bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing local processing technology for black and green tea and evaluation of conformance to ISO standard
Authors: Aroyeun Olusegun , Iremiren Gerald , Omolaja Samuel , Abiodun Okelana Feyisara , Olubamiwa Olayiwola , Ipinmoroti R.R. , Oloyede Amos , Ogunwolu Olalekan Semiu , Andrew Daniel , Olayinka Jayeola Christiana , Abiola Sowunmi Fatai , Ola Odumbaku Lukman
Published: September 2012

Purpose

– The purpose of this paper is to describe a project designed with the aim of developing a black and green tea processing technology for Nigerian farmers and evaluate the conformance of the quality of the processed tea to the recommended international standard.

Design/methodology/approach

– Locally processed and graded black teas were collected from Kakara and Bangoba for analysis. Different grades analyzed were Dust 1, Pekoe fanning (PF), broken pekoe (BP) and Fibre. Green tea was also processed from 21 tea clones selected from the Cocoa Research Institute, Kusuku Station tea plantation located at 1,840 m above mean sea level and analyzed for quality characteristics. The methods used for the quality of black and green teas analysis were in accordance with ISO standard: ISO 9768 method (revised) was used for determining % water extract, ISO 5498 for crude fibre, ISO 1575 for % total ash, and ISO 1577 for acid insoluble ash. Other additional quality parameters evaluated for black tea were theaflavins (TF), thearubigins (TR) and colour brightness (C Br) from another set of 17 clones using flavonost methods. Conformance to ISO standard were assessed in all tea locally processed by the farmers, in comparison to the ones processed under controlled conditions.

Findings

– The results obtained in this study revealed that 59.2 per cent of the tea analyzed conformed to ISO 9768, 81.5 per cent to ISO 5498, 77.8 per cent to ISO 1575 and 96.3 per cent to ISO 1576 and 100 per cent conformed to ISO 1577 and 85.2 per cent to ISO 1578 respectively. In all, only 33 per cent of the processed tea conformed to international standard for black or green tea physical parameters. As for black tea, clones which conformed to correct TF, TR, CBR are UNK, 367, 19, 74, 354, 368, 369, 353, 357, 143, 14 and 108 respectively.

Practical implications

– The paper shows that production of green tea and black tea can be done locally without loss of quality if good manufacturing practices and hygiene practices are followed.

Originality/value

– The use of clonal materials sourced locally that conformed to ISO standard from Nigeria could create new products (black and green tea) with high economic values to the farmers.
Permanent Genetic Resources added to Molecular Ecology Resources Database 1 June 2012–31 July 2012
Authors:   Molecular Ecology Resources Primer Development Consortium, Barat Ashoktaru , Bravo S. P. , Chandra Suresh , Corrêa A. S. , Giombini M. I. , Guedes R. N. C. , Huailei Ma , Lal Kuldeep K. , Liang Lu , Matura Rakesh , Mohindra Vindhya , Oliveira L. O. , Patangia Ruchi , Qiyong Liu , Sah Rama Shankar , Singh Akanksha , Singh Birender Kumar , Singh Rajeev K. , Tosto D. S. , Tripathi Ratnesh K. , Vinson C. C.
Published: September 2012

This article documents the addition of 96 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Clarias batrachus, Marmota himalayana, Schizothorax richardsonii, Sitophilus zeamais and Syagrus romanzoffiana. These loci were cross‐tested on the following species: Clarias dussumeri, Clarias gariepinus, Heteropneustus fossilis, Sitophilus granarius and Sitophilus oryzae.
DNA barcoding reveals taxonomic conflicts in the Herichthys bartoni species group (Pisces: Cichlidae)
Authors: León‐Romero Yatzil , Mejía Omar , Soto‐Galera Eduardo
Published: September 2012

Fishes of the genus Herichthys are the only representatives of the family Cichlidae to have colonized the Neartic region. In this study, we used DNA barcode of 64 individuals of the Herichthys bartoni species group to test the monophyly of the species and the efficiency of this tool to discriminate among species. The Bayesian phylogenetic tree and the neighbour joining (NJ) tree obtained from the Kimura two‐parameter model (K2P) give similar topologies. DNA barcoding resolution was very poor (25%). Additionally, the low levels of genetic divergence among taxa preclude the use of threshold values as has been suggested in earlier studies.
HIV‐1 Imposes Rigidity on Blood and Semen Cytokine Networks
Authors: Lisco Andrea , Introini Andrea , Munawwar Arshi , Vanpouille Christophe , Grivel Jean‐Charles , Blank Paul , Singh Sarman , Margolis Leonid
Published: September 2012

Problem

Although it is established that the levels of individual cytokines are altered by HIV‐1 infection, the changes in cytokine interrelations that organize them into networks have been poorly studied. Here, we evaluated these networks in HIV‐infected and HIV‐uninfected individuals in fluid compartments that are critical for HIV‐1 pathogenesis and transmission, namely blood and semen.

Method of Study

In samples collected from therapy‐naïve HIV‐1‐infected and HIV‐1‐uninfected individuals, we measured HIV‐1‐load, CD4 cell count, and levels of 21 cytokines using a multiplex bead assay.

Results

Cytokine networks in blood and semen were different for HIV‐1‐infected and HIV‐1‐uninfected individuals. In both compartments of HIV‐1‐infected individuals, the cytokine networks were more interlocked than in controls: HIV‐1 infection resulted in the establishment of new correlations and in the strengthening of pre‐existing correlations between different cytokines. In blood and semen of HIV‐infected patients, there were, respectively, 68 and 72 statistically significant correlations between cytokines, while in uninfected individuals, there were 18 and 21 such correlations.

