bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services
Authors: Shanley Christopher , Whitmore Elizabeth , Conforti David , Masso Janine , Jayasinghe Sanjay , Griffiths Rhonda 
Published: May 2011

Aims and objectives. To explore current practice and opportunities to improve practice in decision‐making about transfer of nursing home residents to hospital.Background. Nursing home staff are often faced with the decision of whether to send a resident to hospital for medical treatment. While many residents will benefit from going to hospital, there are also several risks associated with this. This study sought to add to the existing body of research on this issue by seeking the views of nursing home managers, who are the persons most frequently involved in making these decisions.Design. Qualitative design using purposive, quota sampling.Method. Qualitative interviews with 41 nursing home managers from south‐western Sydney, Australia.Results. Factors affecting the decision to transfer a resident to hospital include acuteness of their condition; level and style of medical care available; role of family members; numbers, qualifications and skills mix of staff; and concern about criticism for not transferring to hospital. Two factors that have not featured as strongly in previous research are the roles of advance care planning and support from local hospital and community health services.Conclusion. While transferring a nursing home resident to hospital is often necessary, there are many situations where they could be cared for in the nursing home; therefore, avoid complications associated with being in hospital. Apart from a range of factors already identified in the literature, this study has highlighted the important role that advance care planning and support from local health services can play in reducing unnecessary transfers to hospital.Relevance to clinical practice. There are several strategies that nursing homes and local health authorities can adopt to promote advance care planning and build better support systems between the two sectors, thereby reducing the numbers of residents who need to be transferred to hospital for their health care.
The impact of antipsychotic side effects on attitudes towards medication in people with schizophrenia and related disorders
Authors: Chiang Yan Ling , Klainin‐Yobas Piyanee , Ignacio Jeanette , Chng Cecilia Mui Lee 
Published: May 2011

Aims and objectives. This research aimed to: (i) investigate the prevalence and perceived severity of antipsychotic side effects in people with schizophrenia and related disorders living in communities in Singapore; (ii) examine the relationship between antipsychotic variables (type, dose, route, prescription duration) and side effects; and (iii) examine the relationship between side effects and attitudes towards medication.Background. Antipsychotics are the mainstay treatment in schizophrenia and other psychotic disorders. However, antipsychotics are associated with a wide range of side effects, which potentially have adverse effects on patients’ functioning. A lack of studies comparing the frequency of side effects and their associated levels of distress across multiple antipsychotics and different medication variables has been noted. Additionally, it is essential to assess patients’ attitudes towards antipsychotics in relation to their experience of side effects.Design. A cross‐sectional, non‐experimental research design was used.Method. A convenience sample of 96 adults with schizophrenia and related disorders on antipsychotic treatment and attending the hospital’s outpatient clinic was recruited. Variables collected included antipsychotic type, dose, route, prescription duration and side effects, attitudes towards medication and demographic and clinical variables. They were analysed with descriptive statistics and correlational analyses.Results. Many participants experienced psychic (80·2%), extrapyramidal (69·8%) and miscellaneous side effects (61·5%). Side effects positively correlated with dose (p = 0·016) and negatively correlated with prescription duration (p = 0·014). Negative attitudes towards medication were positively correlated with side effects in general (p = 0·023), along with hormonal (p = 0·013) and psychic side effects (p = 0·008).Conclusion. Findings revealed that majority of the participants experienced and were distressed over psychic, extrapyramidal and weight gain, which may be related to high doses and treatment duration. Additionally, patients experiencing psychic and hormonal side effects are at risk of developing negative attitudes towards medication.Relevance to clinical practice. Findings guide the development of appropriate nursing interventions that aim to alleviate side effects, reduce negative attitudes towards medication and prevent compliance problems.
Comparing the efficacy of aquatic exercises and land‐based exercises for patients with knee osteoarthritis
Authors: Wang Tsae‐Jyy , Lee Shu‐Chiung , Liang Shu‐Yuan , Tung Heng‐Hsin , Wu Shu‐Fang V , Lin Yu‐Ping 
Published: May 2011

