bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Bedside Ultrasonography for Acute Respiratory Failure and Severe Hypoxemia in the Medical Intensive Care Unit: Basics and Comprehensive Approaches
Authors: Lui Justin K. , Banauch Gisela I.
Published: July 2016

Bedside goal-directed ultrasound is a powerful tool for rapid differential diagnosis and monitoring of cardiopulmonary disease in the critically ill patient population. The bedside intensivist is in a unique position to integrate ultrasound findings with the overall clinical situation. Medically critically ill patients who require urgent bedside diagnostic assessment fall into 2 categories: (1) acute respiratory failure and (2) hemodynamic derangements. The first portion of this review outlines the diagnostic role of bedside ultrasound in the medically critically ill patient population for the diagnosis and treatment of acute respiratory failure, acute respiratory distress, and severe hypoxemia. The second portion will focus on the diagnostic role of ultrasound for the evaluation and treatment of shock states, as well as describe protocolized approaches for evaluation of shock during cardiopulmonary resuscitation. Different respiratory system pathologies that result in acute respiratory failure (such as increased interstitial fluid, alveolar consolidation, pleural effusion) cause characteristic ultrasonographic findings; diaphragmatic assessment may also add information. Intracardiac shunting can cause severe hypoxemia. Protocolized approaches for the evaluation of patients with acute respiratory failure or distress are discussed.
Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research
Authors: Cochran Gerald T. , Engel Rafael J. , Hruschak Valerie J. , Tarter Ralph E.
Published: July 2016

Background:

Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids.

Objective:

Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse.

Methods:

We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse.

Results:

A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse.

Conclusions:

Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.
Cascade sliding mode–based robust tracking control of a magnetic levitation system
Authors: Eroğlu Yakup , Ablay Günyaz
Published: July 2016

Magnetic levitation systems are able to provide frictionless, reliable, fast and economical operations in wide-range applications. The effectiveness and applicability of these systems require precise feedback control designs because the magnetic levitation is an unstable process and have highly nonlinear dynamics. In this article, a robust sliding mode–based cascade control approach is proposed for effectively tracking the reference position of a magnetic levitation system. The magnetic levitation plant is described with electrical and mechanical models, and the control problems of these parts are treated with cascade controllers. An integral sliding mode and an output feedback sliding mode controllers are designed for use in the cascade loops. The performance of the sliding mode controllers is compared with a proportional–integral–velocity plus proportional–integral control structure. It is shown that the proposed control structure is able to provide a highly satisfactory tracking performance and can eliminate the effects of the inductance-related uncertainties and operating point originated disturbances. The experimental results are provided to validate the efficacy and feasibility of the approach.
Unmet Needs for Clinical Ethics Support Services in Nurse: Based on focus group interviews
Authors: Kim Sanghee , Seo Minjeong , Kim Doo Ree
Published: July 2016

Background:

As nurses’ ethical competence in their own fields is essential, clinical ethics support services help nurses improve ethical competence.

Objectives:

The purpose of this study was to identify the unmet needs of ethical support for nurses in clinical settings and explore the differences by nursing units.

Research design:

Focus group interview design was applied.

Participants and research context:

Data were collected via four rounds of focus group interviews with 37 nurses at intensive care units, medical-surgical units, emergency departments and oncology units. Major questions were as follows: ‘What is nurses’ experience of ethical difficulties while working as a clinical nurse?’ and ‘What kinds of clinical ethics support services do nurses require in different clinical settings?’ Inductive content analysis was performed to analyse the data.

Ethical considerations:

Ethical approval was obtained from the institutional review of board at the College of Nursing.

Findings:

Five categories (with 14 subcategories) were identified: difficulty providing evidence-based care, lack of support in maintaining patients’ and family members’ dignity, insufficient education regarding clinical ethics, loss of professional self-esteem and expectations concerning organizational support. Nurses’ desire for ethical support varied according to department.

Conclusion:

Nurses face both practical and existential ethical issues that require rapid solution each day. There is a need for ethical counselling to prevent compassion fatigue and identify means via which nurses reflect on their daily lives in their own fields. In-house training should be provided for each unit, to improve ethical competence and facilitate the development of pragmatic, sensible solutions.
Youth unemployment in Italy and Russia: Aggregate trends and individual determinants
Authors: Marelli Enrico , Vakulenko Elena
Published: July 2016

Youth unemployment rates in most countries are considerably higher than total unemployment rates and increased significantly in many countries following the global financial crisis. Young people in long-term unemployment risk becoming a ‘lost generation’. We investigate individual and family characteristics predicting young people’s vulnerability to the scarring effects of long-term unemployment. After overviewing aggregate youth unemployment trends in several European countries, we focus on Russia and Italy – countries with contrasting structural and institutional conditions and exhibiting different macroeconomic trends – in order to determine whether, despite these differences, there were similar patterns in the relationship between individual and family characteristics and the of risk of unemployment and its adverse impacts. We use a Heckman probit model to estimate the unemployment risk of young people – compared to adults – during the period 2004–2011, before and after the global financial crisis. Despite many differences between the two countries, most of the explanatory variables acted in the same direction in each and so we compare the relative size of such effects. The policy significance of the findings is that personal and family characteristics are more amenable to modification than macroeconomic variables. Specific school-to-work interventions are needed to avoid creating a ‘lost generation’.
Narrative Reflection as a Means to Explore Team Effectiveness
Authors: Lohuis Anne Marie , Sools Anneke , van Vuuren Mark , Bohlmeijer Ernst T.
Published: July 2016

