bluuebunny/crossref_metadata_2025_split huggingface dataset:
Score of neonatal acute physiology as a measure of illness severity in mechanically ventilated term babies
Authors: Sutton L , Bajuk B , Berry G , Sayer GP , Richardson V , Henderson‐Smart DJ 
Published: August 2010

The objectives of this population‐based, case‐control cohort study were to describe the use of the score of neonatal acute physiology (SNAP) as a measure of illness severity in mechanically ventilated term infants, to compare the SNAP scores of the different diagnostic groups, to assess the contribution of the individual SNAP items to the overall SNAP severity category, and to assess SNAP as a predictor of mortality and neonatal intensive care unit (NICU) resource utilization (length of stay (LOS) and duration of ventilation (LOV)). The study was carried out in Sydney and four large rural/urban health areas in New South Wales, Australia. The subjects—182 singleton term infants with no major congenital anomalies—were admitted to a tertiary NICU for mechanical ventilation. Highest mean (SD) SNAP scores occurred in infants ventilated for meconium aspiration (18 (9)), and perinatal asphyxia (17 (9)), compared with pulmonary hypertension (14 (6)) and respiratory distress syndrome (13 (5)). The individual SNAP items that contributed most to SNAP moderate and severe categories were blood gas items, creatinine, urine output, blood glucose, and seizures. Predictors of death included total SNAP score, individual SNAP items (urine output, pH, Oxygenation Index (OI)), 5‐min Apgar, gestational age >40 wk, growth restriction, and ventilation for asphyxia/apnoea. SNAP alone was not a good predictor of NICU resource utilization (LOS, LOV) in term infants. The best predictors were LOV for LOS, and a combination of SNAP and the reason for ventilation for LOV. Conclusion: SNAP is a useful measure of severity of illness in sick term neonates admitted to a tertiary NICU. This measure can be used to predict neonatal morbidity and mortality, and to some extent NICU resource utililization.
Psychological well‐being of orphans in Dar El Salaam, Tanzania
Authors: Makame V , Ani C , Grantham‐McGregor S 
Published: August 2010

Forty‐one orphans whose fathers and/or mothers had died from AIDS, and were living in the poor suburbs of Dar Es Salaam, Tanzania, were compared with 41 matched non‐orphans from the same neighbourhoods. The subjects were given an arithmetic test and a semi‐structured questionnaire concerning any internalizing problems, their attendance at school and their experiences of punishment, reward and hunger. The scale of internalizing problems comprised 21 items adapted from the Rand Mental Health and Beck Depression Inventories concerning mood, pessimism, somatic symptoms, sense of failure, anxiety, positive affect and emotional ties. Most orphans lived with aunts and uncles. Compared with non‐orphans, they were significantly less likely to be in school but those who did attend school had similar arithmetic scores. Significantly more orphans went to bed hungry. Orphans had markedly increased internalizing problems compared with non‐orphans (p < 0.0001) and 34% reported they had contemplated suicide in the past year. Multiple regression analysis indicated that the independent predictors of internalizing problem scores were sex (females higher than males), going to bed hungry, no reward for good behaviour, not currently attending school, as well as being an orphan. Conclusion: The orphans not only had unmet basic needs, but also had markedly increased internalizing problems, thus their long‐term mental health would be in jeopardy. There is an urgent need to expand and improve current intervention programmes not only to meet the basic needs but also to include psychosocial support, counselling services for the orphans, and training for their carers and teachers.
French adolescent attitudes towards informal care for physical and emotional or relational problems
Authors: Pommier J , Billot L , Mouchtouris A , Deschamps J‐P , Romero MI , Zubarew T 
Published: August 2010

