bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful blind placement of nasojejunal tubes in paediatric intensive care: impact of training and audit
Authors: Meyer Rosan , Harrison Stephanie , Cooper Mehrengise , Habibi Parviz 
Published: October 2007

AbstractTitle.  Successful blind placement of nasojejunal tubes in paediatric intensive care: impact of training and audit Aim.  This paper is a report of a study to monitor continuing nasojejunal tube placement success rate and to evaluate a training programme for staff placing these tubes at the bedside.Background.  Gastric delivery of enteral feeds is frequently poorly tolerated due to impaired gastric motility in critically ill children. Consequently, there has been an increased interest in the use of the nasojejunal feeding route. Nasojejunal tubes are both safe and well‐tolerated, but placements of these tubes are notoriously difficult and therefore often avoided. Consequently, a blind bedside technique was developed, with a placement success of 96%.Method.  A training programme using this technique was developed for nursing staff on the unit. This included one‐to‐one training of key nurses of the nasojejunal tube placement technique and a supervised nasojejunal placement with either the senior nurse or dietitian. This practice was audited in 100 consecutive patients in 2001 and 2004. Patient demographics, diagnosis, time taken for placement and reasons for unsuccessful placements were documented.Results.  The 2001 audit (n = 100) indicated that the nasojejunal route was used in 19% of all cases, with 1% and 80% of patients fed via the parenteral and nasogastric route respectively. In 2004 (n = 94), 18% of patients were fed via the nasojejunal route, 3% parenterally and 79% via the gastric route. Placement success continued to be between 94·5–95% in 2001 and 2004.Conclusion.  Continued successful placement of blind nasojejunal feeding tubes can be achieved through a well‐monitored education programme, regular audit cycles and multidisciplinary team support.
The impact of team processes on psychiatric case management
Authors: Simpson Alan 
Published: October 2007

AbstractTitle. The impact of team processes on psychiatric case managementAim. This paper is a report of a study to identify the structures and interactions within community mental health teams that facilitate or impede effective teamwork and psychiatric case management.Background. Effective case management requires close collaboration between case managers or care co‐ordinators and other members of the multidisciplinary mental health team, yet there has been little research into this relationship.Method. A multiple case study of seven United Kingdom community mental health teams was conducted between 1999 and 2001, using qualitative methods of participant observation, semi‐structured interviews and document review.Findings. Factors were identified that impacted on the ability of care co‐ordinators to act effectively: ‘structure and procedures’; ‘disrespect and withdrawal’; ‘humour and undermining’; ‘safety and disclosure’. Care co‐ordination was enhanced when team structures and policies were in place and where team interactions were respectful. Where members felt disrespected or undermined, communication, information sharing and collaboration were impaired, with a negative impact on the care provided to service users.Conclusions. Teams require clear operating procedures alongside interprofessional trust and respect to ensure that there is open, safe and reflective participation. Further research is required to identify how best to bring about collaborative, effective teamwork in mental healthcare.
DNA vaccine encoding ESAT‐6 enhances the protective efficacy of BCG against Mycobacterium tuberculosis infection in mice
Authors: Fan X. , Gao Q. , Fu R. 
Published: October 2007

AbstractESAT‐6 is a protein produced by virulent Mycobacterium tuberculosis but absent in Mycobacterium bovis bacillus Calmette–Guerin (BCG) and is considered as a promising vaccine subunit against tuberculosis. The protective efficacy of a new strategy based on the combination of DNA vaccine encoding ESAT‐6 (DNA‐E6) and BCG immunization was investigated in the present study. BALB/c mice were immunized with DNA‐E6, BCG, DNA‐E6 plus BCG, vector plus BCG or vector alone. Three weeks after the last immunization, antigen‐specific interferon (IFN)‐γ secreted upon stimulation with BCG‐PPD or ESAT‐6 protein by splenocytes of the different groups was determined by an ELISA. The immunized mice were challenged intravenously with low‐dose virulent M. tuberculosis H37Rv and bacterial load of the infected mice was measured in the spleen and lung 6 weeks later. Pathological changes in the lung were observed by haematoxylin–eosin (HE) or acid‐fast staining. Our study demonstrated that ESAT‐6‐specific IFN‐γ was improved in mice vaccinated with DNA‐E6 plus BCG, compared with those mice immunized with BCG alone. The combination of DNA‐E6 and BCG resulted in the maximum reduction in bacterial load in both the lung and spleen, and only slight pathological changes were detected in the lung. These results suggested that the combination of DNA‐E6 and BCG vaccination could be a better strategy against M. tuberculosis infections in human.
Worldwide diversity of hair curliness: a new method of assessment
Authors: Loussouarn Geneviève , Garcel Anne‐Lise , Lozano Isabelle , Collaudin Catherine , Porter Crystal , Panhard Ségolène , Saint‐Léger Didier , De La Mettrie Roland 
Published: October 2007

