Journal articles: 'Clinical determinant'

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Yu, M., J. M. Johnson, and V. K. Tuohy. "A predictable sequential determinant spreading cascade invariably accompanies progression of experimental autoimmune encephalomyelitis: a basis for peptide-specific therapy after onset of clinical disease." Journal of Experimental Medicine 183, no. 4 (April 1, 1996): 1777–88. http://dx.doi.org/10.1084/jem.183.4.1777.

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The development of autoimmune disease is accompanied by the acquired recognition of new self-determinants, a process commonly referred to as determinant spreading. In this study, we addressed the question of whether determinant spreading is pathogenic for progression of chronic-relapsing experimental autoimmune encephalomyelitis (EAE), a disease with many similarities to multiple sclerosis (MS). Our approach involved a systematic epitope mapping of responses to myelin proteolipid protein (PLP) as well as assaying responses to known encephalitogenic determinants of myelin basic protein (MBP 87-89) and myelin oligodendrocyte glycoprotein (MOG 92-106) at various times after induction of EAE in (SWR X SJL)F1 mice immunized with PLP 139-151. We found that the order in which new determinants are recognized during the course of disease follows a predictable sequential pattern. At monthly intervals after immunization with p139-151, responses to PLP 249-273, MBP 87-99, and PLP 137-198 were sequentially accumulated in al mice examined. Three lines of evidence showed that determinant spreading is pathogenic for disease progression: (a) spreading determinants mediate passive transfer of acute EAE in naive (SWR X SJL)F1 recipients; (b) an invariant relationship exists between the development of relapse/progression and the spreading of recognition to new immunodominant encephalitogenic determinants; and (c) after EAE onset, the induction of peptide-specific tolerance to spreading but not to nonspreading encephalitogenic determinants prevents subsequent progression of EAE. Thus, the predictability of acquired self-determinant recognition provides a basis for sequential determinant-specific therapeutic intervention after onset of the autoimmune disease process.

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Roberts, M. C., W. O. Chung, and D. E. Roe. "Characterization of tetracycline and erythromycin resistance determinants in Treponema denticola." Antimicrobial Agents and Chemotherapy 40, no. 7 (July 1996): 1690–94. http://dx.doi.org/10.1128/aac.40.7.1690.

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Treponema denticola isolates were evaluated for the presence of known tetracycline and erythromycin resistance determinants by Southern blot hybridization of whole-cell DNA and PCR assays. We examined all isolates available, which included 12 clinical and 4 American Type Culture Collection isolates. Two isolates carried the Tet B determinant, five isolates carried both the Tet B and Erm F determinants, seven isolates carried the Erm F determinant, and two did not carry any of the Tet or Erm determinants tested. Both the Tet B and Erm F determinants appeared to be associated with the chromosome. Neither of the two T. denticola donors tested could transfer the Tet B determinant, but three of four T. denticola tested transferred the Erm F determinant to an Enterococcus faecalis recipient. This extends the host range of both the tetB and ermF genes into the genus Treponema.

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Bachelot, Anne, Jean Louis Golmard, Jérôme Dulon, Nora Dahmoune, Monique Leban, Claire Bouvattier, Sylvie Cabrol, Juliane Leger, Michel Polak, and Philippe Touraine. "Determining clinical and biological indicators for health outcomes in adult patients with childhood onset of congenital adrenal hyperplasia." European Journal of Endocrinology 173, no. 2 (August 2015): 175–84. http://dx.doi.org/10.1530/eje-14-0978.

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AimAdverse outcomes in adult congenital adrenal hyperplasia (CAH) patients are frequent. The determinants of them have not yet been established.ObjectiveTo establish the prevalence of adverse outcomes and to find determining factors for each of them.Design, patients, and methodsCross-sectional monocentric study of 104 patients with childhood onset of CAH (71 women, 33 men). Analysis established first the determinants of clinical, hormonal, genetic variables and second a composite criterion for some of the outcomes and determinants.ResultsBMI was above 25 kg/m2 in 44% of the cohort, adrenal hyperplasia and/or nodules were present in 45% of the patients, and irregular menstrual cycles and hyperandrogenism were found in 50 and 35% of the women respectively. In univariate analysis, the determinants of these outcomes were all linked to disease control, especially 17-hydroxyprogesterone (17OHP) and androstenedione concentrations. Low weight was a determinant of abnormal bone mineral density (BMD) (60% of the cohort). Multivariate analysis confirmed these data. A classic form (CF) of CAH was a determinant of testicular adrenal rest tumors (TARTs) (36% of the men). Total cumulative glucocorticoid dose was a determinant of BMI and TART, whereas fludrocortisone dose was a determinant of TART (P=0.03). In men, the composite criterion was associated with androstenedione concentration and CF. In women, the composite criterion was associated with total testosterone concentration.ConclusionThe present study confirms the high prevalence of adverse outcomes in CAH patients. These are, most often, related to disease control. The impaired health status of adults with CAH could therefore be improved through the modification of treatment.

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Erac, Bayri, Fethiye Ferda Yilmaz, Ismail Ozturk, Sabire Sohret Aydemir, and Mine Hosgor-Limoncu. "Analyses of Plasmids Harbouring Quinolone Resistance Determinants in Enterobacteriaceae Members." Polish Journal of Microbiology 66, no. 4 (December 4, 2017): 529–32. http://dx.doi.org/10.5604/01.3001.0010.7084.

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The aim of this study was to explore the plasmid characteristics of eight clinical Enterobacteriaceae strains containing extended broad spectrum beta-lactamases and plasmid-mediated quinolone resistance. Plasmids were transferred by conjugation or transformation and resistance determinants were investigated by PCR. We showed that at least one plasmid harbouring qnrB or qnrS determinant was transferred by conjugation in five isolates. QepA determinant was confirmed to be on a non-conjugative plasmid. We found at least one beta-lactamase gene in seven of the eight clinical isolates having plasmid-mediated quinolone resistance, which indicated that these two resistance determinants were mostly on the same conjugative plasmids.

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Tuckman, Margareta, Peter J. Petersen, Anita Y. M. Howe, Mark Orlowski, Stanley Mullen, Karen Chan, Patricia A. Bradford, and C. Hal Jones. "Occurrence of Tetracycline Resistance Genes among Escherichia coli Isolates from the Phase 3 Clinical Trials for Tigecycline." Antimicrobial Agents and Chemotherapy 51, no. 9 (July 9, 2007): 3205–11. http://dx.doi.org/10.1128/aac.00625-07.

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ABSTRACT Tigecycline, a member of the glycylcycline class of antibiotics, was designed to maintain the antibacterial spectrum of the tetracyclines while overcoming the classic mechanisms of tetracycline resistance. The current study was designed to monitor the prevalence of the tet(A), tet(B), tet(C), tet(D), tet(E), and tet(M) resistance determinants in Escherichia coli isolates collected during the worldwide tigecycline phase 3 clinical trials. A subset of strains were also screened for the tet(G), tet(K), tet(L), and tet(Y) genes. Of the 1,680 E. coli clinical isolates screened for resistance to classical tetracyclines, 405 (24%) were minocycline resistant (MIC ≥ 8 μg/ml) and 248 (15%) were tetracycline resistant (MIC ≥ 8 μg/ml) but susceptible to minocycline (MIC ≤ 4 μg/ml). A total of 452 tetracycline-resistant, nonduplicate isolates were positive by PCR for at least one of the six tetracycline resistance determinants examined. Over half of the isolates encoding a single determinant were positive for tet(A) (26%) or tet(B) (32%) with tet(C), tet(D), tet(E), and tet(M), collectively, found in 4% of isolates. Approximately 33% of the isolates were positive for more than one resistance determinant, with the tet(B) plus tet(E) combination the most highly represented, found in 11% of isolates. The susceptibilities of the tetracycline-resistant strains to tigecycline (MIC90, 0.5 μg/ml), regardless of the encoded tet determinant(s), were comparable to the tigecycline susceptibility of tetracycline-susceptible strains (MIC90, 0.5 μg/ml). The results provide a current (2002 to 2006) picture of the distribution of common tetracycline resistance determinants encoded in a globally sourced collection of clinical E. coli strains.

