bluuebunny/crossref_metadata_2025_split huggingface dataset:
Roles of managers, frontline staff and local champions, in implementing quality improvement: stakeholders' perspectives
Authors: Kirchner JoAnn E. , Parker Louise E. , Bonner Laura M. , Fickel Jacqueline J. , Yano Elizabeth M. , Ritchie Mona J. 
Published: August 2010

AbstractBackground  Translating promising research findings into routine clinical care has proven difficult to achieve; even highly efficacious programmes remain unadopted. Critical to changing care is an understanding of the context within which the improvement effort occurs, including the climate or culture. Health care systems are multicultural due to the wide variety of professionals, subgroups, divisions and teams within them. Yet, little work describes and compares different stakeholders' views on their and others' roles in promoting successful quality improvement implementation.Objective  To identify manager and frontline staff perspectives about which organizational stakeholders should play a role in implementation efforts as well as what implementation roles these stakeholders should perform.Methods  We conducted qualitative semi‐structured interviews of a purposive sample of stakeholders at the clinic, medical centre and regional network levels. Participants included stakeholders across five clinics (n = 49), their four affiliated medical centres (n = 12) and three regional networks (n = 7). Working in coding teams, we conducted a content analysis utilizing Atlas.ti Version 5.Results  According to informants, individuals at each organizational level have unique and critical roles to play in implementing and sustaining quality improvement efforts. Informants advocated for participation of a wide range of organizational members, described distinct roles for each group, and articulated the need for and defined the characteristics of frontline programme champions.Conclusions  Involvement of multiple types of stakeholders is likely to be costly for health care organizations. Yet, if such organizations are to achieve the highest quality care, it is also likely that such involvement is essential.
Reasons for non‐use of proven pharmacotherapeutic interventions: systematic review and framework development
Authors: Barry Arden R. , Loewen Peter S. , de Lemos Jane , Lee Karen G. 
Published: August 2010

AbstractRationale, aims and objectives  The quality of patient care and safety is dependent on addressing both errors of commission (e.g. overuse of medications) and errors of omission (e.g. patients receiving too little care). Despite guidelines recommending the use of certain proven pharmacotherapeutic interventions, a large gap exists between the patients that have an indication for, and those that actually receive such interventions. To address how the rate of implementation of proven interventions can be improved is dependent on a comprehensive knowledge of the factors contributing to their underuse. The aim of the review is to create an evidence‐based framework of reasons why eligible patients do not receive proven pharmacotherapeutic interventions.Methods  A systemic review of the published reasons for non‐use based on the Cochrane methodology.Results  The systematic review identified 67 articles meeting the inclusion criteria. The reasons for non‐use were extracted from the studies and a framework was created from the results.Conclusions  The factors associated with lack of implementation of proven pharmacotherapeutic interventions are complex and heterogeneous but can be understood from the perspectives of clinicians, patients and health care delivery systems. Efforts to increase the utilization of proven interventions should focus on disease/intervention‐specific programmes that take into account the identified modifiable clinician, patient and system factors.
Application of a sensitive, specific and controlled real‐time PCR assay to surveillance indicates a low prevalence of viral haemorrhagic septicaemia virus (VHSV) in wild herring, Clupea harengus L., in Scottish waters
Authors: Matejusova I , McKay P , Bland F , Snow M 
Published: August 2010

AbstractSurveillance data on the distribution of viral haemorrhagic septicaemia virus (VHSV) in the North Sea (UK), targeting Atlantic herring in areas with previous virus detection, were obtained from research cruises conducted during 2005. The sensitive molecular approach of real‐time RT‐PCR (qRT‐PCR) was applied alongside a newly developed endogenous positive control assay specific for herring (elongation factor 1α) to ensure integrity of template. Three hundred and five pools from 1937 individual herring were tested, and no evidence of VHSV in association with wild Atlantic herring was detected. Samples were obtained from Scottish waters where marine aquaculture is conducted. The results confirm that previous tissue culture studies have most likely not significantly underestimated the prevalence of carrier herring in this area. The significance of migratory species such as herring as a reservoir species for VHSV, with the potential to translocate virus genotypes between geographical areas, is discussed.
Apolipoprotein B, non‐HDL cholesterol and LDL cholesterol for identifying individuals at increased cardiovascular risk
Authors: Holewijn S. , Den Heijer M. , Swinkels D. W. , H Stalenhoef A. F. , De Graaf J. 
Published: August 2010

