher (110·3% versus 104·8% of PN, P = 0·020) in subjects with than without plaques in the ICA. This analysis did not show any statistically significant association between plaques and FEV1 or VC.

Conclusion:  The occurrence of plaques in the ICA was associated with low DL,CO and high RV, but not significantly with FEV1 or COPD status. The results suggest that the relationships between reduced lung function, COPD and CVD are complex and not only linked to bronchial obstruction and low‐grade systemic inflammation.
G‐protein βγ subunits in vasorelaxing and anti‐endothelinergic effects of calcitonin gene‐related peptide
Authors: Meens MJPMT , Mattheij NJA , van Loenen PB , Spijkers LJA , Lemkens P , Nelissen J , Compeer MG , Alewijnse AE , De Mey JGR
Published: November 2011

BACKGROUND AND PURPOSE Calcitonin gene‐related peptide (CGRP) has been proposed to relax vascular smooth muscle cells (VSMC) via cAMP and can promote dissociation of endothelin‐1 (ET‐1) from ETA receptors. The latter is not mimicked by other stimuli of adenylate cyclases. Therefore, we evaluated the involvement of G‐protein βγ subunits (Gβγ) in the arterial effects of CGRP receptor stimulation.

EXPERIMENTAL APPROACH To test the hypothesis that instead of α subunits of G‐proteins (Gαs), Gβγ mediates the effects of CGRP receptor activation, we used (i) rat isolated mesenteric resistance arteries (MRA), (ii) pharmacological modulators of cyclic nucleotides; and (iii) low molecular weight inhibitors of the functions of Gβγ, gallein and M119. To validate these tools with respect to CGRP receptor function, we performed organ bath studies with rat isolated MRA, radioligand binding on membranes from CHO cells expressing human CGRP receptors and cAMP production assays in rat cultured VSMC.

KEY RESULTS In isolated arteries contracted with K+ or ET‐1, IBMX (PDE inhibitor) increased sodium nitroprusside (SNP)‐ and isoprenaline (ISO)‐ but not CGRP‐induced relaxations. While fluorescein (negative control) was without effects, gallein increased binding of [125I]‐CGRP in the absence and presence of GTPγS. Gallein also increased CGRP‐induced cAMP production in VSMC. Despite these stimulating effects, gallein and M119 selectively inhibited the relaxing and anti‐endothelinergic effects of CGRP in isolated arteries while not altering contractile responses to K+ or ET‐1 or relaxing responses to ISO or SNP.

CONCLUSION AND IMPLICATIONS Activated CGRP receptors induce cyclic nucleotide‐independent relaxation of VSMC and terminate arterial effects of ET‐1 via Gβγ.
Biliary atresia and survival into adulthood without transplantation: a collaborative multicentre clinic review
Authors: Kumagi Teru , Drenth Joost P. H. , Guttman Orlee , Ng Vicky , Lilly Les , Therapondos George , Hiasa Yoichi , Michitaka Kojiro , Onji Morikazu , Watanabe Yuji , Sen Sambit , Griffiths William , Roberts Eve , Heathcote Jenny , Hirschfield Gideon M.
Published: November 2011

Background

Biliary atresia is a progressive biliary injury which occurs only in infants.

Aims

To review the experience of patients surviving into adulthood without the need for liver transplantation in childhood.

Methods

A multicentre review of patients with biliary atresia treated surgically who survived into adulthood without the need for transplantation.

Results

Twenty‐two patients were identified across four centres. Median age at the last follow‐up was 25 years (range: 18–46), and 21 patients had clinical features of portal hypertension. At last follow‐up values of liver enzymes varied from normal to 15 × the upper limit of normal (ULN) for ALT (median 2.11 × ULN) and 9 × the ULN for ALP (median 2.02 × ULN). Six patients had a serum bilirubin > 50 μmol/l. Pruritus and jaundice were noted in 8 of 20 patients (40%) and 11 of 22 patients (50%) respectively. Thirteen patients (59.1%) were shown to have imaging features of sclerosing cholangitis, with strictures of intrahepatic bile duct(s) (IHBD), dilatation of IHBD (n = 8), or stone(s) within the IHBD (n = 5). A history of presumed bacterial cholangitis was present in 11 patients (50%). Successful pregnancies were recorded in three of fourteen female patients. Four patients underwent transplant between the ages of 20–27 years. Twenty‐one patients (95.5%) were alive, including 18 (81.8%) with their native liver at the time of last follow‐up.

