bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing disease progression of prostate cancer under active surveillance: a McGill University Health Center cohort
Authors: Barayan Ghassan A. , Brimo Fadi , Bégin Louis R. , Hanley James A. , Liu Zhihui , Kassouf Wassim , Aprikian Armen G. , Tanguay Simon
Published: March 2014

Objective

To evaluate the clinical and pathological factors influencing the risk of disease progression in a cohort of patients with low–intermediate risk prostate cancer under active surveillance (AS).

Patients and Methods

We studied 300 patients diagnosed between 1992 and 2012 with prostate adenocarcinoma with favourable parameters or who refused treatment and were managed with AS. Of those, 155 patients with at least one repeat biopsy and no progression criteria at the time of the diagnosis were included for statistical analyses. Patients were followed every 3–6 months for prostate‐specific antigen (PSA) measurement and physical examination. Patients were offered repeat prostatic biopsy every year. Disease progression was defined as the presence of one or more of the following criteria: ≥3 positive cores, >50% of cancer in at least one core, and a predominant Gleason pattern of 4.

Results

For the 155 patients, the mean (sd) age at diagnosis was 67 (7) years; the median (interquartile range) follow‐up was 5.4 (3.6–9.5) years. Of these, 67, 25, six, and two patients had two, three, four, and five repeat biopsies, respectively. At baseline, 11 (7%) patients had a Gleason score of 3+4, while the remaining 144 (93%) patients had a Gleason score of ≤6. In all, 50 (32.3%) patients had disease progression on repeat biopsies, with a median progression‐free survival time of 7 years. The rate of disease progression decreased after the second repeat biopsy. The 5‐year overall survival rate was 100%. Having a PSA density (PSAD) of >0.15 ng/mL/mL, >1 positive core, and Gleason score >6 at the time of the diagnosis was associated with a significantly higher rate of disease progression on univariate analysis (P < 0.05), while a maximum percentage of cancer in any core of >10% showed a trend toward significance for a higher progression rate (P = 0.054). On multivariate analysis, only the presence of a PSAD of >0.15 ng/mL/mL remained significant for a higher progression rate (P < 0.05). Of the 155 patients, five (3.2%) subsequently received radiotherapy, 13 (8.4%) received hormonal therapy, and 13 (8.4%) underwent radical prostatectomy.

Conclusion

AS is a suitable management option for patients with clinically low‐risk prostate cancer. A PSAD of >0.15 ng/mL/mL is an important predictor for disease progression.
Testosterone therapy and cancer risk
Authors: Eisenberg Michael L. , Li Shufeng , Betts Paul , Herder Danielle , Lamb Dolores J. , Lipshultz Larry I.
Published: March 2014

Objective

To determine if testosterone therapy (TT) status modifies a man's risk of cancer.

Patients and Methods

The Urology clinic hormone database was queried for all men with a serum testosterone level and charts examined to determine TT status. Patient records were linked to the Texas Cancer Registry to determine the incidence of cancer. Men accrued time at risk from the date of initiating TT or the first office visit for men not on TT. Standardised incidence rates and time to event analysis were performed.

Results

In all, 247 men were on TT and 211 did not use testosterone. In all, 47 men developed cancer, 27 (12.8%) were not on TT and 20 (8.1%) on TT. There was no significant difference in the risk of cancer incidence based on TT (hazard ratio [HR] 1.0, 95% confidence interval [CI] 0.57–1.9; P = 1.8). There was no difference in prostate cancer risk based on TT status (HR 1.2, 95% CI 0.54–2.50).

Conclusion

There was no change in cancer risk overall, or prostate cancer risk specifically, for men aged >40 years using long‐term TT.
External validation of the Briganti nomogram to estimate the probability of specimen‐confined disease in patients with high‐risk prostate cancer
Authors: Roumiguié Mathieu , Beauval Jean‐Baptiste , Filleron Thomas , Benoit Thibaut , Rischmann Pascal , de la Taille Alexandre , Salomon Laurent , Soulié Michel , Malavaud Bernard , Ploussard Guillaume
Published: March 2014

Objective

To establish an external validation of the updated nomogram from Briganti et al., which provides estimates of the probability of specimen‐confined disease using the variables age, prostate‐specific antigen (PSA), clinical stage and biopsy Gleason score in preoperatively defined high‐risk prostate cancer (PCa).

Patients and Methods

The study included 523 patients with high‐risk PCa, as defined by d'Amico classification, undergoing radical prostatectomy (RP) and bilateral lymph node dissection in one of two academic centres between 1990 and 2013. Specimen‐confined disease was defined as pT2–pT3a node‐negative PCa with negative surgical margins. The receiver–operator characteristic (ROC) curve was obtained to quantify the overall accuracy (area under the curve [AUC]) of the model in predicting specimen‐confined disease. A calibration curve was then constructed to illustrate the relationship between the risk estimates obtained by the model (x‐axis) and the observed proportion of specimen‐confined disease (y‐axis). The Kaplan–Meier method was used to assess biochemical recurrence (BCR)‐free survival.

