bluuebunny/crossref_metadata_2025 huggingface dataset:
Infection Rates Following Buttonhole Cannulation in Hemodialysis Patients
Authors: Collier Sophie , Kandil Hala , Yewnetu Enat , Cross Jennifer , Caplin Ben , Davenport Andrew
Published: March 2016

Arteriovenous fistula (AVF) is the preferred access for hemodialysis (HD). Buttonhole (BH) needling has increased following the introduction of “blunt” fistula needles. Although some reported advantages for BH needling, others have reported increased infection risk. As such we reviewed our center practice, and the effect of both nasal screening and eradication and re‐education and training programs. We audited the outcomes of 881 HD patients dialyzed between November 2009 and May 2012, divided into three groups: 175 dialyzing exclusively by central venous catheter (CVC), 478 exclusively by area needling AVF (AVF) and 219 by BH. There were 31 Staphylococcus aureus bacteremias (SABs); 14 (45.2%) dialyzing with CVCs, 12 (38.7%) BH and five (16.1%) AVF. The 30 day mortality rate for SAB was 7.5% with a complication rate of 22.6%. The hazard ratio for first SAB was significantly greater for both CVC and BH access compared to AVF (5.3 (95% CI –1.9–18.6), P < 0.001 and 3.6 (1.3–96), P = 0.011, respectively). During the study SAB rates per 1000 CVC days were 0.21, compared to 0.15 for BH. After major re‐education and asepsis technique campaigns the SAB rate for BH fell to 0.06, but quickly returned to 0.17. Extending BH needling to all our dialysis centers, SAB infection rates increased to those not dissimilar to CVC access. Despite re‐education programs coupled with a strict asepsis policy and active SA eradication, followed by audit cycles, the increased infection risk with BH remained, such that we have limited BH to self‐care patients.
Evaluation of Fibrosis Markers: Apelin and Transforming Growth Factor‐β1 in Autosomal Dominant Polycystic Kidney Disease Patients
Authors: Kocer Derya , Karakukcu Cigdem , Ozturk Fahir , Eroglu Eray , Kocyigit Ismail
Published: March 2016

Renal interstitial fibrosis is an important pathological feature of autosomal dominant polycystic kidney disease (ADPKD), which progressively develops to end‐stage renal disease (ESRD). It has been shown that apelin and transforming growth factor‐β1 (TGF‐β1) play important roles in the renal fibrosis process. The aim of the present study is to evaluate the relationship of these fibrosis markers and ADPKD. Forty‐five patients with ADPKD and 28 healthy controls were studied cross‐sectionally. Estimated glomerular filtration rate (eGFR), apelin, TGF‐β1 were measured in all participants, using conventional methods. Apelin levels were lower (1.2 ± 0.9 ng/mL vs. 2.5 ±  1.3 ng/mL, P < 0.001), while TGF‐β1 levels were higher in the patient group according to healthy controls (466.5 ±  200.5 ng/L vs. 367.1 ± 163.45 ng/L, P = 0.031), respectively. Apelin was negatively correlated with TGF‐β1 and highly sensitive C‐reactive protein (hs‐CRP); and positively correlated with eGFR. In all subjects, eGFR was independently predicted by TGF‐β1 and apelin. Apelin and TGF‐β1 may be used as biomarkers of renal fibrosis that is an important pathological feature of ADPKD, which progressively develops to ESRD in ADPKD patients.
Inorganic and Total Arsenic Contents in Rice and Rice‐Based Foods Consumed by a Potential Risk Subpopulation: Sportspeople
Authors: Cano‐Lamadrid M. , Munera‐Picazo S. , Burgos‐Hernández A. , Burló F. , Carbonell‐Barrachina Ángel A.
Published: March 2016

One of the main routes of exposure to inorganic arsenic (i‐As) in humans is food, especially rice and rice‐based products. There are certain groups of consumers that could be highly exposed to i‐As. Maximum levels of i‐As have been issued for infants and young children by the European Union, but perhaps other groups are also at risk. Sportspeople could be one of those groups, due to their specific nutritional requirements, especially its high consumption of cereals, such as rice. Because of the well‐known relationship between rice and i‐As, the intake of i‐As by sportspeople deserved especial attention and was estimated in Spain. This study demonstrated that rice‐based products reached a maximum i‐As content of 178 μg/kg, with a mean for all studied products of 56 μg/kg; the maximum contents were found in rice cakes (149 μg/kg) and brown rice (111 μg/kg). The estimated daily intake of i‐As were 0.16 and 0.18 μg/kg bw (body weight)/d, in sportsmen and sportswomen, respectively. These values were below the BMDL01, 0.3 to 8.0 μg/kg bw/d; thus, it can be concluded that the sportspeople group is not at a significant risk regarding the intake of i‐As. However, further studies are needed to evaluate their whole diet and not only rice‐based products. Finally, it is important to claim that companies producing rice products include as much information as possible about the rice used in their products, including rice percentage and geographical origin.
Food borne bacterial models for detection of benzo[a]pyrene‐DNA adducts formation using RAPD‐PCR
Authors: Lanzone Valentina , Tofalo Rosanna , Fasoli Giuseppe , Perpetuini Giorgia , Suzzi Giovanna , Sergi Manuel , Corrado Federica , Compagnone Dario
Published: March 2016

