bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI features of hepatocellular carcinoma expressing progenitor cell markers
Authors: Jeong Hyeon Tae , Kim Myeong‐Jin , Kim Yeo‐Eun , Park Young Nyun , Choi Gi Hong , Choi Jin Sub 
Published: September 2011

AbstractBackground & AimsTo determine whether magnetic resonance (MR) imaging features differ between hepatocellular carcinomas (HCCs) with and without expression of progenitor cell markers, such as cytokeratin (CK) 19 and epithelial cell adhesion molecule (EpCAM).MethodsSixty‐three patients with 71 HCCs who underwent surgery after preoperative gadoxetic acid‐enhanced MR imaging were evaluated. HCCs expressing progenitor cell markers were defined as showing CK19 or EpCAM expression. MR imaging features, including the fat component, arterial enhancement (global vs. peripheral), dynamic enhancement (washout vs. progressive or persistent), nodule‐in‐nodule appearance and MR gross morphology (expanding vs. non‐expanding), were compared between HCCs with and without progenitor cell markers expression. Lesion‐to‐liver signal intensity ratio (SIR) and apparent diffusion coefficient values were compared using an independent samples t‐test. Early recurrence rates were also compared.ResultsHCCs expressing progenitor cell markers were more commonly of the non‐expanding type (P = 0.016), more frequently had a progressive or persistent dynamic enhancement pattern (P = 0.008) and less frequently demonstrated a nodule‐in‐nodule appearance (P = 0.009). HCCs expressing progenitor cell markers had significantly higher SIRs on diffusion‐weighted images (DWIs) (b = 50 and 800, P < 0.001; b = 400, P = 0.001) and a significantly lower SIR on hepatobiliary phase images (P = 0.024). The early recurrence rate was significantly higher in patients with prior HCCs that expressed progenitor cell markers (P = 0.045).ConclusionsHCCs expressing progenitor cell markers can be characterized according to their non‐expanding MR gross morphology, persistent or progressive dynamic enhancement patterns, higher SIRs on DWIs, lower SIRs on hepatobiliary phase images and less frequent nodule‐in‐nodule appearance.
Genetic polymorphisms and the risk of progressive renal failure in elderly Hungarian patients
Authors: ZSOM Marianna , FÜLÖP Tibor , ZSOM Lajos , BARÁTH Ákos , MARÓTI Zoltán , ENDREFFY Emőke 
Published: September 2011

AbstractThe relationship between renal disease progression and genetic polymorphism of enzymes influencing endothelial function remains incompletely understood. We genotyped three cohorts of elderly Hungarian patients: 245 patients with end‐stage renal disease (ESRD) on chronic hemodialysis (HD), 88 patients with mild chronic kidney disease (CKD), and 200 healthy controls. The underlying diagnoses of renal diseases were primary glomerulonephritis, interstitial nephritis, hypertension, diabetic nephropathy, and hereditary diseases. We examined genetic polymorphisms of eight candidate genes associated with endothelial function: endothelial constitutive nitric oxide synthase (ecNOS) T‐786C, endothelin‐1 G5727T, methylenetetrahydrofolate reductase (MTHFR) C677T, paraoxonase‐1 Q192R and M55L, angiotensinogen M235T, angiotensin‐converting enzyme (ACE) I/D and angiotensin II type 1 receptor A1166C gene. Six gene polymorphisms were detected by real‐time polymerase chain reaction with melting‐point analysis, and two via allele‐specific amplification and gel electrophoresis. Control group patients were in Hardy‐Weinberg equilibrium for all tested genotypes. In ESRD patients attributed to hypertension, the endothelin gene G5727T GG genotype occurred significantly less but GT genotype more frequently (P < 0.01 for both). In ESRD patients attributed to primary glomerulonephritis, more ACE DD and less ID genotypes were found (P < 0.02 for both) than in the controls. The underlying diagnosis may modify the association of genetic polymorphism and dialysis‐dependent ESRD.
Arthroscopic Transosseous Rotator Cuff Repair: A Cautionary Tale
Authors: Bunker Timothy D , Keenan John , Lee Clive 
Published: September 2011

Background High re-tear rates and the cost of anchor repair have led some arthroscopic surgeons to consider going ‘back to the future’ and using Neer type transosseous sutures arthroscopically. Methods We examined the strength of suture repair in the laboratory using a Monsanto tensiometer (Monsanto, Swindon, UK) using a single pull to failure loading programme. Results This shows that, in transosseous repair, the bone tunnels can fail at between 16 N and 115 N compared to anchors that fail at 168 N to 712 N. Discussion This cautionary tale means that going back to ‘the good old days’ might not be such a good idea.
Early Experience of Managing Proximal Humerus Fractures with the S3 Plate
Authors: Stoddard James E. , Pryce David , Potter David , Ali Amjid A. , Morgan Andrew 
Published: September 2011

