bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetics and pharmacodynamics of an extrafine fixed pMDI combination of beclometasone dipropionate/formoterol fumarate in adolescent asthma
Authors: Kuna Piotr , Govoni Mirco , Lucci Germano , Scuri Mario , Acerbi Daniela , Stelmach Iwona
Published: March 2015

Aim

The aim was to investigate the pharmacokinetics and pharmacodynamics of an extrafine pressurized metered‐dose inhaler (pMDI) fixed combination of beclometasone dipropionate (BDP)/formoterol fumarate (FF) in adolescent and adult asthma.

Methods

This was a three‐way crossover study, on 30 asthmatic adolescents receiving BDP/FF pMDI with or without a valved holding chamber (VHC) or a free licenced combination of BDP pMDI and FF pMDI plus a parallel arm of 30 asthmatic adults receiving BDP/FF pMDI. All patients received a single dose of BDP and FF of 400 µg and 24 µg, for each treatment, respectively. Assessments were performed over 8 hours.

Results

In adolescents, the 90% confidence intervals (CIs) for the systemic exposure (AUC(0,t)) geometric mean ratio of the fixed combination with or without VHC vs. the free combination were within the bioequivalence range 0.80–1.25, both for beclometasone‐17‐monopropionate (B17MP, the active metabolite of BDP) and formoterol. Pharmacodynamic variables for plasma potassium and glucose, pulse rate and pulmonary function in adolescents were equivalent between treatments, 95% CI within 0.9, 1.09. The upper level of 90% CIs for AUC(0,t) geometric mean ratio adolescents : adults of B17MP and formoterol after treatment with BDP/FF pMDI was lower than 1.25, 90% CI 0.78, 1.04 and 0.86, 1.17, respectively.

Conclusions

In adolescents the pharmacodynamics and the overall systemic exposure to the active ingredients of an extrafine fixed combination of BDP/FF pMDI with or without a VHC was equivalent to that of a free licenced combination of pMDIs of established safety and efficacy profiles. The systemic exposure in adolescents was not higher than in adults. These results support the indication for use of inhaled corticosteroid/long acting β2‐adrenoceptor agonist pMDIs in adolescents at the same dosage as in adults.
Early feeding after total laryngectomy results in shorter hospital stay without increased risk of complications: a retrospective case–control study
Authors: Serbanescu‐Kele C.M.C. , Halmos G.B. , Wedman J. , van der Laan B.F.A.M. , Plaat B.E.C.
Published: March 2015

Objectives

To evaluate the effects of a reduced nil per os (NPO) period after total laryngectomy (TLE) on general and wound‐related post‐operative complications, swallowing function and duration of hospital stay.

Design, setting and participants

In a retrospective case–control study in 71 patients after TLE with primary closure (i e. without reconstruction with tissue transfer), complications and hospitalisation in 36 patients who started oral feeding on days 3–5 (early feeding) were compared with 30 patients who started oral feeding on days 7–10 (late feeding).

Main outcome measures

Incidence of complications, swallowing function and duration of hospitalisation.

Results

There were no significant differences between the early‐ and late‐feeding groups in the occurrence of pharyngocutaneous fistulae, neopharyngeal stenosis or wound complications in general. Swallowing function was comparable for both groups. Mean overall hospitalisation was 2 days shorter in the early‐feeding group (mean: 17.4 days) as compared to the late‐feeding group (mean: 19.4 days) (P < 0.05).

Conclusions

Early feeding after TLE without flap reconstruction did not contribute to an increase in complications and led to a shorter hospital stay.
Impact of smoking on the surgical outcome of Crohn's disease: a propensity‐score matched National Surgical Quality Improvement Program analysis
Authors: Kulaylat A. N. , Hollenbeak C. S. , Sangster W. , Stewart Sr D. B.
Published: March 2015

Aim

Smoking is known to have a deleterious effect on Crohn's disease (CD). The present study addressed the specific impact of smoking on the outcome of surgery for CD.

Method

A review of the National Surgical Quality Improvement Program (NSQIP) database (2005–2012) identified 7631 patients with CD who underwent surgical resection. Patients were stratified based on smoking status and were compared with univariate statistical tests. Generalized linear regression and multiple logistic regressions were used to model the impact of smoking on the surgical outcome [length of stay (LOS), mortality, postoperative complications and readmission]. To confirm the validity of the regression models and to evaluate the influence of smoking in comparable patient cohorts, a propensity score match was also performed.

Results

There were 2047 (26.8%) patients with CD identified as current smokers, and 5584 (74.2%) identified as non‐ or ex‐smokers. Smokers were more likely to have a pulmonary comorbidity, preoperative weight loss and a higher American Society of Anesthesiologists classification. No differences in mortality were observed between smokers and non‐ or ex‐smokers in univariate analysis. In multivariate analysis, smoking status was not significantly associated with LOS. Morbidity (OR 1.20, P = 0.003), particularly infectious (OR 1.30, P < 0.001) and pulmonary (OR 1.87, P < 0.001) complications, and readmission (OR 1.58, P = 0.004) were significantly associated with smoking status. These findings were validated on propensity‐score matching analysis.

Conclusion

In patients with CD, the detrimental effects of smoking on surgical outcomes are driven by infectious and pulmonary complications, and by an increased likelihood of readmission.
Significance of R1 resection margin in colon cancer resections in the modern era
Authors: Khan M. A. S. , Hakeem A. R. , Scott N. , Saunders R. N.
Published: March 2015

Aim

Circumferential resection margin involvement (R1) in rectal cancer is a predictive factor for poor prognosis. The aim of this study was to confirm the prognostic significance of R1 in colon cancer resection and to establish whether the introduction of laparoscopic colorectal surgery influenced this.

