bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative genome analysis reveals a conserved family of actin-like proteins in apicomplexan parasites
Authors: Gordon Jennifer L , Sibley L David 
Published: December 2005

Abstract

Background
The phylum Apicomplexa is an early-branching eukaryotic lineage that contains a number of important human and animal pathogens. Their complex life cycles and unique cytoskeletal features distinguish them from other model eukaryotes. Apicomplexans rely on actin-based motility for cell invasion, yet the regulation of this system remains largely unknown. Consequently, we focused our efforts on identifying actin-related proteins in the recently completed genomes of Toxoplasma gondii, Plasmodium spp., Cryptosporidium spp., and Theileria spp.

Results
Comparative genomic and phylogenetic studies of apicomplexan genomes reveals that most contain only a single conventional actin and yet they each have 8–10 additional actin-related proteins. Among these are a highly conserved Arp1 protein (likely part of a conserved dynactin complex), and Arp4 and Arp6 homologues (subunits of the chromatin-remodeling machinery). In contrast, apicomplexans lack canonical Arp2 or Arp3 proteins, suggesting they lost the Arp2/3 actin polymerization complex on their evolutionary path towards intracellular parasitism. Seven of these actin-like proteins (ALPs) are novel to apicomplexans. They show no phylogenetic associations to the known Arp groups and likely serve functions specific to this important group of intracellular parasites.

Conclusion
The large diversity of actin-like proteins in apicomplexans suggests that the actin protein family has diverged to fulfill various roles in the unique biology of intracellular parasites. Conserved Arps likely participate in vesicular transport and gene expression, while apicomplexan-specific ALPs may control unique biological traits such as actin-based gliding motility.
Diagnostic and treatment delay among pulmonary tuberculosis patients in Ethiopia: a cross sectional study
Authors: Yimer Solomon , Bjune Gunnar , Alene Getu 
Published: December 2005

Abstract

Background
Delayed diagnosis and treatment of tuberculosis (TB) results in severe disease and a higher mortality. It also leads to an increased period of infectivity in the community. The objective of this study was to determine the length of delays, and analyze the factors affecting the delay from onset of symptoms of pulmonary tuberculosis (PTB) until the commencement of treatment.

Methods
In randomly selected TB management units (TBMUs), i.e. government health institutions which have diagnosing and treatment facilities for TB in Amhara Region, we conducted a cross sectional study from September 1-December 31/2003. Delay was analyzed from two perspectives, 1. Period between onset of TB symptoms to first visit to any health provider (health seeking period), and from the first health provider visit to initiation of treatment (health providers' delay), and 2. Period between onset of TB symptoms to first visit to a medical provider (patients' delay), and from this visit to commencement of anti-TB treatment (health systems' delay). Patients were interviewed on the same date of diagnosis using a semi-structured questionnaire. Logistics regression analysis was applied to analyze the risk factors of delays.

Results
A total of 384 new smear positive PTB patients participated in the study. The median total delay was 80 days. The median health-seeking period and health providers' delays were 15 and 61 days, respectively. Conversely, the median patients' and health systems' delays were 30 and 21 days, respectively. Taking medical providers as a reference point, we found that forty eight percent of the subjects delayed for more than one month. Patients' delays were strongly associated with first visit to non-formal health providers and self treatment (P < 0.0001). Prior attendance to a health post/clinic was associated with increased health systems' delay (p < 0.0001).

Conclusion
Delay in the diagnosis and treatment of PTB is unacceptably high in Amhara region. Health providers' and health systems' delays represent the major portion of the total delay. Accessing a simple and rapid diagnostic test for TB at the lowest level of health care facility and encouraging a dialogue among all health providers are imperative interventions.
High-resolution genotyping of Pseudomonas aeruginosa strains linked to acute post cataract surgery endophthalmitis outbreaks in India
Authors: Kenchappa Prashanth , Sangwan Virender S , Ahmed Niyaz , Rao K Rajender , Pathengay Avinash , Mathai Annie , Mansoori Tarannum , Das Taraprasad , Hasnain Seyed E , Sharma Savitri 
Published: December 2005

Abstract

Background
Investigation of two independent outbreaks of post cataract surgery endophthalmitis identified the reservoir of epidemic strains of P. aeruginosa.

