bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in incidence and outcomes of revision total hip arthroplasty in Spain: A population based study
Authors: Villanueva-Martınez Manuel , Hernandez-Barrera Valentın , Chana-Rodríguez Francisco , Rojo-Manaute José , Rıos-Luna Antonio , San Roman Montero Jesus , Gil-de-Miguel Angel , Jimenez-Garcıa Rodrigo
Published: March 2012

Background

To analyze changes in incidence and outcomes of patients undergoing revision total hip arthroplasty (RTHA) over an 8-year study period in Spain.

Methods

We selected all surgical admissions in individuals aged ≥ 40 years who underwent RTHA (ICD-9-CM procedure code 81.53) between 2001 and 2008 from the Spanish National Hospital Discharge Database. Age- and sex-specific incidence rates, Charlson co-morbidity index, length of stay (LOS), costs and in-hospital mortality (IHM) were estimated for each year. Multivariate analyses were conducted to asses time trends.

Results

32, 280 discharges of patients (13, 391 men/18, 889 women) having undergone RTHA were identified. Overall crude incidence showed a small but significant increase from 20.2 to 21.8 RTHA per 100, 000 inhabitants from 2001 to 2008 (p < 0.01).

The incidence increased for men (17.7 to 19.8 in 2008) but did not vary for women (22.3 in 2001 and 22.2 in 2008). Greater increments were observed in patients older than 84 years and in the age group 75-84. In 2001, 19% of RTHA patients had a Charlson Index ≥ 1 and this proportion rose to 24.6% in 2008 (p < 0.001). The ratio RTHA/THA remained stable and around 20% in Spain along the entire period

The crude overall in-hospital mortality (IHM) increased from 1.16% in 2001 to 1.77% (p = 0.025) in 2008. For both sexes the risk of death was higher with age, with the highest mortality rates found among those aged 85 or over. After multivariate analysis no change was observed in IHM over time. The mean inflation adjusted cost per patient increased by 78.3%, from 9, 375 to 16, 715 Euros from 2001 to 2008.

After controlling for possible confounders using Poisson regression models, we observed that the incidence of RTHA hospitalizations significantly increased for men and women over the period 2001 to 2008 (IRR 1.10, 95% CI 1.03-1.18 and 1.08, 95% CI 1.02-1.14 respectively).

Conclusions

The crude incidence of RTHA in Spain showed a small but significant increase from 2001 to 2008 with concomitant reductions in LOS, significant increase in co-morbidities and cost per patient.
Design and testing of an MRI-compatible cycle ergometer for non-invasive cardiac assessments during exercise
Authors: Gusso Silmara , Salvador Carlo , Hofman Paul , Cutfield Wayne , Baldi James C , Taberner Andrew , Nielsen Poul
Published: March 2012

Background

Magnetic resonance imaging (MRI) is an important tool for cardiac research, and it is frequently used for resting cardiac assessments. However, research into non-pharmacological stress cardiac evaluation is limited.

Methods

We aimed to design a portable and relatively inexpensive MRI cycle ergometer capable of continuously measuring pedalling workload while patients exercise to maintain target heart rates.

Results

We constructed and tested an MRI-compatible cycle ergometer for a 1.5 T MRI scanner. Resting and sub-maximal exercise images (at 110 beats per minute) were successfully obtained in 8 healthy adults.

Conclusions

The MRI-compatible cycle ergometer constructed by our research group enabled cardiac assessments at fixed heart rates, while continuously recording power output by directly measuring pedal force and crank rotation.
Expression of chemokine receptors on circulating tumor cells in patients with solid tumors
Authors: Fusi Alberto , Liu Zhian , Kümmerlen Verena , Nonnemacher Anika , Jeske Judith , Keilholz Ulrich
Published: March 2012

Background

The study was performed to investigate the expression of chemokine receptors (CR) on circulating tumor cells (CTC), which may be of importance for organ-specific metastases and cancer treatment since CR are potential drug-targets.

Methods

Blood samples from patients with metastatic carcinoma (MC) or melanoma (MM) were enriched for CTC and expression of CR (CXCR4, CCR6, CCR7 and CCR9) was evaluated by flow cytometry.

Results

CTC were detected in 49 of 68 patients (72%) [28 MC; 21 MM] with a median number of 3 CTC (range: 1-94)/10 mL of blood. CXCR4 was expressed on CTC in 82% (40/49) of patients [median number 1 CTC/10 mL blood; range 1-14] and CCR6 in 29 patients (59%; median 1, range: 1-14). In MM patients, CCR7 was expressed on CTC in 6 (29%) samples and CCR9 in 12 (57%). A positive correlation between surface expression of CR and organ-specific metastatic pattern was not observed.