Aims. The study aims to compare changes over time among three study groups on the primary outcome, pain, as well as on the secondary outcomes, other symptoms, activities of daily living function, sport and recreation function, knee‐related quality of life, knee range of motions and the six‐minute walk test and to investigate whether aquatic exercises would be superior compared with land exercise on pain reduction.Background. Osteoarthritis is a prevalent musculoskeletal disorder. Appropriate exercise may prevent osteoarthritis‐associated disabilities and increase life quality. To date, research that compares the effects of different types of exercise for knee osteoarthritis has been limited.Design. The study is a randomised trial.Methods. Eighty‐four participants with knee osteoarthritis were recruited from local community centres. Participants were randomly assigned to the control, aquatic or land‐based exercise group. Exercise in both groups ran for 60 minutes, three times a week for 12 weeks. Data were collected at baseline, week 6 and week 12 during 2006–2007. The instruments included the Knee Injury and Osteoarthritis Outcome Score, a standard plastic goniometer and the six‐minute walk test. Generalised estimation equations were used to compare changes over time among groups for key outcomes.Results. Results showed statistically significant group‐by‐time interactions in pain, symptoms, sport/recreation and knee‐related quality of life dimensions of Knee Injury and Osteoarthritis Outcome Score, knee range of motions and the six‐minute walk test. However, the aquatic group did not show any significant difference from the land group at both weeks 12 and 6.Conclusions. Both aquatic and land‐based exercise programmes are effective in reducing pain, improving knee range of motions, six‐minute walk test and knee‐related quality of life in people with knee osteoarthritis. The aquatic exercise is not superior to land‐based exercise in pain reduction.Relevance to clinical practice. Similar outcomes could be possible with the two programmes. Health care professionals may consider suggesting well‐designed aquatic or land‐based exercise classes for patients with osteoarthritis, based on their preferences and convenience.
Characterization of Bacillus subtilis uracil‐DNA glycosylase and its inhibition by phage φ29 protein p56
Authors: Pérez‐Lago Laura , Serrano‐Heras Gemma , Baños Benito , Lázaro José M. , Alcorlo Martín , Villar Laurentino , Salas Margarita 
Published: May 2011

SummaryUracil‐DNA glycosylase (UDG) is a conserved DNA repair enzyme involved in uracil excision from DNA. Here, we report the biochemical characterization of UDG encoded by Bacillus subtilis, a model low G+C Gram‐positive organism. The purified enzyme removes uracil preferentially from single‐stranded DNA over double‐stranded DNA, exhibiting higher preference for U:G than U:A mismatches. Furthermore, we have identified key amino acids necessary for B. subtilis UDG activity. Our results showed that Asp‐65 and His‐187 are catalytic residues involved in glycosidic bond cleavage, whereas Phe‐78 would participate in DNA recognition. Recently, it has been reported that B. subtilis phage φ29 encodes an inhibitor of the UDG enzyme, named protein p56, whose role has been proposed to ensure an efficient viral DNA replication, preventing the deleterious effect caused by UDG when it eliminates uracils present in the φ29 genome. In this work, we also show that a φ29‐related phage, GA‐1, encodes a p56‐like protein with UDG inhibition activity. In addition, mutagenesis analysis revealed that residue Phe‐191 of B. subtilis UDG is critical for the interaction with φ29 and GA‐1 p56 proteins, suggesting that both proteins have similar mechanism of inhibition.
Assembly of the Caulobacter cell division machine
Authors: Goley Erin D. , Yeh Yi‐Chun , Hong Sun‐Hae , Fero Michael J. , Abeliuk Eduardo , McAdams Harley H. , Shapiro Lucy 
Published: May 2011

