bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired Glucose Tolerance and Insulin Resistance Are Associated With Increased Adipose 11β-Hydroxysteroid Dehydrogenase Type 1 Expression and Elevated Hepatic 5α-Reductase Activity
Authors: Tomlinson Jeremy W. , Finney Joanne , Gay Christopher , Hughes Beverly A. , Hughes Susan V. , Stewart Paul M.
Published: July 2008

OBJECTIVE—The precise molecular mechanisms contributing to the development of insulin resistance, impaired glucose tolerance (IGT), and type 2 diabetes are largely unknown. Altered endogenous glucocorticoid metabolism, including 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), which generates active cortisol from cortisone, and 5α-reductase (5αR), which inactivates cortisol, has been implicated.

RESEARCH DESIGN AND METHODS—A total of 101 obese patients (mean age 48 ± 7 years, BMI 34.4 ± 4.3 kg/m2, 66 women, 35 men) underwent 75-g oral glucose tolerance testing (OGTT), body composition analysis (dual-energy X-ray absorptiometry), assessment of glucocorticoid metabolism (24-h urine steroid metabolite analysis by gas chromatography/mass spectrometry), and subcutaneous abdominal adipose tissue biopsies.

RESULTS—A total of 22.7% of women had IGT compared with 34.2% of men. Two women and five men were diagnosed with type 2 diabetes. In women, adipose 11β-HSD1 expression was increased in patients with IGT and correlated with glucose levels across the OGTT (R = 0.44, P < 0.001) but was independent of fat mass. Total glucocorticoid secretion was higher in men with and without IGT (normal 13,743 ± 863 vs. 7,453 ± 469 μg/24 h, P < 0.001; IGT 16,871 ± 2,113 vs. 10,133 ± 1,488 μg/24 h, P < 0.05), and in women, it was higher in those with IGT (7,453 ± 469 vs. 10,133 ± 1,488 μg/24 h, P < 0.001). In both sexes, 5αR activity correlated with fasting insulin (men R = 0.53, P = 0.003; women R = 0.33, P = 0.02), insulin secretion across an OGTT (men R = 0.46, P = 0.01; women R = 0.40, P = 0.004), and homeostasis model assessment of insulin resistance (men R = 0.52, P = 0.004; women R = 0.33, P = 0.02).

CONCLUSIONS—Increased adipose 11β-HSD1 expression in women may contribute to glucose intolerance. Enhanced 5αR activity in both sexes is associated with insulin resistance but not body composition. Augmented glucocorticoid inactivation may serve as a compensatory, protective mechanism to preserve insulin sensitivity.
Effect of Aging on A1C Levels in Individuals Without Diabetes
Authors: Pani Lydie N. , Korenda Leslie , Meigs James B. , Driver Cynthia , Chamany Shadi , Fox Caroline S. , Sullivan Lisa , D’Agostino Ralph B. , Nathan David M.
Published: July 2008

OBJECTIVE—Although glycemic levels are known to rise with normal aging, the nondiabetic A1C range is not age specific. We examined whether A1C was associated with age in nondiabetic subjects and in subjects with normal glucose tolerance (NGT) in two population-based cohorts.

RESEARCH DESIGN AND METHODS—We performed cross-sectional analyses of A1C across age categories in 2,473 nondiabetic participants of the Framingham Offspring Study (FOS) and in 3,270 nondiabetic participants from the National Health and Nutrition Examination Survey (NHANES) 2001–2004. In FOS, we examined A1C by age in a subset with NGT, i.e., after excluding those with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). Multivariate analyses were performed, adjusting for sex, BMI, fasting glucose, and 2-h postload glucose values.

RESULTS—In the FOS and NHANES cohorts, A1C levels were positively associated with age in nondiabetic subjects. Linear regression revealed 0.014- and 0.010-unit increases in A1C per year in the nondiabetic FOS and NHANES populations, respectively. The 97.5th percentiles for A1C were 6.0% and 5.6% for nondiabetic individuals aged <40 years in FOS and NHANES, respectively, compared with 6.6% and 6.2% for individuals aged ≥70 years (Ptrend < 0.001). The association of A1C with age was similar when restricted to the subset of FOS subjects with NGT and after adjustments for sex, BMI, fasting glucose, and 2-h postload glucose values.

CONCLUSIONS—A1C levels are positively associated with age in nondiabetic populations even after exclusion of subjects with IFG and/or IGT. Further studies are needed to determine whether age-specific diagnostic and treatment criteria would be appropriate.
Risk Factors Related to Inflammation and Endothelial Dysfunction in the DCCT/EDIC Cohort and Their Relationship With Nephropathy and Macrovascular Complications
Authors: Lopes-Virella Maria F. , Carter Rickey E. , Gilbert Gregory E. , Klein Richard L. , Jaffa Miran , Jenkins Alicia J. , Lyons Timothy J. , Garvey W. Timothy , Virella Gabriel ,   and the DCCT/EDIC Cohort Study Group
Published: July 2008

OBJECTIVE—Because endothelial cell dysfunction and inflammation are key contributors to the development of complications in type 1 diabetes, we studied risk factors related to endothelial dysfunction and inflammation (C-reactive protein and fibrinogen, soluble vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and E-selectin, and fibrinolytic markers) in a subgroup of patients from the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Intervention and Complications (EDIC) study cohort.

RESEARCH DESIGN AND METHODS—We determined which of these risk factors or clusters thereof are associated with the presence of and subsequent development of nephropathy and macrovascular complications (reflected by carotid intima-media thickness [IMT]).

