bluuebunny/crossref_metadata_2025 huggingface dataset:
Does the Modified Harris Hip Score Reflect Patient Satisfaction After Hip Arthroscopy?
Authors: Aprato Alessandro , Jayasekera Narlaka , Villar Richard N.
Published: October 2012

Background:

No published studies have explored the relationship between commonly reported clinical outcomes and patient satisfaction after hip arthroscopy.

Purpose:

To compare the modified Harris Hip Score (mHHS) with patient satisfaction in a prospective study over a 2-year period.

Study Design:

Case series; Level of evidence, 4.

Methods:

We reviewed our institutional database for prospectively collected mHHS and patient satisfaction data from 697 patients. Patients were evaluated preoperatively and at 1 and 2 years after surgery.

Results:

The mHHS correlated with patient satisfaction at 1 year ( P < .001, Pearson R = 0.451) and at 2 years ( P < .001, Pearson R = .454). Considering scores from excellent to good as positive results and from fair to poor as negative results, sensitivity was 73% at 1 year and 77% at 2 years. Respectively, the specificity was 64% and 73%, positive predictive value 86% and 91%, negative predictive value 45% and 46%, and accuracy 71% and 76%. At 1- and 2-year follow-up, a respective 55% and 54% of patients with fair to poor mHHS were satisfied with the outcome of hip arthroscopy. In contrast, for those patients with an excellent to good mHHS at 1 and 2 years after surgery, 14% and 9%, respectively, were dissatisfied with their outcome.

Conclusion:

Our results show a correlation between patient satisfaction and the mHHS but also demonstrate a limitation of the mHHS as an outcome measure in the prediction of patient satisfaction. Further investigation is required to assess factors beyond current standard orthopaedic clinical outcome measures that may influence patient satisfaction after hip arthroscopy.
Synergestic effect of lycopene and Melatonin against the genesis of oxidative stress induced by cyclophosphamide in rats
Authors: Al-Malki Abdulrahman L
Published: October 2012

Cyclophosphamide (CP) is an alkylating agent that has been considered effective for cancer treatment. Lycopene, the pigment in tomato fruits, has beneficial effect in the treatment of some diseases. The goal of this study is to evaluate the protective effect of lycopene alone or combined with melatonin (Mel) in inhibiting the oxidative stress and toxic effect of CP in rats. Five groups of rats were included in this study; Group I served as the control. Rats in groups II-V were administrated with single dose of CP (150 mg/kg B.W) interperitoneally for 3 days. On the same day of CP administration, the rats in group III were fed a diet supplemented with lycopene (50 mg/kg of diet), rats in group IV were administered with a dose of 2.5 mg Mel/kg body weight (bw) injected subcutaneously and rats in group V were supplemented with lycopene and a dose of 2.5 mg Mel/kg bw injected subcutaneously. After 15 days the blood samples were collected. Results obtained showed that CP exerted its toxic effect by increasing the free radicals and reactive oxygen species that causes lipid peroxidation and cell damage, and this in turn is detected by elevation in nitric oxide (NO) and malondialdehyde (MDA), while the activities of antioxidants enzymes including (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)) were significantly decreased as compared with the control rats. The combined treatment (Lyco + Mel) group showed potential reduction in these parameters more than those treated with lyco alone. The activities of SOD, CAT and GPx were found significantly high than lyco alone treated rats. A positive significant correlation between NO and MDA ( r = .81). In conclusion, these results suggested that supplementation of diet with lycopene and Mel provided antioxidant defense with strong chemopreventive activity against Cp-induced cytotoxicity.
Reduction of aflatoxin in rice by different cooking methods
Authors: Sani Ali Mohamadi , Azizi Eisa Gholampour , Salehi Esmaeel Ataye , Rahimi Khadije
Published: October 2012

Rice ( Oryza sativa Linn) is one of the basic diets in the north of Iran. The aim of present study was to detect total aflatoxin (AFT) in domestic and imported rice in Amol (in the north of Iran) and to evaluate the effect of different cooking methods on the levels of the toxin. For this purpose, 42 rice samples were collected from retail stores. The raw samples were analysed by enzyme-linked immunosorbent assay (ELISA) technique for toxin assessment and then submitted to two different cooking methods including traditional local method and in rice cooker. After treatment, AFT was determined. Results show that the average concentration of AFT in domestic and imported samples was 1.08 ± 0.02 and 1.89 ± 0.87 ppb, respectively, which is lower than national and European Union standards. The highest AFT reduction (24.8%) was observed when rice samples were cooked by rice cooker  but the difference with local method was not statistically significant ( p > 0.05).
Dialectics of the African Diaspora: The glocality of race and resistance in the Brazilian economy of violence
Authors: Alves Jaime Amparo
Published: October 2012

