bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparing Patients and Caregivers to Participate in Care Delivered Across Settings: The Care Transitions Intervention
Authors: Coleman Eric A. , Smith Jodi D. , Frank Janet C. , Min Sung‐Joon , Parry Carla , Kramer Andrew M. 
Published: October 2004

Objectives: To test whether an intervention designed to encourage older patients and their caregivers to assert a more active role during care transitions can reduce rehospitalization rates.Design: Quasi‐experimental design whereby subjects receiving the intervention (n=158) were compared with control subjects derived from administrative data (n=1,235).Setting: A large integrated delivery system in Colorado.Participants: Community‐dwelling adults aged 65 and older admitted to the study hospital with one of nine selected conditions.Intervention: Intervention subjects received tools to promote cross‐site communication, encouragement to take a more active role in their care and assert their preferences, and continuity across settings and guidance from a transition coach.Measurements: Rates of postdischarge hospital use at 30, 60, and 90 days. Intervention subjects' care experience was assessed using the care transitions measure.Results: The adjusted odds ratio comparing rehospitalization of intervention subjects with that of controls was 0.52 (95% confidence interval (CI)=0.28–0.96) at 30 days, 0.43 (95% CI=0.25–0.72) at 90 days, and 0.57 (95% CI=0.36–0.92) at 180 days. Intervention patients reported high levels of confidence in obtaining essential information for managing their condition, communicating with members of the healthcare team, and understanding their medication regimen.Conclusion: Supporting patients and caregivers to take a more active role during care transitions appears promising for reducing rates of subsequent hospitalization. Further testing may include more diverse populations and patients at risk for transitions who are not acutely ill.
Biomechanical Properties of Shoes and Risk of Falls in Older Adults
Authors: Tencer Allan F. , Koepsell Thomas D. , Wolf Marsha E. , Frankenfeld Cara L. , Buchner David M. , Kukull Walter A. , LaCroix Andrea Z. , Larson Eric B. , Tautvydas Milda 
Published: October 2004

Objectives: To determine the relationships between the biomechanical properties of shoes worn in a cohort of healthy older adults and the risk of falling.Design: Nested case‐control study, comparing biomechanical measurements of shoes worn by those who reported a fall with measurements of shoes worn by age‐ and sex‐matched nonfallers engaged in broadly similar activities.Setting:On‐site measurements where falls occurred.Participants:A cohort of 1,371 older adults, of whom 327 reported a fall and 327 served as age‐ and sex‐matched controls.Measurements: Shoe measurements related to lateral stability (heel height and width, critical tipping angle), foot position sense (heel‐collar height, sole thickness, and sole flexibility), and the shoe/surface interface (foresole material, shoe‐to‐ground coefficient of friction, sole contact area).Results: Greater heel height was associated with increased risk of a fall (P for trend=.03), whereas greater sole contact area was associated with reduced risk (P for trend=.005). Shoe characteristics related to foot position sense bore little apparent relation to fall risk. Coefficients of friction of 0.5 or greater were observed in 93% of shoes measured, indicating that very few were excessively slippery.Conclusion: Certain measurable properties of shoes were found to be significantly related to risk of falls in older adults. Wearing shoes with low heels and large contact area may help older adults reduce the risk of a fall in everyday settings and activities.
Translating Research into Clinical Practice: Making Change Happen
Authors: Bradley Elizabeth H. , Schlesinger Mark , Webster Tashonna R. , Baker Dorothy , Inouye Sharon K. 
Published: October 2004

Objectives:To describe the process of adoption of an evidence‐based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges.Design: Qualitative study design based on in‐depth, open‐ended telephone interviews.Setting: Nine hospitals implementing HELP throughout the United States.Participants: Thirty‐two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation.Measurements: Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation.Results: Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital‐specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described.Conclusion: Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations.
Safety and Immunogenicity of Haemophilus Influenzae Type B Polysaccharide or Conjugate Vaccines in an Elderly Adult Population
Authors: Lottenbach Kathleen R. , Granoff Dan M. , Barenkamp Stephen J. , Powers Douglas C. , Kennedy Donald , Irby‐Moore Sharon , Homan Sharon M. , Mink ChrisAnna M. 
Published: October 2004