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Chebanenko, N. V., P. L. Sokol, and A. G. Prityko. "Congenital cerebral palsy with epilepsy: clinical and genetic comparisons." Russian Journal of Child Neurology 17, no. 3 (December 17, 2022): 43–54. http://dx.doi.org/10.17650/2073-8803-2022-17-3-43-54.

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Background. The problem of congenital cerebral palsy (CP) is relevant due to the limited complexity of habilitation and social adaptation of such patients. The genetic aspects of the pathogenesis of the disease are being actively studied. CP is often accompanied by epilepsy, which is characterized by refractoriness.Aim. To analyze the clinical, genetic and neuroimaging aspects of this pathology in CP patients.Materials and methods. The study included 136 patients with CP. Genetic studies were carried out on venous blood material using NGS and Sanger trio methods. The distribution of genes into groups of determinants was carried out.Results. In 136 patients, 91 genes with pathogenic variants were found. There were more of them in the determinant groups CS (regulation of cytoskeleton formation and functioning), ENM (regulation of neuronal membrane excitability), CMTR (control of chromatin modifications, transcription and replication processes), NTS (regulation of neurotransmitter metabolism and synapse functioning). The distribution of genes according to the degree of motor deficiency was specific: in all groups, except for canalopathy genes (ENM): certain genes corresponded to each degree of motor deficiency. This specificity was less pronounced in the ENM group. The largest number of cases of abnormalities in the structure of the brain was in the CMTR (control of chromatin modifications, transcription and replication processes), CS (regulation of the formation and functioning of the cytoskeleton) and ENM (regulation of the excitability of the neuronal membrane) groups. The RMF group (regulation of the functions of the mitochondrial apparatus) was characterized by the highest resistance to epilepsy. In cases from the group with the canalopathy genes (ENM), the epileptic process was not the most refractory.Conclusions. According to the contribution to the pathogenesis of CP with epilepsy, the distribution of determinants for the provision of excitability and conduction of the nervous tissue (ENM and NTS), the regulation of neuroontogenesis processes (NOG and CMTR), and the predetermination of enzymatic defects leading to storage diseases (GSD) are permissible. The determinant ENM is responsible for both the formation of motor deficits and the formation of the epileptic process. At the same time, its influence on motor deficit is nonspecific, and the degree of refractoriness of the epileptic process largely determines the determinant of mitochondrial function regulation.

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Hamdanillah, Rela, Anom Suardika, Made Darmayasa, and Ida Bagus Gde Fajar Manuaba. "Faktor determinan kematian ibu di RSUP Sanglah Denpasar tahun 2016." Intisari Sains Medis 11, no. 3 (December 1, 2020): 1075–80. http://dx.doi.org/10.15562/ism.v11i3.249.

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Background: Maternal mortality is the death of women during pregnancy or within 42 days of delivery, whether associated with pregnancy or complications exacerbated by pregnancy and not related to incidental causes. Maternal mortality is a critical indicator in assessing the level of wellbeing and public health status. The risk of maternal death is divided into three such as remote determinants, intermediate determinants, and acute clinical determinants.Aim: This study aims to determine the determinant factors as a role player in maternal mortality at Sanglah Hospital Denpasar in 2016.Method: This research is cross-sectional descriptive research conducted at RSUP Sanglah Denpasar. The sample of the study was all mothers died at Sanglah Hospital during the year 2016. The data obtained in the form of patient medical record data. Data were analyzed by descriptive methods.Result and Conclusion: The maternal mortality caused by the remoted determinant factors which were the highest in the maternal group with 9-12 years of education (77.3%) and the working mother group (54.5%). On the intermediate determinant, the highest is at age 20-35 years (81.8%), with parity 2-3 (63.6%), 2-10 year of gestational distance (54.5%), the most top obstetric factors are preeclampsia/eclampsia (27.2%), but the nonobstetric cause is the leading cause of maternal mortality. Kematian ibu adalah kematian wanita selama masa kehamilan atau dalam kurun waktu 42 hari setelah melahirkan, baik yang berhubungan dengan kehamilan maupun komplikasi yang diperburuk oleh masa kehamilan, serta tidak berhubungan dengan penyebab incidental. Angka kematian ibu merupakan indikator penting dalam menilai tingkat kesejahteraan dan status kesehatan masyarakat. Faktor yang berkontribusi terhadap kematian ibu secara garis besar dapat kelompokkan menjadi penyebab obstetrik dan penyebab non obstetrik. Menurut McCarthy dan Maine, risiko kematian ibu dibagi menjadi 3 yaitu, determinan jauh, determinan antara dan determinan dekat.Tujuan: Untuk mengetahui faktor-faktor determinan yang berperan dalam kematian ibu di RSUP Sanglah Denpasar tahun 2016.Metode: Penelitian ini merupakan penelitian deskriptif cross-sectional yang dilakukan di RSUP Sanglah Denpasar. Sampel penelitian adalah semua ibu meninggal di RSUP Sanglah selama tahun 2016. Data yang diperoleh berupa data rekam medis pasien, kemudian dianalisis secara deskriptif.Hasil dan Kesimpulan: Kematian ibu yang disebabkan karena faktor determinan yang tertinggi yaitu pada kelompok ibu dengan pendidikan 9-12 tahun (36,4%) dan kelompok ibu yang bekerja (54,5%). Pada faktor determinan antara yang tertinggi yaitu pada usia 20-35 tahun (81,8%), dengan paritas 2-3 (63,6%), jarak kehamilan 2-10 tahun (54,5%), faktor penyebab obstetrik yang tertinggi adalah preeklampsia/eklampsia (27,2%), namun secara garis besar penyebab non obstetrik merupakan penyebab utama kematian ibu.

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McFarland, Hugh I., Adrian A. Lobito, Michele M. Johnson, Jeffrey T. Nyswaner, Joseph A. Frank, Gregory R. Palardy, Nancy Tresser, et al. "Determinant Spreading Associated with Demyelination in a Nonhuman Primate Model of Multiple Sclerosis." Journal of Immunology 162, no. 4 (February 15, 1999): 2384–90. http://dx.doi.org/10.4049/jimmunol.162.4.2384.

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Abstract Definition of the immune process that causes demyelination in multiple sclerosis is essential to determine the feasibility of Ag-directed immunotherapy. Using the nonhuman primate, Callithrix jacchus jacchus (common marmoset), we show that immunization with myelin basic protein and proteolipid protein determinants results in clinical disease with significant demyelination. Demyelination was associated with spreading to myelin oligodendrocyte glycoprotein (MOG) determinants that generated anti-MOG serum Abs and Ig deposition in central nervous system white matter lesions. These data associate intermolecular “determinant spreading” with clinical autoimmune disease in primates and raise important issues for the pathogenesis and treatment of multiple sclerosis.

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Maeland, Johan A., Lars Bevanger, and Randi Valsoe Lyng. "Immunological Markers of the R4 Protein of Streptococcus agalactiae." Clinical Diagnostic Laboratory Immunology 12, no. 11 (November 2005): 1305–10. http://dx.doi.org/10.1128/cdli.12.11.1305-1310.2005.

