bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review of integrated working between care homes and health care services
Authors: Davies Sue L , Goodman Claire , Bunn Frances , Victor Christina , Dickinson Angela , Iliffe Steve , Gage Heather , Martin Wendy , Froggatt Katherine 
Published: November 2011

Abstract

Background
In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working.

Methods
A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis.

Results
Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration.

Conclusions
Despite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes.
New Pathogenic Thyrotropin Receptor Mutations Decipher Differentiated Activity Switching at a Conserved Helix 6 Motif of Family A GPCR
Authors: Biebermann Heike , Winkler Franziska , Handke Daniela , Teichmann Anke , Gerling Burkhard , Cameron Fergus , Eichhorst Jenny , Grüters Annette , Wiesner Burkhard , Kühnen Peter , Krude Heiko , Kleinau Gunnar 
Published: November 2011

Context:
In this paper we report two new TSH receptor (TSHR) mutations. One mutation (Pro6396.50Leu) was identified in two siblings with congenital hypothyroidism, and a second mutation (Cys6366.47Arg) was found in a patient suffering from nonautoimmune hyperthyroidism. Both mutations are located in transmembrane helix (TMH) 6 at the conserved Cys6.47-Trp(Met)6.48-Leu(Ala)6.49-Pro6.50 motif of family A G protein-coupled receptors (GPCR).

Objective:
To study the pathogenic mechanisms, we tested patients' mutations and further side chain variations regarding their effects on TSHR signaling.

Results:
Substitution Pro639Leu fully inactivates the promiscuous TSHR for cAMP (Gs) and IP (Gq) signaling. In contrast, Cys636Arg leads to constitutive activation of Gs. Organization of TSHR in oligomers was not modified by mutations at position 636. Interestingly, it is known from crystal structures of GPCR that Pro6.50 is located at a TMH6 kink-distortion, which is a pivot during activation-related helical movements. However, the cell surface expressions of all mutants at position 639 were comparable to wild type, indicating a helical conformation like wild type.

Conclusion:
Until now, only naturally occurring constitutively activating mutations in TSHR TMH6 have been reported, but here we present the first pathogenic inactivating mutation (Pro639Leu). Our data are indicative of differentiated regulation of Gs and Gq signaling at particular TMH6 positions, but without any effects on TSHR oligomer constellation. Details of signaling modulation by each mutant at positions 6366.47 and 6396.50 help us to understand high conservation of these amino acids in family A GPCR. Described molecular (pathogenic) mechanisms are likely not unique for TSHR.
Hispanic Ethnicity and Vascular Access Use in Patients Initiating Hemodialysis in the United States
Authors: Arce Cristina M. , Mitani Aya A. , Goldstein Benjamin A. , Winkelmayer Wolfgang C. 
Published: November 2011

Summary

Background and objectives
Hispanics are the largest minority in the United States (comprising 16.3% of the US population) and have 1.5 times the age-, sex-, and race-adjusted incidence of ESRD compared with non-Hispanics. Poor health care access and low-quality care generally received by Hispanics are well documented. However, little is known regarding dialysis preparation of Hispanic patients with progressive CKD.

Design, setting, participants, & measurements
Using data from Medical Evidence Report form CMS-2728-U3, 321,996 adult patients of white or black race were identified who initiated hemodialysis (HD) between July 1, 2005 and December 31, 2008. The form captures Hispanic ethnicity, vascular access use at first outpatient HD, sociodemographic characteristics, and comorbidities. This study also examined whether use of an arteriovenous fistula (AVF) or graft (AVG) was reported.

Results
AVF/AVG use was reported in 14.5% of Hispanics and 17.6% in non-Hispanics (P<0.001). The unadjusted prevalence ratio (PR) was 0.85 (95% confidence interval [95% CI], 0.83–0.88), indicating that Hispanics were 15% less likely to use AVG/AVF for their first outpatient HD. Adjustment for age, sex, and race, as well as a large number of comorbidities and frailty indicators, did not change this association (PR, 0.85; 95% CI, 0.83–0.88). Further adjustment for timing of first predialysis nephrology care, however, attenuated the PR by two-thirds (PR, 0.94; 95% CI, 0.92–0.97).

