bluuebunny/crossref_metadata_2025 huggingface dataset:
μ‐Opioid receptor activation and noradrenaline transport inhibition by tapentadol in rat single locus coeruleus neurons
Authors: Sadeghi Mahsa , Tzschentke Thomas M , Christie MacDonald J
Published: December 2013

Background and Purpose

Tapentadol is a novel analgesic that combines moderate μ‐opioid receptor agonism and noradrenaline reuptake inhibition in a single molecule. Both mechanisms of action are involved in producing analgesia; however, the potency and efficacy of tapentadol in individual neurons has not been characterized.

Experimental Approach

Whole‐cell patch‐clamp recordings of G‐protein‐coupled inwardly rectifying K+ (KIR3.x) currents were made from rat locus coeruleus neurons in brain slices to investigate the potency and relative efficacy of tapentadol and compare its intrinsic activity with other clinically used opioids.

Key Results

Tapentadol showed agonist activity at μ receptors and was approximately six times less potent than morphine with respect to KIR3.x current modulation. The intrinsic activity of tapentadol was lower than [Met]enkephalin, morphine and oxycodone, but higher than buprenorphine and pentazocine. Tapentadol inhibited the noradrenaline transporter (NAT) with potency similar to that at μ receptors. The interaction between these two mechanisms of action was additive in individual LC neurons.

Conclusions and Implications

Tapentadol displays similar potency for both µ receptor activation and NAT inhibition in functioning neurons. The intrinsic activity of tapentadol at the μ receptor lies between that of buprenorphine and oxycodone, potentially explaining the favourable profile of side effects, related to μ receptors.

Linked Articles

This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2
Review of the role of refined dietary sugars (fructose and glucose) in the genesis of retinal disease
Authors: Kearney Frances M , Fagan Xavier J , Al‐Qureshi Salmaan
Published: December 2013

This review examines the current evidence of the relationship between sugar consumption and the development of retinal and other eye diseases including diabetic retinopathy, hypertensive retinopathy, age‐related macular degeneration, non‐arteritic anterior ischaemic optic neuropathy and cataract. Sucrose is comprised of fructose and glucose. Sugar consumption has increased five‐fold over the last century, with high quantities of sucrose and high‐fructose corn syrup found in processed food and soft drinks. This increased consumption is increasingly recognized as a central factor in the rapidly rising rates of obesity and type 2 diabetes. The body metabolizes fructose and glucose differently, with fructose appearing to have the greater propensity to contribute to the metabolic syndrome. This review examines the effect of high rates of dietary consumption of refined carbohydrates on the eye, including the effect of chronic hyperglycaemia on microvascular disease in diabetic retinopathy, and the pathophysiological changes in the retinal circulation in hypertensive retinopathy.
Role of MICA antibodies in solid organ transplantation
Authors: Luo Lei , Li Zhengyu , Wu Weidong , Luo Guangheng , Xu Chuan , Sun Zhaolin , Mei Hong
Published: December 2013

As a potential transplant antigen, major histocompatibility complex class I chain‐related gene A (MICA) antigen, has attracted increased attention because of its possible role in solid organ transplantation. There are two MICA forms, and MICA antibodies and soluble MICA (sMICA) have been found in the serum of transplant recipients. We searched MEDLINE, EMBASE, and the Cochrane Library for original reports of clinical studies involving the effect of MICA on outcomes of renal, heart, lung, and liver transplantation. In addition to the human leukocyte antigen antigens, which elicit a strong immune response, the polymorphic MICA antigens induce production of MICA antibodies and sMICA. A number of clinical studies have shown that MICA antibodies correlate with an increased incidence of rejection and a decreased allograft survival rate following renal or heart transplantation. Although it is clearly associated with chronic rejection of lung allografts, no such correlation was found for liver transplantation. Moreover, sMICA showed a negative association with acute rejection (AR) and may be a good predictor of heart transplant outcomes. These data suggest MICA expression patterns and regulatory function may be tissue specific and that different transplants have different organ‐specific outcomes.
The pitfalls of ignoring behaviour when quantifying habitat selection
Authors: Roever C. L. , Beyer H. L. , Chase M. J. , van Aarde R. J.
Published: December 2013

Aim

Habitat selection is a behavioural mechanism by which animals attempt to maximize their inclusive fitness while balancing competing demands, such as finding food and rearing offspring while avoiding predation, in a heterogeneous and changing environment. Different habitat characteristics may be associated with each of these demands, implying that habitat selection varies depending on the behavioural motivations of the animal. Here, we investigate behaviour‐specific habitat selection in African elephants and discuss its implications for distribution modelling and conservation.

Location

Northern Botswana, Africa, case study.

Methods

We use Bayesian state‐space models to characterize location time series data of elephants into two behavioural states (encamped and exploratory). We then develop habitat selection models for each behavioural state and contrast them to models based on data pooled among behaviours.

Results

Spatial predictions of habitat use were often markedly different among the models. Behaviour‐specific and pooled habitat selection models differed in model structure, the magnitude of model coefficients and the form of the selection curve (linear or quadratic). Selection was typically strongest in the behaviour‐specific models, although this varied according to behavioural state and habitat covariate.

