bluuebunny/crossref_metadata_2025 huggingface dataset:
Absorption, Distribution and Excretion of Four Forms of Titanium Dioxide Pigment in the Rat
Authors: Farrell Thomas P. , Magnuson Berna
Published: June 2017

Titanium dioxide (TiO2) is a white color additive that has a long history of global approval and use in food. There is, however, considerable confusion regarding the applicability of the biological effects of novel, engineered, nano‐sized forms of TiO2 developed for nonpigmentary applications to the safety of oral exposure to food grade TiO2 pigment. The objective of this study was to assess the absorption, distribution, and routes of excretion in rats after oral exposure to food grade TiO2.

Four different grades of TiO2 (200 ppm) or control (0 ppm) diets were fed to rats for 7 consecutive days, followed by control diet only for 1, 24, or 72 h.

Concentrations of titanium in liver, kidney and muscle were mainly below the limit of detection (<0.1 to < 0.2 mg/kg wet weight); tissue concentrations of titanium above the LOD were in the range of 0.1 to 0.3 mg/kg wet weight for all groups. Whole blood concentrations of titanium were <0.04 mg/L for all groups. Urinary excretion of titanium was equivalent to <2% daily dose/L of urine for all groups and was generally below the limit of quantification (<0.04 mg/L). Feces represented the predominant route of excretion. These results demonstrate that there is no accumulation of titanium in tissues following consumption of diets containing 200 ppm food grade TiO2. No differences in systemic absorption of the 4 forms of TiO2 were observed indicating that the bioavailability of TiO2 is consistently low for the range of particle sizes and morphologies examined in this study.
Drug repurposing for aging research using model organisms
Authors: Ziehm Matthias , Kaur Satwant , Ivanov Dobril K. , Ballester Pedro J. , Marcus David , Partridge Linda , Thornton Janet M.
Published: June 2017

Many increasingly prevalent diseases share a common risk factor: age. However, little is known about pharmaceutical interventions against aging, despite many genes and pathways shown to be important in the aging process and numerous studies demonstrating that genetic interventions can lead to a healthier aging phenotype. An important challenge is to assess the potential to repurpose existing drugs for initial testing on model organisms, where such experiments are possible. To this end, we present a new approach to rank drug‐like compounds with known mammalian targets according to their likelihood to modulate aging in the invertebrates Caenorhabditis elegans and Drosophila. Our approach combines information on genetic effects on aging, orthology relationships and sequence conservation, 3D protein structures, drug binding and bioavailability. Overall, we rank 743 different drug‐like compounds for their likelihood to modulate aging. We provide various lines of evidence for the successful enrichment of our ranking for compounds modulating aging, despite sparse public data suitable for validation. The top ranked compounds are thus prime candidates for in vivo testing of their effects on lifespan in C. elegans or Drosophila. As such, these compounds are promising as research tools and ultimately a step towards identifying drugs for a healthier human aging.
Adherence to Standards for Reporting Diagnostic Accuracy in Emergency Medicine Research
Authors: Gallo Lucas , Hua Nadia , Mercuri Mathew , Silveira Angela , Worster Andrew ,   Best Evidence in Emergency Medicine (BEEM; beem.ca)
Published: June 2017

Background

Diagnostic tests are used frequently in the emergency department (ED) to guide clinical decision making and, hence, influence clinical outcomes. The Standards for Reporting of Diagnostic Accuracy (STARD) criteria were developed to ensure that diagnostic test studies are performed and reported to best inform clinical decision making in the ED.

Objective

The objective was to determine the extent to which diagnostic studies published in emergency medicine journals adhered to STARD 2003 criteria.

Methods

Diagnostic studies published in eight MEDLINE‐listed, peer‐reviewed, emergency medicine journals over a 5‐year period were reviewed for compliance to STARD criteria.

Results

A total of 12,649 articles were screened and 114 studies were included in our study. Twenty percent of these were randomly selected for assessment using STARD 2003 criteria. Adherence to STARD 2003 reporting standards for each criteria ranged from 8.7% adherence (criteria—reporting adverse events from performing index test or reference standard) to 100% (multiple criteria).

Conclusion

Just over half of STARD criteria are reported in more than 80% studies. As poorly reported studies may negatively impact their clinical usefulness, it is essential that studies of diagnostic test accuracy be performed and reported adequately. Future studies should assess whether studies have improved compliance with the STARD 2015 criteria amendment.
Independent housing and support for people with severe mental illness: systematic review
Authors: Richter D. , Hoffmann H.
Published: June 2017

Objective

To systematically explore the outcomes of Independent Housing and Support (IHS) for people with severe mental disorders when compared to other residential settings.

Method

Systematic review of Randomised and Non‐Randomised Controlled Trials of publications that analyse the outcomes of living in independent settings versus institutionalised accommodation. Risk of bias assessment was adapted from the Cochrane Collaboration's ACROBAT‐Tool. The analysis was conducted separately for publications with homeless and non‐homeless people.

Results

Twenty‐four publications from studies with homeless people and eight publications from studies with non‐homeless people were included. Risk of bias was much lower in studies with the homeless. No RCT was found in the sample of publications with the non‐homeless. Overall, results from Independent Housing and Support‐settings are not inferior to results from institutionalised settings.

