bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cellulose Binding Domains of a Phytophthora Cell Wall Protein Are Novel Pathogen-Associated Molecular Patterns
Authors: Gaulin Elodie , Dramé Nani , Lafitte Claude , Torto-Alalibo Trudy , Martinez Yves , Ameline-Torregrosa Carine , Khatib Moustafa , Mazarguil Honoré , Villalba-Mateos François , Kamoun Sophien , Mazars Christian , Dumas Bernard , Bottin Arnaud , Esquerré-Tugayé Marie-Thérèse , Rickauer Martina 
Published: June 2006

Abstract
The cellulose binding elicitor lectin (CBEL) from Phytophthora parasitica nicotianae contains two cellulose binding domains (CBDs) belonging to the Carbohydrate Binding Module1 family, which is found almost exclusively in fungi. The mechanism by which CBEL is perceived by the host plant remains unknown. The role of CBDs in eliciting activity was investigated using modified versions of the protein produced in Escherichia coli or synthesized in planta through the potato virus X expression system. Recombinant CBEL produced by E. coli elicited necrotic lesions and defense gene expression when injected into tobacco (Nicotiana tabacum) leaves. CBEL production in planta induced necrosis. Site-directed mutagenesis on aromatic amino acid residues located within the CBDs as well as leaf infiltration assays using mutated and truncated recombinant proteins confirmed the importance of intact CBDs to induce defense responses. Tobacco and Arabidopsis thaliana leaf infiltration assays using synthetic peptides showed that the CBDs of CBEL are essential and sufficient to stimulate defense responses. Moreover, CBEL elicits a transient variation of cytosolic calcium levels in tobacco cells but not in protoplasts. These results define CBDs as a novel class of molecular patterns in oomycetes that are targeted by the innate immune system of plants and might act through interaction with the cell wall.
A Comprehensive Structure–Function Analysis ofArabidopsisSNI1 Defines Essential Regions and Transcriptional Repressor Activity
Authors: Mosher Rebecca A. , Durrant Wendy E. , Wang Dong , Song Junqi , Dong Xinnian 
Published: June 2006

AbstractThe expression of systemic acquired resistance (SAR) in plants involves the upregulation of many Pathogenesis-Related (PR) genes, which work in concert to confer resistance to a broad spectrum of pathogens. Because SAR is a costly process, SAR-associated transcription must be tightly regulated. Arabidopsis thaliana SNI1 (for Suppressor of NPR1, Inducible) is a negative regulator of SAR required to dampen the basal expression of PR genes. Whole genome transcriptional profiling showed that in the sni1 mutant, Nonexpresser of PR genes (NPR1)–dependent benzothiadiazole S-methylester–responsive genes were specifically derepressed. Interestingly, SNI1 also repressed transcription when expressed in yeast, suggesting that it functions as an active transcriptional repressor through a highly conserved mechanism. Chromatin immunoprecipitation indicated that histone modification may be involved in SNI1-mediated repression. Sequence comparison with orthologs in other plant species and a saturating NAAIRS-scanning mutagenesis of SNI1 identified regions in SNI1 that are required for its activity. The structural similarity of SNI1 to Armadillo repeat proteins implies that SNI1 may form a scaffold for interaction with proteins that modulate transcription.
Quality of life comparison between corticosteroidand-mycofenolate mofetil and corticosteroidand-oral cyclophosphamide in the treatment of severe lupus nephritis
Authors: Tse K C , Tang C SO , Lio W I , Lam M F , Chan T M 
Published: June 2006

