bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Dietary Modification on Incident Carotid Artery Disease in Postmenopausal Women
Authors: Allison Matthew A. , Aragaki Aaron , Eaton Charles , Li Wenjun , Van Horn Linda , Daviglus Martha L. , Berger Jeffrey S. 
Published: April 2014

Background and Purpose—
Because the diagnosis and treatment of carotid artery disease may reduce the rate of stroke, the aim of this study was to determine whether a diet intervention was associated with incident carotid artery disease.

Methods—
Participants were 48 835 postmenopausal women aged 50 to 79 years who were randomly assigned to either the intervention or comparison group in the Women’s Health Initiative Diet Modification Trial. Incident carotid artery disease was defined as an overnight hospitalization with either symptoms or a surgical intervention to improve flow.

Results—
After a mean follow-up of 8.3 years from 1994 to 2005, there were 297 (0.61%) incident carotid artery events. In contrast to the comparison group, the risk of incident carotid disease did not differ from those assigned to the intervention group (hazard ratio, 1.08; 95% confidence interval, 0.9–1.4). In secondary analysis, there was no significant effect of the intervention on the risk for incident carotid disease during the 5 years of postintervention follow-up from 2005 to 2010 (hazard ratio, 1.24; 95% confidence interval, 0.9–1.7) and no significant effect during cumulative follow-up from 1994 to 2010 (hazard ratio, 1.13; 95% confidence interval, 0.9–1.4).

Conclusions—
Among postmenopausal women, a dietary intervention aimed at reducing total fat intake and encouraging increased intake of fruit, vegetables, and grains did not significantly change the risk for incident carotid artery disease.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00000611.
Second-Look Arthroscopic Evaluation of Cartilage Lesions After Mesenchymal Stem Cell Implantation in Osteoarthritic Knees
Authors: Koh Yong Gon , Choi Yun Jin , Kwon Oh Ryong , Kim Yong Sang 
Published: April 2014

Background: Cartilage regenerative procedures have been receiving increased interest because of their potential to alter the progression of osteoarthritis (OA). The application of mesenchymal stem cells (MSCs) has been proposed as a new treatment option for OA based on the ability of these cells to differentiate into chondrocytes. Purpose: To investigate the clinical and second-look arthroscopic outcomes of MSC implantation and to identify prognostic factors associated with this treatment. Study Design: Case series; Level of evidence, 4. Methods: This study retrospectively evaluated 37 knees examined using second-look arthroscopic surgery after MSC implantation for cartilage lesions in OA knees. Clinical outcomes were evaluated according to the International Knee Documentation Committee (IKDC) score and Tegner activity scale, and cartilage repair was assessed using International Cartilage Repair Society (ICRS) grading. Statistical analyses were performed to identify various prognostic factors associated with the clinical and second-look arthroscopic outcomes. Results: The mean patient age was 57.4 years (range, 48-69 years), the mean follow-up period was 26.5 months (range, 24-34 months), the mean body mass index (BMI) was 26.3 kg/m2 (range, 19.8-31.2 kg/m2), and the mean lesion size was 5.4 ± 2.9 cm2 (range, 2.3-8.9 cm2). The mean IKDC and Tegner activity scale scores were significantly improved from 38.0 ± 7.8 to 61.0 ± 11.0 and from 2.5 ± 0.5 to 3.6 ± 0.7, respectively ( P < .001 for both). According to the ICRS overall repair grades at second-look arthroscopic surgery, 2 of the 37 lesions (5%) were grade I (normal), 7 (19%) were grade II (near normal), 20 (54%) were grade III (abnormal), and 8 (22%) were grade IV (severely abnormal). In terms of overall patient satisfaction with the operation, 33 (94%) patients reported good to excellent satisfaction. High BMI (≥27.5 kg/m2) and large lesion size (≥5.4 cm2) were found to be significant predictors of poor clinical and arthroscopic outcomes ( P < .05 for both). Other prognostic factors, including patient age, sex, cartilage lesion location, and presence of subchondral cysts, did not significantly influence the outcomes ( P > .05). Conclusion: The outcomes of MSC implantation for cartilage repair in OA knees seem encouraging; high BMI and large lesion size are important factors affecting outcomes. Although still in the early stages of application, MSC implantation for cartilage repair may have great potential for the treatment of OA knees. However, second-look arthroscopic findings revealed that 76% had the repair rated as abnormal or severely abnormal by ICRS standards. The development of an advanced surgical procedure with tissue-engineered scaffolds may be needed to treat patients with large cartilage lesions.
The Carotid Intima–Media Thickness Modification Following Atorvastatin is Bound to the Modification of the Oxidative Balance
Authors: Belcaro Gianni , Cornelli Umberto , Finco Annarosa 
Published: April 2014

