bluuebunny/crossref_metadata_2025 huggingface dataset:
“IH8U”: Confronting Cyberbullying and Exploring the Use of Cybertools in Teen Dating Relationships
Authors: Alvarez Antonia R.G.
Published: September 2012

Cyberbullying among adolescents has been a major focus of attention in mainstream media and has been documented to have many negative effects, as evidenced by several highly publicized suicides of teens who had been bullied online. The growing body of research about cyberbullying has rarely considered, however, the practice of cyberbullying between intimate partners. This article focuses on the frequency, types, and effect of cyberbullying between intimate partners in teen dating relationships. I examine the use of cybertools (electronic forms of communication) as mechanisms of power and control in relationships for both the target and the perpetrator. Suggested methods of prevention and intervention for adults working with teens who are experiencing cyberbullying in dating relationships are discussed.
Evaluation of incremental healthcare resource burden and readmission rates associated with hospitalized hyponatremic patients in the US
Authors: Amin Alpesh , Deitelzweig Steven , Christian Rudell , Friend Keith , Lin Jay , Belk Kathy , Baumer Dorothy , Lowe Timothy J.
Published: September 2012

BACKGROUND:

Hyponatremia is a prevalent electrolyte disorder in hospitalized patients indicative of greater morbidity and mortality. A large‐scale retrospective analysis was conducted to evaluate the incremental burden of hospitalized hyponatremic (HN) versus non‐HN patients in terms of hospital resource utilization, costs, and hospital readmissions in the real‐world setting.

METHODS:

HN patients (≥18 years) were selected from the Premier Hospital Database between January 1, 2007 and March 31, 2010 and matched to a non‐HN control cohort using propensity score matching. Bivariate and multivariate statistics were employed to evaluate the differences in healthcare resource utilization, costs, and hospital readmissions between patient cohorts.

RESULTS:

Among the matched patient cohorts, length of stay (LOS) (8.8 ± 10.3 vs 7.7 ± 8.5 days, P < 0.001), hospital admission costs ($15,281 ± $24,054 vs $13,439 ± $22,198, P < 0.001), intensive care unit (ICU) LOS (5.5 ± 7.9 vs 4.9 ± 7.1 days, P < 0.001), and ICU costs ($8525 ± $13,342 vs $7597 ± $12,695, P < 0.001) were greater for the HN versus non‐HN cohort, as were hospital readmission rates 30 days postdischarge. Multivariate regressions further demonstrated that hyponatremia was associated with an increase of 10.9% for LOS, 8.2% for total hospitalization costs, 10.2% for ICU LOS, and 8.9% for ICU costs. Additionally, after multivariate adjustment, hyponatremia was associated with a 15.0% increased chance for hospital readmission 30 days postdischarge (P < 0.0001).

CONCLUSIONS:

Hyponatremia is an independent predictor of increased hospitalization LOS and cost, ICU admission and cost, and 30‐day hospital readmission, and therefore represents a potential target for intervention to reduce healthcare expenditures for a large population of hospitalized hyponatremic patients. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine
Pyrroloquinoline quinone and a quinoprotein kinase support γ‐radiation resistance in Deinococcus radiodurans and regulate gene expression
Authors: Rajpurohit Yogendra Singh , Desai Shruti Sumeet , Misra Hari Sharan
Published: September 2012

Deinococcus radiodurans is known for its extraordinary resistance to various DNA damaging agents including γ‐radiation and desiccation. The pqqE:cat and Δdr2518 mutants making these cells devoid of pyrroloquinoline quinone (PQQ) and a PQQ inducible Ser/Thr protein kinase, respectively, became sensitive to γ‐radiation. Transcriptome analysis of these mutants showed differential expression of the genes including those play roles in oxidative stress tolerance and (DSB) repair in D. radiodurans and in genome maintenance and stress response in other bacteria. Escherichia coli cells expressing DR2518 and PQQ showed improved resistance to γ‐radiation, which increased further when both DR2518 and PQQ were present together. Although, profiles of genes getting affected in these mutants were different, there were still a few common genes showing similar expression trends in both the mutants and some others as reported earlier in oxyR and pprI mutant of this bacterium. These results suggested that PQQ and DR2518 have independent roles in γ‐radiation resistance of D. radiodurans but their co‐existence improves radioresistance further, possibly by regulating differential expression of the genes important for bacterial response to oxidative stress and DNA damage.
Winter daily precipitation variability over the East Anglian region of Great Britain and its relationship with river flow
Authors: Smith Michael J. , Phillips Ian D.
Published: September 2012

This paper investigates winter (DJF) precipitation variability over East Anglia at the daily and 2 d timescales using rain gauge data from 134 sites. The first three principal components (PCs) explain 80.2% (82.0%) of the variance in daily (2 d totals). Precipitation displays higher spatial coherence in winter, with the first three PCs of summer daily totals (Neal and Phillips, 2009, International Journal of Climatology 29: 1661–1679) explaining only 72.3% of the variance. The winter PCs for both 24‐ and 48‐h timescales display precipitation maxima in South Essex (PC 1), NE Norfolk (PC 2), and NW Cambridgeshire (PC 3). The rainfall maximum over South Essex is more important in winter than in summer. Lamb Weather Types and synoptic charts are used to explain the causes of the PCs. A precipitation regionalization is also produced. Discharge for 11 rivers is then modelled as a linear function of the rainfall patterns (as represented by the PC scores). With the exception of the River Babingley, whose discharge is not significantly related to the PCs, these models explain on average 26.5% of the variance. For most rivers, there are significant relationships between discharge and precipitation that fell up to 4 d ago on average. In general, East Anglian river flows show persistence over 6–8 d.
Analysis of amino acids in latent fingerprint residue by capillary electrophoresis‐mass spectrometry
Authors: Atherton Tom , Croxton Ruth , Baron Mark , Gonzalez‐Rodriguez Jose , Gámiz‐Gracia Laura , García‐Campaña Ana M.
Published: September 2012

