bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucose test provenance recording in UK primary care: was that fasted or random?
Authors: McGovern A. P. , Fieldhouse H. , Tippu Z. , Jones S. , Munro N. , de Lusignan S.
Published: January 2016

Aims

To describe the proportion of glucose tests with unrecorded provenance in routine primary care data and identify the impact on clinical practice.

Methods

A cross‐sectional analysis was conducted of blood glucose measurements from the Royal College of General Practitioner Research and Surveillance Centre database, which includes primary care records from >100 practices across England and Wales. All blood glucose results recorded during 2013 were identified. Tests were grouped by provenance (fasting, oral glucose tolerance test, random, none specified and other). A clinical audit in a single primary care practice was also performed to identify the impact of failing to record glucose provenance on diabetes diagnosis.

Results

A total of 2 137 098 people were included in the cross‐sectional analysis. Of 203 350 recorded glucose measurements the majority (117 893; 58%) did not have any provenance information. The most commonly reported provenance was fasting glucose (75 044; 37%). The distribution of glucose values where provenance was not recorded was most similar to that of fasting samples. The glucose measurements of 256 people with diabetes in the audit practice (size 11 514 people) were analysed. The initial glucose measurement had no provenance information in 164 cases (64.1%). A clinician questioned the provenance of a result in 41 cases (16.0%); of these, 14 (34.1%) required repeating. Lack of provenance led to delays in the diagnosis of diabetes [median (range) 30 (3–614) days].

Conclusions

The recording of glucose provenance in UK primary care could be improved. Failure to record provenance causes unnecessary repeated testing, delayed diagnosis and wasted clinician time.
Safety and efficacy of insulin degludec/insulin aspart with bolus mealtime insulin aspart compared with standard basal–bolus treatment in people with Type 1 diabetes: 1–year results from a randomized clinical trial (BOOST® T1)
Authors: Hirsch I. B. , Franek E. , Mersebach H. , Bardtrum L. , Hermansen K.
Published: January 2016

Aims

To evaluate the long‐term safety and efficacy of a simplified basal–bolus regimen of once‐daily insulin degludec/insulin aspart (IDegAsp) with additional IAsp vs. a standard basal–bolus insulin regimen of insulin detemir (IDet) with IAsp in adults with Type 1 diabetes.

Methods

This was an open‐label trial comprising a 26‐week core phase followed by a 26‐week extension phase. Participants were randomized to IDegAsp once daily at the main meal and IAsp at remaining meals (IDegAsp+IAsp), or IDet (once or twice daily) and IAsp at all meals (IDet+IAsp). Insulins were titrated to target plasma glucose of < 5 mmol/l (< 90 mg/dl) at pre‐breakfast (IDegAsp and IDet) and at pre‐meal (IAsp).

Results

After 52 weeks, the overall confirmed hypoglycaemia rate was 31.8 episodes/patient‐years of exposure (PYE) with IDegAsp+Asp and 36.7 episodes/PYE with IDet+IAsp, and the rate of nocturnal confirmed hypoglycaemia was significantly lower with IDegAsp+Asp than with IDet+IAsp (3.1 vs. 5.4 episodes/PYE, respectively; P < 0.05). Adverse event rates were comparable between groups. Mean HbA1c decreased from baseline by 0.7% (IDegAsp+IAsp) and 0.6% (IDet+IAsp), achieving 60 or 61 mmol/mol (7.6% or 7.7%, respectively), at Week 52. The mean total daily insulin dose was lower with IDegAsp+IAsp than with IDet+IAsp (ratio: 0.87; 95% CI 0.79–0.95; P = 0.0026).

Conclusions

Once‐daily treatment with IDegAsp and IAsp as bolus insulin for remaining meals was associated with significantly lower risk of nocturnal confirmed hypoglycaemia, improved glycaemic control and showed non‐inferiority compared with IDet+IAsp, the standard of care in Type 1 diabetes.
Insulin degludec/insulin aspart once daily in Type 2 diabetes: a comparison of simple or stepwise titration algorithms (BOOST®: SIMPLE USE)
Authors: Park S. W. , Bebakar W. M. W. , Hernandez P. G. , Macura S. , Hersløv M. L. , de la Rosa R.
Published: January 2016

Aims

To compare the efficacy and safety of two titration algorithms for insulin degludec/insulin aspart (IDegAsp) administered once daily with metformin in participants with insulin‐naïve Type 2 diabetes mellitus.

Methods

This open‐label, parallel‐group, 26‐week, multicentre, treat‐to‐target trial, randomly allocated participants (1:1) to two titration arms. The Simple algorithm titrated IDegAsp twice weekly based on a single pre‐breakfast self‐monitored plasma glucose (SMPG) measurement. The Stepwise algorithm titrated IDegAsp once weekly based on the lowest of three consecutive pre‐breakfast SMPG measurements. In both groups, IDegAsp once daily was titrated to pre‐breakfast plasma glucose values of 4.0–5.0 mmol/l. Primary endpoint was change from baseline in HbA1c (%) after 26 weeks.

