bluuebunny/crossref_metadata_2025 huggingface dataset:
Prostatic Metastases from Testicular Nonseminomatous Germ Cell Cancer: Two Case Reports and a Review of the Literature
Authors: Torelli Tullio , Lughezzani Giovanni , Catanzaro Mario , Nicolai Nicola , Colecchia Maurizio , Biasoni Davide , Piva Luigi , Maffezzini Massimo , Stagni Silvia , Necchi Andrea , Giannatempo Patrizia , Farè Elena , Salvioni Roberto
Published: February 2018

Background

Prostatic metastases from testicular germ cell tumors (TGCTs) are extremely uncommon. To the best of our knowledge, only five cases of prostatic metastases from seminoma have been reported in the literature. Conversely, no cases of metastases to the prostate from nonseminomatous germ cell tumors (NSGCT) have been previously reported.

Case presentation

We present two patients who developed prostatic metastases 5 and 21 years after the initial diagnosis. The first case concerned a 28-year-old Caucasian man who underwent a right orchiectomy and right retroperitoneal lymph node dissection (RPLND) for a stage I NSGCT in 1999 and five years later was diagnosed with prostatic metastases. The second case concerned a 30-year-old man treated with a right orchiectomy and right RPLND for stage I NSGCT in 1985 who was diagnosed with prostatic metastases in 2006, 21 years after primary surgery. We reviewed the available literature on the topic.

Conclusion

Prostatic metastases from TCGTs are highly unusual. Lower urinary tract symptoms in patients treated for previous testicular cancer require immediate clinical attention. However, because of their extreme rarity, specific clinical investigations to screen for possible prostatic involvement from TGCT should not be recommended.
Treatment of Cutaneous Angiosarcoma of the Face: Efficacy of Combined Chemotherapy and Radiotherapy
Authors: Ravo Vincenzo , Falivene Sara , De Chiara Annarosaria , De Palma Giampaolo , Pizzolorusso Antonio , Di Franco Rossella , Muto Paolo , Apice Gaetano
Published: February 2018

Introduction

Cutaneous angiosarcoma (AS) is a rare form of soft tissue sarcoma. It is aggressive and has a poor prognosis. The aim of our report is to show that with combined chemotherapy and radiotherapy it is possible to obtain good results in terms of local control, complete response, and aesthetic outcome.

Case report

We present the case of a 60-year-old man affected by AS covering the entire surface of the nose. Surgery, although indicated, was excluded because it was considered mutilating and would give a poor cosmetic result. The patient was treated with chemotherapy consisting of paclitaxel 80 mg/m2 for 6 cycles followed by radiotherapy at a dose of 50 Gy. Then 3 additional cycles of chemotherapy were administered according to the same scheme. A complete response was obtained. At 40 months after treatment, the patient did not show any signs of late toxicity, all lesions had disappeared, and all laboratory tests were negative.

Conclusions

Our experience shows that concomitant chemoradiotherapy can be delivered safely and can be tolerated with low toxicity and good results in terms of local control and complete response. We obtained an excellent aesthetic result with improvement of the patient's quality of life.
Application of Helical Tomotherapy for the Treatment of a Right Atrium Angiosarcoma: A Case Report
Authors: Franceschini Davide , Scotti Vieri , Simontacchi Gabriele , Meattini Icro , Paiar Fabiola , Greto Daniela , Bonomo Pierluigi , Franzese Ciro , Di Cataldo Vanessa , Pallotta Stefania , Biti Giampaolo
Published: February 2018

We report the case of a 48-year-old woman affected by inoperable primary angiosarcoma of the right atrium who was treated with 4 cycles of induction chemotherapy and radical radiotherapy. We present the application and the result of helical tomotherapy for this patient. We also describe the technical aspects of the simulation, planning, setup and delivery of radiotherapy. At 16 months after the diagnosis the patient is still in good condition without any symptoms and with a partial response of the lesion. This case shows the feasibility of treatment with high doses of radiation for a primary unresectable cardiac sarcoma.
Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer
Authors: Piacentini Paolo , Greco Filippo , Mercanti Anna , Trolese Anna Rita , Durante Emilia , Moratello Giacomo , Tognetto Michele , Furini Lara , Giuliani Jacopo , Bonetti Andrea
Published: February 2018

Aims and background

More than 50% of patients with advanced non-small cell lung cancer are diagnosed in the elderly. Few prospective clinical data with cisplatin-based chemotherapy are available, and some authors have suggested that a non-platinum single agent should be the preferred form of cure in these patients. The aim of the study was to evaluate the efficacy and safety of first-line chemotherapy based on platinums (carboplatin or cisplatin) plus a third generation compound (vinorelbine or gemcitabine) in elderly patients with advanced non-small cell lung cancer in daily clinical practice.

Methods

A retrospective analysis of consecutive elderly (≥70 years of age) patients with advanced non-small cell lung cancer treated at our Medical Oncology Unit from February 2005 to September 2011 was performed.

Results

A total of 249 cycles of chemotherapy was administered to 62 patients (median age, 72 years; range, 70–81) presenting a median Charlson comorbidity index of 1 and a good ECOG PS (0–1, 52 patients; 2, 10 patients). The median number of cycles/patient was 4, and all 62 patients received a platinum-based doublet as first-line chemotherapy: 57 with carboplatin (92%) and 5 with cisplatin (8%). As best response to the treatment, 19 (31%) partial responses and 20 (32%) stable diseases were observed. Median overall survival was 9.8 months. Toxicity was mild; grade III-IV neutropenia was the most frequently observed side effect in 19 administered cycles (8%).

