bluuebunny/crossref_metadata_2025 huggingface dataset:
Adiponectin, C‐reactive protein, fibrinogen and tissue plasminogen activator antigen levels among glucose‐intolerant women with and without histories of gestational diabetes
Authors: Kim C. , Christophi C. A. , Goldberg R. B. , Perreault L. , Dabelea D. , Marcovina S. M. , Pi‐Sunyer X. , Barrett‐Connor E.
Published: May 2015

Aim

To examine concentrations of biomarkers (adiponectin, C‐reactive protein, fibrinogen and tissue plasminogen‐activator antigen) associated with glucose homeostasis and diabetes risk by history of gestational diabetes (GDM).

Methods

We conducted a secondary analysis of the Diabetes Prevention Program, a randomized trial of lifestyle intervention or metformin for diabetes prevention. At baseline, participants were overweight and had impaired glucose tolerance. Biomarkers at baseline and 1 year after enrolment were compared between parous women with (n = 350) and without histories of GDM (n = 1466). Cox proportional hazard models evaluated whether history of GDM was associated with diabetes risk, after adjustment for baseline biomarker levels as well as for change in biomarker levels, demographic factors and anthropometrics.

Results

At baseline, women with histories of GDM had lower adiponectin (7.5 μg/ml vs. 8.7 μg/ml; p < 0.0001) and greater log C‐reactive protein (‐0.90 mg/l vs. ‐0.78 mg/l, p = 0.04) levels than women without histories of GDM, but these associations did not persist after adjustment for demographic factors. Fibrinogen and tissue plasminogen‐activator antigen were similar between women with and without histories of GDM. Women with and without histories of GDM had a similar pattern of changes in biomarkers within randomization arm. Adjustment for age, race/ethnicity, baseline weight, change in weight, baseline biomarker level and change in biomarker level did not significantly alter the association between history of GDM, and diabetes risk.

Conclusions

Among women with impaired glucose tolerance, biomarkers in women with and without histories of GDM are similar and respond similarly to lifestyle changes and metformin. Adjustment for biomarker levels did not explain the higher risk of diabetes observed in women with histories of GDM.
Biosimilar insulins: guidance for data interpretation by clinicians and users
Authors: Heinemann L. , Home P. D. , Hompesch M.
Published: May 2015

Biosimilar insulins are approved copies of insulins outside patent protection. Advantages may include greater market competition and potential cost reduction, but clinicians and users lack a clear perspective on ‘biosimilarity’ for insulins. The manufacturing processes for biosimilar insulins are manufacturer‐specific and, although these are reviewed by regulators there are few public data available to allow independent assessment or review of issues such as intrinsic quality or batch‐to‐batch variation. Preclinical measures used to assess biosimilarity, such as tissue and cellular studies of metabolic activity, physico‐chemical stability and animal studies of pharmacodynamics, pharmacokinetics and immunogenicity may be insufficiently sensitive to differences, and are often not formally published. Pharmacokinetic and pharmacodynamic studies (glucose clamps) with humans, although core assessments, have problems of precision which are relevant for accurate insulin dosing. Studies that assess clinical efficacy and safety and device compatibility are limited by current outcome measures, such as glycated haemoblobin levels and hypoglycaemia, which are insensitive to differences between insulins. To address these issues, we suggest that all comparative data are put in the public domain, and that systematic clinical studies are performed to address batch‐to‐batch variability, delivery devices, interchangeability in practice and long‐term efficacy and safety. Despite these challenges biosimilar insulins are a welcome addition to diabetes therapy and, with a transparent approach, should provide useful benefit to insulin users.
Weight‐sparing effect of insulin detemir: a consequence of central nervous system‐mediated reduced energy intake?
Authors: Russell‐Jones D. , Danne T. , Hermansen K. , Niswender K. , Robertson K. , Thalange N. , Vasselli J. R. , Yildiz B. , Häring H. U.
Published: May 2015

Insulin therapy is often associated with adverse weight gain. This is attributable, at least in part, to changes in energy balance and insulin's anabolic effects. Adverse weight gain increases the risk of poor macrovascular outcomes in people with diabetes and should therefore be mitigated if possible. Clinical studies have shown that insulin detemir, a basal insulin analogue, exerts a unique weight‐sparing effect compared with other basal insulins. To understand this property, several hypotheses have been proposed. These explore the interplay of efferent and afferent signals between the muscles, brain, liver, renal and adipose tissues in response to insulin detemir and comparator basal insulins. The following models have been proposed: insulin detemir may reduce food intake through direct or indirect effects on the central nervous system (CNS); it may have favourable actions on hepatic glucose metabolism through a selective effect on the liver, or it may influence fluid homeostasis through renal effects. Studies have consistently shown that insulin detemir reduces energy intake, and moreover, it is clear that this shift in energy balance is not a consequence of reduced hypoglycaemia. CNS effects may be mediated by direct action, by indirect stimulation by peripheral mediators and/or via a more physiological counter‐regulatory response to insulin through restoration of the hepatic–peripheral insulin gradient. Although the precise mechanism remains unclear, it is likely that the weight‐sparing effect of insulin detemir can be explained by a combination of mechanisms. The evidence for each hypothesis is considered in this review.
Larval dispersal dampens population fluctuation and shapes the interspecific spatial distribution patterns of rocky intertidal gastropods
Authors: Sahara Ryosuke , Fukaya Keiichi , Okuda Takehiro , Hori Masakazu , Yamamoto Tomoko , Nakaoka Masahiro , Noda Takashi
Published: May 2015

