bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial
Authors: Frøssing Signe , Nylander Malin , Chabanova Elizaveta , Frystyk Jan , Holst Jens J. , Kistorp Caroline , Skouby Sven O. , Faber Jens
Published: July 2017

Women with polycystic ovary syndrome (PCOS) were treated with the GLP‐1 receptor agonist liraglutide to investigate the effect on liver fat content, visceral adipose tissue (VAT) and the prevalence of nonalcoholic fatty liver disease (NAFLD). In a double‐blind, placebo‐controlled, randomized clinical trial 72 women with PCOS, with a BMI > 25 kg/m2 and/or insulin resistance, were treated with liraglutide or received placebo 1.8 mg/d (2:1) for 26 weeks. Liver fat content was assessed by 1
HMR spectroscopy, VAT by MRI, body composition by DXA, and glucose metabolism by oral glucose tolerance test. Compared with placebo, liraglutide treatment reduced body weight by 5.2 kg (5.6%), liver fat content by 44%, VAT by 18%, and the prevalence of NAFLD by two‐thirds (all P < .01). Sex‐hormone‐binding‐globulin (SHBG) levels increased by 19% (P = .03), and free testosterone decreased by 19% (P = .054). HbA1c, fasting glucose and leptin were reduced (all: P < .05), whereas measures of insulin resistance, adiponectin and glucagon did not change. In conclusion, 26 weeks of liraglutide treatment in PCOS resulted in significant reductions in liver fat content, VAT and the prevalence of NAFLD.
Metformin‐associated prevention of weight gain in insulin‐treated type 2 diabetic patients cannot be explained by decreased energy intake: A post hoc analysis of a randomized placebo‐controlled 4.3‐year trial
Authors: Out Mattijs , Miedema Ida , Jager‐Wittenaar Harriët , van der Schans Cees , Krijnen Wim , Lehert Philippe , Stehouwer Coen , Kooy Adriaan
Published: July 2017

Metformin prevents weight gain in patients with type 2 diabetes (T2D). However, the mechanisms involved are still unknown. In this post hoc analysis of the HOME trial, we aimed to determine whether metformin affects energy intake. Patients with T2D were treated with 850 mg metformin or received placebo added to insulin (1‐3 times daily) for 4.3 years. Dietary intake was assessed at baseline, after 1 year and after 4.3 years, according to the dietary history method. Among the 310 included participants, 179 (93 placebo, 86 metformin) completed all 3 dietary assessments. We found no significant difference in energy intake after 4.3 years between the groups (metformin vs placebo: −31.0 kcal/d; 95% CI, –107.4 to 45.4; F‐value, 1.3; df = 415; P = .27). Body weight in placebo users increased significantly more than in metformin‐users during 4.3 years (4.9 ± 4.9 vs 1.1 ± 5.2 kg; t test: P ≤ .001). Linear mixed models did not show a significant effect of energy intake as explanation for the difference in weight gain between the groups (F‐value, 0.1; df = 1; P = .82). In conclusion, the prevention of weight gain by metformin cannot be explained by reduced energy intake.
Apelin administration improves insulin sensitivity in overweight men during hyperinsulinaemic‐euglycaemic clamp
Authors: Gourdy Pierre , Cazals Laurent , Thalamas Claire , Sommet Agnès , Calvas Fabienne , Galitzky Monique , Vinel Claire , Dray Cédric , Hanaire Hélène , Castan‐Laurell Isabelle , Valet Philippe
Published: July 2017

Aims

Apelin is a recently identified adipokine known to improve glucose tolerance and insulin sensitivity in murine models. This study was dedicated to the proof of concept that apelin administration also enhances insulin sensitivity in humans.

Materials and Methods

Healthy overweight men were enrolled in this randomized, double‐blind, placebo‐controlled, cross‐over study that successively considered the efficacy and the tolerance of 2 doses of (pyr1)‐Apelin‐13. A first group of subjects received 9 nmol/kg (n = 8) of (pyr1)‐Apelin‐13 and, after examination of safety data, a second group received 30 nmol/kg (n = 8). Each volunteer underwent 2 hyperinsulinaemic‐euglycaemic clamps where the basal level of glucose infusion rate (GIR) was measured from the 90th to the 120th minute (level 1). Continuous intravenous administration of apelin or placebo was ongoing for 2 hours and GIR was finally evaluated from the 210th to the 240th minute (level 2). Primary evaluation endpoint was the difference in GIR between level 2 and level 1 (ΔGIR).

Results

A slight increase in ΔGIR was observed with the low apelin dose (0.65 ± 0.71 mg/kg/min, P = .055) whereas the highest dose significantly improved insulin sensitivity (0.82 ± 0.71 mg/kg/min, P = .033). Cardiovascular monitoring and safety reports did not reveal any side effect of apelin administration.

