bluuebunny/crossref_metadata_2025 huggingface dataset:
Injectate spread following ultrasound‐guided lateral to medial approach for dual transversus abdominis plane blocks
Authors: SONDEKOPPAM R. V. , BROOKES J. , MORRIS L. , JOHNSON M. , GANAPATHY S.
Published: January 2015

Background

Bilateral dual transversus abdominis plane (BD‐TAP) injections were devised to cover the T7–8 and L1 dermatomes, which are usually spared with classical and mid‐axillary TAP injections. The purpose of this study was to delineate the vertical and lateral extent of injectate spread following a lateral to medial approach for TAP injections in embalmed cadavers.

Methods

Ultrasound‐guided subcostal and lateral TAP injections were performed on nine embalmed cadavers using 30 ml of 0.5% methylcellulose (20 ml for subcostal and 10 ml for lateral injections) with a 12‐cm Tuohy needle in the first six cadavers (nine hemi‐abdomens). Vertical extent and the medial to lateral extent of the dye spread were recorded after dissections of the abdominal wall. In a pilot of three cadavers not receiving TAP injections, anatomical impediments to proximal injectate spread were explored separately.

Results

The vertical spread of injectate was T7–L1 (n = 2/9), T8–L1 (n = 5/9) and T9–L1 (n = 2/9). None of the TAP injections extended beyond the mid‐axillary line. No anatomical impediments for the flow of injectate to the T7 or T8 intercostal nerves were found at the level of the interdigitations of the transversus abdominis muscle and diaphragm.

Conclusion

A lateral to medial approach for TAP injection resulted in spread of the injectate ranging from T7/8–L1 dermatomes in the majority of the hemi‐abdomens. Subcostal and lateral TAP injections do not cover the lateral cutaneous branches of the segmental nerves.
Intravenous lidocaine increases the depth of anaesthesia of propofol for skin incision – a randomised controlled trial
Authors: WEBER U. , KRAMMEL M. , LINKE S. , HAMP T. , STIMPFL T. , REITER B. , PLÖCHL W.
Published: January 2015

Background

The anaesthetic potency of intravenous propofol is quantified by its Cp50 value, which is defined as the plasma concentration required to prevent movement response in 50% of patients to surgical stimuli. We hypothesised that, in addition to propofol anaesthesia, an intravenous bolus of lidocaine 1.5 mg/kg will decrease the Cp50 value of propofol during anaesthesia.

Methods

We enrolled 54 elective surgical patients undergoing propofol‐based anaesthesia, and randomised them to either lidocaine 1.5 mg/kg, lidocaine 0.5 mg/kg or placebo (NaCl 0.9%) 3 min before skin incision. The propofol Cp50 value was then calculated using the ‘up‐and‐down’ method of Dixon and Massey.

Results

There was no significant reduction in propofol requirements after the administration of 0.5 mg/kg lidocaine from 8.5 μg/ml [confidence interval (CI) 6.0–11.625] to 8.25 μg/ml (CI 6.75–9.76); however, a bolus of 1.5 mg/kg lidocaine decreased the Cp50 value of propofol by 42% from 8.5 μg/ml (CI 6.0–11.625) to 4.92 μg/ml (CI 4.5–5.78) (P < 0.05).

Conclusion

An intravenous bolus injection of 1.5 mg/kg lidocaine 2% caused a significant reduction of the propofol Cp50 value.
Social Cognition Deficits and Associations with Drinking History in Alcoholic Men and Women
Authors: Valmas Mary M. , Mosher Ruiz Susan , Gansler David A. , Sawyer Kayle S. , Oscar‐Berman Marlene
Published: January 2015

Background

Previous studies have demonstrated the presence of a social cognition factor as an element of general cognition in healthy control and clinical populations. Recently developed measures of social cognition include the social perception and faces subtests of the Wechsler Advanced Clinical Solutions (ACS) Social Cognition module. While these measures have been validated on various clinical samples, they have not been studied in alcoholics. Alcoholism has been associated with emotional abnormalities and diminished social cognitive functioning as well as neuropathology of brain areas underlying social processing abilities. We used the ACS Social Perception and Faces subtests to assess alcoholism‐related impairments in social cognition.

Methods

Social cognitive functioning was assessed in 77 abstinent alcoholic individuals (37 women) and 59 nonalcoholic control participants (29 women), using measures of the ACS Social Cognition module and subtests of the Wechsler Adult Intelligence Scale‐Fourth Edition (WAIS‐IV) that contain a social cognition component (Picture Completion and Comprehension). Group and gender differences in ACS and WAIS‐IV performance were assessed, as well as relationships between measures of alcoholism severity and social cognitive functioning.

Results

Alcoholics performed significantly worse than nonalcoholics on the ACS measures of Affect Naming and Faces Content. Alcoholic men were impaired relative to alcoholic women on Prosody Face Matching and Faces Content scores. Among alcoholics, longer durations of heavy drinking were associated with poorer performance on Affect Naming, and a greater number of daily drinks were associated with lower Prosody Face Matching performance. For alcoholic women, a longer duration of abstinence was associated with better performance on Affect Naming.