Results

Change in HbA1c at Week 26 was IDegAspSimple −14.6 mmol/mol (−1.3%) (to 52.4 mmol/mol; 6.9%) and IDegAspStepwise −11.9 mmol/mol (−1.1%) (to 54.7 mmol/mol; 7.2%). The estimated between‐group treatment difference was −1.97 mmol/mol [95% confidence interval (CI) −4.1, 0.2] (−0.2%, 95% CI −0.4, 0.02), confirming the non‐inferiority of IDegAspSimple to IDegAspStepwise (non‐inferiority limit of ≤ 0.4%). Mean reduction in fasting plasma glucose and 8‐point SMPG profiles were similar between groups. Rates of confirmed hypoglycaemia were lower for IDegAspStepwise [2.1 per patient years of exposure (PYE)] vs. IDegAspSimple (3.3 PYE) (estimated rate ratio IDegAspSimple/IDegAspStepwise 1.8; 95% CI 1.1, 2.9). Nocturnal hypoglycaemia rates were similar between groups. No severe hypoglycaemic events were reported.

Conclusions

In participants with insulin‐naïve Type 2 diabetes mellitus, the IDegAspSimple titration algorithm improved HbA1c levels as effectively as a Stepwise titration algorithm. Hypoglycaemia rates were lower in the Stepwise arm.
Association of aerobic fitness level with exercise‐induced hypoglycaemia in Type 1 diabetes
Authors: Al Khalifah R. A. , Suppère C. , Haidar A. , Rabasa‐Lhoret R. , Ladouceur M. , Legault L.
Published: January 2016

Aim

To determine the impact of physical fitness level on hypoglycaemia risk during exercise in people with Type 1 diabetes.

Methods

A total of 44 patients [34 adults (aged 22–70 years) and 10 adolescents (aged 12–18 years)] with Type 1 diabetes, treated with insulin pump therapy, underwent a standardized exercise session. Cardiorespiratory fitness (maximum oxygen uptake) was measured and classified, based on established norms for age and sex, into either poor (< 25th percentile) or good fitness level (> 25th percentile). Plasma glucose levels were measured every 10 min, each patient performed physical activity at 60% maximum oxygen uptake either on a treadmill for 1 h or on a bicycle for 30 min. Frequency of hypoglycaemia (plasma glucose < 4 mmol/l) and decline in plasma glucose levels during exercise were assessed.

Results

In all, 23 patients had a good exercise fitness level. Hypoglycaemic events occurred in 17/23 patients (74.0%) in the good fitness level group compared with 8/21 patients (38.0%) in the poor fitness level group (P = 0.02). Both groups had similar pre‐exercise plasma glucose levels. The plasma glucose values during exercise in the good fitness level group compared with the poor fitness level group were: plasma glucose nadir 3.9 ± 1.6 vs 5.5 ± 2.4 mmol/l (P = 0.01) and plasma glucose change −4.6 ± 3.4 vs. −2.1 ± 3.1 mmol/l (P = 0.01). The correlation between the plasma glucose nadir and maximum oxygen uptake was r = −0.38 (P = 0.01).

Conclusions

Patients with good fitness level seem to be more prone to hypoglycaemia during exercise. This could be the result of better insulin sensitivity and the fact that they tend to exercise at greater work thresholds. These results are a step toward a better understanding of the association between physical fitness and exercise‐induced hypoglycaemia.
Impact of lifestyle intervention in primary prevention of Type 2 diabetes did not differ by baseline age and BMI among Asian‐Indian people with impaired glucose tolerance
Authors: Nanditha A. , Snehalatha C. , Ram J. , Selvam S. , Vijaya L. , Shetty S. A. , Arun R. , Ramachandran A.
Published: January 2016

Aim

To investigate whether the effectiveness of lifestyle interventions on the incidence of diabetes was influenced by the baseline age and BMI of the Asian‐Indian participants with prediabetes.

Methods

Pooled data, obtained from two of our Indian Diabetes Prevention Programmes (2006, n=236 and 2013, n=473; total N=709) which had similar baseline characteristics and intervention principles, were analysed. For the present secondary analysis we dichotomously categorized the participants' baseline age (<45 and ≥45 years) and BMI (<25.0 and ≥ 25.0 kg/m2). Glycaemic status was ascertained at 6‐monthly intervals by oral glucose tolerance tests. The incidence rates of diabetes and relative risk reduction in both the intervention and the control group were calculated for categories of baseline age and BMI. Interactions between the intervention and baseline age and BMI on diabetes risk were also analysed.

Results

Incident diabetes was diagnosed in 227 of the total 709 participants (32.0%) [control group 139 participants (38.8%) vs intervention group 88 participants (24.2%)] during the median follow‐up period of 2 years. The overall relative risk reduction was 35.4% (95% CI 19.3–48.3). Lifestyle intervention was equally effective in both age groups [relative risk reduction in those aged <45 years: 43.7% (95% CI 19.8–60.5) and in those aged ≥ 45 years: 28.9% (95% CI 5.3–46.6) P for interaction = 0.52] and in categories of BMI [BMI <25 kg/m2: 36.1% (95% CI 9.5–54.9); and BMI ≥ 25 kg/m2: 34.8% (95% CI 12.9–51.2); P for interaction = 0.95].

