bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Age on Breast Cancer Outcomes in Women With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: Results From a Herceptin Adjuvant Trial
Authors: Partridge Ann H. , Gelber Shari , Piccart-Gebhart Martine J. , Focant Florine , Scullion Matthew , Holmes Eileen , Winer Eric P. , Gelber Richard D.
Published: June 2013

Purpose

Previous research has suggested that young age at diagnosis is an independent risk factor for breast cancer recurrence and death. No prior studies have adequately controlled for human epidermal growth factor receptor 2 (HER2) status or anti-HER2 treatment. We sought to evaluate whether age was a prognostic or predictive factor in the HERA trial.

Patients and Methods

We used 2-year median follow-up data and dichotomized age at 40 years to evaluate its prognostic effect on outcomes for women assigned to trastuzumab for 1 year or observation.

Results

Of the 1,703 women randomly assigned to 1 year of trastuzumab and 1,698 to observation, 722 (21%) were age ≤ 40 years at study entry. In separate Cox models, controlling for relevant prognostic and predictive factors, disease-free (DFS) and overall survival (OS) hazard ratios (HRs) were consistent for women age ≤ 40 versus > 40 years, regardless of treatment assignment (observation group: DFS HR age ≤ 40 v > 40 years, 1.18; 95% CI, 0.90 to 1.54; OS HR age ≤ 40 v > 40 years, 1.01; 95% CI, 0.60 to 1.69; trastuzumab group: DFS HR age ≤ 40 v > 40 years, 1.11; 95% CI, 0.81 to 1.51; OS HR age ≤ 40 v > 40 years, 1.18; 95% CI, 0.66 to 2.09). Interaction between age group and treatment effect was not statistically significant (DFS P = .89; OS P = .55).

Conclusion

In a retrospective analysis of a large randomized controlled trial of women with early-stage HER2-positive breast cancer, age was not strongly associated with risk of early recurrence or prediction of benefit from trastuzumab therapy. Future research should investigate whether age is a predictor of later recurrence and evaluate the impact of age within groups with other tumor subtypes.
Outcomes of Critically Ill Patients With Hematologic Malignancies: Prospective Multicenter Data From France and Belgium—A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique Study
Authors: Azoulay Elie , Mokart Djamel , Pène Frédéric , Lambert Jérôme , Kouatchet Achille , Mayaux Julien , Vincent François , Nyunga Martine , Bruneel Fabrice , Laisne Louise-Marie , Rabbat Antoine , Lebert Christine , Perez Pierre , Chaize Marine , Renault Anne , Meert Anne-Pascale , Benoit Dominique , Hamidfar Rebecca , Jourdain Mercé , Darmon Michael , Schlemmer Benoit , Chevret Sylvie , Lemiale Virginie
Published: June 2013

Purpose

Patients with hematologic malignancies are increasingly admitted to the intensive care unit (ICU) when life-threatening events occur. We sought to report outcomes and prognostic factors in these patients.

Patients and Methods

Ours was a prospective, multicenter cohort study of critically ill patients with hematologic malignancies. Health-related quality of life (HRQOL) and disease status were collected after 3 to 6 months.

Results

Of the 1,011 patients, 38.2% had newly diagnosed malignancies, 23.1% were in remission, and 24.9% had received hematopoietic stem-cell transplantations (HSCT, including 145 allogeneic). ICU admission was mostly required for acute respiratory failure (62.5%) and/or shock (42.3%). On day1, 733 patients (72.5%) received life-supporting interventions. Hospital, day-90, and 1-year survival rates were 60.7%, 52.5%, and 43.3%, respectively. By multivariate analysis, cancer remission and time to ICU admission less than 24 hours were associated with better hospital survival. Poor performance status, Charlson comorbidity index, allogeneic HSCT, organ dysfunction score, cardiac arrest, acute respiratory failure, malignant organ infiltration, and invasive aspergillosis were associated with higher hospital mortality. Mechanical ventilation (47.9% of patients), vasoactive drugs (51.2%), and dialysis (25.9%) were associated with mortality rates of 60.5%, 57.5%, and 59.2%, respectively. On day 90, 80% of survivors had no HRQOL alterations (physical and mental health similar to that of the overall cancer population). After 6 months, 80% of survivors had no change in treatment intensity compared with similar patients not admitted to the ICU, and 80% were in remission.

Conclusion

Critically ill patients with hematologic malignancies have good survival, disease control, and post-ICU HRQOL. Earlier ICU admission is associated with better survival.
FTO Deficiency Induces UCP-1 Expression and Mitochondrial Uncoupling in Adipocytes
Authors: Tews D. , Fischer-Posovszky P. , Fromme T. , Klingenspor M. , Fischer J. , Rüther U. , Marienfeld R. , Barth T. F. , Möller P. , Debatin K. M. , Wabitsch M.
Published: June 2013

