bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory Markers Are Increased in Youth with Type 1 Diabetes: The SEARCH Case-Control Study
Authors: Snell-Bergeon Janet K. , West Nancy A. , Mayer-Davis Elizabeth J. , Liese Angela D. , Marcovina Santica M. , D'Agostino Ralph B. , Hamman Richard F. , Dabelea Dana 
Published: April 2010

Abstract
Context: Increased inflammation may contribute to type 1 diabetes (T1D) complications.
Objective: The objective of the study was to investigate the association of inflammation with obesity, hyperglycemia and dyslipidemia in youth with T1D.
Design: This was a cross-sectional study of youth with and without T1D.
Setting: The study was conducted in Colorado and South Carolina.
Patients: SEARCH Case-Control participants with T1D [n = 553, mean age 15 yr (range 10–22), median duration 2.7 yr] and without diabetes [n = 215, mean age 15 yr (range 10–22)].
Intervention: This was an observational study.
Main Outcome Measures: IL-6, high-sensitivity C-reactive protein (hsCRP), fibrinogen, and leptin were measured.
Results: Inflammatory markers were evaluated by diabetes status, quartiles of glycated hemoglobin, and obesity using multiple linear regression analyses, adjusted for age, sex, study site, race/ethnicity, T1D duration, body mass index, and pubertal status. Compared with controls, youth with T1D had higher IL-6 and fibrinogen levels at all levels of glycemia and obesity, and hsCRP levels were significantly higher in youth with T1D in the top three quartiles of glycated hemoglobin (≥7.2%) and among normal-weight subjects. Leptin was lower in youth with poor glycemic control. Higher hsCRP and fibrinogen were correlated with higher total and LDL cholesterol, and apolipoprotein B in youth with T1D, whereas higher fibrinogen was correlated with higher LDL and apolipoprotein B in controls.
Conclusions: T1D is characterized by excess inflammation, independent of adiposity and glycemic control. Even T1D youth in good glycemic control had higher levels of IL-6 and fibrinogen than controls. Elevated inflammatory markers were associated with an atherogenic lipid profile, which may contribute to accelerated atherosclerosis in youth with T1D.
Subtle Cognitive Impairments in Patients with Long-Term Cure of Cushing’s Disease
Authors: Tiemensma Jitske , Kokshoorn Nieke E. , Biermasz Nienke R. , Keijser Bart-Jan S. A. , Wassenaar Moniek J. E. , Middelkoop Huub A. M. , Pereira Alberto M. , Romijn Johannes A. 
Published: April 2010

Abstract
Context and Objective: Active Cushing’s disease is associated with cognitive impairments. We hypothesized that previous hypercortisolism in patients with Cushing’s disease results in irreversible impairments in cognitive functioning. Therefore, our aim was to assess cognitive functioning after long-term cure of Cushing’s disease.
Design: Cognitive assessment consisted of 11 tests, which evaluated global cognitive functioning, memory, and executive functioning.
Patients and Control Subjects: We included 74 patients cured of Cushing’s disease and 74 controls matched for age, gender, and education. Furthermore, we included 54 patients previously treated for nonfunctioning pituitary macroadenomas (NFMA) and 54 controls matched for age, gender, and education.
Results: Compared with NFMA patients, patients cured from Cushing’s disease had lower scores on the Mini Mental State Examination (P = 0.001), and on the memory quotient of the Wechsler Memory Scale (P = 0.050). Furthermore, patients cured from Cushing’s disease tended to recall fewer words on the imprinting (P = 0.013), immediate recall (P = 0.012), and delayed recall (P = 0.003) trials of the Verbal Learning Test of Rey. On the Rey Complex Figure Test, patients cured from Cushing’s disease had lower scores on both trials (P = 0.002 and P = 0.007) compared with NFMA patients. Patients cured from Cushing’s disease also made fewer correct substitutions on the Letter-Digit Substitution Test (P = 0.039) and came up with fewer correct patterns on the Figure Fluency Test (P = 0.003) compared with treated NFMA patients.
Conclusions: Cognitive function, reflecting memory and executive functions, is impaired in patients despite long-term cure of Cushing’s disease. These observations indicate irreversible effects of previous hypercortisolism on cognitive function and, thus, on the central nervous system. These observations may also be of relevance for patients treated with high-dose exogenous glucocorticoids.
Glucocorticoid Receptor Gene, Low-Grade Inflammation, and Heart Failure: The Heart and Soul Study
Authors: Otte Christian , Wüst Stefan , Zhao Shoujun , Pawlikowska Ludmila , Kwok Pui-Yan , Whooley Mary A. 
Published: April 2010