The analysis of the chemical composition of fingerprints is important for the development and improvement of existing fingerprint enhancement techniques. This study demonstrates the first analysis of a latent fingerprint sample, using an optimized CE‐MS method. In total 12 amino acids were detected in the fingerprint sample. MS/MS fragmentation was used to provide additional identity confirmation, for which eight of the twelve detected amino acids generated confirmatory product ions. Nine amino acids were quantified and their relative abundances were consistent with previous studies with serine and glycine being the most abundant. The successful detection of amino acids from latent fingerprints demonstrates that CE‐MS is a potential future technique for further study of such compounds in fingerprint samples.
Determination of thiols by capillary micellar electrokinetic chromatography with laser induced fluorescence detection using 1,3,5,7‐tetramethyl‐8‐phenyl‐(4‐iodoacetamido) difluoroboradiaza‐s‐indacene as labeling reagent
Authors: Guo Xiao‐Feng , Zhang Hui‐Xian , Ma Li‐Na , Wang Hong , Zhang Hua‐Shan , Guo Jian
Published: September 2012

A sensitive and effective micellar electrokinetic capillary chromatography with laser‐induced fluorescence detection approach was described for the determination of low molecular‐mass thiols using 1,3,5,7‐tetramethyl‐8‐phenyl‐(4‐iodoacetamido) difluoroboradiaza‐s‐indacene as the labeling reagent. After precolumn derivatization, baseline separation of six thiol compounds including cysteine, glutathione, N‐acetylcysteine, homocysteine, 6‐mercaptopurine, and penicillamine were achieved within 18 min. The optimal running buffer was composed of mixtures involving 25 mM sodium dodecyl sulfate, 25% (v/v) acetonitrile and 15 mM sodium phosphate buffer, pH 7.5. The detection limits (S/N = 3) were found as low as 40 pM under argon ion laser‐induced fluorescence detector (λex/λem = 488/520 nm), which were much better than the reported approaches. The accuracy and specificity of this assay for real samples were assured by a standard addition method. The proposed method has been applied to the analysis of thiols both in human plasma and plum flower samples with recoveries of 92.0–109.4%.
Effects of chemesthetic stimuli mixtures with barium on swallowing apnea duration
Authors: Todd J. Tee , Butler Susan G. , Plonk Drew P. , Grace‐Martin Karen , Pelletier Cathy A.
Published: September 2012

Objectives/Hypothesis:

This study tested the hypotheses that swallowing apnea duration (SAD) will increase given barium versus water, chemesthetic stimuli (i.e., water < ethanol, acid, and carbonation) mixed with barium, age (older > younger), and genetic taste differences (supertasters > nontasters).

Study Design:

Prospective group design.

Setting:

University Medical Center.

Methods:

Eighty healthy women were identified as nontasters and supertasters, equally comprising two age groups: 18 to 35 years and 60+ years. The KayPentax Swallowing Signals Lab was used to acquire SAD via nasal cannula during individually randomized swallows of 5 mL barium, 2.7% w/v citric acid with barium, carbonation with barium, and 50:50 diluted ethanol with barium. Data were analyzed using path analysis, with the mediator of chemesthetic perception, adjusted for repeated measures.

Results:

Significant main effects of age (P = .012) and chemesthetic stimuli (P = .014) were found, as well as a significant interaction between chemesthetic stimuli and age (P = .028). Older women had a significantly longer SAD than younger women. Post hoc analyses revealed that barium mixed with ethanol elicited a significantly longer SAD than other bolus conditions, regardless of age group. There were no significant differences in SAD between barium and water conditions, and no significant effect of chemesthetic perception (P > .05).

Conclusions:

Ethanol added to barium elicited longer SAD compared to plain barium, but not the other chemesthetic conditions. Older women had a longer SAD than younger women in all conditions. These findings may influence design of future studies examining effects of various stimuli on SAD.
Exploring the clinical value and implications of routine pathological examination of septoplasty specimens
Authors: Haffey Timothy , Pabon Sheila , Hawley Karen , Hoschar Aaron , Sindwani Raj
Published: September 2012

Objectives/Hypothesis:

During septoplasty, otherwise normal cartilage and bone are removed and routinely submitted for pathologic examination. According to the College of American Pathologists, however, the examination of bone and cartilage from septoplasty and rhinoplasty may be left to the pathologist's discretion. We explored the processing of tissues removed during septoplasty, examining the clinical value and implications of current practices.

Study Design:

Retrospective chart review.

Methods:

Our database was searched for septoplasty (CPT code 30520) procedures performed specifically for the indication of nasal obstruction.

