bluuebunny/crossref_metadata_2025 huggingface dataset:
Photovoltaic Array Modeling under Uniform Irradiation and Partial Shading Condition
Authors: Ardhenta Lunde , Wijono Wijono
Published: August 2017

Wind energy and solar energy are the prime energy sources which are being utilized for renewal energy. The performance of a photovoltaic (PV) array for solar energy is affected by temperature, irradiation, shading, and array configuration. Often, the PV arrays are shadowed, completely or partially, by the passing clouds, neighboring buildings and towers, trees, and utility and telephone poles. Under partially shaded conditions, the PV characteristics are more complex with multiple peaks, hence, it is very important to understand and predict the MPP under PSC in order to extract the maximum possible power. This paper presents the development of PV array simulator for studying the I–V and P–V characteristics of a PV array under a partial shading condition. It can also be used for developing and evaluating new maximum power point tracking techniques, for PV array with partially shaded conditions. It is observed that, for a given number of PV modules, the array configuration significantly affects the maximum available power under partially shaded conditions. This is another aspect to which the developed tool can be applied. The model has been experimentally validated and the usefulness of this research is highlighted with the help of several illustrations
On Load Characteristic of the New Design Permanent Magnets Reluctance Generator
Authors: Pawawoi Andi , Syafii Syafii
Published: August 2017

These The new design of a permanent magnet reluctance generator claimed to be able to convert the energy of the permanent magnet is the source of the main field into electrical energy, so that the generator output power can reach 167% compared with the input power axis. In this paper will discuss the characteristics of the generator voltage when under load, pure resistance, inductive load and capacitive load. The results showed that when given a purely resistive load, the terminal voltage tends to be constant, but if given the inductive load, the voltage drop occurs significantly approaching zero voltage at full load current. It is very different when loaded capacitive load. When the generator under load is capacitive, the generator voltage at full load increased by 224.7% from no-load voltage
Mobilização social online da APP-Sindicato
Authors: Luvizotto Caroline Kraus , Silveira Fábio Alves , Vanzini Kátia Viviane da Silva , Caldeira Priscila Santana
Published: August 2017

Este artigo analisa como a APP-Sindicato (Sindicato dos Trabalhadores em Educação Pública do Paraná) utilizou as plataformas online Facebook, YouTube e o website da entidade para divulgação de suas demandas e da mobilização social durante a greve dos professores do Paraná em 2015, avaliando se as iniciativas são apresentadas de forma integrada e se buscam incentivar a participação popular em suas ações. Além da revisão bibliográfica acerca dos principais conceitos que envolvem a temática, fizemos uso da análise descritiva e examinamos a utilização das plataformas. A análise indica que o uso das plataformas não seguiu um formato integrado de disponibilização, o que indicaria a falta de um plano integrado de gestão de comunicação pública através das mídias sociais e do uso das Tecnologias de Informação e Comunicação.
Acute and Midterm Outcomes of Transcatheter Pulmonary Valve Replacement for Treatment of Dysfunctional Left Ventricular Outflow Tract Conduits in Patients With Aortopulmonary Transposition and a Systemic Right Ventricle
Authors: Whiteside Wendy , Tretter Justin T. , Aboulhosn Jamil , Aldoss Osamah , Armstrong Aimee K. , Bocks Martin L. , Gillespie Matthew J. , Jones Thomas K. , Martin Mary Hunt , Meadows Jeffrey J. , Metcalf Christina M. , Turner Mariel E. , Zellers Thomas , Goldstein Bryan H.
Published: August 2017

Background—

Transcatheter pulmonary valve replacement (TPVR) is an established therapy for dysfunctional right ventricular (RV) outflow tract conduits. TPVR in patients with congenitally corrected transposition of the great arteries, subpulmonary left ventricle, and left ventricular outflow tract (LVOT) conduit dysfunction has not been studied. Unique anatomic and physiological aspects of this population may contribute to distinct risks and outcomes.

Methods and Results—

Across 10 US centers, 27 patients with a dysfunctional LVOT conduit were evaluated in the catheterization laboratory between December 2008 and August 2015 with the intent to perform TPVR. TPVR was successful in 23 patients (85%). Five serious adverse events occurred in 4 cases (15%), including pulmonary hemorrhage, hypotension requiring vasoactive support, conduit disruption requiring covered stent (n=2), and acute RV dysfunction with flash pulmonary edema. After TPVR, the LVOT peak systolic ejection gradient decreased from median of 35 to 17 mm Hg (
P
<0.001); pulmonary insufficiency was trivial/none in all but 1 patient, where it was mild. Worsening of systemic RV dysfunction or tricuspid regurgitation was seen in 12 patients (57%) and was associated with a significantly lower post-TPVR LVOT peak systolic ejection gradient (median 17 versus 21 mm Hg;
P
=0.02) and higher post-TPVR RV sphericity index (median 0.88 versus 0.52;
P
=0.004). Post-TPVR, there were 2 late deaths because of RV failure and 1 cardiac transplantation because of progressive RV dysfunction and tricuspid regurgitation.