Random amplified polymorphic DNA (RAPD) PCR is a feasible method to evaluate genotoxin‐induced DNA damage and mutations. In this study, Lactobacillus plantarum ATCC 14917T, Enterococcus faecium DSMZ 20477T, Escherichia coli PQ37 and Saccharomyces cerevisiae S441 were screened for DNA genetic alterations by DNA fingerprinting using M13 and LA1 primers after treatment with three compounds forming covalent adducts with DNA [benzo[a]pyrenediol epoxide (BPDE), methyl methanesulfonate and 1,2,3,4‐diepoxybutane (DEB)]. M13 RAPD fingerprinting revealed that the total number of bands decreased in all treated DNA compared to control samples and generally the lost bands were characterized by high molecular weight. Some extra bands were detected for L. plantarum and E. faecium, while in E. coli and S. cerevisiae DNAs BPDE and DEB treatments did not result in new extra bands. Besides qualitatively analysis, cluster analysis based on Unweighted Pair‐Group Method with Average algorithm was performed to compare DNA fingerprints before and after treatments. This analysis confirmed the absence of significant differences between negative controls and treated DNA in S. cerevisiae and E. coli however the disappearance of some bands can be detected. The data indicate that this approach can be used for DNA damage detection and mutations induced by genotoxic compounds and highlighted the possible use of L. plantarum and E. faecium M13 based fingerprinting as reference for hazard identification in risk assessment.
Nitrate Dynamics in Two Streams Impacted by Wastewater Treatment Plant Discharge: Point Sources or Sinks?
Authors: Rahm Brian G. , Hill Nicole B. , Shaw Stephen B. , Riha Susan J.
Published: March 2016

We examined nitrate processing in headwater stream reaches downstream of two wastewater treatment plant outfalls during low streamflow. Our objectives were to quantify nitrate mass flux before and after effluent discharge and to use field and laboratory techniques to assess the mechanism of nitrate uptake. Microcosm experiments were utilized to determine the location of nitrate processing, and molecular biomarkers were used to detect and quantify microbial denitrification. At one site, downstream nitrate mass flux was significantly (p = 0.01) lower than sum of upstream and wastewater effluent fluxes, indicating rapid stream assimilation of incoming nitrate in the vicinity of the point source. Microcosm experiments supported the theory that nitrate processing occurs in sediments. Molecular assays for denitrifcation‐associated functional genes nosZ, nirS, and nirK, provided evidence that effluent contained enriched denitrifying communities relative to ambient stream water. Nitrate loss at the site with greater uptake was correlated with sulfate loss (p < 0.01; r2 = 0.86), suggesting a possible link between sulfate reducing bacteria and denitrifying bacterial communities. Results suggest there is an opportunity to better understand nitrate dynamics in cases where point sources may act as point sinks under specific sets of conditions.
Polyethylene glycol loxenatide injections added to metformin effectively improve glycemic control and exhibit favorable safety in type 2 diabetic patients
Authors: Chen Xiaoping , Lv Xiaofeng , Yang Gangyi , Lu Dan , Piao Chunli , Zhang Xiaomei , Jiang Hong , Xie Ying , Yang Jinkui , Li Xuefeng , Li Yanbing , Xiao Xinhua , Li Yukun , Sun Li , Zheng Shaoxiong , Cheng Qingfeng , Peng Yongde , Yang Wenying
Published: March 2016

Background

The aim of the present study was to evaluate the efficacy and safety of polyethylene glycol loxenatide (PEX168) injections in Chinese type 2 diabetic (T2D) patients.

Methods

The present multicenter randomized double‐blind parallel placebo‐controlled clinical trial enrolled patients who had been treated with a stable dose of metformin (≥1500 mg/day) for ≥12 weeks and had an HbA1c level between 7% and 11%. Subjects were randomly divided into three groups (1: 1: 1) and were treated with once weekly subcutaneous injections of either placebo or 100 or 200 μg PEX168 for 12 weeks. All subjects continued to receive metformin daily.

Results

After 12 weeks treatment, the adjusted least‐squares mean of HbA1c reductions from baseline values in the 100 and 200 μg PEX168 groups were significantly higher than in the placebo group (−1.02% [95% confidence interval {CI} –1.33, −0.71), −1.36% [95% CI –1.68, −1.04], and 0.13% [95% CI –0.20, 0.45], respectively; P < 0.05). After treatment, 50% and 60.5% of subjects in the 100 and 200 μg PEX168 groups, respectively, achieved HbA1c levels <7% (P < 0.01 for both vs placebo [HbA1c 11.1%]). The most frequent adverse reactions in the PEX168 groups were mild to moderate dose‐dependent gastrointestinal reactions. There were no reports of hypoglycemia or pancreatitis in any of the groups.

Conclusions

Continuous 12 week treatment with PEX168 showed excellent safety and efficacy in T2D patients whose glucose was not well controlled with metformin alone.
Fibrobronchoscopic cryosurgery for secondary malignant tumors of the trachea and main bronchi
Authors: Ma Qianli , Shi Bin , Tian Yanchu , Liu Deruo
Published: March 2016

Background

Patients with secondary malignant tracheal and main bronchial tumors may suffer severe symptoms as a result of major airway obstruction. Curative surgical resection is usually not suitable because of the presence of metastatic disease and poor performance status. In this study, the use of bronchoscopic cryosurgery to reopen the airway is analyzed.

Methods

The clinical records of 37 patients who experienced secondary maglinancies from December 2001 to January 2013 were retrospectively reviewed. Low temperature cryotherapy (−50°C to −70°C) was delivered to the central part of the tumor by cryoprobe for four to six minutes causing destruction of the tumor mass (Cryo‐melt method). Subsequently, the edge of the tumor was frozen for 30 seconds to two minutes, followed by piecemeal removal of the frozen tumor tissue (Cryo‐resection method).

