bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Approach to the Study of Potentially Preventable Nosocomial Infections
Authors: Rosselló-Urgell José , Vaqué-Rafart Josep , Hermosilla-Pérez Eduardo , Allepuz-Palau Alejandro ,   EPINE Working Group
Published: March 2006

AbstractObjective:To analyze a method that identifies potentially preventable nosocomial infections, as a tool to evaluate the performance of infection control programs through quantification of their potential for reducing nosocomial infections.Methods:The database of the Study of the Prevalence of Nosocomial Infections in Spain (EPINE) was reanalyzed. The method was based on the use of false negatives of the classification table obtained from application of a fixed multiple logistic regression model, as an estimator of the number of potentially preventable nosocomial infections.Results:The calculated number of patients with preventable infections was 7,493, which constituted 21.6% of the infected patients. Among hospital areas, intensive care had the lowest preventability rate (4.6%), whereas gynecology and obstetrics had the highest (40.6%). There was a significant inverse exposure-effect relationship between the proportion of preventable infections and the National Nosocomial Infections Surveillance (NNIS) System risk index. No correlation was observed between the prevalence of patients with nosocomial infection and the percentage of preventable infections.Conclusion:This analysis suggests that fewer nosocomial infections may be preventable in Spanish hospitals than previously assumed.
Footwear Exchange Has No Influence on the Incidence of Febrile Neutropenia in Patients Undergoing Chemotherapy for Hematologic Malignancies
Authors: Sugahara Hiroyuki , Mizuki Masao , Matsumae Sayoko , Nabetani Yoshiko , Kikuchi Motoko , Kanakura Yuzuru 
Published: March 2006

AbstractObjective:To determine whether footwear exchange affects the incidence of febrile neutropenia among patients undergoing chemotherapy for hematologic malignancies.Design:Open trial with historical comparison.Setting:The 12-bed high-efficiency particulate air-fil-tered hematology unit at Osaka University Hospital, Suita, Japan.Patients:Those with hematologic malignancies who underwent chemotherapy from January 1997 through January 2003. Footwear exchange was discontinued in January 2000.Methods:The surveillance system was based on the National Nosocomial Infections Surveillance System of the Centers for Disease Control and Prevention. Rates of febrile neutropenia were calculated for neutropenic patient-days (ie, days with neutropenia < 500/μL).Results:From January 1997 through December 1999 and from February 2000 through January 2003, 58 and 54 patients endured 237 and 184 neutropenic periods following chemotherapy, and their total neutropenic days were 3,123 and 2,503, respectively. They showed episodes of febrile neutropenia 89 and 68 times, respectively. Infection rates were 28.5 and 27.2 per 1,000 neutropenic patient-days (P = .83), respectively.Conclusion:The incidence of febrile neutropenia was not affected by footwear exchange. In hematology units, changing shoes does not appear to affect the rate of infections during neutropenic periods.
Susceptibilities ofCandidaSpecies to Amphotericin B and Fluconazole: The Emergence of Fluconazole Resistance inCandida tropicalis
Authors: Yang Yun-Liang , Ho Yong-An , Cheng Hsiao-Hsu , Ho Monto , Lo Hsiu-Jung 
Published: March 2006

AbstractObjective:To determine the susceptibilities ofCandidaspecies isolated from Taiwan to amphotericin B and fluconazole.Design:Prospective surveillance study.Methods:Each hospital was asked to submit up to 10C. albicansand 40non-albicans Candidaspecies during the collection period, from April 15 to June 15, 1999. One isolate was accepted from each episode of infection. The broth microdilution method was used to determine susceptibilities to amphotericin B and fluconazole.Results:Only 3 of 632 isolates, one each ofC. famata, C. krusei,andC. tropicalis,were resistant to amphotericin B. A total of 53 (8.4%) of 632 clinical yeast isolates, consisting of 4%C. albicans,8%C. glabrata,15%C. tropicalis,and 70%C. krusei,were resistant to fluconazole. In contrast, noC. parapsilosisisolate was resistant to fluconazole. Isolates from tertiary-care medical centers had higher rates of resistance to fluconazole than did those from regional and local hospitals (11.4% vs 6.6%). Isolates from different sources showed different levels of susceptibility to fluconazole. All of the isolates with the exception ofC. tropicalisandC. kruseiisolated from blood were susceptible to fluconazole. A pattern of co-resistance to both amphotericin B and fluconazole was observed.Conclusions:Non-albicans Candidaspecies had higher rates of resistance to fluconazole than didC. albicans(44 of 395 [11.2%] vs 9 of 237 [3.8%];P= .002). The increasing rate of fluconazole resistance inC. tropicalis(15%) is important becauseC. tropicalisis one of the most commonly isolatednon-albicans Candidaspecies.
Performance Improvement in the Long-Term–Care Setting Building on the Foundation of Infection Control
Authors: Stevenson Kurt B. , Loeb Mark 
Published: March 2006

