bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practical difficulties in the management of hepatitis B in the Asia–Pacific region
Authors: MOHAMED ROSMAWATI , DESMOND PAUL , SUH DONG‐JIN , AMARAPURKAR DEEPAK , GANE EDWARD , GUANGBI YAO , HOU JIN‐LIN , JAFRI WASIM , LAI CHING LUNG , LEE CHANG‐HONG , LEE SHOU‐DONG , LIM SENG GEE , GUAN RICHARD , PHIET PHAM HOANG , PIRATVISUTH TEERHA , SOLLANO JOSE , WU JAW‐CHING 
Published: August 2004

AbstractThe Asia–Pacific Expert Committee on Hepatitis B Management recently reviewed the impact of hepatitis B in the region and assessed the differences and similarities observed in the practical management of the disease in individual Asia–Pacific countries. Hepatitis B is a major health concern in the Asia–Pacific region, and of all chronically infected carriers worldwide, approximately 75% are found in Asia. The disease poses a considerable burden on healthcare systems, and is likely to remain a cause of substantial morbidity and mortality for several decades. Disease prevention activities, including screening and vaccination programs, have been implemented successfully in some Asia–Pacific countries and similar measures are being established in other parts of the region. The management of hepatitis B in the Asia–Pacific varies throughout the region, with each country confronting different issues related to treatment options, disease monitoring and duration of therapy. The influence of cost, availability of diagnostic equipment, and patient awareness and compliance are of additional concern. Although guidelines such as those developed by the Asian Pacific Association for the Study of the Liver have been created to address problems encountered in the management of hepatitis B, many physicians in the region still find it difficult to make satisfactory management decisions because of the treatment choices available. This article examines the different approaches to hepatitis B management in a number of Asia–Pacific countries, and highlights the difficulties that can arise when adhering to treatment guidelines and disease prevention solutions that have proved to be successful in the region.
Inquiry into the ideal function of the pharmacy in home care*
Authors: Onda Mitsuko 
Published: August 2004

Background:  The aim of this study is to analyze why home‐care services provided by pharmacists have not been effectively utilized.Method:  Questionnaires were submitted to home‐care service users, physicians, visiting nurses and home‐helpers and pharmacy directors. We studied whether gaps existed between users’ needs, physicians’ expectations of pharmacy services and pharmacists’ awareness of the importance of pharmacy services. We also investigated whether a failure to recognize the importance of cooperation with pharmacists in home‐care provision existed among physicians and nurses/home‐helpers.Results:  Users and physicians expect pharmacists to be more involved in counseling about home care and welfare services than home‐visiting services. Pharmacists recognize home visiting services as being of greater importance than counseling about home care and welfare services. The results indicated that gaps existed between users’ needs, the physicians’ expectations and pharmacists’ awareness of the importance of pharmacy services. In terms of cooperation with pharmacists, study results implied that: (i) nurses/home‐helpers’ awareness of pharmacists’ home‐visiting service is lower than that of physicians; (ii) physicians’ expectations regarding pharmacists’ participation in home care services is lower than that of nurses/home‐helpers; (iii) over 70% of both groups recognize the necessity of pharmacists’ home‐visiting service.Conclusions:  Pharmacists need to get more involved in counseling users about home care and welfare. Also, there should be a special focus on heightening nurses/home‐helpers’ awareness of pharmacists’ home‐visiting service and on raising physicians’ expectations for pharmacists’ participation in home care services to develop home‐care related pharmacy services in Japan.
Abdominal surgery in patients 90 years of age and older at a provincial general hospital
Authors: Ichikawa Hideyuki , Hayashi Shiro 
Published: August 2004

