bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishing the Digital Library
Authors: Hopkinson Alan
Published: November 2011

The literature on Digital Libraries tends to be about developing your own digital library, but most usage of digital libraries worldwide is access to commercial databases of full-text material: initially scholarly materials, but more recently, newspapers and monographs. There is no difference in principle between the industrialized world and developing countries; everyone want to access the same materials. Electronic materials are cheaper to deliver to developing countries when compared with printed materials. The main problems concern spending wisely the little money that developing countries have and establishing the infrastructure to get the digital material to the users who need them. The standards needed to implement digital libraries are universal, and librarians in developing countries need to be aware of these standards and support their implementation in their systems, develop an appropriate infrastructure, and put resources into training so that the tools can be used to good effect. The Open Access movement must be taken into account and repositories set up for institutional materials as in the industrialized world.
Information Flow and Democratic Governance
Authors: Aremu F. A. , Saka H. T.
Published: November 2011

Information is the life-line of governance. This is particularly true with democratic political systems. Even undemocratic regimes require steady information flow to sustain their power base. Indeed, the effectiveness in the management of information flow distinguishes a functional political system from a dysfunctional one. With the emergence of new media in the information matrix, there has been a dramatic democratization of content development which had hitherto been the exclusive preserve of “experts” in the media arena. The expansion of space in content development and dissemination of information through the various internet-based mechanisms has proven to be a double-edged sword: a force for popular mobilization and participation in the governance process and a source of destabilization. Depending on the political system in question, information science and technology is exerting tremendous influence in the governance arena. This chapter examines the unfolding dynamics in Information Science and Technology and its place in the democratization of the governance process in Africa. It dwells on the changing contexts of information content development besides engaging the core conceptual issues. It also explores the nexus between the “democratization of information content development” and democratic consolidation in Africa.
Librarians, Records Managers, and E-Government
Authors: Nengomasha Cathrine T.
Published: November 2011

Governments have turned to the use of information and communication technologies with the aim of improving service delivery, encouraging citizens in the decision making process, and enhancing accountability, transparency, and effectiveness. Effective inclusive participation of citizens in the government of their country requires access to information through modern technologies. Access to information is vital for transparency, accountability, participation, and the rule of law – all hallmarks of democratic governance. This chapter looks at the role of librarians and records managers in promoting e-government. Their traditional role of collecting, organizing, preserving, and disseminating information places them in a very significant position in e-governance implementation. However, in an electronic environment, they face a number of challenges which include economic, technological, and information literacy. The role played by these professionals, and the challenges each meet are discussed. Some recommendations are provided to enhance the role of these professionals in e-government implementation.
Organisation of Information and the Information Retrieval System
Authors: Onwuchekwa Edeama O.
Published: November 2011

Since the 19th century, the world has witnessed an exponential growth in the number and variety of information products, sources, and services. This development has resulted in technological innovations for faster and more efficient processing and storage of information, as individuals and organisations strive to keep up with increasing demands. The value of information organisation cannot be overemphasized. The volume of information generated, transmitted and stored is of such immense proportion that without adequate organisation, the retrieval process would be cumbersome and frustrating. This chapter will highlight and describe the roles of an information retrieval system and the context of information organisation in several institutions. It will also discuss the various information retrieval tools and the different models used in information retrieval process. The ultimate goal of this chapter is to enable students, practicing librarians, and others interested in information services to understand the concepts, principles, and tools behind information organisation and retrieval. The conclusion of the chapter will emphasize the need for continuous evaluation of these principles and tools for sustained improvement.
Bibliometric Analysis of DESIDOC Journal of Library & Information Technology
Authors: Thanuskodi S.
Published: November 2011

This chapter presents a bibliometric analysis of the journal, DESIDOC Journal of Library & Information Technology, for the period between 2006 and 2010. The data were downloaded from the journal’s website. The analysis covers mainly the number of articles, authorship pattern, subject, distribution of articles, average number of references per articles, forms of documents cited, year distribution of cited journals, et cetera. Findings of the studies point towards the merits and weakness of the journal which are helpful for its further development. The result showed that out of 199 articles, 116 (58.29%) articles were contributed by joint authors while the rest 83 (41.71%) articles were contributed by single author. The study reveals that most of the contributions are from India with 93.97%, and the remaining 6.03% were from foreign authors.
The Role of Stochastic Simulations to Extend Food Web Analyses
Authors: Scotti Marco
Published: November 2011

Food webs are schematic representations of who eats whom in ecosystems. They are widely used in linking process to pattern (e.g., degree distribution and vulnerability) and investigating the roles played by particular species within the interaction web (e.g., centrality indices and trophic position). First, I present the dominator tree, a topological structure reducing food web complexity into linear pathways that are essential for energy delivery. Then, I describe how the dominance relations based on dominator trees extracted from binary food webs may be modified by including interaction strength. Consequences related to the skewed distribution of weak links towards the trophic chain are discussed to explain higher risks of secondary extinction that characterize top predators dominated by basal species. Finally, stochastic simulations are introduced to suggest an alternative approach to static analyses based on food web topology. Ranking species importance using stochastic-based simulations partially contradicts the predictions based on network analyses.
Process Algebra Models in Biology
Authors: Kahramanogullari Ozan
Published: November 2011

