bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review
Authors: Kennedy Fiona , McDonnell Ann , Gerrish Kate , Howarth Amanda , Pollard Carol , Redman Judith 
Published: September 2011

kennedy f., mcdonnell a., gerrish k., howarth a., pollard c. & redman j. (2011) Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review. Journal of Advanced Nursing 68(4), 721–742.AbstractAim.  This paper reports a mixed methods systematic review examining the impact of nurse consultant roles in adult healthcare settings, with a view to identifying indicators for demonstrating their impact on patient and professional outcomes.Background.  Nurse consultants were introduced in England in 2000 with the intention to achieve better outcomes for patients by improving quality and services. Previous studies have investigated the impact of nurse consultants, but attempts to amalgamate this evidence have been methodologically limited. Since these reviews were published, the importance of demonstrating the contribution of nurse consultants has prompted new research. A robust review of the evidence is now required.Data sources.  A broad search strategy was adapted for eight databases. Grey literature was sought from various sources.Review methods.  Quantitative and qualitative studies were included. Study quality was assessed using appropriate instruments. Cross‐study synthesis combined the quantitative and qualitative findings in relation to the dimensions of impact identified. Measures of impact were mapped against a framework for assessing clinical and professional outcomes.Results.  Thirty‐six studies were included. The findings suggest a largely positive influence of nurse consultants on a range of clinical and professional outcomes, which map onto the proposed framework of impact. However, there was very little robust evidence and the methodological quality of studies was often weak.Conclusion.  Further robust research is required to explore nurse consultants’ impact on patient and professional outcomes. The proposed framework for assessing impact could be used to guide future research and assist nurse consultants assess their impact.
Territory quality determines social group composition in Ethiopian wolves Canis simensis
Authors: Tallents Lucy A. , Randall Deborah A. , Williams Stuart D. , Macdonald David W. 
Published: September 2011

Summary1. We contrast the value of four different models to predict variation in territory size as follows: resource density (the ideal free distribution), population density, group size and intruder pressure (relative resource‐holding potential). In the framework of the resource dispersion hypothesis, we test the effect of resource abundance and spatial variation in resource distribution on the age/sex composition of social groups.2. We explore these drivers of territory size and group size/composition in Ethiopian wolves Canis simensis in the Bale Mountains, Ethiopia, using fine‐scale distribution maps of their major prey species based on satellite‐derived vegetation maps.3. The number of adult males is correlated with territory size, while prey density, wolf population density and intruder pressure are not associated with territory size. On average, each additional adult male increases territory size by 1·18 km2.4. Prey abundance increases with territory size (average biomass accumulation of 6·5 kg km−2), and larger territories provide greater per capita access to prime foraging habitat and prey.5. The age/sex composition of wolf packs is more closely related to territory quality than territory size. Subordinate adult females are more likely to be present in territories with greater proportions of prime giant molerat Tachyoryctes macrocephalus habitat (i.e. >80% of Web Valley territories and >20% in Sanetti/Morebawa), and more yearlings (aged 12–23 months) occur in territories with greater overall prey biomass.6. Wolf packs with restricted access to good foraging habitat tend to defend more exclusive territories, having a lower degree of overlap with neighbouring packs.7. The greater per capita access to prey in large groups suggests a strong evolutionary advantage of collaborative territorial defence in this species, although the relative costs of territorial expansion vs. exclusion depend upon the spatial distribution of resources. We propose a model whereby territory size is determined by the number of adult males, with the presence of subordinate females and yearlings dependent on the quality of habitat, and the abundance and distribution of prey, incorporated within territory boundaries.
Marine megaherbivore grazing may increase seagrass tolerance to high nutrient loads
Authors: Christianen Marjolijn J. A. , Govers Laura L. , Bouma Tjeerd J. , Kiswara Wawan , Roelofs Jan G.M. , Lamers Leon P. M. , van Katwijk Marieke M. 
Published: September 2011

