bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing nursing home placement of patients with dementia: a retrospective, single‐centre study in Japan
Authors: Ota Kazumi , Arikawa Masatoshi , Ohashi Shizuko , Azekawa Takaharu , Matsumoto Toshihiko 
Published: October 2018

AimThis was an exploratory study to examine the factors influencing nursing home placement (NHP) in Japan.MethodsFor this analysis, 633 patients were selected. The data were collected from the clinical records of each patient. A log‐rank test was performed. The time from the patient's first visit to the clinic until the nursing home placement was the independent variable. Age (<80 or ≥80 years), biological sex (male or female), Clinical Dementia Rating scale (CDR) score (overall index 0.5, 1, 2, or 3), living situation (living alone or with someone), and voxel‐based specific regional analysis systems for Alzheimer's disease Z‐score (<2 or ≥2) were the dependent variables. Survival curves were obtained by using the Kaplan–Meier estimate. After the log‐rank test, we conducted a Cox proportional hazards regression analysis.ResultsThe results of log‐rank test indicated that all the variables could significantly influence time to NHP. Cox proportional hazards regression analysis suggested that CDR 3 exhibited the highest hazard ratio and Z‐score showed the lowest hazard ratio. There were significant differences in age, sex, CDR 2, CDR 3, and living situation.ConclusionsThe results indicated that the voxel‐based specific regional analysis systems for Alzheimer's disease Z‐score is unlikely to influence NHP. This may suggest that even if the atrophy in the medial temporal lobe is rather progressed, patients can remain living at their own home with protective factors. Future studies need to investigate the risk and protective factors of time to NHP by combining the variables.
Beyond the recovery of women: The evolving study of gender in Tibetan Buddhism
Authors: Melnick Alison 
Published: October 2018

AbstractTaking the study of women as a cousin to—but not a conflation of—the broader realm of gender studies, this article examines recent developments at the intersection of Tibetan and gender studies. Focusing specifically on the historical study of religious women, it addresses scholarship dedicated to women in Tibet as the beginning of a potentially broad conversation about how we engage with the field of gender studies in the Tibetan context. The article offers a review of recent scholarship—highlighting the themes of female inferiority, the relational nature of individual identity, and women's authorship—and makes suggestions for a more sustained focus on issues related to privilege, masculinity, and intersectional identity, in the study of Tibetan Buddhism and gender.
Phase I–II Trial Design for Biologic Agents Using Conditional Auto-Regressive Models for Toxicity and Efficacy
Authors: Muenz Daniel G. , Taylor Jeremy M. G. , Braun Thomas M. 
Published: October 2018

SummaryA traditional assumption in the design of chemotherapy phase I–II trial designs is that dose increases lead to both more toxicity as well as more efficacy. This assumption of monotonic rates of toxicity and efficacy has come into question as potential cancer treatments are less likely to be chemotherapy and are instead biologic agents. These biologic agents tend to have mechanisms of action that act as ‘on–off’ switches for cancer growth, so giving more of the biologic agents will not necessarily provide any more benefit (and possibly no further risk) to the patient. We propose the use of a conditional auto-regressive (CAR) model as a way to estimate adaptively the rates of dose limiting toxicities (DLTs) and efficacy by smoothing the data collected for all doses in such a way that allows for non-increasing rates of either outcome with dose. We present the study design for our CAR model approach and compare, via simulation, the operating characteristics of our design with two existing contemporary published approaches. We demonstrate that our CAR model approach is a viable design for an adaptive phase I–II trial that can accommodate a variety of toxicity–dose and efficacy–dose patterns.
A qualitative study of home visiting as a palliative care strategy to follow‐up cancer patients by nurses in clinical setting in a developing country
Authors: Ndiok Akon , Ncama Busisiwe 
Published: October 2018

