bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescribing heroin for addiction: Some untapped potentials and unanswered questions
Authors: Wakeman Stephen
Published: March 2015

The prescription of heroin to dependent users has been a distinctive feature of British drug policy for almost a century now, and in recent years the policy’s evidence-base has grown significantly. However, while the evidence for heroin assisted treatment’s effectiveness is strong it is somewhat limited by the clinical setting of the randomized control trial and thus leaves a number of important areas unexplored. This article investigates some of these through a sociological lens informed by both developments in regulatory theory and ethnographic research with a heroin-using population in north-west England. It is argued that heroin prescription has currently ‘untapped potential’ as a means of regulating heroin markets, but also that it presents a number of ‘unanswered questions’ regarding heroin’s socio-economic roles in marginalized communities and the importance of heroin-using identities.
Still fighting in the trenches: ‘War discourse’ and the memory of the First World War in Britain
Authors: Wilson Ross J
Published: March 2015

This article examines how the memory of the First World War (1914–1918) across Britain has been structured by the use of a specific ‘war discourse’. This means of communication draws upon the vast array of words, phrases and sayings that were popularised through the experience of large numbers of civilians in military service during the conflict. This lexicon has been subsequently incorporated into wider usage and retains a prominent place within cultural expression. However, rather than merely being used as an illustrative device, the ‘war discourse’ is employed to make specific references regarding both the past and the present within the political, media and public sphere, as issues of blame, responsibility and neglect are integral parts of its usage. Through the application of critical discourse analysis, the ‘war discourse’ can be observed as a significant means by which society remembers the Great War.
From historical perspectives to modern therapy: a review of current and future biological treatments for Crohn’s disease
Authors: Randall Charles W. , Vizuete John A. , Martinez Nicholas , Alvarez John J. , Garapati Karthik V. , Malakouti Mazyar , Taboada Carlo M.
Published: March 2015

Crohn’s disease (CD) is a debilitating, systemic inflammatory disorder with both gastrointestinal and extraintestinal manifestations. Its existence predates modern medicine, but its precise etiology remains incompletely understood. Most authorities suggest a multifactorial pathogenesis owing to a mixture of genetic disorders, immunologic dysregulation, microbiota disequilibrium and environmental influences. Of these factors, the overactive immunologic response seen in CD appears to be the most promising target of medical therapy. Biological agents comprise a relatively new class of drugs that can induce and maintain remission in moderate to severe CD, as well as in ulcerative colitis. This review will provide an overview of CD, its history, clinical features, pathophysiology, and treatment options focusing on current and future biological agents with an emphasis on drug development, dosage and administration.
Cannulation of the biliary tree under endoscopic control with an echoendoscope, without fluoroscopy: report of a case series
Authors: Arcidiacono Paolo Giorgio , Mangiavillano Benedetto , Carrara Silvia , Petrone Maria Chiara , Santoro Tara , Testoni Pier Alberto
Published: March 2015

Introduction:

Endoscopic ultrasonography (EUS) is a validated technique allowing precise diagnosis and staging of pancreatic, biliary and ampullary disease. Developments in instruments and accessories have led to a more extensive use of this technology to perform operations. The use of EUS as an operative technique, alone or in conjunction with other endoscopic procedures, has already been described in the literature in several reports. However, despite the use of EUS, fluoroscopy has always been required to perform these operations. There are no data in the literature describing the feasibility, safety and efficacy of operative EUS in the treatment of common bile duct (CBD) obstruction, following a malignant or benign disease, performed completely under EUS guidance without fluoroscopic assistance.

Methods:

In this series we describe three cases of EUS treatment of CBD diseases performed without fluoroscopic assistance.

Results:

All the cases were treated by EUS without fluoroscopic assistance and no complications were encountered.

Conclusion:

Operative EUS without fluoroscopy appears to be a feasible technique. Its major advantages could be to shorten the examination time and to enable biliary or pancreatic operative endoscopy in patients in whom fluoroscopy could be dangerous, such as pregnant women. The endoscopist should have a good training both in EUS and endoscopic retrograde cholangiopancreatography. Prospective, larger studies are needed to confirm our preliminary data.
Evidence on the deleterious impact of sustained use of polynomial regression on causal inference
Authors: Gelman Andrew , Zelizer Adam
Published: March 2015

It is common in regression discontinuity analysis to control for third- or fifth-degree polynomials of the assignment variable. Such models can overfit, leading to causal inferences that are substantively implausible and that arbitrarily attribute variation to the high-degree polynomial or the discontinuity. This paper examines two recent studies that make use of regression discontinuity to discuss evident practical problems with these estimates and how they interact with pathologies of the current system of scientific publication. First, we discuss a recent study that estimates the effect on air pollution and life expectancy of a coal-heating policy in China. The reported effects, based on a third-degree polynomial, are statistically significant but substantively dubious, and are sensitive to model choice. This study is indicative of a category of policy analyses where strong claims are based on weak data and methodologies which permit the researcher wide latitude in presenting estimated treatment effects. We then replicate a procedure from Green et al., in which regression discontinuity is used to recover estimated treatment effects relative to an experimental benchmark, to illustrate one practical problem with the regression discontinuity estimates in the coal-heating paper: high-degree polynomials yield noisy estimates of treatment effects that do not accurately convey uncertainty. We recommend that (a) researchers consider the problems which may result from controlling for higher-order polynomials; and (b) that journals recognize that quantitative analyses of policy issues are often inconclusive and relax the implicit rule under which statistical significance is a condition for publication.
Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams
Authors: Franklin Catherine M. , Bernhardt Jean M. , Lopez Ruth Palan , Long-Middleton Ellen R. , Davis Sheila
Published: March 2015

Objectives:

Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams.