Process algebras are formal languages, which were originally designed to study the properties of complex reactive computer systems. Due to highly parallelized interactions and stochasticity inherit in biological systems, programming languages that implement stochastic extensions of processes algebras are gaining increasing attention as modeling and simulation tools in systems biology. The author discusses stochastic process algebras from the point of view of their broader potential as unifying instruments in systems biology. They argue that process algebras can help to complement conventional more established approaches to systems biology with new insights that emerge from computer science and software engineering. Along these lines, the author illustrates on examples their capability of addressing a spectrum of otherwise challenging biological phenomena, and their capacity to provide novel techniques and tools for modeling and analysis of biological systems. For the example models, they resort to phagocytosis, an evolutionarily conserved process by which cells engulf larger particles.
Paroxysmal Hemicrania as the Clinical Presentation of Giant Cell Arteritis
Authors: Beams Jennifer L. , Rozen Todd D.
Published: November 2011

Head pain is the most common complaint in patients with giant cell arteritis but the headache has no distinct diagnostic features. There have been no published reports of giant cell arteritis presenting as a trigeminal autonomic cephalalgia. We describe a patient who developed a new onset headache in her fifties, which fit the diagnostic criteria for paroxysmal hemicrania and was completely responsive to corticosteroids. Removal of the steroid therapy brought a reemergence of her headaches. Giant cell arteritis should be considered in the evaluation of secondary causes of paroxysmal hemicrania; in addition giant cell arteritis needs to be ruled out in patients who are over the age of 50 years with a new onset trigeminal autonomic cephalalgia.
Versatility of the Cone Beam Computed Tomography in Oral Surgery: An Overview
Authors: Panicker Kishan G. , Nair Anuroopa Pudukulangara , Reddy Bipin Chandra
Published: November 2011

Cone beam CT (CBCT) produces threedimensional information on the facial skeleton, teeth and their surrounding tissues; and is increasingly being used in many of the dental specialties. This is usually achieved with a substantially lower effective dose compared with conventional medical computed tomography (CT). Periapical pathologies, root fractures, root canal anatomy and the true nature of the alveolar bone topography around teeth may be assessed. CBCT scans are desirable to assess posterior teeth prior to periapical surgery, as the thickness of the cortical and cancellous bone can be accurately determined as can the inclination of roots in relation to the surrounding jaw. The relationship of anatomical structures such as the maxillary sinus and inferior dental nerve to the root apices may also be clearly visualized. Measurements on CBCT are more accurate when compared with OPG. Therefore, CBCT permits the clinician to have all necessary information when planning dental implants. The purpose of this article is to provide an overview of the unique image display capabilities of maxillofacial CBCT systems and to illustrate specific applications in clinical practice.
Blood Flow Redistribution and Ventilation‐Perfusion Mismatch During Embolic Pulmonary Arterial Occlusion
Authors: Burrowes K. S. , Clark A. R. , Tawhai M. H.
Published: November 2011

Acute pulmonary embolism causes redistribution of blood in the lung, which impairs ventilation/perfusion matching and gas exchange and can elevate pulmonary arterial pressure (PAP) by increasing pulmonary vascular resistance (PVR). An anatomically‐based multi‐scale model of the human pulmonary circulation was used to simulate pre‐ and post‐occlusion flow, to study blood flow redistribution in the presence of an embolus, and to evaluate whether reduction in perfused vascular bed is sufficient to increase PAP to hypertensive levels, or whether other vasoconstrictive mechanisms are necessary. A model of oxygen transfer from air to blood was included to assess the impact of vascular occlusion on oxygen exchange. Emboli of 5, 7, and 10 mm radius were introduced to occlude increasing proportions of the vasculature. Blood flow redistribution was calculated after arterial occlusion, giving predictions of PAP, PVR, flow redistribution, and micro‐circulatory flow dynamics. Because of the large flow reserve capacity (via both capillary recruitment and distension), approximately 55% of the vasculature was occluded before PAP reached clinically significant levels indicative of hypertension. In contrast, model predictions showed that even relatively low levels of occlusion could cause localized oxygen deficit. Flow preferentially redistributed to gravitationally non‐dependent regions regardless of occlusion location, due to the greater potential for capillary recruitment in this region. Red blood cell transit times decreased below the minimum time for oxygen saturation (<0.25 s) and capillary pressures became high enough to initiate cell damage (which may result in edema) only after ~80% of the lung was occluded.
Imatinib Mesylate: Past Successes and Future Challenges in the Treatment of Gastrointestinal Stromal Tumors
Authors: Ksienski Doran
Published: November 2011

Just over a decade ago, gastrointestinal tumours were a poorly understood mesenchymal neoplasm unsuccessfully treated with chemotherapy. Cytotoxic therapy for advanced disease yielded response rates of 10% and median survival of just 18 months. However, the discovery of KIT and platelet derived growth factor receptor alpha ( PDGFRA) mutations as oncogenic drivers of most gastrointestinal tumours, paved the way for targeted therapy. Imatinib mesylate, a tyrosine kinase inhibitor, produces a clinical benefit rate (complete response, partial response, and stable disease) of more than 80% in metastatic setting and a median survival of 57 months. Imatinib is now also approved in adult patients following resection of KIT-positive GIST. Major insights into the mechanism of action of imatinib, unique pharmacokinetics, drug resistance, and management of low grade but chronic adverse effects continue to be made.
Endoscopic Treatment with Wallgraft Stenting of Complete Iatrogenic Iliac Ureteral Injury in a High-Risk Surgical Patient
Authors: Bonamini Alberto , Ninotta Gaetano , Gallo Fabrizio , Gastaldi Emilio , Schenone Maurizio , Giberti Claudio , Barile Antonio
Published: November 2011

Background

Injury of the ureter is a potential complication of any difficult abdominopelvic surgical procedure, with an incidence ranging between 0.5% and 10% in most series. The treatment depends on the severity and the place of the lesion. The severe mid and upper ureteral injuries usually require complex treatment procedures, which can be contraindicated in case of severe comorbidities with high anesthesiologic risk. We report our experience in the endoscopic treatment with Wallgraft stenting of complete iatrogenic iliac ureteral injury in a high-risk surgical patient.