The aim of this article is to explore how teams make sense of their effectiveness over time by telling their team story. We selected five team stories from health care teams perceived by the organization as effective. We analyzed their stories using three-level narrative analysis, which addresses the temporal, social, and normative complexities of narrating effective teamwork. Two story types were identified: developing effectiveness stories, which represent stories about a transition from ineffective to effective, and continuous improvement stories, which represent relatively consistent high performance. This distinction seems to indicate differences in the way teams engage in and profit from narrative reflection, and how they relate to the organizational context. Our findings showed that narrative reflection provides insights into incongruence between teamwork elements, invites members to exchange perspectives, and reveals lessons learned for future recycling. Future research could explore how composite stories might provide insights for other teams to reflect on.
Extending Symbolic Convergence Theory
Authors: Zanin Alaina C. , Hoelscher Carrisa S. , Kramer Michael W.
Published: July 2016

This study addresses theoretical and contextual weaknesses of symbolic convergence theory (SCT) through a fantasy theme analysis of a life enrichment group (i.e., an all-female club rugby team). By using a variety of data sources, including group social media posts, participant observation, and interviews, the authors found two concurrent rhetorical visions present within this group: belong and triumph. These visions were created through member chaining of fantasy themes. In contrast with current assumptions of SCT, results indicated several tensions within concurrent fantasy themes and the two rhetorical visions. Theoretical and pragmatic implications for transferability and application of symbolic convergence and fantasy themes in other life enrichment groups are discussed.
The Impact of Climate Change–Related Imagery and Text on Public Opinion and Behavior Change
Authors: Hart P. Sol , Feldman Lauren
Published: July 2016

This experimental study investigates how imagery and text in news coverage of climate change affect perceptions of issue importance, efficacy, and intentions to conserve energy and engage in climate change-related political behavior. The results reveal that images of solar panels and texts that discuss actions to address climate change increase individuals’ perceptions of efficacy. Perceived efficacy and issue importance each have a positive association with behavior change. In contrast to previous studies, the present investigation finds no evidence that exposure to images of either climate impacts or climate pollution negatively influence perceived efficacy or positively influence perceived issue importance.
Analytical approximation formulas in quantum calculus
Authors: Nemri Akram , Soltani Fethi
Published: July 2016

We study the class of q-Fourier multiplier operators [Formula: see text], which are acted on the q-Sobolev space [Formula: see text], and we obtain the exact expression and some properties for the extremal functions of the best approximation problem in quantum calculus [Formula: see text], where [Formula: see text] and [Formula: see text]. As an application, we provide numerical approximate formulas for a limit case [Formula: see text]; using q-calculus, which generalizes the Gauss-Kronrod method studied given in [14] in one-dimensional space.
Lichen Planus Pigmentosus-like Reaction to Guasha
Authors: Yang Gang , Tan Cheng
Published: July 2016

Background and Objective:

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus (LP) that manifests as macular hyperpigmentation involving chiefly the face and upper limbs. Although its etiology has not been fully elucidated, a relationship with hepatitis C infection, restrictive underwear, localized friction, and sun exposure have been proposed. Rarely, exposure to mustard oil, amla oil, henna, or hair dyes has been reported.

Conclusion:

We herein describe an LPP-like reaction to Guasha.
Behold the monster: Mythical explanations of deviance and evil in news of the Amish school shooting
Authors: Gutsche Robert E , Salkin Erica
Published: July 2016

In October 2006, Charles Carl Roberts IV walked into a one-room Amish schoolhouse in West Nickel Mines, PA, USA, brandished a handgun, and killed five female students who were all under the age of 13. Through an analysis of 215 news articles published in 10 local, regional, and national newspapers in 2006 and 2007, this article examines news characterizations of Roberts that cast him as a ‘Monster’. We explore interdisciplinary notions of pure evil to expand current literature of news myth to include a form of explanation that appears in news when no other current mythical archetype will suffice. This study complicates current perspectives on news myth by expanding the ideological tools to examine the nature of evil in loss through the example of the Amish shootings.
Individualist and collectivist consumer motivations in local organic food markets
Authors: Schrank Zachary , Running Katrina
Published: July 2016

