bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing and testing a framework to measure and monitor safety in healthcare
Authors: Illingworth John
Published: June 2014

The NHS excels at measuring incidences of past harm – whether it is falls or hospital-acquired infections – but research undertaken by Charles Vincent, Jane Carthey and Susan Burnett for the Health Foundation suggests past harm is only one element of what is needed to understand how safe care is. The researchers developed a framework to incorporate other necessary elements, such as anticipating and preparing for risks before they lead to harm to patients. In 2013, the Health Foundation road-tested this framework with staff in three NHS organisations and held a two-day summit with leaders from across the healthcare system to get feedback on its potential. This article presents the findings of this phase of work and sets it in the context of recent changes in the policy and regulatory landscape for patient safety in England. It concludes that the framework offers a great deal of potential for supporting organisations to understand the safety of their services. The framework could be most effective when used to identify the relative strengths and weaknesses of current safety measures, and when staff are given sufficient time, resource and support to consider the complex issues surfaced by the questions in the framework. This needs to be matched by a system of regulation which is aligned and mature, and an approach from NHS Trust Boards which welcomes information about the risks of its services.
Peer Training of Community Health Workers to Improve Heart Health Among African American Women
Authors: Josiah Willock Robina , Mayberry Robert M. , Yan Fengxia , Daniels Pamela
Published: June 2014

Introduction. Training community health workers (CHWs) builds a workforce that is essential to addressing the chronic disease crisis. This article describes a highly replicable CHW training program that targets heart disease risk among African American women. Background. African American women suffer disproportionately from heart disease mortality and morbidity. Well-trained CHWs are uniquely positioned to close this disparity gap. Method. We used a Learning Circle approach to train CHWs in heart health education. The curriculum blended web-based, self-directed learning and in-person peer coaching. CHWs learned through (a) peer-to-peer sharing, (b) problem solving and brainstorming, and (c) leadership and experiential activities. Training evaluation measures were CHWs’ (a) self-confidence, (b) heart health knowledge, (c) satisfaction with training, (d) training retention, and (e) replication of training within 90 days after training. Results. This training resulted in appreciable effects on four of five outcome measures. Heart health knowledge increased significantly among experienced CHWs (p = .011). CHWs were satisfied with training and retention was 100%. CHWs initiated and subsequently delivered 122 person hours of community heart health education and CHW training in their communities. Discussion/Conclusion. CHW heart health training using Learning Circles is a practical and replicable method of training CHWs and holds significant potential for building capacity in resource-poor community organizations.
Practical management of patients with chronic myeloid leukemia who develop tyrosine kinase inhibitor-resistant BCR-ABL1 mutations
Authors: Ai Jing , Tiu Ramon V.
Published: June 2014

Five BCR-ABL1 tyrosine kinase inhibitors (TKIs), imatinib, nilotinib, dasatinib, bosutinib, and ponatinib, are currently approved for the treatment of chronic myeloid leukemia (CML). Standard treatment of CML with TKIs is highly effective in reducing disease burden, delaying disease progression, and prolonging overall survival of patients; however, resistance to TKI treatment has become an increasingly important cause of treatment failure. The emergence of mutations in the BCR-ABL1 kinase domain is a common mechanism of TKI resistance, and laboratory testing to detect these mutations is currently available for clinical use. Patients who do not respond or have lost their response to TKI therapy should be considered for mutational testing. Despite clinical practice guidelines that recommend testing for BCR-ABL1 mutations in patients with clinical signs of TKI resistance, many oncologists and hematologists managing patients with CML do not perform such testing. This review addresses outstanding questions related to when testing should be conducted, what type of testing should be done, and how testing results should be applied to subsequent therapeutic decisions. It describes how BCR-ABL1 kinase domain mutations confer resistance, outlines the prevalence of mutations in patients with resistance to TKIs, summarizes the common and investigational methods used in mutational testing, and presents an algorithm reflecting a clinical perspective on how and when to conduct mutational testing, and what to do with test results.
Analysis of energy utilisation efficiency in laser–GTA hybrid welding process
Authors: Liu L. , Li C. , Shi J.
Published: June 2014

The effect of welding parameters on energy utilisation efficiency in laser–gas tungsten arc (GTA) hybrid welding process is investigated. Then, optimum butt joints are made by laser welding, GTA welding and laser–GTA hybrid welding, and the energy consumption in each process is calculated and compared. Both plasma and keyhole behaviours are studied. Results indicate that the parameter Dla greatly affects the energy utilisation efficiency in hybrid welding. The reason is that Dla determines keyhole behaviour and laser induced plasma, and these determine the coupling discharge of laser induced and GTA plasmas. Compared with laser and GTA welding, hybrid welding is more energy efficient.
ALK-negative anaplastic large cell lymphoma is a genetically heterogeneous disease with widely disparate clinical outcomes
Authors: Parrilla Castellar Edgardo R. , Jaffe Elaine S. , Said Jonathan W. , Swerdlow Steven H. , Ketterling Rhett P. , Knudson Ryan A. , Sidhu Jagmohan S. , Hsi Eric D. , Karikehalli Shridevi , Jiang Liuyan , Vasmatzis George , Gibson Sarah E. , Ondrejka Sarah , Nicolae Alina , Grogg Karen L. , Allmer Cristine , Ristow Kay M. , Wilson Wyndham H. , Macon William R. , Law Mark E. , Cerhan James R. , Habermann Thomas M. , Ansell Stephen M. , Dogan Ahmet , Maurer Matthew J. , Feldman Andrew L.
Published: June 2014