Conclusions

Advanced non-small cell lung cancer in elderly patients can be safely treated with a platinum-based doublet. Observed toxicity is manageable, and overall survival is in keeping with data from the literature.
The evaluation of bcl-2 expression as a prognostic marker in early stage laryngeal cancer
Authors: Gurlek Umit , Abakay Candan Demiroz , Ozkan Lutfi , Saraydaroglu Ozlem , Kurt Meral , Cetintas Sibel Kahraman
Published: February 2018

Aims and background

To evaluate the effect of bcl-2 expression on the local control and overall survival of patients with early stage laryngeal cancer treated with radiotherapy alone.

Methods and study design

We included 53 patients with stage Tis, T1, and T2 laryngeal cancer who were irradiated in our department. Paraffin blocks of all biopsy specimens were subjected to immunohistochemical analysis with a bcl-2 oncoprotein mouse clone 124 Scytek kit.

Results

The mean follow-up time was 61 months (range, 7–166). Local-regional recurrence was observed in 10 (19%) patients. Forty-three patients (81%) had negative bcl-2 staining, 5 patients (9%) had + staining, 3 patients (6%) ++ staining, and 2 patients (4%) +++ staining. No relationship was detected between bcl-2 expression and local control or overall survival. The emergence of a recurrence and a younger age (<50 years) were significantly related to poor overall survival (P = 0.000 and P = 0.021, respectively). Patients with hemoglobin levels in the middle of radiotherapy and at the end of radiotherapy higher than 13 g/dl had improved overall survival in multivariate analyses (P = 0.002 and P = 0.001, respectively). Regarding local control, the following were poor prognostic factors: smoking more than 20 cigarettes a day (P = 0.001) and being younger than 50 years of age (P = 0.001).

Conclusions

No correlation was observed between bcl-2 expression and local control or overall survival. Whereas hemoglobin level, age and existence of a recurrence had a prognostic impact on overall survival, patient age and smoking status influenced local control rates.
Increased expression of EphA2 and E-N cadherin switch in primary hepatocellular carcinoma
Authors: Fan Min , Liu Yu , Xia Fada , Wang Zhuolu , Huang Yun , Li Jingdong , Wang Zhiming , Li Xinying
Published: February 2018

Aim

To investigate the expression and clinical significance of ephrin type-A receptor 2 and epithelial-mesenchymal transition-related proteins in primary hepatocellular carcinoma.

Methods

Tissues from 52 primary hepatocellular carcinomas and 12 human normal liver tissues were detected for expression of ephrin type-A receptor 2, E-cadherin, and N-cadherin by immunochemistry. Cinicopathological features of hepatocellular carcinoma and tumor recurrence after operation were studied for the association with these molecular expressions and E-N cadherin switch.

Results

Increased expressions of ephrin type-A receptor 2 and N-cadherin and reduced expression of E-cadherin were significantly detected in hepatocellular carcinoma compared with normal liver tissues. Univariate analysis showed that there were close associations between unfavorable clinicopathological features and expressions of ephrin type-A receptor 2, E-cadherin, N-cadherin, and E-N cadherin switch. Ephrin type-A receptor 2 and E-cadherin expressions were confirmed as independent prognostic factors when corrected with age, gender, AFP, HBsAg, liver cirrhosis, tumor size, nodules, capsule, portal vein invasion, cell differentiation, and TNM stage.

Conclusions

The overexpression of ephrin type-A receptor 2 protein is correlated with the number of tumors, capsular integrity, portal vein cancer thrombus and clinical stages. Epithelial-mesenchymal transition regulated by ephrin type-A receptor 2 is involved in the aggressive clinicopathological features and prognosis, suggesting that the receptor may play an important role in the progression and metastasis of hepatocellular carcinoma.
Trefoil factor 1 gene alternations and expression in colorectal carcinomas
Authors: Huang You-Guang , Li Yun-Feng , Pan Bao-Long , Wang Li-Ping , Zhang Yong , Lee Wen-Hui , Zhang Yun
Published: February 2018

Aims and background

Aberrant expression of the trefoil factor family (TFF) has been recognized to be involved in the development and/or progression of various solid tumors. Increased trefoil factor 1 (TFF1) expression is found associated with tumor progression in some tumors, and TFF1 missense mutations have been detected in gastric cancer. The aim of the study was to analyze TFF1 alternations and expression in colorectal carcinoma and their correlation with cancer progression and pathological aspects.

Methods

TFF1 mutations were detected in colorectal carcinomas by DNA sequencing. TFF1mRNA and protein levels in subsets of the primary tumors were determined using quantitative reverse transcription polymerase chain reaction and immunohistochemistry analyses. The serum level of TFF1 was also detected by enzyme-linked immunosorbent assay for patients with colorectal carcinoma.

Results

Five variants were detected in the 5'-untranslation region and intron 1 of TFF1. TFF1 expression was increased in colorectal carcinoma compared to paired distal colonic mucosa. Immunohistochemistry in primary colorectal carcinoma showed no significant differences in tumor TFF1 levels with respect to clinicopathological parameters such as the patient's sex, cancer differentiation, stage and lymph node metastasis. However, serum TFF1 levels were significantly elevated in patients with colorectal carcinoma compared to healthy individuals.

