bluuebunny/crossref_metadata_2025 huggingface dataset:
Adult male circumcision as an intervention against HIV: An operational study of uptake in a South African community (ANRS 12126)
Authors: Lissouba Pascale , Taljaard Dirk , Rech Dino , Dermaux-Msimang Veerle , Legeai Camille , Lewis David , Singh Beverley , Puren Adrian , Auvert Bertran
Published: September 2011

Background

To evaluate the knowledge, attitudes and beliefs about adult male circumcision (AMC), assess the association of AMC with HIV incidence and prevalence, and estimate AMC uptake in a Southern African community.

Methods

A cross-sectional biomedical survey (ANRS-12126) conducted in 2007-2008 among a random sample of 1198 men aged 15 to 49 from Orange Farm (South Africa). Face-to-face interviews were conducted by structured questionnaire. Recent HIV infections were evaluated using the BED incidence assay. Circumcision status was self-reported and clinically assessed. Adjusted HIV incidence rate ratios (aIRR) and prevalence ratios (aPR) were calculated using Poisson regression.

Results

The response rate was 73.9%. Most respondents agreed that circumcised men could become HIV infected and needed to use condoms, although 19.3% (95%CI: 17.1% to 21.6%) asserted that AMC protected fully against HIV. Among self-reported circumcised men, 44.9% (95%CI: 39.6% to 50.3%) had intact foreskins. Men without foreskins had lower HIV incidence and prevalence than men with foreskins (aIRR = 0.35; 95%CI: 0.14 to 0.88; aPR = 0.45, 95%CI: 0.26 to 0.79). No significant difference was found between self-reported circumcised men with foreskins and other uncircumcised men. Intention to undergo AMC was associated with ethnic group and partner and family support of AMC. Uptake of AMC was 58.8% (95%CI: 55.4% to 62.0%).

Conclusions

AMC uptake in this community is high but communication and counseling should emphasize what clinical AMC is and its effect on HIV acquisition. These findings suggest that AMC roll-out is promising but requires careful implementation strategies to be successful against the African HIV epidemic.
Evaluation of an electronic warfarin nomogram for anticoagulation of hemodialysis patients
Authors: Thomson Benjamin KA , MacRae Jennifer M , Barnieh Lianne , Zhang Jianguo , MacKay Elizabeth , Manning Megan A , Hemmelgarn Brenda R
Published: September 2011

Background

Warfarin nomograms to guide dosing have been shown to improve control of the international normalized ratio (INR) in the general outpatient setting. However, the effectiveness of these nomograms in hemodialysis patients is unknown. We evaluated the effectiveness of anticoagulation using an electronic warfarin nomogram administered by nurses in outpatient hemodialysis patients, compared to physician directed therapy.

Methods

Hemodialysis patients at any of the six outpatient clinics in Calgary, Alberta, treated with warfarin anticoagulation were included. Two five-month time periods were compared: prior to and post implementation of the nomogram. The primary endpoint was adequacy of anticoagulation (proportion of INR measurements within range ± 0.5 units).

Results

Overall, 67 patients were included in the pre- and 55 in the post-period (with 40 patients in both periods). Using generalized linear mixed models, the adequacy of INR control was similar in both periods for all range INR levels: in detail, range INR 1.5 to 2.5 (pre 93.6% (95% CI: 88.6% - 96.5%); post 95.6% (95% CI: 89.4% - 98.3%); p = 0.95); INR 2.0 to 3.0 (pre 82.2% (95% CI: 77.9% - 85.8%); post 77.4% (95% CI: 72.0% - 82.0%); p = 0.20); and, INR 2.5 to 3.5 (pre 84.3% (95% CI: 59.4% - 95.1%); post 66.8% (95% CI: 39.9% - 86.0%); p = 0.29). The mean number of INR measurements per patient decreased significantly between the pre- (30.5, 95% CI: 27.0 - 34.0) and post- (22.3, 95% CI: 18.4 - 26.1) (p = 0.003) period. There were 3 bleeding events in each of the periods.

Conclusions

An electronic warfarin anticoagulation nomogram administered by nurses achieved INR control similar to that of physician directed therapy among hemodialysis patients in an outpatient setting, with a significant reduction in frequency of testing. Future controlled trials are required to confirm the efficacy of this nomogram.
Water outage increases the risk of gastroenteritis and eyes and skin diseases
Authors: Huang Ling-Ya , Wang Yu-Chun , Liu Chung-Ming , Wu Trong-Neng , Chou Chang-Hung , Sung Fung-Chang , Wu Chin-Ching
Published: September 2011

Background

The present study used insurance claims data to investigate infections associated with short-term water outage because of constructions or pipe breaks.

Methods

The present study used medical claims of one million insured persons for 2004-2006. We estimated incidences of gastroenteritis and eye and skin complaints for 10 days before, during, and after 10 days of water supply restriction for outpatient visits and for emergency and in-patient care combined.

Results

There was an increase in medical services for these complaints in outpatient visits because of water outages. Poisson regression analyses showed that increased risks of medical services were significant for gastroenteritis (relative risk [RR] 1.31, 95% confidence interval [CI] 1.26-1.37), skin disease (RR 1.36, 95% CI 1.30-1.42), and eye disease patients (RR 1.34, 95% CI 1.26-1.44). Similar risks were observed during 10-day lag periods. Compared with those in cool days, risks of medical services are higher when average daily temperature is above 30°C for gastroenteritis (RR 12.1, 95% CI 6.17-23.7), skin diseases (RR 4.48, 95% CI 2.29-8.78), and eye diseases (RR 40.3, 95% CI 7.23-224).