Conclusion

As the first demonstration of the insulin‐sensitizing action of apelin in humans, alongside numerous studies in rodents, this trial confirms that the apelin/APJ pathway should be considered as a new target to design alternative therapeutic strategies to control insulin resistance in type 2 diabetic patients.
Underappreciated occurrence of discrete subaortic membranes producing left ventricular outflow obstruction in hypertrophic cardiomyopathy
Authors: Kannappan Muhil , Maron Barry J. , Rastegar Hassan , Pandian Natesa G. , Maron Martin S. , Rowin Ethan J.
Published: July 2017

Subaortic obstruction due to systolic anterior motion (SAM) of the mitral valve with ventricular septal contact is a major cause of progressive heart failure symptoms in patients with hypertrophic cardiomyopathy (HCM). However, we have recently observed a unique, but not uncommon subgroup of HCM patients with outflow tract obstruction due only to discrete subaortic membrane or who have a membrane in addition to SAM‐septal contact. HCM patients with subaortic membranes may be at increased risk for developing progressive heart failure symptoms. Identification requires a high index of suspicion and raises important management considerations, including need for surgical myectomy for definitive relief of obstruction with associated excellent outcomes, as the alternative invasive treatment option with percutaneous alcohol septal ablation would be ineffective.
An observational study of microcirculation in dialysis patients and kidney transplant recipients
Authors: Yeh Yu Chang , Chao Anne , Lee Chih‐Yuan , Lee Chen‐Tse , Yeh Chi‐Chuan , Liu Chih‐Min , Tsai Meng‐Kun
Published: July 2017

Background

Microcirculatory dysfunction contributes to acute and chronic kidney diseases. To the best of our knowledge, no study has compared differences in microcirculation among healthy volunteers, dialysis patients and kidney transplant recipients.

Materials and methods

Sublingual microcirculation was examined using sidestream dark field imaging and was compared among 90 healthy volunteers, 40 dialysis patients and 40 kidney transplant recipients. The gender effect on microcirculation and the correlations among the microcirculation parameters, age, body mass index, heart rate and blood pressure were analysed.

Results

Total small vessel density, perfused small vessel density and the proportion of perfused small vessels were lower in the dialysis patients than in the healthy volunteers and kidney transplant recipients [total small vessel density; healthy volunteers vs. dialysis patients vs. kidney transplant recipients, 25·2 (2·3) vs. 22·8 (2·6) vs. 24·2 (2·9) mm/mm2, P < 0·001]. Systolic blood pressure showed a weak negative correlation with the microvascular flow index scores in the healthy volunteers. By contrast, systolic blood pressure, diastolic blood pressure and mean arterial pressure showed weak positive correlations with proportion of perfused small vessels and the microvascular flow index scores in the dialysis patients.

Conclusions

Microcirculatory dysfunction is noted in dialysis patients, and this alteration is ameliorated in KT recipients. The positive correlation between blood pressure and microcirculation in dialysis patients suggests that additional studies should investigate the optimal goal of blood pressure management for dialysis patients.
Multibiomarker analysis in patients with acute myocardial infarction
Authors: Schernthaner Christiana , Lichtenauer Michael , Wernly Bernhard , Paar Vera , Pistulli Rudin , Rohm Ilonka , Jung Christian , Figulla Hans‐Reiner , Yilmaz Attila , Cadamuro Janne , Haschke‐Becher Elisabeth , Pernow John , Schulze Paul Christian , Hoppe Uta C. , Kretzschmar Daniel
Published: July 2017

Background

Novel biomarkers representing different pathobiological pathways and their role in patients with acute myocardial infarction (AMI) were studied.

Methods

We retrospectively analysed serum levels of soluble suppression of tumorigenicity (sST2), growth‐differentiation factor‐15 (GDF‐15), soluble urokinase plasminogen activator receptor (suPAR), heart‐type fatty acid‐binding protein (H‐FABP) and plasma fetuin A in blood of patients with AMI (STEMI, n = 61; NSTEMI, n = 57) compared to controls with excluded coronary artery disease (n = 76). Furthermore, detailed correlation analysis was performed.

Results

Compared with controls, in patients with STEMI and NSTEMI higher levels expressed as median of sST2 in pg/mL (STEMI: 13210·9, NSTEMI: 11989·1, control: 5248; P < 0·001), GDF‐15 in pg/mL (STEMI: 818·8, NSTEMI 677·5, control 548·6; P < 0·001), suPAR in pg/mL (STEMI: 3461·1, NSTEMI: 3466·7, control: 2463·6; P < 0·001), H‐FABP in ng/mL (STEMI: 5·8, NSTEMI: 5·4, control: 0·0; P < 0·001) and lower plasma fetuin A levels in μg/mL (STEMI: 95, NSTEMI: 54, control: 116·6; P < 0·001) were detected. Correlation analysis found clinical and biochemical parameters such as ejection fraction, length of hospital stay, creatine kinase, NT‐proBNP and hs Troponin T levels as well as inflammatory markers (CRP, leucocytes) to be significantly correlated with novel biomarkers.

Conclusion

Plasma levels of novel biomarkers were significantly elevated (sST2, GDF‐15, H‐FABP, suPAR) or inversely downregulated (fetuin A) in patients with AMI compared to a control group with excluded coronary artery disease. Significant correlations with various clinical parameters and standard biochemical markers were found.
Nerve ultrasound as follow‐up tool in treated multifocal motor neuropathy
Authors: Rattay T. W. , Winter N. , Décard B. F. , Dammeier N. M. , Härtig F. , Ceanga M. , Axer H. , Grimm A.
Published: July 2017

Background and purpose

High‐resolution ultrasound is a valuable tool in supporting the diagnosis of multifocal motor neuropathy (MMN) but longitudinal data under therapy are lacking.

Methods

The change in peripheral nerve ultrasound pattern in patients with MMN was assessed over time. Patients with MMN received a thorough initial examination and follow‐up over a period of 6–12 months using high‐resolution ultrasound of the cervical roots and the nerves of the arms and legs, nerve conduction studies, Medical Research Council Sum Score (MRCSS) and Rotterdam Inflammatory Neuropathy Cause and Treatment Group (INCAT) score to evaluate changes under treatment. The Ultrasound Pattern Sum Score (UPSS) was used as standardized peripheral nerve ultrasound protocol.

