bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Protocols for the Inpatient Care of Older Adults: Results from a Statewide Survey
Authors: Neuman Mark D. , Speck Rebecca M. , Karlawish Jason H. , Schwartz J. Sanford , Shea Judy A. 
Published: September 2010

OBJECTIVES: To assess the prevalence of protocols or guidelines for selected domains of inpatient care for older adults; to explore associations between hospital characteristics and adoption of these guidelines or protocols.DESIGN: Telephone‐ and Web‐based questionnaire.SETTING: General acute care hospitals in Pennsylvania.PARTICIPANTS: Chief nursing officers, directors of nursing, other hospital executives.MEASUREMENTS: Questionnaire items assessed the presence of written protocols or guidelines for selected processes of inpatient care; written guidelines, protocols, or pathways for hip fracture care; and inpatient geriatric consultation.RESULTS: Responses were obtained from 103 of 147 hospitals (70%) between June 21, 2009, and October 12, 2009. The prevalence of written protocols for general hospital practices (e.g., dosing of preoperative antibiotics, deep venous thrombosis prophylaxis) ranged from 84 of 98 (86%) to 90 of 97 (93%) respondents. Twenty of 95 (21%) and 16 of 94 (17%) respondents reported guidelines for the assessment of risk factors for delirium and for routine screening for delirium. Sixty‐six of 92 respondents (72%) reported the presence of a written protocol, guideline, or pathway for hip fracture, and 61 of 100 respondents (39%) confirmed availability of inpatient geriatric consultation. No systematic differences were found in survey responses between facilities on the basis of geriatric consultation availability, hospital size, or teaching status.CONCLUSION: Hospitals vary in their adoption of protocols and guidelines for the care of older adults. Broad opportunities may exist to improve the quality of inpatient care for older adults through better dissemination and implementation of guidelines and protocols for selected geriatric conditions.
Indoor and Outdoor Falls in Older Adults Are Different: The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study
Authors: Kelsey Jennifer L. , Berry Sarah D. , Procter‐Gray Elizabeth , Quach Lien , Nguyen Uyen‐Sa D. T. , Li Wenjun , Kiel Douglas P. , Lipsitz Lewis A. , Hannan Marian T. 
Published: September 2010

OBJECTIVES: To identify risk factors for indoor and outdoor falls.DESIGN: Prospective cohort study.SETTING: The MOBILIZE Boston Study, a study of falls etiology in community‐dwelling older individuals.PARTICIPANTS: Seven hundred sixty‐five women and men, mainly aged 70 and older, from randomly sampled households in the Boston, Massachusetts, area.MEASUREMENTS: Baseline data were collected by questionnaire and comprehensive clinic examination. During follow‐up, participants recorded falls on daily calendars. The location and circumstances of each fall were asked during telephone interviews.RESULTS: Five hundred ninety‐eight indoor and 524 outdoor falls were reported over a median follow‐up of 21.7 months. Risk factors for indoor falls included older age, being female, and various indicators of poor health. Risk factors for outdoor falls included younger age, being male, and being relatively physically active and healthy. For instance, the age‐ and sex‐adjusted rate ratio for having much difficulty or inability to perform activities of daily living relative to no difficulty was 2.57 (95% confidence interval (CI)=1.69–3.90) for indoor falls but 0.27 (95% CI=0.13–0.56) for outdoor falls. The rate ratio for gait speed of less than 0.68 m/s relative to a speed of greater than 1.33 m/s was 1.48 (95% CI=0.81–2.68) for indoor falls but 0.27 (95% CI=0.15–0.50) for outdoor falls.CONCLUSION: Risk factors for indoor and outdoor falls differ. Combining these falls, as is done in many studies, masks important information. Prevention recommendations for noninstitutionalized older people would probably be more effective if targeted differently for frail, inactive older people at high risk for indoor falls and relatively active, healthy people at high risk for outdoor falls.
The Optimum Follow‐Up Period for Assessing Mortality Outcomes in Injured Older Adults
Authors: Fleischman Ross J. , Adams Annette L. , Hedges Jerris R. , Ma O. John , Mullins Richard J. , Newgard Craig D. 
Published: September 2010

