Meta regression analysis to indirectly compare dalteparin to enoxaparin for the prevention of venous thromboembolic events following total hip replacement

<p>Abstract</p> <p>Background</p> <p>Patients undergoing elective total hip replacement (THR) surgery are at an increased risk for venous thromboembolic events (VTEs). Dalteparin and enoxaparin are recommended as thromboprophylaxis for at least 10 days in these patients. Even though both agents have proven clinical effectiveness through placebo controlled studies, there have been no head to head trials to assess comparative effectiveness. Indirect statistical techniques were used to compare safety and efficacy between dalteparin and enoxaparin following THR surgery.</p> <p>Methods</p> <p>A literature search was conducted from January 1980 to November 2009 for randomized trials evaluating dalteparin or enoxaparin prophylaxis in THR patients. In trials where a common control was used (e.g. placebo), indirect statistical comparisons between dalteparin and enoxaparin were performed using meta regression analysis with active drug as the primary independent variable.</p> <p>Results</p> <p>A total of nine placebo controlled enoxaparin (n = 5) and dalteparin (n = 4) trials met the inclusion criteria. THR patients treated with enoxaparin or dalteparin had a 50% VTE risk reduction compared to the placebo control (RR = 0.50, p < 0.001). This benefit was achieved without a significant increase in the risk for major bleeds (RR = 1.19, p = 0.76), heparin induced thrombocytopenia (HIT) (RR = 1.13, p = 0.83) or death (RR = 0.72, p = 0.59). The indirect comparison was not able to find significant differences between enoxaparin and dalteparin in terms of VTEs (p = 0.36), major bleeds (p = 0.45), HIT (p = 0.48) and death (p = 0.86).</p> <p>Conclusions</p> <p>The findings suggested comparable safety and efficacy between dalteparin and enoxaparin in TKR patients. Therefore, treatment decisions should be based on other considerations, such as patient or physician preference, ease of administration and cost.</p

Effects of a study abroad teacher training program on the language, identity, affect, and intercultural competence of Korean teachers of English

textThis study investigated the linguistic, affective, and intercultural outcomes of a four-week study abroad program for Korean teachers of English offered through a U.S. southwestern university. In an effort to understand better what the 42 participants experienced during their study abroad, mixed methods including quantitative and qualitative data analysis, were used. To measure the participants‟ linguistic development, pretest and posttest measures of Listening, Reading, Structure, Speaking, and Writing were administered by the study abroad program. Also, participants responded to Self- Assessment questionnaires developed by the National Language Service Corps that asked them to assess the degree to which their reading, speaking, and listening had improved. The participants‟ daily journal entries were collected throughout the program, and some of the participants were interviewed at the beginning, at the middle, and at the end of the program on a volunteer basis. For the quantitative data analysis, the pretest and posttest scores of each measure were statistically compared by using MANOVA with follow-up ANOVA tests. Except for the reading scores, the other four measures showed significant improvement from pretest to posttest. For the Self-Assessment questionnaire, most participants checked only a few items as having improved. Interestingly, a few perceived that they had become less able to do some of the listening and speaking items over the program. These findings can be explained as resulting from overestimation before this program or as a result of increase in self-monitoring processes during the program. Through the constant comparison method (Strauss & Corbin, 1998), four themes emerged from analysis of the qualitative data. First, many participants were motivated to improve their English proficiency and increase authentic contacts with local people, with various sources shaping their motivation. Second, they increased their awareness of cultural and linguistic differences between the United States and Korea. Third, some participants showed a feeling of resistance to the dominant culture represented by native English-speaking instructors of the program. Fourth, at the end of the program, many showed improved intercultural competence. Results provide some theoretical, methodological, pedagogical, and policy implications for study abroad researchers, participants, and program instructors.Curriculum and Instructio

Warming Up Your Tick-Tock: Temperature-Dependent Regulation of Circadian Clocks

Circadian clocks are endogenous time-keeping mechanisms to adaptively coordinate animal behaviors and physiology with daily environmental changes. So far many circadian studies in model organisms have identified evolutionarily conserved molecular frames of circadian clock genes in the context of transcription-translation feedback loops. The molecular clockwork drives cell-autonomously cycling gene expression with similar to 24-hour periodicity, which is fundamental to circadian rhythms. Light and temperature are two of the most potent external time cues to reset the circadian phase of the internal clocks, yet relatively little is known about temperature-relevant clock regulation. In this review, we describe recent findings on temperature-dependent clock mechanisms in homeothermic mammals as compared with poikilothermic Drosophila at molecular, neural, and organismal levels. We propose thermodynamic transitions in RNA secondary structures might have been potent substrates for the molecular evolution of temperature-relevant post-transcriptional mechanisms. Future works should thus validate the potential involvement of specific post-transcriptional steps in temperature-dependent plasticity of circadian clocks.close0

The Neuroprotective Effect of NEUROMIDE, a Compound Bioidentical to Commensal Bacteria Metabolites

