bluuebunny/crossref_metadata_2025 huggingface dataset:
Androgen deprivation therapy: past, present and future
Authors: Schröder F. , Crawford E.D. , Axcrona K. , Payne H. , Keane T.E.
Published: June 2012

Since Huggins and Hodges demonstrated the responsiveness of prostate cancer to androgen deprivation therapy (ADT), androgen‐suppressing strategies have formed the cornerstone of management of advanced prostate cancer. Approaches to ADT have included orchidectomy, oestrogens, luteinizing hormone‐releasing hormone (LHRH) agonists, anti‐androgens and more recently the gonadotrophin‐releasing hormone antagonists. The most extensively studied antagonist, degarelix, avoids the testosterone surge and clinical flare associated with LHRH agonists, offering more rapid PSA and testosterone suppression, improved testosterone control and improved PSA progression‐free survival compared with agonists. The clinical profile of degarelix appears to make it a particularly suitable therapeutic option for certain subgroups of patients, including those with metastatic disease, high baseline PSA (>20 ng/mL) and highly symptomatic disease. As well as forming the mainstay of treatment for advanced prostate cancer, ADT is increasingly used in earlier disease stages. While data from clinical trials support the use of ADT neoadjuvant/adjuvant to radiotherapy for locally advanced or high‐risk localized prostate cancer, it remains to be established whether specific ADT classes/agents provide particular benefits in this clinical setting.
A study comparing insulin lispro mix 25 with glargine plus lispro therapy in patients with Type 2 diabetes who have inadequate glycaemic control on oral anti‐hyperglycaemic medication: results of the PARADIGM study
Authors: Bowering K. , Reed V. A. , Felicio J. , Landry J. , Ji L. , Oliveira J.
Published: June 2012

Diabet. Med. 29, e263‐e272 (2012)

Aims  To test the hypothesis that initiation and intensification with 25% insulin lispro, 75% insulin lispro protamine suspension (LM25), is non‐inferior to initiation and intensification with glargine + insulin lispro therapy on change from baseline in HbA1c.

Methods  In this randomized, non‐inferiority (margin of 0.4%), parallel, prospective, multi‐country, 48‐week, open‐label study, patients (n = 426) with Type 2 diabetes inadequately controlled with oral anti‐hyperglycaemic medications were assigned to either initiating therapy with one daily LM25 injection, progressing up to three daily injections (full analysis set n = 211; per protocol set n = 177) or initiating therapy with one daily glargine injection and progressing up to three daily insulin lispro injections (full analysis set n = 212; per protocol set n = 184).

Results  LM25 therapy was found to be non‐inferior to glargine + insulin lispro therapy by study end (upper limit of 95% CI < 0.4), with a least‐squares mean difference (95% CI) in HbA1c (LM25 minus glargine + insulin lispro) of −0.4 mmol/mol (95% CI −2.7 to 1.9); −0.04% (95% CI −0.25 to 0.17). No statistically significant differences between treatment groups were found in the percentage of patients achieving HbA1c targets or postprandial blood glucose levels. The increase in insulin dose, number of injections and weight change during the course of the study were similar in both groups. Patients in both groups experienced similar hypoglycaemia rates and safety profile.

Conclusions  For patients with Type 2 diabetes inadequately controlled with oral anti‐hyperglycaemic medications, glycaemic control when initiating and intensifying with LM25 therapy was found to be non‐inferior to treatment with glargine + insulin lispro therapy.
Impact of community pharmacy diabetes monitoring and education programme on diabetes management: a randomized controlled study
Authors: Ali M. , Schifano F. , Robinson P. , Phillips G. , Doherty L. , Melnick P. , Laming L. , Sinclair A. , Dhillon S.
Published: June 2012

Diabet. Med. 29, e326–e333 (2012)

Aims  To evaluate the impact of a pharmacist‐led patient education and diabetes monitoring programme on HbA1c and other cardiovascular risk factors in the community setting.

Methods  Patients with Type 2 diabetes (n = 46) attending two community pharmacies in Hertfordshire, UK were randomized to one of two groups. Patients in the intervention group (n = 23) received a programme of education about diabetes, its treatment and associated cardiovascular risk factors. These patients were seen for monitoring/counselling by a community pharmacist on six occasions over a 12‐month period. Measures included HbA1c, BMI, blood pressure, blood glucose and lipid profile. Patients in the control group (n = 23) underwent these measurements at baseline and at 12 months only, without specific counselling or education over and above usual care.

Results  HbA1c fell from 66 mmol/mol (8.2%) to 49 mmol/mol (6.6%) (P < 0.001) in intervention group, compared with reduction from 65 mmol/mol (8.1%) to 59 mmol/mol (7.5%) in the control group (P = 0.03). Blood pressure fell from 146/87 to 126/81 mmHg in the intervention group (P = 0.01) compared with no significant change in the control group (136/86 to 139/82 mmHg). Significant reductions in BMI (30.8 to 27 kg/m2, P < 0.001) and blood glucose (8.8 to 6.9 mmol/l, P < 0.001) were also observed in the intervention group as compared with no significant changes in the control group. Lipid profile changes were mixed. In the intervention group, improvements were seen in diabetes‐related quality of life (P = 0.001), diabetes knowledge (P = 0.018), belief about the need for medication (P = 0.004) and reduced concerns regarding medication (P < 0.001).

