bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-tonsillectomy haemorrhage: a prospective, randomized, controlled clinical trial of cold dissection versus bipolar diathermy dissection
Authors: Haddow K , Montague M-L , Hussain S S M 
Published: January 2006

Objective: To determine whether bipolar dissection tonsillectomy is associated with a higher post-operative haemorrhage rate than cold dissection tonsillectomy.Design: Prospective, randomized, controlled trial.Setting: Otolaryngology department of a teaching hospital.Participants: Two hundred and forty-five patients undergoing elective tonsillectomy between July 2002 and November 2004.Interventions: Patients were randomly assigned to either bipolar dissection or cold dissection (with bipolar haemostasis).Main outcome measures: Post-operative haemorrhage rates, management (conservative or surgical) and blood transfusion requirements were recorded. The grade of surgeon and history of quinsy were also recorded.Results: One hundred and forty-one patients (58 per cent) were randomized to the bipolar dissection and 104 (42 per cent) to the cold dissection groups. Seventeen patients (12.1 per cent) in the bipolar dissection group and eight patients (7.7 per cent) in the cold dissection group suffered haemorrhage (p = 1.0; degrees of freedom (Df) 0.0; 95 per cent confidence intervals (CI) −0.1 to 0.0). The haemorrhage rates for procedures conducted by senior house officers, specialist registrars and consultants were 11.4 per cent, 10.3 per cent and 5.0 per cent, respectively. Two patients required surgical intervention, both from the bipolar dissection group. No patients required blood transfusion. A history of quinsy was not associated with an increased haemorrhage rate.Conclusion: The difference in haemorrhage rates between groups and surgeon grades did not reach statistical significance. Nonetheless the trend towards a greater incidence of haemorrhage in the bipolar group and in procedures conducted by more junior surgeons during the trial raised concerns. The results of the National Prospective Tonsillectomy Audit and our interim results have led us to abandon the trial and disallow the use of bipolar dissection in tonsillectomies performed by junior staff members.
Making Something of Nothing: The Excesses of Storytelling in the
Lais
of Marie de France and
La Chastelaine de Vergi
Authors: Ramm Ben 
Published: January 2006

Abstract

The notion of exemplarity in literary texts is beset by irony and paradox, for the example must serve the dual and contrary functions of being both a one-off and also a paradigm to be copied. This article seeks to explore ways in which a ‘tactic of exemplarity’ at work in the text seizes upon the inherent ambiguity of the example in order to question the purpose and indeed the very viability of an exemplary narrative. The discussion focuses on two Old French texts which share common narrative material and employ this ‘tactic of exemplarity’: the twelfth-century Anglo-Norman
Lais
, attributed to Marie de France, and the anonymous thirteenth-century poem
La Chastelaine de Vergi
. Through analysis of the texts' narrative framework—their prologues and/or epilogues—it is argued that a fundamental disparity emerges between the proclaimed didacticism of the narrative example and the way in which that example is then (not) worked through the text. The example is constituted by these texts as an absence or narrative hiatus, suggesting that the example represents a fundamental aporia in the text, and that any claim to exemplarity necessarily implies a problematic narrative standpoint which leaves itself open to deconstruction.
The Meaning Beyond the Dress: Alterity and Economy of Desire in Mallarmé's
Berthe Morisot
Authors: Anderson Jill 
Published: January 2006

Abstract

This essay explores Mallarmé's late prose text
Berthe Morisot
,

1

the preface to the catalogue of the 1896 posthumous exhibition. Morisot was one of Mallarmé's privileged others. Their relationship sheds light on the economy of desire and evolving cultural practice in two major figures of late nineteenth-century France. I aim to show how poet and painter came to speak the same language via a remarkable intercultural and gender exchange. The narrator's relational self hides behind the dispassionate art historian's mask, yet emerges in unexpected ways.

