bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypoglycemia Associated With Hospitalization and Adverse Events in Older People
Authors: Majumdar Sumit R. , Hemmelgarn Brenda R. , Lin Meng , McBrien Kerry , Manns Braden J. , Tonelli Marcello 
Published: October 2013

OBJECTIVE
Little is known about the prognostic impact of hypoglycemia associated with hospitalization. We hypothesized that hospitalized hypoglycemia would be associated with increased long-term morbidity and mortality, irrespective of diabetes status.

RESEARCH DESIGN AND METHODS
We undertook a cohort study using linked administrative health care and laboratory databases in Alberta, Canada. From 1 January 2004 to 31 March 2009, we included all outpatients 66 years of age and older who had at least one serum creatinine and one A1C measured. To examine the independent association between hospitalized hypoglycemia and all-cause mortality, we used time-varying Cox proportional hazards (adjusted hazard ratio [aHR]), and for all-cause hospitalizations, we used Poisson regression (adjusted incidence rate ratio [aIRR]).

RESULTS
The cohort included 85,810 patients: mean age 75 years, 51% female, and 50% had diabetes defined by administrative data. Overall, 440 patients (0.5%) had severe hypoglycemia associated with hospitalization and most (93%) had diabetes. During 4 years of follow-up, 16,320 (19%) patients died. Hospitalized hypoglycemia was independently associated with increased mortality (60 vs. 19% mortality for no hypoglycemia; aHR 2.55 [95% CI 2.25–2.88]), and this increased in a dose-dependent manner (aHR no hypoglycemia = 1.0 vs. one episode = 2.49 vs. one or more = 3.78, P trend &lt;0.001). Hospitalized hypoglycemia was also independently associated with subsequent hospitalizations (aIRR no hypoglycemia = 1.0 vs. one episode = 1.90 vs. one or more = 2.61, P trend &lt;0.001) and recurrent hypoglycemia (aHR no hypoglycemia = 1.0 vs. one episode = 2.45 vs. one or more = 9.66, P trend &lt;0.001).

CONCLUSIONS
Older people who have an episode of hospitalized hypoglycemia are easily identified and at substantially increased risk of morbidity and mortality.
Classical spin dynamics of anisotropic Heisenberg dimmers
Authors: Pérez Laura , Suarez Omar , Laroze David , Mancini Hector 
Published: October 2013

Abstract
In the present work we study the deterministic spin dynamics of two interacting anisotropic magnetic particles in the presence of an external magnetic field using the Landau-Lifshitz equation. The interaction between particles is through the exchange energy. We study both conservative and dissipative cases. In the first one, we characterize the dynamical behavior of the system by monitoring the Lyapunov exponents and bifurcation diagrams. In particular, we explore the dependence of the largest Lyapunov exponent respect to the magnitude of applied magnetic field and exchange constant. We find that the system presents multiple transitions between regular and chaotic behaviors. We show that the dynamical phases display a very complicated topology of intricately intermingled chaotic and regular regions. In the dissipative case, we calculate the final saturation states as a function of the magnitude of the applied magnetic field, exchange constant as well as the anisotropy constants.
Mott scattering of a Klein-Gordon particle in an intense laser field
Authors: Boca Madalina 
Published: October 2013

AbstractWe study the Mott scattering of charged spinless particles in the presence of an intense plane wave laser pulse with fixed propagation direction and arbitrary duration and shape. We derive two equivalent forms of the transition amplitude and we discuss the relation between the respective results obtained in the case of a laser pulse and the monochromatic case. We obtain the condition defining the boundaries of the “bright” domain (the domain of allowed values in the energy-direction space of the scattered particle) and we illustrate our results with numerical examples.
Kinetics of the maintenance of the epidermis
Authors: Zhdanov Vladimir , Cho Nam-Joon 
Published: October 2013

