bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate change and adoption of sustainable land management practices in the Niger basin of Benin
Authors: Lokonon Boris O. K. , Mbaye Aly A.
Published: February 2018

Due to the important role that the agricultural sector plays in sustaining growth and reducing poverty in developing countries, the adoption of practices that have the potential to simultaneously improve agricultural productivity while minimizing environmental impacts is essential. This paper examines the determinants of farmers’ perceptions of climate change and subsequent adoption of sustainable land management practices in the Niger basin of Benin. Binary and multivariate probit models are applied in a two‐stage regression procedure to cross‐sectional data collected through a survey of 545 randomly selected farm households in 28 villages. The findings indicate that there are substitutabilities among three pairs of sustainable land management practices being used by the farmers. Climate change perception is positively related to land tenure, experience in farming, number of relatives, tractor use, and membership in farmers’ organizations, and negatively related to household size, remoteness, and plough use. Moreover, the findings reveal that the uptake of land management practices is related to assets, land tenure, education level of the household head, remoteness, social network, non‐irrigated land size, having a farm located near a river/lake/stream, tractor and plough use, being a subsistence farmer or not, and memberships in farmers’ organizations. The adoption of sustainable land management practices could be encouraged through improving access to markets, adequate roads, and technologies, as well as by promoting membership in farmers’ organizations.
Burnout among female emergency medicine physicians: A nationwide study
Authors: Soltanifar Atefeh , Pishbin Elham , Attaran Mashhadi Negin , Najaf Najafi Mona , Siahtir Maryam
Published: February 2018

Objective

The challenging and stressful nature of emergency medicine place the practitioners of this young branch of medicine at risk of burnout. In Iran, the number of women choosing the specialty of emergency medicine has been increasing in recent years. No studies have focused on burnout among female emergency medicine physicians. We conducted this study to evaluate the level of burnout in female emergency medicine physicians in Iran.

Methods

In this cross‐sectional study, all Iranian female emergency medicine physicians with more than 2 years of work experience as specialists, received a questionnaire containing 22‐item Maslach Burnout Inventory scales and 7‐item Cassidy social support scale, as well as questions about workload and career satisfaction.

Results

In total, 77 questionnaires were analysed (response rate: 75%; median age: 36 years, median for work experience = 3 years). A total of 34% of participants were academic faculties. The level of burnout in three subscales of emotional exhaustion, depersonalisation and perceived low personal accomplishment was moderate to high in 84.5, 48.1 and 80.5% of participants respectively. A total of 94.8% of female emergency medicine physicians perceived their workload to be moderate to high and only 1.3% of them had high job satisfaction.

Conclusions

Alarming high rate of burnout and job dissatisfaction among female emergency medicine physicians in our study requires careful attention. Further investigations are suggested to identify the contributory factors to burnout and the probability of some gender disparities in this field.
Rationale and developmental methodology for the SIMPLE approach: A Systematised, Interdisciplinary Malnutrition Pathway for impLementation and Evaluation in hospitals
Authors: Bell Jack J. , Young Adrienne , Hill Jan , Banks Merrilyn , Comans Tracy , Barnes Rhiannon , Keller Heather H.
Published: February 2018

Aim

Changing population demographics, service demands, and healthcare provider expectations suggest that a shift is required regarding how malnutrition care is managed in hospitals. The present study aims to build the reason for required change, and to describe the process used to develop a model for managing malnutrition for implementation across six Queensland hospitals.

Methods

A cross‐sectional survey of approaches to managing malnutrition in Queensland public hospitals, and development of a new model of care (guided by Knowledge‐to‐Action Framework and qualitative interviews) for testing within a broader implementation program.

Results

Twenty‐three surveys were distributed with 21 completed by metropolitan (n = 11), regional (n = 8), and rural/remote (n = 2) settings. Substantial within and across site variance was observed, with care processes focused towards highly individualised, dietitian delivered care. Some early adopter sites demonstrated systematic, interdisciplinary or delegated malnutrition care processes; however, the latter was rarely or never undertaken in eight sites. A model for the Systematised, Interdisciplinary Malnutrition Pathway for impLementation and Evaluation (SIMPLE) in hospitals was drafted based on identified contemporary models and supporting literature. A mixed‐methods approach combined survey data with structured interviews conducted in six sites, purposively sampled for maximal variation to iteratively refine the model. Consensus for implementation of the final model was achieved across site clinicians, leaders, and governance structures.

Conclusions

Systematised, delegated, and interdisciplinary nutrition care activities are realistic in at least some settings. A model is now available to provide interdisciplinary care. Next steps including testing implementation will determine if this interdisciplinary model improves malnutrition care delivered in hospitals.
Exploring the impact of Aboriginal health placement experiences on the preparation of dietetic graduates for practice with Aboriginal communities
Authors: Svarc Ruby , Davis Corinne , McDonald Helena , Perruzza Julia , Browne Jennifer , Delbridge Robyn , Morgan Keith , O’Reilly Sharleen , Margerison Claire , Palermo Claire
Published: February 2018

Aim

A health workforce with the ability to practice with Aboriginal communities is crucial to bridge the health gap between Aboriginal and non‐Aboriginal Australians. This study aimed to explore the impact of university Aboriginal health placements on preparing dietetic graduates for practice with Aboriginal communities.