Conclusion

HIV‐1 infection reorganizes the cytokine networks, establishing new strong correlations between various cytokines and thus imposes a high rigidity on the cytokine network. This rigidity may reflect the impairment of the ability of the immune system to respond to microbial challenges.
Anaphylaxis in an emergency setting – elicitors, therapy and incidence of severe allergic reactions
Authors: Beyer K. , Eckermann O. , Hompes S. , Grabenhenrich L. , Worm M.
Published: September 2012

Background

Anaphylaxis is a severe potentially life‐threatening hypersensitivity reaction with an estimated lifetime prevalence of 0.5–2.0%. The prevalence and incidence of anaphylactic reactions in Germany are unknown. We therefore assessed anaphylactic patients seen by emergency physicians in the Berlin area covering 4 million people.

Methods

A standardised questionnaire was filled from 2008 to 2010 by the emergency physicians.

Results

A total of 333 cases of anaphylaxis were reported. 295 of these met the inclusion criteria for severity and were analysed. 13.9% (n = 41) were reactions with respiratory symptoms, 25.4% (n = 75) with cardiovascular, and in 60.7% (n = 179) of cases, respiratory and cardiovascular symptoms were reported. Two reactions were fatal. The most common elicitors were food products (32.2%), drugs (29.2%) and insect venom (19.3%). The most frequently given drugs were corticoids and antihistamines, but not adrenaline. For 2008, the calculated incidence was 4.5 per 100 000.

Conclusions

Our data show that food products are frequent elicitors of severe allergic reactions in the general population including children and adults. It unravels a strong underuse of adrenaline by emergency physicians, not reflecting treatment protocols according to the current guidelines. As data obtained from allergists reveal a different rank order of elicitors, this study suggests that food‐allergic adult patients may present a risk population and should receive more attention by allergists.
Loss of caveolin‐1 from bronchial epithelial cells and monocytes in human subjects with asthma
Authors: Bains S. N. , Tourkina E. , Atkinson C. , Joseph K. , Tholanikunnel B. , Chu H. W. , Riemer E. C. , Martin R. , Hoffman S.
Published: September 2012

Background

Caveolin‐1 has emerged as a critical regulator of signaling pathways involved in lung fibrosis and inflammation.

Methods

Therefore, we investigated whether caveolin‐1 is deficient in asthmatic patients and in a murine model of asthma.

Results

Immunohistochemical analyses of endobronchial biopsies showed a remarkable loss of caveolin‐1 in the lungs of asthmatic patients compared with controls. This loss was most evident in bronchial epithelial cells and associated with an increase in the expression of extracellular matrix proteins: collagen I, tenascin, and periostin. Cultured primary bronchial epithelial cells of asthmatics had lower caveolin‐1 expression compared with control cells. In addition, caveolin‐1 expression was significantly decreased in peripheral blood monocytes from asthma patients. The loss of caveolin‐1 was also observed in a mouse model for asthma (mice sensitized and challenged with aspergillus fumigatus).

Conclusions

To our knowledge, this is the first demonstration that the regulatory protein caveolin‐1 is reduced in patients with asthma.
Neonatal protein kinase C zeta expression determines the neonatal T‐Cell cytokine phenotype and predicts the development and severity of infant allergic disease
Authors: D'Vaz N. , Ma Y. , Dunstan J. A. , Lee‐Pullen T. F. , Hii C. , Meldrum S. , Zhang G. , Metcalfe J. , Ferrante A. , Prescott S. L.
Published: September 2012

Background

Previous studies have demonstrated that reduced T‐cell protein kinase C zeta (PKCζ) expression is associated with allergy development in infants born to atopic mothers. This study examined whether this relationship extends to a general population and addressed the basis for the association.

Methods

A flow cytometry assay was developed for the measurement of T‐cell PKCζ levels in PBMC, cord blood mononuclear cell and whole blood. Cord blood T‐cell PKCζ levels were measured in 135 neonates, and allergic disease was evaluated by skin prick test and clinical examination at 12 months of age.

Results

Allergic children (particularly those with eczema) had significantly lower neonatal T‐cell PKCζ expression than nonallergic children (P < 0.001). PKCζ levels predicted allergic disease with optimal specificity of 86% and sensitivity of 54%. The sensitivity was increased in the children of allergic mothers, who had significantly lower PKC levels than the children of nonallergic mothers. Cord blood PKCζ levels did not affect T‐cell maturation in culture as assessed by CD45RA/RO expression, but low PKCζ expression was associated with reduced capacity for IFNγ production by matured T cells. Low cord blood PKC expression was further associated with increased IL‐13 responses at 6 months.

Conclusions

The findings suggest a potential role for the use of PKCζ levels in cord blood T cells as a presymptomatic test to predict allergy risk in children, particularly offspring of allergic mothers, and that the basis of this relationship is related to cytokine patterns in mature T cells.
Ethnic disparities in the risk of adverse neonatal outcome after spontaneous preterm birth
Authors: SCHAAF JELLE M. , MOL BEN‐WILLEM J. , ABU‐HANNA AMEEN , RAVELLI ANITA C.J.
Published: September 2012