There is accumulating evidence that mycophenolate mofetil (MMF), when combined with corticosteroid, is an effective induction treatment for severe proliferative lupus nephritis and is associated with fewer adverse effects compared to cyclophosphamide (CTX), but the quality of life (QOL) associated with these regimens as perceived by the patient has not been compared. This study included patients who had experienced both treatment regimens, for distinct episodes of diffuse proliferative lupus nephritis. QOL parameters during the first six months of each treatment were assessed through SF36 and WHOQOL questionnaires. Twelve patients and 24 episodes of severe lupus nephritis were studied. CTX-treated and MMF-treated episodes showed comparable baseline characteristics and response rate, with complete remission occurring in 83.3%. MMF treatment was associated with higher numerical scores for all domains across both QOL instruments than CTX. MMF treatment was associated with significantly less fatigue, less impediment of physical and social functioning, and better psychological well being compared to CTX. When each patient served as her/his own control, most patients ascribed higher QOL domain scores to the MMF-treated episode. Seventy-five percent of patients found MMF treatment more acceptable and preferred when compared with CTX, and the complications that most concerned them included Cushingoid features, alopecia, menstrual disturbance and infections. These data showed that MMF-based induction immunosuppression for severe lupus nephritis was associated with better QOL than CTX as perceived by patients, which was most likely attributed to the reduced side-effects during MMF treatment.
Ro52, Ro60 and La IgG autoantibody levels and Ro52 IgG subclass profiles longitudinally throughout pregnancy in congenital heart block risk pregnancies
Authors: Strandberg L , Salomonsson S , Bremme K , Sonesson S-E , Wahren-Herlenius M 
Published: June 2006

Congenital heart block occurs in fetuses of Ro/SSA and La/SSB positive women. To investigate the stability of maternal autoantibody levels during pregnancy, we followed Ro52, Ro60 and La autoantibody IgG level variation and Ro52 subclass profiles longitudinally in selected congenital heart block risk pregnancies. Serum samples were obtained from 12 Ro/La positive women diagnosed with a systemic rheumatic disease and followed on average 60 months (range two to 84) which included 13 pregnancies. Seven children were affected by neonatal lupus, whereof four developed complete congenital heart block. Serum was also collected from the babies at birth. Ro52, Ro60 and La IgG as well as subclass antibodies were analysed by ELISA using recombinant antigens. Six Ro/La negative rheumatic patients were included as controls for antibody levels during pregnancy. Ro52, Ro60 and La IgG levels decreased progressively from early to late pregnancy, significantly for Ro52 and Ro60 ( P < 0.01). No peaks or persistent elevation of antibody levels were noted in any of the CHB risk pregnancies. Ro52 IgG1 antibody levels were significantly higher than IgG2 ( P < 0.01), IgG3 ( P < 0.01) and IgG4 ( P < 0.05) levels in the mothers during pregnancy. Ro52 IgG1 and IgG4 levels decreased significantly from early to late pregnancy ( P = 0.02), while levels of IgG2 and IgG3 were low and the decrease was not significant. All IgG subclasses were transferred to the children. We conclude that maternal levels of Ro52, Ro60 and La autoantibodies tended rather to decrease than to increase during pregnancy.
Blood Cultures Do Not Change Management in Hospitalized Patients with Community‐acquired Pneumonia
Authors: Ramanujam Prasanthi , Rathlev Niels K. 
Published: June 2006

Objectives:
To determine if blood cultures identify organisms that are not appropriately treated with initial empiric antibiotics in hospitalized patients with community‐acquired pneumonia, and to calculate the costs of blood cultures and cost savings realized by changing to narrower‐spectrum antibiotics based on the results.
Methods:
This was a retrospective observational study conducted in an urban academic emergency department (ED). Patients with an ED and final diagnosis of community‐acquired pneumonia admitted between January 1, 2001, and August 30, 2003, were eligible when the results of at least one set of blood cultures obtained in the ED were available. Exclusion criteria included documented human immunodeficiency virus infection, immunosuppressive illness, chronic renal failure, chronic corticosteroid therapy, documented hospitalization within seven days before ED visit, transfer from another hospital, nursing home residency, and suspected aspiration pneumonia. The cost of blood cultures in all patients was calculated. The cost of the antibiotic regimens administered was compared with narrower‐spectrum and less expensive alternatives based on the results.
Results:
A total of 480 patients were eligible, and 191 were excluded. Thirteen (4.5%) of the 289 enrolled patients had true bacteremia; the organisms isolated were sensitive to the empiric antibiotics initially administered in all 13 cases (100%; 95% confidence interval = 75% to 100%). Streptococcus pneumoniae and Haemophilus influenzae were isolated in 11 and two patients, respectively. The potential savings of changing the antibiotic regimens to narrower‐spectrum alternatives was only 170.
Conclusions:
Appropriate empiric antibiotics were administered in all bacteremic patients. Antibiotic regimens were rarely changed based on blood culture results, and the potential savings from changes were minimal.
Met5‐enkephalin‐Arg6‐Phe7 (MEAP): A Cardioprotective Hormonal Opioid
Authors: Dickson Eric W. , Ludwig Paula S. , Ackermann Laynez W. , Buresh Christopher T. , Denning Gerene M. 
Published: June 2006

