bluuebunny/crossref_metadata_2025 huggingface dataset:
Postprandial hypoglycaemia after Roux‐en‐Y gastric bypass and the effects of acarbose, sitagliptin, verapamil, liraglutide and pasireotide
Authors: Øhrstrøm Caroline Christfort , Worm Dorte , Højager Anna , Andersen Ditte , Holst Jens Juul , Kielgast Urd Lynge , Hansen Dorte Lindqvist
Published: May 2019

Aim

To investigate the effects of acarbose, sitagliptin, verapamil, liraglutide and pasireotide on post‐bariatric hypoglycaemia (PBH) after Roux‐en‐Y gastric bypass.

Materials and methods

In a randomized crossover study, 11 women who had undergone Roux‐en‐Y gastric bypass and had documented hypoglycaemia were each evaluated during a baseline period without treatment and during five treatment periods with the following interventions: acarbose 50 mg for 1 week, sitagliptin 100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1.2 mg for 3 weeks and pasireotide 300 μg as a single dose. Treatment effects were evaluated by a mixed‐meal tolerance test (MMTT) and, for all treatment periods except pasireotide, by 6 days of continuous glucose monitoring (CGM).

Results

Treatment with acarbose and treatment with pasireotide both significantly lifted nadir glucose levels (mean ± SEM 3.9 ± 0.2 and 7.9 ± 0.4 vs 3.4 ± 0.2; P < .03) and reduced time in hypoglycaemia during the MMTTs. Acarbose reduced peak glucose levels and time in hyperglycaemia, whereas pasireotide greatly increased both variables. Acarbose and pasireotide reduced insulin and C‐peptide levels, and pasireotide also diminished glucagon‐like peptide‐1 levels. Sitagliptin lowered nadir glucose values, while verapamil and liraglutide had no effect on hypoglycaemia. During the CGM periods, the treatments had no impact on hypoglycaemia, whereas acarbose and liraglutide reduced hyperglycaemia and glycaemic variability.

Conclusions

In an experimental setting, treatment with acarbose and pasireotide reduced PBH. Acarbose appears to have an overall glucose‐stabilizing effect, whereas pasireotide leads to increased and sustained hyperglycaemia.
Use of fast‐acting insulin aspart in insulin pump therapy in clinical practice
Authors: Evans Mark , Ceriello Antonio , Danne Thomas , De Block Christophe , DeVries J. Hans , Lind Marcus , Mathieu Chantal , Nørgaard Kirsten , Renard Eric , Wilmot Emma G.
Published: May 2019

Fast‐acting insulin aspart (faster aspart) is a novel formulation of insulin aspart (IAsp) containing the additional excipients niacinamide and L‐arginine. The improved pharmacological profile and greater early glucose‐lowering action of faster aspart compared with IAsp suggests that faster aspart may be advantageous for people with diabetes using continuous subcutaneous insulin infusion (CSII). The recent onset 5 trial was the first to evaluate the efficacy and safety of an ultra‐fast‐acting insulin in CSII therapy in a large number of participants with type 1 diabetes (T1D). Non‐inferiority of faster aspart to IAsp in terms of change from baseline in HbA1c was confirmed, with an estimated treatment difference (ETD) of 0.09% (95% CI, 0.01; 0.17; P < 0.001 for non‐inferiority [0.4% margin]). Faster aspart was superior to IAsp in terms of change from baseline in 1‐hour post‐prandial glucose (PPG) increment after a meal test (ETD [95% CI], −0.91 mmol/L [−1.43; −0.39]; P = 0.001), with statistically significant improvements also at 30 minutes and 2 hours. The overall rate of severe or blood glucose‐confirmed hypoglycaemia was not statistically significantly different between treatments, with an estimated rate ratio of 1.00 (95% CI, 0.85; 1.16). A numerical imbalance in severe hypoglycaemic episodes between faster aspart and IAsp was seen in the treatment (21 vs 7) and the 4‐week run‐in periods (4 vs 0). Experience from clinical practice indicates that all pump settings should be reviewed when initiating faster aspart with CSII, and that the use of continuous glucose monitoring or flash glucose monitoring, along with a good understanding of meal content and bolus type, may also facilitate optimal use. This review summarizes the available clinical evidence for faster aspart administered via CSII and highlights practical considerations based on clinical experience that may help healthcare providers and individuals with T1D successfully initiate and adjust faster aspart with CSII.
Inter‐individual variation in honey bee dance intensity correlates with expression of the foraging gene
Authors: George Ebi A. , Bröger Ann‐Kathrin , Thamm Markus , Brockmann Axel , Scheiner Ricarda
Published: May 2019

Individual behavioural differences in responding to the same stimuli is an integral part of division of labour in eusocial insect colonies. Amongst honey bee nectar foragers, individuals strongly differ in their sucrose responsiveness, which correlates with strong differences in behavioural decisions. In this study, we explored whether the mechanisms underlying the regulation of foraging are linked to inter‐individual differences in the waggle dance activity of honey bee foragers. We first quantified the variation in dance activity amongst groups of foragers visiting an artificial feeder filled consecutively with different sucrose concentrations. We then determined, for these foragers, the sucrose responsiveness and the brain expression levels of three genes associated with food search and foraging; the foraging gene Amfor, octopamine receptor gene AmoctαR1 and insulin receptor AmInR‐2. As expected, foragers showed large inter‐individual differences in their dance activity, irrespective of the reward offered at the feeder. The sucrose responsiveness correlated positively with the intensity of the dance activity at the higher reward condition, with the more responsive foragers having a higher intensity of dancing. Out of the three genes tested, Amfor expression significantly correlated with dance activity, with more active dancers having lower expression levels. Our results show that dance and foraging behaviour in honey bees have similar mechanistic underpinnings and supports the hypothesis that the social communication behaviour of honey bees might have evolved by co‐opting behavioural modules involved in food search and foraging in solitary insects.
The role of chief executive tenure for public organizations' hiring of management consultants
Authors: Pemer Frida , Börjeson Love , Werr Andreas
Published: May 2019

