bluuebunny/crossref_metadata_2025 huggingface dataset:
The decision‐making process for breast reconstruction after cancer surgery: Representations of heterosexual couples in long‐standing relationships
Authors: Fasse Léonor , Flahault Cécile , Vioulac Christel , Lamore Kristopher , Van Wersch Anna , Quintard Bruno , Untas Aurélie
Published: January 2017

Objectives

Most people deal with intrusive life events such as cancer and the care trajectory together with their intimate partners. To our knowledge, no research has studied the involvement of the partner in the decision‐making process regarding breast reconstruction (BR) after cancer. This study aimed to gain a better understanding of the couples’ decision‐making process for BR in the cancer context and particularly to investigate the partners’ involvement in this process.

Method

Eighteen participants (nine women who underwent a mastectomy following a first breast cancer and their intimate partners) took part in this study. We conducted semidirective interviews, and a general inductive approach was chosen to capture the representations of the couples.

Results

The women in the sample were aged between 33 and 66 years (M = 54, SD = 7.5) and their partner between 40 and 76 years (M = 59, SD = 11.6). The duration of their intimate relationship was on average 18 years (SD = 10.4; minimum = 4; maximum = 33). The analysis revealed 11 major themes. The two most salient ones were ‘external influence’ and ‘implication of the partner’. The exploration of the subthemes revealed that the decision‐making process is often reported as an interrelated experience by the couples and as a dyadic stressor. The partner's role is depicted as consultative and mostly supportive.

Conclusion

These results provide new insights on the involvement of the partner in decision‐making. Thus, it now seems crucial to develop a prospective study, which will help understand the progression of the decision‐making process over time.

Statement of contribution

What is already known on this subject?

Most people deal with intrusive life events such as cancer and the care trajectory together with their intimate partners. Shared decision‐making between patients and physicians is now the ‘gold standard’ in Western Europe and the United States. However, in the context of breast reconstruction (BR) after cancer, factors guiding the decision‐making process for BR, especially the potential involvement of the partner, are not very well understood.

What does this study add?

Provides a qualitative insight on the specific nature of heterosexual couples’ representations regarding the decision‐making process for breast reconstruction after cancer.

Reveals that the decision‐making process is often reported as an interrelated experience by the couples and as a dyadic stressor.

Underlines the consultative function of partners with women engaged in breast reconstruction.
Parent–child value similarity in families with young children: The predictive power of prosocial educational goals
Authors: Döring Anna K. , Makarova Elena , Herzog Walter , Bardi Anat
Published: January 2017

Value transmission from one generation to the next is a key issue in every society, but it is not clear which parents are the most successful in transmitting their values to their children. We propose parents’ prosocial educational goals as key predictors of parent–child value similarity. Accordingly, we hypothesized that the more parents wanted their children to endorse values of self‐transcendence (helping, supporting, and caring for others) and the less parents wanted their children to endorse the opposing values of self‐enhancement (striving for power and achievement), the higher would be parent–child overall value similarity. Findings from two studies of families – Study 1: 261 Swiss families, children aged 7–9 years; Study 2: 157 German families, children aged 6–11 years – confirmed this hypothesis. The effect was even stronger after controlling for values that prevail in the Swiss and German society, respectively. We integrate evidence from this study of values in families with young children with existing findings from studies with adolescent and adult children, and we discuss potential pathways from parents’ educational goals to parent–child value similarity.
Suppression of carboxylesterases by imatinib mediated by the down‐regulation of pregnane X receptor
Authors: Luo Wenjing , Xin Yu , Zhao Xia , Zhang Feng , Liu Changqing , Fan Hongwei , Xi Tao , Xiong Jing
Published: January 2017

Background and Purpose

Imatinib mesylate (IM) is a first‐line treatment for chronic myeloid leukaemia (CML) as a specific inhibitor of BCR‐ABL tyrosine kinase. As IM is widely used in CML, in combination with other drugs, the effects of IM on drug‐metabolizing enzymes (DMEs) are crucial to the design of rational drug administration. Carboxylesterases (CESs) are enzymes catalysing the hydrolytic biotransformation of several clinically useful drugs. Although IM is known to inhibit cytochromes P450 (CYPs), its effects on DMEs, and CESs in particular, are still largely undefined.

Experimental Approach

Hepatoma cell lines (HepG2 and Huh7) and primary mouse hepatocytes were used. mRNA and protein expression were evaluated by quantitative RT‐PCR and Western blot analysis. Reporter luciferase activity was determined by transient co‐transfection experiment. Pregnane X receptor (PXR) expression was regulated by overexpression and RNA interference. The activity of CESs was determined by enzymic and toxicological assays. Mice were treated with a range of doses of IM to analyse expression of CESs in mouse liver.

Key Results

The expression and activity of CESs were markedly repressed by IM, along with the down‐regulation of PXR and inhibited expression and activity of CYP3A4 and P‐gp.

