bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical trial: efficacy of a low or modified fat diet for the prevention of gastrointestinal toxicity in patients receiving radiotherapy treatment for pelvic malignancies
Authors: Wedlake L. J. , McGough C. , Shaw C. , Klopper T. , Thomas K. , Lalji A. , Dearnaley D. P. , Blake P. , Tait D. , Khoo V. S. , Andreyev H. J. N.
Published: April 2012

How to cite this article: Wedlake L.J., McGough C., Shaw C., Klopper T., Thomas K., Lalji A., Dearnaley D.P., Blake P., Tait D., Khoo V.S. & Andreyev H.J.N. (2012) Clinical trial: efficacy of a low or modified fat diet for the prevention of gastrointestinal toxicity in patients receiving radiotherapy treatment for pelvic malignancies. J Hum Nutr Diet.25, 247–259

Background:  Inflammatory responses to pelvic radiotherapy can result in severe changes to normal gastrointestinal function with potentially severe long‐term effects. Reduced or modified fat diets may confer benefit.

Methods:  This randomised controlled trial recruited patients with gynaecological, urological or lower gastrointestinal malignancy due to receive radical radiotherapy. Patients were randomised to a low fat (20% total energy from long chain triglycerides), modified fat (20% from long chain triglycerides and 20% from medium chain triglycerides) or normal fat diet (40% total energy from long chain triglycerides). The primary outcome was a difference in change in Inflammatory Bowel Disease Questionnaire – Bowel (IBDQ‐B) score, from the start to end of radiotherapy.

Results:  A total of 117 patients with pelvic tumours (48% urological; 32% gastrointestinal; 20% gynaecological), with mean (SD) age: 65 (11.0) years, male : female ratio: 79 : 38, were randomised. The mean (SE) fall in paired IBDQ‐B score was −7.3 (0.9) points, indicating a worsening toxicity. Differences between groups were not significant: P = 0.914 (low versus modified fat), P = 0.793 (low versus normal fat) and P = 0.890 (modified versus normal fat). The difference in fat intake between low and normal fat groups was 29.5 g [1109 kJ (265 kcal)] amounting to 11% (of total energy intake) compared to the planned 20% differential. Full compliance with fat prescription was only 9% in the normal fat group compared to 93% in the low fat group.

Conclusions:  A low or modified fat diet during pelvic radiotherapy did not improve gastrointestinal symptom scores compared to a normal fat intake. An inadequate differential in fat intake between the groups may have confounded the results.
Faking good: self‐enhancement in medical school applicants
Authors: Griffin Barbara , Wilson Ian G
Published: April 2012

Medical Education 2012: 46: 485–490

Objectives  The problem of dissimulation by applicants when self‐report tests of personality are used for job selection has received considerable attention in non‐medical contexts. Personality testing is not yet widely used in medical student selection, but this may change in the light of recent research demonstrating significant relationships between personality and performance in medical school. This study therefore aimed to assess the extent of self‐enhancement in a sample of medical school applicants.

Methods  A within‐subjects design compared personality test scores collected in 2007 for 83 newly enrolled medical students with scores for the same students obtained on the same personality test administered during the selection process 4 months previously. Five factors of personality were measured using the International Personality Item Pool and mean differences in scores were assessed using paired t‐tests.

Results  At the time of selection, the personality scores of successful applicants were similar to those of candidates who were not accepted (n = 271). Once selected, the medical students achieved significantly lower scores on four of the five personality factors (conscientiousness, extroversion, openness to experience, agreeableness) and higher scores on the fifth factor (neuroticism). Of the selected students, 62.7% appeared to have ‘faked good’ on at least one of the five factors measured.

Conclusions  Applicants to medical school are likely to dissimulate when completing self‐report tests of personality used for selection. The authors review the evidence as to whether such dissimulation reduces construct and predictive validity and summarise methods used to reduce self‐enhancement in applicant samples.
The application of the challenge point framework in medical education
Authors: Guadagnoli Mark , Morin Marie‐Paule , Dubrowski Adam
Published: April 2012

Medical Education 2012: 46: 447–453

Objectives  The current paper describes a model of learning that has been used to produce efficient learning, thus yielding greater retention of information and superior performance under stress. In this paper, the model is applied to the learning of technical skills.

Structure  After a brief review of the learning–performance paradox and other relevant literature from the field of movement science, the benefits of challenge and adversity for learning are discussed in the context of a framework for learning known as the challenge point framework (CPF). The framework is based on laboratory and field studies of methods that have been shown to consistently enhance learning, and is used to model and generate insight into the relationships between practice protocols and the learning that results from them.

Application  The practical application of the CPF to simulation‐based medical education and training is described. Firstly, a simple conceptual model that utilises three key elements to adjust the functional difficulty of the tasks to be learned is outlined. Secondly, a number of assessment strategies that may be necessary to ensure that the trainee remains in the optimal learning zone are proposed. Thirdly, a practical example is used to demonstrate how to utilise this conceptual model to design simulation environments suitable for teaching an endotracheal intubation task to beginners and more advanced trainees.
Reflection as a strategy to foster medical students’ acquisition of diagnostic competence
Authors: Mamede Sílvia , van Gog Tamara , Moura Alexandre S , de Faria Rosa M D , Peixoto José M , Rikers Remy M J P , Schmidt Henk G
Published: April 2012

Medical Education 2012: 46: 464–472

Objectives  Developing diagnostic competence in students is a major goal of medical education, but there is little empirical evidence on instructional strategies that foster the acquisition of this competence. The aim of this study was to investigate the effects of structured reflection compared with the generation of immediate or differential diagnosis while practising with clinical cases on learning clinical diagnosis.

