bluuebunny/crossref_metadata_2025 huggingface dataset:
Early processing in the human lateral occipital complex is highly responsive to illusory contours but not to salient regions
Authors: Shpaner Marina , Murray Micah M. , Foxe John J.
Published: November 2009

Human electrophysiological studies support a model whereby sensitivity to so‐called illusory contour stimuli is first seen within the lateral occipital complex. A challenge to this model posits that the lateral occipital complex is a general site for crude region‐based segmentation, based on findings of equivalent hemodynamic activations in the lateral occipital complex to illusory contour and so‐called salient region stimuli, a stimulus class that lacks the classic bounding contours of illusory contours. Using high‐density electrical mapping of visual evoked potentials, we show that early lateral occipital cortex activity is substantially stronger to illusory contour than to salient region stimuli, whereas later lateral occipital complex activity is stronger to salient region than to illusory contour stimuli. Our results suggest that equivalent hemodynamic activity to illusory contour and salient region stimuli probably reflects temporally integrated responses, a result of the poor temporal resolution of hemodynamic imaging. The temporal precision of visual evoked potentials is critical for establishing viable models of completion processes and visual scene analysis. We propose that crude spatial segmentation analyses, which are insensitive to illusory contours, occur first within dorsal visual regions, not the lateral occipital complex, and that initial illusory contour sensitivity is a function of the lateral occipital complex.
Large‐scale reorganization of corticofugal fibers after neonatal hemidecortication for functional restoration of forelimb movements
Authors: Takahashi Masahito , Vattanajun Anusara , Umeda Tatsuya , Isa Kaoru , Isa Tadashi
Published: November 2009

As an experimental model to study the mechanism of large‐scale network plasticity of the juvenile brain, functional compensation after neonatal brain damage was studied in rats that received unilateral decortication at postnatal day 5. These animals exhibited a marked ability in reaching and grasping movements in the contralesional side of the forelimb when tested at 10–14 weeks of age. Additional lesion of the sensorimotor cortex in the remaining contralesional hemisphere at this stage resulted in severe impairment of both forelimbs. It was suggested that the sensorimotor cortex on the contralesional side was controlling the movements of both forelimbs. Following the injection of an anterograde tracer into the remaining sensorimotor cortex, the corticofugal axons from the remaining sensorimotor cortex were found to issue aberrant projections to the contralateral red nucleus, contralateral superior colliculus, contralateral pontine nuclei, ipsilateral dorsal column nucleus and ipsilateral gray matter of the cervical spinal cord, all of which appeared to be necessary for the control of contralesional forelimb movements. These results suggest that the forelimb movements on the contralesional side were compensated by large‐scale reorganization of the corticofugal axons from the remaining sensorimotor cortex.
Colorectal foreign bodies: a systematic review
Authors: Kurer M. A. , Davey C. , Khan S. , Chintapatla S.
Published: November 2009

Aim  To perform a systematic review of the published reports on retained colorectal foreign bodies (CFBs) to collate the features and formulate a simple management plan based on the available evidence.

Method  An extensive search was carried out to identify articles on CFBs. The search was carried out on electronic databases Cinahl, Embase, Medline, PubMed and PsychInfo from 1950 to January 2009. Internet journals were also scoured and a general search was carried out using the search engine ‘Google’. Papers published in languages other than English were not included.

Results  This review covers a total of 193 patients with 196 presentations. There were 188 men and 5 women, a ratio of approximately 37:1. The mean age at presentation was 44.1 years (SD 16.6) in the single case reports and 39.3, 40 and 60.8 years in the three case series. Household objects, such as bottles and glasses, accounted for the largest percentage (42.2%) of inserted objects. Presentation for treatment occurred most often within 24 h of insertion and the majority of objects were removed transanally using manual manipulation with or without the use of a variety of tools, or via a scope.

Conclusions  The incidence of CFBs is disproportionately higher in men. Various techniques for removal are available, including some that are minimally invasive. The appropriate technique will depend on the size and surface of the retained object and the presence of complications such as perforation or obstruction.
Retracted: Early supplementation of parenteral nutrition is capable of improving quality of life, chemotherapy‐related toxicity and body composition in patients with advanced colorectal carcinoma undergoing palliative treatment: results from a prospective, randomized clinical trial
Authors: Hasenberg T. , Essenbreis M. , Herold A. , Post S. , Shang E.
Published: November 2009

Aim  Patients suffering from advanced colorectal cancer can experience unintended weight loss and/or treatment‐induced gastrointestinal toxicity. Based on current evidence, the routine use of parenteral nutrition (PN) for patients with colorectal cancer is not recommended. This study evaluates the effect of PN supplementation on body composition, quality of life (QoL), chemotherapy‐associated side effects and survival in patients with advanced colorectal cancer.

Method  Eighty‐two patients with advanced colorectal cancer receiving a palliative chemotherapy were prospectively randomized to either oral enteral nutrition supplement (PN‐) or oral enteral nutrition supplement plus supplemental PN (PN+). Every 6 weeks body weight, body mass index (BMI), chemotherapy‐associated side effects and caloric intake were assessed, haemoglobin and serum albumin were measured. Body composition was assessed by body impedance analysis, and QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) QLQC30 questionnaire.

Results  No differences were evident at baseline between the groups for age, sex, diagnosis, weight, BMI or QoL. A difference in BMI was observed by week 36, whereas differences of the mean body cell mass could be observed from week 6, albumin dropped significantly in the PN‐ group in week 36 and QoL showed significant differences from week 18. Chemotherapy‐associated side effects were higher in PN‐. The survival rate was significantly greater in the PN+ group.

