bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Thrombolysis with Intravenous Alteplase for Acute Ischemic Stroke in Daily Practice
Authors: Dirks Maaike , Niessen Louis W. , van Wijngaarden Jeroen , Koudstaal Peter J. , Franke Cees L. , van Oostenbrugge Robert J. , Dippel Diederik W. J. ,   on behalf of the PRACTISE investigators
Published: December 2011

Background

Thrombolysis with intravenous alteplase has been proven an effective treatment for patients with acute ischemic stroke in randomized clinical trials. In daily practice, the effect of thrombolysis may be less, and complications may occur more often.

Aims

The aim of this study was to assess effectiveness and safety of thrombolysis in an unselected observational cohort of patients.

Methods

During a two-year period, all patients over 18 years with acute stroke who were admitted within four-hours from onset of symptoms in 12 centers were registered. We compared outcomes in patients who were treated with alteplase with patients who were not treated with alteplase. The primary outcome was good functional outcome at three-months measured with the modified Rankin Scale ≤2). The safety end point was symptomatic intracranial hemorrhage and mortality. We used a multivariable logistic regression model to adjust for baseline imbalances and multilevel analysis to take into account within center correlations.

Results

Overall, 1657 patients with ischemic stroke were admitted within four-hours from onset of symptoms and 696 (42%) were treated with alteplase. Treatment with alteplase was associated with a favorable outcome (adjusted odds ratio 1·3; 95% confidence interval 1·0 to 1·7). After further adjustment for potential clustering effects, the adjusted odds ratio for good outcome was 1·4 (95% confidence interval 1·0 to 1·8). Thirty-six (5%) of the 696 patients treated with alteplase had a symptomatic intracranial bleeding complication.

Conclusions

Thrombolysis for ischemic stroke with intravenous alteplase is an effective treatment also in an unselected observational cohort of patients.
Lingering Effects: Stereotype Threat Hurts More than You Think
Authors: Inzlicht Michael , Tullett Alexa M. , Legault Lisa , Kang Sonia K.
Published: December 2011

Starting with the first realization that negative stereotypes can cause people to underperform in the stereotyped domain, an impressive body of work has documented the robust and wide‐ranging nature of stereotype and social identity threat. In this article, we look beyond the stereotyped ability domain and present evidence that coping with stereotypes and prejudice can linger, affecting a broad range of behaviors even in areas unrelated to the stigmatized ability. This stereotype threat spillover occurs because coping with negative stereotypes and prejudice leaves self‐control resources depleted for challenges that arise later, even in unrelated situations. We suggest a number of different ways that individuals can empower and hopefully inoculate themselves against spillover including shifting appraisals and adopting positive coping strategies. We also discuss societal changes, encouraging governments and other organizations to enact policy that will reduce the prevalence of stereotyping and cultivate feelings of intrinsic motivation to reduce prejudice.
DPP‐4 inhibition and islet function
Authors: Ahrén Bo
Published: December 2011

During recent years, dipeptidyl peptidase‐4 (DPP‐4) inhibition has been included in the clinical management of type 2 diabetes, both as monotherapy and as add‐on to several other therapies. DPP‐4 inhibition prevents the inactivation of the incretin hormones, glucose‐dependent insulinotropic polypeptide (GIP) and glucagon‐like peptide‐1 (GLP‐1). This results in stimulation of insulin secretion and inhibition of glucagon secretion, and there is also a potential β‐cell preservation effect, as judged from rodent studies; that is, it might target the key islet dysfunction in the disease. In type 2 diabetes. This reduces 24‐h glucose levels and reduces HbA1c by ≈ 0.8–1.1% from baseline levels of 7.7–8.5%. DPP‐4 inhibition is safe, with a very low risk for adverse events including hypoglycemia, and it prevents weight gain. The present review summarizes the studies on the influence of DPP‐4 inhibition on islet function. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00184.x, 2012)
Amelioration of Type 2 Diabetes by Antibody-Mediated Activation of Fibroblast Growth Factor Receptor 1
Authors: Wu Ai-Luen , Kolumam Ganesh , Stawicki Scott , Chen Yongmei , Li Jun , Zavala-Solorio Jose , Phamluong Khanhky , Feng Bo , Li Li , Marsters Scot , Kates Lance , van Bruggen Nicholas , Leabman Maya , Wong Anne , West David , Stern Howard , Luis Elizabeth , Kim Hok Seon , Yansura Daniel , Peterson Andrew S. , Filvaroff Ellen , Wu Yan , Sonoda Junichiro
Published: December 2011

Antibody-mediated activation of fibroblast growth factor receptor 1 reverses the diabetic phenotype in mice, likely by affecting brown adipose tissues.
Pathogenesis of Lethal Cardiac Arrhythmias in
Mecp2
Mutant Mice: Implication for Therapy in Rett Syndrome
Authors: McCauley Mark D. , Wang Tiannan , Mike Elise , Herrera Jose , Beavers David L. , Huang Teng-Wei , Ward Christopher S. , Skinner Steven , Percy Alan K. , Glaze Daniel G. , Wehrens Xander H. T. , Neul Jeffrey L.
Published: December 2011

Lethal ventricular arrhythmias in a mouse model of Rett syndrome can be prevented by phenytoin, which blocks a persistent sodium current.
Epsilon-Toxin Production by Clostridium perfringens Type D Strain CN3718 Is Dependent upon theagrOperon but Not the VirS/VirR Two-Component Regulatory System
Authors: Chen Jianming , Rood Julian I. , McClane Bruce A.
Published: December 2011