The objective of this study was to determine adolescents' attitudes concerning the use of self‐care and traditional medicines. A self‐administered anonymous questionnaire with open‐ended questions was completed by 543 adolescents aged 15–19 y. The results showed that the most frequent self‐care activity for general health problems, in more than three‐quarters of them, was self‐medication; 14% of them resorted to minor home treatment such as taking care of wounds, bandaging or massages. Instructions for use were mentioned by 69% of adolescents as a way of choosing self‐prescribed drugs. Natural medicines were used by 32% of the girls and 23% of the boys, mainly herbal teas or plant‐based medicines, followed by homoeopathy. Self‐care for emotional and relational problems mainly involved thinking about the problem and questioning themselves about their own behaviour or about the way they are. They also mentioned activities such as sports, going out, listening to music, watching television, and trying to think about something else by keeping themselves occupied. Natural medicines were used by 19% of the girls and 13% of the boys. Plant‐based medicines or herbal teas were used most often, followed by drugs or alcohol, with homoeopathy in third place. Conclusion: Self‐care and alternative medicines were used by adolescents in this study for physical as well as for emotional or relational problems. Their use did not reflect dissatisfaction with physicians and hospital treatment or an objection to formal services, but rather was a choice of these approaches for their own specific characteristics. They were also viewed as being less harmful than conventional treatment.
Screening for duct‐dependent congenital heart disease with pulse oximetry: A critical evaluation of strategies to maximize sensitivity
Authors: GRANELLI ANNE DE‐WAHL , MELLANDER MATS , SUNNEGÅRDH JAN , & KENNETH SANDBERG , ÖSTMAN‐SMITH INGEGERD 
Published: August 2010

AbstractAim: To evaluate the feasibility of detecting duct‐dependent congenital heart disease before hospital discharge by using pulse oximetry. Design: Case‐control study. Setting: A supra‐regional referral centre for paediatric cardiac surgery in Sweden. Patients: 200 normal term newborns with echocardiographically normal hearts (median age 1.0 d) and 66 infants with critical congenital heart disease (CCHD; median age 3 d).Methods: Pulse oximetry was performed in the right hand and one foot using a new‐generation pulse oximeter (NGoxi) and a conventional‐technology oximeter (CToxi).Results: With the NGoxi, normal newborns showed a median postductal saturation of 99% (range 94–100%); intra‐observer variability showed a mean difference of 0% (SD 1.3%), and inter‐observer variability was 0% (SD 1.5%). The CToxi recorded a significantly greater proportion of postductal values below 95% (41% vs 1%) in the normal newborns compared with NGoxi (p < 0.0001). The CCHD group showed a median postductal saturation of 90% (45–99%) with the NGoxi. Analysis of distributions suggested a screening cut‐off of < 95%; however, this still gave 7/66 false‐negative patients, all with aortic arch obstruction. Best sensitivity was obtained by adding one further criterion: saturation of < 95% in both hand and foot or a difference of > ± 3% between hand and foot. These combined criteria gave a sensitivity of 98.5%, specificity of 96.0%, positive predictive value of 89.0% and negative predictive value of 99.5%.Conclusion: Systematic screening for CCHD with high accuracy requires a new‐generation oximeter, and comparison of saturation values from the right hand and one foot substantially improves the detection of CCHD.
Glycosylation of therapeutic proteins in different production systems
Authors: Werner Rolf G , Kopp Kristina , Schlueter Michael 
Published: August 2010

AbstractGlycosylation plays an important role in a number of therapeutic proteins, including monoclonal antibodies. The enzymatic activity of a therapeutic protein is mainly determined by the protein structure, whereas the pharmacokinetics, pharmacodistribution, solubility, stability, enhancement of effector function and receptor binding are all influenced by the carbohydrate moiety.Hyperglycosylated proteins show increased serum half‐life, are less sensitive to proteolysis and more heat‐stable compared with the non‐glycosylated forms. Molecular engineering of the TNK‐tissue plasminogen activator molecule results in a more complex type of glycosylation and increases the half‐life of the protein, which allows a single bolus injection at a lower dose for the treatment of acute myocardial infarction.Antibody‐dependent cell cytotoxicity (ADCC) is determined partially by the specific N‐glycosylation of the Fc domain of the monoclonal antibody. Specific glycoforms of monoclonal antibodies, which interact solely with the FcγRIIIa receptor of natural killer cells, result in superior ADCC compared with heterogeneous glycoforms that interact with different Fc receptors. This demonstrates that glycoengineering for directed glycosylation of therapeutic proteins can improve the therapeutic effect.While the amino acid sequence of the therapeutic protein is determined by the nucleotide sequence of the inserted gene, glycosylation depends on the glycosylating enzymes in the endoplasmatic reticulum and the Golgi apparatus of the eukaryotic host cell. In addition, the glycosylation of the therapeutic protein is affected by the culture medium used, the efficiency of protein expression and the physiological status of the host cell.Conclusion: For a given protein, changes in the type of host cell, composition of the culture media and fermentation conditions during process development will most likely result in changes in the site occupation and heterogeneity of glycosylation. This, of course, can influence the therapeutic profile. Therefore, the early selection of the host cell and selection of upstream parameters are key in the process development of a product.
Pathogenic mechanisms in lysosomal disease: a reappraisal of the role of the lysosome
Authors: Walkley Steven U 
Published: August 2010

