bluuebunny/crossref_metadata_2025 huggingface dataset:
Proton pump inhibitors do not impair the effectiveness of metformin in patients with diabetes
Authors: Flory James , Haynes Kevin , Leonard Charles E. , Hennessy Sean
Published: September 2014

Aims

In order to exert its pharmacodynamic effect, the diabetes drug metformin needs to be taken up into hepatocytes by the organic cation transporter (OCT) system. A recent in vitro study found that proton pump inhibitors (PPIs) inhibit OCT1, OCT2 and OCT3, suggesting that PPIs might reduce metformin's effectiveness. This pharmacoepidemiologic study looked for evidence of a clinical effect of such an interaction.

Methods

This was an observational cohort study examining changes in glycosylated haemoglobin (HbA1c) with exposure to metformin and to PPIs as single agents and in combination. The aim was to assess evidence of a deleterious drug−drug interaction.

Results

PPIs did not reduce the effectiveness of metformin, and indeed were associated with a minimally better glycaemic response by − 0.06 HbA1c percentage points (95% confidence interval, −0.10, −0.01) in metformin initiators.

Conclusions

Despite a mechanistic basis for a potential drug–drug interaction, we found no evidence of a deleterious interaction between PPIs and metformin.
Development and validation of a system of assimilation indices: A mixed method approach to understand change in psychotherapy
Authors: Neto David D. , Baptista Telmo M. , Dent‐Brown Kim
Published: September 2014

Objectives

Assimilation is an important process in understanding change in psychotherapy. Similar to other psychological processes, assimilation may be traceable in the speech of clients by attending to its signs or indices. In the present research, we aimed to build a system of indices of assimilation.

Design and methods

This research follows a mixed method design. The indices were derived through qualitative analysis, using grounded theory. Subsequently, the indices were adjusted quantitatively and applied to 30 single psychotherapy sessions of adult clients with depression and 11 therapists. Forty‐two indices were found and grouped into the following five process categories of assimilation: external distress, pain, noticing, decentring and action.

Results

The indices showed good inter‐rater reliability and internal consistency. Except for noticing, all process categories correlated significantly with each other according to conceptual proximity. The system of indices also showed convergent validity with an existing coding system of assimilation for two process categories.

Conclusions

The results suggest that the system of indices is a useful approach for understanding assimilation. The consideration of assimilation in a continuous fashion through sub‐processes may help to extend our knowledge of this process and provide a tool for clinical practice.

Practitioner points

Assimilation is an important process in understanding change in psychotherapy in the sense that it takes into account insight and action‐related processes.

Clients convey in their speech signs or indices of the assimilation process which can be observed both in the style and content of their utterances.

Using these indices, therapists can continuously assess assimilation and use this information in choosing interventions.

Limitations

This study follows a cross‐sectional design and does not allow consideration of the predictive value of the indices.

The outcome of the therapy was not taken into account, which restricts validity considerations to the comparison with an existing instrument and the observation of the relation between sub‐processes of assimilation.
Clinical characteristics and healthcare utilization of patients with multicentric Castleman disease
Authors: Casper Corey , Teltsch Dana Y. , Robinson Don , Desrosiers Marie‐Pierre , Rotella Philip , Dispenzieri Angela , Qi Ming , Habermann Thomas , Reynolds Matthew W.
Published: September 2014

Multicentric Castleman disease (MCD) is a rare lymphoproliferative disease. Little is known about how patient clinical features and healthcare utilization varies by human immunodeficiency virus (HIV) status and disease subtype. Data of MCD patients identified between 2000 and 2009 were collected from medical records at two United States treatment centres. Clinical, demographic, and biochemical characteristics, drug therapies and medical utilization were descriptively reported by HIV status and cell histology, and statistically compared with the Fisher's Exact and Kruskal–Wallis tests. Patients (n = 59) had a pathologically and clinically confirmed MCD diagnosis: plasmacytic (42%), hyaline vascular (29%) and mixed (15%); 10% had HIV infection. In the first year after diagnosis, MCD patients on average saw a healthcare provider more than six times, were hospitalized at least once and underwent frequent radiological and laboratory testing. Rituximab was the most commonly used drug therapy, followed by corticosteroids and conventional chemotherapy. One‐ and 2‐year survival was excellent in HIV‐negative patients (100% and 97%, respectively) but inferior for HIV‐positive cases (67% and 67%, respectively). Heterogeneous treatment decisions were observed in this MCD study; HIV status was the only distinguishing clinical criteria associated with pharmacotherapies. Additional research is necessary to guide treatment of this rare lymphoproliferative disorder.
‘I saw Santa drinking soda!’ Advertising and children's food preferences
Authors: Lioutas E. D. , Tzimitra‐Kalogianni I.
Published: September 2014

Background

The influence of advertising on children's food preferences is well documented in the research literature. In this study we aim to examine the ways in which food advertising propels children's consumer behaviour and to investigate how food advertising affects the frequency of unhealthy food consumption.

Methods

Data were drawn from a sample of elementary school children in the region of Thessaly (Greece). Three scales were used to measure children's lifestyle patterns, food consumption frequencies, and their response to advertising. Univariate and inferential statistics were used to answer the research questions.