Conclusions  Education and counselling by community pharmacists can result in favourable improvements to the cardiovascular risk profile of patients with Type 2 diabetes.
Gene expression in the developing aleurone and starchy endosperm of wheat
Authors: Gillies Susan A. , Futardo Agnelo , Henry Robert J.
Published: June 2012

Wheat is a critical food source globally. Food security is an increasing concern; current production levels are not expected to keep pace with global demand. New technologies have provided a vast array of wheat genetic data; however, best use of this data requires placing it within a framework in which the various genes, pathways and interactions can be examined. Here we present the first systematic comparison of the global transcriptomes of the aleurone and starchy endosperm of the developing wheat seed (Triticum aestivum), at time points critical to the development of the aleurone layer; 6‐, 9‐ and 14‐day post‐anthesis. Illumina sequencing gave 25—55 million sequence reads per tissue, of the trimmed reads, 70%—81% mapped to reference expressed sequence transcripts. Transcript abundance was analysed by performing RNA‐Seq normalization to generate reads per kilobase of exon model per million mapped reads values, and these were used in comparative analyses between the tissues at each time point using Kal’s Z‐test. This identified 9414—13 202 highly differentially expressed transcripts that were categorized on the basis of tissue and time point expression and functionally analysed revealing two very distinct tissues. The results demonstrate the fundamental biological reprogramming of the two major biologically and economically significant tissues of the wheat seed over this time course. Understanding these changes in gene expression profiles is essential to mining the potential these tissues hold for human nutrition and contributing to the systems biology of this important crop plant.
Child Temperament Moderates Effects of Parent–Child Mutuality on Self‐Regulation: A Relationship‐Based Path for Emotionally Negative Infants
Authors: Kim Sanghag , Kochanska Grazyna
Published: June 2012

This study examined infants’ negative emotionality as moderating the effect of parent–child mutually responsive orientation (MRO) on children’s self‐regulation (n = 102). Negative emotionality was observed in anger‐eliciting episodes and in interactions with parents at 7 months. MRO was coded in naturalistic interactions at 15 months. Self‐regulation was measured at 25 months in effortful control battery and as self‐regulated compliance to parental requests and prohibitions. Negative emotionality moderated the effects of mother–child, but not father–child, MRO. Highly negative infants were less self‐regulated when they were in unresponsive relationships (low MRO), but more self‐regulated when in responsive relationships (high MRO). For infants not prone to negative emotionality, there was no link between MRO and self‐regulation. The “regions of significance” analysis supported the differential susceptibility model not the diathesis–stress model.
Primary health care resources for rehabilitation and secondary prevention after myocardial infarction – a questionnaire survey
Authors: Sjöström‐Strand Annica , Ivarsson Bodil , Sjöberg Trygve
Published: June 2012

Scand J Caring Sci; 2013; 27; 260–266

Primary health care resources for rehabilitation and secondary prevention after myocardial infarction – a questionnaire survey

Background:  During the first year after a cardiac event, many patients are offered participation in a cardiac rehabilitation programme, after which the patients are often not given the opportunity to continue to attend rehabilitation and secondary prevention programmes.

Aim:  This study describes the primary health care centres’ (PHCC) resources regarding cardiac rehabilitation/secondary prevention programmes for coronary heart disease (CHD) patients in a southern Swedish region.

Method:  A questionnaire containing 26 dichotomous or multiple choice questions was sent to the responsible manager of all 137 public and private PHCCs in Region Skåne. Questionnaires from 91 (66%) of the PHCCs were completed and returned.

Result:  Few nurses at the PHCCs had special training regarding CHD (10%), cardiac rehabilitation (8%) or heart failure (32%). Twenty‐one per cent of the physicians had special training regarding CHD. One third of the PHCCs did not offer long‐term secondary prevention programmes, and few (6%) had any routines for offering socio‐economic support to CHD patients. Comparison of private and public PHCCs showed that the private centres could not offer a physiotherapist (61 vs. 84%) or dietician (32 vs. 73%; p = 0.03) to the same extension as the public ones. Furthermore, the majority (91%) of PHCCs had no cooperation with patient organizations.

Conclusions:  The PHCCs need to improve the strategies and long‐term rehabilitation programmes. Furthermore, they need to focus on education programme for the staff. The result revealed that the PHCCs lack resources, strategies and long‐term care programmes for CHD patients.
Psychometric properties of the Swedish version of the selection, optimization, compensation questionnaire
Authors: Viglund Kerstin , Aléx Lena , Jonsén Elisabeth , Lundman Berit , Norberg Astrid , Fischer Regina Santamäki , Strandberg Gunilla , Nygren Björn
Published: June 2012

Scand J Caring Sci; 2013; 27; 460–467

Psychometric properties of the Swedish version of the selection, optimization, compensation questionnaire

Background:  The model of selection, optimization and compensation has been proposed as a model of adaptive management strategies throughout the lifespan.

Aim:  The aim of this study was to test the psychometric properties of a translated Swedish version of the 12‐item selection, optimization, and compensation (SOC) questionnaire.

Method:  The 12‐item SOC questionnaire is composed of four subscales: elective selection (ES), loss‐based selection, optimization and compensation. A convenience sample of 122 Swedish‐speaking people, aged 19–85, participated in a study of the validity and reliability of the SOC questionnaire. Cronbach’s alpha coefficient, corrected item–total correlation and Cronbach’s alpha if item deleted were used for reliability testing. Two other scales, the ways of coping questionnaire and Rosenberg’s self‐esteem scale, were used to test convergent validity, and the geriatric depression scale was used to test discriminant validity. Stability over time was evaluated using a test–retest model with a 2‐week interval.

