bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Propionibacterium acnes and frozen shoulder: a pilot study
Authors: Bunker Tim D , Boyd Matthew , Gallacher Sian , Auckland Cressida R , Kitson Jeff , Smith Chris D
Published: May 2014

Background

Frozen shoulder has not previously been shown to be associated with infection. The present study set out to confirm the null hypothesis that there is no relationship between infection and frozen shoulder using two modern scientific methods, extended culture and polymerase chain reaction (PCR) for bacterial nucleic acids.

Methods

A prospective cohort of 10 patients undergoing arthroscopic release for stage II idiopathic frozen shoulder had two biopsies of tissue taken from the affected shoulder joint capsule at the time of surgery, along with control biopsies of subdermal fat. The biopsies and controls were examined with extended culture and PCR for microbial nucleic acid.

Results

Eight of the 10 patients had positive findings on extended culture in their shoulder capsule and, in six of these, Propionibacterium acnes was present.

Conclusions

The findings mean that we must reject the null hypothesis that there is no relationship between infection and frozen shoulder. More studies are urgently needed to confirm or refute these findings. If they are confirmed, this could potentially lead to new and effective treatments for this common, painful and disabling condition. Could P. acnes be the Helicobacter of frozen shoulder?
Responsiveness of outcome measures in patients with superior labral anterior and posterior lesions
Authors: Skare Øystein , Mowinckel Petter , Schrøder Cecilie Piene , Liavaag Sigurd , Reikerås Olav , Brox Jens Ivar
Published: May 2014

Background

Evaluation of patients with superior labral anterior and posterior (SLAP) lesions requires outcome measures validated for the purpose. The present study aimed to evaluate the responsiveness of the Rowe score, Oxford Instability Shoulder Score (OISS), Western Ontario Shoulder Instability Index (WOSI) and EuroQol (EQ-5D and EQ-VAS) in patients treated for SLAP lesions.

Methods

Eighty-nine patients were included: 34 had arthroscopic labral repair, 28 had mini-open biceps tenodesis and 27 had physical treatment. The outcome measures were administrated before treatment and after 6 months. Responsiveness was evaluated using standardized response mean (SRM), area under receiver-operating characteristic curve (ROCAUC), reliable chance proportion (RCP) statistics and hypothesis testing. Minimal clinically important change (MCIC) estimates were reported.

Results

All outcome measures had high values of SRM (0.86–1.92). RCPs for the improved group were 68% to 79% for OISS, WOSI and Rowe score, and 15% to 49% for EuroQol. ROCAUC was >0.70 for all outcomes. MCIC estimates were 8 and 10 for OISS; 451 and 569 for WOSI; 17 and 18 for Rowe score; 0.39 and 0.53 for EQ-5D; and 35 and 41 for EQ-VAS. Responsiveness tested with hypotheses favours the shoulder-specific outcomes.

Conclusions

OISS, WOSI and Rowe score are more responsive than EuroQol in evaluation of patients with SLAP lesions.
Strength and Functional Performance Recovery After Anterior Cruciate Ligament Reconstruction in Preadolescent Athletes
Authors: Greenberg Elliot M. , Greenberg Eric T. , Ganley Theodore J. , Lawrence J. Todd R.
Published: May 2014

Background:

In the skeletally immature population, the incidence of anterior cruciate ligament (ACL) injuries and ACL reconstructions appears to be increasing. Differences in surgical techniques, physiology, and emotional maturity may alter the rehabilitation progression and impact the outcomes when compared with adults. Reports of objective strength recovery and performance-based outcome measures after pediatric ACL reconstruction (ACLR) are limited.

Study Design:

Retrospective case series.

Level of Evidence:

Level 4.

Methods:

All patients that underwent all-epiphyseal ACLR from January 2008 to August 2010 were identified. Isokinetic peak quadriceps/hamstring torque values and functional performance measures in unilateral hopping tasks were extracted and compared with the noninjured limb. A limb symmetry index (LSI) of ≥90% was considered satisfactory.

Results:

Complete data were available for 16 patients (mean age, 12.28 years; range, 8.51-14.88 years). By a mean 7 months (range, 3.02-12.56 years) postoperatively, only 9 of 16 (56%) were able to achieve a satisfactory LSI for quadriceps strength. For hamstring strength, 15 of 16 (94%) were able to achieve satisfactory LSI. By a mean of 12 months (range, 5.39-24.39 months) postoperatively, only 6 of 16 subjects (38%) were able to achieve satisfactory performance on all functional hop tests. At a mean 15.42 months (range, 8.58-24.39 months) postsurgery, only 4 of 16 (25%) subjects were able to achieve an LSI of ≥90% on all testing parameters.

Conclusion:

For some pediatric patients, significant strength and functional deficits may be present at greater than 1 year after ACLR. This population may require more prolonged rehabilitation programs to allow for adequate recovery of strength and function because of unique characteristics of normal growth and development.
Variation in caecal intubation rates between screening and symptomatic patients
Authors: Nagrath Nalin , Phull Perminder S
Published: May 2014

Background

The caecal intubation rate (CIR) is an important quality standard for endoscopists, as well as for national bowel cancer screening programmes; however, individuals undergoing colonoscopy for bowel screening and symptomatic patients represent different groups, and their characteristics may affect colonoscopy performance.

