bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunotherapy in Melanoma
Authors: Saraceni Megan M. , Khushalani Nikhil I. , Jarkowski Anthony
Published: March 2014

The incidence and mortality of melanoma are on the rise. Historically, patients diagnosed with metastatic melanoma were faced with a grim prognosis, with survival rates of 15% at 5 years. Prior to 2011, no drug or therapeutic regimen had been shown to improve overall survival (OS) in metastatic melanoma. Chemotherapeutic agents, such as dacarbazine or temozolomide, are often given to patients for palliative purposes; high-dose interleukin 2 and biochemotherapy are immunotherapeutic options that could be offered to patients with a good performance status at specialized centers. Neither has been shown to impact OS, but durable complete responses are seen in a minority of patients. Since 2011, 4 new drugs have been approved by the US Food and Drug Administration for the treatment of metastatic melanoma, all of which improve survival. Three of these agents (vemurafenib, dabrafenib, and trametinib) are targeted therapies, with ipilimumab being the only new immunotherapy. With a focus on immunotherapeutic agents, this review seeks to summarize the treatment options currently available for metastatic melanoma and to examine those on the near horizon.
An investigation into contact pressure distribution in bolted joints
Authors: Stephen JT , Marshall MB , Lewis R
Published: March 2014

Bolted joints are widely used in modern engineering structures and machine designs due to their low cost and reliability when correctly selected. Their integrity depends on quantitative representation of the contact pressure distribution at the interface during design. Because of the difficulty in reaching and assessing clamped interfaces with traditional experimental methods, presently bolted joint design and evaluation is based on theoretical analysis, with assumptions to quantify pressure distribution at the clamped interface, which may not represent their true operating conditions. The present work utilises a non-intrusive ultrasonic technique to investigate and quantify the pressure distribution in bolted joints. The effect of variation in plate thickness on the contact pressure distribution at bolted interfaces under varying axial loads is investigated. While it was observed that the contact pressure at the interface increases as the applied load increases, the distance from the edge of the bolt hole at which the distribution becomes stable is independent of the applied load on the bolted joint. However, the contact pressure distribution was observed to vary with the plate thickness. Although the variation in the peak value of the average contact pressure distribution in bolted joints does not depend on the plate thickness, the distance from the edge of bolt hole at which the value of the distribution becomes stable increases as the plate thickness is increased. It was also observed that the edge of the bolt head affected the position of the peak value of the contact pressure distribution at the interface, though its effect was dependent on plate thickness. Furthermore, a model based on a Weibull distribution has been proposed to fit the experimental data and a good correlation was observed.
Awareness and utilization of HIV services of an AIDS community-based organization in Kuala Lumpur, Malaysia
Authors: Dangerfield Derek T , Gravitt Patti , Rompalo Anne M , Yap Ivan , Tai Raymond , Lim Sin H
Published: March 2014

Summary

In Malaysia, homosexuality is illegal; little is known about access to HIV prevention services among Malaysian men who have sex with men (MSM). We analysed PT Foundation outreach data to describe the profiles among MSM who accessed PT Foundation services and to examine factors associated with being aware of PT Foundation and having visited the organization. A survey was administered during weekly outreach throughout Kuala Lumpur from March–December 2012. Pearson's Chi square tests were used to compare demographic and behavioural characteristics of participants who were and were not aware of the PT Foundation. Binary logistic regression was used to identify correlates of MSM visiting the PT Foundation among those who had heard of the organization. Of 614 MSM, this study found significantly higher awareness of the PT Foundation among MSM who perceived they had “good” HIV knowledge ( p = .026) and participants who reported always using condoms ( p = .009). MSM who reported being paid for sex were 2.81 times as likely to visit the PT Foundation compared to men who did not. A subgroup of MSM known to be at high risk for HIV infection is accessing prevention services. Future studies should uncover motivations and barriers of accessing these services among MSM in Malaysia.
Sexual history taking in general practice: managing sexually transmitted infections for female sex workers by doctors and assistant doctors in Vietnam
Authors: Do Khoi , Minichiello Victor , Hussain Rafat , Khan Asaduzzaman
Published: March 2014

Sexually transmitted infections (STIs) in Vietnam have been increasing. Control of STIs among female sex workers (FSWs) is important in controlling the epidemic. Effective STI control requires that physicians are skilful in taking sexual history for FSW patients. Three hundred and seventy-one physicians responded to a survey conducted in three provinces in Vietnam. The respondents were asked whether they asked FSW patients about their sexual history and information asked during sexual history taking. The respondents were also asked about their barriers for taking sexual history. Over one-fourth (27%) respondents always, over half (54%) respondents sometimes and 19% respondents never obtained a sexual history from FSW patients. Multivariable analysis revealed that factors associated with always taking a sexual history were being doctor, training in STIs and working at provincial level facilities. Physician’s discomfort was found to be inversely associated with training on communication with patients, seeing 15 or fewer patients a week, working at provincial level facilities. Issues in sexual history taking among FSW patients in general practice in Vietnam were identified. These issues can help STI control for FSW patients and need due attention in order to improve STI management in Vietnam.
Major disturbance to aquatic ecosystems in the South Island, New Zealand, following human settlement in the Late Holocene
Authors: Woodward Craig , Shulmeister James , Zawadzki Atun , Jacobsen Geraldine
Published: March 2014

