bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential infection of mononuclear phagocytes by Francisella tularensis: role of the macrophage mannose receptor
Authors: Schulert Grant S , Allen Lee-Ann H 
Published: July 2006

Abstract
Francisella tularensis (Ft) is a Gram-negative bacterium and the causative agent of tularemia. It is well established that this organism replicates inside macrophages, but we are only beginning to understand this interface at the molecular level. Herein, we compared directly the ability of Ft subspecies holarctica live-vaccine strain to infect freshly isolated human peripheral blood monocytes, monocyte-derived macrophages (MDM), and cells of the murine macrophage cell line J774A.1 (J774). We now show that unopsonized bacteria infected human MDM fivefold more efficiently than monocytes or J774 cells in standard media. Moreover, enhanced infection of MDM was mediated, in part, by te macrophage mannose receptor (MR). Forming Ft phagosomes accumulated MR, and infection was inhibited by MR-blocking antibody or soluble mannan but not by the dectin-1 ligand laminarin. Up-regulation of MR in MDM (by exposure to interleukin-4) increased Ft phagocytosis, as did expression of MR in J774 cells. Conversely, opsonized Ft were ingested readily by monocytes and MDM. Medium supplementation with 2.5% fresh autologous serum was sufficient to confer opsonophagocytosis and CD11b accumulated in the membrane at sites of Ft engulfment. Infection of monocytes by opsonized Ft was nearly ablated by complement receptor 3 (CR3) blockade. Conversely, MDM used MR and CD11b/CD18 to ingest opsonized organisms. Altogether, our data demonstrate differential infection of mononuclear phagocytes by Ft and define distinct roles for MR and CR3 in phagocytosis.
Outcomes of an effectiveness trial of cognitive–behavioural intervention by mental health nurses in schizophrenia
Authors: Turkington Douglas , Kingdon David , Rathod Shanaya , Hammond Katie , Pelton Jeremy , Mehta Raj 
Published: July 2006

BackgroundLittle is known about the medium-term durability of cognitive–behavioural therapy (CBT) in a community sample of people with schizophrenia.AimsTo investigate whether brief CBT produces clinically important outcomes in relation to recovery, symptom burden and readmission to hospital in people with schizophrenia at 1-year follow-up.MethodParticipants (336 of 422 randomised at baseline) were followed up at a mean of 388 days (s.d. =53) by raters masked to treatment allocation (CBT or usual care).ResultsAt 1-year follow-up, participants who received CBT had significantly more insight (P=0.021) and significantly fewer negative symptoms (P=0.002). Brief therapy protected against depression with improving insight and against relapse; significantly reduced time spent in hospital for those who did relapse and delayed time to admission. It did not improve psychotic symptoms or occupational recovery, nor have a lasting effect on overall symptoms or depression at follow-up.ConclusionsMental health nurses should be trained in brief CBT for schizophrenia to supplement case management, family interventions and expert therapy for treatment resistance.
Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders
Authors: Kendrick Tony , Simons Lucy , Mynors-Wallis Laurence , Gray Alastair , Lathlean Judith , Pickering Ruth , Harris Scott , Rivero-Arias Oliver , Gerard Karen , Thompson Chris 
Published: July 2006

BackgroundUK general practitioners (GPs) refer patients with common mental disorders to community mental health nurses.AimsTo determine the effectiveness and cost-effectiveness of this practice.MethodRandomised trial with three arms: usual GP care, generic mental health nurse care, and care from nurses trained in problem-solving treatment; 98 GPs in 62 practices referred 247 adult patients with new episodes of anxiety, depression and life difficulties, to 37 nurses.ResultsThere were 212 (86%) and 190 (77%) patients followed up at 8 and 26 weeks respectively. No significant differences between groups were found in effectiveness at either point. Mean differences in Clinical Interview Schedule – Revised scores at 26 weeks compared with GP care were –1.4 (95% Cl –5.5 to 2.8) for generic nurse care, and 1.1 (–2.9 to 5.1) for nurse problem-solving. Satisfaction was significantly higher in both nurse-treated groups. Mean extra costs per patient were £283 (95% Cl 154–411) for generic nurse care, and £315 (183–481) for nurse problem-solving treatment.ConclusionsGPs should not refer unselected patients with common mental disorders to specialist nurses. Problem-solving should be reserved for patients who have not responded to initial GP care.
Premorbid functioning and treatment response in recent-onset schizophrenia
Authors: Rabinowitz Jonathan , Harvey Philip D. , Eerdekens Marielle , Davidson Michael 
Published: July 2006