Methods  This was a three‐phase experimental study. During a learning phase, 46 Year 4 students diagnosed six clinical cases under different experimental conditions: structured reflection, immediate diagnosis, or differential diagnosis. This was followed by an immediate test and a delayed test administered 1 week later. Each test consisted of diagnosing four different cases of diseases presented in the learning phase. Performance in diagnosing these new cases was used as a measure of learning.

Results  Repeated‐measures analysis of variance on the mean diagnostic accuracy scores (range: 0–1) showed a significant interaction between performance moment (i.e. performance in the learning phase and on each test) and instructions followed during the learning phase (p = 0.003). Follow‐up analyses of this interaction showed that diagnostic performance did not differ between conditions in the learning phase. On the immediate test, scores in the reflection condition (mean = 0.48, 95% confidence interval [CI] 0.38–0.58) were significantly lower than scores in the differential diagnosis condition (mean = 0.62, 95% CI 0.54–0.70; p = 0.012) and marginally lower than those in the immediate diagnosis condition (mean = 0.61, 95% CI 0.52–0.70; p = 0.04). One week later, however, scores in the reflection condition (mean = 0.66, 95% CI 0.56–0.76) significantly outperformed those in the other conditions (differential diagnosis: mean = 0.48, 95% CI 0.37–0.58 [p < 0.01]; immediate diagnosis: mean = 0.52, 95% CI 0.43–0.60 [p = 0.01]). Comparisons within experimental conditions showed that performance from the immediate to the delayed test decreased in the immediate and differential diagnosis conditions (immediate diagnosis: p = 0.042; differential diagnosis: p = 0.012), but increased in the reflection condition (p = 0.003).

Conclusions  Structured reflection while practising with cases appears to foster the learning of clinical knowledge more effectively than the generation of immediate or differential diagnoses and therefore seems to be an effective instructional approach to developing diagnostic competence in students.
Phosphorylation of histone H2A is associated with centromere function and maintenance in meiosis
Authors: Dong Qianhua , Han Fangpu
Published: April 2012

Histone phosphorylation is dynamically regulated during cell division, for example phosphorylation of histone H3 (H3)‐Ser10, H3‐Thr11 and H3‐Ser28. Here we analyzed maize (Zea mays L) for Thr133‐phosphorylated histone H2A, which is important for spindle checkpoint control and localization of the centromere cohesion protector Shugoshin in mammals and yeast. Immunostaining results indicate that phosphorylated H2A‐Thr133 signals bridged those of the centromeric H3 histone variant CENH3 by using a plant displaying yellow fluorescent protein‐CENH3 signals and H2A‐Thr133 is phosphorylated in different cell types. During mitosis, H2A‐Thr133 phosphorylation becomes strong in metaphase and is specific to centromere regions but drops during later anaphase and telophase. Immunostaining for several maize dicentric chromosomes revealed that the inactive centromeres have lost phosphorylation of H2A‐Thr133. During meiosis in maize meiocytes, H2A phosphorylation becomes strong in the early pachytene stage and increases to a maximum at metaphase I. In the maize meiotic mutant afd1 (absence of first division), sister chromatids show equational separation at metaphase I, but there are no changes in H2A‐Thr‐133 phosphorylation during meiosis compared with the wild type. In sgo1 mutants, sister chromatids segregate randomly during meiosis II, and phosphorylation of H2A‐Thr‐133 is observed on the centromere regions during meiosis II. The availability of such mutants in maize that lack sister cohesion and Shugoshin indicate that the signals for phosphorylation are not dependent on cohesion but on centromere activity.
Functional identification of the phosphorylation sites of Arabidopsis PIN‐FORMED3 for its subcellular localization and biological role
Authors: Ganguly Anindya , Lee Sang‐Ho , Cho Hyung‐Taeg
Published: April 2012

Directional cell‐to‐cell movement of auxin is mediated by asymmetrically localized PIN‐FORMED (PIN) auxin efflux transporters. The polar localization of PINs has been reported to be modulated by phosphorylation. In this study, the function of the phosphorylation sites of the PIN3 central hydrophilic loop (HL) was characterized. The phosphorylation sites were located in two conserved neighboring motifs, RKSNASRRSF(/L) and TPRPSNL, where the former played a more decisive role than the latter. Mutations of these phosphorylatable residues disrupted in planta phosphorylation of PIN3 and its subcellular trafficking, and caused defects in PIN3‐mediated biological processes such as auxin efflux activity, auxin maxima formation, root growth, and root gravitropism. Because the defective intracellular trafficking behaviors of phospho‐mutated PIN3 varied according to cell type, phosphorylation codes in PIN3‐HL are likely to operate in a cell‐type‐specific manner.
Factors related to health locus of control among lung transplant candidates
Authors: Burker Eileen J. , Phillips Kristin M. , Giza Mallory
Published: April 2012

