bluuebunny/crossref_metadata_2025_split huggingface dataset:
Normal Pregnancy and Healthy Child After Continued Exposure to Gliclazide and Ramipril During Pregnancy
Authors: Kolagasi Oykun , Sari Funda , Akar Munire , Sari Ramazan 
Published: December 2008

OBJECTIVE To report a case of exposure to gliclazide and ramipril during pregnancy in a patient with diabetes mellitus and hypertension. CASE SUMMARY A 42-year-old female with type 2 diabetes mellitus and hypertension who had been taking gliclazide 30 mg/day and ramipril 10 mg/day for 2 years was admitted in the 16th week of gestation. The following week, gliclazide and ramipril were discontinued and methyldopa 500 mg 4 times daily and intensive insulin therapy were instituted. Blood glucose concentrations and blood pressure remained within acceptable levels throughout the pregnancy. The patient gave birth to a healthy child (3200 g) by cesarean section after completing an uneventful gestation period. DISCUSSION Oral antidiabetic drug use in pregnancy is not recommended secondary to known effects on the fetus such as congenital abnormalities, fetal hyperinsulinemia, macrosomia, and neonatal hypoglycemia. Although this infant had no abnormalities after being exposed to gliclazide and ramipril during the first 16 weeks of gestation, this case is not an unconditionally acceptable indication for safety of these medications in pregnancy. Angiotensin-converting enzyme inhibitors increase fetal risks and therefore should not be used during pregnancy, according to data from animals and humans. There are few data available on use of sulfonylureas; thus, their use should also be avoided during pregnancy. CONCLUSIONS Although the normal pregnancy outcome in our patient does not indicate that use of gliclazide and ramipril is safe during gestation, these data contribute to limited information regarding human exposure to these drugs.
Visceral fat mass is a strong predictor of circulating ghrelin levels in premenopausal women
Authors: Sondergaard E , Gormsen L C , Nellemann B , Vestergaard E T , Christiansen J S , Nielsen S 
Published: December 2008

ObjectiveA well known inverse relationship exists between obesity and circulating ghrelin concentrations. However, obesity is a heterogeneous disease entity and upper-body obesity (UBO) is associated with more profound metabolic disturbances than lower-body obesity (LBO). We therefore aimed to investigate the impact of body composition on circulating ghrelin levels in women spanning a wide range of body composition phenotypes.Subjects and methodsTen (UBO; waist-to-hip ratio (WHR) >0.85, body mass index (BMI) >28 kg/m2), ten LBO (WHR <0.80, BMI >28 kg/m2) and ten lean women (BMI<25 kg/m2) were studied. Total ghrelin levels were measured under basal and hyperinsulinemic (0.6 mU/kg per min) conditions. Body fat distribution was determined by dual X-ray absorptiometry in combination with computed tomography at the L2-L3 level.ResultsAs expected, an inverse correlation existed between basal ghrelin concentration and BMI (r=−0.40,P=0.03) and total fat mass (r=−0.39,P=0.04). Visceral fat mass was a strong predictor (r=−0.56,P=0.003) of circulating ghrelin levels, even when adjusted for BMI (P=0.02) or body composition group (P=0.04). The suppressive effect of insulin on ghrelin concentration was significantly diminished in the UBO compared with the lean controls (P=0.012) and a highly significant inverse correlation existed with visceral fat mass (r=−0.52,P=0.004).ConclusionsVisceral fat mass is a strong predictor of basal ghrelin concentrations and also attenuates the suppressive effect of insulin on ghrelin concentrations. These data provide further evidence that the UBO phenotype is associated with more profound metabolic abnormalities than obesityper se.
Temporary Tongue-Lip Traction during the Initial Period of Mandibular Distraction in Pierre Robin Sequence
Authors: Lee Jun-Ho , Kim Yong-Ha 
Published: December 2008

