Fenofibrate in the management of AbdoMinal aortic anEurysm (FAME): Study protocol for a randomised controlled trial

Background: Abdominal aortic aneurysm (AAA) is a slowly progressive destructive process of the main abdominal artery. Experimental studies indicate that fibrates exert beneficial effects on AAAs by mechanisms involving both serum lipid modification and favourable changes to the AAA wall. Methods/design: Fenofibrate in the management of AbdoMinal aortic anEurysm (FAME) is a multicentre, randomised, double-blind, placebo-controlled clinical trial to assess the effect of orally administered therapy with fenofibrate on key pathological markers of AAA in patients undergoing open AAA repair. A total of 42 participants scheduled for an elective open AAA repair will be randomly assigned to either 145 mg of fenofibrate per day or identical placebo for a minimum period of 2 weeks prior to surgery. Primary outcome measures will be macrophage number and osteopontin (OPN) concentration within the AAA wall as well as serum concentrations of OPN. Secondary outcome measures will include levels of matrix metalloproteinases and proinflammatory cytokines within the AAA wall, periaortic fat and intramural thrombus and circulating concentrations of AAA biomarkers. Discussion: At present, there is no recognised medical therapy to limit AAA progression. The FAME trial aims to assess the ability of fenofibrate to alter tissue markers of AAA pathology. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12612001226897. Registered on 20 November 2012. © 2017 The Author(s)

Temporal and Spatial Localization of the Dentin Matrix Proteins During Dentin Biomineralization

Formation of bone and dentin are classical examples of matrix-mediated mineralization. The mineral phase is essentially the same in these two tissues and primarily consists of a carbonated hydroxyapatite, but the difference lies in the crystal size and shape. There are three components that are necessary for proper mineralization, namely the proper synthesis and secretion of the non-collagenous proteins (NCPs), self-assembly of the collagenous matrix, and delivery of calcium and phosphate ions to the extracellular matrix. Three major NCPs present in the dentin matrix are dentin matrix protein 1 (DMP1), dentin phosphophorin (DPP), and dentin sialoprotein (DSP). In this study, we show the temporal and spatial localization of these NCPs and correlate their expression with the presence of collagenous matrix and calcified deposits in developing mouse incisors and molars. DMP1, an acidic protein, is present predominantly at the mineralization front and in the nucleus of undifferentiated preodontoblast cells. DPP, the major NCP, is present in large amounts at the mineralization front and might function to regulate the size of the growing hydroxyapatite crystals. For the first time, we report the localization of DPP in the nucleus of preodontoblast cells, suggesting a signaling function during the odontoblast differentiation process. DSP is localized predominantly in the dentinal tubules at the site of peritubular dentin, which is highly mineralized in nature. Thus, the precise localization of DMP1, DPP, and DSP in the dentin tissue suggests that a concerted effort between several NCPs is necessary for dentin formation. (J Histochem Cytochem 57:227–237, 2009

Civil servants’ perspectives on the role of citizens in public service delivery in Uganda

In this article we study civil servants’ perceptions about the role of citizens in the provision of public services in Uganda. In other words, we examine the views of those who deliver civil services regarding the actual and desired influence of service recipients. An empirical study was conducted focusing on the health and education sectors in Uganda. It is concluded that due to a number of tensions regarding the role of the citizen in Uganda, civil servants feel that service recipients are not yet adequately engaged in the demand for and delivery of quality public services. More effective public service delivery in Uganda cannot be achieved without the development of a culture that supports the building of capacity at all levels, including the community and individual service recipients