bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth hormone (GH) replacement decreases serum total and LDL‐cholesterol in hypopituitary patients on maintenance HMG CoA reductase inhibitor (statin) therapy
Authors: Monson John P. , Jönsson Peter , Koltowska‐Häggström Maria , Kourides Ione 
Published: June 2007

SummaryObjective  Adult onset GH deficiency (GHD) is characterized by abnormalities of serum lipoprotein profiles and GH replacement results in favourable alterations in serum total and low density lipoprotein (LDL)‐cholesterol. Preliminary evidence has indicated that the effect of GH replacement in this respect may be additive to that of HMG CoA reductase inhibitor (statin) therapy. We have examined this possibility during prospective follow‐up of adult onset hypopituitary patients enrolled in KIMS (Pfizer International Metabolic Database), a pharmacoepidemiological study of GH replacement in adult hypopituitary patients.Design  Lipoprotein profiles were measured centrally at baseline and after 12 months GH replacement therapy.Patients  Sixty‐one hypopituitary patients (30 male, 31 female) on maintenance statin therapy (mean 2·5 ± 2·7 SD years before GH) (statin group – SG) and 1247 (608 male, 639 female) patients not on hypolipidaemic therapy (nonstatin group – NSG) were studied. All patients were naïve or had not received GH replacement during the 6 months prior to study. Patients who developed diabetes mellitus during the first year of GH therapy or in the subsequent year and those with childhood onset GHD were excluded from this analysis. An established diagnosis of diabetes mellitus was present in 18% SG and 4·4% NSG at baseline.Measurements  Serum concentrations of total, high density lipoprotein (HDL)‐cholesterol, triglycerides and IGF‐I were measured centrally in all patients and LDL‐cholesterol was estimated using Friedewald's formula.Results  The relative frequency of various statin use was simvastatin 52% (15·8 ± 8·1 mg, mean ± SD), atorvastatin 30% (14·4 ± 7·8 mg), pravastatin 9·8% (31·6 mg ± 13·9 mg), lovastatin 6·6% (17·5 ± 5 mg) and fluvastatin 1·6% (40 mg). Baseline serum total and LDL‐cholesterol (mean ± SD) were 5·2 ± 1·4 and 3·1 ± 1·3 mmol/l in SG and 5·8 ± 1·2 and 3·7 ± 1·0 mmol/l in NSG, respectively (P < 0·0001, SG vs. NSG). After 12 months GH replacement (SG: 0·32 ± 0·17 mg/day; NSG: 0·38 ± 0·1 mg/day) serum total and LDL‐cholesterol decreased by a mean (±SD) of 0·48 (± 1·25) mmol/l (P < 0·0004) and 0·53 (± 1·08) mmol/l (P < 0·0001) in SG and by 0·30 (± 0·89) mmol/l (P < 0·0001) and 0·28 (± 0·80) mmol/l (P < 0·0001) in NSG, respectively. There were no significant changes in HDL‐cholesterol or triglycerides in either group (SG vs. NSG: NS). A relationship between LDL‐cholesterol at baseline and the decrease in LDL‐cholesterol after 12 months GH was evident in both groups (SG: R = –0·54, P < 0·001; NSG: R = –0·4, P < 0·001) and a similar relationship for cholesterol was observed.Conclusions  These data indicate that GH replacement exerts additional beneficial effects on lipoprotein profiles in patients on maintenance statin therapy, confirming that the effects of these interventions are complementary rather than exclusive.
Can intra‐specific genetic variation in arbuscular mycorrhizal fungi (Glomus etunicatum) affect a mesophyll‐feeding herbivore (Tupiocoris notatusDistant)?
Authors: WOOLEY STUART C. , PAINE TIMOTHY D. 
Published: June 2007

Abstract1. Arbuscular mycorrhizal fungal (AMF) infection can have negative, positive or neutral effects on insect herbivore populations, but patterns are difficult to predict.2. Intra‐specific genetic variation in nutrient uptake ability between fungal isolates may also have indirect effects on insect herbivores due to changes in plant quality. In preliminary studies mirid (Tupiocoris notatus) populations were significantly reduced on tobacco (Nicotiana rustica) colonised by AMF but it was unknown if same‐species fungal isolates differed in their effect.3. An experiment was performed as a first test of the effect of intra‐specific genetic variation in the mycorrhizal fungusGlomus etunicatumon mirid nymphal population structure, dynamics, and growth rate.4. Mirid nymphal populations were lower on mycorrhizal fungal‐infected plants. Population size, however, did not differ between the mycorrhizal isolates. While no statistical difference in population between isolates was found, one isolate consistently had 1.7–2.4 times lower mirid populations compared with the controls, indicating that the magnitude of effect is different between mycorrhizal isolates.5. The significantly negative effect of AMF on mirid populations likely resulted from AMF‐induced changes in plant quality (e.g. increased defence). This study lends further support to recent demonstrations that below‐ground symbionts significantly influence above‐ground processes. In addition, mycorrhizal fungi can affect insect population structure, which may have consequences for future herbivory.
Successional phases and species replacements in freshwater rock pools: towards a biological definition of ephemeral systems
Authors: JOCQUÉ MERLIJN , RIDDOCH BRUCE J. , BRENDONCK LUC 
Published: June 2007