Objective: Distraction osteogenesis is a good technique to correct micrognathia and to prevent tracheostomy in patients with Pierre Robin sequence. However, the airway must be maintained during the distraction period. The purpose of this study was to determine the usefulness of temporary tongue-lip traction during the initial period of mandibular distraction in Pierre Robin sequence patients with severe airway problems requiring operative procedures. Patients: Three Pierre Robin sequence patients between 4 months and 3 years of age requiring surgical procedures to correct recurrent and severe pulmonary complications. Method: All patients underwent distraction osteogenesis of the mandible. During surgery, a deep one-tension suture was used to apply traction to the tongue. When the patient gained control of the upper airway during the initial period of distraction and micrognathia was corrected, the traction suture was removed. Results: The patients were followed for a mean of 5.4 years. No patients complained of severe pulmonary complications, and tracheostomy was avoided. The lower face area was increased in all three patients. Conclusion: In severe Pierre Robin sequence cases, temporary tongue-lip traction was a good adjunct to distraction osteogenesis because this method avoided tracheostomy.
Effects of Altered Fundamental Frequency on Nasalance during Vowel Production by Adult Speakers at Targeted Sound Pressure Levels
Authors: Mandulak Kerry C. , Zajac David J. 
Published: December 2008

Objective: This study investigated the effects of altered fundamental frequency (F0) on nasalance levels of the vowels /i/ and /a/ produced by adults without cleft palate within a controlled sound pressure level (SPL) range. Design: A prospective group design with convenience sampling from the University of North Carolina at Chapel Hill was used. Participants: 20 men and 20 women participated, aged 18 to 55 years. All were native English speakers with normal speech and language skills and adequate velopharyngeal function. Main Outcome Measures: The outcome measures were percentage nasalance obtained from the Nasometer 6200 (KayPentax) headset and the Computerized Speech Lab Model 4400 (CSL, KayPentax) during vowel production while speakers (1) targeted an SPL range of 75 to 85 dB and (2) targeted the SPL plus F0 range of 165 to 175 Hz. Results: A significant univariate effect was found for the vowels /i/ and /a/ in the targeted SPL condition such that /i/ was produced with higher nasalance than /a/. A significant univariate effect was also found during production of /a/ in the targeted SPL plus F0 condition such that men produced /a/ with higher nasalance than women did. Conclusions: SPL appears to largely account for percentage nasalance differences between the vowels /i/ and /a/ produced by adult male and female speakers. Increased F0 by male speakers appears to influence percentage nasalance during production of the vowel /a/. Clinical implications in regard to assessment of hypernasality are discussed.
Alveolar Bone Grafting for Patients with Unilateral Complete Alveolar and Palatal Clefts Improves the Bony Structure of the Nose
Authors: Nagasao Tomohisa , Ogata Hisao , Miyamoto Junpei , Jiang Hua , Kaneko Tsuyoshi , Isshiki Yasushige , Nakajima Tatsuo 
Published: December 2008

Objective: This is a retrospective study regarding the effect of alveolar bone grafting (ABG) on morphological changes in the bony structure of the nose in alveolar and palatal cleft patients. Methods: Sixty-five randomly selected adults were included in the present study. Of the 65 subjects, 21 had no congenital anomaly and were designated as the control group (n  =  21; mean age 22.4 ± 4.3 years). Forty-four had unilateral complete clefts of the alveolus and palate on the left side. The patients with clefts were further divided into two subgroups based on presence or absence of ABG in their histories. These groups were termed the ABG(+) group (n  =  24; mean age 20.3 ± 2.5 years) and the ABG(−) group (n  =  20; mean age 32 ± 4.5 years), respectively. An anatomical structure that constitutes the bony component of the nose was defined. This structure, composed of the nasal bones and part of the frontal process of the maxilla, was termed the BSEN (bony structure of the external nose). The symmetry of the BSEN was assessed quantitatively by performing morphological measurements on computerized tomographic images of each patient's skull, and these measurements were compared among the control, ABG(+), and ABG(−) groups. Results: The BSEN presented more symmetric features in the ABG(+) group patients than in the ABG(−) group patients. Conclusion: ABG improves symmetry of the BSEN. This finding justifies ABG in terms of cosmetic improvement of the external nose in patients with unilateral complete alveolar and palatal clefts.
Evaluation of Hypernasality in Vowels Using Voice Low Tone to High Tone Ratio
Authors: Lee Guo-She , Wang Ching-Ping , Fu Sherry 
Published: December 2008