Public organizations increasingly rely on management consultants to access expertise, impose reforms, and drive organizational change, and spend large sums each year on their services. Despite this, we know little about the antecedents of public organizations' use of management consulting services. Drawing on upper echelon theory, a longitudinal hypothesis‐testing study of the hiring of management consultants in 72 Swedish public organizations, and interviews with Swedish chief executives (CEs), we find an inverted U‐shaped relationship between CE tenure and public organizations' use of management consulting services. We also find that this relationship is moderated by CEs' previous experience and managerial discretion. These findings contribute to theorizing on the use of management consulting services and the influence of CEs in public organizations.
Optimizing patient flow in a multidisciplinary haemophilia clinic using quality improvement methodology
Authors: Drayton Jackson Meghan , Bartman Thomas , McGinniss Jessica , Widener Pamela , Dunn Amy L.
Published: May 2019

Introduction

Multidisciplinary clinics in academic settings are often inefficient and can lead to lengthy clinic visits for patients and staff.

Aim

We aimed to use quality improvement (QI) methodology and a multidisciplinary approach to optimize outpatient comprehensive haemophilia clinic flow.

Methods

At baseline, a multidisciplinary QI team created a key driver diagram to identify drivers of haemophilia clinic flow. Identified drivers included patient needs/scheduling, provider flow and laboratory/research requirements. From December 2016 to August 2017, value stream mapping (VSM) was used to identify barriers to clinic flow, and plan–do–study–act cycles were used to address these barriers. Interventions included (a) standardizing the order in which providers saw patients to enable time‐sensitive laboratories, (b) improving HTC team meeting functionality, (c) optimizing a visual management board and implementing a flow coordinator, (d) initiating a team huddle prior to clinic start and (e) modifying the clinic appointment template. Timely laboratory draw was used as a surrogate marker of clinic flow, and VSM utilization percentage was used as an objective measure of efficiency.

Results

We did not demonstrate a statistically significant improvement in timed laboratory draws; however, clinic utilization percentage increased by 30%, which resulted in adding point‐of‐care musculoskeletal ultrasound services without lengthening clinic duration.

Conclusion

Quality improvement methodology is an effective means of improving clinic utilization in a multidisciplinary clinic.
Autotaxin is a valuable biomarker for the prediction of liver fibrosis in patients with non‐alcoholic fatty liver disease
Authors: Honda Yasushi , Imajo Kento , Kobayashi Takashi , Kessoku Takaomi , Ogawa Yuji , Tomeno Wataru , Yoneda Masato , Kobayashi Noritoshi , Saito Satoru , Nakajima Atsushi
Published: May 2019

Aim

We investigated the characteristics of serum autotaxin (ATX) and its diagnostic performance for liver fibrosis in a large cohort of patients with non‐alcoholic fatty liver disease (NAFLD).

Methods

We compared the usefulness of ATX and other fibrosis markers in 307 biopsy‐confirmed NAFLD patients. In addition, in 145 participants with NAFLD, we compared the diagnostic performance of ATX with that of non‐invasive imaging methods (vibration‐controlled transient elastography and magnetic resonance elastography [MRE]).

Results

Serum ATX concentration was significantly correlated with fibrosis stage in male and female NAFLD patients. In male patients, the area under the receiver operating characteristic (AUROC) curve values of ATX for the diagnosis of ≥stage 1, ≥stage 2, ≥stage 3, and ≥stage 4 fibrosis were 0.65, 0.75, 0.81, and 0.95, respectively. In female NAFLD participants, the AUROC values were all >0.81. The sensitivity of ATX was highest for the diagnosis of ≥stage 2 and ≥stage 3 fibrosis in both men and women with NAFLD. In the comparison between ATX and non‐invasive imaging methods, the AUROC for MRE was the highest at every stage of fibrosis.

Conclusions

Serum ATX concentration is significantly correlated with fibrosis stage in NAFLD patients. The diagnostic accuracy of ATX for liver fibrosis is lower than that of MRE, but the sensitivities of ATX for the diagnosis of ≥stage 2 and ≥stage 3 were highest. We conclude that ATX is useful for the selection of patients requiring further evaluation for liver fibrosis.
The currency of power in late Anglo‐Saxon England
Authors: Naismith Rory
Published: May 2019