As the number of individuals pursuing lung transplantation to treat lung disease increases, transplant team members have an opportunity to maximize patients' chances for post‐transplant success through identifying and addressing psychosocial factors that have been previously associated with patients' post‐transplant survival, such as health locus of control (HLC). The purpose of this cross‐sectional study was to understand the factors associated with HLC in lung transplant candidates. The aims were to (i) identify the demographic factors associated with internal (IHLC), chance (CHLC), and powerful others (PHLC) HLC; (ii) examine the associations between HLC and anxiety, depression, and optimism; and (iii) determine whether these factors explain a significant proportion of variance in HLC. Hierarchical regression analyses indicated that age, education, trait anxiety, and optimism explained 20% of the variance in CHLC; gender, trait anxiety, and depression accounted for 9% of the variance in IHLC; and lower education accounted for 5% of the variance in PHLC. Helping transplant team members understand the factors that influence patients' perceptions that their own behaviors impact their health status is important for maximizing post‐transplant success.
Prevention of relapse using DLI can increase survival following HLA‐identical transplantation in patients with advanced‐stage acute leukemia: a multi‐center study
Authors: Wang Yu , Liu Dai‐Hong , Fan Zhi‐Ping , Sun Jing , Wu Xiao‐Jin , Ma Xiao , Xu Lan‐Ping , Liu Kai‐Yan , Liu Qi‐Fa , Wu De‐Pei , Huang Xiao‐Jun
Published: April 2012

A total of 123 consecutive patients with advanced‐stage, acute leukemia undergoing HSCT from HLA‐identical sibling donors were analyzed. A G‐CSF‐primed DLI was planned within day 60 post‐transplantation before hematologic relapse was diagnosed. Fifty of the 123 individuals received prophylactic DLI, and 73 individuals received no prophylactic treatment. The incidence of grades II–IV acute graft‐versus‐host disease (GVHD) was 17% for patients receiving DLI and 23% for patients not receiving DLI (p = 0.35). The incidence of chronic GVHD was 38% for patients receiving DLI and 17% for patients not receiving DLI (p = 0.021). The two‐yr cumulative incidence of relapse was significantly lower in patients who received prophylactic DLI (46%) compared with patients who did not receive prophylactic DLI (66%) (p = 0.02). The three‐yr probability of overall survival was higher in patients who received prophylactic DLI (36%) than in patients who did not receive prophylactic DLI (11%) (p = 0.001). The leukemia‐free survival was also higher in patients who received prophylactic DLI (29%) than in patients who did not receive prophylactic DLI (9%) (p = 0.001). Our comparisons suggest that the prophylactic use of DLI can significantly increase survival of patients with advanced‐stage, acute leukemia who receive HLA‐identical sibling HSCT.
Sperm competition roles and ejaculate investment in a promiscuous mammal
Authors: LEMAÎTRE J.‐F. , RAMM S. A. , HURST J. L. , STOCKLEY P.
Published: April 2012

Theoretical models of sperm competition predict how males should allocate sperm and seminal fluid components to ejaculates according to their mating role (dominant vs. subordinate). Here, we present a detailed analysis of ejaculate expenditure according to male roles in the bank vole (Myodes glareolus). Sperm competition occurs regularly in this species, and dominant males typically achieve higher fertilization success than subordinates. Contrary to theoretical predictions, we found that dominant male bank voles invest more sperm per ejaculate than subordinates, both absolutely and relative to body and testes mass. The testes of dominant males were also absolutely (although not relatively) larger than those of subordinates. However, we found no evidence that subordinate males compensate for lower sperm numbers per ejaculate by increasing ejaculation frequency or sperm velocity. Similarly, we found no evidence for differential investment in copulatory plug size according to male roles in sperm competition, although dominant males had significantly larger seminal vesicles (both absolutely and relative to body mass) compared with subordinates. We conclude that sperm competition roles can have significant but unexpected influences on ejaculate investment in mammals with clearly defined differences in male social status.
Molecular Characterization of Stolbur Phytoplasma Associated with Pea Plants in Poland
Authors: Zwolińska Agnieszka , Krawczyk Krzysztof , Pospieszny Henryk
Published: April 2012

Pea plants (Pisum sativum) showing symptoms of stunting, shoot proliferation and leaf chlorosis were observed in 2008 during routine greenhouse cultivation of garden pea cultivars from commercially obtained seeds. The disease incidence occurred in over 25% of grown plants. To confirm phytoplasma infection, fresh tissue samples, from symptomatic and asymptomatic peas, were collected, and total DNA was extracted, using a modified CTAB method. Nested‐PCR assay was carried out with specific phytoplasma 16S rDNA primers: P1/P7 followed by R16F2n/R16R2. The product, of expected size 1.2 kb, was restricted with 6 different endonucleases, and on the basis of obtained RFLP profile, phytoplasma was identified as a 16Sr XII‐A ribosomal subgroup member. For further differentiation, the nucleotide sequence of the tuf gene encoding a transcription factor was analysed. This is the first report of phytoplasma affecting pea plants.
Patterns in the abundance of hyperbenthic zooplankton and colonization of marine benthic invertebrates on the seafloor of Saanich Inlet, a seasonally hypoxic fjord
Authors: Dinning Kristin M. , Metaxas Anna
Published: April 2012

