bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining continuing education with expert consultation via telemedicine in Cambodia
Authors: Engle Xavier , Aird James , Tho Ly , Bintcliffe Fiona , Monsell Fergal , Gollogly Jim , Noor Saqib
Published: December 2013

Telemedicine has the potential to increase access to both clinical consultation and continuing medical education in Cambodia. We present a Cambodian surgical centre's experience with a collaboration in which complicated orthopaedic cases were presented to a panel of consultants using free online videoconferencing software, providing a combined opportunity for both continuing education and the enhancement of patient care. Effects of the case conference on patient care were examined via a retrospective review and clinician perspectives were elicited via a qualitative survey. The case conference altered patient care in 69% of cases. All Cambodian staff reported learning from the conference and 78% reported changes in their care for patients not presented at the conference. Real-time videoconferencing between consultants in the developed world and physicians in a developing country may be an effective, low-cost and easily replicable means of combining direct benefits to patient care with continuing medical education.
Perceived flexibility requirements: Exploring mediating mechanisms in positive and negative effects on worker well-being
Authors: Höge Thomas , Hornung Severin
Published: December 2013

Based upon the interdisciplinary literature on organizational flexibility, the study investigates positive and negative effects of perceived flexibility requirements (PFR) on worker well-being. The authors define PFR as perceived expectations conveyed by the organization to its employees, regarding self-directed behavior related to flexibility and efficiency in organizational practices; their content can refer to (1) task fulfillment, (2) career development, (3) learning, and (4) working time. Based on a heterogeneous sample of N = 931 employees, the authors tested a structural equation model, in which time pressure, work–family conflict, and personal initiative mediated between PFR and strain. Negative effects on well-being were most pronounced for PFR with regard to working time and mediated via time pressure and work–family conflict. PFR related to task fulfillment had both negative and positive effects via time pressure, but also stimulating employee initiative. The other two dimensions of PFR explained only small amounts of additional variance in dependent variables.
Underestimating Our Influence Over Others’ Unethical Behavior and Decisions
Authors: Bohns Vanessa K. , Roghanizad M. Mahdi , Xu Amy Z.
Published: December 2013

We examined the psychology of “instigators,” people who surround an unethical act and influence the wrongdoer (the “actor”) without directly committing the act themselves. In four studies, we found that instigators of unethical acts underestimated their influence over actors. In Studies 1 and 2, university students enlisted other students to commit a “white lie” (Study 1) or commit a small act of vandalism (Study 2) after making predictions about how easy it would be to get their fellow students to do so. In Studies 3 and 4, online samples of participants responded to hypothetical vignettes, for example, about buying children alcohol and taking office supplies home for personal use. In all four studies, instigators failed to recognize the social pressure they levied on actors through simple unethical suggestions, that is, the discomfort actors would experience by making a decision that was inconsistent with the instigator’s suggestion.
Esophageal diverticula: Analysis of 25 cases
Authors: Bagheri Reza , Maddah Ghodratollah , Mashhadi Mohammadtaghi Rajabi , Haghi Seyed Ziaollah , Tavassoli Alireza , Ghamari Mohammad Javad , Sheibani Shima
Published: December 2013

Background:

esophageal diverticula are classified as 2 types: true diverticula and pseudodiverticula. These disorders result in clinical manifestations such as dysphagia and esophageal reflux. In this study, we evaluated the results of surgical treatment for diverticula.

Methods:

all patients suffering from symptomatic esophageal diverticulum, who underwent surgical treatment in Ghaem Hospital from 2000 to 2012 and were followed up for at least for one year, were included in the study. Age, sex, clinical manifestations, location, surgical approach, and mortality were evaluated. There were 25 patients (15 men and 10 women) with a mean age of 41 ± 8.3 years.

Results:

the most common site of involvement was inferior (epiphrenic diverticulum). Barium swallow was diagnostic. After surgical treatment, complications occurred in 4 (16%) patients, comprising anastomosis site leakage, hoarseness, atelectasis, and wound infection; all were treated medically. There was no postoperative mortality. All patients experienced an improvement in symptoms during one year of follow-up.

Conclusion:

due to the good results and minimal complications postoperatively, surgical treatment is recommended for patients with symptomatic esophageal diverticulum.
Periodic Epileptiform Discharges Clarified for the Nonneurologist Intensivist
Authors: Lahiri Shouri , Boro Alexis D. , Shiloh Ariel L. , Milstein Mark J. , Savel Richard H.
Published: December 2013

Periodic epileptiform discharges (PEDs) are frequently encountered during continuous electroencephalography monitoring in the intensive care unit. Their implications and management are variable and highly dependent on the clinical context. This article is intended for the nonneurologist intensivist, reviews basic terminology and clinical implications (including causes, prognosis, and association with seizures), and suggests an approach to management. Several case vignettes are included to illustrate the clinical variability associated with PEDs.
Social Reactions to Sexual Assault Disclosure and Problem Drinking
Authors: Peter-Hagene Liana C. , Ullman Sarah E.
Published: December 2013