Background:  It has been commonly accepted that age itself is never an absolute contraindication for surgical treatment in the elderly. Some of the many problems with the oldest old could be solved by surgical intervention. However, there are quite a few issues to be resolved for the surgical treatment of patients aged in their nineties. We therefore investigated cases of abdominal operations performed during the past decade, and wish to give our point of view on the indication, significance, merits and demerits of conducting surgical operations in this age‐group of patients.Methods:  We studied perioperative status, postoperative morbidity/mortality, and short‐ and long‐term outcomes of abdominal surgery in patients 90 years of age and older who underwent abdominal surgical operation at a provincial general hospital.Results:  Seven patients had elective operations and six patients underwent emergency operations. The postoperative morbidity was fairly high after both elective and emergency operations. Major complications occurred in one patient who died of multiple organ failure 20 days after the operation. One patient stayed in the hospital and died there 240 days after gastrectomy. Three patients survived more than 4 years after surgery. No definite relationship was revealed between the risk score and postoperative morbidity/mortality. No evident change was recognized in the performance status in patients who received abdominal surgical operations.Conclusion:  The results indicate that more meticulous consideration as well as more precise decision about the indication for surgical intervention, and more intensive perioperative management will be necessary in order to secure more favorable outcomes of therapy and quality of life for high‐risk patients aged in their nineties.
Association of a single nucleotide polymorphism in the secreted frizzled‐related protein 4 (sFRP4) gene with bone mineral density
Authors: Fujita Masayo , Urano Tomohiko , Shiraki Masataka , Momoeda Mikio , Tsutsumi Osamu , Hosoi Takayuki , Orimo Hajime , Ouchi Yasuyoshi , Inoue Satoshi 
Published: August 2004

Background:  Wnt‐β‐catenin signaling pathway is involved in the regulation of bone mineral density (BMD). Secreted frizzled‐related protein (sFRP) 4 that antagonize Wnt signals may modulate Wnt‐β‐catenin signaling pathway in the bone. Therefore, we analyzed expression of sFRP4 mRNA in primary osteoblasts and the association of a single nucleotide polymorphism (SNP) in the sFRP4 gene with BMD.Methods:  Expression levels of sFRP4 mRNA were analyzed during the culture course of rat primary osteoblasts. Association of a SNP in the sFRP4 gene at Arg262 (CGC to CGT) with BMD was examined in 372 healthy post‐menopausal Japanese women.Results:  sFRP4 mRNA was detected and increased during the differentiation of rat primary osteoblasts. As an association study of the SNP in the sFRP4 gene, the subjects without the T allele (CC; n = 129) had significantly higher lumbar BMD than the subjects bearing at least one T allele (TT + CT; n = 243) (Z score; 0.054 versus−0.324; P = 0.0188).Conclusion:  sFRP4 mRNA was expressed and regulated in primary osteoblasts. A genetic variation at the sFRP4 gene locus is associated with BMD, suggesting an involvement of sFRP4 gene in the bone metabolism.
Risk factors for insomnia in community‐dwelling older persons
Authors: Kawamoto Ryuichi , Yoshida Osamu , Oka Yuichiro , Takagi Yaemi 
Published: August 2004

Background:  Aging is associated with changes in both subjective sleep quality and objective sleep patterns. The objectives of this study were to clarify risk factors for sleeping habits and insomnia symptoms in the community‐dwelling older persons.Methods:  Study subjects were 1270 (33.5%), of the 3786 community‐dwelling persons aged 65 and older who responded to questionnaires concerning sleep disorders between July and October 2001.Results:  Out of 556 men (mean age 73 ± 6.6) and 714 women (75 ± 7.5), 416 persons (32.8%) experienced insomnia. Multiple regression analysis on insomnia showed that significantly independent explanatory variables included gender (female: odds ratio [OR], 1.94; 95% confidence interval [CI], 1.39–2.71), activity status (OR, 1.54; 95% CI, 1.04–2.28), prescription medication (OR, 1.66; 95% CI, 1.25–2.20), presence of visual impairment (OR, 1.85; 95% CI, 1.42–2.42), presence of hearing impairment (OR, 1.47; 95% CI, 1.12–1.95) and depressive symptoms (OR, 2.54; 95% CI, 1.93–3.34). Interaction between the activity status and the depressive symptoms (F = 4.231, P = 0.040) was a significant independent explanatory variable with other risk factors.Conclusion:  These results indicate that the aging process per se is not responsible for the increase of insomnia, which is often reported in elderly, but that inactivity, depressive symptoms, and use of prescription medication, visual impairment and hearing impairment were the best predictors of insomnia, the age being insignificant.
International Differences in Student Achievement: An Economic Perspective
Authors: Jürges Hendrik , Schneider Kerstin 
Published: August 2004

AbstractInternational comparisons reveal large cross-country differentials in average student performance. Although there is considerable public debate about these differences, their sources are hardly identified. Using school, teacher and student data from the Third International Mathematics and Science Study (TIMSS), the present paper attempts to explain what causes between-country gaps in mathematics test score distributions. Following a three-pronged strategy of microlevel and cross-country regressions as well as bilateral country comparisons, we show how these gaps are explained by differences in school, teacher and student characteristics, or financial resources devoted to the school system. Institutional characteristics, such as competition between schools and the composition of the faculty can also help to understand international differences in student achievement.
Oral health status and change in handgrip strength over a 5‐year period in 80‐year‐old people
Authors: Hämäläinen Piia , Rantanen Taina , Keskinen Marja , Meurman Jukka H. 
Published: August 2004