Clostridium perfringenstype B and D strains cause enterotoxemias and enteritis in livestock after proliferating in the intestines and producing epsilon-toxin (ETX), alpha-toxin (CPA), and, usually, perfringolysin O (PFO). Although ETX is one of the most potent bacterial toxins, the regulation of ETX production by type B or D strains remains poorly understood. The present work determined that the type D strain CN3718 upregulates production of ETX upon close contact with enterocyte-like Caco-2 cells. This host cell-induced upregulation of ETX expression was mediated at the transcriptional level. Using an isogenicagrBnull mutant and complemented strain, theagroperon was shown to be required when CN3718 produces ETX in broth culture or, via a secreted signal consistent with a quorum-sensing (QS) effect, upregulates ETX production upon contact with host cells. These findings provide the first insights into the regulation of ETX production, as well as additional evidence that the Agr-like QS system functions as a global regulator ofC. perfringenstoxin production. Since it was proposed previously that the Agr-like QS system regulatesC. perfringensgene expression via the VirS/VirR two-component regulatory system, an isogenicvirRnull mutant of CN3718 was constructed to evaluate the importance of VirS/VirR for CN3718 toxin production. This mutation affected production of CPA and PFO, but not ETX, by CN3718. These results provide the first indication thatC. perfringenstoxin expression regulation by the Agr-like quorum-sensing system may not always act via the VirS/VirR two-component system.

IMPORTANCEMechanisms by whichClostridium perfringenstype B and D strains regulate production of epsilon-toxin (ETX), a CDC class B select toxin, are poorly understood. Production of several other toxins expressed byC. perfringensis wholly or partially regulated by both the Agr-like quorum-sensing (QS) system and the VirS/VirR two-component regulatory system, so the present study tested whether ETX expression by type D strain CN3718 also requires these regulatory systems. Theagroperon was shown to be essential for signaling CN3718 to produce ETX in broth culture or to upregulate ETX production upon close contact with enterocyte-like Caco-2 cells, which may have pathogenic relevance since ETX is produced intestinally. However, ETX production remained at wild-type levels after inactivation of the VirS/VirR system in CN3718. These findings provide the first information regarding regulation of ETX production and suggest Agr-like QS toxin production regulation inC. perfringensdoes not always require the VirS/VirR system.
Synthesis of polyhydroxylated flavonoids bearing a lipophilic decyl tail as potential therapeutic antioxidants
Authors: Caldwell Stuart T. , McPhail Donald B. , Duthie Garry G. , Hartley Richard C.
Published: December 2011

Antioxidants have potential for the treatment of stroke and neurodegeneration, and chimeric compounds that combine a flavon-3-ol head group related to myricetin and a lipophilic decyl tail are known to protect membranes from oxidative damage at least as well as vitamin E. New flavon-3-ols that are highly hydroxylated in the B ring in ways not found in natural flavon-3-ols and bearing a lipophilic decyl tail have been prepared from trimethoxy- and tetramethoxybenzoic acids accessed by lithiation–carboxylation reactions. Direct enolate acylation was preferred over Baker–Venkataraman rearrangement when there were methoxy groups at both the 2- and the 6-position of the benzoic acid derivatives.
Tandem reaction of Morita–Baylis–Hillman alcohols derived from acrylic nitrile with 2-aminobenzimidazole in ionic liquid [BMIM]Cl/H2O
Authors: Wang Yan , Liu Li , Wang Dong , Chen Yong-Jun
Published: December 2011

The tandem reaction of Morita–Baylis–Hillman (MBH) alcohols 1a–1l derived from acrylic nitrile with 2-aminobenzimidazole (2) in ionic iquid (IL) [BMIM]Cl/H2O without additional catalyst was developed for the efficient synthesis of benzimidazol[1,2-a]pyrimidin-7(8H)-imine compounds. The tandem reaction included aza-Michael addition and intramolecular addition of an amino group to the cyano group in one pot. The combination of ionic liquid and water was found to be the best reaction medium, which played a role for accelerating the tandem reaction.
Surface etching of silicone elastomers by depolymerization
Authors: Brook Michael A. , Zhao Shigui , Liu Lihua , Chen Yang
Published: December 2011

Silicone elastomer surfaces that are rough at the nanometer to micron scales could be useful for biomaterials, but there are few efficient routes for their preparation. Silicones undergo depolymerization under equilibrating conditions. We demonstrate that surface roughness can be induced by depolymerizing silicone elastomers using triflic acid, tetrabutylammonium fluoride or KOH as catalysts. The efficiency of depolymerization, however, is decoupled from the roughness that develops. When the catalysts are dissolved in solvents that do not effectively swell silicones, the etching reaction can be mostly directed to the elastomer surface. Acid catalysis leads to slow, nearly homogenous surface erosion with surface roughnesses only increasing from 15 to about 125 nm root mean squared roughness. By contrast, once KOH partitions into the elastomer, the rate of erosion is more efficient than return of the catalyst to the solvent, leading to deep channels and roughnesses of up to ∼850 nm. The use of fluoride requires good solvents for silicone, and leads to surfaces of intermediate roughness. Thus, judicious choice of catalyst and solvent permits independent control over depolymerization and the induction of surface roughness.
Rational size control of gold nanoparticles employing an organometallic precursor [Au-C≡C- t-Bu]4 and tunable thiolate-functionalized ionic liquids in organic medium
Authors: Luska Kylie L. , Moores Audrey
Published: December 2011