Results

Patients' median age and PSA level were 64 years and 21 ng/mL, respectively. The definition of high‐risk PCa was based on PSA level only in 38.3%, a biopsy Gleason score >7 in 34.5%, a clinical stage >T2b in 6.9%, or a combination of these two or three factors in 20.3% of patients. Positive surgical margins were observed in 43.6%, with a rate of 14.8% in pT2 cancers and lymph node metastasis in 12.1% of patients. pT stage was pT0 in 0.9%, pT2 in 28.9%, pT3a in 37.5% and pT3b–4 in 32.7% of patients. Overall, 44.4% of patients (N = 232) had specimen‐confined disease. PSA and cT stage were independently predictive of specimen‐confined disease. The median (range) 2‐, 5‐, and 8‐year BCR‐free survival rates were significantly higher in specimen‐confined disease as compared with non‐specimen‐confined disease: 80.87 (73.67–86.29) vs 37.55 (30.64–44.44)%, 63.53 (52.37–72.74) vs 26.93 (19.97–34.36)% and 55.08 (41.49–66.74) vs 19.52 (12.50–27.70)%, respectively (P < 0.001). The ROC curve analysis showed relevant accuracy of the model (AUC 0.6470, 95% CI 0.60–0.69) although the calibration plot suggested that, for risks ranging from 0.3 to 0.5, the odds of extracapsular extension were underestimated.

Conclusions

This external validation of the Briganti nomogram shows relevant accuracy, although the relative imprecision for intermediate risk may limit its clinical relevance. Our follow‐up findings confirm the large proportion of specimen‐confined PCa with good oncological outcomes in this heterogeneous subgroup of patients with high‐risk PCa.
Retracted: Synthesis, Characterization, and In vitro Studies of PLGA–PEG Nanoparticles for Oral Insulin Delivery
Authors: Hosseininasab Sara , Pashaei‐Asl Roghiyeh , Khandaghi Amir Ahmad , Nasrabadi Hamid Tayefi , Nejati‐Koshki Kazem , Akbarzadeh Abolfazl , Joo Sang Woo , Hanifehpour Younes , Davaran Soodabeh
Published: March 2014

Therapeutic proteins and peptides are corresponding to a major area of research in biotechnology companies and current pharmaceutical. Because of their natural instability, the enormous majority of these drugs require parentéral administration. Oral insulin delivery would be a highly attractive alternative process of administration, though it continues to be a mysterious target due to the enzymatic digestion of insulin and low levels of absorption from the gastrointestinal region. Hydrogel polymers can be considered as potential carriers for oral insulin delivery. In particular, a pH responsive hydrogel composed of PLGA–PEG has shown the ability to protect insulin from enzymes in the gastric environment and release in small intestines. However, this material has not shown similar potential for oral protein delivery of further model drugs. To date, the unique interaction between PLGA–PEG and insulin, as a potential drug for oral delivery, is not completely understood. The focus of this research is synthetization and characterization of hydrogels PLGA–PEG insulin nanoparticles and also pH sensitivity of insulin nanoparticles was investigated.
Impact of mood disorders on oral health‐care utilization among middle‐aged and older adults
Authors: Mago Anjali , Thyvalikakath Thankam P.
Published: March 2014

Background

Good oral health improves quality of life and is an integral part of active aging. Similar to some other systemic diseases, mood disorders are more prevalent in middle to older ages and have an associated risk of developing poor oral health. Consequently, people with mood disorders need to have regular dental care. There is scarce evidence in Canada linking mood disorders to the use of professional oral care services. The purpose of this study was to investigate the association between mood disorders and utilization of oral health‐care services in a population‐based sample of middle aged and older adults in Canada.

Methods

Data were extracted from Canadian Community Health Survey – Healthy Aging, 2008. Multinomial logistic regression was used to investigate the association between mood disorders and oral care utilization, adjusted for the confounders.

Results

Among 30 354 respondents included in our sample, 2162 (6.9%) reported having mood disorders. After adjusting for age, sex, education, marital status, and dental insurance status, the respondents who had mood disorders had a significant increased odds of not visiting a dental professional in the past year (OR:1.21, 95% CI: 1.08–1.35). The association of never visiting a dental professional and mood disorders was even stronger (OR: 1.49, 95% CI: 0.91–2.46).

Conclusion

Mood disorders were found to have a strong association with underutilization of oral care services among aging adults of Canada. Given the associated poor oral health risks for elderly with mood disorders, oral health planners should strengthen the implementation of surveillance programs directed toward better oral health for this disadvantaged subpopulation.
Matching children and substitute homes: some theoretical and empirical notions
Authors: Pösö Tarja , Laakso Riitta
Published: March 2014