Abstract.  Holewijn S, den Heijer M, Swinkels DW, Stalenhoef AFH, de Graaf J. (Address: Division of Vascular Medicine, Department of General Internal Medicine; Department of Epidemiology and Biostatistics; Department of Endocrinology; and Department of Laboratory Medicine; Laboratory of Clinical Chemistry, all at the Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands) Apolipoprotein B, non‐HDL cholesterol and LDL cholesterol for identifying individuals at increased cardiovascular risk. J Intern Med 2010; 268: 567–577.Background.  To compare apolipoprotein B (apoB), nonhigh‐density lipoprotein‐cholesterol (non‐HDL‐c) and low‐density lipoprotein‐cholesterol (LDL‐c) for identifying individuals with a deteriorated cardiovascular (CV) risk profile, including a panel of subclinical atherosclerosis measurements and prevalent cardiovascular disease (CVD) in a Dutch population‐based cohort.Methods.  Clinical and biochemical measurements and a panel of noninvasive parameters of subclinical atherosclerosis were determined in 1517 individuals, aged 50–70 years.Results.  Both men and women with increasing levels of apoB and non‐HDL‐c were more obese, had higher blood pressure and fasting glucose levels, and a more atherogenic lipid profile. Furthermore, compared to the reference group (composed of those with apoB, non‐HDL‐c and LDL‐c levels in the bottom quartiles), participants with high apoB and high non‐HDL‐c levels had a lower ankle–brachial index at rest (−3.5% and −3.1%, respectively) and after exercise (−6.3% and −4.7%, respectively), a thicker near wall (+4.8% and +4.2%, respectively), far wall (both +6.2%), and mean intima–media thickness (+5.7% and +5.3%, respectively) and more plaques (+54.2% and +54.3%, respectively). In addition, they also showed increased stiffness parameters (e.g. pulse wave velocity both +3.6%). Less clear differences in CV risk profile and subclinical atherosclerosis parameters were observed when participants were stratified by LDL‐c level. Furthermore, apoB but not LDL‐c detected prevalent CVD, and non‐HDL‐c only detected prevalent CVD in men. The discriminatory power for prevalent CVD expressed as area under the receiver operating characteristic curve was 0.60 (P < 0.001) for apoB, 0.57 (P = 0.001) for non‐HDL‐c and 0.54 (P = 0.108) for LDL‐c.Conclusion.  Our data support the use of first apoB and secondly non‐HDL‐c above LDL‐c for identifying individuals from the general population with a compromised CV phenotype.
Obesity, smoking and secular trends in cardiovascular risk factors in middle‐aged women: data from population studies in Göteborg from 1980 to 2003
Authors: Johansson S. , Wilhelmsen L. , Welin C. , Eriksson H. , Welin L. , Rosengren A. 
Published: August 2010

Abstract.  Johansson S, Wilhelmsen L, Welin C, Eriksson H, Welin L, Rosengren A. (Sahlgrenska University Hospital/Östra, Göteborg; AstraZeneca R&D, Mölndal; and Lidköping Hospital, Lidköping, Sweden) Obesity, smoking and secular trends in cardiovascular risk factors in middle‐aged women: data from population studies in Göteborg from 1980 to 2003. J Intern Med 2010; 268: 594–603.Background.  To study the trends in cardiovascular risk factors in middle‐aged city‐dwelling Swedish women from 1980 to 2003.Methods.  Using cross‐sectional population‐based surveys, five random population samples of a total of 1915 women aged between 45 and 54 years, participating in the BEDA study in 1980, WHO MONICA studies in 1985, 1990 and 1995, and a study of 50‐year‐old women in 2003 were measured for the following parameters: anthropometry, serum cholesterol and triglyceride levels, smoking habits, blood pressure, physical activity and stress.Results.  Over almost 25 years, middle‐aged women gained on average 4.4 kg in weight, with a net increase in body mass index (BMI) from 24.7 to 25.6 kg m−2. The proportion of participants classified as obese (≥30 kg m−2) increased by 50% from 10.4% to 15.1%. Women who were smokers in 2003 did not have lower BMI values than nonsmokers. Mean serum cholesterol concentrations decreased markedly, whereas smoking habits did not significantly change. The prevalence of hypertension decreased by 8%, whereas that of diabetes remained stable at around 2%. Optimal risk factor status – no smoking, normotension and serum cholesterol <5 mmol l−1– was present in less than one in six women in 2003, and similar across BMI categories.Conclusion.  The favourable decline in cholesterol levels and hypertension and the increase in leisure time physical activity were offset by an increase in obesity, triglyceride levels and experience of stress, with only a minority of participants (less than one in six) having an optimal level of risk factors with respect to smoking, serum cholesterol and hypertension in 2003. This applied also to overweight and obese women. In earlier cohorts, subjects with low BMI values were more often smokers, whereas the opposite is observed in recent cohorts. Thus, women who smoke no longer have the advantage of lower weight.
Diverse associations of 25‐hydroxyvitamin D and 1,25‐dihydroxy‐vitamin D with dyslipidaemias
Authors: Karhapää P. , Pihlajamäki J. , Pörsti I. , Kastarinen M. , Mustonen J. , Niemelä O. , Kuusisto J. 
Published: August 2010