Methods
Patient isolates cultured from vitreous fluid of all the nine cases and from the peripheral devices of phacoemulsification machine were subjected to high-resolution Fluorescent Amplified Fragment Length Polymorphism (FAFLP) analysis.

Results
FAFLP based genotyping of the isolates confirmed nosocomial transmission. Although biochemical characterization and antibiotic susceptibility profiles grouped all the isolates together, FAFLP based genotyping revealed that, all the outbreak isolates were derived from 2 different strains, with independent origins. One group of isolates was traced to phacoprobe and the second one to the internal tubing system of the phacoemulsification machine used in cataract surgery. In silico analysis indicated possible evolution in both the clusters of P. aeruginosa isolates due to genetic polymorphisms. The polymorphisms were mapped to gene products (cell envelope, outer membrane proteins) possibly having significant role in pathogenesis.

Conclusion
The present study is probably the first one to apply FAFLP typing successfully to investigate outbreaks of postoperative endophthalmitis (POE) in an ophthalmic setting, which was able to identify the source, and helped to make rational decisions on sterilization procedures that halted more cases of infection in these hospitals.
Repolarization of the action potential enabled by Na+ channel deactivation in PSpice simulation of cardiac muscle propagation
Authors: Ramasamy Lakshminarayanan , Sperelakis Nicholas 
Published: December 2005

Abstract

Background
In previous studies on propagation of simulated action potentials (APs) in cardiac muscle using PSpice modeling, we reported that a second black-box (BB) could not be inserted into the K+ leg of the basic membrane unit because that caused the PSpice program to become very unstable. Therefore, only the rising phase of the APs could be simulated. This restriction was acceptable since only the mechanism of transmission of excitation from one cell to the next was being investigated.

Methods and results
We have now been able to repolarize the AP by inserting a second BB into the Na+ leg of the basic units. This second BB effectively mimicked deactivation of the Na+ channel conductance. This produced repolarization of the AP, not by activation of K+ conductance, but by deactivation of the Na+ conductance. The propagation of complete APs was studied in a chain (strand) of 10 cardiac muscle cells, in which various numbers of gap-junction (gj) channels (assumed to be 100 pS each) were inserted across the cell junctions. The shunt resistance across the junctions produced by the gj-channels (Rgj) was varied from 100,000 M? (0 gj-channels) to 10,000 M? (1 gj-channel), to 1,000 M? (10 channels), to 100 M? (100 channels), and 10 M? (1000 channels). The velocity of propagation (θ, in cm/s) was calculated from the measured total propagation time (TPT, the time difference between when the AP rising phase of the first cell and the last cell crossed -20 mV, assuming a cell length of 150 μm. When there were no gj-channels, or only a few, the transmission of excitation between cells was produced by the electric field (EF), i.e. the negative junctional cleft potential, that is generated in the narrow junctional clefts (e.g. 100 A) when the prejunctional membrane fires an AP. When there were many gj-channels (e.g. 1000 or 10,000), the transmission of excitation was produced by local-circuit current flow from one cell to the next through the gj-channels.

Conclusion
We have now been able to simulate complete APs in cardiac muscle cells that could propagate along a single chain of 10 cells, even when there were no gj-channels between the cells.
Impact of standalone and embedded telephone triage systems on after hours primary medical care service utilisation and mix in Australia
Authors: Dunt David , Day Susan E , Kelaher Margaret , Montalto Michael 
Published: December 2005

Abstract

Background
The Australian government sponsored five local trials aimed at addressing problems in after hours (AH) primary medical care (PMC). The study's objective was to determine if the four trials, where telephone triage was the sole innovation, led to a reduction in AH service utilisation and change in service mix towards AH GP clinics. Changes in utilisation and mix of AH GP clinic and home visits, ED and ambulance use were monitored in the trial areas, and in a national sample to adjust for the effects of secular trend. Pre- and post-trial telephone surveys of two separate random samples of approximately 350 AH PMC user households in each area were conducted.