Results:

Five hundred sixteen consecutive cases from 15 surgeons spanning a 2‐year period were identified. In the majority of cases, septal tissues removed during surgery were submitted to pathology. The majority of cases (>90%) involved septoplasty performed in conjunction with another procedure, most commonly addressing the inferior turbinates. All septal specimens received gross examination by a pathologist, and a smaller fraction were also examined histologically. Gross findings included the qualitative appearance of the specimen and dimensional measurements of bone and cartilage fragments. No abnormalities were identified (by gross or histologic examination) in any of the specimens. Associated costs included specimen handling, storage, and pathology fees.

Conclusions:

In our health care system, it is common practice to submit tissues removed during septoplasty for pathologic examination. This study demonstrates that routine evaluation of septal tissues following surgery for obstruction has no clinical value whatsoever, and is associated with direct and indirect costs. Given the current health care climate, this practice should be further scrutinized and reconsidered.
Subglottic injury: A clinically relevant animal model
Authors: Kelly Nicola A. , Murphy Madeline , Giles Seamus , Russell John D.
Published: September 2012

Objectives/Hypothesis:

To develop a clinically aligned, reproducible model for subglottic injury.

Study Design:

Prospective randomized control pilot study.

Methods:

Juvenile (3‐month‐old) New Zealand White rabbits underwent intubation with a 3‐cm length of an endotracheal tube that was chosen so that there would be no air leak below 20 cm of water. This tube was one or two sizes above the appropriate tube for the animal. It was held in situ with a suture placed at the trachea and secured over a button in the neck for a period of 1 week. Animals were sacrificed 1 week postextubation, and larynges were harvested. A range of histological techniques and gross morphology were utilized to examine the injury caused at the level of the subglottis. Unintubated animals constituted controlled specimens.

Results:

Intubated animals demonstrated considerable histopathology including evidence of ulceration, inflammation, granulation tissue, perichondritis, and chondritis when compared with control animals. Morphometric analysis demonstrated a significant increase in lamina propria thickness (P= .0013), mucosal thickness (P≤ .0001), and in goblet cell areal density (P= .014). Analysis of mucin types found a significant decrease in acidic (P= .0001) mucin coinciding with a significant increase in mixed mucin types (P= .0013).

Conclusions:

Our model provides a reliable and reproducible technique for acute/subacute injury to the subglottis secondary to intubation, which is consistent with previous histological findings of early changes associated with acquired subglottic stenosis (SGS). Future uses of this model could include the examination of current adjunctive therapies and their effects on limiting progression to SGS.
Image‐guided surgical navigation in otology
Authors: Kohan Darius , Jethanamest Daniel
Published: September 2012

Objectives/Hypothesis:

To evaluate the efficacy of image‐guided surgical navigation (IGSN) in otologic surgery and establish practice guidelines.

Study Design:

Prospective study.

Methods:

Between January 2003 and January 2010, all patients requiring complicated surgery for chronic otitis media, glomus jugulare, atresia, cerebrospinal fluid leak with or without encephalocele, and cholesterol granuloma of the petrous apex were offered IGSN. The accuracy of IGSN relative to pertinent pathology and 11 anatomic landmarks was established. Additionally IGSN‐related operative time, complications, and surgical outcome were recorded.

Results:

In the study period there were 820 otologic procedures, among 94 patients (96 ears) with disease meeting proposed criteria. Thirteen patients (15 procedures) consented to the use of IGSN. All patients had a minimum 6 months of follow‐up. The average additional operative time required was 36.7 minutes. The mean accuracy error was 1.1 mm laterally at the tragus but decreased to 0.8 mm medially at the level of the oval window. The mean accuracy of IGSN was within 1 mm in 10 of the 11 targeted surgical anatomic landmarks.

Conclusions:

Interactive image‐guided surgical navigation during complex otologic surgery may improve surgical outcome and decrease morbidity by providing an accurate real‐time display of surgical instrumentation relative to patient anatomy and pathology. In select cases, the extra cost of imaging immediately prior to surgery and extra operating room time may be compensated by enhancing the ability to distinguish distorted anatomy relative to disease, potentially improving surgical outcome. IGSN, although useful, does not replace surgical expertise and experience.
Validation of a task‐specific scoring system for a microvascular surgery simulation model
Authors: Nimmons Grace L. , Chang Kristi E. , Funk Gerry F. , Shonka David C. , Pagedar Nitin A.
Published: September 2012

Objective/Hypothesis:

Simulation models can help develop procedural skills outside the clinical setting while also providing a means for evaluation of trainees. Objective Structured Assessment of Technical Skills (OSATS) have been developed for several procedures. The purpose of this study was to demonstrate the construct validity of an OSATS for microvascular anastomosis performed on a simulation model using chicken thigh vessels.

Study Design:

Validation study.

Methods:

An expert panel constructed a task‐specific checklist for an OSATS for microvascular anastomosis. Twenty surgical staff and trainees performed a microvascular anastomosis of a chicken ischiatic artery. Training level and microsurgical experience were assessed by questionnaire. The performances were recorded and scored by two experts using the task‐specific and global scales of the OSATS.

Results:

Analysis of variance revealed a significant effect of training and microvascular experience for both the task‐specific score and global rating scale score (P < .005). Interrater reliability was 0.7. Experience level demonstrated a logarithmic relationship with task time.

