bluuebunny/crossref_metadata_2025 huggingface dataset:
Glomerular disease search filters for Pubmed, Ovid Medline, and Embase: a development and validation study
Authors: Hildebrand Ainslie M , Iansavichus Arthur V , Lee Christopher WC , Haynes R Brian , Wilczynski Nancy L , McKibbon K Ann , Hladunewich Michelle A , Clark William F , Cattran Daniel C , Garg Amit X
Published: June 2012

Background

Tools to enhance physician searches of Medline and other bibliographic databases have potential to improve the application of new knowledge in patient care. This is particularly true for articles about glomerular disease, which are published across multiple disciplines and are often difficult to track down. Our objective was to develop and test search filters for PubMed, Ovid Medline, and Embase that allow physicians to search within a subset of the database to retrieve articles relevant to glomerular disease.

Methods

We used a diagnostic test assessment framework with development and validation phases. We read a total of 22,992 full text articles for relevance and assigned them to the development or validation set to define the reference standard. We then used combinations of search terms to develop 997,298 unique glomerular disease filters. Outcome measures for each filter included sensitivity, specificity, precision, and accuracy. We selected optimal sensitive and specific search filters for each database and applied them to the validation set to test performance.

Results

High performance filters achieved at least 93.8% sensitivity and specificity in the development set. Filters optimized for sensitivity reached at least 96.7% sensitivity and filters optimized for specificity reached at least 98.4% specificity. Performance of these filters was consistent in the validation set and similar among all three databases.

Conclusions

PubMed, Ovid Medline, and Embase can be filtered for articles relevant to glomerular disease in a reliable manner. These filters can now be used to facilitate physician searching.
Can echocardiographic particle image velocimetry correctly detect motion patterns as they occur in blood inside heart chambers? A validation study using moving phantoms
Authors: Prinz Christian , Faludi Reka , Walker Andrew , Amzulescu Mihaela , Gao Hang , Uejima Tokuhisa , Fraser Alan G , Voigt Jens-Uwe
Published: June 2012

Aims

To validate Echo Particle Image Velocimetry (PIV)

Methods

High fidelity string and rotating phantoms moving with different speed patterns were imaged with different high-end ultrasound systems at varying insonation angles and frame rates. Images were analyzed for velocity and direction and for complex motion patterns of blood flow with dedicated software. Post-processing was done with MATLAB-based tools (Dflow, JUV, University Leuven).

Results

Velocity estimation was accurate up to a velocity of 42 cm/s (r = 0.99, p < 0.001, mean difference 0.4 ± 2 cm/s). Maximally detectable velocity, however, was strongly dependent on frame rate and insonation angle and reached 42 cm/s under optimal conditions. At higher velocities estimates became random. Direction estimates did depend less on velocity and were accurate in 80-90%. In-plane motion patterns were correctly identified with three ultrasound systems.

Conclusion

Echo-PIV appears feasible. Velocity estimates are accurate, but the maximal detectable velocity depends strongly on acquisition parameters. Direction estimation works sufficiently, even at higher velocities. Echo-PIV appears to be a promising technical approach to investigate flow patterns by echocardiography.
Direct synthesis of vertically aligned ZnO nanowires on FTO substrates using a CVD method and the improvement of photovoltaic performance
Authors: Lu Liyou , Chen Jiajun , Li Lijuan , Wang Wenyong
Published: June 2012

In this work, we report a direct synthesis of vertically aligned ZnO nanowires on fluorine-doped tin oxide-coated substrates using the chemical vapor deposition (CVD) method. ZnO nanowires with a length of more than 30 μm were synthesized, and dye-sensitized solar cells (DSSCs) based on the as-grown nanowires were fabricated, which showed improvement of the device performance compared to those fabricated using transferred ZnO nanowires. Dependence of the cell performance on nanowire length and annealing temperature was also examined. This synthesis method provided a straightforward, one-step CVD process to grow relatively long ZnO nanowires and avoided subsequent nanowire transfer process, which simplified DSSC fabrication and improved cell performance.
Suspended hybrid films assembled from thiol-capped gold nanoparticles
Authors: Zhang Yu Xin , Huang Ming , Hao Xiao Dong , Dong Meng , Li Xin Lu , Huang Jia Mu
Published: June 2012

In this work, we explored the formation processes of suspended hybrid thin films of thiol-capped Au nanoparticles (AuNPs) inside metal oxide tubular structures. We found that a balance between in-film interactions of the AuNPs and boundary interactions with metal oxides is a key in making these special organic–inorganic thin films. The hybrid films process many processing advantages and flexibilities, such as controllable film thickness, interfacial shape and inter-AuNPs distance, tuning of particle sizes, thiol population, chain lengths, and other new properties by introducing functional groups to thiol chains. Among their many unique features, the assembly-disassembly property may be useful for future on-off or store-release applications.
An information transmission model for transcription factor binding at regulatory DNA sites
Authors: Tan Mingfeng , Yu Dong , Jin Yuan , Dou Lei , LI Beiping , Wang Yuelan , Yue Junjie , Liang Long
Published: June 2012

Background

Computational identification of transcription factor binding sites (TFBSs) is a rapid, cost-efficient way to locate unknown regulatory elements. With increased potential for high-throughput genome sequencing, the availability of accurate computational methods for TFBS prediction has never been as important as it currently is. To date, identifying TFBSs with high sensitivity and specificity is still an open challenge, necessitating the development of novel models for predicting transcription factor-binding regulatory DNA elements.

