bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunohistochemical distribution of toll‐like receptor 4 in preterm human fetal membrane
Authors: Choi Seong Jin , Jung Soon‐Hee , Eom Minseob , Han Kyoung Hee , Chung In‐Bai , Kim Soo‐Ki 
Published: August 2011

AbstractAim:  Toll‐like receptor 4 (TLR‐4) is the major receptor used for recognition of specific gram negative bacteria by the host immune system. The role of TLR‐4 has been revealed in preterm parturition. This study aims to demonstrate the immunohistochemical expression of TLR‐4 with regard to histological layers and anatomical regions of the human fetal membranes.Material and Methods:  Fetal membranes were obtained from the uterine fundus and low segment. Immunohistochemical staining for TLR‐4 and hematoxylin and eosin stain were performed.Results:  The chorion expressed significantly higher levels of TLR‐4 than the amnion (P = 0.001). There was no difference in the expression of TLR‐4 between the uterine fundus and the uterine low segment (P = 0.942). There was no significant difference in TLR‐4 expression according to the presence of histological chorioamnionitis (P = 0.444). TLR‐4 expression decreased significantly with the progression of gestation (P = 0.002).Conclusions:  The level of expression of TLR‐4 did not differ according to anatomic location, but did differ according to the histological layer of the human fetal membranes and gestational age. These results suggest that TLR‐4 may be involved in preterm parturition.
Comparison of success rates of ‘transvaginal aspiration and tetracycline sclerotherapy’ versus ‘only aspiration’ in the management of non‐neoplastic ovarian cysts
Authors: Kars Bulent , Buyukbayrak Esra E. , Karsidag A. Yasemin K. , Pirimoglu Meltem , Unal Orhan , Turan Cem 
Published: August 2011

AbstractAim:  To investigate the value of tetracycline sclerotherapy for management of recurrent or persisting non‐neoplastic ovarian cysts in comparison to the aspiration without sclerotherapy.Material and Methods:  Ninety‐six patients with proven non‐neoplastic ovarian cysts were randomized into two groups. Group 1 patients underwent cyst aspiration together with tetracycline sclerotherapy (n = 48). Group 2 patients underwent only cyst aspiration without tetracycline sclerotherapy (n = 48). Then, all patients were followed up monthly with ultrasonography for 12 months. The procedure was considered to have failed if the recurring cyst, detected by ultrasound, was 4 cm in size or greater.Results:  There were no differences between the two groups regarding demographic data, initial cyst volume and tumor markers. Recurrence rates within 12 months were 14.6% in group 1 and 50% in group 2 (P < 0.001).Conclusion:  Based on the recurrence rates, we suggest transvaginal aspiration together with tetracycline sclerotherapy rather than only simple transvaginal aspiration in the management of non‐neoplastic ovarian cysts.
Exploiting the antioxidant potential of a common vitamin: Could vitamin C prevent postmenopausal osteoporosis?
Authors: Talaulikar Vikram Sinai , Chambers Timothy , Manyonda Isaac 
Published: August 2011

AbstractAim:  Oxidative stress is thought to play a central role in the pathophysiology of various conditions affecting women's health, including cancer, preeclampsia and osteoporosis. On the back of animal experimentation, we sought to establish whether the oral administration of vitamin C at high doses to postmenopausal women would achieve the plasma antioxidant activity that could prevent osteoporosis.Methods:  In our pilot study, we administered vitamin C at a dose of 10 grams daily to eight healthy postmenopausal women over a period of four weeks and measured their serum levels of vitamin C and crosslaps (markers of bone turnover) at baseline and then on a weekly basis.Results:  We found an initial rise in the plasma levels of vitamin C, but these rapidly fell over four weeks and could not be sustained despite continued therapy, presumably due to limited absorption and possibly even augmented excretion. We found no discernable change in the serum levels of crosslaps in association with the consumption of high doses of vitamin C.Conclusion:  Although vitamin C has antioxidant properties, when given orally, even at a high dose, the serum levels required for it to exhibit antioxidant activity cannot be attained. This approach holds no potential for the use of vitamin C in the prevention of osteoporosis, although other routes of administration could overcome this.
Promptness of diagnosis is the main prognostic factor after colonoscopic perforation
Authors: La Torre M. , Velluti F. , Giuliani G. , Di Giulio E. , Ziparo V. , La Torre F. 
Published: August 2011