Objective

To compare colonoscopists’ performance, as assessed by the CIR, in symptomatic patients compared to individuals undergoing colonoscopy for bowel cancer screening.

Methods

Retrospective audit of CIRs for all patients undergoing colonoscopy at our institution during the year 2008. We retrieved the data from an endoscopy reporting software database and from the local bowel cancer screening programme database. Demographic data was extracted, as well as details of known factors that may affect completion of colonoscopy, such as poor bowel preparation, presence of diverticular disease, polyps, tumour and strictures. The unadjusted CIRs for colonoscopists participating in the screening programme were compared between the bowel screening and the symptomatic patient groups.

Results

Five screening colonoscopists performed 1056 colonoscopies, of which 488 were bowel screening procedures. The overall CIR was significantly lower in the symptomatic, compared to the screening, individuals (88.5% versus 93%, P  < 0.02). No significant differences were observed between the two groups for risk factors that could impair the CIR. The CIR was <90% for two of the five colonoscopists in symptomatic patients, and just under 90% for one colonoscopist in screening individuals. Multivariate analysis revealed that non‐screening colonoscopy was an independent predictor for an incomplete procedure (OR 1.8; 95% CI 1.2–2.8).

Conclusions

The CIR, a key quality performance indicator for colonoscopy, is lower in symptomatic patients compared to individuals undergoing colorectal cancer screening. These results suggested that CIR should be monitored independently in screening and non‐screening colonoscopies.
Determining the Validity and Reliability of Elastographic Analytics Using Rotator Cuff Muscles
Authors: Volz Kevin R. , Dashottar Amitabh , Evans Kevin D.
Published: May 2014

The purpose of this study was to determine the feasibility and reliability of using elastography and subsequent image analysis to evaluate two rotator cuff muscles. Elastography imaging was conducted on the infraspinatus muscles of four cadavers. Next, elastography imaging was conducted on the supraspinatus muscles of 10 human subjects. Image analysis was conducted retrospectively to determine the relative computed strain value. Pearson correlations and two-tailed t tests for equal variance were used to demonstrate an interclass correlation (ICC) for two researchers performing image analysis. A significance value of P < .05 was set a priori. In the cadaver portion of the study, a Pearson correlation had an r = 0.99, and a two-tailed t test for equal variance showed P = .08. In the human portion of the study, a Pearson correlation had an r = 0.92, and a two-tailed t test for equal variance yielded a P < .05. When all elastography images from both portions of the experiment were combined, the analysis showed an r = 0.97 and a P < .05. This descriptive research study provides lower level scientific evidence that steady-state quasi-static elastography could provide valid and reliable information that will assist in the evaluation of the rotator cuff muscles of the shoulder.
The orally bioavailable MDM2 antagonist RG7112 and pegylated interferon α 2a target JAK2V617F-positive progenitor and stem cells
Authors: Lu Min , Xia Lijuan , Li Yan , Wang Xiaoli , Hoffman Ronald
Published: May 2014

Key Points

Combination treatment with RG7112 and Peg-IFNα 2a targets primitive JAK2V617F+ progenitor cells in myeloproliferative neoplasms.
Dissection of vertebrate hematopoiesis using zebrafish thrombopoietin
Authors: Svoboda Ondřej , Stachura David L. , Machoňová Olga , Pajer Petr , Brynda Jiří , Zon Leonard I. , Traver David , Bartůněk Petr
Published: May 2014

Key Points

Erythro-/thrombopoiesis is driven by the differentiation of bipotent thrombocytic-erythroid progenitors (TEPs) in vertebrates. Clonogenic and proliferative capacity of TEPs, thrombocytic and erythroid progenitors, is conserved from nonmammalian vertebrates to man.
Lapatinib Plus Paclitaxel Versus Paclitaxel Alone in the Second-Line Treatment of HER2-Amplified Advanced Gastric Cancer in Asian Populations: TyTAN—A Randomized, Phase III Study
Authors: Satoh Taroh , Xu Rui-Hua , Chung Hyun Cheol , Sun Guo-Ping , Doi Toshihiko , Xu Jian-Ming , Tsuji Akihito , Omuro Yasushi , Li Jin , Wang Jin-Wan , Miwa Hiroto , Qin Shu-Kui , Chung Ik-Joo , Yeh Kun-Huei , Feng Ji-Feng , Mukaiyama Akihira , Kobayashi Mikiro , Ohtsu Atsushi , Bang Yung-Jue
Published: May 2014

Purpose

In Asian countries, paclitaxel once per week is used as second-line treatment in advanced gastric cancer, including human epidermal growth factor receptor 2 (HER2) –positive tumors. The role of anti-HER2 agents, including lapatinib, in this setting and population is unclear.

Patients and Methods

TyTAN was a two-part, parallel-group, phase III study in Asian patients. An open-label, dose-optimization phase (n = 12) was followed by a randomized phase (n = 261), in which patients who were HER2 positive by fluorescence in situ hybridization (FISH) received lapatinib 1,500 mg once per day plus once-per-week paclitaxel 80 mg/m2 or paclitaxel alone. The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), time to progression (TTP), overall response rate (ORR), time to response, response duration, and safety. Analyses were based on immunohistochemistry (IHC) and gastrectomy status, prior trastuzumab therapy, and regional subpopulations.