Abstract
Context: A common haplotype of the glucocorticoid receptor (GR) gene has been associated with increased susceptibility to coronary heart disease (CHD). Whether this haplotype predisposes to heart failure (HF) is unknown.
Objective: The objective of the study was to determine whether GR haplotype 3 is associated with HF and whether this association is explained by low-grade inflammation (C-reactive protein).
Design: In a prospective cohort study, participants were genotyped for common GR gene polymorphisms (ER22/23EK, BclI C/G, N363S, 9β A/G). Haplotype analyses were conducted.
Setting: The study was conducted at one university medical center, two Veterans Affairs medical centers, and nine public health clinics.
Patients: Patients included 526 white outpatients with stable CHD.
Main Outcome Measures: Echocardiographic evidence of ventricular dysfunction, self-reported heart failure, and subsequent hospitalization for heart failure were measured.
Results: After adjusting for age, sex, smoking, and body mass index, participants with two copies of haplotype 3 were more likely than those with 0 or 1 copy to report heart failure [hazard ratio (HR) 4.15, 95% confidence interval (CI) 1.5–11.3, P &lt; 0.01], have systolic dysfunction (left ventricular ejection fraction &lt;50%) (HR 3.0, 95% CI 0.9–9.9, P = 0.07), and be hospitalized for HF during a mean follow-up of 6 yr (HR 3.0, 95% CI 1.3–7.0, P = 0.01). These associations were attenuated after adjustment for higher C-reactive protein levels in patients with two copies of haplotype 3.
Conclusions: We found that the GR gene haplotype 3 was associated with prevalent HF, systolic dysfunction, and subsequent HF hospitalization in patients with CHD. This association was partly mediated by low-grade inflammation.
Basal Follicle-Stimulating Hormone and Peak Gonadotropin Levels after Gonadotropin-Releasing Hormone Infusion Show High Diagnostic Accuracy in Boys with Suspicion of Hypogonadotropic Hypogonadism
Authors: Grinspon Romina P. , Ropelato María Gabriela , Gottlieb Silvia , Keselman Ana , Martínez Alicia , Ballerini María Gabriela , Domené Horacio M. , Rey Rodolfo A. 
Published: April 2010

Abstract
Context: Differential diagnosis between hypogonadotropic hypogonadism (HH) and constitutional delay of puberty in boys is challenging. Most tests use an acute GnRH stimulus, allowing only the release of previously synthesized gonadotropins. A constant GnRH infusion, inducing de novo gonadotropin synthesis, may allow a better discrimination.
Objective: We evaluated the diagnostic accuracy of basal and peak gonadotropins after GnRH infusion, measured by ultrasensitive assays, to confirm the diagnosis in boys with suspected HH.
Design and Setting: We conducted a validation study following Standards for Reporting of Diagnostic Accuracy criteria at a tertiary public hospital.
Patients and Methods: A GnRH iv infusion test was performed in 32 boys. LH and FSH were determined by immunofluorometric assay at 0–120 min.
Diagnosis Ascertainment: The following diagnoses were ascertained: complete HH (n = 19; testes &lt; 4 ml at 18 yr), partial HH (n = 6; testes enlargement remained arrested for ≥1 yr or did not reach 15 ml), and constitutional delay of puberty (n = 7; testes ≥ 15 ml at 18 yr).
Main Outcome Measures: Sensitivity, specificity, positive and negative predictive values, and diagnostic efficiency were assessed.
Results: Basal FSH less than 1.2 IU/liter confirmed HH with specificity of 1.00 (95% confidence interval = 0.59–1.00), rendering GnRH infusion unnecessary. In patients with basal FSH of at least 1.2 IU/liter, the coexistence of peak FSH less than 4.6 IU/liter and peak LH less than 5.8 IU/liter after GnRH infusion had high specificity (1.00; 95% confidence interval = 0.59–1.00) and diagnostic efficiency (76.9%) for HH.
Conclusions: Basal FSH less than 1.2 IU/liter confirms HH, which precludes from further testing, reducing patient discomfort and healthcare system costs. In patients with basal FSH of at least 1.2 IU/liter, a GnRH infusion test has a high diagnostic efficiency.
Improvement in Appropriate Utilization of Recombinant Human Erythropoietin Pre- and Post-Implementation of a Required Order Form
Authors: Burns Tammy L , Ferry Brenna A , Malesker Mark A , Morrow Lee E , Bruckner Anne L , Lee Debra L 
Published: April 2010