Conclusion  A supplementation with PN slows weight loss, stabilizes body‐composition and improves QoL in patients with advanced colorectal cancer. Furthermore, it can reduce chemotherapy‐related side effects.
Cannabinoid type 1 receptor blockade induces transdifferentiation towards a brown fat phenotype in white adipocytes
Authors: Perwitz N. , Wenzel J. , Wagner I. , Büning J. , Drenckhan M. , Zarse K. , Ristow M. , Lilienthal W. , Lehnert H. , Klein J.
Published: November 2009

Aim:The endocannabinoid (EC) system is a major component in the control of energy homeostasis. It mediates a positive energy balance via central and peripheral pathways. Blockade of the cannabinoid type 1 receptor induces weight reduction and improves cardiovascular risk factors in overweight patients. Cannabinoid receptor type 1 (CB1R)‐deficient mice are resistant to diet‐induced obesity. The mechanisms responsible for these effects remain only partially elucidated. We hypothesized peripheral effects via direct modulation of adipocyte function to be an integral part of EC action on energy metabolism and insulin sensitivity.

Methods:SV40 immortalized murine white and brown adipocytes were used for all experiments. We investigated the effect of CB1R blockade by stimulating the cells acutely and chronically with rimonabant, a selective antagonist for the CB1R, or by knocking down the receptor with small interfering RNA (siRNA). Changes in thermogenic mRNA and protein expression as well as mitochondrial biogenesis and function were assessed by real‐time RT‐PCR, immunoblotting, fluorescent staining techniques, electron microscopy and by measuring oxygen consumption.

Results:Acute and chronic blockade of the CB1R with the selective antagonist rimonabant or by siRNA in murine white adipocytes strongly induced the thermogenic uncoupling protein‐1 (UCP‐1). UCP‐1 expression was increased in a time‐ and dose‐dependent manner both at the RNA and protein level. Furthermore, this effect was paralleled by enhanced peroxisome proliferator‐activated receptor γ coactivator 1α (PGC‐1α) expression. In accordance with these findings, AMP‐activated protein kinase (AMPK) phosphorylation was also increased after rimonabant treatment. Mitochondria‐specific fluorescent staining demonstrated an augmentation in the number of mitochondria. This was confirmed by electron microscopy images. Moreover, rimonabant treatment enhanced the cytochrome c oxidase activity and increased cellular oxygen consumption.

Conclusions:Taken together, our data demonstrate that inhibition of peripheral CB1R action in adipocytes directly promotes transdifferentiation of white adipocytes into a mitochondria‐rich, thermogenic brown fat phenotype. Enhanced thermogenesis and insulin sensitivity may represent a peripheral mechanism contributing to weight loss and improved glucose homeostasis in rimonabant‐treated patients.
Mid‐ and high‐ratio premix insulin analogues: potential treatment options for patients with type 2 diabetes in need of greater postprandial blood glucose control
Authors: Christiansen J. S. , Liebl A. , Davidson J. A. , Ligthelm R. J. , Halimi S.
Published: November 2009

Some patients with type 2 diabetes continue to have high postprandial blood glucose levels on twice‐daily regimens of ‘low‐ratio’ premix insulin formulations (up to 30% rapid‐acting, with 70% protracted insulin). These patients require intensified insulin therapy, which can be provided by a twice‐ or thrice‐daily regimen of mid‐ratio (50% rapid‐acting and 50% protaminated intermediate‐acting insulin – human or analogue) or high‐ratio (70% rapid‐acting and 30% protaminated insulin – analogue only) premix insulin. Alternatively, a third daily injection of low‐ratio premix insulin can be added to the regimen, with the option of incorporating one or more injections of mid‐ or high‐ratio premix as required, and as an alternative to basal–bolus therapy. How these mid‐ and high‐ratio formulations differ from the low‐ratio premix insulins is reviewed here, with the aim of identifying the role of these formulations in diabetes management. Glucose clamp studies have shown that premix analogues give serum insulin levels proportional to their percentage of rapid‐acting uncomplexed insulin: the higher the proportion, the greater the maximum level reached. Other pharmacokinetic parameters were not always significantly different between the mid‐ and high‐ratio formulations. In clinical trials, postprandial plasma glucose and glycated haemoglobin A1c (HbA1c) levels were significantly reduced with thrice‐daily mid‐ /high‐ratio premix analogue when compared with twice‐daily low‐ratio biphasic human insulin (BHI) 30/70 or once‐daily insulin glargine. Moreover, glycaemic control with mid‐/high‐ratio premix analogue was found to be similar to that with a basal–bolus therapy. Mid‐ and high‐ratio premix regimens are generally well tolerated. The frequency of minor hypoglycaemia was reportedly higher with mid‐ /high‐ratio premix analogues than with BHI 30, but nocturnal hypoglycaemia was less frequent. Although there is little evidence that clinical outcomes with mid‐ratio premix analogues are different from those with high‐ratio, they are useful additions to the low‐ratio formulations for the management of diabetes, and addressing postprandial hyperglycaemia in particular.
Bioengineered skin in diabetic foot ulcers
Authors: Teng Y. J. , Li Y. P. , Wang J. W. , Yang K. H. , Zhang Y. C. , Wang Y. J. , Tian J. H. , Ma B. , Wang J. M. , Yan X.
Published: November 2009

Objective: Bioengineered skin (BS) has been shown to play an important role in the treatment of diabetic foot ulcers (DFUs). Whether BS in the therapy of DFU can improve the outcomes still remains uncertain. We performed a quantitative meta‐analysis of available randomized controlled trials to determine the effectiveness and safety of BS in the treatment of patients with DFUs.