AbstractThe view that lysosomes simply represent end organelles in the serial degradation of polymeric molecules derived from the cell surface and its interior has led to major misconceptions about the nature of lysosomal storage diseases and the pathogenic cascades that characterize them. Accordingly, lysosomal storage bodies are often considered ‘inert’, inducing cell dysfunction and death primarily through mechanical overcrowding of normal organelles or by other non‐specific means leading to generalized cytotoxicity. However, modern studies of lysosomes and their component proteins provide evidence to support a far greater role for these organelles in cell metabolism. In intimate association with endosomal, autophagosomal and related vesicular systems, the greater lysosomal system can be conceptualized as a vital recycling centre that serves as a central metabolic coordinator, influencing literally every aspect of the cell, from signal transduction to regulation of gene expression.Conclusion: This broader view of the role of lysosomes in cells not only provides insight into how single gene defects impacting on lysosomal function can result in the plethora of complex cellular transformations characteristic of these diseases, but also suggests new and innovative therapies that may hold considerable promise for ameliorating disease progression.
Quantification of brain tissue alterations in Fabry disease using diffusion‐tensor imaging
Authors: Fellgiebel Andreas , Albrecht Juliane , Dellani Paulo R , Schermuly Ingrid , Stoeter Peter , Müller Matthias J 
Published: August 2010

AbstractCentral nervous system involvement is a major burden in Fabry disease. Conventional cranial magnetic resonance imaging (MRI) shows micro‐ and macroangiopathic changes such as severe and progressive white matter lesions (WMLs) at an early age on T2‐ and fluid‐attenuated inversion recovery‐weighted images, increased signal intensity in the pulvinar on T1‐weighted MRI, as well as tortuosity and dilatation of the larger vessels (dolicho‐ectasia). Using diffusion tensor imaging (DTI), a new structural MRI‐technique that measures water diffusion characteristics, we showed marked brain tissue alterations in Fabry disease predominantly in the periventricular white matter. Even patients with few WMLs had significantly elevated brain tissue diffusivity.Conclusion: DTI is more sensitive in detecting brain tissue changes in Fabry disease than conventional MRI. DTI measurements could provide appropriate surrogate parameters with which to monitor the natural history of structural brain involvement and potential effects of therapy (such as enzyme replacement) in Fabry disease.
Animal models for mucopolysaccharidosis disorders and their clinical relevance
Authors: Haskins Mark E 
Published: August 2010

AbstractProgress in understanding how a particular genotype produces the phenotype of an inborn error of metabolism, such as a mucopolysaccharidosis, in human patients has been facilitated by the study of animals with mutations in the orthologous genes. These are not just animal models, but true orthologues of the human genetic disease, with defects involving the same evolutionarily conserved genes and the same molecular, biochemical, and anatomic lesions as in human patients. These animals are often domestic species because of the individual medical attention paid to them, particularly dogs and cats. In addition, naturally occurring mouse models have also been found in breeding colonies. Within the last several decades, advances in molecular biology have allowed the production of knockout mouse models of human genetic disease, including the lysosomal storage diseases. The ability to use both inbred strains of a small, prolific species together with larger out‐bred animals found because of their disease phenotype provides a powerful combination with which to investigate pathogenesis, develop approaches to therapy, and define biomarkers to evaluate therapeutic success. This has been true for the inborn errors of metabolism and, in particular, the mucopolysaccharidoses.Conclusion: Animal models of human genetic disease continue to play an important role in understanding the molecular and physiological consequences of lysosomal storage diseases and to provide an opportunity to evaluate the efficacy and safety of therapeutic interventions.
Mucopolysaccharidosis type II: an update on mutation spectrum
Authors: Froissart Roseline , Da Silva Isabel Moreira , Maire Irène 
Published: August 2010

