bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications after type one thyroplasty: is day-case surgery feasible?
Authors: Bray D , Young J P , Harries M L 
Published: April 2008

AbstractObjectives and hypothesis:Isshiki type one medialisation thyroplasty is an accepted treatment for a unilateral immobile vocal fold. It can also be performed simultaneously as a bilateral procedure in patients with severe bowing of the vocal folds (e.g. presbyphonia). The objectives of this study were to assess the incidence and timing of post-operative complications, and to evaluate whether patients undergoing this operation could, in future, be treated as day cases.Study design and methods:A retrospective analysis was undertaken of 57 consecutive patients who had undergone a type one thyroplasty (52 unilateral and five bilateral) at a tertiary referral centre between April 2003 and April 2006. Post-operative improvement in the voice (measured subjectively, perceptually and quantitatively) was considered to constitute a successful outcome. Any complications were documented.Results:Fifty-seven patients who had undergone laryngeal framework surgery were recruited from the study database. All of these patients had undergone either unilateral or bilateral type one medialisation thyroplasty but no arytenoid surgery. Thirty-seven were male (65 per cent) and 20 female (35 per cent), and there was left-sided predominance (74 per cent). All patients were discharged the morning following afternoon surgery (i.e. within 24 hours). Complications occurred in four patients (7 per cent). One patient, who was taking warfarin, developed a post-operative haematoma which resolved with conservative treatment. Two patients (both of whom had undergone revision thyroplasty) developed a wound infection three days post-operatively, which resolved with antibiotics. One patient returned with hoarseness five months post-operatively, after an initially successful result. This patient had previously received radiotherapy for early glottic carcinoma, and the Silastic® implant was eroding through the mucosa. This was subsequently removed under general anaesthesia. No patients developed complications leading to airway compromise.Conclusion:The only complications in this series were in patients taking anticoagulation medication, undergoing revision surgery, or in whom the laryngeal tissue was atrophic or absent. Careful patient selection to exclude any of the above should reduce the risk of complications. The authors would therefore advocate type one thyroplasty for unilateral or bilateral vocal fold paralysis as a suitable procedure for day-case surgery within our department.
Stable contour-following control of wheeled mobile robots
Authors: Toibero Juan Marcos , Roberti Flavio , Carelli Ricardo 
Published: April 2008

SUMMARYThis paper presents a continuous wall-following controller for wheeled mobile robots based on odometry and distance information. The reference for this controller is the desired distance from the robot to the wall and allows the robot to follow straight wall contour as well as smoothly varying wall contours by including the curvature of the wall into the controller. The asymptotic stability of the control system is proved using a Lyapunov analysis. The controller is designed so as to avoid saturation of the angular velocity command to the robot. A novel switching scheme is also proposed that allows the robot to follow discontinuous contours allowing the robotic system to deal with typical problems of continuous wall-following controllers such as open corners and possible collisions. This strategy overcomes these instances by switching between dedicated behavior-based controllers. The stability of the switching control system is discussed by considering Lyapunov concepts. The proposed control systems are verified experimentally in laboratory and office environments to show the feasibility and good performance of the control algorithms.
Nursing home performance in resident care in the United States: is it only a matter of for-profit versus not-for-profit?
Authors: DECKER FREDERIC H. 
Published: April 2008

Abstract:Poorer resident care in US for-profit relative to not-for-profit nursing homes is usually blamed on the profit motive. But US nursing home performance may relate to Medicaid public financing in a manner qualifying the relationship between ownership and quality. We investigated effects of Medicaid resident census, Medicaid payment, and occupancy on performance. Resource dependence theory implies these predictors may affect discretion in resources invested in resident care across for-profit and not-for-profit facilities. Models on physical restraint use and registered nurse (RN) staffing were studied using generalized estimating equations with panel data derived from certification inspections of nursing homes. Restraint use increased and RN staffing levels decreased among for-profit and not-for-profit facilities when the Medicaid census increased and Medicaid payment decreased. Interaction effects supported a theory that performance relates to available discretion in resource allocation. Effects of occupancy appear contingent on the dependence on Medicaid. Poorer performance among US for-profit nursing homes may relate to for-profit homes having lower occupancy, higher Medicaid census, and operating in US states with lower Medicaid payments compared to not-for-profit homes. Understanding the complexity of factors affecting resources expended on resident care may further our understanding of the production of quality in nursing homes, whether in the US or elsewhere.
Transforming growth factor-beta 1 (tgf-&946;1) induces angiogenesis through vascular endothelial growth factor (vegf)-mediated apoptosis
Authors: Ferrari Giovanni , Cook B , Terushkin Vitaly , Pintucci Giuseppe , Mignatti Paolo 
Published: April 2008

