bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient perception of nursing service quality; an applied model of Donabedian’s structure‐process‐outcome approach theory
Authors: Kobayashi Hideyuki , Takemura Yukie , Kanda Katsuya 
Published: November 2010

Scand J Caring Sci; 2011; 25; 419–425 Patient perception of nursing service quality; an applied model of Donabedian’s structure‐process‐outcome approach theoryBackground: Nursing is a labour‐intensive field, and an extensive amount of latent information exists to aid in evaluating the quality of nursing service, with patients’ experiences, the primary focus of such evaluations. To effect further improvement in nursing as well as medical care, Donabedian’s structure‐process‐outcome approach has been applied.Aims: To classify and confirm patients’ specific experiences with regard to nursing service based on Donabedian’s structure‐process‐outcomes model for improving the quality of nursing care.Methods: Items were compiled from existing scales and assigned to structure, process or outcomes in Donabedian’s model through discussion among expert nurses and pilot data collection. With regard to comfort, surroundings were classified as structure (e.g. accessibility to nurses, disturbance); with regard to patient–practitioner interaction, patient participation was classified as a process (e.g. expertise and skill, patient decision‐making); and with regard to changes in patients, satisfaction was classified as an outcome (e.g. information support, overall satisfaction). Patient inquiry was carried out using the finalized questionnaire at general wards in Japanese hospitals in 2005–2006. Reliability and validity were tested using psychometric methods.Results: Data from 1,810 patients (mean age: 59.7 years; mean length of stay: 23.7 days) were analysed. Internal consistency reliability was supported (α = 0.69–0.96), with factor analysis items of structure aggregated to one factor and overall satisfaction under outcome aggregated to one. The remaining items of outcome and process were distributed together in two factors. Inter‐scale correlation (r = 0.442–0.807) supported the construct validity of each structure‐process‐outcome approach. All structure items were represented as negative‐worded examples, as they dealt with basic conditions under Japanese universal health care system, and were regarded as representative related to concepts of dissatisfaction and no dissatisfaction.Conclusion: Patients’ experiences with nursing service were confirmed using Donabedian’s approach and can therefore be applied to improve quality of nursing practice by practitioners, managers and policy makers.
Reshaping the global agricultural landscape: perspectives from Brazil
Authors: Zylbersztajn Decio 
Published: November 2010

AbstractThis article highlights the main changes observed in Brazilian agriculture and analyzes the connections of the observed changes in global agriculture. My approach to the analysis focuses the main drivers of changes, where institutions play a central role. Three driving forces are are considered: first, the effects of global demand for food, fiber, and energy; second, the sustainability debate; and third, the bio‐energy paradigm. Each driver presents both local as well as global effects. The article does not emphasize the impact changes in Brazil had on the global agricultural landscape but argues that the impacts run from local and global changes, which cannot be discussed separately.
Modeling complex systems
Authors: Xepapadeas Anastasios 
Published: November 2010

AbstractEmpirical observations suggest that linear dynamics are not an adequate representation of ecological systems and that a realistic representation would require adoption of complex nonlinear dynamical systems with characteristics encountered in complex adaptive systems (CAS). Adequate modeling should include and combine elements, such as strategic interactions among economic agents, nonconvexities induced by nonlinear feedbacks, separate spatial and temporal scales and modeling of spatiotemporal dynamics, and allowance of alternative time scales. Ignoring these characteristics might obscure very important features that we observe in reality, such as bifurcations and irreversibilities or hysteresis. As a consequence, the design of policies that do not take CAS characteristics into account might lead to erroneous results and undesirable states of managed economic–ecological systems.
Importance of serine727 phosphorylated STAT1 in IFNγ‐induced signaling and apoptosis of human salivary gland cells
Authors: TSUBOI Hiroto , WAKAMATSU Ei , IIZUKA Mana , NAKAMURA Yumi , SUGIHARA Makoto , SUZUKI Takeshi , OGISHIMA Hiroshi , HAYASHI Taichi , GOTO Daisuke , ITO Satoshi , MATSUMOTO Isao , SUMIDA Takayuki 
Published: November 2010