Sexual assault survivors receive various positive and negative social reactions to assault disclosures, yet little is known about mechanisms linking these social reactions to posttraumatic stress disorder (PTSD) symptoms and problem drinking. Data from a large, diverse sample of women who had experienced adult sexual assault were analyzed with structural equation modeling to test a theoretical model of the relationships between specific negative social reactions (e.g., controlling, infantilizing) and positive reactions (e.g., tangible support), perceived control over recovery, PTSD, and drinking outcomes ( N = 1,863). A model disaggregating controlling reactions from infantilizing reactions showed that infantilizing reactions in particular related to less perceived control, which in turn was related to more PTSD and problem drinking, whereas controlling reactions were not related to perceived control, PTSD, or problem drinking. Tangible support was related to increased perceived control over recovery, yet it was not protective against PTSD or problem drinking. Finally, PTSD and drinking to cope fully mediated the effect of perceived control on problem drinking. Implications for practice and suggestions for future research are discussed.
Relationship of Trauma Exposure and Substance Abuse to Self-Reported Violence Among Men and Women in Substance Abuse Treatment
Authors: Clark C. Brendan , Reiland Sarah , Thorne Chris , Cropsey Karen L.
Published: December 2013

Past research showed a relationship between substance abuse and aggression and past trauma and aggression. The nature of the relationships between substance use, trauma, and aggression is inconclusive. The current research hypothesized greater aggression among those with a history of substance abuse and trauma compared with those without such a history and an additive relationship between substance abuse and trauma on aggression. Participants were 615 individuals in a substance abuse treatment program for individuals under criminal justice supervision. Data were collected from face-to-face interviews and self-report measures. Univariate and multivariate analyses assessed the relationships among substance use, trauma, and aggression. Participants with a history of trauma and regular substance use reported the highest rates of homicidal ideation, problem behaviors, and person offenses. Participants in this group also reported greater desire for help managing their stress and tension, dealing with problems in their intimate relationships, developing healthier relationships in general, and learning prosocial approaches to express their feelings. Substance abusing participants who experienced trauma reported more externalizing behaviors and a greater desire for coping- and social-skills training than participants who abused substances but did not report a history of trauma. This suggests that participants in substance abuse treatment programs may have improved outcomes with the addition of components to address these issues.
What causes international variations in length of stay: A comparative analysis for two inpatient conditions in Japanese and Canadian hospitals
Authors: Tiessen James , Kambara Hirofumi , Sakai Tsuneo , Kato Ken , Yamauchi Kazunobu , McMillan Charles
Published: December 2013

Hospital average length of stay varies considerably between countries. However, there is limited patient-level research identifying or discounting possible reasons for these differences. This study compares the length of stay of patients in Japan, where it is the longest in the OECD, and Canada, where length of stay is closer to the OECD mean. Administrative patient-level data, including age, gender, co-morbidities, intervention, discharge plan, outcome and length of stay were collected from two Japanese and two Ontario, Canada hospitals for two diagnoses: colorectal cancer surgery and acute myocardial infarction. Analyses examined linkages between patient characteristics, hospitals and countries and length of stay. When controlling for patient demographic characteristics, the incidence of co-morbidities and discharge plan practices, Japanese length of stay tended to be significantly longer than that in Canada for both diagnoses. Mortality rates were not significantly different; however, the readmission rate (28 days or less) for acute myocardial infarction was higher in the Canadian hospitals. The findings indicate that non-clinical factors contribute to sustained international differences in length of stay. These factors may include professional or cultural norms, differing payment schemes and access to long-term care facilities. The study also introduces a protocol that can be used for international patient-level comparisons that can enable effective policy and management learning.
The study on the compatibility of epoxy resin with liquid oxygen
Authors: Sun Tao , Fan Hongyu , Wu Zhanjun
Published: December 2013

Lightweight liquid oxygen (LOX) tank has attracted much attention recently, and epoxy resin is considered to be one of the most likely candidate materials. In this work, polymer wafer made from bisphenol-A epoxy resin was firstly treated with LOX, and then its macroscopic morphology, microscopic structure, and chemical composition were analyzed by atomic force microscopy and Fourier transformed infrared spectroscopy. Finally, its compatibility with LOX was studied by mechanical impact test. The results showed that LOX treatment has little influence on the macroscopic morphology and chemical composition of the epoxy resin wafer, but has a large influence on its microstructure and compatibility with LOX. With the increase of immersion time, the surface roughness, the number, length, and depth of the cracks appeared on the sample surface were all increased. The reaction caused by mechanical impact became more frequent and intense. Finally, possible damage mechanism was discussed.
Measuring Implementation of Evidence-Based Programs Targeting Young Children at Risk for Emotional/Behavioral Disorders
Authors: Sutherland Kevin S. , McLeod Bryce D. , Conroy Maureen A. , Cox Julia R.
Published: December 2013

Young children with and at risk for emotional/behavioral disorders (EBD) present challenges for early childhood teachers. Evidence-based programs designed to address these young children’s behavior problems exist, but there are a number of barriers to implementing these programs in early childhood settings. Advancing the science of treatment integrity measurement can assist researchers and consumers interested in implementing evidence-based programs in early childhood classrooms. To provide guidance for researchers interested in assessing the integrity of implementation efforts, we describe a conceptual model of implementation of evidence-based programs designed to prevent EBD when applied in early childhood settings. Next, we describe steps that can be used to develop treatment integrity measures. Last, we discuss factors to consider when developing treatment integrity measures with specific emphasis on psychometrically strong measures that have maximum utility for implementation research in early childhood classrooms.
Commentary on Turing instabilities and symbolic material culture by Froese, Woodward and Ikegami
Authors: Hodgson Derek
Published: December 2013