Conclusions

CR were expressed on CTC of patients with solid tumors. Along with our findings, the observation that CR could be involved in CTC proliferation and migration of tumor cells appoints CTC as potential CR-antagonist therapeutic target.
Is inhibition of kinase activity the only therapeutic strategy for LRRK2-associated Parkinson's disease?
Authors: Rudenko Iakov N , Chia Ruth , Cookson Mark R
Published: March 2012

Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene are a common cause of familial Parkinson's disease (PD). Variation around the LRRK2 locus also contributes to the risk of sporadic PD. The LRRK2 protein contains a central catalytic region, and pathogenic mutations cluster in the Ras of complex protein C terminus of Ras of complex protein (mutations N1437H, R1441G/C and Y1699C) and kinase (G2019S and I2020T) domains. Much attention has been focused on the kinase domain, because kinase-dead versions of mutant LRRK2 are less toxic than kinase-active versions of the same proteins. Furthermore, kinase inhibitors may be able to mimic this effect in mouse models, although the currently tested inhibitors are not completely specific. In this review, we discuss the recent progress in the development of specific LRRK2 kinase inhibitors. We also discuss non-kinase-based therapeutic strategies for LRRK2-associated PD as it is possible that different approaches may be needed for different mutations.
Renal cell carcinoma associated with peritumoral sarcoid-like reaction without intratumoral granuloma
Authors: Ouellet Simon , Albadine Roula , Sabbagh Robert
Published: March 2012

Non-necrotizing epithelioid granulomas have been described in association with many primary tumors. In such cases, they are designated as sarcoid-like reaction. Although it is more seen in carcinomas than in sarcomas, it is very rarely reported in renal carcinoma. Here, we describe a rare association of prominent peritumoral sarcoid-like reaction without intratumoral granulomas and conventional clear cell renal carcinoma in a 62-year-old-male, without clinical or laboratory finding of sarcoidosis. At 30 months follow-up, he had no recurrence.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4054525336657922
An integrated analysis of miRNA and gene copy numbers in xenografts of Ewing's sarcoma
Authors: Mosakhani Neda , Guled Mohamed , Leen Gayle , Calabuig-Fariñas Silvia , Niini Tarja , Machado Isidro , Savola Suvi , Scotlandi Katia , López-Guerrero José Antonio , Llombart-Bosch Antonio , Knuutila Sakari
Published: March 2012

Background

Xenografts have been shown to provide a suitable source of tumor tissue for molecular analysis in the absence of primary tumor material. We utilized ES xenograft series for integrated microarray analyses to identify novel biomarkers.

Method

Microarray technology (array comparative genomic hybridization (aCGH) and micro RNA arrays) was used to screen and identify copy number changes and differentially expressed miRNAs of 34 and 14 passages, respectively. Incubated cells used for xenografting (Passage 0) were considered to represent the primary tumor. Four important differentially expressed miRNAs (miR-31, miR-31*, miR-145, miR-106) were selected for further validation by real time polymerase chain reaction (RT-PCR). Integrated analysis of aCGH and miRNA data was performed on 14 xenograft passages by bioinformatic methods.

Results

The most frequent losses and gains of DNA copy number were detected at 9p21.3, 16q and at 8, 15, 17q21.32-qter, 1q21.1-qter, respectively. The presence of these alterations was consistent in all tumor passages. aCGH profiles of xenograft passages of each series resembled their corresponding primary tumors (passage 0). MiR-21, miR-31, miR-31*, miR-106b, miR-145, miR-150*, miR-371-5p, miR-557 and miR-598 showed recurrently altered expression. These miRNAS were predicted to regulate many ES-associated genes, such as genes of the IGF1 pathway, EWSR1, FLI1 and their fusion gene (EWS-FLI1). Twenty differentially expressed miRNAs were pinpointed in regions carrying altered copy numbers.

Conclusion

In the present study, ES xenografts were successfully applied for integrated microarray analyses. Our findings showed expression changes of miRNAs that were predicted to regulate many ES associated genes, such as IGF1 pathway genes, FLI1, EWSR1, and the EWS-FLI1 fusion genes.
Temperature variability analysis using wavelets and multiscale entropy in patients with systemic inflammatory response syndrome, sepsis, and septic shock
Authors: Papaioannou Vasilios E , Chouvarda Ioanna G , Maglaveras Nikos K , Pneumatikos Ioannis A
Published: March 2012

Background

Even though temperature is a continuous quantitative variable, its measurement has been considered a snapshot of a process, indicating whether a patient is febrile or afebrile. Recently, other diagnostic techniques have been proposed for the association between different properties of the temperature curve with severity of illness in the Intensive Care Unit (ICU), based on complexity analysis of continuously monitored body temperature. In this study, we tried to assess temperature complexity in patients with systemic inflammation during a suspected ICU-acquired infection, by using wavelets transformation and multiscale entropy of temperature signals, in a cohort of mixed critically ill patients.

Methods

Twenty-two patients were enrolled in the study. In five, systemic inflammatory response syndrome (SIRS, group 1) developed, 10 had sepsis (group 2), and seven had septic shock (group 3). All temperature curves were studied during the first 24 hours of an inflammatory state. A wavelet transformation was applied, decomposing the signal in different frequency components (scales) that have been found to reflect neurogenic and metabolic inputs on temperature oscillations. Wavelet energy and entropy per different scales associated with complexity in specific frequency bands and multiscale entropy of the whole signal were calculated. Moreover, a clustering technique and a linear discriminant analysis (LDA) were applied for permitting pattern recognition in data sets and assessing diagnostic accuracy of different wavelet features among the three classes of patients.

Results

Statistically significant differences were found in wavelet entropy between patients with SIRS and groups 2 and 3, and in specific ultradian bands between SIRS and group 3, with decreased entropy in sepsis. Cluster analysis using wavelet features in specific bands revealed concrete clusters closely related with the groups in focus. LDA after wrapper-based feature selection was able to classify with an accuracy of more than 80% SIRS from the two sepsis groups, based on multiparametric patterns of entropy values in the very low frequencies and indicating reduced metabolic inputs on local thermoregulation, probably associated with extensive vasodilatation.