Matching describes the process of selecting the substitute home for a child who needs to be placed away from the care of his/her birth parents. However, very little theorizing is done about matching and there is also a lack of systematic investigation into models of practice currently in use. Most importantly, very little is known about front‐line matching practices in different socio‐historical child welfare contexts. This paper aims to explore the concept of matching by addressing it theoretically and empirically as a decision‐making practice in social work. Based on the analysis of phone interviews (49) and focus group interviews (five groups with 18 child welfare practitioners) in Finland, we claim that matching includes a high degree of navigation: decision‐making balances between professional discretion, legal norms and principles, subjective views of the children and their parents as well as the economic and bureaucratic conditions of the service provision administration in the municipality. Navigation is shadowed by uncertainty and compromises. The analysis suggests that the notion of matching needs further analysis as it plays an important role in child welfare decision‐making. The interplay between front‐line practice and the socio‐historical context needs to be further addressed.
Buccal bone deficiency in fresh extraction sockets: a prospective single cohort study
Authors: Barone Antonio , Ricci Massimiliano , Romanos Georgios E. , Tonelli Paolo , Alfonsi Fortunato , Covani Ugo
Published: March 2014

Objective

The purpose of this prospective single cohort study was to evaluate the use of xenograft and collagen membranes in treating full or partial buccal bone defects of fresh extraction sockets in the esthetic zone.

Materials and methods

Thirty‐three patients requiring tooth extraction in the anterior maxillary area and showing a complete or partial buccal bone plate deficiency (more than 2 mm) were consecutively enrolled and treated. Corticocancellous porcine bone and platelet‐rich fibrin (PRF) with a collagen membrane were used to graft the extraction sockets, and the membranes were left exposed to the oral cavity with a secondary soft tissue healing. The outcome variables were as follows: width of keratinized mucosa, facial soft tissue levels, clinical bone changes (measured with a clinical splint), implant and prosthesis failures, and peri‐implant marginal bone changes.

Results

All treated sites allowed the placement of implants; the width of keratinized mucosa at the mid‐facial aspect showed an increase of 2.3 mm 5 months after the grafting procedure, and its value was 3.2 ± 0.6 mm at 1‐year follow‐up. The mean values of the facial soft tissue level indicated an increase over time. The bone level showed an improvement of 0.8 ± 0.1 mm and 0.7 ± 0.1 mm at mesial and distal sites, respectively, when compared to the baseline measurements. Finally, in the palatal area, no bone changes were observed. No implant failed during the entire observation period.

Conclusions

Findings from this study showed that xenograft and PRF, used for ridge preservation of the extraction sockets with buccal bone plate dehiscence in the esthetic zone, can be considered effective in repairing bone defects before implant placement. The secondary soft tissue healing over the grafted sockets did not compromise bone formation; moreover, the soft tissue level and the width of keratinized gingiva showed a significant improvement over time.
Immediate loading of implants installed in a healed alveolar bony ridge or immediately after tooth extraction: an experimental study in dogs
Authors: Mainetti Tomaso , Lang Niklaus P. , Bengazi Franco , Sbricoli Luca , Soto Cantero Luis , Botticelli Daniele
Published: March 2014

Objective

To compare the sequential healing at immediately loaded implants installed in a healed alveolar bony ridge or immediately after tooth extraction.

Material and methods

In the mandible of 12 dogs, the second premolars were extracted. After 3 months, the mesial roots of the third premolars were endodontically treated and the distal roots extracted. Implants were placed immediately into the extraction sockets (test) and in the second premolar region (control). Crowns were applied at the second and third maxillary premolars, and healing abutments of appropriate length were applied at both implants placed in the mandible and adapted to allow occlusal contacts with the crowns in the maxilla. The time of surgery and time of sacrifices were planned in such a way to obtain biopsies representing the healing after 1 and 2 weeks and 1 and 3 months. Ground sections were prepared for histological analyses.

Results

At the control sites, a resorption of the buccal bone of 1 mm was found after 1 week and remained stable thereafter. At the test sites, the resorption was 0.4 mm at 1‐week period and further loss was observed after 1 month. The height of the peri‐implant soft tissue was 3.8 mm both at test and control sites. Higher values of mineralized bone‐to‐implant contact and bone density were seen at the controls compared with the test sites. The differences, however, were not statistically significant.

Conclusions

Different patterns of sequential early healing were found at implants installed in healed alveolar bone or in alveolar sockets immediately after tooth extractions. However, three months after implant installation, no statistically significant differences were found for the hard‐ and soft‐tissue dimensions.
Healing of implants installed in over‐ or under‐prepared sites – An experimental study in dogs
Authors: Rea Massimiliano , Lang Niklaus P. , Ricci Sara , Mintrone Francesco , González González Gladys , Botticelli Daniele
Published: March 2014

Objective

To study bone healing at implants installed with different insertion torques.

Material and methods

In six Labrador dogs, all mandibular premolars and first molars were extracted. After 4 months of healing, flaps were elevated, and two implant sites were prepared at each side of the mandible. In the right side of the mandible, the distal sites were prepared conventionally, while the mesial sites were over‐prepared by 0.2 mm. As a consequence, a final insertion torque of ~30 Ncm at the distal and a minimal insertion torque close to 0 Ncm at the mesial sites were obtained. In the left sides of the mandible, however, the recipient sites were underprepared by 0.3 mm resulting in an insertion torque of ≥70 Ncm at both implants. Cover screws were applied, and flaps sutured to fully submerge the experimental sites. After 4 months, the animals were sacrificed and ground sections obtained for histological evaluation.

