bluuebunny/crossref_metadata_2025 huggingface dataset:
Usefulness of the insulin tolerance test in patients with type 2 diabetes receiving insulin therapy
Authors: Okita Kohei , Iwahashi Hiromi , Kozawa Junji , Okauchi Yukiyoshi , Funahashi Tohru , Imagawa Akihisa , Shimomura Iichiro
Published: October 2013

Aims/Introduction

To establish the validity of the plasma glucose disappearance rate (KITT), derived from an insulin‐tolerance test (ITT), for evaluating the insulin sensitivity of patients with type 2 diabetes after insulin therapy.

Materials and Methods

In the first arm of the study, 19 patients with poorly controlled diabetes were treated with insulin and underwent an ITT and a euglycemic clamp test (clamp‐IR). The relationship between the insulin resistance index, as assessed by both the clamp‐IR and KITT tests, was examined. In the second arm of the study, the relationships between KITT values and various clinical parameters were investigated in 135 patients with poorly controlled diabetes, after achieving glycemic control with insulin.

Results

In study 1, a close correlation between KITT and the average glucose infusion rate during the last 30 min of the standard clamp‐IR test (M‐value) was noted (P < 0.001). In study 2, body mass index (P = 0.0011), waist circumference (P = 0.0004), visceral fat area (P = 0.0011) and the log‐transformed homeostasis model assessment of insulin resistance value (P = 0.0003) were negatively correlated with the log‐transformed KITT. High‐density lipoprotein cholesterol (P = 0.0183), low‐density lipoprotein cholesterol (P = 0.0121) and adiponectin (P = 0.0384) levels were positively correlated with the log‐transformed KITT.

Conclusions

The ITT is a valid and useful test for evaluating the insulin sensitivity of patients with diabetes, even after treatment with insulin.
Methylentetrahydrofolatereductase (rs1801133) polymorphism and psoriasis: contribution to oxidative stress, lipid peroxidation and correlation with vascular adhesion protein 1, preliminary report
Authors: Asefi M. , Vaisi‐Raygani A. , Khodarahmi R. , Nemati H. , Rahimi Z. , Vaisi‐Raygani H. , Tavilani H. , Pourmotabbed T.
Published: October 2013

Background

Psoriatic patients are at greater risk of oxidative stress and inflammation which is associated with abnormal plasma lipid metabolism and lipid peroxidation.There is not any information about the clinical significance of relation between methylentetrahydrofolatereductase (MTHFR) 677‐T allele with malondialdehyde (MDA), lipids, apolipoproteins and vascular adhesion protein‐1 (VAP‐1) partakes in the migration process of lymphocytes into sites of inflammation.

Objectives

This study is the first investigation to examine the association of MTHFR (rs1801133) C677T polymorphism, serum level of MDA, VAP‐1, lipid‐lipoprotein and apolipoproteins with the risk of psoriasis.

Methods

The present case–control study consisted of 100 psoriatic patients and 100 gender‐ and age‐matched unrelated healthy controls from west population of Iran. MTHFR‐C677T (rs1801133) polymorphisms were detected by restriction fragment length polymorphism (PCR‐RFLP), VAP‐1 by ELISA, apolipoproteins by immunoprecipitation, lipid and apolipoproteins by spectrophotometery and MDA by HPLC.

Results

We found that dominant/recessive model (CC + CT/TT) and T allele of MTHFR‐677 alleles significantly 7.45 and 1.76 times increased risk of psoriasis, respectively. The psoriasis patients with MTHFR‐677‐T (C/T + T/T) allele had significantly higher serum MDA, VAP‐1 and apolipoproteinsAPOB concentrations and ratio of APOB/APOA1 than the control subjects.The MTHFR‐677‐T allele frequencies in psoriasis patients were significantly higher than that in control group (28.5% vs. 18.5%; P = 0.018).We found a significant positive correlation between VAP‐1 with MDA (P = 0.047) and LP (a) (P = 0.025).

Conclusion

In the present study, we demonstrated for the first time that the psoriasis patients with MTHFR‐677‐T (C/T + T/T) allele had higher serum levels of MDA, VAP‐1, APOB and ratio of APOB/APOA1 and dominant/recessive model (CC+CT/TT) and T allele of MTHFR‐677 are significantly more common in psoriasis and increased risk of psoriasis by 7.45 and 1.76 fold, respectively. These data suggest that psoriasis patients carrying of TT genotypes and T allele of MTHFR‐677 may be more susceptible to cardiovascular disease and myocardial infarction.
The efficacy in treatment of facial atrophic acne scars in Asians with a fractional radiofrequency microneedle system
Authors: Vejjabhinanta V. , Wanitphakdeedecha R. , Limtanyakul P. , Manuskiatti W.
Published: October 2013

Background

Treatment of acne scars remains a challenge to dermatologists. Multiple modalities have been employed with variable results and adverse effects.

Objective

To determine the efficacy and adverse effects of a fractional radiofrequency microneedle system (FRMS) on acne scars in Asians at 1‐, 3‐ and 6‐month follow‐up visits after treatment.

Methods

Thirty subjects with atrophic acne scars for more than 6 months were enrolled in the study. All volunteers were treated with a FRMS on affected areas. The subjects were treated for a total number of three treatment sessions at 1‐month intervals. Subjective assessments were obtained at baseline, 1, 3 and 6 months after the last treatment session by self‐evaluation and two blinded dermatologists. Objective evaluation using an ultraviolet A‐light video camera was also performed. In addition, pain scores, immediate reactions, healing times and other adverse effects were evaluated.