Abstract
The epidermis is the outermost layer of skin. It is comprised of keratin-containing cells called keratinocytes. Functionally, the epidermis serves as a physical barrier that can prevent infection and regulate body hydration. Maintenance and repair of the epidermis are important for human health. Mechanistically, these processes occur primarily via proliferation and differentiation of stem cells located in the basal monolayer. These processes are believed to depend on cell-cell communication and spatial constraints but existing kinetic models focus mainly on proliferation and differentiation. To address this issue, we present a mean-field kinetic model that takes these additional factors into account and describes the epidermis at a biosystem level. The corresponding equations operate with the populations of stem cells and differentiated cells in the basal layer. The keratinocytes located above the basal layer are treated at a more coarse-grained level by considering the thickness of the epidermis. The model clarifies the likely role of various negative feedbacks that may control the epidermis and, accordingly, provides insight into the cellular mechanisms underlying complex biological phenomena such as wound healing.
Le Soudan, un pays indivisible, dual ou pluriel ?
Authors: Sharkey Heather J. 
Published: October 2013

Bois « sacré » du domaine réservé du chef de l’État sous la V e République, l’Afrique est passée du « secret du roi » incarné par Jacques Foccart aux feux médiatiques des scandales. Ce changement de registre, dont « l’affaire des diamants » constitue l’archétype, a profondément altéré l’interprétation de la politique africaine de la France. Pensée comme le socle du programme d’indépendance nationale imaginée par le général de Gaulle, elle a été réduite à une succession d’affaires, parsemées des ombres inquiétantes de « barbouzes ». L’archéologie du récit (médiatique) de la « Françafrique » doit permettre de comprendre le « syndrome Foccart », par-delà les fantasmes attachés à la cellule africaine de l’Élysée vue comme la plus secrète boîte noire de la République.
Sud-Soudan : l'État et les sociétés nilotiques traditionnelles
Authors: Delmet Christian 
Published: October 2013

La colonisation et le conflit Nord-Sud ont tragiquement bouleversé l’existence des populations, mais n’ont pas totalement détruit les anciennes structures sociales, politiques et religieuses des sociétés nilotiques traditionnelles Dinka et Nuer. Ces dernières ont autant subi que « digéré » à leur façon les changements dans les domaines économique et juridique, et elles demeurent basées pour l’essentiel sur le bétail. L’article revient sur le rôle de celui-ci dans les relations sociales et matrimoniales, dans la religion et dans le règlement des conflits. La « nouveauté » semble avoir eu raison de l’ancien système de médiation par les « chefs religieux ». Le fusil a remplacé la lance et le sang versé n’a plus la même valeur : le combattant d’aujourd’hui n’est plus tenu à aucune réparation et les chefs religieux n’ont plus à procéder à des sacrifices de réconciliation.
Systemic Disease during Streptococcus pneumoniae Acute Lung Infection Requires 12-Lipoxygenase–Dependent Inflammation
Authors: Bhowmick Rudra , Tin Maung Nang H. , Hurley Bryan P. , Ghanem Elsa Bou , Gronert Karsten , McCormick Beth A. , Leong John M. 
Published: October 2013

Abstract
Acute pulmonary infection by Streptococcus pneumoniae is characterized by high bacterial numbers in the lung, a robust alveolar influx of polymorphonuclear cells (PMNs), and a risk of systemic spread of the bacterium. We investigated host mediators of S. pneumoniae-induced PMN migration and the role of inflammation in septicemia following pneumococcal lung infection. Hepoxilin A3 (HXA3) is a PMN chemoattractant and a metabolite of the 12-lipoxygenase (12-LOX) pathway. We observed that S. pneumoniae infection induced the production of 12-LOX in cultured pulmonary epithelium and in the lungs of infected mice. Inhibition of the 12-LOX pathway prevented pathogen-induced PMN transepithelial migration in vitro and dramatically reduced lung inflammation upon high-dose pulmonary challenge with S. pneumoniae in vivo, thus implicating HXA3 in pneumococcus-induced pulmonary inflammation. PMN basolateral-to-apical transmigration in vitro significantly increased apical-to-basolateral transepithelial migration of bacteria. Mice suppressed in the expression of 12-LOX exhibited little or no bacteremia and survived an otherwise lethal pulmonary challenge. Our data suggest that pneumococcal pulmonary inflammation is required for high-level bacteremia and systemic infection, partly by disrupting lung epithelium through 12-LOX–dependent HXA3 production and subsequent PMN transepithelial migration.
Influenza A Exacerbates Staphylococcus aureus Pneumonia by Attenuating IL-1β Production in Mice
Authors: Robinson Keven M. , Choi Sun Mi , McHugh Kevin J. , Mandalapu Sivanarayana , Enelow Richard I. , Kolls Jay K. , Alcorn John F. 
Published: October 2013