Conclusions and Implications

Down‐regulation of PXR mediates IM‐induced suppression of CESs. IM may inhibit expression of other genes targeted by PXR, thus inducing a wide range of potential drug–drug interactions during treatment of CML. The data deserve further elucidation including clinical trials.
Protein arginine deiminase 4 inhibition is sufficient for the amelioration of collagen-induced arthritis
Authors: Willis V C , Banda N K , Cordova K N , Chandra P E , Robinson W H , Cooper D C , Lugo D , Mehta G , Taylor S , Tak P P , Prinjha R K , Lewis H D , Holers V M
Published: January 2017

Citrullination of joint proteins by the protein arginine deiminase (PAD) family of enzymes is recognized increasingly as a key process in the pathogenesis of rheumatoid arthritis. This present study was undertaken to explore the efficacy of a novel PAD4-selective inhibitor, GSK199, in the murine collagen-induced arthritis model of rheumatoid arthritis. Mice were dosed daily from the time of collagen immunization with GSK199. Efficacy was assessed against a wide range of end-points, including clinical disease scores, joint histology and immunohistochemistry, serum and joint citrulline levels and quantification of synovial autoantibodies using a proteomic array containing joint peptides. Administration of GSK199 at 30 mg/kg led to significant effects on arthritis, assessed both by global clinical disease activity and by histological analyses of synovial inflammation, pannus formation and damage to cartilage and bone. In addition, significant decreases in complement C3 deposition in both synovium and cartilage were observed robustly with GSK199 at 10 mg/kg. Neither the total levels of citrulline measurable in joint and serum, nor levels of circulating collagen antibodies, were affected significantly by treatment with GSK199 at any dose level. In contrast, a subset of serum antibodies reactive against citrullinated and non-citrullinated joint peptides were reduced with GSK199 treatment. These data extend our previous demonstration of efficacy with the pan-PAD inhibitor Cl-amidine and demonstrate robustly that PAD4 inhibition alone is sufficient to block murine arthritis clinical and histopathological end-points.
Determinants of the increase in ketone concentration during SGLT2 inhibition in NGT, IFG and T2DM patients
Authors: Al Jobori Hussein , Daniele Giuseppe , Adams John , Cersosimo Eugenio , Triplitt Curtis , DeFronzo Ralph A. , Abdul‐Ghani Muhammad
Published: January 2017

Aim

To examine metabolic factors that influence ketone production after sodium‐glucose cotransport inhibitor (SGLT2) administration.

Research design and methods

Fasting plasma glucose (FPG), insulin, glucagon, free fatty acid and ketone concentrations were measured in 15 type 2 diabetes mellitus (T2DM) and 16 non‐diabetic subjects before and at day 1 and day 14 after treatment with empagliflozin.

Results

Empagliflozin caused a 38 mg/dL reduction in FPG concentration in T2DM patients. However, it caused only a small but significant (7 mg/dL) reduction in the FPG concentration in impaired fasting glucose (IFG) subjects and did not affect FPG concentration in normal glucose tolerant (NGT) subjects. Empagliflozin caused a significant increase in mean plasma glucagon, free fatty acid (FFA) and ketone concentrations in T2DM subjects. However, empagliflozin did not cause a significant change in mean plasma insulin, glucagon or ketone concentrations in non‐diabetic subjects. An index that integrates change in plasma glucose, insulin and FFA concentration at day 1 strongly correlates with plasma ketone concentration at day 1 (r = 0.85,
P
< .001) and day 14 (r = 0.63, r = 0.01) and predicts, with 86% sensitivity and 83% specificity, subjects at the top tertile for plasma ketone concentration after empagliflozin treatment.

Conclusion

Results of the present study demonstrate that SGLT2 inhibition exerts different metabolic effects in non‐diabetic individuals as compared to diabetic patients.
Hybridisation and lack of prezygotic barriers betweenPhymata pennsylvanicaandamericana
Authors: PUNZALAN DAVID , ROWE LOCKE
Published: January 2017

1. The persistence of both geographical and reproductive boundaries between related species poses a fundamental puzzle in biology. Reproductive interactions between species can have a substantial impact on the maintenance of a boundary, potentially contributing to its collapse (e.g. via hybridisation) or facilitating reproductive isolation (e.g. via reinforcement).

2. The degree to which two parapatric insect species in the genusPhymataare reproductively isolated was evaluated and several mechanisms that could contribute to the maintenance of species boundaries were assessed.

3. Behavioural assays showed no indication of species‐assortative mating, nor any fecundity costs associated with heterospecific mating. Thus, there was no evidence of prezygotic mechanisms of reproductive isolation between the two species.

4.In laboratory crosses, it was found that the two species were indeed capable of producing viableF1hybrids. Morphologically, these hybrids were phenotypically intermediate to the two parental species, and similar to the phenotypes seen in natural populations thought to occur in a hybrid zone.F1hybrids did not show reduced viability, although there was some suggestion of ‘hybrid breakdown’, evident from the lower viability observed for progeny of ‘natural hybrids’.

5. Collectively, we show that despite genetically based morphological differences between species,P. americanaandpennsylvanicacan, and probably do hybridise. More studies are needed to understand the mechanisms that maintain the distinct phenotypes and geographical ranges of these species, despite the considerable potential for introgression.
Private Law, Regulation, and Justice
Authors: Hesselink Martijn W.
Published: January 2017

This paper critically engages with the European Regulatory Private Law thesis (ERPL). The main strength of ERPL is that it offers an entirely new perspective on European private law. However, as a complete theory of European private law, ERPL is too one‐sided, both from a descriptive and from a normative point of view. With its strong focus on the private law locked up in regulatory silos for specific market sectors, it obscures the reality of the consumer acquis and its transformative force. A fuller picture would include the contours of a loosely coherent system of European private law that is currently emerging. The main pillars of that pragmatic system are (for now) the withdrawal rights, unfair term control, and remedies for nonconformity. Moreover, the contribution of European private law to access justice cannot be the only standard for its evaluation and critique; at least as important are interpersonal justice and democratic legitimacy.
The EU's Private Law in the Regulated Sectors: Competitive Market Handmaiden or Institutional Platform?
Authors: Svetiev Yane
Published: January 2017

