bluuebunny/crossref_metadata_2025_split huggingface dataset:
A paramedic study comparing the use of the Airtraq®, Airway Scope and Macintosh laryngoscopes in simulated prehospital airway scenarios*
Authors: Lewis A. R. , Hodzovic I. , Whelan J. , Wilkes A. R. , Bowler I. , Whitfield R. 
Published: October 2010

SummaryIn a randomised, cross‐over study, we compared the use of the Airtraq®, Airway Scope and Macintosh laryngoscopes by paramedics for tracheal intubation in three simulated prehospital scenarios. Fifty‐four paramedics were invited to take part. When evaluated in a difficult airway manikin, median IQR [range] time to intubation with the Airtraq (21 (16–37 [6–80] s) and Airway Scope (16 (5–75 [12–23] s) was shorter than that with the Macintosh laryngoscope (39 (25–54 [7–120] s; p < 0.0001). The success rate within 30 s was greater with the Airtraq (61%) and Airway Scope (93%) than with the Macintosh laryngoscope (22%; p < 0.0001). When used for a standard intubation and in the sitting position, we found minimal differences among the three laryngoscopes. We conclude that the Airway Scope and Airtraq have significant advantages over the Macintosh laryngoscope and that of the two, the Airway Scope is the more effective device to use in the prehospital environment.
Comparison of the LMA Supreme vs the i‐gel™ in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation*
Authors: Teoh W. H. L. , Lee K. M. , Suhitharan T. , Yahaya Z. , Teo M. M. , Sia A. T. H. 
Published: October 2010

SummaryWe compared the efficacy of the inflatable cuff of the LMA Supreme™ against the non‐inflatable i‐gel™ cuff in providing an adequate seal for laparoscopic surgery in the Trendelenburg position in 100 female patients. There was no difference in our primary outcome, oropharyngeal leak pressure, between the LMA Supreme and the i‐gel (mean (SD) 26.4 (5.1) vs 25.0 (5.7) cmH2O, respectively; p = 0.18). Forty‐seven (94%) LMA Supremes and 48 (96%) i‐gels were successfully inserted on the first attempt, with similar ease, and comparable times to the first capnograph trace (mean (SD) 14.3 (4.7) s for the LMA Supreme vs 15.4 (8.2) s for the i‐gel; p = 0.4). Gastric tube insertion was easier and achieved more quickly with the LMA Supreme vs the i‐gel (9.0 (2.5) s vs 15.1 (7.3) s, respectively; p < 0.001). After creation of the pneumoperitoneum, there was a smaller difference between expired and inspired tidal volumes with the LMA Supreme (21.5 (15.2) ml) than with the i‐gel (31.2 (23.5) ml; p = 0.009). There was blood on removal of two LMA Supremes and one i‐gel. Four patients in the LMA Supreme group and one patient in the i‐gel group experienced mild postoperative sore throat.
Molecular characterization of paediatric idiopathic hypereosinophilia
Authors: Rapanotti Maria Cristina , Caruso Roberta , Ammatuna Emanuele , Zaza Serena , Trotta Laura , Divona Mariadomenica , Cicconi Laura , Funaro Daria , Federici Giorgio , Amadori Sergio , De Rossi Giulio , Lo‐Coco Francesco 
Published: October 2010

SummaryThe hypereosinophilic syndromes (HES) include a group of heterogeneous diseases characterized by the persistent increase of the number of eosinophils in blood and bone marrow. Few cases of paediatric hypereosinophilia (pHES) have been described in the literature. Early identification of pHES that may evolve towards a lymphomyeloproliferative disease is relevant in light of prognostic and therapeutic implications. Molecular features of 10 pHES patients were analysed at presentation and during their clinical course, including analysis of BCR‐ABL1 and FIP1L1/PDGFRA fusion genes, quantitation of WT1 gene copy number and clonality of T‐cell receptor (TCR) and immunoglobulin heavy chain (IGH). All patients had normal karyotype and germline TCR configuration. Five children showed IGH clonality at presentation: of these, two developed a B non‐Hodgkin lymphoma and a B‐lineage acute lymphocytic leukaemia at six and 12 months respectively, two spontaneously reverted to a polyclonal IGH profile during the follow‐up, and the last one persisted with pHES without B‐clonal evolution after 19 months. One patient had a PDGFRA/FIP1L1 fusion and achieved hematologic and molecular remission after imatinib therapy. IGH rearrangement was observed to be a frequent molecular feature of pHES and may precede B‐cell clonal expansion and evolution into B‐cell malignancies in children.
A randomized phase II trial of Arginine Butyrate with standard local therapy in refractory sickle cell leg ulcers
Authors: McMahon Lillian , Tamary Hannah , Askin Melissa , Adams‐Graves Patricia , Eberhardt Robert T. , Sutton Millicent , Wright Elizabeth C. , Castaneda Serguei A. , Faller Douglas V. , Perrine Susan P. 
Published: October 2010

