bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect Of Nurse-Led Multidisciplinary Rounds On Reducing the Unnecessary Use Of Urinary Catheterization in Hospitalized Patients
Authors: Fakih Mohamad G. , Dueweke Cathleen , Meisner Susan , Berriel-Cass Dorine , Savoy-Moore Ruth , Brach Nicole , Rey Janice , Desantis Laura , Saravolatz Louis D. 
Published: August 2008

Objective.To determine the effect of nurse-led multidisciplinary rounds on reducing the unnecessary use of urinary catheters (UCs).Design.Quasi-experimental study with a control group, in 3 phases: preintervention, intervention, and postintervention.Setting.Twelve medical-surgical units within a 608-bed teaching hospital, from May 2006 through April 2007.Intervention.A nurse trained in the indications for UC utilization participated in daily multidisciplinary rounds on 10 medical-surgical units. If no appropriate indication for a patient's UC was found, the patient's nurse was asked to contact the physician to request discontinuation. Data were collected before the intervention (for 5 days), during the intervention (for 10 days), and 4 weeks after the intervention (for 5 days). Two units served as controls.Results.Of 4,963 patient-days observed, a UC was present in 885 (for a total of 885 “UC-days”). There was a significant reduction in the rate of UC utilization from 203 UC-days per 1,000 patient-days in the preintervention phase to 162 UC-days per 1,000 patient-days in the intervention phase (P = .002). The postintervention rate of 187 UC-days per 1,000 patient-days was higher than the rate during the intervention (P = .05) but not significantly different from the preintervention rate (P = .32). The rate of unnecessary use of UCs also decreased from 102 UC-days per 1,000 patient-days in the preintervention phase to 64 UC-days per 1,000 patient-days during the intervention phase (P < .001); and, significantly, the rate rose to 91 UC-days per 1,000 patient-days in the postintervention phase (P = .01). The rate of discontinuation of unnecessary UCs in the intervention phase was 73 (45%) of 162.Conclusions.A nurse-led multidisciplinary approach to evaluate the need for UCs was associated with a reduction of unnecessary UC use. Efforts to sustain the intervention-induced reduction may be successful when trained advocates continue this effort with each team.
Cancer outlier detection based on likelihood ratio test
Authors: Hu Jianhua 
Published: August 2008

AbstractMotivation: Microarray experiments can be used to help study the role of chromosomal translocation in cancer development through cancer outlier detection. The aim is to identify genes that are up- or down-regulated in a subset of cancer samples in comparison to normal samples.Results: We propose a likelihood-based approach which targets detecting the change of point in mean expression intensity in the group of cancer samples. A desirable property of the proposed approach is the availability of theoretical significance-level results. Simulation studies showed that the performance of the proposed approach is appealing in terms of both detection power and false discovery rate. And the real data example also favored the likelihood-based approach in terms of the biological relevance of the results.Availability: R code to implement the proposed method in the statistical package R is available at: http://odin.mdacc.tmc.edu/~jhhu/cod-analysis/.Contact: jhu@mdanderson.orgSupplementary information: Supplementary data are available at Bioinformatics online.
Protein function prediction and annotation in an integrated environment powered by web services (AFAWE)
Authors: Jöcker Anika , Hoffmann Fabian , Groscurth Andreas , Schoof Heiko 
Published: August 2008

Abstract
Summary: Many sequenced genes are mainly annotated through automatic transfer of annotation from similar sequences. Manual comparison of results or intermediate results from different tools can help avoid wrong annotations and give hints to the function of a gene even if none of the automated tools could return any result.
AFAWE simplifies the task of manual functional annotation by running different tools and workflows for automatic function prediction and displaying the results in a way that facilitates comparison. Because all programs are executed as web services, AFAWE is easily extensible and can directly query primary databases, thereby always using the most up-to-date data sources. Visual filters help to distinguish trustworthy results from non-significant results. Furthermore, an interface to add detailed manual annotation to each gene is provided, which can be displayed to other users.
Availability: AFAWE is available at http://bioinfo.mpiz-koeln.mpg.de/afawe/
Contact: afawe-admin@mpiz-koeln.mpg.de
Supplementary information: SIFTER pipeline (S1), AFAWE tutorial (S2).
Change in plasma acylation stimulating protein during euglycaemic‐hyperinsulinaemic clamp in overweight and obese postmenopausal women: a MONET study
Authors: St‐Pierre David H. , Cianflone Katherine , Smith Jessica , Coderre Lise , Karelis Antony D. , Imbeault Pascal , Lavoie Jean‐Marc , Rabasa‐Lhoret Rémi 
Published: August 2008