AbstractInfection control programs were among the first organized efforts to improve the quality of healthcare delivered to patients and are an excellent model for the development of other healthcare performance improvement activities. Whether labeled as infection control, quality improvement, or patient safety, performance improvement initiatives share similar methods and principles. The quality of care in long-term–care facilities (LTCFs) has been scrutinized foryears and has received renewed attention with the recent initiation of public reporting of quality measures by Medicare. This article reviews the principles of performance improvement, discusses the importance of employing evidence-based interventions, and emphasizes the value of local performance improvement in LTCFs. Residents of LTCFs remain at high risk for the development of nosocomial infections, and among performance improvement initiatives, infection control is recom-mended as a high priority for all LTCFs. Fortunately, infection control contains the essential elements for performance improvement, and a successful infection control program can provide the foun-dation for expanding performance improvement throughout the LTCF. There is still much that needs to be done to determine the best clinical practices for LTCFs, and this should remain a priority for future research. Furthermore, efforts should continue to apply these principles at the local level to ensure that all residents of LTCFs receive the best care possible.
Multicenter Study of the Prevalence of Nosocomial Infections in Italian Hospitals
Authors: Pietrantonj Carlo Di , Ferrara Lorenza , Lomolino G. 
Published: March 2006

AbstractA point-prevalence study of nosocomial infections was conducted in 10 generai hospitals in northwestern Italy in June and July 2000. Infection rates were compared by type and site among the different hospitals. Urinary tract infections were most frequent, accounting for 57.8% of 128 nosocomial infections.
Treaty Interpretation And The Incorporation Of Extraneous Legal Rules
Authors: French Duncan 
Published: March 2006

AbstractThis paper considers under what circumstances, and for what reasons, an international tribunal may want to range beyond the primary text of a treaty to determine its ‘correct’ meaning; such extraneous legal material potentially including rules of customary international law, other treaties between the parties, general principles of law, and documents of a ‘soft law’ nature. The paper suggests a variety of ‘mechanisms’ by which a tribunal may undertake a broader interpretative approach, though all ultimately raise the same inevitable tension between accusations of judicial activism and counter-arguments of inflexibility and insularity. Nevertheless, many tribunals and individual judges continue to utilize such techniques, particularly noticeable in some recent environmental disputes. The paper will conclude with a note of caution; that though such interpretations are becoming an increasingly significant part of modern judicial decision-making—something that is generally to be welcomed—tribunals must concurrently take care to ensure that they remain within the accepted parameters of the adjudicative function.
Binding Armed Opposition Groups
Authors: Sivakumaran Sandesh 
Published: March 2006

AbstractThis article considers how armed opposition groups fighting in an internal armed conflict are bound by the rules of international humanitarian law despite not being party to the relevant treaties. It assesses a number of explanations—customary international law, general principles of international humanitarian law, rules governing treaties and third parties and claims to succession—and argues that each has limited value. The ability of the state to legislate on behalf of all its individuals is considered the best explanation. This principle is explored and objections to it are countered. This article also examines the expressed commitment of armed opposition groups to the rules of international humanitarian law.
Identification of Primary Target Genes of Phytochrome Signaling. Early Transcriptional Control during Shade Avoidance Responses in Arabidopsis
Authors: Roig-Villanova Irma , Bou Jordi , Sorin Céline , Devlin Paul F. , Martínez-García Jaime F. 
Published: March 2006

