bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive Performance following Lacunar Stroke in Spanish-Speaking Patients: Results from the SPS3 Trial
Authors: Jacova Claudia , Pearce Lesly A. , Roldan Ana M. , Arauz Antonio , Tapia Jorge , Costello Raymond , McClure Leslie A. , Hart Robert G. , Benavente Oscar R. 
Published: May 2015

Background Cognitive impairment is frequent in lacunar stroke patients. The prevalence and pattern among Spanish-speaking patients are unknown and have not been compared across regions or with English-speaking patients. Aims The aim of this study was to characterize cognitive impairment in Spanish-speaking patients and compare it with English-speaking patients. Methods The baseline neuropsychological test performance and the prevalence of mild cognitive impairment, defined as a z-score ≤ -1·5 on memory and/or non-memory tests, were evaluated in Spanish-speaking patients in the Secondary Prevention of Small Subcortical Strokes trial. Results Out of 3020 participants, 1177 were Spanish-speaking patients residing in Latin America ( n = 693), the United States ( n = 121), and Spain ( n = 363). Low education (zero- to eight-years) was frequent in Spanish-speaking patients (49–57%). Latin American Spanish-speaking patients had frequent post-stroke upper extremity motor impairment (83%). Compared with English-speaking patients, all Spanish-speaking patient groups had smaller memory deficits and larger non-memory/motor deficits, with Latin American Spanish-speaking patients showing the largest deficits median z-score -1·3 to −0·6 non-memory tests; ≤5·0 for Grooved Pegboard; −0·7 to −0·3 for memory tests). The prevalence of mild cognitive impairment was high and comparable with English-speaking patients in the United States and Latin American Spanish-speaking patients but not the Spanish group: English-speaking patients = 47%, Latin American Spanish-speaking patients = 51%, US Spanish-speaking patients = 40%, Spanish Spanish-speaking patients = 29%, with >50% characterized as non-amnestic in Spanish-speaking patient groups. Older age [odds ratio per 10 years =1·52, confidence interval = 1·35–1·71), lower education (odds ratio 0–4 years = 1·23, confidence interval = 0·90–1·67), being a Latin American resident (odds ratio = 1·31, confidence interval = 0·87–1·98), and post-stroke disability (odds ratio Barthel Index <95=1·89, confidence interval = 1·43–2·50) were independently associated with mild cognitive impairment. Conclusions Mild cognitive impairment in Secondary Prevention of Small Subcortical Strokes Spanish-speaking patients with recent lacunar stroke is highly prevalent but has a different pattern to that observed in English-speaking patients. A combination of socio-demographics, stroke biology, and stroke care may account for these differences.
Invariant natural killer T cells and their ligands: focus on multiple sclerosis
Authors: O'Keeffe Joan , Podbielska Maria , Hogan Edward L. 
Published: May 2015

SummaryInvariant natural killer T (iNKT) cells are an innate population of T cells identified by the expression of an invariant T‐cell receptor and reactivity to lipid‐based antigens complexed with CD1d. They account for a small percentage of lymphocytes, but are extremely potent and play central roles in immunity to infection, in some cancers, and in autoimmunity. The list of relevant stimulatory lipids and glycolipid antigens now includes a range of endogenous self‐antigens including the myelin‐derived acetylated galactosylceramides. Recent progress in studies to identify the nature of lipid recognition for iNKT cells in autoimmune diseases like multiple sclerosis is likely to foster the development of therapeutic strategies aimed at harnessing iNKT cell activity.
Transfer of the human NKG2D ligands UL16 binding proteins (ULBP) 1–3 is related to lytic granule release and leads to ligand retransfer and killing of ULBP‐recipient natural killer cells
Authors: López‐Cobo Sheila , Romera‐Cárdenas Gema , García‐Cuesta Eva M. , Reyburn Hugh T. , Valés‐Gómez Mar 
Published: May 2015

