bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intersectoral action for health equity as it relates to climate change in Canada: contributions from critical systems heuristics
Authors: Buse Chris 
Published: June 2013

AbstractRationaleIntersectoral action (ISA) has been at the forefront of public health policy discussions since the 1970s. ISA incorporates a broader perspective of public health issues and coordinates efforts to address the social, political, economic and environmental contexts from which health determinants operate and are created. Despite being forwarded as a useful way to address and treat complex or ‘wicked’ problems, such policy issues are still often addressed within, rather than across, disciplinary silos and ISA has been documented to fail more often than it succeeds.Aims and objectivesThis paper contributes to an understanding of ISA by outlining and applying critical systems heuristics (CSH) theory and methods.MethodsCSH theory and methods are described and discussed before applying them to the example of addressing climate change and health equity through public health practice.ResultsCSH thinking provides useful tools to engage stakeholders, question relations of power that may exist between collaborating partners, and move beyond power inequalities that guide ISA initiatives.ConclusionsCSH is a compelling framing that can improve an understanding of the collaborative relationships that are a prerequisite for engaging in ISA to address complex or ‘wicked’ policy problems such as climate change.
Protargol Synthesis: An In‐house Protocol
Authors: Pan Xuming , Bourland William A. , Song Weibo 
Published: June 2013

AbstractThe protargol staining method has proved to be indispensable for revealing the cellular structures of a variety of protozoa, especially the flagellates and ciliates. Protargol provides permanent stains of a variety of cellular structures: nuclei, extrusomes, basal bodies, and microfilamentous constituents of cells. Together with the older silver nitrate methods, protargol impregnations have provided the basis for the detailed descriptions of nearly all ciliates to date. The performance of commercially available preparations has varied widely. Recently, suppliers have stopped stocking the effective forms of protargol resulting in a worldwide shortage. Thus, it has become necessary for protistologists to explore on‐site synthesis of this critically important agent. An optimum protocol for synthesis of protargol should be rapid, relatively inexpensive, simple enough to be done by non‐chemists, and achievable without specialized equipment. In this article, the authors briefly review the interesting history of protargol and describe a protocol, based on the early studies of neuroanatomists, that yields a protargol producing impregnations of ciliates comparable to those obtained with previously available commercial preparations.
Guggulsterone attenuates activation and survival of hepatic stellate cell by inhibiting nuclear factor kappa B activation and inducing apoptosis
Authors: Kim Bo Hyun , Yoon Jung‐Hwan , Yang Jong In , Myung Sun Jung , Lee Jeong‐Hoon , Jung Eun Uk , Yu Su Jong , Kim Yoon Jun , Lee Hyo‐Suk , Kim Chung Yong 
Published: June 2013

AbstractBackground and AimLiver fibrosis is associated with the deposition of the extracellular matrix, and hepatic stellate cells (HSCs) are the major source of these matrix proteins. Guggulsterone has recently been shown to induce apoptosis in several cell lines. Thus, the aim of this study was to evaluate whether guggulsterone has antifibrotic activities by reducing the activation and survival of HSCs.MethodsApoptotic and fibrosis‐related signaling pathways and nuclear factor kappa B (NF‐κB) activity were explored in LX‐2 cells, an immortalized human HSC line, and in a mice model of liver fibrosis.ResultsGuggulsterone suppressed LX‐2 cell growth in a dose‐ and activation‐dependent manner. This growth suppression was due to the induction of HSC apoptosis, which was mediated by the activation of c‐Jun N‐terminal kinase and mitochondrial apoptotic signaling. Additionally, guggulsterone regulated phosphorylation of Akt and adenosine monophosphate‐activated protein kinase, which were subsequently proven responsible for the guggulsterone‐induced HSC growth suppression. Guggulsterone inhibited NF‐κB activation in LX‐2 cells, which is one of the major mediators in HSC activation. Indeed, guggulsterone decreased collagen α1 synthesis and α‐smooth muscle actin expression in these cells. Compared with the control mice or mice treated with a low dose of guggulsterone, high dose of guggulsterone significantly decreased the extent of collagen deposition and the percentage of activated HSCs undergoing apoptosis.ConclusionsThese results demonstrate that guggulsterone suppressed HSC activation and survival by inhibiting NF‐κB activation and inducing apoptosis. Therefore, guggulsterone may be useful as an antifibrotic agent in chronic liver diseases.
Ethnicity is a strong predictor for Helicobacter pylori infection in young women in a multi‐ethnic European city
Authors: den Hollander Wouter J , Holster I Lisanne , den Hoed Caroline M , van Deurzen Frances , van Vuuren Anneke J , Jaddoe Vincent W , Hofman Albert , Perez Perez Guillermo I , Blaser Martin J , Moll Henriëtte A , Kuipers Ernst J 
Published: June 2013

