bluuebunny/crossref_metadata_2025 huggingface dataset:
A Phase I-II Study of Docetaxel and Atrasentan in Men with Castration-Resistant Metastatic Prostate Cancer
Authors: Armstrong Andrew J. , Creel Patricia , Turnbull James , Moore Cassandra , Jaffe Tracy A. , Haley Sherri , Petros William , Yenser Sarah , Gockerman Jon P. , Sleep Darryl , Hurwitz Herbert , George Daniel J.
Published: October 2008

Purpose: The primary aims of this phase I-II study were to determine the maximum tolerated dose, dose-limiting toxicity, pharmacokinetics, and preliminary efficacy of the combination of docetaxel and the endothelin A receptor antagonist atrasentan as first-line treatment for men with metastatic castration-resistant prostate cancer.

Experimental Design: Patients were treated with docetaxel at doses ranging from 60 to 75 mg/m2 every 21 days, with daily oral atrasentan 10 mg starting on day 3. Patients were treated until evidence of disease progression or unacceptable toxicity.

Results: Thirty-one patients were enrolled over three docetaxel dose levels (8 at 60 mg/m2, 19 at 70 mg/m2, and 4 at 75 mg/m2) including dose expansion at 70 mg/m2. The maximum tolerated dose of docetaxel was 70 to 75 mg/m2. Drug-related grade 3-4 toxicities included neutropenia (50-63%) and febrile neutropenia (16-25%); other grade 1-2 toxicities included fatigue, peripheral edema, diarrhea, headache, rhinitis, anorexia, and nausea. Confirmed prostate-specific antigen (PSA) responses were observed in 23% [95% confidence interval (95% CI), 10-41%]; the rate of >30% declines in PSA was 35% (95% CI, 19-55%). Median overall survival was 17.6 months (95% CI, 13.0-23.2) and median progression-free survival was 4.2 months (95% CI, 2.3-5.8). Significant declines in bone alkaline phosphatase and serum N-telopeptides were observed with therapy.

Conclusions: The maximum tolerated dose of every-3-week docetaxel with 10 mg atrasentan is 70 to 75 mg/m2. Overall survival and progression-free survival are comparable to that seen with docetaxel and prednisone, whereas the rates of PSA decline are slightly lower than expected. A phase III study of this combination with prednisone has been initiated and is ongoing.
CASP3 Polymorphisms and Risk of Squamous Cell Carcinoma of the Head and Neck
Authors: Chen Kexin , Zhao Hui , Hu Zhibin , Wang Li-E , Zhang Wei , Sturgis Erich M. , Wei Qingyi
Published: October 2008

Purpose: Caspase-3 plays a central role in executing cell apoptosis and thus in carcinogenesis, but little is known about the role of CASP3 variants in susceptibility to SCCHN.

Experimental Design: Genotype and haplotypes of the first intron (rs4647601:G>T and rs4647602:C>A) and 5′-untranslated region (UTR; rs4647603:G>A) of CASP3 (NT_022792.17) were determined for 930 SCCHN patients and 993 cancer-free controls in a U.S. non-Hispanic white population. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated in multivariate logistic regression analysis.

Results: We found that the CASP3 rs4647601:TT variant genotype was associated with an increased risk of SCCHN (adjusted OR, 1.32; 95% CI, 1.00-1.73) compared with the GG genotype. This risk was more evident in the subgroups of younger (≤56 years) subjects, males, and never smokers with a significant trend for increased risk with increased number of variant T allele (P < 0.05 for all). However, these risks were not found for other two SNPs. Furthermore, individuals with two copies of haplotypes TCG or GCA were found to have a significant increased risk of SCCHN (OR, 1.31; 95% CI, 1.07-1.61) compared with the other haplotypes, and this risk was more evident in less advanced diseases (OR, 1.45; 95% CI, 1.11-1.89) than in the advanced diseases (OR, 1.22; 95% CI, 0.96-1.54).

Conclusions: These results suggested that genetic variation in CASP3 may contribute to SCCHN risk. Larger studies are needed to confirm our findings.
Phase I Study of Epigenetic Modulation with 5-Azacytidine and Valproic Acid in Patients with Advanced Cancers
Authors: Braiteh Fadi , Soriano Andres O. , Garcia-Manero Guillermo , Hong David , Johnson Marcella M. , Silva Leandro De Padua , Yang Hui , Alexander Stefanie , Wolff Johannes , Kurzrock Razelle
Published: October 2008

Purpose: 5-Azacytidine (5-AZA) is a DNA-hypomethylating agent. Valproic acid is a histone deacetylase inhibitor. Combining hypomethylating agents and histone deacetylase inhibitors produces synergistic anticancer activity in vitro and in vivo. On the basis of this evidence, we conducted a phase I study of the combination of 5-AZA and valproic acid in patients with advanced cancers.

