bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing the length of stay for acute hospital patients needing admission into inpatient rehabilitation: a multicentre study of process barriers
Authors: New P. W. , Andrianopoulos N. , Cameron P. A. , Olver J. H , Stoelwinder J. U. 
Published: June 2013

AbstractBackgroundPatient flow is a major problem in hospitals. Delays in accessing inpatient rehabilitation have not been well studied.AimsMeasure the time taken for key processes in the patient journey from acute hospital admission through to inpatient rehabilitation admission in order to identify opportunities for improvement.MethodsRetrospective open cohort study. All patients admitted over 8‐ and 10‐month periods during 2008 into two inpatient rehabilitation units in Melbourne, Australia. Main outcome measures were the duration of the following key processes: acute hospital admission until referral for rehabilitation, referral until assessment by the rehabilitation service, assessment until deemed ready for transfer to rehabilitation, ready for transfer until rehabilitation admission.ResultsThree hundred and sixty patients were in the study sample (females = 186; 51.7%); mean age = 58.4 (standard deviation = 15.0) years. There was a median of 7 (interquartile range [IQR] 4–13) days from acute hospital admission till referral for rehabilitation, a median of 1 (IQR 0–1) day from referral till assessment, a median of 0 (IQR 0–2) days from assessment till deemed ready for transfer and a median of 1 (IQR 0–3) day from ready till admission into rehabilitation. Overall, patients spent 12.0% (804/6682) of their acute hospital admission waiting for a rehabilitation bed.ConclusionsThere are opportunities to improve the efficiency of key processes in the acute hospital journey for patients subsequently admitted to inpatient rehabilitation; in particular, reducing the time from acute hospital admission till referral for rehabilitation and from being deemed ready for transfer to rehabilitation till admission.
A randomized, double‐blind, placebo‐controlled trial of venlafaxine for the treatment of depressed cocaine‐dependent patients
Authors: Raby Wilfrid Noel , Rubin Eric A. , Garawi Fatima , Cheng Wendy , Mason Ella , Sanfilippo Lisa , Lord Stephanie , Bisaga Adam , Aharonovich Efrat , Levin Frances , McDowell David , Nunes Edward V. 
Published: June 2013

ObjectiveThis study tested the hypothesis that the antidepressant venlafaxine would be an effective treatment for cocaine abusers with concurrent depressive disorders.MethodsThis was a randomized, 12‐week, double‐blind, placebo‐controlled trial of outpatients (N = 130) meeting DSM‐IIIR criteria for cocaine dependence and major depression or dysthymia (by SCID interview). Participants were treated with venlafaxine, up to 300 mg/day versus placebo. All patients received weekly individual manual‐guided relapse prevention therapy. Weekly outcome measures included Clinical Global Impression Scale (CGI), self‐reported cocaine use, urine toxicology and the Hamilton Depression Scale (Ham‐D).ResultsMood response, defined as a 50% reduction in the Ham‐D between randomization and end of study, was 41% (26/64) on venlafaxine, and 33% (22/66) on placebo (p = .39). Measures of depression (Ham‐D and CGI) improved more rapidly on venlafaxine than placebo, but these differences disappeared by weeks 6–8. Cocaine outcomes did not differ between treatment groups, and the proportion of patients achieving three or more consecutive weeks of urine‐confirmed abstinence was low (venlafaxine: 16%; placebo: 15%). Reduction in cocaine use was associated with mood response.ConclusionsOverall, venlafaxine was not superior to placebo on either mood or cocaine use outcomes. Mood improvement was associated with improvement in cocaine use. However, placebo mood response was only moderate, and the proportion of patients achieving sustained abstinence was low. This suggests that the subgroup of cocaine‐dependent patients with depressive disorders is relatively treatment resistant, and that further research is needed to improve outcomes for these patients. (Am J Addict 2014;23:68–75)
Retrospective analysis of safety and efficacy of insulin‐to‐liraglutide switch in Japanese type 2 diabetes: A caution against inappropriate use in patients with reduced β‐cell function
Authors: Usui Ryota , Yabe Daisuke , Kuwata Hitoshi , Fujiwara Shuichi , Watanabe Koin , Hyo Takanori , Yasuhara Akihiro , Iwasaki Masahiro , Kitatani Naomi , Kuwabara Kyoko , Yokota Kayo , Kurose Takeshi , Seino Yutaka 
Published: June 2013