Gold nanoparticles (Au NPs) stabilized with six different thiolate-functionalized ionic liquids (TFILs) were synthesized in an organic solvent. The size and optical properties of the TFIL-stabilized Au NPs can be rationally controlled by altering the N-alkyl chain length and (or) the counteranion of the TFIL-stabilizing ligand. Au NPs were prepared from the reduction of a gold precursor (HAuCl4 or [Au-C≡C-t-Bu]4) employing NaBH4 in the presence of the different disulfide precursors. A model, based on Israelachvili theory, is proposed to account for the dependence of NP size on the N-alkyl chain length and the counteranion of the surfactantlike TFIL stabilizers.
TUNABLE MAGNETIC AND ELECTRICAL PROPERTIES OF Co-DOPED ZnO FILMS BY VARYING OXYGEN PARTIAL PRESSURE
Authors: WANG L. G. , ZHANG H. W. , TANG X. L. , LI Y. X. , ZHONG Z. Y.
Published: December 2011

High quality Co -doped ZnO films with good reproducibility have been prepared under different oxygen partial pressure by radio-frequency magnetron sputtering. These films were characterized using numerous characterization techniques including X-ray diffraction, electrical transport, and magnetization measurements. The effect of oxygen partial pressure on the structural, magnetic, and electrical properties of Co -doped ZnO films has been systematically studied. It was found that the structural, magnetic, and electrical properties of Co -doped ZnO films are dependent on oxygen partial pressure. The saturated magnetization of Co -doped ZnO films rapidly increases with decreasing oxygen partial pressure, whereas the resistivity decreases with decreasing oxygen partial pressure. Our findings indicate that the magnetic and electrical properties of Co -doped ZnO films can be tuned by careful control of oxygen partial pressure. In addition, it was further demonstrated that the oxygen vacancy defect is absolutely necessary to induce ferromagnetic couplings in Co -doped ZnO films.
THROUGH A FRACTURED LENS: WOMEN ENTREPRENEURS AND THE PRIVATE EQUITY NEGOTIATION PROCESS
Authors: AMATUCCI FRANCES M. , SWARTZ ETHNÉ
Published: December 2011

Access to financial resources remains an important aspect of new venture start-up and growth strategies. While women still obtain a small amount of total private equity investment, they are increasingly involved in developing high growth ventures which may be attractive investment opportunities for venture capitalists and business angels. Contract, or term sheet, negotiation is an important stage of the investment process. Although gender-related differences in negotiation styles are well documented in other fields, they have not been examined in entrepreneurship. This research utilizes a mixed method study of gender and negotiation strategies employed during the private equity investment process.
AN EMPIRICAL EXAMINATION OF THE INTERACTIVE EFFECTS OF GOAL ORIENTATION, PARTICIPATIVE LEADERSHIP AND TASK CONFLICT ON INNOVATION IN SMALL BUSINESS
Authors: YAN JUN
Published: December 2011

This study investigates the relationship between task conflict and innovation in small business. It also investigates the interactive effects of an entrepreneur's goal orientation and participative leadership style on the relationship between task conflict and innovation in small business. Hierarchical multiple regression analysis of data collected from 201 small businesses found a significant and positive relationship between task conflict and innovation. Analysis also revealed significant two-way interactive effect of an entrepreneur's participative leadership style and task conflict on innovation and significant three-way interactive effect between entrepreneur's goal orientation, participative leadership style and task conflict on innovation in small business. Results showed the relationship between task conflict and innovation is strongest in a small business of which the entrepreneur adopts a participative leadership style and the primary goal is growth and profit. Both the theoretical and practical implications of the results are discussed.
Effect of bromination on the electrochemistry, frontier orbitals, and spectroscopy of metallocorroles
Authors: Mahammed Atif , Tumanskii Boris , Gross Zeev
Published: December 2011

A series of fully β-pyrrole brominated triarylcorrole metal complexes has been prepared for investigating the changes in visible spectra and redox potentials relative to the non-brominated derivatives, as well as for comparing the effect of bromination in corroles and porphyrins. The results reveal that bromination has a much larger effect on the electrochemistry of metallocorroles relative to metalloporphyrins, for both macrocycle- and metal-centered redox processes. The HOMO–LUMO gap energy of the triarylcorrole post-transition metal complexes decreases upon bromination because the effect on the LUMO is about twice as large of as on the HOMO; and both the HOMO and the LUMO are more affected in corroles than in porphyrins. Spectroscopic examinations of the transition metal complexes reveal that the synthetic access to divalent metallocorroles becomes feasible for the brominated derivatives.
Tackling endothelial dysfunction by modulating NOS uncoupling: new insights into its pathogenesis and therapeutic possibilities
Authors: Kietadisorn Rinrada , Juni Rio P. , Moens An L.
Published: December 2011