BACKGROUND: Erythropoietin stimulating agents (ESAs) are high-cost medications that have a significant impact on many pharmacy budgets. Recently, ESAs have received stronger safety warnings and reimbursement has been curtailed by third-party payers including the Centers for Medicare and Medicaid Services. For these reasons, many hospitals are developing strategies to optimize their use. A required order form with acceptable indications and dosing was implemented at an academic medical center in an attempt to improve dosing and appropriate utilization of ESAs. OBJECTIVE: To determine whether implementation of a required order form increased appropriate use and/or decreased total utilization of recombinant human erythropoietin (rHuEPO). METHODS: This was a retrospective cohort study of rHuEPO utilization for 4 months pre- and 6 months post-implementation (April 2008-January 2009). RESULTS: Implementation of a required order form for rHuEPO resulted in significantly fewer patients receiving inappropriate doses of rHuEPO (51.3% vs 19.2%, p < 0.001). The number of patients treated, adjusted to hospital census, was also reduced after implementation of the order form (0.003 vs 0.004 pts./average pt. days, p = 0.03). Annual spending for rHuEPO was reduced by 47% during 2008 despite an increased acquisition cost. CONCLUSIONS: Implementation of a required order form with evidence-based dosing recommendations can be an effective strategy to improve appropriate utilization of rHuEPO.
Association of Pancreatitis with Glucagon-Like Peptide-1 Agonist Use
Authors: Anderson Sarah L , Trujillo Jennifer M 
Published: April 2010

OBJECTIVE: To review the possible association between glucagon-like peptide-1 (GLP-1) agonist use and pancreatitis in patients with type 2 diabetes mellitus. DATA SOURCES: A MEDLINE search (1950-January 2010) identified key clinical trials delineating adverse effects associated with GLP-1 agonist use. Key search terms included type 2 diabetes mellitus, pancreatitis, incretins, exenatide, liraglutide, albiglutide, and taspoglutide. Review of references listed in the articles identified was also performed. The Food and Drug Administration (FDA) Web site and Amylin Pharmaceuticals file data were utilized to extract case report information and unpublished clinical development data related to GLP-1 agonist use and pancreatitis. STUDY SELECTION AND DATA EXTRACTION: Phase 2 and 3 clinical trials evaluating exenatide, liraglutide, albiglutide, and taspoglutide that discussed treatment-related adverse effects as well as FDA-reviewed case reports of pancreatitis in patients taking these same therapies were included. One study evaluating type 2 diabetes as a risk factor for development of acute pancreatitis was also included. Exenatide case reports and clinical development data were also included. DATA SYNTHESIS: Currently there have been 8 cases during clinical development and 36 postmarketing reports of acute pancreatitis in exenatide-treated patients. Four patients have developed acute (n = 3) or chronic (1) pancreatitis during liraglutide clinical trials. There have been no reports to date of development of acute pancreatitis in patients taking albiglutide or taspoglutide. CONCLUSIONS: Observational reports and clinical trial data suggest an association between GLP-1 agonist use and acute pancreatitis; however, additional clinical trial data and in-depth case report analysis are needed to further evaluate and verify this finding.
Use of Information Technology in Medication Reconciliation: A Scoping Review
Authors: Bassi Jesdeep , Lau Francis , Bardal Stan 
Published: April 2010

OBJECTIVE: To identify studies involving information technology (IT) in medication reconciliation (MedRec) and determine how IT is used to facilitate the MedRec process. DATA SOURCES: The search strategy included a database search of MEDLINE and Cumulative Index of Nursing and Allied Health Literature (CINAHL), hand-searching of collected material, and references from articles retrieved. The database search was limited to English-language papers. MEDLINE includes publications dating back to 1950 and CINAHL includes those dating back to 1982. The search included articles in both databases up to March 2009. Boolean queries were constructed using combinations of search terms for medication reconciliation, IT, and electronic records. STUDY SELECTION AND DATA EXTRACTION: Three inclusion criteria were used. The study had to (1) involve the MedRec process, (2) be a primary study, and (3) involve the use of IT. Selection was performed by 2 reviewers through consensus. Data related to study characteristics, focus, and IT use were extracted. DATA SYNTHESIS: The included studies described a range of IT used throughout the MedRec process, from basic email and databases to specialized MedRec tools. A generic MedRec workflow was created and types of IT found in the studies were mapped to the workflow activities as well as to a set of functionalities based on the Institute of Medicine's Key Capabilities of an Electronic Health Record System. In the studies reviewed, IT was mainly used to obtain medication information. Although there were only a few MedRec tools in the studies, those that did exist supported the central activities for MedRec: comparison of medications and clarification of discrepancies. CONCLUSIONS: MedRec is an important process to ensure patient medication safety. Evidence was found that IT can and has been used to facilitate some MedRec activities and new applications are being developed to support the entire MedRec process.
Actin-mediated gene expression in neurons: the MRTF-SRF connection
Authors: Knöll Bernd 
Published: April 2010