Results

Twenty‐six subjects with skin phototypes III–V completed treatment protocol. The average mean scar age was 7 years (range: 0.5–15 years). At 6‐month follow‐up visit, the majority of the subjects (42.3%) reported a 26–50% improvement on their acne scars. Percent reduction in scar volume corresponded to clinical evaluation. Adverse reactions of the treatment included pain, immediate oedema/erythema, minimal scabbing and transient pigmentary alteration on treated areas. The average pain score was 5.6 of 10. Worsening of skin texture or new scar formation was not observed in any subjects.

Conclusion

Fractional radiofrequency microneedle system is a safe and effective device for treating acne scars in Asians with minimal risk of downtime and adverse effects.
Histological features of localized scleroderma ‘en coup de sabre’: a study of 16 cases
Authors: Taniguchi T. , Asano Y. , Tamaki Z. , Akamata K. , Aozasa N. , Noda S. , Takahashi T. , Ichimura Y. , Toyama T. , Sugita M. , Sumida H. , Kuwano Y. , Miyazaki M. , Yanaba K. , Sato S.
Published: October 2013

Background

Early lesions of localized scleroderma are histologically characterized by perivascular lymphocytic infiltrate in the reticular dermis and swollen endothelial cells. However, there have been few information regarding histological features other than these findings in localized scleroderma.

Objective

Since en coup de sabre (ECDS) is a certain subset of localized scleroderma with a relatively uniform clinical manifestation, we focused on this disease subset and evaluated its histopathological features.

Methods

A total of 16 patients with ECDS were retrospectively evaluated on the basis of clinical and histological findings.

Results

Regardless of clinical manifestations, vacuolar degeneration was found in all of the ECDS patients. Importantly, keratinocyte necroses were restricted to early and active ECDS lesions. In early ECDS patients (disease duration of <3 years), moderate to severe perivascular and/or periappendageal lymphocytic infiltrate and vacuolar changes in follicular epithelium were more prominent, whereas epidermal atrophy was less frequently observed, than in late ECDS patients (disease duration of ≥6 years).

Conclusion

Vacuolar degeneration at the dermoepidermal junction is a common histological feature in ECDS and perivascular and/or periappendageal lymphocytic infiltrate and vacuolar degeneration of follicular epithelium are characteristic especially in early ECDS, further supporting a canonical idea that the elimination of mutated epidermal cells by immune surveillance contributes to tissue damage and resultant fibrosis in localized scleroderma.
Adaptation and constraint in a stickleback radiation
Authors: Voje K. L. , Mazzarella A. B. , Hansen T. F. , Østbye K. , Klepaker T. , Bass A. , Herland A. , Bærum K. M. , Gregersen F. , Vøllestad L. A.
Published: October 2013

The evolution of threespine sticklebacks in freshwater lakes constitutes a well‐studied example of a phenotypic radiation that has produced numerous instances of parallel evolution, but the exact selective agents that drive these changes are not yet fully understood. We present a comparative study across 74 freshwater populations of threespine stickleback in Norway to test whether evolutionary changes in stickleback morphology are consistent with adaptations to physical parameters such as lake depth, lake area, lake perimeter and shoreline complexity, variables thought to reflect different habitats and feeding niches. Only weak indications of adaptation were found. Instead, populations seem to have diversified in phenotypic directions consistent with allometric scaling relationships. This indicates that evolutionary constraints may have played a role in structuring phenotypic variation across freshwater populations of stickleback. We also tested whether the number of lateral plates evolved in response to lake calcium levels, but found no evidence for this hypothesis.
Heritability of gonad size varies across season in a wild songbird
Authors: Schaper S. V. , Gienapp P. , Dawson A. , Visser M. E.
Published: October 2013

Many organisms advance their seasonal reproduction in response to global warming. In birds, which regress their gonads to a nonfunctional state each winter, these shifts are ultimately constrained by the time required for gonadal development in spring. Gonadal development is photoperiodically controlled and shows limited phenotypic plasticity in relation to environmental factors, such as temperature. Heritable variation in the time required for full gonadal maturation to be completed, based on both onset and speed of development and resulting in seasonally different gonad sizes among individuals, is thus a crucial prerequisite for an adaptive advancement of seasonal reproduction in response to changing temperatures. We measured seasonal gonadal development in climate‐controlled aviaries for 144 great tit (Parus major) pairs, which consisted of siblings obtained as whole broods from the wild. We show that the extent of ovarian follicle development (follicle size) in early spring is highly heritable (h2 = 0.73) in females, but found no heritability of the extent of testis development in males. However, heritability in females decreased as spring advanced, caused by an increase in environmental variance and a decrease in additive genetic variation. This low heritability of the variation in a physiological mechanism underlying reproductive timing at the time of selection may hamper genetic adaptation to climate change, a key insight as this great tit population is currently under directional selection for advanced egg‐laying.
The role of learning by a predator, Rivulus hartii, in the rare‐morph survival advantage in guppies
Authors: Fraser B. A. , Hughes K. A. , Tosh D. N. , Rodd F. H.
Published: October 2013