Methods

A mixed methods sequential explanatory design was used. A sample of 594 dietetic graduates was invited to complete a survey that identified Aboriginal health experiences and measured attitudes and self‐confidence towards working in Aboriginal health using a five‐point Likert scale. Participants were divided into placement versus no‐placement groups and compared using chi‐squared tests. Sixteen of 33 participants who had completed an Aboriginal health placement were invited to participate in a semi‐structured interview to explore how placement influenced practice with Aboriginal communities. Interviews were analysed using content analysis.

Results

A final sample of 120 participants showed that placement participants reported significantly higher self‐confidence towards working in Aboriginal health compared with no‐placement participants (No‐placement = 35% agree, 36% neutral, 29% disagree; Placement = 74% agree, 11% neutral, 16% disagree; χ2 (2, 88) = 9.4; P = 0.01). Fifteen participants were interviewed. Interview data indicated that situated learning experiences, breaking down stereotypes, empathy through learning from Aboriginal people, and Aboriginal health role‐models were key components of Aboriginal health placements in preparing dietetic graduates for practice with Aboriginal communities.

Conclusions

The results suggest that Aboriginal health placements may be an effective strategy for preparing dietetic graduates for practice with Aboriginal communities. The feasibility of placement or alternative curriculum content needs to be explored.
Feather content of porphyrins in Eurasian eagle owl (Bubo bubo) fledglings depends on body condition and breeding site quality
Authors: GALVÁN Ismael , DELGADO María del Mar , CAMARERO Pablo R. , MATEO Rafael , LOURENÇO Rui , PENTERIANI Vincenzo
Published: February 2018

Porphyrins are pigments produced in most animal cells during the synthesis of heme, but their importance for external coloration is unclear. Owls (Order Strigiformes) are among the few animals that accumulate porphyrins in the integument, where it could serve as a means of signaling. Here we hypothesized that the porphyrin content of feathers may depend on body condition and breeding site quality in Eurasian eagle owl (Bubo bubo) fledglings and, thus, constitute amplifiers of the quality of the area where they are born. Using high‐performance liquid chromatography, we found 2 porphyrins (protoporphyrin IX and coproporphyrin III) in the body feathers of 19 eagle owl fledglings from 7 breeding territories. Coproporphyrin III, but not protoporphyrin IX feather concentration, was positively associated with the body mass of fledglings and with the quality of the breeding sites where they were reared with respect to food quality and availability. As coproporphyrin III is produced under oxidative stress, we suggest that good breeding sites may lead to fledglings in good condition. This, in turn, may make fledglings induce a certain level of free radical and coproporphyrin III production to signal to conspecifics their site‐mediated capacity to cope with oxidative stress. This is the first time that porphyrin content in the integument has been found to be related to individual quality, opening a new scenario for studying evolution of animal coloration.
Summer egg diapause in a matchstick grasshopper synchronizes the life cycle and buffers thermal extremes
Authors: KEARNEY Michael R. , DEUTSCHER John , KONG Jacinta D. , HOFFMANN Ary A.
Published: February 2018

The phenological response is among the most important traits affecting a species’ sensitivity to climate. In insects, strongly seasonal environments often select for a univoltine life cycle such that one seasonal extreme is avoided as an inactive stage. Through understanding the underlying mechanisms for univoltinism, and the consequences of its failure, we can better predict insect responses to climate change. Here we combine empirical data and simulation studies to investigate the consequences of an unusual diapause mechanism in a parthenogenetic matchstick grasshopper, Warramaba virgo, from arid southern Australia. Our field body temperature measurements indicate that this species is a thermoconformer and our laboratory studies of the thermal response of feeding rate imply strong constraints on winter activity. However, the species exhibits no obligate winter diapause, and eggs can develop in 1 month under constant temperatures approximating the mean soil temperature at the time of oviposition (summer). We show that diurnal temperature cycles exceeding a peak of 36 °C inhibit egg development in summer, and that this is sufficient to prevent autumnal hatching of eggs. Development is also strongly retarded below 24 °C. Microclimate‐driven simulation studies of egg development show that these thermal responses provide robust maintenance of a univoltine life cycle, thereby resulting in survival of heat stress as an egg (due to limited developmental state) and avoidance of cold stress as a nymph and adult (due to overwintering in the soil as an egg).
Non‐high‐density lipoprotein cholesterol:  High‐density lipoprotein cholesterol ratio is an independent risk factor for diabetes mellitus: Results from a population‐based cohort study
Authors: Zhang Nan , Hu Xiang , Zhang Qiao , Bai Peng , Cai Miao , Zeng Tian Shu , Zhang Jiao‐Yue , Tian Sheng‐Hua , Min Jie , Huang Han‐Tao , Zheng Juan , Peng Miao‐Miao , Li Meng‐Jia , Chen Lu‐Lu
Published: February 2018

Background

Dyslipidemia predicts the development and progression of diabetes. A higher non‐high‐density lipoprotein cholesterol (HDL‐C):  HDL‐C ratio is reportedly associated with metabolic syndrome and insulin resistance, but its relationship with glycemic levels and diabetes remains unclear.

Methods

In all, 4882 subjects aged ≥40 years without diabetes and not using lipid‐lowering drugs were enrolled in the study. The non‐HDL‐C:  HDL‐C ratio was log10 transformed to achieve normal distribution. Multivariate logistic regression was used to investigate the association between the log10‐transformed non‐HDL‐C:  HDL‐C ratio and diabetes. Stratified analyses of the association by age, gender, and body mass index (BMI) were also performed.