Conclusions

In Asian‐Indian individuals with prediabetes, the effectiveness of lifestyle intervention was not modified by baseline age and BMI.
The future of Evo‐Devo: the inaugural meeting of the Pan American Society for evolutionary developmental biology
Authors: Lesoway Maryna P.
Published: January 2016

What is the future of evolutionary developmental biology? This question and more were discussed at the inaugural meeting for the Pan American Society for Evolutionary Developmental Biology, held August 5−9, 2015, in Berkeley, California, USA. More than 300 participants attended the first meeting of the new society, representing the current diversity of Evo‐Devo. Speakers came from throughout the Americas, presenting work using an impressive range of study systems, techniques, and approaches. Current research draws from themes including the role of gene regulatory networks, plasticity and the role of the environment, novelty, population genetics, and regeneration, using new and emerging techniques as well as traditional tools. Multiple workshops and a discussion session covered subjects both practical and theoretical, providing an opportunity for members to discuss the current challenges and future directions for Evo‐Devo. The excitement and discussion generated over the course of the meeting demonstrates the current dynamism of the field, suggesting that the future of Evo‐Devo is bright indeed.
Outcome of patients with systemic light chain amyloidosis with concurrent renal and cardiac involvement
Authors: Badar Talha , Cornelison Amanda Megan , Shah Nina D. , Bashir Qaiser , Parmar Simrit , Patel Krina , Hosing Chitra , Popat Uday , Weber Donna M. , Thomas Sheeba K. , Shah Jatin J. , Orlowski Robert Z. , Champlin Richard E. , Qazilbash Muzaffar H.
Published: January 2016

Cardiac involvement in systemic light chain amyloidosis (AL) is generally associated with a worse outcome, especially if other organs are also involved. We sought to determine whether concurrent cardiac and renal involvement were associated with a worse outcome than either organ alone. We identified 129 patients with AL, who received high‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation (auto‐HCT) at our institution between 1997 and 2014. Ninety‐nine patients had either renal (group 1: n = 62, 62%), cardiac (group 2: n = 20, 20%), or both cardiac and renal (group 3: n = 17, 17%) involvement. The overall hematological response rate (CR+VGPR+PR) post‐auto‐HCT in groups 1, 2, and 3 was 69%, 74% and 82%, respectively (P = 0.62). Overall, organ response in groups 1, 2, and 3 was 39%, 42%, and 70%, respectively. The median PFS from auto‐HCT in groups 1, 2, and 3 was not reached (NR), 13.3 and 21 months, respectively (P = 0.02). The median OS in groups 1, 2, and 3 was 120, 46, and 60 months, respectively (P = 0.1). In conclusion, median PFS and OS in patients with concurrent cardiac and renal AL were comparable to patients with cardiac AL only, but worse than patients with renal AL.
Fertility in premenopausal women post autologous stem cell transplant with BEAM conditioning
Authors: Lasica Masa , Taylor Emma , Bhattacharyya Puja , Bennett Ashwini , Cooke Rachel E. , Stern Catharyn , Agresta Franca , Ayton Rosemary , Grigg Andrew
Published: January 2016

There is currently minimal data on fertility outcomes in premenopausal women undergoing autologous stem cell transplant (ASCT) with carmustine, etoposide, cytarabine and melphalan (BEAM) conditioning. A retrospective analysis of fertility outcomes in premenopausal females aged between 18 and 40 yr who underwent BEAM/ASCT for lymphoma between 1995 and 2011 was performed at four transplant centres. Of 41 premenopausal women who underwent BEAM conditioning, 25 met the inclusion criteria with the main exclusion criterion being inadequate documentation. Eighteen had Hodgkin lymphoma, and seven had non‐Hodgkin lymphoma. Median number of chemotherapy regimens pretransplant was 2 (1–3). Seventeen women (68%) with a median age at transplant of 25 yr (range 17–33) recovered their menses. The comparative group without recovery was older with a median age of 34 yr (range 20–40) (P = 0.007). Ten patients, with a median age at transplant of 22 yr (range 17–30), had 15 naturally conceived pregnancies. Chemotherapy regimens and lymphoma type did not obviously influence the incidence of menses recovery or conception. The incidence of recovery of menses and fertility in premenopausal women undergoing BEAM/ASCT for lymphoma is substantial. Younger age at transplant correlates with superior fertility outcomes.
Combined surgical and radiotherapy treatment of a mandibular ameloblastic carcinoma in a pony
Authors: Reardon R. J. M. , Dixon P. M. , Kane‐Smyth J. , Froydenlund T. , Booth S. A. , Dobson J. , Smith K.
Published: January 2016

A 9‐year‐old Welsh Section D gelding was referred to an equine hospital for evaluation and computed tomographic (CT) imaging of a left mandibular swelling. An expansile mass, found within the left mandible at the level of the caudal 2 cheek teeth, was surgically debulked and histology of the lesion identified it as an ameloblastic carcinoma. Radiotherapy using 4 fractions of 800 cGy, 7 days apart, was subsequently undertaken. The pony made excellent clinical progression following treatment. Repeat CT imaging at 7.5 and 19.5 months post surgery showed no apparent recurrence of the lesion and marked improvement in the remodelling of the mandible. In conclusion, radiotherapy in conjunction with surgical debulking appears to have been successful in treating an ameloblastic carcinoma in this pony and could be considered for similar tumours in other cases.
Nutritional management and practical feeding of the orphan foal
Authors: Stoneham S. J. , Morresey P. , Ousey J.
Published: January 2016

Foals are dependent on a milk‐based diet for the first 3–4 months of life. If they are orphaned during this period they require appropriate nutritional and behavioural management to allow them to develop into sound, well‐grown horses and ponies with well established normal behavioural patterns. In order to meet these needs it is necessary to understand the metabolic requirements of the foal and the composition of mares' milk. Usually managing these foals requires short‐term, emergency feeding of the foal while a long‐term option is sought. Long‐term options include use of a foster mare, induction of lactation in a parous, barren mare or hand rearing with suitable equine company. It is important to monitor growth and development of these foals to ensure that over the long term their nutritional needs are being met to allow normal growth and development.
Health literacy, associated lifestyle and demographic factors in adult population of an English city: a cross‐sectional survey
Authors: Protheroe Joanne , Whittle Rebecca , Bartlam Bernadette , Estacio Emee Vida , Clark Linda , Kurth Judith
Published: January 2016

Background

Lower health literacy is a public health issue that follows a social gradient, potentially reinforcing existing health inequalities. However, levels of health literacy in particular populations can be unclear and are a key to identifying effective public health interventions. This research examined health literacy levels in Stoke‐on‐Trent, where 31.2% of the population live in areas classified amongst the 10% most deprived in England.

