bluuebunny/crossref_metadata_2025 huggingface dataset:
Antigen peptide transporter 1 is involved in the development of fructose‐induced hepatic steatosis in mice
Authors: Arindkar Shailendra , Bhattacharjee Jashdeep , Kumar Jerald Mahesh , Das Barun , Upadhyay Pramod , Asif Shajahan , Juyal Ramesh C , Majumdar Subeer S , Perumal Nagarajan
Published: March 2013

Background and Aim

The purpose of this study is to assess whether the decrease in CD8 cells has any role in the development of non‐alcoholic fatty liver disease (NAFLD). In this study, we therefore used antigen peptide transporter 1 (TAP1−/−) mice that cannot transport major histocompatibility complex class I antigens onto the cell surface resulting in failure of the generation of CD8 cells.

Methods

Wild‐type C57Bl/6J and TAP1−/− mice were fed with 30% fructose solution for 8 weeks. The percentage of CD4, CD8 cells in peripheral blood mononuclear cells, and liver were sorted by fluorescence‐activated cell sorting in both control and fructose‐treated mice. Bodyweight, histopathological changes, oil red O staining, glucose tolerance test, intraperitoneal insulin tolerance test, serum levels of triglycerides, cholesterol, aspartate aminotransferase, and alanine aminotransferase were also evaluated. Quantitative real‐time polymerase chain reaction was performed to determine the expression of specific genes involved in development of fatty changes in the liver.

Results

Chronic consumption of fructose in TAP1−/− mice did not develop NAFLD, insulin resistance, or change in level of CD8 cells. Moreover, there was delay in relative expression levels of genes involved in development of NAFLD in fructose‐treated TAP1−/− mice.

Conclusion

Taken together, the data suggest that TAP1−/−‐deficient mice displayed reduced levels of CD8 cells that have a vital role in the initiation and propagation of liver inflammation and is a casual role in the beginning of fructose‐induced liver damage as well as insulin resistance in mice.
Characteristics of belching, swallowing, and gastroesophageal reflux in belching patients based on Rome III criteria
Authors: Li Jianbo , Xiao Yinglian , Peng Sui , Lin Jinkun , Chen Minhu
Published: March 2013

Background and Aims

Belching is a common disorder with undetermined pathogenesis. With the combined multichannel intraluminal impedance pH monitoring, two different models of belching have been defined: gastric belching (GB) and supragastric belching (SB). The aim of this study was to assess whether SB was associated with air swallowing as compared with GB or healthy volunteers based on Rome III criteria.

Methods

Consecutive patients who presented with troublesome repetitive belching were recruited. Both upper endoscopy and multichannel intraluminal impedance pH monitoring were performed. Patients were divided into two groups: SB and GB groups according to the percentage of the predominant belching types. Twenty volunteers were enrolled as healthy controls. The number of air swallowing, regular swallowing, and gastroesophageal reflux profile was compared among the three groups.

Results

Thirty‐seven patients were included in the study: 25 in the SB group and 12 in GB group. SB patients presented more belching events than GB patients (P < 0.05). There were no significant differences among the SB, GB patients, and healthy volunteers concerning the episodes of air swallowing and regular swallowing (P > 0.05). No significant difference was found among the three groups in regard with the reflux parameters (P > 0.05). The number of gas‐containing reflux episodes were 33.0 (20.0, 48.0), 39.5 (29.5, 47.5), and 30.5 (27.0, 41.8) among SB, GB, and healthy volunteers (P = 0.383), respectively.

Conclusions

SB patients presented with more belching events compared with GB patients. However, air swallowing and reflux profile were similar among the SB, GB patients, and normal controls.
Cancer risk in Japanese Crohn's disease patients: Investigation of the standardized incidence ratio
Authors: Yano Yutaka , Matsui Toshiyuki , Hirai Fumihito , Okado Yuki , Sato Yuho , Tsurumi Kozue , Ishikawa Satoshi , Beppu Tsuyoshi , Koga Akihiro , Yoshizawa Naoyuki , Higashi Daijiro , Futami Kitaro
Published: March 2013

Background and Aim

There have been very few reported investigations on the standardized incidence ratio (SIR) of intestinal cancer and all cancers other than intestinal cancer with Crohn's disease (CD) by organ in Japan. This study examined the risk of developing cancer (i.e. SIR) that occurs in association with CD.

Methods

The subjects were 770 CD patients managed at our hospital department, which specializes in inflammatory bowel disease, during the approximately 25 years from July 1985 to August 2010. The number of expected cancer patients in a healthy population matched for sex and age with the CD patients in our hospital was then calculated. The relative risk, or SIR, was also calculated.

Results

The total observation period was 10 552 person‐years, during which 19 cases (2.5%) of cancer were discovered in 770 subjects. The cancer cases included nine cases of colorectal cancer (CRC), one case of small bowel cancer, one case of stomach cancer, three cases of acute myeloid leukemia, two cases of endometrial cancer, one case of lung cancer, one case of skin cancer, and one case of thyroid cancer. The SIR for cancers in Japan in 2003 was 0.87 (95% confidence interval [CI] 0.52–1.35) for all cancers, 2.79 (95% CI 1.28–5.29) for CRC, and 6.94 (95% CI 1.43–20.3) for leukemia.

