bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential effects of advanced glycation end‐products on renal tubular cell inflammation
Authors: TANG SYDNEY CW , CHAN LORETTA YY , LEUNG JOSEPH CK , CHENG AMY S , LIN MIAO , LAN HUI Y , LAI KAR N 
Published: December 2010

AbstractAim:  The authors recently showed that advanced glycation end‐products (AGE) in the form of glycated albumin (GA) upregulated renal tubular expression of interleukin (IL)‐8 and soluble intercellular adhesion molecule‐1 (sICAM‐1), but not other important cytokines known to mediate diabetic nephropathy. This implies that other molecules such as the carbonyl intermediates of AGE or other modified protein lysine‐albumin may participate in diabetic tubular injury.Methods:  Human proximal tubular epithelial cells (PTEC) were growth‐arrested and exposed to methylglyoxal (MG), MG‐bovine serum albumin (BSA)‐AGE, carboxymethyllysine (CML)‐BSA, AGE‐BSA or BSA with or without prior addition of rosiglitazone that was previously shown to attenuate the pro‐inflammatory effect of GA alone.Results:  MG‐BSA‐AGE and AGE‐BSA upregulated tubular expression of connective tissue growth factor (CTGF), transforming growth factor (TGF)‐β, and vascular endothelial growth factor (VEGF), whereas CML‐BSA stimulated expression of IL‐6, CCL‐2, CTGF, TGF‐β and VEGF. These AGE compounds also activated nuclear factor (NF)‐κB and their effects were attenuated by pre‐incubation with anti‐RAGE antibody. MG and BSA did not affect the expression of any of these molecules. Rosiglitazone did not affect the in vitro biological effects of MG, MG‐BSA‐AGE, AGE‐BSA or CML‐BSA on PTEC.Conclusion:  AGE exhibit differential inflammatory and fibrotic effects on PTEC via RAGE activation and NF‐κB signal transduction. Rosiglitazone had no effect on these responses. Further investigations on compounds that nullify the downstream effects of these AGE are warranted.
Changing incidence of non‐melanoma skin cancer in New Zealand
Authors: Brougham Nicholas D. L. , Dennett Elizabeth R. , Tan Swee T. 
Published: December 2010

AbstractBackground:  Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the commonest types of non‐melanoma skin cancer (NMSC). The incidence of NMSC has been increasing globally with Australia recording a 1.5‐fold increase over the last 17 years. The incidence of NMSC in New Zealand is currently unknown. Given that Australia and New Zealand share similar latitude, sun exposure levels, and other risk factors, it is conceivable this increase has also occurred in New Zealand. This study aimed to provide an analysis of the incidence of NMSC within the Central Region of New Zealand based on longitudinal data derived from pathology reports.Methods:  This retrospective study examined the pathology records of 26 411 patients who underwent surgical excision for 54 004 NMSC lesions which were histologically confirmed, over a 10‐year period from 1 January, 1997 to 1 January, 2007, within the Central Region of New Zealand.Results:  Over the study period, 50 411 primary NMSC lesions were excised. The age‐standardized incidence for NMSC, BCC and SCC was 406, 299 and 118 per 100 000, respectively. Since 1999, the annual incidence of BCC and SCC has increased by 4.0% and 1.1%, respectively, with the greatest increases seen in the population over the age of 50 years.Conclusion:  New Zealand has one of the highest incidence of NMSC in the world. The high and increasing incidence of NMSC underscores the importance for the development and implementation of a national health‐care delivery model, and a commitment to continued monitoring of the NMSC problem.
Risk factors for non‐union in the non‐operative management of type II dens fractures
Authors: Lewis Emma , Liew Susan , Dowrick Adam 
Published: December 2010

