bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing quality of nutritional care in Dutch and German nursing homes
Authors: van Nie‐Visser Noémi C , Meijers Judith MM , Schols Jos MGA , Lohrmann Christa , Bartholomeyczik Sabine , Halfens Ruud JG 
Published: July 2011

Aims and objectives.  This study investigates possible differences in malnutrition prevalence rates in Dutch and German nursing homes. It seeks to provide insight into the screening, prevention and treatment of malnutrition and the indicators for nutritional care policy.Background.  For decades, malnutrition has been an important problem in health care settings worldwide. A considerable percentage of frail older people suffer from malnutrition. In European nursing homes, the reported prevalence rates range widely (2% to 85%).Method.  This is a multicentre, cross‐sectional prevalence study of malnutrition in Dutch and German nursing homes using standardised methodology, with the participation of respectively 5848 and 4923 residents (65+ years).Results.  Patient characteristics differed significantly between the two countries. Dutch residents were more often male, younger, more care‐dependent and significantly more at risk of malnutrition (31·7%). However, overall malnutrition prevalence rates did not differ significantly (Netherlands 26·8% and Germany 26·5%). All German residents were screened at admission, whereas only 73·1% of the Dutch residents were. As part of screening, nutritional screening tools were used in 38·0% of Dutch and 42·1% of the German residents. A dietician was consulted for 36·7% Dutch and 9·3% German malnourished residents. The proportion of malnourished receiving nutritional intervention was larger in Germany than in the Netherlands. Structural indicators for nutritional policy were fulfilled more often in the Netherlands care at institutional level whereas in Germany they were fulfilled more often at ward level.Conclusion.  In this study, German residents had a somewhat better nutritional status than Dutch residents and more is done to enhance nutritional status in German nursing homes. The differences would be somewhat larger if both populations were more comparable.Relevance to clinical practice.  Comparing malnutrition prevalence rates, prevention and interventions in health care institutions and countries gives insight into international differences in quality of care.
Primary care for tinnitus: practice and opinion among GPs in England
Authors: El‐Shunnar Suliman K. , Hoare Derek J. , Smith Sandra , Gander Phillip E. , Kang Sujin , Fackrell Kathryn , Hall Deborah A. 
Published: June 2011

AbstractRationale, aim and objective  Effective tinnitus management starts with appropriate general practitioner (GP) triage, which in England can be guided by the Department of Health's Good Practice Guide (GPG). Despite the prevalence of the condition, there has never been a systematic survey of its management in primary care in England. We aimed to evaluate how people with tinnitus are assessed and managed in general practice, noting variation in practice across GPs and health authorities, and evaluating how closely typical practice aligns to the GPG for tinnitus.Methods  A nine‐item postal questionnaire was sent to 2000 GPs randomly selected to proportionally represent the number of primary care trusts and strategic health authorities in England.Results  We received 368 responses. Responses indicated a mix of frequent and infrequent practices, for example, 90% of GPs assessed the impact of tinnitus on quality of life, but fewer examined cranial nerves (38%) or assessed for a carotid bruit (26%) during a tinnitus consultation. In the management of tinnitus, 83% routinely removed earwax, and 87% provided information‐based advice. In contrast, only 4% of responders would offer antidepressant drugs or psychological therapies. Thematic analysis revealed a desire for concise training on tinnitus management.Conclusions  GP assessment and management of tinnitus represents potential inequity of service for tinnitus patients. While the GPG aims to promote equity of care, it is only referred to by a minority of clinicians and so its utility for guiding service delivery is questionable. Although some GPs highlighted little demand for tinnitus management within their practice, many others expressed an unmet need for specific and concise GP training on tinnitus management. Further work should therefore evaluate current informational resources and propose effective modes of delivering educational updates.
Identification and functional validation of CDH11, PCSK6 and SH3GL3 as novel glioma invasion‐associated candidate genes
Authors: Delic S. , Lottmann N. , Jetschke K. , Reifenberger G. , Riemenschneider M. J. 
Published: July 2011