Results

After 3 years of follow‐up, 704 participants developed diabetes. After adjustment for age, gender, current smoking, current drinking, physical activity, BMI, systolic blood pressure, and family history of diabetes, each 1‐SD increase in the log(non‐HDL‐C:  HDL‐C ratio) was associated with higher fasting blood glucose (FPG) levels (β = 0.1; 95% confidence interval [CI] 0.1–0.1), 2‐h postload plasma glucose levels (2‐h glucose; β = 0.2; 95% CI 0.1–0.2), and risk of diabetes (odds ratio [OR] 1.1; 95% CI 1.0–1.2). In a multivariate model, subjects in the top quartile of non‐HDL‐C:  HDL‐C ratio had higher FPG (β = 0.2; 95% CI 0.2–0.3), 2‐h glucose (β = 0.5; 95% CI 0.3–0.7) and HbA1c (β = 0.1; 95% CI 0.1–0.2) levels, and a 40% increased risk of diabetes (OR 1.4; 95% CI 1.1–1.8) than participants in the bottom quartile.

Conclusions

The non‐HDL‐C:  HDL‐C ratio was found to be an independent risk factor for diabetes.
Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series
Authors: James Melissa , Swadi Sami , Yi Ma , Johansson Lisa , Robinson Bridget , Dixit Ashutosh
Published: February 2018

Introduction

We report the incidence of ischaemic cardiac toxicity in a contemporary cohort of patients receiving conventional (CFRT) or hypofractionated (HFRT) radiation after surgery for early breast cancer and investigate the interplay of cardiac risk factors and fractionation.

Methods

Included were patients receiving external beam radiation treatment from 2002 to 2006 at the Christchurch public hospital. Hospital coding databases, oncology databases and medical records were reviewed for baseline characteristics, treatment details and outcomes. The primary outcome was cardiac toxicity (including myocardial infarction, admission for cardiac chest pain, coronary angiogram positivity and ischaemic cardiac death). Kaplan‐Meier methods were used to derive ischaemic cardiac event free and overall survival. Predefined univariate and multivariate analysis was performed to investigate interaction with radiation fraction size, cardiac risk factors, age and side of cancer. Standardised mortality ratios were constructed.

Results

Five hundred and one patients were identified, 220 treated with CFRT and 281 with HFRT. The median age was 56 and median follow‐up 10.33 years. The 10‐year breast cancer specific survival was 81.8% (95% CI %.78.1–85.0). The 10‐year freedom from cardiac death was 98.6% (95% CI 96.9–99.4). There were 27 post radiation cardiac events including 5 cardiac deaths and 19 cases of acute myocardial infarction. 265 (53%) had at least one cardiac risk factor. Twenty five of the 27 patients with a cardiac event had cardiac risk factors. On univariate and multivariate analysis, fractionation schedule was not significantly associated with a post radiation ischaemic event, however, there was a significant relationship with age and the presence of a cardiac risk factor. The standardised mortality ratio was 0.89 (95% CI: 0–3.13).

Conclusions

Our study has shown a low rate of ischaemic cardiac disease for both CFRT and HFRT in women treated for breast cancer with no evidence of an effect with fractionation schedule. Coexisting cardiac risk factors are common in the population.
Drones count wildlife more accurately and precisely than humans
Authors: Hodgson Jarrod C. , Mott Rowan , Baylis Shane M. , Pham Trung T. , Wotherspoon Simon , Kilpatrick Adam D. , Raja Segaran Ramesh , Reid Ian , Terauds Aleks , Koh Lian Pin
Published: February 2018

Knowing how many individuals are in a wildlife population allows informed management decisions to be made. Ecologists are increasingly using technologies, such as remotely piloted aircraft (RPA; commonly known as “drones,” unmanned aerial systems or unmanned aerial vehicles), for wildlife monitoring applications. Although RPA are widely touted as a cost‐effective way to collect high‐quality wildlife population data, the validity of these claims is unclear.

Using life‐sized, replica seabird colonies containing a known number of fake birds, we assessed the accuracy of RPA‐facilitated wildlife population monitoring compared to the traditional ground‐based counting method. The task for both approaches was to count the number of fake birds in each of 10 replica seabird colonies.

We show that RPA‐derived data are, on average, between 43% and 96% more accurate than the traditional ground‐based data collection method. We also demonstrate that counts from this remotely sensed imagery can be semi‐automated with a high degree of accuracy.

The increased accuracy and increased precision of RPA‐derived wildlife monitoring data provides greater statistical power to detect fine‐scale population fluctuations allowing for more informed and proactive ecological management.
Effects of Early Alcohol Exposure on Functional Organization and Microstructure of a Visual‐Tactile Integrative Circuit
Authors: Tang Shiyu , Xu Su , Gullapalli Rao P. , Medina Alexandre E.
Published: February 2018

Background

Children with fetal alcohol spectrum disorders (FASD) often have deficits associated with multisensory processing. Because ethanol (EtOH) disrupts activity‐dependent neuronal plasticity, a process that is essential for refining connections during cortical development, we hypothesize that early alcohol exposure results in alterations in multisensory cortical networks, which could explain the multisensory processing deficits seen in FASD. Here, we use a gyrencephalic animal model to test the prediction that early alcohol exposure alters the functional connectivity and microstructural features of the rostral posterior parietal cortex (PPr), a visual‐tactile integrative area.