Endothelial nitric oxide synthase (eNOS) serves as a critical enzyme in maintaining vascular pressure by producing nitric oxide (NO); hence, it has a crucial role in the regulation of endothelial function. The bioavailability of eNOS-derived NO is crucial for this function and might be affected at multiple levels. Uncoupling of eNOS, with subsequently less NO and more superoxide generation, is one of the major underlying causes of endothelial dysfunction found in atherosclerosis, diabetes, hypertension, cigarette smoking, hyperhomocysteinemia, and ischemia/reperfusion injury. Therefore, modulating eNOS uncoupling by stabilizing eNOS activity, enhancing its substrate, cofactors, and transcription, and reversing uncoupled eNOS are attractive therapeutic approaches to improve endothelial function. This review provides an extensive overview of the important role of eNOS uncoupling in the pathogenesis of endothelial dysfunction and the potential therapeutic interventions to modulate eNOS for tackling endothelial dysfunction.
A Proof for the Existence of Chaos in Diffusively Coupled Map Lattices with Open Boundary Conditions
Authors: Yuan Li-Guo , Yang Qi-Gui
Published: December 2011

We first study how to make use of the Marotto theory to prove rigorously the existence of the Li‐Yorke chaos in diffusively coupled map lattices with open boundary conditions (i.e., a high‐dimensional discrete dynamical system). Then, the recent 0‐1 test for chaos is applied to confirm our theoretical claim. In addition, we control the chaotic motions to a fixed point with delay feedback method. Numerical results support the theoretical analysis.
Neuroendocrine Carcinoma of the Stomach: A Case Study
Authors: Kubota Keisuke , Okada Akihiro , Kuroda Junko , Yoshida Masashi , Ohta Keiichiro , Adachi Miki , Itabashi Masayuki , Osamura Yoshiyuki , Kitajima Masaki
Published: December 2011

Gastric neuroendocrine carcinomas are rare and have a poor prognosis, and the diagnostic criteria for this disease have recently changed. We herein report a case of sporadic gastric neuroendocrine carcinoma. A 75-year-old man was referred to our hospital with epigastric pain. Endoscopic examination revealed a localized ulcerative lesion (diameter, 4 cm) at the upper stomach. The diagnosis on biopsy was neuroendocrine carcinoma. Total gastrectomy with D2 lymphadenectomy, splenectomy, and cholecystectomy was performed. Pathologically, the tumor infiltrated the subserosal layer, and 6/49 lymph nodes were involved. The tumor was uniform in shape and arranged in a rosette-like structure to form solid nests, with medium-sized, round-to-cuboid-shaped tumor cells and intense mitosis 46/10 HPF. It was positive for synaptophysin and chromogranin A, and the Ki-67 labeling index was 70–80%. The diagnosis of neuroendocrine carcinoma was made according to the WHO 2010 criteria. The patient was followed up for three years without recurrence.
Experimental Assessment ofMoringa oleiferaLeaf and Fruit for Its Antistress, Antioxidant, and Scavenging Potential UsingIn VitroandIn VivoAssays
Authors: Luqman Suaib , Srivastava Suchita , Kumar Ritesh , Maurya Anil Kumar , Chanda Debabrata
Published: December 2011

We have investigated effect ofMoringa oleiferaleaf and fruit extracts on markers of oxidative stress, its toxicity evaluation, and correlation with antioxidant properties usingin vitroandin vitroassays. The aqueous extract of leaf was able to increase the GSH and reduce MDA level in a concentration-dependent manner. The ethanolic extract of fruit showed highest phenolic content, strong reducing power and free radical scavenging capacity. The antioxidant capacity of ethanolic extract of both fruit and leaf was higher in thein vitroassay compared to aqueous extract which showed higher potentialin vivo. Safety evaluation studies showed no toxicity of the extracts up to a dose of 100 mg/kg body weight. Our results support the potent antioxidant activity of aqueous and ethanolic extract ofMoringa oleiferawhich adds one more positive attribute to its known pharmacological importance.
Mid-Term Neurodevelopmental Outcome in Isolated Mild Ventriculomegaly Diagnosed in Fetal Life
Authors: Gómez-Arriaga Paula , Herraiz Ignacio , Puente Jose Manuel , Zamora-Crespo Berta , Núñez-Enamorado Noemi , Galindo Alberto
Published: December 2011

Objective: To analyze mid-term neurodevelopment outcome in children with isolated mild ventriculomegaly (VM) ≤12 mm diagnosed in fetal life, using the Battelle Developmental Inventory Screening Test (BDIST). Methods: 86 cases of mild VM were identified. 68 were excluded due to: other cerebral anomalies (n = 40), extra-cerebral anomalies (n = 3), chromosomal defects (n = 4), dysmorphic syndromes (n = 4), congenital infections (n = 2), termination of pregnancy (n = 9), stillbirth (n = 2) and incomplete follow-up (n = 4). 18 cases (range 1-8 years) of isolated mild VM were included for analysis. Seven neurodevelopment domains were assessed by BDIST. Results: Routine neuropediatrical evaluation detected neurological disorders in five children (28%; 3 with language impairment, one left hemiparesis and one intellectual retardation). BDIST showed some degree of neurodevelopmental delay in higher proportions: 66% in social-personal skills, 56% in gross motor skills, 39% in adaptive behavior and 28% in fine motor skills. Communicative and cognitive areas were the least affected (11 and 22% had moderate-to-severe involvement, respectively). A general trend towards worse outcomes was observed in the group of ≧4 years, although significant differences were only found for gross motor skills. Conclusion: Subtle neurological delays may appear during the infant period in fetuses prenatally diagnosed of isolated mild VM. In consequence, adequate measures should be established for early detection and treatment.
An Australian Approach to the Policy Translation of Deliberated Citizen Perspectives on Biobanking
Authors: Molster Caron , Maxwell Susannah , Youngs Leanne , Potts Ayla , Kyne Gaenor , Hope Fiona , Dawkins Hugh , O’Leary Peter
Published: December 2011