Results

Based on the information theory, we propose a model for transcription factor binding of regulatory DNA sites. Our model incorporates position interdependencies in effective ways. The model computes the information transferred (TI) between the transcription factor and the TFBS during the binding process and uses TI as the criterion to determine whether the sequence motif is a possible TFBS. Based on this model, we developed a computational method to identify TFBSs. By theoretically proving and testing our model using both real and artificial data, we found that our model provides highly accurate predictive results.

Conclusions

In this study, we present a novel model for transcription factor binding regulatory DNA sites. The model can provide an increased ability to detect TFBSs.
A long diagnostic delay in patients with Hereditary Haemorrhagic Telangiectasia: a questionnaire-based retrospective study
Authors: Pierucci Paola , Lenato Gennaro M , Suppressa Patrizia , Lastella Patrizia , Triggiani Vincenzo , Valerio Raffaella , Comelli Mario , Salvante Daniela , Stella Alessandro , Resta Nicoletta , Logroscino Giancarlo , Resta Francesco , Sabbà Carlo
Published: June 2012

Background

The difficulty in establishing a timely correct diagnosis is a relevant matter of concern for several rare diseases. Many rare-disease-affected patients suffer from considerable diagnostic delay, mainly due to their poor knowledge among healthcare professionals, insufficient disease awareness among patients’ families, and lack of promptly available diagnostic tools. Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal-dominantly inherited vascular dysplasia, affecting 1:5,000-10,000 patients. HHT is characterized by high variability of clinical manifestations, which show remarkable overlapping with several common diseases.

Aim

To perform a detailed analysis concerning the diagnostic time lag occurring in patients with HHT, defined as the time period spanning from the first clinical manifestation to the attainment of a definite, correct diagnosis.

Methods

A questionnaire was administered to the HHT patients previously recruited from 2000 and 2009. Clinical onset, first referral to a physician for disease manifestations, and first correct diagnosis of definite HHT were collected. Eventual misdiagnosis at first referral and serious complications occurring throughout the time elapsing between disease onset and definite diagnosis were also addressed.

Results

In the 233 respondents, the clinical onset of disease occurred at an age of 14.1 yrs, while the age of first referral and the age of first definite diagnosis of HHT were 29.2 yrs and 40.1 yrs, respectively. Only 88/233 patients received a correct diagnosis at first counseling. Thus, the diagnostic time lag, represented by the time elapsing from disease onset and first definite diagnosis of HHT, proved to be 25.7 yrs. Twenty-two patients suffered from severe complications during this time interval. The diagnostic delay was significantly longer (p < 0.001) in index patients (first patients who attained definite HHT diagnosis in a given family) than in non-index patients (relative of index patients). The diagnostic time lag was also significantly associated with education grade (p < 0.001).

Conclusions

Our data report for the first time a systematic inquiry of diagnostic delay in HHT showing that patients receive a definite diagnosis only after nearly three decades from disease onset. Concerted efforts are still to be made to increase awareness of this disease among both families and physicians.
Potential utility of eGFP-expressing NOG mice (NOG-EGFP) as a high purity cancer sampling system
Authors: Shima Kentaro , Mizuma Masamichi , Hayashi Hiroki , Nakagawa Kei , Okada Takaho , Sakata Naoaki , Omura Noriyuki , Kitamura Yo , Motoi Fuyuhiko , Rikiyama Toshiki , Katayose Yu , Egawa Shinichi , Ishii Naoto , Horii Akira , Unno Michiaki
Published: June 2012

Purpose

It is still technically difficult to collect high purity cancer cells from tumor tissues, which contain noncancerous cells. We hypothesized that xenograft models of NOG mice expressing enhanced green fluorescent protein (eGFP), referred to as NOG-EGFP mice, may be useful for obtaining such high purity cancer cells for detailed molecular and cellular analyses.

Methods

Pancreato-biliary cancer cell lines were implanted subcutaneously to compare the tumorigenicity between NOG-EGFP mice and nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice. To obtain high purity cancer cells, the subcutaneous tumors were harvested from the mice and enzymatically dissociated into single-cell suspensions. Then, the cells were sorted by fluorescence-activated cell sorting (FACS) for separation of the host cells and the cancer cells. Thereafter, the contamination rate of host cells in collected cancer cells was quantified by using FACS analysis. The viability of cancer cells after FACS sorting was evaluated by cell culture and subsequent subcutaneous reimplantation in NOG-EGFP mice.

Results

The tumorigenicity of NOG-EGFP mice was significantly better than that of NOD/SCID mice in all of the analyzed cell lines (p < 0.01). Sorting procedures enabled an almost pure collection of cancer cells with only slight contamination by host cells. Reimplantation of the sorted cancer cells formed tumors again, which demonstrated that cell viability after sorting was well maintained.