Background Fractures of the proximal humerus contribute a large number of admissions to our unit each year both for operative and conservative treatment. They can be a cause of great morbidity in many of these patients. Open reduction and internal fixation of fractures is performed in those patients who have displaced fractures and who are significantly independent to warrant surgical management. Methods This is a retrospective study evaluating the early experiences of a new type of plate fixation, the S3 plate (DePuy, Warsaw, IN, USA), in patients with displaced three- and four-part fractures. The case notes of those patients with more than 1 year of follow-up following fixation of their humeral fracture with a S3 plate were retrospectively reviewed. Each patient was also sent an Oxford Shoulder Score in the post for completion. Fifty-three patients were identified for inclusion in the study from 2007 onwards. Patients with a two-part fracture ( n = 10) were excluded from the study because it was felt that these patients represented a group in whom conservative management was often the more commonly used treatment modality. Results Mean age was 54.1 years (range 21 years to 76 years); the male to female ratio was 1 : 2.4; and there were 25 three-part fractures and 17 four-part fractures. Time to discharge ranged from 4 months to 16 months, with a mean of 6.7 months. There were no intra-operative complications, one superficial wound infection and only one patient required further surgery. At 1 year, we have seen a low complication rate with good return to activity. Conclusions The implant has a very low revision rate and union was seen in most fractures by 6 months. The present study was limited by documented union time, numbers and differing discharge protocols. This new plating technique appears to offer a decreased complication rate compared to other plating systems without compromising patient outcomes.
Detection of Methicillin‐Resistant Staphylococcus aureus (MRSA) in Backyard Pigs and Their Owners, Michigan, USA
Authors: Gordoncillo M. J. , Abdujamilova N. , Perri M. , Donabedian S. , Zervos M. , Bartlett P. 
Published: September 2011

SummaryMethicillin‐resistant Staphylococcus aureus (MRSA) have been reported in commercially raised pigs and their human handlers, raising concerns of zoonotic transmission. To determine whether MRSA in backyard‐raised pigs is commonly transmitted to their human owners, a matched study of this type of pigs and their owners was conducted in selected counties in Michigan. Nasal swabs from matched owner–pig pairs (n = 50 pairs) with a few unmatched pig (n = 3) and human (n = 4) samples were collected and processed using standard isolation and identification protocols. No matched owner–pig pair was found; however, MRSA was isolated from 1/54 (1.9%) human samples and 2/53(3.8%) of the pigs. The single human isolate was not strain type USA100‐1100 by pulsed‐field gel electrophoresis (PFGE), was sequence type (ST) 8 by multilocus sequence typing (MLST), possessed SCCmec type IVb and agr I and was negative for the Panton–Valentine leukocidin (PVL) toxin gene. The two pig isolates were indistinguishable by PFGE (not USA100‐1100), and both isolates were ST5 by MLST, possessed SCCmec type III and agr II and were negative for the PVL gene. Persons raising backyard swine from the selected Michigan counties had MRSA carriage rates similar to that of the general US population, suggesting that their avocational pig exposure did not increase their risk of MRSA.
Occupational stress, job characteristics, coping, and the mental health of nurses
Authors: Mark G. , Smith A. P. 
Published: September 2011

Objectives. This study investigated the relationships between job characteristics and coping in predicting levels of anxiety and depression in nurses. The study was based on current theories of occupational stress, and predictors included job demands, social support, decision authority and skill discretion control, effort, over‐commitment, rewards, and ways of coping. It was predicted that job demands, extrinsic effort, over‐commitment, and negative coping behaviours would be positively associated with depression and anxiety, and social support, rewards, decision authority, skill discretion control, and positive coping would be negatively associated with depression and anxiety.Methods. Participants were 870 nurses, who responded to a bulk mail sent randomly to 4,000 nurses from the south of England.Results. The results showed that job demands, extrinsic effort, and over‐commitment were associated with higher levels of anxiety and depression. Social support, rewards, and skill discretion were negatively associated with mental health problems. Few interactions were found between the variables. Coping behaviours significantly added to the explanation of variance in anxiety and depression outcomes, over and above the use of demand–control–support, and effort–reward factors alone.Conclusion. The results from the study demonstrated the importance of coping factors in work‐stress research, in accordance with the multi‐factorial premise of transactional stress models. It is argued that multi‐factor research is needed to help develop effective organizational interventions.
Negative self‐conscious emotion and grief: An actor–partner analysis in couples bereaved by stillbirth or neonatal death
Authors: Barr Peter 
Published: September 2011

