bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drugs with anticholinergic effects and cognitive impairment, falls and all‐cause mortality in older adults: A systematic review and meta‐analysis
Authors: Ruxton Kimberley , Woodman Richard J. , Mangoni Arduino A. 
Published: March 2015

AimThe aim was to investigate associations between drugs with anticholinergic effects (DACEs) and cognitive impairment, falls and all‐cause mortality in older adults.MethodsA literature search using CINAHL, Cochrane Library, Embase and PubMed databases was conducted for randomized controlled trials, prospective and retrospective cohort and case‐control studies examining the use of DACEs in subjects ≥65 years with outcomes on falls, cognitive impairment and all‐cause mortality. Retrieved articles were published on or before June 2013. Anticholinergic exposure was investigated using drug class, DACE scoring systems (anticholinergic cognitive burden scale, ACB; anticholinergic drug scale, ADS; anticholinergic risk scale, ARS; anticholinergic component of the drug burden index, DBIAC) or assessment of individual DACEs. Meta‐analyses were performed to pool the results from individual studies.ResultsEighteen studies fulfilled the inclusion criteria (total 124 286 participants). Exposure to DACEs as a class was associated with increased odds of cognitive impairment (OR 1.45, 95% CI 1.16, 1.73). Olanzapine and trazodone were associated with increased odds and risk of falls (OR 2.16, 95% CI 1.05, 4.44; RR 1.79, 95% CI 1.60, 1.97, respectively), but amitriptyline, paroxetine and risperidone were not (RR 1.73, 95% CI 0.81, 2.65; RR 1.80, 95% CI 0.81, 2.79; RR 1.39, 95% CI 0.59, 3.26, respectively). A unit increase in the ACB scale was associated with a doubling in odds of all‐cause mortality (OR 2.06, 95% CI 1.82, 2.33) but there were no associations with the DBIAC (OR 0.88, 95% CI 0.55, 1.42) or the ARS (OR 3.56, 95% CI 0.29, 43.27).ConclusionsCertain individual DACEs or increased overall DACE exposure may increase the risks of cognitive impairment, falls and all‐cause mortality in older adults.
Third‐Generation Beta‐Adrenoceptor Antagonists in the Treatment of Hypertension and Heart Failure
Authors: Fisker Filip Y. , Grimm Daniela , Wehland Markus 
Published: March 2015

AbstractHypertensive treatment with beta‐adrenoceptor antagonists (BAAs) has been successfully applied for four decades. These drugs have a beneficial effect on the health of the patients by both decreasing number of deaths and improving morbidity. Nevertheless, the BAAs differ in pharmacological properties. They have different lipophilicity, different adrenoceptor selectivity and/or varying additional abilities in cardiac tissue and periphery vasculature hereby exceeding their known receptor‐blocking effects. Nebivolol shows nitric oxide‐mediated vasodilating properties that improve arterial rigidity. Carvedilol has anti‐oxidative and antiproliferative effects, which exert a beneficial effect on patients with chronic congestive heart failure (CHF). These findings suggest that the true potential of the third‐generation BAAs and their value in the treatment of CHF, hypertension and following cardiovascular events has yet to be acknowledged. This MiniReview provides an overview of the third‐generation BAAs and their effects on the vasculature of hypertensive patients and patients with CHF. Additionally, BAAs that potentially can be used in different patient groups are discussed.
Transformation of teacher practice using mobile technology with one‐to‐one classes: M‐learning pedagogical approaches
Authors: Lindsay Lucie 
Published: March 2015

AbstractThe rapid global uptake of mobile technology is reflected in pioneering New Zealand schools. Teachers of classes where each student uses a mobile device were surveyed on how frequently they use various mobile learning activities and asked to describe the new pedagogical opportunities it offers. The teachers' m‐learning pedagogical approaches and the extent of transformation were considered. This study finds the main use of mobile technology is to enhance learning with task activities and information access; however, innovative content production is also common. The opportunities for pedagogical transformation that collaborative learning offers appear to be partially realised, but the potential for situative learning using authentic contexts and experts seems to be largely unrealised. Presently, transformative pedagogical approaches are not prevalent despite collaborative inquiry and situative approaches with authentic contexts being linked to developing higher order thinking and fostering future focused skills, which are a key focus for educators. The use of one‐to‐one mobile technology in the classroom is a new educational practice with significant potential. This study provides a snapshot to contribute to building the necessary body of work on m‐learning pedagogical transformation.
The influence of paediatric HIV infection on circulating B cell subsets and CXCR5+ T helper cells
Authors: Bamford A , Hart M , Lyall H , Goldblatt D , Kelleher P , Kampmann B 
Published: March 2015