Lake sediment records from three lakes in the South Island of New Zealand were examined to determine the effects of human (Māori and European) impacts on the lake catchments during the Late Holocene. Major changes in lake biota occurred in the Early to Middle Holocene (11,000–6000 cal. yr BP), but there were no major changes between c. 6000 cal. yr BP and the time of human impact. Intensive Māori forest clearance occurred here between c. ad 1200 and 1600, which is consistent with other New Zealand records. Catchment erosion and increased sedimentation probably occurred in all of the studied lakes, but the most obvious changes occurred in Lake Clearwater and the Māori Lakes. There was evidence for gravity-induced slumping of the littoral sediments in Lake Clearwater due to increased sediment loading, and the outflow from the Māori Lakes was blocked by a migrating alluvial fan. The erosion of sediment (and nutrients) from the lake catchments led to eutrophication, but increases in lake depth were just as important in two of the lakes. Increased water depth was caused by damming of the Māori lakes outflow by a migrating alluvial fan. Reduced evapotranspiration following deforestation would also have led to increased water yield in lake catchments. European impacts were minor compared with the impacts of Māori deforestation, and all lakes display different levels of recovery towards pre-human impact conditions. Complete recovery is prevented by permanent changes in catchment hydrology and probable internal feedback mechanism such as wind-induced sediment re-suspension in the larger lakes.
Genotoxic and cytotoxic effects of doxorubicin and silymarin on human hepatocellular carcinoma cells
Authors: Yurtcu E , İşeri ÖD , Sahin FI
Published: March 2014

The aim of this study was to investigate genotoxic and cytotoxic effects of doxorubicin, silymarin, or in combination on HepG2 cells for 24 and 48 h. Both doxorubicin and silymarin caused dose-dependent inhibition of cell proliferation. After 48 h of treatment, doxorubicin application caused dramatically increased ratio of apoptotic cells. Both 24 and 48 h of silymarin and doxorubicin–silymarin combination caused significant increases in the rate of apoptotic cells. Applications of doxorubicin and silymarin separately for 24 h led to deoxyribonucleic acid (DNA) damages. After 48 h of incubation, doxorubicin-induced genotoxic damage was 2-fold higher than the silymarin-induced damage. After 24 and 48 h, DNA damage in response to combined applications of doxorubicin and silymarin was indifferent from silymarin- and doxorubicin-induced damage respectively. There was not any difference in genotoxicity levels between incubation periods in combined applications of doxorubicin and silymarin. Lipid peroxidation levels increased in all applications. Biopharmacotherapy with chemotherapeutic agents are of interest in the issue of adjuvant therapy. Here, we demonstrate in vitro potential genotoxic and cytotoxic antitumor effect of silymarin on HepG2 cells at achievable plasma level concentrations.
Reconstructing the public in old and new governance: A Korean case of nuclear energy policy
Authors: Kim Hyomin
Published: March 2014

Korean nuclear energy regulatory policies started to change from earlier exclusively technocratic policies into open dialogues after several anti-nuclear protests in the 1990s. However, technocratic policies still coexist with the new regulatory orientation towards openness, participation and institutional accountability. This paper analyzes Korean nuclear regulatory policies since approximately 2005 as a blend of old and new governance. The aim of the paper is not to decide whether new nuclear governance is deliberative or not by completely reviewing Korean nuclear policies after the 2000s. Instead, it provides an empirical account of how seemingly more participatory processes in decision-making entail new problems while they work with and reproduce social assumptions of different groups of the public.
The four medical theses of Samuel Hahnemann (1755–1843)
Authors: Lang Christoph JG
Published: March 2014

Samuel Hahnemann, the founder of homoeopathy, over a period of 33 years wrote four medical theses at three different universities. The first, in 1779 at the University of Erlangen, Franconia, dealt with agents that allegedly induce spasms, granting him a MD degree. The second two theses in 1784 dealt with obstetrical matters and were imposed upon him by the University of Wittenberg, Saxony, for becoming a medical officer, a position he apparently aspired to mostly for financial reasons. The fourth thesis in 1812 at the University of Leipzig, Saxony, his most elaborate dissertation on a toxic plant, white hellebore, served as a habilitation, allowing him to hold university lectures in order to disseminate his new ideas.
Lady Brilliana Harley (1598–1643): Her medicines and her doctors
Authors: Connor Henry
Published: March 2014

