bluuebunny/crossref_metadata_2025 huggingface dataset:
Nipple Aspirate Fluid Collection, Related Factors and Relationship between Carcinoembryonic Antigen in Nipple Aspirate Fluid and Breast Diseases in Women in Harbin, PRC
Authors: Zhao Ya-shuang , Pang Da , Wang Fan , Xue Ying-wei , Gao Dan-ning , Li Hui , Li Kang , Wang Bin-you , Wang Da , Li Hong-yuan
Published: March 2009

This study aimed to examine the factors related to the ability to obtain nipple aspirate fluids in Chinese women and to evaluate the diagnostic value of carcinoembryonic antigen (CEA) in nipple aspiration fluids. Cross-sectional and case-control studies were used to examine the factors associated with the ability to obtain nipple aspiration fluids. A matched case-control study was used to explore the association of CEA level in nipple aspiration fluids with breast disease. CEA level was log10-transformed to normalize the distribution. Univariate and multivariate logistic regression were adopted to analyze the variables in relation to obtaining fluid and the association of its CEA levels and breast diseases. Receiver operating characteristic curve was used to evaluate the value of CEA levels for the detection of breast disease. The nipple aspiration fluid collection rate was 34.24% (201 of 587). Multivariate logistic regression analysis results showed the following to be significantly associated with a greater ability to obtain nipple aspiration fluids: earlier age at menarche [odds ratio (OR), 2.61; 95% confidence interval (95% CI), 1.15-5.91], lactating >12 months (OR, 2.28; 95% CI, 1.44-3.60), wet-type ear wax (OR, 3.80; 95% CI, 2.39-6.02), and fatty diet (OR, 1.56; 95% CI, 1.02-2.39). CEA levels in nipple aspiration fluids of cancerous breasts were significantly higher than those from breasts with benign disease and healthy controls (ORadj, 5.39; P < 0.01). However, the sensitivity of CEAs was 35.42% and the specificity was 85.42% whereas the CEA cutoff value was 307.61 ng/mL. The area under the receiver operating characteristic curve was 0.65. The nipple aspiration fluid collection rate in Chinese native women is lower compared to non-Asian-descendant women. CEA level does not seem to be a useful diagnostic tool for early cancer detection; it can only be used in conjugation with other methods. (Cancer Epidemiol Biomarkers Prev 2009;18(3):732–8)
Suboptimal DNA Repair Capacity Predisposes Coke-Oven Workers To Accumulate More Chromosomal Damages in Peripheral Lymphocytes
Authors: Cheng Juan , Leng Shuguang , Li Haishan , Huang Chuanfeng , Niu Yong , Zhang Linyuan , Liang Xuemiao , Lin Han , Zheng Yuxin
Published: March 2009

DNA repair is an essential mechanism for cells to maintain their genomic integrity under endogenous or exogenous assault. Reduced DNA repair capacity (DRC) is associated with increased risk for several environmentally related cancers. The micronucleus in peripheral lymphocytes has been validated as a biomarker of chromosomal damage, increasing cancer risk in human populations. We hypothesized that suboptimal DRC is associated with the increase in chromosomal damage among 94 coke-oven workers and 64 noncoke-oven controls. DRC was evaluated in isolated lymphocytes by comet assay. Chromosomal damage in peripheral lymphocytes was detected by cytokinesis-block micronucleus assay. Four common coding single nucleotide polymorphisms in the XRCC1 gene were genotyped. Coke-oven workers have significantly increased urinary 1-hydroxypyrene (9.0; 6.8-11.7 μg/L versus 1.5, 1.3-1.7 μg/L; P < 0.01) and micronucleus frequency (7.4‰ ± 4.3‰ versus 3.0‰ ± 3.0‰; P < 0.01), and decreased DRC (55.9% ± 16.4% versus 63.6% ± 18.5%; P < 0.01) compared with controls. Significant correlations between DRC and micronucleus frequency were found in coke-oven workers (r = −0.32; P < 0.01; n = 94) and all study subjects (r = −0.32; P < 0.001; n = 158) but not in controls (r = −0.21; P = 0.11; n = 64). Variants of the Arg399Gln polymorphism were associated with a decreased DRC in both coke-oven workers (51.6% ± 16.1% versus 60.6% ± 15.7%; P < 0.01) and controls (59.1% ± 18.5% versus 68.4% ± 17.5%; P = 0.04). The complicated interrelationship of these multiple biomarkers was also identified by path analysis. These findings should facilitate developing a biomarker-based risk assessment model for lung cancer in this occupational population. (Cancer Epidemiol Biomarkers Prev 2009;18(3):987–93)
Analysis of Colorectal Adenoma Recurrence Data Subject to Informative Censoring
Authors: Hsu Chiu-Hsieh , Taylor Jeremy M.G. , Long Qi , Alberts David S.
Published: March 2009