This article looks at the dialectics of race, space and death in the structuring of black urban life and in the making of the African Diaspora. It argues the African diaspora should be understood not only within the perspectives of the historical trauma of racial terror but also through the spatial agency developed by people of African descent as a way to reconstitute the self and forge a political community. Based on fieldwork with black youth in a shantytown in the city of São Paulo, the article aims to investigate the political subjectivities created through the state’s (morbid) interpellation of black youth in the global city. In order to answer this question, it pays attention to the spatial praxis developed by the direct victims of state violence to reclaim their right to a city divided along racial lines. Finally, it suggests that the global and local articulations of race and racism also convey a transnational explosive black political identity of which black youth spatially grounded strategies of resistance are just one example.
Multi-steps degradation process prediction for bearing based on improved back propagation neural network
Authors: Mi Lin , Tan Wei , Chen Ran
Published: October 2012

Bearing degradation process prediction is extremely important in industry. This article proposed a new method to achieve multi-steps bearing degradation prediction based on an improved back propagation neural network model. Firstly, time domain and time–frequency domain features extraction methods are employed to extract the original features from the mass vibration signals. However, the extracted original features still with high dimensional and include superfluous information, the multi-features fusion technique principal component analysis is used to merge the original features and reduce the dimension, the typical sensitive features can be extracted. Then, based on the extracted features, the improved three-layer back propagation neural network model is constructed and trained for multi-steps bearing degradation process prediction. The phase space construction method is used to determine the embedding dimension of the back propagation neural network model. An accelerated bearing run-to-failure experiment was carried out, the results proved the effectiveness of the methodology.
Nature and Nurture in Personality Development
Authors: Kandler Christian
Published: October 2012

The stability of interindividual differences (i.e., rank-order continuity) in personality traits tends to increase with age until it plateaus in middle adulthood and finally decreases in old age. Rank-order continuity also tends to decrease as the time intervals between occasions of personality assessment increase, irrespective of age. These patterns show that personality development is a lifelong process. Yet the sources of these patterns are unknown. Theories suggest that personality continuity and change may result from environmentally mediated processes of identity development due to age-graded social roles and individual life experiences, but also from biological maturation. Genetically informative longitudinal studies across different age cohorts allow a differentiated picture of genetic and environmental sources. In this article, I give a short overview of the genetic and environmental contributions to rank-order continuity and change in neuroticism and extraversion. Both genetic and environmental factors contribute to personality continuity and change, but genetic factors affect rank-order change only in younger decades of life, whereas environmental influences appear to represent a lifelong source of interindividual differences in personality development.
Testing Enhances the Transfer of Learning
Authors: Carpenter Shana K.
Published: October 2012

Many studies have shown that retrieving information during a test facilitates later memory for that information. Most research on this testing effect has focused on retention of information measured via a final test that is similar to the initial test. Much less is known about the potential of testing to promote the application—i.e., transfer—of learning. In this article, I review recent studies that have begun to address this issue, specifically with regard to the benefits of testing on transfer across temporal contexts, test formats, and knowledge domains. The small but growing number of studies on this topic have so far reported robust benefits of testing on transfer of learning. Future research is encouraged that explores the potential of tests to promote not just direct retention of information, but also the application of knowledge to new situations.
The Development of Human Reproductive Strategies
Authors: Belsky Jay
Published: October 2012

An evolutionary-biological perspective on the effects of the extrafamilial and familial environment on multiple psychological, behavioral, and even somatic features of children’s development challenges prevailing thinking about human development, which regards some contextual conditions and their sequelae as “good” and others as “bad.” Theory and research on the development of human reproductive strategies based on such evolutionary thinking has evolved substantially over the past two decades. In this article, I review two decades of theory and research findings pertaining to the development of reproductive strategies—highlighting the contextual regulation of pubertal timing, the distinctive role of fathers, individuals’ differential susceptibility to rearing influences, mechanisms of influence, and new ways of conceptualizing influential environmental features—and outline future directions for research.
The Psychoneuroimmunology of Stress in Pregnancy
Authors: Coussons-Read Mary E.
Published: October 2012

The rate of preterm birth in the United States remains high. In up to 40% of cases of preterm birth, the mothers are healthy women who have no clear risk factors. Accordingly, research has begun to explore the effect of prenatal stress on the risk of preterm birth and shortened gestational age at birth. There is increasing evidence that psychosocial stress throughout gestation increases the risk of preterm birth through changes in maternal endocrine, immune, and inflammatory activity during pregnancy. In this article, I describe foundational and current research examining the effects and biological mechanisms of prenatal stress in preterm birth and shortened gestational age at birth. I emphasize psychoneuroimmunology-focused studies showing that prenatal stress alters inflammatory and endocrine markers during gestation and that these changes are associated with preterm birth and shortened gestational age at birth.
Activities and Programs That Improve Children’s Executive Functions
Authors: Diamond Adele
Published: October 2012