Objective. To describe ethnic disparities in the risk of spontaneous preterm birth and related adverse neonatal outcome. Design. Nationwide prospective cohort study. Setting. The Netherlands, 1999–2007. Population. Nine hundred and sixty‐nine thousand, four hundred and ninety‐one singleton pregnancies with a spontaneous onset of labor. Methods. We investigated ethnic disparities in perinatal outcome for European white, African, South‐Asian, Mediterranean and East‐Asian women. We performed multivariate logistic regression analyses to calculate the adjusted odds ratio (aOR) and confidence intervals (CIs) of spontaneous preterm birth and the risk of subsequent neonatal morbidity and mortality. Main outcome measures. The primary outcome measure was spontaneous preterm birth before 37 completed weeks of gestation. Secondarily, we investigated subsequent adverse neonatal outcome, which was a composite outcome of intraventricular hemorrhage, bronchopulmonary dysplasia, infant respiratory distress syndrome, neonatal sepsis or neonatal mortality within 28 days after birth. Results. Compared with European whites, the aOR of delivering preterm was 1.33 (95% CI 1.26–1.41) for African women, 1.58 (95% CI 1.47–1.69) for South‐Asians, 0.88 (95% CI 0.84–0.91) for Mediterraneans and 1.04 (95% CI 0.98–1.11) for East‐Asians. Subsequent odds of adverse neonatal outcome were significantly lower for African (aOR 0.51; 95% CI 0.41–0.64) and Mediterranean women (aOR 0.86; 95% CI 0.75–0.99) when compared with European whites. Conclusions. African and South‐Asian women are at higher risk for preterm birth than European white women. However, the harmful effect of preterm birth on neonatal outcome is less severe for these women.
On the potential of metformin to prevent preterm delivery in women with polycystic ovary syndrome – an epi‐analysis
Authors: VANKY ESZTER , DE ZEGHER FRANCIS , DÍAZ MARTA , IBÁÑEZ LOURDES , CARLSEN SVEN M.
Published: September 2012

Our aim was to re‐evaluate whether metformin may reduce late miscarriage/preterm delivery, pre‐eclampsia and gestational diabetes in women with polycystic ovary syndrome (PCOS). We performed an epi‐analysis of two randomized controlled trials. The participants were 313 women aged 18–42 years with PCOS who had singleton pregnancies. They were randomized to metformin or placebo treatment from first trimester until delivery. We analysed the prevalence of late miscarriage/preterm delivery, pre‐eclampsia and gestational diabetes according to both the intention‐to‐treat principle and per protocol analysis. The metformin‐treated patients had less late miscarriage/preterm delivery; five (3%) vs. 18 (11%) in the placebo group (p < 0.01). There was no difference in the prevalence of gestational diabetes and pre‐eclampsia between the metformin and the placebo group. In this epi‐analysis, metformin treatment during pregnancy seems to reduce early delivery in women with PCOS. We believe that further randomized studies should be performed before firm conclusions can be drawn.
Oropharyngeal Candida colonization in human immunodeficiency virus infected patients
Authors: Li Xiaoxu , Lei Lei , Tan Dan , Jiang Lu , Zeng Xin , Dan Hongxia , Liao Ga , Chen Qianming
Published: September 2012

Oropharyngeal candidiasis (OPC) is a very common oral symptom for HIV infected patients. OPC is often caused by overgrowth of commensal Candida strains which asymptomatically colonize oral cavity of HIV+ patients. HIV infection can not only weaken the systemic and local mucosal immunity but also interact with Candida species colonizing in oral cavity. These changes in host immunity and Candida species may facilitate Candida colonization in oral cavity of HIV infected patients. This review will discuss oral Candida colonization (including asymptomatic Candida carriage and OPC) prevalence, colonization spectrum, colonization intensity, relationship between oropharyngeal Candida colonization and peripheral blood CD4+ T cell counts, association of plasma levels of HIV RNA and Candida colonization, and other factors related with Candida colonization in HIV+ patients.
Oral xylose isomerase decreases breath hydrogen excretion and improves gastrointestinal symptoms in fructose malabsorption – a double‐blind, placebo‐controlled study
Authors: Komericki P. , Akkilic‐Materna M. , Strimitzer T. , Weyermair K. , Hammer H. F. , Aberer W.
Published: September 2012

Background

Incomplete resorption of fructose results in increased colonic hydrogen production and is a frequent cause of abdominal symptoms. The only treatment available is diet.

Aim

To study whether orally administered xylose isomerase (XI), an enzyme that catalyses the reversible isomerisation of glucose and fructose, can decrease breath hydrogen excretion in patients with fructose malabsorption.

Methods

Patients received 25 g fructose in 100 mL water together with either placebo or XI capsules. Primary endpoint was the reduction in breath hydrogen excretion, as assessed by the area under the breath hydrogen curve over 4 h (AUC). A secondary endpoint was the reduction in abdominal pain, bloating and nausea assessed on a visual analogue scale (VAS, range: 0–10). A P value <0.05 was considered statistically significant.

Results

Sixty‐five patients in whom fructose malabsorption had been diagnosed by positive breath hydrogen test within the previous year, were included in the study [15 males, 50 females; mean age 43.3 (s.d. = 14.4), range: 21–73 years]. The median AUC was 885 ppm/240 min in the XI group compared to 2071 ppm/240 min in the placebo group (P = 0.00). Median scores for abdominal pain (0.7 vs. 1.3) and nausea (0.2 vs. 0.6), but not for bloating (P = 0.053), were significantly improved after XI (P = 0.009 and P = 0.005) as compared with placebo.