Conclusions

Some patients treated for biliary atresia will survive into adulthood with their native liver, but commonly with secondary biliary disease including cholangitis and portal hypertension.
Cellular‐based therapies to prevent or reduce thrombocytopenia
Authors: Pineault Nicolas , Boyer Lucie
Published: November 2011

BACKGROUND: Thrombocytopenia is a serious side effect following high‐dose chemotherapy or whole‐body irradiation. For many patients, a hematopoietic stem cell (HSC) transplant is required as part of the treatment or to restore the integrity of the hematopoietic system. In this article, we first review the origin of thrombocytopenia in the context of umbilical cord blood (UCB) transplantation and current cellular therapies developed to overcome this condition. Results obtained in recent clinical trials and in the laboratory using a mouse‐based xenograft model were also discussed. Second, we investigate the kinetic of human platelet production in two immunodeficient mouse strains transplanted with UCB cells to determine which of the two is better suited to measure the thrombopoietic potential of human hematopoietic cells.

STUDY DESIGN AND METHODS: NOD/SCID/IL2Rγnull or NOD.CB17‐Prkdcscid/NcrCrl (NOD/SCID) mice were transplanted with ex vivo expanded UCB cells. Human platelet levels and marrow engraftments were measured by cytometry analyses.

RESULTS: Human platelets appeared earlier and at greater levels in the NOD/SCID/IL2Rγnull mouse strain. Consistent with these results and previous reports, human marrow engraftment was also greater in the IL2Rγnull‐based NOD/SCID mice.

CONCLUSION: The NOD/SCID/IL2Rγnull mouse strain is an ideal choice for preclinical studies aimed at measuring the in vivo thrombopoietic potential of human HPCs. Exploitation of such a model should facilitate the development of new cellular therapies aimed at improving hematological recoveries following HSC transplantation.
Cellular therapies supplement: strategies for improving transplant efficiency in the context of cellular therapeutics
Authors: Jimenez Antonio , Fung Henry C. , Christopherson 2nd Kent W.
Published: November 2011

The field of hematopoietic stem cell transplantation (HSCT) has overcome many obstacles that have led to our current clinical ability to utilize cells collected from marrow, mobilized peripheral blood, or umbilical cord blood for the treatment of malignant and nonmalignant hematologic diseases. It is in this context that it becomes evident that future progress will lie in our development of an understanding of the biology by which the process of HSCT is regulated. By understanding the cellular components and the mechanisms by which HSCT is either enhanced or suppressed it will then be possible to design therapeutic strategies to improve rates of engraftment that will have a positive impact on immune reconstitution post‐HSCT. In this review we focus primarily on allogeneic hematopoietic stem cell transplantation (allo‐HSCT), the current challenges associated with allo‐HSCT, and some developing strategies to improve engraftment in this setting.
Production of cytotoxic, KIR‐negative NK cells from CD34+ cord blood cells with the use of Notch signaling
Authors: Beck Rose C.
Published: November 2011

The use of natural killer (NK) cells as cell therapy against acute leukemia is an active area of investigation. The optimal source of cytotoxic NK cells for therapeutic use is presently unknown. With funds from the National Blood Foundation, the author's lab has developed in vitro culture systems that use the Notch receptor ligand Delta4 for the differentiation and expansion of functional NK cells from CD34+ cord blood hematopoietic progenitor cells. These Notch‐induced NK (N‐NK) cells display a predominantly immature, CD56bright surface phenotype, with expression of activating receptors important for leukemia cell recognition and killing, but with an absence of inhibitory receptors that bind major histocompatibility complex (MHC) class I, making them free of restriction by self‐MHC. They are capable of directly killing hematopoietic tumor cell lines and primary leukemia cells in vitro. Thus, cytotoxic, HLA‐independent N‐NK cells may represent a novel cell therapy for hematopoietic malignancy.
Cellular therapies supplement: the role of granulocyte macrophage colony‐stimulating factor and dendritic cells in regulatory T‐cell homeostasis and expansion
Authors: Zou Tao , Satake Atsushi , Ojha Priti , Kambayashi Taku
Published: November 2011

