bluuebunny/crossref_metadata_2025_split huggingface dataset:
The rapid resolution of depression and anxiety symptoms after lower limb amputation
Authors: Singh Rajiv , Hunter John , Philip Alistair 
Published: September 2007

Objective : To ascertain the course of depressive and anxiety symptoms shortly after amputation and again after a period of inpatient rehabilitation. Design and settings : A cohort study in inpatients admitted to a rehabilitation ward after lower limb amputation. Subjects : One hundred and five successive admissions over a one-year period. Interventions : Nil. Main measures : Hospital Anxiety and Depression Scale (HADS) on admission and discharge with correlation to demographic and patient features. Results : At admission, 28 (26.7%) and 26 (24.8%) patients had symptoms of depression and anxiety respectively. This dropped to 4 (3.8%) and 5 (4.8%) by time of discharge, a mean of 54.3 days later. These reductions were statistically significant, as was the association between patients having symptoms of both depression and anxiety (P < 0.001). Patient stay was longer in those with symptoms (depression, P < 0.03; anxiety P < 0.001). There was no association with level of amputation, success of limb-fitting, age or gender. Depressive symptoms were associated with presence of other medical conditions (P < 0.01) and anxiety scores with living in isolation (P < 0.05). Conclusion : Depression and anxiety are commonly reported after lower limb amputation and previously thought to remain high for up to 10 years. We have found that levels of both depression and anxiety resolve rapidly. It is possible that a period of rehabilitation teaching new skills and improving patient independence and mobility may modify the previous bleak outlook of amputees. This positive finding may be useful in the rehabilitation of even the most distressed of amputees.
Additional exercise for older subacute hospital inpatients to prevent falls: benefits and barriers to implementation and evaluation
Authors: Haines Terry P. , Hill Keith D. , Bennell Kim L. , Osborne Richard H. 
Published: September 2007

Objective: To evaluate the clinical effectiveness and implementation of a falls prevention exercise programme for preventing falls in the subacute hospital setting. Design: Randomized controlled trial, subgroup analysis. Participants: Patients of a metropolitan subacute/aged rehabilitation hospital who were recommended for a falls prevention exercise programme when enrolled in a larger randomized controlled trial of a falls prevention programme. Methods: Participants in both the control and intervention groups who were recommended for the exercise programme intervention were followed for the duration of their hospital stay to determine if falls occurred. Participants had their balance, strength and mobility assessed upon referral for the exercise programme and then again prior to discharge. Participation rates in the exercise programme were also recorded. Results: Intervention group participants in this subgroup analysis had a significantly lower incidence of falls than their control group counterparts (control: 16.0 falls/1000 participant-days, intervention: 8.2 falls/1000 participant-days, log-rank test: P = 0.007). However few differences in secondary balance, strength and mobility outcomes were evident. Conclusion: This exercise programme provided in addition to usual care may assist in the prevention of falls in the subacute hospital setting.
The use of long-term low-molecular weight heparin for the treatment of venous thromboembolism in palliative care patients with advanced cancer: a case series of sixty two patients
Authors: Noble S.I.R. , Hood K. , Finlay I.G. 
Published: September 2007

The advantages of low-molecular weight heparin (LMWH) over warfarin, in the treatment of cancer associated venous thromboembolism (VTE) are well reported. However the studies supporting LMWH include few patients representative of the palliative care population. Although LMWH has advantages over warfarin it is still unclear, within the palliative care environment, how long anticoagulation should be continued, what dose of LMWH should be used and whether palliative care patients experience different complication rates such as bleeding, heparin-induced thrombocytopenia and osteoporosis. We report a case series of 62 patients with advanced malignancy and VTE treated with long-term LMWH according to either the CLOT (full dose) or Monreal (reduced dose) regime. Seventy-four percent of patients self-administered LMWH, whereas 24% had it given by a carer and 2% by the district nurse. LMWH was given for median duration of 97 days; the most common reason for discontinuation of therapy being admission to die or commencement of the care pathway (n = 50, 81%). A further 11% (n = 7) stopped after 6 months of treatment. Of these 3 (43%) developed clinical symptomatic recurrence of VTE. The overall minor bleeding rate was 8.1% (95% confidence interval 3.5—17.5%), and this was not associated with NSAID or steroid use. No major bleeding events were observed. No patients developed evidence of heparin-induced thrombocytopenia or osteoporosis. Long-term LMWH appears effective in treatment of VTE in the palliative care population with advanced cancer. A randomised control trial is required to identify the best dose required to ensure optimum efficacy and safety. Palliative Medicine 2007;21 : 473—476
Stethoscopes: a study of contamination and the effectiveness of disinfection procedures
Authors: Waghorn D.J. , Wan W.Y. , Greaves C. , Whittome N. , Bosley H.C. , Cantrill S. 
Published: September 2007