Results:  The 12‐item SOC questionnaire showed a Cronbach’s alpha value of 0.50, and the subscales ranged from α = 0.16 to α = 0.64. Two items in the ES subscale had negative values on the corrected item–total correlation and showed substantial improvement (>0.05) in Cronbach’s alpha when item deleted. When these two items that influenced internal consistency were deleted, Cronbach’s alpha rose to 0.68.

Conclusion:  The Swedish version of the 12‐item SOC questionnaire showed deficiencies in a test of internal consistency because of two items in the ES subscale, and these two items were deleted. A consequence of the reduction is a weakening of the ES subscale and thereby to some extent the SOC questionnaire in total. Further testing is advisable. However, the 10‐item SOC questionnaire was acceptable in a test of validity and reliability.
Formulation optimization, skin irritation, and efficacy characterization of a novel skin‐lightening agent
Authors: Jain Piyush , Sonti Sujatha , Garruto John , Mehta Rahul , Banga Ajay K.
Published: June 2012

Background  Skin‐lightening preparations are used by people all over the world for a diverse range of dermatologic indications. The gold standard treatment for skin lightening is with hydroquinone but has been controversial because of the presence of several side effects. Therefore, there has been a constant search for developing new treatment alternatives. Furthermore, the new amendments and bans on animal testing by ECVAM have made the three‐dimensional models like EpiDerm™ and MelanoDerm™ increasingly popular.

Objective  This work aims at the formulation development for a new skin‐lightening agent, SMA‐012, followed by testing for skin irritation and efficacy.

Methods  Formulation parameters such as concentration of SMA‐012, amount of ethanol, effect of permeation enhancers and pH were first optimized using Franz cell experiments. Tape stripping and underlying skin assays were performed to analyze the amounts of SMA‐012 in different layers of skin. The irritation potential and efficacy of the screened formulation were evaluated using Epiderm™ and Melanoderm™ models.

Results  Skin permeation experiments suggested that concentrations of 0.1% SMA‐012, 35% ethanol, and pH of 8.5 to be the best formulation characteristics. This particular formulation was found to be nonirritant for short‐term exposure, when tested in Epiderm™ model and also significantly effective in decreasing the amount of melanin in pigmented skin equivalent models.

Conclusion  SMA‐012 shows a good promise as a skin‐lightening agent for cosmetic and therapeutic applications. Additionally, our study demonstrates the application of skin equivalent models as alternatives to animal testing in studying the regulation of skin pigmentation.
TESTING AN ALTERNATIVE HIGH‐THROUGHPUT TOOL FOR INVESTIGATING BONE DIAGENESIS: FTIR IN ATTENUATED TOTAL REFLECTION (ATR) MODE*
Authors: HOLLUND H. I. , ARIESE F. , FERNANDES R. , JANS M. M. E. , KARS H.
Published: June 2012

Archaeological bone undergoes alterations after burial (diagenesis) that constitute a problem for the survival of archaeological information. A common method to assess this alteration is Fourier transform infrared spectrometry (FTIR). However, the commonly applied method (FTIR–KBr) is destructive and sample preparation may influence the results. This paper tests the suitability of FTIR attenuated total reflection (FTIR–ATR), a method not commonly used to investigate bone diagenesis. FTIR–ATR requires less sample preparation and can be non‐destructive, allowing analysis of bone cross‐sections. Modern and archaeological bones were analysed using both methods and different sample preparation methods were tested. The results show that FTIR–ATR has advantages for the rapid assessment of bone diagenesis.
Activity Theory and Language Teacher Agency
Authors: FERYOK ANNE
Published: June 2012

This article takes a broadly sociocultural perspective on the development of an Armenian English as a foreign language (EFL) teacher. It focuses on how experiences and actions outside the professional development classroom influence language teacher agency. The paper is framed within activity theory and specifically draws on Galperin's orienting activity, the psychological process of regulating internalization, which may occur through an image that guides actions. Data from email interviews, oral interviews, and classroom observations are iteratively analyzed to show how the participant oriented to her actions through a specific image. This image was based on the participant's early experiences with her English teacher as a school pupil, and it mediated her developing sense of agency by guiding the way she engaged in individual actions as a language teaching student, English teacher, and teacher trainer. The participant appeared to be leading emerging activity in her local teaching situation, but social activity provided the requisite background to her individual actions. The article concludes by suggesting that individual agentive actions can contribute to local social activity, that professional development occurs over a life, and that case studies may contribute to professional development not only as a model of personal reflection but also as a professional call to action.
Word Knowledge and Its Relation to Text Comprehension: A Comparative Study of Chinese‐ and Korean‐Speaking L2 Learners and L1 Speakers of Japanese
Authors: HORIBA YUKIE
Published: June 2012

In this study, word knowledge and its relation to text comprehension was examined with 50 Chinese‐ and 20 Korean‐speaking second language (L2) learners and 40 first language (L1) speakers of Japanese. Breadth and depth of word knowledge were assessed by a word‐definition matching test and a word‐associates selection test, respectively. Text comprehension, which was assessed by recall and summary completion, was regressed with word knowledge scores. The results suggest, first, that there are some differences in the relative strengths in components of word knowledge between Chinese and Korean speakers and between L2 learners and L1 speakers. Second, L2 learners’ text comprehension is moderately correlated with breadth and depth of word knowledge, with breadth being a stronger explanatory variable, unlike the case for native speakers. Among components of word knowledge, syntagmatic association seems to be particularly important to Chinese speakers, but not to Korean speakers and to natives. Thus, L2 learners’ word knowledge and its relation to text comprehension may be influenced in a complex way by L1‐related factors.
Cantonese English as a Second Language Learners’ Perceived Relations Between “Similar” L1 and L2 Speech Sounds: A Test of the Speech Learning Model
Authors: CHAN ALICE Y. W.
Published: June 2012

