bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparedness of newly qualified doctors in Ireland for prescribing in clinical practice
Authors: Geoghegan Sheena Elizabeth , Clarke Eric , Byrne Dara , Power Dermot , Moneley Daragh , Strawbridge Judith , Williams David James 
Published: February 2017

AimThe aim of the study was to investigate the level of preparedness of newly qualified Irish‐trained doctors for prescribing, and to investigate their attitudes towards prescribing and prescribing education, through a national survey.MethodsA 29‐item online survey was distributed to 686 newly qualified doctors 1 month prior to the completion of their first year of clinical practice (internship). Only graduates from Irish medical schools were included.ResultsThe response rate was 20.4% (n = 140; female : male 56%:44%). The majority of respondents felt confident in prescription writing (89%), medication history taking (81%) and accessing drug information in the hospital setting (80%). Only 58% of respondents felt confident in drug dose calculation, and 35% felt confident in preparing and administering drugs. When asked if their undergraduate medical education had prepared them for prescribing in clinical practice, 28% of respondents agreed. Confidence that their undergraduate education had prepared them was associated with receiving formal training in prescribing skills (P = 0.0045; 27% vs. 0%). Thirty‐seven per cent of respondents agreed that they felt stressed about prescribing medications.ConclusionThis survey of newly qualified doctors in Ireland found that only 28% of respondents agreed that their undergraduate medical education had prepared them for prescribing, which was comparable to a previous survey of UK medical students and graduates. Investigating confidence and preparedness for prescribing provides important insights for educators. Dedicated teaching of prescribing, with an emphasis on practical training and assessment, may help graduates to feel more prepared for the challenges of prescribing in the clinical setting.
Cobalt(II) Chloride Modifies the Phenotype of Macrophage Activation
Authors: Kumanto Mona , Paukkeri Erja‐Leena , Nieminen Riina , Moilanen Eeva 
Published: February 2017

AbstractCobalt (Co) is vital for cells in trace amounts, but excessive exposure to Co is possible due to surgical devices such as artificial metal‐on‐metal joints. Cobalt(II) chloride (CoCl2) has also been shown to imitate hypoxic conditions in cells by stabilizing the transcription factor hypoxia‐inducible factor‐1α (HIF‐1α). The purpose of this study was to investigate the possible immunomodulatory action of CoCl2 by investigating its effects on the expression of inflammatory genes in macrophages. The following factors were assessed: inducible nitric oxidase synthase (iNOS), nicotinamide adenine dinucleotide phosphate‐oxidase 2 (NOX2), interleukin‐6 (IL‐6), arginase‐1 and HIF‐1α. In the absence of exogenous cytokines, CoCl2 enhanced alternative (M2) macrophage activation as demonstrated by increased arginase‐1 expression, but had no direct effect on inflammatory factors associated with classical (M1) activation. Interestingly, in lipopolysaccharide (LPS)‐stimulated macrophages, CoCl2 modified the M1‐type activation profile by increasing iNOS expression and nitric oxide production and decreasing NOX2 and IL‐6. Also, CoCl2 increased HIF‐1α levels in unstimulated and LPS‐stimulated cells as expected. In conclusion, we showed that CoCl2 enhanced alternative (M2) activation in resting macrophages. In addition, CoCl2 was found to remodel the classical M1 phenotype of macrophage activation by changing the balance of iNOS, NOX2 and IL‐6.
Decrease in Long‐Chain Acylcarnitine Tissue Content Determines the Duration of and Correlates with the Cardioprotective Effect of Methyl‐GBB
Authors: Kuka Janis , Makrecka‐Kuka Marina , Cirule Helena , Grinberga Solveiga , Sevostjanovs Eduards , Dambrova Maija , Liepinsh Edgars 
Published: February 2017

