bluuebunny/crossref_metadata_2025_split huggingface dataset:
The multifaceted vigilance – nurses’ experiences of caring encounters with patients suffering from substance use disorder
Authors: Johansson Louice , Wiklund‐Gustin Lena 
Published: June 2015

BackgroundNursing care is guided by a value base focusing on promoting dignity and health by means of the caring relationship. However, previous research has revealed that negative attitudes towards ‘addicted’ patients, as well as these patients’ behaviour, can give rise to negative emotions such as frustration and disappointment among nurses. This can contribute to a judgmental and controlling attitude towards patients. To preserve order, nursing interventions focusing on creating structure and stability could be applied in a way that challenges caring values.Aims and objectivesThis study aimed to describe how nurses’ working in inpatient psychiatric care experience caring encounters with patients suffering from substance use disorder (SUD).DesignThis qualitative study is part of a clinical application project focusing on value‐based care of patients suffering from SUD. Data were obtained during four reflective group dialogues with six nurses in a psychiatric hospital.MethodsThe transcribed dialogues were subjected to latent qualitative content analysis.ResultsThe analysis facilitated the organisation of the findings into a coherent pattern. A common thread of meaning was conceptualised as a theme labelled ‘the multifaceted vigilance’, describing how nurses strived to deliver good care, while at the same time being vigilant towards patients’ behaviour as well as their own reactions to it. Within that theme, four categories described experiences related to different challenges nurses face in caring encounters.ConclusionWe suggest that this perhaps unavoidable aspect of caring encounters can be an asset. Thus, if acknowledged and subject to reflection, being vigilant could be understood as a strength enabling nurses to safeguard caring values, and to use their authority to promote patients’ health and alleviate suffering.
Patient explanations for non‐attendance at type 2 diabetes self‐management education: a qualitative study
Authors: Schwennesen Nete , Henriksen Jan Erik , Willaing Ingrid 
Published: June 2015

AimTo explore reasons for non‐attendance at type 2 diabetes self‐management education.MethodsTo elicit the main themes explaining non‐attendance, 15 semi‐structured interviews were conducted with persons referred to, but not attending, self‐management education. Systematic text condensation was applied to code and generate themes subsequently organised under individual and organisational factors.ResultsIndividual (illness, lack of perceived benefit) and organisational factors relating to schedule (four whole days, time of day, notification) and content (supermarket visit) were cited as reasons for non‐attendance.ConclusionsIn this study, patients cited both individual and organisational factors as explaining non‐attendance at type 2 diabetes self‐management education. Further studies should take into account the importance of timing and of tailoring schedules and content to individuals’ life situations and resources. As organisational factors are likely to vary across programmes and settings, more case studies are needed to further elucidate the dynamic relationship between individual and organisational factors to explain non‐attendance at type 2 diabetes self‐management education.
Europe 2020 and the Fight against Poverty – Beyond Competence Clash, Towards ‘Hybrid’ Governance Solutions?
Authors: Jessoula Matteo 
Published: June 2015

AbstractThe supranational strategy ‘Europe 2020’ came along with two main innovations for social policy coordination in the EU: a quantified poverty reduction target and a new governance framework – the ‘European Semester’. Aiming to assess the effectiveness of the novel strategy in prompting the emergence of a European(‐ized) anti‐poverty arena – thus inherently multilevel and multi‐stakeholder, as well as integrated (across policy sectors) – the article first presents the strategy evolution at the supranational level in 2011–14. Then it analyzes its implementation in five member states – Germany, Italy, Poland, Sweden and the UK – through the first four annual cycles. By directing the analytical focus on processes – rather than outcomes – in order to capture the domestic changes produced by the Europe 2020 anti‐poverty strategy, the article argues that the latter marked significant discontinuity with the Social Inclusion Open Method of Coordination. The new strategy increased the political salience of the poverty issue both at the supranational level and in the selected member states, while leading to a ‘competence clash’ between national governments and the EU in Germany, Sweden and the UK. The emergence of such main tension substantially constrained the Europe 2020 potential in these three countries. Differently, in Italy and Poland, the implementation was smoother and the effects along the participation and integration dimensions were more evident. We contend that national policy legacies, the relevance of EU social funds, as well as partisan preferences, help to explain the differential effects of Europe 2020. The article concludes by suggesting that recent decisions at the EU level might eventually bring European anti‐poverty coordination beyond soft‐law towards ‘hybrid’ governance solutions.
In vivoconfocal microscopy for the detection of canine fungal keratitis and monitoring of therapeutic response
Authors: Ledbetter Eric C. , Norman Mary L. , Starr Jennifer K. 
Published: June 2015