Conclusion

We suggest promoting personal hygiene education during water supply shortages, particularly during the warm months.
Geo-mapping of caries risk in children and adolescents - a novel approach for allocation of preventive care
Authors: Strömberg Ulf , Magnusson Kerstin , Holmén Anders , Twetman Svante
Published: September 2011

Background

Dental caries in children is unevenly distributed within populations with a higher burden in low socio-economy groups. Thus, tools are needed to allocate resources and establish evidence-based programs that meet the needs of those at risk. The aim of the study was to apply a novel concept for presenting epidemiological data based on caries risk in the region of Halland in southwest Sweden, using geo-maps.

Methods

The study population consisted of 46,536 individuals between 3-19 years of age (75% of the eligible population) from whom caries data were reported in 2010. Reported dmfs/DMFS>0 for an individual was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish. A parish-specific relative risk (RR) was calculated as the observed-to-expected ratio, where the expected number of individuals with dmfs/DMFS>0 was obtained from the age- and sex-specific caries (dmfs/DMFS>0) rates for the total study population. Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI® ArcGIS system.

Results

The geo-maps of preschool children (3-6 years), schoolchildren (7-11 years) and adolescents (12-19 years) displayed obvious geographical variations in caries risk, albeit most marked among the preschoolers. Among the preschool children the smoothed relative risk (SmRR) varied from 0.33 to 2.37 in different parishes. With increasing age, the contrasts seemed to diminish although the gross geographical risk pattern persisted also among the adolescents (SmRR range 0.75-1.20).

Conclusion

Geo-maps based on caries risk may provide a novel option to allocate resources and tailor supportive and preventive measures within regions with sections of the population with relatively high caries rates.
It's all about the children: a participant-driven photo-elicitation study of Mexican-origin mothers' food choices
Authors: Johnson Cassandra M , Sharkey Joseph R , Dean Wesley R
Published: September 2011

Background

There is a desperate need to address diet-related chronic diseases in Mexican-origin women, particularly for those in border regioncolonias(Mexican settlements) and other new destination communities in rural and non-rural areas of the U.S. Understanding the food choices of mothers, who lead food and health activities in their families, provides one way to improve health outcomes in Mexican-origin women and their children. This study used a visual method, participant-driven photo-elicitation, and grounded theory in a contextual study of food choices from the perspectives of Mexican-origin mothers.

Methods

Teams of trainedpromotoras(female community health workers from the area) collected all data in Spanish. Ten Mexican-origin mothers living incoloniasin Hidalgo County, TX completed a creative photography assignment and an in-depth interview using their photographs as visual prompts and examples. English transcripts were coded inductively by hand, and initial observations emphasized the salience of mothers' food practices in their routine care-giving. This was explored further by coding transcripts in the qualitative data analysis software Atlas.ti.

Results

An inductive conceptual framework was created to provide context for understanding mothers' daily practices and their food practices in particular. Three themes emerged from the data: 1) a mother's primary orientation was toward her children; 2) leveraging resources to provide the best for her children; and 3) a mother's daily food practices kept her children happy, healthy, and well-fed. Results offer insight into the intricate meanings embedded in Mexican-origin mothers' routine food choices.

Conclusions

This paper provides a new perspective for understanding food choice through the eyes of mothers living in thecoloniasof South Texas -- one that emphasizes the importance of children in their routine food practices and the resilience of the mothers themselves. Additional research is needed to better understand mothers' perspectives and food practices with larger samples of women and among other socioeconomic groups.
Members of the murine Pate family are predominantly expressed in the epididymis in a segment-specific fashion and regulated by androgens and other testicular factors
Authors: Turunen Heikki T , Sipilä Petra , Pujianto Dwi Ari , Damdimopoulos Anastasios E , Björkgren Ida , Huhtaniemi Ilpo , Poutanen Matti
Published: September 2011

Background

Spermatozoa leaving the testis are not able to fertilize the eggin vivo. They must undergo further maturation in the epididymis. Proteins secreted to the epididymal lumen by the epithelial cells interact with the spermatozoa and enable these maturational changes, and are responsible for proper storage conditions before ejaculation. The present study was carried out in order to characterize the expression of a novelPate(prostateandtestisexpression) gene family, coding for secreted cysteine-rich proteins, in the epididymis.

Methods

Murine genome databases were searched and sequence comparisons were performed to identify members of thePategene family, and their expression profiles in several mouse tissues were characterized by RT-PCR. Alternate transcripts were identified by RT-PCR, sequencing and Northern hybridization. Also, to study the regulation of expression ofPatefamily genes by the testis, quantitative (q) RT-PCR analyses were performed to compare gene expression levels in the epididymides of intact mice, gonadectomized mice, and gonadectomized mice under testosterone replacement treatment.

Results

A revised family tree ofPategenes is presented, including a previously uncharacterizedPategene namedPate-X, and the data revealed thatAcrv1andSslp1should also be considered as members of thePatefamily. Alternate splicing was observed forPate-X, Pate-CandPate-M. All thePategenes studied are predominantly expressed in the epididymis, whereas expression in the testis and prostate is notably lower. Loss of androgens and/or testicular luminal factors was observed to affect the epididymal expression of severalPategenes.