This article reports on the results of a research study that investigated Cantonese English as a second language (ESL) learners’ perception of English speech sounds, their perceived relations between “similar” English and Cantonese sounds, as well as the applicability of the claims of the Speech Learning Model (SLM) to second language (L2) learning by Cantonese ESL learners in Hong Kong. Forty university English majors participated in a perception study that required them to identify English minimal pairs, to classify a target English sound as a Cantonese sound and to rate the degree of similarity of a certain English sound to a “similar” Cantonese sound. It is found that Cantonese ESL learners’ perception of L2 speech sounds is intimately related to their perceived similarity between certain first language (L1) and L2 contrasts. The research provides empirical support for the SLM, affirming the adverse effects of similarity on L2 learning. It also calls for the inclusion of perception training in an L2 phonology program. Further research is needed to include learners from different linguistic backgrounds and at different English proficiency levels.
The Advanced Learner's Sociolinguistic Profile: On Issues of Individual Differences, Second Language Exposure Conditions, and Type of Sociolinguistic Variable
Authors: HOWARD MARTIN
Published: June 2012

Situated within the recent new wave of second language acquisition studies investigating the acquisition of sociolinguistic variation, this article draws on a longitudinal database of advanced French interlanguage to explore a number of issues that have not yet been extensively investigated. They concern the issue of individual variation in the use of sociolinguistic variables, the issue of the relationship between the use of different sociolinguistic variables within the individual learner's sociolinguistic repertoire, and the issue of the long‐term impact of naturalistic exposure on the instructed learner's sociolinguistic development. Quantitative results provide a close‐up picture of the advanced learner's sociolinguistic profile, the detail of which calls into question a number of previously accepted findings, such as the traditional ideas that classroom learners make minimal use, if any, of informal sociolinguistic variants and that even with naturalistic exposure, they continue to underuse such variants relative to the native speaker. Our results demonstrate the value of focusing on the individual learner, as opposed to the traditional approach of providing group results. Our findings further underline the need to compare use of different variable types by the individual learner in order to illuminate how use of a specific variable relates to others.
Socializer or Signal?, How Agency Accreditation Affects Organizational Culture
Authors: Teodoro Manuel P. , Hughes Adam G.
Published: June 2012

Agency accreditation has grown steadily as a management strategy in recent decades. Accreditation is meant to help professionalize public administration work by requiring an agency to adopt policies and practices that are sanctioned by an external organization. Advocates claim that accreditation facilitates the diffusion of best practices and builds a culture of professionalism in an agency. Accreditation clearly leads agencies to adopt formal policies. This article identifies two ways in which accreditation might affect organizational culture: (1) by socializing employees, and (2) by signaling the agency’s priorities to employees. Analyzing attitudinal data from officers in six American police departments, this study finds no association between accreditation and officers’ own values, but finds that accreditation is strongly correlated with officers’ perceptions of their agencies’ priorities.
Leveraging Technologies in Public Agencies: The Case of the U.S. Census Bureau and the 2010 Census
Authors: Desouza Kevin C. , Bhagwatwar Akshay
Published: June 2012

Emerging technologies are transforming government agencies and the nature of governance and pose new challenges for public managers. Under the leadership of Steven J. Jost, associate director for communications, the U.S. Census Bureau leveraged emerging technologies during the 2010 Census to complete the project under budget while also engaging citizens through the design of viable participatory platforms. The 2010 Census campaign focused on increasing response rates and encouraging citizen participation through innovations in the communication process with citizens and through the infusion of technology. The Census Bureau also effectively managed risks associated with the use of emerging technologies. The authors examine the innovations, the risks, and the effort to manage those risks under Jost’s leadership.
Why Do Entrepreneurs Switch Lead Venture Capitalists?
Authors: Cumming Douglas , Dai Na
Published: June 2012

We examine the dynamics of the positive sorting in the venture capital industry. Our findings indicate that switching lead venture capitalists (VCs) is not uncommon during the course of entrepreneurial firms’ development. Companies with upwardly revised perceived quality are more likely to switch to more reputable VCs. Further, companies that switch lead VCs obtain larger capital infusion and higher pre–money valuation. However, companies that switch to more reputable VCs accept smaller investment size and lower pre–money valuation in follow–on rounds. In addition, it takes significantly more time for switchers with downwardly revised perceived quality to obtain subsequent financing.
Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio are Prolonged in Patients with Moderate and Severe Obstructive Sleep Apnea
Authors: KILICASLAN FETHI , TOKATLI ALPTUG , OZDAG FATIH , UZUN MEHMET , UZ OMER , ISILAK ZAFER , YIGINER OMER , YALCIN MURAT , GUNEY MEHMET SENOL , CEBECI BEKIR SITKI
Published: June 2012

Background:

Prolongation of the peak and the end of T wave (Tp‐e) has been reported to be associated with ventricular arrhythmias. Tp‐e/QT ratio and Tp‐e/QTc ratio are used as an index of ventricular arrhythmogenesis. An increased incidence of ventricular arrhythmias has been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess ventricular repolarization in patients with OSA by using Tp‐e interval, Tp‐e/QT ratio, and Tp‐e/QTc ratio.

