bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in HbA1c and Weight Following Transition to Continuous Subcutaneous Insulin Infusion Therapy in Adults With Type 1 Diabetes
Authors: Mehta Sanjeev N. , Andersen Henrik Ullits , Abrahamson Martin J. , Wolpert Howard A. , Hommel Eva E. , McMullen William , Ridderstråle Martin
Published: July 2016

Background:

Historically, intensive insulin therapy for type 1 diabetes (T1D) has improved glycemic control at the risk of adverse weight gain. The impact of continuous subcutaneous insulin infusion therapy (CSII) on weight in the current era remains unknown. We assessed changes in hemoglobin A1c (HbA1c) and weight in adults with T1D transitioning to CSII at 2 diabetes centers in Denmark and the United States.

Methods:

Patients with T1D, aged ≥18 years, managed with multiple daily injections (MDI) who transitioned to CSII between 2002 and 2013 were identified using electronic health record data from the Steno Diabetes Center (n = 600) and Joslin Diabetes Center (n = 658). Changes in HbA1c and weight after 1 year was assessed overall and by baseline HbA1c cut points. Multivariate regression assessed correlates of HbA1c reduction.

Results:

In adults with T1D transitioning to CSII, clinically significant HbA1c reductions were found in patients with baseline HbA1c 8.0-8.9% (Steno, –0.7%; Joslin, –0.4%) and baseline HbA1c ≥9.0% (Steno, –1.1%; Joslin, –0.9%) ( P < .005 for all). Overall, there was no significant change in weight after 1 year at either center. Modest (<2%) weight gain was noted in patients with baseline HbA1c ≥9% at Steno (1.1 ± 0.3 kg, P < .0001) and Joslin (1.7 ± 1.1, P < .005). In multivariate models, HbA1c reduction was associated with higher HbA1c, older age, female sex at Steno ( R2 = .28, P < .005), but only higher baseline HbA1c at Joslin ( R2 = .19, P < .005).

Conclusion:

Adults with T1D with suboptimal glycemic control significantly improved HbA1c without a negative impact on weight 1 year after transitioning from MDI to CSII.
Income Reliably Predicts Daily Sadness, but Not Happiness
Authors: Hudson Nathan W. , Lucas Richard E. , Donnellan M. Brent , Kushlev Kostadin
Published: July 2016

Kushlev, Dunn, and Lucas (2015) found that income predicts less daily sadness—but not greater happiness—among Americans. The present study used longitudinal data from an approximately representative German sample to replicate and extend these findings. Our results largely replicated Kushlev et al.’s results: Income predicted less daily sadness (albeit with a smaller effect size) but was unrelated to happiness. Moreover, the association between income and sadness could not be explained by demographics, stress, or daily time use. Extending Kushlev et al.’s findings, new analyses indicated that only between-persons variance in income (but not within-persons variance) predicted daily sadness—perhaps because there was relatively little within-persons variance in income. Finally, income predicted less daily sadness and worry, but not less anger or frustration—potentially suggesting that income predicts less “internalizing” but not less “externalizing” negative emotions. Together, our study and Kushlev et al.’s study provide evidence that income robustly predicts select daily negative emotions—but not positive ones.
The Folded Paper Size Illusion: Evidence of Inability to Perceptually Integrate More Than One Geometrical Dimension
Authors: Carbon Claus-Christian
Published: July 2016

The folded paper-size illusion is as easy to demonstrate as it is powerful in generating insights into perceptual processing: First take two A4 sheets of paper, one original sized, another halved by folding, then compare them in terms of area size by centering the halved sheet on the center of the original one! We perceive the larger sheet as far less than double (i.e., 100%) the size of the small one, typically only being about two thirds larger—this illusion is preserved by rotating the inner sheet and even by aligning it to one or two sides, but is dissolved by aligning both sheets to three sides, here documented by 88 participants’ data. A potential explanation might be the general incapability of accurately comparing more than one geometrical dimension at once—in everyday life, we solve this perceptual-cognitive bottleneck by reducing the complexity of such a task via aligning parts with same lengths.
Preliminary study of novel, timed walking tests for children with spina bifida or cerebral palsy
Authors: Kane Kyra J , Lanovaz Joel , Bisaro Derek , Oates Alison , Musselman Kristin E
Published: July 2016

Objective:

Walking assessment is an important aspect of rehabilitation practice; yet, clinicians have few psychometrically sound options for evaluating walking in highly ambulatory children. The purpose of this study was to evaluate the validity and reliability of two new measures of walking function—the Obstacles and Curb tests—relative to the 10-Meter Walk test and Timed Up and Go test in children with spina bifida or cerebral palsy.

Methods:

A total of 16 ambulatory children with spina bifida ( n=9) or cerebral palsy ( n=7) (9 boys; mean age 7years, 7months; standard deviation 3years, 4months) and 16 age- and gender-matched typically developing children participated. Children completed the walking tests, at both self-selected and fast speeds, twice. To evaluate discriminative validity, scores were compared between typically developing and spina bifida/cerebral palsy groups. Within the spina bifida/cerebral palsy group, inter-test correlations evaluated convergent validity and intraclass correlation coefficients evaluated within-session test–retest reliability.