Conclusion

The results indicate that Independent Housing and Support‐settings provide at least similar outcomes than residential care. We propose that clients’ preferences should determine the choice of housing setting.
An unusual case of dental infection by Pseudomonas aeruginosa causing a brain abscess: case report
Authors: Pereira RS , Bonardi JP , Ferreira ACD , Latini GL
Published: June 2017

A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23 year old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis. Antibiotics and analgesics were prescribed to treat the disease. However, after 10 days, she returned to the emergency room, presenting with proptosis of the right eyeball, subconjunctival haemorrhage, ophthalmoplegia and intense pain in the right orbit, in addition to headaches. After computed tomography was performed, she was diagnosed with a brain abscess in the frontal lobe with the involvement of the maxillary right first molar, the maxillary sinus, the ethmoid sinus and the orbital cavity. With culturing of the secretion, the growth of Pseudomonas aeruginosa colonies was evident. Treatment consisted of a craniotomy to drain the brain abscess, a Caldwell–Luc procedure to drain the right maxillary sinus, dental extraction and aggressive antibiotic therapy. After 6 weeks, the patient was discharged with no neurological sequelae.
Multiple external cervical root resorptions after home whitening treatment: a case report
Authors: Velloso GR , de Freitas MM , Alves ATNN , Silva ARS , Barboza ESP , Moraschini V
Published: June 2017

Invasive multiple cervical root resorptions after vital tooth bleaching is a rare condition. The aim of this article is to present a case of multiple external cervical root resorptions (ECRR) after a misguided home whitening treatment. A 34 year old male patient presented with slight sensitivity and mobility in several teeth. Despite the manufacturer's recommendations, the patient used a 22% carbamide peroxide‐based tooth bleaching gel at home for 4 days consecutively, at night, on the upper and lower arches. Clinical examination revealed gingival swelling, probing depths ranging 5–7 mm on the buccal and proximal surfaces, and grade 2 mobility of the teeth affected by ECRR. Radiographs revealed presence of ECRR in several teeth during initial examination, and development of multiple new lesions 6 months later. The teeth were subsequently extracted. Histological analysis showed multiple dentine lacunae and areas of dentine reparation. The careful use of these products can prevent sequelae such as those reported in this clinical case. As the vital bleaching has a variable success rate, patients should be informed through a consent form of the benefits and risks of tooth bleaching treatment.
Can spruce beetle (Dendroctonus rufipennisKirky) pheromone trap catches or stand conditions predict Engelmann spruce (Picea engelmanniiParry ex Engelm.) tree mortality in Colorado?
Authors: Negrón José F. , Popp John B.
Published: June 2017

Bark beetles (Coleoptera: Curculionidae: Scolytinae) can cause extensive tree mortality in forests dominated by their hosts. Among these, the spruce beetle (Dendroctonus rufipennis) is one of the most important beetles in western North America causing Engelmann spruce (Picea engelmannii) tree mortality.

Although pheromone traps with attractants are commonly used to monitor spruce beetle populations, the relationship between the numbers of beetles caught in pheromone traps and subsequent tree mortality has not been investigated adequately.

We used pheromone traps to catch spruce beetles in plots throughout the insect flight period, quantified subsequent tree mortality, and modelled spruce tree mortality as a function of spruce beetle trap catches and stand conditions.

The number of beetles caught was not different between years. It was also positively associated with tree mortality, as was the amount of available host. The year of sampling was significant in all models as a result of different mortality levels between years.

We conclude that, although the models had good fit, the difference in mortality between the years with a similar beetle catch negates reliable estimates of tree mortality across years. Managers and forest health specialists will be better served by continued monitoring of spruce beetle populations with pheromone traps and the use of stand variables to identify susceptible stands.
Molecular Characterisation of α‐ and β‐Thalassaemia among Indigenous Senoi Orang Asli Communities in Peninsular Malaysia
Authors: Koh Danny Xuan Rong , Raja Sabudin Raja Zahratul Azma , Mohd Yusoff Malisa , Hussin Noor Hamidah , Ahmad Rahimah , Othman Ainoon , Ismail Endom
Published: June 2017

Thalassaemia is a public health problem in Malaysia, with each ethnic group having their own common mutations. However, there is a lack on data on the prevalence and common mutations among the indigenous people. This cross‐sectional study was performed to determine the common mutations of α‐ and β‐thalassaemia among the subethnic groups of Senoi, the largest Orang Asli group in Peninsular Malaysia. Blood samples collected from six Senoi subethnic groups were analysed for full blood count and haemoglobin analysis (HbAn). Samples with abnormal findings were then screened for α‐ and β‐globin gene mutations. Out of the 752 samples collected, 255 showed abnormal HbAn results, and 122 cases showing abnormal red cell indices with normal HbAn findings were subjected to molecular screening. DNA analysis revealed a mixture of α‐ and β‐globin gene mutations with 25 concomitant cases. The types of gene abnormalities detected for α‐thalassaemia were termination codon (T>C) Hb CS (αCSα), Cd59 (G>A) haemoglobin Adana (Hb Adana) (αCd59α), initiation codon (ATG>A‐G) (αIniCdα), two‐gene deletion (–SEA), and single‐gene 3.7‐kb deletion (‐α3.7). For β‐thalassaemia, there were Cd26 (G>A) Hb E (βE), Cd19 (A>G) Haemoglobin Malay (Hb Malay) (βCd19), and IVS 1–5 (G>C) (βIVS 1–5).
Meaningful use of computers has a potential therapeutic and preventative role in dementia care: A systematic review
Authors: Liapis Jimmy , Harding Katherine E
Published: June 2017

Objective

Personal computers provide an increasingly accessible resource for leisure, social engagement and activities of daily living. This systematic review aimed to explore preventative or therapeutic benefits of such technology in people at risk of, or living with, dementia.