SummaryObjective  Acylation‐stimulating protein (ASP) has been shown to positively stimulate fatty acid esterification and glucose uptake in adipocytes. In vitro studies demonstrate that insulin stimulates ASP secretion from adipocytes. Individuals with obesity and/or metabolic disturbances (insulin resistance and type 2 diabetes) have increased plasma ASP.Design  The present study was designed to evaluate whether ASP levels are influenced by the metabolic profiles of overweight and obese postmenopausal women during a euglycaemic/hyperinsulinaemic clamp (EHC).Patients  The study population consisted of 76 overweight and obese sedentary postmenopausal women.Measurements  We evaluated insulin sensitivity, plasma ASP levels, body composition including visceral adipose tissue area, blood lipid profiles, liver enzymes, peak aerobic capacity, resting metabolic rate (RMR) and total energy expenditure (TEE).Results  We observed wide interindividual variations of ASP levels during the EHC. Therefore, subjects were divided into three groups based on ASP changes. Negative ASP Responders (NAR; n = 24) showed a –20% or greater decrease in ASP levels while Positive ASP Responders (PAR; n = 42) displayed ASP fluctuations superior to +20%. Ten subjects had little or no ASP change and were considered as Zero ASP responders (ZAR). PAR women displayed a worse metabolic profile than NAR women, including higher BMI, visceral adipose tissue, fasting insulin levels, lean body mass, and alanine aminotransferase (ALT), a marker of impaired liver function. After adjustment for BMI, only ALT remained significantly different, while lean body mass (P = 0·08) and visceral adipose tissue (P = 0·07) remained marginally higher. Correlation analysis of all subjects demonstrated that fasting ASP levels correlated positively with albumin and VO2 peak and this association remained significant after adjustments for the effect of BMI. In addition, the percentage maximal change in ASP levels during the EHC was positively associated with BMI, lean body mass, visceral adipose tissue, fasting insulin, HOMA, TEE, RMR, ALT and AST.Conclusion  Overall these results suggest that an elevated ASP response during the EHC is associated with metabolic disturbances in overweight and obese postmenopausal women.
Applying life‐history strategies for freshwater macroinvertebrates to lentic waters
Authors: VERBERK WILCO C. E. P. , SIEPEL HENK , ESSELINK HANS 
Published: August 2008

Summary

Effective environmental management requires a sound understanding of the causal mechanisms underlying the relationship of species with their environment. Mechanistic explanations linking species and environment are ultimately based on species traits. Many tools for ecological assessment and biomonitoring lack such explanations. Elsewhere, we have defined life‐history strategies, based on the interrelations between species traits and their functional implications.
This study tests the hypothesis that life‐history strategies represent different solutions to particular ecological problems, thus connecting species and their environment through species traits. Data on aquatic macroinvertebrates in a variety of waterbodies were analysed in terms of life‐history strategies. These waterbodies differed in environmental conditions and macroinvertebrate assemblages. Solutions to the ecological problems present in each type of water body were expected to be reflected in the abundance of (species exhibiting) different life‐history strategies.
Results show clear differences in strategy composition between the different water types, which could be related to the prevailing environmental conditions through mechanistic explanations. For example, species with a long period of juvenile development and a synchronized emergence of short‐lived adults were most dominant in large mesotrophic waterbodies with stable and predictable environmental conditions. In contrast, species that have a rapid development and spread successive reproduction attempts over a longer time period were most abundant in waterbodies with fluctuating and less predictable environmental conditions.
Differences in strategy composition provide insight into the prevailing environmental conditions related to temporal predictability, and habitat favourability, from the perspective of the species themselves. By reducing diverse species assemblages to a small number of strategies, representing easily interpretable relationships, this approach may be useful in environmental quality assessment programmes, including those required by the European Water Framework Directive. Based on mechanistic explanations, life‐history strategies may generate testable predictions and guide future research. Further research may focus on expanding life‐history strategies to include other species groups and ecosystems.
Feeding difficulty in older adults with dementia
Authors: Chang Chia‐Chi , Roberts Beverly L 
Published: August 2008