Turing instabilities are invoked by Froese, Woodward, and Ikegami in support of the neural dynamics of the primary visual cortex that give rise to subjectively experienced geometric patterns or form constants. Although the authors provide a convincing case for the relevance of such instabilities to understanding the provenance of form constants, their reliance on altered states of consciousness and shamanic practices of Lewis-Williams is less convincing as the latter’s proposal continues to be controversial. In this commentary, I will show that abnormal subjective states are neither necessary nor essential to understanding the universality of geometric art. In effect, the geometric art from the Middle Stone/Palaeolithic Age and later can be sufficiently explained by recourse to the normal function of the visual cortex in the context of the regular engagement with everyday materials.
Deepening Couples Counseling Through Inner Critic Dialogue
Authors: Green Eric J. , Elliott Kathryn , Myrick Amie C.
Published: December 2013

The psychological construct of the Inner Critic (IC) describes the internal, negative valuations made by individuals within relationships based upon previous faulty thinking (Earley, 2012; Green, 2008; Kugel, 2010). Marriage and family counselors working with couples may benefit from understanding the IC construct and utilizing the anthetic relationship therapy (ART) paradigm (Elliott & Elliott, 2000) to assist couples with neutralizing the deleterious effects of the IC’s messages. The purpose of this article, therefore, is to (a) describe the development of the IC as an integral psychodynamic construct in psychological functioning and treatment; (b) highlight the mechanisms in which the IC manifests intrapersonally and sabotages individuals interpersonally; and (c) discuss the implications for utilizing ART to address the IC’s destructive messages so couples can reengage in healthy and optimal interpersonal communication.
Crisis Intervention With Families
Authors: Myer Rick A. , Williams R. Craig , Haley Melinda , Brownfield Jamie N. , McNicols Kelley B. , Pribozie Nickole
Published: December 2013

This article identifies six characteristics in families that are subject to changing during crisis situations: (a) roles, (b) boundaries, (c) communication, (d) rules/processes, (e) goals, and (f) values. Understanding changes in these characteristics provides valuable information for helping crisis counselors assist families cope with and resolve the crisis. Identification of these characteristics is a step toward development of a theoretical model for helping families in crisis.
Introducing the Short Dark Triad (SD3)
Authors: Jones Daniel N. , Paulhus Delroy L.
Published: December 2013

Three socially aversive traits—Machiavellianism, narcissism, and psychopathy—have been studied as an overlapping constellation known as the Dark Triad. Here, we develop and validate the Short Dark Triad (SD3), a brief proxy measure. Four studies (total N = 1,063) examined the structure, reliability, and validity of the subscales in both community and student samples. In Studies 1 and 2, structural analyses yielded three factors with the final 27 items loading appropriately on their respective factors. Study 3 confirmed that the resulting SD3 subscales map well onto the longer standard measures. Study 4 validated the SD3 subscales against informant ratings. Together, these studies indicate that the SD3 provides efficient, reliable, and valid measures of the Dark Triad of personalities.
Making voice count
Authors: Rowe Kelly T
Published: December 2013

Economic voting claims that citizens will reward or punish the incumbent government based on the state of the economy as a mechanism of democratic accountability. In negative economic voting, in order to vote against the government, citizens must have options (parties) in which to place their vote to voice discontent. If not, there is no opportunity to cast an ‘economic vote’ and abstention results, leading to a weakened economic effect. In this article I argue that the electoral system indirectly mediates the relationship between the economy and the vote by determining the number of viable parties which act as the conduit for punishing the incumbent. Cross-national data and individual-level data for the case of Spain are used to test the impact of the number of parties on economic voting. The findings suggest that when there are more viable parties competing, the probability of casting an economic vote increases.
Speakers’ orientations to directional terms in a map task
Authors: Filipi Anna
Published: December 2013

Drawing on a corpus of eight task-based interactions involving a map task (Australian National Database of Spoken Language (ANDOSL)), this article seeks to focus on how speakers orient to directional terms in an interactional context, and in so doing, to add to features that can be deemed to characterize this speech exchange system. Analysis of the data using conversation analysis showed that features of the talk were confirmation and clarification checks, which provided an opportunity to check understanding and the accuracy of the instruction leading to a correction, acknowledgement or further information; modulated repair and mitigated criticism, resulting in the maintenance of an affiliative stance towards the other speaker; and avoidance of problems that viewpoints or directional terms might cause. Problems with the directional terms in this corpus confirm prior research that the confusion between east and west, and left and right are the terms that cause problems for speakers.
Beyond the Public Eye
Authors: Nath Anjali
Published: December 2013

During the War on Terror, increased secrecy and noncompliance with Freedom of Information Act requests allowed military detention programs to function with systematic efficiency in Guantanamo, Iraq, Afghanistan, and numerous other sites. Often, the released torture memos were heavily redacted and nearly unreadable. Through close readings of redacted documents, this article argues that the visual politics of redaction offer an aesthetic point of entry that brings into focus the limits of transparency for making visible necropolitical systems of violence. Although incongruent with the intention of concealing text, redacted spaces paradoxically can make contrapuntal readings easily available, as they visualize the ungraspable violent dimensions of detainee torture.
Differential Impact of Types of Social Support in the Mental Health of Formerly Incarcerated Latino Men
Authors: Muñoz-Laboy Miguel , Severson Nicolette , Perry Ashley , Guilamo-Ramos Vincent
Published: December 2013

