bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of ErbB Receptors in Pulmonary Carcinoid Tumors
Authors: Rickman Otis B. , Vohra Pawan K. , Sanyal Bharati , Vrana Julie A. , Aubry Marie-Christine , Wigle Dennis A. , Thomas Charles F.
Published: May 2009

Purpose: This study aimed to investigate the expression of the ErbB family of receptor tyrosine kinases in pulmonary typical carcinoid and atypical carcinoid tumors and to understand the role of epidermal growth factor receptor (EGFR) signaling in pulmonary carcinoid tumor proliferation.

Experimental Design: Surgically resected typical carcinoid (n = 24) and atypical carcinoid (n = 7) tumor tissues were analyzed by immunohistochemical staining for EGFR, ErbB2, ErbB3, and ErbB4. Sequencing of tumor DNA of exons 18 to 21 of the EGFR gene and the KRAS gene was carried out. Biochemical analysis of lung carcinoid cell lines was used to investigate EGFR signal transduction and response to erlotinib inhibition.

Results: The analysis showed that 45.8% of typical carcinoid and 28.6% of atypical carcinoid tumors express EGFR, 100% of the tumors lack expression of ErbB2, and 100% have moderate to intense staining for ErbB3 and ErbB4. Sequencing of tumor DNA of exons 18 to 21 of the EGFR gene revealed the absence of tyrosine kinase domain mutations in these tumors. Instead, 80.6% tumors harbored a synonymous single nucleotide polymorphism in exon 20. Because EGFR and KRAS mutations tend not to be present at the same time, we sequenced the KRAS gene from pulmonary carcinoid tumor DNA and found that 100% were wild-type. Using a lung carcinoid cell line that expresses EGFR, we found that erlotinib reduced proliferation by inhibiting EGFR signal transduction.

Conclusions: Our findings suggest clinical potential for the use of EGFR inhibitors in the treatment of patients with pulmonary carcinoid tumors, particularly for patients with EGFR-positive pulmonary carcinoid tumors not amenable to surgical resection.
Baseline Vascular Endothelial Growth Factor Concentration as a Potential Predictive Marker of Benefit from Vandetanib in Non–Small Cell Lung Cancer
Authors: Hanrahan Emer O. , Ryan Anderson J. , Mann Helen , Kennedy Sarah J. , Langmuir Peter , Natale Ronald B. , Herbst Roy S. , Johnson Bruce E. , Heymach John V.
Published: May 2009

Purpose: Vandetanib [vascular endothelial growth factor (VEGF) receptor/epidermal growth factor receptor/RET inhibitor] has shown improvements in progression-free survival (PFS) in advanced non-small cell lung cancer in three randomized phase II studies: vandetanib versus gefitinib (study 3), docetaxel ± vandetanib (study 6), and carboplatin-paclitaxel and/or vandetanib (study 7). In study 7, vandetanib monotherapy was inferior to carboplatin-paclitaxel. We performed an exploratory retrospective analysis of the relationship between baseline circulating VEGF concentrations and PFS.

Experimental Design: Mean baseline VEGF levels were determined by ELISA from two baseline samples of plasma (163 of 168 patients, study 3; 65 of 127, study 6) or serum (144 of 181, study 7). High baseline VEGF values were above the immunoassay reference range for healthy subjects; low baseline VEGF values were within the range.

Results: Patients with low baseline VEGF had a lower risk of disease progression with vandetanib versus gefitinib [hazard ratio (HR), 0.55; 95% confidence interval (95% CI), 0.35-0.86; P = 0.01] or vandetanib 100 mg/d + docetaxel versus docetaxel (HR, 0.25; 95% CI, 0.09-0.68; P = 0.01). High VEGF patients had a similar risk of disease progression with vandetanib monotherapy versus gefitinib (HR, 1.03; 95% CI, 0.60-1.75; P = 0.92) or vandetanib 100 mg/d + docetaxel versus docetaxel (HR, 0.95; 95% CI, 0.25-3.61; P = 0.94). In study 7, low VEGF patients had a similar risk of disease progression with vandetanib monotherapy 300 mg/d versus carboplatin-paclitaxel (HR, 0.80; 95% CI, 0.41-1.56; P = 0.51); high VEGF patients progressed more quickly (HR, 1.60; 95% CI, 0.81-3.15; P = 0.17).

Conclusions: These analyses suggest that low baseline circulating VEGF may be predictive of PFS advantage in patients with advanced non-small cell lung cancer receiving vandetanib versus gefitinib or vandetanib + docetaxel versus docetaxel. Moreover, patients with low VEGF levels may have a similar outcome with either vandetanib monotherapy or carboplatin-paclitaxel.
Proangiogenic Contribution of Adiponectin toward Mammary Tumor Growth In vivo
Authors: Landskroner-Eiger Shira , Qian Binzhi , Muise Eric S. , Nawrocki Andrea R. , Berger Joel P. , Fine Eugene J. , Koba Wade , Deng Yingfeng , Pollard Jeffrey W. , Scherer Philipp E.
Published: May 2009

Purpose: Adipocytes represent one of the most abundant constituents of the mammary gland. They are essential for mammary tumor growth and survival. Metabolically, one of the more important fat-derived factors (“adipokines”) is adiponectin (APN). Serum concentrations of APN negatively correlate with body mass index and insulin resistance. To explore the association of APN with breast cancer and tumor angiogenesis, we took an in vivo approach aiming to study its role in the mouse mammary tumor virus (MMTV)-polyoma middle T antigen (PyMT) mammary tumor model.

