bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Diet Higher in Carbohydrate/Lower in Fat Versus Lower in Carbohydrate/Higher in Monounsaturated Fat on Postmeal Triglyceride Concentrations and Other Cardiovascular Risk Factors in Type 1 Diabetes
Authors: Strychar Irene , Cohn Jeffrey S. , Renier Geneviève , Rivard Michèle , Aris-Jilwan Nahla , Beauregard Hugues , Meltzer Sara , Bélanger André , Dumas Richard , Ishac Alain , Radwan Farouk , Yale Jean-François 
Published: June 2009

OBJECTIVE
To compare the effects of a eucaloric diet higher in carbohydrate/lower in fat versus lower in carbohydrate/higher in monounsaturated fat on postmeal triglyceride (TG) concentrations and other cardiovascular disease risk factors in nonobese subjects with type 1 diabetes and in good glycemic control.

RESEARCH DESIGN AND METHODS
In a parallel group design study, 30 subjects were randomly assigned and completed one of the two eucaloric diets. Assessments included: BMI, blood pressure, A1C, plasma lipids, and markers of oxidation, thrombosis, and inflammation. At 6 months, subjects were hospitalized for 24 h to measure plasma TG excursions.

RESULTS
There were no significant differences between groups other than decreased plasminogen activator inhibitor 1 (PAI-1) levels and weight gain in the lower-carbohydrate/higher–monounsaturated fat group. During the 24-h testing, the lower-carbohydrate/higher–monounsaturated fat group had a lower plasma TG profile.

CONCLUSIONS
A diet lower in carbohydrate/higher in monounsaturated fat could offer an appropriate choice for nonobese type 1 diabetic individuals with good metabolic and weight control.
A Controlled Examination of Medical and Psychosocial Factors Associated With Low Back Pain in Combination With Widespread Musculoskeletal Pain
Authors: Friedrich Martin , Hahne Julia , Wepner Florian 
Published: June 2009

BackgroundLittle is known about chronic low back pain (CLBP) in combination with widespread musculoskeletal pain (WMP).ObjectiveThis study examined factors that may be common to these conditions, with the objective of detecting factors that could improve the course of these diseases.DesignThis was a prospective case control study.Patients and InterventionA group of patients with CLBP and WMP (CLBP+WMP group, n=97) was compared with a group of individuals who were pain-free and without a history of musculoskeletal problems (control group, n=97) and with a group of patients with CLBP but without WMP (CLBP-only group, n=52). The mean age of the participants was 42.9 years (SD=8.74); 76% were women, and 24% were men.MeasurementsA total of 74 variables were measured, including sociodemographic, physical, and psychosocial variables. After univariate examination for group differences and analyses of variables available for all 3 groups, logistic regression on selected factors was performed. The α level was set at .05, but was adjusted to avoid randomly significant results.ResultsFor a number of variables, significant differences among the 3 groups were observed. For regression model 1 for the CLBP+WMP and control groups, 4 out of 9 variables showed significant likelihood tests: income (lower in the WMP group), depression, anxiety, and fear-avoidance behavior. For regression model 2, 2 out of 13 variables showed significant likelihood tests: endurance capacity (more in the CLBP+WMP group) and balance capability (worse in the CLBP+WMP group). The models predicted at least 91.2% of all cases to the correct group. The regression analysis regarding the CLBP+WMP and CLBP-only groups predicted 86.7% of all cases to the correct group. Three out of 10 variables showed significant likelihood tests: high disability, fear-avoidance behavior, and number of treatments.LimitationsSome variables in testing the patients with WMP and the individuals who were pain-free were not used with the patients with CLBP only.ConclusionsPatients with CLBP and WMP should be examined for indicated physical and psychosocial factors. Therapeutic management should consider them in the early stage of the disease. These findings also might apply to patients with fibromyalgia or myofascial pain.
Comparison of Maximum Tolerated Muscle Torques Produced by 2 Pulse Durations
Authors: Scott Wayne B. , Causey James B. , Marshall Tara L. 
Published: June 2009