Summary
Antiretroviral therapy (ART) only partially restores HIV-induced alterations in lymphocyte populations. We assessed B and T cell phenotypes in a cohort of children from a single centre in the United Kingdom with perinatally acquired HIV compared to healthy controls. The majority of HIV infected children (44 of 56) were on fully suppressive combination ART. Children with perinatally acquired HIV had significantly lower memory B and CD4+CD45RO+CXCR5+ [follicular T helper cell (Tfh)-like] T cell percentages. Detectable viraemia was associated with higher CD21− (activated and exhausted/tissue-like memory) B cells. A greater proportion of life spent on suppressive ART was associated with higher memory B cell percentages. These results suggest that early and sustained suppressive ART may preserve B and T cell phenotypes in perinatally acquired HIV and limit deficits in humoral immunity. A lower proportion of circulating Tfh-like cells in HIV infected children appears to be independent of HIV treatment history and ongoing HIV viraemia and warrants further investigation.
Trophy hunters’ willingness to pay for wildlife conservation and community benefits
Authors: Fischer Anke , Tibebe Weldesemaet Yitbarek , Czajkowski Mikołaj , Tadie Degu , Hanley Nick 
Published: March 2015

AbstractIn the face of fundamental land‐use changes, the potential for trophy hunting to contribute to conservation is increasingly recognized. Trophy hunting can, for example, provide economic incentives to protect wildlife populations and their habitat, but empirical studies on these relationships are few and tend to focus on the effects of benefit‐sharing schemes from an ex post perspective. We investigated the conditions under which trophy hunting could facilitate wildlife conservation in Ethiopia ex ante. We used a choice experiment approach to survey international trophy hunters’ (n = 224) preferences for trips to Ethiopia, here operationalized as trade‐offs between different attributes of a hunting package, as expressed through choices with an associated willingness to pay. Participants expressed strong preferences and, consequently, were willing to pay substantial premiums for hunting trips to areas with abundant nontarget wildlife where domestic livestock was absent and for arrangements that offered benefit sharing with local communities. For example, within the range of percentages considered in the survey, respondents were on average willing to pay an additional $3900 for every 10 percentage points of the revenue being given to local communities. By contrast, respondents were less supportive of hunting revenue being retained by governmental bodies: Willingness to pay decreased by $1900 for every 10 percentage points of the revenue given to government. Hunters’ preferences for such attributes of hunting trips differed depending on the degree to which they declared an interest in Ethiopian culture, nature conservation, or believed Ethiopia to be politically unstable. Overall, respondents thus expressly valued the outcomes of nature conservation activities—the presence of wildlife in hunting areas—and they were willing to pay for them. Our findings highlight the usefulness of insights from choice modeling for the design of wildlife management and conservation policies and suggest that trophy hunting in Ethiopia could generate substantially more financial support for conservation and be more in line with conservation objectives than is currently the case.
Effects of neurotrophin receptor‐mediated MAGE homology on proliferation and odontoblastic differentiation of mouse dental pulp cells
Authors: Qi S. , Wu Q. , Ma J. , Li J. , Chen F. , Xu Y. , Pan Q. , Wang R. 
Published: March 2015