England between the early 970s and 1066 had a remarkable monetary system, consisting of silver pennies of standardised type which were reminted frequently. Each penny carried the name of the individual responsible for its manufacture and identified where he was based. This formidable currency came about thanks to unique conditions in the late 10th and early 11th centuries. An initial reform by Edgar was followed by a rapid sequence of recoinages under his son Æthelred II, which constituted one means of asserting morally responsible governance in the face of perceived divine displeasure. It follows that the chronology and motivation behind the coinage need to be seen as products of central, courtly developments. Actual minting, however, was a matter of individual moneyers dealing with individual customers. Here, it is argued that moneyers and mint‐places need to be seen as part of the wider landscape of formal and informal social power, and that production of coin generally came about through networks of lordship and authority. Integration of the moneyers (typically drawn from the lower elite) across England into centrally controlled mechanisms such as the coinage was one of the underpinning strengths of the late Anglo‐Saxon kingdom, linking different forms of power and giving a large swathe of the political community a stake in the realm's institutions.
The place of geography in lesbian history
Authors: Millward Liz
Published: May 2019

Lesbian history has undergone several paradigm shifts in recent decades. Historians draw on the theoretical and methodological approaches taken in other disciplines as part of their interest in remaining accountable to the present‐day community. Lesbian geographies, part of the geographies of sexualities field, offer a valuable way to consider the role of place and space in lesbians' lives in the past. It also suggests that an intersectional approach can aid in demonstrating the ongoing value of lesbian history to current struggles.
Crystallisation of palm olein under the influence of sucrose esters
Authors: Tangsanthatkun Janjira , Sonwai Sopark
Published: May 2019

This work studied the effects of three sucrose esters (S170, P170 and L195) on the crystallisation of palm olein (PO). The effect of the emulsifiers on the crystallisation behaviour, crystallisation curves, microstructure and polymorphism was investigated. Both S170 and P170 accelerated the early stages, via template effects, but suppressed the later stages of PO crystallisation. The effect on the latter stages was stronger with P170 than S170. In contrast, L195 suppressed PO crystallisation at all time points. Through DSC, S170 and P170 only associated with the high‐melting fraction of PO whereas L195 showed little influence. All SEs exhibited no effect on polymorphism. S170 and P170 greatly reduced PO crystal size but increased crystal number while the L195 increased the crystal size but decreased the crystal number especially at low concentration. Overall, S170, P170 and L195 influence PO crystallisation kinetics but the effect was dependent on the emulsifier concentration.
Suplatast tosilate in patients with interstitial cystitis: Efficacy and treatment possibilities, with suggestions for future assessments
Authors: Ueda Tomohiro , Homma Yukio , Yoshimura Naoki
Published: May 2019

Objective

Suplatast tosilate, a Th2 cytokine inhibitor, was predicted to relieve interstitial cystitis symptoms. Four studies with suplatast tosilate in Japanese interstitial cystitis patients have been conducted: a single‐arm clinical study, a phase II dose‐ranging trial, a phase III trial with placebo, and a second phase PIII trial with placebo. Treatment efficacy was observed in the first two studies; however, in the phase PIII trials, no significant difference in interstitial cystitis symptom score changes was observed between suplatast tosilate and placebo. We summarized these four studies to investigate factors causing the difference in observed efficacy.

Methods

Placebo effects in the first two studies and differences regarding study design between the four studies were considered to be possible factors. Therefore, placebo effects were investigated by comparing interstitial cystitis symptom score changes, and the study designs were compared to investigate the effects on observed efficacy.

Results

Interstitial cystitis symptom score changes in the phase PII treatment groups increased in a dose‐dependent manner and showed an almost linear relationship with interstitial cystitis symptom score changes observed in placebo groups of 2 phase PIII studies. A major difference regarding the phase PIII study design was the use of diagnostic hydrodistention. Diagnostic hydrodistention and its washout period were applied only in the phase PIII trials.

Conclusions

Comparison of interstitial cystitis symptom score changes suggested that the placebo effect was very small. Use of diagnostic hydrodistention was considered to be a major difference in the population characteristics of the studies and may have resulted in different observed efficacies. Diagnostic hydrodistention, which potentially influences the treatment effect, is probably not essential for trials of suplatast in interstitial cystitis patients.
Interstitial cystitis, bladder pain syndrome, hypersensitive bladder, and interstitial cystitis/bladder pain syndrome – clarification of definitions and relationships
Authors: Homma Yukio
Published: May 2019

Interstitial cystitis and interstitial cystitis‐related conditions such as bladder pain syndrome and hypersensitive bladder have a similar symptomatic profile but probably different etiologies. A meaningful classification of these diseases/conditions is mandatory for clinical and investigational progress. The condition with Hunner lesions (Hunner type interstitial cystitis) is distinct from other categories in terms of histopathology, gene expression, and clinical management. Classification should clearly differentiate the presence or absence of Hunner lesions. The term covering patients as a whole should contain interstitial cystitis, since interstitial cystitis is historically a well‐known name and used for insurance reimbursement. The proposed taxonomy features an umbrella term (interstitial cystitis/bladder pain syndrome) and two subgroups, Hunner type interstitial cystitis (with Hunner lesions) and bladder pain syndrome (without Hunner lesions). Interstitial cystitis/bladder pain syndrome is convenient for initial management, and subgroups can categorize the patients for specific management. The characteristic symptom profile is to be collectively termed as hypersensitive bladder symptoms.
Minimally invasive device for intravesical instillation by urological syringe adapter (MID‐ii U.S.A.) for catheter‐free instillation therapy of the bladder in interstitial cystitis/bladder pain syndrome
Authors: Lovasz Sandor
Published: May 2019

Objective

The intravesical instillation of bladder cocktails via catheter is a widely spread, most effective way of treatment of interstitial cystitis/bladder pain syndrome. This disease often affects the urethra too, causing tenderness and pain. Therefore, catheterization causing superficial mucosal lesions triggers strong and long‐lasting pain, sometimes bleeding, and a higher risk of infection.