Executive functions (EFs; e.g., reasoning, working memory, and self-control) can be improved. Good news indeed, since EFs are critical for school and job success and for mental and physical health. Various activities appear to improve children’s EFs. The best evidence exists for computer-based training, traditional martial arts, and two school curricula. Weaker evidence, though strong enough to pass peer review, exists for aerobics, yoga, mindfulness, and other school curricula. Here I address what can be learned from the research thus far, including that EFs need to be progressively challenged as children improve and that repeated practice is key. Children devote time and effort to activities they love; therefore, EF interventions might use children’s motivation to advantage. Focusing narrowly on EFs or aerobic activity alone appears not to be as efficacious in improving EFs as also addressing children’s emotional, social, and character development (as do martial arts, yoga, and curricula shown to improve EFs). Children with poorer EFs benefit more from training; hence, training might provide them an opportunity to “catch up” with their peers and not be left behind. Remaining questions include how long benefits of EF training last and who benefits most from which activities.
Regretting it After? Focus Group Perspectives on Alcohol Consumption, Nonconsensual Sex and False Allegations of Rape
Authors: Gunby Clare , Carline Anna , Beynon Caryl
Published: October 2012

Research indicates that individuals often endorse beliefs that false allegations in rape cases are commonplace and are also reluctant to believe a woman who states she was raped whilst drinking alcohol. On this basis, it can be hypothesised that people are increasingly likely to believe that false allegations occur more often when the complainant has been drinking. In order to examine the ways in which alcohol intoxication and false allegations of rape intertwine, this article critically examines the findings of four focus groups which were based around a vignette in which sex takes place between intoxicated individuals and consent is disputed. The article examines participants’ personal beliefs around three major themes: ‘not quite rape’; false allegations of rape; and voluntary intoxication and intercourse. Although participants acknowledged that sexual intercourse when drunk to the point of incapacity may amount to an unpleasant experience, it was held to constitute something distinctly different to rape. Participants also argued that it would be unfair to hold a defendant criminally liable for intercourse when parties were equally drunk and that alcohol-involved consensual sex may be reclassified as rape the next morning in order to rationalise regretted drunken behaviour.
Hybrid solving algorithms for an extended dynamic constraint satisfaction problem based configuration system
Authors: Wang Lin , Ng Wee-Keong
Published: October 2012

In modern manufacturing, constraint satisfaction problem based product configuration systems have been recognized as an effective and promising approach to represent and solve product family design tasks. In this article, based on an extended dynamic constraint satisfaction problem based product configuration system, a hybrid constraint satisfaction problem solving algorithm with forward checking and backjumping with fail-first heuristic is proposed. To control backtracking occurrence in this hybrid solving algorithm when new active variables are introduced into dynamic constraint satisfaction problem, a hybrid heuristic (a combination of an amended most-constrained heuristic and fail-first heuristic) is integrated with forward checking and backjumping for better solution efficiency. Experiments on both algorithms have been performed on a dynamic constraint satisfaction problem based PC configuration task.
Active magnetic bearing design study
Authors: Barbaraci Gabriele , Mariotti Gabriele Virzì , Piscopo Alessio
Published: October 2012

The purpose of this paper is to propose a useful method to implement active magnetic bearings (AMBs) on an existing rotating shaft which rotates on conventional bearings. This is feasible if AMBs can produce the same reaction loads of conventional ones and if the size of vane is large enough to host an AMB. As this substitution could offer some difficulties due to the different size between magnetic bearings and conventional ones, a set of equations are performed to show that a variation of some parameters can solve this problem. The journal ratio is the geometrical parameter introduced to develop the present analysis. The variation of journal ratio does not produce a variation of the pole’s surface so that the reaction load does not change. The results are analyzed by numerical analysis by mathematical relationships involving the design parameters, magneto-static simulations and dynamic simulation on shaft when it is tested by disturbance rejection and reference tracking input in order to analyze the differences on dynamic behavior of the shaft on its suspended sections. Results show that the displacement pattern of the suspended sections remains unchanged, confirming that the reaction load, produced by pole expansion, remains the same varying the journal ratio.
Evaluation of clinical pharmacists’ follow-up service in an oncology pain clinic
Authors: Ryan Nikki , Chambers Carole , Ralph Christopher , England Dean , Cusano Frances
Published: October 2012

Background:

Patients who present with pain in an oncology setting are often complex and require a multidisciplinary approach for symptom control. The Pain and Symptom Control Clinic at Tom Baker Cancer Center includes two pharmacists who participate in weekly multidisciplinary clinics and provide a follow-up service to patients.

Objective:

This study will assess the impact of the pharmacists’ follow-up service with respect to activities performed as well as patient and health care professional satisfaction. The activities performed will also be compared to defined objectives for pharmacy practice in a hospital setting.

Methods:

Activities performed by the pharmacists over a 10-week period were recorded and tabulated. Online surveys were completed by health care professionals and telephone surveys were completed by patients 1 month post clinic visit.

Results:

Over 6 weeks, 44 patients assessed in clinic required follow-up from a pharmacist. There was an average of 2.3 interactions per patient and an average time of 85 min was spent on each patient outside of clinic. The three activities that occurred most frequently included: (1) interacting with other health care professionals, (2) making alterations to patients’ medication regimens, and (3) organizing refills. All health care professionals surveyed felt that the pharmacists’ follow-up service was a valuable component of the Pain and Symptom Control Clinic and nearly all patients surveyed reported a positive experience with the service received.