Design and Methods: Comprehensive search strategies of various electronic databases were used for this study to evaluate the effectiveness and safety between BS and conventional treatment (CT) in patients with DFU, and only randomized controlled trials were adopted in our review. Search terms included ‘bioengineered skin’, ‘tissue‐engineering skin’, ‘human‐tissue graft', ‘human‐skin device’, ‘living‐skin equivalent' and ‘diabetic foot', ‘diabetic ulcer’, ‘diabetic wound’. Analysis outcomes included complete wound closure, complications, ulcer recurrence and adverse severe events (ASEs).

Results: Seven randomized controlled trials on BS vs. CT were included, and 880 participants met inclusion criteria. Pooled analysis showed a significant effectiveness and safety advantages for BS treatment compared to CT for patients with DFUs. In analysis of complications, only statistically significant difference of infection was noted. And no included trials reported ASEs related to these treatments.

Conclusions: Based on the meta‐analysis, patients with DFUs may benefit from the BS because of its high effectiveness and safety and reduced risk for infections in comparison to CT.
Comparison between a basal‐bolus and a premixed insulin regimen in individuals with type 2 diabetes–results of the GINGER study
Authors: Fritsche A. , Larbig M. , Owens D. , Häring H.‐U. ,   on behalf of the GINGER study group
Published: November 2009

Aim: To compare the efficacy and safety of an intensified insulin regimen, using insulin glargine (glargine) once daily and pre‐meal insulin glulisine (glulisine) (basal‐bolus), with a conventional therapy, using premixed insulin (premix) twice daily.

Methods: This 52‐week, open‐label, randomized, multinational, multicentre trial included 310 subjects with type 2 diabetes (T2D) on premix, with or without metformin, who were randomized to a basal‐bolus regimen with glargine and glulisine (n = 153; mean ± s.d. age 60.2 ± 7.5 years; HbA1c 8.6 ± 0.8%; weight 87.0 ± 15.1 kg; T2D duration 12.8 ± 5.8 years) or twice‐daily premix (n = 157; age 60.9 ± 7.8 years; HbA1c 8.5 ± 0.9%; weight 84.3 ± 15.0 kg; T2D duration 12.5 ± 6.8 years). The primary endpoint was change in HbA1c from baseline to endpoint.

Results: Mean decrease in baseline‐to‐endpoint HbA1c for basal‐bolus vs. premix was −1.31 vs. −0.80% (difference: −0.476%; 95% Cl: −0.714, −0.238; p = 0.0001, ancova). More subjects reached HbA1c ≤ 7.0% in the basal‐bolus group than in the premix group [68 (46.6%) vs. 43 (27.9%); p = 0.0004], while they also experienced significantly lower mean ± s.d. daytime (−2.7 ± 2.3 vs. −2.3 ± 2.5 mmol/l; p = 0.0033) and postprandial (−3.1 ± 2.6 vs. −2.5 ± 2.8 mmol/l; p < 0.0001) blood glucose. Endpoint daily insulin doses were 98.0 ± 48.7 vs. 91.3 ± 44.3 IU (p = 0.2104); mean weight gain was +3.6 ± 4.0 vs. +2.2 ± 4.5 kg (p = 0.0073). Mean number of overall hypoglycaemic events with basal‐bolus and premix was 13.99 and 18.54 events/patient year, respectively (difference: −3.90; 95% CI: −10.40, 2.60; p = 0.2385).

Conclusions: An intensified basal‐bolus regimen using glargine/glulisine results in a significantly superior glycaemic control vs. premix therapy in a population with long‐standing insulin‐treated T2D, with no increase in the rates of hypoglycaemia.
Tanshinone IIA pretreatment protects myocardium against ischaemia/reperfusion injury through the phosphatidylinositol 3‐kinase/Akt‐dependent pathway in diabetic rats
Authors: Zhang Y. , Wei L. , Sun D. , Cao F. , Gao H. , Zhao L. , Du J. , Li Y. , Wang H.
Published: November 2009

Aim: Diabetes Mellitus (DM) is widely acknowledged to increase the risk of cardiovascular death, which warrants the use of aggressive primary prevention strategies. The aim of the present study was to investigate the pretreatment effects of tanshinone IIA (TSN), a traditional Chinese medicine, on myocardial infarct size, apoptosis, inflammation and cardiac functional recovery in diabetic rats subjected to myocardial ischaemia/reperfusion (I/R).

Methods: Streptozocin (STZ) induced diabetic rats (n = 80) were randomized to receive TSN, TSN plus wortmannin [a phosphatidylinositol 3‐kinase (PI3K) inhibitor] or saline. They were exposed to a 30‐min ischaemia by ligation of the left coronary artery except for the sham group. Haemodynamics, infarct size and myocardial apoptosis were examined 3 h after reperfusion. The effects of TSN on Akt and NF‐κB phosphorylation and the expression of tumour necrosis factor‐alpha (TNF‐α) and interleukin‐6 (IL‐6) in cardiac tissues were examined.

Results: Our results revealed that TSN administration significantly reduced myocardial infarct size (0.252 ± 0.038 vs. 0.327 ± 0.027, p < 0.05), improved left ventricular ejection fraction (LVEF) (0.774 ± 0.058 vs. 0.716 ± 0.054, p < 0.05), decreased myocardial apoptotic death (0.114 ± 0.026 vs. 0.191 ± 0.023, p < 0.05) compared with I/R group. Western blot analysis showed that TSN treatment enhanced Akt phosphorylation and inhibited NF‐κB phosphorylation in cardiac tissues. Moreover, pretreatment with wortmannin abolished the beneficial effects of TSN: a reduction of infarct size, a decrease in LVEF, inhibition of myocardial apoptosis and Akt phosphorylation, enhancement of NF‐κB phosphorylation and an increase of cytokine production including TNF‐α and IL‐6 after I/R injury in diabetic rats.