The treatment effect of a colorectal polyp prevention trial is often evaluated from the colorectal adenoma recurrence status at the end of the trial. However, early colonoscopy from some participants complicates estimation of the final study end recurrence rate. The early colonoscopy could be informative of status of recurrence and induce informative differential follow-up into the data. In this article, we use midpoint imputation to handle interval-censored observations. We then apply a weighted Kaplan-Meier method to the imputed data to adjust for potential informative differential follow-up, while estimating the recurrence rate at the end of the trial. In addition, we modify the weighted Kaplan-Meier method to handle a situation with multiple prognostic covariates by deriving a risk score of recurrence from a working logistic regression model and then use the risk score to define risk groups to perform weighted Kaplan-Meier estimation. We argue that midpoint imputation will produce an unbiased estimate of recurrence rate at the end of the trial under an assumption that censoring only depends on the status of early colonoscopy. The method described here is illustrated with an example from a colon polyp prevention study. (Cancer Epidemiol Biomarkers Prev 2009;18(3):712–7)
Is it Time to Test Metformin in Breast Cancer Clinical Trials?
Authors: Cazzaniga Massimiliano , Bonanni Bernardo , Guerrieri-Gonzaga Aliana , Decensi Andrea
Published: March 2009

Several studies have identified an increased risk of cancer in type 2 diabetic patients and this is in accordance with the hypothesis that increased insulin levels might promote cancer. Thus, there is a great interest in exploring the possibility that antidiabetic therapies lowering insulin levels could decrease cancer incidence or cancer-related mortality. Recent observational studies have shown that metformin, an oral safe and well-tolerated insulin-sensitizer antidiabetic drug, has been associated with reduced cancer risk. Recently, several preclinical studies have evaluated the effect of metformin in vivo on nude mice and showed a significant reduction of both breast epithelial cell proliferation and protein synthesis. Further investigations in the clinical setting are well-supported by the promising results obtained thus far. At the European Institute of Oncology, the Division of Cancer Prevention and Genetics is planning to conduct a clinical trial to evaluate the activity of metformin on tumor cell proliferation in breast cancer patients undergoing surgery. It will be a presurgical randomized, double blind, placebo-controlled phase II biomarker trial: 100 histologically confirmed breast cancer patients will be randomly assigned to metformin (850 mg twice/daily) or placebo for 28 + 7 days till surgery to assess drug activity on tumor proliferation, as measured by Ki-67. The confirmation of the efficacy of metformin on cancer cell proliferation may lead the way to larger chemoprevention clinical trials. (Cancer Epidemiol Biomarkers Prev 2009;18(3):701–5)
The Association of Tumor Microsatellite Instability Phenotype with Family History of Colorectal Cancer
Authors: Bapat Bharati , Lindor Noralane M. , Baron John , Siegmund Kim , Li Lin , Zheng Yingye , Haile Robert , Gallinger Steve , Jass Jeremy R. , Young Joanne P. , Cotterchio Michelle , Jenkins Mark , Grove John , Casey Graham , Thibodeau Stephen N. , Bishop D. Timothy , Hopper John L. , Ahnen Dennis , Newcomb Polly A. , Le Marchand Loic , Potter John D. , Seminara Daniela ,   and the Colon Cancer Family Registry
Published: March 2009

Family history is a strong predictor of colorectal cancer risk; however, a diagnosis of colorectal cancer among first-degree relatives has not been systematically investigated as a function of the colorectal cancer molecular subtypes related to tumor microsatellite instability (MSI) status. We investigated whether the observable familial colorectal cancer risks differed according to tumor MSI subtypes, stratified as MSI-High (>30% instability), MSI-Low (<30% instability), and MSS (no instability). Data from 3,143 population-based colorectal cancer cases from five institutions were assessed for family history according to the Amsterdam criteria and the Bethesda guidelines, age at diagnosis, sex, tumor location, and MSI status. The distribution of patient characteristics by MSI status was compared using polytomous logistic regression. Overall, 2.8% colorectal cancer cases met the Amsterdam criteria and 37% met the Bethesda guidelines. There were 14% MSI-High, 13% MSI-Low, and 73% MSS colorectal cancers. MSI-High (P < 0.0001) and MSI-Low tumors (P = 0.01) were more proximally located than MSS tumors. MSI-High tumors were more common among females (P < 0.001). The highest proportion of MSI-High tumors occurred in cases <40 years of age whereas the age-dependent distribution of MSI-Low tumors was unchanged. MSI-High tumors showed a statistically significant association with increasing numbers of first-degree relatives with colorectal cancer (P = 0.002); this association disappeared, however, when MSI-High cases meeting Amsterdam criteria were removed from the analysis. MSI-Low tumors did not show a similar association with family history of colorectal cancer. Familial risk associated with MSI-High tumors is primarily driven by the Amsterdam-criteria patients. MSI-Low tumors may represent a distinct subtype of colorectal cancer with respect to certain epidemiologic variables studied here. (Cancer Epidemiol Biomarkers Prev 2009;18(3):967–75)
Cost-Effectiveness Analysis of Mammography and Clinical Breast Examination Strategies: A Comparison with Current Guidelines
Authors: Ahern Charlotte Hsieh , Shen Yu
Published: March 2009

Purpose: Breast cancer screening by mammography and clinical breast exam are commonly used for early tumor detection. Previous cost-effectiveness studies considered mammography alone or did not account for all relevant costs. In this study, we assessed the cost-effectiveness of screening schedules recommended by three major cancer organizations and compared them with alternative strategies. We considered costs of screening examinations, subsequent work-up, biopsy, and treatment interventions after diagnosis.