Regulatory T cells are a subset of T cells with inhibitory function that are critical for protection against autoimmunity and immunopathology. A failure to maintain adequate regulatory T‐cell numbers in the periphery results in autoimmune manifestations, highlighting the importance of the continuous maintenance of peripheral regulatory T cells. The cellular and molecular requirements for regulatory T‐cell homeostasis and expansion are not fully understood but involve a complex interplay among dendritic cells, conventional T cells, and regulatory T cells. In addition, soluble factors such as the cytokine granulocyte macrophage colony‐stimulating factor may play a role in enhancing these interactions. In this review, we discuss our National Blood Foundation‐funded studies relating to the role of granulocyte macrophage colony‐stimulating factor and dendritic cells in controlling regulatory T‐cell homeostasis and expansion.
Hemodynamic responses to a hemoglobin bis‐tetramer and its polyethylene glycol conjugate
Authors: Lui Francine E. , Yu Binglan , Baron David M. , Lei Chong , Zapol Warren M. , Kluger Ronald
Published: November 2011

BACKGROUND: The design of hemoglobin‐based oxygen carriers (HBOCs) poses a significant challenge as clinical trials of many materials have reported adverse side effects that may come from the scavenging of the vasodilator nitric oxide (NO). A compensating reaction, reduction of endogenous nitrite by hemoglobin (Hb) and its derivatives, generates NO. Polyethylene glycol (PEG) conjugation of Hb enhances the rate of the reaction.

STUDY DESIGN AND METHODS: Hemoglobin bis‐tetramers (BT) and their PEGylated derivative (BT‐PEG) bind oxygen with a degree of cooperativity and also have significantly enhanced nitrite reductase activity compared to the native protein. Circulatory evaluation will test if the properties of BT and BT‐PEG are reflected in their effects in vivo. BT and BT‐PEG were evaluated as infusions into healthy wild‐type (WT) and diabetic (db/db) mouse models. The effects were compared to infusions of murine Hb.

RESULTS: The materials were found not to cause significant increases in systemic blood pressure in either WT mice or db/db mice. The latter are highly sensitive to NO scavenging. Further hemodynamic measurements in WT mice indicate that while a slight increase in systemic vascular resistance (SVR) was observed after infusion of BT, the extent is not significant. No change in SVR from baseline was observed after infusion of BT‐PEG.

CONCLUSION: The enlarged Hb derivatives do not evoke unfavorable circulatory responses that have been noted to result from infusion of Hb derivatives. These results suggest that a compromise between the P50, n50, and nitrite reductase activity of a Hb derivative can serve as the basis for producing HBOCs that can be tested for vasoactivity.
Semiparametric Frailty Models for Clustered Failure Time Data
Authors: Yu Zhangsheng , Lin Xihong , Tu Wanzhu
Published: November 2011

Summary We consider frailty models with additive semiparametric covariate effects for clustered failure time data. We propose a doubly penalized partial likelihood (DPPL) procedure to estimate the nonparametric functions using smoothing splines. We show that the DPPL estimators could be obtained from fitting an augmented working frailty model with parametric covariate effects, whereas the nonparametric functions being estimated as linear combinations of fixed and random effects, and the smoothing parameters being estimated as extra variance components. This approach allows us to conveniently estimate all model components within a unified frailty model framework. We evaluate the finite sample performance of the proposed method via a simulation study, and apply the method to analyze data from a study of sexually transmitted infections (STI).
Pregnancy and Multiple Sclerosis
Authors: Stuart Mari , Bergstrom Linda
Published: November 2011

Multiple sclerosis (MS) is often diagnosed among women of childbearing age. This article reviews how MS affects pregnancy and provides information for health care providers who care for women with this disorder. Women with MS need to be informed regarding how the disease will affect their reproductive health. The disease itself does not usually have a negative impact on fertility or pregnancy, although some studies indicate that women with MS have a slightly increased risk for having small‐for‐gestational‐age newborns. Some of the common MS symptoms such as fatigue, urinary frequency, constipation, and mood changes are similar to pregnancy‐related symptoms. Mode of birth and anesthesia choices are similar to those for women without MS. Immunomodulatory therapy for MS needs to be discontinued before conception because most of the medications are still under investigation with regard to safety during pregnancy or have adverse effects on pregnancy. Relapse rates are increased for up to 6 months in the postpartum period. Breast feeding does not appear to increase the risk of postpartum relapses. All hormonal contraception can be used by women with MS. Some studies suggest that estrogen may have protective effects against disease progression.
The Experience of Being a Traditional Midwife: Living and Working in Relationship With Women
Authors: Dietsch Elaine , Mulimbalimba‐Masururu Luc
Published: November 2011

Introduction: The purpose of this project was to learn from traditional midwives about their experience of practicing in an area of rural Kenya.

