Σάββατο, 30 Ιουλίου 2016

Experience Playing a Musical Instrument and Overnight Sleep Enhance Performance on a Sequential Typing Task.

Experience Playing a Musical Instrument and Overnight Sleep Enhance Performance on a Sequential Typing Task.

PLoS One. 2016;11(7):e0159608

Authors: Tucker MA, Nguyen N, Stickgold R

Abstract
The smooth, coordinated fine motor movements required to play a musical instrument are not only highly valued in our society; they also predict academic success in areas that generalize beyond the motor domain, including reading and math readiness, and verbal abilities. Interestingly, motor skills that overlap with those required to play a musical instrument (e.g., sequential finger tapping) markedly improve (get faster) over a night of sleep, but not after a day spent awake. Here we studied whether individuals who play musical instruments that require fine finger motor skill are better able to learn and consolidate a simple motor skill task compared to those who do not play an instrument, and whether sleep-specific motor skill benefits interact with those imparted by musical experience. We used the motor sequence task (MST), which taps into a core skill learned and used by musicians, namely, the repetition of learned sequences of key presses. Not surprisingly, we found that musicians were faster than non-musicians throughout the learning session, typing more correct sequences per 30-sec trial. In the 12hrs that followed learning we found that sleep and musical experience both led to greater improvement in performance. Surprisingly, musicians retested after a day of wake performed slightly better than non-musicians who had slept between training and retest, suggesting that musicians have the capacity to consolidate a motor skill across waking hours, while non-musicians appear to lack this capacity. These findings suggest that the musically trained brain is optimized for motor skill consolidation across both wake and sleep, and that sleep may simply promote a more effective use of this machinery. In sum, there may be something special about musicians, perhaps a neurophysiological advantage, that leads to both the expected-greater motor speed at learning-and the surprising-greater motor skill improvement over time.

PMID: 27472398 [PubMed - as supplied by publisher]



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The Effect of Casein Protein Prior to Sleep on Fat Metabolism in Obese Men.

The Effect of Casein Protein Prior to Sleep on Fat Metabolism in Obese Men.

Nutrients. 2016;8(8)

Authors: Kinsey AW, Cappadona SR, Panton LB, Allman BR, Contreras RJ, Hickner RC, Ormsbee MJ

Abstract
We have previously shown that ingesting protein at night before sleep is either beneficial or non-detrimental to metabolism, health, and body composition in obese women. However, the overnight protein-induced lipolytic actions and mechanism for improved metabolism and body composition have not been fully established. Therefore, in a crossover design, twelve obese men (age, 27.0 ± 2.2 years) were randomly assigned to ingest (within 30 min of sleep) casein protein (CAS, 120 kcal) or a non-nutritive placebo (PLA) before going to sleep. Markers of fat metabolism (lipolysis, substrate utilization, growth hormone), insulin, glucose, resting energy expenditure (REE), and appetite (questionnaire and ghrelin) were measured. During sleep and the next morning, interstitial glycerol from the subcutaneous abdominal adipose tissue (SCAAT) was measured using microdialysis. There were no differences in SCAAT glycerol (overnight: CAS, 177.4 ± 26.7; PLA, 183.8 ± 20.2 μmol/L; morning: CAS, 171.6 ± 19.1; PLA, 161.5 ± 18.6 μmol/L), substrate utilization, REE, or any blood markers between CAS and PLA. Desire to eat was greater for CAS compared to baseline (p = 0.03), but not different from PLA (baseline: 39 ± 6, CAS: 62 ± 8, PLA: 55 ± 5 mm). CAS consumption before sleep did not affect fat or glucose metabolism, REE, or suppress appetite in hyperinsulemic obese men. CAS may be consumed before sleep without impeding overnight or morning fat metabolism in young, obese men.

PMID: 27472361 [PubMed - as supplied by publisher]



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Breakfast Consumption and Its Associations with Health-Related Behaviors among School-Aged Adolescents: A Cross-Sectional Study in Zhejiang Province, China.

Breakfast Consumption and Its Associations with Health-Related Behaviors among School-Aged Adolescents: A Cross-Sectional Study in Zhejiang Province, China.

Int J Environ Res Public Health. 2016;13(8)

Authors: Wang M, Zhong JM, Wang H, Zhao M, Gong WW, Pan J, Fei FR, Wu HB, Yu M

Abstract
Evidence indicates that breakfast consumption is associated with a cluster of health-related behaviors, yet studies in mainland China are scarce. This study is conducted to describe the frequency of breakfast consumption among Chinese adolescents and examine its associations with other dietary, physical activity, sedentary, sleep, cigarette-smoking, and alcohol-drinking behaviors. Breakfast consumption and other health-related behaviors data was collected via a self-administered questionnaire in a cross-sectional study in Zhejiang Province, China. A total of 19,542 school-aged adolescents were recruited in this survey. The associations between breakfast consumption and other health-related behaviors were examined using logistic regression models. A significantly higher prevalence of daily breakfast consumption was found among students who were younger (p for trend <0.001), from urban schools (p < 0.001), and academic high schools (p < 0.001). More frequent vegetable and milk consumption, greater physical activity, and longer sleep duration were positively associated with daily breakfast consumption, while soft drinks and fast food consumption, computer use, cigarette-smoking and alcohol-drinking behaviors were inversely associated. The prevalence of irregular breakfast consumption was relatively high among Chinese adolescents in Zhejiang Province. Daily breakfast consumption was associated with a constellation of health-related behaviors.

PMID: 27472357 [PubMed - as supplied by publisher]



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Short-Range Noncontact Sensors for Healthcare and Other Emerging Applications: A Review.

Short-Range Noncontact Sensors for Healthcare and Other Emerging Applications: A Review.

Sensors (Basel). 2016;16(8)

Authors: Gu C

Abstract
Short-range noncontact sensors are capable of remotely detecting the precise movements of the subjects or wirelessly estimating the distance from the sensor to the subject. They find wide applications in our day lives such as noncontact vital sign detection of heart beat and respiration, sleep monitoring, occupancy sensing, and gesture sensing. In recent years, short-range noncontact sensors are attracting more and more efforts from both academia and industry due to their vast applications. Compared to other radar architectures such as pulse radar and frequency-modulated continuous-wave (FMCW) radar, Doppler radar is gaining more popularity in terms of system integration and low-power operation. This paper reviews the recent technical advances in Doppler radars for healthcare applications, including system hardware improvement, digital signal processing, and chip integration. This paper also discusses the hybrid FMCW-interferometry radars and the emerging applications and the future trends.

PMID: 27472330 [PubMed - as supplied by publisher]



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Symptom Clusters and Impact of Fatigue and Sleep Disturbance on Symptom Experiences of Hepatoma Patients in Taiwan.

Symptom Clusters and Impact of Fatigue and Sleep Disturbance on Symptom Experiences of Hepatoma Patients in Taiwan.

Cancer Nurs. 2016 Jul 28;

Authors: Chung MH, Wang SY, Lin CC

Abstract
BACKGROUND: Hepatoma is the second leading cause of cancer mortality among patients with cancer in Taiwan. Patients with cancer simultaneously experience multiple symptoms in clusters. Relevant studies have generally focused on a single hepatoma symptom.
OBJECTIVES: The aim of this study is to explore the prevalence of symptom clusters and the impact of fatigue and sleep on symptom experiences of patients with hepatoma.
METHODS: The Taiwanese version of the M.D. Anderson Symptom Inventory was administered to a sample of 100 patients. Data were analyzed using descriptive statistics, Pearson correlation, and regression, factor, and hierarchical cluster analyses.
RESULTS: The results showed that fatigue and sleep disturbance were the most severe symptoms experienced by patients with hepatoma. Patients with hepatoma who concurrently experienced fatigue and sleep disturbance experienced more symptoms and more severe symptoms than did those who experienced either symptom or no symptom. This study identified 2 clusters: 1 cluster comprised 8 symptoms and the other cluster comprised 5 symptoms. Factor analysis revealed the following 3 factors: pain-, gastrointestinal-, and sensation-related symptoms.
CONCLUSIONS: Patients with hepatoma who concurrently experienced fatigue and sleep disturbance experienced more symptoms and more severe symptoms than did those who experienced either symptom or no symptom. This study identified 2 clusters experienced by patients with hepatoma.
IMPLICATIONS FOR PRACTICE: Our results provide implications for further research on managing the most common co-occurring symptoms to reduce symptom clusters and improve the quality of life of hepatoma patients.

PMID: 27472191 [PubMed - as supplied by publisher]



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Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change.

Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change.