SummaryAfter immune interactions, membrane fragments can be transferred between cells. This fast transfer of molecules is transient and shows selectivity for certain proteins; however, the constraints underlying acquisition of a protein are unknown. To characterize the mechanism and functional consequences of this process in natural killer (NK) cells, we have compared the transfer of different NKG2D ligands. We show that human NKG2D ligands can be acquired by NK cells with different efficiencies. The main findings are that NKG2D ligand transfer is related to immune activation and receptor–ligand interaction and that NK cells acquire these proteins during interactions with target cells that lead to degranulation. Our results further demonstrate that NK cells that have acquired NKG2D ligands can stimulate activation of autologous NK cells. Surprisingly, NK cells can also re‐transfer the acquired molecule to autologous effector cells during this immune recognition that leads to their death. These data demonstrate that transfer of molecules occurs as a consequence of immune recognition and imply that this process might play a role in homeostatic tuning‐down of the immune response or be used as marker of interaction.
Delirium: The lived experience of older people who are delirious post‐orthopaedic surgery
Authors: Pollard Cecily , Fitzgerald Mary , Ford Karen 
Published: May 2015

AbstractDelirium is a common, potentially preventable and reversible cause of postoperative functional disability, morbidity, and mortality. It can lead to increased health‐care use and also poses a substantial challenge for nurses caring for patients who experience delirium after surgery. Predominantly, the published work concentrates on diagnosis, reduction of the modifiable risk factors, and treatments. Compared with this body of published work, the experience of delirium from a patient's perspective has been largely ignored except for a limited number of qualitative research reports. The importance of researching the lived experience of delirium is that a better understanding may lead to more empathic, therapeutic nursing care and help other sufferers to know they are not alone. The aims of the study were to explore and clarify the lived experience of delirium. Eleven patients were recruited to the study following discharge post‐surgery from an orthopaedic ward of a major tertiary hospital. The study used a qualitative descriptive approach and incorporated grounded theory data analysis processes. The findings of this study provide an insight into the incomprehensible emotional pain suffered by patients while they were delirious and the disparate feelings of remorse, guilt, and shame they experienced after the episode of delirium. Following this study, recommendations for nursing practice include formal follow‐up support for patients with post‐delirium episodes and more research into the long‐term impact of the experience of delirium.
Factors influencing engagement with case managers: Perspectives of young people with a diagnosis of first episode psychosis
Authors: Tindall Rachel , Francey Shona , Hamilton Bridget 
Published: May 2015

AbstractHolistic treatment during a first episode psychosis (FEP) can significantly impact the longevity and chronicity of the illness, as well as reduce the risk of premature death by suicide. However, treatment can only be effective if the young person participates. Given that 19–40% of young people disengage from early intervention services for FEP, this qualitative study aimed to understand how young people experienced engagement with case managers at an early intervention service. Semistructured interviews were conducted with seven young people and themes were identified using interpretive phenomenological analysis. Young people detailed how engagement with a service could be viewed as a process, following different stages between initial referral and discharge. Throughout this process, a number of factors influenced young people's decision to engage with, or disengage from, their case manager. This created a push–pull dynamic with periods of good engagement and poor engagement. Discussion of this dynamic adds nuance to established scholarship about engagement, including shifts over time in the importance of client empowerment and valued features of therapeutic relationships. Awareness and understanding of these concepts may guide changes to early intervention services and address the core issue of engagement.
Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end‐of‐life care
Authors: Ramasamy Venkatasalu Munikumar , Whiting Dean , Cairnduff Karen 
Published: May 2015

AbstractAimTo explore the experiences, challenges and practices of critical care practitioners since the discontinuation of the Liverpool Care Pathway in critical care settings.BackgroundThe Liverpool Care Pathway was widely used with an aim to improve communication and care for dying individuals and their relatives. However, widespread media criticism prompted a review, which resulted in the discontinuation of the Liverpool Care Pathway across all UK clinical settings.DesignA qualitative study.MethodThe study was carried out in two large acute hospitals in England. Semi‐structured interviews were conducted with 14 critical care practitioners, 6 months after discontinuation of the Liverpool Care Pathway. Transcribed verbatim data were analysed using framework analysis.ResultsThree key themes emerged: ‘lessons learned’, ‘uncertainties and ambivalences’ and ‘the future’. Critical care practitioners reported that life after the Liverpool Care Pathway in critical care settings often involved various clinical ambivalences, uncertainties and inconsistencies in the delivery of end‐of‐life care, especially for less experienced practitioners. Critical care practitioners had ‘become accustomed’ to the components of the Liverpool Care Pathway, which still guide them in principle to ensure quality end‐of‐life care. The Liverpool Care Pathway's structured format was perceived to be a useful clinical tool, but was also criticized as a ‘tick‐box exercise’ and for lacking in family involvement.ConclusionsThis study posits two key conclusions. Despite experienced critical care practitioners being able to deliver quality end‐of‐life care without using the Liverpool Care Pathway, junior nursing and medical staff need clear guidelines and support from experienced mentors in practice. Evidence‐based guidelines related to family involvement in end‐of‐life care planning in critical care settings are also needed to avoid future controversies.
Type 1 diabetes patients have lower strength in femoral bone determined by quantitative computed tomography: A cross‐sectional study
Authors: Ishikawa Koji , Fukui Tomoyasu , Nagai Takashi , Kuroda Takuma , Hara Noriko , Yamamoto Takeshi , Inagaki Katsunori , Hirano Tsutomu 
Published: May 2015