S. Delic, N. Lottmann, K. Jetschke, G. Reifenberger and M. J. Riemenschneider (2012) Neuropathology and Applied Neurobiology38, 201–212Identification and functional validation of CDH11, PCSK6 and SH3GL3 as novel glioma invasion‐associated candidate genesAims: The molecular mechanisms underlying the infiltrative growth of glioblastomas, the most common primary tumours of the central nervous system in adults, are still poorly understood. We aimed to identify and functionally validate novel glioma invasion‐associated candidate genes. Methods: Microarray‐based expression analysis was applied to identify differentially expressed genes in microdissected infiltrating glioma cells in vivo. Promising candidate genes were selected by the invasion‐associated gene ontology terms cell adhesion, endocytosis, extracellular matrix and cell migration and validated in vitro by invasion assays and in situ by immunohistochemistry. Results: We identified 180 up‐regulated and 61 down‐regulated genes (fold change: ≥2; P < 0.01) in the infiltration zone relative to more central cell‐rich tumour areas of malignant astrocytic gliomas (n = 11). Twenty‐seven of these genes matched to invasion‐related gene ontology terms. From these, we confirmed the genes encoding cadherin‐11 (CDH11), proprotein convertase subtilisin/kexin type 6 (PCSK6) and SH3‐domain GRB2‐like 3 (SH3GL3) as novel glioma invasion‐associated candidate genes, with knockdown of PCSK6 and SH3GL3 inhibiting glioma cell invasion, while inhibition of CDH11 promoted glioma cell invasion in vitro. Immunohistochemistry on glioblastoma tissue sections revealed expression of CDH11 and PCSK6 protein in glioma cells of more central, cell‐rich tumour areas, with only weak or absent CDH11 immunoreactivity but consistent PCSK6 staining in infiltrating glioma cells. Conclusion: Using molecular profiling of microdissected primary tumour tissue specimens followed by functional in vitro analysis, we identified and validated CDH11, PCSK6 and SH3GL3 as novel glioma invasion‐associated candidate genes that likely contribute to the invasive phenotype of malignant gliomas.
Changes in light intensity reveal a major role for carbon balance inArabidopsisresponses to high temperature
Authors: VASSEUR FRANÇOIS , PANTIN FLORENT , VILE DENIS 
Published: June 2011

ABSTRACTHigh temperature (HT) is a major limiting factor for plant productivity. Because some responses to HT, notably hyponasty, resemble those encountered in low light (LL), we hypothesized that plant responses to HT are under the control of carbon balance. We analysed the interactive effects of HT and irradiance level on hyponasty and a set of traits related to plant growth in natural accessions ofArabidopsis thalianaand mutants affected in heat dissipation through transpiration (NCED6‐OE,ost2) and starch metabolism (pgm). HT induced hyponasty, reduced plant growth and modified leaf structure. LL worsened the effects of HT, while increasing light restored trait values close to levels observed at control temperature. Leaf temperatureper sedid not play a major role in the observed responses. By contrast, a major role of carbon balance was supported by hyponastic growth ofpgm, as well as morphological, physiological (photosynthesis, sugar and starch contents) and transcriptional data. Carbon balance could be a common sensor of HT and LL, leading to responses specific of the shade avoidance syndrome. Hyponasty and associated changes in plant traits could be key traits conditioning plant performance under competition for light, particularly in warm environments.
Water supply and not nitrate concentration determines primary root growth in Arabidopsis
Authors: CHAPMAN NICK , WHALLEY W. RICHARD , LINDSEY KEITH , MILLER ANTHONY J. 
Published: June 2011

