bluuebunny/crossref_metadata_2025 huggingface dataset:
Room temperature ferromagnetism in two-step-prepared Co-doped ZnO bulks
Authors: Zhu T. , Zhan W. S. , Wang W. G. , Xiao John Q.
Published: July 2006

We have prepared Co-doped ZnO bulks with a two-step method. The bulk samples are sintered at the temperature above 1000°C to get pure single phase and then treated by Zn vapor in a vacuum. Based on such two-step preparation, clear carrier induced ferromagnetism is found in Zn treated Co-doped ZnO bulks, which suggests that the magnetism mechanism can be of codoping effect. The onset of ferromagnetism is associated with the further increase of the hybridization of the impurity band with 3d states near the Fermi level when additional carrier induced to let the Stoner criterion for ferromagnetism to be satisfied.
Capping of InAs quantum dots grown on (311)B InP studied by cross-sectional scanning tunneling microscopy
Authors: Çelebi C. , Ulloa J. M. , Koenraad P. M. , Simon A. , Letoublon A. , Bertru N.
Published: July 2006

Cross-sectional scanning tunneling microscopy was used to study at the atomic scale the impact of the capping material on the structural properties of self-assembled InAs quantum dots (QDs) grown on a high index (311)B InP substrate. Important differences were found in the capping process when InP or lattice matched InGaAs(P) alloys are used. The QDs capped with InP have a smaller height due to As∕P exchange induced decomposition. This effect is not present when InGaAs is used as the capping material. However, in this case a strong strain driven phase separation appears, creating In rich regions above the QDs and degrading the dot/capping layer interface. If the InAs dots are capped by the quaternary alloy InGaAsP the phase separation is much weaker as compared to capping with InGaAs and well defined interfaces are obtained.
Self-assembled ZnO quantum dots with tunable optical properties
Authors: Lu J. G. , Ye Z. Z. , Zhang Y. Z. , Liang Q. L. , Fujita Sz. , Wang Z. L.
Published: July 2006

Self-assembled ZnO quantum dots (QDs) were achieved by a vapor phase transport process. ZnO nanodots were naturally formed on solid substrates in the Volmer-Weber growth mode. Size control of nanodots could be readily realized by varying the growth time. The as-prepared ZnO QDs are of high quality and very stable after formation. The blueshift of band gap energies derived from quantum confinement effects was confirmed by optical absorption spectra. Photoluminescence spectra revealed the tunable behavior of ultraviolet luminescence due to exciton localization. The realization of size-tuned color from ZnO QDs makes them more promising for practical applications.
Structural, optical, and magnetic properties of As-doped (Zn0.93Mn0.07)O thin films
Authors: Lee Sejoon , Kim Deuk Young , Shon Yoon , Yoon Chong S.
Published: July 2006

The As-doped (Zn0.93Mn0.07)O thin film prepared by As+ ion implantation showed a clear peak of (A0,X) having acceptor binding energy of 181meV. The sample showed high TC ferromagnetism persisting up to 285K. The contribution of magnetization from Mn ion at 280K was determined to be 0.13μB∕Mn. The improved ferromagnetism is expected to be originated from hole-induced ferromagnetism and enhanced magnetic anisotropy because crystallographically improved sample showed p-type conductivity with hole concentration of 4.8×1018cm−3 and hole mobility of 11.8cm2V−1s−1. These results suggest that high TC ferromagnetism can be realized by codoping the acceptor dopant and improving the magnetic anisotropy.
Spatial remapping of touch: Confusion of perceived stimulus order across hand and foot
Authors: Schicke Tobias , Röder Brigitte
Published: July 2006

The “body schema,” a spatial representation of the body in its environment, has been suggested to be an emergent property of a widespread network of effector-specific frontal and parietal areas, many of which integrate sensory input from the different modalities. On a behavioral level, such multimodality has been shown with temporal order judgment tasks, in which participants decide which of the two hands received a tactile stimulus first. The accuracy of these judgments is influenced by body posture, indicating that tactile stimuli are not simply represented in an anatomical reference frame, but are transformed into external spatial coordinates. So far, these studies have only investigated the hands. It is therefore unclear whether a default remapping of touch into external space is a special feature of visual–manual control or whether all body parts are represented in a common nonanatomically anchored reference frame. In the present study, blindfolded participants made temporal order judgments of stimuli presented to both hands, both feet, or one hand and one foot. The stimulated limbs were held in either a parallel or a crossed posture. Judgments were equally impaired by limb crossing in all limb combinations (hands only, feet only, hand and foot). These results suggest a remapping of tactile location of all body parts into a nonanatomically anchored and, importantly, common reference frame rather than a specific remapping for eye–hand coordination only.
Molecular dynamics analyses of cross-β-spine steric zipper models: β-Sheet twisting and aggregation
Authors: Esposito Luciana , Pedone Carlo , Vitagliano Luigi
Published: July 2006