Methods

A systematic search of health databases combined key concepts of dementia and computer use. Inclusion criteria were applied, studies appraised for quality and results synthesised descriptively.

Results

Nine studies met inclusion criteria: Four population‐based studies and five small observational/intervention studies. Findings show an association between computer use in older age and decreased risk of dementia and provide preliminary evidence that computer‐based activity interventions are feasible and enjoyable for people with dementia.

Conclusion

Early findings are promising, but more rigorous studies are required to examine the nature of the relationship between computer use and dementia risk, and the potential of computer activities to improve outcomes for people experiencing cognitive decline.
Effects of Intradialytic Neuromuscular Electrical Stimulation on Strength and Muscle Architecture in Patients With Chronic Kidney Failure: Randomized Clinical Trial
Authors: Schardong Jociane , Dipp Thiago , Bozzeto Camila Bassani , da Silva Marília Godoy , Baldissera Gabriela Leivas , Ribeiro Raíssa de Castro , Valdemarca Bruna Pan , do Pinho Alexandre Severo , Sbruzzi Graciele , Plentz Rodrigo Della Méa
Published: June 2017

This study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) on muscle strength and architecture, functional capacity, and endothelial function in patients with chronic kidney failure (CKF) on hemodialysis (HD). Twenty‐one patients with CKF on HD were randomized into a control group (CG; n = 10) and neuromuscular electrical stimulation group (NMESG; n = 11) who received NMES in the quadriceps muscle for 8 weeks, 3 times/week (20–34 min) during HD sessions. The muscle strength of the lower limbs was evaluated by dynamometry and sit‐and‐stand test (SST); muscle architecture through ultrasonography; functional capacity by the distance covered in a 6‐min walk test and the endothelial function by flow‐mediated dilatation technique of the brachial artery. There was an increase in the strength of the lower limbs in the NMESG compared to the CG (dynamometry: 43.28 ± 16.94 vs. 35.84 ± 16.89, P = 0.006; SST: 16.10 ± 6.51 vs. 12.50 ± 4.7, P = 0.029). There was a significant reduction in pennation angles of the right vastus lateralis (RVL) and left vastus lateralis (LVL) in the CG when compared to the NMESG (RVL: 11.93 [10.70–15.11] vs. 13.57 [11.81–15.96], P = 0.039; LVL: 11.62 [9.00–14.20] vs. 15.52 [12.86–20.02], P = 0.042). There was no change in functional capacity and in the endothelial function for CG and NMESG, respectively. In conclusion, NMES increases muscle strength and has a protective effect against muscle atrophy of the lower limbs of patients with chronic kidney failure on HD.
Enhanced Skin Regeneration by Herbal Extract‐Coated Poly‐L‐Lactic Acid Nanofibrous Scaffold
Authors: Jouybar Aytak , Seyedjafari Ehsan , Ardeshirylajimi Abdolreza , Zandi‐Karimi Ali , Feizi Nikta , Khani Mohammad‐Mehdi , Pousti Iraj
Published: June 2017

The wound healing process is directly related to the type of treatment. Existing methods of treatment are not responsive enough for severe wounds. The aim of this study was the potential capacity investigation of poly‐L‐lactic acid (PLLA) nanofibrous scaffolds coated by aloe vera gel for wound dressing applications. In this study, electrospinning method was used for preparing PLLA nanofibers, and after characterization by SEM and MTT, its influence on the wound healing process was investigated with and without aloe vera gel as a wound dressing in full‐thickness skin defect in mice. Band‐Aids were used as a positive control and vaseline gauze as a negative control. SEM and MTT assays confirmed the nanometer size and biocompatibility of fabricated nanofibers. Macroscopic and histopathological characteristics were evaluated at the end of days 7, 12, and 17 and their results showed that the gel‐coated scaffold accelerated the wound‐healing process compared with other groups. At the end of the experiment, it was shown that during the whole time of study, gel‐coated scaffold had the highest overall repair score. Therefore, gel‐coated PLLA scaffold would be an ideal construct for wound healing and skin regenerative medicine application.
Exercise Capacity and Functional Performance in Heart Failure Patients Supported by a Left Ventricular Assist Device at Discharge From Inpatient Rehabilitation
Authors: Schmidt Thomas , Bjarnason‐Wehrens Birna , Bartsch Petra , Deniz Ezin , Schmitto Jan , Schulte‐Eistrup Sebastian , Willemsen Detlev , Reiss Nils
Published: June 2017

Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self‐determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted. The results from 68 LVAD patients (59 males, 9 females; 55.9 ± 11.7 years; 47 HVAD, 2 MVAD, 15 HeartMate II, 4 HeartMate 3, and 4 different implanting centers) were included in the analysis. Exercise capacity was assessed using a cardiopulmonary exercise test on a bicycle ergometer (ramp protocol; 10 W/min). The 6‐min walk test was used to determine functional performance. At discharge from CR (53 ± 17 days after implantation), the mean peak work load achieved was 62.2 ± 19.3 W (38% of predicted values) or 0.79 ± 0.25 W/kg body weight. The mean cardiopulmonary exercise capacity (relative peak oxygen uptake) was 10.6 ± 5.3 mL/kg/min (37% of predicted values). The 6‐min walk distance improved significantly during CR (325 ± 106 to 405 ± 77 m; P < 0.01). No adverse events were documented during CR. The results show that, even following LVAD implantation, cardiopulmonary exercise capacity remains considerably restricted. In contrast, functional performance, measured by the 6‐min walk distance, reaches an acceptable level. Light everyday tasks seem to be realistically surmountable for patients, making discharge from inpatient rehabilitation possible. Long‐term monitoring is required in order to evaluate the situation and how it develops further.
Editorial: which iron preparation for patients with IBD?
Authors: Kennedy N. A. , Goodhand J. R. , Rampton D. S.
Published: June 2017

Linked Content

This article is linked to Aksan et al papers. To view these articles visit https://doi.org/10.1111/apt.14126 and https://doi.org/10.1111/apt.14043.
Editorial: when to be suspicious of malignancy‐associated pseudoachalasia
Authors: Carlson D. A. , Kahrilas P. J.
Published: June 2017

Linked Content

This article is linked to Ponds et al paper. To view this article visit
https://doi.org/10.1111/apt.14057.
Editorial: which iron preparation for patients with IBD? Authors’ reply
Authors: Aksan A. , Işık H. , Radeke H. H. , Dignass A. , Stein J.
Published: June 2017

Linked Content

This article is linked to Kennedy et al and Aksan et al papers. To view these articles visit https://doi.org/10.1111/apt.14105 and https://doi.org/10.1111/apt.14043.
Letter: HBV/HCV coinfection in the era of direct‐acting antivirals
Authors: Hsu C.‐S. , Wang P.‐C. , Li C.‐H. , Lin H. H.
Published: June 2017

Linked Content

This article is linked to Londoño et al paper. To view this article visit https://doi.org/10.1111/apt.13985.
Editorial: food for thought—the low‐FODMAP diet and IBS in perspective
Authors: Quigley E. M. M.
Published: June 2017

Linked Content

This article is linked to Krogsgaard et al paper. To view this article visit
https://doi.org/10.1111/apt.14065.
The Potential of EBSD and EDS for Ceramics Investigations—Case Studies on Sherds of Pre‐Columbian Pottery
Authors: Dietrich D. , Nolze G. , Del‐Solar‐Velarde N. , Nickel D. , Lampke T. , Chapoulie R. , Castillo Butters L. J.
Published: June 2017

The work focuses on the potential of structural and chemical examinations by scanning electron microscopy based methods for archaeometric studies on ceramics. Achieved by a single preparation technique (polished block sections), the feasibility and benefits of electron backscatter diffraction are demonstrated as case studies using polychrome examples of pre‐Columbian pottery (Wari, Moche and Cajamarca). Elemental and phase maps allow for separate consideration of clay and temper. Identification of mineral phases and intergrowths of temper particles provide information for clarifying clay procurement and firing techniques with respect to local versus non‐local pottery to enlighten trade relations, technological transfer and shared heritage of pre‐Columbian cultures.
Development of a patient and institutional‐based model for estimation of operative times for robot‐assisted radical cystectomy: results from the International Robotic Cystectomy Consortium
Authors: Hussein Ahmed A. , May Paul R. , Ahmed Youssef E. , Saar Matthias , Wijburg Carl J. , Richstone Lee , Wagner Andrew , Wilson Timothy , Yuh Bertram , Redorta Joan P. , Dasgupta Prokar , Kawa Omar , Khan Mohammad S. , Menon Mani , Peabody James O. , Hosseini Abolfazl , Gaboardi Franco , Pini Giovannalberto , Schanne Francis , Mottrie Alexandre , Rha Koon‐ho , Hemal Ashok , Stockle Michael , Kelly John , Tan Wei S. , Maatman Thomas J. , Poulakis Vassilis , Kaouk Jihad , Canda Abdullah E. , Balbay Mevlana D. , Wiklund Peter , Guru Khurshid A.
Published: June 2017

Objectives

To design a methodology to predict operative times for robot‐assisted radical cystectomy (RARC) based on variation in institutional, patient, and disease characteristics to help in operating room scheduling and quality control.

Patients and Methods

The model included preoperative variables and therefore can be used for prediction of surgical times: institutional volume, age, gender, body mass index, American Society of Anesthesiologists score, history of prior surgery and radiation, clinical stage, neoadjuvant chemotherapy, type, technique of diversion, and the extent of lymph node dissection. A conditional inference tree method was used to fit a binary decision tree predicting operative time. Permutation tests were performed to determine the variables having the strongest association with surgical time. The data were split at the value of this variable resulting in the largest difference in means for the surgical time across the split. This process was repeated recursively on the resultant data sets until the permutation tests showed no significant association with operative time.