Results

The analysis revealed that a significant proportion of children (47.4%) frequently consume unhealthy foods. Children who have little understanding of the persuasive intent of advertising rate advertised foods as healthier and more nutritious. The frequency of unhealthy food consumption is influenced by the entertaining dimension of advertising and the level of the motivational arousal after children's exposure to food advertisements.

Conclusions

Food advertising impels children's consumer behaviour through four different modes. First, advertising engenders expectations, which raise purchase motivation. Second, the purchase of advertised foods is accompanied by positive feelings (happiness, satisfaction). Third, the entertaining dimension of advertising generates pleasant mood, which positively predisposes the evaluation of advertised foods. Fourth, children do not always possess the ability to recognize the persuasive nature of advertising.
Pharmacokinetics, pharmacodynamics and safety of QGE031 (ligelizumab), a novel high‐affinity anti‐IgE antibody, in atopic subjects
Authors: Arm J. P. , Bottoli I. , Skerjanec A. , Floch D. , Groenewegen A. , Maahs S. , Owen C. E. , Jones I. , Lowe P. J.
Published: September 2014

Background

Using a monoclonal antibody with greater affinity for IgE than omalizumab, we examined whether more complete suppression of IgE provided greater pharmacodynamic effects, including suppression of skin prick responses to allergen.

Objective

To explore the pharmacokinetics, pharmacodynamics and safety of QGE031 (ligelizumab), a novel high‐affinity humanized monoclonal IgG1κ anti‐IgE.

Methods

Preclinical assessments and two randomized, placebo‐controlled, double‐blind clinical trials were conducted in atopic subjects. The first trial administered single doses of QGE031 (0.1–10 mg/kg) or placebo intravenously, while the second trial administered two to four doses of QGE031 (0.2– 4 mg/kg) or placebo subcutaneously at 2‐week intervals. Both trials included an open‐label omalizumab arm.

Results

Sixty of 73 (82%) and 96 of 110 (87%) subjects completed the intravenous and subcutaneous studies, respectively. Exposure to QGE031 and its half‐life depended on the QGE031 dose and serum IgE level. QGE031 had a biexponential pharmacokinetic profile after intravenous administration and a terminal half‐life of approximately 20 days. QGE031 demonstrated dose‐ and time‐dependent suppression of free IgE, basophil FcεRI and basophil surface IgE superior in extent (free IgE and surface IgE) and duration to omalizumab. At Day 85, 6 weeks after the last dose, skin prick wheal responses to allergen were suppressed by > 95% and 41% in subjects treated subcutaneously with QGE031 (2 mg/kg) or omalizumab, respectively (P < 0.001). Urticaria was observed in QGE031‐ and placebo‐treated subjects and was accompanied by systemic symptoms in one subject treated with 10 mg/kg intravenous QGE031. There were no serious adverse events.

Conclusion and Clinical Relevance

These first clinical data for QGE031, a high‐affinity IgG1κ anti‐IgE, demonstrate that increased suppression of free IgE compared with omalizumab translated to superior pharmacodynamic effects in atopic subjects, including those with high IgE levels. QGE031 may therefore benefit patients unable to receive, or suboptimally treated with, omalizumab.
Asthma and allergy development: contrasting influences of yeasts and other fungal exposures
Authors: Behbod B. , Sordillo J. E. , Hoffman E. B. , Datta S. , Webb T. E. , Kwan D. L. , Kamel J. A. , Muilenberg M. L. , Scott J. A. , Chew G. L. , Platts‐Mills T. A. E. , Schwartz J. , Coull B. , Burge H. , Gold D. R.
Published: September 2014

Background

Infancy is a developmental stage with heightened susceptibility to environmental influences on the risk of chronic childhood disease. Few birth cohort studies have detailed measures of fungal diversity data in infants' bedrooms, limiting the potential to measure long‐term associations of these complex exposures with development of asthma or allergy.

Objective

We evaluated the relation of home fungal levels in infancy to repeated measures of wheeze and development of asthma and rhinitis by age 13, and sensitization by age 12 years.

Methods

In the Epidemiology of Home Allergens and Asthma prospective birth cohort study, we recruited 408 children with family history of allergic disease or asthma. When children were aged 2–3 months, we measured culturable fungi in bedroom air and dust, and in outdoor air. Main outcomes included ascertainment of symptoms/disease onset by questionnaire from birth through age 13. We estimated hazard ratios and, for wheeze and sensitization, odds ratios for an interquartile increase in log‐transformed fungal concentrations, adjusting for other outcome predictors and potential confounders.

Results

Elevated levels of yeasts in bedroom floor dust were associated with reduced: i) wheeze at any age; ii) fungal sensitization; and iii) asthma development by age 13 (hazard ratio (HR) = 0.86; 95% confidence interval (CI), [0.75 to 0.98]). Outdoor airborneCladosporiumand dustborneAspergilluspredicted increased rhinitis. Risk of fungal sensitization by age 12, in response to environmentalAlternariaandAspergillus, was elevated in children with a maternal history of fungal sensitization.

Conclusions and Clinical Relevance

Despite the irritant and allergenic properties of fungi, early‐life elevated dust yeast exposures or their components may be protective against allergy and asthma in children at risk for these outcomes. Ascertainment of fungal components associated with immunoprotective effects may have therapeutic relevance for asthma.
Epitope analysis of Ara h 2 and Ara h 6: characteristic patterns of IgE‐binding fingerprints among individuals with similar clinical histories
Authors: Otsu K. , Guo R. , Dreskin S. C.
Published: September 2014

Background

Ara h 2 and Ara h 6 are moderately homologous and highly potent peanut allergens.