Conclusions

Alcoholic men and women showed different patterns of associations between alcoholism indices and clinically validated social cognition assessments. These findings extend into the social cognition domain, previous literature demonstrating the presence of cognitive deficits in alcoholism, their association with alcoholism severity, and variability by gender. Moreover, because impairments in social cognition can persist despite extended abstinence, they have important implications for relapse prevention.
Protective Effects of Hypothalamic Beta‐Endorphin Neurons Against Alcohol‐Induced Liver Injuries and Liver Cancers in Rat Animal Models
Authors: Murugan Sengottuvelan , Boyadjieva Nadka , Sarkar Dipak K.
Published: January 2015

Background

Recently, retrograde tracing has provided evidence for an influence of hypothalamic β‐endorphin (BEP) neurons on the liver, but functions of these neurons are not known. We evaluated the effect of BEP neuronal activation on alcohol‐induced liver injury and hepatocellular cancer.

Methods

Male rats received either BEP neuron transplants or control transplants in the hypothalamus and were randomly assigned to feeding alcohol‐containing liquid diet or control liquid diet for 8 weeks or to treatment of a carcinogen diethylnitrosamine (DEN). Liver tissues of these animals were analyzed histochemically and biochemically for tissue injuries or cancer.

Results

Alcohol feeding increased liver weight and induced several histopathological changes such as prominent microvesicular steatosis and hepatic fibrosis. Alcohol feeding also increased the levels of triglyceride, hepatic stellate cell (HSC) activation factors, and catecholamines in the liver and endotoxin levels in the plasma. However, these effects of alcohol on the liver were reduced in animals with BEP neuron transplants. BEP neuron transplants also suppressed carcinogen‐induced liver histopathologies such as extensive fibrosis, large focus of inflammatory infiltration, hepatocellular carcinoma (HCC), collagen deposition, numbers of preneoplastic foci, levels of HSC activation factors and catecholamines, as well as inflammatory milieu and increased the levels of natural killer cell cytotoxic factors in the liver.

Conclusions

These findings are the first evidence for a role of hypothalamic BEP neurons in influencing liver functions. Additionally, the data identify that BEP neuron transplantation prevents hepatocellular injury and HCC formation possibly via influencing the immune function.
An overview of the endodontic curriculum in Fiji from 2009 to 2013
Authors: Devi Arpana A. , Abbott Paul V.
Published: January 2015

This paper seeks to provide the reader with an overview of the endodontic curriculum in Fiji from 2009 to 2013. It also intends to inform readers of the changes in endodontic teaching, the learning methods utilised, curriculum development, the transition from block teaching to partial block teaching combined with longitudinal teaching, and the future plans for the endodontic module.
Tectonic evolution of sedimentary basins of northern Somalia
Authors: Ali M. Y. , Watts A. B.
Published: January 2015

Regional seismic reflection profiles tied to lithological and biostratigraphic data from deep exploration wells have been used to determine the structure and evolution of the poorly known basins of northern Somalia. We recognize six major tectonostratigraphic sequences in the seismic profiles: Middle‐Late Jurassic syn‐rift sequences (Adigrat and Bihen Group), ?Cenomanian‐Campanian syn‐rift sequences (Gumburo Group), Campanian‐Maastrichtian syn‐rift sequences (Jesomma Sandstones), Palaeocene post‐rift sequences (Auradu Limestones), Early‐Middle Eocene post‐rift sequences (Taleh Formation) and Oligocene‐Miocene (Daban Group) syn‐rift sequences. Backstripping of well data provides new constraints on the age of rifting, the amount of crustal and mantle extension, and the development of the northern Somalia rifted basins. The tectonic subsidence and uplift history at the wells can be explained by a uniform extension model with three episodes of rifting punctuated by periods of relative tectonic quiescence and thermal subsidence. The first event initiated in the Late Jurassic (~156 Ma) and lasted for ~10 Myr and had a NW‐SE trend. We interpret the rift as a late stage event associated with the break‐up of Gondwana and the separation of Africa and Madagascar. The second event initiated in the Late Cretaceous (~80 Ma) and lasted for ~20–40 Myr. This event probably correlates with a rapid increase in spreading rate on the ridges separating the African and Indian and African and Antarctica plates and a contemporaneous slowing down of Africa's plate motion. The backstripped tectonic subsidence data can be explained by a multi‐rift extensional model with stretching factor, β, of 1.09–1.14 and 1.05–1.28 for the first and second rifting events, respectively. The model, fails, however, to completely explain the slow subsidence and uplift history of the margin during Early Cretaceous to Late Cretaceous. We attribute this slow subsidence to the combined effect of a sea‐level fall and regional uplift, which caused a major unconformity in northern Somalia. The third and most recent event occurred in the Oligocene (~32 Ma) and lasted for ~10 Myr. This rift developed along the Gulf of Aden and reactivated the Guban, Nogal and Daroor basins, and is related to the opening of the Gulf of Aden. As a result of these events the crust and upper mantle were thinned by up to a factor of two in some basins. In addition, several distinct petroleum systems developed. The principal exploration play is for Mesozoic petroleum systems with the syn‐rift Oligocene‐Miocene as a subordinate objective owing to low maturity and seal problems. The main seals for the different plays are various shales, some of which are also source rocks, but the Early Eocene evaporites of the Taleh formations can also perform a sealing role for Palaeogene or older generated hydrocarbons migrating vertically.
Predictors of response in initial users of metformin and sulphonylurea derivatives: a systematic review
Authors: Martono D. P. , Lub R. , Lambers Heerspink H. J. , Hak E. , Wilffert B. , Denig P.
Published: January 2015

Aim

To provide an overview of factors predicting metformin and sulphonylurea treatment response.