Methods:

A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy.

Results:

Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork.

Conclusions:

Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.
Visceral fat obesity is highly associated with primary gout in a metabolically obese but normal weighted population: a case control study
Authors: Lee Jennifer , Lee Ji-Yeon , Lee Jae-Ho , Jung Seung-Min , Suh Young Sun , Koh Jung-Hee , Kwok Seung-Ki , Ju Ji Hyeon , Park Kyung-Su , Park Sung-Hwan
Published: March 2015

Introduction

Gout is a chronic inflammatory disease the development of which is associated with obesity-induced metabolic abnormalities. However, a substantial number of non-obese patients (body mass index [BMI] <25 kg/m2) also develop gout in Korea. It was suggested that accumulation of visceral fat rather than subcutaneous fat is associated with metabolic abnormalities and hyperuricemia in patients with gout; therefore, we hypothesized that visceral fat accumulation was increased in non-obese gout patients.

Methods

One hundred and three male patients with primary gout and 204 age-matched healthy controls who attended a health check-up examination were recruited after the review of medical charts. The visceral fat area (VFA) was measured using the bioelectrical impedance analysis (BIA) method, and a VFA >100 cm2 was defined as visceral fat obesity (VFO). The frequency of VFO was compared in patients and control groups. The frequencies of metabolic syndrome and related parameters were also investigated.

Results

BMI, waist circumference, total fat mass, serum triglycerides, and serum glucose levels were significantly greater in patients compared with controls. VFA and the prevalence of VFO was increased in gout patients compared with controls. There were positive correlations between VFA and serum triglyceride levels and serum glucose levels. Multivariate regression analysis revealed that VFO is an independent risk factor for gout (odds ratio 2.488, 95% confidence interval 1.041–4.435). In non-obese subgroup analyses (gout patients, n = 38; healthy controls, n = 150), VFA (98.7 ± 19.3 vs. 91.0 ± 16.7, P = 0.016) and the frequency of VFO (47.4 vs. 27.3%, P = 0.017) remained significantly higher in gout patients. There was no difference in either BMI or total fat mass between patients and controls in the non-obese subgroup. The prevalence of metabolic syndrome in patients with gout was 31.7% (33/104), compared with 13.2% (5/38) in the non-obese subgroup according to modified ATP III criteria.

Conclusion

VFO, measured using BIA, is observed more frequently in patients with primary gout compared with healthy controls, even in non-obese individuals. Therefore, VFO might more properly represent metabolic derangements in patients with gout than general obesity.
Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research
Authors: Ritchie Craig W , Terrera Graciela Muniz , Quinn Terence J
Published: March 2015

Dementia is a substantial and increasing public health concern. Despite decades of research, a cure or effective preventative treatment for dementia remains elusive. We offer critical review of contemporary dementia research and discuss potential reasons why progress in the field has not been as rapid as in other disciplines. We adopt a broad approach in keeping with the broad nature of the topic. We cover the difficulties inherent in studying dementia from 'bench' to 'bedside' to 'population'. We make particular reference to issues of operationalisation of the dementia syndrome and our evolving understanding of dementia as a research 'outcome'. We discuss contemporary 'hot topics' in dementia research methodology focussing on dementia models, pre-dementia states and biomarkers. Recognising the importance of prospective epidemiological cohorts and large-scale clinical trials we pay particular attention to these approaches and the challenges of generating results that have 'real world' external validity. Based on our thoughts we end with suggestions for future dementia research. Our review is designed to be critical but not unnecessarily negative. There is reason for cautious optimism in dementia research. The recent G8 summit on dementia and subsequent establishment of the World Dementia Council are examples of initiatives that reflect societal and political will to increase research efforts in dementia.
Untested, unproven, and unethical: the promotion and provision of autologous stem cell therapies in Australia
Authors: McLean Alison K , Stewart Cameron , Kerridge Ian
Published: March 2015