Methods: We used a microsimulation model to generate women's life histories, and assessed screening and treatment effects on survival. Using statistical models, we accounted for age-specific incidence, preclinical disease duration, and age-specific sensitivity and specificity for each screening modality. The outcomes of interest were quality-adjusted life years (QALY) saved and total costs with a 3% annual discount rate. Incremental cost-effectiveness ratios were used to compare strategies. Sensitivity analyses were done by varying some of the assumptions.

Results: Compared with guidelines from the National Cancer Institute and the U.S. Preventive Services Task Force, alternative strategies were more efficient. Mammography and clinical breast exam in alternating years from ages 40 to 79 years was a cost-effective alternative compared with the guidelines, costing $35,500 per QALY saved compared with no screening. The American Cancer Society guideline was the most effective and the most expensive, costing over $680,000 for an added QALY compared with the above alternative.

Conclusion: Screening strategies with lower costs and benefits comparable with those currently recommended should be considered for implementation in practice and for future guidelines. (Cancer Epidemiol Biomarkers Prev 2009;18(3):718–25)
Predisposing Factors Associated with Compliance to Biennial Breast Screening among Centers with and without Nurses
Authors: Edwards Sarah A. , Chiarelli Anna M. , Stewart Lindsay , Majpruz Vicky , Ritvo Paul , Mai Verna
Published: March 2009

Background: Previous research suggests that predisposing factors such as previous screening experience, participation in preventive health behaviors, and knowledge/beliefs about breast cancer and screening influence a woman's decision to make a timely return for a second screen.

Methods: A stratified random sample of compliers and noncompliers to biennial screening were selected from a cohort of 51,242 women ages 50 to 65 years who had their initial screen at the Ontario Breast Screening Program. In total, 1,901 women were telephone-interviewed. The associations between predisposing factors and compliance were estimated separately for centers with and without nurses using logistic regression analyses adjusted for demographics and smoking status.

Results: Women screened at nurse centers were less likely to comply if they thought women should stop having mammograms before age 70 years [odds ratio (OR), 0.39; 95% confidence interval (95% CI), 0.19-0.79], did not consider mammograms very likely to find cancer (OR, 0.73; 95% CI, 0.56-0.95), felt their likeliness of getting breast cancer was below average (OR, 0.69; 95% CI, 0.54-0.89), or believed a high-fat diet was not an important risk factor for breast cancer (OR, 0.59; 95% CI, 0.36-0.97). Women attending nurse centers were significantly more likely to comply if they sometimes had thoughts or worries about developing breast cancer (OR, 1.40; 95% CI, 1.10-1.80).

Conclusions: Nurses at screening centers may reinforce a woman's knowledge or beliefs about breast cancer or screening and as a result increase their compliance to biennial breast screening. (Cancer Epidemiol Biomarkers Prev 2009;18(3):739–47)
Serum Prostate-Specific Antigen Hemodilution Among Obese Men Undergoing Screening in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Authors: Grubb Robert L. , Black Amanda , Izmirlian Grant , Hickey Thomas P. , Pinsky Paul F. , Mabie Jerome E. , Riley Thomas L. , Ragard Lawrence R. , Prorok Philip C. , Berg Christine D. , Crawford E. David , Church Timothy R. , Andriole Gerald L. ,   for the PLCO Project Team
Published: March 2009

Background: Previous studies have shown an inverse relationship between prostate-specific antigen (PSA) concentration and body mass index (BMI). It has been recently proposed that this relationship may be explained by the larger plasma volume of obese men diluting a fixed amount of PSA (hemodilution effect). We examined this hypothesis in a cohort of men enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

Methods: Of 38,349 men ages 55 to 74 years randomized in PLCO to receive annual PSA and digital rectal examination screening, 28,380 had a baseline PSA, complete demographic information, and no prostate cancer diagnosis within 6 years from baseline. Self-reported height and weight were used to calculate BMI and to estimate plasma volume. PSA mass was estimated as PSA concentration times plasma volume. Multivariable linear regression models were used to investigate the relationship between PSA concentration, plasma volume, PSA mass, and BMI.

Results: PSA concentration significantly decreased with increasing BMI (P < 0.001); mean PSA values were 1.27, 1.25, 1.18, and 1.07 ng/mL among normal (BMI, 18.5-25), overweight (BMI, 25-30), obese (BMI, 30-35), and morbidly obese (BMI, >35) men, respectively. However, plasma volume also increased with increasing BMI and PSA mass showed no association with BMI, with mean values of 3.78, 3.95, 3.97, and 3.82 μg across the four BMI categories (P = 0.10).

