bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracellular factors and immunosuppressive drugs influencing insulin secretion of murine islets
Authors: Auer V J , Janas E , Ninichuk V , Eppler E , Weiss T S , Kirchner S , Otto A M , Stangl M J 
Published: September 2012

SummaryApproximately 60% of transplanted islets undergo apoptosis within the first week post-transplantation into the liver attributed to poor engraftment, immune rejection and toxicity of immunosuppressive drugs. Understanding how extracellular matrix (ECM) components, immunosuppressive drugs and proinflammatory cytokines affect insulin secretion will contribute to an improved clinical outcome of islet transplantations. In this study, functional activity of isolated murine islets was measured by glucose-stimulated insulin secretion (GSIS) and by electrophysiological measurements using patch-clamp. Cultivating islets with soluble fibronectin or laminin, as opposed to with coated laminin, markedly increased GSIS. Addition of cyclosporin A reduced GSIS and suppressed glucose-induced spike activity. Tacrolimus affected neither GSIS nor spike activity, indicating a different mechanism. To evaluate the influence of proinflammatory cytokines, islets were incubated with interleukin (IL)-1β, tumour necrosis factor (TNF)-α or with supernatants from cultured Kupffer cells, the main mediators of inflammation in the hepatic sinusoids. IL-1β exerted a bimodal effect on insulin secretion, stimulating below 2 ng/ml and suppressing above 10 ng/ml. Soluble laminin in combination with a stimulatory IL-1β concentration further increased insulin secretion by 20% compared to IL-1β alone, while with high IL-1β concentrations soluble laminin slightly attenuated GSIS inhibition. TNF-α alone did not affect GSIS, but with stimulatory IL-1β concentrations completely abolished it. Similarly, supernatants derived from Kupffer cells exerted a bimodal effect on GSIS. Our data suggest that improved insulin secretion of transplanted islets could be achieved by including soluble laminin and low IL-1β concentrations in the islet cultivation medium, and by a simultaneous inhibition of cytokine secretion from Kupffer cells.
Systemic mast cell activation disease: the role of molecular genetic alterations in pathogenesis, heritability and diagnostics
Authors: Haenisch Britta , Nöthen Markus M. , Molderings Gerhard J. 
Published: September 2012

SummaryDespite increasing understanding of its pathophysiology, the aetiology of systemic mast cell activation disease (MCAD) remains largely unknown. Research has shown that somatic mutations in kinases are necessary for the establishment of a clonal mast cell population, in particular mutations in the tyrosine kinase Kit and in enzymes and receptors with crucial involvement in the regulation of mast cell activity. However, other, as yet undetermined, abnormalities are necessary for the manifestation of clinical disease. The present article reviews molecular genetic research into the identification of disease‐associated genes and their mutational alterations. The authors also present novel data on familial systemic MCAD and review the associated literature. Finally, the importance of understanding the molecular basis of inherited mutations in terms of diagnostics and therapy is emphasized.
The relationship between the levels of nurses’ competence and the length of their clinical experience: a tentative model for nursing competence development
Authors: Takase Miyuki 
Published: September 2012

Aims and objectives.  To explore the relationship between the levels of nurses’ competence and the length of their clinical experience, in order to provide a tentative model of the continuing competence of nurses.Background.  The professional development of employees has attracted great interest. This interest has led to the development of various models that illustrate how employees develop their competence throughout their careers. However, little is known of how nurses maintain and develop their competence throughout their career pathways.Design.  A cross‐sectional design was used.Methods.  Using a survey method, five dimensions of self‐assessed nursing competence and the length of the nurses’ clinical practice were measured (n = 325). Each dimension of competence was plotted against the length of their clinical experience using locally weighted scatterplot smoothing. Then, the shapes of the plots were analysed by fractional polynomial regression analysis.Results.  Overall, the relationships between the levels of nursing competence and the length of clinical experience were illustrated by curves with a rapid increase in competence levels at the early stage of the nursing career and a slower increase later. These curves were modelled by either a logarithmic, square‐root function or its reciprocal. The results supported the learning curve model.Conclusions.  The competence development of nurses may be characterised by two distinctive periods: a rapid growth period followed by stable periods. However, the modality of the growth may be different depending on which dimension of nursing competence is in focus.Relevance to clinical practice.  The level of nursing competence directly affects the quality of care provided to patients. The findings of the study enable healthcare organisations to take proactive approaches to enhance nurses’ competence by identifying when and how to assist nurses.
The reported expression of pain and distress by people with an intellectual disability
Authors: McKenzie Karen , Smith Marion , Purcell Ann‐Marie 
Published: September 2012