Objective

To identify IgE‐binding linear epitopes of Ara h 6, compare them to those of Ara h 2, and to stratify binding based on clinical histories.

Methods

Thirty highly peanut‐allergic subjects were stratified by clinical history. Sera were diluted to contain the same amount of anti‐peanut IgE. IgE binding to overlapping 20‐mer peptides of Ara h 2 and Ara h 6 was assessed using microarrays.

Results

Each subject had a unique IgE‐binding fingerprint to peptides; these data were coalesced into epitope binding. IgE from subjects with a history of more severe reactions (n = 19) had a smaller frequency of binding events (BEs) for both Ara h 2 (52 BEs of 152 (19X8epitopes) possible BEs and Ara h 6 (13 BEs of 133 (19X7 epitopes) possible BEs) compared to IgE from those with milder histories (n = 11) (Ara h 2: 47 BEs of 88 (11X8 epitopes) possible BEs, P < 0.01; Ara h 6: 25 BEs of 77 (11X7 epitopes) possible BEs, P < 0.001). Using an unsupervised hierarchal cluster analysis, subjects with similar histories tended to cluster. We have tentatively identified a high‐risk pattern of binding to peptides of Ara h 2 and Ara h 6, predominantly in subjects with a history of more severe reactions (OR = 12.6; 95% CI: 2.0–79.5; P < 0.01).

Conclusions and Clinical Relevance

IgE from patients with more severe clinical histories recognize fewer linear epitopes of Ara h 2 and Ara h 6 than do subjects with milder reactions and bind these epitopes in characteristic patterns. Close examination of IgE binding to epitopes of Ara h 2 and Ara h 6 may have prognostic value.
Cornelia de Lange syndrome
Authors: Boyle M.I. , Jespersgaard C. , Brøndum‐Nielsen K. , Bisgaard A.‐M. , Tümer Z.
Published: September 2014

Cornelia de Lange syndrome (CdLS; MIM #122470, 300590, 610759, 614701, 300882) is a rare and clinically variable disorder that affects multiple organs. It is characterized by intellectual disability (mild to severe), distinctive facial features, prenatal and postnatal growth retardation, and hirsutism. Congenital anomalies include malformations of the upper limbs, gastrointestinal malformation/rotation, pyloric stenosis, diaphragmatic hernia, heart defects and genitourinary malformations. Gastroesophageal reflux disease is present in almost all patients. In addition to classic forms, milder phenotypes have been reported. To date five genes [NIPBL (Nipped‐B‐like protein), SMC1A (structural maintenance of chromosomes 1A), SMC3 (structural maintenance of chromosomes 3), RAD21 (human homolog of Schizosaccharomyces pombe radiation sensitive mutant 21) and HDAC8 (histone deacetylase 8)] have been associated with CdLS and mutations of these genes comprise the underlying defect in 70% of the patients. Here, we will provide a brief review of the clinical features of CdLS, summarize the known underlying genetic defects, prenatal and postnatal diagnosis possibilities, and genetic counseling.
Frequencies and geographic distributions of genetic mutations in transthyretin‐ and non‐transthyretin‐related familial amyloidosis
Authors: Zhen D.B. , Swiecicki P.L. , Zeldenrust S.R. , Dispenzieri A. , Mauermann M.L. , Gertz M.A.
Published: September 2014

Inherited forms of amyloidosis are rare; of these, transthyretin‐related (ATTR) is the most common, but non‐ATTR has been described as well. We studied a large case series of ATTR and a small series of non‐ATTR to better determine the mutation frequencies and geographic distributions of these inherited forms of amyloidosis in the United States. We performed a retrospective cross‐sectional study of 284 ATTR and non‐ATTR patients seen at Mayo Clinic in Rochester, Minnesota, from 1 January 1970 through 29 January 2013. Mutations were identified by DNA sequencing, restriction fragment length polymorphism, or mass spectroscopy. The genetic testing method was unknown for several patients, but a small proportion were identified by family history or by classical clinical presentation associated with a specific mutation. The most common ATTR mutations were Thr60Ala (24%), Val30Met (15%), Val122Ile (10%), and Ser77Tyr (5%). Non‐ATTR mutations included gelsolin (n = 3), apolipoprotein A‐I (n = 6), apolipoprotein A‐II (n = 1), fibrinogen A‐α (n = 9), and lysozyme (n = 1). Although rare, ATTR and, to a lesser extent, non‐ATTR are prevalent in the United States and should be considered for patients presenting in the appropriate clinical context.
Chlorhexidine in cosmetic products – a market survey
Authors: Opstrup Morten S. , Johansen Jeanne D. , Bossi Rossana , Lundov Michael D. , Garvey Lene H.
Published: September 2014

Background

Chlorhexidine may cause type I and type IV allergy. Some chlorhexidine‐allergic individuals have been exposed in the healthcare setting as patients or healthcare workers, but for others the source of sensitization is unknown. Chlorhexidine may be used as a preservative or an antimicrobial agent in cosmetic products at a concentration up to 0.3%, as set by the European Cosmetics Directive (now Regulations).

Objectives

To identify cosmetic product types containing chlorhexidine, and to measure the concentration of chlorhexidine in selected products.