Conclusions
Hispanics are less likely to use arteriovenous access for first outpatient HD compared with non-Hispanics, which seems to be explained by variation in the access to predialysis nephrology care.
Chloroplast microsatellite primers for cacao (Theobroma cacao) and other Malvaceae
Authors: Yang Ji Y. , Motilal Lambert A. , Dempewolf Hannes , Maharaj Kamaldeo , Cronk Q. C. B. 
Published: November 2011

• Premise of the study: Chloroplast microsatellites were developed in Theobroma cacao to examine the genetic diversity of cacao cultivars in Trinidad and Tobago.• Methods and Results: Nine polymorphic microsatellites were designed from the chloroplast genomes of two T. cacao accessions. These microsatellites were tested in 95 hybrid accessions from Trinidad and Tobago. An average of 2.9 alleles per locus was found.• Conclusions: These chloroplast microsatellites, particularly the highly polymorphic pentameric repeat, were useful in assessing genetic variation in T. cacao. In addition, these markers should also prove to be useful for population genetic studies in other species of Malvaceae.
A Mouse Model of Clonal CD8+ T Lymphocyte-Mediated Alopecia Areata Progressing to Alopecia Universalis
Authors: Alli Rajshekhar , Nguyen Phuong , Boyd Kelli , Sundberg John P. , Geiger Terrence L. 
Published: November 2011

Abstract
Alopecia areata is among the most prevalent autoimmune diseases, yet compared with other autoimmune conditions, it is not well studied. This in part results from limitations in the C3H/HeJ mouse and DEBR rat model systems most commonly used to study the disease, which display a low frequency and late onset. We describe a novel high-incidence model for spontaneous alopecia areata. The 1MOG244 T cell expresses dual TCRA chains, one of which, when combined with the single TCRB present, promotes the development of CD8+ T cells with specificity for hair follicles. Retroviral transgenic mice expressing this TCR develop spontaneous alopecia areata at nearly 100% incidence. Disease initially follows a reticular pattern, with regionally cyclic episodes of hair loss and regrowth, and ultimately progresses to alopecia universalis. Alopecia development is associated with CD8+ T cell activation, migration into the intrafollicular region, and hair follicle destruction. The disease may be adoptively transferred with T lymphocytes and is class I and not class II MHC-dependent. Pathologic T cells primarily express IFNG and IL-17 early in disease, with dramatic increases in cytokine production and recruitment of IL-4 and IL-10 production with disease progression. Inhibition of individual cytokines did not significantly alter disease incidence, potentially indicating redundancy in cytokine responses. These results therefore characterize a new high-incidence model for alopecia areata in C57BL/6J mice, the first to our knowledge to apply a monoclonal TCR, and indicate that class I MHC-restricted CD8+ T lymphocytes can independently mediate the pathologic response.
Memory CD4 T Cells Induce Selective Expression of IL-27 in CD8+ Dendritic Cells and Regulate Homeostatic Naive T Cell Proliferation
Authors: Do Jeong-su , Visperas Anabelle , Oh Keunhee , Stohlman Stephen A. , Min Booki 
Published: November 2011

Abstract
Naive T cells undergo robust proliferation in lymphopenic conditions, whereas they remain quiescent in steady-state conditions. However, a mechanism by which naive T cells are kept from proliferating under steady-state conditions remains unclear. In this study, we report that memory CD4 T cells are able to limit naive T cell proliferation within lymphopenic hosts by modulating stimulatory functions of dendritic cells (DC). The inhibition was mediated by IL-27, which was primarily expressed in CD8+ DC subsets as the result of memory CD4 T cell–DC interaction. IL-27 appeared to be the major mediator of inhibition, as naive T cells deficient in IL-27R were resistant to memory CD4 T cell-mediated inhibition. Finally, IL-27–mediated regulation of T cell proliferation was also observed in steady-state conditions as well as during Ag-mediated immune responses. We propose a new model for maintaining peripheral T cell homeostasis via memory CD4 T cells and CD8+ DC-derived IL-27 in vivo.
Immediate Changes of Bone Density Caused by the Implantation of a Femoral Stem - A Dexa Study
Authors: Leichtle Ulf G. , Leasure Jeremi , Martini Franz , Leichtle Carmen I. 
Published: November 2011