Conclusions

We have characterized a gene cluster consisting of at least 14 expressedPategene members, includingAcrv1, Sslp1and a previously uncharacterized gene which we namedPate-X. The genes code for putatively secreted, cysteine-rich proteins with a TFP/Ly-6/uPAR domain. Members of thePategene cluster characterized are predominantly expressed in the murine epididymis, not in the testis or prostate, and are regulated by testicular factors. Similar proteins are present in venoms of several reptiles, and they are thought to mediate their effects by regulating certain ion channels, and are thus expected to have a clinical relevance in sperm maturation and epididymal infections.
c-Jun NH2-terminal kinase activation is essential for up-regulation of LC3 during ceramide-induced autophagy in human nasopharyngeal carcinoma cells
Authors: Sun Ting , Li DanDan , Wang LinLin , Xia LiangPing , Ma JianGuo , Guan Zhong , Feng GongKan , Zhu XiaoFeng
Published: September 2011

Background

Autophagy is a dynamic catabolic process characterized by the formation of double membrane vacuoles termed autophagosomes. LC3, a homologue of yeast Atg8, takes part in autophagosome formation, but the exact regulation mechanism of LC3 still needs to be elucidated.

Methods

Ceramide-induced autophagy was determined by detecting LC3 expression with Western blotting and confocal microscopy in human nasopharyngeal carcinoma cell lines CNE2 and SUNE1. The activation of JNK pathway was assessed by Western blotting for phospho-specific forms of JNK and c-Jun. The JNK activity specific inhibitor, SP600125, and siRNA directed against JNK were used to block JNK/c-Jun pathway. ChIP and luciferase reporter analysis were applied to determine whether c-Jun was involved in the regulation of LC3 transcription.

Results

Ceramide-treated cells exhibited the characteristics of autophagy and JNK pathway activation. Inhibition of JNK pathway could block the ceramide-induced autophagy and the up-regulation of LC3 expression. Transcription factor c-Jun was involved in LC3 transcription regulation in response to ceramide treatment.

Conclusions

Ceramide could induce autophagy in human nasopharyngeal carcinoma cells, and activation of JNK pathway was involved in ceramide-induced autophagy and LC3 expression.
Fixed point theory for multivalued φ-contractions
Authors: Lazăr Vasile L
Published: September 2011

The purpose of this paper is to present a fixed point theory for multivalued φ-contractions using the following concepts: fixed points, strict fixed points, periodic points, strict periodic points, multivalued Picard and weakly Picard operators; data dependence of the fixed point set, sequence of multivalued operators and fixed points, Ulam-Hyers stability of a multivalued fixed point equation, well-posedness of the fixed point problem, limit shadowing property of a multivalued operator, set-to-set operatorial equations and fractal operators. Our results generalize some recent theorems given in Petruşel and Rus (The theory of a metric fixed point theorem for multivalued operators, Proc. Ninth International Conference on Fixed Point Theory and its Applications, Changhua, Taiwan, July 16-22, 2009, 161-175, 2010).

2010 Mathematics Subject Classification

47H10; 54H25; 47H04; 47H14; 37C50; 37C70
In vivo kinetics of transcription initiation of the lar promoter in Escherichia coli. Evidence for a sequential mechanism with two rate-limiting steps
Authors: Kandhavelu Meenakshisundaram , Mannerström Henrik , Gupta Abhishekh , Häkkinen Antti , Lloyd-Price Jason , Yli-Harja Olli , Ribeiro Andre S
Published: September 2011

Background

InEscherichia colithe mean and cell-to-cell diversity in RNA numbers of different genes vary widely. This is likely due to different kinetics of transcription initiation, a complex process with multiple rate-limiting steps that affect RNA production.

Results

We measured thein vivokinetics of production of individual RNA molecules under the control of the lar promoter inE. coli. From the analysis of the distributions of intervals between transcription events in the regimes of weak and medium induction, we find that the process of transcription initiation of this promoter involves a sequential mechanism with two main rate-limiting steps, each lasting hundreds of seconds. Both steps become faster with increasing induction by IPTG and Arabinose.

Conclusions

The two rate-limiting steps in initiation are found to be important regulators of the dynamics of RNA production under the control of the lar promoter in the regimes of weak and medium induction. Variability in the intervals between consecutive RNA productions is much lower than if there was only one rate-limiting step with a duration following an exponential distribution. The methodology proposed here to analyze thein vivodynamics of transcription may be applicable at a genome-wide scale and provide valuable insight into the dynamics of prokaryotic genetic networks.
Metabolic network modeling of redox balancing and biohydrogen production in purple nonsulfur bacteria
Authors: Hädicke Oliver , Grammel Hartmut , Klamt Steffen
Published: September 2011

Background

Purple nonsulfur bacteria (PNSB) are facultative photosynthetic bacteria and exhibit an extremely versatile metabolism. A central focus of research on PNSB dealt with the elucidation of mechanisms by which they manage to balance cellular redox under diverse conditions, in particular under photoheterotrophic growth.