Methods

Between February 2013 and April 2013, we checked for chlorhexidine in cosmetic products in 14 supermarkets, one hairdressing salon and one beauty and retail store in Copenhagen, Denmark by reading the ingredient labels. The chlorhexidine concentration was measured in 10 selected products by high‐performance liquid chromatography (HPLC) with an ultraviolet (UV) detector.

Results

Chlorhexidine was found in 80 of 2251 checked products (3.6%) in the following categories: hair products (57/760), creams (9/324), face washes (4/24), wet wipes (4/63), skin tonics (3/22), make‐up removers (2/25), and mouth washes (1/17). Chlorhexidine concentrations were 0.01–0.15%.

Conclusions

We found chlorhexidine in various cosmetic product types, predominantly aimed at females, and in hair products. The measured chlorhexidine concentrations were all within the permitted limit. The relevance for allergic sensitization should be further explored.
A technical modification of video‐assisted ablation for recurrent pilonidal sinus
Authors: Milone M. , Bianco P. , Musella M. , Milone F.
Published: September 2014

Aim

The study evaluated, in a proof of concept, the usefulness of a prosthesis (plug) in addition to video assisted ablation of pilonidal sinus (VAAPS) for treatment of recurrent pilonidal sinus.

Method

This is a case series of recurrent complex pilonidal sinus treated by VAAPS plus plug positioning.

Results

Four patients were analysed. All were successfully treated by this new approach. No difficulties in inserting the plug were identified. Complete healing was achieved in all cases. No infection or recurrence was reported during a limited follow‐up.

Conclusion

This new technique allows a minimally invasive scarless approach to recurrent pilonidal sinus.
Adipogenic differentiation potential of adipose‐derived mesenchymal stem cells from ovariectomized mice
Authors: Fu Y. , Li R. , Zhong J. , Fu N. , Wei X. , Cun X. , Deng S. , Li G. , Xie J. , Cai X. , Lin Y.
Published: September 2014

Objectives

In human post‐menopausal osteoporosis, enhanced adipogenesis in bone marrow and enhanced formation of adipose tissue in vivo are observed. These changes correlate with reduced trabecular bone volume and increased adipocyte cell size as well as cell number. However, cellular and molecular mechanisms underlying osteoporosis‐related changes in adipocyte cell volume are not known. This study was designed to compare adipogenic potential of adipose tissue‐derived stem cells (ADSCs) obtained from ovariectomized mice with that of control ADSCs, and to analyse pathological mechanisms from the point of functional changes of ADSCs.

Materials and methods

Healthy female C57BL/6J mice were randomly divided into ovariectomy and sham‐surgery groups. Mouse ADSCs were isolated and cultured in vitro up to passage 3. After adipogenic induction, oil red O staining of lipid droplets was used to detect adipogenic ability of ADSCs; real‐time PCR and immunofluorescence staining were used to detect expression of adipogenesis‐related genes and proteins.

Results

As indicated by increased expression of adipogenic and lipogenic genes and proteins, and lipid droplets accumulation shown by oil red‐O staining, adipogenic differentiation of ADSCs was significantly enhanced in the ovariectomy group compared to the sham‐surgery group (P < 0.05).

Conclusion

These findings suggest that enhanced adipogenic differentiation of ADSCs is likely to be the important cause for increased adipogenesis in vivo and subsequent obesity‐like changes in body mass, in mice, after ovariectomy.
Retrieval of the pancreas allograft for whole‐organ transplantation
Authors: Fridell Jonathan A. , Powelson John A. , Kubal Chandrashekhar A. , Burke George W. , Sageshima Junichiro , Rogers Jeffrey , Stratta Robert J.
Published: September 2014

Proper pancreas retrieval during multi‐organ recovery is one of the cornerstones of technically successful whole‐organ pancreas transplantation. With evolving surgical approaches for organ retrieval and implantation, it has become standard to procure the pancreas in conjunction with other abdominal organs without compromising either vasculature, graft quality, or transplant outcomes. This review summarizes the major steps required for proper whole‐organ retrieval of the pancreas allograft with suggestions and tips whenever alternative approaches are available.
Hand‐assisted and pure laparoscopic living donor nephrectomy: a matched‐cohort comparison over 10 yr at a single institute
Authors: Choi Sae Woong , Kim Kang Sup , Kim Seol , Choi Yong Sun , Bae Woong Jin , Hong Sung‐Hoo , Lee Ji Youl , Kim Sae Woong , Hwang Tae‐Kon , Cho Hyuk Jin
Published: September 2014

Objective

To compare outcomes between matched patients who underwent hand‐assisted laparoscopic donor nephrectomy (HALDN) and pure laparoscopic donor nephrectomy (PLDN) from living donors.

Method

Between February 2000 and July 2012, 608 consecutive patients underwent laparoscopic living donor nephrectomy at a single center. In September 2003, we began to perform the PLDN for the first time. A matched‐pair cohort of 80 patients who underwent PLDN and 80 patients who underwent HALDN was selected for retrospective comparison.

Result

No significant differences in operative time, warm ischemia time, estimated blood loss, transfusion rate, analgesic requirement, or hospital stay were observed between the HALDN and PLDN groups. No differences were found in the recipient serum creatinine values (mg/dL) and estimated glomerular filtration rate by the Modification of Diet in Renal Disease (MDRD‐eGFR; mL/min/1.73 m2).