Experimental Design: We compared the rates of tumor growth in MMTV-PyMT mice in wild-type and APN-null backgrounds.

Results: Histology and micro-positron emission tomography imaging show that the rate of tumor growth is significantly reduced in the absence of APN at early stages. PyMT/APN knockout mice exhibit a reduction in their angiogenic profile resulting in nutrient deprivation of the tumors and tumor-associated cell death. Surprisingly, in more advanced malignant stages of the disease, tumor growth develops more aggressively in mice lacking APN, giving rise to a larger tumor burden, an increase in the mobilization of circulating endothelial progenitor cells, and a gene expression fingerprint indicative of more aggressive tumor cells.

Conclusions: These observations highlight a novel important contribution of APN in mammary tumor development and angiogenesis, indicating that APN has potent angio-mimetic properties in tumor vascularization. However, in tumors deprived of APN, this antiangiogenic stress results in an adaptive response that fuels tumor growth through mobilization of circulating endothelial progenitor cells and the development of mechanisms enabling massive cell proliferation despite a chronically hypoxic microenvironment.
Adiponectin Deficiency Limits Tumor Vascularization in the MMTV-PyV-mT Mouse Model of Mammary Cancer
Authors: Denzel Martin S. , Hebbard Lionel W. , Shostak Gregory , Shapiro Lawrence , Cardiff Robert D. , Ranscht Barbara
Published: May 2009

Purpose: High levels of the fat-secreted cytokine adiponectin (APN) are present in the circulation of healthy people, whereas low levels correlate with an increased incidence of breast cancer in women. The current study experimentally probes the physiologic functions of APN in mammary cancer in a newly generated genetic mouse model.

Experimental Design: We established an APN null mouse model of mammary cancer by introducing the polyoma virus middle T (PyV-mT) oncogene expressed from mouse mammary tumor virus (MMTV) regulatory elements into APN null mice. MMTV-PyV-mT–induced tumors resemble ErbB2–amplified human breast cancers. We monitored tumor onset, kinetics, and animal survival, and analyzed vascular coverage, apoptosis, and hypoxia in sections from the primary tumors. Metastatic spreading was evaluated by analyses of the lungs.

Results: APN prominently localized to the vasculature in human and mouse mammary tumors. In APN null mice, MMTV-PyV-mT–induced tumors appeared with delayed onset and exhibited reduced growth rates. Affected animals survived control tumor-bearing mice by an average of 21 days. Pathologic analyses revealed reduced vascularization of APN null tumors along with increased hypoxia and apoptosis. At the experimental end point, APN null transgenic mice showed increased frequency of pulmonary metastases.

Conclusion: The current work identifies a proangiogenic contribution of APN in mammary cancer that, in turn, affects tumor progression. APN interactions with vascular receptors may be useful targets for developing therapies aimed at controlling tumor vascularization in cancer patients.
Combined Vascular Endothelial Growth Factor Receptor and Epidermal Growth Factor Receptor (EGFR) Blockade Inhibits Tumor Growth in Xenograft Models of EGFR Inhibitor Resistance
Authors: Naumov George N. , Nilsson Monique B. , Cascone Tina , Briggs Alexandra , Straume Oddbjorn , Akslen Lars A. , Lifshits Eugene , Byers Lauren Averett , Xu Li , Wu Hua-kang , Jänne Pasi , Kobayashi Susumu , Halmos Balazs , Tenen Daniel , Tang Xi M. , Engelman Jeffrey , Yeap Beow , Folkman Judah , Johnson Bruce E. , Heymach John V.
Published: May 2009

Purpose: The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) gefitinib and erlotinib benefit some non–small cell lung cancer (NSCLC) patients, but most do not respond (primary resistance) and those who initially respond eventually progress (acquired resistance). EGFR TKI resistance is not completely understood and has been associated with certain EGFR and K-RAS mutations and MET amplification.

Experimental Design: We hypothesized that dual inhibition of the vascular endothelial growth factor (VEGF) and EGFR pathways may overcome primary and acquired resistance. We investigated the VEGF receptor/EGFR TKI vandetanib, and the combination of bevacizumab and erlotinib in vivo using xenograft models of EGFR TKI sensitivity, primary resistance, and three models of acquired resistance, including models with mutated K-RAS and secondary EGFR T790M mutation.

Results: Vandetanib, gefitinib, and erlotinib had similar profiles of in vitro activity and caused sustained tumor regressions in vivo in the sensitive HCC827 model. In all four resistant models, vandetanib and bevacizumab/erlotinib were significantly more effective than erlotinib or gefitinib alone. Erlotinib resistance was associated with a rise in both host and tumor-derived VEGF but not EGFR secondary mutations in the KRAS mutant-bearing A549 xenografts. Dual inhibition reduced tumor endothelial proliferation compared with VEGF or EGFR blockade alone, suggesting that the enhanced activity of dual inhibition is due at least in part to antiendothelial effects.

Conclusion: These studies suggest that erlotinib resistance may be associated with a rise in both tumor cell and host stromal VEGF and that combined blockade of the VEGFR and EGFR pathways can abrogate primary or acquired resistance to EGFR TKIs. This approach merits further evaluation in NSCLC patients.
Low-Dose Methotrexate Enhances Aminolevulinate-Based Photodynamic Therapy in Skin Carcinoma Cells In vitro and In vivo
Authors: Anand Sanjay , Honari Golara , Hasan Tayyaba , Elson Paul , Maytin Edward V.
Published: May 2009

Purpose: To improve treatment efficacy and tumor cell selectivity of δ-aminolevulinic acid (ALA)-based photodynamic therapy (PDT) via pretreatment of cells and tumors with methotrexate to enhance intracellular photosensitizer levels.