Main conclusions

Ignoring behavioural states often had important consequences for quantifying habitat selection. Quantifying selection irrespective of behaviour (among all behaviours) can obscure important species–habitat relationships, thereby risking weak or incorrect inferences. Behaviour‐specific habitat selection provides greater insight into the process of habitat selection and can improve predictive habitat selection estimates. As some behaviours are more relevant to specific conservation objectives than others, focusing on behaviour‐specific selection could improve how habitats are prioritized for conservation or management.
Individual Exploration, Sensemaking, and Innovation: A Design for the Discovery of Novel Information
Authors: Jenkin Tracy A. , Chan Yolande E. , Skillicorn David B. , Rogers Keith W.
Published: December 2013

Discovering novel information can result in the generation of potentially valuable new ideas and can therefore be beneficial to organizations interested in innovation. To be useful, novel information must have a particular relationship to existing organizational knowledge. It must be far enough away to qualify as novel, but it must be close enough that it can be understood and exploited. Therefore, a key challenge for novel‐information discovery (NID) is to find concepts that have such relationships to a given starting point or focal concept of interest. Despite the potential benefits, organizations face a number of challenges when discovering novel information on the Web: locating it, understanding its relevance, and making sense of it given the constraints and biases of existing mental models. In this article, we develop an understanding of the challenges of NID and how a tool can support individuals in locating and translating novel information into novel ideas. Using a design science approach, we develop a design theory for NID. A prototype is developed and evaluated. Our findings show that an NID tool performs better than other Web search tools such as Google in terms of the perceived levels of novel information provided and radicalness of the ideas generated.
Analyzing the Integration of WiMAX and Wi‐Fi Services: Bandwidth Sharing and Channel Collaboration
Authors: Li Yung‐Ming , Jhang‐Li Jhih‐Hua
Published: December 2013

Several emerging studies have focused on the pricing issue of bandwidth sharing between Wi‐Fi and WiMAX networks; however, most either concentrate on the design of collaborated protocols or figure out the issue without the overall consideration of consumer preferences and contract design. In this study, we explore a wireless service market in which there are two wireless service providers operating Wi‐Fi and WiMAX. One of the research dimensions given in this study is whether wireless service providers implement bandwidth sharing, while the other is whether they make decisions individually or jointly. By involving consumer preferences and a wholesale price contract in the present model, we find that bandwidth sharing would benefit a WiMAX service provider, yet a Wi‐Fi service provider would make no significant savings under a wholesale price contract. In addition, the profit of a WiMAX service provider may increase with Wi‐Fi coverage when bandwidth sharing has been implemented but decrease with Wi‐Fi coverage when both wireless services operate without bandwidth sharing. Furthermore, the WiMAX service provider allocates more capacity when the average usage rate increases, but lowers the expenditure of capacity when the average usage rate is too high.
Cost‐effectiveness of insulin degludec compared with insulin glargine for patients with type 2 diabetes treated with basal insulin – from the UK health care cost perspective
Authors: Evans M. , Wolden M. , Gundgaard J. , Chubb B. , Christensen T.
Published: December 2013

Aims

The aim of this analysis was to evaluate the cost‐effectiveness of insulin degludec (IDeg) versus insulin glargine (IGlar) in adults with type 2 diabetes mellitus (T2DM) who are considered appropriate for treatment with a basal insulin analogue, using a short‐term economic model.

Methods

Meta‐analysis data from three phase III clinical studies were used to populate a simple and transparent short‐term model. The costs and effects of treatment with IDeg versus IGlar were calculated over a 12‐month period. The analysis was conducted from the perspective of the UK National Health Service. Sensitivity analyses were conducted to assess the degree of uncertainty surrounding the results.

Results

IDeg is a cost‐effective treatment option versus IGlar in patients with T2DM using basal insulin. Base case incremental cost‐effectiveness ratios (ICERs) were estimated at £15 795 per quality‐adjusted life‐year (QALY) and £13 078 per QALY, which are below commonly accepted thresholds for cost‐effectiveness. Sensitivity analyses demonstrated that hypoglycaemia event rates had an important effect on the results. With higher event rates for non‐severe hypoglycaemia IDeg was less costly and more effective than IGlar (dominant). Conversely, using lower event rates for severe hypoglycaemia generated higher ICERs. Using hypoglycaemia rates from a subgroup of patients who experienced ≥1 hypoglycaemic event per year IDeg was highly cost‐effective versus IGlar; with estimated ICERS of £4887 and £2625 per QALY.

Conclusions

This short‐term modelling approach allows the economic evaluation of newer insulin analogues when advanced long‐term modelling based on HbA1c differences is inappropriate. For patients with T2DM who are considered appropriate for treatment with a basal insulin analogue, IDeg is a cost‐effective treatment option compared with IGlar and offers additional benefits to subgroups of patients, such as those suffering from recurrent hypoglycaemia.
The extra‐pancreatic effects of GLP‐1 receptor agonists: a focus on the cardiovascular, gastrointestinal and central nervous systems
Authors: Seufert J. , Gallwitz B.
Published: December 2013

The glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) exenatide, liraglutide and lixisenatide have been shown to improve glycaemic control and beta‐cell function with a low risk of hypoglycaemia in people with type 2 diabetes. GLP‐1 receptors are also expressed in extra‐pancreatic tissues and trial data suggest that GLP‐1RAs also have effects beyond their glycaemic actions. Preclinical studies using native GLP‐1 or GLP‐1RAs provide substantial evidence for cardioprotective effects, while clinical trial data have shown beneficial actions on hypertension and dyslipidaemia in people with type 2 diabetes. Significant weight loss has been reported with GLP‐1RAs in both people with type 2 diabetes and obese people without diabetes. GLP‐1RAs also slow down gastric emptying, but preclinical data suggest that the main mechanism behind GLP‐1RA‐induced weight loss is more likely to involve their effects on appetite signalling in the brain. GLP‐1RAs have also been shown to exert a neuroprotective role in rodent models of stroke, Alzheimer's disease and Parkinson's disease. These extra‐pancreatic effects of GLP‐1RAs could provide multi‐factorial benefits to people with type 2 diabetes. Potential adverse effects of GLP‐1RA treatment are usually manageable but may include gastrointestinal effects, increased heart rate and renal injury. While extensive further research is still required, early data suggest that GLP‐1RAs may also have the potential to favourably impact cardiovascular disease, obesity or neurological disorders in people without diabetes in the future.
Lixisenatide, a novel GLP‐1 receptor agonist: efficacy, safety and clinical implications for type 2 diabetes mellitus
Authors: Bolli G. B. , Owens D. R.
Published: December 2013

Recent advances in therapies for the treatment of type 2 diabetes mellitus (T2DM) have led to the development of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), which, unlike insulin and sulphonylurea, are effective, with a low risk of hypoglycaemia. Lixisenatide is recommended as a once‐daily GLP‐1 RA for the treatment of T2DM. In persons with T2DM, lixisenatide 20 µg once‐daily given by bolus subcutaneous injection improves insulin secretion and suppresses glucagon secretion in a glucose‐dependent manner. Compared with the longer‐acting GLP‐1 RA liraglutide, lixisenatide achieved a significantly greater reduction in postprandial plasma glucose (PPG) during a standardized test breakfast in persons with T2DM otherwise insufficiently controlled on metformin alone. This is primarily due to the greater inhibition of gastric motility by lixisenatide compared with liraglutide. The efficacy and safety of lixisenatide was evaluated across a spectrum of T2DM in a series of phase III, randomized, placebo‐controlled trials known as the GetGoal programme. Lixisenatide monotherapy or as add‐on to oral antidiabetic agents or basal insulin achieved significant reductions in glycated haemoglobin, PPG and fasting plasma glucose, with either weight loss or no weight gain. The most frequent adverse events were gastrointestinal and transient in nature. Lixisenatide provides an easy, once‐daily, single‐dose, add‐on treatment to oral antidiabetic agents or basal insulin for the management of T2DM, with little or no increased risk of hypoglycaemia and a potential beneficial effect on body weight.
Septal Curvature Is Marker of Hemodynamic, Anatomical, and Electromechanical Ventricular Interdependence in Patients with Pulmonary Arterial Hypertension
Authors: Haddad Francois , Guihaire Julien , Skhiri Mehdi , Denault Andre Y. , Mercier Olaf , Al‐Halabi Shadi , Vrtovec Bojan , Fadel Elie , Zamanian Roham T. , Schnittger Ingela
Published: December 2013

Aims

The objective of this study was to determine the factors independently associated with septal curvature in patients with pulmonary arterial hypertension (PAH).

Methods

Eighty‐five consecutive patients with PAH who had an echocardiogram and a right heart catheterization within 24 hours of each others were included in the study. Septal curvature was assessed at the mid‐papillary level using the eccentricity index (EI). Marked early systolic septal anterior motion was defined as a change in EI > 0.2 between end‐diastole and early systole. Inter‐ventricular mechanical delay was calculated as the percent time difference between right ventricular (RV) to left ventricular (LV) end‐ejection time normalized for the RR interval.

Results

Average age was 45 ± 11 years and the majority of patients were women (75%). Mean right atrial pressure was 11 ± 7 mmHg, mean PAP was 52 ± 13 mmHg, relative RV area 1.8 ± 0.9, and RV fractional area change 24 ± 8%. End‐diastolic EI was 1.6 ± 0.4 and systolic EI was 2.5 ± 0.8. On multivariate analysis relative pulmonary pressure, relative RV area, and inter‐ventricular mechanical delay were independently associated with systolic EI (R2 = 0.72, P < 0.001). Independent determinants of diastolic EI included relative RV area and mean PAP (R2 = 0.69, P < 0.001). A systolic EI >1.08 differentiated patients with PAH from healthy controls with an AUC = 0.99. Patients with early systolic septal anterior motion (44% of subjects) had lower exercise capacity, more extensive ventricular remodeling, and worst ventricular function.

Conclusion

Septal curvature is a useful marker of structural, hemodynamic, and electromechanical ventricular interdependence in PAH.
Theorizing Social Justice Ambiguities in an Era of Neoliberalism: The Case of Postapartheid South Africa
Authors: Subreenduth Sharon
Published: December 2013

In this essay, Sharon Subreenduth explores how social justice policies have both global–local and historical dynamics and maintains that, as a result, dominant Western models of social justice limit engagement with alternative modes of understanding social justice in non‐Western locations. She uses the South African experience as a case study for examining the complexities of social justice policy in the context of the decolonizing efforts that undergird national policy in South Africa as it simultaneously negotiates neoliberal globalizing dynamics. The essay specifically analyzes the neoliberal concept of choice and how it figures within the discourse and practice of race and education within society. Moving beyond binaries, Subreenduth highlights the murky areas of social justice and articulates what they tell us about meta‐analysis, narrative, resistance, complicities, infiltration, and the neoliberal il/logic of local–global histories.
Mature human odontoblasts express virus‐recognizing toll‐like receptors
Authors: Pääkkönen V. , Rusanen P. , Hagström J. , Tjäderhane L.
Published: December 2013

Aim

To study the expression of toll‐like receptors (TLR) ‐3, ‐7, ‐8 and ‐9 as well as interferon receptors alpha and gamma (IFNAR1/IFNAR2 and IFNGR1/IFNGR2), which play important roles in the defence against viruses.