BackgroundInvestigating the relationship between premorbid functioning and treatment response in schizophrenia is relevant to understanding the illness and predicting treatment outcomes.AimsTo examine the relationship between premorbid characteristics and treatment response of people with recent-onset schizophrenia.MethodData came from a large, double-blind trial of recent-onset psychosis treated with a flexible dose of risperidone or haloperidol. Median treatment length was 206 days. Premorbid functioning was categorised using the Cannon-Spoor Premorbid Adjustment Scale.ResultsThere were significant differences between the premorbid groups on change on the Positive and Negative Syndrome Scale, Clinical Global Impression severity and cognitive functioning and Extrapyramidal Symptoms Rating Scale. Patients in the ‘stable–good’ premorbid group (n=251) improved more than those in the ‘stable–poor’ (n=198) and ‘declining’ (n=81) groups. The ‘stable–good’ group received the lowest doses of antipsychotic and had the least extrapyramidal symptoms. Patients in the declining’ group had the highest dosages and the most extrapyramidal symptoms.ConclusionsIn first-episode psychosis good premorbid functioning is associated with better response to treatment and fewer extrapyramidal symptoms.
Driving, dementia and the Driver and Vehicle Licensing Agency: a survey of old age psychiatrists
Authors: Naidu Anitha , McKeith Ian G. 
Published: June 2006

Aims and MethodWe surveyed old age psychiatrists in the north-east of England to determine what they considered relevant indicators of driving ability. The survey asked about their satisfaction with the current Driver and Vehicle Licensing Agency (DVLA) procedure of assessing competence to drive in patients with dementia and how they thought this could be improved.ResultsFifty-seven out of 76 psychiatrists (75%) responded; 26 (45%) respondents thought the forms issued by the DVLA were unsatisfactory but 32 (57%) were satisfied with the eventual decisions made about individual patients. Factors thought to be relevant indicators of driving ability were occupational therapy (n=46, 81%), neuropsychological assessments (n=43, 75%) and carer's report of driving (n=48, 84%). Factors thought not to be relevant were patient's report of driving ability (n=13, 23%) and the Mini Mental State Examination (n=21, 38%).Clinical ImplicationsThe current system for determining driving ability in people with cognitive impairment and dementia was felt to be unsatisfactory. A multidisciplinary approach and use of on-road driving assessments may improve decision-making.
Formulas Calculating Creatinine Clearance Are Inadequate for Determining Eligibility for Cisplatin-Based Chemotherapy in Bladder Cancer
Authors: Raj Ganesh V. , Iasonos Alexia , Herr Harry , Donat Sherri Machele 
Published: June 2006

Purpose Efficacy of formulas calculating creatinine clearance (CrCl) to determine renal function eligibility (CrCl > 60 mL/min) for cisplatin-based chemotherapy has not been examined adequately in the bladder cancer population. We hypothesize these formulas may underestimate measured CrCl, and therefore the eligibility for cisplatin-based chemotherapy. Patients and Methods A database of 208 patients with unresectable or metastatic bladder cancer treated on protocol at Memorial Sloan-Kettering Cancer Center (New York, NY) with cisplatin-based chemotherapy between 1983 and 1994 was examined retrospectively. The association between measured and calculated CrCl and the ability to complete three cycles (minimum therapeutic) of chemotherapy was examined. Results Baseline measured CrCl was less than 60 mL/min in 16% compared with 12% to 44% using various formulas. Concordance between calculated and measured CrCl less than 60 mL/min was poor (range of κ, 0.14 to 0.38). In patients older than age 65, 22% had a measured CrCl less than 60 mL/min, compared with 10% to 63% calculated using various formulas. Overall, 80% completed at least three cycles of cisplatin-based chemotherapy. The ability to complete at least three cycles was statistically significantly related with a measured CrCl more than 60 mL/min (P = .02), but not with calculated CrCl more than 60 mL/min. Conclusion Current formulas estimating CrCl tend to underestimate measured CrCl, especially in those older than 65 years. Depending on the formula used, up to 44% who actually received cisplatin-based chemotherapy based on measured CrCl would be deemed ineligible at present, potentially affecting survival outcomes. Methodology for determining CrCl and/or renal eligibility for cisplatin-based chemotherapy in patients with bladder cancer should be re-examined.
Renal Cell Carcinoma Recurrence After Nephrectomy for Localized Disease: Predicting Survival From Time of Recurrence
Authors: Eggener Scott E. , Yossepowitch Ofer , Pettus Joseph A. , Snyder Mark E. , Motzer Robert J. , Russo Paul 
Published: June 2006

