bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educating Families on Real Time Continuous Glucose Monitoring
Authors: Messer Laurel , Ruedy Katrina , Dongyuan Xing  , Coffey Julie , Englert Kimberly , Caswell Kimberly , Ives Brett 
Published: February 2009

Purpose The purpose of this article is to describe the process of educating families and children with type 1 diabetes on real time continuous glucose monitoring (RT-CGM) and to note the similarities and differences of training patients using continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI). Methods A total of 30 CSII participants and 27 MDI participants were educated using the Navigator RT-CGM in a clinical trial. Time spent with families for visits and calls was tracked and compared between patient groups. The Diabetes Research in Children Network (DirecNet) educators were surveyed to assess the most crucial, time intensive, and difficult educational concepts related to CGM. Results Of the 27 MDI families, an average of 9.6 hours was spent on protocol-prescribed visits and calls (not measured in CSII) and 2 hours on participant-initiated contacts over 3 months. MDI families required an average of 5.4 more phone contacts over 3 months than CSII families. According to the DirecNet educators, lag time and calibrations were the most crucial teaching concepts for successful RT-CGM use. The most time was spent on teaching technical aspects, troubleshooting, and insulin dosing. The most unanticipated difficulties were skin problems including irritation and the sensor not adhering well. Conclusion Educators who teach RT-CGM should emphasize lag time and calibration techniques, technical device training, and sensor insertion. Follow-up focus should include insulin dosing adjustments and skin issues. The time and effort required to introduce RT-CGM provided an opportunity for the diabetes educators to reemphasize good diabetes care practices and promote self-awareness and autonomy to patients and families.
Psychometric Properties of an Instrument for Assessing Treatment Satisfaction Associated With Pramlintide Use
Authors: Rubin Richard R. , Peyrot Mark 
Published: February 2009

Background The clinical benefits of any new treatment depend substantially on patient acceptance and treatment satisfaction, because only well-accepted treatments will be widely used. Thus, it is important to understand how patients experience a new treatment. Objective This study assessed the psychometric properties of a questionnaire (PRAM-TSQ) designed to measure treatment satisfaction in patients using pramlintide (an analog of amylin, a glucoregulatory hormone co-secreted with insulin), which is designed to improve glucose control. Methods Patients with diabetes completed the 14-item PRAM-TSQ at the end of 2 separate placebo-controlled, double-blind, randomized clinical trials in which they added active or placebo pramlintide to their established insulin regimen. Factor analysis was used to assess item clustering for the PRAM-TSQ, and the Cronbach's α measure of inter-item agreement was used to assess scale reliability. PRAM-TSQ validity was assessed by comparing scores between treatment arms, and effect sizes were measured by the η statistic. Validity was also assessed by associations (Pearson correlations) between the PRAM-TSQ and clinical study outcomes (end of study values and during study changes in clinical measures: postprandial glucose [PPG], A1C, weight, and insulin requirements). Results Scaling revealed 4 PRAM-TSQ components: Global Benefits, Specific Benefits, Absence of Side Effects, Treatment Preference. The total composite PRAM-TSQ had good reliability in both studies (type 1 α = .93; type 2 α = .94); subscale reliabilities ranged from .65 to 94. Composite scores differed for pramlintide-treated and placebo-treated patients (type 1 P < .01; type 2 P < .05), and were associated with lower PPG, weight, and insulin requirements (all P < .05). Results were similar for PRAM-TSQ subscales assessing Global Benefits and Treatment Preference; Specific Benefits subscale scores were associated with lower PPG and weight (all P < .05). Conclusions The PRAM-TSQ shows evidence of being a valid, reliable instrument for assessing treatment satisfaction in patients using pramlintide. The subscales are comprehensive and sensitive to the known potential effects of pramlintide treatment. Diabetes educators can use patient responses to the PRAM-TSQ to facilitate treatment adherence by reminding patients of treatment benefits they experience and by helping patients overcome negative effects they report.
Safety evaluation of the aqueous extract of Leonotis leonurus shoots in rats
Authors: Maphosa V , Masika PJ , Adedapo AA 
Published: February 2009