Methodology

DNA microarray and quantitative PCR analyses of TLR3, ‐7, ‐8 and ‐9 as well as IFNAR1/IFNAR2 and IFNGR1/IFNGR2 genes in mature native human odontoblasts and pulp were performed. Immunohistochemistry was used to confirm TLR8 protein in odontoblasts of healthy and carious human teeth.

Results

TLR3, ‐7, ‐8 and ‐9 mRNAs were detected both in odontoblasts and in pulp, but TLR8 expression level was higher in the odontoblasts. IFNAR and IFNGR expression was observed in both tissues. Immunohistochemical analysis of healthy teeth revealed positive TLR8 staining in the pre‐dentine and the dentine but varying staining patterns in the different portions of tooth. Lighter TLR8 staining was observed in dentine of mildly carious teeth. In teeth with carious lesions extending into the mid‐dentine, only very weak staining was detected.

Conclusions

The finding of these virus‐recognition‐related genes in odontoblasts strengthens the view that odontoblasts participate in the immune response of the dentine–pulp complex.
Deteriorating patients managed with end‐of‐life care following Medical Emergency Team calls
Authors: Orosz J. , Bailey M. , Bohensky M. , Gold M. , Zalstein S. , Pilcher D.
Published: December 2013

Aim

To describe the characteristics of patients whose end‐of‐life care was initiated in response to a Medical Emergency Team (MET) call and to develop a predictive score to aid prospective identification of these patients.

Methods

Retrospective cohort study of all MET calls in a tertiary teaching hospital between April 2010 and March 2011. All inpatients attended by the hospital MET. The main outcome measures were patient demographics, admission features and comorbidities in active and palliative patients, timing, frequency, physiology, and interventions in active and palliative MET calls.

Results

One thousand, five hundred and sixty‐seven MET calls were called for 1073 patients. Sixty (5.6%) patients had at least one MET call resulting in initiation of end‐of‐life care. Palliative MET call patients compared with active patients were older (76.4 vs 65.9 years; P < 0.0001), had a shorter hospital stay (7.5 vs 12 days; P = 0.0002), had increased in‐hospital mortality (73.3% vs 13.5%; P < 0.001), had higher Charlson comorbidity scores (3.1 vs 2.1; P = 0.0002) and were more likely to receive multiple MET calls (1.95/patient vs 1.43/patient; P = 0.011). Patient physiological parameters were worse at palliative MET calls. Prior history of malignancy, hemiplegia and peripheral vascular disease, and increasing age were independently associated with initiation of end‐of‐life care and were used to derive a 13‐point predictive score. Patients with a score of 7 or more had a 20% chance of having a palliative MET call.

Conclusion

Prospective identification of patients requiring palliative care may be possible prior to MET involvement. This may allow more timely and appropriate end‐of‐life discussions.
Medical practitioners' knowledge and self‐reported practices of substitute decision making and implementation of advance care plans
Authors: Cartwright C. , Montgomery J. , Rhee J. , Zwar N. , Banbury A.
Published: December 2013

Background

Advance care planning (ACP) provides patients with the ability to make their decisions known about how they would like to be treated if they lose capacity. Medical practitioners have a key role to play in providing information on ACP to their patients. This research explores their knowledge and attitudes to advance care planning and how this affects their practice.

Aim

The objective of this study is to assess the NSW medical practitioners' knowledge and self‐reported practice of ACP.

Methods

A postal survey of a random sample of 650 general practitioners plus 350 medical specialists from specialties most often involved in end‐of‐life decisions was conducted. Respondents' work location post codes were subsequently used to assign respondents to one of the eight NSW Area Health Services. The main outcome measures were medical practitioners' knowledge of and practice pertaining to ACP.

Results

Thirty‐four per cent of specialists (n = 110) and 24% of general practitioners (n = 150) responded; the majority of respondents had heard of all ACP options. However, respondents' understanding of the uses and legal requirements of the relevant ACP options vary widely.

Conclusions

Respect for patient wishes expressed in advance directives is reassuringly high. The findings suggest significant misunderstanding by medical practitioners of terminologies and systems around substitute decision‐making for incompetent persons. Further education and standardisation of terminologies and systems across different jurisdictions would assist in addressing these issues. Low response rate, relating to only one legal jurisdiction, means results may not be generalisable.
Intramolecular polyspecificity in CD4 T‐cell recognition of Ad‐restricted epitopes of proteoglycan aggrecan
Authors: Falconer Jane , Lowes Katie , Furmanski Anna L. , Dyson Julian , Ng Wan Fai , Robinson John H.
Published: December 2013