Experimental Design: Skin carcinoma cells, in vitro and in vivo, served as the model system. Cultured human SCC13 and HEK1 cells, normal keratinocytes, and in vivo skin tumor models were preconditioned with methotrexate for 72 h and then incubated with ALA for 4 h. Changes in protoporphyrin IX (PpIX) levels and cell survival after light exposure were assessed.

Results: Methotrexate preconditioning of monolayer cultures preferentially increased intracellular PpIX levels 2- to 4-fold in carcinoma cells versus normal keratinocytes. Photodynamic killing was synergistically enhanced by the combined therapy compared with PDT alone. Methotrexate enhancement of PpIX levels was achieved over a broad methotrexate concentration range (0.0003-1.0 mg/L; 0.6 nmol/L-2 mmol/L). PpIX enhancement correlated with changes in protein expression of key porphyrin pathway enzymes, ∼4-fold increase in coproporphyrinogen oxidase and stable or slightly decreased expression of ferrochelatase. Differentiation markers (E-cadherin, involucrin, and filaggrin) were also selectively induced by methotrexate in carcinoma cells. In vivo relevance was established by showing that methotrexate preconditioning enhances PpIX accumulation in three models: (a) organotypic cultures of immortalized keratinocytes, (b) chemically induced skin tumors in mice; and (c) human A431 squamous cell tumors implanted subcutaneously in mice.

Conclusion: Combination therapy using short-term exposure to low-dose methotrexate followed by ALA-PDT should be further investigated as a new combination modality to enhance efficacy and selectivity of PDT for epithelial carcinomas.
Bringing DNA Repair in Tumors into Focus
Authors: Lord Christopher J. , Ashworth Alan
Published: May 2009

Biomarkers are of crucial importance in optimizing cancer therapies. In this edition of Clinical Cancer Research, Bañuelos and colleagues assess H2AX phosphorylation as a predictive biomarker of response to DNA damaging agents. We discuss these results as well as the impact that double strand break repair biomarkers may have in cancer therapy.
Cardiac Resynchronization Therapy Corrects Dyssynchrony-Induced Regional Gene Expression Changes on a Genomic Level
Authors: Barth Andreas S. , Aiba Takeshi , Halperin Victoria , DiSilvestre Deborah , Chakir Khalid , Colantuoni Carlo , Tunin Richard S. , Dimaano Victoria Lea , Yu Wayne , Abraham Theodore P. , Kass David A. , Tomaselli Gordon F.
Published: May 2009

Background—

Cardiac electromechanical dyssynchrony causes regional disparities in workload, oxygen consumption, and myocardial perfusion within the left ventricle. We hypothesized that such dyssynchrony also induces region-specific alterations in the myocardial transcriptome that are corrected by cardiac resynchronization therapy (CRT).

Methods and Results—

Adult dogs underwent left bundle branch ablation and right atrial pacing at 200 bpm for either 6 weeks (dyssynchronous heart failure, n=12) or 3 weeks, followed by 3 weeks of resynchronization by biventricular pacing at the same pacing rate (CRT, n=10). Control animals without left bundle branch block were not paced (n=13). At 6 weeks, RNA was isolated from the anterior and lateral left ventricular (LV) walls and hybridized onto canine-specific 44K microarrays. Echocardiographically, CRT led to a significant decrease in the dyssynchrony index, while dyssynchronous heart failure and CRT animals had a comparable degree of LV dysfunction. In dyssynchronous heart failure, changes in gene expression were primarily observed in the anterior LV, resulting in increased regional heterogeneity of gene expression within the LV. Dyssynchrony-induced expression changes in 1050 transcripts were reversed by CRT to levels of nonpaced hearts (false discovery rate <5%). CRT remodeled transcripts with metabolic and cell signaling function and greatly reduced regional heterogeneity of gene expression as compared with dyssynchronous heart failure.

Conclusions—

Our results demonstrate a profound effect of electromechanical dyssynchrony on the regional cardiac transcriptome, causing gene expression changes primarily in the anterior LV wall. CRT corrected the alterations in gene expression in the anterior wall, supporting a global effect of biventricular pacing on the ventricular transcriptome that extends beyond the pacing site in the lateral wall.
A Genome-Wide Association Scan of RR and QT Interval Duration in 3 European Genetically Isolated Populations
Authors: Marroni Fabio , Pfeufer Arne , Aulchenko Yurii S. , Franklin Christopher S. , Isaacs Aaron , Pichler Irene , Wild Sarah H. , Oostra Ben A. , Wright Alan F. , Campbell Harry , Witteman Jacqueline C. , Kääb Stefan , Hicks Andrew A. , Gyllensten Ulf , Rudan Igor , Meitinger Thomas , Pattaro Cristian , van Duijn Cornelia M. , Wilson James F. , Pramstaller Peter P.
Published: May 2009

Background—

We set out to identify common genetic determinants of the length of the RR and QT intervals in 2325 individuals from isolated European populations.