This elegiac text stages an eroticized encounter with a feminine alter ego that takes on broader significance, a ‘symptom’ of the foreign that disrupts and enriches French culture. Speaking as an outsider, yet clearly implicated, Mallarmé's narrator moves from the intimate to public sphere and from the foreign to the national. The poet recovers a marginalized, private form of discourse, previously eschewed, to forge
une poésie à côté de la loi
such as Kahn had wished, revealing the passionate attachment to the other generally erased for ideological reasons. Ostensibly evacuated from Mallarmé's poetic practice as fitting only for autobiography,
le sentiment
, purified according to Morisot's definition, is conveyed in a language of restrained sensuality.
Neogene supradetachment basin development on Crete (Greece) during exhumation of the South Aegean core complex
Authors: van Hinsbergen Douwe J. J. , Meulenkamp Johan E. 
Published: January 2006

ABSTRACTTertiary extension in the Aegean region has led to extensional detachment faulting, along which metamorphic core complexes were exhumed, among which is the Early to Middle Miocene South Aegean core complex. This paper focuses on the supradetachment basin developed during the final stages of exhumation of the South Aegean core complex along the Cretan detachment, plus the Late Miocene to Pliocene basin development and palaeogeography associated with the southward motion of Crete during the opening of the Aegean arc. For the latter purpose, the sedimentary and palaeobathymetric evolutions of a large number of Middle Miocene to Late Pliocene sequences exposed on Crete, Gavdos and Koufonisi were studied. The supradetachment basin development of Crete is characterised by a break‐up of the hanging wall of the Cretan detachment into extensional klippen and subsequent migration of laterally coexisting sedimentary systems, and finally the deformation of the exhumed core complex by processes related to the opening of the Aegean arc. Hence, three main tectonic phases are recognised: (1) Early to Middle Miocene N–S extension formed during the Cretan detachment, exhumed in the South Aegean core complex. The Cretan detachment remained active until 11–10 Ma, based on the oldest sediments that unconformably overlie the metamorphic rocks. Successions older than 11–10 Ma unconformably overlie only the hanging wall of the Cretan detachment, and do not contain fragments of the footwall rocks; they therefore predate the oldest exposure of the metamorphic rocks of the footwall. The hanging wall rocks and Middle Miocene sediments form isolated blocks on top of the exhumed metamorphic rocks, which are interpreted as extensional klippen. (2) From approximately 10 Ma onward, southward migration of the area that presently covers Crete was accompanied by E–W extension, and the opening of the Sea of Crete to the north. Contemporaneously, large folds with WNW–ESE striking, NNE dipping axial planes developed, possibly in response to sinistral transpression. (3) During the Pliocene, Crete emerged and tilted to the NNW, probably as a result of left‐lateral transpression in the Hellenic fore‐arc, induced by the collision with the African promontory.
Side‐effects of allergen‐specific immunotherapy. A prospective multi‐centre study
Authors: Winther L. , Arnved J. , Malling H.‐J. , Nolte H. , Mosbech H. 
Published: January 2006

SummaryBackground and objective
The safety of allergen‐specific immunotherapy (SIT) is a parameter of great interest in the overall assessment of the treatment. A clinical database was developed in order to obtain early warnings of changes in the frequency and severity of side‐effects and sufficient data for the evaluation of possible risk factors.Methods
During a 3‐year period, four allergy centres in Copenhagen, Denmark, included data from all patients initiating SIT to a common database. Information on initial allergic symptoms, allergens used for treatment, treatment regimens and systemic side‐effects (SSEs) during the build‐up phase was collected.Results
A total of 1038 patients received treatment with 1709 allergens (timothy, birch, mugwort, house dust mite (HDM), cat, and wasp and bee venom), 23 047 injections in total. Most SIT patients completed the updosing phase without side‐effects, but there was a significant difference between allergens: wasp (89%), birch (82%), HDM (81%), cat (74%) and grass (70%) (P=0.004). A total of 582 SSEs were registered in 341 patients. Most side‐effects were mild grade 2 reactions (78%). A difference in severity between allergens was observed (P=0.02), with grass giving most problems. The type of allergen but not patient‐ or centre‐related parameters seemed predictive of side‐effects.Conclusions
Allergen extracts differ in their tendency to produce side‐effects. Multi‐centre studies like the present one allow more patients to be evaluated, and thereby provide a more efficient surveillance of side‐effects. Online Internet‐based registration to a central national database of every allergen injection would be an even more powerful tool for evaluation of risk factors and surveillance of side‐effects.
Repair of the injury to respiratory epithelial cells characteristic of asthma is stimulated byAllomyrina dichotomaagglutinin specific serum glycoproteins
Authors: Patchell B. J. , Dorscheid D. R. 
Published: January 2006

