bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prostaglandin E2induces contraction of liver myofibroblasts by activating EP3and FP prostanoid receptors
Authors: Ayabe S , Murata T , Maruyama T , Hori M , Ozaki H 
Published: February 2009

Background and purpose: Increased portal pressure in liver injury results from hypercontraction of perivascular non‐parenchymal cells including liver myofibroblasts (MFs). Prostaglandin E2(PGE2) is the major eicosanoid which is released around the venous system during liver injury, but little is known about their contractile effect on MFs.Experimental approach: Contraction of primary rat liver MFs was measured by a collagen gel contraction assay. Expression of E prostanoid (EP) receptor subtypes was assessed by reverse transcription‐polymerase chain reaction. Fura‐2 fluorescence was used to determine intracellular Ca2+concentration ([Ca2+]i). Phosphorylation of protein kinase C (PKC) was detected by Western blot analysis.Key results: Liver MFs expressed mRNAs for all four EP receptors. PGE2induced contraction in a dose‐ and time‐dependent manner, and slightly increased [Ca2+]ionly at high concentrations (10 µmol·L−1). An agonist selective for EP3receptors, ONO‐AE‐248, dose‐dependently induced MF contraction but did not increase [Ca2+]i. Pretreatment with rottlerin (a specific novel PKC inhibitor) and Ro 31‐8425 (a general PKC inhibitor) significantly reduced 1 µmol·L−1PGE2‐ or ONO‐AE‐248‐induced contractions. Furthermore, 1 µmol·L−1PGE2stimulated phosphorylation of PKC isoforms PKCδ and PKCε. The F prostanoid (FP) receptor antagonist AL8810 abolished the [Ca2+]ielevation and the rapid contraction induced by 10 µmol·L−1PGE2.Conclusions and implications: Lower concentrations up to 1 µmol·L−1of PGE2induce liver MF contraction via a [Ca2+]i‐independent PKC‐mediated pathway through the EP3receptor, while higher concentrations have an additional pathway leading to Ca2+‐dependent contraction through activating the FP receptor.
The integrin α2β1agonist, aggretin, promotes proliferation and migration of VSMC through NF‐kB translocation and PDGF production
Authors: Chung Ching‐Hu , Lin Kuan‐Ting , Chang Chien‐Hsin , Peng Hui‐Chin , Huang Tur‐Fu 
Published: February 2009

Background and purpose: During the development of atherosclerotic plaques, vascular smooth muscle cells (VSMCs) migrate from the media to the intima through the basement membrane and interstitial collagenous matrix, and proliferate to form neointima. Here, we investigate the mechanism of VSMC migration and proliferation caused by aggretin, a snake venom integrin α2β1 agonist.Experimental approach: Cultures of rat and human VSMCs were treated with aggretin and the signal transduction pathways induced by this agonist were examined by Western blotting, immunoprecipitation and electrophoretic mobility shift assay techniques.Key results: Aggretin‐induced VSMC proliferation was blocked by a monoclonal antibody (mAb) against integrin α2 (AII2E10) or against the platelet‐derived growth factor receptor (PDGFR)‐β. Proliferation was also blocked by inhibition of the tyrosine kinase Src with PP2, phospholipase C (PLC) with U73122, extracellular signal‐regulated kinase (ERK) with PD98059 or nuclear factor‐kappa B (NF‐kB) activation with pyrrolidine dithiocarbamate (PDTC). VSMC migration towards immobilized aggretin was increased in a modified Boyden chamber and this effect was blocked by α2β1‐Src‐PLC‐MAPK axis inhibitors, but not by PDTC, PDGFR‐β mAb, or a phosphoinositide‐3 kinase inhibitor, LY294002. Aggretin stimulated the phosphorylation of PDGFR‐β, Src and ERK in a time‐dependent manner. NF‐kB translocation and platelet‐derived growth factor (PDGF)‐BB production were also observed. The ERK activation, NF‐kB translocation and PDGF‐BB production were blocked by PP2, U73122 and PD98059.Conclusions and implications: Aggretin induces VSMC proliferation and migration mainly through binding to integrin α2β1, and subsequently activates Src, PLC and ERK pathways, inducing NF‐kB activation and PDGF production.
Exploring the quality of dying of patients with chronic obstructive pulmonary disease in the intensive care unit: a mixed methods study
Authors: Goodridge Donna , Duggleby Wendy , Gjevre John , Rennie Donna 
Published: February 2009