AimsThe aims are to examine the effect of home visiting and resources for instituting the programme as a follow‐up strategy in integration of palliative care in daily clinical practice by nurses caring for cancer patients in Nigeria, and on how it can be used to improve care for cancer patients.BackgroundHome visiting by nurses has been used as a follow‐up option in maternal and child health care globally. Most cancer patients default after diagnosis, home visiting offers potential as a strategy for follow‐up of these patients too.MethodsThis was a qualitative study which employed a focus group discussion with nurse managers and interviews with cancer in‐patients in two teaching hospitals in Nigeria. It utilised an interpretive paradigm to reach the best understanding of the problem. A total of 19 nurse managers who were directly involved with the care of cancer patients and 11 cancer patients participated in the study between July and September 2016. A qualitative content analysis was employed to analyse the data.FindingsNine major themes were identified in relation to perceived benefits of home visiting services and six in relation to needed resources in instituting the programme. Similar findings emerged from both the focus group discussions and the interviews with patients. Participants agreed that visiting cancer patients would ease many problems commonly encountered by patients following diagnosis of cancer, including psychological, financial, and emotional problems. Needed resources included hospital policies, adequate staff strength, staff commitment and funding.ConclusionsViable home visiting requires palliative care teams to carry out the service and hospital policy to direct their activities. Putting this into practice will be in line with World Health Organisation (WHO) advocacy of integrated palliative care for chronic diseases.
Editors’ Introduction and Review: Sociolinguistic Variation and Cognitive Science
Authors: Chevrot Jean‐Pierre , Drager Katie , Foulkes Paul 
Published: October 2018

AbstractSociolinguists study the interaction between language and society. Variationist sociolinguistics — the subfield of sociolinguistics which is the focus of this issue — uses empirical and quantitative methods to study the production and perception of linguistic variation. Linguistic variation refers to how speakers choose between linguistic forms that say the same thing in different ways, with the variants differing in their social meaning. For example, how frequently someone says fishin’ or fishing depends on a number of factors, such as the speaker's regional and social background and the formality of the speech event. Likewise, if listeners are asked to use a rating scale make judgements about speakers who say fishin’ or fishing, their ratings depend on what other social characteristics are attributed to the speaker. This issue aims to reflect the growing number of interactions that bring variationist sociolinguistics into contact of different branches of cognitive science. After presenting current trends in sociolinguistics, we identify five areas of contact between the two fields: cognitive sociolinguistics, sociolinguistic cognition, acquisition of variation, computational modeling, and a comparative approach of variation in animal communication. We then explain the benefits of interdisciplinary work: fostering the study of variability and cultural diversity in cognition; bringing together data and modeling; understanding the cognitive mechanisms through which sociolinguistic variation is processed; examining indexical meaning; exploring links between different levels of grammar; and improving methods of data collection and analysis. Finally we explain how the articles in this issue contribute to each of these benefits. We conclude by suggesting that sociolinguistics holds a strategic position for facing the challenge of building theories of language through integrating its linguistic, cognitive, and social aspects at the collective and individual levels.
Effects of hydraulic retention time and proteins on sludge toxicity for 4‐chlorophenol wastewater treatment in sequencing batch reactors
Authors: Zhao Jianguo , Li Yahe , Chen Xiurong , Wang Lu , Xu Yan 
Published: October 2018

AbstractDue to the higher uncertainty of environmental risk for pollutants’ treatment by activated sludge, 10 mg/L influent 4‐chlorophenol (4‐CP) treated via a sequencing batch reactor (SBR) was used as acclimated SBR. Another SBR was used as control SBR without 4‐CP. The effects of hydraulic retention time (HRT) and proteins on sludge toxicity for 4‐CP treatment were analysed, and compared to the control SBR. Results showed that the sludge toxicity in acclimated SBR was significantly higher than that of the control SBR. Shortening HRT from 12 to 8 hours was beneficial to degrade 4‐CP and lower sludge toxicity. The identified highly expressed protein of ABC transporter co‐existed in control and acclimated SBRs, while other proteins of TonB‐dependent receptor, heat shock 70 kDa protein and superoxide dismutase in acclimated sludge were overexpressed relative to the control sludge, which played an important function in degrading 4‐CP, resisting 4‐CP toxicity and eliminating sludge toxicity.
Slow periodic activity in the longitudinal hippocampal slice can self‐propagate non‐synaptically by a mechanism consistent with ephaptic coupling
Authors: Chiang Chia‐Chu , Shivacharan Rajat S. , Wei Xile , Gonzalez‐Reyes Luis E. , Durand Dominique M. 
Published: October 2018

