bluuebunny/crossref_metadata_2025 huggingface dataset:
Current management of diabetes mellitus and future directions in care
Authors: Chatterjee Sudesna , Davies Melanie J
Published: October 2015

The last 90 years have seen considerable advances in the management of type 1 and type 2 diabetes. Prof MacLean of Guy’s Hospital wrote in the Postgraduate Medical Journal in 1926 about the numerous challenges that faced patients and their healthcare professionals in delivering safe and effective diabetes care at that time. The discovery of insulin in 1922 heralded a new age in enabling long-term glycaemic control, which reduced morbidity and mortality. Thirty years later, the first oral agents for diabetes, the biguanides and sulfonylureas, appeared and freed type 2 patients from having to inject insulin following diagnosis. Improvements in insulin formulations over the decades, including rapid-acting and long-acting insulin analogues that more closely mimic physiological insulin secretion, have increased the flexibility and efficacy of type 1 diabetes management. The last two decades have seen major advances in technology, which has manifested in more accurate glucose monitoring systems and insulin delivery devices (‘insulin pump’). Increased understanding of the pathophysiological deficits underlying type 2 diabetes has led to the development of targeted therapeutic approaches such as on the small intestine (glucagon-like peptide-1 receptor analogues and dipeptidyl-peptidase IV inhibitors) and kidneys (sodium-glucose cotransporter-2 inhibitors). A patient-centred approach delivered by a multidisciplinary team is now advocated. Glycaemic targets are set according to individual circumstances, taking into account factors such as weight, hypoglycaemia risk and patient preference. Stepwise treatment guidelines devised by international diabetes organisations standardise and rationalise management. Structured education programmes and psychological support are now well-established as essential for improving patient motivation and self-empowerment. Large multicentre randomised trials have confirmed the effectiveness of intensive glycaemic control on microvascular outcomes, but macrovascular outcomes and cardiovascular safety remain controversial with several glucose-lowering agents. Future directions in diabetes care include strategies such as the ‘bionic pancreas’, stem cell therapy and targeting the intestinal microbiome. All of these treatments are still being refined, and it may be several decades before they are clinically useful. Prevention and cure of diabetes is the Holy Grail but remain elusive due to lack of detailed understanding of the metabolic, genetic and immunological causes that underpin diabetes. Much progress has been made since the time of Prof MacLean 90 years ago, but there are still great strides to be taken before the life of the patient with diabetes improves even more significantly.
New approach to improve soil-water characteristic curve to reduce variation in estimation of unsaturated permeability function
Authors: Rahimi Arezoo , Rahardjo Harianto
Published: October 2015

The unsaturated permeability function is often estimated from the soil-water characteristic curve (SWCC) of a soil. A complete SWCC measurement can improve the estimation of the unsaturated permeability function. In most laboratories, the SWCC can be measured up to a suction of 100 kPa using a Tempe cell. However, complete measurement of the SWCC is an expensive and time-consuming task. Therefore, this paper presents a new approach to estimate SWCC data points beyond 100 kPa suction to complement the SWCC measured up to a suction of 100 kPa. The new SWCC is then used to estimate the unsaturated permeability function. The proposed approach uses knowledge of the grain-size distribution curve and measured SWCC data at 100 kPa suction to estimate the SWCC data points beyond 100 kPa suction. To verify the proposed procedure, SWCC tests were conducted over a wide range of suctions for coarse kaolin and a triaxial permeameter system was used to directly measure unsaturated permeability of the coarse kaolin. The proposed procedure is found to reduce the variation between unsaturated permeability functions estimated by various estimation models.
Effects of aerobic interval training and continuous training on cellular markers of endothelial integrity in coronary artery disease: a SAINTEX-CAD substudy
Authors: Van Craenenbroeck Emeline M. , Frederix Geert , Pattyn Nele , Beckers Paul , Van Craenenbroeck Amaryllis H. , Gevaert Andreas , Possemiers Nadine , Cornelissen Veronique , Goetschalckx Kaatje , Vrints Christiaan J. , Vanhees Luc , Hoymans Vicky Y.
Published: October 2015

In this large multicenter trial, we aimed to assess the effect of aerobic exercise training in stable coronary artery disease (CAD) patients on cellular markers of endothelial integrity and to examine their relation with improvement of endothelial function. Two-hundred CAD patients (left ventricular ejection fraction > 40%, 90% male, mean age 58.4 ± 9.1 yr) were randomized on a 1:1 base to a supervised 12-wk rehabilitation program of either aerobic interval training or aerobic continuous training on a bicycle. At baseline and after 12 wk, numbers of circulating CD34+/KDR+/CD45dimendothelial progenitor cells (EPCs), CD31+/CD3+/CXCR4+angiogenic T cells, and CD31+/CD42b−endothelial microparticles (EMPs) were analyzed by flow cytometry. Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. After 12 wk of aerobic interval training or aerobic continuous training, numbers of circulating EPCs, angiogenic T cells, and EMPs were comparable with baseline levels. Whereas improvement in peak oxygen consumption was correlated to improvement in FMD (Pearson r = 0.17, P = 0.035), a direct correlation of baseline or posttraining EPCs, angiogenic T cells, and EMP levels with FMD was absent. Baseline EMPs related inversely to the magnitude of the increases in peak oxygen consumption (Spearman rho = −0.245, P = 0.027) and FMD (Spearman rho = −0.374, P = 0.001) following exercise training. In conclusion, endothelial function improvement in response to exercise training in patients with CAD did not relate to altered levels of EPCs and angiogenic T cells and/or a diminished shedding of EMPs into the circulation. EMP flow cytometry may be predictive of the increase in aerobic capacity and endothelial function.
Role of miR-124 and miR-141 in the regulation of vascular reactivity and the relationship to RhoA and Rac1 after hemorrhage and hypoxia
Authors: Liu Liangming , Zang Jiatao , Chen Xiangyun , Yang Guangming , Zhu Yu , Wu Yue , Li Tao
Published: October 2015

