bluuebunny/crossref_metadata_2025 huggingface dataset:
Plumbagin Triggers ER Stress-Mediated Apoptosis in Prostate Cancer Cells via Induction of ROS
Authors: Huang Hang , Xie Hui , Pan Yue , Zheng Kewen , Xia Yiqun , Chen Wei
Published: January 2018

Background/Aims: Prostate cancer (PCa) is the second most frequently diagnosed cancer in men worldwide. Currently available therapies for hormone-refractory PCa are only marginally effective. Plumbagin (PLB), a natural naphthoquinone isolated from the traditional folk medicine Plumbago zeylanica, is known to selectively kill tumor cells. Nevertheless, antitumor mechanisms initiated by PLB in cancer cells have not been fully defined. Methods: MTT assay was used to evaluate the effect of PLB on the viability of cancer cells. Cell apoptosis and reactive oxygen species (ROS) production were determined by flow cytometry. Protein expression was detected by western blotting. In vivo anti-tumor effect was measured by using tumor xenoqraft model in nude mice. Results: In the present study, we found that PLB decreases cancer cell growth and induces apoptosis in DU145 and PC-3 cells. In addition, by increasing intracellular ROS levels, PLB induced a lethal endoplasmic reticulum stress response in PCa cells. Importantly, blockage of ROS production significantly reversed PLB-induced ER stress activation and cell apoptosis. In vivo, we found that PLB inhibits the growth of PCa xenografts without exhibiting toxicity Treatment of mice bearing human PCa xenografts with PLB was also associated with induction of ER stress activation. Conclusion: Inducing ER stress by PLB thus discloses a previously unrecognized mechanism underlying the biological activity of PLB and provides an in-depth insight into the action of PLB in the treatment of hormone-refractory PCa.
Prevalence of Cardiovascular Disease and Its Risk Factors in Primary Aldosteronism
Authors: Ohno Youichi , Sone Masakatsu , Inagaki Nobuya , Yamasaki Toshinari , Ogawa Osamu , Takeda Yoshiyu , Kurihara Isao , Itoh Hiroshi , Umakoshi Hironobu , Tsuiki Mika , Ichijo Takamasa , Katabami Takuyuki , Tanaka Yasushi , Wada Norio , Shibayama Yui , Yoshimoto Takanobu , Ogawa Yoshihiro , Kawashima Junji , Takahashi Katsutoshi , Fujita Megumi , Watanabe Minemori , Matsuda Yuichi , Kobayashi Hiroki , Shibata Hirotaka , Kamemura Kohei , Otsuki Michio , Fujii Yuichi , Yamamoto Koichi , Ogo Atsushi , Okamura Shintaro , Miyauchi Shozo , Fukuoka Tomikazu , Izawa Shoichiro , Yoneda Takashi , Hashimoto Shigeatsu , Yanase Toshihiko , Suzuki Tomoko , Kawamura Takashi , Tabara Yasuharu , Matsuda Fumihiko , Naruse Mitsuhide ,   Nagahama Study*, Kawaguchi Takahisa , Setoh Kazuya , Matsuda Fumihiko , Takahashi Yoshimitsu , Nakayama Takeo , Kosugi Shinji
Published: January 2018

There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) in patients with primary aldosteronism (PA); however, their results have left it unclear whether CVD is affected by the plasma aldosterone concentration or hypokalemia. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalence of CVD among patients with PA with that among age-, sex-, and blood pressure-matched essential hypertension patients and participants with hypertension in a general population cohort. We also performed binary logistic regression analysis to determine which parameters significantly increased the odds ratio for CVD. Of the 2582 patients with PA studied, the prevalence of CVD, including stroke (cerebral infarction, cerebral hemorrhage, or subarachnoid hemorrhage), ischemic heart disease (myocardial infarction or angina pectoris), and heart failure, was 9.4% (stroke, 7.4%; ischemic heart disease, 2.1%; and heart failure, 0.6%). The prevalence of CVD, especially stroke, was higher among the patients with PA than those with essential hypertension/hypertension. Hypokalemia (K
+
≤3.5 mEq/L) and the unilateral subtype significantly increased adjusted odds ratios for CVD. Although aldosterone levels were not linearly related to the adjusted odds ratio for CVD, patients with plasma aldosterone concentrations ≥125 pg/mL had significantly higher adjusted odds ratios for CVD than those with plasma aldosterone concentrations <125 pg/mL. Thus, patients with PA seem to be at a higher risk of developing CVD than patients with essential hypertension. Moreover, patients with PA presenting with hypokalemia, the unilateral subtype, or plasma aldosterone concentration ≥125 pg/mL are at a greater risk of CVD and have a greater need for PA-specific treatments than others.
Balance-Unbalance: Transforming Paradigms (Art ↔ Environment)
Authors: Dal Farra Ricardo
Published: January 2018