RESULTS—After adjustment for conventional risk factors (age, sex, DCCT treatment group, diabetes duration, A1C, systolic blood pressure, waist-to-hip ratio, total and HDL cholesterol, and smoking status), fibrinogen remained strongly associated with progression of internal and common carotid IMT (P < 0.01) and soluble E-selectin had a strong association with nephropathy (P < 0.01).

CONCLUSIONS—The best predictor for IMT progression in the DCCT/EDIC cohort was plasma fibrinogen, and the levels of soluble E-selectin discriminate patients with albuminuria better than conventional risk factors.
Alcohol Consumption, Mediating Biomarkers, and Risk of Type 2 Diabetes Among Middle-Aged Women
Authors: Beulens Joline W.J. , Rimm Eric B. , Hu Frank B. , Hendriks Henk F.J. , Mukamal Kenneth J.
Published: July 2008

OBJECTIVE—The purpose of this study was to investigate whether adiponectin concentrations and biomarkers of inflammation, endothelial dysfunction, and insulin resistance mediate the association between alcohol consumption and diabetes.

RESEARCH DESIGN AND METHODS—In a nested case-control study of 705 women with incident diabetes and 787 matched control subjects, we examined the adjusted relationship between baseline alcohol consumption and risk of diabetes before and after adjustment for markers of inflammation/endothelial dysfunction (C-reactive protein, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin, tumor necrosis factor-α receptor 2, and interleukin-6), fasting insulin, and adiponectin concentrations.

RESULTS—Alcohol consumption was associated with a decreased risk of diabetes (odds ratio per 12.5 g/day increment in alcohol use 0.58; 95% CI 0.49–0.69; P < 0.001). Adjustment for BMI attenuated the association by 25%. None of the markers of inflammation or fasting insulin appeared to account for >2% of the observed relationship. Without adjustment for BMI, these biomarkers individually explained slightly more of the association, but <10% in all cases. Adiponectin accounted for 25% in a fully adjusted model and for 29% without adjustment for BMI.

CONCLUSIONS—In this population of women, alcohol consumption was inversely associated with risk of type 2 diabetes. Adiponectin appeared to be a mediator of this association, but circulating biomarkers of inflammation, endothelial dysfunction, and fasting insulin did not explain this association. These results suggest that further research is needed into the potentially mediating roles of other biomarkers affected by alcohol consumption.
Changes in Risk Variables of Metabolic Syndrome Since Childhood in Pre-Diabetic and Type 2 Diabetic Subjects
Authors: Nguyen Quoc Manh , Srinivasan Sathanur R. , Xu Ji-Hua , Chen Wei , Berenson Gerald S.
Published: July 2008

OBJECTIVE—That type 2 diabetes is associated with the metabolic syndrome is known. However, information is lacking regarding the long-term and adverse changes of metabolic syndrome variables in the development of type 2 diabetes from childhood to adulthood.

RESEARCH DESIGN AND METHODS—Observations were examined, retrospectively, in a community-based cohort of normoglycemic (n = 1,838), pre-diabetic (n = 90), and type 2 diabetic (n = 60) subjects followed serially for cardiovascular risk factors during childhood (4–11 years), adolescence (12–18 years), and adulthood (19–44 years).

RESULTS—Diabetic subjects versus normoglycemic subjects had significantly higher levels of subscapular skinfold, BMI, triglycerides, glucose, insulin, and homeostasis model assessment of insulin resistance and lower levels of HDL cholesterol beginning in childhood and higher levels of mean arterial pressure (MAP) in adolescence and adulthood. In a multivariate model including BMI, MAP, HDL cholesterol, LDL cholesterol, triglycerides, glucose, and insulin, adjusted for age, age2, race, sex, and race × sex interaction, adverse changes in glucose and LDL cholesterol were independently associated with pre-diabetic subjects, whereas adverse changes in BMI, glucose, and HDL cholesterol were associated with diabetic subjects. As young adults, pre-diabetic and diabetic groups displayed a significantly higher prevalence of obesity, hypertension, dyslipidemia, hyperinsulinemia, and metabolic syndrome.

CONCLUSIONS—These findings indicate that adverse levels of risk variables of metabolic syndrome, adiposity, and measures of glucose homeostasis accelerating since childhood characterize the early natural history of type 2 diabetes and underscore the importance of early prevention and intervention on risk factors beginning in childhood.
Diabetes and Obesity-Related Risks for Pelvic Reconstructive Surgery in a Cohort of Swedish Twins
Authors: Forsman Mats , Iliadou Anastasia , Magnusson Patrik , Falconer Christian , Altman Daniel
Published: July 2008

OBJECTIVE—To determine the diabetes- and obesity-related risks for surgically managed stress urinary incontinence and pelvic organ prolapse.

RESEARCH DESIGN AND METHODS—This twin cohort study used the Swedish Twin Register to identify 8,443 female twin pairs born from 1926 through 1958. The association between diabetes and pelvic floor surgery was estimated while taking into account the correlated (twin) structure of the data.

RESULTS—For type 1 and type 2 diabetes, no significant associations were observed for stress urinary incontinence (odds ratio [OR] 1.0 [95% CI 0.1–9.2] and 2.0 [1.0–4.0], respectively). There were no cases of prolapse surgery in type 1 diabetic subjects, and for type 2 diabetes the risk estimate was nonsignificant (1.6 [1.0–2.7]). BMI >25 kg/m2, age ≥60 years, and childbirth were the strongest risk factors for having incontinence surgery.

