bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin therapy improves islet functions by restoring pancreatic vasculature in high‐fat diet‐fed streptozotocin‐diabetic rats (胰岛素治疗通过恢复胰腺血管提高高脂饮食联合链脲佐菌素诱导的糖尿病大鼠的胰岛功能)
Authors: Gu Huimin , Xia Xuan , Chen Zonglan , Liang Hua , Yan Jinhua , Xu Fen , Weng Jianping 
Published: November 2013

AbstractBackgroundIn a previous study, we showed early insulin therapy could improve β‐cell function in type 2 diabetic patients. However, the molecular mechanism was not clear. In the present study, we addressed this question by analyzing the pancreatic microvasculature in diabetic rats after insulin treatment.MethodsDiabetes was induced in rats by a combination of low dose streptozotocin (STZ; 40 mg/kg) and feeding of a high‐fat diet. After the induction of diabetes, rats were treated with neutral protamine Hagedorn insulin (NPH; 6–8 U/day, s.c.) for 3 weeks. Three days after the end of treatment, rats were subjected to an intraperitoneal glucose tolerance test (IPGTT). The pancreatic microvasculature and the amount and size of the islets were evaluated by immunohistochemistry. Western blot analysis was used to determine levels of vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGF‐R2) protein.ResultsTreatment with NPH improved insulin secretion from β‐cells during the IPGTT and increased pancreatic islet size. The density of the microvasculature in the pancreas was determined by quantification of CD31, a marker of endothelial cells. Insulin treatment increased CD31 protein levels, as well as the expression of VEGF and VEGFR2.ConclusionsThe results suggest that insulin treatment improves islet recovery by increasing angiogenesis in the pancreas. The mechanism is related to the induction of VEGF and VEGFR2 expression in diabetic rats.
NKX2‐5, SIL/TAL and TLX3/HOX11L2 expression in Egyptian pediatric T‐cell acute lymphoblastic leukemia
Authors: Moussa Heba , Sidhom Iman 
Published: November 2013

AbstractAimCohorts of T‐cell acute lymphoblastic leukemia (T‐ALL) patients show regional geographic differences in incidence, biological features and clinical outcome, implying that in different populations, cases may harbor different genetic lesions than those reported elsewhere. In this study, we prospectively evaluated the frequency and the clinical relevance of NKX2‐5, TLX3/HOX11L2 and SIL/TAL expression in Egyptian childhood T‐ALL.MethodsNKX2‐5, TLX3/HOX11L2 and SIL/TAL expression were tested in peripheral blood and/or bone marrow of 83 newly diagnosed Egyptian childhood T‐ALL patients.ResultsNKX2‐5 expression was detected in 11/83 cases (13%), TLX3/HOX11L2 (5/83, 6%) and SIL/TAL (4/83, 5%). Initial central nervous system involvement was significantly higher in the NKX2‐5 positive versus negative patients (P = 0.009). The follow‐up period was a median of 65.5 months. The 5‐year leukemia‐free and event‐free survival rates of the whole T‐ALL population were 70 ± 6% and 58 ± 6%, respectively. The 5‐year leukemia‐free and event‐free survival rates of NKX2‐5 were 86 ± 13% and 60 ± 16%, respectively. There were no statistically significant differences in clinical presentation, biological features, initial response to chemotherapy, or subsequent treatments between the subgroups and the total population.ConclusionEgyptian T‐ALL cases seemed to have a different genetic pattern compared to other populations, with a lower incidence of TLX3/HOX11L2 and SIL/TAL but a higher incidence of NKX2‐5 expression than recorded in Western countries.
Relation of Low Vitamin D to Nonvalvular Persistent Atrial Fibrillation in Chinese Patients
Authors: Chen Wei Ren , Liu Zhi Ying , Shi Yang , Yin Da Wei , Wang Hao , Sha Yuan , Chen Yun Dai 
Published: November 2013