Conclusions: This study indicates that TSN pretreatment reduces infarct size and improves cardiac dysfunction after I/R injury in diabetic rats. This was accompanied with decreased cardiac apoptosis and inflammation. The possible mechanism responsible for the effects of TSN is associated with the PI3K/Akt‐dependent pathway.
Twelve weeks treatment with the DPP‐4 inhibitor, sitagliptin, prevents degradation of peptide YY and improves glucose and non‐glucose induced insulin secretion in patients with type 2 diabetes mellitus
Authors: Aaboe K. , Knop F. K. , Vilsbøll T. , Deacon C. F. , Holst J. J. , Madsbad S. , Krarup T.
Published: November 2009

Aim: To examine the effects of 12 weeks of treatment with the DPP‐4 inhibitor, sitagliptin, on gastrointestinal hormone responses to a standardized mixed meal and beta cell secretory capacity, measured as glucose and non‐glucose induced insulin secretion during a hyperglycaemic clamp, in patients with type 2 diabetes.

Method: A double‐blinded, placebo‐controlled study over 12 weeks in which 24 patients with T2DM were randomized to receive either sitagliptin (Januvia) 100 mg qd or placebo as an add‐on therapy to metformin. In week 0, 1 and 12 patients underwent a meal test and a 90‐min 20 mM hyperglycaemic clamp with 5 g of l‐arginine infusion. Main outcome measure was postprandial total glucagon‐like peptide 1 (GLP‐1) concentration. Additional measures were insulin and C‐peptide, glycaemic control, intact and total peptide YY (PYY) and glucose‐dependent insulinotropic polypeptide (GIP), and intact glucagon‐like peptide 2 (GLP‐2) and GLP‐1.

Results: All patients [sitagliptin n = 12, age: 59.5 (39–64) years, HbA1c: 8.0 (7.3–10.0)%, BMI: 33.2 (29.3–39.4); placebo n = 12, age: 60 (31–72) years, HbA1c: 7.7 (7.1–9.8)%, BMI: 30.7 (25.7–40.5)] [median (range)] completed the trial. Sitagliptin treatment improved glycaemic control, had no effect on total GLP‐1, GIP or intact GLP‐2, but reduced total PYY and PYY3‐ 36, and increased PYY1‐ 36 and intact incretin hormones. Sitagliptin improved first and second phases of beta cell secretion and maximal secretory capacity. All effects were achieved after 1 week. No significant changes occurred in the placebo group.

Conclusion: The postprandial responses of total GLP‐1 and GIP and intact GLP‐2 were unaltered. PYY degradation was prevented. Glucose and non‐glucose induced beta cell secretion was improved. There was no difference in responses to sitagliptin between 1 and 12 weeks of treatment.
Pharmacokinetics following continuous subcutaneous insulin infusion of insulin aspart with or without initial subcutaneous bolus
Authors: Petersen S. B. , Kildegaard J. , Nielsen F. S. , Søndergaard E. , Parkner T. , Laursen T. , Lauritzen T. , Skyggebjerg O. , Christiansen J. S.
Published: November 2009

Aim: To evaluate time to steady state insulin concentration (Css) following continuous subcutaneous insulin infusion (CSII) of insulin aspart (IAsp) with or without an initial s.c. bolus.

Methods: In random order 10 healthy volunteers were given a basal insulin infusion rate (0.5 U/h) for 8 h with or without an initial s.c. bolus (1.4 U). Serum IAsp was measured until 3 h after infusion was stopped.

Results: An overshoot of IAsp was seen before Css was achieved following an initial bolus of insulin as compared to no bolus. The apparent half‐life (t½) with or without bolus did not differ (p = 0.15). Time to steady state (Tss) was evaluated in two ways: (1) Tss defined as the first point within an interval of Css± 2 × CV was 233 vs. 166 min with and without a bolus respectively (p = 0.068). (2) A t‐test was performed for each concentration‐time point vs. mean Css, and the first point with no significance was defined, Tss. This gave 208 (p = 0.09) and 178 min (p = 0.24) with and without bolus respectively. Mathematical modelling suggests that an ideal mean bolus should be 0.89 U, and that this bolus dose may result in a shorter Tss.

Conclusion: A bolus of 1.4 U resulted in an overshoot of serum IAsp before Css and a longer period before Css is achieved. Mathematical modelling suggests that a mean bolus of 0.89 U would result in a faster achievement of Css compared to no bolus
Leptin‐based glycopeptide induces weight loss and simultaneously restores fertility in animal models
Authors: Kovalszky I. , Surmacz E. , Scolaro L. , Cassone M. , Ferla R. , Sztodola A. , Olah J. , Hatfield M. P. D. , Lovas S. , Otvos L.
Published: November 2009

Aim: To design, manufacture and test a second generation leptin receptor (ObR) agonist glycopeptide derivative. The major drawback to current experimental therapies involving leptin protein is the appearance of treatment resistance. Our novel peptidomimetic was tested for efficacy and lack of resistance induction in rodent models of obesity and appetite reduction.