The role of social support in the mental health of formerly incarcerated Latino men (FILM) is an issue overlooked in public health prevention efforts. The objectives of this analysis were to (a) describe the levels of social support perceived and received by FILM; (b) identify the associations, if any, between levels of social support and mental health indicators such as depression and anxiety; and (c) explore the impact of familism and hypermasculinity on the receptivity of social support and the potential role of these factors in mediating associations between social support and mental health indicators. To accomplish the objectives, we conducted a cross-sectional survey with FILM ( n = 259), ages 18 to 59, in New York City, and one nominated member of their social network ( n = 130 dyads). In this analysis, we examined four dimensions of social support (instrumental, informational, appraisal, and emotional) from two perspectives: provided (as reported by members of the social networks) and perceived (as reported by FILM). The major outcome variables for this analysis were the presence/absence of major anxiety and depressive symptoms. Our logistic regression analyses suggest that perceived emotional support was inversely associated with both anxiety and depression. Our findings suggest that familism mediated the association between perceived emotional support and anxiety/depression. Therefore, we must consider designing network enhancement interventions that focus on both FILM and their social support systems.
Protein-bound polysaccharide-K induces IL-1β via TLR2 and NLRP3 inflammasome activation
Authors: Yang Yi , Inatsuka Carol , Gad Ekram , Disis Mary L , Standish Leanna J , Pugh Nirmal , Pasco David S , Lu Hailing
Published: December 2013

Inflammasome activation has been shown to regulate both innate and adaptive immune responses. It is important to investigate whether immune-enhancing natural products can also activate inflammasome. The current study examined the potential of protein-bound polysaccharide-K (PSK), a hot water extract from Trametes versicolor, to activate inflammasome. Using THP-1 cells, we have demonstrated that PSK induces both pro-IL-1β and mature IL-1β in THP-1 cells in a caspase 1- and NLRP3-dependent manner. PSK also induces IL-1β and IL-18 in human PBMC. Cathepsin B is required for PSK-induced inflammasome activation as CA-074-Me, a cathepsin B inhibitor, significantly decreased PSK-induced IL-1β. PSK induces NLRP3 at both mRNA and protein level. Comparison of PSK-induced IL-1β in bone marrow-derived macrophages from wild type C57BL/6 mice, TLR2-/-, P2X7R-/- and NLRP3-/- mice demonstrated that PSK-induced IL-1β is dependent on both TLR2 and NLRP3. P2X7R is not required for PSK-induced inflammasome activation, but enhances PSK-induced caspase-1 activation and IL-1β induction. Altogether, these results demonstrated that PSK induces inflammasome activation and production of IL-1β in a TLR2- and NLRP3-dependent mechanism. These results provide novel insights into the mechanisms of the immune modulatory effects of PSK.
The relationship between serum bilirubin concentration and coronary slow flow
Authors: Demir Mehmet , Demir Canan , Coşar Selvi
Published: December 2013

Background:

The pathophysiology of coronary slow flow (CSF) has not been clearly identified, although multiple abnormalities including arteritis, endothelial dysfunction, and atherothrombosis have been reported. Several studies have demonstrated that higher serum bilirubin inhibits the inflammation and proliferation of vascular smooth muscle cells; in addition, there is a relationship between serum bilirubin and cardiovascular disease. However, the relationship between bilirubin and CSF is still unknown. In our study, we compared serum bilirubin concentrations between CSF patients and controls.

Methods:

The study included 50 CSF patients (19 male, mean age 65.6 ± 13.7 years) and 30 controls (10 male, mean age 57.86 ± 11.6 years). Concurrent routine biochemical tests and leukocyte count, hemoglobin, hematocrit, and platelet count on whole blood count were performed in patients that underwent a coronary angiogram. These parameters were compared between groups.

Results:

No statistically significant difference was found between the two groups in terms of basic characteristics. Total, direct, and indirect serum bilirubin levels were significantly lower among CSF patients than controls (14.0 ± 12.0 versus 6.15 ± 6.8, 5.6 ± 3.4 versus 2.6 ± 1.7, and 8.4 ± 8.5 versus 3.6 ± 3.4 µmol/l; all p < 0.001, respectively).

Conclusions:

The study revealed a relationship between serum bilirubin and CSF.
Scaling up of physical activity interventions in Brazil: how partnerships and research evidence contributed to policy action
Authors: Parra Diana C. , Hoehner Christine M. , Hallal Pedro C. , Reis Rodrigo S. , Simoes Eduardo J. , Malta Deborah C. , Pratt Michael , Brownson Ross C.
Published: December 2013

The global health burden due to physical inactivity is enormous and growing. There is a need to consider new ways of generating evidence and to identify the role of government in promoting physical activity at the population level. In this paper, we summarize key findings from a large-scale cross-national collaboration to understand physical activity promotion in Brazil. We describe the main aspects of the partnership of Project GUIA (Guide for Useful Interventions for Activity in Brazil and Latin America) that sustained the collaborative effort for eight years and describe how the evidence gathered from the collaboration triggered political action in Brazil to scale up a physical activity intervention at the national level. Project GUIA is a cross-national multidisciplinary research partnership designed to understand and evaluate current efforts for physical activity promotion at the community level in Latin America. This example of scaling up is unprecedented for promoting health in the region and is an example that must be followed and evaluated.
Big data, smart cities and city planning
Authors: Batty Michael
Published: December 2013