AbstractAims/IntroductionThe safety and efficacy of insulin‐to‐liraglutide switch in type 2 diabetes has not been studied adequately. Here, we retrospectively characterize clinical parameters that might predict insulin‐to‐liraglutide treatment switch without termination due to hyperglycemia, and examine the effects of switching the therapies on glycated hemoglobin (HbA1c) and bodyweight in Japanese type 2 diabetes.Materials and MethodsJapanese type 2 diabetes patients who underwent the switch of therapy were evaluated for their clinical data including β‐cell function‐related indices, such as increment of serum C‐peptide during glucagon stimulation test (GST‐ΔCPR). HbA1c and bodyweight were analyzed in patients continuing with liraglutide after switching from insulin for 12 weeks.ResultsOf 147 patients, 28 failed in the switch due to hyperglycemia, nine failed because of other reasons and 110 continued with liraglutide for the 12‐week period. Patients failing in the switch due to hyperglycemia showed longer duration and higher daily insulin dose, as well as lower GST‐ΔCPR. Receiver–operating characteristic analysis showed that GST‐ΔCPR of 1.34 ng/mL is a cut‐off point for insulin‐to‐liraglutide switch without termination due to hyperglycemia. In patients continuing liraglutide for 12 weeks, the switch significantly reduced HbA1c and bodyweight with no severe hypoglycemia, irrespective of sulfonylurea co‐administration, body mass index, duration and total daily insulin dose. The switch also significantly reduced the percentage of body fat and visceral fat areas.ConclusionsInsulin‐to‐liraglutide switch can improve glycemic control and reduce bodyweight in Japanese type 2 diabetes patients. However, caution must be taken with the switch in patients with reduced insulin secretory capacity as predicted by GST‐ΔCPR.
Correlation between mean platelet volume and blood glucose levels after oral glucose loading in normoglycemic and prediabetic Japanese subjects
Authors: Shimodaira Masanori , Niwa Tomohiro , Nakajima Koji , Kobayashi Mutsuhiro , Hanyu Norinao , Nakayama Tomohiro 
Published: June 2013

AbstractAims/IntroductionMean platelet volume (MPV) reflects platelet activity, and high MPV is associated with thrombogenic activation and increased cardiovascular disease risk. Although a positive correlation between MPV and fasting plasma glucose (FPG) levels has been reported, the correlation between MPV and postprandial glucose levels remains unclear. The purpose of the present study was to evaluate the correlation between MPV and postprandial glucose levels in prediabetic and normoglycemic participants.Materials and MethodsWe evaluated 1,080 Japanese participants who underwent the 75‐g oral glucose tolerance test (OGTT). Based on these results, the participants were divided into three groups: normal glucose tolerance group (NGT; n = 582), impaired fasting glucose group (IFG; n = 205) and impaired glucose tolerance group (IGT; n = 252). The relationship between MPV, FPG, and postchallenge glucose levels after 1 h (1 h‐PG) and 2 h (2 h‐PG) were analyzed.ResultsBivariate correlation analyses showed a significant positive correlation between MPV and both FPG and 1 h‐PG levels in the NGT group, as well as between MPV and 2 h‐PG, total cholesterol, and low‐density lipoprotein cholesterol in the IGT group. In contrast, no significant correlation was observed between MPV and postchallenge glucose levels in the IFG group. Multiple correlation analyses showed that FPG levels significantly correlated with MPV in the NGT and IGT groups. In addition, 1 h‐PG and 2 h‐PG levels correlated with MPV in the NTG and IGT groups, respectively.ConclusionsThese results suggest a possible mechanism by which subjects with postprandial hyperglycemia might be at increased cardiovascular risk.
A comparison of inflammatory mediator expression between palmoplantar pustulosis and pompholyx
Authors: Kim D.Y. , Kim J.Y. , Kim T.G. , Kwon J.E. , Sohn H. , Park J. , Lim B.J. , Oh S.H. 
Published: June 2013

