bluuebunny/crossref_metadata_2025 huggingface dataset:
Health service utilization and related costs attributable to diabetes
Authors: O'Neill K. N. , McHugh S. M. , Tracey M. L. , Fitzgerald A. P. , Kearney P. M.
Published: August 2018

Aims

To estimate the health service use and direct healthcare costs attributable to diabetes using best available data and methods.

Methods

A nationally representative sample of adults aged ≥50 years was analysed (n=8107). Health service use in the previous 12 months included the number of general practitioner visits, outpatient department visits, hospital admissions, and accident and emergency department attendances. Multivariable negative binomial regression was used to estimate the associations between diabetes and frequency of visits. Average marginal effects were applied to unit costs for each health service and extrapolated to the total population, calculating the incremental costs associated with diabetes.

Results

The prevalence of diabetes was 8.0% (95% CI: 7.4, 8.6). In fully adjusted models, diabetes was associated with additional health service use. Compared to those without diabetes, people with diabetes have, on average, 1.49 (95% CI: 1.10, 1.88) additional general practitioner visits annually. Diabetes was associated with an 87% increase in outpatient visits, a 52% increase in hospital admissions and a 33% increase in accident and emergency department attendances (P<0.001). The incremental cost of this additional service use, nationally, is an estimated €88,894,421 annually, with hospital admissions accounting for 67% of these costs.

Conclusion

Using robust methods, we identified substantially increased service use attributable to diabetes across the health system. Our findings highlight the urgent need to invest in the prevention and management of diabetes.
Type 1 diabetes mellitus: Complex interplay of oxidative stress, cytokines, gastrointestinal motility and small intestinal bacterial overgrowth
Authors: Malik Aastha , Morya Rajesh Kumar , Bhadada Sanjay Kumar , Rana Satyavati
Published: August 2018

Background

Oxidative stress is risk factor in progression of diabetes. It can increase cytokine production via several different mechanisms. Inflammation can affect gut neural apparatus that may lead to dysmotility which may exaggerate occurrence of bacterial overgrowth in intestine. Thus, a study was planned to understand the complex interplay of oxidative stress, inflammatory cytokines, gut motility and small intestinal bacterial overgrowth in type 1 diabetes mellitus (T1DM) patients.

Materials and Methods

Seventy‐five T1DM patients and 75 healthy controls were enrolled. Small intestinal bacterial overgrowth (SIBO) and orocecal transit time (OCTT) were measured using noninvasive glucose and lactulose hydrogen breath tests, respectively. Plasma levels of interleukin‐6 (IL‐6), tissue necrosis factor‐alfa (TNF‐α) and interleukin‐10 (IL‐10) were measured in all subjects by ELISA. Oxidative stress and anti‐oxidant parameters were measured by standard methods.

Results

Out of 75 T1DM patients, 36 were males with Mean ± SD age 22.3 ± 5.2 years, IL‐6, TNF‐α and IL‐10 were significantly higher (P < 0.05) in T1DM patients as compared to controls. Lipid peroxidation (LPO) was significantly increased (P < 0.001), while reduced glutathione (GSH) significantly decreased (P < 0.01), whereas superoxide dismutase (SOD) and catalase significantly higher (P < 0.05) in T1DM patients as compared to controls. Positive correlation was observed between glycated haemoglobin (HbA1c) levels with LPO and negative correlation with GSH. Further, there was positive correlation between LPO and inflammatory cytokines (IL‐6 & IL‐10). OCTT was delayed and SIBO significantly higher in patients as compared to controls. On comparison of T1DM based on duration of disease, effect of all parameters was more pronounced in disease duration ≥5 years.

Conclusion

This study indicates that there is association between hyperglycaemia, oxidative stress (LPO), anti‐oxidants (GSH, SOD and catalase), inflammatory cytokines, gut motility (OCTT), and small intestinal overgrowth in type 1 diabetes mellitus patients. This association is intensified as duration of disease increases.
How should resource‐rich countries diversify? Estimating forward‐linkage effects of mining on productivity growth
Authors: Joya Omar
Published: August 2018

Resource‐rich countries willing to diversify their economies are faced with dual policy options; to either develop resource‐based industries, or diversify their economies as a whole and invest into new activities that are not necessarily resource dependent. Not only does the economic theory fail to provide a consensual guidance on this issue but empirical evidence is also lacking. This paper empirically assesses which of these two patterns of diversification is associated with higher productivity growth outcomes for resource‐rich countries. Using panel data for 50 resource‐abundant countries over the period 1970–2010, I find that stronger downstream linkages to mining and extractives do not lead to productivity enhancements. Broadening and diversifying the production structure as a whole offers potential for productivity growth at higher levels of income.
Effects of antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications: A randomized controlled trial
Authors: Zhao Ying , Munro‐Kramer Michelle L. , Shi Shenxun , Wang Jing , Zhao Qi
Published: August 2018

Aim

High‐risk pregnant women with antenatal depression are prone to postpartum depression. The purpose of this study was to evaluate the effectiveness of an antenatal depression screening and intervention among Chinese high‐risk pregnant women with medically defined complications.

Methods

Using a randomized controlled trial design, we enrolled 352 pregnant women with obstetrical complications and an Edinburgh postnatal depression scale (EPDS) ≥9 or postpartum depression screen scale (PDSS) ≥60. These participants were randomly assigned into the intervention group (n = 176) and control group (n = 176). The intervention group underwent a six‐session group intervention with one session focused on the husbands; the control group received the usual care. Participants were assessed at baseline, late pregnancy (≥28 weeks), 3 days and 42 days after delivery with PDSS and EPDS.