Results

Seventeen patients with MMN received initial examinations of whom 12 were successfully followed up. All patients with MMN showed at least localized but often multifocal peripheral nerve enlargement. An enlarged overall cross‐sectional area as well as enlarged single fascicles (>3 mm²) in clinically and electrophysiologically affected (>90%) and unaffected (>70%) nerves were found. The UPSS did not correlate with clinical disability at both visits. However, the change in clinical disability (evaluated as difference in MRCSS) and the change in UPSS correlated significantly inversely (P = 0.004).

Conclusions

High‐resolution sonography of peripheral nerves revealed multifocal nerve enlargement in MMN. Distinct enlargement patterns may support the diagnosis. Ultrasound findings did not correlate well with clinical severity or electrophysiological findings at initial presentation. As changes in UPSS correlated significantly with the clinical course in terms of muscle strength (MRCSS), sonographic assessment may represent a useful tool for therapeutic monitoring.
Neuronal decanoic acid oxidation is markedly lower than that of octanoic acid: A mechanistic insight into the medium‐chain triglyceride ketogenic diet
Authors: Khabbush Aziza , Orford Michael , Tsai Yi‐Chen , Rutherford Tricia , O'Donnell Maura , Eaton Simon , Heales Simon J. R.
Published: July 2017

Objective

The medium‐chain triglyceride (MCT) ketogenic diet contains both octanoic (C8) and decanoic (C10) acids. The diet is an effective treatment for pharmacoresistant epilepsy. Although the exact mechanism for its efficacy is not known, it is emerging that C10, but not C8, interacts with targets that can explain antiseizure effects, for example, peroxisome proliferator‐activated receptor‐γ (eliciting mitochondrial biogenesis and increased antioxidant status) and the α‐amino‐3‐hydroxy‐5‐methyl‐4‐isoxazolepropionic acid receptor. For such effects to occur, significant concentrations of C10 are likely to be required in the brain.

Methods

To investigate how this might occur, we measured the β‐oxidation rate of 13C‐labeled C8 and C10 in neuronal SH‐SY5Y cells using isotope‐ratio mass spectrometry. The effects of carnitine palmitoyltransferase I (CPT1) inhibition, with the CPT1 inhibitor etomoxir, on C8 and C10 β‐oxidation were also investigated.

Results

Both fatty acids were catabolized, as judged by 13CO2 release. However, C10 was β‐oxidized at a significantly lower rate, 20% that of C8. This difference was explained by a clear dependence of C10 on CPT1 activity, which is low in neurons, whereas 66% of C8 β‐oxidation was independent of CPT1. In addition, C10 β‐oxidation was decreased further in the presence of C8.

Significance

It is concluded that, because CPT1 is poorly expressed in the brain, C10 is relatively spared from β‐oxidation and can accumulate. This is further facilitated by the presence of C8 in the MCT ketogenic diet, which has a sparing effect upon C10 β‐oxidation.
Non‐myopic portfolio choice with unpredictable returns: The jump‐to‐default case
Authors: Battauz Anna , Sbuelz Alessandro
Published: July 2017

If a risky asset is subject to a jump‐to‐default event, the investment horizon affects the optimal portfolio rule, even if the asset returns are unpredictable. The optimal rule solves a non‐linear differential equation that, by not depending on the investor's pre‐default value function, allows for its direct computation. Importantly for financial planners offering portfolio advice for the long term, tiny amounts of constant jump‐to‐default risk induce marked time variation in the optimal portfolios of long‐run conservative investors. Our results are robust to the introduction of multiple non‐defaultable risky assets.
Reason for the transition of fatigue crack initiation site from surface to subsurface inclusions in high‐strength steels
Authors: Grad P. , Kerscher E.
Published: July 2017

The fatigue crack initiation in high‐strength steels at surface inclusions is linked to high stress amplitudes. Low stress amplitudes are associated with a crack initiation at subsurface inclusions. The aim of the paper is to gain insight regarding the factors that lead to the transition of the crack initiation site from the surface to the interior. On the basis of fatigue tests and fracture mechanics evaluation, it was determined that the transition of the crack initiation site is effected by a constant threshold value for crack initiation at the surface and different crack propagation rates at the surface as opposed to the interior. It is shown that with lower stress amplitudes no critical inclusions with stress intensity factors above this threshold value are positioned at the specimen's surface. Therefore, the cumulative number of inclusions on the surface is calculated based on the cumulative number of inclusions in a metallographic section.
Productivity influences trophic structure in a temporally forced aquatic ecosystem
Authors: Mazumder Debashish , Saintilan Neil , Wen Li , Kobayashi Tsuyoshi , Rogers Kerrylee
Published: July 2017

Previous studies on the relationship between ecosystem productivity, size and food‐chain length have been restricted to comparisons between locations.

We examined the effect of temporal variability in productivity on trophic structure of a floodplain ecosystem, hypothesising that during the wet‐flood pulses, the increased resource availability might lead to higher food‐chain lengths.

We examined multiple common sampling locations and species during a severe El Niño drought which followed a consecutive series of historically wet La Niña years, comparing trophic position and dietary sources.

While carbon stable isotopes showed no significant difference between the two phases, nitrogen stable isotopes indicated that most species were feeding higher in the food chain in the wet phase.