Variants in the fat mass- and obesity-associated (FTO) gene are associated with obesity and body fat mass in genome-wide association studies. However, the mechanism by which FTO predisposes individuals to obesity is not clear so far. First mechanistic evidence was shown in Fto-negative mice. These mice are resistant to obesity due to enhanced energy expenditure, whereas the mass of brown adipose tissue remains unchanged. We hypothesize that FTO is involved in the induction of white adipose tissue browning, which leads to mitochondrial uncoupling and increases energy expenditure. Uncoupling protein 1 (Ucp-1) was significantly higher expressed in both gonadal and inguinal adipose depots of Fto−/− compared with Fto+/+ littermates accompanied by the appearance of multivacuolar, Ucp-1-positive adipocytes in these tissues. By using lentiviral short hairpin RNA constructs, we established FTO-deficient human preadipocytes and adipocytes and analyzed key metabolic processes. FTO-deficient adipocytes showed an adipogenic differentiation rate comparable with control cells but exhibited a reduced de novo lipogenesis despite unchanged glucose uptake. In agreement with the mouse data, FTO-deficient adipocytes exhibited 4-fold higher expression of UCP-1 in mitochondria compared with control cells. The up-regulation of UCP-1 in FTO-deficient adipocytes resulted in enhanced mitochondrial uncoupling. We conclude that FTO deficiency leads to the induction of a brown adipocyte phenotype, thereby enhancing energy expenditure. Further understanding of the signaling pathway connecting FTO with UCP-1 expression might lead to new options for obesity and overweight treatment.
Metabolic Programming of Puberty: Sexually Dimorphic Responses to Early Nutritional Challenges
Authors: Sánchez-Garrido M. A , Castellano J. M. , Ruiz-Pino F. , Garcia-Galiano D. , Manfredi-Lozano M. , Leon S. , Romero-Ruiz A. , Diéguez C. , Pinilla L. , Tena-Sempere M.
Published: June 2013

Body energy stores and metabolic cues influence the onset of puberty. However, the pubertal impact of early nutritional challenges has been only fragmentarily addressed. We evaluated here the consequences, in terms of pubertal timing and hormonal markers, of various nutritional manipulations during pre- or postnatal maturation in rats of both sexes. Males and females were submitted to gestational undernutrition (UNG) or peripubertal (SUB) subnutrition or were raised in large (LL; underfeeding) or small (SL; overfeeding) litters. In addition, groups of UNG, LL, and SL rats were fed on a high-fat diet (HFD) after weaning. Postnatal overfeeding resulted in higher body weights (BWs) during pubertal transition in both sexes, but only SL males displayed overtly advanced external signs of puberty. Postnatal underfeeding persistently decreased BW gain during puberty, yet the magnitude of pubertal delay was greater in LL males. In contrast, regardless of postnatal nutrition, HFD tended to advance the onset of puberty in females but did not alter pubertal timing in males. Likewise, SUB females displayed a marked delay in BW gain and puberty onset, whereas despite similar reduction in BW, SUB males showed normal timing of puberty. These sex divergences were also detected in various hormonal and metabolic indices so that postnatal overnutrition consistently increased LH, FSH, leptin, and insulin levels only in pubertal females, whereas HFD decreased gonadotropin levels in SL females but increased them in SL males. Notably, UNG rats did not show signs of delayed puberty but displayed a striking sex dimorphism in serum insulin/glucose levels, regardless of the diet, so that only UNG males had signs of presumable insulin resistance. Our data disclose important sex differences in the impact of various early nutritional challenges on the timing of puberty, which may help to explain the different trends of altered puberty and related comorbidities between sexes.
Full-Length Human Chromogranin-A Cardioactivity: Myocardial, Coronary, and Stimulus-Induced Processing Evidence in Normotensive and Hypertensive Male Rat Hearts
Authors: Pasqua Teresa , Corti Angelo , Gentile Stefano , Pochini Lorena , Bianco Mimma , Metz-Boutigue Marie-Hélène , Cerra Maria Carmela , Tota Bruno , Angelone Tommaso
Published: June 2013

Plasma chromogranin-A (CgA) concentrations correlate with severe cardiovascular diseases, whereas CgA-derived vasostatin-I and catestatin elicit cardiosuppression via an antiadrenergic/nitric oxide-cGMP mediated mechanism. Whether these phenomena are related is unknown. We here investigated whether and to what extent full-length CgA directly influences heart performance and may be subjected to stimulus-elicited intracardiac processing. Using normotensive and hypertensive rats, we evaluated the following: 1) direct myocardial and coronary effects of full-length CgA; 2) the signal-transduction pathway involved in its action mechanism; and 3) CgA intracardiac processing after β-adrenergic [isoproterenol (Iso)]- and endothelin-1(ET-1)-dependent stimulation. The study was performed by using a Langendorff perfusion apparatus, Western blotting, affinity chromatography, and ELISA. We found that CgA (1–4 nM) dilated coronaries and induced negative inotropism and lusitropism, which disappeared at higher concentrations (10–16 nM). In spontaneously hypertensive rats (SHRs), negative inotropism and lusitropism were more potent than in young normotensive rats. We found that perfusion itself, Iso-, and endothelin-1 stimulation induced intracardiac CgA processing in low-molecular-weight fragments in young, Wistar Kyoto, and SHR rats. In young normotensive and adult hypertensive rats, CgA increased endothelial nitric oxide synthase phosphorylation and cGMP levels. Analysis of the perfusate from both Wistar rats and SHRs of untreated and treated (Iso) hearts revealed CgA absence. In conclusion, in normotensive and hypertensive rats, we evidenced the following: 1) full-length CgA directly affects myocardial and coronary function by AkT/nitric oxide synthase/nitric oxide/cGMP/protein kinase G pathway; and 2) the heart generates intracardiac CgA fragments in response to hemodynamic and excitatory challenges. For the first time at the cardiovascular level, our data provide a conceptual link between systemic and intracardiac actions of full-length CgA and its fragments, expanding the knowledge on the sympathochromaffin/CgA axis under normal and physiopathological conditions.
Molecular Differences Between Human Thyroid Follicular Adenoma and Carcinoma Revealed by Analysis of a Murine Model of Thyroid Cancer
Authors: Sponziello Marialuisa , Lavarone Elisa , Pegolo Enrico , Di Loreto Carla , Puppin Cinzia , Russo Marika A. , Bruno Rocco , Filetti Sebastiano , Durante Cosimo , Russo Diego , Di Cristofano Antonio , Damante Giuseppe
Published: June 2013

