bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to environmental bacteria may have differing effects on tumour necrosis factor‐α and interleukin‐6‐producing capacity in infancy
Authors: Lappalainen M. H. J. , Roponen M. , Hyvärinen A. , Nevalainen A. , Laine O. , Pekkanen J. , Hirvonen M.‐R. 
Published: July 2008

SummaryBackground
Our previous study showed an association between increased concentration of endotoxin in house dust and elevated IFN‐γ responses in neonates. The impact of other microbial agents on immune responses in infancy is poorly known.Objective
To examine whether stimulated cytokine responses of mothers and their children are associated with concentrations of other microbial markers in addition to endotoxin in house dust samples.Methods
Mitogen‐stimulated production of IFN‐γ, IL‐4, IL‐6 and TNF‐α was measured in cord blood and in peripheral blood of mothers (n=29) and their children (n=29) 3 months after birth. Gas chromatography mass spectrometric analysis was applied to measure the concentrations of ergosterol (marker of fungal biomass), muramic acid (indicating the presence of Gram‐positive bacteria) and 3‐hydroxy fatty acids (C10:0–C14:0, indicating the presence of Gram‐negative bacteria) in house dust. Endotoxin was determined with Limulus assay.Results
Significant mother‐to‐child correlations were observed in stimulated production of TNF‐α and IL‐6 3 months after birth. 3‐hydroxy fatty acid (C10:0–C14:0) levels in bed dust were inversely associated with the production of TNF‐α and IL‐6 in blood samples of mothers and their 3‐month‐old children. High concentrations of muramic acid in floor dust were related to increased production of TNF‐α and IL‐6 at the age of 3 months. In contrast to endotoxin, none of the other microbial markers were significantly associated with enhanced IFN‐γ‐producing capacity from birth to 3 months.Conclusions
Exposure to Gram‐negative bacteria and their components may be associated with down‐regulated immune responses in early infancy, indicated as an impaired production of pro‐inflammatory cytokines following mitogen stimulation. Gram‐positive bacteria and their constituents seem to have opposite effects. Of the measured markers, exposure to bioactive endotoxin appears to have the strongest impact on T‐helper type 1 responses.
Supplementation with Lactobacillus rhamnosus or Bifidobacterium lactis probiotics in pregnancy increases cord blood interferon‐γ and breast milk transforming growth factor‐β and immunoglobin A detection
Authors: Prescott S. L. , Wickens K. , Westcott L. , Jung W. , Currie H. , Black P. N. , Stanley T. V. , Mitchell E. A. , Fitzharris P. , Siebers R. , Wu L. , Crane J. ,   the Probiotic Study Group
Published: July 2008

SummaryBackground
This study explored the effects of maternal probiotic supplementation on immune markers in cord blood (CB) and breast milk.Methods
CB plasma and breast milk samples were collected from a cohort of women who had received daily supplements of either 6 × 109 CFU/day Lactobacillus rhamnosus HN001 (n=34), 9 × 109 CFU/day Bifidobacterium lactis HN019 (n=35) or a placebo (n=36) beginning 2–5 weeks before delivery and continuing for 6 months in lactating women. CB plasma and breast milk (collected at 3–7 days, 3 months and 6 months postpartum) were assayed for cytokines (IL‐13, IFN‐γ, IL‐6, TNF‐α, IL‐10, TGF‐β1) and sCD14. Breast milk samples were also assayed for total IgA.Results
Neonates of mothers who received a probiotic had higher CB IFN‐γ levels (P=0.026), and a higher proportion had detectable blood IFN‐γ levels, compared with the placebo group (P=0.034), although levels were undetectable in many infants. While this pattern was evident for both probiotics, when examined separately only the L. rhamnosus HN001 group showed statistically significant higher IFN‐γ levels (P=0.030) compared with the placebo group. TGF‐β1 levels were higher in early breast milk (week 1) from the probiotic groups (P=0.028). This was evident for the B. lactis HN019 group (P=0.041) with a parallel trend in the L. rhamnosus HN001 group (P=0.075). Similar patterns were seen for breast milk IgA, which was more readily detected in breast milk from both the B. lactis HN019 (P=0.008) and the L. rhamnosus HN001 group (P=0.011). Neonatal plasma sCD14 levels were lower in the B. lactis HN019 group compared with the placebo group (P=0.041).Conclusion
The findings suggest that supplementation with probiotics in pregnancy has the potential to influence fetal immune parameters as well as immunomodulatory factors in breast milk.
The effect of lubricant contamination on ThinPrep® (Cytyc) cervical cytology liquid‐based preparations
Authors: Holton T. , Smith D. , Terry M. , Madgwick A. , Levine T. 
Published: July 2008