Results

The endpoints of the study were degree of symptomatic improvement and survival. The rates of dramatic and partial symptomatic alleviation were 57.1% and 28.6%, respectively, there were no intraoperative deaths, and median survival was 16.0 months. Prolonged survival was significantly correlated to age (under 60 years of age 22.2% vs. over 60 100%, P = 0.011), tumor location (main bronchi 0% vs. trachea 77.8%, P = 0.003), and cryorecanalization times (once 33.3% vs. twice or more 80.0%, P = 0.037).

Conclusion

Bronchoscopic cryorecanalization is a safe, effective, non‐invasive choice for improving the symptoms of malignant airway obstruction. In addition to achieving local‐regional control, the technique may also contribute to improved survival.
Grapevine xylem response to fungi involved in trunk diseases
Authors: Gómez P. , Báidez A.G. , Ortuño A. , Del Río J.A.
Published: March 2016

Grapevine trunk diseases (GTD), caused by a wide range of different fungi, are responsible for decline and productivity losses in vines at all growth stages. Grapevine responses to fungal attack include morphological and physiochemical defence mechanisms in the vascular system to reduce fungal infections. However, the extent to which these responses could control further spread by GTD‐fungi in the xylem vessels is poorly known. This study shows the formation of tyloses inside xylem vessels of diseased grapevines, as well as extracellular ligninolytic activities [lignin peroxidase, manganese peroxidase (MnP) and/or laccase] exhibited by some GTD‐fungi isolated here from symptomatic grapevines. In particular, Botryosphaeriaceae spp. and Phaeoacremonium minimum showed all three lignin‐degrading enzymatic activities. We also examined whether selected vine phenolic compounds, often located in the vascular system in response to fungal infection, could affect the lignin‐degrading activity from those GTD‐fungi as well as fungal colonisation. We found that phenolic compounds appeared to inhibit MnP activity, in addition to reducing fungal growth by causing anomalies in the hyphae morphology. Our results support that affected grapevines can initiate the tylosis formation in order to constrain fungi in the xylem vessels, while highlight the complementary action of the phenolic compounds to inhibit the fungi growth and colonisation. Phenolic compounds are therefore likely to have important role in alternative strategies for preventing trunk diseases.
Does Routine Midazolam Administration Prior to Nasogastric Tube Insertion in the Emergency Department Decrease Patients’ Pain? (A Pilot Study)
Authors: Manning Chelsea Taylor , Buinewicz Jacob Dillon , Sewatsky Thomas Patrick , Zgonis Evangelia , Gutierrez Kathy , O'Keefe Michael F. , Freeman Kalev
Published: March 2016

Objectives

Patients report pain and discomfort with nasogastric tube (NGT) intubation. We tested the hypothesis that premedication with midazolam alleviates pain during NGT placement in the emergency department (ED) by > 13 on a 100‐mm visual analog scale (VAS).

Methods

We performed a double‐blind randomized controlled pilot study, assigning ED patients requiring NGT placement to midazolam or placebo. All patients received intranasal cophenylcaine; additionally, they received an intravenous (IV) dose of the study drug, either 2 mg of IV midazolam or saline control. Nurses placed NGTs while observed by research staff, who then interviewed subjects to determine the primary outcome of pain using a VAS. Additional data collected from patients and their nurses included discomfort during the procedure, difficulty of tube insertion, and complications.

Results

We enrolled 23 eligible patients and obtained complete data in all: 10 midazolam and 13 controls. We found a significant reduction in mean pain VAS score of −31 (95% confidence interval = −53 to −9 mm) with 2 mg of midazolam (mean ± SD = 52 ± 30 mm), compared to placebo (mean ± SD = 21 ± 18 mm), more than double the effect size considered clinically relevant. Treatment did not impact ease of placement and there were no serious adverse effects.

Conclusions

Premedication with 2 mg of IV midazolam reduces pain of NGT insertion in ED patients without the need for full procedural sedation.
Continuous delivery of naltrexone and nalmefene leads to tolerance in reducing alcohol drinking and to supersensitivity of brain opioid receptors
Authors: Korpi Esa R. , Linden Anni‐Maija , Hytönen Heidi R. , Paasikoski Nelli , Vashchinkina Elena , Dudek Mateusz , Herr Deron R. , Hyytiä Petri
Published: March 2016

Opioid antagonist treatments reduce alcohol drinking in rodent models and in alcohol‐dependent patients, with variable efficacy across different studies. These treatments may suffer from the development of tolerance and opioid receptor supersensitivity, as suggested by preclinical models showing activation of these processes during and after subchronic high‐dose administration of the short‐acting opioid antagonist naloxone. In the present study, we compared equipotent low and moderate daily doses of naltrexone and nalmefene, two opioid antagonists in the clinical practice for treatment of alcoholism. The antagonists were given here subcutaneously for 7 days either as daily injections or continuous osmotic minipump‐driven infusions to alcohol‐preferring AA rats having trained to drink 10% alcohol in a limited access protocol. One day after stopping the antagonist treatment, [35S]GTPγS autoradiography on brain cryostat sections was carried out to examine the coupling of receptors to G protein activation. The results prove the efficacy of repeated injections over infused opioid antagonists in reducing alcohol drinking. Tolerance to the reducing effect on alcohol drinking and to the enhancement of G protein coupling to μ‐opioid receptors in various brain regions were consistently detected only after infused antagonists. Supersensitivity of κ‐opioid receptors was seen in the ventral and dorsal striatal regions especially by infused nalmefene. Nalmefene showed no clear agonistic activity in rat brain sections or at human recombinant κ‐opioid receptors. The findings support the as‐needed dosing practice, rather than the standard continual dosing, in the treatment of alcoholism with opioid receptor antagonists.
History of the Australian entomological society
Authors: Fletcher Murray J , Monteith Geoff B
Published: March 2016