Conclusions:

The microvascular OSATS applied to the chicken thigh simulator model differentiated between levels of microvascular experience. It demonstrated construct validity and reliability for the assessment of procedural competence using a cost‐effective and easily accessible model.
UNDERSTANDING SOIL CONSERVATION DECISION OF FARMERS IN THE GEDEB WATERSHED, ETHIOPIA
Authors: Tesfaye A. , Negatu W. , Brouwer R. , van der Zaag P.
Published: September 2012

The aim of this study was to investigate the main factors that influence smallholders' adoption decision of soil conservation measures in the Gedeb watershed. Data from 498 household heads who live in the three districts of the watershed were analysed using the binary logistic regression model. We find that farmers need adequate cash to invest in soil conservation measures. Moreover, farmers would be more encouraged to implement soil conservation measures when they have larger areas of cropland. We explore the possibility that when farmers presume that they have fertile land, they exploit their land more. This hints at the need for extension advice about the benefit of sustainable use of farmers' cropland so that they can maintain their land and pass it on to the future generation. Farmers' awareness about the benefit of land management practices and recognition of the problem erosion is causing on their crop land are central to their decision to adopt soil conservation measures. Furthermore, to adopt these measures, farmers have to be convinced about the effectiveness of these measures. Thus, awareness creation and demonstration of the effectiveness of these measures is essential. Because of the transboundary nature of the problem, policy makers in downstream countries that are suffering from the off‐site impact (e.g. Sudan) would benefit from the information provided and support efforts in the implementation of soil conservation measures. Copyright © 2013 John Wiley & Sons, Ltd.
Concomitant consumption of lycopene and fish oil inhibits tumor growth and progression in a mouse xenograft model of colon cancer
Authors: Tang Feng‐Yao , Pai Man‐Hui , Kuo Yueh‐Hsiung , Wang Xiang‐Dong
Published: September 2012

Scope

Our previous report showed that concomitant supplementation of lycopene and eicosa‐pentaenoic acid synergistically inhibited the proliferation of human colon cancer HT‐29 cells in vitro.

Methods and results

To validate our findings, the present study investigated whether consumption of lycopene and fish oil would help prevent tumor growth and progression in a mouse xenograft model of colon cancer. The inhibitory effects of lycopene and fish oil on tumor growth were verified by western blotting analysis, bioluminescent imaging, immunohistochemical (IHC) staining and ELISA. The results demonstrated that lycopene and fish oil synergistically inhibited the growth of colon cancer in tumor‐bearing mice. The bioluminescent imaging, histopathological and IHC staining results indicated that lycopene and fish oil effectively suppressed tumor growth and progression of colon cancer in vivo. The chemopreventive effects of lycopene and fish oil were associated with augmented expression of the cell cycle inhibitors such as p21CIP1/WAF1 and p27Kip1, and suppression of proliferating cell nuclear antigen, β‐catenin, cyclin D1 and c‐Myc proteins. Furthermore, lycopene and fish oil inhibited tumor progression through suppression of MMP‐7, MMP‐9, COX‐2 and PGE2.

Conclusion

These results show that lycopene and fish oil act synergistically as chemopreventive agents against tumor growth and progression in a mouse xenograft model of colon cancer.
The Continuing Professional Development for Nurses and Allied Health Professionals Working Within Musculoskeletal Services: A National UK Survey
Authors: Haywood Hannah , Pain Helen , Ryan Sarah , Adams Jo
Published: September 2012

Objectives

To explore the current UK status of continuing professional development (CPD) for nurses and allied health professionals (AHPs) working in musculoskeletal (MSK) services in the UK.

Methods

A web‐based survey was developed and used to collect data from service managers, nurses and AHPs who work with people who have MSK conditions, recruited through professional interest groups via email and website notices. The questionnaire was designed following focus groups and telephone conference calls with managers and AHPs from MSK services to ensure content validity. Results were collected online and analysed in SPSS PASW 17 using frequency data and χ2 analyses.

Results

A total of 354 responses were analysed. The most frequently reported reason for undertaking CPD was to improve patient care. The level of staff experience made no significant difference to the CPD activities undertaken. The majority of respondents reported that their organization was supportive of CPD activities and in applying new knowledge to practice, but lack of funding and having too many other tasks to complete at work were the most frequently reported barriers to CPD. Many commented about the difficulty in accessing CPD in the face of increasing workload pressure and tightened budgets.

Conclusions

The results indicate that despite the organizational support for CPD, respondents faced substantial challenges in accessing CPD when under pressure to achieve productivity targets, with little assistance in terms of funding. This discrepancy may indicate that greater support is required to meet MSK nurses' and AHPs' CPD needs. Copyright © 2012 John Wiley & Sons, Ltd.
A detailed investigation of block dynamic sliding by the discontinuous deformation analysis
Authors: Ning Youjun , Zhao Zhiye
Published: September 2012