Abstract.  Karhapää P, Pihlajamäki J, Pörsti I, Kastarinen M, Mustonen J, Niemelä O, Kuusisto J (University of Eastern Finland, Kuopio; University of Tampere, Tampere; and Laboratory and Medical Research Unit, University of Tampere, Tampere; Finland). Diverse associations of 25‐hydroxyvitamin D and 1,25‐dihydroxyvitamin D with dyslipidaemias. J Intern Med 2010; 268: 604–610.Background and Aim.  Previous studies have suggested a link between circulating levels of 25‐hydroxyvitamin D (25‐D) and dyslipidaemias. However, it is not known whether 25‐D and the active hormone 1,25‐dihydroxyvitamin D (1,25‐D) have similar associations with dyslipidaemias. Therefore, we studied the associations between both 25‐D and 1,25‐D and total cholesterol (total‐C), low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C) and triglycerides in a population‐based study.Design.  Cross‐sectional population‐based study.Setting.  Kuopio, Eastern Finland.Subjects.  A total of 909 men, aged from 45 to 70 years, who were not receiving antidiabetic medication were enrolled.Main Outcome Measures.  Fasting serum samples were obtained for measurement of 25‐D, 1,25‐D and lipid levels. An oral glucose tolerance test was performed, and insulin sensitivity was evaluated using the Matsuda insulin sensitivity index (Matsuda ISI).Results.  We found a significant inverse association between 25‐D and total‐C, LDL‐C and triglycerides (β = −0.15, −0.13 and −0.17, respectively, P < 0.001), but no association between 25‐D and HDL‐C was observed. By contrast, 1,25‐D was associated with HDL‐C (β = 0.18, P < 0.001), whereas no relationship was found between 1,25‐D and LDL‐C or triglycerides. The associations remained significant after the exclusion of subjects receiving statin treatment and after adjustment for age, waist circumference, body mass index, alcohol consumption, smoking, renal function, glucose tolerance and Matsuda ISI.Conclusion.  Low levels of active vitamin D (1,25‐D) are associated with low HDL‐C levels, whereas low levels of the storage form 25‐D are associated with high levels of total‐C, LDL‐C and triglycerides. Our findings may provide new insights into the understanding of the link between vitamin D deficiency and cardiovascular disease.
The use of laser scanning confocal microscopy (LSCM) in materials science
Authors: HOVIS D.B. , HEUER A.H. 
Published: August 2010

SummaryLaser scanning confocal microscopes are essential and ubiquitous tools in the biological, biochemical and biomedical sciences, and play a similar role to scanning electron microscopes in materials science. However, modern laser scanning confocal microscopes have a number of advantages for the study of materials, in addition to their obvious uses for high resolution reflected and transmitted light optical microscopy. In this paper, we provide several examples that exploit the laser scanning confocal microscope's capabilities of pseudo‐infinite depth of field imaging, topographic imaging, photo‐stimulated luminescence imaging and Raman spectroscopic imaging.
Asp3 mediates multiple protein–protein interactions within the accessory Sec system of Streptococcus gordonii
Authors: Seepersaud Ravin , Bensing Barbara A. , Yen Yihfen T. , Sullam Paul M. 
Published: August 2010