Conclusion:

The inclusion of pharmacists in the Pain and Symptom Control Clinic is favored by patients and health care professionals and provides increased efficiency to the clinic.
Research Use in School District Central Office Decision Making
Authors: Farley-Ripple Elizabeth N.
Published: October 2012

The current educational policy climate in the USA places immense pressure on school district central offices to use evidence to inform their decisions in order to improve student learning. In light of both the expectations of evidence-based decision making and the significance of central offices in supporting teaching and learning, there is considerably little understanding of whether, how and why central office decision makers use research evidence to support educational decisions. Through an embedded case study of Hamilton School District and three central office decisions, this research examines the role of research in central office decisions, focusing on how research is used, what research resources are used and the factors that influence use. Evidence of limited instrumental and political uses of research in comparison to conceptual and symbolic use, preferences for practitioner-oriented resources, and the importance of research attributes, organizational context and culture, and decision-maker characteristics are presented. Findings suggest a need for strategies to improve instrumental use, including reconsidering the production and dissemination of research, facilitating the flow of knowledge within the central office, and further examination of conceptual uses of research.
Integrated treatment of model and parameter uncertainties through a Bayesian approach
Authors: Droguett Enrique López , Mosleh Ali
Published: October 2012

Bayesian and non-Bayesian approaches have been proposed for treating model uncertainty; in general, model and parameter uncertainties have been tackled as separate domains. This article discusses a Bayesian framework for an integrated assessment of model and parameter uncertainties. The approach accommodates cases involving multiple dependent models, and we also demonstrate that under certain conditions, the model uncertainty assessment approaches known as model averaging and uncertainty-factor are special cases of the proposed formulation. These features are also demonstrated by means of a few examples of interest in the risk and safety domain.
Concussion in Sports
Authors: McCrea Heather J. , Perrine Kenneth , Niogi Sumit , Härtl Roger
Published: October 2012

Context:

Recently, concussion has become a topic of much discussion within sports. The goal of this review is to provide an overview of the literature concerning the definition of concussion, management of initial injury, return to play, and future health risks.

Evidence Acquisition:

This article reviews the most recent findings on recognizing and managing sports-related concussion, which has become a significant health risk. We reviewed articles from the literature discussing concussion and its effects.

Results:

Though concussion patients typically have negative head imaging, imaging is warranted in those with severe mechanism, significant loss of consciousness, focal neurologic deficit, or worsening symptoms. The existence of “second-impact syndrome,” whereby a first minor head injury predisposes an athlete to later catastrophic injury, remains controversial; however, it is clear that concussion has significant effects on a patient and should be considered carefully in return-to-play decisions.

Conclusions:

A comprehensive understanding of concussion and its related risks is important in making return-to-play decisions as well as health care and league policy.
The Current Care Delivery Practice for Asthma at the Emergency Department in a Tertiary Hospital in Singapore
Authors: Prabhakaran Lathy , Vasu Alicia , Yian Tay Seow , Abisheganaden John , Meiyi Wang , Mun Wong Wai
Published: October 2012

Introduction. Acute exacerbation of asthma is a common condition managed at emergency departments (EDs) globally, and many patients recognize the ED as a major source for their relief. Objectives. This study was done to evaluate the current care delivery practice for asthma at an ED and proposes possible strategies for improvement. Method. A retrospective chart review of all treated and discharged patients who were diagnosed with asthma was conducted between January 1, 2008, and December 31, 2008. Patients were excluded if they had a history of chronic obstructive pulmonary disease and congestive cardiac failure or were admitted for further management. Results. A total of 1303 patients treated and discharged from the ED were included. The mean age of the study population was 36.2 ± 16.2 years; 52.3% were male and 47.7% were female. Forty-eight percent of the patients were treated and discharged with no follow-up. Of those who were given follow-up appointments, 220 (16.9%) were referred to polyclinics and 41 (3.1%) to general practitioners. Ninety-six (7.4%) patients had a relapse within 30 days of discharge from the ED. The median number of days to relapse was 9 days (interquartile range = 3-19 days). Three hundred twenty-three (24.7%) patients re-attended the ED within the 1-year follow-up period. Of these, 252 (19.3%) re-attended ≤2 times and 71 (5.4%) re-attended ≥3 times. Within the follow-up period, 113 (8.7%) patients required admission for further management. Conclusion. There is a need to address gaps in the system and possible strategies have been proposed to improve asthma care for patients seeking treatment at the ED.
Long-term follow-up of hematologic relapse-free survival in a phase 2 study of blinatumomab in patients with MRD in B-lineage ALL
Authors: Topp Max S. , Gökbuget Nicola , Zugmaier Gerhard , Degenhard Evelyn , Goebeler Marie-Elisabeth , Klinger Matthias , Neumann Svenja A. , Horst Heinz A. , Raff Thorsten , Viardot Andreas , Stelljes Matthias , Schaich Markus , Köhne-Volland Rudolf , Brüggemann Monika , Ottmann Oliver G. , Burmeister Thomas , Baeuerle Patrick A. , Nagorsen Dirk , Schmidt Margit , Einsele Hermann , Riethmüller Gert , Kneba Michael , Hoelzer Dieter , Kufer Peter , Bargou Ralf C.
Published: October 2012