Method

Prospectively collected data on a patient pathway data manager for sequential patients with colon cancer treated at our specialist unit from January 2005 to December 2010 were analysed. There were 1110 colonic resections (elective 865; emergency 245). A circumferential resection margin involvement of < 1 mm was considered positive.

Results

The total R1 rate was 13.3% (elective 10.4%; emergency 23.6%; P < 0.001). Other statistically significant risk factors for an R1 resection included tumour perforation (P < 0.001), poorly differentiated carcinoma (P < 0.001), T4 tumour (P < 0.001), vascular invasion (P < 0.001), lymph node metastasis (P < 0.001), distant metastasis (P < 0.001) and palliative resection (P < 0.001). Over half of the elective resections were undertaken laparoscopically (486/865; 56.2%). When compared with elective open resection (379/865; 43.8%), the R1 rate was similar (P = 0.491) with similar disease‐free survival (DFS) and overall survival (OS). The overall relapse rate was 18.9% in R0 and 55.5% in R1 resections (P < 0.001). Kaplan–Meier survival analysis showed significant improvements in DFS and OS in R0 over R1 patients.

Conclusion

The R1 margin in colon cancer resection is an important marker for advanced disease and a prognostic factor for DFS and OS. The introduction of laparoscopic surgery has not influenced the outcome in our unit despite a complex case mix.
Availability of Alternatives and the Processing of Scalar Implicatures: A Visual World Eye‐Tracking Study
Authors: Degen Judith , Tanenhaus Michael K.
Published: March 2015

Two visual world experiments investigated the processing of the implicature associated with some using a “gumball paradigm.” On each trial, participants saw an image of a gumball machine with an upper chamber with orange and blue gumballs and an empty lower chamber. Gumballs dropped to the lower chamber, creating a contrast between a partitioned set of gumballs of one color and an unpartitioned set of the other. Participants then evaluated spoken statements, such as “You got some of the blue gumballs.” Experiment 1 investigated the time course of the pragmatic enrichment from some to not all when the only utterance alternatives available to refer to the different sets were some and all. In Experiment 2, the number terms two, three, four, and five were also included in the set of alternatives. Scalar implicatures were delayed relative to the interpretation of literal statements with all only when number terms were available. The results are interpreted as evidence for a constraint‐based account of scalar implicature processing.
Immunocytochemical analysis of p63 and 34βE12 in fine needle aspiration cytology specimens for breast lesions: a potentially useful discriminatory marker between intraductal papilloma and ductal carcinoma in situ
Authors: Hoshikawa S. , Sano T. , Hirato J. , Oyama T. , Fukuda T.
Published: March 2015

Objective

We applied immunocytochemistry to fine needle aspiration (FNA) breast lesion slides in an attempt to enhance their objectivity and specificity.

Methods

We analysed 56 FNA specimens from patients with histologically confirmed breast lesions, using 34βE12 and p63 antibodies. Immunostained slides were examined in terms of both solitary positive cells (within clusters and non‐clusters) and positive clusters within a slide.

Results

Positive scores (≥2) for p63+ cells and percentages of p63+ clusters differed significantly (P < 0.001) between malignant (3 of 34; 9%) and benign (11 of 22; 50%) cases and varied between benign and malignant groups: intraductal papilloma (IDP) (2 of 8), other benign lesions (9 of 14), ductal carcinoma in situ (DCIS) (1 of 11) and invasive carcinoma (IC) (2 of 23). Similarly, 34βE12 scores were higher in benign cases (IDP, 8 of 8; other benign, 9 of 14) than in malignant cases (DCIS, 1 of 11; IC, 3 of 23). As well as a significant difference between benign and malignant cases (17 of 22, 77% versus 4 of 34, 12%; P < 0.001), the percentage of 34βE12+ clusters was significantly higher in IDP compared with DCIS (P = 0.001).

Conclusions

The immunostaining of FNA breast specimens for p63 and 34βE12 may help in difficult diagnoses.
New systemic agents in dermatology with respect to fertility, pregnancy, and lactation
Authors: Grunewald Sonja , Jank Alexander
Published: March 2015

With the increasing use of new, predominantly biologic drugs in dermatology, questions frequently arise in clinical practice as to their safety in women wishing to conceive as well as during pregnancy and lactation. Apart from the Summary of Product Characteristics and the Physician's Desk Reference, reliable information may be obtained from databases such as the one compiled by the Center for Pharmacovigilance and Consultation on Embryonal Toxicology at Charité University Medical Center Berlin (https://www.embryotox.de). Another source of information is researching recent publications, for example via PubMed (http://www.ncbi.nlm.nih.gov/pubmed).