Aims and objectives.  To use concept analysis to identify characteristics of feeding difficulty and its antecedents and consequences that provide direction for assessment and management.Background.  Feeding difficulty is often recognised as a common problem for older adults and is associated with weight loss, poor nutrition and risk for aspiration pneumonia. The cognitive impairment found in persons with dementia impairs the ability of these adults to complete motor and perceptual tasks required for eating and often prevent the older adult from accepting help with feeding from caregivers.Design.  Systematic review.Methods.  In 2006, literature searches using keywords (feeding, eating, nutrition, malnutrition, feeding assessment, dementia, ageing and concept analysis, dementia and feeding and excluding enteral feeding, tube feedings, PEG and enteral nutrition) were done in Medline, CINHAL, AGELINE and Social Science Full Text. Seventy relevant articles in English were found. After a review of the relevant articles, concept analysis was used to develop a definition of feeding difficulty, its defining characteristics and to delineate feeding difficulty from its antecedents and consequences.Results.  Feeding difficulties arise at the interface between the caregiver strategies to assist the older adult with getting food into the mouth and chewing and swallowing food. A model of feeding difficulty delineates the antecedents and consequences of feeding difficulties.Conclusions.  The conceptual model of feeding difficulties provides a strong and clear organising structure for research that can be used to developed evidence based guidelines for practice.Relevance to clinical practice.  The conceptual model provides directions for assessment of feeding difficulties and their antecedents. The model can be used to identify interventions that address antecedents of feeding difficulty (risk factors) and different types of feeding difficulties.
Patients’ perceptions of their participation in discharge planning after acute stroke
Authors: Almborg Ann‐Helene , Ulander Kerstin , Thulin Anders , Berg Stig 
Published: August 2008

Aims and objectives.  To describe stroke patients’ perceptions of their participation in the discharge planning process and identify correlates of perceived participation.Background.  Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal‐setting during discharge planning.Design.  Cross‐sectional study.Methods.  The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face‐to‐face interviews 2–3 weeks after discharge using the ‘Patients’ Questionnaire on Participation in Discharge Planning’. This instrument measures perceived participation in discharge planning in three subscales: P‐Information, P‐Medical Treatment, P‐Goals and Needs.Results.  The percentage of patients who perceived that they had participated in discharge planning was as follows: 72–90% according to P‐Information, 29–38% according to P‐Medical Treatment and 15–47% according to P‐Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales.Conclusions.  Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal‐setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning.Relevance to clinical practice.  To facilitate and increase patients’ participation in discharge planning, methods should be implemented for goal‐setting and identifying patients’ needs. Methods that foster patient participation may improve goal‐orientated care, services and rehabilitation after discharge.
Evaluation of the performance of using mean absolute amplitude analysis of thoracic and abdominal signals for immediate indication of sleep apnoea events
Authors: Ng Alice SL , Chung Joanne WY , Gohel Mayur DI , Yu Winnie WM , Fan Ka L , Wong Thomas KS 
Published: August 2008

Aim.  To evaluate the sensitivity of mean absolute amplitudes of the thoracic and the abdominal signals as a prompt indicator of the occurrence of sleep apnoea events.Background.  To provide symptomatic management of sleep apnoea, a reliable method of detecting sleep apnoea is essential to ensure that the intervention can be applied only when needed. It is also crucial to identify the threshold for the trigger of an intervention using a deployed sensor.Design.  Twenty‐six subjects aged between 18–65 years who were diagnosed with obstructive or central sleep apnoea underwent an overnight sleep study.Method.  Signals of nasal and oral airflow, thoracic and abdominal efforts and pulse oximetry level were recorded using a polysomnography device.Results.  With a 95% CI, the overall area under the receiver operating characteristic of the thoracic signal, the abdominal signal and the combination of the thoracic and the abdominal signals were 84·56, 87·48 and 90·91%, respectively. Using −20, −25 and −30% as a cut‐off point, the sensitivity values of thoracic signal, abdominal signal and combination of the thoracic and the abdominal signals ranged from 70·29–86·25% and the specificity values ranged from 74·82 to 90·09%.Conclusions.  Using mean absolute amplitude analysis, the results of this study showed that combination of the thoracic and the abdominal signals achieved the best overall and individual performances compared with thoracic signal and abdominal signal. Overall, thoracic signal, abdominal signal and combination of the thoracic and the abdominal signals have a good performance with an receiver operating characteristic value higher than 80%. The thoracic and the abdominal signals were good parameters for the identification of the occurrence of sleep apnoea, being as quick as the nasal airflow signal.Relevance to clinical practice.  These results suggested that sleep apnoea events could be identified through constant monitoring of the patient’s thoracic and abdominal signals. Knowledge of these signals could help nurses to manage sleep apnoea in patients.
Cytotoxic chemotherapy for incurable colorectal cancer: living with a PICC‐line
Authors: Molloy Doreen , Smith Lorraine N , Aitchison Tom 
Published: August 2008