Conclusions—

TPVR in dysfunctional LVOT conduits is feasible but associated with an important rate of TPV nonimplantation and procedural serious adverse events. Worsening systemic RV function and tricuspid regurgitation may develop after LVOT TPVR.
Postnatal Cardiac Gene Editing Using CRISPR/Cas9 With AAV9-Mediated Delivery of Short Guide RNAs Results in Mosaic Gene Disruption
Authors: Johansen Anne Katrine , Molenaar Bas , Versteeg Danielle , Leitoguinho Ana Rita , Demkes Charlotte , Spanjaard Bastiaan , de Ruiter Hesther , Akbari Moqadam Farhad , Kooijman Lieneke , Zentilin Lorena , Giacca Mauro , van Rooij Eva
Published: August 2017

Rationale:

CRISPR/Cas9 (clustered regularly interspaced palindromic repeats/CRISPR-associated protein 9)–based DNA editing has rapidly evolved as an attractive tool to modify the genome. Although CRISPR/Cas9 has been extensively used to manipulate the germline in zygotes, its application in postnatal gene editing remains incompletely characterized.

Objective:

To evaluate the feasibility of CRISPR/Cas9-based cardiac genome editing in vivo in postnatal mice.

Methods and Results:

We generated cardiomyocyte-specific Cas9 mice and demonstrated that Cas9 expression does not affect cardiac function or gene expression. As a proof-of-concept, we delivered short guide RNAs targeting 3 genes critical for cardiac physiology,
Myh6
,
Sav1
, and
Tbx20
, using a cardiotropic adeno-associated viral vector 9. Despite a similar degree of DNA disruption and subsequent mRNA downregulation, only disruption of
Myh6
was sufficient to induce a cardiac phenotype, irrespective of short guide RNA exposure or the level of Cas9 expression. DNA sequencing analysis revealed target-dependent mutations that were highly reproducible across mice resulting in differential rates of in- and out-of-frame mutations. Finally, we applied a dual short guide RNA approach to effectively delete an important coding region of
Sav1
, which increased the editing efficiency.

Conclusions:

Our results indicate that the effect of postnatal CRISPR/Cas9-based cardiac gene editing using adeno-associated virus serotype 9 to deliver a single short guide RNA is target dependent. We demonstrate a mosaic pattern of gene disruption, which hinders the application of the technology to study gene function. Further studies are required to expand the versatility of CRISPR/Cas9 as a robust tool to study novel cardiac gene functions in vivo.
Perisesarma tuerkayi, a new species of mangrove crab from Vietnam (Decapoda, Brachyura, Sesarmidae), with an assessment of its phylogenetic relationships
Authors: Shahdadi Adnan , Davie Peter J. F. , Schubart Christoph D.
Published: August 2017

A new species of Perisesarma, P. tuerkayi, is described from mangroves of Tan Thoi Island, southern Vietnam. Morphologically, the new species differs most significantly from congeners by the tuberculation pattern of the chelar dactylus, its unique G1 morphology, an unusually large maximum body size, and relatively short and broad ambulatory legs. Genetically, P. tuerkayi n. sp. is markedly divergent from other congeneric species, both in mitochondrial and nuclear DNA. It is the fifth species of Perisesarma reported from Vietnam.
The Menace of Domestic Violence: Improving the Lives of Women in Nigeria
Authors: Adeyemo Olaitan O , Bamidele Ifeoluwayimika
Published: August 2017

The scourge of domestic violence as well as other forms of violence against women has eaten deep into the fabric of our society creating a lopsided gender balance with the female gender being the greatest victim. Violence has taken different forms ranging from sexual to physical and psychological as well as other forms. This degrades the humanity of the woman in our society. Abusive partners and perpetrators base their actions on superior nature of the male sex, religion, law, custom, economic situation, family pressure, and their behavioural pattern. It is believed that lack of a legal framework universally enforced as well as lack of trained law enforcement officers promotes the violence of women in Nigeria.

A proactive legal framework, establishment of confidential and well equipped family courts, training of law enforcement officers, shelters and counselling centres can reduce the abuse of women in Nigeria and across the globe. The physical, sociological and psychological effect of violence against women is unquantifiable. To achieve a fair and balanced society, women must be valued, respected and supported and not battered either by stick or word of mouth.
The Ineffectiveness and Inadequacies of International Instruments in Combatting and Ending the Transboundary Movement of Hazardous Wastes and Environmental Degradation in Africa
Authors: Agbor Avitus A.
Published: August 2017

Despite the fact that international instruments prohibit such activities, recent recurrent incidents involving the transboundary movement of hazardous wastes on the African continent highlight their inadequacies and ineffectiveness of international law in solving this problem. Despite some noticeable milestones achieved by the Bamako Convention, its shortcomings are conspicuous. In addition, the ban on transboundary movement of hazardous wastes is simply one dimension of the bigger problem faced by (many poor) African countries: poor management of the environment that ranges from water and air pollution, poor disposal of wastes, improper and inadequate treatment of domestically generated hazardous wastes, congestion, noise, and dumping. These international instruments deal with only a dimension of the problem faced by African states. It is argued that additional measures must be taken to complement these efforts. Such measures include the enactment of strong laws and policies, education of the masses and a virile civil society.
The Legal Protection of Development-Induced Displaced Persons in Africa
Authors: Adeola Romola
Published: August 2017

Development-induced displacement has become one of the pressing human rights
concern in Africa with thousands displaced by development projects across the
continent each year. The political viewpoint that development projects are
panaceas for economic development has often made their socio-economic
implications for displaced persons’ pale in comparison.