Results:

At fast speeds, all tests showed discriminative validity ( p<0.006 for typically developing and spina bifida/cerebral palsy comparisons) and convergent validity ( rho=0.81–0.90, p⩽0.001, for inter-test correlations). At self-selected speeds, only the Obstacles test discriminated between groups ( p=0.001). Moderately strong correlations ( rho=0.73–0.78, p⩽0.001) were seen between the 10-Meter Walk test, Curb test, and Timed Up and Go test. Intraclass correlation coefficients ranged from 0.81 to 0.97, with higher test–retest reliability for tests performed at fast speeds rather than self-selected speeds.

Conclusion:

The Obstacles and Curb tests are promising measures for assessing walking in this population. Performing tests at fast walking speeds may improve their validity and test–retest reliability for children with spina bifida/cerebral palsy.
Early multicentre experience of ultra-mini percutaneous nephrolithotomy in the UK
Authors: Pullar Ben , Havranek Eric , Blacker Tony J R , Datta Sam N , Somani Bhaskar , Sriprasad Seshadri , Ratan Hari , Scriven Sharon , Choong Simon , Smith R Daron , Mackie Simon , Watson Graham , Wiseman Oliver J
Published: July 2016

Objectives:

Ultra-mini percutaneous nephrolithotomy (UMP) is a novel technique recently introduced allowing percutaneous renal access to stones using a specially modified 11 or 13 Fr sheath, a 6 Fr nephroscope, and permits laser fragmentation and stone evacuation. This study aimed to review the early practice of UMP in the UK.

Methods:

All centres in the UK which had performed UMP were contacted to submit data. Data were submitted to a central database from nine centres around the UK who performed UMP between July 2013 and December 2014. Data were collected on patient, stone, operative factors and outcomes.

Results:

A total of 32 UMP cases were performed in the contributing centres. Stone size ranged from 7 mm×5 mm to 24 mm×24 mm across the 32 cases, with a mean of 13 mm×10 mm. Stone-free rates were excellent with 31/32 cases stone-free post procedure; 26/32 patients were left without a nephrostomy tube. Complications were uncommon; there were two Clavien 1 complications in this series (6%).

Conclusion:

This study has shown the efficacy of UMP during its introduction into UK practice. It is likely that UMP will become a useful addition to the armamentarium to treat renal stones, especially smaller stones in the lower pole calyx, and in specialised cases such as paediatric stone disease and in patients with stones in calyceal diverticulae.
Is acute ureteroscopy for painful ureteric colic cost effective and beneficial for patients? a cost-analysis
Authors: Darrad Maitrey , Sibartie Tara , Inglis John , Rukin Nick
Published: July 2016

Introduction and objectives:

Admissions for ureteric colic are relatively common, with up to 80% of stones passing spontaneously. In patients with refractory pain, drainage with stenting, percutaneous nephrostomy or stone removal can be performed. Due to the financial restrictions of the NHS, it is paramount to ensure patients are receiving optimal cost-effective care. We present a cost effectiveness analysis between primary ureteric stenting and emergency ureteroscopic stone removal in patients with refractory pain secondary to acute ureteric calculi.

Methods:

Fifty patients were analysed who underwent either primary ureteric stenting or emergency ureteroscopic stone removal in our institution. Each group contained 25 consecutive patients. The primary outcomes compared were: time to stone-free status, number of hospital re-admissions, and overall cost of treatment until stone free.

Results:

Both stenting ( n=25) and ureteroscopic stone removal ( n=25) groups were comparable with respect to age, sex, stone size and location. The hospital re-admission rate secondary to stone-specific issues was significantly lower in the ureteroscopy group, two versus 20. Patients became stone free significantly quicker in the ureteroscopy group (2.5 days vs. 61.9 days). The total overall cost until being declared stone free was significantly lower in the ureteroscopy group (£3104 vs. £4041, P⩽0.001).

Conclusions:

This study highlights that those patients undergoing ureteric stenting take significantly longer to become stone free, leading to increased hospital re-admissions, potentially increased morbidity and inevitably greater cost implications. We advocate that primary ureteroscopic stone removal should be consider instead of ureteric stenting in patients with ongoing, painful ureteric colic.
Doing social media analytics
Authors: Brooker Phillip , Barnett Julie , Cribbin Timothy
Published: July 2016

In the few years since the advent of ‘Big Data’ research, social media analytics has begun to accumulate studies drawing on social media as a resource and tool for research work. Yet, there has been relatively little attention paid to the development of methodologies for handling this kind of data. The few works that exist in this area often reflect upon the implications of ‘grand’ social science methodological concepts for new social media research (i.e. they focus on general issues such as sampling, data validity, ethics, etc.). By contrast, we advance an abductively oriented methodological suite designed to explore the construction of phenomena played out through social media. To do this, we use a software tool – Chorus – to illustrate a visual analytic approach to data. Informed by visual analytic principles, we posit a two-by-two methodological model of social media analytics, combining two data collection strategies with two analytic modes. We go on to demonstrate each of these four approaches ‘in action’, to help clarify how and why they might be used to address various research questions.
Idiopathic pulmonary malformation: A case report
Authors: Vargas Cruz Antonio , Fernández-Ceseña Ernesto , Bastien-Araujo Yuri , Alcántara-Meléndez Marco Antonio
Published: July 2016

Background:

Pulmonary arteriovenous malformations have been associated with clinical situations that put life at risk or cause physical disability. When the clinical picture is evident, percutaneous occlusion is recommended.

Methods:

We describe the use of an Amplatzer vascular plug in a female patient for the treatment of an idiopathic pulmonary arteriovenous malformation associated with syncope and transient ischemic attacks.