Conclusions

Oral administration of xylose isomerase significantly decreased breath hydrogen excretion after ingestion of a watery fructose solution. Nausea and abdominal pain were significantly improved by xylose isomerase.
Comparative proteomic study for profiling differentially expressed proteins between Chinese left‐ and right‐sided colon cancers
Authors: Shen Hong , Huang Jinlin , Pei Haiping , Zeng Shan , Tao Yiming , Shen Liangfang , Zeng Liang , Zhu Hong
Published: September 2012

The aim of the present study is to profile differentially expressed protein markers between left‐sided colon cancer (LSCC) and right‐sided colon cancer (RSCC). Fresh tumor tissue samples from LSCC (n = 7) and RSCC (n = 7) groups were analyzed by two‐dimensional electrophoresis coupled with MALDI‐TOF‐MS, followed by Western blotting. In 50 paraffin embedded samples from each group, levels of four differentially expressed proteins (identified by proteomics analysis) were measured by tissue microarray with immunohistochemistry staining to compare the different protein markers between LSCC and RSCC. Sixteen proteins were found to be differentially expressed between LSCC and RSCC. Ten proteins including HSP‐60 and PDIA1 were identified to be highly expressed in LSCC (P < 0.01 or P < 0.05), while the expression of six proteins including EEF1D and HSP‐27 were higher in RSCC (P < 0.01 or P < 0.05). Virtually all of the indentified proteins were involved in cellular energy metabolism, protein folding/unfolding, and/or oxidative stress. Human colon tumors at various locations have different proteomic biomarkers. Differentially expressed proteins associated with energy metabolism, protein folding/unfolding and oxidative stress contribute to different tumorigenesis, tumor progression, and prognosis between left‐ and right‐sided colon cancer. (Cancer Sci 2013; 104: 141–135)
Identification of Small Molecule Hes1 Modulators as Potential Anticancer Chemotherapeutics
Authors: Sail Vibhavari , Hadden M. Kyle
Published: September 2012

Hes1 is a key transcriptional regulator primarily controlled by the Notch signaling pathway, and recent studies have demonstrated both an oncogenic and tumor suppressor role for Hes1, depending on the cell type. Small molecules that activate and inhibit Hes1 activity hold promise as future anticancer chemotherapeutics. We have utilized a cell‐based dual luciferase assay to identify modulators of Hes1 expression in a medium‐throughput format. A modest screen was performed in HCT‐116 colon cancer cell lines, and two small molecules were identified and characterized as Hes1 regulators. Compound 3 induced Hes1 expression and exhibited anticancer effects in pulmonary carcinoid tumor cells, a cell type in which the upregulated Notch/Hes1 signaling plays a tumor suppressive role. Treatment of HCT‐116 cells with compound 12 resulted in Hes1 downregulation and antitumor effects.
Design of Peptidomimetics for Inhibition of HER2 Receptor Dimerization by a Combination of Virtual Screening, MD Simulations, and QSAR In Silico Methods
Authors: Jamalan Mostafa , Zeinali Majid , Barzegari Asadabadi Ebrahim
Published: September 2012

Malfunction or overexpression of ErbB receptors (epidermal growth factor receptors) is associated with occurrence and severity of several types of cancer. Initiation of signal cascades by ErbB2 (also known as human epidermal growth factor receptor 2/neu) in breast cancer has been blocked by monoclonal antibodies such as Trastuzumab (Herceptin), which interact with the extracellular domain of human epidermal growth factor receptor 2. Due to some disadvantages of monoclonal antibodies, a new approach in blocking human epidermal growth factor receptor 2 dimerization and activation is designing peptidomimetic ligands based on human epidermal growth factor receptor 2‐Trastuzumab interaction model. Growth of human epidermal growth factor receptor 2+ SK‐BR3 cells could be specifically inhibited by peptidomimetic herceptin‐based peptidomimetic 5. In this study, herceptin‐based peptidomimetic 5 was used as a benchmark peptidomimetic compound to perform a ligand‐based virtual screening followed by structure‐based screening by applying the molecular docking approach. The study aimed to explore more potent peptidomimetic molecules against extracellular part of human epidermal growth factor receptor 2. Our results showed that the newly designed peptidomimetic herceptin‐based peptidomimetic n33B in comparison with herceptin‐based peptidomimetic 5 binds more tightly to the extracellular domain of human epidermal growth factor receptor 2. Mechanistic aspects of herceptin‐based peptidomimetic n33B interaction with human epidermal growth factor receptor 2 were more investigated through 20‐ns molecular dynamic simulations. Additionally, a quantitative structure–activity relationships study was performed to develop a model for identification of structural determinants in herceptin‐based peptidomimetic 5‐based peptidomimetics.
What goes around comes around: revisiting the hypothesized vicious cycle of dental fear and avoidance
Authors: Armfield Jason M.
Published: September 2012

Objectives

A vicious cycle is believed to operate in the maintenance of dental fear, whereby greater dental fear leads to the delay or avoidance of dental visiting, deteriorated oral health and problem‐oriented treatment, which then serves to reinforce the fear. The current study sought to uncover the existence of this vicious cycle pattern and to investigate the role of both dental fear and avoidance in terms of their hypothesized effect on treatment needs and visiting for problems.

Methods

Study participants were 1036 (response rate = 71.6%) dentate Australians (aged 15+) from all Australian states and territories.

Results

Dental fear was associated with avoidance, treatment need and problem‐oriented visiting. For people with moderate to high dental fear, 38.5% fit the hypothesized vicious cycle pattern of avoiding dental visiting because of fear, having treatment need and visiting for a problem. This compared with only 0.9% of people with no dental fear. Avoiding going to the dentist was an important predictor of treatment need and problem‐oriented visiting independent of dental fear. Dental fear was a statistically significant predictor of treatment need and problem‐oriented visiting and also acted as an effect modifier on avoidance because of fear.

Conclusion

The results support the premises underlying the vicious cycle model of dental fear maintenance. Dental fear appears to act as a determinant of avoiding or delaying dental visit, which has flow‐on effects in terms of greater treatment need and problem‐oriented visiting.
Limited response to CRH stimulation tests at 2 weeks of age in preterm infants born at less than 30 weeks of gestational age
Authors: Niwa Fusako , Kawai Masahiko , Kanazawa Hoshinori , Iwanaga Kougorou , Matsukura Takashi , Shibata Minoru , Hasegawa Takeshi , Heike Toshio
Published: September 2012

Background

The high incidence of glucocorticoid‐responsive complications in extremely preterm infants suggests the immaturity of their adrenal function; however, knowledge of the hypothalamus–pituitary–adrenal (HPA) axis in extremely preterm infants is limited.