Methods

Ferrets were exposed to moderate doses of EtOH during the brain growth spurt period. Functional connectivity and microstructural features were assessed using resting‐state functional magnetic resonance imaging and ex vivo diffusion kurtosis imaging (DKI), respectively, when the animals reached juvenile age and adulthood, respectively.

Results

While the whole brain volume was smaller in alcohol‐treated animals, the relative size of the frontal brain area was larger when compared to control animals. Altered functional connectivity was observed in alcohol‐treated animals, where increased connectivity was observed between PPr and the region that provides its major visual inputs (the caudal portion of the parietal cortex), but not with the region that provides its major somatosensory inputs (tertiary somatosensory cortex). DKI revealed reduced microstructural tissue complexity in all investigated sensory areas of alcohol‐treated animals.

Conclusions

In this study, we observed alterations in cortical functional connectivity and microstructural integrity in a cortical area involved in multisensory processing in a ferret FASD model. These findings indicate an alteration in cortical networks that may be related to the multisensory processing deficiencies observed in FASD.
Investigation of estimated glomerular filtration rate and its perioperative change in patients with upper urinary tract urothelial carcinoma: A multi‐institutional retrospective study
Authors: Koguchi Dai , Matsumoto Kazumasa , Ikeda Masaomi , Taoka Yoshinori , Hirayama Takahiro , Murakami Yasukiyo , Utsunomiya Takuji , Matsuda Daisuke , Okuno Norihiko , Irie Akira , Iwamura Masatsugu
Published: February 2018

Aim

To investigate the association of perioperative estimated glomerular filtration rate (eGFR) with prognosis in patients with upper urinary tract urothoelial caicinoma (UTUC).

Methods

A total of 433 patients underwent radical nephroureterectomy with excision of the bladder cuff (RNU) at six hospitals affiliated with Kitasato University in Japan. Patients were divided into three groups each in terms of preoperative eGFR: normal eGFR (>60 mL/min/1.73 m2; n = 172), moderately reduced eGFR (45–60 mL/min/1.73 m2; n = 147) and severely reduced eGFR (<45 mL/min/1.73 m2; n = 114), and with regard to changes between pre‐ and postoperative eGFR: normal change (increased or <10% decreased; n = 132), moderate change (10%–30% decreased; n = 172) and severe change (>30% decreased; n = 129). Statistical analyses were performed to investigate the association between perioperative eGFR and prognosis.

Results

Patients in the preoperative normal and moderately reduced eGFR group had significantly better progression‐free survival (PFS) and cancer‐specific survival (CSS) than those in the severely reduced eGFR group (both; P < 0.001). With regard to changes in postoperative eGFR, PFS and CSS were significantly better in patients in the severe and moderate change group than in those in the normal change group (both; P < 0.001). When adjusted for the effects of clinicopathological features, pathologic factors were associated with both PFS and CSS, but perioperative eGFR were not independent prognostic factors.

Conclusions

Patients with preoperative normal and moderately reduced eGFR and those with severe and moderate change in postoperative eGFR appeared to have a significantly better prognosis.
Titanium Surface Chemical Composition Interferes in the Pseudomonas aeruginosa Biofilm Formation
Authors: Nunes Filho Antonio , Aires Michelle de Medeiros , Braz Danilo Cavalcante , Hinrichs Ruth , Macedo Alexandre José , Alves Jr Clodomiro
Published: February 2018

Bacterial adhesion on three different surfaces: untreated Ti, plasma nitriding, and plasma carbonitriding Ti substrates were investigated. The samples were placed in bacterial cultures of Pseudomonas aeruginosa to assess biofilm formation. The correlation between the amount of bacteria attached to the surface after a lapse of time with nanotopography and physicochemical properties was performed. TiN showed the highest capacity to avoid bacterial adhesion, while presenting intermediate roughness and wettability. Although the surface of TiCN had the highest surface roughness and low contact angle (high wettability), bacterial adhesion was intermediate on this sample. Untreated Ti, even though presenting a smooth surface and low wettability, had the highest tendency to form biofilms.
Type II Minimal‐Invasive Extracorporeal Circuit for Aortic Valve Replacement: A Randomized Controlled Trial
Authors: Gygax Erich , Kaeser Hans‐Ulrich , Stalder Mario , Gahl Brigitta , Rieben Robert , Carrel Thierry , Erdoes Gabor
Published: February 2018

Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally‐invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end‐points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC. Fifty patients were prospectively randomized to MiECC or CECC perfusion regimen. Complement activation (sC5b‐9), inflammation (IL‐6, TNF‐α, sCD40‐ligand) and activation of the coagulation system (D‐dimer, TAT‐complex) were determined before operation, at 2 hours and 24 hours after surgery. Clinical end‐points included perfusion time, transfusion of allogeneic blood products, postoperative bleeding, sepsis, new onset of atrial fibrillation, stroke and in‐hospital mortality. Patient characteristics and baseline plasma markers were similar in both groups. Levels for sC5b‐9, TNF‐α, sCD40 ligand, TAT‐complex and D‐dimers were not significantly different between MiECC and CECC at 2 hours and 24 hours after surgery. The IL‐6 plasma concentration was lower in the CECC group at 24 hours (P = 0.026, vs. MiECC). Comparisons of the baseline level to values at 2 hours and 24 hours, adjusted for the type of oxygenator and hemoglobin, showed a significantly lower sC5b‐9 in MiECC at 2 hours (P = 0.013), but no difference at 24 hours (P=0.990). Compared with CECC, MiECC patients had a shorter perfusion time (P = 0.037) and less transfusion requirements (P = 0.04). In this selected cohort of SAVR patients, the type II MiECC was not inferior to CECC in terms of inflammatory response and complement activation. Thus, MiECC might be an alternative perfusion strategy to conventional.
Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment
Authors: Falletta Calogero , Pasta Salvatore , Raffa Giuseppe Maria , Crinò Francesca , Sciacca Sergio , Clemenza Francesco
Published: February 2018