CONCLUSIONS—Our data suggest that diabetes is not associated with stress urinary incontinence or pelvic organ prolapse surgery.
Rare Tumor of the Tongue in a Child: Alveolar Soft Part Sarcoma
Authors: Rodríguez-Velasco Alicia , Ferman-Cano Floribel , Cerecedo-Díaz Fernando
Published: July 2008

Alveolar soft part sarcoma (ASPS) is a rare, malignant tumor of uncertain histogenesis that has no benign counterpart. In some cases, a structural rearrangement of chromosome 17 involving band q25 has been reported. The neoplasm occurs most frequently in female adolescents and young adults, where it arises predominantly in the extremities. In contrast, the most common sites of occurrence in infants and children are the orbit (41%) and the tongue (25%). The primary therapeutic option is a complete surgical excision. Because of the indolent growth and lack of pain associated with the mass, 20% of patients have metastases at the time of initial diagnosis. Median survival time reported for all sites of the body is 79 months. When ASPS presents in the tongue region, however, the patients involved are usually children and have a better prognosis than patients affected in the extremities. The utility of adjuvant chemotherapy or radiation therapy in children is open to question. Because metastases may occur after several decades, children with ASPS should be followed throughout adolescence and well into adulthood. Only 10 cases of ASPS occurring in the tongues of children younger than 5 years of age were indexed by MEDLINE between 1952 and 2006. Here, we describe the 1st case consistent with typical ASPS of the tongue in 15 years at our hospital. The patient is a 2-year-old girl who has been disease-free for 32 months.
Symmetric Crystals for $\mathfrak{gl}_∞$
Authors: Enomoto Naoya , Kashiwara Masaki
Published: July 2008

In the preceding paper, we formulated a conjecture on the relations between certain classes of irreducible representations of affine Hecke algebras of type B and symmetric crystals for

\mathfrak{gl}_∞

. In the present paper, we prove the existence of the symmetric crystal and the global basis for

\mathfrak{gl}_∞

.
On “$M$-Functions” Closely Related to the Distribution of $L'/L$-Values
Authors: Ihara Yasutaka
Published: July 2008

For each global ﬁeld

K

, we shall construct and study two basic arithmetic functions,

M_σ^{(K)}(z)

and its Fourier dual

\tilde M_σ^{(K)}(z)

, on

ℂ

parametrized by

σ > 1/2

. These functions are closely related to the density measure for the distribution of values on

ℂ

of the logarithmic derivatives of

L

-functions

L(χ, s)

, where

s

is ﬁxed, with

\textit{Re}(s) = σ

, and

χ

runs over a natural inﬁnite family of Dirichlet or Hecke characters on

K

. Connections with the Bohr–Jessen type value-distribution theories for the logarithms or (not much studied) logarithmic derivatives of

ζ_K(σ + τi)

, where

σ

is ﬁxed and

τ

varies, will also be brieﬂy discussed.
Metastatic Skeletal Disease of the Foot: Case Reports and Literature Review
Authors: Maheshwari Aditya V. , Chiappetta Geno , Kugler Carlos D. , Pitcher J. David , Temple H. Thomas
Published: July 2008

Background: Metastatic disease of the skeleton occurs in at least 20% to 30% of patients with malignancy, but metastasis to the foot and hand (acrometastasis) is extremely rare (0.007% to 0.3%). Metastases to the feet are even rarer and have been reported in half to one-third the rate for hand metastases. Failure to recognize these lesions has led to delayed diagnosis and/or inappropriate treatment. The purpose of this report is to highlight the clinical and radiologic features that aid in the diagnosis and potential treatment of this condition along with a pertinent review of the literature. Materials and Methods: In a retrospective review of 694 patients with histologically proven metastatic skeletal disease (January 1988 to January 2007), 14 cases of metastatic lesions to the foot were identified. Results: The most frequent primary site was in the genito-urinary system in eight patients and the most common bones involved were the calcaneus and the talus in six patients each. All patients died after a mean survival of 14.8 (range, 1 to 54) months after diagnosis of metastases. Conclusion: Although metastatic disease of the foot is rare, it should be considered in the diagnosis of a painful foot, especially if suspicious radiographic changes are present in an older patient. The common primary sites are the genito-urinary, lungs, breast, and the colo-rectum. Treatment is usually palliative to reduce pain and maintain function.
Medial Malleolar Stress Fracture Secondary to Chronic Ankle Impingement
Authors: Jowett Andrew J. L. , Birks Christopher L. , Blackney Mark C.
Published: July 2008

Background: Medial malleolar stress fractures are uncommon even in the sporting population. We believe that stress fractures of the medial malleolus may be the end stage of chronic anteromedial ankle impingement in elite running and jumping athletes. Materials and Methods: We present five cases of elite athletes who presented to our institution with stress fractures of the medial malleolus over a 3-year period (2004 to 2007). In each case preoperative imaging revealed an anteromedial bony spur on the tibia. All fractures were internally fixed and at the same sitting had arthroscopic debridement of the bony spur. Results: All fractures united without further intervention, average time to union was 10.2 (range, 6 to 16) weeks. At most recent review (average, 18 months; range, 8 to 37 months), all patients had resumed sporting activity to their previous level. No patient had suffered a recurrent fracture of the medial malleolus. Conclusion: We believe this region of impingement to be important in the development of the stress fracture and should be addressed at the time of fracture fixation.
Validité et utilité clinique d'une grille d'observation (PACSLAC-F) pour évaluer la douleur chez des aînés atteints de démence vivant en milieu de soins de longue durée
Authors: Aubin Michèle , Verreault René , Savoie Maryse , LeMay Sylvie , Hadjistavropoulos Thomas , Fillion Lise , Beaulieu Marie , Viens Chantal , Bergeron Rénald , Vézina Lucie , Misson Lucie , Fuchs-Lacelle Shannon
Published: July 2008