Recent studies show that hypoxia can alter expression levels of microRNAs (miRNAs). Whether hypoxia or hemorrhage-induced vascular hyporeactivity is related to miRNAs and the underlying mechanisms of this process is not clear. Using hypoxia-treated superior mesenteric arteries (SMAs) and vascular smooth muscle cells (VSMCs) of rats that underwent hemorrhage, we observed the regulatory effects of miR-124/miR-141 on vascular reactivity, the relationship of these miRNAs to RhoA and Rac1, and the mutual regulation of miR-124 and miR-141. The contractile responses of SMAs and VSMCs showed an increase in early stages and a decrease in late stages of hypoxia and hemorrhage. Forty-five miRNAs appeared to have been significantly changed in SMAs after hypoxia, and miR-124 and miR-141 underwent the most change. Overexpressed miR-124 or miR-141 and their antisenses appeared to alter both vascular reactivity and expression of the proteins RhoA and Rac1 after hypoxia. miR-124 inhibited Rac1 by acting at the Rac1 mRNA 3′-untranslated region (UTR), but it led to an increase in RhoA by inhibiting miR-141. miR-141 inhibited RhoA by acting at the RhoA mRNA 3′-UTR, but it led to an increase in Rac1 by inhibiting miR-124. Further study found that miR-124 inhibited miR-141 via transcription factor early growth response gene-1 (Egr-1), whereas miR-141 inhibited miR-124 via transcription of nuclear factor erythroid 2-related factor 2 (Nrf-2). These results suggest that miR-124 and miR-141 participate in the regulation of vascular reactivity after hypoxia and hemorrhage by regulating expression of the RhoA and Rac1 proteins, and in doing so, miR-124 and miR-141 are mutually regulated. These findings provide potential targets for restoring vascular function as part of the treatment protocol for hemorrhagic shock and some other critical illness.
Deletion of Src family kinase Lyn aggravates endotoxin-induced lung inflammation
Authors: Gao Rong , Ma Zhongsen , Ma Mengshi , Yu Jinyan , Chen Jiao , Li Zhenyu , Shetty Sreerama , Fu Jian
Published: October 2015

Overwhelming acute inflammation often leads to tissue damage during endotoxemia. In the present study, we investigated the role of Lyn, a member of the Src family tyrosine kinases, in modulating inflammatory responses in a murine model of endotoxemia. We examined lung inflammatory signaling in Lyn knockout (Lyn−/−) mice and wild-type littermates (Lyn+/+) during endotoxemia. Our data indicate that Lyn deletion aggravates endotoxin-induced pulmonary inflammation and proinflammatory signaling. We found increased activation of proinflammatory transcription factor NF-κB in the lung tissues of Lyn−/− mice after endotoxin challenge. Furthermore, during endotoxemia, the lung tissues of Lyn−/− mice showed increased inflammasome activation indicated by augmented caspase-1 and IL-1β cleavage and activation. The aggravated lung inflammatory signaling in Lyn−/− mice was associated with increased production of proinflammatory mediators and elevated matrix metallopeptidase 9 and reduced VE-cadherin levels. Our results suggest that Lyn kinase modulates inhibitory signaling to suppress endotoxin-induced lung inflammation.
Defining a New Prognostic Index for Stage I Nonseminomatous Germ Cell Tumors Using CXCL12 Expression and Proportion of Embryonal Carcinoma
Authors: Gilbert Duncan C. , Al-Saadi Reem , Thway Khin , Chandler Ian , Berney Daniel , Gabe Rhian , Stenning Sally P. , Sweet Joan , Huddart Robert , Shipley Janet M.
Published: October 2015

Purpose: Up to 50% of patients diagnosed with stage I nonseminomatous germ cell tumors (NSGCTs) harbor occult metastases. Patients are managed by surveillance with chemotherapy at relapse or adjuvant treatment up front. Late toxicities from chemotherapy are increasingly recognized. Based on a potential biologic role in germ cells/tumors and pilot data, our aim was to evaluate tumor expression of the chemokine CXCL12 alongside previously proposed markers as clinically useful biomarkers of relapse.

Experimental Design: Immunohistochemistry for tumor expression of CXCL12 was assessed as a biomarker of relapse alongside vascular invasion, histology (percentage embryonal carcinoma), and MIB1 staining for proliferation in formalin-fixed paraffin-embedded orchidectomy samples from patients enrolled in the Medical Research Council's TE08/22 prospective trials of surveillance in stage I NSGCTs.

