bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Chinese herbal medicine Jinlida in type 2 diabetes patients based on stratification: Results of subgroup analysis from a 12‐week trial
Authors: Tian Jiaxing , Lian Fengmei , Yang Libo , Tong Xiaolin 
Published: April 2017

AbstractBackgroundThe Chinese herbal medicine Jinlida can significantly enhance the hypoglycemic action of metformin. However, the population showing the best responses to Jinlida has not been clarified. The aim of the present study was to compare the efficacy of Jinlida in type 2 diabetes mellitus (T2DM) after stratification.MethodsData were analyzed from a 12‐week randomized placebo‐controlled double‐blind multicenter study with 192 T2DM patients (186 completed the study). The efficacy evaluation included HbA1c, fasting plasma glucose (FPG), and 2‐h postprandial glucose (2hPG) levels stratified by baseline HbA1c, sex, age, body mass index (BMI), and duration of T2DM diagnosis. Homeostasis model assessment of insulin resistance (HOMA‐IR) and homeostatic model assessment of β‐cell function (HOMA‐β) were also evaluated stratified by baseline insulin levels.ResultsIn the Jinlida group, HbA1c was significantly reduced (P < 0.05). Greater reductions were observed in patients with baseline HbA1c >8.5%, in males and in those aged >60 years, with a BMI ≤24 kg/m2, or with a duration of T2DM diagnosis >5 years (P < 0.05). Compared with baseline, Jinlida significantly alleviated insulin resistance (P < 0.05) in patients with baseline insulin levels >20 mU/L. Jinlida also significantly improved β‐cell function in patients with baseline insulin levels ≤20 mU/L (P < 0.05).ConclusionsJinlida significantly improved glycemic control, with greater improvements in patients with poor glycemic control and male, elderly, of normal weight, or with a long disease course. Furthermore, Jinlida alleviated insulin resistance with hyperinsulinemia and promoted insulin secretion with hypoinsulinemia. These results need to be further confirmed in clinical trials.
Allometric equations for yield predictions of enset (Ensete ventricosum) and khat (Catha edulis) grown in home gardens of southern Ethiopia
Authors: Mellisse B.T. , Descheemaeker K. , Mourik M.J. , van de Ven G.W.J. 
Published: April 2017

AbstractEnset is a large, single‐stemmed perennial herbaceous plant domesticated as a staple food crop only in Ethiopia. Khat is a perennial plant cultivated for its economically important leaves and twigs that are the sources of stimulant when chewed. We address the issue of yield estimation of both crops, as they are important for the livelihoods of smallholders in the home garden systems in Southern Ethiopia and have received little attention so far. The objective of this study was to develop linear allometric models for estimating the edible (food and feed) and commercial yields of enset and khat plants, respectively. Data were collected from 20 enset and 100 khat plants. Diameter at 50‐cm height (d50), pseudostem height (hp) and their combination were good predictor variables for the food products of enset with adjusted R2 values above 0.85, while d50, hp, edible pseudostem height (hep), total height (ht) and their combination were good predictor variables for the feed products of enset with adjusted R2 values above 0.70. For dwarf khat plants crown area (ca) combined with total height (ht) resulted in the best prediction with an adjusted R2 of 0.77, while the leaf and twig dry weight for tall khat plants was best predicted by ca with adjusted R2 of 0.43. In all cases linear models were used.
Methodological Reflections on the Contribution of Qualitative Research to the Evaluation of Clinical Ethics Support Services
Authors: Wäscher Sebastian , Salloch Sabine , Ritter Peter , Vollmann Jochen , Schildmann Jan 
Published: April 2017

AbstractThis article describes a process of developing, implementing and evaluating a clinical ethics support service intervention with the goal of building up a context‐sensitive structure of minimal clinical‐ethics in an oncology department without prior clinical ethics structure. Scholars from different disciplines have called for an improvement in the evaluation of clinical ethics support services (CESS) for different reasons over several decades. However, while a lot has been said about the concepts and methodological challenges of evaluating CESS up to the present time, relatively few empirical studies have been carried out. The aim of this article is twofold. On the one hand, it describes a process of development, modifying and evaluating a CESS intervention as part of the ETHICO research project, using the approach of qualitative‐formative evaluation. On the other hand, it provides a methodological analysis which specifies the contribution of qualitative empirical methods to the (formative) evaluation of CESS. We conclude with a consideration of the strengths and limitations of qualitative evaluation research with regards to the evaluation and development of context sensitive CESS. We further discuss our own approach in contrast to rather traditional consult or committee models.
Effect of weight reduction on glycated haemoglobin in weight loss trials in patients with type 2 diabetes
Authors: Gummesson Anders , Nyman Elisabeth , Knutsson Mikael , Karpefors Martin 
Published: April 2017