Conclusions

This method provides a novel cancer sampling system for molecular and cellular analysis with high accuracy and should contribute to the development of personalized medicine.
Fasting Induces CART Down-Regulation in the Zebrafish Nervous System in a Cannabinoid Receptor 1-Dependent Manner
Authors: Nishio Shin-Ichi , Gibert Yann , Berekelya Liubov , Bernard Laure , Brunet Frédéric , Guillot Etienne , Le Bail Jean-Christophe , Sánchez Juan Antonio , Galzin Anne Marie , Triqueneaux Gerard , Laudet Vincent
Published: June 2012

Central and peripheral mechanisms modulate food intake and energy balance in mammals and the precise role of the type 1 cannabinoid receptor (CB1) in these processes is still being explored. Using the zebrafish, Danio rerio, we show that rimonabant, a CB1-specific antagonist with an EC50 of 5.15 × 10−8 m, decreases embryonic yolk sac reserve use. We reveal a developmental overlap between CART genes and CB1 expression in the hypothalamus and medulla oblongata, two brain structures that play crucial roles in appetite regulation in mammals. We show that morpholino knockdown of CB1 or fasting decreases cocaine- and amphetamine-related transcript (CART)-3 expression. Strikingly, this down-regulation occurs only in regions coexpressing CB1 and CART3, reinforcing the link between CB1, CART, and appetite regulation. We show that rimonabant treatment impairs the fasting-induced down-regulation of CART expression in specific brain regions, whereas vehicle alone-treated embryos do not display this rescue of CART expression. Our data reveal that CB1 lies upstream of CART and signals the appetite through the down-regulation of CART expression. Thus, our results establish the zebrafish as a promising system to study appetite regulation.
BDNF Alters ERK/p38 MAPK Activity Ratios to Promote Differentiation in Growth Plate Chondrocytes
Authors: Hutchison Michele R.
Published: June 2012

The ERK and p38 MAPK pathways are well-known transducers of signals that regulate proliferation and differentiation, but precisely how these pathways control growth plate chondrocyte development is unclear. For example, the ERK pathway has been reported to be required by some investigators but inhibitory to chondrocyte development by others. Moreover, how these two pathways interact to regulate chondrocyte development is even less clear. Using primary bovine growth plate chondrocytes and murine ATDC5 cells, we demonstrate that the ERK and p38 pathways have opposing effects on proliferation but are both absolutely required for differentiation. Two factors that promote chondrocyte differentiation, brain-derived neurotrophic factor (BDNF) and C-type natriuretic peptide, increase p38 activity while decreasing, but not completely inhibiting, ERK activity. The attenuation of ERK activity by BDNF occurs via p38-dependent raf-1 inhibition. The inhibition of raf-1 by p38 is direct, because purified p38 protein inhibits the kinase activity of purified active raf-1 as well as raf-1 immunoprecipitated from chondrocyte lysates. Moreover, IGF-I, which stimulates proliferation, suppresses p38 activation. This work describes a model wherein unopposed IGF-I promotes high ERK/p38 activity ratios favoring proliferation, whereas BDNF signals a transition to differentiation by decreasing the ERK/p38 activity ratio without completely inhibiting ERK, which involves the direct inhibition of raf-1 by p38.
The Patient Protection and Affordable Care Act: The Victory of Unorthodox Lawmaking
Authors: Beaussier Anne-Laure
Published: June 2012

The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as “unorthodox lawmaking,” enabled the Democratic leadership to overcome multiple institutional and political veto players.
The Evolution of an Innovation: Variations in Medicaid Managed Care Program Extensiveness
Authors: Kim Ae-Sook , Jennings Edward
Published: June 2012

This article utilizes a theoretical framework of policy innovation, diffusion, and reinvention to investigate the evolving nature of Medicaid managed care programs over time. By estimating two separate models, one for primary care case management (PCCM) and a second for risk-based program enrollment, this study seeks to disentangle two different paths of learning (internal and external), investigate the potential effects of vertical diffusion of policy, and examine the impact of internal state characteristics on the extent of Medicaid managed care. With respect to diffusion and learning, the data reveal that earlier adopters implement more extensive programs. The data fail to reveal much internal learning, although there is evidence of some. External impacts are clear: managed care enrollments in neighboring states and changes in the federal waiver process affect states' decisions. Other policy choices are important: states with more generous Medicaid eligibility rules implement more extensive managed care programs. Complementing other studies of Medicaid, we find that politics and economics make a difference for the extent of managed care programs; unlike other Medicaid studies, we find no effect of race and ethnicity.
Temperature dependence of current-voltage characteristics in μc-Si:H and pm-Si:H PIN structures
Authors: Avila Francisco Temoltzi , Kosarev Andrey , Cosme Ismael , Moreno Mario , Cabarrocas P. Roca y
Published: June 2012

The dark current-voltage characteristics of PIN structures are studied and analyzed for PV samples as for integral device without taking account the performance of the different elements typically used in equivalent circuit model such as diode n-factor, shunt and series resistances. The contribution of all these elements is very important in the development of devices because they determine the performance characteristics. In this work we have studied and compared the temperature dependence of current-voltage characteristics in μc-Si:H and pm-Si:H p-i-n structures having approximately the same efficiencies with emphasis on their different electronic characteristics such as shunt (Rsh) and series (Rs) resistance, ideality factor (n), and the saturation current (Is), which give us some ideas on role of these elements. In the pm-Si:H cell it was observed that the Rs increases with the increase of the temperature in contrast to the μc-Si:H structures, where the series resistance reduces with temperature change from T = 300 up to 480K. In both the pm-Si:H and μc-Si:H samples Rshreduces with temperature change from 300 up to 480 K. The ideality factor in the pm-Si:H structure shows an increase, and in μc-Si:H a reduction, when temperature increases. Saturation current in both cases increases with temperature as it was expected. From the saturation current it was obtained the build-in potential. Analysis behavior of both saturation current and n-factor with temperature shows that build-in potential increases with temperature in the pm-Si:H, but reduces in μc-Si:H structure.
Model-based Quantitative Assessment of Crystallinity and Parasitic Absorption in Microcrystalline Silicon Solar Cells
Authors: Lanz Thomas , Battaglia Corsin , Ballif Christophe , Ruhstaller Beat
Published: June 2012