Results

In all, 2 134 procedures were included. The variable most strongly associated with surgical time was type of diversion, with ileal conduits being 70 min shorter (P < 0.001). Amongst patients who received neobladders, the type of lymph node dissection was also strongly associated with surgical time. Amongst ileal conduit patients, institutional surgeon volume (>66 RARCs) was important, with those with a higher volume being 55 min shorter (P < 0.001). The regression tree output was in the form of box plots that show the median and ranges of surgical times according to the patient, disease, and institutional characteristics.

Conclusion

We developed a method to estimate operative times for RARC based on patient, disease, and institutional metrics that can help operating room scheduling for RARC.
Awareness and use of systematic literature reviews and meta‐analyses by ministerial policy analysts
Authors: Bédard Pierre‐Olivier , Ouimet Mathieu
Published: June 2017

Systematic literature reviews and meta‐analyses have been promoted as important types of evidence to inform policy analysis and policy decisions. Little is known, however, about ministerial policy analysts' knowledge of this type of evidence. Drawing from a survey conducted among policy analysts (Québec), we report on the extent to which these research methods and contributions are known and used across policy sectors, and develop a socio‐professional profile of users. We conclude with recommendations for researchers and policy makers to improve the uptake of systematic reviews and meta‐analyses and to more effectively implement evidence‐informed practices.
The emergence of public‐private partnerships (P3s) in Alberta: Lessons from the Anthony Henday highway
Authors: Opara Michael , Elloumi Fathi
Published: June 2017

This article traces the emergence of public‐private partnerships (P3) in Alberta from 2003‐2016, using a case study of Edmonton's Anthony Henday highway projects. We describe how P3s emerged following dissatisfaction with the conventional delivery model, specifically with late project delivery and over‐budget performance, and the need to attract private financing arising from Alberta's fiscal deterioration beginning in 2001. We also highlight how political, policy, and organizational support were critical enablers of the emergence, acceptance and normalization of Alberta's P3 model.
Feasibility study of personalized peptide vaccination for hepatocellular carcinoma patients refractory to locoregional therapies
Authors: Yutani Shigeru , Shirahama Takahisa , Muroya Daisuke , Matsueda Satoko , Yamaguchi Rin , Morita Michi , Shichijo Shigeki , Yamada Akira , Sasada Tetsuro , Itoh Kyogo
Published: June 2017

Overall survival of patients with hepatocellular carcinoma (HCC) refractory to locoregional therapy is dismal, even following treatment with sorafenib, a multikinase inhibitor. To develop a more efficacious treatment, we undertook a feasibility study of personalized peptide vaccination (PPV) for HCC, in which the peptides were selected from 31 peptide candidates based on the pre‐existing immunity. Twenty‐six HCC patients refractory to locoregional therapies (cohort 1) and 30 patients refractory to both locoregional and systemic therapies (cohort 2) were entered into the study. There were no severe adverse events related to PPV except for one injection site reaction. At the end of the first cycle of six vaccinations, successful CTL or IgG boosting was observed in 57% or 46% of patients in cohort 1 and in 54% or 52% of patients in cohort 2, respectively. Successful IgG boosting at the end of the second cycle was observed in the majority of patients tested. Median overall survival was 18.7 months (95% confidence interval, 12.2–22.5 months) in cohort 1, and 8.5 months (95% confidence interval, 5.9–12.2 months) in cohort 2. Based on the higher rates of immune boosting and the safety profile of PPV, further clinical studies of PPV would be warranted for patients with HCC refractory to not only locoregional therapy but also both locoregional and systemic therapies. The protocol of this study was registered with the UMIN Clinical Trials Registry (UMIN000001882 and UMIN000003590).
Single port laparoscopic ileocaecal resection for Crohn's disease: a multicentre comparison with multi‐port laparoscopy
Authors: Carvello M. , de Groof E. J. , de Buck van Overstraeten A. , Sacchi M. , Wolthuis A. M. , Buskens C. J. , D'Hoore A. , Bemelman W. A. , Spinelli A.
Published: June 2017

Aim

Single port (SP) ileocaecal resection (ICR) is an established technique but there are no large studies comparing SP and multi‐port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP laparoscopic ICR for CD.

Method

This was a retrospective study of patients undergoing SP or MP ICR for CD in three tertiary referral centres from February 1999 to October 2014. Baseline characteristics (age, sex, body mass index and indication for surgery) were compared. Primary end‐points were postoperative pain scores, analgesia requirements and short‐term postoperative outcomes.

Results

SP ICR (n = 101) and MP ICR (n = 156) patients were included in the study. Visual analogue scale scores were significantly lower after SP ICR on postoperative day 1 (P = 0.016) and day 2 (P = 0.04). Analgesia requirements were significantly reduced on postoperative day 2 in the SP group compared with the MP group (P = 0.007). Duration of surgery, conversion to open surgery and stoma rates were comparable between the two groups. Surgery was more complex in terms of additional procedures when MP was adopted (P = 0.001). There were no differences in postoperative complication rates, postoperative food intake, length of stay and readmissions.