AimTo quantify the effect of weight loss on glycated haemoglobin (HbA1c) at group level, based on data from published weight loss trials in overweight and obese patients with type 2 diabetes (T2D).MethodsA systematic literature search in MEDLINE, EMBASE and Cochrane CENTRAL (January 1990 through December 2012) was conducted to identify prospective trials of energy‐reduced diets, obesity drugs or bariatric surgery in adult, overweight and obese patients with T2D. Based on clinical data with follow‐up from 3 to 24 months, a linear model was developed to describe the effect of weight reduction on HbA1c.ResultsThe literature search identified 58 eligible articles consisting of 124 treatment groups and 17 204 subjects, yielding a total of 250 data points with concurrent mean changes from baseline in weight and HbA1c. The model‐based analyses indicated a linear relationship between weight loss and HbA1c reduction, with an estimated mean HbA1c reduction of 0.1 percentage points for each 1 kg of reduced body weight for the overall population. Baseline HbA1c was a significant covariate for the relationship between weight loss and HbA1c: high HbA1c at baseline was associated with a greater reduction in HbA1c for the same degree of weight loss. The collected trial data also indicated weight‐loss‐dependent reductions in antidiabetic medication.ConclusionsAt group level, weight loss in obese and overweight patients with T2D was consistently accompanied by HbA1c reduction in a dose‐dependent manner. The model developed in the present study estimates that for each kg of mean weight loss, there is a mean HbA1c reduction of 0.1 percentage points. HbA1c‐lowering is greater in populations with poor glycaemic control than in well controlled populations with the same degree of weight loss. This summary of data from previous trials regarding the effect of weight reduction on HbA1c may be used to support the design and interpretation of future studies that aim to demonstrate the efficacy of weight loss interventions for T2D treatment.
Effects of dapagliflozin on insulin‐requirement, glucose excretion and ß‐hydroxybutyrate levels are not related to baseline HbA1c in youth with type 1 diabetes
Authors: Biester Torben , Aschemeier Baerbel , Fath Maryam , Frey Marcel , Scheerer Markus F. , Kordonouri Olga , Danne Thomas 
Published: April 2017

Youth with type 1 diabetes (T1D) infrequently achieve HbA1c targets. Therefore, this placebo‐controlled, randomized, crossover study was set up to assess the safety, effect and pharmacokinetics of a single dose of 10 mg dapagliflozin (DAPA) as add‐on to insulin in relationship to HbA1c in youth. A total of 33 youths (14 males, median age 16 years, diabetes duration 8 years) were included and stratified into 3 baseline HbA1c categories (<7.5%, 7.5%‐9.0% or >9.0; n = 11 each). During the study period of 24 hours, intravenous insulin administration and glucose‐infusion kept blood glucose levels at 160 to 220 mg/dL. DAPA reduced mean insulin dose by 13.6% (
P
< .0001 by ANOVA) and increased urinary glucose excretion by 610% (143.4 vs 22.4 g/24 h;
P
< .0001), both irrespective of baseline HbA1c. Six independent episodes in 6 patients with plasma ß‐hydroxybutyrate levels between ≥0.6 and <1.0 mmol/L were observed after liquid meal challenges, 5 episodes in the DAPA group and 1 in the placebo group. This study provides a proof‐of‐concept, irrespective of preexisting HbA1c levels, for adjunct SGLT2‐inhibitor therapy in the paediatric age group by lowering insulin dose and increasing glucose excretion.
Split tasks of asymmetric nucleotide‐binding sites in the heterodimeric ABC exporter EfrCD
Authors: Hürlimann Lea M. , Hohl Michael , Seeger Markus A. 
Published: April 2017