Key points
Slow periodic activity can propagate with speeds around 0.1 m s−1 and be modulated by weak electric fields.
Slow periodic activity in the longitudinal hippocampal slice can propagate without chemical synaptic transmission or gap junctions, but can generate electric fields which in turn activate neighbouring cells.
Applying local extracellular electric fields with amplitude in the range of endogenous fields is sufficient to modulate or block the propagation of this activity both in the in silico and in the in vitro models.
Results support the hypothesis that endogenous electric fields, previously thought to be too small to trigger neural activity, play a significant role in the self‐propagation of slow periodic activity in the hippocampus.
Experiments indicate that a neural network can give rise to sustained self‐propagating waves by ephaptic coupling, suggesting a novel propagation mechanism for neural activity under normal physiological conditions.
AbstractSlow oscillations are a standard feature observed in the cortex and the hippocampus during slow wave sleep. Slow oscillations are characterized by low‐frequency periodic activity (<1 Hz) and are thought to be related to memory consolidation. These waves are assumed to be a reflection of the underlying neural activity, but it is not known if they can, by themselves, be self‐sustained and propagate. Previous studies have shown that slow periodic activity can be reproduced in the in vitro preparation to mimic in vivo slow oscillations. Slow periodic activity can propagate with speeds around 0.1 m s−1 and be modulated by weak electric fields. In the present study, we show that slow periodic activity in the longitudinal hippocampal slice is a self‐regenerating wave which can propagate with and without chemical or electrical synaptic transmission at the same speeds. We also show that applying local extracellular electric fields can modulate or even block the propagation of this wave in both in silico and in vitro models. Our results support the notion that ephaptic coupling plays a significant role in the propagation of the slow hippocampal periodic activity. Moreover, these results indicate that a neural network can give rise to sustained self‐propagating waves by ephaptic coupling, suggesting a novel propagation mechanism for neural activity under normal physiological conditions.
Optimizing the Correlation between Results of Testing In Vitro and Therapeutic Outcome In Vivo for Fluconazole by Testing Critical Isolates in a Murine Model of Invasive Candidiasis
Authors: Rex John H. , Nelson Page W. , Paetznick Victor L. , Lozano-Chiu Mario , Espinel-Ingroff A. , Anaissie Elias J. 
Published: October 2018

ABSTRACT

The trailing growth phenomenon seen when determining the susceptibilities of
Candida
isolates to the azole antifungal agents makes consistent endpoint determination difficult, and the M27-A method of the National Committee for Clinical Laboratory Standards addresses this problem by requiring an 80% reduction in growth after 48 h of incubation. For some isolates, however, minor variations of this endpoint criterion can produce up to 128-fold variations in the resulting MIC. To investigate the significance of this effect, isolates of
Candida
that exhibited various forms of trailing growth when tested against fluconazole were identified. The isolates were examined in a murine model of invasive candidiasis and were ranked by their relative response to fluconazole by using both improvement in survival and reduction in fungal burden in the kidney. The resulting rank order of in vivo response did not match the MICs obtained by using the M27-A criterion, and these MICs significantly overestimated the resistance of three of the six isolates tested. However, if the MIC was determined after 24 h of incubation and the endpoint required a less restrictive 50% reduction in growth, MICs which better matched the in vivo response pattern could be obtained. Minor variations in the M27-A endpoint criterion are thus required to optimize the in vitro-in vivo correlation for isolates that demonstrate significant trailing growth when tested against fluconazole.
Overexpression, Purification, and Characterization of the Cloned Metallo-β-Lactamase L1 from
Stenotrophomonas maltophilia
Authors: Crowder Michael W. , Walsh Timothy R. , Banovic Linda , Pettit Margaret , Spencer James 
Published: October 2018