J Clin Child Adolesc Psychol. 2016 Jul 29;:1-11

Authors: Gershon A, Singh MK

Abstract
Sleep disturbances are common features of bipolar disorder (BD), yet little is known about trajectories of sleep disturbances in youth with BD. Using longitudinal data, this study assessed the stability of sleep disturbances and their ability to predict symptom progression in adolescents diagnosed with BD compared to controls. Thirteen- to 19-year-olds meeting diagnostic criteria for BD I (n = 19, 16.2 ± 1.75 years, 57.9 % female, 68.4% Caucasian) and psychiatrically healthy age-comparable controls (n = 21, 15.7 ± 1.48 years. 52.4% female, 57.1% Caucasian) were assessed for sleep onset latency, number of awakenings, and wake time, separately for weekdays and weekends using a self-report questionnaire. Sleep indices and symptoms of mania (Young Mania Rating Scale) and depression (Children's Depression Rating Scale) were assessed at two time points, T1 and T2, approximately 12 months apart. Correlations were used to examine stability of sleep indices across time points and regression models to examine the effects of T1 sleep on T2 symptoms. Adolescents with BD showed low stability on most sleep indices, whereas controls showed high stability on all sleep indices. After controlling for T1 depression symptoms, more T1 weekend awakenings and weekend wake time predicted significantly greater T2 depression symptoms in youth with BD but not in controls. No significant associations were found between T1 sleep and T2 mania symptoms. These findings suggest that increased awakenings and wakefulness on weekends may represent an important therapeutic target for reducing depression in adolescents with BD.

PMID: 27472039 [PubMed - as supplied by publisher]



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Effects of Standing and Light-Intensity Walking and Cycling on 24-h Glucose.

Effects of Standing and Light-Intensity Walking and Cycling on 24-h Glucose.

Med Sci Sports Exerc. 2016 Jul 27;

Authors: Crespo NC, Mullane SL, Zeigler ZS, Buman MP, Gaesser GA

Abstract
PURPOSE: To compare 24-h and postprandial glucose responses to incremental intervals of standing (STAND), walking (WALK) and cycling (CYCLE) to a sit-only (SIT) condition.
METHODS: Nine overweight/obese (BMI= 29 ± 3 kgm) adults (30 ± 15 yr) participated in this randomized crossover full-factorial study, with each condition performed 1 wk apart. STAND, CYCLE and WALK intervals increased from 10 minh to 30 minh (2.5 h total) during an 8-h workday. WALK (1.0 mileh) and STAND were matched for upright time, and WALK and CYCLE were matched for energy expenditure (~2 METs). Continuous interstitial glucose monitoring was performed for 24 h to include the 8-h workday (LAB), after-work evening hours (EVE), and sleep (SLEEP). Three 2-h postprandial periods were also analyzed. Linear mixed models were used to test for condition differences.
RESULTS: Compared to SIT (5.7 ± 1.0 mmolL), mean 24-h glucose during STAND (5.4 ± 0.9 mmolL) and WALK (5.3 ± 0.9 mmolL) were lower, and CYCLE (5.1 ± 1.0 mmolL) was lower than all other conditions (all P<0.001). During LAB and EVE, mean glucose was lower for STAND, WALK, and CYCLE compared to SIT (P<0.001). During SLEEP, mean glucose for CYCLE was lower than all other conditions (P<0.001). Compared to SIT, cumulative 6-h postprandial mean glucose was 5-12% lower (P<0.001) during STAND, WALK and CYCLE, and 6-h postprandial glucose integrated area under the curve was 24% during WALK (P<0.05) and 44% lower during CYCLE (P<0.001).
CONCLUSIONS: Replacing sitting with regular intervals of standing or light-intensity activity during an 8-h workday reduces 24-h and postprandial glucose. These effects persist during evening hours, with CYCLE having the largest and most sustained effect.

PMID: 27471786 [PubMed - as supplied by publisher]



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Comparisons of Portable Sleep Monitors of Different Modalities: Potential as Naturalistic Sleep Recorders.

Comparisons of Portable Sleep Monitors of Different Modalities: Potential as Naturalistic Sleep Recorders.

Front Neurol. 2016;7:110

Authors: Matsuo M, Masuda F, Sumi Y, Takahashi M, Yamada N, Ohira MH, Fujiwara K, Kanemura T, Kadotani H

Abstract
BACKGROUND: Humans spend more than one-fourth of their life sleeping, and sleep quality has been significantly linked to health. However, the objective examination of ambulatory sleep quality remains a challenge, since sleep is a state of unconsciousness, which limits the reliability of self-reports. Therefore, a non-invasive, continuous, and objective method for the recording and analysis of naturalistic sleep is required.
OBJECTIVE: Portable sleep recording devices provide a suitable solution for the ambulatory analysis of sleep quality. In this study, the performance of two activity-based sleep monitors (Actiwatch and MTN-210) and a single-channel electroencephalography (EEG)-based sleep monitor (SleepScope) were compared in order to examine their reliability for the assessment of sleep quality.
METHODS: Twenty healthy adults were recruited for this study. First, data from daily activity recorded by Actiwatch and MTN-210 were compared to determine whether MTN-210, a more affordable device, could yield data similar to Actiwatch, the de facto standard. In addition, sleep detection ability was examined using data obtained by polysomnography as reference. One simple analysis included comparing the sleep/wake detection ability of Actiwatch, MTN-210, and SleepScope. Furthermore, the fidelity of sleep stage determination was examined using SleepScope in finer time resolution.
RESULTS: The results indicate that MTN-210 demonstrates an activity pattern comparable to that of Actiwatch, although their sensitivity preferences were not identical. Moreover, MTN-210 provides assessment of sleep duration comparable to that of the wrist-worn Actiwatch when MTN-210 was attached to the body. SleepScope featured superior overall sleep detection performance among the three methods tested. Furthermore, SleepScope was able to provide information regarding sleep architecture, although systemic bias was found.
CONCLUSION: The present results suggest that single-channel EEG-based sleep monitors are the superior option for the examination of naturalistic sleep. The current results pave a possible future use for reliable portable sleep assessment methods in an ambulatory rather than a laboratory setting.

PMID: 27471489 [PubMed]



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Free Energy and Virtual Reality in Neuroscience and Psychoanalysis: A Complexity Theory of Dreaming and Mental Disorder.

Free Energy and Virtual Reality in Neuroscience and Psychoanalysis: A Complexity Theory of Dreaming and Mental Disorder.

Front Psychol. 2016;7:922

Authors: Hopkins J

Abstract
The main concepts of the free energy (FE) neuroscience developed by Karl Friston and colleagues parallel those of Freud's Project for a Scientific Psychology. In Hobson et al. (2014) these include an innate virtual reality generator that produces the fictive prior beliefs that Freud described as the primary process. This enables Friston's account to encompass a unified treatment-a complexity theory-of the role of virtual reality in both dreaming and mental disorder. In both accounts the brain operates to minimize FE aroused by sensory impingements-including interoceptive impingements that report compliance with biological imperatives-and constructs a representation/model of the causes of impingement that enables this minimization. In Friston's account (variational) FE equals complexity minus accuracy, and is minimized by increasing accuracy and decreasing complexity. Roughly the brain (or model) increases accuracy together with complexity in waking. This is mediated by consciousness-creating active inference-by which it explains sensory impingements in terms of perceptual experiences of their causes. In sleep it reduces complexity by processes that include both synaptic pruning and consciousness/virtual reality/dreaming in REM. The consciousness-creating active inference that effects complexity-reduction in REM dreaming must operate on FE-arousing data distinct from sensory impingement. The most relevant source is remembered arousals of emotion, both recent and remote, as processed in SWS and REM on "active systems" accounts of memory consolidation/reconsolidation. Freud describes these remembered arousals as condensed in the dreamwork for use in the conscious contents of dreams, and similar condensation can be seen in symptoms. Complexity partly reflects emotional conflict and trauma. This indicates that dreams and symptoms are both produced to reduce complexity in the form of potentially adverse (traumatic or conflicting) arousals of amygdala-related emotions. Mental disorder is thus caused by computational complexity together with mechanisms like synaptic pruning that have evolved for complexity-reduction; and important features of disorder can be understood in these terms. Details of the consilience among Freudian, systems consolidation, and complexity-reduction accounts appear clearly in the analysis of a single fragment of a dream, indicating also how complexity reduction proceeds by a process resembling Bayesian model selection.

PMID: 27471478 [PubMed]



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Novel class of medications, orexin receptor antagonists, in the treatment of insomnia - critical appraisal of suvorexant.

Novel class of medications, orexin receptor antagonists, in the treatment of insomnia - critical appraisal of suvorexant.