T‐cell recognition of MHC–peptide complexes shows a high degree of polyspecificity extending to recognition of a large number of structurally unrelated peptides. Examples of polyspecificity reported to date are confined to recognition of epitopes from distinct proteins or synthetic peptide libraries. Here we describe intramolecular polyspecificity of CD4 T cells specific for several epitopes within proteoglycan aggrecan, a structural glycoprotein of cartilage and candidate autoantigen in rheumatoid arthritis. T‐cell hybridomas from aggrecan‐immunized mice recognized four structurally unrelated epitopes from the G1 domain of aggrecan, but not other aggrecan epitopes or a variety of other peptide epitopes restricted by the same MHC class II allele. We also showed that the hierarchy of cross‐reactivity broadly correlated with the strength of peptide binding to MHC class II. Similar polyspecificity was observed in responses of lymph node cells from peptide‐immunized mice, suggesting polyspecificity of a significant proportion of the in vivo aggrecan specific T‐cell repertoire. Polyspecific recognition of several epitopes within the same autoantigen may provide a novel mechanism to reach the activation threshold of low‐affinity autoreactive T cells in the initiation of autoimmune diseases.
Mental and physical health‐related functioning mediates between psychological job demands and sickness absence among nurses
Authors: Roelen Corné , van Rhenen Willem , Schaufeli Wilmar , van der Klink Jac , Magerøy Nils , Moen Bente , Bjorvatn Bjørn , Pallesen Ståle
Published: December 2013

Aims

To investigate whether health‐related functioning mediates the effect of psychological job demands on sickness absence in nurses.

Background

Nurses face high job demands that can have adverse health effects resulting in sickness absence.

Design

Prospective cohort study with 1‐year follow‐up.

Methods

Data for 2964 Norwegian nurses were collected in the period 2008–2010. At baseline, psychological job demands were measured with the Demand–Control–Support Questionnaire. Health‐related functioning was assessed by the Mental Composite Score and the Physical Composite Score of the SF‐12 Health Survey (2nd version). Sickness absence (no = 0, yes = 1) was self‐reported at 1‐year follow‐up. Interaction and mediation analyses were conducted stratified by tenure (<1‐year, 1–2 years, 3–6 years, >6 years) as a registered nurse.

Results

A total of 2180 nurses (74%) with complete data were eligible for analysis. A significant three‐way interaction between job demands, control and support was found in newly licensed nurses (tenure <1‐year). Baseline psychological job demands were positively associated with sickness absence at 1‐year follow‐up. This association was substantially weakened when Mental Composite Score and Physical Composite Score were introduced as mediator variables, indicating a partial mediation effect that was particularly pronounced in newly licensed nurses. Psychological job demands did not modify the effect of health‐related functioning on sickness absence.

Conclusion

Both mental and physical health‐related functioning mediated between psychological job demands and sickness absence. Nurse managers should pay attention to health‐related functioning, because poor health‐related functioning may predict sickness absence, especially in newly licensed nurses.
Psoriasis beyond the skin: an expert group consensus on the management of psoriatic arthritis and common co‐morbidities in patients with moderate‐to‐severe psoriasis
Authors: Strohal R. , Kirby B. , Puig L. ,   the Psoriasis Expert Panel (G. Girolomoni, K. Kragballe, T. Luger, F.O. Nestle, J.C. Prinz, M. Ståhle, N. Yawalkar)
Published: December 2013

Background

Psoriatic arthritis (PsA) and co‐morbidities of psoriasis represent a significant clinical and economic burden for patients with moderate‐to‐severe psoriasis. Often these co‐morbidities may go unrecognized or undertreated. While published data are available on the incidence and impact of some of them, practical guidance for dermatologists on detection and management of these co‐morbidities is lacking.

Objective

To prepare expert recommendations to improve the detection and management of common co‐morbidities in patients with moderate‐to‐severe psoriasis.

Methods

A systematic literature review was conducted on some common co‐morbidities of psoriasis–cardiovascular (CV) diseases (including obesity, hypertension, hyperglycaemia and dyslipidaemia), psychological co‐morbidities (including depression, alcohol abuse and smoking) and PsA–to establish the incidence and impact of each. Data gaps were identified and a Delphi survey was carried out to obtain consensus on the detection and management of each co‐morbidity. The expert panel members for the Delphi survey comprised 10 dermatologists with substantial clinical expertise in managing moderate‐to‐severe psoriasis patients, as well as a cardiologist and a psychologist (see appendix) with an interest in dermatology. Agreement was defined using a Likert scale of 1–7. Consensus regarding agreement for each statement was defined as ≥75% of respondents scoring either 1 (strongly agree) or 2 (agree).

Results

The expert panel members addressed several topics including screening, intervention, monitoring frequency, and the effects of anti‐psoriatic treatment on each co‐morbidity. Consensus was achieved on 12 statements out of 22 (3 relating to PsA, 4 relating to psychological factors, 5 relating to CV factors). The panel members felt that dermatologists have an important role in screening their psoriasis patients for PsA and in assessing them for psychological and CV co‐morbidities. In most cases, however, patients should be referred for specialist management if other co‐morbidities are detected.