The structural characterization of amyloid fibers is one of the most investigated areas in structural biology. The structural motif, denoted as steric zipper, recently discovered for the peptide GNNQQNY [Nelson, R., Sawaya, M. R., Balbirnie, M., Madsen, A. O., Riekel, C., Grothe, R. & Eisenberg, D. (2005)
Nature
435, 773–778], is expected to exert strong influence in this field. To obtain further insights into the features of this unique structural motif, we report several molecular dynamics simulations of various GNNQQNY aggregates. Our analyses show that even pairs of β-sheets composed of a limited number of β-strands are stable in the 20-ns time interval considered, which suggests that steric zipper interactions at a β-sheet–β-sheet interface strongly contribute to the stability of these aggregates. Moreover, although the basic features of side chain–side chain interactions are preserved in the simulation, the backbone structure undergoes significant variations. Upon equilibration, a significant twist of the β-strands that compose the β-sheets is observed. These results demonstrate that the occurrence of steric zipper interactions is compatible with flat and twisted β-sheets. Molecular dynamics simulations carried out on two pairs of β-sheets, separated in the crystal state by a hydrated interface, lead to interesting results. The two pairs of sheets, while twisting, associate through stable peptide–peptide interactions. These findings provide insight into the mechanism that leads to the formation of higher aggregates. On these bases, it is possible to reconcile the crystallographic and the EM data on the size of the basic GNNQQNY fiber unit.
A family of conserved noncoding elements derived from an ancient transposable element
Authors: Xie Xiaohui , Kamal Michael , Lander Eric S.
Published: July 2006

The evolutionary origin of the conserved noncoding elements (CNEs) in the human genome remains poorly understood but may hold important clues to their biological functions. Here, we report the discovery of a CNE family with ≈124 instances in the human genome that demonstrates a clear signature of having been derived from an ancient transposon. The CNE family is also present in the chicken genome, although typically not at orthologous locations. The CNE family is closely related to the active transposon SINE3 in zebrafish and also to a previously uncharacterized transposon in the coelacanth, the so-called “living fossil” belonging to the lobe-finned fish lineage. The mammal, bird, zebrafish, and coelacanth families all share a highly similar core element of ≈180 bp but have important differences in their 5′ and 3′ ends. The core element has thus been preserved over 450 million years of evolution, implying an important biological function. In addition, we identify 95 additional CNE families that likely predate the mammalian radiation. The results highlight both the creative role of transposons and the importance of CNE families.
Structural basis for the design of potent and species-specific inhibitors of 3-hydroxy-3-methylglutaryl CoA synthases
Authors: Pojer Florence , Ferrer Jean-Luc , Richard Stéphane B. , Nagegowda Dinesh A. , Chye Mee-Len , Bach Thomas J. , Noel Joseph P.
Published: July 2006

3-Hydroxy-3-methylglutaryl CoA synthase (HMGS) catalyzes the first committed step in the mevalonate metabolic pathway for isoprenoid biosynthesis and serves as an alternative target for cholesterol-lowering and antibiotic drugs. We have determined a previously undescribed crystal structure of a eukaryotic HMGS bound covalently to a potent and specific inhibitor F-244 [(E,E)-11-[3-(hydroxymethyl)-4-oxo-2-oxytanyl]-3,5,7-trimethyl-2,4-undecadienenoic acid]. Given the accessibility of synthetic analogs of the F-244 natural product, this inhibited eukaryotic HMGS structure serves as a necessary starting point for structure-based methods that may improve the potency and species-specific selectivity of the next generation of F-244 analogs designed to target particular eukaryotic and prokaryotic HMGS.
Simultaneous identification of differential gene expression and connectivity in inflammation, adipogenesis and cancer
Authors: Reverter Antonio , Ingham Aaron , Lehnert Sigrid A. , Tan Siok-Hwee , Wang Yonghong , Ratnakumar Abhirami , Dalrymple Brian P.
Published: July 2006

Motivation: Biological differences between classes are reflected in transcriptional changes which in turn affect the levels by which essential genes are individually expressed and collectively connected. The purpose of this communication is to introduce an analytical procedure to simultaneously identify genes that are differentially expressed (DE) as well as differentially connected (DC) in two or more classes of interest.

Results: Our procedure is based on a two-step approach: First, mixed-model equations are applied to obtain the normalized expression levels of each gene in each class treatment. These normalized expressions form the basis to compute a measure of (possible) DE as well as the correlation structure existing among genes. Second, a two-component mixture of bi-variate distributions is fitted to identify the component that encapsulates those genes that are DE and/or DC. We demonstrate our approach using three distinct datasets including a human systemic inflammation oligonucleotide data; a spotted cDNA data dealing with bovine in vitro adipogenesis and SAGE database on cancerous and normal tissue samples.

Contact:  Tony.Reverter-Gomez@csiro.au

Supplementary information:  Supplementary data are available at Bioinformatics online.
Reevaluation of Gray and White Matter Injury after Spinal Cord Ischemia in Rabbits
Authors: Kurita Naoko , Kawaguchi Masahiko , Kakimoto Meiko , Yamamoto Yuri , Inoue Satoki , Nakamura Mitsutoshi , Konishi Noboru , Patel Piyush M. , Furuya Hitoshi
Published: July 2006

Background

Although gray matter injury has been well characterized, the available data on white matter injury after spinal cord ischemia (SCI) in rabbits are limited. The current study was conducted to investigate the evolution of ischemia induced injury to gray and white matter and to correlate this damage to hind-limb motor function in rabbits subjected to SCI.

Methods

Thirty-eight rabbits were randomly assigned to 24-h, 4-day, or 14-day reperfusion groups or a sham group (n = 9 or 10 per group). SCI was induced by occlusion of the infrarenal aorta for 16 min. Hind-limb motor function was assessed using the Tarlov scale (0 = paraplegia, 4 = normal). The gray matter damage was assessed on the basis of the number of normal neurons in the anterior spinal cord. White matter damage was assessed on the basis of the extent of vacuolation and accumulation of amyloid precursor protein immunoreactivity.