Nat Sci Sleep. 2016;8:239-47

Authors: Norman JL, Anderson SL

Abstract
Insomnia, a highly prevalent disorder, can be detrimental to patients' overall health and worsen existing comorbidities. Patients may have acute episodes of insomnia related to a traumatic event, but more commonly insomnia occurs chronically. While proper sleep hygiene and behavioral therapy play important roles in the nonpharmacologic management of short-term and chronic insomnia, medications may also be required. Historically, insomnia has been treated with agents such as benzodiazepines, nonbenzodiazepine receptor agonists, and melatonin agonists. Dual orexin receptor antagonists represent a new class of medications for the treatment of insomnia, which block the binding of wakefulness-promoting neuropeptides orexin A and orexin B to their respective receptor sites. Suvorexant (Belsomra) is the first dual orexin receptor antagonist to be approved in the US and Japan and has demonstrated efficacy in decreasing time to sleep onset and increasing total sleep time. Its unique mechanism of action, data to support efficacy and safety over 12 months of use, and relative lack of withdrawal effects when discontinued may represent an alternative for patients with chronic insomnia who cannot tolerate or do not receive benefit from more traditional sleep agents. Suvorexant is effective and well tolerated, but precautions exist for certain patient populations, including females, obese patients, and those with respiratory disease. Suvorexant has only been studied vs placebo, and hence it is unknown how it directly compares with other medications approved by the US Food and Drug Administration for insomnia. Suvorexant is not likely to replace benzodiazepines or nonbenzodiazepine receptor antagonists as a first-line sleep agent but does represent a novel option for the treatment of patients with chronic insomnia.

PMID: 27471419 [PubMed]



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Unihemispheric sleep and asymmetrical sleep: behavioral, neurophysiological, and functional perspectives.

Unihemispheric sleep and asymmetrical sleep: behavioral, neurophysiological, and functional perspectives.

Nat Sci Sleep. 2016;8:221-38

Authors: Mascetti GG

Abstract
Sleep is a behavior characterized by a typical body posture, both eyes' closure, raised sensory threshold, distinctive electrographic signs, and a marked decrease of motor activity. In addition, sleep is a periodically necessary behavior and therefore, in the majority of animals, it involves the whole brain and body. However, certain marine mammals and species of birds show a different sleep behavior, in which one cerebral hemisphere sleeps while the other is awake. In dolphins, eared seals, and manatees, unihemispheric sleep allows them to have the benefits of sleep, breathing, thermoregulation, and vigilance. In birds, antipredation vigilance is the main function of unihemispheric sleep, but in domestic chicks, it is also associated with brain lateralization or dominance in the control of behavior. Compared to bihemispheric sleep, unihemispheric sleep would mean a reduction of the time spent sleeping and of the associated recovery processes. However, the behavior and health of aquatic mammals and birds does not seem at all impaired by the reduction of sleep. The neural mechanisms of unihemispheric sleep are unknown, but assuming that the neural structures involved in sleep in cetaceans, seals, and birds are similar to those of terrestrial mammals, it is suggested that they involve the interaction of structures of the hypothalamus, basal forebrain, and brain stem. The neural mechanisms promoting wakefulness dominate one side of the brain, while those promoting sleep predominates the other side. For cetaceans, unihemispheric sleep is the only way to sleep, while in seals and birds, unihemispheric sleep events are intermingled with bihemispheric and rapid eye movement sleep events. Electroencephalogram hemispheric asymmetries are also reported during bihemispheric sleep, at awakening, and at sleep onset, as well as being associated with a use-dependent process (local sleep).

PMID: 27471418 [PubMed]



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Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations.

Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations.

Patient Prefer Adherence. 2016;10:1205-15

Authors: Lee LK, Goren A, Boytsov NN, Donatucci CF, McVary KT

Abstract
OBJECTIVE: Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) frequently co-occur in men aged ≥40, along with lower urinary tract symptoms (LUTS) secondary to BPH. Given little real-world evidence on treatment use or satisfaction with treatment for concurrent BPH/LUTS and/or ED, this study examined medication regimens and differences in satisfaction and health-related quality of life (HRQoL) across regimens among men with concurrent BPH and ED.
METHODS: A cross-sectional study was conducted using an Internet survey of participants recruited through an online panel. Respondents (N=736) included men (aged ≥40) who self-reported a diagnosis of both ED and BPH with prescription treatment in the past 3 months for both conditions. Treatment satisfaction (eg, convenience and ease of planning) and HRQoL (eg, International Prostate Symptom Score, sleep quality) were self-reported. Generalized linear models examined the association of regimen with treatment satisfaction and HRQoL, adjusting for covariates (eg, age and comorbidities).
RESULTS: Final analyses included participants (N=507) using: tadalafil once-daily monotherapy (22%), tadalafil for ED with an alternate BPH therapy (36%), or another phosphodiesterase type-5 inhibitor (PDE5-I) combination (41%). These groups represented the major categories of treatment regimens found in the sample, excluded participants with ambiguous regimens, and were aligned with current standard of care for BPH and ED. Overall, patients reported moderate levels of BPH and a moderate-to-severe degree of ED. Tadalafil monotherapy patients had higher treatment satisfaction scores and greater reported ease of treatment planning and convenience than PDE5-I combination patients. No significant intergroup differences were found on HRQoL.
CONCLUSION: A majority of patients (59%) took tadalafil alone or in combination for BPH/ED treatment. Tadalafil monotherapy patients reported greater treatment satisfaction than patients taking PDE5-I combination therapy. Higher satisfaction for both effectiveness and convenience of once-daily tadalafil may inform both patient and clinician decisions regarding pharmacotherapy regimens.

PMID: 27471377 [PubMed]



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Intermittent hypoxia induces murine macrophage foam cell formation by IKK-β-dependent NF-kappa B pathway activation.

Intermittent hypoxia induces murine macrophage foam cell formation by IKK-β-dependent NF-kappa B pathway activation.

J Appl Physiol (1985). 2016 Jul 28;:jap.00307.2016

Authors: Imamura T, Poulsen O, Haddad GG

Abstract
Obstructive sleep apnea (OSA) is a common sleep disorder characterized by intermittent hypoxia (IH). Clinical studies have previously shown that OSA is an independent risk factor for atherosclerosis. Atherogenicity in OSA patients has been assumed to be associated with the NF-κB pathways. Although foam cells are considered to be a hallmark of atherosclerosis, how IH as in OSA affects their development has not been fully understood. Therefore, we hypothesized that IH induces macrophage foam cell formation through NF-κB pathway activation. To test this hypothesis, peritoneal macrophages collected from myeloid-restricted IKK-β deleted mice were incubated with native LDL and exposed to either IH or normoxia. After exposure, NF-κB pathway activity and intracellular cholesterol were measured. In control macrophages, IH significantly increased NF-κB pathway activity by 93% compared to normoxia (P < 0.05). However, such response to IH was diminished by IKK-β deletion (increased by +31% compared to normoxia; P = 0.64), suggesting that IKK-β is critical for IH-induced NF-κB pathway activation. Likewise, in control macrophages, total cholesterol was increased in IH compared to normoxia (65.7 ± 3.8 μg/mg cellular protein and 53.2 ± 1.2, respectively; P < 0.05). However, this IH-induced foam cell formation was disappeared when IKK-β was deleted (52.2 ± 1.2 μg/mg cellular protein for IH and 46.3 ± 1.7 for normoxia; P = 0.55). This IH-mediated effect still existed in macrophages without LDL receptor. Taken together, our findings show that IH activates the IKK-β-dependent NF-κB pathway and that this, in turn, induces foam cell formation in murine macrophages.

PMID: 27471237 [PubMed - as supplied by publisher]



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Efficacy of pirfenidone in patients with idiopathic pulmonary fibrosis with more preserved lung function.

Efficacy of pirfenidone in patients with idiopathic pulmonary fibrosis with more preserved lung function.

Eur Respir J. 2016 Jul 28;

Authors: Albera C, Costabel U, Fagan EA, Glassberg MK, Gorina E, Lancaster L, Lederer DJ, Nathan SD, Spirig D, Swigris JJ

Abstract
This post hoc analysis examined the differences in idiopathic pulmonary fibrosis disease progression and the effects of pirfenidone in patients stratified by more preserved versus less preserved baseline lung function status using forced vital capacity (FVC) or GAP (gender, age and physiology) index stage.Efficacy outcomes, i.e. FVC, 6-min walking distance (6MWD) and dyspnoea (University of California San Diego Shortness of Breath Questionnaire (UCSD SOBQ)), were analysed at 12 months in patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the pooled phase 3 CAPACITY/ASCEND population (n=1247), with subgroups stratified by baseline FVC ≥80% versus <80% or GAP stage I versus II-III. Treatment-by-subgroup interaction was tested based on a rank ANCOVA model; factors in the model included study, region, treatment, subgroup and treatment-by-subgroup interaction term.Patients with both more preserved (FVC ≥80% or GAP stage I) and less preserved (FVC <80% or GAP stage II-III) lung function at baseline demonstrated clinically significant disease progression at 12 months in terms of categorical decline in FVC, 6MWD and UCSD SOBQ. The magnitude of pirfenidone treatment effect was comparable between subgroups, regardless of whether lung function was classified using FVC or GAP index stage.These findings support the initiation of treatment with pirfenidone, irrespective of stage of baseline lung function in this patient population.