Results:

The patient was successfully treated via percutaneous intervention without complications. At 6 months follow-up, there was an absence of the pulmonary arteriovenous malformation confirmed via angiotomography and a full reintegration into her daily activities with no-clinical eventualities.

Conclusion:

The use of an Amplatzer vascular plug should be considered for the treatment of idiopathic pulmonary arteriovenous malformation. In experienced centers the procedure can be done safely with excellent clinical outcomes.
The Relationship Between Youngsters’ Gender Role Attitudes and Individual, Home, and School Characteristics
Authors: Halimi Myriam , Consuegra Els , Struyven Katrien , Engels Nadine
Published: July 2016

Because of the importance of gender role attitudes (GRA) for both academic and social outcomes, it is crucial to understand how GRA is constructed and changes over time. A systematic literature review was conducted to look into the relationship between youngsters’ GRA and individual, home, and school characteristics. Thirty-five international studies were identified through searches in different databases. The review reveals that the studies mostly apply a deterministic view to studying the construction of GRA, focusing predominantly on parent–child transmission. Effects of the school environment and individuals’ own life experiences are under-studied. Also, data are mostly cross-sectional and leave little room for investigating evolutions of GRA over time. Suggestions for future research are formulated focusing on (a) a life-course approach that considers GRA as situated, experience-related, and therefore changing over time and (b) an intersectionality-informed approach investigating GRA at the intersects of multiple diversity dimensions.
Street Smarts ↔ Book Smarts
Authors: Valaitis Ruta K. , Wahoush Olive , Murray Nancy , Isaacs Sandy , Derbyshire David , Semogas Dyanne , Rolfe Steven
Published: July 2016

This article describes the development, implementation, and evaluation of an interdisciplinary undergraduate course embedded within a campus–community partnership initiative involving McMaster University School of Nursing, and three urban priority neighborhoods in Hamilton, Ontario, Canada. Students worked together with community residents and faculty to address selected priority community issues identified by neighborhood members. Using the qualitative interpretive description method, the evaluation explored different partners’ (students, community residents, and faculty) perceptions of the course (SWOT analysis: strengths, weaknesses, opportunities, and threats, as well as outcomes) as a community engagement and knowledge exchange intervention. Results provide lessons learned and recommendations for future campus–community engaged courses that can be transferred to similar contexts.
Minority Report
Authors: Degnin Francis Dominic
Published: July 2016

The Epic of Gilgamesh attempts to answer the question of how, given the finality of death, one might find meaning and happiness in life. Many commentators argue that the text provides two separate, although ultimately unsatisfactory, alternatives. What these commentators appear to miss, however, is the possibility that these two solutions may not be separate. Using Levinas’s distinction between “need” and “desire,” I argue that, by the end of the Epic, they may in fact be synthesized into a single solution, one that suggests the priority of an affective moral grounding as prior to and more fundamental than intellectual solutions.
Proactive Interventions
Authors: Rehnström Karin , Dahlborg-Lyckhage Elisabeth
Published: July 2016

Overcrowding in the emergency department is a frequent topic in the news. This results in long waiting time and dissatisfaction among patients, but also involves medical risks for the individual patient. When a high workload occurs in the emergency apartment, staff members have to work harder, which leads to reactive behavior. To improve both patient safety and the working environment, staff members and management need to be flexible, patient-focused, and proactive. Being proactive means taking control and making things happen, anticipating and preventing problems, as well as seizing opportunities. Emergency nurses perform advanced nursing interventions, a prerequisite of which is proactive behavior based on practical nursing wisdom. Being proactive requires something beyond normal work performance. However, not all staff members have sufficient knowledge and experience. Identifying proactive interventions that everyone can perform would be valuable.
The Stability of Old Skills During Transfer
Authors: Speelman Craig P. , Forbes John D. , Giesen Kris , Parkinson Matthew , Johnson Lois
Published: July 2016

This research was designed to evaluate the extent to which power functions can predict performance on a task when performance context has been altered. Since power functions reliably describe performance improvements during practice, an assumption implicit in some theories of skill acquisition and transfer is that transfer performance will continue to improve as an extrapolation of the practice power function. In the training phase of Experiment 1, 120 participants practiced solving simple problems from the six-times table. In the transfer phase, these same problems were presented again, intermixed with problems from one of the six conditions differing in various respects to the target problems. With the exception of two of these six conditions, performance on the target problems was slower than was predicted by training phase power function extrapolations. Where the nature of the task was altered, this disruption only occurred in the initial stages of transfer, with performance returning quickly to predicted levels. Where an increased scope of knowledge was required to perform the task, the disruption was more prolonged. Experiment 2 demonstrated that a spacing effect explanation of the results of Experiment 1 was not valid. Results were interpreted as reflecting the effect a change in the conceptual context of a task has on transfer performance. These findings have implications for theories of skill acquisition and transfer that assume transfer performance of established skills will continue to improve according to an extrapolation of the practice power function regardless of the conceptual context of the task.
East and South China Seas Maritime Dispute Resolution and Escalation: Two Sides of the Same Coin?
Authors: Magcamit Michael I. , Tan Alexander C.
Published: July 2016