This overview of the history of the Australian Entomological Society is based on a keynote presentation made by the first author to the 45th Scientific Conference of the Society in Canberra, September 2014. It summarises the efforts over many years to establish a national entomological Society and provides details of the visionaries involved in the eventual creation of the society despite certain rivalries and the political manoeuvring that was needed to negotiate a path to the Society that we know and love today. It also covers the evolution of the society's publications, the various awards given by the society and the establishment of the society in the international community through hosting the International Congress of Entomology in Australia in 1972.
Temperature‐dependent demography ofAgriphila aeneociliella(Lepidoptera:Crambidae), a new insect pest of wheat inChina
Authors: Chi Baojie , Zheng Xuan , Liang Xiaochen , Liu Yong
Published: March 2016

Agriphila aeneociliella(Eversmann) (Lepidoptera:Crambidae) was newly reported inChina in 2010. Its larvae severely damage wheat in early spring and cause substantial economic losses in wheat crops.

The present study involves a detailed study of the demography ofA. aeneociliellabased on the age‐stage, two‐sex life table. The developmental threshold and the effective accumulated temperature have been calculated for each developmental stage.

Individuals were found to have either six or seven instars, with the percentage of seven‐instar larvae increasing at higher temperatures.

The total pre‐adult development time ranged from 119.67 days at 25 °Cto 147.26 days at 18 °C. The highest pre‐adult survival rate was 72.60% at 18 °C, whereas the highest mean fecundity was 495.53 eggs per female at 25°C. The highest growth rates (r = 0.0368 day−1,λ = 1.0375 day−1) were observed at 23 °C, whereas the shortest mean generation time (T = 127.67 days) occurred at 25 °C. No significant differences were found in population parameters between cohorts raised at 23 and 25 °C.

The present study provides a basis for understanding the population ecology ofA. aeneociliellaand can be instrumental in constructing future integrated pest management programmes against this widespread pest.
Trajectories of marijuana use from adolescence to adulthood as predictors of unemployment status in the early forties
Authors: Zhang Chenshu , Brook Judith S. , Leukefeld Carl G. , Brook David W.
Published: March 2016

Objectives

To study the degree to which individuals in different trajectories of marijuana use are similar or different in terms of unemployment status at mean age 43.

Methods

We gathered longitudinal data on a prospective cohort taken from a community sample (N = 548). Forty‐nine percent of the original participants were females. Over 90% of the participants were white. The participants were followed from adolescence to early midlife. The mean ages of participants at the follow‐up interviews were 14.1, 16.3, 22.3, 27.0, 31.9, 36.6, and 43.0, respectively. We used the growth mixture modeling (GMM) approach to identify the trajectories of marijuana use over a 29‐year period.

Results

Five trajectories of marijuana use were identified: chronic users/decreasers (8.3%), quitters (18.6%), increasing users (7.3%), chronic occasional users (25.6%), and nonusers/experimenters (40.2%). Compared with nonusers/experimenters, chronic users/decreasers had a significantly higher likelihood of unemployment at mean age 43 (adjusted odds ratio = 3.51, 95% confidence interval = 1.13–10.91), even after controlling for the covariates.

Conclusions and Scientific Significance

The results of the associations between the distinct trajectories of marijuana use and unemployment in early midlife indicate that it is important to develop intervention programs targeting chronic marijuana use as well as unemployment in individuals at this stage of development. Results from this study should encourage clinicians, teachers, and parents to assess and treat chronic marijuana use in adolescents. (Am J Addict 2016;25:203–209)
Effect of humour therapy on psychotropic medication use in nursing homes
Authors: Leow Jerome BY , Pont Lisa , Low Lee‐Fay
Published: March 2016

Aim

The aim of this study was to assess the effect of Play Up humour therapy on antipsychotic, benzodiazepine and antidepressant use in Australian nursing homes.

Methods

Play Up is a humour therapy program that has been implemented in Australian nursing homes. This study was an uncontrolled retrospective review of psychotropic medication charts of 406 residents in thirty‐three nursing homes before and after 12 weeks of participation in Play Up. Prevalence and mean daily equivalent doses of psychotropic medication use were analysed.

Results

There were significant reductions from before to after the Play Up program in the prevalence of any psychotropic medication use, antipsychotic use and benzodiazepine use (P = 0.001, 0.02, 0.007, respectively). Mean daily dose equivalents of pro re nata (PRN) antipsychotics and PRN benzodiazepines significantly reduced over time (P = 0.007; P = 0.001).

Conclusions

Play Up was associated with an overall decline in the use of psychotropic medications. Further trials are required to confirm and better define this association.
Estimation of the prevalence and direct medical costs of chronic myeloid leukemia in the I.R. of Iran in the era of tyrosine kinase inhibitors
Authors: Daroudi Rajabali , Mirzania Mehrzad , Nikravanfard Nazila , Sadighi Sanambar , Sedighi Zahra , Zendehdel Kazem
Published: March 2016

Background

After the introduction of tyrosine kinase inhibitors for chronic myeloid leukemia (CML), the survival of these patients has increased significantly. However, these new drugs are expensive and impose considerable expense to patients and governments. Epidemiologic and economic evaluation studies provide good information for resource allocation and decision making. We estimated the incidence, prevalence and direct medical cost of CML in Iran.

