bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ knowledge and skills in colonoscopy patients’ pain management
Authors: Eeva‐Riitta Ylinen , Katri Vehviläinen‐Julkunen , Anna‐Maija Pietilä 
Published: May 2007

Aim.  This study aimed to describe the knowledge and skills of nurses in managing pain during colonoscopy procedures.Background.  Colonoscopy is a procedure to diagnose diseases of the intestine, and patients consider it even painful. However, few studies have described patients’ pain management during the colonoscopy procedure.Design.  A quantitative survey design was used. The data were collected from colonoscopy nurses with a self‐completed semi‐structured questionnaire developed for the study.Methods.  The hospitals performing colonoscopies in Finland, with the exception of the ones where the questionnaire was pilot‐tested, were included in the study (n = 12). The optional sample was drawn by mailing questionnaires (n = 147) to endoscopy units to be filled in by three colonoscopy nurses during 2002. The response rate was 79% (n = 116).Results.  The majority of nurses used versatile non‐pharmacological methods of managing pain and had practice‐based knowledge of pain management during the colonoscopy procedure, but pain education and the acquisition of new professional knowledge were rarely reported. Pain scales were not in use and ethical conversation was lacking among the endoscopy staff in most (95%) hospitals.Conclusion.  The study showed that colonoscopy nurses used numerous non‐pharmacological methods, but only rarely acquired professional knowledge. There was a lack of pain scales and ethical conversation in the participating endoscopy units.Relevance to clinical practice.  The results can be used to improve the treatment of pain during colonoscopy procedures and endoscopy nurses’ education. Nurses should be motivated by education and ethical conversation. Future studies should aim to analyse patients’ own evaluation of pain during the colonoscopy procedure. The applicability of the existing pain scales and non‐pharmacological methods should be tested in practice.
Evaluating cardiovascular mortality in type 2 diabetes patients: an analysis based on competing risks Markov Chains and additive regression models
Authors: Rosato Rosalba , Ciccone G. , Bo S. , Pagano G. F. , Merletti F. , Gregori D. 
Published: May 2007

AbstractRationale, aims and objectives Type 2 diabetes represents a condition significantly associated with increased cardiovascular mortality. The aims of the study are: (i) to estimate the cumulative incidence function for cause‐specific mortality using Cox and Aalen model; (ii) to describe how the prediction of cardiovascular or other causes mortality changes for patients with different pattern of covariates; (iii) to show if different statistical methods may give different results.Methods Cox and Aalen additive regression model through the Markov chain approach, are used to estimate the cause‐specific hazard for cardiovascular or other causes mortality in a cohort of 2865 type 2 diabetic patients without insulin treatment. The models are compared in the estimation of the risk of death for patients of different severity.Results For younger patients with a better covariates profile, the Cumulative Incidence Function estimated by Cox and Aalen model was almost the same; for patients with the worst covariates profile, models gave different results: at the end of follow‐up cardiovascular mortality rate estimated by Cox and Aalen model was 0.26 [95% confidence interval (CI) = 0.21–0.31] and 0.14 (95% CI = 0.09–0.18).Conclusions Standard Cox and Aalen model capture the risk process for patients equally well with average profiles of co‐morbidities. The Aalen model, in addition, is shown to be better at identifying cause‐specific risk of death for patients with more severe clinical profiles. This result is relevant in the development of analytic tools for research and resource management within diabetes care.
Decision analysis model evaluating the cost‐effectiveness of risperidone, olanzapine and haloperidol in the treatment of schizophrenia
Authors: Bounthavong Mark , Okamoto Mark P. 
Published: May 2007