Results: TE08/TE22 trial patients had a 76.4% 2-year relapse-free rate, and both CXCL12 expression and percentage embryonal carcinoma provided prognostic value independently of vascular invasion (stratified log rank test P = 0.006 for both). There was no additional prognostic value for MIB1 staining. A model using CXCL12, percentage embryonal carcinoma, and VI defines three prognostic groups that were independently validated.

Conclusions: CXCL12 and percentage embryonal carcinoma both stratify patients' relapse risk over and above vascular invasion alone. This is anticipated to improve the stratification of patients and identify high-risk cases to be considered for adjuvant therapy. Clin Cancer Res; 22(5); 1265–73. ©2015 AACR.
RAD51 and BRCA2 Enhance Oncolytic Adenovirus Type 5 Activity in Ovarian Cancer
Authors: Tookman Laura A. , Browne Ashley K. , Connell Claire M. , Bridge Gemma , Ingemarsdotter Carin K. , Dowson Suzanne , Shibata Atsushi , Lockley Michelle , Martin Sarah A. , McNeish Iain A.
Published: October 2015

Homologous recombination (HR) function is critically important in high-grade serous ovarian cancer (HGSOC). HGSOC with intact HR has a worse prognosis and is less likely to respond to platinum chemotherapy and PARP inhibitors. Oncolytic adenovirus, a novel therapy for human malignancies, stimulates a potent DNA damage response that influences overall antitumor activity. Here, the importance of HR was investigated by determining the efficacy of adenovirus type 5 (Ad5) vectors in ovarian cancer. Using matched BRCA2-mutant and wild-type HGSOC cells, it was demonstrated that intact HR function promotes viral DNA replication and augments overall efficacy, without influencing viral DNA processing. These data were confirmed in a wider panel of HR competent and defective ovarian cancer lines. Mechanistically, both BRCA2 and RAD51 localize to viral replication centers within the infected cell nucleus and that RAD51 localization occurs independently of BRCA2. In addition, a direct interaction was identified between RAD51 and adenovirus E2 DNA binding protein. Finally, using functional assays of HR competence, despite inducing degradation of MRE11, Ad5 infection does not alter cellular ability to repair DNA double-strand break damage via HR. These data reveal that Ad5 redistributes critical HR components to viral replication centers and enhances cytotoxicity.

Implications: Oncolytic adenoviral therapy may be most clinically relevant in tumors with intact HR function. Mol Cancer Res; 14(1); 44–55. ©2015 AACR.
Predicting the Presence of an Acute Coronary Lesion Among Patients Resuscitated From Cardiac Arrest
Authors: Waldo Stephen W. , Chang Lee , Strom Jordan B. , O’Brien Cashel , Pomerantsev Eugene , Yeh Robert W.
Published: October 2015

Background—

A mechanism to stratify patients resuscitated from a cardiac arrest according to the likelihood of an acute coronary lesion would have significant utility. We thus sought to develop and validate a risk prediction model for the presence of an acute coronary lesion among patients resuscitated from an arrest.

Methods and Results—

All subjects undergoing coronary angiography after resuscitation from a cardiac arrest were identified in an ongoing institutional registry from 2009 to 2014. Backwards stepwise selection of candidate covariates was used to create a logistic regression model for the presence of an angiographic culprit lesion and internally validated with bootstrapping. A clinical point score was generated and its prognostic abilities compared with contemporary measures. Among 247 subjects undergoing coronary angiography after resuscitation from a cardiac arrest, 130 (52%) had an acute lesion in a coronary artery. A multivariable model—including angina, congestive heart failure symptoms, shockable arrest rhythm (ventricular fibrillation/ventricular tachycardia), and ST-elevations—had excellent discrimination (optimism corrected C-Statistic, 0.88) and calibration (Hosmer–Lemeshow
P
=0.540) for an acute coronary lesion. Compared with electrocardiographic findings alone, a point score based on this model more accurately predicted the presence of an acute lesion among patients resuscitated from a cardiac arrest (integrated discrimination improvement, 0.10; 95% confidence interval, 0.04–0.19;
P
<0.001).

Conclusions—

Patients with a cardiac arrest can be risk stratified for the presence of an acute coronary lesion using 4 easily measured variables. This simple risk score may be used to improve patient selection for emergent coronary angiography among resuscitated patients.
Early Coronary Angiography and Survival After Out-of-Hospital Cardiac Arrest
Authors: Vyas Ankur , Chan Paul S. , Cram Peter , Nallamothu Brahmajee K. , McNally Bryan , Girotra Saket
Published: October 2015

Background—

Although out-of-hospital cardiac arrest is common because of acute myocardial infarction, it is unknown whether early coronary angiography is associated with improved survival in these patients.