AbstractIschaemia in the heart is accompanied by the accumulation of long‐chain acylcarnitines (LCACs) which is one of the multiple factors that contribute to the ischaemia–reperfusion damage development. Long‐term pre‐treatment that decreases carnitine and LCAC contents also reduces ischaemia–reperfusion (IR) damage; however, the duration of the post‐treatment effects is not known. The aim of the study was to assess the post‐treatment effects of the carnitine transport (OCTN2) inhibitor, methyl‐GBB, on LCAC content and the duration of its cardioprotective effect. Male Wistar rats received methyl‐GBB (5 mg/kg for 28 days), and the anti‐infarction effects on Langendorff‐perfused hearts and the acylcarnitine profile in cardiac tissues were measured up to 28 days following the end of the treatment. Methyl‐GBB pre‐treatment for 28 days decreased LCAC heart tissue content by 87%, and the infarct size was decreased by 57%. Fourteen days post‐treatment, the LCAC content was still decreased by 69%, and the infarct size was decreased by 32% compared to Control. A significant Pearson correlation (r = 0.48, p = 0.026) was found between infarct size and LCAC tissue content in the methyl‐GBB‐treated rat hearts. The addition of 2 mM carnitine to isolated heart perfusate significantly diminished the methyl‐GBB‐induced decrease in LCACs and infarct size. In conclusion, the anti‐infarction effect of methyl‐GBB continues for at least 2 weeks post‐treatment. No less than a 70% decrease in LCAC content is required to protect ischaemic heart tissues, and the decrease in LCAC levels defines the duration of the post‐treatment cardioprotective effect of the OCTN2 inhibitor, methyl‐GBB.
Risk and blood‐borne virus testing among men who inject image and performance enhancing drugs, Sydney, Australia
Authors: Rowe Rachel , Berger Israel , Yaseen Bilal , Copeland Jan 
Published: February 2017

AbstractIntroduction and AimsNeedle and syringe program (NSP) workers have highlighted that people who inject image and performance enhancing drugs (IPED) in Australia are a younger and more culturally and linguistically diverse (CALD) group compared with other groups who inject drugs. Previous research has found riskier injecting practices and faster Hepatitis C acquisition rates among people who are new to injecting drugs and self‐identify with CALD backgrounds, compared with their Anglo‐Australian counterparts. Given recent indications of increasing IPED prevalence in Australia and elsewhere, this study sought to update knowledge of infection risk among a large group of IPED injectors, as well as explore sub‐group differences.Design and MethodsA cross‐sectional survey of men who inject IPEDs was conducted from September 2014 to January 2015 at nine NSP sites, across five local health districts in Sydney, Australia.ResultsSix hundred and five people participated. Small proportions reported previous 12month needle or syringe sharing (2.3%), sharing vials (4.6%), injecting psychostimulants (5.1%) or personal needle or syringe reuse (5.2%). Participants from CALD backgrounds were more likely to report sharing needles or syringes (P = 0.004), and participants from Middle Eastern and North African backgrounds were less likely to have ever been tested for blood‐borne viruses, compared with Anglo‐Australian participants (P = 0.04).Discussion and ConclusionsThe findings show that some groups who inject IPEDs may be more vulnerable to blood‐borne virus transmission and/or less likely to know their blood‐borne virus status. From design to delivery, IPED harm minimisation strategies should pay attention to the needs of CALD groups.
Short‐ and long‐term mortality after bariatric surgery: A systematic review and meta‐analysis
Authors: Cardoso Luís , Rodrigues Dírcea , Gomes Leonor , Carrilho Francisco 
Published: February 2017

AimsThe objective of this study was to investigate short‐ (≤ 30 days) and long‐term (≥ 2 years) all‐cause mortality after bariatric surgery among adult patients with obesity.Materials and methodsFor short‐term mortality, eligible studies comprised randomized controlled trials (RCTs) reporting perioperative mortality. For long‐term mortality, eligible studies comprised RCTs and observational studies comparing mortality between obese patients after bariatric surgery and non‐operated controls. Random‐effects models using a Bayesian or frequentist approach were used to pool effect estimates of short‐ and long‐term mortality, respectively.ResultsShort‐term all‐cause mortality based on 38 RCTs involving 4030 patients was 0.18% (95% CI, 0.04%‐0.38%) and was higher for open surgeries (0.31%; 95% CI, 0.03%‐0.97%) and similar in mixed surgeries (0.17%; 95% CI, 0.03%‐0.43%) and restrictive surgeries (0.17%; 95% CI, 0.03%‐0.45%). For long‐term mortality, 12 observational studies involving 27 258 operated patients and 97 154 non‐operated obese controls were included. Of these, 8 studies were eligible for the meta‐analysis, which showed a reduction of 41% in all‐cause mortality (hazard ratio, 0.59; 95% CI, 0.52‐0.67; P < .001). Additionally, operated patients were 0.42 times as likely (95% CI, 0.25‐0.72, P < .001) and 0.47 times as likely (95% CI, 0.36‐0.63, P < .001) as non–operated obese controls to die from cardiovascular diseases and cancer, respectively.ConclusionsBariatric surgery is associated with low short‐term mortality and may be associated with long‐term reductions in all‐cause, cardiovascular and cancer‐related mortality.
Dapagliflozin improves insulin resistance and glucose intolerance in a novel transgenic rat model of chronic glucose overproduction and glucose toxicity
Authors: Joannides Christos N. , Mangiafico Salvatore P. , Waters Matthew F. , Lamont Benjamin J. , Andrikopoulos Sofianos 
Published: February 2017