In a bid to address this form of displacement, the African Union Convention for
the Protection and Assistance of Internally Displaced Persons mandate states to
prevent development-induced displacement. Seeking to mitigate the tension
between the essence of the development project and respect for the rights of
displaced persons, article 10 of the Convention mandate states to prevent
development-induced displacement. This paper discusses the content of the
obligation in fostering legal protection for development-induced displaced
persons in Africa.
Phyllogomphoides enriquei (Odonata: Gomphidae) a new species from Mexico
Authors: TORRES-PACHÓN MÓNICA , NOVELO-GUTIÉRREZ RODOLFO
Published: August 2017

Phyllogomphoides Belle, 1970, is the second most diverse genus with 46 species within neotropical Gomphidae, after Progomphus Selys, 1854 with 69 species. Most of the Mexican species are very similar in color pattern, however, the male accessory genitalia, cerci and epiproct allow to identify and separate species. Here, Phyllogomphoides enriquei sp. nov. (holotype ♂: Mexico, Michoacán, Municipality of Tepalcatepec, Río Pinolapa, 19º00.524 N; 103º01.456 W, elevation 616m, 04 July 2005, R. Novelo & J.A. Gómez leg.; to be deposited in Colección Entomológica del Instituto de Ecología, A.C., Xalapa) is described and illustrated, being characterized by the anterior hamuli bilobed, tumid anteriorly, ending in a strong spine posteriorly, followed by a wide, deep cleft between anterior and posterior lobes. It appears to be closely related to Phyllogomphoides luisi González-Soriano & Novelo-Gutiérrez, 1990. A distributional map of Phyllogomphoides species from Michoacan State is provided. With this discovery, the number of species of Phyllogomphoides for Mexico rises to 13.
A monograph of the Afrotropical Cassidinae (Coleoptera: Chrysomelidae). Part 4. Revision of the genus Chiridopsis Spaeth
Authors: BOROWIEC LECH , ŚWIĘTOJAŃSKA JOLANTA
Published: August 2017

African members of the genus Chiridopsis Spaeth, 1922 are revised and 32 species are recognized in this area. Three species are described as new: Chiridopsis klapperichi n.sp. (Republic of South Africa), Chiridopsis tanzaniensis n.sp. (Tanzania) and Chiridopsis zambiana n.sp. (Zambia). The following new synonyms are proposed: Chiridopsis aequinoctialis (Olivier, 1808) = Coptocycla kraatzi Wagener, 1880 syn. nov.; Chiridopsis aubei (Boheman, 1855) = Chiridopsis weisei Spaeth, 1924 syn. nov.; Chiridopsis boutareli (Spaeth, 1917) = Chirida subgibbosa Spaeth, 1917 syn. nov.; Chiridopsis flavipennis (Spaeth, 1902) = Chiridopsis rothschildi Spaeth, 1922 syn. nov.; Chiridopsis nigrosepta (Fairmaire, 1891) = Coptocycla vernicata Fairmaire, 1891 syn. nov. = Cassida circumcincta Weise, 1919 syn. nov.; Chiridopsis observabilis (Spaeth, 1916) = Chiridopsis athinia Spaeth, 1924 syn. nov. Lectotypes are designated for Chirida ariadne Weise, 1896, Chirida circe Weise, 1896, Chirida observabilis Spaeth, 1916 and Chirida tessellata Spaeth, 1917. Colour photos of species, including intraspecific variablity, key to species and maps of distribution are given.
Unlawfulness’s Doctrinal and Normative Irrelevance to Complicity Liability
Authors: Baker Dennis J
Published: August 2017

In this essay I shall try to show that there is normative nor doctrinal foundation for the extended joint enterprise doctrine. I shall argue that the “unlawfulness” justification that has been invoked to justify the extended joint enterprise has no doctrinal basis in English law and is also normatively vacuous. Almost every case concerning common purpose complicity scenarios where unlawfulness has been an issue hinge on the doctrine of constructive crime, so I shall attempt to show that those who are invoking that doctrine of unlawfulness to support their normative case for extended joint enterprise liability are working from a mistaken doctrinal premise, because the doctrine of constructive crime in the development of the law of complicity was limited to homicides, whereas complicity’s doctrine of common intent applied to all unlawful joint enterprises. Furthermore, it is contended that unlawful agreements (conspiracies) in themselves do not supply a normative justification for this sort of complicity, even when the agreement is consummated, because the accessory does not take an equal normative position in an unintended collateral crime that is merely foreseen as a possibility.
Analytical and numerical investigations of weld bead shape in plasma arc welding of thin Ti-6al-4v sheets
Authors: Dhinakaran V , Siva Shanmugam N , Sankaranarayanasamy K , Rahul R
Published: August 2017