Mouse models can provide useful information to understand molecular mechanisms of human tumorigenesis. In this study, the conditional thyroid mutagenesis of Pten and Ras genes in the mouse, which induces very aggressive follicular carcinomas (FTCs), has been used to identify genes differentially expressed among human normal thyroid tissue (NT), follicular adenoma (FA), and FTC. Global gene expression of mouse FTC was compared with that of mouse normal thyroids: 911 genes were found deregulated ± 2-fold in FTC samples. Then the expression of 45 deregulated genes in mouse tumors was investigated by quantitative RT-PCR in a first cohort of human NT, FA, and FTC (discovery group). Five genes were found significantly down-regulated in FA and FTC compared with NT. However, 17 genes were found differentially expressed between FA and FTC: 5 and 12 genes were overexpressed and underexpressed in FTC vs FA, respectively. Finally, 7 gene products, selected from results obtained in the discovery group, were investigated in a second cohort of human tumors (validation group) by immunohistochemistry. Four proteins showed significant differences between FA and FTC (peroxisomal proliferator-activated receptor-γ, serum deprivation response protein, osteoglycin, and dipeptidase 1). Altogether our data indicate that the establishment of an enriched panel of molecular biomarkers using data coming from mouse thyroid tumors and validated in human specimens may help to set up a more valid platform to further improve diagnosis and prognosis of thyroid malignancies.
Adult Pituitary Cell Maintenance: Lineage-Specific Contribution of Self-Duplication
Authors: Langlais David , Couture Catherine , Kmita Marie , Drouin Jacques
Published: June 2013

The identification of a stable pool of progenitor/stem cells in the adult pituitary has renewed the interest of identifying mechanisms for maintenance of pituitary cells throughout life. Whereas developmental studies have shown that progenitor expansion is the major source of new differentiated cells during pituitary organogenesis, the contribution of these progenitors for maintenance of the adult tissue is not clear although progenitors were clearly involved in cell expansion following end-organ ablation, notably after adrenalectomy and/or gonadectomy. We have used a genetic trick that eliminates dividing cells by apoptosis in order to assess the contribution of differentiated corticotropes and melanotropes for maintenance of their population in the adult pituitary. The system relies on chromosome instability created by the action of the Cre recombinase on inverted loxP sites. Expression of Cre recombinase in corticotropes and melanotropes led to progressive loss of corticotropes whereas melanotropes were unaffected. Because the Cre transgene is not expressed in progenitors, the data indicate that maintenance of the adult corticotrope pool is primarily due to self-duplication of differentiated cells. In contrast, melanotropes do not divide. Maintenance of corticotropes by self-duplication contrasts with the reported proliferative response of undifferentiated cells observed after adrenalectomy. If corticotrope reentry into cell cycle constitutes a normal mechanism to maintain the adult corticotrope pool, this same mechanism may also be perturbed during corticotrope adenoma development in Cushing's disease.
Lineage-dependent circuit assembly in the neocortex
Authors: Gao Peng , Sultan Khadeejah T. , Zhang Xin-Jun , Shi Song-Hai
Published: June 2013

The neocortex plays a key role in higher-order brain functions, such as perception, language and decision-making. Since the groundbreaking work of Ramón y Cajal over a century ago, defining the neural circuits underlying brain functions has been a field of intense study. Here, we review recent findings on the formation of neocortical circuits, which have taken advantage of improvements to mouse genetics and circuit-mapping tools. These findings are beginning to reveal how individual components of circuits are generated and assembled during development, and how early developmental processes, such as neurogenesis and neuronal migration, guide precise circuit assembly.
Laminin β1a controls distinct steps during the establishment of digestive organ laterality
Authors: Hochgreb-Hägele Tatiana , Yin Chunyue , Koo Daniel E. S. , Bronner Marianne E. , Stainier Didier Y. R.
Published: June 2013

Visceral organs, including the liver and pancreas, adopt asymmetric positions to ensure proper function. Yet the molecular and cellular mechanisms controlling organ laterality are not well understood. We identified a mutation affecting zebrafish laminin β1a (lamb1a) that disrupts left-right asymmetry of the liver and pancreas. In these mutants, the liver spans the midline and the ventral pancreatic bud remains split into bilateral structures. We show that lamb1a regulates asymmetric left-right gene expression in the lateral plate mesoderm (LPM). In particular, lamb1a functions in Kupffer’s vesicle (KV), a ciliated organ analogous to the mouse node, to control the length and function of the KV cilia. Later during gut-looping stages, dynamic expression of Lamb1a is required for the bilayered organization and asymmetric migration of the LPM. Loss of Lamb1a function also results in aberrant protrusion of LPM cells into the gut. Collectively, our results provide cellular and molecular mechanisms by which extracellular matrix proteins regulate left-right organ morphogenesis.
Genome editing of human pluripotent stem cells to generate human cellular disease models
Authors: Musunuru Kiran
Published: June 2013