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ABSTRACT This study focuses on immunological markers of R4, an important Streptococcus group B (GBS) protein. The results obtained by using rabbit antisera and purified proteins for antigens in enzyme-linked immunosorbent assay-based experiments provided evidence that R4 possesses two antigenic determinants. One of the determinants is shared with the alpha-like protein 3 (Alp3) of GBS, was named R4/Alp3 common, and was expressed by GBS, which possessed the Alp3-encoding gene alp3 or the R4-encoding gene rib. The other antigenic determinant was detected only in rib-positive GBS organisms and was named R4 specific. This determinant probably is an immunological marker unique to the R4 protein. Neither of the antigenic R4 determinants showed serological cross-reactivity with the GBS proteins Cα, Cβ, and R3 or with alpha-like protein 2. Of 60 clinical serotype III GBS strains, 56 (93%) isolates possessed the rib gene and 50 (89%) of the rib-positive isolates expressed levels of R4 detectable by antibody-based tests, consistent with R4 expression failure or low-level expression in ∼10% of rib-positive GBS. alp3 was not detected in type III GBS but was possessed by six of eight type V strains and six of six type VIII strains. All alp3-positive strains were recognized by the R4/Alp3 common antibodies, but none of them were recognized by the R4-specific antibodies. NCTC 9828, a reference strain for R3 and R4, expressed the determinant R4/Alp3 common but not R4 specific. A monoclonal R4 antibody, previously considered to be R4 specific and used in GBS serotyping, targeted R4/Alp3 common and is thus not R4 specific. The results show that failure to discriminate between R4 specific and R4/Alp3 common by antisera designed for GBS serotyping can result in the false identification of Alp3 as R4 or vice versa, whereas anti-R4 antibodies targeting only the determinant R4 specific will detect only R4. Both R4 and Alp3 need further evaluation with respect to the immunobiological function of each distinct antigenic determinant, for instance, with regard to their potential as GBS vaccine components.

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He, Xiaoye, Stephen J. Clarke, and Andrew J. McLachlan. "Clinical Pharmacology of Chemotherapy Agents in Older People with Cancer." Current Gerontology and Geriatrics Research 2011 (2011): 1–6. http://dx.doi.org/10.1155/2011/628670.

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Populations around the world are aging, and the associated increase in cancer incidence has led to the recognition of the importance of geriatric oncology. Chronological age is a poor determinant of pharmacological response to cancer chemotherapy agents. Age-associated changes in physiology and organ function have a significant impact on the clinical pharmacology of cancer chemotherapy agents used in cancer treatment. Altered response to medicines in older people is a consequence of changes in body composition, organ function, concomitant pathophysiology, multiple medications, genetic determinants of drug response, and patient's clinical status. These issues highlight the need to individualize the management of cancer in the older people with consideration of age-related changes in the clinical pharmacology of cancer drugs, analgesics, and adjunctive therapies.

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Milheiriço, Catarina, Alexander Tomasz, and Hermínia de Lencastre. "Impact of the Stringent Stress Response on the Expression of Methicillin Resistance in Staphylococcaceae Strains Carrying mecA, mecA1 and mecC." Antibiotics 11, no. 2 (February 16, 2022): 255. http://dx.doi.org/10.3390/antibiotics11020255.

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The acquisition of the resistance determinant mecA by Staphylococcus aureus is of major clinical importance, since it confers a resistant phenotype to virtually the entire large family of structurally diverse β-lactam antibiotics. While the common resistance determinant mecA is essential, the optimal expression of the resistance phenotype also requires additional factors. Previous studies showed that the great majority of clinical isolates of methicillin-resistant S. aureus (MRSA) have a heterogeneous resistant phenotype, and we observed that strains carrying methicillin genetic determinants other than mecA also produce similar heterogeneous phenotypes. All these strains were able to express high and homogeneous levels of oxacillin resistance when sub-inhibitory concentrations of mupirocin, an effector of the stringent stress response, were added to growth media. Our studies show that the gene gmk, involved in guanine metabolism, was one of the first genes to exhibit mutations in homoresistant (H*R) derivatives obtained through serial passages (with increasing concentrations of oxacillin) of the prototype mecC-carrying MRSA strain LGA251. All these observations led us to propose that a common molecular mechanism for the establishment of high and homogeneous oxacillin resistance must be present among isolates carrying different methicillin resistance determinants. In this work, we tested this hypothesis using whole-genome sequencing (WGS) to compare isogenic populations differing only in their degrees of oxacillin resistance and carrying various methicillin genetic determinants

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Garg, MK, Sanjay Kalra, and Namita Mahalle. "The intestinal calcistat: Determinant of clinical vitamin D deficiency." Indian Journal of Endocrinology and Metabolism 17, no. 5 (2013): 780. http://dx.doi.org/10.4103/2230-8210.117187.

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Adams, C. A., B. Austin, P. G. Meaden, and D. McIntosh. "Molecular Characterization of Plasmid-Mediated Oxytetracycline Resistance in Aeromonas salmonicida." Applied and Environmental Microbiology 64, no. 11 (November 1, 1998): 4194–201. http://dx.doi.org/10.1128/aem.64.11.4194-4201.1998.

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ABSTRACT Using broth conjugation, we found that 19 of 29 (66%) oxytetracycline (OT)-resistant isolates of Aeromonas salmonicida transferred the OT resistance phenotype toEscherichia coli. The OT resistance phenotype was encoded by high-molecular-weight R-plasmids that were capable of transferring OT resistance to both environmental and clinical isolates ofAeromonas spp. The molecular basis for antibiotic resistance in OT-resistant isolates of A. salmonicida was determined. The OT resistance determinant from one plasmid (pASOT) ofA. salmonicida was cloned and used in Southern blotting and hybridization experiments as a probe. The determinant was identified on a 5.4-kb EcoRI fragment on R-plasmids from the 19 OT-resistant isolates of A. salmonicida. Hybridization with plasmids encoding the five classes (classes A to E) of OT resistance determinants demonstrated that the OT resistance plasmids of the 19A. salmonicida isolates carried the class A resistance determinant. Analysis of data generated from restriction enzyme digests showed that the OT resistance plasmids were not identical; three profiles were characterized, two of which showed a high degree of homology.

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Davis, Margery H., Gominda G. Ponnamperuma, Sean McAleer, and Vicki H. M. Dale. "The Objective Structured Clinical Examination (OSCE) as a Determinant of Veterinary Clinical Skills." Journal of Veterinary Medical Education 33, no. 4 (December 2006): 578–87. http://dx.doi.org/10.3138/jvme.33.4.578.

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Saputro, Dito Bagus, and Kurniawati. "The Determinant of Intention to Purchase." International Journal of Psychosocial Rehabilitation 24, no. 03 (February 18, 2020): 752–64. http://dx.doi.org/10.37200/ijpr/v24i3/pr200830.

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Maeland, Johan A., Lars Bevanger, and Randi Valsoe Lyng. "Antigenic Determinants of Alpha-Like Proteins of Streptococcus agalactiae." Clinical Diagnostic Laboratory Immunology 11, no. 6 (November 2004): 1035–39. http://dx.doi.org/10.1128/cdli.11.6.1035-1039.2004.

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ABSTRACT The majority of group B streptococcus (GBS) isolates express one or more of a family of surface-anchored proteins that vary by strain and that form ladder-like patterns on Western blotting due to large repeat units. These proteins, which are important as GBS serotype markers and as inducers of protective antibodies, include the alpha C (Cα) and R4 proteins and the recently described alpha-like protein 2 (Alp2), encoded by alp2, and Alp3, encoded by alp3. In this study, we examined antigenic determinants possessed by Alp2 and Alp3 by testing of antibodies raised in rabbits, mainly by using enzyme-linked immunosorbent assays (ELISA) and an ELISA absorption test. The results showed that Alp2 and Alp3 shared an antigenic determinant, which may be a unique immunological marker of the Alp variants of GBS proteins. Alp2, in addition, possessed an antigenic determinant which showed specificity for Alp2 and a third determinant which showed serological cross-reactivity with Cα. Alp3, in addition to the determinant common to Alp2 and Alp3, harbored an antigenic site which also was present in the R4 protein, whereas no Alp3-specific antigenic site was detected. These ELISA-based results were confirmed by Western blotting and a fluorescent-antibody test. The results are consistent with highly complex antigenic structures of the alpha-like proteins in a fashion which is in agreement with the recently described structural mosaicism of the alp2 and alp3 genes. The results are expected to influence GBS serotyping, immunoprotection studies, and GBS vaccine developments.