AbstractBackground  For many years, cosmetic scientists have attempted to measure the physical features of human hair, such as its shape and colour, as these can be artificially modified using cosmetic products. With regard to hair shape, previous anthropologic studies have emphasized its variability within and between human ethnic groups. Many studies have broadly distinguished three ethnic human subgroups: African, Asian, and Caucasian. Such a broad classification cannot account for the great complexity of human biological diversity, resulting from multiple, past or recent mixed origins. The verbal description of hair shape ranges from the classic to the more sophisticated, with terms such as straight, wavy, curly, frizzy, kinky, woolly, helical, etc. Although these descriptions evoke a global appearance, they remain confusing as their definitions and limits are unclear. Assessments are therefore required to more accurately define such verbal attributes.Objective  The work reported here attempts to address the following issues: (i) to define hair types according to specific shape criteria through objective and simple measurements; and (ii) to define such hair types without referring to human ethnicity.Methods  Measurements of four parameters related to hair curliness (curve diameter, curl index) or kinking of the hair (numbers of waves, numbers of twists) were performed on hair from 2449 subjects from 22 different countries. Principal components analysis and hierarchical ascendant classification were used to identify homogeneous groups of hair and to determine key variables for the assignment of group membership. Finally, a segmentation tree was prepared in order to establish simple rules for predicting group membership of new subjects.Results and conclusions  This study has shown that it is possible to classify the various hair types found worldwide into eight main groups. The approach involves objective descriptors of hair shape, and is more reliable than traditional methods relying on categories such as curly, wavy, and kinky. Applied to worldwide human diversity, it avoids reference to the putative, unclear ethnic origin of subjects. Briefly, a straight hair type I is just that, and whether it originates from a Caucasian or an Asian subject is not at issue. The hair types defined here also more adequately reflect the large variation of hair shape diversity around the world, and may possibly help to trace past mixed origins amongst human subgroups.
Human hair keratin network and curvature
Authors: Thibaut Sebastien , Barbarat Philippe , Leroy Frederic , Bernard Bruno A. 
Published: October 2007

AbstractBackground  In human hair, very little is known about the substructures relating to the curl pattern. The interpretation of the macroscopic shape of the fiber at the molecular and cellular scales is still unclear.Methods  A comparative and multiscale study was carried out on a set of human hair samples, ranging in shape from straight to tightly curled, in order to investigate structural elements that might be related to hair curl pattern.Results  At the macroscopic level, the frequency and amplitude of cross‐sectional rotations were found to be crucial for an accurate description of curliness. At the cellular level, transmission electron microscopy experiments made it possible to confirm that macrofibril organization was strongly related to hair curliness. The curly hair follicles exhibited retrocurvature, independent of ethnic origin. A direct comparison of straight hair and curly hair highlighted an intrinsic asymmetry in the proliferative compartment that clearly extended above the Auber line on the convex side of the curvature. This phenomenon caused delayed differentiation of both inner and outer root sheaths. The hair cortex itself was elliptical and asymmetric, as evidenced by hHa8 keratin. In curly hair, this hair keratin accumulated on the concave side of the curvature, whereas, in straight hair, positive cortical cells were evenly distributed throughout the circular fiber.Conclusion  The curly shape of the hair shaft seems to result from the asymmetric differentiation of the precortex. Hair fiber can thus be considered as a shape memory material.
Skin cancers at the National University Hospital of Cotonou from 1985 to 2004
Authors: Adegbidi Hugues , Yedomon Hubert , Atadokpede Felix , Balley‐Pognon Marie‐Claire , Do Ango‐Padonou Florencia 
Published: October 2007