The results suggest that oscillations in climate phase‐driven changes have effects on food‐chain lengths through changes in productivity, without the introduction of new sources of carbon or changes to the composition of higher‐order predators.
Fiscal Equalization and Tax Enforcement
Authors: Bönke Timm , Schröder Carsten , Jochimsen Beate
Published: July 2017

In many countries organized as federations, fiscal equalization schemes have been implemented to mitigate vertical or horizontal imbalances. Such schemes usually imply that the member states of the federation can only partly internalize (marginal) tax revenue before redistribution. Aside from the internalized marginal revenue, referred to as the marginal tax-back rate, the remainder is redistributed. We investigate the extent to which state-level authorities in such federation under-exploit their tax bases. By means of a stylized model, we show that the member states have an incentive to align the effective tax rates on their residents with the level of the marginal tax-back rate. We empirically test the model using state-level and micro-level taxpayer data, OLS regressions and natural experiments. Our empirical findings support the results from our theoretical model. Particularly, we find that states with a higher marginal tax-back rate exploit the tax base to a higher extent.
Mobile Phones and Entrepreneurial Identity Negotiation by Urban Female Street Traders in Uganda
Authors: Masika Rachel
Published: July 2017

Mobile phones have been posited as enhancing women's entrepreneurship and gender equality in developing countries, yet empowerment outcomes are unclear. This article considers how women in the gender‐segregated informal economy construct their entrepreneurial identity in relation to mobile phones and the discursive repertoires that marginalize and empower. Using data from interviews with six urban female street traders in Kampala, Uganda, it explores how these repertoires illustrate their sense of self, positioning and belonging to the business community. Normative representations and positioning of female traders can sideline entrepreneurial identity and over‐validate gender identity. But, participants also negotiate entrepreneurial identity construction in response to these marginalizing influences. Although the data demonstrate that participants are equivocal about their entrepreneurial identity or fit in business, some representations are more validating and offer a sense of belonging. The article concludes by highlighting the nuanced opportunities for social change their discursive repertoires may present.
Comparison of Electrostatic and Non‐Electrostatic Models for U(VI) Sorption on Aquifer Sediments
Authors: Arora Bhavna , Davis James A. , Spycher Nicolas F. , Dong Wenming , Wainwright Haruko M.
Published: July 2017

A non‐electrostatic generalized composite surface complexation model (SCM) was developed for U(VI) sorption on contaminated F‐Area sediments from the U.S. Department of Energy Savannah River Site, South Carolina. The objective of this study was to test if a simpler, semi‐empirical, non‐electrostatic U(VI) sorption model (NEM) could achieve the same predictive performance as a SCM with electrostatic correction terms in describing U(VI) plume evolution and long‐term mobility. One‐dimensional reactive transport simulations considering key hydrodynamic processes, Al and Fe minerals, as well as H+ and U surface complexation, with and without electrostatic correction terms, were conducted. The NEM was first calibrated with laboratory batch H+ and U(VI) sorption data on F‐Area sediments, and then the surface area of the NEM was adjusted to match field observations of dissolved U(VI). Modeling results indicate that the calibrated NEM was able to perform as well as the previously developed electrostatic model in predicting the long‐term evolution of H+ and U(VI) at the site, given the variability of field‐site data. The electrostatic and NEM models yield somewhat different results for the time period when basin discharge was active; however, it is not clear which modeling approach may be better to model this early time period because groundwater quality data during this period were not available. A key finding of this study is that the applicability of NEM (and thus robustness of its predictions) to the field system evolves with time and is strongly dependent on the pH range that was used to develop the model.
Role of oxidative stress in melasma: a prospective study on serum and blood markers of oxidative stress in melasma patients
Authors: Choubey Vikrant , Sarkar Rashmi , Garg Vijay , Kaushik Smita , Ghunawat Sneha , Sonthalia Sidharth
Published: July 2017

Background

Melasma is a common pigmentary disorder presenting in the dermatological clinic. Many factors have been implicated in the pathogenesis, however, the cause still remains elusive. Recently the effect of oxidative damage has been proposed in the etiopathogenesis of melasma. This study was undertaken to evaluate the role of oxidative stress in patients with melasma.

Material and methods

Fifty patients with melasma, age 18 years of age and older, and an equal number of age and sex‐matched controls were included in the study. Baseline severity assessment using the modified Melasma Area and Severity Index (modified MASI score) was done in all patients. Serum malondialdehyde, blood superoxide dismutase, and blood glutathione peroxidase levels were measured in cases and controls group and results were compared.

Result

The serum levels of malondialdehyde, superoxide dismutase, and blood glutathione were significantly higher among the cases compared to controls. The difference in the serum concentrations was significant between the two groups (P < 0.01). A positive correlation was found between these enzyme levels and severity of melasma (modified MASI score); however, this correlation was statistically significant with serum malondialdehyde only. The level of oxidative stress among the male and female melasma patients was not statistically different.