Results

Median OS was 11.0 months with lapatinib plus paclitaxel versus 8.9 months with paclitaxel alone (P = .1044), with no significant difference in median PFS (5.4 v 4.4 months) or TTP (5.5 v 4.4 months). ORR was higher with lapatinib plus paclitaxel versus paclitaxel alone (odds ratio, 3.85; P < .001). Better efficacy with lapatinib plus paclitaxel was demonstrated in IHC3+ compared with IHC0/1+ and 2+ patients and in Chinese compared with Japanese patients. A similar proportion of patients experienced adverse events with each treatment (lapatinib plus paclitaxel, 100% v paclitaxel alone, 98%).

Conclusion

Lapatinib plus paclitaxel demonstrated activity in the second-line treatment of patients with HER2 FISH-positive IHC3+ advanced gastric cancer but did not significantly improve OS in the intent-to-treat population.
Non-visual numerical discrimination in a blind cavefish (Phreatichthys andruzzii)
Authors: Bisazza Angelo , Tagliapietra Christian , Bertolucci Cristiano , Foà Augusto , Agrillo Christian
Published: May 2014

Over a decade of comparative studies, researchers have found that rudimentary numerical abilities are widespread among vertebrates. While experiments in mammals and birds have employed a variety of stimuli (visual, auditory and tactile), all fish studies involved visual stimuli and it is unknown whether fish can process numbers in other sensory modalities. To fill this gap, we studied numerical abilities in Phreatichthys andruzzii, a blind cave-dwelling species that evolved in the phreatic layer of the Somalia desert. Fish were trained to receive a food reward to discriminate between two groups of objects placed in opposite positions of their home tank. In Experiment 1, subjects learned to discriminate between two and six objects, with stimuli not controlled for non-numerical continuous variables that co-vary with numbers, such as total area occupied by stimuli or density. In Experiment 2, the discrimination was two versus four, with half of the stimuli controlled for continuous quantities and half not controlled for continuous quantities. The subjects discriminated only the latter condition, indicating that they spontaneously used non-numerical information, as other vertebrates tested in similar experiments. In Experiments 3 and 4, cavefish trained from the beginning only with stimuli controlled for continuous quantities proved able to learn the discrimination of quantities based on the sole numerical information. However, their numerical acuity was lower than that reported in other teleost fish tested with visual stimuli.
Semiotics of “the fourth generation” – an unfinished project?
Authors: Panas Pawel
Published: May 2014

Review of W kręgu metody semiotycznej [In the Circle of the Semiotic Method], by Władysław Panas. Lublin: Towarzystwo Naukowe Katolickiego Uniwersytetu Lubelskiego, 1991.
Generalized Synthesis Algorithm of Fluorescent and Combined Methods related to Definitions of Indicators of Sea Waters Pollution by Oil and Oil Products
Authors: Ахмедов  , Akhmedov A. , Абдуллаева  , Abdullaeva S.
Published: May 2014

A generalized algorithm of complex determination of marine oil spills parameters based on three consecutive

measurements of allocated signs has been offered. Signs for independent measurements of oil spills parameters have

been defined based on carried-out scientific literature review. The offered complex algorithm’s experimental check

results have been reported.
State of medical service in Kamchatka as a contributor to the region’s medical tourism development
Authors: Улько Елена , Ulko Elena
Published: May 2014

The tourism and hospitality industry is immediately dependent on such factors as qualified personnel, service quality, material and technical foundation, and well-developed infrastructure. The initial stage of any tourist activity development should include a thorough analysis of the corresponding industry’s state. The author of the article provides an overview of Kamchatka, the state of medical care in the region, and analyses the results of the opinion poll conducted in order to collect data on the Kamchatka population’s evaluation of the medical service quality and suggestions on medical service improvement in Kamchatka.
Russian catering market development trends in the sphere of tourism and hospitality
Authors: Соколова Антонина , Sokolova Antonina , Лапшина Ольга , Lapshina Olga
Published: May 2014

The article deals with the organization of catering market in Russia. The authors identify the specific characteristics of catering service marketing strategies as applied to tourism and provide an analysis-based forecast for the Russian catering market capacity.
On research into the interdependence between service quality indices and a hotel’s business processes
Authors: Кузнецова Екатерина , Kuznetsova Ekaterina , Морозова Любовь , Morozova Lyubov , Трусевич Ирина , Trusevich Iryna
Published: May 2014

The article covers the major technical and human factors (indices) determining hotel guest satisfaction, and proposes a questionnaire model. An analysis of the models of service quality and guest satisfaction assessment, a number of service quality assessment models employed by international hotel networks, and the Cause and Effect diagram developed by Ishikawa lead the authors to relate guest-satisfaction-determining factors to the hotel’s individual business processes. The authors have developed a Guest Questionnaire designed to reveal a guest’s evaluation of the “significance” and “perceived quality” of service provision for each of the factors identified. The authors also rely on Noriaki Kano’s model, which is widely used in managerial decision-making on issues concerning business-process improvement, to develop a methodology for hotel service factor significance evaluation. The hotel service factors most affecting guest satisfaction are grouped by the authors into (1) quantitative, (2), compulsory, (3) surprise, (4) neutral, and (5) reverse. According to the authors, when making decisions on business-process improvement, managers should take into account the processes related to qualitative and compulsory hotel service factors.
Innovations for tourism and service enterprises
Authors: Коновалова Елена , Konovalova Elena , Силаева Анна , Silaeva Anna
Published: May 2014

