bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized, double‐blind, placebo‐controlled multicenter trial evaluating topical zinc oxide for acute open wounds following pilonidal disease excision
Authors: Ågren Magnus S. , Ostenfeld Ulla , Kallehave Finn , Gong Yan , Raffn Kjeld , Crawford Michael E. , Kiss Katalin , Friis‐Møller Alice , Gluud Christian , Jorgensen Lars N. 
Published: September 2006

ABSTRACTThe purpose of this randomized, double‐blind, placebo‐controlled multicenter trial was to compare topical zinc oxide with placebo mesh on secondary healing pilonidal wounds. Sixty‐four (53 men) consecutive patients, aged 17–60 years, were centrally randomized to either treatment with 3% zinc oxide (n=33) or placebo (n=31) by concealed allocation. Patients were followed with strict recording of beneficial and harmful effects including masked assessment of time to complete wound closure. Analysis was carried out on an intention‐to‐treat basis. Median healing times were 54 days (interquartile range 42–71 days) for the zinc and 62 days (55–82 days) for the placebo group (p=0.32). Topical zinc oxide increased (p<0.001) wound fluid zinc levels to 1,540 (1,035–2,265) μM and decreased (p<0.05) the occurrence of Staphylococcus aureus in wounds. Fewer zinc oxide (n=3) than placebo‐treated patients (n=12) were prescribed postoperative antibiotics (p=0.005). Serum‐zinc levels increased (p<0.001) postoperatively in both groups but did not differ significantly between the two groups on day 7. Zinc oxide was not associated with increased pain by the visual analog scale, cellular abnormalities by histopathological examination of wound biopsies, or other harmful effects. Larger clinical trials will be required to show definitive effects of topical zinc oxide on wound healing and infection.
Longer‐term changes in quality of life in chronic leg ulceration
Authors: Franks Peter J. , Moffatt Christine J. , Doherty Debra C. , Smithdale Rachael , Martin Ruth 
Published: September 2006

ABSTRACTStudies that have examined patients' health‐related quality of life have consistently shown improvements following intensive and effective treatments over relatively short follow‐ups. However, little is known of the longer‐term effects of treatment on patients. As part of a study in southwest London, United Kingdom, all patients having a current leg ulcer were examined (n=113) and those who were able completed the Nottingham Health Profile (n=95) and were then followed up at 24 and 48 weeks. The patients had a mean age of 76±13 (SD) years, with 60 (63.2%) being women. Before the study, the ulcer had been present for a median of 8 months (range 0.5–144), and a median area of ulceration of 4.0 cm2 (range 0.5–171.5 cm2). After 24 weeks, there was a significant improvement in pain (mean difference [d]=9.6, p=0.002), which was true for both the 41 patients with ulcers present (d=10.07, p=0.013) and the 43 patients whose ulcers had healed (d=11.46, p=0.047). However, after 48 weeks, these improvements had been reduced in both groups (healed ulceration d=5.76, unhealed patients d=6.41). Energy, which had improved after 24 weeks in the patients whose ulcers, had healed (d=11.46), deteriorated in both patient groups after 48 weeks (healed=−5.67, unhealed=−13.43). Mobility status was maintained with healed ulceration (d=1.05) but deteriorated with unhealed ulceration (d=−13.19). The positive effects of treatment on health‐related quality of life may not be sustained over time. This may be a consequence of the general deterioration in the health status of these elderly patients as they age.
Administration of prednisolone phosphate–liposomes reduces wound contraction in a rat partial‐thickness wound model
Authors: Richters Cornelia D. , Paauw Nanne J. , Mayen Ilvy , Van Bloois Louis , Metselaer Josbert M. , Storm Gert , Pont John S. du , Hoekstra Matthias J. , Kreis Robert W. , Kamperdijk Eduard W.A. 
Published: September 2006

ABSTRACTMacrophages play an important role in the inflammatory phase of wound healing and their activity regulates fibroblasts and keratinocytes. Modulation of macrophage function may result in improvement of the wound healing process. Prednisolone phosphate (PLP) encapsulated into liposomes was administered to partial‐thickness wounds in rats. A single dose of 75 μg/kg, applied directly after wounding, resulted in up to a 30% reduction of wound contraction at 28 days after wounding. This effect could not be achieved in the group that was administered free PLP or liposomes containing phosphate‐buffered saline to the wound. The number of myofibroblasts was up to 50% lower in wounds treated with the liposomal PLP at 4 days after wounding. The number of macrophages present in the wounds was not statistically different between groups. Most probably, the production of cytokines and growth factors by macrophages is altered after phagocytosing the liposomes, resulting in reduced wound contraction.
Delivery of plasmid DNA expression vector for keratinocyte growth factor‐1 using electroporation to improve cutaneous wound healing in a septic rat model
Authors: Lin Michael P. , Marti Guy P. , Dieb Rami , Wang Jiaai , Ferguson Mark , Qaiser Rabia , Bonde Pramod , Duncan Mark D. , Harmon John W. 
Published: September 2006