Community-Supported Agriculture programs have become a popular model for providing consumers with direct economic engagement with independent local organic farms. The degree to which Community-Supported Agriculture members are unified in their identity and consumer interests, however, is unclear. One possibility is that mostly individual interests including supposed nutritional benefits, superior taste, and avoidance of synthetic pesticides motivate Community-Supported Agriculture members. Another is that they are motivated more by environmental and economic concerns at the collective level. Our study engages this debate by analyzing emergent themes in consumers’ motivational narratives using interview data with 58 members of a Community-Supported Agriculture program in a large southwestern city in the United States. We find that Community-Supported Agriculture members are largely unified in their consumer orientation and pursue individualist and collectivist goals equally. In other words, Community-Supported Agriculture members are neither primarily altruistic nor egoistic consumers, but they approach their consumption as a holistic act. Specifically, they emphasize environmental issues and a commitment to sustainability through local organic consumption as a pathway to individual health. This suggests that an internally homogeneous, yet multidimensional, framework constitutes the motivational structure of local organic food consumption. We argue this framework aligns with an emerging eco-habitus exhibited in environmentally conscious market fields that translate into both collective and individual benefits.
Rationing at the bedside: Immoral or unavoidable?
Authors: Magelssen Morten , Nortvedt Per , Solbakk Jan Helge
Published: July 2016

Although most theorists of healthcare rationing argue that rationing, including rationing that takes place in the physician–patient relationship (“bedside rationing”) is unavoidable, some health professionals strongly disagree. In a recent essay, Vegard Bruun Wyller argues that bedside rationing is immoral and thoroughly at odds with a sound view of the physician–patient relationship. We take Wyller to be an articulate exponent of the reluctance to participate in rationing found among some clinicians. Our essay attempts to refute the five crucial premises of his argument yet build on his genuine insights. In our analysis, Wyller’s critique of bedside rationing is instructive both for harbouring some very common misconceptions that must be exposed and refuted, but also for offering important words of caution. In particular, bedside rationing must be performed in ways that do not harm the physician–patient relationship. Read irenically, Wyller’s critique is a reminder of what must not be lost in our painful endeavour to update the ethics of medicine to encompass the unavoidability of rationing.
Weekly Cisplatin and Volumetric-Modulated Arc Therapy With Simultaneous Integrated Boost for Radical Treatment of Advanced Cervical Cancer in Elderly Patients: Feasibility and Clinical Preliminary Results
Authors: Mazzola Rosario , Ricchetti Francesco , Fiorentino Alba , Levra Niccolò Giaj , Fersino Sergio , Di Paola Gioacchino , Ruggieri Ruggero , Alongi Filippo
Published: July 2016

Background:

To evaluate the feasibility and clinical preliminary results of weekly cisplatin and volumetric-modulated arc therapy to the pelvis with simultaneous integrated boost to macroscopic disease in a cohort of elderly patients.

Materials and Methods:

Inclusion criteria of this prospective study were age ≥70 years, Karnofsky performance status 70 to 100, locally advanced histologically proven squamous cervical carcinoma, and patients unable to undergo brachytherapy. Radiation doses prescribed were 66 Gy to the macroscopic disease and 54 Gy to the pelvic nodes in 30 fractions. Weekly cisplatin dose was 40 mg/mq.

Results:

A total of 30 patients were recruited. Median follow-up was 32 months (range: 8-48 months). Median age was 72 years (range: 70-84 years). The 3-year overall survival and local control were 93% and 80%, respectively. The median time to progression was 24 months (range: 6-30 months). Analyzing clinical outcome grouping based on the stage of disease, II versus III, the 3-year overall survival was 100% and 85%, respectively. The 3-year local control was 91% for stage II and 67% for stage III. Acute and late toxicities were acceptable without severe events.

Conclusion:

Weekly cisplatin and volumetric-modulated arc therapy–simultaneous integrated boost for radical treatment of advanced cervical cancer in the current cohort of elderly patients were feasible. Long-term results and prospective randomized trials are advocated.
Changing the Scale of Analysis for Urban Renewal Research
Authors: Appler Douglas R.
Published: July 2016

Traditional urban renewal scholarship has emphasized the experiences of America’s largest cities, leaving the equally significant story of urban renewal in small cities largely unexplored. This is particularly surprising, given that the overwhelming majority of communities to have received urban renewal funds had populations of less than 50,000. This article uses the state of Kentucky to develop a framework for analyzing the effects of the federal urban renewal program on small cities in the United States. Of particular importance for this research is recognizing the value of the June 30, 1974, Urban Renewal Directory as a data source.
Static metal sealing mechanism of a subsea pipeline mechanical connector
Authors: Wei Zongliang , Wang Liquan , Guan Yu , Yao Shaoming , Li Shaokai
Published: July 2016