The equilibrium between a healthy environment, the energy our society needs to maintain or improve this lifestyle, and the world’s interconnected economies, could pass more quickly than expected from the current complex balance to an entirely new reality where human beings would need to be more creative than ever before to survive. The frequency and severity that certain weather and climate-related events are having around us is increasing, and the ability of human beings to modify our adjacent surroundings has turned into a power capable of altering the planet. Do the media arts have a role in all this?
Does the size of local government debt affect the level of debt of off-budget entities? The case of local government in Korea
Authors: Jeong Seong-ho
Published: January 2018

The rapid growth of debt of off-budget entities is the result of budgetary constraints. When local governments face fiscal stress, with rising debt, they tend to rely on local public enterprise debt to minimize debt limits and budgetary constraints. This study tests how the debt level of local governments affects the debt level of off-budget entities in 16 Korean metropolitan cities and provinces from 2008 to 2013, applying panel regressions. The results assert that as the debt of a local government increases, public enterprise debt increases accordingly. The findings confirm that public enterprises are used to lessen budget pressure by increasing the total public debt. This practice is like concealing local government debt by using off-budget entities, which eventually creates a fiscal illusion.

Points for practitioners

Off-budget entities are tools for bigger government and larger debt, so it is necessary to control the use of off-budget debt by imposing ceilings on the off-budget debt limit. From a comprehensive debt management perspective, off-budget entities should be used less to pursue government projects. Additionally, a segmented accounting system should be introduced within the off-budget entities.
Technological capacity in the public sector: the case of Estonia
Authors: Lember Veiko , Kattel Rainer , Tõnurist Piret
Published: January 2018

Technology is clearly a critical factor in the lives of organizations, yet there are only a few studies that deal with technology and public organizations. In this article, we propose to understand technological change in the public sector, in particular, how technology influences administrative capacity, through a new concept of technological capacity. We use the case of Estonia – internationally associated with a strong e-state profile – as an exploratory case to answer two research questions: ‘Why and how does technological change take place in the public sector?’ and ‘How does technological change influence administrative capacity in public organizations?’ We demonstrate how dynamic and static change in technological capacities is influenced by four different public sector feedback and selection mechanisms. We conclude that in spite of the neglected position of technology in the public administration literature, technology is an intrinsic factor in how administrative capacity evolves.
Getting to Know “The Known Unknowns”: Heterogeneity in the Oral Microbiome
Authors: Burne R.A.
Published: January 2018

Technological advances in DNA sequencing have provided unprecedented insights into the composition of the oral microbiome in health and disease, and RNA-sequencing and metabolomics-related technologies are beginning to yield information on the activities of these organisms. Importantly, progress in this area has brought the scientific community closer to an understanding of what constitutes a health-associated microbiome and is supporting the notion that the microbiota in healthy sites assumes an active role in promoting health and suppressing the acquisition, persistence, and activities of overt and opportunistic pathogens. It is also becoming clear that a significant impediment to developing a conclusive body of evidence that defines a healthy microbiome and the mechanisms by which beneficial bacteria promote health is that an inherent characteristic of the most abundant members of the oral flora, those that potentially play the greatest roles in health and disease, is intraspecies genomic diversity. In particular, individual isolates of abundant commensal and pathogenic streptococci show tremendous variability in gene content, and this variability manifests in tremendous phenotypic heterogeneity. Analysis of the consequences of this diversity has been complicated by the exquisite sensitivity these bacteria have evolved to environmental inputs, inducing rapid and substantial fluctuations in behaviors, and often only within subpopulations of the organisms. Thus, the conditions under which the oral microbiota is studied can produce widely different results within and between species. Fortunately, continually diminishing costs and ongoing refinements in sequencing and metabolomics are making it practical to study the oral microbiome at a level that will create a sufficiently robust understanding of the functions of individual organisms and reveal the complex interrelationships of these microbes (“the known unknowns”) in a way that researchers will be able to engage in the rational design of reliable and economical risk assessments and preventive therapies.
Cariology Clinical Trials: What Are We—and What Should We Be—Looking At?
Authors: Innes N.P.T.
Published: January 2018

Randomized control trial (RCT) methodology has compared interventions for the prevention and management of dental caries since the late 1960s. Despite almost 50 years and evidence of significant wastage within the wider biomedical research field, there has been little investigation into what works well and where weaknesses lie. This paper aims to draw attention to areas for improvement within cariology clinical trial methodology by summarizing systematic reviews on interventions and outcomes, and using examples to illustrate some challenges with intervention delivery fidelity, outcome analyses, and intervention co-production. Trial design stage choices are critical to ensure that optimum information is obtained when testing interventions. Intervention choice, outcome choice, and analyses are particularly important, and cariology trials have specific issues associated with them. A systematic search and review of cariology RCTs found 650 RCT reports. Social Network Analysis of interventions revealed a high degree of separation between prevention and management trials, gaps in clinically important comparisons, and a tendency for there to be comparisons within groups; e.g., comparison of interventions within the same, rather than different, levels of invasiveness. Outcomes measured for the same trial reports show: a focus on restoration performance and individual/population caries burden; the growing use of carious lesion activity and economic-related outcomes; and sparse, although an increase in the use of, patient-reported/patient-centered outcomes. Fidelity of adherence to complex interventions can be challenging to measure but is important in interpreting trial findings. Involving target populations in intervention design, delivery, and relating it to the planned rollout, are opportunities to ensure intervention relevance and improved uptake. Outcomes analyses should consider the minimum clinically important differences and outcome relevance measures for the target population. Factors underlying trialists’ comparator and outcome choices need to be identified, and there is a need to ensure that a minimum dataset of outcomes allow for combination and comparisons of trial data for systematic review.
Oral Microbiome Studies: Potential Diagnostic and Therapeutic Implications
Authors: Mira A.
Published: January 2018