AbstractAims/IntroductionPrevious studies have reported osteoporosis measured by dual‐energy X‐ray absorptiometry in younger patients with type 1 diabetes. Limitations of 2‐D imaging, however, limit the precision of dual‐energy X‐ray absorptiometry for the measurement of bone mineral density and bone strength.Materials and MethodsThree‐dimensional quantitative computed tomography was used to calculate volumetric‐bone mineral density (vBMD) and strength in femoral bone subfractions. A total of 17 male type 1 diabetes patients and 18 sex‐matched healthy controls aged from 18 to 49 years were investigated in the present cross‐sectional study. Patients with overt nephropathy were excluded.ResultsType 1 diabetes patients had significantly lower cortical vBMD in the femoral neck, and significantly lower total vBMD, cortical thickness and cortical cross‐sectional area (cortical CSA) in the intertrochanter. Bone strength estimated by the buckling ratio (an index of cortical instability) of the intertrochanter was significantly higher in type 1 diabetes patients. The following serum bone markers were comparable between the two groups: bone‐specific alkaline phosphatase, N‐terminal propeptide of type 1 procollagen, osteocalcin, pentosidine and homocysteine. Serum insulin‐like growth factor‐1 values were significantly lower in the type 1 diabetes patients than in controls. Serum insulin‐like growth factor‐1values were positively correlated with serum bone formation markers, and the total vBMD of the femoral neck and lumbar spine in type 1 diabetes patients.ConclusionsThe present study is the first investigation by quantitative computed tomography measurement to show cortical instability and lower vBMD in the intertrochanter of young and middle‐aged type 1 diabetes patients. Low insulin‐like growth factor‐1 might be a causative factor for osteoporosis in type 1 diabetes.
Molecular Polymorphism in the MTA and MTB Mating Type Genes of Tetrahymena thermophila and Related Asexual Species
Authors: Booth Laurie , Wolfe Benjamin , Doerder F. Paul 
Published: May 2015

AbstractEach of the seven mating types of Tetrahymena thermophila is determined by a pair of large genes, MTA and MTB, whose expression peaks at early conjugation. Each protein consists of a mating‐type specific domain and a common transmembrane domain. To assess variation in natural populations, regions of both domains from wild isolates expressing mating types V and VII were analyzed. Corresponding regions of amicronucleates incapable of mating also were examined. MTA and MTB showed high haplotype diversity, with greater sequence variation in MTB. Mating type VII was less variable than mating type V, suggesting more recent origin. No polymorphism distinguished between mat1‐ and mat2‐like alleles encoding different arrays of mating types, nor did polymorphisms give evidence of population structure. MTA and MTB variants have different phylogenies, suggesting independent rather than concerted evolution, and are under weak purifying selection. Codon usage is less biased than for housekeeping genes, and reassigned glutamine encoding stop codons are preferentially used. Amicronucleate T. thermophila and closely related nsp15 and nsp25 have higher levels of nucleotide and amino acid substitution, consistent with cox1 distances. The results suggest that complete sequencing of mating type genes of wild isolates coupled with functional analysis will be informative.
Image Segmentation of Bananas in a Crate Using a Multiple Threshold Method
Authors: Hu Meng‐Han , Dong Qing‐Li , Liu Bao‐Lin , Pan Lei‐Qing , Walshaw John 
Published: May 2015