Background: Despite the reduction in cholesterol (CH) levels, the modification of carotid intima–media thickness (CIMT) is not evident in all the patients treated with statins. Activities other than CH reduction may determine the improvement in CIMT. Methods: Twenty-two patients with hypercholesterolemia (aged 45-60; males) with CIMT increase started the treatment with atorvastatin. The CIMT (via echography), CH level, and the oxidative balance (OB) were measured at baseline and after 4 weeks. The OB consisted of the determination of the plasmatic hydroperoxides (reactive oxygen metabolites [d-ROMs] test) and the antioxidant reserve (plasma antioxidants test [PAT]). The d-ROMs/CH and PAT/CH ratios allowed to measure, respectively, the oxidative index (OI) and the protective index (PI). The OI/PI ratio represented the OB Risk Index (OBRI) to be compared with the CIMT modifications. Results: An average reduction of 22% in CH was achieved in the group of patients together with an increase in both OI and PI (16% and 39% respectively) with a significant improvement in OBRI from 2.6 to 1.7 (analysis of variance P < .01). A reduction of >20% in CIMT was obtained in 10 patients whereas in the 12 patients no modification of CIMT was detected, despite the same CH reduction (−55 ± 24.8 and −66 ± 27.1 mg/dL respectively; P > .05). Only those patients with a decrease in OBRI ≥0.8 showed a reduction in CIMT >20%. Conclusions: In this preliminary study, a significant modification in CIMT was obtained with atorvastatin treatment only in those patients showing an improvement in the OB (OBRI > 0.8).
Sixty-Seven Consecutive Resuscitative Thoracotomies by A Single Surgeon
Authors: Rabinovici R. 
Published: April 2014

Background: Resuscitative thoracotomy is a dramatic operation performed in otherwise unsalvageable trauma patients. Analysis of its efficacy is based mostly on institutional series compiling the experience of multiple surgeons. This study aimed to report more consistent information by describing the resuscitative thoracotomy practice of a single surgeon and its evolution during more than two decades. Methods: A retrospective review of consecutive patients who underwent resuscitative thoracotomy in July 1990 to December 2012. Demographics, mechanism of injury, signs of life, injuries, and outcomes were analyzed. Comparisons were made between penetrating and blunt trauma patients and between pre- and post-introduction of a selective resuscitative thoracotomy protocol. Results: Sixty-seven resuscitative thoracotomies were performed. Most patients were males (84%), and mean age was 38 years. Mechanism of injury was stab wounds (54%, 36), blunt force (25%, 17), and gunshot wounds (21%, 14). Survival was 22% (8/36), 0% (0/17), and 7% (1/14), respectively. All nine survivors had signs of life upon admission, and survival in patients with signs of life on admission was 25% (8/32) in the stab wounds group and 8% (1/12) in the gunshot wounds group. Seven of the nine survivors (78%) were discharged neurologically intact. The most common injury in survivors was cardiac laceration with tamponade (6/9) and lung injury (3/9). Three survivors had a cardiac and lung injury, one had a lung hilum injury, and one had an abdominal inferior vena cava laceration. The switch to resuscitative thoracotomy protocol (2002) improved overall (31 vs 8%, p < 0.05) and penetrating trauma (45 vs 10%, p < 0.05) survival, eliminated resuscitative thoracotomy in patients presenting with no signs of life, and tended to reduce resuscitative thoracotomy utilization in blunt trauma patients. Conclusion: This single-surgeon series supports that resuscitative thoracotomy can be lifesaving in selected penetrating trauma patients in extremis. A switch to a selective evidence-based protocol increased overall and penetrating resuscitative thoracotomy survival and limited resuscitative thoracotomy performance to patients arriving with signs of life.
G protein-coupled receptor 56 regulates matrix production and motility of lung fibroblasts
Authors: Yang Jian , Wang Zhanyong , Leng Dong , Dai Huaping , Wang Jun , Liang Jiurong , Jiang Dianhua , Wang Chen 
Published: April 2014