Understanding the microbiology of dental caries is not a mere academic exercise; it provides the basis for preventive, diagnostic, and treatment strategies and gives the dentist a theoretical framework to become a better professional. The last years have seen the development of new research methodologies, ranging from high-throughput sequencing or “omics” techniques to new fluorescence microscopy applications and microfluidics, which have allowed the study of the oral microbiome to an unprecedented level of detail. Those studies have provided new insights about oral biofilm formation, biomarkers of caries risk, microbial etiology, appropriate sampling, identification of health-associated bacteria, and new anticaries strategies, among others. Several pitfalls are associated with the new technologies, including a small number of samples per study group, elevated cost, and genus- or species-based analyses that do not take into consideration intraspecies variability. However, the new data strongly suggest that saliva may not be an appropriate sample for etiological studies or for bacterial caries-risk tests, that microbial composition alone may be insufficient to predict caries risk, and that antimicrobial or immunization strategies targeting single species are unlikely to be effective. Strategies directed toward modulation of the oral biofilm, such as pre- and probiotics, emerge as promising new approaches to prevent tooth decay.
Silver Diamine Fluoride: A Successful Anticarious Solution with Limits
Authors: Burgess J.O. , Vaghela P.M.
Published: January 2018

Silver diamine fluoride (SDF) is a solution containing ionic silver, fluoride, and ammonia that arrests the progress of carious lesions and prevents the development of future caries. The silver particle extends into the dentin tubules and could create some bonding problems for subsequent composite resin restorations placed over SDF-treated darkened tooth structures. The fluoride penetrates deeper into the tooth with SDF as compared with other fluoride solutions, creating a fluoride reservoir in the tooth structure. The fluoride component of SDF contributes to remineralization and fluorapatite formation, producing harder, more caries-resistant tooth structures. The silver provides the antimicrobial activity for the material and inhibits biofilm formation. It has been evaluated in >20 clinical studies and reviewed in systemic reviews. The material was recently approved by the Food and Drug Administration for desensitizing cold-sensitive teeth and has been used off-label to treat carious lesions. SDF will produce a caries lesion darker (brown to black) than the original, which is the major criticism of the material. A nanoparticle-sized silver material was recently developed that may retain the antimicrobial properties of the larger-sized ion silver material without the discoloring effects. The application of SDF is easily adapted for field use. The lesion is isolated, and the solution is painted onto the clean caries lesion and dried. This simple application process requires little equipment, and its low cost per application makes the material ideal for large populations.
Baltimore
Authors: Durham Rachel E. , Shiller Jessica , Connolly Faith
Published: January 2018

As community schools spread across the country, community school staff need effective approaches to engaging families and community-based partners. Such principles must be broadly applicable, given community schools’ mandate to adapt to different local contexts. Based on recent research on Baltimore City’s community schools, the authors highlight the approaches shared by community school coordinators in schools that have demonstrated comparatively high student attendance and positive school climate.
Restoring religion through collective memory: How Chinese Pentecostals engage in mnemonic practices after the Cultural Revolution
Authors: Huang Ke-hsien
Published: January 2018

China has experienced remarkable religious revivals since the Cultural Revolution. I argue that the revivals rely on religious elites summoning collective memory to restore religion, among other factors. In addition, a micro-level perspective is taken, to see how collective memory, more than a group’s collective representation, is the product and resources of religious elites in pursuit of their own interest; the remembrance of the sacred past is a contested, unfolding process of key actors engaging in varied mnemonic practices. Through data collected from long-term fieldwork, I demonstrate how Chinese Pentecostals, after lengthy political suppression, use religious collective memory to rebuild the national community, strengthen the leadership by proving their orthodox character, and fight against mystical separatists. In conclusion, I explain why religious collective memory matters in the case of China in particular, where the state tends to repress religious institutionalization, and Chinese people emphasize the importance of orthodoxy lineage.
A Funny Thing Happened on The Way to the Parable: The Steward, Tricksters and (Non)sense in Luke 16:1–8
Authors: King Fergus J.
Published: January 2018