An increasing number of private clinics in Australia are marketing and providing autologous stem cell therapies to patients. Although advocates point to the importance of medical innovation and the primacy of patient choice, these arguments are unconvincing. First, it is a stark truth that these clinics are flourishing while the efficacy and safety of autologous stem cell therapies, outside of established indications for hematopioetic stem cell transplantation, are yet to be shown. Second, few of these therapies are offered within clinical trials. Third, patients with chronic and debilitating illnesses, who are often the ones who take up these therapies, incur significant financial burdens in the expectation of benefiting from these treatments. Finally, the provision of these stem cell therapies does not follow the established pathways for legitimate medical advancement. We argue that greater regulatory oversight and professional action are necessary to protect vulnerable patients and that at this time the provision of unproven stem cell therapies outside of clinical trials is unethical.
Numerical model of fiber wetting with finite resin volume
Authors: Yeager Michael , Advani Suresh G
Published: March 2015

The partial wetting of cylindrical surfaces is encountered in many industrial applications such as composites manufacturing, MEMS, hair care products, and textile engineering. Understanding the impact of key parameters such as resin and fiber surface interaction properties and the geometric arrangement of the fibers on wetting would lead to tailoring a desired interface between the resin and the fiber surface. A three-dimensional model of resin wetting a single fiber is presented. This model is then extended to study a finite volume of resin wetting fibers in square and triangular packing arrangements. The impact of changing wetting properties and fiber volume fraction is examined for each packing arrangement.
Optimized procedure for the determination of P species in soil by liquid-state 31P-NMR spectroscopy
Authors: Li Meng , Mazzei Pierluigi , Cozzolino Vincenza , Monda Hiarhi , Hu Zhengyi , Piccolo Alessandro
Published: March 2015

Background

Liquid-state 31P-NMR spectroscopy becomes progressively an important role for studying phosphorus (P) dynamics in soil. Soils of different origin and organic matter content were used to optimize sample preparation and re-dissolution procedures to improve characterization of P species in soil by 31P-NMR spectroscopy. The efficiency of P extraction from an untreated fresh soil was compared to that from freeze-dried and air-dried soil samples.

Results

A freeze-drying pretreatment not only provided the greatest extraction yields of total and organic P from both farmland and forest soils but also enhanced the intensity of signals for inorganic and organic P species in 31P-NMR spectra, except for polyphosphates. Re-dissolution of freeze-dried soil extracts in relatively dilute alkaline solution and addition of a small aliquot of concentrated HCl to the NMR tube prior to analysis improved the quality of NMR spectra. Finally, the visibility of relatively weak P signals, such as for phosphorus diesters, phosphonates, polyphosphate, phospholipids, and DNA were reproducibly enhanced when 31P-NMR spectra were generated after at least 15 h of acquisition time.

Conclusion

The optimized procedure presented here ensured the greatest detectability of inorganic and organic P species by liquid-state P-NMR spectroscopy in soil extracts.
Increased monocyte turnover is associated with interstitial macrophage accumulation and pulmonary tissue damage in SIV-infected rhesus macaques
Authors: Cai Yanhui , Sugimoto Chie , Liu David Xianhong , Midkiff Cecily C , Alvarez Xavier , Lackner Andrew A , Kim Woong-Ki , Didier Elizabeth S , Kuroda Marcelo J
Published: March 2015

We recently reported that increasing blood monocyte turnover that was associated with tissue macrophage death better predicts terminal disease progression in adult SIV-infected macaques than does declining CD4+ T cell levels. To understand better mechanisms of pathogenesis, this study relates severity of lung-tissue damage to the ratio, distribution, and inflammatory responses of lung macrophage subsets during SIV infection in rhesus macaques exhibiting varying rates of monocyte turnover. In vivo BrdU incorporation was used to evaluate kinetics of monocyte/tissue macrophage turnover. Tissue damage was scored microscopically from H&E-stained lung-tissue sections, and cytokine expression was examined via immunohistochemistry and confocal microscopy. Increased monocyte turnover in SIV-infected rhesus macaques significantly correlated with severity of lung-tissue damage, as exhibited by perivasculitis, vasculitis, interstitial pneumonia, alveolar histiocytosis, foamy macrophages, multinucleated giant cells, fibrin, and edema in the alveoli. In addition, the higher monocyte turnover correlated with declining AI ratio, increased accumulation of IM in the perivascular region of the lung, and higher expression of IL-6 in the IM of the lung tissue exposed to a LPS, calcium ionophore, and tumor promoter combination stimulation ex vivo. Accumulation of IM associated with increasing monocyte turnover during SIV infection appears to contribute to chronic pulmonary inflammation and tissue damage during disease progression to AIDS.
Modeling attenuation and dispersion in porous heterogeneous rocks with dynamic fluid modulus
Authors: Yao Qiuliang , Han De-hua , Yan Fuyong , Zhao Luanxiao
Published: March 2015