Negative frequency‐dependent selection (NFDS), where rare types are favoured by selection, can maintain diversity. However, the ecological processes that mediate NFDS are often not known. Male guppies (Poecilia reticulata) exhibit extreme diversity of colour patterning and, in a previous field experiment, rare morphs had a survival advantage. Here, we test the hypothesis that predators impose NFDS because they are efficient at capturing familiar prey morphs, but are less efficient at capturing unfamiliar morphs. Over a series of trials, we presented Rivulus hartii, a natural predator of guppies, with male guppies with the same colour patterning (A trials); then, for a second series of trials, we presented the rivulus with guppies with a new colour pattern (B trials). The success of rivulus at capturing guppies on the first attack increased over successive A trials. First attack success decreased significantly for the early B trials, and then increased during successive B trials, eventually reaching the same level as in the best A trials. This experiment demonstrates that learning, perhaps through long‐term search image formation, plays a role in predation success on familiar vs. unfamiliar prey morphs. These results support the hypothesis that predator learning contributes to the maintenance of the extreme male guppy polymorphism seen in nature.
The oxidative costs of territory quality and offspring provisioning
Authors: Guindre‐Parker S. , Baldo S. , Gilchrist H. G. , Macdonald C. A. , Harris C. M. , Love O. P.
Published: October 2013

The costs of reproduction are an important constraint that shapes the evolution of life histories, yet our understanding of the proximate mechanism(s) leading to such life‐history trade‐offs is not well understood. Oxidative stress is a strong candidate measure thought to mediate the costs of reproduction, yet empirical evidence supporting that increased reproductive investment leads to oxidative stress is equivocal. We investigated whether territory quality and offspring provisioning increase oxidative stress in male snow buntings (Plectrophenax nivalis) using a repeated sampling design. We show that arrival oxidative stress is not a constraint on territory quality or the number of offspring fledged. Nevertheless, owners of higher‐quality territories experienced an oxidative cost, with this cost increasing more rapidly in younger males. Males that provisioned offspring at a high rate also experienced increased oxidative stress. Together, these findings support the potential role of oxidative stress in mediating life‐history trade‐offs. Future work should consider that reproductive workload is not limited to offspring care, and other activities – including territory defence – may contribute significantly to the costs of reproduction.
Effectiveness of health education programs on exercise behavior among patients with heart disease: a systematic review and meta‐analysis
Authors: Zhu Li‐Xia , Ho Shuk‐Ching , Wong Thomas KS
Published: October 2013

Background and Objective

Regular exercise has been shown to be beneficial to patients with heart disease. Previous studies have indicated that health education can effectively increase participants’ physical activity. However, no systematic review was conducted to evaluate the effectiveness of health education programs on changing exercise behavior among patients with heart disease. The aim of this study was to examine the effectiveness of health education programs on exercise behavior among heart disease patients.

Method

Potential studies were retrieved in the Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, EMbase, PsycINFO, the British Nursing Index and Archive, Science Direct, and ERIC via EBSCOhost. Meta‐analysis was done using the random‐effect model.

Results

Thirty‐seven studies were identified. Only 12 studies delivered health education based on various theories/models. Twenty‐eight studies were included in the meta‐analyses. The results showed that health education had significantly positive effects on exercise adherence (risk ratio = 1.35 to 1.48), exercise duration (SMD = 0.25 to 0.69), exercise frequency (MD = 0.54 to 1.46 session/week), and exercise level (SMD = 0.25), while no significant effects were found on exercise energy expenditure and cognitive exercise behavior.

Conclusion

Health education has overall positive effects on changing exercise behavior among heart disease patients. Few theoretical underpinning studies were conducted for changing exercise behavior among heart disease patients. The findings suggest that health education improves exercise behavior for heart disease patients. Health professionals should reinforce health education programs for them.
Mass‐rearing conditions do not affect responsiveness to sex pheromone and flight activity in sweetpotato weevils
Authors: Kuriwada T. , Kumano N. , Shiromoto K. , Haraguchi D.
Published: October 2013

For ensuring the effectiveness of sterile insect technique (SIT) programmes, maintaining the reproductive competitiveness and dispersal ability of mass‐reared sterile males is essential. Inadvertent selection is an important genetic process that frequently occurs during mass rearing to produce sterile males. We investigated the effect of mass‐rearing conditions on the responsiveness to sex pheromones and spontaneous flight activity of males of the sweetpotato weevil Cylas formicarius (Coleoptera: Brentidae). There were no significant differences in the responsiveness to sex pheromones and spontaneous flight activity between wild and mass‐reared strains. These results indicate that mass‐reared strains of C. formicarius might not cause serious problems for implementing SIT programmes.
Sublethal effects of deltamethrin exposure of parental generations on physiological traits and overwintering in Leptinotarsa decemlineata
Authors: Piiroinen S. , Boman S. , Lyytinen A. , Mappes J. , Lindström L.
Published: October 2013

Although the evolution of insecticide resistance has received a lot of attention, less is known about sublethal effects of insecticide stress experienced by the preceding generations on the performance of pest populations. We investigated whether three generations of parental exposure to a deltamethrin insecticide influences physiological traits and overwintering success of offspring in Leptinotarsa decemlineata (Say) (Coleoptera: Chrysomelidae). Beetles descending from insecticide‐exposed parents had lower adult body mass but higher relative lipid content and resting metabolic rate than those descending from non‐insecticide‐exposed parents. Also, a higher proportion of beetles descending from insecticide‐exposed parents than from control parents overwintered on the soil surface, which was associated with very low overwintering survival. When burrowed into the soil for overwintering, both groups had similar probability to survive the overwintering period. Parental insecticide exposure can reduce overall overwintering survival in the next generation by disturbing overwintering behaviour. Although beetles descending from insecticide‐exposed parents were small, the overwintering conditions seem to select for high lipid content, which could override the negative effects of small weight, and possibly improve fitness in the following growing season. Thus, insecticide application may have unintended consequences, which should be considered in pest management.
White spot syndrome virus epizootic in cultured Pacific white shrimp Litopenaeus vannamei (Boone) in Taiwan
Authors: Cheng L , Lin W‐H , Wang P‐C , Tsai M‐A , Hsu J‐P , Chen S‐C
Published: October 2013