Results

Analysis of variance of repeated measures showed significant differences at each time point between groups. Analysis of the Kruskal‐Wallis test showed that there was no statistically significant differences in the PDSS and EPDS scores at any time point among the high‐risk pregnant women who attended different frequencies of the maternal intervention sessions (P > 0.05). Analysis of the Mann‐Whitney U test showed that the PDSS and EPDS were also not impacted based on whether or not the husbands participated in Session 6 of the intervention (P > 0.05).

Conclusions

This study highlights the effectiveness of the screening and the targeted management of antenatal depression in Chinese high‐risk pregnant women.
The neurologist's approach to cerebral infarct and transient ischaemic attack in patients receiving anticoagulant treatment for non‐valvular atrial fibrillation: ANITA‐FA study
Authors: Zapata‐Wainberg G. , Masjuan J. , Quintas S. , Ximénez‐Carrillo Á. , García Pastor A. , Martínez Zabaleta M. , Cardona P. , Freijo Guerrero M. M. , Llull L. , Benavente Fernández L. , Castellanos Rodrigo M. , Egido J. , Serena J. , Vivancos J. ,   the researchers in the ANITA‐FA study
Published: August 2018

Background and purpose

The aim of this study was to describe the clinical and epidemiological characteristics of acute ischaemic stroke (AIS) in patients with atrial fibrillation (AF) previously treated with oral anticoagulants (OACs) according to the type of OAC prescribed. Also, to analyze the outcomes of the patients and the therapeutic approach adopted by the neurologist in the acute phase and for secondary prevention.

Methods

We performed a multicenter, observational study based on prospective registries. We included patients with AF treated with OACs admitted for AIS over a 1‐year period. Detailed clinical data and functional outcome at 3 months (modified Rankin Scale score) were collected. Patients were divided into two groups according to their pre‐AIS anticoagulant therapy: vitamin K antagonists (AIS‐VKA) and direct‐acting OACs (AIS‐DOAC).

Results

We recruited 1240 patients (80.4% AIS‐VKA and 19.6% AIS‐DOAC). In the AIS‐DOAC group, transient ischaemic attack was more frequent (18.1% vs. 10.8%; P = 0.001), symptomatic hemorrhagic transformation was less frequent (1.6% vs. 4.6%; P = 0.035) and hospital stay was shorter (median 6 vs. 7 days; P = 0.03). Intravenous thrombolysis was more commonly used in AIS‐VKA (9.2% vs. 1.6%; P < 0.001). There were no differences between the groups with respect to mechanical thrombectomy, mortality and modified Rankin Scale score at 3 months. At 3 months, 54% of patients required a DOAC as antithrombotic treatment for secondary prevention.

Conclusions

Patients with AF treated with DOACs who experienced AIS more frequently had transient symptoms (transient ischaemic attack), less symptomatic hemorrhagic transformation and a shorter mean stay than those treated with VKAs. Most patients who had been previously anticoagulated with AIS received long‐term treatment with DOACs.
Acute and long‐term consequences of exposure to organophosphate nerve agents in humans
Authors: Figueiredo Taiza H. , Apland James P. , Braga Maria F. M. , Marini Ann M.
Published: August 2018

Nerve agents are organophosphate (OP) compounds and among the most powerful poisons known to man. A terrorist attack on civilian or military populations causing mass casualties is a real threat. The OP nerve agents include soman, sarin, cyclosarin, tabun, and VX. The major mechanism of acute toxicity is the irreversible inhibition of acetylcholinesterase. Acetylcholinesterase inhibition results in the accumulation of excessive acetylcholine levels in synapses, leading to progression of toxic signs including hypersecretions, tremors, status epilepticus, respiratory distress, and death. Miosis and rhinorrhea are the most common clinical findings in those individuals acutely exposed to OP nerve agents. Prolonged seizures are responsible for the neuropathology. The brain region that shows the most severe damage is the amygdala, followed by the piriform cortex, hippocampus, cortex, thalamus, and caudate/putamen. Current medical countermeasures are only modestly effective in attenuating the seizures and neuropathology. Anticonvulsants such as benzodiazepines decrease seizure activity and improve outcome, but their efficacy depends upon the administration time after exposure to the nerve agent. Administration of benzodiazepines may increase the risk for seizure recurrence. Recent studies document long‐term neurologic and behavior deficits, and technological advances demonstrate structural brain changes on magnetic resonance imaging.
The larval fishery onLimnothrissa miodonin the Congolese waters of Lake Tanganyika: Impact on exploitable biomass and the value of the fishery
Authors: Mulimbwa N'sibula , Sarvala Jouko , Micha Jean‐Claude
Published: August 2018