Methods

We invented an adapter fitting on both Luer‐lock and Luer‐slip syringes allowing the injection of “bladder cocktails” into the bladder through the urethra in a retrograde way; the injected fluid opens the bladder sphincter. Its radiused tip and the specially shaped flexible isolating collar allow us to perform drop‐free instillation without catheterization.

In the last 2 years, clinical evaluations were conducted in 270 interstitial cystitis/bladder pain syndrome patients (243 female, 27 male), altogether totalling 1520 instillations.

Results

In 5 of 243 female patients (2%) using the syringe adapter was unsuccessful due to the deep located urethral orifice or cicatricose vaginal opening. This made visualization of the urethral orifice impossible (success rate: 98%). All the 27 male patients (100%) could be treated without any difficulties. No infection due to the instillation was observed.

All treatable patients preferred the catheter‐free method to conventional catheterization. They did not report any pain, long‐lasting burning sensation or any other complications.

Conclusions

The new non‐invasive instillation method prevents superficial lesions of the urethra and treats urethral and bladder mucosa simultaneously. It reduces pain and the complication rate compared to conventional catheterization and at the same time reduces time, costs and inconvenience of bladder instillation.
Temper outbursts in Lowe syndrome: Characteristics, sequence, environmental context and comparison to Prader–Willi syndrome
Authors: Cressey Helen , Oliver Chris , Crawford Hayley , Waite Jane
Published: May 2019

Background

There is limited research into the nature and aetiology of temper outbursts in people with intellectual disabilities. In this study, we describe the phenomenology and environmental context of temper outbursts in Lowe syndrome, a rare genetic syndrome in which outbursts are purportedly frequent.

Method

A temper outburst interview (TOI) was conducted with caregivers of seventeen individuals with Lowe syndrome to generate an account of the behavioural sequence, common antecedents and consequences of temper outbursts, and to enable comparisons with similar work on Prader–Willi syndrome.

Results

Outbursts in Lowe syndrome were frequently triggered by thwarted goal‐directed behaviour and were associated with high levels of physical aggression and property destruction.

Conclusions

Form and sequence of outbursts showed similarities to Prader–Willi syndrome and to behaviours reported in literature on typically developing children. The results highlight the importance of considering shared aetiology as well as syndrome‐specific pathways in the development of outbursts.
Alisol A attenuates high‐fat‐diet‐induced obesity and metabolic disorders via the AMPK/ACC/SREBP‐1c pathway
Authors: Ho Chiakang , Gao Ya , Zheng Danning , Liu Yanjun , Shan Shengzhou , Fang Bin , Zhao Yixuan , Song Dingzhong , Zhang Yifan , Li Qingfeng
Published: May 2019

Obesity and its associated metabolic disorders such as diabetes, hepatic steatosis and chronic heart diseases are affecting billions of individuals. However there is no satisfactory drug to treat such diseases. In this study, we found that alisol A, a major active triterpene isolated from the Chinese traditional medicine Rhizoma Alismatis, could significantly attenuate high‐fat‐diet‐induced obesity. Our biochemical detection demonstrated that alisol A remarkably decreased lipid levels, alleviated glucose metabolism disorders and insulin resistance in high‐fat‐diet‐induced obese mice. We also found that alisol A reduced hepatic steatosis and improved liver function in the obese mice model.In addition, protein expression investigation revealed that alisol A had an active effect on AMPK/ACC/SREBP‐1c pathway. As suggested by the molecular docking study, such bioactivity of alisol A may result from its selective binding to the catalytic region of AMPK.Therefore, we believe that Alisol A could serve as a promising agent for treatment of obesity and its related metabolic diseases.
Loss of cell polarity regulated by PTEN/Cdc42 enrolled in the process of Hepatopulmonary Syndrome
Authors: Gao Jing , Yu Hongfu , Bai Xuehong , Liu Chang , Chen Lin , Belguise Karine , Wang Xiaobo , Lu Kaizhi , Hu Zhiyong , Yi Bin
Published: May 2019

One central factor in hepatopulmonary syndrome (HPS) pathogenesis is pulmonary vascular remodelling (PVR) which involves dysregulation of proliferation and migration in pulmonary microvascular endothelial cells (PMVECs). Growing evidence suggests that Apical/basolateral polarity plays an important role in cell proliferation, migration, adhesion and differentiation. In this study, we explored whether cell polarity is involved and critical in experimental HPS rats that are induced by common bile duct ligation (CBDL). Cell polarity related proteins were analysed in CBDL rats lung and PMVECs under the HPS serum stimulation by immunofluorescence assay. Cdc42/PTEN activity, cell proliferation and migration and Annexin A2 (AX2) in PMVECs were determined, respectively. Cell polarity related proteins, lost their specialized luminal localization in PMVECs of the CBDL rat. The loss of cell polarity was induced by abnormal activity of Cdc42, which was strongly enhanced by the interaction between p‐PTEN and Annexin A2 in PMVECs, after treatment with serum from CBDL rats. It led to over‐proliferation and high migration ability of PMVECs. Down‐regulation of PTEN‐Cdc42 activity in PMVECs restored cell polarity and thus reduced their ability of migration and proliferation. Our study suggested that the loss of cell polarity plays a critical role in the pathogenesis of HPS‐associated PVR and may become a potentially effective therapeutic target.
Towards an Antifederalist Theory of the EU: Democratic Federal Lessons for the European Union
Authors: Jörke Dirk , Sonnicksen Jared
Published: May 2019

