bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual Aids for Multimodal Treatment Options to Support Decision Making of Patients with Colorectal Cancer
Authors: Hofmann Sabine , Vetter Janina , Wachter Christiane , Henne-Bruns Doris , Porzsolt Franz , Kornmann Marko
Published: October 2012

Background

A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer.

Methods

We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265) and to patients with colorectal cancer (n = 102).

Results

Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88% – 100%). Patients (79%) chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%). No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant) but without survival benefit.

Conclusions

Healthy persons’ and patients’ decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.
Correlation analyses of clinical and molecular findings identify candidate biological pathways in systemic juvenile idiopathic arthritis
Authors: Ling Xuefeng B , Macaubas Claudia , Alexander Heather C , Wen Qiaojun , Chen Edward , Peng Sihua , Sun Yue , Deshpande Chetan , Pan Kuang-Hung , Lin Richard , Lih Chih-Jian , Chang Sheng-Yung P , Lee Tzielan , Sandborg Christy , Begovich Ann B , Cohen Stanley N , Mellins Elizabeth D
Published: October 2012

Background

Clinicians have long appreciated the distinct phenotype of systemic juvenile idiopathic arthritis (SJIA) compared to polyarticular juvenile idiopathic arthritis (POLY). We hypothesized that gene expression profiles of peripheral blood mononuclear cells (PBMC) from children with each disease would reveal distinct biological pathways when analyzed for significant associations with elevations in two markers of JIA activity, erythrocyte sedimentation rate (ESR) and number of affected joints (joint count, JC).

Methods

PBMC RNA from SJIA and POLY patients was profiled by kinetic PCR to analyze expression of 181 genes, selected for relevance to immune response pathways. Pearson correlation and Student'st-test analyses were performed to identify transcripts significantly associated with clinical parameters (ESR and JC) in SJIA or POLY samples. These transcripts were used to find related biological pathways.

Results

Combining Pearson andt-test analyses, we found 91 ESR-related and 92 JC-related genes in SJIA. For POLY, 20 ESR-related and 0 JC-related genes were found. Using Ingenuity Systems Pathways Analysis, we identified SJIA ESR-related and JC-related pathways. The two sets of pathways are strongly correlated. In contrast, there is a weaker correlation between SJIA and POLY ESR-related pathways. Notably, distinct biological processes were found to correlate with JC in samples from the earlier systemic plus arthritic phase (SAF) of SJIA compared to samples from the later arthritis-predominant phase (AF). Within the SJIA SAF group, IL-10 expression was related to JC, whereas lack of IL-4 appeared to characterize the chronic arthritis (AF) subgroup.

Conclusions

The strong correlation between pathways implicated in elevations of both ESR and JC in SJIA argues that the systemic and arthritic components of the disease are related mechanistically. Inflammatory pathways in SJIA are distinct from those in POLY course JIA, consistent with differences in clinically appreciated target organs. The limited number of ESR-related SJIA genes that also are associated with elevations of ESR in POLY implies that the SJIA associations are specific for SJIA, at least to some degree. The distinct pathways associated with arthritis in early and late SJIA raise the possibility that different immunobiology underlies arthritis over the course of SJIA.
Anti-inflammatory and neuroprotective effects of an orally active apocynin derivative in pre-clinical models of Parkinson’s disease
Authors: Ghosh Anamitra , Kanthasamy Arthi , Joseph Joy , Anantharam Vellareddy , Srivastava Pallavi , Dranka Brian P , Kalyanaraman Balaraman , Kanthasamy Anumantha G
Published: October 2012

Background

Parkinson’s disease (PD) is a devastating neurodegenerative disorder characterized by progressive motor debilitation, which affects several million people worldwide. Recent evidence suggests that glial cell activation and its inflammatory response may contribute to the progressive degeneration of dopaminergic neurons in PD. Currently, there are no neuroprotective agents available that can effectively slow the disease progression. Herein, we evaluated the anti-inflammatory and antioxidant efficacy of diapocynin, an oxidative metabolite of the naturally occurring agent apocynin, in a pre-clinical 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD.

Methods

Both pre-treatment and post-treatment of diapocynin were tested in the MPTP mouse model of PD. Diapocynin was administered via oral gavage to MPTP-treated mice. Following the treatment, behavioral, neurochemical and immunohistological studies were performed. Neuroinflammatory markers, such as ionized calcium binding adaptor molecule 1 (Iba-1), glial fibrillary acidic protein (GFAP), gp91phox and inducible nitric oxide synthase (iNOS), were measured in the nigrostriatal system. Nigral tyrosine hydroxylase (TH)-positive neurons as well as oxidative markers 3-nitrotyrosine (3-NT), 4-hydroxynonenal (4-HNE) and striatal dopamine levels were quantified for assessment of the neuroprotective efficacy of diapocynin.

Results

Oral administration of diapocynin significantly attenuated MPTP-induced microglial and astroglial cell activation in the substantia nigra (SN). MPTP-induced expression of gp91phox and iNOS activation in the glial cells of SN was also completely blocked by diapocynin. Notably, diapocynin markedly inhibited MPTP-induced oxidative markers including 3-NT and 4-HNE levels in the SN. Treatment with diapocynin also significantly improved locomotor activity, restored dopamine and its metabolites, and protected dopaminergic neurons and their nerve terminals in this pre-clinical model of PD. Importantly, diapocynin administered 3 days after initiation of the disease restored the neurochemical deficits. Diapocynin also halted the disease progression in a chronic mouse model of PD.