Results

Tarlov scores gradually decreased and reached a nadir 14 days after reperfusion. There were no significant differences in the number of normal neurons among the 24-h, 4-day, and 14-day groups. The extent of vacuolation, expressed as a percent of total white matter area, was significantly greater in the 4-day and 14-day groups in comparison with the sham group. By contrast, there was no difference in vacuolation between the sham and 24-h groups. Amyloid precursor protein immunoreactivity was greater in the 4-day and 14-day groups.

Conclusion

The results in the current study show that SCI induced white matter injury as well as gray matter injury in a rabbit model of SCI. The time course for 14 days after reperfusion may differ among the gray and white matter damages and hind-limb motor function in rabbits subjected to SCI.
Gabapentin Increases a Tonic Inhibitory Conductance in Hippocampal Pyramidal Neurons
Authors: Cheng Victor Y. , Bonin Robert P. , Chiu Mary W. , Newell J Glen , MacDonald John F. , Orser Beverley A.
Published: July 2006

Background

The mechanisms underlying the therapeutic actions of gabapentin remain poorly understood. The chemical structure and behavioral properties of gabapentin strongly suggest actions on inhibitory neurotransmission mediated by gamma-aminobutyric acid (GABA); however, gabapentin does not directly modulate GABAA or GABAB receptors. Two distinct forms of GABAergic inhibition occur in the brain: postsynaptic conductance and a persistent tonic inhibitory conductance primarily generated by extrasynaptic GABAA receptors. The aim of this study was to determine whether gabapentin increased the tonic conductance in hippocampal neurons in vitro. As a positive control, the effects of vigabatrin, which irreversibly inhibits GABA transaminase, were also examined.

Methods

GABAA receptors in hippocampal neurons from embryonic mice were studied using whole cell patch clamp recordings. Miniature inhibitory postsynaptic currents and the tonic current were recorded from cultured neurons that were treated for 36-48 h with gabapentin, vigabatrin, or gabapentin and vigabatrin. To determine whether gabapentin increased the expression of GABAA receptors, Western blots were stained with antibodies selective for alpha1, alpha2, and alpha5 subunits.

Results

GABAA receptors were insensitive to the acute application of gabapentin, whereas chronic treatment increased the amplitude of the tonic current threefold (EC50 = 209 microm) but did not influence miniature inhibitory postsynaptic currents. Vigabatrin increased the tonic conductance, and the maximally effective concentration did not occlude the actions of gabapentin, which suggests that these compounds act by different mechanisms. Neither gabapentin nor vigabatrin increased the expression of GABAA receptors in the neurons.

Conclusions

Gabapentin increases a tonic inhibitory conductance in mammalian neurons. High-affinity GABAA receptors that generate the tonic conductance may detect small increases in the ambient concentration of neurotransmitter caused by gabapentin.
Modifying the Baricity of Local Anesthetics for Spinal Anesthesia by Temperature Adjustment
Authors: Heller Axel R. , Zimmermann Katrin , Seele Kristin , Rössel Thomas , Koch Thea , Litz Rainer J.
Published: July 2006

Background

Although local anesthetics (LAs) are hyperbaric at room temperature, density drops within minutes after administration into the subarachnoid space. LAs become hypobaric and therefore may cranially ascend during spinal anesthesia in an uncontrolled manner. The authors hypothesized that temperature and density of LA solutions have a nonlinear relation that may be described by a polynomial equation, and that conversion of this equation may provide the temperature at which individual LAs are isobaric.

Methods

Density of cerebrospinal fluid was measured using a vibrating tube densitometer. Temperature-dependent density data were obtained from all LAs commonly used for spinal anesthesia, at least in triplicate at 5 degrees, 20 degrees, 30 degrees, and 37 degrees C. The hypothesis was tested by fitting the obtained data into polynomial mathematical models allowing calculations of substance-specific isobaric temperatures.

Results

Cerebrospinal fluid at 37 degrees C had a density of 1.000646 +/- 0.000086 g/ml. Three groups of local anesthetics with similar temperature (T, degrees C)-dependent density (rho) characteristics were identified: articaine and mepivacaine, rho1(T) = 1.008-5.36 E-06 T2 (heavy LAs, isobaric at body temperature); L-bupivacaine, rho2(T) = 1.007-5.46 E-06 T2 (intermediate LA, less hypobaric than saline); bupivacaine, ropivacaine, prilocaine, and lidocaine, rho3(T) = 1.0063-5.0 E-06 T (light LAs, more hypobaric than saline). Isobaric temperatures (degrees C) were as follows: 5 mg/ml bupivacaine, 35.1; 5 mg/ml L-bupivacaine, 37.0; 5 mg/ml ropivacaine, 35.1; 20 mg/ml articaine, 39.4.

Conclusion

Sophisticated measurements and mathematic models now allow calculation of the ideal injection temperature of LAs and, thus, even better control of LA distribution within the cerebrospinal fluid. The given formulae allow the adaptation on subpopulations with varying cerebrospinal fluid density.
Statistical Process Control as a Tool for Monitoring Nonoperative Time
Authors: Seim Andreas , Andersen Bjørn , Sandberg Warren S.
Published: July 2006

Background

Administrators need simple tools to quickly identify even small changes in the performance of perioperative systems. This applies both to established systems and to impact assessments of deliberate perioperative system design changes.