Conclusions

Among the cancers in CD patients in our hospital, no significant difference was seen in the risk for all cancers in comparison with the standard population. However, the risks for CRC and leukemia were significantly higher than in the standard population.
Hepatic and systemic hemodynamic derangements predict early mortality and recovery in patients with acute‐on‐chronic liver failure
Authors: Garg Hitendra , Kumar Ashish , Garg Vishal , Kumar Manoj , Kumar Ramesh , Sharma Barjesh Chander , Sarin Shiv Kumar
Published: March 2013

Background and Aims

Acute‐on‐chronic liver failure (ACLF) is a clinical entity where there is a potential for reversibility of hepatic dysfunction once the acute hepatic insult resolves. The portal and systemic hemodynamics in ACLF patients to study its relevance in determining the clinical outcomes was studied.

Methods

Clinical, laboratory, portal, and systemic hemodynamic assessments were done at admission and after 3 months. Standard medical care was given to all the patients.

Results

Fifty‐seven patients with ACLF were enrolled, and they underwent baseline hepatic venous pressure gradient (HVPG) measurement. Twenty‐six (46%) patients died during the 3‐month follow‐up. Presence of high HVPG and hepatic encephalopathy were found to be independent baseline predictors of mortality. Of the 31 surviving patients, 24 consented for a repeat HVPG. The baseline HVPG reduced from 16 (range 12–30) to 13 (range 6–21) mmHg; (P < 0.05). The reduction in HVPG correlated with clinical and biochemical recovery, and reduction in Child–Turcotte–Pugh score score (P < 0.05), while the aortic mean arterial pressure, cardiac index and systemic vascular resistance index improved significantly (< 0.05). Six (25%) patients developed upper gastrointestinal bleed; the median HVPG between bleeders and non‐bleeders was not different possibly because of early onset of bleed (median 20 [15–45 days]).

Conclusions

Baseline HVPG is an independent predictor of mortality in ACLF patients. The portal and systemic circulatory anomalies regress substantially by 90 days and correlate with clinical recovery. However, in the initial phase, the raised portal pressure predisposes these patients to high risk of variceal bleeding.
Proteomics and metabolomics in inflammatory bowel disease
Authors: Yau Yunki , Leong Rupert W , Zeng Ming , Wasinger Valerie C
Published: March 2013

Genome‐wide studies in inflammatory bowel disease (IBD) have allowed us to understand Crohn's disease and ulcerative colitis as forms of related autoinflammatory disorders that arise from a multitude of pathogenic origins. Proteomics and metabolomics are the offspring of genomics that possess unprecedented possibilities to characterize unknown pathogenic pathways. It has been about a decade since proteomics was first applied to IBD, and 5 years for metabolomics. These techniques have yielded novel and potentially important findings, but turning these results into beneficial patient outcomes remains challenging. This review recounts the history and context of clinical IBD developments before and after proteomics and metabolomics IBD in this field, discusses the challenges in consolidating high complexity data with physiological understanding, and provides an outlook on the emerging principles that will help interface the bioanalytical laboratory with IBD prognosis.
Association of N‐acetyltransferase 2 and cytochrome P450 2E1 gene polymorphisms with antituberculosis drug‐induced hepatotoxicity in Western India
Authors: Gupta Vinod H , Amarapurkar Deepak N , Singh Meenakshi , Sasi Preetha , Joshi Jyotsna M , Baijal Rajiv , Ramegowda Praveenkumar H , Amarapurkar Anjali D , Joshi Kalpana , Wangikar Pramod P
Published: March 2013

Background and Aim

Tuberculosis (TB) is a major public health problem in India. Despite the treatment availability and monitoring, drug‐induced hepatotoxicity (DIH) is a serious concern and can lead to discontinuation of treatment. Anti‐TB DIH is well known and can aggravate because of pharmacokinetic and pharmacodynamic interactions. Genetic polymorphism in the drug‐metabolizing enzyme genes is an important factor that predisposes certain fraction of the population to drug‐induced toxicity. The purpose of this study was to assess the association of N‐acetyltransferase 2 (NAT2) and cytochrome P450 2E1 (CYP2E1) gene polymorphism with anti‐TB DIH in Western Indian population.

Methods

A prospective cohort study of 215 patients taking treatment against TB was performed. The NAT2 and CYP2E1 genotypes were determined using polymerase chain reaction and restriction fragment length polymorphism methods. Logistic regression model was used to calculate odds ratio at 95% confidence interval and their respective P values.

Results

The risk of anti‐TB DIH was significantly higher in slow acetylator (SA) than in intermediate and rapid acetylator of NAT2 genotypes (odds ratio: 2.3, P = 0.01). We also observed the homozygous point mutation at position 481, associated with higher risk of hepatotoxicity (P < 0.01). The major haplotype NAT2*4 seems to provide protection in DIH compared with non‐DIH TB patients (P = 0.04). However, we did not find a significant association between CYP2E1 genotypes and anti‐TB DIH.