The parable of the Steward (Luke 16:1–8) has long vexed interpreters. Central to its difficulty is how the behaviour of a steward identified variously as “dishonest” or “unjust” can stand as an exemplary figure. Previous attempts to resolve this issue have included studies which have identified the Steward as a slave, and compared him to figures who appear in literary studies (the Trickster) and the Comedy of the ancient world (the servus fallax or callidus). However, these have failed to realize fully the moral ambiguity offered by these literary types. When set in the fictive world of moral ambiguity and subversion that they represent, it becomes easier to see how the Steward, with all the subversion he brings, becomes an exemplary model of discipleship. His financial chicanery will mirror the unorthodoxy of reconciliation that is lived out by Jesus of Nazareth.
A Disciple in Damascus
Authors: Sanders James A.
Published: January 2018

The story of Saul of Tarsus's switch from enthusiastic support of mainstream Judaism to joining and preaching the new messianic Judaism of the Jesus followers of his day invites probing into what the concept of phronesis meant both to Paul and to those who knew Scripture, especially the prophets. Close reading of the accounts in Acts and Philippians about his dramatic change of identity and his own self-doubts underscores the importance of understanding how the monotheizing process changes how one thinks brought Saul the student of Gamliel to become Paul the apostle of Christ and how that set the Jesus movement on a path that changed the world.
Feedback and assessment in higher-education, practice-based entrepreneurship courses
Authors: Warhuus Jan P. , Blenker Per , Elmholdt Stine Trolle
Published: January 2018

When educators teach entrepreneurship experientially in higher education, a need arises for different procedures for assessment, evaluation and feedback, and the legitimacy of this type of course is often questioned. In traditional courses, students accumulate knowledge and the educator’s primary concern is what students learn. When learning ‘through’ practising entrepreneurship, students and educators must also care about how students learn. While research brought awareness to this area of concern more than a decade ago, feedback and assessment in entrepreneurship education have received very limited attention. This article addresses these issues both theoretically and empirically. The findings allow the authors to map out the feedback mechanisms needed in experimental entrepreneurship education and to provide an embedded two-by-two model that describes the purpose and outcome of the feedback. The findings also suggest an approach for design and assessment that may help resolve the pedagogical and legitimacy challenges of such courses. These contributions are directly relevant for students, educators and administrators involved with entrepreneurship courses, and they may be applicable to a wider range of process-based courses.
Use of interval estimations in design and evaluation of multiregional clinical trials with continuous outcomes
Authors: Chiang Chieh , Hsiao Chin-Fu
Published: January 2018

Multiregional clinical trials have been accepted in recent years as a useful means of accelerating the development of new drugs and abridging their approval time. The statistical properties of multiregional clinical trials are being widely discussed. In practice, variance of a continuous response may be different from region to region, but it leads to the assessment of the efficacy response falling into a Behrens–Fisher problem—there is no exact testing or interval estimator for mean difference with unequal variances. As a solution, this study applies interval estimations of the efficacy response based on Howe’s, Cochran–Cox’s, and Satterthwaite’s approximations, which have been shown to have well-controlled type I error rates. However, the traditional sample size determination cannot be applied to the interval estimators. The sample size determination to achieve a desired power based on these interval estimators is then presented. Moreover, the consistency criteria suggested by the Japanese Ministry of Health, Labour and Welfare guidance to decide whether the overall results from the multiregional clinical trial obtained via the proposed interval estimation were also applied. A real example is used to illustrate the proposed method. The results of simulation studies indicate that the proposed method can correctly determine the required sample size and evaluate the assurance probability of the consistency criteria.
Prime minister leadership style and the role of parliament in security policy
Authors: Kaarbo Juliet
Published: January 2018

This article explores how differences in prime ministers’ leadership styles may affect parliamentary influence in security policy. Drawing on work on personality differences in political psychology, I argue leadership style is a critical but often overlooked factor in the growing area of research on parliaments and foreign affairs. My key argument is that prime ministers vary in how they respond to and manage parliamentary involvement in security policymaking. I propose Leadership Trait Analysis to capture prime ministers’ orientations towards parliamentary involvement. I examine the plausibility of my argument with intra-country comparisons of Turkish and UK prime ministers’ orientations towards parliament in specific cases of security policy. More generally, this article challenges more formal-institutional approaches to parliaments’ role in security policy. A focus on prime ministers has an analytic advantage of bringing together some of the various factors (such as intraparty divisions and public opinion) to explain parliamentary influence in security policy.
Is there a parliamentary peace? Parliamentary veto power and military interventions from Kosovo to Daesh
Authors: Wagner Wolfgang
Published: January 2018