This study presents the validation of the French Canadian version (PACLSAC-F) of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC). Unlike the published validation of the English version of the PACSLAC, which was validated retrospectively, the French version was validated prospectively. The PACSLAC-F was completed by nurses working in long-term care facilities after observing 86 seniors, with severe cognitive impairment, in calm, painful or distressing but non-painful situations. The test-retest and inter-observer reliability, the internal consistency, and the discriminent validity were found to be satisfactory. To evaluate the convergent validity with the DOLOPLUS-2 and the clinical relevance of the PACSLAC, it was also completed by nurses during their work shift, with 26 additional patients, for three days per week during a period of four weeks. These results encourage us to test the PACSLAC in a comprehensive program of pain management targeting this population.
New Places, New Identities: The (Ever) Changing Concept of Heimat
Authors: Larkey Uta
Published: July 2008

This article analyzes contrasting notions of Heimat and Fremde, as explored cinematographically by three contemporary German filmmakers. The spatial aspect of Heimat, traditionally connected to a particular region or even neighborhood denotes the sense of belonging, whereas the temporal aspect—often associated with childhood and youth—carries the sense of longing. In the second half of the twentieth century, the concept has shifted to include identity, reflection and self-reflection, the loss of Heimat, and even multiple Heimaten. The article argues further that the notions of Heimat and Fremde are not mutually exclusive, but interdependent. Peter Lilienthal's film Ein Fremder concludes that in parts of German society the binary opposites of Heimat and Fremde are still intact. On the other hand, Peter Patzak in Adeus und Goodbye shows how Heimat and Fremde are mutually dependent and include a search for identity and individuality. In Michael Gutmann's travelogue-documentary, Familienreise, the protagonists experience aspects of Fremde and Heimatlosigkeit without ever finding Heimat.
Transport Infrastructure in Shrinking (East) Germany
Authors: Canzler Weert
Published: July 2008

Policy on transport infrastructure in Germany will come under increasing pressure thanks to considerable changes in basic conditions. Demographic change, shifts in economic and regional structures, continued social individualization, and the chronic budget crisis in the public sphere are forcing a readjustment of government action. At root, the impact of the changes in demographics and economic structures touches on what Germans themselves think their postwar democracy stands for. Highly consensual underlying assumptions about Germany as a model are being shaken. The doctrine that development of infrastructure is tantamount to growth and prosperity no longer holds. The experience in eastern Germany shows that more and better infrastructure does not automatically lead to more growth. Moreover, uniform government regulation is hitting limits. If the differences between boom regions and depopulated zones remain as large as they are, then it makes no sense to have the same regulatory maze apply to both cases. In transportation policy, that shift would mean recasting the legal foundations of public transport.
Two Ways to the Outside
Authors: Kouba Petr
Published: July 2008

Are Lévinas and Deleuze two allies in their effort to break away from the Western ontology, which is based on the logic of the One and the Same, or do their philosophies represent two distant galaxies? The purpose of this paper is not to argue for either possibility, but to show the issue in all its complexity. Conjunctions as well as disjunctions of Lévinas' metaphysical thinking and Deleuze's nomadic philosophy should be dealt with on the background of the problems of sexual difference and human face that play an important part in both conceptions. The analysis of these phenomena shall allow us to see the common denominator of both philosophical conceptions in the relation of thought to the outside, even though they approach the outside in two different ways.
Correspondence Why Deleuze Doesn't Blow the Actual on Virtual Priority. A Rejoinder to Jack Reynolds
Authors: Williams James
Published: July 2008

Your classic Jaguar XK 120 stands useless by the roadside. Why? Because you gave priority to the admittedly gorgeous 6 cylinder straight six engine; because you privileged the highest value part. Rubber pipes perish, though, and now thanks to a leak in a cheap hose the head gasket has blown. You are stranded and facing a costly bill. More seriously, your mechanical gaffe is a sign of your misunderstanding of Deleuze. Like Sir William Lyons, he engineers systems where the concept of priority must not be confused with independence, separateness, abstraction or ethical superiority. As a good engineer, Deleuze's constructions are holistic and opposed to abstract hierarchies: if a crucial small, actual part perishes in a particular practical situation where it has a role to play, then it does not matter how much virtual power you have in reserve. Your feet are still in a pool of hot water as you survey the wasted potential of actual motion and ideal expressions, hand made in Coventry.
Strata/Sedimenta/Lamina: In Ruin(s)
Authors: Barker Stephen
Published: July 2008

Ruins, their evocations and enigmas, have been a source of fascination since the advent of civilization. Both coordinating and distressing the relations of space and time, ruins are unparalleled catalysts of cultural analysis, as both history and adumbration. Ruins, and the concept of ruin on which they ‘rest’ and through which they decay, can be regarded in space, as strata, in time, as sedimenta, and in dynamic terms, as lamina. This essay works down through each focusing on the forceof ruin occurring between them. The essay itself is a lamination: (1) Anselm Kiefer's exploration of ruins as artefacts, in recent works such as ‘Falling Star’, shown at Paris’ Grand Palais in the summer of 2007 as the first installation in its Monumenta series, plays across many dimensions of ruins’ themes; (2) Derrida's exploration of the very idea of ruin – not ruins but ruin, as artefacture – conceptualizing ruins’ liminal nature, at the very limit of phenomenology, in Mémoires d'aveuglesand elsewhere; (3) the ruin-caught-in-motion of the virtually unknown French-Italian painter ‘Monsù Desiderio’; (4) and the linguistic ruin of Samuel Beckett's ‘D'un ouvrage abandonné’ and ‘Sans’. Each contributes to the others as ruins and ruin accumulate. Finally, ruin's decay passes into and through a passe partout into the uninhabitable.
Reception Thresholds for Sentences in Quiet, Continuous Noise, and Interrupted Noise in School-Age Children
Authors: Stuart Andrew
Published: July 2008

