bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between changes in the use of psychotropic drugs and behavioural and psychological symptoms of dementia over 1 year among long‐term care facility residents
Authors: Ozaki Takashi , Katsumata Yuriko , Arai Asuna 
Published: October 2018

AimPharmacological treatments are often used in treating the behavioural and psychological symptoms of dementia (BPSD) in nursing homes, despite the fact that non‐pharmacological treatments are recommended as a first‐line treatment and can provide a suitable alternative. Because the course of BPSD is known to fluctuate depending on individual symptoms over time, the frequencies of drug use and BPSD, as well as their association, should be observed over a longer period. We investigated the association between the changes in psychotropic drug (PD) use and BPSD, focusing on the number of symptoms, severity, and care burden over 1 year among long‐term care facility residents.MethodsA 1‐year follow‐up study was conducted among older residents with dementia or similar symptoms (n = 312 at baseline; n = 237 at follow‐up) by using a care staff questionnaire in 10 long‐term care facilities in Hokkaido, Japan. Medication use was determined based on prescription information. The brief questionnaire form of the Neuropsychiatric Inventory was used to assess BPSD.ResultsAmong residents followed up for 1 year, new users of PD—particularly anxiolytics and hypnotics—had a significantly increased number and severity of BPSD, compared with non‐PD users. Continuing PDs was also related to increased severity over the year. Among residents with any persistent BPSD for 1 year, new use of PDs—particularly anxiolytics and hypnotics—was significantly associated with an increased care burden of BPSD, compared with the non‐use of PDs. The discontinuation of PDs was significantly associated with a decreased care burden, compared with the non‐use of PDs.ConclusionsOur study suggests that PDs, particularly anxiolytics and hypnotics, may be prescribed carefully in response to exacerbation of BPSD in terms of the number of symptoms, severity, and care burden in long‐term care facilities. Continuous monitoring of PDs use and BPSD is important to effectively address BPSD.
Taxing and Regulating Vices*
Authors: Immordino Giovanni , Menichini Anna Maria C. , Romano Maria Grazia 
Published: October 2018

AbstractWe study the optimal taxation and regulation of sin goods – goods that are enjoyable to consume but also create future negative health consequences – within a setting in which individuals are time‐inconsistent (and thus consume too much), regulation makes the consumption of sin goods less pleasurable, and taxation involves administrative and compliance costs. In contrast to previous literature, we find that regulation can be beneficial even when corrective taxes are available and individuals are homogeneous. Moreover, despite the inefficiencies associated with the use of both instruments, the consumption of the sin good might fall short of the first best. The results are robust to consumers’ heterogeneity.
A game of faith: Role‐playing games as an active learning strategy for value formation and faith integration in the theological classroom
Authors: Howard Melanie A. 
Published: October 2018

AbstractRole‐playing games have been a part of scholarly conversations about pedagogy for several decades. However, more work is needed in understanding how gaming pedagogy can best fit with and augment particular disciplines. After providing two examples of role‐playing games that have been used successfully in teaching the New Testament, this article argues that role‐playing games contribute to theological and religious studies classrooms by forming positive values (e.g. openness to multiple viewpoints, civility, and empathy) and assisting students in integrating their faith and learning. Because of the low‐risk settings that games provide, students can practice skills that increase their achievement of learning outcomes and contribute to their value formation and faith formation.
“Make your own religion”: The fictive religion assignment as educational game
Authors: Zeller Benjamin E. 
Published: October 2018

AbstractThis article considers the “create your own religion” or “fictive religion” assignment as a pedagogical tool, contextualizing it within the scholarship of teaching and learning, and positioning it as a tool for broad adoption in a variety of courses. I argue that we ought to conceptualize the fictive religion assignment as an instructional game, and make use of scholarship on teaching through games as a foundation for my analysis. While I offer the example of my own fictive religion assignment as a case study, the overall argument is a theoretical one, namely that the assignment works because of the nature of games.
Sequence analyses of variable cytomegalovirus genes for distinction between breast milk– and transfusion‐transmitted infections in very‐low‐birth‐weight infants
Authors: Furui Yasumi , Yamagishi Naoji , Morioka Ichiro , Taira Rikizo , Nishida Kosuke , Ohyama Shohei , Matsumoto Hisayuki , Nakamachi Yuji , Hasegawa Takashi , Matsubayashi Keiji , Nagai Tadashi , Satake Masahiro 
Published: October 2018