Methods

Statistical process control was originally developed to detect nonrandom variation in manufacturing processes by continuous comparison to previous performance. The authors applied the technique to assess the nonoperative time performance between successive cases for same surgeon following themselves in a redesigned operating room. This operating room specifically implemented a new patient care pathway that improves throughput by reducing the nonoperative time. The authors tested how quickly statistical process control detected reductions in nonoperative time. They also tested the ability of statistical process control to detect successively smaller performance changes and investigated its utility for longitudinal process monitoring.

Results

Statistical process control detected a clear reduction in nonoperative time after the new operating room had been used for only 2 days. The method could detect nonoperative time changes of between 5 and 10 min per case for a single operating room within one fiscal quarter. Nonoperative time for the new process was globally stable over the 31 months analyzed, but late in the analysis period, the authors detected small performance decrements, mostly attributable to factors external to the new operating room.

Conclusions

Statistical process control is useful for detecting changes in perioperative system performance, represented in this study by nonoperative time. The technique is able to detect changes quickly and to detect small changes over time.
Post–Dural Puncture Bacterial Meningitis
Authors: Baer Estelle Traurig , Warltier David C.
Published: July 2006

A fatal case of viridans streptococcus meningitis is reported, which occurred as a complication of epidural anesthesia. One hundred seventy-nine reported cases of post-dural puncture meningitis are reviewed. Evidence suggests that most cases are probably caused by contamination of the puncture site by aerosolized mouth commensals from medical personnel, some are caused from contamination by skin bacteria, and, less frequently, other cases are caused directly or hematogenously by spread from an endogenous infectious site. Controversy exists regarding prevention, surveillance, incidence, and treatment of this serious complication.
The 13carbon urea breath test for the diagnosis of Helicobacter pylori infection in subjects with atrophic gastritis: evaluation in a primary care setting
Authors: KORSTANJE A. , VAN EEDEN S. , OFFERHAUS G. J. A. , SABBE L. J. M. , DEN HARTOG G. , BIEMOND I. , LAMERS C. B. H. W.
Published: July 2006

Background

13Carbon urea breath testing is reliable to detect current infection with Helicobacter pylori but has been reported to be of limited value in selected patients with atrophic body gastritis or acid‐lowering medication.

Aim

To evaluate the accuracy of 13carbon urea breath testing for H. pylori detection in 20 asymptomatic patients with histologically confirmed atrophic body gastritis in a primary care setting.

Methods

13Carbon urea breath testing and serology were compared with H. pylori culture of a corpus biopsy as reference test.

Results

All tests were in agreement in 12 patients, being all positive in six and all negative in six. One patient was positive for serology and culture but negative for 13carbon urea breath testing, five patients had only positive serology and two patients had only positive 13carbon urea breath testing. 13Carbon urea breath testing showed an accuracy with culture of 85% and anti‐H. pylori serology with culture of 75%. 13Carbon urea breath testing carried out in patients with positive serology showed an accuracy of 92%. Receiver operating characteristic curve analysis of 13carbon urea breath testing shows optimal discrimination at the prescribed cut‐off value.

Conclusions

13Carbon urea breath testing can be used as diagnostic H. pylori test in asymptomatic patients with atrophic body gastritis, preferably in addition to serology, to select subjects for anti‐H. pylori therapy.
Proton pump inhibitor therapy is a risk factor for Clostridium difficile‐associated diarrhoea
Authors: YEARSLEY K. A. , GILBY L. J. , RAMADAS A. V. , KUBIAK E. M. , FONE D. L. , ALLISON M. C.
Published: July 2006

Background

Inhibition of gastric acid removes a defence against ingested bacteria and spores, increasing the risk of some forms of gastroenteritis. Previous studies investigating a possible link between acid suppression therapy and Clostridium difficile‐associated diarrhoea have reported conflicting results.

Aim

To investigate whether acid suppression therapy is associated with an increased risk of C. difficile‐associated diarrhoea.

Methods

Prospective case–control study of 155 consecutive in‐patients with C. difficile‐associated diarrhoea.

Results

Antibiotics had been received by 143 (92%) of the C. difficile‐associated diarrhoea group and 76 (50%) of the controls during the preceding 3 months. Among those receiving antibiotics, 59 (41%) of the C. difficile‐associated diarrhoea group had also received acid suppression, compared with 21 (28%) of controls (OR 1.84, CI 1.01, 3.36, χ2 = 4.0, P = 0.046). Among the entire C. difficile‐associated diarrhoea group 64 (41%) had received acid suppression compared with 40 (26%) of controls (OR 1.99, CI 1.19, 3.31, χ2 = 7.9, P = 0.005). Logistic regression analyses found that C. difficile‐associated diarrhoea was independently associated with: antibiotic use (OR 13.1, 95% CI: 6.6, 26.1); acid suppression therapy (OR 1.90, 95% CI: 1.10, 3.29); and female sex (OR 1.79, 95% CI: 1.06, 3.04).