Conclusion

Increased susceptibility to isoniazid (INH)‐induced hepatotoxicity due to presence of NAT2 SA polymorphism was demonstrated in Western Indian population. NAT2 genotyping can therefore serve as an important tool for identifying patients predisposed to anti‐TB DIH.
Hemodynamic effects of continuous versus bolus infusion of terlipressin for portal hypertension: A randomized comparison
Authors: Ding Chao , Wu Xingjiang , Fan Xinxin , He Changsheng , Li Jieshou
Published: March 2013

Background and Aim

The hemodynamics of patients with portal hypertension within 4 h after a single injection of terlipressin has been studied. However, the hemodynamics in a longer phase under different infusion styles is unknown. This study aims to compare the effects of bolus and continuous infusion of terlipressin on systemic and hepatic hemodynamics in patients with portal hypertension.

Methods

Twenty patients who underwent transjugular intrahepatic portosystemic shunt procedure were randomly assigned to be treated with either intravenous bolus infusion of terlipressin (1 mg) followed by a continuous infusion (4 mg/24 h, n = 10), or intravenous bolus injection of terlipressin (2 mg) followed by intermittent injections (1 mg/6 h, n = 10). The mean arterial pressure, heart rate, and portal venous pressure (PVP) were monitored and recorded at baseline, 1 min, 5 min, 10 min, 30 min, and then once an hour. Serum renin activity, serum angiotensin II, and aldosterone levels were measured prior to and 24 h after the administration of terlipressin.

Results

PVP dropped rapidly in both groups, and reduced 16.46% and 28.22%, respectively, at the 1‐h time point. Thereafter, PVP remained stable in continuous group while rebounded obviously in intermittent group. One hour after the start of drug administration, heart rate decreased significantly in both groups (84.1 ± 12.8 vs 73.8 ± 12.6 in intermittent group and 86.7 ± 11.5 vs 77.1 ± 13.6 in continuous group, P < 0.005), and mean arterial pressure increased in both groups, although no statistical differences were found.

Conclusion

Continuous infusion of terlipressin reduces PVP stably and may become an alternative to traditional bolus injection.
Limited role of allergy testing in patients with eosinophilic gastrointestinal disorders
Authors: Ishimura Norihisa , Furuta Kenji , Sato Shuichi , Ishihara Shunji , Kinoshita Yoshikazu
Published: March 2013

Background and Aim

Allergies have been implicated in the pathogenesis of eosinophilic gastrointestinal disorders, although it remains unknown what type of allergen is closely associated with their development. The aim of this study is to investigate the possible involvement of food and/or aeroallergen factors in eosinophilic gastrointestinal disorders.

Methods

Eighteen patients with eosinophilic esophagitis (EoE), 23 with eosinophilic gastroenteritis (EGE), and 28 healthy volunteers were enrolled. The levels of total serum immunoglobulin E (IgE) and 33 different allergen‐specific IgE antibodies, including those for six foods used in a standard EoE elimination diet, were determined in each subject. Serum antigen‐specific IgE levels were measured using a chemiluminescence enzyme immunoassay with a multiple antigen simultaneous test 33 (MAST33). The expression patterns of specific antigens were compared among the groups.

Results

The mean level of total IgE antibodies was significantly higher in patients with EGE (553.6 ± 115.3 IU/mL) than the healthy volunteers (230.6 ± 87.1 IU/mL). Two thirds of all subjects had sensitivity to at least one inhaled antigen. In positive cases, allergies against multiple antigens were more frequently seen in the EoE and EGE patients. Japanese cedar and dust mite aeroallergens were more prevalent than food antigens.

Conclusions

Consistent with higher levels of serum total IgE antibodies, patients with EoE and EGE were frequently sensitized to several different allergens. Reactions to aeroallergens were more prevalent in these groups, although no particular antigen causing EoE and/or EGE was detected by measuring serum antigen‐specific IgE antibodies.
Cloning, Characterization and Functional Analysis of Two Type 1 diacylglycerol acyltransferases (DGAT1s) from Tetraena mongolica
Authors: Li Minchun , Zhao Mingming , Wu Hanying , Wu Wang , Xu Yinong
Published: March 2013

Two cDNAs encoding putative type 1 acyl‐CoA: diacylglycerol acyltransferases (DGAT1, EC 2.3.1.20), were cloned from Tetraena mongolica, an extreme xerophyte with high oil content in the stems. The 1 488‐bp and 1 485‐bp of the open reading frame (ORF) of the two cDNAs, designated as TmDGAT1a and TmDGAT1b, were both predicted to encode proteins of 495 and 494 amino acids, respectively. Southern blot analysis revealed that TmDGAT1a and TmDGAT1b both had low copy numbers in the T. mongolica genome. In addition to ubiquitous expression with different intensity in different tissues, including stems, leaves and roots, TmDGAT1a and TmDGAT1b, were found to be strongly induced by high salinity, drought and osmotic stress, resulting in a remarkable increase of triacylglycerol (TAG) accumulation in T. mongolica plantlets. TmDGAT1a and TmDGAT1b activities were confirmed in the yeast H1246 quadruple mutant (DGA1, LRO1, ARE1, ARE2) by restoring DGAT activity of the mutant host to produce TAG. Overexpression of TmDGAT1a and TmDGAT1b in soybean hairy roots as well as in T. mongolica calli both resulted in an increase in oil content (ranging from 37% to 108%), accompanied by altered fatty acid profiles.
The significance of aspects of screening for obstructive sleep apnoea in children with Down syndrome
Authors: Stores R. J. , Stores G.
Published: March 2013

Background

The sleep problems of children with intellectual disabilities remains a relatively neglected topic in spite of the consistent reports that such problems are common, often severe and persistent with potentially serious consequences for the children and their families. Children with Down syndrome (DS) are a case in point. They often suffer from obstructive sleep apnoea (OSA), early detection of which is recommended because of its potentially adverse effects on development. This study is concerned with aspects of assessment that have been considered important in helping to recognise OSA in children with DS. The relationships between different objective measures, and between these measures and parental reports of their child's sleep and daytime behaviour, were explored.

