bluuebunny/crossref_metadata_2025_split huggingface dataset:
OP89 Challenges in Managing Multimorbid Patients: A Meta-Ethnography of the GPS Perspective
Authors: Sinnott C , Hugh S Mc , Browne J , Bradley C P 
Published: September 2013

BackgroundMultimorbidity refers to the co-existence of two or more long-term conditions in an individual patient, and is the norm amongst patients attending primary care for chronic disease management. Qualitative research shows that GP’s experience challenges in the management of patients with multimorbidity, which are not experienced in the management of single chronic diseases. However, it is unclear how the challenges revealed by individual studies relate to each other and the overall problem of managing multimorbidity. The aim of this study was to establish the overarching challenges faced by GPs in the management of multimorbid patients, by systematically reviewing and synthesising the published literature in this field.MethodsA systematic literature search and synthesis was performed using the meta-ethnographic approach described by Noblit and Hare. This 7 step model involves a process of comparison and cross-interpretation between studies but allows the context of the primary data to be preserved.ResultsThe initial search yielded 1805 potential papers. Following screening, 10 papers were included in the review. Four overarching concepts emerged from these papers: 1) Organisation & Fragmentation of Health Care, 2) Conflict with evidence based medicine 3) Delivering patient centred care 4) Challenges in Shared Decision Making. Subthemes developed within the core concepts, and many cases of contradictory opinions were seen. By translating individual studies to the key concepts higher order interpretations were developed and a ‘line of argument’ was drawn. The line of argument pointed to GP’s sense of isolation in decision making for patients with multimorbidity.DiscussionThis systematic review and qualitative synthesis has generated a fuller understanding of the difficulties in managing multimorbidity than would be possible from a single study. It has generated novel findings, most strikingly that GPs feel professionally isolated when making decisions for multimorbid patients. Further research is required to explore the reasons for this in order to design interventions that may help GPs in this regard.
OP09 Prescribing of Nicotine Replacement Therapy in and Around Pregnancy in the UK – A Population Based Study using Primary Care Data
Authors: Dhalwani N N , Tata L J , Coleman T , Szatkowski L 
Published: September 2013

BackgroundSmoking in pregnancy increases the risk of foetal and maternal problems; therefore reducing smoking in pregnancy is a public health priority. In 2005, licensing arrangements for nicotine replacement therapy (NRT) in the United Kingdom were broadened such that NRT could be prescribed to pregnant smokers. However, little is known about trends and uptake of NRT by pregnant women. We aimed to quantify annual trends of NRT uptake in and around pregnancy and variation in prescribing by maternal characteristics.MethodsIn The Health Improvement Network primary care database we identified all pregnancies from 2000 to 2010 in women aged 15–49 years and used READ codes to determine women’s smoking status. NRT prescriptions were identified in all women during three time periods: up to 9 months before conception, during pregnancy, and up to 9 months after delivery. Annual proportions of pregnancies where NRT was prescribed were calculated and variations by age and socio-economic deprivation were assessed using logistic regression.ResultsWomen were classified as smokers in 19% of 227,552 pregnancies identified in 215,703 women. NRT was prescribed in 4,827 of all pregnancies which represented a prescribing prevalence of 9% of pregnancies in smokers and 2% of pregnancies overall. The rate of NRT prescribing was approximately 50% lower 9 months before and after pregnancy, compared to during pregnancy. There was a gradual increase in the annual rate of prescribing until 2005, after which the rate became stable. The rate of prescribing during pregnancy in smokers was higher in older age groups such that the rate in 30–35 years age group was 17% higher (95% CI 1.05, 1.31) and the rate in 15–20 year age group was 4% lower (0.85, 1.08) than the rate of prescribing in the 25–30 year age group. The rate of prescribing during pregnancy in smokers also increased with deprivation such that it was 34% (1.16, 1.54) higher in the most deprived group than in the least deprived group. Pregnant smokers with asthma and mental illness were 22% (1.11, 1.34) and (1.38, 1.58) more likely to receive a prescription for NRT respectively as compared to pregnant smokers without these comorbidities.ConclusionUptake of NRT is higher during pregnancy compared to time periods outside pregnancy and is higher in smokers from older and more socio-economically deprived groups.
OP94 Bias in Consent to Health Data Linkage: Evidence from a UK Cross-Sectional Survey
Authors: Patterson L , Cruise S M , O’Reilly D 
Published: September 2013