Methods:

We have studied 72 patients who underwent overnight polysomnography (PSG) between the years 2010–2011 at our institution. Patients with moderate and severe OSA (23 patients; mean age: 45±10), according to the apnea‐hypopnea index, constituted the study group. Patients with normal PSG (23 patients; mean age: 42±11) were used as the control group. In all patients, Tp‐e interval, Tp‐e/QT ratio, Tp‐e/QTc ratio, as well as some other electrocardiogram intervals were measured. Independent samples t‐tests were used for comparison of continuous and categorical variables and correlations were calculated by Spearman rank correlation.

Results:

Although QT and QTc intervals were not different between the groups, mean Tp‐e interval (81.6±11.1 msn; 63.9±7.3 msn; respectively; P < 0.001), Tp‐e/QT ratio (0.21±0.03; 0.17±0.02; respectively; P < 0.001), and Tp‐e/QTc ratio (0.20±0.03; 0.16±0.02; respectively; P < 0.001) were prolonged in the study group compared to the control group. Correlation analysis showed a significant positive correlation between the presence of moderate and severe OSA and Tp‐e interval (r = 0.72; P < 0.001), Tpe/QT ratio (r = 0.70; P < 0.001), and Tp‐e/QTc ratio (r = 0.70; P < 0.001).

Conclusions:

Tp‐e interval, Tp‐e/QT ratio, and Tp‐e/QTc ratio are prolonged in patients with moderate and severe OSA patients. There is a positive correlation between the presence of OSA and Tp‐e interval, Tp‐e/QT ratio, and Tp‐e/QTc ratio.
(PACE 2012; 35:966–972)
The Importance of Bidirectional Block during Pulmonary Vein Isolation
Authors: KIM JOONHYUK , DESAI SHALIN , JADONATH RAM , BELDNER STUART J.
Published: June 2012

The definition of a successful ablation of atrial fibrillation can vary among electrophysiologists. A commonly described endpoint is bidirectional block of the four pulmonary veins. A case is described in which entrance block into a pulmonary vein was achieved early during pulmonary vein isolation. However, triggers from the pulmonary vein continued to conduct into the atrium, revealing the block was only unidirectional. Further ablation resulted in true electrical isolation and highlights the importance of achieving bidirectional block. (PACE 2013; 36:e143–e145)
Tachycardia Associated with Twin Atrioventricular Nodes in an Infant with Heterotaxy and Interruption of Inferior Vena Cava
Authors: KATO YOSHIAKI , HORIGOME HITOSHI , TAKAHASHI‐IGARI MIHO , SUMITOMO NAOKATA , AONUMA KAZUTAKA
Published: June 2012

We report a 12‐month‐old boy with heterotaxy and interruption of inferior vena cava who showed sustained tachycardia associated with twin atrioventricular nodes (AVNs). Atrioventricular reciprocating tachycardia with antegrade conduction through the posterior AVN and retrograde conduction through the anterior AVN were successfully ablated using an upper approach from the left internal jugular vein. (PACE 2012; 35:e302–e305)
Progression of Subclinical Myocardial Dysfunction in Type 2 Diabetes after 5 years Despite Improved Glycemic Control
Authors: Vintila Vlad Damian , Roberts Aled , Vinereanu Dragos , Fraser Alan Gordon
Published: June 2012

Background: Patients with uncomplicated diabetes have reduced left ventricular long‐axis function, related to poor glycemic control and increased conduit arterial stiffness, with increased radial function. It is unknown if improved control of risk factors can reverse these subclinical changes. Patients and methods: We studied 27 patients with type 2 diabetes (18 men) 57 ± 1 months (mean ± SD) after an initial visit when they were compared with healthy age‐ and sex‐matched controls. On both visits patients had detailed echocardiographic studies including tissue Doppler, noninvasive tests of conduit arterial function, and metabolic and lipid profiling. Results: Mean age at this second review was 63.4 ± 8.1 years; 48% of patients received insulin. Mean HbA1c had decreased by 13% to 8 ± 1.6% and cholesterol by 17% to 4.3 ± 1.3 mmol/L (both, P < 0.01), but long‐axis systolic and early diastolic myocardial velocities had also declined, by 13% and 20%, respectively (both, P < 0.001). Body mass index had increased by 4%, arterial pulse pressure by 17% (both P < 0.01), and carotid arterial stiffness by 49% (P < 0.01). Fractional shortening (by 21%, P < 0.001), radial systolic velocity (by 13%, P < 0.05), and ejection fraction (by 9% to 68 ± 7%, P < 0.01) had all declined. Reductions in longitudinal function were best predicted by its baseline measurements, duration of diabetes, fasting triglycerides, and arterial stiffness (epsilon index). Conclusions: Despite improved diabetic control, subclinical left ventricular dysfunction progressed over 5 years. Radial compensation was reversed. Prevention of subclinical myocardial dysfunction in diabetes might require more intensive control of net cardiovascular risk.
Comparison of Left Ventricular Stroke Volume Assessment by Two‐ and Three‐Dimensional Echocardiography in a Swine Model of Acute Myocardial Infarction Validated by Thermodilution Method
Authors: Shimada Yuichi J. , Ishikawa Kiyotake , Kawase Yoshiaki , Ladage Dennis , Tilemann Lisa , Shiota Takahiro , Hajjar Roger J.
Published: June 2012

