bluuebunny/crossref_metadata_2025 huggingface dataset:
The −174G/C and −572G/C Interleukin 6 Promoter Gene Polymorphisms in Mexican Patients with Rheumatoid Arthritis: A Case-Control Study
Authors: Zavaleta-Muñiz S. A. , Martín-Márquez B. T. , Gonzalez-Lopez L. , Gonzalez-Montoya N. G. , Díaz-Toscano M. L. , Ponce-Guarneros J. M. , Ruiz-Padilla A. J. , Mercado M. Vázquez-Del , Maldonado-González M. , Fafutis-Morris M. , Flores-Martínez S. E. , Martínez-García E. A. , Gamez-Nava J. I.
Published: September 2013

Objective. There is a lack of information about the genotype frequencies of IL-6 −174G/C and −572G/C polymorphisms in Mexicans with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the association of the IL-6 −174G/C and −572G/C polymorphisms in Mexican mestizo with RA.Methods. We included 137 patients with RA and 102 healthy controls. Patients were assessed for clinical characteristics. IL-6 −174G/C and −572G/C polymorphisms were genotyped using PCR-RFLP analysis. Allele and genotype frequencies and the Hardy-Weinberg equilibrium were computed. Odds ratios (ORs) were computed to identify the risk for RA associated with the presence of GG genotype in comparison with the GC or CC genotypes.Results. The genotype −174GG occurred at a higher frequency in cases and controls (77.4% versus 78.4%,P=0.845). We found similar results for the genotype −572GG (54% in patients versus 60.8% in controls,P=0.295).Conclusions. This is the first study to evaluate the association of −174G/C and −572G/C polymorphisms of the IL-6 gene with RA in Mexican mestizo patients. These two polymorphisms were not associated with RA in the studied sample. Additional studies are required to evaluate if these IL-6 polymorphisms have relevance to the development of more severe disease.
Histopathological Correlation of Atypical (C3) and Suspicious (C4) Categories in Fine Needle Aspiration Cytology of the Breast
Authors: Goyal Prashant , Sehgal Shelly , Ghosh Soumyesh , Aggarwal Deepti , Shukla Pritesh , Kumar Awanindra , Gupta Ruchika , Singh Sompal
Published: September 2013

Introduction.According to the National Cancer Institute (NCI) guidelines in 1996, breast lesions are categorized as C1 to C5 on fine needle aspiration (FNA) cytology. Very few studies are available in the English literature analyzing histopathology outcome of C3 (atypical, probably benign) and C4 (suspicious, probably malignant) lesions. Our study aims to correlate FNA cytology of breast lump diagnosed as C3 and C4 lesion with histopathological examination.Methods.During a period of 2 years, 59 cases of C3 and 26 cases of C4 were retrieved from total 1093 cases of breast FNA. All the cases were reviewed by two cytopathologists independently. The final 24 cases of C3 and 16 cases of C4 categories were correlated with histopathological diagnosis.Result.Among C3 category, 37.5% revealed malignant findings, whereas of C4 category, 87.5% were malignant on histopathology. This difference was statistically significant (P=0.0017). Sensitivity, specificity, positive predictive values, and negative predictive value of C4 category in diagnosing breast malignancy were 60.8%, 88.2%, 87.5%, and 62.5%, respectively.Conclusion.Although FNAC is simple, safe, cost-effective and accurate method for diagnosis of breast masses, one must be aware of its limitations particularly in C3 and C4 categories. Also, since both these categories carry different probabilities of malignancy and thus different management, we therefore, support maintaining C3 and C4 categories.
Refinements on the Hermite-Hadamard Inequalities forr-Convex Functions
Authors: Chen Feixiang , Liu Xuefei
Published: September 2013

We give some new generalizations of the well-known Hermite-Hadamard inequality forr-convex functions.
Measurement Effects of Survey Mode on the Equivalence of Attitudinal Rating Scale Questions
Authors: Klausch Thomas , Hox Joop J. , Schouten Barry
Published: September 2013

This study applies ordinal confirmatory factor analysis for multiple groups to assess equivalence of scale, random errors and systematic (nonrandom) errors of attitudinal questions surveyed on rating scales under different survey modes (Face-to-Face [F2F], Telephone, Paper, and Web). Empirical findings from a large-scale experiment are presented. Consistent with theoretical expectations, interviewer- and self-administered surveys measured all assessed questions on systematically different scales, with different systematic bias, and with differing extents of random error. These measurement effects were absent when comparing Paper with Web or F2F with Telephone. It is concluded that modes impact primarily systematic measurement effects affecting multiple items equally. Interviewer- and self-administered modes should only be combined with great care in mixed-mode surveys that focus on attitudinal constructs. Combining Paper and Web or Telephone and F2F are the viable options. Thereby choosing the self-administered modes appears more efficient, because these modes exhibited higher indicator reliabilities (smaller random error) than the interviewer modes.
Meeting AYP
Authors: Genao Soribel
Published: September 2013

‘The commander of our ship knows that the eyes and ears of the shipmates will provide valuable information; that when combined with the experience and knowledge of leadership will navigate the ship to clear waters and bountiful lands’ (Intertech, 2011). This analogy is reflective of the critical issue of meeting AYP (Adequate Yearly Progress) measures because it has made it very difficult to lead, teach, and learn in schools today. Therefore, as the analogy of ships above demonstrates, in order to traverse the rough waters that are the pressures of the daunting AYP, all the members of the ship [school], or the stakeholders [leaders, teachers, students], need to work together to plan and tackle AYP. Using pertinent questions created after reviewing literature on how stakeholders feel about AYP, research was conducted via surveys with stakeholders at a New York City school building that showed all the necessary parties must work together to meet AYP successfully.
Governance practice in English Further Education colleges
Authors: Masunga Robert
Published: September 2013