Abstract
The traditional view of cellular actin is a rather autarkic cytoskeletal framework function confined to the cytoplasm. However, there is now evidence that alterations in actin dynamics are sensed by the nucleus and subsequently modulate gene expression. In communicating with the nucleus, cytoplasmic, and most likely also nucleus-resident actin, provides a further (gene) regulatory loop to cell motility. A transcription module composed of MRTF (myocardin-related transcription factor) and SRF (serum response factor) emerges as prime target of such actin signaling. Here, I focus on the nervous system, where the actin-MRTF-SRF entity governs multiple aspects of neuronal motility.
Contributions of the Ah receptor to bilirubin homeostasis and its antioxidative and atheroprotective functions
Authors: Bock Karl Walter , Köhle Christoph 
Published: April 2010

AbstractThe homeostasis and atheroprotective function of bilirubin could be an appealing model to investigate one of the many physiologic functions of the human aryl hydrocarbon receptor (AhR). Several clinical and epidemiological studies have been carried out on key enzymes generating and eliminating bilirubin (heme oxygenase-1 and UDP-glucuronosyltransferase UGT1A1, respectively) and their regulation by the AhR. Studies with AhR-deficient mice strongly suggest a role of the AhR in vascular biology. Atherosclerosis, a major cause of premature death, is initiated by pro-oxidative insults of the vascular endothelium. The strong antioxidant and activator of AhR bilirubin is generated in vascular endothelial cells, smooth muscles and macrophages. It acts mostly in the lipid environment, thereby complementing other antioxidants such as glutathione which act mostly on water-soluble proteins. In conclusion, the atheroprotective functions of bilirubin might not only provide models to study physiologic functions of the human AhR but also provide opportunities to improve prevention and treatment of a major life-threatening disease.
Functional study of elafin cleaved by Pseudomonas aeruginosa metalloproteinases
Authors: Guyot Nicolas , Bergsson Gudmundur , Butler Marcus W. , Greene Catherine M. , Weldon Sinéad , Kessler Efrat , Levine Rodney L. , O'Neill Shane J. , Taggart Clifford C. , McElvaney Noel G. 
Published: April 2010

AbstractElafin is a 6-kDa innate immune protein present at several epithelial surfaces including the pulmonary epithelium. It is a canonical protease inhibitor of two neutrophil serine proteases [neutrophil elastase (NE) and proteinase 3] with the capacity to covalently bind extracellular matrix proteins by transglutamination. In addition to these properties, elafin also possesses antimicrobial and immunomodulatory activities. The aim of the present study was to investigate the effect ofPseudomonas aeruginosaproteases on elafin function. We found thatP. aeruginosaPAO1-conditioned medium and two purifiedPseudomonasmetalloproteases, pseudolysin (elastase) and aeruginolysin (alkaline protease), are able to cleave recombinant elafin. Pseudolysin was shown to inactivate the anti-NE activity of elafin by cleaving its protease-binding loop. Interestingly, antibacterial properties of elafin against PAO1 were found to be unaffected after pseudolysin treatment. In contrast to pseudolysin, aeruginolysin failed to inactivate the inhibitory properties of elafin against NE. Aeruginolysin cleaves elafin at the amino-terminal Lys6-Gly7 peptide bond, resulting in a decreased ability to covalently bind purified fibronectin following transglutaminase activity. In conclusion, this study provides evidence that elafin is susceptible to proteolytic cleavage at alternative sites byP. aeruginosametalloproteinases, which can affect different biological functions of elafin.
Avoiding Revictimization: Shifting from Police Interrogations to Police Interviewing in China
Authors: Yuan Chuanyou 
Published: April 2010

The present thesis conducts a forensic linguistic study on the issue of revictimization not of rape victims but of battered women suspects who go on to kill their aggressors (Walker 1999, Liu and Chan 1999, Zhao 2001, Tang et al. 2002). Awarding Institution: Guangdong University of Foreign Studies Date of award: December 2007
In Vivo Angiogenic Activity of Enamel Matrix Derivative
Authors: Kauvar Amy S. , Thoma Daniel S. , Carnes David L. , Cochran David L. 
Published: April 2010