We investigate the influence of the crystallinity of the absorber layer and parasitic absorption in the doped layers and electrodes on the external quantum efficiency and reflection of microcrystalline silicon (μc-Si:H) solar cells. Using an optical light scattering model we systematically study variations in the crystallinity and validate a simple normalization procedure that allows assessing the gains that can be achieved by reducing the parasitic absorption. The optimization potential is demonstrated with solar cell samples with increased crystallinity and eliminated parasitic absorption.
Effect of Si2H6 as a gas phase additive to increase growth rate of a-Si:H films and solar cells
Authors: Zhu Lala , Das Ujjwal K , Das Chandan , Hegedus Steven S
Published: June 2012

We have studied the growth rate enhancement of a-Si:H films using Si2H6 as a gas phase additive to SiH4+ H2 gas mixtures using relatively low pressure and standard 13.56 MHz RF power. With the addition of 1.7% Si2H6 in the gas mixtures (10% more Si atoms into the chamber), the a-Si:H film growth rate increased by ∼30% at 1.25 Torr and ∼60% at 2.5 Torr. The optical emission spectroscopy (OES) exhibits reduction of SiH* intensity with addition of Si2H6, which indicates the reduction of high energy electron impacts with Si containing molecules. The microstructural defect parameter (fraction of dihydride bonding in the film) appears to decrease with increase of RF power (i.e. increase of growth rate). Similar a-Si:H p-i-n cell efficiency 7-8% is achieved with and without enhanced i layer growth rate with the Si2H6additive.
Nonvolatile Power-Gating FPGA Based on Pseudo-Spin-Transistor Architecture with Spin-Transfer-Torque MTJs
Authors: Yamamoto Shuu’ichirou , Shuto Yusuke , Sugahara Satoshi
Published: June 2012

We proposed and computationally analyzed a nonvolatile power-gating field programmable gate array (NVPG-FPGA) based on pseudo-spin-transistor architecture with spin-transfer-torque magnetic tunnel junctions (STT-MTJs). The circuit employs nonvolatile static random memory (NV-SRAM) cells and nonvolatile flip-flops (NV-FFs) as the storage circuits. The circuit configuration and microarchitecture are compatible with SRAM-based FPGAs, and the additional nonvolatile memory functionality makes it possible to execute efficient power-gating (PG). Break-even time (BET) for the nonvolatile configuration logic block (NV-CLB) of the NVPG-FPGA was also analyzed, and reduction techniques of the BET were proposed, which allows highly efficient PG operations with a fine granularity.
Flexible and practical modeling of animal telemetry data: hidden Markov models and extensions
Authors: Langrock Roland , King Ruth , Matthiopoulos Jason , Thomas Len , Fortin Daniel , Morales Juan M.
Published: June 2012

We discuss hidden Markov‐type models for fitting a variety of multistate random walks to wildlife movement data. Discrete‐time hidden Markov models (HMMs) achieve considerable computational gains by focusing on observations that are regularly spaced in time, and for which the measurement error is negligible. These conditions are often met, in particular for data related to terrestrial animals, so that a likelihood‐based HMM approach is feasible. We describe a number of extensions of HMMs for animal movement modeling, including more flexible state transition models and individual random effects (fitted in a non‐Bayesian framework). In particular we consider so‐called hidden semi‐Markov models, which may substantially improve the goodness of fit and provide important insights into the behavioral state switching dynamics. To showcase the expediency of these methods, we consider an application of a hierarchical hidden semi‐Markov model to multiple bison movement paths.
Adenine Phosphoribosyltransferase Deficiency
Authors: Bollée Guillaume , Harambat Jérôme , Bensman Albert , Knebelmann Bertrand , Daudon Michel , Ceballos-Picot Irène
Published: June 2012

Complete adenine phosphoribosyltransferase (APRT) deficiency is a rare inherited metabolic disorder that leads to the formation and hyperexcretion of 2,8-dihydroxyadenine (DHA) into urine. The low solubility of DHA results in precipitation of this compound and the formation of urinary crystals and stones. The disease can present as recurrent urolithiasis or nephropathy secondary to crystal precipitation into renal parenchyma (DHA nephropathy). The diagnostic tools available—including stone analysis, crystalluria, and APRT activity measurement—make the diagnosis easy to confirm when APRT deficiency is suspected. However, the disease can present at any age, and the variability of symptoms can present a diagnostic challenge to many physicians. The early recognition and treatment of APRT deficiency are of crucial importance for preventing irreversible loss of renal function, which still occurs in a non-negligible proportion of cases. This review summarizes the genetic and metabolic mechanisms underlying stone formation and renal disease, along with the diagnosis and management of APRT deficiency.
Does the Exposure of Urine Samples to Air Affect Diagnostic Tests for Urine Acidification?
Authors: Yi Joo-Hark , Shin Hyun-Jong , Kim Sun-Moon , Han Sang-Woong , Kim Ho-Jung , Oh Man-Seok
Published: June 2012

Background and objectives

For accurate measurement of pH, urine collection under oil to limit the escape of CO2 on air exposure is recommended. This study aims to test the hypothesis that urine collection under oil is not necessary in acidic urine in which bicarbonate and CO2 are minor buffers, because loss of CO2 would have little effect on its pH.