Results
Some types of AH PMC use became more frequent in both of the standalone services using nurse-administered proprietary call centre software, which were aimed at better addressing population need (Statewide call centre; Regional call centre). Service use overall (95%CI: 1.03–1.83) and GP clinic use (95%CI: 1.07–2.00) increased in the metro area of the Statewide call centre and in GP clinic (95%CI: 1.04–2.14) and home visits (95%CI: 1.03–3.91) in the non-metro area of the Regional call centre. Service mix only changed in the non-metro area of the Regional call centre with increased contact in GP home visits (95%CI: 1.02–4.38). Levels of use remained unchanged in both embedded services using other than proprietary software, which were established to support the GP workforce (Deputising service; Local triage centre). Service mix only changed in the Deputising service with a change away from AH GP clinics in both contact (95%CI: 0.39–0.97) and frequency (95% CI: -2.12 – -0.7).

Conclusion
Bearing in mind limitations in estimating AH PMC utilisation levels and mix, it is concluded that the impacts of telephone triage were generally smaller in Australia than reported elsewhere. There were different impacts on levels of service utilisation and service mix in standalone call centres and embedded services. Impacts of telephone triage on service utilisation and mix are influenced by the type of telephone triage offered, the goals of the agency providing the service, as well as local factors. (345 words)
A health policy for hearing impairment in older Australians: what should it include?
Authors: Smith Jennifer L , Mitchell Paul , Wang Jie Jin , Leeder Stephen R 
Published: December 2005

Abstract

Background
As in all western countries, Australia's older population experiences high levels of hearing impairment coupled with relatively low levels of hearing device usage. Poor hearing diminishes the quality of life of affected individuals and their families. This paper discusses how to improve Australian hearing health policies in order to better combat this impairment amongst older Australians.

Method
We searched the databases Medline, Meditext and Web of Science to find articles that discussed strategies and innovations to assist the hearing health of older people, and related this material to observations made during the Blue Mountains Hearing Study in NSW between 1997 and 2003.

Results and Discussion
The literature search identified five areas for inclusion in a comprehensive hearing health policy in Australia. These are: early intervention; addressing of hearing aid expense; the use of assisted listening devices; hearing rehabilitation, and; screening and education. Further research in Australia is critical if we are to develop a strong approach to the increasing prevalence of age-related hearing loss.

Conclusion
Australia needs to act now to address hearing impairment as it is a major cause of disability in those aged 55 and over. Federal and State governments should collaborate to construct a comprehensive hearing health policy that tackles poor levels of hearing health through early intervention, addressing hearing aid expense, encouraging the use of assisted listening devices, rehabilitation, screening and education. A good start would be to declare age related hearing impairment as a National Health Priority Area.
New MUC1 Serum Immunoassay Differentiates Pancreatic Cancer From Pancreatitis
Authors: Gold David V. , Modrak David E. , Ying Zhiliang , Cardillo Thomas M. , Sharkey Robert M. , Goldenberg David M. 
Published: December 2005