BackgroundThe linkage of data from representative population surveys to routine administrative data sources is a powerful and efficient way of turning a cross-sectional study into a longitudinal one that obviates responder burden and bias, and simplifies issues of temporality. However, linkage depends on individual consent and while the factors influencing survey response are well described much less is known about factors influencing consent for record linkage. The aims of this study were to examine the demographic, socioeconomic, health and lifestyle factors associated with consent to linkage to personal medical records within wave 1 of Understanding Society. Wave 1 was conducted between January 2009 and December 2010 and had an overall household response rate of 57.6% and an individual response rate of 81.8% (all general population sample estimates).MethodsAll survey respondents were provided with an information leaflet about the linkage of health data and were asked to read and sign a consent form (main outcome). The analysis herein included individuals aged 16-74 years (n = 47,367). After removing proxy respondents and those with missing data the final dataset included 43,709 individuals. Univariate and multivariate multi-level logistic regression models were used to investigate demographic, socioeconomic, health and lifestyle factors associated with consent to linkage.ResultsOverall, 68.6% (30,003/43,709) of respondents agreed to data linkage. Consent to linkage was lower at older ages, but there was no variation according to sex; those who were married/divorced were slightly more likely to consent (Adjusted Odds Ratio (AOR) 1.13 [95% CI 1.06, 1.25]) as were those of white ethnicity (1.61 [1.52, 1.71]). Individuals with a limiting and long term illness had slightly higher consent rates (1.11 [1.06, 1.16]). Regional variation in consent emerged, with respondents from Scotland 17% more likely, than those from England, to consent to linkage (1.17 [1.07, 1.29]) with individuals from Northern Ireland 44% less likely to consent (0.56 [0.50, 0.63]).ConclusionThere are important differences in the factors influencing response to an initial survey and subsequent consent to data linkage. An unexpected finding was the regional variation in consent rates, particularly the higher uptake in Scotland. More research is needed to understand if these variations reflect general mistrust, lack of understanding or factors related to interviewer perception.
OP96 Applying Missing Data Methods to Routine Data: A Prospective Population-Based Register of People with Diabetes
Authors: Read S H , Lewis S , Wild S 
Published: September 2013

BackgroundResearch using data from large population-based datasets is often hindered by the presence of non-trivial proportions of missing data. Numerous approaches for handling missing data are available, each of which make important assumptions regarding the mechanism by which the missing data occurred. Using a 2008 extract of the Scottish Care Information-Diabetes Collaboration (SCI-DC), a population-based register of patients with diabetes data, we compared the use of four methods for handling missing patient BMI data in a retrospective cohort study of the association between body mass index (BMI) at date of diagnosis of diabetes and all-cause mortality in patients with Type 2 diabetes.MethodsThe appropriateness of selected missing data approaches were investigated by assessment of the likely missing data mechanism. Descriptive analyses and logistic regression were used to investigate whether there were differences in characteristics between people with BMI data available (n = 99,472) and those without BMI data available (n = 117,007). Complete case analysis (CCA), population-mean imputation, stochastic imputation and multiple imputation (MI) methods were applied to deal with missing data in the BMI variable. Cox proportional hazard model coefficients for the association between BMI and all-cause mortality were compared for each missing data method.ResultsThere were 41,555 deaths among the diabetes cohort between 2001 and 2008. Patients with missing BMI were considerably more likely to have an earlier year of diagnosis (OR before 1995 vs. After 2004 60.29 [95% CI 57.23, 63.51]) and be ‘Never’ smokers (Never vs. Ever 1.08 [1.06, 1.10]). Depending on the missing data method used, a U- or J-shaped relationship between patient BMI and all-cause mortality was observed amongst patients with diabetes. Results from CCA and MI were largely dissimilar amongst patients with a BMI 20 to <25 kg/m2(CCA HR 1.25 [1.17, 1.33] vs. MI HR 1.01 [0.97, 1.06]). Similarly, MI attenuated the excess mortality observed amongst patients with a BMI of 40 to <45 kg/m2(CCA HR 1.35 [1.20, 1.52] vs. MI HR 1.09 [1.01, 1.18]).ConclusionStudies using routinely collected data are particularly susceptible to missing data. Initial analyses suggest that the choice of imputation method may strongly influence final model estimates and therefore a study’s conclusions. The selection of methods for handling missing data should be guided by careful preliminary analyses which investigate the most plausible mechanism of missingness.
Interaction of Fatty Acid Genotype and Diet on Changes in Colonic Fatty Acids in a Mediterranean Diet Intervention Study
Authors: Porenta Shannon R. , Ko Yi-An , Raskin Leon , Gruber Stephen B. , Mukherjee Bhramar , Baylin Ana , Ren Jianwei , Djuric Zora 
Published: September 2013