BACKGROUNDCytomegalovirus (CMV) transmission to very‐low‐birth‐weight infants (VLBWIs) sometimes induces serious clinical symptoms. Although breast milk is considered a major source of transmission, transfusion‐transmitted CMV (TT‐CMV) infection is often suspected when CMV disease develops after transfusion. Thus, it is clinically important to distinguish between transfusion‐transmitted and breast milk–transmitted CMV infections.STUDY DESIGN AND METHODSStudy A: The incidence of acquired CMV transmission was prospectively investigated in 65 VLBWIs. Study B: To determine the transmission routes in 18 TT‐CMV–suspected VLBWIs who had been reported in our hemovigilance system, we performed polymerase chain reaction for CMV DNA in fed breast milk and/or repository blood samples related to transfused leukoreduced blood products. Furthermore, we evaluated the identity of CMV strains in patients' urine/blood samples and fed breast milk by sequence analyses of variable CMV genes UL139 and UL146.RESULTSStudy A: Acquired CMV infection was found in 4 of 65 VLBWIs (6.2%). Study B: CMV DNA was detected in fed breast milk for 12 of 14 TT‐CMV–suspected cases, for which breast milk was available. Furthermore, CMV DNA sequence‐matching rates between fed breast milk and patients' urine/blood for both UL139 and UL146 genes were 100% or nearly 100% in 11 patients. In contrast, repository blood samples for 11 of 14 patients were CMV DNA negative.CONCLUSIONCMV is principally transmitted through breast milk in VLBWIs. The risk of TT‐CMV seems to be extremely low when using leukoreduced blood products. Sequence analyses of the variable CMV genes are useful for evaluating CMV transmission routes.
Has the crisis affected Spanish investment strategy abroad? A spatial panel data approach
Authors: Gutiérrez‐Portilla Paula , Maza Adolfo , Villaverde José 
Published: October 2018

AbstractThis paper investigates whether the Spanish investment strategy abroad has been affected by the Great Recession. Applying a panel spatial Durbin model for two sample periods, pre‐crisis (1996–2007) and crisis (2008–14), our findings indicate that Spanish foreign direct investment (FDI) strategy has been indeed markedly altered by the global economic crisis. Complex‐vertical FDI motives prevailed over the pre‐crisis period, whereas horizontal FDI did so over the crisis. These results are robust to the use of sectoral FDI data and alternative specifications of the spatial weight matrix.
Fuzzy‐based gaps assessment of flood disaster risk reduction management systems in Metro Manila, Philippines
Authors: Gilbuena Romeo , Kawamura Akira , Medina Reynaldo , Amaguchi Hideo 
Published: October 2018

AbstractPlanning and prioritization in flood disaster risk reduction (FDRR) is critical and often tedious to both planners and decision‐makers. In Metro Manila, Philippines, flooding is a perennial problem that requires regular assessments and updating of its municipal‐based FDRR management systems. A simple, but practical approach may prove useful in the identification of priority schemes, especially when the need for improvement is urgent and resources are limited. This study provides a simple quantitative approach to gaps assessment for FDRR management systems using a fuzzy multiattribute decision‐making technique. This is demonstrated by utilizing the stakeholders’ perceptions and field information obtained during the aftermath of the tropical storm Ketsana in 2009. Study results show that the gaps can be quantified and ranked to establish the priority schemes for the improvement of the FDRR management systems in Metro Manila, focusing mainly on the following FDRR management systems: prevention, preparedness, response and disaster recovery.
Colossal grain growth yields single-crystal metal foils by contact-free annealing
Authors: Jin Sunghwan , Huang Ming , Kwon Youngwoo , Zhang Leining , Li Bao-Wen , Oh Sangjun , Dong Jichen , Luo Da , Biswal Mandakini , Cunning Benjamin V. , Bakharev Pavel V. , Moon Inyong , Yoo Won Jong , Camacho-Mojica Dulce C. , Kim Yong-Jin , Lee Sun Hwa , Wang Bin , Seong Won Kyung , Saxena Manav , Ding Feng , Shin Hyung-Joon , Ruoff Rodney S. 
Published: October 2018