BackgroundLow vitamin D status has been associated with increased risk of cardiovascular disease. Atrial fibrillation (AF) is the most common cardiac arrhythmia. We evaluated the association between low vitamin D and AF.MethodsWe analyzed data from 162 Chinese patients with nonvalvular persistent AF and no other cardiovascular disease whose serum 25‐hydroxyvitamin D [25(OH)D] levels were measured in our hospital (AF group). Healthy subjects without AF who underwent health screening at our hospital served as controls (non‐AF group, n = 160). 25(OH)D was measured by chemiluminescence assay.ResultsThe serum 25(OH)D level was significantly lower in the AF group than in the non‐AF group (18.5 ± 10.3 vs 21.4 ± 10.7 ng/mL, P < 0.05). The high‐sensitivity C‐reactive protein (hsCRP) level was significantly higher in the AF group than in the non‐AF group (0.35 ± 0.19 vs 0.2 ± 0.17 mg/dL, P < 0.01). The average left atrial diameter was significantly larger in the AF group than in the non‐AF group (P < 0.01). The serum 25(OH)D level showed a negative correlation with left atrial diameter, hsCRP level, and pulmonary artery systolic pressure. Logistic regression analysis identified that 25(OH)D was related to AF. Patients whose vitamin D levels were in the lowest 25(OH)D category (<20 ng/mL) were more often in the AF group, with their incidence about twofold higher than those in the highest 25(OH)D category (>30 ng/mL).ConclusionsLow vitamin D levels are associated with AF. It may be involved in its development.
Electrophysiological toxicity testing of VEGF Trap‐Eye in an isolated perfused vertebrate retina organ culture model
Authors: Januschowski Kai , Schnichels Sven , Hagemann Ulrike , Koch Vanessa , Hofmann Johanna , Spitzer Martin S. , Bartz‐Schmidt Karl‐Ulrich , Szurman Peter , Lüke Matthias , Aisenbrey Sabine 
Published: November 2013

AbstractPurposeAge‐related macular degeneration (AMD) is the leading cause of visual impairment in Western nations. Since the discovery of the importance of vascular endothelial growth factor (VEGF) in the pathogenesis of neovascular AMD, anti‐VEGF agents including pegaptanib, ranibizumab and bevacizumab provide a treatment option to improve vision in affected persons. VEGF Trap‐Eye (Aflibercept) is a new agent available for the treatment of exudative AMD. The molecule is a receptor decoy with a longer half‐life and a higher affinity to VEGF compared with ranibizumab or bevacizumab. The presented study has been designed to evaluate the short‐term toxic effects of VEGF Trap‐Eye on retinal function during and after direct exposure to the drug.MethodsIsolated bovine retinas were perfused with an oxygen‐saturated nutrient solution, and the electroretinogram (ERG) was recorded using silver/silver chloride electrodes. A total of 0.5 mg or 2 mg VEGF Trap‐Eye was added to the nutrient solution and retinas were exposed for 45 min, followed by a washout period of 100 min. The percentage of a‐ and b‐wave reduction at the end of the washout was compared with the baseline values. Additionally, retinal whole mount cultures were exposed for 24 hr to VEGF Trap‐Eye, and the amount of apoptotic cells were determined using the terminal deoxynucleotidyl transferase‐mediated uridine 5'‐triphosphate‐biotin nick end labelling (TUNEL) assay.ResultsDuring simulation of intraocular application, no significant reduction in the a‐wave amplitude for 0.5 mg (2.70%, p = 0.37) and 2 mg (3.84%, p = 0.37) VEGF Trap‐Eye and b‐wave amplitude for 0.5 mg (19.68%, p = 0.17) and 2 mg (24.1%, p = 0.06) VEGF Trap‐Eye was observed at the end of the washout. However, there were significant changes in a‐wave and b‐wave amplitudes directly after exposure to 0.5 mg VEGF Trap‐Eye (18.4%, p = 0.004 and 43.1%, p = 0.006, respectively).ConclusionsThe presented data suggest that intraocular application of up to 2 mg VEGF Trap‐Eye does not induce irreversible toxic retinal damage. However, short‐term results showed a negative effect directly after the application for 0.5 mg and 2 mg VEGF Trap‐Eye.
Effect of body position on preterm newborns receiving continuous positive airway pressure
Authors: Brunherotti Marisa AA , Martinez Edson Z , Martinez Francisco E 
Published: November 2013

