bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social inequality in motorcycle helmet use: when a reduction in inequality is not necessarily good news
Authors: Chiou Shu-Ti , Lu Tsung-Hsueh , Lai Ching-Huei , Chiang Tung-liang , Kawachi Ichiro 
Published: March 2014

BackgroundWe sought to examine changes in the magnitude of social inequality in motorcycle helmet use in Taiwan between 2001 and 2009.MethodsUsing data from the 2001 and 2009 Taiwan National Health Interview Surveys, we calculated absolute (the slope index of inequality, SII) and relative (relative index of inequality, RII) measures of inequality in helmet use by three indicators of socioeconomic position.ResultsThe rate of motorcycle helmet use was 92% (14 801/16 100) in 2001 and decreased to 89% (15 748/17 948) in 2009. We noted a significant decrease in social inequality in helmet use in RII according to urbanisation level, a significant decrease in SII and RII according to income level, and a significant increase in SII according to education level. The reduction in RII according to urbanisation level was more prominent than that based on income level, from 1.73 (95% CI 1.63 to 1.84) in 2001 to 1.33 (95% CI 1.27 to 1.39) in 2009. The decline in helmet use was most prominent for motorcycle users who live in suburban areas, from 94% in 2001 to 88% in 2009.ConclusionsThe significant reduction of social inequality in helmet use according to urbanisation level and income is not a public health success story. Rather, it is a warning sign of slackening law enforcement in Taiwan.
Transient Antiangiogenic Treatment Improves Delivery of Cytotoxic Compounds and Therapeutic Outcome in Lung Cancer
Authors: Chatterjee Sampurna , Wieczorek Caroline , Schöttle Jakob , Siobal Maike , Hinze Yvonne , Franz Thomas , Florin Alexandra , Adamczak Joanna , Heukamp Lukas C. , Neumaier Bernd , Ullrich Roland T. 
Published: March 2014

Abstract
Extensive oncologic experience argues that the most efficacious applications of antiangiogenic agents rely upon a combination with cytotoxic drugs. Yet there remains a lack of clarity about how to optimize scheduling for such drug combinations. Prudent antiangiogenic therapy might transiently normalize blood vessels to improve tumor oxygenation and drug exposure. Using [15O]H2O positron emission tomography imaging in a preclinical mouse model of non–small cell lung cancer, we observed that short-term treatment with the vascular endothelial growth factor receptor/platelet-derived growth factor receptor inhibitor PTK787 licensed a transient window of improved tumor blood flow. The improvement observed was associated with a reduced leakiness from tumor vessels, consistent with induction of a vascular normalization process. Initiation of a cytotoxic treatment in this window of tumor vessel normalization resulted in increased efficacy, as illustrated by improved outcomes of erlotinib administration after initial PTK787 treatment. Notably, intermittent PTK787 treatment also facilitated long-term tumor regression. In summary, our findings offer strong evidence that short-term antiangiogenic therapy can promote a transient vessel normalization process that improves the delivery and efficacy of a targeted cytotoxic drug. Cancer Res; 74(10); 2816–24. ©2014 AACR.
Preclinical Evaluation of the Supercritical Extract of Azadirachta Indica (Neem) Leaves In Vitro and In Vivo on Inhibition of Prostate Cancer Tumor Growth
Authors: Wu Qiang , Kohli Manish , Bergen H. Robert. , Cheville John C. , Karnes R. Jeffrey , Cao Hong , Young Charles Y.F. , Tindall Donald J. , McNiven Mark A. , Donkena Krishna Vanaja 
Published: March 2014