SummaryBacterial binding to human platelets is an important step in the pathogenesis of infective endocarditis. Streptococcus gordonii can mediate its platelet attachment through a cell wall glycoprotein termed GspB (‘gordonii surface protein B’). GspB export is mediated by a seven‐component accessory Sec system, containing two homologues of the general secretory pathway (SecA2 and SecY2) and five accessory Sec proteins (Asps1–5). Here we show that the Asps are required for optimal export of GspB independent of the glycosylation process. Furthermore, yeast two‐hybrid screening of the accessory Sec system revealed interactions occurring between Asp3 and the other components of the system. Asp3 was shown to bind SecA2, Asp1, Asp2 and itself. Mutagenesis of Asp3 identified N‐ and C‐terminal regions that are essential for GspB transport, and conserved residues within the C‐terminal domain mediated Asp3 binding to other accessory Sec components. The loss of binding by Asp3 also resulted in an impaired ability of S. gordonii to secrete GspB. These studies indicate that Asp3 is a central element mediating multiple interactions among accessory Sec components that are essential for GspB transport to the cell surface.
An essential role for UshA in processing of extracellular flavin electron shuttles by Shewanella oneidensis
Authors: Covington Elizabeth D. , Gelbmann Christopher B. , Kotloski Nicholas J. , Gralnick Jeffrey A. 
Published: August 2010

SummaryThe facultative anaerobe Shewanella oneidensis can reduce a number of insoluble extracellular metals. Direct adsorption of cells to the metal surface is not necessary, and it has been shown that S. oneidensis releases low concentrations flavins, including riboflavin and flavin mononucleotide (FMN), into the surrounding medium to act as extracellular electron shuttles. However, the mechanism of flavin release by Shewanella remains unknown. We have conducted a transposon mutagenesis screen to identify mutants deficient in extracellular flavin accumulation. Mutations in ushA, encoding a predicted 5′‐nucleotidase, resulted in accumulation of flavin adenine dinucleotide (FAD) in culture supernatants, with a corresponding decrease in FMN and riboflavin. Cellular extracts of S. oneidensis convert FAD to FMN, whereas extracts of ushA mutants do not, and fractionation experiments show that UshA activity is periplasmic. We hypothesize that S. oneidensis secretes FAD into the periplasmic space, where it is hydrolysed by UshA to FMN and adenosine monophosphate (AMP). FMN diffuses through outer membrane porins where it accelerates extracellular electron transfer, and AMP is dephosphorylated by UshA and reassimilated by the cell. We predict that transport of FAD into the periplasm also satisfies the cofactor requirement of the unusual periplasmic fumarate reductase found in Shewanella.
Importance of the tmRNA system for cell survival when transcription is blocked by DNA–protein cross‐links
Authors: Kuo H. Kenny , Krasich Rachel , Bhagwat Ashok S. , Kreuzer Kenneth N. 
Published: August 2010

SummaryAnticancer drug 5‐azacytidine (aza‐C) induces DNA–protein cross‐links (DPCs) between cytosine methyltransferase and DNA as the drug inhibits methylation. We found that mutants defective in the tmRNA translational quality control system are hypersensitive to aza‐C. Hypersensitivity requires expression of active methyltransferase, indicating the importance of DPC formation. Furthermore, the tmRNA pathway is activated upon aza‐C treatment in cells expressing methyltransferase, resulting in increased levels of SsrA tagged proteins. These results argue that the tmRNA pathway clears stalled ribosome‐mRNA complexes generated after transcriptional blockage by aza‐C‐induced DPCs. In support, an ssrA mutant is also hypersensitive to streptolydigin, which blocks RNA polymerase elongation by a different mechanism. The tmRNA pathway is thought to act only on ribosomes containing a 3′ RNA end near the A site, and the known pathway for releasing RNA 3′ ends from a blocked polymerase involves Mfd helicase. However, an mfd knockout mutant is not hypersensitive to either aza‐C‐induced DPC formation or streptolydigin, indicating that Mfd is not involved. Transcription termination factor Rho is also likely not involved, because the Rho‐specific inhibitor bicyclomycin failed to show synergism with either aza‐C or streptolydigin. Based on these findings, we discuss models for how E. coli processes transcription/translation complexes blocked at DPCs.
A new role for coenzyme F420 in aflatoxin reduction by soil mycobacteria
Authors: Graham David E. 
Published: August 2010