Results

Given the complexity of the central metabolism of PNSB, metabolic modeling becomes crucial for an integrated analysis of the accumulated biological knowledge. We reconstructed a stoichiometric model capturing the central metabolism of three important representatives of PNSB (Rhodospirillum rubrum, Rhodobacter sphaeroidesandRhodopseudomonas palustris). Using flux variability analysis, the model reveals key metabolic constraints related to redox homeostasis in these bacteria. With the help of the model we can (i) give quantitative explanations for non-intuitive, partially species-specific phenomena of photoheterotrophic growth of PNSB, (ii) reproduce various quantitative experimental data, and (iii) formulate several new hypotheses. For example, model analysis of photoheterotrophic growth reveals that - despite a large number of utilizable catabolic pathways - substrate-specific biomass and CO2yields are fixed constraints, irrespective of the assumption of optimal growth. Furthermore, our model explains quantitatively why a CO2fixing pathway such as the Calvin cycle is required by PNSB for many substrates (even if CO2is released). We also analyze the role of other pathways potentially involved in redox metabolism and how they affect quantitatively the required capacity of the Calvin cycle. Our model also enables us to discriminate between different acetate assimilation pathways that were proposed recently forR. sphaeroidesandR. rubrum, both lacking the isocitrate lyase. Finally, we demonstrate the value of the metabolic model also for potential biotechnological applications: we examine the theoretical capabilities of PNSB for photoheterotrophic hydrogen production and identify suitable genetic interventions to increase the hydrogen yield.

Conclusions

Taken together, the metabolic model (i) explains various redox-related phenomena of the versatile metabolism of PNSB, (ii) delivers new hypotheses on the operation and relevance of several metabolic pathways, and (iii) holds significant potential as a tool for rational metabolic engineering of PNSB in biotechnological applications.
Preoperative radiological characterization of hepatic angiomyolipoma using magnetic resonance imaging and contrast-enhanced ultrasonography: a case report
Authors: Krebs Stephanie , Esposito Irene , Lersch Christian , Gaa Jochen , Schmid Roland M. , Ebert Oliver
Published: September 2011

Introduction

A hepatic angiomyolipoma is a rare benign tumor of the liver composed of a mixture of smooth muscle cells, blood vessels and a variable amount of adipose tissue. Differentiating them from malignant liver tumors can often be very difficult.

Case presentation

We report the case of a 43-year-old Caucasian man presenting with a large liver mass in the right lobe. The results of magnetic resonance imaging and contrast-enhanced ultrasonography were consistent with a well-demarcated adipose tissue- containing tumor, showing prolonged hyperperfusion in comparison with the surrounding liver tissue. Surgery was performed and the diagnosis of hepatic angiomyolipoma was made with histopathology.

Conclusion

Preoperative radiological characterization using magnetic resonance imaging and contrast-enhanced ultrasonography may improve diagnostic accuracy of hepatic angiomyolipoma. Identification of smooth muscle cells, blood vessels and adipose tissue with a positive immunohistochemical reaction for HMB-45 is the final evidence for an angiomyolipoma.
A comparative gene expression database for invertebrates
Authors: Ormestad Mattias , Martindale Mark Q , Röttinger Eric
Published: September 2011

Background

As whole genome and transcriptome sequencing gets cheaper and faster, a great number of 'exotic' animal models are emerging, rapidly adding valuable data to the ever-expanding Evo-Devo field. All these new organisms serve as a fantastic resource for the research community, but the sheer amount of data, some published, some not, makes detailed comparison of gene expression patterns very difficult to summarize - a problem sometimes even noticeable within a single lab. The need to merge existing data with new information in an organized manner that is publicly available to the research community is now more necessary than ever.

Description

In order to offer a homogenous way of storing and handling gene expression patterns from a variety of organisms, we have developed the first web-based comparative gene expression database for invertebrates that allows species-specific as well as cross-species gene expression comparisons. The database can be queried by gene name, developmental stage and/or expression domains.

Conclusions

This database provides a unique tool for the Evo-Devo research community that allows the retrieval, analysis and comparison of gene expression patterns within or among species. In addition, this database enables a quick identification of putative syn-expression groups that can be used to initiate, among other things, gene regulatory network (GRN) projects.
Is Drotrecogin alfa (activated) for adults with severe sepsis, cost-effective in routine clinical practice?
Authors: Sadique M Zia , Grieve Richard , Harrison David A , Cuthbertson Brian H , Rowan Kathryn M
Published: September 2011

Introduction

Previous cost-effectiveness analyses (CEA) reported that Drotrecogin alfa (DrotAA) is cost-effective based on a Phase III clinical trial (PROWESS). There is little evidence on whether DrotAA is cost-effective in routine clinical practice. We assessed whether DrotAA is cost-effective in routine practice for adult patients with severe sepsis and multiple organ systems failing.

Methods

This CEA used data from a prospective cohort study that compared DrotAA versus no DrotAA (control) for severe sepsis patients with multiple organ systems failing admitted to critical care units in England, Wales, and Northern Ireland. The cohort study used case-mix and mortality data from a national audit, linked with a separate audit of DrotAA infusions. Re-admissions to critical care and corresponding mortality were recorded for four years. Patients receiving DrotAA (n = 1,076) were matched to controls (n = 1,650) with a propensity score (Pscore), and Genetic Matching (GenMatch). The CEA projected long-term survival to report lifetime incremental costs per quality-adjusted life year (QALY) overall, and for subgroups with two or three to five organ systems failing at baseline.