Methods: This qualitative, service‐based research project used a simple exploratory and descriptive design. Data were collected through in‐depth interviews and fieldwork notes taken during and immediately after the interviews with 84 traditional midwives. Data were thematically analyzed and themes identified through paired‐author consensus. Exemplars using the participants’ translated words were used for analysis and presentation purposes.

Results: In being humble, patient, and kind, the traditional midwives used their relationships with women to create an enabling, calm, and physiologically sound intrapartum environment.

Discussion: Traditional midwives provide a valuable service to women in this area of Kenya at a time when their role is being increasingly devalued by global health agencies. We recommend a redirection of global policy from one that esteems only professional caregivers to one that recognizes the potential value of traditional midwives and supports them through sustainable, evidence‐based education and resourcing.
An Educational Intervention to Change Planned Behavior Concerning Midwife‐Assisted Out‐of‐Hospital Childbirth
Authors: Hans Jason D. , Kimberly Claire
Published: November 2011

Introduction: The Business of Being Born is a documentary film that reviews the history, economics, and culture of birth in the United States, with an emphasis on viewing low‐risk birth as a natural and reasonably safe experience that does not require medical intervention.

Methods: A nonequivalent control group design with 468 American university students was used to examine the potential of The Business of Being Born for changing attitudes toward, and planned behavior concerning, midwife‐assisted out‐of‐hospital childbirth.

Results: Viewing the film had a large positive effect on planned behavior concerning midwife‐assisted out‐of‐hospital childbirth. Rationales for planned behaviors indicated that trust and safety concerns accounted for the appeal of physician‐assisted hospital childbirth over midwife‐assisted out‐of‐hospital childbirth, but that viewing the film substantially tempered these concerns vis‐à‐vis midwife‐assisted out‐of‐hospital childbirth among a large portion of participants.

Discussion: The results indicate that The Business of Being Born can increase awareness of and support for the midwifery profession, and that these changes may result in increased demand for midwifery services. However, proactive efforts must be taken to ensure that the film reaches its target audience.
Oral Health and Oral Health Care Practices Among Low‐Income Pregnant Women
Authors: Hunter Lauren P. , Yount Susan M.
Published: November 2011

Introduction: Access to dental care is a problem in California as in many parts of the United States. Many women, including half of those having dental problems, do not see a dentist during pregnancy. The objective of this study was to describe the oral health status and oral health practices of low‐income pregnant women in San Diego, California, and to determine the needs for oral health care education in this population.

Methods: This descriptive, retrospective, correlational study examined oral health and oral health care practices by age, ethnicity, and gravidity by using medical records from a convenience sample of 380 low‐income pregnant women.

Results: Most participants were primigravida, aged between 19 and 29 years, of Hispanic ethnicity, and insured by the state (Medi‐Cal). All women received education on oral health. The majority (84%) were encouraged to get a dental examination. It had been more than 1 year since the last dental visit for most women (55%). Hispanic women were in need of dental care more than Filipina women or women of other ethnicities. A broken tooth was the primary reason for immediate dental referrals. Regularity of flossing and brushing teeth differed significantly (P= .015, P < .001) across ethnic groups, with Filipina women reporting better oral care practices.

Discussion: The results provide information for the future planning of effective dental health promotion programs. Findings suggest that low‐income pregnant women have some healthy oral health care practices but are in need of dental services and oral health education. An oral health history, oral health education, dental screening, and dental referral, if needed, should be a routine part of prenatal care and annual examinations.
IMPLEMENTING GROUP PRENATAL CARE IN 2 URBAN CLINICS
Authors: Novick Gina , Sadler Lois S. , Knafl Kathleen A. , Kennedy Holly Powell , Groce Nora E.
Published: November 2011