AbstractBackground and AimAt the same time that Helicobacter pylori prevalence is declining in Western countries, immigrants from developing countries with high H. pylori prevalence have settled in Western urban areas. Actual epidemiological data on H. pylori in a migrant community may help in realizing a more selective approach to assess H. pylori‐related diseases. We aimed to define H. pylori prevalence as well as risk groups for H. pylori in a cohort of young women living in a multi‐ethnic European city.MethodsWe measured Immunoglobulin G (IgG) anti‐H. pylori and CagA‐antibodies in serum of pregnant women included in a population‐based prospective cohort study, the Generation R study. Information on demographics and socioeconomic status was collected by questionnaires. Chi‐square and logistic regression were used.ResultsIn total, 3146 (46%) of the 6837 tested women (mean age 29.7 ± 5.3) were H. pylori‐positive and 1110 (35%) of them were CagA‐positive. The H. pylori prevalence in Dutch women was 24%, which was significantly lower than in non‐Dutch women (64%; P < 0.001). In particular, H. pylori positivity was found in 92% of Moroccan (odds ratio 19.2; 95% confidence interval 11.8–32.0), 80% of Cape Verdean (7.6; 5.0–11.5), 81% of Turkish (9.0; 6.7–12.1), 60% of Dutch Antillean (3.3; 2.3–4.7), and 58% of Surinamese women (3.0; 2.3–3.8). Among H. pylori‐positive Dutch subjects, 19% were CagA‐positive compared with 40% of the non‐Dutch subjects (P < 0.001).ConclusionsDespite a general trend of declining prevalence in Western countries, H. pylori remains highly prevalent in migrant communities, which may constitute target groups for screening and eradication to prevent H. pylori‐related diseases.
Fibroscan can avoid liver biopsy in Indian patients with chronic hepatitis B
Authors: Goyal Rohit , Mallick Saumya Ranjan , Mahanta Mousumi , Kedia Saurabh , Shalimar  , Dhingra Rajan , Sharma Hanish , Das Prasenjit , Datta Gupta Siddhartha , Panda Subrat , Acharya Subrat K 
Published: June 2013

AbstractBackground and AimLiver fibrosis is an established determinant of prognosis and therapy in chronic hepatitis B (CHB). The role of fibroscan in assessing fibrosis in CHB remains unclear. Present study was designed to correlate fibroscan with liver biopsy and determine whether fibroscan can avoid liver biopsy in patients with CHB.MethodsFibroscan and liver biopsy were performed in 382 consecutive patients with CHB. Biopsies were reviewed by pathologist blinded to the fibroscan value. Discriminant values of liver stiffness measurement (LSM) to reasonably exclude and predict significant fibrosis were calculated from receiver operating characteristic (ROC) curves. The factors affecting LSM independent of fibrosis were assessed.ResultsThree hundred fifty‐seven patients were included (mean age 30.1 ± 9.7 years, male : female 17 : 3). There was significant correlation between LSM and histological fibrosis (r = 0.58, P < 0.001). The area under ROC curve of LSM for significant fibrosis (F0‐1 vs F2‐4), bridging fibrosis (F0‐2 vs F3‐4), and cirrhosis (F0‐3 vs F4) was 0.84 (95%CI:0.78–0.89), 0.94 (95%CI:0.89–0.99), and 0.93 (95%CI:0.85–1.00), respectively. LSM < 6.0 KPa could exclude significant (F ≥ 2) and bridging fibrosis (F ≥ 3) with a negative predictive value (NPV) of 92.4% and 99.5%, respectively. Cut‐off of 9 KPa could detect significant (F ≥ 2) and bridging fibrosis (F ≥ 3) with specificity of 95% and 97%, respectively, and had a positive predictive value (PPV) of 84.3% in predicting significant fibrosis. LSM < 6 KPa and > 9 KPa matched with histological fibrosis in 227/250 (91%) patients. Therefore, fibroscan could avoid liver biopsy in 70% (250/357) patients with an accuracy > 90%. Histological fibrosis, ALT > 5 times, and age > 40 years were independent determinants of increased liver stiffness.ConclusionsFibroscan accurately assessed fibrosis and could avoid liver biopsy in more than two‐thirds of patients with CHB.
Healthy Foods North improves diet among Inuit and Inuvialuit women of childbearing age in Arctic Canada
Authors: Bains A. , Pakseresht M. , Roache C. , Beck L. , Sheehy T. , Gittelsohn J. , Corriveau A. , Sharma S. 
Published: June 2013

