bluuebunny/crossref_metadata_2025_split huggingface dataset:
Realistic Evaluation of Early Warning Systems and the Acute Life‐threatening Events – Recognition and Treatment training course for early recognition and management of deteriorating ward‐based patients: research protocol
Authors: McGaughey Jennifer , Blackwood Bronagh , O’Halloran Peter , Trinder Thomas John , Porter Sam 
Published: March 2010

mcgaughey j., blackwood b., o’halloran p., trinder t.j. & porter s. (2010) Realistic Evaluation of Early Warning Systems and the Acute Life‐threatening Events – Recognition and Treatment training course for early recognition and management of deteriorating ward‐based patients: research protocol. Journal of Advanced Nursing66(4), 923–932.AbstractTitle.  Realistic Evaluation of Early Warning Systems and the Acute Life‐threatening Events – Recognition and Treatment training course for early recognition and management of deteriorating ward‐based patients: research protocol. Aim.  This paper is a description of a study protocol designed to evaluate the factors that enable or constrain the delivery and sustainability of Early Warning Systems and the Acute Life‐threatening Events – Recognition and Treatment training course in practice.Background.  Rapid response system initiatives have been introduced to try to improve early detection and treatment of patients who deteriorate on general hospital wards. However, recent systematic reviews of the effectiveness of these initiatives show no effect on patient outcomes. Systematic reviews and professional consensus recommend that future research should focus on a broader range of process and outcome measures which consider the social, behavioural and organizational factors that had an impact on the delivery of these initiatives.Design.  The design is a multiple case study on four wards in two hospitals in Northern Ireland that have implemented Early Warning Systems and Acute Life‐threatening Events – Recognition and Treatment training. Data will be collected from key stakeholders using individual and focus group interviews, non‐participant observation, Acute Life‐threatening Events – Recognition and Treatment training records and audit of patients’ observation charts and medical notes. Realistic Evaluation of the data will enable the development and refinement of theories to explain which mechanisms work in a particular context to achieve desired outcomes.Discussion.  This study will produce important information that will contribute to knowledge of the organizational processes that have an impact on the delivery of initiatives to identify, respond and manage acutely ill patients in hospital.
Patient safety: numerical skills and drug calculation abilities of nursing students and Registered Nurses
Authors: McMullan Miriam , Jones Ray , Lea Susan 
Published: March 2010

mcmullan m., jones r. & lea s. (2010) Patient safety: numerical skills and drug calculation abilities of nursing students and Registered Nurses. Journal of Advanced Nursing 66(4), 891–899.AbstractTitle.  Patient safety: numerical skills and drug calculation abilities of nursing students and Registered Nurses. Aim.  This paper is a report of a correlational study of the relations of age, status, experience and drug calculation ability to numerical ability of nursing students and Registered Nurses.Background.  Competent numerical and drug calculation skills are essential for nurses as mistakes can put patients’ lives at risk.Method.  A cross‐sectional study was carried out in 2006 in one United Kingdom university. Validated numerical and drug calculation tests were given to 229 second year nursing students and 44 Registered Nurses attending a non‐medical prescribing programme.Results.  The numeracy test was failed by 55% of students and 45% of Registered Nurses, while 92% of students and 89% of nurses failed the drug calculation test. Independent of status or experience, older participants (≥35 years) were statistically significantly more able to perform numerical calculations. There was no statistically significant difference between nursing students and Registered Nurses in their overall drug calculation ability, but nurses were statistically significantly more able than students to perform basic numerical calculations and calculations for solids, oral liquids and injections. Both nursing students and Registered Nurses were statistically significantly more able to perform calculations for solids, liquid oral and injections than calculations for drug percentages, drip and infusion rates.Conclusion.  To prevent deskilling, Registered Nurses should continue to practise and refresh all the different types of drug calculations as often as possible with regular (self)‐testing of their ability. Time should be set aside in curricula for nursing students to learn how to perform basic numerical and drug calculations. This learning should be reinforced through regular practice and assessment.
Top predators, mesopredators and their prey: interference ecosystems along bioclimatic productivity gradients
Authors: Elmhagen B. , Ludwig G. , Rushton S. P. , Helle P. , Lindén H. 
Published: March 2010

