Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G)

Kamradt M, Bozorgmehr K, Krisam J, et al. Assessing self-management in patients with diabetes mellitus type 2 in Germany: validation of a German version of the Summary of Diabetes Self-Care Activities measure (SDSCA-G). Health and Quality of Life Outcomes. 2014;12(1): 185

The Majority of Active Rhodobacteraceae in Marine Sediments Belong to Uncultured Genera: A Molecular Approach to Link Their Distribution to Environmental Conditions

General studies on benthic microbial communities focus on fundamental biogeochemical processes or the most abundant constituents. Thereby, minor fractions such as the Rhodobacteraceae are frequently neglected. Even though this family belongs to the most widely distributed bacteria in the marine environment, their proportion on benthic microbial communities is usually within or below the single digit range. Thus, knowledge on these community members is limited, even though their absolute numbers might exceed those from the pelagic zone by orders of magnitudes. To unravel the distribution and diversity of benthic, metabolically active Rhodobacteraceae, we have now analyzed an already existing library of bacterial 16S rRNA transcripts. The dataset originated from 154 individual sediment samples comprising seven oceanic regions and a broad variety of environmental conditions. Across all samples, a total of 0.7% of all 16S rRNA transcripts was annotated as Rhodobacteraceae. Among those, Sulfitobacter, Paracoccus, and Phaeomarinomonas were the most abundant cultured representatives, but the majority (78%) was affiliated to uncultured family members. To define them, the 45 most abundant Rhodobacteraceae-OTUs assigned as “uncultured” were phylogenetically assembled in new clusters. Their next relatives particularly belonged to different subgroups other than the Roseobacter group, reflecting a large part of the hidden diversity within the benthic Rhodobacteraceae with unknown functions. The general composition of active Rhodobacteraceae communities was found to be specific for the geographical location, exhibiting a decreasing richness with sediment depth. One-third of the Rhodobacteraceae-OTUs significantly responded to the prevailing redox regime, suggesting an adaption to anoxic conditions. A possible approach to predict their physiological properties is to identify the metabolic capabilities of their nearest relatives. Those need to be proven by physiological experiments, as soon an isolate is available. Because many uncultured members of these subgroups likely thrive under anoxic conditions, in future research, a molecular-guided cultivation strategy can be pursued to isolate novel Rhodobacteraceae from sediments

Exploring causality in the association between circulating 25-hydroxyvitamin D and colorectal cancer risk:a large Mendelian randomisation study

Background: Whilst observational studies establish that lower plasma 25-hydroxyvitamin D (25-OHD) levels are associated with higher risk of colorectal cancer (CRC), establishing causality has proven challenging. Since vitamin D is modifiable, these observations have substantial clinical and public health implications. Indeed, many health agencies already recommend supplemental vitamin D. Here, we explore causality in a large Mendelian randomisation (MR) study using an improved genetic instrument for circulating 25-OHD. Methods: We developed a weighted genetic score for circulating 25-OHD using six genetic variants that we recently reported to be associated with circulating 25-OHD in a large genome-wide association study (GWAS) meta-analysis. Using this score as instrumental variable in MR analyses, we sought to determine whether circulating 25-OHD is causally linked with CRC risk We conducted MR analysis using individual-level data from 10,725 CRC cases and 30,794 controls (Scotland, UK Biobank and Croatia). We then applied estimates from meta-analysis of 11 GWAS of CRC risk (18,967 cases; 48,168 controls) in a summary statistics MR approach. Results: The new genetic score for 25-OHD was strongly associated with measured plasma 25-OHD levels in 2821 healthy Scottish controls (P = 1.47 x 10(-11)), improving upon previous genetic instruments (F-statistic 46.0 vs. 13.0). However, individual-level MR revealed no association between 25-OHD score and CRC risk (OR 1.03/unit log-transformed circulating 25-OHD, 95% CI 0.51-2.07, P= 0.93). Similarly, we found no evidence for a causal relationship between 25-OHD and CRC risk using summary statistics MR analysis (OR 0.91, 95% CI 0.69-1.19, P= 0.48). Conclusions: Despite the scale of this study and employing an improved score capturing more of the genetic contribution to circulating 25-OHD, we found no evidence for a causal relationship between circulating 25-OHD and CRC risk Although the magnitude of effect for vitamin D suggested by observational studies can confidently be excluded, smaller effects sizes and non-linear relationships remain plausible. Circulating vitamin D may be a CRC biomarker, but a causal effect on CRC risk remains unproven

Differences between Practice Patterns of Conventional and Naturopathic GPs in Germany

<div><p>Background</p><p>Limited evidence exists whether practice patterns of general practitioners (GPs) who have additionally completed training in naturopathy are different from those of conventional GPs. We aimed to assess and compare practice patterns of GPs in conventional and naturopathic GPs.</p><p>Methods</p><p>Routine data from 41 GPs (31 with and 11 without additional qualification in NP, respectively) and 180,789 patients, drawn from the CONTinuous morbidity registration Epidemiologic NeTwork (CONTENT)-registry and collected between 2009 and 2014, were used. To assess practice patterns determinants of (non-)phytopharmaceutical prescriptions, referrals and hospitalizations were analyzed using mixed-effects Poisson regression models. As explanatory variables, the qualification of the GP in NM, the age group and sex of the patient, as well as bivariate interactions between these variables were considered.</p><p>Results</p><p>GPs additionally qualified in naturopathy exhibited higher rates of phytopharmaceutical prescriptions (p<0.034; independent effect) compared to conventional GPs. This association was not observed with respect to non-phytopharmaceutical prescriptions. However, interaction effects between qualification and age group as well as sex were present with respect to both phytopharmaceutical and non-phytopharmaceutical prescriptions (all p<0.001). No further independent association existed between qualification and either referral rates or hospitalization rates, but again interactions between qualification and age group and sex (only referrals) were statistically significant (all p<0.0001).</p><p>Conclusion</p><p>The results show that the rate of phyto-pharmaceutical prescriptions are generally higher when the GP has an additional qualification in naturopathy. Further differences in practice patterns between conventional and naturopathy GPs could be subject to certain age groups and sex. However, the magnitude of these differences seem to be rather small.</p></div

Life in the woods: Taphonomic evolution of a diverse saproxylic community within fossil woods from Upper Cretaceous submarine mass flow deposits (Mzamba Formation, southeast Africa)

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Rates of hospitalizations according to qualification of physician, stratified by age group and sex of patients

<p>Rates of hospitalizations according to qualification of physician, stratified by age group and sex of patients</p

Rates of referrals according to qualification of physician, stratified by age group and sex of patients.

<p>Rates of referrals according to qualification of physician, stratified by age group and sex of patients.</p

Study population.

<p>Study population.</p

Rates of phytopharmaceutical prescriptions according to qualification of physician, stratified by age group and sex of patients.

<p>Rates of phytopharmaceutical prescriptions according to qualification of physician, stratified by age group and sex of patients.</p

Rates of non-phytopharmaceutical prescriptions according to qualification of physician, stratified by age group and sex of patients.

<p>Rates of non-phytopharmaceutical prescriptions according to qualification of physician, stratified by age group and sex of patients.</p