Conclusion

Oxidative stress was found to be increased in cases of melasma compared to the control group in this study. This substantiates the role of oxidative stress in etiopathogenesis of melasma; however, further studies are required to reach a definitive conclusion.
Governing the coordination of care for older people: Comparing care agreements in Denmark and Norway
Authors: Vabo Signy Irene , Burau Viola
Published: July 2017

Increasing specialisation and demands to decrease the length of hospital stays have important consequences for the integration of specialised health and local care services. Based on case studies of care agreements in Denmark and Norway, this article compares subnational governance strategies for coordinating care services for older people discharged from hospitals. The question is how, and to what degree, national government regulations have an impact on local service coordination strategies. The analysis reveals that the numerous subnational procedures for coordination are somewhat more itemised in Denmark, and that regional variation in care agreements is greater in Norway. The identified differences can partly be accounted for by national differences in regulation, which is tighter in Denmark than in Norway. The study suggests that despite decentralisation of responsibility, subnational procedures to facilitate coordination are heavily influenced by national government policy.
Wealth‐to‐Income Ratio and Stock Market Movements: Evidence from a Nonparametric Causality Test
Authors: Balcilar Mehmet , Gupta Rangan , Sousa Ricardo M. , Wohar Mark E.
Published: July 2017

We use a nonparametric causality‐in‐quantile test to analyze the predictive ability of the wealth‐to‐income ratio (wy) for excess stock returns and their volatility. Our results reveal that the wy is nonlinearly related with excess stock returns, and hence, results from linear Granger causality tests cannot be deemed robust. When we apply the nonparametric causality‐in‐quantile test, we find that the wy can predict excess stock returns over the majority of the conditional distribution, with the exception being the extreme ends, that is, when the market is in deep bear or bull phases. However, the wy has no predictability for the volatility of excess stock returns.
Chronic periodontitis is associated with platelet factor 4 (PF4) secretion: A pilot study
Authors: Brousseau‐Nault Mathieu , Kizhakkedathu Jayachandran N. , Kim Hugh
Published: July 2017

Aim

Platelets contribute to chronic inflammation, but their role in periodontitis is not well understood. The aim of this study was to compare platelet recruitment and activation in healthy and inflamed periodontium.

Materials and Methods

Gingival crevicular fluid (GCF) samples were obtained from sites of healthy periodontium, gingivitis and periodontitis. Platelets were quantified in the GCF by staining and microscopy. GCF concentrations of platelet factor 4 (PF4) [PF4]GCF and glycoprotein IIbIIIa ([GPIIbIIIa]GCF) were determined by ELISA. Blood samples were obtained from the three patient groups. Platelets were isolated from whole blood and stimulated with lipopolysaccharide (LPS) from Porphyromonas gingivalis to evaluate and compare the LPS‐induced PF4 release.

Results

Compared to controls, platelet recruitment was increased at gingivitis and periodontitis sites, based on platelet counts and [GPIIbIIIa]GCF. [PF4]GCF was elevated in periodontal pockets but not at gingivitis or healthy sites. Circulating plasma levels of PF4 were higher in patients with generalized severe periodontitis (SP), compared to patients with gingivitis or healthy periodontium. Platelets isolated from SP patients contained and released more PF4 in response to P. gingivalis LPS than platelets from gingivitis or periodontally healthy patients.

Conclusions

Periodontitis is associated with increased platelet activation and PF4 release, both locally and systemically.
Endodontic treatment of dens evaginatus by performing a splint guided access cavity
Authors: Mena‐Álvarez Jesús , Rico‐Romano Cristina , Lobo‐Galindo Ana Belén , Zubizarreta‐Macho Álvaro
Published: July 2017

Aim

Dens evaginatus (DE) is described as an unusual dental malformation. Tooth structure variations attached to this anatomical disturbance complicates the performance of a conservative access cavity for a conventional root canal treatment. Author's purpose is to describe the treatment of a type V DE by using splits as guides to perform access cavity.

Clinical considerations

This clinical case shows a root canal treatment of a type V DE diagnosed by using a cone beam computed tomography (CBCT). Access cavity was planned through an osseointegrated implant planning software and guided by a stereolithographied split. After endodontic treatment, tooth was sculpted for placing a veneer, processed by a chair‐side system in a single session.

Conclusions

CBCT is an effective method for obtaining internal anatomical information of teeth with anatomical malformations. The osseointegrated implant planning software is an effective method for planning root canal treatment and designing stereolithograped splits (for performing minimally invasive access cavities).

CLINICAL SIGNIFICANCE

Stereolithographed splints allow performing a guided and conservative access cavity of teeth affected by dental malformations whereas digital technology allows us to esthetically reconstruct a tooth in a single session.
Need to Recalibrate Research Outcomes in Alzheimer's Disease: Focus on Neuropsychiatric Symptoms
Authors: Canevelli Marco , Cesari Matteo , Lucchini Flaminia , Valletta Martina , Sabino Michele , Lacorte Eleonora , Vanacore Nicola , Bruno Giuseppe
Published: July 2017

Objectives

To determine whether neuropsychiatric symptoms (NPSs) are adequately considered in clinical research on Alzheimer's disease (AD).

Design

Systematic review.

Setting

Randomized controlled trials (RCTs) recruiting individuals with AD and published during the last 10 years in 16 major general medicine, neurology, psychiatry, and geriatric psychiatry journals and RCTs registered on clinicaltrials.gov and currently enrolling individuals with AD.

Participants

Individuals with AD.

Measurements

Outcome measures adopted by the included studies.

Results

Only 21.4% of the included studies identified through the bibliographic searches had measures of NPSs as a primary outcome. Only 17.7% of the studies retrieved on clinicaltrials.gov made a specific effort to test the effect of pharmacological or nonpharmacological interventions on NPSs.