Methods

We used the National Cancer Registry (NCR) data from 2006 to 2009 to estimate the incidence rate of CML (ICD‐10 code C92.1). After adjustment for the underestimation of incidence rates, we used survival rates of CML and estimated the 5‐year prevalence for these patients. In addition, we used clinical practice guideline, expert opinions and medical tariffs to estimate the direct medical costs through the prevalence approach.

Results

After an adjustment for the underestimation, the incidence rate of CML was 0.5 per 100 000 in the I.R. of Iran. The 5‐year prevalence was about 2263 cases (2.98 per 100 000). The total direct medical cost of CML was $23 089 323 and the majority of the cost (97%) was related to drug costs. The total cost will increase considerably to $40 728 869 if all patients use the new drug nilotinib (800 mg/day) as a second‐line treatment.

Conclusions

The increased survival of CML patients and a possible increase in incidence of CML in Iran will most likely lead to a considerable rise in its prevalence and economic burden.
The significance of Delphian lymph node in papillary thyroid cancer
Authors: Tan Zhuo , Ge Ming‐Hua , Zheng Chuan‐Ming , Wang Qing‐Liang , Nie Xi‐Lin , Jiang Lie‐Hao
Published: March 2016

Aim

To investigate the clinical significance of the DLN metastasis in papillary thyroid cancer (PTC).

Methods

A total of 231 PTC patients who underwent first surgical treatment in the Department of Hand and Neck Surgery of Zhejiang Cancer Hospital from January 2013 to June 2014 were enrolled. The relationship between Delphian lymph node (DLN) metastasis and patient age, gender, tumor size, tumor number, unilateral or bilateral, capsular invasion, pretracheal and paratracheal node metastasis, and lateral node metastasis was analyzed.

Results

Within 231 cases, 69 showed DLN, but only 19 (8.23%) were found with metastasis. In the univariate analysis, DLN metastasis was significantly associated with tumor size (P = 0.023), capsular invasion (P = 0.001), pretracheal or paratracheal node metastasis (P = 0.003) and lateral node metastasis (P = 0.001), while there were no significant correlation between DLN metastasis and gender (P = 0.976), age (P = 0.976), tumor number (P = 0.234) and unilateral or bilateral (P = 0.724). In the multivariate analysis, capsular invasion was an independent risk factor of DLN metastasis (P < 0.05, odds ratio = 10.15).

Conclusion

Capsular invasion is an independent risk factor of DLN metastasis and DLN metastasis could be used as a predictor of lateral node metastasis. The dissection of DLN in PTC patients is recommended and lateral lymph node should be evaluated for patients with DLN positive.
The characteristics of oncology social work in Australia: Implications for workforce planning in integrated cancer care
Authors: Pockett Rosalie , Peate Michelle , Hobbs Kim , Dzidowska Monika , L Bell Melanie , Baylock Brandi , Epstein Irwin
Published: March 2016

Aims

To describe the demographics, professional characteristics, self‐reported professional development needs and research involvement of oncology social workers in Australia and to describe perceived barriers to provision of quality psychosocial care.

Methods

A cross‐sectional online survey was administered to social workers working in the oncology field who were contacted through three professional organizations; the Australian Association of Social Workers, Oncology Social Work Australia and the Psycho‐oncology Co‐operative Research Group, the University of Sydney. A snowball recruitment method was adopted to maximize the sample size.

Results

Two thirds of respondents had over 10 years professional practice experience but with lesser experience in oncology settings. Twenty‐eight percent had post‐graduate qualifications. Professional development needs were reported as moderate or high by 68% of respondents. No association between professional needs and work setting was found. Years of experience in oncology practice and living in an urban area increased the likelihood of involvement in research. Barriers to psychosocial care included poor understandings of the social work role, time constraints and an inadequate number of social work positions.

Conclusion

In this first Australian study of the social work oncology workforce, the results demonstrated active, well‐qualified and experienced social workers providing frontline services to people with cancer and their caregivers in geographically diverse locations across Australia. Inadequate resources and a lack of integrated psychosocial care were identified as barriers to comprehensive cancer care. The need for Aboriginal and Torres Strait Islander social workers was identified as an urgent workforce priority.
GARP inhibits allergic airway inflammation in a humanized mouse model
Authors: Meyer‐Martin H. , Hahn S. A. , Beckert H. , Belz C. , Heinz A. , Jonuleit H. , Becker C. , Taube C. , Korn S. , Buhl R. , Reuter S. , Tuettenberg A.
Published: March 2016

Background

Regulatory T cells (Treg) represent a promising target for novel treatment strategies in patients with inflammatory/allergic diseases. A soluble derivate of the Treg surface molecule glycoprotein A repetitions predominant (sGARP) has strong anti‐inflammatory and regulatory effects on human cells in vitro as well as in vivo through de novo induction of peripheral Treg. The aim of this study was to investigate the immunomodulatory function of sGARP and its possible role as a new therapeutic option in allergic diseases using a humanized mouse model.

Methods

To analyze the therapeutic effects of sGARP, adult NOD/Scidγc−/− (NSG) mice received peripheral blood mononuclear cells (PBMC) derived from allergic patients with sensitization against birch allergen. Subsequently, allergic inflammation was induced in the presence of Treg alone or in combination with sGARP.