Disease modeling with human pluripotent stem cells has come into the public spotlight with the awarding of the Nobel Prize in Physiology or Medicine for 2012 to Drs John Gurdon and Shinya Yamanaka for the discovery that mature cells can be reprogrammed to become pluripotent. This discovery has opened the door for the generation of pluripotent stem cells from individuals with disease and the differentiation of these cells into somatic cell types for the study of disease pathophysiology. The emergence of genome-editing technology over the past few years has made it feasible to generate and investigate human cellular disease models with even greater speed and efficiency. Here, recent technological advances in genome editing, and its utility in human biology and disease studies, are reviewed.
Why Don't the Poor Save More? Evidence from Health Savings Experiments
Authors: Dupas Pascaline , Robinson Jonathan
Published: June 2013

Using data from a field experiment in Kenya, we document that providing individuals with simple informal savings technologies can substantially increase investment in preventative health and reduce vulnerability to health shocks. Simply providing a safe place to keep money was sufficient to increase health savings by 66 percent. Adding an earmarking feature was only helpful when funds were put toward emergencies, or for individuals that are frequently taxed by friends and relatives. Group-based savings and credit schemes had very large effects. (JEL C93, D14, D91, I12, O12)
Unconventional Fiscal Policy at the Zero Bound
Authors: Correia Isabel , Farhi Emmanuel , Nicolini Juan Pablo , Teles Pedro
Published: June 2013

When the zero lower bound on nominal interest rates binds, monetary policy cannot provide appropriate stimulus. We show that, in the standard New Keynesian model, tax policy can deliver such stimulus at no cost and in a time-consistent manner. There is no need to use inefficient policies such as wasteful public spending or future commitments to low interest rates. (JEL E12, E43, E52, E62, H20)
A Theory of Strategic Voting in Runoff Elections
Authors: Bouton Laurent
Published: June 2013

This paper analyzes the properties of runoff electoral systems when voters are strategic. A model of three-candidate runoff elections is presented, and two new features are included: the risk of upset victory in the second round is endogenous, and many types of runoff systems are considered. Three main results emerge. First, runoff elections produce equilibria in which only two candidates receive a positive fraction of the votes. Second, a sincere voting equilibrium does not always exist. Finally, runoff systems with a threshold below 50 percent produce an Ortega effect that may lead to the systematic victory of the Condorcet loser. (JEL C72, D72)
Going to a Better School: Effects and Behavioral Responses
Authors: Pop-Eleches Cristian , Urquiola Miguel
Published: June 2013

This paper applies a regression discontinuity design to the Romanian secondary school system, generating two findings. First, students who have access to higher achievement schools perform better in a (high stakes) graduation test. Second, the stratification of schools by quality in general, and the opportunity to attend a better school in particular, result in significant behavioral responses: (i) teachers sort in a manner consistent with a preference for higher achieving students; (ii) children who make it into more selective schools realize they are relatively weaker and feel marginalized; (iii) parents reduce effort when their children attend a better school. (JEL I21, I28, J13)
The Lure of Authority: Motivation and Incentive Effects of Power
Authors: Fehr Ernst , Herz Holger , Wilkening Tom
Published: June 2013

Authority and power permeate political, social, and economic life, but empirical knowledge about the motivational origins and consequences of authority is limited. We study the motivation and incentive effects of authority experimentally in an authority-delegation game. Individuals often retain authority even when its delegation is in their material interest—suggesting that authority has nonpecuniary consequences for utility. Authority also leads to overprovision of effort by the controlling parties, while a large percentage of subordinates underprovide effort despite pecuniary incentives to the contrary. Authority thus has important motivational consequences that exacerbate the inefficiencies arising from suboptimal delegation choices. (JEL C92, D23, D82)
Preferences and Incentives of Appointed and Elected Public Officials: Evidence from State Trial Court Judges
Authors: Lim Claire S. H
Published: June 2013

We study how two selection systems for public officials, appointment and election, affect policy outcomes, focusing on state court judges and their criminal sentencing decisions. First, under appointment, policy congruence with voter preferences is attained through selecting judges with homogeneous preferences. In contrast, under election, judges face strong reelection incentives, while selection on preferences is weak. Second, the effectiveness of election in attaining policy congruence critically depends on payoffs from the job, which implies that the effectiveness of election may vary substantially across public offices. Third, reelection incentives may discourage judges with significant human capital from holding office. (JEL D72, K41)
Just Luck: An Experimental Study of Risk-Taking and Fairness
Authors: Cappelen Alexander W , Konow James , Sørensen Erik Ø , Tungodden Bertil
Published: June 2013

Choices involving risk significantly affect the distribution of income and wealth in society. This paper reports the results of the first experiment, to our knowledge, to study fairness views about risk-taking, specifically whether such views are based chiefly on ex ante opportunities or on ex post outcomes. We find that, even though many participants focus exclusively on ex ante opportunities, most favor some redistribution ex post. Many participants also make a distinction between ex post inequalities that reflect differences in luck and ex post inequalities that reflect differences in choices. These findings apply to both stakeholders and impartial spectators. (JEL D63, D81, H23)
Lemons Markets and the Transmission of Aggregate Shocks
Authors: Kurlat Pablo
Published: June 2013