Abstract
A Mediterranean diet increases intakes of n-3 and n-9 fatty acids and lowers intake of n-6 fatty acids. This can impact colon cancer risk as n-6 fatty acids are metabolized to proinflammatory eicosanoids. The purpose of this study was to evaluate interactions of polymorphisms in the fatty acid desaturase (FADS) genes, FADS1 and FADS2, and changes in diet on fatty acid concentrations in serum and colon. A total of 108 individuals at increased risk of colon cancer were randomized to either a Mediterranean or a Healthy Eating diet. Fatty acids were measured in both serum and colonic mucosa at baseline and after six months. Each individual was genotyped for four single-nucleotide polymorphisms in the FADS gene cluster. Linear regression was used to evaluate the effects of diet, genotype, and the diet by genotype interaction on fatty acid concentrations in serum and colon. Genetic variation in the FADS genes was strongly associated with baseline serum arachidonic acid (n-6) but serum eicosapentaenoic acid (n-3) and colonic fatty acid concentrations were not significantly associated with genotype. After intervention, there was a significant diet by genotype interaction for arachidonic acid concentrations in colon. Subjects who had all major alleles for FADS1/2 and were following a Mediterranean diet had 16% lower arachidonic acid concentrations in the colon after six months of intervention than subjects following the Healthy Eating diet. These results indicate that FADS genotype could modify the effects of changes in dietary fat intakes on arachidonic acid concentrations in the colon. Cancer Prev Res; 6(11); 1212–21. ©2013 AACR.
A review of the genus Eriocheir De Haan, 1835 and related genera, with the description of a new genus and a new species (Brachyura, Grapsoidea, Varunidae)
Authors: Sakai Katsushi 
Published: September 2013

Mitten crabs (Brachyura, Varunidae, Varuninae) are currently classified into six species belonging to three genera: Eriocheir De Haan, 1835, Neoeriocheir T. Sakai, 1983, and Platyeriocheir Ng, Guo & Ng, 1999, i.e., Eriocheir japonica (De Haan, 1835), E. hepuensis Dai, 1991, E. ogasawaraensis Komai, Yamasaki, Kobayashi, Yamamoto & Watanabe, 2006, and E. sinensis H. Milne Edwards, 1853; Neoeriocheir leptognatha (Rathbun, 1913); and Platyeriocheir formosa (Chan, Hung & Yu, 1995). The results of the present study, however, indicate a reclassification into four genera including one new genus, together lodging seven species, including one new species, and with an eighth currently nameless species remaining as a species inquirenda, as follows: Eriocheir De Haan, 1835, with E. japonica (De Haan, 1835) and E. ogasawaraensis Komai et al., 2006; Paraeriocheir gen. nov., with P. hepuensis (Dai, 1991) and P. sinensis (H. Milne Edwards, 1853); Platyeriocheir Ng et al., 1999, with P. formosa (Chan et al., 1995) and P. guangdonga sp. nov.; and Neoeriocheir T. Sakai, 1983, with N. leptognatha (Rathbun, 1913); under the prevailing circumstances, the species now indicated as Eriocheir sp. [= Eriocheir recta sensu Stimpson, 1858] is to be considered a species inquirenda.
Do studies of functional groups give more insight to amphipod biodiversity?
Authors: Scipione M. Beatrice 
Published: September 2013