AbstractBackground:  Despite the publication of numerous studies, there remains controversy regarding the non‐operative treatment of type II dens fractures. The halo‐thoracic vest (HTV) and rigid cervical collar are the most commonly used. We sought to compare the outcomes of patients managed with these devices in terms of risk factors for non‐union and complication rates.Methods:  This study was a retrospective review of adult patients with type II dens fractures treated non‐operatively at a Level 1 Trauma Centre between 2001 and 2007. Patient medical records and imaging studies were reviewed. Union was defined as stable fibrous union or bony union at 3 months.Results:  Sixty‐seven patients were included – 35 treated using a HTV and 32 with a collar. Non‐union was associated with increased time in HTV or collar (P= 0.011), a mechanism of injury involving a low fall (P= 0.008), or low velocity injuries (P= 0.04). The proportion of patients with stable union at 3 months was 60% for the HTV group versus 35% for the cervical collar group (P= 0.10). There were trends to support increased risk of non‐union with age ≥65 years (P= 0.13) or with fracture displacement ≥2 mm (P= 0.17) at the time of presentation. Clinically significant complications of the HTV were more common than those experienced with collar. Of HTV patients, 60% suffered one or more complications compared with 6% for collar.Conclusions:  We were unable to demonstrate any statistically significant advantage or disadvantage of either device. Further investigation of mortality and morbidity would be beneficial.
Low‐cost production of proinsulin in tobacco and lettuce chloroplasts for injectable or oral delivery of functional insulin and C‐peptide
Authors: Boyhan Diane , Daniell Henry 
Published: December 2010

SummaryCurrent treatment for type I diabetes includes delivery of insulin via injection or pump, which is highly invasive and expensive. The production of chloroplast‐derived proinsulin should reduce cost and facilitate oral delivery. Therefore, tobacco and lettuce chloroplasts were transformed with the cholera toxin B subunit fused with human proinsulin (A, B, C peptides) containing three furin cleavage sites (CTB‐PFx3). Transplastomic lines were confirmed for site‐specific integration of transgene and homoplasmy. Old tobacco leaves accumulated proinsulin up to 47% of total leaf protein (TLP). Old lettuce leaves accumulated proinsulin up to 53% TLP. Accumulation was so stable that up to ∼40% proinsulin in TLP was observed even in senescent and dried lettuce leaves, facilitating their processing and storage in the field. Based on the yield of only monomers and dimers of proinsulin (3 mg/g leaf, a significant underestimation), with a 50% loss of protein during the purification process, one acre of tobacco could yield up to 20 million daily doses of insulin per year. Proinsulin from tobacco leaves was purified up to 98% using metal affinity chromatography without any His‐tag. Furin protease cleaved insulin peptides in vitro. Oral delivery of unprocessed proinsulin bioencapsulated in plant cells or injectable delivery into mice showed reduction in blood glucose levels similar to processed commercial insulin. C‐peptide should aid in long‐term treatment of diabetic complications including stimulation of nerve and renal functions. Hyper‐expression of functional proinsulin and exceptional stability in dehydrated leaves offer a low‐cost platform for oral and injectable delivery of cleavable proinsulin.
Predictors of Activity Limitation and Dependence on Walking Aids After Primary Total Hip Arthroplasty
Authors: Singh Jasvinder A. , Lewallen David G. 
Published: December 2010

OBJECTIVES: To study function outcomes and their predictors after primary total hip arthroplasty (THA).DESIGN: Prospective cohort study.SETTING: Mayo Clinic.PARTICIPANTS: All patients who underwent primary THA at the Mayo Clinic between 1993 and 2005 and were alive at the time of follow‐up.MEASUREMENTS: Whether sex, age, body mass index (BMI), comorbidity, anxiety, and depression predict moderate to severe activity limitation (limitation in ≥3 activities) and complete dependence on waling aids 2 and 5 years after primary THA was examined. Multivariable logistic regression adjusted for operative diagnosis, American Society of Anesthesiologists score, implant type, and distance from medical center.RESULTS: At 2 years, 30.3% of participants reported moderate to severe activity limitation; at 5 years, 35% of participants reported moderate to severe activity limitation. Significant predictors of moderate to severe activity limitations at 2‐year follow‐up were female sex (odds ratio (OR)=1.2, 95% confidence interval (CI)=1.1–1.4), aged 71 to 80 (OR=2.0, 95% CI=1.6–2.5), aged 80 and older (OR=4.5, 95% CI=3.4–6.0), depression (OR=2.1, 95% CI=1.6–2.7), and BMI greater than 30.0. At 5‐year follow‐up, significant predictors were aged 71 to 80 (OR=1.7, 95% CI=1.3–2.2), older than 80 (OR=4.3, 95% CI=2.8–6.6), depression (OR=2.3, 95% CI=1.6–3.4), and BMI greater than 30.0.Significant predictors of complete dependence on walking aids at 2 years were female sex (OR=2.0, 95% CI=1.4–2.7), aged 71 to 80 (OR=2.4, 95% CI=1.4–4.2), older than 80 (OR=11.4, 95% CI=6.0–21.9), higher Deyo‐Charlson score (OR=1.5, 95% CI=(1.1–1.2) for 5‐point increase, depression (OR=2.0, 95% CI=1.2–3.4), and BMI greater than 35.0. Each of these factors also significantly predicted complete dependence on walking at 5‐year follow‐up, with similar odds ratios, except that BMI of 30.0 to 34.9 was not significantly associated.CONCLUSION: Higher BMI, depression, older age, and female sex predict activity limitation and complete dependence on walking aids 2 and 5 years after primary THA.
Stages of Change for the Component Behaviors of Advance Care Planning
Authors: Fried Terri R. , Redding Colleen A. , Robbins Mark L. , Paiva Andrea , O'Leary John R. , Iannone Lynne 
Published: December 2010