The static metal sealing mechanism is essential for the structural design of subsea pipeline mechanical connector. By analyzing the sealing mechanism and contact pressure on sealing face, the critical condition of the seal is obtained. Based on the superposition theorem of elasticity, the formula of critical mean contact pressure ensuring seal is deduced. The finite element analysis result of critical mean contact pressure agrees with the analysis result very well and the critical mean contact pressure decreases with the increase in pipeline wall thickness and sealing width; however, the radius of pipeline has less influence on it. The critical mean contact pressure of 8-in subsea pipeline mechanical connector is 223.34 MPa and subsea pipeline mechanical connector is designed with ANSYS. The internal pressure experiments indicate that the sealing performance of final designed subsea pipeline mechanical connectors is higher than the design pressure of 4.5 MPa and all the initial designed ones cannot seal up to 4.5 MPa. By observing the sealing indentation on pipeline surface, when the mean contact pressure is higher than the critical mean contact pressure and the contact pressure variance is smaller, a full contact is seen to form a seal. Finally, the vibration experiments prove that the number of vibration is more than 107 and final designed subsea pipeline mechanical connector meets the experiment specification.
Never let an academic crisis go to waste: Leadership Studies in the wake of journal retractions
Authors: Spoelstra Sverre , Butler Nick , Delaney Helen
Published: July 2016

In 2014, leadership studies saw the retraction of a number of journal articles written by prominent researchers who are closely associated with popular concepts such as transformational leadership, authentic leadership, ethical leadership and spiritual leadership. In response, The Leadership Quarterly published a lengthy editorial that presented these retractions as a sign of health in a mature scientific field. For the editors of The Leadership Quarterly, there is no crisis in leadership studies. In this paper, we suggest that the editorial is a missed opportunity to reflect on positivist leadership studies. In our view, leadership ought to be in crisis because this would stimulate the community to question its guiding assumptions and reconsider its methods and objectives. We therefore hope to open up a critical discussion about the means and ends of mainstream leadership studies – not least of all its scientific pretensions.
An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: Results from the SOPHIE study
Authors: Hoey Edel , Staines Anthony , Walsh Denise , Corby Deirdre , Bowers Kirsty , Belton Sarahjane , Meegan Sarah , McVeigh Treasa , McKeon Michael , Trépel Dominic , Griffin Peter , Sweeney Mary Rose
Published: July 2016

The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16–64 years were recruited from intellectual disability service provider organizations ( n = 131). Data were collected using questionnaires; 4-day food dairies and weight, height and waist circumference measurements. Participants’ mean body mass index (BMI) was 29.4 kg/m2 ± 6.1, 2.4% were underweight, 22.6% were normal weight, 28.2% were overweight and 46.8% were obese. Having a diagnosis of Down syndrome ( p = 0.03) was associated with increasing BMI. Increasing waist circumference was associated with increasing severity of ID ( p = 0.04). The mean-reported energy intake was 1890 kcal/day. Mean energy intakes from sugar, fat and saturated fat were above recommendations and few participants met micronutrient recommended daily amounts. This study highlights the alarming prevalence of overweight and obesity and poor diet quality of individuals with intellectual disabilities.
A Comprehensive Evaluation of a Novel Color Range Indicator in Multiple Blood Glucose Meters Demonstrates Improved Glucose Range Interpretation and Awareness in Subjects With Type 1 and Type 2 Diabetes
Authors: Grady Mike , Katz Laurence B. , Cameron Hilary , Levy Brian L.
Published: July 2016

Aims:

We previously demonstrated that people with type 2 diabetes (T2DM) can improve their ability to categorize blood glucose (BG) results into low, in range, or high glycemic ranges after experiencing a color range indicator (CRI or ColorSure™ Technology) in a single meter. This study examined whether a CRI was effective in people with type 1 (T1) or T2DM when used in 3 glucose meters.

Methods:

A total of 179 subjects (139 T2DM and 40 T1DM) classified BG values as low, in range, or high based on individual current knowledge. Subjects then experienced the CRI which showed whether different BG values were low, in range, or high. After CRI interaction, subjects repeated the classification.

Results:

Following interaction with the CRI, subjects significantly improved their ability to categorize BG results into low, in range, and high glycemic ranges by 27.9% (T2DM) and 27.2% (T1DM) (each P < .001). Improvement was not accompanied by an increase in time spent categorizing results. There was no difference in classification ability between subjects with T1 or T2DM. There was also no correlation between HbA1c, numeracy level, test frequency, or duration of diabetes and the ability to correctly classify results. Subjects agreed the CRI feature helped them easily interpret glucose values and improved their awareness of glucose ranges.

Conclusion:

Interaction with a CRI improved the ability of subjects with T1 and T2DM to interpret and categorize BG values into recommended glycemic ranges, irrespective of the glucose meter providing the CRI insights.
Facing Up to China’s Realpolitik Approach in the South China Sea Dispute: The Case of the 2012 Scarborough Shoal Stand-off and Its Aftermath
Authors: De Castro Renato Cruz
Published: July 2016