Objectives:  To assess the extent of lubricant use by smear‐takers and the effect of lubricant contamination of ThinPrep® processed cervical cytology samples.Methods:  All primary care smear‐takers were sent a questionnaire on lubricant type and frequency of use. Fifty cervical cytology samples were then contaminated with incremental amounts of K‐Y® jelly, 50 samples contaminated with incremental amounts of Aquagel® and ten non‐contaminated vials were processed using the ThinPrep® T2000 processor followed by Papanicolaou staining. The morphological appearances of lubricant contamination were described microscopically and formal cell counts performed on all slides.Results:  Seventy of 94 (74.5%) primary care smear‐takers indicated lubricant use of whom 9/70 (12.8%) used Aquagel® and 61/70 (87.2%) used K‐Y® jelly. K‐Y® jelly appeared as mucoid blue deposits in the slide background whereas Aquagel® appeared as pink stringy background material. Cell counting showed a significant difference between Aquagel® and K‐Y® jelly contaminated slides compared to the original non‐contaminated preparations for all fields and the average fields (P < 0.001) with a significantly higher count for the original non‐contaminated slides than the lubricant contaminated groups.Conclusion:  Lubricant contamination of ThinPrep® cervical cytology samples may result in reduced cellularity of the subsequent slide. This study provides evidence‐based data to support British Society for Clinical Cytology recommendations for no lubricant use when taking cervical samples.
Immunocytochemical panel for distinguishing carcinoma cells from reactive mesothelial cells in pleural effusions
Authors: Wu G‐P. , Zhang S‐S. , Fang C‐Q. , Liu S‐L. , Wang E‐H. 
Published: July 2008

Objective:  The aim of this study was to evaluate the individual and combined diagnostic utility of carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CK19) and HBME‐1 in pleural effusions of patients with lung cancer.Study design:  CEA, CK19 and HBME‐1 were detected by immunocytochemistry in pleural effusions from patients with lung cancer (86 cases) and without lung cancer (40 cases).Results:  CEA and CK19 expression were significantly higher in the carcinoma cell group and in three subgrouped as adenocarcinoma (AC), squamous cell carcinoma (SCC) and small cell lung cancer than in the mesothelial cell group, whereas HBME‐1 expression was lower in the former group (P < 0.01). In the subgrouped tumours, CEA expression was higher in AC than in SCC (P < 0.05), whereas HBME‐1 expression was higher in SCC than in AC (P < 0.01). Used alone, CK19 had the highest sensitivity (95.3%) and accuracy (93.7%), whereas CEA had the highest specificity (97.5%). When combinations of antibodies were evaluated together and membrane staining with HBME‐1 taken as a negative outcome, CK19 and HBME‐1 gave a high diagnostic performance: sensitivity of 100.0% and accuracy of 95.2% respectively.Conclusion:  A panel of CEA, CK19 and HBME‐1 monoclonal antibodies proved to be suitable for distinguishing carcinoma cells from reactive mesothelial cells in pleural effusions.
Paraganglioma‐like medullary thyroid carcinoma: fine needle aspiration cytology features with histological correlation
Authors: Ryska A. , Cap J. , Vaclavikova E. , Dvorakova S. , Bendlova B. , Hovorkova E. , Kohout A. 
Published: July 2008