AbstractAim  The authors present their experience of colonoscopic perforation and its management, with an analysis of factors affecting outcome.Method  During the last 10 years, 22 cases of colonoscopic perforation (CP) were identified in two different institutions. Multiple logistic regression analysis was used to identify significant predictors of morbidity and mortality.Results  Morbidity and mortality rates were 31% and 13.6%, respectively. Prompt diagnosis was the most powerful predictor of outcome of CP. Multiple logistic regression analysis showed that morbidity and mortality were significantly related to a delay in diagnosis of more than 24 h (P = 0.03 and P = 0.04).Conclusion  The results emphasize the importance of prompt assessment of a patient who develops symptoms after colonoscopy.
Effects of colesevelam on glucose absorption and hepatic/peripheral insulin sensitivity in patients with type 2 diabetes mellitus
Authors: Henry R. R. , Aroda V. R. , Mudaliar S. , Garvey W. T. , Chou H. S. , Jones M. R. 
Published: August 2011

Aim: Colesevelam lowers glucose and low‐density lipoprotein cholesterol levels in patients with type 2 diabetes mellitus. This study examined the mechanisms by which colesevelam might affect glucose control.Methods: In this 12‐week, randomized, double‐blind, placebo‐controlled study, subjects with type 2 diabetes and haemoglobin A1c(HbA1c) ≥7.5% on either stable diet and exercise or sulphonylurea therapy were randomized to colesevelam 3.75 g/day (n = 16) or placebo (n = 14). Hepatic/peripheral insulin sensitivity was evaluated at baseline and at week 12 by infusion of 3H‐labelled glucose followed by a 2‐step hyperinsulinemic–euglycemic clamp. Two 75‐g oral glucose tolerance tests (OGTTs) were conducted at baseline, one with and one without co‐administration of colesevelam. A final OGTT was conducted at week 12. HbA1c and fasting plasma glucose (FPG) levels were evaluated pre‐ and post‐treatment.Results: Treatment with colesevelam, compared to placebo, had no significant effects on basal endogenous glucose output, response to insulin or on maximal steady‐state glucose disposal rate. At baseline, co‐administration of colesevelam with oral glucose reduced total area under the glucose curve (AUCg) but not incremental AUCg. At week 12, neither total AUCg nor incremental AUCg were changed from pre‐treatment values in either group. Post‐load insulin levels increased with colesevelam at 30 and 120 min, but these changes in total area under the insulin curve (AUCi) and incremental AUCi did not differ between groups. Both HbA1c and FPG improved with colesevelam, but treatment differences were not significant.Conclusions: Colesevelam does not affect hepatic or peripheral insulin sensitivity and does not directly affect glucose absorption.
Mechanisms linking obesity to hypertension
Authors: Dorresteijn J. A. N. , Visseren F. L. J. , Spiering W. 
Published: August 2011

SummaryObesity‐related hypertension is increasingly recognized as a distinct hypertensive phenotype requiring a modified approach to diagnosis and management. In this review rapidly evolving insights into the complex and interdependent mechanisms linking obesity to hypertension are discussed. Overweight and obesity are associated with adipose tissue dysfunction, characterized by enlarged hypertrophied adipocytes, increased infiltration by macrophages and marked changes in secretion of adipokines and free fatty acids. This results in chronic vascular inflammation, oxidative stress, activation of the renin‐angiotensin‐aldosterone system and sympathetic overdrive, eventually leading to hypertension. These mechanisms may provide novel targets for anti‐hypertensive drug treatment. Recognition of obesity‐related hypertension as a distinct diagnosis enables tailored therapy in clinical practice. This includes lifestyle modification and accommodated choice of blood pressure‐lowering drugs.
Long‐term outcome of primary non‐responders to tenofovir therapy in HIV/HBV‐co‐infected patients: impact of HBV genotype G
Authors: Lada Olivier , Gervais Anne , Branger Michel , Peytavin Gilles , Roquebert Benedicte , Collin Gilles , Fraqueiro Gil , Moucari Rami , Hamet Gwen , Martinot‐Peignoux Michelle , Matheron Sophie , Marcellin Patrick 
Published: August 2011