Many heterodimeric ATP‐binding cassette (ABC) exporters evolved asymmetric ATP‐binding sites containing a degenerate site incapable of ATP hydrolysis due to noncanonical substitutions in conserved sequence motifs. Recent studies revealed that nucleotide binding to the degenerate site stabilizes contacts between the nucleotide‐binding domains (NBDs) of the inward‐facing transporter and regulates ATP hydrolysis at the consensus site via allosteric coupling mediated by the D‐loops. However, it is unclear whether nucleotide binding to the degenerate site is strictly required for substrate transport. In this study, we examined the functional consequences of a systematic set of mutations introduced at the degenerate and consensus site of the multidrug efflux pump EfrCD of Enterococcus faecalis. Mutating motifs which differ among the two ATP‐binding sites (Walker B, switch loop, and ABC signature) or which are involved in interdomain communication (D‐loop and Q‐loop) led to asymmetric results in the functional assays and were better tolerated at the degenerate site. This highlights the importance of the degenerate site to allosterically regulate the events at the consensus site. Mutating invariant motifs involved in ATP binding and NBD closure (A‐loop and Walker A) resulted in equally reduced transport activities, regardless at which ATP‐binding site they were introduced. In contrast to previously investigated heterodimeric ABC exporters, mutation of the degenerate site Walker A lysine completely inactivated ATPase activity and substrate transport, indicating that ATP binding to the degenerate site is essential for EfrCD. This study provides novel insights into the split tasks of asymmetric ATP‐binding sites of heterodimeric ABC exporters.
An Evaluation of Benchmarks for Esthetic Orientation of the Occlusal Plane
Authors: Priest George , Wilson Michael G. 
Published: April 2017

AbstractPurposeThis patient study was designed to measure the validity of both the horizontal and Camper's planes, which are used as benchmarks to reestablish the sagittal orientation of the occlusal plane angles in dental rehabilitation.Materials and MethodsProfile digital photographs were made of the first 100 consenting dentate patients as they closed on an occlusal plane analyzer while maintaining natural head posture. Using a digital screen protractor, three angles were measured: the occlusal plane angle relative to the horizontal plane, and the angle between the occlusal plane and Camper's plane from both the superior and inferior borders of the tragus of the ear.ResultsThe angle between the occlusal plane and the horizontal reference plane for the 100 patients ranged from –8.72° to +18.08° (mean +3.25°); the angle between the occlusal plane and Camper's plane, from the superior border of the tragus to the ala of the nose demonstrated a range from –8.49° to +15.16° (mean +3.03°); and the angle between Camper's plane, from the inferior border of the tragus to the ala of the nose and the occlusal plane demonstrated a range from –15.57° to +9.15° (mean –4.09°).ConclusionsOcclusal plane angles measured in this patient population with natural dentitions demonstrated a relatively small mean deviation from both the horizontal plane and Camper's plane when using the superior border of the tragus as the distal reference point, but the range was quite broad and could result in unacceptable occlusal plane angles in many patients undergoing dental rehabilitation. Clinical Implications: Both Camper's plane and the horizontal reference plane may be acceptable initial reference planes for oral rehabilitation, but additional anatomic and esthetic parameters are required for verification of an esthetically pleasing occlusal plane angle.
The Effects of Perceived Procedural Justice on Conflict Management between Spouses, and the Mediating Role of Dyadic Adjustment
Authors: Peleg‐Koriat Inbal , Nelson Noa , Ben‐ari Rachel 
Published: April 2017

In this study, we examined the role that perceived procedural justice (PPJ) plays in the conflict management behaviors that intimate spouses adopt and endorse. In this context, PPJ has been defined as the degree to which one perceives that his or her spouse makes decisions fairly, considerately, and in a participatory manner. To test the impact of perceived procedural justice on conflict resolution behavior, we applied the dual‐concern model of conflict management style. In an experiment in which participants read fictional scenarios and predicted spouses’ responses, we found that perceptions of strong PPJ enhanced the prediction of integrating (problem solving), compromising, and, to a lesser degree, obliging behavior. Perceived procedural justice also caused a reduction in avoidance behavior, but no effect we found on dominating (competing) behavior.In a following correlational study, we also found that PPJ positively correlated to enhanced integrating, compromising, and obliging behaviors, and these correlations were partially or fully mediated by the degree of “dyadic adjustment,” which is a measure of relationship health. In addition, in this second study, we found no correlation between perceived procedural justice and dominating or avoiding behavior.In both studies, participants either predicted or chose collaborative behaviors more than non‐collaborative ones. We conclude that the perception that one's partner is behaving in a procedurally just way can enhance active and egalitarian collaboration in marriage and other intimate partner relationships, but that the absence of PPJ does not seem to encourage active non‐collaboration, particularly not highly self‐centered dominating behavior.
The GAN Exonuclease or the Flap Endonuclease Fen1 and RNase HII Are Necessary for Viability of Thermococcus kodakarensis
Authors: Burkhart Brett W. , Cubonova Lubomira , Heider Margaret R. , Kelman Zvi , Reeve John N. , Santangelo Thomas J. 
Published: April 2017