AbstractObjectiveTo describein vivocorneal confocal microscopy of dogs during the clinical course of fungal keratitis and correlate findings with clinical evaluations and anex vivoexperimental canine fungal keratitis model.Animals StudiedSeven dogs with naturally acquired fungal keratitis andex vivocanine corneas experimentally infected with clinical fungal isolates.ProceduresDogs with naturally acquired fungal keratitis were examined byin vivolaser scanning confocal microscopy. Initial confocal microscopic examinations were performed to assist in establishing the diagnosis of fungal keratitis. Serial confocal microscopic examinations were performed to guide antifungal chemotherapy. Confocal microscopy images of canine corneal fungal isolates were obtained by examination of experimentally infectedex vivocanine corneas to corroboratein vivofindings.ResultsFungi cultured and detected byPCRfrom canine corneal samples includedCandida albicans,Fusarium incarnatum‐equiseti,Malassezia pachydermatis, and aRhodotorulasp. Linear, branching, interlocking, hyperreflective structures were detected by confocal microscopy in dogs with filamentous fungal keratitis and round to oval hyperreflective structures were detected in dogs with yeast fungal keratitis. Antifungal chemotherapy was associated with a progressive reduction in the distribution and density of corneal fungal elements, alterations to fungal morphology, decreased leukocyte numbers, restoration of epithelial layers, and an increased number of visible keratocyte nuclei. No dogs had a recurrence of fungal keratitis following medication discontinuation. Confocal microscopic fungal morphologies were similar betweenin vivoandex vivoexaminations.ConclusionsIn vivocorneal confocal microscopy is a rapid method of diagnosing fungal keratitis in dogs and provides a noninvasive mechanism for monitoring therapeutic response.
Deterministic absorbed dose estimation in computed tomography using a discrete ordinates method
Authors: Norris Edward T. , Liu Xin , Hsieh Jiang 
Published: June 2015

Purpose:Organ dose estimation for a patient undergoing computed tomography (CT) scanning is very important. Although Monte Carlo methods are considered gold‐standard in patient dose estimation, the computation time required is formidable for routine clinical calculations. Here, the authors instigate a deterministic method for estimating an absorbed dose more efficiently.Methods:Compared with current Monte Carlo methods, a more efficient approach to estimating the absorbed dose is to solve the linear Boltzmann equation numerically. In this study, an axial CT scan was modeled with a software package, Denovo, which solved the linear Boltzmann equation using the discrete ordinates method. The CT scanning configuration included 16 x‐ray source positions, beam collimators, flat filters, and bowtie filters. The phantom was the standard 32 cm CT dose index (CTDI) phantom. Four different Denovo simulations were performed with different simulation parameters, including the number of quadrature sets and the order of Legendre polynomial expansions. A Monte Carlo simulation was also performed for benchmarking the Denovo simulations. A quantitative comparison was made of the simulation results obtained by the Denovo and the Monte Carlo methods.Results:The difference in the simulation results of the discrete ordinates method and those of the Monte Carlo methods was found to be small, with a root‐mean‐square difference of around 2.4%. It was found that the discrete ordinates method, with a higher order of Legendre polynomial expansions, underestimated the absorbed dose near the center of the phantom (i.e., low dose region). Simulations of the quadrature set 8 and the first order of the Legendre polynomial expansions proved to be the most efficient computation method in the authors’ study. The single‐thread computation time of the deterministic simulation of the quadrature set 8 and the first order of the Legendre polynomial expansions was 21 min on a personal computer.Conclusions:The simulation results showed that the deterministic method can be effectively used to estimate the absorbed dose in a CTDI phantom. The accuracy of the discrete ordinates method was close to that of a Monte Carlo simulation, and the primary benefit of the discrete ordinates method lies in its rapid computation speed. It is expected that further optimization of this method in routine clinical CT dose estimation will improve its accuracy and speed.
Monoclonal Antibody-Defined Specific C Epitope of Brucella O-Polysaccharide Revisited
Authors: Zygmunt Michel S. , Bundle David R. , Ganesh N. Vijaya , Guiard Julie , Cloeckaert Axel 
Published: June 2015