Aims and objectives.  To explore the assumption that people with ID are unable to communicate effectively about pain by examining the extent to which they were reported as using language and behaviour that was readily understandable to others to communicate pain as distinct from distress.Background.  The healthcare needs of people with an intellectual disability (ID) are frequently overlooked or dealt with inappropriately. One proposed reason is the difficulty that such individuals have in communicating about their pain.Design.  A postal questionnaire‐based mixed method design was used.Methods.  Data from carer reports (n = 29) of the ways people with ID supported expressed pain and distress were categorised and analysed using descriptive statistics and thematic content analysis.Results.  Nineteen of the 22 people who used verbal communication were reported to express pain using words that would be understandable to someone else, often accompanied by behavioural indications of the location of the pain. The language and behaviour that were reported as being used to express distress was more idiosyncratic, and there was little overlap between this and the ways in which pain was expressed.Conclusion.  The results provide some challenges to the view that people with ID are necessarily unable to communicate effectively about their pain and support the view that pain and distress can be conceptually distinguished and differentially communicated by some people with ID.Relevance to clinical practice.  The results suggest that many people with ID can be active participants in describing their experience of pain and that nurses should attempt to obtain this information directly from the individual during the diagnostic process. Nurses should be mindful of the distinction between pain and distress and should not respond to signs of distress in this group as being indicative of pain, without carrying out further assessment.
HRTEM of 1DSnTe@SWNT nanocomposite located on thin layers of graphite
Authors: KUMSKOV A.S. , ELISEEV A.A. , FREITAG B. , KISELEV N.A. 
Published: September 2012

SummaryThe method for imaging of highly sensitive nanostructures unstable under electron beam irradiation is introduced. To reduce charge and thermally generated beam damage, highly conductive multilayered graphene or thin graphite layers were used as supports for nanostructures. Well‐defined crystalline structure of graphite layers enables image reconstruction by Fourier filtering and allows maintaining high quality of images. The approach was tested for imaging of highly sensitive quasi one‐dimensional SnTe nanocrystals hosted inside single‐walled carbon nanotubes. Relying on the filtered images and the image simulation, the structure of one‐dimensional SnTe was established as a chain of fcc NaCl type unit cells, connected by the [001] edges with <110> direction coinciding with nanotube axis.
Social Opportunity Causes Rapid Transcriptional Changes in the Social Behaviour Network of the Brain in an African Cichlid Fish
Authors: Maruska K. P. , Zhang A. , Neboori A. , Fernald R. D. 
Published: September 2012

Animals constantly integrate external stimuli with their own internal physiological state to make appropriate behavioural decisions. Little is known, however, about where in the brain the salience of these signals is evaluated, or which neural and transcriptional mechanisms link this integration to adaptive behaviours. We used an African cichlid fish Astatotilapia burtoni to test the hypothesis that a new social opportunity activates the conserved ‘social behaviour network’ (SBN), a collection of brain nuclei known to regulate social behaviours across vertebrates. We measured mRNA levels of immediate early genes (IEGs) in microdissected brain regions as a proxy for neuronal activation, and discovered that IEGs were higher in all SBN nuclei in males that were given an opportunity to rise in social rank compared to control stable subordinate and dominant individuals. Furthermore, because the presence of sex‐steroid receptors is one defining criteria of SBN nuclei, we also tested whether social opportunity or status influenced androgen and oestrogen receptor mRNA levels within these same regions. There were several rapid region‐specific changes in receptor mRNA levels induced by social opportunity, most notably in oestrogen receptor subtypes in areas that regulate social aggression and reproduction, suggesting that oestrogenic signalling pathways play an important role in regulating male status. Several receptor mRNA changes occurred in regions with putative homologies to the mammalian septum and extended amygdala, two regions shared by SBN and reward circuits, suggesting an important role in the integration of social salience, stressors, hormonal state and adaptive behaviours. We also demonstrated increases in plasma sex‐ and stress‐steroids at 30 min after a rise in social rank. This rapid endocrine and transcriptional response suggests that the SBN is involved in the integration of social inputs with internal hormonal state to facilitate the transition to dominant status, which ultimately leads to improved fitness for the previously reproductively‐suppressed individual.
Pyrite geochemistry in the Toarcian Posidonia Shale of south‐west Germany: Evidence for contrasting trace‐element patterns of diagenetic and syngenetic pyrites
Authors: BERNER ZSOLT A. , PUCHELT HARALD , NÖLTNER THOMAS , KRAMAR UTZ 
Published: September 2012