AbstractRationale for the study:  Improving the quality of end‐of‐life (EOL) care in critical care settings is a high priority. Patients with advanced chronic obstructive pulmonary disease (COPD) are frequently admitted to and die in critical care units. To date, there has been little research examining the quality of EOL care for this unique subpopulation of critical care patients.Aims:  The aims of this study were (a) to examine critical care clinician perspectives on the quality of dying of patients with COPD and (b) to compare nurse ratings of the quality of dying and death between patients with COPD with those who died from other illnesses in critical care settings.Design and sample:  A sequential mixed method design was used. Three focus groups provided data describing the EOL care provided to patients with COPD dying in the intensive care unit (ICU). Nurses caring for patients who died in the ICU completed a previously validated, cross‐sectional survey (Quality of Dying and Death) rating the quality of dying for 103 patients.Data analysis:  Thematic analysis was used to analyse the focus group data. Total and item scores for 34 patients who had died in the ICU with COPD were compared with those for 69 patients who died from other causes.Results:  Three primary themes emerged from the qualitative data are as follows: managing difficult symptoms, questioning the appropriateness of care and establishing care priorities. Ratings for the quality of dying were significantly lower for patients with COPD than for those who died from other causes on several survey items, including dyspnoea, anxiety and the belief that the patient had been kept alive too long. The qualitative data allowed for in‐depth explication of the survey results.Conclusions:  Attention to the management of dyspnoea, anxiety and treatment decision‐making are priority concerns when providing EOL care in the ICU to patients with COPD.
Matching service need with staff development: a project management experience
Authors: Wadams Beverley 
Published: February 2009

AbstractAim:  This paper will investigate the development of enhanced clinical practice of the senior nurses’ role (band 6 and above) within one cardiac intensive care unit. The enhanced role was primarily patient focused and supported local need. Role development was perceived to run parallel with national trend rather than follow it directly.Method:  The process and strategies used to facilitate such clinical development will be explored in depth.Conclusions:  The aim of the developed senior role was to expedite respiratory care for critical care patients, specifically, requesting chest X ray and supplying and administrating limited respiratory drugs for the deteriorating patient. To enable this, an education framework was required to support new policy formulation. Wider organization issues confronted during this policy construction are additionally explored.
Factors leading to self‐extubation of endotracheal tubes in the intensive care unit
Authors: Huang Yuan‐Ting 
Published: February 2009

AbstractAim and objective:  To discuss the factors leading to self‐extubation of endotracheal tubes (ETTs) and explore the differences between the groups of patients who did and did not self‐remove their ETTs.Background:  Self‐extubation of ETTs has been reported to occur in 4·2% of severely ill patients and is associated with adverse medical effects.Design:  A case‐control study.Methods:  One hundred and thirty‐nine subjects were recruited from a teaching hospital in southern Taiwan based on purposive sampling. The rate of self‐extubation of ETTs was 6·4%. Analysis of the two groups demonstrated that significant variables were identified and fell into three categories: (1) the department to which the patient was admitted (p < 0·001), (2) whether the patient met the criteria for extubation (p < 0·001) and (3) the patient age (p < 0·05). Based on multiple logistic regression analysis, whether the patient met the criteria for extubation was a main variable that was associated with self‐extubation of the ETT. Among the 44 patients who had self‐extubation of their ETT, 28 met the criteria to be extubated, 70% and 81·8% of whom were not sedated, and self‐extubation of their ETT was conscious of the act. Of the patients who attempted to self‐remove their ETT, 80% were successful and 93·2% did not incur any adverse medical effects.Conclusion:  The medical doctor and nurse should fully evaluate a patient’s oxygenation status, decrease the length of the extubation training session for patients and extubate patients promptly when extubation criteria are met.Relevance to clinical practice:  Adopting a proactive approach to patient extubation will improve the overall quality of care.
Ventilatory weaning: a case study of protracted weaning
Authors: Pattison Natalie , Watson Jennifer 
Published: February 2009