Objectives: To evaluate the safety and immunogenicity of unconjugated Haemophilus influenzae type b (Hib) polysaccharide (PRP) vaccine and two PRP‐protein‐conjugated vaccines as a model for the comparison of protein‐conjugated versus plain polysaccharide vaccines in the elderly.Design: Randomized, double‐blind, prospective study.Setting: University‐based center for vaccine research and development.Participants: A total of 125 adults, aged 64 to 92, who were judged to be in general good health and lacking any significant underlying medical conditions.Intervention: Subjects were randomized to receive one of three vaccines: Group 1 (n=39), PRP; Group 2 (n=44), PRP conjugated to an outer‐membrane protein complex of Neisseria meningitidis (PRP‐OMP); and Group 3 (n=42), PRP conjugated to diphtheria toxoid (PRP‐D). Sera were obtained before immunization and 1 and 12 months later.Measurements: Subjects maintained a diary of injection site and systemic reactions for 3 days after immunization. A radioantigen‐binding assay was used to measure total concentrations of serum anticapsular antibody, and an enzyme‐linked immunosorbent assay was used to measure immunoglobulin (Ig) G1 and IgG2 anticapsular antibody responses. Antibody functional activity was assessed using a complement‐mediated bactericidal assay.Results: Before vaccination, the geometric mean serum anticapsular antibody concentration was 0.8 μg/mL, but fewer than 10% of subjects had detectable bactericidal activity (titer>1:4). The magnitude, subclass distribution, and bactericidal activity of antibody responses to unconjugated PRP vaccine were similar to those observed in previous studies of younger adults immunized with PRP. The OMP conjugate, which is highly immunogenic after one dose in 2‐month old infants, did not elicit anticapsular antibody responses in the elderly greater than those elicited by PRP vaccine (P=.43). In contrast, the D conjugate, which is poorly immunogenic in 2‐month old infants, elicited higher anticapsular antibody responses than PRP vaccine in the elderly (P=.01) and higher levels than the OMP‐conjugate 1 year after vaccination (P<.006).Conclusion: Elderly adults develop protective anticapsular antibody responses to unconjugated and conjugated PRP vaccine. The higher anticapsular antibody responses to the D conjugate but not to the OMP conjugate in the elderly, which is the reverse of that observed in immunized infants, implies fundamental differences in the immunological mechanisms by which the two age groups respond to PRP and by which the OMP and D conjugates elicit anticapsular antibody responses.
Bathing Disability in Community‐Living Older Persons: Common, Consequential, and Complex
Authors: Naik Aanand D. , Concato John , Gill Thomas M. 
Published: October 2004

Objectives: To identify the specific bathing subtasks that are affected in community‐living‐older persons with bathing disability and to determine the self‐reported reasons for bathing disability.Design: Cross‐sectional study.Setting: General community of greater New Haven, Connecticut.Participants: A total of 626 community‐living persons, aged 73 and older, who completed a comprehensive assessment, including a detailed evaluation of bathing disability.Measurements: Trained research nurses assessed bathing disability (defined as requiring personal assistance or having difficulty washing and drying the whole body), the specific bathing subtasks that were affected, and the main reasons (up to three) for bathing disability.Results: Disability in bathing was present in 195 (31%) participants; of these, 97 required personal assistance (i.e., dependence), and 98 had difficulty bathing. Participants with bathing disability reported a mean±standard deviation of 4.0±2.4 affected subtasks. The prevalence rate of disability for the eight prespecified bathing subtasks ranged from 25% for taking off clothes to 75% for leaving the bathing position. The majority of participants (59%) provided more than one reason for bathing disability. The most common reasons cited by participants for their bathing disability were balance problems (28%), arthritic complaints (26%), and fall or fear of falling (23%).Conclusion: For community‐living older persons, disability in bathing is common, involves multiple subtasks, and is attributable to an array of physical and psychological problems. Preventive and restorative interventions for bathing disability will need to account for the inherent complexity of this essential activity of daily living.
Does Self‐Rated Health Predict Survival in Older Persons with Cognitive Impairment?
Authors: Walker Jennifer D. , Maxwell Colleen J. , Hogan David B. , Ebly Erika M. 
Published: October 2004