Results

The mineralized bone‐to‐implant contact was in the range of 55.2–62.1%, displaying the highest value at implants with ~30 Ncm insertion torque and the lowest value at the implant sites with close to 0 Ncm insertion torque. No statistically significant differences were revealed. Bone density was in the range of 43.4–54.9%, yielding the highest value at implants with ≥70 Ncm insertion torque and the lowest at the implant sites with close to 0 Ncm insertion torque. The difference between the sites of ~30 Ncm and the corresponding ≥70 Ncm insertion torque reached statistical significance.

Conclusions

Similar amounts of osseointegration were obtained irrespective of the insertion torque applied. Moreover, implants installed in sites with close to 0 Ncm insertion torque may properly osseointegrate as well.
Fingolimod Therapy in Early Multiple Sclerosis: An Efficacy Analysis of the TRANSFORMS and FREEDOMS Studies by Time Since First Symptom
Authors: Agius Mark , Meng Xiangyi , Chin Peter , Grinspan Augusto , Hashmonay Ronny
Published: March 2014

Aims

The phase 3 TRANSFORMS and FREEDOMS studies established the efficacy of fingolimod in reducing multiple sclerosis (MS) relapses and magnetic resonance imaging lesions compared with intramuscular (IM) interferon (IFN) β‐1a and placebo over 12 and 24 months, respectively.

Methods

To investigate the efficacy of fingolimod at the approved 0.5 mg dose in patients early in the MS disease course, post hoc subgroup analyses of TRANSFORMS (n = 272) and FREEDOMS (n = 217) data were conducted in patients who experienced their first MS symptom <3 years before randomization.

Results

Fingolimod 0.5 mg reduced annualized relapse rate by 73.4% (P = 0.0002) versus IFNβ‐1a IM and by 67.4% (P < 0.0001) versus placebo in patients with <3 years since first symptom; respective reductions were 45.4% and 51.4% in subgroups of patients with ≥3 years since first symptom. For patients with <3 years since their first symptom, significantly fewer new/newly enlarged T2 lesions were observed with fingolimod versus IFNβ‐1a IM (mean number, 1.94 vs. 2.95; P = 0.036) or placebo (4.1 vs. 10.7; P < 0.001); the mean number of gadolinium‐enhancing T1 lesions was significantly reduced versus placebo (0.3 vs. 1.1; P < 0.001).

Conclusion

Fingolimod 0.5 mg is highly effective in reducing relapses and MRI activity in patients early in the MS disease course.
Molecular Hydrogen Suppresses Reactive Astrogliosis Related to Oxidative Injury during Spinal Cord Injury in Rats
Authors: Liu Fang‐Ting , Xu Sheng‐Ming , Xiang Zheng‐Hua , Li Xiang‐Nan , Li Jian , Yuan Hong‐Bin , Sun Xue‐Jun
Published: March 2014

Aims

Spinal cord injury (SCI) can induce excessive astrocyte activation. Hydrogen has been deemed as a novel antioxidant. We investigated whether molecular hydrogen could act as an antiastrogliosis agent during SCI and oxidative injury in experimental rats and cultured astrocytes.

Methods

Hydrogen‐rich saline (HS, 8 mL/kg, i.p.) was injected every 12 h after SCI in rats. The expression of STAT3, p‐STAT3, and glial fibrillary acidic protein (GFAP); the release of IL‐1β, IL‐6, and TNF‐α; and astrogliosis, along with the BBB score, were evaluated. Culturing astrocytes with hydrogen‐rich medium, the intracellular reactive oxygen species (ROS), astrogliosis, and the release of proinflammatory cytokines were assessed after H2O2‐induced injury.

Results

In the HS group, the expression of STAT3, p‐STAT3, and GFAP and the proinflammatory cytokines were decreased in local spinal cord on postoperation day (POD) 3; on PODs 7 and 14, reactive astrogliosis was suppressed, and the locomotor function was also improved. Furthermore, hydrogen‐rich medium attenuated the intracellular production of ROS (especially HO•), astrogliosis, and the secretion of proinflammatory cytokines in astrocytes 12 h after H2O2‐induced injury.

Conclusions

Molecular hydrogen could suppress reactive astrogliosis after contusive SCI and reduce the release of proinflammatory cytokines produced by active astrocytes related to oxidative injury. Thus, molecular hydrogen is potential to be a neuroprotective agent.
Cortistatin‐14 Mediates its Anticonvulsant Effects Via sst2 and sst3 but Not Ghrelin Receptors
Authors: Aourz Najat , Portelli Jeanelle , Coppens Jessica , De Bundel Dimitri , Di Giovanni Giuseppe , Van Eeckhaut Ann , Michotte Yvette , Smolders Ilse
Published: March 2014