This article explores the purpose of governance in the further education (FE) sector in England and the increasing tasks demands that are expected from the governors of standards committees (SC) as part of their changing role. It will then examine how these task demands impact SC governors’ perceptions of FE governance. This research is done at a critical time when central government challenges the sector to strike a balance on the purpose of FE governance as: maximizing institutional performance and success; accountability and compliance; and governance for representation and democracy. A multi-case study design was used: six principals and 14 SC governors from six FE colleges in the English Midlands region were purposefully selected to participate in this study. Data were obtained from individually, digitally recorded face-to-face semi-structured interviews. Findings suggest that FE governance is very important but that the purpose(s) that it serves are ambiguous, and that the task demands expected from SC governors have greatly increased, causing detrimental effects on their perception of FE governance. In order to help improve practice, a new role conceptualization for SC governors is suggested.
Head teachers’ experiences of school inspection under Ofsted’s January 2012 framework
Authors: Courtney Steven J
Published: September 2013

This article focuses on head teachers’ experiences of inspection under Ofsted’s revised school inspection framework, their views of its principles and its implications for school leaders and leadership. The article draws on findings from a mixed-methods study to show that inspections are more focused on pupils’ attainment and progress. Head teachers intend to prioritize these and other judged areas over those no longer explicitly judged. Whilst broadly agreeing with the framework’s principles, many head teachers report that inspection was less positive owing to variation in inspector quality and rigidity in the (interpretation of the) framework. The article argues that leaders of schools serving socio-economically disadvantaged areas might find it harder to obtain a good Ofsted rating, with implications for head teacher recruitment and retention. It argues for improved Ofsted inspector training, a broad, values-driven leadership agenda by head teachers, and the recognition and promotion of contextual responses to educational challenges.
Evolution of tumefactive lesions in multiple sclerosis: A 12-year study with serial imaging in a single patient
Authors: Ikonomidou Vasiliki N , Richert Nancy D , Vortmeyer Alexander , Tovar-Moll Fernanda , Bielekova Bibiana , Cook Natalie E , Duyn Jeff H , Bagnato Francesca
Published: September 2013

We describe the acute presentation and the long-term evolution of recurrent tumefactive lesions (TLs) in a patient with relapsing–remitting multiple sclerosis. Five TLs occurred on three different occasions over a period of 12 years and these were followed by 73 serial magnetic resonance images (MRI). TL evolution was described by means of magnetization transfer imaging (MTI) and cerebrospinal fluid tissue specific imaging (TSI) over the follow-up period. During the study period, the patient had three clinical relapses with only minimal disability progression. MTI demonstrated that only the peripheral portion of each TL reverted to pre-lesional MT ratios within six months’ post-enhancement. Recurring TLs may present a similar pattern of evolution that may be associated with a long-term favourable clinical outcome.
Disease-modifying treatments for progressive multiple sclerosis
Authors: Comi Giancarlo
Published: September 2013

The last 20 years have seen major progress in the treatment of relapsing–remitting multiple sclerosis (RRMS) using a variety of drugs targeting immune dysfunction. In contrast, all clinical trials of such agents in primary progressive multiple sclerosis (PPMS) have failed and there is limited evidence of their efficacy in secondary progressive disease. Evolving concepts of the complex interplay between inflammatory and neurodegenerative processes across the course of multiple sclerosis (MS) may explain this discrepancy. This paper will provide an up-to-date overview of the rationale and results of the published clinical trials that have sought to alter the trajectory of both primary and secondary MS, considering studies involving drugs with a primary immune target and also those aiming for neuroprotection. Future areas of study will be discussed, building on these results combined with the experience of treating RRMS and new concepts emerging from laboratory science and animal models.
Retinoic acid has different effects on UCP1 expression in mouse and human adipocytes
Authors: Murholm Maria , Isidor Marie S , Basse Astrid L , Winther Sally , Sørensen Cathrine , Skovgaard-Petersen Jonas , Nielsen Maja M , Hansen Aina S , Quistorff Bjørn , Hansen Jacob B
Published: September 2013

Background

Increased adipose thermogenesis is being considered as a strategy aimed at preventing or reversing obesity. Thus, regulation of the uncoupling protein 1 (UCP1) gene in human adipocytes is of significant interest. Retinoic acid (RA), the carboxylic acid form of vitamin A, displays agonist activity toward several nuclear hormone receptors, including RA receptors (RARs) and peroxisome proliferator-activated receptor δ (PPARδ). Moreover, RA is a potent positive regulator of UCP1 expression in mouse adipocytes.

Results

The effects of all-trans RA (ATRA) on UCP1 gene expression in models of mouse and human adipocyte differentiation were investigated. ATRA induced UCP1 expression in all mouse white and brown adipocytes, but inhibited or had no effect on UCP1 expression in human adipocyte cell lines and primary human white adipocytes. Experiments with various RAR agonists and a RAR antagonist in mouse cells demonstrated that the stimulatory effect of ATRA on UCP1 gene expression was indeed mediated by RARs. Consistently, a PPARδ agonist was without effect. Moreover, the ATRA-mediated induction of UCP1 expression in mouse adipocytes was independent of PPARγ coactivator-1α.