PMID: 27471208 [PubMed - as supplied by publisher]



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Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force.

Principles of practice parameters for the treatment of sleep disordered breathing in the elderly and frail elderly: the consensus of the International Geriatric Sleep Medicine Task Force.

Eur Respir J. 2016 Jul 28;

Authors: Netzer NC, Ancoli-Israel S, Bliwise DL, Fulda S, Roffe C, Almeida F, Onen H, Onen F, Raschke F, Martinez Garcia MA, Frohnhofen H

Abstract
Sleep disordered breathing (SDB) is a leading cause of morbidity worldwide. Its prevalence increases with age. Due to the demographic changes in industrial societies, pulmonologists and sleep physicians are confronted with a rapidly growing number of elderly SDB patients. For many physicians, it remains unclear how current guidelines for SDB management apply to elderly and frail elderly patients. The goal of this consensus statement is to provide guidance based on published evidence for SDB treatment in this specific patient group.Clinicians and researchers with expertise in geriatric sleep medicine representing several countries were invited to participate in a task force. A literature search of PubMed from the past 12 years and a systematic review of evidence of studies deemed relevant was performed.Recommendations for treatment management of elderly and frail elderly SDB patients based on published evidence were formulated via discussion and consensus.In the last 12 years, there have been surprisingly few studies examining treatment of SDB in older adults and even fewer in frail older adults. Studies that have been conducted on the management of SDB in the older patient population were rarely stratified for age. Studies in SDB treatment that did include age stratification mainly focused on middle-aged and younger patient groups. Based on the evidence that is available, this consensus statement highlights the treatment forms that can be recommended for elderly SDB patients and encourages treatment of SDB in this large patient group.

PMID: 27471200 [PubMed - as supplied by publisher]



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Armband activity monitor data do not correlate with reported pain scores in patients receiving vertebroplasty.

Armband activity monitor data do not correlate with reported pain scores in patients receiving vertebroplasty.

J Neurointerv Surg. 2016 Jul 28;

Authors: Peacock JG, Vine RL, McDonald JS, Novotny PJ, Kallmes DF

Abstract
BACKGROUND: Prior research on the efficacy of vertebroplasty has focused primarily on subjective, patient-reported outcomes.
OBJECTIVE: To apply an armband activity monitor (SenseWear by BodyMedia Inc, USA) to patients presenting for consideration for vertebroplasty and to determine the correlation between patient-reported outcomes and quantitative activity metrics at baseline and 30 days after presentation.
MATERIALS AND METHODS: Nineteen patients were enrolled (15 receiving vertebroplasty, 4 not receiving vertebroplasty). Patients reported their average pain over the past 24 hours and completed the Roland-Morris disability questionnaire at baseline and 30 days. Patients wore the SenseWear Armband activity monitor for a median of 4 days at baseline and at the 30-day time period to assess steps, metabolic equivalents expended, sedentary activity time, moderate activity time, sleep efficiency, and total sleep time. Pain and disability scores were correlated with activity monitor metrics using linear regression analysis.
RESULTS: Changes in reported average pain in the past 24 hours and disability scores were not significantly different between vertebroplasty and non-vertebroplasty groups (p>0.05). Changes in activity monitor data were not significantly different between the vertebroplasty and non-vertebroplasty groups (p>0.05). None of the correlations between the reported pain or disability scores and the activity monitor data were significant.
CONCLUSIONS: Activity monitors can be used to objectively record changes in activity following vertebroplasty procedures. Patient-reported pain or disability scores do not correlate with activity monitor-measured activity or sleep metrics.

PMID: 27471185 [PubMed - as supplied by publisher]



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Transthyrohyoid access to the larynx for endoscopic resection of early-stage glottic cancer

Abstract

Background

The effectiveness of transoral microsurgery for early-stage glottic cancer relies on the possibility to obtain adequate exposure of the lesion. The purpose of this study was to design a new surgical technique allowing efficient endoscopic removal of these tumors in patients with unsatisfactory transoral exposure.

Methods

A minimal invasive access to the glottis, made through the thyrohyoid membrane and the preepiglottic space, was used for endoscopic resection of an early-stage glottic tumor in a patient with a medical history of previous radiotherapy and unsatisfactory endoscopic exposure of the lesion.

Results

This approach provided excellent exposure of the glottis and allowed endoscopic resection with adequate surgical margins. The surgical procedure and the postoperative period were uneventful. Functional outcomes were back to baseline after 1 month.

Conclusion

This technique represents an attractive solution for patients presenting with early-stage glottic tumors that cannot be exposed transorally and have contraindications to alternative therapeutic procedures. © 2016 Wiley Periodicals, Inc. Head Neck 38:1286–1289, 2016



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health technology; +123 new citations

123 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

health technology

These pubmed results were generated on 2016/07/30

PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.



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IJMS, Vol. 17, Pages 1234: Molecular Mechanisms of Cutaneous Inflammatory Disorder: Atopic Dermatitis

ag

Atopic dermatitis (AD) is a multifactorial inflammatory skin disease resulting from interactions between genetic susceptibility and environmental factors. The pathogenesis of AD is poorly understood, and the treatment of recalcitrant AD is still challenging. There is accumulating evidence for new gene polymorphisms related to the epidermal barrier function and innate and adaptive immunity in patients with AD. Newly-found T cells and dendritic cell subsets, cytokines, chemokines and signaling pathways have extended our understanding of the molecular pathomechanism underlying AD. Genetic changes caused by environmental factors have been shown to contribute to the pathogenesis of AD. We herein present a review of the genetics, epigenetics, barrier dysfunction and immunological abnormalities in AD with a focus on updated molecular biology.

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Genetic susceptibility to cutaneous melanoma in southern Switzerland: role of CDKN2A, MC1R and MITF

Summary

Background

Nearly 10% of all cases of cutaneous melanoma (CM) occur in patients with a personal or family history of the disease.

Objectives

To obtain information about genetic predisposition to CM in Ticino, the southern region of Switzerland, a zone with moderate-to-high CM incidence.

Methods

We identified germline mutations in highly CM-associated genes (CDKN2A and CDK4) and low/medium-penetrance variants (MC1R and MITF) in patients with multiple primary CMs or individuals with one or more CM and a positive family history for CM or pancreatic cancer among first- or second-degree relatives. Healthy blood donors (n = 146) were included as a control group.

Results

From July 2010 to July 2012, 57 patients (41 pedigrees) were included. Twenty-six were melanoma-prone families (with at least two cases) and 15 had multiple CMs. Pancreatic cancer was found in six families. The CDKN2A mutation p.V126D was identified in five patients (four families) with a founder effect, whereas CDKN2A A148T was detected in seven cases and seven healthy donors (odds ratio 3.39, 95% confidence interval 1.12–10.23; P = 0.031). At least one MC1R melanoma-associated polymorphism was detected in 39 patients (81%) and 97 healthy donors (66%), with more than one polymorphism in 16 patients (33%) and 25 healthy donors (17%). The MITF variant p.E318K was identified in four patients from three additional pedigrees (8%) and one healthy control (0.7%).

Conclusions

Inclusion criteria for the Ticino population for genetic assessment should follow the rule of two (two affected individuals in a family or a patient with multiple CMs), as we detected a CDKN2A mutation in almost 10% of our pedigrees (four of 41), MITF p.E318K in 7% (three of 41) and a higher number of MC1R variants than in the control population.

This article is protected by copyright. All rights reserved.



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Public participation in decision-making on the coverage of new antivirals for hepatitis C.

Public participation in decision-making on the coverage of new antivirals for hepatitis C.

J Health Organ Manag. 2016 Aug 15;30(5):769-85

Authors: Kieslich K, Ahn J, Badano G, Chalkidou K, Cubillos L, Hauegen RC, Henshall C, Krubiner CB, Littlejohns P, Lu L, Pearson SD, Rid A, Whitty JA, Wilson J

Abstract
Purpose - New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations. Design/methodology/approach - The paper employs a comparative case study approach. It explores the experience of four countries - Brazil, England, South Korea and the USA - in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes. Findings - Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public. Originality/value - The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

PMID: 27468625 [PubMed - in process]



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Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice.