Amphipod crustaceans are able to colonise different micro-habitats of coastal marine benthos due to a multiplicity of trophic and morpho-functional adaptations, and may be considered a key taxon in describing the structure of assemblages. Literature concerning amphipod feeding behaviour and way of life showed that studies on functional groups (FGs) started only in the 1980s. A short review about the state of the art of the knowledge is presented here. Aiming at investigating the functional role of amphipods and to ascertain to what extent their adaptations could be a response to different biotic and abiotic conditions, some examples of studies conducted in the Mediterranean Sea on various plant substrata (Posidonia oceanica, Cymodocea nodosa, Zostera marina, Caulerpa racemosa var. cylindracea), at different spatial and temporal scales, were given. Despite many doubts about some species, due to the lack of information and their opportunistic behaviour, the identified taxa were grouped in the main categories of suspension feeders, deposit feeders, carnivores, commensals, herbivores, plant detritus feeders, omnivores, and in the mixed categories of deposit-suspension feeders, deposit feeders-carnivores, herbivores-deposit feeders, according to the food ingested and their feeding strategies; and, according to their life-habits, in epifaunal free-living and domicolous, and infaunal free-burrowing and tube-building. FGs might be considered good descriptors of zonation patterns, mainly against gradients such as depth, where strong environmental factors play a role. FG composition was differentiated according to the structural complexity and the stability of the host plant. Changes observed on a long-term scale, due to regression phenomena in P. oceanica meadows or to the spread of the invasive species C. racemosa var. cylindracea, were well described by FGs. In the first case the trophic diversity was maintained and in the latter the lack of herbivorous forms pointed out the poor role as structuring plant of the seaweed. Although caution is suggested in studies on FGs, they can give further insight in comprehending structural and functional processes in amphipod ecology.
Structure and diversity of the lobster community on the Amazon continental shelf
Authors: Silva K. C. A. , Cruz R. , Cintra I. H. A. , Abrunhosa F. A. 
Published: September 2013

The present study analyses the diversity and community structure of the lobsters captured using bottom trawl shrimp nets at depths of 41 to 626 m during fishery prospection cruises conducted between 1996 and 1998. The study area encompasses the coasts of the Brazilian states of Amapá and Pará, which were divided into two sectors, to the north and to south of Cape North. The 44 lobster specimens identified belonged to nine species: Acanthacaris caeca (A. Milne-Edwards, 1881), Nephropsis aculeata Smith, 1881, Nephropsis rosea Bate, 1888, Palinustus truncatus A. Milne-Edwards, 1880, Panulirus argus (Latreille, 1804), Parribacus antarcticus (Lund, 1793), Polycheles typhlops Heller, 1862, Scyllarides delfosi Holthuis, 1960 and Stereomastis sculpta (Smith, 1880). The specimens were captured preferentially on muddy sand substrates in the northern sector and gravelly and muddy sand in the southern sector. All species were more common in the northern sector during the dry season (June-November), and in the southern sector in the rainy season (December-May).
Extreme Rapid Intensification of Typhoon Vicente (2012) in the South China Sea
Authors: Shieh Owen H. , Fiorino Michael , Kucas Matthew E. , Wang Bin 
Published: September 2013

Abstract
One of the primary challenges for both tropical cyclone (TC) research and forecasting is the problem of intensity change. Accurately forecasting TC rapid intensification (RI) is particularly important to interests along coastlines and shipping routes, which are vulnerable to storm surge and heavy seas induced by intense tropical cyclones. One particular RI event in the western North Pacific Ocean with important scientific implications is the explosive deepening of Typhoon Vicente (2012). Vicente underwent extreme RI in the northern South China Sea just prior to landfall west of Hong Kong, China, with maximum sustained winds increasing from 50 kt (1 kt = 0.51 m s−1) at 0000 UTC 23 July to 115 kt at 1500 UTC 23 July. This increase of 65 kt in 15 h far exceeds established thresholds for TC RI. Just prior to this RI episode, Vicente exhibited a near-90° poleward track shift. The relationship between the track and intensity change is described, and the authors speculate that the passage of an upper-tropospheric (UT) “inverted” trough was a significant influence. An analysis of real-time numerical model guidance is provided and is discussed from an operational perspective, and high-resolution global model analyses are evaluated. Numerical model forecasts of the UT trough interaction with the TC circulation were determined to be a shortcoming that contributed to the intensity prediction errors for Vicente. This case study discusses the importance of considering UT features in TC intensity forecasting and establishes current modeling capabilities for future research.
Restoration of angiogenic capacity of diabetes-insulted mesenchymal stem cells by oxytocin
Authors: Kim Yong Sook , Kwon Jin Sook , Hong Moon Hwa , Kang Wan Seok , Jeong Hye-yun , Kang Hye-jin , Jeong Myung Ho , Ahn Youngkeun 
Published: September 2013

Abstract

Background
Angiogenesis is the main therapeutic mechanism of cell therapy for cardiovascular diseases, but diabetes is reported to reduce the function and number of progenitor cells. Therefore, we studied the effect of streptozotocin-induced diabetes on the bone marrow-mesenchymal stem cell (MSC) function, and examined whether diabetes-impaired MSC could be rescued by pretreatment with oxytocin.