SummarySickle cell leg ulcers are often debilitating, refractory to healing, and prone to recurrence. Healing of leg ulcers was incidentally observed during dose‐ranging trials of Arginine Butyrate in beta haemoglobinopathies. Here, a controlled Phase II trial was performed in sickle cell patients who had lower extremity ulcers refractory to standard care for at least 6 months. Patients were randomized to receive standard local care alone (Control Arm) or standard care with Arginine Butyrate administered 5 d/week (Treatment Arm), for 12 weeks. Ulcers were photographed weekly, traced, and ulcer areas were calculated by computerized planimetry and compared between the two study arms. Twenty‐seven study courses were evaluated. Control Arm subjects had 25 ulcers with a mean area of 25·7 cm2 initially and 23·2 cm2 after 12 weeks; 2/25 (8%) healed completely. Treatment Arm subjects had 37 ulcers with a mean area of 50·6 cm2 initially and 28·3 cm2 at 12 weeks; 11/37 of these (30%) healed completely. After 3 months, proportions of ulcers which healed were 6/25 (24%) and 29/37 (78%), in the Control and Treatment Arms respectively (P < 0·001). These findings strongly suggest that Arginine Butyrate merits further evaluation for the treatment of refractory sickle cell leg ulcers in larger trials.
Desensitization to hydroxycarbamide following long‐term treatment of thalassaemia intermedia as observed in vivo and in primary erythroid cultures from treated patients
Authors: Rigano Paolo , Pecoraro Alice , Calzolari Roberta , Troia Antonio , Acuto Santina , Renda Disma , Pantalone Gaetano Restivo , Maggio Aurelio , Marzo Rosalba Di 
Published: October 2010

SummaryHydroxycarbamide (HC) is a pharmacological agent capable of stimulating fetal haemoglobin (HbF) production during adult life. High levels of HbF may ameliorate the clinical course of β‐thalassaemia and sickle cell disease. The efficacy of HC for the treatment of thalassaemia major and thalassaemia intermedia is variable. Although an increase of HbF has been observed in most patients, only some patients experience significant improvement in total haemoglobin levels. This study aimed to determine the effectiveness and safety of short‐ (1 year) and long‐term (mean follow‐up 68 months) HC treatment in 24 thalassaemia intermedia patients. Additionally, we evaluated if primary erythroid progenitor cells cultured from treated patients responded to HC treatment in a manner similar to that observed in vivo. Our results confirm a good response to HC after a short‐term follow‐up in 70% of thalassaemia intermedia patients and a reduction of clinical response in patients with a long follow‐up. Erythroid cultures obtained from patients during treatment reproduced the observed in vivo response. Interestingly, haematopoietic stem cells from long‐term treated patients showed reduced ability to develop into primary erythroid cultures some months before the reduction of the ‘in vivo’ response. The mechanism of this loss of response to HC remains to be determined.
HER2 molecular subtype is a dominant subtype of mammary Paget’s cells. An immunohistochemical study
Authors: Sek Piotr , Zawrocki Antoni , Biernat Wojciech , Piekarski Janusz H 
Published: October 2010