Conclusions

We suggest that complexity analysis of temperature signals can assess inherent thermoregulatory dynamics during systemic inflammation and has increased discriminating value in patients with infectious versus noninfectious conditions, probably associated with severity of illness.
Patient-Reported Outcomes After Hepatic Resection of Colorectal Cancer Metastases
Authors: Rees Jonathan R. , Blazeby Jane M. , Fayers Peter , Friend Elizabeth A. , Welsh Fenella K.S. , John Timothy G. , Rees Myrddin
Published: March 2012

Purpose

Hepatic resection of colorectal carcinoma (CRC) liver metastases is increasing, but evidence for the impact of surgery on patient-reported outcomes (PROs) is limited. This study aimed to describe comprehensively the impact of liver surgery for CRC hepatic metastases on PROs.

Patients and Methods

Consecutive patients selected for hepatic resection completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–C30 and Quality of Life Questionnaire–Liver Metastases C21 before and 3, 6, and 12 months after surgery. For functional scales, mean scores with 95% CIs were calculated at each time point, with differences in scores of at least 10 points considered clinically significant. Responses to symptom scales and items were categorized as minimal or severe. Proportions and 95% CIs for each symptom category were calculated.

Results

Hepatic surgery was planned in 241 patients but abandoned in nine because of unresectable disease. There were two postoperative deaths, 58 complications (25.2%), and 32 patients (14.9%) with disease recurrence. Questionnaire compliance was excellent (> 95% at all time points). After surgery, most functional aspects of health decreased, and the proportions of patients with severe symptoms increased; role function deteriorated significantly, and 30% of patients reported severe activity/vigor problems. Functional scales recovered by 6 months and were maintained at 1 year. Postoperative symptoms returned to baseline levels at 12 months, but 32.1% of patients reported severe problems with sexual dysfunction and 11.9% with abdominal pain.

Conclusion

These findings provide new evidence regarding outcomes of liver resection for CRC metastases. It is recommended that patients be reassured that surgery has a minimal and short-lived detrimental impact on health.
Phase II Study of Bevacizumab in Patients With HIV-Associated Kaposi's Sarcoma Receiving Antiretroviral Therapy
Authors: Uldrick Thomas S. , Wyvill Kathleen M. , Kumar Pallavi , O'Mahony Deirdre , Bernstein Wendy , Aleman Karen , Polizzotto Mark N. , Steinberg Seth M. , Pittaluga Stefania , Marshall Vickie , Whitby Denise , Little Richard F. , Yarchoan Robert
Published: March 2012

Purpose

Alternatives to cytotoxic agents are desirable for patients with HIV-associated Kaposi's sarcoma (KS). Vascular endothelial growth factor-A (VEGF-A) contributes to KS pathogenesis. We evaluated the humanized anti–VEGF-A monoclonal antibody, bevacizumab, in patients with HIV-KS.

Patients and Methods

Patients with HIV-KS who either experienced progression while receiving highly active antiretroviral therapy (HAART) for at least 1 month or did not regress despite HAART for at least 4 months were administered bevacizumab 15 mg/kg intravenously on days 1 and 8 and then every 3 weeks. The primary objective was assessment of antitumor activity using modified AIDS Clinical Trial Group (ACTG) criteria for HIV-KS. HIV-uninfected patients were also eligible and observed separately.

Results

Seventeen HIV-infected patients were enrolled. Fourteen patients had been receiving effective HAART for at least 6 months (median, 1 year). Thirteen patients had advanced disease (ACTG T1), 13 patients had received prior chemotherapy for KS, and seven patients had CD4 count less than 200 cells/μL. Median number of cycles was 10 (range, 1 to 37 cycles); median follow-up was 8.3 months (range, 3 to 36 months). Of 16 assessable patients, best tumor responses observed were complete response (CR) in three patients (19%), partial response (PR) in two patients (12%), stable disease in nine patients (56%), and progressive disease in two patients (12%). Overall response rate (CR + PR) was 31% (95% CI, 11% to 58.7%). Four of five responders had received prior chemotherapy for KS. Over 202 cycles, grade 3 to 4 adverse events at least possibly attributed to therapy included hypertension (n = 7), neutropenia (n = 5), cellulitis (n = 3), and headache (n = 2).

Conclusion

Bevacizumab is tolerated in patients with HIV-KS and has activity in a subset of patients.
The transcriptional co-repressor Grg3/Tle3 promotes pancreatic endocrine progenitor delamination and β-cell differentiation
Authors: Metzger David E. , Gasperowicz Malgorzata , Otto Florian , Cross James C. , Gradwohl Gerard , Zaret Kenneth S.
Published: March 2012