BackgroundNeuromuscular electrical stimulation (NMES) is an effective therapeutic technique for strengthening weak muscles. A positive dose-response relationship exists between the elicited muscle forces during training and strength (force-generating capacity) gains. Patient discomfort limits NMES muscle forces, potentially compromising efficacy.ObjectiveThe purpose of this study was to compare the NMES muscle torques produced by stimulation trains consisting of 2 different pulse durations.DesignDuring a single testing session, the 2 pulse duration conditions (50 and 200 microseconds) were tested on the opposite lower extremities of the participants.MethodsThe study participants were 10 adults without remarkable medical histories. The maximum tolerated isometric knee extensor torque was the primary dependent variable. The peak currents and phase charges that produced the maximally tolerated torques, as well as the sensory, motor, and pain thresholds for the 2 pulse conditions, were compared.ResultsThe 200-microsecond pulse duration condition resulted in participants tolerating significantly greater muscle torques; it was associated with significantly greater phase charges but significantly lower peak currents.LimitationsThis study only compared muscle torques in response to stimulation trains consisting of pulses with short (50-microsecond) or medium (200-microsecond) durations and did not examine long (∼400- to 600-microsecond) durations. Furthermore, the result of this study may not apply to NMES that uses stimulation patterns other than monophasic, square-wave pulsed current.ConclusionsIt has been suggested that short pulse durations are most appropriate for NMES because they are less likely to recruit nociceptors. The results of this study, however, support the use of a medium pulse duration rather than a short pulse duration when the goal is to produce a maximum torque response from a muscle. These observations may be related to the currents and phase charges for the pain thresholds for the 2 pulse duration conditions.
Screening for Elevated Levels of Fear-Avoidance Beliefs Regarding Work or Physical Activities in People Receiving Outpatient Therapy
Authors: Hart Dennis L. , Werneke Mark W. , George Steven Z. , Matheson James W. , Wang Ying-Chih , Cook Karon F. , Mioduski Jerome E. , Choi Seung W. 
Published: June 2009

BackgroundScreening people for elevated levels of fear-avoidance beliefs is uncommon, but elevated levels of fear could worsen outcomes. Developing short screening tools might reduce the data collection burden and facilitate screening, which could prompt further testing or management strategy modifications to improve outcomes.ObjectiveThe purpose of this study was to develop efficient yet accurate screening methods for identifying elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient rehabilitation.DesignA secondary analysis of data collected prospectively from people with a variety of common neuromusculoskeletal diagnoses was conducted.MethodsIntake Fear-Avoidance Beliefs Questionnaire (FABQ) data were collected from 17,804 people who had common neuromusculoskeletal conditions and were receiving outpatient rehabilitation in 121 clinics in 26 states (in the United States). Item response theory (IRT) methods were used to analyze the FABQ data, with particular emphasis on differential item functioning among clinically logical groups of subjects, and to identify screening items. The accuracy of screening items for identifying subjects with elevated levels of fear was assessed with receiver operating characteristic analyses.ResultsThree items for fear of physical activities and 10 items for fear of work activities represented unidimensional scales with adequate IRT model fit. Differential item functioning was negligible for variables known to affect functional status outcomes: sex, age, symptom acuity, surgical history, pain intensity, condition severity, and impairment. Items that provided maximum information at the median for the FABQ scales were selected as screening items to dichotomize subjects by high versus low levels of fear. The accuracy of the screening items was supported for both scales.LimitationsThis study represents a retrospective analysis, which should be replicated using prospective designs. Future prospective studies should assess the reliability and validity of using one FABQ item to screen people for high levels of fear-avoidance beliefs.ConclusionsThe lack of differential item functioning in the FABQ scales in the sample tested in this study suggested that FABQ screening could be useful in routine clinical practice and allowed the development of single-item screening for fear-avoidance beliefs that accurately identified subjects with elevated levels of fear. Because screening was accurate and efficient, single IRT-based FABQ screening items are recommended to facilitate improved evaluation and care of heterogeneous populations of people receiving outpatient rehabilitation.
Mirror of the soul: a cortical stimulation study on recognition of facial emotions
Authors: Giussani Carlo , Pirillo David , Roux Franck-Emmanuel 
Published: June 2009

Object
The capability of recognizing the expressions of facial emotions has been hypothesized to depend on a right hemispheric cortical-subcortical network. Its impairment deeply disturbs social relationships. To spare right hemispheric cortical areas involved in recognizing facial emotion, the authors used intraoperative cortical stimulation and the awake surgery technique in a consecutive series of patients. The feasibility and the interest to map them during brain mapping for neurosurgical procedures are discussed.