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Taveira, Fernanda M., Nayara F. T. Braz, Elizabeth R. Comini-Frota, Antônio L. Teixeira, and Renan B. Domingues. "Disability as a determinant of fatigue in MS patients." Arquivos de Neuro-Psiquiatria 77, no. 4 (April 2019): 248–53. http://dx.doi.org/10.1590/0004-282x20190035.

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ABSTRACT Fatigue is one of the most frequent and disabling symptoms in multiple sclerosis (MS). Central, psychological, and peripheral factors may contribute to the occurrence of fatigue. Objectives: The current study aimed to evaluate potential fatigue determinants in patients with relapsing-remitting MS with a low functional impairment. Methods: We compared inflammatory markers, respiratory pressures, disability, and quality of life in 39 relapsing-remitting MS patients with and without fatigue. Results: Patients with relapsing-remitting MS with fatigue had higher Expanded Disability Status Scale scores (p = 0.002). We observed a significant association between the results of the Guy Neurological Disability Scale, the Functional Assessment of MS Quality of Life Rating Scale and the presence of fatigue (p < 0.05). Conclusions: The degree of functional impairment is a determinant for the presence of fatigue in MS patients, but respiratory function and inflammatory markers are not.

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Ciatto, S., T. Rubeca, R. Franceschini, C. Trevisiol, M. Confortini, G. Pontenani, and C. Lombardi. "On the Clinical Usefulness of the Free-to-Total Prostate-Specific Antigen Ratio." International Journal of Biological Markers 21, no. 1 (January 2006): 1–5. http://dx.doi.org/10.1177/172460080602100101.

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The free-to-total prostate-specific antigen ratio (F/T PSA) is associated with the presence of prostate cancer and is thus used as an indicator for suspicion of prostate cancer and as a determinant for biopsy. We reviewed a recent retrospective series of 966 consecutive prostate biopsies where F/T PSA was blindly determined and did not influence biopsy indication. We simulated the association of F/T PSA with biopsy outcome and its impact as a biopsy determinant. When adopting an F/T PSA cutoff of 10%, 13%, 16% or 20% among random sextant biopsies in the 4–10 ng/mL total PSA range, the sensitivity was 15%, 37%, 55% and 72% and the specificity 89%, 80%, 64% and 44%, respectively. Using F/T PSA as a biopsy determinant, from 1.7 to 2.6 cancer biopsies would have been delayed to avoid 10 benign biopsies. As this balance is not acceptable, F/T PSA has no role as a biopsy indicator and its clinical use is questionable.

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Burghel, George J., Unzela Khan, Wei-Yu Lin, William Whittaker, and Siddharth Banka. "Presence of pathogenic copy number variants (CNVs) is correlated with socioeconomic status." Journal of Medical Genetics 57, no. 1 (September 23, 2019): 70–72. http://dx.doi.org/10.1136/jmedgenet-2019-106292.

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Socioeconomic status (SES) is a major determinant of health. We studied the Index of Multiple Deprivation Rank of 473 families with individuals with pathogenic autosomal copy number variants (CNVs) and known inheritance status. The IMDR distribution of families with pathogenic CNVs was significantly different from the general population. Families with inherited CNVs were significantly more likely to be living in areas of higher deprivation when compared with families that had individuals with de novo CNVs. These results provide unique insights into biological determinants of SES. As CNVs are relatively frequent in the general population, these results have important medical and policy consequences.

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Maier, Smaranda, Zoltán Bajkó, Ruxandra Roșescu, Laura Bărcuțean, Emanuela Sărmășan, Septimiu Voidăzan, and Rodica Bălașa. "Sociodemographic and Clinical Determinants of Fatigue in Multiple Sclerosis." Life 13, no. 11 (October 29, 2023): 2132. http://dx.doi.org/10.3390/life13112132.

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Fatigue is the most common and disabling symptom in patients with multiple sclerosis (PwMS), representing one of the main determinants of reduced quality of life among PwMS due to its interference with social activities and work capacity. This study aimed to identify the sociodemographic determinants of fatigue in a cohort of 150 PwMS and 100 healthy controls (HCs). Fatigue was assessed using one of the most suitable and appropriate tools for measuring the degree of fatigue: the Modified Fatigue Impact Scale (MFIS). By comparing the median scores for the MFIS, we observed that the PwMS group had significantly higher MFIS scores than the HCs (p = 0.0001). In PwMS, MFIS scores correlated positively with age, total number of relapses, total disease duration, disability status, and Beck Depression Inventory-II score and negatively with cognitive performance. Patients with relapsing-remitting MS had significantly lower fatigue levels than those with secondary progressive MS (p = 0.0010). Fatigue levels were significantly lower among male than female PwMS (p = 0.0120). Other determinant factors of fatigue in our study proved to be the marital and occupational status, as well as the presence of children, but in a linear multivariate regressions analysis with MFIS score as the dependent variable, the fatigue levels were influenced only by sex, occupational status, marital status, children status, and BDI-II test results. Considering the significant impact of fatigue on the quality of life of PwMS, clinicians must diagnose fatigue as early as possible, identify its modifiable determinants, and manage it effectively to increase their quality of life.

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da Silva Souza, Cacilda, Cláudia Goldenstein-Schainberg, Sonia Maria Alvarenga Anti Loduca Lima, Natali Spelling Gormezano, Renata Ferreira Magalhães, and Roberto Ranza. "Clinical Specialty Setting as Determinant of Management of Psoriatic Arthritis." JCR: Journal of Clinical Rheumatology 28, no. 3 (December 15, 2021): 120–25. http://dx.doi.org/10.1097/rhu.0000000000001812.

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Sánchez-Céspedes, Javier, M. Dolores Blasco, Sara Marti, Elena Alcalde, Jordi Vila, Verónica Alba, and Consuelo Esteve. "Plasmid-Mediated QnrS2 Determinant from a Clinical Aeromonas veronii Isolate." Antimicrobial Agents and Chemotherapy 52, no. 8 (May 27, 2008): 2990–91. http://dx.doi.org/10.1128/aac.00287-08.

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Bondaryuk, Artem N., Nina V. Kulakova, Ulyana V. Potapova, Olga I. Belykh, Anzhelika V. Yudinceva, and Yurij S. Bukin. "Genomic Determinants Potentially Associated with Clinical Manifestations of Human-Pathogenic Tick-Borne Flaviviruses." International Journal of Molecular Sciences 23, no. 21 (November 2, 2022): 13404. http://dx.doi.org/10.3390/ijms232113404.

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The tick-borne flavivirus group contains at least five species that are pathogenic to humans, three of which induce encephalitis (tick-borne encephalitis virus, louping-ill virus, Powassan virus) and another two species induce hemorrhagic fever (Omsk hemorrhagic fever virus, Kyasanur Forest disease virus). To date, the molecular mechanisms responsible for these strikingly different clinical forms are not completely understood. Using a bioinformatic approach, we performed the analysis of each amino acid (aa) position in the alignment of 323 polyprotein sequences to calculate the fixation index (Fst) per site and find the regions (determinants) where sequences belonging to two designated groups were most different. Our algorithm revealed 36 potential determinants (Fst ranges from 0.91 to 1.0) located in all viral proteins except a capsid protein. In an envelope (E) protein, most of the determinants were located on the virion surface regions (domains II and III) and one (absolutely specific site 457) was located in the transmembrane region. Another 100% specific determinant site (E63D) with Fst = 1.0 was located in the central hydrophilic domain of the NS2b, which mediates NS3 protease activity. The NS5 protein contains the largest number of determinants (14) and two of them are absolutely specific (T226S, E290D) and are located near the RNA binding site 219 (methyltransferase domain) and the extension structure. We assume that even if not absolutely, highly specific sites, together with absolutely specific ones (Fst = 1.0) can play a supporting role in cell and tissue tropism determination.

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Endalifer, Melese Linger, and Gedefaw Diress. "Epidemiology and determinant factors of neural tube defect: Narrative review." Surgical Neurology International 11 (April 25, 2020): 81. http://dx.doi.org/10.25259/sni_84_2020.