In this research work, a new analytical model has been developed to predict the temperature distribution during plasma arc welding of thin Ti-6Al-4V sheets. Dhinakaran’s model based on a three-dimensional parabolic Gaussian heat source is considered as a plasma arc heat source moving on a semi-infinite body to derive the analytical model and the same heat source model is substituted in the three-dimensional Fourier’s law of heat conduction and implemented in the finite element package. Thermo physical properties, such as density, specific heat, and thermal conductivity, are used as temperature-dependent properties in finite element simulation. Numerical simulation is carried out using COMSOL. The new analytical model is expressed as a function of three-dimensional spatial co-ordinates and the time co-ordinate. A computer program has been written to solve the analytical model in order to obtain the distribution of transient temperature at any point of interest. The transient temperature distribution predicted by the analytical model has been compared with both the experimental result and the numerical result. Experimental work is carried out to measure the thermal cycle during welding. The thermal cycle is measured by using an infrared thermometer. Very good correlation has been obtained between the predicted transient temperature by analytical solution and the measured temperature, as well as the finite element simulation result. This provides a reliable alternative for using these analytical solutions in the future to obtain the thermal cycle, distortion, and thermal stress during plasma arc welding.
Supportive Messages Female Offenders Receive From Probation and Parole Officers About Substance Avoidance: Message Perceptions and Effects
Authors: Holmstrom Amanda J. , Adams Elizabeth A. , Morash Merry , Smith Sandi W. , Cobbina Jennifer E.
Published: August 2017

Substance use is a key reason for initial offending and recidivism for the over one million women on probation and parole in the United States. Social support protects against both recidivism and relapse to substance use. However, many women supervised in the community with a history of substance abuse lack social support from family and friends. Probation and parole officers (POs) may serve as sources of social support for such women. In the current study, types of supportive communication and their effects were coded from semistructured interview responses from 284 female offenders who recalled supportive messages from their POs regarding substance use avoidance. Results indicate that informational support is most likely to be provided by POs, whereas tangible and network support were reported infrequently. Most supportive communication was perceived positively. Implications of this study include identification of helpful message strategies for POs and gaps in female offenders’ social support resources.
Pensions, Peasants, and the Informal Economy: Family and Livelihood in Contemporary Peru
Authors: Vincent Susan
Published: August 2017

A Peruvian case study explores how urban informal workers negotiate their livelihoods as they age, highlighting reciprocity among urban informal workers, retired formal sector workers, and peasants in a pattern of rural-urban circular migration. Labor-intensive mining in the twentieth century created a proletarian workforce that included men from the peasant community of Allpachico. Their wages became an anchor for kin-linked clusters of households. Now, despite an economic boom, the lack of formal jobs forces younger Allpachiqueños to undertake precarious and informal work. Resource-sector-funded state social spending, such as through state-administered pensions for retired workers and the elderly poor, has replaced wages as a stable source of cash. This state mediation between the technology-intensive resource sector and citizens elicits suspicion and uncertainty. Dispossessed of the right to work and subjected to conditions of eligibility for social programs, urban informal workers continue to rely on kin and community.

Un estudio de caso peruano explora cómo los trabajadores informales urbanos negocian sus formas de ganarse la vida conforma envejecen, y destaca la reciprocidad entre dichos trabajadores, los trabajadores jubilados del sector formal y los campesinos en un patrón de migración circular del campo a la ciudad. Durante el siglo XX, la minería intensiva dio lugar a una fuerza de trabajo proletaria que incluía a hombres de la comunidad campesina de Allpachico. Sus salarios se convirtieron en una forma de anclaje para grupos de hogares con vínculos consanguíneos. Ahora, a pesar del auge económico, la falta de empleos formales oblige a los jóvenes de Allpachico a trabajar de manera precaria e informal. El gasto social estatal financiado por los recursos del sector, como las pensiones estatales para trabajadores jubilados y los ancianos pobres, ha sustituido los salarios como fuente estable de efectivo. Dicha mediación estatal entre un sector de recursos con tecnología intensiva y la ciudadanía provoca sospechas e incertidumbre. Sin derecho a un trabajo y sometidos a los criterios impuestos de admisibilidad para recibir asistencia social, los trabajadores informales urbanos continúan dependiendo de sus familiares y comunidad.
Becoming dead: Two solitudes?
Authors: Wasylenko Eric
Published: August 2017

The moral divide between proponents and opponents of medical assistance in dying is wide and can be ascribed to a number of dichotomous beliefs. This article addresses a particular and less commonly described platform for the divide: human acquiescence to physical decline and death as an important stage of life, versus presumptive human mastery over the timing and manner of some peoples’ death. Practical ideas are then offered for health systems that wish to bridge the divide, to provide both robust palliative end-of-life care and medical assistance in dying programs for their patients, while keeping health workers whole.
Evaluation of the Thyroid Nodule
Authors: McCaffrey Thomas V.
Published: August 2017

Background

Clinically detectable thyroid nodules occur in up to 4% of the population in the United States. With ultrasound, nodules may be found in up to 50% of those over 50 years of age.

Methods

The author reviews his own experience as well as that of others to define a sound clinical approach to the differential diagnosis and detection of thyroid cancer.

Results

Prior neck irradiation is a risk factor for thyroid malignancy. The association of a thyroid nodule with enlarged lymph nodes or fixation of the nodule to strap muscles or the trachea suggests malignancy. A diffusely multinodular gland is usually benign.

Conclusions

Thyroid function tests rarely help a differential diagnosis. Fine-needle aspiration is the “gold standard” for diagnosis. Tiny “incidentalomas” are often followed with repeat monitoring for change of size or character.
Physician-Assisted Suicide: The Legal Slippery Slope
Authors: Walker Robert M.
Published: August 2017

Background

In Oregon, physicians can prescribe lethal amounts of medication only if requested by competent, terminally ill patients. However, the possibility of extending the practice to patients who lack decisional capacity exists. This paper examines why the legal extension of physician-assisted suicide (PAS) to incapacitated patients is possible, and perhaps likely.

