bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of sorafenib in very elderly patients aged 80 years and older with advanced hepatocellular carcinoma
Authors: Jo Masayasu , Yasui Kohichiroh , Kirishima Toshihiko , Shima Toshihide , Niimi Toshihisa , Katayama Takayuki , Mori Takahiro , Funaki Jun , Sumida Yoshio , Fujii Hideki , Takami Shiro , Kimura Hiroyuki , Mitsumoto Yasuhide , Minami Masahito , Yamaguchi Kanji , Yoshinami Naomi , Mizuno Masayuki , Sendo Rei , Tanaka Saiyu , Shintani Hiroyuki , Kagawa Keizo , Okanoue Takeshi , Itoh Yoshito
Published: February 2014

Aim

Sorafenib is the standard systemic therapy for patients with advanced hepatocellular carcinoma (HCC). We aimed to assess the efficacy and safety of sorafenib therapy in very elderly patients aged 80 years and older with advanced HCC.

Methods

In a retrospective multicenter study in Japan, we reviewed 185 patients (median age, 71 years; 82% male; 95% Child–Pugh class A) with advanced HCC who received sorafenib therapy. Data were compared between 24 (13%) patients aged 80 years and older and 161 (87%) patients aged less than 80 years. We used propensity score matching to adjust for differences between the two groups.

Results

Median overall survival was 10.6 months in all patients: 11.7 months in patients aged 80 years and older and 10.5 months in those aged less than 80 years. There were no significant differences in overall survival, tumor response, and frequency and severity of drug‐related adverse events between patients aged 80 years and older and those aged less than 80 years in both the entire study cohort and the propensity‐matched cohort.

Conclusion

Sorafenib may be effective and well tolerated, even in patients with advanced HCC who are aged 80 years and older, as well as those aged less than 80 years.
Shared decision‐making behaviours in health professionals: a systematic review of studies based on the Theory of Planned Behaviour
Authors: Thompson‐Leduc Philippe , Clayman Marla L. , Turcotte Stéphane , Légaré France
Published: February 2014

Background

Shared decision making (SDM) requires health professionals to change their practice. Socio‐cognitive theories, such as the Theory of Planned Behaviour (TPB), provide the needed theoretical underpinnings for designing behaviour change interventions.

Objective

We systematically reviewed studies that used the TPB to assess SDM behaviours in health professionals to explore how theory is being used to explain influences on SDM intentions and/or behaviours, and which construct is identified as most influential.

Search strategy

We searched PsycINFO, MEDLINE, EMBASE, CINAHL, Index to theses, Proquest dissertations and Current Contents for all years up to April 2012.

Inclusion criteria

We included all studies in French or English that used the TPB and related socio‐cognitive theories to assess SDM behavioural intentions or behaviours in health professionals. We used Makoul & Clayman's integrative SDM model to identify SDM behaviours.

Data extraction and synthesis

We extracted study characteristics, nature of the socio‐cognitive theory, SDM behaviour, and theory‐based determinants of the SDM behavioural intention or behaviour. We computed simple frequency counts.

Main results

Of 12 388 titles, we assessed 136 full‐text articles for eligibility. We kept 20 eligible studies, all published in English between 1996 and 2012. Studies were conducted in Canada (n = 8), the USA (n = 6), the Netherlands (n = 3), the United Kingdom (n = 2) and Australia (n = 1). The determinant most frequently and significantly associated with intention was the subjective norm (n = 15/21 analyses).

Discussion

There was great variance in the way socio‐cognitive theories predicted SDM intention and/or behaviour, but frequency of significance indicated that subjective norm was most influential.
Immunohistochemical assessment of Ki67 with antibodies SP6 and MIB1 in primary breast cancer: a comparison of prognostic value and reproducibility
Authors: Ekholm Maria , Beglerbegovic Sanda , Grabau Dorthe , Lövgren Kristina , Malmström Per , Hartman Linda , Fernö Mårten
Published: February 2014

Aims

To compare SP6 and MIB1 antibodies for assessment of Ki67 in primary breast cancer with regard to prognostic value and reproducibility.

Methods and results

A cohort of 237 premenopausal women with node‐negative breast cancer, mainly (87%) not treated with adjuvant systemic therapy, was used. Assessment of Ki67 (SP6 and MIB1) was performed on tissue microarray by three different investigators. The seventh decile was applied for cut‐off. Distant disease‐free survival (DDFS) was chosen as endpoint and the follow‐up was restricted to 5 years. Eighty‐nine per cent of the samples were classified into the same proliferation group, irrespective of antibody used. For both antibodies, high Ki67 was associated with inferior DDFS in univariable analyses (SP6: HR 2.5, P = 0.01; and MIB1: HR 2.8, P = 0.004), but failed to reach statistical significance for DDFS in multivariable analyses adjusted for HER2, age, and tumour size (SP6: HR 2.0, P = 0.074; and MIB1: HR 2.2, P = 0.058). The agreement between different assessors was somewhat higher for MIB1 than for SP6 (κ 0.83–0.88 versus 0.72–0.77).

Conclusions

SP6 was not superior to MIB1, but the two antibodies were comparable in the assessment of Ki67. Both MIB1 and SP6 could therefore be considered for prognostic use in primary breast cancer.
Micro‐CT evaluation of root filling quality in oval‐shaped canals
Authors: Keleş A. , Alcin H. , Kamalak A. , Versiani M. A.
Published: February 2014

Aim

To assess the percentage volumes of filling materials and voids in oval‐shaped canals filled with either cold lateral compaction or warm compaction techniques, using micro‐computed tomography (micro‐CT).