Background: Porcine enamel matrix derivative (EMD) has a clinical use in facilitating periodontal healing by enhancing the regeneration of alveolar bone, cementum, and periodontal ligament. The mechanism of clinical use has not been elucidated, but in vitro studies suggest that EMD may enhance healing, in part, by stimulating angiogenesis. This study analyzes the effect of EMD on the production of blood vessels in the chorioallantoic membrane (CAM) of the developing chicken egg.Methods: Various amounts of EMD ranging from 15 to 125 ng/5 μl were pipetted onto a 3‐mm diameter × 2‐mm thick bioabsorbable hemostatic gelatin and placed onto the surface of the CAM. Recombinant human amelogenin and a purified 5‐kDa protein fraction derived from EMD were also tested at various amounts ranging from 15 to 62 ng/5 μl. A mixture of fibroblast growth factor and vascular endothelial growth factor served as the positive control. The negative control was 0.9% saline. A histologic examination of the interface of the gelatin and CAM was performed, evaluating for new blood‐vessel formation on an ordinal scale of 0 to 3. Non‐parametric statistical analyses were applied to compare test groups with the negative controls.Results: CAM treated with EMD displayed moderate vascularity as indicated by a maximal score of 3.0 ± 0.05 (mean ± SEM). This compared favorably to the degree of vascularity stimulated by the mixture of fibroblast growth factor and vascular endothelial growth factor, which had a score of 3.0 ± 0.05. Interestingly, the stimulation of angiogenesis by EMD was significant only at the lowest amounts tested. At the higher amounts, vascularity was reduced and not significantly different from the negative control. Vascularity was also increased by recombinant human amelogenin as indicated by a maximal score of 2.9 ± 0.14. By contrast, there was only mild vascularity in sections treated with the negative control as indicated by a score of 1.7 ± 0.4. The vascularity of the 5‐kDa EMD‐protein fraction was not different from the negative‐control group (2.5 ± 0.5 versus 1.7 ± 0.4, respectively).Conclusions: EMD stimulates angiogenesis in the CAM model. As a heterogeneous mixture of extracellular matrix components, EMD may have multiple biologic functions, but it is likely that at least part of the explanation for its observed positive clinical effects may be the stimulation of angiogenesis. The fact that vascularity was also increased by recombinant human amelogenin raises the possibility that this 28.9‐kDa protein may be the source of the angiogenic activity because it is the predominant protein of the EMD mixture. These results, taken together with results from previously reported in vitro studies, suggest that EMD may increase angiogenesis directly and/or indirectly at the wound‐healing site.
The Impact of Oral Contraceptives on Women's Periodontal Health and the Subgingival Occurrence of Aggressive Periodontopathogens and Candida Species
Authors: Brusca María Isabel , Rosa Alcira , Albaina Olatz , Moragues María D. , Verdugo Fernando , Pontón José 
Published: April 2010

Background: The purpose of this study is to evaluate the influence of oral contraceptive (OC) use on the subgingival occurrence of specific periodontopathogens and the host's periodontal status.Methods: Ninety‐two females aged 19 to 40 years were included in the study. They were divided into two groups, OC users and non‐users, and subgrouped according to the most severe periodontal condition and duration of OC usage. A pooled subgingival sample from each subject was cultured to investigate the presence of Candida species, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Prevotella intermedia.Results: OC users, particularly smokers, show a statistically significant increase in the prevalence of severe periodontitis. OC users had deeper probing depths (≥5 mm) than non‐users. Moreover, OC users had higher gingival index scores and clinical attachment loss, ≥2 and ≥5 mm, respectively, than non‐users (P <0.01). Patients taking OCs had significantly higher numbers of cultures positive for Candida. Seven Candida species were isolated. Subgingival Candida was associated with P. gingivalis and P. intermedia in 82.9% and 85.4%, respectively, in patients taking OCs. A. actinomycetemcomitans was isolated in patients with moderate and severe periodontitis and was associated with subgingival P. gingivalis, P. intermedia, and Candida.Conclusions: OC use may increase the risk of severe periodontitis and seems to cause a selection of certain Candida species in periodontal pockets. OC users showed a higher prevalence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans compared to non‐users. C. albicans, C. parapsilosis, C. krusei, C. tropicalis, and C. glabrata were the species with the ability to survive in the conditions created by the sex hormones after 3 years.