Methods

A cross‐sectional survey using the Newest Vital Sign examined associations with demographic factors, lifestyle behaviours, Internet use and self‐rated health. The sample (n = 1046) took account of variance in levels of health literacy by age, educational attainment and deprivation. Bivariate logistic regression and multivariate logistic regression were used to estimate associations with health literacy when adjusted for other demographic factors and lifestyle behaviours.

Results

Nine hundred and seventy‐two respondents completed the health literacy measure (93%): 277 (28.5%) scored low, 228 (23.5%) scored marginal and 467 (48.0%) scored adequate. Associations with higher rates of limited health literacy included older age, lower educational level, lower income, perceived poor health and lack of access to the Internet.

Conclusions

Given the complexity of factors influencing health literacy interdisciplinary approaches across health and social care and the voluntary sector are essential in identifying and developing appropriate interventions.
Impact of established shrub shelterbelts around oases on the diversity of ground beetles in arid ecosystems of Northwestern China
Authors: Li Feng‐Rui , Liu Ji‐Liang , Sun Te‐Sheng , Ma Ling‐Fa , Liu Lu‐Lu , Yang Kun
Published: January 2016

Oases in arid regions of northwestern China are main sites for agriculture and human settlement. Conservation of these important oasis habitats involves establishing shrub shelterbelts around the oases. We investigated how different types of shrub shelterbelts affect the diversity of ground beetles.

We sampled carabid and tenebrionid assemblages with pitfall traps in spring and summer and measured key environmental variables in four habitats of the arid region: planted stands of pure and mixed plantations of two long‐lived shrubs (Haloxylon ammodendron and Tamarix ramosissima) and natural grassland (NG) from which planted systems were converted.

Beetle abundance and species richness reduced significantly in the pure plantations but the mixed plantation had similar abundance and higher richness in spring and lower richness in summer relative to NG. We found differences in response between functional groups of beetles. The pure plantations resulted in reduced abundance and richness of herbivores and detritivores and increased predator abundance in spring and reduced predator abundance in summer. The mixed plantation resulted in increased detritivore richness in spring and reduced detritivore richness in summer as well as increased herbivore abundance in spring and reduced herbivore and predator abundance and richness in summer. The beetle community was largely determined by shrub cover and herbaceous plant diversity.

We conclude that the pure shrub plantations reduce beetle diversity, whereas the mixed shrub plantation has less adverse effect on beetle diversity. Shrub mixtures can therefore be a practical measure to minimise the negative impacts of shrub shelterbelts on beetles.
Oral health‐related quality of life following dental treatment under general anaesthesia for early childhood caries – a UK‐based study
Authors: de Souza Michelle C. , Harrison Mike , Marshman Zoe
Published: January 2016

Objective

To assess parental reports of changes in oral health‐related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction‐only (Exo) treatment approaches on this.

Methods

Data were collected using the proxy reported components of the Child Oral Health‐Related Quality of Life (COHRQoL®) questionnaire: the Parent‐Caregivers Perceptions questionnaire (P‐CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department. Mean scores and prevalence impacts were compared pre‐ and postoperatively with mean change score and effect sizes calculations.

Results

Seventy‐eight parents were recruited (51 children undergoing OR, 27 Exo) with 6 lost to follow‐up (92.3%). Following treatment, changes in mean P‐CPQ and FIS scores were statistically significant (P < 0.0001) with medium to large effect sizes (0.45–1.39). The differences in change scores between the two treatment approaches were not statistically different.

Conclusion

DGA for young children with early childhood caries resulted in substantial improvements in parent's ratings of their child's OHRQoL and of the impact on their families. Larger cohort studies are needed to validate these preliminary findings.
Signs of attention deficit/hyperactivity disorder as a risk factor for traumatic dental injury among schoolchildren: a case–control study
Authors: Mota‐Veloso Isabella , Soares Maria Eliza C. , Homem Márcio Alexandre , Marques Leandro Silva , Ramos‐Jorge Maria Letícia , Ramos‐Jorge Joana
Published: January 2016

Background

The determination of risk factors for traumatic dental injury (TDI) is important to the implementation of preventive measures.

Aim

The aim of this study was to evaluate the association between signs of attention deficit/hyperactivity disorder (ADHD) and TDI.

Material and Methods

A case–control (1 : 1) study involved a population‐based sample of 230 schoolchildren aged seven to 12 years. The case and control groups were composed of children with (n = 115) and without (n = 115) TDI, respectively. The groups were matched for age and sex. The outcome variable (TDI) was detected using the O'Brien criteria. The main independent variable (signs of ADHD) was evaluated using the Swanson, Nolan and Pelham scale (version IV) administered to parents and teachers. Socio‐demographic characteristics and accentuated overjet were analyzed as confounding factors. Statistical analysis involved the McNemar's test as well as the bivariate and multivariate conditional logistic regression.