Objective: The voice low tone to high tone ratio (VLHR) is defined as the power ratio of low frequency to high frequency energy obtained by dividing the voice spectrum with a specific cutoff frequency. In a previous study, VLHR correlated significantly with nasalance and perceptual rating of hypernasality for a single vowel. The methodology was optimized in this study by investigating the correlations among other vowels. Design: Voice signals of six sustained vowels vocalized by subjects with hypernasality were collected. Vowel nasalance was obtained with a nasometer, and hypernasality rating scores were provided by two speech-language pathologists. The VLHRs calculated using different cutoff frequencies were correlated with nasalance and hypernasality rating scores. Participants: Eight subjects with hypernasality caused by palatal fistula or velopharyngeal insufficiency. Main Outcome Measures: VLHR, nasalance, and hypernasality rating score. Results: The correlation of VLHR with nasalance and hypernasality rating was most significant using a cutoff frequency of 600 Hz. The correlation of VLHR with nasalance was significant (r  =  .62, p < .01, Pearson's correlation), as was the correlation of VLHR with hypernasality score (Spearman's rank correlation coefficient  =  .62, p < .01). Conclusions: VLHR correlated significantly with nasalance and hypernasality in the six sustained vowels and may provide another quantitative index for the evaluation of hypernasality in sustained vowels.
Correlates of Improvement in Walking Ability in Older Persons in the United States
Authors: Feinglass Joe , Song Jing , Manheim Larry M. , Semanik Pamela , Chang Rowland W. , Dunlop Dorothy D. 
Published: December 2008

Objectives. We analyzed factors associated with improvement in walking ability among respondents to the nationally representative Health and Retirement Study. Methods. We analyzed data from 6574 respondents aged 53 years or older who reported difficulty walking several blocks, 1 block, or across the room in 2000 or 2002. We examined associations between improvement (versus no change, deterioration, or death) and baseline health status, chronic conditions, baseline walking difficulty, demographic characteristics, socioeconomic status, and behavioral risk factors. Results. Among the 25% of the study population with baseline walking limitations, 29% experienced improved walking ability, 40% experienced no change in walking ability, and 31% experienced deteriorated walking ability or died. In a multivariate analysis, we found positive associations between walking improvement and more recent onset and more severe walking difficulty, being overweight, and engaging in vigorous physical activity. A history of diabetes, having any difficulty with activities of daily living, and being a current smoker were all negatively associated with improvement in walking ability. After we controlled for baseline health, improvement in walking ability was equally likely among racial and ethnic minorities and those with lower socioeconomic status. Conclusions. Interventions to reduce smoking and to increase physical activity may help improve walking ability in older Americans.
Primary Defects in β-Cell Function Further Exacerbated by Worsening of Insulin Resistance Mark the Development of Impaired Glucose Tolerance in Obese Adolescents
Authors: Cali Anna M.G. , Man Chiara Dalla , Cobelli Claudio , Dziura James , Seyal Aisha , Shaw Melissa , Allen Karin , Chen Shu , Caprio Sonia 
Published: December 2008

OBJECTIVE—Impaired glucose tolerance (IGT) is a pre-diabetic state of increasing prevalence among obese adolescents. The purpose of this study was to determine the natural history of progression from normal glucose tolerance (NGT) to IGT in obese adolescents.
RESEARCH DESIGN AND METHODS—We determined the evolution of β-cell function, insulin sensitivity (SI), and glucose tolerance in a multiethnic group of 60 obese adolescents over the course of approximately 30 months. Each subject underwent three serial 3-h oral glucose tolerance tests. Dynamic, static, and total β-cell responsivity (Φd, Φs, and Φtot, respectively) and Si were assessed by oral C-peptide and glucose minimal models. The disposition index (DI), which adjusts insulin secretion for Si, was calculated.
RESULTS—At baseline, all 60 subjects had NGT. Seventy-seven percent (46 subjects) maintained NGT over the three testing periods (nonprogressors), whereas 23% (14 subjects) developed IGT over time (progressors). At baseline, percent fat and BMI Z score were comparable between the groups. Fasting plasma glucose, 2-h glucose, glucose area under the curve at 180 min, and Φd were significantly different between the two groups at baseline, whereas Si was comparable between the two groups. Over time, although Si remained unchanged in nonprogressors, it steadily worsened by ∼45% (P &gt; 0.04) in progressors. β-Cell responsivity decreased by 20% in progressors, whereas it remained stable in nonprogressors. The DI showed a progressive decline in progressors compared with a modest improvement in nonprogressors (P = 0.02).
CONCLUSIONS—Obese adolescents who progress to IGT may manifest primary defects in β-cell function. In addition, progressive decline in Si further aggravates β-cell function, contributing to the worsening of glucose intolerance.
Managing severe hoof pain in a horse using multimodal analgesia and a modified composite pain score
Authors: Dutton D. W. , Lashnits K. J. , Wegner K. 
Published: December 2008