Based on poroelasticity analysis, we developed a new concept of frequency-dependent dynamic fluid modulus (DFM) to understand the velocity dispersion and wave attenuation due to wave-induced fluid flow. Conventional applications of Gassmann’s equation require a complete homogeneity inside the porous media (or equivalently, at zero frequency) and closed boundary condition. We first analyzed the fluid effect on the bulk modulus in homogeneous porous media with a nonclosed condition. The partial drainage of pore fluid causes additional pore volume change under applied stress. An incoming fluid flow stiffens the porous system, and an outgoing flow softens it. Such a phenomenon can still be effectively formulated as a closed system with Gassmann’s equation, by introducing a DFM, which adds a flow term into the original fluid modulus. We further proved that in heterogeneous porous media, the wave-induced internal fluid flow caused additional bulk volume deformation. It equals the amount of the fluid flow from a soft phase to a stiff phase times the difference of Skempton coefficients between the two phases. Again, with a frequency-dependent complex number DFM, the use of Gassmann’s equation can be extended into heterogeneous porous media at nonzero frequencies to fully characterize its viscoelastic behavior on rock’s bulk modulus. We evaluated three examples to show how to model the P-wave attenuation and velocity dispersion in porous media due to microscopic and mesoscopic scale heterogeneities, as well as in the presence of multiple sets of heterogeneities. Finally, we demonstrated that the DFM can be conveniently and deterministically inverted from the measured lab data. The inverted results can be used to identify the possible mechanisms behind the observed wave attenuation and velocity dispersion, and they were good indicators of the degree and distribution of heterogeneities inside the rocks.
Lapatinib or Trastuzumab Plus Taxane Therapy for Human Epidermal Growth Factor Receptor 2–Positive Advanced Breast Cancer: Final Results of NCIC CTG MA.31
Authors: Gelmon Karen A. , Boyle Frances M. , Kaufman Bella , Huntsman David G. , Manikhas Alexey , Di Leo Angelo , Martin Miguel , Schwartzberg Lee S. , Lemieux Julie , Aparicio Samuel , Shepherd Lois E. , Dent Susan , Ellard Susan L. , Tonkin Katia , Pritchard Kathleen I. , Whelan Timothy J. , Nomikos Dora , Nusch Arnd , Coleman Robert E. , Mukai Hirofumi , Tjulandin Sergei , Khasanov Rustem , Rizel Shulamith , Connor Anne P. , Santillana Sergio L. , Chapman Judith-Anne W. , Parulekar Wendy R.
Published: March 2015

Purpose

The efficacy of lapatinib versus trastuzumab combined with taxanes in the first-line setting of human epidermal growth factor receptor 2 (HER2) –positive metastatic breast cancer (BC) is unknown.

Patients and Methods

The MA.31 trial compared a combination of first-line anti-HER2 therapy (lapatinib or trastuzumab) and taxane therapy for 24 weeks, followed by the same anti-HER2 monotherapy until progression. Stratification was by prior (neo)adjuvant anti-HER2 therapy, prior (neo)adjuvant taxane, planned taxane, and liver metastases. The primary end point was intention-to-treat (ITT) progression-free survival (PFS), defined as time from random assignment to progression by RECIST (version 1.0) criteria, or death for patients with locally assessed HER2-positive tumors. The primary test statistic was a stratified log-rank test for noninferiority. PFS was also assessed for patients with centrally confirmed HER2-positive tumors.

Results

From July 17, 2008, to December 1, 2011, 652 patients were accrued from 21 countries, resulting in 537 patients with centrally confirmed HER2-positive tumors. Median follow-up was 21.5 months. Median ITT PFS was 9.0 months with lapatinib and 11.3 months with trastuzumab. By ITT analysis, PFS was inferior for lapatinib compared with trastuzumab, with a stratified hazard ratio (HR) of 1.37 (95% CI, 1.13 to 1.65; P = .001). In patients with centrally confirmed HER2-positive tumors, median PFS was 9.1 months with lapatinib and 13.6 months with trastuzumab (HR, 1.48; 95% CI, 1.20 to 1.83; P < .001). More grade 3 or 4 diarrhea and rash were observed with lapatinib (P < .001). PFS results were supported by the secondary end point of overall survival, with an ITT HR of 1.28 (95% CI, 0.95 to 1.72; P = .11); in patients with centrally confirmed HER2-positive tumors, the HR was 1.47 (95% CI, 1.03 to 2.09; P = .03).

Conclusion

As first-line therapy for HER2-positive metastatic BC, lapatinib combined with taxane was associated with shorter PFS and more toxicity compared with trastuzumab combined with taxane.
Antibody Positron Emission Tomography Imaging in Anticancer Drug Development
Authors: Lamberts Laetitia E. , Williams Simon P. , Terwisscha van Scheltinga Anton G.T. , Lub-de Hooge Marjolijn N. , Schröder Carolien P. , Gietema Jourik A. , Brouwers Adrienne H. , de Vries Elisabeth G.E.
Published: March 2015