Summary1. In temporary aquatic habitats, time is probably the dominant environmental factor affecting community composition, mainly by setting constraints on colonization success and the replacement of taxa over time. The mechanism and effect of a decreasing inundation period on community development, mostly in terms of truncation, are still poorly documented. The permanent and ephemeral components of temporary communities are expected to be differently influenced by the degree of persistence of the habitat.2. To study the effect of time on invertebrate community assembly and dynamics in a short duration type of temporary aquatic habitat, we monitored 16 ephemeral rock pools which persisted from less than a week to about 1 month at two rock pool sites in semi‐arid south‐eastern Botswana. Data were collected every 2 days during a full inundation cycle.3. All communities were initially assembled by permanent residents recolonizing the habitat from egg banks and were later joined by actively dispersing ephemeral taxa. Species replacements only occurred in two pools. Concurrent with a decrease in the densities of Branchipodopsis wolfi, population sizes of Leberis sp. and Culicidae (Aedes sp. and Anopheles sp.) increased in these pools. Although it was possible to distinguish two successive phases at one rock pool site, community assembly was generally a gradual process determined by dispersal strategies of the inhabitants. Additional rains after initial filling triggered dispersal by ephemeral taxa, mainly Micronecta youngiana and Hydroglyphus infirmus, and positively influenced colonization success.4. Decreasing persistence shortens community development down to a critical point below which lack of time eliminates the possibility of species replacement. Based on these findings, we define ephemeral waters as aquatic habitats lacking species replacements. Other temporary water types have a relatively longer persistence, permitting successional replacement of species.
Peritoneal natural killer cells from epithelial ovarian cancer patients show an altered phenotype and bind to the tumour marker MUC16 (CA125)
Authors: Belisle Jennifer A. , Gubbels Jennifer A. A. , Raphael Cara A. , Migneault Martine , Rancourt Claudine , Connor Joseph P. , Patankar Manish S. 
Published: July 2007

SummaryThe ovarian tumour marker MUC16 (CA125) inhibits the cytotoxic responses of human natural killer (NK) cells and down‐regulates CD16. Here we show that approximately 10% of the peripheral blood NK cells (PBNK) from the epithelial ovarian cancer (EOC) patients are CD16– CD56br whereas 40% of the peritoneal fluid NK (PFNK) carry this phenotype, which is usually associated with NK cells from the lymph nodes or human decidua. PBNK from healthy donors exposed to PF show a significant increase in the CD16– CD56br population. This shift in phenotype is not caused by increased apoptosis of the CD16+ CD56dim cells or selective proliferation of the CD16– CD56br NK cells. Thus, the terminal differentiation of the CD16– CD56br NK cells to CD16+ CD56dim subset that occurs during normal NK cell development may actually be a reversible step. A majority of the NK cell receptors (NKp46, NKp44, NKG2D, CD244, CD226, CD158a, CD158b, and CD158e) studied were down‐regulated in the PFNK. MUC16 binds selectively to 30–40% of CD16+ CD56dim NK cells in EOC patients indicating that phenotypic alterations in these cells are mediated by tumour‐derived soluble factors. Similar to EOC, MUC16 in early pregnancy also binds to NK cells suggesting shared mechanisms of NK cell suppression in feto‐maternal tolerance and immune evasion by ovarian cancers.
Close relatives in intensive care from the perspective of critical care nurses
Authors: Åsa Engström , Siv Söderberg 
Published: June 2007

Aim.  The aim was to describe critical care nurses’ experiences of close relatives within intensive care.Background.  There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives.Design and method.  The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis.Results.  The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given.Relevance to clinical practice.  This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives.
A comparison of sleep assessment tools by nurses and patients in critical care
Authors: Richardson Annette , Crow Wendy , Coghill Elaine , Turnock Christopher 
Published: June 2007