ABSTRACT

The metallo-β-lactamase L1 from
Stenotrophomonas maltophilia
was cloned, overexpressed, and characterized by spectrometric and biochemical techniques. Results of metal analyses were consistent with the cloned enzyme having 2 mol of tightly bound Zn(II) per monomer. Gel filtration chromatography demonstrated that the cloned enzyme exists as a tightly held tetramer with a molecular mass of ca. 115 kDa, and matrix-assisted laser desorption ionization and time-of-flight mass spectrometry indicated a monomeric molecular mass of 28.8 kDa. Steady-state kinetic studies with a number of diverse penicillin and cephalosporin antibiotics demonstrated that L1 effectively hydrolyzes all tested compounds, with
k
cat
/

K
m

values ranging between 0.002 and 5.5 μM
−1
s
−1
. These characteristics of the recombinant enzyme are contrasted to those previously reported for metallo-β-lactamases isolated directly from
S. maltophilia.
Antimicrobial Resistance of 914 Beta-Hemolytic Streptococci Isolated from Pharyngeal Swabs in Spain: Results of a 1-Year (1996–1997) Multicenter Surveillance Study
Authors: Baquero Fernando , García-Rodríguez José Angel , de Lomas Juan García , Aguilar Lorenzo ,   the Spanish Surveillance Group for Respiratory Pathogens
Published: October 2018

ABSTRACT

A nationwide susceptibility surveillance study of beta-hemolytic streptococcal isolates from pharyngeal swabs obtained in 11 Spanish hospitals between May 1996 and April 1997 against 12 antibiotics was carried out. Of the isolates 86% (786 of 914 isolates) were group A and 8.4% (77 of 914 isolates) were group C. No resistance was found to β-lactam antibiotics, but significant differences (
P
< 0.001) with respect to lack of susceptibility to macrolides were found between groups (27% for group A and 12% for group C) and between seasons (13.2% in summer and 31.7% in winter). Most of these isolates displayed the M phenotype (low-level resistance to erythromycin and susceptibility to clindamycin).
Erythromycin Resistance Genes in Group A Streptococci in Finland
Authors: Kataja Janne , Huovinen Pentti , Skurnik Mikael ,   the Finnish Study Group for Antimicrobial Resistance, Seppälä Helena 
Published: October 2018

ABSTRACT

Streptococcus pyogenes
isolates (group A streptococcus) of different erythromycin resistance phenotypes were collected from all over Finland in 1994 and 1995 and studied; they were evaluated for their susceptibilities to 14 antimicrobial agents (396 isolates) and the presence of different erythromycin resistance genes (45 isolates). The erythromycin-resistant isolates with the macrolide-resistant but lincosamide- and streptogramin B-susceptible phenotype (M phenotype) were further studied for their plasmid contents and the transferability of resistance genes. Resistance to antimicrobial agents other than macrolides, clindamycin, tetracycline, and chloramphenicol was not found. When compared to our previous study performed in 1990, the rate of resistance to tetracycline increased from 10 to 93% among isolates with the inducible resistance (IR) phenotype of macrolide, lincosamide, and streptogramin B (MLS
B
) resistance. Tetracycline resistance was also found among 75% of the MLS
B
-resistant isolates with the constitutive resistance (CR) phenotype. Resistance to chloramphenicol was found for the first time in
S. pyogenes
in Finland; 3% of the isolates with the IR phenotype were resistant. All the chloramphenicol-resistant isolates were also resistant to tetracycline. Detection of erythromycin resistance genes by PCR indicated that, with the exception of one isolate with the CR phenotype, all M-phenotype isolates had the macrolide efflux (
mefA
) gene and all the MLS
B
-resistant isolates had the erythromycin resistance methylase (
ermTR
) gene; the isolate with the CR phenotype contained the
ermB
gene. No plasmid DNA could be isolated from the M-phenotype isolates, but the
mefA
gene was transferred by conjugation.
Cloning, Sequence Analyses, Expression, and Distribution of
ampC-ampR
from
Morganella morganii
Clinical Isolates
Authors: Poirel Laurent , Guibert Michele , Girlich Delphine , Naas Thierry , Nordmann Patrice 
Published: October 2018