I study a dynamic economy featuring adverse selection in asset markets. Borrowing constrained entrepreneurs sell past projects to finance new investment, but asymmetric information creates a lemons problem. I show that this friction is equivalent to a tax on financial transactions. The implicit tax rate responds to aggregate shocks, generating amplification in the response of investment and cyclical variation in liquidity. (JEL D82, D92, E32, E44, G31, L15)
Discretionary Tax Changes and the Macroeconomy: New Narrative Evidence from the United Kingdom
Authors: Cloyne James
Published: June 2013

This paper provides new estimates of the macroeconomic effects of tax changes using a new narrative dataset for the United Kingdom. Identification is achieved by isolating “exogenous” tax policy changes using the Romer and Romer narrative strategy. I find that a 1 percent cut in taxes increases GDP by 0.6 percent on impact and 2.5 percent over three years. The findings are remarkably similar to Romer and Romer narrative estimates for the United States, reinforcing the view that tax changes have powerful and persistent effects. “Exogenous” tax changes are also shown to have contributed to important episodes in the UK business cycle. (JEL E23, E32, E62, H20, H61)
Even (Mixed) Risk Lovers are Prudent
Authors: Crainich David , Eeckhoudt Louis , Trannoy Alain
Published: June 2013

The purpose of this note is to analyze properties of the risk lovers' utility function beyond the positive sign of its second order derivative. We show that—contrarily to a priori beliefs—risk lovers are prudent and are willing to accumulate precautionary savings. (JEL D81)
DEVELOPMENT AND IMPLEMENTATION OF ORGANIZATION’S STRATEGY WITH CORPORATE SOCIAL RESPONSIBILITY
Authors: Курлыкова Анна , Kurlykova Anna
Published: June 2013

The author investigated. The questions of impact of corporate social responsibility factors on the process of developing and implementing of company’s strategy; examined the examples of social responsibility of well-known companies; identified the key factors that provide the corporate social responsibility; represented the main provisions of the strategy, considering the factors of corporate social responsibility.
INCREASING PROFITS BY KNOWLEDGES: HOW TO TEACH BUSINESS LEADERS
Authors: Кондратьев Эдуард , Kondratev Eduard
Published: June 2013

With the reduction of satisfaction with the quality of the

business knowledge of college graduates the issue of quality of knowledge of the future managers is considered. The author offers the model of a Manager’s Knowledge System consisting of three levels of management.
Cycles in Leavitt path algebras by means of idempotents
Authors: Aranda Pino Gonzalo , Brox Jose , Siles Molina Mercedes
Published: June 2013

We characterize, in terms of its idempotents, the Leavitt path algebras of an arbitrary graph that satisfies Condition (L) or Condition (NE). In the latter case, we also provide the structure of such algebras. Dual graph techniques are considered and demonstrated to be useful in the approach of the study of Leavitt path algebras of arbitrary graphs. A refining of the so-called Reduction Theorem is achieved and is used to prove that I(Pc
(E)), the ideal of the vertices which are base of cycles without exits of the graph E, a construction with a clear parallelism to the socle, is a ring isomorphism invariant for arbitrary Leavitt path algebras. We also determine its structure in any case.
Comparison of the penetration and passage of Streptococcus mutans and Aggregatibacter actinomycetemcomitans through membranes loaded with tetracycline, amoxicillin, and chlorhexidine: an in vitro study
Authors: Yaghobee Siamak , Samadi Nasrin , Khorsand Afshin , Ghahroudi Amir Ali Rasouli , Kadkhodazadeh Mahdi
Published: June 2013

Background: This study aimed at comparing the colonization and passage of Streptococcus mutans and Aggregatibacter actinomycetemcomitans (Aa) through polytetrafluoroethylene (PTFE) and acellular dermal matrix (ADM) membranes loaded with tetracycline, amoxicillin, and chlorhexidine.

Methods: In this in vitro study, PTFE and ADM membranes were loaded with tetracycline, amoxicillin, and chlorhexidine. The colonization and crossing of S. mutans and Aa through these membranes were evaluated using vials containing culture medium. Three-way analysis of variance and Tukey’s honestly significant difference test were used for the statistical analyses (p<0.05).

Results: The membranes loaded with antimicrobial agents significantly decreased bacterial passage compared with the control membranes (not loaded with antimicrobial agents). Significant differences were also detected between membranes in their inhibitory properties (p=0.011). PTFE membrane had higher barrier effect than ADM. Tetracycline had greater antibacterial activity against both species compared with amoxicillin (p=0.021) but had no significant difference with chlorhexidine in this respect (p=0.068). The antimicrobial efficacy of chlorhexidine was in between those of tetracycline and amoxicillin, but the difference between amoxicillin and chlorhexidine in this respect was not statistically significant (p=0.992). Aa had better penetration into the membranes compared with S. mutans.