Persistence or recurrence of minimal residual disease (MRD) after chemotherapy results in clinical relapse in patients with acute lymphoblastic leukemia (ALL). In a phase 2 trial of B-lineage ALL patients with persistent or relapsed MRD, a T cell–engaging bispecific Ab construct induced an 80% MRD response rate. In the present study, we show that after a median follow-up of 33 months, the hematologic relapse-free survival of the entire evaluable study cohort of 20 patients was 61% (Kaplan-Meier estimate). The hema-tologic relapse-free survival rate of a subgroup of 9 patients who received allogeneic hematopoietic stem cell transplantation after blinatumomab treatment was 65% (Kaplan-Meier estimate). Of the subgroup of 6 Philadelphia chromosome–negative MRD responders with no further therapy after blinatumomab, 4 are in ongoing hematologic and molecular remission. We conclude that blinatumomab can induce long-lasting complete remission in B-lineage ALL patients with persistent or recurrent MRD. The original study and this follow-up study are registered at www.clinicaltrials.gov as NCT00198991 and NCT00198978, respectively.
Subcongenic analysis of tabw2obesity QTL on mouse chromosome 6
Authors: Stewart Taryn P , Mao Xia , Aqqad Maha N , Uffort Deon , Dillon Kristy D , Saxton Arnold M , Kim Jung Han
Published: October 2012

Background

We previously established a congenic mouse strain with TALLYHO/Jng (TH) donor segment on chromosome 6 in a C57BL/6 (B6) background that harbors an obesity quantitative trait locus, tabw2. The B6.TH-tabw2 congenic mice developed increased adiposity that became exacerbated upon feeding a high fat-high sucrose (HFS) diet. To fine map the tabw2, in this study we generated and characterized subcongenic lines with smaller TH donor segments.

Results

We fixed four subcongenic lines, with maximum size of donor segment retained in the lines ranging from 10.8 – 92.5 Mb. For mapping, all the subcongenic mice, along with B6.TH-tabw2 congenic and B6-homozygous control mice were fed either chow or HFS diets, and their post-mortem fat pads were weighed. Mice were also characterized for energy expenditure, respiratory exchange ratio, locomotor activity, and food intake. As previously reported, B6.TH-tabw2 congenic mice showed a significantly larger fat mass than controls on both diets. On chow, a subcongenic line retaining the distal region of the TH donor congenic interval exhibited significantly larger fat mass than B6-homozygous controls, and comparable that to B6.TH-tabw2 congenic mice. Two nested subcongenic lines within that region suggested that the effect of tabw2 on obesity could be attributed to at least two subloci. On HFS diets, on the other hand, all the subcongenic mice had significantly larger fat mass than controls without genotype differences, but none of them had fat mass as large as the original congenic mice. This possibly implicates that further genetic complexity involves in the effect of tabw2 on diet-induced obesity. Significantly reduced locomotor activity was exhibited in B6.TH-tabw2 congenic and subcongenic mice compared to controls when animals were fed HFS diets. B6.TH-tabw2 congenic mice, but not subcongenic mice, also had significantly increased food intake on HFS diets.

Conclusions

It appears that at least two subloci explaining the tabw2 effect under chow feeding map to the distal region of the congenic interval, whereas the diet-induced obesity mediated by tabw2 is attributed to more complex genetic mechanism.
Polymorphisms in ERCC1, GSTs, TS and MTHFR predict clinical outcomes of gastric cancer patients treated with platinum/5-Fu-based chemotherapy: a systematic review
Authors: Wang Zhen , Chen Jun-qiang , Liu Jin-lu , Qin Xin-gan , Huang Yuan
Published: October 2012

Background

Despite genetic polymorphism in response to platinum/5-Fu chemotherapy in gastric cancer (GC) has been studied, data reported so far are conflicting and critical consideration is needed before translation to the treatment of GC.

Methods

We performed a meta-analysis by using 20 eligible studies to examine polymorphisms of ERCC1, GSTs, TS and MTHFR in predicting clinical outcomes (response rate, overall survival and toxicity) of GC patients treated with platinum/5-Fu-based chemotherapy. The association was measured using random/fixed effect odds ratios (ORs) or hazard ratios (HRs) combined with their 95% confidence intervals (CIs) according to the studies’ heterogeneity. Statistical analysis was performed with the software STATA 9.0 package.

Results

No significant association was found between response rate and genetic polymorphism in TS, MTHFR, ERCC1, GSTM1 and GSTP1. However, response rate was higher in GSTT1 (+) genotype compared with GSTT1 (−) genotype (T-/T+: OR=0.67, 95% CI: 0.47–0.97). With regard to long term outcomes, we could observe a significant longer overall survival in TS 3R/3R [(2R2R+2R3R)/3R3R: HR=1.29, 95% CI: 1.02–1.64] and GSTP1 GG/GA [(GG+AG)/AA: HR=0.51, 95% CI: (0.39, 0.67)] genotypes. In addition, significant association was demonstrated between toxicity and genetic polymorphism in TS, MTHFR and GSTP1 in included studies.