Lady Brilliana Harley was the redoubtable chatelaine of Brampton Bryan Castle in Herefordshire during the mid-seventeenth century. Her many letters reveal much about the medications which she dispensed to her family and about the family’s medical attendants. Whenever possible the Harleys preferred to consult university-educated physicians rather than the local apothecary or surgeon. These physicians are all known from other sources but Brilliana’s letters add to what is known of their provincial practices. In particular, they reveal their willingness to undertake blood-letting, often thought to be the province of the more lowly surgeon, and they emphasise the great distances travelled by these practitioners and the difficulties faced by two of them during the Civil War.
Catholic unionism and heterodoxy in Irish Victorian Medicine: A biography of Thomas More Madden (1838–1902)
Authors: Kennerk Barry
Published: March 2014

It is not easy to précis the life of gynaecologist and obstetrician Thomas More Madden. Aside from his prolific penmanship and championing of societal issues, a study of his life serves to demonstrate the crossroads at which orthodox medicine stood during the late nineteenth century – a period of transition between ‘heroic’ and modern health care. Reflecting this state of flux, Madden wrote several books about childbirth but he was also interested in heterodox subjects including heliotherapy and hydrotherapy. His political beliefs were no less eclectic. On one hand he was a Catholic ‘Unionist’, in favour of maintaining Ireland's place in the UK, but his writing was also imbued with the spirit of the Gaelic literary revival. Through his work he tried to make a case, not just for Ireland's place in the western health care tradition but also for its contribution to contemporary medicine.
Survivors of Childhood Cancer Report High Levels of Independence Five Years After Diagnosis
Authors: Jervaeus Anna , af Sandeberg Margareta , Johansson Eva , Wettergren Lena
Published: March 2014

The aim was to compare self-rated independence in childhood cancer survivors 5 years after diagnosis with corresponding ratings during initial cancer treatment and those in a comparison group. A further aim was to determine whether and how certain clinical and demographic variables affected self-rated independence. Self-rated independence, a dimension included in the health-related quality of life (HRQoL) measure DISABKIDS Chronic Generic Measure (DCGM-37), was assessed in a Swedish cohort of survivors (n = 63, aged 12-22 years) and compared with ratings during initial cancer treatment and those in an age-matched comparison group (n = 257). Potential predictors of self-rated independence were estimated using multiple regression analysis. Survivors rated their independence significantly higher 5 years after diagnosis than during initial cancer treatment and higher than the comparison group. Neither demographic nor clinical variables (age, sex, diagnosis, initial cancer treatment) predicted self-rated independence 5 years post diagnosis. Five years after diagnosis, survivors of childhood cancer appear to have reached a satisfactory level of independence. However, survivors are likely to experience complications over the longer term, and therefore continued follow-up is warranted to follow possible changes in self-reported independence.
Two-dimensional near-field multiple signal classification algorithm–based impact localization
Authors: Yuan Shenfang , Zhong Yongteng , Qiu Lei , Wang Zhiling
Published: March 2014

The susceptibility of composite materials to internal damage caused by low-velocity impact is well known and creates a major concern related to structural health monitoring. This research presents a near-field impact monitoring method based on the two-dimensional multiple signal classification method for the composite structure. Since elastic waves attenuate quickly in the complex aircraft composite structures and impacts may happen near the sensors, near-field impact monitoring method is important. However, most of the methods reported are based on the far-field assumption. When impacts occur not far enough from the sensors, this belongs to the near-field situation, where the elastic wave fronts are spherical and the direction estimation method with the plane wave hypothesis is no longer valid. Hence, this article focuses the research of a near-field multiple signal classification–based impact localization method. To verify the proposed method, two experiments are performed on composite structures. The localization results are in good agreement with the actual impact occurring positions in near-field area. Finally, the proposed method is applied to a real aircraft composite oil tank showing its successful performance on complex composite structure.
Feasibility of Cu-Al-Mn superelastic alloy bar as a self-sensor material
Authors: Shrestha Kshitij C , Araki Yoshikazu , Yamakawa Makoto , Yoshida Nobutoshi , Omori Toshihiro , Sutou Yuji , Kainuma Ryosuke
Published: March 2014

This article examines the feasibility of Cu-Al-Mn superelastic alloy bars as possible self-sensor components, taking electrical resistance measurement as a feedback. Superelastic alloy bars change their crystallographic structure with phase transformation, as well as electrical resistance during loading–unloading process at ambient temperature. This work studies the relationship between strain and electrical resistance measurements of superelastic alloys at room temperature. Such relationship can be used in determining the state of a shape memory alloy–based structure effectively, without separate sensors, by appropriately measuring the changes in electrical resistance during and after structure’s loading history. Quasi-static cyclic tensile tests are conducted in this article to investigate the relationship between electrical resistance and strain for a 4-mm-diameter Cu-Al-Mn superelastic alloy bar. It was demonstrated that linear relationship with little hysteresis can be achieved up to 10% strain. The test observations support the feasibility of newly developed Cu-Al-Mn superelastic alloy bars, characterized by low material cost and high machinability, as a multifunctional material for both structural and sensing elements.
The Need to Nurse the Nurse
Authors: Cricco-Lizza Roberta
Published: March 2014