AbstractAimTo evaluate the early virological response (EVR) to combined tenofovir‐lamivudine or emtricitabine regimen in HBV/HIV‐co‐infected patients and the long‐term efficacy of tenofovir.MethodsIn this retrospective monocentric study, among the 166 HIV/HBV‐co‐infected patients regularly followed from 2003 to 2008 at Bichat Claude Bernard Hospital, 61 patients had received, either de novo combination therapy with tenofovir and lamivudine or emtricitabine (group I, n = 15) or add‐on tenofovir to lamivudine therapy (group II, n = 46). The HBV polymerase region was sequenced and analysed for all patients with available samples.ResultsAll 15 group I patients achieved EVR vs 32 (82%) of group II patients (P = 0.15). Seven adherent group II patients met criteria for primary non‐response, but achieved delayed response (DR) to therapy. In these seven patients, when compared with the 39 group II patients, there was a trend to longer duration of lamivudine pre‐treatment and to higher rate of lamivudine‐resistant mutants; and HBV genotype‐G proportion was higher (P = 0.026). No virological breakthrough occurred after a median of 46 months follow up.ConclusionIn these HBV/HIV‐co‐infected patients, first‐line HBV therapy with tenofovir and emtricitabine or lamivudine was associated with EVR. However, DR to tenofovir was observed in 15% of patients who added tenofovir to lamivudine therapy, of whom four of seven (57%) had genotype G‐HBV infection. No resistance was evidenced after 46 months of therapy even in patients with DR to tenofovir. At last, a good renal safety profile of TDF was observed after a median follow‐up of 4 years of therapy.
Comparative Effectiveness of Different Chemotherapeutic Regimens on Survival of People Aged 66 and Older with Stage III Colon Cancer: A “Real World” Analysis Using Surveillance, Epidemiology, and End Results–Medicare Data
Authors: Hsiao Fei‐Yuan , Mullins C. Daniel , Onukwugha Ebere , Pandya Naimish , Hanna Nader 
Published: August 2011

OBJECTIVES: To compare the effectiveness and utilization trends of irinotecan (IRI)‐based and oxaliplatin (OX)‐based regimens with those of 5‐fluorouracil and leucovorin (5FU/LV) alone in people aged 66 and older with Stage III colon cancer.
DESIGN: Retrospective cohort study.
SETTING: Data from the Surveillance, Epidemiology, and End Results (SEER)–Medicare data.
PARTICIPANTS: People with Stage III surgically resected colon cancer who received adjuvant chemotherapy were categorized into 5FU/LV‐alone (n=3,581), OX‐based regimen (n=814), and IRI‐based regimen (n=219) subgroups.
MEASUREMENTS: Multivariable Cox proportional hazards models examined the effect of chemotherapies on overall survival, colon cancer–specific survival, and non‐colon cancer–specific survival.
RESULTS: Use of the OX‐based regimen increased, and use of the 5FU/LV‐alone and IRI‐based regimens decreased over time. OX was statistically significantly associated with longer overall survival (hazard ratio (HR)=0.73, 95% confidence interval (CI)=0.62–0.86, P<.001) and colorectal cancer–specific survival (HR=0.39, 95% CI, 0.28–0.55, P<.001) than 5FU/LV alone. There was a greater risk of overall mortality (HR=1.38, 95% CI=1.14–1.67, P<.001) and cancer‐specific mortality (HR=1.92, 95% CI=1.49–2.47, P<.001) associated with IRI than with 5FU/LV. The superiority of OX on survival was found in participants aged 66 to 79 but not in those aged 80 and older.
CONCLUSION: This “real world” comparative effectiveness research extends randomized controlled trial results by documenting the relative survival benefit of OX in older adults with Stage III colon cancer. The associated shift in treatment away from 5FU/LV alone or IRI toward OX is consistent with evidence‐based medicine from real‐world outcomes research.
Exposure to Potentially Harmful Drug–Disease Interactions in Older Community‐Dwelling Veterans Based on the Healthcare Effectiveness Data and Information Set Quality Measure: Who Is at Risk?
Authors: Pugh Mary Jo V. , Starner Catherine I. , Amuan Megan E. , Berlowitz Dan R. , Horton Monica , Marcum Zachary A. , Hanlon Joseph T. 
Published: August 2011