OBJECTIVES: To compare mortality rates of hospitalized injured aged 67 and older across commonly used follow‐up periods (e.g., in‐hospital, 30‐day, 1‐year) and to determine the postinjury time after which mortality rates stabilize.DESIGN: Retrospective analysis of Medicare claims.SETTING: Oregon and Washington Medicare patients.PARTICIPANTS: Patients admitted to 171 Oregon and Washington facilities during 2001/02 with injuries identified according to International Classification of Diseases, Ninth Revision, code and followed for 1 year.MEASUREMENTS: The primary outcome was in‐hospital mortality and mortality at 30, 60, 90, 180, and 365 days. Kaplan‐Meier survival curves and daily postadmission mortality rates were also evaluated. The rate of change (slope) of the survival curves and daily mortality rates were analyzed to select the point after which mortality rates were no longer decreasing.RESULTS: There were 32,135 injured older adults hospitalized over the 2‐year period, with a median age of 82 (interquartile range 77–88). Cumulative in‐hospital mortality and at 30, 60, 90, 180, and 365 days was 4.1%, 9.7%, 13.6%, 16.1%, 21.3%, and 28.4%, respectively. Mortality rates stabilized by 6 months after injury, with 89% of the change occurring within 60 days. Although serious injuries, medical comorbidities, and preinjury nursing facility residence were all associated with higher mortality, they did not affect the pattern of mortality after injury.CONCLUSION: In‐hospital mortality is much lower than postdischarge mortality in injured older adults, with a substantial portion of persons dying shortly after discharge from the hospital. Mortality appears to stabilize by 6 months after injury, although 60‐day postadmission follow‐up captures most of the excess daily mortality rate.
Corneal curvature, pachymetry, and endothelial cell density in Marfan syndrome
Authors: Konradsen Tiina R. , Koivula Annemari , Kugelberg Maria , Zetterström Charlotta 
Published: September 2010

Abstract.Purpose:  To evaluate corneal curvature, pachymetry, and endothelial cell density (ECD) in Marfan syndrome (MFS).Methods:  A case–control study in which K values, pachymetry, and ECD were compared in 39 MFS eyes and 40 control eyes matched for age and refraction was conducted. MFS eyes with lens subluxation also were compared with eyes without subluxation.Results:  The mean Kmed value in MFS eyes was lower than in the control eyes, 42.2 ± 1.9 versus 43.4 ± 1.4 dioptres (D), respectively (p = 0.02). Fifteen MFS eyes (38%) and three control eyes (8%) had Kmed values below 41.5 D (p = 0.0012). MFS eyes had generally more corneal astigmatism than control eyes, 1.1 ± 0.9 versus 0.8 ± 0.4 D (p = 0.035), and MFS eyes with lens subluxation had more corneal astigmatism than those without, 1.6 ± 1.1 versus 0.6 ± 0.3 D (p = 0.0002). Nine MFS eyes with corneal astigmatism exceeding 1.5 D also had a subluxated lens. No eyes had keratoconus. The mean pachymetry value was lower in MFS eyes compared to the controls, 485 ± 54.5 versus 514 ± 37.3 μm (p = 0.007); 24 MFS eyes (62%) and 10 control eyes (25%) had measurements below 500 μm (p = 0.01). The mean ECD values were similar in MFS and control eyes, 2815 ± 430 versus 2858 ± 458 cells/mm2 (p = 0.66). The mean K value, pachymetry, and ECD values did not differ between MFS eyes with and without lens subluxation.Conclusion:  Decreased K values and pachymetry could indicate MFS regardless of subluxation. High corneal astigmatism is associated with subluxation in MFS. Subluxation should be identified in MFS eyes with high corneal astigmatism.
Increased serum total antioxidant status and decreased urinary 8‐hydroxy‐2′‐deoxyguanosine levels in patients with normal‐tension glaucoma
Authors: Yuki Kenya , Murat Dogru , Kimura Itaru , Tsubota Kazuo 
Published: September 2010