Conclusion

These data suggest that in comparison to standard laparoscopic surgery SP ICR might be less painful and patients might require less opioid analgesia.
HEALTH INSURANCE, FERTILITY, AND THE WANTEDNESS OF PREGNANCIES: EVIDENCE FROM MASSACHUSETTS
Authors: Apostolova‐Mihaylova Maria , Yelowitz Aaron
Published: June 2017

Health insurance reform in Massachusetts lowered the cost of both pregnancy (by increased coverage of pregnancy‐related medical events) and pregnancy prevention (by increasing access to reliable contraception). We empirically examine fertility responses and find no overall effect from increased coverage due to the Massachusetts reform. This finding, however, masks substantial heterogeneity. For married women aged 20 to 34—with high latent fertility and pregnancy wantedness—fertility increased by approximately 1%. For unmarried women in the same age range—for whom pregnancies are typically unwanted—fertility declined by 8%. (JEL I13, I18, J13)
One minute sit‐to‐stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients
Authors: Reychler Gregory , Boucard Eliott , Peran Loïc , Pichon Romain , Le Ber‐Moy Catherine , Ouksel Hakima , Liistro Giuseppe , Chambellan Arnaud , Beaumont Marc
Published: June 2017

Introduction

Chronic obstructive pulmonary disease (COPD) is frequently associated with a reduced functional exercise performance. Even if this parameter is routinely evaluated using 6‐minute walking test (6MWT), new field tests are regularly investigated as alternative tests. The aim of this study was to compare functional exercise performance evaluation by sit‐to‐stand test (STST) and 6MWT and to evaluate reliability and repeatability of the STST in COPD patients.

Method

Forty‐two COPD patients performed randomly two tests: 6MWT and STST. Each test was repeated two times. Distance (6MWD) and number of repetitions were measured. Cardiorespiratory parameters, dyspnea and lower limb fatigue (Borg) were recorded before and after the tests.

Results

Sit‐to‐stand repetitions (19 ± 6) and 6MWD (441 ± 104 m) were correlated (r = .716; P < .001). Good repeatability was found for STST and 6MWT. Good reliability was observed for STST (ICC = 0.902). Variations of heart rate and pulsed oxygen saturation were significantly different between these two tests (23% ± 17% vs 13% ± 11%; P = .022 and −7.6% ± 4.6% vs −0.7% ± 2.7%; P < .001 for 6MWT and STST, respectively). Variations of dyspnea and lower limb fatigue were similar between both tests (P = .827 and P = .467).

Conclusion

The one minute sit‐to‐stand test is a valuable alternative to 6MWT to estimate functional exercise performance in COPD patients. The cardiorespiratory demand is different between both tests although the variation of dypsnea is similar. No learning effect was observed for STST.
Autoimmune hemolytic anemia in solid organ transplantation—The role of immunosuppression
Authors: Kanellopoulou Theoni
Published: June 2017

Hemolysis after solid organ transplantation can be caused by both immune and non‐immune‐mediated mechanisms, and the evaluation must take into account issues distinctive to the post‐transplant period. Autoimmune hemolytic anemia usually occurs within the first year and has been attributed to immunosuppressive treatment, infections, or underlying post‐transplant lymphoproliferative disorder. Review of the literature revealed 59 cases with autoimmune hemolytic anemia mostly in children after liver transplantation. Almost all of the patients at the time of diagnosis received immunosuppression with tacrolimus, and first‐line treatment with steroids and/or intravenous immunoglobulin was ineffective for complete remission. Rituximab was used as second‐line treatment especially in patients with underlying lymphoproliferative disorders whereas sirolimus showed encouraging results.
College Readiness: Are California Charter School Students Better Prepared?
Authors: Adzima Kerry A.
Published: June 2017

Using US data from the Los Angeles Unified School District (LAUSD) I analyse student outcomes from Advanced Placement tests and Smarter Balanced Summative Assessments to determine whether charter school students display higher levels of college readiness. Using panel data from 2011–12 through 2014–15 for the Advanced Placement tests, I find a gain of between 10.8 and 21.0 percentage points for charter students on average over students attending traditional public schools. For the Smarter Balanced Assessment using school years 2014–15 and 2015–16, I again find that charter students outperform traditional public students on average with gains in all categories for both the English and the mathematics portions of the exam. The results of this study seem to offer some support for the view that offering choice in schooling tends to improve performance.
What Marx Means Today
Authors: Sinn Hans‐Werner
Published: June 2017

Marx made significant contributions to macroeconomics, laying the grounds for both Keynes's theory of aggregate demand and Schumpeter's theory of creative destruction. His law of the tendency of the rate of profit to fall parallels Alvin Hansen's theory of secular stagnation which has recently received much attention among scholars studying the financial crises in Japan, the US and the Eurozone. This article argues that part of the new stagnation does not result from a natural exhaustion of investment possibilities, but from an overly loose central bank monetary policy that keeps zombie banks and their zombie clients alive and blocks the emergence of new start‐up firms.
Larval food affects oviposition preference, female fecundity and offspring survival in Yponomeuta evonymellus
Authors: KAROLEWSKI PIOTR , ŁUKOWSKI ADRIAN , WALCZAK URSZULA , BARANIAK EDWARD , MUCHA JOANNA , GIERTYCH MARIAN J.
Published: June 2017

1. Yponomeuta evonymellus is a monophagous moth that feeds on Prunus padus which is native to Europe. In recent years, larval feeding and egg clusters have also been observed on non‐native Prunus serotina plants; however, survival of larvae on this new host is very low.