Conclusions

Collectively, these results demonstrate that diapocynin exhibits profound neuroprotective effects in a pre-clinical animal model of PD by attenuating oxidative damage and neuroinflammatory responses. These findings may have important translational implications for treating PD patients.
Prognostic value of X-chromosome inactivation in symptomatic female carriers of dystrophinopathy
Authors: Juan-Mateu Jonàs , Rodríguez Maria José , Nascimento Andrés , Jiménez-Mallebrera Cecilia , González-Quereda Lidia , Rivas Eloy , Paradas Carmen , Madruga Marcos , Sánchez-Ayaso Pedro , Jou Cristina , González-Mera Laura , Munell Francina , Roig-Quilis Manuel , Rabasa Maria , Hernández-Lain Aurelio , Díaz-Manera Jorge , Gallardo Eduard , Pascual Jordi , Verdura Edgard , Colomer Jaume , Baiget Montserrat , Olivé Montse , Gallano Pia
Published: October 2012

Background

Between 8% and 22% of female carriers of DMD mutations exhibit clinical symptoms of variable severity. Development of symptoms in DMD mutation carriers without chromosomal rearrangements has been attributed to skewed X-chromosome inactivation (XCI) favouring predominant expression of the DMD mutant allele. However the prognostic use of XCI analysis is controversial. We aimed to evaluate the correlation between X-chromosome inactivation and development of clinical symptoms in a series of symptomatic female carriers of dystrophinopathy.

Methods

We reviewed the clinical, pathological and genetic features of twenty-four symptomatic carriers covering a wide spectrum of clinical phenotypes. DMD gene analysis was performed using MLPA and whole gene sequencing in blood DNA and muscle cDNA. Blood and muscle DNA was used for X-chromosome inactivation (XCI) analysis thought the AR methylation assay in symptomatic carriers and their female relatives, asymptomatic carriers as well as non-carrier females.

Results

Symptomatic carriers exhibited 49.2% more skewed XCI profiles than asymptomatic carriers. The extent of XCI skewing in blood tended to increase in line with the severity of muscle symptoms. Skewed XCI patterns were found in at least one first-degree female relative in 78.6% of symptomatic carrier families. No mutations altering XCI in the XIST gene promoter were found.

Conclusions

Skewed XCI is in many cases familial inherited. The extent of XCI skewing is related to phenotype severity. However, the assessment of XCI by means of the AR methylation assay has a poor prognostic value, probably because the methylation status of the AR gene in muscle may not reflect in all cases the methylation status of the DMD gene.
Differential impact of body mass index and its change on the risk of breast cancer by molecular subtype: A case-control study in Japanese women
Authors: Sueta Aiko , Ito Hidemi , Islam Tania , Hosono Satoyo , Watanabe Miki , Hirose Kaoru , Fujita Takashi , Yatabe Yasushi , Iwata Hiroji , Tajima Kazuo , Tanaka Hideo , Iwase Hirotaka , Matsuo Keitaro
Published: October 2012

Body mass index (BMI) is an independent risk factor for luminal-type breast cancer in Western populations. However, it is unclear whether the impact of BMI differs according to breast cancer subtype in Japanese populations. We conducted a case–control study with 715 cases and 1430 age- and menopausal status-matched controls to evaluate the associations of BMI and its change (from age 20 years to the current age) with breast cancer risk. We applied conditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tumor subtypes were divided into four subtypes, namely the luminal, luminal/HER2, HER2-rich, and triple-negative subtypes. Current BMI and BMI change were positively associated with postmenopausal breast cancer risk. On stratified analysis by tumor subtype, we observed associations between current BMI and BMI change and postmenopausal breast cancer risk for the luminal subtype, with OR for each 1 kg/m2 increase in current BMI of 1.14 (95% CI: 1.07 - 1.20) and the corresponding OR of BMI change of 1.16 (1.09 - 1.23) (each P
trend
< 0.001). Additionally, we found the same tendency for the triple-negative subtype, with the OR for a 1 kg/m2 increase in current BMI of 1.21 (1.05 - 1.39) and that for BMI change of 1.18 (1.02 - 1.36) (P
trend
was 0.008 and 0.024, respectively). In premenopausal women, a suggestive inverse association was observed between BMI change and breast cancer risk for the luminal subtype only, with OR of BMI change of 0.93 (0.87 - 1.00, P
trend = 0.054). No association was seen between BMI at age 20 years and risk of any tumor subtype. In conclusion, BMI and its change are associated with the risk of both luminal and triple-negative breast cancer among postmenopausal Japanese women. These findings suggest the etiological heterogeneity of breast cancer among tumor subtypes.
Ca2+ activation of cytosolic calpain induces the transition from apoptosis to necrosis in neutrophils with externalized phosphatidylserine
Authors: Francis R J , Kotecha S , Hallett M B
Published: October 2012

Imaging individual aged neutrophils reveals elevated cytosolic Ca2+ in cells with externalized PS, which are vulnerable to necrosis by subsequent elevations of Ca2+.