Acta Ophthalmol. 2010: 88: e259–e264Abstract.Purpose:  To investigate the amount of systemic oxidative stress‐related DNA damage and serum total antioxidant status of patients with normal‐tension glaucoma compared with healthy controls.Methods:  Forty‐three patients with normal‐tension glaucoma selected from 60 consecutive newly diagnosed patients with primary open‐angle glaucoma were enrolled. Each patient’s intraocular pressure (IOP) was measured seven times over a 24‐hour period. Those whose highest IOP was over 21 mmHg were excluded. Forty control subjects were recruited. The serum total antioxidant status was assessed colorimetrically by its ability to reduce the generation of the radical cation ABTS (2,2‐azinobis‐3‐ethylbenzthiazoline sulphonate). The urinary 8‐hydroxy‐2′‐deoxyguanosine was measured as a marker of oxidative DNA damage and normalized to creatinine. The results were compared between healthy subjects and patients with normal‐tension glaucoma.Results:  The control and normal‐tension glaucoma groups did now show significant differences for age, gender, serum fructosamine, cholesterol and triglyceride levels; systolic and diastolic blood pressure, body mass index; and prevalence of hypertension. The serum total antioxidant status was significantly higher (p = 0.01) and the urinary 8‐hydroxy‐2′‐deoxyguanosine/creatinine level significantly lower (p = 0.03) in the patients with normal‐tension glaucoma compared with the controls. Even after we adjusted the data for independent variables, the incidence of normal‐tension glaucoma was significantly correlated with high serum total antioxidant levels (p = 0.03; odds ratio, 1.007; 95% confidence interval, 1.001–1.013) and low urinary 8‐hydroxy‐2′‐deoxyguanosine/creatinine (p = 0.02; odds ratio 0.76; 95% confidence interval, 0.61–0.96).Conclusions:  Increased serum total antioxidant and decreased 8‐hydroxy‐2′‐deoxyguanosine may reflect compensatory alterations in response to increased systemic oxidative stress in patients with normal‐tension glaucoma.
Human Immunodeficiency Virus Type 1 Protease Inhibitor Drug-Resistant Mutants Give Discordant Results When Compared in Single-Cycle and Multiple-Cycle Fitness Assays
Authors: Dykes Carrie , Wu Hulin , Sims Matthew , Holden-Wiltse Jeanne , Demeter Lisa M. 
Published: September 2010

ABSTRACT

The replication fitness of HIV-1 drug-resistant mutants has been measured using either multiple-cycle or single-cycle assays (MCAs or SCAs); these assays have not been systematically compared. We developed an MCA and an SCA that utilized either intact or
env
-deleted recombinant viral vectors, respectively, in which virus-infected cells were detected by flow cytometry of a reporter gene product. Fitness was measured using each assay for 11 protease mutants, 9 reverse transcriptase mutants, and two mutants with mutations in
gag
p6, which is important for the release of virus particles from the cell membrane. In the SCA, fitness (replication capacity [RC]) was defined as the proportion of cells infected by the mutant compared to the wild type 40 h after infection. MCA fitness (1+s) was determined by comparing the changes in the relative proportions of cells infected by the mutant and the wild type between 3 and 5 days after infection. Five protease mutants showed statistically different fitness values by the MCA versus the SCA: the D30N, G48V, I50V, I54L, and I54M mutants. When all the mutants were ranked in order from most to least fit for both assays, 4 protease mutants moved more than 5 positions in rank: the D30N, I54L, I54M, and V82A mutants. There were no significant differences in fitness for the
gag
p6 or reverse transcriptase mutants. We propose that discordant results in the MCA and SCA are due to alterations in late events in the virus life cycle that are not captured in an SCA, such as burst size, cell-to-cell transmission, or infected-cell life span.
Multicenter Evaluation of the BD Max GBS Assay for Detection of Group B Streptococci in Prenatal Vaginal and Rectal Screening Swab Specimens from Pregnant Women
Authors: Riedlinger Jennifer , Beqaj Safedin H. , Milish Marsha A. , Young Stephen , Smith Rebecca , Dodd Monique , Hankerd Rosemary E. , LeBar William D. , Newton Duane W. 
Published: September 2010

ABSTRACT
A new integrated extraction and real-time PCR-based system for the detection of group B streptococci in antepartum screening samples enriched in Lim broth was compared to the CDC-recommended culture method. The BD Max GBS assay exhibited acceptable sensitivity (95%) and specificity (96.7%) compared to those of the culture method in this multisite evaluation.
Coagulase-Negative Staphylococcal Skin Carriage among Neonatal Intensive Care Unit Personnel: from Population to Infection
Authors: Hira Vishal , Sluijter Marcel , Goessens Wil H. F. , Ott Alewijn , de Groot Ronald , Hermans Peter W. M. , Kornelisse René F. 
Published: September 2010

ABSTRACT

Coagulase-negative staphylococci (CoNS) are a major cause of sepsis in neonatal intensive care units (NICU) worldwide. Infecting strains of these commensal bacteria may originate from NICU personnel. Therefore, we studied the characteristics of CoNS isolates from NICU personnel and compared them to those of isolates from the general population and from sepsis patients. Furthermore, we studied the epidemiological effect on CoNS carriage of NICU personnel after a period of absence. In our study, we isolated CoNS from the thumbs of NICU personnel every 2 weeks during the summer of 2005 and sampled personnel returning from vacation and a control group from the general population. Furthermore, we collected sepsis isolates from this period. Isolates were tested for antibiotic resistance,
mecA
and
icaA
carriage, biofilm production, and genetic relatedness. We found that
mecA
and
icaA
carriage as well as penicillin, oxacillin, and gentamicin resistance were significantly more prevalent in CoNS strains from NICU personnel than in community isolates. Similar trends were observed when postvacation strains were compared to prevacation strains. Furthermore, genetic analysis showed that 90% of the blood isolates were closely related to strains found on the hands of NICU personnel. Our findings revealed that CoNS carried by NICU personnel differ from those in the general population. Hospital strains are replaced by community CoNS after a period of absence. NICU personnel are a likely cause for the cross-contamination of virulent CoNS that originate from the NICU to patients.
Single-Nucleotide Polymorphism in the
fadD28
Gene as a Genetic Marker for East Asia Lineage
Mycobacterium tuberculosis
Authors: Chuang Pei-Chun , Chen Huang-Yau , Jou Ruwen 
Published: September 2010