Methods and Results—

We analyzed the heart rate at rest, measured as the RR interval, and the length of the corrected QT interval for association with 318 237 single-nucleotide polymorphisms. The RR interval was associated with common variants within
GPR133
, a G-protein–coupled receptor (rs885389,
P
=3.9�10
−8
). The QT interval was associated with the earlier reported
NOS1AP
gene (rs2880058,
P
=2.00�10
−10
) and with a region on chromosome 13 (rs2478333,
P
=4.34�10
−8
), which is 100 kb from the closest known transcript
LOC730174
and has previously not been associated with the length of the QT interval.

Conclusion—

Our results suggested an association between the RR interval and
GPR133
and confirmed an association between the QT interval and
NOS1AP
.
Clinical and Functional Characterization of
TNNT2
Mutations Identified in Patients With Dilated Cardiomyopathy
Authors: Hershberger Ray E. , Pinto Jose Renato , Parks Sharie B. , Kushner Jessica D. , Li Duanxiang , Ludwigsen Susan , Cowan Jason , Morales Ana , Parvatiyar Michelle S. , Potter James D.
Published: May 2009

Background—

A key issue for cardiovascular genetic medicine is ascertaining if a putative mutation indeed causes dilated cardiomyopathy (DCM). This is critically important as genetic DCM, usually presenting with advanced, life-threatening disease, may be preventable with early intervention in relatives known to carry the mutation.

Methods and Results—

We recently undertook bidirectional resequencing of
TNNT2
, the cardiac troponin T gene, in 313 probands with DCM. We identified 6
TNNT2
protein-altering variants in 9 probands, all who had early onset, aggressive disease. Additional family members of mutation carriers were then studied when available. Four of the 9 probands had DCM without a family history, and 5 probands had familial DCM. Only 1 mutation (Lys210del) could be attributed as definitively causative from previous reports. Four of the 5 missense mutations were novel (Arg134Gly, Arg151Cys, Arg159Gln, and Arg205Trp), and one was previously reported with hypertrophic cardiomyopathy (Glu244Asp). Based on the clinical, pedigree, and molecular genetic data, these 5 mutations were considered possibly or likely disease causing. To further clarify their potential pathophysiologic impact, we undertook functional studies of these mutations in cardiac myocytes reconstituted with mutant troponin T proteins. We observed decreased Ca
2+
sensitivity of force development, a hallmark of DCM, in support of the conclusion that these mutations are disease causing.

Conclusions—

We conclude that the combination of clinical, pedigree, molecular genetic, and functional data strengthen the interpretation of
TNNT2
mutations in DCM.
Integration of Infarct Size, Tissue Perfusion, and Metabolism by Hybrid Cardiac Positron Emission Tomography/Computed Tomography
Authors: Lautamäki Riikka , Schuleri Karl H. , Sasano Tetsuo , Javadi Mehrbod S. , Youssef Amr , Merrill Jennifer , Nekolla Stephan G. , Abraham M. Roselle , Lardo Albert C. , Bengel Frank M.
Published: May 2009

Background—

Hybrid positron emission tomography/computed tomography (PET-CT) allows for combination of PET perfusion/metabolism imaging with infarct detection by CT delayed contrast enhancement. We used this technique to obtain biomorphological insights into the interrelation between tissue damage, inflammation, and microvascular obstruction early after myocardial infarction.

Methods and Results—

A porcine model of left anterior descending coronary artery occlusion/reperfusion was studied. Seven animals underwent PET-CT within 3 days of infarction, and a control group of 3 animals was scanned at >4 weeks. Perfusion and glucose uptake were assessed by [
13
N]-ammonia/[
18
F]-deoxyglucose (FDG), and 64-slice CT delayed contrast enhancement was measured. In the acute infarct model, CT revealed a no-reflow phenomenon suggesting microvascular obstruction in 80% of all infarct segments. PET showed increased FDG uptake in 68% of the CT-defined infarct segments. Ex vivo staining and histology showed active inflammation in the acute infarct area as an explanation for increased glucose uptake. In chronic infarction, CT showed no microvascular obstruction and agreed well with matched perfusion/metabolism defects on PET.

Conclusions—

Perfusion/metabolism PET and delayed enhancement CT can be combined within a single hybrid PET-CT session. Increased regional FDG uptake in the acute infarct area is frequently observed. In contrast to the chronic infarct setting, this indicates tissue inflammation that is commonly associated with microvascular obstruction as identified by no reflow on CT. The consequences of these pathophysiological findings for subsequent ventricular remodeling should be explored in further studies.
Effects of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) at Age 8 Years: Preliminary Data
Authors: McAnulty Gloria B. , Butler Samantha C. , Bernstein Jane H. , Als Heidelise , Duffy Frank H. , Zurakowski David
Published: May 2009

The current study reports the effects of NIDCAP (Newborn Individualized Developmental Care and Assessment Program) at 8 years of age for a randomized controlled trial of 38 very early born (≤29 weeks postmenstrual age), high-risk preterm infants. It was hypothesized that the experimental group at school age in comparison with the control group would perform significantly better neuropsychologically and neuroelectrophysiologically. Twenty-two (11 control, 11 experimental) children of the original 38 (18 control, 20 experimental) participants were studied at school age with a detailed neuropsychological battery and with EEG spectral coherence measures. Results indicated significantly better right hemisphere and frontal lobe function in the experimental group than the control group, both neuropsychologically and neurophysiologically. Neurobehavioral and physiological results in the newborn period successfully predicted the beneficial brain function effects at age 8 years. Results support the conclusion that the NIDCAP intervention has lasting effects into school age.
Ensuring the Safe Use of Genomic Medicine in Children
Authors: Haga Susanne B. , Terry Sharon F.
Published: May 2009