Purpose To evaluate a new immunoassay for identification and quantitation of MUC1 in the sera of patients with pancreatic cancer or pancreatitis. The sensitivity and specificity of the assay are examined and compared to results from a CA19-9 immunoassay. Methods An in vitro enzyme immunoassay was established with monoclonal antibody PAM4 as the capture reagent, and a polyclonal anti-MUC1 antibody as the probe. Patient sera were obtained from healthy, adult patients with acute and chronic pancreatitis, and those with pancreatic and other forms of cancer, and were measured for PAM4-reactive MUC1. Results At a cutoff of 10.2 units/mL, 41 (77%) of 53 pancreatic cancer patients, none of the healthy individuals (n = 43), and only four (5%) of 87 patients with pancreatitis were positive above this value. Among nonpancreatic cancers investigated, colorectal cancers gave the highest percentage of positives (14%; five of 36). Overall, the sensitivity and specificity of the immunoassay for pancreatic cancer were 77% and 95%, respectively. Receiver operator characteristic analyses for discrimination of pancreatic cancer from pancreatitis provided an area under the curve of 0.89 (95% CI, 0.82 to 0.93), with a specificity of 95.4% and a positive likelihood ratio of 16.8. A direct pair-wise comparison of PAM4 and CA19-9 immunoassays for discrimination of pancreatic cancer and pancreatitis resulted in a significant difference (P < .003), with the PAM4 immunoassay demonstrating superior sensitivity and specificity. Conclusion The high sensitivity and specificity observed suggest that the PAM4-based immunoassay of circulating MUC1 may be useful in the diagnosis of pancreatic cancer.
Treatment for Acute Myelogenous Leukemia by Low-Dose, Total-Body, Irradiation-Based Conditioning and Hematopoietic Cell Transplantation From Related and Unrelated Donors
Authors: Hegenbart Ute , Niederwieser Dietger , Sandmaier Brenda M. , Maris Michael B. , Shizuru Judith A. , Greinix Hildegard , Cordonnier Catherine , Rio Bernard , Gratwohl Alois , Lange Thoralf , Al-Ali Haifa , Storer Barry , Maloney David , McSweeney Peter , Chauncey Thomas , Agura Ed , Bruno Benedetto , Maziarz Richard T. , Petersen Finn , Storb Rainer 
Published: December 2005

Purpose The use of low-dose, irradiation-based preparative regimens have allowed the extension of allografting to older and medically infirm patients. The study reported here assessed outcomes for patients with acute myeloid leukemia (AML) in different stages of their disease, who were not considered candidates for conventional hematopoietic cell transplantation (HCT) because of age and/or other known risk factors and were given minimal conditioning followed by HCT from related or unrelated donors. Patients and Methods The present study included 122 patients with AML, who were conditioned with 2 Gy total-body irradiation (TBI) on day 0 with or without preceding fludarabine (30 mg/m2/d from days −4 to −2), and given postgrafting cyclosporine at 6.25 mg/kg twice daily from day −3 and mycophenolate mofetil at 15 mg/kg twice daily from day 0. Results Durable engraftment was observed in 95% of the patients. Cumulative incidences of acute graft-versus-host disease grades 2 to 4 at 6 months were 35% after related and 42% after unrelated HCT, respectively. With a median follow-up of 44 months (range, 26 to 79 months), 51 patients were alive, of whom 48 were in complete remission (CR). Cumulative nonrelapse mortalities were 10% and 22%, and cumulative mortalities from disease progression were 47% and 33% at 2 years for related and unrelated recipients, respectively. Overall, 2-year survival was 48%, and disease-free survival was 44%. Patients receiving transplantation in CR1 had 2-year overall survivals of 44% after related and 63% after unrelated HCT, respectively. Conclusion We conclude that HCT from related and unrelated donors after low-dose TBI is a promising treatment for elderly patients with AML.
High Complete Remission Rate and Promising Outcome by Combination of Imatinib and Chemotherapy for Newly Diagnosed BCR-ABL–Positive Acute Lymphoblastic Leukemia: A Phase II Study by the Japan Adult Leukemia Study Group
Authors: Yanada Masamitsu , Takeuchi Jin , Sugiura Isamu , Akiyama Hideki , Usui Noriko , Yagasaki Fumiharu , Kobayashi Tohru , Ueda Yasunori , Takeuchi Makoto , Miyawaki Shuichi , Maruta Atsuo , Emi Nobuhiko , Miyazaki Yasushi , Ohtake Shigeki , Jinnai Itsuro , Matsuo Keitaro , Naoe Tomoki , Ohno Ryuzo 
Published: December 2005