This article studies the effect of parliamentary involvement on security policy. Building on Democratic Peace Theory, it examines whether democracies with a parliamentary veto power are indeed less likely to participate in military interventions, than democracies without such a veto power, ceteris paribus. By studying patterns of participation across 25 to 35 countries in five military missions, this paper finds modest evidence for such a parliamentary peace and suggests that it depends on the character of the military mission in question. If a mission is framed as a test case of alliance solidarity, as was the case with OEF and the Iraq War, domestic institutional constraints can be trumped by alliance politics. If, however, countries enjoy more discretion in deciding on the use of force, domestic constraints such as parliamentary war powers have a tangible impact on government policy.
Congress, public opinion, and an informal constraint on the commander-in-chief
Authors: Kriner Douglas L
Published: January 2018

US presidents have routinely ordered the use of force without seeking prior authorisation from Congress. However, this practice does not mean that the legislature is irrelevant, as Congress often influences decisions by exercising informal political levers. One of the most important is through Congress’ ability to affect popular support for the commander-in-chief. Through a pair of experiments embedded on nationally representative opinion surveys, this article evaluates whether Congress’ constitutional prerogatives in war powers remain relevant when battling the president in the public sphere. Policy criticism significantly decreased support for the use of force, as did challenges to administration actions on constitutional grounds. Although Congress routinely fails to use the constitutional tools at its disposal to check the commander-in-chief, these powers bolster Congress’ capacity to influence public opinion. Hence, while presidents enjoy considerable leeway in the military arena, Congress’ capacity to erode public support can serve as a check on presidential power.
Why do all our feelings about politics matter?
Authors: Jenkins Laura
Published: January 2018

This article examines disenchantment with democracy and the role of emotions in politics. Its contribution is to develop our understanding of emotions in situations of political disenchantment. It is argued that (1) there are a wide variety of emotions involved in political disaffection which need explication, (2) it is important to consider the dynamic of political motivation and demotivation and (3) we should be concerned about political disenchantment, not only because citizens are becoming negative and disengaging but because the concerns of some raise important issues with justice and equality in democracies. Greater attention to the cultivation of emotions, such as hope, in public life might help us to understand, (re)kindle, and sustain people’s affection for, and engagement in, politics.
Fundamental analysis on auto-ignition condition of a lubricant oil droplet for understanding a mechanism of low-speed pre-ignition in highly charged spark-ignition engines
Authors: Ohtomo Mitsuaki , Suzuoki Tetsunori , Miyagawa Hiroshi , Koike Makoto , Yokoo Nozomi , Nakata Koichi
Published: January 2018

This article presents a study of the mechanism that the lubricant oil droplet initiates low-speed pre-ignition in highly boosted downsized gasoline engines. Low-speed pre-ignition is a phenomenon that the fuel–air mixture ignites before the spark timing, leading to flame propagation that results in a heavy knock. The ignition of lubricant oil droplets is thought to be one possible mechanism for low-speed pre-ignition. However, the oil droplet ignition conditions are not yet well understood. First, the conditions under which a single oil droplet initiates the combustion of a fuel–air mixture were investigated using a rapid compression and expansion machine. When an initial droplet temperature was above 250 °C, the vaporized oil ignited before the gasoline–air mixture, in which case the combustion of the gasoline–air mixture around the droplet was initiated. The numerical results showed that the oil droplet temperature increases above 250 °C if the droplet is heated by burned gas remaining in the combustion chamber from the previous cycle. A direct-injection single-cylinder research engine was operated under the condition that no residual gas exists in the combustion chamber. In this case, no low-speed pre-ignition occurred even if gross indicated that mean effective pressure was 2.5 MPa. These results indicate that an oil droplet does not cause low-speed pre-ignition if any droplet flies into the combustion chamber unless it remains in the chamber over the exhaust stroke.
The appreciation of LED-based white light sources by Dutch and Chinese people in three application areas
Authors: Tang X , Teunissen C
Published: January 2018

The aim of this study was to evaluate differences in appreciation for LED-based white-light sources between Dutch and Chinese people, when used for the illumination of three applications: fresh food, packaging material and skin tone. Furthermore, the contribution of the CIE special and general colour rendering indices ( Ri and Ra), a colour gamut measure ( Ga), and chroma changes for specific test-colour samples to perceived attractiveness was investigated. Thirty-four Dutch and 36 Chinese people assessed the attractiveness of the object appearance, with paired comparison experiments, for seven light sources at two CCT settings, 3000 K (Dutch and Chinese) and 4000 K (Chinese only), and a range of Ra and Ga values. It was found that for illuminating fresh food and packaging material, most Dutch and Chinese participants preferred light settings with an increased colour gamut. In contrast to colour rendering indices, the chroma change for the strong red test colour sample could be used to predict object attractiveness, but the established equations were different per application and culture. There was no clear relation between objective measures and skin tone preference for the Dutch study. Finally, Chinese participants did not like an increase in red saturation at 3000 K, but they allowed an increase at 4000 K.
Evaluating the new teacher evaluation system in South Korea: Case studies of successful implementation, adaptation, and transformation of mandated policy
Authors: Yoo Jisung
Published: January 2018