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Background: The epidemiology of neural tube defect (NTD) is face ignorance from the global community. However, the problem is complex and it is a cause for child mortality and morbidity. We provide the latest insights with respect to determinant factors of NTD. Methods: Google Scholar and PubMed were systematically searched to identify potential research articles concerning the epidemiology and its determinant factors of NTD. Results: The epidemiology of Neural tube defects increased in some countries. The epidemiology and determinant factors were varies across countries,geographical regions and socioeconomic status of the populations. In general, the determinant factors of NTD were summarized as behavioral, nutrition-related, environmental, medical illness, and health service-related factors. Conclusion: Birth defect is fatal which affects the new generation; specifically, NTD is the problem of middle- and low-income countries. It is a direct cause for neonatal and perinatal mortality rate globally. Even if little factors identified, yet conducting experimental and clinical trial researches are a better approach to slow down the progress.

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Gospodarowicz, M. K., S. B. Sutcliffe, T. C. Brown, T. Chua, and R. S. Bush. "Patterns of disease in localized extranodal lymphomas." Journal of Clinical Oncology 5, no. 6 (June 1987): 875–80. http://dx.doi.org/10.1200/jco.1987.5.6.875.

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The site of origin of lymphoid tissue is an important determinant of lymphocyte migration patterns. The association of gastrointestinal (GI) and Waldeyer's ring lymphoma and the unique lymphocyte migration pattern of gut-associated lymphoid tissue (GALT) have been previously described. To establish whether predictive clinical patterns of disease occur in localized Non-Hodgkin's lymphoma, survival and relapse patterns for 496 patients with stage I and II non-Hodgkin's lymphoma (NHL) treated with loco-regional irradiation (XRT) alone were examined. We identified 139 patients with GALT lymphoma (defined as arising from primitive gut and including Waldeyers' ring, thyroid, and GI lymphomas) and 87 patients with extranodal non-gut-associated lymphoma (ENL). Survival and relapse data were assessed in multifactorial analysis to correct for previously identified other prognostic variables. GALT lymphomas (GALT-L) have a survival advantage compared with other ENL (P = .017) independent of stage and histology. A difference in distant relapse (DR) rate between GALT-L and other ENL (P = .0002) was also identified. The presentation site of localized extranodal NHL is predictive of clinical behavior and is an independent determinant of outcome. This may be an expression of lymphocytic origin and determinants of migration patterns.

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Benichou, G., E. Fedoseyeva, P. V. Lehmann, C. A. Olson, H. M. Geysen, M. McMillan, and E. E. Sercarz. "Limited T cell response to donor MHC peptides during allograft rejection. Implications for selective immune therapy in transplantation." Journal of Immunology 153, no. 3 (August 1, 1994): 938–45. http://dx.doi.org/10.4049/jimmunol.153.3.938.

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Abstract Previously, we have demonstrated that during allograft rejection, MHC molecules of the donor are processed and presented to alloreactive CD4+ T lymphocytes in the form of peptides associated with the MHC class II molecules of the recipient. There is an increasing body of evidence that this indirect pathway of allorecognition may play a major role in allograft rejection. Herein, we have used a series of overlapping MHC peptides progressing along the sequence of the donor MHC molecule in single residue steps. We have mapped all potential MHC Ag determinants to which T cell responses could be generated after s.c. injection of allogeneic splenocytes. We have shown that splenic T cell proliferative responses to the beta 1 domains of donor Ak, Ad, and A(s) mouse MHC class II molecules were directed toward a single immunodominant determinant in each of three donor/recipient combinations. Interestingly, after allogeneic spleen cell transplantation, an additional determinant on donor MHC could be detected in the draining lymph nodes. This result shows that the fine specificity of T cell response to donor transplantation Ags can differ between lymphoid organs. Then, we investigated whether limitation of T cell response to donor MHC peptides applies to the clinical situation of a graft. We have shown that after an allogeneic skin graft, self-restricted alloreactive T cells proliferated to the same determinant on the donor MHC molecule. These results indicate that immune intervention, such as tolerance induction to the dominant T cell determinant on donor MHC molecules, may be developed for the prevention of allograft rejection.

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Price, R. N., A. R. Hasugian, A. Ratcliff, H. Siswantoro, H. L. E. Purba, E. Kenangalem, N. Lindegardh, et al. "Clinical and Pharmacological Determinants of the Therapeutic Response to Dihydroartemisinin-Piperaquine for Drug-Resistant Malaria." Antimicrobial Agents and Chemotherapy 51, no. 11 (September 10, 2007): 4090–97. http://dx.doi.org/10.1128/aac.00486-07.

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ABSTRACT Dihydroartemisinin-piperaquine (DHP) is an important new treatment for drug-resistant malaria, although pharmacokinetic studies on the combination are limited. In Papua, Indonesia, we assessed determinants of the therapeutic efficacy of DHP for uncomplicated malaria. Plasma piperaquine concentrations were measured on day 7 and day 28, and the cumulative risk of parasitological failure at day 42 was calculated using survival analysis. Of the 598 patients in the evaluable population 342 had infections with Plasmodium falciparum, 83 with Plasmodium vivax, and 173 with a mixture of both species. The unadjusted cumulative risks of recurrence were 7.0% (95% confidence interval [CI]: 4.6 to 9.4%) for P. falciparum and 8.9% (95% CI: 6.0 to 12%) for P. vivax. After correcting for reinfections the risk of recrudescence with P. falciparum was 1.1% (95% CI: 0.1 to 2.1%). The major determinant of parasitological failure was the plasma piperaquine concentration. A concentration below 30 ng/ml on day 7 was observed in 38% (21/56) of children less than 15 years old and 22% (31/140) of adults (P = 0.04), even though the overall dose (mg per kg of body weight) in children was 9% higher than that in adults (P < 0.001). Patients with piperaquine levels below 30 ng/ml were more likely to have a recurrence with P. falciparum (hazard ratio [HR] = 6.6 [95% CI: 1.9 to 23]; P = 0.003) or P. vivax (HR = 9.0 [95% CI: 2.3 to 35]; P = 0.001). The plasma concentration of piperaquine on day 7 was the major determinant of the therapeutic response to DHP. Lower plasma piperaquine concentrations and higher failure rates in children suggest that dose revision may be warranted in this age group.

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Cattoir, Vincent, Laurent Poirel, and Patrice Nordmann. "Plasmid-Mediated Quinolone Resistance Determinant QnrB4 Identified in France in an Enterobacter cloacae Clinical Isolate Coexpressing a QnrS1 Determinant." Antimicrobial Agents and Chemotherapy 51, no. 7 (May 14, 2007): 2652–53. http://dx.doi.org/10.1128/aac.01616-06.

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Alsahafi, Akram, Davina Li Xin Ling, Micheál Newell, and Thomas Kropmans. "A systematic review of effective quality feedback measurement tools used in clinical skills assessment." MedEdPublish 12 (February 25, 2022): 11. http://dx.doi.org/10.12688/mep.18940.1.

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Background: Objective Structured Clinical Examination (OSCE) is a valid tool to assess the clinical skills of medical students. Feedback after OSCE is essential for student improvement and safe clinical practice. Many examiners do not provide helpful or insightful feedback in the text space provided after OSCE stations, which may adversely affect learning outcomes. The aim of this systematic review was to identify the best determinants for quality written feedback in the field of medicine. Methods: PubMed, Medline, Embase, CINHAL, Scopus, and Web of Science were searched for relevant literature up to February 2021. We included studies that described the quality of good/effective feedback in clinical skills assessment in the field of medicine. Four independent reviewers extracted determinants used to assess the quality of written feedback. The percentage agreement and kappa coefficients were calculated for each determinant. The ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool was used to assess the risk of bias. Results: 14 studies were included in this systematic review. 10 determinants were identified for assessing feedback. The determinants with the highest agreement among reviewers were specific, described gap, balanced, constructive and behavioural; with kappa values of 0.79, 0.45, 0.33, 0.33 and 0.26 respectively. All other determinants had low agreement (kappa values below 0.22) indicating that even though they have been used in the literature, they might not be applicable for good quality feedback. The risk of bias was low or moderate overall. Conclusions: This work suggests that good quality written feedback should be specific, balanced, and constructive in nature, and should describe the gap in student learning as well as observed behavioural actions in the exams. Integrating these determinants in OSCE assessment will help guide and support educators for providing effective feedback for the learner.