Conclusions: This study confirms earlier findings that the inverse relationship between PSA concentration and BMI may be explained by a hemodilution effect. These findings could have implications for prostate cancer screening in large men. (Cancer Epidemiol Biomarkers Prev 2009;18(3):748–51)
Is Antioxidant and n–3 Supplementation Able to Improve Functional Status in Poststroke Patients? Results from the Nutristroke Trial
Authors: Garbagnati F. , Cairella G. , De Martino A. , Multari M. , Scognamiglio U. , Venturiero V. , Paolucci S.
Published: March 2009

Background: To test whether supplementary antioxidants and n–3 fatty acids, alone or in combination, could improve functional status in stroke survivors. Methods: We performed a randomized, double-blind, placebo-controlled clinical trial in 72 stroke patients (47 males; age 65.3 ± 12.9 years) admitted to a rehabilitation hospital for sequelae of first-ever ischemic stroke, and divided them into 4 subgroups. Group 1 patients received daily oral antioxidants, group 2 received n–3 polyunsaturated fatty acids, group 3 both supplements, and group 4 placebo, all for 12 months. No difference at baseline was observed among groups in neurological severity or in disability. All measures were repeated after 6 and 12 months of treatment. All major clinical events were recorded. Results: At baseline, 25% of the patients had a low plasma vitamin status, and 48.5% was at risk of undernutrition. At the 1-year follow-up, we observed a trend for lower mortality (p = 0.060) in subgroups treated with n–3 fatty acids, but without significant differences in rehabilitation result status among groups. Conclusions: Malnutrition is widely observed in patients admitted to a rehabilitative hospital for stroke rehabilitation, and dietary supplementation, even if not able to improve rehabilitation results, is likely to reduce mortality at the 1-year follow-up.
The Association between Inflammatory Markers and Carotid Atherosclerosis Is Sex Dependent: the Tromsø Study
Authors: Halvorsen Dag S. , Johnsen Stein H. , Mathiesen Ellisiv B. , Njølstad Inger
Published: March 2009

Background: The presence of echolucent artery plaques is associated with increased risk of cardiovascular events as compared to echogenic plaques. Whether inflammatory markers are associated with carotid plaque morphology is questioned. Methods: 5,341 individuals were examined with ultrasonography of the right carotid artery. Of these, 3,205 had carotid plaque(s), in whom plaque area (mm2) and plaque echogenicity, expressed as the computer-assisted gray scale median (GSM), were determined. White blood cell count (WBC), fibrinogen and C-reactive protein (CRP) were analyzed, as well as other cardiovascular risk factors. In multiple linear and logistic regression models, we determined the relationship between plaque area and echogenicity, and inflammatory markers. Results: Women and men with carotid plaque(s) had significantly elevated levels of WBC and fibrinogen, but not CRP, as compared to subjects without plaques. All inflammatory markers were significantly associated with plaque area in men. WBC was significantly associated with plaque echogenicity in women, whereas no association was found between fibrinogen and CRP and plaque echogenicity in either gender. Conclusions: This cross-sectional study showed sex-dependent differences in associations between measures of carotid atherosclerosis and inflammatory markers. CRP did not discriminate echolucent from echogenic carotid plaques in either gender. Our data highlight the importance of sex-specific analyses in future studies.
Pre-Stroke Use of Antihypertensives, Antiplatelets, or Statins and Early Ischemic Stroke Outcomes
Authors: Yu Amy Y.X. , Keezer Mark R. , Zhu Bin , Wolfson Christina , Côté Robert
Published: March 2009

Background: The effect of pre-stroke use of antihypertensives, antiplatelets, and statins on initial severity and early outcome of ischemic stroke is uncertain. Methods: We performed a retrospective chart review of 553 consecutive acute ischemic stroke patients presenting to the Montreal General Hospital between April 1st 2002 and October 15th 2005. We defined a severe stroke as a Canadian Neurological Scale score of ≤7 and a poor early outcome as a modified Rankin Scale score of >3 at 10 days post-stroke. Results: In total, 339 patients were included. Superior early functional outcome was associated with the premorbid use of statins (OR = 0.50, 95% CI: 0.25–1.00) and the combination of all 3 medications (OR = 0.37, 95% CI: 0.16–0.87). Angiotensin-II-decreasing agents were associated with an increased risk of severe strokes (OR = 2.13, 95% CI: 1.00–4.52). Conclusions: Pre-stroke use of statins and the combination of antihypertensives, antiplatelets, and statins were both associated with a favorable functional outcome at 10 days post-stroke. Angiotensin-II-decreasing agents were associated with increased initial stroke severity.
Influence of Clinical and Neuropsychological Variables on the Psychosocial and Occupational Outcome of Remitted Bipolar Patients
Authors: Mur Maria , Portella Maria J. , Martinez-Aran Anabel , Pifarre Josep , Vieta Eduard
Published: March 2009

Objective: To measure the impact of the clinical course, the residual mood symptoms and the cognitive variables on the psychosocial and occupational functioning in bipolar disorder patients in remission. Method: Forty-four euthymic DSM-IV-TR bipolar lithium-treated outpatients were assessed with a clinical interview and neuropsychological testing. To assess psychosocial function, some psychometric scales were administered (Global Assessment of Functioning Scale and World Health Organization Disability Assessment Schedule), and to evaluate occupational function, the sample was divided according to the current work status (active vs. inactive). Cognitive assessment was performed by means of a neuropsychological test battery tapping into the main cognitive domains (executive function, attention, processing speed, verbal memory and visual memory). Results: Measures of psychosocial functioning were significantly correlated with cognition (processing speed, p = 0.004), clinical severity (p = 0.03) and residual depressive symptoms (p = 0.05). Occupational functioning showed a significant effect with a cognitive domain (visual memory, p = 0.006) and a clinical variable (chronicity, p = 0.04) but not with residual mood symptoms (p > 0.2). Conclusions: Remission in bipolar disorder is not synonymous with recovering in psychosocial and occupational functioning. Cognitive deficits, clinical course and persistent subsyndromal symptoms may compromise psychosocial functioning, and neurocognitive symptoms and chronicity may particularly affect occupational functioning.
Renal Dendritic Cells: An Update
Authors: Velázquez Peter , Dustin Michael L. , Nelson Peter J.
Published: March 2009