Conclusion

This article provides useful and practical guidance for the detection and management of common co‐morbidities in patients with moderate‐to‐severe psoriasis.
Using insect traps to increase weaver ant (Oecophylla longinoda) prey capture
Authors: Lynegaard G. K. , Offenberg J. , Fast T. S. , Axelsen J. A. , Mwatawala M. W. , Rwegasira G. M.
Published: December 2013

Weaver ants (Oecophyllaspp.) are managed in plantations to control insect pests and are sometimes harvested as a protein‐rich food source. In both cases, the amount of insect prey caught by the ants is imperative for returns, as more prey leads to more effective biocontrol and to a higher production of ants. Malaise‐like traps placed in trees may catch flying insects without catching ants, as ants may use pheromone trails to navigate in and out of the traps. Thus, ants may increase their prey intake if they are able to extract insects caught in traps. In a mango plantation in Tanzania, we estimated the amount of insects caught by simple traps (cost per trap = 3.9USD), and whetherOecophylla longinodawas able to collect insects from them. On average, a trap caught 110 insects per month without catching any weaver ants. The number of insects found in traps with ant access was 25% lower than in control traps (ants excluded), showing that ants were able to gather prey from the traps. Ant activity in traps increased over time, showing that prey extraction efficiency may increase as ants customize to the traps. The prey removed from traps by ants constituted 5% of the number of prey items collected byO. longinodaunder natural conditions (without traps), potentially increasing to 14% if ants learn to extract all insects. Thus, prey intake may be increased with 5–14% per 3.9USDinvested in traps. These numbers increased to 38 and 78%, respectively, when light was used to attract insects during night time. Combining ant predation with insect trapping is a new approach potentially building increased returns to ant biocontrol and to ant entomophagy.
Diagnosis and treatment of congestive heart failure secondary to dilated cardiomyopathy in a hedgehog
Authors: Delk K. W. , Eshar D. , Garcia E. , Harkin K.
Published: December 2013

A one‐year‐old African pygmy hedgehog (Atelerix albiventris) was evaluated for severe respiratory distress. Physical examination findings included marked dyspnoea, cyanosis and tachypnoea. Radiographic findings included an enlarged heart and pulmonary oedema, and dilated cardiomyopathy was confirmed via echocardiogram. The patient was treated for congestive heart failure because of dilated cardiomyopathy with furosemide, enalapril, pimobendan and l‐carnitine. Within 24 hours of treatment, the pulmonary oedema and cyanosis had resolved. Following discharge, clinical improvement was noted by the owner and echocardiogram confirmed improved fractional shortening. Cardiomyopathy has been reported at post‐mortem examination in hedgehogs, but there are no reports of ante‐mortem diagnosis and treatment. Performing baseline cardiac assessment in hedgehogs is recommended, and treatment with l‐carnitine and pimobendan may improve outcome, as carnitine deficiency is a possible cause of cardiomyopathy in hedgehogs. Successful emergency treatment of congestive heart failure in the hedgehog of this report may be effective for other hedgehogs presented with similar clinical signs.
Third‐Party Logistics: A Meta‐Analytic Review and Investigation of its Impact on Performance
Authors: Leuschner Rudolf , Carter Craig R. , Goldsby Thomas J. , Rogers Zachary S.
Published: December 2013

Interest in third‐party logistics has been steadily increasing over the last two decades. Recently, increased focus by researchers has produced a solid literature base of academic research. In this article, a meta‐analytic approach is employed to provide a quantitative review of the empirical literature and examine relevant constructs. Fifty‐four samples across 69 peer‐reviewed journal articles, yielding a total of 9,386 observations, were obtained and analyzed. We used transaction cost economics and the resource‐based view as lenses to hypothesize a structural model of the relationships between relational governance structure, logistics customer service, and firm performance. Additional relationships were also found and analyzed, helping to clarify the mixed existing findings in the literature. The study concludes by mapping out future directions for 3PL research, based on the study's findings.
Structural Changes Within a Biscuit Bolus During Mastication
Authors: Rodrigues Sophia A. , Young Ashley K. , James Bryony J. , Morgenstern Marco P.
Published: December 2013

Solid food undergoes drastic structural changes during its transformation into a cohesive bolus, which play a key role in the perception of different textures during mastication. This article describes the structural changes in biscuits during mastication through particle agglomeration. Apparent particle size and bolus moisture content were measured at different chewing stages by image and gravimetric analyses. The microstructure of the ready‐to‐swallow bolus was also examined with light microscopy and cryo‐scanning electron microscopy (cryo‐SEM). The results reveal that moisture content increased at a parabolic rate during mastication, and the absorbed saliva increased apparent particle size and decreased particle number through agglomeration. Furthermore, both cryo‐SEM and light microscopy indicate that a majority of the solid particles in the ready‐to‐swallow bolus were individual starch granules. The results from cryo‐SEM also suggest that saliva composition varied locally within the final bolus, thereby implying that laminar mixing governs bolus formation during mastication.

Practical Applications

In materials science it is well‐known that the properties of a material are related to its structure. This concept can also be applied to the food bolus: the structure of a bolus determines its mechanical and rheological properties. These properties are perceived by senses within our mouths during mastication and translate to the perception of food texture. Hence, texture perception cannot be fully understood without analyzing bolus structure. This article also suggests that bolus structure is related to the type of mixing that operates within the mouth. Identifying the mechanisms involved in mastication will contribute towards a better understanding of texture perception, and can be applied in computational models of food breakdown and flavor release. This knowledge will allow solid food structures to be designed to enhance sensory appeal or follow a particular breakdown path in health food applications.
Critical appraisal of 13C breath tests for microsomal liver function: aminopyrine revisited
Authors: Pijls Kirsten E. , de Vries Hanne , Nikkessen Suzan , Bast Aalt , Wodzig Will K. W. H. , Koek Ger H.
Published: December 2013