SummaryThis report describes a clinically useful modified composite pain score (MCPS) for horses with hoof pain. The horse in this report initially suffered from acute pain from a subsolar seroma as well as suspected pain from chronic laminitis. Following surgical debridement, corium prolapsed through the wound and it became infected. During the course of conventional hoof and wound management, the pain experienced by the patient was refractory to nonsteroidal anti‐inflammatory drugs. Using the MCPS as a guide, inflammatory and neuropathic pain states were identified and multimodal analgesia was employed in response to the varying pain states. Drugs used for the anti‐inflammatory pain management protocol included firocoxib, butorphanol, phenylbutazone, aspirin and fish oil. Neuropathic pain modulators included parenteral and local anaesthetics, pentoxifylline, ketamine and gabapentin. Composite pain scoring in horses, which includes observational, physiological and interactive components, may have greater sensitivity for demonstrating response to therapy when multiple types and stages of pain exist.
Book Reviews
Authors: Sandle Mark , Taylor Gary , Welch Penny 
Published: December 2008

Geoff Timmins, Keith Vernon and Christine Kinealy (2005) Teaching and Learning HistoryReview by Mark SandleLorraine McIlrath and Iain Mac Labhrainn (eds) (2007) Higher Education and Civic Engagement: International PerspectivesReview by Gary TaylorJoanna Bull and Colleen McKenna (2004) Blueprint for Computer-Assisted AssessmentReview by Penny WelchPeter Redman (2006) Good Essay WritingReview by Penny Welch
Multiple sodium channel isoforms and mitogen‐activated protein kinases are present in painful human neuromas
Authors: Black Joel A. , Nikolajsen Lone , Kroner Karsten , Jensen Troels S. , Waxman Stephen G. 
Published: December 2008

AbstractObjectiveAlthough axons within neuromas have been shown to produce inappropriate spontaneous ectopic discharges, the molecular basis for pain in patients with neuromas is still not fully understood. Because sodium channels are known to play critical roles in neuronal electrogenesis and hyperexcitability, we examined the expression of all the neuronal voltage‐gated sodium channels (Nav1.1, Nav1.2, Nav1.3, Nav1.6, Nav1.7, Nav1.8, and Nav1.9) within human painful neuromas. We also examined the expression of two mitogen‐activated protein (MAP) kinases, activated p38 and extracellular signal‐regulated kinases 1 and 2 (ERK1/2), which are known to contribute to chronic pain, within these human neuromas.MethodsWe used immunocytochemical methods with specific antibodies to sodium channels Nav1.1, Nav1.2, Nav1.3, Nav1.6, Nav1.7, Nav1.8, and Nav1.9, and to activated MAP kinases p38 and ERK1/2 to study by confocal microscopy control and painful neuroma tissue from five patients with well‐documented pain.ResultsWe demonstrate upregulation of sodium channel Nav1.3, as well as Nav1.7 and Nav1.8, in blind‐ending axons within human painful neuromas. We also demonstrate upregulation of activated p38 and ERK1/2 MAP kinases in axons within these neuromas.InterpretationThese results demonstrate that multiple sodium channel isoforms (Nav1.3, Nav1.7, and Nav1.8), as well as activated p38 and ERK1/2 MAP kinases, are expressed in painful human neuromas, indicating that these molecules merit study as possible therapeutic targets for the treatment of pain associated with traumatic neuromas. Ann Neurol 2008;64:644–653
Epigenetics and the nervous system
Authors: Mehler Mark F. 
Published: December 2008

AbstractWe are in the midst of a revolution in the genomic sciences that will forever change the way we view biology and medicine, particularly with respect to brain form, function, development, evolution, plasticity, neurological disease pathogenesis and neural regenerative potential. The application of epigenetic principles has already begun to identify and characterize previously unrecognized molecular signatures of disease latency, onset and progression, mechanisms underlying disease pathogenesis, and responses to new and evolving therapeutic modalities. Moreover, epigenomic medicine promises to usher in a new era of neurological therapeutics designed to promote disease prevention and recovery of seemingly lost neurological function via reprogramming of stem cells, redirecting cell fate decisions and dynamically modulating neural network plasticity and connectivity. Ann Neurol 2008;64:602–617
Modelling and forecasting vehicle stocks using the trends of stochastic Gompertz diffusion models: The case of Spain
Authors: Gutiérrez R. , Gutiérrez‐Sánchez R. , Nafidi A. 
Published: December 2008