Summary1. Populations of marine megaherbivores including green turtle (Chelonia mydas) have declined dramatically at a global scale as a result of overharvesting and habitat loss. This decline can be expected to also affect the tolerance of seagrass systems to coastal eutrophication. Until now, however, simultaneous effects of top–down control by megaherbivore grazing and bottom–up control by nutrient input have not been tested experimentally.2. We therefore investigated the interacting effects of nutrient (N and P) addition and mimicked green turtle grazing on seagrass and epiphyte productivity, seagrass biomass and nutrient contents in exclosures at a pristine seagrass site in the Indo‐Pacific region (Kalimantan, Indonesia).3. Grazing almost doubled leaf biomass production rates, while nutrient addition (N+P, slow‐release granules) did not have an effect on these rates. Rhizome biomass was, however, strongly reduced by nutrient addition. In contrast to phosphorus, tissue nitrogen contents increased after nutrient addition, showing that nitrogen was not limiting primary productivity. Epiphyte growth was, however, strongly correlated with high water column P concentrations, indicating an indirect negative effect of eutrophication when turtle grazing would be absent. We calculated that green turtle leaf grazing leads to substantial exports of N and P, at rates of at least 8% of the standing stock per day equalling the daily seagrass production, up to 13 (N) and 1.4 (P) mg m−2 day−1.4. Synthesis. By combining our quantified effects with literature data, we propose a conceptual model of seagrass functioning under megaherbivore leaf grazing and eutrophication. In tropical seagrass systems with high green turtle grazing pressure, grazing alleviates the negative effects of eutrophication by the stimulation of seagrass production and concomitant nutrient uptake, the increased export of nutrients and the indirect prevention of low below‐ground biomass. Similar to the role of terrestrial megaherbivores, these strong top–down controls show the pivotal role of green turtles in current coastal systems, which is lacking in systems where their numbers have greatly declined. These marine megaherbivores do not only drive structure and functioning of their foraging grounds but also increase the tolerance of seagrass ecosystems to eutrophication.
Receptor subtype‐dependent galanin actions on gamma‐aminobutyric acidergic neurotransmission and ethanol responses in the central amygdala
Authors: Bajo Michal , Madamba Samuel G. , Lu Xiaoying , Sharkey Lisa M. , Bartfai Tamas , Siggins George Robert 
Published: September 2011

ABSTRACTThe neuropeptide galanin and its three receptor subtypes (GalR1‐3) are expressed in the central amygdala (CeA), a brain region involved in stress‐ and anxiety‐related behaviors, as well as alcohol dependence. Galanin also has been suggested to play a role in alcohol intake and alcohol dependence. We examined the effects of galanin in CeA slices from wild‐type and knockout (KO) mice deficient of GalR2 and both GalR1 and GalR2 receptors. Galanin had dual effects on gamma‐aminobutyric acid (GABA)‐ergic transmission, decreasing the amplitudes of pharmacologically isolated GABAergic inhibitory postsynaptic potentials (IPSPs) in over half of CeA neurons but augmenting IPSPs in the others. The increase in IPSP size was absent after superfusion of the GalR3 antagonist SNAP 37889, whereas the IPSP depression was absent in CeA neurons of GalR1 × GalR2 double KO and GalR2 KO mice. Paired‐pulse facilitation studies showed weak or infrequent effects of galanin on GABA release. Thus, galanin may act postsynaptically through GalR3 to augment GABAergic transmission in some CeA neurons, whereas GalR2 receptors likely are involved in the depression of IPSPs. Co‐superfusion of ethanol, which augments IPSPs presynaptically, together with galanin caused summated effects of ethanol and galanin in those CeA neurons showing galanin‐augmented IPSPs, suggesting the two agents act via different mechanisms in this population. However, in neurons showing IPSP‐diminishing galanin effects, galanin blunted the ethanol effects, suggesting a preemptive effect of galanin. These findings may increase understanding of the complex cellular mechanisms that underlie the anxiety‐related behavioral effects of galanin and ethanol in CeA.
EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference
Authors: Schram M. E. , Spuls Ph. I. , Leeflang M. M. G. , Lindeboom R. , Bos J. D. , Schmitt J. 
Published: September 2011