The article serves to substantiate the expediency of innovation in tourism. The authors provide specific examples of innovations which benefitted the tourist industry, and suggest new approaches to management that tourism and service enterprises could implement. The authors also carry out an in-depth comprehensive analysis of the elements that ensure the tourist industry’s adaptability to the changes in the types of tourism and, hence, in marketing strategies, innovative services, products and processes.
MICROSTRUCTURE AND IN-VITRO TEST BIOACTIVITY BEHAVIOR OF Co-Cr-Mo (F-75)/HYDROXYAPATITE IN PHOSPHATE BUFFERED SALINE SOLUTION
Authors: Jamaludin Shamsul Baharin , Shima Adzali Nur Maizatul , Derman Mohd Nazree
Published: May 2014

Cobalt based alloys were the first metallic materials successfully used in orthopedic applications. However, these alloys are bio-inert, it is necessary to make them bioactive in the human body to improve their application as biomaterials. This research reported the microstructure and in-vitro bioactivity behavior of the novel Co-Cr-Mo alloy (ASTM F-75) filled with different amounts of hydroxyapatite (HAP). F-75 powder was mixed with 2, 6 and 10 wt. % of HAP before being cold compacted at 550 MPa using a uni-axial press machine. The composites then were sintered at 1100°C for 2 h. In-vitro bioactivity behavior of the composites was evaluated by immersing the composites into simulated body fluids for up to 18 days. Results showed that the nucleus of apatite, identified as the apatite layer formed on the surface of the prepared F-75/HAP composite after 18 days of immersion in the phosphate buffered solution (PBS). The Co-Cr-Mo alloy was successfully converted into a bioactive composite by adding 2, 6 and 10 wt. % of HAP particles. It was proposed that the formation of the apatite layer on the surface of F-75/HAP can contribute to the improved biocompatibility and osteoconductivity of F-75/HAP.
TOTAL MINERAL SOURCES EXTRACTING IN PERIOD 2008 – 2012 IN SLOVAKIA
Authors: Čičmanec Peter
Published: May 2014

In Slovakia we having actually 317 preserved mineral deposit areas, 561 exclusive deposits, of these is by 376 stated mining table spaces, and 167 are preserved as guarded deposit area. We have also 349 non reserved minerals deposits. One hundred extractive companies are extracting minerals in 202 deposits.Territory of Slovakia we having relatively good explored. Actually are exercised other exploration works. Ministry of Environment allocated more than 130 reconnaissance areas ore and non-ore mineral sources survey. Geological survey works results referring the mineral sources wealth of our country.
INVESTIGATIONS ON COATING OF DIES FOR ADVANCED SQUEEZE CASTING PROCESS
Authors: Peter Ildiko , Rosso Mario , Castella Christian
Published: May 2014

Premature failure of dies is a critical problem of manufacturers in hot-working processes, e.g. metal die casting, hot extrusion and/or thixoextrusion of aluminium/magnesium or steel. Typically, die material has to be resistant to heat cycling or corrosion environment, to plastic deformation and wear, especially when exposed to high temperature during continuous working cycle. The resistance of dies could be increased by the modification of their surfaces, i.e. by the application of an adequate coating. An improvement of the resistance of H11 steel substrate will be presented and discussed. Here, the coatings will be realized through both by High Velocity Oxy-Fuel coating spray method and by plasma spray method. Firstly, the measurement of the residual stress will be carried out on the un-coated and coated substrate. Secondly, morphological analysis by optical and scanning electron microscopy will be performed on the powders used for the coating and on the coated materials. Such investigations aim finding the most favourable conditions, as concern the materials to be employed for the deposition and the more appropriate deposition techniques, in order to achieve improved properties for the dies which can be used in innovative casting techniques, i.e. squeeze casting and/or some related modified processes.
AN UPPER BOUND SOLUTION OF BACKWARD TUBE EXTRUSION PROCESS THROUGH CURVED PUNCHES
Authors: Haghighat Heshmatollah , Asgari Gholam Reza
Published: May 2014

In this paper, an upper bound approach is used to analyze the process of backward tube extrusion through arbitrarily curved punches. Based on the assumptions of proportional angles and proportional distances from the mandrel surface in the deformation zone, two kinematically admissible velocity fields are proposed and those are used in upper bound solution. By using the developed upper bound solution, optimum punch lengths which minimize the extrusion forces are determined for a streamlined punch shape and also for a conical punch. The corresponding results are also determined by using a finite element code, ABAQUS, and by doing some experiments and compared with the analytical results. This comparisons show a good agreement.
ANTICORROSION PROPERTIES OF PEROVSKITES SURFACE-MODIFIED WITH CONDUCTING POLYMERS IN ALKYDE COATINGS
Authors: Hájková Tereza , Hejdová Martina , Kalendová Andrea
Published: May 2014