Method

Overnight recordings were carried out on a group of children with DS (n = 31) involving video and audio recording, oximetry and activity monitoring during sleep. Parents also completed questionnaires concerning their child's sleep and daytime behaviour.

Results

Parents' reports of restless sleep and noisy breathing were supported by objective measures of activity during sleep and audio recording respectively.

No significant association was found between objective measures of restlessness during sleep and ‘snoring’ (see later for definition), nor were objective measures of restlessness related to reductions in overnight blood oxygen levels. However, the objective measure of snoring was significantly associated with reductions in overnight blood oxygen levels.

All three of the objective measures were significantly associated with parental reports of various types of disturbed daytime behaviour.

Conclusions

The findings have implications for aspects of screening for OSA in children with DS and for the interpretation of the relevance of the results to the children's daytime behaviour.
Object discrimination and reversal learning in infant and juvenile non‐human primates in a non‐clinical laboratory
Authors: Makori Norbert , Watson Rebecca E. , Hogrefe Casey E. , Lalayeva Narine , Oneda Satoru
Published: March 2013

Background

Biopharmaceutical development necessitates use of non‐human primates in toxicology, leading to adoption of non‐traditional methods including cognitive function assessment.

Methods

A two‐object discrimination and reversal test in cynomolgus monkeys (Macaca fascicularis) was performed using a Wisconsin General Testing Apparatus (WGTA). Non‐clinical study design and regulatory considerations dictate that infants are raised by their biological mothers until weaning at 6 months. Thirty‐four animals (6–21 months of age) were trained to discriminate between two randomly selected stimulus objects to retrieve a reward. Following training, days to first reversal after interchanging the reward were measured.

Results

Both sexes acquired visual discrimination skills at similar rates. Trends in learning and reversals completed were uniform across age groups. Completing training early in some subjects had no impact on subsequent testing phases.

Conclusions

Weaned cynomolgus monkey infants can be successfully tested for cognitive abilities using the WGTA in a non‐clinical laboratory setting.
The effects of joint immobilization on articular cartilage of the knee in previously exercised rats
Authors: Maldonado Diogo Correa , Silva Marcelo Cavenaghi Pereira da , Neto Semaan El‐Razi , de Souza Mônica Rodrigues , de Souza Romeu Rodrigues
Published: March 2013

Studies have determined the effects of joint immobilization on the articular cartilage of sedentary animals, but we are not aware of any studies reporting the effects of joint immobilization in previously trained animals. The objective of the present study was to determine whether exercise could prevent degeneration of the articular cartilage that accompanies joint immobilization. We used light microscopy to study the thickness, cell density, nuclear size, and collagen density of articular cartilage of the femoral condyle of Wistar rats subjected to aerobic physical activity on an adapted treadmill five times per week. Four groups of Wistar rats were used: a control group (C), an immobilized group (I), an exercised group (E), and an exercised and then immobilized group (EI). The right knee joints from rats in groups I and EI were immobilized at 90 °C of flexion using a plastic cast for 8 weeks. Cartilage thickness decreased significantly in group I (mean, 120.14 ± 15.6 μm, P < 0.05), but not in group EI (mean, 174 ± 2.25), and increased significantly in group E (mean, 289.49 ± 9.15) compared with group C (mean, 239.20 ± 6.25). The same results were obtained for cell density, nuclear size, and collagen density (in all cases, P < 0.05). We concluded that exercise can prevent degenerative changes in femoral articular cartilage caused by immobilization of the knee joint.
Reframing ‘Crisis’ in Fair Trade Coffee Production: Trajectories of Agrarian Change in Nicaragua
Authors: Fraser James , Fisher Eleanor , Arce Alberto
Published: March 2013

A focus on crisis provides a methodological window to understand how agrarian change shapes producer engagement in fair trade. This orientation challenges a separation between the market and development, situating fair trade within global processes that incorporate agrarian histories of social change and conflict. Reframing crisis as a condition of agrarian life, rather than emphasizing its cyclical manifestation within the global economy, reveals how market‐driven development encompasses the material conditions of peoples' existence in ambiguous and contradictory ways. Drawing on the case of coffee production in Nicaragua, experiences of crisis demonstrate that greater attention needs to be paid to the socioeconomic and political dimensions of development within regional commodity assemblages to address entrenched power relations and unequal access to land and resources. This questions moral certainties when examining the paradox of working in and against the market, and suggests that a better understanding of specific trajectories of development could improve fair trade's objective of enhancing producer livelihoods.
Measuring and improving the quality of postoperative epidural analgesia for major abdominal surgery using statistical process control charts
Authors: Duncan Fiona , Haigh Carol
Published: March 2013

Aims and objectives

To explore and improve the quality of continuous epidural analgesia for pain relief using Statistical Process Control tools.