Experimental Design: 5-AZA was administered s.c. daily for 10 days. Valproic acid was given orally daily with a goal to titrate to plasma levels of 75 to 100 μg/mL (therapeutic for seizures). Cycles were 28 days long. 5-AZA was started at 20 mg/m2 and escalated using an adaptive algorithm based on the toxicity profile in the prior cohort (6 + 6 design). Peripheral blood mononuclear cell global DNA methylation and histone H3 acetylation were estimated with the long interspersed nucleotide elements pyrosequencing assay and Western blots, respectively, on days 1 and 10 of each cycle when patients agreed to provide them.

Results: Fifty-five patients were enrolled. Median age was 60 years (range, 12-77 years). The maximum tolerated dose was 75 mg/m2 of 5-AZA in combination with valproic acid. Dose-limiting toxicities were neutropenic fever and thrombocytopenia, which occurred at a dose of 94 mg/m2 of 5-AZA. Stable disease lasting 4 to 12 months (median, 6 months) was observed in 14 patients (25%). A significant decrease in global DNA methylation and induction of histone acetylation were observed.

Conclusion: The combination of 5-AZA and valproic acid is safe at doses up to 75 mg/m2 for 5-AZA in patients with advanced malignancies.
Integrin Agonists as Adjuvants in Chemotherapy for Melanoma
Authors: Schwartz Martin A. , McRoberts Kevin , Coyner Matthew , Andarawewa Kumari L. , Frierson Henry F. , Sanders John M. , Swenson Stephen , Markland Frank , Conaway Mark R. , Theodorescu Dan
Published: October 2008

Purpose: Metastatic melanomas are generally resistant to chemotherapy and radiation, even when wild-type for p53. These tumors often grow in small nests where many of the cells have little contact with extracellular matrix (ECM). Previous work showed that M21 melanomas undergo apoptosis in response to chemotherapy when cells are adherent to ECM but not in suspension. Thus, reduced integrin-dependent adhesion to ECM could mediate therapy resistance. The goal of this study was to test whether stimulation of integrin signaling could increase chemotherapeutic efficacy.

Experimental Design: Colony forming assays and survival assays were used to test the responses of melanoma lines in vitro. Severe combined immunodeficient mice with subcutaneous human melanomas received chemotherapy with or without reagents that stimulate integrin signaling; tumor volume was then monitored over time.

Results: Clonal growth assays confirmed that M21 cells showed reduced sensitivity to the chemotherapeutic drug 1-β-d-arabinofuranosylcytosine (araC). When five additional primary melanoma lines were screened, 80% showed higher sensitivity when adherent compared with suspended. Subcutaneous M21 tumors in vivo showed minimal ECM between tumor cells. To evaluate the importance of integrin signaling in chemoresistance in this model, mice were treated with araC, with or without the multivalent snake venom disintegrin contortrostatin or the activating anti-β1 integrin antibody TS2/16. Although araC, TS2/16, or contortrostatin alone had little effect on M21 tumor growth, combining araC with either integrin signaling reagents strongly reduced growth (P = 0001).

Conclusions: Loss of integrin-mediated adhesion is rate limiting for therapeutic response in this model. Combining chemotherapy with reagents that stimulate integrin signaling may therefore provide a new approach to therapy.
True Carcinosarcoma of the Esophagus: Report of a Case
Authors: Yamamoto Yuji , Watanabe Yuji , Horiuchi Atushi , Yoshida Motohira , Yukumi Shungo , Sato Koichi , Nakagawa Hiromichi , Sugishita Hiroki , Ishida Naoki , Furuta Satoshi , Kawachi Kanji
Published: October 2008