Abstract
Azadirachta indica, commonly known as neem, has gained worldwide prominence because of its medical properties, namely antitumor, antiviral, anti-inflammatory, antihyperglycemic, antifungal, and antibacterial activities. Despite these promising results, gaps remain in our understanding of the molecular mechanism of action of neem compounds and their potential for use in clinical trials. We investigated supercritical extract of neem leaves (SENL) for the following: molecular targets in vitro, in vivo efficacy to inhibit tumor growth, and bioactive compounds that exert antitumor activity. Treatment of LNCaP-luc2 prostate cancer cells with SENL suppressed dihydrotestosterone-induced androgen receptor and prostate-specific antigen levels. SENL inhibited integrin β1, calreticulin, and focal adhesion kinase activation in LNCaP-luc2 and PC3 prostate cancer cells. Oral administration of SENL significantly reduced LNCaP-luc2 xenograft tumor growth in mice with the formation of hyalinized fibrous tumor tissue, reduction in the prostate-specific antigen, and increase in AKR1C2 levels. To identify the active anticancer compounds, we fractionated SENL by high-pressure liquid chromatography and evaluated 16 peaks for cytotoxic activity. Four of the 16 peaks exhibited significant cytotoxic activity against prostate cancer cells. Mass spectrometry of the isolated peaks suggested the compounds with cytotoxic activity were nimbandiol, nimbolide, 2′,3′-dihydronimbolide, and 28-deoxonimbolide. Analysis of tumor tissue and plasma samples from mice treated with SENL indicated 28-deoxonimbolide and nimbolide as the bioactive compounds. Overall, our data revealed the bioactive compounds in SENL and suggested that the anticancer activity could be mediated through alteration in androgen receptor and calreticulin levels in prostate cancer. Mol Cancer Ther; 13(5); 1067–77. ©2014 AACR.
Hepatic Overexpression of Idol Increases Circulating Protein Convertase Subtilisin/Kexin Type 9 in Mice and Hamsters via Dual Mechanisms
Authors: Sasaki Makoto , Terao Yoshio , Ayaori Makoto , Uto-Kondo Harumi , Iizuka Maki , Yogo Makiko , Hagisawa Kosuke , Takiguchi Shunichi , Yakushiji Emi , Nakaya Kazuhiro , Ogura Masatsune , Komatsu Tomohiro , Ikewaki Katsunori 
Published: March 2014

Objective—
Low-density lipoprotein receptor (LDLR) is degraded by inducible degrader of LDLR (Idol) and protein convertase subtilisin/kexin type 9 (PCSK9), thereby regulating circulating LDL levels. However, it remains unclear whether, and if so how, these LDLR degraders affect each other. We therefore investigated effects of liver-specific expression of Idol on LDL/PCSK9 metabolism in mice and hamsters.

Approach and Results—

Injection of adenoviral vector expressing Idol (Ad-Idol) induced a liver-specific reduction in LDLR expression which, in turn, increased very-low-density lipoprotein/LDL cholesterol levels in wild-type mice because of delayed LDL catabolism. Interestingly, hepatic Idol overexpression markedly increased plasma PCSK9 levels. In LDLR-deficient mice, plasma PCSK9 levels were already elevated at baseline and unchanged by Idol overexpression, which was comparable with the observation for Ad-Idol–injected wild-type mice, indicating that Idol-induced PCSK9 elevation depended on LDLR. In wild-type mice, but not in LDLR-deficient mice, Ad-Idol enhanced hepatic PCSK9 expression, with activation of sterol regulatory element–binding protein 2 and subsequently increased expression of its target genes. Supporting in vivo findings, Idol transactivated PCSK9/LDLR in sterol regulatory element–binding protein 2/LDLR-dependent manners in vitro. Furthermore, an in vivo kinetic study using
125
I-labeled PCSK9 revealed delayed clearance of circulating PCSK9, which could be another mechanism. Finally, to extend these findings into cholesteryl ester transfer protein–expressing animals, we repeated the above in vivo experiments in hamsters and obtained similar results.

