bluuebunny/crossref_metadata_2025_split huggingface dataset:
The needs and experiences of family members of adult patients in an intensive care unit: a review of the literature
Authors: Verhaeghe Sofie , Defloor Tom , Van Zuuren Florence , Duijnstee Mia , Grypdonck Mieke 
Published: March 2005

Aims and objectives.  Insight into the needs and experiences of family members is an initial but necessary step in providing appropriate care for both family members and the patient. This literature review aims to structure the available scientific knowledge on needs and experiences of family members of intensive care unit patients with particular extension to coma patients. Qualitative as well as quantitative studies are discussed.Method.  Literature review.Results.  Needs are divided into four categories: cognitive, emotional, social and practical needs. The need for accurate and comprehensible information that leaves room for hope is universal. Family members want to speak to a doctor every day about the condition of and the prognosis for the patient, and want a nurse to explain to them about the care, the unit, the equipment and what they can do for the patient during visiting hours. Family members place great importance on being called at home if the condition of the patient changes. Emotional needs as hope, reassurance and being able to remain in the vicinity of the patient are crucial. Family members always give priority to the welfare of their relative. In their confused state, they often do not get around to paying attention to themselves. Caregivers underestimate all of the needs of family members and do not do enough to meet these needs.Relevance to clinical practice.  Priority needs should be central in the nurses’ approach of family members. The initiative for meeting the needs must be with the caregivers. Future, focused and well‐designed qualitative research over a longer period of time could clarify the process that family members go through and explain the results of quantitative studies.
Overcoming the barriers to patient‐centred care: time, tools and training
Authors: West Elizabeth , Barron David N , Reeves Rachel 
Published: March 2005

Aims and objectives.  To investigate whether nurses experience barriers to delivering high quality care in areas that are of particular concern to patients and to describe which aspects of care are most affected when nurses lack the required resources, such as time, tools and training to do their job.Background.  Patient surveys conducted in the National Health Service of the United Kingdom tend to show there is variation in the extent to which they are satisfied with care in a number of important areas, such as physical comfort, emotional support and the coordination of care. Design.  A sample of nurses working in 20 acute London hospitals was asked to complete a postal questionnaire based on a prototype employee survey developed in the United States and adapted by the authors for use in the United Kingdom.Method.  Staff in the human resources departments of participating hospitals mailed the questionnaires to nurses’ home addresses. After two reminders, 2880 (out of 6160) useable responses were returned, giving a response rate of 47%.Results.  Nurses are aware that there are deficits in standards of care in areas that are particularly important to patients. The majority feel overworked (64%) and report that they do not have enough time to perform essential nursing tasks, such as addressing patients’ anxieties, fears and concerns and giving patients and relatives information. Their work is often made more difficult by the lack of staff, space, equipment and cleanliness. They are often unable to control noise and temperature in clinical areas. Nurses in acute London hospitals are subject to high levels of aggressive behaviour, mainly from patients and their relatives, but also from other members of staff. More positively, high proportions of the nurses in our survey expressed the desire for further training, particularly in social and interpersonal aspects of care.Relevance to clinical practice.  This paper goes beyond reporting problems with the quality and safety of care to try to understand why patients do not always receive optimum care in areas that are important to them. In many cases nurses lack the time, tools and training to deliver high quality care in acute London hospitals. We suggest a number of low‐cost interventions that might remove some of the barriers to patient‐centred care. The questionnaire we have developed could be a useful tool for improving quality locally.
Computer‐aided disease prediction system: development of application software with SAS component language
Authors: Chang Chi‐Ming , Kuo Hsu‐Sung , Chang Shu‐Hui , Chang Hong‐Jen , Liou Der‐Ming , Laszlo Tabar , Chen Tony Hsiu‐Hsi 
Published: March 2005