SummaryBackgroundThe airway epithelium acts as a protective barrier, separating the external environment from the underlying tissue. Daily challenges result in damage to the epithelium that, in normal individuals, is quickly and effectively repaired. In respiratory diseases, such as asthma, this repair is compromised. Following injury to the epithelium, plasma leaks into the airway lumen acting as a protective protein cap. Carbohydrates are mediators of epithelial repair, however, the associated regulatory proteins remain unknown.ObjectiveTo identify mediators of epithelial repair based on their carbohydrate moieties using anin vitrowound repair culture model of human airway epithelial cells (1HAEo−).MethodsUsing the lectinAllomyrina dichotomaagglutinin (AlloA) as a tool, ligands essential in the repair of damaged epithelium were characterized. AlloA was subsequently used to purify and identify a glycoprotein associated with epithelial repair.ResultsThe addition of AlloA to the media of mechanically wounded monolayers inhibited repair. Fetuin, a highly glycosylated serum protein, was identified as a glycoprotein bound by AlloA. The addition of fetuin to serum starved monolayers stimulated wound closure.ConclusionThese results indicate that following mechanical injury to the epithelium, serum glycoproteins, not only provide a protective barrier, but also are involved in the initiation of wound closure.
A hydrolysed rice‐based formula is tolerated by children with cow's milk allergy: a multi‐centre study
Authors: Fiocchi A. , Restani P. , Bernardini R. , Lucarelli S. , Lombardi G. , Magazzù G. , Marseglia G. L. , Pittschieler K. , Tripodi S. , Troncone R. , Ranzini C. 
Published: January 2006

SummaryBackground
Children allergic to cow's milk are fed a soy‐ or a hydrolysed cow's milk‐based substitute. Neither can rule out a sensitization risk. Previous studies have shown that hydrolysed rice is tolerated by animals and children with multiple food hypersensitivities.Objective
A prospective clinical assessment of tolerance to a rice‐based hydrolysed formula was carried out in children allergic to cow's milk.Patients and methods
One hundred children (42 girls and 58 boys, mean age 3.17±2.93 years, median 2.20, range 0.18–14.6 years) with a history of immediate reactions to cow's milk and confirmed at double‐blind, placebo‐controlled food challenge (DBPCFC) when not contraindicated were assessed for clinical tolerance to cow's milk proteins. Their allergy work‐up included skin prick tests with whole milk, α‐lactalbumin (ALA), β‐lactoglobulin (BLG) and total caseins, and specific IgE determinations using CAP technology were performed against whole milk, ALA, BLG and casein. Sensitization to rice and rice‐based hydrolysed formula was similarly investigated. Patients' sera were evaluated at immunoblotting for specific IgE to cow's milk proteins, rice and rice‐based hydrolysed formula. DBPCFC was carried out with increasing doses of a rice‐based hydrolysed formula.Results
All patients were sensitized to cow's milk and/or at least one cow's milk protein fraction. Eighty‐seven out of 99 were positive to cow's milk and/or a cow's milk protein fraction at skin prick test. Positive (>0.35 kUA/L) specific IgE determinations were found for cow's milk and/or milk fractions (92/95), rice (21/91) and hydrolysed rice infant formula (4/91). At immunoblotting, sera from 96 children were positive to α‐casein (n=54), β‐casein (n=38), ALA (n=57), BLG (n=37) and bovine serum albumin (n=61). Similarly, although patients' sera often contained specific IgE against rice proteins at CAP (21/91) and immunoblotting (70/96), only six very weakly positive responses were observed against rice‐based hydrolysed formula. All DBPCFC with rice‐based hydrolysed formula were negative.Conclusions
Rice‐based hydrolysed formula is a possible alternative not only for children with multiple allergies, but also for children with cow's milk allergy.
Tumour necrosis factor-α production stimulated by heat shock protein 70 and its inhibition in circulating dendritic cells and cells eluted from mucosal tissues in Crohn’s disease
Authors: Whittall T , Wang Y , Kelly C G , Thompson R , Sanderson J , Lomer M , Soon S Y , Bergmeier L A , Singh M , Lehner T 
Published: January 2006