AbstractVEGF and TGF-[beta]1 induce angiogenesis but have opposing effects on endothelial cells. VEGF protects endothelial cells from apoptosis; TGF-[beta]1 induces apoptosis. We have previously shown that VEGF / VEGF receptor-2 (flk-1) signaling mediates TGF-[beta]1 induction of apoptosis. This finding raised an important question: Does this mechanism stimulate or inhibit angiogenesis? Here we report that VEGF-mediated apoptosis is required for TGF-[beta]1 induction of angiogenesis. In vitro the apoptotic effect of TGF-[beta]1 on endothelial cells is rapid and followed by a long period in which the cells are refractory to apoptosis induction by TGF-[beta]1. Inhibition of VEGF / flk-1 signaling abrogates formation of vessel-like structures by TGF-[beta]1 with an effect comparable to that of z-VAD, an apoptosis inhibitor. Similarly, genetic deficiency of VEGF abolishes TGF-[beta]1 upregulation of endothelial cell differentiation and formation of vascular structures in embryoid bodies. In vivo TGF-[beta]1 induces endothelial cell apoptosis as rapidly as in vitro. Inhibition of VEGF blocks TGF-[beta]1 induction of both apoptosis and angiogenesis, an effect similar to that of z-VAD. Thus, TGF-[beta]1 induction of angiogenesis requires rapid and transient endothelial cell apoptosis mediated by VEGF/flk-1. This novel, unexpected role of VEGF and flk-1 indicates VEGF-mediated apoptosis as a potential target to control angiogenesis.
Alcohol and Primary Care
Authors: Bolland Will 
Published: April 2008

In most countries and cultures of the world, alcohol consumption is tolerated and commonplace. In the UK, alcohol is an integral feature of many aspects of British culture. However, the consumption of alcohol is a major public health issue: 90% of the alcohol-related work in the NHS occurs in primary care—with 259 million alcohol-related consultations each year in the UK Alcohol misuse is associated with around 150 000 hospital admissions each year Around 70% of Accident and Emergency Department attendances between midnight and 5 am on weekend nights are alcohol related Between 15 000 and 22 000 deaths each year are associated with alcohol misuse, mainly resulting from stroke, cancer, liver disease, accidental injury or suicide 360 000 incidents of domestic violence are linked with alcohol misuse, around a third of all domestic violence Half of all violent crimes are alcohol related Up to 17 million days absent from work are alcohol-related. The overall cost burden to the NHS from alcohol-related problems is calculated to be £1.7 billion, and the loss to the economy due to premature death from alcohol misuse is estimated to be ∼ £2.4 billion each year. However, the annual revenue to the Treasury in alcohol duties and VAT totals £13.3 billion. In recent years, official statistics have shown a sharp rise in alcohol consumption, both in terms of overall per capita consumption and an increased prevalence of hazardous and harmful patterns of drinking, notably among women and young people. It was in response to this situation that the government published the Alcohol Harm Reduction Strategy for England in 2004.
What helps when it hurts: children's views on pain relief
Authors: Franck L. S. , Sheikh A. , Oulton K. 
Published: April 2008