White spot syndrome virus (WSSV) has caused significant losses in shrimp farms worldwide. Between 2004 and 2006, Pacific white shrimp Litopenaeus vannamei (Boone) were collected from 220 farms in Taiwan to determine the prevalence and impact of WSSV infection on the shrimp farm industry. Polymerase chain reaction (PCR) analysis detected WSSV in shrimp from 26% of farms. Juvenile shrimp farms had the highest infection levels (38%; 19/50 farms) and brooder shrimp farms had the lowest (5%; one of 20 farms). The average extent of infection at each farm was as follows for WSSV‐positive farms: post‐larvae farms, 71%; juvenile farms, 61%; subadult farms, 62%; adult farms, 49%; and brooder farms, 40%. Characteristic white spots, hypertrophied nuclei and basophilic viral inclusion bodies were found in the epithelia of gills and tail fans, appendages, cephalothorax and hepatopancreas, and virions of WSSV were observed. Of shrimp that had WSSV lesions, 100% had lesions on the cephalothorax, 96% in gills and tail fans, 91% on appendages and 17% in the hepatopancreas. WSSV was also detected in copepoda and crustaceans from the shrimp farms. Sequence comparison using the pms146 gene fragment of WSSV showed that isolates from the farms had 99.7–100% nucleotide sequence identity with four strains in the GenBank database – China (AF332093), Taiwan (AF440570 and U50923) and Thailand (AF369029). This is the first broad study of WSSV infection in L. vannamei in Taiwan.
Pharmacokinetics and residue depletion of erythromycin in rainbow trout Oncorhynchus mykiss (Walbaum)
Authors: Di Salvo A , della Rocca G , Cagnardi P , Pellegrino R M
Published: October 2013

Erythromycin (ERY) is a drug active against Gram‐positive bacteria such as Lactococcus garvieae, a pathogen responsible for an important disease that may cause a substantial decrease in rainbow trout Oncorhynchus mykiss (Walbaum) production, the species of fish most commonly produced in Italy. In the literature, studies on the kinetics behaviour of ERY in fish are limited. Therefore, the aim of the present study was to evaluate the pharmacokinetics of ERY in rainbow trout after a single oral treatment with 75 mg kg−1 body weight (b.w.) of ERY and the residue depletion after multiple oral administration of 75 mg kg−1 b.w. day−1 of ERY for 10 days. Blood concentrations of ERY increased up to 20.24 ± 13.32 μg mL−1 at 6 h, then decreased to 5.97 ± 3.89 μg mL−1 at 24 h. The time during which the antibiotic remains in the bloodstream at concentrations exceeding the MIC (T > MIC) and the area under the serum concentration–time curve (AUC)/MIC are both pharmacokinetic–pharmacodynamic (PK/PD) predictors of ERY efficacy, and the data obtained allowed us to hypothesize that a dosage of 75 mg kg−1 b.w. day−1 of ERY could treat the lactococcosis in trout. Regarding the study of ERY depletion, rapid elimination was observed in tissue (muscle plus adherent skin); in fact the concentrations were below the limit of quantification in all samples (except two) by day 10 post‐treatment. ERY is not licensed in Europe for use in aquaculture, and its use is possible only by off‐label prescription with a precautionary withdrawal time of 500 degree‐days, as established by Directive 2004/28/EC. From the data obtained in this study, a withdrawal time of 8.90 days was calculated, corresponding, in our experimental conditions, to 117.5 degree‐days, a value significantly lower than that established by the European directive.
A new type of lordosis and vertebral body compression in Gilthead sea bream, Sparus aurata L.: aetiology, anatomy and consequences for survival
Authors: Loizides M , Georgiou A N , Somarakis S , Witten P E , Koumoundouros G
Published: October 2013

A new type of vertebral malformation is described, consisting of deformed cartilaginous neural and haemal processes and the compression and fusion of vertebral bodies. The malformation is designated as haemal vertebral compression and fusion (haemal VCF). We studied the aetiology of the malformations and described microanatomical histopathological alterations. The malformations were detected during routine quality control in one of six monitored Gilthead sea bream populations. Haemal VCF affected the posterior part of the vertebral column (haemal vertebrae). In 20% of the deformed specimens, haemal VCF was combined with lordosis. At 35 dph (days post‐hatching), early anatomical signs of the haemal VCF consisted of abnormal centrum mineralization, malformed cartilaginous neural and haemal processes and developing lordotic alterations. The histological examination of the deformed individuals revealed that haemal VCF is preceded by notochord abnormalities. The frequency of deformed individuals was three times higher at 35 than at 61 dph (50.3% vs. 17.2%, n = 157 and n = 250, respectively). No signs of repair or reversion of malformations have been observed. Thus, the steep decrease in deformities in older animals suggests that haemal VCF is linked to high mortality rates. The results are discussed in respect of the possible causative factors of haemal VCF.
Drying Kinetics and Expansion of Non‐predried Extruded Starch‐Based Pellets during Microwave Vacuum Processing
Authors: Kraus Stefan , Sólyom Katalin , Schuchmann Heike P. , Gaukel Volker
Published: October 2013

Drying kinetics of extruded, starch‐based pellets with initial moisture content of 0.695 kg/kg d.b. were experimentally investigated in a microwave vacuum drying system. The influence of the initial sample amount (100, 200 and 300 g), microwave power (400, 600 and 800 W) and system pressure (20, 50 and 100 mbar) were examined in detail. An increase in microwave power and a decrease in initial sample amount significantly shortened the drying time. Among several thin layer models, the model of Balbay and Sahin best describes the experimental data for starch‐based pellets. The activation energy was calculated to be 10.89 W/g and effective moisture diffusivity varied from 3.4 × 10−9 to 1.2 × 10−8 m2/s, depending on microwave power level and sample amount.