Physiologically, apoptotic neutrophils are ingested before they undergo necrosis. However, failure of ingestion will lead to necrosis of neutrophils and the unregulated release of neutrophil-derived pathogenic molecules, such as protease and hydrolases. Understanding the mechanism of postapoptotic necrosis is thus clearly important. Here, we monitored the apoptotic-to-necrotic transition in individual-aged human neutrophils in vitro by imaging fluorescent probes for externalized PS, cytosolic Ca2+, and membrane integrity. This showed that prenecrotic-aged neutrophils with externalized PS had a significantly elevated cytosolic-free Ca2+ level. A further unregulated Ca2+ influx into PS-externalized neutrophils always preceded the necrotic transition. Ca2+ elevation was not simply a consequence of aging, as PS externalization was not uniform in similarly aged neutrophil populations. PS-externalized neutrophils could be induced to undergo necrosis experimentally by simply elevating cytosolic Ca2+ further with ionomycin. This effect was observed only in neutrophils that had externalized PS, and was independent of the time after their isolation from blood (i.e., in vitro age). As pharmacological inhibition of calpain-1 inhibition significantly reduced this CAIN, it was concluded that the apoptotic-to-necrotic transition was a consequence of uncontrolled calpain activation that resulted from Ca2+ overload in PS-externalized neutrophils.
Research Participants' High Expectations of Benefit in Early-Phase Oncology Trials: Are We Asking the Right Question?
Authors: Weinfurt Kevin P. , Seils Damon M. , Lin Li , Sulmasy Daniel P. , Astrow Alan B. , Hurwitz Herbert I. , Cohen Roger B. , Meropol Neal J.
Published: October 2012

Purpose

To determine whether patients' expectations of benefit in early-phase oncology trials depend on how patients are queried and to explore whether expectations are associated with patient characteristics.

Patients and Methods

Participants were 171 patients in phase I or II oncology trials in the United States. After providing informed consent for a trial but before receiving the investigational therapy, participants answered questions about expectations of benefit. We randomly assigned participants to one of three groups corresponding to three queries about expectations: frequency type, belief type, or both. Main outcomes were differences in expectations by question type and the extent to which expectations were associated with demographic characteristics, numeracy, dispositional optimism, religiousness/spirituality, understanding of research, and other measures.

Results

The belief-type group had a higher mean expectation of benefit (64.4 of 100) than the combination group (51.6; P = .01) and the frequency-type group (43.1; P < .001). Mean expectations in the combination and frequency groups were not significantly different (P = .06). Belief-type expectations were associated with a preference for nonquantitative information (r = −0.19; 95% CI, −0.19 to −0.36), knowledge about research (r = −0.21; 95% CI, −0.38 to −0.03), dispositional optimism (r = 0.20; 95% CI, 0.01 to 0.37), and spirituality (r = 0.22; 95% CI, 0.03 to 0.38). Frequency-type expectations were associated with knowledge about clinical research (r = −0.27; 95% CI, −0.27 to −0.51).

Conclusion

In early-phase oncology trials, patients' reported expectations of benefit differed according to how patients were queried and were associated with patient characteristics. These findings have implications for how informed consent is obtained and assessed.
In vitro organogenesis in three dimensions: self-organising stem cells
Authors: Sasai Yoshiki , Eiraku Mototsugu , Suga Hidetaka
Published: October 2012

Organ formation during embryogenesis is a complex process that involves various local cell-cell interactions at the molecular and mechanical levels. Despite this complexity, organogenesis can be modelled in vitro. In this article, we focus on two recent examples in which embryonic stem cells can self-organise into three-dimensional structures – the optic cup and the pituitary epithelium; and one case of self-organising adult stem cells – the gut epithelium. We summarise how these approaches have revealed intrinsic programs that drive locally autonomous modes of organogenesis and homeostasis. We also attempt to interpret the results of previous in vivo studies of retinal development in light of the self-organising nature of the retina.
Cytoplasmic Ca2+ changes dynamically during the interaction of the pollen tube with synergid cells
Authors: Iwano Megumi , Ngo Quy A. , Entani Tetsuyuki , Shiba Hiroshi , Nagai Takeharu , Miyawaki Atsushi , Isogai Akira , Grossniklaus Ueli , Takayama Seiji
Published: October 2012

The directional growth of the pollen tube from the stigma to the embryo sac in the ovules is regulated by pollen-pistil interactions based on intercellular communication. Although pollen tube growth is regulated by the cytoplasmic Ca2+ concentration ([Ca2+]cyt), it is not known whether [Ca2+]cyt is involved in pollen tube guidance and reception. Using Arabidopsis expressing the GFP-based Ca2+-sensor yellow cameleon 3.60 (YC3.60) in pollen tubes and synergid cells, we monitored Ca2+ dynamics in these cells during pollen tube guidance and reception under semi-in vivo fertilization conditions. In the pollen tube growing towards the micropyle, pollen tubes initiated turning within 150 μm of the micropylar opening; the [Ca2+]cyt in these pollen tube tips was higher than in those not growing towards an ovule in assays with myb98 mutant ovules, in which pollen tube guidance is disrupted. These results suggest that attractants secreted from the ovules affect Ca2+ dynamics in the pollen tube. [Ca2+]cyt in synergid cells did not change when the pollen tube grew towards the micropyle or entered the ovule. Upon pollen tube arrival at the synergid cell, however, [Ca2+]cyt oscillation began at the micropylar pole of the synergid, spreading towards the chalazal pole. Finally, [Ca2+]cyt in the synergid cell reached a maximum at pollen tube rupture. These results suggest that signals from the pollen tube induce Ca2+ oscillations in synergid cells, and that this Ca2+ oscillation is involved in the interaction between the pollen tube and synergid cell.
The zebrafish issue ofDevelopment
Authors: Nüsslein-Volhard Christiane
Published: October 2012