Design, setting, participants, & measurements

One hundred consecutive random urine samples were collected under oil and analyzed for pH, pCO2, and HCO3
− immediately and after 5 minutes of vigorous shaking in uncovered flasks to allow CO2 escape.

Results

The pH values in 97 unshaken samples ranged from 5.03 to 6.83. With shaking, urine pCO2 decreased by 76%, whereas urine HCO3
− decreased by 60%. Meanwhile, urine baseline median pH (interquartile range) of 5.84 (5.44–6.25) increased to 5.93 (5.50–6.54) after shaking (ΔpH=0.12 [0.07–0.29], P<0.001). ΔpH with pH≤6.0 was significantly lower than the ΔpH with pH>6.0 (0.08 [0.05–0.12] versus 0.36 [0.23–0.51], P<0.001). Overall, the lower the baseline pH, the smaller the ΔpH.

Conclusions

The calculation of buffer reactions in a hypothetical acidic urine predicted a negligible effect on urine pH on loss of CO2 by air exposure, which was empirically proven by the experimental study. Therefore, exposure of urine to air does not substantially alter the results of diagnostic tests for urine acidification, and urine collection under oil is not necessary.
Pharmacokinetics of Intraperitoneal Gentamicin in Peritoneal Dialysis Patients with Peritonitis (GIPD Study)
Authors: Varghese Julie M. , Roberts Jason A. , Wallis Steven C. , Boots Robert J. , Healy Helen , Fassett Robert G. , Lipman Jeffrey , Ranganathan Dwarakanathan
Published: June 2012

Background and objectives

Peritonitis is a major infectious complication in peritoneal dialysis patients, and intraperitoneal antibiotic administration is preferred to ensure maximal antibiotic concentrations at the site of infection. This study aimed to describe the plasma and infection site pharmacokinetics of intraperitoneal gentamicin in patients with peritonitis.

Design, setting, participants, & measurements

This prospective pharmacokinetic study of intraperitoneal gentamicin was conducted in peritoneal dialysis patients presenting to hospital with clinically defined signs and symptoms of peritonitis. Twenty-four patients were administered a 0.6-mg/kg dose of intraperitoneal gentamicin, which was allowed to dwell for 6 hours. Serial blood and dialysate samples were collected for 24 hours after the first dose. Gentamicin concentrations in plasma and dialysate were measured using a validated assay.

Results

The median percentage of the dose absorbed into the systemic circulation was 76% (interquartile range=69%–82%) and significantly different between patients with low average, high average, and high peritoneal membrane transporter status (P=0.03). The calculated pharmacokinetic parameters were plasma terminal elimination half-life of 24.7 (20.4–29.9) hours, terminal volume of distribution of 0.30 (0.20–0.36) L/kg, observed peak plasma concentration of 3.1 (2.4–3.4) mg/L, and observed trough plasma concentration of 1.9 (1.4–2.2) mg/L. The peak gentamicin concentration in dialysate was at least eight times the minimum inhibitory concentration of the likely pathogens.

Conclusions

The high systemic absorption of gentamicin in patients with peritonitis and prolonged plasma elimination half-life may lead to drug accumulation in the systemic circulation, increasing the risk of toxicity.
Circulating Dopamine and C-Peptide Levels in Fasting Nondiabetic Hypertensive Patients
Authors: Tomaschitz Andreas , Ritz Eberhard , Kienreich Katharina , Pieske Burkert , März Winfried , Boehm Bernhard O. , Drechsler Christiane , Meinitzer Andreas , Pilz Stefan
Published: June 2012

OBJECTIVE

Accumulating evidence supports a potential role for dopamine in the regulation of insulin secretion. We examined the association between circulating dopamine and C-peptide concentrations using data from the Graz Endocrine Causes of Hypertension (GECOH) study.

RESEARCH DESIGN AND METHODS

After 12 h of fasting, we measured plasma dopamine and serum C-peptide levels and established determining factors of insulin secretion in 201 nondiabetic hypertensive patients (mean age 48.1 ± 16.0 years; 61.7% women).

RESULTS

Mean dopamine and C-peptide concentration were 33.4 ± 38.6 pg/mL and 3.1 ± 2.7 ng/mL, respectively. A strong and inverse correlation was observed between dopamine and C-peptide levels (r = −0.423, P < 0.001). There was no significant relationship between C-peptide, plasma epinephrine, and norepinephrine. C-peptide levels decreased steadily and significantly from tertile 1 of dopamine (3.6 ng/mL [95% CI 2.9–4.1]) to tertile 3 (1.6 ng/mL [1.5–2.7], P < 0.001) after multivariate adjustment.