Many marine benthic invertebrates pass through a planktonic larval stage whereas others spend their entire lifetimes in benthic habitats. Recent studies indicate that non‐planktonic species show relatively greater fine‐scale patchiness than do planktonic species, but the underlying mechanisms remain unknown. One hypothesis for such a difference is that larval dispersal enhances the connectivity of populations and buffers population fluctuations and reduces local extinction risk, consequently increasing patch occupancy rate and decreasing spatial patchiness. If this mechanism does indeed play a significant role, then the distribution of non‐planktonic species should be more aggregated – both temporally and spatially – than the distribution of species with a planktonic larval stage. To test this prediction, we compared 1) both the spatial and the temporal abundance–occupancy relationships and 2) both the spatial and the temporal mean–variance relationships of population size across species of rocky intertidal gastropods with differing dispersive traits from the Pacific coast of Japan. We found that, compared to planktonic species, non‐planktonic species exhibited 1) a smaller occupancy rate for any given level of mean population size and 2) greater variations in population size, both spatially and temporally. This suggests that the macroecological patterns observed in this study (i.e. the abundance–occupancy relationships and mean–variance relationships of population size across species) were shaped by the effect of larval dispersal dampening population fluctuation, which works over both space and time. While it has been widely assumed that larval dispersal enhances population fluctuations, larval dispersal may in fact enhance the connectively of populations and buffer population fluctuations and reduce local extinction risks.
virtualspecies, an R package to generate virtual species distributions
Authors: Leroy Boris , Meynard Christine N. , Bellard Céline , Courchamp Franck
Published: May 2015

virtualspecies is a freely available package for R designed to generate virtual species distributions, a procedure increasingly used in ecology to improve species distribution models. This package combines the existing methodological approaches with the objective of generating virtual species distributions with increased ecological realism. The package includes 1) generating the probability of occurrence of a virtual species from a spatial set of environmental conditions (i.e. environmental suitability), with two different approaches; 2) converting the environmental suitability into presence–absence with a probabilistic approach; 3) introducing dispersal limitations in the realised virtual species distributions and 4) sampling occurrences with different biases in the sampling procedure. The package was designed to be extremely flexible, to allow users to simulate their own defined species–environment relationships, as well as to provide a fine control over every simulation parameter. The package also includes a function to generate random virtual species distributions. We provide a simple example in this paper showing how increasing ecological realism of the virtual species impacts the predictive performance of species distribution models. We expect that this new package will be valuable to researchers willing to test techniques and protocols of species distribution models as well as various biogeographical hypotheses.
Selective and divided attention modulates auditory–vocal integration in the processing of pitch feedback errors
Authors: Liu Ying , Hu Huijing , Jones Jeffery A. , Guo Zhiqiang , Li Weifeng , Chen Xi , Liu Peng , Liu Hanjun
Published: May 2015

Speakers rapidly adjust their ongoing vocal productions to compensate for errors they hear in their auditory feedback. It is currently unclear what role attention plays in these vocal compensations. This event‐related potential (ERP) study examined the influence of selective and divided attention on the vocal and cortical responses to pitch errors heard in auditory feedback regarding ongoing vocalisations. During the production of a sustained vowel, participants briefly heard their vocal pitch shifted up two semitones while they actively attended to auditory or visual events (selective attention), or both auditory and visual events (divided attention), or were not told to attend to either modality (control condition). The behavioral results showed that attending to the pitch perturbations elicited larger vocal compensations than attending to the visual stimuli. Moreover, ERPs were likewise sensitive to the attentional manipulations: P2 responses to pitch perturbations were larger when participants attended to the auditory stimuli compared to when they attended to the visual stimuli, and compared to when they were not explicitly told to attend to either the visual or auditory stimuli. By contrast, dividing attention between the auditory and visual modalities caused suppressed P2 responses relative to all the other conditions and caused enhanced N1 responses relative to the control condition. These findings provide strong evidence for the influence of attention on the mechanisms underlying the auditory–vocal integration in the processing of pitch feedback errors. In addition, selective attention and divided attention appear to modulate the neurobehavioral processing of pitch feedback errors in different ways.
Cell toxicity of 2‐hydroxyethyl methacrylate (HEMA): the role of oxidative stress
Authors: Morisbak Else , Ansteinsson Vibeke , Samuelsen Jan T.
Published: May 2015

2‐Hydroxyethyl methacrylate (HEMA) is a methacrylate monomer used in polymer‐based dental‐restorative materials. In this study, the viability of human lung epithelial cells, BEAS‐2B, was investigated after exposure to this monomer. Exposure to HEMA reduced the viability of the BEAS‐2B cells as a result of increased apoptosis, interruption of the cell cycle, and decreased cell proliferation. Depletion of cellular glutathione and increased levels of reactive oxygen species (ROS) were seen after exposure of BEAS‐2B cells to HEMA. The glutathione synthase inhibitor, L‐buthioninesulfoximine (BSO), was used to study whether the reduced viability was caused by glutathione depletion and increased levels of ROS. Similarly to incubation with HEMA, incubation with BSO resulted in glutathione depletion and increased ROS levels, without increasing cell death or inhibiting cell growth. The results indicate that HEMA‐induced cell damage is not caused exclusively by these mechanisms. Mechanisms other than glutathione depletion and ROS formation seem to be of importance for the toxic effect of HEMA on lung epithelial cells.
The importance of considering animal body mass in IPCC greenhouse inventories and the underappreciated role of wild herbivores
Authors: Smith Felisa A. , Lyons S. Kathleen , Wagner Peter J. , Elliott Scott M.
Published: May 2015