OBJECTIVES: To develop stages‐of‐change measures for advance care planning (ACP), conceptualized as a group of interrelated but separate behaviors, and to use these measures to characterize older persons' engagement in and factors associated with readiness to participate in ACP.DESIGN: Observational cohort study.SETTING: Community.PARTICIPANTS: Persons aged 65 and older recruited from physician offices and a senior center.MEASUREMENTS: Stages of change for six ACP behaviors: completion of a living will and healthcare proxy, communication with loved ones regarding use of life‐sustaining treatments and quantity versus quality of life, and communication with physicians about these same issues.RESULTS: Readiness to participate in ACP varied widely across behaviors. Whereas between approximately 50% and 60% of participants were in the action or maintenance stage for communicating with loved ones about life‐sustaining treatment and completing a living will, 40% were in the precontemplation stage for communicating with loved ones about quantity versus quality of life, and 70% and 75% were in the precontemplation stage for communicating with physicians. Participants were frequently in different stages for different behaviors. Few sociodemographic, health, or psychosocial factors were associated with stages of change for completing a living will, but a broader range of factors was associated with stages of change for communication with loved ones about quantity versus quality of life.CONCLUSION: Older persons show a range of readiness to engage in different aspects of ACP. Individualized assessment and interventions targeted to stage of behavior change for each component of ACP may be an effective strategy to increase participation in ACP.
Patterns of Tooth Loss in Older Adults with and without Dementia: A Retrospective Study Based on a Minnesota Cohort
Authors: Chen Xi , Shuman Stephen K. , Hodges James S. , Gatewood Laël C. , Xu Jia 
Published: December 2010

OBJECTIVES: To study tooth loss patterns in older adults with dementia.DESIGN: Retrospective longitudinal study.SETTING: A community‐based geriatric dental clinic in Minnesota.PARTICIPANTS: Four hundred ninety‐one older adults who presented to the study clinic as new patients during the study period, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were retrospectively selected. One hundred nineteen elderly people with International Classification of Diseases, Ninth Revision, codes 290.x, 294.1, or 331.2 or a plain‐text diagnosis of dementia, Alzheimer's disease, or chronic brain syndrome in the medical history were considered having dementia.INTERVENTION: All existing dental conditions were treated before enrollment. Dental treatment was continually provided for all participants during follow‐up.MEASUREMENTS: Tooth loss patterns, including time to first tooth loss, number of tooth loss events, and number of teeth lost per patient‐year were estimated and compared for participants with and without dementia using Cox, Poisson, and negative‐binomial regressions.RESULTS: Participants with dementia arrived with an average of 18 and those without dementia with an average of 20 teeth; 27% of remaining teeth in the group with dementia were decayed or retained roots, higher than in the group without dementia (P<.001). Patterns of tooth loss did not significantly differ between the two groups; 11% of participants in both groups had lost teeth by 12 months of follow‐up. By 48 months, 31% of participants without dementia and 37% of participants with dementia had lost at least one tooth (P=.50). On average, 15% of participants in both groups lost at least one tooth each year. Mean numbers of teeth lost in 5 years were 1.21 for participants with dementia and 1.01 for participants without dementia (P=.89).CONCLUSION: Based on data available in a community‐based geriatric dental clinic, dementia was not associated with tooth loss. Although their oral health was poor at arrival, participants with dementia maintained their dentition as well as participants without dementia when dental treatment was provided.
Factor Structure of Pain Medication Questionnaire in Community‐Dwelling Older Adults with Chronic Pain
Authors: Park Juyoung , Clement Russell , Lavin Robert 
Published: December 2010