AbstractBackgroundHealthy Foods North (HFN) is a community‐based intervention designed to promote a healthy diet and lifestyle of Inuit and Inuvialuit populations in Arctic Canada. The objective of the present study was to determine the effects of HFN on the nutrient intake of women of childbearing age.MethodsSix communities in Nunavut (n = 3) and the Northwest Territories (n = 3) were selected for programme implementation; four received a 12‐month intervention and two served as controls. Quantitative food frequency questionnaires were used to assess dietary intake at baseline and 1 year post‐intervention. Among women participants aged 19–44 years (n = 136), 79 were exposed to the intervention and 57 were not. Mean daily energy and nutrient intake and density were determined. Dietary adequacy was assessed by comparing the women's daily nutrient intakes with dietary reference intakes (DRI).ResultsMain outcomes were the pre‐ to post‐intervention changes between intervention and control groups for energy and selected nutrient intakes, nutrient density and dietary adequacy. Among the participants, the intervention had a beneficial effect on vitamin A and D intake. The percentage of individuals with nutrient intakes below the DRI increased from pre‐ to post‐intervention for vitamin A and D in the control group but only for vitamin A in the intervention group. The programme did not have a significant impact on calorie, sugar, or fat consumption.ConclusionsThe HFN programme is effective in mitigating some of the negative impacts of the nutrition transition on dietary adequacy among Inuit and Inuvialuit women of childbearing age.
Patient satisfaction with nutrition services amongst cancer patients treated with autologous stem cell transplantation: a comparison of usual and extended care
Authors: Hung Y.‐C. , Bauer J. , Horsley P. , Isenring E. 
Published: June 2013

AbstractBackgroundThis study aimed to determine patient satisfaction with clinical nutrition services delivered by an accredited practicing dietitian amongst cancer patients treated with autologous stem cell transplantation that was provided with usual and extended care at 100 days post‐transplantation.MethodsPatients were randomised to receive usual nutrition care or extended nutrition care during the course of their stem cell transplantation. After hospital discharge, usual care patients received no further nutrition support, whereas extended care patients received telephone dietary counselling from the same dietitian for up to 100 days post‐transplantation. The patient satisfaction with clinical nutrition service questionnaire was completed anonymously at 100 days post‐transplantation. Group comparisons were made using independent t‐tests.ResultsThirty‐seven patients consented to participate in the study (54% male; mean age 58.7 ± 9.5 years; median body mass index 26.8 kg m–2, range 16.4–47.6 kg m–2); 33 patients completed the study and 28 patients returned the questionnaire (response rate = 85%). All components of the questionnaire were rated highly by both groups; there was no significant difference between the groups (P > 0.05). Although not statistically significant, extended care patients who received at least three telephone calls rated a higher overall satisfaction compared to those who received less calls; this difference was clinically important (score difference = 0.56).ConclusionsCancer patients treated with autologous stem cell transplantation were satisfied with usual and extended nutrition care. Extended care patients who received at least three telephone calls after hospital discharge were more satisfied than those with less frequent intervention. Further exploration regarding the frequency and intensity of nutrition service is required.
An exploration of illness representations and treatment beliefs in heart failure
Authors: MacInnes Julie 
Published: June 2013