AbstractAim:  It is reported that in salivary glands of Sjögren’s syndrome (SS), interferon gamma (IFNγ) and IFNγ‐inducible genes containing signal transducers and activators of transcription 1 (STAT1) are upregulated and play a crucial role in the pathogenesis of SS. The aim of this study is to clarify which phosphorylation of STAT1, serine727 (Ser727) or tyrosine701 (Tyr701) of STAT1, is important for IFNγ signaling and IFNγ‐induced apoptosis in salivary gland cells.Methods:  We established STAT1 Tyr701 variant (tyrosine to phenylalanine; Y701F) and STAT1 Ser727 variant (serine to alanine; S727A), which were transfected into human salivary gland (HSG) cells. HSG cells transfected with these mutant‐STAT1 were analyzed on the expression of IFNγ‐inducible genes and apoptosis after stimulation with IFNγ.Results:  In Y701F mutant‐STAT1 transfected HSG cells (Ser727‐dominant HSG cells), IFNγ‐inducible genes such as IP10, IRF1, and Fas expression were increased after stimulation with IFNγ. In Ser727‐dominant HSG cells, the induction of apoptosis after stimulation with IFNγ was also increased compared with S727A mutant‐STAT1 transfected HSG cells (Tyr701‐dominant HSG cells).Conclusion:  Phosphorylation of Ser727 in STAT1 might be more important in IFNγ signaling and the induction of apoptosis in HSG cells than phosphorylation of Tyr701. Accordingly, we propose that phosphorylation of Ser727 in STAT1 could be a potentially suitable new therapeutic target for SS patients to prevent the destruction of salivary glands.
Identification and Characterization of Persistent Intracellular Human Immunodeficiency Virus Type 1 Integrase Strand Transfer Inhibitor Activity
Authors: Koh Yasuhiro , Haim Hillel , Engelman Alan 
Published: November 2010

ABSTRACT
Pharmacokinetic and pharmacodynamic considerations significantly impact infectious disease treatment options. One aspect of pharmacodynamics is the postantibiotic effect, classically defined as delayed bacterial growth after antibiotic removal. The same principle can apply to antiviral drugs. For example, significant delays in human immunodeficiency virus type 1 (HIV-1) replication can be observed after nucleoside/nucleotide reverse transcriptase inhibitor (N/NtRTI) removal from culture medium, because these prodrugs must be anabolized into active, phosphorylated forms once internalized into cells. A relatively new class of anti-HIV-1 drugs is the integrase strand transfer inhibitors (INSTIs), and the INSTIs raltegravir (RAL) and elvitegravir (EVG) were tested here alongside positive N/NtRTI controls tenofovir disoproxil fumarate (TDF) and azidothymidine (AZT), as well as the nonnucleoside reverse transcriptase inhibitor negative control nevirapine (NVP), to assess potential postantiviral effects. Transformed and primary CD4-positive cells pretreated with INSTIs significantly resisted subsequent challenge by HIV-1, revealing the following hierarchy of persistent intracellular drug strength: TDF > EVG ∼ AZT > RAL > NVP. A modified time-of-addition assay was moreover developed to assess residual drug activity levels. Approximately 0.8% of RAL and 2% of initial EVG and TDF 1-h pulse drug levels persisted during the acute phase of HIV-1 infection. EVG furthermore displayed significant virucidal activity. Although there is no reason to suspect obligate intracellular modification, this study nevertheless defines significant intracellular persistence of prototype INSTIs. Ongoing second-generation formulations should therefore consider the potential for significant postantiviral effects among this drug class. Combined intracellular persistence and virucidal activities suggest potential pre-exposure prophylaxis applications for EVG.
Long Exposure of Environmental Tobacco Smoke Associated with Activating EGFR Mutations in Never-Smokers with Non–Small Cell Lung Cancer
Authors: Kawaguchi Tomoya , Ando Masahiko , Kubo Akihito , Takada Minoru , Atagi Shinji , Okishio Kyoichi , Asami Kazuhiro , Matsumura Akihide , Tsujino Kazuyuki , Ignatius Ou Sai-Hong , Sasaki Hidefumi 
Published: November 2010