Background: Deliberative public engagement is recommended for policy development in contested ethical areas. Scholars provide little guidance on how deliberative outputs can be translated to policy. This paper describes the processes we undertook to design a deliberative public forum for citizens to develop recommendations on biobanking that were adopted as health policy. Method: The 4-day forum, held in 2008 in Perth, Western Australia, was designed in collaboration with academic experts. Deliberant recommendations were recorded in a formal report presented to policy-makers. Deliberations were audio-taped and transcribed. Translation involved transcript analyses, comparison of recommendations to other stakeholder views and post-forum consultations. Results: Sixteen citizens made recommendations on ethical, legal and social issues related to biobanking. Most recommendations were translated into biobanking guidelines, with which Western Australia government health agencies must comply. The value of deliberative public participation in policy-making was most evident when trade-offs in competing interests, hopes and concerns were required. Translation issues included the impact of a small number of participants with limited socio-demographic diversity on procedural and policy legitimacy. Conclusions: Assessing the sufficiency of diversity in citizen representation was central to the deliberation-to-translation process. Institutional context facilitated the uptake of deliberation and translation processes. The use of these processes influenced policy substance and credibility among stakeholders and contributed to the state government directive that policy compliance be mandatory. We urge others to publish deliberation-to-translation processes so that best-practices may be identified.
Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients
Authors: Kaťuchová J. , Bober J. , Kaťuch V. , Radoňak J.
Published: December 2011

Background /Aims: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. Methods: Between January 2006 and December 2010 at the First Department of Surgery in Košice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical lymphadenectomy were subjected to immunohistochemical staining to detect occult micrometastasis. A comparison of the median survival rate in groups of patients with immunohistochemistry-positive and -negative lymph nodes was performed. Results: Radical pancreatic resection with standard radical lymphadenectomy was performed on 64 pancreatic cancer patients. The median survival time was 15 months. Out of the 319 histopathologically negative lymph nodes (34 patients), 134 lymph nodes were classified as immunohistochemistry positive (21 patients). The median survival rate in the group of patients with immunohistochemistry-negative lymph nodes was 23 months, but in the group of patients with immunohistochemistry-positive lymph nodes it was 14 months. There was a statistically significant difference between these 2 groups of patients (p ≤ 0.01). Conclusion: The immunohistochemical examination of histopathologically negative lymph nodes can lead to positive lymph node detection. The presence of lymph node micrometastasis could predict the survival rate.
Prognostic Factors for Survival post Surgery for Patients with Gastrointestinal Stromal Tumors
Authors: Mrowiec Sławomir , Jabłońska Beata , Liszka Łukasz , Pająk Jacek , Leidgens Marcin , Szydło Ryszard , Sandecka Agnieszka , Lampe Paweł
Published: December 2011

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms located in the alimentary tract. Our aim was to assess the influence of prognostic factors on survival in patients surgically treated for GISTs. Study: One hundred and five patients treated between January 1989 and December 2008 were available for study. A retrospective analysis of prognostic factors (age, gender, mitotic index, tumor location, tumor size, risk of malignant behavior, and coexisting other neoplasm) was performed. Univariate and multivariate survival analyses were undertaken. Results: Univariate analyses revealed the importance of patient gender (p = 0.007), disease location (p = 0.055), mitotic index (p = 0.054) and coexistence with other neoplasms (p = 0.004). However, multivariate analysis showed 3 independently statistically significant factors: coexistence with other neoplasm (RR = 3.53, p = 0.004), male gender (RR = 2.60, p = 0.011) and mitotic index ≧10/50 HPF, (RR = 2.60, p = 0.042). Conclusions: Our study has shown that male gender, a high mitotic index ≧10/50 HPF, and coexistence with other malignant neoplasms were independent poor prognostic factors in patients with GIST. The presence of middle or lower gut disease location leads to an increased risk of mortality when compared with the upper gut.
Towards Understanding the Cause of Stroke in Young Adults Utilising a New Stroke Classification System (A-S-C-O)
Authors: Cotter P.E. , Belham M. , Martin P.J.
Published: December 2011

Background: Stroke in younger people is relatively common and frequently unexplained. While understanding of the causes of young stroke has improved, there remains uncertainty over the role of low-risk lesions such as a patent foramen ovale (PFO). The TOAST criteria are often used to describe stroke aetiology, but in younger people in whom PFOs are frequent, there is a very high proportion of cases attributed to cardiac embolism. The impact of using the newer A-S-C-O criteria on stroke aetiology was investigated. Methods: Consecutive patients with ischaemic stroke were investigated and categorised by the TOAST and ASCO1 criteria. Stroke aetiology was presented and compared by the different classification systems. Results: Of the 106 ischaemic stroke cases, by TOAST 6% were ‘large artery atheroma’, 11% ‘small vessel occlusion’, 28% ‘cardioembolic’, 22% ‘other determined cause’ and 33% ‘undetermined cause’. The vascular territory and associated causes are presented. With the ASCO1 criteria, there were more cases of unclassified stroke (51.9 vs. 34.0%; p < 0.001) and fewer cases of cardiac embolism. Kappa ranged from 0.5 for ‘undetermined aetiology’ to 1.0 for both ‘large artery atheroma’ and ‘other determined aetiology’. Younger cases (<45 years) were less likely to be either ‘large artery atheroma’ or ‘small vessel occlusion’. Conclusion: Using the ASCO criteria, more patients fall into the undetermined group which more accurately reflects our current uncertainty regarding the pathogenic relevance of PFOs in this age group.
Risk Prediction Models: A Framework for Assessment
Authors: Dent T.H.S. , Wright C.F. , Stephan B.C.M. , Brayne C. , Janssens A.C.J.W.
Published: December 2011