More than 50 monoclonal antibodies (mAbs), including several antibody–drug conjugates, are in advanced clinical development, forming an important part of the many molecularly targeted anticancer therapeutics currently in development. Drug development is a relatively slow and expensive process, limiting the number of drugs that can be brought into late-stage trials. Development decisions could benefit from quantitative biomarkers, enabling visualization of the tissue distribution of (potentially modified) therapeutic mAbs to confirm effective whole-body target expression, engagement, and modulation and to evaluate heterogeneity across lesions and patients. Such biomarkers may be realized with positron emission tomography imaging of radioactively labeled antibodies, a process called immunoPET. This approach could potentially increase the power and value of early trials by improving patient selection, optimizing dose and schedule, and rationalizing observed drug responses. In this review, we summarize the available literature and the status of clinical trials regarding the potential of immunoPET during early anticancer drug development.
Emergency Room Visits and Hospital Admission Rates After Curative Chemotherapy for Breast Cancer
Authors: Pittman Natalia M. , Hopman Wilma M. , Mates Mihaela
Published: March 2015

The authors conclude that over half of all patients receiving curative chemotherapy for breast cancer visited the emergency room at least once, and 13% required hospital admissions.
Estimating Demand and Unmet Need for Allogeneic Hematopoietic Cell Transplantation in the United States Using Geographic Information Systems
Authors: Besse Kelsey L. , Preussler Jaime M. , Murphy Elizabeth A. , Denzen Ellen M. , Lill Michael C. , Chell Jeffrey W. , Senneka Mary K. , Majhail Navneet S. , Williams Eric P.
Published: March 2015

Market area maps and statistics developed using geographic information systems will help communicate the unmet need for HCTs, inform policy, and assist transplantation centers in planning for the anticipated growth in HCT use.
Impact of Observation Status on Hospital Use for Patients With Cancer
Authors: Lipitz-Snyderman Allison , Klotz Adam , Atoria Coral L. , Martin Steven , Groeger Jeffrey
Published: March 2015

The authors observed reductions in hospital use for patients with cancer related to an observation unit in a comprehensive cancer center. Adoption of this approach could reduce hospital use, which is of interest to hospitals, payers, and patients.
Outcomes and Satisfaction After Delivery of a Breast Cancer Survivorship Care Plan: Results of a Multicenter Trial
Authors: Palmer Steven C. , Stricker Carrie Tompkins , Panzer SarahLena L. , Arvey Sarah A. , Baker K. Scott , Casillas Jackie , Ganz Patricia A. , McCabe Mary S. , Nekhlyudov Larissa , Overholser Linda , Partridge Ann H. , Risendal Betsy , Rosenstein Donald L. , Syrjala Karen L. , Jacobs Linda A.
Published: March 2015

This study demonstrates improvements in perceived knowledge and quality of survivorship care after receipt of a comprehensive survivorship care plan.
Why Bundled Payments Could Drive Innovation: An Example From Interventional Oncology
Authors: Steele Joseph R. , Jones A. Kyle , Ninan Elizabeth P. , Clarke Ryan K. , Odisio Bruno C. , Avritscher Rony , Murthy Ravi , Mahvash Armeen
Published: March 2015

This case study illustrates that in a fee-for-service payment environment, innovation that results in more efficient care may also result in lost revenue.
Escalation of Oncologic Services at the End of Life Among Patients With Gynecologic Cancer at an Urban, Public Hospital
Authors: Wu Eijean , Rogers Anna , Ji Lingyun , Sposto Richard , Church Terry , Roman Lynda , Tripathy Debu , Lin Yvonne G.
Published: March 2015

Marked changes in interventions in a patient's final 2 months of life highlight the need for cost-effective, evidence-based metrics for delivering cancer care.
Population-Based Assessment of Cancer Survivors' Financial Burden and Quality of Life: A Prospective Cohort Study
Authors: Zafar S. Yousuf , McNeil Rebecca B. , Thomas Catherine M. , Lathan Christopher S. , Ayanian John Z. , Provenzale Dawn
Published: March 2015

Financial burden is prevalent among cancer survivors and is related to patients' health-related quality of life. Future studies should consider interventions to improve patient education and engagement with regard to financial burden.
Improving Documentation of Pain Management at MedStar Washington Cancer Institute
Authors: Ranpura Vishal , Agrawal Sundeep , Chokshi Puja , Yerasi Charan , Wood Lynne , Beasley Janet , Harkness Jaylon , Heller Stephanie , Self Linda , Swain Sandra M. , Jang Sekwon
Published: March 2015

After one plan-do-study-act cycle, the authors achieved their goal of a 90% pain documentation rate. They continue quarterly monitoring of documentation rate, as well as education and orientation of new staff members.
Challenges Faced by Pediatric Oncology Fellows When Patients Die During Their Training
Authors: Granek Leeat , Bartels Ute , Barrera Maru , Scheinemann Katrin
Published: March 2015

Structural changes to the fellowship model can be made to enhance support with patient death, including informing fellows of all patient deaths and incorporating fellows into follow-up practices with bereaved families.
Perceptions of Palliative Care Among Hematologic Malignancy Specialists: A Mixed-Methods Study
Authors: LeBlanc Thomas W. , O'Donnell Jonathan D. , Crowley-Matoka Megan , Rabow Michael W. , Smith Cardinale B. , White Douglas B. , Tiver Greer A. , Arnold Robert M. , Schenker Yael
Published: March 2015