Methods
After a preoperative neuropsychological evaluation, 18 consecutive patients with right hemispheric lesions (5 metastases, 6 high-grade gliomas, 4 low-grade gliomas, 2 arteriovenous malformations, and 1 malignant meningioma) were tested by intraoperative cortical stimulation while performing a facial emotion recognition task along with sensorimotor and visuospatial tasks.

Results
Three hundred eighty-six cortical sites were studied. Five (1.30%) reproducible interference sites for facial emotion recognition were identified in 5 patients: 1 site in the medial segment of T1; 1 site in the posterior segment of T1; 1 site in the posterior segment of T2; and 2 sites in the supramarginal gyrus. No selective impairment was found regarding the emotion category. All facial emotion recognition sites were spared during surgery, and none of the patients experienced postoperative deficits in recognition of facial emotions.

Conclusions
The finding of interference sites in facial emotion recognition in the right posterior perisylvian area, independent to sensorimotor or visuospatial orientation processes, reinforces the theory about the role of anatomically and functionally segregated right hemisphere structures in this cognitive process. The authors advocate offering a brain mapping of facial emotion recognition to patients with right posterior perisylvian tumors.
Phase II study of ifosfamide, carboplatin, and etoposide in patients with a first recurrence of glioblastoma multiforme
Authors: Aoki Tomokazu , Mizutani Tomohiko , Nojima Kuniharu , Takagi Takehisa , Okumura Ryosuke , Yuba Yoshiaki , Ueba Tetsuya , Takahashi Jun A. , Miyatake Shin-Ichi , Nozaki Kazuhiko , Taki Waro , Matsutani Masao 
Published: June 2009

Object
The prognosis of recurrent glioblastoma multiforme (GBM) remains unsatisfactory. The authors conducted a Phase II study of ifosfamide, carboplatin, and etoposide (ICE) for a first recurrence of GBM to determine whether it prolonged a patient's good-quality life.

Methods
This trial was an open-label, single-center Phase II study. Forty-two patients with a first GBM relapse after surgery followed by standard radiotherapy (60 Gy) and first-line temozolomide- or nimustine-based chemotherapy were eligible to participate. The primary end point was progression-free survival at 6 months after the ICE treatment (PFS-6), and secondary end points were response rate, toxicity, and overall survival. Chemotherapy consisted of ifosfamide (1000 mg/m2 on Days 1, 2, and 3), carboplatin (110 mg/m2 on Day 1), etoposide (100 mg/m2 on Days 1, 2, and 3), every 6 weeks.

Results
Progression-free survival at 6 months after ICE treatment was 35% (95% CI 22–50%). The median duration of PFS was 17 weeks (95% CI 10–24 weeks). The response rate was 25% (95% CI 9–34%). Adverse events were generally mild and consisted mainly of alopecia.

Conclusions
This regimen was well tolerated and has some activity and could be one of the options for patients with recurrent GBM.
Judgments of Critical Care Nurses About Risk for Secondary Brain Injury
Authors: McNett Molly , Doheny Margaret , Sedlak Carol A. , Ludwick Ruth 
Published: June 2009

Background Interdisciplinary care for patients with traumatic brain injury focuses on treating the primary brain injury and limiting further brain damage from secondary injury. Intensive care unit nurses have an integral role in preventing secondary brain injury; however, little is known about factors that influence nurses’ judgments about risk for secondary brain injury.Objective To investigate which physiological and situational variables influence judgments of intensive care unit nurses about patients’ risk for secondary brain injury, management solely with nursing interventions, and management by consulting another member of the health care team.Methods A multiple segment factorial survey design was used. Vignettes reflecting the complexity of real-life scenarios were randomly generated by using different values of each independent variable. Surveys containing the vignettes were sent to nurses at 2 level I trauma centers. Multiple regression was used to determine which variables influenced judgments about secondary brain injury.Results Judgments about risk for secondary brain injury were influenced by a patient’s oxygen saturation, intracranial pressure, cerebral perfusion pressure, mechanism of injury, and primary diagnosis, as well as by nursing shift. Judgments about interventions were influenced by a patient’s oxygen saturation, intracranial pressure, and cerebral perfusion pressure and by nursing shift. The initial judgments made by nurses were the most significant variable predictive of follow-up judgments.Conclusions Nurses need standardized, evidence-based content for management of secondary brain injury in critically ill patients with traumatic brain injury.
Production of Both IL-27 and IFN-γ after the Treatment with a Ligand for Invariant NK T Cells Is Responsible for the Suppression of Th2 Response and Allergic Inflammation in a Mouse Experimental Asthma Model
Authors: Fujita Hiroyuki , Teng Annabelle , Nozawa Risa , Takamoto-Matsui Yukiko , Katagiri-Matsumura Haruka , Ikezawa Zenro , Ishii Yasuyuki 
Published: June 2009