Conclusion

Polymorphisms of ERCC1, GSTs, TS and MTHFR were closely associated with clinical outcomes of GC patients treated with platinum/5-Fu-based chemotherapy. Studies with large sample size using the method of multi-variant analyses may help us to give more persuasive data on the putative association in future.
Evidence for different mechanisms of ‘unhooking’ for melphalan and cisplatin-induced DNA interstrand cross-links in vitroand in clinical acquired resistant tumour samples
Authors: Spanswick Victoria J , Lowe Helen L , Newton Claire , Bingham John P , Bagnobianchi Alessia , Kiakos Konstantinos , Craddock Charles , Ledermann Jonathan A , Hochhauser Daniel , Hartley John A
Published: October 2012

Background

DNA interstrand cross-links (ICLs) are critical lesions produced by several cancer chemotherapy agents including platinum drugs and nitrogen mustards. We have previously shown in haematological (multiple myeloma) and solid tumours (ovarian cancer) that clinical sensitivity to such agents can result from a defect in DNA ICL processing leading to their persistence. Conversely, enhanced repair can result in clinical acquired resistance following chemotherapy. The repair of ICLs is complex but it is assumed that the ‘unhooking’ step is common to all ICLs.

Methods

Using a modification of the single cell gel electrophoresis (Comet) assay we measured the formation and unhooking of melphalan and cisplatin-induced ICLs in cell lines and clinical samples. DNA damage response in the form of γ-H2AX foci formation and the formation of RAD51 foci as a marker of homologous recombination were also determined. Real-time PCR of 84 genes involved in DNA damage signalling pathways was also examined pre- and post-treatment.

Results

Plasma cells from multiple myeloma patients known to be clinically resistant to melphalan showed significant unhooking of melphalan-induced ICLs at 48 hours, but did not unhook cisplatin-induced ICLs. In ovarian cancer cells obtained from patients following platinum-based chemotherapy, unhooking of cisplatin-induced ICLs was observed at 48 hours, but no unhooking of melphalan-induced ICLs. In vitro, A549 cells were proficient at unhooking both melphalan and cisplatin-induced ICLs. γ-H2AX foci formation closely followed the formation of ICLs for both drugs, and rapidly declined following the peak of formation. RPMI8226 cells unhooked melphalan, but not cisplatin-induced ICLs. In these cells, although cross-links form with cisplatin, the γ-H2AX response is weak. In A549 cells, addition of 3nM gemcitabine resulted in complete inhibition of cisplatin-induced ICL unhooking but no effect on repair of melphalan ICLs. The RAD51 foci response was both drug and cell line specific. Real time PCR studies highlighted differences in the damage response to melphalan and cisplatin following equi-ICL forming doses.

Conclusions

These data suggest that the mechanisms by which melphalan and cisplatin-induced ICLs are ‘unhooked’ in vitro are distinct, and the mechanisms of clinical acquired resistance involving repair of ICLs, are drug specific.
A cluster-randomized controlled trial of strategies to increase adolescents’ physical activity and motivation during physical education lessons: the Motivating Active Learning in Physical Education (MALP) trial
Authors: Rosenkranz Richard R , Lubans David R , Peralta Louisa R , Bennie Andrew , Sanders Taren , Lonsdale Chris
Published: October 2012

Background

The physical activity (PA) levels of many children and adolescents in Australia are currently insufficient to promote health benefits. Physical education (PE) programs aim to promote PA and reach nearly all school-aged children, but PA levels within PE lessons are often low. PE teachers may influence children’s motivation to be physically active in PE lessons, but little is known about teacher strategies that effectively motivate children to participate in PA, and few intervention studies have examined motivational strategies in PE. The purpose of this study was to compare the effect of three motivational strategies, each based on Self-Determination Theory (SDT), on PA levels, and their hypothesized antecedents, during year 8 PE lessons.

Methods/design

This study employed a cluster-randomized controlled trial design. Following a familiarization session, PA levels and hypothesized PA antecedents were measured during a baseline lesson and a post-intervention or control lesson. Teachers (n = 16) and their classes from five secondary schools in Sydney, Australia were randomly assigned into four blocks and instructed to provide one of four 20-min lesson teaching strategy conditions: (1) explaining the relevance of activities; (2) providing choice from PA options selected by the teacher; (3) providing equipment and free choice of activities; or (4) usual practice. The primary outcomes were lesson time spent in moderate-to-vigorous PA, and motivation towards the lesson. Secondary outcomes were perceptions of teacher behavior, psychological needs satisfaction, and lesson time spent in sedentary behavior. PA and sedentary behavior were measured during baseline and post-intervention lessons with waist-mounted Actigraph GT3X accelerometers. Teacher behavior, psychological needs satisfaction, and motivation were assessed via questionnaires at the end of each lesson. Linear mixed-model analyses will be run on all outcomes, with students nested within teachers as a random effect.

Discussion

Study findings will inform the development of effective SDT-based teaching strategy interventions to enhance students’ psychological needs satisfaction, motivation, and PA levels. More effective teaching strategies may be identified that are capable of improving adolescents’ PA levels, and thereby provide beneficial population health outcomes.