Methane is an important greenhouse gas, but characterizing production by source sector has proven difficult. Current estimates suggest herbivores produce ~20% (~76–189 Tg yr−1) of methane globally, with wildlife contributions uncertain. We develop a simple and accurate method to estimate methane emissions and reevaluate production by wildlife. We find a strikingly robust relationship between body mass and methane output exceeding the scaling expected by differences in metabolic rate. Our allometric model gives a significantly better fit to empirical data than IPCC Tier 1 and 2 calculations. Our analysis suggests that (i) the allometric model provides an easier and more robust estimate of methane production than IPCC models currently in use; (ii) output from wildlife is much higher than previously considered; and (iii) because of the allometric scaling of methane output with body mass, national emissions could be reduced if countries favored more, smaller livestock, over fewer, larger ones.
Quantifying landscape‐level methane fluxes in subarctic Finland using a multiscale approach
Authors: Hartley Iain. P. , Hill Timothy. C. , Wade Thomas. J. , Clement Robert. J. , Moncrieff John. B. , Prieto‐Blanco Ana. , Disney Mathias. I. , Huntley Brian. , Williams Mathew. , Howden Nicholas. J. K. , Wookey Philip. A. , Baxter Robert.
Published: May 2015

Quantifying landscape‐scale methane (CH4) fluxes from boreal and arctic regions, and determining how they are controlled, is critical for predicting the magnitude of any CH4 emission feedback to climate change. Furthermore, there remains uncertainty regarding the relative importance of small areas of strong methanogenic activity, vs. larger areas with net CH4 uptake, in controlling landscape‐level fluxes. We measured CH4 fluxes from multiple microtopographical subunits (sedge‐dominated lawns, interhummocks and hummocks) within an aapa mire in subarctic Finland, as well as in drier ecosystems present in the wider landscape, lichen heath and mountain birch forest. An intercomparison was carried out between fluxes measured using static chambers, up‐scaled using a high‐resolution landcover map derived from aerial photography and eddy covariance. Strong agreement was observed between the two methodologies, with emission rates greatest in lawns. CH4 fluxes from lawns were strongly related to seasonal fluctuations in temperature, but their floating nature meant that water‐table depth was not a key factor in controlling CH4 release. In contrast, chamber measurements identified net CH4 uptake in birch forest soils. An intercomparison between the aerial photography and satellite remote sensing demonstrated that quantifying the distribution of the key CH4 emitting and consuming plant communities was possible from satellite, allowing fluxes to be scaled up to a 100 km2 area. For the full growing season (May to October), ~ 1.1–1.4 g CH4 m−2 was released across the 100 km2 area. This was based on up‐scaled lawn emissions of 1.2–1.5 g CH4 m−2, vs. an up‐scaled uptake of 0.07–0.15 g CH4 m−2 by the wider landscape. Given the strong temperature sensitivity of the dominant lawn fluxes, and the fact that lawns are unlikely to dry out, climate warming may substantially increase CH4 emissions in northern Finland, and in aapa mire regions in general.
Pathologists are able to differentiate reliably the lamina propria associated with Barrett's musculofibrous anomaly from submucosa in oesophageal endoscopic resections
Authors: Kaye Philip V , O'Donovan Maria , Mapstone Nicholas , Disep Babett , Novelli Marco , Ragunath Krish
Published: May 2015

Aims

Endoscopic resection (ER) is the standard therapy for early oesophageal neoplasia and is used for diagnosis and treatment. Accurate staging is especially important, as further treatment depends on this. Because Barrett's mucosa often develops fibromuscular hyperplasia with a fibrotic lamina propria and reduplicated muscularis mucosae, pathologists have expressed concern that it may not be possible to differentiate lamina propria reliably from submucosa in such resections. This study aimed to develop criteria for distinguishing submucosa from abnormal lamina propria and test reproducibility.

Methods and results

Virtual slides of oesophagectomy cases with early cancer were reviewed by participants, all gastrointestinal (GI) pathologists. Criteria were agreed for recognition of submucosa – the presence of any of submucosal glands, fat and large muscular vessels. A set of 20 endoscopic resections were then uploaded and 45 areas annotated and participants asked to categorize as submucosa or lamina propria. Agreement was excellent, with 35 areas showing agreement by all pathologists and a further seven areas with four of five agreeing. Paired interobserver kappa values varied between 0.69 and 0.955.