Results

In comparison with mice that received Treg alone, additional treatment with sGARP reduced airway hyperresponsiveness (AHR), influx of neutrophils and macrophages into the bronchoalveolar lavage (BAL), and human CD45+ cells in the lungs. Furthermore, the numbers of mucus‐producing goblet cells and inflammatory cell infiltrates were reduced. To elucidate whether the mechanism of action of sGARP involves the TGF‐β receptor pathway, mice additionally received anti‐TGF‐β receptor II (TGF‐βRII) antibodies. Blocking the signaling of TGF‐β through TGF‐βRII abrogated the anti‐inflammatory effects of sGARP, confirming its essential role in inhibiting the allergic inflammation.

Conclusion

Induction of peripheral tolerance via sGARP is a promising potential approach to treat allergic airway diseases.
Leydig cells contribute to the inhibition of spermatogonial differentiation after irradiation of the rat
Authors: Shetty G. , Zhou W. , Weng C. C. Y. , Shao S. H. , Meistrich M. L.
Published: March 2016

Irradiation with 6 Gy produces a complete block of spermatogonial differentiation inLBNF1rats that would be permanent without treatment. Subsequent suppression of gonadotropins and testosterone (T) restores differentiation to the spermatocyte stage; however, this process requires 6 weeks. We evaluated the role of Leydig cells (LCs) in maintenance of the block in spermatogonial differentiation after exposure to radiation by specifically eliminating functionalLCs with ethane dimethane sulfonate (EDS).EDS(but not another alkylating agent), given at 10 weeks after irradiation, induced spermatogonial differentiation in 24% of seminiferous tubules 2 weeks later. However, differentiation became blocked again at 4 weeks asLCs recovered. WhenEDSwas followed by treatment with GnRHantagonist and flutamide, sustained spermatogonial differentiation was induced in >70% of tubules within 2 weeks. WhenEDSwas followed by GnRHantagonist plus exogenous T, which also inhibitsLCrecovery but restores follicle stimulating hormone (FSH) levels, the spermatogonial differentiation was again rapid but transient. These results confirm that the factors that block spermatogonial differentiation are indirectly regulated by T, and probablyFSH, and that adult and possibly immatureLCs contribute to the production of such inhibitory factors. We tested whether insulin‐like 3 (INSL3), aLC‐produced protein whose expression correlated with the block in spermatogonial differentiation, was indeed responsible for the block by injecting syntheticINSL3 into the testes and knocking down its expression in vivo with siRNA. Neither treatment had any effect on spermatogonial differentiation. The Leydig cell products that contribute to the inhibition of spermatogonial differentiation in irradiated rats remain to be elucidated.
Cross‐sectional association between physical activity and serum testosterone levels in US men: results from NHANES 1999–2004
Authors: Steeves J. A. , Fitzhugh E. C. , Bradwin G. , McGlynn K. A. , Platz E. A. , Joshu C. E.
Published: March 2016

Testosterone levels and physical activity each play important roles in men's health, but the relationship between the two remains unclear. We evaluated the cross‐sectional association between self‐reported total physical activity and serum testosterone levels in 738 men (mean age 42.4 years, range 20–≥85 years) who participated in National Health and Nutrition Examination Survey 1999–2004. We compared geometric mean testosterone concentrations measured by radioimmunoassay (RIA) and calculated the odds ratio (OR) of having low or low normal testosterone (≤3.46 ng/mL) across tertiles of total physical activity in all men, and men stratified by age (20–49, ≥50 years), and obesity status (BMI < 30, ≥30 kg/m2). The geometric mean testosterone concentration was 5.31 ng/mL; 18.6% of the men had low or low normal serum testosterone levels. Physical activity tertiles were not associated with testosterone levels overall, or when stratified by age or obesity status. Similarly, there was no association between physical activity tertiles and the odds of low or low normal testosterone, overall or by age. However, among non‐obese men, those in the highest physical activity tertile were significantly less likely to have low or low normal testosterone than those in the lowest tertile (OR 0.50; 95% CI = 0.26–0.95); there was no association among obese men. Greater physical activity was not associated with testosterone levels, but may be associated with a reduced odds of low or low normal testosterone in non‐obese men, but not in obese men.
Vitamin D and gonadal function in men: a potential inverse U‐shaped association?
Authors: Karras S. , Anagnostis P. , Kotsa K. , Goulis D. G.
Published: March 2016

Accumulating evidence from animal and human studies suggests that vitamin D, apart from its regulatory effects on musculoskeletal health, is involved in reproductive function in both genders. The basis of the interplay between vitamin D and reproduction lays on the presence of both vitamin D receptor (VDR) and 1α‐hydroxylase (CYP27B1) enzyme in reproductive organs. In males, VDR are present in testis, epididymis, prostate, and seminal vesicles. In Sertoli cells, whose secretory activities are ion channel‐dependent, vitamin D has been shown to stimulate calcium uptake through a nuclear receptor activity. Epidemiological studies support a positive association between serum 25‐hydroxy‐vitamin D [25(OH)D] concentrations and sperm motility in both fertile and infertile men In addition, large multi‐center, cross‐sectional studies from Europe and USA have shown positive, linear association between 25(OH)D and androgen concentrations. On the contrary, there are studies that support an inverse U‐shaped association, that is, men with both low and high 25(OH)D concentrations demonstrate poorer gonadal function compared with those with intermediate concentrations. Given the rapid increase in over‐the‐counter use of vitamin D supplements by men that anticipate advantageous health outcomes, the aim of the present commentary is to provide an overview of the studies that present either U‐shaped or linear association between 25(OH)D concentrations and male gonadal function.
Repair of congenital diaphragmatic hernia during extracorporeal life support: experience with six neonates
Authors: Prabhu Sudesh , Mattke Adrian C. , Anderson Ben , McBride Craig , Cooke Lucy , Karl Tom , Alphonso Nelson
Published: March 2016

Background

The management of congenital diaphragmatic hernia (CDH) in neonates has evolved considerably over the last three decades. Initial stabilization followed by surgical repair is the current standard of care. A subset fails to achieve adequate oxygenation with medical management, including the use of high frequency oscillation and inhaled nitric oxide. The mortality in this group exceeds 80% without additional management strategies. Extracorporeal life support (ECLS) is a well‐established modality for managing these neonates with CDH and has been shown to improve early survival in selected cases.