Methods: The glycopeptide containing two additional non‐proteinogenic amino acids was synthesized by standard solid‐phase methods. Normal mice were fed with peanuts until their blood laboratory data and liver histology showed typical signs of obesity but not diabetes. The mice were treated with the peptidomimetic at 0.02, 0.1 or 0.5 mg/kg/day intraperitoneally side‐by‐side with 0.1 mg/kg/day leptin for 11 days. After termination of the assay, the blood cholesterol and glucose amounts were measured, the liver fat content was visualized and quantified and the remaining mice returned to normal diet and were allowed to mate. In parallel experiments normal rats were treated intranasally with the glycopeptide at 0.1 mg/kg/day for 10 days.

Results: The 12‐residue glycosylated leptin‐based peptidomimetic E1/6‐amino‐hexanoic acid (Aca) was designed to target a principal leptin/ObR‐binding interface. E1/Aca induced leptin effects in ObR‐positive cell lines at picomolar concentrations and readily crossed the blood‐brain barrier (BBB) following intraperitoneal administration. The peptide initiated typical leptin‐dependent signal transduction pathways both in the presence and absence of leptin protein. The peptide also reduced weight gain in mice fed with high‐fat peanut diet in a dose‐dependent manner. Obese mice receiving peptide E1/Aca at a 0.5 mg/kg/day dose lost weight, corresponding to a net 6.5% total body weight loss, while similar mice treated with leptin protein did not. Upon cessation of the weight loss treatment, several obesity‐related pathologies (i.e. abnormal metabolic profile and liver histology as well as infertility) normalized in peptide‐, but not leptin‐treated, mice. Peptide E1/Aca added intranasally to growing normal rats decelerated normal weight gain corresponding to a net 6.8% net total body weight loss with statistical significance.

Conclusions: No resistance induction to peptide E1/Aca or toxicity in either obese or healthy rodents was observed, indicating the potential for widespread utility of the peptidomimetic in the treatment of leptin‐deficiency disorders. We provide additional proof for the hypothesis that difficulties in current leptin therapies reside at the BBB penetration stage, and we document that by either glycosylation or intranasal peptide administration we can overcome this limitation.
Bariatric surgery vs. advanced practice medical management in the treatment of type 2 diabetes mellitus: rationale and design of the Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently trial (STAMPEDE)
Authors: Kashyap Sangeeta R. , Bhatt Deepak L. , Schauer Philip R. ,   on behalf of the STAMPEDE Investigators, Cleveland Clinic, OH
Published: November 2009

Obesity and Type 2 diabetes mellitus (T2DM) are closely interrelated, and are two of the most common chronic, debilitating diseases worldwide. Surgical approaches to weight loss (bariatric surgery) result in marked improvement of T2DM, however randomized trials directly comparing the efficacy of surgical and medical approaches are lacking. The Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial was designed to evaluate the efficacy of two bariatric surgery procedures involving gastric restriction only (laparascopic sleeve gastrectomy) and gastric bypass (Roux‐en‐Y) to advanced medical therapy in patients with T2DM with modest obesity with BMI of 27–42 kg/m2. This single site, prospective, randomized controlled trial will enroll 150 subjects who will be followed. The primary end point will be the rate of biochemical resolution of T2DM at 1 year as measured by HbA1c < 6%. The safety and adverse event rates will also be compared between the three arms of the study.
Efficacy and safety of sitagliptin when added to insulin therapy in patients with type 2 diabetes
Authors: Vilsbøll T. , Rosenstock J. , Yki‐Järvinen H. , Cefalu W. T. , Chen Y. , Luo E. , Musser B. , Andryuk P. J. , Ling Y. , Kaufman K. D. , Amatruda J. M. , Engel S. S. , Katz L.
Published: November 2009

Objective: To evaluate the efficacy and tolerability of sitagliptin when added to insulin therapy alone or in combination with metformin in patients with type 2 diabetes.

Methods: After a 2 week placebo run‐in period, eligible patients inadequately controlled on long‐acting, intermediate‐acting or premixed insulin (HbA1c ≥ 7.5% and ≤ 11%), were randomised 1:1 to the addition of once‐daily sitagliptin 100 mg or matching placebo over a 24‐week study period. The study capped the proportion of randomised patients on insulin plus metformin at 75%. Further, the study capped the proportion of randomised patients on premixed insulin at 25%. The metformin dose and the insulin dose were to remain stable throughout the study. The primary endpoint was HbA1c change from baseline at week 24.

Results: Mean baseline characteristics were similar between the sitagliptin (n = 322) and placebo (n = 319) groups, including HbA1c (8.7 vs. 8.6%), diabetes duration (13 vs. 12 years), body mass index (31.4 vs. 31.4 kg/m2), and total daily insulin dose (51 vs. 52 IU), respectively. At 24 weeks, the addition of sitagliptin significantly (p < 0.001) reduced HbA1c by 0.6% compared with placebo (0.0%). A greater proportion of patients achieved an HbA1c level < 7% while randomised to sitagliptin as compared with placebo (13 vs. 5% respectively; p < 0.001). Similar HbA1c reductions were observed in the patient strata defined by insulin type (long‐acting and intermediate‐acting insulins or premixed insulins) and by baseline metformin treatment. The addition of sitagliptin significantly (p < 0.001) reduced fasting plasma glucose by 15.0 mg/dl (0.8 mmol/l) and 2‐h postmeal glucose by 36.1 mg/dl (2.0 mmol/l) relative to placebo. A higher incidence of adverse experiences was reported with sitagliptin (52%) compared with placebo (43%), due mainly to the increased incidence of hypoglycaemia (sitagliptin, 16% vs. placebo, 8%). The number of hypoglycaemic events meeting the protocol‐specified criteria for severity was low with sitagliptin (n = 2) and placebo (n = 1). No significant change from baseline in body weight was observed in either group.