To cite this article: Schram ME, Spuls PI, Leeflang MMG, Lindeboom R, Bos JD, Schmitt J. EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference. Allergy 2012; 67: 99–106.AbstractBackground:  Demonstration of adequate reliability and validity is sufficient for concluding that an instrument is applicable for descriptive and predictive purposes, but before we can confidently use an outcome measure in clinical trials, the responsiveness (synonymous with sensitivity to change) and minimal clinically important difference (MCID) should be known. With this study, we aimed to assess responsiveness and MCID of four outcome measures used in atopic eczema: the Severity Scoring of Atopic Dermatitis (SCORAD), the objective SCORAD, Eczema Area and Severity Index (EASI), and the Patient‐Oriented Eczema Measure (POEM).Methods:  Data of three randomized controlled trials were used. To demonstrate responsiveness, we plotted receiver operating characteristic (ROC) curves. MCID was estimated using mean change scores of patients that showed a relevant improvement. Bland and Altman methods were used to quantify the limits of agreement.Results:  Area under the ROC curve for the SCORAD was 0.70 [95% confidence interval (CI): 0.61–0.78], for the objective SCORAD, 0.73 (95% CI: 0.70–0.77), for the EASI, 0.67 (95% CI: 0.60–0.76), and for the POEM, 0.67 (95% CI: 0.59–0.75). Scores above 0.70 represent a fair responsiveness. The MCID was 8.7 points for the SCORAD, 8.2 for the objective SCORAD, 6.6 for the EASI, and 3.4 for the POEM.Conclusion:  The objective SCORAD and SCORAD showed a fair responsiveness. The MCIDs are an important prerequisite for the interpretation of published eczema trials and for the planning/sample size estimation of future trials.
Extreme xanthomatosis in patients with both familial hypercholesterolemia and cerebrotendinous xanthomatosis
Authors: Huijgen R , Stork ADM , Defesche JC , Peter J , Alonso R , Cuevas A , Kastelein JJP , Duran M , Stroes ESG 
Published: September 2011

Huijgen R, Stork ADM, Defesche JC, Peter J, Alonso R, Cuevas A, Kastelein JJP, Duran M, Stroes ESG. Extreme xanthomatosis in patients with both familial hypercholesterolemia and cerebrotendinous xanthomatosis.Two unrelated individuals were referred to Lipid Clinics in The Netherlands and Chile with extreme xanthomatosis and hypercholesterolemia. Both were diagnosed with heterozygous familial hypercholesterolemia (heFH) after molecular genetic analysis of the low‐density lipoprotein (LDL) receptor gene. Since heFH by itself could not account for the massive xanthomas, the presence of an additional hereditary lipid or lipoprotein disorder was suspected. Further genetic analysis revealed homozygozity for mutations in the sterol 27‐hydroxylase gene, confirming the diagnosis of cerebrotendinous xanthomatosis (CTX). Markedly, the typical neurological manifestations of CTX were absent, suggestive of a protective role of LDL‐receptor deficiency against the severe neurological consequences of CTX.
Microbial ureteral stent colonization in renal transplant recipients: frequency and influence on the short‐time functional outcome
Authors: Bonkat G. , Rieken M. , Siegel F.P. , Frei R. , Steiger J. , Gröschl I. , Gasser T.C. , Dell‐Kuster S. , Rosenthal R. , Gürke L. , Wyler S. , Bachmann A. , Widmer A.F. 
Published: September 2011

Abstract:Ureteral stent insertion at the time of renal transplantation significantly decreases complications of urine leakage and obstruction, but bears an intrinsic risk of microbial colonization. Associated urinary tract infection (UTI) may pose a significant risk for graft infection and subsequent graft failure, in particular, during high‐level immunosuppression in the early phase after transplantation. The aims of this prospective study were (i) to assess the frequency of microbial ureteral stent colonization (MUSC) in renal transplant recipients by sonication, (ii) to compare the diagnostic value of sonication with that of conventional urine culture (CUC), (iii) to determine biofilm forming organisms, and (iv) to investigate the influence of MUSC on the short‐time functional outcome. A total of 80 ureteral stents from 78 renal transplant recipients (deceased donors n = 50, living donors n = 28) were prospectively included in the study. CUC was obtained prior to renal transplantation and at ureteral stent removal. In addition, a new stent sonication technique was performed to dislodge adherent microorganisms. CUCs were positive in 4% of patients. Sonicate‐fluid culture significantly increased the yield of microbial growth to 27% (P < 0.001). Most commonly isolated microorganisms by sonication were Enterococcus species (31%), coagulase‐negative staphylococci (19%), and Lactobacillus species (19%), microorganisms not commonly observed in UTIs after renal transplantation. The median glomerular filtraton rate (GFR) of the study population increases from 39 mL/min immediately after transplantation (time point A) to 50 mL/min 6 month post transplantation (time point B). In patients without MUSC, the GFR improves from 39 mL/min (A) to 48 mL/min (B) and in patients with MUSC from 39 mL/min (A) to 50 mL/min (B), respectively. In summary, MUSC in renal transplant recipients is common and remains frequently undetected by routine CUC, but colonization had no measurable effect on renal function.
Relationship Between Contractions of the Uterus and Concentration of PGF2α in Uterine Venous Blood after Luteolysis in Gilts
Authors: Stefańczyk‐Krzymowska S , Wąsowska B , Gilun P , Muszak J , Grzegorzewski W 
Published: September 2011