Conclusions

The risk of C. difficile‐associated diarrhoea in hospitalized patients receiving antibiotics may be compounded by exposure to proton pump inhibitor therapy.
Clinical outcome in upper gastrointestinal bleeding complicating low‐dose aspirin and antithrombotic drugs
Authors: TAHA A. S. , ANGERSON W. J. , KNILL‐JONES R. P. , BLATCHFORD O.
Published: July 2006

Background

The current risk stratification systems in upper gastrointestinal bleeding do not correct for the intake of low‐dose aspirin and other antithrombotic drugs.

Aim

To test the Blatchford scores in evaluating the clinical outcome in bleeders using these drugs.

Methods

We calculated the Blatchford scores in 510 bleeders, including 123 on low‐dose aspirin, 44 on other antithrombotic drugs, and 68 on non‐steroidal anti‐inflammatory drugs.

Results

The median clinical scores distributed according to aetiological risk factors were as follows: no risk factors, 5; non‐steroidal anti‐inflammatory drugs, 8; aspirin, 7; other antithrombotics, 6; excess alcohol, 4; multiple risk factors, 7; (P = 0.003, Kruskal–Wallis test). Scores correlated positively with the duration of admission in the entire group (rs = 0.285; P < 0.001) and in those taking aspirin and antithrombotics (rs = 0.211; P = 0.029). The median scores in patients requiring the blood transfusion were 10 in the entire group and 11 in users of aspirin or antithrombotics, compared with 3 and 4, respectively, in those not transfused (P < 0.001).

Conclusions

The Blatchford scores are significantly elevated in users of non‐steroidal anti‐inflammatory drugs, low‐dose aspirin, and other antithrombotic drugs. They correlate positively with the duration of admission and the need for blood transfusion.
Rates and predictors of hepatitis C virus treatment in HCV–HIV‐coinfected subjects
Authors: BUTT A. A. , JUSTICE A. C. , SKANDERSON M. , GOOD C. , KWOH C. K.
Published: July 2006

Background

True treatment rates and the impact of comorbidities on treatment rates for hepatitis C virus in the HCV–HIV‐coinfected subjects are unknown.

Aim

To quantify the rates of treatment prescription and the effect of comorbidities on hepatitis C virus treatment rates in HCV–HIV‐coinfected veterans.

Methods

The Veterans Affairs National Patient Care Database was used to identify all hepatitis C virus‐infected subjects between 1999 and 2003 using ICD‐9 codes. Demographics, comorbidities and pharmacy data were retrieved. We used logistic regression to compare the predictors of hepatitis C virus treatment in hepatitis C virus‐monoinfected and HCV–HIV‐coinfected subjects.

Findings

We identified 120 507 hepatitis C virus‐infected subjects, of which 6502 were HIV coinfected. 12% of the hepatitis C virus‐monoinfected and 7% of the ‐coinfected subjects were prescribed hepatitis C virus treatment (P < 0.0001). Those not prescribed treatment were older (48.6 years vs. 47.7 years, P = 0.007) and more likely to be black (52% vs. 32%, P < 0.0001). HIV coinfected was less likely to be prescribed hepatitis C virus treatment (OR 0.74, 95% CI: 0.67–0.82). Among the coinfected subjects, the following were associated with non‐treatment (OR, 95% CI): black race (0.45, 0.35–0.57); Hispanic race (0.56, 0.38–0.82); drug use (0.68, 0.53–0.88); anaemia (0.17, 0.11–0.26); bipolar disorder (0.63, 0.40–0.99); major depression (0.72, 0.53–0.99); mild depression (0.47, 0.35–0.62).

Conclusions

A small number of HCV–HIV‐coinfected veterans are prescribed treatment for hepatitis C virus. Non‐treatment is associated with increasing age, minority race, drug use and psychiatric illness. Further studies are needed to determine the eligibility for treatment and reasons for non‐treatment for hepatitis C virus.
Evaluation of topical pharyngeal anaesthesia by benzocaine lozenge for upper endoscopy
Authors: SHAOUL R. , HIGAZE H. , LAVY A.
Published: July 2006

Background

Among the randomized controlled trials evaluating the effect of pharyngeal anaesthesia only some suggest benefit. Spray is irritating for some people and leaves bitter taste in the throat. We hypothesized that delivering the local anaesthetic as a sucking lozenge would benefit the patients in terms of decreasing anxiety and will improve procedure performance and patient tolerance.

Aim

To determine whether benzocaine/tyrothricin sucking lozenges with conscious sedation is superior to conscious sedation alone, with respect to procedure performance and tolerance in patients undergoing upper endoscopy.

Methods

One hundred and seventy‐four adult patients undergoing upper endoscopy with conscious sedation completed the study. They were randomized to receive sucking lozenge containing benzocaine or placebo before the procedure. Patients were asked to rate prestudy anxiety, tolerance for topical pharyngeal anaesthesia, comfort during endoscopy, degree of difficulty of intubation, postprocedure throat discomfort and willingness to undergo subsequent examinations using a 10‐cm visual analogue scale. Endoscopists were asked to estimate the ease of oesophageal intubation and procedure performance.

Results

No significant statistical differences regarding all the points studied were found between the groups.

Conclusions

Topical pharyngeal anaesthesia with benzocaine/tyrothricin lozenges with conscious sedation has no advantages over conscious sedation alone in patients undergoing upper endoscopy.
Antireflux surgery for non‐erosive and erosive reflux disease in community practice
Authors: THIBAULT R. , CORON E. , SÉBILLE V. , SACHER‐HUVELIN S. , BRULEY DES VARANNES S. , GOURNAY J. , GALMICHE J. P.
Published: July 2006

Background  Antireflux surgery has been mainly evaluated in tertiary referral centres. Data regarding post‐operative outcome in non‐erosive reflux disease are lacking.