Methods

This is a retrospective analysis of six neonates with CDH who underwent repair during ECLS between September 2011 and November 2014.

Results

Of 24 admissions with CDH, there were six neonates (25%) who required ECLS. All the six had CDH repair during ECLS. There were no intra‐operative bleeding complications. There were no clotting complications related to stopping heparin during CDH repair. There was one hospital death. Five neonates were weaned from ECLS and discharged home.

Conclusions

Data from our small cohort of patients illustrate that early survival is possible in extremely compromised neonates who otherwise would have died without ECLS. Our experience demonstrates that CDH repair can safely be performed during ECLS. Use of ECLS, early repair during ECLS, lung protective ventilation strategies and aggressive management of pulmonary hypertension were associated with good early survival. ECLS should be considered as an integral part of therapeutic armamentarium for CDH in neonates.
Factors predicting poor outcomes in T1N0 oral squamous cell carcinoma: indicators for treatment intensification
Authors: Low Tsu‐Hui (Hubert) , Gao Kan , Gupta Ruta , Clifford Anthony , Elliott Michael , Ch'ng Sydney , Milross Chris , Clark Jonathan R.
Published: March 2016

Background

This study investigated the impact of adverse pathological features (APFs) amongst patients with T1N0 oral squamous cell carcinoma (OSCC) on both tumour control and survival. We aimed to investigate clinicopathological factors that would predict poor outcomes and determine a clinically relevant threshold for the recommendation of additional treatment.

Methods

Retrospective analysis of 121 patients from a single institution (1988–2013) who were treated with surgery only (wide local excision of the primary tumour with or without neck dissection). Only patients who are pT1cN0 or pT1pN0 were included. Patients who had received adjuvant radiotherapy were excluded from the study.

Results

APFs were associated with increased regional failure included tumour thickness (TT) ≥5 mm (P = 0.007), perineural invasion (PNI) (P = 0.003), infiltrative border (P = 0.030) and poor differentiation (P = 0.005). Poorly differentiated tumours were also associated with increased local failure (P = 0.03). Local control (LC), regional control (RC) and disease‐specific survival (DSS) decreased with an increasing number of APFs (P = 0.009, P = <0.001 and P = 0.009, respectively). Patients with four or more APFs had significantly worse outcomes in LC (P < 0.001), RC (P < 0.001) and DSS (P < 0.001).

Conclusion

T1N0 OSCC exhibiting four or more APFs or demonstrating poor differentiation on histology had an increased risk of locoregional failure. The presence of PNI, infiltrative border and TT ≥5 mm are associated with increased regional failure. These factors may prompt escalation of treatment for patients with T1N0 OSCC.
Obstetric anal sphincter injury and incontinence 15–23 years after vaginal delivery
Authors: Halle Tuva K. , Salvesen Kjell Å. , Volløyhaug Ingrid
Published: March 2016

Introduction

The primary aim was to study prevalence of obstetric anal sphincter injuries (OASIS) after normal vaginal deliveries (NVD) and operative vaginal deliveries (OVD) with a subgroup analysis of forceps (FD) vs. vacuum deliveries (VD). The secondary aim was to study the association betweenOASISand anal incontinence 15–23 years later.

Material and methods

This was a cross‐sectional study including 8137 primiparous women in Trondheim, Norway, from 1990 to 1997. The outcome measure was the adjusted odds ratio (aOR) forOASISbetween delivery groups. A total of 1122 women responded to a postal questionnaire containing the Colorectal‐Anal Distress Inventory (CRADI) in 2013. TheaORfor anal incontinence and the difference inCRADIscore between women with and withoutOASISwere calculated.

Results

OASISprevalence was 2% forNVDand 10% forOVD(10%FD, 9%VD).aORforOASISwas 5.01 (95%CI3.85–6.51) comparingOVDwithNVD. There was no difference betweenFDandVD(aOR1.15, 95%CI0.79–1.67).FDwas associated with higher risk of fourth degree perineal tear thanVD(aOR5.08, 95%CI1.47–17.49).OASISwas associated with increased risk of leakage of well‐formed (aOR8.61, 95%CI3.08–24.12) and loose stool (aOR2.75, 95%CI1.43–5.27) and higherCRADIscore (Mann–WhitneyU‐test,p= 0.01).

Conclusions

OVDwas associated with increased risk ofOASIS.FDwas associated with higher risk of fourth degree perineal tear compared withVD.OASISwas associated with increased risk of anal incontinence and higherCRADIscore 15–23 years later.
Volvulus in term and preterm infants ‐ clinical presentation and outcome
Authors: Horsch Sandra , Albayrak Bilge , Tröbs Ralf‐Bodo , Roll Claudia
Published: March 2016

Aim

Our aim was to assess if term and preterm infants with volvulus showed different patterns with regard to pathogenesis, clinical presentation and outcome.

Methods

We reviewed the medical records and imaging data of infants aged less than six months with volvulus treated in a single surgical referral centre from 2006–2013.