AbstractPurpose  To evaluate the cost‐effectiveness of three antipsychotic medications (olanzapine, risperidone and haloperidol) in the treatment of schizophrenia using the Positive and Negative Symptom Scale.Study design and methods  A decision analysis model was created to evaluate the cost‐effectiveness of two atypical antipsychotics (risperidone and olanzapine) and haloperidol. Outcome probabilities were determined from published clinical trials. The main dependent variable of interest was to compare the incremental cost‐effectiveness ratios (ICER) of the atypical antipsychotic with haloperidol, and also to compare the ICER of olanzapine and risperidone. Sensitivity analyses were conducted for olanzapine and risperidone to determine the effects of altering drug cost, efficacy and re‐hospitalization rate on total costs.Results  Risperidone and olanzapine were dominant strategies compared with haloperidol (less costly and more effective). Risperidone was also dominant when compared with olanzapine. A one‐way sensitivity analysis for efficacy indicated that the efficacy of risperidone would need to decrease by approximately 3% from the base‐case in order for olanzapine and risperidone to have equal total costs. In a two‐way sensitivity analysis varying both the cost of olanzapine and risperidone, the difference in drug costs between them would have to increase from $2.12 per day to $4.12 per day in order to have equal total costs. In terms of varying re‐hospitalization rates, the re‐hospitalization rate for risperidone would have to increase from 3% to 33% greater than the re‐hospitalization rate for olanzapine in order to have equal total direct costs.Conclusion  Based on this decision model, atypical antipsychotics were a dominant strategy over haloperidol primarily because of increased efficacy and lower re‐hospitalizations. The ICER indicated that risperidone was dominant over olanzapine because of lower drug costs and increased number of responders, which leads to decreased total costs.
Identification and characterization of the immunity repressor (ImmR) that controls the mobile genetic element ICEBs1 of Bacillus subtilis
Authors: Auchtung Jennifer M. , Lee Catherine A. , Garrison Katherine L. , Grossman Alan D. 
Published: May 2007

SummaryICEBs1 is a mobile genetic element found in the chromosome of Bacillus subtilis. Excision and transfer of ICEBs1 is regulated by the global DNA damage response and intercellular peptide signalling. We identified and characterized a repressor, ImmR (formerly YdcN), encoded by ICEBs1. ImmR represses transcription of genes required for excision and transfer, and both activates and represses its own transcription. ImmR regulates transcription within ICEBs1 by binding to several sites in the region of DNA that contains promoters for both immR and xis (encoding excisionase). In addition, we found that ImmR confers immunity from acquisition of additional copies of ICEBs1. ImmR‐mediated regulation serves to keep a single copy of ICEBs1 stably maintained in the absence of induction, allows a rapid response to inducing signals, and helps limit acquisition of additional copies of ICEBs1.
Structural asymmetry and discrete nucleic acid subdomains in the Trypanosoma brucei kinetoplast
Authors: Gluenz Eva , Shaw Michael K. , Gull Keith 
Published: May 2007

SummaryThe mitochondrial genome of Trypanosoma brucei is contained in a specialized structure termed the kinetoplast. Kinetoplast DNA (kDNA) is organized into a concatenated network of mini and maxicircles, positioned at the base of the flagellum, to which it is physically attached. Here we have used electron microscope cytochemistry to determine structural and functional domains involved in replication and segregation of the kinetoplast. We identified two distinct subdomains within the kinetoflagellar zone (KFZ) and show that the unilateral filaments are composed of distinct inner and outer filaments. Ethanolic phosphotungstic acid (E‐PTA) and EDTA regressive staining indicate that basic proteins and DNA are major constituents of the inner unilateral filaments adjoining the kDNA disc. This evidence for an intimate connection of the unilateral filaments in the KFZ with DNA provides support for models of minicircle replication involving vectorial export of free minicircles into the KFZ. Unexpectedly however, detection of DNA in the KFZ throughout the cell cycle suggests that other processes involving kDNA occur in this domain. We also describe a hitherto unrecognized, intramitochondrial, filamentous structure rich in basic proteins that links the kDNA discs during their segregation and is maintained between them for an extended period of the cell cycle.
Conversion to mycophenolate mofetil for modulating recurrent hepatitis C in liver transplant recipients
Authors: Kornberg A. , Küpper B. , Wilberg J. , Tannapfel A. , Thrum K. , Bärthel E. , Hommann M. , Settmacher U. 
Published: May 2007