Practical Application

Third generation snacks provide an alternative to fully prepared puffed snack foods. In contrast to conventional extrusion, nonexpanded pellets are formed via extrusion, then predried and then expanded to achieve a crispy and porous texture. In this alternative process, the extrusion can be performed at high moisture content, moderate temperature and shearing conditions. This is beneficial for the preservation of thermally and mechanically sensitive ingredients and allows the production of snacks with high nutritional quality. A special feature of the process investigated in this study is that the expansion is achieved by microwave‐vacuum processing which allows an indirect expansion without a time‐ and energy‐consuming predrying process. In addition, due to the processing under vacuum, the temperature inside the product can be kept at desired moderate values. The drying kinetics, drying rate and diffusion coefficient in connection with the volume expansion allow process design and product quality improvement.
Risk factors and clinical outcomes of gastric cancer identified by screening endoscopy: A case–control study
Authors: Gong Eun Jeong , Ahn Ji Yong , Jung Hwoon‐Yong , Lim Hyun , Choi Kwi‐Sook , Lee Jeong Hoon , Kim Do Hoon , Choi Kee Don , Song Ho June , Lee Gin Hyug , Kim Jin‐Ho , Choi Son Yeong , Choe Jae Won , Kim Min‐Ju
Published: October 2013

Background and Aim

A customized screening program for gastric cancer would optimize the benefits of screening endoscopy. This study investigated the risk factors for gastric cancer detected during screening and factors affecting clinical outcomes.

Methods

From April 2000 to December 2010, subjects who underwent screening endoscopy at Asan Medical Center were included. To investigate risk factors, age‐ and sex‐matched control group was selected. The clinical outcomes of gastric cancer identified during screening (screening group) were compared with age, sex, and date of diagnosis‐matched subjects who were diagnosed with gastric cancer in the outpatient clinic (outpatient group).

Results

Of 109 530 subjects, 327 were diagnosed with gastric cancer. The median age of the screening group was 63.6 years (interquartile range 56–71 years), and the male‐to‐female ratio was 2.4:1. When comparing with the control group, Helicobacter pylori seropositivity (odds ratio [OR] 2.933, P < 0.001), carcinoembryonic antigen (OR 8.633, P = 0.004), family history of gastric cancer (OR 2.254, P = 0.007), and drinking (OR 3.312, P < 0.001) were independent positive risk factors, and the use of aspirin a negative risk factor for gastric cancer (OR 0.445, P = 0.012) in multivariate analysis. Low‐density lipoprotein cholesterol (hazard ratio [HR] 0.987, P = 0.005), cancer antigen 19‐9 (HR 21.713, P < 0.001), resectability (HR 59.833, P < 0.001), and family history (HR 0.308, P = 0.009) were independent risk factors for death. The 5‐year survival rate was significantly higher in the screening group than in the outpatient group (P < 0.001).

Conclusions

Early detection of gastric cancer by screening endoscopy while asymptomatic enhances patient outcomes, especially in high‐risk groups.
The impact of parental‐rearing styles on irritable bowel syndrome in adolescents: A school‐based study
Authors: Xing Zhouxiong , Hou Xiaohua , Zhou Kan , Qin Diyuan , Pan Wen
Published: October 2013

Background and Aim

A strong association between family function and irritable bowel syndrome (IBS) has been observed. Parental rearing styles, as a comprehensive mark for family function, may provide new clues to the etiology of IBS. This study aimed to explore which dimensions of parental rearing styles were risk factors or protective factors for IBS in adolescents.

Methods

Two thousand three hundred twenty adolescents were recruited from one middle school and one high school randomly selected from Jiangan District (an urban district in Wuhan City). Data were collected using two Chinese versions of validated self‐report questionnaires including the Rome III diagnostic criteria for pediatric IBS and the Egna Minnen Beträffande Uppfostran: One's Memories of Upbringing for perceived parental rearing styles.

Results

Ninety‐six subjects diagnosed as pediatric IBS were compared with 1618 controls. The IBS patients reported less both paternal and maternal emotional warmth (all P < 0.01) and more both paternal and maternal punishment, overinterference, rejection, and overprotection (only for father) (all P < 0.01) than the controls. Furthermore, the IBS patients had higher total scores of parental rearing styles (all P < 0.001) than the controls. With univariate logistic regression, standardized regression coefficients and odds ratios of parental rearing variables were calculated. Multivariate logistic regression revealed that paternal rejection (P = 0.001) and maternal overinterference (P = 0.002) were independent risk factors for IBS in adolescents.