tethoscopes are universally used by healthcare professionals. They can come into contact with numerous patients and may harbour organisms that can be transferred between individuals. Wycombe hospital has a policy that stethoscopes should be disinfected with a 70% isopropyl alcohol swab after each patient use. A study was undertaken to assess the degree of stethoscope contamination and the effectiveness of the disinfection procedure. A randomly chosen group of healthcare professionals submitted their stethoscopes for microbiological analysis. A selection of ward-based stethoscopes were also tested. Personal stethoscopes were then disinfected with an alcohol wipe and re-sampled. All stethoscopes showed bacterial contamination before disinfection, the highest concentration of organisms being seen on doctors' stethoscopes. Skin flora was grown from all samples and 12% grew Staphylococcus aureus. Following decontamination, bacterial levels were greatly reduced, but three contaminated stethoscopes remained heavily colonised even after the disinfection procedure. Staff need to be made more aware of the need to routinely disinfect stethoscopes correctly between each patient use. The increased placement of bed- or ward-specific stethoscopes needs to be considered.
Using computer technology to deliver an infection control update on hand hygiene
Authors: Columbine A.M. , Wharrad H.J. 
Published: September 2007

Media coverage of life-threatening hospital infections highlights the importance of ongoing infection control education for healthcare workers. Using computer technology to deliver infection control updates to healthcare workers has the advantage of being accessible throughout the 24-hour shift pattern. The update can therefore be undertaken at a time to suit the healthcare worker and their workload. This paper describes the development process required to produce a computer-aided learning (CAL) package on hand hygiene, suitable for use as an infection control update for hospital nurses. It outlines the resources and costs involved and the technical problems encountered in implementation. It was trialled by 12 nurses who found it an enjoyable and acceptable method of updating. It provides useful information and recommendations for other clinical educators, who may be considering this method of update delivery.
CD3+CD4low and CD3+CD8low are induced by HLA-G: novel human peripheral blood suppressor T-cell subsets involved in transplant acceptance
Authors: Naji Abderrahim , Le Rond Solene , Durrbach Antoine , Krawice-Radanne Irene , Creput Caroline , Daouya Marina , Caumartin Julien , LeMaoult Joel , Carosella Edgardo D. , Rouas-Freiss Nathalie 
Published: September 2007

AbstractHLA-G is a tolerogenic molecule whose detection in sera and within allografted tissues is associated with better graft acceptance. HLA-G mediates T-cell differentiation into suppressor cells, which are thought to promote tolerance. Here, we investigated such T cells phenotypically and functionally and assessed their clinical relevance in the peripheral blood of patients who have undergone transplantation. Our results demonstrate that HLA-G expressed by antigen-presenting cells or present as soluble protein down-regulates the expression of CD4 and CD8 on allostimulated T cells at both transcriptional and posttranslational levels. These CD3+CD4low and CD3+CD8low T-cell subsets are characterized by an increased proportion of cells expressing CD45RA and HLA-DR, and a decreased number of cells expressing CD62L. In addition, these HLA-G–induced CD3+CD4low and CD3+CD8low subpopulations are Foxp3-negative suppressor T cells whose function involves IL-10. Biologic relevance came from analysis of patients who underwent transplantation, with high HLA-G plasma concentrations associated with better graft survival. Peripheral blood from these patients contains increased levels of IL-10 concomitantly to an enhanced representation of CD3+CD4low and CD3+CD8low T cells compared with HLA-G–negative patients who underwent transplantation and healthy individuals. These data define novel immunosuppressive subpopulations of peripheral blood T cells induced by HLA-G with potent implications in peripheral tolerance.
Erythropoiesis and iron metabolism in dominant erythropoietic protoporphyria
Authors: Holme S. Alexander , Worwood Mark , Anstey Alexander V. , Elder George H. , Badminton Michael N. 
Published: September 2007