Declining catches of freshwater clupeids in Lake Tanganyika have recently led to widespread illegal fishing on the clupeid larvae with mosquito nets. This paper examines whether this larval fishery could have a negative impact on the exploitable biomass of the clupeidLimnothrissa miodonBoulenger and whether the sale of clupeid larvae is actually causing economic losses for the male fishers. The beach seine fishery onL. miodonlarvae in the coastal zone ofDRCongo was surveyed during a cruise in May 2013 from the north to the south of Lake Tanganyika. Local women fishing with their own gear were interviewed, their catch sampled, and their fishing effort evaluated. Based on catch sampling, the annual yield of larval fishing at the 17 fishing sites surveyed was about 24.5 t, worth ofUS$1.5 per kg. If these fish, now harvested as larvae, were allowed to grow to the average size in the lift‐net catches, they would have annually produced 620 t of fish. Applying a price ofUS$3.5 per kg for adult fish, and subtracting the value of larvae sold, this indicates that the current income ofUS $36, 800from the larval fishery translated in to aUS$2.1 million loss for the lift‐net fishery, thus accentuating the problems facing the fishing community.
Biophysical connectivity of snapper spawning aggregations and marine protected area management alternatives in Cuba
Authors: Claro Rodolfo , Lindeman Kenyon C. , Kough Andrew S. , Paris Claire B.
Published: August 2018

The ability of larvae to move beyond the spatial range of adult migrations can be critical to the resilience of populations that aggregate to spawn. We reviewed the literature and unpublished information on larval transport modeling, reef fish spawning aggregations, and marine protected area (MPA) management to identify alternatives for Cuban spawning site conservation. Larval transport information is available at annual and decadal scales for eight Cuban sites for five species of snappers. Connectivity patterns were examined: (a) within Cuban regions, (b) among Cuban regions, and (c) among other countries. We compared this information with the distribution of protected areas relative to spawning sites, site management attributes, and potential alternatives. Of eight focal spawning sites, seven are in protected areas and one is proposed. Southeast and north‐central Cuba had highest estimated within‐region retention levels. Southwest and northwest sites exported relatively more larvae out‐of‐region. Southern regions produced larvae that reached Jamaica, the Cayman Islands and Haiti. All northern regions can export larvae to the southern Bahamas. The regions and sites within are geomorphologically diverse with variable fishing and socio‐economic attributes. Information on stock status and protected area efficacy is limited and field assessments of aggregation status are needed for multispecies spawning sites. Few management plans address spawning conservation or network connectivity opportunities for MPAs. An alternative is development of one or more regional workgroups of protected area specialists, fishery scientists, expert fishers, and other stakeholders. Temporal closures of fisheries before and during spawning season could also amplify effectiveness of current gear‐ and zoning‐based management tools.
Sfh1, an essential component of the RSC chromatin remodeling complex, maintains genome integrity in fission yeast
Authors: Kotomura Naoe , Tsunemine Satoru , Kuragano Masahiro , Asanuma Takahiro , Nakagawa Hiromi , Tanaka Katsunori , Murakami Yota
Published: August 2018

Abp1 is a fission yeast CENP‐B homologue that contributes to centromere function, silencing at pericentromeric heterochromatin and silencing of retrotransposons. We identified the sfh1 gene, encoding a core subunit of the fission yeast chromatin remodeling complex RSC as an Abp1‐interacting protein. Because sfh1 is essential for growth, we isolated temperature‐sensitive sfh1 mutants. These mutants showed defects in centromere functions, reflected by sensitivity to an inhibitor of spindle formation and minichromosome instability. Sfh1 localized at both kinetochore and pericentromeric heterochromatin regions. Although sfh1 mutations had minor effect on silencing at these regions, they decreased the levels of cohesin on centromeric heterochromatin. Sfh1 also localized at a retrotransposon, Tf2, in a partly Abp1‐dependent manner, and assisted in silencing of Tf2 by Abp1 probably in the same pathway as a histone chaperon, HIRA, which is also known to involve in Tf2 repression. Furthermore, sfh1 mutants were sensitive to several DNA‐damaging treatments (HU, MMS, UV and X‐ray). Increase in spontaneous foci of Rad22, a recombination Mediator protein Rad52 homologue, in sfh1 mutant suggests that RSC functions in homologous recombination repair of double‐stranded break downstream of the Rad22 recruitment. These results indicate that RSC plays multiple roles in the maintenance of genome integrity.
Real‐time PCR for Helicobacter pylori diagnosis. The best tools available
Authors: Bénéjat Lucie , Ducournau Astrid , Lehours Philippe , Mégraud Francis
Published: August 2018

Background

Knowledge of antimicrobial susceptibility, especially to macrolides, has become crucial for the management of Helicobacter pylori infection. Our aim was to evaluate two new PCR kits able to detect H. pylori in gastric biopsies as well as the mutations associated with macrolide resistance.

Materials and Methods

Two hundred successive biopsies (received from gastroenterologists all over France) were used. The two new kits tested were Amplidiag H. pylori+ClariR from Mobidiag Espoo, Finland, and RIDA®GENE H. pylori from R‐Biopharm, Darmstadt, Germany. Culture and a validated in‐house real‐time PCR were also performed, and in the case of a positive culture, Etest for clarithromycin was carried out. Discrepancies were solved by looking at the pathologic data.

Results

Culture was positive in 68 cases (34%), and with our in‐house real‐time PCR in these 68 cases plus 5 others (N = 73, 36%). All were also detected by the two new kits. In addition, RIDA®GENE H. pylori detected one more positive also detected by Amplidiag H. pylori+ClariR, and Amplidiag detected two other positives. Of these three additional cases, pathology confirmed the positivity for two. Only one case diagnosed by Amplidiag could be considered as a false positive. With regard to clarithromycin resistance, 22 cases were detected. The corresponding mutations (A2142/43G) were all identified with the three PCRs.