Aim.  The aim of this critical care sleep assessment pilot study was to evaluate the usefulness of three sleep assessment tools to identify which, if any, provided the closest comparison between the nurses’ judgement and the patients’ experience of their sleep. The study objectives were to: (i) compare patients' and nurses' assessment of sleep using three different rating tools. (ii) Ascertain patients’ preferences with non‐interventional, user friendly, practical tools in critical care. (iii) Recommend changes and improvements to the way that sleep is assessed and documented.Background.  Sleep is important for promoting critical care recovery and sleep disturbance is known to cause irritability, aggression and increased stress levels. The availability and use of valid critical care sleep assessment tools is limited.Design.  A descriptive comparative study using three sleep assessment‐rating scales were constructed to provide easy to understand tools for completion by both patients and nurses in critical care.Methods.  Structured interviews were undertaken with 82 patients and 82 nurses using a convenience sample from four multispecialty critical care units in one large teaching trust. Patients were included in the study if they met a list of pre‐defined criteria to obtain responses from lucid orientated patients.Results.  No tool produced a close association between the nurses’ assessment of the patients sleep and the patients’ assessment of their sleep. Patients found two of the three tools easy to use when rating their sleep.Discussion.  Objective invasive measurements of sleep as well as complex subjective tools appear inappropriate to be used as a part of daily critical care practice. The application of simple rating scores has a high degree of error when nurses assess patients’ sleep, even though high levels of patient observation and assessment are practiced in critical care.Conclusions.  More research is needed to examine the assessment of sleep in critical care, particularly linking rating scales to alternative methods of physiological assessment of sleep. Findings indicate nurses are unable to accurately assess critical care patients’ sleep using rating assessment tools. However patients were found to prefer two sleep assessment tools, one banded in hours to assess sleep quantity and one as a comparison against normal sleep to assess sleep quality.Relevance to clinical practice.  This study reviews the importance of sleep assessment and the diverse methods available for assessing sleep focussing on the critically ill patient. More noteworthy it highlights how nurses sole judgements of patients sleep is not a reliable method in clinical practice, however it provides some indication on the application of ‘easy to use’ tools to assist in the patients assessments of their sleep.
Deliberate self‐harm: emergency department nurses’ attitudes, triage and care intentions
Authors: McCann Terence V , Clark Eileen , McConnachie Susan , Harvey Isabel 
Published: June 2007

Aim and objectives.  This exploratory study investigates emergency department nurses’ attitudes towards patients who engage in deliberate self‐harm. It examines their attitudes towards, and triage and care decisions with, patients who self‐harm.Background.  Emergency department nurses sometimes show unsympathetic attitudes towards patients who present with self‐harm and these can contribute to difficulties in assessing and providing appropriate care.Design.  A modified version of the Suicide Opinion Questionnaire was used. A non‐probability sample of 43 emergency department nurses from a large Australian hospital participated in the study. Data were analysed using SPSS.Results.  Most nurses had received no educational preparation to care for patients with self‐harm; over 20% claimed that the department either had no practice guidelines for deliberate self‐harm or they did not know of their existence and one‐third who knew of them had not read them. Overall, nurses had sympathetic attitudes towards patients who self‐harm, including both professional and lay conceptualizations of deliberate self‐harm. They did not discriminate against this group of patients in their triage and care decisions.Conclusions.  The findings of this exploratory study are important because attitudes can affect care decisions. Recommendations are made for improving the educational preparation of emergency department nurses, for improving awareness and implementation of practice guidelines, and for improving attitudes towards patients with deliberate self‐harm. Further research is needed to confirm these results.
Clinical validation of the signs and symptoms and the nature of the respiratory nursing diagnoses in patients under invasive mechanical ventilation*
Authors: Zeitoun Sandra Salloum , De Barros Alba Lúcia Bottura Leite , Michel Jeanne Liliane Marlene , De Bettencourt Ana Rita Cássia 
Published: June 2007