Considerable immediate periprosthetic bone density changes after implantation of femoral stems have been observed comparing DEXA measurements taken pre- and post-operatively. This is important in relation to the interpretation of DEXA studies. We analysed these density changes under standardised experimental conditions. Five human femora were implanted with a custom made femoral stem and ten femora with a standard cementless prosthesis. Densitometry was performed at various stages of implantation. Following rasping only slight density changes were noted (–2.7% to +0.7%). Comparing post-implantation and pre-operative measurements, all custom made stems with a proximal press-fit demonstrated clear increases in proximal periprosthetic bone density of +11% and +14%. In contrast, the standard prosthesis with a distal press-fit showed a loss of –5% and –2% in the proximal zones. Measurements following removal of the implants demonstrated hardly any density changes (0% to –4%) compared to the pre-operative measurements. We concluded that compacting of trabecular bone or bone loss due to rasping are not the main causes of density changes. Substantial measuring errors exist. For examination of periprosthetic bone density changes, pre-operative initial measurements should not be used as a baseline for comparison. Studies should commence with an immediate postoperative measurement.
In vitro Evaluation of Antimicrobial Efficacy of Endodontic Irrigants
Authors: Dagna Alberto , Arciola Carla Renata , Florindi Filippo , Scribante Andrea , Saino Enrica , Visai Livia , Poggio Claudio 
Published: November 2011

Purpose The objective of this study was to compare in vitro, by MTT assay, the antimicrobial efficacy of Niclor 5 (5% NaOCl solution), Cloreximid (0.2% chlorhexidine and 0.2% cetrimide solution), 3% hydrogen peroxide and 17% EDTA against two microorganisms associated with primary endodontic infections. Methods Enterococcus faecalis and Streptococcus mutans strains were selected for this test. Freshly extracted single-rooted human teeth were endodontically treated, inoculated with bacterial strains and then divided into different groups, each of them rinsed with Niclor 5 (5% NaOCl solution), Cloreximid (0.2% chlorhexidine and 0.2% cetrimide solution), 3% hydrogen peroxide, 17% EDTA and with 5% NaOCl solution (positive control). Results Even though all the tested irrigating solutions demonstrated antibacterial effects against E. faecalis and S. mutans, the results were significantly different between the various groups. The greatest antimicrobial effects were observed in groups treated with 5% NaOCl and 17% EDTA. Interestingly, the effectiveness of EDTA could be ascribed to its capability of detaching biofilm from canal walls.
Estudio de la fracción de materia orgánica de mayor remoción en el proceso de coagulación-floculación usando agua superficial
Authors: Tapia AK , Reyes A , Garcia I 
Published: November 2011