Conclusions

UCP1 expression is differently affected by ATRA in mouse and human adipocytes. ATRA induces UCP1 expression in mouse adipocytes through activation of RARs, whereas expression of UCP1 in human adipocytes is not increased by exposure to ATRA.
Beneficial association of serum ghrelin and peptide YY with bone mineral density in the Newfoundland population
Authors: Amini Peyvand , Cahill Farrell , Wadden Danny , Ji Yunqi , Pedram Pardis , Vidyasankar Sangeetha , Yi Yanqing , Gulliver Wayne , Paterno Gary , Zhang Hongwei , Rideout Alecia , Sun Guang
Published: September 2013

Background

Ghrelin and peptide YY (PYY) are appetite regulating hormones secreted from the gastrointestinal tract (gut). Aside from their known effect on energy homeostasis, accumulating data indicates that these gut hormones also affect bone metabolism. However, data regarding the influence of ghrelin and PYY on bone density in humans is very limited, and the results are inconclusive. Therefore, this study was designed to investigate the potential association between circulating ghrelin and PYY with bone density indices in the general population.

Methods

A total of 2257 adult subjects from the CODING (Complex Diseases in the Newfoundland Population: Environment and Genetics) study participated in this investigation. Acylated ghrelin and total PYY were measured in serum after a 12-hour fasting, with the Enzyme- Linked Immunosorbent Assay (ELISA) method. Bone mineral density was measured by dual-energy X-ray absorptiometry at the spine, femoral neck, and total hip. Multiple regression analyses adjusting for age, BMI, physical activity, smoking, and alcohol consumption were employed to analyze the association between serum ghrelin and PYY with bone mineral density parameters.

Results

Significant positive associations of ghrelin concentration with L2-L4 BMD, L2-L4 Z-score, femoral neck BMD, femoral neck Z-score, total hip BMD, and total hip Z-score were found in women. No significant correlations between ghrelin and bone density indices were present in men. After dividing the female group into pre-menopausal and post-menopausal, ghrelin was positively correlated with femoral neck Z-score, and total hip Z-score in pre-menopausal women and L2-L4 BMD, and Z-score in post-menopausal group. Moreover, no significant association was discovered between serum PYY and bone density at any site.

Conclusion

Our results suggest a beneficial association of circulating ghrelin concentration with bone density in women at the population level. This association is independent of major confounding factors including BMI, physical activity, age, alcohol consumption, and smoking. Effect of menopause on this association seemed to be site specific. However, PYY does not seem to be associated with bone density parameters.
Non-invasive evaluation of energy loss in the pulmonary arteries using 4D phase contrast MR measurement: a proof of concept
Authors: Lee Namheon , Taylor Michael D , Hor Kan N , Banerjee Rupak K
Published: September 2013

Background

The repair surgery of congenital heart disease (CHD) associated with the right ventricular (RV)-pulmonary artery (PA) pathophysiology often left patients with critical post-operative lesions, leading to regurgitation and obstruction in the PAs. These lesions need longitudinal (with time) assessment for monitoring the RV function, in order for patients to have appropriate treatment before irreversible RV dysfunction occurs. In this research, we computed energy loss in the branch PAs using blood flow and pressure drop data obtained from 4D phase contrast (PC) MRI, to non-invasively quantify the RV-PA pathophysiology.

Methods

4D PC MRI was acquired for a CHD patient with abnormal RV-PA physiology, including pulmonary regurgitation and PA stenosis, and a subject with normal RV-PA physiology. The blood velocity, flow rate, and pressure drop data, obtained from 4D PC MRI, were used to compute and compare the energy loss values between the patient and normal subjects.

Results

The pressure drop in the branch PAs for the patient was −1.3 mmHg/s and −0.2 mmHg/s for the RPA and LPA, respectively, and was larger (one order of magnitude) than that for the control. Similarly, the total energy loss in the branch PAs for the patient, -96.9 mJ/s and −16.4 mJ/s, for the RPA and LPA, respectively, was larger than that for the control.

Conclusions

The amount of energy loss in the pulmonary blood flow for the patient was considerably larger than the normal subject due to PA regurgitation and PA stenosis. Thus, we believe that the status of RV-PA pathophysiology for CHD patients can be evaluated non-invasively using energy loss endpoint.
Increased long-term expression of pentraxin 3 in irradiated human arteries and veins compared to internal controls from free tissue transfers
Authors: Christersdottir Björklund Tinna , Reilly Sarah-Jayne , Gahm Caroline , Bottazzi Barbara , Mantovani Alberto , Tornvall Per , Halle Martin
Published: September 2013

Background

Clinical studies have shown that radiotherapy increases the risk of cardiovascular disease at irradiated sites years after exposure. However, there is a lack of biological explanations in humans. We therefore examined human blood vessels exposed to radiotherapy and studied C-reactive protein (CRP) and pentraxin 3 (PTX3), a new marker for adverse cardiovascular outcome dependent on TNF- alpha (TNFα) or interleukin-1beta (IL-1β) expression.

Methods

Pairs of irradiated and non-irradiated human conduit arteries and veins were harvested from the same patient during autologous free tissue transfer for cancer-reconstruction at a median time of 48 weeks after radiotherapy. Differential gene expression was studied using qRT-PCR, confirmed by immunohistochemistry and cellular origins determined by immunofluorescence.