In this 14-month ethnographic study, I examined the emotional labor and coping strategies of 114, level-4, neonatal intensive care unit (NICU) nurses. Emotional labor was an underrecognized component in the care of vulnerable infants and families. The nature of this labor was contextualized within complex personal, professional, and organizational layers of demand on the emotions of NICU nurses. Coping strategies included talking with the sisterhood of nurses, being a super nurse, using social talk and humor, taking breaks, offering flexible aid, withdrawing from emotional pain, transferring out of the NICU, attending memorial services, and reframing loss to find meaning in work. The organization had strong staffing, but emotional labor was not recognized, supported, or rewarded. The findings can contribute to the development of interventions to nurse the nurse, and to ultimately facilitate NICU nurses’ nurturance of stressed families. These have implications for staff retention, job satisfaction, and delivery of care.
The Evolution of School Nursing Data Indicators in Massachusetts
Authors: Gapinski Mary Ann , Sheetz Anne H.
Published: March 2014

The National Association of School Nurses’ research priorities include the recommendation that data reliability, quality, and availability be addressed to advance research in child and school health. However, identifying a national school nursing data set has remained a challenge for school nurses, school nursing leaders, school nurse professional organizations, and state school nurse consultants. While there is much agreement that school nursing data (with associated data integrity) is an incredibly powerful tool for multiple uses, the content of a national data set must be developed. In 1993, recognizing the unique power of data, Massachusetts began addressing the need for consistent school nurse data collection. With more than 20 years’ experience—and much experimentation, pilot testing, and system modification—Massachusetts is now ready to share its data collection system and certain key indicators with other states, thus offering a beginning foundation for a national school nursing data set.
Vortioxetine for the Treatment of Depression
Authors: Pearce Erica F. , Murphy Julie A.
Published: March 2014

Objective: To evaluate the clinical literature and potential clinical role of vortioxetine (Brintellix) for the treatment of major depressive disorder (MDD). Data Sources: A MEDLINE search (1966-February 2014) was conducted using the search terms vortioxetine, Lu AA21004, and depression. Bibliographies of all articles retrieved were also reviewed. All references included were published between 1999 and 2014. Study Selection/Data Extraction: All studies that included humans and were published in English, with data describing vortioxetine for the treatment of MDD, were reviewed. Data Synthesis: Vortioxetine is a novel multimodal antidepressant agent, which inhibits the 5-HT transporter protein, acts as a 5-HT3 antagonist, 5-HT1A receptor agonist, 5-HT7 receptor antagonist, and a partial agonist of the 5-HT1B receptor. It has been studied in 10 short-term (6-8 weeks), 1 relapse-prevention, and 3 long-term extension trials. Vortioxetine demonstrated efficacy in reducing Montgomery-Asberg Depression Rating Scale or Hamilton Rating Scale for Depression scores in 6 of the short-term trials. The proportion of individuals who responded to treatment and achieved remission increased over time in all 3 long-term trials. The most common adverse effects, consistently reported by >10% of individuals in the clinical trials include nausea and headache. Conclusions: Vortioxetine is an effective agent for the treatment of MDD, but it does not have any clear advantages over other available treatment options.
Management of a Prediabetes Case With the DPP-4 Inhibitor Sitagliptin
Authors: Johnson Jeremy L. , O’Neal Katherine S. , Pack Christopher C. , Kim Minhye K.
Published: March 2014

Objective: It is important to prevent or slow the progression of prediabetes to type 2 diabetes and, therefore, reduce the risk of long-term complications. New therapeutic options will allow more patients to be effectively managed. Although theorized to be effective for prediabetes, dipeptidyl peptidase-4 (DPP-4) inhibitors have not been studied in this population. The purpose of this article is to report the results of a case in which a patient with prediabetes was treated with the DPP-4 inhibitor, sitagliptin. Case Summary: A 56-year-old woman was diagnosed with prediabetes at a hemoglobin A1C (A1C) of 6.2%. After 6 months of consistent lifestyle modifications, her A1C was 6.3%, and she wanted to start a medication to prevent disease progression. Because of anticipated risk or intolerability with standard prediabetes treatments, she was started on sitagliptin 100 mg daily; 6 weeks later, she noted improvements in glucometer readings. After 18 months on sitagliptin, her A1C had improved to 5.8% without further lifestyle improvements, and by 32 months, her A1C had improved to 5.6%. Her A1C was maintained within or below the prediabetes range of 5.7% to 6.4% over 3 years of treatment with sitagliptin. Discussion: Although human studies with DPP-4 inhibitors are lacking, the available studies have shown improvements in β-cell function and postprandial and fasting glucose levels. Furthermore, animal studies have shown a delay in progression of prediabetes. No case reports have been found regarding DPP-4 inhibitor use in prediabetes. Conclusion: Sitagliptin may have a role in treating prediabetes and should be further studied.
Calcaneocuboid Joint Subluxation After the Calcaneal Lengthening Procedure in Children
Authors: Ahn Ji-Yong , Lee Ho-Seong , Kim Chul-Ho , Yang Jin-Pil , Park Soo-Sung
Published: March 2014

Background:

We investigated radiographic changes of calcaneocuboid (CC) joint subluxation following calcaneal lengthening procedure for the treatment of pediatric planovalgus foot deformities.