ABSTRACTWe have previously shown that wound healing was improved in a diabetic mouse model of impaired wound healing following transfection with keratinocyte growth factor‐1 (KGF‐1) cDNA. We now extend these findings to the characterization of the effects of DNA plasmid vectors delivered to rats using electroporation (EP) in vivo in a sepsis‐based model of impaired wound healing. To assess plasmid transfection and wound healing, gWIZ luciferase and PCDNA3.1/KGF‐1 expression vectors were used, respectively. Cutaneous wounds were produced using an 8 mm‐punch biopsy in Sprague–Dawley rats in which healing was impaired by cecal ligation‐induced sepsis. We used National Institutes of Health image analysis software and histologic assessment to analyze wound closure and found that EP increased expression of gWIZ luciferase vector up to 53‐fold compared with transfection without EP (p<0.001). EP‐assisted plasmid transfection was found to be localized to skin. Septic rats had a 4.7 times larger average wound area on day 9 compared with control (p<0.001). Rats that underwent PCDNA3.1/KGF‐1 transfection with EP had 60% smaller wounds on day 12 compared with vector without EP (p<0.009). Quality of healing with KGF‐1 vector plus EP scored 3.0±0.3 and was significantly better than that of 1.8±0.3 for treatment with vector alone (p<0.05). We conclude that both the rate and quality of healing were improved with DNA plasmid expression vector for growth factor delivered with EP to septic rats.
Effect of Development Stage on the Artemisinin Content and the Sequence Characterized Amplified Region (SCAR) Marker of High‐Artemisinin Yielding Strains of Artemisia annua L.
Authors: Zhang Long , Ye He‐Chun , Li Guo‐Feng 
Published: October 2006

AbstractThe effects of development states on the artemisinin content of clone S1 of Artemisia anuua L. grown in a greenhouse were investigated in the present study. The artemisinin content increased gradually during the phase of vegetative growth and reached its highest level at 8–9 mg/g dry weight (DW) when the S1 was 6 months old on a long day (LD) photoperiod. Treatment with 9–18 d of short day (SD) photoperiod resulted in the artemisinin content reaching and being maintained at a higher level (2.059–2.289 mg/g DW), twofold that of control plants and plants of S1 presented at the pro‐flower budding and flower‐budding stages. The artemisinin content varied in different parts of the plant. The artemisinin content of leaves was higher than that of florets and branches. The artemisinin content in middle leaves was higher than that of bottom leaves, and then top leaves. Different densities of capitate glands (the storage organ of artemisinin) located on the surface of leaves, florets, and branches explained the variations in artemisinin content in these parts of the plant. The correlation coefficient between artemisinin content and density of capitate glands on the surface of different organs was 0.987. The genetic marker for artemisinin content was screened using random amplified polymorphic DNA (RAPD) and sequence characterized amplified region (SCAR) techniques. The random primer OPA15 (5′‐TTCCGAACCC‐3′) could amplify a specific band of approximately 1 000 bp that was present in all high‐artemisinin yielding strains, but absent in all low‐yielding strains in three independent replications. This specific band was cloned and its sequence was analyzed. This RAPD marker was converted into a SCAR marker to obtain a more stable marker.(Managing editor: Wei Wang)
Personal and Social Responsibility for Health
Authors: Wikler Daniel 
Published: September 2006

Everyone wants to be healthy, but many of us decline to act in healthy ways. What bearing, if any, should these choices have on the ethics of clinical practice and health policy? Should risk-takers have the same claim on scarce resources, such as organs for transplant, as those whose plight is due to no choices of their own? And is there any reason not to impose fees and taxes on risk-takers, be they smokers or mountain climbers, to defray the added expense of the care they may need? In health resource allocation aimed at reducing the burden of disease, should we regard certain burdens as individual responsibilities: for example, dealing with stigma, or caretaking for family members?Socioeconomic status (SES) and health expectancy are strongly linked. To the extent that this results from risk-taking by the poor, is reduction of SES-linked health inequalities a morally important social goal? International public health aims at improving health on a population level. The World Health Organization has been criticized for failing to distinguish genuine health risks from personal lifestyle choices, as when it speaks of a tobacco-related “epidemic” as if cigarette use were a contagious disease like malaria. Should personal responsibility for health be taken into account in setting the agenda for global public health, and in measuring progress by countries in improving health. This paper addresses applications of the notions of personal and social responsibility for health. It also looks at the vulnerability of the notion of personal responsibility for health to intentional manipulation by self-interested parties in health policy debates.
International Justice and Health: A Proposal
Authors: Sreenivasan Gopal 
Published: September 2006