Objectives: To determine whether baseline self‐rated health (SRH) independently predicted survival in an older Canadian population and to investigate the role of cognition on the SRH‐mortality relationship.Design: Population‐based prospective cohort study.Setting: Ten Canadian provinces, community‐based.Participants: A total of 8,697 community‐dwelling participants aged 65 and older.Measurements: Self‐reported measures of overall health, physical function, comorbidities, and demographic characteristics were obtained by interview. Cognitive ability was ascertained using the Modified Mini‐Mental State Examination (3MS). Participants were followed for their survival status from the initial interview in 1991 until October 31, 1996.Results: Subjects with reports of poor SRH were significantly more likely to die during follow‐up than those reporting good SRH, after adjusting for relevant covariates (adjusted hazard ratio (AHR)=1.38, 95% confidence interval (CI)=1.24–1.53). SRH was also related to other measures of health status across levels of cognitive impairment. SRH remained a significant predictor of mortality in subjects with mild to moderate cognitive impairment (AHR=1.26, 95% CI=1.01–1.59) but not in those with severe cognitive impairment (AHR=1.00, 95% CI=0.76–1.31).Conclusion: This study supports the utility of SRH assessments in predicting survival of individuals with mild to moderate cognitive impairment. The findings highlight the potential role of complex cognitive processes underlying the SRH‐mortality relationship.
Association Between Visual Attention and Mobility in Older Adults
Authors: Owsley Cynthia , McGwin Gerald 
Published: October 2004

Objectives: To examine the association between visual attention/processing speed and mobility in older adults.Design: Cross‐sectional.Setting: Clinical research unit of a department of ophthalmology.Participants: Three hundred forty‐two older adults (aged 55–85) living independently in the community recruited from primary eye care practices.Measurements: In addition to demographic, health, and functional information, the following variables were collected at the second annual visit of a prospective study on mobility: a test of visual attention/processing speed; a performance mobility assessment; and self‐reported measures of falls, falls efficacy, mobility/balance, and physical activity.Results: Lower scores on visual attention/processing speed were significantly related to poorer scores on the performance mobility assessment, even after adjustment for age, sex, race, education, number of chronic medical conditions, cognitive status, depressive symptoms, visual acuity, and contrast sensitivity (P=.04). Scores on the visual attention/processing speed test were unrelated to the self‐reported measures of mobility.Conclusion: Results imply that visual attention impairment/slowed visual processing speed in older adults is independently associated with mobility problems. Interventions to reverse or minimize the progression of mobility dysfunction in older adults should take this common aging‐related deficit in visual processing into account.
Unprovoked and Glyceryl Trinitrate–Provoked Head‐Up Tilt Table Test Is Safe in Older People: A Review of 10 Years' Experience
Authors: Gieroba Zbigniew J. , Newton Julia L. , Parry Steve W. , Norton Michael , Lawson Joanna , Kenny Rose Anne 
Published: October 2004

Objectives: To test the safety of the head‐up tilt test (HUT) in older adults.Design: Direct observation and measurements.Setting: Tests performed in a quiet room with dim lighting in a laboratory setting.Participants: One thousand ninety‐six subjects aged 60 to 74; 873 aged 75 and older.Measurements: Blood pressure and pulse at baseline for 10 minutes and 70° tilt for maximum of 45 minutes. Subjects with unprovoked HUT had test repeated on a separate day after 800 mg glyceryl trinitrate (GTN).Results: One thousand four hundred ninety‐five drug‐free and 474 GTN‐provoked HUTs were studied. In those aged 60 to 74, the proportion of hypotensive unprovoked HUT was 16% (27% in those aged ≥75); this was higher with GTN provocation (43% in those aged 60–74, 44% in those aged ≥75; P<.01). Systolic blood pressure decreased during provoked HUT (lowest mean±standard deviation=67±20 in those aged 60–74, 63±24 in those aged ≥75; P<.01). There was one cardiovascular and no neurological complications.Conclusion: This study included 10 times as many people as previous studies and demonstrates the safety of HUT in older people.
Upregulation of RANTES Gene Expression in Neuroglia by Japanese Encephalitis Virus Infection
Authors: Chen Chun-Jung , Chen Jian-Hong , Chen Shih-Yun , Liao Su-Lan , Raung Shue-Ling 
Published: October 2004