AbstractErythropoietic protoporphyria (EPP) results from deficiency of ferrochelatase (FECH). Accumulation of protoporphyrin IX causes life-long acute photosensitivity. Microcytic anemia occurs in 20% to 60% of patients. We investigated 178 patients with dominant EPP confirmed by molecular analysis. Erythropoiesis was impaired in all patients; all had a downward shift in hemoglobin (Hb), and the mean decreased in males by 12 g/L (1.2 g/dL). By World Health Organization criteria, 48% of women and 33% of men were anemic. Iron stores, assessed by serum ferritin (sFn), were decreased by two-thirds, but normal serum soluble transferrin receptor-1 and iron concentrations suggested that erythropoiesis was not limited by iron supply. FECH deficiency in EPP appears to lead to a steady state in which decreased erythropoiesis is matched by reduced iron absorption and supply. This response may in part be mediated by protoporphyrin, but we found no correlation between erythrocyte protoporphyrin and Hb, sFn, total iron-binding capacity, or transferrin saturation.
The evolution of imprinting: chromosomal mapping of orthologues of mammalian imprinted domains in monotreme and marsupial mammals
Authors: Edwards Carol A , Rens Willem , Clarke Oliver , Mungall Andrew J , Hore Timothy , Graves Jennifer A Marshall , Dunham Ian , Ferguson-Smith Anne C , Ferguson-Smith Malcolm A 
Published: September 2007

Abstract

Background
The evolution of genomic imprinting, the parental-origin specific expression of genes, is the subject of much debate. There are several theories to account for how the mechanism evolved including the hypothesis that it was driven by the evolution of X-inactivation, or that it arose from an ancestrally imprinted chromosome.

Results
Here we demonstrate that mammalian orthologues of imprinted genes are dispersed amongst autosomes in both monotreme and marsupial karyotypes.

Conclusion
These data, along with the similar distribution seen in birds, suggest that imprinted genes were not located on an ancestrally imprinted chromosome or associated with a sex chromosome. Our results suggest imprinting evolution was a stepwise, adaptive process, with each gene/cluster independently becoming imprinted as the need arose.
Apparent survival of the salamander Salamandra salamandra is low because of high migratory activity
Authors: Schmidt Benedikt R , Schaub Michael , Steinfartz Sebastian 
Published: September 2007

Abstract

Background
Understanding the demographic processes underlying population dynamics is a central theme in ecology. Populations decline if losses from the population (i.e., mortality and emigration) exceed gains (i.e., recruitment and immigration). Amphibians are thought to exhibit little movement even though local populations often fluctuate dramatically and are likely to go exinct if there is no rescue effect through immigration from nearby populations. Terrestrial salamanders are generally portrayed as amphibians with low migratory activity. Our study uses demographic analysis as a key to unravel whether emigration or mortality is the main cause of "losses" from the population. In particular, we use the analysis to challenge the common belief that terrestrial salamanders show low migratory activity.

Results
The mark-recapture analysis of adult salamanders showed that monthly survival was high (> 90%) without a seasonal pattern. These estimates, however, translate into rather low rates of local annual survival of only ~40% and suggest that emigration was important. The estimated probability of emigration was 49%.

Conclusion
Our analysis shows that terrestrial salamanders exhibit more migratory activity than commonly thought. This may be due either because the spatial extent of salamander populations is underestimated or because there is a substantial exchange of individuals between populations. Our current results are in line with several other studies that suggest high migratory activity in amphibians. In particular, many amphibian populations may be characterized by high proportions of transients and/or floaters.
Comparison of direct machine parameter optimization versus fluence optimization with sequential sequencing in IMRT of hypopharyngeal carcinoma
Authors: Dobler Barbara , Pohl Fabian , Bogner Ludwig , Koelbl Oliver 
Published: September 2007

Abstract
Background
To evaluate the effects of direct machine parameter optimization in the treatment planning of intensity-modulated radiation therapy (IMRT) for hypopharyngeal cancer as compared to subsequent leaf sequencing in Oncentra Masterplan v1.5.