Abstract
Using an allergen-induced airway inflammation model, we show that an injection of α-galactosylceramide (α-GalCer), a ligand for invariant NK T (iNKT) cells, induced IL-27 and that this process is essential for the attenuation of the Th2 response. After the systemic administration of α-GalCer into the mice primed with OVA in alum, Th2 cytokine production of OVA-primed CD4+ T cells in their lymph nodes, IgG1 and IgE Ab formation, and infiltration of eosinophils in bronchoalveolar lavage after the OVA challenge were suppressed. Systemic administration of rIFN-γ into OVA-primed mice could not reproduce these effects of α-GalCer. IL-27p28 was detected both in the culture supernatant of α-GalCer-stimulated spleen cells and in the serum of the α-GalCer-treated mice, but not in the iNKT cell-deficient mice. Splenic iNKT cells produced IL-27p28 in the culture supernatant upon stimulation with PMA plus ionomycin, although the transcript of IL-27p28 in the iNKT cells was constitutively expressed regardless of the stimulation. By contrast, the transcript of IL-27EBI3 was induced in the iNKT cells upon stimulation with PMA plus ionomycin in vitro and with α-GalCer treatment in vivo, suggesting that IL-27 (p28/EBI3) could be produced by iNKT cells in an activation-dependent manner. Although repeated injections of rIL-27 did not substitute for the effects of a single injection of α-GalCer, administration of rIL-27 along with rIFN-γ reproduced in vivo effects of the α-GalCer injection. These data indicate that production of both IL-27 and IFN-γ by the α-GalCer treatment is responsible for suppression of the Th2 response and allergic inflammation.
Gap Junctions at the Dendritic Cell-T Cell Interface Are Key Elements for Antigen-Dependent T Cell Activation
Authors: Elgueta Raul , Tobar Jaime A. , Shoji Kenji F. , De Calisto Jaime , Kalergis Alexis M. , Bono Maria R. , Rosemblatt Mario , Sáez Juan C. 
Published: June 2009

Abstract
The acquired immune response begins with Ag presentation by dendritic cells (DCs) to naive T cells in a heterocellular cell-cell contact-dependent process. Although both DCs and T cells are known to express connexin43, a gap junction protein subunit, the role of connexin43 on the initiation of T cell responses remains to be elucidated. In the present work, we report the formation of gap junctions between DCs and T cells and their role on T cell activation during Ag presentation by DCs. In cocultures of DCs and T cells, Lucifer yellow microinjected into DCs is transferred to adjacent transgenic CD4+ T cells, only if the specific antigenic peptide was present at least during the first 24 h of cocultures. This dye transfer was sensitive to gap junction blockers, such as oleamide, and small peptides containing the extracellular loop sequences of conexin. Furthermore, in this system, gap junction blockers drastically reduced T cell activation as reflected by lower proliferation, CD69 expression, and IL-2 secretion. This lower T cell activation produced by gap junction blockers was not due to a lower expression of CD80, CD86, CD40, and MHC-II on DCs. Furthermore, gap junction blocker did not affect polyclonal activation of T cell induced with anti-CD3 plus anti-CD28 Abs in the absence of DCs. These results strongly suggest that functional gap junctions assemble at the interface between DCs and T cells during Ag presentation and that they play an essential role in T cell activation.
Vav1 Regulates the Migration and Adhesion of Dendritic Cells
Authors: Spurrell David R. , Luckashenak Nancy A. , Minney Derek C. , Chaplin Anna , Penninger Joseph M. , Liwski Robert S. , Clements James L. , West Kenneth A. 
Published: June 2009