Central to improving the quality of education is developing a teacher evaluation system that promotes teachers’ professional growth, the improvement of student learning, and educational equality for all students regardless of social factors such as socio-economic status, educational environment, race, and gender. To address these issues in South Korea and to respond to pressure from parents, educators, and policymakers, a new national teacher evaluation system was implemented in 2011. This paper briefly describes the evolution of the teacher evaluation system in South Korea and analyzes the newly developed mechanism by which teachers are evaluated. The new evaluation system resulted in a backlash from teachers and debate among educational stakeholders, including parents, educators, and policymakers. Both the support of and opposition to the new policy are discussed. Although the new evaluation system has not been viewed as effective in all schools, several cases of schools that have had success under the new system are examined to determine the factors that led to their success. This article argues that the teacher evaluation system consisting of fair and reliable components that measure teachers’ performance and support professional development can be an effective means of ensuring high-quality teaching, which, in turn, can positively impact student achievement. However, based on an examination of the case studies presented and grounded in the theoretical perspective on accountability proposed by Thorn and Harris, this study asserts that for the evaluation system to be successful in each school, accountability, necessary modification, and mutual adaptation are required. Implications for policymakers, researchers, and politicians are provided.
Gay and Bisexual Men’s Perceptions of HIV Risk in Various Relationships
Authors: Shaver John , Freeland Ryan , Goldenberg Tamar , Stephenson Rob
Published: January 2018

Men who have sex with men (MSM) bear a disproportionate burden of HIV incidence in the United States. Previous study of sexual decision-making and HIV risk among MSM has not accounted for relationship dynamics. Further research must examine this connection between relationship dynamics and sexual decision-making, especially regarding condomless anal intercourse. This study analyzes data gathered from gay and bisexual men regarding their sexual partners and sexual decision-making over a 10-week period through personal relationship diaries (PRDs) and a follow-up in-depth interview (IDI). Through coding and extraction of relationship dynamics, key patterns of participants’ sexual decision-making processes were examined based on relationship type, which was categorized by commitment, formality, and sexual agreement. Participants’ sexual relationships can be divided into five categories: (a) Uncommitted, one time, (b) Uncommitted, ongoing, (c) Transitioning or unknown commitment, (d) Committed, nonmonogamous, and (e) Committed, monogamous. These five categories correspond to patterns in sexual decision making and consequent sexual risk-taking behaviors. Each of these influence HIV risk within male–male sexual encounters in a particular manner, and understanding these is important for appropriately tailored HIV prevention interventions for MSM. Recommendations are included for interventions seeking to address HIV risk across a wide variety of MSM sexual relationships.
Translation and validation of Simplified Chinese version of the Pain Catastrophizing Scale in chronic pain patients: Education may matter
Authors: Shen Bangli , Wu Bo , Abdullah Taha B , Zhan Gonghao , Lian Qingquan , Vania Apkarian Apkar , Huang Lejian
Published: January 2018

Objective

Pain catastrophizing is linked to many aspects of pain perception and defines a unique dimension in predicting pain intensity and physical disability. Pain Catastrophizing Scale (PCS) is an effective, validated,self-report measure, commonly used in clinical trials. Here, we present a Simplified Chinese PCS (SC-PCS) version developed in Chinese patients suffering from chronic pain.

Methods

The SC-PCS was generated in five steps and tested on an initial patient cohort (N = 30). A convenience sample (N = 200) of in-hospital patients with non-malignant pain lasting for more than 12 weeks were recruited for the study, of which 81 completed 5 additional pain questionnaires. A subset (N = 24) of the patients completed an additional SC-PCS, 10 days after the initial query to assess test–retest validation.

Results

Intra-class correlations coefficient indicated high reproducibility and temporal consistency, (0.97), for the total score. Cronbach’s alpha determined high internal consistency across the SC-PCS total score and its three subscales (0.87, 0.85, 0.62, and 0.65). The SC-PCS total score moderately or weakly (R = −0.2 to 0.49), but significantly, correlated with other measurements, such as pain Visual Analog Scale, Beck Depression Inventory, Pain Anxiety Symptoms Scales, Positive and Negative Affect Schedule, and education. We used exploratory factor analysis to examine the dimensionality of the SC-PCS, which indicated instability of the current three-factor model. However, a confirmatory factor analysis indicated that the three-factor model had the best goodness-fitting.