ABSTRACT

Mycobacterium tuberculosis
isolates with a region of difference 105 (RD105) deletion, mainly Beijing family spoligotypes, were phylogenetically grouped into the East Asia lineage. We identified a single nucleotide polymorphism in codon 507, ATC to ATT, of the
fadD28
gene as a robust marker and developed a rapid assay for East Asia lineage
M. tuberculosis
.
High Prevalence of Clarithromycin Resistance and
cagA
,
vacA
,
iceA2
, and
babA2
Genotypes of
Helicobacter pylori
in Brazilian Children
Authors: Garcia Gabriella T. , Aranda Katia R. S. , Gonçalves Manoel E. P. , Cardoso Silvia R. , Iriya Kiyoshi , Silva Neusa P. , Scaletsky Isabel C. A. 
Published: September 2010

ABSTRACT

We isolated 45
Helicobacter pylori
strains from 217 child patients. Resistance to clarithromycin, metronidazole, amoxicillin, and tetracycline was detected in 27%, 13%, 4%, and 0% of strains, respectively. The A2143G mutation was the most prevalent (67%) among clarithromycin-resistant strains. In addition, strain genotyping revealed a significant association between gastritis severity and the simultaneous presence of
cagA
,
vacA s1m1
,
iceA2
, and
babA2
genes.
Real-Time Detection of Influenza A, Influenza B, and Respiratory Syncytial Virus A and B in Respiratory Specimens by Use of Nanoparticle Probes
Authors: Jannetto Paul J. , Buchan Blake W. , Vaughan Kimberly A. , Ledford Joellen S. , Anderson Dennis K. , Henley Donald C. , Quigley Neil B. , Ledeboer Nathan A. 
Published: September 2010

ABSTRACT

Seasonal epidemics of influenza and respiratory syncytial virus are responsible for significant morbidity and mortality worldwide. Infrequently, novel or reemergent strains of influenza A virus have caused rapid, severe global pandemics resulting in millions of fatalities. The ability to efficiently and accurately detect and differentiate respiratory viruses is paramount for effective treatment, infection control, and epidemiological surveillance. We evaluated the ability of two FDA-cleared nucleic acid-based tests, the semiautomated respiratory virus nucleic acid test (VRNAT) and the fully automated respiratory virus nucleic acid test
SP
(RVNAT

SP

) (Nanosphere Inc., Northbrook, IL) to detect influenza A virus, influenza B virus, and respiratory syncytial virus A and B (RSV A/B) from clinical nasopharyngeal swab specimens. Detection of viral RNA in both tests is based on nucleic acid amplification followed by hybridization to capture probes immobilized on a glass slide. A novel technology utilizing gold nanoparticle-conjugated probes is utilized to detect the presence of captured target DNA. This microarray-based approach to detection has proven to be more sensitive than the traditional culture/direct fluorescent-antibody assay (DFA) method for detecting RSV and influenza viruses in clinical specimens, including the novel 2009 H1N1 strain. Specifically, we report 98.0% sensitivity and 96.5% specificity for the VRNAT compared to culture/DFA. Further, the VRNAT detected virus in an additional 58% of specimens that were culture negative. These data were confirmed using bidirectional sequencing. Evaluation of the fully automated RVNAT

SP

, which is built on the same detection technology as the VRNAT but contains an updated processor enabling complete automation, revealed the two tests to be functionally equivalent. Thus, the RVNAT

SP

is a fully automated sample-to-result test capable of reliable detection of select respiratory viruses directly from clinical specimens in 3.5 h.
Generation of Replication-Competent Recombinant Influenza A Viruses Carrying a Reporter Gene Harbored in the Neuraminidase Segment
Authors: Li Feng , Feng Liqiang , Pan Weiqi , Dong Zhenyuan , Li Chufang , Sun Caijun , Chen Ling 
Published: September 2010