Methodology

Twenty‐four single‐rooted maxillary premolar teeth with oval‐shaped canals were selected and the root canals prepared and assigned to two groups (n = 12), according to the filling technique: cold lateral compaction (CLC) or warm vertical compaction (WVC). Each specimen was scanned using a micro‐CT device at an isotropic resolution of 12.5 μm. Percentage volumes of root filling materials and voids were calculated, and data were statistically analysed using Student's t‐test and Friedman's test, with a significance level of 5%.

Results

Overall, mean percentage volumes of gutta‐percha, sealer and voids were 82.33 ± 3.14, 13.42 ± 2.91 and 4.26 ± 0.74 in the CLC group and 91.73 ± 4.48, 7.70 ± 4.44 and 0.57 ± 0.44 in the WVC group, respectively, with a statistically significant difference between groups (P < 0.05). At the apical level, differences in the percentage volumes of filling materials and voids between groups were not significant (P > 0.05).

Conclusions

No root fillings were void free. Warm vertical compaction produced a significantly greater volume of gutta‐percha and a significantly lower percentage of voids than those achieved with cold lateral compaction. Distribution of sealer and voids within the root canal space after root filling was unpredictable, irrespective of the technique used.
Interfacial Reaction Between Low‐Temperature Co‐fired Ceramics and NiCuZn Ferrites in Multilayer Composites
Authors: Hsiang Hsing‐I , Lyu Bing Jyun , Mei Li‐Then , Hsi Chi‐Shiung
Published: February 2014

In this study, the co‐firing behavior and interfacial interaction between a low‐dielectric‐constant low‐temperature co‐fired ceramics (LTCC) and NiCuZn ferrites at 900°C were studied using X‐ray diffractometer, dilatometer, scanning electron microscopy, electron probe microanalysis, and transmission electron microscope. It was observed that the delamination occurred at the interface between LTCC and NiCuZn ferrites added with Bi2O3. It may be due to the Bi concentrated at the interface and diffused into LTCC, which shifted the densification curve of LTCC toward low temperature, and hence resulted in the shrinkage mismatch between LTCC and NiCuZn ferrites.
The effect of consumers' involvement and innovativeness on the utilization of fashion wardrobe
Authors: Choo Ho Jung , Sim So Yun , Lee Ha Kyung , Kim Ha Bin
Published: February 2014

This study proposed wardrobe utilization as a means of explaining consumer clothing use behaviour, and aimed to explore its relationship with other antecedent variables. We posit that use innovativeness functions as an antecedent of wardrobe utilization within a model comprised of fashion‐related variables, such as fashion innovativeness and fashion involvement. An empirical study was conducted to test this relationship with 211 adult women between the ages of 20 and 40 years. In order to calculate wardrobe utilization, the number of clothing items worn by each respondent was divided by the total number of clothes that the respective respondent owns. The findings of this study revealed a measureable effect of use innovativeness on wardrobe utilization and apparel purchase behaviour. In addition, fashion innovativeness and fashion involvement was shown to affect use innovativeness; however, the two variables did not have a significant impact on influencing wardrobe utilization. These results showed that use innovativeness plays a role of the full mediator variable in the path from fashion involvement and fashion innovativeness to wardrobe utilization. These also indicated that people who are very innovative in their use of fashion are likely to broadly utilize their respective wardrobes. Finally, the impact of purchase behaviour on wardrobe utilization was dismissed, as purchase behaviour and use behaviour were found to be clearly distinguished from one another. Clothing utilization is related to the life cycle of clothes including their purchase, usage and disposal. And in better understanding clothing utilization, the needless waste of clothing would be reduced and would encourage better management of clothes after their purchase. In the context of the product life cycle, this study of clothing use behaviour can assist in building a more sustainable environment for the textile and fashion industry.
Personal values associated with political consumption: an exploratory study with university students in Brazil
Authors: de Barcellos Marcia Dutra , Teixeira Caio Mascarello , Venturini Jonas Cardona
Published: February 2014

Emerging countries have witnessed an incredible change in their societal structure in the last few years. In Brazil, the economical rise of the middle class brought more that 100 million people to the marketplace. This stimulus to consumerism (i.e. the social and economic order that encourages the purchase of goods and services in ever‐greater amounts) is accompanied by a notable growth in social movements and mobilization of citizen‐consumers, which indicates changes in the values of individuals and concerns with the direction the society is taking. Conscious and political consumption consequently arises as an alternative way. Especially among young consumers such issues are interesting to address from a theoretical and social point of view, as this new generation will shape the future of the nation. Therefore, the main objective of this study is to analyse socially conscious and political consumption in terms of consumers’ civic engagement as political citizens. We argue that the young political consumer is value‐oriented. The study relied on quantitative research, conducted through an internet‐based survey where 458 valid questionnaires were obtained. Schwartz's Portrait Values Questionnaire was used to measure personal values of the interviewees. Conscious and political consumption were measured through eight questions addressing alter‐ and anti‐consumption actions. The results indicated significant differences among the personal values of the university students that were classified as political consumers. Universalism and benevolence stood out among the core values of this group, with prominence of self‐transcendence, appreciation for equality and concerns for the well‐being of others. However, a gap was observed between the discourse and action of interviewees, once only one‐third of the sample undertook some form of political consumption. The conclusion was that most of the university students interviewed show the will to change society with individual actions, but demonstrate very little political commitment, and currently do not act politically in their purchases.
Genetic endowment of proinflammatory cytokine tumor necrosis factor‐α (–) 308 G > A polymorphism to Parthenium hysterophorus‐induced airborne contact dermatitis in an Indian cohort
Authors: Khatri Rakesh , Akhtar Nasim , Mukhopadhyay Kasturi , Verma Kaushal K. , Sethuraman Gomathy , Sharma Alpana
Published: February 2014

Background

Parthenium dermatitis is a common airborne allergic health problem that induces a cell‐mediated hypersensitivity immune response involving activated T lymphocytes, which culminates in injury to the skin. The disease is manifested as itchy erythematous papules and plaques and primarily affects the exposed areas and flexures. This study aimed to identify the role of tumor necrosis factor (TNF)‐α (−) 308 G>A polymorphism in the pathogenesis of parthenium dermatitis.