Methods and Results—

Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), we identified 4029 adult patients admitted to 374 hospitals after successful resuscitation from out-of-hospital cardiac arrest because of ventricular fibrillation, pulseless ventricular tachycardia, or unknown shockable rhythm between January 2010 and December 2013. Early coronary angiography (occurring within one calendar day of cardiac arrest) was performed in 1953 (48.5%) patients, of whom 1253 (64.2%) received coronary revascularization. Patients who underwent early coronary angiography were younger (59.9 versus 62.0 years); more likely to be men (78.1% versus 64.3%), have a witnessed arrest (84.6% versus 77.4%), and have ST-segment–elevation myocardial infarction (32.7% versus 7.9%); and less likely to have known cardiovascular disease (22.8% versus 35.0%), diabetes mellitus (11.0% versus 17.0%), and renal disease (1.8% versus 5.8%;
P
<0.01 for all comparisons). In analysis of 1312 propensity score–matched pairs, early coronary angiography was associated with higher odds of survival to discharge (odds ratio 1.52 [95% confidence interval 1.28–1.80];
P
<0.0001) and survival with favorable neurological outcome (odds ratio 1.47 [95% confidence interval 1.25–1.71];
P
<0.0001). Further adjustment for coronary revascularization in our models significantly attenuated both odds ratios, suggesting that revascularization was a key mediator of the survival benefit.

Conclusions—

Among initial survivors of out-of-hospital cardiac arrest caused by VF or pulseless VT, we found early coronary angiography was associated with higher odds of survival to discharge and favorable neurological outcome.
Procedural Results and Clinical Outcomes of Transcatheter Aortic Valve Implantation in Switzerland
Authors: Binder Ronald K , Stortecky Stefan , Heg Dik , Tueller David , Jeger Raban , Toggweiler Stefan , Pedrazzini Giovanni , Amann Franz W , Ferrari Enrico , Noble Stephane , Nietlispach Fabian , Maisano Francesco , Räber Lorenz , Roffi Marco , Grünenfelder Jürg , Jüni Peter , Huber Christoph , Windecker Stephan , Wenaweser Peter
Published: October 2015

Background—

New generation transcatheter heart valves (THV) may improve clinical outcomes of transcatheter aortic valve implantation.

Methods and Results—

In a nationwide, prospective, multicenter cohort study (Swiss Transcatheter Aortic Valve Implantation Registry, NCT01368250), outcomes of consecutive transfemoral transcatheter aortic valve implantation patients treated with the Sapien 3 THV (S3) versus the Sapien XT THV (XT) were investigated. An overall of 153 consecutive S3 patients were compared with 445 consecutive XT patients. Postprocedural mean transprosthetic gradient (6.5±3.0 versus 7.8±6.3 mm Hg,
P
=0.17) did not differ between S3 and XT patients, respectively. The rate of more than mild paravalvular regurgitation (1.3% versus 5.3%,
P
=0.04) and of vascular (5.3% versus 16.9%,
P
<0.01) complications were significantly lower in S3 patients. A higher rate of new permanent pacemaker implantations was observed in patients receiving the S3 valve (17.0% versus 11.0%,
P
=0.01). There were no significant differences for disabling stroke (S3 1.3% versus XT 3.1%,
P
=0.29) and all-cause mortality (S3 3.3% versus XT 4.5%,
P
=0.27).

Conclusions—

The use of the new generation S3 balloon-expandable THV reduced the risk of more than mild paravalvular regurgitation and vascular complications but was associated with an increased permanent pacemaker rate compared with the XT. Transcatheter aortic valve implantation using the newest generation balloon-expandable THV is associated with a low risk of stroke and favorable clinical outcomes.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01368250.
Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes and Chronic Obstructive Pulmonary Disease: An Analysis From the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Authors: Andell Pontus , James Stefan K. , Cannon Christopher P. , Cyr Derek D. , Himmelmann Anders , Husted Steen , Keltai Matyas , Koul Sasha , Santoso Anwar , Steg Ph. Gabriel , Storey Robert F. , Wallentin Lars , Erlinge David ,   the PLATO Investigators
Published: October 2015

Background

Patients with chronic obstructive pulmonary disease (
COPD
) experiencing acute coronary syndromes (
ACS
) are at high risk for clinical events. In the Platelet Inhibition and Patient Outcomes (
PLATO
) trial, ticagrelor versus clopidogrel reduced the primary endpoint of death from vascular causes, myocardial infarction, or stroke after
ACS,
but increased the incidence of dyspnea, which may lead clinicians to withhold ticagrelor from
COPD
patients.

Methods and Results

In 18 624 patients with
ACS
randomized to treatment with ticagrelor or clopidogrel, history of
COPD
was recorded in 1085 (5.8%). At 1 year, the primary endpoint occurred in 17.7% of patients with
COPD
versus 10.4% in those without
COPD
(
P
<0.001). The 1‐year event rate for the primary endpoint in
COPD
patients treated with ticagrelor versus clopidogrel was 14.8% versus 20.6% (hazard ratio [
HR
]=0.72; 95% confidence interval [
CI
]: 0.54 to 0.97), for death from any cause 8.4% versus 12.4% (
HR
=0.70; 95%
CI
: 0.47 to 1.04), and for
PLATO
‐defined major bleeding rates at 1 year 14.6% versus 16.6% (
HR
=0.85; 95%
CI
: 0.61 to 1.17). Dyspnea occurred more frequently with ticagrelor (26.1% vs. 16.3%;
HR
=1.71; 95%
CI
: 1.28 to 2.30). There was no differential increase in the relative risk of dyspnea compared to non‐
COPD
patients (
HR=
1.85). No
COPD
status‐by‐treatment interactions were found, showing consistency with the main trial results.