Turning many into oneSingle-crystal metal foils are valuable for their surface properties that allow for synthesis of materials like graphene. Jinet al.present a strategy for creating colossal single-crystal metal foils called “contact-free annealing” (see the Perspective by Rollett). The method relies on hanging and heating commercially available, inexpensive, cold-rolled metal foils. Almost as if by magic, the polycrystalline grains rotate and anneal into a large single-crystal sheet with a specific crystal orientation. The strategy allows for the creation of much larger and much cheaper single-crystal metal foils.Science, this issue p.1021; see also p.996
Use of Licensed Vaccines for Active Immunization of the Immunocompromised Host
Authors: Pirofski Liise-anne , Casadevall Arturo 
Published: October 2018

SUMMARYThe latter part of the 20th century has witnessed an unprecedented rise in the number of individuals with impaired immunity. This is primarily attributable to the increased development and use of antineoplastic therapy for malignancies, organ and bone marrow transplantation, and the AIDS epidemic. Individuals with impaired immunity are often at increased risk for infections, and they can experience more severe and complicated courses of infection. The lack of therapy for a variety of viruses and the rise in antimicrobial resistance of many pathogens have focused attention on vaccination to prevent infectious diseases. The efficacy of most licensed vaccines has been established in immunocompetent hosts. However, there is also considerable experience with most vaccines in those with impaired immunity. We reviewed the use of licensed live, inactivated, and polysaccharide vaccines in this group, and several themes emerged: (i) most vaccines are less immunogenic in those with impaired immunity than in normal individuals; (ii) live vaccines are generally contraindicated in this group; and (iii) the efficacy of many commonly used vaccines has not been established in people with impaired immunity. This review suggests that for most vaccines there are little or no efficacy data in those with impaired immunity but their use in this patient group is generally safe.
DiarrheagenicEscherichia coli
Authors: Nataro James P. , Kaper James B. 
Published: October 2018

SUMMARYEscherichia coli is the predominant nonpathogenic facultative flora of the human intestine. Some E. coli strains, however, have developed the ability to cause disease of the gastrointestinal, urinary, or central nervous system in even the most robust human hosts. Diarrheagenic strains of E. coli can be divided into at least six different categories with corresponding distinct pathogenic schemes. Taken together, these organisms probably represent the most common cause of pediatric diarrhea worldwide. Several distinct clinical syndromes accompany infection with diarrheagenic E. coli categories, including traveler’s diarrhea (enterotoxigenic E. coli), hemorrhagic colitis and hemolytic-uremic syndrome (enterohemorrhagic E. coli), persistent diarrhea (enteroaggregative E. coli), and watery diarrhea of infants (enteropathogenic E. coli). This review discusses the current level of understanding of the pathogenesis of the diarrheagenic E. coli strains and describes how their pathogenic schemes underlie the clinical manifestations, diagnostic approach, and epidemiologic investigation of these important pathogens.
The Lipids of
Pneumocystis carinii
Authors: Kaneshiro Edna S. 
Published: October 2018