Background

Measuring the quality of pain management interventions is complex. Intermittent audits do not accurately capture the results of quality improvement initiatives. The failure rate for one intervention, epidural analgesia, is approximately 30% in everyday practice, so it is an important area for improvement. Continuous measurement and analysis are required to understand the multiple factors involved in providing effective pain relief.

Design

Process control and quality improvement

Methods

Routine prospectively acquired data collection started in 2006. Patients were asked about their pain and side effects of treatment. Statistical Process Control methods were applied for continuous data analysis. A multidisciplinary group worked together to identify reasons for variation in the data and instigated ideas for improvement. The key measure for improvement was a reduction in the percentage of patients with an epidural in severe pain.

Results

The baseline control charts illustrated the recorded variation in the rate of several processes and outcomes for 293 surgical patients. The mean visual analogue pain score (VNRS) was four. There was no special cause variation when data were stratified by surgeons, clinical area or patients who had experienced pain before surgery. Fifty‐seven per cent of patients were hypotensive on the first day after surgery. We were able to demonstrate a significant improvement in the failure rate of epidurals as the project continued with quality improvement interventions.

Conclusion

Statistical Process Control is a useful tool for measuring and improving the quality of pain management.

Implications for nursing management

The applications of Statistical Process Control methods offer the potential to learn more about the process of change and outcomes in an Acute Pain Service both locally and nationally. We have been able to develop measures for improvement and benchmarking in routine care that has led to the establishment of a national pain registry.
The experience of food, eating and meals following radiotherapy for head and neck cancer: a qualitative study
Authors: Ottosson Sandra , Laurell Göran , Olsson Cecilia
Published: March 2013

Aims and objectives

To describe the experience of food, eating and meals following radiotherapy in patients with head and neck cancer.

Background

Eating problems are common in patients with head and neck cancer and may remain for a long period of time after treatment.

Design

A qualitative study design using in‐depth semi‐structured interviews.

Methods

Interviews were conducted nine months after the termination of radiotherapy. A purposive sample of thirteen patients with head and neck cancer participated in the study. The interviews were tape‐recorded, transcribed verbatim and analysed using content analysis.

Results

The experience of food, eating and meals up to nine months after radiotherapy was captured in six categories: ‘A long journey – taking small steps to an uncertain future’, ‘A new way of eating’, ‘Eating without satisfaction’, ‘Challenging meals outside the family’, ‘Support and information – the key to a successful journey’ and ‘The creation and acceptance of a new normal’.

Conclusion

This study provides new information on the long‐term aspects of food, eating and meals in patients with head and neck cancer. Head and neck cancer signifies a long journey with problems affecting physical, psychological and social aspects of food. Information and support and the use of strategies are important for patients with head and neck cancer to adapt to new possibilities for living after cancer treatment.

Relevance to clinical practice

All members of the multiprofessional team need to be aware of the struggles with food and eating experienced by patients with head and neck cancer during the convalescent period. It is therefore important that the follow‐up focuses on all aspects of food, eating and meals as a part of a holistic approach.
Parenting support for families with young children – a public health, user‐focused study undertaken in a semi‐rural area of Scotland
Authors: Hogg Rhona , Ritchie Deborah , de Kok Bregje , Wood Cathy , Huby Guro
Published: March 2013

Aims and objectives

To work with parents and public health nurses (health visitors), to identify and design a range of public health interventions to provide support to parents of young children.

Background

In the UK, only vulnerable families are now eligible for pro‐active health visiting interventions on an individual family basis beyond the early days. Public health approaches are recommended for the majority of families who are not eligible for one‐to‐one professional support.

Design

Focus groups were carried out with parents of young children, health visitors and other professionals working with them.

Methods

The study was carried out in a semi‐rural area of Scotland, consisting of a small town, and the surrounding rural area, including one area of deprivation. The area is served by a team consisting of six health visitors and one health assistant, based in two health centres in the area. Nineteen parents, five members of the health visiting team and 11 other professionals from health, education and social work took part via an invitation to contact the research team.

Results

The needs of parents identified by both parents and professionals could best be met by social support, with skilled facilitation and suitable resources. The resolution of tensions between caseload‐based and population‐based health visiting, as well as the management of the tensions inherent in these changes, seems to be vital in order to implement these approaches. Many parents would like information made available online.

Conclusions

Services to support families with young children need to be designed from the perspectives of parents and their needs.

Relevance to clinical practice

Services need to be set up in partnership with parents to provide them with information and access to peer and professional support, using public health approaches. Multiagency working, including among senior managers, may be the most effective way of providing this support.
Long‐Term Clinical Outcomes of the One‐Stent Technique versus the Two‐Stent Technique for Non‐Left Main True Coronary Bifurcation Disease in the Era of Drug‐Eluting Stents
Authors: KOH YOON‐SEOK , KIM PUM‐JOON , CHANG KIYUK , PARK HUN‐JUN , JEONG MYUNG‐HO , KIM HYO‐SOO , JANG YANGSOO , GWON HYEON‐CHEOL , PARK SEUNG‐JUNG , SEUNG KI‐BAE
Published: March 2013

Background

Few studies have compared the long‐term major adverse cardiac events (MACEs) between the one‐stent technique (stenting only the main branch) and the two‐stent technique (stenting of both the main and side branches) for the treatment of true coronary bifurcation lesions in the drug‐eluting stent era. Therefore, we investigated this issue using the large nationwide coronary bifurcation registry.