Results

Gene expression in irradiated arteries compared to non-irradiated showed a consistent up-regulation of PTX3 in all patients and in a majority of veins (p < 0.001). Both TNFα and IL-1β were increased in irradiated compared to non-irradiated arteries (p < 0.01) and IL-1β correlated to the PTX3 expression (p = 0.017). Immunohistochemical and immunofluorescence staining confirmed an increased expression of PTX3 in endothelial cells, macrophages and smooth muscle cells.

Conclusions

The sustained expression of PTX3 in arteries and veins tie biological evidence in humans to clinical studies and encourage further exploration of innate immunity in the pathogenesis of a radiation-induced vasculopathy.
Combination of autophagy inducer rapamycin and oncolytic adenovirus improves antitumor effect in cancer cells
Authors: Cheng Pei-Hsin , Lian Serena , Zhao Robin , Rao Xiao-Mei , McMasters Kelly M , Zhou Heshan Sam
Published: September 2013

Background

Combination of oncolytic adenoviruses (Ads) and chemotherapy drugs has shown promising therapeutic results and is considered as a potential approach for cancer therapy. We previously have shown that autophagy may generate decomposed cellular molecules that can be used as nutrition to support virus replication in cancer cells. In this study, we evaluated a unique combination of the novel oncolytic Ad-cycE with rapamycin, an autophagy inducer and first-line chemotherapeutic drug.

Methods

The combination of oncolytic Ad-cycE and the autophagy inducer rapamycin was assessed for enhanced antitumor effect. We also evaluated the combined effects of rapamycin and Ad-cycE on cancer cell viability. The interaction between Ad-cycE and rapamycin was analyzed with Calcusyn (Biosoft, Ferguson, MO).

Results

We show that rapamycin induces autophagy, enhances Ad E1A expression and increases Ad oncolytic replication. Combination of rapamycin and Ad-cycE elicits stronger cytotoxicity than single treatment alone. The analyzed data indicates that the Ad-cycE and rapamycin combination has a significantly synergistic antitumor effect.

Conclusions

Our study provides a new insight into vector development and demonstrates the novel roles of autophagy in adenovirus replication. The combination of autophagy-induced chemotherapy and oncolytic virotherapy may be a new approach to improve future cancer treatment.
Long-term neurological outcome of a cohort of 80 patients with classical organic acidurias
Authors: Nizon Mathilde , Ottolenghi Chris , Valayannopoulos Vassili , Arnoux Jean-Baptiste , Barbier Valérie , Habarou Florence , Desguerre Isabelle , Boddaert Nathalie , Bonnefont Jean-Paul , Acquaviva Cécile , Benoist Jean-François , Rabier Daniel , Touati Guy , de Lonlay Pascale
Published: September 2013

Background

Classical organic acidurias including methylmalonic aciduria (MMA), propionic aciduria (PA) and isovaleric aciduria (IVA) are severe inborn errors of the catabolism of branched-chain amino acids and odd-numbered chain fatty acids, presenting with severe complications.

Methods

This study investigated the long-term outcome of 80 patients with classical organic aciduria (38 with MMA, 24 with PA and 18 with IVA) by integrating clinical, radiological, biochemical and genetic data.

Results

Patients were followed-up for a mean of 14 years [age 3.3-46.3 years]. PA included a greater number of patients with abnormal neurological examination (37% in PA, 24% in MMA and 0% in IVA), lower psychometric scores (abnormal evaluation at age 3 years in 61% of patients with PA versus 26% in MMA and 18% in IVA) and more frequent basal ganglia lesions (56% of patients versus 36% in MMA and 17% in IVA). All patients with IVA presented a normal neurological examination and only 1/3 presented cognitive troubles. Prognosis for MMA was intermediate. Biochemical metabolite analysis excluding acute decompensations revealed significant progressive increases of glycine, alanine and glutamine particularly in PA and possibly in MMA but no correlation with neurological outcome. A significant increase of plasma methylmalonic acid was found in MMA patients with intellectual deficiency (mean level of 199 μmol/L versus 70 μmol/L, p < 0.05), with an estimated significant probability of severe outcome for average levels between birth and age 6 years above 167 μmol/L. Urinary 3-hydroxypropionate (3-HP) levels were significantly higher in PA patients with intellectual deficiency (mean level of 68.9 μmol/mmol of creatinine versus 34.6 μmol/mmol of creatinine, p < 0.01), with an estimated significant probability of severe outcome for average levels between birth and age 6 years above 55 μmol/mmol. As for molecular analysis, prognosis of MMA patients with mutations involving the MMAA gene was better compared to patients with mutations involving the MUT gene.

Conclusion

Propionic aciduria had the most severe neurological prognosis. Our radiological and biochemical data are consistent with a mitochondrial toxicity mechanism. Follow-up plasma MMA and urinary 3-HP levels may have prognostic significance calling for greater efforts to optimize long-term management in these patients.
CD38 in the nucleus accumbens and oxytocin are related to paternal behavior in mice
Authors: Akther Shirin , Korshnova Natalia , Zhong Jing , Liang Mingkun , Cherepanov Stanislav M , Lopatina Olga , Komleva Yulia K , Salmina Alla B , Nishimura Tomoko , Fakhrul Azam AKM , Hirai Hirokazu , Kato Ichiro , Yamamoto Yasuhiko , Takasawa Shin , Okamoto Hiroshi , Higashida Haruhiro
Published: September 2013

Background

Mammalian sires participate in infant care. We previously demonstrated that sires of a strain of nonmonogamous laboratory mice initiate parental retrieval behavior in response to olfactory and auditory signals from the dam during isolation in a new environment. This behavior is rapidly lost in the absence of such signals when the sires are caged alone. The neural circuitry and hormones that control paternal behavior are not well-understood. CD38, a membrane glycoprotein, catalyzes synthesis of cyclic ADP-ribose and facilitates oxytocin (OT) secretion due to cyclic ADP-ribose-dependent increases in cytosolic free calcium concentrations in oxytocinergic neurons in the hypothalamus. In this paper, we studied CD38 in the nucleus accumbens (NAcc) and the role of OT on paternal pup retrieval behavior using CD38 knockout (CD38−/−) mice of the ICR strain.