Pancreatic β-cells arise from Ngn3+ endocrine progenitors within the trunk epithelium of the embryonic pancreas. The emergence of endocrine cells requires E-cadherin downregulation, but the crucial steps that elicit such are not clear, yet probably important for ultimately being able to efficiently generate β-cells de novo from stem cells. Grg3 (groucho-related gene 3, also known as Tle3), encodes a member of the Groucho/TLE family of co-repressors and its function in various cell contexts is mediated by recruitment to target genes by different transcription factors. Grg proteins broadly regulate the progression of progenitor cells to differentiated cell types, but specific developmental mechanisms have not been clear. We find that Grg3 is expressed in most β-cells and a subset of other endocrine cell types in the pancreas. Grg3 is highly expressed in Ngn3+ endocrine progenitor descendants just after transient Ngn3 expression. Grg3-null embryos die at E14.5, which is associated with placental defects, so we explanted E12.5 pancreata to allow endocrine differentiation to occur in culture. Grg3 knockout explants displayed a drastic decrease in the differentiation of all endocrine cell types owing to defects in the delamination of early endocrine progenitors from the trunk epithelium. We find that Grg3 normally suppresses E-cadherin gene expression, thereby allowing delamination of endocrine cells from the trunk epithelium and revealing how this transcriptional co-repressor modulates this crucial step of β-cell development.
Dermal β-catenin activity in response to epidermal Wnt ligands is required for fibroblast proliferation and hair follicle initiation
Authors: Chen Demeng , Jarrell Andrew , Guo Canting , Lang Richard , Atit Radhika
Published: March 2012

Dermal fibroblasts are required for structural integrity of the skin and for hair follicle development. Uniform Wnt signaling activity is present in dermal fibroblast precursors preceding hair follicle initiation, but the functional requirement of dermal Wnt signaling at early stages of skin differentiation and patterning remains largely uncharacterized. We show in mice that epidermal Wnt ligands are required for uniform dermal Wnt signaling/β-catenin activity and regulate fibroblast cell proliferation and initiation of hair follicle placodes. In the absence of dermal Wnt signaling/β-catenin activity, patterned upregulation of epidermal β-catenin activity and Edar expression are absent. Conversely, forced activation of β-catenin signaling leads to the formation of thickened dermis, enlarged epidermal placodes and dermal condensates that result in prematurely differentiated enlarged hair follicles. These data reveal functional roles for dermal Wnt signaling/β-catenin in fibroblast proliferation and in the epidermal hair follicle initiation program.
Intraosseous Venous Malformations of the Facial Bone: A Retrospective Study in 11 Patients
Authors: Zhu C , Zhu H G , Zhang Z Y , Wang L Z , Zheng J W , Ye W M , He Y , Wang Y A
Published: March 2012

Objectives:

To investigate the clinical symptoms, computed tomography (CT) features and treatments of intraosseous venous malformations (IVM) that occur in the facial bone.

Methods and Results:

Eleven patients with facial IVM were treated with two surgical techniques, excision ( n = 4) or curettage ( n = 7). No recurrence was encountered at follow-up (45.8 ± 16.0 months). Postoperative deformities were left in two paediatric patients who were treated with excision.

Conclusions:

The diagnosis of IVM can be difficult and is mainly based on clinical symptoms and CT features. IVM should be differentiated from other lesions, including ameloblastoma, odontogenic cysts, osteosarcoma, aneurysmal bone cysts and arteriovenous malformations, among others. Conventional block biopsy should be replaced by fine needle aspiration cytology for further diagnosis. Curettage is a more appropriate method for IVM compared with excessive en-bloc osteotomy, while transosseous embolo-sclerotherapy may be a promising alternative method. Finally, the terminological confusion between ‘intraosseous haemangioma’ and ‘intraosseous venous malformation’ should be avoided according to the binary classification.
‘Test and treat’ policy in dyspepsia: time for a reappraisal
Authors: Kashyap Bineeta , Kaur Iqbal R , Garg Pankaj Kumar , Das Dipmala , Goel Sunny
Published: March 2012

The ‘test and treat’ policy is the recommended way to eradicate Helicobacter pylori in young patients with uninvestigated dyspepsia if the prevalence of H. pylori is high. India is considered to have a high prevalence of H. pylori. This observational study was conducted in order to discover the prevalence of H. pylori disease in uninvestigated dyspeptic patients, based on stool antigen test and immunoglobulin M (IgM) antibodies in the sera in order to ascertain the role of the ‘test and treat’ policy in this geographical area. Fifty patients (age <55 years) with uninvestigated dyspepsia presenting to surgery out-patient department of a tertiary teaching hospital in northern India were included in the study. Fifty healthy controls were also included. Dyspeptic patients with alarm symptoms were excluded from the study. Patients and controls were tested for IgM antibodies in their sera and H. pylori antigen in their stools. The positivity of the IgM antibody and H. pylori antigen in stools of the cases was 16% and 8%, respectively, while only 4% IgM positivity was found in the controls' samples. This study highlights the low prevalence of H. pylori in dyspeptic Indian patients. This indicates that initial proton pump therapy may be a better option than the ‘test and treat’ policy for young patients with uninvestigated dyspepsia.
Placental malaria and the relationship to pregnancy outcome at Gushegu District Hospital, Northern Ghana
Authors: van Spronsen Joanne H M , Schneider Tom A J , Atasige Stephen
Published: March 2012