Most hematologic oncologists view palliative care as end-of-life care, whereas solid tumor oncologists more often view palliative care as a subspecialty for comanaging patients with complex cases.
Wait Times for Breast Cancer Surgery: Effect of Magnetic Resonance Imaging and Preoperative Investigations on the Diagnostic Pathway
Authors: Nessim Carolyn , Winocour Julian , Holloway Diana P.M. , Saskin Refik , Holloway Claire M.B.
Published: March 2015

A defined pathway and rapid access to an integrated multidisciplinary breast cancer center once an imaging abnormality has been identified are needed and should be addressed by public health care officials and health care providers.
Centers for Medicare and Medicaid Services: Using an Episode-Based Payment Model to Improve Oncology Care
Authors: Kline Ronald M. , Bazell Carol , Smith Erin , Schumacher Heidi , Rajkumar Rahul , Conway Patrick H.
Published: March 2015

Centers for Medicare and Medicaid Services have designed an episode-based model of oncology care that incorporates elements from several successful model tests. It is hoped that this model will demonstrate how oncology care in the United States can be transformed into a high-value, high-quality system.
Systematic Approach to Providing Breast Cancer Survivors With Survivorship Care Plans: A Feasibility Study
Authors: Bulloch Kaleigh J. , Irwin Melinda L. , Chagpar Anees B. , Pusztai Lajos , Killelea Brigid K. , Horowitz Nina R. , Hofstatter Erin W. , Abu-Khalaf Maysa M. , DiGiovanna Michael , Chung Gina G. , Sanft Tara B.
Published: March 2015

It is feasible to identify and deliver SCPs to women with breast cancer who are approached during the postoperative visit in a surgical clinic.
Análise da aplicação do método desdobramento da função qualidade “QFD” em serviços preventivos de polícia
Authors: Freitas Lauro Soares de , Melo Filho Leonel Del Rey de , Cheng Lin Chih , Carmo Marco Aurélio Zancanela do
Published: March 2015

Apesar da expressiva contribuição do QFD para a construção do framework teórico sobre a gestão do desenvolvimento de produtos e serviços, verifica-se uma embrionária aplicação no setor público. O objetivo deste artigo é analisar a aplicação do método no contexto da segurança pública, sendo o estudo delimitado ao serviço Patrulha Escolar na Polícia Militar de Minas Gerais. A estratégia de pesquisa escolhida foi a pesquisa-ação, e instrumentos qualitativos e quantitativos foram utilizados na coleta e análise de dados. O método mostrou-se eficaz para: sistematizar um grande conjunto de informações internas e externas à corporação, facilitando o planejamento posterior de ações de policiamento; promover uma dinâmica orientada e estruturada nos encontros da polícia com a comunidade; identificar as necessidades do público escolar bem como priorizar as atividades de policiamento que melhor atenderiam a tais anseios e para compreender a capacidade de prestação de serviço de uma unidade de patrulha escolar. Por outro lado, o serviço policial apresenta um conjunto singular de características que dificultou parcialmente o planejamento pelo método. Tal serviço não tem nicho de mercado específico, sendo um serviço de direito e, não, por aquisição. Também se apoia em aspectos legais e regulamenta comportamentos, gerando rejeição. Apesar dessa natureza particular, dois fatores favoreceram a aplicação do método: a institucionalização da filosofia de polícia comunitária na organização e a familiarização dos policiais com conceitos de gestão e qualidade. A conclusão final é que o método QFD se apresentou como um instrumento promissor para melhorar a qualidade dos serviços públicos brasileiros.
Chemical Reaction Effects in Maxwell Fluid Flow Over Permeable Surface: Dual Solutions
Authors: Awais M. , Muhammad N. , Hayat T. , Alsaedi A.
Published: March 2015

This communication addresses the chemical reaction effects in two-dimensional boundary layer flow of an upper convected Maxwell (UCM) fluid over a shrinking surface. Mathematical modeling has been performed and the adequate transformations have been utilized for the conversion of partial differential system into coupled nonlinear ordinary differential system. Numerical techniques namely shooting method combined with Runge–Kutta fourth order and Newton’s method are utilized for the construction of the solutions for the velocity and the concentration fields. Dual nature of solutions for both velocity and concentration field is displayed and discussed. It is noted that the range for suction is larger for the non-Newtonian fluid when compared with the Newtonian fluid. It is also observed that two solutions exist for different values of Deborah number.
Sustainable Development in a Global Context: A Success or a Nuisance?
Authors: Bakari Mohamed El-Kamel
Published: March 2015