Abstract
The phytochrome (phy) photoreceptors modulate plant development after perception of light. Upon illumination of etiolated seedlings, phys initiate a transcriptional cascade by directly transducing light signals to the promoters of genes encoding regulators of morphogenesis. In light-grown plants, however, little is known about the transcriptional cascade modulated by phys in response to changes in light. The phy entry points in this cascade are completely unknown. We are particularly interested in the shade avoidance syndrome (SAS). Here we describe a subset of six genes whose expression is rapidly modulated by phys during both deetiolation and SAS in Arabidopsis (Arabidopsis thaliana). Using cycloheximide, we provide evidence that four of these phy rapidly regulated (PAR) genes are direct targets of phy signaling during SAS, revealing these genes as upstream components of the transcriptional cascade. Promoter-β-glucuronidase fusions confirmed that PAR genes are photoregulated at the transcriptional level. Analysis of gene expression in light signal transduction mutants showed that COP1 and DET1 (but not DET2 or HY5) play a role in modulating PAR expression in response to shade in light-grown seedlings. Moreover, genetic analyses showed that one of the genes identified as a direct target of phy signaling was phy-interacting factor 3-like-1 (PIL1). PIL1 has previously been implicated in SAS in response to transient shade, but we show here that it also plays a key role in response to long-term shade. The action of PIL1 was particularly apparent in a phyB background, suggesting an important negative role for PIL1 under dense vegetation canopies.
Production and clearance of cyclobutane dipyrimidine dimers in UV‐irradiated skin pretreated with 1% pimecrolimus or 0.1% triamcinolone acetonide creams in normal and atopic patients
Authors: Doelker Laurence , Tran Christian , Gkomouzas Angelos , Grand Denise , Sorg Olivier , Saurat Jean‐Hilaire , Lübbe Jann 
Published: March 2006

Background:  Ultraviolet (UV)‐induced pyrimidine dimers are an early step in skin carcinogenesis, which is accelerated in the setting of long‐term immunosuppression with systemic calcineurin inhibitors. It is not known whether topical application of calcineurin inhibitors exposes to a similar risk.Objective:  To assess the formation and clearance of UV‐induced dipyrimidine dimers in human epidermis treated with topical pimecrolimus as compared to topical steroid, vehicle and untreated control.Methods:  Pretreated buttock skin of 20 human volunteers with (10) or without (10) atopic dermatitis was exposed to two minimal erythema doses (MED) of simulated solar radiation. DNA was extracted from epidermis 1 and 24 h postirradiation. Pyrimidine dimers were visualized by immuno slot blots and quantified by chemoluminescence image analysis.Results:  One‐hour postirradiation, pimecrolimus‐treated epidermis contains less DNA damage as compared to untreated control, but there were no statistically significant differences between pimecrolimus, triamcinolone acetonide and vehicle. Dimer levels at 24 h postirradiation showed no significant differences between different treatments.Conclusion:  Treatment with pimecrolimus cream, triamcinolone acetonide cream and vehicle is not associated with increased epidermal DNA damage at 1 and 24 h post‐UV exposure.
Induction of centrosome amplification in p53 siRNA‐treated human fibroblast cells by radiation exposure
Authors: Kawamura Kenji , Morita Nobuyo , Domiki Chizue , Fujikawa‐Yamamoto Kozaburo , Hashimoto Mitsumasa , Iwabuchi Kuniyoshi , Suzuki Koji 
Published: March 2006