Results

The multivariate regression demonstrated that schoolchildren with the signs of hyperactivity (parental reports) had a 2.33‐fold greater chance of exhibiting TDI (95% CI: 1.10–4.94) than those without this condition, as well as those with accentuated overjet (OR = 3.13, 95% CI: 1.70–5.77).

Conclusion

Schoolchildren whose parents reported signs suggestive of hyperactivity had a greater chance of exhibiting TDI than those without such signs.
Blood Pressure Effects of Yoga, Alone or in Combination With Lifestyle Measures: Results of the Lifestyle Modification and Blood Pressure Study (LIMBS)
Authors: Cohen Debbie L. , Boudhar Sanaa , Bowler Anne , Townsend Raymond R.
Published: January 2016

The authors conducted a study to assess the effects of yoga on blood pressure (BP). Patients were randomized to yoga (Blood Pressure Education Program [BPEP]), or a combined program (COMBO). Ambulatory BP was measured at baseline and at 12 and 24 weeks. Data are presented for all enrolled patients (n=137) and for completers only (n=90). Systolic BP (SBP) and diastolic BP (DBP) were significantly decreased within all groups at 12 and 24 weeks (P<.001) for enrolled patients and completers. SBP was significantly reduced in the yoga and COMBO groups as compared with the BPEP group at 12 weeks in all enrolled and completers. SBP differences were no longer significant at 24 weeks between groups in all enrolled patients; however, there was a greater reduction in SBP at 24 weeks in completers favoring BPEP over yoga. No differences in DBP between groups or in BP between the yoga and COMBO groups were present. The authors did not observe an additive benefit from combining yoga with BPEP measures. Reasons for this are unclear at this time. BP lowering with yoga, however, was similar to that achieved with lifestyle measures.
Gut‐derived cholecystokinin contributes to visceral hypersensitivity via nerve growth factor‐dependent neurite outgrowth
Authors: Hsu Luo‐Ting , Hung Kuan‐Yang , Wu Hsiu‐Wei , Liu Wei‐Wen , She Meng‐Ping , Lee Tsung‐Chun , Sun Chin‐Hung , Yu Wei‐Hsuan , Buret Andre G , Yu Linda Chia‐Hui
Published: January 2016

Background and Aim:

Irritable bowel syndrome is characterized by abdominal pain and altered bowel habits and may occur following stressful events or infectious gastroenteritis such as giardiasis. Recent findings revealed a link between cholecystokinin (CCK), neurotrophin synthesis, and intestinal hyperalgesia. The aim was to investigate the role of CCK in visceral hypersensitivity using mouse models challenged with a bout of infection with Giardia lamblia or psychological stress, either alone or in combination.

Methods:

Abdominal pain was evaluated by visceromoter response to colorectal distension. Nerve fibers in intestinal tissues were stained using immunohistochemistry (PGP9.5). Human neuroblastoma SH‐SY5Y cells incubated with bacterial‐free mouse gut supernatant or recombinant CCK‐8S were assessed for neurite outgrowth and nerve growth factor (NGF) production.

Results:

Intestinal hypersensitivity was induced by either stress or Giardia infection, and a trend of increased pain was seen following dual stimuli. Increased CCK levels and PGP9.5 immunoreactivity were found in colonic mucosa of mice following stress and/or infection. Inhibitors to the CCK‐A receptor (L‐364718) or CCK‐B receptor (L‐365260) blocked visceral hypersensitivity caused by stress, but not when induced by giardiasis. Nerve fiber elongation and NGF synthesis were observed in SH‐SY5Y cells after incubation with colonic supernatants from mice given the dual stimuli, or after treatment with CCK‐8S. Increased nerve fiber length by colonic supernatant and CCK‐8S was attenuated by L‐365260 or neutralizing anti‐NGF.

Conclusions:

This new model successfully recapitulates intestinal hypernociception induced by stress or Giardia. Colonic CCK contributes to visceral hypersensitivity caused by stress, but not by Giardia, partly via NGF‐dependent neurite outgrowth.
Maternal Outcomes in Birth Centers: An Integrative Review of the Literature
Authors: Alliman Jill , Phillippi Julia C.
Published: January 2016

Introduction

The birth center, a relatively recent innovation in maternity care, is an increasingly popular location of birth. The purpose of this integrative literature review is to assess the research on maternal outcomes from birth center care.

Methods

Using methods by Whittemore and Knafl, we conducted an integrative review of studies of birth centers published in English since 1980. Twenty‐three quantitative sources and 9 qualitative sources describing maternal outcomes of birth center care were reviewed and synthesized.

Results

Outcomes for women receiving birth care were positive. Spontaneous vaginal birth rates and perineal integrity were higher for women beginning care in a birth center compared to women in hospital care. Rates of cesarean birth were also lower for women planning birth center care. Transfer rates are difficult to compare across studies, but antepartum transfer rates ranged from 13% to 27.2%. Intrapartum transfer rates ranged from 11.6% to 37.4%, and from 11.6% to 16.5% in studies published from 2011 to 2013. Nulliparous women had higher rates of transfer than multiparous women. Few severe maternal outcomes and no maternal deaths were reported in any studies. Women were satisfied with the comprehensive, personalized care that they received from birth centers.