Carcinosarcoma of the esophagus is a malignant neoplasm involving both carcinomatous and sarcomatous components. We report a patient with true esophageal carcinosarcoma who underwent laparoscopy-assisted surgery. An upper gastrointestinal barium study revealed a lobulated intraluminal filling defect in the lower intrathoracic esophagus. The patient underwent esophagectomy and regional lymphadenectomy with gastric tube reconstruction by laparoscopy-assisted surgery and thoracotomy. The esophageal hiatus was entered and the mediastinal esophagus was dissected using a laparoscopic approach. Microscopically, the tumor comprised poorly differentiated squamous cell carcinoma and spindle-shaped cells resembling leiomyosarcoma. Immunohistochemically, spindle-shaped sarcomatous cells displayed strongly positive reaction to vimentin and negative reaction to cytokeratin AE1/AE3 and CD68. No transitional zone was seen between sarcomatous and carcinomatous elements. The patient was finally diagnosed with true esophageal carcinosarcoma. Laparoscopic transhiatal esophagectomy seems to be a rational and safe procedure for lower esophageal neoplasms, even for patients with impaired respiratory function.
Mucosa-Associated Lymphoid Tissue Lymphoma Presenting as Massive Gastrointestinal Bleeding: A Case Report
Authors: Kanneganti Kalyan , Balar Bhavna
Published: October 2008

We present a 71-year-old man with mucosa-associated lymphoid tissue (MALT) lymphoma of the colon presenting with massive gastrointestinal hemorrhage. At laparotomy two areas of irregular mucosa were noted in the ascending colon and cecum. Pathology revealed MALT lymphoma. MALT lymphoma of the colon is rare and the presentation as well as outcome of our case makes him unique.
Seborrheic Area Erythema as a Common Skin Manifestation in Japanese Patients with Dermatomyositis
Authors: Okiyama N. , Kohsaka H. , Ueda N. , Satoh T. , Katayama I. , Nishioka K. , Yokozeki H.
Published: October 2008

Background: Although dermatomyositis (DM)-associated facial erythema was noted in the nasolabial folds of Japanese patients, DM-associated facial erythema other than heliotrope rash has drawn little attention in previous studies. Objectives: To characterize phenotypical features and frequencies of erythema, especially those in the seborrheic area of the head, in DM patients. Methods: A retrospective study on skin manifestations in 33 DM patients followed up at our department during the past 15 years was conducted. Results: Macular violaceous erythema (MVE) in the seborrheic area of the face was most frequent (67%). Patients with facial MVE had also MVE in the scalp significantly more frequently than those without facial MVE. The pathology of the facial MVE was dominated by DM-associated changes with slight changes compatible with seborrheic dermatitis (SD). Conclusions: Japanese DM patients had MVE frequently in the seborrheic area of the head. Its phenotypical features suggested that it might be triggered by SD.
Filtration and Breakdown of Clay Clusters during Resin Transfer Molding of Nanoclay/Glass/Epoxy Composites
Authors: Aktas Levent , Dharmavaram Sudha , Hamidi Youssef K. , Cengiz Altan M.
Published: October 2008

Dispersion of nanoclay clusters during resin transfer molding of nanoclay/glass/epoxy disks is investigated. In addition to a center-gated disk containing only 14% glass fibers, three nanocomposite disks are fabricated with the addition of 2, 5 or 10 wt% Cloisite® 25A nanoclay. The spatial distribution of nanoclay clusters along the radial axis of the nanocomposite disks are characterized at two length scales. Clusters larger than 1.5 μm are characterized by performing image analysis on the SEM micrographs whereas smaller nanoclay clusters are identified by wavelength dispersive spectrometry. Results obtained from image analysis indicate that nanoclay clusters are filtered out by as much as 50% in the flow direction by the glass fiber preforms. In addition, increasing nanoclay content led to higher filtration, suggesting that cluster formation is more prominent at higher nanoclay loadings. Cluster size distribution analyses revealed that the outer edges of the disks, on average, contain finer nanoclay particles. For instance, the outer edge of the nanocomposite with 2% clay contains 22% more small nanoclay clusters compared to center of the disk. Glass transition temperature, Tg, of four specimens obtained from each molded disks is characterized under oscillatory shear. Glass transition temperature of the samples are shown to increase with the nanoclay content, yielding a 40% higher Tg at 10% nanoclay loading compared to glass/epoxy composite without clay. Increasing glass transition temperature with increasing nanoclay content may be an indication of intercalation of nanoclay within the epoxy matrix.
Illuminating the Role of Agglomerates on Critical Physicochemical Properties of Amorphous Calcium Phosphate Composites
Authors: O'Donnell J.N.R. , Antonucci J.M. , Skrtic D.
Published: October 2008