Purpose Prognostic factors for patients with metastatic renal cell carcinoma (RCC) are well established. However, the risk profile is unknown for patients with recurrent RCC after a nephrectomy for localized disease. Patients and Methods From January 1989 to July 2005, we identified patients with localized RCC treated by nephrectomy who subsequently developed recurrent disease. We applied a validated prognostic scoring system previously developed for patients with metastatic RCC. Each patient was given a total risk score of 0 to 5, with one point for each of five prognostic variables (recurrence < 12 months after nephrectomy, serum calcium > 10 mg/dL, hemoglobin < lower limit of normal, lactate dehydrogenase > 1.5× upper limit of normal, and Karnofsky performance status < 80%). Patients were categorized into low- (score = 0), intermediate- (score = 1 to 2), and high-risk subgroups (score = 3 to 5). Results Our final cohort included 118 patients, with a median survival time of 21 months from the time of recurrence. Median follow-up time for survivors was 27 months. Overall survival was strongly associated with risk group category (P < .0001). Low-risk, intermediate-risk, and high-risk criteria were fulfilled in 34%, 50%, and 16% of patients, respectively. Median survival time for low-risk, intermediate-risk, and high-risk patients was 76, 25, and 6 months, respectively. Two-year overall survival rates for low-risk, intermediate-risk, and high-risk patients were 88% (95% CI, 77% to 99%), 51% (95% CI, 37% to 65%), and 11% (95% CI, 0% to 24%), respectively. Conclusion At disease recurrence after nephrectomy for localized disease, a scoring system based on objective clinical and laboratory data provides meaningful risk stratification for both patient counseling and clinical trial entry.
Neoadjuvant Treatment of Regional Stage IIIB Melanoma With High-Dose Interferon Alfa-2b Induces Objective Tumor Regression in Association With Modulation of Tumor Infiltrating Host Cellular Immune Responses
Authors: Moschos Stergios J. , Edington Howard D. , Land Stephanie R. , Rao Uma N. , Jukic Drazen , Shipe-Spotloe Janice , Kirkwood John M. 
Published: June 2006

Purpose Adjuvant high-dose interferon-alfa-2b (HDI) improves disease-free and overall survival in patients with high-risk melanoma. However, its mechanism of action is largely unknown. Therefore, HDI was investigated in the neoadjuvant setting to assess clinical and pathologic responses after 4 weeks of HDI and to perform immunohistochemical evaluation of immune cell subsets and melanoma-associated antigens. Patients and Methods Patients with palpable regional lymph node metastases from melanoma (American Joint Committee on Cancer stage IIIB-C) underwent surgical biopsy at study entry and then received standard intravenous HDI (20 million units/m2, 5 days per week) for 4 weeks followed by complete lymphadenectomy and standard maintenance subcutaneous HDI (10 million units/m2 3 times per week) for 48 weeks. Biopsy samples were obtained before and after intravenous HDI and subjected to immunohistochemical analysis as well as routine pathologic study. Results Twenty patients were enrolled, and biopsy samples were informative for 17. Eleven patients (55%) demonstrated objective clinical response, and 3 patients (15%) had complete pathologic response. At a median follow-up of 18.5 months (range, 7 months to 50 months) 10 patients had no evidence of recurrent disease. Clinical responders had significantly greater increases in endotumoral CD11c+ and CD3+ cells and significantly greater decreases in endotumoral CD83+ cells compared with nonresponders. No changes in the expression of melanoma-associated lineage antigens, tumor cell proliferation, angiogenesis, or apoptosis were evident. Conclusion Neoadjuvant HDI is highly effective for the treatment of palpable stage IIIB-C melanoma, and the findings of this study implicate an indirect immunomodulatory mechanism rather than a direct antitumor mechanism.
Health-Related Quality of Life Measurement in Randomized Clinical Trials in Surgical Oncology
Authors: Blazeby Jane M. , Avery Kerry , Sprangers Mirjam , Pikhart Hynek , Fayers Peter , Donovan Jenny 
Published: June 2006