Objective: The number of remaining teeth may indicate the extent of life‐long exposure to inflammation, a known risk factor for muscle loss and consequent disability. The aim was to study dental health status as a risk factor for muscle strength loss in very old people.Design: Cross‐sectional and prospective cohort study over a 5‐year follow‐up.Setting: Research laboratory.Participants: One hundred and ninety‐three 80‐year‐old people participated in the baseline examinations. Five years later, 79 survivors were retested.Main outcome measures: Number of remaining teeth, presence of periodontitis and handgrip strength.Results: At baseline, grip strength of men correlated positively with number of teeth but not with the presence of periodontitis. In women, the cross‐sectional associations were not statistically significant. In the prospective analyses, the presence of periodontitis at baseline showed a clear association with a steeper decline in handgrip over the 5‐year follow‐up in both sexes. The values adjusted for gender, height, weight, number of chronic conditions and physical activity were −28.3% (SE 5.7) among those with periodontitis vs. −11.9% (SE 3.1,p = 0.015) among those with healthy gingiva. No association between the number of teeth at baseline and change in grip strength over 5 years was observed.Conclusions: The presence of oral inflammation may lead to loss in muscle strength increasing the risk of disability. Therefore, good dental care throughout the life span may decrease risk of disability in old age.
An Active Type IV Secretion System Encoded by the F Plasmid SensitizesEscherichia colito Bile Salts
Authors: Bidlack James E. , Silverman Philip M. 
Published: August 2004

ABSTRACTF+strains ofEscherichia coliinfected with donor-specific bacteriophage such as M13 are sensitive to bile salts. We show here that this sensitivity has two components. The first derives from secretion of bacteriophage particles through the cell envelope, but the second can be attributed to expression of the F genes required for the formation of conjugative (F) pili. The latter component was manifested as reduced or no growth of an F+strain in liquid medium containing bile salts at concentrations that had little or no effect on the isogenic F−strain or as a reduced plating efficiency of the F+strain on solid media; at 2% bile salts, plating efficiency was reduced 104-fold. Strains with F or F-like R factors were consistently more sensitive to bile salts than isogenic, plasmid-free strains, but the quantitative effect of bile salts depended on both the plasmid and the strain. Sensitivity also depended on the bile salt, with conjugated bile salts (glycocholate and taurocholate) being less active than unconjugated bile salts (deoxycholate and cholate). F+cells were also more sensitive to sodium dodecyl sulfate than otherwise isogenic F−cells, suggesting a selectivity for amphipathic anions. A mutation in any but one Ftragene required for the assembly of F pili, including thetraAgene encoding F pilin, substantially restored bile salt resistance, suggesting that bile salt sensitivity requires an active system for F pilin secretion. The exception wastraW. AtraWmutant was 100-fold more sensitive to cholate than thetra+strain but only marginally more sensitive to taurocholate or glycocholate. Bile salt sensitivity could not be attributed to a generalized change in the surface permeability of F+cells, as judged by the effects of hydrophilic and hydrophobic antibiotics and by leakage of periplasmic β-lactamase into the medium.
Genetic Manipulation of Carotenoid Biosynthesis in the Green Sulfur Bacterium
Chlorobium tepidum
Authors: Frigaard Niels-Ulrik , Maresca Julia A. , Yunker Colleen E. , Jones A. Daniel , Bryant Donald A. 
Published: August 2004