Conclusions: The study results demonstrated that the penetration of S. mutans and Aa decreased into the membranes loaded with tetracycline, amoxicillin, and chlorhexidine and PTFE membrane had a greater barrier effect than ADM. Loading membranes with antimicrobial agents can effectively reduce membrane-associated infections during regenerative procedures.
On the partial Π-property of subgroups of finite groups
Authors: Chen Xiaoyu , Guo Wenbin
Published: June 2013

Let
Coordination chemistry and applications of metal phenolates containing an oxazoline group
Authors: Taghvaee Mahroo , Gossage Robert A.
Published: June 2013

This review details the coordination chemistry aspects, applications, and catalytic relevance of materials containing a phenol unit appended to an oxazoline ring. The latter functionality can be chiral or achiral in nature. The binding motifs and catalytic potency of these materials in carbon-carbon bond forming processes and related reactions are compared and contrasted.
Properties of Concrete With Crumb Rubber Replacing Fine Aggregates (Sand)
Authors: Siringi Gideon M. , Abolmaali Ali , Aswath Pranesh B.
Published: June 2013

In this paper, crumb rubber is proposed as a possible lightweight replacement for fine aggregate in concrete. The performance of concrete with crumb rubber is analyzed through comparison to conventional concrete in terms of compressive strength (ASTM C39), tensile strength (ASTM C78 and ASTM C496), failure patterns, energy absorption during loading, and workability. The results show that up to 15 % of fine aggregates can be replaced with an equal volume of crumb rubber with a slight improvement of the concrete workability. The crumb rubber improves the compressive strength by over 5 %. The splitting tensile strength decreases with an increase in the quantity of crumb rubber, and the modulus of rupture is decreased by an average of 12 %. However, increased strain at failure, good energy absorption, improved modulus of toughness, and ductility are observed in rubberized concrete. Typical concrete brittle failure is not observed in rubberized concrete.
Material Characterization Studies on Low- and High-Carbon Rice Husk Ash and Their Performance in Portland Cement Mixtures
Authors: Venkatanarayanan Harish Kizhakkumodom , Rangaraju Prasada Rao
Published: June 2013

In this study, low- and high-carbon rice husk ash (RHA) in their as-received and ground forms were characterized by means of different methods in order to evaluate their performance in Portland cement mixtures. RHA-cement pastes and mortars, at three different RHA replacement levels of 0 %, 10 %, and 20 %, were prepared at a constant water/cement ratio of 0.485. Results from this investigation indicate that the material characteristics of low- and high-carbon RHA were significantly different in most of the tests conducted. In the as-received condition, the high-carbon RHA had a greater bulk density than low-carbon RHA, but their bulk densities were comparable after grinding. The low-carbon RHA was more effective in its pozzolanic reaction than high-carbon RHA in both ground and as-received conditions. The microstructures of both low-carbon and high-carbon RHA cement pastes were denser than those of control pastes. At a given dosage of RHA and superplasticizer, the ground and the as-received low-carbon RHA mixtures performed significantly better than the high-carbon RHA mixtures. Similarly, mixtures with low-carbon RHA showed significantly higher strength activity indices than those with high-carbon RHA at both dosage levels investigated. Grinding RHA was found to be beneficial in all the tests conducted, as the ground RHA mixtures depleted more calcium hydroxide, registered higher flow values, and possessed greater strength than unground RHA mixtures at all replacement levels. Thus, the grinding process significantly helps in utilizing both high- and low-carbon RHA in concrete.
The RIVUR Trial: Profile and Baseline Clinical Associations of Children With Vesicoureteral Reflux
Authors: Carpenter Myra A. , Hoberman Alejandro , Mattoo Tej K. , Mathews Ranjiv , Keren Ron , Chesney Russell W. , Moxey-Mims Marva , Greenfield Saul P. ,   for the RIVUR Trial Investigators
Published: June 2013

BACKGROUND AND OBJECTIVE:

Vesicoureteral reflux (VUR) is diagnosed in ∼30% to 40% of children who have imaging studies after urinary tract infections (UTIs). Our goal is to characterize children enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial and to compare our study cohort with those from previously published studies.

METHODS:

RIVUR investigators from 19 pediatric sites in the United States recruited 607 children with grade I through IV VUR. Children were enrolled after a first or second UTI. This cross-sectional report of baseline data includes extensive clinical, parental report, and imaging study results.

RESULTS:

RIVUR recruited 607 children (558 girls, 49 boys) with grade I (11%), II (42%), III (38%), or IV (8%) reflux. The median age was 12 months, and most children (91%) were enrolled after their first UTI. The UTI leading to enrollment was both febrile and symptomatic for 323 children, febrile only in 197 children, and symptomatic only in 86. Renal involvement at baseline as documented by a 99mTc dimercaptosuccinic acid scan was uncommon with cortical defects identified in 89 (15%) children. Bladder and bowel dysfunction was identified in 71 (56%) of 126 toilet-trained subjects assessed.

CONCLUSIONS:

RIVUR is the largest prospective, randomized trial for children with primary VUR to date, comparing prophylaxis with placebo. The study sample comprises patients from 19 pediatric clinical sites in the United States, whose demographic and clinical characteristics may differ from those of children enrolled in previous trials from other countries.
Simplified Definitions of Elevated Pediatric Blood Pressure and High Adult Arterial Stiffness
Authors: Aatola Heikki , Magnussen Costan G. , Koivistoinen Teemu , Hutri-Kähönen Nina , Juonala Markus , Viikari Jorma S.A. , Lehtimäki Terho , Raitakari Olli T. , Kähönen Mika
Published: June 2013

OBJECTIVE:

The ability of childhood elevated blood pressure (BP) to predict high pulse wave velocity (PWV), a surrogate marker for cardiovascular disease, in adulthood has not been reported. We studied whether elevated pediatric BP could predict high PWV in adulthood and if there is a difference in the predictive ability between the standard BP definition endorsed by the National High Blood Pressure Education Program and the recently proposed 2 simplified definitions.