This article argues that the evolution of, and challenges to, sustainable development cannot be understood completely outside its contemporary global context, consisting mainly of three interconnected spheres, i.e., the global governance system, the North-South debate, and global trade liberalization. As the boundaries of these three spheres get more and more blurred in a context of an intensifying globalization, the project of sustainable development is very often faced with obstacles that set back its evolution and might very well bring it to a halt. Above all, sustainable development is now caught in the crossfire between the push for exponential economic growth, on the one hand, and a compelling need to reverse catastrophic ecological threats and social exigencies, on the other. More often than not, the current structure and scope of global governance constitutes more of a hindrance than a help to the emerging paradigm of sustainable development. Accordingly, this article seeks to pinpoint the different challenges to the implementation of sustainable development in the field of global governance and to discuss to what extent these challenges are inherent in the structure and scope of this system. In a similar vein, this article examines and discusses the challenges to sustainability within two other highly interrelated spheres, namely global trade and the North-South politics. With this end in view, a special focus is placed throughout this paper on the interconnectedness of, and overlap between, these three global spheres and the determinant role played by the major actors therein.
Globalization and the Emergence of Violent Non-state Actors: The Case of Human Trafficking
Authors: Zhidkova Tatiana
Published: March 2015

This study examines the impact of globalization on the emergence of human trafficking as a transnational security threat. The author discusses the relationship between globalization and violent non-state actors (VNSAs), seeing human trafficking as one of VNSAs threatening the state in the age of globalization. The erosion of state sovereignty and emergence of transnational organized crime are analyzed in an attempt to understand the role of globalization in transforming human trafficking into a transnational challenge.
A novel variant of FGFR3 causes proportionate short stature
Authors: Kant Sarina G , Cervenkova Iveta , Balek Lukas , Trantirek Lukas , Santen Gijs W E , de Vries Martine C , van Duyvenvoorde Hermine A , van der Wielen Michiel J R , Verkerk Annemieke J M H , Uitterlinden André G , Hannema Sabine E , Wit Jan M , Oostdijk Wilma , Krejci Pavel , Losekoot Monique
Published: March 2015

Objective

Mutations of the fibroblast growth factor receptor 3 (FGFR3) cause various forms of short stature, of which the least severe phenotype is hypochondroplasia, mainly characterized by disproportionate short stature. Testing for an FGFR3 mutation is currently not part of routine diagnostic testing in children with short stature without disproportion.

Design

A three-generation family A with dominantly transmitted proportionate short stature was studied by whole-exome sequencing to identify the causal gene mutation. Functional studies and protein modeling studies were performed to confirm the pathogenicity of the mutation found in FGFR3. We performed Sanger sequencing in a second family B with dominant proportionate short stature and identified a rare variant in FGFR3.

Methods

Exome sequencing and/or Sanger sequencing was performed, followed by functional studies using transfection of the mutant FGFR3 into cultured cells; homology modeling was used to construct a three-dimensional model of the two FGFR3 variants.

Results

A novel p.M528I mutation in FGFR3 was detected in family A, which segregates with short stature and proved to be activating in vitro. In family B, a rare variant (p.F384L) was found in FGFR3, which did not segregate with short stature and showed normal functionality in vitro compared with WT.

Conclusions

Proportionate short stature can be caused by a mutation in FGFR3. Sequencing of this gene can be considered in patients with short stature, especially when there is an autosomal dominant pattern of inheritance. However, functional studies and segregation studies should be performed before concluding that a variant is pathogenic.
Med1 regulates meiotic progression during spermatogenesis in mice
Authors: Huszar Jessica M , Jia Yuzhi , Reddy Janardan K , Payne Christopher J
Published: March 2015

Spermatogenesis is a highly coordinated process. Signaling from nuclear hormone receptors, like those for retinoic acid (RA), is important for normal spermatogenesis. However, the mechanisms regulating these signals are poorly understood. Mediator complex subunit 1 (MED1) is a transcriptional enhancer that directly modulates transcription from nuclear hormone receptors. MED1 is present in male germ cells throughout mammalian development, but its function during spermatogenesis is unknown. To determine its role, we generated mice lacking Med1 specifically in their germ cells beginning just before birth. Conditional Med1 knockout males are fertile, exhibiting normal testis weights and siring ordinary numbers of offspring. RA-responsive gene products stimulated by RA gene 8 (Stra8) and synaptonemal complex protein 3 (Sycp3) are first detected in knockout spermatogonia at the expected time points during the first wave of spermatogenesis, and persist with normal patterns of cellular distribution in adult knockout testes. Meiotic progression, however, is altered in the absence of Med1. At postnatal day 7 (P7), zygotene-stage knockout spermatocytes are already detected, unlike in control testes, with fewer pre-leptotene-stage cells and more leptotene spermatocytes observed in the knockouts. At P9, Med1 knockout spermatocytes prematurely enter pachynema. Once formed, greater numbers of knockout spermatocytes remain in pachynema relative to the other stages of meiosis throughout testis development and its maintenance in the adult. Meiotic exit is not inhibited. We conclude that MED1 regulates the temporal progression of primary spermatocytes through meiosis, with its absence resulting in abbreviated pre-leptotene, leptotene, and zygotene stages, and a prolonged pachytene stage.
Continuous Positive Airway Pressure With Helmet Versus Mask in Infants With Bronchiolitis: An RCT
Authors: Chidini Giovanna , Piastra Marco , Marchesi Tiziana , De Luca Daniele , Napolitano Luisa , Salvo Ida , Wolfler Andrea , Pelosi Paolo , Damasco Mirco , Conti Giorgio , Calderini Edoardo
Published: March 2015

BACKGROUND:

Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF.

