bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of primary and secondary low‐grade respiratory syncytial virus infections in a murine model of asthma
Authors: Kondo Y. , Matsuse H. , Machida I. , Kawano T. , Saeki S. , Tomari S. , Obase Y. , Fukushima C. , Kohno S. 
Published: August 2004

SummaryBackground
Respiratory syncytial virus (RSV) infection is known to develop and exacerbate asthma in young children. In adult, RSV causes recurrent but asymptomatic infections. However, the impact of asymptomatic RSV infection on adult asthma is yet to be determined. The present study is designed to determine the effects of primary and secondary low‐grade RSV infections on allergic airway inflammation in a murine model of allergic asthma.Methods
A low‐grade RSV (2 × 103 plaque‐forming units/mouse) was inoculated, and this caused neither pulmonary inflammation nor symptoms but induced significant IFN‐γ production in thoracic lymph nodes. To investigate interaction between low‐grade virus and Dermatophagoides farinae (Df), airway hyper‐responsiveness, lung inflammation and cytokine production from thoracic lymph nodes were compared after primary and secondary low‐grade RSV infections in four groups of mice; control, Df allergen‐sensitized, RSV‐infected and Df‐sensitized RSV‐infected mice. A direct comparison between low‐ and high‐grade RSV infections was also performed in primary infection. To investigate the role of IL‐5 during secondary RSV infection, anti‐IL‐5 monoclonal antibody (anti‐IL‐5 mAb) was injected in mice and similar parameters were compared in four groups of mice.Results
Primary high‐grade RSV infection increased allergen‐induced airway inflammation, while primary low‐grade RSV infection attenuated allergen‐induced airway inflammation concomitant with significant IFN‐γ production in lung‐draining lymph nodes. In marked contrast, secondary low‐grade RSV infection increased both IFN‐γ and IL‐5 production, resulting in exacerbation of allergen‐induced airway inflammation. Anti‐IL‐5 mAb treatment in secondary low‐grade RSV infection and Df allergen‐sensitized mice attenuated virus and allergen‐induced airway inflammation.Conclusions
Low‐grade RSV infection per se does not cause pulmonary inflammation, whereas it induces a significant immunological response in the allergen‐sensitized host. These results indicate that subclinical and recurrent RSV infection may play an important role in exacerbation and maintenance of asthma in adults, wherein IL‐5 is critically involved.
The influence of moisture content on the rheological properties of processed cheese spreads
Authors: Lee Siew Kim , Anema Skelte , Klostermeyer Henning 
Published: July 2004

SummaryModel processed cheese spreads were prepared from rennet casein, sunflower oil, water and a trisodium citrate/citric acid chelating salt system. The samples were cooked using a laboratory‐scale processed cheese cooker. The moisture content of the samples varied from 49.1 to 55.6%. The samples were characterized by dynamic rheology, rotational viscometry and fat particle size analysis. With increasing moisture content, the rheological behaviour of the samples changed from solid‐like (concentrated solution) to liquid‐like (dilute solution). The moduli decreased and the frequencies at which G′‐G′′ crossed over increased with increasing moisture content. Increasing moisture content resulted in an increase in pH and increase in the volume‐to‐surface diameter of the fat droplets. Rotational viscometry indicated that all the samples were shear thinning. The flow curves fitted a power law relationship (r2 = 0.993). Thixotropic behaviour was displayed by all samples except those above 54% moisture. The shear stress at any particular shear rate increased with decreasing moisture content, indicating a stronger network structure in the low moisture samples.
The effect of whitening agents on the gel‐forming ability and whiteness of surimi
Authors: Benjakul Soottawat , Visessanguan Wonnop , Kwalumtharn Yuwathida 
Published: July 2004