Discovery into the role of renal dendritic cells (rDCs) in health and disease of the kidney is rapidly accelerating. Progress in deciphering DC precursors and the heterogeneity of monocyte subsets in mice and humans is providing insight into the biology of rDCs. Recent findings have extended knowledge of the origins, anatomy and function of the rDC network at steady state and during periods of injury to the renal parenchyma. This brief review highlights these new findings and provides an update on the study of rDCs.
Public service motivation and organizational performance in Swiss federal government
Authors: Ritz Adrian
Published: March 2009

During the last 20 years public sector reforms focused on the increase of organizational performance mainly by implementing managerial tools and methods. The one-sided, output-oriented reforms meet with criticism. In our study we focus on the links between employee attitudes, managerial measures, institutional factors and organizational performance. Therefore, three attitudinal constructs, public service motivation, organizational commitment and job satisfaction, are analysed. The study empirically tests the effects of these dimensions on perceived performance in the federal administration of Switzerland. The analysed data of 13,532 federal employees give insight into the importance of employee commitment to the public interest and the need for goal-oriented management techniques. The results are discussed in light of previous studies.

Points for practitioners Public administration research raises more and more criticism against New Public Management reforms. This study, however, shows that there is an important link between managerial techniques and the individual perception of organizational performance in administrative practice. There are a range of private management tools immigrating into the public sector. But for the tools to be effective, practitioners need to integrate them with consideration of the specific requirements of the employee's commitment to the public interest.
What determines the behaviour and performance of health professionals? Public service motivation, professional norms and/or economic incentives
Authors: Andersen Lotte Bøgh
Published: March 2009

Theories about professions, public service motivation (PSM) and economic incentives provide different explanations for the behaviour and performance of the producers of public services. PSM theory expects higher performance in the public sector due to the higher levels of public service motivation among public employees, whereas the economic incentive perspective expects performance and behaviour to depend on economic incentives, and the sociology of professions stresses the importance of the employees' occupation. Few have attempted to integrate these three theories, and little is known about the relative strength of the motives. This article aims to analyse the effects of PSM, professional norms and economic incentives on the behaviour and performance of health professionals. Interviews, surveys and register data are used to investigate how professional norms, public service motivation and economic incentives affect the behaviour and performance of Danish dentists, GPs and orthopaedic surgeons. The results indicate that when strong professional norms exist, economic incentives are unimportant. As this is not always the case, however, the perspectives ought to be combined.

Points for practitioners The article will be of interest to practitioners working with professionals, not only healthcare professionals, but all kinds of occupations with specialized, theoretical knowledge and occupational norms. Practitioners, especially those who design incentive systems for professionals, will find the article helpful, as it shows how both economic incentives and professional norms should be taken into consideration when such systems are designed. The key finding is that the performance and behaviour of professionals with different incentives is almost similar for services governed by firm norms within the profession, whereas performance and behaviour depend on the economic incentives in the absence of professional norms. This implies that while we may depend on the professional norms to constrain some behaviour, even highly professionalized employees can be moved by selfish motives.
Evaluating financial performance in local government: maximizing the benchmarking value
Authors: Zafra-Gómez José Luis , López-Hernández Antonio Manuel , Hernández-Bastida Agustín
Published: March 2009

One of the main problems in evaluating financial performance arises in carrying out comparisons between municipalities, as no account is taken of the impact of certain factors of the social and economic environment on the indicators in question. In this study, the concept of financial condition is applied, revealing the influence of such factors, and a methodology is proposed to minimize their effects on the results of the evaluation. The results of applying these to a sample of municipalities in Spain reveal that the model is useful for reinforcing the value of benchmarking between municipalities with similar characteristics.

Points for practitioners The use of indicators for evaluating financial performance has advanced considerably in recent years. However, many criticisms have been made by public sector managers concerning the application of such indicators. One of these is that, in many cases, the values measured by different authorities are not comparable, as the services they provide differ significantly. If local authorities were grouped according to the social and economic factors influencing their provision of public services, the evaluations made would be much more effective, facilitating decision-making by supervisory bodies and by municipal managers.
Late 19th century administrative reform in America: re-articulating Hamiltonian thought
Authors: O'Hara Jonathan
Published: March 2009

In this article, the intellectual thought of a group of key late 19th century national administrative reformers is isolated and analyzed. These reformers were interested in reforming the civil, military and business administrative functions of the executive branch to provide for greater elite administrative supervision over and intervention in the national society and economy. The reformers often articulated their reform purposes, motives and goals in the Hamiltonian language of administrative authority and popular deference to executive administrative counsels. An important key to understanding this article is recognizing that while environmental social and economic conditions had changed significantly for the Gilded Age reformers since the American constitutional founding, many elements of the Hamiltonian tradition still resonated with the reformers a full century later. In this way, the historically transmitted ideology and rhetoric of Hamiltonian thought can be seen as having an independent, causative impact on the administrative reformers' purposes, motives and goals related to executive administrative reform.