An extensive examination of the discontinuous deformation analysis (DDA) in block dynamic sliding modeling is carried out in this paper. Theoretical solutions for a single block sliding on an arbitrarily inclined plane by applying the horizontal/vertical seismic loadings to the sliding block as acceleration time histories or to the base as constraint displacement time histories are derived. As compared with the theoretical solutions, for a single block sliding, the DDA predicts the sliding displacements and block interaction forces accurately under various base incline angles and friction angles under both the harmonic loadings and a real seismic loading. The vertical seismic component may influence the block sliding displacements to different extent, and the DDA can capture these phenomena successfully and give accurate results. For the calculation of the single block relative sliding, both the theoretical and the DDA solutions indicate that applying the seismic accelerations as constraint displacement time histories (derived by integrating the seismic accelerations twice) to the base is equivalent to applying the seismic accelerations as volume forces to the sliding block in the opposite directions. The DDA modeling also demonstrates that this conclusion still stands for the case of multi‐block sliding. Copyright © 2012 John Wiley & Sons, Ltd.
Affine recourse for the robust network design problem: Between static and dynamic routing
Authors: Poss Michael , Raack Christian
Published: September 2012

Affinely Adjustable Robust Counterparts provide tractable alternatives to (two‐stage) robust programs with arbitrary recourse. Following Ouorou and Vial, we apply them to robust network design with polyhedral demand uncertainty, introducing the notion of affine routing. We compare the new affine routing scheme to the well‐studied static and dynamic routing schemes for robust network design. It is shown that affine routing can be seen as a generalization of the widely used static routing while still being tractable and providing cheaper solutions. We investigate properties of the demand polytope under which affine routings reduce to static routings and also develop conditions on the uncertainty set leading to dynamic routings being affine. We show however that affine routings suffer from the drawback that (even totally) dominated demand vectors are not necessarily supported by affine solutions. Uncertainty sets have to be designed accordingly. Finally, we present computational results on networks from SNDlib. We conclude that for these instances the optimal solutions based on affine routings tend to be as cheap as optimal network designs for dynamic routings. In this respect the affine routing principle can be used to approximate the cost for two‐stage solutions with free recourse which are hard to compute. © 2012 Wiley Periodicals, Inc. NETWORKS, 2013
Hop‐level flow formulation for the survivable network design with hop constraints problem
Authors: Mahjoub A. Ridha , Simonetti Luidi , Uchoa Eduardo
Published: September 2012

The hop‐constrained survivable network design problem consists of finding a minimum cost subgraph containing K edge‐disjoint paths with length at most H joining each pair of vertices in a given demand set. When all demands have a common vertex, the instance is said to be rooted. We propose a new extended formulation for the rooted case, called hop‐level multicommodity flow (MCF), that can be significantly stronger than the previously known formulations, at the expense of having a larger number of variables and constraints, growing linearly with the number of edges and demands and quadratically with H. However, for the particular case where H = 2, it can be specialized into a very compact and efficient formulation. Even when H = 3, hop‐level‐MCF can still be quite efficient and it has solved several instances from the literature for the first time. © 2012 Wiley Periodicals, Inc. NETWORKS, 2013
Phase I trial and pharmacokinetic study of sorafenib in children with neurofibromatosis type I and plexiform neurofibromas
Authors: Kim AeRang , Dombi Eva , Tepas Kathleen , Fox Elizabeth , Martin Staci , Wolters Pamela , Balis Frank M. , Jayaprakash Nalini , Turkbey Baris , Muradyan Naira , Choyke Peter L. , Reddy Alyssa , Korf Bruce , Widemann Brigitte C.
Published: September 2012

Background

Sorafenib targets multiple pathways thought to be crucial in growth of plexiform neurofibroma (PN) in children with neurofibromatosis type 1 (NF1). Sorafenib has been tolerated with manageable toxicities in adults and children with refractory cancer. We conducted a separate study in this population. Monitoring long‐term toxicities such as effects on growth and obtaining additional pharmacokinetic data were of importance due to the young age and long duration of therapy seen in previous phase I trials in children with NF1.

Procedure

Children ≥3 and ≤18‐year‐old with NF1 and inoperable PN were eligible. Sorafenib was administered orally twice daily for consecutive 28‐day cycles. Maximum tolerated dose (MTD) was determined from toxicities observed during the first three cycles.

Results

Nine children enrolled, median age 8 (6–12) years. At the starting 115 mg/m2/dose (n = 5), two experienced dose‐limiting grade 3 pain in their PN. At the de‐escalated 80 mg/m2/dose (n = 4), approximately 40% of the pediatric solid tumor MTD, two had dose‐limiting toxicity (grade 3 rash and grade 4 mood alteration), exceeding the MTD. At 80 mg/m2/dose, the median AUC0–12 hours at steady‐state was 39.5 µg hours/ml. Toxicities appeared to correspond with decreases in quality of life (QOL). No tumor shrinkage was observed.