SummaryThe effect of different concentrations of the whitening agents, calcium carbonate, titanium dioxide and soybean oil, on the gel‐forming ability and whiteness of a mixture of bigeye snapper and mackerel surimi was investigated. The whiteness of the surimi gels increased as the concentration of all whitening agents increased (P < 0.05). Titanium dioxide was a good whitening agent and it had no detrimental effects on gel‐forming ability, while oil reduced the gel breaking force and deformation. The addition of calcium carbonate did not result in a marked increase in whiteness, but it did increase the breaking force and deformation to some extent. The different whitening agents showed different influences on the whiteness and gelling characteristics of surimi gel.
Introducing the Learning Practice – I. The characteristics of Learning Organizations in Primary Care
Authors: Rushmer Rosemary , Kelly Diane , Lough Murray , Wilkinson Joyce E. , Davies Huw T. O. 
Published: August 2004

AbstractRationale, aims and objectives  This paper is the first of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery. Here we introduce the notion of the Learning Practice (LP) and outline the characteristics and nature of an LP, exploring cultural and structural factors in detail.Methods  Drawing upon both theoretical concepts and empirical research into LOs in health care settings, the format, focus and feasibility of an LP is explored.Results and conclusions  Characteristics of LPs include flatter team‐based structures that prioritize learning and empowered change, involve staff and are open to suggestions and innovation. Potential benefits include: timely changes in service provision that are realistic, acceptable, sustainable, and owned at practitioner level; smoother interprofessional working; and fast flowing informal communication backed up by records of key decisions to facilitate permanent learning. Critical comment on potential pitfalls and practical difficulties highlights features of the present system that hinder development: tightly defined roles; political behaviours and individual‐oriented support systems; plus the ongoing difficulties involved in tolerating errors (whilst people learn). This paper contributes to the wider quality improvement debate in the area in three main ways. First, by locating Government's desires to create health systems capable of learning within the theoretical and empirical evidence on LOs. Second, it suggests what an LP could be like and how its culture and structures might benefit both staff and patients in addition to meeting externally driven reforms and health priorities. Third, it extends the application of LO concepts to the health care sector locating the principles in bottom‐up change.
Introducing the Learning Practice – III. Leadership, empowerment, protected time and reflective practice as core contextual conditions
Authors: Rushmer Rosemary , Kelly Diane , Lough Murray , Wilkinson Joyce E. , Davies Huw T. O. 
Published: August 2004

AbstractRationale, aims and objectives This paper is the third of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery.Methods Here we provide a systematic literature review of contextual factors that either play a key role in providing a facilitative context for a Learning Practice or manifest themselves as barriers to any Practice's attempts to develop a learning culture.Results and conclusion Core contextual conditions are identified as, first, the requirement for strong and visionary leadership. Leaders who support and develop others, ask challenging questions, are willing to be learners themselves, see possibilities and make things happen, facilitate learning environments. The second core condition is the involvement and empowerment of staff where changes grow from the willing participation of all concerned. The third prerequisite is the setting‐aside of times and places for learning and reflection. This paper contributes to the wider quality improvement debate in three main ways. First, by highlighting the local contextual issues that are most likely to impact on the success or failure of a Practice's attempts to work towards a learning culture. Second, by demonstrating that the very same factors can either help or hinder depending on how they are manifest and played out in context. Third, it adds to the evidence available to support the case for LOs in health care settings.
Involving patients in decision making and communicating risk: a longitudinal evaluation of doctors’ attitudes and confidence during a randomized trial
Authors: Edwards Adrian , Elwyn Glyn 
Published: August 2004