Methods

The author reviews several pivotal court cases that have served to define the distinctions and legalities among “right-to-die” cases and the various forms of euthanasia and PAS.

Results

Significant public support exists for legalizing PAS and voluntary euthanasia in the United States. The only defenses against sliding from PAS to voluntary euthanasia are adhering to traditional physician morality that stands against it and keeping the issue of voluntary euthanasia legally framed as homicide. However, if voluntary euthanasia evolves euphemistically as a medical choice issue, then the possibility of its legalization exists.

Conclusions

If courts allow PAS to be framed as a basic personal right akin to the right to refuse treatment, and if they rely on right-to-die case precedents, then they will likely extend PAS to voluntary euthanasia and nonvoluntary euthanasia. This would be done by extending the right to PAS to incapacitated patients, who may or may not have expressed a choice for PAS prior to incapacity.
The Evolving Role of Prostate Brachytherapy
Authors: Beyer David C.
Published: August 2017

Background

The publication of several large studies with long-term results on the use of prostate brachytherapy has resulted in increased use of this option for patients with localized prostate cancer.

Methods

A historical review of brachytherapy as an approach to prostate cancer management is provided, as well as a general summary of the implant technique and the results to date according to patient risk. The effects of combination therapies for specific patient groups are also reviewed.

Results

A recent 12-year follow-up reported no failures after 10 years, and 75% of recurrences occurred within the first 5 years. Patients at low risk for failure based on stage, grade, and prostate-specific antigen (PSA) parameters are likely to have disease confined to the prostate. Those with more advanced disease are likely to have a lower probability of cure with brachytherapy as monotherapy. Complications involve primarily the urinary tract. Ideal candidates have a PSA of = 10, Gleason score of = 7, and low-volume/low-stage disease (stage T1c or T2a). Patients with more-advanced disease are candidates for brachytherapy combined with external-beam radiation therapy (EBRT). For high-risk men with multiple adverse prognostic features, consideration should be given to clinical trials investigating innovative treatment combinations (eg, the addition of androgen blockade, and EBRT).

Conclusions

The rarity of failures after 5 years and the absence of recurrence after 10 years suggest a that brachytherapy for localized prostate cancer can provide durable disease control. Future improvements in pathologic tools may lead to selection of patients more likely to respond well to brachytherapy.
Sexual Functioning in Breast Cancer Survivors
Authors: Thors Christina L. , Broeckel Jo Ann , Jacobsen Paul B.
Published: August 2017

Background

A growing body of evidence suggests that sexual dysfunction may be among the more common and distressing symptoms experienced by breast cancer survivors.

Methods

This report reviews studies in which sexual functioning in breast cancer survivors has been investigated. Included are reports on the prevalence and nature of sexual difficulties, the relationship between specific breast cancer treatments and sexual difficulties, and the treatment of sexual dysfunction following completion of breast cancer treatment.

Results

A review of the literature suggests a wide range of rates for the prevalence of sexual problems in breast cancer survivors. Factors that may affect prevalence rates include the methods used to determine prevalence and the demographic and medical characteristics of the patients studied. With regard to treatment effects, evidence suggests that breast cancer patients who undergo chemotherapy are at high risk for sexual dysfunction after treatment. In contrast, there is little evidence of a link between type of surgical treatment (eg, lumpectomy vs mastectomy) or treatment with tamoxifen and sexual functioning outcomes.

Conclusions

A growing body of evidence suggests that sexual problems can be a long-term side effect of breast cancer treatment. Oncology professionals should initiate communication about sexual difficulties, perform comprehensive assessments, and educate and counsel patients about the management of these difficulties.
Impact of Age and Colony-Stimulating Factor Use on Hospital Length of Stay for Febrile Neutropenia in CHOP-Treated Non-Hodgkin's Lymphoma
Authors: Chrischilles Elizabeth , Delgado David J. , Stolshek Bradley S. , Lawless Grant , Fridman Moshe , Carter William B. ,   for the Oncology Practice Pattern Study Working Group
Published: August 2017

Background

In intermediate-grade non-Hodgkin's lymphoma (NHL) patients, full-dose CHOP improves survival but increases myelosuppression, causing febrile neutropenia hospitalization (FNH) in 28% of patients 65 years of age or greater. Several risk factors for FNH are known, but their relationship to length of stay (LOS), an indicator of the total burden of FNH, is unclear.

Methods

We conducted a study to identify factors associated with the incidence, recurrence, and duration of hospitalizations for FN and to describe the frequency of administration of colony-stimulating factor (CSF) as primary and secondary prophylaxis and its association with repeated hospitalization episodes.

Results

Compared with patients who did not experience hospitalizations for FN, those who did were significantly older, had more comorbid conditions, were planned for standard dose intensity, and received CSF less often during the first 5 days of cycle 1 (early CSF). Overall, 73% of these hospitalizations occurred within the first 2 cycles of chemotherapy, with 56% occurring within the first cycle. Patients age ≥65 years accounted for 66% of cycle 1 FNH. Patients receiving early CSF were less likely to experience repeated hospitalizations (0% vs 12%; P.05). Multiple regression analysis of those hospitalized found a 3.9-day longer LOS for patients age ≥65 years and a 5.13-day longer LOS for those not receiving early CSF.