Conclusion: In this 24‐week study, the addition of sitagliptin to ongoing, stable‐dose insulin therapy with or without concomitant metformin improved glycaemic control and was generally well tolerated in patients with type 2 diabetes.
Moderate caloric restriction during gestation results in lower arcuate nucleus NPY‐ andαMSH‐neurons and impairs hypothalamic response to fed/fasting conditions in weaned rats
Authors: García A. P. , Palou M. , Priego T. , Sánchez J. , Palou A. , Picó C.
Published: November 2009

Aim:We aimed to characterize the developmental programming effects of moderate caloric restriction during early pregnancy on factors involved in hypothalamic control of energy balance.

Methods:Twenty‐five‐days‐old offspring Wistar rats from 20% caloric restricted dams (from 1 to 12 days of pregnancy) (CR) and from control dams were studied under fed and 12 h fasting conditions. Morphometric studies on arcuate nucleus (ARC) and determinations of circulating parameters and hypothalamic levels of neuropeptide Y (NPY), proopiomelanocortin (POMC), long‐form leptin receptor (ObRb), insulin receptor (InsR) and suppressor of cytokine signalling‐3 (SOCS‐3) mRNA were performed.

Results:CR animals did not show different body weight with respect to their controls, but presented higher food intake. They exhibited lower neuropeptide Y‐ andα‐melanocyte‐stimulating hormone‐neurons (decreases of 18 and 13% in males, and 10 and 18% in females respectively) and lower total cells (decrease of 3% in males and 18% in females) in ARC. Under fed conditions, CR animals presented lower circulating leptin and ghrelin levels (decreases of 37 and 43% in males, and 15 and 34% in females respectively); furthermore, hypothalamic POMC, NPY (only in females), ObRb and InsR mRNA levels were reduced (39, 16 and 26% in males, and 112, 33, 61 and 56% in females), and those of SOCS‐3 were increased (86% in males and 74% in females). Unlike control animals, under fasting conditions, ObRb, InsR and POMC mRNA levels did not decrease in CR females, and NPY mRNA decreased instead of increase in CR males.

Conclusions:Moderate caloric restriction during gestation affects offspring hypothalamic structure and function, impairing its response to fed/fasting conditions, which suggests a predisposition to insulin and leptin resistance.
Visioning New Modes of Integrated and Shared Schooling in Northern Ireland
Authors: MCALEAVY GERRY , DONEGAN TONY , O'HAGAN CELIA
Published: November 2009

Planning for shared schooling in Northern Ireland requires a re‐consideration of the decision‐making processes that underpin the choices made by parents and a re‐thinking of the nature and purpose of alternative modes of educating young people from the different communities together. The article provides evidence that demand for existing integrated schools in Northern Ireland is growing at a rapid rate and that there is a need to ensure that school places are provided where demand exists. Given recent developments in Scotland, however, in relation to shared schools, it is suggested that new approaches may involve examining the application of this policy to Northern Ireland and, also, opening debate concerning the potential for further development of new forms of shared schooling. These new possibilities offer opportunities to enable young people to encounter a broader range of peers and experience more diverse cultures while retaining the support of the current Controlled (Protestant) and Maintained (Catholic) sectors. The fraught journey towards integrated education in a divided society has implications for European societies where religious belief, intertwined with ethnicity, has been implicated in communal discord and conflict.
European Schoolnet: enabling school networking
Authors: SCIMECA SANTI , DUMITRU PETRU , DURANDO MARC , GILLERAN ANNE , JOYCE ALEXA , VUORIKARI RIINA
Published: November 2009

School networking is increasingly important in a globalised world, where schools themselves can be actors on an international stage. This article builds on the activities and experience of the longest established European initiative in this area, European Schoolnet (EUN), a network of 31 Ministries of Education. First, we offer an introduction covering school networks. We then describe the case of European Schoolnet, its history, role, and relationship with other school networks in the world. We then describe the underlying structure of EUN school networks and their basic characteristics. Using these basic characteristics as a framework, we consider a number of eTwinning, European Schoolnet networks: Network of Innovative Schools (ENIS) and myEUROPE. Last, we identify key features of network literacy, potential future trends in school networks, and areas where further research is needed in this field, and offer some recommendations.
Networking School Teachers to Promote Better Practice in the Teaching of Science across Europe
Authors: GATT SUZANNE ,   MANUEL FILIPE PEREIRA CUNHA MARTINS COSTA
Published: November 2009

Teachers are often confined to their classrooms with limited or no time to share with colleagues the difficulties they face, their concerns, and their successful initiatives. This leads to a situation where they end up teaching in ways and approaches they believe to be best with no chance to know how others may be approaching similar difficulties in different and potentially more effective ways. Teachers do not have the opportunity to share and collaborate on projects with other education professionals, as their daily routine confines them to their school premises. This article discusses how the Comenius 3 project ‘Hands on Science’ has helped to create a network through which regular meetings in the forms of conferences on science for teachers were and are still organised to promote good practice in science teaching. The method used for connecting so many teachers across Europe was through key persons strategically chosen across the different partner countries. The conferences organised by the network differed from academic conferences in that they provided a platform for teachers to share their successes in teaching different aspects of science, particularly through the promotion of the use of experiments and other hands on approaches.
Better Schools through Health: networking for health promoting schools in Europe
Authors: BUIJS GOOF J.
Published: November 2009

Education and health have shared interests. Unifying these allows schools to become better places to enjoy learning, teaching and working. Health promoting schools have shown evidence of improving the health and well‐being of the whole school community. At the European level, the Schools for Health in Europe (SHE) network is one of the most sustainable school networks in Europe and worldwide.