Purpose There is debate about the value of measuring health-related quality of life (HRQL) in clinical trials in oncology because of evidence suggesting that HRQL does not influence clinical decisions. Analysis of HRQL in surgical trials, however, may inform decision making because it provides detailed assessment of the immediate detrimental short-term impact of surgery on HRQL that needs to be considered against the long-term survival benefits and functional outcomes of surgery. This study evaluated whether HRQL in randomized trials in surgical oncology contributes to clinical decision making. Methods A systematic review identified randomized trials in surgical oncology with HRQL. Trials were evaluated independently by two reviewers and the value of HRQL in clinical decision making was categorized in three ways: whether trial investigators reported that HRQL influenced final treatment recommendations, whether trial investigators reported that HRQL would be useful for informed consent, and whether HRQL was assessed robustly according to predefined criteria. Results Thirty-three randomized trials with valid HRQL questionnaires were identified; 22 (67%) concluded that HRQL outcomes influenced treatment decisions or provided valuable data for informed consent, and seven of these trials had robust HRQL design. Another five trials had robust HRQL design but investigators reported that HRQL outcomes were not clinically important enough to influence treatment recommendations. Conclusion In surgical trials in oncology, HRQL informed clinical decision making. It is recommended that HRQL be included in relevant surgical trials, and that information be used to inform clinicians and patients about the impact of surgery on short- and long-term HRQL.
A novel secreted endonuclease from Culex quinquefasciatussalivary glands
Authors: Calvo Eric , Ribeiro José M. C. 
Published: June 2006

SUMMARY
Previous analysis of the salivary gland transcriptome of Culex quinquefasciatus showed the potential presence of an endonuclease with sequence similarities to shrimp, crab and two tsetse salivary proteins. Indeed, not only was the cloned cDNA shown to encode an active double-stranded endonuclease, but also the same activity was demonstrated to be secreted by salivary glands of Cx. quinquefasciatus. Preliminary studies with salivary gland extracts confirmed the presence of a highly active nuclease. This enzyme was shown to be present in the saliva of female mosquitoes by allowing starved mosquitoes to probe DNA-containing agarose gel. The recombinant Cx. quinquefasciatus endonuclease (CuquEndo) produced in mammalian cells showed no sequence specificity for DNA substrate except that it only cleaves double-stranded DNA. Recombinant Cx. quinquefasciatusendonuclease was active in the presence of Mg2+ ions at pH 7.0-8.0,but no endonuclease activity was detected in the presence of calcium ions. The final hydrolysis products of this enzyme, detected by ion exchange chromatography, yielded DNA fragments ranging form 8-12 base pairs. Although endonucleases have been associated with a variety of cellular functions, their role in mosquito saliva is not clear. This female-specific secreted endonuclease may assist blood meal intake by lowering the local viscosity created by the release of host DNA in the bite site and/or acting as an indirect anticoagulant factor by producing a defibrotide-like mixture of DNA haptamers.
Effects of moderate and substantial hypoxia on erythropoietin levels in rainbow trout kidney and spleen
Authors: Lai Jimmy C. C. , Kakuta Izuru , Mok Helen O. L. , Rummer Jodie L. , Randall David 
Published: June 2006