Conclusions

These two new kits which have an excellent sensitivity and specificity are convenient to use, adaptable to different thermocyclers, provide quick results, and deserve to be used in H. pylori diagnosis for a better choice of treatment regimen.
The association of garlic with Helicobacter pylori infection and gastric cancer risk: A systematic review and meta‐analysis
Authors: Li Ziyu , Ying Xiangji , Shan Fei , Ji Jiafu
Published: August 2018

Background

Garlic may be protective against Helicobacter pylori infection and gastric cancer development. We conducted this study to quantitatively update evidence on garlic intake and gastric cancer with the inclusion of most recent cohort studies and qualitatively summarize epidemiological studies of garlic consumption and Helicobacter pylori infection.

Materials and Methods

PubMed, Embase, MEDLINE, and Cochrane Library were searched on April 2018. We conducted a meta‐analysis to determine whether garlic intake reduced gastric cancer risk using random‐effect models and a systematic review to summarize evidence on the association between garlic consumption and Helicobacter pylori infection. Risk of bias was assessed using tools of Cochrane risk of bias and Robins‐I for randomized and nonrandomized studies, respectively.

Results

Meta‐analysis of 18 studies (142 921 subjects) demonstrated high garlic consumption (as comparing the highest category to the lowest) was associated with a reduced gastric cancer risk (OR = 0.51, 95% CI = 0.44‐0.57). This association became nonsignificant if only derived from the prospective studies (OR = 0.95, 95% CI = 0.66‐1.24). Thirteen studies (4889 participants) were included in the systematic review for garlic consumption and Helicobacter pylori infection; ten of which found no significant results. The majority of these studies were poor in quality given the small sample size and high risk of bias.

Conclusions

Pooled evidence, mainly from case‐control studies, suggested a significant inverse association of garlic intake with gastric cancer risk. Given the limitations of included studies, current epidemiological evidence is not sufficient to reach any definite conclusion regarding the association of garlic with Helicobacter pylori infection.
Histopathological and molecular analysis of idiopathic pulmonary fibrosis lungs from patients treated with pirfenidone or nintedanib
Authors: Zhang Yingwei , Jones Kirk D , Achtar‐Zadeh Natalia , Green Gary , Kukreja Jasleen , Xu Biyun , Wolters Paul J
Published: August 2018

Aims

The objective of this study was to quantify the impact of pirfenidone or nintedanib treatment on lung histopathology and molecular mediators of fibrosis in patients with idiopathic pulmonary fibrosis (IPF).

Methods and results

We collected lung tissue from IPF patients at the time of lung transplantation. Histopathological changes were quantified using a blinded scoring method. Proteins associated with senescence or active TGF‐β were quantified in lung tissues by immunoblot and immunostaining. Histopathological quantification showed similar amounts of dense collagen fibrosis, fibroblast foci and alveolar macrophages in untreated or pirfenidone‐ or nintedanib‐treated IPF patients. There was less diffuse alveolar damage and organising pneumonia in pirfenidone‐treated IPF patients. Lungs of nintedanib‐treated patients had a trend towards less lymphocytic interstitial infiltration. There was no difference in expression of p‐SMAD3, p21 or p16 in the lungs of untreated, pirfenidone‐ or nintedanib‐treated IPF patients. Alveolar epithelial cells, but not fibroblast foci, were immunoreactive to p16. Pirfenidone or nintedanib treatment did not inhibit activation of senescence programming in cultured lung epithelial cells mediated by hydrogen peroxide.

Conclusion

Pirfenidone and nintedanib do not modulate expression of senescence markers, levels of p‐SMAD3 or the amount of fibrosis in IPF lungs. Treated patients have less histopathological evidence of acute lung injury at the time of lung transplantation.
HIV infection is independently associated with a higher concentration of alpha‐1 antitrypsin
Authors: Thudium RF , Lundgren J , Benfield T , Nordestgaard BG , Borges ÁH , Gerstoft J , Nielsen SD , Ronit A ,   the Copenhagen Co‐morbidity in HIV Infection (COCOMO) Study Group
Published: August 2018

Objectives

Alpha‐1 antitrypsin (AAT) deficiency is associated with an increased risk of chronic obstructive pulmonary disease and has been related to CD4 T‐cell count decline in people living with HIV (PLWH). We determined whether HIV status is associated with AAT concentrations and assessed associations between AAT concentration, pulmonary function and immunological status.

Methods

Alpha‐1 antitrypsin was measured and spirometry performed in 1011 PLWH from the Copenhagen Comorbidity in HIV Infection (COCOMO) study and in 11 962 age‐ and sex‐matched uninfected controls. We studied associations between AAT concentration, HIV status, pulmonary function, and current and nadir CD4 T‐cell counts using multivariate linear regression analyses.

Results

The mean age of PLWH was 50.7 [standard deviation (SD) 11.3] years and 98.6% were receiving combination antiretroviral therapy (cART). The mean current CD4 T‐cell count was 718 (SD 284) cells/μL. PLWH had a higher median AAT concentration than uninfected controls [1.4 (interquartile range (IQR) 1.3–1.6) versus 1.3 (IQR 1.2–1.4) g/L; P < 0.0001] and HIV infection was independently associated with higher AAT concentration [adjusted β = 0.10 g/L; 95% confidence interval (CI) 0.08; 0.11 g/L; P < 0.001]. Low AAT concentration (< 1.0 g/L) was not more common in PLWH with airflow limitation (defined as forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) < 0.7 with FEV1‐predicted < 80%) compared with uninfected controls with airflow limitation, and the effect of AAT on FEV1%‐predicted was comparable to that in uninfected controls (P‐interaction = 0.66). AAT concentration was not associated with current or nadir CD4 T‐cell count.