AbstractAims  The intricacy of predictive models associated with prognosis and risk classification of disease often discourages medical personnel who are interested in this field. The aim of this study was therefore to develop a computer‐aided disease prediction model underpinning a step‐by‐step statistics‐guided approach including five components: (1) data management; (2) exploratory analysis; (3) type of predictive model; (4) model verification; (5) interactive mode of disease prediction using SAS 8.02 Windows 2000 as a platform.Methods  The application of this system was illustrated by using data from the Swedish Two‐County Trial on breast cancer screening. The effects of tumour size, node status, and histological grade on breast cancer death using logistic regression model or survival models were predicted. A total of 20 questions were designed to exemplify the usefulness of each component. We also evaluated the system using a controlled randomized trial. Times to finish the above 20 questions were used as endpoint to evaluate the performance of the current system. User satisfaction with the current system such as easy to use, the efficiency of risk prediction, and the reduction of barrier to predictive  model  was also evaluated.Results  The intervention group not only performed more efficiently than the control group but also satisfied with this application software.Conclusions  The MD‐DP‐SOS system characterized by menu‐driven style, comprehensiveness, accuracy and adequacy assessment, and interactive mode of disease prediction is helpful for medical personnel who are involved in disease prediction.
Understanding safer practices in health care: a prologue for the role of indicators
Authors: Kazandjian Vahé A. , Wicker Karol , Ogunbo Sam , Silverman Nicole 
Published: March 2005

AbstractObjectives  Patient safety and safer practices are central themes to many national strategies for accountability. The multinational Quality Indicator Project® (QI Project®) database is used to identify patterns of indicator use to measure safety of care in Asia, Europe, and the USA. The second objective is to assess, within the context of an indicator project, the usefulness of indicators to measure errors or mishaps. Design and setting   This descriptive study retrospectively analyses indicator use patterns among hospitals in Asia, Europe, and the USA. The QI Project® database is used for the 1999–2002 period. Statistical testing (P‐value) of the differences in use percentages across five countries is based on ‘country’ rather than ‘hospital’ as the unit of analysis.Results  There was a significant increase in overall QI Project® indicator use worldwide between 1999 and 2002. The average change in use was 6.8% for safety indicators and 4.2% for all other indicators. When analysed by country (USA, Austria, Belgium, UK, and Taiwan), the average increases in use percentage were highest in Taiwan and Belgium. When the country‐specific differences were tested for significance, Taiwan showed the largest (and statistically significant) increase in safety indicator use between 1999 and 2002 (P < 0.0001). In the USA, the rates of safety indicator use have decreased (P = 0.0502) during the same time period.Conclusion  This paper identifies, perhaps for the first time, how traditional indicators of hospital performance are being used to understand a hospital's performance and associated safety of care. Although the study's time frame is limited to 3 years, the findings seem to suggest that the interest in using these traditional indicators as proxies for safer practice measures is increasing among the QI Project® participants worldwide. The challenge of using inherently value‐free indicators as indicators of safety (hence de facto labelled as ‘error’ focused) should be further studied.
Medicine and literature: writing and reading
Authors: Bolton Gillie 
Published: March 2005

AbstractThe humanities and arts are appropriate areas of study within interdisciplinary medicine. Medicine has long been considered to be both a science and an art. Within each patient, the psychological, emotional, spiritual, and the physical are all inextricably linked. The values, ideas and images of individuals and culture, as well as the way the human body and mind physically function and dysfunction, impinge in an equally inextricable way upon all these elements. The humanities and arts, included within medical study, enable people, the subject of medicine, to be usefully considered in their entirety. Literature has a particularly vital role to play in medicine and health care. It opens up a wealth of experience and knowledge, as well as offering vital understandings of the narrative nature of human lives. A knowledge of the nature of narrative, and the way we understand our lives narratively can be vital for effective communication and understanding of patients’ situations. Literature also offers dynamic ethical issues with which to grapple. Expressive and explorative writing is used in professional development, and undergraduate courses. Medical humanities, literature and medicine and narrative medicine are established in the USA and developing fast in Britain.
Transgenic rice hybrids that carry the Rf‐1 gene at multiple loci show improved fertility at low temperature
Authors: KOMORI TOSHIYUKI , IMASEKI HIDEMASA 
Published: March 2005