AbstractObjectivesThis study aimed to investigate effects of neurotrophin receptor‐mediated melanoma antigen‐encoding gene homology (NRAGE) on proliferation and odontoblastic differentiation of mouse dental pulp cells (mDPCs).Materials and methodsMouse dental pulp cells were infected with recombinant lentivirus to stably knockdown expression of NRAGE, and biological effects of NRAGE on the cells were detected. Proliferation and odontoblastic differentiation of mDPCs were observed. Simultaneously, mRNA and protein levels of NRAGE and nuclear factor‐κB (NF‐κB) protein expression were detected. Immunofluorescence assay was used to detect expression and location of NRAGE and NF‐κB.ResultsNRAGE mRNA and protein levels reduced significantly after mDPC odontoblastic induction. Knockdown of NRAGE inhibited the proliferation of mDPCs. However, knockdown of NRAGE enhanced their odontoblastic differentiation with up‐regulated ALPase activity. It also promoted mineral nodule formation as well as mRNA and protein expressions of ALP, DSPP and DMP1. Protein levels of NF‐κB/p50 significantly increased, whereas NF‐κB/p105 protein expression decreased in the mDPC/shNRG group. Immunofluorescence revealed that relocation of NF‐κB was similar to that of NRAGE during odontoblastic induction, in which NF‐κB translocated from the cytoplasm to the nucleus.ConclusionNRAGE is a potent regulator of proliferation and odontoblastic differentiation of mDPCs, which might be via the NF‐κB signalling pathway.
Efficacy and safety of beloranib for weight loss in obese adults: a randomized controlled trial
Authors: Kim D. D. , Krishnarajah J. , Lillioja S. , de Looze F. , Marjason J. , Proietto J. , Shakib S. , Stuckey B. G. A. , Vath J. E. , Hughes T. E. 
Published: March 2015

AimTo assess the efficacy, safety and tolerability of beloranib treatment for obesity.MethodsThis phase II, double‐blind, randomized study investigated the effects of beloranib suspension (0.6, 1.2 and 2.4 mg) or placebo, administered subcutaneously, for 12 weeks in 147 participants (primarily white women) with obesity. No diet or exercise advice was administered.ResultsAt week 12, beloranib resulted in dose‐dependent progressive weight loss of −5.5 ± 0.5, −6.9 ± 0.6 and −10.9 ± 1.1 kg for the 0.6, 1.2 and 2.4 mg beloranib doses, respectively, compared with −0.4 ± 0.4 kg with placebo (all p < 0.0001 vs placebo). Weight loss with beloranib was associated with corresponding reductions in waist circumference and body fat mass, as well as improvements in lipids, high‐sensitivity C‐reactive protein and blood pressure. Sleep disturbance and gastrointestinal adverse events were more common with beloranib than with placebo; these were generally mild to moderate, transient and dose‐related, and led to more early study withdrawals in participants in the group with the highest dose of beloranib.ConclusionsIn this 12‐week phase II study, beloranib produced clinically and statistically significant weight loss and corresponding improvements in cardiometabolic risk factors. Beloranib appeared safe, and the 0.6 and 1.2 mg doses were generally well tolerated. The 2.4 mg dose was associated with increased sleep latency and mild to moderate gastrointestinal adverse events over the first month of treatment. These findings represent a novel mechanism for producing clinically meaningful weight loss.
Endodontic management of immature teeth with spontaneous apical closure and periapical lesions: case series and review of the literature
Authors: Çalışkan Mehmet Kemal , Kaval Mehmet Emin 
Published: March 2015

AbstractSpontaneous apical closure in non‐vital immature teeth has been rarely encountered and outcome of non‐surgical endodontic treatment of related teeth associated with periapical lesions has not yet been adequately elucidated. The aim of this article was to report endodontic management of spontaneous apical closure of infected untreated immature teeth with periapical lesions and to review previously proposed mechanisms for the development of spontaneous hard tissue barrier. Three patients were referred at different time intervals to the endodontic clinic for treatment of their maxillary anterior incisors with acute or chronic apical periodontitis. Dental histories indicated that related teeth had been subjected to trauma approximately 12–18 years previously. Radiographically, the involved teeth exhibited incomplete root formation with spontaneous apical closure and were associated with an apical radiolucency. After biomechanical preparation, calcium hydroxide paste was applied and was changed once or twice within 3 months. All canals were then filled with gutta‐percha and AH Plus and the follow‐up period was 16–50 months; both clinical and radiographic examinations revealed adequate function, the absence of clinical symptoms and significant healing of the periapical radiolucency.
A conceptual framework for studying the strength of plant–animal mutualistic interactions
Authors: Vázquez Diego P. , Ramos‐Jiliberto Rodrigo , Urbani Pasquinell , Valdovinos Fernanda S. 
Published: March 2015