Conclusions

In this post‐hoc analysis,
COPD
patients experienced high rates of ischemic events. Ticagrelor versus clopidogrel reduced and substantially decreased the absolute risk of ischemic events (5.8%) in
COPD
patients, without increasing overall major bleeding events. The benefit‐risk profile supports the use of ticagrelor in patients with
ACS
and concomitant
COPD
.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00391872.
Effect of substrate temperature on behavioural plasticity in antlion larvae
Authors: Klokočovnik Vesna , Hauptman Gregor , Devetak Dušan
Published: October 2015

Temperature is of crucial importance, affecting all aspects of insect life such as survival, development and daily activity patterns, and consequently behaviour. In the present study we evaluated the effect of temperature on the behavioural plasticity of antlion larvae, the sit-and-wait predators, which are considerably more dependent on local habitat conditions. We provided ethological descriptions of pit construction and feeding behaviour. An increase in temperature led to greater activity and consequently to greater frequency of sand tossing during pit construction. Larvae constructed bigger pits at higher temperatures, but required less time than at lower temperatures, when the resulting pits were the smallest. At low temperature, larvae required more time for feeding, and behaviour followed a core pattern with little variety, in comparison to behaviour at high temperatures. Two behavioural patterns occurred only at the highest temperature: ‘relocation’ and ‘submergence’, presumably in response to high temperatures.
The transmission of capital and a feel for the game
Authors: Kosunen Sonja , Seppänen Piia
Published: October 2015

We examine parental choice in the context of lower secondary schools in urban Finland by means of qualitative content analysis of interviews conducted with upper-class parents ( n=33). The analysis concentrates on the social construction of selective school choice within a public education system. The families in question were willing and able to choose their selective classes in schools in which intake is based on aptitude tests. This practice was justified on meritocratic grounds and was therefore not considered a class practice in the parental discourse. We argue that the capacity of upper-class families to transform economic capital into embodied cultural capital becomes an asset in the competition over study positions. The process includes the transfer of trump cards acquired in the field of culture – such as via music or sports, with their acknowledged interconnectedness with social position – to the field of public comprehensive education, despite the fact that social background should not define the allocation of pupils to schools in Finland. The role of the transmission of capital in this process is misrecognised, despite the fact that the result is social exclusion.
Task Segregation as a Mechanism for Within-job Inequality
Authors: Chan Curtis K. , Anteby Michel
Published: October 2015

In this article, we examine a case of task segregation—when a group of workers is disproportionately allocated, relative to other groups, to spend more time on specific tasks in a given job—and argue that such segregation is a potential mechanism for generating within-job inequality in the quality of a job. When performing those tasks is undesirable, this allocation has unfavorable implications for that group’s experienced job quality. We articulate the processes by which task segregation can lead to workplace inequality in job quality through an inductive, interview-based case study of airport security-screening workers in a unit of the U.S. Transportation Security Administration (TSA) at a large urban airport. Female workers were disproportionately allocated to the pat-down task, the manual screening of travelers for prohibited items. Our findings suggest that this segregation led to overall poorer job quality outcomes for women. Task segregation overexposed female workers to processes of physical exertion, emotional labor, and relational strain, giving rise to work intensity, emotional exhaustion, and lack of coping resources. Task segregation also seemed to disproportionately expose female workers to managerial sanctions for taking recuperative time off and a narrowing of their skill set that may have contributed to worse promotion chances, pay, satisfaction, and turnover rates for women. We conclude with a theoretical model of how task segregation can act as a mechanism for generating within-job inequality in job quality.
Risk Factors for Dysplasia in Recurrent Respiratory Papillomatosis in an Adult and Pediatric Population
Authors: Karatayli-Ozgursoy Selmin , Bishop Justin Avery , Hillel Alexander , Akst Lee , Best Simon R.A.
Published: October 2015

Aim:

Recurrent respiratory papillomatosis (RRP) is classically described as a benign neoplasm of the larynx caused by the low-risk human papillomavirus (HPV) viral subtypes. Nevertheless, transformation to dysplasia and invasive carcinoma can occur. We aimed to assess the prevalence of dysplasia and carcinoma-ex-papilloma in both adult-onset and juvenile-onset RRP and identify patient risk factors for this dysplastic transformation.

Material and Methods:

Ten-year retrospective chart review of a tertiary otolaryngology referral center. Patients with papilloma were identified from a review of a pathology database and clinical records. Patient demographics, pathologic data, and treatment history, including use of cidofovir as an adjunctive therapy for papilloma, were extracted from electronic medical records.

Results:

One hundred fifty-nine RRP patients were identified, 96 adult-onset (AORRP) and 63 juvenile-onset (JORRP) cases. Of this cohort, 139 (87%) had only benign papilloma as a pathologic diagnosis. In the AORRP cohort, 10 patients (10%) were diagnosed with dysplasia or carcinoma in situ in addition to papilloma, and 5 patients (5%) had malignant transformation to invasive carcinoma-ex-papilloma. There was a significantly higher age of disease onset for those with dysplasia or carcinoma versus those without dysplasia or carcinoma (56 vs 45 years old; P = .0005). Of the 63 JORRP patients, there were no cases of dysplasia but 3 (5%) cases of invasive carcinoma-ex-papilloma, all involving pulmonary disease. The JORRP patients with carcinoma-ex-papilloma had a younger average disease onset (2 vs 6 years old; P = .009) and a higher rate of tracheal involvement than those without carcinoma. Gender, smoking history, number of operations, or use of cidofovir showed no association with the development of dysplasia or carcinoma-ex-papillomatosis in either the AORRP or JORRP population.