This paper discusses obligations of international distributive justice-specifically, obligations rich countries have to transfer resources to poor countries. It argues that the major seven OECD countries each have an obligation to transfer at least one percent of their GDP to developing countries.The strategy of the paper is to defend this position without having to resolve the many debates that attend questions of international distributive justice. In this respect, it belongs to the neglected category of nonideal theory. The key to the strategy is to show that a significant amount of good would be accomplished by a one percent transfer, despite the fact that one percent is quite a small amount.To make this showing, the paper takes health as a fundamental measure of individual well-being and examines the improvement in life expectancy that would likely result from devoting the one percent transfer to the major determinants of health. It adduces data indicating that substantial progress towards raising life expectancy in developing countries to the global average of 64.5 years can be expected from expenditures of $125 per capita, divided between health care, education, and basic nutrition and income support. A one percent transfer from the major seven is enough to cover expenditures on that scale for the poorest fifth of the world's population.
Letting the Exception Prove the Rule
Authors: Byers Michael 
Published: September 2006

It is unlikely that George W. Bush feels constrained by international law when deciding whether to use military force abroad. Nevertheless, many of the United States' allies are reluctant to cooperate with and participate in military actions that cannot reasonably be justified under international law. And supportive allies, while perhaps not strictly necessary to the United States in its recent and foreseeable military campaigns, do make the military option easier to pursue. A war against Iraq would be difficult without access to bases and airspace in countries as diverse as Turkey, Saudi Arabia, Germany, and Canada. For this reason, at least, it would seem to be worth the president's while to adhere to international law where possible and, where this is not possible, to seek to change the rules.International lawyers in the Department of State, together with lawyers in other parts of the U.S. government, have excelled in shaping the law to accommodate the interests of the United States. One example, though by no means the only one, concerns the response to the September 11, 2001, terrorist attacks.
Developing Just Monetary Arrangements
Authors: Reddy Sanjay G. 
Published: September 2006

International monetary arrangements–the practices and rules governing the creation, distribution, and management of money and credit in the world economy–have received little attention from philosophers concerned with international distributive justice. A convincing account of international distributive justice requires a description of how these arrangements should function. International monetary arrangements currently appear to have consequences that are incompatible with a global egalitarian conception of distributive justice.There are at least three categories of questions– relating respectively to money supply, exchange rates, and debt–that can be raised in the international context. First, who should have control over key monetary decisions, such as how much, and on what terms, money and credit are being supplied within each monetary zone? Should this control belong to the citizens of a given monetary zone and their representatives alone? How should the benefits arising from the ability to create money be distributed internationally? Second, should the stability of exchange rates be a goal and, if so, how should the responsibility for maintaining stability be apportioned? When adjustment of exchange rates is required, who should bear the burdens associated with such adjustment? Third, what arrangements should govern the accumulation and discharge of debt in the international setting? In what respects should debt contracted by states be governed by different rules than debt contracted by private agents? What forms of conditionality may be imposed by creditors, such as international institutions, governments, or private lenders, as part of a just framework of international borrowing and repayment? These questions exemplify rather than exhaust the dilemmas that arise with regard to international monetary arrangements. Global egalitarians should imagine the alternative forms that such arrangements can take as elements of a realistic utopia.
Race and Ethnicity: Responsible Use from Epidemiological and Public Health Perspectives
Authors: Bhopal Raj 
Published: September 2006

Race and ethnicity are closely related, contentious concepts that have been abused and misinterpreted through history, but have a vast potential for good, at least in the health sciences. This article is not intending to elaborate on the conceptual foundations of race and ethnicity; I have addressed that elsewhere and summarized my stance in the glossary reprinted below in the Appendix. The terminology used here follows the glossary. Assuming that the conceptual foundations of my stance are reasonable, the questions addressed here focus on public health and its primary health science, epidemiology, in a European context. The questions are simple ones:1.In epidemiology and public health what are we trying to achieve when we use the concepts of race and ethnicity?2.What would we lose by rejecting these concepts?3.If we do not reject them, how do we put the concepts into operation to help achieve our goals?4.What practical actions can result from the application of these concepts in order to improve the health and well-being of populations?
Currents in Contemporary Ethics
Authors: DeCoster Barry 
Published: September 2006

The flu has an interesting history with respect to health care rationing in the United States. Consider that just about two years ago, the American public faced a shortage of influenza vaccine. Dire predictions were made about how many people might perish, and rationing protocols were created. However, many of the rationing protocols were ignored. Luckily, that flu season did not result in the horrible fatalities that were predicted. For these reasons, problems of health care rationing around issues of the flu were postponed, rather than resolved.Over the last year, the public has focused its anxious attention on the possible avian influenza pandemic. Last week I noticed that at least once each day I heard mention in some discussion or another of the threat of this disease becoming easily transmissible from human to human.
A single‐blinded case controlled study on effects of cardiopulmonary circulation on hearing during coronary artery bypass grafting
Authors: Donne A.J. , Waterman P. , Crawford L. , Balaji H.P. , Nigam A. 
Published: October 2006