Conclusions

The results indicate that TFF1 missense mutations seem to be a rare event in colorectal carcinogenesis. Serum TFF1 may be a potential useful marker for patients with colorectal carcinoma.
18FDG-PET for Early Prediction of Complete Response to Lapatinib and Capecitabine in HER2-Positive Metastatic Breast Cancer: A Case Report
Authors: Riccardi Ferdinando , Mocerino Carmela , Barbato Carmela , Vitale Maria Giuseppa , Carrillo Giovanna , Trunfio Martino , Minelli Salvatore , Cartenì Giacomo
Published: February 2018

Targeted therapies against HER2 (trastuzumab, lapatinib) have improved the efficacy of treatment and the outcome of patients with HER2-positive breast cancer. Lapatinib is a tyrosine kinase inhibitor targeting EGFR1 and HER2: it binds the intracellular domain of these receptors and blocks their downstream signaling pathways. In combination with capecitabine, it is the standard of care for patients with trastuzumab-resistant advanced breast cancer. We present the case of a patient exhibiting a complete and prolonged clinical response to second-line treatment with lapatinib and capecitabine after failure of trastuzumab-based therapy. 18FDG-PET allowed the detection of disease remission several months before computed tomography. Molecular imaging with 18FDG seems the most powerful way to measure the pharmacodynamic effects of targeted anticancer drugs. This case report confirms that18FDG-PET plays a key role not only in detecting metastatic disease but also in evaluating the response to HER2-directed therapy.
Lapatinib and Letrozole as First-Line Therapy for Metastatic Breast Cancer: Case Report of Bone Metastasis 18 Years Later
Authors: Mariani Gabriella , Ricchini Francesca , Sica Lorenzo , Bianchi Giulia Valeria
Published: February 2018

We describe a 63-year-old woman with a diagnosis of breast cancer who relapsed with multiple bone lesions 18 years later. The biological characteristics were estrogen receptor positive, progesterone receptor positive, and HER2-positive cancer. Lapatinib and letrozole was the treatment of choice as a manageable and active first-line therapy for this patient.
Metastatic Breast Cancer Treated with Lapatinib with a Prolonged Benefit: A Case Report and a Review of Therapeutic Options Available
Authors: Bianchi Giulia Valeria , Duca Matteo , Sica Lorenzo , Mariani Gabriella
Published: February 2018

A 53-year-old woman was treated, after trastuzumab progression of HER2-positive metastatic disease, with capecitabine plus lapatinib and subsequently with lapatinib alone. To date, she has had persistent remission of disease since 2009.
Circulating Free DNA in a Screening Program for Early Colorectal Cancer Detection
Authors: Perrone Federica , Lampis Andrea , Bertan Claudia , Verderio Paolo , Ciniselli Chiara M , Pizzamiglio Sara , Frattini Milo , Nucifora Martina , Molinari Francesca , Gallino Gianfranco , Gariboldi Manuela , Meroni Emanuele , Leo Ermanno , Pierotti Marco A , Pilotti Silvana
Published: February 2018

Aims and Background

The quantification and molecular characterization of circulating free DNA (cfDNA) have attracted much interest as new and promising, noninvasive means of detecting and monitoring the presence of surgical resectable colorectal cancer (CRC). Instead, the role of cfDNA in the early detection of malignant and premalignant colorectal lesions is still unclear. The aim of this study was to evaluate the predictive power of the quantification and KRAS status of cfDNA in detecting early colorectal lesions in plasma from healthy high-risk subjects.

Methods

The study population consisted of 170 consecutive healthy high-risk subjects aged >50 years who participated in the screening program promoted by the Local Health Service (ASL-Milano) for early CRC detection and who underwent endoscopic examination after being found positive at fecal occult blood test (FOBT). Thirty-four participants had malignant lesions consisting of 12 adenocarcinomas (at an early stage in half of the cases) and 22 instances of high-grade intraepithelial neoplasia (HGIN) in adenomas; 73 participants had premalignant lesions (adenomas and hyperplasia), and 63 participants had no lesions. Plasma cfDNA was quantified by quantitative real-time PCR and analyzed for KRAS mutations by a mutant-enriched PCR. KRAS status was assessed also in matched adenocarcinoma and HGIN tissues. The distribution of cfDNA concentrations among FOBT-positive subjects with diagnosed lesion (cases) was compared with that of FOBT-positive subjects without lesions (controls) and its predictive capability (AUC) was assessed.

Results

The predictive capability of cfDNA levels was satisfactory in predicting adenocarcinomas (AUC 0.709; 95% CI, 0.508–0.909) but not HGIN and premalignant lesions. The rate of KRAS mutations in plasma was low (5/170 = 3%) compared with the rate observed in the matched adenocarcinoma and HGIN tissues (45%).