AbstractIn this paper, an automatic segmentation algorithm based on the threshold technique was designed for the image segmentation of bananas in a crate. The pixels of banana and background were selected discretely in the manually segmented regions, and subsequently, nine color features were extracted from RGB, HSV and CIE L*a*b* color space. Three thresholds, which were determined by statistical analysis of B, L* and b* color channel, were used for the design of the automatic segmentation algorithm. The intuitive comparison was applied for the qualitative assessment of segmentation performance. The results showed that the outlines of manually segmented and automatically segmented regions were almost similar to each other. The quantitative evaluation of segmentation performance was carried out by area ratio, and the results demonstrated that the average area ratio of 10 tested samples was more than 80%. These two tested results indicated that the performance of this automatic segmentation algorithm might be acceptable, and this methodology could provide a key technology to realize the real‐time quality monitoring and control system in banana ripening rooms.Practical ApplicationsAn automatic image segmentation developed in the current study provides the potential of segmenting the bananas in a crate with the plastic bag. The algorithm is designed on the basis of a multiple threshold approach, thus allowing the high segmentation speed and accuracy. The obtained results demonstrated that the proposed multiple threshold‐based segmentation algorithm could be used for achieving in situ quality monitoring and control system in banana ripening rooms.
Clinical significance and prognostic impact of the total diameter of enlarged lymph nodes on preoperative multidetector computed tomography in patients with gastric cancer
Authors: Kawaguchi Tsutomu , Komatsu Shuhei , Ichikawa Daisuke , Kosuga Toshiyuki , Kubota Takeshi , Okamoto Kazuma , Konishi Hirotaka , Shiozaki Atsushi , Fujiwara Hitoshi , Otsuji Eigo 
Published: May 2015

AbstractBackground and AimThis study was designed to evaluate the clinical significance and prognostic impact of the total diameter of enlarged lymph nodes (TDL) on preoperative multidetector computed tomography (MDCT) in gastric cancer (GC).MethodsOf a total of 480 GC patients between 2005 and 2009, 70 patients with a preoperative diagnosis of nodal metastasis on MDCT were included in this study. All regional lymph nodes showing metastatic involvement were preoperatively counted and measured.ResultsThe TDL was calculated, and using a receiver operating characteristic curve, a cutoff value of 45 mm in the two groups of large TDL (LTDL) and small TDL was found to be appropriate for TDL. No significant differences were observed in clinicopathological features, except for tumor recurrence, between the two groups. Univariate survival analysis revealed that patients with LTDL had a worse prognosis as well as an upper tumor location, deeper tumor depth, and further advanced pathological stage. Multivariable prognostic analysis identified LTDL as an independent worse prognostic factor (P = 0.0128).ConclusionsGC patients with the total nodal diameter measuring 45 mm or more on MDCT have a worse prognosis. GC patients with the novel surrogate indicator of worse prognosis for a preoperative imaging diagnosis may have need of multimodal treatment to improve the survival.
Diagnosis of Helicobacter pylori‐induced gastritis by serum pepsinogen levels
Authors: Kitamura Yoko , Yoshihara Masaharu , Ito Masanori , Boda Tomoyuki , Matsuo Taiji , Kotachi Takahiro , Tanaka Shinji , Chayama Kazuaki 
Published: May 2015

AbstractBackground and AimGastric cancer develops due to atrophic gastritis induced by Helicobacter pylori (H. pylori) infection. Serum levels of pepsinogen (PG) are known to be excellent markers for evaluating the degree of atrophic gastritis. We investigated whether chronic gastritis could be diagnosed by evaluating serum PG levels.MethodsA total of 4483 patients (average age, 49.7 years; 2879 men) were included in this study. Fasting serum samples were collected and anti‐H. pylori antibody and PG levels were evaluated. We evaluated the endoscopic atrophy grade or histological extent of gastritis, and calculated the diagnostic capability of this serum marker.ResultsA total of 4483 patients, were diagnosed as being positive (4160) or negative (323) for H. pylori‐induced gastritis. In patients with H. pylori‐induced gastritis, the PG II levels were higher and the PG I/II ratios were lower than among those without H. pylori gastritis. A cut‐off values of (i) PG I/II ≤ 5; (ii) PG II ≥ 10 or PG I/II ≤ 5; (iii) PG II ≥ 12 or PG I/II ≤ 4.5 showed high sensitivity and accuracy (over 90%) for diagnosing H. pylori‐induced gastritis. Moreover, in a mass screening of healthy subjects, a cut‐off value of PG I/II ≤ 4.5 might be better for diagnosing the presence of gastritis because of a sensitivity and specificity > 80%.ConclusionsThe presence of H. pylori‐induced gastritis can be evaluated using serum PG levels.
Hepatic differentiation of human amniotic epithelial cells and in vivo therapeutic effect on animal model of cirrhosis
Authors: Lin Jaymie Siqi , Zhou Lei , Sagayaraj Antony , Jumat Nur Halisah Bte , Choolani Mahesh , Chan Jerry Kok Yen , Biswas Arijit , Wong Peng Cheang , Lim Seng Gee , Dan Yock Young 
Published: May 2015