AbstractBackgroundBoth palmoplantar pustulosis (PPP) and pompholyx are clinically characterized by acute eruptions of vesicles or pustules on the palms or soles.ObjectivesThis study aims to compare the expression of certain inflammatory mediator genes and proteins between patients with PPP and pompholyx using skin tissue samples.MethodsSkin biopsies obtained from lesional skin from patients with PPP (n = 7) and pompholyx (n = 5) were analysed by quantitative RT‐PCR to measure the mRNA levels of nine genes, including IL‐4, IL‐8, IL‐9, IL‐17, IL‐22, IFN‐γ, CCL‐20, granzyme and perforin. For immunohistochemical analysis, 34 paraffin‐embedded skin specimens (PPP, n = 22; pompholyx, n = 12) were stained with anti‐IL‐8, IL‐17A, IL‐22 and granzyme B antibodies.ResultsOf genes analysed, IL‐8 and IL‐17A mRNA expression levels were significantly higher in the PPP group than the pompholyx group (P = 0.012 in both), whereas the mRNA expression of granzyme B was significantly higher in pompholyx when compared with PPP (P = 0.004). Regarding the IL‐17A immunohistochemical staining, tissue from the PPP lesions contained significantly more IL‐17A+ cells in both the epidermis and papillary dermis when compared with pompholyx (P < 0.001 and P = 0.019 respectively). Moreover, the intensity of the IL‐8 immunoreactivity was also greater in the PPP skin lesions than the pompholyx tissue (P < 0.001).ConclusionsIL‐8 and IL‐17A, both are increased in PPP tissue, may represent important immunologic mediators that help to differentiate this clinical entity from pompholyx. This study may provide useful clues in distinguishing PPP from pompholyx, as well as helping to understand the pathogeneses of these two diseases.
Pharmacokinetics, pharmacodynamics, and safety of esomeprazole injection/infusion in healthy Chinese volunteers: A five‐way crossover study
Authors: Yang Hong , Li Jingnan , Zhao Qian , Li Ji , Shen Kai , Yang Xiaoou , Jiang Ji , Hu Pei , Qian Jiaming 
Published: June 2013

AbstractBackgroundEsomeprazole provides effective and long lasting inhibition of gastric acid secretion. However, the pharmacokinetics and pharmacodynamics of intravenous esomeprazole in the Chinese population remain unclear.AimTo compare the pharmacokinetics and pharmacodynamics of intravenous esomeprazole (injection and infusion) and their clinical safety and tolerability in healthy Chinese subjects.MethodsA randomized, single‐center, open‐label, five‐way crossover study was conducted in 20 healthy volunteers. CYP2C19 metabolizer genotype and Helicobacter pylori status were examined. Five dosing regimens were used: single 40 mg injection, 40 mg infusion every 12 h, 40 mg infusion followed by continuous infusion at 8 mg/h, 80 mg infusion followed by continuous infusion at 4 or 8 mg/h. Intragastric pH was recorded within 24 h. Plasma concentration‐time curve, maximum plasma concentration (Cmax), steady state concentration, and total plasma clearance were determined. Adverse events were also recorded.ResultsContinuous infusion resulted in a higher mean area under the curve and Cmax than injection. There were no significant differences among the four infusion groups in terms of percentages of time at pH > 4, > 5, > 6, > 7 within 24 h and pH > 6 within the first 3 h. There were no significant differences in pharmacokinetic or pH values among variants of CYP2C19 genotype. The pH value within 24 h was unaffected by H. pylori infection in subjects with continuous infusion.ConclusionsEsomeprazole administrated by infusion produces better pharmacokinetic and intragastric pH profiles compared with those by injection. The optimal administration schedule for esomeprazole in Chinese subjects is infusion with 40 mg/12 h.
Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: A single‐center retrospective study
Authors: Gundabattula Sirisha Rao , Marakani Lakshmi Rathna , Dasari Shashikala , Surampudi Kameswari , Pochiraju Manjula , Nirmalan Praveen Kumar 
Published: June 2013

AbstractAimThe aim of this study was to evaluate outcome of pregnancies in women with rescue cerclage for cervical insufficiency.Material and MethodsA retrospective study of all women who underwent rescue cerclage between 2002 and 2011 at an advanced tertiary care perinatal institute in India was conducted. Data retrieved from medical records was used to explore potential associations with prolongation of pregnancy beyond 28 weeks.ResultsThe mean (standard deviation) gestational age at cerclage was 21.9 (2.7) weeks for the 74 women in the study. The McDonald technique was the preferred method for rescue cerclage (91.9%). All women received antibiotics; tocolytics were used in 35.1% and progesterones in 62.2% of women. The mean prolongation of pregnancy was 7.4 weeks with 42.0% women delivering after 28 weeks and 30.4% after 34 weeks. The take‐home‐baby rate was 50.7% (95% confidence interval: 38.7–62.6%). Postoperative vaginal infection was present in 16.2% of women, preterm premature rupture of membranes in 31.1% of women and neonatal sepsis in 5.8% of neonates. Cerclage placement after 20 weeks and negative pathogenic organisms in vaginal swab culture were significantly associated with delivery beyond 28 weeks.ConclusionsAlthough half of the women had successful pregnancy outcomes after rescue cerclage, pregnancy extended from previability to prematurity in most of them.
Influence of late Quaternary climate change on present patterns of genetic variation in valley oak, Quercus lobata Née
Authors: Gugger Paul F. , Ikegami Makihiko , Sork Victoria L. 
Published: June 2013