Abstract
Purpose: To examine an association between environmental tobacco smoke (ETS) and activating epidermal growth factor receptor (EGFR) mutations in never-smokers with non–small cell lung cancer (NSCLC).
Experimental Design: A total of 126 never-smokers with NSCLC were prospectively included in this study. Detailed ETS information was obtained through a standardized questionnaire including exposure period, place, and duration. Cumulative dose of ETS (CETS) was evaluated as a sum of the number of the exposure years at home and/or workplace. EGFR and K-ras mutations were determined using real-time PCR amplification.
Results: A total of 124 patients (98.4%) had ETS exposure with median CETS of 50 years (range: 0–118). Activating EGFR mutations were detected in 62.7% of the 126 patients and K-ras in 2 of 114 patients. The incidence of activating EGFR mutations was significantly higher in females than in males (67.6% vs. 26.7%; P = 0.002), and increased in quintile groups separated on the basis of CETS (shortest group = 44.0%, longest = 84.6%; P = 0.0033). In the multivariate logistic regression model, including gender, CETS, age, and family history of cancer, both gender and CETS were significantly associated with an incidence of activating EGFR mutations; the odds ratio for the EGFR mutations were 5.13 [95% confidence interval, CI = 1.47–18.0; P = 0.0105] for females and 1.02 (95% CI = 1.00–1.04; P = 0.0193) for each 1-year increment in CETS.
Conclusions: Females and increased ETS exposure are closely associated with EGFR mutations in never-smokers with NSCLC. Clin Cancer Res; 17(1); 39–45. ©2010 AACR.
How many antiviral small interfering RNAs may be encoded by the mammalian genomes?
Authors: Zabolotneva Anastasia , Tkachev Victor , Filatov Felix , Buzdin Anton 
Published: November 2010

Abstract

Background
The discovery of RNA interference phenomenon (RNAi) and understanding of its mechanisms has revolutionized our views on many molecular processes in the living cell. Among the other, RNAi is involved in silencing of transposable elements and in inhibition of virus infection in various eukaryotic organisms. Recent experimental studies demonstrate few cases of viral replication suppression via complementary interactions between the mammalian small RNAs and viral transcripts.

Presentation of the hypothesis
It was found that >50% of the human genome is transcribed in different cell types and that these transcripts are mainly not associated with known protein coding genes, but represent non-coding RNAs of unknown functions. We propose a hypothesis that mammalian DNAs encode thousands RNA motifs that may serve for antiviral protection. We also presume that the evolutional success of some groups of genomic repeats and, in particular, of transposable elements (TEs) may be due to their ability to provide antiviral RNA motifs to the host organism. Intense genomic repeat propagation into the genome would inevitably cause bidirectional transcription of these sequences, and the resulting double-stranded RNAs may be recognized and processed by the RNA interference enzymatic machinery. Provided that these processed target motifs may be complementary to viral transcripts, fixation of the repeats into the host genome may be of a considerable benefit to the host. It fits with our bioinformatical data revealing thousands of 21-28 bp long motifs identical between human DNA and human-pathogenic adenoviral and herpesviral genomes. Many of these motifs are transcribed in human cells, and the transcribed part grows proportionally to their lengths. Many such motifs are included in human TEs. For example, one 23 nt-long motif that is a part of human abundant Alu retrotransposon, shares sequence identity with eight human adenoviral genomes.

Testing the hypothesis
This hypothesis could be tested on various mammalian species and viruses infecting mammalian cells.

Implications of the hypothesis
This hypothesis proposes that mammalian organisms may use their own genomes as sources of thousands of putative interfering RNA motifs that can be recruited to repress intracellular pathogens like proliferating viruses.

Reviewers
This article was reviewed by Eugene V. Koonin, Valerian V. Dolja and Yuri V. Shpakovski.
Aktuelle Aspekte zur Bestimmung der Retikulozytenzahl / Current aspects of reticulocyte analysis
Authors: Nebe Carl Thomas , Diem Heinz , Heimpel Hermann 
Published: November 2010

Zusammenfassung
Die Retikulozytenbestimmung ist heute eine labordiagnostische Standarduntersuchung und wird in der Regel mit zytometrischen Blutbildgeräten durchgeführt. Sie wird jedoch in der Differenzialdiagnostik der Anämien nur unzureichend angefragt und hat im Rahmen der Blutdopingkontrollen neues Interesse erlangt. Ringversuche und eine multizentrische Normwertstudie zeigen methodische Unterschiede und die Notwendigkeit gerätespezifischer Normwertbereiche. Das Kontrollmaterial unterscheidet sich in relevanter Weise von der Patientenprobe, was für das Verständnis der Qualitätskontrolle wichtig ist. Ebenso wichtig ist die Kenntnis der Störgrößen, die bei Gesunden, an deren Blutproben die Hersteller ihre Methoden entwickelt haben, nicht auftreten. Die Interpretation der Messergebnisse im Rahmen der Anämiediagnostik bereitet immer noch Schwierigkeiten, da Referenzbereiche für gesunde Personen existieren, jedoch nicht für anämische Patienten, wo ihre Bestimmung zur Differenzialdiagnostik beitragen soll. Hier wurde die Hilfsgröße des Retikulozytenproduktionsindex entwickelt, zu dem noch wenig Literatur vorliegt. Eine neue Entwicklung ist die Be-stimmung sogenannter retikulierter Thrombozyten, die mit gleichen Methoden versucht wird und sich dennoch deutlich unterscheidet. Im vorliegenden Manuskript werden die Grundlagen der Analytik besprochen. Die Interpretation der Ergebnisse der Retikulozytenbestimmung wurden in einem getrennten Artikel dargelegt.
Improving Access to Mental Health Care for Children: The Massachusetts Child Psychiatry Access Project
Authors: Sarvet Barry , Gold Joseph , Bostic Jeff Q. , Masek Bruce J. , Prince Jefferson B. , Jeffers-Terry Mary , Moore Charles F. , Molbert Benjamin , Straus John H. 
Published: November 2010