Conclusions

HIV infection was independently associated with a higher concentration of AAT through unknown mechanisms. However, AAT does not seem to contribute to lower pulmonary function or to low CD4 T‐cell counts in PLWH.
Activation of orexin‐1 receptors in the ventrolateral periaqueductal grey matter (vlPAG) modulates pulpal nociception and the induction of substance P in vlPAG and trigeminal nucleus caudalis
Authors: Raoof M. , Soofiabadi S. , Abbasnejad M. , Kooshki R. , Esmaeili‐Mahani S. , Mansoori M.
Published: August 2018

Aim

To characterize the role of orexin‐1 receptors (OX1Rs) in ventrolateral periaqueductal grey matter (vlPAG) on modulation of capsaicin‐induced pulpal nociception in rats.

Methodology

Sixty‐six adult male Wistar rats (2 months old) weighing between 230 and 260 g were used. The animals were cannulated for microinjection of drugs into the vlPAG matter. Pulpalgia was induced by intradental application of capsaicin solution (100 μg) into the incisor teeth of the rats. Ten min prior to capsaicin application, orexin‐A (50, 100 and 150 pmol L−1 per rat) was administered. Orexin‐A (150 pmol L−1) was also co‐administrated with SB‐334867 (40 nmol L−1 per rat), an OX1Rs antagonist; or bicuculline (1 μg per rat), a GABAA receptors antagonist. Moreover, treatment effects on the release of pro‐nociceptive modulator substance P (SP) in vlPAG and trigeminal nucleus caudalis (Vc) of rats were explored using an immunofluorescence technique. One‐way analysis of variance was used for the statistical analysis.

Results

Orexin‐A dose‐dependently decreased capsaicin‐induced nociceptive behaviour. However, SB‐334867 (40 nmol L−1 per rat) pretreatment (P < 0.05), but not bicuculline (1 μg per rat), attenuated the analgesic effect of orexin‐A (150 pmol L−1). The level of SP was significantly increased in Vc and decreased in vlPAG of capsaicin‐treated rats (P < 0.05). Capsaicin‐induced changes in SP levels, however, were prohibited by orexin‐A treatment (150 pmol L−1) (P < 0.05).

Conclusions

Orexin‐A administration into the vlPAG was associated with an inhibitory effect on capsaicin‐induced pulpal nociception and bidirectional effects on the induction of SP in vlPAG and Vc of rats. Central activation of OX1Rs is a potential therapeutic tool for pulpalgia.
Impact sourcing in India: Trends and implications
Authors: Madon Shirin , C. R. Ranjini
Published: August 2018

This paper focuses on impact sourcing, which refers to a type of business process outsourcing activity whereby service providers elect to provide high quality, information‐based services to clients by purposefully employing youth from low‐income communities to carry out simple data handling tasks. Whilst this activity proliferated across countries in Africa, Asia, and Latin America from 2010 providing jobs and skills to many individuals, its growth seems to have been constrained in recent years. In order to explain this phenomenon, we undertake a longitudinal study of impact sourcing based on the case of Karnataka, which has been a prominent player in this sector since 2008. We commence by describing the operations of three impact‐sourcing enterprises in the state and locate this activity within the broader scope of state government policy focusing on two key aspects. First, we assess the adequacy of state support for rural entrepreneurs to sustain their operations for client companies and, second, whether there has been sufficient policy focus on ameliorating the socio‐economic context within which impact‐sourcing activity takes place. Finally, we reflect on important implications of our findings for further research on impact sourcing in the field of information systems and for policy prescriptions in order to create a conducive environment for this socially focused business activity to thrive.
Invariance of parent ratings of attention deficit hyperactivity disorder symptoms for children with and without intellectual disability
Authors: Arias Víctor B. , Arias Benito , Burns G. Leonard , Servera Mateu
Published: August 2018

Background

Although attention deficit hyperactivity disorder (ADHD) is considered a valid diagnosis for children with intellectual disability, no studies have evaluated the invariance of ADHD symptom ratings across children with and without intellectual disability.

Method

Parents completed ratings on the ADHD symptoms for 189 children with intellectual disability and for 474 children without intellectual disability. Differential item functioning analysis was used to determine the equivalence of the ADHD symptoms across the two groups.

Results

The symptoms loses things, talks too much, and blurts out answers showed significant bias against children with intellectual disability. The prevalence of ADHD in children with intellectual disability was 18% (according to the symptom criterion), and 7.4% when the academic and/or social impairment criterion was also considered.

Conclusions

Most of the ADHD symptoms can be valid for the assessment of ADHD in children with mild and moderate intellectual disability. ADHD symptoms may be used in further studies to establish base rates of the disorder in the intellectual disability population.
LncRNA‐RMRP promotes nucleus pulposus cell proliferation through regulating miR‐206 expression
Authors: Wang Xuesong , Peng Lei , Gong Xiaojin , Zhang Xiugong , Sun Ruifu , Du Jinlong
Published: August 2018