This article presents current knowledge from the sources mentioned above, and gives detailed information about the use of new biologic agents in women wishing to conceive as well as during pregnancy and lactation. Drugs reviewed include: infliximab, adalimumab, etanercept, metastatic for psoriasis, vemurafenib, dabrafenib, imatinib, ipilimumab for melanoma, vismodegib for basal cell carcinoma, rituximab for cutaneous lymphoma as well as omalizumab and anakinra used in the treatment of allergies.
Charcot foot syndrome
Authors: Jeffcoate W. J.
Published: March 2015

Charcot foot syndrome is an uncommon complication of diabetes but is potentially devastating in its consequences. Outcome is made worse by widespread professional ignorance leading to delayed diagnosis, but it is also hampered by lack of understanding of its causes and lack of treatments with proven effectiveness, other than offloading. There remains a desperate need for studies into its causes as well as comparative audit and trials designed to determine the best treatment for this difficult condition. Such work can probably only be effectively carried out through the establishment of multicentre networks. Nevertheless, improved understanding in recent years of the likely role of inflammatory pathways has raised awareness of the multiple ways in which the effects of neuropathy may be manifest in the development of the Charcot foot. This awareness is also leading to the realization that similar processes may conceivably contribute to the refractoriness of other foot diseases in diabetes, including both chronic unhealing ulcers and osteomyelitis.
Linking anthropogenic resources to wildlife–pathogen dynamics: a review and meta‐analysis
Authors: Becker Daniel J. , Streicker Daniel G. , Altizer Sonia
Published: March 2015

Urbanisation and agriculture cause declines for many wildlife, but some species benefit from novel resources, especially food, provided in human‐dominated habitats. Resulting shifts in wildlife ecology can alter infectious disease dynamics and create opportunities for cross‐species transmission, yet predicting host–pathogen responses to resource provisioning is challenging. Factors enhancing transmission, such as increased aggregation, could be offset by better host immunity due to improved nutrition. Here, we conduct a review and meta‐analysis to show that food provisioning results in highly heterogeneous infection outcomes that depend on pathogen type and anthropogenic food source. We also find empirical support for behavioural and immune mechanisms through which human‐provided resources alter host exposure and tolerance to pathogens. A review of recent theoretical models of resource provisioning and infection dynamics shows that changes in host contact rates and immunity produce strong non‐linear responses in pathogen invasion and prevalence. By integrating results of our meta‐analysis back into a theoretical framework, we find provisioning amplifies pathogen invasion under increased host aggregation and tolerance, but reduces transmission if provisioned food decreases dietary exposure to parasites. These results carry implications for wildlife disease management and highlight areas for future work, such as how resource shifts might affect virulence evolution.
Prevalence and etiology of epilepsy in a Norwegian county—A population based study
Authors: Syvertsen Marte , Nakken Karl Otto , Edland Astrid , Hansen Gunnar , Hellum Morten Kristoffer , Koht Jeanette
Published: March 2015

Objective

Epilepsy represents a substantial personal and social burden worldwide. When addressing the multifaceted issues of epilepsy care, updated epidemiologic studies using recent guidelines are essential. The aim of this study was to find the prevalence and causes of epilepsy in a representative Norwegian county, implementing the new guidelines and terminology suggested by the International League Against Epilepsy (ILAE).

Methods

Included in the study were all patients from Buskerud County in Norway with a diagnosis of epilepsy at Drammen Hospital and the National Center for Epilepsy at Oslo University Hospital. The study period was 1999–2014. Patients with active epilepsy were identified through a systematic review of medical records, containing information about case history, electroencephalography (EEG), cerebral magnetic resonance imaging (MRI), genetic tests, blood samples, treatment, and other investigations. Epilepsies were classified according to the revised terminology suggested by the ILAE in 2010.

Results

In a population of 272,228 inhabitants, 1,771 persons had active epilepsy. Point prevalence on January 1, 2014 was 0.65%. Of the subjects registered with a diagnostic code of epilepsy, 20% did not fulfill the ILAE criteria of the diagnosis. Epilepsy etiology was structural‐metabolic in 43%, genetic/presumed genetic in 20%, and unknown in 32%. Due to lack of information, etiology could not be determined in 4%.

Significance

Epilepsy is a common disorder, affecting 0.65% of the subjects in this cohort. Every fifth subject registered with a diagnosis of epilepsy was misdiagnosed. In those with a reliable epilepsy diagnosis, every third patient had an unknown etiology. Future advances in genetic research will probably lead to an increased identification of genetic and hopefully treatable causes of epilepsy.
Anti‐ictogenic and antiepileptogenic properties of brivaracetam in mature and immature rats
Authors: Dupuis Nina , Matagne Alain , Staelens Ludovicus , Dournaud Pascal , Desnous Béatrice , Gressens Pierre , Auvin Stéphane
Published: March 2015

Objective

Brivaracetam (BRV) is a new antiepileptic drug candidate rationally designed for high affinity and selectivity for the synaptic vesicle protein 2A. This study explored anti‐ictogenic and antiepileptogenic effects of BRV in rats at different stages of development.

Methods

Using a rapid kindling model in P14, P21, P28, and P60 rats, we studied two doses of BRV: 10 and 100 mg/kg injected intraperitoneally 30 min before afterdischarge assessment. We also assessed blood and brain concentrations of BRV 30 min after the injection.

Results

BRV 100 mg/kg significantly increased the afterdischarge threshold (ADT) at all ages, whereas BRV at 10 mg/kg increased ADT in P60, P28, and P21 rats. BRV also shortens the afterdischarge duration (ADD), achieving statistical significance with 10 and 100 mg/kg at P60 and with 100 mg/kg at P21. At P60, BRV increases the number of stimulations required to achieve a stage 4–5 seizure in a dose‐dependent manner. At P28 and P21, BRV increased the number of stimulations required to develop a stage 4–5 seizure in a dose‐dependent manner with almost complete elimination of stage 4–5 seizures. In contrast, at P14, BRV had no effect on the number of stage 4–5 seizures. An age‐related decrease in blood and brain concentrations of BRV was observed 30 min after injection of BRV 10 mg/kg, whereas with 100 mg/kg there were no significant age‐correlated differences in brain and serum BRV concentrations.