AbstractBackground Important barriers to the wider implementation of shared decision making (SDM) and risk communication in practice remain. The attitudes of professionals undergoing training in these approaches may inform how to overcome these barriers, but there are few such data yet available.Aim To identify the attitudes of professionals during participation in a large practice‐based intervention study with substantial individual exposure to SDM and risk communication, and to assess their confidence with these approaches and reported frequency of implementing them.Setting and participants Twenty general practitioners (GPs) who had been in practice between 1 and 10 years, and participated in an explanatory trial lasting 6 months. The trial interventions comprised training in SDM skills and the use of risk communication materials. The doctors consulted with up to 48 patients each (mean = 40, half of them audio‐taped) for the study.Methods Questionnaire assessments before and after each training stage.Results The GPs indicated positive attitudes towards involving patients and towards the training interventions. They indicated that the risk information packs were applicable but had used them only occasionally with patients outside the trial. No statistically significant changes were associated with the specific interventions in terms of doctors’ confidence in discussing risk information after the risk communication intervention, or attitudes to patient involvement after the SDM intervention. Most attitudes and confidence ratings showed positive changes during the course of the trial as a cohort effect. Such positive changes were associated with female doctors more than male doctors, but not with MRCGP (postgraduate vocational) qualification. Time constraints remained important throughout the study in not implementing the approach more frequently.Conclusions Professionals appear receptive to patient involvement, and willing to acquire the relevant skills. SDM and risk communication training did not appear to contribute differentially to this. Practical barriers such as time constraints should probably be addressed with greater priority than the precise content of training or continuing professional development initiatives if ‘involvement’ is to become a commoner experience for patients in primary care.
Resource effects of training general practitioners in risk communication skills and shared decision making competences
Authors: Cohen David , Longo M. F. , Hood Kerenza , Edwards Adrian , Elwyn Glyn 
Published: August 2004

AbstractRationale, aims and objectives  Involving patients more in decisions about their own care requires doctors to be trained in effective ways of communicating information and in developing competences to negotiate levels of patient involvement which are most appropriate for each case. The aim of this study was to determine the cost of such training and identify which service resource variables are subsequently affected.Methods  An explanatory cluster randomized crossover trial was carried out which involved training general practitioners (GPs) in the use of risk communication (RC) tools, shared decision making (SDM) competences or both. Continuing care by GPs of patients with one of four chronic conditions (menopausal symptoms, menorrhagia, atrial fibrillation, prostatism) was reviewed before and after training. Cost of training was assessed by prospective monitoring of resources used. Data on prescribing, referrals and investigations were collected via questionnaires to participating practitioners. Data on follow‐up GP consultations were extracted from medical records. Three two‐level logistic models were performed to investigate the probability of training having an effect on prescribing, referrals and investigations ordered at the review consultation.Results  Training cost £1218 per practitioner which increased the cost of a consultation by £2.89. Training in SDM or combined with RC significantly affected the probability of a prescription being issued to women with menopausal symptoms and menorrhagia (although RC on its own had no effect) but did not significantly affect prescribing for patients with prostatism or atrial fibrillation. It did not significantly affect the probability of investigations, referrals or follow‐up GP visits for any of the conditions.Conclusion  Unless training has a major influence on consultation length, it is unlikely to have any major impacts on cost.
Quality circles to improve prescribing patterns in primary medical care: what is their actual impact?
Authors: Wensing Michel , Broge Björn , Kaufmann‐Kolle Petra , Andres Edith , Szecsenyi Joachim 
Published: August 2004

AbstractRationale, aims and objectives  Quality circles comprise small group sessions of doctors and written feedback on their individual practice patterns. Although 50% of German primary care doctors participate in quality circles, their effectiveness has hardly been evaluated in Germany. This study determined the impact of a large‐scale programme of quality circles on quality and costs of prescribing.Method  A controlled before–after study was performed, in which primary care doctors were allocated to a quality circles group or a control group. Subjects were 100 000 patients in 1996 and in 1998, who had visited one of 177 doctors in the 3 month registration periods in one region in Germany. The intervention comprised a quality circles programme, comprising 11 sessions and repeated feedback on prescribing. Main outcome measures were proportion of patients who received a prescription, mean prescription costs per patient and proportion of generic prescriptions.Results  The absolute numbers of prescriptions decreased in both groups, but the mean prescription costs per patient increased. The quality circles reduced the proportion of patients who received a prescription (OR = 0.86) and the mean prescription costs per patient (B =−3.99 euro), while it increased the proportion of generic drugs (OR = 1.10). The intervention had intended effects on four of the 15 secondary indicators.Conclusions  Large‐scale application of quality circles had intended effects on prescribing decisions in primary care in Germany. The effects found in this study may reflect better what improvements can be achieved than randomized trials of similar interventions.
Humoral response and susceptibility of five full‐sib families of Atlantic salmon, Salmo salar L., to the haemoflagellate, Cryptobia salmositica
Authors: Chin A , Glebe B D , Woo P T K 
Published: August 2004