Results

The incremental costs per QALY for DrotAA were £30,000 overall, and £16,000 for the subgroups with three to five organ systems failing. For patients with two organ systems failing, DrotAA resulted in an average loss of one QALY at an incremental cost of £15,000. When the subgroup with two organ systems was restricted to patients receiving DrotAA within 24 hours, DrotAA led to a gain of 1.2 QALYs at a cost per QALY of £11,000. The results were robust to other assumptions including the approach taken to projecting long-term outcomes.

Conclusions

DrotAA is cost-effective in routine practice for severe sepsis patients with three to five organ systems failing. For patients with two organ systems failing, this study could not provide unequivocal evidence on the cost-effectiveness of DrotAA.
Estrogen Receptor (ESR1) mRNA Expression and Benefit From Tamoxifen in the Treatment and Prevention of Estrogen Receptor–Positive Breast Cancer
Authors: Kim Chungyeul , Tang Gong , Pogue-Geile Katherine L. , Costantino Joseph P. , Baehner Frederick L. , Baker Joffre , Cronin Maureen T. , Watson Drew , Shak Steven , Bohn Olga L. , Fumagalli Debora , Taniyama Yusuke , Lee Ahwon , Reilly Megan L. , Vogel Victor G. , McCaskill-Stevens Worta , Ford Leslie G. , Geyer Charles E. , Wickerham D. Lawrence , Wolmark Norman , Paik Soonmyung
Published: September 2011

Purpose

Several mechanisms have been proposed to explain tamoxifen resistance of estrogen receptor (ER) –positive tumors, but a clinically useful explanation for such resistance has not been described. Because the ER is the treatment target for tamoxifen, a linear association between ER expression levels and the degree of benefit from tamoxifen might be expected. However, such an association has never been demonstrated with conventional clinical ER assays, and the ER is currently used clinically as a dichotomous marker. We used gene expression profiling and ER protein assays to help elucidate molecular mechanism(s) responsible for tamoxifen resistance in breast tumors.

Patients and Methods

We performed gene expression profiling of paraffin-embedded tumors from National Surgical Adjuvant Breast and Bowel Project (NSABP) trials that tested the worth of tamoxifen as an adjuvant systemic therapy (B-14) and as a preventive agent (P-1). This was a retrospective subset analysis based on available materials.

Results

In B-14, ESR1 was the strongest linear predictor of tamoxifen benefit among 16 genes examined, including PGR and ERBB2. On the basis of these data, we hypothesized that, in the P-1 trial, a lower level of ESR1 mRNA in the tamoxifen arm was the main difference between the two study arms. Only ESR1 was downregulated by more than two-fold in ER-positive cancer events in the tamoxifen arm (P < .001). Tamoxifen did not prevent ER-positive tumors with low levels of ESR1 expression.

Conclusion

These data suggest that low-level expression of ESR1 is a determinant of tamoxifen resistance in ER-positive breast cancer. Strategies should be developed to identify, treat, and prevent such tumors.
The Germinal Center/Activated B-Cell Subclassification Has a Prognostic Impact for Response to Salvage Therapy in Relapsed/Refractory Diffuse Large B-Cell Lymphoma: A Bio-CORAL Study
Authors: Thieblemont Catherine , Briere Josette , Mounier Nicolas , Voelker Hans-Ullrich , Cuccuini Wendy , Hirchaud Edouard , Rosenwald Andreas , Jack Andrew , Sundstrom Christer , Cogliatti Sergio , Trougouboff Philippe , Boudova Ludmila , Ysebaert Loic , Soulier Jean , Chevalier Catherine , Bron Dominique , Schmitz Norbert , Gaulard Philippe , Houlgatte Remi , Gisselbrecht Christian
Published: September 2011

Purpose

To evaluate the prognostic value of the cell of origin (COO) in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBLC), prospectively treated by rituximab, dexamethasone, high-dose cytarabine, and cisplatin (R-DHAP) versus rituximab, ifosfamide, carboplatin, and etoposide and followed by intensive therapy plus autologous stem-cell transplantation on the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) trial.

Patients and Methods

Among the 396 patients included on the trial, histologic material was available for a total of 249 patients at diagnosis (n = 189 patients) and/or at relapse (n = 147 patients), which included 87 matched pairs. The patient data were analyzed by immunochemistry for CD10, BCL6, MUM1, FOXP1, and BCL2 expression and by fluorescent in situ hybridization for BCL2, BCL6 and c-MYC breakpoints. The correlation with survival data was performed by using the log-rank test and the Cox model.

Results

Characteristics of immunophenotype and chromosomal abnormalities were statistically highly concordant in the matched biopsies. In univariate analysis, the presence of c-MYC gene rearrangement was the only parameter to be significantly correlated with a worse progression-free survival (PFS; P = .02) and a worse overall survival (P = .04). When treatment interaction was tested, the germinal center B (GCB) –like DLBCL that was based on the algorithm by Hans was significantly associated with a better PFS in the R-DHAP arm. In multivariate analysis, independent prognostic relevance was found for the GCB/non-GCB the Hans phenotype interaction treatment (P = .04), prior rituximab exposure (P = .0052), secondary age-adjusted International Prognostic Index (P = .039), and FoxP1 expression (P = .047). Confirmation was obtained by gene expression profiling in a subset of 39 patients.