Conclusions

The use of cfDNA quantification to predict adenocarcinoma at an early stage in high-risk (aged >50 years and FOBT positive) subjects seems to be promising but needs more sensitive methods to improve cfDNA detection.
Do High-risk Features Support the Use of Adjuvant Chemotherapy in Stage II Colon Cancer? A Turkish Oncology Group Study
Authors: Artac Mehmet , Turhal Nazim Serdar , Kocer Murat , Karabulut Bulent , Bozcuk Hakan , Yalcin Suayip , Karaagac Mustafa , Gündüz Seyda , Isik Nalan , Uygun Kazim
Published: February 2018

Background

A high-risk group of patients with stage II colon cancer has been identified by the results of studies in Western populations. The aim of this study was to investigate the prognostic factors of adjuvant chemotherapy in Turkish patients with stage II colon cancer.

Methods

A total of 554 stage II colon cancer patients were retrospectively enrolled in the study. Three hundred fifty-three patients had received adjuvant chemotherapy (5-FU-LV, FOLFOX or FLOX) and 201 had received no adjuvant chemotherapy. T4 tumor stage, lymphovascular invasion, perineural invasion, bowel obstruction and/or perforation, <12 harvested lymph nodes, and poor differentiation were defined as high-risk factors.

Results

The median age of the patients was 62 years (range 26–88). The median disease-free survival (DFS) was 58.1 months (95% CI, 47.6 months to 68.5 months) in the non-treatment group and has not been reached in the treatment group (P <0.01). In univariate analysis, patient age >60 years and T4 tumor stage were statistically significant factors that affected DFS as poor prognostic factors. Adjuvant chemotherapy reduced the risk of recurrence with statistical significance (P <0.01). In multivariate analysis, patient age >60 years and T4 tumor stage were independent risk factors affecting DFS. In addition, adjuvant chemotherapy was an independent favorable prognostic factor for DFS (P <0.01).

Conclusions

Clinical and pathological risk factors in patients with stage II colon cancer may be different in the Turkish population compared to other populations. Further prospective studies in colon cancer are needed to understand the differences in biology and risk factors between races.
Radiotherapy in Patients with Vestibular Schwannoma and Neurofibromatosis Type 2: Clinical Results and Review of the Literature
Authors: Wagner Johanna , Welzel Thomas , Habermehl Daniel , Debus Jürgen , Combs Stephanie E
Published: February 2018

Aims and Background

To evaluate the long-term outcome of patients with vestibular schwannoma (VS) and neurofibromatosis type 2 (NF2) treated with fractionated stereotactic radiotherapy (FSRT) or stereotactic radiosurgery (SRS).

Patients and Methods

Sixteen VS in 14 patients with NF2 were treated with FSRT (n = 14) and SRS (n = 2). Patients with tumor progression and/or progression of clinical symptoms were selected for treatment. For patients treated with FSRT a median total dose of 57.6 Gy was prescribed with a median fractionation of 5 × 1.8 Gy per week. For patients who underwent SRS a median single dose of 17 Gy was prescribed to the 80% isodose.

Results

FSRT and SRS were well tolerated. Local control rate was 94% for a median follow-up time of 131 months; 2- and 5-year progression-free survival were 100%. The probability of maintaining the pretreatment hearing level was 44%. Useful hearing preservation was 33%. Cranial nerve toxicity was moderate. Trigeminal nerve function worsened in 2 patients (12%) and facial nerve function in 3 patients (19%). One patient developed a new tinnitus.

Conclusion

FSRT and SRS are both safe and effective noninvasive and minimally invasive treatment options for patients with VS in the setting of NF2. The long-term local control rates are excellent. Functional hearing preservation is worse in patients with VS and NF2 than in patients with sporadic VS.
Usefulness of Combined PET/CT to Assess Regional Lymph Node Involvement in Gastric Cancer
Authors: Park Kwonoh , Jang Geundoo , Baek Sora , Song Hunho
Published: February 2018

Aims and Background

The aim of this study was to evaluate the value of positron emission tomography/computed tomography (PET/CT) for preoperative staging of gastric cancer and to compare the diagnostic performance of PET/CT with that of contrast-enhanced computed tomography (CECT).

Methods

We retrospectively reviewed 74 gastric cancer patients who underwent preoperative PET/CT and CECT, and subsequent curative surgical resection between April 2007 and July 2011. Preoperative PET/CT and CECT images for primary tumors of the stomach and lymph node metastases were reviewed retrospectively. The final diagnoses of primary tumors and LN metastases were based on histopathological specimens in all patients.

Results

Advanced gastric cancer was present in 65% of patients (n = 48), and the remaining patients had early gastric cancer (n = 26). Sixteen patients (22%) showed signet-ring-cell histology. For the detection of the primary tumor, the sensitivity of PET/CT was significantly higher than that of CECT (67% vs 55%, respectively; P = 0.049). For the evaluation of regional lymph node metastasis, the sensitivity, specificity, and accuracy of PET/CT and CECT were 34% and 51% (P = 0.065), 88% and 79% (P = 0.687), and 58% and 64% (P = 0.332), respectively. Neither PET/CT nor CECT detected regional lymph node metastases in early gastric cancer patients. Signet-ringcell histology showed trends of non-FDG-avid lymph node metastases (odds ratio = 0.15, 95% confidence interval 0.17–1.37, P = 0.093)

Conclusions

The accuracy of PET/CT is low and it is not a useful tool in the staging of gastric cancer overall in early gastric cancer and in signet-ring-cell carcinoma. Furthermore, the sensitivity of PET/CT could be inferior to that of CECT in the diagnosis of regional lymph node metastasis.
Outcome and Patterns of Care in Advanced Biliary Tract Carcinoma (ABC): Experience from Two Tertiary Institutions in the United Kingdom
Authors: Huggett Matthew T , Passant Helen , Hurt Chris , Pereira Stephen P , Bridgewater John , Mukherjee Somnath
Published: February 2018

Aims and Background

The ABC-02 trial has defined the standard therapy for patients with advanced biliary tract cancer (ABC); however, outcome in an unselected patient population in the UK has not been described. We aimed to investigate the outcome of a series of patients with ABC from two large UK cancer networks.