ABSTRACT

The green sulfur bacterium
Chlorobium tepidum
is a strict anaerobe and an obligate photoautotroph. On the basis of sequence similarity with known enzymes or sequence motifs, nine open reading frames encoding putative enzymes of carotenoid biosynthesis were identified in the genome sequence of
C. tepidum
, and all nine genes were inactivated. Analysis of the carotenoid composition in the resulting mutants allowed the genes encoding the following six enzymes to be identified: phytoene synthase (
crtB
/
CT1386
), phytoene desaturase (
crtP
/
CT0807
), ζ-carotene desaturase (
crtQ
/
CT1414
), γ-carotene desaturase (
crtU
/
CT0323
), carotenoid 1′,2′-hydratase (
crtC
/
CT0301
), and carotenoid
cis
-
trans
isomerase (
crtH
/
CT0649
). Three mutants (
CT0180
,
CT1357
, and
CT1416
mutants) did not exhibit a discernible phenotype. The carotenoid biosynthetic pathway in
C. tepidum
is similar to that in cyanobacteria and plants by converting phytoene into lycopene using two plant-like desaturases (CrtP and CrtQ) and a plant-like
cis
-
trans
isomerase (CrtH) and thus differs from the pathway known in all other bacteria. In contrast to the situation in cyanobacteria and plants, the construction of a
crtB
mutant completely lacking carotenoids demonstrates that carotenoids are not essential for photosynthetic growth of green sulfur bacteria. However, the bacteriochlorophyll
a
contents of mutants lacking colored carotenoids (
crtB
,
crtP
, and
crtQ
mutants) were decreased from that of the wild type, and these mutants exhibited a significant growth rate defect under all light intensities tested. Therefore, colored carotenoids may have both structural and photoprotection roles in green sulfur bacteria. The ability to manipulate the carotenoid composition so dramatically in
C. tepidum
offers excellent possibilities for studying the roles of carotenoids in the light-harvesting chlorosome antenna and iron-sulfur-type (photosystem I-like) reaction center. The phylogeny of carotenogenic enzymes in green sulfur bacteria and green filamentous bacteria is also discussed.
The CcpA Protein Is Necessary for Efficient Sporulation and Enterotoxin Gene (cpe) Regulation inClostridium perfringens
Authors: Varga John , Stirewalt Veronica L. , Melville Stephen B. 
Published: August 2004

ABSTRACTClostridium perfringensis the cause of several human diseases, including gas gangrene (clostridial myonecrosis), enteritis necroticans, antibiotic-associated diarrhea, and acute food poisoning. The symptoms of antibiotic-associated diarrhea and acute food poisoning are due to sporulation-dependent production ofC. perfringensenterotoxin encoded by thecpegene. Glucose is a catabolite repressor of sporulation byC. perfringens. In order to identify the mechanism of catabolite repression by glucose, a mutation was introduced into theccpAgene ofC. perfringensby conjugational transfer of a nonreplicating plasmid intoC. perfringens, which led to inactivation of theccpAgene by homologous recombination. CcpA is a transcriptional regulator known to mediate catabolite repression in a number of low-G+C-content gram-positive bacteria, of whichC. perfringensis a member. TheccpAmutant strain sporulated at a 60-fold lower efficiency than the wild-type strain in the absence of glucose. In the presence of 5 mM glucose, sporulation was repressed about 2,000-fold in the wild-type strain and 800-fold in theccpAmutant strain compared to sporulation levels for the same strains grown in the absence of glucose. Therefore, while CcpA is necessary for efficient sporulation inC. perfringens, glucose-mediated catabolite repression of sporulation is not due to the activity of CcpA. Transcription of thecpegene was measured in the wild-type andccpAmutant strains grown in sporulation medium by using acpe-gusAfusion (gusAis anEscherichia coligene encoding the enzyme β-glucuronidase). In the exponential growth phase,cpetranscription was two times higher in theccpAmutant strain than in the wild-type strain. Transcription ofcpewas highly induced during the entry into stationary phase in wild-type cells but was not induced in theccpAmutant strain. Glucose repressedcpetranscription in both the wild-type andccpAmutant strain. Therefore, CcpA appears to act as a repressor ofcpetranscription in exponential growth but is required for efficient sporulation andcpetranscription upon entry into stationary phase. CcpA was also required for maximum synthesis of collagenase (kappa toxin) and acted as a repressor of polysaccharide capsule synthesis in the presence of glucose, but it did not regulate synthesis of the phospholipase PLC (alpha toxin).
Differences in Enzymatic Properties Allow SodCI but Not SodCII To Contribute to Virulence in
Salmonella enterica
Serovar Typhimurium Strain 14028
Authors: Krishnakumar Radha , Craig Maureen , Imlay James A. , Slauch James M. 
Published: August 2004