Results

Volvulus was diagnosed in 19 infants, with no anatomical anomaly in three of the 12 preterm infants and one of the seven term infants. Most cases (74%) presented during the first eight days of life. Later presentations occurred exclusively in preterm infants, with only one of the five having no anatomic anomalies. Bilious vomiting was the leading symptom in six of the seven term infants, while the symptoms in preterm infants were rather nonspecific. Intestinal necrosis, with the need for bowel resection, occurred in one term (14%) infant and nine (75%) preterm infants.

Conclusion

The clinical presentation and outcome of volvulus differed between preterm and term infants, but the rate and distribution of underlying anomalies did not differ. Symptoms in preterm infants were often nonspecific and led to a delay in diagnosis. This might have contributed to the higher rate of intestinal necrosis in preterm infants.
Parent and adolescent reports in assessing adolescent sleep problems: results from a large population study
Authors: Fatima Yaqoot , Doi Suhail A.R. , O'Callaghan Michael , Williams Gail , Najman Jake M. , Mamun Abdullah Al
Published: March 2016

Aim

To compare parent and adolescent reports in exploring adolescent sleep problems and to identify the factors associated with adolescent sleep problem disclosures.

Methods

Parent (n = 5185) and adolescent reports (n = 5171, age=13.9 ± 0.3 years), from a birth cohort were used to explore adolescent sleep problems. Kappa coefficients were used to assess the agreement, whereas, conditional agreement and disagreement ratios were used to identify the optimal informant. Logistic regression analysis was used to determine the factors affecting adolescent sleep problem disclosure.

Results

Parental reports identified only about one‐third of the sleep problems reported by adolescents. Whereas adolescent reports identified up to two‐thirds of the sleep problems reported by parents. Combined reports of parents and adolescent did not show any considerable difference from the adolescent report. Adolescent and parent health, maternal depression, and family communication were significantly associated with adolescents sleep problem disclosures.

Conclusion

Adolescent reports could be used as the preferred source to explore adolescent sleep problems. Parental reports should be used when parents as observers are more reliable reporters, or where adolescents are cognitively unable to report sleep problems. Additionally, the impact of poor health, maternal depression and family communication on sleep problems disclosure should be considered for adolescent sleep problem diagnosis.
Metabolomic profiling reveals differential effects of glucagon‐like peptide‐1 and insulin on nutrient partitioning in ovine liver
Authors: El‐Sabagh Mabrouk , Taniguchi Dai , Sugino Toshihisa , Obitsu Taketo
Published: March 2016

This study was conducted to identify the insulin‐independent actions of glucagon‐like peptide‐1 (GLP‐1 (7‐36 amide)) in partitioning nutrient metabolism in ovine liver. Four Suffolk wethers (60.0 ± 6.7 kg body weight (BW)) were used in a repeated‐measure design under euglycemic‐‐hyperinsulinemic and hyper ‐GLP‐1 clamps for 150 min with intravenous infusion of insulin (0.5 mU/kg BW/min; from 0 to 90 min), GLP‐1 (0.5 µg/kg BW/min; from 60 to 150 min) and both hormones co‐administered from 60 to 90 min. Liver biopsies were collected at 0, 60, 90 and 150 min to represent the metabolomic profiling of baseline, insulin, insulin plus GLP‐1, and GLP‐1, respectively, and were analyzed for metabolites using Capillary Electrophoresis Time‐of‐Flight Mass Spectrometer. Metabolomics analysis reveals 51 metabolites as being significantly altered (P < 0.05) by insulin and GLP‐1 infusion compared to baseline values. Insulin infusion enhanced glycolysis, lipogenesis, oxidative stress defense and cell proliferation pathways, but reduced protein breakdown, gluconeogenesis and ketogenesis pathways. Conversely, GLP‐1 infusion promoted lipolytic and ketogenic pathways accompanied by a lowered lipid clearance from the liver as well as elevated oxidative stress defense and nucleotide degradation. Despite further research still being warranted, our data suggest that GLP‐1 may exert insulin‐antagonistic effects on hepatic lipid and nucleotide metabolism in ruminants.
Sprucification in protected forests: myth or veracity? – Clues from 60 yrs survey data
Authors: Hedwall Per‐Ola , Mikusiński Grzegorz
Published: March 2016

Questions

The purpose of this study was to examine how compositional characteristics of forest reserves in production landscapes change over time and to explore the local site conditions that drive these processes. Our hypothesis was according to the general paradigm that suppression of natural disturbance regimes and lack of active management causes protected forest areas (PFAs) to develop into forests of high density dominated by late successional tree species.

Location

Boreal and hemiboreal forests of Sweden.

Methods

We used long‐term (60 yrs) data from the Swedish National Forest Inventory (NFI), representing all the PFAs in Sweden, to study changes in tree species composition in relation to site factors and the initial state of the forest.

Results

During the period of our study the average density expressed by the growing stock (GS) increased from 70 to 140 m3·ha−1. This increase concerned both early and late successional tree species and there was no evidence for a faster increase of the late successional species Norway spruce (Picea abies) and the species composition was stable over time. A net volume increment (NVINCR) in spruce was mostly related to sites where spruce already was present, sites with high productivity and forest of high age. The probability of an increase in Scots pine (Pinus sylvestris) was negatively linked to productivity and stand age, while the NVINCR was higher on more productive sites. The NVINCR of deciduous trees was unrelated to site productivity and age but positively affected by the initial GS, increasing slope and soil depth.

Conclusions

Our results suggest that the relative composition of species is stable over time and balanced by site productivity, which is in accordance with the resource‐ratio hypothesis. An important cause of this stability could be the low number of tree species in northern Europe, which limits the number of potential successional pathways.