AbstractBackground  Skin cancer is the most common form of cancer occurring in adults in Europe and the USA. A low incidence has been reported in the black American population and in Africa, however. This study investigates the incidence of melanoma and epidermoid and basocellular carcinoma at Cotonou in Benin.Methods  Over 20 years, 19 patient records were collected, 16 of which were the subject of a retrospective epidemiologic study.Results  The main characteristic of skin cancer in the Department of Dermatology, Cotonou, Benin was its extreme rarity. The frequency was 0.00066%, with a male to female ratio of 1.28 and a mean age of 54.81 years. The mean ages at diagnosis for epidermoid carcinoma, melanoma, and basocellular carcinoma were 61.66, 59.40, and 54.56 years, respectively. The mean duration of epidermoid carcinoma was 6–10 times longer than that of melanoma and basocellular carcinoma. Of the 16 patients included in the study, five were albinos. In this group, the frequency was 31.25%.Discussion  The extreme rarity of skin cancers in our series cannot be the result of recruitment bias alone. It reflects the actual situation. All of our cases of melanoma were in a plantar location. This inconsistency with other studies is probably a result of the size of our series. The duration of disease in our cases of carcinoma was comparable with the results obtained in a previous study in Dakar, Senegal. In our study, oculocutaneous albinism was the main preneoplastic factor.Conclusion  This study confirms the low incidence of skin cancer in the black population, the fact that basocellular carcinoma affects a relatively young population, and the predilection of melanoma for acral locations in black individuals.
Kaposi's sarcoma in a hospital setting in Lomé (Togo): a study of 93 cases
Authors: Pitche Palokinam T. , Kombate Koussaké , Owono Françoise , Tchangai‐Walla Kissem 
Published: October 2007

AbstractAim  To define the epidemiologic and clinical profile and course of the disease in African Kaposi's sarcoma (KS) and acquired immunodeficiency syndrome (AIDS)‐associated KS in Togo.Methods  This was a retrospective study performed on the medical records of patients seen at the Department of Dermatology, University Hospital of Lomé, Togo from January 1994 to December 2004. The medical records of all patients with KS, who had undergone human immunodeficiency virus (HIV) serology, were included in the study.Results  Ninety‐three files on 98 patients with KS, who had undergone HIV serology, were included in the study. The annual incidence during the study period was 8.5. HIV serology was positive in 73 patients (78.5%) and negative in 20 patients (21.5%). The mean age of the patients with AIDS‐associated KS was 33.8 ± 8.2 years, and 49.5 ± 15.8 years for African KS. The male to female ratio for AIDS‐associated KS was 1.4, and 9 for African KS. The mortality rate at 2 years for African KS was 5%, and 45% for AIDS‐associated KS.Conclusion  The low level of access to antiretroviral drugs in HIV‐infected patients explains the morbidity and mortality from AIDS‐associated KS in Togo.
Strategy for allergenicity assessment of ‘natural novel foods’: clinical and molecular investigation of exotic vegetables (water spinach, hyacinth bean and Ethiopian eggplant)
Authors: Gubesch M. , Theler B. , Dutta M. , Baumer B. , Mathis A. , Holzhauser T. , Vieths S. , Ballmer‐Weber B. K. 
Published: October 2007

Background:  Foods not commonly consumed in the European Union must be proven safe before being brought to market, including an assessment of allergenicity. We present a three‐stepwise strategy for allergenicity assessment of natural novel foods using three novel vegetables, namely, water spinach, hyacinth bean, Ethiopian eggplant.Methods:  First, vegetable extracts were analyzed for the presence of pan‐allergens [Bet v 1 homologous proteins, profilins, nonspecific lipid transfer proteins (LTP)] by immunoblot analysis with specific animal antibodies. Secondly, the IgE‐binding of the food extracts was investigated by EAST (Enzyme‐allergosorbent test) and immunoblot analysis using sera with IgE‐reactivity to known pan‐allergens or to phylogenetically related foods from subjects (i) allergic to birch, grass and mugwort pollen, (ii) with food allergy to soy, peanut, tomato, multiple pollen‐related foods and (iii) sensitized to LTP. Thirdly, the clinical relevance of IgE‐binding was assessed in vivo by skin prick testing (SPT) and open oral food challenges (OFC).Results:  Profilin and LTP were detected by animal antibodies in all vegetables, a Bet v 1 homologue selectively in hyacinth bean. IgE‐binding to LTP, profilin and a Bet v 1 homologue was proven by immunoblot analysis and EAST. Positive SPT and OFC results were observed for all vegetables in pollen‐allergic patients.Conclusions:  Our stepwise procedure confirmed the presence and IgE‐binding capacity of novel vegetable proteins homologous to known allergens in endemic vegetable foods. In vivo testing proved the potential of the novel vegetables to elicit clinical allergy. Hence, our described algorithm seems to be applicable for allergenicity testing of natural novel foods.
Interactions between mature Der p 1 and its free prodomain indicate membership of a new family of C1 peptidases
Authors: Zhang J. , Hamilton J. M. , Garrod D. R. , Robinson C. 
Published: October 2007