Methods:

This study included 44 cases of planovalgus foot deformities in 24 patients with mean age of 9.7 (range, 8 to 13) years who underwent calcaneal lengthening between 1999 and 2011. The mean follow-up period was 25 (range, 12 to 159) months. Anteroposterior (AP) and lateral radiographs of the weight-bearing view of the foot from immediate postoperative, 3-month postoperative, and last follow-up evaluations were reviewed and also used for trend analysis. Percentage of CC joint subluxations was measured on both AP and lateral view of the foot. Correlations between the percentage of CC joint subluxation and follow-up periods were assessed.

Results:

All of the feet showed dorsal subluxation of their CC joint on the immediate postoperative lateral plain radiographs. The median percentage of dorsal subluxation of the CC joint improved from 26.0% (range, 10.0 to 67.0) at the immediate postoperative evaluation to 16.5% (range, 7.0 to 47.0, P = .0001) at the 3-month postoperative evaluation and to 11% (range, 2.0 to 30.0, P = .0003) at last follow-up. The trend analysis over time indicated that the CC joint subluxation percentage with calcaneal lengthening generally decreased over time ( rs = −.67, P = .001). No patients showed osteoarthritic changes in the CC joint or nonunion at the calcaneal osteotomy site at last follow-up.

Conclusion:

At midterm follow-up, the CC joint subluxation was gradually resolving over time, with no evidence of osteoarthritic change in the CC joint.

Level of Evidence:

Level IV, case series.
The Effects of a Social Skills Training Package on Social Engagement of Children With Autism Spectrum Disorders in a Generalized Recess Setting
Authors: Radley Keith C. , Ford W. Blake , Battaglia Allison A. , McHugh Melissa B.
Published: March 2014

The present study provides a preliminary evaluation of the effects of the Superheroes Social Skills program, a practice-ready, multimedia social skills program, on social engagements of elementary-age children with autism spectrum disorders (ASD). Four children with ASD between the ages of 8 and 10 with current placements in inclusive public school settings participated in an 8-week intervention utilizing the intermediate skill components of the Superheroes Social Skills program. The intervention was presented once per week for approximately 30 min in the school settings. Analysis of data suggests that social engagements of participants during generalized recess periods increased following the introduction of intervention. Data on frequency of initiations and responses, as well as sociometric outcomes, were also collected as a secondary dependent variable and are discussed. Results suggest that pullout social skills training may result in effects that are generalized to more naturalistic settings. Limitations of the current study and suggestions for future research are reviewed.
Wave propagation in a sandwich plate with a periodic composite core
Authors: Liu Xiao-Feng , Wang Yan-Feng , Wang Yue-Sheng , Zhang Chuanzeng
Published: March 2014

By using the finite element method, the propagation of Lamb waves in a sandwich plate with a periodic composite core is investigated. The periodic composite core is constituted by a square array of elastic cylinders embedded in a solid matrix. The dispersion relations and transmission responses are calculated. The results show that both stop and pass bands are involved in the dispersion relations. The influences of the thickness and material properties of the facesheets and the filling fraction of the inclusions in the core on the stop band are discussed. It is noted that the thickness of either the core or the facesheets, the material properties as well as the filling fraction play key roles in tuning the dispersion relations of the sandwich plates. The analysis of the displacement fields shows that the eigenmodes located at the edges of the stop bands are influenced by the thickness of the facesheets. Besides, by removing one or an array of cylinders, a point or line defect is introduced into the sandwich plate. The dispersion relations and the displacement fields of the eigenmodes for such defected systems are calculated. The localization and/or propagation behaviors of the defect modes appearing in the frequency ranges of the stop bands are discussed in detail. The study is relevant to understanding the vibration and the wave motion of the sandwich plate with a periodic composite core and manipulating the propagation of the vibration and the wave motion in this structure.
The ‘abnormal’ state: Identity, norm/exception and Japan
Authors: Hagström Linus
Published: March 2014

The term ‘abnormal’ has frequently been used to describe post-war Japan. Together with the idea that the country will, or should have to, ‘normalise’ its foreign and security policy, it has been reproduced in both academia and Japanese society. Why is Japan branded as ‘abnormal’, and from where does the desire to ‘normalise’ it come? Drawing on a relational concept of identity, and the distinction between norm and exception, this article argues that the ‘abnormality–normalisation nexus’ can be understood in terms of three identity-producing processes: (1) the process whereby the Japanese Self is socialised in US/‘Western’ norms, ultimately constructing it as an Other in the international system; (2) the process whereby the Japanese Self imagines itself as ‘legitimately exceptional’ (what is called ‘exceptionalisation’), but also ‘illegitimately abnormal’ — both of which are epitomised by Japan’s ‘pacifism’; and (3) the process whereby both the Self’s ‘negative abnormality’ and China/Asia are securitised in attempts to realise a more ‘normal’ (or super-normal) Japanese Self. How Japan is inter subjectively constructed on a scale between ‘normal’ and ‘abnormal’ enables and constrains action. Although Japan has not remilitarised nearly as much in the 2000s as is often claimed, these processes might very well forebode an exceptional decision to become ‘normal’ and therefore more significant steps towards remilitarisation.
The malleable effect of name fluency on pharmaceutical drug perception
Authors: Cho Hyejeung
Published: March 2014