Points for practitioners This article explores an era of American administrative reform that should be of interest to practitioners of administration in other countries. The article's narrative displays a route to reform that is distinct from the more conventionally studied pathways of bureaucratic efficiency and administrative legal mechanisms applied to administrative organizations. The particular American ideas and thinkers examined in this article give a glimpse of a pathway to reform that is absent in many other societies.
Norm Regress: US Revisionism and the Slow Death of the Torture Norm
Authors: McKeown Ryder
Published: March 2009

Is the norm against torture suffering a crisis of legitimacy within the United States, and if so, does this constitute a crisis in the norm itself? Can constructivist international relations theory explain how the norm came to be significantly weakened by its most important proponent? Constructivist literature on norms has hitherto suffered from a `nice norm bias' that does not adequately take into account the reversibility of so-called `internalized' norms like the one prohibiting torture. Through an examination of the rhetoric, policies and practices surrounding US interrogation after 9/11, this article addresses omissions in constructivist literature by providing a theoretical model to explain `norm regress', or the death of norms. It claims that the torture norm is suffering a crisis of legitimacy within the United States and any future incidences of torture by liberal states may well bring about a crisis of legitimacy in the international norm itself.
Symptom management for the adult patient dying with advanced chronic kidney disease: A review of the literature and development of evidence-based guidelines by a United Kingdom Expert Consensus Group
Authors: Douglas C , Murtagh FEM , Chambers EJ , Howse M , Ellershaw J
Published: March 2009

Abstract

Improvement in end-of-life-care is required for patients dying with chronic kidney disease (CKD). The UK government now recommends that tools such as the Liverpool Care Pathway for the Dying Patient (LCP) be used to enhance the care of those patients dying with CKD. The LCP was originally developed for patients dying with terminal cancer, however has been shown to be transferable to patients dying with heart failure or stroke. On this background, in 2005 a UK National Renal LCP Steering Group was formed. The aim was to determine whether or not the generic LCP was transferable to patients dying with CKD. An Expert Consensus sub-group was established to produce evidence-based prescribing guidelines to allow safe and effective symptom control for patients dying with renal failure. These guidelines were finalised by the Expert Consensus group in August 2007 and endorsed by the Department of Health in March 2008. A literature search on symptom control and end-of-life care in renal failure was performed. A summary of the evidence was presented at a National Steering Group meeting. Opinions were given and provisional guidelines discussed. A first draft was produced and individually reviewed by all members of the Expert Group. Following review, amendments were made and a second draft written. This was presented to the entire National Steering Group and again individual comments were taken into consideration. A third and fourth draft were written and individually reviewed, before the guidelines were finalised by the Expert Consensus group. Patients dying with advanced CKD suffer symptoms similar to patients dying of cancer. The Renal LCP prescribing guidelines aim to control the same symptoms as the generic LCP: pain, dyspnoea, terminal restlessness and agitation, nausea and respiratory tract secretions. The evidence for the production of the guidelines is discussed and how a consensus was reached. A summary of the guidelines is given and the complete guidelines document is available via the Marie Curie Palliative Care Institute, Liverpool website.
Peroneal Nerve Regeneration Using a Unique Bilayer Polyurethane-collagen Guide Conduit
Authors: Xiahong Wang  , Tongkui Cui  , Yongnian Yan  , Renji Zhang
Published: March 2009

Unique double layer polyurethane (PU)-collagen nerve guide conduits with desirable biocompatibility and mechanical properties were fabricated using a newly developed double-nozzle low-temperature deposition manufacturing (DLDM) technique. The inner collagen layer of the conduit had oriented nano-size filaments with micro-pores (pore size 20—100μm) that permitted nutrient infiltration, while the outer PU layer had micro-pores (pore size 15—20 μm) preventing fibrous tissue invasion. In vivo animal tests (n = 6) on bridging a 10 mm long peroneal nerve defect was conducted using rats. Single layer pure PU conduit (n = 6) was used as the positive control and the same size defect with no implantation (n = 2) as the negative control. Through walk track analysis as well as electrophysiological and histological evaluations of the regenerated nerves, the double layer PU-collagen conduit demonstrated better nerve repair than the controls. This new PU-collagen has the potential for significant clinical applications in peripheral nerve repair.
Hybrid Nanoapatite by Polysaccharide Nanogel-templated Mineralization
Authors: Yamane Setsuko , Sugawara Ayae , Watanabe Akihiko , Akiyoshi Kazunari
Published: March 2009