Several recent crises and the increasing populism and Euroscepticism across member states have intensified debates on the nature of the EU. While researchers have looked to US federal experience and theory, a bias remains towards the federalism of theFederalistsand ‘Madisonian' lessons for the EU. In contrast, we argue that the federalism of the Antifederalists provides an alternative, more appropriate frame for assessing the EU's federal challenges. First, we revisited their political thought on democratic federalism and their opposition to the US Constitution. We derived three basic lines of federal‐democratic critique of the power of elites, and losses to state sovereignty and to democracy and popular control. Subsequently, we transferred them to the EU to analyse the corresponding challenges. Finally, we drew Antifederalist lessons for the EU. They may inform not only research on multilevel governments but also the search for a balance between governance, integration and popular rule in a compound polity.
Triglyceride to high‐density lipoprotein cholesterol ratio is associated with incident diabetes in men: A retrospective study of Chinese individuals
Authors: Qin Hailun , Chen Zekai , Zhang Yunzhang , Wang Lingyu , Ouyang Piao , Cheng Lan , Zhang Yonggang
Published: May 2019

Aims/Introduction

Dyslipidemia is commonly present in type 2 diabetes mellitus patients. Recently, the triglyceride : high‐density lipoprotein cholesterol (TG/HDL‐C) ratio, a novel parameter of lipid abnormality, has been seen as an independent predictor for incident diabetes. However, the correlation of the TG/HDL‐C ratio with incident diabetes in the Chinese population and how this relationship is impacted by sex have been rarely studied. In the present study, the correlation of the TG/HDL‐C ratio with incident diabetes is investigated between different sexes of the Chinese population.

Materials and Methods

A total of 116,855 participants who were free of diabetes at baseline were enrolled in the study. The participants were grouped by the median value (0.82) of the TG/HDL‐C ratio. Then, participants were further analyzed according to their sex. Cumulative incidence and person‐years incidence were used to express the incidence rate. The predictive value of the TG/HDL‐C ratio for incident diabetes was probed by the Cox regression proportional hazards model.

Results

The mean age of the participants was 44.1 ± 12.9 years, and 53% of participants (n = 62,868) were the men. A total of 2,685 incident diabetes cases occurred during the 3.1 years of the median follow‐up period. The cumulative incidence in total incident diabetes patients, men and women was 2.30% (2.21–2.38%), 3.01% (2.87–3.14%) and 1.47% (1.37–1.57%), respectively. After the adjustment of multivariate factors, the multivariate Cox regression analysis results showed that a higher TG/HDL‐C ratio was the independent predictive factor of incident diabetes in men (hazard ratio 1.30, 95% confidence interval 1.03–1.64), compared with women (hazard ratio 0.85, 95% confidence interval 0.53–1.38).

Conclusions

Among the Chinese population, the TG/HDL‐C ratio is an independent predictor for incident diabetes in male patients.
Comparing treatment intensification and clinical outcomes of metformin and dipeptidyl peptidase‐4 inhibitors in treatment‐naïve patients with type 2 diabetes in Japan
Authors: Horii Takeshi , Iwasawa Makiko , Shimizu Jyunichi , Atsuda Koichiro
Published: May 2019

Japan's guidelines emphasize tailored therapy, but do not guide physicians on the use of a specific regimen in drug‐naive patients. The role of long‐term initial therapy could be important in key elements of diabetes treatment, such as continuation of the initially prescribed drug. We investigated the frequency of occurrence to treatment intensification after the initiation of metformin or dipeptidyl peptidase‐4 inhibitor treatment. In multivariable‐adjusted Cox proportional hazards models, initiation of dipeptidyl peptidase‐4 inhibitor was associated with a low hazard of intensification. The findings of this survey showed that dipeptidyl peptidase‐4 inhibitors were the preferred first‐line treatment in Japan because of the high continuation rate of the treatment and hemoglobin A1c‐lowering effect. This information would provide guidance in selecting initial hypoglycemic drugs to optimize the treatment of type 2 diabetes mellitus patients in Japan and Asia.
Susceptibility of selected apple cultivars to the Mediterranean fruit fly
Authors: Zanoni Sara , Baldessari Mario , De Cristofaro Antonio , Angeli Gino , Ioriatti Claudio
Published: May 2019