GPR119 is a novel cannabinoid receptor that is primarily expressed in the pancreas and gastrointestinal tract and has beneficial effects on glucose homeostasis exerted through the stimulation of GLP-1 secretion, as demonstrated in the rodent brain. GLP-1 also has important anti-inflammatory effects in chronic inflammatory diseases, including type 1 and 2 diabetes, asthma, psoriasis, and neurodegenerative disorders. Recently, there has been increasing interest in the effect of the gut microbiota on both the gut and the brain. However, few studies have examined how gut microbes affect brain health through the endocannabinoid system. NEUROMIDE is a compound that shares a bioidentical structure with certain commensal bacterial metabolites, acting as a CB1 and GPR119 agonist. In an in vitro system exposed to reactive oxygen species (ROS), pretreatment with NEUROMIDE resulted in a significant increase in cell viability. The ROS-exposed system also showed decreased acetylcholine and an increase in inflammatory cytokines such as IL-1β, changes that were counteracted in a dose-dependent manner in the NEUROMIDE treatment groups. To measure the effectiveness of NEUROMIDE in an in vivo system, we used scopolamine-treated mice as a neurodegenerative disease model and performed a series of passive avoidance tests to observe and quantify the cognitive impairment of the mice. Mice in the NEUROMIDE treatment group had increased latency time, thus indicating an improvement in their cognitive function. Furthermore, the NEUROMIDE treatment groups showed dose-dependent increases in acetylcholine along with decreases in TNF-α and IL-1β. These experiments demonstrate that NEUROMIDE can potentially be used for neuroprotection and the improvement of cognitive ability

Quercetin reduces obesity-induced hepatosteatosis by enhancing mitochondrial oxidative metabolism via heme oxygenase-1

Background: Obesity-induced hepatic lipid accumulation causes lipotoxicity, mitochondrial dysfunction, oxidative stress, and insulin resistance, and is implicated in non-alcoholic hepatic pathologies such as steatohepatitis and fibrosis. Heme oxygenase-1 (HO-1), an important antioxidant enzyme catalyzing the rate-limiting step in heme degradation, protects against oxidative stress, inflammation, and metabolic dysregulation. Here, we demonstrate that the phytochemical, quercetin, a natural polyphenol flavonoid, protects against hepatic steatosis in obese mice fed a high-fat diet, and that it does so by inducing HO-1 and stimulating increased hepatic mitochondrial oxidative metabolism. Methods: Male C57BL/6 mice were fed a regular diet (RD), a high-fat diet (HFD), and an HFD supplemented with quercetin for 9 weeks. Levels of mitochondrial biogenesis and oxidative metabolic transcripts/proteins were measured by real-time PCR and/or Western blotting. HO-1 transcripts/proteins were measured real-time PCR and/or Western blotting. Results: Quercetin upregulated genes involved in mitochondrial biogenesis and oxidative metabolism in lipid-laden hepatocytes and the livers of HFD-fed obese mice, and this was accompanied by increased levels of the transcription factor, nuclear erythroid 2-related factor 2 (Nrf-2), and HO-1 protein. The HO-1 inducer hemin and the HO-1 byproduct carbon monoxide (CO) also enhanced hepatic oxidative metabolism in HFD-fed obese mice. Moreover, the metabolic changes and the lipid-lowering effects of quercetin were completely blocked by the HO-1 inhibitor ZnPP and by deficiency of Nrf-2. Conclusion: These findings suggest that quercetin stimulates hepatic mitochondrial oxidative metabolism by inducing HO-1 via the Nrf-2 pathway. Quercetin may be useful in protecting against obesity-induced hepatosteatosis

An ethanol extract of <i>Ramulus mori</i> improves blood circulation by inhibiting platelet aggregation

<p>Inappropriate platelet aggregation can cause blood coagulation and thrombosis. In this study, the effect of an ethanol extract of <i>Ramulus mori</i> (ERM) on blood circulation was investigated. The antithrombotic activity of ERM on rat carotid arterial thrombosis was evaluated <i>in vivo,</i> and the effect of ERM on platelet aggregation and blood coagulation time was evaluated <i>ex vivo</i>. To evaluate the safety of ERM, its cytotoxicity to platelets and its effect on tail bleeding time were assessed; ERM was not toxic to rat platelets and did not prolong bleeding time. Moreover, administering ERM to rats had a significant preventive effect on carotid arterial thrombosis <i>in vivo</i>, and significantly inhibited adenosine diphosphate- and collagen-induced platelet aggregation <i>ex vivo</i>, whereas it did not prolong coagulation periods, such as prothrombin time and activated partial thromboplastin time. The results suggest that ERM is effective in improving blood circulation via antiplatelet activity rather than anticoagulation activity.</p> <p><i>Ex vivo</i> antiplatelet effect of the ethanol extract of <i>Ramulus mori</i> containing 6.79% oxyresveratrol. Platelet aggregation was induced by (A) ADP and (B) collagen.</p

HSP70-1 is required for interleukin-5-induced angiogenic responses through eNOS pathway

general view, cityscape seen from minaret of Ulugh Beg Madrasa , 200