Objectives:  Two cases of an extremely rare paraganglioma‐like variant of medullary thyroid carcinoma (MTC) are reported.Methods:  The patients were a 65‐year‐old male (case 1) and a 14‐year‐old female (case 2). Unilateral thyroid nodule and homolateral cervical lymphadenopathy was present in case 1; bilateral thyroid nodules were seen in case 2. Fine needle aspiration cytology (FNAC) was performed from thyroid nodules (in both cases) and from a cervical lymph node (in case 1).Results:  The cytological smears contained predominantly ovoid to spindled epithelial cells arranged in cohesive three‐dimensional clusters with sharp margins; isolated individual cells were seen only rarely. No colloid or other material was present in the background. The tumour cells showed significant nuclear atypia with occasional bizarre and/or binucleated cells. The nuclear chromatin was coarse and granular, sometimes with grooves and intranuclear inclusions. The cytoplasm was inconspicuous. Polygonal or triangular cells, amyloid and azurophillic cytoplasmic granules were absent in both cases. Calcitonin expression was demonstrated in case 2. Histological examination confirmed the paraganglioma variant of MTC in both cases.Mutation of RET proto‐oncogene in exon 16 (Met918Thr) – germline in case 2 and somatic in case 1 was detected by sequencing of DNA in both cases.Conclusions:  This is the first description of cytological findings in the paraganglioma‐like variant of MTC. Despite its rarity, it can be reliably diagnosed by FNAC if material for immunocytochemistry is obtained.
Could nuclear matrix protein 22 (NMP22) play a role with urine cytology in screening for bladder cancer? – experience at Kuwait University
Authors: Kapila K. , Kehinde E. O. , Anim J. T. , Mojiminiyi O. A. , Vinsu A. , George S. S. , Al‐Maghrebi M. , Al‐Mulla F. 
Published: July 2008

Objectives:  This prospective study was undertaken to evaluate nuclear matrix protein (NMP22) compared to urine cytology in the detection of bladder cancer and also to determine whether indexing suspicious cytology to NMP22 could enhance the clinical utility of cytology.Methods:  Cytological findings of voided urine collected prior to a cystoscopic biopsy were correlated with urine NMP22 assay in 46 patients attending the urology clinic in Mubarak Al‐Kabeer Hospital. The patients were clinically categorized into newly diagnosed cases of transitional cell carcinoma (TCC), recurrent TCC, TCC in remission and controls.Results:  Using histological diagnosis as the gold standard the sensitivity and specificity of NMP22 were 78% and 43% respectively and of cases with malignant urine cytology were 30% and 87% respectively. If suspicious and malignant cytology were combined as positive results the sensitivity increased significantly to 87% while the specificity decreased but not significantly to 74%. Suspicious or malignant cytology enhanced by positive NMP22 gave a sensitivity of 70% and specificity of 87% neither of which was significantly different from cytology alone. There were three false positive cases on cytology and 13 false positive cases on NMP22 assay. There were three false negative cytology and five false negative NMP22 cases but only one was false negative for both, resulting in a high sensitivity (96%) but low specificity (30%) if either positive NMP22 or malignant or suspicious cytology was taken as a positive result.Conclusion:  Combining NMP22 with malignant or suspicious cytological result improved sensitivity for the detection of bladder cancer but with a major decrease in specificity, suggesting a potential role in screening rather than diagnosis.
Influence of land use on stream ecosystem function in a Mediterranean catchment
Authors: VON SCHILLER D. , MARTÍ E. , RIERA J. L. , RIBOT M. , MARKS J. C. , SABATER F. 
Published: July 2008

Summary1. Due to the hierarchical organization of stream networks, land use changes occurring at larger spatial scales (i.e. the catchment) can affect physical, chemical and biological characteristics at lower spatial scales, ultimately altering stream structure and function. Anthropogenic effects on streams have primarily been documented using structural metrics such as water chemistry, channel alteration and algal biomass. Functional parameters, including metrics of nutrient retention and metabolism, are now being widely used as indicators of stream condition.2. Within this hierarchical context, we used a multivariate approach to examine how structural and functional (i.e. nutrient retention and metabolism) attributes of streams are related to catchment variables, including land use. The study was done in 13 streams located within a single Mediterranean catchment, but draining sub‐catchments with contrasting land use.3. At the catchment scale, results showed two contrasting land use gradients: (i) from forested‐ to urban‐dominated catchments and (ii) from low to moderate agricultural‐dominated catchments. Variation in structural and functional parameters was strongly related to these land use gradients. Specifically, NH4+ demand (measured as the uptake velocity, Vf) decreased along the gradient from forested‐ to urban‐dominated catchments primarily in response to increases in stream nutrient concentrations [NH4+, dissolved organic nitrogen (DON) and carbon (DOC)]. Both primary production and respiration increased along the gradient of agricultural development in response to increases in algal biomass (chlorophyll a). Soluble reactive phosphorus demand was not related to any of the land use gradients.4. Our results illustrate the connections among factors operating at different spatial scales (i.e. from catchments to streams) and their distinct influence on stream ecosystem function. Managers should take into consideration these connections when designing stream management and restoration plans. Because ecologically successful stream management and restoration is expected to restore function as well as structure to streams, the use of appropriate measures of functional processes is required. Nutrient retention and metabolism parameters are good candidates to fill this gap.
Using computer assisted learning for clinical skills education in nursing: integrative review
Authors: Bloomfield Jacqueline G. , While Alison E. , Roberts Julia D. 
Published: July 2008