Conclusions

Children with NF1 and PN did not tolerate sorafenib at doses substantially lower than the MTD in children and adults with malignant solid tumors. Future trials with targeted agents for children with NF1 may require a more conservative starting dose and separate definitions of dose limiting toxicities (DLT) than children with cancer. Pediatr Blood Cancer 2013; 60: 396–401. © 2012 Wiley Periodicals, Inc.
Demonstration of type II latency in T lymphocytes of Epstein–Barr Virus‐associated hemophagocytic lymphohistiocytosis
Authors: Ito Yoshinori , Kawamura Yoshiki , Iwata Seiko , Kawada Jun‐ichi , Yoshikawa Tetsushi , Kimura Hiroshi
Published: September 2012

Epstein–Barr virus (EBV) is the most common infectious cause of non‐genetic hemophagocytic lymphohistiocytosis (HLH). To investigate EBV‐infected lymphocytes and immune dysfunction in EBV‐associated HLH, blood samples from a 6‐year‐old boy were longitudinally analyzed using molecular techniques. EBV‐positive lymphocytes were detected as CD5+, CD8+, and/or HLA DR+ lymphocytes on Day 25 of the disease, mostly disappearing thereafter. CD8+ cells specific for lytic antigen BRLF1 were detected, but cells specific for latent antigens EBNA3 and LMP2 were not. EBV genes EBNA1, LMP1, LMP2, EBER1, BARTs were detected, suggesting a latency type II gene expression pattern in this case. Pediatr Blood Cancer 2013;60:326–328. © 2012 Wiley Periodicals, Inc.
Islet cell transplantation: current status in the UK
Authors: Choudhary Pratik , Parrott Neil R , Birtles Linda , Rutter Martin K
Published: September 2012

Up to a third of patients with type 1 diabetes have impaired awareness of hypoglycaemia, putting them at a six‐fold higher risk of severe hypoglycaemia, requiring third‐party assistance. Following the success of a Diabetes UK funded research programme, islet transplantation is centrally funded at seven UK sites.

Islet transplantation is indicated for patients with recurrent, severe, disabling hypoglycaemia despite best medical therapy. In most patients, this includes a trial of insulin pump therapy. International data suggest five‐year graft survival of between 30–50%, with those patients remaining free from hypoglycaemia and insulin‐independence rates of 20–25% at five years. The UK programme is focused on hypoglycaemia protection, and UK data from 24 recipients show a reduction in the frequency of severe hypoglycaemia from 23/patient per year to 0.56/patient per year.

The main alternative to islet transplantation is whole pancreas transplantation, which also has a five‐year graft survival rate of 50%, but much higher insulin independence rates. However, this is associated with significantly higher surgical morbidity.

Islet transplantation is very safe, the main risks being related to immunosuppression. We have a lot of experience with these drugs in solid organ transplantation. The main risk is a 4% excess risk of skin cancers, the majority of which are curable.

It is important for hypoglycaemia status to be assessed in all patients with type 1 diabetes, so that those with problematic severe hypoglycaemia can be identified. In these patients, islet transplantation can offer potential normalisation of blood glucose with complete resolution of hypoglycaemia. Copyright © 2012 John Wiley & Sons.
Primary care: the custodian of diabetes care?
Authors: Farooqi Azhar
Published: September 2012

Type 2 diabetes is the disease of our times. With some 3 million cases in the UK, primary care has a vital role in coordinating and delivering evidence‐based care which includes the prevention, detection and management of diabetes.

However, primary care has not always been able to deliver such a role; up to the end of the 1980s, despite the drawbacks of busy hospital outpatient clinics, primary care could rarely offer the systematic care and skills that people with diabetes require.

Quality improvement and audit in the 1990s heralded the increased adoption of evidence‐based practice in primary care. Many GP practices significantly improved the organisation and quality of care for diabetes as a result. The widespread adoption of IT systems and the emergence of a more robust evidence base for care (for example, UKPDS) accelerated this process.

More lately, investment in general practice through the Quality and Outcomes Framework and practice education programmes have helped deliver significant improvements in the quality of primary care diabetes.

However, there is still much to do, with variation in care and health inequalities persisting. The development of clinical commissioning offers further opportunities to make the best use of available resources and target investment where it is most likely to benefit patients. A health care system where primary care in collaboration with other stakeholders coordinates the care of people with diabetes offers the best hope in addressing this modern epidemic that we face. Copyright © 2012 John Wiley & Sons.

This paper was presented as the 2012 Mary Mackinnon lecture at the 2012 Diabetes UK Annual Professional Conference held in Glasgow
Transient insulin‐treated diabetes mellitus in a patient with pancreatic tuberculosis
Authors: Thondam SK , Shrotri M , Oyegade A , Daousi C , Cuthbertson DJ
Published: September 2012

Isolated pancreatic tuberculosis (TB) is uncommon, and overt diabetes mellitus subsequent to it is rare. We report an unusual case of transient diabetes mellitus in a 46‐year‐old Asian man, nearly three months after a modified Whipple's surgical procedure for pancreatic TB. Our patient had severe hyperglycaemia initially requiring insulin treatment followed by recurrent hypoglycaemia over the next two weeks and near normalisation of blood glucose without any medication thereafter. We discuss the likely pathogenic mechanisms leading to the unusual course of diabetes mellitus in our patient. Copyright © 2012 John Wiley & Sons.
Direct observation of Cu, Zn cation disorder in Cu2ZnSnS4 solar cell absorber material using aberration corrected scanning transmission electron microscopy
Authors: Mendis Budhika G. , Shannon Mervyn D , Goodman Max CJ , Major Jon D , Claridge Richard , Halliday Douglas P. , Durose Ken
Published: September 2012