AbstractSusceptibility and antibody production against pathogenic and vaccine strains of the haemoflagellate, Cryptobia salmositica were investigated in five full‐sib families (A–E) of Atlantic salmon, Salmo salar. Humoral response and susceptibility of families were compared within three treatments: infection, vaccination and vaccination followed by challenge. Parasitaemias caused by the vaccine strain of C. salmositica were considerably lower than those caused by the pathogenic strain. All vaccinated families were protected when challenged with the pathogenic strain. Family B had significantly lower parasitaemias (with both strains) than the other families. When naïve fish were infected with the pathogenic strain, this family had a significantly lower and earlier peak parasitaemia (4.3 ±1.3 × 106 parasites mL−1 blood at 3 weeks post‐infection; w.p.i.) than the other families. Family C had the highest peak (11.1 ± 1.2 × 106 parasites mL−1 blood), which occurred at 4 w.p.i. Antibodies against C. salmositica were detected earlier in Family B (3 w.p.i.) than in Family C (5 w.p.i.). This demonstrates an association of increased susceptibility with a delayed antibody response. Western immunoblot identified antibodies against 112, 181 and 200 kDa antigens earlier in more resistant fish (Family B). Antigenic stimulation leading to a stronger antibody response was shown with the vaccine strain and in the later stages of infection.
Salmonid gill bacteria and their relationship to amoebic gill disease
Authors: Bowman J P , Nowak B 
Published: August 2004

Abstract16S ribosomal RNA gene analysis was used to assess the bacterial community associated with Atlantic salmon, Salmo salar L., gills which were either affected by amoebic gill disease (AGD) or were AGD‐negative, in order to determine the role that bacteria may play in the development of AGD. AGD‐positive specimens were either infected in the laboratory with Neoparamoeba pemaquidensis, the causative agent of AGD, or were obtained from commercial salmon cages. Samples from laboratory fish maintained in sea water possessed a marine‐type community while field samples which had been treated by a series of freshwater baths possessed a more diverse community which included variable proportions of different bacterial ecotypes, including groups typically associated with soil, skin surfaces and faeces. Samples from fish infected with AGD in the laboratory and a sample from one of two salmon cage fish specimens were dominated by a phylotype belonging to the strictly marine bacterial genus Psychroserpens (family Flavobacteriaceae, phylum Bacteroidetes). The phylotype was not detected in any of the AGD‐negative samples or in one of two AGD‐positive samples obtained from fish subjected to temporary freshwater immersion. The possibility of certain Psychroserpens species as potential opportunistic pathogens associated with salmonid AGD is proposed.
A double‐blind randomized trial of 5% ascorbic acid vs. 4% hydroquinone in melasma
Authors: Espinal‐Perez Liliana Elizabeth , Moncada Benjamin , Castanedo‐Cazares Juan Pablo 
Published: August 2004

AbstractBackground  Melasma is an acquired treatment‐resistant hyperpigmentation of the skin.Methods  Sixteen women with idiopathic melasma were included in our trial. After randomization by another clinician, they were instructed to use, at night, 5% ascorbic acid cream on one side of the face and 4% hydroquinone cream on the other side, for 16 weeks. Sunscreen was applied daily throughout the period of observation. They were evaluated every month by colorimetry, digital photography, and regular color slides. Subjective evaluation by each patient was also taken into account.Results  The best subjective improvement was observed on the hydroquinone side with 93% good and excellent results, compared with 62.5% on the ascorbic acid side (P < 0.05); however, colorimetric measures showed no statistical differences. Side‐effects were present in 68.7% (11/16) with hydroquinone vs. 6.2% (1/16) with ascorbic acid.Conclusion  Although hydroquinone showed a better response, ascorbic acid may play a role in the therapy of melasma as it is almost devoid of side‐effects; it could be used alone or in combination therapy.
Foot dermatitis from the shoes
Authors: Onder Meltem , Atahan Asena Cigdem , Bassoy Banu 
Published: August 2004