METHODS:

The sample comprised 1241 subjects from the Cardiovascular Risk in Young Finns Study followed-up 27 years since baseline (1980, aged 6–15 years). Arterial PWV was measured in 2007 by whole-body impedance cardiography.

RESULTS:

The relative risk for high PWV was 1.5 using the simple 1 (age-specific) definition, 1.6 using the simple 2 (age- and gender-specific) definition, and 1.7 using the complex (age-, gender-, and height-specific) definition (95% confidence interval: 1.1–2.0, P = .007; 1.2–2.2, P = .001; and 1.2–2.2, P = .001, respectively). Predictions of high PWV were equivalent for the simple 1 or simple 2 versus complex definition (P = .25 and P = .68 for area under the curve comparisons, P = .13 and P = .35 for net reclassification indexes, respectively).

CONCLUSIONS:

Our results support the previous finding that elevated BP tracks from childhood to adulthood and accelerates the atherosclerotic process. The simplified BP tables could be used to identify pediatric patients at increased risk of high arterial stiffness in adulthood and hence to improve the primary prevention of cardiovascular diseases.
Mortality Risks in New-Onset Childhood Epilepsy
Authors: Berg Anne T. , Nickels Katherine , Wirrell Elaine C. , Geerts Ada T. , Callenbach Petra M.C. , Arts Willem F. , Rios Christina , Camfield Peter R. , Camfield Carol S.
Published: June 2013

OBJECTIVES:

Estimate the causes and risk of death, specifically seizure related, in children followed from onset of epilepsy and to contrast the risk of seizure-related death with other common causes of death in the population.

METHODS:

Mortality experiences from 4 pediatric cohorts of newly diagnosed patients were combined. Causes of death were classified as seizure related (including sudden unexpected death [SUDEP]), natural causes, nonnatural causes, and unknown.

RESULTS:

Of 2239 subjects followed up for >30 000 person-years, 79 died. Ten subjects with lethal neurometabolic conditions were ultimately excluded. The overall death rate (per 100 000 person-years) was 228; 743 in complicated epilepsy (with associated neurodisability or underlying brain condition) and 36 in uncomplicated epilepsy. Thirteen deaths were seizure-related (10 SUDEP, 3 other), accounting for 19% of all deaths. Seizure-related death rates were 43 overall, 122 for complicated epilepsy, and 14 for uncomplicated epilepsy. Death rates from other natural causes were 159, 561, and 9, respectively. Of 48 deaths from other natural causes, 37 were due to pneumonia or other respiratory complications.

CONCLUSIONS:

Most excess death in young people with epilepsy is not seizure-related. Mortality is significantly higher compared with the general population in children with complicated epilepsy but not uncomplicated epilepsy. The SUDEP rate was similar to or higher than sudden infant death syndrome rates. In uncomplicated epilepsy, sudden and seizure-related death rates were similar to or higher than rates for other common causes of death in young people (eg, accidents, suicides, homicides). Relating the risk of death in epilepsy to familiar risks may facilitate discussions of seizure-related mortality with patients and families.
Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury
Authors: Kurowski Brad G. , Wade Shari L. , Kirkwood Michael W. , Brown Tanya M. , Stancin Terry , Taylor H. Gerry
Published: June 2013

OBJECTIVE:

Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant problems in functioning across multiple settings. The objective of this study was to evaluate the efficacy of a web-based counselor-assisted problem solving (CAPS) intervention compared with an Internet resource comparison (IRC) for treatment of executive dysfunction within 12 months after complicated mild to severe TBI in adolescents. We hypothesized that CAPS would significantly improve parent ratings of executive dysfunction compared with an IRC.

METHODS:

Participants included 132 adolescents aged 12 to 17 years who sustained a complicated mild to severe TBI within 1 to 6 months before study enrollment. Study design was a multisite, assessor-blinded, randomized controlled trial. Study sites included 3 tertiary pediatric hospitals and 2 tertiary general medical centers. The main outcome measure was primary caregiver Behavioral Rating Inventory of Executive Function Global Executive Composite at baseline and 6-month follow-up. Generalized linear models that controlled for baseline scores were used to compare the CAPS and IRC scores.

RESULTS:

In older teens, the CAPS group showed significant improvement in executive function behaviors at 6-month follow-up compared with the IRC group (F = 6.74, P = .01, Cohen’s d = 0.63).

CONCLUSIONS:

Findings indicate that web-based CAPS improves primary caregiver-rated executive functioning within the first 12 months after TBI in older adolescents. Future research needs to define the optimal timing after injury for delivery of CAPS and characteristics of individuals and families who are most likely to benefit from CAPS.
Time Interval Between Concussions and Symptom Duration
Authors: Eisenberg Matthew A. , Andrea John , Meehan William , Mannix Rebekah
Published: June 2013

OBJECTIVE:

To test the hypothesis that children with a previous history of concussion have a longer duration of symptoms after a repeat concussion than those without such a history.

METHODS:

Prospective cohort study of consecutive patients 11 to 22 years old presenting to the emergency department of a children's hospital with an acute concussion. The main outcome measure was time to symptom resolution, assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPSQ). Patients and providers completed a questionnaire describing mechanism of injury, associated symptoms, past medical history, examination findings, diagnostic studies, and the RPSQ. Patients were then serially administered the RPSQ for 3 months after the concussion or until all symptoms resolved.