AbstractObjectives:  This study was to develop a version of the Pain Medication Questionnaire (PMQ) specific to the elderly chronic pain population and to identify relevant subscales and items for that population. Exploratory factor analysis (EFA) was conducted to assess the factor structure of the PMQ, to eliminate items that are not appropriate for this population, and to improve ease of administration in the elderly population.Methods:  Data were obtained through a survey administered to older adults with chronic pain who consumed opioid medications in a cross‐sectional study at outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System. EFA was conducted on the PMQ in the geriatric chronic pain population, which was compared with the PMQ studies from the general chronic pain population.Results:  A two‐factor solution yielded Factor 1 with four items and Factor 2 with three items; 18 items did not load significantly on either factor, and only seven items loaded significantly on either factor. All of the chosen factor loadings ranged from 0.41 to 0.88.Conclusion:  The findings suggest that, although a small number of the items were identified from the overall scale, they adequately explain two relatively unique factors pertaining to pain management among older adults. This preliminary study suggests that the seven‐item PMQ may be useful in assessing opioid medication misuse in community‐dwelling older adults with chronic pain. Future studies are needed to confirm the reliability, validity, and factor structure of this modified PMQ in the geriatric population.
Sequencing and Optimization Within an Embodied Task Dynamic Model
Authors: Simko Juraj , Cummins Fred 
Published: December 2010

AbstractA model of gestural sequencing in speech is proposed that aspires to producing biologically plausible fluent and efficient movement in generating an utterance. We have previously proposed a modification of the well‐known task dynamic implementation of articulatory phonology such that any given articulatory movement can be associated with a quantification of effort (Simko & Cummins, 2010). To this we add a quantitative cost that decreases as speech gestures become more precise, and hence intelligible, and a third cost component that places a premium on the duration of an utterance. Together, these three cost elements allow us to derive algorithmically optimal sequences of gestures and dynamical parameters for generating articulator movement. We show that the optimized movement displays many timing characteristics that are representative of real speech movement, capturing subtle details of relative timing between gestures. Optimal movement sequences also display invariances in timing that suggest syllable‐level coordination for CV sequences. We explore the behavior of the model as prosodic context is manipulated in two dimensions: clarity of articulation and speech rate. Smooth, fluid, and efficient movements result.
Risk Assessment of Hemorrhagic Transformation of Acute Middle Cerebral Artery Stroke Using Multimodal CT
Authors: Lin Ke , Zink Walter E. , Tsiouris A. John , John Majnu , Tekchandani Leena , Sanelli Pina C. 
Published: December 2010

ABSTRACTPURPOSEMultimodal CT with CT angiography (CTA) and CT perfusion (CTP) are increasingly used in stroke triage. Our aim was to identify parameters most predictive of hemorrhagic transformation (HT), especially symptomatic intracerebral hemorrhage (SICH).METHODSThis retrospective study included patients evaluated by baseline multimodal CT ≤ 9 hours from ictus with acute nonlacunar middle cerebral artery (MCA) territory infarction. Two readers independently evaluated CTP maps for ischemic severity and CTA source images (CTA‐SI) for infarct extent (as measured by ASPECTS). Presence of proximal occlusion (ICA or M1) and degree of collateralization (collateral score) were also assessed on CTA. HT was defined as SICH if associated with deterioration ≥ 4‐points on NIHSS. Multivariate logistic regression analysis identified independent predictors of SICH. ROC curves selected optimal thresholds.RESULTSOf 84 patients reviewed, HT occurred in 22 (26.2%) and SICH in 8 (9.5%). Univariate predictors for SICH were proximal occlusion (OR = 8.65, P= .049), collateral score (OR = .34, P= .017), ASPECTS (OR = .46, P= .001), and CBV (OR = .001, P= .005). Multivariate analysis revealed ASPECTS as the only independent predictor with optimal threshold ≤ 5 and sensitivity and specificity of 75.0% and 85.5%, respectively.CONCLUSIONFor acute MCA infarcts ≤ 9 hours, the strongest predictor of SICH on multimodal CT was ASPECTS on CTA‐SI. J Neuroimaging 2012;22:160‐166
The Effects of Commensal Bacteria on Innate Immune Responses in the Female Genital Tract
Authors: Mirmonsef Paria , Gilbert Douglas , Zariffard Mohammad R. , Hamaker Bruce R. , Kaur Amandeep , Landay Alan L. , Spear Greg T. 
Published: December 2010

