Aims/hypothesis Glomerular matrix accumulation is a hallmark of diabetic nephropathy. Recent data have linked the serine/threonine kinase protein kinase B (Akt) to matrix modulation. Here, we studied its role in high glucoseinduced collagen elaboration by mesangial cells. Methods Primary rat mesangial cells were treated with high glucose levels (30 mmol/l) or mannitol as osmotic control. Western blots, northern blots, ELISA and immunohistochemistry were used for assessment. Diabetes was induced in rats by streptozotocin.

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Introduction: Much of the research presented at conference meetings never go on to be published in peer-reviewed literature, thereby limiting the dispersion of these findings to a larger audience. We sought to assess if this was true with regard to CAEP meetings, by establishing the publication rate and factors correlated with publication of CAEP abstracts in peer-reviewed journals from 2013-2017. Methods: We conducted a scoping review that included all CAEP abstracts from 2013-2017, obtained through the Canadian Journal of Emergency Medicine. Two reviewers screened and extracted data from all abstracts individually, with any conflicts resolved by a third reviewer. Data extracted from abstracts included province of authors, sample size, study design, the presence of statistically positive or negative findings, status of publication, date of acceptance to a journal, and journal of publication. Databases searched for publication status included MEDLINE, EMBASE, The Cochrane Library and Ovid Health Star. A level of evidence (LOE) was assigned using the 2011 Oxford Centre for Evidence-Based Medicine criteria. Results: All abstracts (1090) from 2014-2017 have been analyzed thus far. Inter-rater agreement for data extraction was high ( value 0.85). 17.1% (186/1090) of abstracts presented at the conference had a corresponding full text publication in the peer-reviewed literature. Articles were published in 102 different journals, with the greatest number of publications in the Canadian Journal of Emergency Medicine (CJEM) (15.1%, 28/186), followed by Academic Emergency Medicine (10.2%, 19/186). The mean time to publication was 51 weeks (95% CI 43,59). 30.6% (57/186) of published abstracts had statistically positive findings, while 10.8% (20/186) had negative findings. A significant difference was present between publication findings and publication status (p<0.0001, chi-squared). 68.8% (128/186) of published articles were of level III evidence. A statistical difference was found between LOE and publication status (p<0.0001, chi-squared). Conclusion: A large number of abstracts presented at CAEP are presently unpublished. There may be a publication bias in the literature as a greater number of studies with positive findings have been published. Additionally, two-thirds of studies published are of level III evidence. An increasing emphasis should be placed in publishing studies with higher levels of evidence, and more studies with negative findings.

Introduction: The CAEP annual meeting presents the latest evidence for clinical practice, but there has not yet been an appraisal of the abstracts presented at this conference. Therefore, we sought to evaluate the level of evidence of research presented at the annual meeting, and assess for trends over a five-year period (2013-2017). Methods: We conducted a scoping review that included all CAEP abstracts from 2013-2017, obtained through the Canadian Journal of Emergency Medicine. Two reviewers assessed eligibility and extracted data from abstracts individually, with conflicts resolved by a third reviewer. Qualitative research was excluded. Extracted data included type of presentation (ex. oral, poster), sample size, study design and type of study (therapeutic, prognostic, diagnostic, education, quality improvement, or systems-wide/economic analyses research). A level of evidence (LOE) was assigned using the 2011 Oxford Centre for Evidence-Based Medicine criteria. Results: Abstracts from 2014-2017 have been analyzed thus far, 1090 of which were eligible and 990 included. Inter-rater agreement for screening and data extraction was high ( value 0.87 and 0.84 respectively). Systems-wide/economic analyses research was the predominant type of study (28.6%, 283/990), followed by therapeutic (19.9%, 197/990) and education (19.9%, 195/990). The mean LOE was 2.81 (95% CI 2.77,2.85). The highest proportion of studies were of level III evidence (77.7%, 769/990), followed by level II (9.6%, 95/990) and level I evidence (7.8%, 77/990). 72.1% (124/172) of all level I and II abstracts were presented in 2016 and 2017. A significant change in LOE between years was evident (p<0.0001, chi-squared). The greatest proportion of level I and II abstracts were lightning oral (41.9%, 72/172), followed by posters (36.0%, 62/172). The best average LOE was observed for lightning oral (2.64, 95% CI 2.56, 2.72), with the poorest average LOE witnessed for moderated posters (2.90, 95% CI 2.83, 2.97). A significant difference was present in mean LOE between types of presentations (p<0.0001, one-sided ANOVA). Conclusion: The majority of abstracts were level III evidence. The lightning oral sessions had the greatest proportion of level I and II evidence presented. Recent years of the conference have also seen the presentation of a greater number of level I and II evidence, which may suggest a shift towards generating and disseminating higher level evidence in emergency medicine.

Since the first reports of laparoscopic hepatectomy in the early 1990s there has been a gradual increase in the use of the technique. Consensus conferences in Louisville USA and Morioka Japan have provided guidance on case selection. This study reports the adoption of the laparoscopic approach by predominantly one attending (consultant) surgeon in this regional liver surgery service. Methods: Laparoscopic liver surgery was initially adopted by the lead surgeon in 2009. All operations were undertaken using a two-surgeon approach until individuals had achieved competence. Demographic data are presented as median (range) where appropriate and non-parametric tests are used for comparison accepting significance at the P < 0.05 level. Patients were allocated to one of two temporal cohorts. Results: The total number of patients in this cohort were 400 (2006-2017) (197 [49%] male; median [range] age 68 ). In the initial cohort from 2006 to 2011 the total number of liver resections undertaken were 173 with 10 (5.8%) undertaken laparoscopically. From 2012 to 2017 there were 227 liver resections with 67 (29.5%) undertaken laparoscopically. The difference in the proportion of laparoscopic cases was significant (P< 0.001). In the overall series of 400 there were 4 (1%) post-operative deaths. There were no deaths after laparoscopic liver surgery and no conversions. Conclusion: Laparoscopic hepatectomy can be safely and uneventfully incorporated into modern liver surgical practice.