One complication of malaria infection during pregnancy is the sequestration of parasites in the placenta. The aim of this study was to determine the association between placental malaria and pregnancy outcome. This study was conducted at the Gushegu District Hospital in Ghana from June to August 2010. Sulfadoxine-pyrimethamine (SP) was used as intermittent preventative treatment (IPT) during pregnancy. All mothers reporting for delivery were enrolled, except in cases of multiple pregnancies. The data was documented using a questionnaire. A placental blood sample was collected and analysed for malaria parasites. There were 56/107(52%) malaria positive samples. In women with placental malaria perinatal mortality was higher, duration of pregnancy shorter and birth weight lower. These results were statistically significant. In primigravidae the negative effects were more obvious. IPT is extensively implemented in Ghana, but this study found no evidence for an association between the number of doses and the outcome of pregnancy.
Fracture of a ceramic component in total hip replacement
Authors: Whittingham-Jones P. , Mann B. , Coward P. , Hart A. J. , Skinner J. A.
Published: March 2012

Fracture of a ceramic component in total hip replacement is a rare but potentially catastrophic complication. The incidence is likely to increase as the use of ceramics becomes more widespread. We describe such a case, which illustrates how inadequate initial management will lead to further morbidity and require additional surgery. We present the case as a warning that fracture of a ceramic component should be revised to another ceramic-on-ceramic articulation in order to minimise the risk of further catastrophic wear.
Modern military surgery
Authors: Brown K. V. , Guthrie H. C. , Ramasamy A. , Kendrew J. M. , Clasper J.
Published: March 2012

The types of explosive devices used in warfare and the pattern of war wounds have changed in recent years. There has, for instance, been a considerable increase in high amputation of the lower limb and unsalvageable leg injuries combined with pelvic trauma.

The conflicts in Iraq and Afghanistan prompted the Department of Military Surgery and Trauma in the United Kingdom to establish working groups to promote the development of best practice and act as a focus for research.

In this review, we present lessons learnt in the initial care of military personnel sustaining major orthopaedic trauma in the Middle East.
Roman dolia and the Fattening of Dormice
Authors: Beerden Kim
Published: March 2012

The edible dormouse was known as a delicious treat to rich Romans. This short article aims to emphasise the importance of the archaeological materials for getting to know more about the degree to which dormice were eaten, by whom, and where. The material evidence, consisting of dormouse-jars in which the animals were fattened, is critically reexamined.
Latin Teachers in Film
Authors: Sellers Ryan G.
Published: March 2012

The Latin teachers who appear in film are not the dedicated, innovative teachers of the modern era who work hard to make Latin relevant, interesting, and fun. Instead, they tend to be cruel tormentors, social pariahs, and mirthless taskmasters. It may be easy to dismiss these characters as cartoonish stereotypes, but they nevertheless damage the reputation of real Latin teachers and the reputation of Latin itself. This article examines the portrayal of Latin teachers in relatively well-known films such as Goodbye, Mr. Chips and The Browning Version and more obscure films like A Feast at Midnight and Hets .
Active Latin: Quo Tendimus?
Authors: Coffee Neil
Published: March 2012

This article examines the current state of active Latin pedagogy and practice, which includes speaking and writing as well as listening. It offers a short historical survey of the activities, methods, and aims of active Latin practitioners to provide bearings for those working with these methods, and information for those unfamiliar with them.
Sophistic Ethics, Old Atheism, and "Critias" on Religion
Authors: O'Sullivan Patrick
Published: March 2012

The famous dramatic fragment (TrGF 43 F 19), often ascribed to Critias, positing the existence of the gods as a fiction, has been widely considered a cynical, dangerous denunciation of religion per se. But the fragment's enumeration of the benefits of religion in eradicating injustice, violence, and lawlessness suggests that belief in the gods can be seen pragmatically in more positive terms. Seen more fully in its intellectual context, the piece is better understood as a paradox which attributes to religion many of the values and aims of much ethical and sophistic speculation of the fifth and fourth centuries B.C.
Genre, Gender, and Suicide Threats in Roman Comedy
Authors: Dutsch Dorota
Published: March 2012

Several frustrated lovers in Roman comedy threaten to kill themselves, but of course never act on their threats. In this paper, I first situate the parasuicidal amator within the literary tradition of Greek tragedy, its Roman adaptations, and the praetexta , and then ask how gendered connotations of suicide contribute to the humor of empty threats. Particularly poignant is comedy's relationship to the praetexta and the logic of sacrifice for the sake of collective values. When juxtaposed to heroic and manly acts of self-inflicted death, the comic lover's weakness comes into sharp focus.
The Plague under Commodus as an Unintended Consequence of Roman Grain Market Regulation
Authors: Silver Morris
Published: March 2012

This paper begins with a review of Roman grain market policies. It is argued that policies such as forced sales and maximum prices made urban consumers hesitant to rely on the market for secure access to grain. Consequently, consumers hoarded grain in their homes. The hoarded grain formed a volatile fuel ready to be ignited by the arrival of the bubonic plague bacillus. This scenario fits events in the city of Rome under Commodus. Attested grain market interventions were followed by a severe epidemic, arguably bubonic plague, which decimated the city's population.
Asian American Health Research: What Community Agencies on the Front Line Need to Know
Authors: Hirano Douglas M.
Published: March 2012