ABSTRACT

The C epitope of
Brucella
O-polysaccharide (O-PS) has so far lacked definitive structural identity. Revised structures for this antigen revealed a unique capping perosamine tetrasaccharide consisting of a sequence of 1,2:1,3:1,2 interresidue linkages. Here, using synthetic oligosaccharide glycoconjugates, the α-1,3 linkage of the O-PS is shown to be an integral structural requirement of this epitope. Although A-dominant strains possess only one or two copies of the capping tetrasaccharide, this creates a unique pentasaccharide antigenic determinant with the linkage sequence 1,2:1,3:1,2:1,2 that is always present in major pathogenic
Brucella
species.
Infection Patterns Induced in Naive Adult Woodchucks by Virions of Woodchuck Hepatitis Virus Collected during either the Acute or Chronic Phase of Infection
Authors: Freitas Natalia , Lukash Tetyana , Rodrigues Louise , Litwin Sam , Kallakury Bhaskar V. , Menne Stephan , Gudima Severin O. 
Published: June 2015

ABSTRACT

The infectivity of hepadnavirus virions produced during either acute or chronic stages of infection was compared by testing the ability of the virions of woodchuck hepatitis virus (WHV) to induce productive acute infection in naive adult woodchucks. Serum WHV collected during acute infection was compared to virions harvested from WHV-infected woodchucks during either (i) early chronic infection, when WHV-induced hepatocellular carcinoma (HCC) was not yet developed, or (ii) late chronic infection, when established HCC was terminal. All tested types of WHV inoculum were related, because they were collected from woodchucks that originally were infected with standardized WHV7 inoculum. Despite the individual differences between animals, the kinetics of accumulation of serum relaxed circular DNA of WHV demonstrated that the virions produced during early or late chronic infection are fully capable of inducing productive acute infection with long-lasting high viremia. These findings were further supported by the analysis of such intrahepatic markers of WHV infection as replicative intermediate DNA, covalently closed circular DNA, pregenomic RNA, and the percentage of WHV core antigen-positive hepatocytes measured at several time points over the course of 17.5 weeks after the inoculation. In addition, the observed relationship between the production of antibodies against WHV surface antigens and parameters of WHV infection appears to be complex. Taken together, the generated data suggest that
in vivo
hepadnavirus virions produced during different phases of chronic infection did not demonstrate any considerable deficiencies in infectivity compared to that of virions generated during the acute phase of infection.

IMPORTANCE
The generated data suggest that infectivity of virions produced during the early or late stages of chronic hepadnavirus infection is not compromised. Our novel results provided several lines of further evidence supporting the idea that during the state of chronic infection
in vivo
, the limitations of hepadnavirus cell-to-cell spread/superinfection (observed recently in the woodchuck model) are not due to the diminished infectivity of the virions circulating in the blood and likely are (i) related to the properties of hepatocytes (i.e., their capacity to support hepadnavirus infection/replication) and (ii) influenced by the immune system. The obtained results further extend the understanding of the mechanisms regulating the persistence of hepadnavirus infection. Follow-up studies that will further investigate hepadnavirus cell-to-cell spread as a potential regulator of the chronic state of the infection are warranted.
Ultrasound-guided hip joint injections are more accurate than landmark-guided injections: a systematic review and meta-analysis
Authors: Hoeber Shane , Aly Abdel-Rahman , Ashworth Nigel , Rajasekaran Sathish 
Published: June 2015