Conclusions—
A vicious cycle in LDLR degradation might be generated by PCSK9 induced by hepatic Idol overexpression via dual mechanisms: sterol regulatory element–binding protein 2/LDLR. Furthermore, these effects would be independent of cholesteryl ester transfer protein expression.
Palliative and End-of-Life Care in Stroke
Authors: Holloway Robert G. , Arnold Robert M. , Creutzfeldt Claire J. , Lewis Eldrin F. , Lutz Barbara J. , McCann Robert M. , Rabinstein Alejandro A. , Saposnik Gustavo , Sheth Kevin N. , Zahuranec Darin B. , Zipfel Gregory J. , Zorowitz Richard D. 
Published: March 2014

Background and Purpose—
The purpose of this statement is to delineate basic expectations regarding primary palliative care competencies and skills to be considered, learned, and practiced by providers and healthcare services across hospitals and community settings when caring for patients and families with stroke.

Methods—
Members of the writing group were appointed by the American Heart Association Stroke Council’s Scientific Statement Oversight Committee and the American Heart Association’s Manuscript Oversight Committee. Members were chosen to reflect the diversity and expertise of professional roles in delivering optimal palliative care. Writing group members were assigned topics relevant to their areas of expertise, reviewed the appropriate literature, and drafted manuscript content and recommendations in accordance with the American Heart Association’s framework for defining classes and level of evidence and recommendations.

Results—
The palliative care needs of patients with serious or life-threatening stroke and their families are enormous: complex decision making, aligning treatment with goals, and symptom control. Primary palliative care should be available to all patients with serious or life-threatening stroke and their families throughout the entire course of illness. To optimally deliver primary palliative care, stroke systems of care and provider teams should (1) promote and practice patient- and family-centered care; (2) effectively estimate prognosis; (3) develop appropriate goals of care; (4) be familiar with the evidence for common stroke decisions with end-of-life implications; (5) assess and effectively manage emerging stroke symptoms; (6) possess experience with palliative treatments at the end of life; (7) assist with care coordination, including referral to a palliative care specialist or hospice if necessary; (8) provide the patient and family the opportunity for personal growth and make bereavement resources available if death is anticipated; and (9) actively participate in continuous quality improvement and research.

Conclusions—
Addressing the palliative care needs of patients and families throughout the course of illness can complement existing practices and improve the quality of life of stroke patients, their families, and their care providers. There is an urgent need for further research in this area.
Epidemiology of Moyamoya Disease in Taiwan
Authors: Chen Pei-Chun , Yang Shih-Hung , Chien Kuo-Liong , Tsai I-Ju , Kuo Meng-Fai 
Published: March 2014

Background and Purpose—
Previous studies have shown regional and temporal variations in epidemiological features of moyamoya disease, but population-based studies in regions other than Japan are limited. We investigated the incidence and patients characteristics of moyamoya disease during 12 years in Taiwan using claims databases of a universal health insurance system.

Methods—
From the inpatient databases of the Taiwan National Health Insurance program, we identified subjects who had an initial hospitalization with moyamoya disease and had been underwent cerebral angiography as incidence cases during 2000 to 2011. The incidence and the patient characteristics were described by age and time periods of the hospitalization.

Results—

During the 12-year period, 422 patients were identified, representing an annual incidence of 0.15 per 100 000 person-years. Adults exhibited an upward trend in incidence with an incidence rate ratio of 1.74 (95% confidence interval [1.17–2.58]) in years 2010 to 2011 comparing with years 2000 to 2001. However, children had a decreased incidence except a slightly increase in the last 2 years. Compared with patients hospitalized during 2000 to 2005, patients identified during 2006 to 2011 had greater women-to-men ratio (1.7 versus 1.1,
P
=0.048). Children were more likely to have comorbid epilepsy than were adult patients (25.0% versus 3.4%,
P
=0.002). Hemorrhagic stroke was rare among pediatric patients but presented more frequently in adults. However, ischemic stroke was more prevalent in both groups.