Abstract
Pneumonia is a leading cause of death worldwide. Staphylococcal aureus can be a cause of severe pneumonia alone or a common pathogen in secondary pneumonia following influenza. Recently, we reported that preceding influenza attenuated the Type 17 pathway, increasing the lung’s susceptibility to secondary infection. IL-1β is known to regulate host defense, including playing a role in Th17 polarization. We examined whether IL-1β signaling is required for S. aureus host defense and whether influenza infection impacted S. aureus–induced IL-1β production and subsequent Type 17 pathway activation. Mice were challenged with S. aureus (USA 300), with or without preceding Influenza A/PR/8/34 H1N1 infection. IL-1R1−/− mice had significantly higher S. aureus burden, increased mortality, and decreased Type 17 pathway activation following S. aureus challenge. Coinfected mice had significantly decreased IL-1β production versus S. aureus infection alone at early time points following bacterial challenge. Preceding influenza did not attenuate S. aureus–induced inflammasome activation, but there was early suppression of NF-κB activation, suggesting an inhibition of NF-κB–dependent transcription of pro–IL-1β. Furthermore, overexpression of IL-1β in influenza and S. aureus–coinfected mice rescued the induction of IL-17 and IL-22 by S. aureus and improved bacterial clearance. Finally, exogenous IL-1β did not significantly rescue S. aureus host defense during coinfection in IL-17RA−/− mice or in mice in which IL-17 and IL-22 activity were blocked. These data reveal a novel mechanism by which Influenza A inhibits S. aureus–induced IL-1β production, resulting in attenuation of Type 17 immunity and increased susceptibility to bacterial infection.
Mitochondrial Reactive Oxygen Species Induces NLRP3-Dependent Lysosomal Damage and Inflammasome Activation
Authors: Heid Michelle E. , Keyel Peter A. , Kamga Christelle , Shiva Sruti , Watkins Simon C. , Salter Russell D. 
Published: October 2013

Abstract
The nucleotide-binding oligomerization domain–like receptor family, pyrin domain–containing 3 (NLRP3) inflammasome drives many inflammatory processes and mediates IL-1 family cytokine release. Inflammasome activators typically damage cells and may release lysosomal and mitochondrial products into the cytosol. Macrophages triggered by the NLRP3 inflammasome activator nigericin show reduced mitochondrial function and decreased cellular ATP. Release of mitochondrial reactive oxygen species (ROS) leads to subsequent lysosomal membrane permeabilization (LMP). NLRP3-deficient macrophages show comparable reduced mitochondrial function and ATP loss, but maintain lysosomal acidity, demonstrating that LMP is NLRP3 dependent. A subset of wild-type macrophages undergo subsequent mitochondrial membrane permeabilization and die. Both LMP and mitochondrial membrane permeabilization are inhibited by potassium, scavenging mitochondrial ROS, or NLRP3 deficiency, but are unaffected by cathepsin B or caspase-1 inhibitors. In contrast, IL-1β secretion is ablated by potassium, scavenging mitochondrial ROS, and both cathepsin B and caspase-1 inhibition. These results demonstrate interplay between lysosomes and mitochondria that sustain NLRP3 activation and distinguish cell death from IL-1β release.
Phenotypic Polarization of Activated Astrocytes: The Critical Role of Lipocalin-2 in the Classical Inflammatory Activation of Astrocytes
Authors: Jang Eunha , Kim Jong-Heon , Lee Shinrye , Kim Jae-Hong , Seo Jung-Wan , Jin Myungwon , Lee Maan-Gee , Jang Il-Sung , Lee Won-Ha , Suk Kyoungho 
Published: October 2013