In December 1996, a special issue of Development appeared that presented in 37 papers the results of two large screens for zebrafish mutants performed in Tübingen and Boston. The papers describe about 1500 mutations in more than 400 new genes involved in a wide range of processes that govern development and organogenesis. Up to this day, the mutants provide a rich resource for many laboratories, and the issue significantly augmented the importance of zebrafish as vertebrate model organism for the study of embryogenesis, neuronal networks, regeneration and disease. This essay relates a personal account of the history of this unique endeavor.
Arterial spin labeling in patients with chronic cerebral artery steno-occlusive disease: Correlation with 15O-PET
Authors: Kamano Hironori , Yoshiura Takashi , Hiwatashi Akio , Abe Koichiro , Togao Osamu , Yamashita Koji , Honda Hiroshi
Published: October 2012

Background

Heterogeneity of arterial transit time due to cerebral artery steno-occlusive lesions hampers accurate regional cerebral blood flow measurement by arterial spin labeling (ASL).

Purpose

To assess the feasibility of regional cerebral blood flow measurement by ASL with multiple-delay time sampling in patients with steno-occlusive diseases by comparing with positron emission tomography (PET), and to determine whether regional arterial transit time measured by this ASL technique is correlated with regional mean transit time, a PET index of perfusion pressure.

Material and Methods

Sixteen patients with steno-occlusive diseases received both ASL and 15O-PET. The mean regional cerebral blood flow measured by ASL and PET, regional arterial transit time by ASL, and regional mean transit time by PET were obtained by a region-of-interest analysis. Correlation between regional cerebral blood flow by ASL and that by PET, and correlation between regional arterial transit time by ASL and regional mean transit time by PET were tested using Pearson's correlation coefficient for both absolute and relative values. A multivariate regression analysis was performed to test whether regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling the effect of regional cerebral blood flow by ASL.

Results

A significant positive correlation was found between regional cerebral blood flow by ASL and that by PET for both absolute (r = 0.520, P < 0.0001) and relative (r = 0.691, P < 0.0001) values. A significant positive correlation was found between regional arterial transit time by ASL and regional mean transit time by PET both for absolute (r = 0.369, P = 0.0002) and relative (r = 0.443, P < 0.0001) values. The regression analysis revealed that regional arterial transit time by ASL was a significant contributor in modeling regional mean transit time by PET after controlling regional cerebral blood flow by ASL (P = 0.0011).

Conclusion

The feasibility of regional cerebral blood flow measurement using ASL with multiple-delay time sampling was confirmed in patients with cerebral artery steno-occlusive diseases. Moreover, it was suggested that mapping of regional arterial transit time has the potential to detect hemodynamic impairment.
CT differentiation of abscess and non-infected fluid in the postoperative neck
Authors: Yoon Soo Jeong , Yoon Dae Young , Kim Sam Soo , Rho Young-Soo , Chung Eun-Jae , Eom Joong Sik , Lee Jin Seo
Published: October 2012

Background

Differentiation of postoperative neck abscess from non-infected fluid is important because the treatment is different.

Purpose

To determine specific CT findings that might help to differentiate abscesses from non-infected fluid collections in the postoperative neck.

Material and Methods

We retrospectively reviewed CT scans of 50 patients (43 men and 7 women; mean age, 62.5±8.9 years) who had postoperative fluid collections in the neck (26 abscesses and 24 non-infected fluid collections). Diagnosis of an abscess was determined by a positive bacteria culture from the fluid collection. Diagnoses were correlated with the following CT findings: anatomic spaces involved, the maximum transverse diameter, margin, attenuation, rim enhancement, gas bubbles, and manifestations of soft tissue adjacent to a fluid collection.

Results

Rim enhancement pattern and soft tissue manifestations showed significant differences between abscess and non-infected fluid. The reliable CT findings for abscess were: (i) rim enhancement,> 50% of the circumference, 54% sensitive, 71% specific, and 62% accurate; and (ii) severe soft tissue manifestations, 39% sensitive, 92% specific, and 64% accurate. There were no significant differences in the anatomic spaces involved, the maximum transverse diameter, margin, attenuation, and gas bubbles between abscess and non-infected fluid.

Conclusion

CT findings that may help differentiate postoperative neck abscess from non-infected fluid were rim enhancement > 50% of the circumference and severe soft tissue manifestations.
Evaluating the evidence: direct-to-consumer screening tests advertised online
Authors: Lovett Kimberly M , Mackey Timothy K , Liang Bryan A
Published: October 2012

Objectives

Unsupervised online direct-to-consumer (DTC) access to medical services has rapidly expanded to medical screening tests, which have not been critically evaluated for their evidence basis. The objective of this study is to identify the scope of online-advertised DTC screening tests, outline the evidence for use of available DTC testing and suggest regulatory reform to address the relevant issues.

Methods

An observational study of website advertisements, testing services and counselling/follow-up services for DTC testing was conducted. Data were collected from websites between 4 April and 1 June 2011. Each website was assessed for tests offered, advertised indications and availability of counselling/follow-up services. Advertised testing indications were compared with US Preventive Services Task Force recommendations and/or specialty guidelines and categorized as Supported, Against, Insufficient Evidence or No Guidance.