Cortistatin (CST)‐14, a neuropeptide that is structurally and functionally related to somatostatin‐14 (SRIF) binds all five somatostatin receptor subtypes (sst1–sst5). Using in vivo microdialysis and telemetry‐based electroencephalographic recordings, we provide the first experimental evidence for anticonvulsive effects of CST‐14 in a pilocarpine‐induced seizure model in rats and mice and for the involvement of sst2 and sst3 receptors in these anticonvulsant actions of CST‐14. Both receptor subtypes are required for the anticonvulsant effects of CST‐14 given that co‐perfusion of a selective sst2 antagonist (cyanamid15486) or a selective sst3 antagonist (SST3‐ODN‐8) reversed anticonvulsant effect of CST‐14, and this, independently of each other. Next, as the ghrelin receptor has been proposed as a target for the biological effects of CST‐14, we used ghrelin receptor knockout mice and their wild type littermates to study the involvement of this receptor in the anticonvulsive actions of CST‐14. Our results show a significant decrease in seizure duration in both genotypes when CST‐14 treated mice were compared with corresponding control animals receiving only pilocarpine. In addition, this CST‐14‐induced decrease was comparable in both genotypes. We here thus provide the first evidence that ghrelin receptors are not involved in mediating anticonvulsant actions of CST‐14 in vivo.
Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects
Authors: Gray Dennis , Wilson Mandy , Allsop Steve , Saggers Sherry , Wilkes Edward , Ober Coralie
Published: March 2014

Introduction and Aims

To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them.

Design and Methods

Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described.

Results

While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co‐ordinate comprehensive referral networks and service provision.

Discussion

Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised.

Conclusions

There is no simple way to reduce alcohol‐related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research. [Gray D, Wilson M, Allsop S, Saggers S, Wilkes E, Ober C. Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects. Drug Alcohol Rev 2014;33:482‐490]
Lymph node metastasis after endoscopic submucosal dissection of a differentiated gastric cancer confined to the mucosa with an ulcer smaller than 30 mm
Authors: Fujii Hiroyuki , Ishii Eiji , Tochitani Shinako , Nakaji So , Hirata Nobuto , Kusanagi Hiroshi , Narita Makoto
Published: March 2014

In the expanded indications for endoscopic resection, Japanese guidelines for gastric cancer include differentiated cancers confined to the mucosa with an ulcer <30 mm. We describe a patient with lymph node metastasis after curative endoscopic submucosal dissection (ESD) for a tumor of this indication. The patient was a 70‐year‐old man with chronic hepatitis C. He underwent ESD for early gastric cancer in May 2010. Pathology revealed a moderately differentiated adenocarcinoma, 22 × 17 mm in size, that was confined to the mucosa with an ulcer. The horizontal and vertical margins were negative for the tumor. We diagnosed thiscase as curative resection of expanded indication and followed this patient with endoscopy, abdominal ultrasonography (AUS) or enhanced computed tomography (CT) approximately every 6 months. After 17 months, lymph node metastasis was detected with AUS and CT and diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration biopsy in August 2011. Distal gastrectomy with D2 dissection was carried out in December 2011. Although it is low, the possibility of recurrence should be borne in mind after endoscopic treatment of early gastric cancer, despite its inclusion in the expanded indications for endoscopic resection.
Hepatic steatosis and non‐alcoholic fatty liver disease are not associated with decline in renal function in people with Type 2 diabetes
Authors: Jenks S. J. , Conway B. R. , Hor T. J. , Williamson R. M. , McLachlan S. , Robertson C. , Morling J. R. , Strachan M. W. J. , Price J. F.
Published: March 2014

Aims

We aimed to determine whether the presence of hepatic steatosis and/or non‐alcoholic fatty liver disease was associated with decline in renal function or onset of microalbuminuria in a cohort of people with Type 2 diabetes, including those managed in both primary and secondary care.

Methods

Nine hundred and thirty‐three patients from the Edinburgh Type 2 Diabetes Study, a cohort of Scottish men and women aged 60–74 years with Type 2 diabetes, underwent assessment for hepatic steatosis by liver ultrasonography 1 year after recruitment. Non‐alcoholic fatty liver disease was defined as the presence of steatosis following exclusion of secondary causes of liver disease. Patients were followed for 4 years and decline in renal function was assessed by the change in estimated glomerular filtration rate over time.

Results

Of the 933 subjects, 530 had hepatic steatosis and, of those with hepatic steatosis, 388 had non‐alcoholic fatty liver disease. Neither hepatic steatosis nor non‐alcoholic fatty liver disease were significantly associated with rate of decline in renal function, with the mean rate of decline in estimated glomerular filtration rate being –1.55 ml min−1 1.73 m−2 per year for participants with hepatic steatosis compared with –1.84 ml min−1 1.73 m−2 for those without steatosis (P = 0.19). Similar results were obtained when the analysis was restricted to participants with and without non‐alcoholic fatty liver disease (–1.44 vs. –1.64 ml min−1 1.73 m−2 per year, respectively; P = 0.44). Additionally, neither hepatic steatosis nor non‐alcoholic fatty liver disease were associated with the onset or regression of albuminuria during follow‐up (all P ≥ 0.05).

