bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nighttime Insomnia Treatment and Education for Alzheimer's Disease: A Randomized, Controlled Trial
Authors: McCurry Susan M. , Gibbons Laura E. , Logsdon Rebecca G. , Vitiello Michael V. , Teri Linda 
Published: May 2005

Objectives: To evaluate whether a comprehensive sleep education program (Nighttime Insomnia Treatment and Education for Alzheimer's Disease (NITE‐AD)) could improve sleep in dementia patients living at home with their family caregivers.Design: A randomized, controlled trial.Participants: Thirty‐six community‐dwelling patients with Alzheimer's disease (AD) and their family caregivers.Intervention: All participants received written materials describing age‐ and dementia‐related changes in sleep and standard principles of good sleep hygiene. Caregivers in active treatment (n=17) received specific recommendations about setting up and implementing a sleep hygiene program for the dementia patient and training in behavior management skills. Patients in active treatment were also instructed to walk daily and increase daytime light exposure with the use of a light box. Control subjects (n=19) received general dementia education and caregiver support.Measurements: Primary sleep outcomes were derived for patients and caregivers from 1 week of sleep‐wake activity measured at baseline, posttest (2 months), and 6‐month follow‐up using an Actillume wrist‐movement recorder. Secondary patient outcomes included the Epworth Sleepiness Scale, the Cornell Depression Scale, and the Revised Memory and Behavior Problem Checklist. Caregiver self‐reports included the Pittsburgh Sleep Quality Index and the Center for Epidemiological Study of Depression Scale.Results: Patients participating in NITE‐AD showed significantly greater (P<.05) posttest reductions in number of nighttime awakenings, total time awake at night, and depression, and increases in weekly exercise days than control subjects. At 6‐month follow‐up, treatment gains were maintained, and additional significant improvements in duration of night awakenings emerged. When cognitive level was controlled, NITE‐AD patients had lower longitudinal ratings of daytime sleepiness than controls. There was a trend for control subjects to spend more time in bed at 6 months than NITE‐AD patients.Conclusion: This study provides the first evidence that patients with AD who are experiencing sleep problems can benefit from behavioral techniques (specifically, sleep hygiene education, daily walking, and increased light exposure) that are known to improve sleep in nondemented, institutionalized older adults.
Pneumonia Versus Aspiration Pneumonitis in Nursing Home Residents: Prospective Application of a Clinical Algorithm
Authors: Mylotte Joseph M. , Goodnough Susan , Gould Margaret 
Published: May 2005

Objectives: To prospectively evaluate a clinical algorithm for the diagnosis of pneumonitis and pneumonia in nursing home residents.Design: Prospective cohort study.Setting: Inpatient geriatrics unit.Participants: Nursing home residents admitted to the hospital with suspected pneumonia.Measurements: Identification of pneumonitis and pneumonia using the algorithm; medical record review and abstraction of clinical data; hospital outcome and length of stay.Results: One hundred seventy episodes of suspected pneumonia were screened with the algorithm and classified into four groups: 25% pneumonia, 28% aspiration pneumonitis of 24 hours or less duration, 12% aspiration pneumonitis of more than 24 hours' duration, and 35% an aspiration event without pneumonitis. Presenting symptoms and signs, laboratory tests, severity of illness measures, or serum C‐reactive protein levels did not distinguish between the four groups. Those with an aspiration event without pneumonitis tended to be treated less often with antibiotic therapy after admission (P=.004) and after discharge (P=.01). Of those who survived, there was no significant difference in mean hospital length of stay between the four groups. There was no significant difference in the percentage of case fatality between the four groups, but those with aspiration pneumonitis of 24 hours or less duration and with an aspiration event without pneumonitis had a lower mortality than the other two groups.Conclusion: Distribution of episodes of suspected pneumonia by clinical category as determined using the algorithm was similar to that of the derivation study, as were case fatality rates in each category. These findings suggest that the algorithm may be useful for making the distinction between pneumonitis and pneumonia in nursing home residents; further studies are warranted.
Capsaicin Troche for Swallowing Dysfunction in Older People
Authors: Ebihara Takae , Takahashi Hidenori , Ebihara Satoru , Okazaki Tatsuma , Sasaki Takahiko , Watando Aya , Nemoto Miyako , Sasaki Hidetada 
Published: May 2005