Aims and objectivesTo explore the beliefs patients with heart failure hold about their illness and its treatment using the common‐sense model of illness cognitions and behaviour as the theoretical framework.BackgroundHeart failure is a disabling condition, which has a significant impact on individuals, their families and healthcare provision. The common‐sense model provides a framework within which lay beliefs about illness and its treatment can be examined. Previous studies have reported a number of misconceptions in relation to the nature of and treatment for heart failure. Inaccurate beliefs are related to limited self‐care and nonadherence to medication.DesignA qualitative research design was used in which thematic analysis was used to interpret interview data.MethodsSemi‐structured interviews were carried out with twelve patients with chronic heart failure in a community setting in South East England. An interview schedule based on the dimensions of the common‐sense model guided data collection. Data were analysed thematically using the framework method.ResultsA cluster of beliefs around a chronic illness with serious consequences was found. However, patients were unable to distinguish between symptoms of heart failure, effects of medication and emotional responses to the illness. The illness was attributed to external factors, especially stressful life events. There was a strong belief in the necessity of medication coupled with the belief that the illness and its symptoms could be controlled by medication. Concerns about drug interactions and side effects were prevalent.ConclusionsThis study highlights the need for nurses to explore illness representations and treatment beliefs in heart failure. Misconceptions should be corrected to influence behaviour change.Relevance to clinical practiceAn understanding of illness representations and treatment beliefs should enable structured interventions to be developed, which improve clinical outcomes in this population.
Attitudes of emergency department patients about handover at the bedside
Authors: Kerr Debra , McKay Kate , Klim Sharon , Kelly Anne‐Maree , McCann Terence 
Published: June 2013

Aims and objectivesTo explore patients' perspectives of bedside handover by nurses in the emergency department (ED).BackgroundInternational guidelines promote standardisation in clinical handover. Poor handover can lead to adverse incidents and expose patients to harm. Studies have shown that nurses and patients have favourable opinions about handover that is conducted at the bedside in hospital wards; however, there is a lack of evidence for patients' perspective of nursing handover in the ED environment.DesignQualitative descriptive study.MethodsSemi‐structured interviews with 30 ED patients occurred within one hour of bedside handover. Data were analysed using thematic content analysis.ResultsTwo main themes were identified in the data. First, patients perceive that participating in bedside handover enhances individual care. It provides the opportunity for patients to clarify discrepancies and to contribute further information during the handover process, and is valued by patients. Patients are reassured about the competence of nurses and continuum of care after hearing handover conversations. Second, maintaining privacy and confidentiality during bedside handover is important for patients. Preference was expressed for handover to be conducted in the ED cubicle area to protect privacy of patient information and for discretion to be used with sensitive or new information.ConclusionsBedside handover is an acceptable method of performing handover for patients in the ED who value the opportunity to contribute and clarify information, and are reassured that their information is communicated in a private location.Relevance to clinical practiceFrom the patients' perspective, nursing handover that is performed at the bedside enhances the quality and continuum of care and maintains privacy and confidentiality of information. Nurses should use discretion when dealing with sensitive or new patient information.
The Tetrad Test: Looking Back, Looking Forward
Authors: O'Mahony Michael 
Published: June 2013

AbstractUntil recently, the tetrad test was considered an interesting idea but was seldom used. It was not until Ennis and Jesionka revisited the topic of power for discrimination tests, that it was observed that the tetrad test had, theoretically, considerably more power than the triangle test. This made it a suitable candidate as a replacement for the low powered, yet commonly used, triangle method. This has sparked a lot of activity concerning the tetrad and there will be more to come. Yet, the tetrad had been explored beforehand, for the purposes of testing Thurstonian models. Had the authors had the right tools, could they have produced any evidence to support Ennis and Jesionka's observation?Practical ApplicationsThe use of difference tests where the attribute change is not described to the judge, is especially useful for testing consumers in normal conditions of consumption. In such normal conditions, unlike those for a two‐alternative forced choice (paired comparison), there is no person nearby specifying the nature of the attribute that should be attended to while consuming food samples. The nature of the difference between such food samples has to be discovered by the consumer. Available tests like the triangle or duo‐trio are not statistically powerful and therefore require large samples of data, which can incur greater expense. Yet, the tetrad is more theoretically powerful than these tests and is thus worthy of, and is indeed receiving, further investigation.
Occlusal trauma accelerates attachment loss at the onset of experimental periodontitis in rats
Authors: Nakatsu S. , Yoshinaga Y. , Kuramoto A. , Nagano F. , Ichimura I. , Oshino K. , Yoshimura A. , Yano Y. , Hara Y. 
Published: July 2013