Summary 1. The Mesopredator Release Hypothesis (MRH) suggests that top predator suppression of mesopredators is a key ecosystem function with cascading impacts on herbivore prey, but it remains to be shown that this top‐down cascade impacts the large‐scale structure of ecosystems. 2. The Exploitation Ecosystems Hypothesis (EEH) predicts that regional ecosystem structures are determined by top‐down exploitation and bottom‐up productivity. In contrast to MRH, EEH assumes that interference among predators has a negligible impact on the structure of ecosystems with three trophic levels. 3. We use the recolonization of a top predator in a three‐level boreal ecosystem as a natural experiment to test if large‐scale biomass distributions and population trends support MRH. Inspired by EEH, we also test if top‐down interference and bottom‐up productivity impact regional ecosystem structures. 4. We use data from the Finnish Wildlife Triangle Scheme which has monitored top predator (lynx Lynx lynx), mesopredator (red fox Vulpes vulpes) and prey (mountain hare Lepus timidus) abundance for 17 years in a 200 000 km2 study area which covers a distinct productivity gradient. 5. Fox biomass was lower than expected from productivity where lynx biomass was high, whilst hare biomass was lower than expected from productivity where fox biomass was high. Hence, where interference controlled fox abundance, lynx had an indirect positive impact on hare abundance as predicted by MRH. The rates of change indicated that lynx expansion gradually suppressed fox biomass. 6. Lynx status caused shifts between ecosystem structures. In the ‘interference ecosystem’, lynx and hare biomass increased with productivity whilst fox biomass did not. In the ‘mesopredator release ecosystem’, fox biomass increased with productivity but hare biomass did not. Thus, biomass controlled top‐down did not respond to changes in productivity. This fulfils a critical prediction of EEH. 7. We conclude that the cascade involving top predators, mesopredators and their prey can determine large‐scale biomass distribution patterns and regional ecosystem structures. Hence, interference within trophic levels has to be taken into account to understand how terrestrial ecosystem structures are shaped.
Complete compensation in Daphnia fecundity and stage‐specific biomass in response to size‐independent mortality
Authors: Nilsson Karin A. , Persson Lennart , Van Kooten Tobias 
Published: March 2010

Summary 1. Recent theory suggests that compensation or even overcompensation in stage‐specific biomass can arise in response to increased mortality. Which stage that will show compensation depends on whether maturation or reproduction is the more limiting process in the population. Size‐structured theory also provides a strong link between the type of regulation and the expected population dynamics as both depend on size/stage‐specific competitive ability. 2. We imposed a size‐independent mortality on a consumer‐resource system with Daphnia pulex feeding on Scenedesmus obtusiusculus to asses the compensatory responses in Daphnia populations. We also extended an existing stage‐structured biomass model by including several juvenile stages to test whether this extension affected the qualitative results of the existing model. 3. We found complete compensation in juvenile biomass and total population fecundity in response to harvesting. The compensation in fecundity was caused by both a higher proportion of fecund females and a larger clutch size under increased mortality. We did not detect any difference in resource levels between treatments. 4. The model results showed that both stages of juveniles have to be superior to adults in terms of resource competition for the compensatory response to take place in juvenile biomass. 5. The results are all in correspondence with that the regulating process within the population was reproduction. From this, we also conclude that juveniles were superior competitors to adults, which has implications for population dynamics and the kind of cohort cycles seen in Daphnia populations. 6. The compensatory responses demonstrated in this experiment have major implications for community dynamics and are potentially present in any organisms with food‐dependent growth or development.
Contribution of complementary foods to the total daily water needs of urban Guatemalan infants
Authors: Enneman A. , Campos R. , Hernández L. , Palma A. V. , Vossenaar M. , Solomons N. W. 
Published: March 2010