Results

CD38−/− sires failed to retrieve when they were reunited with their pups after isolation together with the mate dams, but not with pup, in a novel cage for 10 min. CD38−/− sires treated with a single subcutaneous injection of OT exhibited recovery in the retrieval events when caged with CD38−/− dams treated with OT. We introduced human CD38 in the NAcc of CD38−/− sires using a lentiviral infection technique and examined the effects of local expression of CD38. Pairs of knockout dams treated with OT and sires expressing CD38 in the NAcc showed more retrieval (83% of wild-type sire levels). Complete recovery of retrieval was obtained in sires with the expression of CD38 in the NAcc in combination with OT administration. Other paternal behaviors, including pup grooming, crouching and huddling, were also more common in CD38−/− sires with CD38 expression in the NAcc compared with those in CD38−/− sires without CD38 expression in the NAcc.

Conclusions

CD38 in the NAcc and OT are critical in paternal behavior.
Real-time prostate motion assessment: image-guidance and the temporal dependence of intra-fraction motion
Authors: Cramer Avilash K , Haile Amanu G , Ognjenovic Sanja , Doshi Tulsee S , Reilly William Matthew , Rubinstein Katherine E , Nabavizadeh Nima , Nguyen Thuan , Meng Lu Z , Fuss Martin , Tanyi James A , Hung Arthur Y
Published: September 2013

Background

The rapid adoption of image-guidance in prostate intensity-modulated radiotherapy (IMRT) results in longer treatment times, which may result in larger intrafraction motion, thereby negating the advantage of image-guidance. This study aims to qualify and quantify the contribution of image-guidance to the temporal dependence of intrafraction motion during prostate IMRT.

Methods

One-hundred and forty-three patients who underwent conventional IMRT (n=67) or intensity-modulated arc therapy (IMAT/RapidArc, n=76) for localized prostate cancer were evaluated. Intrafraction motion assessment was based on continuous RL (lateral), SI (longitudinal), and AP (vertical) positional detection of electromagnetic transponders at 10 Hz. Daily motion amplitudes were reported as session mean, median, and root-mean-square (RMS) displacements. Temporal effect was evaluated by categorizing treatment sessions into 4 different classes: IMRTc (transponder only localization), IMRTcc (transponder + CBCT localization), IMATc (transponder only localization), or IMATcc (transponder + CBCT localization).

Results

Mean/median session times were 4.15/3.99 min (IMATc), 12.74/12.19 min (IMATcc), 5.99/5.77 min (IMRTc), and 12.98/12.39 min (IMRTcc), with significant pair-wise difference (p<0.0001) between all category combinations except for IMRTcc vs. IMATcc (p>0.05). Median intrafraction motion difference between CBCT and non-CBCT categories strongly correlated with time for RMS (t-value=17.29; p<0.0001), SI (t-value=−4.25; p<0.0001), and AP (t-value=2.76; p<0.0066), with a weak correlation for RL (t-value=1.67; p=0.0971). Treatment time reduction with non-CBCT treatment categories showed reductions in the observed intrafraction motion: systematic error (Σ)<0.6 mm and random error (σ)<1.2 mm compared with ≤0.8 mm and <1.6 mm, respectively, for CBCT-involved treatment categories.

Conclusions

For treatment durations >4-6 minutes, and without any intrafraction motion mitigation protocol in place, patient repositioning is recommended, with at least the acquisition of the lateral component of an orthogonal image pair in the absence of volumetric imaging.
Bridge jobs in Europe
Authors: Brunello Giorgio , Langella Monica
Published: September 2013

We study the transitions from career to gradual and permanent retirement by a sample of (Continental) European males aged 55 to 70 in the late 2000s. We find that only 14.6% of the workers in this sample moved from a career to a bridge job by the time of the interview, much less than in the United States, where this share is estimated at close to 60%. We use the cross country and time variation in employment protection legislation and minimum retirement age to study whether recent changes in these labour market institutions have had any effect on the transitions out of career jobs. We find that policies that have increased minimum retirement age and reduced the strictness of employment protection legislation have raised the hazard into gradual retirement in Northern and Central European countries and the permanence in career jobs in Mediterranean countries.

JEL codes

J26, J11, J21
Proliferation and estrogen signaling can distinguish patients at risk for early versus late relapse among estrogen receptor positive breast cancers
Authors: Bianchini Giampaolo , Pusztai Lajos , Karn Thomas , Iwamoto Takayuki , Rody Achim , Kelly Catherine M , Müller Volkmar , Schmidt Marcus , Qi Yuan , Holtrich Uwe , Becker Sven , Santarpia Libero , Fasolo Angelica , Del Conte Gianluca , Zambetti Milvia , Sotiriou Christos , Haibe-Kains Benjamin , Symmans W Fraser , Gianni Luca
Published: September 2013

Introduction

We examined if a combination of proliferation markers and estrogen receptor (ER) activity could predict early versus late relapses in ER-positive breast cancer and inform the choice and length of adjuvant endocrine therapy.