Conclusion:

In a large series of RRP, age of disease onset is the strongest predictor of dysplastic transformation in the adult and pediatric population. Carcinoma-ex-papillomatosis was uniformly associated with pulmonary disease in the JORRP population in this series. No other demographic or behavioral factors, including adjunctive therapy with cidofovir, were statistically associated with dysplasia or carcinoma-ex-papilloma.
A Single Primary Site Obstruction May Lead to Sleep-Disordered Breathing in Multiple Sites
Authors: Lee Myung-Chul , Rhee Chae-Seo , Joe Sam , Yoon In-Young , Kim Jeong-Whun
Published: October 2015

Objectives:

This study aimed to investigate the dynamic upper airway changes occurring in an obstructive sleep apnea (OSA) rabbit model using dynamic computerized tomography (CT).

Methods:

In this study, 2.5 U of botulinum toxin type A was injected into the genioglossus to paralyze the tongue in the OSA group (n = 7). The control group was injected with normal saline (n = 7). Apnea-hypopnea index was measured using ApneaLink at baseline and at 1, 2, 3, 4, 6, and 8 weeks post-injection. Anterior to posterior (AP) and transverse diameters at the levels of the palate and tongue base were measured using a dynamic CT at baseline and at 1 and 2 weeks post-injection.

Results:

The success rate of OSA induction was higher in the OSA group ( P = .02). In the OSA group, transverse and AP diameters at the palate level and AP diameter at the tongue base level significantly decreased 2 weeks post-injection ( P = .01).

Conclusions:

A single obstruction site may constitute the primary pathogenesis in some OSA patients, even when the involvement of multiple sites is indicated. These findings may contribute to the identification of OSA pathogenesis and improve the planning of treatment based on the primary cause of OSA.
Are the “Customers” of Business Ethics Courses Satisfied? An Examination of One Source of Business Ethics Education Legitimacy
Authors: Reynolds Scott J. , Dang Carolyn T.
Published: October 2015

Though there are many factors that contribute to the perceived legitimacy of business ethics education, this research focuses on one factor that is given great attention both formally and informally in many business schools: student satisfaction with the course. To understand the nature of student satisfaction, the authors draw from multiple theories with central claims relating (met) expectations with satisfaction. The authors then compare student expectations of business ethics courses with instructor objectives and discover that business ethics courses are not necessarily designed to meet student expectations. The authors speculate that this general mismatch between student expectations and instructor objectives has material consequences. As one example, the authors analyze student evaluations from three business schools and identify a “business ethics course effect”: a negative association between business ethics courses and student evaluations. The authors discuss the implications for business ethics education of a situation where pedagogical objectives (“Educate!”) and market prescriptions (“Satisfy!”) point in different directions.
The Changing Face of Psychology
Authors: Gregor Margo A. , O’Brien Karen M.
Published: October 2015

Given the increasing number of women entering the field of psychology, this study investigated the degree to which achievement motivation, leader identity, career salience, and willingness to compromise career for partner and children were predictive of leadership aspirations generally and in the American Psychological Association. Data from 202 female graduate students in counseling and clinical doctoral programs indicated that leader identity, career salience, and willingness to compromise career for children predicted overall leadership aspirations. Achievement motivation, leader identity, and career salience also predicted plans to pursue leadership positions in the American Psychological Association. Graduate students nearing the end of their doctoral programs were more willing to compromise career for children and prioritize their partner than women early in their program. The implications of these findings for research, training, and counseling are discussed.
The Psychological Well-Being of Early Identified Gifted Children
Authors: Kroesbergen Evelyn H. , van Hooijdonk Mare , Van Viersen Sietske , Middel-Lalleman Marieke M. N. , Reijnders Julièt J. W.
Published: October 2015

This study examined the psychological well-being of gifted primary school children. From a screening sample of 233 children in Grades 1 and 2 across five schools in the Netherlands, 35 children achieving high scores on two out of three selection criteria (teacher nomination, creativity, and nonverbal reasoning ability) and 34 typically developing children were selected to participate in the study. Combinations of grouping criteria were used to create different subsamples within the gifted sample. In general, the differences in well-being between the gifted and the comparison group were relatively small, although the gifted children experienced lower self-worth and social acceptance. In contrast, within the sample of gifted children, some differences were found between selected subgroups. Highly creative gifted children experienced lower feelings of well-being than less creative gifted children, while the reverse was true for children who were nominated by their teacher. Additionally, high-performing gifted children showed higher psychological well-being than underachievers.
Development of a human papillomavirus vaccination intervention for Australian adolescents
Authors: Cooper Spring C , Davies Cristyn , McBride Kate , Blades Joanna , Stoney Tanya , Marshall Helen , Skinner S Rachel
Published: October 2015

Objective:

Australia has implemented a nation-wide programme providing a human papillomavirus (HPV) vaccine to girls and boys through school-based programmes. Previous research has identified three distinct areas for attention: (1) lack of understanding about HPV and HPV vaccination, (2) young people’s desire for involvement in decision-making about HPV vaccination and (3) fear of HPV vaccination. We aimed to develop an intervention to address young people’s low levels of understanding, to promote their involvement in consent and reduce vaccination-related fear and anxiety.