Sek P, Zawrocki A, Biernat W & Piekarski J H (2010) Histopathology57, 564–571 HER2 molecular subtype is a dominant subtype of mammary Paget’s cells. An immunohistochemical studyAims:  To test the hypothesis that the similarity of the molecular subtypes of Paget’s cells to the molecular subtypes of the underlying breast carcinomas favours the epidermotrophic theory of the origin of Paget’s cells.Methods and results:  The immunohistochemical expression of markers that define particular molecular subtypes of breast carcinomas were analysed. The whole analysis was performed by means of tissue microarrays in mammary Paget’s disease and in the underlying breast carcinoma(s). Human epidermal growth factor receptor type 2 (HER2)‐overexpression subtype [oestrogen receptor (ER−); HER2+] was a dominant molecular subtype of Paget’s cells (37 of 43 analysed cases; 86%). Luminal B (ER+; HER2+) and luminal A (ER+; HER−) subtypes were identified in 12% and 2% of cases, respectively. None of the analysed tumours presented a basal‐like phenotype. A similar distribution of molecular subtypes was identified in the underlying in situ breast carcinomas (HER2 subtype, 82%; luminal A, 6%; luminal B, 6%; basal‐like, 6% of cases) and in the invasive component (HER2 subtype, 84%; luminal A, 8%; luminal B, 8%; basal‐like, 0% of cases).Conclusions:  HER2 molecular subtype is the dominant, but not the sole subtype seen in Paget’s cells of the nipple. A similar distribution of molecular subtypes in both Paget’s cells and in the underlying carcinomas strongly suggests their common origin.
Emergency nurse practitioners: the views of patients and hospital staff at a major acute trust in the UK
Authors: Melby Vidar , Gillespie Mark , Martin Stephanie 
Published: October 2010

Aim.  The study reported in this paper aimed at exploring the views of staff and patients of a potential emergency nurse practitioner service in an acute trust in the UK.Background.  The role of the nurse in emergency care has changed considerably in recent years, and the evolution of the emergency nurse practitioner role has changed emergency service provision dramatically. The emergency nurse practitioner role is not uniformly defined across emergency care in the UK, and the resulting blurring of the role of emergency nurse practitioners with that of emergency department medical staff is not helpful to hospital staff or patients.Design.  A quantitative and qualitative mixed method design was used that enabled exploration of an individual’s viewpoint within their own practice or natural surroundings.Method.  Self‐completed questionnaires were used to determine health professionals’ opinions, and semi‐structured interviews were employed to explore patients’ views.Results.  A total of 144 health professionals responded to the questionnaire survey giving a response rate of 28·5%, and 10 patients participated in qualitative interviews. Health professionals and patients alike were generally supportive of an emergency nurse practitioner service, but there were some concerns in relation to the role and functions of the emergency nurse practitioner and associated accountability issues.Conclusions.  This paper contributes further data that demonstrate the inter‐professional and patient support of the advanced role of the emergency nurse practitioner and highlights potential conflictual issues and barriers to implementation that can and must be resolved successfully through proper consultation prior to the service being introduced.Relevance to clinical practice.  This paper provides important information to health professionals and service providers that should help to facilitate the introduction and maintenance of a successful and effective emergency nurse practitioner service in any trust.
Nurses’ practice of blood transfusion in the United Arab Emirates: an observational study
Authors: Hijji Belal , Parahoo Kader , Hossain Mohammad M , Barr Owen , Murray Shirley 
Published: October 2010

Aims.  The aim of this study was to document nurses’ practice of red blood cells transfusion.Background.  In the United Arab Emirates hospitals, nurses are responsible for the administration of blood transfusions. The safety and effectiveness of the transfusion process is dependent, among others, on the knowledge and skills of nurses who perform the procedure. Poor practice may result in avoidable complications that may threaten patients’ safety. Published work indicated that nurses’ practice varied across contexts and highlighted that patients received suboptimal care and incorrect transfusion that culminated in death or morbidity. In the United Arab Emirates, publications related to nurses’ practice of blood transfusion are lacking.Design.  Descriptive.Methods.  Data were collected by means of non‐participant structured observation. Data collection was undertaken in two general public hospitals in the Emirate of Abu Dhabi, United Arab Emirates. A random sample of 50 nurses from both hospitals was selected. Each nurse was observed once, from 10 minutes prior to blood collection until 15 minutes after initiating a transfusion.Results.  Forty‐nine nurses (98%) were observed. The maximum obtained score was 13 points of a possible score of 21, and 75% of nurses scored below the 50% level. Practice deficiencies included improper patient identification, suboptimal vital signs documentation and invalid methods of blood warming.Conclusions.  Patients in both hospitals were at risk of receiving incorrect blood, suffering unobserved transfusion reaction and acquiring bacterial infection.Relevance to clinical practice.  This study revealed inadequate practices that nurses and hospitals should strive to change to provide a safer and more effective care that would, hopefully, minimise the risks and maximise the benefits of blood transfusion. These findings also have implications for clinical supervision and nurse education.
Urinary incontinence in pregnant women and their quality of life
Authors: Kocaöz Semra , Talas Melek S , Atabekoğlu Cem S 
Published: October 2010