Aim  To assess long‐term outcome after antireflux surgery performed in a community practice setting.

Methods  We selected consecutively 60 non‐erosive reflux disease patients and 61 erosive oesophagitis patients with symptomatic gastro‐oesophageal reflux disease. After surgery, each subject answered a validated disease‐specific health‐related quality of life questionnaire and another questionnaire focusing on symptoms, late morbidity and drug use.

Results  After a 43‐month median follow‐up, an excellent outcome was reported by less than two‐thirds of patients. Quality of life scores were lower in the non‐erosive reflux disease group, especially in female patients. Non‐erosive reflux disease patients reported more daily symptoms and more reflux‐related symptoms (P = 0.04). Proton‐pump inhibitor use was higher in non‐erosive reflux disease patients (P < 0.005). Multivariate analysis identified four independent predictive factors associated with better outcome, namely male gender, abnormal preoperative acid exposure, a long duration of symptoms and surgical expertise.

Conclusions  In community practice, the results of antireflux surgery are inferior to those reported by tertiary centres. Outcome seems poorer in non‐erosive reflux disease especially in female patients. Nearly one‐third of the non‐erosive reflux disease patients continue to take proton‐pump inhibitors. These results highlight the need for careful selection of patients before antireflux surgery.
Impact of Helicobacter pylori on the management of dyspepsia in primary care
Authors: BENNETT K. , FEELY J. , THORNTON O. , DOBSON M. , O'MORAIN C. A. , O'CONNOR H. J.
Published: July 2006

Background  It is unclear what impact Helicobacter pylori infection has had on the management of dyspepsia in primary care and to what extent published guidelines on H. pylori are implemented in routine clinical practice.

Aim  To assess the impact of H. pylori infection on the management of dyspepsia in primary care.

Methods  Patients referred by primary care doctors to an open‐access 13‐carbon urea breath test service over a 2‐year period for their first urea breath test were included in the study. Individual breath results were linked with data on prescribing obtained from the General Medical Services prescription database.

Results  Of 805 patients, 374 (47%) had a positive urea breath test and 431 (54%) a negative urea breath test. Of positive urea breath test patients, only 245 (64%) were prescribed eradication therapy in the 3 months after the breath test and only 43% were referred back for re‐testing. In the year after the urea breath test, there was a significant fall in prescribing of antisecretory therapy which was greatest in the patients who received H. pylori therapy (P < 0.001).

Conclusions  There appears to be under and inappropriate treatment of H. pylori infection in primary care, and a low rate of re‐testing after eradication, indicating that current guidelines are not well implemented in practice.
Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong
Authors: CHEUNG T.‐K. , LAI C.‐L. , WONG B. C.‐Y. , FUNG J. , YUEN M.‐F.
Published: July 2006

Background  Clinical features of hepatocellular carcinoma patients are changing because of screening.

Aim  To examine the clinical features of hepatocellular carcinoma patients in Hong Kong and validity of different staging systems.

Methods  A total of 223 Chinese patients with hepatocellular carcinoma were studied.

Results  Seventy‐eight percent of hepatocellular carcinoma patients had chronic hepatitis B (43% diagnosed by screening). Hepatitis B positivity, weight loss, jaundice, encephalopathy, alpha‐fetoprotein level, portal vein thrombosis, extrahepatic metastasis, and treatment were shown to be independent factors affecting survival. Of chronic hepatitis B patients, hepatitis B virus DNA levels (P = 0.001) and portal vein thrombosis (P = 0.008) were independent factors affecting survival. Seventy‐six percent of chronic hepatitis B patients with hepatocellular carcinoma were hepatitis B e antigen negative. Screening patients had hepatocellular carcinoma detected at an earlier stage and better survival (median survival: 21 vs. 4 months, P < 0.0001). All staging systems had good stratification of survival. Prognosis and median survival generated were different when compared with the US data.

Conclusions  Chronic hepatitis B was the most common cause of hepatocellular carcinoma in Hong Kong. High‐risk chronic hepatitis B patients should be followed irrespective of the hepatitis B e antigen status. Hepatitis B virus DNA levels at the time of diagnosis are an important survival predictor. Screening detected hepatocellular carcinoma at an earlier stage and prolonged survival. Staging systems should be validated in different populations.
Coming to conclusions: social workers’ perceptions of the decision‐making process in care proceedings
Authors: Beckett Chris , McKeigue Bridget , Taylor Hilary
Published: July 2006

This study reports on an analysis of the transcripts of four focus groups involving social workers from four English social work teams working with children and families. In the groups, social workers discussed the process of coming to a decision in care proceedings (where decisions are made about the future care of a child where there are concerns about the care provided in the family of origin). It explores how social workers described themselves coming to conclusions about cases, and how they perceive the courts as doing so. Noting the need in such important proceedings both for thoroughness and for speed (for delay is likely to be harmful to children in need of a secure home), the authors consider ways in which decision‐making might be distorted or delayed and discuss the perception of the social workers that some kinds of evidence are under‐ or overvalued by the courts. The authors conclude that, while it may seem that there is a trade‐off between thoroughness and speed, this is not always the case and that factors that cause poor decision‐making can also cause delay.
Good helping relationships in child welfare: learning from stories of success
Authors: De Boer Catherine , Coady Nick
Published: July 2006