AimTo determine whether the excretion of glucose improves insulin resistance, impaired insulin secretion or both.Materials and methodsAppropriate methods were used to assess insulin sensitivity (euglycaemic–hyperinsulinaemic clamp) and insulin secretion (hyperglycaemic clamp) in insulin‐resistant and hyperglycaemic phosphoenolpyruvate carboxykinase (PEPCK) transgenic rats after treatment with the sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor dapagliflozin.ResultsIn 14‐week‐old rats with hyperglycaemia, insulin resistance and glucose intolerance, 6 weeks of dapagliflozin treatment resulted in lower weight gain, plasma glucose and insulin levels, and improved glucose tolerance, associated with enhanced insulin sensitivity (rate of glucose disappearance: 51.6 ± 2.3 vs 110.6 ± 3.9 µmol/min/kg; P < .005) and glucose uptake in muscle (0.9 ± 0.1 vs 1.7 ± 0.3 µmol/min/100 g; P < .05) and fat (0.23 ± 0.04 vs 0.55 ± 0.10 µmol/min/100 g, P < .05). Additionally, adipose tissue GLUT4 protein levels were increased (0.78 ± 0.05 vs 1.20 ± 0.09 arbitrary units; P < .05), adipocyte count was higher (221.4 ± 17.7 vs 302.3 ± 21.7 per mm2 fat area; P < .05) and adipocyte size was reduced (4631.8 ± 351.5 vs 3397.6 ± 229.4 µm2, P < .05). There was no improvement, however, in insulin secretion. To determine whether earlier intervention is necessary, 5‐week‐old PEPCK transgenic rats were treated with dapagliflozin for 9 weeks and insulin secretion assessed. Dapagliflozin resulted in improved plasma glucose and insulin levels, and lower weight gain but, again, insulin secretion was not improved.ConclusionsIn this transgenic model of low‐grade chronic hyperglycaemia, SGLT2 inhibitor treatment resulted in reduced blood glucose and insulin levels and enhanced glucose tolerance, associated with improved muscle and fat insulin resistance but not improved insulin secretory function.
Effect of linagliptin on pulse wave velocity in early type 2 diabetes: A randomized, double‐blind, controlled 26‐week trial (RELEASE)
Authors: de Boer Stefanie A. , Heerspink Hiddo J. L. , Juárez Orozco Luis E. , van Roon Arie M. , Kamphuisen Pieter W. , Smit Andries J. , Slart Riemer H. J. A. , Lefrandt Joop D. , Mulder Douwe J. 
Published: February 2017

AimsTo evaluate the effects of the dipeptidyl peptidase‐4 (DPP‐4) inhibitor linagliptin on aortic pulse wave velocity (PWV) as a surrogate marker of arterial stiffness and early atherosclerosis in people with early type 2 diabetes.MethodsA total of 45 people with type 2 diabetes (median [interquartile range] age 63 [54‐66] years, 61% men, mean ± standard deviation glycated haemoglobin [HbA1c] 6.3% ± 0.4% [45 ± 4.6 mmol/mol]), without cardiovascular disease and naïve to antidiabetic treatment, were randomized (1:1) to treatment with linagliptin 5 mg once daily or placebo for 26 weeks in a double‐blind fashion. PWV was assessed at baseline, 4 and 26 weeks of treatment, and again at 30, 4 weeks after treatment. The primary endpoint was between‐group difference in PWV (corrected for systolic blood pressure [SBP]) at week 26. Secondary endpoints included differences in central SBP and augmentation index (AIx).ResultsCompared with placebo, 26 weeks of linagliptin decreased PWV by an average of 0.91 m/s (95% confidence interval −1.76 to −0.06; P = .035). PWV returned to baseline after 4 weeks washout. Differences in central SBP and AIx were not different between linagliptin and placebo. Linagliptin decreased HbA1c (−0.4%; P < .001), fasting plasma glucose (−0.7 mmol/L; P = .002) and triglycerides (−0.49 mmol/L; P = .019) as compared with placebo. The changes in body weight, cholesterol and high‐sensitivity C‐reactive protein did not differ between groups.ConclusionsLinagliptin decreased aortic PWV in people with early‐stage type 2 diabetes as compared with placebo after 26 weeks of treatment. These results suggest that linagliptin has a favourable effect on arterial stiffness.
Laser thermal ablation for mesiotemporal epilepsy: Analysis of ablation volumes and trajectories
Authors: Jermakowicz Walter J. , Kanner Andres M. , Sur Samir , Bermudez Christina , D'Haese Pierre‐Francois , Kolcun John Paul G. , Cajigas Iahn , Li Rui , Millan Carlos , Ribot Ramses , Serrano Enrique A. , Velez Naymee , Lowe Merredith R. , Rey Gustavo J. , Jagid Jonathan R. 
Published: February 2017

