bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing patients with acute liver failure: developing a tool for practitioners
Authors: O'Neal Helen , Olds Jane , Webster Nicola 
Published: February 2006

AbstractPatients with acute liver failure (ALF) are treated on the general intensive care unit (ICU) within this regional centre for hepatology and liver transplantation. This group of patients are at high risk of developing cerebral oedema, but because of the associated coagulopathy, intracranial pressure is not measured invasively. The safe management of these patients is vital to their outcome, and yet, there is no national or local guidance on the best practice for this group of patients.An absence of guidelines, or evidence base specific to caring for hepatology patients, was highlighted as we reviewed local clinical practices and those at other liver specialty centres, the British Liver Trust and published literature. We identified a need to develop evidence‐based guidance for staff caring for patients with ALF within ICUs. A systematic approach enabled us to identify best practice to support the development of a structured evidence‐based approach to care.
The pathophysiology of hepatic encephalopathy
Authors: Faint Victoria 
Published: February 2006

AbstractHepatic encephalopathy (HE) is a complicated disorder, the pathophysiology of which remains to be fully understood. This article reviews the current main theories including the potential involvement of ammonia, γ‐aminobutyric acid (GABA)/benzodiazipines and false neurotransmitters. Each theory is critically examined with the evidence for each reviewed carefully, and the potential relationship of ammonia to the remaining two theories explored. Known preciptating factors of HE are also considered as evidence. The conclusions drawn from the evidence provided indicate the large role played by ammonia and suggest that this may be the key to understanding HE as science progresses.
Introducing intensive insulin therapy: the nursing perspective
Authors: Preston Sharon , Laver Stephen R. , Lloyd Wendy , Padkin Andrew 
Published: February 2006

AbstractIntensive insulin therapy (IIT) for the management of high blood glucose can reduce mortality and morbidity in the critically ill. However, there is little published literature on how to implement it successfully.The aim of this study is to chronicle the development and difficulties encountered in implementing an IIT protocol in a critical care unit in a district general hospital.A nurse‐led protocol was developed. Qualitative audit was undertaken during development and implementation to identify potential problems with using the Bath Insulin Protocol. Regular feedback sessions were introduced to encourage change and further identify problem issues.Qualitative audit led to changes in practice for individual nurses and changes to other unit protocols. The main change for individual nurses was to measure blood glucose hourly using a bedside glucometer. The unit's feeding and drug dilution policies were identified as a potential cause of glucose instability and were modified.To implement IIT successfully, it is necessary to consider changing working practices and to identify other unit protocols which can cause glucose instability. The additional nursing workload must be considered and appropriate means of supporting staff identified.
The value and role of skin and nail assessment in the critically ill
Authors: Massey Debbie 
Published: February 2006

AbstractOver the last 10 years, numerous political drivers have paved the way for the development of new and innovative models of practice within the critical care environment. Many of these new models of practice required practitioners to perform detailed and comprehensive patient assessment. Within critical care, respiratory assessment is increasingly regarded as an essential element of a critical care practitioner's profile. However, the assessment of other body systems has been adopted more slowly. This article argues that skin and nail assessment should be ascribed a high priority within practitioners’ scope of practice. The skin is the largest organ in the body. A wide range of diseases covering numerous pathologies and specialities manifest in changes in the skin and nails. There has been increasing realization and recognition that there is a connection between the skin and systemic disease. The skin and nails can therefore give valuable diagnostic clues to underlying disease. This article offers practitioners an opportunity to develop and augment their knowledge and understanding of skin and nail assessment and its application to the critically ill patient.
Components of diesel exhaust particles differentially affect Th1/Th2 response in a murine model of allergic airway inflammation
Authors: Yanagisawa R. , Takano H. , Inoue K.‐i. , Ichinose T. , Sadakane K. , Yoshino S. , Yamaki K. , Yoshikawa T. , Hayakawa K. 
Published: February 2006