Idiopathic pulmonary fibrosis is a chronic, progressive, and fatal fibrotic lung disease with a poor prognosis, but no effective treatment is available. G protein-coupled receptor 56 (GPR56) plays a role in cell adhesion and tumor progression, but its function in fibrogenesis has not been explored. In this in vitro study, we found that GPR56 in IPF fibroblasts was lower than in normal fibroblasts. GPR56 regulated the production of fibronectin and type I collagen, and also changed the migratory and invasive capacity of lung fibroblasts. However, it was not sufficient to activate some classic markers of fibroblast and myofibroblast, such as α-smooth muscle actin and fibroblast specific protein 1. These findings demonstrate that reduced expression of GPR56 in lung fibroblasts may be an important link with pulmonary fibrosis, playing a role in regulating some important fibroblast functions.
Neonatal outcomes following in utero exposure to buprenorphine/naloxone or methadone
Authors: Gawronski Kristen M , Prasad Mona R , Backes Carl R , Lehman K Joy , Gardner Debra K , Cordero Leandro 
Published: April 2014

Objectives: To study neonatal outcomes following buprenorphine/naloxone and methadone exposure during pregnancy. Methods: This study is a retrospective review of clinical and demographic information of 58 infants whose mothers were treated with buprenorphine/naloxone and 92 infants whose mothers were treated with methadone for opioid dependence during pregnancy. Results: Gestational age, birth weight, prematurity, admission to neonatal intensive care unit, and length of stay were similar between both groups of infants. Neonatal abstinence syndrome occurred less frequently among infants of mothers treated with buprenorphine/naloxone than those treated with methadone (64% and 80%, respectively, p = 0.03). All infants with neonatal abstinence syndrome were treated postnatally with methadone. There was a trend toward shorter duration of treatment and lower cumulative dosages of methadone among the buprenorphine/naloxone–exposed infants. Conclusions: No apparent significant adverse neonatal outcomes were detected following treatment with either maintenance medication; however, further prospective research is necessary to examine the safety and efficacy of buprenorphine/naloxone in pregnancy and its effects on the neonate.
Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation
Authors: Armand Philippe , Kim Haesook T. , Logan Brent R. , Wang Zhiwei , Alyea Edwin P. , Kalaycio Matt E. , Maziarz Richard T. , Antin Joseph H. , Soiffer Robert J. , Weisdorf Daniel J. , Rizzo J. Douglas , Horowitz Mary M. , Saber Wael 
Published: April 2014

Key Points
The DRI successfully stratified patients in a very large allogeneic transplantation registry cohort. The DRI was refined by using this cohort to build a more inclusive and conditioning intensity–independent index.
Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults
Authors: Dumas Orianne , Laurent Emeline , Bousquet Jean , Metspalu Andres , Milani Lili , Kauffmann Francine , Le Moual Nicole 
Published: April 2014

Occupational exposures make important contributions to asthma morbidity. The role of low/moderate level irritant exposures remains unclear. We aimed to determine which occupational exposures are associated with asthma in an eastern European country with low asthma prevalence.The Estonian Genome Center of University of Tartu collected data from 50 077 adults in 2002–2011. Asthma was assessed through a questionnaire regarding diagnosed diseases, current health status and medication. Exposures to 22 agents during the current and longest held jobs were estimated using an asthma-specific job–exposure matrix.Analyses included 34 015 subjects (aged 18–65 years, 67.0% females), of which 1209 (3.6%) reported asthma (608 with physician-confirmed diagnosis). After adjusting for age, sex and smoking habits, lifetime occupational exposure to known asthmagens (20.4%) was significantly associated with physician-diagnosed asthma (OR 1.28, 95% CI 1.03–1.59), especially high molecular weight agents (flour: OR 2.36, 95% CI 1.31–4.27; animals: OR 1.62, 95% CI 1.00–2.60). Exposure to low/moderate levels of irritants (17.4%) was associated with physician-diagnosed asthma (OR 1.88, 95% CI 1.48–2.37). More pronounced associations were observed in subjects reporting current treated asthma.Beyond confirming the effect of known asthmagens (which are well-known, mostly from observations in western countries), the results provide evidence for a role of low/moderate exposure to irritants. This finding, observed in a country with a low prevalence of asthma and atopy, provides new insight into the understanding of asthma heterogeneity.
Implementation of hospital governing boards: views from the field
Authors: McNatt Zahirah , Thompson Jennifer W , Mengistu Abraham , Tatek Dawit , Linnander Erika , Ageze Leulseged , Lawson Ruth , Berhanu Negalign , Bradley Elizabeth H 
Published: April 2014

Abstract

Background
Decentralization through the establishment of hospital governing boards has been touted as an effective way to improve the quality and efficiency of hospitals in low-income countries. Although several studies have examined the process of decentralization, few have quantitatively assessed the implementation of hospital governing boards and their impact on hospital performance. Therefore, we sought to describe the functioning of governing boards and to determine the association between governing board functioning and hospital performance.