AbstractAstrocytes provide structural and functional support for neurons, as well as display neurotoxic or neuroprotective phenotypes depending upon the presence of an immune or inflammatory microenvironment. This study was undertaken to characterize multiple phenotypes of activated astrocytes and to investigate the regulatory mechanisms involved. We report that activated astrocytes in culture exhibit two functional phenotypes with respect to pro- or anti-inflammatory gene expression, glial fibrillary acidic protein expression, and neurotoxic or neuroprotective activities. The two distinct functional phenotypes of astrocytes were also demonstrated in a mouse neuroinflammation model, which showed pro- or anti-inflammatory gene expression in astrocytes following challenge with classical or alternative activation stimuli; similar results were obtained in the absence of microglia. Subsequent studies involving recombinant lipocalin-2 (LCN2) protein treatment or Lcn2-deficient mice indicated that the pro- or anti-inflammatory functionally polarized phenotypes of astrocytes and their intracellular signaling pathway were critically regulated by LCN2 under in vitro and in vivo conditions. Astrocyte-derived LCN2 promoted classical proinflammatory activation of astrocytes but inhibited IL-4–STAT6 signaling, a canonical pathway involved in alternative anti-inflammatory activation. Our results suggest that the secreted protein LCN2 is an autocrine modulator of the functional polarization of astrocytes in the presence of immune or inflammatory stimuli and that LCN2 could be targeted therapeutically to dampen proinflammatory astrocytic activation and related pathologies in the CNS.
Cutting Edge: CD1a Tetramers and Dextramers Identify Human Lipopeptide–Specific T Cells Ex Vivo
Authors: Kasmar Anne G. , Van Rhijn Ildiko , Magalhaes Kelly G. , Young David C. , Cheng Tan-Yun , Turner Marie T. , Schiefner Andre , Kalathur Ravi C. , Wilson Ian A. , Bhati Mugdha , Gras Stephanie , Birkinshaw Richard W. , Tan Li L. , Rossjohn Jamie , Shires John , Jakobsen Søren , Altman John D. , Moody D. Branch 
Published: October 2013

Abstract
Human CD1a mediates foreign Ag recognition by a T cell clone, but the nature of possible TCR interactions with CD1a/lipid are unknown. After incubating CD1a with a mycobacterial lipopeptide Ag, dideoxymycobactin (DDM), we identified and measured binding to a recombinant TCR (TRAV3/ TRBV3-1, KD of ≈100 μM). Detection of ternary CD1a/lipid/TCR interactions enabled development of CD1a tetramers and CD1a multimers with carbohydrate backbones (dextramers), which specifically stained T cells using a mechanism that was dependent on the precise stereochemistry of the peptide backbone and was blocked with a soluble TCR. Furthermore, sorting of human T cells from unrelated tuberculosis patients for bright DDM-dextramer staining allowed recovery of T cells that were activated by CD1a and DDM. These studies demonstrate that the mechanism of T cell activation by lipopeptides occurs via ternary interactions of CD1a/Ag/TCR. Furthermore, these studies demonstrate the existence of lipopeptide-specific T cells in humans ex vivo.
Coadministration of Polyinosinic:Polycytidylic Acid and Immunostimulatory Complexes Modifies Antigen Processing in Dendritic Cell Subsets and Enhances HIV Gag-Specific T Cell Immunity
Authors: Quinn Kylie M. , Yamamoto Ayako , Costa Andreia , Darrah Patricia A. , Lindsay Ross W. B. , Hegde Sonia T. , Johnson Teresa R. , Flynn Barbara J. , Loré Karin , Seder Robert A. 
Published: October 2013