2. The objective of the present study was to determine how the feeding of larvae on each of the two host plants impacts oviposition, offspring survival and fecundity in Y. evonymellus. Our hypothesis was that, under controlled conditions, females will lay eggs on the host on which they fed as larvae. We also hypothesised that the lower survival of young larvae feeding on P. serotina was due to the smaller buds and leaves present in this species, relative to those of P. padus.

3. A dual‐choice experiment conducted under laboratory conditions demonstrated that females preferentially chose to oviposit on the plant species on which they fed as larvae. In the experiment, potential fecundity and offspring survival were significantly higher on P. padus than on P. serotina. The reduced performance of Y. evonymellus on P. serotina was correlated with a smaller bud mass and volume, lower leaf mass and surface area, and difficulty in constructing a protective tent against unfavourable weather conditions.

4. In summary, the identity of the host plant species during larval feeding determines adult oviposition preference for that host species. The survival of larvae on P. serotina growing in the nature is low, but for phenology‐related reasons.
The spectrum of pre‐dementia stages: cognitive profile of motoric cognitive risk syndrome and relationship with mild cognitive impairment
Authors: Sekhon H. , Allali G. , Launay C. P. , Chabot J. , Beauchet O.
Published: June 2017

Background and purpose

Motoric cognitive risk (MCR) syndrome is a pre‐dementia syndrome. There is little information on the cognitive profile of individuals with MCR syndrome and its overlap with mild cognitive impairment (MCI) syndrome. This study aimed to examine and compare the cognitive performance of non‐demented older community dwellers with and without MCR and MCI syndromes.

Methods

A total of 291 non‐demented individuals were selected from the Gait and Alzheimer Interactions Tracking study, which is a cross‐sectional study. All participants were referred to a memory clinic. Individuals with and without MCR were separated into those with and without MCI. Cognitive performance was measured using the scores of the Mini Mental Status Examination, Frontal Assessment Battery, Free and Cued Selective Reminding Test, Trail Making Test part A and B, and Stroop test.

Results

The prevalence of MCI was 40.1% and that of MCR was 18.2%, with a higher prevalence of MCI in MCR group compared with the non‐MCR group (47.2% vs. 39.5%). Individuals with MCR and MCI syndromes had poorer cognitive performance in all domains compared with those without MCR (P < 0.005), except for the ratio part III: part I of the Stroop test (P = 0.345). The association between cognitive performance and MCR syndrome was worse on the Mini Mental Status Examination score [effect size, −0.57 (95% confidence interval, −1.02 to −0.12)] and Trail Making Test part B [effect size, 0.59 (95% confidence interval, 0.14–1.04)] in individuals with MCR and MCI syndromes.

Conclusions

Motoric cognitive risk syndrome is associated with low global cognitive performance. Association of MCR and MCI syndromes is characterized by a worse cognitive performance.
Nonintravenous rescue medications for pediatric status epilepticus: A cost‐effectiveness analysis
Authors: Sánchez Fernández Iván , Gaínza‐Lein Marina , Loddenkemper Tobias
Published: June 2017

Objective

To quantify the cost‐effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam.

Methods

Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One‐way sensitivity analyses and second‐order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters.

Results

The most cost‐effective rescue medication was buccal midazolam (incremental cost‐effectiveness ratio ([ICER]: $13.16/SS) followed by nasal midazolam (ICER: $38.19/SS). Nasal lorazepam (ICER: −$3.8/SS), intramuscular midazolam (ICER: −$64/SS), and rectal diazepam (ICER: −$2,246.21/SS) are never more cost‐effective than the other options at any willingness to pay. One‐way sensitivity analysis showed the following: (1) at its current effectiveness, rectal diazepam would become the most cost‐effective option only if its cost was $6 or less, and (2) at its current cost, rectal diazepam would become the most cost‐effective option only if effectiveness was higher than 0.89 (and only with very high willingness to pay of $2,859/SS to $31,447/SS). Second‐order Monte Carlo simulations showed the following: (1) nasal midazolam and intramuscular midazolam were the more effective options; (2) the more cost‐effective option was buccal midazolam for a willingness to pay from $14/SS to $41/SS and nasal midazolam for a willingness to pay above $41/SS; (3) cost‐effectiveness overlapped for buccal midazolam, nasal lorazepam, intramuscular midazolam, and nasal midazolam; and (4) rectal diazepam was not cost‐effective at any willingness to pay, and this conclusion remained extremely robust to wide variations of the input parameters.

Significance

For pediatric status epilepticus, buccal midazolam and nasal midazolam are the most cost‐effective nonintravenous rescue medications in the United States. Rectal diazepam is not a cost‐effective alternative, and this conclusion remains extremely robust to wide variations of the input parameters.
Histological assessment of β‐amyloid precursor protein immunolabelled rectal biopsies aids diagnosis of equine grass sickness
Authors: Jago R. C. , Scholes S. , Mair T. S. , Pearson G. R. , Pirie R. S. , Handel I. , Milne E. M. , Coyle F. , Mcgorum B. C.
Published: June 2017

Background

An accurate, minimally invasive, ante‐mortem diagnostic test for equine grass sickness (EGS) is currently lacking. Although histological examination of haematoxylin and eosin‐stained rectal biopsies for chromatolytic neurons is insensitive as a diagnostic test for EGS, we hypothesised that its diagnostic accuracy could be improved by immunolabelling for β‐amyloid precursor protein (β‐APP), which has increased expression in cranial cervical ganglia (CCG) neuronal perikarya in EGS.