AimTo compare the accuracy of ultrasound (US)-guided versus landmark-guided hip joint injections.MethodsPubMed, Medline and Cochrane libraries were searched up to 31 July 2014. Two independent authors selected studies assessing accuracy of intra-articular hip injections based on predetermined inclusion and exclusion criteria. Selected papers were then evaluated for quality and a meta-analysis of accuracy was performed using random effects models.Results4 US-guided (136 hip injections) and 5 landmark-guided (295 hip injections) studies were reviewed. The weighted means for US-guided and landmark-guided hip injection accuracies were 100% (95% CI 98% to 100%) and 72% (95% CI 56% to 85%), respectively. US-guided hip injection accuracy was significantly higher than landmark-guided accuracy (p<0.0001).SummaryThis is the first systematic review and meta-analysis of the accuracy of US-guided versus landmark-guided hip joint injections that has revealed that US-guided injections are significantly more accurate than those that are landmark guided. Future studies should compare US with fluoroscopic-guided hip joint injections for accuracy, efficacy, safety profile, cost-effectiveness and patient satisfaction.
Developments in the invasive diagnostic–therapeutic cascade of women and men with acute coronary syndromes from 2005 to 2011: a nationwide cohort study
Authors: Hansen Kim Wadt , Soerensen R , Madsen M , Madsen J K , Jensen J S , von Kappelgaard L M , Mortensen P E , Galatius S 
Published: June 2015

ObjectivesTo investigate for trends in sex-related differences in the invasive diagnostic–therapeutic cascade in a population of patients with acute coronary syndromes (ACS).DesignA nationwide cohort study.SettingAdministrative and clinical registries covering all hospitalisations, invasive cardiac procedures and deaths in the Danish population of 5.6 million inhabitants.ParticipantsWe included 52 565 patients aged 30–90 years who were hospitalised with a first ACS from January 2005 to November 2011. Follow-up was 60 days from the day of index admission.Main outcome measuresDiagnostic coronary angiography, percutaneous coronary intervention or coronary artery bypass within 60 days of index admission.ResultsWomen constituted 36%, were older, had more comorbidity and were less likely to be admitted to a hospital with cardiac catheterisation facilities than men. Mortality rates were similar for both sexes. Diagnostic coronary angiography was performed less frequently on women compared with men, both within 1 day (31% vs 42%; p<0.001) and within 60 days (67% vs 80%; p<0.001), yielding adjusted female–male HRs of 0.83 (0.79–0.87) and 0.86 (0.84–0.89), respectively.Among the 39 677 patients undergoing coronary angiography, non-obstructive coronary artery disease was more frequent among women than men (22% vs 9%; p<0.001). Women were less likely to undergo percutaneous coronary intervention (58% vs 72%; p<0.001) and coronary artery bypass (6% vs 11%, p<0.001) within 60 days than men, yielding adjusted HRs of 0.96 (0.92–0.99) and 0.81 (0.74–0.89), respectively. The sex-related differences were not attenuated over time for any of the invasive cardiac procedures (p values for trend >0.05).ConclusionsIn this nationwide study, men were more likely to undergo an invasive approach than women when hospitalised with a first ACS—a difference persisting from 2005 to 2011. Future studies should focus on the potential mechanisms behind this differential treatment.
Shallow-water facies setting around the Kačák Event: a multidisciplinary approach
Authors: Königshof P. , Da Silva A. C. , Suttner T. J. , Kido E. , Waters J. , Carmichael S. K. , Jansen U. , Pas D. , Spassov S. 
Published: June 2015