Conclusions

We demonstrate the successful translational adaptation from English to Simplified Chinese as well as the reliability and validity of SC-PCS. An important discovery was education level significantly correlated with SC-PCS, identifying a future consideration for other cross-cultural development of self-reported measures.
The aesthetics of verticality: A gravitational contribution to aesthetic preference
Authors: Gallagher Maria , Ferrè Elisa Raffaella
Published: January 2018

Verticality plays a fundamental role in the arts, portraying concepts such as power, grandeur, or even morality; however, it is unclear whether people have an aesthetic preference for vertical stimuli. The perception of verticality occurs by integrating vestibular-gravitational input with proprioceptive signals about body posture. Thus, these signals may influence the preference for verticality. Here, we show that people have a genuine aesthetic preference for stimuli aligned with the vertical, and this preference depends on the position of the body relative to the gravitational direction. Observers rated the attractiveness of lines that varied in inclination. Perfectly vertical lines were judged to be more attractive than those inclined clockwise or anticlockwise only when participants held an upright posture. Critically, this preference was not present when their body was tilted away from the gravitational vertical. Our results showed that gravitational signals make a contribution to the perception of attractiveness of environmental objects.
Immunogenicity of biologics in inflammatory bowel disease
Authors: Vermeire Séverine , Gils Ann , Accossato Paola , Lula Sadiq , Marren Amy
Published: January 2018

Crohn’s disease and ulcerative colitis are chronic inflammatory disorders of the gastrointestinal tract. Treatment options include biologic therapies; however, a proportion of patients lose response to biologics, partly due to the formation of anti-drug antibodies (ADAbs). Concomitant immunosuppressive agents reduce the development of ADAbs. This review article aims to assess the immunogenicity of biologic therapies and their clinical implications. A comprehensive literature search was conducted for articles published January 2009 to August 2015 reporting immunogenicity to adalimumab (ADM), certolizumab pegol (CZP), golimumab, infliximab (IFX), ustekinumab, and vedolizumab in inflammatory bowel disease (IBD). Eligible articles were reviewed and quality assessed by independent reviewers. Overall, 122 publications reporting 114 studies were assessed. ADAbs were reported for all agents, but the percentage of patients developing ADAbs was extremely variable, with the highest (65.3%) being for IFX administration to patients with IBD. ADAb presence was frequently associated with a reduction in primary efficacy and a loss of response, and, for IFX, an increase in adverse events (AEs). Lower serum levels of ADM, CZP and IFX were seen in ADAbs-positive rather than ADAbs-negative patients; pharmacokinetic data were unavailable for other therapies. Little information was available regarding the timing of ADAb development; studies reported their detection from as early as 10–14 days up to months after treatment initiation. Biologic therapies carry an intrinsic risk of immunogenicity, although reported rates of ADAbs vary considerably. The clinical implications of immunogenicity are a concern for effective treatment; further research, particularly into the more recently approved biologics, is required.
Bevacizumab in temozolomide refractory high-grade gliomas: single-centre experience and review of the literature
Authors: Jeck Jennifer , Kassubek Rebecca , Coburger Jan , Edenhofer Simone , Schönsteiner Stefan S. , Ludolph Albert C. , Schmitz Bernd , Engelke Jens , Mayer-Steinacker Regine , Lewerenz Jan , Bullinger Lars
Published: January 2018

Background:

Despite multidisciplinary treatment approaches, the prognosis for patients with high-grade glioma (HGG) is poor, with a median overall survival (OS) of 14.6 months for glioblastoma multiforme (GB). As high levels of vascular endothelial growth factor A (VEGF) are found in HGG, targeted anti-antiangiogenic therapy using the humanized monoclonal antibody bevacizumab (BEV) was studied in a series of clinical trials. Still, the discrepancy of BEV’s efficacy with regard to initial clinical and radiological response and its reported failure to prolong survival remains to be explained. Here, we illustrate the effectiveness of BEV in recurrent HGG by summarizing our single-centre experience.

Methods:

We have retrospectively investigated the effect of BEV in temozolomide refractory HGG in 39 patients treated at the University Hospital of Ulm, Germany.

Results:

Median duration of BEV treatment was 12.5 weeks; 23% of patients received BEV for more than 6 months and 15% for more than 1 year, until clinical or radiological tumour progression led to discontinuation. Furthermore, Karnofsky performance status increased in 30.6% and steroid dose decreased in 39% of all patients.

Conclusions:

The review of literature reveals that phase II and III studies support BEV as an effective therapy in recurrent HGG, at least with regard to progression-free survival (PFS), but landmark phase III trials failed to prove benefit concerning OS. Here, we discuss reasons that may account for this observation. We conclude that prolonging PFS with maintenance of neurological function and personal and economic independency justifies the off-label use of BEV.
Turning EGFR mutation-positive non-small-cell lung cancer into a chronic disease: optimal sequential therapy with EGFR tyrosine kinase inhibitors
Authors: Hirsh Vera
Published: January 2018