AbstractIn the present study, we treat the stochastic homogeneous Gompertz diffusion process (SHGDP) by the approach of the Kolmogorov equation. Firstly, using a transformation in diffusion processes, we show that the probability transition density function of this process has a lognormal time‐dependent distribution, from which the trend and conditional trend functions and the stationary distribution are obtained. Second, the maximum likelihood approach is adapted to the problem of parameters estimation in the drift and the diffusion coefficient using discrete sampling of the process, then the approximated asymptotic confidence intervals of the parameter are obtained. Later, we obtain the corresponding inference of the stochastic homogeneous lognormal diffusion process as limit from the inference of SHGDP when the deceleration factor tends to zero. A statistical methodology, based on the above results, is proposed for trend analysis. Such a methodology is applied to modelling and forecasting vehicle stocks. Finally, an application is given to illustrate the methodology presented using real data, concretely the total vehicle stocks in Spain. Copyright © 2008 John Wiley & Sons, Ltd.
Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer
Authors: Axelsson C K , Düring M , Christiansen P M , Wamberg P A , Søe K L , Møller S 
Published: December 2008

Abstract

Background
This study examined whether axillary lymph node dissection (ALND) with removal of many normal lymph nodes resulted in a reduced rate of axillary recurrence and better survival, as reported in recent studies.

Methods
The follow-up analyses were based on 8657 patients with node-negative primary breast cancer treated solely by surgery. Median follow-up was 9 years.

Results
The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2·1 to 0·4 per cent; P = 0·037), local recurrence (from 7·4 to 3·8 per cent; P &lt; 0·001) distant metastases (from 15·0 to 10·3 per cent; P &lt; 0·001) and death as first event (from 7·5 to 5·5 per cent; P = 0·012).

Conclusion
When ALND is indicated, at least ten axillary lymph nodes should be retrieved. The role of ALND as primary treatment has decreased significantly during the past decade. The findings leave the concept of the sentinel node biopsy intact, as a highly specific procedure compared to ALND.
Randomized clinical trial comparing decellularized bovine ureter with expanded polytetrafluoroethylene for vascular access
Authors: Chemla E S , Morsy M 
Published: December 2008

Abstract

Background
The SynerGraft® model 100 (SG 100) is a decellularized bovine uereter graft developed to improve on prosthetic conduits for vascular access. Its clinical performance was compared with polytetrafluoroethylene (ePTFE) in a prospective, pilot randomized study.

Methods
Patients requiring haemodialysis with no native vein options were included. Between June 2004 and June 2007, 29 patients received SG 100 and 27 ePTFE grafts. Forty-five patients had undergone previous access surgery. All grafts were between the brachial artery and the axillary vein.

Results
Clinical details were similar between the groups; overall mean(s.d.) follow-up was 469(398) days. After 1 year, there were no significant differences in primary patency (28 per cent for SG 100 versus 48 per cent for ePTFE; P = 0·290), assisted primary patency (52 versus 64 per cent; P = 0·430) or secondary patency (57 versus 68 per cent; P = 0·370). Freedom from infection at 1 year was 96 per cent for SG 100 and 91 per cent for ePTFE (P = 0·410). Fifty-seven further procedures (18 endovascular and 39 surgical) were needed to maintain patency in 50 grafts (23 SG 100 and 27 ePTFE).

Conclusion
Both grafts were adequate conduits for haemodialysis and were amenable to repair. Anticipated advantages for SG 100 were not seen in either patency or stability.
Assessing the affective feelings of two‐ and three‐dimensional objects
Authors: Lee Wen‐Yuan , Luo M. Ronnier , Ou Li‐Chen 
Published: December 2008

AbstractThe aim of this study is to investigate the impact of physical appearance attributes (in terms of color and shape) on our affective feelings of 2D and 3D objects. Twelve colors were studied, each consisting of 12 two‐dimensional and 12 three‐dimensional shapes. This resulted in 144 2D and 144 3D color‐shape combinations. Each color‐shape combination was assessed using 20 emotion scales in a viewing cabinet by a panel of observers with normal color vision. The results show that there are five underlying factors of these 20 scales, i.e., “activity,” “weight,” “heat,” “softness,” and “complexity”. The first three factors were mainly related to color and the other two were linked with shape. © 2008 Wiley Periodicals, Inc. Col Res Appl, 34, 75–83, 2009.