ABSTRACTBy using a genomic fragment that carries the rice (Oryza sativa L.) fertility restorer gene, Rf‐1, rice restorer lines harbouring multiple Rf‐1 genes on different chromosomes were developed by genetic engineering and crossing. Hybrid lines that were obtained by crossing the restorer lines having two and three Rf‐1 genes with a cytoplasmic male sterile (CMS) line had nearly 75 and 87.5% pollen fertility rates under a normal condition, respectively, whereas a conventional hybrid line showed a 50% pollen fertility rate. Furthermore, the seed set percentage under low temperature conditions was much higher in the hybrid lines with multiple Rf‐1 genes than the conventional hybrid line. These results indicate that multiplication of the Rf‐1 gene conferred cold tolerance at the booting stage to hybrid rice through increasing the potentially fertile pollen grains. This strategy to improve fertility at low temperature of hybrids could be applied to any grain crops that are developed based on CMS and its gametophytic restorer gene, let alone rice.
Salt‐induced expression of peroxisome‐associated genes requires components of the ethylene, jasmonate and abscisic acid signalling pathways
Authors: CHARLTON WAYNE L. , MATSUI KYOKO , JOHNSON BARBARA , GRAHAM IAN A. , OHME‐TAKAGI MASARU , BAKER ALISON 
Published: March 2005

ABSTRACTPeroxisomes participate in many biological functions including detoxification of reactive oxygen species and biosynthesis of oxylipin signalling molecules. Peroxisome protein and enzyme activities have been reported to change in response to salt stress. To investigate the relationship between peroxisomes and salt stress the level of expression of three peroxisome‐associated genes, thiolase (PED1), PEX10 and PEX1 was analysed by quantitative real‐time polymerase chain reaction. The steady‐state transcript level of all three genes was increased by salt and ABA treatment, and was blocked in the abi1‐1 mutant. Salt‐dependent increase of transcript for all three genes also required the JAR1 gene as it was prevented in the jar1‐1 mutant. Expression of thiolase, and to a lesser extent PEX1, was increased in the jar1‐1 mutant in the absence of salt, suggesting jasmonate may negatively regulate these genes in the absence of salt stress. PEX1 was up‐regulated in the ethylene over‐producer eto1‐1 and salt had an additive effect on PEX1 transcript level, but salt induction may be inhibited in the ethylene‐insensitive line etr1‐1. Consistent with this, PEX1 was also up‐regulated in transgenic plants over‐expressing the ethylene response element binding factors AtERF1 and AtERF5.
Phycobiliprotein fluorescence of Nostoc punctiforme changes during the life cycle and chromatic adaptation: characterization by spectral confocal laser scanning microscopy and spectral unmixing
Authors: WOLF ELKE , SCHÜΒLER ARTHUR 
Published: March 2005

ABSTRACTMany cyanobacteria are highly adaptable to light quality, and many species undergo a complex life cycle. In this study we show that adaptive changes in the photosynthetic apparatus of cyanobacteria are not only caused by environmental, but also by developmental factors. Spectral confocal laser scanning microscopy (CLSM) was used to analyse in vivo the fluorescence spectra of the photosynthetic pigments chlorophyll a (Chl a), allophycocyanin (APC), phycocyanin (PC) and phycoerythrin (PE) of two Nostoc punctiforme strains. Changes in pigment fluorescence emission occurred in different developmental stages. Strain 1:1‐26 showed an emission maximum at 674 nm in motile hormogonia stages, whereas vegetative stages showed maxima at 658 and 575 nm. These changes were not caused by chromatic adaptation. In contrast, the second strain (1:1‐26lg) showed distinct fluorescence spectra, pigment localization and clear chromatic adaptation in red light. When these properties are known, both strains can be easily distinguished by the spectral CLSM method, which also allows the localization of the pigments within single cells. To calculate the contribution of individual phycobiliproteins to the observed changes, fluorescence spectra were analysed by spectral unmixing. This allowed the mathematical estimation of fluorescence shares for the individual phycobiliproteins in different developmental stages and both before and after chromatic adaptation. It is concluded that care should be taken when characterizing cyanobacteria by differences in pigment fluorescence, because these differences are influenced not only by chromatic adaptation, but also developmental stages. Spectral CLSM offers a powerful method to study the phycobiliprotein composition in vivo.
Root navigation by self inhibition
Authors: FALIK OMER , REIDES PERLA , GERSANI MORDECHAI , NOVOPLANSKY ARIEL 
Published: March 2005