AbstractThe strength of species interactions influences strongly the structure and dynamics of ecological systems. Thus, quantifying such strength is crucial to understand how species interactions shape communities and ecosystems. Although the concepts and measurement of interaction strength in food webs have received much attention, there has been comparatively little progress in the context of mutualism. We propose a conceptual scheme for studying the strength of plant–animal mutualistic interactions. We first review the interaction strength concepts developed for food webs, and explore how these concepts have been applied to mutualistic interactions. We then outline and explain a conceptual framework for defining ecological effects in plant–animal mutualisms. We give recommendations for measuring interaction strength from data collected in field studies based on a proposed approach for the assessment of interaction strength in plant–animal mutualisms. This approach is conceptually integrative and methodologically feasible, as it focuses on two key variables usually measured in field studies: the frequency of interactions and the fitness components influenced by the interactions.
Prevalence and correlates of functional dependence among maintenance dialysis patients
Authors: Kavanagh Niall T. , Schiller Brigitte , Saxena Anjali B. , Thomas I‐Chun , Kurella Tamura Manjula 
Published: March 2015

AbstractFunctional dependence is an important determinant of longevity and quality of life. The purpose of the current study was to determine the prevalence and correlates of functional dependence among patients with end‐stage renal disease (ESRD) receiving maintenance dialysis. We enrolled 148 participants with ESRD from five clinics. Functional status, as measured by basic and instrumental activities of daily living (ADL, IADL), was ascertained by validated questionnaires. Functional dependence was defined as needing assistance in at least one of seven IADLs or at least one of four ADLs. Demographic characteristics, chronic health conditions, anthropometric measurements, and laboratories were assessed by a combination of self‐report and chart review. Cognitive function was assessed with a neurocognitive battery, and depressive symptoms were assessed by questionnaire. Mean age of the sample was 56.2 ± 14.6 years. Eighty‐seven participants (58.8%) demonstrated dependence in ADLs or IADLs, 70 (47.2%) exhibited IADL dependence alone, and 17 (11.5%) exhibited combined IADL and ADL dependence. In a multivariable‐adjusted model, stroke, cognitive impairment, and higher systolic blood pressure were independent correlates of functional dependence. We found no significant association between demographic characteristics, chronic health conditions, depressive symptoms or laboratory measurements, and functional dependence. Impairment in executive function was more strongly associated with functional dependence than memory impairment. Functional dependence is common among ESRD patients and independently associated with stroke, systolic blood pressure, and executive function impairment.
An unusual cause of postdialysis dyspnea: Percutaneous endovascular management
Authors: Patidar Yashwant , Yadav Taruna , Rajesh S , Lata Suman , Kumar Sachin , Mukund Amar 
Published: March 2015

AbstractVascular access through femoral vein is commonly used for hemodialysis treatment in patients with end‐stage renal disease. Consequently, iatrogenic complications, such as femoral arteriovenous fistula, are increasingly being reported in these patients. Percutaneous endovascular management of such iatrogenic arteriovenous fistulas with stent graft placement is a minimally invasive technique with decreased morbidity and hospital stay compared with surgical repair. Here, we report a case with postcatheterization arteriovenous fistula between superficial femoral artery and femoral vein which was successfully managed with a placement of a self‐expanding stent graft.
Morphometric and histological parameters in veins of diabetic patients undergoing brachiocephalic fistula placement
Authors: Lazich Ivana , Chang Anthony , Watson Sydeaka , Dhar Promila , Madhurapantula Rama S. , Hammes Mary 
Published: March 2015

AbstractDiabetic patients with end‐stage renal failure have higher rates of arteriovenous failures when compared with nondiabetics. The aim was to compare differences in indicators of vascular remodeling and endothelial dysfunction in veins of patients with or without diabetes at the time of surgical placement. In this prospective observational trial, vein samples were collected from patients when a brachiocephalic fistula was created. Morphometric measurements and extent of fibrosis were determined using Image J software. Histological analysis, for the presence of myofibroblasts and level of endothelial nitric oxide synthase, was performed by immunohistochemical staining and scored in semi‐quantitative manner. Asymmetric dimethylarginine was determined at the time of access placement. Comparison of diabetics and nondiabetics was performed using Wilcoxon rank sum and Fisher's exact tests. Eighteen patients were included; 10 were diabetics. There was a significant difference in the measurement of vein area between groups, with diabetic vein samples having larger luminal area of average 832,001.18 μm2 (317,582.17–3,695,670.36, P = 0.04). The maximal intimal to medial thickness ratio was higher in diabetic vein samples (0.71 vs. 0.24, P = 0.03) along with statistically significant higher maximal intimal thickness (312.12 vs. 115.14 μm, P = 0.03). There is a significant difference in vascular wall remodeling between diabetics and nondiabetics at the level of the cephalic vein at the time of brachiocephalic placement. The unexpected finding of significantly larger luminal area in diabetic veins could be a major factor positively affecting brachiocephalic outcomes in otherwise impaired remodeling in this patient population.
Reappraisal of shunt surgery for extrahepatic portal vein obstruction in adults: Report of a single‐center case series
Authors: Kokudo Takashi , Bonard Estelle , Gillet Michel , Kokudo Norihiro , Halkic Nermin 
Published: March 2015