The article contests the claim that EU private law is narrowly circumscribed by a market rationality. Such a claim tracks broader criticism of EU functional legal integration, although it tends to obscure the underlying transformative pressures on private law and regulation and the role EU law plays in coping with such pressures. To offer a number of counter‐narratives, the article draws on examples from the regulated sectors, including telecommunications and energy, to reveal their experimentalist features. These suggest that EU private law is constructed through a process of error‐corrections, which allows for mutual adjustment of instruments and hybridisation of EU and local policy goals. The process results in more finely grained assemblages of autonomy and regulation to respond to concrete problems or newly salient policy goals, so that markets are understood as social institutions that are always works‐in‐progress rather than convergence points. Thus, EU private law provides a platform for transnational market‐building through innovating institutions that promote various normative and policy commitments despite the interdependencies that could undermine them.
An ultrasound‐guided, tendon‐sparing, lateral approach to injection of the navicular bursa
Authors: Nottrott K. , De Guio C. , Khairoun A. , Schramme M.
Published: January 2017

Background

Navicular disease in the horse often requires injection of the navicular bursa. We have developed an ultrasound‐guided, lateral needle approach to navicular bursocentesis, which avoids penetration of the deep digital flexor tendon (DDFT) and the need for radiographic control.

Objectives

To describe and evaluate the feasibility and efficacy of an ultrasound‐guided, lateral bursocentesis technique.

Study design

Cadaveric and in vivo experiments.

Methods

The navicular bursa in 62 cadaveric forelimbs of 31 horses and in both forelimbs of 26 live horses, positioned with the foot flexed in a navicular block, were submitted to lateral, ultrasound‐guided injection of 1.5 ml radiocontrast agent. Lateromedial radiographs were taken to locate the contrast. A second injection of 0.5 ml methylene blue was administered during needle withdrawal in cadaveric limbs to investigate the needle pathway during dissection.

Results

Contrast agent was successfully deposited in the navicular bursa in 104 of 114 (91%) limbs and in the navicular bursa alone in 89 of 114 (78%) limbs. Dissection showed no evidence of penetration of the DDFT in cadaver limbs. Failure to inject the navicular bursa was significantly associated with poor quality of the ultrasound image (P = 0.04) and resulted in aberrant injection of the distal interphalangeal joint in five of 114 (4%) limbs, the peribursal soft tissues in four of 114 (4%) limbs and the digital flexor tendon sheath in one of 114 (0.9%) limbs. Synovial fluid was observed at the needle hub in 58% of live horses.

Main limitations

It is unknown whether injection results obtained in the limbs of horses without disease can be extrapolated to horses with clinical disease of the podotrochlear apparatus. The localisation of contrast medium on radiographs may not accurately reflect the behaviour of local anaesthetic solution or therapeutic medications injected in the navicular bursa.

Conclusions

This lateral, ultrasound‐guided technique for injecting the navicular bursa is effective, does not penetrate the DDFT and avoids exposure of personnel to radiation.
Long‐term follow‐up of Norwegian horses affected with acquired equine polyneuropathy
Authors: Hanche‐Olsen S. , Kielland C. , Ihler C. F. , Hultin Jäderlund K.
Published: January 2017

Background

Acquired equine polyneuropathy (AEP), a neurological disease clinically characterised by knuckling of metatarsophalangeal joints, has been described in numerous Nordic horses during the last 20 years. Although clinical recovery has been reported, large‐scale data on long‐term follow‐up of survivors have been lacking.

Objectives

To describe long‐term survival of AEP affected horses registered in Norway, with a focus on athletic performance and possible residual clinical signs connected to the disease.

Study design

A retrospective cohort study.

Methods

The study includes 143 horses recorded with AEP in Norway from 2000 to 2012, with the follow‐up period continuing until 2015. Participating owners of survivors completed a standardised questionnaire, providing information on disease and convalescence, management, performance‐level and possible residual clinical signs. To investigate the follow‐up of survivors, we performed 2 multivariable linear regression models.

Results

The follow‐up time of survivors was 1.0–14.5 years (median 5.3, interquartile range 2.5–7.2). Fifty‐seven horses survived and all but 3 horses returned to previous or higher level of performance. However, possible disease‐related residual clinical signs were reported in 14/57 horses. Forty‐nine of the survivors were in athletic use at time of contact. The majority of survivors were categorised with low severity‐grades at time of diagnosis and the initial grade was significantly associated with time to resumed training. Only 3 horses had experienced relapse/new attack during the follow‐up period.

Main limitation

Athletic performance was judged by owners, which renders a possible source of bias.

Conclusions

Although AEP is a potential fatal disease, most survivors will recover and return to minimum previous level of athletic performance. Some horses display residual clinical signs, but often without negative effect on performance and relapse of disease is rare.
Sulphur cycling in a Neoarchaean microbial mat
Authors: Meyer N. R. , Zerkle A. L. , Fike D. A.
Published: January 2017