Conclusion

These findings show how rarely previous and current research on AD has considered NPSs as primary research targets. Although these symptoms are widely recognized as the most‐stressful and ‐challenging manifestations of dementia, they are addressed much less often than other research targets.
Supportive care needs of patients with amyotrophic lateral sclerosis/motor neuron disease and their caregivers: A scoping review
Authors: Oh Juyeon , Kim Jung A
Published: July 2017

Aims and objectives

To identify the supportive care needs of amyotrophic lateral sclerosis/motor neuron disease patients and their caregivers, categorise and summarise them into a Supportive Care Needs Framework and identify gaps in literature.

Background

Little is known about the supportive care needs of amyotrophic lateral sclerosis/motor neuron disease patients and their caregivers, and this subject has not previously been systemically reviewed.

Design

Scoping review.

Methods

We conducted a scoping review from the MEDLINE, EMBASE, CINAHL and Cochrane databases for the period January 2000–July 2016, using the following inclusion criteria: (i) written in English only, (ii) published in peer‐reviewed journals, (iii) at least part of the research considered the supportive care needs perspective of amyotrophic lateral sclerosis/motor neuron disease patients or their caregivers and (iv) the population sample included patients of amyotrophic lateral sclerosis/motor neuron disease or their caregivers.

Results

Thirty‐seven articles were included. Our review shows that amyotrophic lateral sclerosis/motor neuron disease patients and their caregivers’ supportive care needs were mentioned across all seven domains of the Supportive Care Needs Framework. Most common were practical needs (n = 24), followed by Informational needs (n = 19), Social needs (n = 18), Psychological needs (n = 16), Physical needs (n = 15), Emotional needs (n = 13) and Spiritual needs (n = 8).

Conclusion

From the perspectives of amyotrophic lateral sclerosis/motor neuron disease patients and their caregivers, there is a significant need for more practical, social, informational, psychological, physical, emotional and spiritual support.

Relevance to clinical practice

The Supportive Care Needs Framework has potential utility in the development of patient‐centred support services or healthcare policies and serves as an important base for further studies; especially, specific examples of each supportive care needs domain can guide in clinical settings when healthcare professionals provide multidisciplinary care to amyotrophic lateral sclerosis/motor neuron disease patients and individualised care.
Impact of immunosuppressive therapy on therapy‐neutralizing antibodies in transplanted patients with Fabry disease
Authors: Lenders M. , Oder D. , Nowak A. , Canaan‐Kühl S. , Arash‐Kaps L. , Drechsler C. , Schmitz B. , Nordbeck P. , Hennermann J. B. , Kampmann C. , Reuter S. , Brand S.‐M. , Wanner C. , Brand E.
Published: July 2017

Background

Inhibitory antibodies towards enzyme replacement therapy (ERT) are associated with disease progression and poor outcome in affected male patients with lysosomal disorders such as Fabry disease (FD). However, little is known about the impact of immunosuppressive therapy on ERT inhibition in these patients with FD.

Methods

In this retrospective study, we investigated the effect of long‐term immunosuppression on ERT inhibition in male patients with FD (n = 26) receiving immunosuppressive therapy due to kidney (n = 24) or heart (n = 2) transplantation.

Results

No ERT‐naïve transplanted patient (n = 8) developed antibodies within follow‐up (80 ±72 months) after ERT initiation. Seven (26.9%) patients were tested ERT inhibition positive prior to transplantation. No de novo ERT inhibition was observed after transplantation (n = 18). In patients treated with high dosages of immunosuppressive medication such as prednisolone, tacrolimus and mycophenolate‐mofetil/mycophenolate acid, ERT inhibition decreased after transplantation (n = 12; P = 0.0160). Tapering of immunosuppression (especially prednisolone) seemed to re‐increase ERT inhibition (n = 4, median [range]: 16.6 [6.9; 36.9] %; P = 0.0972) over time. One ERT inhibition‐positive patient required interventions with steroid therapy and increased doses of tacrolimus, which also lowered ERT inhibition.

Conclusion

We conclude that the immunosuppressive maintenance therapy after transplantations seems to be sufficient to prevent de novo ERT inhibition in ERT‐naïve patients. Intensified high dosages of immunosuppressive drugs are associated with decreased antibody titres and decreased ERT inhibition in affected patients, but did not result in long‐term protection. Future studies are needed to establish ERT inhibition‐specific immunosuppressive protocols with long‐term modulating properties to warrant an improved disease course in ERT inhibition‐positive males.
Plasma levels of hepatocyte growth factor and placental growth factor predict mortality in a general population: a prospective cohort study
Authors: Santalahti K. , Havulinna A. , Maksimow M. , Zeller T. , Blankenberg S. , Vehtari A. , Joensuu H. , Jalkanen S. , Salomaa V. , Salmi M.
Published: July 2017

Background

Circulating levels of growth factors involved in leucocyte production and angiogenesis could be indicative of underlying aberrations of tissue homeostasis and therefore be utilized as predictors of risk for all‐cause cardiovascular disease (CVD) or cancer mortality.

Methods

Baseline plasma levels of a range of growth factors were measured in two cohorts of the population‐based FINRISK study (1997 Discovery cohort, N = 8444, aged 25–74; 2002 Replication cohort, N = 2951, aged 51–74 years) using a multiplexed bead array methodology and ELISA. Participants were followed up by linking them to registry data.