Methods

Baseline affymetrix gene-expression profiles from ER-positive patients who received no systemic therapy (n = 559), adjuvant tamoxifen for 5 years (cohort-1: n = 683, cohort-2: n = 282) and from 58 patients treated with neoadjuvant letrozole for 3 months (gene-expression available at baseline, 14 and 90 days) were analyzed. A proliferation score based on the expression of mitotic kinases (MKS) and an ER-related score (ERS) adopted from Oncotype DX® were calculated. The same analysis was performed using the Genomic Grade Index as proliferation marker and the luminal gene score from the PAM50 classifier as measure of estrogen-related genes. Median values were used to define low and high marker groups and four combinations were created. Relapses were grouped into time cohorts of 0–2.5, 0–5, 5-10 years.

Results

In the overall 10 years period, the proportional hazards assumption was violated for several biomarker groups indicating time-dependent effects. In tamoxifen-treated patients Low-MKS/Low-ERS cancers had continuously increasing risk of relapse that was higher after 5 years than Low-MKS/High-ERS cancers [0 to 10 year, HR 3.36; p = 0.013]. High-MKS/High-ERS cancers had low risk of early relapse [0–2.5 years HR 0.13; p = 0.0006], but high risk of late relapse which was higher than in the High-MKS/Low-ERS group [after 5 years HR 3.86; p = 0.007]. The High-MKS/Low-ERS subset had most of the early relapses [0 to 2.5 years, HR 6.53; p < 0.0001] especially in node negative tumors and showed minimal response to neoadjuvant letrozole. These findings were qualitatively confirmed in a smaller independent cohort of tamoxifen-treated patients. Using different biomarkers provided similar results.

Conclusions

Early relapses are highest in highly proliferative/low-ERS cancers, in particular in node negative tumors. Relapses occurring after 5 years of adjuvant tamoxifen are highest among the highly-proliferative/high-ERS tumors although their risk of recurrence is modest in the first 5 years on tamoxifen. These tumors could be the best candidates for extended endocrine therapy.
Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax: review of the literature and meta-analysis
Authors: Alrajab Saadah , Youssef Asser M , Akkus Nuri I , Caldito Gloria
Published: September 2013

Introduction

Ultrasonography is being increasingly utilized in acute care settings with expanding applications. Pneumothorax evaluation by ultrasonography is a fast, safe, easy and inexpensive alternative to chest radiographs. In this review, we provide a comprehensive analysis of the current literature comparing ultrasonography and chest radiography for the diagnosis of pneumothorax.

Methods

We searched English-language articles in MEDLINE, EMBASE and Cochrane Library dealing with both ultrasonography and chest radiography for diagnosis of pneumothorax. In eligible studies that met strict inclusion criteria, we conducted a meta-analysis to evaluate the diagnostic accuracy of pleural ultrasonography in comparison with chest radiography for the diagnosis of pneumothorax.

Results

We reviewed 601 articles and selected 25 original research articles for detailed review. Only 13 articles met all of our inclusion criteria and were included in the final analysis. One study used lung sliding sign alone, 12 studies used lung sliding and comet tail signs, and 6 studies searched for lung point in addition to the other two signs. Ultrasonography had a pooled sensitivity of 78.6% (95% CI, 68.1 to 98.1) and a specificity of 98.4% (95% CI, 97.3 to 99.5). Chest radiography had a pooled sensitivity of 39.8% (95% CI, 29.4 to 50.3) and a specificity of 99.3% (95% CI, 98.4 to 100). Our meta-regression and subgroup analyses indicate that consecutive sampling of patients compared to convenience sampling provided higher sensitivity results for both ultrasonography and chest radiography. Consecutive versus nonconsecutive sampling and trauma versus nontrauma settings were significant sources of heterogeneity. In addition, subgroup analysis showed significant variations related to operator and type of probe used.

Conclusions

Our study indicates that ultrasonography is more accurate than chest radiography for detection of pneumothorax. The results support the previous investigations in this field, add new valuable information obtained from subgroup analysis, and provide accurate estimates for the performance parameters of both bedside ultrasonography and chest radiography for pneumothorax evaluation.
Analysis and Design of Direct Steam Injection for Tomato Concentrate Sterilization
Authors: Casoli Paolo , Copelli Gabriele
Published: September 2013

Direct steam injection is a sterilization technique which is often used for high-viscosity fluid food, when the preservation of the quality characteristics and energy efficiency are the priority. In this work, an apparatus for the sterilization of tomato concentrate has been analyzed by means of a 3D computational fluid dynamics (CFD) model, in order to optimize the exchanger performance in terms of temperature distribution inside the product. A multidimensional two-phase model of steam injection inside a non-Newtonian pseudoplastic fluid was adopted to evaluate the thermal history of the product and the condensation rate of the steam injected in the heat exchanger during the thermal process. Subsequently, the CFD analysis has been extended to examine the effects of the different process parameters (sterilization temperature, steam flow rate, radial and axial temperature profiles and nozzle geometry) on the resulting product. Results obtained allowed to understand the effects of process parameters on the behavior of the condensing steam and obtain better performance of the exchanger in terms of temperature distribution of the treated product.
Study, Copy, and Conquer
Authors: Brown Julie Hedges
Published: September 2013