ABSTRACT

Replication-competent influenza viruses carrying reporter genes are of great use for basic research, screening of antiviral drugs, and neutralizing of antibodies. In this study, two recombinant influenza A viruses with a neuraminidase (NA) segment harboring enhanced green fluorescent protein (EGFP) in the background of A/PR/8/34 (PR8) were generated. The viral RNA (vRNA)-specific packaging signals for NA were largely retained for efficient packaging. An “autocleave” 2A peptide sequence, which was inserted at the N terminus or the COOH terminus of NA to link with EGFP, enabled NA and EGFP to be expressed monocistronically. Further analysis demonstrated that both viruses, named rPR8-EGFP+NA and rPR8-NA+EGPF, although with some characteristic differences in growth and EGFP expression, could replicate in noncomplementary cells and propagate to large quantities while maintaining genome stability after multiple passages in embryonated eggs. These replication-competent influenza viruses carrying reporter genes are a great addition to the tool set for developing antiviral therapeutics and vaccines and for
in vivo
studies of viral dissemination and pathogenicity.
Infectivity of Hepatitis C Virus Is Influenced by Association with Apolipoprotein E Isoforms
Authors: Hishiki Takayuki , Shimizu Yuko , Tobita Reiri , Sugiyama Kazuo , Ogawa Kazuya , Funami Kenji , Ohsaki Yuki , Fujimoto Toyoshi , Takaku Hiroshi , Wakita Takaji , Baumert Thomas F. , Miyanari Yusuke , Shimotohno Kunitada 
Published: September 2010

ABSTRACT
Hepatitis C virus (HCV) is a causative agent of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. HCV in circulating blood associates with lipoproteins such as very low density lipoprotein (VLDL) and low-density lipoprotein (LDL). Although these associations suggest that lipoproteins are important for HCV infectivity, the roles of lipoproteins in HCV production and infectivity are not fully understood. To clarify the roles of lipoprotein in the HCV life cycle, we analyzed the effect of apolipoprotein E (ApoE), a component of lipoprotein, on virus production and infectivity. The production of infectious HCV was significantly reduced by the knockdown of ApoE. When an ApoE mutant that fails to be secreted into the culture medium was used, the amount of infectious HCV in the culture medium was dramatically reduced; the infectious HCV accumulated inside these cells, suggesting that infectious HCV must associate with ApoE prior to virus release. We performed rescue experiments in which ApoE isoforms were ectopically expressed in cells depleted of endogenous ApoE. The ectopic expression of the ApoE2 isoform, which has low affinity for the LDL receptor (LDLR), resulted in poor recovery of infectious HCV, whereas the expression of other isoforms, ApoE3 and ApoE4, rescued the production of infectious virus, raising it to an almost normal level. Furthermore, we found that the infectivity of HCV required both the LDLR and scavenger receptor class B, member I (SR-BI), ligands for ApoE. These findings indicate that ApoE is an essential apolipoprotein for HCV infectivity.
The Globoside Receptor Triggers Structural Changes in the B19 Virus Capsid That Facilitate Virus Internalization
Authors: Bönsch Claudia , Zuercher Christoph , Lieby Patricia , Kempf Christoph , Ros Carlos 
Published: September 2010

ABSTRACT
Globoside (Gb4Cer), Ku80 autoantigen, and α5β1 integrin have been identified as cell receptors/coreceptors for human parvovirus B19 (B19V), but their role and mechanism of interaction with the virus are largely unknown. In UT7/Epo cells, expression of Gb4Cer and CD49e (integrin alpha-5) was high, but expression of Ku80 was insignificant. B19V colocalized with Gb4Cer and, to a lesser extent, with CD49e. However, only anti-Gb4Cer antibodies could disturb virus attachment. Only a small proportion of cell-bound viruses were internalized, while the majority became detached from the receptor. When added to uninfected cells, the receptor-detached virus showed superior cell binding capacity and infectivity. Attachment of B19V to cells triggered conformational changes in the capsid leading to the accessibility of the N terminus of VP1 (VP1u) to antibodies, which was maintained in the receptor-detached virus. VP1u became similarly accessible to antibodies following incubation of B19V particles with increasing concentrations of purified Gb4Cer. The receptor-mediated exposure of VP1u is critical for virus internalization, since capsids lacking VP1 could bind to cells but were not internalized. Moreover, an antibody against the N terminus of VP1u disturbed virus internalization, but only when present during and not after virus attachment, indicating the involvement of this region in binding events required for internalization. These results suggest that Gb4Cer is not only the primary receptor for B19V attachment but also the mediator of capsid rearrangements required for subsequent interactions leading to virus internalization. The capacity of the virus to detach and reattach again would enhance the probability of productive infections.