Background and ObjectiveOcclusal trauma is an important factor that influences the progression of periodontitis, but it is unclear whether occlusal trauma influences periodontal destruction at the onset of periodontitis. We established an experimental periodontitis model with both site‐specific loss of attachment and alveolar bone resorption. The purpose of the present study was to investigate the effects of occlusal trauma on periodontal destruction, particularly loss of attachment, at the onset of experimental periodontitis.Material and MethodsSixty rats were used in the present study. Forty‐eight rats immunized with lipopolysaccharide (LPS) intraperitoneally were divided into four groups. In the trauma (T) group, occlusal trauma was induced by placing an excessively high metal wire in the occlusal surface of the mandibular right first molar. In the inflammation (I) group, periodontal inflammation was induced by topical application of LPS into the palatal gingival sulcus of maxillary right first molars. In the trauma + inflammation (T+I) group, both trauma and periodontal inflammation were simultaneously induced. The PBS group was administered phosphate‐buffered saline only. Another 12 nonimmunized rats (the n−(T+I) group) were treated as described for the T+I group. All rats were killed after 5 or 10 d, and their maxillary first molars with surrounding tissues were observed histopathologically. Loss of attachment and osteoclasts on the alveolar bone crest were investigated histopathologically. To detect immune complexes, immunohistological staining for C1qB was performed. Collagen fibers were also observed using the picrosirius red‐polarization method.ResultsThere were significant increases in loss of attachment and in the number of osteoclasts in the T+I group compared with the other groups. Moreover, widespread distribution of immune complexes was observed in the T + I group, and collagen fibers oriented from the root surface to the alveolar bone crest had partially disappeared in the T, T+I and n−(T+I) groups.ConclusionWhen inflammation was combined with occlusal trauma, immune complexes were confirmed in more expanding areas than in the area of the I group without occlusal trauma, and loss of attachment at the onset of experimental periodontitis was increased. Damage of collagen fibers by occlusal trauma may elevate the permeability of the antigen through the tissue and result in expansion of the area of immune‐complex formation and accelerating inflammatory reaction. The periodontal tissue destruction was thus greater in the T+I group than in the I group.
Evolutionary dynamics of hepatitis C virus NS3 protease domain during and following treatment with narlaprevir, a potent NS3 protease inhibitor
Authors: de Bruijne J. , Thomas X. V. , Rebers S. P. , Weegink C. J. , Treitel M. A. , Hughes E. , Bergmann J. F. , de Knegt R. J. , Janssen H. L. A. , Reesink H. W. , Molenkamp R. , Schinkel J. 
Published: June 2013

SummaryNarlaprevir, a hepatitis C virus (HCV) NS3/4A serine protease inhibitor, has demonstrated robust antiviral activity in a placebo‐controlled phase 1 study. To study evolutionary dynamics of resistant variants, the NS3 protease sequence was clonally analysed in thirty‐two HCV genotype 1–infected patients following treatment with narlaprevir. Narlaprevir monotherapy was administered for one week (period 1) followed by narlaprevir/pegylated interferon‐alpha‐2b combination therapy with or without ritonavir (period 2) during two weeks, interrupted by a washout period of one month. Thereafter, all patients initiated pegylated interferon‐alpha‐2b/ribavirin combination therapy. Longitudinal clonal analysis was performed in those patients with NS3 mutations. After narlaprevir re‐exposure, resistance‐associated mutations at position V36, T54, R155 and A156 were detected in five patients in >95% of the clones. Narlaprevir retreatment resulted in a 2.58 and 5.06 log10 IU/mL viral load decline in patients with and without mutations, respectively (P = <0.01). After treatment, resistant variants were replaced with wild‐type virus within 2–24 weeks in three patients. However, the R155K mutation was still observed 3.1 years after narlaprevir dosing in two patients in 5% and 45% of the viral population. Resistant variants could be detected early during treatment with narlaprevir. A slower viral load decline was observed in those patients with resistance‐associated mutations detectable by direct population sequencing. These mutations disappeared within six months following treatment with the exception of R155K mutation, which persisted in two patients.