SummaryBackground
Diesel exhaust particles (DEP) can enhance various respiratory diseases. However, it is unclear as to which components in DEP are associated with the enhancement. We investigated the effects of DEP components on antigen‐related airway inflammation, using residual carbonaceous nuclei of DEP after extraction (washed DEP), extracted organic chemicals (OC) in DEP (DEP–OC), and DEP–OC plus washed DEP (whole DEP) in the presence or absence of ovalbumin (OVA).Methods
Male ICR mice were intratracheally administrated with OVA and/or DEP components. We examined the cellular profile of bronchoalveolar lavage (BAL) fluid, histological changes, lung expression of inflammatory molecules, and antigen‐specific production of IgG1 in the serum.Results
DEP–OC, rather than washed DEP, enhanced infiltration of inflammatory cells into BAL fluid, magnitude of airway inflammation, and proliferation of goblet cells in the airway epithelium in the presence of OVA, which was paralleled by the enhanced lung expression of eotaxin and IL‐5 as well as the elevated concentration of OVA‐specific IgG1. In contrast, washed DEP with OVA showed less change and increased the lung expression of IFN‐γ. The combination of whole DEP and OVA caused the most remarkable changes in the entire enhancement, which was also accompanied by the enhanced expression of IL‐13 and macrophage inflammatory protein‐1α.Conclusion
DEP–OC, rather than washed DEP, exaggerated allergic airway inflammation through the enhancement of T‐helper type 2 responses. The coexistence of OC with carbonaceous nuclei caused the most remarkable aggravation. DEP components might diversely affect various types of respiratory diseases, while whole DEP might mostly aggravate respiratory diseases.
Impaired functionality and phenotypic profile of dendritic cells from patients with multiple myeloma
Authors: Brimnes M K , Svane I M , Johnsen H E 
Published: February 2006

Summary
Multiple myeloma (MM) is a B cell cancer characterized by clonal proliferation in the bone marrow and impaired immunity. Because MM is an incurable malignancy, efficient consolidation is needed urgently. Targeting clonotypic B cells by idiotype vaccination has proved the principle to be effective and indicated that future strategies, including dendritic cell-based vaccination, could be a suitable approach. However, as MM patients suffer from a general impaired immunity, which may include dendritic cells (DCs), a careful evaluation of phenotypic traits and functionality of DCs from MM patients is necessary before an efficient vaccine can be developed. This study determined the number, phenotypic profile and functionality of myeloid and plasmacytoid DCs purified directly from blood from MM patients at diagnosis. A reduced number and lower expression of human leucocyte antigen (HLA) molecules was observed on both myeloid and plasmacytoid DCs in MM patients compared to healthy controls. Also, the expression of CCR5, CCR7 and DEC205 was lower in MM patients compared to normal donors. In addition, the capacity to stimulate allogeneic T cell proliferation and to stimulate cytokine production was decreased, suggesting that DCs from these patients are functionally impaired. Finally, the analysis of samples following chemotherapy and transplantation demonstrated an increased expression of HLA molecules, suggesting that this time-point is optimal for harvest and use in vaccination.
Spawning habitat and daily egg production of sardine (Sardina pilchardus) in the eastern Mediterranean
Authors: SOMARAKIS S. , GANIAS K. , SIAPATIS A. , KOUTSIKOPOULOS C. , MACHIAS A. , PAPACONSTANTINOU C. 
Published: February 2006