Background:
Acute myocardial ischemia is an important cause of morbidity and mortality worldwide. The heart and other organs can be rendered more resistant to the deleterious effects of ischemia through a variety of preconditioning strategies, including treadmill exercise and brief ischemia of skeletal muscle. Some of the beneficial effects of these preconditioning strategies appear to be mediated by as‐of‐yet unidentified hormonal opioids.
Objectives:
To test the hypothesis that endogenous opioids of the enkephalin class are capable of improving ischemic tolerance and acting in a hormonal manner.
Methods:
In phase one of the investigation, the authors assessed the cardioprotective potential of all four known enkephalins. This was achieved by subjecting isolated buffer‐perfused rabbit hearts to a 25‐minute period of test ischemia and two hours of reperfusion (protocol 1) after receiving treatment with either saline vehicle (controls) or increasing concentrations of purified enkephalins. On the basis of results from these initial studies, the authors performed additional experiments (protocol 2) to determine whether Met5‐enkephalin‐Arg6‐Phe7 (MEAP) could be absorbed from skeletal muscle and exert a cardioprotective effect. Specifically, MEAP or vehicle (controls) was given intramuscularly 24 hours before the hearts were harvested. A similar assessment of ischemic tolerance as described in protocol 1 was then performed. Postischemic myocardial viability (infarct size) was assessed in all cases by triphenyltetrazolium chloride (TTC) staining. Hemodynamic parameters and infarct sizes for concentration‐dependence studies were compared by two‐way analysis of variance, and infarct sizes from protocol 2 studies were compared by using Student's t‐test (significance set at p ≤ 0.05).
Results:
Mean infarct size in control hearts (± SEM) was 33% (± 4%) and 36% (± 6%) for protocol 1 and 2, respectively. Of the four enkephalins tested in protocol 1, only MEAP treatment showed a tendency toward cardioprotection. Interestingly, an alternative enkephalin, methionine5‐enkephalin‐Arg6‐Gly7‐Leu8, tended to exert an injurious effect. In protocol 2, MEAP treatment 24 hours before ischemia significantly reduced infarct size (14%± 4%) compared with controls, suggesting that it can be released from muscle and exert a distant cardioprotective effect.
Conclusions:
When given either directly to the heart or absorbed from a distant tissue, MEAP induces cardioprotection, supporting the hypothesis that it can act as a hormonal modulator of ischemic tolerance.
A Trial of Therapeutic Hypothermia via Endovascular Approach in Awake Patients with Acute Ischemic Stroke: Methodology
Authors: Guluma Kama Z. , Hemmen Thomas M. , Olsen Scott E. , Rapp Karen S. , Lyden Patrick D. 
Published: June 2006