Our assumptions about the nature and conduct of contemporary international politics deeply impact how we view maritime disputes plaguing the East and South China Seas. In this article, our analysis of the push and pull factors that influence the extent and possible resolution of maritime disputes in East Asia reveals that war is neither opposed in principle nor completely forbidden as an alternative. Amid heightening maritime tensions in the region, we argue that the underlying forces sustaining complex interdependence are what prevent rival states from engaging into a realist-inspired, zero-sum warfare. However, this is not to suggest that economic interdependence creates an absolute power that completely eradicates these flashpoints, and neither do we imply that it faithfully reflects East Asia’s maritime political reality. Although East Asian countries (particularly the more powerful ones) may think that open war can be justified, as a matter of practical utility, avoiding it is likely to be more effective in achieving the goals of a given conflict.
Reflections on Michael A. Rynkiewich’s “Do Not Remember the Former Things”
Authors: Tiénou Tite
Published: July 2016

Missiologists and mission practitioners must continually assess their assumptions and categories in light of changes in human societies and academic disciplines ancillary to missiology such as anthropology. While the need for assessment is acknowledged, categories such as “unreached people groups” and the “10/40 Window” show remarkable resilience. Is it possible to reconsider these categories?
Anoxia and glucose supplementation preserve neutrophil viability and function
Authors: Monceaux Valérie , Chiche-Lapierre Clarisse , Chaput Catherine , Witko-Sarsat Véronique , Prevost Marie-Christine , Taylor Cormac T. , Ungeheuer Marie-Noelle , Sansonetti Philippe J. , Marteyn Benoit S.
Published: July 2016

Key Points

Anoxia combined with glucose supplementation maintains viability of neutrophils for 20 hours without affecting their functions. Such conditioned neutrophils are suitable for efficient DNA transfection and transfusion.
Corticosteroids compared with intravenous immunoglobulin for the treatment of immune thrombocytopenia in pregnancy
Authors: Sun Dongmei , Shehata Nadine , Ye Xiang Y. , Gregorovich Sandra , De France Bryon , Arnold Donald M. , Shah Prakesh S. , Malinowski Ann Kinga
Published: July 2016

Key Points

Maternal platelet count response was not different for IVIg and corticosteroids in this retrospective study of pregnant women with ITP. Neonatal outcomes were overall favorable and similar after treatment of maternal ITP with IVIg or corticosteroids.
Objectively measured physical activity during pregnancy: a study in obese and overweight women
Authors: McParlin Catherine , Robson Stephen C , Tennant Peter WG , Besson Hervé , Rankin Judith , Adamson Ashley J , Pearce Mark S , Bell Ruth
Published: July 2016

Background

Obese and overweight women may benefit from increased physical activity (PA) during pregnancy. There is limited published data describing objectively measured PA in such women.

Methods

A longitudinal observational study of PA intensity, type and duration using objective and subjective measurement methods. Fifty five pregnant women with booking body mass index (BMI) ≥ 25 kg/m2 were recruited from a hospital ultrasound clinic in North East England. 26 (47%) were nulliparous and 22 (40%) were obese (BMI ≥ 30 kg/m2). PA was measured by accelerometry and self report questionnaire at 13 weeks, 26 weeks and/or 36 weeks gestation. Outcome measures were daily duration of light, moderate or vigorous activity assessed by accelerometry; calculated overall PA energy expenditure, (PAEE), and PAEE within four domains of activity based on self report.

Results

At median 13 weeks gestation, women recorded a median 125 mins/day light activity and 35 mins/day moderate or vigorous activity (MVPA). 65% achieved the minimum recommended 30 mins/day MVPA. This proportion was maintained at 26 weeks (62%) and 36 weeks (71%). Women achieving more than 30 mins/day MVPA in the first trimester showed a significant reduction in duration of MVPA by the third trimester (11 mins/day, p = 0.003). Walking, swimming and floor exercises were the most commonly reported recreational activities but their contribution to estimated energy expenditure was small.

Conclusion

Overweight and obese pregnant women can achieve and maintain recommended levels of PA throughout pregnancy. Interventions to promote PA should target changes in habitual activities at work and at home, and in particular walking.
Implementation of blinded outcome assessment in the Effective Verruca Treatments trial (EverT) – lessons learned
Authors: Cockayne Sarah , Hewitt Catherine , Hashmi Farina , Hicks Kate , Concannon Michael , McIntosh Caroline , Thomas Kim , Hall Jill , Watson Judith , Torgerson David , Watt Ian
Published: July 2016

Background

Trials using inadequate levels of blinding may report larger effect sizes than blinded studies. It has been suggested that blinded outcome assessment in open trials may in some cases be undertaken by assessments of photographs. The aim of this paper is to explore the effect of using different methods to assess the primary outcome in the EVerT (Effective Verruca Treatments) trial. It also aims to give an overview of the experiences of using digital photographs within the trial.

Methods

We undertook a secondary analysis to explore the effect of using three different methods to assess the primary outcome in the EVerT trial: assessment of digital photographs by blinded healthcare professionals; blinded healthcare professional assessment at the recruiting site and patient self‐report. The verruca clearance rates were calculated using the three different methods of assessment. A Cohen's kappa measure of inter‐rater agreement was used to assess the agreement between the methods. We also investigated the experiences of healthcare professionals using digital photographs within the trial.

Results

Digital photographs for 189 out of 240 (79 %) patients in the trial were received for outcome assessment. Of the 189 photographs, 30 (16 %) were uninterpretable. The overall verruca clearance rates were 21 % (43/202,) using the unblinded patient self‐reported outcome, 6 % (9/159,) using blinded assessment of digital photographs and 14 % (30/210,) using blinded outcome assessment at the site.