Results

In the Discovery cohort (653 deaths; 216 CVD‐related, 231 cancer‐related), fully adjusted Cox proportional hazard regression models showed that increased plasma hepatocyte growth factor (HGF) and placental growth factor (PlGF) were associated with higher risk of 10‐year mortality (HR, 1.29 [95% confidence interval (CI), 1.18–1.41] and HR, 1.23 [95% CI, 1.14–1.32], respectively). In the Replication cohort (259 deaths; 83 CVD‐related, 90 cancer‐related), baseline HGF levels also predicted all‐cause mortality (HR, 1.2 [95% CI, 1.08–1.32]; PlGF data not available). By including HGF levels in a CVD mortality model, 9% of all CVD deaths were correctly reclassified in the Discovery cohort (categorical net reclassification improvement [NRI] for events, P = 4.0 × 10−4). Moreover, adding HGF to all‐cause and CVD mortality models resulted in an overall clinical NRI of 0.10–0.18 in the Discovery cohort and meta‐analyses (P < 0.05 for all tests).

Conclusion

Blood levels of HGF and PlGF may serve as new biomarkers for predicting increased risk of death in the general population.
Does the presence of an occlusal indicator product affect the contact forces between full dentitions?
Authors: Mitchem J. A. , Katona T. R. , Moser E. A. S.
Published: July 2017

Studies have explored occlusal marking interpretation, repeatability and accuracy. But, when an occlusion detection product is interposed between teeth, direct tooth–tooth occlusal contact relationships are replaced by tooth‐material‐tooth structures. Thus, the marks cannot reflect the original contacts. This has been shown for single tooth pair contacts. The purpose of this laboratory study was to similarly examine full dentitions. A dentiform was set into Class I centric occlusion with the mandible supported by a load cell. The maxillary arch was guided by precision slides. As the weighted (~52 N) upper assembly was lowered onto and raised off the mandibular arch, the loads on the mandible were measured. With and without (control) occlusal marking material, the steps were as follows: (cleaning – control 1 – material 1) … (cleaning – control 6 – material 6). The six materials were as follows: Accufilm I and II, Rudischhauser Thick and Thin, Hanel Articulating Silk and T‐Scan. Then, the six sets of (cleaning – control – material) measurements were repeated with the mandibular assembly shifted, in turn, by 0·1 mm in the Anterior, Posterior, Right and Left directions. The five (Centric and four 0·1 mm shifted) occlusal relationships produced grossly different tooth–tooth (control) load profiles. And, in general, these controls were affected, in different ways, by the marking products. Among the five conventional products, the Rudischhausers fared the worst and the electronic T‐Scan was an extreme outlier. Thus, in general, popular occlusal detection products alter the occlusal contact forces, and therefore, their markings cannot characterise the actual occlusion.
Effect of Functional Chewing Training on tongue thrust and drooling in children with cerebral palsy: a randomised controlled trial
Authors: Inal Ö. , Serel Arslan S. , Demir N. , Tunca Yilmaz Ö. , Karaduman A. A.
Published: July 2017

Tongue thrust, which is an oral reflex associated with sucking behaviour, may cause problems in swallowing, speech, oro‐facial development and also drooling. We aimed to examine the effect of Functional Chewing Training (FuCT) on tongue thrust and drooling in children with cerebral palsy. The study included 32 children with a mean age of 58·25 ± 9·58 months who had tongue thrust. Children were divided into two groups: the FuCT group and control group receiving classical oral motor exercises. Each group received training for 12 weeks. Oral motor assessment was performed. Chewing performance level was determined with the Karaduman Chewing Performance Scale. Tongue thrust severity was evaluated with the Tongue Thrust Rating Scale. The Drooling Severity and Frequency Scale was used to evaluate drooling severity and frequency. The evaluations were performed before and after treatment. Groups were well matched in age, gender and oral motor assessment. No significant difference was found between groups in terms of pre‐treatment chewing function, tongue thrust severity, drooling severity and frequency (P > 0·05). The FuCT group showed improvement in chewing performance (P = 0·001), tongue thrust severity (P = 0·046) and drooling severity (P = 0·002), but no improvement was found in terms of drooling frequency (P = 0·082) after treatment. There was no improvement in chewing performance, tongue thrust, drooling severity and frequency in the control group. A significant difference was found between groups in favour of FuCT group in tongue thrust severity (P = 0·043). This study showed that the FuCT is an effective approach on the severity of tongue thrust and drooling in children with CP.
The Digital Revolution, 3D Printing, and Innovation as Data
Authors: Rindfleisch Aric , O'Hern Matthew , Sachdev Vishal
Published: July 2017

The digital revolution has created a data‐rich environment. Increasingly, firms are seeking to acquire and analyze a variety of consumer data such as online shopping, social media, and web browsing behavior to enhance their innovation activities. This approach is termed “Innovation from Data.” At the same time, a growing number of consumers are gaining the ability to transform digital data into innovative physical products through the use of new tools such as audio and video editing software and 3D printing technology. This approach is termed “Innovation as Data.” These two approaches differ substantially in terms of their views on the role of consumers, the relevance of firms, and the nature of products. This article introduces the concept of Innovation as Data and discusses its relation to the digital revolution in general and 3D printing in particular. In addition, it offers a set of recommendations for managers seeking to leverage this new innovation approach and ideas for scholars interested in researching this intriguing domain.
The coralline genera Sporolithon and Heydrichia (Sporolithales, Rhodophyta) clarified by sequencing type material of their generitypes and other species
Authors: Richards Joseph L. , Sauvage Thomas , Schmidt William E. , Fredericq Suzanne , Hughey Jeffery R. , Gabrielson Paul W.
Published: July 2017