SummaryObjectiveTo identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE).MethodsClinical and radiographic data were reviewed from a prospectively maintained database of all patients undergoing LiTT for the treatment of mTLE at the University of Miami Hospital. Standard preoperative and postoperative evaluations, including contrast‐enhanced magnetic resonance imaging (MRI) and neuropsychological testing, were performed in all patients. Laser trajectory and ablation volumes were computed both by manual tracing of mesiotemporal structures and by nonrigid registration of ablation cavities to a common reference system based on 7T MRI data.ResultsAmong 23 patients with at least 1‐year follow‐up, 15 (65%) were free of disabling seizures since the time of their surgery. Sparing of the mesial hippocampal head was significantly correlated with persistent disabling seizures (p = 0.01). A lateral trajectory through the hippocampus showed a trend for poor seizure outcome (p = 0.08). A comparison of baseline and postoperative neurocognitive testing revealed areas of both improvement and worsening, which were not associated with ablation volume or trajectory.SignificanceAt 1‐year follow‐up, LiTT appears to be a safe and effective tool for the treatment of mTLE, although a longer follow‐up period is necessary to confirm these observations. Better understanding of the impact of ablation volume and location could potentially fine‐tune this technique to improve seizure‐freedom rates and associated neurologic and cognitive changes.
How fisher‐influenced marine closed areas contribute to ecosystem‐based management: A review and performance indicator scorecard
Authors: Kincaid Kate , Rose George , Devillers Rodolphe 
Published: February 2017

AbstractA rapid review of the literature on closed areas that recognize key ecosystem‐based management (EBM) principles of fisheries and biodiversity conservation and had fisher involvement was employed to review closed areas worldwide from a fisheries perspective and to develop a scorecard that can assess their efficacy. The review provided 523 abstracts of which 19 areas from various regions worldwide had peer‐reviewed studies that met strict selection criteria. Criteria included fisher involvement, biodiversity conservation and fisheries management objectives. A repeat search without “fisher” and synonyms found, 62,622 papers indicating that most closed area studies had no mention of any fisher involvement. The general success of the areas selected suggests that fisher involvement benefits both biological conservation and fisheries management. Fisheries and biodiversity conservation outcomes were not exclusive to any one type of management closure (e.g. MPA, Fishery Closure). Twenty‐four indicators were selected, designed to provide measurable targets. High scoring indicators included management, planning and socio‐economic indicators such as local support (100%), habitat protection (100%), conservation and fisheries objectives (100%), monitoring (91.7%) and fishers concerns (91.7%). Bio‐ecological‐based indicators scored lower in most cases for all types of areas. Fisheries closures rated as highly as the MPAs with respect to both fisheries and bio‐ecological indicators. The scorecard provided a reasonable means to evaluate management success in the light of often qualitative or missing data. Addressing the interests and utilizing knowledge of those affected by closures and familiar with the area, most often local fishers, is key to achieving management objectives.
Responses of belowground communities to large aboveground herbivores: Meta‐analysis reveals biome‐dependent patterns and critical research gaps
Authors: Andriuzzi Walter S. , Wall Diana H. 
Published: February 2017