Abstract: Background.The aim of this study was to analyze the influence of cyclosporine A (CsA) taper in conjunction with mycophenolate mofetil (MMF) therapy on recurrent hepatitis C virus (HCV) in liver transplant patients.Patients and methods.Nineteen liver recipients with serologically and morphologically confirmed recurrent HCV were included in this study. After MMF introduction up to a maximum dose of 2000 mg/day, CsA dose was significantly tapered. In the control group immunosuppression remained unchanged. Allograft function and morphology, viral loads, and renal function were analyzed continuously.Results.MMF treatment was well tolerated without risk of rejection. Allograft fibrosis progressed in 6 patients of the MMF group (66.6%) and none (0%) of the controls at 12‐month biopsy (P=0.005). Moreover, aminotransferases and viral loads increased slightly in the MMF‐treated patients. Renal function improved significantly (serum creatinine: 239.3±90.2 μmol/L vs. 175.8±46.0 μmol/L;P=0.008) in the treatment group, while deteriorating (serum creatinine: 156.8±44.6 μmol/L vs. 214.8±120.1 μmol/L;P=0.06) in the controls.Conclusion.MMF introduction allows a safe CsA taper in HCV‐positive liver transplant patients and results in significant improvement of renal function. However, there seems to be a risk of marked progression of HCV‐induced allograft injury.
The sustainability of ideals, values and the nursing mandate: evidence from a longitudinal qualitative study
Authors: Maben Jill , Latter Sue , Clark Jill Macleod 
Published: May 2007

This article reports on research that examines newly qualified UK nurses’ experiences of implementing their ideals and values in contemporary nursing practice. Findings are presented from questionnaire and interview data from a longitudinal interpretive study of nurses’ trajectories over time. On qualification nurses emerged with a coherent and strong set of espoused ideals around delivering high quality, patient‐centred, holistic and evidence‐based care. These were consistent with the current UK nursing mandate and had been transmitted and reinforced throughout their ‘prequalification’ programmes. The existence of professional and organisational constraints influenced their ability to implement these ideals and values once in practice. Data analysis revealed that within 2 years in practice the newly qualified nurses could be categorised as sustained idealists, compromised idealists, or crushed idealists. The majority experienced frustration and some level of ‘burnout’ as a consequence of their ideals and values being thwarted. This led to disillusionment, ‘job‐hopping’ and, in some cases, a decision to leave the profession. These data are explored and discussed to inform the question of whether the current nursing mandate is sustainable.
Cryotherapy for the prostate: an in vitro and clinical study of two new developments; advanced cryoneedles and a temperature monitoring system
Authors: Gowardhan Bharat , Greene Damien 
Published: May 2007