This study involved in‐depth exploration of good helping relationships in child welfare. A select sample of six child welfare worker–client dyads was interviewed to determine worker attributes and actions that were key to the development of good working relationships. Innovative features of the research design, such as a multiple interview format with two individual and one joint interview for each worker and client (five interviews per dyad) and opportunities for the worker and client in each dyad to reflect on and respond to the other’s interview transcripts, produced rich data and revealed high levels of congruency among workers, clients and researchers about worker relationship competencies. Two categories of themes that emerged from the qualitative analysis are discussed: (1) soft, mindful and judicious use of power; and (2) humanistic attitude and style that stretches traditional professional ways‐of‐being. Implications for the hiring, education and training, and supervision of child welfare workers are presented.
Subclinical thyroid dysfunction and blood pressure: a community‐based study
Authors: Walsh John P. , Bremner Alexandra P. , Bulsara Max K. , O’Leary Peter , Leedman Peter J. , Feddema Peter , Michelangeli Valdo
Published: July 2006

Objective  Overt hypothyroidism and hyperthyroidism are associated with hypertension, but it is uncertain whether the same is true of subclinical hypothyroidism and hyperthyroidism.

Design, subjects and measurements  Cross‐sectional study of 2033 participants (aged 17–89 years) in the Busselton Thyroid Study who did not have a history of thyroid disease. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension (defined as SBP  140 mmHg, DBP  90 mmHg or on treatment for hypertension) in subjects with thyroid dysfunction and euthyroid subjects were compared using linear regression models. Subjects with treated hypertension (N = 299) were excluded from analyses of SBP and DBP but included in analyses of hypertension prevalence.

Results  Mean SBP, DBP and the prevalence of hypertension did not differ significantly between subjects with subclinical hypothyroidism (N = 105) and euthyroid subjects (N = 1859), nor did they differ between subjects with serum TSH concentrations in the upper reference range (2·0–4·0 mU/l; N = 418) and those with TSH concentrations in the lower reference range (0·4–2·0 mU/l; N = 1441). The prevalence of hypertension was higher in subjects with subclinical hyperthyroidism than euthyroid subjects (prevalence odds ratio 2·8, 95% confidence interval 1·3–6·0 adjusted for age, age2 and sex), but this was based on a small number of subjects with subclinical hyperthyroidism (N = 35).

Conclusions  Subclinical hypothyroidism is not associated with hypertension. The observed association between subclinical hyperthyroidism and hypertension requires confirmation in a larger sample.
Effects of arbuscular mycorrhizae on biomass and nutrients in the aquatic plant Littorella uniflora
Authors: ANDERSEN FREDE Ø. , ANDERSEN TROELS
Published: July 2006

1. It has been hypothesised that the symbiosis with arbuscular mycorrhizal fungi (AMF) leads to a higher uptake of phosphorus (P) and nitrogen (N) in aquatic plants, but it has never been shown experimentally without the use of fungicides. In particular, the symbiosis may be important for nutrient uptake by isoetids in oligotrophic lakes, where low concentrations of inorganic N and P both in the water and in the sediment limit the growth of plants and where symbiosis facilitates the uptake of nutrients from the sediment.

2. Plants of the isoetid Littorella uniflora were propagated under the sterile conditions without an AMF infection. The plants were then grown for 60 days with and without re‐infection by AMF, and with either high (150 μm) or low (ambient concentration approximately 15 μm) CO2 concentration.

3. The study proved that the symbiosis between AMF and L. uniflora had a positive impact on the retention of N and P in the plants at very low nutrient concentrations in the water and on biomass development. Shoot biomass and standing stocks of both P and N were significantly higher in re‐infected plants.

4. Raised CO2 concentration resulted in a fivefold increase in hyphal infection, but had no impact on the number of arbuscules and vesicles in the cross sections. There were significantly higher biomass and lower tissue P and N concentrations in the plants from high CO2 treatments. This resulted in similar standing stocks of P and N in plants from low and high CO2 treatments.

5. The results from this study showed that the symbiosis between AMF and L. uniflora is an important adaptation enabling isoetids to grow on nutrient‐poor sediments in oligotrophic lakes.
Hymenopteran parasitoids synthesize ‘honeydew‐specific’ oligosaccharides
Authors: WÄCKERS F. L. , LEE J. C. , HEIMPEL G. E. , WINKLER K. , WAGENAAR R.
Published: July 2006

Many arthropods depend on carbohydrate‐rich food sources such as nectar or honeydew. Nevertheless, we often know little about the extent to which various sugar sources contribute to the diet of arthropods.

One way to study food use in the field is to analyse guts of collected insects for source‐specific compounds. Sugar sources often show distinct differences in their carbohydrate composition. This applies especially to honeydew, the excretion product of phloem‐feeding ‘Sternorrhynchae’, which often features a broad range of phloem‐feeder synthesized di‐ and oligosaccharides.

Out of these oligosaccharides, melezitose, has been widely used as an indicator of honeydew consumption. The use of melezitose or other honeydew saccharides as ‘signature sugars’ hinges on the assumption that the production of these sugars is unique to honeydew‐secreting insects.

Here we show that the hymenopteran parasitoids Diadegma semiclausum and D. insulare synthesize the trisaccharides melezitose and erlose as well as the disaccharide maltose when fed sucrose, but not when feeding on an equimolar glucose–fructose mixture.