Discussion

Quantitative studies reviewed included more than 84,300 women. The heterogeneity of the studies and variations of practice limit generalization of findings. However, even with multisite studies enrolling a variety of birth centers and practice changes over time, the consistency of positive outcomes supports this model of care. Policy makers in the United States should consider supporting the birth center model as a means of improving maternal outcomes.
Optical Coherence Tomography for the Detection of Remote Optic Neuritis in Multiple Sclerosis
Authors: Xu Lucy T. , Bermel Robert A. , Nowacki Amy S. , Kaiser Peter K.
Published: January 2016

BACKGROUND AND PURPOSE

Evidence of remote optic neuritis is often used to support a diagnosis of multiple sclerosis (MS). Optical coherence tomography (OCT) can provide qualitative and quantitative data on the retina, where the effects of optic neuritis can be seen. Our aim was to determine whether there is a quantitative difference in retinal structures in eyes with optic neuritis compared with those without, and which measures were best able to discriminate eyes with a history of optic neuritis from nonoptic neuritis eyes in MS patients.

METHODS

We performed a prospective cohort study of 30 MS‐optic neuritis patients, 22 MS‐nonoptic neuritis patients, and 24 healthy participants. Patients underwent visual acuity testing and OCT imaging. Retinal measurements were compared across groups. OCT measurements and visual acuities were analyzed for their ability to discriminate between optic neuritis and nonoptic neuritis eyes.

RESULTS

Optic neuritis eyes exhibited a thinner peripapillary retinal nerve fiber layer, papillomacular bundle, and ganglion cell + inner plexiform layer thicknesses compared to MS eyes without optic neuritis and healthy controls. Papillomacular bundle thickness was the best model to discriminate between eyes with optic neuritis and nonoptic neuritis eyes in MS patients. Visual acuity alone yielded rather poor models.

CONCLUSIONS

Optic neuritis is associated with thinning in multiple regions of the retina. Optic neuritis eyes can be differentiated most accurately from nonoptic neuritis eyes using OCT. Our work suggests a potential role for OCT in documenting a remote history of optic neuritis to corroborate a diagnosis of MS.
Esthetic Evaluation of Anterior Single‐Tooth Implants with Different Abutment Designs—Patients’ Satisfaction Compared to Dentists’ Observations
Authors: Patil Ratnadeep , Gresnigt Marco M.M. , Mahesh Kavita , Dilbaghi Anjali , Cune Marco S.
Published: January 2016

Purpose

To correlate patients’ satisfaction and dentists’ observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco‐gingival esthetics.

Materials and Methods

Twenty‐six patients with nonadjacent missing teeth in the esthetic zone were enrolled in a randomized clinical trial (within‐subject comparison). Two implants placed in each were restored using abutments of different geometry. Patients’ appreciation was assessed on a visual analog scale (VAS) by recording answers to three questions, and dentists’ appreciation was determined by means of the Pink Esthetic Score (PES) at T0 (crown cementation, baseline) and at T12 (1 year post‐cementation). ANOVA with post hoc analysis was used to identify differences between groups and at different moments in time. Pearson correlations were calculated between all variables, both at T0 and at T12.

Results

No statistically significant differences were found at any time between the control and experimental abutment design, either for the PES or for the VAS score. PES slightly improved after 1 year, as did the VAS rating related to functioning with the implant‐crown compared to the natural teeth. All PES and VAS scores demonstrated highly significant correlation. Both patient satisfaction and professional appreciation of muco‐gingival conditions after single implant treatment in the esthetic zone were high; however, the curved, experimental abutment design performed no better than the conventional, divergent type.

Conclusion

Curved abutment design does not significantly impact crown or gingival esthetics as assessed by PES and VAS scored by dentists and patients, respectively.
Detachable Palatal Ramp of Teeth to Improve Comfort in a Completely Edentulous Patient with a Segmentally Resected Mandible
Authors: Hindocha Amit D. , Dudani Mohit T.
Published: January 2016

The rehabilitation of a completely edentulous patient with segmental resection of the mandible (without osseous reconstruction) poses a considerable challenge to the restoring prosthodontist. Due to the absence of natural teeth in both arches, it is difficult to correct the mandibular deviation with the aid of guidance prostheses. Prosthetic management of such patients usually consists of a maxillary complete denture and mandibular segmental denture occluding in the deviated position itself. An additional ramp or row of denture teeth is placed on the palatal surface of the maxillary denture to facilitate this; however, patient comfort levels (during functions such as phonation) are found to be adversely impacted due to the encroachment of the tongue space by the position of the ramp. This report describes an innovative technique to overcome this problem by fabrication of a detachable ramp of additional denture teeth in the maxillary denture. The patient could wear the denture comfortably without the palatal ramp throughout the day and could attach the palatal ramp while eating.
Dispositional Anxiety and Frontal‐Midline Theta: On the Modulatory Influence of Sex and Situational Threat
Authors: Osinsky Roman , Karl Christian , Hewig Johannes
Published: January 2016

In their adaptive control hypothesis, Cavanagh and Shackman (2015) recently claimed that dispositional anxiety is correlated with frontal‐midline theta (FMθ) as a generic “need for control” signal of the anterior midcingulate cortex. Here, we tested this assumption, also considering potential modulatory influences of anticipatory threat and individuals’ sex. In a nonclinical sample of 168 participants (84 women), electroencephalogram was recorded while individuals performed a simple two‐choice task. Half of the participants were assigned to a threat anticipation condition (anticipation of public speaking), whereas the other half was assigned to a control condition. State anxiety was monitored across the experiment. Dispositional anxiety was assessed by self‐report scales, which were completed before individuals came to the laboratory. Target stimuli in the two‐choice task induced a transient increase in FMθ power that was subject to an interaction of dispositional anxiety, sex, and experimental group. Only in women who anticipated public speaking did we observe a substantial positive relation between dispositional anxiety and general FMθ power. Our results indicate that the link between dispositional anxiety and FMθ is not universal but rather depends on complex interactions of individuals’ sex and situational threat.
Antioxidant properties in a non-polar environment of difluoromethyl bioisosteres of methyl hydroxycinnamates
Authors: Martínez Mario D , Luna Lorena , Tesio Alvaro Y , Feresin Gabriela E , Durán Fernando J , Burton Gerardo
Published: January 2016