Background

A large variability between individuals in treatment response to metformin and sulphonylurea derivatives exists. Understanding which factors determine response to these drugs may pave the way for more individualized therapy.

Methods

We conducted a systematic search in the MEDLINE, Cochrane and EMBASE databases, between 2003 and 2012 for articles assessing demographic and clinical prediction factors of treatment response in initial users of metformin or sulphonylurea. A literature search of articles referenced within the studies identified was also performed. Treatment response was defined as change in HbA1c level, reaching target HbA1c levels or time to treatment change. Studies were assessed on quality, sample size and type of analysis. Results were summarized by tabulating positive, null and negative associations observed for included predictors.

Results

A total of 10 articles (six trial reports and four cohort studies) were obtained, including three of sufficient quality. For metformin, baseline HbA1c, older age, lower BMI and shorter disease duration were found to be predictors of better treatment response in at least three studies of sufficient quality. For sulphonylurea derivatives, baseline HbA1c and shorter duration were identified as predictors of better treatment response in at least two studies of sufficient quality. Race, smoking status, lipid levels, blood pressure, kidney function and comorbidities were not significantly associated with treatment response.

Conclusions

Several demographic and clinical factors were identified as possible predictors of response to metformin and sulphonylurea, but the number of studies with sufficient quality was small. Generally, early treatment seems important for achieving better glycaemic outcomes.
Impact of crime victimization on initial presentation to an early intervention for psychosis service and 18‐month outcomes
Authors: Fisher Helen L. , Roberts Anna , Day Fern , Reynolds Nicky , Iacoponi Eduardo , Garety Philippa A. , Craig Thomas K.J. , McGuire Philip , Valmaggia Lucia , Power Paddy
Published: January 2015

Aim

To investigate the clinical and social correlates of a lifetime history of crime victimization among first‐episode psychosis patients at entry to an Early Intervention Service and following 18 months of specialist care.

Methods

Face‐to‐face interviews were conducted with 149 individuals who presented to an Early Intervention Service for the first time with psychosis in the London borough of Lambeth, UK. A range of demographic and clinical measures were completed including self‐reported history of victimization along with the type of crime and its subjective effect on the patient. Clinical and functional outcomes at 18‐month follow up were ascertained from clinical case notes by a psychiatrist.

Results

A large proportion of patients (n = 64, 43%) reported a history of crime victimization. This was associated with significantly higher levels of depression and substance misuse at initial presentation. Being a victim of a crime was not significantly associated with poorer clinical or functional outcomes after 18 months of specialist care. However, non‐significant differences were found for those who reported crime victimization in terms of their increased use of illegal substances or having assaulted someone else during the follow‐up period.

Conclusion

Past experience of being a victim of crime appears to be common in patients presenting for the first time with psychosis and is associated with increased likelihood of comorbidity. Thus, Early Intervention Services should consider screening for past victimization and be prepared to deal with comorbid problems. The impact of crime victimization on clinical and functional outcomes requires investigation over a longer period of time.
Therapeutic interference with leukocyte recirculation in multiple sclerosis
Authors: Sellebjerg F. , Sørensen P. S.
Published: January 2015

Multiple sclerosis (MS) is an immune‐mediated disease where T cells are thought to initiate an inflammatory reaction in the brain and spinal cord, resulting in demyelination and axonal pathology. Interfering with the activation and recruitment of immune cells reduces disease activity in MS. We review the mechanism of action and treatment effects of natalizumab and fingolimod, which interfere with the recruitment of pathogenic immune cells in MS. Fingolimod blocks the egress of activated lymphocytes from lymph nodes by binding to the sphingosine‐1‐phosphate (S1P) receptor 1, but may also have effects on S1P receptor‐expressing cells within the central nervous system (CNS). Natalizumab reduces the migration of lymphocytes to the CNS by binding to the α4 integrin very late antigen 4. Fingolimod and natalizumab also have other effects, but these are less well understood. Both treatments are efficacious in reducing relapses, accumulation of persisting disability and magnetic resonance imaging disease activity. Both treatments are safe and well tolerated in the majority of patients, but due to a potential for serious side effects they are licensed as second line therapies or for treatment of highly active MS in most European countries. We conclude that fingolimod and natalizumab have well known effects on the migration of immune cells in MS and have substantial effects on disease activity in relapsing−remitting MS. Additional effects on disease progression, potential effects within the CNS and other effects on immune cells are still being clarified.
Comparison of the in‐feed glucose test and the oral sugar test
Authors: Smith S. , Harris P. A. , Menzies‐Gow N. J.
Published: January 2015

Reasons for performing study

The in‐feed oral glucose test (OGT) and oral sugar test (OST) are advocated as field tests of insulin sensitivity in horses and ponies but have not been directly compared.

Objectives

To compare the insulin response to OGT and OST in 8 ponies and 5 horses of unknown insulin sensitivity.

Study design

Experimental, randomised crossover study.

Methods

Animals were fasted for 8 h overnight before and throughout testing. They were fed 1 g/kg bwt glucose powder with chaff (OGT) or 0.15 ml/kg bwt corn syrup (Karo™ Light Syrup; OST) was administered per os in a randomised crossover study with 48 h between tests. Blood samples were obtained at 0, 30, 60, 75, 90, 120 and 180 min. The maximal insulin concentration (Cmaxi), time to maximal insulin concentration (Tmaxi) and area under the curve of insulin concentration over time (AUCi) for the tests were compared using Student's paired t test. The effect of individual subject, horse or pony and test were analysed using a linear mixed model.