Conclusions

Despite differences in the clearance rates found using different methods of outcome assessment, this did not change the original conclusion of the trial, that there is no evidence of a difference in effectiveness between cryotherapy and salicylic acid. Future trials using digital photographs should consider individual training needs at sites and have a backup method of assessment agreed a priori.

Trial registration

ISRCTN Registry ISRCTN18994246
Europe and North East Asia, a complementary couple?
Authors: Széll György
Published: July 2016

Abstracts

European and North East Asian histories are intermingled since more than 200 years - full of conflicts, but also of cooperation. An issue over the past couple of decades is about European, Asian or universal values. The article confronts these different approaches and comes to the conclusion that diversity and complexity ask for a multidisciplinary approach.

Die europäische und nordostasiatische Geschichte vermengen sich seit mehr als zweitausend Jahren. - voller Konflikte, aber auch Zusammenarbeit. Ein besonderes Problem ist die Frage nach europäischen, asiatischen oder universellen Werten. Der Beitrag stellt diese verschiedenen Ansätze gegenüber und kommt zu dem Ergebnis, dass Vielfalt und Komplexität einen multi-disiziplinären Ansatz erfordern.
Phase II Multicenter, Randomized, Double-Blind Controlled Study of Efficacy and Safety of Umbilical Cord–Derived Mesenchymal Stromal Cells in the Prophylaxis of Chronic Graft-Versus-Host Disease After HLA-Haploidentical Stem-Cell Transplantation
Authors: Gao Lei , Zhang Yanqi , Hu Baoyang , Liu Jia , Kong Peiyan , Lou Shifeng , Su Yi , Yang Tonghua , Li Huimin , Liu Yao , Zhang Cheng , Gao Li , Zhu Lidan , Wen Qin , Wang Ping , Chen Xinghua , Zhong Jiangfan , Zhang Xi
Published: July 2016

Purpose

Although mesenchymal stromal cells (MSCs) possess immunomodulatory properties and exhibit promising efficacy against chronic graft-versus-host disease (cGVHD), little is known about the efficacy of MSCs in the prophylaxis of cGVHD after HLA-haploidentical hematopoietic stem-cell transplantation (HLA-haplo HSCT).

Patients and Methods

In this multicenter, double-blind, randomized controlled trial, we investigated the incidence and severity of cGVHD among patients, and the changes in T, B, and natural killer (NK) cells after the repeated infusion of MSCs.

Results

The 2-year cumulative incidence of cGVHD in the MSCs group was 27.4% (95% CI, 16.2% to 38.6%), compared with 49.0% (95% CI, 36.5% to 61.5%) in the non-MSCs control group (P = .021). Seven patients in the non-MSCs control group had severe lung cGVHD, but no patients in the MSCs group developed typical lung cGVHD (P = .047). After the MSC infusions, increasing memory B lymphocytes and regulatory T cells, as well as the ratio of type 1 T helper to type 2 T helper cells, were observed, whereas the number of NK cells decreased.

Conclusion

Our findings suggest that the repeated infusion of MSCs might inhibit cGVHD symptoms in patients after HLA-haplo HSCT, accompanied by changes in the numbers and subtypes of T, B, and NK cells, leading to the acquisition of immune tolerance.
Improved Outcomes With Retinoic Acid and Arsenic Trioxide Compared With Retinoic Acid and Chemotherapy in Non–High-Risk Acute Promyelocytic Leukemia: Final Results of the Randomized Italian-German APL0406 Trial
Authors: Platzbecker Uwe , Avvisati Giuseppe , Cicconi Laura , Thiede Christian , Paoloni Francesca , Vignetti Marco , Ferrara Felicetto , Divona Mariadomenica , Albano Francesco , Efficace Fabio , Fazi Paola , Sborgia Marco , Di Bona Eros , Breccia Massimo , Borlenghi Erika , Cairoli Roberto , Rambaldi Alessandro , Melillo Lorella , La Nasa Giorgio , Fiedler Walter , Brossart Peter , Hertenstein Bernd , Salih Helmut R. , Wattad Mohammed , Lübbert Michael , Brandts Christian H. , Hänel Mathias , Röllig Christoph , Schmitz Norbert , Link Hartmut , Frairia Chiara , Pogliani Enrico Maria , Fozza Claudio , D’Arco Alfonso Maria , Di Renzo Nicola , Cortelezzi Agostino , Fabbiano Francesco , Döhner Konstanze , Ganser Arnold , Döhner Hartmut , Amadori Sergio , Mandelli Franco , Ehninger Gerhard , Schlenk Richard F. , Lo-Coco Francesco
Published: July 2016

Purpose

The initial results of the APL0406 trial showed that the combination of all- trans-retinoic acid (ATRA) and arsenic trioxide (ATO) is at least not inferior to standard ATRA and chemotherapy (CHT) in first-line therapy of low- or intermediate-risk acute promyelocytic leukemia (APL). We herein report the final analysis on the complete series of patients enrolled onto this trial.

Patients and Methods

The APL0406 study was a prospective, randomized, multicenter, open-label, phase III noninferiority trial. Eligible patients were adults between 18 and 71 years of age with newly diagnosed, low- or intermediate-risk APL (WBC at diagnosis ≤ 10 × 109/L). Overall, 276 patients were randomly assigned to receive ATRA-ATO or ATRA-CHT between October 2007 and January 2013.