To be most effective, community agencies working to improve the health of Asian Americans require a deep knowledge of their target community and have evidence-based programs and policies at their disposal. Unfortunately, Asian American health research is still emerging. For some health promotion curricula that have proven effective among general populations, there is no evidence that these curricula will be as effective among Asian American populations, particularly those with limited English proficiency. In addition, the effect of acculturation on health-seeking behaviors among Asian Americans is still poorly understood, but has a large bearing on looming health problems such as obesity and diabetes. Last, given that 30% of Asian Americans are of limited English proficiency, how does the cultural competency of the American health care system impact access to care among Asian Americans? These and other questions are key considerations in developing effective community health approaches for Asian Americans.
A Community-Based Participatory Approach to a Hepatitis B Intervention for Korean Americans
Authors: Ma Grace X. , Gao Wanzhen , Tan Yin , Chae Wang G. , Rhee Joanne
Published: March 2012

Background: Hepatitis B virus (HBV) infection and liver cancer are severe health problems among Korean Americans. Most Korean Americans are neither screened nor vaccinated against HBV owing to substantial access barriers.
Objectives: The primary objective of this article is to highlight how our team of academic researchers and community partners worked together to apply a community-based participatory research (CBPR) approach to developing, implementing, and evaluating a culturally appropriate, church-based HBV screening and vaccination intervention program for Korean Americans.
Methods: Guided by CBPR, multiple strategies were used to form academic–community partnerships in the development and implementation of the culturally appropriate HBV intervention program in the Korean-American community. These include the formation of a community advisory board (CAB) and adoption of CBPR principles, community needs assessment, development and evaluation of the pilot intervention program, and the full-scale community controlled trial.
Results: The pilot intervention results indicated significant increases in screening and vaccination rates in the intervention group compared with the control group. With the success of the partnership and pilot study, Korean church leaders, CAB members, and researchers are currently co-leading a full-scale intervention study to further evaluate the effectiveness of the intervention program.
Conclusion: The current study highlights the role and contributions of multiple partners through five phases and discusses the challenges and lessons learned for how to sustain intervention programs by emphasizing common vision, trust development, shared recognition, capacity building, long-term commitments to partnership building, and balance between science and community needs.
Project CHARGE: Building an Urban Health Policy Advocacy Community
Authors: Chin John J. , Abesamis-Mendoza Noilyn
Published: March 2012

Background: The Coalition for Health Access to Reach Greater Equity (Project CHARGE) is a health policy advocacy coalition devoted to improving healthcare access for Asian Americans in New York City.
Objectives: This paper discusses Project CHARGE’s strategies for building a successful coalition.
Methods: Findings are based on evaluation data from field observations and surveys of Coalition representatives.
Lessons Learned: (1) Health policy coalitions can gain strength by recruiting from a wider range of organizations; maintaining a diverse coalition requires developing strong relationships among members. (2) Locally focused health policy coalitions should consider modifying course if needed to respond to policy developments at other governmental levels. (3) Health service providers can help to sustain policy advocacy activities if sufficient training is provided to develop them into policy advocates. (4) Early successes need to be planned to galvanize Coalition members.
Conclusions: Aiming to build a policy advocacy “community” may help to ensure that advocacy continues even when funding is scarce.
Developing a Proactive Research Agenda to Advance Nail Salon Worker Health, Safety, and Rights
Authors: Quach Thu , Liou Julia , Fu Lisa , Mendiratta Anuja , Tong My , Reynolds Peggy
Published: March 2012

The Problem: Nail salons represent a burgeoning industry with Vietnamese immigrant workers making up the majority. Workers routinely handle cosmetic products containing hazardous compounds, with implications for their health.
Purpose of Article: This paper describes how a collaborative of multiple organizations and community members collectively developed a proactive research agenda for salon worker health, safety, and rights during a pivotal multistakeholder convening, and advanced on such recommendations, including creating groundbreaking policy changes.
Key Points: Key recommendations included (1) creating a multidisciplinary research advisory committee, (2) conducting research on workplace exposures and long-term health impacts, (3) advocating for better governmental oversight of product manufacturers, and (4) identifying safer product alternatives via green chemistry, albeit with cost considerations to salon businesses.
Conclusion: The participation of diverse stakeholders in the discussions allowed for cross-dialogue on a complex issue, helped to align different stakeholders as allies, and identified critical resources to addressing research gaps.
Pathway out of Poverty: A Values-Based College-Community Partnership to Improve Long-Term Outcomes of Underrepresented Students
Authors: Boyd Jamie Kamailani , Kuuleialoha Kamaka Sharmayne A. , Braun Kathryn L.
Published: March 2012

Background: Native Hawaiians, representing 25% of Hawai‘i’s population, suffer socioeconomic and health strains as evidenced by overrepresentation in low-wage jobs without health insurance and a higher prevalence of chronic disease compared with Hawai‘i’s other ethnic groups. Native Hawaiians are more likely to attend community colleges than 4-year colleges and have high dropout rates.
Objective: To describe a culturally relevant, community-based action research approach to build a program to keep Hawaiians in college to advance career options and improve long-term health and socioeconomic outcomes.
Methods: Culturally relevant approaches that depended on participation from a variety of community partners were used to evaluate needs and design interventions.
Results: The Pathway Out of Poverty Program uses Hawaiian values and traditions of healthy living to lead students through a nursing pathway from nurse aide (NA) to licensed practical nurse (LPN) to registered nurse (RN), with inherent increases in wage-earning potential. In the first 3.5 years, 150 students enrolled in NA training, and 135 students (90%) graduated and were certified. Of the 135, 77 (57%) transitioned to higher education and 79% transitioned to jobs that offered health insurance (20% were in both groups). Of the 77 entering higher education, 33 (43%) aimed for a degree in nursing. Students expressed growing interest in health promotion for themselves, family members, and others.
Conclusion: Community partners were key to developing a successful community college-based Pathway Program to help marginalized and other underrepresented students move from low-wage to living-wage jobs and improve their long-term health outcomes.
Role of Federal Policy in Building Research Infrastructure Among Emerging Minorities: The Asian American Experience
Authors: Trinh-Shevrin Chau , Ro Marguerite , Tseng Winston , Islam Nadia Shilpi , Rey Mariano J. , Kwon Simona C.
Published: March 2012