This article examines the 2012 Scarborough Shoal stand-off between the Philippines and China as a case of Beijing’s application of realpolitik in resolving the South China Sea dispute. It discusses the legal basis of the Philippines’ claim on the Spratly Islands and the Scarborough Shoal. However, since 2010, China has aggressively challenged this claim by building up its navy; undermining the other claimant states diplomatically and militarily; and engaging the Philippines in a maritime brinkmanship game. The 2012 Scarborough Shoal stand-off is the tipping point in China’s realpolitik moves against the Philippines in the disputed area. Lasting for two months, the stand-off has since strained Philippines–China bilateral relations; strained bilateral ties have further deteriorated as China intensifies its efforts to consolidate its expansive maritime claim, and the Aquino Administration applies a balancing policy towards an assertive power. In conclusion, the article argues that confronted with China’s realpolitik tactic during the Scarborough Shoal stand-off, the Philippines has applied a balancing strategy that draws the United States and Japan into the fray. Interestingly, these external maritime powers are anxious to curtail China’s growing strategic clout in East Asia. At present, China is caught in its own security dilemma as it faces increasing American and Japanese naval presence and pressure in the South China Sea.
My Pilgrimage in Mission
Authors: Ma Wonsuk
Published: July 2016

This self-reflection on my missionary journey is characterized as a process of learning, particularly about the meaning of “mission.” Missionary formation is part of one’s spiritual development, and for me, immersion in several cross-cultural contexts accelerated the process. Through long years in the Philippines, combined with study in the United States, my understanding of mission deepened. Another decade of mission leadership at OCMS in Oxford added further dimensions of my understanding of mission. Through this continuing journey, I have had several surprise “teachers” of mission. Reflecting experiences in a “new” missionary church, this “pilgrimage” may speak for mission workers of the Global South.
Helicopter transportation in the era of thrombectomy: The next frontier for acute stroke treatment and research
Authors: Leira Enrique C , Stilley Joshua D , Schnell Thomas , Audebert Heinrich J , Adams Harold P
Published: July 2016

Purpose

Many patients suffer a stroke at a significant distance from a specialized center capable of delivering endovascular therapy. As a result, they require rapid transport by helicopter emergency medical services, sometimes while receiving a recombinant tissue plasminogen activator infusion (drip and ship). Despite its critical role in the new era of reperfusion, helicopter emergency medical services remains a poorly evaluated aspect of stroke care.

Method

Comprehensive narrative review of all published articles of helicopter emergency medical services related to acute stroke care in the inter-hospital and pre-hospital settings, including technical aspects and physical environment implications.

Findings

Helicopter emergency medical services transports are conducted during a critical early time period when specific interventions and ancillary care practices may have a significant influence on outcomes. We have limited knowledge of the potential impact of the unusual physical factors generated by the helicopter on the ischemic brain, which affects our ability to establish rational guidelines for ancillary care and the delivery of specific interventions.

Discussion

Unlike the pre-hospital and hospital settings where stroke interventions are delivered, the inter-hospital helicopter emergency medical services transfer setting remains a “black box” for acute stroke care and research. This gap is particularly relevant for many patients living in rural areas, or in congested urban areas, that depend on helicopter emergency medical services for rapid access to a tertiary stroke center.

Conclusion

Addressing the helicopter emergency medical services stroke gap in clinical trials and acute care delivery would homogenize capabilities through all care settings, thus minimizing potential disparities in research access and outcomes based on geographical location.
tfec controls the hematopoietic stem cell vascular niche during zebrafish embryogenesis
Authors: Mahony Christopher B. , Fish Richard J. , Pasche Corentin , Bertrand Julien Y.
Published: July 2016

Key Points

tfec controls the expression of cytokines in the vascular niche. tfec expands HSCs in a non–cell-autonomous fashion.
Treatment and disease progression in a birth cohort of vertically HIV-1 infected children in Ukraine
Authors: Mahdavi Saboura , Malyuta Ruslan , Semenenko Igor , Pilipenko Tatyana , Thorne Claire ,   Ukraine European Collaborative Study Group
Published: July 2016

Background

Ukraine has the highest HIV prevalence (1.6%) and is facing the fastest growing epidemic in Europe. Our objective was to describe the clinical, immunological and virological characteristics, treatment and response in vertically HIV-infected children living in Ukraine and followed from birth.

Methods

The European Collaborative Study (ECS) is an ongoing cohort study, in which HIV-1 infected pregnant women are enrolled and followed in pregnancy, and their children prospectively followed from birth. ECS enrolment in Ukraine started in 2000 initially with three sites, increasing to seven sites by 2009.

Results

A total of 245 infected children were included in the cohort by April 2009, with a median age of 23 months at most recent follow-up; 33% (n = 77) had injecting drug using mothers and 85% (n = 209) were infected despite some use of antiretroviral prophylaxis for prevention of mother-to-child transmission. Fifty-five (22%) children had developed AIDS, at a median age of 10 months (IQR = 6-19). The most prevalent AIDS indicator disease was Pneumocystis jiroveci pneumonia (PCP). Twenty-seven (11%) children had died (median age, 6.2 months). Overall, 108 (44%) children had started highly active antiretroviral treatment (HAART), at a median 18 months of age; median HAART duration was 6.6 months to date. No child discontinued HAART and 92% (100/108) remained on their first-line HAART regimen to date. Among children with moderate/severe immunosuppression, 36% had not yet started HAART. Among children on HAART, 71% (69/97) had no evidence of immunosuppression at their most recent visit; the median reduction in HIV RNA was 4.69 log10 copies/mL over a median of 10 months treatment. From survival analysis, an estimated 94%, 84% and 81% of children will be alive and AIDS-free at 6, 12 and 18 months of age, respectively. However, survival increased significantly over time: estimated survival rates to 12 months of age were 87% for children born in 2000/03 versus 96% for those born in 2004/08.