Results

The OGT Cmaxi (mean ± s.d.; 154 ± 116 μiu/ml), Tmaxi (136 ± 52 min) and AUCi (15,308 ± 9886 μiu/ml/min) were significantly (P<0.05) greater compared with the OST Cmaxi (72 ± 55 μiu/ml), Tmaxi (63 ± 25 min) and AUCi (5980 ± 4151 μiu/ml/min). The Cmaxi, Tmaxi and AUCi varied significantly between individual subjects. The Tmaxi was significantly different between horses and ponies during OGT and OST. Using previously defined criteria of insulin dysregulation, OGT identified 7/13 animals as insulin resistant, whereas OST identified 5/13 animals as insulin resistant.

Conclusions

The OGT and OST showed agreement in identification of insulin dysregulation in 85% of equine subjects. Results of the OGT and OST are not comparable in all cases. Further work is required to establish which test more accurately diagnoses insulin dysregulation in horses and ponies.
Mathematical modeling improves EC50 estimations from classical dose–response curves
Authors: Nyman Elin , Lindgren Isa , Lövfors William , Lundengård Karin , Cervin Ida , Sjöström Theresia Arbring , Altimiras Jordi , Cedersund Gunnar
Published: January 2015

The β‐adrenergic response is impaired in failing hearts. When studying β‐adrenergic function in vitro, the half‐maximal effective concentration (EC50) is an important measure of ligand response. We previously measured the in vitro contraction force response of chicken heart tissue to increasing concentrations of adrenaline, and observed a decreasing response at high concentrations. The classical interpretation of such data is to assume a maximal response before the decrease, and to fit a sigmoid curve to the remaining data to determine EC50. Instead, we have applied a mathematical modeling approach to interpret the full dose–response curve in a new way. The developed model predicts a non‐steady‐state caused by a short resting time between increased concentrations of agonist, which affect the dose–response characterization. Therefore, an improved estimate of EC50 may be calculated using steady‐state simulations of the model. The model‐based estimation of EC50 is further refined using additional time‐resolved data to decrease the uncertainty of the prediction. The resulting model‐based EC50 (180–525 nm) is higher than the classically interpreted EC50 (46–191 nm). Mathematical modeling thus makes it possible to re‐interpret previously obtained datasets, and to make accurate estimates of EC50 even when steady‐state measurements are not experimentally feasible.

Database

The mathematical models described here have been submitted to the JWS Online Cellular Systems Modelling Database, and may be accessed at http://jjj.bio.vu.nl/database/nyman.
THE GERMANIC AND THE ROMANIC SPIRIT: FRIEDRICH KAPP'S CASTING OF THE AMERICAN STRUGGLE BETWEEN NORTH AND SOUTH
Authors: Geissler Christopher M.
Published: January 2015

In his Geschichte der Sklaverei in den Vereinigten Staaten von Amerika (1860), Friedrich Kapp drew on a German concept of a clash between Germanic and Romanic civilisations to explain the American conflict between North and South. Kapp responded to an analogous ideology propagated by Southerners that divided the US into an Anglo‐Saxon North and Norman South. In doing so, Kapp demonstrated a unique synthesis of German and American thought that set his response to the South apart from that of Anglo‐American anti‐slavery thinkers. More importantly, by applying the clash of civilisations in a transatlantic way, Kapp universalised and strengthened the concept for its eventual later application again in Germany.
‘DAS BÖSE MUSS RAUS’: WITNESSING AND TESTIMONY IN GÜNTER GRASS'S IM KREBSGANG
Authors: Henebury Anja
Published: January 2015

Günter Grass's 2002 novella Im Krebsgang has been widely discussed as one of the central texts of a new literary discourse on German victimhood during World War II that has emerged in the 2000s. At the heart of the novella is the notion of a taboo on the suffering endured by Germans during the expulsions, the repressed narratives of which supposedly resurface now in disfigured shape as right‐wing extremism. While the existence of this taboo has been disputed, little attention has been paid to the fact that the ethical foundation for the story about the sinking of the Wilhelm Gustloff and its afterlife in German memory is gained through a problematic appropriation of narrative tropes of witnessing that can be traced back to the testimonies of the survivors of the Holocaust. By framing the suffering of German civilians in 1944–45 in this manner, Grass gives legitimacy to a claim for public recognition and commemoration that previously had been the domain of the far right. In this way the novella participates in a process of historical de‐contextualisation in which the Holocaust is invoked for strategic purposes.
Relationship between performance barriers and pharmacist competency towards the implementation of an expanded public health pharmacy role
Authors: Mathialagan Amuthaganesh , Nagalinggam Preesha , Mathialagan Saravanabavan , Kirby Brian P
Published: January 2015

Objective

The objective of this study was to examine the relationship between performance barriers and competency, and implementation of an expanded public health role for community pharmacists.

Methods

A validated questionnaire was utilised for this study whereby three variables of the study (performance barriers, competency and public health role) were measured using a 5-point Likert scale. Three hundred questionnaires were distributed to target respondents of registered community pharmacies in five states (Johor, Negeri Sembilan, Selangor, Perak and Penang) in Malaysia. The data were analysed utilising the principles of structural equation modelling.