Conclusions—
The incidence of moyamoya disease has increased in adults but not in children from 2000 to 2011 in Taiwan. Sex ratio and comorbid conditions differed by age and study period.
Age Dependence of Risk Factors for Stroke and Death in Young Patients With Atrial Fibrillation
Authors: Melgaard Line , Rasmussen Lars Hvilsted , Skjøth Flemming , Lip Gregory Y.H. , Larsen Torben Bjerregaard 
Published: March 2014

Background and Purpose—
The risk of stroke and death in patients with atrial fibrillation is strongly associated with age and concomitant comorbidities. The aim of this study was to examine the age dependence of risk factors for stroke and mortality in young patients with atrial fibrillation.

Methods—
This study is a population-based cohort study of 30- to 65-year-old patients with atrial fibrillation and diagnosed during 2000 to 2011, identified by record linkage between nationwide Danish registries. Cox regression models were used to estimate the risk of stroke and mortality according to risk factors within age groups: 30 to 50, 50 to 65, and 65 to 75 years.

Results—

We identified 73 799 nonvalvular atrial fibrillation patients, of which 37 782 (51.2%) were <65 years old (mean age 62.8). A higher modified cardiac failure or dysfunction, hypertension, age 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65–74 and sex category (female) score (CHA
2
DS
2
-VASc score) was associated with decreased survival probability in all age groups. The overall incidence of stroke per year for 1 year (5 years) follow-up was 1.2% (0.6%), 3.5% (1.6%), and 5.6% (2.8%), respectively, for the age groups of 30 to 50, 50 to 65, and 65 to 75. Overall, risk factors such as previous stroke, heart failure, vascular disease, diabetes mellitus, and hypertension remained independent predictors of stroke and death in patients <65 years old with nonvalvular atrial fibrillation.

Conclusions—

The CHA
2
DS
2
-VASc score is an applicable tool for all age groups and in nonvalvular atrial fibrillation patients <65 years old, the same risk factors apply.
L-arginine catabolism is driven mainly towards nitric oxide synthesis in the erythrocytes of patients with type 2 diabetes at first clinical onset
Authors: Savu Octavian , Iosif Liviu , Bradescu Ovidiu Marius , Serafinceanu Cristian , Papacocea Raluca , Stoian Irina 
Published: March 2014

Background We investigated the l-arginine (l-Arg)–nitric oxide (NO) metabolic pathway in the erythrocytes (RBCs) and plasma of subjects with type 2 diabetes at first clinical onset. Methods RBCs and plasma were collected from 26 patients with type 2 diabetes at first clinical onset and 19 age-matched non-diabetes subjects as controls. l-Arg content was assayed by capillary electrophoresis. We measured arginase activity and nitrate/nitrite concentrations by spectrophotometry, and glycosylated haemoglobin (HbA1c) by standardized immunoturbidimetry. Results We found that, when compared with controls, l-Arg content was similar in RBCs while decreased in the plasma of patients with type 2 diabetes. Interestingly, arginase activity was lower in RBCs and increased in plasma of patients with diabetes. NO production was higher in RBCs in patients with type 2 diabetes, while no difference was found in the plasma of our subjects. Conclusions l-Arg catabolism is driven mainly towards NO synthesis in RBCs of patients with type 2 diabetes at first clinical onset. The decreased RBC arginase activity could be considered a potential mechanism of increased RBC NO production in early diabetes. Therefore, the RBC pool would represent a potentially compensatory intravascular compartment for endothelial dysfunction in diabetes.
A revised method for determination of serum mercaptalbumin and non-mercaptalbumin by high-performance liquid chromatography coupled with postcolumn bromocresol green reaction
Authors: Ueyama Jun , Ishikawa Yusuke , Kondo Takaaki , Motoyama Megumi , Matsumoto Hiroyuki , Matsushita Tadashi 
Published: March 2014