Conclusion

No significant differences were observed in surgical outcomes, complication rates, and postoperative parameters between the HALDN and PLDN groups. Moreover, recipient graft function and morbidity between both groups were comparable. Therefore, we believe that PLDN may be a good alternative technique to HALDN.
Multiple sources of uncertainty affect metrics for ranking conservation risk under climate change
Authors: Wright Amber N. , Hijmans Robert J. , Schwartz Mark W. , Shaffer H. Bradley
Published: September 2014

Aim

Ecological niche modelling is one of the main tools that allows for the incorporation of climate change effects into conservation planning. For example, ecological niche model predictions can be used to rank species by degree of predicted future habitat loss. While many studies have considered how different modelling decisions contribute to uncertainty in niche model outputs, here we evaluate how metrics used to rank species by conservation risk respond to the choice of global climate models, greenhouse gas emission scenarios, suitable versus unsuitable threshold values, and the degree of model complexity.

Location

California, USA.

Methods

We built ecological niche models for 153 species of reptiles and amphibians. Reduced complexity models were compared to default complexity models using AICc to select climate variables and tune Maxent' s built‐in regularization parameter. We predicted the distribution of climatically suitable habitat under future (2041–2060) climate conditions according to 11 global climate models, four representative concentration pathways, and three threshold values. Two metrics to rank species by predicted future loss of climatically suitable habitat were calculated for each set of modelling decisions. To determine the effects of modelling decisions on rankings, we used mixed models.

Results

Our results indicate that while individual modelling decisions had relatively small effects on species ranks alone, in combination, they lead to very different conservation assessments.

Main conclusions

We recommend that a wide range of modelling decisions be explored and that variation in ranks across runs be reported as a first step in identifying the uncertainty in rank metrics used for assessing conservation risk under changing, but uncertain climate predictions.
TOKYO criteria 2014 for transpapillary biliary stenting
Authors: Isayama Hiroyuki , Hamada Tsuyoshi , Yasuda Ichiro , Itoi Takao , Ryozawa Shomei , Nakai Yousuke , Kogure Hirofumi , Koike Kazuhiko
Published: September 2014

It is difficult to carry out meta‐analyses or to compare the results of different studies of biliary stents because there is no uniform evaluation method. Therefore, a standardized reporting system is required. We propose a new standardized system for reporting on biliary stents, the ‘TOKYO criteria 2014’, based on a consensus among Japanese pancreatobiliary endoscopists. Instead of stent occlusion, we use recurrent biliary obstruction, which includes occlusion and migration. The time to recurrent biliary obstruction was estimated using Kaplan–Meier analysis with the log–rank test. We can evaluate both plastic and self‐expandable metallic stents (uncovered and covered). We also propose specification of the cause of recurrent biliary obstruction, identification of complications other than recurrent biliary obstruction, indication of severity, measures of technical and clinical success, and a standard for clinical care. Most importantly, the TOKYO criteria 2014 allow comparison of biliary stent quality across studies. Because blocked stents can be drained not only using transpapillary techniques but also by an endoscopic ultrasonography‐guided transmural procedure, we should devise an evaluation method that includes transmural stenting in the near future.
Imaging of the islet neural network
Authors: Tang S.‐C. , Peng S.‐J. , Chien H.‐J.
Published: September 2014

The islets of Langerhans receive signals from the circulation and nerves to modulate hormone secretion in response to physiological cues. Although the rich islet innervation has been documented in the literature dating as far back as Paul Langerhans' discovery of islets in the pancreas, it remains a challenging task for researchers to acquire detailed islet innervation patterns in health and disease due to the dispersed nature of the islet neurovascular network. In this article, we discuss the recent development of 3‐dimensional (3D) islet neurohistology, in which transparent pancreatic specimens were prepared by optical clearing to visualize the islet microstructure, vasculature and innervation with deep‐tissue microscopy. Mouse islets were used as an example to illustrate how to apply this 3D imaging approach to characterize (i) the islet parasympathetic innervation, (ii) the islet sympathetic innervation and its reinnervation after transplantation under the kidney capsule and (iii) the reactive cellular response of the Schwann cell network in islet injury. While presenting and characterizing the innervation patterns, we also discuss how to apply the signals derived from transmitted light microscopy, vessel painting and immunostaining of neural markers to verify the location and source of tissue information. In summary, the systematic development of tissue labelling, clearing and imaging methods to reveal the islet neuroanatomy offers insights to help study the neural‐islet regulatory mechanisms and the role of neural tissue remodelling in the development of diabetes.
IRS2 integrates insulin/IGF1 signalling with metabolism, neurodegeneration and longevity
Authors: White M. F.
Published: September 2014