Abstract
Currently approved adjuvants induce protective Ab responses but are more limited for generating cellular immunity. In this study, we assessed the effect of combining two adjuvants with distinct mechanisms of action on their ability to prime T cells: the TLR3 ligand, polyinosinic:polycytidylic acid (poly I:C), and immunostimulatory complexes (ISCOMs). Each adjuvant was administered alone or together with HIV Gag protein (Gag), and the magnitude, quality, and phenotype of Gag-specific T cell responses were assessed. For CD8 T cells, all adjuvants induced a comparable response magnitude, but combining poly I:C with ISCOMs induced a high frequency of CD127+, IL-2–producing cells with decreased expression of Tbet compared with either adjuvant alone. For CD4 T cells, combining poly I:C and ISCOMs increased the frequency of multifunctional cells, producing IFN-γ, IL-2, and TNF, and the total magnitude of the response compared with either adjuvant alone. CD8 or CD4 T cell responses induced by both adjuvants mediated protection against Gag-expressing Listeria monocytogenes or vaccinia viral infections. Poly I:C and ISCOMs can alter Ag uptake and/or processing, and we therefore used fluorescently labeled HIV Gag and DQ-OVA to assess these mechanisms, respectively, in multiple dendritic cell subsets. Poly I:C promoted uptake and retention of Ag, whereas ISCOMs enhanced Ag degradation. Combining poly I:C and ISCOMs caused substantial death of dendritic cells but persistence of degraded Ag. These data illustrate how combining adjuvants, such as poly I:C and ISCOMs, that modulate Ag processing and have potent innate activity, can enhance the magnitude, quality, and phenotype of T cell immunity.
Understanding the Impact of Residents' Interpersonal Relationships During Emergency Department Referrals and Consultations
Authors: Chan Teresa , Sabir Kameron , Sanhan Sarila , Sherbino Jonathan 
Published: October 2013

AbstractBackgroundCommunicating with colleagues is a key physician competency. Yet few studies have sought to uncover the complex nature of relationships between referring and consulting physicians, which may be affected by the inherent relationships between the participants.ObjectiveOur study examines themes identified from discussions about communications and the role of relationships during the referral-consultation process.MethodsFrom March to September 2010, 30 residents (10 emergency medicine, 10 general surgery, 10 internal medicine) were interviewed using a semistructured focus group protocol. Two investigators independently reviewed the transcripts using inductive methods and grounded theory to generate themes (using codes for ease of analysis) until saturation was reached. Disagreements were resolved by consensus, yielding an inventory of themes and subthemes. Measures for ensuring trustworthiness of the analysis included generating an audit trail and external auditing of the material by investigators not involved with the initial analysis.ResultsTwo main relationship-related themes affected the referral-consultation process: familiarity and trust. Various subthemes were further delineated and studied in the context of pertinent literature.ConclusionsRelationships between physicians have a powerful influence on the emergency department referral-consultation dynamic. The emergency department referral-consultation may be significantly altered by the familiarity and perceived trustworthiness of the referring and consulting physicians. Our proposed framework may further inform and improve instructional methods for teaching interpersonal communication. Most importantly, it may help junior learners understand inherent difficulties they may encounter during the referral process between emergency and consulting physicians.
Comparison of 3 Dilation and Evacuation Technical Skills Models
Authors: Baldwin Maureen K. , Chor Julie , Chen Beatrice A. , Edelman Alison B. , Russo Jennefer 
Published: October 2013

Abstract

Background
Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation (D&E) have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester D&E training.

Objective
We report physicians' assessments of the realism of 3 D&E models to establish a composite training model.

Methods
We surveyed experienced providers at 2 national conferences to evaluate 3 D&E models and rate each model's components on a Likert scale.

Results
Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants.

Conclusions
A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a D&E procedure and should be further developed for testing and training.
Exploring the impact of using tablet devices in enhancing students listening and speaking skills in tertiary education
Authors: Fayed Ismail , Yacoub Amer , Hussein Ali 
Published: October 2013

AbstractWith the massive increase in using mobile devices among individuals of all social backgrounds, the question of how these mobile devices may enhance learning arise. Smart smartphones and the most recent tablet computers have all sustained the vision and potentials of using mobile devices in education and learning. The unprecedented popularity of these devices among teenage learners both in high schools and university level encourages all researchers and educators to explore their influence on learning among individuals and groups. In this research project, students will explore the potentials of using mobile devices and new tablet technologies to sustain students' acquisition of listening and speaking skills in English as a second language (ESL). They will highlight the key features in these modern devices that support these language skills. This investigation process aims to identify possible educational mobile features such as mobile applications developed by other users, mobile collaboration applications over wireless connection, language games, synchronous and asynchronous technologies for optimum use of these devices particularly by tertiary level students in a positive and rather educational manner.