Objectives: To determine whether oral capsaicin troche supplementation with every meal upregulates the impairment of upper respiratory protective reflexes such as the swallowing reflex and the cough reflex.Design: Randomized, controlled study with recruitment through nursing homes.Setting: Sendai, Japan, from September 2002 through December 2003.Participants: Sixty‐four participants in nursing homes with a mean age±standard deviation of 81.9±1.0 with stable physical status.Intervention: Participants were randomly assigned to the program for the supplementation of capsaicin trochisci or placebo trochisci before every meal for 4 weeks.Measurements: Assessment of individual latency time of the swallowing reflex (LTSR) and cough reflex sensitivity.Results: Before the commencement of this study, there were no significant baseline differences in multiple parameters between the intervention group and control group. LTSR in participants in the intervention group was significantly shorter than in the control group (P<.05). The odds ratio (OR) of the shortening of the LTSR of more than 1 minute in the intervention group was 3.4 (95% confidence interval (CI)=1.1−10.4), compared with the control group (P=.03). In particular, daily capsaicin supplementation significantly increased the ratio of LTSR reduction at 4 weeks after the study to baseline LTSR in the high‐risk group (baseline LTSR >6.0 seconds) compared with the low‐risk group (baseline LTSR <3.0 seconds) and the intermediate group (3.0 seconds <baseline LTSR <6.0 seconds) (P<.005). Seventeen (52.1%) participants in the intervention group and seven (21.9%) in the control group showed improvement in cough reflex sensitivity (OR=4.1, 95% CI=1.4−12.2; P<.01).Conclusion: Daily capsaicin supplementation resulted in a significant improvement in upper protective respiratory reflexes, particularly in older people with a high risk for aspiration.
Clinician Assessment of the Driving Competence of Patients with Dementia
Authors: Ott Brian R. , Anthony David , Papandonatos George D. , D'Abreu Anelyssa , Burock Jeffrey , Curtin Alicia , Wu Chuang‐Kuo , Morris John C. 
Published: May 2005

Objectives: To determine the validity and reliability of clinician ratings of the driving competence of patients with mild dementia.Design: Observational study of a cross‐section of drivers with mild dementia based on chart review by clinicians with varying types of expertise and experience.Setting: Outpatient dementia clinic.Participants: Fifty dementia subjects from a longitudinal study of driving and dementia.Measurements: Each clinician reviewed information from the clinic charts and the first study visit. The clinician then rated the drivers as safe, marginal, or unsafe. A professional driving instructor compared these ratings with total driving scores on a standardized road test and categorical ratings of driving competence. Clinicians also completed a visual analog scale assessment of variables that led to their determinations of driving competence.Results: Accuracy of clinician ratings ranged from 62% to 78% for the instructor's global rating of safe versus marginal or unsafe. In general, there was moderate accuracy and interrater reliability. Accuracy could have been improved in the least‐accurate raters by greater attention to dementia duration and severity ratings, as well as less reliance on the history and physical examination. The most accurate predictors were clinicians specially trained in dementia assessment, who were not necessarily the most experienced in their years of clinical experience.Conclusion: Although a clinician may be able to identify many potentially hazardous drivers, accuracy is insufficient to suggest that a clinician's assessment alone is adequate to determine driving competence in those with mild dementia.
Comparison of Commercial Real-Time PCR Assays for Quantification of Epstein-Barr Virus DNA
Authors: Ruiz Guillermo , Peña Pilar , de Ory Fernando , Echevarría Juan Emilio 
Published: May 2005

ABSTRACT

Clinical research suggests a role for viral load measurement in predicting and monitoring Epstein-Barr virus (EBV)-associated diseases. The aim of this study was to assess the performance of the recently commercially available quantitative assays for EBV based on real-time PCR: the RealArt EBV LC PCR kit and the LightCycler EBV quantification kit. A total of 87 samples were analyzed: 67 samples were obtained from transplant recipients and patients with EBV-associated diseases, 8 samples were obtained from the Quality Control for Molecular Diagnostics 2002 EBV Proficiency Program, and 12 negative qualitative nested PCR samples were used as negative controls. Inter- and intra-assay variabilities were determined by running replicates of two samples. All samples were run in a LightCycler instrument. The differences between positive and negative results were not considered statistically significant (
P
= 0.5355). There were no false-positive results using either method for nested PCR negative-control samples. The difference in viral load values using the two different methods was considered statistically significant (
P
< 0.01). The logarithmic linear correlation for both assays was low (
r
= 0.449) but significant (
P
< 0.01). The LightCycler EBV quantification kit showed a wider dispersal in results but produced substantially more-accurate melting temperature profile curves. The bias towards lower measurements was considerable in comparison with higher viral load. The differences in PCR efficiency and the presence of mutations could explain the disparity between the two methods. It was concluded that confidence intervals would be required to report the results rather than plain absolute values of viral load for patient monitoring.
Evaluation of Conventional and Real-Time PCR Assays Using Two Targets for Confirmation of Results of the COBAS AMPLICOR
Chlamydia trachomatis
/
Neisseria gonorrhoeae
Test for Detection of
Neisseria gonorrhoeae
in Clinical Samples
Authors: Boel C. H. E. , van Herk C. M. C. , Berretty P. J. M. , Onland G. H. W. , van den Brule A. J. C. 
Published: May 2005