Self-assembled nanogels of cholesterol-bearing mannan (CHM) containing phosphodiester bonds in its structure were used as templates for calcium phosphate mineralization to prepare novel organic—inorganic hybrid nanocarriers for drug-delivery systems. These hybrid materials were synthesized from a solution of calcium phosphate in the presence of CHM nanogels. The size and crystallinity of the nanomaterials were controlled by changing the calcium ion concentration. Spherical amorphous calcium phosphate (ACP) nanoparticles of ~20 nm in size and needle-shaped hydroxyapatite (HAp) crystals ~80 nm in length were formed from solutions of [Ca2+] = 0.8 and 2.0 mM, respectively. These hybrid nanomaterials showed excellent colloidal stability in solution, which was supported by the polymer chains of CHM on the outer surface of the hybrid nanomaterials. It was also found that an amorphous-to-crystalline transformation occurred during the formation of CHM nanogel-HAp hybrid nanomaterials.
In Vitro Evaluation of Amphiphilic Macromolecular Nanocarriers for Systemic Drug Delivery
Authors: Harmon Alexander M. , Uhrich Kathryn E.
Published: March 2009

Amphiphilic star-like macromolecules and amphiphilic scorpion-like macromolecules are polymeric micelles capable of water-solubilizing hydrophobic molecules for intravenous injection. In this work, four different amphiphilic macromolecules (M12P5, M6P5, NC12P5, NC6P5) were evaluated using human primary cell lines of the vasculature: human umbilical endothelial cells (HUVEC), umbilical arterial smooth muscle cells (UASM), and normal dermal human fibroblasts (NDHF). The three primary cell types were incubated with culture media containing amphiphilic macromolecules at five concentrations ranging from 10-3 M to 10-7 M at 24, 48, and 72 h. All cell types treated with both amphiphilic macromolecules showed similar cell viability compared to the vehicle control at all concentrations, except at 10-3 M, which showed a substantially lower cell viability. Cells treated with amphiphilic macromolecules also exhibited similar characteristic cell morphologies at all concentrations, except for 10-3 M, which showed distressed cells. The initial screening of amphiphilic macromolecules against primary human cells associated with the vasculature exhibited good biocompatibility.
Lack of sleep, work and the long hours culture: evidence from the UK Time Use Survey
Authors: Chatzitheochari Stella , Arber Sara
Published: March 2009

Sleep is functional for individual and societal well-being, with partial sleep deprivation associated with adverse health and safety consequences. Surprisingly, sleep is absent from work—life balance debates and has remained largely under-researched by sociologists. This article examines the relationship of insufficient sleep duration with occupational circumstances and family responsibilities, providing a contribution to the examination of the health consequences of working patterns in the UK. We analyse time use data from 2000, focusing on a sub-sample of workers aged 20—60 years ( n = 2882). Nested logistic regression modelling is used to identify the segments of the working population getting a short sleep duration that if sustained may have negative health outcomes. An inverse relationship between working hours and sleep duration is found, which is stronger for men than women. Shift work and social class are also significant predictors of short sleep for men.
Social reproduction as unregulated work
Authors: McGrath Siobhán , DeFilippis James
Published: March 2009

In this article, two cases of paid social reproductive labour performed in the home in New York City are examined: subsidized child care and paid domestic work. Particular attention is paid to the organization of the industries and the experiences of employees in those worksites. It is demonstrated that there continues to be a persistent and wilful exclusion of this work from regulation, as well as systematic violations of those regulations which do govern the work, constituting what the authors term `unregulated work'. It should be noted that the workers paid by the government are not exempt from this finding, but fit very clearly into this larger pattern.This illustrates the problems which arise from the process of transforming domestic spaces, and communities more broadly, into spaces of wage labour in American cities. It further serves as a powerful re-assertion of the denial of the value of`women's work'.
Vital conjunctures, shifting horizons: high-skilled female immigrants looking for work
Authors: Liversage Anika
Published: March 2009

Focusing on the underdeveloped field of high-skilled female migration, this article relies on life story interviews with high-skilled women immigrating for reasons other than work.The article conceptualizes migration as a`vital conjuncture', a critical life period in which both different futures and different identities are at stake, and shows how some women — mostly with skills from the natural sciences — were able to retain former professional identities. Other women, facing the threat of becoming `just housewives', found work in the higher-skilled sectors of the labour market in different ways: through re-educating themselves; by becoming `cultural brokers' for other immigrants; or by returning to their home country. Women unable to follow through on one of these four options lost claims to being high-skilled. The analysis contributes to our understanding of both high-skilled female migration and the centrality of identity in constraining or enabling movement within social structures.
The rhetoric of the `good worker' versus the realities of employers' use and the experiences of migrant workers
Authors: MacKenzie Robert , Forde Chris
Published: March 2009

The article examines the attitudes and strategies of a UK based employer as they developed their use of migrant labour in the latest manifestation of a strategy that targeted groups of vulnerable workers with lower labour market power. Management's celebration of the `good worker', based on the stereotyping of the perceived attributes of immigrant employees, resonated with the `business case' and `resource based view' debates within the human resource management literature.Yet terms and conditions of employment remained wedded to the bottom of the labour market. The article integrates analysis of the attitudes of employers with the views, experiences and aspirations of migrant workers. Micro level processes are also located in a wider analytical framework, incorporating the broader socio-economic context and key moments of regulatory intervention.
Effect of gabapentin on cognitive processes in rats not exposed and exposed to tobacco smoke during fetal life
Authors: Czubak A , Nowakowska E , Kus K , Sadowski C , Matschay A
Published: March 2009