AbstractMucopolysaccharidosis type II (MPS II; Hunter disease) is caused by deficiency of the enzyme iduronate‐2‐sulphatase (IDS) and patients present with a wide range of clinical signs and symptoms. The level of activity of IDS, however, does not allow prediction of phenotype. In our study of unrelated individuals with MPS II, alterations in the IDS gene could be identified in all 155 patients. Investigations in families in which the occurrence of MPS II was sporadic revealed mosaicism in the mothers of a small number of patients and a high frequency of de novo mutations occurring preferentially during male meiosis. Mutations identified in our patients include 27 large alterations and 128 small gene alterations (96 different alterations). These data further confirm the extreme heterogeneity of IDS gene alterations, as more than 330 have been reported to date. This genetic heterogeneity may explain the high degree of clinical heterogeneity in MPS II. Therefore, attempts have been made to establish genotype–phenotype correlations in order to provide an indication of the likely prognosis and a basis on which to evaluate treatment. To date, some progress has been made in predicting the clinical phenotype from the genotype although it remains difficult in a few individual cases. However, as the crystallographic 3D structure of IDS is yet to be determined, evaluation of the impact of mutations on IDS activity is often time consuming. Furthermore, if a given mutation is recurrent, some patients carrying the same change may present with different phenotypes, suggesting that factors other than the IDS gene (e.g. other genes, environmental factors) can modulate the clinical phenotype.Conclusion: Although genotype–phenotype correlations may be difficult to establish, they will be of increasing importance for choosing the most appropriate therapy for an individual patient, as new therapeutic strategies may be targeted according to phenotype.
Nemesis reconsidered
Authors: Melott Adrian L. , Bambach Richard K. 
Published: August 2010

Abstract
The hypothesis of a companion object (Nemesis) orbiting the Sun was motivated by the claim of a terrestrial extinction periodicity, thought to be mediated by comet showers. The orbit of a distant companion to the Sun is expected to be perturbed by the Galactic tidal field and encounters with passing stars, which will induce variation in the period. We examine the evidence for the previously proposed periodicity, using two modern, greatly improved paleontological data sets of fossil biodiversity. We find that there is a narrow peak at 27 Myr in the cross-spectrum of extinction intensity time series between these independent data sets. This periodicity extends over a time period nearly twice that for which it was originally noted. An excess of extinction events is associated with this periodicity at 99 per cent confidence. In this sense we confirm the originally noted feature in the time series for extinction. However, we find that it displays extremely regular timing for about 0.5 Gyr. The regularity of the timing compared with earlier calculations of orbital perturbation would seem to exclude the Nemesis hypothesis as a causal factor.
A Critical Review Of Current Nursing Faculty Practice
Authors: Sawyer Meghan J. , Alexander Ivy M. , Gordon Lisa , Juszczak Linda J. , Gilliss Catherine 
Published: August 2010

PURPOSETo critically examine the current literature on nursing faculty practice, using the National Organization of Nurse Practitioner Faculties (NONPF) Guidelines for Evaluation of Faculty Practice, and to examine faculty practice models' strengths, weaknesses, and barriers.DATA SOURCESThirty‐five articles describing models of faculty practice were identified through an exhaustive search on CINAHL and Medline. Two NONPF monographs on nursing faculty practice were used as guidelines for the critical review.CONCLUSIONSFaculty practice has become an integral component of faculty‐role expectations at many schools of nursing. Workload, especially without adequate compensation, remains a hindrance to practice. The value of faculty practice time and expertise has not been sufficiently demonstrated. Integration of practitioner, educator and researcher roles remains extremely difficult and sometimes elusive.
Trauma Risks and Prevention Strategies for Snowboarders
Authors: McDonah Margaret R. 
Published: August 2010