Objectives. The purpose of the present study was to examine the intrapersonal (actor) and interpersonal (partner) relationships of personality proneness to negative self‐conscious emotion (shame and guilt) to grief in couples 13 months after a perinatal death.Design. A cohort study using self‐report questionnaire measures of grief, shame, and guilt.Methods. The participants were 63 Australian couples bereaved by stillbirth (N= 31) or neonatal death (N= 32). The actor and partner relationships of chronic shame (Personal Feelings Questionnaire‐2), situational shame (Test of Self‐Conscious Affect‐2), and survivor guilt and omnipotence guilt (Interpersonal Guilt Questionnaire‐67) to grief (Perinatal Grief Scale‐33) were explored using the Actor–Partner Interdependence Model (APIM) method of dyadic analysis.Results. The correlations between the self‐conscious emotions and grief were invariably larger in men compared with women. Chronic shame had a significant actor relationship with grief in women and men and a non‐significant partner relationship in both sexes. Situational shame and survivor guilt had significant actor relationships with grief in men and significant partner relationships in women. Omnipotence guilt had a significant linear actor relationship with grief in men and a significant U‐shaped quadratic actor relationship in women.Conclusions. Negative self‐conscious emotions had intrapersonal relationship with grief in men and both intrapersonal and interpersonal relationships with grief in women. A moderate level of omnipotence guilt was associated with lower grief in women. APIM dyadic analysis furthers understanding of the relationship between personality and parental grief following a perinatal death.
Termination of psychotherapy: The journey of 10 psychoanalytic and psychodynamic therapists
Authors: Fragkiadaki Evangelia , Strauss Susan M. 
Published: September 2011

Objectives. Literature on termination originates mainly from clinical and theoretical accounts as well as practitioners’ autobiographical reports. There is, however, a paucity of psychological research on termination. The purpose of this study is to examine the process of termination of therapy based on therapists’ narratives of experiences of endings with patients.Design. Grounded Theory methodology has been applied in this study in order to conceptualize the process of termination from the therapist's perspective.Methods. Ten psychoanalytic and psychodynamic therapists were interviewed for this study.Results. Grounded Theory analysis of the data revealed five central categories: therapist as a person, therapist's awareness of termination, development of therapeutic relationship, working through termination, and the aftermath (post‐termination phase).Conclusions. The results offer a Grounded Theory model of the therapist's journey through termination of therapy with patients. Subcategories and their relationships will be explored. Implications for clinical practice, limitations and suggestions for further research will be discussed.
Early maladaptive schemas in bipolar disorder
Authors: Ak Mehmet , Lapsekili Nergis , Haciomeroglu Bikem , Sutcigil Levent , Turkcapar Hakan 
Published: September 2011

Objective. According to the cognitive model of depression, negative schemas, formed in early life, increase susceptibility to depression. The objective of this study was to investigate schemas that are proposed to increase susceptibility of depression in bipolar disorder patients who have had depressive episodes.Method. Eighteen patients diagnosed with bipolar disorder according to DSM‐IV and a healthy control group (N= 20) constituted the sample of the study. The Beck Depression Inventory, Young Mania Rating Scale, and Young Schema Scale were applied to patients in order to determine the level of symptoms and schemas.Results. When the scores obtained from Young Schema Scale were compared between groups, significant differences were observed between bipolar patients and control group on all the schemas except abandonment, emotional deprivation, defectiveness, vulnerability to harm or illness, and approval seeking. The negative schema scores of bipolar patients were significantly higher than those of the control group.Conclusion. Of all schemas included in the Young Schema Scale, the scores of bipolar group were higher than the scores of the control group. These findings suggest that, in cognitive‐based psychotherapeutic approaches for patients with bipolar disorder, it would be more effective to focus on schemas related to the perception and allowance of feelings at the proper time and the instability of self‐perceptions.
RACE (Rapid Access to Carers at End of Life)
Authors: Biggs Julie , Westwood Debbie 
Published: September 2011

IntroductionThe Rapid Access to Carers at End of Life service aims to provide a rapid response Hospice at Home night service for the whole of Worcestershire for patients at the end of life when all other appropriate sources of support are unavailable.Aims▶To provide support for carers who are struggling to cope and so enable patients to remain at home▶To prevent avoidable admissions and readmissions to hospital and to enable rapid discharges▶To allow time to review and establish suitable packages of care To support district nursing teams at times of patient crisis by providing rapidly accessible end of life nursing care.MethodsCarers are on-call to provide care at any time of the night. Requests for shifts will be generated by a District Nurse or Community Practitioner who will have completed a risk assessment of the patient and home environment. The service will provide care up until an alternative care package is arranged, up to a maximum of 48 h.Success will be analysed by the number shifts provided, feedback from patients, patients' families and referrers to the service and analysis of intervention outcomes, for example number of admissions avoided or discharges expedited.ResultsThe feedback we have had from referrers and patients has been positive and supportive of the scheme. We have received a total of 41 referrals which resulted in the provision of a total of 61 nights of care which equates to over 535 h of patient support.Current conclusionsInitial findings suggest that the service will continue to expand and the number of referrals increase as the Community Practitioners and other referring staff become more familiar with the service. This is a 6 month pilot and we will be conducting a full evaluation at the end of this period.
Evaluation of a current 24/7 service provided by a community palliative care team
Authors: O'Halloran Helen , Hetherington Linda 
Published: September 2011