SUMMARY

Information about a number of Pneumocystis carinii lipids obtained by the analyses of organisms isolated and purified from infected lungs of corticosteroid-immunosuppressed rats has been reported in recent years. Of the common opportunistic protists associated with AIDS (Cryptosporidium, Toxoplasma, and the microsporidia), more is currently known about the lipids of P. carinii than the others. Lipids that are synthesized by the organism but not by humans are attractive targets for drug development. Thus, the elucidation of Δ
7
C-24-alykylated sterol and cis-9,10-epoxystearic acid biosyntheses in P. carinii is currently being examined in detail, since these have been identified as P. carinii-specific lipids. The development of low-toxicity drugs that prevent sterol C-24 alkylation and the specific inhibition of the lipoxygenase that forms cis-9,10-epoxystearic acid might prove fruitful. Although humans can synthesize coenzyme Q
10
, the anti-P. carinii activity and low toxicity of ubiquinone analogs such as atovaquone suggest that the electron transport chain in the pathogen may differ importantly from that in the host. Although resistance to atovaquone has been observed, development of other naphthoquinone drugs would provide a broader armamentarium of drugs to treat patients with P. carinii pneumonia. Studies of bronchoalveolar lavage fluid and of infected lungs have demonstrated that the infection causes a number of chemical abnormalities. Bronchoalveolar lavage fluid obtained after the removal of lung cellular material and the organisms has been shown to contain larger amounts of surfactant proteins and smaller amounts of phospholipids than do comparable samples from P. carinii-free lungs. Increased phospholipase activity, inhibition of surfactant secretion by type II cells, and uptake and catabolism of lipids by the pathogen may explain this phenomenon related to P. carinii pneumonia. Although not yet thoroughly examined, initial studies on the uptake and metabolism of lipids by P. carinii suggest that the organism relies heavily on exogenous lipid nutrients.
Microbiological and Clinical Aspects of Infection Associated with
Stenotrophomonas maltophilia
Authors: Denton Miles , Kerr Kevin G. 
Published: October 2018

SUMMARY
The gram-negative bacterium Stenotrophomonas maltophilia is increasingly recognized as an important cause of nosocomial infection. Infection occurs principally, but not exclusively, in debilitated and immunosuppressed individuals. Management of S. maltophilia-associated infection is problematic because many strains of the bacterium manifest resistance to multiple antibiotics. These difficulties are compounded by methodological problems in in vitro susceptibility testing for which there are, as yet, no formal guidelines. Despite its acknowledged importance as a nosocomial pathogen, little is known of the epidemiology of S. maltophilia, and although it is considered an environmental bacterium, its sources and reservoirs are often not readily apparent. Molecular typing systems may contribute to our knowledge of the epidemiology of S. maltophilia infection, thus allowing the development of strategies to interrupt the transmission of the bacterium in the hospital setting. Even less is known of pathogenic mechanisms and putative virulence factors involved in the natural history of S. maltophilia infection and this, coupled with difficulties in distinguishing colonization from true infection, has fostered the view that the bacterium is essentially nonpathogenic. This article aims to review the current taxonomic status of S. maltophilia, and it discusses the laboratory identification of the bacterium. The epidemiology of the organism is considered with particular reference to nosocomial outbreaks, several of which have been investigated by molecular typing techniques. Risk factors for acquisition of the bacterium are also reviewed, and the ever-expanding spectrum of clinical syndromes associated with S. maltophilia is surveyed. Antimicrobial resistance mechanisms, pitfalls in in vitro susceptibility testing, and therapy of S. maltophilia infections are also discussed.
Natural Pathogens of Laboratory Mice, Rats, and Rabbits and Their Effects on Research
Authors: Baker David G. 
Published: October 2018

SUMMARYLaboratory mice, rats, and rabbits may harbor a variety of viral, bacterial, parasitic, and fungal agents. Frequently, these organisms cause no overt signs of disease. However, many of the natural pathogens of these laboratory animals may alter host physiology, rendering the host unsuitable for many experimental uses. While the number and prevalence of these pathogens have declined considerably, many still turn up in laboratory animals and represent unwanted variables in research. Investigators using mice, rats, and rabbits in biomedical experimentation should be aware of the profound effects that many of these agents can have on research.
Structures ofToxoplasma gondiiTachyzoites, Bradyzoites, and Sporozoites and Biology and Development of Tissue Cysts
Authors: Dubey J. P. , Lindsay D. S. , Speer C. A. 
Published: October 2018

SUMMARYInfections by the protozoan parasite Toxoplasma gondii are widely prevalent worldwide in animals and humans. This paper reviews the life cycle; the structure of tachyzoites, bradyzoites, oocysts, sporocysts, sporozoites and enteroepithelial stages of T. gondii; and the mode of penetration of T. gondii. The review provides a detailed account of the biology of tissue cysts and bradyzoites including in vivo and in vitro development, methods of separation from host tissue, tissue cyst rupture, and relapse. The mechanism of in vivo and in vitro stage conversion from sporozoites to tachyzoites to bradyzoites and from bradyzoites to tachyzoites to bradyzoites is also discussed.
Onychomycosis: Pathogenesis, Diagnosis, and Management
Authors: Elewski Boni E. 
Published: October 2018