Schumann's 1842 chamber music exemplifies a common theme in his critical writings, that to sustain a notable inherited tradition composers must not merely imitate the past but reinvent it anew. Yet Schumann's innovative practices have not been sufficiently acknowledged, partly because his instrumental repertory seemed conservative to critics of Schumann's day and beyond, especially when compared to his earlier experimental piano works and songs. This essay offers a revisionist perspective by exploring three chamber movements that recast sonata procedure in one of two complementary ways: either the tonic key monopolizes the exposition (as in the first movement of the Piano Quartet in E♭ major, op. 47), or a modulating main theme undercuts a definitive presence of the tonic key at the outset (as in the first movement of the String Quartet in A major, op. 41, no. 3, and the finale of the String Quartet in A minor, op. 41, no. 1). Viewed against conventional sonata practice, these chamber movements appear puzzling, perhaps even incoherent or awkward, since they thwart the tonal contrast of keys so characteristic of the form. Yet these unusual openings, and the compelling if surprising ramifications that they prompt, signal not compositional weakness but rather an effort to reinterpret the form as a way of strengthening its expressive power.

My analyses also draw on other perspectives to illuminate these sonata forms. All three movements adopt a striking thematic idea or formal ploy that evokes a specific Beethovenian precedent; yet each movement also highlights Schumann’s creative distance from his predecessor by departing in notable ways from the conjured model. Aspects of Schumann’s sketches, especially those concerning changes made during the compositional process, also illuminate relevant analytical points. Finally, in the analysis of the finale of the A-minor quartet, I consider how Schumann’s evocation of Hungarian Gypsy music may be not merely incidental to but supportive of his reimagined sonata form. Ultimately, the perspectives offered here easily accommodate—even celebrate—Schumann’s idiosyncratic approach to sonata form. They also demonstrate that Schumann’s earlier experimental tendencies did not contradict his efforts in the early 1840s to further advance his inherited classical past.
Prevalence of Transposed Teeth as Seen on Panoramic Radiographs in Children with Cleft Lip and Palate
Authors: Campbell Richard E. , Levin Linda , Mauseth Spencer E. , Hu Junyi , Zheng Shu , Wilson Stephen , Saal Howard
Published: September 2013

Objective

To assess the prevalence of complete and incomplete transpositions of teeth in subjects with repaired cleft lip and/or palate.

Design

Retrospective review. Panoramic radiographs from 364 subjects with repaired cleft lip and/or palate and with or without syndromes were compared with 364 panoramic radiographs from noncleft controls. The percentages of completely or incompletely transposed teeth, missing teeth, and pegged teeth were recorded for each subject and control.

Setting

Primary care dental clinic in a university affiliated, not-for-profit hospital.

Main Outcome Measures

Presence of complete and incomplete transposed teeth, missing teeth, and pegged teeth detected on subjects' panoramic radiographs.

Results

This study revealed greater prevalence of tooth transposition in subjects with cleft lip and/or palate (52/364 = 14.3%) as compared with noncleft controls (1/364 = 0.3%; P < .001).

Conclusions

There was a higher prevalence of tooth transpositions in subjects with repaired cleft lip and/or palate with/or without syndromes than in noncleft controls. There was a weak association between transpositions and missing teeth ( P = .12) and between transpositions and pegged teeth (.23).
Effects of Gravity on the Velopharyngeal Structures in Children Using Upright Magnetic Resonance Imaging
Authors: Kollara Lakshmi , Perry Jamie L.
Published: September 2013

Objective

The influence of gravity on the velopharyngeal structures in children is unknown. The purpose of this study is to compare the velopharyngeal mechanism in the upright and supine positions while at rest and during sustained speech production in children between 4 and 8 years old.

Methods

A 0.6 Tesla open-type, multipositional magnetic resonance imaging scanner was used to image subjects in the upright and supine positions. The scanning protocol included a T2 fluid attenuation inversion recovery and an oblique coronal turbo spin echo scan with short scanning durations (7.9 seconds) to enable visualization of the velopharyngeal anatomy during rest and production of sustained /i/ and /s/.

Results

The magnetic resonance imaging protocol used for this study enabled successful visualization of the velopharyngeal anatomy in the sagittal and oblique coronal planes at rest and during sustained phonation of /i/ and /s/. Positional differences demonstrated a small nonsignificant ( P > .05) variation for velar measures (length, thickness, and height), retrovelar space, and levator veli palatini measures (length and angles of origin).

Conclusions

Gravity had a negligible effect on velar length, velar thickness, velar height, retrovelar space, levator muscle length, and levator angles of origin. Supine imaging data can be translated to an upright activity such as speech. This is the first study to provide normative levator muscle lengths for children between 4 and 8 years old. Upright imaging may be a promising tool for difficult-to-test populations.
Calorie or Carbohydrate Restriction? The Ketogenic Diet as Another Option for Supportive Cancer Treatment
Authors: Klement Rainer J.
Published: September 2013

The author agrees with Champ et al. that calorie reduction (CR) is a good supportive intervention for patients undergoing radiotherapy or chemotherapy. However, for those with cachexia or for those who are at risk for cachexia, CR may be problematic. Additionally, less food consumed means fewer nutrients. For these patients, the author suggests the addition of the ketogenic diet, which could be designed to include high-quality foods and could be combined with anticancer neutraceuticals.
In Reply
Authors: Champ Colin E. , Simone Nicole L.
Published: September 2013