I define big data with respect to its size but pay particular attention to the fact that the data I am referring to is urban data, that is, data for cities that are invariably tagged to space and time. I argue that this sort of data are largely being streamed from sensors, and this represents a sea change in the kinds of data that we have about what happens where and when in cities. I describe how the growth of big data is shifting the emphasis from longer term strategic planning to short-term thinking about how cities function and can be managed, although with the possibility that over much longer periods of time, this kind of big data will become a source for information about every time horizon. By way of conclusion, I illustrate the need for new theory and analysis with respect to 6 months of smart travel card data of individual trips on Greater London’s public transport systems.
The danger of a big data episteme and the need to evolve geographic information systems
Authors: Gorman Sean P
Published: December 2013

The emergence of big data as a dominant technology meme challenges geography’s technical underpinnings, found in geographic information systems, while engaging the discipline in a conversation about the meme’s impact on society. This allows scholars to engage collaboratively from both a computationally quantitative and critically qualitative perspective. For geography, there is an opportunity to point out these shortcomings through critical appraisals of big data and its reflection of society. Complimentarily this opens the door to developing methodologies that will allow for a more realistic interpretation of big data analysis in the context of an unfiltered societal view.
Advances in immune-modulating therapies to treat atherosclerotic cardiovascular diseases
Authors: Chyu Kuang-Yuh , Shah Prediman K.
Published: December 2013

In addition to hypercholesterolemia, innate and adaptive immune mechanisms play a critical role in atherogenesis, thus making immune-modulation therapy a potentially attractive way of managing atherosclerotic cardiovascular disease. These immune-modulation strategies include both active and passive immunization and confer beneficial reduction in atherosclerosis. Preclinical studies have demonstrated promising results and we review current knowledge on the complex role of the immune system and the potential for immunization as an immune-modulation therapy for atherosclerosis.
Expression of AIM2 is high and correlated with inflammation in hepatitis B virus associated glomerulonephritis
Authors: Du Wenjun , Zhen Junhui , Zheng Zhaomin , Ma Shumin , Chen Shijun
Published: December 2013

Background & aims

Innate immunity is the first line of defense against invasive microbial infection, and AIM2 plays an important role in this process by sensing double-stranded DNA viruses. However, the role of AIM2 in regulating the immune response to viruses in vivo, especially in sensing hepatitis B virus (HBV), has not been examined. We hypothesized that the expression of AIM2 increases corresponding to HBV-mediated inflammation in patients with hepatitis B virus associated glomerulonephritis (HBV-GN), a condition which activates inflammatory mechanisms and causes renal damage. To test this hypothesis, we analyzed the expression of AIM2 in HBV-GN patients in relation to the inflammatory response to HBV infection.

Methods

A total of 79 patients diagnosed with chronic nephritis (CN) were enrolled in this study, including 54 HBV-GN patients as the experimental group and 24 chronic glomerulonephritis (CGN) patients as the negative control group. Six patients diagnosed with chronic hepatitis B (CHB) were also enrolled as positive controls. Each CN patient received renal biopsy, and immunohistochemistry was used to detect the expression of AIM2 and inflammatory factors caspase-1 and IL-1β in the biopsy specimens. CHB patients received liver puncture biopsy, and immunohistochemistry was used to detect the expression of AIM2 in these specimens. Expression of AIM 2 among different groups and in relation to inflammatory factors caspase-1 and IL-1β was analyzed.

Results

The expression of AIM2 in HBV-GN patients (81.4%) was significantly higher than in CGN patients (4.0%). Among the HBV-GN patients, expression of AIM2 was significantly higher in the high HBV replication group than in the low HBV replication group. AIM2 expression was not correlated with age, gender, HBeAg status in serum, HBV-antigen type deposited in renal tissue or pathological type of HBV-GN. However, AIM2 levels were positively correlated with the expression of caspase-1 and IL-1β in HBV-GN patients. The data suggest that AIM2 expression is directly correlated with HBV infection-associated inflammation.

Conclusion

The elevation of AIM2 during HBV infection or replication may contribute to its associated inflammatory damage, thus providing a putative therapeutic target and a new avenue for researching the pathogenesis of HBV-GN.
Psychometric properties of online administered parental strengths and difficulties questionnaire (SDQ), and normative data based on combined online and paper-and-pencil administration
Authors: Björnsdotter Annika , Enebrink Pia , Ghaderi Ata
Published: December 2013

Objective

To examine the psychometric properties of the online administered parental version of the Strength and Difficulties Questionnaire (SDQ), and to provide parental norms from a nationwide Swedish sample.

Methods

A total of 1443 parents from of a national probability sample of 2800 children aged 10-13 years completed the SDQ online or as usual (i.e., using paper-and-pencil).