Methods
We conducted a cross-sectional study with governing board chairpersons to assess board (1) structure, (2) roles and responsibilities and (3) training and orientation practices. Using bivariate analysis and multivariable regression, we examined the association between governing board functioning and hospital performance. Hospital performance indicators: 1) percent of hospital management standards met, measured with the Ethiopian Hospital Reform Implementation Guidelines and 2) patient experience, measured with the Inpatient and Outpatient Assessment of Healthcare surveys.

Results
A total of 92 boards responded to the survey (96% response rate). The average percentage of EHRIG standards met was 58.1% (standard deviation (SD) 21.7 percentage points), and the mean overall patient experience score was 7.2 (SD 2.2). Hospitals with greater hospital management standards met had governing boards that paid members, reviewed performance in several domains quarterly or more frequently, developed new revenue sources, determined services to be outsourced, reviewed patient complaints, and had members with knowledge in business and financial management (all P-values < 0.05). Hospitals with more positive patient experience had governing boards that developed new revenue sources, determined services to be outsourced, and reviewed patient complaints (all P-values < 0.05).

Conclusions
These cross-sectional data suggest that strengthening governing boards to perform essential responsibilities may result in improved hospital performance.
Prophylactic Cannabinoid Administration Blocks the Development of Paclitaxel-Induced Neuropathic Nociception during Analgesic Treatment and following Cessation of Drug Delivery
Authors: Rahn Elizabeth J , Deng Liting , Thakur Ganesh A , Vemuri Kiran , Zvonok Alexander M , Lai Yvonne Y , Makriyannis Alexandros , Hohmann Andrea G 
Published: April 2014

Background: Chemotherapeutic treatment results in chronic pain in an estimated 30–40 percent of patients. Limited and often ineffective treatments make the need for new therapeutics an urgent one. We compared the effects of prophylactic cannabinoids as a preventative strategy for suppressing development of paclitaxel-induced nociception. The mixed CB1/CB2 agonist WIN55,212–2 was compared with the cannabilactone CB2-selective agonist AM1710, administered subcutaneously (s.c.), via osmotic mini pumps before, during, and after paclitaxel treatment. Pharmacological specificity was assessed using CB1 (AM251) and CB2 (AM630) antagonists. The impact of chronic drug infusion on transcriptional regulation of mRNA markers of astrocytes (GFAP), microglia (CD11b) and cannabinoid receptors (CB1,CB2) was assessed in lumbar spinal cords of paclitaxel and vehicle-treated rats. Results: Both WIN55,212–2 and AM1710 blocked the development of paclitaxel-induced mechanical and cold allodynia; anti-allodynic efficacy persisted for approximately two to three weeks following cessation of drug delivery. WIN55,212–2 (0.1 and 0.5 mg/kg/day s.c.) suppressed the development of both paclitaxel-induced mechanical and cold allodynia. WIN55,212–2–mediated suppression of mechanical hypersensitivity was dominated by CB1 activation whereas suppression of cold allodynia was relatively insensitive to blockade by either CB1 (AM251; 3 mg/kg/day s.c.) or CB2 (AM630; 3 mg/kg/day s.c.) antagonists. AM1710 (0.032 and 3.2 mg/kg/day) suppressed development of mechanical allodynia whereas only the highest dose (3.2 mg/kg/day s.c.) suppressed cold allodynia. Anti-allodynic effects of AM1710 (3.2 mg/kg/day s.c.) were mediated by CB2. Anti-allodynic efficacy of AM1710 outlasted that produced by chronic WIN55,212–2 infusion. mRNA expression levels of the astrocytic marker GFAP was marginally increased by paclitaxel treatment whereas expression of the microglial marker CD11b was unchanged. Both WIN55,212–2 (0.5 mg/kg/day s.c.) and AM1710 (3.2 mg/kg/day s.c.) increased CB1 and CB2 mRNA expression in lumbar spinal cord of paclitaxel-treated rats in a manner blocked by AM630. Conclusions and implications: Cannabinoids block development of paclitaxel-induced neuropathy and protect against neuropathic allodynia following cessation of drug delivery. Chronic treatment with both mixed CB1/CB2 and CB2 selective cannabinoids increased mRNA expression of cannabinoid receptors (CB1, CB2) in a CB2-dependent fashion. Our results support the therapeutic potential of cannabinoids for suppressing chemotherapy-induced neuropathy in humans.
Modulation of pro-inflammatory activation of monocytes and dendritic cells by aza-bis-phosphonate dendrimer as an experimental therapeutic agent
Authors: Degboé Yannick , Fruchon Séverine , Baron Michel , Nigon Delphine , Turrin Cédric Olivier , Caminade Anne-Marie , Poupot Rémy , Cantagrel Alain , Davignon Jean-Luc 
Published: April 2014