Methods

To clarify the characteristics of the HPA axis in preterm very low birthweight (VLBW) infants, we performed CRH tests repeatedly: at about 2 weeks of age and at term (37–41 weeks of postmenstrual age) for 21 VLBW infants with a gestational age (GA) <30 weeks at birth.

Results

Basal cortisol values at 2 weeks of age were significantly higher than those at term in VLBW infants < 30 weeks of gestation at birth (304·1 ± 146·3 nmol/l vs 184·7 ± 108·2 nmol/l). Response to corticotropin‐releasing hormone (CRH) stimulation tests at 2 weeks of age was significantly lower than at term (delta cortisol 148·3 ± 90·7 nmol/l vs 271·8 ± 167·0 nmol/l, delta ACTH 3·9 ± 3·2 pmol/l vs 12·3 ± 9·2 pmol/l, respectively). We found that earlier GA contributed to the higher basal cortisol values, and antenatal glucocorticoid (AG) contributed to the lower response of cortisol to CRH tests at 2 weeks of age.

Conclusions

VLBW infants showed a characteristic pattern in the HPA axis at 2 weeks of age: higher basal cortisol values and lower response to CRH tests. This study suggested that AG was related to the lower response to CRH tests, at least partly.
Osteoporosis and metabolic syndrome according to socio‐economic status, contribution of PTH, vitamin D and body weight: The Canarian Osteoporosis Poverty Study (COPS)
Authors: Navarro María del Carmen , Saavedra Pedro , Jódar Esteban , Gómez de Tejada Mª Jesús , Mirallave Ana , Sosa Manuel
Published: September 2012

Background

Poverty is associated with a great number of diseases, but the prevalence of vitamin D deficiency, secondary hyperparathyroidism and the potential association of osteoporosis, osteoporotic fractures and metabolic syndrome in this situation are less well known.

Objective

To evaluate the associations between poverty, bone density, fragility fractures and metabolic syndrome in a population of southern European postmenopausal women. Also, to assess the potential role of vitamin D and parathyroid hormone (PTH) levels in these associations.

Method

Cross‐sectional study was carried out in 1 250 postmenopausal Caucasian Spanish women. The socio‐economic status of the participants was determined after a personal interview, according to the criteria of the Spanish Institute of Statistics. Participants were divided into two socio‐economic levels: low (poverty) and medium or high socioeconomic level. The study protocol included a health questionnaire, a complete physical examination, lateral radiograph of the dorsal and lumbar spine and measurement of bone mineral density (BMD) at the lumbar spine (L2‐L4) and proximal femur. Fasting blood was obtained to measure 25‐hydroxy‐vitamin D (25‐OHD), intact PTH and selected biochemical variables.

Results

Low socio‐economic status was associated with 25‐OHD insufficiency, higher values of PTH, higher body weight and body mass index (BMI), lower values of BMD at the lumbar spine and a higher prevalence of fragility fractures, both vertebral and nonvertebral. Poverty was also associated with higher prevalence of metabolic syndrome, but this association was driven mainly by the higher BMI and not by poverty itself. Both vitamin D insufficiency and elevated PTH were consistently related to poverty and osteoporotic fractures.

Conclusions

Poor postmenopausal women in southern Europe have a high prevalence of metabolic syndrome and osteoporotic fractures. Poverty was associated with higher BMI and metabolic syndrome on the one hand and, on the other, with 25OHD insufficiency, higher PTH levels and osteoporosis. 25OHD insufficiency and/or secondary hyperparathyroidism do not have a significant influence on the presence of metabolic syndrome in this population.
Associations of insulin‐like growth factor‐I and its binding proteins and testosterone with frailty in older men
Authors: Yeap B. B. , Paul Chubb S. A. , Lopez Derrick , Ho K. K. Y. , Hankey Graeme J. , Flicker Leon
Published: September 2012

Objective

Ageing is associated with frailty and decreased anabolic hormones, insulin‐like growth factor‐I (IGF‐I) and testo;?>sterone. We hypothesized that components of the IGF‐I system, in conjunction with testosterone, modulate frailty risk in the elderly. We examined associations between IGF‐I, its binding proteins IGFBP1 and IGFBP3 and testosterone with frailty in men.

Design

Observational study of 3 447 community‐dwelling men aged 70–89 years assessed in 2001–04, with 1 654 reassessed in 2008–09.

Methods

Baseline total IGF‐I, IGFBP1, IGFBP3 and testosterone were assayed. Frailty was assessed using the FRAIL scale, comprising 5 domains: fatigue; difficulty climbing stairs; difficulty walking >100 m; >5 illnesses; weight loss >5%. Men with ≥ 3 domains were considered frail.

Results

At baseline, 527 men (15·3%) were frail. Frail men had lower IGFBP3 (3 630 ng/ml vs not frail: 3 800 ng/ml, P < 0·001) and comparable IGFBP1 (23·5 vs 21·5 ng/ml, P = 0·09). In multivariate analyses, higher IGFBP1 was associated with increased prevalence of frailty (highest vs lowest quartile Q4:Q1, adjusted odds ratio [OR] = 1·39, 95% CI = 1·03–1·88). New‐onset frailty arose in 260 (17·5%) of 1 484 men. Lower baseline IGF‐I predicted new‐onset frailty (Q1:Q4 OR = 1·48, 95% CI = 1·00–2·20) as did higher IGFBP1 (Q4:Q1 OR = 1·59, 95% CI = 1·01–2·50). Men with both IGF‐I and free testosterone in Q1 had greater odds of prevalent frailty (OR = 2·13, 95% CI = 1·54–2·95).