ABSTRACTUnderstanding how root system architecture (RSA) adapts to changing nitrogen and water availability is important for improving acquisition. A sand rhizotron system was developed to study RSA in a porous substrate under tightly regulated nutrient supply. The RSA of Arabidopsis seedlings under differing nitrate (NO3‐) and water supplies in agar and sand was described. The hydraulic conductivity of the root environment was manipulated by using altered sand particle size and matric potentials. Ion‐selective microelectrodes were used to quantify NO3‐ at the surface of growing primary roots in sands of different particle sizes. Differences in RSA were observed between seedlings grown on agar and sand, and the influence of NO3‐ (0.1–10.0 mm) and water on RSA was determined. Primary root length (PRL) was a function of water flux and independent of NO3‐. The percentage of roots with laterals correlated with water flux, whereas NO3‐ supply was important for basal root (BR) growth. In agar and sand, the NO3‐ activities at the root surface were higher than those supplied in the nutrient solution. The sand rhizotron system is a useful tool for the study of RSA, providing a porous growth environment that can be used to simulate the effects of hydraulic conductivity on growth.
Crosstalk between abiotic ultraviolet‐B stress and biotic (flg22) stress signalling in Arabidopsis prevents flavonol accumulation in favor of pathogen defence compound production
Authors: SCHENKE DIRK , BÖTTCHER CHRISTOPH , SCHEEL DIERK 
Published: June 2011

ABSTRACTPlants respond to both abiotic and biotic stresses with alterations in the expression of genes required to produce protective metabolites. Sometimes plants can be challenged with different stresses simultaneously and as they cannot evade from this situation, priorities have to be set to deal with the most urgent threat. The abiotic stress ultraviolet‐B (UV‐B) light induces the production of UV‐protective flavonols in Arabidopsis Col‐0 cell suspension cultures and this accumulation is attenuated by concurrent application of the bacterial elicitor flg22 (simulating biotic stress). This inhibition correlates with strong suppression of the flavonol biosynthesis genes. In parallel, flg22 induces the production of defence‐related compounds, such as the phytoalexins, camalexin and scopoletin, as well as lignin, a structural barrier thought to restrict pathogen spread. This correlated positively with flg22‐mediated expression of enzymes for lignin, scopoletin and camalexin production. As flavonols, lignin and scopoletin are all derived from phenylalanine, it appears that the plant focuses the metabolism on production of scopoletin and lignin at the expense of flavonol production. Furthermore, it appears that this crosstalk involves antagonistic regulation of two opposing MYB transcription factors, the positive regulator of the flavonol pathway MYB12 (UV‐B‐induced and flg22‐suppressed) and the negative regulator MYB4 (UV‐B‐ and flg22‐induced).
Can lay health workers increase the uptake of childhood immunisation? Systematic review and typology
Authors: Glenton Claire , Scheel Inger B. , Lewin Simon , Swingler George H. 
Published: June 2011

SummaryObjectives  Lay health workers (LHWs) are used in many settings to increase immunisation uptake among children. However, little is known about the effectiveness of these interventions. The objective of this review was to assess the effects of LHW interventions on childhood immunisation uptake.Methods  We searched Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, British Nursing Index and Archive, AMED, POPLINE and WHOLIS, reference lists of included papers and relevant reviews, and contacted the authors of relevant papers. We selected randomised and non‐randomised controlled trials, controlled before–after studies, and interrupted time series of any intervention delivered by LHWs and designed to increase childhood immunisation uptake. Two authors independently extracted data using a standard form and assessed risk of bias and evidence quality.Findings  We identified twelve studies, ten of which were randomised controlled trials. Seven studies were conducted among economically disadvantaged populations in high‐income countries. Five studies were from low‐ and middle‐income countries. In ten studies, LHWs promoted childhood immunisation. In two studies, LHWs vaccinated children themselves. In most of the studies, the control group populations received no intervention or standard care. Most of the studies showed that LHWs increased immunisation coverage. However, study settings were diverse, allowing us to carry out only one meta‐analysis including four studies.Conclusion  LHWs could make an important contribution to achieving the Millennium Development Goal for child health. However, more high‐quality studies are needed, particularly from LMICs. More studies are also needed to assess the effects of using LHWs to vaccinate children themselves.
Poor efficacy of oral tacrolimus in the treatment of severe generalized atopic eczema in adults: A small retrospective case series
Authors: Lee Frederick J , Frankum Brad S , Katelaris Constance H 
Published: June 2011