Significance

BRV exerted dose‐dependent anti‐ictogenic effects from P60 to P14 independent of brain maturation. BRV also exhibited antiepileptogenic effects at P60, whereas this effect need to be further evaluated at P28 and P21. We did not observe any effect on epileptogenesis at P14 at either dose.
Ablation of human skin mast cells in situ by lysosomotropic agents
Authors: Hagforsen Eva , Paivandy Aida , Lampinen Maria , Weström Simone , Calounova Gabriela , Melo Fabio R. , Rollman Ola , Pejler Gunnar
Published: March 2015

Mast cells are known to have a detrimental impact on numerous types of inflammatory skin diseases such as contact dermatitis, atopic eczema and cutaneous mastocytosis. Regimens that dampen skin mast cell‐mediated activities can thus offer an attractive therapeutic option under such circumstances. As mast cells are known to secrete a large array of potentially pathogenic compounds, both from preformed stores in secretory lysosomes (granules) and after de novo synthesis, mere inhibition of degranulation or interference with individual mast cell mediators may not be sufficient to provide an effective blockade of harmful mast cell activities. An alternative strategy may therefore be to locally reduce skin mast cell numbers. Here, we explored the possibility of using lysosomotropic agents for this purpose, appreciating the fact that mast cell granules contain bioactive compounds prone to trigger apoptosis if released into the cytosolic compartment. Based on this principle, we show that incubation of human skin punch biopsies with the lysosomotropic agents siramesine or Leu‐Leu methyl ester preferably ablated the mast cell population, without causing any gross adverse effects on the skin morphology. Subsequent analysis revealed that mast cells treated with lysosomotropic agents predominantly underwent apoptotic rather than necrotic cell death. In summary, this study raises the possibility of using lysosomotropic agents as a novel approach to targeting deleterious mast cell populations in cutaneous mastocytosis and other skin disorders negatively influenced by mast cells.
Effects of humic stress on the zooplankton from clear and DOC‐rich lakes
Authors: Robidoux Marilyne , del Giorgio Paul , Derry Alison
Published: March 2015

Humic stress is associated with the widespread and ongoing browning of lakes. Natural landscape gradients in dissolved organic carbon (DOC) potentially result in aquatic communities with different tolerances to humic substances and thus expected contrasting responses to further lake browning.

If zooplanktonic species are adapted to different background concentrations of DOC, then we expected that the zooplankton from naturally DOC‐rich lakes would maintain higher diversity, biomass and overall density in the face of experimental browning than the zooplankton from DOC‐poor lakes. We tested this hypothesis in a common‐garden experiment by exposing, in enclosures, zooplankton from replicate DOC‐rich and DOC‐poor source lakes to simulated browning and to clear water.

We conducted a 2 × 2 × 3 factorial‐design field transplant experiment with zooplankton from replicate DOC‐rich (>8.5 mg L−1) and DOC‐poor (<3.5 mg L−1) lakes (Québec, Canada) over eight weeks. There were two fixed effects: water treatment (brown or clear water) and zooplankton source (from DOC‐rich or DOC‐poor lakes). Lake source was included as a random variable in the model for the response of copepod body size in the enclosures. A substance derived from peat, ‘SuperHume’, was used as a source of DOC.

The diversity, biomass and total density of zooplankton from DOC‐rich and DOC‐poor lakes did not differ upon experimental addition of further DOC. This was despite the presence of different copepod body size phenotypes between source lakes that could have potentially caused different community responses: several dominant species of copepods (Cyclops scutifer, Leptodiaptomus minutus and Tropocyclops prasinus mexicanus) had a larger mean population body size in DOC‐rich source lakes than in DOC‐poor source lakes. Our findings suggest that the zooplankton from DOC‐rich lakes does neither better nor worse than zooplankton from DOC‐poor lakes when faced with browning from a humic stressor.
Development and testing of a scale for assessing the quality of home nursing
Authors: Chiou Chii‐Jun , Wang Hsiu‐Hung , Chang Hsing‐Yi
Published: March 2015

Aim

To develop a home nursing quality scale and to evaluate its psychometric properties.

Method

This was a 3‐year study. In the first year, 19 focus group interviews with caregivers of people using home nursing services were carried out in northern, central and southern Taiwan. Content analysis was carried out and a pool of questionnaire items compiled. In the second year (2007), study was carried out on a stratified random sample selected from home nursing organizations covered by the national health insurance scheme in southern Taiwan. The study population was the co‐resident primary caregivers of home care nursing service users. Item analysis and exploratory factor analysis were carried out on data from 365 self‐administered questionnaires collected from 13 selected home care organizations. In the third year (2008), a random sample of participants was selected from 206 hospital‐based home care nursing organizations throughout Taiwan, resulting in completion of 294 questionnaires from 27 organizations. Confirmatory factor analysis was then carried out on the scale, and the validity and reliability of the scale assessed.

Results

The present study developed a reliable and valid home nursing quality scale from the perspective of users of home nursing services. The scale comprised three factors: dependability, communication skills and service usefulness. This scale is of practical value for the promotion of long‐term community care aging in local policies.