Sentence recognition in noise was employed to investigate the development of temporal resolution in school-age children. Eighty children aged 6 to 15 years and 16 young adults participated. Reception thresholds for sentences (RTSs) were determined in quiet and in backgrounds of competing
continuous and interrupted noise. In the noise conditions, RTSs were determined with a fixed noise level. RTSs were higher in quiet for six- to seven-year-old children (p = .006). Performance was better in the interrupted noise evidenced by lower RTS signal-to-noise ratios (S/Ns) relative
to continuous noise (p < .0001). An effect of age was found in noise (p < .0001) where RTS S/Ns decreased with increasing age. Specifically, children under 14 years performed worse than adults. "Release from masking" was computed by subtracting RTS S/Ns in interrupted
noise from continuous noise for each participant. There was no significant difference in RTS S/N difference scores as a function of age (p = .057). Children were more adversely affected by noise and needed greater S/Ns in order to perform as well as adults. Since there was no effect
of age on the amount of release from masking, one can suggest that school-age children have inherently poorer processing efficiency rather than temporal resolution. Se utilizó el reconocimiento de frases en ruido para investigar el desarrollo de la resolución temporal en niños
de edad escolar. Dieciocho niños con edades entre 6 y 15 años y 16 adultos jóvenes participaron. Los umbrales de recepción de frases (RTS) se determinaron en silencio y ante ruidos de fondo de competencia, continuos o interrumpidos. En condiciones de ruido, los
RTS se determinaron contra un nivel fijo de ruido. Los RTS fueron más alto en silencio para los niños de seis a siete años de edad (p = .006). El desempeño fue mejor en medio de ruido interrumpido, con una tasa señal/ruido (S/N) menor para RTS, en
relación al ruido continuo (p < .0001). Un efecto de la edad se encontró en medio de ruido (p < .0001) donde la S/N para RTS disminuyó conforma aumentó la edad. Específicamente, los niños menores de 14 años de edad funcionaron
peor que los adultos. Se computó "liberación del enmascaramiento" sustrayendo las S/N para RTS en ruido interrumpido, de las de ruido continuo para cada participante. No existieron diferencias significativas en los puntajes de diferencia de las S/N para RTS como función
de la edad (p = .057). Los niños se vieron más adversamente afectados por el ruido y necesitaron de mayores S/N para rendir tan bien como los adultos. Dado que no existió un efecto de la edad en la cantidad de liberación del enmascaramiento, uno puede sugerir
que los niños de edad escolar tienen una eficiencia de procesamiento inherentemente más pobre que su resolución temporal.
Effects of Expansion Algorithms on Speech Reception Thresholds
Authors: Wise Christi L. , Zakis Justin A.
Published: July 2008

Expansion is commonly used to reduce microphone noise and low-level environmental noises that can be annoying to hearing aid users. It may also improve or reduce the perception of low-level speech. This study assessed the impact of two expansion algorithms, single and multiple channel,
on speech reception thresholds (SRT) with 10 hearing impaired listeners wearing hearing aids with ADRO® processing. The single-channel algorithm suppressed sounds below 45 dB A, while the multiple-channel algorithm suppressed sounds below the long-term average spectrum of speech
at either 55 or 45 dB SPL. The mean HINT SRTs in quiet were 39.4, 40.7, 40.6, and 41.8 dB A without expansion, with single-channel expansion, and with multiple-channel expansion at expansion thresholds of 45 and 55 dB SPL, respectively. The difference in mean SRT was only statistically significant
between no expansion and multiple-channel expansion at a 55 dB SPL threshold. A regression analysis between the change in individual SRT for each expansion condition and pure tone average hearing loss showed no correlation. Our calculations indicate that only those with exceptionally good
hearing will find microphone noise audible. The current practice of prescribing expansion algorithms based on hearing thresholds alone is questioned, and other rationales are discussed. La expansión se utiliza comúnmente para reducir el ruido de los micrófonos y los ruidos
ambientales de bajo nivel que pueden ser perturbadores para los usuarios de auxiliares auditivos. También puede mejorar o reducir la percepción de lenguaje a bajo voumen. Este estudio evaluó el impacto de dos algoritmos de expansión, de canal múltiple y el
canal único, sobre los umbrales de recepción del lenguaje (SRT) con 10 sujetos hipoacúsicos utilizando auxiliares auditivos con procesamiento ADRO®. El algoritmo de canal único suprimió sonidos por debajo de 45 dB A, mientras que el algoritmo
de canal múltiple suprimió sonidos por debajo del espectro promedio a largo plazo del lenguaje, a 55 ó 45 dB SPL, respectivamente. La diferencia en el SRT medio fue sólo estadísticamente significativa entre la no expansión y la expansión de
canal múltiple a un umbral de 55 dB SPL. Un análisis de regresión no mostró correlación entre el cambio en los SRT individuales para cada condición de expansión y la pérdida auditiva promedio para tonos puros. Nuestros cálculos
indican que solamente aquellos con una audición excepcionalmente buena encontrarán audible el ruido del micrófono. Se cuestiona la práctica actual de prescribir algoritmos de expansión con base sólo en umbrales auditivos, y se discuten otros razonamientos.
Hearing and Balance Screening and Referrals for Medicare Patients: A National Survey of Primary Care Physicians
Authors: Johnson Carole E. , Danhauer Jeffrey L. , Koch Lindsey Latiolais , Celani Kristina E. , Lopez Ilian Priscilla , Williams Victoria A.
Published: July 2008