AbstractTitle.  Using computer assisted learning for clinical skills education in nursing: integrative review. Aim.  This paper is a report of an integrative review of research investigating computer assisted learning for clinical skills education in nursing, the ways in which it has been studied and the general findings.Background.  Clinical skills are an essential aspect of nursing practice and there is international debate about the most effective ways in which these can be taught. Computer assisted learning has been used as an alternative to conventional teaching methods, and robust research to evaluate its effectiveness is essential.Data sources.  The CINAHL, Medline, BNI, PsycInfo and ERIC electronic databases were searched for the period 1997–2006 for research‐based papers published in English. Electronic citation tracking and hand searching of reference lists and relevant journals was also undertaken.Findings.  Twelve studies met the inclusion criteria. An integrative review was conducted and each paper was explored in relation to: design, aims, sample, outcome measures and findings. Many of the study samples were small and there were weaknesses in designs. There is limited empirical evidence addressing the use of computer assisted learning for clinical skills education in nursing. Computer assisted learning has been used to teach a limited range of clinical skills in a variety of settings.Conclusion.  The paucity of evaluative studies indicates the need for more rigorous research to investigate the effect of computer assisted learning for this purpose. Areas that need to be addressed in future studies include: sample size, range of skills, longitudinal follow‐up and control of confounding variables.
Implementing nursing diagnostics effectively: cluster randomized trial
Authors: Müller‐Staub Maria , Needham Ian , Odenbreit Matthias , Lavin Mary Ann , Van Achterberg Theo 
Published: July 2008

AbstractTitle.  Implementing nursing diagnostics effectively: cluster randomized trial. Aim.  This paper is a report of a study to investigate the effect of guided clinical reasoning. This method was chosen as a follow‐up educational measure (refresher) after initial implementation of standardized language.Background.  Research has demonstrated nurses’ need for education in diagnostic reasoning to state and document accurate nursing diagnoses, and to choose effective nursing interventions to attain favourable patient outcomes.Methods.  In a cluster randomized controlled experimental study, nurses from three wards received guided clinical reasoning, an interactive learning method. Three wards, receiving classic case discussions, functioned as control group. Data were collected in 2004–2005. The quality of 225 randomly selected nursing records, containing 444 documented nursing diagnoses, corresponding interventions and outcomes was evaluated by applying 18 Likert‐type items with a 0–4 scale of the instrument Quality of Nursing Diagnoses, Interventions and Outcomes. The effect of guided clinical reasoning was tested against classic case discussions using T‐tests and mixed effects model analyses.Findings.  The mean scores for nursing diagnoses, interventions and outcomes increased significantly in the intervention group. Guided clinical reasoning led to higher quality of nursing diagnosis documentation; to aetiology‐specific interventions and to enhanced nursing‐sensitive patient outcomes. In the control group, the quality was unchanged.Conclusion.  Guided clinical reasoning supported nurses’ abilities to state accurate nursing diagnoses, to select effective nursing interventions and to reach and document favourable patient outcomes. The results support the use of the North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification classifications and demonstrate implications for the electronic nursing documentation.
The role of inter‐professional relationships and support for nurse prescribing in acute and chronic pain
Authors: Stenner Karen , Courtenay Molly 
Published: July 2008