OBJECTIVESTo assess the characteristics of two new developments in cryotherapy for the prostate, IceRodsTM (Oncura, Amersham, UK; 17 G cryoneedles with an advanced heat exchanger which produces a precise ice‐ball comparable in size to those with larger diameter cryoneedles) and the MultitempTM 1601 temperature monitoring system (TMS, InvivoSense, Trondheim, Norway) probes, in an in vitro model and in a clinical setting, to assess their usefulness, focusing in particular on the TMS probes.PATIENTS, MATERIALS AND METHODSWe assessed the temperature profile and performance of the IceRods in several different configurations, in conjunction with the TMS probes for temperature mapping, in a phantom prostate model. Subsequently 20 patients with prostate cancer were treated with cryosurgery either as a primary or secondary treatment for radiation failure; all had a standard treatment protocol. The temperatures throughout the procedure were recorded accurately and analysed.RESULTSThe IceRods were better able to freeze tissue, reaching lower temperatures than conventional cryoneedles. The IceRods were also capable of forming ice‐balls with a maximum diameter of >6 cm after freezing at full power for 10 min. The TMS probes depicted real‐time temperature gradients over either four or eight points in a linear array, enabling more thorough monitoring of the temperature changes during a treatment cycle. In the clinical setting, in all 20 patients, therapeutic freezing of <−40 °C was achieved in both the cycles. Temperatures of ≈ − 40 °C were attained in the area just outside the prostate, as measured by the TMS probes, but with variation along the longitudinal axis. The rectal and external urinary sphincter temperatures did not fall below 0 °C at any of the points along the eight‐point temperature probe, but there was variation in temperature along the prostate.CONCLUSIONIceRods and the TMS probes are clinically useful, requiring fewer cryoneedles and with more efficient temperature monitoring; this would be expected to reduce morbidity and increase safety without compromising an adequate oncological outcome. The IceRods were useful in larger prostates of >3.5 cm long, which obviated the need for a ‘pull‐back’ technique. The TMS probes showed convincingly the variation in temperatures along one line, suggesting that single‐point temperature monitoring might not accurately depict the lowest temperatures reached during treatment, which is particularly important in the rectum. This is a significant development in cryosurgery and would make the procedure safer, reproducible and allow interested clinicians to learn the technique safely and more quickly.
A continental‐scale analysis of tree cover in African savannas
Authors: Bucini Gabriela , Hanan Niall P. 
Published: May 2007

ABSTRACTAim  We present a continental‐scale analysis that explores the processes controlling woody community structure in tropical savannas. We analyse how biotic and abiotic factors interact to promote and modify tree cover, examine alternative ecological hypotheses and quantify disturbance effects using satellite estimates of tree cover.Location  African savannas.Methods  Tree cover is represented as a resource‐driven potential cover related to rainfall and soil characteristics perturbed by natural and human factors such as fire, cattle grazing, human population and cultivation. Within this framework our approach combines semi‐empirical modelling and information theory to identify the best models.Results  Woody community structure across African savannas is best represented by a sigmoidal response of tree cover to mean annual precipitation (MAP), with a dependency on soil texture, which is modified by the separate effects of fire, domestic livestock, human population density and cultivation intensity. This model explains c. 66% of the variance in tree cover and appears consistent across the savanna regions of Africa.Main conclusions  The analysis provides a new understanding of the importance and interaction of environmental and disturbance factors that create the broad spatial patterns of tree cover observed in African savannas. Woody cover increases with rainfall, but is modified by disturbances. These ‘perturbation’ effects depend on MAP regimes: in arid savannas (MAP < 400 mm) they are generally small (< 1% decrease in cover), while in semi‐arid and mesic savannas (400–1600 mm), perturbations result in an average 2% (400 mm) to 23% (1600 mm) decrease in cover; fire frequency and human population have more influence than cattle, and cultivation appears, on average, to lead to small increases in woody cover. Wet savannas (1600–2200 mm) are controlled by perturbations that inhibit canopy closure and reduce tree cover by, on average, 24–34%. Full understanding of the processes determining savanna structure requires consideration of resource limitation and disturbance dynamics.
Palms tracking climate change
Authors: Walther Gian‐Reto , Gritti Emmanuel S. , Berger Silje , Hickler Thomas , Tang Zhiyao , Sykes Martin T. 
Published: May 2007