METHODS:

In this multicenter randomized controlled trial, 30 infants with respiratory syncytial virus-induced ARF were randomized to receive CPAP by helmet (n = 17) or facial mask (n = 13). The primary endpoint was treatment failure rate (defined as due to intolerance or need for intubation). Secondary outcomes were CPAP application time, number of patients requiring sedation, and complications with each interface.

RESULTS:

Compared with the facial mask, CPAP by helmet had a lower treatment failure rate due to intolerance (3/17 [17%] vs 7/13 [54%], P = .009), and fewer infants required sedation (6/17 [35%] vs 13/13 [100%], P = .023); the intubation rates were similar. In successfully treated patients, CPAP resulted in better gas exchange and breathing pattern with both interfaces. No major complications due to the interfaces occurred, but CPAP by mask had higher rates of cutaneous sores and leaks.

CONCLUSIONS:

These findings confirm that CPAP delivered by helmet is better tolerated than CPAP delivered by facial mask and requires less sedation. In addition, it is safe to use and free from adverse events, even in a prolonged clinical setting.
State-of-the-Art Office-Based Interventions to Eliminate Youth Tobacco Use: The Past Decade
Authors: Pbert Lori , Farber Harold , Horn Kimberly , Lando Harry A. , Muramoto Myra , O’Loughlin Jennifer , Tanski Susanne , Wellman Robert J. , Winickoff Jonathan P. , Klein Jonathan D.
Published: March 2015

Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a “state-of-the-art” article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco.
Trajectories and Outcomes Among Children With Special Health Care Needs
Authors: Quach Jon , Jansen Pauline W. , Mensah Fiona K. , Wake Melissa
Published: March 2015

BACKGROUND AND OBJECTIVE:

Outcomes for children with special health care needs (SHCN) can vary by their patterns and persistence over time. We aimed to empirically establish typical SHCN trajectories throughout childhood and their predictive relationships with child and parent outcomes.

METHODS:

The 2 cohorts of the nationally representative Longitudinal Study of Australian Children were recruited in 2004 at ages 0 to 1 (n = 5107, B cohort) and 4 to 5 years (n = 4983, K cohort). The parent-reported Children With SHCN Screener (Short Form) was completed at each of 4 biennial waves. Wave 4 outcomes were parent-reported behavior and health-related quality of life, teacher-reported learning, and directly assessed cognition. Both parents self-reported mental distress. We derived intracohort trajectories by using latent class analysis in Mplus. We compared mean outcome scores across trajectories by using linear regression, adjusting for socioeconomic position.

RESULTS:

Four distinct SHCN trajectories were replicated in both cohorts: persistent (B 6.8%, K 8.7%), emerging (B 4.1%, K 11.5%), transient (B 7.9%, K 4.2%), and none (B 81.3%, K 75.6%). Every outcome was adversely affected except fathers’ mental health. From infancy to age 6 to 7 years, the persistent and emerging groups had similarly poor outcomes. From age 4 and 5 to 10 and 11 years, outcomes were incrementally poorer on moving from none to transient to emerging and to persistent SHCN. Effect sizes were largest for behavior, learning, and psychosocial outcomes.

CONCLUSIONS:

Adverse outcomes are shaped more by cumulative burden than point prevalence of SHCNs. In addition to providing care according to a child’s need at any given time, prioritizing care toward persistent SHCNs may have the biggest benefits for children and parents.
Delayed-Onset of Multiple Cutaneous Infantile Hemangiomas Due to Propranolol: A Case Report
Authors: Porcel Chacón Rocío , del Boz González Javier , Navarro Morón Juan
Published: March 2015

Infantile hemangiomas are the most common vascular tumors in childhood. In view of its proven effectiveness in such cases, propranolol is the drug of choice. We present the case of a male infant who started treatment with propranolol shortly after birth due to heart disease. After 7 months, when the patient had suffered various respiratory exacerbations, this treatment was suspended. One week later, multiple skin lesions (ie, multifocal infantile hemangiomas) began to appear, with no extracutaneous involvement. It was decided to resume treatment with propranolol, although at lower doses than before, and the skin lesions improved rapidly, with some disappearing completely. Treatment was definitively withdrawn at age 16 months, with only slight recurrence of the lesions. The case described is of multifocal infantile hemangiomas without extracutaneous involvement appearing beyond the neonatal period after treatment with propranolol beginning in the first days of life. The details of the case support the hypothesis that this drug is not only therapeutic but also plays a prophylactic role against infantile hemangiomas. In turn, this supports the recent proposal that this drug may be useful in preventing the growth and spread of tumors with high angiogenic potential. It is postulated that the inhibition of β-adrenergic receptors is associated with multiple intracellular processes related to the progression and metastasis of different tumors.