Background:
Therapeutic hypothermia has been shown to be of benefit in improving neurological outcome in cardiac arrest. It now is being investigated in acute stroke and myocardial infarction. The majority of the literature describes its use in intubated, pharmacologically paralyzed patients, using surface cooling techniques that are susceptible to patient shivering, imprecise temperature control, time lag to target‐temperature acquisition, and rebound hyperthermia.
Objectives:
To develop a method of inducing therapeutic hypothermia in a rapid, precise, and tolerable fashion in awake, nonintubated patients.
Methods:
This method was developed for an ongoing clinical trial investigating a combination of therapeutic hypothermia and intravenous thrombolysis for acute ischemic stroke. In the protocol, an endovascular cooling device is placed in the inferior vena cava of a patient, and a combination of buspirone, meperidine, and cutaneous warming with a heating blanket is used to suppress shivering as the patient is cooled to a target temperature of 33°C, kept there for a total of 24 hours from hypothermia initiation, and then rewarmed in a controlled fashion during the next 12 hours.
Results:
Ten patients underwent the therapeutic hypothermia protocol. The median pretreatment core temperature was 36.1°C (interquartile range [IQR]: 35.8°C–36.4°C). On initiation of cooling, the core temperatures dropped rapidly and then leveled off, approaching a median plateau value of 33.4°C (IQR: 33.2°C–33.9°C) in a mean time of 1.7 (± 0.7) hours from cooling initiation, with a median average postplateau temperature during the cooling phase of 33.8°C (IQR: 33.3°C–34.6°C), and a median lowest temperature of 33.1°C (IQR: 33.0°C–33.3°C). The procedure was well tolerated, with minimal shivering and no rebound hyperthermia.
Conclusions:
This is a method by which a rapid and precise therapeutic decrease in core temperature can be achieved without the necessity for intubation or neuromuscular blockade and with minimal patient discomfort or shivering.
The Association between Emergency Department Crowding and Hospital Performance on Antibiotic Timing for Pneumonia and Percutaneous Intervention for Myocardial Infarction
Authors: Pines Jesse M. , Hollander Judd E. , Localio A. Russell , Metlay Joshua P. 
Published: June 2006

Background:
Antibiotics within four hours of arrival for patients with pneumonia and percutaneous intervention (PCI) within two hours for patients with acute myocardial infarction (AMI) are standard measures of emergency department (ED) quality.
Objectives:
To assess the institutional‐level association between measures of ED crowding and process measures for pneumonia and AMI.
Methods:
The authors used summary data from 24 academic hospitals in the University Health Consortium. Analysis included the 2004 ED cycle time survey and performance data from January to December 2004 regarding the Joint Commission for Accreditation of Healthcare Organizations' PN‐5b (initial antibiotic administration within four hours) for pneumonia and AMI‐8a (PCI received within 120 minutes). Spearman correlation coefficients were used to determine associations between crowding and performance measures.
Results:
Across all institutions, 59% (range 43%–77%) of pneumonia patients received antibiotics within four hours, and 57% (range 22%–95%) of AMI patients received PCI within two hours. An increase in overall ED length of stay (−0.44, p = 0.04) and for admitted patients (−0.37, p = 0.08) was associated with a decrease in the proportion of pneumonia patients receiving antibiotics within four hours. An increase in chest x‐ray turnaround time (−0.83, p < 0.001) and an increase in the left‐without‐being‐seen rate (−0.51, p = 0.01) were also associated with a decrease in the proportion of pneumonia patients receiving antibiotics within four hours. No measures of crowding exhibited an association with time to PCI for AMI patients.
Conclusions:
Administrative measures of ED crowding showed an association with poorer performance on pneumonia quality of care measures but not with AMI quality of care measures. Hospitals might consider improving ED throughput, reducing boarding times for admitted patients, and reducing chest x‐ray turnaround times to improve pneumonia care.
Cervical screening in 20–24-year olds
Authors: Rieck GC , Tristram A , Hauke A , Fielder H , Fiander AN 
Published: June 2006