AbstractBackground:  Dysfunctional ventilatory weaning response (DVWR) is characterized by interrupted and prolonged weaning. This reflective analysis presents how using nursing diagnoses in critical care can raise awareness of, and provide strategies for, managing problems related to ventilatory weaning.Aim:  To examine and reflect upon why one patient took so long to wean from the ventilator using the structured approach of instrumental case study and nursing diagnosis to explain aspects of the weaning process.Analysis:  This case study examines one patient’s experiences around ventilatory weaning using selected nursing diagnoses, exploring the implications that physiological, social, emotional and psychological factors have on both weaning and healing processes in critical care. By using dialogue, an explicit texture is presented of how one patient felt, with particular resonance to the relationships she had and the impact they made. Various nursing diagnoses proved useful in determining why this patient had an extended weaning trajectory and included DVWR, ineffective breathing pattern, impaired spontaneous ventilation, anxiety and impaired verbal communication. There were specific points of interest, in particular her anxiety, which proved a major factor, and her significantly improved functional status after the critical care episode. A DVWR may be minimized by nursing presence, reassurance and respect for patient autonomy. Complex anatomy and physiology contributes to protracted weaning and a DVWR and is compounded by anxiety. Furthermore, there is a significant element of nursing care, timely reassurance and presence, which can have a positive impact on patient well‐being.Conclusions:  This reflective analysis highlights the benefits and importance of the nurse‐patient relationship during what was a very protracted ventilatory wean. This shared trajectory enabled significant patient empowerment, and this case study gives the patient the voice she temporarily lost.
Responses, Actions and Health‐Promoting Behavior Among Rural Taiwanese Women With Abnormal Papanicolaou Test
Authors: Liou Huoy‐In , Ling Xue‐Min , Feng Man‐Xuan , Guo Yue‐Ling , Chen Mei‐Yen 
Published: February 2009

ABSTRACT
Objectives: The incidence and mortality rate of cervical cancer in Taiwan are higher than in other developed countries. This study aimed to explore women's responses and actions after receiving their test reports and their practice of health‐promoting behaviors.Design: This study employed a cross‐sectional descriptive design.Sample: A convenient sample of 101 women living in a rural area.Measurements: Demographic characteristics, semistructured questions and Chinese Adult Health Promotion scale were used in this study.Results: The mode of the duration of their marriages was 20 years. Nearly 14% were diagnosed as precancerous and underwent further treatment. 24 percent of the women took no action during the 3 months after receiving the results. As many as 96% of the participants were not aware of the 90% 5‐year survival rate for localized cervical cancer. From semistructured interviews, 4 behavioral responses and 5 actions were identified. Notably, many women in this study practiced health‐promoting behaviors for health responsibility, regular exercise and stress management with low frequency.Conclusions: These analytical results may prove useful in developing intervention strategies to assist women with positive Papanicolaou test results to choose treatment modalities and adopt healthy behaviors.
The Effect of a Nutrition Education Program on the Nutritional Knowledge, Hemoglobin Levels, and Nutritional Status of Nicaraguan Adolescent Girls
Authors: Moore Jean Burley , Pawloski Lisa , Rodriguez Claudia , Lumbi Laura , Ailinger Rita 
Published: February 2009

ABSTRACT
Objectives: The purpose of this study was to examine the effect of a community‐based nutrition education program on the nutritional knowledge, hemoglobin levels, and nutritional status of Nicaraguan adolescent girls and the nutritional knowledge of their mothers.Theory: Self‐care deficit nursing theory was used in this study.Design: This longitudinal study used a mixed quantitative/qualitative design to study the effect of the nutrition education program.Sample: The nonprobability sample consisted of 182 adolescent girls and 67 of their mothers. The setting for the study was a community (barrio) in Managua, Nicaragua.Intervention/Measurement: A team of nurse and nutrition researchers created the nutrition education program designed to improve girls' and mother's nutrition‐related self‐care operations. Data collection was carried out for 4 years for girls and 2 years for mothers in Managua, Nicaragua, using questionnaires, a HemoCue, and anthropometric measures.Results and Conclusion: The findings of this study were that girls' and mothers' nutritional knowledge scores significantly improved in most cases after participation in the nutrition intervention program. Girls' hemoglobin levels did not significantly improve and their nutritional status findings were mixed. Girls and mothers described what dietary changes girls made and why.
Vaccination Competence
Authors: Nikula Anne , Hupli Maija , Rapola Satu , Leino‐Kilpi Helena 
Published: February 2009