Methods

The 1,147 patients with non‐left main coronary true bifurcation lesions underwent percutaneous coronary intervention in the Korea Coronary Bifurcation Stent (COBIS) registry. All patients were stratified based on the stent placement technique: one stent (n = 898) versus two stents (n = 249). MACE, including death, nonfatal myocardial infarction (MI), and repeat vessel and lesion revascularization (TVR and TLR), were evaluated.

Results

The median follow‐up duration was 20 months. The MACEs did not differ between the 2 groups. Findings from the one‐stent group were similar to those of the two‐stent group in composite of death, MI, or TVR, based on analysis by crude, multivariate Cox hazard regression model, inverse‐probability‐of‐treatment weighting (hazard ratio [HR] 0.911, 95% confidence interval (CI) 0.614–1.351; HR 0.685 95% CI 0.381–1.232; HR 1.235, 95% CI 0.331–4.605, respectively). In further analysis with propensity score matching, the overall findings were consistent.

Conclusions

The findings of the present study indicate that the one‐stent technique was not inferior to the two‐stent technique for the treatment of non‐left main true coronary bifurcation lesions in terms of long‐term MACEs. (J Interven Cardiol 2013;26:245–253)
Esophagoprotection mediated by exogenous and endogenous melatonin in an experimental model of reflux esophagitis
Authors: Konturek Peter C. , Brzozowska Iwona , Targosz Aneta , Pawlik Michal , Kania Joanna , Hess Thomas , Kwiecien Slawomir , Konturek Stanislaw J. , Reiter Russel J. , Brzozowski Tomasz
Published: March 2013

Reflux esophagitis is a common clinical entity in western countries with approximately 30% of the population experiencing the symptoms at least once every month. The imbalance between the protective and aggressive factors leads to inflammation and damage of the esophageal mucosa. We compared the effect of exogenous melatonin and melatonin derived endogenously from L‐tryptophan with that of pantoprazole or ranitidine in acid reflux esophagitis due to ligation of the rat pylorus and the limiting ridge between the forestomach and the corpus. Four hours after the induction of gastric reflux, an increase in mucosal lesions associated with edema of the submucosa and with the infiltration of numerous neutrophils and the fall in esophageal blood flow (EBF) were observed. Both melatonin and L‐tryptophan or pantoprazole significantly reduced the lesion index (LI) and raised the EBF. Pinealectomy that significantly decreased plasma melatonin levels aggravated LI and these effects were reduced by melatonin and L‐tryptophan. Luzindole, the MT2 receptor antagonist, abolished the melatonin‐induced reduction in LI and the rise in EBF. L‐NNA and capsaicin that augmented LI and decreased EBF, also significantly reduced melatonin‐induced protection and hyperemia; both were restored with L‐arginine and calcitonin gene–related peptide (CGRP) added to melatonin. Upregulation of IL‐1β and TNF‐α mRNAs and plasma IL‐1β and TNF‐α levels were significantly attenuated by melatonin and L‐tryptophan. We conclude that melatonin protects against acid reflux‐induced damage via activation of MT2 receptors mediated by NO and CGRP released from sensory nerves and the suppression of expression and release of TNF‐α and IL‐1β.
Impact of Structure Modification on Texture of a Soymilk and Cow's Milk Gel Assessed Using the Napping Procedure
Authors: Grygorczyk A. , Lesschaeve I. , Corredig M. , Duizer L.
Published: March 2013

It was hypothesized that with careful control of the structure of a mixed protein matrix, it is possible to obtain different textures without changing ingredients or their concentrations. A model system containing soymilk, cow's milk and cream was used. To modify the texture of the final matrix, the mode of protein gelation and the order of homogenization of the cream (with soymilk or skim milk alone or with both mixed together) were investigated. Using a partial Napping and ultra‐flash profiling procedure, it was demonstrated that as long as milk was homogenized with cream, the mixed protein gels had higher thickness and mouthcoating compared with gels made from unhomogenized samples or samples made by homogenizing the cream with soymilk. It was found that aggregation of milk proteins before soy proteins resulted in more prominent fat‐related attributes such as slipperiness and fattiness compared with simultaneous aggregation of casein and soy proteins.

Practical Applications

Recently, there has been a growing interest in mixed protein gels; however, little information exists about their sensory properties. Such gels have the potential to be a novel category of healthy high‐protein products exhibiting consumer‐acceptable sensory properties. However, more work is needed to improve understanding of how to generate such products and to understand the processes that impact their sensory properties. The aim of the present study was to examine the sensory texture changes induced when the organization of components is modified within a mixed soymilk–dairy milk gel without changing ingredients or their concentrations. The present study also contributes to the understanding of texture perception as it demonstrates a clear link between texture perception and structure modification in a protein gel. Mixed protein systems present an attractive opportunity for the study of texture–structure relationships as they allow the development of a range of structures without modifying the system's composition.
Targeted case finding for hepatitis B using dry blood spot testing in the British–Chinese and South Asian populations of the North‐East of England
Authors: McPherson S. , Valappil M. , Moses S. E. , Eltringham G. , Miller C. , Baxter K. , Chan A. , Shafiq K. , Saeed A. , Qureshi R. , Hudson M. , Bassendine M. F.
Published: March 2013