AbstractAuthigenic pyrite grains from a section of the Lower Toarcian Posidonia Shale were analysed for their trace‐element contents and sulphur‐isotope compositions. The resulting data are used to evaluate the relationship between depositional conditions and pyrite trace‐element composition. By using factor analysis, trace‐elements in pyrite may be assigned to four groups: (i) heavy metals (including Cu, Ni, Co, Pb, Bi and Tl); (ii) oxyanionic elements (As, Mo and Sb); (iii) elements partitioned in sub‐microscopic sphalerite inclusions (Zn and Cd); and (iv) elements related to organic or silicate impurities (Ga and V). Results indicate that trace‐element contents in pyrite depend on the site and mechanism of pyrite formation, with characteristic features being observed for diagenetic and syngenetic pyrites. Diagenetic pyrite formed within anoxic sediments generally has a high heavy metals content, and the degree of pyritization of these elements increases with increasing oxygen deficiency, similar to the degree of pyritization of reactive Fe. The highest gradient in the increase of the degree of trace element pyritization with bottom‐water oxygenation was found for the elements Ni < Cu < Mo = As < Tl. In contrast, syngenetic pyrite formed within a euxinic water column typically is enriched in As, Mo and Sb, but is low in heavy metals, and the geochemical variation reflects changes in sea water composition.
Management of difficult multidrug‐resistant tuberculosis and extensively drug‐resistant tuberculosis: Update 2012
Authors: CHANG KWOK ‐CHIU , YEW WING‐WAI 
Published: September 2012

ABSTRACTMultidrug‐resistant (MDR) tuberculosis (TB) denotes bacillary resistance to at least isoniazid and rifampicin. Extensively drug‐resistant (XDR) TB is MDR‐TB with additional bacillary resistance to any fluoroquinolone and at least one second‐line injectable drugs. Rooted in inadequate TB treatment and compounded by a vicious circle of diagnostic delay and improper treatment, MDR‐TB/XDR‐TB has become a global epidemic that is fuelled by poverty, human immunodeficiency virus (HIV) and neglect of airborne infection control. The majority of MDR‐TB cases in some settings with high prevalence of MDR‐TB are due to transmission of drug‐resistant bacillary strains to previously untreated patients. Global efforts in controlling MDR‐TB/XDR‐TB can no longer focus solely on high‐risk patients. It is difficult and costly to treat MDR‐TB/XDR‐TB. Without timely implementation of preventive and management strategies, difficult MDR‐TB/XDR‐TB can cripple global TB control efforts. Preventive strategies include prompt diagnosis with adequate TB treatment using the directly observed therapy, short‐course (DOTS) strategy and drug‐resistance programmes, airborne infection control, preventive treatment of TB/HIV, and optimal use of antiretroviral therapy. Management strategies for established cases of difficult MDR‐TB/XDR‐TB rely on harnessing existing drugs (notably newer generation fluoroquinolones, high‐dose isoniazid, linezolid and pyrazinamide with in vitro activity) in the best combinations and dosing schedules, together with adjunctive surgery in carefully selected cases. Immunotherapy may also have a role in the future. New diagnostics, drugs and vaccines are required to meet the challenge, but science alone is insufficient. Difficult MDR‐TB/XDR‐TB cannot be tackled without achieving high cure rates with quality DOTS and beyond, and concurrently addressing poverty and HIV.
Clinical testing for molecular targets for personalized treatment in lung cancer
Authors: LAM DAVID C.L. 
Published: September 2012