This study describes changes in abundance of hyperbenthic zooplankton (including meroplankton) and benthic colonists at the seasonally hypoxic seabed of Saanich Inlet, British Columbia, Canada. We used the Victoria Experimental Network Under the Sea (VENUS) cabled observatory to measure water properties and to sample hyperbenthos with a sediment trap at 97 m from September 2008 to September 2009. Some faunal groups exhibited seasonal reproduction, and abundance peaked during their reproductive periods. These included larvae of the barnacle Balanus crenatus, and the crabs Petrolisthes eriomerus, Oregonia gracilis, and Lophopanopeus bellus bellus. Other groups were most abundant in spring and summer when food and oxygen levels were highest and temperature was lowest. These included cumaceans, the siphonophore Diphyes sp., the bryozoan Triticella pedicellata, and tintinnids. We also collected benthic colonists, predominantly bryozoans and polychaetes, on colonization plates deployed in spring/summer 2008, fall 2008/winter 2009, and spring/summer 2009. The total abundance of colonists and of bryozoans did not vary seasonally or with substrate complexity, whereas polychaetes were more numerous in spring/summer deployments and on a highly complex substrate. Taxon richness of colonists was higher in spring/summer 2008 than in fall 2008/winter 2009, whereas an anoxic episode in spring/summer 2009 reduced richness to similar values with that of fall 2008/winter 2009 levels. Substrate complexity had no effect on richness. Juvenile squat lobsters, digitally imaged in fall 2008/winter 2009, were most numerous when oxygen levels were lowest and potentially excluding larger predators. Our study illustrates how season, food availability, temperature, and oxygen can interact to shape community structure in a seasonally hypoxic habitat.
Vascular calcification in South African dialysis patients: Ethnic variation, prevalence, detection and haemodynamic correlates
Authors: FREERCKS ROBERT , SWANEPOEL CHARLES , CARRARA HENRI , MOOSA SULAIMAN , LACHMAN ANTHONY , RAYNER BRIAN
Published: April 2012

Aim:  Studies from the US have shown little effect of ethnicity on vascular calcification in dialysis patients. This has not been examined in the multi‐ethnic population of South Africa where genetic and environmental differences may exist. We assessed the extent and severity of vascular calcification in South African dialysis patients according to race and known risk factors. We further evaluated the association of abdominal aorta calcification with coronary artery calcification.

Method:  Seventy‐five CKD‐5D patients and 20 healthy controls were enrolled consecutively. All subjects underwent chest computed tomography for coronary calcium score and abdominal X‐ray for abdominal aorta calcium score. Ambulatory blood pressure monitoring was generated via radial artery applanation tonometry.

Results:  Coronary calcification was present in 38.6% of patients and was associated with age and prior cardiovascular disease on multivariate analyses. The median coronary calcium score in black patients was 0 (IQR 0) and 66 in non‐Blacks (IQR 383, P < 0.001); controls had a coronary calcium score of 0 (IQR 0). Black race remained a significant negative predictor for coronary calcification after adjustment, prevalence ratio = 0.14 and 95% confidence interval (CI): 0.0–0.53. Vascular calcification was not associated with any ambulatory blood pressure parameter. Using receiver operator characteristic curves, an abdominal aorta calcification score of ≥1 showed an area under the curve of 0.83 to predict a coronary calcium score ≥ 10.

Conclusion:  Black race appears to protect from vascular calcification in South African CKD‐5D patients and this warrants further study regarding the underlying mechanism. The abdominal X‐ray is a useful screening tool for coronary calcification.
The influence of gender, ethnicity, class, race, the women’s and labour movements on the development of nursing in Sri Lanka
Authors: Aluwihare‐Samaranayake Dilmi , Paul Pauline
Published: April 2012

The paper reveals that historically various socio‐political factors, including gender, class, ethnicity, race, waves of colonization, decolonization, the civil and ethnic wars, the women’s and labour movements, have influenced the development of nursing in Sri Lanka. However, literature presenting the development of nursing in Sri Lanka is sparse. All relevant journals and books published in the English and Sinhalese languages on nursing in Sri Lanka between the years 1878–2011 were examined. Because there are no nursing journals currently produced in Sri Lanka, CINAHL and Medline databases were accessed and relevant literature published in the English language on Sri Lanka was examined. Government, nurses’ union and association reports, other unpublished reports and websites such as Google were also searched to access information related to the influence of gender, race, class, ethnicity, women’s and labour movements in Sri Lanka. Poor pay, shortages of resources, failure in recruitment and retention and limited opportunity for career progression have acted as deterrents to persons entering and remaining in the nursing profession. Being non‐British was a key issue in terms of race. Further, the shift from a colonized state to a welfare state resulted in a class shift from upper middle class to middle and lower class persons entering into nursing. Although there is a paucity of information available in the nursing literature, this analysis offers an intriguing insight into an angle that may be used to examine the influence of gender, ethnicity, class, race and the women’s and labour movements in other contextual situations.
Autopsy case of amebic granulomatous meningoencephalitis caused by Balamuthia mandrillaris in Japan
Authors: Bando Yoshimi , Takahashi Tetsuyuki , Uehara Hisanori , Kagegi Teruyoshi , Nagahiro Shinji , Izumi Keisuke
Published: April 2012