Materials and methods

A total of 120 subjects, including 60 patients exclusively diagnosed for parthenium dermatitis and 60 healthy individuals, were included in the study. The genotyping of the TNF‐α (−) 308 G>A region was carried out by the amplification refractory mutational system.

Results

In the present study, we demonstrated that polymorphism of the TNF‐α (–) 308 position (A and/or G) was not statistically significant, and there was no difference in the distribution of any alleles of this locus in cases and controls.

Conclusion

The present study suggests that there is a lack of association of potent proinflammatory cytokine TNF‐α (−) 308 G>A polymorphism in parthenium dermatitis in the Indian cohort. It interprets genetically endowed transcriptional capacity due to this particular single nucleotide polymorphism but does not support the prevalence of high serum levels of TNF‐α in parthenium‐induced skin allergic inflammation.
Outcome of patients with serology suggestive of past hepatitis B virus infection during antitumor necrosis factor therapy for psoriasis
Authors: Navarro Raquel , Concha‐Garzón María José , Castaño Carlos , Casal Cristina , Guiu Alba , Daudén Esteban
Published: February 2014

Background

Recently, the reactivation during treatment with tumor necrosis factor (TNF) blockers has exceptionally been described in patients with hepatitis B virus (HBV) antigen‐negative (HBsAg). The objective was to evaluate the influence of anti‐TNF agents in patients with psoriasis and serology suggesting past hepatitis B state.

Methods

The inclusion criteria were chronic plaque psoriasis treated with anti‐TNF therapy, HBsAg‐negative, and HBcAb‐positive. We gathered the demographic data and type and duration of anti‐TNF agent. Serum aminotransferase levels and HBV serologic status were requested at baseline and during follow‐up.

Results

We have included 13 patients (four women, nine men) (mean age of 62.1 years). The agent was etanercept in seven cases, infliximab in four patients, and adalimumab in the other two. The mean duration of TNF therapy was 28.6 months. None of them became HBsAg‐positive. Neither signs nor symptoms of acute hepatitis were reported.

Conclusion

The management of HBsAg‐negative patients is unresolved. Only nine cases of HBV reactivation during treatment with TNF blockers have been reported. Despite the low risk of reactivation in these patients, we recommend the monitoring of serum aminotransferase levels, HBsAb titers, HBsAg and, if possible, viral load.
Evaluation of serum sCD40L and homocysteine levels with subclinical atherosclerosis indicators in patients with psoriasis: a pilot study
Authors: Erturan İjlal , Köroğlu Banu Kale , Adiloğlu Ali , Ceyhan Ali M. , Akkaya Vahide B. , Tamer Numan , Başak Pınar Y. , Korkmaz Selma , Ersoy İsmail H. , Kılınç Osman
Published: February 2014

Psoriasis is a chronic inflammatory process associated with an increased risk of cardiovascular risk factors. sCD40L has been suggested to have a possible role in the pathogenesis, of psoriasis and is known to be associated with inflammation, atherogenesis and cardiovascular events. This study investigated cardiovascular risk factors (sCD40L and homocysteine) as well as subclinical atherosclerosis indicators in psoriatic patients and control subjects. The study included 56 consecutive patients with chronic plaque‐type psoriasis and 53 age and gender matched healthy controls admitted to a university hospital. Serum sCD40L and homocysteine levels were measured by ELISA. Carotid artery intima‐media thickness and brachial artery flow mediated dilatation (FMD) measurements were determined ultrasonographically. Subjects who had a history of cardiovascular diseases and cardiovascular risk factors and receiving any systemic treatment were excluded from the study. Plasma sCD40L levels were significantly higher in psoriasis patients compared with healthy controls (1.33 ± 0.72 vs. 0.98 ± 0.70 ng/ml P = 0.012), whereas plasma homocysteine levels did not differ significantly between the two groups. FMD was significantly reduced in the psoriasis group compared to the controls (3.83 ± 5.03 vs. 8.45 ± 7.27% P = 0.0001). Multiple linear regression analyses indicated a significant association between psoriasis, sCD40L, and FMD. Psoriatic patients had higher sCD40L levels than healthy controls, which may lead to an increase in cardiovascular diseases. sCD40L may be a more reliable and early predictive marker of cardiovascular events in psoriatic patients. New treatment options that will be developed over sCD40L will benefit in prevention of psoriasis and its cardiovascular comorbidities.
The characterisation and profile of the bioactive compounds in red guava (Psidium cattleyanum Sabine) and guabiju (Myrcianthes pungens (O. Berg) D. Legrand)
Authors: Dalla Nora Cleice , Jablonski André , Rios Alessandro de O. , Hertz Plinho Francisco , de Jong Erna Vogt , Flôres Simone Hickmann
Published: February 2014