SummaryCytokinesis in Gram‐negative bacteria is mediated by a multiprotein machine (the divisome) that invaginates and remodels the inner membrane, peptidoglycan and outer membrane. Understanding the order of divisome assembly would inform models of the interactions among its components and their respective functions. We leveraged the ability to isolate synchronous populations of Caulobacter crescentus cells to investigate assembly of the divisome and place the arrival of each component into functional context. Additionally, we investigated the genetic dependence of localization among divisome proteins and the cell cycle regulation of their transcript and protein levels to gain insight into the control mechanisms underlying their assembly. Our results revealed a picture of divisome assembly with unprecedented temporal resolution. Specifically, we observed (i) initial establishment of the division site, (ii) recruitment of early FtsZ‐binding proteins, (iii) arrival of proteins involved in peptidoglycan remodelling, (iv) arrival of FtsA, (v) assembly of core divisome components, (vi) initiation of envelope invagination, (vii) recruitment of polar markers and cytoplasmic compartmentalization and (viii) cell separation. Our analysis revealed differences in divisome assembly among Caulobacter and other bacteria that establish a framework for identifying aspects of bacterial cytokinesis that are widely conserved from those that are more variable.
A σW‐dependent stress response in Bacillus subtilis that reduces membrane fluidity
Authors: Kingston Anthony W. , Subramanian Chitra , Rock Charles O. , Helmann John D. 
Published: May 2011

SummaryBacteria respond to physical and chemical stresses that affect the integrity of the cell wall and membrane by activating an intricate cell envelope stress response. The ability of cells to regulate the biophysical properties of the membrane by adjusting fatty acid composition is known as homeoviscous adaptation. Here, we identify a homeoviscous adaptation mechanism in Bacillus subtilis regulated by the extracytoplasmic function σ factor σW. Cell envelope active compounds, including detergents, activate a sense‐oriented, σW‐dependent promoter within the first gene of the fabHa fabF operon. Activation leads to a decrease in the amount of FabHa coupled with an increase in FabF, the initiation and elongation condensing enzymes of fatty acid biosynthesis respectively. Downregulation of FabHa results in an increased reliance on the FabHb paralogue leading to a greater proportion of straight chain fatty acids in the membrane, and the upregulation of FabF increases the average fatty acid chain length. The net effect is to reduce membrane fluidity. The inactivation of the σW‐dependent promoter within fabHa increased sensitivity to detergents and to antimicrobial compounds produced by other Bacillus spp. Thus, the σW stress response provides a mechanism to conditionally decrease membrane fluidity through the opposed regulation of FabHa and FabF.
The two faces of ToxR: activator of ompU, co‐regulator of toxT in Vibrio cholerae
Authors: Morgan Sarah J. , Felek Suleyman , Gadwal Shilpa , Koropatkin Nicole M. , Perry Jeffrey W. , Bryson Alyson B. , Krukonis Eric S. 
Published: May 2011

SummaryToxR of Vibrio cholerae directly activates the ompU promoter, but requires a second activator, TcpP to activate the toxT promoter. ompU encodes a porin, while toxT encodes the transcription factor, ToxT, which activates V. cholerae virulence genes including cholera toxin and the toxin co‐regulated pilus. Using an ompU‐sacB transcriptional fusion, toxR mutant alleles were identified that encode ToxR molecules defective for ompU promoter activation. Many toxR mutants defective for ompU activation affected residues involved in DNA binding. Mutants defective for ompU activation were also tested for activation of the toxT promoter. ToxR‐F69A and ToxR‐V71A, both in the α‐loop of ToxR, were preferentially defective for ompU activation, with ToxR‐V71A nearly completely defective. Six mutants from the ompU‐sacB selection showed more dramatic defects in toxT activation than ompU activation. All but one of the affected residues map to the wing domain of the winged helix–turn–helix of ToxR. Some ToxR mutants preferentially affecting toxT activation had partial DNA‐binding defects, and one mutant, ToxR‐P101L, had altered interactions with TcpP. These data suggest that while certain residues in the α‐loop of ToxR are utilized to activate the ompU promoter, the wing domain of ToxR contributes to both promoter binding and ToxR/TcpP interaction facilitating toxT activation.
The novel Listeria monocytogenes bile sensor BrtA controls expression of the cholic acid efflux pump MdrT
Authors: Quillin Sarah J. , Schwartz Kierstyn T. , Leber Jess H. 
Published: May 2011