CONCLUSIONS

The inverse association between dopamine and C-peptide highlights the need to evaluate whether dopamine could be effective for modulating endocrine pancreatic function.
Diabetes and Cause-Specific Mortality in a Prospective Cohort of One Million U.S. Adults
Authors: Campbell Peter T. , Newton Christina C. , Patel Alpa V. , Jacobs Eric J. , Gapstur Susan M.
Published: June 2012

OBJECTIVE

Diabetes is a major predictor of death from heart disease and stroke; its impact on nonvascular mortality, including specific cancers, is less understood. We examined the association of diabetes with cause-specific mortality, including deaths from specific cancers.

RESEARCH DESIGN AND METHODS

A prospective cohort of 1,053,831 U.S. adults, without cancer at baseline, enrolled in the Cancer Prevention Study-II in 1982 and was followed for mortality until December 2008. At baseline, participants completed a self-administered questionnaire that included information on diabetes, smoking, physical activity, height, and weight. Multivariable-adjusted relative risks (RRs) (95% CI) were estimated using Cox proportional hazards regression.

RESULTS

During 26 years of follow-up, 243,051 men and 222,109 women died. In multivariable models that controlled for age, BMI, and other variables, diabetes was associated with higher risk of all-cause mortality (women RR 1.90 [95% CI 1.87–1.93]; men 1.73 [1.70–1.75]). Among women, diabetes was associated with higher risk of death from cancers of the liver (1.40 [1.05–1.86]), pancreas (1.31 [1.14–1.51]), endometrium (1.33 [1.08–1.65]), colon (1.18 [1.04–1.33]), and breast (1.16 [1.03–1.29]). Among men, diabetes was associated with risk of death from cancers of the breast (4.20 [2.20–8.04]), liver (2.26 [1.89–2.70]), oral cavity and pharynx (1.44 [1.07–1.94]), pancreas (1.40 [1.23–1.59]), bladder (1.22 [1.01–1.47]), colon (1.15 [1.03–1.29]), and (inversely) prostate (0.88 [0.79–0.97]). Diabetes was also associated with higher risks of death involving the circulatory system, respiratory system, digestive system, genitourinary system, and external causes/accidental deaths.

CONCLUSIONS

Diabetes is associated with higher risk of death for many diseases, including several specific forms of cancer.
NH2-Terminal Probrain Natriuretic Peptide Is Associated With Diabetes Complications in the EURODIAB Prospective Complications Study
Authors: Gruden Gabriella , Barutta Federica , Chaturvedi Nish , Schalkwijk Casper , Stehouwer Coen D. , Pinach Silvia , Manzo Maria , Loiacono Maria , Tricarico Marinella , Mengozzi Giulio , Witte Daniel R. , Fuller John H. , Perin Paolo Cavallo , Bruno Graziella
Published: June 2012

OBJECTIVE

Circulating levels of NH2-terminal probrain natriuretic peptide (NT-proBNP), a marker of acute heart failure, are associated with increased risk of cardiovascular disease (CVD) in the general population. However, there is little information on the potential role of NT-proBNP as a biomarker of vascular complications in type 1 diabetic patients. We investigated whether serum NT-proBNP levels were associated with micro- and macrovascular disease in type 1 diabetic subjects.

RESEARCH DESIGN AND METHODS

A cross-sectional nested case-control study from the EURODIAB Prospective Complications Study of 507 type 1 diabetic patients was performed. Case subjects (n = 345) were defined as those with one or more complications of diabetes; control subjects (n = 162) were those with no evidence of any complication. We measured NT-proBNP levels by a two-site sandwich electrochemiluminescence immunoassay and investigated their associations with complications.

RESULTS

Mean NT-proBNP levels were significantly higher in case than in control subjects. In logistic regression analyses, NT-proBNP values >26.46 pg/mL were independently associated with a 2.56-fold increased risk of all complications. Odds ratios of CVD (3.95 [95% CI 1.26–12.35]), nephropathy (4.38 [1.30–14.76]), and distal symmetrical polyneuropathy (4.32 [1.41–13.23]) were significantly increased in patients with NT-proBNP values in the highest quartile (>84.71 pg/mL), independently of renal function and known risk factors. These associations were no longer significant after inclusion of TNF-α into the model.

CONCLUSIONS

In this large cohort of type 1 diabetic subjects, we found an association between NT-proBNP and diabetic micro- and macrovascular complications. Our results suggest that the inflammatory cytokine TNF-α may be involved in this association.
Aortic and Mitral Annular Calcifications Are Predictive of All-Cause and Cardiovascular Mortality in Patients With Type 2 Diabetes
Authors: Rossi Andrea , Targher Giovanni , Zoppini Giacomo , Cicoira Mariantonietta , Bonapace Stefano , Negri Carlo , Stoico Vincenzo , Faggiano Pompilio , Vassanelli Corrado , Bonora Enzo
Published: June 2012

OBJECTIVE

To examine the association of aortic valve sclerosis (AVS) and mitral annulus calcification (MAC) with all-cause and cardiovascular mortality in type 2 diabetic individuals.

RESEARCH DESIGN AND METHODS

We retrospectively analyzed the data from 902 type 2 diabetic outpatients, who had undergone a transthoracic echocardiography for clinical reasons during the years 1992–2007. AVS and MAC were diagnosed by echocardiography, and a heart valve calcium (HVC) score was calculated by summing up the AVS and MAC variables. The study outcomes were all-cause and cardiovascular mortality.