Background: Medical risk prediction models estimate the likelihood of future health-related events. Many make use of information derived from analysis of the genome. Models predict health outcomes such as cardiovascular disease, stroke and cancer, and for some conditions several models exist. Although risk models can help decision-making in clinical medicine and public health, they can also be harmful, for example, by misdirecting clinical effort away from those who are most likely to benefit towards people with less need, thus exacerbating health inequalities. Discussion: Risk prediction models need careful assessment before implementation, but the current approach to their development, evaluation and implementation is inappropriate. As a result, some models are pressed into use before it is clear whether they are suitable, while in other cases there is confusion about which model to use. This paper proposes an approach to the appraisal of risk-scoring models, based on a conference of UK experts. Summary: By specifying what needs to be known before a model can be judged suitable for translation from research into practice, we can ensure that useful models are taken up promptly, that less well-proven ones undergo further evaluation and that resources are not wasted on ineffective ones.
Endoscopy-Based Decision Is Sufficient for Predicting Completeness in Lateral Resection Margin in Colon Endoscopic Submucosal Dissection
Authors: Kang Ki Joo , Kim Dong Uk , Kim Beom Jin , Kim Young-Ho , Rhee Poong-Lyul , Kim Jae J. , Rhee Jong Chul , Chang Dong Kyung
Published: December 2011

We wish to withdraw our article ‘Endoscopy-Based Decision Is Sufficient for Predicting Completeness in Lateral Resection Margin in Colon Endoscopic Submucosal Dissection’ published in Digestion [2012;85:33–39] because it appears to contain an unacceptably high number of errors. The thematic focus continues to be relevant but the authors feel that greater caution and better judgment should have been exercised before submitting this particular article. As a consequence, all of the authors have decided to withdraw it from publication. Authors, Ki Joo Kang Dong Uk Kim Beom Jin Kim Young-Ho Kim Poong-Lyul Rhee Jae Jun Kim Jong Chul Rhee Dong Kyung Chang
Diffusive Feedback Influences on Hierarchical Information Processing
Authors: Miyamoto Ai , Hasegawa Jun , Zheng Meihong , Hoshino Osamu
Published: December 2011

In visual information processing, feedforward projection from primary to secondary visual cortex (V1-to-V2) is essential for integrating combinations of oriented bars in order to extract angular information embedded within contours that represent the shape of objects. For feedback (V2-to-V1) projection, two distinct types of pathways have been observed: clustered projection and diffused projection. The former innervates V1 domains with a preferred orientation similar to that of V2 cells of origin. In contrast, the latter innervates without such orientation specificity. V2 cells send their axons to V1 domains with both similar and dissimilar orientation preferences. It is speculated that the clustered feedback projection has a role in contour integration. The role of the diffused feedback projection, however, remains to be seen. We simulated a minimal, functional V1-V2 neural network model. The diffused feedback projection contributed to achieving ongoing-spontaneous subthreshold membrane oscillations in V1 cells, thereby reducing the reaction time of V1 cells to a pair of bars that represents specific angular information. Interestingly, the feedback influence took place even before V2 responses, which might stem largely from ongoing-spontaneous signaling from V2. We suggest that the diffusive feedback influence from V2 could act early in V1 responses and accelerate their reaction speed to sensory stimulation in order to rapidly extract angular information.
Links Between Young Children’s Behavior and Achievement
Authors: Georges Annie , Brooks-Gunn Jeanne , Malone Lizabeth M.
Published: December 2011

A growing number of studies examine the influence of classroom behavior on teaching and individual children’s behavior. However, limited work has examined the effects of classroom behavior on academic achievement. The present study used 14,537 children in 2,109 classrooms from the Early Childhood Longitudinal Study -Kindergarten Class of 1998-99 (ECLS -K) to examine the association between attention, aggressive behavior, and achievement at two levels --the child and classroom. Children with low attention, alone or in combination with aggressive behavior, made fewer gains in test scores during kindergarten. The achievement gap between children with low attention and those without was larger than those based on low-income status or race/ethnicity. Additionally, having more children in the classroom with low attention was negatively associated with achievement gains. No similar association was found for the number of children with high aggression. The authors discuss avenues for teacher training and intervention to facilitate attention.
Bilious Vomiting Does Not Rule Out Infantile Hypertrophic Pyloric Stenosis
Authors: Piroutek Mary Jane , Brown Lance , Thorp Andrea W.
Published: December 2011