Multiple sulphur (S) isotope ratios are powerful proxies to understand the complexity of S biogeochemical cycling through Deep Time. The disappearance of a sulphur mass‐independent fractionation (S‐MIF) signal in rocks <~2.4 Ga has been used to date a dramatic rise in atmospheric oxygen levels. However, intricacies of the S‐cycle before the Great Oxidation Event remain poorly understood. For example, the isotope composition of coeval atmospherically derived sulphur species is still debated. Furthermore, variation in Archaean pyrite δ34S values has been widely attributed to microbial sulphate reduction (MSR). While petrographic evidence for Archaean early‐diagenetic pyrite formation is common, textural evidence for the presence and distribution of MSR remains enigmatic. We combined detailed petrographic and in situ, high‐resolution multiple S‐isotope studies (δ34S and Δ33S) using secondary ion mass spectrometry (SIMS) to document the S‐isotope signatures of exceptionally well‐preserved, pyritised microbialites in shales from the ~2.65‐Ga Lokammona Formation, Ghaap Group, South Africa. The presence of MSR in this Neoarchaean microbial mat is supported by typical biogenic textures including wavy crinkled laminae, and early‐diagenetic pyrite containing <26‰ μm‐scale variations in δ34S and Δ33S = −0.21 ± 0.65‰ (±1σ). These large variations in δ34S values suggest Rayleigh distillation of a limited sulphate pool during high rates of MSR. Furthermore, we identified a second, morphologically distinct pyrite phase that precipitated after lithification, with δ34S = 8.36 ± 1.16‰ and Δ33S = 5.54 ± 1.53‰ (±1σ). We propose that the S‐MIF signature of this secondary pyrite does not reflect contemporaneous atmospheric processes at the time of deposition; instead, it formed by the influx of later‐stage sulphur‐bearing fluids containing an inherited atmospheric S‐MIF signal and/or from magnetic isotope effects during thermochemical sulphate reduction. These insights highlight the complementary nature of petrography and SIMS studies to resolve multigenerational pyrite formation pathways in the geological record.
The latitudinal diversity gradient and interspecific competition: no global relationship between lizard dietary niche breadth and species richness
Authors: Gainsbury Alison , Meiri Shai
Published: January 2017

Aim

Dietary niche breadth has long been hypothesized to decrease towards lower latitudes as the numbers of competitors increase. Geographical variation in niche breadth is also hypothesized to be linked to high ambient energy levels, water availability, productivity and climate stability – reflecting an increased number of available prey taxa. Range size and body size are also hypothesized to be strongly and positively associated with niche breadth. We sought to determine which of these factors is associated with geographical variation in niche breadth across broad spatial scales and thus potentially drive the latitudinal diversity gradient.

Location

Global.

Methods

We collated volumetric dietary data for 308 lizard species. For each species, we gathered data on number of sympatric lizard species (a proxy for the number of competitors), annual temperature and precipitation, net primary productivity, seasonality, range size and body size. We examined the relationship between dietary niche breadth and focal parameters using both ordinary and phylogenetic generalized least squares regressions.

Results

Niche breadth was positively related to annual precipitation, temperature seasonality and range size, and negatively related to body size. Lizard species richness increased towards lower latitudes. Dietary niche breadth, however, was unrelated to parameters reflecting diversity gradients, such as primary productivity, annual temperature, precipitation seasonality and, crucially, the number of potential competitors.

Main conclusions

Contrary to prevailing ecological theory, competition is unrelated to dietary niche breadth. We found no support for interspecific competition driving the latitudinal diversity gradient. Rather, we found variation in niche breadth to be associated with water availability, climate stability, range size and body size. Our study casts doubt on the common assumption that tropical species are specialists, promoting greater alpha diversity, and on the assumption that the number of sympatric species is reflected in the intensity of interspecific competition.
Creative approach for successful aging: A pilot study of an intergenerational health promotion program
Authors: Lin Yen‐Chun , Dai Yu‐Tzu , Huang Lian‐Hua , Wang Suh‐Chin , Huang Guey‐Shiun
Published: January 2017

Aim

To develop and evaluate the effectiveness of an intergenerational health promotion program.

Methods

This was an action research project. A total of 34 participants attended the 12‐week program and completed the pre‐test and post‐test. There were 16 middle‐aged and nine older adults recruited from a district of Taipei, and nine young adults recruited from the principal investigator's university. The “Attitudes toward Aging Scale” and the “Spiritual Health Scale” were two assessment instruments used in the study.

Results

The results showed that there were significant improvements in the Attitudes toward Aging Scale for the young adult group (aged 18–29 years) and in the Spiritual Health Scale for the older adult group (aged 65–80 years). The evaluation showed that participants were satisfied with the program.

Conclusions

The results of the present study provide future directions for successful aging and intergenerational learning. Geriatr Gerontol Int 2017; 17: 1799–1807.
Cross‐cultural adaptation and psychometric study of the Turkish version of the Rapid Assessment of Physical Activity
Authors: Çekok Fatma Kübra , Kahraman Turhan , Kalkışım Muhammet , Genç Arzu , Keskinoğlu Pembe
Published: January 2017

Aim

The Rapid Assessment of Physical Activity (RAPA) is a valid tool for use in clinical practice to provide an easily administered and interpreted means of assessing levels of physical activity among adults older than 50 years. However, there are some concerns about its reliability. The aim was to linguistically and culturally adapt the RAPA into Turkish, and assess its validity and reliability.

Methods

This methodological and cross‐sectional study included 110 participants (68 women) from the community and a nursing home. The RAPA was translated and culturally adapted into Turkish using established double‐back translation methods. The participants completed the RAPA twice with a 1‐week interval to examine test–retest reliability. The International Physical Activity Questionnaire‐Short Form and Physical Activity Scale for the Elderly were used to examine the validity.