Results

Of 20 companies identified as offering DTC screening tests, 95% (19/20) do not clearly offer pretest counselling, post-test counselling and/or test follow-up. One hundred and twenty-seven different tests were identified. Only 19/127 (15%) could be Supported for screening in a target group selected for testing; 38/127 (30%) were given recommendations to avoid use in specific target group(s) selected for testing (‘ Against recommendations’); 29/127 (23%) had Insufficient Evidence of value, and for 64/127 (50%) No Guidance could be given. Only 4/127 (3%) tests were Supported for general screening use.

Conclusions

Virtually all identified medical tests advertised and offered DTC are not recommended for use in screening by evidence-based guidelines. Limited oversight may lead to inaccurate self-diagnosis, treatment and wasted health resources.
Three peaks in the polymerase chain reaction fragile X analysis
Authors: Sharony Reuven , Shtorch Atalia , Amiel Aliza , Guetta Esther , Peleg Leah , Pras Elon , Ries-Levavi Liat
Published: October 2012

Objective

To report and discuss the observation of three fragments on polymerase chain reaction (PCR) in routine carrier screening for fragile X.

Methods

From 2005 through 2010, 34,500 women underwent prenatal screening for fragile X. PCR was carried out to amplify the repeat segment. The resulting fragments were scanned by a genetic analyser.

Results

Three PCR peaks representing three different-sized fragments were found in 25 of the 34,500 women (1:1380 or 0.072%). Karyotype analysis was performed in 16 subjects. Full triple X was found in three women, while two had triple X mosaicism. Of the 16 karyotyped women, five (31%) had a finding of XXX (full or mosaic).

Conclusions

Triple X (full or mosaic) is the most frequently encountered mechanism responsible for three peaks on fragile X PCR testing.
Dramatic increase in cervical cancer registrations in young women in 2009 in England unlikely to be due to the new policy not to screen women aged 20–24
Authors: Sasieni Peter , Castanon Alejandra
Published: October 2012

Objective

To explore whether the 17% increase in cervical cancer in England in 2009 was due to the change in cervical screening policy.

Methods

Trends in incidence of cervical cancer and of cervical intraepithelial neoplasia grade 3 (CIN3) were analysed for England, Wales and Scotland. Invasive cervical cancer data on 4079 cancers in women aged 20–39 diagnosed between April 2007 and August 2011 in England were analysed by single year of age.

Results

In England there was a 38% (95% confidence intervals [CI] 18–62%) increase in cervical cancer incidence rates in women aged 25–29 in 2009 relative to 2008, and a 30% (11–51%) increase in women aged 35–39. Compared rates in 2010 are similar to those in 2008. The average increase between 2000 and 2010 in women aged 25–29 was no greater in England than in Scotland and Wales (relative risk 0.98, 95% CI 0.69–1.39). In England there has been a gradual increase in CIN3 (particularly for ages 25–29) since 2003, with a more dramatic increase in 2009, but a fall in 2010. Audit data showed an increase in cancers diagnosed at age 25 in 2009/2010 and 2010/2011 ( P ≤ 0.0004). No increase was observed at age 26. For ages 27–29 an increase in cancer was observed for 2008/2009–2009/2010 when compared with 2007/2008–2010/2011 ( P < 0.00001), but linear trends were not significant.

Conclusions

The increase in cervical cancer in England in 2009 cannot be attributed to the lack of screening of women aged 20–24, or to a general decrease in the coverage or quality of cervical screening.
Eosinophilic Gastroenteritis: Two Case Reports
Authors: Chiu Keith , Hauff Corinna
Published: October 2012

Eosinophilic gastroenteritis (EG) is an uncommon and complex disease that affects the gastrointestinal tract. Patients have non-specific symptoms and the disease runs a varied course. We reported two cases of EG. One patient presented acutely, was treated and remained in remission while the other patient had a prolonged relapsing–remitting course. Diagnoses were made after a combination of imaging, histology and biochemical tests. Findings in ultrasound are correlated with computed tomography and histopathology.
Canada's Voluntary Sector Initiative and Sub-National Voluntary Sector-Government Relations: A Third Wave
Authors: Elson Peter R.
Published: October 2012

Following a dismal and antagonistic relationship that coincided with three years of deep and sustained cuts to the voluntary sector in the mid 1990s, voluntary sector-federal government relations in Canada finally began to thaw. A number of high level joint meetings between the federal government and voluntary sector leaders in 1999 led to the announcement in June, 2000 of a joint initiative to “renew and strengthen their long-standing relationship”. This five-year $94.6 million investment entitled the Voluntary Sector Initiative (VSI) included the signing of a Voluntary Sector Accord; personnel exchange programs; policy engagement projects; two major national surveys; a national volunteerism initiative; and numerous capacity building projects.The VSI program ended in 2005 with a change in the governing Liberal party leadership and the subsequent election of a minority Conservative government. Drawing on John Kingdon’s multiple streams framework, this article takes a broad analysis of problems, policies, and political processes across multiple provinces to examine if the VSI may have influenced a third wave of sub-national level policy initiatives. While contextual differences at a provincial level clearly influence the status, structure, and scope of sub-national voluntary sector-government relations, it appears the VSI did contribute in a number of ways to these sub-national initiatives.
Simple groups generated by involutions interchanging residue classes modulo lattices in ℤd
Authors: Kohl Stefan
Published: October 2012