Key findings

There were 191 completed and usable responses received, which represented a 66.7% response rate. This study showed perceived competency had a direct relationship with delivering a general public health role. A perceived lack of competency was shown to be a barrier to fulfilling a public health role. However, other factors, such as design of premises, IT infrastructure and pay, were not viewed as barriers to carrying out a public health role.

Conclusion

Perceived competency is an obstacle for community pharmacists to undertake a public health role in Malaysia. Adequate training programmes in pharmaceutical public health have to be put in place to address this concern and this should therefore be a priority.
Who really knows their patients' penicillin adverse drug reaction status? A cross‐sectional survey
Authors: Fehily S. R. , Stuart R. L. , Horne K. , Korman T. M. , Dendle C.
Published: January 2015

This cross‐sectional survey of patients with adverse drug reactions (ADR) to penicillin and their treating doctor, nurse and pharmacist was undertaken to identify the extent of healthcare workers (HCW) awareness of their patients' ADR, and antibiotic use in hospital. There were 23 (38%) doctors, 53 (87%) nurses and 40 (66%) pharmacists who were aware of their patient's penicillin ADR, despite more than half of their patients receiving antibiotics. Interventions encouraging ‘double checking’ may improve antibiovigilance.
Policies to sustain the nursing workforce: an international perspective
Authors: Buchan J. , Twigg D. , Dussault G. , Duffield C. , Stone P.W.
Published: January 2015

Aim

Examine metrics and policies regarding nurse workforce across four countries.

Background

International comparisons inform health policy makers.

Methods

Data from the OECD were used to compare expenditure, workforce and health in: Australia, Portugal, the United Kingdom (UK) and the United States (US). Workforce policy context was explored.

Results

Public spending varied from less than 50% of gross domestic product in the US to over 80% in the UK. Australia had the highest life expectancy. Portugal has fewer nurses and more physicians. The Australian national health workforce planning agency has increased the scope for co‐ordinated policy intervention. Portugal risks losing nurses through migration. In the UK, the economic crisis resulted in frozen pay, reduced employment, and reduced student nurses. In the US, there has been limited scope to develop a significant national nursing workforce policy approach, with a continuation of State based regulation adding to the complexity of the policy landscape. The US is the most developed in the use of nurses in advanced practice roles. Ageing of the workforce is likely to drive projected shortages in all countries.

Limitations

There are differences as well as variation in the overall impact of the global financial crisis in these countries.

Conclusion

Future supply of nurses in all four countries is vulnerable.

Implications for nursing and health policy

Work force planning is absent or restricted in three of the countries. Scope for improved productivity through use of advanced nurse roles exists in all countries.
Methodology of the EDIFICE Melanoma survey
Authors: Touboul C.
Published: January 2015

Background

Melanoma accounts for a small proportion of skin cancers but is the most serious. The prognosis is, however, good if it is diagnosed early, before the metastatic stages. For these reasons, population awareness and knowledge with regard to melanoma and the associated risk factors are critical to improving the effectiveness of melanoma primary prevention campaigns.

Objectives

The EDIFICE Melanoma survey was designed to cover a large number of topics related to sun exposure and melanoma: knowledge and awareness of the risks associated with sun and artificial ultraviolet exposure, knowledge of melanoma and the associated risk factors, behaviour regarding protective measures in adults and children.

Methods

The survey questionnaire was administered by experienced independent interviewers from the Kantar Health Institute using the Computer‐Assisted Telephone Interview technique. It was important to avoid the effects of ‘contamination’ in answers to questions about sun exposure habits. Questions about exposure habits were therefore asked before those relating to knowledge of best practices for sun protection. A sample of 1502 individuals aged 18 years and over was interviewed. The survey data were weighted to eliminate structural variations between the sample interviewed and the reference population. Quantitative data were described by the means and standard deviations and categorical data by the numbers in each category and corresponding percentages. Three multivariate logistic regression analyses were conducted and expressed in terms of odds ratio and 95% confidence intervals.

Results

In addition to the classic questions relating to sociodemographic characteristics, the EDIFICE Melanoma study questionnaire was organized around three themes: the opinion, attitude and knowledge of individuals regarding sun exposure and melanoma. The survey questionnaire lasted approximately 20 min.

Conclusions

This study provided a complete ‘snapshot’ of opinions, attitudes and knowledge of French people in 2011 with regard to sun exposure.
Prevalence of sunbed use, and characteristics and knowledge of sunbed users: results from the French population‐based Edifice Melanoma survey
Authors: Grange F. , Mortier L. , Crine A. , Robert C. , Sassolas B. , Lebbe C. , Lhomel C. , Saiag P.
Published: January 2015

Background

In addition to natural sunlight, indoor tanning has emerged as a common source of ultraviolet (UV) radiation associated with an increased risk of melanoma. It is classified as a class I human carcinogen by the World Health Organization.

Objectives

This analysis presents data on the prevalence of sunbed use in France, on factors associated with sunbed use, and on risk factors, attitude and awareness of risk among sunbed users and non‐users.

Methods

Edifice Melanoma, a nationwide observational survey, was conducted in France via telephone interviews among a representative sample of 1502 subjects aged ≥18 years, using the quota method. Sunbed users were defined as individuals who reported having used a sunbed at least once in their lifetime. Logistical regressions were conducted in order to identify which factors differentiate the population of sunbed users from that of non‐users.