ABSTRACTWe report a small, but novel case series of four adults with severe generalized atopic eczema (AE) not responsive to several other immunomodulatory therapies, who were treated with oral tacrolimus (5 mg twice‐daily). Three of the four patients failed therapy with systemic tacrolimus, despite two of these showing an initial clinical response; the fourth patient remains on tacrolimus monotherapy with good control of skin disease. Although oral tacrolimus was well‐tolerated in this small group of adults, the clinical efficacy in this series for severe AE was poor. Tacrolimus may yet have a role in less severe disease, but larger prospective studies are required to qualify its place as a treatment option in AE.
Effects of a maternal diet supplemented with chocolate and fructose beverage during gestation and lactation on rat dams and their offspring
Authors: Zhang Zhi‐Yun , Zeng Jin‐Jing , Kjærgaard Marina , Guan Ni , Raun Kirsten , Nilsson Cecilia , Wang Ming‐Wei 
Published: July 2011

Summary1. Consumption of a high‐fat and high‐energy diet during pregnancy leads to a risk of long‐term consequences on fetal development, as well as on the postnatal health of offspring. To investigate the effects of such a diet on fetal programming, we established a high‐energy intake pregnant rat model using chocolate and fructose beverage as supplements to a normal chow diet.2. Pregnant Sprague‐Dawley rats were assigned to either chow (control) or a diet supplemented with chocolate and fructose beverage throughout gestation and lactation. The male F1 pups received normal chow diet after weaning. Physiological or pathological changes in dams and pups (e.g. glucose and lipid metabolism) were evaluated.3. The results showed that dams offered the high‐fat (mainly from chocolate) and high‐calorie diet during gestation consumed more energy and gained more weight than chow‐fed dams. Over‐consumption of chocolate reduced chow intake in dams, leading to low maternal protein supply. As a result, pups from these dams exhibited reduced birth weight that lasted until adulthood. The high‐energy diet during lactation led to increased total body fat, as well as impaired liver function, in offspring; thus, the lactational diet is suggested to be a stronger determinant of offspring fat metabolism than gestational diet.4. The results of the study suggest that over‐supply of carbohydrates, such as chocolate and fructose, either during gestation or lactation has a negative impact on the well‐being of offspring.
Art of persuasion: An analysis of techniques used to market foods to children
Authors: Hebden Lana , King Lesley , Kelly Bridget 
Published: June 2011

Aim:  Persuasive marketing techniques, such as promotional characters, influence children's food preferences and requests for foods. The aim of this research was to describe the techniques used to market unhealthy foods and beverages to children on Sydney free‐to‐air television.Methods:  Marketing techniques designed to appeal to children were identified from international literature and summarised into a systematic coding tool. Using this tool, the marketing techniques used in a random sample of 100 unique food advertisements, broadcasted on Sydney free‐to‐air television, were coded. Frequency of marketing techniques was analysed overall and for use in advertisements marketing unhealthy foods, emotionally or verbally appealing to parents, or featuring child actors.Results:  Advertisers' use of persuasive techniques generally did not differ by type of food advertised. Marketing techniques with greater prominence in unhealthy food advertising were palatability (54% of unhealthy food advertisements), convenience (52%), fantasy/imagination (28%), fun/happiness (17%) and cartoon characters (9%). Advertisements emotionally appealing to parents (24%) were significantly more likely to make general health or nutrition statements (38% vs. 17%), and appealed to children concurrently through fun/happiness and fantasy/imagination appeals. Children were depicted in advertisements as eating with friends or family, situated within the home and frequently snacking on less healthy foods.Conclusions:  Food and beverage advertisers use a range of visual, audio and emotive techniques to appeal to children and their parents that do not discriminate by the type of food advertised. The range and complexity of these techniques complicate the restriction of their use in food advertising to children.
Basic procedures in tension‐free vaginal mesh operation for pelvic organ prolapse
Authors: Takeyama Masami 
Published: June 2011