En este trabajo, se realizó la separación de la materia orgánica natural (MON) presente en el agua cruda que abastece a dos plantas potabilizadoras, una de río (Boaco) y otra de lago (Juigalpa), en dos tipos: hidrofóbica, constituida por las fracciones muy hidrofóbica (MH) y ligeramente hidrofóbica (LH); y el tipo hidrofílica formada por las fracciones cargada (CHA) y neutral (NEU). Las aguas obtenidas de cada fracción fueron sometidas a un proceso de coagulación-floculación-sedimentación a escala de laboratorio usando sulfato de aluminio como coagulante; donde la fracción hidrofílica (CHA y NEU) fue poco removida (< 35 %) en comparación con la hidrofóbica (> 65 %). Se utilizaron parámetros sustitutos para caracterizar dicha MON como carbono orgánico disuelto (COD), color, absorbancia ultravioleta (UV254) y absorbancia especifica ultravioleta (SUVA). Se determinó que estas aguas cruda presentan una mezcla de materia orgánica hidrofóbica e hidrofílica ya que los valores de SUVA estaban entre 2-4 L/mg-m, sin embargo la fracción hidrofóbica (MH+LH) fue la predominante ya que representa 63.6 % y 65 % medidos como COD en época seca para Boaco y Juigalpa respectivamente, en época lluviosa los porcentajes fueron un poco más alto (71.2 % y 66.1 %). Finalmente se halló que el agua de río (Boaco) contiene mayor concentración de trihalometanos (89-166 μg/L) que el agua del lago (Juigalpa) (28-80 μg/L) después de ser clorada. Encontrándose que la fracción hidrofóbica fue la que más contribuyó a la formación de trihalometanos (THMs) en 68.5 % (Boaco) y 78.6 % (Juigalpa) en la época seca en ambas aguas tratadas. Para la época lluviosa, la formación de THMs fue un poco mayor. Palabras claves: Materia orgánica; Trihalometanos; Fraccionamiento; Agua superficial DOI: http://dx.doi.org/10.5377/nexo.v24i1.596 Nexo, Vol. 24, No. 1, pp. 72-80, 2011
Dental evidence for the diets of Plio‐Pleistocene hominins
Authors: Ungar Peter S. 
Published: November 2011

AbstractDiet is fundamental to the interaction between an organism and its environment, and is therefore an important key to understanding ecology and evolution. It should come as no surprise then that paleoanthropologists have put a great deal of effort into reconstructing the diets of Plio‐Pleistocene hominins. Most of this effort has focused on teeth; these durable parts of the digestive system are usually the most commonly preserved elements in vertebrate fossil assemblages. In this article, I review much of this work. Tooth size, occlusal morphology, enamel thickness, and microstructure provide evidence for the physical properties of the foods to which a species was adapted. Dental microwear can offer insights into the properties of foods that an individual ate on a day‐to‐day basis. Taken together, these lines of evidence can offer important insights into early hominin food choices and adaptations. New methods of analysis and theoretical perspectives are improving our understanding of the diets of Australopithecus, Paranthropus, and early Homo, and promise further progress long intothe future. Yrbk Phys Anthropol 54:47–62, 2011. © 2011 Wiley Periodicals, Inc.
Skeletal biology over the life span: A view from the surfaces
Authors: Gosman James H. , Stout Samuel D. , Larsen Clark Spencer 
Published: November 2011

AbstractThe biocultural interpretation of skeletal remains is based upon the foundation of skeletal biology. In this review we examine the current state of skeletal biology research outside of the mainstream anthropology literature. The focus is on the structural changes of bone development and growth, and modeling and repair in the four bone surfaces: periosteal, Haversian, endosteal, and trabecular. The pattern of skeletal changes is placed within the framework of the human life span. New perspectives and direction of research on the environmental, biological, and genetic influences on modeling and remodeling processes are discussed chronologically at each bone surface. Implications for biological anthropologists are considered. This approach emphasizes variation in skeletal biology as a dynamic record of development, maturity, and aging. Yrbk Phys Anthropol 54:86–98, 2011. © 2011 Wiley Periodicals, Inc.
The origin and antiquity of syphilis revisited: An Appraisal of Old World pre‐Columbian evidence for treponemal infection
Authors: Harper Kristin N. , Zuckerman Molly K. , Harper Megan L. , Kingston John D. , Armelagos George J. 
Published: November 2011