Long noncoding RNAs (LncRNAs) are involved in the pathogenesis of intervertebral disc degeneration (IDD). However, the biological function and expression of RMRP were still unclear. In our study, we showed that RMRP expression was up‐regulated in degenerated NP tissues compared to normal NP samples, and higher RMRP expression was associated with the disc degeneration grade. Further studies indicated that ectopic expression of RMRP enhanced NP cell growth and also enhanced the expression of ki‐67, PCNA and cyclin D1 in the NP cell. Moreover, overexpression of RMRP promoted the expression of Type II collagen and aggrecan and suppressed the expression of MMP13 and ADAMTS4. In addition, we found that the expression of miR‐206 was down‐regulated in degenerated NP tissues compared to normal NP samples, and lower miR‐206 expression was correlated with the disc degeneration grade. Interestingly, we indicated that miR‐206 expression in NP tissues was negatively correlated with the expression of RMRP. Ectopic expression of miR‐206 suppressed NP cell proliferation and suppressed the expression of Type II collagen and aggrecan and enhanced the expression of MMP13 and ADAMTS4. Furthermore, we demonstrated that overexpression of RMRP increased NP cell growth and regulated ECM expression through targeting miR‐206. These results suggested that lncRNA‐RMRP promoted the progression of IDD through targeting miR‐206, providing an attractive new therapeutic approach for the treatment of IDD disease.
The caveolae‐associated coiled‐coil protein, NECC2, regulates insulin signalling in Adipocytes
Authors: Trávez Andrés , Rabanal‐Ruiz Yoana , López‐Alcalá Jaime , Molero‐Murillo Laura , Díaz‐Ruiz Alberto , Guzmán‐Ruiz Rocío , Catalán Victoria , Rodríguez Amaia , Frühbeck Gema , Tinahones Francisco J. , Gasman Stéphane , Vitale Nicolas , Jiménez‐Gómez Yolanda , Malagón María M.
Published: August 2018

Adipocyte dysfunction in obesity is commonly associated with impaired insulin signalling in adipocytes and insulin resistance. Insulin signalling has been associated with caveolae, which are coated by large complexes of caveolin and cavin proteins, along with proteins with membrane‐binding and remodelling properties. Here, we analysed the regulation and function of a component of caveolae involved in growth factor signalling in neuroendocrine cells, neuroendocrine long coiled‐coil protein‐2 (NECC2), in adipocytes. Studies in 3T3‐L1 cells showed that NECC2 expression increased during adipogenesis. Furthermore, NECC2 co‐immunoprecipitated with caveolin‐1 (CAV1) and exhibited a distribution pattern similar to that of the components of adipocyte caveolae, CAV1, Cavin1, the insulin receptor and cortical actin. Interestingly, NECC2 overexpression enhanced insulin‐activated Akt phosphorylation, whereas NECC2 downregulation impaired insulin‐induced phosphorylation of Akt and ERK2. Finally, an up‐regulation of NECC2 in subcutaneous and omental adipose tissue was found in association with human obesity and insulin resistance. This effect was also observed in 3T3‐L1 adipocytes exposed to hyperglycaemia/hyperinsulinemia. Overall, the present study identifies NECC2 as a component of adipocyte caveolae that is regulated in response to obesity and associated metabolic complications, and supports the contribution of this protein as a molecular scaffold modulating insulin signal transduction at these membrane microdomains.
Effects of metformin and alogliptin on body composition in people with type 2 diabetes
Authors: Takeshita Yumie , Kita Yuki , Kato Ken‐ichiro , Kanamori Takehiro , Misu Hirofumi , Kaneko Shuichi , Takamura Toshinari
Published: August 2018

Aims/Introduction

The aim of the present study was to investigate the effects of metformin and a dipeptidyl peptidase‐4 inhibitor, alogliptin, on body composition in a 12‐week randomized add‐on trial in Japanese participants with type 2 diabetes.

Materials and Methods

A total of 84 participants with poorly controlled type 2 diabetes undergoing antidiabetic therapy were randomly assigned to receive alogliptin (25 mg, once daily) or metformin (1,000 mg, twice daily) for 12 weeks. The primary efficacy end‐point was body composition. The secondary end‐points included factors associated with decreased bodyweight.

Results

Compared with the baseline values, alogliptin significantly increased bodyweight (66.5 ± 19.2 to 67.6 ± 19.3 kg), body mass index (BMI; 25.4 ± 6.1 to 25.8 ± 6.3 kg/m2) and fat mass (20.3 ± 12.8 to 21.8 ± 14.5 kg), whereas metformin had no significant effect on body composition. Alogliptin was inferior to metformin in reducing bodyweight (0.84 ± 1.57 vs −0.35 ± 1.53 kg, P = 0.002), BMI (0.34 ± 0.69 to −0.15 ± 0.56 kg/m2, P = 0.002) and fat mass (1.49 ± 5.06 vs −0.04 ± 1.81 kg, P = 0.042). BMI at baseline was associated with changes in bodyweight negatively in the metformin group and positively in the alogliptin group.

Conclusions

Metformin and alogliptin exert opposite effects on bodyweight in type 2 diabetes patients who are overweight. The higher the BMI, the more metformin reduces bodyweight and alogliptin increases weight.
Caspase‐independent hepatocyte death: A result of the decrease of lysophosphatidylcholine acyltransferase 3 in non‐alcoholic steatohepatitis
Authors: Kakisaka Keisuke , Suzuki Yuji , Fujiwara Yudai , Suzuki Akiko , Kanazawa Jo , Takikawa Yasuhiro
Published: August 2018

Background and Aims

Lipotoxicity causes liver inflammation, which leads to non‐alcoholic steatohepatitis (NASH). Lysophosphatidylcholine (LPC) is a causal agent of lipotoxicity. Recently, lysophosphatidylcholine acyltransferase (LPCAT) was identified as an enzyme that catalyzes the esterification of LPC, which potentially decreases LPC levels. However, the effect of LPCAT in lipotoxicity of the liver is not fully understood. Our aim was to determine whether LPCAT attenuates lipotoxicity in the liver.