ABSTRACTInfection with Japanese encephalitis virus (JEV) causes cerebral inflammation and stimulates inflammatory cytokine expression. Glial cells orchestrate immunocyte recruitment to focal sites of viral infection within the central nervous system (CNS) and synchronize immune cell functions through a regulated network of cytokines and chemokines. Since immune cell infiltration is prominent, we investigated the production of a responding chemoattractant, RANTES (regulated upon activation, normal T-cell expressed and secreted), in response to JEV infection of glial cells. Infection with JEV was found to elicit the production of RANTES from primary neurons/glia, mixed glia, microglia, and astrocytes but not from neuron cultures. The production of RANTES did not seem to be directly responsible for JEV-induced neuronal death but instead contributed to the recruitment of immune cells. RANTES expression required viral replication and the activation of extracellular signal-regulated kinase (ERK) as well as transcription factors, including nuclear factor kappa B (NF-κB) and nuclear factor IL-6 (NF-IL-6). The induction of RANTES expression by JEV infection in glial cells needed the coordinate activation of NF-κB and NF-IL-6. Using enzymatic inhibitors, we demonstrated a strong correlation between the ERK signaling pathway and RANTES expression. However, JEV replication was not dependent on the activation of ERK, NF-κB, and NF-IL-6. Altogether, these results demonstrated that infection of glial cells by JEV provided the early ERK-, NF-κB-, and NF-IL-6-mediated signals that directly activated RANTES expression, which might be involved in the initiation and amplification of inflammatory responses in the CNS.
New Class of Orthopoxvirus Antiviral Drugs That Block Viral Maturation
Authors: Byrd Chelsea M. , Bolken Tove' C. , Mjalli Adnan M. , Arimilli Murty N. , Andrews Robert C. , Rothlein Robert , Andrea Tariq , Rao Mohan , Owens Katrina L. , Hruby Dennis E. 
Published: October 2004

ABSTRACT

By using a homology-based bioinformatics approach, a structural model of the vaccinia virus (VV) I7L proteinase was developed. A unique chemical library of ∼51,000 compounds was computationally queried to identify potential active site inhibitors. The resulting biased subset of compounds was assayed for both toxicity and the ability to inhibit the growth of VV in tissue culture cells. A family of chemotypically related compounds was found which exhibits selective activity against orthopoxviruses, inhibiting VV with 50% inhibitory concentrations of 3 to 12 μM. These compounds exhibited no significant cytotoxicity in the four cell lines tested and did not inhibit the growth of other organisms such as
Saccharomyces cerevisiae
,
Pseudomonas aeruginosa
, adenovirus, or encephalomyocarditis virus. Phenotypic analyses of virus-infected cells were conducted in the presence of active compounds to verify that the correct biochemical step (I7L-mediated core protein processing) was being inhibited. Electron microscopy of compound-treated VV-infected cells indicated a block in morphogenesis. Compound-resistant viruses were generated and resistance was mapped to the I7L open reading frame. Transient expression with the mutant I7L gene rescued the ability of wild-type virus to replicate in the presence of compound, indicating that this is the only gene necessary for resistance. This novel class of inhibitors has potential for development as an efficient antiviral drug against pathogenic orthopoxviruses, including smallpox.
Identification and Characterization of Persistent Human Erythrovirus Infection in Blood Donor Samples
Authors: Candotti Daniel , Etiz Nermin , Parsyan Armen , Allain Jean-Pierre 
Published: October 2004