Conclusions

The presence of hepatic steatosis/non‐alcoholic fatty liver disease was not associated with decline in renal function during a 4‐year follow‐up in our cohort of older people with Type 2 diabetes.
Dipeptidyl peptidase‐4 inhibitors: pharmacokinetics, efficacy, tolerability and safety in renal impairment
Authors: Davis T. M. E.
Published: March 2014

The dipeptidyl peptidase‐4 (DPP‐4) inhibitors are a new class of blood glucose‐lowering therapy with proven efficacy, tolerability and safety. Four of the five commercially available DPP‐4 inhibitors are subject to significant renal clearance, and pharmacokinetic studies in people with renal impairment have led to lower recommended doses based on creatinine clearance in order to prevent drug accumulation. Data from these pharmacokinetic studies and from supratherapeutic doses in healthy individuals and people with uncomplicated diabetes during development suggest, however, that there is a wide therapeutic margin. This should protect against toxicity if people with renal impairment are inadvertently prescribed higher doses than recommended. Doses appropriate to renal function are associated with reductions in HbA1c that are equivalent to those observed in people with type 2 diabetes who do not have renal impairment. Recent large‐scale cardiovascular safety trials of saxagliptin and alogliptin have identified heart failure as a potential concern and renal impairment may increase the risk of this complication. Although the incidence of pancreatitis does not appear to be significantly increased by DPP‐4 inhibitor therapy, renal impairment is also an independent risk factor. Additional data from other ongoing DPP‐4 inhibitor cardiovascular safety trials should provide a more precise assessment of the risks of these uncommon complications, including in people with renal impairment.
Diplodia sapinea: the main fungal species involved in the colonization of pine shoots in Italy
Authors: Luchi N. , Oliveira Longa C. M. , Danti R. , Capretti P. , Maresi G.
Published: March 2014

Damage to various forest tree species caused by Diplodia sapinea has been reported in Italy since the early 20th century. However, until recently, systematic characterization of this microorganism, based on DNA sequence data, has been limited with only a general description of the fungus in the majority of the reports. To address this and provide a more accurate identification of Diplodia species associated on pine in Italy, we examined a total of 88 Botryosphaeriaceae isolates obtained from symptomatic and asymptomatic material from different hosts located in different geographical regions of Italy. Using molecular analysis, we were able to identify 67 isolates of D. sapinea and eight isolates of D. seriata. Diplodia sapinea was dominant on P. nigra shoots and was also detected on P. halepensis, P. pinea, P. pinaster, P. radiata and P. sylvestris, while D. seriata and other Botryosphaeriaceae appeared to be only occasionally present on shoots. The remaining 13 isolates represented nine different Botryosphaeriaceae species, occurring at low levels. Analysis of molecular variance (amova) based on DAMD‐PCR profiles detected low significant differences among D. sapinea isolates from the different sampling areas throughout Italy.
The very personal history of Nithard: family and honour in the Carolingian world
Authors: Polanichka Dana M. , Cilley Alex
Published: March 2014

Nithard's Histories of the civil wars fought between Louis the Pious's sons reveal much about mid‐ninth‐century nobility, political values, and the author's changing social position. This article considers how Nithard's immediate familial history affected the text's composition. We argue that his incorporation of authorial voice and detail, crafting of the royal lineage, and emphasis on fraternitas suggest that Nithard employed the text to fight for legitimacy and honour, both familial and individual. We propose that the Histories should be read as a social commemoration of Nithard's familial memories, thus complicating the assumption that family histories were the purview of women.
Combining taxon‐by‐trait and taxon‐by‐site matrices for analysing trait patterns of macroinvertebrate communities: a rejoinder to Monaghan & Soares ()
Authors: Schmera Dénes , Podani János , Erős Tibor , Heino Jani
Published: March 2014

Monaghan and Soares (2014) suggested that combining traits with log‐transformed abundance of taxa may cause anomalies in analyses of stream macroinvertebrate communities. While they addressed an important issue in stream ecology, here we present an opposite view. To identify the causes of these contrasting opinions, we carefully examined the examples provided by Monaghan and Soares (2014) and demonstrated how traits can be weighted by the presence, abundance and log‐transformed abundance of the taxa in a meaningful way.

We found that Monaghan and Soares (2014), following other authors, use the term ‘weighting’ differently from classical papers of stream ecology. The general practice is to calculate the sum of trait values multiplied by the abundance of each taxon and divide it by the total invertebrate abundance to get a community‐level trait value. In contrast, Monaghan and Soares (2014) did not perform the final division and consequently did not get a standardised community‐level trait value. It follows that the term ‘weighting’ is used with different meanings in stream ecology, and ecologists should keep these differences in mind.