SummaryMammalian bile has potent anti‐microbial activity, yet bacterial pathogens of the gastrointestinal tract and hepatobiliary system nonetheless persist and replicate within bile‐rich environments. Listeria monocytogenes, a Gram‐positive pathogen, encounters bile at three stages throughout its infectious cycle in vivo: in the gut during initial infection, in the liver where it replicates robustly and in the gallbladder, from which it can return to the intestine and thence to the environment. The mechanisms by which L. monocytogenes senses mammalian bile and counteracts its bactericidal effects are not fully understood. In this report, we have determined the L. monocytogenes bile‐induced transcriptome, finding that many critical virulence factors are regulated by bile. Among these, the multidrug efflux pumps MdrM and MdrT, previously shown to be critical for the bacterial provocation of a pathogenesis‐promoting host innate immune response, are robustly and specifically induced by the bile component cholic acid. This induction is mediated by BrtA, the first identified L. monocytogenes sensor of bile, which loses the ability to bind to and repress the mdrT promoter in the presence of cholic acid. We show that MdrT can export cholic acid, and that ΔmdrT bacteria are significantly attenuated both in vitro when exposed to cholic acid or bile, and in vivo in the gallbladders and livers of infected mice.
Transcription of the plasmid‐encoded toxin gene from Enteroaggregative Escherichia coli is regulated by a novel co‐activation mechanism involving CRP and Fis
Authors: Rossiter Amanda E. , Browning Douglas F. , Leyton Denisse L. , Johnson Matthew D. , Godfrey Rita E. , Wardius Catherine A. , Desvaux Mickael , Cunningham Adam F. , Ruiz‐Perez Fernando , Nataro James P. , Busby Stephen J. W. , Henderson Ian R. 
Published: May 2011

SummaryEnteroaggregative Escherichia coli (EAEC) is a major cause of diarrhoea in developing countries. EAEC 042 is the prototypical strain. EAEC 042 secretes the functionally well‐characterized Pet autotransporter toxin that contributes to virulence through its cytotoxic effects on intestinal epithelial cells. Following a global transposon mutagenesis screen of EAEC 042, the transcription factors, CRP and Fis, were identified as essential for transcription of the pet gene. Using both in vivo and in vitro techniques, we show that the pet promoter is co‐dependent on CRP and Fis. We present a novel co‐activation mechanism whereby CRP is placed at a non‐optimal position for transcription initiation, creating dependence on Fis for full activation of pet. This study complements previous findings that establish Fis as a key virulence regulator in EAEC 042.
Role for Golgi reassembly and stacking protein (GRASP) in polysaccharide secretion and fungal virulence
Authors: Kmetzsch Lívia , Joffe Luna S. , Staats Charley C. , de Oliveira Débora L. , Fonseca Fernanda L. , Cordero Radames J.B. , Casadevall Arturo , Nimrichter Leonardo , Schrank Augusto , Vainstein Marilene H. , Rodrigues Marcio L. 
Published: May 2011

SummarySecretion of virulence factors is a critical mechanism for the establishment of cryptococcosis, a disease caused by the yeast pathogen Cryptococcus neoformans. One key virulence strategy of C. neoformans is the release of glucuronoxylomannan (GXM), a capsule‐associated immune‐modulatory polysaccharide that reaches the extracellular space through secretory vesicles. Golgi reassembly and stacking protein (GRASP) is required for unconventional protein secretion mechanisms in different eukaryotic cells, but its role in polysaccharide secretion is unknown. This study demonstrates that a C. neoformans functional mutant of a GRASP orthologue had attenuated virulence in an animal model of cryptococcosis, in comparison with wild‐type (WT) and reconstituted cells. Mutant cells manifested altered Golgi morphology, failed to produce typical polysaccharide capsules and showed a reduced ability to secrete GXM both in vitro and during animal infection. Isolation of GXM from cultures of WT, reconstituted or mutant strains revealed that the GRASP orthologue mutant produced polysaccharides with reduced dimensions. The mutant was also more efficiently associated to and killed by macrophages than WT and reconstituted cells. These results demonstrate that GRASP, a protein involved in unconventional protein secretion, is also required for polysaccharide secretion and virulence in C. neoformans.
The diguanylate cyclase, Rrp1, regulates critical steps in the enzootic cycle of the Lyme disease spirochetes
Authors: Kostick Jessica L. , Szkotnicki Lee T. , Rogers Elizabeth A. , Bocci Paola , Raffaelli Nadia , Marconi Richard T. 
Published: May 2011