Conclusion

One in five children had AIDS and one in ten had died. The half of children who received HAART has responded well and survival has significantly improved over time. Earlier diagnosis and prompt initiation of HAART remain key challenges.
Transcriptional profiling reveals intrinsic mRNA alterations in multipotent mesenchymal stromal cells isolated from bone marrow of newly-diagnosed type 1 diabetes patients
Authors: de Lima Kalil A. , de Oliveira Gislane L. V. , Yaochite Juliana N. U. , Pinheiro Daniel G. , de Azevedo Júlia T. C. , Silva Jr Wilson Araujo , Covas Dimas T. , Couri Carlos E. B. , Simões Belinda P. , Voltarelli Julio C. , Oliveira Maria C. , Malmegrim Kelen C. R.
Published: July 2016

Background

Bone marrow multipotent mesenchymal stromal cells (MSCs) are a diverse subset of precursors that contribute to the homeostasis of the hematopoietic niche. MSCs can be isolated and expanded in vitro and have unique immunomodulatory and regenerative properties that make them attractive for the treatment of autoimmune diseases, including type 1 diabetes (T1D). Whether autologous or allogeneic MSCs are more suitable for therapeutic purposes has not yet been established. While autologous MSCs may present abnormal function, allogeneic cells may be recognized and rejected by the host immune system. Thus, studies that investigate biological characteristics of MSCs isolated from T1D patients are essential to guide future clinical applications.

Methods

Bone marrow-derived MSCs from recently diagnosed type 1 diabetes patients (T1D-MSCs) were compared with those from healthy individuals (C-MSCs) for morphological and immunophenotypic characteristics and for differentiation potential. Bioinformatics approaches allowed us to match absolute and differential gene expression of several adhesion molecules, immune mediators, growth factors, and their receptors involved with hematopoietic support and immunomodulatory properties of MSCs. Finally, the differentially expressed genes were collated for functional pathway enrichment analysis.

Results

T1D-MSCs and C-MSCs were similar for morphology, immunophenotype, and differentiation potential. Our absolute gene expression results supported previous literature reports, while also detecting new potential molecules related to bone marrow-derived MSC functions. T1D-MSCs showed intrinsic abnormalities in mRNA expression, including the immunomodulatory molecules VCAM-1, CXCL12, HGF, and CCL2. Pathway analyses revealed activation of sympathetic nervous system and JAK STAT signaling in T1D-MSCs.

Conclusions

Collectively, our results indicate that MSCs isolated from T1D patients present intrinsic transcriptional alterations that may affect their therapeutic potential. However, the implications of these abnormalities in T1D development as well as in the therapeutic efficacy of autologous MSCs require further investigation.
Outcome of Patients With Recurrent Osteosarcoma Enrolled in Seven Phase II Trials Through Children's Cancer Group, Pediatric Oncology Group, and Children's Oncology Group: Learning From the Past to Move Forward
Authors: Lagmay Joanne P. , Krailo Mark D. , Dang Ha , Kim AeRang , Hawkins Douglas S. , Beaty Orren , Widemann Brigitte C. , Zwerdling Theodore , Bomgaars Lisa , Langevin Anne-Marie , Grier Holcombe E. , Weigel Brenda , Blaney Susan M. , Gorlick Richard , Janeway Katherine A.
Published: July 2016

Purpose

The use of radiographic response as the primary end point in phase II osteosarcoma trials may limit optimal detection of treatment response because of the calcified tumor matrix. We performed this study to determine if time to progression could be used as an end point for subsequent studies.

Patients and Methods

We performed a retrospective analysis of outcome for patients with recurrent/refractory osteosarcoma enrolled in one of seven phase II trials conducted by the Children’s Oncology Group and predecessor groups from 1997 to 2007. All trials used RECIST or WHO radiographic response criteria and the primary end point of response rate. The following potential prognostic factors—age, trial, number of prior chemotherapy regimens, sex, and race/ethnicity—were evaluated for their impact on event-free survival (EFS). We used data from a phase II study (AOST0221) of patients with osteosarcoma who were given inhaled granulocyte-macrophage colony-stimulating factor with first pulmonary recurrence who had an EFS as well as biologic end point to determine the historical disease control rate for patients with fully resected disease.

Results

In each included trial, the drugs tested were determined to be inactive on the basis of radiographic response rates. The EFS for 96 patients with osteosarcoma and measurable disease was 12% at 4 months (95% CI, 6% to 19%). There was no significant difference in EFS across trials according to number of prior treatment regimens or patient age, sex, and ethnicity. The 12-month EFS for the 42 evaluable patients enrolled in AOST0221 was 20% (95% CI, 10% to 34%).