Key Points

ALK-negative ALCLs have chromosomal rearrangements of DUSP22 or TP63 in 30% and 8% of cases, respectively. DUSP22-rearranged cases have favorable outcomes similar to ALK-positive ALCLs, whereas other genetic subtypes have inferior outcomes.
Associations between impulsivity, aggression, and suicide in Chinese college students
Authors: Wang Lin , He Chang Zhi , Yu Yun Miao , Qiu Xiao Hui , Yang Xiu Xian , Qiao Zheng Xue , Sui Hong , Zhu Xiong Zhao , Yang Yan Jie
Published: June 2014

Background

Although there are accumulating data regarding the epidemiology of suicide in China, there are meager data on suicidal ideation and attempts among college students. Interestingly, elevated impulsivity is thought to facilitate the transition from suicidal thoughts to suicidal behavior. Therefore, the objective of this research was to identify the associations between suicide and the personality factors of impulsivity and aggression.

Methods

This study’s sampling method employed stratified random cluster sampling. A multi-stage stratified sampling procedure was used to select participants (n = 5,245). We conducted structured interviews regarding a range of socio-demographic characteristics and suicidal morbidity. The Patient Health Questionnaire depression module (PHQ-9) was used to acquire the information about thoughts of being better off dead or hurting themselves in some ways during the past two weeks. The impulsivity symptoms in this study were assessed with the BIS-11-CH (i.e., the Chinese version of the BIS-11), and the Aggressive symptoms were assessed with the BAQ. The statistical package for social science (SPSS) v.13.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Socio-demographic variables such as ethnic and gender were compared between groups, through the use of χ
2 tests. The nonparametric test (k Independent Sample test, Kruskal-Wallis H) was performed to determine differences between the personality factors of impulsivity and aggression and suicide.

Results

In total, 9.1% (n = 479) of the 5,245 students reported they have ever thought about committing suicide; and 1% (n = 51) reported a history of attempted suicide (attempters). The analyses detected significant differences in scores on cognitive impulsivity (p < 0.01), when comparing individuals who only had suicidal ideation and individuals who had attempted suicide. Moreover, significant differences were found between ideators only and attempters on scores of self-oriented attack (p < .001).

Conclusions

Suicidal ideation is prevalent among Chinese university students. Students with high aggression scores were more susceptible to committing suicide. Scores on self-oriented attack and cognitive impulsivity may be important factors for differentially predicting suicide ideation and suicide attempts.
Body image in idiopathic scoliosis: a comparison study of psychometric properties between four patient-reported outcome instruments
Authors: Matamalas Antonia , Bagó Joan , D'Agata Elisabetta , Pellisé Ferran
Published: June 2014

Background

Four patient-reported outcome (PRO) instruments are commonly used to assess body image in idiopathic scoliosis (IS): the Quality of Life Profile for Spinal Deformities (QLPSD), SRS-22 Self-Image scale, Spinal Appearance Questionnaire (SAQ), and Trunk Appearance Perception Scale (TAPS). The aim of this study is to compare the psychometric properties of these instruments in patients with IS and report the translational/cultural adaptation of the SAQ to Spanish.

Methods

The four instruments in a Spanish version were administered to 80 patients with IS aged 10 to 40 years old. The sample was stratified according to scoliosis magnitude (less and more than 45º). Analysis was also conducted for age groups. The psychometric properties studied included convergent and divergent construct validity, as well as internal consistency. Convergent validity was evaluated by correlation analysis between the self-image instruments and Cobb angle. Divergent validity was assessed with correlation analysis between PRO scores and SRS-22 dimensions scores such as Function, Pain and Mental Health.

Results

In the overall sample, each of the PRO instruments demonstrated high internal consistency (QLPSD Body Image, α = 0.80; SRS-22 Self Image, α = 0.78; SAQ, α = 0.89; TAPS, α = 0.87), also both for younger and adult patients subgroups. Correlation with curve magnitude was significant for each of the four scales. However, the correlation was higher for the pictorial scales (SAQ Appearance r = 0.61, TAPS r = - 0.62) than for the textual scales (QLPSD-bi r = 0.36, SRS-22 Self-Image scale r = - 0.41). In the younger group, correlation between Cobb angle and textual scales (QLPSD-bi and SRS-22 Self-Image Scale) was not significant. Body Image scales showed significant correlations with SRS-22 Pain, Function and Mental Health dimensions.

Conclusions

All four instruments tested have good psychometric properties. Pictorial scales (SAQ Appearance and TAPS) correlated better with the radiological magnitude of the curve and this correlation is independent of age. Unexpectedly, all four scales demonstrated significant correlations with non-body image dimensions and the divergent hypothesis was not confirmed. Globally, pictorial scales showed slightly better construct validity to test body image perception than textual scales.
Familial urothelial cell carcinoma of the bladder with autosomal dominant inheritance and late onset phenotype
Authors: Brown Robin , Donnelly Deirdre E , Allen Derek , Loughrey Maurice B , Morrison Patrick J
Published: June 2014

Objective

Familial Urothelial cell bladder cancer is rare. We report two families with urothelial cell carcinoma (UCC) of bladder with family history in other relatives, displaying probable autosomal dominant inheritance and a late onset pure UCC phenotype, and document the phenotype in each family.