Objectives

Many natural antioxidants have poor pharmacokinetic properties that impair their therapeutic use. For hydroxycinnamic acids (HCAs) and other phenolic antioxidants, their major drawback is their low lipophilicity and a rapid metabolism. The difluoromethyl group may be considered as a ‘lipophilic hydroxyl' due to its hydrogen bond donor and acceptor properties; this prompted us to assess it as a bioisosteric replacement of a phenolic hydroxyl for increasing the lipophilicity of HCAs.

Methods

Six difluoromethyl-substituted methyl cinnamates (4a-c, 5a-c) related to caffeic acid were synthesized and their antioxidant activity evaluated by chemical (FRAP, DPPH scavenging, inhibition of β-carotene bleaching, at 1–200 μm), electrochemical (differential pulse voltammetry, cyclic voltammetry) and cell-based (inhibition of lipid peroxidation in erythrocytes, at 1 and 50 μm) assays.

Key fndings

Analogues 4a-c and 5a-c were inactive in FRAP and DPPH assays and only those containing a free phenolic hydroxyl (4a and 5a) exhibited electrochemical activity although with high redox potentials. Compounds 4a,b and 5a,b were active in the inhibition of β-carotene bleaching assay and all analogues inhibited lipid peroxidation in the human erythrocytes assay.

Conclusions

Lipophilic difluoromethyl-substituted cinnamic esters retain radical scavenging capabilities that prove useful to confer antioxidant properties in a non-polar environment.
Ruthenium-based nitric oxide-donating and carbon monoxide-donating molecules
Authors: Pauwels Bart , Boydens Charlotte , Vanden Daele Laura , Van de Voorde Johan
Published: January 2016

Objectives

Over the past few years, the use of metallocomplexes for medical purposes has considerably grown. Because of its favourable characteristics, ruthenium has taken a significant place in this expanding field of research. Several ruthenium-containing metal compounds have been developed as delivery agents of physiological important molecules such as nitric oxide (NO) and carbon monoxide (CO).

Key findings

This review focuses on the (vaso)relaxant capacity of ruthenium-based NO-donating and CO-donating molecules in view of their potential usefulness in the treatment of cardiovascular diseases and erectile dysfunction.

Ruthenium seems to be a valuable candidate for the design of NO-donating and CO-donating molecules. To date, ruthenium remains of interest in drug research as the search for new alternatives is still necessary.
Colloidal carriers for extended absorption window of furosemide
Authors: Sultan Amal A , El-Gizawy Sanaa A , Osman Mohamed A , El Maghraby Gamal M
Published: January 2016

Objectives

The aim was to investigate the potential of self-microemulsifying drug delivery systems (SMEDDS) and niosomes as carriers for widening the gastrointestinal absorption window of furosemide (model acidic drug).

Methods

The drug was incorporated in SMEDDS and was encapsulated into niosomes. The intestinal absorption was monitored at two anatomical sites (duodenum and jejuno-ileum). This employed in situ rabbit intestinal perfusion technique.

Key findings

Perfusion of drug solution (control) revealed poor intestinal permeability with per cent fraction absorbed (%Fa) from the duodenum and jejuno-ileum being 1.3 and 0.6 % per cm, respectively. Formulation of furosemide as SMEDDS increased the %Fa from the duodenum and jejuno-ileum to reach 1.7 and 1 % per cm, respectively. Niosomal encapsulation increased the %Fa from duodenum and jejuno-ileum to record 1.9 and 1.2 % per cm, respectively. The increase in the %Fa was also revealed as a reduction in the length required for 95 % absorption of the drug which was reduced from 557.2 to 245.8 cm and to 279.8 cm after delivery as niosomes or SMEDDS, respectively, in case of jejuno-ileum. The same trend was recorded with the duodenum.

Conclusion

The recorded results highlighted the potential for SMEDDS and niosomes for widening the absorption window of acidic drugs after oral administration.
Vegetation patterns along micro‐relief and vegetation type transects in polygonal landscapes of the Siberian Arctic
Authors: Zibulski Romy , Herzschuh Ulrike , Pestryakova Luidmila A.
Published: January 2016

Question

How important is the effect of micro‐relief and vegetation type on the characteristics of vascular plants and bryophytes in low‐centred polygons?

Location

Siberian Arctic, Russia.

Methods

Eight low‐centred polygons in northern Siberia were surveyed for vegetation along transects running from the rim to the pond via the rim–pond transition of each polygon and across a vegetation type gradient from open forest to tundra.

Results

The cover of vascular plants and bryophytes displays no significant differences between the rim and rim–pond transition but is significantly lower in the pond section of the polygons. Alpha‐diversity of vascular plants decreases strongly from rim to pond, whereas bryophyte diversity in pond plots is significantly distinct from the rim and the rim–pond transition. There is no clear trend in cover for either plant group along the vegetation type transect and only a weak trend in α‐diversity. However, both gradients are reflected in the compositional turnover. The applied indicator species analysis identified taxa characteristic of certain environmental conditions. Among others, we found vascular plants primarily characteristic of the rim and bryophyte taxa characteristic of each micro‐relief level and vegetation type.