Background: CenteringPregnancy is an innovative model of group prenatal care (GPNC) that can improve pregnancy outcomes and experiences of care. Yet, because CenteringPregnancy requires significant adaptations in settings designed for individual care, GPNC can be difficult to implement with fidelity. Purpose: This research describes circumstances in 2 clinics and in pregnant women's personal lives related to GPNC, and group leader responses to these circumstances. Methods: Data were gathered through participant‐observation of 4 GPNC series, and 54 semi‐structured interviews of 21 pregnant women and 2 group leaders. Participants were predominantly African‐American or Hispanic. The approach, Interpretive Description, was informed by Situational Analysis. Results: Women's personal lives and clinic settings had profound effects on providing GPNC. Many women had limited social support, severe financial stress, and challenges accessing care. Furthermore, clinics did not provide full resources for GPNC; consequently, recruitment procedures, space, staffing, and materials were sometimes inadequate. Group leaders, who viewed GPNC as providing important benefits for their patients, found themselves “in a hard spot,” struggling to balance model fidelity with these limitations. Strategies they developed included advocating, improvising, compromising, and modifying the CenteringPregnancy model. Conclusions: Limited resources and modifications affected women's experience of GPNC, group stability, and group leader experience. Future research should explore variations of GPNC used across settings, and the impact of variations on outcomes, experience of GPNC, and sustainability of the model. Funding: The project described was funded in part by the National Institute of Nursing Research, T32NR008346 and F31NR00991, the March of Dimes, Sigma Theta Tau Delta Mu Chapter, and the Yale Evelyn Anderson Research Fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research.
Myoendothelial Contacts, Gap Junctions, and Microdomains: Anatomical Links to Function?
Authors: SANDOW SHAUN L. , SENADHEERA SEVVANDI , BERTRAND PAUL P. , MURPHY TIMOTHY V. , TARE MARIANNE
Published: November 2011

Please cite this paper as: Sandow SL, Senadheera S, Bertrand PP, Murphy TV, Tare M. Myoendothelial contacts, gap junctions, and microdomains: anatomical links to function? Microcirculation 19: 403‐415, 2012.

In several species and in many vascular beds, ultrastructural studies describe close contact sites between the endothelium and smooth muscle of <∼20 nm. Such sites are thought to facilitate the local action of signaling molecules and/or the passage of current, as metabolic and electrical coupling conduits between the arterial endothelium and smooth muscle. These sites have the potential for bidirectional communication between the endothelium and smooth muscle, as a key pathway for coordinating vascular function. The aim of this brief review is to summarize the literature on the ultrastructural anatomy and distribution of key components of MECC sites in arteries. In addition to their traditional role of facilitating electrical coupling between the two cell layers, data on the role of MECC sites in arteries, as signaling microdomains involving a spatial localization of channels, receptors and calcium stores are highlighted. Diversity in the density and specific characteristics of MECC sites as signaling microdomains suggests considerable potential for functional diversity within and between arteries in health and disease.
Personal Identification by the Comparison of Facial Profiles: Testing the Reliability of a High‐Resolution 3D–2D Comparison Model
Authors: Cattaneo Cristina , Cantatore Angela , Ciaffi Romina , Gibelli Daniele , Cigada Alfredo , De Angelis Danilo , Sala Remo
Published: November 2011

Abstract:  Identification from video surveillance systems is frequently requested in forensic practice. The “3D–2D” comparison has proven to be reliable in assessing identification but still requires standardization; this study concerns the validation of the 3D–2D profile comparison. The 3D models of the faces of five individuals were compared with photographs from the same subjects as well as from another 45 individuals. The difference in area and distance between maxima (glabella, tip of nose, fore point of upper and lower lips, pogonion) and minima points (selion, subnasale, stomion, suprapogonion) were measured. The highest difference in area between the 3D model and the 2D image was between 43 and 133 mm2 in the five matches, always greater than 157 mm2 in mismatches; the mean distance between the points was greater than 1.96 mm in mismatches, <1.9 mm in five matches (p < 0.05). These results indicate that this difference in areas may point toward a manner of distinguishing “correct” from “incorrect” matches.
Heel–Ball (HB) Index: Sexual Dimorphism of a New Index from Foot Dimensions*
Authors: Krishan Kewal , Kanchan Tanuj , Passi Neelam , DiMaggio John A.
Published: November 2011

Abstract:  The present research is aimed to introduce Heel–ball (HB) index from foot dimensions and determine whether this index exhibits sexual dimorphism. The study was conducted on a sample of 303 North Indian individuals (154 men, and 149 women) aged between 13 and 18 years. The stature, body weight, foot breadth at the ball (BBAL), and foot breadth at heel (BHEL) were measured. The HB index was derived by the formula BHEL × 100/BBAL. Although the mean HB index was larger in women in both feet it showed statistically significant sex differences in the right foot only. The study shows that while the foot dimensions show a positive correlation with stature and weight, the HB index is independent of the stature and weight of an individual. This novel index (HB index) may be utilized in sex determination when a part of the foot is brought for medico‐legal investigation.
An Accuracy Assessment of Forensic Computerized Facial Reconstruction Employing Cone‐Beam Computed Tomography from Live Subjects
Authors: Lee Won‐Joon , Wilkinson Caroline M. , Hwang Hyeon‐Shik
Published: November 2011