Chemical analysis of individual atom columns was carried out to determine the crystal structure and local point defect chemistry of Cu2ZnSnS4. Direct evidence for a nanoscale composition inhomogeneity, in the form of Zn enrichment and Cu depletion, was obtained. The lateral size of the composition inhomogeneity was estimated to be between ~1.5 and 5 nm. Photoluminescence confirmed the presence of a broad donor–acceptor transition consistent with the observed cation disorder. Areas of relatively high concentration of ZnCu+ antisite atom donors locally increases the electrostatic potential and gives rise to band bending. Troughs in the conduction band and peaks in the valence band are ‘potential wells’ for electrons and holes, respectively. For a solar cell, these prevent minority carrier electrons from diffusing towards the edge of the space charge region, thereby reducing the carrier separation efficiency as well as reducing the carrier collection efficiency of majority carrier holes. Furthermore, electrons and holes ‘trapped’ within potential wells in close proximity have a high probability of recombining, so that the carrier lifetime is also reduced. High quality Cu2ZnSnS4 crystals free from composition inhomogeneities are therefore required for achieving high efficiency solar cell devices. Copyright © 2012 John Wiley & Sons, Ltd.
Metal triflates and triflimides as Lewis “superacids”: preparation, synthetic application and affinity tests by mass spectrometry
Authors: Gal Jean‐François , Iacobucci Claudio , Monfardini Ilaria , Massi Lionel , Duñach Elisabet , Olivero Sandra
Published: September 2012

Metal salts of triflic acid, CF3SO2OH and of triflimidic acid, [CF3SO2]2NH, often called “Lewis superacids”, are powerful catalysts for several classes of reactions. Typical applications developed at the Institut de Chimie de Nice during the last decade, mostly in the domain of inter‐ and intramolecular carbon–carbon, carbon–oxygen and carbon–sulfur bond formation, are illustrated. During the last three years, the characterization of metal triflates and triflimides by electrospray mass spectrometry was also accomplished in our Institute. Displacement of one anion of the salt by strong neutral ligands was developed as a mean for generating characteristic positive ions. In an effort toward the quantitative description of the ligand/metal bonding and the catalytic role of the Lewis acid, a ligand competition method was devised. An exploratory study attests that subtle structural effects on the donor/acceptor interaction can be evidenced using this simple mass spectrometric method. Copyright © 2012 John Wiley & Sons, Ltd.
Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice
Authors: Tang Woung‐Ru , Fang Ji‐Tseng , Fang Chun‐Kai , Fujimori Maiko
Published: September 2012

Objective

Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross‐sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice.

Methods

The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth.

Results

Students' truth‐telling awareness was significantly higher than the clinical truth‐telling practice of attending physicians (p < 0.001), and the means for these parameters had a moderate difference, especially in three aspects: method, emotional support, and providing additional information (p < 0.001). Regardless of this difference, students were satisfied with the truth telling of attending physicians (mean ± SD = 7.33 ± 1.74). However, our data also show that when cancer patients were informed of bad news, they all experienced medium to above average distress (5.93 ± 2.19).

Conclusions

To develop the ability to tell the truth well, one must receive regular training in communication skills, including experienced attending physicians. This study found a significant difference between medical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.
Evaluation of the different strategies to oral cancer knowledge: a randomized controlled study
Authors: López‐Jornet Pia , Camacho‐Alonso Fabio , Miñano Francisco Molina , Sanchez‐Siles Mariano
Published: September 2012

Objectives

Oral cavity and pharyngeal cancer has been well recognized as a public health problem. Prognosis for oral cancer is substantially improved when diagnosed early. A study was made of the impact of different educational strategies upon knowledge of oral cancer, evaluating the intervention after 4 weeks.

Methods

Ninety subjects over 40 years of age were consecutively included and randomized to three different groups (video, leaflet, verbal information). All subjects completed a 20‐item pre‐test on their knowledge of the risk factors, signs, and symptoms of oral cancer, and posteriorly received the video, leaflet, or verbal information, with evaluation of the results after 4 weeks.

Results

In relation to the items correctly answered at baseline, all subjects showed an increase in knowledge score after 4 weeks: verbal information 4.77 ± 3.31, leaflets 4.53 ± 3.44, and video 3.67 ± 3.31 – no statistically significant differences being observed for any of the three strategies.

Conclusion

The oral cancer knowledge score increased following the educational intervention, which proved successful over the short term. Copyright © 2012 John Wiley & Sons, Ltd.
Synthesis and evaluation of tripeptidic plasmin inhibitors with nitrile as warhead
Authors: Teno Naoki , Otsubo Tadamune , Gohda Keigo , Wanaka Keiko , Sueda Takuya , Ikeda Kiyoshi , Hijikata‐Okunomiya Akiko , Tsuda Yuko
Published: September 2012

Plasmin is best known as the key molecule in the fibrinolytic system, which is critical for clot lysis and can initiate matrix metalloproteinase (MMP) activation cascade. Along with MMP, plasmin is suggested to be involved in physiological processes that are linked to the risk of carcinoma formation. Plasmin inhibitors could be perceived as a promising new principle in the treatment of diseases triggered by plasmin. On the basis of the peptidic sequence derived from the synthetic plasmin substrate, a series of peptidic plasmin inhibitors possessing nitrile as warhead were prepared and evaluated for their inhibitory activities against plasmin and other serine proteases, plasma kallikrein and urokinase. The most potent peptidic inhibitors with the nitrile warhead exhibit the potency toward plasmin (IC50 = 7.7–11 μM) and are characterized by their selectivity profile against plasma kallikrein and urokinase. The results and molecular modeling of the peptidic inhibitor complexed with plasmin reveal that the P2 residue makes favorable contacts with the open binding pocket comprising the S2 and S3 subsites of plasmin. Copyright © 2012 European Peptide Society and John Wiley & Sons, Ltd.
Elimination of silicon gas phase nucleation using tetrafluorosilane (SiF4) precursor for high quality thick silicon carbide (SiC) homoepitaxy
Authors: Rana T. , Chandrashekhar M. V. S. , Sudarshan T. S.
Published: September 2012