Conclusion

The EFS was uniformly poor for children with recurrent/refractory osteosarcoma in these single-arm phase II trials. We have now constructed baseline EFS outcomes that can be used as a comparison for future phase II trials for recurrent osteosarcoma.
Randomized Phase III Trial of Irinotecan Plus Cisplatin Compared With Paclitaxel Plus Carboplatin As First-Line Chemotherapy for Ovarian Clear Cell Carcinoma: JGOG3017/GCIG Trial
Authors: Sugiyama Toru , Okamoto Aikou , Enomoto Takayuki , Hamano Tetsutaro , Aotani Eriko , Terao Yasuhisa , Suzuki Nao , Mikami Mikio , Yaegashi Nobuo , Kato Kiyoko , Yoshikawa Hiroyuki , Yokoyama Yoshihito , Tanabe Hiroshi , Nishino Koji , Nomura Hiroyuki , Kim Jae-Weon , Kim Byoung-Gie , Pignata Sandro , Alexandre Jerome , Green John , Isonishi Seiji , Terauchi Fumitoshi , Fujiwara Keiichi , Aoki Daisuke
Published: July 2016

Purpose

Clear cell carcinoma (CCC) is a rare histologic subtype that demonstrates poor outcomes in epithelial ovarian cancer. The Japanese Gynecologic Oncology Group conducted the first randomized phase III, CCC-specific clinical trial that compared irinotecan and cisplatin (CPT-P) with paclitaxel plus carboplatin (TC) in patients with CCC.

Patients and Methods

Six hundred sixty-seven patients with stage I to IV CCC of the ovary were randomly assigned to receive irinotecan 60 mg/m2 on days 1, 8, and 15 plus cisplatin 60 mg/m2 on day 1 (CPT-P group) every 4 weeks for six cycles or paclitaxel 175 mg/m2 plus carboplatin area under the curve 6.0 mg/mL/min on day 1 every 3 weeks for six cycles (TC group). The primary end point was progression-free survival. Secondary end points were overall survival, overall response rate, and adverse events.

Results

Six hundred nineteen patients were clinically and pathologically eligible for evaluation. With a median follow-up of 44.3 months, 2-year progression-free survival rates were 73.0% in the CPT-P group and 77.6% in TC group (hazard ratio, 1.17; 95% CI, 0.87 to 1.58; P = .85). Two-year overall survival rates were 85.5% with CPT-P and 87.4% with TC (hazard ratio, 1.13; 95% CI, 0.80 to 1.61; one-sided P = .76). Grade 3/4 anorexia, diarrhea, nausea, vomiting, and febrile neutropenia occurred more frequently with CPT-P, whereas grade 3/4 leukopenia, neutropenia, thrombocytopenia, peripheral sensory neuropathy, and joint pain occurred more frequently with TC.

Conclusion

No significant survival benefit was found for CPT-P. Both regimens were well tolerated, but the toxicity profiles differed significantly. Treatment with existing anticancer agents has limitations to improving the prognosis of CCC.
E-Mail Communication Practices and Preferences Among Patients and Providers in a Large Comprehensive Cancer Center
Authors: Cook Natalie , Maganti Manjula , Dobriyal Aditi , Sheinis Michal , Wei Alice C. , Ringash Jolie , Krzyzanowska Monika K.
Published: July 2016

Purpose:

Little is known about how electronic mail (e-mail) is currently used in oncology practice to facilitate patient care. The objective of our study was to understand the current e-mail practices and preferences of patients and physicians in a large comprehensive cancer center.

Methods:

Separate cross-sectional surveys were administered to patients and physicians (staff physicians and clinical fellows) at the Princess Margaret Cancer Centre. Logistic regression was used to identify factors associated with current e-mail use. Record review was performed to assess the impact of e-mail communication on care.

Results:

The survey was completed by 833 patients. E-mail contact with a member of the health care team was reported by 41% of respondents. The team members contacted included administrative assistants (52%), nurses (45%), specialist physicians (36%), and family physicians (18%). Patient factors associated with a higher likelihood of e-mail contact with the health care team included younger age, higher education, higher income, enrollment in a clinical trial, and receipt of multiple treatments. Eighty percent of physicians (n = 63 of 79) reported previous contact with a patient via e-mail. Physician factors associated with a greater likelihood of e-mail contact with patients included older age, more senior clinical position, and higher patient volume. Nine hundred sixty-two patient records were reviewed, with e-mail correspondence documented in only 9% of cases.