The effect of pigment particle surface treatment with polyaniline and polypyrrole on the corrosion inhibiting properties of organic paints was investigated. Mixed oxides possessing the spinel and perovskite structures were synthesised for the study. Coatings based on an alkyde resin were prepared for the investigation of the corrosion protection properties of the pigments, the surfaces of which had been provided with a polyaniline and polypyrrole layers. Laboratory corrosion tests were applied to the paint films. Polyaniline phosphate was found preferable to polypyrrole as the modifying agent of the pigment surface regarding the pigment’s corrosion inhibiting efficiency.
Eczema and dermatitis: a clinical update for medical aesthetic nurses
Authors: Onselen Julie Van
Published: May 2014

Aesthetic nurses have an important role to play with patients who present to their clinics with ‘sensitive skin’, eczema or irritant/contact dermatitis. As these patients will seek advice from aesthetic nurses on managing their eczema on a day-to-day basis, they will also need to have an awareness of how cosmetic treatments may affect eczema or contact dermatitis. In this article, the author aims to update aesthetic nurses’ knowledge on the several types of eczema and dermatitis, while introducing common treatment options such as emollients, topical corticosteroids and antibiotics.
Coping with changed appearance and body image following a burn injury
Authors: Armstrong-James Laura
Published: May 2014

Appearance in the aftermath of a burn injury can cause a great deal of distress, both physical and psychological, for survivors. In this article, Laura Armstrong-James explores individuals’ body image following a burn injury and their attitudes toward people's perceptions of their appearance, focusing particularly on young people who may be more likely to have lowered self-esteem
Managing clinic recruitment: sourcing the right skills for aesthetic practitioners
Authors: Deakin Barbara
Published: May 2014

Aesthetic practitioners are key to the success of your clinic and employing the right staff can attract new clients and ensure repeat business as a result of positive relationships and word of mouth. In this short series on recruiting for specific roles, Clinic Manager Barbara Deakin highlights the key criteria for any practice interested in sourcing new aesthetic practitioners
Harmony Health and Beauty Clinic, Stratford-upon-Avon: a warm atmosphere
Authors: Zadah Kate
Published: May 2014

When providing advice on running a successful clinic, nothing is better than experiencing the patient journey yourself, from the reception to the treatment room. In this practice management series, PR professional Kate Zadah travels the UK visiting clinics and reviewing their layouts, customer service, treatment menus and follow-up care. She will also highlight areas for improvement for each one
Rule-Based Category Learning in Down Syndrome
Authors: Phillips B. Allyson , Conners Frances A. , Merrill Edward , Klinger Mark R.
Published: May 2014

Rule-based category learning was examined in youths with Down syndrome (DS), youths with intellectual disability (ID), and typically developing (TD) youths. Two tasks measured category learning: the Modified Card Sort task (MCST) and the Concept Formation test of the Woodcock–Johnson-III (Woodock, McGrew, & Mather, 2001). In regression-based analyses, DS and ID groups performed below the level expected for their nonverbal ability. In cross-sectional developmental trajectory analyses, results depended on the task. On the MCST, the DS and ID groups were similar to the TD group. On the Concept Formation test, the DS group had slower cross-sectional change than the other 2 groups. Category learning may be an area of difficulty for those with ID, but task-related factors may affect trajectories for youths with DS.
Student goes on a journey; stranger rides into the classroom: Narratives and the instructor in the design studio
Authors: Boling Elizabeth , Siegel Martin A. , Smith Kennon M. , Parrish Patrick
Published: May 2014

Enthusiasm is growing in non-traditional environments for teaching design by adapting knowledge and approaches from studio pedagogy, described as a ‘signature pedagogy’ by Lee S. Shulman in 2005. Meanwhile, those in fields where some variation of studio pedagogy have been used for decades are engaged in addressing some of its experienced shortcomings. Within this landscape of change, the authors have been engaged in study of their own studio-based courses, (interior design, instructional design, and interaction/experience design), reflecting on how this form of pedagogy is contributing to students’ development as designers. In this study we consider the role of the instructor in the studio using a lens informed by narrative aesthetics and transformative education. The narrative that an instructor encourages students to experience with regard to themselves, to the instructor, or to both, has a profound impact in the studio environment. This article will explore that impact within the context of the authors’ own courses via review of course notes and collaborative reflection with colleagues.
Developing (architectural) design knowledge: A learner-researcher study
Authors: Golja Tanja , Schaverien Lynette
Published: May 2014

While design researchers use diverse approaches to study designing, non-designers face specific impediments in adopting these research approaches in their quest to gain design knowledge. Recognizing such challenges, this article outlines how an education academic engineered a first-person methodology to investigate the nature of designing. Through undertaking a learner-researcher study in an undergraduate architectural design basics subject, learning about design through learning to design, she tracked her developing design ideas and crystallized a view of architectural designing as a three-phase heuristic for value selection: imagining possibilities, interpreting ideas to form architectural principles and distilling quality. This article concludes by speculating on various research directions arising from this learner-researcher methodology and a view of designing as value selection and, in particular, provoking consideration of how similar developmental data might be collected and analysed for explanatory insights in diverse design and educational contexts.
An exploration of foundational design thinking across educational domains
Authors: Cusens Demelza , Byrd Hugh
Published: May 2014