Methods

Descriptive familial study on two pedigrees over three generations.

Results

Two families with UCC bladder were identified, and the phenotype documented, each family having three cases of late onset UCC.

Conclusion

Some cases of UCC are hereditary and may display autosomal dominant inheritance with late onset of the cancer. Clinicians should be aware of the existence of a familial late onset UCC phenotype when managing cases of UCC.
Rare key functional domain missense substitutions in MRE11A, RAD50, and NBNcontribute to breast cancer susceptibility: results from a Breast Cancer Family Registry case-control mutation-screening study
Authors: Damiola Francesca , Pertesi Maroulio , Oliver Javier , Le Calvez-Kelm Florence , Voegele Catherine , Young Erin L , Robinot Nivonirina , Forey Nathalie , Durand Geoffroy , Vallée Maxime P , Tao Kayoko , Roane Terrell C , Williams Gareth J , Hopper John L , Southey Melissa C , Andrulis Irene L , John Esther M , Goldgar David E , Lesueur Fabienne , Tavtigian Sean V
Published: June 2014

Introduction

The MRE11A-RAD50-Nibrin (MRN) complex plays several critical roles related to repair of DNA double-strand breaks. Inherited mutations in the three components predispose to genetic instability disorders and the MRN genes have been implicated in breast cancer susceptibility, but the underlying data are not entirely convincing. Here, we address two related questions: (1) are some rare MRN variants intermediate-risk breast cancer susceptibility alleles, and if so (2) do the MRN genes follow a BRCA1/BRCA2 pattern wherein most susceptibility alleles are protein-truncating variants, or do they follow an ATM/CHEK2 pattern wherein half or more of the susceptibility alleles are missense substitutions?

Methods

Using high-resolution melt curve analysis followed by Sanger sequencing, we mutation screened the coding exons and proximal splice junction regions of the MRN genes in 1,313 early-onset breast cancer cases and 1,123 population controls. Rare variants in the three genes were pooled using bioinformatics methods similar to those previously applied to ATM, BRCA1, BRCA2, and CHEK2, and then assessed by logistic regression.

Results

Re-analysis of our ATM, BRCA1, and BRCA2 mutation screening data revealed that these genes do not harbor pathogenic alleles (other than modest-risk SNPs) with minor allele frequencies >0.1% in Caucasian Americans, African Americans, or East Asians. Limiting our MRN analyses to variants with allele frequencies of <0.1% and combining protein-truncating variants, likely spliceogenic variants, and key functional domain rare missense substitutions, we found significant evidence that the MRN genes are indeed intermediate-risk breast cancer susceptibility genes (odds ratio (OR) = 2.88, P = 0.0090). Key domain missense substitutions were more frequent than the truncating variants (24 versus 12 observations) and conferred a slightly higher OR (3.07 versus 2.61) with a lower P value (0.029 versus 0.14).

Conclusions

These data establish that MRE11A, RAD50, and NBN are intermediate-risk breast cancer susceptibility genes. Like ATM and CHEK2, their spectrum of pathogenic variants includes a relatively high proportion of missense substitutions. However, the data neither establish whether variants in each of the three genes are best evaluated under the same analysis model nor achieve clinically actionable classification of individual variants observed in this study.
Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults
Authors: van Genderen Michel E , Paauwe Jorden , de Jonge Jeroen , van der Valk Ralf JP , Lima Alexandre , Bakker Jan , van Bommel Jasper
Published: June 2014

Introduction

Altered peripheral perfusion is strongly associated with poor outcome in critically ill patients. We wanted to determine whether repeated assessments of peripheral perfusion during the days following surgery could help to early identify patients that are more likely to develop postoperative complications.

Methods

Haemodynamic measurements and peripheral perfusion parameters were collected one day prior to surgery, directly after surgery (D0) and on the first (D1), second (D2) and third (D3) postoperative days. Peripheral perfusion assessment consisted of capillary refill time (CRT), peripheral perfusion index (PPI) and forearm-to-fingertip skin temperature gradient (Tskin-diff). Generalized linear mixed models were used to predict severe complications within ten days after surgery based on Clavien-Dindo classification.

Results

We prospectively followed 137 consecutive patients, from among whom 111 were included in the analysis. Severe complications were observed in 19 patients (17.0%). Postoperatively, peripheral perfusion parameters were significantly altered in patients who subsequently developed severe complications compared to those who did not, and these parameters persisted over time. CRT was altered at D0, and PPI and Tskin-diff were altered on D1 and D2, respectively. Among the different peripheral perfusion parameters, the diagnostic accuracy in predicting severe postoperative complications was highest for CRT on D2 (area under the receiver operating characteristic curve = 0.91 (95% confidence interval (CI) = 0.83 to 0.92)) with a sensitivity of 0.79 (95% CI = 0.54 to 0.94) and a specificity of 0.93 (95% CI = 0.86 to 0.97). Generalized mixed-model analysis demonstrated that abnormal peripheral perfusion on D2 and D3 was an independent predictor of severe postoperative complications (D2 odds ratio (OR) = 8.4, 95% CI = 2.7 to 25.9; D2 OR = 6.4, 95% CI = 2.1 to 19.6).