Objective. To describe the incidence of bilious vomiting in infants with infantile hypertrophic pyloric stenosis that presented to a pediatric emergency department. Methods. A retrospective medical record review included all infants who presented to our level 1 pediatric emergency department from January 1, 2005, through December 31, 2009, who were diagnosed intraoperatively with infantile hypertrophic pyloric stenosis. Emesis was determined to be bilious if the vomit was described as “green,” “containing bile,” or “bilious.” Results. The authors identified 354 infants with infantile hypertrophic pyloric stenosis. The median age was 4 weeks 6 days (range = 11 days to 13 weeks). Bilious emesis was encountered in 1.4% (5/354; 95% confidence interval = 0.5% to 3.2%). The pyloric thickness measurements on ultrasound were significantly smaller in those with bilious emesis compared with those without bilious emesis ( z score = 2.64; P = .014). Conclusion. Bilious emesis was the presenting symptom in a small proportion of infants with infantile hypertrophic pyloric stenosis.
Romiplostim Dose Response in Patients With Immune Thrombocytopenia
Authors: Perez‐Ruixo J. J. , Green B. , Doshi S. , Wang Y.‐M. , Mould D. R.
Published: December 2011

A pharmacodynamic model was developed for platelet counts in 52 patients with immune thrombocytopenia (ITP) receiving subcutaneous romiplostim in 3 phase I/II studies (dose range, 0.2–10 μg/kg). The model consisted of a drug‐sensitive progenitor cell compartment linked to a peripheral blood compartment through 4 transition compartments. The baseline platelet count, mean transit time, and kinetics of drug effect constant were 11.1 times 109/L, 170 hours, and 0.6 day−1, respectively. The ITP patients had a shorter platelet life span and lower progenitor cell production rates than healthy volunteers. Romiplostim response was described for 2 subpopulations. The romiplostim stimulatory effect in ITP patients was 351%/100 μg/wk and 12%/100 μg/wk in 68% and 32% of patients, respectively. Visual and numerical predictive checks suggested accurate prediction of platelet time course and durable response rate in ITP patients. Model‐based simulations confirmed the effectiveness of dose reduction to prevent platelet counts >400 times 109/L.
Pursuing Trust in Environmental Regulatory Interactions
Authors: Pautz Michelle C. , Wamsley Carolyn Slott
Published: December 2011

In environmental policy, the interactions of frontline environmental regulators and their counterparts in the regulated community constitute environmental protection in the United States. The authors offer a framework of the different types of interactions these actors may have with one another based on trust. Kettl and Fiorino, among others, have indicated that trust is a fundamental problem in environmental regulation. Building on these assertions, the authors delve into the extant trust literature and offer a definition of trust and, argue that trust is positive and should be sought in these relationships. The authors develop a framework of relationships between inspectors and facility personnel based on varying degrees of trust and offer testable hypotheses.
Visual Development of Human Milk–Fed Preterm Infants Provided With Extra Energy and Nutrients After Hospital Discharge
Authors: O'Connor Deborah L. , Weishuhn Karen , Rovet Joanne , Mirabella Giuseppe , Jefferies Ann , Campbell Douglas M. , Asztalos Elizabeth , Feldman Mark , Whyte Hilary , Westall Carol ,   on behalf of the Post‐Discharge Feeding Study Group
Published: December 2011

Background: Human milk (HM) is the optimal way to nourish preterm low birth weight (LBW) infants after hospital discharge. However, there are few data on which to assess whether HM alone is sufficient to address hospital‐acquired nutrition deficits, and no adequately powered studies have examined this question using neurodevelopment as an outcome. The purpose of this work was to determine whether adding extra energy and nutrients to the feedings of predominantly HM‐fed LBW infants early after discharge improves their visual development. Visual development was used in this study as a surrogate marker for neurodevelopment. Methods: At discharge, 39 predominantly HM‐fed LBW infants (750–1800 g, 1288 ± 288 g) were randomized to receive human milk alone (control) or around half of the HM received daily mixed with a multinutrient fortifier (intervention) for 12 weeks. Grating acuity (ie, visual acuity) and contrast sensitivity were assessed using sweep visual‐evoked potential tests at 4 and 6 months corrected age. Results: At 4 and 6 months corrected age, intervention infants demonstrated higher grating acuity compared to those in the control group (intervention: 7.8 ± 1.3 and 9.7 ± 1.2 [cycles/degree] vs control 6.9 ± 1.2 and 8.2 ± 1.3, P = .02). Differences in contrast sensitivity did not reach statistical significance (P = .11). Conclusion: Adding a multinutrient fortifier to a portion of the expressed breast milk provided to predominantly HM‐fed LBW infants early after discharge improves their early visual development. Whether these subtle differences in visual development apply to other aspects of development or longer term neurodevelopment are worthy of future investigation.
Stepping Onto the STEM Pathway
Authors: Heilbronner Nancy N.
Published: December 2011

Despite a growing national need to develop capabilities in science, technology, engineering, and mathematics (STEM), many men and women who are considered talented in these areas during high school choose not to pursue STEM undergraduate majors. A purpose of the current study was to better understand factors that contribute to an individual’s formal entry into the domain through the declaration of a STEM college major. Survey methodology was used to explore the perceptions of 360 Science Talent Search semifinalists and finalists from the years 1987 to 1989 and 1997 to 1999, and quantitative procedures were used to analyze the data. A majority (74.2%) of these students declared STEM majors and went on to graduate with STEM degrees. Belief in one’s ability to achieve in STEM and the quality of students’ academic experiences (level of challenge, hands-on nature, and adequacy of preparation for careers) were predictors of STEM majors in college. Reasons for attrition and implications for practice are discussed.
A continuous fuzzy Kano’s model for customer requirements analysis in product development
Authors: Wu M , Wang L
Published: December 2011