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Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice.

PLoS One. 2016;11(3):e0151079

Authors: González-Chica DA, Mnisi Z, Avery J, Duszynski K, Doust J, Tideman P, Murphy A, Burgess J, Beilby J, Stocks N

Abstract
BACKGROUND: Appropriate understanding of health information by patients with cardiovascular disease (CVD) is fundamental for better management of risk factors and improved morbidity, which can also benefit their quality of life.
OBJECTIVES: To assess the relationship between health literacy and health-related quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders.
METHODS: Cross-sectional study of patients with IHD recruited from a stratified sample of general practices in two Australian states (Queensland and South Australia) between 2007 and 2009. Health literacy was measured using a validated questionnaire and classified as inadequate, marginal, or adequate. Physical and mental components of HRQoL were assessed using the Medical Outcomes Study Short Form (SF12) questionnaire. Analyses were adjusted for confounders (sociodemographic variables, clinical history of IHD, number of CVD comorbidities, and CVD risk factors) using multiple linear regression.
RESULTS: A total sample of 587 patients with IHD (mean age 72.0±8.4 years) was evaluated: 76.8% males, 84.2% retired or pensioner, and 51.4% with up to secondary educational level. Health literacy showed a mean of 39.6±6.7 points, with 14.3% (95%CI 11.8-17.3) classified as inadequate. Scores of the physical component of HRQoL were 39.6 (95%CI 37.1-42.1), 42.1 (95%CI 40.8-43.3) and 44.8 (95%CI 43.3-46.2) for inadequate, marginal, and adequate health literacy, respectively (p-value for trend = 0.001). This association persisted after adjustment for confounders. Health literacy was not associated with the mental component of HRQoL (p-value = 0.482). Advanced age, lower educational level, disadvantaged socioeconomic position, and a larger number of CVD comorbidities adversely affected both, health literacy and HRQoL.
CONCLUSION: Inadequate health literacy is a contributing factor to poor physical functioning in patients with IHD. Increasing health literacy may improve HRQoL and reduce the impact of IHD among patients with this chronic CVD.

PMID: 26943925 [PubMed - indexed for MEDLINE]



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Industry Payments to Obstetrician-Gynecologists: An Analysis of 2014 Open Payments Data.

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Industry Payments to Obstetrician-Gynecologists: An Analysis of 2014 Open Payments Data.

Obstet Gynecol. 2016 Feb;127(2):376-82

Authors: Tierney NM, Saenz C, McHale M, Ward K, Plaxe S

Abstract
OBJECTIVE: To evaluate publically available, individually identified data regarding industry payments made to obstetrician-gynecologists (ob-gyns) during 2014 posted on the Centers for Medicare & Medicaid Services' Open Payments website for the purposes of encouraging ob-gyns to partake in disclosure of their fiscal relationships to patients and to take an active role in maintaining accuracy of their payment data.
METHODS: In this retrospective study, we reviewed the Centers for Medicare & Medicaid Services' Open Payments website for all 2014 nonresearch payments to ob-gyns. We compared payments to ob-gyns with payments to those in other specialties as well as subspecialties within the field of obstetrics and gynecology. Univariate statistical analyses were performed.
RESULTS: Payments to ob-gyns totaled $60,004,472 (3.3% of the total value transferred in 2014) and went to 29,783 physician recipients. Fifty percent of these payments were for royalties and licensing. Obstetrics and gynecology ranked seventh in total number of payments made to a single specialty (n=311,485), and 20th of 35 specialties for highest median payment ($140, interquartile range $50-347). Medtronic USA, Inc. was the leading payer to ob-gyns.
CONCLUSION: Ob-gyns are listed as having received substantial payments from industry in 2014. Because this information is publically available, we suggest physicians become familiar with payment data and the correction process, keep independent records, and register for updates to most effectively manage perceived, or real, conflicts of interest.

PMID: 26942368 [PubMed - indexed for MEDLINE]



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Moral Imperialism in NIH Fogarty Training Program and the Continuing Unethical Trials in Poor Countries: A Rejoinder.

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Moral Imperialism in NIH Fogarty Training Program and the Continuing Unethical Trials in Poor Countries: A Rejoinder.

Arch Med Res. 2016 Jan;47(1):67-8

Authors: Hellmann F, Garrafa V, Schlemper Junior BR, Bittencourt SC

PMID: 26845619 [PubMed - indexed for MEDLINE]



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Comparison of Quality of Life Perceived by Patients with Bioprosthetic versus Mechanical Valves after Composite Aortic Root Replacement.

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Comparison of Quality of Life Perceived by Patients with Bioprosthetic versus Mechanical Valves after Composite Aortic Root Replacement.

Cardiology. 2016;133(1):3-9

Authors: Repack A, Ziganshin BA, Elefteriades JA, Mukherjee SK

Abstract
OBJECTIVE: To assess whether postoperative quality of life (QOL) for composite aortic root replacement patients differs according to whether it is based on the use of mechanical valves or bioprosthetic valves.
METHODS: The study included 146 consecutive patients who underwent composite aortic root replacement at our institution from January 2010 to April 2014 with bioprosthetic (34.9%, n = 51) and mechanical (65.1%, n = 95) valves. Patient-perceived QOL was measured by administering the Short Form (SF)-36v2 Health Survey and a series of supplemental questions to further evaluate valve-specific differences. Final survey participation (n = 121) included 82.9% of the qualifying patients, and involved 76.5% (39/51) of those with bioprosthetic valves and 86.3% (82/95) of those with mechanical valves. Reasons for not completing the survey included 5 expired patients (3.4%), 1 lost due to a language barrier (0.7%), 6 who refused to participate (4.1%) and 13 who were lost to follow-up (8.9%). The mean follow-up time was 32 months (range 4-56 months).
RESULTS: Patients in the bioprosthetic valve group were older (mean age 67.5 ± 13.6 years) and included more females (25.6% or 10/39) than those in the mechanical valve group (mean age 56.6 ± 12.0 years; 11.0% or 9/82 were female). No significant differences were found between the bioprosthetic and mechanical valve groups for any QOL aspects scored by the SF-36v2 survey. All 8 domains and 2 summary scales comprising the QOL evaluation were above national norms calculated using gender- and age-matched, norm-based scoring for a standard national average of 50. The supplemental questions indicated satisfaction with each valve type despite characteristics that were of concern to patients. In the mechanical valve group, 90.2% (74/82) reported that the audible valve click was not troublesome, 85.4% (70/82) that taking a blood thinner regularly did not affect daily life and 81.7% (67/82) that blood testing for anticoagulation therapy was not troublesome.
CONCLUSIONS: Receiving a tissue or a mechanical valve does not directly affect postoperative QOL. Answers to supplemental questions suggest that prior concerns with mechanical valves do not affect patients in the commonly anticipated negative manner. The preconception of a heavy QOL burden for mechanical composite grafts is contradicted by this study.

PMID: 26389590 [PubMed - indexed for MEDLINE]



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Quality of Life in Patients of Different Age Groups before and after Coronary Artery By-Pass Surgery.

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Quality of Life in Patients of Different Age Groups before and after Coronary Artery By-Pass Surgery.

Ann Thorac Cardiovasc Surg. 2015;21(5):474-80

Authors: Peric V, Jovanovic-Markovic S, Peric D, Rasic D, Novakovic T, Dejanovic B, Borzanovic M

Abstract
PURPOSE: The study evaluates the changes in quality of life (QOL) six months after coronary artery bypass grafting (CABG) related to the patients' age.
METHODS: The total of 243 consecutive patients completed the Nottingham Health Profile Questionnaire part 1 before and six months after CABG. Postoperative questionnaire was completed by 226 patients. Patients were divided into four examined groups (<50, 50-59, 60-69 and ≥70 years), according to their age.
RESULTS: Six months after CABG, the quality of life in different sections has been significantly improved in most patients.The analysis of the relation between the age and the changes in QOL of patients six months after CABG showed a significant correlation among the patients' age and the improvement of QOL in the sections of physical mobility (r = 0.18, p = 0.008), social isolation (r = 0.17, p = 0.01) and energy ( r = 0.21, p = 0.002). The most prominent improvement was found in older patients. The age was not an independent predictor of QOL deterioration after CABG.
CONCLUSIONS: The most noticeable improvement of QOL six months after CABG was found in older patients. Age is not the independent predictor of deterioration of QOL after CABG.