Four epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), erlotinib, gefitinib, afatinib and osimertinib, are currently available for the management of EGFR mutation-positive non-small-cell lung cancer (NSCLC), with others in development. Although tumors are exquisitely sensitive to these agents, acquired resistance is inevitable. Furthermore, emerging data indicate that first- (erlotinib and gefitinib), second- (afatinib) and third-generation (osimertinib) EGFR TKIs differ in terms of efficacy and tolerability profiles. Therefore, there is a strong imperative to optimize the sequence of TKIs in order to maximize their clinical benefit. Osimertinib has demonstrated striking efficacy as a second-line treatment option in patients with T790M-positive tumors, and also confers efficacy and tolerability advantages over first-generation TKIs in the first-line setting. However, while accrual of T790M is the most predominant mechanism of resistance to erlotinib, gefitinib and afatinib, resistance mechanisms to osimertinib have not been clearly elucidated, meaning that possible therapy options after osimertinib failure are not clear. At present, few data comparing sequential regimens in patients with EGFR mutation-positive NSCLC are available and prospective clinical trials are required. This article reviews the similarities and differences between EGFR TKIs, and discusses key considerations when assessing optimal sequential therapy with these agents for the treatment of EGFR mutation-positive NSCLC.
Direct and inferred influences of the Silk Roads on the ‘golden age’ of the Abbasid Caliphate
Authors: Mansour Imad
Published: January 2018

This article sheds light on the east-west international relations of the first century of the Abbasid Caliphate. It describes discernable Chinese influences on the onset and maintenance of a golden age of Islamic government in this century, distinguished for the flourishing of translation, research contributions in natural sciences and philosophy, sophistication in the fine arts, and economic productivity and prosperity. These influences were in the fields of trade, governance, artisan production, and scientific epistemological knowledge. The article argues that two interlocking factors helped create the conditions of possibility for the golden age of the Abbasid Caliphate: first, a positive disposition defined by pragmatism and accommodation by the Tang Dynasty found a counterpart in Abbasid policy; second, for the Abbasids, relations along the Silk Roads that had been developing for centuries valorized the potential of exchanges with the east, including China. The article explains the varied intensity of influences from the Silk Roads, as well as the Tang Dynasty, on the Abbasid golden age. It concludes by briefly explaining how people-to-people exchanges maintained ties, especially after the political power of both governments weakened and eventually ended.
A Predictive Algorithm to Detect Opioid Use Disorder
Authors: Lee Chee , Sharma Maneesh , Kantorovich Svetlana , Brenton Ashley
Published: January 2018

Purpose:

The purpose of this study was to determine the clinical utility of an algorithm-based decision tool designed to assess risk associated with opioid use in the primary care setting.

Methods:

A prospective, longitudinal study was conducted to assess the utility of precision medicine testing in 1822 patients across 18 family medicine/primary care clinics in the United States. Using the profile, patients were categorized into low, moderate, and high risk for opioid use. Physicians who ordered testing were asked to complete patient evaluations and document their actions, decisions, and perceptions regarding the utility of the precision medicine tests.

Results:

Approximately 47% of primary care physicians surveyed used the profile to guide clinical decision-making. These physicians rated the benefit of the profile on patient care an average of 3.6 on a 5-point scale (1 indicating no benefit and 5 indicating significant benefit). Eighty-eight percent of all clinicians surveyed felt the test exhibited some benefit to their patient care. The most frequent utilization for the profile was to guide a change in opioid prescribed. Physicians reported greater benefit of profile utilization for minority patients. Patients whose treatment was guided by the profile had pain levels that were reduced, on average, 2.7 levels on the numeric rating scale.

Conclusions:

The profile provided primary care physicians with a useful tool to stratify the risk of opioid use disorder and was rated as beneficial for decision-making and patient improvement by the majority of physicians surveyed. Physicians reported the profile resulted in greater clinical improvement for minorities, highlighting the objective use of this profile to guide judicial use of opioids in high-risk patients. Significantly, when physicians used the profile to guide treatment decisions, patient-reported pain was greatly reduced.
Acceptability of Health Kiosks Within African American Community Settings
Authors: Abraham Olufunmilola , Patel Megha , Feathers Alison
Published: January 2018

Introduction:

Health kiosks have been increasingly adopted to provide health-care services to those with limited access. Kiosks have the potential to reach people who may have undiagnosed health conditions or those who are not under regular physician care. Thus far, there is limited research assessing the usefulness of health kiosks in the community. This study aimed to explore the acceptability, usability, usefulness, and overall satisfaction of health kiosks in African American majority community settings.

Methods:

Two health kiosks were placed in predominantly African American low-income areas in an urban city in Western Pennsylvania. After the kiosk interaction, participants 18 years and older were recruited to complete a survey on their overall kiosk use experience. The technology acceptance model was adapted to develop the survey. Survey responses were analyzed using descriptive statistics. Qualitative survey responses were analyzed using content analysis.

Results:

Seventy-seven percent of the 31 survey respondents were female and 37.8% were ages 60 to 69 years old. Overall, 90% of participants were satisfied with their kiosk experience and 97% found the kiosk useful for health self-management, with 94% stating that they would use the kiosk again.

Conclusion:

This study showed that health kiosks are accepted among African Americans in community settings such as churches and community centers. Participants found the kiosks easy to use and an overall useful tool to help manage their health. Future studies are needed to provide a better understanding of health kiosk acceptance among minority populations and in community settings.