Conclusion

With the application of usually easily recognizable criteria, pathologists are able to differentiate submucosa from lamina propria with musculofibrous anomaly in oesophageal ER specimens with a high degree of reproducibility.
Creativity, Self‐exploration and Change: Creative Arts‐based Activities’ Contribution to Desistance Narratives
Authors: ALBERTSON (née WILKINSON) KATHERINE
Published: May 2015

This exploratory article is based on interviews and focus groups with prisoners reflecting on the benefits of engaging in creative arts‐based activities. Desistance theorists emphasise the importance of judgments based on individual personal impressions, feelings and opinions in offenders’ co‐production and ownership of their desistance narratives. The data presented here are used to illustrate the positive changes in offenders’ subjective understandings and to highlight the appropriateness of using more nuanced research designs to provide evidence of effectiveness of engagement with arts‐based projects.
Epidemiology and clinical evolution of non‐melanoma skin cancer in renal transplant recipients: a single‐center experience in São Paulo, Brazil
Authors: Hayashida Marina Zoega , Fernandes Victor Miguel Coutinho , de Melo Fernandes Diana Rosa , Ogawa Marília Marufuji , Tomimori Jane
Published: May 2015

Background

Non‐melanoma skin cancer (NMSC) is very common among renal transplant recipients (RTRs) as a result of the immunosuppressed status of these patients and other factors. Few studies have examined the clinical characteristics and evolution of NMSC in RTRs in tropical countries.

Objectives

The aim of this study was to characterize the epidemiology and clinical evolution of NMSC in RTRs.

Methods

We conducted a retrospective study including 68 RTRs with NMSC diagnosed from July 2004 to December 2009 with a minimum follow‐up of three years. We analyzed demographic and transplant‐ and NMSC‐related data.

Results

The mean age of patients at the first diagnosis of NMSC was 51 years (range: 29–71 years). Most first diagnoses occurred within nine years post‐transplant. The majority of patients (n = 48) had Fitzpatrick skin phototype II, although NMSC was also observed in those with skin phototypes III and IV. Forty‐six (67.6%) RTRs had received a kidney from a living donor. Fifty‐five (80.9%) RTRs had received cytotoxic immunosuppressives, 51 (75.0%) had received calcineurin inhibitors, and two (2.9%) had received mTOR inhibitors. Most of the RTRs developed about eight NMSC lesions, but up to 25 NMSC lesions were diagnosed in one patient. Most lesions (67.6%) were located on sun‐exposed areas. Squamous cell carcinoma (SCC) represented the predominant tumor type, accounting for 70.6% of all tumors, whereas basal cell carcinoma accounted for 29.4% of all tumors. Invasive SCC predominated over in situ SCC. Finally, 48.5% of patients had a previous history of viral warts.

Conclusions

Long‐term use of immunosuppressive therapy increases the risk for tumor occurrence. Multiple NMSC tumors can develop in patients in tropical countries, even in patients with a high skin phototype. Therefore, RTRs should understand the high risk for the development of malignant tumors and should be properly informed about the prevention and treatment of NMSC.
Prevalence and predictors of verbal aggression in a secure mental health service: Use of the HCR‐20
Authors: Gunenc Cevher , O'Shea Laura E. , Dickens Geoffrey L.
Published: May 2015

Despite evidence about the negative effects of verbal aggression in mental health wards there is little research about its prevalence or about the factors that predict the behaviour among inpatients. This study aimed to determine the prevalence of verbal aggression in a secure mental health service, and to examine the relationship of verbal aggression with risk factors for aggression in the risk assessment tool HCR‐20 in order to establish whether, and with which factors, the behaviour can be predicted. Verbal aggression was measured using the Overt Aggression Scale (OAS) over a 3‐month period across a heterogeneous patient group (n = 613). Over half the patients (n = 341, 56%) engaged in 1594 incidents of verbal aggression. The HCR‐20 total, clinical, and risk management subscale scores predicted verbal aggression, though effect sizes were not large. Item‐outcome analysis revealed that impulsivity, negative attitudes, and non‐compliance with medication were the best predictors of verbal aggression and, therefore, should be targeted for intervention. There are key synergies between factors predicting verbal aggression and the core mental health nursing role. Nurses, therefore, are in a prime position to develop and implement interventions that may reduce verbal aggression in mental health inpatients.
The fluid dynamics of simultaneous irrigation with negative pressure wound therapy
Authors: Davis Kathryn E , Moquin Kenneth J , Lavery Lawrence A
Published: May 2015

Saline irrigation has been shown to be both experimentally and clinically efficacious in decreasing bacterial contamination as well as decreasing infection rates. The dynamics of irrigation delivery fall into two primary categories: simultaneous and intermittent irrigation. An important component to irrigation therapy is distribution of irrigation solution to hard‐to‐reach areas of a wound bed, including undermining and fissure‐like structures. Here we test the effectiveness of simultaneous irrigation to fill the irregular structures of a wound bed. In order to visualise the dynamic movement of irrigation solution, three‐dimensional wound models were constructed using clear synthetic ballistic gel. Wounds with the aforementioned characteristics were carved into the ballistic gel with varying area, depth and volume. All three wounds were dressed as per manufacturer's instructions. Data demonstrate that simultaneous irrigation is effective in reaching all parts of a wound bed in wound models that have both undermining and tunnelling, and irrigation effectively saturates bridged wounds. Finally, this study shows that there is constant turnover of irrigation solution in the wound that is driven more by administration volume and less by flow rate. These data show that simultaneous irrigation is an effective technique for delivering irrigation solution to both simple and complex wounds.
Effectiveness of body–mind–spirit intervention on well‐being, functional impairment and quality of life among depressive patients – a randomized controlled trial
Authors: Rentala Sreevani , Fong Ted C.T. , Nattala Prasanthi , Chan Cecilia L.W. , Konduru Reddemma
Published: May 2015

Aim

The aim of the study was to examine the efficacy of body–mind–spirit Intervention in improving the outcomes (well‐being, quality of life and functional impairment) among depressive patients.