Abstract

In the Eifel area (western Rheinisches Schiefergebirge), a shallow- to deep-subtidal sequence of mixed carbonates and siltstones around the Kačák Event Interval close to the Eifelian–Givetian stage boundary was studied. An overall transgressive trend is inferred by the microfacies evolution. The stratigraphic variations of magnetic susceptibility in carbonates and in shale intervals show an overall decreasing evolution towards the top, which fits well with the transgressive trend. In addition, carbon and oxygen isotopes, and major, trace and rare earth element (REE) analysis have been used to get a better understanding of palaeoenvironmental variations in a shallow-water realm in the late Eifelian (
kockelianus
and
ensensis
conodont biozones): for example, the δ
13
C excursion and Ce anomaly are interpreted to be the local representation of the beginning of the Kačák Event Interval, which is also consistent with the stratigraphy and microfacies analyses.
Suppression of Reserve MCM Complexes Chemosensitizes to Gemcitabine and 5-Fluorouracil
Authors: Bryant Victoria L. , Elias Roy M. , McCarthy Susan M. , Yeatman Timothy J. , Alexandrow Mark G. 
Published: June 2015

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest forms of cancer and is very difficult to treat with conventional chemotherapeutic regimens. Gemcitabine and 5-fluorouracil are used in the management of PDAC and act by indirectly blocking replicative forks. However, these drugs are not highly effective at suppressing disease progression, indicating a need for the development of innovative therapeutic approaches. Recent studies indicate that suppression of the MCM helicase may provide a novel means to sensitize cancer cells to chemotherapeutic agents that inhibit replicative fork progression. Mammalian cells assemble more MCM complexes on DNA than are required to start S-phase. The excess MCM complexes function as backup initiation sites under conditions of replicative stress. The current study provides definitive evidence that cosuppression of the excess/backup MCM complexes sensitizes PDAC tumor lines to both gemcitabine and 5-FU, leading to increased loss of proliferative capacity compared with drugs alone. This occurs because reduced MCM levels prevent efficient recovery of DNA replication in tumor cells exposed to drug. PDAC tumor cells are more sensitive to MCM loss in the presence of gemcitabine than are nontumor, immortalized epithelial cells. Similarly, colon tumor cells are rendered less viable when cosuppression of MCM complexes occurs during exposure to the crosslinking agent oxaliplatin or topoisomerase inhibitor etoposide.
Implications: These studies demonstrate that suppressing the backup complement of MCM complexes provides an effective sensitizing approach with the potential to increase the therapeutic index of drugs used in the clinical management of PDAC and other cancers. Mol Cancer Res; 13(9); 1296–305. ©2015 AACR.
B regulatory cells are increased in hypercholesterolaemic mice and protect from lesion development via IL-10
Authors: Blair Paul , Leib Christoph , Goddard Michael , Rosser Elizabeth , Park Inhye , Nilsson Anna Hultgårdh , Nilsson Jan , Strom Asa , Cross Amanda , Cole Jennifer , Mauri Claudia , Monaco Claudia 
Published: June 2015

SummaryWhilst innate B1-B cells are atheroprotective, adaptive B2-B cells are considered pro-atherogenic. Different subsets of B regulatory cells (Breg) have been described. In experimental arthritis and lupus-like disease, Breg are contained within the CD21hiCD23hiCD24hi B cell pool. The existence and role of Breg in vascular disease is not known. We sought to investigate the existence, identity and location of Breg in vascular disease. The representation of B2-B cell subsets in the spleens and lymph nodes (LNs) of Apolipoprotein E-/- (ApoE-/-) mice compared to controls was characterised by flow cytometry. Additionally, we utilised a model of neointima formation based on the placement of a perivascular collar around the carotid artery in ApoE-/- mice to ascertain whether B cells and B cell subsets confer protection against lesion development. Adoptive transfer of B cells was performed from wild type or genetically modified mice. We showed that CD21hiCD23hiCD24hi B cells are unexpectedly increased in the draining LNs of ApoE-/- mice. Adoptive transfer of LN-derived B2-B cells or purified CD21hiCD23hiCD24hi B cells to syngeneic mice reduced lesion size and inflammation without changing serum cholesterol levels. Follicular B2-B cells did not confer protection. IL-10 blockade or transfer of IL10-deficient B cells prevented LN-derived B cell-mediated protection. This is the first identification of a specific LN-derived B2-Breg subset that confers IL-10 mediated protection from neointima formation. This may open the way for immune modulatory approaches in cardiovascular disease.