Balamuthia mandrillaris is a free‐living ameba that causes amebic encephalitis. Herein, we report an autopsy case of Balamuthia encephalitis proven with polymerase chain reaction (PCR) and immunohistochemistry from paraffin‐embedded brain biopsy specimens. A 68‐year‐old Japanese male presented at a hospital with progressive right hemiparesis approximately 3 months before his death. An open‐brain biopsy specimen showed diffuse meningitis with massive coagulative necrosis. The perivascular spaces contained numerous lymphocytes, histiocytes and giant cells, although the etiology was not determined. The patient deteriorated into coma and died from cerebral herniation. Autopsy revealed abundant trophozoites and cysts in the subarachnoid and Virchow‐Robin's spaces. Electron‐micrographs of the amebic cysts showed a characteristic triple‐walled envelope. The amebas were identified as Balamuthia mandrillaris based on immunohistochemical analysis from the autopsy and biopsy specimens. Primer sets designed to amplify approximately 200 bp bands of mitochondrial 16S rRNA gene of Balamuthia by PCR produced positive results from the biopsy specimens but negative results from the autopsy specimens. In summary, PCR to amplify shorter segments of DNA may be of diagnostic value in detecting suspected cases of balamuthiasis in formalin‐fixed, paraffin‐embedded specimens. Increased awareness and timely diagnosis of Balamuthia encephalitis might lead to earlier initiation of therapy and improved outcome.
The function of the wild carrot's dark central floret: attract, guide or deter?
Authors: POLTE SABRINA , REINHOLD KLAUS
Published: April 2012

Although Charles Darwin wrote about flower polymorphism in the wild carrot, Daucus carota, the function of the conspicuous central dark floret is still unclear. We used video recordings to evaluate the functional significance of the dark central floret as a short‐distance signal for insects landing on the umbels and analyzed the location of landing points, landing orientation and visit duration. These parameters, as well as insect attraction did not differ on umbels with and without a dark central floret. Hence, we found no evidence for the role of the dark central floret in the pollination of D. carota. Umbels with a dark central floret, however, were parasitized significantly less often by the gall midge Kiefferia pericarpiicola than umbels without a dark central floret. We propose that the dark central floret may play a role in reducing parasite infestation by mimicking an already present gall or deterring oviposition of the gall midge by other means.
Analysis of the microbial gene landscape and transcriptome for aromatic pollutants and alkane degradation using a novel internally calibrated microarray system
Authors: Vilchez‐Vargas Ramiro , Geffers Robert , Suárez‐Diez María , Conte Ianina , Waliczek Agnes , Kaser Vanessa Sabrina , Kralova Monika , Junca Howard , Pieper Dietmar H.
Published: April 2012

Despite various efforts to develop tools to detect and compare the catabolic potential and activity for pollutant degradation in environmental samples, there is still a need for an open‐source, curated and reliable array method. We developed a custom array system including a novel normalization strategy that can be applied to any microarray design, allowing the calculation of the reliability of signals and make cross‐experimental comparisons. Array probes, which are fully available to the scientific community, were designed from knowledge‐based curated databases for key aromatic catabolic gene families and key alkane degradation genes. This design assigns signals to the respective protein subfamilies, thus directly inferring function and substrate specificity. Experimental procedures were optimized using DNA of four genome sequenced biodegradation strains and reliability of signals assessed through a novel normalization procedure, where a plasmid containing four artificial targets in increased copy numbers and co‐amplified with the environmental DNA served as an internal calibration curve. The array system was applied to assess the catabolic gene landscape and transcriptome of aromatic contaminated environmental samples, confirming the abundance of catabolic gene subfamilies previously detected by functional metagenomics but also revealing the presence of previously undetected catabolic groups and specifically their expression under pollutant stress.
Longer term safety of dipeptidyl peptidase‐4 inhibitors in patients with type 2 diabetes mellitus: systematic review and meta‐analysis
Authors: Gooßen K. , Gräber S.
Published: April 2012