Conclusions

In a group of patients assessed following major abdominal surgery, peripheral perfusion alterations were associated with the development of severe complications independently of systemic haemodynamics. Further research is needed to confirm these findings and to explore in more detail the effects of peripheral perfusion–targeted resuscitation following major abdominal surgery.
Wave attenuation in partially saturated porous rocks — New observations and interpretations across scales
Authors: Caspari Eva , Qi Qiaomu , Lopes Sofia , Lebedev Maxim , Gurevich Boris , Rubino J. Germán , Velis Danilo R. , Clennell Michael B. , Müller Tobias M.
Published: June 2014

Seismic waves propagating in porous rocks saturated with two immiscible fluids can be strongly attenuated. Predicting saturation effects on seismic responses requires a sound understanding of attenuation and velocity dependencies on the fluid distribution. Decoding these effects involves interpreting laboratory experiments, analyzing well-log data, and performing numerical simulations. Despite striking differences among scales, flow regimes, and frequency bands, some aspects of wave attenuation can be explained with a single mechanism — wave-induced pressure diffusion. Different facets of wave-induced pressure diffusion can be revealed across scales.
A laboratory study of low-frequency wave dispersion and attenuation in water-saturated sandstones
Authors: Mikhaltsevitch Vassily , Lebedev Maxim , Gurevich Boris
Published: June 2014

Laboratory measurements of elastic and anelastic parameters of dry and water-saturated sandstones with low (0.7- and 1.1-mD) and high (425-mD) permeability have been conducted at seismic frequencies (0.1 to 120 Hz). The experiments were performed with a laboratory apparatus that measures the stress-strain relationship in the linear regime. The extensional attenuation in water-saturated low-permeability sandstones exhibits prominent peaks in the seismic band, accompanied by considerable dispersion. Variations in attenuation and dispersion in the high-permeability sandstone are below the measurement error, as is the moduli dispersion in all the sandstones in dry condition. The experiments demonstrate that for low-permeability rocks, seismic frequencies do not necessarily correspond to the low-frequency limit (relaxed pore-fluid pressures) of acoustic wave dispersion.
Long-wave elastic attenuation produced by horizontal layering
Authors: Liner Christopher L.
Published: June 2014

Geometric (or apparent) attenuation arises from layering in the earth. One can argue that it is possible to estimate local, layer-induced attenuation factors (QP, QS) from full-wave sonic and density logs. The argument has three components: Backus-averaging theory of dispersion in layered elastic media, field studies suggesting that layer-induced attenuation is constant Q in nature, and constant-Q theory that connects dispersion and attenuation. This approach implies local negative-Q values for intervals that exhibit reverse dispersion (high frequencies travel slower than low frequencies). This will always be the case for isolated low-velocity layers observed in sonic logs scaled down to surface-seismic exploration frequencies.
Seismic-frequency loss mechanisms: Direct observation
Authors: Batzle Michael L. , Kumar Gautam , Hofmann Ronny , Duranti Luca , Adam Ludmila
Published: June 2014

Direct measurement of seismic attenuation (1/Q) and velocity dispersion in the laboratory point to several independent loss mechanisms. A forced-deformation technique allows measurement at seismic frequencies and amplitudes. Fluid motion is the primary mechanism in porous, permeable clastics. In shales, bulk-fluid motion is inhibited, and clay-particle interaction with bound water might dominate. Another mechanism usually not considered is losses in the fluid phase alone. Heavy, viscous fluids show bulk losses independent of a rock matrix. All these loss mechanisms are frequency dependent, so observations of 1/Q made at seismic frequencies usually will not agree with ultrasonic data. Attenuation and velocity dispersion are coupled processes, and validity of the frequency-dependent 1/Q values can be checked by comparison with observed velocity dispersion over a broad frequency range.
Geophysics Bright Spots
Authors: Stockwell John W.
Published: June 2014

The “Bright Spots” in this month's issue covers a broad spectrum of topics in the May-June issue of Geophysics — an integrated application of seismic reflection/refraction/HTEM data, fracture parameter inversion in the Marcellus Shale, an application of dynamic warping to seismic-to-well-log ties, and a clever method of extracting density from the amplitudes of converted-wave data.
State of the Net
Authors: Swiney Mick
Published: June 2014

In September of last year, regular subscribers to SEG's electronic monthly newsletter, the Extra, noticed that this must-read digest of all things SEG had begun to sport a fresh new design and more streamlined content. And now? SEG's Extra is ready to carry your promotional messages to more than 70,000 readers.
Distant Invasive Breast Cancer Recurrence Risk in Human Epidermal Growth Factor Receptor 2–Positive T1a and T1b Node-Negative Localized Breast Cancer Diagnosed From 2000 to 2006: A Cohort From an Integrated Health Care Delivery System
Authors: Fehrenbacher Louis , Capra Angela M. , Quesenberry Charles P. , Fulton Regan , Shiraz Parveen , Habel Laurel A.
Published: June 2014

Purpose

To determine the invasive recurrence (IR) risk among patients with small, node-negative human epidermal growth factor receptor 2 (HER2) –positive breast cancer.