PMID: 26328597 [PubMed - indexed for MEDLINE]



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Understanding Fertility in Young Female Cancer Patients.

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Understanding Fertility in Young Female Cancer Patients.

J Womens Health (Larchmt). 2015 Oct;24(10):812-8

Authors: Waimey KE, Smith BM, Confino R, Jeruss JS, Pavone ME

Abstract
Young women diagnosed with cancer today have a greater chance of long-term survival than ever before. Successful survivorship for this group of patients includes maintaining a high quality of life after a cancer diagnosis and treatment; however, lifesaving treatments such as chemotherapy, radiation, and surgery can impact survivors by impairing reproductive and endocrine health. Studies demonstrate that future fertility is a concern for many women diagnosed with cancer, but physician knowledge and attitudinal barriers can still prevent females from receiving care. Today, fertility preservation is an option for girls and women facing a cancer diagnosis, and emerging research is providing clinicians with an increasing number of reproductive and hormonal management tools. Physicians can play an important role in fertility by working closely with oncologists, providing patients with information about fertility preservation options prior to the start of cancer treatment, monitoring reproductive capacity after treatment, and working with cancer survivors to explore potential avenues to parenthood.

PMID: 26075731 [PubMed - indexed for MEDLINE]



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Exploration of the content validity and feasibility of the EQ-5D-3L, ICECAP-O and ASCOT in older adults.

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Exploration of the content validity and feasibility of the EQ-5D-3L, ICECAP-O and ASCOT in older adults.

BMC Health Serv Res. 2015;15:201

Authors: van Leeuwen KM, Jansen AP, Muntinga ME, Bosmans JE, Westerman MJ, van Tulder MW, van der Horst HE

Abstract
BACKGROUND: In economic evaluations of care services for older adults health-related quality of life (QoL) measures such as the EQ-5D are increasingly replaced by the ICECAP-O and ASCOT, which cover a broader scope of QoL than health alone. Little is known about the content validity and feasibility of these measures. The purpose of this study was to explore the content validity and feasibility of the EQ-5D-3L, ICECAP-O and ASCOT in older adults.
METHODS: Ten older adults were purposively sampled using a maximum variation principle. Think-aloud and verbal probing techniques were used to identify response issues encountered during the interpretation of items and the selection of response options. We used constant comparative methods to analyse the data.
RESULTS: Two types of response issues were identified for various items in all three measures: interpretation issues and positive responses. Issues with the mapping of a response on one of the response options were least often encountered for the EQ-5D-3L items. Older adults considered the items of the ICECAP-O and ASCOT valuable though more abstract than the EQ-5D-3L.
CONCLUSIONS: Researchers who intend to use the EQ-5D, ICECAP-O or ASCOT in economic evaluations of care services for older adults, should be aware of the response issues that occur during the administration of these measures. Older adults perceived none of the measures as providing a comprehensive picture of their QoL. A preference from older adults for one of the measures depends on the extent to which the items reflect current personal concerns in life.

PMID: 25976227 [PubMed - indexed for MEDLINE]



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Associations between women's autonomy and child nutritional status: a review of the literature.

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Associations between women's autonomy and child nutritional status: a review of the literature.

Matern Child Nutr. 2015 Oct;11(4):452-82

Authors: Carlson GJ, Kordas K, Murray-Kolb LE

Abstract
Around the world, many women continue to experience low levels of autonomy. Recent literature has reported that the health consequences of low maternal autonomy extend beyond mothers and translate into health consequences for their children, and may be an important causal factor in child malnutrition. This review summarises the current knowledge of the relationship between maternal autonomy and children's nutritional status (defined as any measure that reflects the nutritional state of the body, such as birthweight or anthropometric scores) and child-feeding practices. The review also includes both discussion of the limitations found in the literature and directions for future research. A systematic review of the literature was conducted. Results of the studies included in the review strongly suggest that raising maternal autonomy is an important goal for improving children's nutritional status, yet gaps in the current knowledge exist, further confounded by issues with how autonomy is measured and limitations of cross-cultural comparability. A thorough understanding of the consequences of restricting women's autonomy will inform programmes and policy worldwide, and speed progress towards both empowering women and alleviating the global burden of child malnutrition.

PMID: 24521434 [PubMed - indexed for MEDLINE]



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The Effects of Mandibular Advancement Device on Pressure Pain Threshold of Masticatory Muscles: A Prospective Controlled Cohort Study.

The Effects of Mandibular Advancement Device on Pressure Pain Threshold of Masticatory Muscles: A Prospective Controlled Cohort Study.

J Oral Facial Pain Headache. 2016 Summer;30(3):234-240

Authors: Alessandri-Bonetti G, Bortolotti F, Bartolucci ML, Marini I, D'Antò V, Michelotti A

Abstract
AIMS: To determine if pressure pain thresholds (PPTs) of masticatory and neck muscles change after the application of a mandibular advancement device (MAD) in patients with obstructive sleep apnea (OSA).
METHODS: A prospective study was conducted in a sample of 27 OSA patients (24 males and 3 females; mean age ± standard deviation [SD]: 54.8 ± 11.8, mean apnea-hypopnea index ± SD: 23.5 ± 13.3) and 27 age- and sex-matched healthy controls. Exclusion criteria were signs and symptoms of temporomandibular disorders (TMD), metabolic diseases, and use of antidepressants, analgesics, or anti-inflammatory drugs. A calibrated examiner evaluated PPTs of seven head and neck muscles bilaterally by using a Fischer algometer. In the OSA group, PPTs were recorded immediately before the MAD application (T₀), after 15 days (T₁), and after 6 months (T₂) of therapy; in the control group, PPTs were recorded at the same time intervals. PPT differences at baseline and over time within each group and between OSA and control groups were analyzed by Friedman and Mann-Whitney tests.
RESULTS: There were no PPT differences between groups at baseline. In the OSA group, PPTs of temporalis and masseter muscles decreased significantly at T₁ compared with T₀ (P < .05), but no differences were found at T₂. No significant PPT differences were found in the neck muscles or over time in the control group.
CONCLUSION: MAD application induces a decrease of PPTs of masticatory muscles at the beginning of the therapy, but a physiologic adaptation occurs by 6 months.

PMID: 27472526 [PubMed - as supplied by publisher]



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The role of human papillomavirus in head and neck cancer and the impact on radiotherapy outcome.

The role of human papillomavirus in head and neck cancer and the impact on radiotherapy outcome.

Acta Otolaryngol. 2016 Jul 29;:1-8

Authors: Zhu X, Wang Y, Zhu H, Lou W

Abstract
CONCLUSION: HPV + HNSCC patients have improved Overall Survival (OS), Disease Specific Survival (DSS), Disease Free Survival (DFS), and Progression Free Survival (PFS). The radiotherapy treatment can't improve the Survival of the HPV-negative HNSCC patients.
OBJECTIVE: To investigate the role of Human papillomavirus in head and neck cancer and the impact on radiotherapy outcome.
METHODS: A search in PubMed and Chinese CNKI (2000-2015) was performed. This meta-analysis was done using RevMan 5.1 software. Outcomes included OS, DSS, DFS, PFS, and Treatment responses rates (RR).
RESULTS: A total of 2620 patients in 10 studies were included. The Positive detective rates of HPV and P16 are 32.5% (425/1309) and 42.5% (526/1239). OS and PFS were improved in HPV + patients compared to HPV - patients (HR = 0.48; 95% CI = 0.37-0.62, p < 0.0001) and (HR = 0.49; 95% CI = 0.31-0.78, p < 0.0001). The survival benefit was similar in HPV-16 + patients (adjusted HR = 0.39; 95% CI = 0.21-0.60, p < 0.0001). The DFS of P16 + patients improved (HR = 0.70; 95% CI = 0.55-0.89, p < 0.0001). The treatment response of p16 + patients didn't significantly improve compared with p16- patients (HR = 1.44; 95% CI = 1.01-2.05, p = 0.05).

PMID: 27472193 [PubMed - as supplied by publisher]



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An assessment of olfactory function in patients with laryngopharyngeal reflux disease.

An assessment of olfactory function in patients with laryngopharyngeal reflux disease.