Methods

A 74-year-old female patient was admitted at our department due to a complete lesion of the right iliac ureter following right iliac artery aneurysm repair with iatrogenic ileal injury. The patient was in coma, affected by severe respiratory insufficiency, sepsis and uroperitoneum. These conditions contraindicated a general anesthesia encumbering the positioning of a nephrostomy, and influenced our indication of Wallgraft stent placement. The Wallgraft endoprosthesis (10 x 50 mm) is a self-expanding super-alloy metallic high flexible stent covered by PET, which can be placed at the level of the lesion using fluoroscopy after introducing an angiographic catheter and guidewire. This procedure is usually indicated in the treatment of vascular lesions.

Results

After positioning the Wallgraft stent, pyelography showed a complete closure of the lesion. The patient's clinical condition improved quickly and remained stable at a follow-up of 45 months.

Conclusions

Although the Wallgraft stent positioning cannot be considered as a standard treatment for all the complete ureteral lesions, it can be proposed in the management of some patients with severe comorbidities, which do not allow any other approach.
The Roles of CD4+T Cells in Tumor Immunity
Authors: Lai Yo-Ping , Jeng Chung-Jiuan , Chen Shu-Ching
Published: November 2011

Activation of CD8+cytotoxic T cells has long been regarded as a major antitumor mechanism of the immune system. Emerging evidence suggests that CD4+T cells are required for the generation and maintenance of effective CD8+cytotoxic and memory T cells, a phenomenon known as CD4+T-cell help. CD4+T-cell help facilitates the optimal expansion, trafficking, and effector function of CD8+T cells, thereby enhancing tumor destruction. In addition, a specialized subset of CD4+T cells, CD4+CD25+regulatory T cells (TRegs), effectively hampers anti-tumor immune responses, which has been proposed to be one of the major tumor immune evasion mechanisms. Here, we review recent advances in deciphering how anti-tumor immune responses are orchestrated by CD4+T cells. We will also discuss the immunotherapeutic potential of CD4+T-cell manipulation in anti-tumor immune response.
Conflict Resolution, Sociopsychological Barriers to
Authors: Bar‐Tal Daniel , Halperin Eran
Published: November 2011

The intergroup conflicts that rage in different parts of the world over territories, natural resources, power, economic wealth, self‐determination, and/or basic values are real. They center on disagreements which focus on contradictory goals and interests in different domains and there is no doubt that these real issues have to be addressed in conflict resolution. However, it is well known that the disagreements could potentially be resolved if not for the various powerful forces which fuel and maintain the conflicts. These forces, which underlie the disagreements, are the barriers that inhibit and impede progress towards peaceful settlement of conflict. The psychological barriers stand as major obstacles to begin negotiation, to carry the negotiation, to achieve an agreement, and later to engage in a process of reconciliation. These barriers are found among the leaders, as well as among society members involved in intergroup conflict. In practice, when promising opportunities to resolve a conflict occur, or when positive information about the adversary is available, the psychological barriers inhibit progress towards peace by creating biased and distorted information processing of these important pieces of information.
Use of Angio‐Seal Closure Device When the Arteriotomy Is Above or Below the Common Femoral Artery
Authors: Bose Rahul , Schussler Jeffrey M.
Published: November 2011

Background:

The majority of vascular complications during diagnostic coronary angiography occur while accessing the femoral artery. Angio‐Seal vascular closure devices are indicated for closure of arteriotomies of the femoral artery, but not when the puncture site is above or below the femoral artery.

Hypothesis:

Under certain circumstances, use of the Angio‐Seal closure device above or below the common femoral artery may be safe and effective.

Methods:

Consecutive patients at a single high‐volume medical center having documented high or low arteriotomies were closed using an Angio‐Seal closure device. Patients were chosen when they received a single arterial puncture, the arteriotomy was away from branch vessels, and the diameter of the artery at the site of sheath entry was of large enough caliber to suggest placement would be successful. Patients were then followed longitudinally for complications.

Results:

Sixty‐two patients had non–femoral artery sheath placement. Twenty‐two patients had “high” puncture sites, and 40 patients had “low” puncture sites. All were successfully closed using the Angio‐Seal vascular closure device and had no complications.

Conclusions:

Although not approved for placement in areas above or below the femoral artery, off‐label use of the Angio‐Seal arteriotomy closure may be safely performed when patient characteristics are favorable. © 2011 Wiley Periodicals, Inc.

The authors have no funding, financial relationships, or conflicts of interest to disclose. Neither author has a conflict of interest with St. Jude Medical or with the Angio‐Seal device.
Intravascular Ultrasound‐Guided Primary Percutaneous Coronary Intervention With Drug‐Eluting Stent Implantation in Patients With ST‐Segment Elevation Myocardial Infarction
Authors: Youn Young Jin , Yoon Junghan , Lee Jun‐Won , Ahn Sung‐Gyun , Ahn Min‐Soo , Kim Jang‐Young , Yoo Byung‐Soo , Lee Seung‐Hwan , Choe Kyung‐Hoon
Published: November 2011

Background:

Studies investigating the clinical outcome of intravascular ultrasound (IVUS)‐guided primary percutaneous coronary intervention (PPCI) in patients with ST‐segment elevation myocardial infarction (STEMI) show conflicting results. The aim of our study was to evaluate whether IVUS‐guidedPPCI with drug‐eluting stents (DESs) in STEMI patients improves clinical outcome.