Abstract
Dendritic cells (DCs) are the most potent APCs for activating naive T cells, a process facilitated by the ability of immature DCs to mature and home to lymph nodes after encountering an inflammatory stimulus. Proteins involved in cytoskeletal rearrangement play an important role in regulating the adherence and motility of DCs. Vav1, a guanine nucleotide exchange factor for Rho family GTPases, mediates cytoskeletal rearrangement in hematopoietic cells following integrin ligation. We show that Vav1 is not required for the normal maturation of DCs in vitro; however, it is critical for DC binding to fibronectin and regulates the distribution but not the formation of podosomes. We also found that DC Vav1 was an important component of a signaling pathway involving focal adhesion kinase, phospholipase C-γ2, and ERK1/2 following integrin ligation. Surprisingly, Vav1−/− DCs had increased rates of migration in vivo compared with wild-type control DCs. In vitro findings show that the presence of adhesive substrates such as fibronectin resulted in inhibition of migration. However, there was less inhibition in the absence of Vav1. These findings suggest that DC migration is negatively regulated by adhesion and integrin-mediated signaling and that Vav1 has a central role in this process.
IRAK4 Kinase Activity Is Required for Th17 Differentiation and Th17-Mediated Disease
Authors: Staschke Kirk A. , Dong Sucai , Saha Joy , Zhao Jingyong , Brooks Nathan A. , Hepburn Deena L. , Xia Jinqi , Gulen Muhammet F. , Kang Zizhen , Altuntas Cengiz Z. , Tuohy Vincent K. , Gilmour Raymond , Li Xiaoxia , Na Songqing 
Published: June 2009

AbstractBoth IL-23- and IL-1-mediated signaling pathways play important roles in Th17 cell differentiation, cytokine production, and autoimmune diseases. The IL-1R-associated kinase 4 (IRAK4) is critical for IL-1/TLR signaling. We show here that inactivation of IRAK4 kinase in mice (IRAK4 KI) results in significant resistance to experimental autoimmune encephalomyelitis due to a reduction in infiltrating inflammatory cells into the CNS and reduced Ag-specific CD4+ T cell-mediated IL-17 production. Adoptive transfer of myelin oligodendrocyte glycoprotein 35–55-specific IRAK4 KI Th17 cells failed to induce experimental autoimmune encephalomyelitis in either wild-type or IRAK4 KI recipient mice, indicating the lack of autoantigen-specific Th17 cell activities in the absence of IRAK4 kinase activity. Furthermore, the absence of IRAK4 kinase activity blocked induction of IL-23R expression, STAT3 activation by IL-23, and Th17 cytokine expression in differentiated Th17 cells. Importantly, blockade of IL-1 signaling by IL-1RA inhibited Th17 differentiation and IL-23-induced cytokine expression in differentiated Th17 cells. The results of these studies demonstrate that IL-1-mediated IRAK4 kinase activity in T cells is essential for induction of IL-23R expression, Th17 differentiation, and autoimmune disease.
Soluble TLR2 Reduces Inflammation without Compromising Bacterial Clearance by Disrupting TLR2 Triggering
Authors: Raby Anne-Catherine , Le Bouder Emmanuel , Colmont Chantal , Davies James , Richards Peter , Coles Barbara , George Christopher H. , Jones Simon A. , Brennan Paul , Topley Nicholas , Labéta Mario O. 
Published: June 2009

Abstract
TLR overactivation may lead to end organ damage and serious acute and chronic inflammatory conditions. TLR responses must therefore be tightly regulated to control disease outcomes. We show in this study the ability of the soluble form of TLR2 (sTLR2) to regulate proinflammatory responses, and demonstrate the mechanisms underlying sTLR2 regulatory capacity. Cells overexpressing sTLR2, or stimulated in the presence of the sTLR2 protein, are hyporesponsive to TLR2 ligands. Regulation was TLR2 specific, and affected NF-κB activation, phagocytosis, and superoxide production. Natural sTLR2-depleted serum rendered leukocytes hypersensitive to TLR2-mediated stimulation. Mice administered sTLR2 together with Gram-positive bacteria-derived components showed lower peritoneal levels of the neutrophil (PMN) chemoattractant, keratinocyte-derived chemokine; lower PMN numbers; and a reduction in late apoptotic PMN. Mononuclear cell recruitment remained unaffected, and endogenous peritoneal sTLR2 levels increased. Notably, the capacity of sTLR2 to modulate acute inflammatory parameters did not compromise the ability of mice to clear live Gram-positive bacteria-induced infection. Mechanistically, sTLR2 interfered with TLR2 mobilization to lipid rafts for signaling, acted as a decoy microbial receptor, and disrupted the interaction of TLR2 with its coreceptor, CD14, by associating with CD14. These findings establish sTLR2 as a regulator of TLR2-mediated inflammatory responses, capable of blunting immune responses without abrogating microbial recognition and may inform the design of novel therapeutics against acute and chronic inflammatory conditions.