Conclusion

COO remains a major and independent factor in relapsed/refractory DLBCL, with a better response to R-DHAP in GCB-like DLBCL. This needs confirmation by a prospective study.
Health Care Use of Long-Term Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study
Authors: Rebholz Cornelia E. , Reulen Raoul C. , Toogood Andrew A. , Frobisher Clare , Lancashire Emma R. , Winter David L. , Kuehni Claudia E. , Hawkins Michael M.
Published: September 2011

Purpose

Survivors of childhood cancer are at high risk of chronic conditions, but few studies investigated whether this translates into increased health care utilization. We compared health care service utilization between childhood cancer survivors and the general British population and investigated potential risk factors.

Methods

We used data from the British Childhood Cancer Survivor Study, a population-based cohort of 17,981 individuals diagnosed with childhood cancer (1940-1991) and surviving ≥ 5 years. Frequency of talks to a doctor, hospital outpatient visits, and day-patient and inpatient hospitalizations were ascertained by questionnaire in 10,483 survivors and were compared with the General Household Survey 2002 data by using logistic regression.

Results

Among survivors, 16.5% had talked to a doctor in the last 2 weeks, 25.5% had attended the outpatient department of a hospital in the last 3 months, 11.9% had been hospitalized as a day patient in the last 12 months, and 9.8% had been hospitalized as an inpatient in the last 12 months. Survivors had talked slightly more often to a doctor than the general population (odds ratio [OR], 1.2; 95% CI, 1.1 to 1.3) and experienced increased hospital outpatient visits (OR, 2.5; 95% CI, 2.3 to 2.8), day-patient hospitalizations (OR, 1.4; 95% CI, 1.3 to 1.6) and inpatient hospitalizations (OR, 1.9; 95% CI, 1.7 to 2.2). Survivors of Hodgkin's lymphoma, neuroblastoma, and Wilms tumor had the highest ORs for day-patient care, whereas survivors of CNS tumors and bone sarcomas had the highest OR for outpatient and inpatient care. The OR of health care use did not vary significantly with age of survivor.

Conclusion

We have quantified how excess morbidity experienced by survivors of childhood cancer translates into increased use of health care facilities.
Red State, Blue State, Flu State: Media Self-Selection and Partisan Gaps in Swine Flu Vaccinations
Authors: Baum Matthew A.
Published: September 2011

This study assesses the relationship between political partisanship and attitudes and behavior with respect to the H1N1 virus (swine flu) crisis of 2009 in general, and the U.S. mass vaccination program in particular. I argue that even seemingly nonpartisan political issues like public health are increasingly characterized by partisan polarization in public attitudes and that such polarization is attributable, at least partly, to the breakdown of the information commons that characterized the U.S. mass media from roughly the 1950s until the early 1990s. In its place has arisen an increasingly fragmented and niche-oriented media marketplace in which individuals are better able to limit their information exposure to attitudes and opinions that reinforce, rather than challenge, their preexisting beliefs. I test my argument against a variety of data sources, including opinion surveys and state-level swine flu vaccination rate data.
Regional Variations in Public Opinion on the Affordable Care Act
Authors: Brodie Mollyann , Deane Claudia , Cho Sarah
Published: September 2011

One year after passage, the Patient Protection and Affordable Care Act (ACA) remains a divisive topic. Most publicly released polls on the law have focused on the views of Americans as a whole. But with much of the responsibility of implementation lying with the states, this essay explores whether opinion differs geographically. The analysis finds that views on the health reform law do differ by region, and these differences are most likely driven by the political leanings of a given area. While opinion nationally differs by age and race, this pattern does not hold when looking by region. Areas that have a larger share of uninsured and are slated to receive greater federal funding under the ACA also do not differ in their opinions. These data suggest that regional variations in attitudes about the ACA are based less on the demographic structure of a region and more on the political ideologies of residents in a given region. As implementation of the law continues, this analysis shows that national opinion data mask important regional variations in views of the ACA.
Principles of ultrasound elastography
Authors: Hoskins Peter R
Published: September 2011

Many manufacturers of ultrasound systems offer elastography capabilities. Though the research literature describes techniques involving external actuators, commercial systems have preferred to adopt techniques that may be used with a single transducer. Techniques may be divided into those which measure strain and those which measure shear wave velocity. Strain elastography involves deformation of the tissue followed by imaging of the degree of compression or extension of the tissue. Strain elastography does not estimate tissue stiffness; however, the strain ratio may be used as a surrogate index of stiffness. Shear wave elastography provides true quantitative information on elastic modulus. This involves induction of shear waves, estimation of shear wave velocity c s and conversion to elastic modulus E using the equation E = 3 ρ cs2 where ρ is the density. The description of tissues as being purely elastic is simplistic. In practice they may also exhibit time-dependent viscous behaviour. Recent literature describe methods that have been developed for estimation of the viscoelastic behaviour from the change in strain with time or by estimation of the shear wave dispersion, a technique known as ‘shear wave spectroscopy’. These methods may become commercially available in the medium term, offering a new quantity (tissue viscosity) for diagnostic use.
The Effect of Globalization on Employee Psychological Health and Job Satisfaction in Malaysian Workplaces
Authors: Idris Mohd Awang , Dollard Maureen F. , Winefield Anthony H.
Published: September 2011

The Effect of Globalization on Employee Psychological Health and Job Satisfaction in Malaysian Workplaces: Mohd Awang Idris, et al. Work and Stress Research Group, Centre for Applied Psychological Research, School of Psychology, University of South Australia, Australia—

Objective

To examine the impact of globalization on employee psychological health and job satisfaction via job characteristics (i.e., job demands and job resources) in an emerging economy, that of Malaysia. As external factors are regarded as Influences on the working environment, we hypothesized that global forces (increased pressure and competition) would have an impact on burnout and job satisfaction via increased demands (role conflict, emotional demands) and reduced resources (supervisor support, coworkers support).