PURPOSETo provide primary care providers with current information about the risk of injury and trauma prevention measures for snowboarders.DATA SOURCESSelected research articles and Internet sourcesCONCLUSIONSBeginners are at increased risk for snowboarding injuries. Lower extremity injuries have been reduced in recent years by the introduction of the hybrid boot for beginners. Little has been done to reduce the significant impact of head injuries and wrist fractures to snowboarders.IMPLICATIONS FOR PRACTICESnowboarders comprise approximately 25%‐37% of the population on ski slopes. Recommending the use of helmets and wrist guard protection to snowboarding patients is a useful trauma prevention measure. The high rate of injury to the beginner and young snow‐boarder makes a particularly strong argument for these safety recommendations to this patient population.
Meeting National Tobacco Challenges: Recommendations for Smoking Cessation Groups
Authors: Schumann Lorna , Andrews Jeannette , Heath Janie , Harrell Lori , Forbes Mary 
Published: August 2010

PURPOSETo review the literature on model smoking cessation programs and provide an overview of the practice guidelines for intensive smoking cessation groups.DATA SOURCESSelected evidence‐based literature and AHCPR/AHRQ clinical practice guidelines.CONCLUSIONSSmoking is the leading cause of preventable death in our global society and is expected to kill more people than any other disease within 20 years. Data support that most smokers want to quit and are more likely to succeed with a combination of behavioral and pharmacological support.IMPLICATIONS FOR PRACTICESmoking cessation must be a priority in the delivery of patient care. Intensive interventions are more effective than brief interventions and should be available for all smokers.
Management of Chronic Hepatitis C
Authors: Goolsby Mary Jo , Blackwell James 
Published: August 2010

One purpose of the Clinical Practice Guideline column is to increase the awareness of the broad availability of existing guidelines and recommendations on various health topics. The hepatitis C virus (HCV) currently accounts for 20% to 40% of acute viral hepatitis, 60% to 80% of chronic hepatitis, and 20% to 30% of cirrhosis, end‐stage liver disease, and liver cancer. Nearly four million Americans are currently infected with hepatitis C. Nurse practitioners should be aware of the recommendations regarding the diagnosis, management, and monitoring of the dis ease. This column summarizes the content of two NIH documents regarding the care of patients with hepatitis C: Management of Hepatitis C: NIH Consensus Statement (NIH, 1997) and Chronic Hepatitis C: Current Disease Management (NIDDK, 2000).Readers are encouraged to suggest specific CPGs for future columns or to request that the editor search for and summarize a CPG addressing a common health problem. Readers are also invited to submit a manuscript reviewing CPGs that they find helpful in their area of practice.
Unintentional Injuries in the Young Adult Male
Authors: Stiglets Carley 
Published: August 2010

PurposeTo review the primary causes of unintentional deaths in young adult males and suggest strate‐gies for educating young men about reducing risks for accidental death.Data SourcesSelected scientific literature and Internet sources.ConclusionsUnintentional deaths are the fifth leading cause of death in all age groups, after heart dis‐ease, cancer, stroke, and chronic obstructive pulmonary disease. Accidental death is the leading cause of death in males 1 to 44 years of age. Motor vehicle crashes, drowning, gunshot wounds, and occupational fatalities are among the leading injuries that contribute to the unanticipated death of the young adult male.Implications for PracticeThe ability to make sound decisions is a devel‐opmental process that is not achieved until later in adolescence or early adulthood. Nurse practitioners must assess the adolescent devel‐opmentally to provide appropriate guidance and assistance with behavior change.
A Review of Antiphospholipid Antibody Syndrome
Authors: Schumann Lorna , Olmstead Jill 
Published: August 2010

PurposeTo review the pathophysiology, clinical presen‐tation, and management options for antiphos‐pholipid antibody syndrome (APS), a poten‐tially life‐threatening coagulation disorder.Data SourcesSelected scientific literature, consensus guide‐lines, and expert opinion.ConclusionsClinical features that should alert the clinician to consider APS include recurrent fetal loss, arterial or venous thrombosis, thrombocytope‐nia and livedo reticularis. One should be sus‐picious of this diagnosis in a younger patient, one with an autoimmune disease, or family history of autoimmune disease. To confirm the diagnosis one needs both clinical and laborato‐ry abnormalities.Implications for PracticeThe signs and symptoms of APS are varied and could be confused with many disorders. The primary care provider needs to be aware of this syndrome in order to include it in the differ‐ential diagnosis and appropriately recognize and refer the patient in a timely manner.