Results

The mean age of the participants was 70.5 years (SD 10.5 years). The weighted kappa coefficients exceed 0.81 for each of the nine items, the aerobic score and strength and flexibility score, showing that the test–retest reliability was very good. There were positive moderate correlations between the RAPA, International Physical Activity Questionnaire‐Short Form and Physical Activity Scale for the Elderly (P < 0.01). Additionally, the RAPA was negatively correlated with the International Physical Activity Questionnaire‐Short Form sitting time as prehypothesized (P < 0.01). The convergent and discriminate validity of the RAPA were acceptable.

Conclusions

The present study has shown that the Turkish version of the RAPA was an easy‐to‐use, valid and reliable measure of physical activity among adults aged older than 50 years. This study has also provided considerable evidence about the test–retest reliability of the RAPA, which was not investigated in the original validation study. Geriatr Gerontol Int 2017; 17: 1837–1842.
A Prospective Cohort Study of Outpatient Interdisciplinary Rehabilitation of Chronic Headache Patients
Authors: Krause Steven J. , Stillman Mark J. , Tepper Deborah E. , Zajac Deborah
Published: January 2017

Objective

To evaluate the efficacy of an intensive outpatient program designed to improve functioning and reduce psychological impairment in chronic headache patients.

Background

Chronic headaches, occurring 15 or more days per month, for three or more months, may arise from multiple International Classification of Headache Disorders diagnoses: Chronic Migraine, Chronic Tension Type Headache, New Daily Persistent Headache, Chronic Post Traumatic Headaches, and Medication Overuse Headache. Several interdisciplinary programs that treat patients with chronic headaches have reported decreases in headache frequency. This study sought to evaluate the effect of a 3 week interdisciplinary treatment program for patients with chronic headache disorders on headache severity, functional status, and psychological impairment.

Methods

Subjects were 379 patients admitted to an outpatient chronic headache treatment program. Assessments of headache severity, psychological status, and functional impairment were completed by 371 (97.8%) of these at the time of admission. At discharge, 340 subjects (89.7%) provided assessment data, and 152 (40.1%) provided data at 1‐year follow‐up.

Results

Subjects' mean ratings on a 0‐10 scale for their headache pain in the prior week declined, and these improvements were maintained at follow‐up. (Estimated marginal means on a 0‐10 scale for Average pain: admission 6.1, discharge 3.5, follow‐up 3.3; for Least pain: admission 3.2; discharge 1.5; follow‐up 1.3; for Worst pain: admission 8.2; discharge 6.4; follow‐up 5.7), and similar results were found for current pain (admission 4.7; discharge 2.8; follow‐up 2.4): Measures of functional impairment also improved following treatment, and these gains were maintained at 12 month follow up (Estimated marginal mean Headache Impact Test‐6 score: admission 66.1, discharge 55.4, follow‐up 51.9; Estimated marginal mean Pain Disability Index score: admission 36.2, discharge 14.1, follow‐up 11.6). As measured by the Depression, Anxiety and Stress Scale, anxiety and reactivity to stress decreased following treatment, and remained improved at follow‐up (Estimated marginal mean score for Anxiety: admission 8.7, discharge 5.2, follow‐up 4.4; Estimated marginal mean score for stress: admission 14.9, discharge 7.2, follow‐up 7.6). Depression decreased with treatment, but while 1‐year follow‐up depression scores remained significantly lower than at admission, they were also significantly higher than at discharge (Estimated marginal means: admission 13.3, discharge 4.1, follow‐up 6.6).

Conclusions

The study supports the efficacy of the treatment model. Limitations of the study and suggestions for future research are also discussed.
New bismuth‐containing quadruple therapy in patients infected with Helicobacter pylori: A first Italian experience in clinical practice
Authors: Tursi Antonio , Di Mario Francesco , Franceschi Marilisa , De Bastiani Rudi , Elisei Walter , Baldassarre Gianluca , Ferronato Antonio , Grillo Simone , Landi Stefano , Zamparella Maria , De Polo Manuela , Boscariolo Laura , Picchio Marcello
Published: January 2017

Background

Rising antibiotic resistance requires the evaluation of new and effective therapies.

Aims

To test the efficacy and safety of the new bismuth‐containing quadruple therapy in patients infected with Helicobacter pylori.

Material and Methods

Consecutive H. pylori‐positive dyspeptic patients were enrolled, either naïve or with previous failure treatment. Patients were treated with Pylera® (three‐in‐one capsules containing bismuth subcitrate potassium 140 mg, metronidazole 125 mg, and tetracycline 125 mg) three capsules q.i.d. plus omeprazole 20 mg or esomeprazole 40 mg b.i.d. for 10 days. Eradication was confirmed using an urea breath test (at least 30 days after the end of treatment). Efficacy was assessed by UBT and safety by means of treatment‐emergent adverse events.

Results

One hundred and thirty‐one patients were included in the study: 42% of patients were naïve, and 58%, with previous failure treatment. H. pylori eradication was achieved in 124 patients (94.7%, 95% confidence intervals (CIs) 89.3‐97.8) in ITT population. In the PP population, the percentage was 97.6% (95%, CIs 93.3‐99.2). No difference in eradication rate was found either between naïve and previously treated patients (92.7% vs 96.0%, P=.383), or smoking and nonsmoking ones, or in patients taking omeprazole or esomeprazole.

Treatment‐emergent adverse events occurred in 35 patients (26.7%, 95% CIs 19.9‐34.9). They were mild in all cases except in four, who discontinued the study due to diarrhea (three patients) and diffuse urticarial rush (one patient).