Methods
For 10 hypopharyngeal cancer patients IMRT plans were generated in Oncentra Masterplan v1.5 (Nucletron BV, Veenendal, the Netherlands) for a Siemens Primus linear accelerator.
For optimization the dose volume objectives (DVO) for the planning target volume (PTV) were set to 53 Gy minimum dose and 59 Gy maximum dose, in order to reach a dose of 56 Gy to the average of the PTV. For the parotids a median dose of 22 Gy was allowed and for the spinal cord a maximum dose of 35 Gy. The maximum DVO to the external contour of the patient was set to 59 Gy. The treatment plans were optimized with the direct machine parameter optimization ("Direct Step & Shoot", DSS, Raysearch Laboratories, Sweden) newly implemented in Masterplan v1.5 and the fluence modulation technique ("Intensity Modulation", IM) which was available in previous versions of Masterplan already. The two techniques were compared with regard to compliance to the DVO, plan quality, and number of monitor units (MU) required per fraction dose.

Results
The plans optimized with the DSS technique met the DVO for the PTV significantly better than the plans optimized with IM (p = 0.007 for the min DVO and p < 0.0005 for the max DVO). No significant difference could be observed for compliance to the DVO for the organs at risk (OAR) (p > 0.05). Plan quality, target coverage and dose homogeneity inside the PTV were superior for the plans optimized with DSS for similar dose to the spinal cord and lower dose to the normal tissue. The mean dose to the parotids was lower for the plans optimized with IM. Treatment plan efficiency was higher for the DSS plans with (901 ± 160) MU compared to (1151 ± 157) MU for IM (p-value < 0.05).
Renormalization of the IM plans to the mean of the dose to 95% of the PTV (D95) of the DSS plans, resulted in similar target coverage and dose to the parotids for both strategies, at the cost of a significantly higher dose to the normal tissue and maximum dose to the target. The relative volume of the PTV receiving 107% or more of the prescription dose V107 increased to 35.5% ± 20.0% for the IM plan as compared to a mean of 0.9% ± 0.9% for the DSS plan.

Conclusion
The direct machine parameter optimization is a major improvement compared to the fluence modulation with subsequent leaf sequencing in Oncentra Masterplan v1.5. The resulting dose distribution complies better with the DVO and better plan quality is achieved for identical specification of DVO. An additional asset is the reduced number of MU as compared to IM.
Tramiprosate, a drug of potential interest for the treatment of Alzheimer's disease, promotes an abnormal aggregation of tau
Authors: Santa-Maria Ismael , Hernández Félix , Del Rio Joaquín , Moreno Francisco J , Avila Jesús 
Published: September 2007

Abstract
Alzheimer's disease (AD) is characterized by the presence of two histopathological hallmarks; the senile plaques, or extracellular deposits mainly composed of amyloid-β peptide (Aβ), and the neurofibrillary tangles, or intraneuronal inclusions composed of hyperphosphorylated tau protein.
Since Aβ aggregates are found in the pathological cases, several strategies are under way to develop drugs that interact with Aβ to reduce its assembly. One of them is 3-amino-1-propane sulfonic acid (Tramiprosate, 3-APS, Alzhemed™), that was developed as a sulfated glycosaminoglycan mimetic, that could interact with Aβ peptide, preventing its aggregation.
However, little is known about the action of 3-APS on tau protein aggregation. In this work, we have tested the action of 3-APS on cell viability, microtubule network, actin organization and tau aggregation. Our results indicate that 3-APS favours tau aggregation, in tau transfected non-neuronal cells, and in neuronal cells. We also found that 3-APS does not affect the binding of tau to microtubules but may prevent the formation of tau-actin aggregates. We like to emphasize the importance of testing on both types of pathology (amyloid and tau) the potential drugs to be used for AD treatment.
Genome wide expression analysis in HPV16 Cervical Cancer: identification of altered metabolic pathways
Authors: Pérez-Plasencia Carlos , Vázquez-Ortiz Guelaguetza , López-Romero Ricardo , Piña-Sanchez Patricia , Moreno José , Salcedo Mauricio 
Published: September 2007