The presence of melezitose, erlose and maltose was confined to the parasitoid's digestive tract, indicating that enzyme activity is restricted to this area. D. semiclausum excrement contained low overall sugar concentrations and low relative levels of melezitose, erlose and maltose.

Possible functions of sugar synthesis in these nectar‐feeding insects are discussed.
Osmoregulation and adaptive radiation in the ovenbird genusCinclodes(Passeriformes: Furnariidae)
Authors: SABAT P. , MALDONADO K. , CANALS M. , DEL RIO C. MARTINEZ
Published: July 2006

The genusCinclodesis unique among passerines because it includes two species that can be considered marine/coastal and also includes several species that inhabit freshwater streams or that shift habitats between terrestrial/fresh water and marine habitats. TheCinclodesclade satisfies two criteria of an adaptive radiation: it is monophyletic and it experienced recent speciation accompanied by rapid phenotypic diversification.

We focused on the osmoregulatory traits of fiveCinclodesspecies to determine if the clade also satisfies the criterion of adaptive phenotype–environment correlation that characterizes adaptive radiations. We used the δ13C of tissuesto estimate reliance on a marine diet. We predicted that δ13C would be positively correlated with the renal traits responsible for urine concentration (relative kidney size, fraction of the kidney comprising medulla, and number of medullary cones per unit of kidney mass).

Our analyses confirmed these hypotheses. We concluded thatCinclodessatisfies the adaptive phenotype–environment correlation criterion.Cinclodesseems to represents an example of an avian adaptive radiation in osmoregulatory function.
Turkish nurses’ information about, and administration of, chemotherapeutic drugs
Authors: Kosgeroglu Nedime , Ayranci Unal , Ozerdogan Nebahat , Demirustu Canan
Published: July 2006

Aim.  The aim of this study was to determine both the level of information that nurses possessed and the method of administration nurses used during chemotherapeutic drug preparation and administration.

Background.  While compliance with the regulations related to chemotherapeutic drug preparation and administration seems to be very difficult, it is at the same time vital.

Methods.  This descriptive study was conducted between 1 May 2002 and 1 May 2003 in the chemotherapy administration units of all hospitals in Eskisehir, west Turkey. The sample consisted of 121 nurses. Data were obtained first via questionnaire forms developed by the researchers to learn the level of awareness concerning exposure to chemotherapy. This was then followed up by the completion of observation forms during drug administrations.

Results.  The average score for information levels pertaining to nurses’ protection of the environment was 7·82 ± 0·38 of a total of 14 points, and that of self‐protection was 7·94 ± 0·24 of a total of 11 points. Nurses showed that their actual administration method was insufficient according to their level of information, with average administration evaluations of 5·46 for protection of the environment and 6·59 for self‐protection. The ratio for nurses’ usage of the safety cabinet during the preparation of chemotherapeutic drugs was very low at 14·2%. Only 7·4% of nurses had received in‐service education about chemotherapeutics.

Conclusion.  In order to ensure the taking of sufficient preventive precautions during the preparation and administration of chemotherapeutic agents, hospitals should be required to provide sufficient equipment and to give this precedence in hospital politics.

Relevance to clinical practice.  Healthcare workers who prepare and administer chemotherapeutic drugs may experience the cytotoxic effects of the drugs through direct skin contact, respiratory and digestive system exposure, and these effects are vital to human life. Thus, it has been recognized that nurses’ information and administrations during preparation and administration of chemotherapeutic drugs are of utmost vital importance in removing the harmful effects of chemotherapeutic agents.
Nursing the clinic vs. nursing the patient: nurses’ experience of a day hospital chemotherapy service
Authors: Mcilfatrick Sonja , Sullivan Kate , McKenna Hugh
Published: July 2006

Aims and objectives. This study sought to explore the nurses’ experience of a day hospital chemotherapy service in an acute general hospital in Northern Ireland and how this compared with their experience of working in an inpatient setting.

Background. Despite the many changes taking place in cancer care delivery, little research has been conducted on nurses’ experience of working in more acute cancer treatment settings. Research conducted to date has tended to focus on the role of nurses in wards, hospices and palliative care settings.

Design. This Heideggerian hermeneutic phenomenological study explored nurses’ lived experience of day hospital chemotherapy service.

Method. Face‐to‐face focused in‐depth interviews were conducted with the total population of nurses who worked in the day hospital at the time of data collection (n = 10). Data analysis involved a two‐staged approach, the analysis of narratives and narrative analysis, based on the work ofPolkinghorne (1995).

Conclusions. The nurses’ viewed their experience of the chemotherapy day hospital as having both positive and negative dimensions. The positive dimensions included an increased sense of autonomy and the challenge of developing new skills, while the negative dimension included a perceived decrease in their caring role:

(i) The individual characteristics of the nurse were seen to have a key influence on caring experience;

(ii) Role changes led to a perceived dichotomy between their actual and aspired role and their caring and clinical role.

Relevance to clinical practice. There is a need to achieve a balance between delivering a clinical role (administering chemotherapy) while maintaining the centrality of the nurse–patient relationship. This can be likened to achieving a balance between ‘nursing the clinic’ alongside ‘nursing the patient’. These findings have implications for the discourse on caring within other outpatient type clinics and discourse on cancer nursing as therapy and the culture of the cancer clinic.