AbstractThe importance of herbivore–plant and soil biota–plant interactions in terrestrial ecosystems is amply recognized, but the effects of aboveground herbivores on soil biota remain challenging to predict. To find global patterns in belowground responses to vertebrate herbivores, we performed a meta‐analysis of studies that had measured abundance or activity of soil organisms inside and outside field exclosures (areas that excluded herbivores). Responses were often controlled by climate, ecosystem type, and dominant herbivore identity. Soil microfauna and especially root‐feeding nematodes were negatively affected by herbivores in subarctic sites. In arid ecosystems, herbivore presence tended to reduce microbial biomass and nitrogen mineralization. Herbivores decreased soil respiration in subarctic ecosystems and increased it in temperate ecosystems, but had no net effect on microbial biomass or nitrogen mineralization in those ecosystems. Responses of soil fauna, microbial biomass, and nitrogen mineralization shifted from neutral to negative with increasing herbivore body size. Responses of animal decomposers tended to switch from negative to positive with increasing precipitation, but also differed among taxa, for instance Oribatida responded negatively to herbivores, whereas Collembola did not. Our findings imply that losses and gains of aboveground herbivores will interact with climate and land use changes, inducing functional shifts in soil communities. To conceptualize the mechanisms behind our findings and link them with previous theoretical frameworks, we propose two complementary approaches to predict soil biological responses to vertebrate herbivores, one focused on an herbivore body size gradient, and the other on a climate severity gradient. Major research gaps were revealed, with tropical biomes, protists, and soil macrofauna being especially overlooked.
Novel foam dressing using negative pressure wound therapy with instillation to remove thick exudate
Authors: Téot Luc , Boissiere Florian , Fluieraru Sergiu 
Published: February 2017

AbstractWe describe our experience with a novel foam dressing architecture in tandem with negative pressure wound therapy and instillation (NPWTi‐d) for removing viscous wound exudate and infectious materials. A retrospective review was conducted of the outcomes of 21 patients who received NPWTi‐d using a reticulated open cell foam instillation dressing with through holes (ROCF‐CC) designed to facilitate the removal of thick wound exudate and infectious materials. NPWTi‐d with ROCF‐CC was used to treat large complex chronic wounds with viscous wound exudate that contained substantial areas of devitalised tissue. Debridement was performed as appropriate or available. NPWTi‐d with ROCF‐CC assisted in loosening, solubilising and detaching viscous exudate, dry fibrin, wet slough and other infectious materials. Percent surface area of black non‐viable tissue and yellow fibrinous slough was reduced to ≤ 10% in 18/21 (85·7%) and 12/21 (57·1%) wounds, respectively, after an average of 1–3 applications (3–9 days) of NPWTi‐d with ROCF‐CC. Preliminary evidence suggests that adjunctive use of NPWTi‐d with ROCF‐CC may help clean large, complex wounds when complete surgical debridement is not possible or appropriate and/or when areas of slough and non‐viable tissue remain present on the wound surface.
Assessment of the Extravascular Implantable Defibrillator: Feasibility of Substernal Ventricular Pacing
Authors: BROUWER TOM F. , SMEDING LONNEKE , BERGER WOUTER R. , DRIESSEN ANTOINE H. G. , DE GROOT JORIS R. , WILDE ARTHUR A. M. , KNOPS REINOUD E. 
Published: February 2017

Substernal Pacing in HumansIntroductionThe objective of this study was to assess feasibility of ventricular pacing and thresholds from within the substernal space to examine a new extravascular ICD configuration with pacing capabilities.MethodsIn patients undergoing midline sternotomy, a duodecapolar diagnostic pacing catheter was positioned in the substernal space anterior to the pericardium, and a cutaneous patch in left lateral position. Different unipolar and bipolar pacing configurations were assessed. Strength‐duration curves were performed to identify the optimal output, starting at 25 mA with a pulse width of 10 milliseconds.ResultsEight patients with mean age 69 ± 9 years were included. In 5, ventricular capture was achieved in ≥1 configuration. The mean bipolar pacing thresholds at PW 10, 5, 3, 1 milliseconds were 12.4 ± 3.7 mA (5 patients), 13.3 ± 5.8 mA (3 patients), 18.3 ± 5.7 mA (3 patients), and 25 ± 0 mA (2 patients), respectively. The 60‐mm electrode spacing was the most successful bipolar configuration. Unipolar pacing was successful in 3 out of 4 patients with mean thresholds of 10 ± 0 mA at 10 milliseconds (3 patients), 15 ± 0 mA at 5 milliseconds (3 patients), 16.7 ± 2.9 mA at 3 milliseconds (3 patients), and 20 ± 7.1 mA at 1 milliseconds (2 patients).ConclusionVentricular pacing from the substernal space in patients with midline sternotomy is feasible. Closed sternum studies are needed to determine pacing thresholds more accurately.