bluuebunny/crossref_metadata_2025_split huggingface dataset:
YqjD Is an Inner Membrane Protein Associated with Stationary-Phase Ribosomes in Escherichia coli
Authors: Yoshida Hideji , Maki Yasushi , Furuike Shou , Sakai Akiko , Ueta Masami , Wada Akira 
Published: June 2012

ABSTRACT

Here, we provide evidence that YqjD, a hypothetical protein of
Escherichia coli
, is an inner membrane and ribosome binding protein. This protein is expressed during the stationary growth phase, and expression is regulated by stress response sigma factor RpoS. YqjD possesses a transmembrane motif in the C-terminal region and associates with 70S and 100S ribosomes at the N-terminal region. Interestingly,
E. coli
possesses two paralogous proteins of YqjD, ElaB and YgaM, which are expressed and bind to ribosomes in a similar manner to YqjD. Overexpression of YqjD leads to inhibition of cell growth. It has been suggested that YqjD loses ribosomal activity and localizes ribosomes to the membrane during the stationary phase.
Activator Role of the Pneumococcal Mga-Like Virulence Transcriptional Regulator
Authors: Solano-Collado Virtu , Espinosa Manuel , Bravo Alicia 
Published: June 2012

ABSTRACT

Global transcriptional regulators that respond to specific environmental signals are crucial in bacterial pathogenesis. In the case of the Gram-positive pathogen
Streptococcus pneumoniae
(the pneumococcus), the
sp1800
gene of the clinical isolate TIGR4 encodes a protein that exhibits homology to the Mga “stand-alone” response regulator of the group A
Streptococcus
. Such a pneumococcal protein was shown to play a significant role in both nasopharyngeal colonization and development of pneumonia in murine infection models. Moreover, it was shown to repress the expression of several genes located within the
rlrA
pathogenicity islet. The pneumococcal R6 strain, which derives from the D39 clinical isolate, lacks the
rlrA
islet but has a gene (here named

mga
Spn

) equivalent to the
sp1800
gene. In this work, and using
in vivo
approaches, we have identified the promoter of the

mga
Spn

gene (
Pmga
) and demonstrated that four neighboring open reading frames of unknown function (
spr1623
to
spr1626
) constitute an operon. Transcription of this operon is under the control of two promoters (
P1623A
and
P1623B
) that are divergent from the
Pmga
promoter. Furthermore, we have shown that the Mga

Spn

protein activates the
P1623B
promoter
in vivo
. This activation requires sequences located around 50 to 120 nucleotides upstream of the
P1623B
transcription start site. By DNase I footprinting assays, we have also demonstrated that such a region includes an Mga

Spn

binding site. This is the first report on the activator role of the pneumococcal Mga-like protein.
Mycobacterium tuberculosis Protein Kinase K Enables Growth Adaptation through Translation Control
Authors: Malhotra Vandana , Okon Blessing P. , Clark-Curtiss Josephine E. 
Published: June 2012

ABSTRACT

Mycobacterium tuberculosis
serine/threonine protein kinases (STPKs) are responsible for orchestrating critical metabolic and physiological changes that dictate mycobacterial growth adaptation. Previously, we established that PknK participates in regulatory pathways that slow the growth of
M. tuberculosis
in a variety of
in vitro
stress environments and during persistent infection in mice. In the present study, we have elaborated on the mechanism of PknK-mediated regulation. Through transcription profiling of wild-type H37Rv and a Δ
pknK
mutant strain during logarithmic and stationary growth phases, we determined that PknK regulates the expression of a large subset of tRNA genes so that regulation is synchronized with growth phase and cellular energy status. Elevated levels of wild-type
M. tuberculosis
PknK (PknK

Mtb

), but not phosphorylation-defective PknK

Mtb

, in
Mycobacterium smegmatis
cause significant retardation of the growth rate and altered colony morphology. We investigated a role for PknK in translational control and established that PknK directs the inhibition of
in vitro
transcription and translation processes in a phosphorylation-dependent manner. Increasing concentrations of ATP or PknK exert cooperative effects and enhance the inhibitory function of PknK. Furthermore, truncation and mutational analyses of PknK revealed that PknK is autoregulated via intramolecular interactions with its C-terminal region. Significantly, the invariant lysine 55 residue was only essential for activity in the full-length PknK protein, and the truncated mutant proteins were active. A model for PknK autoregulation is proposed and discussed.
Injury risk in Danish youth and senior elite handball using a new SMS text messages approach
Authors: Moller Merete , Attermann Jorn , Myklebust Grethe , Wedderkopp Niels 
Published: June 2012