RESULTS

At baseline, 477 (52.9%) patients had no heart valves affected (HVC-0), 304 (33.7%) had one valve affected (HVC-1), and 121 (13.4%) had both valves affected (HVC-2). During a mean follow-up of 9 years, 137 (15.2%) patients died, 78 of them from cardiovascular causes. Compared with patients with HVC-0, those with HVC-2 had the highest risk of all-cause and cardiovascular mortality, whereas those with HVC-1 had an intermediate risk (P < 0.0001 by the log-rank test). After adjustment for sex, age, BMI, systolic blood pressure, diabetes duration, A1C, LDL cholesterol, estimated glomerular filtration rate, smoking, history of myocardial infarction, and use of antihypertensive and lipid-lowering drugs, the hazard ratio of all-cause mortality was 2.3 (95% CI 1.1–4.9; P < 0.01) for patients with HVC-1 and 9.3 (3.9–17.4; P < 0.001) for those with HVC-2. Similar results were found for cardiovascular mortality.

CONCLUSIONS

Our findings indicate that AVS and MAC, singly or in combination, are independently associated with all-cause and cardiovascular mortality in type 2 diabetic patients.
Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury
Authors: Hornby T. George , Kinnaird Catherine R. , Holleran Carey L. , Rafferty Miriam R. , Rodriguez Kelly S. , Cain Julie B.
Published: June 2012

Background

Robotic-assisted locomotor training has demonstrated some efficacy in individuals with neurological injury and is slowly gaining clinical acceptance. Both exoskeletal devices, which control individual joint movements, and elliptical devices, which control endpoint trajectories, have been utilized with specific patient populations and are available commercially. No studies have directly compared training efficacy or patient performance during stepping between devices.

Objective

The purpose of this study was to evaluate kinematic, electromyographic (EMG), and metabolic responses during elliptical- and exoskeletal-assisted stepping in individuals with incomplete spinal cord injury (SCI) compared with therapist-assisted stepping.

Design

A prospective, cross-sectional, repeated-measures design was used.

Methods

Participants with incomplete SCI (n=11) performed 3 separate bouts of exoskeletal-, elliptical-, or therapist-assisted stepping. Unilateral hip and knee sagittal-plane kinematics, lower-limb EMG recordings, and oxygen consumption were compared across stepping conditions and with control participants (n=10) during treadmill stepping.

Results

Exoskeletal stepping kinematics closely approximated normal gait patterns, whereas significantly greater hip and knee flexion postures were observed during elliptical-assisted stepping. Measures of kinematic variability indicated consistent patterns in control participants and during exoskeletal-assisted stepping, whereas therapist- and elliptical-assisted stepping kinematics were more variable. Despite specific differences, EMG patterns generally were similar across stepping conditions in the participants with SCI. In contrast, oxygen consumption was consistently greater during therapist-assisted stepping.

Limitations

Limitations included a small sample size, lack of ability to evaluate kinetics during stepping, unilateral EMG recordings, and sagittal-plane kinematics.

Conclusions

Despite specific differences in kinematics and EMG activity, metabolic activity was similar during stepping in each robotic device. Understanding potential differences and similarities in stepping performance with robotic assistance may be important in delivery of repeated locomotor training using robotic or therapist assistance and for consumers of robotic devices.
How Student Disability Classifications and Learning Outcomes Respond to Special Education Funding Rules: Evidence from British Columbia
Authors: Battisti Michele , Friesen Jane , Hickey Ross
Published: June 2012

In 2002, British Columbia eliminated supplemental grants to school districts for some students with special needs. This study provides estimates of the response of special needs designations and academic performance to this funding change. Using student-level panel data, we find that students were less likely to receive a gifted, moderate behavioural disorder, or mild mental illness designation under the new funding rules. We study standardized test scores in Grade 7, finding that the reading scores of gifted students declined substantially among those exposed to the new funding rules for the longest duration.
Temporary Foreign Workers and Regional Labour Market Disparities in Canada
Authors: Gross Dominique M. , Schmitt Nicolas
Published: June 2012

Temporary foreign worker programs are typically seen as short-term solutions to shortages of regional or occupational labour. During the past decade, Canadian regions experienced unequal economic growth, and some suffered from significant excess labour demand. The Canadian Temporary Foreign Worker Program was thus expanded and conditions to access it made easier. During the same period, the pattern of regional disparities in unemployment rates became more persistent. This paper shows that some of the persistence is due to the increased availability of temporary foreign workers. This suggests that policy makers did not price them correctly to avoid adverse effects on the Canadian labour market.
Packaging Health: Examining “Better-for-You” Foods Targeted at Children
Authors: Elliott Charlene
Published: June 2012

Concerns over health and obesity have led to a range of “better-for-you” food products targeted at consumers. This analysis examines 354 supermarket foods targeted at children in Canada, assessing the nutritional quality and types of appeals of “better-for-you” packaged foods compared to “regular” fare. While “better-for-you” products fared better nutritionally (particularly for fat or sodium), high levels of sugar are evident in both categories. This analysis further examines some important considerations regarding both “health halos” and the promotion of food as “fun.” Overall, it reveals that products marketed to children as “better-for-you” are as much about marketing as they are about nutrition.
Internal cranial expansion surgery for the treatment of refractory idiopathic intracranial hypertension
Authors: Ellis Jason A. , Anderson Richard C. E. , O'Hanlon Jonathan , Goodman Robert R. , Feldstein Neil A. , Ghatan Saadi
Published: June 2012

Object

Idiopathic intracranial hypertension (IIH) may be refractory to available medical and surgical therapies. Patients with this condition may suffer from intractable headaches, experience visual deterioration, or have other symptoms related to elevated intracranial pressure. Internal cranial expansion (ICE) is a novel surgical procedure that the authors have developed for the treatment of patients with this condition. Here, they describe ICE and present their initial experience in using this surgical procedure for the treatment of patients with refractory IIH.