ABSTRACT

Shotgun cloning experiments with restriction enzyme-digested genomic DNA from
Morganella morganii
1, which expresses high levels of cephalosporinase, into the pBKCMV cloning vector gave a recombinant plasmid, pPON-1, which encoded four entire genes:
ampC
,
ampR
, an
hybF
family gene, and
orf-1
of unknown function. The deduced AmpC β-lactamase of pI 7.6 shared structural and functional homologies with AmpC from
Citrobacter freundii
,
Escherichia coli
,
Yersinia enterocolitica
,
Enterobacter cloacae
, and
Serratia marcescens
. The overlapping promoter organization of
ampC
and
ampR
, although much shorter in
M. morganii
than in the other enterobacterial species, suggested similar AmpR regulatory properties. The MICs of β-lactams for
E. coli
MC4100 (
ampC
mutant) harboring recombinant plasmid pACYC184 containing either
ampC
and
ampR
(pAC-1) or
ampC
(pAC-2) and induction experiments showed that the
ampC
gene of
M. morganii
1 was repressed in the presence of
ampR
and was activated when a β-lactam inducer was added. Moreover, transformation of
M. morganii
1 or of
E. coli
JRG582 (Δ
ampDE
) harboring
ampC
and
ampR
with a recombinant plasmid containing
ampD
from
E. cloacae
resulted in a decrease in the β-lactam MICs and an inducible phenotype for
M. morganii
1, thus underlining the role of an AmpD-like protein in the regulation of the
M. morganii
cephalosporinase. Fifteen other
M. morganii
clinical isolates with phenotypes of either low-level inducible cephalosporinase expression or high-level constitutive cephalosporinase expression harbored the same
ampC-ampR
organization, with the
hybF
and
orf-1
genes surrounding them; the organization of these genes thus differed from those of
ampC-ampR
genes in
C. freundii
and
E. cloacae
, which are located downstream from the fumarate operon. Finally, an identical AmpC β-lactamase (DHA-1) was recently identified as being plasmid encoded in
Salmonella enteritidis
, and this is confirmatory evidence of a chromosomal origin of the plasmid-mediated cephalosporinases.
A Novel Type of AmpC β-Lactamase, ACC-1, Produced by a
Klebsiella pneumoniae
Strain Causing Nosocomial Pneumonia
Authors: Bauernfeind Adolf , Schneider Ines , Jungwirth Renate , Sahly Hany , Ullmann Uwe 
Published: October 2018

ABSTRACT

A
Klebsiella pneumoniae
strain resistant to oxyimino cephalosporins was cultured from respiratory secretions of a patient suffering from nosocomial pneumonia in Kiel, Germany, in 1997. The isolate harbors a
bla
resistance gene located on a transmissible plasmid. An
Escherichia coli
transconjugant produces a β-lactamase with an isoelectric point of 7.7 and a resistance phenotype characteristic of an AmpC (class 1) β-lactamase except for low MICs of cephamycins. The
bla
gene was cloned and sequenced. It encodes a protein of 386 amino acids with the active site serine of the S-X-X-K motif at position 64, as is characteristic for class C β-lactamases. Multiple alignment of the deduced amino acid sequence with 21 other AmpC β-lactamases demonstrates only very distant homology, reaching at maximum 52.3% identity for the chromosomal AmpC β-lactamase of
Serratia marcescens
SR50. The β-lactamase of
K. pneumoniae
KUS represents a new type of AmpC-class enzyme, for which we propose the designation ACC-1 (Ambler class C-1).