ABSTRACT

Two conventional PCR-enzyme immunoassays (PCR-EIAs) and two real-time PCR assays (LightCycler system; Roche Diagnostics) were evaluated as confirmation assays with
cppB
and 16S rRNA genes as targets. Of 765 male and female genitourinary and nasopharyngeal specimens positive for
Neisseria gonorrhoeae
in the COBAS AMPLICOR
Chlamydia trachomatis
/
Neisseria gonorrhoeae
PCR test (Roche Diagnostics), 229 (30%) were confirmed positive; 13 of these (5.7%) were lacking the
cppB
gene. Of the 534 samples (70%) that could not be confirmed, 81 (15%) showed a positive crossing point. However, melting curve analysis revealed an aberrant melting temperature in the LightCycler 16S rRNA assay; therefore, these samples were considered non-
N. gonorrhoeae Neisseria
species. Both of the 16S rRNA assays performed well, with positive predictive values of 99.1% and 100% for the PCR-EIAs and the real-time assays, respectively, and a negative predictive value of 99.8% for both. The
cppB
assays were compromised by the absence of the
cppB
gene in 5.7% of the
N. gonorrhoeae
-positive samples, resulting in negative predictive values of 96.8% and 97.6% for the PCR-EIAs and the real-time assays, respectively. Therefore, the 16S rRNA gene is preferable to the
cppB
gene as a target for confirmation assays. The melting curve analysis of the real-time assays provides useful additional information.
Five-Year Follow-Up Study of Mother-to-Child Transmission ofHelicobacter pyloriInfection Detected by a Random Amplified Polymorphic DNA Fingerprinting Method
Authors: Konno Mutsuko , Fujii Nobuhiro , Yokota Shin-ichi , Sato Kiyoshi , Takahashi Michiko , Sato Kohei , Mino Emi , Sugiyama Toshiro 
Published: May 2005

ABSTRACTRecent studies have speculated on the possible role of the mother in transmittingHelicobacter pyloriinfection to their children. In an attempt to either prove or disprove this supposition, we investigated the rates of infection of children born toH. pylori-positive mothers from birth to 5 years of age using serology and the stool antigen test. When infection of the children did occur, the strains from the children were compared to those of their mothers using DNA analysis. Sixty-nine of the 350 pregnant mothers (19.7%) had a positive serology forH. pylori. Fifty-one children underwent serological examinations and stool antigen tests at 4 to 6 days after birth, followed by 1, 3, and 6 months. They were continuously given the stool antigen test at 4- to 6-month intervals until the age of 5 years. Gastric juice samples were collected from the infected children and their mothers for culture and DNA analyses using a random amplified polymorphic DNA fingerprinting method. None of the 51 children acquiredH. pyloriinfection during the first year of life. Of the 44 children enrolled in a 5-year follow-up study, five (11%) acquiredH. pyloriinfection. They acquired the infection at the age of 1 year 2 months, 1 year 3 months, 1 year 6 months, 1 year 8 months, and 4 years 4 months. Random amplified polymorphic DNA fingerprinting confirmed that the strains of the five children exhibited DNA fingerprinting patterns identical to those of their mothers. These findings suggest that mother-to-child transmission is the most probable cause of intrafamilial spread ofH. pylori.
Role and Significance of Quantitative Urine Cultures in Diagnosis of Melioidosis
Authors: Limmathurotsakul Direk , Wuthiekanun Vanaporn , Chierakul Wirongrong , Cheng Allen C. , Maharjan Bina , Chaowagul Wipada , White Nicholas J. , Day Nicholas P. J. , Peacock Sharon J. 
Published: May 2005