Background: Accurate left ventricular stroke volume (LVSV) measurement is clinically important in patients presenting with acute myocardial infarction. Three‐dimensional echocardiography (3DE) is expected to overcome limitations of two‐dimensional echocardiography (2DE). However, inaccuracy in volumetry by 3DE has often been reported hindering further clinical application. This study aimed at comparing agreement and correlation with the thermodilution method (TDM) between 2DE and 3DE measurement of LVSV. Methods: Swine model of myocardial infarction was created and LVSV was measured by 3DE by subtracting end‐systolic from end‐diastolic volume (3DE‐method). Pulsed Doppler ultrasound and left ventricular outlet tract area were used to measure LVSV by 2DE (2DE‐method). TDM was performed by the Swan‐Ganz catheter. Bland–Altman analysis followed by assessment of intraclass correlation coefficient (ICC) were performed between 2DE‐method and TDM as well as 3DE‐method and TDM. Results: A total of 25 comparisons revealed a significant overestimation of LVSV by the 2DE‐method (bias = 6.5 mL; 95% confidence interval [CI], 3.9–9.0 mL; P < 0.0001), whereas there was no significant bias by the 3DE‐method (bias =–1.6; 95% CI, –4.3 to 1.1 mL; P = 0.22). The ICC between 2DE and TDM was 0.49 (95% CI, 0.14–0.74) whereas ICC between 3DE and TDM was 0.75 (95% CI, 0.51–0.88). Conclusions: This study elucidated that LVSV is better estimated by 3DE‐method compared to the conventional 2DE‐method. This investigation will provide a more accurate, quick and noninvasive way of LVSV and cardiac output assessment at bedside by further application of 3DE.
An Asymptomatic Needle in the Left Ventricular Anterolateral Wall: A Prison Inmate's Strange Radio Antenna
Authors: Akpinar Ibrahim , Sayin Muhammet Rasit , Karabag Turgut , Dogan Sait Mesut , Aydin Mustafa
Published: June 2012

A foreign body such as a needle in the heart can be life‐threatening. While this may occur accidentally, needles may be inserted into the body by psychiatric patients or in cases involving domestic violence. A needle can migrate through the thorax toward the heart. In drug users, needles may also reach the right ventricle via the peripheral veins. Cardiac injury can occur via the esophagus after swallowing a needle. The clinical outcome may vary from an asymptomatic situation to tamponade or shock, depending on how severely the cardiac structures are affected. In injuries involving the thorax, pneumothorax may cause sudden shortness of breath. Here, we report the case of a 34‐year‐old male prison inmate who accidentally lodged a pin in his left ventricle while asleep. As he has refused surgery, it was decided to follow the patient carefully.
Live/Real Time Three‐Dimensional Transesophageal Echocardiography in the Assessment of Aortic Root Patch Dehiscence
Authors: Chen Sheng‐Yuan , Lee Kuo‐Chen , Hsiung Ming‐Chon , Yin Wei‐Hsian
Published: June 2012

We report a 66‐year‐old man who underwent partial reconstruction of the aortic root and presented with heart failure 2 months after the procedure. We used live/real time three‐dimensional transesophageal echocardiography (3DTEE) to detect the exact site of the dehiscence flap and extent of the leakage. This information could be valuable to surgeons.
Trends in Midwife‐Attended Births in the United States, 1989‐2009
Authors: Declercq Eugene
Published: June 2012

Introduction: Data on attendance at birth by midwives in the United States have been available on the national level since 1989. Rates of certified nurse‐midwife (CNM)–attended births more than doubled between 1989 (3.3% of all births) and 2002 (7.7%) and have remained steady since. This article examines trends in midwife‐attended births from 1989 to 2009.

Methods: The data in this report are based on records gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), that allows users to create and download specialized tables.

Results: Between 2007 and 2009, the proportion of all births attended by CNMs increased by 4% from 7.3% of all births to 7.6% and a total of 313,516. This represents a decline in total births attended by CNMs from 2008 but a higher proportion of all births because total US births dropped at a faster rate. The proportion of vaginal births attended by CNMs reached an all‐time high of 11.4% in 2009. There were strong regional patterns to the distribution of CNM‐attended births. Births attended by “other midwives” rose to 21,787 or 0.5% of all US births, and the total proportion of all births attended by midwives reached an all‐time high of 8.1%. The race/ethnicity of mothers attended by CNMs has shifted over the years. In 1990, CNMs attended a disproportionately high number of births to non‐white mothers, whereas in 2009, the profile of CNM births mirrors the national distribution in race/ethnicity.

Discussion: Midwife‐attended births in the United States are increasing. The geographic patterns in the distribution of midwife‐attended births warrant further study.
Electric and Magnetic Properties of Bilayered Lead‐Free Piezoelectric and Multiferroic Bi0.9Dy0.1FeO3/K0.5Na0.5NbO3 Thin Films
Authors: Chen Ling , Ren Wei , Ye Zuo‐Guang , Tian Aifen , Wu Xiaoqing , Shi Peng , Chen Xiaofeng
Published: June 2012