Conclusions

Parental emotional warmth is a protective factor for IBS in adolescents and parental punishment, overinterference, rejection, and overprotection are risk factors for IBS in adolescents.
Endoscopic resection for duodenal carcinoid tumors: A multicenter, retrospective study
Authors: Kim Gwang Ha , Kim Jin Il , Jeon Seong Woo , Moon Jeong Seop , Chung Il‐Kwun , Jee Sam‐Ryong , Kim Heung Up , Seo Geom Seog , Baik Gwang Ho , Lee Yong Chan ,   The Korean College of Helicobacter and Upper Gastrointestinal Research
Published: October 2013

Background and Aim

Gastrointestinal carcinoid tumors < 10 mm in diameter and limited to the submucosal layer demonstrate a low frequency of lymph node and distant metastasis, and are suitable for endoscopic treatment. The aim of this study was to assess the efficacy, safety, and long‐term prognosis of endoscopic resections for the treatment of duodenal carcinoid tumors.

Methods

This study included a total of 41 duodenal carcinoid tumors in 38 patients between January 2006 and December 2011. The indications for endoscopic resection were lesions ≤ 10 mm in diameter, confined to the submucosal layer, and without lymph node or distant metastasis. Endoscopic resection was accomplished using endoscopic mucosal resection (EMR), EMR with a ligation device (EMR‐L), EMR after circumferential precutting, or endoscopic submucosal dissection (ESD).

Results

EMR was performed in 18 tumors, EMR‐L in 16, EMR after circumferential precutting in 3, and ESD in 4. En‐bloc resection was performed in 39 tumors (95%), and endoscopic complete resection was achieved in 40 (98%); pathological complete resection was achieved in 17 tumors (41%). The endoscopic complete resection rate did not differ according to the resection method, but the pathological complete resection rate was higher for ESD than for EMR and EMR‐L. Intraprocedural bleeding was noted in five cases, with no occurrence of perforation. Recurrence was not observed during the mean follow‐up period of 17 months (range 1–53 months).

Conclusion

Endoscopic resection appears to be a safe and effective treatment for duodenal carcinoid tumors measuring ≤ 10 mm in diameter and confined to the submucosal layer.
Transjugular intrahepatic portosystemic shunt in combination with or without variceal embolization for the prevention of variceal rebleeding: A meta‐analysis
Authors: Qi Xingshun , Liu Lei , Bai Ming , Chen Hui , Wang Juan , Yang Zhiping , Han Guohong , Fan Daiming
Published: October 2013

Background and Aim

Transjugular intrahepatic portosystemic shunt (TIPS) is the mainstay treatment option for the complications of portal hypertension. Whether or not variceal embolization should be performed during TIPS procedures remains controversial. A meta‐analysis to compare the incidence of shunt dysfunction, variceal rebleeding, encephalopathy, and death between patients treated with TIPS alone and those treated with TIPS combined with variceal embolization was conducted.

Methods

All relevant studies were searched via PubMed, EMBASE, and Cochrane Library databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled. Heterogeneity among studies and publication bias were assessed.

Results

Six articles were included in our study. Type of stents was covered (n = 2), bare (n = 2), mixed (n = 1), and unknown (n = 1). Varices were angiographically embolized by coils in six studies. Additional liquids agents were employed in three studies. Compared with TIPS alone group, TIPS combined with variceal embolization group had a significantly lower incidence of variceal rebleeding (OR 2.02, 95% CI 1.29–3.17, P = 0.002), but a similar incidence of shunt dysfunction (OR 1.26, 95% CI 0.76–2.08, P = 0.38), encephalopathy (OR 0.81, 95% CI 0.46–1.43, P = 0.47), and death (OR 0.90, 95% CI 0.55–1.47, P = 0.68). Neither any significant heterogeneity nor proof of publication bias among studies was found in all meta‐analyses.

Conclusions

Adjunctive variceal embolization during TIPS procedures might be beneficial in the prevention of variceal rebleeding. However, given the heterogeneity of type of stents, embolic agents, type of varices, and indications of variceal embolization among studies, additional well‐designed randomized, controlled trials with larger sample size and use of covered stents should be warranted to confirm these findings.
Combined therapies versus monotherapies for the first variceal bleeding in patients with high‐risk varices: A meta‐analysis of randomized controlled trials
Authors: Bai Ming , Qi Xingshun , Yang Man , Han Guohong , Fan Daiming
Published: October 2013

Background and Aim

The effect of combined therapies (among non‐selected beta‐blockers [NSBB], endoscopic therapy, and other treatments) on the first variceal bleeding has been evaluated in several randomized controlled trials previously, and the results were controversial. We performed this meta‐analysis to assess the effect of combined therapies in patients with high‐risk varices without previous variceal bleeding.

Methods

The Cochrane Library, The Cochrane Hepato‐Biliary Group Controlled Trials Register, MEDLINE, and EMBASE were searched for eligible trials. Manual searches were also performed for additional studies. Upper gastrointestinal bleeding, variceal bleeding, mortality, and adverse events were evaluated as end‐points by meta‐analysis.

Results

Twelve randomized controlled trials with 1571 patients were included. Compared with the NSBB (propranolol or nadolol) or endoscopic therapy alone, all of the combined therapies did not demonstrate significant improvements in variceal bleeding, total upper gastrointestinal bleeding, and mortality. Only the combinations of isosorbide‐mononitrate or spironolactone with NSBB tended to decrease the risk of variceal bleeding when compared with the use of NSBB alone (isosorbide‐mononitrate plus NSBB vs NSBB: odds ratio = 0.67, 95% confidence interval 0.40–1.13, P = 0.13; spironolactone plus NSBB vs NSBB: odds ratio = 0.41, 95% confidence interval 0.10–1.69, P = 0.22). Adverse events were more frequently observed in the combined therapy groups.