ABSTRACT

Melioidosis is associated with significant mortality in countries in which it is endemic. Previous studies have demonstrated that quantitative
Burkholderia pseudomallei
counts in blood are predictive of mortality. Here we examine the relationship between outcomes and quantitative
B. pseudomallei
counts in urine. A total of 755 patients presenting to Sappasithiprasong Hospital, Ubon Ratchathani, northeast Thailand (in the northeast part of the country), with melioidosis between July 1993 and October 2003 had quantitative urine cultures performed within 72 h of admission. Urine culture results were divided into the following groups: (i) no growth of
B. pseudomallei
from a neat sample or pellet, (ii) positive result from a centrifuged pellet only (<10
3
CFU/ml), (iii) detection of between 10
3
CFU/ml and 10
5
CFU/ml from a neat sample, or (iv) detection of ≥10
5
CFU/ml from a neat sample. The overall in-hospital mortality rate was 45%. Patients with negative urine cultures had the lowest death rate (39%). Mortality rates rose with increasing
B. pseudomallei
counts in urine, from 58% for those with positive spun pellets only to 61% for those with between 10
3
CFU/ml and 10
5
CFU/ml and 71% for those with ≥10
5
CFU/ml. This was independent of age, presence of bacteremia, known risk factors for melioidosis such as diabetes, and the prior administration of antibiotics. The presence of
B. pseudomallei
in urine during systemic infection is associated with a poor prognosis.
Rapid and Sensitive Detection of Severe Acute Respiratory Syndrome Coronavirus by Rolling Circle Amplification
Authors: Wang Bin , Potter Simon J. , Lin Yiguang , Cunningham Anthony L. , Dwyer Dominic E. , Su Yuelong , Ma Xuejun , Hou Yunde , Saksena Nitin K. 
Published: May 2005

ABSTRACT

The severe acute respiratory syndrome (SARS) epidemic of 2003 was responsible for 774 deaths and caused significant economic damage worldwide. Since July 2003, a number of SARS cases have occurred in China, raising the possibility of future epidemics. We describe here a rapid, sensitive, and highly efficient assay for the detection of SARS coronavirus (SARS-CoV) in cultured material and a small number (
n
= 7) of clinical samples. Using rolling circle amplification (RCA), we were able to achieve sensitive detection levels of SARS-CoV RNA in both solid and liquid phases. The main advantage of RCA is that it can be performed under isothermal conditions with minimal reagents and avoids the generation of false-positive results, a problem that is frequently encountered in PCR-based assays. Furthermore, the RCA technology provides a faster, more sensitive, and economical option to currently available PCR-based methods.
Detection and Characterization of New Influenza B Virus Variants in 2002
Authors: Chi X. Sherry , Hu Aizhong , Bolar Trentice V. , Al-Rimawi Wafa , Zhao Ping , Tam John S. , Rappaport Ruth , Cheng Sheau-Mei 
Published: May 2005

ABSTRACT
One-hundred five influenza B-positive specimens obtained from southeast Asia in 2002 were categorized on the basis of DNA sequencing of HA1 gene as well as real-time PCR analysis of the NA gene. Phylogenetic analysis of the HA1 gene sequences showed that the majority of the viruses (96.2%) belonged to the B/Victoria/2/87 lineage, while a smaller percentage of the viruses (3.8%) belonged to the B/Yamagata/16/88 lineage. The B/Yamagata/16/88 viruses displayed significant antigenic drift in the deduced amino acid sequences of the HA1 protein, and the B/Victoria/2/87-like viruses consisted of B/Hong Kong/1351/02-like (72.3%) and B/Hong Kong/330/01-like (27.7%) viruses. The B/Hong Kong/1351/02-like viruses were reassortants with the HA gene belonging to the B/Victoria/2/87 lineage and the NA gene belonging to the B/Yamagata/16/88 lineage, whereas both the HA and NA genes of B/Hong Kong/330/01 virus belonged to the B/Victoria/2/87 lineage. In this study, however, all the B/Hong Kong/330/01-like isolates exhibited the B/Yamagata/16/88-like NA gene, which likely resulted from reassortment of B/Hong Kong/330/01 and B/Hong Kong/1351/02 viruses during coinfection. Additional molecular characterization of the six internal genes showed that the M, NS, PA, and PB2 genes of the new variants were B/Hong Kong/1351/02 in origin, whereas the NP and PA genes retained the B/Hong Kong/330/01 origin. Interestingly, these new variants all appeared late in the year 2002. These results support the notion that influenza B viruses continued to evolve through antigenic drift and shift.
Comparison of a Real-Time Reverse Transcriptase PCR Assay and a Culture Technique for Quantitative Assessment of Viral Load in Children Naturally Infected with Respiratory Syncytial Virus
Authors: Perkins Stephanie M. , Webb David L. , Torrance Shauna A. , El Saleeby Chadi , Harrison Lisa M. , Aitken Jody A. , Patel Anami , DeVincenzo John P. 
Published: May 2005