Methods

Data were collected using a population based survey among 308 employees in the state of Selangor, Malaysia. Participants were approached at home during the weekend or on days off from work. Only one participant was selected per household. Structural equation modelling was used to analyse the data. Nearly 54% of respondents agreed that they need to work harder, 25% agreed that their job was not secure and 24% thought they had lost power and control on the job due to global trade competition.

Results

Consistent with our predictions, demands mediated the globalization to burnout relationship, and resources mediated the globalization to job satisfaction relationship.

Conclusions

Together, these results support the idea that external factors Influence work conditions and in turn employee health and job satisfaction. We conclude that the jobs demands resources framework is applicable in an Eastern setting and that globalization is a key antecedent of working environments.
Phototherapy to Prevent Severe Neonatal Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation
Authors: Bhutani Vinod K. ,   the Committee on Fetus and Newborn
Published: September 2011

This Technical Report was revised. See https://doi.org/10.1542/peds.2024-068026.

OBJECTIVE:

To standardize the use of phototherapy consistent with the American Academy of Pediatrics clinical practice guideline for the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

METHODS:

Relevant literature was reviewed. Phototherapy devices currently marketed in the United States that incorporate fluorescent, halogen, fiber-optic, or blue light-emitting diode light sources were assessed in the laboratory.

RESULTS:

The efficacy of phototherapy units varies widely because of differences in light source and configuration. The following characteristics of a device contribute to its effectiveness: (1) emission of light in the blue-to-green range that overlaps the in vivo plasma bilirubin absorption spectrum (∼460–490 nm); (2) irradiance of at least 30 μW·cm−2·nm−1 (confirmed with an appropriate irradiance meter calibrated over the appropriate wavelength range); (3) illumination of maximal body surface; and (4) demonstration of a decrease in total bilirubin concentrations during the first 4 to 6 hours of exposure.

RECOMMENDATIONS (SEE APPENDIX FOR GRADING DEFINITION):

The intensity and spectral output of phototherapy devices is useful in predicting potential effectiveness in treating hyperbilirubinemia (group B recommendation). Clinical effectiveness should be evaluated before and monitored during use (group B recommendation). Blocking the light source or reducing exposed body surface should be avoided (group B recommendation). Standardization of irradiance meters, improvements in device design, and lower-upper limits of light intensity for phototherapy units merit further study. Comparing the in vivo performance of devices is not practical, in general, and alternative procedures need to be explored.
Recommendations for Administering Hepatitis A Vaccine to Contacts of International Adoptees
Authors:   Committee on Infectious Diseases
Published: September 2011

This Policy Statement was retired January 2015.

The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the American Academy of Pediatrics (AAP) recommend routine administration of hepatitis A vaccine for household members and close contacts, including baby-sitters, when children are adopted from countries with high or intermediate rates of hepatitis A infection. This policy expands previous AAP recommendations to immunize travelers to countries who are seeking to adopt a child in countries with high or medium hepatitis A endemicity. All previously nonimmune unvaccinated people who anticipate close exposure to international adoptees during the 60 days after their arrival should receive hepatitis A immunization, ideally 2 or more weeks before the arrival of the adopted child.
The Use of Systemic and Topical Fluoroquinolones
Authors: Bradley John S. , Jackson Mary Anne ,   the Committee on Infectious Diseases
Published: September 2011

This Clinical Report was revised. See https://doi.org/10.1542/peds.2016-2706.

Appropriate prescribing practices for fluoroquinolones are essential as evolving resistance patterns are considered, additional treatment indications are identified, and the toxicity profile of fluoroquinolones in children becomes better defined. Earlier recommendations for systemic therapy remain; expanded uses of fluoroquinolones for the treatment of certain infections are outlined in this report. Although fluoroquinolones are reasonably safe in children, clinicians should be aware of the specific adverse reactions. Use of fluoroquinolones in children should continue to be limited to treatment of infections for which no safe and effective alternative exists.
Additional Recommendations for Use of Tetanus Toxoid, Reduced-Content Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap)
Authors:   Committee on Infectious Diseases
Published: September 2011

This Policy Statement was retired January 2015.