Aims and objectives.  The aim was to investigate the prevalence of urinary incontinence during pregnancy and the related risk factors as well as to assess its influence on the quality of life.Background.  Although urinary incontinence is common during pregnancy and can have a substantial impact on quality of life, women rarely seek help for this symptom.Design.  This study was designed as a cross‐sectional and descriptive survey.Methods.  A total of 393 pregnant women participated in the study between March and June 2007. The data was collected using the International Consultation on Incontinence Questionnaire Short Form and Wagner’s quality of life scale. Potential risk factors were investigated through logistic regression analysis.Results.  The prevalence of urinary incontinence was 27% (106/393). Factors significantly associated with urinary incontinence included age group, parity, previous urinary incontinence, constipation, urinary incontinence in mother and sister, previous urinary incontinence during pregnancy and postpartum.Conclusion.  According to the results of our study, urinary incontinence is common in women during pregnancy. The quality of life of pregnant women was found to be either unaffected or affected very little by urinary incontinence.Relevance to clinical practice.  This study reveals that the prevalence of urinary incontinence during pregnancy is very high. The findings will help increase the awareness of health care workers involved in the care of pregnant women about urinary incontinence and aid the design of more intensive education programmes directed towards the prevention of urinary incontinence during pregnancy.
Promoting oral health during pregnancy: current evidence and implications for Australian midwives
Authors: George Ajesh , Johnson Maree , Blinkhorn Anthony , Ellis Sharon , Bhole Sameer , Ajwani Shilpi 
Published: October 2010

Aims and objectives.  The aim of this paper is to examine current evidence supporting the promotion of oral health during pregnancy and proffer aspects of a potential role for Australian midwives.Background.  Research continues to show that poor oral health during pregnancy can have an impact on the health outcomes of the mother and baby. Poor maternal oral health increases the chances of infants developing early caries and is strongly associated with adverse pregnancy outcomes such as preterm and low birth‐weight babies. Unfortunately in Australia, no preventive strategies exist to maintain the oral health of pregnant women.Design.  Systematic review.Method.  This review examines all literature on oral health during pregnancy published to date in the English language and focuses on whether preventive oral health strategies during the prenatal period are warranted in Australia and if so, how they could be provided.Results.  Maintaining oral health is important during pregnancy and many developed countries have implemented preventive strategies to address this issue using non‐dental professionals such as prenatal care providers. However, despite the positive international evidence, limited importance is being given to the oral health of pregnant women in Australia. It is also evident that the unique potential of prenatal care providers such as midwives to assess and improve maternal oral heath is not being thoroughly utilised. Compounding the issue in Australia, especially for pregnant women from socioeconomically disadvantaged backgrounds, is the limited access to public dental services and the high cost of private dental treatment.Conclusion.  Promoting and maintaining oral health during pregnancy is crucial, and preventive prenatal oral health services are needed in Australia to achieve this.Relevance to clinical practice.  Midwives have an excellent opportunity to offer preventive oral health services by providing oral health assessments, education and referrals for pregnant women attending antenatal clinics.
Navigating the unknown: model selection in phylogeography
Authors: CARSTENS BRYAN C. , KNOWLES L. L. 
Published: October 2010