AbstractBackgroundCervical carcinoma (CC) is a leading cause of death among women worldwide. Human papilloma virus (HPV) is a major etiological factor in CC and HPV 16 is the more frequent viral type present. Our aim was to characterize metabolic pathways altered in HPV 16 tumor samples by means of transcriptome wide analysis and bioinformatics tools for visualizing expression data in the context of KEGG biological pathways.ResultsWe found 2,067 genes significantly up or down-modulated (at least 2-fold) in tumor clinical samples compared to normal tissues, representing ~3.7% of analyzed genes. Cervical carcinoma was associated with an important up-regulation of Wnt signaling pathway, which was validated by in situ hybridization in clinical samples. Other up-regulated pathways were those of calcium signaling and MAPK signaling, as well as cell cycle-related genes. There was down-regulation of focal adhesion, TGF-β signaling, among other metabolic pathways.ConclusionThis analysis of HPV 16 tumors transcriptome could be useful for the identification of genes and molecular pathways involved in the pathogenesis of cervical carcinoma. Understanding the possible role of these proteins in the pathogenesis of CC deserves further studies.
Interference by new-generation mobile phones on critical care medical equipment
Authors: van Lieshout Erik Jan , van der Veer Sabine N , Hensbroek Reinout , Korevaar Johanna C , Vroom Margreeth B , Schultz Marcus J 
Published: September 2007

Abstract
Introduction
The aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care medical equipment.

Methods
EMI was assessed with two General Packet Radio Service (GPRS) signals (900 MHz, 2 W, two different time-slot occupations) and one Universal Mobile Telecommunications System (UMTS) signal (1,947.2 MHz, 0.2 W), corresponding to maximal transmit performance of mobile phones in daily practice, generated under controlled conditions in the proximity of 61 medical devices. Incidents of EMI were classified in accordance with an adjusted critical care event scale.

Results
A total of 61 medical devices in 17 categories (27 different manufacturers) were tested and demonstrated 48 incidents in 26 devices (43%); 16 (33%) were classified as hazardous, 20 (42%) as significant and 12 (25%) as light. The GPRS-1 signal induced the most EMI incidents (41%), the GRPS-2 signal induced fewer (25%) and the UMTS signal induced the least (13%; P < 0.001). The median distance between antenna and medical device for EMI incidents was 3 cm (range 0.1 to 500 cm). One hazardous incident occurred beyond 100 cm (in a ventilator with GRPS-1 signal at 300 cm).

Conclusion
Critical care equipment is vulnerable to EMI by new-generation wireless telecommunication technologies with median distances of about 3 cm. The policy to keep mobile phones '1 meter' from the critical care bedside in combination with easily accessed areas of unrestricted use still seems warranted.
Phosphorus Segregation and Intergranular Embrittlement in Thermally Aged and Neutron Irradiated Reactor Pressure Vessel Steels
Authors: Nishiyama Yutaka , Onizawa Kunio , Suzuki Masahide 
Published: September 2007

Abstract
A study on phosphorus (P) segregation at grain boundaries and intergranular embrittlement of reactor pressure vessel steels due to thermal aging and neutron irradiation has been performed for A533B steel plates and weld metals doped with different bulk levels of P. The initial P concentration at grain boundaries of these materials determined by scanning Auger microscopy ranged from 9 to 33 %. The materials thermally aged at temperatures ranging from 450 to 550°C for up to 10000 h exhibited increases in P concentration described by the McLean’s equation. A linear correlation was obtained between P concentration and Charpy 41 J transition temperature (T41J). Fracture toughness tests in the ductile-to-brittle transition temperature region have been conducted by the Master Curve method using 1T-CT specimens. The material subject to intergranular embrittlement exhibited the dual fracture toughness distributions typically observed in inhomogeneous materials. This was probably due to two types of initiation of cleavage and intergranular fracture. The lower tail analysis based on the Master Curve method enabled conservative fracture toughness estimates by fitting the lower fracture toughness arising from intergranular fracture. The relation between median KJc values estimated from the lower tail analysis and temperature appeared to follow the Master Curve. For neutron irradiated materials up to a fluence of 6.9×1019 n/cm2 (E&gt;1 MeV) at 290°C by the Japan Materials Testing Reactor, an increase in grain boundary P segregation associated with decrease in carbon segregation was observed with increasing fluence. Relative significant hardening was recognized for the material with high bulk P content. Shifts in the reference temperature T0 and T41J were comparable for the thermally aged and irradiated materials.