Background: In 2003 the NHS Cervical Screening Programme in England changed the age at which women are first invited for cervical screening from 20 to 25 years. The aim of this review was to assess the evidence for benefit and harm of undertaking cervical screening in Wales for women aged 20–24 years. Method: A literature review looking for evidence of the effectiveness and potential harmful effects of cervical screening was undertaken. Welsh data for the number of cases of high-grade cervical intraepithelial neoplasia (CIN3) were examined and rates of invasive cervical cancer (1981–2003) for young women calculated. The medical notes of women less than 25 years old diagnosed with cervical cancer were reviewed and a cost analysis was performed. Results: The literature review failed to identify any randomized controlled studies of the effectiveness of cervical screening in young women, but demonstrated that organized screening programmes result in a decrease in the incidence of cervical carcinoma. Following the introduction of the Welsh organized call/recall cervical screening programme in 1988, cervical cancer has been reduced by 58% in women aged 20–24 years and 45% in women aged 25–29 years (mean age-specific rate per 100,000 women aged 20–24 years: 4.2 in 1981–88 compared with 2.2 in 1989–2003). If these changes can be attributed to the screening of women aged 20–24, then the costs of at least £82,500 are estimated to prevent one cervical cancer in this age group. Conclusions: The incidence of cervical cancer in young women has halved since the introduction of the Welsh-organized call–recall cervical screening programme. In Wales we recommend that women continue to be invited for cervical screening from 20 years of age. This will provide the information required to compare the incidence and stage at diagnosis of cervical cancer in young women invited for first time cervical screening at different ages across the UK.
Prognostic importance of palpability as a feature of screen-detected breast cancers
Authors: Gill Grantley , Luke Colin , Roder David 
Published: June 2006

Objectives: To determine epidemiological characteristics of palpability as a feature of asymptomatic invasive breast cancers detected through screening mammography, and to determine whether palpability is predictive of case survival after adjusting for conventional prognostic indicators such as diameter, grade and nodal status. Setting: The University of Adelaide, South Australian Department of Health, and The Cancer Council South Australia, Adelaide, South Australia. Methods: Sociodemographic and clinical characteristics of 2108 screen-detected invasive breast cancers were compared by tumour palpability using univariate and multiple logistic regression analysis. Survival outcomes from breast cancer were compared using Kaplan–Meier product-limit estimates. Multivariable proportional hazard regression was employed to assess the association of palpability with survival after adjusting for conventional prognostic indicators. Results: Palpability was associated with year of diagnosis, ductal histology type, and unfavourable prognostic indicators such as larger tumour diameter, higher grade and nodal involvement. After adjusting for these variables, no associations were found with age at diagnosis, place of residence or socioeconomic status, or with presence of multifocal disease or presence of an extensive in situ component. Palpability was predictive of death from breast cancer in an unadjusted analysis, the relative risk (95% confidence limits) being 1.75 (1.12, 2.74). After adjusting for nodal involvement and larger tumour size, the relative risk no longer was elevated, reducing to 0.99 (0.60, 1.64). Discussion: Palpability is associated with unfavourable prognostic indicators, such as larger diameter, higher grade and nodal involvement, and is not an independent indicator of survival outcome for screen-detected female-breast cancers after accounting for nodal involvement and diameter.
Towards comprehensive population-based screening for diabetic retinopathy: operation of the North Wales diabetic retinopathy screening programme using a central patient register and various screening methods
Authors: Harvey JN , Craney L , Nagendran S , Ng CS 
Published: June 2006

Objectives: To examine whether population-based retinopathy screening using a central diabetes register and employing various screening methods can achieve a high degree of population coverage to meet National Screening Committee (NSC) targets. To identify the main barriers to achieving comprehensive population coverage. To analyse referrals to ophthalmology and their outcome as a measure of previously unmet need. To assess the influence of modality of screening. Setting: Three local health board areas in North Wales. Methods: Establishment of a district diabetes register to hold records of all patients and subserve call–recall of general practitioner (GP) sole-care patients for screening by optometrists or digital photography. Hospital attenders were screened in diabetic clinic by direct ophthalmoscopy. Data were collected for years 1 and 2 of operation of the scheme. Results: The system held a screening record for 86% of diabetic patients after year 1 and 93% after year 2. Failure to attend was the major barrier to comprehensive population screening, but this improved in year 2 ( P<0.001). Both optometrists and photography identified substantial unmet need: 1% of all GP sole-care patients required immediate laser treatment. Photography was more sensitive than optometrist screening, but the additional retinopathy identified was mostly minor not requiring treatment. Conclusions: Lack of screening is much more important than modality of screening as a cause of missed sight-threatening retinopathy. A central, district-based patient register system identifies those patients not screened for further follow-up and can produce a high level of population coverage, close to NSC targets. Such schemes are needed, particularly to support primary care diabetes management.