Red guava (Psidium cattleyanum Sabine) and guabiju (Myrcianthes pungens (O. Berg) D. Legrand) are small fruits that are native to southern Brazil. This study evaluated the physicochemical composition, antioxidant activity and functional compounds of both fruits. Red guava exhibited a large amount of dietary fibre. Guabiju showed more antioxidant activity, had a higher anthocyanin content and had a higher carotenoid content. In the guabiju fruit, β‐carotene represented 40.4% of the total carotenoids, and malvidin 3‐glycoside represented 60% of the total anthocyanin content. β‐Cryptoxanthin was the predominant carotenoid in red guava, representing 44.8% of the total carotenoids; cyanidin 3‐glycoside was the predominant anthocyanin, representing 51.7% of the total anthocyanins. These native fruits could represent an alternative to traditionally consumed fruits, and then, the characterisation of bioactive compounds of fruits such as red guava and guabiju represents important information to the consumers who looking for a healthy diet.
Effect of a cold‐active pectinolytic system on colour development of Malbec red wines elaborated at low temperature
Authors: Martín María Carolina , Morata de Ambrosini Vilma Inés
Published: February 2014

The effect of a new cold‐active pectinolytic system on colour of Malbec wines was studied under the following winemaking conditions: (i) fermentation at low temperature (20 °C) and (ii) prefermentative cold maceration (PCM) (5 °C–7 days) followed by traditional fermentation (28 °C). The pectinolytic system was mainly composed of polymethylgalacturonase and pectin lyase activities, detected under similar conditions to those in winemaking (pH 3.6–20 °C). The results show that the enzyme system significantly accelerated colour extraction by reducing the maceration time necessary for vinification at low temperature and shortening the PCM stage. Enzyme‐treated wines exhibited better chromatic parameters than their controls at devatting and after 6 months of storage. The cold‐active enzyme compensated the decrease in colour extraction due to the low maceration temperature, achieving high‐quality wines with chromatic characteristics similar to those of traditional wines.
Artificial urinary sphincter for post‐prostatectomy incontinence: A review
Authors: James Mary H , McCammon Kurt A
Published: February 2014

The artificial urinary sphincter remains the gold standard for treatment of post‐prostatectomy urinary incontinence. The AMS 800 (American Medical Systems, Minnetonka, MN, USA) is the most commonly implanted artificial urinary sphincter. Having been on the market for almost 40 years, there is an abundance of literature regarding its use, but no recent review has been published. We reviewed the current literature regarding the indications, surgical principles, outcomes and complications of artificial urinary sphincter implantation for stress urinary incontinence after prostatectomy. A PubMed search was carried out for articles on the artificial urinary sphincter from 1995 to present. The review was centered on articles related to the use of the AMS 800 for stress urinary incontinence in males after prostatectomy. Relevant articles were reviewed. The majority of patients will achieve social continence (1 pad per day) after artificial urinary sphincter implantation; however, rates of total continence (no pad usage) are significantly lower. Patient satisfaction outcomes average greater than 80% in most series. Potential complications requiring reoperation include infection (0.5–10.6%) and urethral erosion (2.9–12%). Revision surgeries are most commonly as a result of urethral atrophy, which ranges from 1.6 to 11.4%. The 5‐year Kaplan–Meier freedom from reoperation ranges from 50 to 79%, while the 10‐year Kaplan–Meier freedom from mechanical failure is 64%. The artificial urinary sphincter is a reliable device with good outcomes. As expected with any prosthetic device, complications including mechanical failure, infection, erosion and recurrent incontinence remain significant concerns. Despite known complications, the patient satisfaction rates after artificial urinary sphincter implantation remain high. Appropriate patient counseling and adherence to surgical principles are imperative.
Intravenous thrombolysis is unsafe in stroke due to infective endocarditis
Authors: Brownlee W. J. , Anderson N. E. , Barber P. A.
Published: February 2014

Embolic stroke is the most common neurological complication of infective endocarditis and a major source of morbidity and mortality. Septic embolism is considered a contraindication to intravenous thrombolysis in patients with ischaemic stroke because of concerns over an increased risk of intracranial haemorrhage. We describe a patient with occult endocarditis who was treated with thrombolysis for acute stroke and review other cases reported in the literature.
Management of ejaculatory dysfunction
Authors: McMahon C. G.
Published: February 2014

Ejaculatory dysfunction is a common complaint and is often associated with a reduced quality of life for sufferer and partner. The spectrum of ejaculatory dysfunction extends from premature ejaculation (PE) to delayed ejaculation (DE) and anejaculation. Over the past 20–30 years, the PE treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Multiple well‐controlled, evidence‐based studies have demonstrated the efficacy and safety of selective serotonin re‐uptake inhibitors in delaying ejaculation, confirming their role as first‐line agents for the treatment of lifelong and acquired PE. More recently, there has been increased attention to the psychosocial consequences of PE, its epidemiology, its aetiology and its pathophysiology by both clinicians and the pharmaceutical industry. DE and anejaculation are probably the least common, least studied and least understood of the male sexual dysfunctions. However, their impact is significant as they may result in a lack of sexual fulfilment for both the man and his partner, an effect further compounded when procreation is among the couple's goals of sexual intercourse. The causes of DE, anejaculation and anorgasmia are manifold. Numerous psychotherapeutic treatments are described for the management of delayed or anejaculation. Although some appear to be effective, none has been properly evaluated in large‐scale samples. Treatment of DE or anejaculation with pharmacotherapy has met with limited success. No drugs have been approved by regulatory agencies for this purpose, and most drugs that have been identified for potential use have limited efficacy, impart significant side‐effects or are yet considered experimental in nature.
Internal medicine in the bush: a clinical audit of a rural and remote outreach programme
Authors: Foy A. , Tierney A.
Published: February 2014

Background

Provision of internal medicine services in rural Australia is always problematic.