BACKGROUND:
Inadequate access to care for mentally ill children and their families is a persistent problem in the United States. Although promotion of pediatric primary care clinicians (PCCs) in detection, management, and coordination of child mental health care is a strategy for improving access, limitations in training, time, and specialist availability represent substantial barriers. The Massachusetts Child Psychiatry Access Project (MCPAP), publicly funded with 6 regional consultation teams, provides Massachusetts PCCs with rapid access to child psychiatry expertise, education, and referral assistance.

METHODS:
Data collected from MCPAP teams measured participation and utilization over 3.5 years from July 1, 2005, to December 31, 2008. Data were analyzed for 35 335 encounters. PCC surveys assessed satisfaction and impact on access to care.

RESULTS:
The MCPAP enrolled 1341 PCCs in 353 practices covering 95% of the youth in Massachusetts. The MCPAP served 10 114 children. Practices varied in their utilization of the MCPAP, with a mean of 12 encounters per practice per quarter (range: 0–245). PCCs contacted the MCPAP for diagnostic questions (34%), identifying community resources (27%), and consultation regarding medication (27%). Provider surveys revealed improvement in ratings of access to child psychiatry. The rate of PCCs who reported that they are usually able to meet the needs of psychiatric patients increased from 8% to 63%. Consultations were reported to be helpful by 91% of PCCs.

CONCLUSIONS:
PCCs have used and value a statewide system that provides access to teams of psychiatric consultants. Access to child mental health care may be substantially improved through public health interventions that promote collaboration between PCCs and child mental health specialists.
Retrospective respiratory triggering renal perfusion MRI
Authors: Attenberger Ulrike I. , Sourbron Steven P. , Michaely Henrik J. , Reiser Maximilian F. , Schoenberg Stefan O. 
Published: November 2010

Background: Artifacts of respiratory motion are one of the well-known limitations of dynamic contrast-enhanced MRI (DCE-MRI) of the kidney. Purpose: To propose and evaluate a retrospective triggering approach to minimize the effect of respiratory motion in DCE-MRI of the kidney. Material and Methods: Nine consecutive patients underwent renal perfusion measurements. Data were acquired with a 2D saturation-recovery TurboFLASH sequence. In order to test the dependence of the results on size and location of the manually drawn triggering regions of interest (ROIs), three widely differing triggering regions were defined by one observer. Mean value, standard deviation, and variability of the renal function parameters plasma flow (FP), plasma volume (VP), plasma transit time (TP), tubular flow (FT), tubular volume (VT), and tubular transit time (TT) were calculated on a per-patient basis. Results: The results show that triggered data have adequate temporal resolution to measure blood flow. The overall average values of the function parameters were: 152.77 (FP), 15.18 (VP), 6,73 (TP), 18.50 (FT), 35.36 (VT), and 117.67 (TT). The variability (calculated in % SD from the mean value) for three different respiratory triggering regions defined on a per-patient basis was between 0.81% and 9.87% for FP, 1.45% and 8.19% for VP, 0% and 9.63% for TP, 2.15% and 12.23% for TF, 0.8% and 17.28% for VT, and 1.97% and 12.87% for TT. Conclusion: Triggering reduces the oscillations in the signal curves and produces sharper parametric maps. In contrast to numerically challenging approaches like registration and segmentation it can be applied in clinical routine, but a (semi)-automatic approach to select the triggering ROI is desirable to reduce user dependence.
Is the location of the Wrisberg ligament related to frequent complete discoid lateral meniscus tear?
Authors: Kim Ji-Eun , Choi Sang-Hee 
Published: November 2010