Use of continuous flow left ventricle assist device (CF‐LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF‐LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD. We report the case of a 53‐year‐old man with HF secondary to ischemic cardiomyopathy supported by the HeartWare HVAD as bridge to transplant, who after the implant developed symptoms suggestive of PAD. We describe additional computational flow analysis for the study of PAD‐related hemodynamic disturbances induced by a CF‐LVAD. Flow simulations enhance the information of clinical image data, and may have an application in clinical investigations of the risk of hemodynamic disturbances induced by LVAD implantation.
Cortistatin inhibits arterial calcification in rats via GSK3β/β‐catenin and protein kinase C signalling but not c‐Jun N‐terminal kinase signalling
Authors: Liu Y. , Lin F. , Fu Y. , Chen W. , Liu W. , Chi J. , Zhang X. , Yin X.
Published: February 2018

Aim

Cortistatin (CST) is a newly discovered endogenous active peptide that exerts protective effects on the cardiovascular system. However, the relationship between CST and aortic calcification and the underlying mechanism remain obscure. Therefore, we investigated effects of CST on aortic calcification and its signalling pathways.

Methods

Calcium content and alkaline phosphatase (ALP) activity were measured using the o‐cresolphthalein colorimetric method and ALP assay kit respectively. Protein expression of smooth muscle (SM)‐ɑ‐actin, osteocalcin (OCN), β‐catenin, glycogen synthase kinase 3β (GSK3β), p‐GSK3β, protein kinase C (PKC), p‐PKC, c‐Jun N‐terminal kinase (JNK) and p‐JNK was determined using Western blotting.

Results

In aorta from a rat vitamin D3 calcification model, CST abrogated calcium deposition and pathological damage, decreased the protein expression of OCN and β‐catenin and increased SM‐ɑ‐actin expression. In a rat cultured vascular smooth muscular cell (VSMC) calcification model induced by β‐glycerophosphate (β‐GP), CST inhibited the increase in ALP activity, calcium content and OCN protein and the decrease in SM‐α‐actin expression. CST also inhibited the β‐GP‐induced increase in p‐GSK3β and β‐catenin protein (both P < .05). The inhibitory effects of CST on ALP activity, calcium deposition and β‐catenin protein were abolished by pretreatment with lithium chloride, a GSK3β inhibitor. CST promoted the protein expression of p‐PKC by 68.5% (P < .01), but not p‐JNK. The ability of CST to attenuate β‐GP‐induced increase in ALP activity, calcium content and OCN expression in the VSMC model was abolished by pretreatment with the PKC inhibitor Go6976.

Conclusion

These results indicate that CST inhibits aortic calcification and osteogenic differentiation of VSMCs likely via the GSK3β/β‐catenin and PKC signalling pathways, but not JNK signalling pathway.
Regional regulation of focal adhesion kinase after concentric and eccentric loading is related to remodelling of human skeletal muscle
Authors: Franchi M. V. , Ruoss S. , Valdivieso P. , Mitchell K. W. , Smith K. , Atherton P. J. , Narici M. V. , Flück M.
Published: February 2018

Aims

We assessed focal adhesion kinase (FAK) response to concentric (CON) vs eccentric (ECC) resistance training (RT) at two vastus lateralis (VL) sites, and the relationships between FAK, muscle protein synthesis (MPS) and morphological remodelling.

Methods

Six young males trained both legs unilaterally 3 times/week for 8 weeks; one leg performed CON RT, the contralateral performed ECC RT. Muscle biopsies were collected after training from VL mid‐belly (MID) and distal (distal) sites at 0, 4, 8 weeks. Focal adhesion kinase content and activation were evaluated by immunoblotting. MPS was assessed by deuterium oxide tracer; morphological adaptations were evaluated by ultrasound and DXA.

Results

pY397‐FAK 8 weeks levels were ~4‐fold greater after ECC at the distal site compared to CON (P < .05); pY397FAK to total FAK ratio was greater in ECC vs CON at 4 (~2.2‐fold, P < .05) and 8 weeks (~9‐fold, P < .001) at the distal site. Meta‐vinculin was found transiently increased at 4 weeks at the distal site only after ECC RT. ECC presented greater fascicle length (Lf) increases (10.5% vs 4%), whereas CON showed greater in pennation angle (PA) changes (12.3% vs 2.1%). MPS did not differ between exercise types or muscle sites at all time points. distal pY397‐FAK and pY397‐FAK/FAK values correlated to changes in Lf at 8 weeks (r = .76, P < .01 and r = .66, P < .05 respectively).