We present a series of countable simple groups generated by involutions interchanging disjoint residue classes modulo lattices in ℤ
Ein »Parlamentsheer« ohne »preußische Erbstücke«? Die zivil-militärischen Konflikte um die Führungsorganisation der Kaiserlichen Schutztruppen
Authors: Bührer Tanja
Published: October 2012

Die Kaiserlichen Schutztruppen waren im Unterschied zur Preußischen Armee und zur Marine der Kaiserlichen Kommandogewalt weitgehend entzogen. Dieser Bruch mit der konservativen Militärpolitik wurde dadurch ermöglicht, dass die politischen und militärischen Eliten in der Gründungsphase der Schutzgebiete und -truppen den absoluten Primat auf die kontinentale Sicherheit legten und ein ernsthaftes Engagement der etablierten Streitkräfte an der Peripherie entschieden ablehnten. Den Führungsspitzen der Armee und der Marine missfiel es aber grundsätzlich, dass die leitenden Stellen der zivilen Kolonialbehörden militärische Kernkompetenzen ausübten. Durch die ganze Institutionsgeschichte der Schutztruppe hindurch sollten sie daher in einem Konflikt mit den Kolonialbehörden über die konstitutionelle Stellung dieser militärischen Formation stehen. Zwar blieb die zivile Kontrolle über das Militär in den Kolonien auf dem Papier erhalten, sie konnte in ausgeprägten Bedrohungslagen dem Druck der Militärs jedoch nicht standhalten. So ignorierte der Kommandeur der ostafrikanischen Schutztruppe, von Lettow-Vorbeck, alle verfassungsrechtlichen Hindernisse und übernahm die militärische Macht im Schutzgebiet. Obwohl es sich dabei letztlich um einen Militärputsch handelt, war Lettow-Vorbecks Handlungsweise zutiefst in der preußischen Militärtradition verankert und machte es möglich, dass der Kommandeur zum Kriegshelden wurde.
»Hilf Dir selbst ...« Selbsthilfe-Initiativen von ehemaligen Kriegsgefangenen im Siedlungsbau der Bundesrepublik in den 1950er und 60er Jahren
Authors: Schwelling Birgit
Published: October 2012

Der Beitrag untersucht Selbsthilfe-Initiativen von ehemaligen Kriegsgefangenen im Siedlungsbau der Bundesrepublik der 1950er und 60er Jahre aus erfahrungs- und erinnerungsgeschichtlicher Perspektive. Diese Initiativen von Heimkehrern innerhalb des Verbandes der Heimkehrer, Kriegsgefangenen und Vermißtenangehörigen Deutschlands e.V. (VdH) können einerseits als Reaktionen auf die verheerende Wohnungsnot in der frühen Bundesrepublik verstanden werden. Andererseits boten sie jedoch auch einen Raum für die Verarbeitung der Erfahrung der Kriegsgefangenschaft, und dies auf vielfältige Weise. Denn nicht nur die eigenen Erfahrungen in den Kriegsgefangenenlagern wurden im Rahmen dieser Bauaktivitäten bearbeitet, sondern es wurden im Rekurs auf die Zwischenkriegszeit auch Erinnerungen an ein anderes Kriegsende und andere Veteranen (re-)aktiviert. Insofern bietet der Beitrag nicht nur einen Einblick in bisher von der Forschung nicht thematisierte Aktivitäten von Veteranen, sondern ermöglicht auch die Entwicklung einer theoretischen Perspektive, die sich als eine erweiterte Erfahrungs- und Erinnerungsgeschichte des Krieges verstehen lässt.
“Tlatelolco me bautizó”: Literary Renewal and the Neoliberal Transition
Authors: Steinberg Samuel
Published: October 2012

This essay takes as its starting point the relative lack of a contender to the “novel of ′68” in Mexico. I argue that Jorge Volpi's 2003 El fin de la locura constitutes the final writing of such a novel, to appear some 35 years after the original events of that year. The double “renewal” pursued by this work is explored both as an intended restoration of the literary to a place of social privilege after a period of decline, and also as a conservative restoration of order following the revolutionary sequences of the 20th century. However, I argue, the novel cannot finally commit to artistic renewal without also confirming the “madness” of the century; the literary renewal pursued in Volpi's text thus becomes the very political renewal that the author seeks to avoid.
Social Class and Voter Preference in Recent Mexican Elections
Authors: Gilbert Dennis
Published: October 2012

The influence of social class on the decisions of Mexican voters is, according to recent literature, modest and irrelevant. In this paper I reassess the role of class in the presidential elections of 2000 and 2006. After discussing how social class should be conceptualized and measured in election surveys, I analyze exit poll data from these two elections. The results show that class is a potent force in Mexican elections and that the middle class, in particular, has played a critical role in the transformation of Mexican politics.
Siglec-6 is expressed in gestational trophoblastic disease and affects proliferation, apoptosis and invasion
Authors: Rumer Kristen K , Post Miriam D , Larivee Rhea S , Zink Martina , Uyenishi Jill , Kramer Anita , Teoh Deanna , Bogart Kevin , Winn Virginia D
Published: October 2012