Results

Of 263 patients evaluable for response to induction, 127 (100%) of 127 patients and 132 (97%) of 136 patients achieved complete remission (CR) in the ATRA-ATO and ATRA-CHT arms, respectively ( P = .12). After a median follow-up of 40.6 months, the event-free survival, cumulative incidence of relapse, and overall survival at 50 months for patients in the ATRA-ATO versus ATRA-CHT arms were 97.3% v 80%, 1.9% v 13.9%, and 99.2% v 92.6%, respectively ( P < .001, P = .0013, and P = .0073, respectively). Postinduction events included two relapses and one death in CR in the ATRA-ATO arm and two instances of molecular resistance after third consolidation, 15 relapses, and five deaths in CR in the ATRA-CHT arm. Two patients in the ATRA-CHT arm developed a therapy-related myeloid neoplasm.

Conclusion

These results show that the advantages of ATRA-ATO over ATRA-CHT increase over time and that there is significantly greater and more sustained antileukemic efficacy of ATO-ATRA compared with ATRA-CHT in low- and intermediate-risk APL.
Barriers to Quality End-of-Life Care for Patients With Blood Cancers
Authors: Odejide Oreofe O. , Cronin Angel M. , Condron Nolan B. , Fletcher Sean A. , Earle Craig C. , Tulsky James A. , Abel Gregory A.
Published: July 2016

Purpose

Patients with blood cancers have been shown to receive suboptimal care at the end of life (EOL) when assessed with standard oncology quality measures (eg, no chemotherapy ≤ 14 days before death). As they were developed primarily for solid tumors, it is unclear if these measures are appropriate for patients with hematologic malignancies. Moreover, barriers to high-quality EOL care for this specific patient population are largely unknown.

Methods

In 2015, we asked a national cohort of hematologic oncologists about the acceptability of eight standard EOL quality measures. Building on prior qualitative work, we prespecified that measures achieving agreement among at least 55% of respondents would be considered acceptable. We also explored perspectives regarding barriers to quality EOL care.

Results

We received 349 surveys (response rate = 57.3%). Six of the standard measures met the threshold of acceptability, and four were acceptable to > 75% of respondents: hospice admission > 7 days before death, no chemotherapy ≤ 14 days before death, no intubation in the last 30 days of life, and no cardiopulmonary resuscitation in the last 30 days of life. The highest-ranked barriers to quality EOL care reported were “unrealistic patient expectations” (97.3%), “clinician concern about taking away hope” (71.3%), and “unrealistic clinician expectations” (59.0%).

Conclusion

In this large national cohort of hematologic oncologists, standard EOL quality measures were highly acceptable. The top barrier to quality EOL care reported was unrealistic patient expectations, which may be best addressed with more timely and effective advance care discussions.
Is FDA-Approved Bevacizumab Cost-Effective When Included in the Treatment of Platinum-Resistant Recurrent Ovarian Cancer?
Authors: Chappell Nicole P. , Miller Caela R. , Fielden Aaron D. , Barnett Jason C.
Published: July 2016

Purpose:

Although the Food and Drug Administration has approved incorporation of bevacizumab (BEV) into the treatment of platinum-resistant ovarian cancer (PROC), cost-value measures are an essential consideration, as evidenced by the recent ASCO Value Framework initiative. We assessed the cost-effectiveness and reviewed the net health benefit (NHB) of this expensive treatment.

Methods:

A cost-effectiveness decision model was constructed using results from a phase III trial comparing BEV plus cytotoxic chemotherapy with chemotherapy alone in patients with PROC. The Avastin Use in Platinum-Resistant Epithelial Ovarian Cancer (AURELIA) trial demonstrated improvement in progression-free survival and quality of life in patients receiving BEV. Costs, paracentesis rates, and adverse events were incorporated, including subgroup analysis of different partner chemotherapy agents.

Results:

Inclusion of BEV in the treatment of platinum-resistant recurrent ovarian cancer meets the common willingness-to-pay incremental cost-effectiveness ratio (ICER) threshold of $100,000 per progression-free life-year saved (LYS) for 15-mg/kg dosing and approaches this threshold for 10-mg/kg dosing, with an ICER of $160,000. In sensitivity analysis, reducing the cost of BEV by 13% (from $9,338 to $8,100 per cycle) allows 10-mg/kg dosing to reach a $100,000 ICER. Exploratory analysis of different BEV chemotherapy partners showed an ICER of $76,000 per progression-free LYS (6.5-month progression-free survival improvement) and $54,000 per LYS (9.1-month overall survival improvement) for the addition of BEV to paclitaxel once per week. Using the ASCO framework for value assessment, the NHB score for BEV plus paclitaxel once per week is 48.

Conclusion:

Using a willingness-to-pay threshold of $100,000 ICER, the addition of BEV to chemotherapy either demonstrates or approaches cost-effectiveness and NHB when added to the treatment of patients with PROC.
Recent Insights and Advances in the Management of Merkel Cell Carcinoma
Authors: Banks Patricia D. , Sandhu Shahneen , Gyorki David E. , Johnston Meredith L. , Rischin Danny
Published: July 2016