Problem: Considerable progress in Asian American health research has occurred over the last two decades. However, greater and sustained federal support is needed for reducing health disparities in Asian American communities.
Purpose of the Article: This paper reviews federal policies that support infrastructure to conduct minority health research and highlights one model for strengthening research capacity and infrastructure in Asian American communities.
Key Points: Research center infrastructures can play a significant role in addressing pipeline/workforce challenges, fostering campus–community research collaborations, engaging communities in health, disseminating evidence-based strategies and health information, and policy development.
Conclusion: Research centers provide the capacity needed for academic institutions and communities to work together synergistically in achieving the goal to reduce health disparities in the Asian American community. Policies that support the development of concentrated and targeted research for Asian Americans must continue so that these centers will reach their full potential.
Improving Asian American, Native Hawaiian, and Pacific Islander Health: National Organizations Leading Community Research Initiatives
Authors: Cook Won Kim , Weir Rosy Chang , Ro Margeurite , Ko Kathy Lim , Panapasa Sela , Bautista Roxanna , Asato Lloyd , Corina Chung , Cabllero Jeffery , Islam Nadia
Published: March 2012

Background: Functionally, many CBPR projects operate through a model of academic partners providing research expertise and community partners playing a supporting role.
Objectives: To demonstrate how national umbrella organizations deeply rooted in communities, cognizant of community needs, and drawing on the insights and assets of community partners, can lead efforts to address health disparities affecting their constituents through research.
Methods: Case studies of two Asian American, Native Hawaiian, and Pacific Islander national organizations
Results: Strategically engaging a diverse range of partners and securing flexible funding mechanisms that support research were important facilitators. Main challenges included limited interest of local community organizations whose primary missions as service or health care providers may deprioritize research.
Conclusions: Efforts to make research relevant to the work of community partners and to instill the value of research in community partners, as well as flexible funding mechanisms, may help to promote community-driven research.
Bridging Academic–Legislative Divides: Models of Policy-Relevant Health Research and Practice by the University of California
Authors: Russ Laura W. , Takahashi Lois M. , Ho Wendy , Tseng Winston , Ponce Ninez A.
Published: March 2012

Problem: This paper argues that it is necessary to strengthen Asian American, Native Hawaiian, and Pacific Islander (AA and NHPI) community-based participatory research (CBPR) models that integrate a health policy agenda through dynamic legislative partnerships.
Purpose: We utilize a case study approach and examine three health research partnership models that impact legislative design and action: The California Program on Access to Care (CPAC), the California Health Benefits Review Program (CHBRP), and the University of California Asian American and Pacific Islander Policy Multicampus Research Program (UC AAPI Policy MRP).
Key Points: In-depth examination reveals the difficulties of engaging in research that collaborates with multiple parties simultaneously and the specific benefits and challenges in each case.
Conclusions: New directions are needed to deepen legislative engagement potential in CBPR and the translation of policy research that considers the health of all AA and NHPI communities.
Developing the Community Empowered Research Training Program: Building Research Capacity for Community-Initiated and Community-Driven Research
Authors: Kwon Simona , Rideout Catlin , Tseng Winston , Islam Nadia , Cook Won Kim , Ro Marguerite , Trinh-Shevrin Chau
Published: March 2012

Health promotion practice research conducted by or in partnership with community-based organizations (CBOs) serving Asian Americans, Native Hawaiians, and Pacific Islanders (AA and NHPI) can address health disparities. Few CBOs have the tools to integrate or initiate research into their programmatic agenda. The New York University (NYU) Center for the Study of Asian American Health (CSAAH) and the Asian & Pacific Islander American Health Forum (APIAHF) created a partnership with the goal to support CBO research infrastructure development by creating the Community Empowered Research Training (CERT) program.
Methods: A survey was conducted and discussions held with CBO leaders representing AA and NHPI communities to inform the development of the CERT program.
Results: The majority of participants are engaged in service-related research and reported interest in building their research capacity. CBOs may require help reframing how data can be collected and used to better inform programmatic activities and to address health disparities facing AA and NHPI communities.
Conclusions: CBOs possess both an interest in and access to local knowledge that can inform health priorities. Findings have been applied to the CERT program to build capacity to support community-initiated/driven research to address health disparities affecting AAs and NHPIs.
Developing a Culturally Based Cardiac Rehabilitation Program: The HELA Study
Authors: Look Mele A , Kaholokula Joseph Keawe‘aimoku , Carvhalo Amy , Seto Todd , de Silva Mapuana
Published: March 2012