Water sorption (WS), mechanical strength, and ion release of polymeric composites formulated with 40% as-made or milled amorphous calcium phosphate (ACP) are compared after 1, 2 and 3 months of aqueous exposure. Ethoxylated bisphenol A dimethacrylate, triethylene glycol dimethacrylate, 2-hydroxyethyl methacrylate, and methacryloxyethyl phthalate comprised the resin. The WS (mass%) peaked at 3 months. WS of as-made ACP composites was significantly higher than WS of milled ACP composites and copolymers. Both composite groups experienced decreases in biaxial flexural strength (BFS) with water aging, with milled ACP composites retaining a significantly higher BFS throughout immersion. Ion release was moderately reduced in milled ACP composites, though they remained superior to as-made ACP composites due to significantly lower WS and higher BFS after prolonged aqueous exposure.
Fatigue Damage of Fiber Reinforced Composites: Simultaneous Growth of Interfacial Debonding and Matrix Annular Crack Surrounding Fiber
Authors: Zhifei Shi  , Rong Zhang
Published: October 2008

By the secondary development of a commercial finite element package, the present study simulates the simultaneous growth of interfacial debonding and matrix annular crack surrounding fiber of fiber reinforced composites under tension—tension cyclic load. Energy release rates are utilized in the Paris law to avoid concerning the singularity of crack tips. With the combination of finite element method and difference approximation, the authors program the degradation model of coefficient of friction, debond criterion, propagation law and loop of load process, and then the relationships between the parameters (such as the crack length and debond length) and number of cyclic load are obtained and discussed. The numerical results show that interaction of growth of two cracks plays an important role in fatigue damage of fiber reinforced composites.
Effect of Low Temperature on Mechanical Properties of Bidirectional Glass Fiber Composites
Authors: Shrivastava A.K. , Nazir Hussain Md.
Published: October 2008

In this article, low temperature and its degradative influence on the material together with hygro-thermal effect are highlighted. Hygrothermal factor is a major environmental factor experienced by the composites. An attempt has been made to study the mechanical properties of bidirectional glass cloth specimens exposed to low temperature and humid condition.

Tensile strength records its highest value after 10 days exposure at -55°C, compressive strength at 0°C exposure increases but after 10 days exposure at -55°C decreases, shear strength of exposed specimen at 0°C increases, flexural strength of exposed specimen at -55°C increases and records its highest value of 10 days exposed specimen. Further, it has been observed that the strength of the composite is in the following order:

Compressive strength of specimen<shear strength of specimen<tensile strength of specimen<flexural strength of specimen.

In this article an attempt has been made to study effect of low temperature on mechanical properties of bidirectional glass fiber composites.
Clinical Pharmacokinetics of XP13512, a Novel Transported Prodrug of Gabapentin
Authors: Cundy Kenneth C. , Sastry Srikonda , Luo Wendy , Zou Joan , Moors Tristen L. , Canafax Daniel M.
Published: October 2008

Gabapentin absorption occurs in only a limited region of the small intestine and saturates at doses used clinically, resulting in dose‐dependent pharmacokinetics, high interpatient variability, and potentially ineffective drug exposure. XP13512/GSK1838262 is a novel transported prodrug of gabapentin that is absorbed throughout the entire length of the intestine by high‐capacity nutrient transporters. In 4 studies of healthy volunteers (136 subjects total), the pharmacokinetics of XP13512 immediate‐ and extended‐release formulations were compared with those of oral gabapentin. XP13512 immediate‐release (up to 2800 mg single dose and 2100 mg twice daily) was well absorbed (>68%, based on urinary recovery of gabapentin), converted rapidly to gabapentin, and provided dose‐proportional exposure, whereas absorption of oral gabapentin declined with increasing doses to <27% at 1200 mg. Compared with 600 mg gabapentin, an equimolar XP13512 extended‐release dose provided extended gabapentin exposure (time to maximum concentration, 8.4 vs 2.7 hours) and superior bioavailability (74.5% vs 36.6%). XP13512 may therefore provide more predictable gabapentin exposure and decreased dosing frequency.
Making Diabetes Self-management Education Culturally Relevant for Filipino Americans in Hawaii
Authors: Finucane Melissa L. , McMullen Carmit K.
Published: October 2008

Purpose The purpose of this study was to identify the cultural val- ues, traditions, and perceptions of diabetes risk and self- care among Filipino Americans in Hawaii with type 2 diabetes that facilitate or impede engagement in diabetes self-management behaviors and education classes.

Methods This qualitative study used 2 rounds of semistructured focus groups and interviews. Participants included 15 patients with type 2 diabetes recruited from a large health-maintenance organization in Hawaii and 7 health care and cultural experts recruited from the community. The taped and transcribed focus groups and interviews were coded thematically. Participants evaluated example materials for diabetes self-management education (DSME) with Filipino Americans.