Understanding how metabolism and nutrient homeostasis integrates with life span and neurodegeneration is a complicated undertaking. Important inconsistencies have emerged recently regarding the role of insulin‐like signalling and the progression of neurodegenerative disease. Insulin resistance and type 2 diabetes are associated with clinical Alzheimer's disease, whereas study in lower organisms shows that reduced insulin‐like signalling slows the progressive neurodegeneration and increases life span. From a clinical perspective, compensatory hyperinsulinaemia to overcome systemic insulin resistance is thought to be a healthy goal, because it circumvents immediate catastrophic consequences of hyperglycaemia; however, study in flies, nematodes and mice indicate that excess insulin signalling can damage cellular function and accelerate ageing. Maintenance of the central nervous system (CNS) has particular importance for life span and metabolism. A conflict arises because reduced insulin/IGF1 signalling in the CNS is associated with longevity, but can dysregulate glucose and energy homeostasis, and promote overweight. Here, we explore how the genetic manipulation of insulin/IGF1 signalling system can influence systemic metabolism, life span and neurodegeneration.
Value of Certain Echocardiographic Findings in the Initial Suspicion of Behçet's Disease
Authors: Farouk Heba , Chilali Karim El , Said Karim , Sakr Basma , Salah Hania , Mahmoud Geilan , Sorour Khaled
Published: September 2014

Purpose

To describe the echocardiographic findings detected as first manifestations of Behçet's disease (BD) and compare these findings with those detected in established cases of BD receiving regular medical treatment.

Methods

Two groups of patients were studied. Group 1 comprised 41 patients with BD on regular medical treatment. Group 2 comprised 5 previously healthy patients who presented to the cardiology department because of cardiac symptoms and were diagnosed in retrospect during hospitalization as BD. Thirty‐two age‐ and sex‐matched individuals served as control subjects (control group). All patients and controls underwent complete M‐mode, two‐dimensional, and Doppler transthoracic echocardiographic examinations.

Results

Of the 41 treated patients with BD (mean age: 32 ± 8 years, 90% males, mean duration since diagnosis: 14.5 years), only 1 patient was found to have severe aortic regurgitation secondary to aortic root dilation. On the other hand, the 5 previously healthy patients who presented with cardiac symptoms (mean age: 24 ± 6 years, all males) had significant cardiac involvement and evident echocardiographic findings (P < 0.001). Four cases had intracardiac masses: 3 in the right atrium (RA), 1 in the right ventricle (RV), while the last patient had pericardial effusion (PE). All these patients were diagnosed in retrospect as BD. The RA masses disappeared on medical therapy, while the RV mass was surgically excised and proved to be multiple thrombi histopathologically. The patient with PE had recurrent attacks of massive effusion so a pericardial window was performed surgically.

Conclusion

Diagnosis of BD might be initially suspected by the cardiologists based on certain echocardiographic findings, namely the presence of right‐sided masses. Diagnosis of BD in such patients has important therapeutic implications and accordingly prognostic value.
Echocardiographic Analysis of an Extracellular Matrix Tricuspid Valve
Authors: Cua Clifford L. , Kollins Kevin , McConnell Patrick I.
Published: September 2014

Mini‐Abstract

Tricuspid valve construction using extracellular matrix (ECM) is a relatively new procedure. In this case, a 26‐year‐old woman with a history of severe tricuspid valve regurgitation secondary to congenital valve dysplasia underwent tricuspid valve surgery. Tricuspid valve repair was unsuccessful and thus a 34‐mm extracellular matrix cylinder valve (ECM‐CV) was constructed for valve replacement. The ECM‐CV is clearly imaged using echocardiography, especially three‐dimensional imaging that can help define valve function. As the use of ECM for valve construction increases, echocardiography will play an essential role in evaluating the function and mechanics of these novel valves.
Multimodality Imaging of Cor Triatriatum Sinister in an Octagenerian
Authors: Bezgin Tahir , Çanga Yiğit , Karagöz Ali , Yılmaz Fatih , Doğan Cem , Elveran Ali , Kaymaz Cihangir
Published: September 2014

Cor triatriatum sinister (CTS) is a rare congenital cardiac anomaly in which a fibromuscular membrane divides the atrium into two chambers. As CTS can occur as an isolated anomaly, it is frequently associated with other cardiac anomalies. Although symptoms are usually encountered in infancy, CTS may rarely present in adulthood when the membrane contains large fenestration or other escape drainage exists. We herein, present an 82‐year‐old patient with a typical late diagnosis of asymptomatic CTS.
Support for Wellness Achievement Programme (SWAP): clinical and demographic characteristics of young people with at‐risk mental state in Singapore
Authors: Tay Sarah Ann , Yuen Spencer , Lim Lay Keow , Pariyasami Santhathevi , Rao Sujatha , Poon Lye Yin , Verma Swapna
Published: September 2014

Aim

Individuals with at‐risk mental state (ARMS) experience subtle changes in thinking, behaviour and emotion before their first psychotic episode. Research has shown intervention provided during this period could delay, reduce, or even prevent the conversion to psychosis. In March 2008, the Support for Wellness Achievement Programme (SWAP) was launched for the assessment and treatment of patients with ARMS in Singapore. This paper examines the sociodemographic and clinical characteristics of patients at baseline.

Methods

In total, 384 patients were screened and 155 were accepted into the service. All patients were evaluated using the Comprehensive Assessment of At‐Risk Mental State (CAARMS). Severity of psychopathology was assessed by Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and levels of functioning were assessed using the Social and Occupational Functioning Assessment Scale (SOFAS).

Results

The mean age of the patients was 21.0 years (standard deviation (SD) = 3.5) and 69.7% were men, 42.6% had a relative with a mental health problem and 69.8% met the criterion solely for the attenuated symptoms group. The mean PANSS total score was 48.9 (SD = 10.8). There was also a high rate of comorbidity with 34.8% having depression and 20.0% had anxiety disorders. The mean baseline SOFAS score was 51.5 (SD = 9.8), indicating moderate impairment in their functioning.