Tetrafluorosilane (SiF4) gas precursor is utilized to eliminate Si gas phase nucleation and Si parasitic deposition during silicon carbide (SiC) epitaxial growth, otherwise unachievable in similar growth conditions using conventional silane (SiH4) and dichlorosilane (SiCl2H2/DCS) precursors. Higher SiF bond strength (565 kJ mol−1) in SiF4 prevents early gas decomposition and Si cluster formation, essential for high temperature SiC chemical vapor deposition (CVD), and yet enables growth of high quality epitaxy in an improved particulate suppressed growth condition. High quality, thick 4H‐SiC epilayers >100 µm have been demonstrated using SiF4 with excellent surface morphology, polytype uniformity, crystallinity and low defect density.

magnified image

Significant (80%) suppression of parasitic deposition (left) using SiF4 reduces particulate generation during growth, and improves the epilayer quality (right).
Ab initio modelling of boron related defects in amorphous silicon
Authors: Oliveira Tiago A. , Torres Vítor J.B.
Published: September 2012

We have modeled boron related point defects in amorphous silicon, using an ab initio method, the Density functional theory‐pseudopotential code Aimpro. The boron atoms were embedded in 64 atom amorphous silicon cubic supercells. The calculations were performed using boron defects in 15 different supercells. These supercells were developed using a modified Wooten‐Winer‐Weaire bond switching mechanism. In average, the properties of the 15 supercells agree with the observed radial and bond angle distributions, as well the electronic and vibrational density of states and Raman spectra. In amorphous silicon it has been very hard to find real self‐interstitials, since for almost all the tested configurations, the amorphous lattice relaxes overall. We found that substitutional boron prefers to be 4‐fold coordinated. We find also an intrinsic hole‐trap in the non‐doped amorphous lattice, which may explain the low efficiency of boron doping. The local vibrational modes are, in average, higher than the correspondent crystalline values (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Mechanical grooving of oxidized porous silicon to reduce the reflectivity of monocrystalline silicon solar cells
Authors: Zarroug A. , Dimassi W. , Ouertani R. , Ezzaouia H.
Published: September 2012

In this work, we are interested to use oxidized porous silicon (ox–PS) as a mask. So, we display the creating of a rough surface which enhances the absorption of incident light by solar cells and reduces the reflectivity of monocrystalline silicon (c–Si). It clearly can be seen that the mechanical grooving enables us to elaborate the texturing of monocrystalline silicon wafer. Results demonstrated that the application of a PS layer followed by a thermal treatment under O2 ambient easily gives us an oxide layer of uniform size which can vary from a nanometer to about ten microns. In addition, the Fourier transform infrared (FTIR) spectroscopy investigations of the PS layer illustrates the possibility to realize oxide layer as a mask for porous silicon. We found also that this simple and low cost method decreases the total reflectivity (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
One‐step synthesis of a highly conductive graphene–polypyrrole nanofiber composite using a redox reaction and its use in gas sensors
Authors: Tien Huynh Ngoc , Hur Seung Hyun
Published: September 2012

A reduced graphene oxide (RGO) and polypyrrole (PPY) nanofiber composite was fabricated using a one‐step redox reaction under UV illumination at room temperature. Graphite oxide (GO) was effectively reduced to RGO without any chemical agent during the formation of the polypyrrole nanofibers. The RGO–PPY nanofiber composite showed four times higher NO2 sensitivity than that of RGO alone. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
A route to ultrathin quantum gases at polar perovskite heterointerfaces
Authors: Nazir S. , Schwingenschlögl U.
Published: September 2012

Oxide interfaces are attracting interest in recent years due to special functionalities of two‐dimensional quantum gases. However, with typical thicknesses of at least 10–12 Å the gases still extend considerably in the third dimension, which compromises the size of quantum effects. To overcome this limitation, we propose incorporation of highly electronegative cations, such as Ag. By ab initio calculations, we demonstrate the formation of a mobile two‐dimensional hole gas in AgNbO3/SrTiO3 that is confined to an ultrathin slab of only 5.6 Å thickness. Electronegative cations therefore are a promising way to enhance the quantum nature of hole gases. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Application of a stochastic model to response assessments in a study of squamous cell carcinoma of the head and neck
Authors: Hassani Habib
Published: September 2012

This paper discusses the application of a stochastic model in the analysis of response assessments made at various time points in a clinical trial of patients with squamous cell carcinoma of the head and neck. The transition rates and probabilities during treatment administration are derived using maximum likelihood methods. The results are then compared with the standard analyses used in solid tumour studies. Stochastic modelling is considered to complement the standard analyses, provide a holistic approach and better explain the underlying disease process. Copyright © 2012 John Wiley & Sons, Ltd.