Chronic infection with the hepatitis B virus (HBV) is a frequent cause of cirrhosis and liver cancer. Targeted HBV screening is recommended by the Centre for Disease Control (CDC) and Prevention for subjects born in countries with >2% HBV prevalence. However, there are no UK guidelines. Here, we applied the (CDC) recommendations to the British–Chinese and British–South Asian community of North‐East (NE) England. British–Chinese and South Asian subjects were invited to attend for HBV education and screening sessions held in community centres. Hepatitis B surface antigen (HBsAg) and hepatitis B core total antibody (HBcAb) were tested with dry blood spot tests. South Asians were also tested for hepatitis C antibody (HCVAb). A total of 1126 subjects (606 Chinese and 520 South Asian) were screened. Sixty‐two (5.5%) were HBsAg positive. Ten of these reported a previous diagnosis of HBV. The prevalence of HBsAg positivity was 4.6% when previously diagnosed individuals were excluded. The HBsAg prevalence was significantly higher in the Chinese subjects compared with South Asians (8.7% VS. 1.7% P < 0.001). In Chinese subjects, HBsAg positivity was highest in subjects born in Vietnam (17.4%), followed by China (11%), Hong Kong (7.8%) and the UK (6.7%). Subjects from Pakistan had the highest HBsAg and HCV Ab prevalence in the South Asians (3.1% and 1.8%, respectively). Ten percentage of HBsAg positive patients who had follow‐up assessment had active disease requiring antiviral treatment. Undiagnosed HBV infection was above the 2% threshold for screening suggested by the CDC in the British–Chinese and Pakistani community of NE England, which provides evidence for a UK HBV‐targeted screening programme.
Alterations in Adipokines in Feline Hepatic Lipidosis
Authors: Mazaki‐Tovi M. , Abood S.K. , Segev G. , Schenck P.A.
Published: March 2013

Background

Feline hepatic lipidosis (HL) is associated with alterations in lipid and carbohydrate metabolism. The adipokines, adiponectin, and leptin have lipid‐lowering and insulin‐sensitizing effects.

Hypothesis

Serum concentrations of adiponectin and leptin are altered in feline HL.

Animals

Client‐owned cats: 55 healthy and 45 with liver disease.

Methods

Cats with liver disease were categorized as having HL (n = 20), HL and concurrent disease (n = 19), or other liver disease (n = 6), based on clinical signs, laboratory findings, abdominal ultrasound examination as well as liver cytopathology, histopathology, or both. Serum samples were collected and body condition score determined.

Results

Mean serum concentrations of adiponectin were higher in overweight cats with HL (4.5 μg/mL), HL and concurrent disease (4.4 μg/mL), or other liver disease (6.1 μg/mL), as compared with healthy cats (1.5 μg/mL; P < .001, P < .001, and P = .04, respectively). Mean serum concentration of leptin was higher in cats with HL (9.8 ng/mL) or HL and concurrent disease (10.7 ng/mL) than healthy cats (4.9 ng/mL, P < .001 and P < .001, respectively). Cats with other liver disease had leptin concentration (4.9 ng/mL) similar to healthy cats. Concentrations of adiponectin were correlated with alanine aminotransferase activity (r = 0.40, P = .0069), and concentrations of leptin were correlated with alkaline phosphatase activity (r = 0.42, P = .0051) in cats with liver disease.

Conclusions and Clinical Importance

Adipokine concentrations are altered in feline HL. Increased concentrations of adiponectin are related to liver disease, whereas increased concentrations of leptin are specifically related to HL.
Comprehension‐Based Versus Production‐Based Grammar Instruction: A Meta‐Analysis of Comparative Studies
Authors: Shintani Natsuko , Li Shaofeng , Ellis Rod
Published: March 2013

This article reports a meta‐analysis of studies that investigated the relative effectiveness of comprehension‐based instruction (CBI) and production‐based instruction (PBI). The meta‐analysis only included studies that featured a direct comparison of CBI and PBI in order to ensure methodological and statistical robustness. A total of 35 research projects in 30 published studies were retrieved. The studies were coded for three types of effect sizes: comparative, absolute, and pre‐to‐post change. The comparative effect sizes were used in a subsequent moderator analysis to test the impact of two mediator variables—CBI with and without Processing Instruction and PBI involving text creation versus text manipulation. The results showed that (1) overall, both types of instruction had large effects on both receptive and productive knowledge; (2) for receptive knowledge, CBI had a greater effect than PBI when the acquisition was measured within one week but the difference diminished in the delayed tests (i.e., posttests administered between 1 week and 75 days after the treatment); (3) for productive knowledge, CBI and PBI had similar effects in short‐term measurement but PBI was more effective in the delayed tests; and (4) the initial advantage found for CBI was largely due to Processing Instruction. We discuss the theoretical and pedagogical significance of these findings.
Novel aspects in the life cycle and biotrophic interactions in Pezizomycetes (Ascomycota, Fungi)
Authors: Tedersoo Leho , Arnold A. Elizabeth , Hansen Karen
Published: March 2013