Methods

Mice fed a high‐fat diet with sucrose (HFDS) or high‐fat diet without sucrose, and Huh‐7 cells treated with palmitate were used.

Results

Mice‐fed HFDS showed advanced liver fibrosis as compared with mice‐fed high‐fat diet or normal chow. Lysophosphatidylcholine acyltransferase 3 (LPCAT3) mRNA expression in the liver was significantly decreased in the HFDS liver, and LPC content in the HFDS liver was significantly increased as compared with the other groups. When Huh‐7 cells with short hairpin RNA‐mediated knockdown of LPCAT3 (shLPCAT3 cells) were treated with palmitate, the intracellular LPC concentration and cell death were significantly higher than those in wild‐type Huh‐7 cells. Palmitate‐induced cell death in shLPCAT3 was attenuated by a combination of receptor‐interacting protein kinase 1 inhibitor with pan‐caspase inhibitor. In contrast, intracellular LPC and palmitate‐induced cell death were significantly lower in LPCAT3‐overexpressing Huh‐7 cells than in wild‐type cells.

Conclusion

Depletion of LPCAT3 in a mouse model of NASH leads to caspase‐independent cell death, and LPCAT3 is a potential therapeutic target in NASH.
Are the therapeutic strategies in anorexia of ageing effective on nutritional status? A systematic review with meta‐analysis
Authors: Perna S. , Rondanelli M. , Spadaccini D. , Lenzi A. , Donini L. M. , Poggiogalle E.
Published: August 2018

Background

Anorexia of ageing (AA) may be considered as a risk factor for frailty and has an important impact on quality of life, morbidity and mortality.

Methods

A systematic review and a meta‐analysis were performed to summarise the results from several trials on the effectiveness of treatments in AA, as associated with depression, sensory impairment of taste and smell, decreased appetite or early satiety, and disability. Eligible studies were required to report baseline and follow‐up values, the mean change (∆‐change) from baseline, and/or the mean difference among intervention groups versus control group, concerning food intake (kcal/daily) and/or nutritional outcomes, such as body weight, body mass index, albumin and Mini Nutritional Assessment.

Results

The systematic review included 20 papers based on different therapeutic approaches concerning food intake and/or nutritional outcomes. The results of the meta‐analysis indicate that the interventions for AA have an important impact on body weight [+1.59 kg; 95% confidence interval (CI) = 1.48–+1.71 kg; P < 0.001) and on energy intake (+56.09 kcal; 95% CI = −54.05 to +166.25 kcal; P = 0.32). Regarding secondary outcomes, it was not possible to meta‐analyse the limited amount of data availab le.

Conclusions

The different variants of AA need to be defined because diverse therapeutic approaches are available. A more precise definition of the functional impairments associated with AA may allow a more correct decision about the most appropriate therapy to be prescribed. Moreover, this may allow for a more effective performance of the different therapeutic approaches once they are better targeted to the different scenarios of AA.
Effects of four soaps on skin trans‐epidermal water loss and erythema index
Authors: Khosrowpour Zeynab , Ahmad Nasrollahi Saman , Ayatollahi Azin , Samadi Aniseh , Firooz Alireza
Published: August 2018

Background

Various tests have been carried out to determine the irritant potential of soaps/cleansers.

Objectives

This study was carried out to compare the effects of four different soap formulations on biophysical parameters of the skin, including trans‐epidermal water loss (TEWL) and erythema index.

Methods

Four different soap formulations (creamy, glycerin containing, syndet, and traditional alkaline soaps) were studied. Twenty healthy volunteers were enrolled and 8% solutions (W/V) of the soaps made with distilled water, 20% sodium dodecyl sulfate (positive control) and water (negative control) were applied to their volar forearms as a single dose patch test. The patches remained on the sites for 4 hours. The skin TEWL and erythema index were measured before applying the patches and 24 and 72 hours after removal of them using TEWAmeter and Mexameter probes, respectively.

Results

Alkaline and creamy soaps caused a significant increase in TEWL 24 hours after patch removal. However, 72 hours after patch removal, this increase was significant only in case of alkaline soap (P‐value = 0.002). A decreasing trend in skin erythema was observed 24 and 72 hours after application of syndent, glycerin, and creamy soaps. In case of creamy soap, this decrease was significant 72 hours after patch removal (P‐value = 0.006).

Conclusion

Traditional alkaline soap increased TEWL and skin erythema, which are signs of prolonged damage to the skin barrier. However, the effects of other formulations were transient, and TEWL returned to baseline at 72 hours. Creamy soap even showed a relative protective effect (decrease in erythema index compared to baseline), probably due to the lanolin content of the formulation.
Fibrinogen for the management of critical obstetric hemorrhage
Authors: Matsunaga Shigetaka , Takai Yasushi , Seki Hiroyuki
Published: August 2018

Aim

In cases of critical obstetric hemorrhage leading to extreme hypofibrinogenemia, fibrinogen is the marker that indicates the critical severity, and early fibrinogen supplementation centering on hemostatic resuscitation is a vital treatment to stabilize a catastrophic condition. In this review, we investigated the effect of fibrinogen level on hemostasis and what we can do to treat hypofibrinogenemia efficiently and improve patients’ outcome.