Sialic acid immunoglobulin-like lectin (Siglec)-6 is a transmembrane receptor that binds leptin. Leptin is an obesity-associated peptide hormone overexpressed in gestational trophoblastic disease (GTD). GTD encompasses several placental abnormalities that range from benign to malignant. Among GTD, molar placentas are characterized by excess proliferation, whereas gestational trophoblastic neoplasias (GTN) have characteristically aggressive invasion. We hypothesized that in GTD, Siglec-6 expression would increase with disease severity and that Siglec-6 and leptin would promote proliferation, inhibit apoptosis and/or promote invasion. Siglec-6 expression patterns were evaluated with particular attention to the diagnostic utility of Siglec-6 in GTD (controls: normal placentas (n=32), hydropic abortus placentas (n=7), non-GTD reproductive tract cancers (n=2); GTD: partial moles (PM; n=11), complete moles (n=24), GTN (n=6)). In normal placentas, Siglec-6 expression dramatically decreased after 8 weeks gestation. Complete molar placentas had significantly higher Siglec-6 expression than controls, but expression was not significantly different from PM. In GTN, Siglec-6 expression was low. These data suggest that Siglec-6 may have diagnostic utility for distinguishing complete moles from normal and hydropic abortus placentas. Functional studies in choriocarcinoma-derived BeWO cells demonstrated a complex interplay between Siglec-6 expression and leptin exposure. In cells lacking Siglec-6, leptin treatment promoted invasion, likely through interaction with LepR leptin receptor, without affecting proliferation or apoptosis. Siglec-6 expression promoted proliferation in a leptin-dependent manner, but protected cells from apoptosis and promoted invasion in a leptin-independent manner. We propose that Siglec-6 and leptin play a role in the aberrant properties characteristic of GTD, namely excess proliferation and invasion.
Bone mineral density in children and young adults with neurofibromatosis type 1
Authors: Lodish Maya B , Dagalakis Urania , Sinaii Ninet , Bornstein Ethan , Kim AeRang , Lokie Kelsey B , Baldwin Andrea M , Reynolds James C , Dombi Eva , Stratakis Constantine A , Widemann Brigitte C
Published: October 2012

Concern for impaired bone health in children with neurofibromatosis type 1 (NF-1) has led to increased interest in bone densitometry in this population. Our study assessed bone mineral apparent density (BMAD) and whole-body bone mineral content (BMC)/height in pediatric patients with NF-1 with a high plexiform neurofibroma burden. Sixty-nine patients with NF-1 (age range 5.2–24.8; mean 13.7±4.8 years) were studied. Hologic dual-energy X-ray absorptiometry scans (Hologic, Inc., Bedford, MA, USA) were performed on all patients. BMD was normalized to derive a reference volume by correcting for height through the use of the BMAD, as well as the BMC. BMAD of the lumbar spine (LS 2–4), femoral neck (FN), and total body BMC/height were measured and Z-scores were calculated. Impaired bone mineral density was defined as a Z-score ≤−2. Forty-seven percent of patients exhibited impaired bone mineral density at any bone site, with 36% at the LS, 18% at the FN, and 20% total BMC/height. BMAD Z-scores of the LS (−1.60±1.26) were more impaired compared with both the FN (−0.54±1.58; P=0.0003) and the whole-body BMC/height Z-scores (−1.16±0.90; P=0.036). Plexiform neurofibroma burden was negatively correlated with LS BMAD (rs=−0.36, P=0.01). In pediatric and young adult patients with NF-1, LS BMAD was more severely affected than the FN BMAD or whole-body BMC/height.
Influence of Hospital Guidelines on Management of Children Hospitalized With Pneumonia
Authors: Neuman Mark I. , Hall Matt , Hersh Adam L. , Brogan Thomas V. , Parikh Kavita , Newland Jason G. , Blaschke Anne J. , Williams Derek J. , Grijalva Carlos G. , Tyler Amy , Shah Samir S.
Published: October 2012

BACKGROUND AND OBJECTIVE:

Clinical practice guidelines (CPGs) assist clinicians in making appropriate diagnostic and treatment decisions based on available evidence. The objective of this study was to describe the availability and content of institutional community-acquired pneumonia (CAP) CPGs, and to evaluate the association between institutional CPGs and care utilization, antibiotic administration, and outcomes among children hospitalized with CAP.

METHODS:

This multicenter retrospective cohort study included children aged 1 to 18 years hospitalized with CAP from July 1, 2009, to June 30, 2011. CPGs from each institution were reviewed to abstract information regarding diagnostic testing and antimicrobial selection. We compared overall and specific utilization patterns, antimicrobial use, and hospital length of stay (LOS) for children with CAP between hospitals with and without CPGs.

RESULTS:

Thirteen (31.7%) of 41 hospitals had an institutional CPG for nonsevere CAP. There was marked heterogeneity among CPGs. Among the 19 710 children hospitalized with CAP, cost of care, hospital LOS, and 14-day readmission rate were not associated with the presence of a CPG. CPGs did not influence ordering patterns for most diagnostic tests, including blood culture and chest radiographs. Penicillin or aminopenicillins were prescribed to 46.3% of children at institutions where a CPG recommended the use of these antibiotics as first-line agents compared with 23.9% of children at institutions without a CPG (odds ratio = 2.7; 95% confidence interval = 1.4–5.5).