Aims.  The aims of this study were to validate the signs and symptoms of the respiratory nursing diagnoses impaired gas exchange, ineffective airway clearance and ineffective breathing pattern in patients under mechanical ventilation; to verify whether intubation time and ventilatory modalities were related factors for respiratory nursing diagnoses; to verify the occurrence of shared signs and symptoms in the diagnoses and compare them with North American Nursing Diagnosis Association's proposition and to ascertain whether respiratory nursing diagnoses occur in isolated or associated patterns.Background.  The need for mechanical ventilation is common in several patients admitted to intensive care units. Therefore, critical care nurses should identify the respiratory nursing diagnoses of high incidence.Design and methods.  Descriptive observational study, with 177 evaluations of surgical and medical critically ill adult patients undergoing invasive mechanical ventilation. The study adopted Fehring's Modified Clinical Diagnostic Validity Model, with a suggested alteration.Results.  The critical signs and symptoms were the same as proposed by North American Nursing Diagnosis Association, when the diagnoses were separately identified, although no particular sign and symptom was found for ineffective breathing pattern. Impaired gas exchange and ineffective airway clearance were identified as having 88 (49·7%) evaluations sharing the critical signs and symptoms. Intubation time and ventilation modality were related factors for the development of ineffective airway clearance and ineffective breathing pattern.Conclusion.  The critical signs and symptoms of impaired gas exchange were abnormal blood gases and hypoxemia. For ineffective airway clearance, they were rhonchi and decreased breath sounds. No highlights were found for ineffective breathing pattern signs and symptoms. Validation by experts has confirmed these findings. The interface between ineffective airway clearance and impaired gas exchange was confirmed by the presence of the shared critical signs and symptoms.Relevance to clinical practice.  Studies like this are relevant to clinical practice because they evaluate the adequacy of Taxonomy II for patients under mechanical ventilation in clinical practice, thus allowing for the intensive care nurses to go from one mechanical and routine practice to a critical, reflexive practice, committed to professional progress.
The challenges for nurses communicating with and gaining valid consent from adults with intellectual disabilities within the accident and emergency care service
Authors: Sowney Margaret , Barr Owen 
Published: June 2007

Aim.  This paper reports the challenges experienced by nurses within accident and emergency departments in communicating with and gaining valid consent from adults with intellectual disabilities.Background.  Consent is both a legal requirement and an ethical principle required to be obtained by health‐care professionals, prior to the start of any examination, treatment and/or care. Central to the process of seeking consent is effective communication. However, evidence shows that people with intellectual disabilities are not viewed by professionals within acute general hospitals as a vital source of information, neither are they often communicated with directly, nor involved in discussions or decisions about their health care and are frequently not directly asked for their consent.Method.  A purposive sample of nurses working within the accident and emergency departments of five general hospitals was recruited to participate in this qualitative study. Data were collected from five focus groups.Findings.  Effective communication was identified as the most challenging aspect in caring for adults with intellectual disabilities within this environment, having an impact on the assessment of needs, informing patients of their health status and seeking valid consent.Conclusions.  Fundamental to the provision of quality care are the concepts communication, choice and control. However, these issues are perceived to be more challenging in the provision of health care to people with intellectual disabilities. Communication and consent, therefore, require further consideration within the educational and clinical areas to strengthen nurses’ competence in caring for people with intellectual disabilities, with an emphasis and understanding that choice and control are key principles for all people, being central aspects to the provision of an inclusive service for people with intellectual disabilities.Relevance to clinical practice.  All nurses need to have a greater awareness of learning disability, how to increase opportunities for effective communication and be very familiar with the issue and guidelines relating to consent, to ensure that people with learning disabilities have choice, control and are more active in decision making regarding their health.
Transcriptional coordination of the biogenesis of the oxidative phosphorylation machinery in plants
Authors: Gonzalez Daniel H. , Welchen Elina , Attallah Carolina V. , Comelli Raúl N. , Mufarrege Eduardo F. 
Published: June 2007

SummaryPublicly available microarray experiments were used to analyze Arabidopsis thaliana genes whose expression is correlated with that of nuclear genes encoding components of the oxidative phosphorylation machinery (OxPhos genes). This analysis indicated the existence of coordination in the expression of genes encoding components of the five respiratory complexes. For these genes, preferential expression was observed in anthers and roots, especially in the elongation zone, while reduced or very low relative expression was evident in leaves and mature pollen grains. A global induction of OxPhos genes by carbohydrates, photo‐destruction of chloroplasts, inhibition of cellulose synthesis, release from dormancy and germination, among other conditions, was also observed. Cluster analysis of the response of Arabidopsis genes to a set of 15 treatments allowed the identification of DNA motifs, known as site II, that are frequently present in the upstream regions of genes with responses like those of OxPhos genes. Mutagenic analysis of site II motifs in several genes encoding respiratory chain components showed that they actively participate in transcription of these genes. We conclude that an important number of nuclear genes encoding components of the five respiratory complexes show coordinated expression under various circumstances, and that site II elements and the putative proteins that interact with them are, together with as yet unidentified factors, important actors in this coordinated response.