Background

Depressive disorders lead to significant dysfunction, disability and poor quality of life among sufferers. Body–mind–spirit intervention has been associated with improvements in the outcomes; however, few studies have examined this among depressive patients.

Design

True experimental pre–post equivalent groups design was adopted with longitudinal measurement of outcomes.

Methods

Participants were 120 adult depressive patients visiting the psychiatric outpatient department in a District Hospital in India. The participants were randomly assigned to either the body–mind–spirit group or the treatment‐as‐usual group between July 2011–January 2013. The treatment‐as‐usual group (n = 64) received only routine treatment (antidepressants and structured psycho‐education) in the hospital. The body–mind–spirit group (n = 56) received four weekly body–mind–spirit group sessions in addition to the routine treatment. Outcome measures on depression, well‐being, functional impairment and quality of life were evaluated for both groups at baseline and at four follow‐up assessments in the 1st, 2nd, 3rd and 6th month. Treatment effects of the body–mind–spirit intervention were analysed by repeated‐measures analysis of covariance.

Findings

Compared with the treatment‐as‐usual group, the body–mind–spirit group showed significant reduction in depression and functional impairment, and significant improvement in the well‐being and quality of life scores over the 6‐month study period.

Conclusion

The present findings provided evidence for the effectiveness of integrating a complementary therapy such as the body–mind–spirit intervention with conventional treatment in improving prospective outcomes among the depressive patients.
Prevalence of periodontitis in an adult population from an urban area in North Italy: findings from a cross‐sectional population‐based epidemiological survey
Authors: Aimetti Mario , Perotto Stefano , Castiglione Anna , Mariani Giulia M. , Ferrarotti Francesco , Romano Federica
Published: May 2015

Aim

There is a paucity of up‐to‐date data regarding prevalence and risk indicators of periodontitis in Italy. Therefore, the aim of this study was to evaluate the prevalence of periodontitis and its risk indicators among adults from an urban area in North Italy.

Material and Methods

This cross‐sectional survey used a stratified two‐stage probability sampling method to draw a representative sample of the adult population of the city of Turin. About 1600 individuals, 20–75 years old, were randomly selected and 736 subjects agreed to participate (47% of the sampled subjects). Clinical parameters were assessed using a full‐mouth protocol. Logistic models were applied to assess associations between periodontitis and its putative risk indicators. Age was included as restricted cubic spline.

Results

Based on CDC/AAP case definition, the prevalence estimates of severe and moderate periodontitis were 34.94% (95% CI: 31.23–38.74) and 40.78% (95% CI: 36.89–44.79). The probability of periodontitis increased in smokers (adjusted OR 2.06, 95% IC: 1.26–3.37, p = 0.004) and with age but leveled off in the 50+ year‐old group (p < 0.001).

Conclusion

Periodontitis was highly prevalent in the Turin population. The present data will enable development of appropriate public health programs and allocation of resources.
Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study
Authors: Sullivan Elinor L. , Holton Kathleen F. , Nousen Elizabeth K. , Barling Ashley N. , Sullivan Ceri A. , Propper Cathi B. , Nigg Joel T.
Published: May 2015

Background

Attention deficit hyperactivity disorder (ADHD) is theorized to have temperamental precursors early in life. These are difficult to identify because many core features of ADHD, such as breakdowns in executive function and self‐control, involve psychological and neural systems that are too immature to reliably show dysfunction in early life. ADHD also involves emotional dysregulation, and these temperamental features appear earlier as well. Here, we report a first attempt to utilize indices of emotional regulation to identify ADHD‐related liability in infancy.

Methods

Fifty women were recruited in the 2nd trimester of pregnancy, with overselection for high parental ADHD symptoms. Measures of maternal body mass index, nutrition, substance use, stress, and mood were examined during pregnancy as potential confounds. Offspring were evaluated at 6 months of age using LABTAB procedures designed to elicit fear, anger, and regulatory behavior. Mothers completed the Infant Behavior Questionnaire about their child's temperament.

Results

After control for associated covariates, including maternal depression and prenatal stress, family history of ADHD was associated with measures of anger/irritability, including infant negative vocalizations during the arm restraint task (p = .004), and maternal ratings of infant distress to limitations (p = .036). In the regulation domain, familial ADHD was associated with less parent‐oriented attention seeking during the still face procedure (p < .001), but this was not echoed in the maternal ratings of recovery from distress.

Conclusions

Affective response at 6 months of age may identify infants with familial history of ADHD, providing an early indicator of ADHD liability. These preliminary results provide a foundation for further studies and will be amplified by enlarging this cohort and following participants longitudinally to evaluate ADHD outcomes.
miR‐27a rs895819 polymorphism and risk of cancer in Chinese population: a meta‐analysis
Authors: Yuan Lu , Zhang Ting‐ting , Ren Yan
Published: May 2015

Objective

Previous studies have evaluated the association between miR‐27a rs895819 polymorphism and cancer risk in Chinese population, but the results were inconclusive. The present meta‐analysis was conducted to clarify these controversies.