Citation  Mirmonsef P, Gilbert D, Zariffard MR, Hamaker BR, Kaur A, Landay AL, Spear GT. The effects of commensal bacteria on innate immune responses in the female genital tract. Am J Reprod Immunol 2011; 65: 190–195The innate and adaptive immune systems are important mechanisms for resistance to pathogens in the female lower genital tract. Lactobacilli at this site help maintain a healthy vagina by producing several factors including lactic acid. Indeed, bacterial vaginosis, a condition in which the genital microbiota is altered, is strongly associated with increased rates of a number of infections including HIV. However, the precise factors that contribute to increased rates of microbial and viral infections in bacterial vaginosis remain to be elucidated. We have studied the effects of bacterial microbiota in the lower genital tract on innate immunity and have found that Toll‐like receptor ligands and short chain fatty acids, produced by bacterial microbiota, have dramatic effects on immune function. In this review, we will discuss these results, in addition to some recent articles that we believe will enhance our understanding of how microbes might interact with the immune system.
In defence of multimodal re‐signification: a response to Håvard Skaar's ‘In defence of writing’
Authors: Adami Elisabetta 
Published: December 2010

AbstractResponding to ‘In defence of writing’ by Håvard Skaar, published in issue 43.1 of this journal (April 2009), the present article argues that (1) compared with text production ‘from scratch’, producing texts through copy‐and‐paste requires a different type of – rather than less – semiotic work, and that (2) digitally produced writing may involve the same amount of semiotic work as texts produced through digitally retrieved images. Supporting the argument with data drawn from the writer's teaching experience in three first‐year graduate courses of Scientific English for the Health Professions, the article discusses the changes in the abilities that are foregrounded/backgrounded (more/less required and developed) in the use of copy‐and‐paste for text production. The results indicate that rather than privileging one mode over another, the learners' semiotic work can be better assessed through a multilayered process of re‐signification and re‐elaboration of texts and contents into multiple modes. The conclusions suggest new priorities for teaching, learning and assessment in the light of the changes in our contemporary semiotic landscape.
Management guideline in haemodynamically unstable patients with pelvic fractures: Outcomes and challenges
Authors: Asadollahi Saeed , De Steiger Richard , Gruen Russell , Richardson Martin 
Published: December 2010

AbstractClinical practice guidelines for haemodynamically unstable patients with pelvic fractures were initiated in February 2005 at our level 1 trauma centre. The purpose of the present study was to evaluate guideline adherence and outcome of guideline performance. In a retrospective clinical study all patients admitted with a pelvic fracture from August 2003 to March 2007 were identified from a prospective trauma registry database. Medical records of all patients were reviewed. Patients with pelvic fractures associated with haemodynamic instability were included. Patients were divided into two groups: preguideline and postguideline. The two groups were compared. Main outcome measurements were 24 h fluid requirement, total blood transfusion, length of stay in ICU and hospital, and mortality rate. Of the 210 patients with pelvic fractures, 32 patients met the inclusion criteria. Preguideline group consisted of 13 and postguideline group 19 patients. Non‐invasive pelvic stabilization was applied significantly more postguideline (92.3% vs 33.3%, P= 0.004). Focused abdominal sonography for trauma and pelvic angiography/embolization have been used significantly more in the postguideline group (5 vs 14, P= 0.046 and 0 vs 6, P= 0.025, respectively). There was no significant difference in 24 h fluid requirement, total blood transfusion, length of stay in ICU and hospital, and mortality rate between the two groups. The introduction of guidelines has influenced the approach to haemodynamically unstable patients with pelvic fractures. Multiple factors can potentially influence the strict adherence to the guideline. Care provided can still be improved by addressing the challenges in guideline performance.