Hypothesis:

IVUS‐guided PPCI is superior to angio‐guided PPCI.

Methods:

Three hundred forty‐one patients who underwent PPCI for STEMI and survived the hospitalization were enrolled in this study. Two hundred sixteen (63.3%) patients were treated with angio‐guided PPCI and 125 (36.7%) patients were treated with IVUS‐guided PPCI. The primary endpoint was defined as the composite of death, myocardial infarction, target vessel revascularization, and target lesion revascularization at the 3‐year follow‐up visit.

Results:

Male gender, dyslipidemia, and smoking were frequent in the IVUS‐guided PPCI group. These patients had a higher rate of radial approach, adjunctive ballooning, thrombectomy, and the use of a glycoprotein IIb/IIIa inhibitor. The number and length of implanted stents were higher in the IVUS‐guided PPCI group. The primary end point (18.1% vs 12.8%, P = 0.22) and stent thrombosis (2.8% vs 2.4%, P = 1.00) was not different between the groups.

Conclusions:

In our observational study, IVUS‐guided PPCI with DESs in patients with STEMI did not improve clinical outcome or stent thrombosis. © 2011 Wiley Periodicals, Inc.

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Pharmacologic Prophylaxis for Venous Thromboembolism and 30‐Day Outcomes Among Older Patients Hospitalized With Heart Failure: An Analysis From the ADHERE National Registry Linked to Medicare Claims
Authors: Kociol Robb D. , Hammill Bradley G. , Hernandez Adrian F. , Klaskala Winslow , Mills Roger M. , Curtis Lesley H. , Fonarow Gregg C.
Published: November 2011

Background:

Hospitalized medically ill patients are at greater risk for venous thromboembolism (VTE). Although pharmacologic prophylaxis regimens have reduced VTE risk in medically ill patients, associations with early postdischarge adverse clinical outcomes among patients with heart failure are unknown.

Hypothesis:

We hypothesized that patients receiving pharmacologic VTE prophylaxis during hospitalization for heart failure would have lower rates of postdischarge adverse clinical outcomes than patients not receiving prophylaxis.

Methods:

Using data from the Acute Decompensated Heart Failure (ADHERE) registry linked to Medicare claims, we estimated 30‐day postdischarge outcome rates for patients who received in‐hospital subcutaneous heparin compared with patients who did not receive in‐hospital VTE prophylaxis. We excluded patients who received warfarin or intravenous heparin. Outcomes included mortality, thromboembolic events, major adverse cardiovascular events, and all‐cause readmission. We used propensity‐score methods to estimate associations between VTE prophylaxis and each outcome. In a secondary analysis, we compared outcomes of patients receiving pharmacologic prophylaxis with unfractionated heparin (UFH) vs low‐molecular‐weight heparin (LMWH).

Results:

Of 36 799 eligible patients in 265 hospitals, 12 169 (33%) received pharmacologic VTE prophylaxis during the hospitalization. In unadjusted analysis and after weighting by the inverse probability of treatment, VTE prophylaxis was not associated with 30‐day postdischarge mortality, thromboembolic events, major adverse cardiovascular events, or all‐cause readmission. There were no differences in outcomes between patients receiving UFH and those receiving LMWH.

Conclusions:

Pharmacologic VTE prophylaxis is provided to one‐third of older patients hospitalized with heart failure. Treatment with LMWH or UFH did not have a statistically significant association with 30‐day postdischarge outcomes. © 2011 Wiley Periodicals, Inc.

This study was supported by a research agreement between Duke University and Johnson & Johnson. Drs Klaskala and Mills are employees of Janssen Scientific Affairs and are shareholders of Johnson & Johnson.
Secondary Prevention of Hyperkalemia With Sodium Polystyrene Sulfonate in Cardiac and Kidney Patients on Renin‐Angiotensin‐Aldosterone System Inhibition Therapy
Authors: Chernin Gil , Gal‐Oz Amir , Ben‐Assa Eyal , Schwartz Idit F. , Weinstein Talia , Schwartz Doron , Silverberg Donald S.
Published: November 2011

Background:

Hyperkalemia, induced by renin‐angiotensin‐aldosterone system inhibition (RAAS‐I) in patients with chronic kidney disease (CKD), or cardiac disease often leads to withdrawal of RAAS‐I therapy. Sodium polystyrene sulfonate (SPS) is a potassium‐binding resin used for the treatment of hyperkalemia. Recently, concerns about the safety and efficacy of SPS were raised. We report here a follow‐up of 14 patients with CKD and heart disease on RAAS‐I treatment who were treated with low‐dose daily SPS to prevent recurrence of hyperkalemia.

Hypothesis:

Daily SPS is safe and effective for secondary prevention of hyperkalemia induced by RAAS‐I therapy in CKD patients with heart disease.

Methods:

We reviewed the medical charts of the patients with CKD (nondialysis patients) and heart disease treated in our CKD clinic from 2005 to 2010 and identified all patients on RAAS‐I therapy who were treated with daily SPS (sorbitol‐free) after episodes of hyperkalemia. Data on hospitalizations, symptoms that may be attributed to SPS therapy, and electrolyte concentration levels were obtained.