AbstractSpawning habitats of two eastern Mediterranean sardine, Sardina pilchardus (Walbaum, 1792), stocks (coastal waters of central Aegean and Ionian Seas) are characterized from daily egg production method (DEPM) surveys conducted during the peak of the spawning period. The latter occurs earlier in the Aegean Sea (December) than in the less‐productive Ionian Sea (February). Single‐parameter quotient analysis showed that the preferred bottom depth for spawning was 40–90 m in both areas but sardine selected sites of increased zooplankton in the Aegean Sea during December and increased fluorescence in the Ionian Sea during February. Estimates of daily egg production (P) and spawning stock biomass (B) were about four times lower for the Ionian Sea (P = 7.81 eggs m−2, B = 3652 tonnes) than the Aegean Sea (P = 27.52 eggs m−2, B = 16 174 tonnes). We suggest that zooplankton biomass might not be sufficient to support sardine reproduction in the highly oligotrophic Ionian Sea where the very small sardine stock may rely on the late‐winter phytoplankton bloom. Actively selecting sites with increased zooplankton or phytoplankton and feeding plasticity (the well‐known switching from selective particle feeding to non‐selective filter feeding in sardines) are interpreted as adaptations to grow and reproduce optimally at varying prey conditions. Despite differences in temperature and productivity regimes, reproductive performance of sardine in the Ionian Sea was very similar to that in the Aegean Sea during the peak of the spawning period. In comparing adult parameters from DEPM applications to Sardina and Sardinops stocks around the world, a highly significant linear relation emerged between mean batch fecundity (F) and mean weight of mature female (W, g) (F = 0.364W, r2 = 0.98). The latter implies that, during the peak of the spawning period, mean relative batch fecundity (eggs g−1) of sardine is fairly constant in contrasting ecosystems around the world.
Does leaf quality mediate the stimulation of leaf breakdown by phosphorus in Neotropical streams?
Authors: ARDÓN MARCELO , STALLCUP LINDSAY A. , PRINGLE CATHERINE M. 
Published: February 2006

Summary1. Lowland tropical streams have a chemically diverse detrital resource base, where leaf quality could potentially alter the effect of high nutrient concentrations on leaf breakdown. This has important implications given the extent and magnitude of anthropogenic nutrient loading to the environment.2. Here, we examine if leaf quality (as determined by concentrations of cellulose, lignin and tannins) mediates the effects of high ambient phosphorus (P) concentration on leaf breakdown in streams of lowland Costa Rica. We hypothesised that P would have a stronger effect on microbial and insect processing of high‐ than of low‐quality leaves.3. We selected three species that represented extremes of quality as measured in leaves of eight common riparian species. Species selected were, from high‐ to low‐quality: Trema integerrima > Castilla elastica > Zygia longifolia. We incubated single‐species leaf packs in five streams that had natural differences in ambient P concentration (10–140 μg soluble reactive phosphorus (SRP) L−1), because of variable inputs of solute‐rich groundwater and also in a stream that was experimentally enriched with P (approximately 200 μg SRP L−1).4. The breakdown rate of all three species varied among the six streams: T. integerrima (k‐values range: 0.0451–0.129 day−1); C. elastica (k‐values range: 0.0064–0.021 day−1); and Z. longifolia (k‐values range: 0.002–0.008 day−1). Both ambient P concentration and flow velocity had significant effects on the breakdown rate of the three species.5. Results supported our initial hypothesis that litter quality mediates the effect of high ambient P concentration on leaf processing by microbes and insects. The response of microbial respiration, fungal biomass and invertebrate density to high ambient P concentration was greater in Trema (high quality) than in Castilla or Zygia (low quality). Variation in flow velocity, however, confounded our ability to determine the magnitude of stimulation of breakdown rate by P.6. Cellulose and lignin appeared to be the most important factors in determining the magnitude of P‐stimulation. Surprisingly, leaf secondary compounds did not have an effect. This contradicts predictions made by other researchers, regarding the key role of plant secondary compounds in affecting leaf breakdown in tropical streams.
Temporal response of stream benthic macroinvertebrate communities to the synergistic effects of anthropogenic acidification and natural drought events
Authors: BOWMAN MICHELLE F. , SOMERS KEITH M. , REID R. A. , SCOTT L. D. 
Published: February 2006