In today’s competitive marketplace, customer requirements (CRs) analysis is critically important in the development phase of a new product. One widely used effective tool for CRs analysis is Kano’s model. However, this model only considers crisp descriptions, ignoring the fact that CRs are imprecise and uncertain due to their linguistic origins. Moreover, it provides limited decision support for designers because it is a qualitative method based on discontinuous classification criteria. To tackle these problems, this paper proposes a continuous fuzzy Kano’s model to more accurately analyse CRs. A modified fuzzy Kano’s questionnaire is developed to deal with the imprecision and uncertainty in CRs. It is a self-administered paper questionnaire that consists of closed-ended questions. Furthermore, a continuous approach for fuzzy Kano evaluation is presented to quantitatively analyse CRs. Also, an evaluation index is introduced that allows CRs to be prioritized. A case study of mobile phone development is presented to evaluate the proposed method.
Characterizing SME migration towards advanced manufacturing technologies
Authors: Thomas A J , Barton R A
Published: December 2011

This paper provides details of a survey conducted into 260 manufacturing SMEs operating in a range of industrial sectors. The survey is a follow-up to a survey performed 3-years earlier on the same companies and it is targeted in this case on investigating the migratory characteristics of advanced manufacturing technology (AMT) implementation in manufacturing SMEs. It provides an overview of the attitudes towards AMT and the benefits obtained by SMEs through its adoption. The paper provides information on the characterization, compatibility, and innovative behaviour of SMEs in AMT implementation. An improved AMT migration classification system is proposed on the basis of the analysis of the obtained data. This study is the first to in-depth compare the AMT implementation issues within SMEs based on large-scale survey data.
Household joblessness and its impact on poverty and deprivation in Europe
Authors: de Graaf-Zijl Marloes , Nolan Brian
Published: December 2011

Working-age households where no-one is in work have become an increasing focus of policy concern even before the economic crisis, and the European Union (EU) has included household joblessness in its new poverty reduction target for 2020. This paper focuses on the variation across EU countries in the prevalence of household joblessness and its impact on income poverty and deprivation, and on the implications for the new EU poverty reduction target. It highlights first that there are some divergences across key data sources in the extent of joblessness. The prevalence of household joblessness varies substantially across EU countries, but there is little evidence of a consistent pattern among groupings of countries often categorized together in terms of welfare regime or geographically. In aggregate there is little association between the overall extent of household joblessness in a country and the percentage in relative income poverty or above a material deprivation threshold. At a micro level, being in a jobless household has a substantial impact on the likelihood of being in relative income poverty or deprived, but the scale of these impacts is shown to be very much greater in some countries than in others, and to vary between single-adult and multiple-adult households. In most EU countries little more than half the working-age adults in jobless households are either income-poor or deprived, so including joblessness in the poverty reduction target does make a difference, without a clearly articulated rationale.
The welfare state and the crisis: the case of Greece
Authors: Matsaganis Manos
Published: December 2011

The paper examines the relationship between the severe economic crisis facing Greece and the country’s social protection system, arguing that this relationship is ambivalent. On one level, the welfare state itself has contributed in a far from trivial way to the fiscal crisis of the state, with its various failures including huge deficits in key programmes such as pensions and health. On a second level, the crisis and the measures to counter it deprive the welfare state of resources, while at the same time setting in motion sweeping changes. On a third level, social protection can help cope with the consequences of the crisis, but enhancing its capacity to do so will require considerable reconfiguration and proper funding of social safety nets. The paper concludes by discussing the prospects for a revival of welfare state building in Greece in the current harsh climate.
Investigating Effects of Tolerance-Intolerance of Ambiguity and the Teaching of Public Relations Writing: A Quasi-Experiment
Authors: Sallot Lynne M. , Lyon Lisa J.
Published: December 2011

An exploratory, quasi-experiment found that students' individual levels of tolerance-intolerance of ambiguity (TIA), along with a portfolio grading teaching technique, mitigated their views of public relations and their evaluations of their experiences in the public relations writing course. Students with low TIA who had portfolio grading for writing assignments were least likely to think their grades reflected the amount of work they put into the course. Students with high TIA were more likely to think public relations problems were simple to solve and they better appreciated instructors who introduced new viewpoints. In general, students who wrote assignments for a predominant “class client” instead of multiple class clients had a better course experience and felt they learned more about public relations practice, while students who wrote assignments for multiple clients thought their grades more accurately reflected their work. This study also found the AT-20 measure of tolerance of ambiguity stable and moderately reliable compared with measures used in earlier TIA studies.
Conflicts of Interest and Hyperbole: Nutrition in the Media
Authors: Hampl Jeffrey S.
Published: December 2011

Food and nutrition issues are popular news topics and have been occurring in the media with increasing frequency, yet few journalists are trained specifically in health reporting. Training in health science may be an approach to pique students' interest and maintain enrollments. Currently, health reporters say that lack of training is the biggest obstacle they face professionally; as a result, health news is often superficial, exaggerated, and not balanced. Providing training in health sciences to undergraduate journalism and mass communication students will give future health reporters the solid foundation they need to communicate health news effectively to the public.