Results:

Fourteen patients were treated with low‐dose SPS therapy for a total of 289 months (median length of follow‐up, 14.5 months). None of the patients developed colonic necrosis or life‐threatening events that could be attributed to SPS use. Mild hypokalemia was noted in 2 patients and responded to reducing the dose of SPS. No further episodes of hyperkalemia were recorded while patients were on the therapy. SPS was well‐tolerated during the follow‐up without need for withdrawal or reduction of the dose of RAAS‐I therapy by any patients.

Conclusions:

Low‐dose SPS was safe and effective as a secondary preventive measure for hyperkalemia induced by RAAS‐I in CKD patients with heart disease. © 2011 Wiley Periodicals, Inc.

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Predictive Value of Preoperative Electrocardiography for Perioperative Cardiovascular Outcomes in Patients Undergoing Noncardiac, Nonvascular Surgery
Authors: Biteker Murat , Duman Dursun , Tekkeşin Ahmet İlker
Published: November 2011

Background:

The utility of routine preoperative electrocardiography (ECG) for assessing perioperative cardiovascular risk in patients undergoing noncardiac, nonvascular surgery (NCNVS) is unclear.

Hypothesis:

There would be an association between preoperative ECG and perioperative cardiovascular outcomes in patients undergoing NCNVS.

Methods:

A total of 660 patients undergoing NCNVS were prospectively evaluated. Patients age >18 years who underwent an elective, nonday case, open surgical procedure were enrolled. Troponin I concentrations and 12‐lead ECG were evaluated the day before surgery, immediately after surgery, and on the first 5 postoperative days. Preoperative ECG showing atrial fibrillation, left or right bundle branch block, left ventricular hypertrophy, frequent premature ventricular complexes, pacemaker rhythm, Q‐wave, ST‐segment changes, or sinus tachycardia or bradycardia were classified as abnormal. The patients were followed up during hospitalization and were evaluated for the presence of perioperative cardiovascular events (PCE).

Results:

Eighty patients (12.1%) experienced PCE. Patients with abnormal ECG findings had a greater incidence of PCE than those with normal ECG results (16% vs 6.4%; P < 0.001). Mean QTc interval was significantly longer in the patients who had PCE (436.6 ± 31.4 vs 413.3 ± 16.7 ms; P < 0.001). Univariate analysis showed a significant association between preoperative atrial fibrillation, pacemaker rhythm, ST‐segment changes, QTc prolongation, and in‐hospital PCE. However, only QTc prolongation (odds ratio: 1.15, 95% confidence interval: 1.06‐1.2, P < 0.001) was an independent predictor of PCE according to the multivariate analysis. Every 10‐ms increase in QTc interval was related to a 13% increase for PCE.

Conclusions:

Prolongation of the QTc interval on the preoperative ECG was related with PCE in patients undergoing NCNVS. © 2011 Wiley Periodicals, Inc.

The authors have no funding, financial relationships, or conflicts of interest to disclose.
Racial disparities in receipt and comparative effectiveness of oxaliplatin for stage III colon cancer in older adults
Authors: Mack Christina D. , Carpenter William , Meyer Anne‐Marie , Sanoff Hanna , Stürmer Til
Published: November 2011

BACKGROUND:

African Americans in the United States have higher rates of colon cancer mortality than other races. This study examines the use of oxaliplatin, a novel chemotherapeutic agent approved in 2004, among African American and Caucasian American patients with stage III colon cancer to determine whether differential receipt or differential effectiveness of the drug may explain the racial disparity in colon cancer mortality.

METHODS:

The authors conducted a population‐based retrospective cohort study of stage III colon cancer patients aged 65 years and older treated from 2004 through 2006 who initiated chemotherapy within 90 days of surgical resection (N = 1162) using Surveillance, Epidemiology and End Results‐Medicare data. Patients receiving oxaliplatin (n = 477) were compared with those receiving 5‐fluorouracil without oxaliplatin (n = 685). The authors estimated prevalence ratios and hazard ratios (HRs) using multivariate binomial regression and Cox models to evaluate racial differences in oxaliplatin receipt and survival.

RESULTS:

African Americans were as likely as Caucasian Americans to receive oxaliplatin (40.5 vs 41.1%; prevalence ratio, 0.90; 95% confidence interval [CI], 0.71‐1.13). Oxaliplatin was associated with lower mortality compared with 5‐fluorouracil (HR, 0.76; 95% CI, 0.58‐1.00). This benefit appeared stronger among African Americans (HR, 0.31; 95% CI, 0.09‐1.05) than Caucasian Americans (HR, 0.80; 95% CI, 0.60‐1.06).

CONCLUSIONS:

In Medicare‐insured patients receiving chemotherapy, the authors observed no meaningful racial disparities in receipt of oxaliplatin and, among those receiving it, potentially better survival among African Americans. Differential receipt and effectiveness of oxaliplatin‐containing regimens does not appear to contribute to the previously documented racial disparities in colon cancer survival. Understanding reasons for potentially enhanced effectiveness among African Americans may inform efforts to resolve racial disparities in colon cancer outcomes. Cancer 2011. © 2011 American Cancer Society.
Completion of and early response to chemoradiation among human immunodeficiency virus (HIV)‐positive and HIV‐negative patients with locally advanced cervical carcinoma in South Africa
Authors: Simonds Hannah M. , Wright Jason D. , du Toit Naomi , Neugut Alfred I. , Jacobson Judith S.
Published: November 2011

BACKGROUND:

Very few published studies have dealt with the management of locally advanced cervix carcinoma among human immunodeficiency virus (HIV)‐positive patients. The objective of this study was to compare the clinical characteristics, radiation and chemotherapy treatments, and outcomes in a cohort of HIV‐positive and HIV‐negative women with cervical cancer.