Methods and Study Design

We retrospectively reviewed all cases of ABC presenting to two UK cancer networks over a nine-year period. Overall survival (OS) and factors influencing OS were assessed.

Results

Four hundred and two patients were available for analysis. The median OS was 6.2 months. On univariate analysis, age ≥70 years (P = 0.047), advanced disease stage (P <0.001), gall bladder primary (P = 0.033), poor performance status (P <0.001) and lack of chemotherapy (P <0.001) were associated with worse outcome. Survival was superior in the 36.4% of patients who received palliative chemotherapy (12.5 vs 4.3 months; P <0.001). On multivariate analysis of patients who had chemotherapy, those who did not receive fluoropyrimidine-based regimens (HR = 5.12; P = 0.022) or gemcitabine-based regimens (HR = 5.01; P = 0.021) had a higher mortality, whereas the effect of platinum-containing regimens was of borderline significance (HR = 2.23; P = 0.086). Sites, age, and multi-agent regimens were not significant.

Conclusions

This is one of the largest retrospective studies reporting outcome of palliative chemotherapy for ABC. It confirms the benefit of palliative chemotherapy in an unselected group of patients. Fluoropyrimidine-based regimens appear to be as effective as gemcitabine-based treatments.
Management of a Ruptured Mucinous Mesenteric Cyst with Hyperthermic Intraperitoneal Chemotherapy
Authors: Nelson John , Deneve Jeremiah , Dickson Paxton , Sylvestre Pamela , Munene Gitonga
Published: February 2018

Mesenteric cysts are rare intra-abdominal cysts that are generally regarded as benign, and the incidence of malignancy is often cited to be 3%. The typical recommendation for treatment is complete excision to minimize recurrence. Excision can be performed laparoscopically, but this can lead to intra-abdominal dissemination of the cyst contents. There has been one case report describing the development of pseudomyxoma peritonei following rupture of a mesenteric cyst. We describe the treatment and outcome of a patient who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for the treatment of an incompletely resected mucinous cystadenocarcinoma originating from the colonic mesentery.
Case Report of a Long-surviving Man with Metastatic Renal Cell Carcinoma Treated with Pazopanib
Authors: Ratta Raffaele , Santini Daniele
Published: February 2018

Renal cell carcinoma is the most common type of kidney cancer in adults. It accounts for approximately 3% of adult malignancies and 90–95% of neoplasms arising from the kidney. At the moment several biological agents are used for the treatment of metastatic renal cell carcinoma. We describe the case of a man who has been treated with pazopanib (Votrient) for metastatic renal cell carcinoma since July 2011. At the time of writing, the patient is still receiving treatment (29 months) and is showing a long-lasting response with a favorable safety profile. This is an excellent example of chronic neoplastic disease in a patient who can be defined as long-surviving.
The Roles of Family and Teacher Support in Moderating and Mediating Externalized and Internalized Outcomes of Exposure to Community Violence Among Arab and Jewish Adolescents in Israel
Authors: Haj-Yahia Muhammad M. , Leshem Becky , Guterman Neil B.
Published: February 2018

The study examined family and teacher support as factors that can protect adolescents from internalized and externalized problems after exposure to community violence (ECV). Self-administered questionnaires were filled out by a sample of 1,832 Arab and Jewish Israeli high school students. The Arab adolescents reported significantly higher levels of community violence victimization, internalized problems, externalized problems, family support, and teacher support than the Jewish adolescents. The girls reported higher levels of internalized problems, and the boys reported higher levels of externalized problems. ECV predicted high levels of internalized and externalized problems, family support predicted low levels of internalized and externalized problems, and teacher support had no predictive role. Path analysis confirmed the significance of the relationships between ECV effects, support variables, and gender. The limitations of the study and implications of the findings for future research and for the development of family care and family intervention programs are discussed.
Workplace Mental Health Training in Health Care: Key Ingredients of Implementation
Authors: Moll Sandra E. , VandenBussche Jessica , Brooks Katelyn , Kirsh Bonnie , Stuart Heather , Patten Scott , MacDermid Joy C.
Published: February 2018

Objectives:

Despite growing awareness of the importance of workplace mental health training and an increasing number of educational resources, there is a gap in knowledge regarding what shapes training effectiveness. The purpose of this study was to compare and describe the active ingredients of 2 workplace mental health education programs for health care workers.

Methods:

Within the context of a randomized clinical trial, a multimethod process evaluation was conducted to explore key process elements shaping implementation outcomes: the innovation, service recipients, service providers, and the organizational context. Data collection included descriptive statistics regarding program participation, postprogram interviews with a purposive sample of 18 service recipients, 182 responses to open-ended questions on postgroup and follow-up surveys, and field journal reflections on the process of implementation. Data analysis was informed by an interpretive description approach, using a process evaluation framework to categorize responses from all data sources, followed by within and cross-case comparison of data from both programs.