We agree with Monaghan and Soares (2014) that the addition of log‐transformed data is equivalent to multiplication on an arithmetic scale. However, we disagree that this provides an inconsistent scaling that confounds quantitative analyses. Using example data sets, we illustrate how trait‐based data analysis can be performed in community ecology in a meaningful way.
Extinction of an instrumental response: a cognitive behavioral assay in Fmr1 knockout mice
Authors: Sidorov M. S. , Krueger D. D. , Taylor M. , Gisin E. , Osterweil E. K. , Bear M. F.
Published: March 2014

Fragile X (FX) is the most common genetic cause of intellectual disability and autism. Previous studies have shown that partial inhibition of metabotropic glutamate receptor signaling is sufficient to correct behavioral phenotypes in a mouse model of FX, including audiogenic seizures, open‐field hyperactivity and social behavior. These phenotypes model well the epilepsy (15%), hyperactivity (20%) and autism (30%) that are comorbid with FX in human patients. Identifying reliable and robust mouse phenotypes to model cognitive impairments is critical considering the 90% comorbidity of FX and intellectual disability. Recent work characterized a five‐choice visuospatial discrimination assay testing cognitive flexibility, in which FX model mice show impairments associated with decreases in synaptic proteins in prefrontal cortex (PFC). In this study, we sought to determine whether instrumental extinction, another process requiring PFC, is altered in FX model mice, and whether downregulation of metabotropic glutamate receptor signaling pathways is sufficient to correct both visuospatial discrimination and extinction phenotypes. We report that instrumental extinction is consistently exaggerated in FX model mice. However, neither the extinction phenotype nor the visuospatial discrimination phenotype is corrected by approaches targeting metabotropic glutamate receptor signaling. This work describes a novel behavioral extinction assay to model impaired cognition in mouse models of neurodevelopmental disorders, provides evidence that extinction is exaggerated in the FX mouse model and suggests possible limitations of metabotropic glutamate receptor‐based pharmacotherapy.
Multifaceted diversity–area relationships reveal global hotspots of mammalian species, trait and lineage diversity
Authors: Mazel Florent , Guilhaumon François , Mouquet Nicolas , Devictor Vincent , Gravel Dominique , Renaud Julien , Cianciaruso Marcus Vinicius , Loyola Rafael , Diniz‐Filho José Alexandre Felizola , Mouillot David , Thuiller Wilfried
Published: March 2014

Aim

To define biome‐scale hotspots of phylogenetic and functional mammalian biodiversity (PDandFD, respectively) and compare them with ‘classical’ hotspots based on species richness (SR) alone.

Location

Global.

Methods

SR,PDandFDwere computed for 782 terrestrial ecoregions using the distribution ranges of 4616 mammalian species. We used a set of comprehensive diversity indices unified by a recent framework incorporating the relative species coverage in each ecoregion. We built large‐scale multifaceted diversity–area relationships to rank ecoregions according to their levels of biodiversity while accounting for the effect of area on each facet of diversity. Finally we defined hotspots as the top‐ranked ecoregions.

Results

While ignoring relative species coverage led to a fairly good congruence between biome‐scale top rankedSR,PDandFDhotspots, ecoregions harbouring a rich and abundantly represented evolutionary history and FD did not match with the top‐ranked ecoregions defined bySR. More importantlyPDandFDhotspots showed important spatial mismatches. We also found thatFDandPDgenerally reached their maximum values faster thanSRas a function of area.

Main conclusions

The fact thatPD/FDreach their maximum value faster thanSRcould suggest that the two former facets might be less vulnerable to habitat loss than the latter. While this point is expected, it is the first time that it has been quantified at a global scale and should have important consequences for conservation. Incorporating relative species coverage into the delineation of multifaceted hotspots of diversity led to weak congruence betweenSR,PDandFDhotspots. This means that maximizing species number may fail to preserve those nodes (in the phylogenetic or functional tree) that are relatively abundant in the ecoregion. As a consequence it may be of prime importance to adopt a multifaceted biodiversity perspective to inform conservation strategies at a global scale.
Competition in online job marketplaces: towards a global labour market for outsourcing services?
Authors: BEEREPOOT NIELS , LAMBREGTS BART
Published: March 2014

A new form of service outsourcing has emerged, namely the global online job marketplace for freelance contractors. Such platforms are currently the closest proxy to the idea of a global labour market where everyone competes for jobs regardless of location. In this article, we examine how competition manifests itself on one such global online platform, namely oDesk. We present a comparative analysis of the relative wages and the rewarding of skills and expertise of contractors from selected countries and investigate whether, via labour arbitrage, wage convergence takes place between Western and developing countries. We find that wage convergence is noticeable but experience and skills hardly translate into better remuneration. While service outsourcing (or microwork) via global online marketplaces provides new employment opportunities for freelancers around the world, the intense competition and the inherent restrictions of this type of marketplace limit the financial gains for most contractors.
Vacuum‐assisted closure (VAC)‐Instill® with continuous irrigation for the treatment of Mycoplasma hominis mediastinitis
Authors: Karaca Saziye , Kalangos Afksendiyos
Published: March 2014

A 56‐year‐old patient who underwent ascending aorta replacement postoperatively developed mediastinitis with atypical Mycoplasma hominis. We present the first successful treatment of M. hominis mediastinitis after cardiac surgery with vacuum‐assisted closure (VAC)‐Instill® therapy combined with dilute antiseptic irrigation for bacterial eradication.
Reconstruction after skin cancer excision through a dermal induction template: our experience
Authors: Onesti Maria G , Fino Pasquale , Fioramonti Paolo , Amorosi Vittoria , Scuderi Nicolò
Published: March 2014

