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  • 1
    Online Resource
    Online Resource
    American Society for Microbiology ; 2006
    In:  Infection and Immunity Vol. 74, No. 10 ( 2006-10), p. 5860-5870
    In: Infection and Immunity, American Society for Microbiology, Vol. 74, No. 10 ( 2006-10), p. 5860-5870
    Abstract: Nontypeable Haemophilus influenzae is an important respiratory pathogen, causing otitis media in children and lower respiratory tract infection in adults with chronic obstructive pulmonary disease (COPD). Immunoglobulin A1 (IgA1) protease is a well-described protein and potential virulence factor in this organism as well as other respiratory pathogens. IgA1 proteases cleave human IgA1, are involved in invasion, and display immunomodulatory effects. We have identified a second IgA1 protease gene, igaB , in H. influenzae that is present in addition to the previously described IgA1 protease gene, iga . Reverse transcriptase PCR and IgA1 protease assays indicated that the gene is transcribed, expressed, and enzymatically active in H. influenzae . The product of this gene is a type 2 IgA1 protease with homology to the iga gene of Neisseria species. Mutants that were deficient in iga , igaB , and both genes were constructed in H. influenzae strain 11P6H, a strain isolated from a patient with COPD who was experiencing an exacerbation. Analysis of these mutants indicated that igaB is the primary mediator of IgA1 protease activity in this strain. IgA1 protease activity assays on 20 clinical isolates indicated that the igaB gene is associated with increased levels of IgA1 protease activity. Approximately one-third of 297 strains of H. influenzae of diverse clinical and geographic origin contained igaB . Significant differences in the prevalence of igaB were observed among isolates from different sites of isolation (sputum 〉 middle ear 〉 nasopharynx). These data support the hypothesis that the newly discovered igaB gene is a potential virulence factor in nontypeable H. influenzae .
    Type of Medium: Online Resource
    ISSN: 0019-9567 , 1098-5522
    RVK:
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2006
    detail.hit.zdb_id: 1483247-1
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  • 2
    Online Resource
    Online Resource
    American Society for Microbiology ; 2006
    In:  Infection and Immunity Vol. 74, No. 6 ( 2006-06), p. 3366-3374
    In: Infection and Immunity, American Society for Microbiology, Vol. 74, No. 6 ( 2006-06), p. 3366-3374
    Abstract: Haemophilus influenzae is an important cause of otitis media in children and lower respiratory infection in adults with chronic obstructive pulmonary disease (COPD). Patients with COPD experience periodic exacerbations that are associated with acquisition of new bacterial strains. However, not every strain acquisition is associated with exacerbation. To test the hypothesis that genetic differences among strains account for differences in pathogenic potential, a microarray consisting of 4,992 random 1.5- to 3-kb genomic fragments of an exacerbation strain was constructed. Competitive hybridization was performed using six strains associated with exacerbation as well as five strains associated with asymptomatic colonization. Seven sequences that were absent in all five colonization strains and present in at least two exacerbation strains were identified. One such sequence was a previously unreported gene with high homology to the meningococcal immunoglobulin A (IgA) protease gene, which is distinct from the previously described H. influenzae IgA protease. To assess the distribution of the seven sequences among well-characterized strains of H. influenzae , 59 exacerbation strains and 73 asymptomatic colonization strains were screened by PCR for the presence of these sequences. The presence or absence of any single sequence was not significantly associated with exacerbations of COPD. However, logistic regression and subgroup analysis identified combinations of the presence and absence of genes that are associated with exacerbations. These results indicate that patterns of genes are associated with the ability of strains of H. influenzae to cause exacerbations of COPD, supporting the concept that differences in pathogenic potential are based in part on genomic differences among infecting strains, not merely host factors.
    Type of Medium: Online Resource
    ISSN: 0019-9567 , 1098-5522
    RVK:
    Language: English
    Publisher: American Society for Microbiology
    Publication Date: 2006
    detail.hit.zdb_id: 1483247-1
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  • 3
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 248-248
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 248-248
    Abstract: Pain assessment is challenging in patients with cognitive impairment that can lead to inappropriate pain management and unfavorable health outcomes. Using a 10% random sample of Medicare home health (HH) patients ≥ 65 years old from the 2017 Outcome and Assessment Information Set (OASIS) national dataset (N=646,109), we tested the relationships of cognitive impairment and constant, severe pain that interfered with daily living activities with acute care utilization (i.e., hospitalization and emergency department [ED] admission without hospitalization). Patients who had constant, severe, interfering pain (32.57%, N=210,444) were younger, more likely to be female, white, Medicare-Medicaid dually eligible, living alone, and having functional limitations and depressive symptoms, but less likely to have moderate-to-severe cognitive impairment (25.0% versus 31.5%, p & lt;0.001) than others. In multivariable logistic regression models adjusting for the above covariates, when compared with patients with neither cognitive impairment nor severe, constant, interfering pain, those with both conditions were 17% more likely to have hospitalization (Odds Ratio [OR] =1.17, p & lt;0.001) and 13% more likely to have an ED admission without hospitalization (OR=1.13, p & lt;0.001). This was the first study that examined co-occurring pain and cognitive impairment in HH recipients using national OASIS data. Findings suggest that: 1) older HH patients with moderate-to-severe cognitive impairment have lower rates of reported pain that suggests under-recognition; and 2) having severe, interfering pain among cognitively impaired patients significantly increased their risk of acute care utilization. Therefore, systematic protocols and guidelines should be in place to facilitate pain assessment for improved outcomes among HH patients with cognitive impairment.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 518-519