Hearing and balance problems are prevalent among the elderly. Primary care physicians (PCPs) are important pivotal points of entry for ensuring that patients receive needed audiology services. New Medicare beneficiaries are entitled to one-time preventative examinations including hearing/balance
screenings. A 35-item questionnaire was developed to assess physicians' participation in, knowledge about, and attitudes toward hearing/balance screenings and referrals for the elderly. The survey was mailed to 710 PCPs (19 undeliverable; 95 returned; response rate = 13.7%) in major metropolitan
areas in the United States. Generally, these PCPs were not conducting hearing/balance screenings, aware of patient self-report screening questionnaires, or likely to screen in the future. They referred to audiologists and otolaryngologists mainly when patients complained of having hearing/balance
difficulties, and they stated that these problems were important in the elderly and that the Medicare program was worthy of funding but that they had little time and were not reimbursed appropriately for screening. Therefore, PCPs could benefit from informational outreach campaigns on the
prevalence of, negative HRQoL (health-related quality of life) effects from, and screening procedures for hearing/balance disorders in the elderly. Los problemas de la audición y el equilibrio son prevalentes entre los ancianos. Los médicos de atención primaria (PCP) son
importantes elementos pivote para asegurar que los pacientes reciban los servicios audiológicos necesarios. Los nuevos beneficiarios de Medicare tienen derecho a exámenes preventivos por una vez, incluyendo tamizaje de audición y equilibrio. Se desarrolló un cuestionario
de 35 ítems para evaluar la participación de los médicos, su conocimiento y sus actitudes hacia el tamizaje de la audición y el equilibrio, y de sus referencias de ancianos. El cuestionario se envío por correo a 710 PCP (19 no llegaron al destinatario; 95
retornaron; tasa de respuesta = 13.7%) distribuidos en áreas metropolitanas principales de los Estados Unidos. Generalmente, estos PCP no estaban realizando tamizajes de audición y equilibrio, ni eran concientes de los cuestionarios de tamizaje de auto-reporte, ni tampoco dispuestos
a tamizar en el futuro. Ellos referían a los audiólogos y otolaringólogos principalmente cuando los pacientes se quejaban de dificultades auditivos o del equilibrio, y mencionaron que estos problemas eran importante para los ancianos y que el programa de Medicare debería
cubrirlos, pero que había poco tiempo y que no existía un pago apropiado para tales tamizajes. Por lo tanto, los PCP podrían beneficiarse de campañas de información sobre la prevalencia, los efectos negativos de la HRQoL (calidad de vida relacionada con la
salud) y sobre los procedimientos de tamizaje para los trastornos de la audición y el equilibrio en los ancianos.
Culture of Postnatal Mesencephalic Dopamine Neurons on an Astrocyte Monolayer
Authors: Fasano Caroline , Thibault Dominic , Trudeau Louis‐Éric
Published: July 2008

This unit presents a protocol for primary culture of postnatal mesencephalic dopamine neurons grown on an astrocyte monolayer, which can be used to investigate cellular and molecular mechanisms regulating dopamine neuron function. Using this in vitro approach, dopamine neurons survive for an extended period of time and establish functional axon terminals and dendrites that display properties similar to those observed in vivo and in brain slices. An alternate protocol is provided for a microculture system in which astrocytes are grown on a spatially limited surface where single or small groups of dopamine neurons develop. Under such conditions, isolated neurons establish synaptic contacts, or autapses, onto their own somatodendritic compartment, thus facilitating morphological and physiological experiments. Curr. Protoc. Neurosci. 44:3.21.1‐3.21.19. © 2008 by John Wiley & Sons, Inc.
Conditional Gene Expression and Targeting in Neuroscience Research
Authors: Morozov Alexei
Published: July 2008

Recently developed techniques for spatially and temporally controlled genetic manipulations based on regulated homologous recombination and/or transcription are extensively used in brain research. In addition to being important for testing the role of specific proteins in the central nervous system, these techniques allow analysis of brain functions at the neuronal circuit level. This overview discusses principles of conditional inactivation and expression of genes, and their specific applications to studies of the mammalian brain. Curr. Protoc. Neurosci. 44:4.31.1‐4.31.10. © 2008 by John Wiley & Sons, Inc.
Vapor Inhalation of Alcohol in Rats
Authors: Gilpin Nicholas W. , Richardson Heather N. , Cole Maury , Koob George F.
Published: July 2008