AbstractPhylogeography and ecological niche models (ENMs) suggest that late Quaternary glacial cycles have played a prominent role in shaping present population genetic structure and diversity, but have not applied quantitative methods to dissect the relative contribution of past and present climate vs. other forces. We integrate multilocus phylogeography, climate‐based ENMs and multivariate statistical approaches to infer the effects of late Quaternary climate change on contemporary genetic variation of valley oak (Quercus lobata Née). ENMs indicated that valley oak maintained a stable distribution with local migration from the last interglacial period (~120 ka) to the Last Glacial Maximum (~21 ka, LGM) to the present compared with large‐scale range shifts for an eastern North American white oak (Quercus alba L.). Coast Range and Sierra Nevada foothill populations diverged in the late Pleistocene before the LGM [104 ka (28–1622)] and have occupied somewhat distinct climate niches, according to ENMs and coalescent analyses of divergence time. In accordance with neutral expectations for stable populations, nuclear microsatellite diversity positively correlated with niche stability from the LGM to present. Most strikingly, nuclear and chloroplast microsatellite variation significantly correlated with LGM climate, even after controlling for associations with geographic location and present climate using partial redundancy analyses. Variance partitioning showed that LGM climate uniquely explains a similar proportion of genetic variance as present climate (16% vs. 11–18%), and together, past and present climate explains more than geography (19%). Climate can influence local expansion–contraction dynamics, flowering phenology and thus gene flow, and/or impose selective pressures. These results highlight the lingering effect of past climate on genetic variation in species with stable distributions.
Signals of selection in outlier loci in a widely dispersing species across an environmental mosaic
Authors: Pespeni Melissa H. , Palumbi Stephen R. 
Published: June 2013

AbstractLocal adaptation reflects a balance between natural selection and gene flow and is classically thought to require the retention of locally adapted alleles. However, organisms with high dispersal potential across a spatially or temporally heterogeneous landscape pose an interesting challenge to this view requiring local selection every generation or when environmental conditions change to generate adaptation in adults. Here, we test for geographical and sequence‐based signals of selection in five putatively adaptive and two putatively neutral genes identified in a previous genome scan of the highly dispersing purple sea urchin,Strongylocentrotus purpuratus. Comparing six populations spanning the species’ wide latitudinal range from Canada to Baja California, Mexico, we find positive tests for selection in the putative adaptive genes and not in the putative neutral genes. Specifically, we find an excess of low‐frequency and nonsynonymous polymorphisms in two transcription factors and a transporter protein, and an excess of common amino acid polymorphisms in the two transcription factors, suggestive of spatially balancing selection. We test for a genetic correlation with temperature, a dominant environmental variable in this coastal ecosystem. We find mild clines and a stronger association of genetic variation with temperature than latitude in four of the five putative adaptive loci and a signal of local adaptation in the Southern California Bight. Overall, patterns of genetic variation match predictions based on spatially or temporally balancing selection in a heterogeneous landscape and illustrate the value of geographical and coalescent tests on candidate loci identified in a genome‐wide scan for selection.
Combined analyses of kinship and FST suggest potential drivers of chaotic genetic patchiness in high gene‐flow populations
Authors: Iacchei Matthew , Ben‐Horin Tal , Selkoe Kimberly A. , Bird Christopher E. , García‐Rodríguez Francisco J. , Toonen Robert J. 
Published: June 2013