SummaryThe objectives were to study the effect of microbial 70 kDa heat shock protein (HSP70) on the production of tumour necrosis factor (TNF)-α and interleukin (IL)-12 by dendritic cells (DC) from patients with Crohn’s disease. TNF-α concentration was increased significantly when DC from Crohn’s disease were stimulated with HSP70 or CD40L and this was associated with signalling by the extracellular signal regulated kinase (ERK) 1/2 and p38 mitogen activated protein (MAP) kinase pathway. IL-12 production was also increased when DC were stimulated with HSP70. Cells eluted from inflamed intestinal mucosa from Crohn’s disease, stimulated with HSP70, CD40L or lipopolysaccharide produced significantly greater TNF-α and IL-12 concentrations than cells from uninflamed mucosa. Significant inhibition of TNF-α production was demonstrated when DC from peripheral blood mononuclear cells or cells eluted from intestinal mucosa of Crohn’s disease were treated with either the HSP70 inhibitory peptide (aa 457–496) or peptides derived from CD40 and CD40L. These inhibitory peptides target the CD40–CD40L and the emerging CD40–HSP70 co-stimulatory pathway. Our findings offer a novel strategy to prevent excessive production of TNF-α in Crohn’s disease.
Intranasal IFNγ extends passive IgA antibody protection of mice againstMycobacterium tuberculosislung infection
Authors: Reljic R , Clark S O , Williams A , Falero-Diaz G , Singh M , Challacombe S , Marsh P D , Ivanyi J 
Published: January 2006

SummaryIntranasal inoculation of mice with monoclonal IgA against the α-crystallin (acr1) antigen can diminish the tuberculous infection in the lungs. As this effect has been observed only over a short-term, we investigated if it could be extended by inoculation of IFNγ 3 days before infection, and further coinoculations with IgA, at 2 h before and 2 and 7 days after aerosol infection with Mycobacterium tuberculosis H37Rv. This treatment reduced the lung infection at 4 weeks more than either IgA or IFNγ alone (i.e. 17-fold, from 4·2 × 107 to 2·5 × 106 CFU, P = 0·006), accompanied also by lower granulomatous infiltration of the lungs. IFNγ added prior to infection of mouse peritoneal macrophages with IgA-opsonized bacilli resulted in a synergistic increase of nitric oxide and TNFα production and a 2–3 fold decrease in bacterial counts. Our improved results suggest, that combined treatment with IFNγ and IgA could be developed towards prophylactic treatment of AIDS patients, or as an adjunct to chemotherapy.
Predicting the influence of wolf‐provided carrion on scavenger community dynamics under climate change scenarios
Authors: WILMERS CHRISTOPHER C. , POST ERIC 
Published: January 2006

AbstractClimate change poses an immediate threat to the persistence and distribution of many species, yet our ability to forecast changes in species composition is hindered by poor understanding of the extent to which higher trophic‐level interactions may buffer or exacerbate the adverse effects of warming. We incorporated species‐specific consumption data from 240 wolf‐killed elk carcasses from Yellowstone National Park into stochastic simulation models to link trends in the El Niño Southern Oscillation (ENSO) to food procurement by a guild of scavengers as a function of gray wolf reintroduction. We find that a shift in ENSO towards the El Niño (warming) phase of the cycle coincident with increasing global temperatures reduces carrion for scavengers, particularly those with strong seasonal patterns in resource use such as grizzly bears. Wolves alleviate these warming‐induced food shortages by rendering control over this crucial resource to biotic rather than abiotic factors. Ecosystems with intact top predators are likely to exhibit stronger biotic regulation and should be more resistant to climate change than ecosystems lacking them.
Impact of a rheumatology expert nurse on the wellbeing of patients attending a drug monitoring clinic
Authors: Ryan Sarah , Hassell Andrew B. , Lewis Martyn , Farrell Adrian 
Published: January 2006