Conclusions

Older men with higher IGFBP1 level, or both lower IGF‐I and testosterone, are more likely to be frail, while those with lower IGF‐I and higher IGFBP1 are more likely to become frail. Components of the IGF‐I system may be biomarkers or independent predictors of frailty.
The risk of maternal obesity to the long‐term health of the offspring
Authors: O'Reilly James R. , Reynolds Rebecca M.
Published: September 2012

The prevalence of maternal obesity has risen dramatically in recent years, with approximately one in five pregnant women in the UK now classed as obese (body mass index ≥ 30 kg/m2) at antenatal booking. Obesity during pregnancy has been hypothesized to exert long‐term health effects on the developing child through ‘early life programming’. While this phenomenon has been well studied in a maternal undernutrition paradigm, the processes by which the programming effects of maternal obesity are mediated are less well understood. In humans, maternal obesity has been associated with a number of long‐term adverse health outcomes in the offspring, including lifelong risk of obesity and metabolic dysregulation with increased insulin resistance, hypertension and dyslipidaemia, as well as behavioural problems and risk of asthma. The complex relationships between the maternal metabolic milieu and the developing foetus, as well as the potential influence of postnatal lifestyle and environment, have complicated efforts to study the programming effects of maternal overnutrition in humans. This review will examine the emerging evidence from human studies linking maternal obesity to adverse offspring outcomes.
Identification and characterization of D410E, a novel mutation in the loop 3 domain of CASR, in autosomal dominant hypocalcemia and a therapeutic approach using a novel calcilytic, AXT914
Authors: Park So Young , Mun Hee‐Chang , Eom Young Sil , Baek Hae Lim , Jung Tae Sik , Kim Chul Hoon , Hong Suntaek , Lee Sihoon
Published: September 2012

Objective

Activating mutations of the calcium‐sensing receptor (CASR) gene are associated with autosomal dominant hypocalcemia (ADH) characterized by benign hypocalcemia, inappropriately low (PTH) levels and mostly hypercalciuria. Herein, we report a novel activating mutation in the CASR gene in a Korean family with ADH.

Method

The CASR gene was sequenced in the patient with ADH. The identified mutations were also evaluated in the patient's family members by PCR‐based sequencing. For functional studies, we examined phosphorylation of ERK1/2. In addition, intracellular Ca2+ mobilization and the effects of the calcilytic, AXT914 were measured using fluorophore Fura‐2 dye.

Result

Direct sequencing analysis of the CASR gene showed that the proband and her daughter possess a novel mutation c.1230T>A, resulting in a D410E missense mutation on exon 4 of the CASR gene. Escalation of the extracellular Ca2+ concentration resulted in stronger phosphorylation of ERK1/2 and higher levels of intracellular Ca2+ in HEK293 cells expressing mutant CASR, compared with wild‐type CASR. The increase in intracellular Ca2+ signalling via CASR was successively blunted by treatment with AXT914.

Conclusions

Over 60 activating mutations in the CASR gene have been identified to cause ADH so far. Here, we add one more activating mutation that causes ADH. The novel activating mutation (D410E) occurred in the loop 3 region of CASR, where its function was believed to be of little importance; therefore, this mutation may be of interest. Further clinical study will be needed to validate the effectiveness of calcilytics in treatment of ADH in vivo.
A lower value for quantitative ultrasound at radius is an additional indicator of metabolic syndrome and cardiovascular disease risk
Authors: Tao Bei , Li Zhen , Zhao Hong‐Yan , Sun Li‐Hao , Zhao Lin , Li Xiao‐Ying , Wang Wei‐Qing , Ning Guang , Liu Jian‐Min
Published: September 2012

Background

The relationships between quantitative ultrasound (QUS) values, metabolic syndrome (MetS) and cardiovascular disease (CVD) risk are unclear.

Objective The objective was to determine the relationships between QUS and MetS as well as CVD risk.

Design

This was a cross‐sectional study conducted in Shanghai, China.

Patients

One‐thousand four hundred and thirty‐nine Chinese women and men with or without MetS were studied.

Measurements

Speed of sound (SOS) at radius, phalanx and tibia and their relationships with MetS and Framingham's 10‐year cardiovascular disease risk scores were investigated.

Results

Premenopausal women with MetS had significant lower SOS at radius than those without MetS after adjusting for age, BMI and fat mass percentage (P = 0·02). The radius SOS was negatively associated with waist circumference (r = −0·109, P = 0·025), waist‐to‐hip ratio (r = −0·124, P = 0·01) and 2 h postprandial glucose level (r = −0·125, P = 0·012) in premenopausal women. Waist circumference, waist‐to‐hip ratio and 2 h postprandial glucose level increased with the decreasing tertiles of radius SOS after adjustment of age (P = 0·003, 0·002 and 0·008, respectively). The CVD risk increased with decreasing tertiles of radius SOS in postmenopausal women even after the adjustment of age, years since menopause, MetS components, smoking and alcohol habits (P < 0·001), but not in premenopausal women and men.

Conclusions

Lower radius SOS is associated with greater risks of MetS and CVD in premenopausal and postmenopausal women, respectively. The QUS value derived from non‐weight‐bearing site, such as radius, may represent an additional indicator of MetS and CVD risk in women.
Efficacy of confocal laser endomicroscopy for discriminating colorectal neoplasms from non‐neoplasms: a systematic review and meta‐analysis
Authors: Su P. , Liu Y. , Lin S. , Xiao K. , Chen P. , An S. , He J. , Bai Y.
Published: September 2012

Aim  Confocal laser endomicroscopy (CLE) has evolved to allow in vivo real‐time biopsy for the classification of colorectal lesions.