AbstractBackground  Previous studies have focused on children's views of sources of pain and only secondarily explored their views on pain‐relief strategies.Methods  An exploratory cross‐sectional descriptive design and ‘draw and write’ technique were used to investigate what children think helps them when they have pain.Results  The sample (n = 71) was comprised of 33% boys and 67% girls, with an age range of 4–16 years (mean ± SD: 9.25 ± 3.04). Four overarching themes were derived that were common to both the texts and drawings: ‘People who help’, ‘What I do that helps’, ‘What other people do that helps’ and ‘Things that help’. Children also described their emotional reactions to pain or pain relief. Multiple themes were represented in most of the texts and drawings. There were few differences in the themes present in the children's texts and drawings based on developmental age and no differences based on gender.Conclusions  Children across the three developmental age groups view themselves as active agents in pain relief. Although less than half of the children described specific behaviours they had taken, almost all children indicated their active role as the central figure in relation to use of objects or the actions of others.
Serum testosterone and bioavailable testosterone correlate with age and body size in hypogonadal men treated with testosterone undecanoate (1000 mg IM – Nebido®)
Authors: Moisey Robert , Swinburne Julie , Orme Steve 
Published: April 2008

SummaryObjective  To investigate the loading regimen for intramuscular (IM) testosterone undecanoate (Nebido®) to determine whether testosterone and bioavailable testosterone levels achieved correlate with age or body size of subjects studied.Design  Retrospective observational study of testosterone naïve patients and patients previously treated with an alternative testosterone therapy.Patients  51 hypogonadal men (35, 68·6% secondary hypogonadism). 8 (16%) had not previously received testosterone therapy.Measurements  Patients received an IM injection of Nebido (1000 mg) at baseline and a second injection after 6 weeks. Serum was assayed at baseline and 18 weeks after commencing Nebido for total testosterone (TT) and SHBG. Bioavailable testosterone was calculated (cBioT) using TT and SHBG. Measurements were taken for weight, body mass index (BMI) and body surface area (BSA).Results  Baseline TT (mean 11·5 nmol/l, range 0·3–54·8) increased by 50% after commencing Nebido (17·2 nmol/l (5·4–32·8), P = 0·0001). 75% of subjects had a TT within the reference range (8·0–25·0 nmol/l). Subjects with primary hypogonadism had a higher 18‐week TT [20·9 nmol/l (9·8–32·8) vs. 15·5 (5·4–32·6), P = 0·02] and SHBG [39·2 nmol/l (11–82) vs. 25·7 (9·0–60·0), P = 0·003] although the cBioT was not significantly different [4·9 nmol/l (2·9–7·3) vs. 4·2 (2·0–7·9), P = 0·12]. The 18‐week TT positively correlated with age (R = 0·36, P = 0·01) and negatively correlated with weight (R = –0·38, P = 0·006), BMI (R = –0·42, P = 0·002) and BSA (R =–0·38, P = 0·007). Similarly cBioT correlated with age (R = 0·28, P = 0·04), weight (R = –0·29, P = 0·03), BMI (R = –0·30, P = 0·03) and BSA (R = –0·27, P = 0·05). Age (t = 2·04, P = 0·05) and baseline testosterone (t = –9·26, P < 0·0001) were independent variables of the increase in TT at 18 weeks.Conclusion  This starting regimen is simple and provides the majority of men with a TT within the reference range. Age and baseline TT are independent variables of the increase in TT with IM testosterone undecanoate. At week 18 age and body size correlated with the cBioT and TT and this may then be used to estimate dosing frequency for this therapy.
New mutation type in pseudohypoparathyroidism type Ia
Authors: Fernandez‐Rebollo Eduardo , Barrio Raquel , Pérez‐Nanclares Gustavo , Carcavilla Atilano , Garin Intza , Castaño Luis , De Nanclares Guiomar Pérez 
Published: April 2008