ABSTRACT

Many aspects of and factors required for DNA replication are conserved across all three domains of life, but there are some significant differences surrounding lagging-strand synthesis. In
Archaea
, a 5′-to-3′ exonuclease, related to both bacterial RecJ and eukaryotic Cdc45, that associates with the replisome specifically through interactions with GINS was identified and designated GAN (for
G
INS-
a
ssociated
n
uclease). Despite the presence of a well-characterized flap endonuclease (Fen1), it was hypothesized that GAN might participate in primer removal during Okazaki fragment maturation, and as a Cdc45 homologue, GAN might also be a structural component of an archaeal CMG (Cdc45, MCM, and GINS) replication complex. We demonstrate here that, individually, either Fen1 or GAN can be deleted, with no discernible effects on viability and growth. However, deletion of both Fen1 and GAN was not possible, consistent with both enzymes catalyzing the same step in primer removal from Okazaki fragments
in vivo
. RNase HII has also been proposed to participate in primer processing during Okazaki fragment maturation. Strains with both Fen1 and RNase HII deleted grew well. GAN activity is therefore sufficient for viability in the absence of both RNase HII and Fen1, but it was not possible to construct a strain with both RNase HII and GAN deleted. Fen1 alone is therefore insufficient for viability in the absence of both RNase HII and GAN. The ability to delete GAN demonstrates that GAN is not required for the activation or stability of the archaeal MCM replicative helicase.

IMPORTANCE
The mechanisms used to remove primer sequences from Okazaki fragments during lagging-strand DNA replication differ in the biological domains. Bacteria use the exonuclease activity of DNA polymerase I, whereas eukaryotes and archaea encode a flap endonuclease (Fen1) that cleaves displaced primer sequences. RNase HII and the GINS-associated exonuclease GAN have also been hypothesized to assist in primer removal in
Archaea
. Here we demonstrate that in
Thermococcus kodakarensis
, either Fen1 or GAN activity is sufficient for viability. Furthermore, GAN can support growth in the absence of both Fen1 and RNase HII, but Fen1 and RNase HII are required for viability in the absence of GAN.
Long-term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study
Authors: Lanhers Charlotte , Walther Guillaume , Chapier Robert , Lesourd Bruno , Naughton Geraldine , Pereira Bruno , Duclos Martine , Vinet Agnès , Obert Philippe , Courteix Daniel , Dutheil Frédéric 
Published: April 2017

ObjectivesTo demonstrate that lifestyle modifications will reduce the cost of routine medications in individuals with type 2 diabetes (T2D), through a mechanism involving glycaemic control.DesignA within-trial cost-medication analysis with a 1-year time horizon.SettingControlled environment within the spa resort of Chatel-Guyon, France.ParticipantsTwenty-nine participants (aged 50–70 years) with T2D.InterventionsA 1-year follow-up intervention, beginning with a 3-week residential programme combining high exercise volume (15–20 hours/week), restrictive diet (−500 kcal/day) and education. Participants continued their routine medication, independently managed by their general practitioner.Main outcome measuresNumber of medications, number of pills, cost of medications and health-related outcomes.ResultsTwenty-six participants completed the 1-year intervention. At 1 year, 14 patients out of 26 (54%) stopped/decreased their medications whereas only 5 (19%) increased or introduced new drugs (χ2=6.3, p=0.02). The number of pills per day decreased by 1.3±0.3 at 12 months (p<0.001). The annual cost of medications for T2D were lower at 1 year (€135.1±43.9) versus baseline (€212.6±35.8) (p=0.03). The regression coefficients on costs of routine medication were 0.507 (95% CI 0.056 to 0.959, p=0.027) for HbA1c and 0.156 (95% CI −0.010 to 0.322, p=0.06) for blood glucose levels. Diabetics patients with HbA1c >6.5% in the highest (last) quartile doubled their routine medication costs (66% vs 33%, p=0.037).ConclusionsIndividuals with T2D reduced routine medication costs following a long-term lifestyle intervention that started with a 3-week residential programme. Combining high exercise volume, restrictive diet and education effectively supported the health of T2D. The main factor explaining reduced medication costs was better glycaemic control, independent of weight changes. Despite limitations precluding generalisability, cost-effective results of reduced medication should contribute to the evidence base required to promote lifestyle interventions for individuals with T2D.Trial registration numberNCT00917917; Post-results.
Peddlers of Paradise
Authors: Laferrière Anik 
Published: April 2017