This article explains how health helps to create better schools. It focuses on the advantages of working as a network at a European level with direct links with schools, policy makers, practitioners and researchers. It describes the impact of networking on schools, what changes take place at the school level, and also at the regional and national level. The SHE strategic plan, which is a roadmap for the future development of the network until 2012, is summarised. Some examples of the results of networking are presented, including the work on developing indicators for health promoting schools within the European context.

The article concludes with a report of the 3rd European Conference on health promoting schools held in June 2009 in Lithuania, with the Vilnius Resolution as its important outcome.
648. NERINE HUMILIS
Authors: Duncan Graham
Published: November 2009

The history, taxonomy, distribution and cultivation requirements of the South African Nerine humilis (Jacq.) Herb. are discussed; a full botanical description, illustration, habitat photograph, and distribution map are provided.
649. LACHENALIA CONGESTA
Authors: Duncan Graham
Published: November 2009

Lachenalia congestaW.F. Barker is a hardy native of the Roggeveld Escarpment in the western Great Karoo, South Africa. Details of its history, taxonomy, ecology, distribution, pollination, seed‐dispersal and cultivation are given, together with an illustration, distribution map and habitat photograph.
651. CYNORKIS GIGAS
Authors: Hermans Johan
Published: November 2009

The history, taxonomy, habitat and cultivation of Cynorkis gigas Schlechter from Madagascar are discussed. A description is included.
652. BENZINGIA REICHENBACHIANA
Authors: Pupulin Franco
Published: November 2009

Benzingia reichenbachiana (Schltr.) Dressler, a pendent epiphyte ranging from Costa Rica to northern Colombia, is described and illustrated. Notes on its phylogenetic affinities, ecology, pollination, and cultural requirements are provided.
653. IRIS ZAGRICA
Authors: Mathew Brian , Zarrei Mehdi
Published: November 2009

Iris zagrica Mathew and Zarrei, a member of subgenus Hermodactyloides, is illustrated. Its relationship with other members of this assemblage of bulbous irises, notably I. reticulata M. Bieb., is discussed.
655. SCHIMA SINENSIS
Authors: McNamara William A.
Published: November 2009

Schima sinensis (Hemsl. & E.H. Wilson) Airy Shaw is described and illustrated. The genus Schima is discussed. Five recent collections of Schima species are reviewed.
656. TWO NEW SPECIES OF SAINTPAULIA FROM THE ULUGURU MOUNTAINS, TANZANIA
Authors: Haston Elspeth M. , Mejissa John , Watkins Colin
Published: November 2009

Two new endemic species of Saintpaulia, S. ulugurensis Haston and S. watkinsii Haston (Gesneriaceae) are described from the Uluguru Mountains. Their discovery emphasises the need for additional floristic work to be carried out in this area and supports the calls for strong conservation measures for the fragile forest habitats of Tanzania.
The fractal yam: botanical imagery and human agency in the Trobriands
Authors: Mosko Mark S.
Published: November 2009

Anthropologists have long appreciated that animals are ‘good to think’. In this essay I ponder whether plants might be good to think too, and particularly whether there is any sense in asking if plants (along with animals) might also be ‘good to act’. The botanical metaphor of ‘base’, ‘body’, and ‘tip’ animates the origin structures of many if not most societies of the Austronesian world. Less attention has been directed at indigenous elaborations in other socio‐cultural domains of the region. Based on recent fieldwork, I outline such ramifications in Trobriand culture, drawing upon the notions of fractal recursion and self‐similarity from chaos theory wherein emergent ‘tips’ yield ‘fruit’ which become the condition or ‘base’ for further production and transformation. Accordingly, the base‐body‐tip‐fruit metaphor serves as a cultural template or scenario for social action, shedding new interpretative light on many topics of long‐standing anthropological interest (e.g. yam propagation, display, and exchange, kula, mortuary celebration, age categories, fame) as well as more recent theoretical interests.

Les anthropologues ont compris il y a longtemps déjà que les animaux sont « bons à penser ». Dans cet essai, l’auteur se demande si les plantes sont elles aussi bonnes à penser, et en particulier s’il vaut la peine de se demander si les plantes (comme les animaux) pourraient être « bonnes à agir ». La métaphore botanique de « base », « corps » et « tête » anime les structures originelles de beaucoup de sociétés du monde austronésien, sinon toutes. On s’est moins intéressé aux élaborations indigènes de la région dans d’autres domaines socioculturels. Sur la base d’un récent travail de terrain, l’auteur retrace ces ramifications dans la culture trobriandaise, utilisant les notions de récursivité fractale et d’autosimilitude de la théorie du chaos, selon lesquelles les « têtes » donnent des « fruits » qui deviennent la condition ou « base » d’une nouvelle production et transformation. En conséquence, la métaphore base‐corps‐tête‐fruit sert de modèle culturel ou de scénario d’action sociale, jetant un nouvel éclairage interprétatif sur de nombreux sujets qui intéressent depuis longtemps les anthropologues (tels que la propagation, la présentation et l’échange des ignames, la kula, les célébrations mortuaires, les classes d’âge, la renommée), mais aussi sur de nouvelles questions théoriques plus récentes.
Shamanism and ritual in South America: an inquiry into Amerindian shape‐shifting
Authors: Praet Istvan
Published: November 2009

Using ethnographic material on the Chachi, an Amerindian group in Northwest Ecuador, this article attempts to develop a renewed understanding of shamanism and ritual among so‐called ‘indigenous peoples’ in South America, in both lowland and highland areas. I show that the human domain and that of spirits are always equivalent. It is also suggested that shamanic curing and many other forms of ritual can fruitfully be understood as instances of metamorphosis. In order to explore this argument I develop the notion of ‘shape‐shifting’.