AbstractTitle.  The role of inter‐professional relationships and support for nurse prescribing in acute and chronic pain. Aim.  This paper is a report of a study to explore nurse prescribers’ views on the role of inter‐professional relationships and other means of support for nurse prescribing for patients in acute and chronic pain.Background.  Research indicates that good team relationships are important for supporting nurse prescribing but that poor understanding of the role by other healthcare professionals can act as a barrier. While collaborative working is central to the role of pain nurses, there is a lack of research on the impact of nurse prescribing on inter‐professional working or the support needs of these nurses.Method.  A qualitative approach was adopted using thematic analysis of semi‐structured interview data collected during 2006 and 2007. Participants were 26 nurses who prescribed medicines for patients with acute and/or chronic pain.Findings.  Nurses’ believed that prescribing encouraged collaborative working and sharing of knowledge across professional boundaries and that this helped to broaden understanding of the wider remit of pain management. Collaboration with doctors served a number of functions, including support and continuous learning. Barriers to effective nurse prescribing were a lack of understanding of its role amongst healthcare professionals and inadequate support. Formal support structures, such as regular clinical supervision, were seen as crucial to meeting nurses’ ongoing learning.Conclusion.  Factors that promote understanding of nurse prescribing and support inter‐professional relationships are likely to have a positive impact on the effectiveness of nurse prescribing. A more consistent approach is required within organisations to support nurse prescribing.
Childbirth‐related fatigue trajectories during labour
Authors: Tzeng Ya‐Ling , Chao Yu‐Mei Y. , Kuo Shu‐Yu , Teng Yu Kuei 
Published: July 2008

AbstractTitle.  Childbirth‐related fatigue trajectories during labour. Aim.  This paper is a report on a study identifying trajectories of childbirth‐related fatigue intensity changes over time and the influencing factors related to specific trajectory patterns.Background.  Childbirth is a period of time that encompasses considerable physiological and psychological fatigue, often having an adverse impact on women in labour. Empirical studies on this issue are scarce. How childbirth‐related fatigue changes over time, and factors influencing fatigue development, remain unclear.Method.  A prospective, correlational design with repeated measures was used. Data were collected by self‐reported measures and laboratory analysis of blood specimens. From December 2004 to November 2005 a convenience sample of 209 low‐risk pregnant Taiwanese women was followed throughout the labour process. Repeated measures of fatigue were analysed by using a semiparametric mixture model. Variables explaining trajectory class membership were identified by means of logistic regression.Results.  Two distinct trajectories of childbirth‐related fatigue were identified: low intensity (30·8% of women) and high intensity (69·2% of women). Fatigue level of both classes intensified following labour. The fastest period of fatigue‐increasing rate was in the active phase. After birth, fatigue levels in the high‐fatigue intensity class remained high. Primiparas in the high‐fatigue intensity class experienced significantly more anxiety and higher lactate concentration at admission than the low‐intensity class.Conclusion.  Caregivers should endeavour to prevent high levels of fatigue once women enter the labour phase. Women who present with high fatigue at onset of labour should be targeted for early intervention, especially in the period of rapid fatigue increase.
Antibiotics for nasopharyngitis are associated with a lower risk of office‐based physician visit for acute otitis media within 14 days for 3‐ to 6‐year‐old children
Authors: Salomon Jérôme , Sommet Agnès , Bernède Claire , Tonéatti Christine , Carbon Claude , Guillemot Didier 
Published: July 2008

AbstractObjectives  This study was designed to analyse factors potentially influencing children's return visits to physicians for symptoms of acute otitis media (AOM) within 14 days after being diagnosed with nasopharyngitis (NP), and the impact of recent antibiotic use.Design  A controlled population‐based pharmaco‐epidemiological trial in 3‐ to 6‐year‐old children conducted from January to May 2000.Setting  Three different geographical regions in France.Participants  Among 2507 eligible children, 2456 could be analysed and 505 children had 634 office‐based physician visits (OBPV) for NP symptoms.Interventions  The statistical associations between antibiotics prescribed for NP and an OBPV for AOM within 14 days in a population‐based study were analysed along with risk factors of AOM.Main outcomes measure  Clinical events and antibiotic use.Results  During the 2 weeks following physician‐diagnosed NP, antibiotic use, especially a beta‐lactam, significantly decreased the risk of OBPV for AOM in children (odds ratio = 0.2; 95% confidence interval = 0.09–0.7; P = 0.002).Conclusion  Antibiotics prescribed to children for NP seem to protect during the following 2 weeks against the risk of OBPV for AOM. It remains to be determined whether a subgroup at high risk of developing AOM after a viral infection exists and what might be the best strategy to adopt for NP in a national programme of optimal antibiotic use.