Summary1. We evaluated whether the surprisingly weak biological recovery associated with declines in acid deposition were related to drought‐induced re‐acidification of streams. We used test site analysis (TSA) to characterise temporal changes (1995–2003) in the degree and nature of impairments to stream benthic macroinvertebrate (BMI) communities influenced by acid deposition and drought.2. The BMI communities in four historically impacted test streams were compared with communities in 30 minimally impacted reference streams. Six multivariate (e.g. ordination axes scores) and four traditional (e.g. % Diptera) summary metrics were used to describe BMI communities. Using all metrics simultaneously (i.e. Mahalanobis or generalised distance), the TSA provided a single probability that a test community was impaired. If a test community was significantly impaired, a further analysis was done to identify the metric(s) important in distinguishing the test community from reference condition.3. Results of the TSAs indicated that the generalised distances between test communities and the reference condition were inversely related to stream water pH (n = 36). The TSAs also indicated ordination metrics based on BMI abundance were important in distinguishing significantly impaired communities from reference conditions. Temporal trends indicated that there has been short‐term recovery of these BMI communities, but that overall improvements have been hampered by acid or metal toxicity associated with drought‐induced re‐acidification of the streams.4. Our use of a variety of summary metrics to obtain a single statistical test of significance within the context of the reference‐condition approach provided a simple and unambiguous framework for evaluating the biological condition of test sites.
Chytrid infections of Daphnia pulicaria: development, ecology, pathology and phylogeny of Polycaryum laeve
Authors: JOHNSON PIETER T. J. , LONGCORE JOYCE E. , STANTON DANIEL E. , CARNEGIE RYAN B. , SHIELDS JEFFREY D. , PREU ERIC R. 
Published: February 2006

Summary1. We combined ecological surveys, life table studies, microscopy and molecular sequencing to determine the development, ecology, pathology and phylogeny of Polycaryum laeve, an endoparasite of cladocerans. We report the first records of P. laeve from North America, where we have used a polymerase chain reaction primer and microscopic examination to confirm infections in 14 lakes. Infections are highly pathogenic and caused increased mortality, reduced growth, and reproductive castration in Daphnia pulicaria during life table studies.2. Biweekly data from Allequash Lake (Wisconsin, U.S.A.) throughout 2003 indicated that fecundity and infection prevalence were inversely correlated. Infection prevalence was highest in late winter and early spring (up to 80%) and lowest during late summer. Epidemics were generally followed by sharp declines in host population density (up to 99%).3. Within the haemocoel of its host, P. laeve forms thick‐walled sporangia, which occur systemically in later stages of infection. Fungal thalli associate closely with muscle fibres and connective tissue, leading to degeneration as the infection becomes advanced. Following death of the host, flagellated zoospores are released through an exit papilla on the sporangium. Based on the infection‐induced castration of the host and increases in infection prevalence with Daphnia size, we postulate that transmission is horizontal, but may be indirect through an additional host or free‐living stage.4. Molecular and morphological data clearly indicate that P. laeve belongs in the fungal phylum Chytriodiomycota, order Blastocladiales. Based on ribosomal RNA gene sequences and morphological features, we transfer the genus Polycaryum from the Haplosporidia to the Chytridiomycota, and designate a lectotype and epitype for P. laeve. Considering the high prevalence of P. laeve infection within Daphnia populations, the frequency with which we detected infections among lakes, and the keystone importance of large‐bodied Daphnia in aquatic food webs, we suggest that P. laeve may exert a regulatory influence on Daphnia populations in lake ecosystems.
Endothelial mechanotransduction, nitric oxide and vascular inflammation
Authors: HARRISON D. G. , WIDDER J. , GRUMBACH I. , CHEN W. , WEBER M. , SEARLES C. 
Published: February 2006

Abstract.Numerous aspects of vascular homeostasis are modulated by nitric oxide and reactive oxygen species (ROS). The production of these is dramatically influenced by mechanical forces imposed on the endothelium and vascular smooth muscle. In this review, we will discuss the effects of mechanical forces on the expression of the endothelial cell nitric oxide synthase, production of ROS and modulation of endothelial cell glutathione. We will also review data that exercise training in vivo has a similar effect as laminar shear on endothelial function and discuss the clinical relevance of these basic findings.
Molecular mechanisms of the vascular responses to haemodynamic forces
Authors: LEHOUX S. , CASTIER Y. , TEDGUI A. 
Published: February 2006