Abstract:  The utilization of 3D computerized systems has allowed more effective procedures for forensic facial reconstruction. Three 3D computerized facial reconstructions were produced using skull models from live adult Korean subjects to assess facial morphology prediction accuracy. The 3D skeletal and facial data were recorded from the subjects in an upright position using a cone‐beam CT scanner. Shell‐to‐shell deviation maps were created using 3D surface comparison software, and the deviation errors between the reconstructed and target faces were measured. Results showed that 54%, 65%, and 77% of the three facial reconstruction surfaces had <2.5 mm of error when compared to the relevant target face. The average error for each reconstruction was −0.46 mm (SD = 2.81) for A, −0.31 mm (SD = 2.40) for B, and −0.49 mm (SD = 2.16) for C. The facial features of the reconstructions demonstrated good levels of accuracy compared to the target faces.
Foot‐and‐mouth disease and the Mexican cattle industry
Authors: Nogueira Lia , Marsh Thomas L. , Tozer Peter R. , Peel Derrell
Published: November 2011

The objective of this article is to analyze the domestic and international effects of a hypothetical foot‐and‐mouth disease (FMD) outbreak in the Mexican cattle industry. A discrete time dynamic optimization model of the Mexican cattle sector is specified, and linked to domestic and international markets. Economic consequences of FMD outbreaks are simulated over time and under different scenarios. Specific findings and general policy recommendations are provided. The study reports a range of outbreaks from localized to large scale and suggests that changes in economic surplus due to FMD range from a positive net gain of $0.89 to $1.6 billion to a net loss of about $67 billion, depending on the specific mitigation strategy and outbreak scenario.
A prospective study on implants installed with flapless‐guided surgery using the all‐on‐four concept in the mandible
Authors: Landázuri‐Del Barrio R. A. , Cosyn J. , De Paula W. N. , De Bruyn H. , Marcantonio E.
Published: November 2011

Aim

Clinical data are scarce on flapless‐guided surgery in the mandible using the all‐on‐four concept. In addition, limited documentation exists on the latter under immediate loading conditions with a pre‐fabricated implant bridge. The aim was to provide detailed documentation focusing on clinical and radiographic outcome and complications.

Material and methods

Sixteen systemically healthy non‐smoking patients (10 women, 6 men, average age 59 years) with sufficient bone volume in the mandible were operated via flapless‐guided surgery using the all‐on‐four concept. Clinical and radiographic data and complications were registered at 3, 6 and 12 months.

Results

The overall implant survival rate was 90% with a trend for higher failure of short implants (P = 0.098). The mean bone level after 12 months of function was 0.83 mm with a maximum of 1.07 mm. Technical complications were common (15/16 patients). These mainly related to a misfit between the pre‐fabricated prosthesis and abutment(s) (13/16 patients).

Conclusion

If immediate loading of implants is pursued fabrication of the implant bridge should be based on actual impression of the implants at the time of surgery and not on their virtual position.
Growth Inhibition of Foodborne Pathogens by Oenococcus oeni
Authors: Chiang I‐Yuan , Worobo Randy W. , Churey John J. , Henick‐Kling Thomas
Published: November 2011

Abstract:  To explore the possibility of using Oenococcus oeni to inhibit foodborne pathogens, and to characterize antimicrobial compounds produced by O. oeni, 24 strains of O. oeni were tested for their ability to inhibit growth of foodborne pathogens, Escherichia coli O157:H7, Salmonella enteritidis, and Listeria monocytogenes by using the spot‐on‐lawn method. Of the 24 strains, 17 strains were able to inhibit all 3 pathogens in this study. Proteases, catalase, and buffer solutions were used for determining the type of inhibitory compounds produced from 4 selected strains with stronger inhibitory activity. Antimicrobial activity of 2 strains against the pathogens was completely inactivated by buffer solution, and other 2 strains against E. coli O157:H7 were partially removed. The antimicrobial compound was not sensitive to selected proteases and catalase.

Practical Application:  There is little information available about using O. oeni for human pathogens control. The results of this study revealed such discovery and potential applications for pathogen control.