Several clinical guidelines recommend that genetic testing in children be limited to tests with immediate clinical benefit. However, use of genome risk profiling will not likely meet this requirement, as the benefits are anticipated to be years away. Children who are at higher risk, though, will benefit the most from early initiation of treatment or interventions. The shift in benefit from immediate to long-term benefit warrants a reevaluation of the current practices of testing in children. In this commentary, the authors advocate the use of genomic risk profiling to identify children at increased risk who would benefit from early intervention, but recognize that its integration in clinical practice for this population will require a more nuanced approach to delivery and follow-up. In particular, the importance of counseling, context, consent, communication, and follow-up in the delivery of genomic risk testing to children and adolescents is highlighted.
Underestimation of Children’s Weight Status: Views of Parents in an Urban Community
Authors: Tschamler Jillian M. , Conn Kelly M. , Cook Stephen R. , Halterman Jill S.
Published: May 2009

Objective. To examine the relationship between parents’ underestimation of their child’s weight status and concerns about their child’s weight and health. Methods. We conducted interviews with parents in an urban pediatric clinic (January through June 2006). Children’s height and weight were measured at the visit using standard techniques. Results. 193 children were included (response rate 87%, 18 months-9 years, 70% black); 31% of parents underestimated their child’s weight status (46% of overweight children, 24% of normal weight). Parents of normal-weight children who underestimated were more likely to be concerned about their child’s weight (39% vs 2.9%, P < .001) than those who did not underestimate. Parents of overweight children who underestimated were less likely to be concerned about their child’s weight (7.7% vs 59%, P < .001) than those who recognized their children as overweight. Conclusions. Many parents continue to underestimate their child’s weight status. These perceptions may present a barrier to the prevention of childhood obesity.
A Comparison of Perceptions of Fever and Fever Phobia by Ethnicity
Authors: Rupe Abbey , Ahlers-Schmidt Carolyn R. , Wittler Robert
Published: May 2009

Background. The purpose of our study was to compare caregiver perceptions of fever between ethnicities in a population with a large percentage of Hispanics. Methods. A 20-item, cross-sectional survey was collected from English- and Spanish-speaking parents of children. Questions addressed level of parental worry, parental definition of fever and high fever, and other items related to fever and its potential outcomes and treatments. Results. Responses indicated 57% of all parents report being “very worried” when their child is febrile. Results also indicated that parental fear of fever varies by race. Worry was also significantly higher in parents of younger children, and in parents with fewer years of education. However, Hispanic ethnicity was the single most predictive factor for fever worry. Conclusions. Fever phobia continues to exist. The prevalence appears to differ by ethnicity, making it important for physicians to use every patient encounter for culturally sensitive fever education.
Ethnic Differences in Parental Perceptions and Management of Childhood Fever
Authors: Cohee Lauren M. S. , Crocetti Michael T. , Serwint Janet R. , Sabath Bruce , Kapoor Sumit
Published: May 2009

To explore knowledge and management of childhood fever among ethnically diverse parents and identify opportunities for educational intervention, we administered a cross-sectional survey to a convenience sample of 487 parents of children enrolled in 2 urban hospital-based pediatric clinics. Outcomes included parental definition of fever, level of concern, and management of fever. Latino parents were least likely to identify a temperature as nonfebrile from 97-100.3°F (adjusted odds ratios [AOR] 0.06) or identify a fever as a temperature from 100.4-107°F (AOR 0.52). African Americans were least likely to believe that fever can cause death or brain damage (AOR 0.4). African Americans were more likely to dose ibuprofen more frequently than recommended (AOR 1.97). All ethnicities are equally likely to treat normal temperatures and dose acetaminophen too frequently.Therefore continued education of all families about fever is necessary, and there are opportunities to develop ethnically sensitive strategies to target educational interventions.
Antibiotic Use in Premature Infants After Discharge From the Neonatal Intensive Care Unit
Authors: Lorch Scott A. , Wade Kelly C. , Bakewell-Sachs Susan , Medoff-Cooper Barbara , Silber Jeffrey H. , Escobar Gabriel J.
Published: May 2009

Using a retrospective cohort of premature infants, we constructed multivariable Poisson models to determine factors associated with the receipt of antibiotics during the first year after discharge, N = 891. Black race (incidence rate ratio 1.80 compared with White infants, P = .008), male gender (incidence rate ratio 1.44; P = .007), bronchopulmonary dysplasia (incidence rate ratio 1.47; P = .04), and each additional child at home (incidence rate ratio 1.21, P = .002) increased the receipt of antibiotics for any reason. Male gender and additional children at home increased the receipt of nonrecommended antibiotics, while Black infants received care at facilities that prescribed more nonrecommended antibiotics. Even in a high-risk population of children, factors other than the medical history and presentation of the child may alter antibiotic prescription patterns and result in variations in care.
Integrating Internationalization in Counseling Psychology Training Programs
Authors: Turner-Essel Laura , Waehler Charles
Published: May 2009

Previous scholars have made specific suggestions regarding what counseling psychology training programs can do to help future psychologists become more cross-culturally aware. This article addresses the questions of whether and how U.S. counseling psychology training programs are currently employing these suggestions. Forty-seven American Psychological Association— accredited counseling psychology programs responded (67% response rate) to a survey designed to assess the availability of international training opportunities to graduate students in counseling psychology. In-depth interviews were also conducted with faculty members from 10 programs. Several ideas emerged from the data, including the role of students and the most common obstacles for developing an international perspective. Specific examples of programs' international activities are provided, and recommendations for future research are discussed.
Revisioning Organization Development
Authors: Bushe Gervase R. , Marshak Robert J.
Published: May 2009