Patients and Methods

Among 16,975 consecutive patients with invasive breast cancer diagnosed from January 1, 2000, to December 31, 2006, in a large, integrated health care system, we identified a cohort of 234 patients with HER2-positive T1aN0M0 or T1bN0M0 (T1abN0M0) disease with a median follow-up of 5.8 years. Kaplan-Meier methods were used to estimate the percentage of patients who were free of invasive recurrence (recurrence-free interval [RFI]) at 5 years for both distant (DRFI) and local (LRFI) recurrences.

Results

Of 15 IRs, 47% were locoregional only. Among T1ab patients not treated with adjuvant trastuzumab or chemotherapy (n = 171), the 5-year invasive DRFI was 98.2% (95% CI, 94.5% to 99.4%); it was 99.0% (95% CI, 93.0% to 99.9%) for T1a patients, and 97.0% (95% CI, 88.6% to 99.2%) for T1b patients. Locoregional plus distant 5-year invasive RFI was 97.0% (95% CI, 90.9% to 99.0%) for T1a and 91.9% (95% CI, 81.5% to 96.6%) for T1b patients; it was 89.4% (95% CI, 70.6% to 96.5%) for T1b tumors reported at 1.0 cm. T1b tumors reported at 1.0 cm accounted for 24% of the T1ab cohort, 61% of the cohort total tumor volume, and 75% of distant recurrences. Invasive RFI for T1b 1.0 cm tumors was lower than that for T1a tumors: 84.5% versus 97.4% (P = .009).

Conclusion

The distant IR risk of T1a HER2-positive breast cancer appears quite low. The distant IR risk in T1b patients, particularly those with 1.0-cm tumors, is higher. Potential risk differences for T1a and T1b, including the 1.0-cm tumors, should be considered when making treatment decisions.
Combination of International Scoring System 3, High Lactate Dehydrogenase, and t(4;14) and/or del(17p) Identifies Patients With Multiple Myeloma (MM) Treated With Front-Line Autologous Stem-Cell Transplantation at High Risk of Early MM Progression–Related Death
Authors: Moreau Philippe , Cavo Michele , Sonneveld Pieter , Rosinol Laura , Attal Michel , Pezzi Annalisa , Goldschmidt Hartmut , Lahuerta Juan Jose , Marit Gerald , Palumbo Antonio , van der Holt Bronno , Bladé Joan , Petrucci Maria Teresa , Neben Kai , san Miguel Jesus , Patriarca Francesca , Lokhorst Henk , Zamagni Elena , Hulin Cyrille , Gutierrez Norma , Facon Thierry , Caillot Denis , Benboubker Lotfi , Harousseau Jean-Luc , Leleu Xavier , Avet-Loiseau Hervé , Mary Jean-Yves
Published: June 2014

Purpose

To construct and validate among patients with multiple myeloma (MM) who were treated with intensive therapy a prognostic index of early MM progression–related death.

Patients and Methods

Patient-level data from the Intergroupe Francophone du Myélome (IFM) 2005-01 trial (N = 482) were used to construct the prognostic index. The event was MM progression–related death within 2 years from treatment initiation. The index was validated using data from three other trials: the Gruppo Italiano Malattie Ematologiche dell' Adulto (GIMEMA) 26866138-MMY-3006 trial (N = 480), the Programa para el Estudio de la Terapéutica en Hemopatía Maligna (PETHEMA)–GEMMENOS65 trial (N = 390), and the Hemato-Oncologie voor Volwassenen Nederland (HOVON) –65/German-Speaking Myeloma Multicenter Group (GMMG) –HD4 trial (N = 827).

Results

The risk of early MM progression–related death was related to three independent prognostic variables: lactate dehydrogenase (LDH) higher than than normal, International Staging System 3 (ISS3), and adverse cytogenetics [t(4;14) and/or del(17p)]. These three variables enabled the definition of an ordinal prognostic classification composed of four scores (0 to 3). Patients with a score of 3, defined by the presence of t(4;14) and/or del(17p) in addition to ISS3 and/or high LDH, comprised 5% (20 of 387 patients) to 8% (94 of 1,139 patients) of the patients in the learning and validation samples, respectively, and they had a very poor prognosis. When applied to the population of 855 patients who had received bortezomib-based induction therapy in the four trials, the prognostic classification was also able to segregate patients into four categories, with a very poor prognosis attributed to patients with a score of 3.

Conclusion

Our model allows the simple definition of a subgroup of MM patients at high risk of early MM progression–related death despite the use of the most modern and effective strategies.
Circulating Tumor Cells and Response to Chemotherapy in Metastatic Breast Cancer: SWOG S0500
Authors: Smerage Jeffrey B. , Barlow William E. , Hortobagyi Gabriel N. , Winer Eric P. , Leyland-Jones Brian , Srkalovic Gordan , Tejwani Sheela , Schott Anne F. , O'Rourke Mark A. , Lew Danika L. , Doyle Gerald V. , Gralow Julie R. , Livingston Robert B. , Hayes Daniel F.
Published: June 2014

Purpose

Increased circulating tumor cells (CTCs; five or more CTCs per 7.5 mL of whole blood) are associated with poor prognosis in metastatic breast cancer (MBC). A randomized trial of patients with persistent increase in CTCs tested whether changing chemotherapy after one cycle of first-line chemotherapy would improve the primary outcome of overall survival (OS).