Methods

A comprehensive search was conducted to identify all relevant case‐control studies of miR‐27a rs895819 polymorphism and cancer risk in Chinese participants. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of any association.

Results

A total of 12 case‐control studies involving 2655 cases and 3106 controls were included. Overall, the results suggested that there was no significant association between miR‐27a rs895819 polymorphism and cancer risk in Chinese population (OR = 1.14, 95%CI 0.86 to1.15, P = 0.85 for GG vs. AA). In the subgroup analysis by the source of controls, no significant association was found either among hospital‐based group (OR = 1.16, 95%CI 0.78 to 1.73) or population‐based group (OR = 1.06, 95%CI 0.74 to 1.35). However, when stratified by cancer types, we found a significant association between the polymorphism with colorectal cancer (OR = 1.56, 95%CI 1.01 to 2.40 for GG vs. AA).

Conclusion

miR‐27a rs895819 polymorphism was associated with increased risk of colorectal cancer in Chinese population.
Medicine's perception of reality – a split picture: critical reflections on apparent anomalies within the biomedical theory of science
Authors: Kirkengen Anna Luise , Ekeland Tor‐Johan , Getz Linn , Hetlevik Irene , Schei Edvin , Ulvestad Elling , Vetlesen Arne Johan
Published: May 2015

Escalating costs, increasing multi‐morbidity, medically unexplained health problems, complex risk, poly‐pharmacy and antibiotic resistance can be regarded as artefacts of the traditional knowledge production in Western medicine, arising from its particular worldview. Our paper presents a historically grounded critical analysis of this view. The materialistic shift of Enlightenment philosophy, separating subjectivity from bodily matter, became normative for modern medicine and yielded astonishing results. The traditional dichotomies of mind/body and subjective/objective are, however, incompatible with modern biological theory. Medical knowledge ignores central tenets of human existence, notably the physiological impact of subjective experience, relationships, history and sociocultural contexts. Biomedicine will not succeed in resolving today's poorly understood health problems by doing ‘more of the same’. We must acknowledge that health, sickness and bodily functioning are interwoven with human meaning‐production, fundamentally personal and biographical. This implies that the biomedical framework, although having engendered ‘success stories’ like the era of antibiotics, needs to be radically revised.
Review of the Mechanism of Tooth Whitening
Authors: Kwon So Ran , Wertz Philip W.
Published: May 2015

Purpose

This review integrated the current literature on diffusion of whitening agents, their interactions with stain molecules, and changes to the surface, with the aim of establishing a better understanding of the mechanism underlying tooth whitening.

Materials and Methods

An electronic PubMed database search, with combinations of the following terms was performed: Tooth Bleaching, Tooth Bleaching Agent, Hydrogen Peroxide, Pharmacokinetics, Tooth Permeability, Oxidation‐Reduction, Tooth Demineralization, and Color.

Results

Tooth whitening is a dynamic process that involves diffusion of the whitening material to interact with stain molecules and also involves micromorphologic alterations on the surface and changes within the tooth that affect its optical properties. The interaction seems not to be limited to stain molecules, but rather an affinity‐based interaction process that also accompanies effects on sound enamel and dentin structures.

Conclusions

This review underlines that supervision by dental health professionals as recommended by the American Dental Association (ADA) Council on Scientific Affairs is critical to achieving a successful and safe whitening outcome.

Clinical Significance

The mechanism that underlies tooth whitening with the use of peroxide‐based materials is a complex phenomenon encompassing diffusion, interaction, and surfaces changes within the tooth. Therefore, supervision by dental health professionals as recommended by the ADA Council on Scientific Affairs is imperative to achieve a successful and safe whitening outcome.
Survival of patients with gastric lymphoma in Germany and in the United States
Authors: Castro Felipe A , Jansen Lina , Krilaviciute Agne , Katalinic Alexander , Pulte Dianne , Sirri Eunice , Ressing Meike , Holleczek Bernd , Luttmann Sabine , Brenner Hermann ,   GEKID Cancer Survival Working Group
Published: May 2015

Background and Aim

This study aims to examine survival for gastric lymphomas and its main subtypes, mucosa‐associated lymphoid tissue lymphoma (MALT), and diffuse large B‐cell lymphoma (DLBCL), in Germany and in the United States.

Methods

Data for patients diagnosed in 1997–2010 were used from 10 population‐based German cancer registries and compared to the data from the US Surveillance, Epidemiology and End Results (SEER) 13 registries database. Patients age 15–74 diagnosed with gastric lymphomas were included in the analysis. Period analysis and modeled period analysis were used to estimate 5‐year and 10‐year relative survival (RS) in 2002–2010 and survival trends from 2002–2004 to 2008–2010.

Results

Overall, the database included 1534 and 2688 patients diagnosed with gastric lymphoma in 1997–2010 in Germany and in the United States, respectively. Survival was substantially higher for MALT (5‐year and 10‐year RS: 89.0% and 80.9% in Germany, 93.8% and 86.8% in the United States) than for DLBCL (67.5% and 59.2% in Germany, and 65.3% and 54.7% in the United States) in 2002–2010. Survival was slightly higher among female patients and decreased by age for gastric lymphomas combined and its main subtypes. A slight, nonsignificant, increase in the 5‐year RS for gastric lymphomas combined was observed in Germany and the United States, with increases in 5‐year RS between 2002–2004 and 2008–2010 from 77.1% to 81.0% and from 77.3% to 82.0%, respectively. Five‐year RS of MALT exceeded 90% in 2008–2010 in both countries.