AbstractBackground  Foot dermatitis from the shoes is a common disorder.Methods  Patients with foot complaints seen at the Contact Dermatitis Unit, Department of Dermatology, Gazi University Faculty of Medicine between May 2001 and May 2002 were evaluated.Results  Four patients with foot dermatitis from shoe allergens were found. Their clinical and patch test results of shoe contact dermatitis were reviewed. We also summarized the standard test allergens for shoe dermatitis. All four patients were treated with topical corticosteroid creams and were informed about patch test‐positive materials.Conclusions  Patients with foot dermatitis from shoes should undergo patch testing to exclude other causes of foot dermatosis. Contact dermatitis from shoes can be managed by the recognition and avoidance of the allergens responsible. The control of hyperhidrosis and the use of topical and systemic corticosteroid therapies may also be beneficial.
Spectrum of skin diseases in Yemen (Hajjah and adjacent region)
Authors: Lal Khatri Mishri 
Published: August 2004

AbstractBackground  Epidemiological study of skin diseases from Yemen is not available, although some data has been published from nearby Arab countries.Objective  To determine the pattern of skin diseases in Yemen and particularly in Hajjah and nearby regions.Methods  This is a prospective study and analysis of the consecutive new patients attending the Dermatology Clinic of Saudi Hospital at Hajjah, Yemen, from January 1997 to December 1999. The majority of the patients were from Hajjah and nearby regions but a substantial number of patients came from different distant regions of Yemen. The diagnosis was mainly based on clinical features but supported by laboratory investigations, diagnostic procedures and histopathology when needed.Results  The total number of new patients was 13,840 with 14,259 diseases, with a male to female ratio of 1 : 0.81. Ninety‐nine percent of the patients were Yemeni nationals. The leading group of diseases was dermatitis and eczematous disorders, followed by infections and infestations (including cutaneous leishmaniasis and mycetoma), followed by acne and acneiform disorders.Conclusion  The spectrum of skin diseases in this analysis revealed that more than 50% of the diseases belonged to dermatitis and eczematous disorders and infectious diseases groups. Socioeconomic and environmental factors of the region are responsible for this. Implementation of public health programs, a proper health education, and inclusion of a suitable training program of dermatology in the undergraduate medical studies of this country may help to prevent and manage these problems rationally.
In vitro effects of flunisolide on MMP‐9, TIMP‐1, fibronectin, TGF‐β1 release and apoptosis in sputum cells freshly isolated from mild to moderate asthmatics
Authors: Profita M. , Gagliardo R. , Di Giorgi R. , Bruno A. , Riccobono L. , Bonanno A. , Bousquet J. , Vignola A. M. 
Published: August 2004

Background:  Corticosteroids play an important role in inflammation and remodelling of airways and are considered an important therapeutic target in asthma. Inflammation in asthma is characterized by a dysregulation of eosinophil apoptosis and of markers of airways remodelling. We evaluated the ability of flunisolide to inhibit in vitro the release of metalloproteinases‐9 (MMP‐9), tissue inhibitor metalloproteinases‐1 (TIMP‐1), transforming growth factor (TGF‐β) and fibronectin by sputum cells (SC) as well as to induce sputum eosinophil apoptosis.Methods:  The SC, isolated from induced sputum samples of 12 mild‐to‐moderate asthmatics, were cultured for 24 h in the presence or absence of flunisolide (1, 10 and 100 μM). The release of mediators was assessed by enzyme‐linked immunosorbent assay (ELISA) whereas apoptosis was studied by TUNEL technique.Results:  Flunisolide (10 μM) significantly reduced MMP‐9 and TIMP‐1 (P = 0.0011 and P < 0.0001 respectively) and increased MMP‐9/TIMP‐1 molar ratio (P = 0.004). In addition, flunisolide decreased TGF‐β and fibronectin release by SC (P = 0.006; and P < 0.0001 respectively) and increased eosinophil apoptosis (P < 0.001).Conclusions:  These results demonstrate that flunisolide may play an important role in the inhibition of airway inflammation and remodelling, by promoting the resolution of eosinophilic inflammation and by inhibiting the release of MMP‐9, TIMP‐1, TGF‐β and fibronectin.