ContentsThe origin and physiological significance of high pulses of prostaglandin F2α (PGF2α) in uterine venous blood that occur 2–3 days after luteolysis are not well understood. We studied the relationship between contractions of the uterus evoked by exogenous oxytocin (OT) and PGF2α concentration in uterine venous blood on day 17 of the porcine oestrous cycle. The infusion of OT into the uterine artery produced an immediate increase in the uterine intraluminal pressure (UIP) (p < 0.001) and a simultaneous elevation in PGF2α concentration in uterine venous blood (p < 0.0001). The infusion of indomethacin (IND) into the uterine artery slightly decreased PGF2α concentration in uterine venous blood, but it did not suppress uterine contraction or the rapid increase in PGF2α concentration in uterine venous blood just after OT infusion (p < 0.0001), which was lower that in gilts not treated with IND. We conclude that the spikes of PGF2α concentration in uterine venous blood occurring after OT infusion on day 17 of the porcine oestrous cycle are mainly caused by the excretion with venous blood from the remodelled uterus and that PGF2α synthesis may contribute to this. These results suggest that the high spikes in PGF2α concentration that occur 2–3 days after luteolysis in pigs, sheep, cows and mares all have a similar origin.
Distribution of Mast Cells in Vaginal, Cervical and Uterine Tissue of Non‐pregnant Mares: Investigations on Correlations with Ovarian Steroids
Authors: Walter J , Klein C , Wehrend A 
Published: September 2011

ContentsMast cells constitute part of the cellular immune system of the genital tract. They play a potential role in cervical remodelling during parturition and are subject to the influence of ovarian steroids. In this study, the influence of oestradiol‐17β and progesterone on the distribution of mast cells in equine vaginal, cervical and uterine tissue was evaluated. Genital tracts were retrieved from healthy mares at a local slaughterhouse. The cervix was divided along the longitudinal axis into five equivalent regions from cranial to caudal (R1 to R5). Toluidine blue staining was used for the detection of mast cells. Hormone values were determined via radioimmunoassay. In cervical tissue, mast cells were present at higher frequency and higher density than in vaginal and uterine tissue. Statistically significant differences were obtained between cervical R1 (cranial) and uterus as well as cervical R2 and uterus (p < 0.05). In cervical tissue, an association between the presence of mast cells and peripheral oestrogen concentrations was observed, whereas such correlation could not be established for vaginal and uterine tissue. With increasing oestradiol‐17β concentrations, the density of mast cells in cervical tissue increased to a statistically significant degree in the cranial (r = 0.46; p = 0.05) and caudal (r = 0.5; p = 0.03) regions. We propose that mast cells play a role in the cyclic remodelling of the equine cervix during the course of the oestrous cycle. Elucidation of mechanisms controlling cervical remodelling could contribute to development of therapies for mares showing a lack in cervical opening during oestrus.
Polypropylene mesh as an alternative option for uterine preservation in pelvic reconstruction in patients with uterine prolapse
Authors: Huang Kuan‐Hui , Chuang Fei‐Chi , Fu Hung‐Chun , Kung Fu‐Tsai 
Published: September 2011