Conclusions

Five‐year RS of MALT meanwhile exceeds 90% in both Germany and the United States, but DLBCL has remained below 70% in both countries.
Impact of acute kidney injury on prognosis of patients with liver cirrhosis and ascites: A retrospective cohort study
Authors: Bucsics Theresa , Mandorfer Mattias , Schwabl Philipp , Bota Simona , Sieghart Wolfgang , Ferlitsch Arnulf , Trauner Michael , Peck‐Radosavljevic Markus , Reiberger Thomas
Published: May 2015

Background and Aim

Acute kidney injury (AKI) is a common complication in patients with liver cirrhosis, and its impact on the clinical course is increasingly recognized. Diagnostic classification systems for AKI in cirrhosis have been suggested. The prognostic significance of the respective AKI stages remains to be evaluated in decompensated cirrhosis with ascites.

Methods

Data of consecutive patients with cirrhosis and ascites undergoing paracentesis at a tertiary care center were analyzed. AKI was defined as an increase in serum creatinine of ≥ 0.3 mg/dL or by ≥ 50% within 7 days after paracentesis, and classified according to (i) revised Acute Kidney Injury Network (AKIN) criteria and (ii) modified AKI criteria for cirrhosis (C‐AKI). In contrast to AKIN, C‐AKI stage A discriminates prognosis based on an absolute creatinine cut‐off at < 1.5 mg/dL versus C‐AKI stage B at ≥ 1.5 mg/dL.

Results

The final study cohort included 239 patients. Median transplant‐free survival was 768 days (95% confidence interval [CI]: 331–1205 days) without AKI, 198 (0–446) in AKI‐1, 91 (0–225) in AKI‐2, 19 (0–40) and in AKI‐3, whereas it was 89 (20–158) days in C‐AKI‐A, 384 (0–1063) in C‐AKI‐B, and 22 (7–776) in C‐AKI‐C. Mild AKI was already associated with significantly increased 30‐day mortality (AKI‐1:26.4%, C‐AKI‐A:33.3%) as compared with patients without AKI (14.3%), even when serum creatinine remained within normal range (< 1.2 mg/dL) we observed a significant 30‐day mortality.

Conclusion

AKIN criteria—considering small increases in serum creatinine rather than absolute thresholds—seem to be more accurate for estimating prognosis of AKI after paracentesis than C‐AKI criteria. Even patients developing AKI‐1 with “normal” serum creatinine are at increased risk for mortality.
Relationship and interaction between serum sodium concentration and portal hemodynamics in patients with cirrhosis
Authors: Maruyama Hitoshi , Kondo Takayuki , Kiyono Soichiro , Sekimoto Tadashi , Takahashi Masanori , Okugawa Hidehiro , Yokosuka Osamu
Published: May 2015

Background and Aim

To examine the relationship between hyponatremia and portal hemodynamics and their effect on the prognosis of cirrhosis.

Methods

Portal hemodynamic parameters measured by Doppler ultrasound and serum sodium concentrations were examined in 153 cirrhosis patients (mean age 62.2 ± 12.0 years; median observation period, 34.1 m).

Results

Study participants included 16 patients with hyponatremia (Na < 135 mEq/L), who showed a significantly greater frequency of possessing a splenorenal shunt (SRS; P = 0.0068), and 137 patients without hyponatremia. Serum sodium concentrations were significantly lower in patients with SRS than in those without (P = 0.0193). An increased prothrombin time‐international normalized ratio was a significant predictive factor for developing hyponatremia a year later (8/96; Hazard ratio 14.415; P = 0.028). The cumulative survival rate was significantly lower in patients with hyponatremia (46.7% at 1 and 3 years) than in those without (91.8% at 1 year, 76.8% at 3 years; P < 0.001). The cumulative survival rate was significantly lower in patients who had developed hyponatremia after 1 year (100% at 1 year, 62.5% at 3 years) than those who had not (100% at 1 year, 89.0% at 3 years; P < 0.001). The cumulative survival rate was significantly worse in patients with both hyponatremia and SRS (20% at 1 year).

Conclusions

There was a close linkage between the serum sodium concentration and portal hemodynamic abnormality, presence of SRS, and their interaction may negatively influence the prognoses in cirrhosis.
Changes in cytokine profile may predict therapeutic efficacy of infliximab in patients with ulcerative colitis
Authors: Sato Shoko , Chiba Toshimi , Nakamura Shotaro , Matsumoto Takayuki
Published: May 2015

Background and Aim

Infliximab is an established therapy for ulcerative colitis (UC). The aim of this study was to examine various serum cytokine levels and to identify possible markers predictive of therapeutic efficacy of infliximab for UC patients.

Methods

Twenty‐one patients with moderately active UC were given intravenous infliximab (5 mg/kg) at 0, 2, and 6 weeks as induction therapy. The serum levels of 17 cytokines were determined using a Bio‐Plex suspension array system before and 8 weeks after induction therapy. Partial Mayo score (PMS) and serum C‐reactive protein levels were used for the determination of clinical activities at 0 and 8 weeks after the treatment. The overall therapeutic effect was determined at 26 weeks according to the PMS.