AbstractAimTo evaluate the effect of body position on the cardiorespiratory indicators of preterm newborns receiving nasal continuous positive airway pressure (CPAP).MethodsAnalytical, observational, prospective, cross‐sectional, randomised crossover study was carried out on sixteen newborns that received nasal CPAP. The infants had a mean gestational age of 29.7 ± 2 weeks and birthweight of 1353 ± 280 g. Cardiorespiratory indicators (respiratory rate, heart rate and oxygen saturation) were evaluated in each infant in the supine, prone and right and left lateral decubitus positions at intervals of 10 min over a period of 60 min.ResultsThe cardiorespiratory indicators were similar and within the normal range in the four decubitus positions. There was no difference in respiratory or heart rate between body positions. Although they showed desirable values, oxygen saturation was significantly lower in left lateral decubitus (96.6 ± 1.7%) when compared to the supine (97.1 ± 1.3%) and prone positions (97.4 ± 1.1%) (p = 0.00) and was also significantly lower in right lateral decubitus (96.9 ± 1.4%) when compared to the prone position (p = 0.00).ConclusionWe found no preferential decubitus position for preterm newborns receiving nasal CPAP, the supine position may be a choice, but the left and right lateral positions were less advantageous in terms of oxygen saturation.
Endothelin‐1 signalling controls early embryonic heart rate in vitro and in vivo
Authors: Karppinen S. , Rapila R. , Mäkikallio K. , Hänninen S. L. , Rysä J. , Vuolteenaho O. , Tavi P. 
Published: November 2013

AbstractAimSpontaneous activity of embryonic cardiomyocytes originates from sarcoplasmic reticulum (SR) Ca2+ release during early cardiogenesis. However, the regulation of heart rate during embryonic development is still not clear. The aim of this study was to determine how endothelin‐1 (ET‐1) affects the heart rate of embryonic mice, as well as the pathway through which it exerts its effects.MethodsThe effects of ET‐1 and ET‐1 receptor inhibition on cardiac contraction were studied using confocal Ca2+ imaging of isolated mouse embryonic ventricular cardiomyocytes and ultrasonographic examination of embryonic cardiac contractions in utero. In addition, the amount of ET‐1 peptide and ET receptor a (ETa) and b (ETb) mRNA levels were measured during different stages of development of the cardiac muscle.ResultsHigh ET‐1 concentration and expression of both ETa and ETb receptors was observed in early cardiac tissue. ET‐1 was found to increase the frequency of spontaneous Ca2+ oscillations in E10.5 embryonic cardiomyocytes in vitro. Non‐specific inhibition of ET receptors with tezosentan caused arrhythmia and bradycardia in isolated embryonic cardiomyocytes and in whole embryonic hearts both in vitro (E10.5) and in utero (E12.5). ET‐1‐mediated stimulation of early heart rate was found to occur via ETb receptors and subsequent inositol trisphosphate receptor activation and increased SR Ca2+ leak.ConclusionEndothelin‐1 is required to maintain a sufficient heart rate, as well as to prevent arrhythmia during early development of the mouse heart. This is achieved through ETb receptor, which stimulates Ca2+ leak through IP3 receptors.
Improving Amphetamine Therapeutic Selectivity: N,N‐dimethyl‐MTA has Dopaminergic Effects and does not Produce Aortic Contraction
Authors: Sotomayor‐Zárate Ramón , Jara Pablo , Araos Patricio , Vinet Raúl , Quiroz Gabriel , Renard Georgina M. , Espinosa Pedro , Hurtado‐Guzmán Claudio , Moya Pablo R. , Iturriaga‐Vásquez Patricio , Gysling Katia , Reyes‐Parada Miguel 
Published: November 2013