Conclusion

The scale is ready to be used to assess the quality of services provided by home care nursing organizations. Geriatr Gerontol Int 2015; 16: 358–364.
How Can One be a Boxer? : Pain and Pleasure in a Manila's Boxing Camp
Authors: Ishioka Tomonori
Published: March 2015

This paper is an ethnographic account of daily life at a boxing gym in Manila in the Philippines. My book, Rokaru Boxer to Hinkon Sekai conducts a social analysis of three different topics in order to grasp the lives of Manilan boxers on both theoretical and empirical grounds—namely, daily life at a boxing gym, an international boxing market structure in which Filipino boxers are consumed as underdog roles, and the daily life in Manila's squatter areas to which the boxers are closely tied. The current study limits its examination to daily life in a boxing gym. Most of the unique characteristics that influence Filipino boxing can be found in the live‐in residencies of its gyms. The gym is a place for training and living. It is not only by training but also as a result of various aspects of their life here that young men are able to become boxers. Unlike the gym in the African American ghetto described by Loïc Wacquant, participating youths in Filipino boxing come from the absolute lowest tiers of society. The youths live in boxing camps where every aspect of their daily live is strictly regulated, and thus are they inscribed with the rules that must be observed in this sport. This study is an examination of the pains and pleasures of life at one such boxing camp.
Changing Boundaries: Sorting Space, Class, Ethnicity and Race in Ontario*
Authors: Driedger Leo
Published: March 2015

Cet article examine les composantes que sont l'espace, la classe, l'ethnicité et la race dans le système urbain ontarien, notamment Toronto, Ottawa‐Hull, Hamilton et London, et surtout comment les trois dernières influent sur la différenciation résidentielle spatiale. Toronto est du type « minorité visible » alors que London est du type britannique‐loyaliste, Hamilton, col bleu industriel, et Thunder Bay, périphérique nord‐ouest. Les zones urbaines d'Ontario semblent remplir une variété de fonctions, qui vont dans le sens de la conception d'Innis d'un centre, d'une semi‐périphérie et d'une périphérie. Toronto agit comme un aimant pour les immigrants. London fait partie du domaine agricole. Hamilton est un fournisseur d'emplois industriels. Thunder Bay est le centre d'approvisionnement des populations du Nord. De plus, l'ethnicité et la race sont des indicateurs cruciaux de frontières, dont il faut tenir compte pour comprendre les communautés urbaines.
Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation
Authors: AKBULAK RUKEN ÖZGE , SCHÄFFER BENJAMIN , JULARIC MARIO , MOSER JULIA , SCHREIBER DOREEN , SALZBRUNN TIM , MEYER CHRISTIAN , EICKHOLT CHRISTIAN , KUKLIK PAWEL , HOFFMANN BORIS A. , WILLEMS STEPHAN
Published: March 2015

Reduced Radiation Exposure in AF Ablation

Introduction

Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3‐dimensional‐(3D)‐electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial.

Methods and results

Between June and November 2014, a total of 60 patients with PAF (73.3% male, 64.0 ± 9.2 years), who underwent PVI with the endpoint of unexcitability of the ablation line, were randomized to either a conventional 3D mapping system (Carto® 3 System) or to an additional IIM on the basis of an assumed reduction of fluoroscopy exposure by the use of IIM. There were no significant differences in baseline characteristics. The median ablation procedure time was identical in both groups (140.7 ± 27.8 minutes vs. 140.8 ± 39.5 minutes; P = 0.851). A significant decrease of mean fluoroscopy time from 11.9 ± 2.1 to 7.4 ± 2.6 minutes (P < 0.0006) and median fluoroscopy dose from 882.9 to 476.5 cGycm2 (P < 0.001) was achieved. The main reduction of radiation could be realized during creation of the 3D‐map. No major complications occurred during the procedures. After a median follow‐up of 125.7 ± 45.6 days 80% of the patients were free from any atrial arrhythmias.

Conclusion

CartoUnivu™ module easily integrates into the workflow of PVI with the endpoint of unexcitability of the ablation line without prolonging the procedure time. It is associated with a marked reduction in fluoroscopic dose when compared to a conventional 3D mapping system.
Pre‐diabetes and well‐controlled diabetes are not associated with periodontal disease: the SHIP Trend Study
Authors: Kowall Bernd , Holtfreter Birte , Völzke Henry , Schipf Sabine , Mundt Torsten , Rathmann Wolfgang , Kocher Thomas
Published: March 2015

Aim

To examine associations of pre‐diabetes and well‐controlled diabetes with periodontitis.

Materials and Methods

The Study of Health in Pomerania (SHIP)‐Trend is a cross‐sectional survey in North‐Eastern Germany including 3086 participants (49.4% men; age 20–82 years). Clinical attachment loss (CAL) and periodontal probing depth (PPD) were assessed applying a random half‐mouth protocol. The number of teeth was determined. Pre‐diabetes comprised impaired fasting glucose and impaired glucose tolerance. Previously known diabetes was defined as well controlled if glycated haemoglobin (HbA1c) was <7.0%. Participants were categorized as follows: normal glucose tolerance (NGT), pre‐diabetes, newly detected type 2 diabetes (T2DM), known T2DM with HbA1c<7.0% and known T2DM with HbA1c≥7.0%.