AimExtrahepatic portal venous obstruction (EHPVO) is a relatively rare disease in adults. The clinical significance of shunt surgery for EHPVO in adult cases remains unclear.MethodsWe retrospectively analyzed the patient characteristics and the results of shunt surgery in 13 adult cases of EHPVO treated between March 1995 and March 2013 at a tertiary care hospital in Switzerland. The indication for shunt surgery was recurrent bleeding after endoscopic treatment. To update the outcomes of shunt surgery in adult cases of EHPVO, we performed a systematic review of published work to examine this issue.ResultsThe mean age of the 13 patients in the present case series was 41.8 years (range, 20–68), and the mean follow‐up duration after surgery was 4.4 years (range, 1–16). The types of shunt surgery performed were mesocaval shunt (n = 8), portacaval shunt (n = 2), splenorenal shunt (n = 1) and mesorenal shunt (n = 2). Two patients (15%) developed postoperative rebleeding, which was successfully treated by endoscopic treatment. None of the patients developed postoperative hepatic encephalopathy. No operative‐related deaths occurred in this series. Six studies, including our own, were identified in the published work. The overall mortality rate was 0–3.7%, and no cases of encephalopathy were observed. The rebleeding rate ranged 2.5–23%.ConclusionShunt surgery for EHPVO in adults after the failure of endoscopic treatment is feasible, with acceptable outcomes at specialized centers. This surgical procedure should always be taken into consideration when managing adult cases of EHPVO.
Prospects for improving outcomes in systemic sclerosis‐related pulmonary hypertension
Authors: Thakkar V. , Nikpour M. , Stevens W. M. , Proudman S. M. 
Published: March 2015

AbstractPulmonary arterial hypertension (PAH) is a leading cause of morbidity and mortality in patients with systemic sclerosis (SSc). Approximately one in 10 will develop PAH during their lifetime. These patients have a worse prognosis than those with PAH due to other causes. The most common clinical feature of SSc‐PAH in the early stages is non‐specific exercise intolerance that can be erroneously attributed to other manifestations of SSc. Screening provides an opportunity for early identification of SSc‐PAH and prompt initiation of therapies with the potential to improve quality of life and survival. International guidelines recommend annual transthoracic Doppler echocardiography (TTE), but TTE has limitations. The tricuspid regurgitant jet required for estimating the systolic pulmonary artery pressure is absent in up to 39% of patients, including a proportion with PAH. This has prompted a move to new screening algorithms that are less dependent on TTE. Not all pulmonary hypertension (PH) in patients with SSc is PAH. Other causes include PH secondary to left heart disease, interstitial lung disease‐related PH, chronic thromboembolic PH and pulmonary veno‐occlusive disease. With the advent of evidence‐based therapies, including newer agents such as macitentan, riociguat and selexipag, the establishment of centres with expertise in PAH and the focus on early detection, there has been considerable improvement in survival. The role of anti‐coagulation for SSc‐PAH has been the subject of a recent meta‐analysis of nine observational studies that suggests it may confer a survival benefit, but to date, there have been no randomised controlled trials to confirm this.
Physicians need to take the lead in deprescribing
Authors: Scott I. A. , Le Couteur D. G. 
Published: March 2015

AbstractInappropriate polypharmacy and its associated harm pose a significant threat to older patients. The prescribing decisions of physicians greatly influence what other practitioners prescribe. Minimising medication‐related harm requires physicians to adopt a systematic approach to the deliberate and judicious deprescribing of potentially inappropriate medicines in at‐risk individuals.