Conclusions

Older NHL patients have a higher risk of hospitalization for FN and longer LOS. The majority of hospitalization days occur in the first 2 cycles of chemotherapy. Early CSF use is associated with decreased risk of repeated hospitalizations and shorter total LOS. Secondary CSF use is also associated with reduced risk of repeated FNH.
Molecular Genetics of Head and Neck Cancer
Authors: Gleich Lyon L. , Salamone Frank N.
Published: August 2017

Background

Head and neck cancers have multiple genetic abnormalities that influence tumor behavior and may be useful in developing new treatments.

Methods

Genetic alterations implicated in head and neck cancer oncogenesis and behavior are reviewed, and molecular techniques for detection and treatment are evaluated.

Results

The large number of genetic changes present in head and neck cancer cells precludes meaningful use of simple molecular tests and treatments. Detection of abnormalities in multiple genes provides better prognostic information than the detection and assessment of single mutations. Screening tests that rely on amplification of genetic material present in bodily fluids are hindered by the genomic complexity of head and neck cancer. Introduction of genetic material into head and neck cancer cells for gene therapy has shown some efficacy.

Conclusions

Head and neck cancers comprise a complex genetic disease. Although much has been learned about the molecular genetics of head and neck cancers, continued study of multiple genes is critical for further progress. Gene therapy, although promising, must also overcome this complexity.
Trastuzumab Use in Breast Cancer: Clinical Issues
Authors: Horton John
Published: August 2017

Background

Overexpression of the epidermal growth factor 2 HER2 in breast cancer tissue is associated with shorter survival. Trastuzumab, a monoclonal antibody against HER2, can induce tumor responses when given alone and enhances the effectiveness of several chemotherapeutic agents.

Methods

The recent clinical data on outcomes regarding testing for HER2 overexpression and the tolerance, toxicity, and antitumor effects of trastuzumab are reviewed.

Results

Trastuzumab use is indicated either alone or with chemotherapy only in patients with IHC 3+ or FISH+ test results and survival is prolonged in patients with metastatic disease. Cardiac toxicity differs from anthracycline cardiac toxicity and is often reversible.

Conclusions

The safety and efficacy profile of trastuzumab in patients with metastatic disease has led to large-scale testing of addition of the intervention in the adjuvant setting.
Hematopoietic Stem Cells and Hematopoiesis
Authors: Smith Clayton
Published: August 2017

Background

The highly orchestrated process of blood cell development and homeostasis is termed “hematopoiesis.” Understanding the biology of hematopoietic stem cells as well as hematopoiesis is important to developing improved treatments for hematologic malignancies, congenital disorders, chemotherapy-related cytopenias, and blood and marrow transplants.

Methods

The author reviews the current state of the art regarding hematopoietic stem cells and hematopoiesis.

Results

Several new concepts, including stem cell plasticity, suggest the possibility that stem cells may have the ability to differentiate into other tissues in addition to blood cells.

Conclusions

While much is known about hematopoietic stem cells and hematopoiesis, much remains to be clarified about the environmental and genetic processes that govern the growth and development of the blood system. In addition, careful studies remain to be conducted to determine whether hematopoietic stem cells can differentiate into extra-hematopoietic tissues.
Intense Immunosuppression and Stem-Cell Transplantation for Patients with Severe Rheumatic Autoimmune Disease: A Review
Authors: Van Laar Jacob M. , Tyndall Alan
Published: August 2017

Background

Intense immunosuppression plus stem-cell transplantation (SCT) has emerged as a new treatment modality for patients with refractory, severe rheumatic autoimmune disease. Its rationale is based on eliminating autoaggressive lymphocytes by lympho- or myeloablative conditioning followed by stem-cell rescue. Preclinical studies in animal models of autoimmune disease and observations in patients with rheumatoid arthritis (RA) who were cured after allogeneic bone marrow transplantation for concomitant hematologic malignancy have provided support for the concept.

Methods

The authors reviewed the results of recent phase I/II studies and data from the EBMT/EULAR Registry on more than 400 patients with autoimmune diseases including RA, systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and juvenile idiopathic arthritis (JIA).

Results

Toxicity resulting from stem-cell grafting depended on underlying disease and the intensity of the conditioning regimen. Treatment-related mortality was low in RA (1.4%) but relatively high (>10%) in patients with JIA, SLE, and SSc, possibly related to visceral involvement in these patients. With the application of uniform and strict criteria, safety has improved. Long-term remissions up to 4 years have been observed in SSc and JIA, while relatively more relapses have occurred in patients with SLE and RA. Sensitivity to anti-rheumatic drugs was restored in RA and SLE patients, however, resulting in improved disease control.

Conclusions

Intense immunosuppression and SCT may be an effective therapy for selected patients with severe rheumatic autoimmune disease. Its merits need to be proven via multicenter phase III studies by comparing efficacy and safety with conventional therapy.
Sexual Function after Surgery for Prostate or Bladder Cancer
Authors: Miranda-Sousa Alejandro J. , Davila Hugo H. , Lockhart Jorge L. , Ordorica Raul C. , Carrion Rafael E.
Published: August 2017

Background

Compromised sexual function is often a side effect for patients following radical surgical procedures for bladder or prostate cancer.