Conclusion

Focal adhesion kinase phosphorylation was greater at 8 weeks after ECC RT and was muscle region‐specific. FAK activity correlated to contraction‐dependent architectural remodelling, suggesting a potential role of FAK in orienting muscle structural changes in response to distinct mechanical stimuli.
Early Discontinuation of Montelukast Treatment; A Danish Nationwide Utilization Study
Authors: Farah Rahmo I. , Damkier Per , Christiansen Anders , Henriksen Daniel P.
Published: February 2018

Montelukast, a leukotriene receptor antagonist, was marketed in 1998 as an oral supplementary treatment to patients with mild to moderate asthma. The aim of this study was to describe the early discontinuation pattern among montelukast users in Denmark in the period of 1 March 1998 to 31 December 2016, and to identify demographic characteristics possibly associated with early discontinuation. This nationwide drug utilization study was based on data collected from three nationwide Danish registers. All montelukast users who redeemed at least one prescription in the study period were identified. Early discontinuation was defined as failing to fill a second prescription for montelukast within at least a year after the initial montelukast prescription. Among 135,271 included montelukast users, 47,480 (35%) discontinued the use of montelukast after a single redeemed prescription. The trend in early discontinuation increased throughout the years. The most predominant demographic risk factors for early discontinuation were prescription for only nasal topical anti‐allergic treatment up to a year prior to montelukast initiation [adjusted odds ratio (OR) 2.25; 95% confidence interval (CI) 2.13–2.38], as well as suspected off‐label use (adjusted OR 2.02; 95% CI 1.97–2.08). Several risk factors were associated with a decreased risk of early discontinuation; most pronounced was a prescription of inhaled corticosteroids within a year up to montelukast initiation [adjusted OR 0.47 (95% CI 0.46–0.49)]. Early discontinuation was more pronounced after patent expiry in 2012 [adjusted OR 1.42 (95% CI 1.38–1.45)]. In conclusion, we found that early montelukast discontinuation increased during the last 19 years. Appropriateness of the treatment indication as estimated by concomitant prescription of adequate inhalation therapy was associated with a low risk of early discontinuation. A more pronounced early discontinuation was observed after patent expiry in 2012, which could reflect a more liberal approach to montelukast prescription.
British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies – penile fracture
Authors: Rees Rowland W. , Brown Gareth , Dorkin Trevor , Lucky Marc , Pearcy Richard , Shabbir Majid , Shukla Chitranjan J. , Summerton Duncan J. , Muneer Asif ,   BAUS Section of Andrology and Genitourethral Surgery (AGUS)
Published: February 2018

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. The aim of these consensus statements is to provide best practice guidance for urological surgeons based in the UK which are developed by an expert consensus. Penile fracture is a rare emergency and in most cases requires prompt exploration and repair to prevent erectile dysfunction and penile curvature.
Identification of caries risk in 2‐year‐olds
Authors: Wigen Tove Irene , Baumgartner Christine Sophie , Wang Nina Johanne
Published: February 2018

Objective

The first aim was to describe presence of plaque, caries and oral health behaviours in 2‐year‐old children. The second aim was to measure increments in caries experience from 2 to 5 years of age and to study whether national background, visible plaque, caries and oral health behaviour at 2 years of age were associated with increments in caries experience.

Methods

The study population consisted of 392 children, of whom 211 were monitored from 2 to 5 years of age. At age 2 years, parents completed a questionnaire about family background and oral health behaviour. The presence of plaque and caries at tooth level was obtained from dental records. Data were tested with chi‐square statistics and Mann‐Whitney U test. Negative binomial regression analysis was conducted to explore the association between caries increment between 2 and 5 years of age and national background, visible plaque, caries and oral health behaviour at 2 years of age.

Results

Caries was found in 4.6% of 2‐year‐olds, and 4.6% had visible plaque. More than half of these children (57.9%) brushed twice daily, toothbrushing was introduced when the child was 7 months or older in 61.0% of the children, and 15.6% consumed sugary snacks daily. Non‐Western children more often had caries, visible plaque and unfavourable oral health behaviour than Western children (P < .05). At age 5 years, 28.9% of the children had caries experience. Non‐Western background, toothbrushing less than twice daily, not using fluoridated toothpaste, not using fluoride lozenges, consuming sugary drinks at night, consuming sugary snacks daily, presence of plaque and caries at 2 years of age were associated with caries increment between 2 and 5 years of age in bivariable analyses. The results from multivariable analysis showed that children who started toothbrushing late, children who brushed less than twice daily at 2 years of age and children of non‐Western background had a higher probability of having caries increment from 2 to 5 years of age than other children.