METHODS:

The authors reviewed the charts of 59 HIV‐positive patients and 324 HIV‐negative patients who had stage IB1 to IIIB cervical carcinoma and who received radiation therapy. Demographic and clinical characteristics were compared at the time of diagnosis; and radiation doses, chemotherapy cycles, and responses were compared at the time of brachytherapy and at 6‐week follow‐up. Logistic regression models of response to treatment were developed.

RESULTS:

Forty‐nine HIV‐positive patients (88.1%) but only 213 HIV‐negative patients (65.7%) presented with stage IIIB disease (P = .009). Forty‐seven HIV‐positive patients (79.7%) and 291 HIV‐negative patients (89.8%) completed the equivalent dose of 68 Grays (Gy) external‐ beam radiation and high‐dose‐rate brachytherapy. (P = .03). Of the 333 patients who commenced concurrent chemotherapy, 26 HIV‐positive patients (53.1%) and 212 HIV‐negative patients (74.6%) completed ≥4 weekly cycles of platinum‐based treatment. Follow‐up was censured at 6 weeks. In models that included age, disease stage, HIV status, and treatment, a poor response at 6 weeks was associated only with stage IIIB disease (odds ratio, 2.39; 95% confidence interval, 1.45‐3.96) and receiving an equivalent radiation dose in 2‐Gy fractions of <68 Gy (OR, 3.14; 95% CI, 1.24‐7.94).

CONCLUSIONS:

HIV‐positive patients fared worse than HIV‐negative patients because of later presentation and a decreased likelihood of completing treatment. The current findings emphasize the importance of completing irradiation therapy. Further studies will address the association of these variables with survival. Cancer 2011. © 2011 American Cancer Society.
Detection and analysis of resource usage anomalies in large distributed systems through multi‐scale visualization
Authors: Schnorr Lucas Mello , Legrand Arnaud , Vincent Jean‐Marc
Published: November 2011

Understanding the behavior of large scale distributed systems is generally extremely difficult as it requires to observe a very large number of components over very large time.

Most analysis tools for distributed systems gather basic information such as individual processor or network utilization. Although scalable because of the data reduction techniques applied before the analysis, these tools are often insufficient to detect or fully understand anomalies in the dynamic behavior of resource utilization and their influence on the applications performance.

In this paper, we propose a methodology for detecting resource usage anomalies in large scale distributed systems. The methodology relies on four functionalities: characterized trace collection, multi‐scale data aggregation, specifically tailored user interaction techniques, and visualization techniques. We show the efficiency of this approach through the analysis of simulations of the volunteer computing Berkeley Open Infrastructure for Network Computing architecture. Three scenarios are analyzed in this paper: analysis of the resource sharing mechanism, resource usage considering response time instead of throughput, and the evaluation of input file size on Berkeley Open Infrastructure for Network Computing architecture. The results show that our methodology enables to easily identify resource usage anomalies, such as unfair resource sharing, contention, moving network bottlenecks, and harmful short‐term resource sharing. Copyright © 2011 John Wiley & Sons, Ltd.
Comparison of cryopreservation methods on T‐cell responses to islet and control antigens from type 1 diabetic patients and controls
Authors: Brooks‐Worrell B. , Tree T. , Mannering S. I. , Durinovic‐Bello I. , James E. , Gottlieb P. , Wong S. , Zhou Z. , Yang L. , Cilio C. M. , Reichow J. , Menart B. , Rutter R. , Schreiner R. , Pham M. , Petrich de Marquesini L. , Lou O. , Scotto M. , Mallone R. , Schloot N. C. ,   T‐Cell Workshop Committee, Immunology of Diabetes Society
Published: November 2011

Background

Type 1 diabetes (T1D) is a cell‐mediated autoimmune disease characterized by destruction of the pancreatic islet cells. The use of cryopreserved cells is preferable to the use of freshly isolated cells to monitor clinical trials to decrease assay and laboratory variability.

Methods

The T‐Cell Workshop Committee of the Immunology of Diabetes Society compared two widely accepted T‐cell freezing protocols (warm and cold) to freshly isolated peripheral blood mononuclear cells from patients with T1D and controls in terms of recovery, viability, cell subset composition, and performance in functional assays currently in use in T1D‐related research. Nine laboratories participated in the study with four different functional assays included.

Results

The cold freezing method yielded higher recovery and viability compared with the warm freezing method. Irrespective of freezing protocol, B cells and CD8+ T cells were enriched, monocyte fraction decreased, and islet antigen‐reactive responses were lower in frozen versus fresh cells. However, these results need to take in to account that the overall response to islet autoantigens was low in some assays.

Conclusions

In the current study, none of the tested T‐cell functional assays performed well using frozen samples. More research is required to identify a freezing method and a T‐cell functional assay that will produce responses in patients with T1D comparable to responses using fresh peripheral blood mononuclear cells. Copyright © 2011 John Wiley & Sons, Ltd.
Persistent glucose transporter expression on pancreatic beta cells from longstanding type 1 diabetic individuals
Authors: Coppieters Ken T. , Wiberg Anna , Amirian Natalie , Kay Thomas W. , von Herrath Matthias G.
Published: November 2011

Background

Recent reports have established the notion that many patients with longstanding type 1 diabetes (T1D) possess a remnant population of insulin‐producing beta cells. It remains questionable, however, whether these surviving cells can physiologically sense and respond to glucose stimuli.