ObjectiveTo assess the injury incidence in elite handball, and if gender and previous injuries are risk factors for new injuries.MethodsCohort study of 517 male and female elite handball players (age groups under (u)16, u-18 and senior). Participants completed a web survey establishing injury history, demographic information and sports experience, and provided weekly reports of time-loss injuries and handball exposure for 31 weeks by short message service text messaging (SMS). Injuries were further classified by telephone interview.ResultsThe weekly response rate ranged from 85% to 90% illustrating the promise of the SMS system as a tool in injury surveillance. Of 448 reported injuries, 165 injuries (37%) were overuse injuries and 283 (63%) traumatic injuries. Knee (19%) and ankle (29%) were the most common traumatic injuries. The injury incidence during match play was 23.5 (95% CI 17.8 to 30.4), 15.1 (95% CI 9.7 to 22.2), 11.1 (95% CI 7.0 to 16.6) injuries per 1000 match hours among senior, u-18 and u-16 players, respectively. U-18 male players had an overall 1.76 (95% CI 1.10 to 2.80) times higher risk of injury compared to females. Having had two or more previous injuries causing absence from handball for more than 4 weeks increased the risk of new injury in the u-16 group (IRR: 1.79 (95% CI 1.03 to 3.11)–2.23 (95% CI 1.22 to 4.10)).ConclusionThe incidence of time-loss injuries in elite handball was higher during match play than previously reported in recreational handball. Previous injuries were a risk factor for new injuries among u-16 players. Male players had a significant higher injury rate in the u-18 group.
Paediatric palliative care: a survey of paediatricians and family practitioners
Authors: Straatman Lynn , Miller Tanice 
Published: June 2012

BackgroundPaediatric palliative care focuses on the enhancement of the quality of life for a child and family through a combination of active and compassionate therapies intended to comfort and support the child and family who are living with a life-threatening illness. The purpose of this study was to assess the experience with and confidence in providing paediatric palliative care of practicing family/general practitioners (GPs) and paediatricians. In addition, the learning needs, modes of learning and their methods of coping/self-care were questioned.MethodsTwo hundred paediatricians and GPs in the province of British Columbia were randomly selected to participate in a mailed survey. The survey consisted of three categories: demographic information, experience and knowledge of paediatric palliative care, educational needs and preferences for learning and provision of their own self-care.ResultsThe response rate of completed surveys was 56.5%. Only 40.1% of respondents felt their knowledge and experience were adequate. Overall, 73.5% of the respondents reported that they would like to learn more about paediatric palliative care. Over 53% of those surveyed preferred that learning be offered remotely through either internet or correspondence. Seventy-four per cent of respondents expressed they had adequate or very adequate self-care strategies to meet their own needs of well-being.ConclusionsThe results of the survey will guide the paediatric palliative care community to design programmes that will better educate practicing physicians and future physicians about paediatric palliative and end of life care, healthcare services and family communication and support.
Multicentre, double-blind, randomised placebo-controlled clinical trial on the efficacy of methylphenidate on depressive symptoms in advanced cancer patients
Authors: Centeno Carlos , Sanz Alvaro , Cuervo Miguel Angel , Ramos Daniel , Hernansanz Silvia , Gonzalez Jesús , Almaraz Maria Jose , Lama Marcos , Vara Francisco , Nabal María , Pascual Antonio 
Published: June 2012

IntroductionMethylphenidate is a psychostimulant that has been used to relieve depressive symptoms in advanced cancer patients. No studies compare its efficacy against placebo in this group of patients.ObjectiveTo explore the efficacy of methylphenidate compared with placebo in the relief of depressive symptoms in advanced cancer patients.Material and methodsA multicentre, double-blind, randomised placebo-controlled clinical trial was undertaken comparing the efficacy of methylphenidate and placebo in depressive symptoms. Advanced stage cancer patients were eligible if they scored at least two points on the Two Question Screening Survey for depression. A reduction of at least two points on the Edmonton Symptom Assessment Scale for depression (0–10) was considered as a response.ResultsSixty-nine patients were included (methylphenidate: n=31, placebo: n=38); median daily dose of methylphenidate was 25 mg. Fifty-eight patients (84%) who completed the first week of treatment were considered suitable for evaluation. In the intention to treat analysis, there were 14/31 (45%) responses with methylphenidate and 10/38 (26%) responses with placebo (difference: 19%; 95% CI: 4% to 39%; p=0.10). With the Hospital Anxiety and Depression Scale, 11/19 (58%) patients with methylphenidate and 10/24 (42%) with placebo improved from a score compatible with depression in the first 7 days (difference 16%; 95% CI 13% to 42%; p=0.29). The proportion of patients indicating adverse effects was similar for both cohorts (p=0.99).ConclusionCompared with the placebo, methylphenidate demonstrated a positive trend in the incidence of response for depressive symptoms in advanced cancer patients.
A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome
Authors: Minton Ollie , Stone Patrick C 
Published: June 2012