SUMMARYAlthough not life-threatening, onychomycosis (a fungal infection of the nail, usually caused by a dermatophyte) constitutes an important public health problem because of its high prevalence (about 10% of the U.S. population) and associated morbidity. The disease can have certain negative consequences for patients, such as pain, and can potentially undermine work and social lives. This review discusses the etiology, classification, diagnosis, and treatment of onychomycosis. Four types of onychomycosis are recognized based on the site and pattern of fungal invasion. Dermatophyte fungi are the predominant pathogens, but yeasts (especially Candida albicans) and nondermatophyte molds may also be implicated. Accurate diagnosis requires direct microscopy and fungal culture. The differential diagnosis includes psoriasis, lichen planus, onychogryphosis, and nail trauma. Onychomycosis is more difficult to treat than most dermatophytoses because of the inherent slow growth of the nail. Older antifungal agents (ketoconazole and griseofulvin) are unsuitable for onychomycosis because of their relatively poor efficacy and potential adverse effects. Three recently developed antimycotic agents (fluconazole, itraconazole, and terbinafine) offer high cure rates and good safety profiles. In addition, the short treatment times (<3 months) and intermittent dosing schedules are likely to enhance compliance and reduce the costs of therapy.
Pathogenesis and Diagnosis of Shiga Toxin-Producing
Escherichia coli
Infections
Authors: Paton James C. , Paton Adrienne W. 
Published: October 2018

SUMMARY
Since their initial recognition 20 years ago, Shiga toxin-producing Escherichia coli (STEC) strains have emerged as an important cause of serious human gastrointestinal disease, which may result in life-threatening complications such as hemolytic-uremic syndrome. Food-borne outbreaks of STEC disease appear to be increasing and, when mass-produced and mass-distributed foods are concerned, can involve large numbers of people. Development of therapeutic and preventative strategies to combat STEC disease requires a thorough understanding of the mechanisms by which STEC organisms colonize the human intestinal tract and cause local and systemic pathological changes. While our knowledge remains incomplete, recent studies have improved our understanding of these processes, particularly the complex interaction between Shiga toxins and host cells, which is central to the pathogenesis of STEC disease. In addition, several putative accessory virulence factors have been identified and partly characterized. The capacity to limit the scale and severity of STEC disease is also dependent upon rapid and sensitive diagnostic procedures for analysis of human samples and suspect vehicles. The increased application of advanced molecular technologies in clinical laboratories has significantly improved our capacity to diagnose STEC infection early in the course of disease and to detect low levels of environmental contamination. This, in turn, has created a potential window of opportunity for future therapeutic intervention.
Klebsiellaspp. as Nosocomial Pathogens: Epidemiology, Taxonomy, Typing Methods, and Pathogenicity Factors
Authors: Podschun R. , Ullmann U. 
Published: October 2018

SUMMARYBacteria belonging to the genus Klebsiella frequently cause human nosocomial infections. In particular, the medically most important Klebsiella species, Klebsiella pneumoniae, accounts for a significant proportion of hospital-acquired urinary tract infections, pneumonia, septicemias, and soft tissue infections. The principal pathogenic reservoirs for transmission of Klebsiella are the gastrointestinal tract and the hands of hospital personnel. Because of their ability to spread rapidly in the hospital environment, these bacteria tend to cause nosocomial outbreaks. Hospital outbreaks of multidrug-resistant Klebsiella spp., especially those in neonatal wards, are often caused by new types of strains, the so-called extended-spectrum-β-lactamase (ESBL) producers. The incidence of ESBL-producing strains among clinical Klebsiella isolates has been steadily increasing over the past years. The resulting limitations on the therapeutic options demand new measures for the management of Klebsiella hospital infections. While the different typing methods are useful epidemiological tools for infection control, recent findings about Klebsiella virulence factors have provided new insights into the pathogenic strategies of these bacteria. Klebsiella pathogenicity factors such as capsules or lipopolysaccharides are presently considered to be promising candidates for vaccination efforts that may serve as immunological infection control measures.