Despite the widespread use and obvious strengths of model‐based methods for phylogeographic study, a persistent concern for such analyses is related to the definition of the model itself. The study by Peter et al. (2010) in this issue of Molecular Ecology demonstrates an approach for overcoming such hurdles. The authors were motivated by a deceptively simple goal; they sought to infer whether a population has remained at a low and stable size or has undergone a decline, and certainly there is no shortage of software packages for such a task (e.g., see list of programs in Excoffier & Heckel 2006). However, each of these software packages makes basic assumptions about the underling population (e.g., is the population subdivided or panmictic); these assumptions are explicit to any model‐based approach but can bias parameter estimates and produce misleading inferences if the model does not approximate the actual demographic history in a reasonable manner. Rather than guessing which model might be best for analyzing the data (microsatellite data from samples of chimpanzees), Peter et al. (2010) quantify the relative fit of competing models for estimating the population genetic parameters of interest. Complemented by a revealing simulation study, the authors highlight the peril inherent to model‐based inferences that lack a statistical evaluation of the fit of a model to the data, while also demonstrating an approach for model selection with broad applicability to phylogeographic analysis.
Toll‐like receptor (TLR) 2 and TLR4 deficiencies exert differential in vivo effects against Schistosoma japonicum
Authors: ZHANG M. , GAO Y. , DU X. , ZHANG D. , JI M. , WU G. 
Published: October 2010

SummaryLittle is known about the functions of Toll‐like receptor 2 (TLR2) and TLR4 in innate/acquired responses to Schistosoma japonicum. Through in vivo study, the contributions of TLR2 and TLR4 to host immune responses during S. japonicum infection were investigated. Early infection experiments showed higher protein and mRNA levels of IL‐12, IFN‐γ and IL‐4 in dermal tissues and retroauricular draining lymph nodes respectively in TLR2−/− mice on day four post‐infection and opposite changes in TLR4−/− mice. In the acute infection with S. japonicum for 6 weeks, TLR2−/− mice manifested lower egg burden as well as the enhancement of T cell activation and upregulated expression of some cytotoxic genes, as assayed by Th1/Th2 cytokine secretion and DNA microarray analysis. Also, the opposite parasitological and immunological effects were observed in TLR4−/− mice. These results demonstrate that during S. japonicum infection, TLR2 and TLR4 might direct distinct adaptive immune responses since the early stage, which may lead to different infection outcomes.
Costs of HIV/AIDS outpatient services delivered through Zambian public health facilities
Authors: Bratt John H. , Torpey Kwasi , Kabaso Mushota , Gondwe Yebo 
Published: October 2010

SummaryObjective  To present evidence on unit and total costs of outpatient HIV/AIDS services in ZPCT‐supported facilities in Zambia; specifically, to measure unit costs of selected outpatient HIV/AIDS services, and to estimate total annual costs of antiretroviral therapy (ART) and prevention of mother‐to‐child transmission (PMTCT) in Zambia.Methods  Cost data from 2008 were collected in 12 ZPCT‐supported facilities (hospitals and health centres) in four provinces. Costs of all resources used to produce ART, PMTCT and CT visits were included, using the perspective of the provider. All shared costs were distributed to clinic visits using appropriate allocation variables. Estimates of annual costs of HIV/AIDS services were made using ZPCT and Ministry of Health data on numbers of persons receiving services in 2009.Results  Unit costs of visits were driven by costs of drugs, laboratory tests and clinical labour, while variability in visit costs across facilities was explained mainly by differences in utilization. First‐year costs of ART per client ranged from US$278 to US$523 depending on drug regimen and facility type; costs of a complete course of antenatal care (ANC) including PMTCT were approximately US$114. Annual costs of ART provided in ZPCT‐supported facilities were estimated at US$14.7–$40.1 million depending on regimen, and annual costs of antenatal care including PMTCT were estimated at US$16 million. In Zambia as a whole, the respective estimates were US$41.0–114.2 million for ART and US$57.7 million for ANC including PMTCT.Conclusions  Consistent with the literature, total costs of services were dominated by drugs, laboratory tests and clinical labour. For each visit type, variability across facilities in total costs and cost components suggests that some potential exists to reduce costs through greater harmonization of care protocols and more intensive use of fixed resources. Improving facility‐level information on the costs of resources used to produce services should be emphasized as an element of health systems strengthening.