The aqueous extract from Leonotis leonurus (L) R.Br. (Lamiaceae) shoots was evaluated in female rats for its acute, sub acute, and chronic toxicity together with hematological, biochemical, and histopathological changes. In the acute toxicity test, the extract caused death in animals receiving 3200 mg/kg dose. The extract also caused significant ( P < 0.05) changes in red blood cells, packed cell volume, hemoglobin concentration, mean corpuscular volume, platelets, white blood cells and its differentials at doses of 1600 mg/kg in sub-acute toxicity and in as low as 200 mg/kg in chronic toxicity. In biochemical parameters, the extract caused a significant ( P < 0.05) decrease in the levels of urea and creatinine at 1600 mg/kg dose and a significant ( P < 0.05) reduction in urea, total bilirubin, total protein, albumin, globulin, glutamine transference gamma-glutamyl transferase (GGT), and alanine transminase in the 400 mg/kg dose in chronic toxicity. Changes were also noted in body weights, but no significant changes were observed in the levels of electrolytes (sodium, potassium, and chloride). Clinico-pathologically, starry hair coat, respiratory distress, and mortality were recorded. The extract also caused various histopathological changes in the organs. The study concluded that farmers need to exercise caution in the use of the plant for medicinal purposes.
A preliminary survey of mycological and fumonisin and aflatoxin contamination of African traditional herbal medicines sold in South Africa
Authors: Katerere DR , Stockenström S , Thembo KM , Rheeder JP , Shephard GS , Vismer HF 
Published: February 2009

Traditional medicine is an important aspect of healthcare delivery in South Africa and is used by at least 70% of the country’s population. The trade in medicinal plants is a multi-million rand business which is a major driver for rural economies. However, the conditions in which these plant products are transported and stored make them prone to fungal contamination which results in economic losses to the traders and pose potential health hazards to consumers. Of major concern is the possible presence of toxigenic fungi and mycotoxins. This study assessed fungal and mycotoxin contamination of African herbal products sold in Cape Town and Tshwane (formerly Pretoria) in South Africa. Of the 16 samples analyzed, 15 were contaminated with at least one of these three fungal genera: Aspergillus, Fusarium, and Penicillium. Fumonisin B1 was present in 13 of the samples in quantities ranging from 14 to 139 μg/kg (detection limit 5 μg/kg). None of the samples was contaminated with aflatoxigenic fungi or aflatoxin (detection limit 0.5 μg/kg). This is the first study to report on mycological and mycotoxin contamination of commercial traditional African medicines in South Africa. There is a need to expand the study to other urban centers to gain enough insight into this problem and then to intervene with measures that can protect the public from potential harm.
Stage 3 immature human natural killer cells found in secondary lymphoid tissue constitutively and selectively express the TH17 cytokine interleukin-22
Authors: Hughes Tiffany , Becknell Brian , McClory Susan , Briercheck Edward , Freud Aharon G. , Zhang Xiaoli , Mao Hsiaoyin , Nuovo Gerard , Yu Jianhua , Caligiuri Michael A. 
Published: February 2009

Abstract
Considerable functional heterogeneity within human natural killer (NK) cells has been revealed through the characterization of distinct NK-cell subsets. Accordingly, a small subset of CD56+NKp44+NK cells, termed NK-22 cells, was recently described within secondary lymphoid tissue (SLT) as IL-22− when resting, with a minor fraction of this population becoming IL-22+ when activated. Here we discover that the vast majority of stage 3 immature NK (iNK) cells in SLT constitutively and selectively express IL-22, a TH17 cytokine important for mucosal immunity, whereas earlier and later stages of NK developmental intermediates do not express IL-22. These iNK cells have a surface phenotype of CD34−CD117+CD161+CD94−, largely lack expression of NKp44 and CD56, and do not produce IFN-γ or possess cytolytic activity. In summary, stage 3 iNK cells are highly enriched for IL-22 and IL-26 messenger RNA, and IL-22 protein production, but do not express IL-17A or IL-17F.
Binding of PFOS to serum albumin and DNA: insight into the molecular toxicity of perfluorochemicals
Authors: Zhang Xian , Chen Ling , Fei Xun-Chang , Ma Yin-Sheng , Gao Hong-Wen 
Published: February 2009

Abstract

Background
Health risk from exposure of perfluorochemicals (PFCs) to wildlife and human has been a subject of great interest for understanding their molecular mechanism of toxicity. Although much work has been done, the toxigenicity of PFCs remains largely unknown. In this work, the non-covalent interactions between perfluorooctane sulfonate (PFOS) and serum albumin (SA) and DNA were investigated under normal physiological conditions, aiming to elucidate the toxigenicity of PFCs.