SummaryContext  The GNAS gene encodes the α‐subunit of the stimulatory G proteins, which play a crucial role in intracellular signal transduction of peptide and neurotransmitter receptors. Heterozygous inactivating maternally inherited mutations of GNAS (including translation initiation mutations, amino acid substitutions, nonsense mutations, splice site mutations and small insertions or deletions) lead to a phenotype in which Albright hereditary osteodystrophy is associated with pseudohypoparathyroidism type Ia.Objective  We sought to identify the molecular defect in a patient who was thought to have PHP‐Ia.Methods and results  The GNAS gene of a 5‐year‐old boy with brachydactily, mental retardation, pseudohypoparathyroidism and congenital hypothyroidism was investigated. We found a heterozygous inversion of exon 2 and part of intron 1 of de novo origin. Molecular studies of cDNA from blood RNA demonstrated that both the normal and the mutant variants were stable and that new splice‐sites were generated.Conclusion  This report demonstrates the first evidence for an inversion at the GNAS gene responsible of pseudohypoparathyroidism type Ia.
CD14 contributes to pulmonary inflammation and mortality during murine tuberculosis
Authors: Wieland Catharina W. , Van Der Windt Gerritje J. W. , Wiersinga W. Joost , Florquin Sandrine , Van Der Poll Tom 
Published: April 2008

SummaryToll‐like receptors play an essential role in the innate recognition of micro‐organisms by the host. CD14 is one of the extracellular adaptor proteins required for recognition of Gram‐negative bacteria and possibly also Mycobacterium tuberculosis. Therefore, we intranasally infected wild‐type (WT) and CD14 knock‐out (KO) mice with virulent M. tuberculosis H37Rv. We found no differences in bacterial load in the main target organ lung up to 32 weeks after infection. From 20 weeks onward 57% of WT mice succumbed, whereas all CD14 KO mice survived. The improved outcome of CD14 KO mice was accompanied by reduced pulmonary inflammation; lung cell counts and percentage of inflamed lung tissue were reduced in CD14 WT mice. These data suggest that during chronic infection CD14 KO mice are protected from lethality caused by lung tuberculosis because of a reduction of the inflammatory response.
Combining individual interviews and focus groups to enhance data richness
Authors: Lambert Sylvie D. , Loiselle Carmen G. 
Published: April 2008

AbstractTitle.  Combining individual interviews and focus groups to enhance data richness. Aim.  This paper is a presentation of the critical reflection on the types of findings obtained from the combination of individual interviews and focus groups, and how such triangulation contributes to knowledge production and synthesis.Background.  Increasingly, qualitative method triangulation is advocated as a strategy to achieve more comprehensive understandings of phenomena. Although ontological and epistemological issues pertaining to triangulation are a topic of debate, more practical discussions are needed on its potential contributions, such as enhanced data richness and depth of inquiry.Method.  Data gathered through individual interviews and focus groups from a study on patterns of cancer information‐seeking behaviour are used to exemplify the added‐value but also the challenges of relying on methods combination.Findings.  The integration of focus group and individual interview data made three main contributions: a productive iterative process whereby an initial model of the phenomenon guided the exploration of individual accounts and successive individual data further enriched the conceptualisation of the phenomenon; identification of the individual and contextual circumstances surrounding the phenomenon, which added to the interpretation of the structure of the phenomenon; and convergence of the central characteristics of the phenomenon across focus groups and individual interviews, which enhanced trustworthiness of findings.Conclusion.  Although the use of triangulation is promising, more work is needed to identify the added‐value or various outcomes pertaining to method combination and data integration.
Governmentality, student autonomy and nurse education
Authors: Darbyshire Chris , Fleming Valerie E.M. 
Published: April 2008

AbstractTitle.  Governmentality, student autonomy and nurse education. Aim.  This paper is a report of a study to explore how governmental practices operated in nurse education.Background.  Since the 1980s nurse education internationally has been strongly influenced by educational theories that aim to promote student autonomy by encouraging self‐direction and critical thinking. Newer curriculum models advocate transformative approaches leading to greater emancipation, social equity and inclusion. Although these changes have been positively evaluated there had been limited critical research on how student behaviour is governed.Method.  A discourse analytic study was conducted from 2000 to 2004 using interviews (n = 30) with a purposive sample students and teachers in one United Kingdom university. Data were also collated from the course curriculum and student handbook for the students’ programme. Data were analysed to identify how student behaviour is governed.Findings.  Two governing practices are described: control and technologies of the self. These practices contribute to an overall system of governing student behaviour that creates tension between the avowed progressive empowerment discourse and taken for granted everyday educational practices. Students are subjected to a range of governmental and disciplinary strategies and, through a process of normalization, ultimately become their own supervisors within the system.Conclusion.  The tensions between the demands of a professional outcome‐based nursing programme and notions of empowerment and student autonomy have not been resolved. Instead, present educational practice is characterized by normalizing discursive practices that aim to produce a specific version of a student subject as autonomous learner. Thus, discourses of both empowerment and professional behaviour govern students.
Can patient lifestyle influence the management of pain?
Authors: Wilson Benita 
Published: April 2008