AbstractBackground:  Estimates of adequate intake (AI) for water only became available in 2005. The daily water AI for 6–12‐month‐old infants of both sexes is 800 mL. The present study aimed to estimate the water intake of urban infants receiving both breast milk and complementary feeding (CF) and to compare them with the reference AI.Methods:  Sixty‐four infants, 42 boys and 22 girls, aged 6–12 months on enrolment, from a low‐income district of Guatemala City, were recruited to the study. Quantitative 24‐h recalls and breastfeeding histories were collected in three serial interviews. The quantity of water was estimated from recipes and food composition moisture values for the CF items reported. The amount of breast milk needed to complement foods and beverages in meeting the individual energy needs was calculated, and breast milk’s water contribution was derived accordingly. The total quantity of water in beverages, including human milk, liquids in recipes and moisture of foods, was tabulated as the infants’ daily intake.Results:  Some 56.3% of the water needs for boys and 41.1% for girls were satisfied by just water obtained from plain water, other complementary beverages and moisture of foods within CF, exclusive of breast milk. Adding the estimated breast milk intake, the median water intake for the infant sample was essentially equal to the 800 mL of the AI.Conclusions:  The infants in this low‐income community are approximating the recommended AI for daily water through the currently selected pattern of lactation and CF.
Nasogastric tube feeding and percutaneous endoscopic gastrostomy tube feeding in patients with head and neck cancer
Authors: Nugent B. , Parker M. J. , McIntyre I. A. 
Published: March 2010

AbstractBackground:  For patients with a diagnosis of head and neck cancer, oral nutrition may not provide adequate nutrition during radical radiotherapy or chemoradiation treatment, resulting in enteral feeding initiation. Enteral feeding may be delivered via a nasogastric tube or by a gastrostomy tube. The present study aimed to determine how different treatment modalities impact on requirement for enteral feeding and which method of enteral feeding provided the most benefit to the patient, as demonstrated by weight loss and the number of unscheduled radiotherapy treatment interruptions.Methods:  Patients who were treated with radical radiotherapy or chemoradiation between January 2004 and June 2007 were reviewed retrospectively (n = 196, male = 149, female = 47). Data were collected on demographics, diagnosis, T and N classification, nutritional status, unscheduled radiotherapy treatment interruptions, and type and duration of enteral feeding. Subjects were divided into three subgroups depending on the treatment received. Comparisons were then made between methods of enteral feeding.Results:  Combined modality treatment (Induction Chemotherapy and Chemoradiation) results in a higher proportion of patients requiring enteral feeding (66–71% compared to 12% for radiotherapy). Patients fed via a prophylactic percutaneous endoscopic gastrostomy lost the least amount of weight during treatment (−4.6% to +1.4%), although the method of enteral feeding did not statistically influence weight difference at the end of treatment. The enteral feeding method did not influence unscheduled radiotherapy treatment interruptions.Conclusions:  Combined modality treatment results in a greater requirement for enteral feeding, with these patient groups having the greatest weight loss. The findings obtained in the present study indicate that the method of enteral feeding did not statistically influence weight loss at the end of treatment or unscheduled radiotherapy treatment interruptions.
Assessment of obesity in children and adolescents: synthesis of recent systematic reviews and clinical guidelines
Authors: Reilly J. J. 
Published: March 2010

AbstractThis review summarises recent systematic reviews and evidence‐based guidelines that deal with the issue of how best to diagnose or define obesity in children and adolescents. A recent systematic review showed that parents typically fail to recognise obesity in their children and adolescents, and a good deal of other evidence suggests that health professionals under‐diagnose obesity in children and adolescents when using informal methods based on observation. There is therefore a need for practical, objective, methods that both identify the fattest children and adolescents adequately, and identify those who are at greatest risk of the ‘co‐morbidities’ of obesity. A large body of consistent evidence shows that a high body mass index (BMI) for age and sex identifies the fattest children adequately, with low–moderate false negative rate and a low false positive rate. Furthermore, children and adolescents at high BMI for age are at much greater risk of the co‐morbidities of obesity. A recent systematic review found that the use of BMI for age with national reference data and cut‐off points (such as the 95th percentile to define obesity) was superior to the Cole–International Obesity Task Force international approach for defining obesity based on BMI for age. The same systematic review also found no evidence that use of waist circumference for age improved the diagnosis of obesity, or the cardio‐metabolic co‐morbidities of obesity, in children and adolescents. Recent systematic reviews are therefore supportive of current guidelines that recommend percentile‐based cut‐offs relative to national reference data to (e.g. BMI at or above the 95th or 98th percentile in the UK) to define obesity for clinical applications in children and adolescents.
A localized multimeric anchor attaches the Caulobacter holdfast to the cell pole
Authors: Hardy Gail G. , Allen Rebecca C. , Toh Evelyn , Long Maria , Brown Pamela J. B. , Cole‐Tobian Jennifer L. , Brun Yves V. 
Published: March 2010