Abstract
Introduction
Our objective was to assess the capacity of dendrimer aza-bis-phosphonate (ABP) to modulate phenotype of monocytes (Mo) and monocytes derived dendritic cells (MoDC) activated in response to toll-like receptor 4 (TLR4) and interferon γ (IFN- γ) stimulation.

Methods
Mo (n = 12) and MoDC (n = 11) from peripheral blood of healthy donors were prepared. Cells were preincubated or not for 1 hour with dendrimer ABP, then incubated with lipopolysaccharide (LPS; as a TLR4 ligand) and (IFN-γ) for 38 hours. Secretion of tumor necrosis factor α (TNFα), interleukin (IL) -1, IL-6, IL-12, IL-10 and IL-23 in the culture medium was measured by enzyme-linked immunosorbent assay (ELISA) and Cytokine Bead Array. Differentiation and subsequent maturation of MoDC from nine donors in the presence of LPS were analyzed by flow cytometry using CD80, CD86, CD83 and CD1a surface expression as markers.

Results
Mo and MoDC were orientated to a pro-inflammatory state. In activated Mo, TNFα, IL-1β and IL-23 levels were significantly lower after prior incubation with dendrimer ABP. In activated MoDC, dendrimer ABP promoted IL-10 secretion while decreasing dramatically the level of IL-12. TNFα and IL-6 secretion were significantly lower in the presence of dendrimer ABP. LPS driven maturation of MoDC was impaired by dendrimer ABP treatment, as attested by the significantly lower expression of CD80 and CD86.

Conclusion
Our data indicate that dendrimer ABP possesses immunomodulatory properties on human Mo and MoDC, in TLR4 + IFN-γ stimulation model, by inducing M2 alternative activation of Mo and promoting tolerogenic MoDC.
Δ9-Tetrahydrocannabinol-induced anti-inflammatory responses in adolescent mice switch to proinflammatory in adulthood
Authors: Moretti Sarah , Castelli Mara , Franchi Silvia , Raggi Maria Augusta , Mercolini Laura , Protti Michele , Somaini Lorenzo , Panerai Alberto E , Sacerdote Paola 
Published: April 2014

AbstractMarijuana abuse is prominent among adolescents. Although Δ9-THC, one of its main components, has been demonstrated to modulate immunity in adults, little is known about its impact during adolescence on the immune system and the long-lasting effects in adulthood. We demonstrate that 10 days of Δ9-THC treatment induced a similar alteration of macrophage and splenocyte cytokines in adolescent and adult mice. Immediately at the end of chronic Δ9-THC, a decrease of proinflammatory cytokines IL- 1β and TNF-α and an increase of anti-inflammatory cytokine IL-10 production by macrophages were present as protein and mRNA in adolescent and adult mice. In splenocytes, Δ9-THC modulated Th1/Th2 cytokines skewing toward Th2: IFN-γ was reduced, and IL-4 and IL-10 increased. These effects were lost in adult animals, 47 days after the last administration. In contrast, in adult animals treated as adolescents, a perturbation of immune responses, although in an opposite direction, was present. In adults treated as adolescents, a proinflammatory macrophage phenotype was observed (IL-1β and TNF-α were elevated; IL-10 decreased), and the production of Th cytokines was blunted. IgM titers were also reduced. Corticosterone concentrations indicate a long-lasting dysregulation of HPA in adolescent mice. We measured blood concentrations of Δ9-THC and its metabolites, showing that Δ9-THC plasma levels in our mice are in the order of those achieved in human heavy smokers. Our data demonstrate that Δ9-THC in adolescent mice triggers immune dysfunctions that last long after the end of abuse, switching the murine immune system to proinflammatory status in adulthood.