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Alsahafi, Akram, Davina Li Xin Ling, Micheál Newell, and Thomas Kropmans. "A systematic review of effective quality feedback measurement tools used in clinical skills assessment." MedEdPublish 12 (June 19, 2023): 11. http://dx.doi.org/10.12688/mep.18940.2.

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Background: Objective Structured Clinical Examination (OSCE) is a valid tool to assess the clinical skills of medical students. Feedback after OSCE is essential for student improvement and safe clinical practice. Many examiners do not provide helpful or insightful feedback in the text space provided after OSCE stations, which may adversely affect learning outcomes. The aim of this systematic review was to identify the best determinants for quality written feedback in the field of medicine. Methods: PubMed, Medline, Embase, CINHAL, Scopus, and Web of Science were searched for relevant literature up to February 2021. We included studies that described the quality of good/effective feedback in clinical skills assessment in the field of medicine. Four independent reviewers extracted determinants used to assess the quality of written feedback. The percentage agreement and kappa coefficients were calculated for each determinant. The ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool was used to assess the risk of bias. Results: 14 studies were included in this systematic review. 10 determinants were identified for assessing feedback. The determinants with the highest agreement among reviewers were specific, described gap, balanced, constructive and behavioural; with kappa values of 0.79, 0.45, 0.33, 0.33 and 0.26 respectively. All other determinants had low agreement (kappa values below 0.22) indicating that even though they have been used in the literature, they might not be applicable for good quality feedback. The risk of bias was low or moderate overall. Conclusions: This work suggests that good quality written feedback should be specific, balanced, and constructive in nature, and should describe the gap in student learning as well as observed behavioural actions in the exams. Integrating these determinants in OSCE assessment will help guide and support educators for providing effective feedback for the learner.

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Sokolov, P. L., N. V. Chebanenko, D. M. Mednaya, and V. V. Arkhipov. "Candidate Genes Associated with the Course of Epilepsy in Cerebral Palsy: Remission or Refractoriness." Personalized Psychiatry and Neurology 3, no. 2 (November 15, 2023): 48–53. http://dx.doi.org/10.52667/2712-9179-2023-3-2-48-53.

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Epilepsy often accompanies congenital cerebral palsy (CP). Canalopathies can be the cause of congenital epilepsy. The aim of the study is to determine the influence of various determinants on the course of epilepsy. Materials and methods: The results of clinical and genetic analysis of 136 cases of cerebral palsy (CP) with epilepsy are presented. The patients were divided into groups according to the syndromes according to the classification of CP (Panteliadis and R. Korinthenberg, 2005). Epileptic syndromes were divided into three groups: focal childhood epilepsy with structural brain changes and benign epileptiform discharges (BEDC) in EEG - 41 children (30.1%), structural focal epilepsy - 37 children (27.2%), epileptic encephalopathies 58 children (42.7%). Pathogenic variants in genes were confirmed by next generation sequencing (NGS) Sanger methods of venous blood. Results. Remission was more difficult to achieve in patients with determinants of regulation of general aspects of cellular metabolism, mitochondrial function, cytoskeleton formation and function, and transport across the outer membrane. The need for polypharmacy was in the groups that regulate the function of mitochondria, the formation and functioning of the cytoskeleton, and the regulation of membrane excitability. Conclusion. Determinant analysis provides a better understanding of the mechanisms of patient responsiveness to anticonvulsant therapy. The determinant of mitochondrial function most significantly affects its effectiveness. Probably, the violation of energy metabolism in the cell neutralizes the stabilization of the neuronal membrane under the influence of anticonvulsants. The determinant of the formation and functioning of the cytoskeleton, according to our preliminary data, is associated with the formation of malformations of the brain. In this case, the refractoriness of epilepsy can be secondary and determined by the severity of structural changes in the brain.

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Yoon, Eun-Jeong, and Seok Hoon Jeong. "MALDI-TOF Mass Spectrometry Technology as a Tool for the Rapid Diagnosis of Antimicrobial Resistance in Bacteria." Antibiotics 10, no. 8 (August 14, 2021): 982. http://dx.doi.org/10.3390/antibiotics10080982.

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Species identification by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a routine diagnostic process for infectious diseases in current clinical settings. The rapid, low-cost, and simple to conduct methodology is expanding its application in clinical microbiology laboratories to diagnose the antimicrobial resistance (AMR) in microorganisms. Primarily, antimicrobial susceptibility testing is able to be carried out either by comparing the area under curve of MALDI spectra of bacteria grown in media with antimicrobial drugs or by identifying the shift peaks of bacteria grown in media including 13C isotope with antimicrobial drugs. Secondly, the antimicrobial resistance is able to be determined through identifying (i) the antimicrobial-resistant clonal groups based on the fingerprints of the clone, (ii) the shift peak of the modified antimicrobial drug, which is inactivated by the resistance determinant, (iii) the shift peak of the modified antimicrobial target, (iv) the peak specific for the antimicrobial determinant, and (v) the biomarkers that are coproduced proteins with AMR determinants. This review aims to present the current usage of the MALDI-TOF MS technique for diagnosing antimicrobial resistance in bacteria, varied approaches for AMR diagnostics using the methodology, and the future applications of the methods for the accurate and rapid identification of AMR in infection-causing bacterial pathogens.

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Chen, Chunhui, Xiaogang Xu, Tingting Qu, Yunsong Yu, Chunmei Ying, Qinzhong Liu, Qinglan Guo, et al. "Prevalence of the fosfomycin-resistance determinant, fosB3, in Enterococcus faecium clinical isolates from China." Journal of Medical Microbiology 63, no. 11 (November 1, 2014): 1484–89. http://dx.doi.org/10.1099/jmm.0.077701-0.

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In order to investigate the prevalence of fosfomycin-resistance (fos) determinants in Enterococcus faecium, clinical strains were collected from hospitals throughout China between January 2008 and December 2009. Antimicrobial susceptibility testing was performed, after which the fos genes in all isolates and van genes in vancomycin-resistant isolates were characterized by PCR and sequencing. Conjugation experiments were carried out with fosB-positive E. faecium, DNA fragments flanking the fosB3 gene were sequenced and the genetic environment of fosB3 was analysed. Fosfomycin-resistant E. faecium (FREF) strains were characterized further by multilocus sequence typing (MLST) and PFGE. Among 145 E. faecium clinical isolates, 10 were resistant to fosfomycin with MICs >1024 mg l−1 including six vancomycin-resistant strains of which five were vanA-positive and the sixth vanM-positive. All ten FREF strains harboured the fosB3 gene. Fosfomycin resistance and fosB3 could be transferred by conjugation from nine isolates. The fosB3 and tnpA genes were located in a circular DNA intermediate in all FREF strains and reversely inserted into vanA transposon Tn1546 in four vanA-positive FREF isolates. Ten different PFGE types and seven MLST types were found among the ten fosB3-positive isolates, while all strains belonged to the common clonal complex CC17. In conclusion, the transferable fosfomycin-resistance determinant fosB3 plays an important role in E. faecium resistance to fosfomycin in China.

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Higgins, Stephen T., Sarah H. Heil, and Jennifer Plebani Lussier. "Clinical Implications of Reinforcement as a Determinant of Substance Use Disorders." Annual Review of Psychology 55, no. 1 (February 2004): 431–61. http://dx.doi.org/10.1146/annurev.psych.55.090902.142033.

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Singh, P. K. "Clinical and Radiological Determinant of Surgical Outcome of Lumbar Disc Disease." Global Spine Journal 4, no. 1_suppl (May 2014): s—0034–1376640—s—0034–1376640. http://dx.doi.org/10.1055/s-0034-1376640.