Dipeptidyl peptidase‐4 (DPP‐4) inhibitors are oral antidiabetic agents that hold the potential of slowing the progress of type 2 diabetes mellitus. Their long‐term safety is still a subject of debate. A systematic review of randomized, controlled trials was undertaken to comprehensively profile the safety of chronic treatment of type 2 diabetes mellitus with DPP‐4 inhibitors. We searched data sources including MEDLINE, CENTRAL, publishers' and manufacturers' databases. Eligible trials were double‐blind, randomized, placebo or active‐controlled trials with ≥18 weeks duration in patients with type 2 diabetes reporting safety outcomes. Meta‐analysis was performed separately for trials in which the control group received placebo (44 studies), another gliptin (3 studies) and any other antidiabetic drug (20 studies). Risk ratios with 95% confidence intervals were computed using a Mantel‐Haenszel fixed‐effect model for general safety outcomes, hypoglycaemia and adverse events by system organ class. Of 307 publications retrieved, 67 randomized, controlled trials met the eligibility criteria and were included in this review (4 alogliptin, 8 linagliptin, 8 saxagliptin, 20 sitagliptin, and 27 vildagliptin trials). Adverse events with gliptin treatment were at placebo level (relative risk (RR) 1.02 [0.99, 1.04]). No increased risk of infections was detectable (RR 0.98 [0.93, 1.05] compared to placebo and 1.02 [0.97, 1.07] compared to other antidiabetic drugs). Asthenia (RR 1.57 [1.09, 2.27]) as well as cardiac (RR 1.37 [1.00, 1.89]) and vascular disorders (RR 1.74 [1.05, 2.86] for linagliptin) emerged as adverse events associated with DPP‐4 inhibitor treatment. The risk of hypoglycaemia was low with DPP‐4 inhibitor treatment (RR 0.92 [0.74, 1.15] compared to placebo, RR 0.20 [0.17, 0.24] compared to sulphonylureas) in the absence of sulphonylurea or insulin co‐therapy, but significantly elevated for combination therapy of sulphonylurea or insulin with sitagliptin or linagliptin (RR 1.86 [1.46, 2.37] compared to placebo). A large body of data supports the long‐term safety of gliptin treatment and refutes an increased risk of infections. Further research is needed to clarify a possible link to asthenia, cardiac and vascular events. For combination therapy with insulin or insulin secretagogues, a careful choice of the agent used may limit the risk of hypoglycaemia.
Imeglimin, a novel glimin oral antidiabetic, exhibits a good efficacy and safety profile in type 2 diabetic patients
Authors: Pirags V. , Lebovitz H. , Fouqueray P.
Published: April 2012

Aims: Imeglimin is the first in a new tetrahydrotriazine‐containing class of oral antidiabetic agents, the glimins. It has been shown to act on the liver, muscle and pancreatic β‐cells to uniquely target the key defects of type 2 diabetes. Two studies were performed to compare the safety and efficacy of imeglimin with metformin and placebo on glycaemic control in type 2 diabetes patients.

Methods: In a 4‐week phase IIa, three‐arm parallel group study, patients were randomized to imeglimin 2000 mg once daily (od), imeglimin 1000 mg twice daily (bid) or metformin 850 mg bid and responses to an oral glucose tolerance test (OGTT) were measured. In an 8‐week phase IIa, four‐arm controlled multi‐centre study, patients were randomized to imeglimin 500 mg bid, imeglimin 1500 mg bid, metformin 850 mg bid or placebo. Glycaemic assessments included area under the curve (AUC) up to 6 h (AUC0−6h) for glucose during a prolonged meal, fasting plasma glucose (FPG) and HbA1c. Safety and tolerability were assessed in both studies through adverse event recording and laboratory parameters, vital signs and electrocardiogram.

Results: Imeglimin was found to be as effective as metformin at reducing the AUCPG and AUC0−6h, FPG and HbA1c. Imeglimin exhibited a favourable tolerability profile in comparison to metformin.

Conclusions: The results from both studies confirm that imeglimin displays a superior benefit : risk profile compared with metformin in type 2 diabetes patients. The encouraging tolerability profile of imeglimin could make it suitable for combination with other classes of antidiabetic agents and may increase availability to a wider patient population.
Combined treatment with a dipeptidyl peptidase‐IV inhibitor (sitagliptin) and an angiotensin II type 1 receptor blocker (losartan) promotes islet regeneration via enhanced differentiation of pancreatic progenitor cells
Authors: Liang J. , Leung K. K. , Lam S. Y. , Leung P. S.
Published: April 2012

Aim: The existence of pancreatic progenitor cells (PPCs) with differentiation capacity in the adult pancreas has rendered that promotion of islet regeneration is feasible. The dipeptidyl peptidase‐IV inhibitor sitagliptin and the angiotensin II type 1 receptor (AT1 receptor) blocker losartan have a common target action in the pancreata. Thus, we evaluated the synergistic/additive effects of these two drugs on the differentiation of islet progenitors.

Methods: The acute and chronic effects of sitagliptin and losartan, individually or in combination, on islet regeneration in vivo were investigated by using a streptozotocin‐induced type 1 diabetes mouse model. Their effects were also examined on an in vitro PPCs model derived from human foetal pancreas.

Results: A chronic combination treatment enhanced glucose tolerance in diabetic mice associated with an increased ratio of β cells to islet; an acute combination treatment resulted in a marked increase in the production of neurogenin 3 (NGN3+) cells in proximity to CK7+ ductal cell and an increased presence of insulin+/CK7+ cells. The in vitro study revealed that a combination treatment significantly enhanced mRNA expression of NGN3, NKX6.1 and PDX‐1 during PPCs differentiation into human islet‐like cell clusters (ICCs). Despite no apparent changes in insulin release, the combined treatment resulted in increasing production of peroxisome proliferator‐activated receptor γ (PPARγ) during PPC differentiation.