This article identifies a bifurcation in the practice of organization development (OD) that is not fully acknowledged or discussed in OD textbooks or journal articles. Forms of OD practice exist that do not adhere to key assumptions and prescriptions of the founders of OD. Some of these dialogical forms of organization development practice are described and contrasts and similarities with the original, diagnostic, form of OD are analyzed. Practices that define dialogical forms of OD are identified with a call for increased acknowledgment of this bifurcation in OD research, practice, and teaching.
Impact Force when Fabric Inflates at High Speed
Authors: Limin Bao  , Kemmochi Kiyoshi
Published: May 2009

Occupant protection systems for automobiles are currently highly publicized. An airbag inflating at high speed impacts an occupant with great force. Airbag safety relies on its construction with primarily woven fabrics. We have referred to a typical pressure-time history of an airbag and developed a device to measure impact load when the fabric airbag inflates at high speed. When interior pressure in the airbag increased, impact load increased. Also, the impact load on a body increased as the distance between the body and airbag decreased. The impact force of an airbag inflating at high speed was simulated by a non-linear finite element method (FEM) combined with an incremental method, where the sample was modeled by a thin elastic shell. An experiment was conducted to verify the theory and this calculation method. Good agreement was obtained between the theoretical and experimental values for two types of fabric sample. This demonstrated that the mathematical technique developed here can satisfactorily predict the impact force when an airbag inflates at high speed and that the impact force depends appreciably on the mechanical properties of fabrics.
Peer and Parent Influences on School Engagement Among Early Adolescents
Authors: Simons-Morton Bruce , Rusan Chen
Published: May 2009

Students who are not motivated and do not try to do well are unlikely to achieve consistent with their abilities. This research assesses the relationships over time between school engagement and parenting practices and peer affiliation among sixth to ninth graders using latent growth models. Participants included 2,453 students recruited from seven public middle schools who were assessed five times between fall of sixth and ninth grades as part of a program evaluation study. School engagement and adjustment declined somewhat, whereas substance use, conduct problems, and problem-behaving friends increased and authoritative parenting practices declined. The significant, positive, over-time associations between school engagement and parent involvement, expectations, and monitoring were fully mediated by growth in problem-behaving friends. School adjustment mediated the relationship between school engagement and parent expectations. Findings suggest that authoritative parenting practices may foster school engagement directly and indirectly by discouraging affiliation with problem-behaving friends and facilitating school adjustment.
Population Pharmacokinetic Study of Cyclosporine in Patients With Nephrotic Syndrome
Authors: Xiaoli Du , Qiang Fu
Published: May 2009

Cyclosporine (CsA) is widely used in the treatment of nephrotic syndrome (NS). A population pharmacokinetic (PopPK) model was developed using trough blood CsA concentration data from 106 patients with NS. The pharmacokinetic analysis was performed using NONMEM with 1‐compartment linear model and first‐order elimination. Proportional and additive error models were used to describe the interindividual and intraindividual variabilities, respectively. Body weight (WT), serum albumin level (ALB), and combination therapy with rifampicin were found to be the most significant covariates explaining the variability of the apparent clearance (CL/F) of CsA among patients. The final model was as follows: TVCL/F = 34.1 × (WT/67.6)1.08 × (1 + RFA × 0.67) × (1 – ALB × 0.0088); TVV/F = 3.5 × WT; Ka = 1.28 fixed; where RFA = 1 with concurrent rifampicin use and 0 otherwise. The interindividual variabilities of CL/F and V/F were 18% and 27%, respectively. The residual error was 0.064 mg/L. The mean ± SD of CL/F and V/F of the 106 patients were 23.5 ± 7.2 L/h and 232.3 ± 71.5 L, respectively. The reliability and stability of the PopPK model were confirmed by nonparametric bootstrap procedure.
Psychopathology of Sex Offenders
Authors: Miller Holly A. , Turner Kim , Henderson Craig E.
Published: May 2009

Although male sex offenders have been the focus of numerous empirical investigations, there exists little data examining the characteristics of female sex offenders. This study examined personality profiles of incarcerated male and female sex offenders by utilizing Latent Profile Analysis (LPA) to categorize offenders based on their responses on the Personality Assessment Inventory (PAI). Building on previous research (see Turner, Miller, Henderson, 2008), the current sample of male and female sex offenders is best described using a 4-class model: Moderate Defensiveness, Elevated Alcohol and Drug Use, Moderate Psychopathology, and Elevated Psychopathology. Analyzing covariates and group membership, results indicated that male sex offenders were more likely to be included in the Elevated Drug and Alcohol group, whereas the female sex offenders were more likely to be included in the Moderate or Elevated Psychopathology group. Additional results of psychopathology and gender difference, as well as treatment implications are discussed.
Exposure to Violent Crime During Incarceration
Authors: Boxer Paul , Middlemass Keesha , Delorenzo Tahlia
Published: May 2009

In this study, formerly incarcerated violent ( n = 38) and nonviolent ( n = 86) offenders were assessed for their experiences as witnesses to or victims of violent crime during incarceration as well as outside of the prison or jail setting. Participants also provided information on several indicators of their current psychological adjustment. Analyses showed that, after controlling the effects of exposure to violence outside of the prison setting as well as a number of demographic factors, encounters with violence during incarceration were significantly related to aggressive and antisocial behavioral tendencies as well as emotional distress. In general, individuals who were witnesses, as well as victims, of violent crime showed the poorest adjustment post-release. These effects were not modified by violent offender status or by time since release from incarceration. The findings presented here underscore important new directions for research on the effects of exposure to violence.
A Self-instructional Program for Diabetes Educators on Preconception Counseling for Women With Diabetes
Authors: Cothran Mary M. , Sereika Susan M. , Fischl Andrea Rodgers , Schmitt Patricia L. , Charron-Prochownik Denise
Published: May 2009

Purpose

The purpose of this study was to develop, implement, and evaluate the effectiveness of a self-instructional preconception counseling (PC) training program for Certified Diabetes Educators (CDEs) to enhance PC knowledge and self-efficacy.