Results Several aspects of Filipino American culture were identi- fied as central to understanding the challenges of engag- ing in self-management behaviors and DSME: (1) undertaking self-management while prioritizing the fam- ily and maintaining social relationships, (2) modifying diet while upholding valued symbolic and social mean- ings of food, (3) participating in storytelling in the face of stigma associated with diabetes, and (4) reconciling spiritual and biomedical interpretations of disease causa- lity and its management. Respondents also emphasized therole of several qualitative aspects of perceived risk (eg, dread, control) in moderating their behaviors. Participants suggested ways to make DSME culturally relevant.

Conclusions Awareness of cultural values and qualitative aspects of perceived risk that influence Filipino Americans' engage- ment in diabetes self-care behaviors and classes may help to improve teaching methods, materials, and recruitment strategies
Low Testosterone and the Association With Type 2 Diabetes
Authors: Farrell JoAnne B. , Deshmukh Anjali , Baghaie Ali A.
Published: October 2008

Purpose The purpose of this article is to describe androgen deficiency in men, the consequences of this clinically underdiagnosed endocrine disorder, and its relationship to the metabolic syndrome and the association with type 2 diabetes. An overview of prevalence, screening, diagnosis, treatment, and monitoring of male hypogonadism is presented.

Method Established guidelines were used to provide definition, diagnosis, treatment, and monitoring information for male hypogonadism. A literature review from 1990 to 2007 revealed study findings that identify the link between low testosterone in men and the development of type 2 diabetes. The following databases were used to review and analyze the current literature: CINAHL, PubMed, and MEDLINE.

Results An analysis of 26 studies was completed. The key findings in all of these studies show that there is a link between low levels of testosterone and an adverse metabolic profile (ie, obesity and insulin resistance). There is evidence that hypogonadism is associated with metabolic syndrome and type 2 diabetes in men.

Conclusion Male hypogonadism is a clinical condition that affects a significant number of men in the United States and can affect up to 50% of men diagnosed with type 2 diabetes. The implications for diabetes educators are two-fold: first, there is a high prevalence of low testosterone in men with type 2 diabetes, and second, educators need to have a better understanding of this disease state to provide instructional guidance for their patients and to coordinate care with other clinicians.
Diabetes Training of Community Health Workers Serving Native Hawaiians and Pacific People
Authors: Look Mele A. , Baumhofer Nicole K. , Ng-Osorio Jackie , Furubayashi Jill K. , Kimata Chieko
Published: October 2008

Purpose Training of community health workers (CHWs) serving Native Hawaiian and Pacific People about diabetes prevention, control, and management was identified as a priority in a needs assessment of health agencies in Hawai`i.

Methods Principles from Community-Based Participatory Research provided a framework to develop and implement a 4-hour training curriculum. The curriculum developers incorporated teaching strategies shown to be effective with this population and included culturally relevant material. Nineteen health organizations participated in the training that reached 111 CHWs over a 3-year period.

Results Based on comparison of pre- and post-diabetes knowledge test results, the training participants showed significant gain in diabetes knowledge.

Conclusions A culturally tailored diabetes education gives CHWs the relevant knowledge and tools to participate in the delivery of diabetes education to a minority group experiencing disparate health outcomes. A community-based method facilitated development of seminar content and delivery strategies.
Psychosocial Factors Related to Diet Among Women with Recent Gestational Diabetes Opportunities for Intervention
Authors: Zehle Katharina , Smith Ben J. , Chey Tien , McLean Mark , Bauman Adrian E. , Wah Cheung N.
Published: October 2008

Purpose This study investigated postpartum dietary behaviors among women with recent gestational diabetes mellitus (GDM), the cognitive and social factors related to these, and preferred types of lifestyle support, in order improve the development of diabetes prevention strategies for this group.

Methods Participants were a random sample of 226 women diagnosed with GDM in the prior 6 to 24 months. Telephone surveys were used to evaluate dietary behaviors, self-efficacy, social support, perceived barriers to healthy eating, and preferred methods of lifestyle support.

Results Only 5% of the respondents consumed 5 servings/day of vegetables and 44% consumed 2 or more servings/day of fruit. Fried food was eaten at least twice per week by 26% of women and 50% usually consumed full-fat milk. Higher vegetable consumption was associated with self-efficacy to cook healthy foods, reporting that a healthy diet is not a difficult change and that dislike of healthy foods by other household members is not a barrier. Fruit consumption was positively related to self-efficacy when busy and when not reporting a dislike of healthy foods by others at home. Advice from a dietitian and telephone support from a health educator were the most preferred forms of health assistance.