Summary Caulobacter crescentus attachment is mediated by the holdfast, a complex of polysaccharide anchored to the cell by HfaA, HfaB and HfaD. We show that all three proteins are surface exposed outer membrane (OM) proteins. HfaA is similar to fimbrial proteins and assembles into a high molecular weight (HMW) form requiring HfaD, but not holdfast polysaccharide. The HfaD HMW form is dependent on HfaA but not on holdfast polysaccharide. We show that HfaA and HfaD form homomultimers and that they require HfaB for stability and OM translocation. All three proteins localize to the late pre‐divisional flagellar pole, remain at this pole in swarmer cells, and localize at the stalk tip after the stalk is synthesized at the same pole. Hfa protein localization requires the holdfast polysaccharide secretion proteins and the polar localization factor PodJ. An hfaB mutant is much more severely deficient in adherence and holdfast attachment than hfaA and hfaD mutants. An hfaA, hfaD double mutant phenocopies either single mutant, suggesting that HfaB is involved in holdfast attachment beyond secretion of HfaA and HfaD. We hypothesize that HfaB secretes HfaA and HfaD across the outer membrane, and the three proteins form a complex anchoring the holdfast to the stalk.
A lipoprotein modulates activity of the MtrAB two‐component system to provide intrinsic multidrug resistance, cytokinetic control and cell wall homeostasis in Mycobacterium
Authors: Nguyen Hoa T. , Wolff Kerstin A. , Cartabuke Richard H. , Ogwang Sam , Nguyen Liem 
Published: March 2010

SummaryThe MtrAB signal transduction system, which participates in multiple cellular processes related to growth and cell wall homeostasis, is the only two‐component system known to be essential in Mycobacterium. In a screen for antibiotic resistance determinants in Mycobacterium smegmatis, we identified a multidrug‐sensitive mutant with a transposon insertion in lpqB, the gene located immediately downstream of mtrA–mtrB. The lpqB mutant exhibited increased cell–cell aggregation and severe defects in surface motility and biofilm growth. lpqB cells displayed hyphal growth and polyploidism, reminiscent of the morphology of Streptomyces, a related group of filamentous Actinobacteria. Heterologous expression of M. tuberculosis LpqB restored wild‐type characteristics to the lpqB mutant. LpqB interacts with the extracellular domain of MtrB, and influences MtrA phosphorylation and promoter activity of dnaA, an MtrA‐regulated gene that affects cell division. Furthermore, in trans expression of the non‐phosphorylated, inactive form of MtrA in wild‐type M. smegmatis resulted in phenotypes similar to those of lpqB deletion, whereas expression of the constitutively active form of MtrA restored wild‐type characteristics to the lpqB mutant. These results support a model in which LpqB, MtrB and MtrA form a three‐component system that co‐ordinates cytokinetic and cell wall homeostatic processes.
Gene position in a long operon governs motility development in Bacillus subtilis
Authors: Cozy Loralyn M. , Kearns Daniel B. 
Published: March 2010