Utilisant des matériaux ethnographiques sur les Chachi, groupe amérindien de la côte pacifique équatorienne, cet article tente de développer une compréhension renouvelée du chamanisme et des rituels des peuples indigènes de l’Amérique du Sud, à la fois dans les basses terres et dans les Andes. L’auteur explique pourquoi le domaine de l’humain et celui des esprits sont toujours équivalents. Il suggère ensuite que l’on gagne à comprendre les thérapies chamaniques et beaucoup d’autres formes rituelles comme des faits de métamorphose. Pour étayer cet argument, il développe la notion de « changement de forme ».
From ‘impregnation’ to ‘attunement’: a sensory view of how magic works
Authors: Novellino Dario
Published: November 2009

Anthropological theories of magic make several claims about the contagious transfer of attributes from object to object and object to person through ‘impregnation’, ‘absorption’, and ‘penetration’. This article argues that such notions, which emphasize violation of physical space and ontological boundaries, are often incongruent with emic perspectives. For the Batak of Palawan, ‘magical efficacy’ in rituals is achieved by attuning the properties of objects, powerful words, sounds, and gestures to other sensory qualities of the environment, in relation to a wider spatio‐temporal dimension. Operating from these general premises, I introduce the analytical concept of tool‐sign(s); these are vehicles of both cross‐ontological communication and action on the material world. This notion sheds new light on long‐standing debates about the look and logic of magic.

Les études anthropologiques de la magie évoquent à maintes reprises un transfert de caractère contagieux des attributs d’un objet à un autre ou d’un objet à une personne par « imprégnation », « absorption » ou « pénétration ». L’auteur avance que ces notions, qui mettent l’accent sur une violation de l’espace physique et des frontières ontologiques, ne concordent pas souvent avec les points de vue émiques. Pour les Bataks du Palawan, « l’efficacité magique » des rituels est obtenue en accordant les propriétés des objets, des mots, sons et gestes de puissance aux autres qualités sensorielles de l’environnement, en lien avec une dimension spatiotemporelle plus large. Sur cette base générale, l’article introduit le concept analytique de signe(s)‐outil(s) : il s’agit de véhicules de communication inter‐ontologique aussi bien que d’action sur le monde matériel. Cette notion jette un nouvel éclairage sur les débats de longue date concernant l’aspect et la logique de la magie.
Raising the roof in the transnational Andes: building houses, forging kinship
Authors: Leinaweaver Jessaca B.
Published: November 2009

Transnational migration transforms houses, the rituals surrounding them, and the people who live in those houses and use them to understand aspects of their social and ethnic identities. I focus on the Andean house‐roofing ritual known as the zafacasa to demonstrate the centrality of the house as a mediator for personal relationships, and the importance of such rituals for reconstituting social bonds both in spite of and because of distance. The article goes on to argue that research on consumption should be complemented by a kinship framework in order fully to represent the local meanings of expenditures.

La migration transnationale transforme les maisons, les rituels qui les entourent et les gens qui les habitent et les utilisent pour saisir certains aspects de leur identité sociale et ethnique. L’auteur s’intéresse au rituel de pose de toit andin connu sous le nom de zafacasa pour démontrer le rôle central de la maison en tant que médiateur de relations personnelles et l’importance de ces rituels pour la reconstitution de liens sociaux malgré, et à cause de, la distance. L’article avance qu’il serait utile d’ajouter aux recherches sur la consommation un cadre concernant la parenté, afin d’appréhender de façon plus complète la signification locale des dépenses.
Playful places, serious times: young women migrants from a peri‐urban settlement, Zimbabwe
Authors: Adams Mary
Published: November 2009

This article builds on recent anthropologies of youth and childhood in contemporary Africa to incorporate perspectives on gender, age, maturation, and life course, particularly as these engage a politics of place and historically specific experiences of emplacement. The ethnography focuses on events surrounding teenage girls' involvement in city work and travel in the peri‐urban areas of Harare, Zimbabwe, at a time when women's bodies and behaviours were the focus of renewed attempts to reform urban domesticities and when young women's urban activities were becoming crucial to peri‐urban household survival. In this context the risks and upheavals of youthfulness become a shared, intergenerational concern with social continuity: young women came to be seen as compliant rebels, involved in marginal, ‘playful’, and vital work that might secure threatened futures. The ethnography thus questions the often assumed equation of youthfulness or youth projects with socio‐cultural transformation.

Le présent article s’appuie sur les travaux anthropologiques récents consacrés à la jeunesse et à l’enfance dans l’Afrique contemporaine pour y intégrer un point de vue sur le sexe, l’âge, la maturation et la destinée, en particulier lorsque ceux‐ci sont liés à une politique des lieux et à des expériences historiquement spécifiques de l’emplacement. L’ethnographie est consacrée à des événements entourant l’engagement d’adolescentes zimbabwéennes dans le travail et les déplacements en ville, dans les quartiers périurbains d’Harare, à une époque où le corps et le comportement des femmes faisaient l’objet de nouvelle tentatives de réformer la sphère domestique et où les activités urbaines des jeunes femmes devenaient indispensables à la survie des ménages périurbains. Dans ce contexte, les risques et les bouleversements de la jeunesse deviennent une préoccupation partagée entre les générations, avec une constante sociale : les jeunes femmes sont finalement considérées comme des rebelles dociles, engagées dans un travail marginal, « ludique » et vital, susceptible de sécuriser des avenirs menacés. L’ethnographie remet donc en question la corrélation souvent implicite de la juvénilité ou des projets des jeunes avec les transformations socioculturelles.