Centrosome amplification can be detected in the tissues of p53−/– mice. In contrast, loss of p53 does not induce centrosome amplification in cultured human cells. However, examination of human cancer tissues and cultured cells has revealed a significant correlation between loss or mutational inactivation of p53 and occurrence of centrosome amplification, supporting the notion that p53 mutation alone is insufficient to induce centrosome amplification in human cells, and that additional regulatory mechanisms are involved. It has recently been shown that gamma irradiation of tumor cells induces centrosome amplification. However, the precise mechanism of radiation‐induced centrosome amplification is not fully understood. In the present study, CCD32SK diploid normal human fibroblasts were transfected transiently with short interfering RNA (siRNA) specific for human p53 (CCD/p53i). There was a small increase in the frequency of centrosome amplification in CCD/p53i cells (4.0%) without irradiation. In contrast, CCD/p53i cells after 5‐Gy irradiation showed a marked increase in abnormal nuclear shapes and pronounced amplification of centrosomes (46.0%). At 12 h after irradiation, irradiated CCD/p53i cells were arrested in G2 phase. By laser scanning cytometry, abnormal mitosis with amplified centrosomes was observed frequently in the accumulating G2/M population at 48 h after irradiation. In the present study, we found that siRNA‐mediated silencing of p53 in normal human fibroblasts, together with DNA damage by irradiation, efficiently induced centrosome amplification and nuclear fragmentation, but these phenomena were not observed with either siRNA‐mediated silencing of p53 or irradiation alone. (Cancer Sci 2006; 97: 252–258)
DMRT‐1 expression during NEC8 human embryonic carcinoma cell differentiation
Authors: Koji Hitoshi , Yamada Akira , Nagasawa Toshihiko , Gamou Shinobu 
Published: March 2006

To elucidate the relationship between dsx and mab‐3 related transcription factor 1 (Dmrt‐1) and differentiation, alteration in mRNA levels during differentiation of NEC8 human embryonic carcinoma cells was investigated. After stimulation with 50 nM phorbol 12‐myristate 13‐acetate (PMA), the cells differentiated into cells with mesenchymal characteristics and upregulated Dmrt‐1 mRNA, possibly through the protein kinase C/mitogen‐activated protein kinase/activated protein‐1 signaling pathway. Conversely, knockdown of Dmrt‐1 by small interfering RNA resulted in cell morphology that was different from that after PMA treatment. These results indicated that Dmrt‐1 expression was apparently associated with the differentiation of NEC8, and this cell line may be a helpful in vitro tool to clarify the role of Dmrt‐1 in the differentiation process. (Cancer Sci 2006; 97: 277 –282)
Cervical and corpus cancer survival disparities by socioeconomic status in a metropolitan area of Japan
Authors: Ueda Kimiko , Kawachi Ichiro , Tsukuma Hideaki 
Published: March 2006

The purpose of this study was to analyze socioeconomic differences in cervical and corpus cancer survival, and to investigate if the differences are due to differences in age, cancer stage, histology and treatment. A total of 14 055 cases with cervical cancer and 3113 cases with corpus cancer were obtained from the Osaka Cancer Registry. Municipality‐based SES measurements were obtained from the System of Social and Demographic Statistics. Survival analysis was carried out with Kaplan–Meier survival curves. Three types of Cox proportional hazards regression models were tested to assess survival differences among groups and effects of SES on survival, controlling for clinical factors. SES was related to age and cancer stage for cervical and corpus cancer patients, and histology for cervical cancer patients. Differences were observed in cumulative 5‐year survival for cervical cancer patients among low, middle and high unemployment municipalities (68.9%, 64.3% and 50.9%, respectively, P < 0.0001). Differences in cumulative 5‐year survival for cervical cancer patients were also observed among high, middle and low education municipalities (65.1%, 62.2% and 56.1%, respectively, P < 0.0001). Similar patterns in 5‐year survival were also found for corpus cancer patients. After adjusting for age, cancer stage, histology and treatment, survival differences between patients from high and low SES areas still remained. In conclusion, our population‐based analysis of a metropolitan representative sample in Japan has demonstrated, for the first time in Japan, SES differences in survival following cervical and corpus cancer. (Cancer Sci 2006; 97: 283 –291)
Review article: intestinal serotonin signalling in irritable bowel syndrome
Authors: MAWE G. M. , COATES M. D. , MOSES P. L. 
Published: March 2006