Conclusions Dietary risks factors are prevalent among women with recent GDM. Confidence and skills in cooking healthy foods, along with family food preferences and time pressures, are important influences on eating habits. Dietary change programs, informed by the beliefs and circumstances of this high-risk population, need to be developed.
Culturally Tailored Intervention for Rural African Americans With Type 2 Diabetes
Authors: Utz Sharon W. , Williams Ishan C. , Jones Randy , Hinton Ivora , Alexander Gina , Yan Guofen , Moore Cynthia , Blankenship Jean , Steeves Richard , Norman Oliver M.
Published: October 2008

Purpose The purpose of this pilot study was to evaluate a culturally tailored intervention for rural African Americans. Social Cognitive Theory provided the framework for the study.

Methods Twenty-two participants were recruited and randomly assigned to either Group or Individual diabetes self-management (DSME). Group DSME included story-telling, hands-on activities, and problem-solving exercises. Individual DSME sessions focused on goal-setting and problem-solving strategies. Sessions were offered in an accessible community center over a 10-week period.

Results Outcomes included glycosylated hemoglobin (A1C), self-care actions, self-efficacy level, goal attainment, and satisfaction with DSME. Participants in both Group and Individual DSME improved slightly over the 3-month period in self-care activities, A1C level, and goal attainment. Although differences were not statistically significant, trends indicate improved scores on dietary actions, foot care, goal attainment, and empowerment for those experiencing Group DSME.

Conclusions The culturally tailored approach was well received by all participants. Improvements among those receiving Individual DSME may indicate that brief sessions using a culturally tailored approach could enhance self-care and glycemic control. Additional testing among more participants over a longer time period is recommended.
Implementing the Community Health Worker Model Within Diabetes Management
Authors: Cherrington Andrea , Ayala Guadalupe X. , Amick Halle , Allison Jeroan , Corbie-Smith Giselle , Scarinci Isabel
Published: October 2008

Purpose The purpose of this qualitative study was to examine methods of implementation of the community health worker (CHW) model within diabetes programs, as well as related challenges and lessons learned.

Methods Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC's 1998 directory of CHW programs, and Google Search Engine were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Sixteen programs were assessed, all but 3 focused on minority populations. Most CHWs were recruited informally; 6 programs required CHWs to have diabetes.

Results CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate nondiabetes related issues.

Conclusions Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes.
Development of an Online University-based Physical Activity and Obesity Education Program
Authors: McFarlin Brian K. , Jackson Andrew S.
Published: October 2008

Purpose The purpose of this article is to describe the development and implementation of an undergraduate university core course titled, Public Health Issues in Physical Activity and Obesity (KIN1304) at a diverse, urban university.

Methods The course was designed to provide the scientific and public health information on obesity with a goal of pre- vention. Whereas the course was administered to college students, there are several applications within diabetes education where its content may be useful.

Results The course is entirely Internet based (by means of WebCT Vista) and is a university core requirement for all undergraduate degree programs on campus. Development of such a course provides an opportunity to reach a large portion of the undergraduate population.

Conclusion Development of the Internet-based course, Public Health Issues in Physical Activity and Obesity (KIN1304) may be useful for educating a wide variety of people regard- ing the risks and prevention associated with obesity and diabetes
Use of a Nasal Bridle Prevents Accidental Nasoenteral Feeding Tube Removal
Authors: Gunn Scott R. , Early Barbara J. , Zenati Mazen S. , Ochoa Juan B.
Published: October 2008

Reinserting feeding tubes that are accidentally removed exposes patients to risk and consumes hospital resources. We were interested to know if using a bridle to secure tubes would be more effective than tape at preventing accidental tube removal. This was a quality improvement project with a before‐and‐after design. Between May 2007 and August 2007, we prospectively followed 90 tubes (50 tape, 40 bridle). Tubes were followed up daily until accidental tube removal, ICU discharge, or planned tube removal. Our primary endpoint was accidental tube removal. We compared the 2 groups on the following: (1) proportion of tubes accidentally removed; (2) rate of accidental tube removal (per 100 tube‐days); and (3) Kaplan‐Meier survival analysis. Survival analysis data were right‐censored at ICU discharge or planned tube removal. There were no significant differences between groups in any demographics. The proportion of tubes accidentally removed was 36% (18 of 50) in the tape group and 10% (4 of 40) in the bridle group; P < .05. The rate of accidental tube removal (per 100 tube‐days) was 6.4 (18 in 281 tube‐days) in the tape group and 1.6 (4 in 248 tube‐days) in the bridle group; P < .05. Survival analysis showed a significant difference between the groups with a log‐rank test for equality of survivor function of P < .05. Using a bridle to secure feeding tubes significantly reduces the proportion and rate of accidental tube removal and results in increased tube survival by Kaplan‐Meier analysis.
Mental Health Clinicians' Beliefs About Medicines, Attitudes, and Expectations of Improved Medication Adherence in Patients
Authors: Byrne Mitchell K. , Deane Frank P. , Caputi Peter
Published: October 2008