Conclusions

A small proportion of 2‐year‐olds had caries, but these children had several decayed teeth. Substantial differences in oral health and oral health behaviour were found between Western and non‐Western children. The preventive care delivered to the studied children failed to prevent caries increment from 2 to 5 years of age.
Exome sequencing reveals three homozygous missense variants in SNRPA in two sisters with syndromic intellectual disability
Authors: Rangel‐Sosa M.M. , Figuera‐Villanueva L.E. , González‐Ramos I.A. , Pérez‐Páramo Y.X. , Martínez‐Jacobo L.A. , Arnaud‐López L. , Nastasi‐Catanese J.A. , Rivas‐Estilla A.M. , Galán‐Huerta K.A. , Rojas‐Martínez A. , Ortiz‐López R. , Córdova‐Fletes C.
Published: February 2018

Splicing‐related gene mutations might affect the expression of a single gene or multiple genes and cause clinically heterogeneous diseases. With the advent of next‐generation sequencing, several splicing gene mutations have been exposed, yet most major spliceosome genes have no reports of germline mutations and therefore, their effects are largely unknown. We describe the previously unreported concurrence of intellectual disability, short stature, poor speech, and minor craniofacial and hand anomalies in 2 female siblings with 3 homozygous missense variants in SNRPA (a component of the U1 small nuclear ribonucleoprotein complex) characterized by homozygosity mapping and whole exome sequencing. Combined, c.97A>G, c.98T>C, and c.100T>A, in exon 2 of SNRPA lead to p.Ile33Ala and p.Phe34Ile exchanges, which were predicted in silico to be deleterious. Although both patients exhibited some clinical features seen in other spliceosomal disorders, their complete clinical phenotype appears to be rather uncommon, a finding that may further support the notion that mutations in components of the major spliceosome do not strictly lead to the same syndromes/phenotypes.
Accuracy of alcohol and breast cancer risk information on Drinkaware’s website
Authors: Larsen John , Wallace Paul , Sim Fiona , Chick Jonathan , Jarvis Sarah , Lidington Iona , Neidle Stephen , Ogden Graham , Owens Lynn
Published: February 2018

A recent paper in Drug and Alcohol Review analysed the information on cancer disseminated by 27 alcohol industry funded organisations. The independent UK alcohol education charity Drinkaware was among the organisations whose information was studied, and based on the analysis claims were made of misrepresentation of evidence about the alcohol‐related risk of cancer and alcohol industry influence. This commentary challenges the validity of these findings in respect to the evidence relating to the Drinkaware information, as the analysis is found to be misrepresenting the information by both disregarding the wider information content provided and the order and prominence with which alcohol‐related cancer risk is presented. Furthermore, it is argued that the public has a right to be provided with relevant evidence‐based information about cancer risk. It is critical that Drinkaware’s important public health function is not compromised by unjustified allegations of inaccuracy and by unwarranted attacks on its independence and integrity.
A 52‐week extension study of switching from gemigliptin vs sitagliptin to gemigliptin only as add‐on therapy for patients with type 2 diabetes who are inadequately controlled with metformin alone
Authors: Jung Chan‐Hee , Rhee Eun‐Jung , Lee Won‐Young , Min Kyung Wan , Shivane Vyankatesh K. , Sosale Aravind R. , Jang Hak Chul , Chung Choon Hee , Nam‐Goong Il Seong ,   for the Gemigliptin Study 006 Group
Published: February 2018

We investigated the long‐term efficacy and safety of gemigliptin and the efficacy and safety of gemigliptin treatment after once‐daily treatment with sitagliptin 100 mg, in patients with type 2 diabetes. This was a 28‐week extension of a 24‐week, randomized, double‐blind, parallel study of gemigliptin or sitagliptin added to ongoing metformin therapy. After randomization to sitagliptin 100 mg qd (S), gemigliptin 25 mg bid (G1) or gemigliptin 50 mg qd (G2) and after completing 24 weeks of treatment, 118 patients switched from gemigliptin 25 mg bid to 50 mg qd (G1/G2), 111 patients continued gemigliptin 50 mg qd (G2/G2) and 106 patients switched from sitagliptin 100 mg qd to gemigliptin 50 mg qd (S/G2). All 3 treatments reduced glycated haemoglobin (HbA1c) (S/G2,−0.99% [95% CI −1.25%, −0.73%]; G1/G2, −1.11% [95% CI −1.33%, −0.89%]; G2/G2, −1.06% [95% CI −1.28%, −0.85%]). The percentage of patients achieving HbA1c < 6.5% was 27.6% in the G1/G2 group at both Week 24 and Week 52, and ranged from 27.3% to 32.7% in the G2/G2 group (difference in proportions, 5% [95% CI −6%, 17%]), while it increased from 6.8% to 27.3% from Week 24 to Week 52 in the S/G2 group (difference in proportions, 20% [95% CI 7%, 34%]). Addition of gemigliptin 50 mg qd to metformin was shown to be efficacious for 52 weeks. Switching from sitagliptin 100 mg to gemigliptin 50 mg showed consistent glyacemic control over the previous treatment.
Alirocumab vs usual lipid‐lowering care as add‐on to statin therapy in individuals with type 2 diabetes and mixed dyslipidaemia: The ODYSSEY DM‐DYSLIPIDEMIA randomized trial
Authors: Ray Kausik K. , Leiter Lawrence A. , Müller‐Wieland Dirk , Cariou Bertrand , Colhoun Helen M. , Henry Robert R. , Tinahones Francisco J. , Bujas‐Bobanovic Maja , Domenger Catherine , Letierce Alexia , Samuel Rita , Del Prato Stefano
Published: February 2018

Aim

To compare alirocumab, a proprotein convertase subtilisin‐kexin type 9 inhibitor, with usual care (UC) in individuals with type 2 diabetes (T2DM) and mixed dyslipidaemia not optimally managed by maximally tolerated statins in the ODYSSEY DM‐DYSLIPIDEMIA trial (NCT02642159).