Ceratitis capitata (Wiedemann), the Mediterranean fruit fly, is one of the key pest species affecting deciduous fruit orchards along the Mediterranean coasts. Because of global warming, C. capitata is gradually spreading north and is becoming a major pest of apples. Determining the susceptibility of the main apple varieties grown in the region will serve as a cornerstone to the management of this pest. In this study, we show the results of a field and laboratory no‐choice test conducted to determine the Medfly preferences on different apple cultivars. The seven main varieties of apples (Gala, Red Delicious, Golden Delicious, Granny Smith, Kanzi, Morgen Dallago and Fuji) were tested. The results demonstrate that C. capitata lays eggs on all apple cultivars in both field and laboratory conditions. The Granny Smith, Red Delicious and Morgen Dallago varieties showed the lowest susceptibility in laboratory conditions, (0.75, 1.55, 2 oviposition punctures/fruit, respectively), with significant differences in oviposition compared to the Golden Delicious, Kanzi and Fuji (3.27, 3.31, 3.1 oviposition punctures/fruit, respectively) varieties, which were shown to be the most susceptible to Medfly attack in laboratory conditions. On the other hand, only slight and not statistically significant differences emerged from the field trials. In relation to the physico‐chemical characteristics, the apple cultivars showing the lowest susceptibility (Granny Smith, Red Delicious and Morgen Dallago) had harder peels and pulps and lower sugar contents than the most susceptible cultivars (Golden Delicious, Fuji and Kanzi). These results were also confirmed through evaluation of larval development on different varieties. In fact, Granny Smith, Red Delicious and Morgen Dallago were the three varieties that did not allow adequate larval and adult development and reduced the possibility of the emergence of a new generation.
Increased temperature induces leaffolder outbreak in rice field
Authors: Ali Md. Panna , Kabir Mir Md. Moniruzzaman , Afrin Sadira , Nowrin Farzana , Haque Sheikh Shamiul , Haque Md. Maksudul , Hashem Abeer , Tabassum Baby , Abd_Allah Elsayed Fathi , Pittendrigh Barry Robert
Published: May 2019

The rice leaffolder, Cnaphalocrosis medinalis Güenée (Lepidoptera: Crambidae), has emerged as a serious pest with significant outbreaks over the last decade in several rice‐growing countries, including China and Bangladesh and resulting in heavy rice yield losses. Climate changes (particularly high temperatures in late winter in Bangladesh) coincide with upsurge in outbreaks of this pest. We generated a statistical model using more than two decades of data to show that increased temperatures associate with this upsurge. Over the 22‐year model period, leaffolder populations in November increased significantly, corresponding to significant monthly temperature trends (but not rainfall) over the same period. Utilizing a linear model, we find that increasing temperature interacts with the amount of rainfall. With the variable month as a proxy for all seasonal effects affecting leaffolder abundance, the model reveals a significant correspondence with climate variations compared to average conditions; specifically, the model predicts that increasing maximum temperatures will lead to more leaffolder, while more rain will decrease their abundance. This study suggests that warmer environment contributed to recent outbreaks of leaffolder in rice‐growing countries; thus, climate change increases rice yield losses by increasing pest population in the field.
Analysis of the referral pattern and wait time for hip arthroscopy in a single payer publicly funded health care system
Authors: Petrera Massimo , Yanez‐Siller Federico , Whelan Daniel , Hoit Graeme , Mahjoob Maryam , Chahal Jas , Dwyer Tim
Published: May 2019

Rationale and objectives

To analyse the referral pattern for hip pain and to investigate the wait time for an orthopaedic assessment by a hip arthroscopy surgeon in a single payer health care system. We hypothesized that a significant delay from time of onset of symptoms to time of assessment by a hip arthroscopy surgeon exists.

Method

Retrospective review of prospectively collected data in an academic hospital in a single payer health care system. An electronic database analysis was conducted searching for all referrals for hip pain between February 2017 and June 2017. Data were then analysed with the aim to identify the most common reason for hip referral, calculate the duration of symptoms between onset and orthopaedic assessment, and categorize previous investigations and treatments.

Results

A total of 96 patients were included (47 male and 49 female). Main source of referrals was Family Medicine Physicians in 37% of cases and Primary Care Sports Medicine Physicians in 35%. The most common reason for referral was labral tear in 44.7% of cases followed by combined femoroacetabular impingement and labral tear in 21.8%.

The duration of symptoms was longer than 2 years in 42% of cases and between 1 and 2 years in 40% of cases. Twenty percent of patients had previous intra‐articular injection while 53% of patients had physiotherapy treatment (64% of patient underwent physiotherapy for longer than 6 months).

Conclusion

In the Canadian single payer health care system, a significant delay from the time of onset of symptoms to the time of assessment by a hip arthroscopy surgeon exists with the vast majority of patients in our cohort waiting more than 1 year. It is unknown if this delay affects the patient outcomes. This will require further investigation. Certainly, based on our findings, we should advocate for a better screening process, centralized referrals to hip arthroscopy specialists, and appropriate patient work‐up.
Patients' perspectives on care pathways and informed shared decision making in the transition between psychiatric hospitalization and the community
Authors: Sather Eva W. , Iversen Valentina C. , Svindseth Marit F. , Crawford Paul , Vasset Froydis
Published: May 2019

Rationale, aims, and objectives

Patients with mental health problems experience numerous transitions into and out of hospital. This study explores former patients' views of pathways in transition between district psychiatric hospital centres (DPCs) and community mental health services.

Method

A descriptive qualitative design was chosen. Three focus group interviews with a total of 10 informants from five different communities were conducted. Interviews were transcribed and analysed thematically where themes describe promoting or inhibitory factors to the transition phase.

Results

The informants shared their experiences on issues promoting and preventing successful care pathways in mental health. Four main paired themes were identified: (a) patient participation/activation/empowerment versus paternalism and institutionalization, (b) patient‐centred care versus care interpreted as humiliation, (c) interprofessional collaboration or teamwork versus unsafe patient pathways in mental health services, and (d) sustainable integrated care versus fragmented, noncollaborative care.