OBJECTIVES: To identify prevalence and risk factors for exposure to drug–disease interactions included in the Healthcare Effectiveness Data and Information Set (HEDIS) Drug–Disease Interaction (Rx‐DIS) measure.
DESIGN: Cross‐sectional retrospective database analysis.
SETTING: Outpatient clinics within the Department of Veterans Affairs (VA).
PARTICIPANTS: Individuals aged 65 and older who received VA outpatient care between October 1, 2003, and September 30, 2006.
MEASUREMENTS: Rx‐DIS exposure based on the HEDIS measure was identified in VA patients with dementia, falls, and chronic renal failure using VA pharmacy and administrative databases. Factors associated with Rx‐DIS exposure were examined, including demographic, health status, and access‐to‐care factors, including VA outpatient health services use and copayment status.
RESULTS: Of the 305,041 older veterans who met criteria for inclusion, the 1‐year prevalence of Rx‐DIS exposure was 15.2%; prevalence was 20.2% for dementia, 16.2% for falls, and 8.5% for chronic renal failure. Patients with high disease burden (physical, psychiatric, number of medications) were significantly more likely to have Rx‐DIS exposure, regardless of condition. Hispanics and individuals with no copayments were more likely to have Rx‐DIS exposure than whites or those with required copayments. There was variation in other predictors based on the type of Rx‐DIS.
CONCLUSION: The prevalence of Rx‐DIS was common in older VA outpatients. Future studies should examine the risk of Rx‐DIS exposure on health outcomes using separate analyses for each type of Rx‐DIS separately before combining all Rx‐DIS into a single measure of exposure. Studies that examine the effectiveness of interventions to reduce Rx‐DIS exposure will also be helpful in improving the quality of care for older adults.
GONe: Software for estimating effective population size in species with generational overlap
Authors: COOMBS J. A. , LETCHER B. H. , NISLOW K. H. 
Published: August 2011

AbstractGONe is a user‐friendly, Windows‐based program for estimating effective size (Ne) in populations with overlapping generations. It uses the Jorde–Ryman modification to the temporal method to account for age structure in populations. This method requires estimates of age‐specific survival and birth rate and allele frequencies measured in two or more consecutive cohorts. Allele frequencies are acquired by reading in genotypic data from files formatted for either GENEPOP or TEMPOFS. For each interval between consecutive cohorts, Ne is estimated at each locus and over all loci. Furthermore, Ne estimates are output for three different genetic drift estimators (Fs, Fc and Fk). Confidence intervals are derived from a chi‐square distribution with degrees of freedom equal to the number of independent alleles. GONe has been validated over a wide range of Ne values, and for scenarios where survival and birth rates differ between sexes, sex ratios are unequal and reproductive variances differ. GONe is freely available for download at https://bcrc.bio.umass.edu/pedigreesoftware/.
Type 1 Interferon Induction of Natural Killer Cell Gamma Interferon Production for Defense during Lymphocytic Choriomeningitis Virus Infection
Authors: Mack Ethan A. , Kallal Lara E. , Demers Delia A. , Biron Christine A. 
Published: August 2011

ABSTRACTNatural killer (NK) cells are equipped to innately produce the cytokine gamma interferon (IFN-γ) in part because they basally express high levels of the signal transducer and activator of transcription 4 (STAT4). Type 1 interferons (IFNs) have the potential to activate STAT4 and promote IFN-γ expression, but concurrent induction of elevated STAT1 negatively regulates access to the pathway. As a consequence, it has been difficult to detect type 1 IFN stimulation of NK cell IFN-γ during viral infections in the presence of STAT1 and to understand the evolutionary advantage for maintaining the pathway. The studies reported here evaluated NK cell responses following infections with lymphocytic choriomeningitis virus (LCMV) in the compartment handling the earliest events after infection, the peritoneal cavity. The production of type 1 IFNs, both IFN-α and IFN-β, was shown to be early and of short duration, peaking at 30 h after challenge. NK cell IFN-γ expression was detected with overlapping kinetics and required activating signals delivered through type 1 IFN receptors and STAT4. It took place under conditions of high STAT4 levels but preceded elevated STAT1 expression in NK cells. The IFN-γ response reduced viral burdens. Interestingly, increases in STAT1 were delayed in NK cells compared to other peritoneal exudate cell (PEC) populations. Taken together, the studies demonstrate a novel mechanism for stimulating IFN-γ production and elucidate a biological role for type 1 IFN access to STAT4 in NK cells.IMPORTANCEPathways regulating the complex and sometimes paradoxical effects of cytokines are poorly understood. Accumulating evidence indicates that the biological consequences of type 1 interferon (IFN) exposure are shaped by modifying the concentrations of particular STATs to change access to the different signaling molecules. The results of the experiments presented conclusively demonstrate that NK cell IFN-γ can be induced through type 1 IFN and STAT4 at the first site of infection during a period with high STAT4 but prior to induction of elevated STAT1 in the cells. The response mediates a role in viral defense. Thus, a very early pathway to and source of IFN-γ in evolving immune responses to infections are identified by this work. The information obtained helps resolve long-standing controversies and advances the understanding of mechanisms regulating key type 1 IFN functions, in different cells and compartments and at different times of infection, for accessing biologically important functions.
A multicentre RCT on community occupational therapy in Alzheimer's disease: 10 sessions are not better than one consultation
Authors: Voigt-Radloff Sebastian , Graff Maud , Leonhart Rainer , Schornstein Katrin , Jessen Frank , Bohlken Jens , Metz Brigitte , Fellgiebel Andreas , Dodel Richard , Eschweiler Gerhard , Vernooij-Dassen Myrra , Olde Rikkert Marcel , Hüll Michael 
Published: August 2011