Composite lead‐free piezoelectric and multiferroic thin films consisting of
Bi

0.9

Dy

0.1

FeO

3 (
BDF
) and
K

0.5

Na

0.5

NbO

3 (
KNN
) nanolayers were prepared on the
Pt
/
TiO

2/
SiO

2/
Si
substrates by pulsed laser deposition. The bilayered
BDF
/
KNN
films exhibited a preferential (100)‐orientation and much enhanced ferroelectric properties (2P
r = 26.5 μC/cm2, 2E
c = 369.2 kV/cm) as compared to those of single layer
BDF
or
KNN
thin film. In addition, the bilayered
BDF
/
KNN
films also showed ferromagnetic behavior at low temperature (2M
r = 1.57 emu/cm3, 2H
c = 3 kOe). The enhanced ferroelectric properties of the bilayered
BDF
/
KNN
thin films were attributed to the significantly reduced leakage current arising from the enhanced crystallinity and the interface reaction of the
BDF
and
KNN
nanolayers. An effective piezoelectric coefficient d
33 of 12 pm/V was measured on the bilayered films.
What is the gold standard for intrapartum fetal monitoring?
Authors: YLI BRANKA M. , KESSLER JØRG , EIKELAND TORUNN , HUSTAD BERIT LUNDEN , DRAGNES WINNIE , HENRIKSEN TORE
Published: June 2012

The health authorities of Stockholm county recently published a Health Technology Assessment report: “Fetal monitoring with computerized STAN analysis during labor – a systematic review” with the aim to ensure that high quality research information on costs, effectiveness and broader impact of health technologies is analysed and presented in the most efficient way for those who use, manage and work in this field. The report claims to analyse available research in relation to ST interval analysis of fetal electrocardiogram (STAN) and concludes that scientific evidence for advantages of the STAN technology for maternal and fetal outcome was insufficient and that clinical use cannot be recommended and should be restricted to research protocols. The Norwegian reference group for fetal surveillance points out that the report suffers from two insufficiencies: selection bias by not providing a complete collection of the evidence for the clinical performance of the STAN technology and, secondly, that it does not provide evidence‐based alternative methods.
Topoisomerase expression in oral squamous cell carcinoma: relationship with cancer stem cells profiles and lymph node metastasis
Authors: Oliveira‐Costa João Paulo , Oliveira Lucinei Roberto , da Silveira Giórgia Gobbi , Soave Danilo Figueiredo , Soares Fernando Augusto , Ribeiro‐Silva Alfredo
Published: June 2012

J Oral Pathol Med (2012) 41: 762–768

Background:  The relationship between predictive proteins and tumors presenting cancer stem cells (CSCs) profiles in oral tumors is still poorly understood. This study aims to identify the relationship between topoisomerases I, IIα, and IIIα and putative CSCs immunophenotype in oral squamous cell carcinoma (OSCC) and determine its influence on prognosis.

Methods:  The following data were retrieved from 127 patients: age, gender, primary anatomic site, smoking and alcohol intake, recurrence, metastases, histologic classification, treatment, and survival. An immunohistochemical study for topoisomerases I, IIα, and IIIα was performed in a tissue microarray containing 127 paraffin blocks of OSCCs.

Results:  In univariate analysis, topoisomerases expression showed significant differences according to CSCs profiles and p53 immunoexpression, but not with survival. Topoisomerases IIα and IIIα also showed significant relationship with lymph node metastasis. The multivariate test confirmed these associations.

Conclusions:  The results that all topoisomerases correlates with OSCC CSCs may indicate a role for topoisomerases in head and neck carcinogenesis. Notwithstanding, it is plausible that other members of topoisomerases family could represent novel therapeutical targets in oral squamous cell carcinoma.
Expression of Wilms’ tumor 1 (WT1) in oral squamous cell carcinoma
Authors: Mikami Toshinari , Hada Tomohiro , Chosa Naoyuki , Ishisaki Akira , Mizuki Harumi , Takeda Yasunori
Published: June 2012

J Oral Pathol Med (2013)42: 133–139

Background:  The product of the Wilms’ tumor gene, WT1 protein, is a tumor antigen for various kinds of cancer, and WT1 peptide‐based cancer immunotherapy is widely anticipated as a new possibility for cancer treatment. The aim of this study was to investigate the expression of WT1 from quantitative and morphological perspectives in oral squamous cell carcinoma (OSCC), the most widespread malignant neoplasm of the oral cavity.

Methods:  Six OSCC cell lines and tissue sections from 29 OSCC patients were analyzed. To detect WT1 expression, reverse transcription‐polymerase chain reaction analysis (RT‐PCR), real‐time PCR, Western blots, and immunofluorescence flow cytometry for WT1 were performed on the cell lines, and immunohistochemistry and fluorescence in situ hybridization (FISH) were performed on the tissue sections.

Results:  WT1 mRNA was found overexpressed in one of the six OSCC cell lines, with expression levels higher than that seen in human leukemia cell line (K562). Immunohistochemical analysis of tissue sections showed overexpression of WT1 protein in two patients, concentrated mainly in the cytoplasm of the outer one to three cell layers of the cancer nests. This was consistent with the expression of WT1 mRNA observed by FISH. Meanwhile, WT1 was not detected on normal oral epithelium. WT1 protein was detected on actively proliferating cancer nests and even on elongated epithelial ridge where new droplet‐cancer‐nests were being formed and starting infiltration toward subepithelial layer.