SUMMARY
Erythropoietin (EPO) is a glycoprotein hormone that regulates the proliferation and differentiation of erythroid progenitor cells in mammals. Although EPO has been identified in fish, the specific function and effects of hypoxia have not been investigated previously. In this study, we have demonstrated a relationship between increases in renal EPO levels and decreases in spleen EPO levels and spleen-somatic index (SSI), with increases in haemoglobin (Hb) concentration in the blood during hypoxia exposure in rainbow trout. Splenic contraction and the subsequent red blood cell release accounts for the initial increase in Hb concentration in the blood, whereas EPO action probably accounts for the later increases in hemoglobin concentration in the blood. Our data indicate that fish and mammalian erythropoietic systems are similar in response to hypoxia, in that erythropoiesis in fish is influenced by EPO.
Multidimensional analysis of suction feeding performance in fishes: fluid speed, acceleration, strike accuracy and the ingested volume of water
Authors: Higham Timothy E. , Day Steven W. , Wainwright Peter C. 
Published: June 2006

SUMMARYSuction feeding fish draw prey into the mouth using a flow field that they generate external to the head. In this paper we present a multidimensional perspective on suction feeding performance that we illustrate in a comparative analysis of suction feeding ability in two members of Centrarchidae, the largemouth bass (Micropterus salmoides) and bluegill sunfish(Lepomis macrochirus). We present the first direct measurements of maximum fluid speed capacity, and we use this to calculate local fluid acceleration and volumetric flow rate. We also calculated the ingested volume and a novel metric of strike accuracy. In addition, we quantified for each species the effects of gape magnitude, time to peak gape, and swimming speed on features of the ingested volume of water. Digital particle image velocimetry (DPIV) and high-speed video were used to measure the flow in front of the mouths of three fish from each species in conjunction with a vertical laser sheet positioned on the mid-sagittal plane of the fish. From this we quantified the maximum fluid speed (in the earthbound and fish's frame of reference), acceleration and ingested volume. Our method for determining strike accuracy involved quantifying the location of the prey relative to the center of the parcel of ingested water. Bluegill sunfish generated higher fluid speeds in the earthbound frame of reference, accelerated the fluid faster, and were more accurate than largemouth bass. However, largemouth bass ingested a larger volume of water and generated a higher volumetric flow rate than bluegill sunfish. In addition, because largemouth bass swam faster during prey capture, they generated higher fluid speeds in the fish's frame of reference. Thus, while bluegill can exert higher drag forces on stationary prey items, largemouth bass more quickly close the distance between themselves and prey. The ingested volume and volumetric flow rate significantly increased as gape increased for both species, while time to peak gape had little effect on the volume. However, peak gape distance did not affect the maximum fluid speed entering the mouth for either species. We suggest that species that generate high fluid speeds in the earthbound frame of reference will commonly exhibit small mouths and a high capacity to deliver force to buccal expansion,while species that ingest a large volume of water and generate high volumetric flow rates will have larger buccal cavities and cranial expansion linkage systems that favor displacement over force delivery.
On the Performance of a Cascade of Turbine Rotor Tip Section Blading in Wet Steam. Part 5: Theoretical Treatment
Authors: Bakhtar F , Henson R J K , Mashmoushy H 
Published: June 2006

During the course of expansion of steam in turbines, the fluid first supercools and then nucleates to become a two-phase mixture. The formation and behaviour of the liquid create problems that lower the performance of turbine wet stages and the mechanisms underlying these are insufficiently understood. Steam turbines play a dominant role in the generation of the main electrical power supply, and the economic returns on improved performance are substantial. This article is the last of a set and describes the theoretical part of an investigation into the performance of a turbine rotor tip section profile in wet steam. The experimental results are described in the earlier parts of the paper. To describe the behaviour of the flow theoretically, the conservation equations describing the main flow field are combined with equations describing droplet behaviour and the set is treated by the time-marching method. Comparisons are carried out with the experimental results presented in the earlier parts of the paper and the agreement obtained is good. When the droplets present in the steam are 0.15 μm in radius at inlet to the cascade, there is considerable secondary nucleation. With droplets of 0.05 μm radius, secondary nucleation is suppressed, but at high pressure ratios, the thermodynamic loss though reduced is not eliminated.