Acta Otolaryngol. 2016 Jul 29;:1-7

Authors: Emre Dinc M, Dalgic A, Avincsal MO, Ulusoy S, Celik A, Develioglu ON

Abstract
CONCLUSIONS: The results reported here indicate that there was a statistically significant difference in the olfactory functions of laryngopharyngeal reflux patients vs the healthy group. To the best of the authors' knowledge, this study is the first to evaluate the olfactory function of patients diagnosed with laryngopharyngeal reflux using an objective method, 24-h pH monitoring.
OBJECTIVES/HYPOTHESIS: The aim of this study was to investigate olfactory functions in laryngopharyngeal reflux (LPR) patients and compare the results with healthy controls.
METHODS: A total of 60 participants; 30 men and women with a diagnosis of laryngopharyngeal reflux and 30 healthy controls, were included in the study. Patients in the laryngopharyngeal reflux group were evaluated by the Reflux Symptom Index (RSI), Reflux Finding Scores (RFS), and finally 24-h pH monitoring to confirm the diagnosis of laryngopharyngeal reflux. The Sniffin' Sticks olfactory test results of the laryngopharyngeal reflux and control groups were compared, and the relationship between the study findings and the olfactory parameters were evaluated.
RESULTS: The odor threshold, odor discrimination, odor identification, and TDI scores of the laryngopharyngeal reflux group were significantly lower than those of the control group. Also there was a statistically significant negative correlation detected between the olfactory test and some symptom and finding scores.

PMID: 27472044 [PubMed - as supplied by publisher]



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High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS).

High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS).

Neurosurgery. 2016 Jul 27;

Authors: Lownie SP, Pelz DM, Sharma M, Pandey SK, Boulton MR, Lee DH

PMID: 27471974 [PubMed - as supplied by publisher]



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House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis.

House dust mite sublingual tablet is effective and safe in patients with allergic rhinitis.

Allergy. 2016 Jul 29;

Authors: Okamoto Y, Fujieda S, Okano M, Yoshida Y, Kakudo S, Masuyama K

Abstract
BACKGROUND: House dust mite (HDM) is the major indoor allergen for allergic diseases such as allergic rhinitis (AR) and asthma. Although sublingual immunotherapy (SLIT) is a curative treatment for HDM-induced AR, data from large-scale studies are limited. We evaluated the efficacy and safety of HDM tablets in adolescent and adult patients (aged 12-64 years) with HDM-induced AR with or without intermittent asthma.
METHODS: In a double-blind trial in Japan, 968 subjects were randomized 1:1:1 to 300 index of reactivity (IR), 500 IR, or placebo groups. The primary endpoint was the Average Adjusted Symptom Score (AASS) in the last 8 weeks of the 52-week treatment. Secondary endpoints included individual nasal and ocular symptom scores, rescue medication use, and the Japanese Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) scores.
RESULTS: The AASS in the last 8 weeks of treatment significantly improved in both the 300 IR and the 500 IR groups compared to that in the placebo group (p < 0.001). In the 300 IR group, the onset of action occurred at week 8-10. All four nasal symptoms significantly improved in both active treatment groups; rescue medication use and JRQLQ outcome improved in the 300 IR group. Most adverse events (AEs) were mild, and 16 serious AEs (SAEs) were reported; however, none of them were drug-related.
CONCLUSIONS: One-year treatment with 300 IR and 500 IR HDM tablets was effective without major safety concerns. The recommended therapeutic dose for AR is 300 IR. This article is protected by copyright. All rights reserved.

PMID: 27471838 [PubMed - as supplied by publisher]



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Review of perforator flaps in head and neck cancer surgery.

Review of perforator flaps in head and neck cancer surgery.

Curr Opin Otolaryngol Head Neck Surg. 2016 Jul 28;

Authors: Cho A, Hall FT

Abstract
PURPOSE OF REVIEW: Perforator flaps are increasingly being used to reconstruct head and neck defects. They offer several advantages over nonperforator-based flaps with lower donor site morbidity and a versatile range of reconstructive options. The anterolateral thigh flap is well established in the head and neck and is a good example of a reliable perforator free flap. With the increasing use of both free and regional perforator-based flaps, it is timely to review their anatomy, clinical applications, and role in head and neck reconstruction. We also discuss increasingly popular perforator flaps such as the submental flap for the head and neck.
RECENT FINDINGS: The anterolateral thigh flap is now commonly used to reconstruct a wide variety of head and neck defects. The submental flap fills a niche role for reconstruction of intraoral defects.
SUMMARY: Perforator flaps are now mainstream reconstructive options in the head and neck surgeon's armamentarium.

PMID: 27471790 [PubMed - as supplied by publisher]



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Epigenetic modification augments the immunogenicity of human leukocyte antigen G serving as a tumor antigen for T cell-based immunotherapy.

Epigenetic modification augments the immunogenicity of human leukocyte antigen G serving as a tumor antigen for T cell-based immunotherapy.

Oncoimmunology. 2016 Jun;5(6):e1169356

Authors: Ishibashi K, Kumai T, Ohkuri T, Kosaka A, Nagato T, Hirata Y, Ohara K, Oikawa K, Aoki N, Akiyama N, Sado M, Kitada M, Harabuchi Y, Celis E, Kobayashi H

Abstract
Tumor immune escape has been a major problem for developing effective immunotherapy. The human leukocyte antigen G (HLA-G) is a non-classical MHC class I molecule whose primary function is to protect the fetus from the mother's immune system. While HLA-G is hardly found in normal adult tissues, various tumor cells are known to express it, aiding their escape from the immune system. Thus, HLA-G is an attractive immunotherapy target. CD4(+) helper T lymphocytes (HTLs) play an important role in the immune reaction against tumors by assisting in the generation and persistence of CD8(+) cytotoxic T lymphocytes (CTLs) or by displaying direct antitumor effects. We report here that HLA-G expression in breast cancer significantly correlates with a poor prognosis. Also, we describe that the MHC class II-binding peptide HLA-G26-40 was effective in eliciting tumor-reactive CD4(+) T cell responses. Furthermore, treatment with the DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine increased HLA-G expression in tumors and subsequently enhanced recognition by HLA-G26-40-specific HTLs. These findings predict that a combination immunotherapy targeting HLA-G together with a DNA methyltransferase inhibitor could be useful against some cancers.

PMID: 27471649 [PubMed]



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CTLA4 blockade reduces immature myeloid cells in head and neck squamous cell carcinoma.

CTLA4 blockade reduces immature myeloid cells in head and neck squamous cell carcinoma.

Oncoimmunology. 2016 Jun;5(6):e1151594

Authors: Yu GT, Bu LL, Zhao YY, Mao L, Deng WW, Wu TF, Zhang WF, Sun ZJ

Abstract
Immature myeloid cells such as myeloid-derived suppressor cells (MDSCs) and M2 macrophages play a vital role in the tumor immune escape and tumor progression. Cytotoxic T lymphocyte-associated antigen 4 (CTLA4), as a negative immune checkpoint, is highly expressed in numerous solid tumors. However, precise functions of CTLA4 in head and neck squamous cell carcinoma (HNSCC) have not yet been elucidated. In this study, we demonstrated that the ratio of CD8(+)/CTLA4 can be used as a potential index with a clinical prognostic value for HNSCC. Using immunocompetent transgenic mouse model with spontaneous HNSCC, we directly observed that targeting CTLA4 decreases MDSCs and M2 macrophages and promotes T cell activation in both tumor microenvironment and macro-environment. In all, our study provides direct evidence in vivo and proposes a rationale for CTLA4 inhibition as a future therapeutic strategy in patients with HNSCC.

PMID: 27471622 [PubMed]



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An oncofetal antigen, IMP-3-derived long peptides induce immune responses of both helper T cells and CTLs.

An oncofetal antigen, IMP-3-derived long peptides induce immune responses of both helper T cells and CTLs.

Oncoimmunology. 2016 Jun;5(6):e1123368

Authors: Hirayama M, Tomita Y, Yuno A, Tsukamoto H, Senju S, Imamura Y, Sayem MA, Irie A, Yoshitake Y, Fukuma D, Shinohara M, Hamada A, Jono H, Yuba E, Kono K, Yoshida K, Tsunoda T, Nakayama H, Nishimura Y

Abstract
Insulin-like growth factor II mRNA-binding protein 3 (IMP-3), an oncofetal antigen identified using genome-wide cDNA microarray analyses, is overexpressed in several malignancies. IMP-3-derived cytotoxic T lymphocyte (CTL) epitopes have been used for peptide-based immunotherapies against various cancers. In addition to CTLs, induction of tumor-associated antigen (TAA)-specific helper T (Th) cells is crucial for establishment of effective antitumor immunity. In this study, we aimed to identify IMP-3-derived long peptides (IMP-3-LPs) carrying CTL and promiscuous Th-cell epitopes for use in cancer immunotherapy. IMP-3-derived Th-cell epitopes that bind to multiple HLA-class II molecules were predicted by in silico analysis, and their immunogenicity was determined by utilizing human T cells. We identified two highly immunogenic IMP-3-LPs presented by multiple HLA-class II molecules. One of the IMP-3-LPs encompassed two CTL epitopes that have been used for peptide-vaccine immunotherapy in ongoing clinical trials. IMP-3-LPs-specific Th cells responded to autologous dendritic cells (DCs) loaded with the recombinant IMP-3 proteins, suggesting that these s (LPs) can be naturally processed and presented. The IMP-3-LPs and specific Th cells augmented the expansion of IMP-3-specific CTLs, which was further enhanced by programmed cell death-1 (PD-1) blockade. In addition, IMP-3-LP encapsulated in liposomes was efficiently cross-presented in vitro, and this LP successfully cross-primed CTLs in HLA-A2 transgenic mice (Tgm) in vivo. Furthermore, one of the IMP-3-LPs induced IMP-3-specific Th cells from peripheral blood mononuclear cells (PBMCs) of head-and-neck malignant tumor (HNMT) patients. These findings suggest the potential usefulness of IMP-3-LPs in propagating both Th cells and CTLs and may have implications for IMP-3-LPs-based cancer immunotherapy.