ObjectiveTo compare the benefits and harms of a Dutch 10-session Community Occupational Therapy programme for patients with Alzheimer's disease with the impact of a one session consultation at home in German routine healthcare.DesignA seven-centre, parallel group, active controlled randomised controlled trial. Patients and carers were not masked. Assessors were fully blind for treatment allocation for one of two primary-outcome measurements.SettingPatients' homes.ParticipantsPatients with mild to moderate Alzheimer's disease (Mini-Mental State Examination 14–24), living in the community with primary carer available and without severe depression or behavioural symptoms, were eligible.InterventionsExperimental 10 home visits within 5 weeks by an occupational therapist, educating patients in the performance of simplified daily activities and in the use of aids to compensate for cognitive decline; and educating carers in coping with behaviour of the patient and in giving supervision to the patient. Control one home visit including individual counselling of patient and carer and explanation of a leaflet on coping with dementia in daily life.Outcome measuresThe primary outcome was the patient's daily functioning measured with the Interview of Deterioration in Daily activities in Dementia and the Perceive, Recall, Plan and Perform System of Task Analysis. Assessments were at baseline, 6, 16 and 26 weeks, with a postal assessment at 52 weeks.Results141 patients were 1:1 randomised to the experimental (N=71) and control group (N=70). Data for 54 and 50 participants were analysed. Patients' daily functioning did not differ significantly between the experimental and control group at week 6, 16, 26 or 52 and remained stable over 26 weeks in both groups. No adverse events were associated with the interventions.ConclusionsIn German healthcare, a Dutch 10-session community occupational therapy was not better than a one-session consultation for the daily functioning of patients with Alzheimer's disease. Further research on the transfer of complex psychosocial is needed.International Clinical Trials Registry PlatformDRKS00000053; Funded by the German Federal Ministry of Health.
HOMOGENIZATION OF A PERIODIC DEGENERATE SEMILINEAR ELLIPTIC PDE
Authors: PARDOUX ÉTIENNE , SOW AHMADOU BAMBA 
Published: August 2011

In this paper, a semilinear elliptic PDE with rapidly oscillating coefficients is homogenized. The novelty of our result lies in the fact that we allow the second order part of the differential operator to be degenerate in some portion of ℝd. Our fully probabilistic method is based on the connection between PDEs and BSDEs with random terminal time and the weak convergence of a class of diffusion processes.
Fighting psychiatric stigma in the classroom: The impact of an educational intervention on secondary school students’ attitudes to schizophrenia
Authors: Economou M. , Louki E. , Peppou L. E. , Gramandani C. , Yotis L. , Stefanis C. N. 
Published: August 2011

Background: Adolescents constitute an appealing target group for fighting stigma and discrimination surrounding mental illness, since it is during this developmental period that adult attitudes about mental illness are formed and consolidated. Aim: The aim of the present study was twofold, to explore adolescents’ beliefs and attitudes to schizophrenia and to evaluate the effectiveness of an anti-stigma intervention in altering them. Methods: A total of 616 high school students participated in the study, divided into a control condition and an anti-stigma intervention group. Data were collected at three time points: before the intervention, upon its completion and at a 12-month follow-up. Results: Baseline measurements indicated that students espoused certain stereotypical beliefs about patients with schizophrenia and were reluctant to interact with them on some occasions. Upon completion of the intervention, positive changes were recorded in students’ beliefs, attitudes and desired social distance; however, only the changes in beliefs and attitudes were maintained after one year. Conclusion: For anti-stigma interventions to be effective, they should be continuously delivered to students throughout the school years and allow for an interaction between students and patients. Health promotion programmes might be an appropriate context for incorporating such interventions.