Objectives

To develop a grading scheme for assessing the distribution and intensity of β‐APP immunoreactivity within individual rectal submucosal neurons and subsequently to determine the value of the distribution of different grades of neurons in EGS diagnosis.

Study design

Retrospective case–control diagnostic accuracy study.

Methods

Initially, a standardised grading scheme was developed and β‐APP immunoreactivity in individual neuronal perikarya and axons was compared in sections of CCG and ileum from EGS and control horses. The grading scheme was then refined before being blindly applied to submucosal neurons in rectal biopsies derived from 21 EGS and 23 control horses.

Results

β‐APP immunoreactivity was increased in neuronal perikarya and axons in sections of CCG, ileum and rectum from EGS horses compared with controls. For rectal biopsies, a mean immunoreactivity grade exceeding 1.1 was 100% specific and sensitive for EGS, and the presence of at least one neuron with diffuse labelling of the entire cytoplasm (grade 3) was 95% sensitive and 100% specific for EGS.

Main limitations

Although the diagnostic criteria facilitated the discrimination of the EGS and control biopsies evaluated in this study, further prospective validation using a larger sample set is required.

Conclusions

Histological assessment of β‐APP immunolabelled rectal biopsies is more sensitive than conventional histological examination in EGS diagnosis. Further validation is required before this technique can be advocated for use in clinical decision making.
Structural plasticity among glutathione transferase Phi members: natural combination of catalytic residues confers dual biochemical activities
Authors: Pégeot Henri , Mathiot Sandrine , Perrot Thomas , Gense Frédéric , Hecker Arnaud , Didierjean Claude , Rouhier Nicolas
Published: June 2017

The glutathione transferase (GST) gene family is divided into 14 classes in photosynthetic organisms. Among them, the Phi class (GSTF) is composed of a large number of genes that are often induced in response to environmental constraints due to their ability to detoxify xenobiotics, to their peroxidase activity and to their involvement in the biosynthesis and/or transport of secondary metabolites. However, the exact functions of GSTFs from many plants including Populus trichocarpa are unknown. Here, following GSTF1 characterization, we have performed a comparative analysis of the seven other GSTFs found in poplar by systematically evaluating the biochemical and enzymatic properties of the corresponding recombinant proteins and of variants mutated for active site residues and by determining the three‐dimensional structures of several representatives. Owing to the presence of a cysteine with a pKa value around 5 in their active site, GSTF3, F7, and F8 displayed a thiol transferase activity in addition to the usual glutathione transferase and peroxidase activities. From structural analyses, it appeared that these dual biochemical properties originate from the existence of a certain variability in the β1‐α1 loop. This allows positioning of several active site residues at proximity of the glutathione molecule, which itself remains unchanged in GSTF three‐dimensional structures. These results highlight the promiscuity of some GSTFs and that changes of active site residues in some isoforms during evolution generated functional diversity by modifying their activity profile.

Database

Structural data are available in the PDB under the accession numbers 5EY6, 5F05, 5F06, and 5F07.
The POU homeodomain transcription factor POUM2 and broad complex isoform 2 transcription factor induced by 20‐hydroxyecdysone collaboratively regulate vitellogenin gene expression and egg formation in the silkworm Bombyx mori
Authors: Lin Y. , Liu H. , Yang C. , Gu J. , Shen G. , Zhang H. , Chen E. , Han C. , Zhang Y. , Xu Y. , Wu J. , Xia Q.
Published: June 2017

Vitellogenin (Vg) is a source of nutrition for embryo development. Our previous study showed that the silkworm (Bombyx mori) transcription factor broad complex isoform 2 (BmBrC‐Z2) regulates gene expression of the Vg gene (BmVg) by induction with 20‐hydroxyecdysone (20E). However, the mechanism by which 20E regulates BmVg expression was not clarified. In this study, cell transfection experiments showed that the BmVg promoter containing the POU homeodomain transcription factor POUM2 (POUM2) and BrC‐Z2 cis‐response elements (CREs) showed a more significant response to 20E than that harbouring only the BrC‐Z2 or POUM2 CRE. An electrophoretic mobility shift assay and chromatin immunoprecipitation assay showed that BmPOUM2 could bind to the POUM2 CRE of the BmVg promoter. Over‐expression of BmPOUM2 and BmBrC‐Z2 in B. mori embryo‐derived cell line (BmE) could enhance the activity of the BmVg promoter carrying both the POUM2 and BrC‐Z2 CREs following 20E induction. Quantitative PCR and immunofluorescence histochemistry showed that the expression pattern and tissue localization of BmPOUM2 correspond to those of BmVg. Glutathione S‐transferase pull‐down and co‐immunoprecipitation assays confirmed that BmPOUM2 interacts only with BmBrC‐Z2 to regulate BmVg expression. Down‐regulation of BmPOUM2 in female silkworm by RNA interference significantly reduced BmVg expression, leading to abnormal egg formation. In summary, these results indicate that BmPOUM2 binds only to BmBrC‐Z2 to collaboratively regulate BmVg expression by 20E induction to control vitellogenesis and egg formation in the silkworm. Moreover, these findings suggest that homeodomain protein POUM2 plays a novel role in regulating insect vitellogenesis.