PMID: 27471607 [PubMed]



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The Expression Levels of XLF and Mutant P53 Are Inversely Correlated in Head and Neck Cancer Cells.

The Expression Levels of XLF and Mutant P53 Are Inversely Correlated in Head and Neck Cancer Cells.

J Cancer. 2016;7(11):1374-82

Authors: Feng S, Rabii R, Liang G, Song C, Chen W, Guo M, Wei X, Messadi D, Hu S

Abstract
XRCC4-like factor (XLF), also known as Cernunnos, is a protein encoded by the human NHEJ1 gene and an important repair factor for DNA double-strand breaks. In this study, we have found that XLF is over-expressed in HPV(+) versus HPV(-) head and neck squamous cell carcinoma (HNSCC) and significantly down-regulated in the HNSCC cell lines expressing high level of mutant p53 protein versus those cell lines harboring wild-type TP53 gene with low p53 protein expression. We have also demonstrated that Werner syndrome protein (WRN), a member of the NHEJ repair pathway, binds to both mutant p53 protein and NHEJ1 gene promoter, and siRNA knockdown of WRN leads to the inhibition of XLF expression in the HNSCC cells. Collectively, these findings suggest that WRN and p53 are involved in the regulation of XLF expression and the activity of WRN might be affected by mutant p53 protein in the HNSCC cells with aberrant TP53 gene mutations, due to the interaction of mutant p53 with WRN. As a result, the expression of XLF in these cancer cells is significantly suppressed. Our study also suggests that XLF is over-expressed in HPV(+) HNSCC with low expression of wild type p53, and might serve as a potential biomarker for HPV(+) HNSCC. Further studies are warranted to investigate the mechanisms underlying the interactive role of WRN and XLF in NHEJ repair pathway.

PMID: 27471552 [PubMed]



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Association of FOXE1 polyalanine repeat region with thyroid cancer is dependent on tumour size

Abstract

Objective

Polymorphisms in the thyroid transcription factor forkhead factor E1 (FOXE1) gene have been implicated in the genetic susceptibility to differentiated thyroid cancer, but little is known about their effect on tumour characteristics. The objective of this study was to determine the contribution of the FOXE1 polyalanine repeat region to the susceptibility to thyroid cancer and to its clinical characteristics.

Design, patients, and measurements

A total of 500 patients with sporadic thyroid cancer (440 papillary and 60 follicular thyroid carcinoma) and 502 healthy controls were included in this case-control association study. The number of FOXE1 alanine repeats in each subject was determined by PCR and multiplex fragment analysis by capillary electrophoresis. FOXE1 genotype and allele frequencies among groups were compared by logistic regression and adjusted for sex and age at diagnosis. Data were analysed according to cancer subtype, tumour size, and the presence of lymph node or distant metastasis.

Results

FOXE1 alleles with 16 or more alanine repeats were more frequent in patients with tumour size > 1 cm compared to tumour size ≤ 1 cm (adjusted OR 1.44; 95% CI 1.05-1.88; p=0.019). Genotypes containing at least one allele with 16 or more alanine repeats were associated with larger tumour size (adjusted OR 1.71; 95% CI 1.15-2.57; p=0.009). No significant differences were observed between cancer subtypes or the presence/absence of metastasis.

Conclusions

FOXE1 polyalanine repeat polymorphisms are associated with thyroid cancer, but only for tumours larger than 1 cm, suggesting a role in disease progression.

This article is protected by copyright. All rights reserved.



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Reassessment of the Cosyntropin Stimulation Test in the Confirmatory Diagnosis and Subtype Classification of Primary Aldosteronism

Abstract

Objective

Although corticotropin is a representative secretagogue of aldosterone, the utility of the cosyntropin stimulation test (C-ST) in diagnosing primary aldosteronism (PA) has not been elucidated. Aim of the study was to evaluate the clinical utility of C-ST for confirmatory testing and subtype classification of PA.

Design, Setting, and Patients

In this retrospective study, we identified patients with hypertension and positive case-detection results for PA who underwent C-ST and saline infusion testing (SIT) between 2006 and 2013 at eight referral centers in Japan. PA and essential hypertension (EH) were distinguished based on SIT results. PA subtype classification was determined by adrenal venous sampling (AVS). Plasma aldosterone concentration (PAC) was measured before and 30 and 60 minutes after intravenous cosyntropin administration. The ability of C-ST to distinguish PA from EH and to distinguish unilateral from bilateral disease was assessed by the area under the receiver operating characteristic curve.

Results

Of 205 patients with hypertension and positive case-detection results, 139 (68%) had PA based on SIT results. Eighteen patients in whom AVS was unsuccessful were excluded from analysis. The baseline PAC before C-ST was significantly higher (P<.01) in patients with PA than in those with EH. However, the degree of difference in PAC between patients with PA and EH was not enhanced by the administration of cosyntropin. In addition, the administration of cosyntropin did not improve the distinction between bilateral and unilateral PA subtypes.

Conclusions

C-ST has no utility as a confirmatory and subtype testing of PA when the diagnosis of PA is based on the positive results in SIT.

This article is protected by copyright. All rights reserved.



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Effects of surface charges of gold nanoclusters on long-term in vivo biodistribution, toxicity, and cancer radiation therapy

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Photothermal effects of laser-activated surface plasmonic gold nanoparticles on the apoptosis and osteogenesis of osteoblast-like cells

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Optimization, formulation, and characterization of multiflavonoids-loaded flavanosome by bulk or sequential technique

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Gallic acid conjugated with gold nanoparticles: antibacterial activity and mechanism of action on foodborne pathogens

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Reply to Letter to the Editor regarding Recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation



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Radiotherapy-associated dental extractions and osteoradionecrosis

Background

Preradiotherapy dental extractions often form a part of the management plan for patients treated with radiotherapy for head and neck cancers in order to prevent complications, such as osteoradionecrosis. There is contention about whether these extractions should be performed and the timing of such extractions. The purpose of this study was to determine if pre-RT extractions were associated with the development of osteoradionecrosis of the jaws.

Methods

Retrospective data on patients treated with RT for oropharyngeal cancer were pooled with a cross-sectional survey.

Results

Pre-radiotherapy dental extractions were associated with a statistically significant increase in the risk of developing ORN.

Conclusion

Pre-radiotherapy dental extractions do not protect against the development of osteoradionecrosis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016



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Letter to the Editor: Recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation



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IJMS, Vol. 17, Pages 1236: Is the Mouse a Good Model of Human PPARγ-Related Metabolic Diseases?

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With the increasing number of patients affected with metabolic diseases such as type 2 diabetes, obesity, atherosclerosis and insulin resistance, academic researchers and pharmaceutical companies are eager to better understand metabolic syndrome and develop new drugs for its treatment. Many studies have focused on the nuclear receptor peroxisome proliferator-activated receptor gamma (PPARγ), which plays a crucial role in adipogenesis and lipid metabolism. These studies have been able to connect this transcription factor to several human metabolic diseases. Due to obvious limitations concerning experimentation in humans, animal models—mainly mouse models—have been generated to investigate the role of PPARγ in different tissues. This review focuses on the metabolic features of human and mouse PPARγ-related diseases and the utility of the mouse as a model.

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50th anniversary leaves English football with mixed feelings - Daily Mail


Mirror.co.uk

50th anniversary leaves English football with mixed feelings
Daily Mail
By Steve Tongue. LONDON, July 30 (Reuters) - Fifty years on from the greatest day in the history of English football, pessimists fear that the prospect of becoming world champions again is as remote as it has ever been. On that day, Saturday, July 30 ...
1966 World Cup still stirs English senses, 50 years onBangkok Post

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