Objectives:  To evaluate the effect of extra‐corporeal (cardiopulmonary) bypass on hearing during coronary artery bypass grafting.Design:  Prospective (single‐blinded) controlled study.Setting:  District General Hospital.Participants:  Fifty‐two patients undergoing coronary artery bypass grafting completed this study. Comparison was made between 14 control patients undergoing off‐pump coronary artery bypass grafting and 38 study patients undergoing on‐pump coronary artery bypass grafting. The age range of patients was 48–81 years, with 50% between 64 and 66 years.Main outcome measures:  Pure tone audiograms were performed in all patients before and after coronary artery bypass grafting. Data were analysed for any significant difference between pre‐ and post‐operative pure tone audiograms.Results:  Mann–Whitney U‐test demonstrated no difference between the area generated between mean pre‐ and post‐operative audiograms (P = 0.754). No significant difference between off versus on pump was demonstrated for average differences at 250–500 Hz, 4 kHz, 4–8 kHz and 8 kHz. Wilcoxon matched‐pairs signed‐rank test demonstrated no difference between right and left ears for each individual frequency. Spearman's test to analyse the effect on vessel number or minutes on bypass pump revealed no significant difference at 4–8 kHz (P = 0.550 for number of vessels and P = 0.276 for minutes on pump.)Conclusion:  In this study, it was not possible to demonstrate any statistically significant deleterious effect of extra‐corporeal (cardiopulmonary) bypass on hearing during coronary artery bypass grafting.
Decisions at the end of life: an empirical study on the involvement, legal understanding and ethical views of preregistration house officers
Authors: Schildmann J , Doyal L , Cushing A , Vollmann J 
Published: September 2006

Objectives:To collect information on the involvement, legal understanding and ethical views of preregistration house officers (PRHO) regarding end-of-life decision making in clinical practice.Design:Structured telephone interviews.Participants:104 PRHO who responded.Main outcome measures:Information on the frequency and quality of involvement of PRHO in end-of-life decision making, their legal understanding and ethical views on do-not-resuscitate (DNR) order and withdrawal of treatment.Results:Most PRHO participated in team discussions on the withdrawal of treatment (n = 95, 91.3%) or a DNR order (n = 99, 95.2%). Of them, 46 (44.2%) participants had themselves discussed the DNR order with patients. In all, it was agreed by 84 (80.8%) respondents that it would be unethical to make a DNR order on any patient who is competent without consulting her or him. With one exception, it was indicated by the participants that patients who are competent may refuse tube feeding (n = 103, 99.0%) and 101 (97.1%) participants thought that patients may refuse intravenous nutrition. The withdrawal of artificial ventilation in incompetent patients with serious and permanent brain damage was considered to be morally appropriate by 95 (91.3%) and 97 (93.3%) thought so about the withdrawal of antibiotics. The withdrawal of intravenous hydration was considered by 67 (64.4%) to be morally appropriate in this case.Conclusions:PRHO are often involved with end-of-life decision making. The results on ethical and legal understanding about the limitations of treatment may be interpreted as a positive outcome of the extensive undergraduate teaching on this subject. Future empirical studies, by a qualitative method, may provide valuable information about the arguments underlying the ethical views of doctors on the limitations of different types of medical treatment.
Stand age and sampling year effect on the fungal fruit body community in Pinus pinaster forests in central Spain
Authors: Fernández-Toirán L.M. , Ágreda T. , Olano J.M. 
Published: September 2006

The process of fungal community succession in forests is still insufficiently known, especially in Mediterranean ecosystems. To reveal successional patterns, we studied changes in aboveground sporocarp composition in managed Pinus pinaster Ait. forests across a stand age chronosequence from 5 to more than 90 years in Soria province (Central Spain). We evaluated the effect of yearly conditions and stand age on species richness, composition, and trophic groups. All aboveground sporocarps were collected and identified in 21 plots, each measuring 150 m2, placed in a random stand age-stratified survey. Sampling was performed weekly in the autumn during 6 years (1997–2002). The effect of year and stand age on species richness was analysed using repeated measures analysis of variance and change in composition. Changes in community composition were evaluated via canonical correspondence analysis (CCA). The response of different trophic groups was analyzed using ANOVA with age as a fixed factor. Fungal community richness increased with stand age. This increase was related to the rise in humicolous saprotroph and mycorrhizal species. The presence of parasitic and lignicolous fungi was always very low, probably as a result of forest management. Yearly conditions exerted a stronger effect than stand age on aboveground sporocarp community richness and composition.