Results
In equilibrium dialysis assay, the bindings of PFOS to SA correspond to the Langmuir isothermal model with two-step sequence model. The saturation binding number of PFOS was 45 per molecule of SA and 1 per three base-pairs of DNA, respectively. ITC results showed that all the interactions were spontaneous driven by entropy change. Static quenching of the fluorescence of SA was observed when interacting with PFOS, indicating PFOS bound Trp residue of SA. CD spectra of SA and DNA changed obviously in the presence of PFOS. At normal physiological conditions, 1.2 mmol/l PFOS reduces the binding ratio of Vitamin B2 to SA by more than 30%.

Conclusion
The ion bond, van der Waals force and hydrophobic interaction contributed to PFOS binding to peptide chain of SA and to the groove bases of DNA duplex. The non-covalent interactions of PFOS with SA and DNA alter their secondary conformations, with the physiological function of SA to transport Vitamin B2 being inhibited consequently. This work provides a useful experimental method for further studying the toxigenicity of PFCs.
Unambiguous molecular detections with multiple genetic approach for the complicated chromosome 22q11 deletion syndrome
Authors: Yang Chen , Huang Cheng-Hung , Cheong Mei-Leng , Hung Kun-Long , Lin Lung-Huang , Yu Yeong-Seng , Chien Chih-Cheng , Huang Huei-Chen , Chen Chan-Wei , Huang Chi-Jung 
Published: February 2009

Abstract

Background
Chromosome 22q11 deletion syndrome (22q11DS) causes a developmental disorder during the embryonic stage, usually because of hemizygous deletions. The clinical pictures of patients with 22q11DS vary because of polymorphisms: on average, approximately 93% of affected individuals have a de novo deletion of 22q11, and the rest have inherited the same deletion from a parent. Methods using multiple genetic markers are thus important for the accurate detection of these microdeletions.

Methods
We studied 12 babies suspected to carry 22q11DS and 18 age-matched healthy controls from unrelated Taiwanese families. We determined genomic variance using microarray-based comparative genomic hybridization (array-CGH), quantitative real-time polymerase chain reaction (qPCR) and multiplex ligation-dependent probe amplification (MLPA).

Results
Changes in genomic copy number were significantly associated with clinical manifestations for the classical criteria of 22q11DS using MPLA and qPCR (p < 0.01). An identical deletion was shown in three affected infants by MLPA. These reduced DNA dosages were also obtained partially using array-CGH and confirmed by qPCR but with some differences in deletion size.

Conclusion
Both MLPA and qPCR could produce a clearly defined range of deleted genomic DNA, whereas there must be a deleted genome that is not distinguishable using MLPA. These data demonstrate that such multiple genetic approaches are necessary for the unambiguous molecular detection of these types of complicated genomic syndromes.
An unexpected phosphate binding site in Glyceraldehyde 3-Phosphate Dehydrogenase: Crystal structures of apo, holo and ternary complex of Cryptosporidium parvum enzyme
Authors: Cook William J , Senkovich Olga , Chattopadhyay Debasish 
Published: February 2009

Abstract

Background
The structure, function and reaction mechanism of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) have been extensively studied. Based on these studies, three anion binding sites have been identified, one 'Ps' site (for binding the C-3 phosphate of the substrate) and two sites, 'Pi' and 'new Pi', for inorganic phosphate. According to the original flip-flop model, the substrate phosphate group switches from the 'Pi' to the 'Ps' site during the multistep reaction. In light of the discovery of the 'new Pi' site, a modified flip-flop mechanism, in which the C-3 phosphate of the substrate binds to the 'new Pi' site and flips to the 'Ps' site before the hydride transfer, was proposed. An alternative model based on a number of structures of B. stearothermophilus GAPDH ternary complexes (non-covalent and thioacyl intermediate) proposes that in the ternary Michaelis complex the C-3 phosphate binds to the 'Ps' site and flips from the 'Ps' to the 'new Pi' site during or after the redox step.