Materials and Methods

The UC options (no additional lipid‐lowering therapy; fenofibrate; ezetimibe; omega‐3 fatty acid; nicotinic acid) were selected prior to stratified randomization to open‐label alirocumab 75 mg every 2 weeks (with increase to 150 mg every 2 weeks at week 12 if week 8 non‐HDL cholesterol concentration was ≥2.59 mmol/L [100 mg/dL]) or UC for 24 weeks. The primary efficacy endpoint was percentage change in non‐HDL cholesterol from baseline to week 24.

Results

The randomized population comprised 413 individuals (intention‐to‐treat population, n = 409; safety population, n = 412). At week 24, the mean non‐HDL cholesterol reductions were superior with alirocumab (−32.5% difference vs UC, 97.5% confidence interval −38.1 to −27.0; P < .0001). Overall, 63.6% of alirocumab‐treated individuals were maintained on 75 mg every 2 weeks. Alirocumab also reduced LDL cholesterol (−43.0%), apolipoprotein B (−32.3%), total cholesterol (−24.6%) and LDL particle number (−37.8%) at week 24 vs UC (all P < .0001). Consistent with the overall trial comparison, alirocumab reduced non‐HDL cholesterol to a greater degree within each UC stratum at week 24. The incidence of treatment‐emergent adverse events was 68.4% (alirocumab) and 66.4% (UC). No clinically meaningful effect on glycated haemoglobin, or change in number of glucose‐lowering agents, was seen.

Conclusions

In individuals with T2DM and mixed dyslipidaemia on maximally tolerated statin, alirocumab showed superiority to UC in non‐HDL cholesterol reduction and was generally well tolerated.
Impact of procedure‐related conduction disturbances after transcatheter aortic valve implantation on myocardial performance and survival evaluated by conventional and speckle tracking echocardiography
Authors: Dimitriadis Zisis , Scholtz Smita , Scholtz Werner , Wiemer Marcus , Piper Cornelia , Ensminger Stephan , Fox Henrik , Horstkotte Dieter , Faber Lothar
Published: February 2018

Objectives

Although procedure‐related new cardiac conduction disturbances (CCDs) remain an important issue in transcatheter aortic valve implantation (TAVI), their effect on myocardial function and overall patient outcome remains unclear. The goal of this study was to analyze the influence of procedure‐related CCDs on systolic and diastolic LV performance and on patient survival after TAVI.

Methods and results

Ninety‐five patients who underwent TAVI for severe symptomatic aortic stenosis (AS) and had a complete follow‐up were evaluated with respect to procedure‐related CCDs. Left ventricular (LV) performance was measured using standard echocardiographic parameters and speckle tracking analysis. Survival was assessed during longer‐term follow‐up (mean: 29.1 ± 16.9 months). After TAVI, the improvement of global LV function expressed as ejection fraction (LVEF; from 45.5 ± 10.0 to 47.8 ± 13.9%, P = .13) was not significant. New CCDs were found in 35.7% of TAVI recipients. A comparison between patients with and without new CCDs showed that LV systolic function improved in those without CCDs, while it tended to deteriorate in patients with CCDs (change in LVEF: 5.5 ± 12.3% vs −4.9% ± 11.5%, P = .001; change in global longitudinal strain (GLS): −1.1 ± 4.6% vs 1.2 ± 4.5%, P = .01). Changes in diastolic function did not differ significantly between the groups (changes in transmitral E/A‐ratio: −0.3 ± 0.6 vs −0.5 ± 0.5, P = .1). Kaplan‐Meier survival analysis revealed no significant differences between the two cohorts (P = .795).

Conclusion

Procedure‐related conduction abnormalities after TAVI lead to an LBBB‐related dyssynchrony with impairment of LV performance but not of overall survival.
Resource density regulates the foraging investment in higher termite species
Authors: ALMEIDA CAMILLA S. , CRISTALDO PAULO F. , DESOUZA OG , BACCI LEANDRO , FLORENCIO DANIELA F. , CRUZ NAYARA G. , SANTOS ABRAÃO A. , SANTANA ALISSON S. , OLIVEIRA ALEXANDRE P. , LIMA ANA P. S. , ARAÚJO ANA P. A.
Published: February 2018

1. Resource density can regulate the area that animals use. At low resource density, there is a conflict in terms of balance between costs of foraging and benefits acquired. The foraging of the higher termite Nasutitermes aff. coxipoensis consists of searching throughout trails and a building galleries phase.

2. In this study, a manipulative field experiment was used to test the hypothesis that colonies of N. aff. coxipoensis forage towards a more profitable balance between the establishment of trails and gallery construction at low resource density.

3. The experiment was conducted in north‐eastern Brazil. Seven experimental plots were established with a continuous increase in resource density (sugarcane baits). Entire colonies of N. aff. coxipoensis were transplanted from their original sites to the experimental plot, totalling 35 nests. The number, branches and total length of trails and galleries were quantified.

4. The results show that N. aff. coxipoensis optimises its foraging output, intensifying the establishment of trails at the cost of gallery construction when resource density is low. The number of trails, the number of trail branches and the total length of trails decreased with increasing resource density. Interestingly, at low resource density, the search effort was concentrated on forming longer and a greater number of trails, a small proportion of which were converted into galleries. The opposite relationship was observed at high resource density.

5. These results suggest an optimisation of search efforts during foraging depending on resource density, a mechanism that may help researchers to understand the use of space by higher termite species.