Aim

The aim was to undertake an audit of an outreach service operating in Northern New South Wales since 2006.

Methods

The service is conducted eight times a year, involving a consultant and an advanced trainee who travel by car to the towns of Moree and Mungindi and conduct clinics in a general practice setting, an Aboriginal medical service and a local health district clinic. Since 2008, a cardiology service and a diabetes service have been added on a fly‐in fly‐out basis. Case records of all patients enrolled in the service between February 2006 and July 2013 were reviewed in determining the demographics, clinical presentations and level of service coverage. The experience of the authors in establishing the service provided insights into the challenges and the success factors involved.

Results

Five hundred and eighty‐three patients were seen on a total of 1070 occasions relating to a wide variety of clinical presentations. Of these, 31.3% were indigenous compared with 20% in the local statistical area, and both indigenous and non‐indigenous patients were seen in all settings. Patients fell into 15 different diagnostic categories with indigenous patients more likely to present for diabetes (P < 0.001) and hepatitis B (P < 0.01), but less likely to present for treatment of hepatitis C (P < 0.01).

Conclusions

In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.
Analysis of knowledge and attitude surveys to identify barriers and enablers of appropriate antimicrobial prescribing in three Australian tertiary hospitals
Authors: Chaves N. J. , Cheng A. C. , Runnegar N. , Kirschner J. , Lee T. , Buising K.
Published: February 2014

Background

Antimicrobial stewardship programmes aim to optimise use of antibiotics and are now mandatory in all Australian hospitals.

Aim

We aimed to identify barriers to and enablers of appropriate antimicrobial prescribing among hospital doctors.

Methods

Two paper‐based and one web‐based surveys were administered at three Australian university teaching hospitals from March 2010 to May 2011. The 18‐item questionnaire recorded doctors' level of experience, their knowledge regarding the use of common antimicrobials and their attitudes regarding antimicrobial prescribing. Local survey modifications allowed inclusion of specific questions on: infections in intensive care unit patients, clinical microbiology and use of local guidelines.

Results

The respondents (n = 272) were comprised of 96 (35%) registrars, 67 (25%) residents, 57 (21%) interns and 47 (17%) consultant hospital doctors. Forty‐one per cent were working in a medical specialty. Identified barriers included: gaps in antimicrobial prescribing knowledge (especially among interns), a lack of awareness about which antimicrobials were restricted and a reliance on senior colleagues to make antimicrobial prescribing decisions. Enablers of optimal prescribing included: an acknowledgement of the need for assistance in prescribing and reported readiness to consult national prescribing guidelines. These results were used to help guide and prioritise interventions to improve prescribing practices.

Conclusion

A transferable knowledge and attitudes survey tool can be used to highlight barriers and facilitators to optimal hospital antimicrobial prescribing in order to inform tailored antimicrobial stewardship interventions.
Long‐term tolerance and efficacy of adjunctive exenatide therapy on glycaemic control and bodyweight in type 2 diabetes: a retrospective study from a specialist diabetes outpatient clinic
Authors: Carrington M. J. , Chan Y.‐K. , Stewart S. , Sjouke B. , Brazilek R. , Cohen N.
Published: February 2014

Background

Weight gain and hypoglycaemia are common adverse effects associated with anti‐diabetic treatments.

Aim

Our aim was to evaluate the long‐term effects of adjunctive exenatide therapy on weight loss and glycaemic control in patients with type 2 diabetes.

Methods

A review of medical records in a specialist diabetes clinic over 5 years identified 446 patients who were prescribed exenatide therapy. We examined change in glycosylated haemoglobin (HbA1c), weight, albumin‐creatinine ratio and hypoglycaemic medication during 24 months follow up.

Results

Subjects were aged 59 ± 10 years (49% women) and received exenatide in combination with oral agents and insulin (47%). During an average of 17 ± 14 months follow up, 51% (more women than men; odds ratio 1.69, 95% confidence interval 1.14–2.49) remained on treatment. Lack of efficacy (33%) and/or gastrointestinal (27%) side‐effects were the main reasons for treatment cessation. At 24 months, there was a reduction in HbA1c of 0.7 ± 1.2% and weight loss of 4.3 ± 5.2 kg. Change in HbA1c was similar regardless of concurrent insulin therapy, yet insulin was associated with greater weight reduction (4.8 ± 5.3 vs 3.8 ± 5.1 kg, P = 0.016). Independent predictors of HbA1c response were higher baseline HbA1c, longer duration of diabetes and use of insulin or sulfonylureas at study end. Predictors of weight response were baseline use of insulin or thiazolidinediones, increased age, female sex and sulfonylurea or thiazolidinediones at study end. Longer exenatide treatment duration was favourable for reducing HbA1c and weight.