RESULTS:

A total of 280 patients were enrolled over 12 months. Patients with a history of previous concussion had a longer duration of symptoms than those without previous concussion (24 vs 12 days, P = .02). Median symptom duration was even longer for patients with multiple previous concussions (28 days, P = .03) and for those who had sustained a concussion within the previous year (35 days, P = .007) compared with patients without those risk factors. In a multivariate model, previous concussion, absence of loss of consciousness, age ≥13, and initial RPSQ score >18 were significant predictors of prolonged recovery.

CONCLUSIONS:

Children with a history of a previous concussion, particularly recent or multiple concussions, are at increased risk for prolonged symptoms after concussion. These findings have direct implications on the management of patients with concussion who are at high risk for repeat injuries.
A Systematic Review of Home-Based Childhood Obesity Prevention Studies
Authors: Showell Nakiya N. , Fawole Oluwakemi , Segal Jodi , Wilson Renee F. , Cheskin Lawrence J. , Bleich Sara N. , Wu Yang , Lau Brandyn , Wang Youfa
Published: June 2013

BACKGROUND AND OBJECTIVES:

Childhood obesity is a global epidemic. Despite emerging research about the role of the family and home on obesity risk behaviors, the evidence base for the effectiveness of home-based interventions on obesity prevention remains uncertain. The objective was to systematically review the effectiveness of home-based interventions on weight, intermediate (eg, diet and physical activity [PA]), and clinical outcomes.

METHODS:

We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library from inception through August 11, 2012. We included experimental and natural experimental studies with ≥1-year follow-up reporting weight-related outcomes and targeting children at home. Two independent reviewers screened studies and extracted data. We graded the strength of the evidence supporting interventions targeting diet, PA, or both for obesity prevention.

RESULTS:

We identified 6 studies; 3 tested combined interventions (diet and PA), 1 used diet intervention, 1 combined intervention with primary care and consumer health informatics components, and 1 combined intervention with school and community components. Select combined interventions had beneficial effects on fruit/vegetable intake and sedentary behaviors. However, none of the 6 studies reported a significant effect on weight outcomes. Overall, the strength of evidence is low that combined home-based interventions effectively prevent obesity. The evidence is insufficient for conclusions about home-based diet interventions or interventions implemented at home in association with other settings.

CONCLUSIONS:

The strength of evidence is low to support the effectiveness of home-based child obesity prevention programs. Additional research is needed to test interventions in the home setting, particularly those incorporating parenting strategies and addressing environmental influences.
The history of reorientation therapy
Authors: Kórász Krisztián
Published: June 2013

Most scientists today agree that sexual orientation is most likely the result of a complex interaction of environmental, cognitive, and biological factors. In past decades in the United States there has been a big discourse as to the necessity and effectiveness of same-sex attraction change. Researchers disagree on whether same-sex attraction can be changed. Position statements of the major mental health organizations state that there is not enough scientific evidence to support the reorientation therapy. In addition, there is some evidence to indicate that some individuals experienced harm or believed they had been harmed by these interventions. The aim of this article is to give a historic overview of the reorientation therapies, to review the efficacy of the therapies, motivations for seeking therapy, arguments for and against the therapy, and to overview the actual mainstream organizations’ statements. Orv. Hetil., 2013, 154, 931–939.
Evaluation of ambulatory antibiotic use in Hungary using drug-specific quality indicators
Authors: Matuz Mária , Benkő Ria , Hajdú Edit , Viola Réka , Soós Gyöngyvér
Published: June 2013

Introduction: Rational use of antibiotics is an important tool in combating antibiotic resistance. Aim: The aim of the authors was to evaluate the quality of ambulatory antibiotic use in Hungary. Method: Crude antibiotic sales data for the period between 1996 and 2010 were converted into DDD (Defined Daily Dose) per 1000 inhabitants and per year. The recently developed and validated drug-specific quality indicators were used to evaluate antibiotic use. Results: Beside constant quantity (18.0±1.8 DDD/1000 inhabitants/day), the authors detected major changes in the composition of antibiotic use. Ratios of the consumption of broad to narrow spectrum beta-lactams and macrolides increased eight-fold (1996: 2.2 vs. 2010: 15.8) and consumption of fluoroquinolones tripled. Out of the ten surveyed drug-specific quality indicators, Hungary belonged to the European elite in case of three, while considering the remaining seven, Hungary ranked among the weak or weakest European countries. Conclusion: In quantity Hungary an ambulatory antibiotic use resembles to Scandinavian countries while it mimics antibiotic consumption patterns of southern countries. Orv. Hetil., 2013, 154, 947–956.
Review of overlap syndromes of autoimmune liver diseases. Difficulties in the diagnosis and treatment
Authors: Hagymási Krisztina , Tulassay Zsolt
Published: June 2013

Overlap syndromes are biochemical, serological, histological and radiological overlaps across the classic autoimmune liver diseases in the presence of autoimmun hepatitis and primary biliary cirrhosis or primary sclerosing cholangitis. The exact prevalence of the disease is not known, but it may vary between 5% and 20%. Because it has no generally accepted diagnostic criteria, clinical signs, biochemical, serological, radiological and histological findings are evaluated together. Treatment depends on the predominant feature of the overlap syndrome; ursodeoxycholic acid and/or immunsuppressive (corticosteroid) treatment are used, based on observations from retrospective, non-randomized studies. Orv. Hetil., 2013, 154, 923–929.