SummaryHepatotoxic aflatoxins have found a worthy adversary in two new families of bacterial oxidoreductases. These enzymes use the reduced coenzyme F420 to initiate the degradation of furanocoumarin compounds, including the major mycotoxin products of Aspergillus flavus. Along with pyridoxal 5′‐phosphate synthases and aryl nitroreductases, these proteins form a large and versatile superfamily of flavin and deazaflavin‐dependent oxidoreductases. F420‐dependent members of this family appear to share a common mechanism of hydride transfer from the reduced, low‐potential deazaflavin to the electron‐deficient ring systems of their substrates.
Mutations affecting Leptospira interrogans lipopolysaccharide attenuate virulence
Authors: Murray Gerald L. , Srikram Amporn , Henry Rebekah , Hartskeerl Rudy A. , Sermswan Rasana W. , Adler Ben 
Published: August 2010

Summary Leptospira interrogans is the causative agent of leptospirosis. Lipopolysaccharide (LPS) is the major outer membrane component of L. interrogans. It is the dominant antigen recognized during infection and the basis for serological classification. The structure of LPS and its role in pathogenesis are unknown. We describe two defined mutants of L. interrogans serovar Manilae with transposon insertions in the LPS locus. Mutant M895 was disrupted in gene la1641 encoding a protein with no known homologues. M1352 was disrupted in a gene unique to serovar Manilae also encoding a protein of unknown function. M895 produced truncated LPS while M1352 showed little or no change in LPS molecular mass. Both mutants showed altered agglutination titres against rabbit antiserum and against a panel of LPS‐specific monoclonal antibodies. The mutants were severely attenuated in virulence via the intraperitoneal route of infection, and were cleared from the host animal by 3 days after infection. M895 was also highly attenuated via the mucosal infection route. Resistance to complement in human serum was unaltered for both mutants. While complementation of mutants was not possible, the attenuation of two independently derived LPS mutants demonstrates for the first time that LPS plays an essential role leptospiral virulence.
Mobilizable genomic islands: going mobile with oriT mimicry
Authors: Waldor Matthew K. 
Published: August 2010

SummaryMany bacterial chromosomes contain genomic islands, large DNA segments that became incorporated into the chromosome following their horizontal transmission. However, the mechanisms that mediate the lateral transfer of genomic islands are for the most part unknown. In this issue of Molecular Microbiology, Daccord et al. describe a new type of transmissible genomic island that can be mobilized by co‐resident integrating conjugative elements (ICEs). These ‘mobilizable genomic islands’ (MGIs) require many ICE‐encoded factors for their transmission, including transcription activators to induce MGI excision, the relaxase to initiate transfer at the MGI oriT and the conjugation machinery to transport MGI DNA to recipient cells. However, MGIs encode their own integrases, which enable their recombination with the chromosome of a new host, as well as a variety of other genes that do not have functions related to mobility. The MGI oriT, which resembles the ICE oriT, can also serve as a site for initiation of ICE‐mediated conjugative transfer of large regions of chromosomal DNA. Overall, these findings raise the possibility that mobilization of chromosomal DNA from cyptic oriTs within genomic islands or elsewhere on the chromosome could be more common place than has been previously appreciated.
A root is a root is a root? Water uptake rates of Citrus root orders
Authors: REWALD BORIS , EPHRATH JHONATHAN E. , RACHMILEVITCH SHIMON 
Published: August 2010

ABSTRACTKnowledge about the physiological function of root orders is scant. In this study, a system to monitor the water flux among root orders was developed using miniaturized chambers. Different root orders of 4‐year‐old Citrus volkameriana trees were analysed with respect to root morphology and water flux. The eight root orders showed a broad overlap in diameter, but differences in tissue densities and specific root area (SRA) were clearly distinguishable. Thirty per cent of the root branch biomass but 50% of the surface area (SA) was possessed by the first root order, while the fifth accounted for 5% of the SA (20% biomass). The root order was identified as a determinant of water flux. First‐order roots showed a significantly higher rate of water uptake than the second and third root orders, whereas the fourth and fifth root orders showed water excess. The water excess suggested the occurrence of hydraulic redistribution (HR) as a result of differences in osmotic potentials. We suggest that plants may utilize hydraulic redistribution to prevent coarse root desiccation and/or to increase nutrient acquisition. Our study showed that the novel ‘miniature depletion chamber’ method enabled direct measurement of water fluxes per root order and can be a major tool for future studies on root order traits.