Methods

Frozen pancreatic sections from non‐diabetic donors (n = 8), type 2 diabetic patients (n = 4), islet autoantibody‐positive non‐diabetic patients (n = 3), type 1 diabetic patients (n = 10) and one case of gestational diabetes were obtained via the network for Pancreatic Organ Donors. All longstanding T1D samples were selected based on the detection of insulin‐producing beta cells in the pancreas by immunohistochemistry. RNA was isolated from all sections followed by cDNA preparation and quantitative real‐time polymerase chain reaction for insulin, glucose transporter 1 (GLUT1), GLUT2 and GLUT3. Finally, immunofluorescent staining was performed on consecutive sections for all four of these markers and a comparison was made between the expression of GLUT2 in humans versus NOD mice.

Results

In contrast to islets from the most widely used T1D model, the NOD mouse, human islets predominantly express GLUT1 and, to a much lesser extent, GLUT3 on their surface instead of GLUT2. Relative expression levels of these receptors do not significantly change in the context of the various (pre‐)diabetic conditions studied. Moreover, in both species preservation of GLUT expression was observed even under conditions of substantial leucocyte infiltration or decades of T1D duration.

Conclusions

These data suggest that despite being subjected to multiple years of physiological stress, the remaining beta‐cell population in longstanding T1D patients retains a capacity to sense glucose via its GLUTs. Copyright © 2011 John Wiley & Sons, Ltd.
Multiple antigens versus single major antigen in type 1 diabetes: arguing for multiple antigens
Authors: DiLorenzo Teresa P.
Published: November 2011

Our recent review of the literature revealed that approximately 20 antigens are now known to be targeted by T cells in the NOD mouse model of the autoimmune disease type 1 diabetes. Of these, insulin has received considerable attention and has been described by some in the research community as an ‘initiating’ or ‘single major’ antigen in the disease. Insulin may indeed be worthy of these titles, at least in NOD mice and in the context of the particular major histocompatibility complex molecules expressed in this strain. However, here we present arguments in favour of viewing type 1 diabetes as a disease in which multiple antigens should be considered, rather than just one. In our view, other antigens may prove to be more worthy of these titles in humans, and the major histocompatibility complex molecules expressed may well be a determining factor. Furthermore, even if insulin is ‘the initiating antigen’ in type 1 diabetes, multiple pathogenic specificities are known to exist even during the prediabetic period and it is at our peril that we ignore them. The recent discovery of novel beta‐cell antigens, e.g. ZnT8 and chromogranin A, has taught us that we still have much to learn about the targets of the autoimmune response in type 1 diabetes. Increased knowledge will promote a clearer picture of disease pathogenesis and will better position the field to be successful in its translational goals of immune monitoring and disease prevention and reversal. Copyright © 2011 John Wiley & Sons, Ltd.
Susceptibility influence of a PTPN22 haplotype with thyroid autoimmunity in Koreans
Authors: Lee Hye‐Soon , Kang Jungoo , Yang Seiwon , Kim Dukhee , Park Yongsoo
Published: November 2011

Background

Considerable amount of evidences in the Caucasians have suggested the association of a missense single‐nucleotide polymorphism (SNP) in the protein tyrosine phosphatase non‐receptor type 22 (PTPN22) gene (rs2476601) with several autoimmune diseases including autoimmune thyroid diseases (AITD) and type 1 diabetes (T1D). As the SNP was reported to be non‐polymorphic in Asians, we attempt to explore an association of PTPN22 without restricting to the rs2476601 with AITD or T1D in Korean population.

Methods

We studied 389 T1D, 212 AITD (84 Graves' disease and 128 Hashimoto's thyroiditis) patients and 225 controls. In addition to the rs2476601, we selected five testing SNPs spanning 58 kb over the PTPN22 gene using the previous resequencing data and International HapMap Project.

Results

We found that neither alleles, genotypes among all five SNPs, nor reconstructed haplotypes of five SNPs were associated with T1D. Interestingly, a minor allele of a SNP (rs12730735) and a haplotype (GGCTT) showed significant association with the susceptibility of AITD, especially with that of Hashimoto's thyroiditis (p < 0.01).

Conclusions

These results indicate that the PTPN22 gene polymorphism independent of the SNP rs2476601 might be a supplementary risk factor to AITD, but not in T1D in Koreans, contradicting a major contributory influence of the PTPN22 gene in explaining common mechanism underlying multiple autoimmune diseases. Copyright © 2011 John Wiley & Sons, Ltd.
Immune regulation by CTLA‐4—relevance to autoimmune diabetes in a transgenic mouse model
Authors: Wang Chun Jing , Schmidt Emily M. , Attridge Kesley , Kenefeck Rupert , Wardzinski Lukasz , Chamberlain Jayne L. , Soulier Annelise , Clough Louise E. , Manzotti Claire N. , Narendran Parth , Walker Lucy S. K.
Published: November 2011

Background

The importance of cytotoxic T lymphocyte antigen‐4 (CTLA‐4) in immune regulation is unquestioned, yet a precise understanding of which cells express it, and how it mediates immune inhibitory function, is lacking. Regulatory T cells are known to constitutively express CTLA‐4 intracellularly, whereas conventional T cells require activation to trigger CTLA‐4 expression. However comparative analysis of CTLA‐4 trafficking in regulatory and conventional subsets has not been performed.