Results
We determined the crystal structure of Cryptosporidium parvum GAPDH in the apo and holo (enzyme + NAD) state and the structure of the ternary enzyme-cofactor-substrate complex using an active site mutant enzyme. The C. parvum GAPDH complex was prepared by pre-incubating the enzyme with substrate and cofactor, thereby allowing free movement of the protein structure and substrate molecules during their initial encounter. Sulfate and phosphate ions were excluded from purification and crystallization steps. The quality of the electron density map at 2Å resolution allowed unambiguous positioning of the substrate. In three subunits of the homotetramer the C-3 phosphate group of the non-covalently bound substrate is in the 'new Pi' site. A concomitant movement of the phosphate binding loop is observed in these three subunits. In the fourth subunit the C-3 phosphate occupies an unexpected site not seen before and the phosphate binding loop remains in the substrate-free conformation. Orientation of the substrate with respect to the active site histidine and serine (in the mutant enzyme) also varies in different subunits.

Conclusion
The structures of the C. parvum GAPDH ternary complex and other GAPDH complexes demonstrate the plasticity of the substrate binding site. We propose that the active site of GAPDH can accommodate the substrate in multiple conformations at multiple locations during the initial encounter. However, the C-3 phosphate group clearly prefers the 'new Pi' site for initial binding in the active site.
Hydroxyethylstarch impairs renal function and induces interstitial proliferation, macrophage infiltration and tubular damage in an isolated renal perfusion model
Authors: Hüter Lars , Simon Tim-Philipp , Weinmann Lenard , Schuerholz Tobias , Reinhart Konrad , Wolf Gunter , Amann Kerstin Ute , Marx Gernot 
Published: February 2009

Abstract
Introduction
The aim of the study was to evaluate some of the underlying pathomechanisms of hydroxyethylstarch (HES) induced adverse effects on renal function using 24 porcine kidneys in an isolated perfusion model over six hours.

Methods
Infusion of either 10% HES 200/0.5, 6% HES 130/0.42 or Ringer's lactate (RL) was performed to achieve an haematocrit of 20% in eight kidneys from four animals per group. Physiological and pathophysiological parameters were determined (including N-acetyl-beta-aminoglucosidase as a marker for lysosomal tubular damage). Histological investigations and immunohistological stainings of the kidneys were performed.

Results
Initially after haemodilution, HES 130/0.42 and HES 200/0.5 reduced urine output compared with RL (P < 0.01). After six hours, N-acetyl-beta-aminoglucosidase was significantly higher in HES 200/0.5 (81 ± 23 U/L) compared with HES 130/0.42 (38 ± 12 U/L) and RL (21 ± 13 U/L; P < 0.001). Osmotic nephrosis-like lesions (OL) of the tubuli were present in all groups showing a significantly lower number of OL in RL (1.1 ± 0.4; P = 0.002) compared with both HES groups (HES 200/0.5 = 2.1 ± 0.6; HES 130/0.42 = 2.0 ± 0.5). Macrophage infiltration was significantly higher in HES 200/0.5 compared with HES 130/0.42 (1.3 ± 1.0 vs. 0.2 ± 0.04; P = 0.044). There was a significant increase in interstitial cell proliferation in the HES 200/0.5 group vs. HES 130/0.42 (18.0 ± 6.9 vs. 6.5 ± 1.6; P = 0.006) with no significant difference in RL (13.5 ± 4.0).

Conclusions
We observed impaired diuresis and sodium excretion by HES and identified renal interstitial proliferation, macrophage infiltration and tubular damage as potential pathological mechanisms of HES-induced adverse effects on renal function using an isolated porcine renal perfusion model. Furthermore, we demonstrated that 10% HES 200/0.5 had more of a pro-inflammatory effect compared with 6% HES 130/0.42 and caused more pronounced tubular damage than 6% HES 130/0.42 and RL. OL were present in all groups, but to a lesser degree after RL administration.
Clinical relevance of the severe abnormalities of the T cell compartment in septic shock patients
Authors: Monserrat Jorge , de Pablo Raul , Reyes Eduardo , Díaz David , Barcenilla Hugo , Zapata Manuel R , De la Hera Antonio , Prieto Alfredo , Álvarez-Mon Melchor 
Published: February 2009

Abstract
Introduction
Given the pivotal role of T lymphocytes in the immune system, patients with septic shock may show T cell abnormalities. We have characterised the T cell compartment in septic shock and assess its clinical implications.

Methods
T lymphocytes from the peripheral blood of 52 patients with septic shock and 36 healthy control subjects were analysed on admission to the intensive care unit, baseline, and 3, 7, 14 and 28 days later. T cell phenotypes (CD3+CD4+/CD3+CD8+, CD45RA+/CD45RO+, CD62L+/CD28+) were assessed by quantitative flow cytometry.