Conclusions

Shared decision making was reported more precisely as informed shared decision making. Shared information between all parties involved in care pathways is key.
Impact of sterilization and storage on the properties of concentrated skim milk by cryoconcentration in comparison with vacuum evaporation and reverse osmosis concentration
Authors: Balde Alseny , Aider Mohammed
Published: May 2019

The aim of this study was to compare the impact of sterilized skim milk after being concentrated by three concentration techniques; namely cryoconcentration, vacuum evaporation, and reverse osmosis. To achieve this objective, skim milk was concentrated up to 18% total dry matter by cryoconcentration, vacuum‐evaporation and reverse osmosis, heat sterilized, and stored during 3 months. The obtained results showed that the surface net charge of the proteins in milk concentrated by vacuum evaporation decreased during storage, while that of the other milks remained stable. The levels of free amino acids decreased as a function of the storage time for the three skim milk samples with a higher rate for the vacuum evaporated milk. Thiol groups were affected by sterilization, but remained stable during storage. After sterilization, the consistency coefficient of milk increased by 8.6, 2.25, and 2.35 times for evaporated milk, concentrated by reverse osmosis, and cryoconcentrated, respectively. This result indicated a more stability of sterilized cryoconcentrated skim milk in comparison with the other skim milk samples which showed a tendency to age thickening.

Practical Applications

The findings of this research work can be applied by the dairy industry to produce concentrated skim milk following a cryoconcentration procedure. This subzero concentrating technique can substitute vacuum evaporation and reverse osmosis. The advantage of cryoconcentration, as used in this work, is its low energy consumption and high product quality. Indeed, because of the low latent heat of freezing of water in comparison with its latent heat of vaporization (seven times lower), cryoconcentration is an effective energy saving technology. Thus, the dairy processing industry can exploit the advantages of cryoconcentration to develop novel dairy foods and to save energy.
IL28B gene polymorphism is correlated with changes in low‐density lipoprotein cholesterol levels after clearance of hepatitis C virus using direct‐acting antiviral treatment
Authors: Morihara Daisuke , Ko Yi‐Ling , Shibata Kumiko , Yamauchi Ryo , Fukuda Hiromi , Tsuchiya Naoaki , Fukunaga Atsushi , Kunimoto Hideo , Iwashita Hideyuki , Takata Kazuhide , Tanaka Takashi , Sakurai Kunitoshi , Inomata Shinjiro , Yokoyama Keiji , Nishizawa Shinya , Takeyama Yasuaki , Irie Makoto , Shakado Satoshi , Sohda Tetsuro , Sakisaka Shotaro
Published: May 2019

Background

Direct‐acting antivirals (DAAs) rapidly clear hepatitis C virus (HCV), but the lipid dynamics after DAA treatment remain unknown. Low‐density lipoprotein (LDL) cholesterolemia is the predicting factor for the onset and death of atherosclerotic cardiovascular diseases. Thus, in this study, we examined the frequency and risk of hyper‐LDL cholesterolemia in HCV patients who achieved sustained virologic response (SVR) with DAA treatment.

Methods

A total of 121 patients with HCV genotype 1b, who achieved SVR with DAA treatment, were examined for serum levels of total cholesterol, LDL‐cholesterol (LDL‐C), high‐density lipoprotein, and triglycerides from the start of treatment until 2 years after SVR (SVR‐2y). ΔLDL‐C was defined as the change in LDL‐C levels from treatment initiation to SVR‐2y. Hyper‐LDL cholesterolemia was defined as ≥ 140 mg/dL LDL‐C at SVR‐2y. Stepwise multiple regression analysis was performed to determine whether ΔLDL‐C and hyper‐LDL cholesterolemia are associated with other factors, including viral kinetics.

Results

A total of 63, 3, and 55 patients were administered daclatasvir + asunaprevir, ombitasvir + paritaprevir + ritonavir, and ledipasvir + sofosbuvir, respectively. ΔLDL‐C in patients with the IL28B (rs8099917) TG/GG genotype was significantly higher than in those with IL28B TT (27.3 ± 27.0 and 9.6 ± 27.3 mg/dL; P < 0.001). In addition, IL28B TG/GG was an independent risk factor for hyper‐LDL cholesterolemia (odds ratio: 8.47; P < 0.001).

Conclusions

An IL28B polymorphism is associated with ΔLDL‐C and hyper‐LDL cholesterolemia after achieving SVR. Thus, lipid markers should be carefully monitored in patients who achieve SVR with DAA.
Systematic review and meta‐analysis on the incidence and prevalence of autoimmune hepatitis in Asian, European, and American population
Authors: Lv Tingting , Li Min , Zeng Na , Zhang Jingqi , Li Shuxiang , Chen Sha , Zhang Chunpan , Shan Shan , Duan Weijia , Wang Qianyi , Wu Shanshan , You Hong , Ou Xiaojuan , Ma Hong , Zhang Dong , Kong Yuanyuan , Jia Jidong
Published: May 2019

Background and Aim

Reported incidence and prevalence rates of autoimmune hepatitis (AIH) have been sparse and heterogeneous. The aim of this meta‐analysis was to estimate the worldwide incidence and prevalence rates of AIH and reveal population difference.

Methods

Published articles on the epidemiology of AIH in PubMed, Embase, and Cochrane Library were systematically searched from inception to April 28, 2019. Two investigators independently reviewed these literatures and evaluated their quality. A random‐effects model was used to pool the overall incidence and prevalence rates. The impact of population difference, gender, age, study period, study quality, diagnostic criteria, and study design was further analyzed with subgroup analysis and meta‐regression.