Results:

Five key forces shaped the implementation and perceived outcomes of both programs: a contact-based education approach, information tailored to the workplace context, varied stakeholder perspectives, sufficient time to integrate and apply learning, and organizational support. The Beyond Silence program provided more opportunity for contact-based education, health care–specific content, and in-depth discussion of diverse perspectives.

Conclusions:

To increase mental health literacy and reduce stigma, workplace training should be based on best practice principles of contact-based education, with contextually relevant examples and support from all levels of the organization.
Metabolic Correlates of Health-Related Quality of Life in Patients With Type 2 Diabetes Mellitus
Authors: Rani Monika , Kumar Raghuvansh , Krishan Pawan
Published: February 2018

Background:

The increasing prevalence of type 2 diabetes mellitus (T2DM) and associated metabolic complications lead to the development of a syndrome known as “metabolic syndrome” (MetS), which is considered as one of the major risk factor not only for the development of cardiovascular diseases but also have a great impact on the quality of life.

Research Design and Methods

A descriptive, observational study involving the recruitment of patients with T2DM with and without MetS was carried out in outpatient department of endocrinology. The MetS was defined as per the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criteria. Patients with T2DM were screened as per the American Diabetes Association (ADA; ie, fasting blood glucose [FBG] ≥ 126 mg/dL) and who were using oral antidiabetic drugs. Short Form-36 (SF-36) was used to assess the health-related quality of life (HRQoL).

Results:

Patients were grouped as T2DM with MetS (n = 100) and T2DM without MetS (n = 100). A greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with T2DM with MetS as compared to patients without MetS ( P ≤ .05). Multiple linear regression analysis revealed that in patients with T2DM having MetS, age and waist circumference (WC) are independent predictors for worsening of both PCS and MCS aspects of health-related quality of life (HRQOL). In addition, high triglycerides and raised FBG were found to be correlated with the decline in PCS and MCS, respectively.

Conclusion:

The study demonstrated that patients with T2DM with MetS have overall poor HRQOL as compared to patients with T2DM without MetS.
Kinematic and dynamic analysis of compliant mechanisms considering both lateral and axial deformations of flexural beams
Authors: Yu Yue-Qing , Zhou Peng , Xu Qi-Ping
Published: February 2018

The kinematic and dynamic analysis of compliant mechanisms is investigated comprehensively in this work. Based on the pseudo-rigid-body model, a new PR model is proposed to simulate both the lateral and axial deformations of flexural beams in compliant mechanisms. An optimization for the characteristic factors and a linear regression for the stiffness coefficients of PR pseudo-rigid-body model are presented. Compared with the 1R and 2R pseudo-rigid-body model, the advantage of the PR model is well illustrated. The dynamic modeling of flexible beams in compliant mechanisms is then developed based on the PR pseudo-rigid-body model. The dynamic equation of a PR pseudo-rigid-body dynamic model is derived and the dynamic responses are then presented. The kinematic and dynamic analysis of a compliant slider-crank mechanism is presented by the 1R, 2R and PR model, respectively. The effectiveness of pseudo-rigid-body models and the superiorities of the PR pseudo-rigid-body model and PR pseudo-rigid-body dynamic model are shown clearly in the numerical example.
Application and optimization of minimally invasive cell-free DNA techniques in oncogenomics
Authors: Kumar Manish , Choudhury Yashmin , Ghosh Sankar Kumar , Mondal Rosy
Published: February 2018

The conventional method of measuring biomarkers in malignant tissue samples has already given subversive growth in cancer diagnosis, prognosis, and therapy selection. However, the regression and heterogeneity associated with tumor tissue biopsy have urged for the development of an alternative approach. Considering the limitations, cell-free DNA has emerged as a surrogate alternative, facilitating preoperative chemoradiotherapy (p < 0.0001) treatment response in rectal cancer and detection of biomarker in lung cancer. This potential of cell-free DNA in several other cancers has yet to be explored based on clinical relevance by optimizing the preanalytical factors. This review has highlighted the crucial parameters from blood collection to cell-free DNA analysis that has a significant impact on the accuracy and reliability of clinical data. The quantity of cell-free DNA is also a limiting factor. Therefore, a proper preanalytical factor for blood collection, its stability, centrifugation speed, and plasma storage condition are to be optimized for developing cancer-specific biomarkers useful for clinical purpose. Liquid biopsy–based origin of cell-free DNA has revolutionized the area of cancer research. Lack of preanalytical and analytical procedures may be considered for identification of novel biomarkers through next-generation sequencing of tumor-originated cell-free DNA in contradiction to tissue biopsy for cancer-specific biomarkers.
Correlates of affective commitment in organizational performance: Multi-level perspectives
Authors: Amedzro ST-Hilaire Walter , de la Robertie Catherine
Published: February 2018

The aim of this study was to investigate the predictors of employees’ affective commitment to an organization. In doing this, we examined the influence of individual work experience and the social relationship it embraced. Three predictors were examined: internal-motivation to remain, job challenge, and workload. All three were significant and positive predictors of affective commitment. We also tested these relationships at different levels of leadership and harmonious co-worker relationships. Results here indicated higher organizational commitment when the supervisor climate was more pleasant. Theoretical and managerial implications are discussed.
Process description of a dialogue-focused intervention to improve career guidance policy in three schools
Authors: Draaisma Aniek , Meijers Frans , Kuijpers Marinka
Published: February 2018