Results

Pre‐diabetes was neither associated with mean CAL and PPD in multivariable adjusted linear regression models nor with edentulism (OR = 1.09 (95%‐CI: 0.69‐1.71)) and number of teeth (OR = 0.96 (95%‐CI: 0.75–1.22), lowest quartile versus higher quartiles) in logistic regression models. Associations with mean CAL and edentulism were stronger in poorly controlled previously known diabetes than in well‐controlled previously known diabetes (for edentulism: OR = 2.19 (95%‐CI: 1.18–4.05), and OR = 1.40 (95%‐CI: 0.82–2.38), respectively, for comparison with NGT).

Conclusions

Periodontitis and edentulism were associated with poorly controlled T2DM, but not with pre‐diabetes and well‐controlled diabetes.
Dendritic connectivity shapes spatial patterns of genetic diversity: a simulation‐based study
Authors: Paz‐Vinas I. , Blanchet S.
Published: March 2015

Landscape features notoriously affect spatial patterns of biodiversity. For instance, in dendritic ecological networks (such as river basins), dendritic connectivity has been proposed to create unique spatial patterns of biodiversity. Here, we compared genetic datasets simulated under a lattice‐like, a dendritic and a circular landscape to test the influence of dendritic connectivity on neutral genetic diversity. The circular landscape had a level of connectivity similar to that of the dendritic landscape, so as to isolate the influence of dendricity on genetic diversity. We found that genetic diversity and differentiation varied strikingly among the three landscapes. For instance, the dendritic landscape generated higher total number of alleles and higher global Fst than the lattice‐like landscape, and these indices also varied between the dendritic and the circular landscapes, suggesting an effect of dendricity. Furthermore, in the dendritic landscape, allelic richness was higher in highly connected demes (e.g. confluences in rivers) than in low‐connected demes (e.g. upstream and downstream populations), which was not the case in the circular landscape, hence confirming the major role of dendricity. This led to bell‐shaped distributions of allelic richness along an upstream–downstream gradient. Conversely, genetic differentiation (Fst) was lower in highly than in low‐connected demes (which was not observed in circular landscape), and significant patterns of isolation by distance (IBD) were also observed in the dendritic landscape. We conclude that in dendritic networks, the combined influence of dendricity and connectivity generates unique spatial patterns of neutral genetic diversity, which has implications for population geneticists and conservationists.
Measures Used to Assess Chronic Pelvic Pain in Randomized Controlled Clinical Trials: A Systematic Review
Authors: Gurian Maria Beatriz F. , Mitidieri Andréia M. d. S. , Rosa e Silva Júlio C. , Poli Neto Omero B. , Nogueira Antônio A. , Candido dos Reis Francisco José
Published: March 2015

Rationale

Many types of pain assessment are available to researchers carrying out clinical trials in chronic pelvic pain (CPP), ranging from a single‐item scale to multidimensional inventories.

Aim

Our objective was to investigate which assessments of pain are more commonly used in clinical trials on CPP.

Method

We have reviewed articles published between 1991 and 2014. A total of 74 studies out of 1299 original research articles reviewed met the selection criteria by containing at least one method of pain assessment. The selected studies were classified according to the dimensions of pain evaluated, the type of scale and the descriptors used.

Results

The instruments most frequently used were single‐item VAS and Biberoglu and Behrman pain score, while multidimensional inventories were used in few studies. The results of clinical studies in CPP are more frequently based on one‐dimensional measurements. Valuable results from clinical studies in CPP might have been omitted because of incomplete outcome measurements.

Conclusion

We believe the authors of clinical studies should report their results in a comprehensive way including in the outcomes of the measurement of one‐dimensional and multidimensional pain characteristics.
Effect of γ‐Irradiation on Cooking, Functional and Pasting Properties of Bambara Groundnut (Vigna subterranea [L.] Verdc.) Cultivars
Authors: Falade Kolawole O. , Adebiyi Alexander O.
Published: March 2015

The effect of γ‐irradiation dose (2, 4, 6, 8 and 10 kGy) on cooking, functional and pasting properties of four bambara groundnut cultivars (TvSu 315, TvSu 571, TvSu 760 and white) was investigated. Generally, sphericity, volume, surface area and aspect ratio of bambara groundnut seed increased significantly (P < 0.05) with increased γ‐irradiation dose and cooking time. Also, volume and surface area of seeds of TvSu 315 and white cultivars increased with increasing cooking time, while sphericity and aspect ratio showed mixed effect. At lower doses, increased γ‐irradiation resulted in decreased cooking time, elongation ratio and water uptake ratio of the seeds in all cultivars. However at higher doses, cooking time increased, while increase in γ‐irradiation showed little effect on seed elongation and water uptake ratio in all cultivars. Generally, water absorption capacity of flours increased significantly (P < 0.05) with increased γ‐irradiation dose in all cultivars, while oil absorption capacity increased until the 4 kGy and then declined. Foaming capacity, foam stability and swelling capacity of flours did not show dose‐dependent increase in all cultivars. Peak, trough, final and setback viscosities of flours decreased significantly (P < 0.05) with increased γ‐irradiation dose, while breakdown viscosity and pasting temperature did not show dose‐dependent increase.