Patients and Methods

Patients with MBC who did not have increased CTCs at baseline remained on initial therapy until progression (arm A). Patients with initially increased CTCs that decreased after 21 days of therapy remained on initial therapy (arm B). Patients with persistently increased CTCs after 21 days of therapy were randomly assigned to continue initial therapy (arm C1) or change to an alternative chemotherapy (arm C2).

Results

Of 595 eligible and evaluable patients, 276 (46%) did not have increased CTCs (arm A). Of those with initially increased CTCs, 31 (10%) were not retested, 165 were assigned to arm B, and 123 were randomly assigned to arm C1 or C2. No difference in median OS was observed between arm C1 and C2 (10.7 and 12.5 months, respectively; P = .98). CTCs were strongly prognostic. Median OS for arms A, B, and C (C1 and C2 combined) were 35 months, 23 months, and 13 months, respectively (P < .001).

Conclusion

This study confirms the prognostic significance of CTCs in patients with MBC receiving first-line chemotherapy. For patients with persistently increased CTCs after 21 days of first-line chemotherapy, early switching to an alternate cytotoxic therapy was not effective in prolonging OS. For this population, there is a need for more effective treatment than standard chemotherapy.
Before the “Inward Turn”: Tracing Represented Thought in the French Novel (1800-1929)
Authors: Conroy Melanie
Published: June 2014

Literary historians have long made an issue of the extent to which the modernist novel broke with conventions established in the nineteenth century. One of the most debated questions is the occurrence, or dating, of an “inward turn,” a rupture with the external orientation of the realist and the naturalist novels, in favor of greater psychological depth and complexity. Such a turn has been located in the early years of modernism by critics like Robert Humphrey (1954), Malcolm Bradbury (1995 [1976]), and Stanley Sultan (1987) and in the late nineteenth century by scholars like Morton Levitt (2006) and Pericles Lewis (2007). One of the most common but seldom tested presuppositions about the alleged “inward turn” is that the linguistic innovations of the modernist period helped portray the mental states of characters in a more advanced manner. This article reviews the debates on the differences between realist and modernist forms of thought representation and uses quantitative techniques to determine whether, and to what extent, there was linguistic and stylistic innovation in how the French novel represented thought before and during the “inward turn” of the 1910s and 1920s. By tracing the use of reporting clauses and mental verbs (e.g., “she thought” and “he said to himself”) in a large sample of nineteenth-century and early twentieth-century French fiction, I measure the frequency of several key markers of represented thought in a range of novels, authors, and decades between 1800 and 1929. I conclude that these common reporting clauses and mental verbs appeared in a wide variety of texts, particularly in the French novels of the 1830s, 1910s, and 1920s, alongside other, “free” techniques, which are more often studied. There is, thus, very little evidence that such “free” forms (notably free indirect thought) displaced their marked counterparts (e.g., plain indirect thought). Indeed, the modernist “inward turn” in France, on which this article concentrates, included a continued recourse to the supposedly more “primitive” (i.e., marked) forms of thought representation associated with the realist novel: the 1910s and 1920s even saw an increase in markers of represented thought that were frequently used in the nineteenth-century French novel.
Ideal Foundations of Human Being in Culture: Socio-Philosophical and Ontological Aspects of Morals
Authors: Копылов Сергей , Kopylov Sergey , Шелекета Владислав , Sheleketa Vladislav
Published: June 2014

The article deals with an acute issue of modern theory of morals, namely, the ontological foundations of morals. According to the authors, morals, as well as human psychological activity in general, have an objective origin and roots. The authors´ idea is based on Jung´s theory of psychoanalysis. The authors claim that such central philosophical problems as the problem of the ideal and the correlation between the objective and the subjective can be solved provided the ontological basis is recognized as underlying all manifestations of the ideal, which is further interpreted through arts, social and moral norms. Thus, the ideal content of the individual and the collective consciousness is viewed through the lens of archetypes, which constitute the narrative content of works of art. Furthermore, the authors ´conception of the ontologically based ideal serves to support the idea of the negative influence of subjectivity as lacking the objective and moral content of the ideal reflecting the activity of the individual and the collective consciousness.

The authors are convinced that every phenomenon of individual consciousness stems from archetypes, which are the basis for feelings, thoughts etc. This approach originates from the theoretical and

methodological principles of psychoanalysis. At the same time, the innovative stance of the approach postulates the existence of archetypes promoting harmonic view and sense of the world, which share the objective moral character. In this respect, phenomena of collective consciousness individually manifest their identity in terms of pandemic unity.

Thus, suprareflexity, unambiguity and regulative character of morals reveal themselves, and the spiritual is viewed as the most harmonic route for subjectifing activity of consciousness in accordance with the principal holistic «matrices», patterns of idealizing activity. The authors see conformity with these supraindividual matrices as the manifestation of the positive character of the life of society. From this perspective, morals are regarded as an expression of the necessity to adhere to definite ontological criteria of proper conduct and thinking.
Contemporary Approaches to Classification of Organization- and Company-Consumed Services
Authors: Поворина Елена , Povorina Elena
Published: June 2014

With the establishment of a set of activities whose agents function as contractors and providers of service facilitating and promoting the service consumers´ entrepreneurial, managerial, financial and economic, as well as industrial, processes, contemporary economy has seen the interaction between companies and organizations going beyond purely industrial co-operation. The inter-business-entity relationship is gaining economic momentum. However, scientists differ as regards the classification of organization- and company-consumed services. It is only a limited number of services, such as business, professional, and intellectual, that have attracted high research effort and are relatively well-explored, with the totality of company- and organization-oriented services still under-researched.