Conclusions:  The results suggest that WT1 plays an important role in the pathogenesis of some types of OSCC, particularly in proliferation of the cancer cells.
Hemolysis induced by an extreme mountain ultra‐marathon is not associated with a decrease in total red blood cell volume
Authors: Robach P. , Boisson R.‐C. , Vincent L. , Lundby C. , Moutereau S. , Gergelé L. , Michel N. , Duthil E. , Féasson L. , Millet G. Y.
Published: June 2012

Prolonged running is known to induce hemolysis. It has been suggested that hemolysis may lead to a significant loss of red blood cells; however, its actual impact on the erythrocyte pool is unknown. Here, we test the hypothesis that prolonged running with high hemolytic potential decreases total red blood cell volume (RCV). Hemolysis (n = 22) and RCV (n = 19) were quantified in ultra‐marathon runners before and after a 166‐km long mountain ultra‐endurance marathon (RUN) with 9500 m of altitude gain/loss. Assessment of total hemoglobin mass (Hbmass) and RCV was performed using a carbon monoxide rebreathing technique. RUN induced a marked acute‐phase response and promoted hemolysis, as shown by a decrease in serum haptoglobin (P < 0.05). Elevated serum erythropoietin concentration and reticulocyte count after RUN were indicative of erythropoietic stimulation. Following RUN, runners experienced hemodilution, mediated by a large plasma volume expansion and associated with a large increase in plasma aldosterone. However, neither Hbmass nor RCV were found to be altered after RUN. Our findings indicate that mechanical/physiological stress associated with RUN promotes hemolysis but this has no impact on total erythrocyte volume. We therefore suggest that exercise ‘anemia’ is entirely due to plasma volume expansion and not to a concomitant decrease in RCV.
Kinematic, strength, and stiffness adaptations after a short‐term sled towing training in athletes
Authors: Alcaraz P. E. , Elvira J. L. L. , Palao J. M.
Published: June 2012

One of the most frequently used methods for training the sprint‐specific strength is the sled towing. To date, no studies have been conducted to explore the effects of this method after a training period in well‐trained athletes. The purpose of this study was to determine the effects of 4 weeks of resisted sprint training with sled towing. Twenty‐two trained athletes experienced in the use of weighted sled (WS) participated in the study. They conducted the same 3‐week training to level their initial condition. After that they were distributed in two groups, unresisted (UR) and WS training. They carried out the same 4‐week, 2 days/week sprint‐specific training, only differing in that the experimental group performed sprints with a (WS) which caused a reduction of 7.5% of their maximum velocity. Pre‐ and posttest were conducted which included the measurement of sprint kinematics, muscular strength (including isoinertial, isokinetic, and jump measurements), and sprinting stiffness (leg and vertical). Results show different adaptations in the groups although no interaction effect was found. The WS group improved the velocity in the transition phase, while the UR group improved the velocity in the maximum velocity phase. No improvements in the height of the jump tests were found.
Tuning Multiple Motor Travel via Single Motor Velocity
Authors: Xu Jing , Shu Zhanyong , King Stephen J. , Gross Steven P.
Published: June 2012

Microtubule‐based molecular motors often work in small groups to transport cargos in cells. A key question in understanding transport (and its regulation in vivo) is to identify the sensitivity of multiple‐motor‐based motion to various single molecule properties. Whereas both single‐motor travel distance and microtubule binding rate have been demonstrated to contribute to cargo travel, the role of single‐motor velocity is yet to be explored. Here, we recast a previous theoretical study, and make explicit a potential contribution of velocity to cargo travel. We test this possibility experimentally, and demonstrate a strong negative correlation between single‐motor velocity and cargo travel for transport driven by two motors. Our study thus discovers a previously unappreciated role of single‐motor velocity in regulating multiple‐motor transport.
Cyclic Changes in the Level of the Innate Immune Molecule, Surfactant Protein‐A, and Cytokines in Vaginal Fluid
Authors: MacNeill Colin , de Guzman Glendell , Sousa Grace E. , Umstead Todd M. , Phelps David S. , Floros Joanna , Ahn Kwangmi , Weisz Judith
Published: June 2012

Problem

Our knowledge of the innate host defenses in the vagina, a site where these defenses are essential to protecting the host upper reproductive tract from invasion by pathogens, is as yet rudimentary. Specifically, little is known about the pattern‐recognition component of vaginal innate immunity, the relationship of pattern‐recognition molecules to known cytokine levels, and the role of gonadal hormones in their regulation.

Method of study

We measured levels of Surfactant Protein‐A (SP‐A), a prototypic innate pattern‐recognition protein, in vaginal fluid (VF) and correlated them with levels of IL‐1β and IL‐8, two cytokines known to be present in VF. Assays were carried out on VF collected over three consecutive cycles from ten healthy naturally cycling women who were sampled at three specific time points in the menstrual cycle. The three time points were chosen to enable correlation with distinct hormonal states.

Results

Both SP‐A and cytokines levels were highest 5–6 days after menses (P < 0.05) and were significantly lower at ovulation and mid‐luteal phase.

Conclusion

Surfactant Protein‐A, like other host defense molecules in the reproductive tract, appears to be regulated by gonadal hormones.
Poverty, Marriage Timing, and Transitions to Adulthood in Nepal
Authors: Bajracharya Ashish , Amin Sajeda
Published: June 2012

This study examines the influence of household poverty during early childhood on schooling, workforce participation, and early marriage among adolescent girls in Nepal. Longitudinal data from the two‐wave panel of the Nepal Living Standards Survey (NLSS) were used to examine these relationships. For 5‐9‐year‐old girls contacted in NLSS I and again when aged 13–17 in NLSS II (N = 400), multinomial logit regression estimates indicate that household poverty during early childhood is associated with greater likelihood of marrying early or joining the workforce rather than remaining in school. Analyzing the data by household wealth quintiles reveals that these associations are largest for the second‐poorest quintile, not the poorest. This study highlights the role of household rather than individual characteristics in adolescent girls' decisionmaking.