Methods

A 1-group, pre-post test study was conducted with 31 CDEs from a large medical center in western Pennsylvania. The self-instructional program included selected readings, such as the American Diabetes Association's position statement on PC of women with diabetes and an interactive CD-ROM, “Reproductive-Health Awareness for Teenage Women With Diabetes” (“READY-Girls”). Paper-and-pencil knowledge and self-efficacy questionnaires regarding PC and pregnancies of women with diabetes were completed by the CDEs before and immediately following the self-instructional program. Upon completion, participants received 5.0 Continuing Nursing Education contact hours (CNEs) from the State Nurses Association.

Results

Prior to receiving the program, all of the participants indicated they would benefit from further training on PC. Pretest knowledge scores averaged in the 70th percentile; following the program, the participants significantly increased (P < .01) PC knowledge and self-efficacy in providing PC to women with diabetes, including adolescents.

Conclusions

Although CDEs knew relevant information, they lacked some specific knowledge about PC, and they lacked confidence in their knowledge and in their ability to counsel patients. Diabetes educators can benefit from an education program to provide PC to their female patients, including adolescents. Computer or Web-based accessibility could make this a low-cost and easily disseminated program.
Slowly Digestible Carbohydrate Sources Can Be Used to Attenuate the Postprandial Glycemic Response to the Ingestion of Diabetes-Specific Enteral Formulas
Authors: Vanschoonbeek K. , Lansink M. , van Laere K.M.J. , Senden J.M.G. , Verdijk L.B. , van Loon L.J.C.
Published: May 2009

Purpose

The purpose of this study is to compare the glycemic and insulinemic responses following the ingestion of recently developed diabetes-specific enteral formulas versus a standard and a high-fat formula.

Methods

Fifteen type 2 diabetes patients were selected to participate in a randomized, double-blind, crossover study. Two enteral formulas (47 energy percent [En%] carbohydrate, 34En% fat, and 4 g fiber/200 mL) were defined with either isomaltulose (formula 1) or sucromalt (formula 2) as the main carbohydrate source. For comparison, an isoenergetic diabetes-specific, high-fat (33En% carbohydrate, 50En% fat, 2.9 g fiber/200 mL) and a standard formula (55En% carbohydrate, 30En% fat, 2.8 g fiber/ 200 mL) were tested.

Results

Ingestion of formulas 1 and 2 and the high-fat formula resulted in an attenuated blood glucose response when compared with the standard formula (P < .05). In accordance, peak plasma glucose concentrations were significantly lower when compared with the standard formula (189 ± 3.6 mg/dL [10.5 ± 0.2 mmol/L], 196.2 ± 3.6 mg/dL [10.9 ± 0.2 mmol/L], 187.2 ± 3.6 mg/dL [10.4 ± 0.2 mmol/L], and 237.6 ± 3.6 mg/dL [13.2 ± 0.2 mmol/L], respectively). Plasma insulin responses were lower after consumption of the newly developed and high-fat formulas. Ingestion of the high-fat formula resulted in a greater postprandial triglyceride response (P < .05).

Conclusions

Diabetes-specific enteral formulas rich in slowly digestible carbohydrate sources can be equally effective in attenuating the postprandial blood glucose response as low-carbohydrate, high-fat enteral formulas without elevating the plasma triglyceride response.
A National Study of the Diabetes Educator
Authors: Zrebiec John
Published: May 2009

Purpose

The practice analysis described in this report was conducted by the National Certification Board for Diabetes Educators (NCBDE) to (1) provide a basis for documenting the continuing validity of the Certification Examination for Diabetes Educators, (2) define new areas that should be assessed in future certification examinations, and (3) ensure that the content of certification examinations is related to practice.

Methods

The study involved developing a diabetes educator job task list and survey, distributing 4103 surveys, and analyzing survey responses from a multidisciplinary and geographically representative sample of certified diabetes educators.

Results

Eight hundred thirty-six surveys were suitable for analysis, with relevant demographic subgroups adequately represented. Based on survey data, an examination matrix and detailed content outline was constructed that will be used by NCBDE to assemble future test forms.