Conclusions: These data indicate that combined sitagliptin–losartan treatment can improve islet function by promoting the differentiation of PPCs into ICCs, perhaps via a mechanism involving PPARγ production, and could thereby, contribute to islet regeneration.
THE EFFECTS OF SPANISH‐LANGUAGE BACKGROUND ON COMPLETED SCHOOLING AND APTITUDE TEST SCORES
Authors: LOCAY LUIS , REGAN TRACY L. , DIAMOND ARTHUR M.
Published: April 2012

We investigate the effect of speaking Spanish at home as a child on completed schooling and aptitude test scores using data from the NLSY79 on Hispanics who grew up in the United States. We model the accumulation of traditional human capital and English fluency, leading to the joint determination of schooling and test scores. We find that speaking Spanish at home reduces test scores, but has no significant effect on completed schooling. The reduction in test scores (1) increases in magnitude in three of the tests when the parents are more educated; (2) is much more dramatic when the choice of home language is made endogenous; and (3) is not systematically greater for the verbal than for the math tests. (JEL I20, J15)
DETERMINANTS OF TRADE AND SPECIALIZATION IN THE ORGANISATION FOR ECONOMIC CO‐OPERATION AND DEVELOPMENT COUNTRIES
Authors: SHIKHER SERGE
Published: April 2012

This paper empirically investigates the relative importance of productivity, factor endowments, trade costs, and tastes in determining the current pattern of trade and specialization. The results show that productivity and taste differences are the first and second most significant determinants of trade and specialization. Factor endowments are the least influential for the average country in the data set, but their effects are much greater in the poorer than richer countries. The results also show the substantial role of trade costs, which is amplified through interactions with other determinants of trade. Trade costs affect the relative costs of intermediate inputs and final goods, link preferences with specialization, and reduce the geographical range of comparative advantages. (JEL F1, F10)
Evolutionary assembly rules for fish life histories
Authors: Charnov Eric L , Gislason Henrik , Pope John G
Published: April 2012

We revisit the empirical equation of Gislasonet al.(2010,Fish and Fisheries11:149–158) for predicting natural mortality (M, year−1) of marine fish. We show it to be equivalent to, whereL∞(cm) andK(year−1) are the von Bertalanffy growth equation (VBGE) parameters, andL(cm) is fish length along the growth trajectory within the species. We then interpretKin terms of the VBGE in mass, and show that the previous equation is itself equivalent to a −⅓ power function rule betweenMand the mass at first reproduction (Wα); this new −⅓ power function emerges directly from the life history that maximizes Darwinian fitness in non‐growing populations. We merge thisM,Wαpower function with other power functions to produce general across‐species scaling rules for yearly reproductive allocation, reproductive effort and age at first reproduction in fish. We then suggest a new way to classify habitats (or lifestyles) as to the life histories they should contain, and we contrast our scheme with the widely used Winemiller–Rose fish lifestyle classification.
Pedagogical challenges of spoken English learning in the Second Life virtual world: A case study
Authors: Zhang Haisen
Published: April 2012

As one of the emerging technologies, the Second Life virtual world provides learners of English as a Foreign Language with a unique opportunity of learning authentic language with native and non‐native speakers of English in a virtual environment. It enables them to learn the target language in a real‐life‐like social communication environment. To date, numerous studies have focused more on the benefits and affordances of learning in such an environment. Little has been done in terms of an empirical exploration into the barriers that impede effective spoken English learning. This study was intended to reduce the gap through investigating a group of Chinese students' experience when they carried out spoken English learning activities in Second Life. A qualitative research method was employed to unveil the challenges of Spoken English learning in this virtual world. Participant observation was made both during the training sessions and in the process of their performing learning tasks. The participants were later interviewed. The study concluded that the success of enabling effective spoken English leaning requires a timely elimination of technical problems and a systemic optimization of learning environments from both pedagogical and administrative perspectives. Limitations of this study and directions for future research were also discussed.

Practitioner Notes

What is already known about this topic

The potential of the Second Life virtual world for educational purposes.

Pedagogical affordances of the virtual world.

Pedagogical applications of the virtual world to the fields of science and humanities.

What this paper adds

Pedagogical exploration of spoken English teaching and learning in the virtual world.

Identification of pedagogical challenges in learning and teaching of spoken English skills.

Countermeasures for fighting off the challenges.

Implications for practice and/or policy

Development of instructors' computer literacy and virtual world literacy skills.

Essentiality of administrative support for ensuring pedagogical success.