Results

One in ten respondents was a sunbed user and three out of four declared having used tanning facilities for over one year. In multivariate analysis, factors significantly associated with the sunbed‐user group were female gender (OR = 3.897 [2.573–5.903], P < 0.001), a higher socio‐professional category (OR = 2.227 [1.542–3.217]; P < 0.001), fair hair (OR = 1.583 [1.025–2.447], P = 0.039), fair skin (OR = 1.879 [1.086–3.253]; P = 0.024), freckles (OR = 1.570 [1.071–2.302]; P = 0.021) and a history of smoking (OR = 2.383 [1.633–3.476]; P < 0.001). In a second multivariate model, the fact of having a large number of melanoma risk factors was strongly associated with sunbed use (P = 0.001). Sunbed users were more likely to be informed of the role of sun exposure in reducing the skin's regenerative capacity (OR = 2.181 [1.319–3.607]; P = 0.002) but were nevertheless more likely to consider that a tan makes a person look more attractive (OR = 2.309 [1.312–4.064]; P = 0.004) and protects the skin (OR = 2.490 [1.532–4.046]; P < 0.001); they were also more frequently exposed to natural sunlight (OR = 2.214 [1.196–4.102]; P = 0.011).

Conclusions

Compared to non‐users, sunbed users cumulate risk factors for melanoma. Knowledge, attitudes and intentions of individuals are critical targets for public education programmes. However, awareness campaigns focusing on sunbed use, and more generally on skin cancer, should also take social and cultural norms into account.
Melanoma risk‐takers: fathers and sons
Authors: Eisinger F. , Morère J.‐F. , Pivot X. , Grange F. , Lhomel C. , Mortier L. , Robert C. , Saiag P. , Sassolas B. , Viguier J.
Published: January 2015

Objectives

The incidence of skin cancers, melanoma in particular, is increasing rapidly. Consequently, specific recommendations for sun‐protection measures now exist. This survey set out to assess the compliance of the general population with these guidelines.

Methods

The French nationwide observational survey, EDIFICE Melanoma, was conducted (28 September to 20 October 2011) through phone interviews of a representative sample of 1502 subjects aged ≥ 18 years, using the quota method. Sun‐protection was defined as frequent or systematic use of clothes or sunscreen. The group of individuals who declared exposure to the sun (N = 1172) was subdivided: risk‐takers (N = 442), and those who used sun protection (N = 730).

Results

Risk‐takers were significantly more often male (62% vs. 44%, P < 0.01), had a lower level of education (40% vs. 26%, P < 0.01), lower incomes (2587 euros vs. 2948 euros/month) and were more often smokers (42% vs. 31%, P < 0.01). In contrast, age, marital status and use of sunbeds were not significantly different between the two groups. Interestingly, risk‐takers had less risk factors for melanoma. However, they were less well‐informed about high‐risk exposure and optimal use of sunscreen. Sun‐protection measures for their children were less stringent than those of the group who used sun protection: systematic/frequent use of sunglasses (42% vs. 59%, P < 0.01), systematic use of sunscreen (77% vs. 86%, P < 0.01), and frequent renewal (69% vs. 82%, P < 0.01), high sun protection factors (SPF) (46% vs. 56%, P < 0.01), use of clothing (84% vs. 92%, P < 0.01) and hats (88% vs. 94%, P < 0.01).

Conclusions

Risk‐takers are characterized by a lesser understanding of sun‐protection measures and behaviours. Their children benefit less from protective measures than those of people who use sun protection themselves. Improved understanding may well improve behaviours; one can therefore legitimately predict a considerable impact on parents' attitude to their own protection and that of their children.
Peripheral neuropathy and parkinsonism: a large clinical and pathogenic spectrum
Authors: Vital Anne , Lepreux Sebastien , Vital Claude
Published: January 2015

Peripheral neuropathy (PN) has been reported in idiopathic and hereditary forms of parkinsonism, but the pathogenic mechanisms are unclear and likely heterogeneous. Levodopa‐induced vitamin B12 deficiency has been discussed as a causal factor of PN in idiopathic Parkinson's disease, but peripheral nervous system involvement might also be a consequence of the underlying neurodegenerative process. Occurrence of PN with parkinsonism has been associated with a panel of mitochondrial cytopathies, more frequently related to a nuclear gene defect and mainly polymerase gamma (POLG1) gene. Parkin (PARK2) gene mutations are responsible for juvenile parkinsonism, and possible peripheral nervous system involvement has been reported. Rarely, an association of parkinsonism with PN may be encountered in other neurodegenerative diseases such as fragile X‐associated tremor and ataxia syndrome related to premutation CGG repeat expansion in the fragile X mental retardation (FMR1) gene, Machado–Joseph disease related to an abnormal CAG repeat expansion in ataxin‐3 (ATXN3) gene, Kufor–Rakeb syndrome caused by mutations in ATP13A2 gene, or in hereditary systemic disorders such as Gaucher disease due to mutations in the β‐glucocerebrosidase (GBA) gene and Chediak–Higashi syndrome due to LYST gene mutations. This article reviews conditions in which PN may coexist with parkinsonism.
Influence of birthweight on perinatal outcome in fetuses with antenatal diagnosis of congenital heart disease
Authors: Story Lisa , Pasupathy Dharmintra , Sankaran Srividhya , Sharland Gurleen , Kyle Pippa
Published: January 2015

Aim

The incidence of congenital heart disease (CHD) accounts for the largest proportion of infant mortality attributable to birth defects. Associations have previously been reported between CHD and low birthweight. Low birthweight is independently associated with adverse outcome and has characteristically been calculated using population‐based charts. This aim of this study was to determine the incidence of small for gestational age (SGA) in fetuses with CHD utilizing customized birthweight centiles and to determine the effect of SGA on adverse outcome.