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy with a propensity for recurrence and a poor prognosis. Incidence of MCC is on the rise and is known to increase with advanced age, immunosuppression, and UV exposure. Merkel cell polyomavirus is implicated in the pathogenesis of virus-positive MCC and accounts for 80% of MCCs in the northern hemisphere and 25% in southern latitudes. In contrast, tumorigenesis of virus-negative MCC is linked to UV-induced DNA damage. Interplay between ubiquitous Merkel cell polyomavirus skin infections that commonly occur in healthy skin and other established risk factors, such as immunosuppression and UV exposure, remains poorly understood. Surgery and radiotherapy achieves excellent locoregional control; however, invariably, a significant proportion of patients develop disseminated disease that is incurable. Chemotherapy offers a high response rate for metastatic disease, but responses are short-lived and the impact on survival is not established. Recent advances in our understanding of the genetic landscape and immunobiology of MCC has led to investigation of novel treatments, including immune checkpoint inhibitors, which are likely to rapidly transform the way we manage these patients. We review epidemiologic, clinical, and histopathologic features of MCC; describe recent insights in MCC biology; and discuss novel therapeutic approaches.
Inhibition of Insulin-Degrading Enzyme Does Not Increase Islet Amyloid Deposition in Vitro
Authors: Hogan Meghan F. , Meier Daniel T. , Zraika Sakeneh , Templin Andrew T. , Mellati Mahnaz , Hull Rebecca L. , Leissring Malcolm A. , Kahn Steven E.
Published: July 2016

Islet amyloid deposition in human type 2 diabetes results in β-cell loss. These amyloid deposits contain the unique amyloidogenic peptide human islet amyloid polypeptide (hIAPP), which is also a known substrate of the protease insulin-degrading enzyme (IDE). Whereas IDE inhibition has recently been demonstrated to improve glucose metabolism in mice, inhibiting it has also been shown to increase cell death when synthetic hIAPP is applied exogenously to a β-cell line. Thus, we wanted to determine whether a similar deleterious effect is observed when hIAPP is endogenously produced and secreted from islets. To address this issue, we cultured hIAPP transgenic mouse islets that have the propensity to form amyloid for 48 and 144 hours in 16.7 mM glucose in the presence and absence of the IDE inhibitor 1. At neither time interval did IDE inhibition increase amyloid formation or β-cell loss. Thus, the inhibition of IDE may represent an approach to improve glucose metabolism in human type 2 diabetes, without inducing amyloid deposition and its deleterious effects.
A Novel Phenotype of Familial Hyperaldosteronism Type III: Concurrence of Aldosteronism and Cushing’s Syndrome
Authors: Tong Anli , Liu Guanghua , Wang Fen , Jiang Jun , Yan Zhaoli , Zhang Dianxi , Zhang Yinsheng , Cai Jun
Published: July 2016

Context:

To date, all the familial hyperaldosteronism type III (FH-III) patients reported presenting with typical primary aldosteronism (PA), without showing other adrenal hormone abnormalities.

Objective:

This study characterized a novel phenotype of FH-III and explored the possible pathogenesis.

Patients and Methods:

A male patient presented with severe hypertension and hypokalemia at the age of 2 years and developed Cushing’s syndrome at 20 years. He was diagnosed with PA and Cushing’s syndrome on the basis of typical biochemical findings. He had massive bilateral adrenal hyperplasia and underwent left adrenalectomy. KCNJ5 was sequenced, and secretion of aldosterone and cortisol were observed both in vivo and in vitro.

Results:

A heterozygous germline p.Glu145Gln mutation of KCNJ5 was identified. ARMC5, PRKAR1A, PDE8B, PDE11A, and PRKACA genes and β-catenin, P53 immunoactivity were normal in the adrenal. CYP11B2 was highly expressed, whereas mRNA expression of CYP11B1, CYP17A1, and STAR was relatively low in the hyperplastic adrenal, compared with normal adrenal cortex and other adrenal diseases. In the primary cell culture of the resected hyperplastic adrenal, verapamil and nifedipine, two calcium channel blockers, markedly inhibited the secretion of both aldosterone and cortisol and the mRNA expression of CYP11B1, CYP11B2, CYP17A1, and STAR.

Conclusions:

We presented the first FH-III patient who had both severe PA and Cushing’s syndrome. Hypersecretion of cortisol might be ascribed to overly large size of the hyperplastic adrenal because CYP11B1 expression was relatively low in his adrenal. Like aldosterone, synthesis and secretion of cortisol in the mutant adrenal may be mediated by voltage-gated Ca2+ channels.
Cannibalizing Doudouisme, Conceptualizing the Morne: Suzanne Césaire's Caribbean Ecopoetics
Authors: Curtius Anny Dominique
Published: July 2016

Focusing on Suzanne Césaire's essays published in Tropiques (1941–45), this study examines how through key concepts such as morne, homme plante, cannibal, camouflage, and doudou, Césaire articulates a Caribbean ecopoetics. As a conceptual cannibalism and a declaration of cultural and civilizational existence, her ecopoetics is an emancipatory aesthetics that annihilates the tenets of exoticism and mimicry and excavates the historical and political matrix of the Caribbean landscape. This study also expands the epistemological underpinnings of the Euro-American ecocritical canon and brings ecocriticism to Caribbean studies through the rehabilitation of Césaire. Ultimately, the essay argues that, as the spokes-theorist of Tropiques, Césaire markedly articulated meaningful prefaces to ongoing debates on entangled constructions of identity and land consciousness in Caribbean critical theory.
Here/Hear Now Aimé Césaire!
Authors: Wilder Gary
Published: July 2016