Alcohol dependence constitutes a neuroadaptive state critical for understanding alcoholism, and various methods have been utilized to induce alcohol dependence in animals, one of which is alcohol vapor exposure. Alcohol vapor inhalation provides certain advantages over other chronic alcohol exposure procedures that share the ultimate goal of producing alcohol dependence in rats. Chronic alcohol vapor inhalation allows the experimenter to control the dose, duration, and pattern of alcohol exposure. Also, this procedure facilitates testing of somatic and motivational aspects of alcohol dependence. Chronic exposure to alcohol vapor produces increases in alcohol‐drinking behavior, increases in anxiety‐like behavior, and reward deficits in rats. Alcohol vapor inhalation as a laboratory protocol is flexible, and the parameters of this procedure can be adjusted to accommodate the specific aims of different experiments. This unit describes the options available to investigators using this procedure for dependence induction, when different options are more or less appropriate, and the implications of each. Curr. Protoc. Neurosci. 44:9.29.1‐9.29.19. © 2008 by John Wiley & Sons, Inc.
Disease Associations and Family‐Based Tests
Authors: Ewens Warren J. , Spielman Richard S. , Kaplan Norman L. , Gao Xiaoyi , Morris Richard W. , Martin Eden R.
Published: July 2008

This unit describes the statistical techniques necessary for performing family‐based association studies (such as the TDT) for genetic polymorphisms. Such studies have become increasingly important in the identification of genes that confer an increased risk to disease, particularly for common diseases with a complex etiology. The family‐based approach avoids some of the problems often encountered when applying the traditional case‐control design to genetic studies. The unit includes the Sib TDT (S‐TDT) method, which allows application of the principle of the TDT to sibships without parental data, and several related tests.Curr. Protoc. Hum. Genet. 58:1.12.1‐1.12.24. © 2008 by John Wiley & Sons, Inc.
High‐Throughput Quantitative Real‐Time PCR
Authors: Arany Zoltan P.
Published: July 2008

Recent technical advances in quantitative real‐time PCR (qRT‐PCR) have allowed for extensive miniaturization, thereby rendering the technique amenable to high‐throughput assays. Large numbers of different nucleic acids can now rapidly be measured quantitatively. Many investigations can benefit from this approach, including determination of gene expression in hundreds of samples, determination of hundreds of genes in a few samples, or even quantification of nucleic acids other than mRNA. A simple technique is described here to quantify 1880 transcripts of choice from any number of starting RNA samples. Curr. Protoc. Hum. Genet. 58:11.10.1–11.10.11. © 2008 by JohnWiley & Sons, Inc.
Investigational Methods for Peroxisomal Disorders
Authors: Steinberg Steven , Jones Richard , Tiffany Carol , Moser Ann
Published: July 2008

Peroxisomes play an important role in cellular metabolism. Defects in peroxisome assembly or of a single peroxisomal pathway are associated with a wide variety of inherited disorders, including X‐linked adrenoleukodystrophy, Zellweger spectrum disorders, rhizomelic chondrodysplasia punctata, and Refsum disease. A group of peroxisome‐specific biomarkers has been shown to be characteristic of specific defects. Patients with defects in peroxisome fatty acid β‐oxidation accumulate very long–chain fatty acids (VLCFA), patients with defects in plasmalogen synthesis are deficient in erythrocyte membrane plasmalogens, and patients with mislocalized pipecolic acid oxidase accumulate pipecolic acid in body fluids. This unit describes three protocols that can be used to measure plasma VLCFA, erythrocyte plasmalogens, and plasma or urine pipecolic acid by capillary gas chromatography (GC) or GC‐mass spectrometry. These techniques can be used to identify the majority of patients with known neurogenetic peroxisome disorders. Curr. Protoc. Hum. Genet. 58:17.6.1‐17.6.23. © 2008 by John Wiley & Sons, Inc.
Flow Cytometric Immunophenotyping of Cerebrospinal Fluid
Authors: Kraan Jaco , Gratama Jan W. , Haioun Corinne , Orfao Alberto , Plonquet Anne , Porwit Anna , Quijano Sandra , Stetler‐Stevenson Maryalice , Subira Dolores , Wilson Wyndham
Published: July 2008

Leptomeningeal disease is an important adverse complication occurring in patients with B and T cell lymphomas and acute leukemias of lymphoid and myeloid origin. Recent reports suggest that multiparameter flow cytometry immunophenotypic assessment of spinal fluid samples could improve the efficiency of detection of CNS involvement, due to its high specificity and greater sensitivity. However, spinal fluid samples are frequently paucicellular with a rapidly decreasing cell viability. Staining of spinal fluid therefore requires dedicated sample storage/transport, staining, and preparation protocols. The Basic Protocol in this unit outlines a consensus multiparameter (3‐ to 8‐color) flow cytometry immunophenotypic protocol for the evaluation of CNS involvement of cerebrospinal fluid (CSF) samples by neoplastic cells. A Support Protocol describing the simultaneous assessment of surface and cytoplasmic antigens is also provided. Finally, in the Alternate Protocol, we describe a method to calculate absolute numbers of both normal and pathological cell subpopulations by adding counting beads to the assay. Curr. Protocol. Cytom. 45:6.25.1‐6.25.16. © 2008 by John Wiley & Sons, Inc.
Use of Spectral Fluorescence Resonance Energy Transfer to Detect Nitric Oxide‐Based Signaling Events in Isolated Perfused Lung
Authors: St. Croix Claudette M. , Bauer Eileen M.
Published: July 2008

Fluorescence resonance energy transfer (FRET) is a fluorescence microscopy technique suitable for live cells and capable of detecting changes in the conformational state of a single protein or the distance between two interacting proteins when the proteins are conjugated with appropriate donor and acceptor fluorophores. Confocal‐based spectral detection systems enable the resolution of fluorescent images by providing full spectral information for each voxel of the image without switching of optical filters. Furthermore, using calibration spectra, it is possible to unambiguously separate the cross‐talk between overlapping donor and acceptor emissions. This unit describes the use of confocal‐based spectral imaging of nitric oxide (NO) sensitive FRET reporters in the vasculature of the intact, isolated perfused mouse lung. This type of in situ imaging approach allows the visualization and study of temporal molecular signaling events within the appropriate physiologic microenvironment of the intact, living organ. Curr. Protocol. Cytom. 45:12.13.1‐12.13.12. © 2008 by John Wiley & Sons, Inc.
Phase‐Transfer Catalysis
Authors: Albanese Domenico
Published: July 2008