To boost the existence of career-learning environments in Dutch vocational education, the innovation project ‘Career Orientation and Guidance (COG) in Secondary Vocational Education’ started in 2012. In this article, we describe the effects of this project on the level of policy formulation and implementation by means of three case studies. Data were collected at three schools through interviews, observations of meetings and teacher training, and analysis of policy documents. We conclude that a dialogue between managers and teachers, as well as among teachers is essential for changes in the learning environment of the students, since formulating a school-wide strategic policy requires communication between the different levels of the organisation, and clear tactical policy or operational plans require teacher teams and their team leaders to engage in substantive dialogues about the Career Orientation and Guidance innovation process. Instructional as well as transformational leadership stimulates a dialogical work environment for teachers and their managers, which is necessary for a dialogical career-learning environment for students.
“Globally adept citizens?”: Varying conceptions of generic graduate attributes by high school career advisers
Authors: Lewis Christopher , Wilson Rachel
Published: February 2018

Research on the conceptions of generic graduate attributes has focused on employers and higher education institutions and finds inconsistent conceptions and differing values attributed to them. Little work exists surrounding those charged with advising prospective students. Adopting phenomenographic methodology, this research establishes conceptions of generic graduate attributes held by Australian career advisers in NSW secondary schools: defining and describing two outcome spaces by which generic graduate attributes are understood. Advisers see generic graduate attributes as close to personal qualities, strongly related to employment, or important for self-development. Advisers value generic graduate attributes as “minimal” or “valid”. The hierarchical nature of the categories, and dichotomy of views on valuing generic graduate attributes, demonstrate varying conceptions, ranging from simplistic to an advanced understanding surpassing those found in the policies of employers and universities. The variation suggests those charged with advising future generations do not share a common understanding of generic graduate attributes and raises critical implications for research, policy, and practice.
Student-Directed Behavioral Community Interventions in Social Work Education
Authors: Bördlein Christoph
Published: February 2018

Behavioral social work is the application of behavior analysis to the field of social work. There are behavioral social work interventions for individuals, groups, and communities. Nevertheless, behavioral social work is far from a widely adopted approach among social work practitioners. A reason for the underuse might be seen in the fact that most interventions in behavioral social work aim at individual clients and groups. Social work could further benefit from the application of methods taken from behavioral community interventions. Behavioral community interventions modify the behavior of a larger group of people (e.g., pedestrians using a crosswalk, cafeteria patrons, students using a university building) with antecedent- and consequence-focused interventions. The article describes a training program for social work students in behavioral community interventions. Results of two projects, undergraduate students designed and performed, are presented. Behavioral community interventions are recommended as a valuable part of the education of social workers.
Public Discourses of Ebola Contagion and Courtesy Stigma: The Real Risk to International Health Care Workers Returning Home From the West Africa Ebola Outbreak?
Authors: Gee Stephanie , Skovdal Morten
Published: February 2018

This article explores the homecoming experiences of international health care workers who responded to the 2014 to 2016 West African Ebola outbreak. Interviews with 11 frontline international medical staff were undertaken and data thematically analyzed. It was found that international health care workers faced an unforeseen risk of stigmatization upon their return home, related to others’ fears of their infectious status. Media representations of the disease appear to have played a significant role in heightening societal perceptions of the risks associated with the returning health care workers, resulting in public hostility toward them. For participants, these social risks overtook concerns about biological risks during the immediate postmission period. The participants developed different strategies to cope with courtesy stigma, by rationalizing stigmatizing attitudes, educating people, or simply through an avoidance of others.
Mindful Self-Care and Secondary Traumatic Stress Mediate a Relationship Between Compassion Satisfaction and Burnout Risk Among Hospice Care Professionals
Authors: Hotchkiss Jason T.
Published: February 2018

Background:

Effective self-care in hospice is anecdotally proclaimed to reduce burnout risk. Yet, the topic has received little empirical attention.

Purpose:

This study developed a model for predicting burnout risk from compassion satisfaction (CS), secondary traumatic stress (STS), and mindful self-care.

Participants:

Hospice care professionals (n = 324).

Design:

Cross-sectional self-report survey.

Results:

Mindful self-care was correlated with CS ( r = 0.497, p < .01), Burnout ( r = −0.726, p < .01), and STS ( r = −0.276, p < .01). A multiple regression model indicated that the combined effect of CS, STS, and mindful self-care explained 73.7% of the variance in Burnout. Mindful self-care and STS mediated a relationship between CS and Burnout. Each self-care category was statistically significant protective factors against burnout risk ( p < .01). Associations with Burnout in order of strength were self-compassion and purpose (SC; r = −0.673), supportive structure (SS; r = −0.650), mindful self-awareness (MS; r = −0.642), mindful relaxation (MR; r = −0.531), supportive relationships (SR; r = −0.503), and physical care (PC; r = −0.435). However, for STS, only SS ( r = −0.407, p < .01) and MR ( r = −0.285, p < .05) were statistically significant protective factors.