Background: A discoid lateral meniscus is a relatively common anatomic variant in Korean and Japanese subjects that presents with snapping knee syndrome. Purpose: To evaluate the relationship between the location of the Wrisberg ligament and the frequency of lateral meniscus tear in patients with complete discoid lateral meniscus. Material and Methods: A total of 109 consecutive patients with arthroscopically proven complete discoid lateral menisci and another 100 patients with non-discoid lateral menisci were evaluated retrospectively. We reviewed the MR images to determine the attachment level of the Wrisberg ligament on the medial femoral condyle, the thickness of the Wrisberg ligament, and the presence and type of lateral meniscus tear. The relationship between the frequency of lateral meniscus tear according to the attachment level on the medial femoral condyle and the thickness of the Wrisberg ligament on both groups was analyzed. Results: Among them, 153 patients had Wrisberg ligament, 76 patients had complete lateral discoid menisci, and 77 patients had non-discoid lateral menisci. Lateral meniscus tears were found in 115 patients; 83 tears were in the Wrisberg ligament group ( n=153) and 32 tears were in the non-Wrisberg ligament group ( n =56). The presence of Wrisberg ligament alone was not significantly related to lateral meniscus tear ( P=0.755). Among 83 lateral meniscus tears in the Wrisberg ligament group, 58 were identified in complete discoid lateral meniscus with high-riding Wrisberg ligament. The frequency of a lateral meniscus tear was lower in patients with low-riding Wrisberg ligament on complete discoid lateral meniscus ( P = 0.020). Conclusion: In patients with complete discoid lateral meniscus, lateral meniscus tear is seen less often with low- than high-riding Wrisberg ligament.
Transcranial Magnetic Stimulation and Volitional Quadriceps Activation
Authors: Gibbons Christopher E. , Pietrosimone Brian G. , Hart Joseph M. , Saliba Susan A. , Ingersoll Christopher D. 
Published: November 2010

Abstract

Context:
Quadriceps-activation deficits have been reported after meniscectomy. Transcranial magnetic stimulation (TMS) in conjunction with maximal contractions affects quadriceps activation in patients after meniscectomy.

Objective:
To determine the effect of single-pulsed TMS on quadriceps central activation ratio (CAR) in patients after meniscectomy.

Design:
Randomized controlled clinical trial.

Setting:
University laboratory.

Patients or Other Participants:
Twenty participants who had partial meniscectomy and who had a CAR less than 85% were assigned randomly to the TMS group (7 men, 4 women; age  =  38.1 ± 16.2 years, height  =  176.8 ± 11.5 cm, mass  =  91.8 ± 27.5 kg, postoperative time  =  36.7 ± 34.9 weeks) or the control group (7 men, 2 women; age  =  38.2 ± 17.5 years, height  =  176.5 ± 7.9 cm, mass  =  86.2 ± 15.3 kg, postoperative time  =  36.6 ± 37.4 weeks).

Intervention(s):
Participants in the experimental group received TMS over the motor cortex that was contralateral to the involved leg and performed 3 maximal quadriceps contractions with the involved leg. The control group performed 3 maximal quadriceps contractions without the TMS.

Main Outcome Measure(s):
Quadriceps activation was assessed using the CAR, which was measured in 70° of knee flexion at baseline and at 0, 10, 30, and 60 minutes posttest. The CAR was expressed as a percentage of full activation.

Results:
Differences in CAR were detected over time (F4,72  =  3.025, P  = .02). No interaction (F4,72  =  1.457, P  =  .22) or between-groups differences (F1,18  =  0.096, P  =  .76) were found for CAR. Moderate CAR effect sizes were found at 10 (Cohen d  =  0.54, 95% confidence interval [CI]  =  −0.33, 1.37) and 60 (Cohen d  =  0.50, 95% CI  =  −0.37, 1.33) minutes in the TMS group compared with CAR at baseline. Strong effect sizes were found for CAR at 10 (Cohen d  =  0.82, 95% CI  =  −0.13, 1.7) and 60 (Cohen d  =  1.06, 95% CI  =  0.08, 1.95) minutes in the TMS group when comparing percentage change scores between groups.

Conclusions:
No differences in CAR were found between groups at selected points within a 60-minute time frame, yet moderate to strong effect sizes for CAR were found at 10 and 60 minutes in the TMS group, indicating increased activation after TMS.