Phase‐transfer catalysis (PTC) is a powerful tool to carry out many organic reactions in a practical fashion, both in the laboratory and on the industrial scale. Significant cost savings and major process improvements can be achieved in reactions performed in water–organic solvent mixtures. Particularly striking is the possibility of replacing expensive solvents and dangerous bases that require strictly anhydrous conditions with aqueous bases and apolar, environmentally friendly, easily recyclable solvents. During the last decade notable results, both in terms of yields and stereoselectivity, were obtained in various reactions performed in the presence of chiral, nonracemic quaternary ammonium salts.
Derivation and Propagation of hESC Under a Therapeutic Environment
Authors: Sidhu Kuldip S. , Walke Sarah , Tuch Bernard E.
Published: July 2008

The pluripotent nature of human embryonic stem cells (hESC) makes them very attractive as a source of various cell types that could be used therapeutically in regenerative medicine. However, eliminating all sources of contamination, animal‐derived or human cell–derived, during hESC derivation and propagation is necessary before hESC derivatives can be used clinically. Although there is continuing progress toward this goal, none of the methods to date to produce hESC lines under good manufacturing practices (GMP) has been published. The long‐term success for GMP compliance depends critically on maintaining and implementing a stringent quality control system which is also dictated by the regulatory authorities in different countries. In this unit, an approach is described based upon the experience of this author and others towards achieving clinical‐grade hESC lines systematically involving all the steps from start to finish under GMP environment. This unit provides a basic layout for GMP set up to achieve quality controls, a step‐by‐step guide to producing new hESC lines under defined conditions, and standard operating procedures used to achieve this outcome. Curr. Protoc. Stem Cell Biol. 6:1A.4.1‐1A.4.31. © 2008 by John Wiley & Sons, Inc.
Differentiation of Mouse Embryonic Stem Cells into Blood
Authors: Ma Yunglin D. , Lugus Jesse J. , Park Changwon , Choi Kyunghee
Published: July 2008

Embryonic stem (ES) cells can be maintained as pluripotent stem cells or induced to differentiate into many different somatic cell types. As ES‐derived somatic cells can potentially be used for cell transplantation or cell‐based therapy, ES cells have gained much scientific and general public attention. Successful derivation of blood from ES cells for tissue engineering will require a comprehensive understanding of inductive signals and downstream effectors involved in blood lineage development. Ideally, directed differentiation of ES cells into blood and isolation of pure hematopoietic progenitors will enhance our ability to utilize ES‐derived blood cells for future clinical applications. The protocols provided in this unit describe methods of maintaining and differentiating mouse ES cells as well as identifying and isolating hematopoietic progenitors by utilizing flow cytometry and progenitor assays. Curr. Protoc. Stem Cell Biol. 6:1F.4.1‐1F.4.19. © 2008 by John Wiley & Sons, Inc.
Isolation and Characterization of Endothelial Progenitor Cells from Human Blood
Authors: Mead Laura E. , Prater Daniel , Yoder Mervin C. , Ingram David A.
Published: July 2008

Circulating endothelial progenitor cells (EPCs) in adult human peripheral blood were originally identified in 1997 by Asahara et al., which challenged the paradigm that vasculogenesis is a process restricted to embryonic development. Since their original identification, EPCs have been extensively studied as biomarkers to assess the risk of cardiovascular disease in human subjects and as a potential cell therapeutic for vascular regeneration. Endothelial colony‐forming cells (ECFCs), which are a subtype of EPCs, were recently identified from circulating adult and human umbilical cord blood. In contrast to other types of EPCs, which display various monocyte/macrophage phenotypes and functions, ECFCs are characterized by robust proliferative potential, secondary and tertiary colony formation upon replating, and de novo blood vessel formation in vivo when transplanted into immunodeficient mice. In this unit, we describe detailed methodologies for isolation and characterization of ECFCs from both human peripheral and umbilical cord blood. Curr. Protoc. Stem Cell Biol. 6:2C.1.1‐2C.1.27. © 2008 by John Wiley & Sons, Inc.
Silk Fibroin‐Regulated Crystallization of Calcium Carbonate
Authors: Cheng Cheng , Shao Zhengzhong , Vollrath Fritz
Published: July 2008

Mollusk shell is one of the best studied of all calcium carbonate biominerals. Its silk‐like binder‐matrix protein plays a pivotal role during the formation of aragonite crystals in the nacre sheets. Here, we provide novel experimental insights into the interaction of mineral and protein compounds using a model system of reconstituted Bombyx mori silk fibroin solutions serving as templates for the crystallization of calcium carbonate (CaCO3). We observed that the inherent (self‐assembling) aggregation process of silk fibroin molecules affected both the morphology and crystallographic polymorph of CaCO3 aggregates. This combination fostered the growth of a novel, rice‐grain‐shaped protein/mineral hybrid with a hollow structure with an aragonite polymorph formed after ripening. Our observations suggest new hypotheses about the role of silk‐like protein in the natural biomineralization process, but it may also serve to shed light on the formation process of those ‘ersatz’ hybrids regulated by artificially selected structural proteins.