Conclusion:

E-mail is commonly used for patient care but is poorly documented. The use of e-mail in this setting can be developed with appropriate guidance; however, there may be concerns about widening the gap between certain groups of patients.
Editing and Editorializing: The New Genetic Cahier of Aimé Césaire
Authors: Miller Christopher L.
Published: July 2016

This essay focuses on the new landscape of Aimé Césaire studies that has been made possible largely through the work of one scholar, A. James Arnold (along with a team including Alex Gil, Daniel Delas, and others). The publication in 2013 of the enormous volume Poésie, théâtre, essais et discours (Centre National de la Recherche Scientifique / Présence Africaine) reorganizes and reorients the study of Césaire's principal texts, especially the Cahier d'un retour au pays natal. Arnold's prefaces in that volume and in his edition of The Original 1939 Notebook of a Return to the Native Land go beyond editing and into editorializing about the evolution of the Cahier. Examining issues of Marxism, surrealism, and poetic politics, this essay attempts to raise certain questions about Arnold's interpretations, while recognizing the immense value of his editorial contributions.
Poetry's Circumstance and Racial Time: Aimé Césaire, 1935–1945
Authors: Melas Natalie
Published: July 2016

This essay starts from a consideration of the conditions of the emergence of Aimé Césaire's long poem Notebook of a Return to the Native Land in terms of the problem racial enunciation presents for lyric form. The essay proposes the working thesis that Césaire's Notebook is an occasional poem, or a poem of circumstance, but where the occasion in question is of a highly paradoxical sort, namely, decolonization. Taking the poem's long period of open composition and revision (1935–56) as the central problem, the essay goes on to sketch a mode of “circumstantial reading” that would circumvent a reductively historicist understanding of how the poem, its ideas, and its poetics move through time. Underlying the argument is a claim about a particular conjugation of race and time in which contingency converts to necessity and circumstance is not reliably ephemeral.
Poetic Productions of Cultural Combat inTropiques
Authors: Seligmann Katerina Gonzalez
Published: July 2016

Tropiques, produced in Martinique between 1941 and 1945, was one of the most influential Caribbean instances of the modernist little magazine, or petit revue. The magazine was a collaborative cultural venture that saw Martinique through its subjection to Vichy rule and ended when direct political participation became possible for its generators. Tropiques was first conceived by Aimé Césaire and edited by him, the philosopher René Ménil, and the cultural theorist Suzanne Césaire, all teachers at the Lycée Schoelcher in Fort-de-France. The magazine's final publication, in 1945, gave way directly to Aimé Césaire's political career as the mayor of Fort-de-France and representative to the French National Assembly. As he explained retrospectively, upon the Liberation, Tropiques' cultural combat gave way to political combat. This essay examines the achievements of Tropiques' cultural combat: resistance to the Vichy regime and literary marginality, a theory of locally situated poetry as an avenue for freedom, and poetic interventions in racist colonial ideology.
Notes on the Journey toward the Future: Négritude, Abject Blackness, and the Emancipatory Force of Spectrality
Authors: Northover Patricia M. , Crichlow Michaeline A.
Published: July 2016

This essay advances an “interpretive analytic” to analyze the character of the politics and strategic intent in Aimé Césaire's poetics and life work. In so doing, it focuses on Césaire's commitment to the method of poetics articulated through the project and politics of négritude. It argues that Césaire's interventions should be treated as part and parcel of the set of cultural practices gathered under the rubric of “creolization” and that his concern is to conduct a “Creole line of escape” from the hegemony of modern cultures of power. The essay teases out the mode of opening that Césaire sought after in “dwelling with power” and eschews a premature closure on his négritude. Certainly, the problem of blackness is implicated in the undoing of the sets of contradictions embedded in our contemporary historical legacy. However, the essay argues that it is the spectral case of “abject blackness” that lies at the heart of Césaire's critique. Given the peculiarity of the conditions sustaining this experience of “being-black-in-the-world,” the essay interprets Césaire's poiesis through an analysis of the aesthetic and aesthetic judgment and within a class of performances called liminal acts.
Conga Mines: Development as Conflict in Peru
Authors: Millones Jorge
Published: July 2016

The US-based Newmont Mining Corporation is the world's wealthiest gold mining company and has been denounced within the United States and by other countries including Indonesia, Ghana, Turkey, and Bolivia. Its critics accuse Newmont of seriously damaging the environment and public health, bribing government officials, abusing its workers, and hiring people to threaten and attack the company's critics. Its activities in Peru date back to the second half of the 1990s, during the Fujimori Dictatorship, when it managed to obtain the deposit reserve of Yanacocha, Cajamarca, in the northern highlands of Peru, which has continuously generated conflicts. In 1998, thousands of trout died in rivers near the mine; in 2000, hundreds of kilos of mercury were spilled in the Choropampa district. Four years later, the water from Cerro Quilish, which supplies the capital Cajamarca, was contaminated. Due to massive popular protest, a municipal ordinance was passed establishing the mountain aquifer as a protected zone. Ollanta Humala, who became Peru's president in 2011, decided to move forward with Newmont's second wealthiest project, called Conga Mines (that would relieve the already exhausted Yanacocha mine). The project was originally approved by former president Alan García and would endanger four large highland Andean lagoons in the region, generating the largest and most important socio-environmental conflict thus far under that government.