The primary aim of this study was to assess the effectiveness of CLE for discriminating colorectal neoplasms from non‐neoplasms and its contributing factors. The secondary aim was to compare the efficacy of endomicroscopy and chromoendoscopy for diagnosing colorectal neoplasms.

Method  A systematic review of the literature published between 2000 and 2012 was conducted. Pooled sensitivity and specificity were compared using univariate regression analysis according to prespecified subgroups. Pooled relative risk was computed to compare the accuracy of endomicroscopy and chromoendoscopy.

Results  Fifteen studies involving 719 patients and 2290 specimens were analysed. The pooled sensitivity of all studies was 0.94 [95% confidence intervals (CI): 0.88–0.97], and pooled specificity was 0.95 (95% CI: 0.89–0.97). Real‐time CLE yielded higher sensitivity (0.96 vs 0.85, P < 0.001) and specificity (0.97 vs 0.82, P < 0.001) than blinded CLE. For real‐time CLE, endoscopy‐based systems had better sensitivity (0.96 vs 0.89, P < 0.001) and specificity (0.99 vs 0.82, P < 0.0001) than probe‐based systems. CLE yielded equivalent accuracy compared with magnifying virtual chromoendoscopy and magnifying pigment chromoendoscopy (P > 0.05).

Conclusion  CLE is comparable to colonoscopic histopathology in diagnosing colorectal neoplasms, and is better in conjunction with conventional endoscopy. An endoscopy‐based rather than a probe‐based modality would be optimal in the application of CLE.
Sucralfate or placebo following argon plasma coagulation for chronic radiation proctitis: a randomized double blind trial
Authors: Chruscielewska‐Kiliszek M. R. , Regula J. , Polkowski M. , Rupinski M. , Kraszewska E. , Pachlewski J. , Czaczkowska‐Kurek E. , Butruk E.
Published: September 2012

Aim  Chronic radiation proctitis is a long‐term complication of radiation therapy for pelvic malignancy. The aim of this study was to compare the efficacy and safety of two treatment regimens, sucralfate or placebo, following argon plasma coagulation (APC) for chronic haemorrhagic radiation proctitis.

Method  A single‐centre, randomized, placebo‐controlled, double‐blind study was performed on patients with haemorrhagic chronic radiation proctitis after irradiation for prostate, uterine, cervical, rectal or vaginal cancer. All patients received APC, and were then randomized to oral sucralfate (6 g twice a day) or placebo treatment for 4 weeks. APC was repeated every 8 weeks if necessary after the first session. Patients were graded clinically and endoscopically according to the Chutkan and Gilinski scales before and at 8 and 16 weeks after initial APC treatment (1.5–2 l/min, 25–40 W) and after 52 weeks (clinical only).

Results  Of 122 patients, 117 completed the entire protocol, with 57/60 in the sucralfate group and 60/62 in the placebo group. At baseline there were no significant differences between the sucralfate and placebo groups. At 1 year, a significant improvement in the clinical scale in both groups occurred compared with baseline. After 16 weeks, the median overall clinical severity scores fell from 4 to 2 points and the median bleeding score from 2 to 0 in both groups.

Conclusion  APC is safe and effective for the management of chronic radiation proctitis. Additional sucralfate treatment did not influence the clinical or endoscopic outcome.
Reduction of lipid‐laden macrophage index after laparoscopic Nissen fundoplication in cystic fibrosis patients after lung transplantation
Authors: Hayes Don , Kirkby Stephen , S. McCoy Karen , Mansour Heidi M. , Khosravi Medhi , Strawbridge Heather , Tobias Joseph D.
Published: September 2012

Background

Lipid‐laden macrophage (LLM) index could be potentially useful in assessing gastroesophageal (GE) reflux and aspiration after lung transplantation (LT) in patients with cystic fibrosis (CF).

Methods

A retrospective review of CF patients undergoing LT and/or laparoscopic Nissen fundoplication (LNF) from January 1, 2009, to December 31, 2011, was performed.

Results

Seventeen CF patients (nine women), mean (±SD) age 27.9 ± 7.5 yr, underwent LT with mean (±SD) pre‐transplant FEV1 of 20.9 ± 5.0% predicted. Seventy percentage (12/17) of patients underwent LNF without complications within 1–2 wk of LT. After LT, but prior to antireflux surgery, there was no significant difference in the mean (±SD) baseline LLM index (154 ± 41 vs. 146 ± 51, p = NS) between patients who were to undergo LNF and patients who did not. After LNF, a significant reduction in the mean (±SD) LLM index occurred following the procedure (154 ± 41–74 ± 54, p < 0.0001) while each patient reported resolution of symptoms of GE reflux, whereas 40% (2/5) undergoing only medical treatment reported resolution of symptoms.

Conclusions

Significant reduction in the LLM index occurred after LNF in CF patients after LT that correlated with resolution of clinical symptoms of GE reflux.
Potential risk map for avian influenza A virus invading Japan
Authors: Moriguchi Sachiko , Onuma Manabu , Goka Koichi
Published: September 2012

Aim

Our goal was to use the occurrence of the influenza A virus in wild birds in Japan to create a potential risk map for the spread of avian influenza by migratory birds. Our modelling included a consideration of the multicollinearity and spatial autocorrelation of environmental variables and an examination of the reproducibility of the model results.

Location

Japan.

Methods

We used the maximum entropy approach to generate potential distribution models from presence‐only data. Independent variables in the model included environmental factors such as winter temperature and precipitation, host factors such as duck population size and habitat abundance and artificial factors such as size of urban areas and poultry density. We used eigenvector‐based spatial filters to alleviate spatial autocorrelation. To explore the reliability of the model, we compared the risk indices of localities positive in past winters for the influenza A virus in wild birds with those of all localities.