Based on the fluency theory, a recent study by Dohle and Siegrist revealed that complex pharmaceutical drug names are perceived as more hazardous than simple drug names and thus negatively influence patients’ willingness to buy. This study explored the malleability of the name fluency effect on pharmaceutical drug perception by examining the fluency effect in the domain of risk versus advancedness judgment. The findings indicated that depending on how the fluency feeling is interpreted in the context of initial judgment task (e.g. advancedness vs risk), disfluent drug names can positively influence a patient’s perception of the drug, reversing the typical fluency effect.
Medical professionalism on television: Student perceptions and pedagogical implications
Authors: Weaver Roslyn , Wilson Ian , Langendyk Vicki
Published: March 2014

Previous research has pointed to the role television can play in informing health practices and beliefs. Within the academic setting in particular, some educators have raised concerns about the influence of medical dramas on students. Less research, however, draws on the perspectives of students, and this study therefore explores medical students’ perceptions of medical practice and professionalism in popular medical television programmes. Qualitative data from surveys of Australian undergraduate medical students showed that students perceived professionalism in dichotomous ways, with three main themes: cure–care, where a doctor’s skill is either technical or interpersonal; work–leisure, where a doctor is either dedicated to work or personal life; and clinical–administration, where work is either direct patient care or administration. There continue to be imagined divisions between curing and caring for students, who express concerns about balancing work and leisure, and expectations that doctors should have little administrative work. Given students were able to identify these important contemporary issues around professionalism on television, there is pedagogical value in using popular images of the medical world in medical education.
Parent-led conferences as sites of medical work
Authors: Dimond Rebecca
Published: March 2014

Conferences are novel sites for understanding medical work. Through describing styles of presentation that take place at conferences attended by patients and parents, this article highlights how clinicians on stage present ordinary and extraordinary aspects of medicine. Attention is drawn to the reaction of the parents in the audience. The power of the presenter to direct proceedings highlights the potential vulnerability of the audience. The relationship between clinician on stage and parents in the audience reflects the clinical relationship between doctor and patient. But through identifying insiders and outsiders, the conference setting also enables new relationships and collective identities to be formed. Drawing on an ethnographic study of rare disease conferences, this article extends understanding of medical work by identifying how conferences offer new ways of witnessing the clinical gaze, the doctor–patient relationship and the formation and enactment of a conference community.
The scope of language contact as a constraint factor in language change: The periphrasis haber de plus infinitive in a corpus of language immediacy in modern Spanish
Authors: Arroyo José Luis Blas
Published: March 2014

In this work an empirical study grounded in the principles and methods of the comparative variationist framework is conducted to measure the scope of language contact as a factor constraining some potentially diverging uses of a Spanish verbal periphrasis that has undergone a sharp decline over the last century ( haber de plus infinitive). The analysis is based on three independent samples of text that correspond to three dialectal areas of peninsular Spanish (monolingual zones, Catalan-speaking linguistic territories and the north-western linguistic area). These samples, extracted from a corpus made up of texts of communicative immediacy from the 19th and the first half of the 20th centuries, confirm the existence of a certain linguistic convergence in the expressive habits of the speakers in the bilingual communities. In each region, however, the outcomes are different, due to parallel differences in the structural position of the periphrasis in each language. However, a thorough analysis of the variable context that surrounds the periphrasis shows that the observed differences do not affect the essence of the underlying grammar of this variant, whose decline (which favours tener que plus infinitive and becomes faster as the 20th century advances) is constrained by identical linguistic and extralinguistic conditioning factors in all the dialectal areas.
Effect of platform screen doors on the indoor air environment of an underground subway station
Authors: Han Hwataik , Lee Jun-Yong , Jang Kyung-Jin
Published: March 2014

Contaminant concentrations in a subway station in Seoul, Korea before (March 2008) and after (March 2009) the installation of platform screen doors (PSDs) were measured to investigate the effect of the PSD system on the subway indoor environment. PM10, CO2 and NO2 concentrations were measured at the platform, concourse and tunnel areas, using an indoor air quality tele-monitoring system (IAQ-TMS) operated by the Korean Ministry of Environment. Spatial correlations of contaminant concentrations at different locations were analysed, to investigate the effect of PSD installation on the movement of contaminants through air passages between zones. The results indicate that PM10 concentrations at the platform were reduced significantly after PSD installation and were within the guideline limit. The R2 value for the platform–tunnel correlation was reduced, indicating that in the absence of PSD, a significant amount of particulate matter was introduced to the platform from the tunnel. Conversely, the CO2 level in the platform was increased slightly after PSD installation, exhibiting a strong correlation with the number of passengers in the station. NO2 was predominantly introduced to the platform from the outdoor environment, on the basis of the source characteristics and their movement through air passages. This paper provides the data to develop a pollution management guide to control air quality contaminants in subway stations.
Inquiries of the body: Novice questions and the instructable observability of endodontic scenes
Authors: Lindwall Oskar , Lymer Gustav
Published: March 2014