CONCLUSIONS:

The availability of a CAP CPG had minimal impact on resource utilization and was not associated with cost or hospital LOS. Institutional CPGs, however, did influence patterns of antimicrobial use.
Organic Foods: Health and Environmental Advantages and Disadvantages
Authors: Forman Joel , Silverstein Janet ,   COMMITTEE ON NUTRITION,   COUNCIL ON ENVIRONMENTAL HEALTH, Bhatia Jatinder J. S. , Abrams Steven A. , Corkins Mark R. , de Ferranti Sarah D. , Golden Neville Hylton , Silverstein Janet , Paulson Jerome A. , Brock-Utne Alice Cantwell , Brumberg Heather Lynn , Campbell Carla C. , Lanphear Bruce Perrin , Osterhoudt Kevin C. , Sandel Megan T. , Trasande Leonardo , Wright Robert O.
Published: October 2012

The US market for organic foods has grown from $3.5 billion in 1996 to $28.6 billion in 2010, according to the Organic Trade Association. Organic products are now sold in specialty stores and conventional supermarkets. Organic products contain numerous marketing claims and terms, only some of which are standardized and regulated.

In terms of health advantages, organic diets have been convincingly demonstrated to expose consumers to fewer pesticides associated with human disease. Organic farming has been demonstrated to have less environmental impact than conventional approaches. However, current evidence does not support any meaningful nutritional benefits or deficits from eating organic compared with conventionally grown foods, and there are no well-powered human studies that directly demonstrate health benefits or disease protection as a result of consuming an organic diet. Studies also have not demonstrated any detrimental or disease-promoting effects from an organic diet. Although organic foods regularly command a significant price premium, well-designed farming studies demonstrate that costs can be competitive and yields comparable to those of conventional farming techniques. Pediatricians should incorporate this evidence when discussing the health and environmental impact of organic foods and organic farming while continuing to encourage all patients and their families to attain optimal nutrition and dietary variety consistent with the US Department of Agriculture’s MyPlate recommendations.

This clinical report reviews the health and environmental issues related to organic food production and consumption. It defines the term “organic,” reviews organic food-labeling standards, describes organic and conventional farming practices, and explores the cost and environmental implications of organic production techniques. It examines the evidence available on nutritional quality and production contaminants in conventionally produced and organic foods. Finally, this report provides guidance for pediatricians to assist them in advising their patients regarding organic and conventionally produced food choices.
Cell-free nucleic acid based non-invasive prenatal diagnosis of fetal aneuploidies
Authors: Lázár Levente , Nagy Gyula Richárd , Rigó jr. János , Nagy Bálint
Published: October 2012

Prenatal detection of fetal aneuploidies is one of the main goals of the prenatal diagnostic approach. As a benefit of the development of advanced ultrasound equipment and advances in molecular biology in the last decade, there is a significant progress in screening methods for fetal aneuploidies, although invasive methods remain the gold standard for aneuploidy detection. Non-invasive prenatal diagnosis has substantial medical impact as it targets the development of safer and more effective methods to avoid the risk of fetal loss associated with currently used invasive methods. Identification of fetal-specific messenger ribonucleic acids, digital polymerase chain reaction and next-generation sequencing give the real chance for non-invasive prenatal diagnosis of fetal aneuploidies. Although all these methods have both advantages and limitations, some of them are moving closer to clinical implementation. In this review the authors highlight the most recent advances in methods for non-invasive prenatal diagnosis of aneuploidies. Orv. Hetil., 2012, 153, 1687–1691.
The past, present and future of food consumption databases
Authors: Szűcs Viktória , Szabó Erzsébet , Bánáti Diána
Published: October 2012

Results of the food consumption surveys are utilized in many areas, such as for example risk assessment, cognition of consumer trends, health education and planning of prevention projects. Standardization of national consumption data for international comparison is an important task. The intention work began in the 1970s. Because of the widespread utilization of food consumption data, many international projects have been done with the aim of their harmonization. The present study shows data collection methods for groups of the food consumption data, their utilization, furthermore, the stations of the international harmonization works in details. The authors underline that for the application of the food consumption data on the international level, it is crucial to harmonize the surveys’ parameters (e.g. time of data collection, method, number of participants, number of the analysed days and the age groups). For this purpose the efforts of the EU menu project, started in 2012, are promising. Orv. Hetil., 2012, 153, 1692–1700.
Estratégias de identificação paramétrica aplicadas à modelagem dinâmica de um servidor web Apache
Authors: Abreu Thiago W. M. , Barra Jr. Walter , Barreiros José A. L. , Costa Junior Carlos T. da
Published: October 2012

Este artigo apresenta um estudo experimental de técnicas de identificação paramétrica aplicadas à modelagem dinâmica de um servidor web Apache. Foi desenvolvido um arranjo experimental para simular variações de carga no servidor. O arranjo é composto por dois computadores PC, sendo um deles utilizado para executar o servidor Apache e o outro utilizado como um gerador de carga, solicitando requisições de serviço ao servidor Apache. Foram estimados modelos paramétricos auto-regressivos (AR) para diferentes pontos de operação e de condição de carga. Cada ponto de operação foi definido em termos dos valores médios para o parâmetro de entrada MaxClients (parâmetro utilizado para definir o número máximo de processos ativos) e a saída percentual de consumo de CPU (Central Processing Unit) do servidor Apache. Para cada ponto de operação foram coletadas 600 amostras, com um intervalo de amostragem de 5 segundos. Metade do conjunto de amostras coletadas em cada ponto de operação foi utilizada para estimação do modelo, enquanto que a outra metade foi utilizada para validação. Um estudo da ordem mais adequada do modelo mostrou que, para um ponto de operação com valor reduzido de MaxClients, um modelo AR de 7ª ordem pode ser satisfatório. Para valores mais elevados de MaxClients, os resultados mostraram que são necessários modelos de ordem mais elevada, devido às não-linearidades inerentes ao sistema.