Results

The model alleviated spatial autocorrelation with a high degree of accuracy. Dabbling duck population, size of urban area, diving duck population and altitude were the variables that were most strongly correlated with the potential distribution of avian influenza. We used the frequency of occurrence of the influenza A virus in five recent years in localities where wild birds were infected to estimate the repeatability of the high‐risk indices; the potential risk indices for avian influenza in wild birds were high in localities where wild birds were infected in past.

Main conclusions

The dabbling duck population in an area appeared to be the best indicator of high risk for the introduction of avian influenza from abroad. Priority monitoring localities for avian influenza carried by wild birds should be designated in western Japan and along the Pacific coast, which we estimated to be high‐risk areas. Poultry farms in these areas should increase their biosecurity to prevent vectors from introducing avian influenza.
Identifying risk and preventing progression to Type 2 diabetes in vulnerable and disadvantaged adults: a pragmatic review
Authors: Taylor J. , Cottrell C. , Chatterton H. , Hill J. , Hughes R. , Wohlgemuth C. , Holt R. I. G.
Published: September 2012

Aim

To identify effective approaches to recognize diabetes risk and prevent progression to Type 2 diabetes in vulnerable groups, whose diabetes risk may be difficult to identify or manage.

Methods

UK‐based interventions that assess diabetes risk and/or target known risk factors were identified through four main sources: submissions to two calls for evidence by the National Institute for Health and Clinical Excellence; local practice examples collected via a targeted email questionnaire; selected electronic databases; and a focused search of relevant websites. No restriction was placed on the study type or evaluation methods used. Key themes and sub‐themes on outcomes, as well as facilitators and barriers to successful delivery, are reported.

Results

Twenty‐four interventions met all inclusion criteria: 15 included a risk identification element and 14 included preventative activities. A range of risk identification tools were used to improve diagnosis of unmet diabetes‐related health needs and raise awareness of diabetes risk factors. All preventative interventions focused on lifestyle change. No interventions monitored blood glucose as an outcome and only one reported improvements in baseline risk scores. Facilitators included tailored and flexible programme design, outreach delivery in familiar locations and effective inter‐agency working. Barriers included literacy and language difficulties, transient participant populations, low prioritization of diabetes prevention and cost.

Conclusions

It is possible to engage successfully with high‐risk adults in vulnerable groups to achieve positive health outcomes relevant to the prevention of diabetes. However, more robust evidence on longer‐term outcomes is required to ensure that programmes are targeted and delivered appropriately.
The impact of calcineurin inhibitors on insulin sensitivity and insulin secretion: a randomized crossover trial in uraemic patients
Authors: Øzbay L. A. , Møller N. , Juhl C. , Bjerre M. , Carstens J. , Rungby J. , Jørgensen K. A.
Published: September 2012

Aims

The calcineurin inhibitors cyclosporine and tacrolimus are implicated in post‐transplant complications such as new‐onset diabetes after transplantation. The relative contribution of each calcineurin inhibitor to new‐onset diabetes after transplantation remains unclear. We sought to compare the impact of cyclosporine and tacrolimus on glucose metabolism in humans.

Methods

Eight haemodialysis patients received 8–10 days of oral treatment followed by 5‐h infusions with cyclosporine, tacrolimus and saline in a randomized, investigator‐blind, crossover study. Glucose metabolism and β‐cell function was investigated through: a hyperinsulinaemic–euglycaemic clamp, an intravenous glucose tolerance test and insulin concentration time series.

Results

Cyclosporine and tacrolimus decreased insulin sensitivity by 22% (P = 0.02) and 13% (P = 0.048), respectively. The acute insulin response and pulsatile insulin secretion were not significantly affected by the drugs.

Conclusion

In conclusion, 8–10 days of treatment with cyclosporine and tacrolimus impairs insulin sensitivity to a similar degree in haemodialysis patients, while acute insulin responses and pulsatile insulin secretion remain unaffected.
Comorbidities and survival in obstructive sleep apnoea beyond the age of 50
Authors: Marrone Oreste , Lo Bue Anna , Salvaggio Adriana , Dardanoni Gabriella , Insalaco Giuseppe
Published: September 2012

Eur J Clin Invest 2012

Background  Although mortality risk associated with obstructive sleep apnoea (OSA) tends to disappear from the age of 50, it has been suggested that OSA treatment by continuous positive airway pressure (CPAP) improves survival even in older subjects. Life expectancy of subjects with several diseases is worse if OSA coexists. The objectives of this study were to evaluate the relevance of comorbidities in the relationship between OSA and mortality, and in the effect of CPAP on survival, in subjects ≥ 50 years old.

Methods  Data from 810 patients studied by polysomnography for suspected OSA between 1991 and 2000 were retrospectively evaluated. In 2009, state of survival and use of CPAP were enquired. Three hundred and thirteen subjects were < 50 and 497 were ≥ 50 years at diagnosis.

Results  Age and comorbidities, but not apnoea/hypopnoea index (AHI) or lowest nocturnal arterial oxygen saturation (Nadir SaO2), predicted mortality in the whole sample. Nadir SaO2 was related to mortality among the younger subjects without comorbidities (P = 0·01), but not among the older subjects. In the older patients with an AHI > 30 CPAP treatment was associated with a better survival only if comorbidities coexisted.

Conclusions  Unlike in younger subjects, in subjects ≥ 50 years old, comorbidities do not mask an effect of OSA on mortality. Among OSA subjects ≥ 50 years old, comorbidities could separate those who may expect an improvement in survival with CPAP treatment from those who may not. Possibly, after the age of 50, OSA per se does not affect survival, but worsens prognosis of subjects with coexisting diseases.