Conclusions

The observed gradual pattern in α‐diversity and composition of polygonal vegetation suggests that micro‐relief is the main driver of changes in the vegetation composition, while vegetation type and the related forest cover change are of subordinate importance for polygonal vegetation patterns along the Siberian tree line.
Why Listen to Philosophers? A Constructive Critique of Disciplinary Philosophy
Authors: Loncar Samuel
Published: January 2016

This article articulates a fundamental crisis of disciplinary philosophy—its lack of disciplinary self‐consciousness and the skeptical problems this generates—and, through that articulation, exemplifies a means of mitigating its force. Disciplinary philosophy organizes itself as a producer of specialized knowledge, with the apparatus of journals, publication requirements, and other professional standards, but it cannot agree on what constitutes knowledge, progress, or value, and evinces ignorance of its history and alternatives. This situation engenders a skepticism that threatens the legitimacy of disciplinary philosophy. The article proposes a response to this skepticism, rooted in the conditions that philosophers evince a specific kind of awareness of their own activity and its professional and cultural location, demonstrate this awareness by articulating it in the practice of philosophy itself, and recognize that precisely such articulation lies at the core of the Socratic idea of philosophy as a form of self‐knowledge.
The Institution of Philosophy: Escaping Disciplinary Capture
Authors: Briggle Adam , Frodeman Robert
Published: January 2016

Philosophers view themselves as critical thinkers par excellence. But they have overlooked the institutional arrangements that govern their lives. The early twentieth‐century research university disciplined philosophers, placing them in departments, where they wrote for and were judged by their disciplinary (and now increasingly subdisciplinary) peers. Oddly, this change has been unremarked upon, or has been treated as simply part of the necessary professionalization of an academic field of research. The department has been tacitly assumed to be a neutral space from which thought germinates; it is not itself an object of reflection. We find no explorations of the effects that departmentalization might have on philosophical theorizing, or speculations about where else philosophers could be housed, or how, by being located elsewhere, they might develop alternative accounts of the world or have come up with new ways of philosophizing.
The Problem of Relevance and the Future of Philosophy of Religion
Authors: Carroll Thomas D.
Published: January 2016

Despite the growth in research in philosophy of religion over the past several decades, recent years have seen a number of critical studies of this subfield in an effort to redirect the methods and topics of inquiry. This article argues that in addition to problems of religious parochialism described by critics such as Wesley Wildman, the subfield is facing a problem of relevance. In responding to this problem, it suggests that philosophers of religion should do three things: first, be critically self‐aware about their aims of inquiry; second, investigate concepts used by other philosophers, scientists, and religious studies scholars to identify and dispel confusion about religions; and third, following the model of applied ethics, work to clarify concepts and advance arguments of contemporary practical urgency.
Philosophy's Tragedy
Authors: Cooper Andrew
Published: January 2016

Is tragedy, as Nietzsche declared, dead? In recent years many philosophers have reconsidered tragedy's relation to philosophy. While tragedy is deemed to contain important lessons for philosophy, there is a consensus that it remains a thing of the past. This article calls this consensus into question, arguing that it reifies tragedy, keeping tragedy at arm's length. With the interest of identifying the necessity of tragedy to philosophy, it draws from Quentin Skinner to put forward an alternative approach to genre as living form. This approach alters our understanding of the philosopher at the heart of philosophy's dialogue with tragedy, Immanuel Kant. Moreover, it shows that tragedy is closer to contemporary philosophy than we might think.
Business Ethics without Philosophers? Evidence for and Implications of the Shift From Applied Philosophers to Business Scholars on the Editorial Boards of Business Ethics Journals
Authors: Seele Peter
Published: January 2016

This article considers the relationship between business ethics and philosophy, specifically in relation to the field and persons working in it. The starting point is a grammatical one: business ethics by the rules of grammar belongs to ethics. In terms of academic disciplines, it belongs to applied ethics, which belongs to ethics, which belongs to practical philosophy, which belongs to philosophy. However, in the field of business ethics today one will seldom meet colleagues from philosophy; instead, they will come from business, applying business studies perspectives, approaches, and increasingly quantitative methods. This article provides empirical evidence that today the three top journals with “business ethics” in their titles (and “awarded” a high impact factor) are mostly run (in terms of their editorial boards) by business scholars with PhDs in business. The article compares the three journals today with their inaugural issues and finds that at their inception all three were run by a majority of philosophers. The article discusses six possible explanations for this shift and provides suggestions for how to bring business ethics back to philosophers (and vice versa).
Utopias and Comparative Assessments of Justice
Authors: García Gibson Francisco
Published: January 2016

When we make public policy choices, is it helpful to know how utopia (that is, the perfectly just institutional design) would look? Amartya Sen argues that it is neither necessary, nor sufficient, nor even contributory. He claims that before making a policy choice one should compare several feasible institutional designs to see which promotes justice most (a “comparative assessment” of justice), and that it is misleading to use the perfect design as a standard in those comparisons. Principles of justice are the proper standard. The present article contends that the perfect design has nevertheless an important role to play in the prior task of identifying and refining our principles of justice. It also shows that the perfect design—in at least one sense of this term—may be a legitimate long‐term goal for present policy choices.