ABSTRACT
The presence of human erythrovirus DNA in 2,440 blood donations from the United Kingdom and sub-Saharan Africa (Ghana, Malawi, and South Africa) was screened. Sensitive qualitative and real-time quantitative PCR assays revealed a higher prevalence of persistent infection with the simultaneous presence of immunoglobulin G (IgG) and viral DNA (0.55 to 1.3%) than previously reported. This condition was characterized by a low viral load (median, 558 IU/ml; range, 42 to 135,000 IU/ml), antibody-complexed virus, free specific IgG, and potentially infectious free virus. Human erythrovirus genotype 1 (formerly parvovirus B19) was prevalent in the United Kingdom, Malawi, and South Africa. In contrast, only human erythrovirus genotype 3 (erythrovirus variant V9) was prevalent in Ghana. Genotype 3 had considerable genetic diversity, clustering in two probable subtypes. Genotype 1-based antibody assays failed to detect 38.5% of Ghanaian samples containing antibodies to genotype 3 virus but did not fail to detect cases of persistent infection. This study indicates a potential African origin of genotype 3 human erythrovirus and considerable shortcomings in the tools currently used to diagnose erythrovirus infection.
Novel Host Range and Cytopathic Variant of Ecotropic Friend Murine Leukemia Virus
Authors: Jung Yong Tae , Wu Tiyun , Kozak Christine A. 
Published: October 2004

ABSTRACT

A variant ecotropic Friend murine leukemia virus, F-S MLV, is capable of inducing the formation of large multinucleated syncytia in
Mus dunni
cells. This cytopathicity resembles that of Spl574 MLV, a novel variant recently isolated from the spleen of a
Mus spicilegus
mouse neonatally inoculated with Moloney MLV. F-S MLV is an N-tropic Friend MLV that also has the unusual ability to infect hamster cells, which are normally resistant to mouse ecotropic MLVs. Syncytium induction by both F-S MLV and Spl574 is accompanied by the accumulation of large amounts of unintegrated viral DNA, a hallmark of pathogenic retroviruses, but not previously reported for mouse ecotropic gammaretroviruses. Sequencing and site-specific mutagenesis determined that the syncytium-inducing phenotype of F-S MLV can be attributed to a single amino acid substitution (S84A) in the VRA region of the viral
env
gene. This site corresponds to that of the single substitution previously shown to be responsible for the cytopathicity of Spl574, S82F. The S84A substitution in F-S MLV also contributes to the ability of this virus to infect hamster cells, but Spl574 MLV is unable to infect hamster cells. Because this serine residue is one of the critical amino acids that form the CAT-1 receptor binding site, and because
M. dunni
and hamster cells have variant CAT-1 receptors, these results suggest that syncytium formation as well as altered host range may be a consequence of altered interaction between virus and receptor.
Cell Cycle Arrest in G
2
Induces Human Immunodeficiency Virus Type 1 Transcriptional Activation through Histone Acetylation and Recruitment of CBP, NF-κB, and c-Jun to the Long Terminal Repeat Promoter
Authors: Thierry Sylvain , Marechal Vincent , Rosenzwajg Michelle , Sabbah Michèle , Redeuilh Gérard , Nicolas Jean-Claude , Gozlan Joël 
Published: October 2004

ABSTRACT

In human immunodeficiency virus type 1 (HIV-1)-infected cells, a cell cycle arrest in G
2
increases viral expression and may represent a strategy for the virus to optimize its expression. In latently infected cells, balance between viral silencing and reactivation relies on the nucleosomal organization of the integrated long terminal repeat (LTR). It is shown here that nucleosome nuc-1, which is located downstream of the TATA box, is specifically modified when latently infected cells are arrested in G
2
by chemical inducers. Notably, histones H3 and H4 are hyperacetylated, and this modification is associated with an increased LTR-driven transcription. nuc-1 hyperacetylation is also associated with the recruitment of histone acetyltransferase CBP and transcription factors NF-κB and c-Jun. NF-κB and/or c-Jun binding to the LTR in G
2
-arrested cells appears to be required for CBP recruitment as well as for nuc-1 remodeling and viral reactivation.