AbstractAmphetamine derivatives have therapeutic potential in diseases such as attention deficit hyperactivity disorder, narcolepsy and obesity. However, their prolonged use has been associated with cardiovascular toxicity and addiction. In recent years, we have studied the pharmacological effects of amphetamine derivatives such as methylthioamphetamine (MTA) and N,N‐dimethyl‐thioamphetamine, with the aim of improving their therapeutic selectivity. In this work, we show that similarly to MTA, N,N‐dimethyl‐thioamphetamine has effects on the dopamine system, producing a significant increase in extracellular levels of dopamine (as measured by in vivo brain microdialysis) and locomotor activity, which is a behavioural measure of dopaminergic activation. However, unlike MTA, N,N‐dimethyl‐ thioamphetamine does not produce aortic contraction in vitro. Our results show that N,N‐dimethyl‐thioamphetamine is a drug that retains the dopaminergic effects of amphetamine derivatives but exhibits a lower potential for producing cardiovascular side effects.
Moral Distress and Moral Conflict in Clinical Ethics
Authors: Fourie Carina 
Published: November 2013

AbstractMuch research is currently being conducted on health care practitioners' experiences of moral distress, especially the experience of nurses. What moral distress is, however, is not always clearly delineated and there is some debate as to how it should be defined. This article aims to help to clarify moral distress. My methodology consists primarily of a conceptual analysis, with especial focus on Andrew Jameton's influential description of moral distress.I will identify and aim to resolve two sources of confusion about moral distress: (1) the compound nature of a narrow definition of distress which stipulates a particular cause, i.e. moral constraint, and (2) the distinction drawn between moral dilemma (or, more accurately, moral conflict) and moral distress, which implies that the two are mutually exclusive.In light of these concerns, I argue that the definition of moral distress should be revised so that moral constraint should not be a necessary condition of moral distress, and that moral conflict should be included as a potential cause of distress. Ultimately, I claim that moral distress should be understood as a specific psychological response to morally challenging situations such as those of moral constraint or moral conflict, or both.
Fleshing Out Vulnerability
Authors: Tavaglione Nicolas , Martin Angela K. , Mezger Nathalie , Durieux‐Paillard Sophie , François Anne , Jackson Yves , Hurst Samia A. 
Published: November 2013

AbstractIn the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged – that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care – thus fleshing out a claim‐based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self‐respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice.
Specific Language Impairment Across Languages
Authors: Leonard Laurence B. 
Published: November 2013

AbstractChildren with specific language impairment (SLI) have a significant and longstanding deficit in spoken language ability that adversely affects their social and academic well‐being. Studies of children with SLI in a wide variety of languages reveal diverse symptoms, most of which seem to reflect weaknesses in grammatical computation and phonological short‐term memory. The symptoms of the disorder are sensitive to the type of language being acquired, with extraordinary weaknesses seen in those areas of language that are relatively challenging for younger typically developing children. Although these children's deficits warrant clinical and educational attention, their weaknesses might reflect the extreme end of a language aptitude continuum rather than a distinct, separable condition.
Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries‐active adults
Authors: Brown John P. , Amaechi Bennett T. , Bader James D. , Gilbert Gregg H. , Makhija Sonia K. , Lozano‐Pineda Juanita , Leo Michael C. , Chen Chuhe , Vollmer William M. 
Published: November 2013

AbstractObjectivesTo better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency.MethodsAs part of the Xylitol for Adult Caries Trial (X‐ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations, were selected from the 691 randomized into the 3‐year trial, conducted at three sites. Acceptable inter‐ and intra‐examiner reliability before and during the trial was quantified using the kappa statistic.ResultsThe mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit.ConclusionsThere was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X‐ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full‐scale, placebo‐controlled, multisite, randomized, double‐blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration: ClinicalTrials.Gov NCT00393055.
Chinese herbal medicine for idiopathic sudden sensorineural hearing loss: a systematic review of randomised clinical trials
Authors: Su C.‐X. , Yan L.‐J. , Lewith G. , Liu J.‐P. 
Published: November 2013