Conclusions

Exenatide is effective in reducing HbA1c and weight, regardless of concurrent insulin, and in a specialist diabetes outpatient clinic, is recommended for use in clinical practice.
VGX‐1027 modulates genes involved in lipopolysaccharide‐induced Toll‐like receptor 4 activation and in a murine model of systemic lupus erythematosus
Authors: Fagone Paolo , Muthumani Karuppiah , Mangano Katia , Magro Gaetano , Meroni Pier Luigi , Kim Joseph J. , Sardesai Niranjan Y. , Weiner David B. , Nicoletti Ferdinando
Published: February 2014

VGX‐1027 [(S,R)‐3‐phenyl‐4,5‐dihydro‐5‐isoxasole acetic acid] is a small molecule compound with immunomodulatory properties, which favourably influences the development of immuno‐inflammatory and autoimmune diseases in different animal models such as type 1 diabetes mellitus, pleurisy, rheumatoid arthritis and inflammatory bowel disease. However, the precise mechanism of action of VGX‐1027 remains to be ascertained. With this aim, we have studied the immunomodulatory effects of VGX‐1027 in vitro, using a genome‐wide oligonucleotide microarray approach, and in vivo, using the NZB/NZW F1 model of systemic lupus erythematosus. Microarray data revealed that the administration of VGX‐1027 profoundly affected the immune response to exogenous antigens, by modulating the expression of genes that are primarily involved in antigen processing and presentation as well as genes that regulate immune activation. When administered in vivo VGX‐1027 ameliorated the course of the disease in the NZB/NZW F1 mice, which correlated with higher per cent survival and improved clinical and histopathological signs. The data presented herein support the theory that VGX‐1027 modulates immunity, probably by inhibiting inflammatory antigen presentation and so limiting immune cell expansion.
Embryonic stem cell‐derived haematopoietic progenitor cells down‐regulate the CD3 ξ chain on T cells, abrogating alloreactive T cells
Authors: Kim Eun‐Mi , Miyake Bob , Aggarwal Manish , Voetlause Ruth , Griffith Maia , Zavazava Nicholas
Published: February 2014

Murine embryonic stem (ES) cell‐derived haematopoietic progenitor cells (HPCs) engraft and populate lymphoid organs. In vivo, HPCs engraft across MHC barriers protecting donor‐type allografts from rejection. However, the underlying phenomenon remains elusive. Here, we sought to determine the mechanism by which ES cell‐derived HPCs regulate alloreactive T cells. We used the 2C mouse, which expresses a transgenic T‐cell receptor against H2‐Ld to determine whether HPCs are deleted by cytotoxic T lymphocytes (CTLs). Previously, we reported that HPCs express MHC class I antigens poorly and do not express class II antigens. In vitro stimulated 2C CTLs failed to lyse H2‐Ld HPCs in a standard 4‐hr 51chromium release assay. Similarly, when the HPCs were tested in an ELISPOT assay measuring the release of interferon‐γ by CTLs, HPCs failed to induce CTL degranulation. In addition, mice that were injected with HPCs showed a marked decrease in T‐cell responses to alloantigen and CD3 stimulation, but showed a normal response to PMA/ionomycin, suggesting that HPCs impaired T‐cell signalling through the T‐cell receptor/CD3 complex. Here, we show that HPCs secrete arginase, an enzyme that scavenges l‐arginine, leading to metabolites that down‐regulate CD3 ζ chain. Indeed an arginase inhibitor partially restored expression of the CD3 ζ chain, implicating arginase 1 in the down‐regulation of T cells. This previously unrecognized property of ES cell‐derived HPCs could positively enhance the engraftment of ES cell‐derived HPCs across MHC barriers by preventing rejection.
Transfixation Pinning and Casting of a Comminuted Metacarpal Fracture in a 870 kg Bull
Authors: Kofler Johann , Wetchy Gaby , Schöffmann Gudrun
Published: February 2014

Objective

To report metacarpal fracture repair in a bull.

Study Design

Clinical report.

Animals

Simmental bull (n = 1; 870 kg).

Methods

A comminuted right metacarpal fracture was repaired using 2 transfixation pins (6 mm diameter) through the distal metaphysis and diaphysis of the radius and a full limb synthetic resin cast.

Results

Slight bending of both pins occurred 1 day after surgery. Both pins were loose and removed at 31 days and a full‐limb cast reapplied. The cast was changed at approximately −4 week intervals. On day 50, the right carpus had moderate overextension and a valgus deformity. An exercise program was started on day 62, and on day 110, the cast was replaced with a Robert‐Jones‐bandage. At 130 days there was circumferential callus formation and the bull was discharged. At 6.5 months, overextension of the right carpus had resolved and carpal valgus had improved. The bull returned to at 7.5 months after surgery, and was successfully used for 4 years.

Conclusion

For highly valuable cattle like this breeding bull, a surgical treatment of such a fracture should be attempted despite a primarily poor prognosis.
Microstructure, Ferroelectric, Piezoelectric, and Ferromagnetic Properties of Sc‐Modified BiFeO3–BaTiO3 Multiferroic Ceramics with MnO2 Addition
Authors: Wan Yang , Li Ying , Li Qiang , Zhou Wei , Zheng Qiaoji , Wu Xiaochun , Xu Chenggang , Zhu Benpeng , Lin Dunmin
Published: February 2014