The author has conducted an analysis of service-grouping classification criteria, the results of which serve to emphasize the expediency of major classification criteria identification and of working out a classification based on the principles of the differentiated approach to defining the company- and organization-consumed service market with the view to identifying the common properties and shared characteristics of various services.
Rusologia as a complex scientific study of Early Rus
Authors: Чудинов Валерий , Chudinov Valeriy
Published: June 2014

The article provides a definition of a prospective complex scientific discipline on Rus — rusologia (russologie). The author dwells on the resource-base and borrowed names of individual periods of history of Rus, demonstrates nomination analogies relevant for a complex historical study of states other than Rus, and lists innovative scientific methods peculiar to this particular discipline.

The article contains illustrations, which serve to demonstrate the potential of the new epigraphic research methods, and presents critical views of them, as well as the author´s arguments in their favour.

The author dares to assume that rusologia (russologie) is to become a complex scientific discipline, a distinct study of Rus and its inhabitants (the rusiches). With Rus´s population worshiping different Vedic gods on an alternating basis, the author deems it consistent to nominalise each period of Rus´s history accordingly. Thus, the subdisciplines of rusologia (rossulogie) are Mokosh/ (Mokos) — rusologia, Mara-rusologia, Rod-rusologia, Yar-rusologia, Arctorusologia, Slavic-rusologia and Pre-Romanov-rusologia. Each subdiscipline is responsible for a particular period of the historical development of Rus and the rusiches. Later periods are central to the study of such disciplines as Russian cultural anthropology, Russian historiography, the old and modern Russian language etc.
The Effect of Content on Global Internet Adoption and the Global “Digital Divide”
Authors: Viard V. Brian , Economides Nicholas
Published: June 2014

A country's human capital and economic productivity increasingly depend on the Internet as a result of its expanding role in providing information and communications. This has prompted a search for ways to increase Internet adoption and narrow its disparity across countries—the global “digital divide.” Previous work has focused on demographic, economic, and infrastructure determinants of Internet access that are difficult to change in the short run. Internet content increases adoption and can be changed more quickly; however, the magnitude of its impact, and therefore its effectiveness as a policy and strategy tool, has until now been unknown. Quantifying the role of content is challenging because of feedback (network effects) between content and adoption: more content stimulates adoption, which in turn increases the incentive to create content. We develop a methodology to overcome this endogeneity problem. We find a statistically and economically significant effect, implying that policies promoting content creation can substantially increase adoption. Because it is ubiquitous, Internet content is also useful to effect social change across countries. Content has a greater effect on adoption in countries with more disparate languages, making it a useful tool to overcome linguistic isolation. Our results offer guidance for policymakers on country characteristics that influence adoption's responsiveness to content and for Internet firms on where to expand internationally and how to quantify content investments.

This paper was accepted by Lorin Hitt, information systems.
How structural factors promote instrumental motivations within youth volunteering: a qualitative analysis of volunteer brokerage
Authors: Dean Jon
Published: June 2014

This article presents a structural, multi-level analysis, showing how volunteering policy, specific volunteering programmes and operational practices in volunteer brokerage organisations promote instrumental motivations in young volunteers. Through evidence drawn from a qualitative study of youth volunteering brokerage workers and volunteering policy-practitioners, it is shown how young people are increasingly pressured into volunteering, and into seeing volunteering as primarily a route into employment. Volunteer recruiters do not challenge these structural factors; instead, employability and easing the transition to work and university form a large part of ‘selling’ volunteering, with young people encouraged to trade their time for experience. It is concluded that these findings fit into a wider theoretical narrative about the changing nature of volunteering, and have the potential to create significant problems for volunteer-involving organisations.
White middle-class families and urban comprehensives: the struggle for social solidarity in an era of amoral familism
Authors: Reay Diane
Published: June 2014

This article examines the extent to which families can operate against the dominant practices of the societies they are part of by focusing on a specific fraction of the white middle classes: those who can be seen to be acting against the grain of white middle-class orthodoxy by sending their children to schools with a substantial percentage of working-class and/or minority ethnic students. Drawing on concepts of ‘amoral familism’ and ‘social solidarity’, it explores the tensions the families confront between a strong commitment to comprehensive schooling and a wider collectivity, and a more narrow inward focus on the interests of the immediate family to the exclusion of wider society. It concludes that as long as neoliberalism remains the dominant ideology, there is little hope for the development of new ways of ‘doing family’ that involve looking out in inclusive open ways rather than focusing inwards in exclusive, and often excluding, ways.
Existence of positive periodic solutions for fourth-order nonlinear neutral differential equations with variable delay
Authors: Ardjouni Abdelouaheb , Rezaiguia Ali , Djoudi Ahcene
Published: June 2014

In this article we study the existence of positive periodic solutions for a
fourth-order nonlinear neutral differential equation with variable delay. The
main tool employed here is the Krasnoselskii's fixed point theorem dealing
with a sum of two mappings, one is a contraction and the other one is completely continuous.
Landesbibliothek Coburg – eine Bibliothek zwischen den Ländern
Authors: Pfister Silvia
Published: June 2014