Conclusion:

Hospice care professional had higher self-care, CS, lower STS, and Burnout compared to published norms. Those who engaged in multiple and frequent self-care strategies experienced higher professional quality of life. Implications for hospice providers and suggestions for future research are discussed.
Bullying Victimization Type and Feeling Unsafe in Middle School
Authors: Bowser John , Larson James D. , Bellmore Amy , Olson Chelsea , Resnik Felice
Published: February 2018

Given their significance to school violence, this study quantifies the association between bullying victimization and perceptions of safety separately for victimization where the type is not specified versus victimization that is physical in nature. Generalized liner mixed modeling was employed with 5,138 sixth- to eighth-grade students in 24 schools who self-reported on their bullying victimization and perceptions of school safety on an anonymous survey in fall 2015. Results indicate a multiplicative interaction exists with regard to the odds of feeling unsafe at school among those who were bullied at all (odds ratio [ OR] = 3.1) compared to those who were bullied physically ( OR = 9.12). For school nurses who work with students with a variety of concerns and health issues, this research indicates that the use of bullying victimization as an outcome, proxy and/or predictor, requires inquiry into the type of bullying experienced to aid in the care and support received.
Dolutegravir Plus Rilpivirine as a Switch Option in cART-Experienced Patients: 96-Week Data
Authors: Capetti Amedeo Ferdinando , Cossu Maria Vittoria , Sterrantino Gaetana , Barbarini Giorgio , Di Giambenedetto Simona , De Socio Giuseppe Vittorio , Orofino GianCarlo , Di Biagio Antonio , Celesia Benedetto M. , Rusconi Stefano , Argenteri Barbara , Rizzardini Giuliano
Published: February 2018

Background: Data from clinical studies confirm the efficacy of switching to dolutegravir (DTG) plus rilpivirine (RPV) in selected patients. Objective: The primary objective is to report the 96-week virological suppression in our cohort, assessing the durability of this strategy in complicated situations. The secondary objective is to describe the safety and metabolic profile. Methods: All patients who had switched to DTG plus RPV between October 1, 2014, and September 30, 2015, were analyzed using a retrospective-prospective design, approved by ethics committees. Routine metabolic, immunological, and virological data were regularly sent to the coordinating center. Viral control was classified as HIV-1 RNA ≥50 copies/mL, 1 to 49 copies/mL, or undetectable (no virus detected [NVD]). Results: We followed 145 patients for a median of 101 weeks. The median age was 52 years; 31.7% were women, and 9.6% non-Caucasian; 50.3% had failed at least 1 antiretroviral regimen; and 15% had ≥50 copies/mL at baseline. The reasons for switching were as follows: simplification (51.7%), toxicity (36.5%), drug-drug interactions (6.9%), persistent low-level viremia (3.0%), nonadherence (2.1%), and viral failure (1.4%). By week 96, seven patients dropped out. At week 96, none had ≥50 HIV-1 RNA copies/mL, 138 (95.2%) had <50 copies/mL, and 123 (84.8%) had NVD. The low- to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio decreased significantly ( P = 0.04). Of the 287 baseline altered laboratory parameters, 32.7% normalized by week 96. Serum glucose and total- and LDL-cholesterol normalization were statistically significant. Conclusions: Switching to DTG plus RPV improved viral suppression and LDL-C/HDL-C ratio.
Anger and Sadness: Gendered Emotional Responses to Climate Threats in Four Island Nations
Authors: du Bray Margaret , Wutich Amber , Larson Kelli L. , White Dave D. , Brewis Alexandra
Published: February 2018

Climate change presents an important threat to community livelihoods and well-being around the world. Biophysical vulnerability to the effects of climate change, such as sea level rise, coastal erosion, changing flora and fauna, and changing precipitation patterns are predicted to affect island nations in particular. Emotional geographies offers a theoretical entry point to understand how changing landscapes, which are often imbued with emotion and personal significance, may result in heightened emotional states and result in different outcomes depending on the severity of these changes and the biophysical vulnerability that produces them. Historically, emotion and gender have been closely linked; we use biophysical vulnerability to climate change, along with emotion and gender, to argue for a differentiated perspective on how men and women in different places may experience different emotional responses to climate change. Using a cross-cultural analysis of qualitative data from four island countries (Fiji, Cyprus, New Zealand, and the United Kingdom; total N = 272), this article explores how different sensitivities to climate change may produce differentiated emotional responses among men versus women across these four sites. Our results indicate that gender does affect the emotional response of respondents in these sites, but that local sensitivity plays an important role in differentiating these emotional responses, and their causes, between the four sites.
Experimental study of ballistic resistance of sandwich targets with aluminum face-sheet and graded foam core
Authors: Nia A Alavi , Kazemi M
Published: February 2018

In this research, we have investigated the ballistic resistance of sandwich structures with aluminum face-sheet and graded polyurethane foam core with different densities. The effects of graded changes of core foam density and the effect of the sequence of foam layers with different densities on energy absorption and ballistic limit of sandwich structures under the impact of hemispherical nose projectiles at high speeds (160 to 300 m/s) are studied. The results of this study showed that increasing the density and thickness of the foam core leads to increase in the ballistic limit and energy absorption; also, the ballistic limit of sandwich structures with the same mass with graded foam core for three- and five-layer panels is, respectively, 10.37 and 5.57% more than single-layer foam core with the average density in case the foam layer with less density is placed in the impact side. By using the graded foam core (laminate), the core resistance is increased and the damaged zone shape is changed, and the energy absorption of back face-sheet is increased.