Aim.  This paper reports a study to test the hypothesis that consultation with a clinical nurse specialist in a drug monitor clinic has a measurable impact on the well‐being of patients with rheumatoid arthritis.Method.  A single blinded randomized controlled trial was carried out with 71 patients with rheumatoid arthritis who were starting new disease‐modifying anti‐rheumatic therapy at a district general hospital. Patients were randomized into two groups over a 3‐year recruitment period. Intervention group patients were monitored by a rheumatology clinical nurse specialist using Pendelton's framework to assess patient needs alongside safety monitoring. Control group patients were seen by an outpatient staff nurse for safety monitoring only over a 1‐year period. The primary outcome measures were the Arthritis Impact Measurement Scales and the Rheumatology Attitude Index. Data were also collected on the Disease Activity Score, number of consultations with healthcare professionals and changes in drug therapy. Data were collected at baseline, 3, 7 and 12 months between 1999 and 2002.Results.  The Intervention group had greater change scores than the Control group for the Arthritis Impact Scale, with statistical significance shown at 7 months (P = 0·03). At 12 months the Rheumatology Attitude Index had improved by a mean of 1·8 in the Intervention group and deteriorated by 0·3 in the Control group. Changes in the Disease Activity Score were greater in the Intervention group at all time points, with statistical significance at 12 months (P = 0·048). There was little difference in the number of consultations or changes in drug therapy between the two groups.Conclusion.  Consultation with an expert rheumatology nurse in a drug monitor clinic may add value in terms of improving patients’ perceived ability to cope with the arthritis.
Validity, trustworthiness and rigour: quality and the idea of qualitative research
Authors: Rolfe Gary 
Published: January 2006

Aim.  In this paper, I call into question the widely‐held assumption of a single, more or less unified paradigm of ‘qualitative research’ whose methodologies share certain epistemological and ontological characteristics, and explore the implications of this position for judgements about the quality of research studies.Background.  After a quarter of a century of debate in nursing about how best to judge the quality of qualitative research, we appear to be no closer to a consensus, or even to deciding whether it is appropriate to try to achieve a consensus. The literature on this issue can be broadly divided into three positions: those writers who wish qualitative research to be judged according to the same criteria as quantitative research; those who believe that a different set of criteria is required; and those who question the appropriateness of any predetermined criteria for judging qualitative research. Of the three positions, the second appears to have generated most debate, and a number of different frameworks and guidelines for judging the quality of qualitative research have been devised over recent years.Discussion.  The second of the above positions is rejected in favour of the third. It argues that, if there is no unified qualitative research paradigm, then it makes little sense to attempt to establish a set of generic criteria for making quality judgements about qualitative research studies. We need either to acknowledge that the commonly perceived quantitative–qualitative dichotomy is in fact a continuum which requires a continuum of quality criteria, or to recognize that each study is individual and unique, and that the task of producing frameworks and predetermined criteria for assessing the quality of research studies is futile.Conclusion.  Some of the implications of this latter position are explored, including the requirement that all published research reports should include a reflexive research diary.
Impact of the perceived public image of nursing on nurses’ work behaviour
Authors: Takase Miyuki , Maude Phillip , Manias Elizabeth 
Published: January 2006

Aim. This paper reports a study comparing nurses’ perceptions of their public image with their self‐image, and examining how the relationship between their perceived public image and self‐image was associated with their job performance and turnover intentions.Background. The stereotypical public image of nursing is a major concern to nurses. However, it is relatively unknown how this image affects nurses. A few studies have investigated how nurses’ interpretations of their public image affect their self‐image and work behaviour.Methods. A convenience sample of 346 Australian nurses participated in a questionnaire study in 2003. The results were analysed byt‐test, polynomial regression and response surface analysis. Six participants from the survey participated in a focus group to provide further interpretation of the findings.Results. Nurses rated their aptitude for leadership more positively than they thought the public viewed them. In contrast, nurses rated their image as being caring less negatively than their perceived public image. Job performance was predicted by self‐image relating to leadership aptitude. On the contrary, the relationship between self‐image and perception of the public image as being caring predicted job performance. When nurses perceived their public image as caring less positively than their self‐image, their job performance tended to improve. As for turnover intention, both self‐image and perceived public images of having an aptitude for leadership and being caring were negatively related to intention to quit the job.Conclusion. To enhance nurses’ job performance and reduce their turnover intentions, it is important to improve both the public image and self‐image of nurses.