IntroductionThe ‘End of Life Care Strategy’ recommends the importance of 24/7 community support enabling people to be cared for in their place of choice. The hospice has provided this service since 1986. The service provides support for patients, carers and healthcare professionals. Literature shows that there is little research into out of hours (OOHs)palliative care provision.AimsTo evaluate a long established service by exploring views of stakeholders.MethodsA qualitative approach through focus groups, structured, semi-structured, telephone and face to face interviews. A purposive sample was used to select specific stakeholders. Interviews and focus groups with clinicians from the hospice and local district nursing teams, GP service representatives and hospice in patient unit staff. Analysis of key documents; service level agreements with PCTs, operational policy and record book of all contacts made to the service.Results▶Total number of calls received 614▶Weekend/Bank Holiday calls 401▶On call calls 213▶Visits undertaken 34.Primary reason for calls from healthcare professionals was for symptom management with 35.91% (weekend/bank holiday) from district nursing staff. 58.39% of calls were from carers.Stakeholders were positive about the present service model.DiscussionThere were recurring themes around more effective cross service boundary communication and improved knowledge and skills transfer to improve community staff competence and confidence.ConclusionThe service model used is valuable for community healthcare professionals, patients and carers. The service responds to need and provides continuity of care over the weekend/bank holiday and OOHs period. Data collected from hospice nursing, medical staff and local healthcare providers ascertains what works well in practice with recommendations towards potential service development and improvement.
Partnership working to deliver seven day access to specialist palliative care
Authors: Foster Alison , Livingstone Tracy , Cadell Gail 
Published: September 2011

IntroductionProvision of 7-day specialist palliative care services in all care settings has been identified as a key standard for statutory sector providers for a number of years. In 2009, in response to the recommendations of the All Wales Palliative Care Review and the Palliative Care Implementation Board, a Ministerial Letter was issued throughout Wales, requiring implementation of 7-day working for specialist palliative care.AimThis paper will firstly, discuss the development of partnership working between a statutory sector specialist palliative care team (SPCT) and independent sector Hospice to deliver 7 day access to specialist palliative care assessment and intervention, across all healthcare settings; secondly, it will discuss the benefits for patients, families, services, the wider health community and economy.MethodThe SPCT Clinical Nurse Specialists (CNS) base their service from the Hospice at weekends and Bank Holidays, where out of hour's advice calls from primary and secondary care have historically been received. This decision was made to support safe lone working, governance, access to medical and hospice support for CNS's, and streamline access to the service.ResultsEvaluation of this initiative provides evidence of:▶Closer integration and team working▶Rapid access to specialist palliative care, across primary and secondary care, improving outcomes and experiences for patients and their families, and increasing quality and standards of care▶Access to hospice inpatient admission for patients requiring urgent transfer into a specialist palliative care bed, at weekends and Bank Holidays▶Prevention of unscheduled acute hospital admissions▶Support for providers of general palliative care, throughout primary and secondary care.ConclusionPartnership working between the SPCT and Hospice has enabled an innovative approach to the delivery of 7 day working that benefits patients, their families, and service providers.
Helping the developing world…..the story of an outward looking hospice
Authors: Collins Karilyn 
Published: September 2011

A hospice in the UK became linked with Africa when one of the medical staff left in 2001 to set up a hospice in Tanzania. The aim was to extend some of the ethos and philosophy of the hospice movement to the developing world. The link has involved six staff visits from the UK to Tanzania and six staff visits the other way. These visits have been of great benefit to both sides. A description of this link won an essay prize from the Tropical Health Education Trust in 2007.The original hospice in Tanzania has been the centre for a roll out programme, using the Help the Hospices Toolkit and mentoring, to set up teams in many other district and regional hospitals. The UK hospice has encouraged this mentorship by allowing their staff sabbaticals to assist in setting up palliative care teams, to give confidence in prescribing morphine and help in making community links to establish home visiting. The latest Tanzanian hospital to receive mentorship has been the control site in research, as yet unpublished, showing the difference that palliative care training makes to the quality of life of patients in HIV care and treatment.The benefits of this link to Tanzania are obvious, education, books, equipment and experience but those to the UK hospice are less immediately evident. For the staff, they include life changing experiences, and relationships, for patients and relatives, the distraction of hearing about the struggle to get palliative care and pain relief into the developing world. Hospices have often been inward looking, patient orientated places that need to raise funds and keep up standards but this need not preclude involvement worldwide. This link is a replicable model that proves the benefits can be mutual without jeopardising standards or fund raising at home.