The American Academy of Pediatrics and the Centers for Disease Control and Prevention are amending previous recommendations and making additional recommendations for the use of tetanus toxoid, reduced-content diphtheria toxoid, and acellular pertussis vaccine (Tdap). Review of the results from clinical trials and other studies has revealed no excess reactogenicity when Tdap is given within a short interval after other tetanus- or diphtheria-containing toxoid products, and accrual of postmarketing adverse-events reports reveals an excellent safety record for Tdap. Thus, the recommendation for caution regarding Tdap use within any interval after a tetanus- or diphtheria-containing toxoid product is removed. Tdap should be given when it is indicated and when no contraindication exists. In further efforts to protect people who are susceptible to pertussis, the American Academy of Pediatrics and Centers for Disease Control and Prevention recommend a single dose of Tdap for children 7 through 10 years of age who were underimmunized with diphtheria-tetanus-acellular pertussis (DTaP). Also, the age for recommendation for Tdap is extended to those aged 65 years and older who have or are likely to have contact with an infant younger than 12 months (eg, health care personnel, grandparents, and other caregivers).
Surgical repair of postintubation esophago-tracheal fistulas: report of two operated cases
Authors: Balázs Ákos , Kupcsulik Péter
Published: September 2011

Persistence of postintubation esophago-tracheal fistulas is a difficult therapeutic problem. Authors present and discuss two successfully operated cases. Surgical reconstruction was done via left lateral cervical approach, including dissection of the fistulous tract, closure of the defect on both sides by suture, exclusion of the esophagus with a linear stapler beyond a loop esophagostomy, separation the suture lines with interposing of omohioid muscle flap, and making a Pezzer-catheter splinted esophagostomy. In the first case the spontaneous recanalization of the occluded esophagus was prolonged and the fistula recurred. Reoperation was done by the same procedure without exclusion of the esophagus. The second patient needed intervention because of the prolonged closure of esophagostomy. Recovery of both patients was successful. In conclusion, it can be stated that adaptation of surgical techniques for the individual pathologic situation helped the authors to find the way to the successful outcome. Orv. Hetil., 2011, 152, 1618–1622.
Physical Exercise for Cancer Patients with Advanced Disease: A Randomized Controlled Trial
Authors: Oldervoll Line M. , Loge Jon H. , Lydersen Stian , Paltiel Hanne , Asp May B. , Nygaard Unni V. , Oredalen Elisabeth , Frantzen Tone L. , Lesteberg Ingvild , Amundsen Lise , Hjermstad Marianne J. , Haugen Dagny F. , Paulsen Ørnulf , Kaasa Stein
Published: September 2011

Learning Objectives

After completing this course, the reader will be able to: Describe the impact of physical exercise on fatigue and physical performance outcomes in cancer patients with advanced and incurable disease.Identify potential clinical benefits of inclusion of physical exercise in treatment regimens for cancer patients with advanced disease.

CME This article is available for continuing medical education credit at CME.TheOncologist.com

Background.

Physical exercise can improve cancer patients' functioning and reduce their symptom levels. A randomized, controlled trial was launched to test the hypothesis that physical exercise reduces fatigue and improves physical performance in cancer patients with advanced and incurable disease.

Methods.

Cancer patients (n = 231) with a life expectancy ≤2 years were randomized to a physical exercise group (PEG, n = 121) or a control usual care group (UCG, n = 110). The PEG exercised under supervision 60 minutes twice a week for 8 weeks. Assessments were performed before and after the intervention. The primary outcome was physical fatigue (PF) measured by the Fatigue Questionnaire. Physical performance was a secondary outcome measured by the Shuttle Walk Test (SWT) and hand grip strength (HGS) test. Analyses were performed after multiple imputations for missing data. The trial is registered with ClinicalTrials.gov (identifier, NCT00397774).

Findings.

Thirty-six percent of the PEG were lost to follow-up compared with 23% of the UCG, primarily as a result of disease progression. Seventy-eight PEG and 85 UCG patients completed the intervention. Analyses showed no significant between-group effects in PF. However, clinically and statistically significant between-group effects were found for the SWT and HGS test.

Interpretation.

Fatigue was not reduced but physical performance (SWT and HGS test) was significantly improved after 8 weeks of physical exercise. Physical exercise might therefore be a suitable approach for maintaining physical capacity in cancer patients with incurable and advanced disease.
Foreign Aid, FDI, Economic Freedom and Economic Growth in Asian Countries
Authors: Tiwari Aviral Kumar
Published: September 2011

This study examines the effectiveness of foreign aid, foreign direct investment, and economic freedom for selected 28 Asian countries in a panel framework. The model includes foreign aid, foreign direct investment, economic freedom, labor force, and capital stock. The estimation procedure was carried out on pooled annual time series data for the period 1998-2007. For the purpose of analysis, we used static and dynamic panel data techniques. The results indicated that an increase in the fiscal freedom, financial freedom and domestic capital stock were significant factors positively affecting economic growth. Freedom from corruption, inflow of foreign direct investment and foreign aid were significant factors negatively affecting economic growth. Further, we found that life expectancy played a significant and positive role in economic growth. Foreign aid had a non-linear impact (negative impact of high aid flows) upon economic growth.
Monetary Policy and Oil Prices
Authors: Monadjemi Mehdi S.
Published: September 2011

Because of volatility, commodity prices are excluded from the CPI when inflation targeting is exercised. Rising commodity prices contribute to inflation but central banks show no reaction since the CPI does not register rise in prices. Frankel (2006) argues that monetary policy should consider the price of important export commodities such as oil, in oil exporting countries. He maintains that by doing so, central banks are able to benefit from the fluctuations of the exchange rate in the presence of a negative international trade shocks. Central banks cannot benefit from the fluctuation of the exchange rate if inflation targeting is the strategy for conducting monetary policy.