ABSTRACTLung cancer is the leading cause of cancer mortality worldwide. Over the past decades, the management of advanced stage lung cancer has been revolutionized from very limited options of systemic chemotherapy with limited efficacy to the present stage of testing for biomarkers (epidermal growth factor receptor (EGFR), gene mutations) to guide therapeutic decision and to improve efficacy of treatment. Relevant advancement in understanding of lung cancer biology also revealed that different lung tumours may carry different cancer driver gene mutations and thus adopt different carcinogenic pathways. These cancer driver gene mutations were found to be mutually exclusive in individual lung tumour further supporting the rationale of testing tumour sample for the presence of these mutations, especially when there could be corresponding specific agents against these molecular targets. The aim of this article is to review the current understanding of molecular targets that are important in the personalized therapy of lung cancer and how the testing for these molecular targets, namely EGFR, KRAS and ALK, will guide therapeutic decision in advanced stage lung cancer.
Health‐related quality of life among Tianjin Chinese patients with type 2 diabetes: A cross‐sectional survey
Authors: Cong Ji‐Yan , Zhao Yue , Xu Qun‐Yan , Zhong Chun‐De , Xing Qiu‐Ling 
Published: September 2012

AbstractThe purpose of this study was to examine factors that influence the quality of life among Tianjin Chinese living with type 2 diabetes. In this study, the quality of life was assessed in 174 participants. The dependent variables included demographic and clinical data, depressive symptoms and lifestyle behavioral factors. Chi‐square tests and logistic regression analysis were conducted to identify significant factors. Using multiple regression analyses, the odds ratios (ORs) of having low quality of life were 4.53 (95% confidence interval (CI) = 1.89–10.87), 2.83 (95% CI = 1.21–6.63), and 2.48 (95% CI = 1.03–5.96) for patients with microvascular complications, diabetic neuropathy, and peripheral vascular disease, respectively. Coronary heart disease, depression, and unhealthy eating habits were also found to have significant negative effects on quality of life. In addition, multiple regression analysis showed that regular exercise (OR = 0.29, 95% CI = 0.12–0.71) was a protective factor for health‐related quality of life. The identification of these influencing factors will assist nurses to provide continuous care to people living with diabetes, thus to postpone or avoid complications as well as improve their quality of life.
Tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: A randomized placebo‐ and tamsulosin‐controlled 12‐week study in Asian men
Authors: Yokoyama Osamu , Yoshida Masaki , Kim Sae Chul , Wang Chii‐Jye , Imaoka Takeshi , Morisaki Yoji , Viktrup Lars 
Published: September 2012

ObjectivesTo examine the efficacy and safety of tadalafil in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.MethodsAsian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia were randomized to once‐daily placebo (n = 154), tadalafil 2.5 mg (n = 151), tadalafil 5.0 mg (n = 155) or tamsulosin 0.2 mg (active control, n = 152) for 12 weeks.ResultsTotal International Prostate Symptom Score least‐squares mean changes from baseline to end‐point significantly improved with tadalafil 2.5 mg (−4.8, P = 0.003) and 5 mg (−4.7, P = 0.004) versus placebo (−3.0). Significant improvement in the International Prostate Symptom Score versus placebo was observed earlier (week 2) for tadalafil 5.0 mg than for tadalafil 2.5 mg (week 8). Significant improvements (P < 0.05) in both tadalafil groups versus placebo were observed for the International Prostate Symptom Score voiding subscore, International Prostate Symptom Score Quality of Life, and for Patient and Clinician Global Impressions of Improvement. Significant improvements versus placebo were observed in the International Prostate Symptom Score storage subscore for tadalafil 5.0 mg (−1.7, P = 0.021), but not tadalafil 2.5 mg (−1.5, P = 0.072). No significant improvements in benign prostatic hyperplasia Impact Index or improvements in peak urinary flow rates were observed with tadalafil 2.5 mg or 5.0 mg versus placebo. Tamsulosin treatment resulted in significant improvements versus placebo across all efficacy parameters, except for peak urinary flow rates. Safety results were consistent with the known tadalafil and tamsulosin safety profiles.ConclusionsTadalafil once daily represents an effective and well tolerated medical treatment for Asian men presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
Management and outcomes of patients with epiphora referred to a specialist ophthalmic plastic unit
Authors: Sibley Daniel , Norris Jonathan H , Malhotra Raman 
Published: September 2012