Conclusions

Based on the available evidences, no combined therapy can be recommended as the first‐line treatment for the primary prevention of variceal bleeding currently. Further studies with large sample sizes and long‐term follow up are warranted.
Prediction of liver stiffness hepatocellular carcinoma in chronic hepatitis C patients on interferon‐based anti‐viral therapy
Authors: Narita Yutaka , Genda Takuya , Tsuzura Hironori , Sato Shunsuke , Kanemitsu Yoshio , Ishikawa Sachiko , Kikuchi Tetsu , Hirano Katsuharu , Iijima Katsuyori , Wada Ryo , Ichida Takafumi
Published: October 2013

Background and Aim

The purpose of this study was to evaluate the usefulness of liver stiffness measurement (LSM) for assessing the risk of hepatocellular carcinoma (HCC) in chronic hepatitis C (CHC) patients receiving interferon (IFN) therapy.

Methods

One hundred fifty‐one CHC patients who underwent LSM and received IFN therapy were included in the estimation cohort, and 56 were included in the validation study. The cumulative HCC incidences were evaluated using Kaplan–Meier plot analysis and the log‐rank test. Multivariate Cox proportional hazard analyses were used to estimate the hazard ratios (HRs) of variables for HCC.

Results

In the estimation cohort, 9 of 151 patients developed HCC during the median follow‐up time of 722 days. Multivariate analysis identified three independent risk factors for HCC: LSM (≥ 14.0 kPa, HR 5.58, P = 0.020), platelet count (< 14.1 × 104/μL, HR 5.59, P = 0.034), and non‐sustained virological response (HR 8.28, P = 0.049). The cumulative incidence of HCC development at 3 years was 59.6%, 8.2%, and 0.0% in patients with all three risk factors, one to two risk factors, and none of these risk factors, respectively. The incidence of HCC was significantly different between these groups (P < 0.001). In the validation cohort, HCC incidence was also significantly different with respect to these risk factors (P = 0.037).

Conclusion

LSM, platelet count, and IFN‐therapeutic effect could be used to successfully stratify the risk of HCC in patients receiving IFN therapy and demonstrate the usefulness of LSM before IFN therapy for the management of CHC patients.
Nonmotor Symptoms in Nursing Home Residents with Parkinson's Disease: Prevalence and Effect on Quality of Life
Authors: Weerkamp Nico J. , Tissingh Gerrit , Poels Petra J.E. , Zuidema Systse U. , Munneke Marten , Koopmans Raymond T.C.M. , Bloem Bastiaan R.
Published: October 2013

Objectives

To determine the prevalence of nonmotor symptoms (NMS) in nursing home (NH) residents with Parkinson's disease (PD) and to establish the association with quality of life.

Design

Cross‐sectional.

Setting

Nursing homes in the southeast of the Netherlands.

Participants

Nursing home residents with PD and a Mini‐Mental State Examination score of 18 or greater (N = 73; mean age 78.7, disease duration 10 years, mainly Hoehn and Yahr Stages 4 (38%) and 5 (49%)) underwent detailed examination to determine the prevalence of NMS.

Measurements

Validated instruments for PD‐related NMS were used to examine the NH residents with PD. The overall burden of NMS, and autonomic problems in particular, were measured using the Non‐Motor Symptoms Scale (NMSS). Depression, neuropsychiatric symptoms, sleep problems, cognitive dysfunction, and motor impairments were focused on in further detail using established clinimetric tests. Linear regression analysis was used to examine the relationship between these symptoms and quality of life, which was measured using the Parkinson's Disease Questionnaire (PDQ‐8).

Results

The NMSS revealed a mean of nearly 13 different NMS per resident. Autonomic problems (constipation, urinary urgency) were particularly prevalent (48–75% of residents). Depressive symptoms were present in 45%. The most prevalent neuropsychiatric symptoms other than depression were irritability and apathy. The most common sleep problems were overall poor nighttime sleep quality, daytime sleepiness, and nocturia. Cognitive problems were highly prevalent, and 77% of the residents met the criteria for PD‐related dementia. High scores were also obtained for motor impairments. Mean PDQ‐8 score was high, indicating poor quality of life. Poor quality of life was most strongly associated with the prevalence and severity of overall NMS burden (coefficient of determination = 0.45).

Conclusion

Nonmotor symptoms were highly prevalent in NH residents with PD. Quality of life was poor, largely because of NMS. Because many NMS are potentially treatable, diagnosis and treatment of these severely affected individuals deserve more attention.
Hospice Use and Public Expenditures at the End of Life in Assisted Living Residents in a Florida Medicaid Waiver Program
Authors: Meng Hongdao , Dobbs Debra , Wang Su , Hyer Kathryn
Published: October 2013

Objectives

To examine the association between hospice use and public expenditures in a sample of dually eligible assisted living (AL) residents at the end of life.

Design

A retrospective cohort study.

Setting

Florida AL facilities.

Participants

Newly enrolled dually eligible older AL residents under Florida's Medicaid Assisted Living for the Elderly waiver program who died between January 2003 and December 2004 (N = 382).

Measurements

Individual sociodemographic characteristics were obtained from Florida's Medicaid comprehensive assessment data. Medicaid eligibility status, enrollment in the AL waiver programs, International Classification of Diseases, Ninth Revision, Clinical Modification, codes and Medicaid claims data were obtained from Florida's Medicaid payment agency. Individual characteristics and Medicare and Medicaid claims data were merged with vital statistics to determine diagnoses, date of death, hospice enrollment, and public expenditures.