Background: Heart disease disproportionately affects Native Hawaiians and other Pacific people. In response, researchers proposed and communities endorsed, developing a cardiac rehabilitation (CR) program based on the hula, a Native Hawaiian dance form. The utilization of cultural practices in health interventions can improve outcomes and increase enrollment and retention, but requires sensitivity and understanding.
Objective: This paper provides the conceptual framework and methods used for integration of multiple communities’ perspectives to inform the design of a hula-based CR intervention.
Methods: Specific strategies and processes were established to ensure the equity of scientific—clinical and patient— cultural knowledge and perspectives. Multiple methods were used and a flow diagram defined steps for the intervention development.
Results: Patient and cultural consultations provided information about the multidimensional benefits of hula and its use in a CR intervention. Clinical and scientific consultations provided specific guidelines for exercise prescription and patient monitoring. Integrating findings from all consultations identified important direction and requirements.
Conclusions: Community-based participatory research (CBPR) principles guided a complex collaboration of multiple communities; although time consuming, inclusive consultations provided valuable information and relationships.
Community-Based Participatory Research Approach to Evidence-Based Research: Lessons From the Pacific Islander American Health Study
Authors: Panapasa Sela , Jackson James , Caldwell Cleopatra , Heeringa Steve , McNally James , Williams David , Coral Debra , Taumoepeau Leafa , Young Louisa , Young Setafano , Fa’asisila Saia
Published: March 2012

Objectives: Reports on the challenges and lessons learned from the Pacific Island American Health Study engagement with community-based organizations (CBOs) and faith-based organizations (FBOs) in Pacific Islander (PI) communities and mechanisms to facilitate the collection of robust data.
Methods: Academic–community partnership building was achieved with PI CBOs and FBOs. Focus group meetings were organized to plan various aspects of the study, develop questionnaire themes and protocols for survey, assist with the interviewer recruitment process, and strategize data dissemination plan.
Lessons Learned: The PIA-HS represents a model for overcoming challenges in data collection among small understudied populations. FBOs represent a valuable resource for community-based participatory research (CBPR) data collection and for effective interventions.
Conclusion: The study methodology can be replicated for other racial/ethnic groups with high levels of religiosity combined with concentrated levels of residential clustering. Expansion of the Pacific Islander American Health Study (PIA-HS) to include other PI subgroups is encouraged.
Misunderstanding the New Paul: Marcion's Transformation of the Sonderzeit Paul
Authors: Marshal John W.
Published: March 2012

The study of Marcion's reception of Paul has not kept pace with changes in the historical-critical interpretation of Paul's letters. This study seeks to understand Marcion's view of the future of the Jewish people by means of the "two paths" interpretation of Paul. I argue that Marcion's doctrine of the two Christs both transforms and preserves something of Paul's conception of the special way into salvation that he offered to Gentiles. Marcion's transformation of Paul consists in the ubiquitous second-century containment or removal of Paul's intense eschatology. Marcion participates in this wider movement in second-century Christianity but stands as a rare instance of preserving distinct salvific paths for Jews and Gentiles.
Christian Use of Magic in Late Antique Egypt
Authors: Shandruk Walter M.
Published: March 2012

Determining the contours of late antique Christian use of magic involves two variables: (1) the religious affiliation of the user and (2) the content of the magic. The presence or absence of Christian motifs does not provide a clear-cut solution to a user's personal religious identity since Christian and non-Christian elements are often found side-by-side. This paper proposes that an onomastic analysis of user names from applied magical texts can provide a possible solution. An analysis of those results in comparison with the content of the texts reveals some significant patterns in the type of magic used and its chronological distribution.
Reassessing Salona's Churches: Martyrium Evolution in Question
Authors: Yasin Ann Marie
Published: March 2012

Using the extramural basilicas at Salona as a testing ground, this article seeks to examine a central historiographical and methodological issue in early Christian archaeology: the narrative of evolutionary development of martyria sites from saint's tomb to monumental center of burial, worship, and pilgrimage. While the widely accepted model may accurately describe the steps of monumentalization at some cult places, it can also deceptively streamline much more complicated, and less predictable, site histories. At Salona, a site often held up as exemplifying the conventional pattern of martryium development, the archaeological evidence does not substantiate many of the model's central principles. Moreover, I suggest that adopting a more critical perspective on the model itself helps us to recognize other possible narratives of cult development suggested by the archaeological, epigraphic, and hagiographic evidence.
The Epistula fidei of Evagrius of Pontus: An Answer to Constantinople
Authors: Kalvesmaki Joel
Published: March 2012

The De fide or Epistula fidei by Evagrius is widely thought to have been written from Constantinople around 381 to Christians back home in Pontus. In this article, I revive and refine a thesis advanced in 1923 by Melcher, that the letter was written in fact to Constantinople, after Evagrius fled the city in 382. Building on Melcher's insights, I argue that Evagrius wrote the letter from Jerusalem or Egypt, as a monk, sometime in 383 or later. Thus, the letter is not really a defense of his actions, even though he explains why he fled Constantinople. It is rather a pastoral letter, draped in the spiritual and intellectual mantle of Gregory of Nazianzus—an attack on the heresies in the city and a demonstration to the orthodox of a higher epistemology. Revising the date and audience of the Epistula fidei permits new insights into the development of Evagrius's theology, the state of Constantinople under Nectarius, and the contested inheritance of Gregory of Nazianzus.