Background Previously, high-performance liquid chromatography (HPLC) equipped with ultraviolet or fluorescence detectors has been used for separation of human mercaptalbumin (HMA) and human non-mercaptalbumin (HNA). However, it is difficult to perform reliable chromatographic analysis due to peak interference of such serum compounds as uric acid and bilirubin. The aim of this study is to explore a selective and simple analytical method for the determination of HMA and HNA. Method HMA and HNA in serum sample were separated by HPLC and reacted with bromocresol green using a postcolumn reaction scheme. Results A complete separation of HMA and HNA is achieved in less than 30 min by using weak anion exchange columns and isocratic elution. Within-run and between-day precisions at albumin concentration of 45 g/L were 4.2 and 1.7% for HMA and 4.5 and 4.6% for HNA, respectively. There was no interference in HMA and HNA peaks when bilirubin-, haemoglobin- or chyle-spiked pooled serum samples were analysed. Conclusion Our method is reliable and not labour-intensive and, therefore, might be applicable for clinical and epidemiological studies.
Visually Guided Tracking on a Handheld Device
Authors: Hölzle Patricia , Tatarau Christian , Hermsdörfer Joachim 
Published: March 2014

Objective: We introduced a new visually controlled tracking task that can be assessed on a handheld device in shift workers to evaluate time-of-day dependent modulations in visuomotor performance. Background: Tracking tasks have been used to predict performance fluctuations depending on time of day mainly under laboratory conditions. One challenge to an extended use at the actual working site is the complex and fixed test setup consisting of a test unit, a monitor, and a manipulation object, such as a joystick. Method: Participants followed an unpredictably moving target on the screen of a handheld device with an attachable stylus. A total of 11 shift workers (age range: 20–59, mean: 33.64, standard deviation: 10.56) were tested in the morning, the evening, and the night shift in 2-hr intervals with the tracking task and indicated their fatigue levels on visual analogue scales. We evaluated tracking precision by calculating the mean spatial deviation from the target for each session. Results: Tracking precision was significantly influenced by the interaction between shift and session, suggesting a clear time-of-day effect of visuomotor performance under real-life conditions. Tracking performance declined during early-morning hours whereas fatigue ratings increased. Conclusion: These findings suggest that our setup is suitable to detect time-of-day dependent performance changes in visually guided tracking. Application: Our task could be used to evaluate fluctuations in visuomotor coordination, a skill that is decisive in various production steps at the actual working place to assess productivity.
Polyethylene terephthalate/chitosan tubular knits made by using a freeze-drying method
Authors: Lin Jia-Horng , Li Mei-Hui , Wen Shih-Peng , Lou Ching-Wen 
Published: March 2014

Biomaterials are commonly used in vitro or in vivo. Synthetic vascular prostheses, artificial bones, and artificial joints are used in vitro. Bone scaffolds demand components with good biocompatibility, mechanical strengths, and pore size. This allows the bone tissue to attach to and grow inside the bone scaffolds. Polyethylene terephthalate (PET) filaments and chitosan have good biocompatibility and are non-toxic. This study prepares biocompatible, porous, 1- and 2-layer three-dimensional PET/chitosan tubular knits by a freeze-drying method. PET plied yarns with three combinations of various denier (D) and coefficients of twist-150D/2, 225D/4, and 300D/3-are knitted into tubular knits with proper mechanical properties and porous structure. The resulting tubular knits are then alkali treated with 3 M sodium hydroxide (NaOH) reagent for 90 min, immersed in 1 wt% chitosan solution, and then freeze-dried, forming the porous PET/chitosan tubular knits. The functional group analysis and degradation of the alkali-treated chitosan films are first evaluated, and then the tensile strength, surface observation, pore size, and biocompatibility of the resulting PET/chitosan tubular knits are evaluated. The experimental result shows that 1- and 2-layer PET/chitosan tubular knits have desirable mechanical strength, stability, and biocompatibility antibacterial properties.
Improving Diabetes Health Literacy by Animation
Authors: Calderón José L. , Shaheen Magda , Hays Ron D. , Fleming Erik S. , Norris Keith C. , Baker Richard S. 
Published: March 2014

Purpose and Scope To produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics. Methods Participatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to “easy to read” diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS). Results No significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant ( F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy ( P = .009). Conclusions The positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the English and Spanish versions of the video.