ABSTRACT
Objective: Vaccinating is one of the most significant methods of health promotion in the world. The purpose of this study was to describe vaccination competence from the perspective of professionals, clients, and students.Design: A cross‐sectional interview study.Sample: Participants (n=40) were public health nurses, physicians, nursing teachers and graduating public health nursing students, and vaccinated clients of various ages or vaccinated children's parents in Finland.Measurements: Interview data were collected using semistructured interviews in focus groups and individual interviews, and were analyzed by content analysis.Results: The participants pointed out that the competent vaccinator (CV) displays distinctive personal qualities, possesses the necessary attributes required in the vaccinator‐client relationship, and is authorized to administer vaccinations. The competent vaccinator is a health care professional who is committed to vaccinating and who fosters social awareness of vaccinations. The competent implementation of the vaccination procedure consists of the vaccinator's actions before, during, and after the vaccination. The outcomes of a competent implementation are divided into immediate and long‐term outcomes.Conclusions: Vaccination competence is a broad entity. These results may be utilized for improving the practical implementation of vaccinations, administration, education, and research of vaccination procedures.
Prospects in Lyophilization of Bovine Pericardium
Authors: Leirner Adolfo A. , Tattini Virgílio , Pitombo Ronaldo N.M. 
Published: February 2009

AbstractAlmost 30 years after the introduction of heart valve prostheses patients worldwide are benefiting from the implant of these devices. Among the various types of heart valves, the ones made of treated bovine pericardium have become a frequently used replacement of the heart's native valve. Lyophilization, also known as freeze‐drying, is an extremely useful technique for tissue storage for surgical applications. This article gives a brief overview on the current bovine pericardium lyophilization development, including the chemical modification to improve physical–chemical characteristics and the advanced technologies used to guarantee a high‐quality product. It was shown that lyophilization process can be successfully applied as a method of bovine pericardium preservation and also as a technological tool to prepare new materials obtained by chemical modification of native tissues.
Development and Validation of Small‐diameter Vascular Tissue From a Decellularized Scaffold Coated With Heparin and Vascular Endothelial Growth Factor
Authors: Zhou Min , Liu Zhao , Wei Zhiqing , Liu Changjian , Qiao Tong , Ran Feng , Bai Yan , Jiang Xuefeng , Ding Ying 
Published: February 2009

AbstractTo overcome shortcomings of current small‐diameter vascular prostheses, we developed a novel allogenic vascular graft from a decellularized scaffold modified through heparin immobilization and vascular endothelial growth factor (VEGF) coating. The VEGF coating and release profiles were assayed by enzyme‐linked immunosorbent assay, the biological activity of modified surface was validated by human umbilical vein endothelial cells seeding and proliferation for 10 days in vitro. In vivo, we implanted either a modified or a nonmodified scaffold as bilateral carotid allogenic graft in canines (n = 15). The morphological examination of decellularized scaffolds showed complete removal of cellular components while the extracellular matrix structure remained intact. After modification, the scaffolds possessed local sustained release of VEGF up to 20 days, on which the cells cultured showed significantly higher proliferation rate throughout the time after incubation compared with the cells cultured on nonmodified scaffolds (P < 0.0001). After 6 months of implantation, the luminal surfaces of modified scaffolds exhibited complete endothelium regeneration, however, only a few disorderly cells and thrombosis overlay the luminal surfaces of nonmodified scaffolds. Specifically, the modified scaffolds exhibited significantly smaller hyperplastic neointima area compared with the nonmodified, not only at midportion (0.56 ± 0.07 vs. 2.04 ± 0.12 mm2, P < 0.0001), but also at anastomotic sites (1.76 ± 0.12 vs. 3.67 ± 0.20 mm2, P < 0.0001). Moreover, modified scaffolds had a significantly higher patency rate than the nonmodified after 6 months of implantation (14/15 vs. 7/15, P = 0.005). Overall, this modified decellularized scaffold provides a promising direction for fabrication of small‐diameter vascular grafts.
Reversal Blood Flow Component as Determinant of the Arterial Functional Capability: Theoretical Implications in Physiological and Therapeutic Conditions
Authors: Bia Daniel , Zócalo Yanina , Armentano Ricardo L. , De Forteza Eduardo , Cabrera‐Fischer Edmundo 
Published: February 2009