Background:  Studies in vivo have shown that the cysteine peptidase activity of group 1 house dust mite allergens contributes to their allergenicity. These allergens are synthesized initially as proenzymes and removal of the propiece is necessary to unmask their proteolytic activity. In related C1 family cysteine peptidases of enzyme clan CA, liberated propieces continue to inhibit the mature peptidase as tight binding inhibitors. As it is not known whether mite peptidase allergens behave similarly, our objective was to investigate the effect of the Der p 1 propiece on the catalytic activity of Der p 1 and Der f 1.Methods:  Enzymatic activity of natural Der p 1 and Der f 1 was assessed using a specific substrate and the effect of the recombinant propiece on its enzyme kinetics defined. The integrity of the propiece during these interactions was studied functionally and by analysis of the reaction mixtures.Results:  Der p 1 propiece was a potent competitive inhibitor of Der p 1 and Der f 1. In contrast to other cysteine peptidase prodomains, which are cognate tight binding inhibitors, the Der p 1 propiece behaves as a substrate and is fully degraded during this interaction.Conclusion:  Mature Der p 1‐prodomain interactions differ from other C1 family cysteine peptidases, suggesting that group 1 mite allergens are a new subgroup among C1 family cysteine peptidases. The rapid inactivation of Der p 1 prodomain is a newly identified mechanism that may contribute to the potency of this allergen.
Randomized, placebo‐controlled trial of Lactobacillus rhamnosus GG as treatment of atopic dermatitis in infancy
Authors: Grüber C. , Wendt M. , Sulser C. , Lau S. , Kulig M. , Wahn U. , Werfel T. , Niggemann B. 
Published: October 2007

Background:  Some studies have suggested that supplementation of food with lactobacilli may prevent or improve atopic dermatitis in children. This study was designed to investigate the therapeutic effect of Lactobacillus rhamnosus GG (LGG) as a food supplement in infants suffering from atopic dermatitis.Methods:  Infants aged 3–12 months suffering from mild‐to‐moderate atopic dermatitis (severity scoring of atopic dermatitis or SCORAD index of 15–40) without current antiinflammatory treatment were randomized to receive LGG (5 × 109 colony forming units b.i.d.) or placebo as a food supplement for 12 weeks. Severity scoring of atopic dermatitis index and use of hydrocortisone 1% ointment as rescue medication (2 points per application) were recorded at 4, 8, and 12 weeks of treatment and combined as symptom load (SL).Results:  Fifty‐four infants (LGG group, mean ± SD SCORAD index 24.6 ± 8.8) and 48 infants (placebo group, SCORAD index 23.6 ± 7.8) were randomized and completed the treatment period (intention‐to‐treat analysis). Symptom load generally improved over time at 4 weeks (LGG vs placebo, 23.8 ± 12.4 vs 20.6 ± 9.9), 8 weeks (22.5 ± 14.6 vs 17.9 ± 13.1), and 12 weeks (19.6 ± 15.4 vs 15.1 ± 12.1), without statistically significant group differences. When stratified for age, eczema severity or use of rescue medication, no statistically significant group differences, in improvement, were found. No significant group differences were found for the use of rescue medication (0.8 ± 45.0 g vs 3.5 ± 29.8 g), increase in mean logarithmic total serum IgE (0.17 ± 0.30 kU/l vs 0.26 ± 0.45 kU/l), and newly developed allergic sensitization against hen’s egg or cow’s milk (18.8%vs 10.0%).Conclusion:  This placebo‐controlled trial showed no therapeutic effect of LGG against mild‐to‐moderate atopic dermatitis in infancy.
Islet autoantibodies are associated with HLA‐DQ genotypes in Han Chinese patients with type 1 diabetes and their relatives
Authors: Wang J.‐P. , Zhou Z.‐G. , Lin J. , Huang G. , Zhang C. , Yang L. , Yuan Y. , Zhou H.‐F. , Zhou M. , Hou C. , Zhou W.‐D. , Peng H. , Hagopian W. A. 
Published: October 2007