SummaryGrowing cultures of Bacillus subtilis bifurcate into subpopulations of motile individuals and non‐motile chains of cells that are differentiated at the level of gene expression. The motile cells are ON and the chaining cells are OFF for transcription that depends on RNA polymerase and the alternative sigma factor σD. Here we show that chaining cells were OFF for σD‐dependent gene expression because σD levels fell below a threshold and σD activity was inhibited by the anti‐sigma factor FlgM. The probability that σD exceeded the threshold was governed by the position of the sigD gene. The proportion of ON cells increased when sigD was artificially moved forward in the 27 kb fla/che operon. In addition, we identified a new σD‐dependent promoter that increases sigD expression and may provide positive feedback to stabilize the ON state. Finally, we demonstrate that ON/OFF motility states in B. subtilis are a form of development because mosaics of stable and differentiated epigenotypes were evident when the normally dispersed bacteria were forced to grow in one dimension.
Gene position within a long transcript as a determinant for stochastic switching in bacteria
Authors: Veening Jan‐Willem , Kuipers Oscar P. 
Published: March 2010

SummaryHow cultures of genetically identical cells bifurcate into distinct phenotypic subpopulations under uniform growth conditions is an important question in developmental biology of relevance even to relatively simple developmental systems, such as spore formation in bacteria. A growing Bacillus subtilis culture consists of either cells that are motile and can swim or cells that are non‐motile and are chained together. In this issue of Molecular Microbiology, Cozy and Kearns show that the probability of a cell to become motile depends on the position of the sigD gene within the long (27 kb) motility operon. sigD encodes the alternative sigma factor σD that, together with RNA polymerase, drives expression of genes required for cell separation and the assembly of flagella. sigD is the penultimate gene of the B. subtilis motility operon and, in the control strain approximately, 70% of the cells are motile. When sigD was moved upstream within the operon, a larger fraction of cells became motile (up to 100%). This study highlights that the position of a gene within an operon can have a large impact on the control of gene expression. Furthermore, it suggests that RNA polymerase processivity or mRNA turnover can play important roles as sources of noise in bacterial development, and that gene position might be an unrecognized and possibly widespread mechanism to regulate phenotypic variation.
Structure determination and analysis of a haemolytic gingipain adhesin domain from Porphyromonas gingivalis
Authors: Li Nan , Yun Peter , Nadkarni Mangala A. , Ghadikolaee Nazila Babapoor , Nguyen Ky‐Anh , Lee Mihwa , Hunter Neil , Collyer Charles A. 
Published: March 2010

Summary Porphyromonas gingivalis is an obligately anaerobic bacterium recognized as an aetiological agent of adult periodontitis. P. gingivalis produces cysteine proteinases, the gingipains. The crystal structure of a domain within the haemagglutinin region of the lysine gingipain (Kgp) is reported here. The domain was named K2 as it is the second of three homologous structural modules in Kgp. The K2 domain structure is a ‘jelly‐roll’ fold with two anti‐parallel β‐sheets. This fold topology is shared with adhesive domains from functionally diverse receptors such as MAM domains, ephrin receptor ligand binding domains and a number of carbohydrate binding modules. Possible functions of K2 were investigated. K2 induced haemolysis of erythrocytes in a dose‐dependent manner that was augmented by the blocking of anion transport. Further, cysteine‐activated arginine gingipain RgpB, which degrades glycophorin A, sensitized erythrocytes to the haemolytic effect of K2. Cleaved K2, similar to that found in extracted Kgp, lacks the haemolytic activity indicating that autolysis of Kgp may be a staged process which is artificially enhanced by extraction of the protein. The data indicate a functional role for K2 in the integrated capacity conferred by Kgp to enable the porphyrin auxotroph P. gingivalis to capture essential haem from erythrocytes.
The development of Arabidopsis as a model plant
Authors: Koornneef Maarten , Meinke David 
Published: March 2010

SummaryTwenty‐five years ago, Arabidopsis thaliana emerged as the model organism of choice for research in plant biology. A consensus was reached about the need to focus on a single organism to integrate the classical disciplines of plant science with the expanding fields of genetics and molecular biology. Ten years after publication of its genome sequence, Arabidopsis remains the standard reference plant for all of biology. We reflect here on the major advances and shared resources that led to the extraordinary growth of the Arabidopsis research community. We also underscore the importance of continuing to expand and refine our detailed knowledge of Arabidopsis while seeking to appreciate the remarkable diversity that characterizes the plant kingdom.