Conclusions

Pylera® achieved a remarkable eradication rate in clinical practice, irrespective if it was used as first treatment or as a rescue therapy. Treatment‐emergent adverse events were uncommon generally mild.
ITPA gene variation and ribavirin‐induced anemia in patients with genotype 2 chronic hepatitis C treated with sofosbuvir plus ribavirin
Authors: Murakawa Miyako , Asahina Yasuhiro , Nagata Hiroko , Nakagawa Mina , Kakinuma Sei , Nitta Sayuri , Kawai‐Kitahata Fukiko , Otani Satoshi , Kaneko Shun , Miyoshi Masato , Tsunoda Tomoyuki , Asano Yu , Sato Ayako , Itsui Yasuhiro , Azuma Seishin , Nouchi Toshihiko , Furumoto Yohei , Asano Tooru , Chuganji Yoshimichi , Tohda Shuji , Watanabe Mamoru
Published: January 2017

Aim

Sofosbuvir (SOF) and ribavirin (RBV) combination therapy produces a sustained response in many patients with genotype 2 chronic hepatitis C. However, RBV‐induced anemia is a troublesome side‐effect that may limit this treatment. Genetic variation leading to inosine triphosphatase (ITPA) deficiency is known to protect against RBV‐induced hemolytic anemia. This study aimed to evaluate the relationships between the efficacy and safety of SOF/RBV treatment and ITPA gene variants.

Methods

Ninety patients with genotype 2 chronic hepatitis C treated with SOF/RBV were studied. The relationships among genetic polymorphisms of ITPA and the decline in hemoglobin levels from baseline, RBV dose reduction, and sustained virological response (SVR) rates were analyzed.

Results

Overall SVR at 12 weeks was 94.4% (85/90). Patients with the ITPA CA/AA genotypes had a lower degree of anemia throughout the therapy than those with the ITPA CC genotype. The percentage of patients requiring RBV dose reduction was significantly lower for those with the ITPA CA/AA variation, a difference even more apparent when the pretreatment hemoglobin level was <12 g/dL. The dose reduction of RBV and serum albumin level were significantly associated with SVR.

Conclusions

Patients with the ITPA CA/AA genotype were less likely to develop anemia than those with the ITPA CC genotype and were more likely to complete SOF/RBV therapy. These results may provide a valuable pharmacogenetic diagnostic tool to predict drug‐induced adverse events, particularly in patients with pre‐existing anemia.
The comparative effectiveness and safety of three activated irrigation techniques in the isthmus area using a transparent tooth model
Authors: Malentacca A. , Uccioli U. , Mannocci F. , Bhuva B. , Zangari D. , Pulella C. , Lajolo C.
Published: January 2017

Aim

To compare the effectiveness and safety of three activated irrigation techniques when removing pulp tissue from the isthmus of a transparent tooth model. The three techniques assessed were: the EndoVac (EV), passive ultrasonic irrigation (PUI) and ultrasonic wave aspiration (TUWA). Conventional syringe irrigation (CSI) was used as a control.

Methodology

A transparent tooth model was created using the mesial root of an extracted mandibular first molar that had an isthmus and two independent mesial canals. An artificial 0.3‐mL cylindrical chamber was created below the apical foramen. The tooth was then cleared. After preparation, the root canals were filled with fuchsine‐stained bovine pulp tissue. The irrigation protocols were compared in respect of their effectiveness at removing pulp tissue from the isthmus and their safety with regard to irrigant extrusion. For all four groups, 5.25% sodium hypochlorite solution was used as the irrigant. Photographs were taken and analysed using an imaging software. A Kruskal–Wallis test was used to detect the differences between groups (statistical significance was set at P < 0.05).

Results

No group was associated with extrusion of irrigant beyond the apex. Significant differences were observed between the groups: TUWA was the most effective technique at removing pulp tissue from the isthmus (3.39 mm2; standard deviation (SD) = 0.67; range = 1.25–3.69), followed by PUI (2.16 mm2; SD = 0.38; range = 1.37–2.96), EV (0.73 mm2; SD = 0.14; range = 0.49–0.98) and CSI (0.27 mm2; SD = 0.01; range = 0.26–0.28).

Conclusion

Ultrasonic wave aspiration was the most effective technique at removing artificial pulp tissue from the isthmus of a transparent tooth model. None of the techniques extruded irrigant.
The Impact of Transforming Growth Factor‐β1 Level on Outcome After Catheter Ablation in Patients With Atrial Fibrillation
Authors: KISHIMA HIDEYUKI , MINE TAKANAO , TAKAHASHI SATOSHI , ASHIDA KENKI , ISHIHARA MASAHARU , MASUYAMA TOHRU
Published: January 2017

Transforming Growth Factor‐β1 and Atrial Fibrillation

Introduction

Transforming growth factor‐β1 (TGF‐β1) is an important factor that induces atrial fibrosis and atrial fibrillation (AF). The purpose of this study was to evaluate the association between TGF‐β1 level and clinical factors before catheter ablation (CA), and to investigate the impact of TGF‐β1 level on the outcome after CA for AF.

Methods and Results

This prospective study included 151 patients (persistent AF group: n = 59, paroxysmal AF [PAF] group: n = 54, and control group: n = 38). All patients who underwent CA for AF were followed up for 12 months. The PAF group had the highest TGF‐β1 levels in all patients. An early recurrence of AF (ERAF: defined as episodes of atrial tachyarrhythmia within a 3‐month blanking period) was detected in 60 patients (53%). Recurrent AF after the blanking period was detected in 36 patients (32%). On multivariate analysis, low TGF‐β1 level was the only independent factor associated with recurrent AF. Moreover, the AF recurrence ratio was higher in the low TGF‐β1 group (< 12.56 ng/mL) than in the high TGF‐β1 group (16 of 29 patients, 55% vs. 20 of 84 patients, 24%, P = 0.002 by log‐rank test).