Methods

The authors review the classification and physiology of sexual function and dysfunction. Moreover, they explain the possible pathophysiology directly resulting from surgery, and they discuss several approaches available to address these problems.

Results

Options for male sexual dysfunction, primarily erectile dysfunction resulting from radical prostatectomy or surgery for bladder cancer, range from patient education to penile prosthesis implantation. Female sexual dysfunction caused by surgical intervention for bladder cancer includes problems with libido, arousal, orgasm, and dyspareunia. Treatment options for women can include sex therapy, hormonal therapy, and preventive strategies. However, no consensus has been established on the most effective agents and time points to treat male or female sexual dysfunction following radical cystectomies or prostatectomies. The chronic intermittent treatment of erectile dysfunction following radical prostatectomy has been commonly referred to as penile rehabilitation.

Conclusions

Additional research is needed to obtain further data concerning sexual dysfunction in both men and women following radical pelvic surgeries. Modification of surgical techniques, the use of various treatment modalities for sexual dysfunction, and the development of new agents will help to successfully minimize or prevent damage and restore normal sexual function after local surgical therapy for prostate or bladder cancer in the future.
Human T-Cell Leukemia Virus Type I Induces Adult T-Cell Leukemia: From Clinical Aspects to Molecular Mechanisms
Authors: Yasunaga Jun-Ichirou , Matsuoka Masao
Published: August 2017

Background

Human T-cell leukemia virus type I (HTLV-I) is a causative virus of adult T-cell leukemia (ATL), HTLV-I-associated myelopathy/tropical spastic paraparesis, and HTLV-I-associated uveitis. ATL is a neoplastic disease of CD4-positive T lymphocytes that is characterized by pleomorphic tumor cells with hypersegmented nuclei, termed “flower cells.” The mechanisms of leukemogenesis have not been fully clarified.

Methods

The authors reviewed the virological, clinical, and immunological features of HTLV-I and ATL and summarized recent findings on the oncogenic mechanisms of ATL and therapeutic advances.

Results

Multiple factors, such as viral genes, genetic and epigenetic alterations, and the host immune system, may be implicated in the leukemogenesis of ATL. Among them, viral genes, tax, and HBZ have been thought to play important roles. The prognosis of aggressive-type ATL remains poor, regardless of intensive chemotherapy. Effectiveness of allogeneic stem cell transplantation for ATL has been recently reported.

Conclusions

Although the precise mechanism of leukemogenesis of ATL remains unclear, recent progress provides important clues in oncogenesis by HTLV-I. Future research should focus on the composition of novel therapeutic strategies, including prevention, based on the evidence in the leukemogenic mechanisms.
Management Options after Prophylactic Surgeries in Women with BRCA Mutations: A Review
Authors: Allain Dawn C. , Sweet Kevin , Agnese Doreen M.
Published: August 2017

Background

Although breast cancer is relatively common, only about 5% of cases are due to inheritance of highly penetrant cancer susceptibility genes. The majority of these are caused by mutations in the BRCA1 and BRCA2 genes, which are also associated with an increased risk of ovarian cancer. Increased surveillance, chemoprevention, and prophylactic surgeries are standard options for the effective medical management of mutation carriers. However, optimal management of female carriers who choose to undergo prophylactic surgeries is still poorly understood.

Methods

The authors provide an overview of the current literature regarding medical management options for women carriers of BRCA1 and BRCA2 gene mutations and the implications for those individuals who have chosen to undergo prophylactic surgeries.

Results

BRCA mutation carriers who opt for prophylactic surgeries are still at risk for development of malignancy, and appropriate monitoring is warranted.

Conclusions

There are limited data on the appropriate medical management for BRCA mutation carriers after prophylactic surgeries. However, a management plan can be extrapolated from the general management recommendations for surveillance and other risk-reducing strategies in BRCA-positive individuals.
Health Disparities in Receipt of Screening Mammography in Latinas: A Critical Review of Recent Literature
Authors: Wells Kristen J. , Roetzheim Richard G.
Published: August 2017

Background

Increased use of screening mammography is associated with lower death rates from breast cancer in the United States. Despite recommendations that women over 40 years of age should obtain regular screening mammography at least every 2 years, many women do not adhere to these guidelines. Historically, women from underserved and minority populations have been less likely to receive screening mammography.

Methods

A critical review of recent research literature was conducted to evaluate whether Latinas are less likely to receive screening mammography, determine whether disparities in screening mammography persist when controlling for other variables, and examine what other variables are associated with screening mammography. The articles were obtained from a search of the PubMed database.

Results

Fifteen published articles met the inclusion criteria and were critically reviewed. The unadjusted odds ratios (ORs) of the association between Hispanic ethnicity and screening mammography ranged from 0.40 to 0.93. For the most part, the ORs adjusted for other variables in multiple logistic regression analyses increased (range: 0.3 to 1.67). Age, education, income, health insurance, having a usual source of care, and having a recent visit to a physician were consistently related to screening mammography in multiple logistic regression analysis.