Dermal substitutes offer alternative approaches for wounds of all thicknesses where sufficient donation sites are not available for self‐grafts. Several dermal substitutes are described in literature. This study included 20 patients treated with a dermal induction template after the removal of malignant skin cancers situated in various parts of the body. The participants were especially aged patients with multiple skin cancers, and complex clinical conditions, often affected by pathologies such as cardiopathy, diabetes mellitus, and hypercholesterolaemia, and receiving pharmacological multi‐therapies, particularly antiplatelets and anticoagulants. In many of these patients, the general complex clinical picture provided significant contraindication for complex reconstructive surgery because of the high risk involved. All patients achieved complete healing about 8 weeks after the first surgery. By using a dermal induction template, it was possible to cover substantial loss of substances without the need of autologous tissue, with smoother and less apparent scar, minor occurrence of hypertrophic and retracted scars, better flexibility of healed skin and therefore a better result from an aesthetic point of view.
Australasian nutrition research for prevention and management of child obesity: innovation and progress in the last decade
Authors: Golley R. K. , McNaughton S. A. , Collins C. E. , Magarey A. , Garnett S. P. , Campbell K. J. , Mallan K. , Burrows T.
Published: March 2014

Background/Objective

The Food and Nutrition stream of Australasian Child and Adolescent Obesity Research Network (ACAORN) aims to improve the quality of dietary methodologies and the reporting of dietary intake within Australasian child obesity research (http://www.acaorn.org.au/streams/nutrition/).

Methods/Results

With 2012 marking ACAORN's 10th anniversary, this commentary profiles a selection of child obesity nutrition research published over the last decade by Food and Nutrition Stream members. In addition, stream activities have included the development of an online selection guide to assist researchers in their selection of appropriate dietary intake methodologies (http://www.acaorn.org.au/streams/nutrition/dietary‐intake/index.php).

Conclusions

The quantity and quality of research to guide effective child obesity prevention and treatment has increased substantially over the last decade. ACAORN provides a successful case study of how research networks can provide a collegial atmosphere to foster and coordinate research efforts in an otherwise competitive environment.
Growth of Devitrite, Na2Ca3Si6O16, in Soda–Lime–Silica Glass
Authors: Knowles Kevin M. , Thompson Robert P.
Published: March 2014

The morphology and crystal growth of devitrite crystals nucleated heterogeneously on glass surfaces have been studied. The crystals grow as fans of needles, with each needle having a characteristic [100] growth direction with respect to the centrosymmetric triclinic unit cell. An analysis of crystal growth data reported here and a reappraisal of crystal growth data reported in prior studies suggests a best estimate of 260 kJ/mol for the activation enthalpy for the crystal growth of devitrite along [100], higher than the values previously reported.
A randomized controlled trial of the effectiveness of a self‐help psychoeducation programme on outcomes of outpatients with coronary heart disease: study protocol
Authors: Wang Wenru , Lopez Violeta , Chow Aloysius , Chan Sally Wai‐Chi , Cheng Karis Kin Fong , He Hong‐Gu
Published: March 2014

Aim

To develop and examine the effectiveness of a home‐based self‐help psychoeducation programme on health‐related quality of life, stress level, anxiety and depression symptoms, self‐efficacy, cardiac risk factors and health service use of outpatients with coronary heart disease.

Background

Hospital‐based cardiac rehabilitation programmes have been shown to improve, effectively, the quality of life of patients with coronary heart disease. However, a majority of these patients do not participate in these programmes, while those who do enrol in these programmes fail to complete the programmes.

Design

Randomized controlled trial with repeated measures.

Methods

This study was approved and received the grant in July 2013. A convenience sample of 128 coronary heart disease outpatients will be recruited from a tertiary hospital in Singapore. Participants are randomly assigned to the 4‐week experimental group and will participate in the programme or the control group who will not participate in the programme. The outcome measures include the: 12‐item Short Form Health Survey, Perceived Stress Scale, Hospital Anxiety and Depression Scale and General Self‐Efficacy Scale. Data will be collected at baseline, then 4 and 16 weeks from baseline. At the end, a process evaluation will be conducted to assess the acceptability, strengths and weaknesses of our programme based on the participants' perspectives.

Discussion

Our programme offers coronary heart disease patients an additional option to the existing cardiac rehabilitative services in Singapore hospitals. It aims to help them manage their disease effectively by reducing cardiac risk factors and improve their health‐related quality of life and psychological well‐being.
Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi‐centre prospective study
Authors: Cicolini Giancarlo , Manzoli Lamberto , Simonetti Valentina , Flacco Maria Elena , Comparcini Dania , Capasso Lorenzo , Di Baldassarre Angela , Eltaji Elfarouki Ghaleb
Published: March 2014

Aims

This multi‐centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter‐related phlebitis. Potential predictors of phlebitis were also investigated.

Background

Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal.

Design

A prospective cohort design was carried out from January–June 2012.

Methods

The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed‐effects regression.

Results

The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade.

Conclusions

Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines – more attention to this issue is required.