AbstractFor nearly 500 years, scholars have argued about the origin and antiquity of syphilis. Did Columbus bring the disease from the New World to the Old World? Or did syphilis exist in the Old World before 1493? Here, we evaluate all 54 published reports of pre‐Columbian, Old World treponemal disease using a standardized, systematic approach. The certainty of diagnosis and dating of each case is considered, and novel information pertinent to the dating of these cases, including radiocarbon dates, is presented. Among the reports, we did not find a single case of Old World treponemal disease that has both a certain diagnosis and a secure pre‐Columbian date. We also demonstrate that many of the reports use nonspecific indicators to diagnose treponemal disease, do not provide adequate information about the methods used to date specimens, and do not include high‐quality photographs of the lesions of interest. Thus, despite an increasing number of published reports of pre‐Columbian treponemal infection, it appears that solid evidence supporting an Old World origin for the disease remains absent. Yrbk Phys Anthropol 54:99–133, 2011. © 2011 Wiley Periodicals, Inc.
A new pliopithecid genus (primates: pliopithecoidea) from castell de barberà (vallès‐penedès basin, catalonia, spain)
Authors: Alba David M. , Moyà‐Solà Salvador 
Published: November 2011

AbstractBarberapithecus huerzeleri gen. et sp. nov. (Primates, Pliopithecidae) is erected on the basis of material from Castell de Barberà (Middle to Late Miocene, ca. 11.2–10.5 Ma), in the Vallès‐Penedès Basin (Catalonia, Spain), including: 15 teeth (representing most of the permanent dentition) from a single female individual (holotype); an isolated P/3 (paratype); and a male C1/ (referred to the hypodigm). Previously, this material had been only partially figured and described, being attributed to Pliopithecus or to a new taxon with possible crouzeliine affinities. The erection of a new genus is justified by several autapomorphic features, such as markedly buccolingually compressed and mesiodistally elongated C1/, extremely buccolingually compressed, and mesiodistally oriented C/1 main cusp, P/4 with a large trigonid subequal to the talonid, very large distal foveae on the M/1 and especially the M/2, and lower molars with a quadrangular central fovea and a mesially situated entoconid. These features are associated with a set of crouzeliine synapomorphies, such as buccolingually compressed and peripheralized cusps, well‐developed crests, large and well‐defined occlusal foveae, upper molars with long preprotocrista, short hypoparacrista, somewhat distally situated protocone and short distal fovea, distinct P/3 metaconid, well‐developed P/4 premetacristid, and relatively narrow lower molars with a reduced entoconid. Although more primitive, Barberapithecus resembles Anapithecus in some derived features. Both taxa are included into a new tribe (Anapithecini), together with other crouzeliines except Plesiopliopithecus (tribe Crouzeliini). The retention of primitive, pliopithecine‐like features in Barberapithecus suggests that anapithecins might have evolved from a Pliopithecus ancestor, so that as currently conceived the Crouzeliinae might be polyphyletic. Am J Phys Anthropol 2012. © 2011 Wiley Periodicals, Inc.
Technical note: Quantitative measures of iris color using high resolution photographs
Authors: Edwards Melissa , Gozdzik Agnes , Ross Kendra , Miles Jon , Parra Esteban J. 
Published: November 2011

AbstractOur understanding of the genetic architecture of iris color is still limited. This is partly related to difficulties associated with obtaining quantitative measurements of eye color. Here we introduce a new automated method for measuring iris color using high resolution photographs. This method extracts color measurements in the CIE 1976 L*a*b* (CIELAB) color space from a 256 by 256 pixel square sampled from the 9:00 meridian of the iris. Color is defined across three dimensions: L* (the lightness coordinate), a* (the red‐green coordinate), and b* (the blue‐yellow coordinate). We applied this method to a sample of individuals of diverse ancestry (East Asian, European and South Asian) that was genotyped for the HERC2 rs12913832 polymorphism, which is strongly associated with blue eye color. We identified substantial variation in the CIELAB color space, not only in the European sample, but also in the East Asian and South Asian samples. As expected, rs12913832 was significantly associated with quantitative iris color measurements in subjects of European ancestry. However, this SNP was also strongly associated with iris color in the South Asian sample, although there were no participants with blue irides in this sample. The usefulness of this method is not restricted only to the study of iris pigmentation. High‐resolution pictures of the iris will also make it possible to study the genetic variation involved in iris textural patterns, which show substantial heritability in human populations. Am J Phys Anthropol, 2012. © 2011 Wiley Periodicals, Inc.