Conclusions

Certification examination specifications were developed directly related to the important activities that diabetes educators perform. Future forms of the certification examination will continue to be matched to job-related, criterion-referenced test specifications and will have strong evidence of content validity. Future forms of the exam will contain 200 items at specified cognitive levels with a representative sampling of tasks within 3 core areas from the detailed content outline.
Science and Power in Global Food Regulation: The Rise of the Codex Alimentarius
Authors: Winickoff David E. , Bushey Douglas M.
Published: May 2009

The emergence of the global administrative sector and its new forms of knowledge production, expert rationality, and standardization, remains an understudied topic in science studies. Using a coproductionist theoretical framework, we argue tha the mutual construction of epistemic and legal authority across international organizations has been critical for constituting and stabilizing a global regime for the regulation of food safety. The authors demonstrate how this process has also given rise to an authoritative framework for risk analysis touted as ‘‘scientifically rigorous’’ but embodying particular value choices regarding health, environment, and the dispensation of regulatory power. Finally, the authors trace how enrollment of the Codex Alimentarius in World Trade Law has heightened institutional dilemmas around legitimacy and credibility in science advice at the global level. Taken together, the case illustrates the importance of attending to the iterative construction of law and science in the constitution of new global administrative regimes.
Transforming Verbal Counts in Reports of Qualitative Descriptive Studies Into Numbers
Authors: Chang YunKyung , Voils Corrine I. , Sandelowski Margarete , Hasselblad Vic , Crandell Jamie L.
Published: May 2009

Reports of qualitative studies typically do not offer much information on the numbers of respondents linked to any one finding. This information may be especially useful in reports of basic, or minimally interpretive, qualitative descriptive studies focused on surveying a range of experiences in a target domain, and its lack may limit the ability to synthesize the results of such studies with quantitative results in systematic reviews. Accordingly, the authors illustrate strategies for deriving plausible ranges of respondents expressing a finding in a set of reports of basic qualitative descriptive studies on antiretroviral adherence and suggest how the results might be used. These strategies have limitations and are never appropriate for use with findings from interpretive qualitative studies. Yet they offer a temporary workaround for preserving and maximizing the value of information from basic qualitative descriptive studies for systematic reviews. They show also why quantitizing is never simply quantitative.
Preparation of Nursing Students for Change and Innovation
Authors: Kalisch Beatrice J. , Begeny Suzanne
Published: May 2009

As health care technology advances and patients require more care, nurses will need to be prepared to change old and incorporate new care practices and systems. Nurses must not only be able to deliver quality nursing care, but will also need to be capable of creating innovative approaches, reacting quickly, and taking calculated risks. Using the Organizational Engineering Model, this study examines the informational processing styles of students entering the nursing profession and in turn, measures the way they process information at the end of their education. The information processing style predicts the ability to innovate, take risks, and change. The findings of this study demonstrate that we attract nursing students who fall within the Conservator information processing style. Conservators focus on outcome certainty and a deliberate response. Schools of nursing also graduate students with this same profile, indicating that we have not altered their information processing style during their education.
The Effects of Integrative Reminiscence on Depressive Symptoms in Older African Americans
Authors: Shellman Juliette M. , Mokel Melissa , Hewitt Nnewka
Published: May 2009

The purpose of this pilot study was to evaluate the effect of integrative reminiscence on depressive symptoms in older African Americans. Fifty-six community-dwelling participants from a northeast urban setting were randomized into a reminiscence intervention group ( n = 19), attention control group (health education; n = 19), or true control group ( n = 18). Data were collected pre- and posttest using the Center for Epidemiological Studies Depression Scale. Significant differences were found between groups, F(2, 52) = 8.6, p = .001, η2 = .10. Using Holm’s method of post hoc analysis, the mean score for the reminiscence group was 6.8 ( SD = 4.7), significantly different from the control group 14.6 ( SD = 10.1) and the health education group 11.7 ( SD = 7.1). Findings demonstrate that integrative reminiscence has a positive effect on decreasing depressive symptoms in older African Americans.
Psychometric properties of the Stroke and Aphasia Quality of Life Scale (SAQOL-39) in a generic stroke population
Authors: Hilari Katerina , Lamping Donna L , Smith Sarah C , Northcott Sarah , Lamb Alice , Marshall Jane
Published: May 2009

Background: We previously developed the Stroke and Aphasia Quality of Life scale (SAQOL-39) and tested it with people with chronic aphasia. A scale allowing comparisons of quality of life between people with versus without aphasia post-stroke would be of value to clinicians.

Objectives: To evaluate the psychometrics of the SAQOL-39 in a generic stroke sample. Should this process result in a generic-stroke version of the scale (SAQOL-39g), a further aim is to compare the latter and the SAQOL-39 as tested in chronic aphasia.

Design and subjects: Repeated measures psychometric study, evaluating internal consistency, test—retest reliability, construct validity and responsiveness to change. People admitted to hospital with a first stroke were assessed two weeks, three months and six months post stroke.

Measures: SAQOL-39, National Institutes of Health Stroke Scale, Barthel, Frenchay Aphasia Screening Test, General Health Questionnaire-12 and Frenchay Activities Index.

Results: Of 126 eligible participants, 96 (76%) participated and 87 (69%) were able to self-report and are presented here. Testing the SAQOL-39 in generic stroke resulted in the SAQOL-39g, which has the same items as the SAQOL-39 but three domains: physical, psychosocial, communication. The SAQOL-39g showed good internal consistency (α = 0.95 overall score, 0.92—0.95 domains), test—retest reliability (interclass correlation (ICC) = 0.96 overall, 0.92—0.98 domains), convergent (r = 0.36—0.70 overall, 0.47—0.78 domains) and discriminant validity (r = 0.26 overall, 0.03—0.40 domains). It differentiated people by stroke severity and visual analogue scale (VAS)-defined quality of life. Moderate changes (d = 0.35—0.49; standardized response mean (SRM) = 0.29—0.53) from two weeks to six months supported responsiveness.

Conclusions: The SAQOL-39g demonstrated good reliability, validity and responsiveness to change. It can be used to evaluate quality of life in people with and without aphasia post stroke.