Nonadherence to antipsychotic medications remains a major factor in poor clinical outcomes. This study sought to identify clinician beliefs about patients who do not adhere to treatment, the clinicians' own beliefs about medicines, and the impact of beliefs on efforts to enhance patient adherence. In total, 292 clinicians responded to an anonymous questionnaire that included questions about their beliefs and their efforts to enhance adherence. Results indicated that clinicians' beliefs about their own adequacy to enhance adherence significantly predicted actual efforts to enhance adherence. Both pessimism about outcomes and empathy for the patient predicted outcome expectancy. It was concluded that enhancing clinicians' beliefs about working with nonadherent patients is a potentially important ingredient in efforts to improve patient adherence.
Morphological variability in the comprehension of agreement: an argument for representation over computation
Authors: McCarthy Corrine
Published: October 2008

Previous accounts of morphological variability disagree over whether its cause is representational or computational in nature. Under a computational account, variability is confined to production; under a representational account, variability extends to comprehension and is qualitatively similar to variability in production. This article presents experimental evidence from the comprehension and production of gender and number agreement in second language (L2) Spanish clitics and adjectives. Intermediate-level participants show variability across comprehension and production; across tasks, masculine defaults are adopted. Advanced-level participants show less variability, although evidence for masculine defaults emerges across tasks. Number agreement proved relatively unproblematic, except in the production of adjective agreement where singular defaults are systematically adopted by intermediate- and advanced-level speakers. The qualitative similarity of variability across comprehension and production supports a representational account; however, previous research disfavours an account based in syntactic deficits. This article argues for a theory of morphological variability that places the representational cause in the morphology, rather than the syntax.
The Human Side of Public Organizations
Authors: O'Toole Laurence J. , Meier Kenneth J.
Published: October 2008

Researchers in recent years have focused systematically on whether public management matters in the performance of public organizations. Internal management of organizations' human capital is one such managerial function, and a growing literature argues for its importance in delivering results. A management-and-performance model available in the literature suggests an approach to test empirically for this relationship. Here evidence from hundreds of public organizations over a 4-year period is assembled toward that end. Even when a number of other aspects of management are included, the management of human capital is related positively to virtually all performance indicators. The findings validate arguments in the recent literature of the field and emphasize the importance for performance of public organizations' investing in their people.
The Biologistical Construction of Race
Authors: Fullwiley Duana
Published: October 2008

This paper presents an ethnographic case study of the use of race in two interconnected laboratories of medical genetics. Specifically, it examines how researchers committed to reducing health disparities in Latinos with asthma advance hypotheses and structure research to show that relative frequencies of genetic markers characterize commonly understood groupings of race. They do this first by unapologetically advancing the idea that peoples whom they take to be of the `Old World', or `Africans', `Europeans', `East Asians', and `Native Americans', can serve as putatively pure reference populations against which genetic risk for common diseases such as asthma can be calculated for those in the `New World'. Technologically, they deploy a tool called ancestry informative markers (AIMs), which are a collection of genetic sequence variants said to differ in present-day West Africans, East Asians, Europeans, and (ideally Pre-Columbian) Native Americans. I argue that this technology, compelling as it may be to a range of actors who span the political spectrum, is, at base, designed to bring about a correspondence of familiar ideas of race and supposed socially neutral DNA. This correspondence happens, in part, as the scientists in question often bracket the environment while privileging racialized genetic variance as the primary source of health disparities for common disease, in this case between Mexicans and Puerto Ricans with asthma. With their various collaborators, these scientists represent a growing movement within medical genetics to re-consider race and `racial admixture' as biogenetically valid points of departure. Furthermore, many actors at the center of this ethnography focus on race as a function of their personal identity politics as scientists of color. This to say, they are driven not by racist notions of human difference, but by a commitment to reduce health disparities and to include `their' communities in what they describe as the `genetic revolution'.
Teaching `Race' at Medical School
Authors: Anderson Warwick
Published: October 2008