To teach design effectively, foundational design thinking needs to be understood. Treating the design process as a mysterious mental talent provides little scope for teaching the subject. This study explores the origin of designs and how experience impacts the sophistication of design ideas across educational domains. Secondary and tertiary students were given a common architectural brief and students’ outcomes were compared and contrasted to seek commonalities or differences in their approaches to solving design problems. In addition, interviews were conducted with participants and a panel of design experts to further explore the students’ design practices. The results provide an insight into design cognition from multiple viewpoints. We suggest that designs come from various forms of copying; metaphors, analogies and icons are used as preconceptions by which a design problem is understood. Moreover, experience had a direct link to expertise, which is evident across educational domains.
Role of Hormones in Cancer Prevention
Authors: Vogel Victor G.
Published: May 2014

Risk for breast cancer can be easily and rapidly assessed using validated, quantitative models. Multiple randomized studies show that the selective estrogen response modifiers (SERMs) tamoxifen and raloxifene can safely reduce the risk of invasive breast cancer in both pre- and postmenopausal women. Treatment resulted in a 38% reduction in breast cancer incidence, and 42 women would need to be treated to prevent one breast cancer event in the first 10 years of follow-up. Reduction was larger in the first 5 years of follow-up than in years 5 to 10, but no studies treated patients for longer than 5 years. Thromboembolic events were significantly increased with all SERMs, whereas vertebral fractures were reduced. Tamoxifen provides net benefit to all premenopausal women who are at increased risk, whereas raloxifene reduces risk nearly as much in postmenopausal women and offers increased safety. Both tamoxifen and raloxifene reduce the incidence of in situ cancers. Lasofoxifene reduced the risk of breast cancer by 79% in postmenopausal women with osteoporosis. The MAP3 trial showed a 65% reduction in the annual incidence of invasive breast cancer in postmenopausal women who were at moderately increased risk for breast cancer who took the aromatase inhibitor exemestane. The IBIS-II trial showed a 53% reduction in the risk of invasive breast cancer in postmenopausal women aged 40 to 70 who took the aromatase inhibitor anastrozole. Of the 50 million white women in the United States aged 35 to 79, 2.4 million would have a positive benefit/risk index for chemoprevention.
Immunotherapy for Glioma: From Illusion to Realistic Prospects?
Authors: Dietrich Pierre-Yves , Dutoit Valérie , Walker Paul R.
Published: May 2014

There is now evidence that the rules established for tumor immunology and immunotherapy in general are relevant for brain tumors. Treatment strategies explored have mainly involved vaccines using either tumor cells or components, and vaccines with defined synthetic peptides. This latter approach offers the advantage to select well-characterized antigens with selective or preferential expression on glioma. This is a prerequisite because collateral damage to the brain is not allowed. A second strategy which is reaching clinical trials is T cell therapy using the patients' own lymphocytes engineered to become tumor reactive. Tumor specificity can be conferred by forced expression of either a high-avidity T cell receptor or an antitumor antibody (the latter cells are called chimeric antigen receptors). An advantage of T cell engineering is the possibility to modify the cells to augment cellular activation, in vivo persistence and resistance to the tumor immunosuppressive milieu. A direct targeting of the hostile glioma microenvironment will additionally be required for achieving potent immunotherapy and various trials are assessing this issue. Finally, combining immunotherapy with immune checkpoint inhibitors and chemotherapy must be explored within rigorous clinical trials that favor constant interactions between the bench and bedside. Regarding immunotherapy for glioma patients, what was an unrealistic dream a decade ago is today a credible prospect.
The Evolution of Our Molecular Understanding of Colorectal Cancer: What We Are Doing Now, What the Future Holds, and How Tumor Profiling Is Just the Beginning
Authors: Dienstmann Rodrigo , Salazar Ramon , Tabernero Josep
Published: May 2014

Colorectal cancer (CRC) has been extensively molecularly characterized in recent years. In addition to the understanding of biologic hallmarks of the disease, the ultimate goal of these studies was to provide tools that could allow us to differentiate subgroups of CRC with prognostic and predictive implications. So far, subtype classification has been largely driven by well-described features: (1) defective mismatch repair resulting in higher mutation rate; (2) cellular proliferation along with chromosomal instability and copy number aberrations; and (3) an invasive stromal phenotype mainly driven by TGF-β linked to epithelial-mesenchymal transition. Recent studies have outlined the complexity of CRC at the gene expression level, confirming how heterogeneous the disease is beyond currently validated parameters, namely KRAS, BRAF mutations and microsatellite instability. In fact, adopting an extended mutation profile upfront, which includes nonrecurrent KRAS, NRAS, and PIK3CA gene variants, likely improves outcomes. In this article, we review the current trends of translational research in CRC, summarize ongoing genomically driven clinical trials, and describe the challenges for defining a comprehensive, robust, and reproducible disease classification system that links molecular features to personalized medicine. We believe that identification of CRC subtypes based on integrative genomic analyses will provide a better guide for patient stratification and for rational design of drugs targeting specific pathways.
Reforming the Community Research Program: From Community Clinical Oncology Program to the National Cancer Institute Community Oncology Research Program
Authors: Zon Robin T.
Published: May 2014