Conclusion

These preliminary findings have highlighted that our data are similar to other ARMS programmes, and in addition to the management of ARMS, there is a need to treat both the comorbidities and impairment in social occupational functioning.
Striatal firing rate reflects head movement velocity
Authors: Kim Namsoo , Barter Joseph W. , Sukharnikova Tatyana , Yin Henry H.
Published: September 2014

Although the basal ganglia have long been implicated in the initiation of actions, their contribution to movement remains a matter of dispute. Using wireless multi‐electrode recording and motion tracking, we examined the relationship between single‐unit activity in the sensorimotor striatum and movement kinematics. We recorded single‐unit activity from medium spiny projection neurons and fast‐spiking interneurons while monitoring the movements of mice using motion tracking. In Experiment 1, we trained mice to generate movements reliably by water‐depriving them and giving them periodic cued sucrose rewards. We found high correlations between single‐unit activity and movement velocity in particular directions. This correlation was found in both putative medium spiny projection neurons and fast‐spiking interneurons. In Experiment 2, to rule out the possibility that the observed correlations were due to reward expectancy, we repeated the same procedure but added trials in which sucrose delivery was replaced by an aversive air puff stimulus. The air puff generated avoidance movements that were clearly different from movements on rewarded trials, but the same neurons that showed velocity correlation on reward trials exhibited a similar correlation on air puff trials. These experiments show for the first time that the firing rate of striatal neurons reflects movement velocity for different types of movements, whether to seek rewards or to avoid harm.
Burst‐firing patterns in the prefrontal cortex underlying the neuronal mechanisms of depression probed by antidepressants
Authors: Guo Fei , Zhang Qi , Zhang Bing , Fu Zhiwen , Wu Bin , Huang Chenggang , Li Yang
Published: September 2014

Major depressive disorder (MDD) is one of the leading causes of morbidity worldwide. Several antidepressants have been widely prescribed to treat patients with MDD. However, neuronal changes in brain function remain poorly understood. Based on the standard chronic mild stress (CMS) model of depression in mice, we investigated the neuronal mechanisms of the classic antidepressant, fluoxetine, and a new compound (termed YY‐23 in this study) derived from furostanol saponin. The results showed that both fluoxetine and YY‐23 normalized CMS‐induced depressive‐like behaviors. YY‐23 caused antidepressant‐like behaviors with a faster action than fluoxetine. In terms of in vivo neuronal activities, a CMS‐induced decrease in spontaneous firing in burst of medial prefrontal cortex pyramidal neurons rather than ventral tegmental area (VTA) was reversed by the chronic administration of fluoxetine and YY‐23. We also found that CMS‐induced deficits in the expression of prefrontal brain‐derived neurotrophic factor (BDNF) were also restored by chronically administering YY‐23 and fluoxetine. In addition, chronic administration of fluoxetine rather than YY‐23 resulted in an improvement of antidepressive‐like behavior and a change of burst firing of VTA in control‐housed animals, indicating that the pharmacological effects of YY‐23 were specific to CMS‐treated animals. Together, these data suggest that the burst‐firing patterns of pyramidal cells may be a neural biomarker of depressive‐like mice and antidepressant action. Furthermore, synaptic transmission and BDNF may contribute to the rapid antidepressant‐like effects on depression.
Sperm traits of masculinized fish relative to wild‐type males: a systematic review and meta‐analyses
Authors: Senior Alistair M , Johnson Sheri L , Nakagawa Shinichi
Published: September 2014

Environmental sex reversal (ESR), whereby environmental effects (e.g. exogenous chemicals) override genetic sex determination, is a commonly used technique in aquaculture and physiology research. We performed a systematic review and meta‐analyses of the literature that compares the sperm characteristics of masculinized genotypic females to wild‐type males. We detected no mean differences between the ejaculate volume, sperm motility, duration or linearity of each type of male. We found some large mean differences in sperm concentration (d = 2.541, CI = −0.004 to 5.086), reproductive success (d = −1.400, CI = −2.943 to 0.142), semen osmolality (d = 1.850, CI = 0.622 to 3.077) and sperm velocity (d = −0.933, CI=−1.426 to −0.441); in the case of the latter two traits, the mean effect was statistically significant. However, any significance did not stand up to a more conservative analysis. Additionally, heterogeneity was high and we found that where large differences between the sperm of sex‐reversed and wild‐type males are reported, these effects are attributable to sperm sampling methodology. Overall, we found little evidence for large systematic differences between the sperm produced by masculinized and wild‐type male fish. Thus, masculinized genotypic females may enjoy reproductive success comparable to genotypic males. This conclusion leads to two potential implications: (i) sex‐reversed fish may influence the dynamics of wild populations and (ii) aquaculture practices may use ESR to produce males with sperm quality similar to that of genotypic males. Most studies appear to have been performed in aquaculture species (i.e. Salmonidae); thus future experiments in non‐model organisms may provide important insights in to the uniformity of the effects described.
Oral healthcare education of future nursing personnel and auxiliary nurses
Authors: Mehl Astrid E. , Ellingsen Øivind G. , Kjeksrud Joakim , Willumsen Tiril
Published: September 2014

Objective

To investigate the oral healthcare training in the education of auxiliary nurses in Norway.