Methods

A retrospective cohort study was performed between 2006 and 2011. All singleton fetuses with CHD, with no associated karyotype or structural extra‐cardiac abnormalities, who delivered at St Thomas's Hospital, London, were included. Population and customized birthweight centiles were calculated and perinatal outcome data were recorded.

Results

A total of 17% of fetuses with CHD had a birthweight centile <10th when population centiles were used, and 25% when customized birthweight centiles were applied. There was no correlation between SGA and increased adverse perinatal outcome.

Conclusions

A high proportion of fetuses with CHD are classified as SGA when both population and customized birthweight centiles are used. SGA does not correlate with adverse outcome in the perinatal period. The cardiac defect therefore appears to be the main determinant of outcome and not the size of the baby at delivery.
Cardiovascular disease risk burden in primary Sjögren's syndrome: results of a population‐based multicentre cohort study
Authors: Bartoloni E. , Baldini C. , Schillaci G. , Quartuccio L. , Priori R. , Carubbi F. , Bini V. , Alunno A. , Bombardieri S. , De Vita S. , Valesini G. , Giacomelli R. , Gerli R.
Published: January 2015

Objective

Systemic autoimmune diseases, in particular systemic lupus erythematosus and rheumatoid arthritis, are characterized by a high risk of premature cardiovascular (CV) events. Disease‐related characteristics and traditional CV disease risk factors may contribute to atherosclerotic damage. However, there are limited data on the risk of overt CV events in primary Sjögren's syndrome (pSS).

Methods

We retrospectively analysed a cohort of patients with 1343 pSS. Disease‐related clinical and laboratory data, traditional CV disease risk factors and overt CV events were recorded. Prevalence of traditional CV disease risk factors and of major CV events was compared between a subgroup of 788 female patients with pSS aged from 35 to 74 years and 4774 age‐matched healthy women.

Results

Hypertension and hypercholesterolaemia were more prevalent, whereas smoking, obesity and diabetes mellitus were less prevalent, in women with pSS than in control subjects. Cerebrovascular events (2.5% vs. 1.4%, P = 0.005) and myocardial infarction (MI) (1.0% vs. 0.4%, P = 0.002) were more common in patients with pSS. In the whole population, central nervous system involvement (odds ratio (OR) 5.6, 95% confidence interval (CI) 1.35–23.7, P = 0.02) and use of immunosuppressive therapy (OR 1.9, 95% CI 1.04–3.70, P = 0.04) were associated with a higher risk of CV events. Patients with leucopenia had a higher risk of angina (P = 0.01).

Conclusions

pSS is associated with an increased risk of cerebrovascular events and MI. Disease‐related clinical and immunological markers may have a role in promoting CV events.
Successful closed suction drain management of a canine elbow hygroma
Authors: Pavletic M. M. , Brum D. E.
Published: January 2015

A 1‐year‐old castrated male St. Bernard dog presented to Angell Animal Medical Center with bilateral elbow hygromas which had been present for several weeks. The largest hygroma involving the left elbow was managed with a closed suction (active) drain system to continuously collapse the hygroma pocket over a 3‐week period. Soft bedding was used to protect the elbows from further impact trauma to the olecranon areas. Following drain removal, there was no evidence of hygroma recurrence based on periodic examinations over an 18‐month period. The smaller non‐operated right elbow hygroma had slightly enlarged during this period. Closed suction drain management of the hygroma proved to be a simple and economical method of collapsing the left elbow hygroma. This closed drainage system eliminated the need for the postoperative bandage care required with the use of the Penrose (passive) drain method of managing elbow hygromas. The external drain tube should be adequately secured in order to minimise the risk of its inadvertent displacement.
Successful treatment with telaprevir‐based regimens for chronic hepatitis C results in significant improvements to serum markers of liver fibrosis
Authors: Haseltine E. L. , Penney M. S. , George S. , Kieffer T. L.
Published: January 2015

Patients infected with hepatitis C virus (HCV) have differing levels of liver health when they initiate treatment. We sought to quantify whether liver health improves following successful treatment with telaprevir‐based antiviral regimens. We performed a retrospective analysis of data generated from one Phase 2 and two Phase 3 telaprevir clinical studies. 1208 patients treated with a telaprevir‐based regimen were included in the analysis. Patients were grouped according to their baseline Metavir score (F0–F1, F2 and F3–F4) and whether or not they attained sustained virologic response (SVR). Scores from four biomarker tests, FibroTest, APRI, FIB‐4 and Forns' Score, were monitored both before and after HCV treatment. All four of these tests differentiated the fibrosis stage as determined by Metavir score at baseline. Consistent with previous studies, patients who attained SVR exhibited significant improvements in scores from each of these tests after treatment. These improvements remained significant even when patients were grouped according to their baseline Metavir score. On average, the scores from different tests exhibited differential improvements following SVR. Improvements in APRI scores corresponded to complete fibrosis regression (i.e. a Metavir stage of F0‐F1). In contrast, improvements in scores from Forns' Score, FIB‐4 and FibroTest were more modest (i.e. fibrosis regression of less than a Metavir stage). Overall, these results demonstrated that attaining SVR with a telaprevir‐based regimen led to significant improvements in liver health as determined by four biomarker tests. However, not all correlations observed between noninvasive markers and fibrosis stage at baseline hold after SVR is attained.
Pharmacokinetics and effects on thromboxane B2production following intravenous administration of flunixin meglumine to exercised thoroughbred horses
Authors: Knych H. K. , Arthur R. M. , McKemie D. S. , Chapman N.
Published: January 2015