BackgroundChronic fatigue is a feature in a subset of women successfully treated for breast cancer but is not well characterised. This study examines differences in objective cognitive function, activity levels and sleep in disease-free women who do and do not meet criteria for cancer-related fatigue syndrome (CRFS).MethodsWomen between 3 months and 2 years after completion of any primary therapy were recruited from a cancer centre follow-up clinic. On the basis of a diagnostic semi-structured interview they were classified as being CRFS cases or non-fatigued controls. Participants underwent objective cognitive testing using a computerised battery, wore an activity monitor for 1 week and completed quality of life and fatigue questionnaires.Results114 women were recruited (69 controls and 45 CRFS cases). There were significant differences between groups on fatigue, mood, sleep and quality of life scores, and in objective cognitive testing (tests of sustained attention, reaction time and verbal memory all p<0.03). There was an overall difference in daytime activity (p=0.03) from actigraphy recordings. There were no differences on objective measures of sleep or in routine laboratory measures.ConclusionsOur preliminary results suggest that disease-free women with CRFS after successful breast cancer treatment have significantly lower subjective quality of life and mood. Additionally, objective cognitive impairment in certain domains may play an important role in the subjective manifestation of these symptoms. There is also objective evidence on actigraphy of differing levels of activity. The subjective sleep disturbance and higher prevalence of insomnia do not correlate with objective measures.
Hospice inpatients' views on physical examination by medical students: is it acceptable?
Authors: Hayes Jennifer 
Published: June 2012

ObjectivesHospices are increasingly involved in medical student teaching, which the patients generally enjoy. No studies have specifically investigated how hospice patients view the prospect of physical examination by students. Previous evidence involves patients who have already seen students, while the views of other patients are unknown. This study aimed to provide an initial understanding of the views of a diverse group of hospice inpatients on the acceptability and perceived importance of students physically examining them.Methods42 hospice inpatients completed a short questionnaire focusing on their views of medical students examining them. Patients chose to do this alone or via a short interview. All inpatients at Exeter Hospice were considered eligible, including patients who were asked and those who may not have been asked to see students; all 42 patients completed the study.ResultsIn accordance with existing evidence, patients generally held positive views about seeing students. However, many patients expressed concerns about being physically examined by students, specifically including that it might be painful, tiring or embarrassing. Most importantly, several patients who did not wish to be examined by medical students said they would feel obliged to accept it, or would find it difficult to decline.ConclusionsHospice inpatients generally wish to be involved in medical student teaching, but many are concerned about being physically examined, and some feel a sense of obligation to participate. There are implications for hospices that teach students. Further research is necessary to investigate the frequency and severity of these concerns.
On the emotional connection of medical specialists dealing with death and dying: a qualitative study of oncologists, surgeons, intensive care specialists and palliative medicine specialists
Authors: Zambrano Sofia Carolina , Chur-Hansen Anna , Crawford Brian 
Published: June 2012

ObjectivesThis paper reports on qualitative data exploring the experiences and coping mechanisms of medical specialists from the specialties of intensive care, surgery, oncology and palliative care, when dealing with death and dying and their emotional connection with dying patients in the context of a life-threatening illness.MethodsThirty-three semi-structured individual interviews were analysed using thematic analysis.ResultsOne of the key themes of medical specialists' experiences with death and dying was their ambivalence about developing emotional connections with patients and families. Advantages of not engaging emotionally with patients were related to preserving objectivity in the decision making process, while a perceived disadvantage was the loss of the opportunity to engage in meaningful relationships that could positively influence patients, families and the medical specialist. Finding a balance in the face of ambivalence was a preferred approach and participants employed a variety of coping strategies.ConclusionsParticipants took different positions about the emotional connection that should develop with their dying patients and their families. Although there was agreement about finding a balance between objectivity and connection, their strategies for achieving this seem to be subjective and prescribed by individual notions. By sharing perspectives and learning how other colleagues deal with similar issues, there is an opportunity for medical practitioners to develop a well-rounded approach to dealing with death and dying, which may enhance personal and professional relationships and may ultimately influence future generations of medical practitioners.
Patients' reports or clinicians' assessments: which are better for prognosticating?
Authors: Stone Paddy , Gwilliam Bridget , Keeley Vaughan , Todd Chris , Gittins Matthew , Kelly Laura , Barclay Stephen , Roberts Chris 
Published: June 2012