Interspecific systematics in the red algal order Sporolithales remains problematic. To re‐evaluate its species, DNA analyses were performed on historical type material and recently collected specimens assigned to the two genera Sporolithon and Heydrichia. Partial rbcL sequences from the lectotype specimens of Sporolithon ptychoides (the generitype species) and Sporolithon molle, both from El Tor, Egypt, are exact matches to field‐collected topotype specimens. Sporolithon crassum and Sporolithon erythraeum also have the same type locality; material of the former appears to no longer exist, and we were unable to PCR amplify DNA from the latter. A new species, Sporolithon eltorensis, is described from the same type locality. We have not found any morpho‐anatomical characters that distinguish these three species. No sequenced specimens reported as S. ptychoides from other parts of the world represent this species, and likely reports of S. ptychoides and S. molle based on morpho‐anatomy are incorrect. A partial rbcL sequence from the holotype of Sporolithon dimotum indicates it is not a synonym of S. ptychoides, and data from the holotype of S. episporum confirm its specific recognition. DNA sequences from topotype material of Heydrichia woelkerlingii, the generitype species, and isotype material of Heydrichia cerasina confirm that these are distinct species; the taxon reported to be H. woelkerlingii from New Zealand is likely an undescribed species. Type specimens of all other Sporolithon and Heydrichia species need to be sequenced to confirm that they are distinct species; morpho‐anatomical studies have proved inadequate for this task.
Work for Passion or Money? Variations in Artists’ Labor Supply
Authors: Bille Trine , Løyland Knut , Holm Anders
Published: July 2017

This paper assesses the relative impact of work for money or work for passion on Norwegian artists by examining artists’ labor supply. Our contribution is twofold. The first is to test the work‐preference model and the second is to investigate the impact of arts grants on artists’ labor supply. The empirical specification draws two distinctions: between arts and non‐arts income and between labor and non‐labor income. Non‐labor income is divided into three different sources: (1) spouse's income, (2) income from financial assets and social benefits, and (3) arts grants and subsidies. Our contribution adds to the literature by estimating the significance of these various income sources on the time allocated to arts work, non‐arts work, and leisure. The results provide convincing evidence for the work‐preference model, and ad hoc evidence shows that art grants have a significant positive effect on the supply of arts hours. This finding supports arts policy and shows the impact of art grants on artists’ motivation to work on their arts. The causality of wages on supply is demonstrated by estimating the effects of wage shocks (grants) on arts labor supply using fixed‐effect and difference‐in‐difference methods.
Dissociated recovery between dementia and parkinsonism by transvenous embolization of recurrent dural arteriovenous fistula
Authors: Nakano Yumiko , Nomura Emi , Hiramatsu Masafumi , Takemoto Mami , Sato Kota , Hishikawa Nozomi , Yamashita Toru , Ohta Yasuyuki , Sugiu Kenji , Date Isao , Abe Koji
Published: July 2017

Dementia and parkinsonism are rarely observed in dural arteriovenous fistula. Here, we report a case of a 63‐year‐old man with recurrent dural arteriovenous fistula, who developed progressive dementia and parkinsonism as a result of a dural arteriovenous fistula at the torcular herophili. A sinus thrombosis induced the abnormal cortical venous reflux from the isolated straight sinus, resulting in the deep venous congestion of the thalamus and basal ganglia, which led to dementia and parkinsonism. However, the third endovascular embolization ameliorated memory disturbance and apathy with a slight improvement of parkinsonism. Although recoveries from dural arteriovenous fistula‐associated neurological deficits are variable depending on the severity, duration and, furthermore, selective vulnerability of the responsible ischemic lesions, early treatment should be essential for better recovery.
Diagnostic use of endoscopic full‐thickness wall resection (eFTR)—a novel minimally invasive technique for colonic tissue sampling in patients with severe gastrointestinal motility disorders
Authors: Valli P. V. , Pohl D. , Fried M. , Caduff R. , Bauerfeind P.
Published: July 2017

Background

Complex gastrointestinal (GI) motility disorders such as chronic intestinal pseudo‐obstruction (CIPO) or Hirschsprung's disease (HD) are challenging to diagnose and treat appropriately. Thorough assessment of patient history, radiographic exams, endoscopy, and motility measurements aid in diagnostic workup, yet underlying histology is the cornerstone to enable a more distinct diagnosis of neuromuscular GI disorders. Traditionally, surgical procedures have been performed to obtain specimen suitable for accurate histologic analysis.

Methods

We performed endoscopic full‐thickness resection (eFTR) using a full‐thickness‐resection device (FTRD) under moderate propofol sedation in four patients with suspected severe neuromuscular gut disorders including CIPO.

Key Results

The mean age of the four patients was 43 y (range 19‐56 y). Technical and histological success providing large colonic full‐thickness tissue samples of excellent quality was achieved in all four patients (success rate 100%). The mean procedure time was 12 min (range 5‐20 min). The mean diameter of the resected specimen was 21 mm (range 20‐22 mm). No adverse events connected to the procedure itself occurred. Histology ranged from aganglionosis such as Hirschsprung's disease (HD) to hypoganglionosis and eosinophilic leiomyositis combined with lymphocytic ganglionitis in a third patient. Histology was unspecific in one patient.

Conclusion and Inferences

EFTR allows safe and minimal invasive harvesting of ample full‐thickness tissue samples for accurate histological analysis in patients with suspicion of neuromuscular gut disorders.