Conclusions

PAF was associated with a higher TGF‐β1 level. Moreover, lower TGF‐β1 level in AF patients could be a cause of recurrent AF after CA.
Sodium and potassium urinary excretion levels of preschool children: Individual, daily, and seasonal differences
Authors: Yasutake Kenichiro , Nagafuchi Mikako , Izu Ryoji , Kajiyama Tomomi , Imai Katsumi , Murata Yusuke , Ohe Kenji , Enjoji Munechika , Tsuchihashi Takuya
Published: January 2017

In this study, the authors measured sodium and potassium concentrations in spot urine samples of preschool children on multiple days, and evaluated individual, daily, and seasonal effects. A total of 104 healthy preschool children aged 4 to 5 years were studied. Urine samples were collected from the first urine of the day after waking for three consecutive days (Monday–Wednesday) four times a year (spring, summer, autumn, winter). The authors estimated the daily urine volume as 500 mL and daily creatinine excretion as 300 mg, and used these to calculate daily sodium and potassium excretion levels. Daily sodium and potassium excretion levels and sodium to potassium ratios were highly variable. The coefficient variant in the children's excretion levels were also high within and between individuals. Sodium excretion levels and sodium to potassium ratios were higher on Monday (weekend sodium intakes) than Tuesday. Season had no effect on sodium or potassium excretion levels, but the sodium to potassium ratio was higher in summer than in winter. In conclusion, levels of urinary sodium excretion are comparatively high and those of potassium are low in preschool students, with high variability within and between individuals.
The number of microvascular complications is associated with an increased risk for severity of periodontitis in type 2 diabetes patients: Results of a multicenter hospital‐based cross‐sectional study
Authors: Nitta Hiroshi , Katagiri Sayaka , Nagasawa Toshiyuki , Izumi Yuichi , Ishikawa Isao , Izumiyama Hajime , Uchimura Isao , Kanazawa Masao , Chiba Hiroshige , Matsuo Akira , Utsunomiya Kazunori , Tanabe Haruyasu , Takei Izumi , Asanami Soichiro , Kajio Hiroshi , Ono Toaki , Hayashi Yoichi , Ueki Kiichi , Tsuji Masatomi , Kurachi Yoichi , Yamanouchi Toshikazu , Ichinokawa Yoshimi , Inokuchi Toshiki , Fukui Akiko , Miyazaki Shigeru , Miyauchi Takashi , Kawahara Reiko , Ogiuchi Hideki , Yoshioka Narihito , Negishi Jun , Mori Masatomo , Mogi Kenji , Saito Yasushi , Tanzawa Hideki , Nishikawa Tetsuo , Takada Norihiko , Nanjo Kishio , Morita Nobuo , Nakamura Naoto , Kanamura Narisato , Makino Hirofumi , Nishimura Fusanori , Kobayashi Kunihisa , Higuchi Yoshinori , Sakata Toshiie , Yanagisawa Shigetaka , Tei Chuwa , Ando Yuichi , Hanada Nobuhiro , Inoue Shuji
Published: January 2017

Aims/Introduction

To explore the relationships between periodontitis and microvascular complications as well as glycemic control in type 2 diabetes patients.

Materials and Methods

This multicenter, hospital‐based, cross‐sectional study included 620 patients with type 2 diabetes. We compared the prevalence and severity of periodontitis between patients with ≥1 microvascular complication and those without microvascular complications. We also compared the prevalence and severity of periodontitis among patients with different degrees of glycemic control.

Results

After adjusting for confounding factors, multiple logistic regression analysis showed that the severity of periodontitis was significantly associated with the number of microvascular complications (odds ratio 1.3, 95% confidence interval 1.1–1.6), glycated hemoglobin ≥8.0% (64 mmol/mol; odds ratio 1.6; 95% confidence interval 1.1–2.3), and older age (≥50 years; odds ratio 1.7; 95% confidence interval 1.1–2.6). However, the prevalence of periodontitis was not significantly associated with the number of microvascular complications, but was associated with male sex, high glycated hemoglobin (≥8.0% [64 mmol/mol]), older age (≥40 years), longer duration of diabetes (≥15 years) and fewer teeth (≤25). Furthermore, propensity score matching for age, sex, diabetes duration and glycated hemoglobin showed that the incidence of severe periodontitis was significantly higher among patients with microvascular complications than among those without microvascular complications (P < 0.05).

Conclusions

The number of microvascular complications is a risk factor for more severe periodontitis in patients with type 2 diabetes, whereas poor glycemic control is a risk factor for increased prevalence and severity of periodontitis.
Predictors of tanning dependence in white non‐Hispanic females and males
Authors: Cartmel B. , Bale A.E. , Mayne S.T. , Gelernter J.E. , DeWan A.T. , Spain P. , Leffell D.J. , Pagoto S. , Ferrucci L.M.
Published: January 2017

Background

Growing evidence suggests that some individuals may exhibit symptoms of dependence on ultraviolet (UV) light, a known carcinogen, in the context of tanning; however, few studies have investigated predictors of tanning dependence (TD).

Objective

To identify predictors of TD.