Aims.  (i) To determine which aspects of living with a peripherally inserted central catheter (PICC) line cause Modified de Gramont (MdG) patients most difficulty. (ii) To explore MdG patients’ views of the PICC‐line experience. (iii) To determine if patients view PICC‐lines as a benefit or a burden when receiving ambulatory MdG chemotherapy.Design.  A two‐stage, descriptive study.Methods.  Phase 1 comprised semi‐structured interviews. Phase 2 surveyed the MdG population. Phase 1 interview data informed the Phase 2 questionnaire. The setting was a West of Scotland Cancer Care Centre and the sample was: Phase 1, a convenience sample of 10 MdG patients; Phase 2, 62 consecutive patients.Results.  A response rate of 93·9% for Phase 2. The majority of PICC‐line patients held favourable views towards having a PICC‐line and adapted well with minimal disruption to daily life. Concerns were evident regarding coping at home with a PICC‐line, chemotherapy spillage, dealing with complex information and the responsibility of patients/carers regarding PICC‐line management. Patients preferred ambulatory chemotherapy to in‐patient treatment.Conclusions.  PICC‐lines should be considered for more chemotherapy patients but service development is necessary to ensure individual needs are addressed.Relevance to clinical practice.  Contributes to the PICC‐line literature by providing a national patient perspective on a range of daily living activities (DLAs). PICC‐line patients prefer out‐patient ambulatory chemotherapy rather than in‐patient treatment. The longer a patient has a PICC‐line, the more able they are to manage activities such as dressing. Concerns remain over chemotherapy spillage, partner/carer responsibility for PICC‐line maintenance and the proper balance between required information and what the patient wants to know.
A family caregiver‐oriented discharge planning program for older stroke patients and their family caregivers
Authors: Shyu Yea‐Ing Lotus , Chen Min‐Chi , Chen Sien‐Tsong , Wang Hsiao‐Ping , Shao Jung‐Hua 
Published: August 2008

Aims.  To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan.Background.  Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families.Design.  A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers.Methods.  The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver‐oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge. Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale.Results.  Caregivers in the experimental group had significantly better nurse evaluation and self‐evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self‐evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs.Conclusions.  This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge.Relevance to clinical practice.  This caregiver‐oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers’ preparation and the satisfaction of their needs during the discharge transition.
Disentangling the effects of recombination, selection, and demography on the genetic variation at a major histocompatibility complex class II gene in the alpine chamois
Authors: MONA S. , CRESTANELLO B. , BANKHEAD‐DRONNET S. , PECCHIOLI E. , INGROSSO S. , D’AMELIO S. , ROSSI L. , MENEGUZ P. G. , BERTORELLE G. 
Published: August 2008

AbstractThe major histocompatibility complex (MHC) harbours some of the most polymorphic loci in vertebrate genomes. MHC genes are thought to be subject to some form of balancing selection, most likely pathogen‐mediated selection. Hence, MHC genes are excellent candidates for exploring adaptive processes. In this study, we investigated the genetic variation at exon 2 of the DRB class II MHC locus in 191 alpine chamois (Rupicapra rupicapra) from 10 populations in the eastern Alps of Italy. In particular, we were interested in distinguishing and estimating the relative impact of selective and demographic factors, while taking into account the confounding effect of recombination. The extremely highdn/dsratio and the presence of trans‐species polymorphisms suggest that a strong long‐term balancing selection effect has been operating at this locus throughout the evolutionary history of this species. We analysed patterns of genetic variation within and between populations, and the mitochondrial D‐loop polymorphism patterns were analysed to provide a baseline indicator of the effects of demographic processes. These analyses showed that (i) the chamois experienced a demographic decline in the last 5000–30 000 years, most likely related to the postglacial elevation in temperature; (ii) this demographic process can explain the results of neutrality tests applied to MHC variation within populations, but cannot justify the much weaker divergence between populations implied by MHC as opposed to mitochondrial DNA; (iii) similar sets of divergent alleles are probably maintained with similar frequencies by balancing selection in different populations, and this mechanism is also operating in small isolated populations, which are strongly affected by drift.