This study explores questions posed by students in response to live video broadcasts of dental treatments. The aim of the study is to show and discuss the reflexive relationship between the questions, what they were occasioned by and how they are responded to. Procedures and anatomical features, that for the seminar leader are unproblematically seen in endodontic terms, repeatedly present problems for the students. Visible but unrecognized shifts in the dentist’s work, for instance, provide occasions for questions of the form ‘What is he doing now?’. In the midst of an ongoing procedure, questions tend to be formulated as noticings that elicit instruction either about some detail of the dentist’s actions or about what a generic ‘one should’ or ‘should not do’, what ‘frequently’ happens and so on. It is shown, however, that the movement between specific here-and-now features on the one hand and more general issues on the other characterizes the entire scope of the relevant material, particularly because the seminar leaders’ answers tend to place even minute details within more general endodontic considerations.
Instructed perception in prenatal ultrasound examinations
Authors: Nishizaka Aug
Published: March 2014

The purpose of this study is to elucidate various practices for the structuring of images on an ultrasound monitor during prenatal ultrasound examinations. This study focuses on the practices that healthcare providers employ to invite pregnant women to differentiate a gray-tone image on the ultrasound monitor from the image’s background. In sequential environments in which pregnant women display difficulty in differentiating an image on the screen in response to the healthcare provider’s invitation, the healthcare provider employs practices that require additional bodily involvement to structure the images on the screen. Furthermore, on certain occasions, the healthcare provider also points to a particular abdominal location with the ultrasound transducer, which is held against the abdomen to produce the very image being differentiated. This study demonstrates that the image on the ultrasound monitor is intrinsically embodied and spatially (between the screen and the participants’ bodies) and modally (among vocal/auditory, visual, and tactile modes of orientation) distributed. In addition, the study suggests an interaction-organizational ground for an aspect of the ‘personification of the fetus’ through obstetric ultrasound.
Judith Butler’s post-Hegelian ethics and the problem with recognition
Authors: Stark Hannah
Published: March 2014

Judith Butler’s recent work is exemplary of the trend in contemporary theory to consider ethics. Her deliberation over ethical questions, and the place of ethics in intellectual work, has undeniably intensified since September 11. This article will demonstrate, however, that this is a rendering explicit of what has always been implicit in her work. Rather than perceiving the ethical dimension of Butler’s writings in her increasing interest in thinkers such as Emmanuel Levinas and Hannah Arendt, I contend that it is in her sustained interest in Hegel, and specifically in Hegelian recognition, that her work can be read as engaged with ethical concerns. This article highlights the growing critical concern with the prevalence of recognition in ethical theory and questions the possibility of theorising ethics outside of the recognition-paradigm.
How to die well: Aesthetic and ethical issues in confessional cancer diaries
Authors: Coward Rosalind
Published: March 2014

Why would anyone want to write about dying of cancer and why would anyone want to read about it in a newspaper? Until recently, accounts of dying were by and large confined to literature while first-person accounts of those last months and days were shared with intimates. Now, people regularly chart their demise in newspapers or personal blogs. The article looks at how these narratives of illness, especially cancer, belong to the wider phenomenon of confessional journalism, which can be understood as a subset of literary journalism. These accounts should be seen as constructed narratives with stylistic conventions shaping what is said and what is not said, sharing many of the formal generic aspects of confessional journalism.
Do electoral rules matter? Explaining national differences in women's representation in the European Parliament
Authors: Fortin-Rittberger Jessica , Rittberger Berthold
Published: March 2014

The European Parliament (EP) has one of the highest proportions of women in its ranks, with over a third in 2009. Although previous research has pointed to the use of proportional representation (PR) in European elections as ‘friendlier’ to women, few have looked at differences in the types of PR rules in use in each country. In this article, we argue that the conventional wisdom according to which institutional design—the choice of electoral rules—should shape the composition of the EP does not hold, and suggest that the well-documented empirical connection between electoral rules and descriptive representation might in fact be an endogenous rather than a causal relationship.
Patient Perspectives on the Hula Empowering Lifestyle Adaptation Study
Authors: Maskarinec Gregory G. , Look Mele , Tolentino Kalehua , Trask-Batti Mililani , Seto Todd , de Silva Mapuana , Kaholokula Joseph Keawe‘aimoku
Published: March 2014