Results
CD3+, CD3+CD4+ and CD3+CD8+ lymphocyte counts were significantly lower in patients with septic shock than control subjects. In surviving patients, CD3+CD4+ lymphocytes had normalised after 14 days, yet CD3+CD8+ numbers were still low. Non effector CD45RA+CD45RO- subsets of CD3+CD4+ and CD3+CD8+ were persistently low during patient follow up. CD3+CD8+CD28+ and CD3+CD8+CD62L+ were reduced in patients versus controls and survivors versus nonsurvivors in the first three days. A prediction receptor operative curve revealed that for the CD3+CD8+CD28+ subset, a cutoff of 136 cells/ml showed 70% sensitivity and 100% specificity for predicting death and the area under the curve was 0.84 at admission. Corresponding values for CD3+CD8+CD62L+ were 141 cells/ml, 60% sensitivity, 100% specificity and an area under the curve of 0.75.

Conclusions
A severe redistribution of T lymphocyte subsets is found in septic shock patients. A different kinetic pattern of T cell subset involvement is observed in surviving and nonsurviving patients, with lower numbers of circulating CD3+CD8+CD28+ and CD3+CD8+CD62L+ associated with a better disease outcome.
Infancy Weight Gain Predicts Childhood Body Fat and Age at Menarche in Girls
Authors: Ong Ken K. , Emmett Pauline , Northstone Kate , Golding Jean , Rogers Imogen , Ness Andrew R. , Wells Jonathan C. , Dunger David B. 
Published: February 2009

Abstract
Context: Rapid postnatal weight gain has been associated with subsequent increased childhood adiposity. However, the contribution of rapid weight gain during specific infancy periods is not clear.
Objective: We aimed to determine which periods of infancy weight gain are related to childhood adiposity and also to age at menarche in UK girls.
Design, Setting, and Participants: A total of 2715 girls from a prospective UK birth cohort study participated in the study.
Main Outcome Measures: Routinely measured weights and lengths at ages 2, 9, and 19 months were extracted from the local child health computer database. Body composition was assessed by dual-energy x-ray absorptiometry at age 10 yr, and age at menarche was assessed by questionnaire (categorized into three groups: &lt;12.0, 12.0–13.0, and &gt;13.0 yr).
Results: Faster early infancy weight gain between 0 and 2 months and also 2 to 9 months were associated with increased body fat mass relative to lean mass at age 10 yr and also with earlier age at menarche. Each +1 unit gain in weight sd score between 0 and 9 months was associated with an odds ratio (95% confidence interval) = 1.48 (1.27–1.60) for overweight (body mass index &gt; 85th centile) at 10 yr, and 1.34 (1.21–1.49) for menarche at less than 12 yr. In contrast, subsequent weight gain between 9 and 19 months was not associated with later adiposity or age at menarche.
Conclusions: In developed settings, rapid weight gain during the first 9 months of life is a risk factor for both increased childhood adiposity and early menarche in girls.
A Larger Slice or a Larger Pie? An Empirical Investigation of Bargaining Power in the Distribution Channel
Authors: Draganska Michaela , Klapper Daniel , Villas-Boas Sofia B. 
Published: February 2009

This research aims to provide insights into the determinants of channel profitability and the relative power in the channel by considering consumer demand and the interactions between manufacturers and retailers in an equilibrium model. We use the Nash bargaining solution to determine wholesale prices and thus how margins are split in the channel. Equilibrium margins are a function of demand primitives and of retailer and manufacturer bargaining power. Bargaining power is itself a function of exogenous retail and manufacturer characteristics. The parties' bargaining positions are determined endogenously from the estimated substitution patterns on the demand side. The more they have to lose in a negotiation relative to an outside option, the weaker the bargaining position. We use the proposed bargaining model to investigate the role of the three main factors that have been blamed for the power shift from manufacturers to retailers in recent years (firm-size increases, store-brand introductions, and service-level differentiation). In our empirical analysis of the German market for coffee, we find that bargaining power varies among the different manufacturer-retailer pairs. This result suggests that bargaining power is not an inherent characteristic of a firm but rather depends on the negotiation partner. We are able to confirm empirically previous theoretical findings that there can be cases where the slice of the pie that goes to one of the channel members may decrease, but the overall pie increases and compensates for the smaller share of profits.