This essay focuses on how Aimé Césaire's postwar confrontation with the problem of colonial emancipation may speak directly to our current political and theoretical impasses, especially regarding alternative (nonliberal) forms of humanism and cosmopolitanism. By pursuing alternative forms of decolonization that would enable self-determination without state sovereignty, Césaire challenged the territorial and national assumptions that typically governed twentieth-century cultural and political thinking and which still inform social thought today. This essay examines several of Césaire's critical strategies—political pragmatism, radical literalism, poetic knowledge, untimely vision, and situated humanism—through which we can think with him about his world as well as ours. It seeks, in Césairean fashion, to treat him as a contemporary thinker through whom we might begin to decolonize intellectual history, deprovincialize black thought, and globalize critical theory.
Patriarchy from Margin to Center: Discipline, Territoriality, and Cruelty in the Apocalyptic Phase of Capital
Authors: Segato Rita Laura
Published: July 2016

Colonial intervention in what I have called the village world (Segato 2015) has minoritized everything regarding women. The term minoritization refers to women's representation and collective position in social thought: minoritizing women means relegating all issues related to them to the realm of the intimate, the private, the particular, that is, treating theirs as minority (and consequently minor) issues. Such minoritization of women is the result of a historical transition to colonial modernity.

This transition was driven at first by the process of conquest and colonization led by the overseas metropolis and then later by the administration of the Criollo-elite constructed state. Therefore, this process can also be described as criollization. The transition to colonial-modernity—the current rapid expansion of the state-business-media-Christianity front—intrudes into the mode of existence of the village world and has a massive impact on interpersonal relationships and the organization of gender relations in societies that are still governed by communitarian or collectivist models of coexistence, or where a communitarian fabric can still be found that, if not unscathed, is at least recognizable and vital. In its wake, that transition integrates different peoples in the mass of the national “citizenry.” Considering transformations in the gender system, the history of the patriarchal structure is indispensable for understanding the social shift introduced by modernity. Correctly reading what this transition has meant and how intervention has readjusted and eroded preexisting hierarchies allows us to understand a number of current phenomena that affect society as a whole, phenomena that cannot be expressed or contained by the term the woman problem.
Communal Strategies for Controlling Microfinance in Chuimeq'ena' Guatemala
Authors: Tzul Gladys Tzul
Published: July 2016

Can the presence of indebtedness and microfinance policies in communal lands in Guatemala be understood and characterized only as a form of domination and exploitation from above? No, they cannot. They cannot, firstly, because in communal lands, life is organized through pluralistic political formats that function in overlapping relational webs in order to guarantee the reproduction of life. Those policies are presented as a series of obstacles preventing the full unfolding of the communal webs. They cannot, secondly, because policies of entrepreneurship do not function as a sort of domination without resistance: communal webs invent a number of ways of constraining and transforming such policies, and communal authorities protect families when financial agencies want to extract late fees by dispossessing people of their land or housing. These communal webs have a particular space and geography in Chuimeq'ena' (Totonicapán), and from there they deploy a series of strategies for controlling microfinance institutions. How then can we understand the role of credit for families who organize their lives on communal lands?
Lenin of the Camps: Radical Translation in Colonial Digoel and Nazi Terezín
Authors: Mrázek Rudolf
Published: July 2016

Boven Digoel was a camp in colonial Dutch East Indies where Indonesian communists were exiled for their participation in a failed revolution in 1927. Terezín was a Nazi-built camp in Bohemia for the European Jews. Lenin was read and quoted in both camps—in Dutch, German, Czech, and other languages. Only a few internees had a Moscow experience and read or quoted Lenin in Russian. This essay presents the camps as a moment of radical translation. It was the crucial presumption of this translation that there could be nobody but Lenin for the people in the camps—or perhaps, to put it a better way—that there could be nobody but the people of the camp to conceive Lenin. Only when “born to them,” Lenin could grow into the particular militancy and need of the camps to say the world in a totally new—the only appropriate—code.
“History's Coffin Can Never Be Closed”: Qu Qiubai Translates Social Science
Authors: Barlow Tani
Published: July 2016

This article argues that the polymath Marxist philosopher and Communist Party apparatchik Qu Qiubai, who established sociology in the Chinese Marxist tradition by organizing the Sociology Department at Shanghai University in 1930, proposed that “society” was the sine qua non of human existence. To establish the contours of society and exploit the value of the social sciences, however, Qu as a translator struggled against China's written language in the name of sociology and social justice. In this regard, Qu understood that the diglossic literary language harbored ancient “ghosts” and philosophy dating from the origins of the written graphemes that make up the hanzi, or written medium. Always ill, always fleeing, the polylingual and cosmopolitan Qu, who died at age thirty-six, left behind a vast archive of unfinished work and fresh, complex ideas about the real, the social, the experiential, and the work of translation.
Inter-Asia Journal Work
Authors: Chen Kuan-Hsing
Published: July 2016

Journals have played a central role in the formation of intellectual communities throughout Asia since modern times. Inter-Asia Cultural Studies: Movements, launched in 2000, is no exception, except that it has attempted to connect with local intellectual circles and to build a multilayered international network in the region to overcome divisions and boundaries produced by the history of neo/colonialism and the cold war. Over the past sixteen years, the journal work has generated an archive of knowledge, a society, and a consortium of institutions to organize a biennial conference and a summer school, and it has established an Inter-Asia School to launch regional projects inside/outside the universities. However, the Inter-Asia Network is not yet a cohesive community capable of developing an analytical framework beyond nation-states from the angle of the continent as a whole, and of linking with its counterparts in Africa, Latin America, and the Caribbean.