Methods

Here we assess CTLA‐4 expression in antigen‐specific conventional and regulatory cells responding to immunizing antigen in vivo and analyse the membrane trafficking of CTLA‐4 using an in vitro recycling assay. We assess the expression of CTLA‐4 on Treg infiltrating the pancreas in the DO11 × RIP‐mOVA diabetes model and the role of CTLA‐4 in Treg function.

Results

Regulatory T cells show an enhanced capacity to traffic CTLA‐4 following stimulation compared with conventional T cells. Treg infiltrating the pancreas in DO11 × RIP‐mOVA mice show high expression of CTLA‐4. Furthermore CTLA‐4‐deficient Treg fail to control diabetes in an adoptive transfer model of diabetes, even in situations where they outnumber the disease‐inducing conventional T cells.

Conclusions

These data show that not only do regulatory T cells express higher levels of intracellular CTLA‐4 than conventional T cells, but they also show an increased capacity to traffic CTLA‐4 to the cell surface following stimulation. CTLA‐4 is strongly upregulated in regulatory T cells infiltrating the target tissue in a mouse model of type 1 diabetes and expression of this protein is critical for effective regulation. Copyright © 2011 John Wiley & Sons, Ltd.
LADA prevalence estimation and insulin dependency during follow‐up
Authors: Park Yongsoo , Hong Sangmo , Park Leejin , Woo Jungtaek , Baik Sehyun , Nam Munsuk , Lee Kwanwoo , Kim Youngseol ,   and on behalf of The KNDP collaboratory Group
Published: November 2011

Background

Latent autoimmune diabetes in adults (LADA) is a form of autoimmune‐mediated diabetes in adults, usually defined by GAD autoantibody positivity. Few epidemiological surveys on LADA in Asians did not come to a conclusive answer regarding prevalence and incidence, because of different criteria used in patient ascertainment.

Methods

We estimated LADA prevalence in a recent type 2 diabetes cohort by the positivity of circulating autoantibodies to pancreatic islet cell antigens (GAD, IA‐2 and zinc transporter 8 (ZnT8)) applying a comparable Caucasian criteria. We then observed the development of insulin dependency prospectively for 36 months.

Results

Applying the European NIRAD LADA group criteria, we found a high prevalence of LADA (4.4%) in Korean patients with phenotypic type 2 diabetes. This high prevalence of LADA in Korea is noteworthy since the previous population‐based LADA prevalence survey reported low prevalence (1.7%). When we consider the low‐titre GAD antibodies and the low prevalence of multiple autoantibodies, however, increased LADA prevalence does not necessarily mean increase in future insulin dependency. After 36 months of follow‐up, only 3 of 39 patients who were initially classified as LADA have become insulin‐dependent. Those three were all positive for multiple autoantibodies (GAD, IA‐2 and zinc transporter 8 antibody). Other features of insulin secretion or insulin resistance did not determine future insulin necessity.

Conclusions

Although the LADA prevalence estimated by anti‐GAD positivity appeared to increase, the true insulin dependency evidenced by multiple antibody positivity did not increase in Korea. Copyright © 2011 John Wiley & Sons, Ltd.
Suppressive effect of docosahexaenoyl‐lysophosphatidylcholine and 17‐hydroxydocosahexaenoyl‐lysophosphatidylcholine on levels of cytokines in spleen of mice treated with lipopolysaccharide
Authors: Jim Mei Chen , Hung Nguyen Dang , Yoo Jae Myung , Kim Mee Ree , Sok Dai‐Eun
Published: November 2011

Lysophosphatidylcholine (lysoPC) with polyunsaturated fatty acyl chains has been known to be anti‐inflammatory in vivo. In the present study, we examined the effect of docosahexaenoyl‐lysophosphatidylcholine (DHE‐lysoPC) and 17‐hydroxydocosahexaenoyl‐lysophosphatidylcholine (17‐HDHE‐lysoPC) on spleen weight and cytokine level in spleen of mice treated with lipopolysaccharide (LPS). For this purpose, mice were administrated i.p. with DHE‐lysoPC or 17‐HDHE‐lysoPC 1 h before i.p. injection of LPS. First, DHE‐lysoPC (50–400 µg/kg) was found to suppress the LPS‐induced increase of spleen weight dose‐dependently, and such a suppressive effect was greater for 17‐HDHE‐lysoPC, compared to DHE‐lysoPC. Next, in an attempt to see the effect of DHE‐lysoPC on cytokine levels in spleen of mice treated with LPS, DHE‐lysoPC was found to suppress LPS‐induced increase in the levels of cytokines such as TNF‐α, IL‐1β, or IL‐6 in a dose dependent manner (50–400 µg/kg), in contrast to DHA showing a significant action at a high dose (400 µg/kg) only. The greater suppressive effect of 17‐HDHE‐lysoPC (15–150 µg/kg) than DHE‐lysoPC suggested that action of DHE‐lysoPC may be enhanced through lipoxygenation process. Presumably in support of this, when the interval time between 17‐HDHE‐lysoPC administration and LPS challenge was varied, the cytokine‐suppressing effect was found to be augmented in a time‐dependent manner. Taken all together, it is suggested that DHE‐lysoPC and 17‐HDHE‐lysoPC may be beneficial in suppressing the inflammation in spleen tissue.