Trial registration

This trial is registered with Current Controlled Trials and is traceable as ISRCTN07038258.
Homeopathy for mental fatigue: lessons from a randomized, triple blind, placebo-controlled cross-over clinical trial
Authors: Dean Michael Emmans , Karsandas Raj , Bland J Martin , Gooch Debbie , MacPherson Hugh
Published: October 2012

Background

Difficulty in controlling attention can lead to mental fatigue in the healthy population. We identified one trial reporting a benefit in patients’ attention using a homeopathic formula preparation. One component of the preparation was potassium phosphate, widely available off the shelf as Kali phos 6x for cognitive problems. The aim of this exploratory trial was to assess the effectiveness of Kali phos 6x for attention problems associated with mental fatigue.

Methods

We recruited student and staff volunteers (University of York) with self-reported mental fatigue, excluding any using homeopathy or prescribed stimulants, or with a diagnosis of chronic fatigue syndrome. In a triple blind, cross-over, placebo-controlled clinical trial, 86 volunteers were randomized to receive Kali phos 6x or identical placebo 10 minutes before taking a psychological test of attention (Stroop Colour-Word Test). One week later they were crossed over and took the other preparation before repeating the test.

Results

We found no evidence of a treatment effect in a comparison of Kali phos 6x with placebo (Kali phos minus placebo = −1.1 (95% CI −3.0 to 0.9, P = 0.3) Stroop score units, Cohen effect size = −0.17) even when allowing for a weak period effect with accuracy scores in the second period being higher than those in the first (P = 0.05). We observed a ceiling effect in the Stroop test which undermined our ability to interpret this result.

Conclusions

Kali phos 6x was not found to be effective in reducing mental fatigue. A ceiling effect in our primary outcome measure meant that we could not rule out a type II error. Thorough piloting of an adequate outcome measure could have led to an unequivocal result.

Current Controlled Trials

ISRCTN16521161
Frequency of subtype B and F1 dual infection in HIV-1 positive, Brazilian men who have sex with men
Authors: Soares de Oliveira Ana Carolina , Pessôa de Farias Rodrigo , da Costa Antonio Charlys , Sauer Mariana Melillo , Bassichetto Katia Cristina , Oliveira Solange Maria Santos , Costa Priscilla Ramos , Tomiyama Claudia , Tomiyama Helena Tomoko Iwashita , Sabino Ester Cerdeira , Kallas Esper Georges , Sanabani Sabri Saeed
Published: October 2012

Background

Because various HIV vaccination studies are in progress, it is important to understand how often inter- and intra-subtype co/superinfection occurs in different HIV-infected high-risk groups. This knowledge would aid in the development of future prevention programs. In this cross-sectional study, we report the frequency of subtype B and F1 co-infection in a clinical group of 41 recently HIV-1 infected men who have sex with men (MSM) in São Paulo, Brazil.

Methodology

Proviral HIV-1 DNA was isolated from subject's peripheral blood polymorphonuclear leukocytes that were obtained at the time of enrollment. Each subject was known to be infected with a subtype B virus as determined in a previous study. A small fragment of the integrase gene (nucleotide 4255–4478 of HXB2) was amplified by nested polymerase chain reaction (PCR) using subclade F1 specific primers. The PCR results were further confirmed by phylogenetic analysis. Viral load (VL) data were extrapolated from the medical records of each patient.

Results

For the 41 samples from MSM who were recently infected with subtype B virus, it was possible to detect subclade F1 proviral DNA in five patients, which represents a co-infection rate of 12.2%. In subjects with dual infection, the median VL was 5.3 × 104 copies/ML, whereas in MSM that were infected with only subtype B virus the median VL was 3.8 × 104 copies/ML (p > 0.8).

Conclusions

This study indicated that subtype B and F1 co-infection occurs frequently within the HIV-positive MSM population as suggested by large number of BF1 recombinant viruses reported in Brazil. This finding will help us track the epidemic and provide support for the development of immunization strategies against the HIV.
Identification of a conserved linear B-cell epitope in the M protein of porcine epidemic diarrhea virus
Authors: Zhang Zhibang , Chen Jianfei , Shi Hongyan , Chen Xiaojin , Shi Da , Feng Li , Yang Bin
Published: October 2012

Background

The major structural protein of coronaviruses, the membrane (M) protein, can elicit the formation of protective antibodies, but little information is available about the M protein of porcine epidemic diarrhea virus (PEDV). Identification of epitopes on the PEDV M protein will be helpful in the elucidation of the antigenic properties of this protein.

Results

One hybridoma cell line secreting anti-M protein monoclonal antibody (McAb) was generated and designated 4D4. To map the epitopes on the PEDV M protein, a total of 17 partially overlapping fragments covering the C-terminus of M protein were expressed as fusion proteins with a 6×His tag or a GST tag. A linear motif, 193TGWAFYVR200, was identified by enzyme-linked immunosorbent assay (ELISA) and western blot (WB) analysis using McAb 4D4. The motif 195WAFYVR200 was the minimal requirement for reactivity, as demonstrated by removing amino acids individually from both ends of the motif 193TGWAFYVR200. The result of WB analysis showed that the 4D4-defined epitope could be recognized by PEDV-positive serum, but not transmissible gastroenteritis virus (TGEV)-positive serum. Furthermore, this epitope was highly conserved among different PEDV strains, as shown by alignment and comparison of sequences.