ABSTRACTAim  Many species are currently expanding their ranges in response to climate change, but the mechanisms underlying these range expansions are in many cases poorly understood. In this paper we explore potential climatic factors governing the recent establishment of new palm populations far to the north of any other viable palm population in the world.Location  Southern Switzerland, Europe, Asia and the world.Methods  We identified ecological threshold values for the target species, Trachycarpus fortunei, based on gridded climate data, altitude and distributional records from the native range and applied them to the introduced range using local field monitoring and measured meteorological data as well as a bioclimatic model.Results  We identified a strong relationship between minimum winter temperatures, influenced by growing season length and the distribution of the palm in its native range. Recent climate change strongly coincides with the palm's recent spread into southern Switzerland, which is in concert with the expansion of the global range of palms across various continents.Main conclusions  Our results strongly suggest that the expansion of palms into (semi‐)natural forests is driven by changes in winter temperature and growing season length and not by delayed population expansion. This implies that this rapid expansion is likely to continue in the future under a warming climate. Palms in general, and T. fortunei in particular, are significant bioindicators across continents for present‐day climate change and reflect a global signal towards warmer conditions.
Etudes de tolérances oculaire et cutanée chez le lapin de differents echantillons d'esters d'acides gras
Authors: GUILLOT J. P. , GIAUFFRET J. Y. , MARTINI M. C. , GONNET J. F. , SOULÉ G. 
Published: May 2007

SynopsisDes tests ont été conduits, en complément d'études antérieures (1, 2), sur dés produits commerciaux en provenance de différents fournisseurs. La série examinée comporte sept esters isopropyliques et cinq esters butyliques d'acides gras, assez couramment utilisés en cosmétologie. Les essais de tolérances oculaire et cutanée ont été effectués sur le lapin selon les méthodes officielles francaises, mais avec quelques compléments ou modifications. Les résultats montrent que pratiquement tous les produits, testés à l'état pur, ont provoqué des réactions d'intolérance plus ou moins marquées. Seul un stéarate d'isopropyle (sur deux) semble relativement bien tolére malgré un indice d'irritation cutanée primaire supérieur à 1. Deux esters ont été particulièrement agressifs, puisqu'il a fallu interrompre le traitement après cinq semaines d'applications, ce sont: l'isostéarate d'isopropyle et l'un des deux linoléates d'isopropyle. D'autre part, l'étude de ces matières premières en suspension aqueuse à 10% a permis de mettre en évidence une diminution notable des réactions observées à l'état pur, dans la plupart des cas. Eye and skin irritation tests on the rabbit of several fatty acid esters SummaryContinuing preceding work (1,2), a series of tests has been carried out on the toxicological evaluation of samples of different fatty esters obtained from several manufacturers.Eye irritation tests and skin irritation and sensitisation tests were carried on the rabbit following the official French methods with minor modifications. When tested pure, nearly all the isopropyl and butyl esters used gave some adverse reactions. Only one sample (out of two tested) of isopropyl stearate appeared to be well tolerated although the primary irritation index on skin was greater than one. The two esters with the greatest adverse skin reactions were isopropyl isostearate and one of two isopropyl linoleates.Ten per cent aqueous dispersion showed considerable diminution of the adverse reactions in the majority of the cases.Considering the results obtained in this paper together with those published previously (1) being twenty‐seven samples covering fifteen different fatty esters, the worse reactions were obtained with the C8, C12, C14 saturated together with the oleate and linoleate esters. Isopropyl palmitate, stearyl heptonate and arachidyl propionate were the best tolerated as pure materials.Other adverse reactions were obtained with the isopropyl, butyl and octyl stearates and isostearates (except for one of two isopropyl stearates) and from these results appears that the alcohol moiety plays little part in irritation when compared with the fatty acid chain.Examination of peroxy values indicates that these have a significant adverse effect for oleates and linoleates.
Synthetic hectorite – a new toothpaste binder
Authors: MAYES BARRY J. R. 
Published: May 2007

SynopsisThe use of the synthetic inorganic colloid ‘Laponite’ as a toothpaste binder is reviewed. Variables examined include the effect of polishing agent, humectant type and cellulosic co‐binder. Results indicate that stable pastes may be prepared using a blend of Laponite and sodium carboxymethyl cellulose with a small reduction in overall binder level. The maximum binder reduction is achieved using sorbitol as the sole humectant. A simple comparison test also indicates that flavour level may be reduced by up to 25%. L'hectorite synthetique – un nouveau liant pour dentifrices