In response to Dr. Klement's comments, Drs. Simone and Champ agree that a ketogenic diet (KD) may be added as a dietary intervention in cancer treatment. They suggest that patients with certain cancers that put them at risk for cachexia may respond best to a KD, whereas patients with cancers that do worse with weight gain might benefit more from calorie restriction or intermittent fasting.
Plant responses, climate pivot points, and trade‐offs in water‐limited ecosystems
Authors: Munson Seth M.
Published: September 2013

Plant species in dryland ecosystems are limited by water availability and may be vulnerable to increases in aridity. Methods are needed to monitor and assess the rate of change in plant abundance and composition in relation to climate, understand the potential for degradation in dryland ecosystems, and forecast future changes in plant species assemblages. I employ nearly a century of vegetation monitoring data from three North American deserts to demonstrate an approach to determine plant species responses to climate and critical points over a range of climatic conditions at which plant species shift from increases to decreases in abundance (climate pivot points). I assess these metrics from a site to regional scale and highlight how these indicators of plant performance can be modified by the physical and biotic environment. For example, shrubs were more responsive to drought and high temperatures on shallow soils with limited capacity to store water and fine‐textured soils with slow percolation rates, whereas perennial grasses were more responsive to precipitation in sparse shrublands than in relatively dense grasslands and shrublands, where competition for water is likely more intense. The responses and associated climate pivot points of plant species aligned with their lifespan and structural characteristics, and the relationship between responses and climate pivot points provides evidence of the trade‐off between the capacity of a plant species to increase in abundance when water is available and its drought resistance.
Dynamic Dependency Pairs for Algebraic Functional Systems
Authors: Kop Cynthia , van Raamsdonk Femke
Published: September 2013

We extend the higher-order termination method of dynamic dependency pairs to
Algebraic Functional Systems (AFSs). In this setting, simply typed lambda-terms
with algebraic reduction and separate {\beta}-steps are considered. For
left-linear AFSs, the method is shown to be complete. For so-called local AFSs
we define a variation of usable rules and an extension of argument filterings.
All these techniques have been implemented in the higher-order termination tool
WANDA.
Generic Fibrational Induction
Authors: Ghani Neil , Johann Patricia , Fumex Clement
Published: September 2013

This paper provides an induction rule that can be used to prove properties of
data structures whose types are inductive, i.e., are carriers of initial
algebras of functors. Our results are semantic in nature and are inspired by
Hermida and Jacobs' elegant algebraic formulation of induction for polynomial
data types. Our contribution is to derive, under slightly different
assumptions, a sound induction rule that is generic over all inductive types,
polynomial or not. Our induction rule is generic over the kinds of properties
to be proved as well: like Hermida and Jacobs, we work in a general fibrational
setting and so can accommodate very general notions of properties on inductive
types rather than just those of a particular syntactic form. We establish the
soundness of our generic induction rule by reducing induction to iteration. We
then show how our generic induction rule can be instantiated to give induction
rules for the data types of rose trees, finite hereditary sets, and
hyperfunctions. The first of these lies outside the scope of Hermida and
Jacobs' work because it is not polynomial, and as far as we are aware, no
induction rules have been known to exist for the second and third in a general
fibrational framework. Our instantiation for hyperfunctions underscores the
value of working in the general fibrational setting since this data type cannot
be interpreted as a set.
Efficient CSL Model Checking Using Stratification
Authors: Zhang Lijun , Jansen David N. , Nielson Flemming , Hermanns Holger
Published: September 2013

For continuous-time Markov chains, the model-checking problem with respect to
continuous-time stochastic logic (CSL) has been introduced and shown to be
decidable by Aziz, Sanwal, Singhal and Brayton in 1996. Their proof can be
turned into an approximation algorithm with worse than exponential complexity.
In 2000, Baier, Haverkort, Hermanns and Katoen presented an efficient
polynomial-time approximation algorithm for the sublogic in which only binary
until is allowed. In this paper, we propose such an efficient polynomial-time
approximation algorithm for full CSL. The key to our method is the notion of
stratified CTMCs with respect to the CSL property to be checked. On a
stratified CTMC, the probability to satisfy a CSL path formula can be
approximated by a transient analysis in polynomial time (using uniformization).
We present a measure-preserving, linear-time and -space transformation of any
CTMC into an equivalent, stratified one. This makes the present work the
centerpiece of a broadly applicable full CSL model checker. Recently, the
decision algorithm by Aziz et al. was shown to work only for stratified CTMCs.
As an additional contribution, our measure-preserving transformation can be
used to ensure the decidability for general CTMCs.
Quantifier-Free Interpolation of a Theory of Arrays
Authors: Bruttomesso Roberto , Ghilardi Silvio , Ranise Silvio
Published: September 2013

The use of interpolants in model checking is becoming an enabling technology
to allow fast and robust verification of hardware and software. The application
of encodings based on the theory of arrays, however, is limited by the
impossibility of deriving quantifier- free interpolants in general. In this
paper, we show that it is possible to obtain quantifier-free interpolants for a
Skolemized version of the extensional theory of arrays. We prove this in two
ways: (1) non-constructively, by using the model theoretic notion of
amalgamation, which is known to be equivalent to admit quantifier-free
interpolation for universal theories; and (2) constructively, by designing an
interpolating procedure, based on solving equations between array updates.
(Interestingly, rewriting techniques are used in the key steps of the solver
and its proof of correctness.) To the best of our knowledge, this is the first
successful attempt of computing quantifier- free interpolants for a variant of
the theory of arrays with extensionality.