Results

The mean age of the study sample was 84.8 (range 65–102); 71.5% were female, and 63.4% were white. During the average 9.6 months of follow‐up, 35.6% of the sample enrolled in hospice, and the average hospice length of stay was 47.9 d; 73.3% of the sample had been admitted to a hospital, and 38.0% had been admitted to a nursing home. The generalized linear model showed that hospice use was not significantly associated with lower public expenditures (average marginal effect = −$1,127, 95% confidence interval = −$8,377, $6,122).

Conclusion

Hospice use at the end of life may not be associated with lower public expenditures in older dually eligible AL residents. Future research should examine the association between hospice enrollment and the quality of end‐of‐life care.
Vitamin D and Physical Performance in Older Men and Women Visiting the Emergency Department Because of a Fall: Data from the Improving Medication Prescribing to reduce Risk Of FALLs (IMPROveFALL) Study
Authors: Boyé Nicole D. A. , Oudshoorn Christian , van der Velde Nathalie , van Lieshout Esther M. M. , de Vries Oscar J. , Lips Paul , van Beeck Ed F. , Patka Peter , van der Cammen Tischa J. M.
Published: October 2013

Objectives

To investigate whether serum 25‐hydroxy vitamin D (25(OH)D) is associated with physical performance in men and women.

Design

Cross‐sectional.

Setting

Emergency departments (EDs) of five hospitals.

Participants

Older adults who visited an ED because of a fall (N = 616).

Measurements

Physical performance was assessed using the Timed Up and Go Test, the Five Time Sit to Stand Test, handgrip strength, and the tandem stand test. Multivariate linear regression was used to assess the association between physical performance and log‐transformed 25(OH)D concentration adjusted for potential confounders.

Results

In men, higher serum 25(OH)D concentration was significantly associated with better handgrip strength (regression coefficient (B) = 3.86, 95% confidence interval (CI) = 2.04−5.69), faster TUG time (B = −2.82, 95% CI = −4.91 to −0.73), and faster FTSS time (B = −3.39, 95% CI = −5.67 to −1.11). In women, higher serum 25(OH)D concentration was significantly associated with faster TUG time (B = −2.68, 95% CI = −4.87 to −0.49).

Conclusion

A positive association was found between serum 25(OH)D level and physical performance in men and women. Intervention studies are needed of vitamin D–deficient older men and women to further investigate the effect of vitamin D supplementation in this group.
Development of exchange lists for Mediterranean and Healthy Eating Diets: implementation in an intervention trial
Authors: Sidahmed E. , Cornellier M. L. , Ren J. , Askew L. M. , Li Y. , Talaat N. , Rapai M. S. , Ruffin M. T. , Turgeon D. K. , Brenner D. , Sen A. , Djuric Z.
Published: October 2013

Background

There has been little research published on the adaptation of diabetic exchange list diet approaches for the design of intervention diets in health research despite their clinical utility. The exchange list approach can provide clear and precise guidance on multiple dietary changes simultaneously. The present study aimed to develop exchange list diets for Mediterranean and Healthy Eating, and to evaluate adherence, dietary intakes and markers of health risks with each counselling approach in 120 subjects at increased risk for developing colon cancer.

Methods

A randomised clinical trial was implemented in the USA involving telephone counselling. The Mediterranean diet had 10 dietary goals targeting increases in mono‐unsaturated fats, n‐3 fats, whole grains and the amount and variety of fruits and vegetables. The Healthy Eating diet had five dietary goals that were based on the US Healthy People 2010 recommendations.

Results

Dietary compliance was similar in both diet arms, with 82–88% of goals being met at 6 months, although subjects took more time to achieve the Mediterranean goals than the Healthy Eating goals. The relatively modest fruit and vegetable goals in the Healthy Eating arm were exceeded, resulting in fruit and vegetable intakes of approximately eight servings per day in each arm after 6 months. A significant (P < 0.05) weight loss and a decrease in serum C‐reactive protein concentrations were observed in the overweight/obese subgroup of subjects in the Mediterranean arm in the absence of weight loss goals.

Conclusions

Counselling for the Mediterranean diet may be useful for both improving diet quality and for achieving a modest weight loss in overweight or obese individuals.
Consumption‐based Material Flow Accounting
Authors: Schaffartzik Anke , Eisenmenger Nina , Krausmann Fridolin , Weisz Helga
Published: October 2013

In 2007, imports accounted for approximately 34% of the material input (domestic extraction and imports) into the Austrian economy and almost 60% of the GDP stemmed from exports. Upstream material inputs into the production of traded goods, however, are not yet included in the standard framework of material flow accounting (MFA). We have reviewed different approaches accounting for these upstream material inputs, or raw material equivalents (RME), positioning them in a wider debate about consumption‐based perspectives in environmental accounting. For the period 1995–2007, we calculated annual RME of Austria's trade and consumption applying a hybrid approach. For exports and competitive imports, we used an environmentally extended input‐output model of the Austrian economy, based on annual supply and use tables and MFA data. For noncompetitive imports, coefficients for upstream material inputs were extracted from life cycle inventories. The RME of Austria's imports and exports were approximately three times larger than the trade flows themselves. In 2007, Austria's raw material consumption was 30 million tonnes or 15% higher than its domestic material consumption. We discuss the material composition of these flows and their temporal dynamics. Our results demonstrate the need for a consumption‐based perspective in MFA to provide robust indicators for dematerialization and resource efficiency analysis of open economies.