ABSTRACTCircumventing physical obstacles is critical for a plant's survival and performance. Although the ability of roots to circumvent obstacles has been known for over 100 years, the phenomena and its mechanisms have received relatively little attention. In this study it is demonstrated that roots of Pisum sativum are able to detect and avoid growth towards inanimate obstacles and the hypothesis that this behaviour is based on the sensitivity of roots to their own allelopathic exudates that accumulate in the vicinity of physical obstacles is tested. The development of lateral roots of Pisum sativum towards an obstacle (a piece of nylon string, similar in dimensions to a plant root) was followed. Lateral roots were similar in number, but significantly shorter in the direction of the nylon string. In addition, up to half of the lateral roots that developed towards the nylon string withered, whereas no withering was observed in the absence of the nylon string. These avoidance growth patterns were suppressed in the presence of potassium permanganate or activated carbon, indicating a role of allelopathic exudates in promoting obstacle avoidance. The demonstrated obstacle avoidance by self inhibition could increase plant performance by limiting resource allocation to less promising parts of the root system.
Site and extent of starch degradation in the dairy cow – a comparison between in vivo, in situ and in vitro measurements
Authors: Hindle V. A. , Vuuren van A. M. , Klop A. , Mathijssen‐Kamman A. A. , Van Gelder A. H. , Cone J. W. 
Published: March 2005

SummaryPrediction of the supply of glycogenic precursors to dairy cows and the site of degradation of wheat, maize and potato starch (PS) were determined in an in vivo experiment and the results were compared with data obtained from experiments involving in situ nylon bag and in vitro gas production techniques. In a Latin square design experiment four lactating dairy cows fitted with a rumen cannula and T‐piece cannulae in the duodenum and terminal ileum, received either a low‐starch control diet or diets in which sugar beet pulp in the concentrate mixture had been replaced by wheat, maize or PS. Starch from the different sources was almost completely degraded in the total gastrointestinal tract. For all starches, the rumen was the main site of degradation in vivo. No digestion of PS in the small intestine was observed. In situ results suggested that 14% of wheat starch (WS), 47% of maize starch and 34% of PS escaped rumen fermentation. According to the gas production technique WS ferments quickest and potato slowest. PS had a low degradability during the first 8 (gas production) to 11 (in situ) h. However, according to both in vitro and in vivo measurements rumen degradability of PS was high. The results suggest that in situ and in vitro techniques should be performed in animals that have adapted to starch source to provide a more accurate simulation of the in vivo situation.
In Vivo Selection of Respiratory Syncytial Viruses Resistant to Palivizumab
Authors: Zhao Xiaodong , Sullender Wayne M. 
Published: March 2005