BackgroundThe Prognosis in Palliative care Scale (PiPS) predicts survival in advanced cancer patients more accurately than a doctor's or a nurse's estimate. PiPS scores are derived using observer ratings of symptom severity and performance status. The purpose of this study was to determine whether patient-rated data would provide better prognostic estimates than clinician observer ratings.Patients and methods1018 subjects with advanced cancer no longer undergoing tumour-directed therapy were recruited to a multi-centre study. Prognostic models were developed using observer ratings, patient ratings or a composite method that used patient ratings when available or else used observer ratings. The performance of the prognostic models was compared by determining the agreement between the models' predictions and the survival of study participants.ResultsAll three approaches to model development resulted in prognostic scores that were able to differentiate between patients with a survival of ‘days’, ‘weeks’ or ‘months+’. However, the observer-rated models were significantly (p<0.05) more accurate than the patient-rated models.ConclusionsA prognostic model derived using observer-rated data was more accurate at predicting survival than a similar model derived using patient self-report measures. This is clinically important because patient-rated data can be burdensome and difficult to obtain in patients with terminal illnesses.
Defining the palliative care patient: its challenges and implications for service delivery
Authors: Mitchell Helen , Noble Simon , Finlay Ilora , Nelson Annmarie 
Published: June 2012

BackgroundWithin the UK, general practitioners (GPs) are required to maintain a register of palliative patients under their care. The term ‘palliative’ when applied to patients encompasses a highly heterogeneous population with varying meanings amongst health professionals. We explored GPs views of what defines a palliative care patient in the context of identifying clinical service needs.MethodsAudiotaped semi-structured interviews were conducted with GPs to explore how they identify patients requiring inclusion on a palliative care register. Thematic analysis was undertaken and emerging themes identified.ResultsMajor themes suggested GPs found it difficult to define the palliative care patient. The decision to include a patient on the palliative care register was made as a multidisciplinary team. Patients not identified as ‘palliative’ were often discussed unofficially if care requirements were significant or prognosis uncertain. The needs of patients with non-malignant disease were considered equal to those with cancer but the challenges of identifying such patients greater. More emphasis was placed on intensity of care required than prognosis. Inclusion on a register triggered greater professional input and was considered beneficial to patient care.ConclusionsNo definition of the palliative care patient exists in working practice and without one there is a risk that some patients with palliative needs will not receive the necessary support, while others may access valuable resources before time. Achieving health policy targets which require identification of palliative patients will continue to be a challenge until a workable and reliable definition of the term ‘palliative’ is agreed upon.
Reduction of gastric inflation by use of a pressure relief valve connected to an acoustic expiration control device during mouth-to-mask ventilation of a manikin model of an unprotected airway
Authors: Mutzbauer Elke Elisabeth , Weiss Manfred , Mutzbauer Till Sebastian 
Published: June 2012

BackgroundGastric inflation is a significant issue when ventilation of the unprotected airway is performed. The purpose of this study was to evaluate a prototype pressure relief valve with an acoustic expiration control mechanism connected to two different masks.Methods12 non-physician healthcare professionals (group 1) and 10 newly certified dentists (group 2) performed 10 cycles of cardiopulmonary resuscitation on a manikin using this device compared with mouth-to-mouth technique. Dentists also employed a mask without the valve. Lower oesophageal sphincter pressures had been adjusted to 1.5 kPa (group 1) and 0.3 kPa (group 2); the valve relief pressure to 1.5 kPa (group 1) and 2.0 kPa (group 2).ResultsIn group 1 tidal volumes by valve mask techniques (medians 350 and 400 ml) differed minimally from mouth-to-mouth ventilation (medians 475 and 600 ml). Almost no gastric inflation was observed. Gastric inflation only occurred using the safety valve connected to the mask (median 122 ml) and the mask alone (median 260 ml) (p=0.004). Only in group 1 the acoustic device delivered adequate signals.ConclusionGastric inflation occurred less frequently and to a lesser extent when the valve was connected, going ahead with a trend towards lower tidal volumes. The protective effect of the safety valve may be of benefit even if it leads to smaller tidal volumes.
The impact of 24 h consultant shop floor presence on emergency department performance: a natural experiment
Authors: Christmas Emma , Johnson Ian , Locker Thomas 
Published: June 2012

ObjectivesAs a result of gaps in middle-grade cover in the emergency department it became necessary for consultants to work some night shifts. This study aimed to examine the effect of this change in practice on performance.MethodsA prospective observational study was conducted. Staffing and workload variables were collected over a period of 6 months in a single district general emergency department. The outcomes assessed were process times, the proportion of patients admitted and the proportion of patients returning within 7 days.ResultsConsultants worked 26 of 182 night shifts during the period studied. There were no differences in the number of patients present in the department at the start of the middle-grade or consultant night shifts. Fewer patients presented per hour during middle-grade night shifts: 3.8 patients per hour versus 4.4 patients per hour during consultant nights. Compared with middle-grade night shifts, the median waiting time was on average 19.6 min less and the median emergency department length of stay was 20.5 min less during consultant night shifts. The proportion of patients admitted from the emergency department was on average 3.9% less than during middle-grade night shifts but there was no difference in the proportion returning within 7 days.ConclusionIn this small single-site study, a consultant working nights has been shown to reduce process times and the rate of admission. It remains unclear whether such improvements would be sustained in the longer term.