As liver diseases are a major health problem and especially the incidence of metabolic liver diseases like non‐alcoholic fatty liver disease (NAFLD) is rising, the demand for non‐invasive tests is growing to replace liver biopsy. Non‐invasive tests such as carbon‐labelled breath tests can provide a valuable contribution to the evaluation of metabolic liver function. This review aims to critically appraise the value of the 13C‐labelled microsomal breath tests for the evaluation of metabolic liver function, and to discuss the role of cytochrome P450 enzymes in the metabolism of the different probe drugs, especially of aminopyrine. Although a number of different probe drugs have been used in breath tests, the perfect drug to assess the functional metabolic capacity of the liver has not been found. Data suggest that both the 13C2‐aminopyrine and the 13C‐methacetin breath test can play a role in assessing the capacity of the microsomal liver function and may be useful in the follow‐up of patients with chronic liver diseases. Furthermore, CYP2C19 seems to be an important enzyme in the N‐demethylation of aminopyrine, and polymorphisms in this gene may influence breath test values, which should be kept in mind when performing the 13C2‐aminopyrine breath test in clinical practice.
Drugs plus ligation to prevent rebleeding in cirrhosis: an updated systematic review
Authors: Puente Angela , Hernández‐Gea Virginia , Graupera Isabel , Roque Marta , Colomo Alan , Poca Maria , Aracil Carles , Gich Ignasi , Guarner Carlos , Villanueva Càndid
Published: December 2013

Background & Aims

Combined therapy with endoscopic variceal ligation (EVL) and β‐blockers ± isosorbide mononitrate (ISMN) is currently recommended to prevent variceal rebleeding. However, the role of this combined therapy has been challenged by some studies. We performed a systematic review to assess the value of combined therapy with EVL and β‐blockers ± ISMN as compared with each treatment alone to prevent rebleeding.

Methods

Databases, references and meeting abstracts were searched to retrieve randomized trials comparing combined therapy with EVL and β‐blockers ± ISMN vs either treatment alone, to prevent variceal rebleeding in cirrhosis. Random‐effects model was used for meta‐analysis.

Results

We identified five studies comparing EVL alone or combined with drugs, including a total of 476 patients. Combination therapy reduced overall rebleeding [risk ratios (RR) = 0.44, 95% confidence interval (CI) = 0.28–0.69], and showed a trend towards lower mortality (RR = 0.58, 95% CI = 0.33–1.03), without increasing complications. We identified four trials comparing drugs alone or associated with EVL, including 409 patients. All used β‐blockers plus ISMN. Variceal rebleeding decreased with combined therapy (P < 0.01) but rebleeding from oesophageal ulcers increased (P = 0.01). Overall, there was a trend towards lower rebleeding (RR = 0.76, 95% CI = 0.58–1.00) without effect on mortality (RR = 1.24, 95% CI = 0.90–1.70).

Conclusions

The addition of drug therapy to EVL improves the efficacy of EVL alone. However, the addition of EVL to β‐blockers and ISMN achieves a non‐significant decrease of rebleeding with no effect on mortality. Although combination therapy with EVL plus β‐blockers ± ISMN is adequate to prevent rebleeding, β‐blockers + ISMN alone may be a valid alternative.
Inflammatory markers and pulmonary granuloma infiltration in sarcoidosis
Authors: Terčelj Marjeta , Salobir Barbara , Zupancic Mirjana , Wraber Branka , Rylander Ragnar
Published: December 2013

Background and objective

Previous studies have demonstrated increases of inflammatory mediators in sarcoidosis while epidemiological studies have also demonstrated an association with increased fungi exposure. This study measured the level of β‐glucan in the lungs and of inflammatory mediators in serum, and correlated both with the extent of pulmonary granuloma infiltration.

Methods

This is a cross‐sectional study of 98 patients with sarcoidosis and 26 controls. β‐glucan, a cell wall constituent of fungi, was measured in bronchoalveolar lavage. Inflammatory mediator levels were determined in serum. The extent of granuloma infiltration was estimated on the chest X‐ray. Exposure to fungi at home was determined by taking air samples in bedrooms and analysing for the presence of β‐N‐acetylhexosaminidase.

Results

Significantly, higher levels of β‐glucan were found in broncho‐alveolar lavage in subjects with sarcoidosis as compared with controls. There were significant positive relationships between the extent of granuloma infiltration and the levels of the different inflammatory mediators, except for interleukin‐10. Domestic fungal exposure was higher among subjects with sarcoidosis.

Conclusions

This is the first time that a specific agent, previously suspected to be related to the risk of sarcoidosis, has been detected in the lung of subjects with sarcoidosis and related to the levels of inflammatory mediators and the degree of home exposure to fungi. The results suggest that exposure to fungi should be explored when investigating patients with sarcoidosis.
High expression of high‐mobility group box 1 in the blood and lungs is associated with the development of chronic obstructive pulmonary disease in smokers
Authors: Ko Hsin‐Kuo , Hsu Wen‐Hu , Hsieh Chih‐Cheng , Lien Te‐Cheng , Lee Tzong‐Shyuan , Kou Yu Ru
Published: December 2013

Background and objective

High‐mobility group box 1 (HMGB1) is an important mediator in multiple pathological conditions, but the expression of HMGB1 in chronic obstructive pulmonary disease (COPD) has not yet been completely investigated. We aimed to analyze the relationship between HMGB1 expression in blood and lung tissue and the development of COPD.