ABSTRACT

Salmonella enterica
serovar Typhimurium produces two Cu/Zn cofactored periplasmic superoxide dismutases, SodCI and SodCII. While mutations in
sodCI
attenuate virulence eightfold, loss of SodCII does not confer a virulence phenotype, nor does it enhance the defect observed in a
sodCI
background. Despite this in vivo phenotype, SodCI and SodCII are expressed at similar levels in vitro during the stationary phase of growth. By exchanging the open reading frames of
sodCI
and
sodCII
, we found that SodCI contributes to virulence when placed under the control of the
sodCII
promoter. In contrast, SodCII does not contribute to virulence even when expressed from the
sodCI
promoter. Thus, the disparity in virulence phenotypes is due primarily to some physical difference between the two enzymes. In an attempt to identify the unique property of SodCI, we have tested factors that might affect enzyme activity inside a phagosome. We found no significant difference between SodCI and SodCII in their resistance to acid, resistance to hydrogen peroxide, or ability to obtain copper in a copper-limiting environment. Both enzymes are synthesized as apoenzymes in the absence of copper and can be fully remetallated when copper is added. The one striking difference that we noted is that, whereas SodCII is released normally by an osmotic shock, SodCI is “tethered” within the periplasm by an apparently noncovalent interaction. We propose that this novel property of SodCI is crucial to its ability to contribute to virulence in serovar Typhimurium.
Comparative Genetic Diversity of
Pseudomonas stutzeri
Genomovars, Clonal Structure, and Phylogeny of the Species
Authors: Cladera Aina Maria , Bennasar Antonio , Barceló Maria , Lalucat Jorge , García-Valdés Elena 
Published: August 2004

ABSTRACT

A combined phylogenetic and multilocus DNA sequence analysis of 26
Pseudomonas stutzeri
strains distributed within the 9 genomovars of the species has been performed. Type strains of the two most closely related species (
P. balearica
, former genomovar 6, and
P. mendocina
), together with
P. aeruginosa
, as the type species of the genus, have been included in the study. The extremely high genetic diversity and the clonal structure of the species were confirmed by the sequence analysis. Clustering of strains in the consensus phylogeny inferred from the analysis of seven nucleotide sequences (16S ribosomal DNA, internally transcribed spacer region 1,
gyrB
,
rpoD
,
nosZ
,
catA
, and
nahH
) confirmed the monophyletic origin of the genomovars within the
Pseudomonas
branch and is in good agreement with earlier DNA-DNA similarity analysis, indicating that the selected genes are representative of the whole genome in members of the species.
TheEscherichia coliGTPase CgtAECofractionates with the 50S Ribosomal Subunit and Interacts with SpoT, a ppGpp Synthetase/Hydrolase
Authors: Wout P. , Pu K. , Sullivan S. M. , Reese V. , Zhou S. , Lin B. , Maddock J. R. 
Published: August 2004

ABSTRACTCgtAE/ObgE/YhbZ is anEscherichia coliguanine nucleotide binding protein of the Obg/GTP1 subfamily whose members have been implicated in a number of cellular functions including GTP-GDP sensing, sporulation initiation, and translation. Here we describe a kinetic analysis of CgtAEwith guanine nucleotides and show that its properties are similar to those of theCaulobacter crescentushomolog CgtAC. CgtAEbinds both GTP and GDP with moderate affinity, shows high guanine nucleotide exchange rate constants for both nucleotides, and has a relatively low GTP hydrolysis rate. We show that CgtAEis associated predominantly with the 50S ribosomal subunit. Interestingly, CgtAEcopurifies with SpoT, a ribosome-associated ppGpp hydrolase/synthetase involved in the stress response. The interaction between CgtAEand SpoT was confirmed by reciprocal coprecipitation experiments and by two-hybrid assays. These studies raise the possibility that the ribosome-associated CgtAEis involved in the SpoT-mediated stress response.
Control of Virulence by the Two-Component System CiaR/H Is Mediated via HtrA, a Major Virulence Factor ofStreptococcus pneumoniae
Authors: Ibrahim Yasser Musa , Kerr Alison R. , McCluskey Jackie , Mitchell Tim J. 
Published: August 2004

ABSTRACTThe CiaR/H two-component system is involved in regulating virulence and competence inStreptococcus pneumoniae. The system is known to regulate many genes, including that for high-temperature requirement A (HtrA). This gene has been implicated in the ability of the pneumococcus to colonize the nasopharynx of infant rats. We reported previously that deletion of the gene for HtrA made the pneumococcal strains much less virulent in mouse models, less able to grow at higher temperatures, and more sensitive to oxidative stress. In this report, we show that the growth phenotype as well as sensitivity to oxidative stress of ΔciaRmutant was very similar to that of a ΔhtrAmutant and that the expression of the HtrA protein was reduced in aciaR-null mutant. Both the in vitro phenotype and the reduced virulence of ΔciaRmutant could be restored by increasing the expression of HtrA.