Results

The median value of the PMS decreased significantly 8 weeks after the treatment (from 6 to 1.5, P < 0.05). However, C‐reactive protein levels did not change significantly. Levels of serum interleukin (IL)‐8 (P < 0.05) and macrophage inflammatory protein‐1β (P < 0.005) significantly decreased 8 weeks after the induction. Serum levels of the other 15 cytokines did not change significantly. At 26 weeks, 13 of 20 patients (65%) were responders while 7 patients were non‐responders. Levels of serum IL‐6 at 8 weeks were significantly lower in responders than in non‐responders (P < 0.05).

Conclusions

Serum IL‐8 and macrophage inflammatory protein‐1β seem to be sensitive markers for UC patients treated with infliximab, while IL‐6 at 8 weeks after induction therapy may be predictive of subsequent response to infliximab.
p53 gene therapy‐based transarterial chemoembolization for unresectable hepatocellular carcinoma: A prospective cohort study
Authors: Shen Ai , Liu Shihong , Yu Weiqian , Deng Hejun , Li Qingdong
Published: May 2015

Background and Aim

Transarterial chemoembolization (TACE) is used for treating unresectable hepatocellular carcinoma (HCC), but its efficacy still needs to be improved. Recombinant adenovirus p53 (rAd‐p53) injection is a gene therapeutic agent that could improve the prognosis of HCC patients. This study aimed to evaluate the efficacy and safety of rAd‐p53‐based TACE for treating unresectable HCC.

Methods

Prospective analysis of patients who received rAd‐p53‐based TACE or TACE alone in Chongqing Cancer Institute from January 1, 2011 to December 31, 2012. The primary endpoint is overall survival. The secondary endpoints were progression‐free survival, response rate, and safety.

Results

One hundred two patients were enrolled in this study. Forty‐nine patients received the rAd‐p53‐based TACE, and 53 patients received TACE alone. The rAd‐p53‐based TACE treatment strategy improved the overall survival (hazard ratio: 0.58, 95% confidence interval: 0.35–0.96, P = 0.035), progression‐free survival (hazard ratio: 0.60, 95% confidence interval: 0.37–0.97, P = 0.037), response rate (P = 0.047) compared with TACE monotherapy. The rAd‐p53‐based TACE treatment group caused more occurrences of fever than with TACE alone (P = 0.01). However, symptomatic treatment may solve this problem.

Conclusions

rAd‐p53‐based TACE treatment strategy is effective and safe for treating unresectable HCC. Large‐scale randomized clinical trials are needed to verify these results.
Metallothionein as a clonable tag for protein localization by electron microscopy of cells
Authors: MORPHEW M.K. , O'TOOLE E.T. , PAGE C.L. , PAGRATIS M. , MEEHL J. , GIDDINGS T. , GARDNER J.M. , ACKERSON C. , JASPERSEN S.L. , WINEY M. , HOENGER A. , MCINTOSH J.R.
Published: May 2015

A benign, clonable tag for the localization of proteins by electron microscopy of cells would be valuable, especially if it provided labelling with high signal‐to‐noise ratio and good spatial resolution. Here we explore the use of metallothionein as such a localization marker. We have achieved good success with desmin labelled in vitro and with a component of the yeast spindle pole body labelled in cells. Heavy metals added after fixation and embedding or during the process of freeze‐substitution fixation provide readily visible signals with no concern that the heavy atoms are affecting the behaviour of the protein in its physiological environment. However, our methods did not work with protein components of the nuclear pore complex, suggesting that this approach is not yet universally applicable. We provide a full description of our optimal labelling conditions and other conditions tried, hoping that our work will allow others to label their own proteins of interest and/or improve on the methods we have defined.
Assessing the performance of four different categories of histological criteria in brain tumours grading by means of a computer‐aided diagnosis image analysis system
Authors: KOSTOPOULOS S. , KONSTANDINOU C. , SIDIROPOULOS K. , RAVAZOULA P. , KALATZIS I. , ASVESTAS P. , CAVOURAS D. , GLOTSOS D.
Published: May 2015

Brain tumours are considered one of the most lethal and difficult to treat forms of cancer, with unknown aetiology and lack of any realistic screening. In this study, we examine, whether the combination of descriptive criteria, used by expert histopathologists in assessing histologic tissue samples, and quantitative image analysis features may improve the diagnostic accuracy of brain tumour grading. Data comprised 61 cases of brain cancers (astrocytomas, oligodendrogliomas, meningiomas) collected from the archives of the University Hospital of Patras, Greece. Incorporating physician's descriptive criteria and image analysis's quantitative features into a discriminant function, a computer‐aided diagnosis system was designed for discriminating low‐grade from high‐grade brain tumours. Physician's descriptive features, when solely used in the system, proved of high discrimination accuracy (93.4%). When verbal descriptive features were combined with quantitative image analysis features in the system, discrimination accuracy improved to 98.4%. The generalization of the proposed system to unseen data converged to an overall prediction accuracy of 86.7% ± 5.4%. Considering that histological grading affects treatment selection and diagnostic errors may be notable in clinical practice, the utilization of the proposed system may safeguard against diagnostic misinterpretations in every day clinical practice.