Conclusions

Hispanic ethnicity is a risk factor for lack of adherence to screening mammography. However, other demographic, socioeconomic, and health system variables account for some of the disparity related to Hispanic ethnicity.
Practical Issues of Intraoperative Frozen Section Diagnosis of Bone and Soft Tissue Lesions
Authors: Bui Marilyn M. , Smith Prudence , Agresta Samuel V. , Cheong David , Letson G. Douglas
Published: August 2017

Background

Intraoperative pathologic diagnosis of bone and soft tissue lesions is an important yet challenging tool in clinical musculoskeletal oncology practice. There is limited information in the literature addressing the practical issues commonly encountered regarding intraoperative frozen section of musculoskeletal lesions.

Methods

A literature review and retrospective review of practical experience in intraoperative pathology consultation at our institute's sarcoma program were conducted to investigate the pitfalls and limitations of frozen section and potential solutions to overcome these problems.

Results

Frozen section evaluation is an essential and reliable procedure for guiding intraoperative decisions. Intraoperative cytology as an adjunct to frozen section enhances the accuracy of diagnosis of bone and soft tissue lesions. Cytology can accurately diagnose certain entities alone and is superior to frozen section for certain tumor types and for evaluating bone marrow margins. It is also invaluable in triaging cases for ancillary studies and for tumor banking. Practical working protocols can be developed to optimize the usefulness of intraoperative pathologic consultation.

Conclusions

Intraoperative pathology consultation should be done in an interdisciplinary approach by correlating clinical, radiologic, and pathologic information. As an adjunct to frozen section, cytology and gross examination enhance the accuracy of diagnosis of musculoskeletal lesions.
Advanced-Technology Radiation Therapy for Bone Sarcomas
Authors: Patel Samir , Delaney Thomas F.
Published: August 2017

Background

Bone sarcomas are rare primary tumors. Radiation therapy (RT) can be useful in securing local control in cases where negative surgical margins cannot be obtained or where tumors are not resected. Recent technical advances in RT offer the opportunity to deliver radiation to these tumors with higher precision, thus allowing higher doses to the tumor target with lower doses to critical normal tissues, which can improve local tumor control and/or reduce treatment-related morbidity.

Methods

The authors conducted a survey of recent technical developments that have been applied to the RT for bone sarcomas.

Results

RT techniques that show promise include intensity-modulated photon radiation therapy, 3-D conformal proton RT, intensity-modulated proton RT, heavy charged-particle RT, intraoperative RT, and brachytherapy. All of these techniques permit the delivery of higher radiation doses to the target and less dose to normal tissue than had been possible with conventional 3-D conformal radiation techniques. Protons deliver substantially less dose to normal tissues than photons.

Conclusions

Data from clinical studies using these advanced radiation techniques suggest that they can improve the therapeutic ratio (the ratio of local control efficacy to the risk of complications). This is expected to improve the treatment outcome for these challenging tumors.
The Molecular Biology of Endometrial Cancers and the Implications for Pathogenesis, Classification, and Targeted Therapies
Authors: Bansal Nisha , Yendluri Vimala , Wenham Robert M.
Published: August 2017

Background

Understanding and identifying molecular biology and genetics of endometrial cancer are central to the development of novel therapies. This article reviews the molecular basis for genesis of endometrial cancer with regard to pathogenesis, classification, and implications for targeted therapies.

Methods

Genes and cellular pathways that may have an important role in endometrial cancers, both endometrioid and non-endometrioid cancers, are identified. Recently studied drugs and potential future drugs that target some of these genes and pathways are reviewed.

Results

The most frequent genetic alteration of endometrioid endometrial cancer is PTEN. PI3CA and K-ras mutations are less common but are often associated with PTEN. Alterations in MLH1 and MSH6 are documented with microsatellite instability. β-catenin has a minor but significant association. Conversely, p53 mutation is more often associated with non-endometrioid cancer; others being inactivation of p16 and/or overexpression of HER-2/neu. Absence of E-cadherin is more often than not present in non-endometrioid cancers and is associated with poor prognosis. Novel agents that target the AKT-PI3K-mTOR pathway and those that inhibit epidermal growth factor receptor (EGFR), vascular endothelial growth factors (VEGF), fibroblast growth factor receptor 2 (FGFR2), and folate receptors are currently being investigated.

Conclusions

Novel targeted agents, either alone or in combination with cytotoxic agents, may result in superior treatment for patients.
A Review of Triple-Negative Breast Cancer
Authors: Ismail-Khan Roohi , Bui Marilyn M.
Published: August 2017

Background

An estimated 1 million cases of breast cancer are diagnosed annually worldwide. Of these, more than 170,000 are described as triple-negative. Triple-negative breast cancer (TNBC) is defined by the lack of protein expression of estrogen receptor (ER) and progesterone receptor (PR) and the absence of HER2 protein overexpression. TNBC is a subtype of breast cancer that overlaps with the “basal-like” breast cancer. TNBC has significant clinical implications.

Methods

The epidemiology, diagnosis, clinical course, prognosis, and pathology of this subtype of breast cancer are reviewed. The authors compare the “triple-negative” and “basal-like” definitions of breast cancer. A discussion of both standard and experimental treatments for TNBC is included.

Results

The poor prognosis of high-grade TNBC relates to poor disease-free interval in the adjuvant setting, shortened progression-free survival in the metastatic setting, and the lack of targeted therapy. However, not all TNBCs are associated with a poor prognosis.

Conclusions

Although chemotherapy is the main current treatment of this subtype of breast cancer, new agents such as PARP inhibitors, which show promise in the treatment of TNBC, are currently in clinical trials.