Methods

Non‐Hispanics of European ancestry who had previously participated in a case–control study of early‐onset basal cell carcinoma completed an online survey to ascertain TD and other behaviours (alcohol dependence, nicotine dependence, seasonal affective disorder (SAD), exercise ‘addiction’ and depression). Information on host factors, such as skin and eye colour and history of sunbathing and indoor tanning, was obtained from a study in which the participants were previously enrolled. Lifetime TD was assessed using the modified Cut down, Annoyed, Guilty, Eye‐opener (mCAGE) and the modified Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (mDSM‐IV‐TR) questionnaires. Participants were classified as ‘TD’ if positive on both questionnaires and not TD if negative on both questionnaires.

Results

In total, 499 individuals completed the online survey (81.9% participation rate), and 24.4% were classified as ‘TD’. In the multivariate model, women were more likely to be TD [odds ratio (OR) 6.93; 95% confidence intervals (95% CI) (3.36–14.27)] than men. Alcohol dependence (OR 6.55: 95% CI 3.19–13.42), SAD (OR 2.77; 95% CI 1.26–6.09) and exercise ‘addiction’ (OR 5.47; 95% CI 1.15–26.06) were all significant predictors for TD.

Conclusion

Increased knowledge of those at risk for TD will allow appropriate interventions to be designed.
Does this patient need telemetry? An analysis of telemetry ordering practices at an academic medical center
Authors: Chen Stephanie , Palchaudhuri Sonali , Johnson Amber , Trost Jeff , Ponor Ileana , Zakaria Sammy
Published: January 2017

Introduction

The American Heart Association and Choosing Wisely campaign recommend guideline‐based usage of telemetry. Inappropriate use leads to increased costs, alarm fatigue, and inefficient nursing care. This study assesses provider ordering practices for telemetry at a US‐based academic hospital.

Methods

This retrospective study includes all telemetry orders in the medicine and progressive care units from April 2014 to March 2015. Indications were grouped into categories per American Heart Association guidelines.

Results

The top 3 cardiac indications included angina/acute coronary syndrome (35.3%), arrhythmias (19.7%), and heart failure (10.2%). However, noncardiac indications accounted for 20.2% of orders, including respiratory conditions (17.4%), infection (17.4%), substance abuse (14.0%), bleeding (12.4%), vital sign monitoring (10.4%), altered mental status (7.0%), and pulmonary embolus/deep vein thrombosis (7.0%).

Conclusions

One‐fifth of patients were monitored on telemetry for noncardiac indications. We recommend further study on the benefits and risks of telemetry in these patients and systems‐based changes for appropriate usage.
Are antipredator behaviours of hatchery Salmo salar juveniles similar to wild juveniles?
Authors: Salvanes A. G. V.
Published: January 2017

This study explores how antipredator behaviour of juvenile Atlantic salmon Salmo salar developed during conventional hatchery rearing of eggs from wild brood stock, compared with the behaviour of wild‐caught juveniles from the same population. Juveniles aged 1+ years were tested in two unfamiliar environments; in one S. salar were presented with simulated predator attacks and in the other they were given the opportunity to explore an open‐field arena. No difference was found in their spontaneous escape responses or ventilation rate (reflex responses) after simulated predator attacks. Hatchery‐reared juveniles were more risk‐prone in their behaviours than wild‐caught individuals. Hatchery juveniles stayed less time in association with shelter. In the open‐field arena, hatchery juveniles were more active than wild juveniles. Hatchery juveniles were also immobile for less time and spent a shorter amount of time than wild juveniles in the fringe of the open‐field arena. Salmo salar size had no effect on the observed behaviour. Overall, this study provides empirical evidence that one generation of hatchery rearing does not change reflex responses associated with threats, whereas antipredator behaviour, typically associated with prior experience, was less developed in hatchery‐reared than in wild individuals.
Risk factors and nomogram for pancreatic pseudocysts in chronic pancreatitis: A cohort of 1998 patients
Authors: Hao Lu , Pan Jun , Wang Dan , Bi Ya‐Wei , Ji Jun‐Tao , Xin Lei , Liao Zhuan , Du Ting‐Ting , Lin Jin‐Huan , Zhang Di , Zeng Xiang‐Peng , Ye Bo , Zou Wen‐Bin , Chen Hui , Xie Ting , Li Bai‐Rong , Zheng Zhao‐Hong , Hu Liang‐Hao , Li Zhao‐Shen
Published: January 2017

Background and Aim

Pancreatic pseudocyst is a common complication of chronic pancreatitis. The identification of risk factors and development of a nomogram for pancreatic pseudocysts in chronic pancreatitis patients may contribute to the early diagnosis and intervention of pancreatic pseudocysts.

Methods

Patients with chronic pancreatitis admitted to our center from January 2000 to December 2013 were enrolled. Cumulative rates of pancreatic pseudocysts after the onset of chronic pancreatitis and after the diagnosis of chronic pancreatitis were calculated. Patients were randomly assigned, in a 2:1 ratio, to the training and validation cohort. Based on the training cohort, risk factors were identified through Cox proportional hazards regression model, and nomogram was developed. Internal and external validations were performed based on the training and validation cohort, respectively.

Results

With a total of 1998 patients, pancreatic pseudocysts were detected in 228 (11.41%) patients. Age at the onset of chronic pancreatitis, smoking, and severe acute pancreatitis were identified risk factors for pancreatic pseudocysts development while steatorrhea and pancreatic stones were protective factors. Incorporating these five factors, the nomogram achieved good concordance indexes of 0.735 and 0.628 in the training and validation cohorts, respectively, with well‐fitted calibration curves.

Conclusion

The nomogram achieved an individualized prediction of pancreatic pseudocysts development in chronic pancreatitis. It may help the early diagnosis and management of pancreatic pseudocysts.