Background. The Hula Empowering Lifestyle Adaption Study, funded by the National Institute on Minority Health and Health Disparities, was a 5-year research trial evaluating the impact of the traditional Native Hawaiian dance form, hula, as an exercise modality for cardiac rehabilitation, compared with usual care, on individuals recently hospitalized for a cardiac event or who had recently undergone coronary artery bypass surgery. Method and results. Seeking to learn what physical, mental, spiritual, and social effects the intervention may have had for participants, we interviewed 20 of a total of 35 patients who were enrolled in the dance arm of the study. Classical thematic triangulation analysis was used. Participants recognized that hula’s coordination of body, mind, and spirit as a group activity deepened their appreciation of and connections to Hawaiian culture. This was true for those who were Native Hawaiian, connecting to their own cultural heritage, as well as for non–Native Hawaiians, who found that it improved their appreciation of the surrounding cultural traditions of the host culture where they now live. Conclusions. Not only was hula a safe activity that improved functional capacity, participants also regarded its significant sociocultural aspects—even for participants who are not Native Hawaiian —as enhancing its value and meaningfulness. Learning the words of well-known Hawaiian songs provided additional long-term cues that encouraged “ownership” of the therapy and acted as practical reminders of the importance of exercise and lifestyle moderation while also offering new spiritual connections to the surrounding social environment.
VER-155008, a small molecule inhibitor of HSP70 with potent anti-cancer activity on lung cancer cell lines
Authors: Wen Wei , Liu Wuxin , Shao Yongfeng , Chen Liang
Published: March 2014

Lung cancer is the most common malignancy and exhibits significant morbidity and mortality worldwide. Among all lung cancer subtypes, non-small-cell lung cancer (NSCLC) accounts for the majority of all lung cancer cases. Although there have been intensive investigations on the underlying mechanism of NSCLC development and progression, the exact molecular basis is not well understood. Further insights on important molecular regulators of lung cancer are needed for development of novel therapeutics. The heat shock protein (HSP) family is a group of molecular chaperones that assist in protein folding, modification, and transportation. Different HSPs are essential for tumor cell survival by binding diverse client proteins and regulating homeostasis. In the current study, we sought to characterize HSP70 and HSP90 as potent regulators of NSCLC growth. Our results indicate that differential expression of HSP70 is associated with the malignant phenotype of NSCLC cell lines and plays an important regulatory role in NSCLC cell proliferation. Moreover, a specific inhibitor of HSP70, VER-155008 significantly inhibits NSCLC proliferation and cell cycle progression. We showed that this effect is largely abolished by HSP70 overexpression, indicating that the inhibitory effect of VER-155008 on cell growth is specifically through HSP70 inhibition. In addition, 17-AAD, an inhibitor of HSP90, exerts a potent synergistic effect on NSCLC proliferation with VER-155008. We also observed that inhibition of HSP70 by VER-155008 can sensitize A549 cells to ionizing radiation. These data provide proof-of-principle that VER-155008 can be a good candidate for NSCLC treatment and HSP machinery is a good target for developing NSCLC therapeutics.
Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity
Authors: Wright Charmaine , Smith Bryan , Wright Sean , Weiner Mark , Wright Kevin , Rubin David
Published: March 2014

Purpose

To examine the prevalence, onset, and risk factors of carpal tunnel syndrome during pregnancy.

Methods

Maternal electronic medical records were linked to birth certificate records using social security number. The outcome of carpal tunnel syndrome during pregnancy was defined as ICD9 code 354.0 given at a prenatal visit. Chi-square, t-test, and adjusted logistic regression were performed.

Results

We analyzed 17,623 prenatal visits from the Hospital of the University of Pennsylvania from 1/2003–12/2007. Mean maternal age was 26.4 (6.5) years, with 21% white, 69% black, and 46% overweight or obese. Ninety-one (2.8%) mothers participated in 765 prenatal visits given a carpal tunnel syndrome diagnosis code. Compared to mothers without carpal tunnel syndrome, mothers with carpal tunnel syndrome were older (29.72 (5.42) versus 26.04 (6.37) years, p = 0.005), gained more weight during pregnancy (40.65 (10.13) pounds versus 34.2 (9.41) pounds, p = 0.04), and more likely to have college education (69.9% versus 44.5%, p = 0.03). Average onset (SD) of carpal tunnel syndrome was 18.1 (8.4) weeks’ gestation.

Conclusion

Mothers with carpal tunnel syndrome had high rates of overweight, obesity, and excessive gestational weight gain. Diagnosis of carpal tunnel syndrome was rare but often occurred in the first and second trimesters, earlier than the frequently reported third trimester onset seen in literature. When looking at predictors of carpal tunnel syndrome, obese prepregnancy body mass index (BMI ≥ 30 kg/m2) and excessive gestational weight gain, greater than two previous live births, higher level of maternal education and more prenatal care (>10 visits) were associated with increased risk of carpal tunnel syndrome. Higher maternal age was not associated with carpal tunnel syndrome diagnosis after adjusting for weight and parity, suggesting mediation by these covariates.