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Ryan, B. M., G. Murphy, and C. A. O’Morain. "Host cytokine responses toHelicobacter pylori: an important determinant of clinical outcome." Irish Journal of Medical Science 170, no. 2 (April 2001): 90–91. http://dx.doi.org/10.1007/bf03168814.

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Alonso, Ana, Patricia Sanchez, and José L. Martínez. "Stenotrophomonas maltophilia D457R Contains a Cluster of Genes from Gram-Positive Bacteria Involved in Antibiotic and Heavy Metal Resistance." Antimicrobial Agents and Chemotherapy 44, no. 7 (July 1, 2000): 1778–82. http://dx.doi.org/10.1128/aac.44.7.1778-1782.2000.

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ABSTRACT A cluster of genes involved in antibiotic and heavy metal resistance has been characterized from a clinical isolate of the gram-negative bacterium Stenotrophomonas maltophilia. These genes include a macrolide phosphotransferase (mphBM) and a cadmium efflux determinant (cadA), together with the genecadC coding for its transcriptional regulator. ThecadC cadA region is flanked by a truncated IS257 sequence and a region coding for a bin3invertase. Despite their presence in a gram-negative bacterium, these genetic elements share a common gram-positive origin. The possible origin of these determinants as a remnant composite transposon as well as the role of gene transfer between gram-positive and gram-negative bacteria for the acquisition of antibiotic resistance determinants in chronic, mixed infections is discussed.

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Hutagaol, Iin Octaviana, Hepti Mulyati, Pesta Corry Sihotang, Evi Setyawati, and Hasnidar. "Determinant Analysis of the Onset Postpartum Women’s Lactation." International Journal of Psychosocial Rehabilitation 24, Special Issue 1 (February 28, 2020): 1081–90. http://dx.doi.org/10.37200/ijpr/v24sp1/pr201254.

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Shetty, Naresh, Sanath Shetty, Hasan Sarfaraz, Syed Ghouse Ahmed, and Fahad Mohammad. "Influence of Anterior Guidance on the Inclination of Horizontal Condylar Guidance in Dentulous Subjects - A Clinical Study." Journal of Evolution of Medical and Dental Sciences 10, no. 28 (July 12, 2021): 2072–77. http://dx.doi.org/10.14260/jemds/2021/424.

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BACKGROUND One of the most widely used methods to record horizontal condylar guidance is the use of protrusive interocclusal records. Therefore, this study was done to evaluate the reliability of protrusive interocclusal record with and without the influence of anterior determinant on horizontal condylar guidance among dentulous patients. METHODS Diagnostic impressions of 21 participants were made and casts were poured. Facebow record were obtained and transferred to semi-adjustable articulator. Protrusive interocclusal records were made using Alu-wax. In group 1, protrusive interocclusal records were obtained at incisal edge to edge position (conventional method). In group 2, 3 and 4 protrusive interocclusal records were obtained at a distance of 4 mm, 6 mm and at incisal edge to edge position respectively using a customized flat anterior jig. Programming of the Hanau articulator were done for all the 4 groups. One-way ANOVA test and Pearson’s correlation tests were done to compare and correlate horizontal condylar guidance. RESULTS The mean values obtained for flat anterior jig at incisal edge to edge position, at 4 mm and 6 mm provided good Pearson correlation values for the right (R = 0.773, R = 0.779, R = 0.632) as well as the left side (R = 0.631, R = 0.601, R = 0.545) respectively, on comparison with the conventional incisal edge to edge values. This indicated a positive correlation which was statistically significant. CONCLUSIONS The horizontal condylar guidance is influenced by anterior determinant. Therefore, the reliability of protrusive records is dependent on eliminating the influence of anterior determinant. KEY WORDS Horizontal Condylar Guidance, Anterior Determinant, Protrusive Interocclusal Records

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Li, Feng, Lei Zhang, Li-Da Wu, Zhi-Yuan Zhang, Huan-Huan Liu, Zhen-Ye Zhang, Jie Zhang, Ling-Ling Qian, and Ru-Xing Wang. "Do Elderly Patients with Atrial Fibrillation Have Comparable Ablation Outcomes Compared to Younger Ones? Evidence from Pooled Clinical Studies." Journal of Clinical Medicine 11, no. 15 (July 31, 2022): 4468. http://dx.doi.org/10.3390/jcm11154468.

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Background: Age is an independent risk factor of the progress and prognosis of atrial fibrillation (AF). However, ablation outcomes between elderly and younger patients with AF remain elusive. Methods: Cochrane Library, Embase, PubMed, and Web of Science were systematically searched up to 1 April 2022. Studies comparing AF ablation outcomes between elderly and younger patients and comprising outcomes of AF ablation for elderly patients were included. Trial sequential analysis (TSA) was performed to adjust for random error and lower statistical power in our meta-analysis. Subgroup analysis identified possible determinants of outcome impact for elderly patients after ablation. Moreover, linear and quadratic prediction fit plots with confidence intervals were performed, as appropriate. Results: A total of 27 studies with 113,106 AF patients were eligible. Compared with the younger group, the elderly group was significantly associated with a lower rate of freedom from AF (risk ratio [RR], 0.95; p = 0.008), as well as a higher incidence of safety outcomes (cerebrovascular events: RR, 1.64; p = 0.000; serious hemorrhage complications: RR, 1.50; p = 0.035; all-cause death: RR, 2.61; p = 0.003). Subgroup analysis and quadratic prediction fit analysis revealed the follow-up time was the potential determinant of freedom from AF for elderly patients after AF ablation. Conclusions: Our meta-analysis suggests that elderly patients may have inferior efficacy and safety outcomes to younger patients with AF ablation. Moreover, the follow-up time may be a potential determinant of outcome impact on freedom from AF for elderly patients after AF ablation.

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Kvam, Augusta I., Rooyen T. Mavenyengwa, Andreas Radtke, and Johan A. Maeland. "Streptococcus agalactiae Alpha-Like Protein 1 Possesses Both Cross-Reacting and Alp1-Specific Epitopes." Clinical and Vaccine Immunology 18, no. 8 (June 8, 2011): 1365–70. http://dx.doi.org/10.1128/cvi.05005-11.

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ABSTRACTMost isolates of group B streptococci (GBS) express an alpha-like protein (Alp), Cα (encoded bybca), Alp1 (also called epsilon;alp1), Alp2 (alp2), Alp3 (alp3), Alp4 (alp4), or R4/Rib (rib). These proteins are chimeras with a mosaic structure and with antigenic determinants with variable immunological cross-reactivities between the Alps, including Alp1 and Cα cross-reactivity. This study focused on antigenic domains of Alp1, studied by using rabbit antisera in immunofluorescence, Western blotting, and enzyme-linked immunosorbent assay (ELISA)-based tests and whole cells of GBS or trypsin-extracted and partially purified antigens from the strains A909 (serotype Ia/Cα, Cβ) and 335 (Ia/Alp1). Alp1 and Cα shared an antigenic determinant, Alp1/Cα common, not harbored by other Alps, probably located in the Alp1 and Cα repeat units, as these units are nearly identical in genomic sequence. An antigenic Alp1 determinant was Alp1 specific and was most likely located in the N-terminal unit of Alp1 in which an Alp1-specific primer site for PCR is also located. In addition, Alp1 possessed a domain with low immunogenicity which cross-reacted immunologically with Alp2 and Alp3, with unknown location in Alp1. Alp1 was partially degraded by trypsin during antigen extraction but with the antigenic domains preserved. The results indicate that Cα and Alp1 are immunologically related in the same manner that R4 (Rib) and Alp3 are related. The domain called Alp1 specific should be important in GBS serotyping as a surface-anchored serosubtype marker. The Alp1/Cα common determinant may be of prime interest as an immunogenic domain in a GBS vaccine.

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Heimer, Susan R., David A. Rasko, C. Virginia Lockatell, David E. Johnson, and Harry L. T. Mobley. "Autotransporter Genes pic and tsh Are Associated with Escherichia coli Strains That Cause Acute Pyelonephritis and Are Expressed during Urinary Tract Infection." Infection and Immunity 72, no. 1 (January 2004): 593–97. http://dx.doi.org/10.1128/iai.72.1.593-597.2004.