Flunixin meglumine is commonly used in horses for the treatment of musculoskeletal injuries. The current ARCI threshold recommendation is 20 ng/mLwhen administered at least 24 h prior to race time. In light of samples exceeding the regulatory threshold at 24 h postadministration, the primary goal of the study reported here was to update the pharmacokinetics of flunixin following intravenous administration, utilizing a highly sensitive liquid chromatography–mass spectrometry (LC‐MS). An additional objective was to characterize the effects of flunixin on COX‐1 and COX‐2 inhibition when drug concentrations reached the recommended regulatory threshold. Sixteen exercised adult horses received a single intravenous dose of 1.1 mg/kg. Blood samples were collected up to 72 h postadministration and analyzed using LC‐MS. Blood samples were collected from 8 horses for determination of TxB2and PGE2concentrations prior to and up to 96 h postflunixin administration. Mean systemic clearance, steady‐state volume of distribution and terminal elimination half‐life was 0.767 ± 0.098 mL/min/kg, 0.137 ± 0.12 L/kg, and 4.8 ± 1.59 h, respectively. Four of the 16 horses had serum concentrations in excess of the current ARCI recommended regulatory threshold at 24 h postadministration. TxB2suppression was significant for up to 24 h postadministration.
Evaluation of a new balloon occlusion catheter specifically designed for measurement of hepatic venous pressure gradient
Authors: Ferlitsch Arnulf , Bota Simona , Paternostro Rafael , Reiberger Thomas , Mandorfer Mattias , Heinisch Birgit , Salzl Petra , Schwarzer Remy , Sieghart Wolfgang , Peck‐Radosavljevic Markus , Ferlitsch Monika
Published: January 2015

Background & Aims

Despite the important clinical value of hepatic venous pressure gradient (HVPG) and its increasing use, no specific balloon occlusion catheters have been designed to cannulate liver veins. The aim of the study was to evaluate the clinical applicability of a novel balloon (NC) occlusion catheter specifically designed for HVPG measurement.

Methods

Comparison of a new CE‐certified 7 French balloon occlusion catheter with a 150° angled tip and radiopaque markers (NC, Pejcl Medizintechnik, Austria), to a commonly used straight balloon catheter (SC; Boston Scientific, USA). Successful liver vein cannulation rate, need for extra equipment and total fluoroscopy time were recorded. Experts (>200) and novices (<20) in HVPG measurements were evaluated separately.

Results

566 HVPG measurements taken by 11 investigators (five experts and six novices) were analysed. Overall, HVPG could be successfully measured in 98.7% of cases. The rate of successful liver vein cannulation at first attempt was significantly higher among experts when compared to novices (87.3% vs 67.3%, P < 0.001). Moreover, the rate of successful liver vein cannulation without need for any additional equipment was higher when using the NC, both among experts (NC:91.9% vs SC:80.6%, P = 0.03) and novices (NC:73.3% vs SC:50.7%, P = 0.001). The mean fluoroscopy time needed to cannulate the hepatic vein was significantly shorter in experts as compared to novices [2.37(0.10–26) vs 5.2(0.6–30.2] min, P < 0.0001), but not significantly different between catheters.

Conclusions

Both novices and experts achieve higher liver vein cannulation rates using the new specifically designed catheter. The use of the novel catheter might increase rates of successful liver vein cannulation and reduce the need for additional equipment, especially in novices.
A LINE‐1–encoded reverse transcriptase–dependent regulatory mechanism is active in embryogenesis and tumorigenesis
Authors: Spadafora Corrado
Published: January 2015

LINE‐1 (long interspersed nuclear elements) retrotransposons constitute a large family of retrotransposable elements, accounting for 17% of the human genome. They encode proteins required for their own mobilization, including a reverse transcriptase (RT) enzyme highly expressed in mouse embryos and mouse and human cancer cells and repressed in somatic differentiated healthy cells. We have found that reverse transcription takes place in early murine embryos, yielding an increase in LINE‐1 copy number during preimplantation development, which also occurs in tumor progression. RT inhibition irreversibly arrests embryo development, reduces cancer cell proliferation, promotes differentiation, antagonizes tumor growth, and causes a global reprogramming of transcription profiles. These results strongly suggest that a previously unrecognized RT‐dependent regulatory mechanism operates during preimplantation development, is repressed during differentiation to normal tissues, and, when erroneously reactivated in adult life, promotes cell transformation and cancer progression by “resurrecting” embryonic transcriptional pathways. The RT‐dependent mechanism emerges as a major source of genetic and epigenetic changes with physiological, pathological, and evolutionary implications.