Practical Application

Bambara groundnut is underutilized because of constraints like hard‐to‐cook phenomenon, strong beany flavor, presence of antinutrient and poor dehulling and milling characteristics. In many developing countries, the grain legume is stored as dry seeds. However, the seeds are very susceptible to insect infestation, which may start from the field, and vast qualities of seeds are lost annually as a result of insect attacks. Infestation of bambara groundnut seeds by Callosobruchus maculatus causes qualitative and quantitative losses and wastage. Also, the seeds are unsafe for immediate consumption due to the fact that fumigation chemicals are perceived to be carcinogenic. Therefore, γ‐irradiation was proposed as a viable alternative to the use of chemicals for pest control. Consequently, it is important to determine the effect of γ‐irradiation on cooking, functional, pasting and cooking properties of bambara groundnut seeds.
Methamphetamine acutely inhibits voltage‐gated calcium channels but chronically up‐regulates L‐type channels
Authors: Andres Marilou A. , Cooke Ian M. , Bellinger Frederick P. , Berry Marla J. , Zaporteza Maribel M. , Rueli Rachel H. , Barayuga Stephanie M. , Chang Linda
Published: March 2015

In neurons, calcium (Ca2+) channels regulate a wide variety of functions ranging from synaptic transmission to gene expression. They also induce neuroplastic changes that alter gene expression following psychostimulant administration. Ca2+ channel blockers have been considered as potential therapeutic agents for the treatment of methamphetamine (METH) dependence because of their ability to reduce drug craving among METH users. Here, we studied the effects of METH exposure on voltage‐gated Ca2+ channels using SH‐SY5Y cells as a model of dopaminergic neurons. We found that METH has different short‐ and long‐term effects. A short‐term effect involves immediate (< 5 min) direct inhibition of Ca2+ ion movements through Ca2+ channels. Longer exposure to METH (20 min or 48 h) selectively up‐regulates the expression of only the CACNA1C gene, thus increasing the number of L‐type Ca2+ channels. This up‐regulation of CACNA1C is associated with the expression of the cAMP‐responsive element‐binding protein (CREB), a known regulator of CACNA1C gene expression, and the MYC gene, which encodes a transcription factor that putatively binds to a site proximal to the CACNA1C gene transcription initiation site. The short‐term inhibition of Ca2+ ion movement and later, the up‐regulation of Ca2+ channel gene expression together suggest the operation of cAMP‐responsive element‐binding protein‐ and C‐MYC‐mediated mechanisms to compensate for Ca2+ channel inhibition by METH. Increased Ca2+ current density and subsequent increased intracellular Ca2+ may contribute to the neurodegeneration accompanying chronic METH abuse.

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Methamphetamine (METH) exposure has both short‐ and long‐term effects. Acutely, methamphetamine directly inhibits voltage‐gated calcium channels. Chronically, neurons compensate by up‐regulating the L‐type Ca2+ channel gene, CACNA1C. This compensatory mechanism is mediated by transcription factors C‐MYC and CREB, in which CREB is linked to the dopamine D1 receptor signaling pathway. These findings suggest Ca2+‐mediated neurotoxicity owing to over‐expression of calcium channels.
Nutrient Sensing Overrides Somatostatin and Growth Hormone‐Releasing Hormone to Control Pulsatile Growth Hormone Release
Authors: Steyn F. J.
Published: March 2015

Pharmacological studies reveal that interactions between hypothalamic inhibitory somatostatin and stimulatory growth hormone‐releasing hormone (GHRH) govern pulsatile GH release. However, in vivo analysis of somatostatin and GHRH release into the pituitary portal vasculature and peripheral GH output demonstrates that the withdrawal of somatostatin or the appearance of GHRH into pituitary portal blood does not reliably dictate GH release. Consequently, additional intermediates acting at the level of the hypothalamus and within the anterior pituitary gland are likely to contribute to the release of GH, entraining GH secretory patterns to meet physiological demand. The identification and validation of the actions of such intermediates is particularly important, given that the pattern of GH release defines several of the physiological actions of GH. This review highlights the actions of neuropeptide Y in regulating GH release. It is acknowledged that pulsatile GH release may not occur selectively in response to hypothalamic control of pituitary function. As such, interactions between somatotroph networks, the median eminence and pituitary microvasculature and blood flow, and the emerging role of tanycytes and pericytes as critical regulators of pulsatility are considered. It is argued that collective interactions between the hypothalamus, the median eminence and pituitary vasculature, and structural components within the pituitary gland dictate somatotroph function and thereby pulsatile GH release. These interactions may override hypothalamic somatostatin and GHRH‐mediated GH release, and modify pulsatile GH release relative to the peripheral glucose supply, and thereby physiological demand.
Investigating the Disconnect between Financial Knowledge and Behavior: The Role of Parental Influence and Psychological Characteristics in Responsible Financial Behaviors among Young Adults
Authors: TANG NING , BAKER ANDREW , PETER PAULA C.
Published: March 2015

Financial knowledge is an essential component in financial decision making; however, knowledge is insufficient to ensure responsible financial behavior. We investigate the weak association between financial knowledge and behavior by simultaneously testing the roles financial knowledge, parental influence, and individual psychological characteristics (self‐discipline and thoroughness) play in young adults' financial behaviors. Results from 2,712 respondents from the 1997 National Longitudinal Survey of Youth confirm there is a weak association between financial knowledge and behavior. Parental influence and self‐discipline positively associate with responsible financial behavior. We also investigate the moderating role of gender and observe that financial knowledge and parental influence improve women's financial behavior more than men, whereas being thorough has a larger impact among males. These findings suggest that considering social and individual psychological factors in financial education programs could improve program efficiency. The results also highlight the importance of adopting tailored financial education to suit gender differences.
Influence of the complex of retinol–vitamin C on skin surface lipids
Authors: Wójcik Aneta , Bartnicka Ewelina , Namieciński Piotr , Rotsztejn Helena
Published: March 2015

Background

Retinol is used to reduce symptoms of skin aging. It affects surface lipids and increases skin regeneration ability.