Purpose A novel therapeutic approach is urgently needed for BCR-ABL–positive acute lymphoblastic leukemia (ALL). In this study, we assessed the efficacy and feasibility of chemotherapy combined with imatinib. Patients and Methods A phase II study of imatinib-combined chemotherapy was conducted for newly diagnosed BCR-ABL–positive ALL in adults. Eighty patients were entered into the trial between September 2002 and January 2005. Results Remission induction therapy resulted in complete remission (CR) in 77 patients (96.2%), resistant disease in one patient, and early death in two patients, as well as polymerase chain reaction negativity of bone marrow in 71.3%. The profile and incidence of severe toxicity were not different from those associated with our historic chemotherapy-alone regimen. Relapse occurred in 20 patients after median CR duration of 5.2 months. Allogeneic hematopoietic stem-cell transplantation (HSCT) was performed for 49 patients, 39 of whom underwent transplantation during their first CR. The 1-year event-free and overall survival (OS) rates were estimated to be 60.0%, and 76.1%, respectively, which were significantly better than those for our historic controls treated with chemotherapy alone (P < .0001 for both). Among the current trial patients, the probability for OS at 1 year was 73.3% for those who underwent allogeneic HSCT, and 84.8% for those who did not. Conclusion Our results demonstrated that imatinib-combined regimen is effective and feasible for newly diagnosed BCR-ABL–positive ALL. Despite a relatively short period of observation, a major potential of this treatment is recognized. Longer follow-up is required to determine its overall effect on survival.
Pharmacy students' perceptions of their profession relative to other health care professions
Authors: Kritikos Vicky , Sainsbury Erica J , Bosnic-Anticevich Sinthia Z , Watt Helen M G 
Published: December 2005

AbstractObjectives(1) To investigate pharmacy students' perceptions of 10 occupations within the medical and allied professions: community pharmacists, dentists, dietitians, general medical practitioners (GPs), hospital pharmacists, medical specialists, nurses, occupational therapists, physiotherapists and social workers. (2) To explore students' perceptions of community and hospital pharmacists at different stages of a four-year undergraduate programme and at the year of pre-registration training.MethodA 90-item questionnaire was administered to 543 pharmacy undergraduates and 95 graduates undergoing their pre-registration year training in 2001.SettingFaculty of Pharmacy, The University of Sydney, Australia.Key findingsStudents perceived the health care professions along three major dimensions, relating to “empathy”, “potency” and “expertise”. On an empathy dimension, students rated community pharmacists the highest and medical specialists the lowest. On a potency dimension, students rated medical specialists the most powerful, community and hospital pharmacists significantly lower, and nurses the lowest. On an expertise dimension, students rated medical specialists the highest and dietitians the lowest. A significant pattern of differences was noted in students' perceptions and a possible decline was identified in the potency rating of pharmacists at different stages of the pharmacy programme.ConclusionThese differences may be attributed to the differences in the students' value systems, skills and experiences, the influence of reference groups and the content and structure of the educational and training programme in each year.
Schizophrenia care and the Dutch community pharmacy: the unmet needs
Authors: Rijcken C A W , de Jong-van den Berg L T W , van der Veur H , Knegtering H 
Published: December 2005

Abstract

Background
Schizophrenia is a severe psychiatric disease with a prevalence of 0.6% both worldwide and in the Netherlands. Without proper treatment, schizophrenia will be increasingly incapacitating for up to 70% of patients. Management consists of drug treatment and education and can include cognitive therapy. Information about antipsychotic drugs and the importance of treatment compliance are most often given to the patient by the treating psychiatrist.

Method
Structured postal questionnaires to patients and relatives - 250 members of Anoiksis, a Dutch patients' association for people suffering from psychotic illnesses and 250 members of Ypsilon, a Dutch support network for relatives of patients suffering from schizophrenia or psychosis. Face to face, semi-structured interviews with 25 community pharmacists randomly selected from different parts of the Netherlands.

Key findings
Patients and their relatives were unaware of the possible information-giving and support roles of the community pharmacist. More than 60% of patients and relatives agreed that they would have liked to receive more information about drug treatment. Two-thirds of patients and relatives thought that an active reminder to collect refill medication would be a valuable service. However, the community pharmacists were unaware of patients' unmet needs and of the support they could offer to patients with schizophrenia.

Conclusion
Patients and their relatives have needs for medication information and support that are not currently being met. Dutch community pharmacists do not currently perceive that they have a contribution to make to the care of patients with schizophrenia. As the first stage in developing future community pharmacy services, the findings of this study should be disseminated to pharmacists.

Objective
To investigate the role of the Dutch community pharmacist in schizophrenia care.