Cognitive deficits, including memory deficiencies, are currently deemed one of key symptoms of psychopathologic mental disorders or epilepsy. The impairment of neurocognitive processes could be due to the administered therapy, in particular combined therapy or therapy using antiepileptics of older type. Gabapentin (GBP) is one of new antiepileptics with normothymic properties. It is known that epileptic patients run a significant risk of developing depression and mood changes. Smoking may also have a negative effect on memory processes and efficacy of administered drugs. Note that smoking in pregnant women also leads to neurobehavioral changes in their children. The objective of our research was to evaluate the effect of GBP on memory functions and antidepressant effect in rats not exposed and exposed to tobacco smoke in fetal life. We were also intent on finding whether GBP has an anticonvulsant effect in contact and without contact with tobacco smoke, and whether it affects motor coordination in animals if administered in the dose of 25 mg/kg. Spatial memory of the animals was assessed in the Morris test and the antidepressant effect in the Porsolt test. The ED50value was determined in the Swinyard maximum electric shock test, and the effect on motor coordination was assessed in the chimney test. GBP administered in the dose of 25 mg/kg intraperitoneal (i.p.) significantly reduced the immobility time on days 1 and 7 of the test in animals exposed to tobacco smoke, and on days 7 and 14 of the test in rats not exposed to tobacco smoke. Upon single and multiple administration of GBP to animals not exposed to tobacco smoke, the spatial memory improved, whereas in animals exposed to tobacco smoke in fetal life tolerance for procognitive effect was observed on day 21 of the test. It has been found that in rats not exposed to tobacco smoke, ED50of GBP was 28.73 mg/kg, whereas in animals exposed to tobacco smoke in fetal life, ED50was 46.2 mg/kg. Upon 14 and 21 days of drug administration, motor coordination was impaired in both GBP receiving animal groups. In conclusion, GBP beside its anticonvulsant efficacy also improves memory processes and has antidepressant effect. We also proved that GBP may reverse cognitive deficits concerning working memory induced by prenatal exposure to tobacco smoke and may have antidepressant effect in rats exposed to tobacco smoke.
Reptile bite in pregnancy
Authors: Duru M , Helvaci MR , Peker E , Dolapcioglu K , Kaya E
Published: March 2009

Reptile bites are rarely seen cases in emergency departments. But particularly in the warm summer months, the prevalence is relatively higher in rural areas. Snakebites during pregnancy is little known and only a few cases have been reported in the literature. However, in case of pregnancy, the outcomes may be different both for mother and the fetus. Interestingly, there is limited number of reptile bite cases during pregnancy in the literature. We report here a woman who was bitten at her 28th week of gestation. Obstetric consultation with ultrasonography was performed and seen that fetus was normal according to a 28-week gestation. We infused four vials of antiserum in a period of 1 h in a saline solution. In all, 30 min after the initiation of the antiserum infusion, the lesion started to regress. Her obstetric consultation was repeated 1 h, 36 h, and before discharge were performed and seen that the fetus was normal. After a period of five days, the patient and fetus were evaluated once more, and nothing was abnormal for both.
Assessment of levels of organochlorine pesticides and their metabolites in the hair of a Greek rural human population
Authors: Tsatsakis AM , Tzatzarakis MN , Tutudaki M , Babatsikou F , Alegakis AK , Koutis C
Published: March 2009

We present the assessment of chronic exposure of the rural population of Helia Peloponnesus, Greece to banned organochlorine pesticides, hexachlorocyclohexane (HCH), and 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT), using hair analysis. A total of 222 head hair samples were collected and analyzed for the presence of those organochlorine pesticides and their metabolites or isomers. Gas chromatography coupled to mass spectrometry was used to measure the levels of the pollutants. The median concentrations of α-HCH, hexachlorobenzene, lindane, ortho para 1,1-dichloro-2,2-bis-(4-chlorophenyl)ethylene (opDDE), para para 1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene (ppDDE), ortho para 1,1-dichloro-2,2-bis(4-chlorophenyl)ethane (opDDD), para para 1,1-dichloro-2,2-bis(4-chlorophenyl)ethane (ppDDD) + ortho para 1,1,1-trichloro-2,2-bis(4-chlorophenyl)-ethane, and para para 1,1,1-trichloro-2,2-bis(4-chlorophenyl)-ethane were determined at 40.4, 19.7, 124.2, 6.2, 7.8, 73.1, 8.0, and 5.7 pg/mg. The median concentration of total HCHs and DDTs were 117.8 pg/mg and 9.4 pg/mg, respectively. The levels of total HCHs were much higher than the levels of DDTs in the hair samples of the studied population. This may be attributed to the presence of lindane, a pesticide officially banned in 2002. It is interesting to see that DDTs are still traced in samples despite their use being banned for more than three decades. There was no difference in the levels of the detected pesticides in hair sampled from men or women. The concentration of HCHs remains high and relatively stable across the age groups, suggesting constant exposure until very recently. The concentration of the total DDTs and the parent compound, pp-DDT presents a statistically significant decreasing trend across the age groups.