Results

The SDQ subscales obtained from the online administration showed high internal consistency (polychoric ordinal alpha), and confirmatory factor analysis of the SDQ five factor model resulted in excellent fit. The Total Difficulties score of the SDQ and its other subscales were significantly related to the Disruptive Behavior Disorders (DBD) rating scale. Norms for the parent version of SDQ obtained from the Internet were identical to those collected using paper-and-pencil. They were thus combined and are presented sorted by child gender and age.

Conclusions

The SDQ seems to be a reliable and valid instrument given its high internal consistency, clear factor structure and high correlation with other instruments capturing the intended constructs. Findings in the present study support its use for online data collection, as well as using norms obtained through paper-and-pencil-administration even when SDQ has been administrated online.
Parenteral organophosphorus poisoning in a rural emergency department: a case report
Authors: Malla Gyanendra , Basnet Bibhusan , Vohra Rais , Lohani Shyam Prasad , Yadav Ajay , Dhungana Vivek
Published: December 2013

Background

Poisoning is a common presentation in the emergency department. Oral exposures to organophosphorus compounds are especially frequent in rural and agricultural regions of South Asia and throughout the developing world.

Case presentation

Here we report a case of deliberate self-harm with an organophosphorus pesticide via the relatively uncommon parenteral route. A young woman injected herself with chlorpyriphos. Although the cholinergic effects were mild, cellulitis and abscess development were noted as a result.

Conclusion

Resource limited agricultural countries like Nepal present health care workers with numerous challenges in poisoning management. This case represents a rare but potentially morbid method of agrochemical poison exposure.
Circulating levels of soluble MER in lupus reflect M2c activation of monocytes/macrophages, autoantibody specificities and disease activity
Authors: Zizzo Gaetano , Guerrieri Justus , Dittman Lindsay M , Merrill Joan T , Cohen Philip L
Published: December 2013

Introduction

Systemic lupus erythematosus (SLE) is characterized by impaired efferocytosis and aberrant activation of innate immunity. We asked if shedding of MER receptor tyrosine kinase (MerTK) and AXL into soluble (s) ectodomains was related to immunological and clinical aspects of SLE.

Methods

Levels of sMER and sAXL in the plasma of 107 SLE patients and 45 matched controls were measured by ELISA. In 40 consecutive SLE patients, we examined potential correlations between either sMER or sAXL and plasma levels of sCD163, a marker of M2 activation. All three soluble receptors were measured in supernatants of monocytes/macrophages cultured in various immunological conditions. Membrane expression of MerTK, AXL and CD163 was assessed by flow cytometry.

Results

Both sMER and sAXL were associated with anti-chromatin and anti-phospholipid autoantibodies, and with hematological and renal involvement. However, sMER and sAXL did not significantly correlate with each other; sAXL correlated with growth arrest-specific 6 (Gas6), whereas sMER correlated with reduced free protein S (PROS) levels. Only sMER showed significant associations with lupus-specific anti-dsDNA, anti-Sm, anti-ribonucleoprotein (anti-RNP) and anti-Ro60 autoantibodies. Strong correlations with disease activity indices (Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), complement reduction, titer of circulating anti-dsDNA) were found for sMER, not for sAXL. Patients with active SLEDAI, nephritis, anti-dsDNA and anti-Ro60 positivity showed higher levels of sMER compared to controls. Levels of sMER, not sAXL, correlated with sCD163 levels, and these correlated with SLEDAI. Production of sMER and sCD163 occurred under “M2c” polarizing conditions, whereas sAXL was released upon type-I IFN exposure.

Conclusions

Alterations in homeostasis of anti-inflammatory and efferocytic “M2c” monocytes/macrophages may have a role in immunopathogenesis of SLE.
Evaluation of ultra-deep targeted sequencing for personalized breast cancer care
Authors: Harismendy Olivier , Schwab Richard B , Alakus Hakan , Yost Shawn E , Matsui Hiroko , Hasteh Farnaz , Wallace Anne M , Park Hannah L , Madlensky Lisa , Parker Barbara , Carpenter Philip M , Jepsen Kristen , Anton-Culver Hoda , Frazer Kelly A
Published: December 2013

Introduction

The increasing number of targeted therapies, together with a deeper understanding of cancer genetics and drug response, have prompted major healthcare centers to implement personalized treatment approaches relying on high-throughput tumor DNA sequencing. However, the optimal way to implement this transformative methodology is not yet clear. Current assays may miss important clinical information such as the mutation allelic fraction, the presence of sub-clones or chromosomal rearrangements, or the distinction between inherited variants and somatic mutations. Here, we present the evaluation of ultra-deep targeted sequencing (UDT-Seq) to generate and interpret the molecular profile of 38 breast cancer patients from two academic medical centers.

Methods

We sequenced 47 genes in matched germline and tumor DNA samples from 38 breast cancer patients. The selected genes, or the pathways they belong to, can be targeted by drugs or are important in familial cancer risk or drug metabolism.

Results

Relying on the added value of sequencing matched tumor and germline DNA and using a dedicated analysis, UDT-Seq has a high sensitivity to identify mutations in tumors with low malignant cell content. Applying UDT-Seq to matched tumor and germline specimens from the 38 patients resulted in a proposal for at least one targeted therapy for 22 patients, the identification of tumor sub-clones in 3 patients, the suggestion of potential adverse drug effects in 3 patients and a recommendation for genetic counseling for 2 patients.