SummaryRrp1 is the sole c‐di‐GMP‐producing protein (diguanylate cyclase) of Borrelia burgdorferi. To test the hypothesis that Rrp1 regulates critical processes involved in the transmission of spirochetes between ticks and mammals, an rrp1 deletion mutant (B31‐Δrrp1) and a strain that constitutively produces elevated levels of Rrp1 (B31‐OV) were constructed. The strains were assessed for progression through the enzootic cycle using an Ixodes tick/C3H‐HeJ mouse model and tick immersion feeding methods. B31‐Δrrp1 infected mice as efficiently as wild type but had altered motility, decreased chemotactic responses to N‐acetylglucosamine (NAG) and attenuated ability to disseminate or colonize distal organs. While this strain infected mice, it was not able to survive in ticks. In contrast, B31‐OV displayed normal motility patterns and chemotactic responses but was non‐infectious in mice. Using immersion feeding techniques, we demonstrate that B31‐OV can establish a population in ticks and survive exposure to a natural bloodmeal. The results presented here indicate Rrp1, and by extension, c‐di‐GMP, are not strictly required for murine infection, but are required for the successful establishment of a productive population of B. burgdorferi in ticks. These analyses provide significant new insight into the genetic regulatory mechanisms of the Lyme disease spirochetes.
The oxidative stress response in yeast cells involves changes in the stability of Aft1 regulon mRNAs
Authors: Castells‐Roca Laia , Mühlenhoff Ulrich , Lill Roland , Herrero Enrique , Bellí Gemma 
Published: May 2011

Summary Saccharomyces cerevisiae can import iron through a high‐affinity system consisting of the Ftr1/Fet3‐mediated reductive pathway and the siderophore‐mediated non‐reductive one. Expression of components of the high‐affinity system is controlled by the Aft1 transcriptional factor. In this study we show that, upon oxidative stress, Aft1 is transitorily internalized into the nucleus, followed by transcription activation of components of its regulon. In these conditions, the mRNA levels of the genes of the non‐reductive pathway become increased, while those of FTR1 and FET3 remain low because of destabilization of the mRNAs. Consequently, the respective protein levels also remain low. Such mRNA destabilization is mediated by the general 5′–3′ mRNA decay pathway and is independent of the RNA binding protein Cth2. Yeast cells are hypersensitive to peroxides in growth conditions where only the high‐affinity reductive pathway is functional for iron assimilation. On the contrary, peroxide does not affect growth when iron uptake occurs exclusively through the non‐reductive pathway. This reinforces the idea that upon oxidative stress S. cerevisiae cells redirect iron assimilation through the non‐reductive pathway to minimize oxidative damage by the ferrous ions, which are formed during iron import through the Ftr1/Fet3 complexes.
The incidence and risk factors of immediate type food allergy during the first year of life in Korean infants: a birth cohort study
Authors: Kim Jihyun , Chang Eunyoung , Han Youngshin , Ahn Kangmo , Lee Sang‐Il 
Published: May 2011

To cite this article: Kim J, Chang E, Han Y, Ahn K, Lee S‐I. The incidence and risk factors of immediate type food allergy during the first year of life in Korean infants: a birth cohort study. Pediatric Allergy Immunology 2011; 22: 715–719.AbstractObjectives:  We conducted this study to determine the incidence of food allergy (FA) in Korean infants and identify the risk factors of FAs during the first year of life in a birth cohort study.Methods:  Pregnant women ≥34 weeks of gestation were enrolled in this study. Participants were asked to complete questionnaires describing basic demographic information including family history of allergic diseases. Since birth, all the babies were regularly followed up for FA symptoms through telephone interviews at 4, 8, and 12 months of age. FA was defined as a repetitive convincing history of immediate allergic reactions following the ingestion of offending food.Results & conclusions:  A total of 1177 infants and their parents completed this study. The prevalence of FA was 5.3% in infants. The three leading food allergens were hen’s eggs (33/62), cow’s milk (20/62) and peanut/nuts (8/62). Children with a history of maternal AD showed a significantly higher prevalence of FA (P = 0.012) [aRR = 3.17]. In addition, children who were born during autumn had a higher prevalence than those born during spring (p = 0.005) [aRR = 3.48]. In conclusion, we identified several characteristics that may influence the development of FA in the next generation, including maternal AD and autumn birth.