AbstractIn several physiological, pathological, and therapeutic circumstances, the arterial blood flow is acutely modified, increasing, in some vascular segments the reversal (SSR) and oscillatory (SSO) components of the shear stress. Recently, in an in vivo model we found a relationship between acute changes in SSR and SSO, and variations in the arterial viscoelasticity. As the arterial viscoelasticity and diameter are the main determinants of the arterial buffering (BF) and conduit (CF) functions, changes in those functions could be expected associated with variations in SSR and SSO. The aim was to analyze the association between acute increases in SSR and SSO, and changes in the aortic CF and BF. Aortic flow, pressure, and diameter were measured in 16 sheep under basal and high reversal and oscillatory flow conditions (high SSR and SSO). Aortic BF and CF were quantified, and their potential association with the SSR and SSO components were analyzed. During high reversal flow rate conditions, a smooth muscle contraction‐pattern was evidenced, with an increase in BF and a decrease in CF. Changes in BF and CF were associated with the changes in SSR and SSO. The acute effects on the arterial wall biomechanics of variations in SSR and SSO could contribute to comprehend their chronic effects, and the meaning of the acute vascular effects of changes in SSR and SSO would depend on the situation. Increases in SSR and SSO could be associated with smooth muscle tone increase‐dependent changes in arterial BF and CF.
Adjunctive levetiracetam in infants and young children with refractory partial‐onset seizures
Authors: Piña‐Garza Jesus Eric , Nordli Jr Douglas R. , Rating Dietz , Yang Haichen , Schiemann‐Delgado Jimmy , Duncan Benjamin ,   on behalf of the Levetiracetam N01009 Study Group
Published: February 2009

SummaryPurpose:  To evaluate the efficacy and tolerability of adjunctive levetiracetam in very young children (aged 1 month to <4 years) with partial‐onset seizures inadequately controlled with one or two antiepileptic drugs.Methods:  This multicenter, double‐blind, randomized, placebo‐controlled study consisted of a 48‐h inpatient baseline video‐EEG (electroencephalography) and a 5‐day inpatient treatment period (1‐day up‐titration; 48‐h evaluation video‐EEG in the last 2 days). Children who experienced at least two partial‐onset seizures during the 48‐h baseline video‐EEG were randomized to either levetiracetam [40 mg/kg/day (age 1 to <6 months); 50 mg/kg/day (age ≥6 months to <4 years] or placebo.Results:  Of 175 patients screened, 116 patients were randomized [60 levetiracetam; 56 placebo; intent‐to‐treat (ITT) population], and 111 completed the study. The responder rate in average daily partial‐onset seizures frequency (48‐h video‐EEG monitoring; primary efficacy variable) was 43.1% for levetiracetam [modified ITT (mITT) = 58] versus 19.6% for placebo (mITT = 51; p=0.013), with odds ratio for response 3.11 [95% confidence interval (CI), 1.22–8.26]. The median percent reduction from baseline in average daily partial‐onset seizure frequency was 43.6% for levetiracetam and 7.1% for placebo with a median difference between treatment groups of 39.2% (95% CI, 17.5–62.2; p < 0.001). In general, levetiracetam was well tolerated. Treatment‐emergent adverse events were reported by 55.0% levetiracetam‐ and 44.6% placebo‐treated patients (ITT population). The most frequently reported adverse events were somnolence (13.3% levetiracetam, 1.8% placebo) and irritability (11.7% levetiracetam, 0% placebo).Discussion:  Adjunctive levetiracetam is an efficacious and well‐tolerated treatment for partial‐onset seizures in infants and young children.