Results

A total of 22 studies were included in the meta‐analysis. The pooled worldwide annual incidence and prevalence of AIH were 1.37 (95% confidence interval [CI]: 0.95–1.80) and 17.44 (95% CI: 12.01–22.87) per 100 000 persons, respectively. Subgroup analysis showed that the pooled annual incidence for Asian, European, and American population was 1.31 (95% CI: 0.42–2.20), 1.37 (95% CI: 1.10–1.64), and 1.00 (95% CI: 0.44–1.56) per 100 000 persons, respectively; the pooled prevalence for Asian, European, and American population was 12.99 (95% CI: 2.05–23.92), 19.44 (95% CI: 15.63–23.24), and 22.80 (95% CI: −13.48 to 59.07) per 100 000 persons, respectively. In addition, higher incidence and prevalence rates were observed in women than men, and a higher prevalence rate was observed in elderly than young people.

Conclusions

Autoimmune hepatitis is a rare disease, with a similar incidence worldwide and a higher prevalence in European and American than in Asian population.
Color, Culture, or Cousin? Multiracial Americans and Framing Boundaries in Interracial Relationships
Authors: Buggs Shantel Gabrieal
Published: May 2019

Objective:This article analyzes how some multiracial people—the “products” of interracial relationships—conceptualize what counts as an interracial relationship and how they discuss the circumstances that influence these definitions.

Background:Scholars have argued that the added complexity expanding multiracial populations contribute to dating and marriage‐market conditions requires additional study; this article expands on the limited research regarding how multiracial people perceive interraciality.

Method:The article uses in‐depth interviews with self‐identified multiracial women (N= 30) who used online dating platforms to facilitate their dating lives in the following three cities in Texas: Austin, Houston, and San Antonio.

Results:In framing their relationships through lenses centered around skin color, cultural difference, and “familiarity” in terms of seeing potential partners as similar to non‐White male family members, multiracial women illustrate varied and overlapping means of describing their intimate relationships, providing additional nuance to sociological understandings of shifts in preferences and norms around partner choice across racial/ethnic lines and opening up opportunities to continue the exploration of the impact of racial inequality on partner choice.

Conclusion:Multiracial people internalize racial, gendered, and fetishistic framings about potential partners similarly to monoracial people, demonstrating how racial boundaries and degrees of intimacy are (re)constructed for this growing demographic in the United States.
Effects of Parkinson's disease on molar bite force, electromyographic activity and muscle thickness of the masseter, temporal and sternocleidomastoid muscles: A case‐control study
Authors: Donizetti Verri Edson , da Silva Gabriel Pádua , Marianetti Fioco Evandro , Soares da Silva Nayara , Valin Fabrin Saulo César , Augusto Bueno Zanella Cesar , Roberta Garrefa Camila , Faria Júnior Milton , Siéssere Selma , Hallak Jaime Eduardo Cecilio , Palinkas Marcelo , Chaves Thais Cristina , Regalo Simone Cecilio Hallak
Published: May 2019

Background

Parkinson's disease is a neurological disorder that promotes motor changes in the body.

Objective

The aim of this study was to investigate the impairment of the stomatognathic function regarding molar bite force, electromyographic activity and thickness of the craniocervical muscles in patients with Parkinson's disease in comparison with those in asymptomatic controls.

Methods

Twenty‐four subjects were divided into two groups, a Parkinson's disease group (n = 12) and a control group (n = 12). The subjects were evaluated on the basis of molar bite force, electromyographic activity (rest, right and left laterality, protrusion, maximum voluntary contraction) and thickness (rest and maximum voluntary contraction) of the right and left temporal (anterior portion), masseter and sternocleidomastoid muscles. The results were submitted to a multivariate analysis of variance (MANOVA) to compare the means of the two independent groups, considering diagnosis of Parkinson's disease and craniocervical muscles as independent variables. For the post hoc comparisons, Bonferroni correction was used (P < 0.05).

Results

Parkinson's disease group presented lower mean values both sides for maximal molar bite force, significant increases in the electromyographic activities during mandibular tasks, lower mean thickness values of the masseter and sternocleidomastoid muscles, and higher mean thickness values of the temporalis muscles (anterior portion).

Conclusion

The results suggest that patients with Parkinson's disease may present functional changes of the stomatognathic system, related to bite force, electromyographic activity and thickness of the craniocervical muscles. The greater temporal muscle thickness in Parkinson's disease patients may compromise their daily life activities, especially with respect to chewing and nutrition.
Digital Tissue Preservation Concept: A Workflow for Guided Immediate Implant Placement and Restoration
Authors: Schubert Oliver , Beuer Florian , Schweiger Josef , Güth Jan
Published: May 2019

The digital workflow presented here allows for fabrication and placement of a definitive custom abutment at the time of tooth extraction and guided immediate implant placement, thus preserving soft tissue anatomy. Since abutment design was based on the shape of the original tooth, it represented a de facto emergence‐analog that provided ideal soft tissue support. The approach of superposing and merging of custom abutment design data with data captured intraorally after abutment placement enabled a digital impression without gingival displacement and associated trauma. The generated data facilitated the fabrication of a precisely fitting restoration concurrent with the implant healing period.