AbstractBackground and AimHuman amniotic epithelial cells (hAECs) have been touted as an ideal stem cell candidate, being ethically neutral, immunologically naïve, plentiful in origin, and retaining plasticity in its fetal stage. We hypothesized that by applying natural physiological signals of the developing liver, hAECs can be coaxed into becoming functional immunopermissive hepatocyte‐like cells. These cells would have tremendous potential for allogenic cellular transplantation in the treatment of chronic liver insufficiency.MethodshAECs were obtained from term placentas and subjected to hepatic trans‐differentiation. Hepatic differentiated cells were analyzed with immunophenotyping, electron microscopy, reverse transcription–polymerase chain reaction as well as characterized for hepatic metabolic function. In vivo efficacy was tested using intrasplenic transplantation into non‐obese diabetic (NOD) Scid Gamma mice with thioacetamide‐induced chronic liver failure and analyzed for engraftment and improvement in liver indices.ResultsWith hepatic differentiation, hAECs assumed a hepatocytic polygonal morphology with upregulation of transcription factors responsible for liver specification. These hepatic differentiated‐hAECs (HD‐AECs) demonstrated bile canaliculi formation, secreted albumin, eliminated indo‐cyanine green, uptook low‐density lipoprotein, and inducible CYP3A4 and CYP2C9 enzymatic activities. Transplantation of HD‐AECs and de novo hAECs in mice model of cirrhosis showed successful in vivo engraftment and differentiation into functional hepatocytes positive for human‐specific albumin. HD‐AEC cells that had undergone hepatic differentiation showed the greatest improvement in albumin function while preserving human leukocyte antigen‐G expression postdifferentiation.ConclusionhAECs were able to differentiate into functional hepatocyte‐like cells both in vivo and in vitro. They showed therapeutic efficacy after transplantation in mice model of cirrhosis, offering an exciting source of cells for generation of functionally useful hepatocytes.
Crassulacean acid metabolism: a continuous or discrete trait?
Authors: Winter Klaus , Holtum Joseph A. M. , Smith J. Andrew C. 
Published: May 2015

SummaryThe key components of crassulacean acid metabolism (CAM) – nocturnal fixation of atmospheric CO2 and its processing via Rubisco in the subsequent light period – are now reasonably well understood in terms of the biochemical reactions defining this water‐saving mode of carbon assimilation. Phenotypically, however, the degree to which plants engage in the CAM cycle relative to regular C3 photosynthesis is highly variable. Depending upon species, ontogeny and environment, the contribution of nocturnal CO2 fixation to 24‐h carbon gain can range continuously from close to 0% to 100%. Nevertheless, not all possible combinations of light and dark CO2 fixation appear equally common. Large‐scale surveys of carbon‐isotope ratios typically show a strongly bimodal frequency distribution, with relatively few intermediate values. Recent research has revealed that many species capable of low‐level CAM activity are nested within the peak of C3‐type isotope signatures. While questions remain concerning the adaptive significance of dark CO2 fixation in such species, plants with low‐level CAM should prove valuable models for investigating the discrete changes in genetic architecture and gene expression that have enabled the evolutionary transition from C3 to CAM.

Contents

Summary
73

I.
Introduction
73

II.
Phenotypic diversity
74

III.
Ecological context
74

IV.
Structure–function context
75

V.
Biochemical–genomics context
76

VI.
Transitional states?
76

VII.
Conclusions – what is a CAM plant?
77

Acknowledgements
77

References
77