This study investigates the activities of the Austin Friars in England in the fifteenth and early sixteenth centuries regarding the sale of expurgatory services. Through an analysis of their letters of confraternity and indulgences, this study argues that around the end of the fifteenth century, the Austin Friars experienced a change in attitude in the sale of their religious services. They exponentially increased their efforts in selling indulgences and letters of confraternity and in advertising their popular Scala Coeli services, an attitude that reached its zenith in 1516 when Pope Leo X licensed the Austin Friars to sell and promote a lucrative plenary indulgence. This change has significant consequences for considerations of the actions of English Augustinian reformers in the sixteenth century, primarily Robert Barnes, whose criticisms of clerical wealth are put into relief when examined within this monastic context.
Evaluating the Effect of Virtual Reality Temporal Bone Simulation on Mastoidectomy Performance: A Meta‐analysis
Authors: Lui Justin T. , Hoy Monica Y. 
Published: April 2017

BackgroundThe increasing prevalence of virtual reality simulation in temporal bone surgery warrants an investigation to assess training effectiveness.ObjectivesTo determine if temporal bone simulator use improves mastoidectomy performance.Data SourcesOvid Medline, Embase, and PubMed databases were systematically searched per the PRISMA guidelines.Review MethodsInclusion criteria were peer‐reviewed publications that utilized quantitative data of mastoidectomy performance following the use of a temporal bone simulator. The search was restricted to human studies published in English. Studies were excluded if they were in non‐peer‐reviewed format, were descriptive in nature, or failed to provide surgical performance outcomes. Meta‐analysis calculations were then performed.ResultsA meta‐analysis based on the random‐effects model revealed an improvement in overall mastoidectomy performance following training on the temporal bone simulator. A standardized mean difference of 0.87 (95% CI, 0.38‐1.35) was generated in the setting of a heterogeneous study population (I2 = 64.3%, P <. 006).ConclusionIn the context of a diverse population of virtual reality simulation temporal bone surgery studies, meta‐analysis calculations demonstrate an improvement in trainee mastoidectomy performance with virtual simulation training.
Thalidomide for Epistaxis in Patients with Hereditary Hemorrhagic Telangiectasia: A Preliminary Study
Authors: Fang Jia , Chen Xiaomeng , Zhu Bijun , Ye Haibo , Zhang Weitian , Guan Jian , Su Kaiming 
Published: April 2017

To evaluate the effectiveness of thalidomide for epistaxis in hereditary hemorrhagic telangiectasia (HHT), 7 HHT patients with recurrent epistaxis were treated with thalidomide at an initial dose of 50 mg/d, gradually increasing to 100 mg/d if needed. The Epistaxis Severity Score (ESS) was used to evaluate the treatment effects. Patients reported that epistaxis improved 1 to 3 weeks after starting thalidomide. The mean ESS before treatment, at the end of treatment, and 3 months after stopping treatment was 5.03 ± 2.05, 0.90 ± 0.84 (P =. 003), and 1.98 ± 1.33 (P =. 006), respectively. Four patients reported mild to moderate side effects, including drowsiness, dizziness, constipation, nausea, and peripheral neuropathy. Two patients stopped the treatment because of adverse effects. Those results showed that thalidomide may be a treatment choice for recurrent epistaxis in HHT patients, although the side effects should be considered. Further study should focus on guidelines for dosing and course and investigate how to reduce the adverse effects.