AbstractAim:  The aim of this study was to evaluate the efficacy and safety of polypropylene mesh for uterine preservation during pelvic reconstruction in patients with severe uterine prolapse.Materials and Methods:  The study included 67 women with severe uterine prolapse (pelvic organ prolapse quantification stage III/IV) who received transvaginal mesh reconstruction with uterine preservation. Surgery combined with a transobturator membrane sling procedure (tension‐free vaginal tape–transobturator route) was performed in 54 patients. Among them, 18 had urodynamic stress incontinence, 30 had occult stress urinary incontinence, and six had mixed urinary incontinence. Objective assessments were carried out with the pelvic organ prolapse quantification staging system, urodynamic examination, and 1‐h pad test. Evaluation of urinary and prolapse symptoms comprised the subjective assessment.Results:  The mean follow‐up interval was 19.6 months (12–40 months). The objective cure rate for the treatment of uterine prolapse was 89.5%, and the objective cure rate for the treatment of urinary incontinence was more than 90%.Conclusions:  Uterine preservation in pelvic reconstruction is technically feasible and the subjective and objective assessments imply that uterine preservation in pelvic reconstruction is an alternative option for indicated patients.
Intrapartum translabial ultrasound demonstration of face presentation during first stage of labor
Authors: Lau Wai‐lam , Cho Lai‐yin , Leung Wing‐cheong 
Published: September 2011

AbstractWe report an unusual case in which sonographic diagnosis of face presentation was made by translabial ultrasound examination during the first stage of labor. In a multigravida, induction of labor was performed at 39 weeks' gestation for suspected small‐for‐gestational age. The diagnosis of face presentation was confirmed by the use of intrapartum translabial ultrasound examination. In face presentation, the orbits and nasal bridge are shown in the center of the presenting part at the mid‐sagittal plane. Emergency cesarean delivery was performed for labor dystocia. Here we discuss the merits and limitations of transabdominal, transvaginal and translabial ultrasound examinations in assisting clinical diagnosis of non‐vertex malpresentation. We propose the use of intrapartum translabial scan in documentation, counseling and education in case of unusual non‐vertex malpresentation.
Molecular characterization of putative biocorroding microbiota with a novel niche detection of Epsilon‐ and Zetaproteobacteria in Pacific Ocean coastal seawaters
Authors: Dang Hongyue , Chen Ruipeng , Wang Lin , Shao Sudong , Dai Lingqing , Ye Ying , Guo Lizhong , Huang Guiqiao , Klotz Martin G. 
Published: September 2011

SummarySubmerged metal surfaces in marine waters undergo rapid microbial colonization and biocorrosion, causing huge damage to marine engineering facilities and significant financial losses. In coastal areas, an accelerated and particularly severe form of biocorrosion termed accelerated low water corrosion (ALWC) is widespread globally. While identification of biocorroding microorganisms and the dynamics of their community structures is the key for understanding the processes and mechanisms leading to ALWC, neither one is presently understood. In this study, analysis of constructed clone libraries and qPCR assays targeting group‐specific 16S rRNA or functional marker genes were used to determine the identity and abundance of putative early carbon steel surface‐colonizing and biocorroding microbes in coastal seawater. Diverse microbial groups including 10 bacterial phyla, archaea and algae were found to putatively participate in the surface‐colonizing process. Analysis of the community structure of carbon steel surface microbiota revealed a temporal succession leading to ALWC. By extending the current state of knowledge, our work demonstrates the global importance of Alphaproteobacteria (mainly Rhodobacterales), Gammaproteobacteria (mainly Alteromonadales and Oceanospirillales), Bacteroidetes (mainly Flavobacteriales) and microalgae as the pioneer and sustaining surface colonizers that contribute to initial formation and development of surface biofilms. We also discovered Epsilonproteobacteria and the recently described Zetaproteobacteria as putative corrosion‐causing microorganisms during early steps of the ALWC process. Hence, our study reports that Zetaproteobacteria may be ubiquitous also in non‐hydrothermal coastal seawaters and that ALWC of submerged carbon steel surfaces in coastal waters may involve a highly diverse, complex and dynamic microbial consortium. Our finding that Epsilon‐ and Zetaproteobacteria may play pivotal roles in ALWC provides a new starting point for future investigation of the ALWC process and mechanism in marine environments. Further studies of Epsilon‐ and Zetaproteobacteria in particular may thus help with the design of effective corrosion prevention and control strategies.