Aim

The aim of our study was to investigate the effect of retinol peel on the face and neck skin lipids in women, aged 50–69.

Material and methods

The level of secreted sebum was measured using Sebumeter SM15 (Courage & Khazaka, Germany) on the forehead, cheeks, nose, chin, and neck. The measurements were carried out before each of the 3 retinol peel treatments applied at 3‐week interval and 3 weeks after the last treatment.

Results

A statistically significant increase of lipid film in both U‐zone and T‐zone and on the neck was observed in the study group.

Conclusion

Retinol peel treatments can help to increase the amount of skin surface lipids in women during menopause.
Osteoporosis: the emperor has no clothes
Authors: Järvinen T. L. N. , Michaëlsson K. , Aspenberg P. , Sievänen H.
Published: March 2015

Current prevention strategies for low‐trauma fractures amongst older persons depend on the notions that fractures are mainly caused by osteoporosis (pathophysiology), that patients at high risk can be identified (screening) and that the risk is amenable to bone‐targeted pharmacotherapy (treatment). However, all these three notions can be disputed.

Pathophysiology

Most fracture patients have fallen, but actually do not have osteoporosis. A high likelihood of falling, in turn, is attributable to an ageing‐related decline in physical functioning and general frailty.

Screening

Currently available fracture risk prediction strategies including bone densitometry and multifactorial prediction tools are unable to identify a large proportion of patients who will sustain a fracture, whereas many of those with a high fracture risk score will not sustain a fracture.

Treatment

The evidence for the viability of bone‐targeted pharmacotherapy in preventing hip fracture and other clinical fragility fractures is mainly limited to women aged 65–80 years with osteoporosis, whereas the proof of hip fracture‐preventing efficacy in women over 80 years of age and in men at all ages is meagre or absent. Further, the antihip fracture efficacy shown in clinical trials is absent in real‐life studies. Many drugs for the treatment of osteoporosis have also been associated with increased risks of serious adverse events. There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20–25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment.
Prognostic implication of CD57, CD16, and TGF‐β expression in oral squamous cell carcinoma
Authors: Taghavi Nasim , Bagheri Sara , Akbarzadeh Alireza
Published: March 2015

Background

Natural killer (NK) cells are important immune effector cells against tumors especially in the absence or reducing MHC class I antigen. Downregulation of CD16 receptor is accompanied by decreasing NK cell‐killing activity. It has also been shown that some of tumor cells can evade from immune system through producing transforming growth factor beta (TGF‐β) and affect prognosis. The objective of this study was to evaluate the prognostic significance of CD57+ and CD16+ cells and TGF‐β expression in samples of oral squamous cell carcinoma (OSCC).

Methods

CD57, CD16, and TGF‐β expressions were examined immunohistochemically in 57 cases of OSCC. The relationship between markers’ expression and clinicopathologic data using bivariate and multivariate analysis was assessed.

Results

Multivariate analysis revealed that CD57 expression [HR 17.34 (95% CI 3.815–78.830); P < 0.001] and mode of invasion [HR 0.362 (95% CI 0.138–0.947); P = 0.038] correlated with survival rate, but no relation between CD57 expression and mode of invasion was seen (P = 0.96). Furthermore, no correlation between CD57, CD16, and TGF‐β expression was found.

Conclusion

These findings suggest that CD57 expression and mode of invasion are independent prognostic factors of survival in OSCC patients.
Daily differential expression of melatonin‐related genes and clock genes in rat cumulus–oocyte complex: changes after pinealectomy
Authors: Coelho L. A. , Peres R. , Amaral F. G. , Reiter R. J. , Cipolla‐Neto J.
Published: March 2015

This study investigated the maturational stage (immature and mature ovaries) differences of mRNA expression of melatonin‐forming enzymes (Aanat and Asmt), melatonin membrane receptors (Mt1 and Mt2) and putative nuclear (Rorα) receptors, and clock genes (Clock, Bmal1, Per1, Per2, Cry1, Cry2) in cumulus–oocyte complexes (COC) from weaning Wistar rats. We also examined the effects of pinealectomy and of melatonin pharmacological replacement on the daily expression of these genes in COC. qRT‐PCR analysis revealed that in oocytes, the mRNA expression of Asmt, Mt2, Clock, Bmal1, Per2, and Cry1 were higher (P < 0.05) in immature ovaries than in the mature ones. In cumulus cells, the same pattern of mRNA expression for Asmt, Aanat, Rorα, Clock, Per1, Cry1, and Cry2 genes was observed. In oocytes, pinealectomy altered the daily mRNA expression profiles of Asmt, Mt1, Mt2, Clock, Per1, Cry1, and Cry2 genes. In cumulus cells, removal of the pineal altered the mRNA expression profiles of Mt1, Mt2, Rorα, Aanat, Asmt, Clock, Bmal1, Per2, Cry1, and Cry2 genes. Melatonin treatment partially or completely re‐established the daily mRNA expression profiles of most genes studied. The mRNA expression of melatonin‐related genes and clock genes in rat COC varies with the maturational stage of the meiotic cellular cycle in addition to the hour of the day. This suggests that melatonin might act differentially in accordance with the maturational stage of cumulus/oocyte complex. In addition, it seems that circulating pineal melatonin is very important in the design of the daily profile of mRNA expression of COC clock genes and genes related to melatonin synthesis and action.