The ascomycete class Pezizomycetes (single order Pezizales) is known for its cup‐shaped fruit bodies and the evolution of edible truffles and morels, but little is known about the ontogeny and ecology of this large and ecologically diverse fungal group. In this issue of Molecular Ecology, Healy et al. () make a great leap forward by describing and identifying asexual, anamorphic structures that produce mitotic spores in many ectomycorrhiza‐forming truffle and nontruffle species on soil surfaces worldwide (Fig. ). Although such anamorphic forms have been reported sporadically from certain ectomycorrhizal and saprotrophic Pezizomycetes (e.g. Warcup ), Healy et al. () demonstrate that these terricolous asexual forms are both taxonomically and geographically more widespread and, in fact, much more common than previously understood. We anticipate that deeper insight into other substrates, provided by molecular analyses of materials such as dead wood and seeds, is likely to reveal numerous anamorphs of saprotrophic and pathogenic Pezizomycetes as well (see Marek et al. ).
Contaminants and impoSEX: transcriptomics of contaminant‐induced sex change
Authors: Chapman Robert W. , Guillette Louis J.
Published: March 2013

Reproduction is the goal of living organisms, and environmental conditions that influence sexual development are therefore critical to understanding adaptation in natural populations. It is not surprising that so much attention has been devoted to the impacts of the physical and chemical environment on this process (Vandenberg et al. ). Chemicals of concern include a variety of endocrine disruptors (EDs) including oestrogen and oestrogen mimics that directly lead to malformation of the gonad. On the molecular side, the impact that EDs have on genes directly involved in the feminization or masculinization of the gonad such as Cyp 19A (or aromatase), foxl2, Sox9, Dmrt1 and NrOb1, has received considerable attention due to their direct involvement in the regulation of oestrogen and testosterone. In this issue of Molecular Ecology, Pascoal et al. () examine the impact of a known endocrine disruptor (tributyltin or TBT) on the transcriptome of the dog whelk, Nucella lapillus (Fig. ), in relation to the formation of imposex individuals (masculinized females). They conclude that TBT mimics the endogenous ligand of the nuclear retinoid X receptor (RXR) and/or peroxisome profilerator‐activated receptor (PPAR) disrupting pathways.
Rethinking programme evaluation in health professions education: beyond ‘did it work?’
Authors: Haji Faizal , Morin Marie‐Paule , Parker Kathryn
Published: March 2013

Context  For nearly 40 years, outcome‐based models have dominated programme evaluation in health professions education. However, there is increasing recognition that these models cannot address the complexities of the health professions context and studies employing alternative evaluation approaches that are appearing in the literature. A similar paradigm shift occurred over 50 years ago in the broader discipline of programme evaluation. Understanding the development of contemporary paradigms within this field provides important insights to support the evolution of programme evaluation in the health professions.

Methods  In this discussion paper, we review the historical roots of programme evaluation as a discipline, demonstrating parallels with the dominant approach to evaluation in the health professions. In tracing the evolution of contemporary paradigms within this field, we demonstrate how their aim is not only to judge a programme’s merit or worth, but also to generate information for curriculum designers seeking to adapt programmes to evolving contexts, and researchers seeking to generate knowledge to inform the work of others.

Discussion  From this evolution, we distil seven essential elements of educational programmes that should be evaluated to achieve the stated goals. Our formulation is not a prescriptive method for conducting programme evaluation; rather, we use these elements as a guide for the development of a holistic ‘programme of evaluation’ that involves multiple stakeholders, uses a combination of available models and methods, and occurs throughout the life of a programme. Thus, these elements provide a roadmap for the programme evaluation process, which allows evaluators to move beyond asking whether a programme worked, to establishing how it worked, why it worked and what else happened. By engaging in this process, evaluators will generate a sound understanding of the relationships among programmes, the contexts in which they operate, and the outcomes that result from them.
Longitudinal integrated rural placements: a social learning systems perspective
Authors: Daly Michele , Roberts Chris , Kumar Koshila , Perkins David
Published: March 2013

Objectives  There is currently little theoretically informed exploration of how non‐traditional clinical placement programmes that are longitudinal, immersive, based on community‐engaged education principles and located in rural and remote settings may contribute to medical student learning. This paper aims to theoretically illustrate the pedagogical and socio‐cultural underpinnings of student learning within a longitudinal, integrated, community‐engaged rural placement.

Methods  Data collected using semi‐structured interviews with medical students, their supervisors and other health clinicians participating in a longitudinal rural placement programme were analysed using framework analysis. Data interpretation was informed by the theory of social learning systems (SLSs).

Results  In a longitudinal, rural clinical placement students participate in an SLS with distinct yet interrelated learning spaces that contain embedded communities of practice (CoPs). These spaces are characterised by varying degrees of formality, membership and interaction, and different learning opportunities and experiences. They are situated within and shaped by a unique geography of place comprising the physical and social features of the placement setting. Within these learning spaces, students acquire clinical knowledge, skills and competencies, professional attitudes, behaviours and professional values. The process of connectivity helps explain how students access and cross the boundaries between these learning spaces and develop a more complex sense of professional identity.

Conclusions  Longitudinal, integrated clinical placement models can be understood as SLSs comprising synergistic and complementary learning spaces, in which students engage and participate in multiple CoPs. This occurs in a context shaped by unique influences of the geography of place. This engagement provides for a range of student learning experiences, which contribute to clinical learning and the development of a more sophisticated professional identity. A range of pedagogical and practical strategies can be embedded within this SLS to enhance student learning.