Methods

We reviewed numerous articles related to hypofibrinogenemia in critical obstetric hemorrhage. Especially, we performed a systematic review on target value of fibrinogen for hemostasis and effectiveness of fibrinogen concentrate. We also reviewed the articles about the methods for early normalization of fibrinogen level such as tranexamic acid, massive transfusion protocol, and point‐of‐care testing.

Results

The target value of fibrinogen calculated by needs for massive transfusion was 200 mg/dL or 10 mm of A5FIBTEM. Although fibrinogen concentrate worked poorly on fibrinogen levels within the normal range, it improved the blood fibrinogen levels rapidly when it was administered to critical obstetric hemorrhage patients with serious hypofibrinogenemia. Hence, the volume of FFP transfused could be reduced along with a reduction in the frequency of pulmonary edema due to volume overload.

Conclusion

The patient group for which fibrinogen concentrate works most effectively is cases with severe hypofibrinogenemia. Further research is required in the light of evidence. The essence of the transfusion algorithm in critical obstetric hemorrhage is to approach the target value for obtaining hemostasis, ensure an accurate and prompt grasp of the severity using point‐of‐care testing, introduce a massive transfusion protocol and use tranexamic acid.
Caregivers’ understanding of fluoride varnish: implications for future clinical strategies and research on preventive care decision making
Authors: Chi Donald L. , Richman Julia , Senturia Kirsten , Zahlis Ellen
Published: August 2018

Objective

To describe caregivers' understanding of fluoride varnish.

Methods

We administered the Oral Health Literacy Inventory for Parents within a pediatric dental clinic (N = 113). Caregivers were asked to read and define each item. Interviews were audio recorded, transcribed, and coded inductively. The main analyses focused on responses to “fluoride varnish” and were conducted at the response level.

Results

Of the 140 responses, 22.1 percent of the responses indicated lack of knowledge about fluoride varnish, 23.6 percent that it was for teeth, 8.6 percent as something in toothpaste or water, and 45.7 percent as something that helps teeth. About 52.7 percent of responses indicated lack of knowledge, incomplete, or incorrect understanding. At the caregiver‐level, 50.4 percent did not know what fluoride varnish was or provided an incorrect or incomplete response.

Conclusion

Many caregivers have an incomplete or inaccurate understanding of fluoride varnish, which has implications for how healthcare providers communicate about preventive care and future research on caregiver decision making.
Impact of pharmacist's directed medication reconciliation on reducing medication discrepancies during transition of care in hospital setting
Authors: Salameh Lana K. , Abu Farha Rana K. , Abu Hammour Khawla M. , Basheti Iman A.
Published: August 2018

Objectives

To evaluate the effect of pharmacist's directed services (reconciliation plus counselling) on reducing medication discrepancies and improving patient's outcomes at discharge from hospital.

Methods

During the 3-month study period, 200 patients were randomly selected from internal medicine department from Jordan University Hospital (JUH) and allocated into two groups (intervention and control groups). The number and types of medication discrepancies were identified at admission. Then, pharmacist implemented medication reconciliation and medication counselling services to the intervention group patients. At discharge, the number of unintentional discrepancies was evaluated for both groups. Patients were assessed at 1 month following their discharge for any subsequent hospital readmissions, emergency department visits or side effects of medication therapy.

Key findings

The total number of identified unintentional discrepancies was 84 for the intervention group compared with 60 discrepancies for the control group. Omission and addition represented the most common types of discrepancies for both groups. Of the 84 recommendations submitted by pharmacists, clinicians accepted 78 cases (92.8%), and implemented only 46 recommendations (54.7%). At discharge, a significant reduction in the number of unintentional discrepancies was achieved for the intervention group, P-value (0.014), while no significant change was found for the control group, P-value = 0.508. One month postdischarge, a significantly higher number of patients in the control group reported experiencing side effects compared with the intervention group, P-value = 0.020.

Conclusion

The presence of clinical pharmacists in hospital wards had a promising effect on decreasing the number of medication errors and improving health outcomes.
Near‐Infrared Spectroscopy as a New Tool for Neurofeedback Training: Applications in Psychiatry and Methodological Considerations
Authors: Ehlis Ann‐Christine , Barth Beatrix , Hudak Justin , Storchak Helena , Weber Lydia , Kimmig Ann‐Christin S. , Kreifelts Benjamin , Dresler Thomas , Fallgatter Andreas J.
Published: August 2018

Over the past decades, functional near‐infrared spectroscopy (fNIRS) has become a valuable tool in the online assessment of brain function in psychological and neuropsychiatric research. Recently, fNIRS has also been employed in the context of neurofeedback (NF), with pilot studies indicating that hemodynamic responses can be deliberately regulated and that neuroplastic changes occur over the course of several training sessions. This review article provides a comprehensive overview of the recent implementation and development of fNIRS as an NF tool; specifically, we will outline initial studies in healthy participants as well as children and adults with attention deficit hyperactivity disorder and describe new protocols aimed at reducing auditory verbal hallucinations (schizophrenic patients) and anxiety symptoms (patients with social anxiety disorder), respectively. Finally, we will discuss recent methodological developments and concerns as well as potential future perspectives. We conclude that fNIRS is a useful tool for conducting NF, especially in terms of multi‐session training. However, methodological details need to be considered when designing fNIRS‐based NF studies, and future protocols should aim at training broader network structures and implementing implicit training protocols. Finally, future studies should focus not only on (clinical) effects of fNIRS‐based NF, but also on the underlying mechanisms and activity changes in extended brain networks.