Results
MSCs were isolated and cultured from diabetic (DM) or non-diabetic (non-DM) rat, and proliferation rate was compared. DM-MSC was pretreated with oxytocin and compared with non-DM-MSC. Angiogenic capacity was estimated by tube formation and Matrigel plug assay, and therapeutic efficacy was studied in rat myocardial infarction (MI) model.
The proliferation and angiogenic activity of DM-MSC were severely impaired but significantly improved by pretreatment with oxytocin. Krüppel-like factor 2 (KLF2), a critical angiogenic factor, was dramatically reduced in DM-MSC and significantly restored by oxytocin. In the Matrigel plug assay, vessel formation of DM-BMSCs was attenuated but was recovered by oxytocin. In rat MI model, DM-MSC injection did not ameliorate cardiac injury, whereas oxytocin-pretreated DM-MSC improved cardiac function and reduced fibrosis.

Conclusions
Our results show that diabetes influenced MSC by reducing angiogenic capacity and therapeutic potential. We demonstrate the striking effect of oxytocin on stem cell dysfunction and suggest the use of oxytocin as a priming reagent in autologous stem cell therapy.
Expansion of ruminant-specific microRNAs shapes target gene expression divergence between ruminant and non-ruminant species
Authors: Bao Hua , Kommadath Arun , Sun Xu , Meng Yan , Arantes Adriano S , Plastow Graham S , Guan Le Luo , Stothard Paul 
Published: September 2013

Abstract

Background
Understanding how species-specific microRNAs (miRNAs) contribute to species-specific phenotypes is a central topic in biology. This study aimed to elucidate the role of ruminant-specific miRNAs in shaping mRNA expression divergence between ruminant and non-ruminant species.

Results
We analyzed miRNA and mRNA transcriptomes generated by Illumina sequencing from whole blood samples of cattle and a closely related non-ruminant species, pig. We found evidence of expansion of cattle-specific miRNAs by analyzing miRNA conservation among 57 vertebrate species. The emergence of cattle-specific miRNAs was accompanied by accelerated sequence evolution at their target sites. Further, the target genes of cattle-specific miRNAs show markedly reduced expression compared to their pig and human orthologues. We found that target genes with conserved or non-conserved target sites of cattle-specific miRNAs exhibit reduced expression. One of the significantly enriched KEGG pathway terms for the target genes of the cattle-specific miRNAs is the insulin signalling pathway, raising the possibility that some of these miRNAs may modulate insulin resistance in ruminants.

Conclusions
We provide evidence of rapid miRNA-mediated regulatory evolution in the ruminant lineage. Cattle-specific miRNAs play an important role in shaping gene expression divergence between ruminant and non-ruminant species, by influencing the expression of targets genes through both conserved and cattle-specific target sites.
miR-204 mediated loss of Myeloid cell leukemia-1 results in pancreatic cancer cell death
Authors: Chen Zhiyu , Sangwan Veena , Banerjee Sulagna , Mackenzie Tiffany , Dudeja Vikas , Li Xiaowu , Wang Huaizhi , Vickers Selwyn M , Saluja Ashok K 
Published: September 2013

Abstract

Background
Pancreatic cancer is one of the most lethal human malignancies, with an all-stage 5-year survival of <5%, mainly due to lack of effective available therapies. Cancer cell survival is dependent upon up-regulation of the pro-survival response, mediated by anti-apoptotic proteins such as Mcl-1.

Results
Here we show that over-expression of Mcl-1 in pancreatic patient tumor samples is linked to advancement of the disease. We have previously shown that triptolide, a diterpene triepoxide, is effective both in vitro and in vivo, in killing pancreatic cancer cells. Decrease of Mcl-1 levels, either by siRNA or by treatment with triptolide results in cell death. Using pancreatic cancer cell lines, we have shown that miR-204, a putative regulator of Mcl-1, is repressed in cancer cell lines compared to normal cells. Over-expression of miR-204, either by a miR-204 mimic, or by triptolide treatment results in a decrease in Mcl-1 levels, and a subsequent decrease in cell viability. Using luciferase reporter assays, we confirmed the ability of miR-204 to down-regulate Mcl-1 by directly binding to the Mcl-1 3’ UTR. Using human xenograft samples treated with Minnelide, a water soluble variant of triptolide, we have shown that miR-204 is up-regulated and Mcl-1 is down-regulated in treated vs. control tumors.

Conclusion
Triptolide mediated miR-204 increase causes pancreatic cancer cell death via loss of Mcl-1.