ABSTRACT
Palivizumab (PZ) is the only monoclonal antibody currently available for use in humans against an infectious disease. PZ is administered prophylactically for respiratory syncytial virus (RSV) infections. RSV selected in cell culture for growth in the presence of PZ develops F gene mutations and can be resistant to PZ prophylaxis in cotton rats. Here, we evaluated the potential for PZ-resistant RSV mutants to arise in vivo. Cotton rats were immunosuppressed with cyclophosphamide, administered PZ, and inoculated intranasally with RSV. Lungs were harvested 12 weeks after RSV infection, reverse transcription-PCR-amplified F gene fragments were cloned into plasmids, and the nucleotide sequences of the cloned cDNAs were determined. Three of the five animals had mixed populations of lung virus, and over 50% of the clones from the three animals revealed F gene mutations associated with resistance to PZ. A virus completely resistant to PZ neutralization was recovered from the lung homogenate of a rat that had received PZ. Thus, prolonged pulmonary replication of RSV in the presence of PZ was followed by the appearance of viruses resistant to PZ. The potential for the development of resistance is a consideration as the antibody is used prophylactically against RSV and as passively administered antibodies are under development for other infections, including emerging viruses and agents of biodefense.
Herpes Simplex Virus Infection Stabilizes Cellular IEX-1 mRNA
Authors: Hsu Wei-Li , Saffran Holly A. , Smiley James R. 
Published: March 2005

ABSTRACTHerpes simplex virus (HSV) virion host shutoff protein (vhs) destabilizes cellular and viral mRNAs. Previous work from several laboratories has indicated that vhs accelerates the turnover of most host mRNAs and provided evidence that at least some of these are degraded via endonucleolytic cleavage near regions of translational initiation followed by 5′→3′ decay. In contrast, several recent reports have argued that vhs is selective, preferentially targeting a subset of mRNAs including some that bear AU-rich instability elements (such as the stress-inducible IEX-1 mRNA). These reports concluded that vhs triggers deadenylation, 3′ cleavage, and 3′→5′ decay of IEX-1 mRNA. However, we report here that HSV infection does not increase the rate of degradation of IEX-1 mRNA; rather, actinomycin D chase assays indicate that the transcript is stabilized relative to that in uninfected cells in both the presence and absence of functional vhs. Moreover, deadenylated but otherwise intact IEX-1 mRNA was readily detected in uninfected cells cultured under our experimental conditions, and its relative abundance did not increase following HSV type 1 (HSV-1) infection. We confirm that HSV infection increases the relative abundance of a discrete 0.75-kb 3′-truncated IEX-1 RNA species in a vhs-dependent manner. This truncated transcript was also detected (albeit at lower levels) in cells infected with vhs mutants and in uninfected cells, where it increased in abundance in response to tumor necrosis factor alpha, cycloheximide, and puromycin. We conclude that IEX-1 mRNA is not preferentially degraded during HSV-1 infection and that HSV-1 instead inhibits the normal turnover of this mRNA.
Requirements for the Selective Degradation of Endoplasmic Reticulum-Resident Major Histocompatibility Complex Class I Proteins by the Viral Immune Evasion Molecule mK3
Authors: Wang Xiaoli , Connors Rose , Harris Michael R. , Hansen Ted H. , Lybarger Lonnie 
Published: March 2005

ABSTRACTRecent studies suggest that certain viral proteins co-opt endoplasmic reticulum (ER) degradation pathways to prevent the surface display of major histocompatibility complex class I molecules to the immune system. A novel example of such a molecule is the mK3 protein of gammaherpesvirus 68. mK3 belongs to an extensive family of structurally similar viral and cellular proteins that function as ubiquitin ligases using a conserved RING-CH domain. In the specific case of mK3, it selectively targets the rapid degradation of nascent class I heavy chains in the ER while they are associated with the class I peptide-loading complex (PLC). We present here evidence that the PLC imposes a relative proximity and/or orientation on the RING-CH domain of mK3 that is required for it to specifically target class I molecules for degradation. Furthermore, we demonstrate that full assembly of class I molecules with peptide is not a prerequisite for mK3-mediated degradation. Surprisingly, although the cytosolic tail of class I is required for rapid mK3-mediated degradation, we observed that a class I mutant lacking lysine residues in its cytosolic tail was ubiquitinated and degraded in the presence of mK3 in a manner indistinguishable from wild-type class I molecules. These findings are consistent with a “partial dislocation” model for turnover of ER proteins and define some common features of ER degradation pathways initiated by structurally distinct herpesvirus proteins.