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ABSTRACT We have identified two chromosomal open reading frames in uropathogenic Escherichia coli (UPEC) strain CFT073 which are highly homologous to serine protease autotransporters Pic and Tsh. Both cloned determinants were correlated with the presence of 105- to 110-kDa proteins in the culture supernatants. Furthermore, in cellular fractionation experiments, 30-kDa polypeptides were identified in the outer membrane; we speculated that these proteins are the β-barrel portions of the autotransporter homologues. Furthermore, Pic-containing culture supernatants have serine protease activity. In reverse transcription-PCR analyses, the expression of the pic and tsh genes in E. coli CFT073 was higher in broth cultures grown at 37°C than at 25°C. Moreover, pic and tsh were expressed by bacteria isolated from urine of transurethrally infected mice. The tsh determinant was identified in 63% of our clinical UPEC strain isolates (n = 87) and in 33% of fecal strains (n = 27), whereas pic was present in 31% of the pyelonephritis (n = 67) and 7% of the fecal strains. There was no significant correlation between cystitis strains (n = 20) and the pic determinant.

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Schultz, Anja, Viola Hoffacker, Annette Wilisch, Wilfried Nix, Ralf Gold, Berthold Schalke, Socrates Tzartos, Hans-Konrad M�ller-Hermelink, and Alexander Marx. "Neurofilament is an autoantigenic determinant in myasthenia gravis." Annals of Neurology 46, no. 2 (August 1999): 167–75. http://dx.doi.org/10.1002/1531-8249(199908)46:2<167::aid-ana5>3.0.co;2-3.

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Shields, Ian W., and V. Jane Knox. "Level of processing as a determinant of hypnotic hypermnesia." Journal of Abnormal Psychology 95, no. 4 (1986): 358–64. http://dx.doi.org/10.1037/0021-843x.95.4.358.

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Rogawski, Michael A., and Michael R. Johnson. "Intrinsic Severity as a Determinant of Antiepileptic Drug Refractoriness." Epilepsy Currents 8, no. 5 (September 2008): 127–30. http://dx.doi.org/10.1111/j.1535-7511.2008.00272.x.

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du Plessis, Mignon, Edouard Bingen, and Keith P. Klugman. "Analysis of Penicillin-Binding Protein Genes of Clinical Isolates of Streptococcus pneumoniae with Reduced Susceptibility to Amoxicillin." Antimicrobial Agents and Chemotherapy 46, no. 8 (August 2002): 2349–57. http://dx.doi.org/10.1128/aac.46.8.2349-2357.2002.

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ABSTRACT The recent emergence of pneumococcal isolates exhibiting an unusual resistance phenotype of higher amoxicillin MICs in relation to the penicillin MICs prompted an analysis of the pbp genes from three such strains isolated in France. For comparison, three amoxicillin-susceptible strains were included in the study. DNA sequence analysis of the pbp2x, pbp2b, and pbp1a genes revealed extensive sequence divergence in all six isolates compared to the sequences of the genes of penicillin-susceptible strain R6. With the exception of pbp2b, no amino acid mutations were unique to the resistant isolates. Transformation experiments with cloned pbp genes isolated from one of the resistant isolates demonstrated a stepwise development of amoxicillin resistance involving penicillin-binding proteins (PBPs) 2X, 2B, and 1A. Full resistance, equivalent to that of the donor strain, was achieved only when genomic DNA was transformed into R62x/2b/1a mutants, suggesting that full resistance development in this isolate is mediated by a non-PBP determinant. Moreover, the recently identified murMN resistance determinant does not appear to have any impact on resistance in this isolate. This determinant (from the French isolate) was, however, able to transform an R6 mutant harboring pbp2x, pbp2b, and pbp1a genes from a Hungarian clone with an extremely high level of penicillin resistance so that it had increased levels of penicillin resistance. These results indicate that the development of high-level β-lactam resistance is a complex process and that the involvement of MurMN in penicillin resistance appears to be dependent on specific mutations in PBPs 2X, 2B, and/or 1A. Furthermore, an additional (as yet unidentified) non-PBP-mediated resistance determinant is required for full resistance development in some pneumococci.

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Zhou, Yihan, and Shan Ding. "Key Determinants of Immune-Mediated Adverse Reactions to Oncology Drugs." Cancers 15, no. 23 (November 28, 2023): 5622. http://dx.doi.org/10.3390/cancers15235622.

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To overcome the epidemiological severity of cancer, developing effective treatments is urgently required. In response, immune checkpoint inhibitors (ICIs) have been revealed as a promising resolution for treatment-resistant cancers across the world. Yet, they have both advantages and disadvantages, bringing therapeutic benefits while simultaneously inducing toxicity, and in particular, immune-mediated adverse drug reactions (imADRs), to the human body. These imADRs can be pathogenic and sometimes lethal, hampering health prediction and monitoring following the provision of ICI treatment. Therefore, it is necessary to collectively identify the determinant factors that contribute to these imADRs induced by ICIs. This article evaluated treatment-, tumor-, and patient-related determinants, and indicated a research gap for future investigations on the pathogenic mechanism of imADRs and translational conversion of determinants into clinical biomarkers to aid pharmacovigilance and cancer therapies.

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Chavadi, Manjunath, Rahul Narasanna, Ashajyothi Chavan, Ajay Kumar Oli, and Chandrakanth Kelmani. R. "Prevalence of Methicillin Resistant and Virulence Determinants in Clinical Isolates of Staphylococcus aureus." Open Infectious Diseases Journal 10, no. 1 (August 13, 2018): 108–15. http://dx.doi.org/10.2174/1874279301810010108.

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Introduction:Methicillin-resistantStaphylococcus aureus(MRSA) is the major threat that is a result of the uncontrolled use of antibiotics causing a huge loss in health, so understanding their prevalence is necessary as a public health measure.Objective:The aim of this study was to determine the prevalence of methicillin-resistant MRSA and virulence determinant among associatedS. aureusfrom the clinical samples obtained from various hospital and health care centers of the Gulbarga region in India.Materials and Methods:All the collected samples were subjected for the screening ofS. aureusand were further characterized by conventional and molecular methods including their antibiotic profiling. Further, the response of methicillin antibiotic on cell morphology was studied using scanning electron microscopy.Results:A total 126S. aureuswas isolated from the clinical samples which showed, 100% resistant to penicillin, 55.5% to oxacillin, 75.3% to ampicillin, 70.6% to streptomycin, 66.6% to gentamicin, 8.7% to vancomycin and 6.3% to teicoplanin. The selected MRSA strains were found to possessmecA(gene coding for penicillin-binding protein 2A) andfemA(factor essential for methicillin resistance)genetic determinants in their genome with virulence determinants such as Coagulase (coa) and the X region of the protein A (spa)gene. Further, the methicillin response in resistantS. aureusshowed to be enlarged and malformed on cell morphology.Conclusion:The molecular typing of clinical isolates ofS. aureusin this study was highly virulent and also resistant to methicillin; this will assist health professionals to control, exploration of alternative medicines and new approaches to combat Staphylococcal infections more efficiently by using targeted therapy.

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Bastari, Ary, Hamidah, and Hapzi Ali. "DETERMINANT SERVICE PERFORMANCE THROUGH MOTIVATION ANALYSIS AND TRANSFORMATIONAL LEADERSHIP." International Journal of Psychosocial Rehabilitation 24, no. 04 (February 29, 2020): 1355–72. http://dx.doi.org/10.37200/ijpr/v24i4/pr201108.

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Down, P. M., M. J. Green, and C. D. Hudson. "Rate of transmission: A major determinant of the cost of clinical mastitis." Journal of Dairy Science 96, no. 10 (October 2013): 6301–14. http://dx.doi.org/10.3168/jds.2012-6470.

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Journal articles on the topic 'Clinical determinant'

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