AbstractThe objective of this study was to explore the relationship between islet autoantibodies of glutamic acid decarboxylase (GADA), islet antigen‐2A (IA‐2A), insulin autoantibody (IAA), and human leukocyte antigen (HLA)‐DQ genotypes in type 1 diabetes (T1D) patients and their first‐degree relatives (FDRs). Cross‐sectional and case–control study. Four hundred and ninety‐five T1D patients, 419 FDRs, and 376 control subjects in Han Chinese populations were recruited and tested for GADA and IA‐2A, while 71 cases, all FDRs and 300 controls were tested for IAA. The 338 T1D patients (including 187 antibody‐positive and 151 antibody‐negative patients), 173 FDRs and 278 controls were genotyped for HLA‐DQ with polymerase chain reaction sequencing‐based method. Compared with the control, the frequency of DQA1*03‐DQB1*0303, DQA1*05‐DQB1*0201, and DQA1*03‐DQB1*0401 haplotypes was higher (P < 0.05–0.01) but DQA1*0102‐DQB1*0602 haplotype was lower (P < 0.01) in T1D patients. DQA1*03 allele was less in the FDRs than in their probands (P < 0.05). GADA was more prevalent in T1D patients carrying DQA1*05‐DQB1*0201 or DQA1*03‐DQB1*0401 haplotype (55.8% vs 41.0%, 65.5% vs 40.3%, P < 0.05–0.01), whereas IA‐2A presented more in the patients carrying DQA1*03‐DQB1*0303 haplotype (27.0% vs 7.9%, P < 0.05–0.01), both GADA and IA‐2A showed frequently in the patients with DQA1*03‐DQB1*0303/DQA1*05‐DQB1*0201 haplotypes (34.5% vs 9.7%, P < 0.01). GADA positivity was lower in the patients with DQA1*0102‐DQB1*0602 haplotype (16.7% vs 45.9%, P < 0.05). The frequency of IAA was not different between patients with and without susceptible DQ haplotypes (P > 0.05). GADA, IA‐2A or IAA presented frequently in FDRs with DQA1*03‐DQB1*0303 haplotype. The findings in the study indicate that some of specific HLA‐DQA1/‐DQB1 genotypes and haplotypes not only confer susceptibility to T1D but also are associated with the presence of the islet autoantibodies in the Han Chinese population.
Outcomes for women in a flexible sigmoidoscopy‐based colorectal cancer screening programme
Authors: Viiala C. H. , Olynyk J. K. 
Published: October 2007

AbstractBackground:  There are concerns that technical and anatomical factors can reduce the potential benefit of flexible sigmoidoscopy (FS) as a colorectal cancer (CRC) screening tool in women compared with men. Our aim was to review the outcomes for female participants in a community‐based CRC screening project using FS.Methods:  In 1995, a programme of unsedated FS‐based screening of asymptomatic average‐risk individuals aged 55–64 years was established at Fremantle Hospital, Western Australia. Insertion depths, pathological findings and site of adenomas and subject‐rated pain scores have been prospectively recorded. Later diagnoses of malignancy were determined by linkage of the cohort with the West Australian Cancer Registry.Results:  Between 1995 and 2005, 3402 primary screening FS examinations had been carried out (women 41%). Mean age of participants was 59.6 years. Women were more likely to undergo a FS with insertion depth less than 40 cm (17 vs 6%, P < 0.0001). Mean pain score was 2.9 for men and 4.0 for women (P < 0.0001). Women were less likely to have any neoplasia detected, independent of pain score or insertion depth (odds ratio 0.5, 95% confidence interval 0.4–0.6). Increasing insertion depth from 50 to 60 cm in a woman would only have a 0.4% chance of detecting any additional neoplasia. An insignificant trend to higher incidence of later interval CRC was observed in women with normal sigmoidoscopy.Conclusion:  Women probably undergo FS with more discomfort and lesser insertion depth than men. It is unlikely that moderate increases in insertion depth would have a substantial benefit.