Design, Setting, Methods:

Formative qualitative research was conducted in six public, private and Catholic schools in the Sydney metropolitan area. Girls who were offered the vaccine in a school programme and aged 12–13 years were interviewed in focus groups. Piloting of materials was conducted in three private schools across Sydney with both girls and boys, and changes and additions were made to the materials in accordance with feedback.

Results:

We developed an educational intervention aimed at addressing gaps in young people’s knowledge and understanding, and offering strategies to improve confidence with vaccination and reduce needle-related anxiety. Components of the final intervention include film chapters, a magazine, a website, an app and teacher support materials. The intervention is designed for teachers and/or nurses to deliver and is linked to the school-based HPV vaccination programme.

Conclusions:

This is the first educational intervention designed for young people in HPV school-based vaccination, to be developed from empirical data with the involvement of young people themselves.
The Impact of Family Structure, Relationships, and Support on African American Students’ Collegiate Experiences
Authors: Brooks Jada E.
Published: October 2015

This qualitative study examined the ways in which African American college students perceive family structure, relationships, and support as impacting their academic persistence and collegiate experiences. Participants included nine females and five males attending a Historically Black University. Participants described family structure and relationships in a variety of ways. Furthermore, some participants experienced a change in relationships with immediate family members while attending college. Family issues occurring at home, being a financial burden on family members, the importance of family support, and being a role model for other family members were also cited as influencing collegiate experiences. The study concluded that family structures, relationships, and support do indeed influence the collegiate experiences and academic outcomes of African American college students.
Evaluation of surface roughness and material removal rate in the wire electrical discharge machining of Al/B4C composites via the Taguchi method
Authors: Ekici Ergün , Motorcu Ali Riza , Kuş Abdil
Published: October 2015

This study researched the effects of machining parameters on surface roughness and material removal rate in the wire electrical discharge cutting of high-density Al/B4C metal matrix composites produced via the hot pressing method. Wire tension, reinforcement percentage, wire speed, pulse-on time and pulse-off time were set as the control factors. The Taguchi L18 (21 × 34) orthogonal array was used in the experiment design and determination of the optimum control factors. Variance analysis was applied to determine the effects of the control factors on the surface roughness and material removal rate. The results showed the most effective parameters to be pulse-on time (30.22%) for surface roughness and wire speed (83.20%) for material removal rate, and the optimum levels of the control factors to be A2B1C2D1E1 and A2B2C3D2E2, respectively. Predictive equations were then developed by applying linear regression analysis, and the adjusted correlation coefficients were calculated as 0.61 for surface roughness and 0.785 for material removal rate.
Aiming at Doves
Authors: Caverley Jonathan D. , Krupnikov Yanna
Published: October 2015

Politicians (and journalists covering them) assume that association with the military has political consequences. We propose and experimentally test conditions under which military images have such effects. We presented subjects with images of the US president before varying backgrounds—including soldiers, students, children, and “ordinary” people. Only the image of soldiers has any significant effect, shifting participant preferences toward spending money on defense over education. The image does this by increasing respondent sense of threats to national security, despite the military’s depiction out of combat and in the background. The soldiers image does little to shift opinion about the president. However, the image has the largest hawkish effect on both the president’s copartisans and the strongest supporters. Given the routine use by many democracies of tactics unlikely to produce images of one’s fellow citizens in combat, the power of more sanitized images to cue hawkish policy preferences requires increased attention.
An unusual case of impalement injury
Authors: Yadav Jayanthi , Badkur DS
Published: October 2015

Impalement injuries result when a hard elongated object penetrates the body cavity or any body part and remains in place. A rare and unusual case of impalement by a bamboo stick in the thoracic cavity through the oropharynx is described. Injury resulted when a man tried to pole-vault with a bamboo stick, which slipped and entered his mouth. Impalement injury through the natural orifice of the oropharynx is discussed, along with the mechanism of the trauma and subsequent death.
Racial Differences in Awareness of the Affordable Care Act and Application Assistance Among Low-Income Adults in Three Southern States
Authors: Garcia Mosqueira Adrian , Hua Lynn M. , Sommers Benjamin D.
Published: October 2015

The Affordable Care Act (ACA) expanded Medicaid eligibility to adults with incomes under 138% of the federal poverty level, leading to substantial reductions in uninsured rates among low-income adults. Despite large gains in coverage, studies suggest that Latinos may be less likely than other racial/ethnic groups to apply and enroll in health insurance, and they remain the group with the highest uninsured rate in the United States. We explore two potential factors related to racial/ethnic differences in ACA enrollment—awareness of the law and receipt of application assistance such as navigator services. Using a survey of nearly 3000 low-income U.S. citizens (aged 19-64) in 3 states in late 2014, we find that Latinos had significantly lower levels of awareness of the ACA relative to other groups, even after adjusting for demographic covariates. Higher education was the strongest positive predictor of ACA awareness. In contrast, Latinos were much more likely to receive assistance from navigators or social workers when applying, relative to other racial/ethnic groups. Taken together, these results highlight the importance of ACA outreach efforts to increase awareness among low-income and less educated populations, two groups that are overrepresented in the Latino population, to close existing disparities in coverage.
Using Twitter for Demographic and Social Science Research: Tools for Data Collection and Processing
Authors: McCormick Tyler H. , Lee Hedwig , Cesare Nina , Shojaie Ali , Spiro Emma S.
Published: October 2015