AbstractWe combine kinship estimates with traditional F‐statistics to explain contemporary drivers of population genetic differentiation despite high gene flow. We investigate range‐wide population genetic structure of the California spiny (or red rock) lobster (Panulirus interruptus) and find slight, but significant global population differentiation in mtDNA (ΦST = 0.006, P = 0.001; Dest_Chao = 0.025) and seven nuclear microsatellites (FST = 0.004, P < 0.001; Dest_Chao = 0.03), despite the species’ 240‐ to 330‐day pelagic larval duration. Significant population structure does not correlate with distance between sampling locations, and pairwise FST between adjacent sites often exceeds that among geographically distant locations. This result would typically be interpreted as unexplainable, chaotic genetic patchiness. However, kinship levels differ significantly among sites (pseudo‐F16,988 = 1.39, P = 0.001), and ten of 17 sample sites have significantly greater numbers of kin than expected by chance (P < 0.05). Moreover, a higher proportion of kin within sites strongly correlates with greater genetic differentiation among sites (Dest_Chao, R2 = 0.66, P < 0.005). Sites with elevated mean kinship were geographically proximate to regions of high upwelling intensity (R2 = 0.41, P = 0.0009). These results indicate that P. interruptus does not maintain a single homogenous population, despite extreme dispersal potential. Instead, these lobsters appear to either have substantial localized recruitment or maintain planktonic larval cohesiveness whereby siblings more likely settle together than disperse across sites. More broadly, our results contribute to a growing number of studies showing that low FST and high family structure across populations can coexist, illuminating the foundations of cryptic genetic patterns and the nature of marine dispersal.
Complexity of the genetic basis of ageing in nature revealed by a clinal study of lifespan and methuselah, a gene for ageing, in Drosophila from eastern Australia
Authors: Sgrò Carla M. , van Heerwaarden Belinda , Kellermann Vanessa , Wee Choon W. , Hoffmann Ary A. , Lee Siu F. 
Published: June 2013

AbstractClinal studies are a powerful tool for understanding the genetic basis of climatic adaptation. However, while clines in quantitative traits and genetic polymorphisms have been observed within and across continents, few studies have attempted to demonstrate direct links between them. The gene methuselah in Drosophila has been shown to have a major effect on stress response and longevity phenotypes based largely on laboratory studies of induced mutations in the mth gene. Clinal patterns in the most common mth haplotype and for lifespan (both increasing with latitude) have been observed in North American populations of D. melanogaster, implicating climatic selection. While these clinal patterns have led some to suggest that mth influences ageing in natural populations, limited evidence on the association between the two has so far been collected. Here, we describe a significant cline in the mth haplotype in eastern Australian D. melanogaster populations that parallel the cline in North America. We also describe a cline in mth gene expression. These findings further support the idea that mth is itself under selection. In contrast, we show that lifespan has a strong nonlinear clinal pattern, increasing southwards from the tropics, but then decreasing again from mid‐latitudes. Furthermore, in association studies, we find no evidence for a direct link between mth haplotype and lifespan. Thus, while our data support a role for mth variation being under natural selection, we found no link to naturally occurring variation in lifespan and ageing in Australian populations of D. melanogaster. Our results indicate that the mth locus likely has genetic background and environment‐specific effects.
Differential control of Salmonella heat shock operons by structured mRNAs
Authors: Cimdins Annika , Roßmanith Johanna , Langklotz Sina , Bandow Julia E. , Narberhaus Franz 
Published: June 2013

SummaryDnaK–DnaJ–GrpE and GroES–GroEL are the major chaperone machineries in bacteria. In many species, dnaKJ and groESL are encoded in bicistronic operons. Quantitative proteomics revealed that DnaK and GroEL amounts in Salmonella dominate over DnaJ and GroES respectively. An imperfect transcriptional terminator in the intergenic region of dnaKJ is known to result in higher transcript levels of the first gene. Here, we examined the groESL operon and asked how the second gene in a heat shock operon can be preferentially expressed and found that an RNA structure in the 5′untranslated region of groES is responsible. The secondary structure masks the Shine–Dalgarno (SD) sequence and AUG start codon and thereby modulates translation of groES mRNA. Reporter gene assays combined with structure probing and toeprinting analysis revealed a dynamic temperature‐sensitive RNA structure. Following an increase in temperature, only the second of two RNA hairpins melts and partially liberates the SD sequence, thus facilitating translation. Translation of groEL is not temperature‐regulated leading to an excess of the chaperonin in the cell at low temperature. Discussion in a broader context shows how structured RNA segments can differentially control expression of temperature‐affected operons in various ways.