Community research has been an integral and influential component of the National Research Program since the late 1970s. Institutionalization of community research in the Community Clinical Oncology Program (CCOP) has resulted in successful collaborations, meaningful accrual, achievement of quality standards, and translation of research into clinical practice. Although the national clinical trial system is undergoing modernization and improvement, the success of the CCOP and minority-based CCOP in cancer treatment, prevention, and control research is being extended to include cancer care delivery research in the newly created National Cancer Institute (NCI) Community Oncology Research Program. This article briefly presents a historic perspective of community involvement in federally sponsored clinical trials and introduces the continued involvement in the newly created NCI program.
The Role of Preclinical Models in Radiopharmaceutical Therapy
Authors: Sgouros George , Hobbs Robert F. , Abou Diane S.
Published: May 2014

Radiopharmaceutical therapy (RPT) is a treatment modality that involves the use of radioactively labeled targeting agents to deliver a cytotoxic dose of radiation to tumor while sparing normal tissue. The biologic function of the target and the biologic action of the targeting agent is largely irrelevant as long as the targeting agent delivers cytotoxic radiation to the tumor. Preclinical RPT studies use imaging and ex vivo evaluation of radioactivity concentration in target and normal tissues to obtain biodistribution and pharmacokinetic data that can be used to evaluate radiation absorbed doses. Since the efficacy and toxicity of RPT depend on radiation absorbed dose, this quantity can be used to translate results from preclinical studies to human studies. The absorbed dose can also be used to customize therapy to account for pharmacokinetic and other differences among patients so as to deliver a prespecified absorbed dose to the tumor or to dose-limiting tissue. The combination of RPT with other agents can be investigated and optimized by identifying the effect of other agents on tumor or normal tissue radiosensitivity and also on how other agents change the absorbed dose to these tissues. RPT is a distinct therapeutic modality whose mechanism of action is well understood. Measurements can be made in preclinical models to help guide clinical implementation of RPT and optimize combination therapy using RPT.
The Optimal Duration and Selection of Adjuvant Endocrine Therapy for Breast Cancer: How Long Is Enough?
Authors: Smith Ian E. , Yeo Belinda , Schiavon Gaia
Published: May 2014

Women with estrogen receptor (ER)+ early breast cancer (BC) are at continuing risk of relapse up to at least 15 years after diagnosis, despite being on adjuvant endocrine therapy for approximately 5 years. Extended adjuvant endocrine therapy with an aromatase inhibitor (AI) after 5 years of tamoxifen further reduces the risk of recurrence in postmenopausal women. More recently, continuing tamoxifen for 10 years has also been shown to further reduce the risk of recurrence compared with 5 years. There are no direct comparative data on the relative merits of extended tamoxifen compared with an AI; indirect evidence suggests that an AI may have increased efficacy but a greater adverse effect on quality of life. Results are awaited on the need for continuing front-line adjuvant AIs for more than 5 years. The next challenge is to determine which patients will benefit from this long-term treatment. Currently, tumor size, nodal involvement, and gene expression profile as measured by the PAM50 Risk of Recurrence (ROR) score have all been shown to have prognostic significance for late recurrence beyond 5 years.
Novel Formulations and New Mechanisms of Delivering Chemotherapy
Authors: Stinchcombe Thomas E.
Published: May 2014

The identification of epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangements and the development of targeted therapy for patients with these molecular alterations has been a tremendous advance in the treatment of advanced stage or metastatic non-small cell lung cancer (NSCLC). However, the majority of patients with advanced stage NSCLC will not have one of these molecular alterations and will receive chemotherapy as their primary therapy. Chemotherapy remains a critical component of therapy for resected and locally advanced NSCLC, as well as for patients with limited-stage and extensive stage small cell lung cancer (SCLC). A significant unmet need exists to develop novel chemotherapy agents and to improve the efficacy and toxicity of currently available agents. Several novel formulations of currently available chemotherapy agents are in development for NSCLC and SCLC. Antibody conjugates are therapeutic agents that employ a tumor-specific monoclonal antibody conjugated to a cytotoxic or radionuclide agent. After the monoclonal antibody binds to the tumor antigen, these agents are internalized, and the link between the antibody and the therapeutic agent is dissolved and the cytotoxic agent is release intracellularly. This enhanced delivery of chemotherapy to malignant tissues has the potential to improve efficacy and reduce toxicity. Antibody conjugates to therapeutic agents are currently available for other malignancies and are in development for NSCLC and SCLC.
Predisposition to Pediatric and Hematologic Cancers: A Moving Target
Authors: Malkin David , Nichols Kim E. , Zelley Kristin , Schiffman Joshua D.
Published: May 2014