Methods

The authors conducted a retrospective review of 10 consecutive patients who underwent ICE for the treatment of IIH during a 5-year period. Preoperative and postoperative clinical parameters including patient symptoms, presence of papilledema, and available ICP or CSF opening pressures were compared. Procedural details and complications were noted. Intracranial volume increases were calculated using available pre- and postoperative CT scans.

Results

Follow-up for the 10 patients in this series ranged from 1 to 39.6 months (mean 15.5 months). Technically successful ICE was performed in all patients within the cohort. Surgical complications included a single postoperative seizure in one patient and a sagittal sinus tear with no clinical sequelae in another patient. At the time of last follow-up, 7 (70%) of 10 patients were either symptomatically improved or asymptomatic. Six (67%) of 9 patients with preoperative headaches had reduction or resolution of this symptom, and all patients (4 of 4) with preoperative papilledema had a reduction in or complete resolution of this sign. Postoperative ICP or CSF opening pressures were normal in all patients (4 of 4) tested. Postoperative intracranial volume expansion ranged between 3.8% and 12%.

Conclusions

Internal cranial expansion is a safe and effective surgery for the treatment of patients with refractory IIH. This surgery expands the intracranial volume and thus promotes ICP normalization, which may lead to the reduction or complete resolution of the signs and symptoms of IIH. Internal cranial expansion may be used as part of a multidisciplinary management approach in the treatment of refractory IIH.
Transient perioperative brainstem paralysis secondary to a local anesthetic
Authors: Joannides Alexis J. , Santarius Thomas , Fernandes Helen M. , Laing Rodney J. C. , Trivedi Rikin A.
Published: June 2012

Local anesthesia is widely used, in isolation or in conjunction with general anesthesia. The authors describe 2 adolescent patients presenting with absent brainstem reflexes and delayed awakening following elective foramen magnum decompression for Chiari Type I malformation. In both cases, neurological deficits were closely associated with the administration of a levobupivacaine field block following wound closure. In the absence of any structural or biochemical abnormalities, and with spontaneous recovery approximating the anesthetic half-life, the authors' observations are consistent with transient brainstem paralysis caused by perioperative local anesthetic infiltration.
Intraventricular hemorrhage on computed tomography and corpus callosum injury on magnetic resonance imaging in patients with isolated blunt traumatic brain injury
Authors: Matsukawa Hidetoshi , Shinoda Masaki , Fujii Motoharu , Takahashi Osamu , Murakata Atsushi , Yamamoto Daisuke , Sumiyoshi Sosuke , Ishikawa Ryoichi
Published: June 2012

Object

Intraventricular hemorrhage (IVH) is widely regarded as one element of a complex involving severe blunt traumatic brain injury (TBI); corpus callosum injury (CCI) is recently considered to be one factor associated with poor outcome in patients with TBI. Although postmortem studies have focused on the relationship between IVH and CCI, there have been few investigations of IVH evidenced on CT scans as a predictor of CCI evidenced on MRI.

Methods

The authors retrospectively reviewed prospectively collected data from 371 patients with blunt TBI, without trauma to the face, chest, abdomen, extremities, or pelvic girdle, requiring immediate therapeutic intervention. Their aim was to investigate whether IVH found on CT predicts CCI on MRI. Clinical and radiological data were collected between June 2003 and February 2011. First, the authors classified patients into groups of those with CCI and those without CCI, and they compared clinical and radiological findings between them. Then, they investigated prognostic factors that were related to the development of disability at 6 months after injury. The outcomes at 6 months after injury were evaluated using the Extended Glasgow Outcome Scale (GOS-E). Finally, the authors evaluated the correlation between the severity of the IVH on CT and the number of CCI lesions on MRI. The severity of the IVH was defined by the number of ventricles in which IVH was seen, and the number of CCI lesions was counted on the MRI study.

Results

On multivariate logistic regression analysis, Glasgow Coma Scale score less than 9 (OR 2.70 [95% CI 1.10–6.27]), traffic accident (OR 2.59 [95% CI 1.37–4.93]), and IVH on CT (OR 3.31 [95% CI 1.25–8.49]) were significantly related to CCI. Multivariate analysis also showed that older age (p = 0.0001), male sex (OR 3.26 [95% CI 1.46–8.08], p = 0.0065), Glasgow Coma Scale score less than 9 (OR 8.27 [95% CI 3.39–21.4], p < 0.0001), evidence of IVH on CT (OR 4.09 [95% CI 1.45–11.9], p = 0.0081), and evidence of CCI on MRI (OR 8.32 [95% CI 3.89–18.8], p < 0.0001) were associated with future development of disability (GOS-E score ≤6). Furthermore, simple regression analysis revealed the existence of a strong correlation between the severity of IVH and the number of CCI lesions (r = 0.0668, p = 0.0022).

Conclusions

The authors' results suggest that evidence of IVH on CT may indicate CCI, which can lead to disability in patients with isolated blunt TBI.