AbstractA variety of tension‐free vaginal mesh (TVM) systems are available for surgical treatment of pelvic organ prolapse (POP). These include Prolift, Apogee/Perigee and Avaulta, all of which vary in terms of mesh size, shape and surgical technique to such an extent that they cannot truly be considered the same operation for the purpose of evaluating results. I began carrying out self‐made mesh cut out from Gynemesh PS in 2005. This system has four main characteristics: (i) the mesh is intended as a replacement for defective visceral pelvic fascia; (ii) it bridges between the left and right arcus tendineus fascia pelvis (white line, or ATFP); (iii) large‐size mesh is held in place by passing cannulas through the obturator fascia (anterior wall) or the sacrospinous ligament (SSL) to attach the arms of the mesh graft; and (iv) the bladder neck is preserved. The mesh that I have used since then has been essentially similar to the Prolift System, developed by a French TVM group, in terms of size and shape of its central portion. Mesh grafts used for the anterior wall are quite large, so skillful execution will provide sufficient room between the left and right ATFP in almost all cases.This video discusses the fundamental techniques necessary for skillful execution of the tension‐free vaginal mesh (TVM) procedure using the Prolift System, focusing on the following points: (i) surgical separation of the correct layers of the vaginal wall, and the area separated, and effective hemostasis; (ii) precise puncture technique, especially the second puncture for the anterior TVM (TVM‐A) procedure and the sacrospinous ligament (SSL) puncture in the posterior TVM (TVM‐P) procedure; (iii) firmly securing the mesh to the vaginal wall or cervical canal; and (iv) careful mesh placement and formation of a bridge between the left and right arcus tendineus fascia pelvis (ATFP). Proper separation of the vaginal wall layers, in particular, is crucial for preventing unnecessary blood loss and mesh erosion. The second puncture in the TVM‐A is the most important of the puncture maneuvers for the procedure. Penetrating the tough tissue near the ischial spine represents a significant challenge, and the SSL penetration in the TVM‐P procedure is unexpectedly difficult for those without sufficient experience. In order to become proficient, the surgeon must have hands‐on experience under the supervision of experts.Finally, TVM is a relatively new procedure, so one must master the fundamentals before gaining true proficiency. The technique does not call for virtuosity on the part of the surgeon, but key points must be mastered to reduce the risk of complications and recurrences. With repeated hands‐on training, surgical skills will gradually improve to the requisite level. This is a translated section of a video article originally published in Japanese as a DVD in the Audio‐Visual Journal Vol.15 No.15. 2009 by The Japanese Urological Association.
In‐home controls of pacemakers in debilitated elderly patients
Authors: Folino Antonio F , Breda Roberto , Calzavara Patrizia , Migliore Federico , Iliceto Sabino , Buja Gianfranco 
Published: June 2011

Aim:  We assessed the efficacy, reliability and cost of an in‐home control service, devoted to debilitated patients with pacemakers, during long‐term follow up.Methods:  We admitted 802 patients (mean age 87.8 ± 6.9 years) with pacemakers into our program, which were monitored periodically during in‐home visits by nurses. During these controls, patients underwent a standard electrocardiogram with and without magnet, during which stimulation intervals were measured. In‐home pacemaker assessments were performed by a portable programmer only for patients with Biotronik pacemakers. Electrocardiograms and technical data were evaluated at hospital, and a report was sent by mail to the patient. Moreover, we compared the costs for the hospital, patients and society between in‐home and ambulatory assessments.Results:  During 80 months of follow up, 2418 controls were performed. The monthly average of patients who were followed at home was 283.9 ± 23.9. The mean number of controls per month was 30.2 ± 10 (range 4–51). One hundred and twenty‐three pacemakers were replaced due to battery exhaustion, after a mean device longevity of 7.4 years (range 4.9–12.4 years). Four hundred and sixty‐eight patients died (8.7% annual mortality). Fifteen patients (annual incidence 0.3%) were invited to in‐hospital visits for reprogramming. The cumulative cost for in‐home assessment were 20.5% lower than conventional in‐hospital controls and 66.5% lower if patients are transported by ambulance.Conclusion:  Elderly debilitated patients can be monitored by effective and reliable pacemaker assessments at home, alleviating them and their families from the issues that are associated with their transfer from the home to the hospital and concurrently reducing overall costs. Geriatr Gerontol Int 2012; 12: 30–35.