Aim.  The aim of this study was to explore whether a patient's lifestyle influences nurses’ pain assessment and management decisions.Background.  Nurses’ inferences of physical pain are thought to be affected by a matrix of implicit assumptions that operate without effort and thought, motivating behaviour and guiding reactions in the clinical setting. Studies have demonstrated how patient characteristics not only influence assessment but also the nurse's choice of pain management.Design.  One of two patient scenarios was employed in a self‐administered questionnaire that also addressed pain knowledge, inferences of physical pain, general attitudes and beliefs about pain management. The variable lifestyle/socio‐economic status (SES) of the patient was manipulated; all other patient variables were kept constant. The participants were then required to identify the patient's pain level and make pain management decisions.Method.  One hundred questionnaires were distributed and 86 were returned. Following selection of the sample, 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data analysis was carried out using SPSS and qualitative analysis of the written responses.Results.  Both the specialist and general nurses differentiated between the patients in the scenarios, influencing their decisions to acknowledge the patient's self‐report and choice of pain management. However, both patients were undermedicated with the nurses identifying undue concern about addiction and respiratory depression.Conclusion.  The findings lend direct support to the proposal that a patient's lifestyle/SES can affect nurses’ pain management behaviours.Relevance to clinical practice.  It is proposed that schemas induce bias that then influence nurses’ inferences of patients’ physical pain and management decisions; this is compounded by the myths about addiction and respiratory depression. It would appear that educational and clinical experiences fail to ameliorate the affects of bias and myth.
Processing of the circumsporozoite protein in infected hepatocytes is not dependent on aspartic proteases
Authors: BONGFEN S. E. , BALAM S. , TORGLER R. , ROMERO J. F. , CORRADIN G. 
Published: April 2008

SUMMARY CD8+ T cells play a major role in the protective immune response against the liver stage of malaria. It was previously shown that the circumsporozoite protein (CSP) is processed and presented to specific T cells by both traversed and infected hepatocytes, but their respective antigen processing requirements were not completely defined. In the present study, we show that in vitro processing of the Plasmodium berghei CSP by infected mouse primary hepatocytes is exclusively dependent on proteasomes, while aspartic proteases are also needed in the case of traversed hepatocytes.
The effects of allergens in outdoor air on both atopic and nonatopic subjects with airway disease
Authors: Burney P. G. J. , Newson R. B. , Burrows M. S. , Wheeler D. M. 
Published: April 2008

Background:  Reports on air pollution and asthma exacerbations have been inconsistent, although effects of airborne allergen can be spectacular. With no generalized test for allergen in air, it is not known how far allergen is responsible for nonepidemic exacerbations of the disease.Methods:  Two hundred and ninety‐seven patients using bronchodilators aged 18–64 years attending a London practice provided serum samples and were asked to report any acute respiratory events over the coming months. Small particles with a mean aerodynamic diameter <10 μm (PM10) were collected using a high volume sampler on the roof of the practice. The ability of airborne particles to bind IgE from the patients was compared for particles sampled on the weekend before their reported exacerbation with particles sampled on the weekend 2 weeks before or after.Results:  Exacerbations were associated with a 25% increase in IgE binding to particles collected on the previous weekend compared with the control weekends (95% confidence interval: 10–43%; P = 0.00089). This increase was not higher in patients with positive skin tests or in those sensitized to grass or tree pollens.Conclusions:  Airborne allergen is an important cause of exacerbations even in those with ‘intrinsic’ asthma. It is important to identify the allergens responsible, as some of these may be controllable. Interpretation of associations of asthma exacerbations with other air pollutants is difficult in the light of these findings.