Conclusion

Overall our study highlights the additional benefits of a sequencing strategy, which includes germline DNA and is optimized for heterogeneous tumor tissues.
Decreased HLA-DR antigen-associated invariant chain (CD74) mRNA expression predicts mortality after septic shock
Authors: Cazalis Marie-Angélique , Friggeri Arnaud , Cavé Laura , Demaret Julie , Barbalat Véronique , Cerrato Elisabeth , Lepape Alain , Pachot Alexandre , Monneret Guillaume , Venet Fabienne
Published: December 2013

Introduction

Septic syndromes remain the leading cause of mortality in intensive care units (ICU). Septic patients rapidly develop immune dysfunctions, the intensity and duration of which have been linked with deleterious outcomes. Decreased mRNA expressions of major histocompatibility complex (MHC) class II-related genes have been reported after sepsis. We investigated whether their mRNA levels in whole blood could predict mortality in septic shock patients.

Methods

A total of 93 septic shock patients were included. On the third day after shock, the mRNA expressions of five MHC class II-related genes (CD74, HLA-DRA, HLA-DMB, HLA-DMA, CIITA) were measured by qRT-PCR and monocyte human leukocyte antigen-DR (mHLA-DR) by flow cytometry.

Results

A significant correlation was found among MHC class II related gene expressions. Among mRNA markers, the best prognostic value was obtained for CD74 (HLA-DR antigen-associated invariant chain). For this parameter, the area under the receiver operating characteristic curve (AUC) was calculated (AUC = 0.67, 95% confidence interval (CI) = 0.55 to 0.79; P = 0.01) as well as the optimal cut-off value. After stratification based on this threshold, survival curves showed that a decreased CD74 mRNA level was associated with increased mortality after septic shock (Log rank test, P = 0.0043, Hazard Ratio = 3.0, 95% CI: 1.4 to 6.5). Importantly, this association remained significant after multivariate logistic regression analysis including usual clinical confounders (that is, severity scores, P = 0.026, Odds Ratio = 3.4, 95% CI: 1.2 to 9.8).

Conclusion

Decreased CD74 mRNA expression significantly predicts 28-day mortality after septic shock. After validation in a larger multicentric study, this biomarker could become a robust predictor of death in septic patients.
Loss of Major Molecular Response As a Trigger for Restarting Tyrosine Kinase Inhibitor Therapy in Patients With Chronic-Phase Chronic Myelogenous Leukemia Who Have Stopped Imatinib After Durable Undetectable Disease
Authors: Rousselot Philippe , Charbonnier Aude , Cony-Makhoul Pascale , Agape Philippe , Nicolini Franck E. , Varet Bruno , Gardembas Martine , Etienne Gabriel , Réa Delphine , Roy Lydia , Escoffre-Barbe Martine , Guerci-Bresler Agnès , Tulliez Michel , Prost Stéphane , Spentchian Marc , Cayuela Jean Michel , Reiffers Josy , Chomel Jean Claude , Turhan Ali , Guilhot Joëlle , Guilhot François , Mahon François-Xavier
Published: December 2013

Purpose

More than half of patients with chronic-phase chronic myelogenous leukemia (CP-CML) in complete molecular response (CMR) experience molecular relapse after imatinib discontinuation. We investigated loss of major molecular response (MMR) as a criterion for resuming therapy.

Patients and Methods

A multicenter observational study (A-STIM [According to Stop Imatinib]) evaluating MMR persistence was conducted in 80 patients with CP-CML who had stopped imatinib after prolonged CMR.

Results

Median time from imatinib initiation to discontinuation was 79 months (range, 30 to 145 months);median duration of CMR before imatinib discontinuation was 41 months (range, 24 to 96 months); median follow-up after discontinuation was 31 months (range, 8 to 92 months). Twenty-nine patients (36%) lost MMR after a median of 4 months off therapy (range, 2 to 17 months). Cumulative incidence of MMR loss was estimated as 35% (95% CI, 25% to 46%) at 12 months and 36% (95% CI, 26% to 47%) at 24 months, whereas probability of losing CMR was higher. Fluctuation of BCR-ABL transcript levels below the MMR threshold (≥ two consecutive positive values) was observed in 31% of patients after imatinib discontinuation. Treatment-free remission was estimated as 64% (95% CI, 54% to 75%) at 12 and 24 months and 61% (95% CI, 51% to 73%) at 36 months. Median to time to second CMR was estimated as 7.3 months in re-treated patients.

Conclusion

Loss of MMR is a practical and safe criterion for restarting therapy in patients with CML with prolonged CMR.
Targeted Androgen Pathway Suppression in Localized Prostate Cancer: A Pilot Study
Authors: Mostaghel Elahe A. , Nelson Peter S. , Lange Paul , Lin Daniel W. , Taplin Mary Ellen , Balk Steven , Ellis William , Kantoff Philip , Marck Brett , Tamae Daniel , Matsumoto Alvin M. , True Lawrence D. , Vessella Robert , Penning Trevor , Hunter Merrill Rachel , Gulati Roman , Montgomery Bruce
Published: December 2013

Purpose

Ligand-mediated activation of the androgen receptor (AR) is critical for prostate cancer (PCa) survival and proliferation. The failure to completely ablate tissue androgens may limit suppression of PCa growth. We evaluated combinations of CYP17A and 5-α-reductase inhibitors for reducing prostate androgen levels, AR signaling, and PCa volumes.