Our understanding of hereditary cancer syndromes in children, adolescents, and young adults continues to grow. In addition, we now recognize the wide variation in tumor spectrum found within each specific cancer predisposition syndrome including the risk for hematologic malignancies. An increased understanding of the genetic mutations, biologic consequences, tumor risk, and clinical management of these syndromes will improve patient outcome. In this article, we illustrate the diversity of molecular mechanisms by which these disorders develop in both children and adults with a focus on Li-Fraumeni syndrome, hereditary paraganglioma syndrome, DICER1 syndrome, and multiple endocrine neoplasia syndrome. This is followed by a detailed discussion of adult-onset tumors that can occur in the pediatric population including basal cell carcinoma, colorectal cancer, medullary thyroid cancer, and adrenal cortical carcinoma, and the underlying hereditary cancer syndromes that these tumors could indicate. Finally, the topic of leukemia predisposition syndromes is explored with a specific focus on the different categories of syndromes associated with leukemia risk (genetic instability/DNA repair syndromes, cell cycle/differentiation, bone marrow failure syndromes, telomere maintenance, immunodeficiency syndromes, and transcription factors/pure familial leukemia syndromes). Throughout this article, special attention is made to clinical recognition of these syndromes, genetic testing, and management with early tumor surveillance and screening.
Compassion, Compassion Fatigue, and Burnout: Key Insights for Oncology Professionals
Authors: Back Anthony L. , Deignan Paul F. , Potter Patricia A.
Published: May 2014

When cancer care clinicians become stressed, sad, isolated—and unaware of this—they are placing themselves at risk for burnout and their patients at risk for suboptimal care. Despite their best intentions, clinicians can sink from a healthy work state of compassion, empathy, and well-being into compassion fatigue and burnout. Lessons from first responders demonstrate the importance for clinicians to recognize the warning signs of compassion and fatigue and burnout, as this recognition can enable them to take action towards prevention and/or recovery. The recognition of these issues as a threat to clinician performance has outstripped the development of evidence-based interventions, but interventions tested to date are effective, feasible, and scalable. These interventions could be incorporated systematically into cancer care.
Nutritional Supplements and Cancer: Potential Benefits and Proven Harms
Authors: Harvie Michelle
Published: May 2014

Nutritional supplements are widely used among patients with cancer who perceive them to be anticancer and antitoxicity agents. Large-scale, randomized cancer prevention trials have mainly been negative, with some notable adverse and beneficial effects. For example, these trials showed that beta-carotene increases the risk of lung and stomach cancer, vitamin E increases prostate cancer and colorectal adenoma, and selenium reduces gastric and lung cancer in populations with low selenium levels but increase rates in those with higher levels. Both beta-carotene and vitamin E supplementation increase overall mortality. This article reviews phase II and III trials that examine the effects of multivitamins, antioxidants, vitamin D, and n-3 supplements on outcome and toxicity from cancer treatments. Although vitamin E and beta-carotene reduce toxicity from radiotherapy among patients with head and neck cancer, it has been found to increase recurrence, especially among smokers. Antioxidants have mixed effects on chemotherapy toxicity, but there are no data on outcome. Vitamin D deficiency is relatively common among patients with cancer, and ongoing phase III trials are studying the effect of vitamin D on outcome as well as optimum vitamin D and calcium intakes for bone health. Docosahexanoic and eicosopentanoic acid supplements have mixed effects on cachexia and are currently being tested as potential adjuncts to maximize response to chemotherapy. Nutritional supplementation tailored to an individual's background diet, genetics, tumor histology, and treatments may yield benefits in subsets of patients. Clinicians should have an open dialogue with patients about nutritional supplements. Supplement advice needs to be individualized and come from a credible source, and it is best communicated by the physician.
The Rising Incidence of Second Cancers: Patterns of Occurrence and Identification of Risk Factors for Children and Adults
Authors: Morton Lindsay M. , Onel Kenan , Curtis Rochelle E. , Hungate Eric A. , Armstrong Gregory T.
Published: May 2014

As the population of cancer survivors has increased and continues to age, the occurrence of second cancers has risen dramatically—from 9% of all cancer diagnoses in 1975–1979 to 19% in 2005–2009. The Childhood Cancer Survivor Study, a cohort of more than 14,000 childhood cancer survivors with detailed exposure data and long-term follow-up, has substantially contributed to our understanding of the roles of radiotherapy and chemotherapy in second cancer occurrence. In particular, dose-related risks have been demonstrated for second cancers of the breast, thyroid, central nervous system, gastrointestinal tract, and sarcomas following radiation. Cytotoxic chemotherapy—which has long been known to be leukemogenic—also appears to contribute to risk for a range of other second cancer types. Individuals who develop a second cancer are at particularly high risk for developing additional second cancers. A genome-wide association study of survivors of Hodgkin lymphoma who received radiotherapy identified a locus on chromosome 6q21 as being associated with second cancer risk, demonstrating that recent advances in genomics are likely to prove invaluable for elucidating the contribution of genetic susceptibility to second cancer etiology. Among adults, risk of second cancers varies substantially by type of first and second cancer, patient age, and prevalence of second cancer risk factors, including primary cancer treatments, environmental and lifestyle exposures, and genetic susceptibility. Further research is needed to quantify second cancer risks associated with specific etiologic factors and to identify the patients at highest risk of developing a second cancer to target prevention and screening efforts.