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 518-519
    Abstract: This secondary analysis used a 10% random sample from the national Outcome and Assessment Information Set (OASIS) of Medicare beneficiaries ≥ 65 years old who received home health (HH) care in 2017 (N=646,109). We examined the risk of hospital admission during a 60-day HH episode among Medicare home health patients in different living arrangements, including living alone at home (23.8%), living with other at home (64.8%), and residing in assisted facility (AL) facilities (11.4%). At the start of the HH episode, AL residents were older, more likely to have cognitive impairment, depressive symptoms, and limitations in activities of daily living (ADL) than those living at home at home (alone/with others). In the multivariable logistic regression model of hospital admission adjusting for demographic status (age, sex, race/ethnicity, Medicaid status), cognitive impairment, depressive symptoms, and ADL limitations, when compared to HH patients living with others at home (reference), AL residents were 15% less likely to have hospital admission (Odds Ratio [OR] =0.85, 95% Confidence Interval [CI]: 0.84, 0.88, p & lt;0.001). HH patients living at home alone were not statistically significantly different from the reference (OR=0.99, 95% CI: 0.98, 1.01, p=0.47). HH patients in AL, despite having worse cognitive, mental, and physical function at baseline, had better outcomes than those living at home. This suggests 1) older adults living at home may have unmet health or personal care needs, and 2) synergies may exist between post-acute care through HH care and long-term care and support at AL that are critical to patient welfare.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2905697-4
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  • 5
    In: The Gerontologist, Oxford University Press (OUP), Vol. 60, No. 3 ( 2020-04-02), p. 494-502
    Abstract: Previous studies have shown that staff perception of team effectiveness is related to better health outcomes in various care settings. This study focused on the Veterans Health Administration’s Home-Based Primary Care (HBPC) program. We examined variations in HBPC interdisciplinary teamwork (IDT) and identified modifiable team and program characteristics that may influence staff perceptions of team effectiveness. Research Design We used a broadly validated survey instrument to measure perceived team effectiveness, workplace conditions/resources, group culture, and respondents’ characteristics. Surveys were initiated in January and completed in July, 2016. Methods Team membership rosters (n = 249) included 2,852 IDT members. The final analytical data set included 1,403 surveys (49%) from 221 (89%) teams. A generalized estimating equation model with logit link function, weighted by survey response rates, was used to examine factors associated with perceived team effectiveness. Results Respondents who served as primary care providers (PCPs) were 8% more likely (p = .0044) to view team’s performance as highly effective compared to other team members. Teams with nurse practitioners serving as team leader reported 6% higher likelihood of high-perceived team effectiveness (p = .0234). High team effectiveness was 13% more likely in sites where the predominant culture was characterized as group/developmental, and 7%–8% more likely in sites with lower environmental stress and better resources and staffing, respectively. Conclusions and Implications Team effectiveness is an important indirect measure of HBPC teams’ function. HBPC teams should examine their predominant culture, workplace stress, resources and staffing, and PCP leadership model as part of their quality improvement efforts.
    Type of Medium: Online Resource
    ISSN: 0016-9013 , 1758-5341
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2043844-8
    SSG: 12
    SSG: 5,2
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  • 6
    Online Resource
    Online Resource
    IACSIT Press ; 2022
    In:  International Journal of Engineering and Technology Vol. 14, No. 2 ( 2022-5), p. 15-18
    In: International Journal of Engineering and Technology, IACSIT Press, Vol. 14, No. 2 ( 2022-5), p. 15-18
    Abstract: This paper analyzes the research progress of remote sensing technology in lake water environment monitoring in China in recent years, including the research progress of suspended matter concentration in water, the research progress of bloom characteristics and the research status of chlorophyll concentration A.Although great progress has been made in lake water environment monitoring, the use of remote sensing to capture the spectral characteristics of water remains to be strengthened. It is necessary to improve the lake remote sensing algorithm for long time series and large range.
    Type of Medium: Online Resource
    ISSN: 1793-8236
    Uniform Title: Research Progress of Remote Sensing Technology in Lake Water Environment Monitoring in China
    Language: Unknown
    Publisher: IACSIT Press
    Publication Date: 2022
    detail.hit.zdb_id: 2716545-0
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  • 7
    Online Resource
    Online Resource
    Health Affairs (Project Hope) ; 2015
    In:  Health Affairs Vol. 34, No. 12 ( 2015-12), p. 2129-2137
    In: Health Affairs, Health Affairs (Project Hope), Vol. 34, No. 12 ( 2015-12), p. 2129-2137
    Type of Medium: Online Resource
    ISSN: 0278-2715 , 1544-5208
    Language: English
    Publisher: Health Affairs (Project Hope)
    Publication Date: 2015
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  • 8
    In: Vaccine, Elsevier BV, Vol. 28, No. 1 ( 2009-12), p. 279-289
    Type of Medium: Online Resource
    ISSN: 0264-410X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 1468474-3
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  • 9
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2019
    In:  BMC Health Services Research Vol. 19, No. 1 ( 2019-12)
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2050434-2
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  • 10
    Online Resource
    Online Resource
    Health Affairs (Project Hope) ; 2019
    In:  Health Affairs Vol. 38, No. 2 ( 2019-02), p. 190-196
    In: Health Affairs, Health Affairs (Project Hope), Vol. 38, No. 2 ( 2019-02), p. 190-196
    Type of Medium: Online Resource
    ISSN: 0278-2715 , 1544-5208
    Language: English
    Publisher: Health Affairs (Project Hope)
    Publication Date: 2019
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