Patients and Methods

Thirty-five men with intermediate/high-risk clinically localized PCa were randomly assigned to goserelin combined with dutasteride (ZD), bicalutamide and dutasteride (ZBD), or bicalutamide, dutasteride, and ketoconazole (ZBDK) for 3 months before prostatectomy. Controls included patients receiving combined androgen blockade with luteinizing hormone-releasing hormone agonist and bicalutamide. The primary outcome measure was tissue dihydrotestosterone (DHT) concentration.

Results

Prostate DHT levels were substantially lower in all experimental arms (0.02 to 0.04 ng/g v 0.92 ng/g in controls; P < .001). The ZBDK group demonstrated the greatest percentage decline in serum testosterone, androsterone, and dehydroepiandrosterone sulfate (P < .05 for all). Staining for AR and the androgen-regulated genes prostate-specific antigen and TMPRSS2 was strongly suppressed in benign glands and moderately in malignant glands (P < .05 for all). Two patients had pathologic complete response, and nine had ≤ 0.2 cm3 of residual tumor (defined as a near-complete response), with the largest numbers of complete and near-complete responses in the ZBDK group.

Conclusion

Addition of androgen synthesis inhibitors lowers prostate androgens below that achieved with standard therapy, but significant AR signaling remains. Tissue-based analysis of steroids and AR signaling is critical to informing the search for optimal local and systemic control of high-risk prostate cancer.
Integrative and Comparative Genomic Analysis of Lung Squamous Cell Carcinomas in East Asian Patients
Authors: Kim Youngwook , Hammerman Peter S. , Kim Jaegil , Yoon Ji-ae , Lee Yoomi , Sun Jong-Mu , Wilkerson Matthew D. , Pedamallu Chandra Sekhar , Cibulskis Kristian , Yoo Yeong Kyung , Lawrence Michael S. , Stojanov Petar , Carter Scott L. , McKenna Aaron , Stewart Chip , Sivachenko Andrey Y. , Oh In-Jae , Kim Hong Kwan , Choi Yong Soo , Kim Kwhanmien , Shim Young Mog , Kim Kyu-Sik , Song Sang-Yun , Na Kook-Joo , Choi Yoon-La , Hayes D. Neil , Kim Jhingook , Cho Sukki , Kim Young-Chul , Ahn Jin Seok , Ahn Myung-Ju , Getz Gad , Meyerson Matthew , Park Keunchil
Published: December 2013

Purpose

Lung squamous cell carcinoma (SCC) is the second most prevalent type of lung cancer. Currently, no targeted therapeutics are approved for treatment of this cancer, largely because of a lack of systematic understanding of the molecular pathogenesis of the disease. To identify therapeutic targets and perform comparative analyses of lung SCC, we probed somatic genome alterations of lung SCC by using samples from Korean patients.

Patients and Methods

We performed whole-exome sequencing of DNA from 104 lung SCC samples from Korean patients and matched normal DNA. In addition, copy-number analysis and transcriptome analysis were conducted for a subset of these samples. Clinical association with cancer-specific somatic alterations was investigated.

Results

This cancer cohort is characterized by a high mutational burden with an average of 261 somatic exonic mutations per tumor and a mutational spectrum showing a signature of exposure to cigarette smoke. Seven genes demonstrated statistical enrichment for mutation: TP53, RB1, PTEN, NFE2L2, KEAP1, MLL2, and PIK3CA). Comparative analysis between Korean and North American lung SCC samples demonstrated a similar spectrum of alterations in these two populations in contrast to the differences seen in lung adenocarcinoma. We also uncovered recurrent occurrence of therapeutically actionable FGFR3-TACC3 fusion in lung SCC.

Conclusion

These findings provide new steps toward the identification of genomic target candidates for precision medicine in lung SCC, a disease with significant unmet medical needs.
Clock Time, National Space, and the Limits of Guomindang Anti-Imperialism
Authors: Tsui Brian
Published: December 2013

This article examines the politics of time and space in Nationalist China in connection with the regime's compromised anti-imperialism. It demonstrates that the Guomindang's nation-building project, which failed to confront capitalist social relations and the imperialist powers that underpinned them, overdetermined the party-state's ambivalent attitude toward modernity. The school campuses on which the Guomindang projected its social vision were, on the one hand, constructed as efficient, mechanical-clock-timed training grounds of wage laborers and, on the other hand, spaces of authenticity and beauty free from social alienation. This search for aestheticized spaces outside capitalism, in combination with a rejection of fundamental social changes, put the Guomindang in ideological league with radical right-wing movements active around the world between the two world wars.

My exposition of the Guomindang's ideological import serves as a critique of recent scholarship that tends to subsume the Guomindang and its peculiar approach to capitalism under a blanket denunciation of modern political movements. Adopting a poststructuralist suspicion of post-Enlightenment rationality, some scholars of China view twentieth-century history as a unilinear succession of nation-states that, regardless of ideological affiliation, destroyed pluralistic local particularities and everyday idiosyncrasies in favor of national unity and industrial productivity. The communist movement is, according to this view, equally guilty as the Guomindang in perpetuating this process. I argue that this one-dimensional reading of political modernity not only trivializes the politics of competing revolutions but abstracts everyday experiences as basic as those of space and time from their embeddedness in larger social relations.