Despite recent and growing interest in using Twitter to examine human behavior and attitudes, there is still significant room for growth regarding the ability to leverage Twitter data for social science research. In particular, gleaning demographic information about Twitter users—a key component of much social science research—remains a challenge. This article develops an accurate and reliable data processing approach for social science researchers interested in using Twitter data to examine behaviors and attitudes, as well as the demographic characteristics of the populations expressing or engaging in them. Using information gathered from Twitter users who state an intention to not vote in the 2012 presidential election, we describe and evaluate a method for processing data to retrieve demographic information reported by users that is not encoded as text (e.g., details of images) and evaluate the reliability of these techniques. We end by assessing the challenges of this data collection strategy and discussing how large-scale social media data may benefit demographic researchers.
Testing the mediation of work–family balance in the relationship between work–family conflict and job and family satisfaction
Authors: Pattusamy Murugan , Jacob Jayanth
Published: October 2015

This article attempts to understand the effect of work–family conflict on work–family balance and in turn, on the satisfaction perceived by individuals in their job and family roles. Using an online questionnaire, we collected data from 218 participants who were members of teaching faculty in higher education institutions in the southern part of India. To test the mediating effect of work–family balance on job and family satisfaction in relation to work–family conflict, we used the structural equation modeling technique along with the Bollen–Stine bootstrap estimation method. The structural equation modeling results show that the relationship between work–family conflict and satisfaction (job and family) is partially mediated by work–family balance. The study shows that both job and family satisfaction can be enhanced by balancing job and family roles. The implication and scope for further research are discussed.
Rousseau and Republicanism
Authors: de Dijn Annelien
Published: October 2015

Rousseau was arguably one of the most important and influential of eighteenth-century republican thinkers. However, contemporary republican theorists, most notably Philip Pettit, have written him out of the republican canon by describing Rousseau as a “populist” rather than a republican. I argue that this miscasting of Rousseau is not just historically incorrect but that it has also led to a weakening of contemporary republican political theory. Rousseau was one of the few early modern republican thinkers to take seriously the problem of the tyranny of the majority and to attempt to formulate a cogent answer to that problem. Ignoring his contribution to republican political thought therefore cuts off contemporary republicans from an important resource for thinking about this problem.
Does Core Task Matter for Decision-Making? A Comparative Case Study on Whether Differences in Job Characteristics Affect Discretionary Street-Level Decision-Making
Authors: Jensen Didde Cramer
Published: October 2015

This article sets out to test the hypothesis that differences in fundamental job characteristics (service vs. regulation) affect discretionary street-level decision-making. The hypothesis was tested by examining whether systematic variation could be found in the moral assessments on which street-level bureaucrats performing different types of core tasks base their decisions. The issue was addressed in a comparative case study comprising three institutions, which differ systematically as far as variables of tasks are concerned. Findings showed that differences in core tasks do affect discretionary decision-making, as divergent moral assessments determine and justify decision-making across different core tasks.
Dipeptidyl Peptidase-4 Inhibitors in Diverse Patient Populations With Type 2 Diabetes
Authors: Hinnen Deborah
Published: October 2015

Purpose

The purpose of this review is to discuss the clinical evidence for dipeptidyl peptidase-4 (DPP-4) inhibitors and to better define their use in treating type 2 diabetes mellitus (T2DM), including in special populations, such as the elderly. DPP-4 inhibitors are incretin-based therapies that can be used as monotherapy or in combination with other antidiabetes medications to treat T2DM. As monotherapy, DPP-4 inhibitors have demonstrated a modest and comparable glycated hemoglobin-lowering effect. As initial dual therapy with other antidiabetes agents, DPP-4 inhibitors significantly improved glycated hemoglobin when compared with monotherapy arms. Similarly, in triple combinations, DPP-4 inhibitors consistently provided additive glycemic benefits. In patients who were continuing insulin, glycemic parameters were improved with the addition of a DPP-4 inhibitor, and they required less insulin uptitration. In clinical trials, the overall occurrence of adverse events was similar between DPP-4 inhibitor groups and controls, and a low occurrence of hypoglycemia was observed, except when used in combination with a sulfonylurea. A neutral effect on weight was maintained, even in combination with insulin. Similar to outcomes observed in younger patients, DPP-4 inhibitors significantly improved glycemic efficacy in older patients, without increasing the risk for hypoglycemia. Efficacy and safety in patients with renal insufficiency are also documented.

Conclusion

DPP-4 inhibitors are therapeutically beneficial for a diverse population of patients with T2DM, including elderly patients, based on demonstrated efficacy, tolerability, and a low risk for hypoglycemia.