BackgroundIdiopathic sudden sensorineural hearing loss has great impact on quality of life. Many clinical trials using Chinese herbal medicine for idiopathic sudden sensorineural hearing loss have been conducted and reported beneficial results. However, there is no critical appraised evidence on efficacy and safety of Chinese herbal medicine for idiopathic sudden sensorineural hearing loss to inform clinical use.Objective of reviewTo assess the beneficial effect and safety of Chinese herbal medicine for idiopathic sudden sensorineural hearing loss.Type of reviewSystematic review of randomised clinical trials.Search strategySeven electronic databases and two trial registries were searched for all eligible trials from inception to January 2013.Evaluation methodTwo authors independently selected trials and extracted data. The Cochrane risk of bias tool was utilised to assess the methodological quality of the included trials. revman 5.2 software was applied for data analysis with effect estimate presented as risk ratio and mean difference with its 95% confidence interval.ResultsForty‐one randomised clinical trials involving 3560 participants were identified. Five kinds of Chinese herbal medicine were trialed. All trials compared conventional therapies of steroids, vasodilaltors, anticoagulants, nutritional supplements or hyperbaric oxygen with or without herbal medicine. No trial was identified that compared herbal medicine alone with placebo. No trial was identified that blinded the participants or the observers to their herbal medication. Only one trial adequately reported its method of randomisation. No trial reported the sample size calculated to show an effect. All trials had material other defects giving a high likelihood of bias. Because of the overall poor quality of all 41 trials, it was concluded that there was no level‐one evidence to support the use of Chinese herbal medicine, alone or in addition to conventional therapies, to improve the hearing in adults with idiopathic sudden sensorineural hearing loss. Two trials reported adverse effects, and no severe adverse effects were found in the Chinese herbal medicine groups.ConclusionsThe existing evidence for the beneficial effect and safety of Chinese herbal medicine for idiopathic sudden sensorineural hearing loss comes from methodologically poor studies and therefore cannot be reliably used to support their clinical use. We identify a justification to further investigate the effect and safety of Chinese herbal medicine for people with idiopathic sudden sensorineural hearing loss in rigorously designed randomised trials.
Identifying Barriers to Healthcare to Reduce Health Disparity in Zuni Indians Using Focus Group Conducted by Community Health Workers
Authors: Shah Vallabh O. , Ghahate Donica M , Bobelu Jeanette , Sandy Phillip , Newman Sara , Helitzer Deborah L. , Faber Thomas , Zager Philip 
Published: November 2013

AbstractThe Zuni Pueblo is home to an economically disadvantaged population, which faces a public health challenge from the interrelated epidemics of obesity, diabetes and kidney disease. Efforts to decrease the impact of these epidemics have been complicated by historical, economic and cultural barriers, which may limit healthcare utilization. The NIH supported Zuni Health Initiative (ZHI) conducted a study to identify barriers to healthcare in the Zuni Pueblo.Community health representatives (CHRs) led 14 one‐hour focus group sessions at which a total of 112 people participated posed unique questions that took into account the Zuni culture to elicit information on perceived barriers to healthcare. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program.We identified nine themes emerged regarding the barriers experienced in receiving healthcare and adhering to medical advice. These included distance; transportation; embarrassment; relating to healthcare professionals; navigating the medical system; awareness of available resources; waiting times; adhering to medication; and incentives in health promotion.In conclusion the implementation of culturally appropriate community‐based health promotion programs and preventive screening techniques will improve access to healthcare and diminish health disparities.
The Social Value of Knowledge and International Clinical Research
Authors: Wenner Danielle M. 
Published: November 2013

AbstractIn light of the growth in the conduct of international clinical research in developing populations, this paper seeks to explore what is owed to developing world communities who host international clinical research. Although existing paradigms for assigning and assessing benefits to host communities offer valuable insight, I criticize their failure to distinguish between those benefits which can justify the conduct of research in a developing world setting and those which cannot. I argue that the justification for human subjects research is fundamentally grounded in the social value of knowledge, and that this value is context‐dependent in a manner which should inform our ethical evaluation of the conduct of research in specific settings. I propose a new framework for the assessment of research benefits assigned to developing world host communities, a natural implication of which is to limit the types of research projects which may permissibly be conducted in developing world settings.