Abstract.Blood vessels are permanently subjected to mechanical forces in the form of stretch, encompassing cyclic mechanical strain due to the pulsatile nature of blood flow and shear stress. Significant variations in mechanical forces, of physiological or physiopathological nature, occur in vivo. These are accompanied by phenotypical modulation of smooth muscle cells and endothelial cells, producing structural modifications of the arterial wall. In all the cases, vascular remodelling can be allotted to a modification of the tensional strain or shear, and underlie a trend to reestablish baseline mechanical conditions. Vascular cells are equipped with numerous receptors that allow them to detect and respond to the mechanical forces generated by pressure and shear stress. The cytoskeleton and other structural components have an established role in mechanotransduction, being able to transmit and modulate tension within the cell via focal adhesion sites, integrins, cellular junctions and the extracellular matrix. Mechanical forces also initiate complex signal transduction cascades, including nuclear factor‐κB and mitogen‐activated protein kinase pathways, leading to functional changes within the cell.
Genetically determined apo B levels and peak LDL density predict angiographic response to intensive lipid‐lowering therapy
Authors: ZAMBON A. , BROWN B. G. , HOKANSON J. E. , MOTULSKY A. G. , BRUNZELL J. D. 
Published: February 2006

Abstract.Objective:  Lipid‐lowering therapy (LL‐Rx) reduces coronary artery disease (CAD) but the response varies amongst individuals. We investigated the contribution of three genetic forms of dyslipidaemia characterized by elevated plasma apo B, familial hypercholesterolaemia (FH), familial combined hyperlipidaemia (FCHL), and elevated Lp(a), to the angiographic response with LL‐Rx.Methods and results:  Fifty‐one men, with premature CAD and elevated plasma apo B, were selected in whom a genetic diagnosis was based on lipid phenotypes in relatives. Subjects received conventional (diet ± colestipol) or intensive LL‐Rx (niacin or lovastatin plus colestipol). Clinical parameters and CAD severity were measured before and after 2 years of treatment. Twenty‐seven patients had FCHL, 12 FH and 12 elevated Lp(a). Regression of coronary stenosis was dependent on the effect of therapy (P < 0.001), genetic form of dyslipidaemia (P = 0.004) and the interaction between the two variables (P = 0.02). Significant regression of coronary stenosis occurred only in FCHL and Lp(a) (P = 0.03, vs. control groups); CAD progression was only slowed in FH.Conclusions:  Three genetic forms of dyslipidaemia were associated with different angiographic outcomes during intensive LL‐Rx. Different forms of dyslipidaemia therefore may require different lipid‐lowering strategy. Patients with FH and buoyant LDL require more aggressive reduction of LDL cholesterol whilst those with either FCHL or elevated Lp(a) with dense LDL need LDL cholesterol reduction as well as therapies aimed at reduction of the small, dense LDL particles.
Scanning electron microscope imaging in liquids – some data on electron interactions in water
Authors: JOY D. C. , JOY C. S. 
Published: February 2006

SummaryThe electron backscattering coefficient of liquid water has been determined for electrons in the energy range 15–30 keV using QuantomixTM capsules. Values of the mean atomic number for water estimated from a fit to the backscatter yield, the mean ionization potential of water and from Monte Carlo simulations, show that the scattering behaviour of water is not anomalous despite the effects of hydrogen bonding. Computations of the electron range, and of the mean depth for backscattering, in water as a function of incident beam energy show that water and vitreous ice are good media for imaging purposes.
Laser autofocusing system for high‐resolution cell biological imaging
Authors: LIRON Y. , PARAN Y. , ZATORSKY N. G. , GEIGER B. , KAM Z. 
Published: February 2006

SummaryAutomated acquisition of high resolution, light microscope images of cells is becoming a common requirement in modern proteomic and cellomic research. A prerequisite for such microscopy is fine focus tuning, commonly optimized by multiple exposures, followed by image sharpness analysis. We describe here an extremely fast and accurate laser autofocusing system with distinct advantages for large‐scale cell‐based screening.