Background

Many elderly residents need assistance in every aspect of daily living, including help with oral care. Auxiliary nurses are the professional group who most often provide this help.

Materials and methods

An e‐mail administered questionnaire was sent to all 164 high schools in Norway offering basic education for auxiliary nurse.

Results

Of the 114 high schools responding to the survey (69.5% response rate), 83.3% reported mandatory courses, 49.1% offered three or more hours of teaching in oral health care. 89.5% offered both lectures and practical training, 93.9% had training in tooth cleaning, 37.7% lectured about different dental restorations, 50% lectured on ergonomic working positions, 12.3% on the working lights, 16.7% on inspection techniques, 25.4% on interdental brushes and 6.1% on electrical powered toothbrushes. Additionally, 45.6% assessed that their students are prepared for later work with oral health care. More lessons led to better quality of education.

Conclusion

Almost all of the high schools had mandatory education in oral care in the auxiliary nurse programme. Increasing the number of lessons may improve the quality of knowledge, but the teaching programmes for a number of topics seem insufficient. There is a need to strengthen the position of oral health in the education of auxiliary nurses. To meet the future challenges in oral health, international or national expert‐developed guidelines for oral care training programmes would be useful for the education of auxiliary nurses.
Communicative characteristics of interactions between surgeons and Chinese women with breast cancer in oncology consultation: a conversation analysis
Authors: Yoon Sungwon , Chan Miranda , Hung Wai Ka , Ying Marcus , Or Amy , Lam Wendy WT
Published: September 2014

Background

While previous studies have analysed features of interaction in cancer consultations using observational coding frames, relatively little attention is being given to how actual interactions are sequentially organized and achieved by participants in the course of talk‐in‐interaction. Research into the interactional practices in consultations, which involves Chinese patients, is largely absent.

Objective

To provide insight into the talk‐in‐interaction in surgical‐oncology consultations in the context of a Chinese medical setting.

Methods

Thirty‐one consultations involving 31 patients with breast cancer and eight surgeons were videotaped. The recordings were transcribed verbatim and analysed using conversation analysis.

Results

The manner in which surgeons delivered the diagnostic results was fairly similar across all the consultations. Most surgeons gave the diagnosis in a very straightforward and abrupt manner at the outset of the consultation with no mitigation. While patients in our study conformed to the traditional information giving and receiving roles, how information was presented by surgeons shaped the subsequent sequential organization of surgeon‐patient interaction and turn‐taking patterns. More importantly, there was a tendency by the surgeons to move from issues of psychosocial nature to clinical matters regardless of the topics taken up in the specific encounter.

Conclusions

This study demonstrated the potential of conversation analysis as a context‐sensitive method that enabled researchers to gain a more thorough understanding of dynamics of interaction in cancer consultations, thereby informing training interventions for surgeons. Our findings underscore the importance of discursive practices in shaping and encouraging (or discouraging) patient participation in oncology consultation.
Chronic idiopathic angioedema: a single center experience
Authors: Eli Magen , Joseph Mishal , Kuznik Boris , Menachem Schlesinger
Published: September 2014

Objective

Chronic idiopathic angioedema (CIA) is defined as three or more episodes of angioedema in a period of > 6 months without a clear etiology. In the study, we tried to explore clinical and laboratory characteristics of patients with CIA unaccompanied by urticaria.

Methods

We retrospectively reviewed clinical and laboratory characteristics of 1238 patients with chronic urticaria and/or angioedema referred to our allergy clinic.

Results

Eight hundred and forty‐one (67.9%) subjects had chronic urticaria without angioedema (CU Group), 323 (26.1%) had both urticaria and angioedema (CU + CA group), and 74 (5.9%) had chronic angioedema without urticaria (CA). In 29 (39.2%) cases of CA, no etiologic factor of angioedema was discovered, thus the patients were defined as having chronic idiopathic angioedema (CIA Group). Twenty‐two (75.8%) subjects had antihistamine‐responsive CIA and seven (24.1%) had antihistamine‐unresponsive CIA. There were no statistically significant differences in clinical (except of urticarial eruptions) and laboratory characteristics between CU, CA + CU, and CIA groups. Antihistamine responsive and antihistamine‐unresponsive CIA groups had no distinguishable clinical or laboratory features.

Conclusions

We suppose that CIA, at least its antihistamine‐responsive form, represents a rare form of chronic spontaneous urticaria. The reasons why in CIA there are no other clinical signs of mast cell/basophil activation, such as pruritus, urticarial, and dermatographism, are largely unknown and have to be elucidated in future studies.
Compound heterozygous PLEC mutations in a patient of consanguineous parentage with epidermolysis bullosa simplex with muscular dystrophy and diffuse alopecia
Authors: Yin Jinghua , Ren Yali , Lin Zhimiao , Wang Huijun , Zhou Yun , Yang Yong
Published: September 2014

Epidermolysis bullosa simplex with muscular dystrophy (EBS‐MD; OMIM 226670) is an autosomal recessive form of EBS, characterized by skin blistering at birth and delayed onset of muscle dystrophy. Mutations in PLEC, the gene encoding plectin, have been identified to be causal for EBS‐MD. We report a case of EBS‐MD with diffuse alopecia. Genetic study revealed the patient carrying compound heterozygous mutations in PLEC despite the consanguineous parentage.