AbstractBackgroundTo describe the aetiology and management of the symptom epiphora presenting to a specialist ophthalmic service.DesignA retrospective case series and patient postal questionnaire of all new referrals seen in a specialist unit with primary symptoms of epiphora between January 2007 and December 2008. The study was begun in 2010 to allow a 2‐year follow‐up for this cohort.ParticipantsTwo hundred thirty‐seven patients were identified, of which 192 met the inclusion criteria. Fifty‐seven were male, 135 were female, with a mean age of 60.7 (range 0–95) years.MethodsPatients were identified using a key word search of clinic letters and a search of primary care coding.Main Outcome MeasuresDuration of symptoms, referral source, aetiology and subjective improvement of symptoms post treatment.ResultsAt consultation, patients had experienced epiphora for a mean of 41.1 (range 0.066–360) months. A diagnosis of partial or complete nasolacrimal duct obstruction (31.8%), dry eye with secondary reflex tearing (29.2%), eyelid malposition (10.4%) and multi‐factorial epiphora (28.7%) was made after follow‐up and treatment. A postal questionnaire follow‐up showed that 25% of patients no longer had any epiphora, with 67% reporting an improvement in their symptoms. Final follow‐up was 30–54 months.ConclusionsThis study highlights the protean aetiology of the symptom and sign, epiphora. Sparse data exist on the audited success in managing this common symptom and sign. This study helps introduce an example of a benchmark for evaluating the effectiveness of epiphora. The majority of patients were referred, usually by ophthalmologists for lacrimal surgery.
Choroidal thickness profiles in retinitis pigmentosa
Authors: Ayton Lauren N , Guymer Robyn H , Luu Chi D 
Published: September 2012

AbstractBackgroundLittle quantitative information exists regarding the effect that retinitis pigmentosa (RP) has on the choroid. The aim of this study was to determine choroidal thickness profiles in patients with RP.DesignProspective.ParticipantsForty‐two RP and 22 control subjects participated in the study. RP patients had mild to severe disease, with a visual acuity range of logMAR 0.1 to no light perception.MethodsImages of the retina and choroid were obtained using the enhanced depth‐imaging method and optical coherence tomography (OCT). Choroidal thickness measures were determined via manual segmentation of the OCT image.Main Outcome MeasuresThe thickness profiles of the normal and RP groups were compared. The associations between choroidal thickness, visual acuity and duration of RP were determined.ResultsThe choroid was thickest in the control eyes at the subfoveal location (336.60 ± 70.42 μm), and the thickness gradually decreased towards the peripheral retina (temporal 8° = 295.55 ± 60.52 μm; nasal 8° = 251.68 ± 49.93 μm). In RP, the mean thickness was also greater at the fovea (215.60 ± 94.91 μm) than the temporal (191.66 ± 72.42 μm) and nasal (149.91 ± 57.42 μm) retina, but all values were significantly lower than those of the controls (P ≤ 0.001). Subfoveal choroidal thickness was significantly correlated with visual acuity (r = −0.46, P < 0.001) and duration of disease (r = −0.4, P = 0.001).ConclusionsPatients with RP have a thinner choroid than controls. Patients with poorer visual acuity or longer duration of symptoms tended to have thinner choroids. Knowledge of choroidal thickness profile in RP is important for the field of restorative vision research and the development of suprachoroidal retinal prostheses.