ABSTRACT

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory infection of children. Understanding RSV pathogenesis and evaluating interventions requires quantitative RSV testing. Previous studies have used the plaque assay technique. Real-time reverse transcriptase PCR (RTrtPCR) offers possible greater sensitivity, stability after freeze/thaw, and lower cost, thus facilitating multicenter studies. We developed RTrtPCR assays based upon the RSV N and F genes. The N-gene assay detected greater RSV quantity and was further evaluated. Standard curves utilized both extractions from RSV culture supernatants of known quantity and cloned purified copies of the target DNA. In vitro, the ratio of RSV subgroup A (RSV-A) genome copies to PFU was 153:1. A total of 462 samples collected quantitatively from 259 children were analyzed in duplicate by RTrtPCR. Results were compared with those of RSV plaque assays performed on fresh aliquots from the same children. Duplicate RTrtPCR results were highly correlated (
r
2
= 0.9964). The mean viral load from nasal washes obtained on the first study day was 5.75 ± standard error of the mean 0.09 log PFU equivalents (PFUe)/ml. Viral load by RTrtPCR correlated with plaque assay results (
r

2

= 0.158;
P
< 0.0001). Within individuals, upper and lower respiratory tract secretions contained similar viral concentrations. RSV-A-infected children had 1.17 log PFUe higher viral loads than did those with RSV-B (
P
< 0.0001). RSV quantification by RTrtPCR of the N gene is precise and has significant, though limited, correlation with quantitative culture. The utility of the RTrtPCR quantification technique for clinical studies would be solidified after its correlation with RSV disease severity is established.
Preclinical and Clinical Performance of the Efoora Test, a Rapid Test for Detection of Human Immunodeficiency Virus-Specific Antibodies
Authors: Arens Max Q. , Mundy Linda M. , Amsterdam Daniel , Barrett J. Tom , Bigg Dan , Bruckner David , Hanna Bruce , Prince Harry , Purington Timothy , Hanna Todd , Hewitt Ross , Kalinka Carolyn , Koppes Thomas , Maxwell Sarz , Moe Ardis , Doymaz Mehmet , Poulter Melinda , Saber-Tehrani Maryam , Simard Lorenzo , Wilkins-Carmody Donna , Vidaver John , Berger Cheryl , Davis Alan H. , Alzona Mortimer T. 
Published: May 2005

ABSTRACT

Barriers to effective diagnostic testing for human immunodeficiency virus type 1 (HIV-1) infection can be reduced with simple, reliable, and rapid detection methods. Our objective was to determine the accuracy, sensitivity, and specificity of a new rapid, lateral-flow immunochromatographic HIV-1 antibody detection device. Preclinical studies were performed using seroconversion, cross-reaction, and interference panels, archived clinical specimens, and fresh whole blood. In a multicenter, prospective clinical trial, a four-sample matrix of capillary (fingerstick) whole-blood specimens and venous whole blood, plasma, and serum was tested for HIV-1 antibodies with the Efoora HIV rapid test (Efoora Inc., Buffalo Grove, IL) and compared with an enzyme immunoassay (EIA) (Abbott Laboratories) licensed by the Food and Drug Administration. Western blot and nucleic acid test supplemental assays were employed to adjudicate discordant samples. Preclinical testing of seroconversion panels showed that antibodies were often detected earlier by the rapid test than by a reference EIA. No significant interference or cross-reactions were observed. Testing of 4,984 archived specimens yielded a sensitivity of 99.2% and a specificity of 99.7%. A prospective multicenter clinical study with 2,954 adult volunteers demonstrated sensitivity and specificity for the Efoora HIV rapid test of 99.8% (95% confidence interval [CI], 99.3 and 99.98%) and 99.0% (95% CI, 98.5 and 99.4%), respectively. Reactive rapid HIV-1 antibody detection was confirmed in 99.6% of those with a known HIV infection (
n
= 939), 5.2% of those in the high-risk group (
n
= 1,003), and 0.1% of those in the low-risk group (
n
= 1,012). For 21 (0.71%) patients, there was discordance between the results of the rapid test and the confirmatory EIA/Western blot tests. We conclude that the Efoora HIV rapid test is a simple, rapid assay for detection of HIV-1 antibodies, with high sensitivity and specificity compared to a standardized HIV-1 EIA.