SummaryAlterations in motility, secretion and visceral sensation are hallmarks of irritable bowel syndrome. As all of these aspects of gastrointestinal function involve serotonin signalling between enterochromaffin cells and sensory nerve fibres in the mucosal layer of the gut, potential alterations in mucosal serotonin signalling have been explored as a possible mechanism of altered function and sensation in irritable bowel syndrome. Literature related to intestinal serotonin signalling in normal and pathophysiological conditions has been searched and summarized.Elements of serotonin signalling that are altered in irritable bowel syndrome include: enterochromaffin cell numbers, serotonin content, tryptophan hydroxylase message levels, 5‐hydroxyindoleacedic acid levels, serum serotonin levels and expression of the serotonin‐selective reuptake transporter. Both genetic and epigenetic factors could contribute to decreased serotonin‐selective reuptake transporter in irritable bowel syndrome. A serotonin‐selective reuptake transporter gene promoter polymorphism may cause a genetic predisposition, and inflammatory mediators can induce serotonin‐selective reuptake transporter downregulation.While a psychiatric co‐morbidity exists with IBS, changes in mucosal serotonin handling support the concept that there is a gastrointestinal component to the aetiology of irritable bowel syndrome. Additional studies will be required to gain a more complete understanding of changes in serotonin signalling that are occurring, their cause and effect relationship, and which of these changes have pathophysiological consequences.
Systematic review: are probiotics useful in controlling gastric colonization by Helicobacter pylori?
Authors: GOTTELAND M. , BRUNSER O. , CRUCHET S. 
Published: March 2006

Summary Helicobacter pylori is a highly prevalent pathogen considered as an aetiological factor for gastroduodenal ulcers, and a risk factor for gastric adenocarcinoma and lymphoma in humans. Most subjects colonized by this micro‐organism are asymptomatic and remain untreated. In symptomatic patients, the antibiotic treatment has a high cost and is not 100% effective because of resistance to antibiotics and to moderate patient compliance. This review discusses the role of probiotics as alternative solutions to assist in the control of H. pylori colonization in at‐risk populations.The evidence that some strains of Lactobacillus and Bifidobacterium are able to inhibit H. pylori growth through the release of bacteriocins or organic acids, and may also decrease its adhesion to epithelial cells, is reviewed. In addition, probiotics have a possible role in the stabilization of the gastric barrier function and the decrease of mucosal inflammation. Other aspects that are considered are the contribution of probiotics to the healing of the gastric mucosa linked to their antioxidant and anti‐inflammatory properties.Clinical trials in colonized adults and children are reviewed, and suggest that probiotics do not eradicate H. pylori but maintain lower levels of this pathogen in the stomach; in combination with antibiotics, probiotics may increase eradication rate and/or decrease adverse effects. Papers suggesting similar effects on H. pylori by foodstuffs such as berry juice and some milk proteins are quoted. Regular intake of these and other dietary products might constitute a low‐cost, large‐scale alternative solution applicable for populations at‐risk for H. pylori colonization.
Oesophagitis is common in patients with achalasia after pneumatic dilatation
Authors: LEEUWENBURGH I. , VAN DEKKEN H. , SCHOLTEN P. , HANSEN B. E. , HARINGSMA J. , SIERSEMA P. D. , KUIPERS E. J. 
Published: March 2006

SummaryBackground  Achalasia, an oesophageal motor disease, is associated with functional oesophageal obstruction. Food stasis can predispose for oesophagitis. Treatment aims at lowering of the lower oesophageal sphincter pressure, enhancing the risk of gastro‐oesophageal reflux. Nevertheless, the incidence of oesophagitis after achalasia treatment is unknown.Aim  To investigate the incidence and severity of oesophagitis in achalasia patients treated with pneumatic dilatation.Methods  A cohort of 331 patients with achalasia were treated with pneumatic dilatation and followed. Oesophagitis and stasis were assessed by endoscopy and inflammation was graded by histology.Results  251 patients were followed for a mean values of 8.4 years (range: 1–26). The average number of endoscopies with biopsy sample sets per patient was 4 (range: 1–17). Three patients had no histological signs of oesophagitis throughout follow‐up, 139 had oesophagitis grade 1, 49 oesophagitis grade 2 and 60 grade 3. Specialized intestinal metaplasia was found in 37 patients. The association between endoscopic food stasis and histological inflammation was significant. The association between endoscopic signs of oesophagitis and histological inflammation was poor.Conclusions  Forty percent of the achalasia patients develop chronic active or ulcerating oesophagitis after treatment. Inflammation was associated with food stasis. Because the sensitivity of endoscopy to detect inflammation is low, surveillance endoscopy with biopsy sampling and assessment of stasis is warranted to detect early neoplastic changes.