0.725BiFe1−xScxO3–0.275BaTiO3 + y mol% MnO2 multiferroic ceramics were fabricated by a conventional ceramic technique and the effects of Sc doping and sintering temperature on microstructure, multiferroic, and piezoelectric properties of the ceramics were studied. The ceramics can be well sintered at the wide low sintering temperature range 930°C–990°C and possess a pure perovskite structure. The ceramics with x/y = 0.01–0.02/1.0 sintered at 960°C possess high resistivity (~2 × 109 Ω·cm), strong ferroelectricity (Pr = 19.1–20.4 μm/cm2), good piezoelectric properties (d33 = 127–128 pC/N, kp = 36.6%–36.9%), and very high Curie temperature (618°C–636°C). The increase in sintering temperature improves the densification, electric insulation, ferroelectric, and piezoelectric properties of the ceramics. A small amount of Sc doping (x ≤ 0.04) and the increase in the sintering temperature significantly enhance the ferromagnetic properties of the ceramics. Improved ferromagnetism with remnant magnetization Mr of 0.059 and 0.10 emu/g and coercive field Hc of 2.51 and 2.76 kOe are obtained in the ceramics with x/y = 0.04/1.0 (sintered at 960°C) and 0.02/1.0 (sintered at 1050°C), respectively. Because of the high TC (636°C), the ceramic with x/y = 0.02/1.0 shows good temperature stability of piezoelectric properties. Our results also show that the addition of MnO2 is essential to obtain the ceramics with good electrical properties and electric insulation.
Ink‐jet Printing of Hollow SnO2 Nanospheres for Gas Sensing Applications
Authors: Von Hagen Robin , Sneha Mahima , Mathur Sanjay
Published: February 2014

Hollow tin‐oxide (SnO2) nanospheres were synthesized by coating, carbon nanospheres (CNs) as hard templates, with a tin(IV) sol obtained by partial hydrolysis of [Sn(OBut)4] under ambient conditions. Formation of crystalline SnO2 spheres upon calcination was confirmed by powder X‐ray diffraction data, whereas the hollow interiors of SnO2 particles were verified by scanning and transmission electron microscopy of both intact and broken spheres. The shell of SnO2 nanospheres sintered at 700°C consisted of a single layer of nanocrystallites (~6 nm) self‐assembled in a ball‐like superlattice. Tin‐oxide hollow spheres showed an average diameter of 150 nm and could be homogeneously dispersed in water/ethylene glycol (50:50 vol%) mixture to form stable inorganic inks viable for their use in commercial ink‐jet printers demonstrated by printing porous ceramic structures on an interdigitated sensor chip. The integration of large surface and nanoscopic voids in the final structures imparted higher sensitivity to the as‐printed sensors toward both oxidizing (nitrogen dioxide) and reducing gases (methane and ethanol), which validates the enormous potential of printable inorganics in functional applications.
A Decomposition Route for Synthesis of Al2O3 Crystal and its Applications as Thermal Conductivity Filler
Authors: Yanhui Li , Lianglong Li , Cheng Peng , Mingmin Bai , Wei Zhao , Pinggen Rao
Published: February 2014

Platelike α‐Al2O3 powder was obtained at 850°C by thermal decomposition of ammonium aluminum carbonate hydroxide precursor, which was treated by hydrofluoric acid. The results showed the decomposition of the as‐prepared precursors experienced via three steps, adsorption of physical water, dehydration of crystalline water, and decomposition of the precursor, and the activation energies of the above three steps were calculated using the Coats–Redfern method. Meanwhile, the intermediate of (NH4)3AlF6 obtained played an important role in decreasing activation energy of the decomposition and phase transformation. Moreover, the thermal conductivity of the epoxy resin filled with platelike alumina was improved obviously.
An Efficient Route for the Synthesis of Aluminum Nitride/Graphene Nanohybrids
Authors: Gao Zhifang , Wan Yizao , Luo Honglin
Published: February 2014

A facile method for the synthesis of aluminum nitride/graphene (AlN/GE) nanohybrids by a urea route was demonstrated. The structures, morphologies, and microstructures of the hybrids were examined by X‐ray diffraction, scanning electron microscope, and transmission electron microscope. Results showed that the content of GE played an important role in the phase composition and could even affect the morphology of AlN/GE nanohybrids. The c ‐AlN nanoparticles occured at high amount of graphene. In addition, the introduction of GE into the AlN/GE hybrids suppressed the aggregation of AlN nanoparticles. Furthermore, the formation mechanism of AlN/GE nanohybrids was proposed.
Nanodomains in KNN‐Based Lead‐Free Piezoelectric ceramics: Origin of Strong Piezoelectric Properties
Authors: Huan Yu , Wang Xiaohui , Shen Zhengbo , Kim Jingyong , Zhou Huihua , Li Longtu
Published: February 2014

Excellent piezoelectric properties of d33* = 768 pm/V and strain = 0.07% at 1 kV/mm, were obtained by lead‐free in (Na0.52K0.4425Li0.0375)(Nb0.86Ta0.06Sb0.08)O3 ceramics. They displayed good temperature stability up to 200°C. Significantly enhanced piezoelectricity originated from nanodomains of width 20–30 nm, and the result was confirmed by transmission electron microscopy. The above‐mentioned nanodomains emerged because of low domain wall energy near polymorphic phase transition regions and insignificant differences in cell parameters between orthorhombic and tetragonal phases. The nanodomain configuration easily responded to an external electric field, leading to high electric field‐induced strain.
Gateway to genetic exchange? DNA double‐strand breaks in the bdelloid rotifer Adineta vaga submitted to desiccation
Authors: Hespeels B. , Knapen M. , Hanot‐Mambres D. , Heuskin A.‐C. , Pineux F. , Lucas S. , Koszul R. , van Doninck K.
Published: February 2014