Im Mittelpunkt steht die wechselvolle Geschichte der Landesbibliothek Coburg. Die ehemalige Bibliothek eines thüringischen Herzogtums gehört seit 1973 zu den regionalen Staatlichen Bibliotheken in Bayern. In den letzten 200 Jahren wechselte ihre Verwaltung mehrfach. Die Folge sind wiederholte strukturelle Neuanfänge und in der Konsequenz eine große Zahl von Sammlungen von oft herausragender Qualität. Diese gilt es in die neuen virtuellen Bücherwelten zu integrieren.
Development, Implementation and Evaluation of a Peer Review of Teaching (PRoT) Initiative in Nursing Education
Authors: Mager Diana R. , Kazer Meredith W. , Conelius Jaclyn , Shea Joyce , Lippman Doris T. , Torosyan Roben , Nantz Kathryn
Published: June 2014

For many years, an area of research in higher education has been emerging around the development and implementation of fair and effective peer evaluation programs. Recently, a new body of knowledge has developed regarding the development and implementation of fair and effective peer evaluation programs resulting in formative and summative evaluations. The purpose of this article is to describe the development, implementation, and evaluation of a peer review of teaching (PRoT) program for nursing faculty, initiated at one small comprehensive university in the northeastern United States. Pairs of nursing faculty evaluated each other’s teaching, syllabi, and course materials after collaborating in a pre-evaluation conference to discuss goals of the classroom visit. Qualitative data gathered in post project focus groups revealed that faculty found their modified PRoT process to be a mutually beneficial experience that was more useful, flexible and collegial, and less stressful than their previous evaluation process.
Haemophilia and Joint Disease: Pathophysiology, Evaluation, and Management
Authors: Knobe Karin , Berntorp Erik
Published: June 2014

In patients with haemophilia, regular replacement therapy with clotting factor concentrates (prophylaxis) is effective in preventing recurrent bleeding episodes into joints and muscles. However, despite this success, intra-articular and intramuscular bleeding is still a major clinical manifestation of the disease. Bleeding most commonly occurs in the knees, elbows, and ankles, and is often evident from early childhood. The pathogenesis of haemophilic arthropathy is multifactorial, with changes occurring in the synovium, bone, cartilage, and blood vessels. Recurrent joint bleeding causes synovial proliferation and inflammation (haemophilic synovitis) that contribute to end-stage degeneration (haemophilic arthropathy); with pain and limitation of motion severely affecting patients’ quality of life. If joint bleeding is not treated adequately, it tends to recur, resulting in a vicious cycle that must be broken to prevent the development of chronic synovitis and degenerative arthritis. Effective prevention and management of haemophilic arthropathy includes the use of early, aggressive prophylaxis with factor replacement therapies, as well as elective procedures, including restorative physical therapy, analgesia, aspiration, synovectomy, and orthopaedic surgery. Optimal treatment of patients with haemophilia requires a multidisciplinary team comprising a haematologist, physiotherapist, orthopaedic practitioner, rehabilitation physician, occupational therapist, psychologist, social workers, and nurses.
The Acute Oncologist's Role in Managing Patients with Cancer and other Comorbidities
Authors: Shankland Kate , Kirkbride Peter , Bourke Anne-Marie , Price James , Walkington Lucy , Danson Sarah
Published: June 2014

Background

An Acute Oncology Service (AOS) is paramount to providing timely and improved pathways of care for patients who are admitted to hospital with cancer-related problems or suspected cancer.

Objective

To establish an AOS pilot study to decide how best to implement such a service locally.

Methods

The AOS, which included collaboration between the oncology and palliative care teams at the Northern General Hospital in Sheffield, UK, ensured that the majority of oncology patients in the region received timely assessment by an oncologist if they became acutely unwell as a result of their cancer or its treatment. The AOS consisted of a thrice-weekly ward round, and daily telephone advice service.

Results

We report on patient data during the first 12 months of the pilot study. Delivery of the AOS enhanced communication between the services and provided inter-professional education and support, resulting in earlier oncological team involvement in the management of patients with cancer admitted under other teams, as well as provision of advice to patients and their caregivers and families. Provision of the AOS shortened the mean length of hospital stay by 6 days. Two case studies are presented to illustrate the typical challenges faced when managing these patients.

Conclusions

Establishment of the AOS enabled effective collaboration between the oncology and other clinical teams to provide a rapid and streamlined referral pathway of patients to the AOS. Locally, this process has been supported by the development of acute oncology protocols, which are now in use across the local cancer network.
How to Design and Evaluate Interventions to Improve Outcomes for Patients with Multimorbidity
Authors: Smith Susan M. , Bayliss Elizabeth A. , Mercer Stewart W. , Gunn Jane , Vestergaard Mogens , Wyke Sally , Salisbury Chris , Fortin Martin
Published: June 2014

Multimorbidity is a major challenge for patients and healthcare providers. The limited evidence of the effectiveness of interventions for people with multimorbidity means that there is a need for much more research and trials of potential interventions. Here we present a consensus view from a group of international researchers working to improve care for people with multimorbidity to guide future studies of interventions. We suggest that there is a need for careful consideration of whom to include, how to target interventions that address specific problems and that do not add to treatment burden, and selecting outcomes that matter both to patients and the healthcare system. Innovative design of these interventions will be necessary as many will be introduced in service settings and it will be important to ensure methodological rigour, relevance to service delivery, and generalizability across healthcare systems.