Methods

Twenty‐eight patients admitted for single pulmonary surgical intervention were enrolled. The expression of HMGB1 in blood and lung tissue was evaluated by enzyme‐linked immunosorbent assay analysis and immunohistochemistry stain, respectively. The study patients were divided into smokers with COPD (n = 11), smokers without COPD (n = 8) and non‐smoker healthy controls (n = 9).

Results

Smokers with COPD compared with smokers without COPD and healthy controls were older in age, with lower post‐bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio (63.1 ± 5.5 vs 77.6 ± 3.6 and 84.5 ± 5.8, P < 0.001 and P < 0.001, respectively) and higher levels of plasma HMGB1 (93.2 ± 139.9 vs 7.3 ± 4.8 and 17.0 ± 19.6 ng/mL, P = 0.016 and P = 0.021, respectively). In smokers with COPD, the numbers and portion of HMGB1‐expressing cells in epithelium and submucosal areas were significantly increased. Notably, plasma HMGB1 levels negatively correlated with post‐bronchodilator FEV1/FVC ratio (r = −0.585, P = 0.008) in smokers, but not in non‐smokers.

Conclusions

In smokers, high expression of HMGB1 in the blood and lungs is related to the lung function impairment and appears to be associated with the development of COPD.
EBUS‐TBNA: Popular but not universal
Authors: Ulasli Sevinc Sarinc , Kupeli Elif
Published: December 2013

In recent years, the number of publications concerning interventional bronchoscopy has increased dramatically. The present paper focused on publications related to endobronchial ultrasound technique. Its aim was to provide an overview of the nature of publications about endobronchial ultrasound technique, especially with regard to the countries of origin of publications and the categories of journals in which these papers are published. Overall, the review demonstrates a limited use of endobronchial ultrasound technique in many countries.
Rising Asia and postcolonial geography
Authors: Raghuram Parvati , Noxolo Pat , Madge Clare
Published: December 2013

There has been much discussion recently about the future of postcolonial theory. Some suggest that it is on the wane, while others defend its continued capacity for transformative critique. This paper contributes to these debates by considering postcolonial geography's future through the prism of ‘Rising Asia’. Rising Asia presents challenges to the spatial matrices underpinning current thinking in postcolonial geography, particularly the global South/North distinction and the histories of colonialism. What is the constituency of, and the emerging collectivities around, Rising Asia? What are the tensions between past, present and future in thinking about Rising Asia? We route our response to these questions by conceptualizing postcolonial geography as a disciplinary performance that draws on its subdisciplines. The argument is developed through three conceptual hooks—field, constituency and temporality—drawn from a reading of Edward Said's works Beginnings: Intention and Method (1975) and On Late Style: Music and Literature against the Grain (2007). Ultimately we do not seek to set an agenda for postcolonial geography; instead we suggest that greater attentiveness to the indeterminacies of postcolonial theory as it passes into postcolonial geography might allow more generative responses to the questions posed by Rising Asia.
The postcolonial city in South Asia
Authors: Anwar Nausheen H.
Published: December 2013

As a colonial invention, Karachi embodies the dynamics of postcolonial movement, diasporic populations, class inequality, new aspirations and abrasions, and a radical assortment of ethnicities and cultures. While Karachi remains a space where relations of power established during British colonial rule linger, it is also a site where new structures of power and a politics of identity have been negotiated and autochthonous claims contested. In the 1980s the rise of Muhajir militant nationalism inscribed within Karachi's landscape punctured dreams of a cosmopolitan city aligned with the visions of its postcolonial elite. Karachi's brutal ethnic riots and subsequent army operations brought to light the violent, anarchic side of the city. For many Karachi was never the same again. Engaging with history, anthropology, and postcolonial theory and geography, I reflect in this essay on the changing nature of the Pakistani metropolis in the context of its ethnic marking and various national projects. I consider how new formations are intertwined with Karachi's reconstruction, especially current missions that endeavour to transform the insurgent metropolis into a space symbolic of a progressive and secular Pakistan.
Applicability of Bio‐wipes for the collection of human faecal specimens for detection and characterisation of enteric viruses
Authors: Mans J. , van Zyl W. B. , Taylor M. B. , Page N. A. , Sobsey M. D. , Barnard T. G. , Potgieter N.
Published: December 2013

Objective

To determine whether gastroenteritis viruses and other enteric viruses could be detected in faecal specimens collected with Bio‐wipes.

Methods

Faecal specimens, self‐collected with Bio‐wipes, from 190 individuals (94 diarrhoeal, 93 non‐diarrhoeal, 3 unknown) were screened for eight human enteric viruses (enterovirus, hepatitis A virus, adenovirus, astrovirus, norovirus GI and GII, sapovirus and rotavirus) by real‐time (reverse transcription)‐polymerase chain reaction. Rotaviruses and noroviruses from positive specimens were genotyped.

Results

At least one enteric virus could be detected in 82.6% (157/190) of faecal specimens. Mixed infections of up to four different viruses could be detected in both diarrhoeal and non‐diarrhoeal specimens. Enteroviruses were detected most frequently (63.7%), followed by adenoviruses (48.4%) and noroviruses (32.2%). Genotyping was successful for 78.6% of rotaviruses and 44.8% of noroviruses.

Conclusions

Bio‐wipes provide a user friendly, easier method for stool collection that facilitates enteric virus detection and genetic characterisation.