The bdelloid rotifer lineage Adineta vaga inhabits temporary habitats subjected to frequent episodes of drought. The recently published draft sequence of the genome of A. vaga revealed a peculiar genomic structure incompatible with meiosis and suggesting that DNA damage induced by desiccation may have reshaped the genomic structure of these organisms. However, the causative link between DNA damage and desiccation has never been proven to date in rotifers. To test for the hypothesis that desiccation induces DNA double‐strand breaks (DSBs), we developed a protocol allowing a high survival rate of desiccated A. vaga. Using pulsed‐field gel electrophoresis to monitor genomic integrity, we followed the occurrence of DSBs in dried bdelloids and observed an accumulation of these breaks with time spent in dehydrated state. These DSBs are gradually repaired upon rehydration. Even when the genome was entirely shattered into small DNA fragments by proton radiation, A. vaga individuals were able to efficiently recover from desiccation and repair a large amount of DSBs. Interestingly, when investigating the influence of UV‐A and UV‐B exposure on the genomic integrity of desiccated bdelloids, we observed that these natural radiations also caused important DNA DSBs, suggesting that the genome is not protected during the desiccated stage but that the repair mechanisms are extremely efficient in these intriguing organisms.
Vertically transmitted symbiont reduces host fitness along temperature gradient
Authors: Dusi E. , Krenek S. , Schrallhammer M. , Sachse R. , Rauch G. , Kaltz O. , Berendonk T. U.
Published: February 2014

Parasites with exclusive vertical transmission from host parent to offspring are an evolutionary puzzle. With parasite fitness entirely linked to host reproduction, any fitness cost for infected hosts risks their selective elimination. Environmental conditions likely influence parasite impact and thereby the success of purely vertical transmission strategies. We tested for temperature‐dependent virulence of Caedibacter taeniospiralis, a vertically transmitted bacterial symbiont of the protozoan Paramecium tetraurelia. We compared growth of infected and cured host populations at five temperatures (16–32 °C). Infection reduced host density at all temperatures, with a peak of −30% at 28 °C. These patterns were largely consistent across five infected Paramecium strains. Similar to Wolbachia symbionts, C. taeniospiralis may compensate fitness costs by conferring to the host a ‘killer trait’, targeting uninfected competitors. Considerable loss of infection at 32 °C suggests that killer efficacy is not universal and that limited heat tolerance restricts the conditions for persistence of C. taeniospiralis.
Parasitic success without sex – the nematode experience
Authors: Castagnone‐Sereno P. , Danchin E. G. J.
Published: February 2014

Asexual reproduction is usually considered as an evolutionary dead end, and difficulties for asexual lineages to adapt to a fluctuating environment are anticipated due to the lack of sufficient genetic plasticity. Yet, unlike their sexual congeners, mitotic parthenogenetic root‐knot nematode species,Meloidogynespp., are remarkably widespread and polyphagous, with the ability to parasitize most flowering plants. Although this may reflect in part the short‐term stability of agricultural environments, the extreme parasitic success of these clonal species points them as an outstanding evolutionary paradox regarding current theories on the benefits of sex. The discovery that most of the genome of the clonal speciesM. incognitais composed of pairs of homologous but divergent segments that have presumably been evolving independently in the absence of sexual recombination has shed new light on this evolutionary paradox. Together with recent studies on other biological systems, including the closely related sexual speciesM. haplaand the ancient asexual bdelloid rotifers, this observation suggests that functional innovation could emerge from such a peculiar genome architecture, which may in turn account for the extreme adaptive capacities of these asexual parasites. Additionally, the higher proportion of transposable elements inM. incognitacompared toM. haplaand other nematodes may also be responsible in part for genome plasticity in the absence of sexual reproduction. We foresee that ongoing sequencing efforts should lead soon to a genomic framework involving genetically diverseMeloidogynespecies with various different reproductive modes. This will undoubtedly promote the entire genus as a unique and valuable model system to help deciphering the evolution of asexual reproduction in eukaryotes.
Effect of Bleaching on Mercury Release from Amalgam Fillings and Antioxidant Enzyme Activities: A Pilot Study
Authors: Yalcin Cakir Filiz , Ergin Esra , Gurgan Sevil , Sabuncuoglu Suna , Sahin Arpa Cigdem , Tokgoz İlknur , Ozgunes Hilal , Kiremitci Arlin
Published: February 2014

Objective

The aim of this pilot clinical study was to determine the mercury release from amalgam fillings and antioxidant enzyme activities (Superoxide Dismutase [SOD] and Catalase[CAT] ) in body fluids after exposure to two different vital tooth bleaching systems.

Material and Methods

Twenty eight subjects with an average age of 25.6 years (18–41) having at least two but not more than four Class II amalgam fillings on each quadrant arch in the mouth participated in the study. Baseline concentrations of mercury levels in whole blood, urine, and saliva were measured by a Vapor Generation Accessory connected to an Atomic Absorption Spectrometer. Erythrocyte enzymes, SOD, and CAT activities in blood were determined kinetically. Subjects were randomly assigned to two groups of 14 volunteers. Group 1 was treated with an at‐home bleaching system (Opalescence PF 35% Carbamide Peroxide, Ultradent), and Group 2 was treated with a chemically activated office bleaching system (Opalescence Xtra Boost 38% Hydrogen Peroxide, Ultradent) according to the manufacturer's recommendations. Twenty‐four hours after bleaching treatments, concentrations of mercury and enzymes were remeasured.

Results

 There were no significant differences on mercury levels in blood, urine, and saliva before and after bleaching treatments (p > 0.05). No differences were also found in the level of antioxidant enzyme activities (SOD and CAT) before and after treatments (p > 0.05). Mercury release did not affect the enzyme activities (p > 0.05).

Conclusion

 Bleaching treatments either office or home did not affect the amount of mercury released from amalgam fillings in blood, urine, and saliva and the antioxidant‐enzyme activities in blood.

Clinical Significance

Bleaching treatments with the systems tested in this pilot study have no deleterious effect on the mercury release from amalgam fillings and antioxidant enzymes in body fluids.