Conclusion

A McAb, 4D4, directed against the M protein of PEDV, was obtained, and the 4D4-defined minimal epitope sequence was 195WAFYVR200. The McAb could serve as a candidate for development of a McAb-based antigen capture ELISA for detection of PEDV. The epitope identified provides a basis for the development of epitope-based differential diagnostic techniques and may be useful in the design of epitope-based vaccines.
Incidental intraoperative discovery of a pancreatic neuroendocrine tumor associated with chronic pancreatitis
Authors: Surlin Valeriu , Ramboiu Sandu , Ghilusi Mirela , Plesea Iancu Emil
Published: October 2012

Pancreatic neuroendocrine tumors are a rare entity with an incidence between 2 per million to 5 per 100 000. Association with pancreatitis (acute or chronic) is rare and is considered to be determined by the tumoral obstruction of pancreatic ducts, but sometimes occurs without any apparent relationship between them. Non-functional neuroendocrine pancreatic tumors are usually diagnosed when either very large or metastatic. Small ones are occasionally diagnosed when imagery is performed for other diagnostic reasons. Intraoperative discovery is even rarer and poses problems of differential diagnosis with other pancreatic tumors. Association with chronic pancreatitis is rare and usually due to pancreatic duct obstruction by the tumor. We describe the case of a patient with a small non-functioning neuroendocrine tumor in the pancreatic tail accidentally discovered during surgery for delayed traumatic splenic rupture associated with chronic alcoholic pancreatitis. The tumor of 1.5cm size was well differentiated and confined to the pancreas, and was resected by a distal splenopancreatectomy.

Conclusions

Surgeons should be well aware of the rare possibility of a non-functional neuroendocrine tumor in the pancreas, associated with chronic pancreatitis, surgical resection being the optimal treatment for cure. Histopathology is of utmost importance to establish the correct diagnosis, grade of differentiation, malignancy and prognosis.

Virtual slides

The virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/2114470176676003.
Reduction of peak plantar pressure in people with diabetes‐related peripheral neuropathy: an evaluation of the DH Pressure Relief Shoe™
Authors: Raspovic Anita , Landorf Karl B , Gazarek Jana , Stark Megan
Published: October 2012

Background

Offloading plantar pressure is a key strategy for the prevention or healing of neuropathic plantar ulcers in diabetes. Non‐removable walking casts, such as total contact casts, are currently considered the gold‐standard for offloading this type of wound. However, alternative methods for offloading that are more cost effective and easier to use are continually being sought. The aim of this study was to evaluate the capacity of the DH Pressure Relief Shoe™ to offload high pressure areas under the neuropathic foot in diabetes.

Methods

A within‐subjects, repeated measures design was used. Sixteen participants with diabetic peripheral neuropathy were recruited and three footwear conditions were evaluated in a randomised order: a canvas shoe (the control), the participants' own standard shoe, and the DH Pressure Relief Shoe™. The primary outcome was peak plantar pressure, measured using the pedar‐X® mobile in‐shoe system between the three conditions.

Results

Data analysis was conducted on 14 out of the 16 participants because two participants could not complete data collection. The mean peak pressure values in kPa (±SD) for each condition were: control shoe 315.9 (±140.7), participants' standard shoe 273.0 (±127.1) and DH Pressure Relief Shoe™ 155.4 (±89.9). There was a statistically significant difference in peak plantar pressure between the DH Pressure Relief Shoe™ compared to both the control shoe (p = 0.002) and participants' standard shoe (p = 0.001). The DH Pressure Relief Shoe™ decreased plantar pressures by 51% compared to the control shoe and by 43% compared to participants' standard shoe. Importantly, for a couple of study participants, the DH Pressure Relief Shoe™ appeared unsuitable for day‐to‐day wearing.

Conclusions

The DH Pressure Relief Shoe™ reduced plantar pressures more than the other two shoe conditions. The DH Pressure Relief Shoe™ may be a useful alternative to current offloading modalities used in clinical management of diabetic foot ulceration. However, clinical trials are needed to test their effectiveness for ulcer healing and to ensure they are useable and safe for patients in everyday activities.
A positive serum basophil histamine release assay is a marker for ciclosporin‐responsiveness in patients with chronic spontaneous urticaria
Authors: Iqbal Kamran , Bhargava Kapil , Skov Per Stahl , Falkencrone Sidsel , Grattan Clive EH
Published: October 2012

The electronic records of 398 patients with chronic spontaneous urticaria (CSU) who had had a serum basophil histamine release assay (BHRA) performed as a marker of functional autoantibodies were audited. The BHRA was positive in 105 patients (26.4%). Fifty eight were treated with ciclosporin because they were H1 anti‐histamine unresponsive. CSU patients with a positive BHRA were more likely to respond clinically (P<0.001) and to have raised thyroid autoantibodies (P<0.02) than those with a negative BHRA. The BHRA offers a useful predictive biomarker for a good response of H1 antihistamine‐unresponsive CSU patients to ciclosporin.