Instructors' awareness of increasing workload.
POLICY CHANGE AND EXPERT INVOLVEMENT IN CHINA
Authors: ZHU XUFENG
Published: April 2012

Expert involvement is usually regarded as one of the causes of policy changes. However, how does the nature of policy change, in turn, influence expert involvement? This study constructs an analytical model by adopting and developing policy network and principal‐agent theories, suggesting that expert involvement can be regarded as the result of the inherent characteristics of policy change in the Chinese policy process. Two key characteristics of policy change, namely ‘loss embeddedness' and ‘knowledge complexity’, are employed to form four types of policy changes. Empirically, a comparative study with four policy change cases illustrates that Chinese experts adopt four behavioural strategies, such as linear access, outside‐in enlightenment, deprofessionalized campaign, and locked‐out, in different types of policy change. These policy change cases include the new‐type rural cooperative medical care system, the new urban medical care system, revocation of detention and repatriation system, and the new economically affordable urban housing policy.
INTRODUCTION: WHITHER SPATIAL ECONOMETRICS?
Authors: Partridge Mark D. , Boarnet Marlon , Brakman Steven , Ottaviano Gianmarco
Published: April 2012

ABSTRACT Spatial econometrics has become a mainstay for regional scientists aiming to estimate geographic spillovers in regional outcomes. Yet, many remain skeptical, especially urban economists who prefer natural experimental approaches. Their concerns revolve around identification and a general lack of a theoretical foundation in the estimation of spatial econometric models. This theme issue includes three papers from leading regional scientists to appraise the status of spatial econometrics. The outcome is sweeping proposals from (1) abandoning standard spatial econometrics because it cannot identify causality, (2) using nonparametric approaches, and (3) implementing more nuanced changes revolving around better theoretical and empirical modeling.
Firm Size and Employment Dynamics: Estimations of Labor Demand Elasticities Using a Fractional Panel Probit Model
Authors: Kölling Arnd
Published: April 2012

This paper examines the comprehensive discussion on the relationship between job creation, or destruction and firm size. More specifically, the study will determine whether the argument about small‐ and medium‐sized enterprises (SMEs) showing higher employment dynamics is confirmed or not. As such, the following work applies elasticities from a standard labor demand model derived from the estimations of fractional probit models for panel data, as process recommended in Papke and Wooldridge [2008; Journal of Econometrics 145(1–2): 121–133]. Elasticities are a useful measure of employment dynamics, if it is assumed that SMEs act on the same markets. The elasticity results from German establishment data illustrate that firm size does matter for the increase or decrease of employment. SMEs with less than 10 workers exhibit a higher employment dynamic, compared with other entities, at each respective percentile in the distribution of the wage share. Additionally, the outcome of the analysis weakly confirms the hypothesis that smaller firms are more restricted to capital markets, compared with large entities. The results also illustrate that firm size only explains one aspect of job creation and destruction. As stated in the well‐known Hicks–Marshall rules for elasticities of factor demand, the results illustrate that the reaction of labor demand on economic changes increases with the share of labor. Firms with a high share of labor also have larger elasticities, compared with firms with a strong use of capital. Both effects, the size effect and the effect of the proportion of labor, would blend in reality, and therefore, possibly lead to controversial results for the relationship between firm size and employment dynamics. In addition, a model with a negative relationship among both variables is too simple to explain the behavior of firms.
The Maghribi traders: a reappraisal?1
Authors: GREIF AVNER
Published: April 2012

Previous studies concluded that a private‐order institution based on a multilateral reputation mechanism was particularly important in governing agency relations among the Maghribi traders who operated in the Muslim Mediterranean. The legal system and a bilateral reputation mechanism were particularly important among the Genoese traders. Initial cultural, social, and political factors led to this institutional distinction, while the incorporation of culture in the resulting institutions influenced subsequent institutional developments. In particular, the particularities of the late medieval European institutions contributed to the rise of the modern—impersonal—markets in Europe. The analysis also substantiates the contention that private‐order institutions can support sophisticated exchange and market‐promoting policies should take this into account, particularly in countries lacking an effective court system. An article by Edwards and Ogilvie challenges this analysis. It alleges that the Maghribis, like European traders, relied on court enforcement and a bilateral reputation mechanism in which a narrow social circle responded to opportunism. This article shows that Edwards and Ogilvie's analysis and conclusions are wrong. It refutes each of their empirical claims and presents additional pieces of evidence supporting the institutional distinction conjecture. The discussion is structured around the methodological challenge associated with comparative and historical institutional analysis.
Applying the ICF‐CY to identify children's everyday life situations: A step towards participation‐focused code sets
Authors: Adolfsson Margareta
Published: April 2012

Adolfsson M. Applying the ICF‐CY to identify children's everyday life situations: a step towards participation‐focused code sets

With the long‐term goal to create an interdisciplinary screening tool with code sets focusing on children's participation in everyday life situations (ELS), the purpose of the present study was to identify ELS for children 0–17 years. The views of professionals and parents in Sweden, South Africa and the USA were integrated based on ICF‐CY1 linkages. The chapters Self‐care and Major life areas seemed most obvious to include in ELS. At the 2nd ICF‐CY level, 11 categories emerged as ELS, with Hygiene and Recreation as the most obvious. Two sets of ELS were identified for infants/preschoolers and school‐aged children/adolescents. Professionals and parents agreed on ELS for the older age group. Findings suggest that ELS differ in context specificity depending on maturity and growing autonomy. The study has implications for the future screening tool that is intended to support children with disabilities in describing what matters most to them in intervention planning.

Key Practitioner Message: •Children and parents need opportunities to express their opinions during intervention processes, but a structured family–professional collaboration model is lacking; •Using ICF‐CY‐based models, including holistic views of participation in everyday life situations, increases professionals' focus on family perspectives; •Models to connect interventions to participation in everyday life situations enhance children's motivation and support interdisciplinary assessment.