This essay examines the efforts of social scientists and humanities scholars to teach students at a major US medical school about `race'. The objectives were to explain that race is no longer considered a biologically legitimate concept and to demonstrate that race remains an influential social classification, causing social and biological harm. That is, these educators sought to reframe the medical significance of race. An examination of the email discussions of those involved in this teaching exercise (which included the author) reveals concerns over the credibility of social scientists and humanities scholars speaking on genetics in the modern medical school. It also indicates the intellectual and curricular marginalization of critiques of racial classification in medical education. In science studies journals one can read convincing deconstructions of the new genetics of race, but it is rare to find an analysis of how ideas about race figure in the mundane practice of educating future medical doctors and researchers. Through examination of an exemplary, wide-ranging discussion of an attempt to teach on race in the medical curriculum, this essay addresses the disciplinary and institutional difficulties of translating critiques of controversial science into pedagogy.
The Bare Bones of Race
Authors: Fausto-Sterling Anne
Published: October 2008

In this paper I examine claims of racial difference in bone density and find that the use and definitions of race in medicine lack a theoretical foundation. My central argument is that the social produces the biological in a system of constant feedback between body and social experience. By providing a different angle of vision on claimed racial differences I hope to move the conversation away from an ultimately futile discussion of nature versus nurture, where time is held constant and place seen as irrelevant, and begin to build a new paradigm for examining the contributions of geographic ancestry, individual lifecycle experience, race, and gender to varied patterns of health and disease.
Introduction: Race, Genetics, and Disease
Authors: Fujimura Joan H. , Duster Troy , Rajagopalan Ramya
Published: October 2008

This special issue of Studies of Science highlights ongoing debates concerning race, genomics, and disease. Some of the papers examine the production of disease etiology research, pharmaceutical drug response, or DNA genealogy tests, while others analyze institutional consequences and challenges arising from contemporary biomedicine, such as medical education and recruiting subjects for clinical research. In this introduction, we outline major issues that provide background and foreground for the specific studies that follow, and end with a brief description of the papers. First, we briefly outline the debates around contemporary genetics research on race, ancestry, population, and disease. Second, we describe genomics and disease research projects on the genetics of populations that provide the ground on which the past debates have played, as well as introduce very recent projects that may change the tenor of future debates. We discuss why some scientists argue that their research does not biologize race, while others argue that their findings do demonstrate racial differences. Finally, we relate these complex genomic sciences and their biopolitical debates to relevant STS themes.
Exploiting Race in Drug Development
Authors: Kahn Jonathan
Published: October 2008

This paper explores events surrounding the US Food and Drug Administration's formal approval of the heart failure drug BiDil in 2005. BiDil is the first drug ever to be approved with a race-specific indication, in this case to treat heart failure in `self-identified black patients'. BiDil has been cast by many as a step toward the promised land of individualized pharmacogenomic therapies. This paper argues, however, that when examined in context, the approval of BiDil emerges as a new model of how a pharmaceutical company may exploit race in the marketplace by literally capitalizing on the racial identity of minority populations and leveraging the disproportionate risk of adverse health outcomes they suffer into a cheaper, more efficient way to gain the US Food and Drug Administration's approval for drugs. Discussions of BiDil in both popular media and professional journals have repeatedly elided the difference between pharmacogenomic and race-based medicine. In fact, broad-based true pharmacogenomic therapies remain years—perhaps decades—in the future. The story of BiDil's development elucidates an alternative model to developing tailored therapies that promises to fill in the gap between the promise and reality of pharmacogenomic medicine. It is a model that exploits race to gain regulatory and commercial advantage, while ignoring its power to promote a regeneticization of racial categories in society at large.
Bio Science
Authors: Nelson Alondra
Published: October 2008

This paper considers the extent to which the geneticization of `race' and ethnicity is the prevailing outcome of genetic testing for genealogical purposes. The decoding of the human genome precipitated a change of paradigms in genetics research, from an emphasis on genetic similarity to a focus on molecular-level differences among individuals and groups. This shift from lumping to splitting spurred ongoing disagreements among scholars about the significance of `race' and ethnicity in the genetics era. I characterize these divergent perspectives as `pragmatism' and `naturalism'. Drawing upon ethnographic fieldwork and interviews, I argue that neither position fully accounts for how understandings of `race' and ethnicity are being transformed with genetic genealogy testing. While there is some acquiescence to genetic thinking about ancestry, and by implication, `race', among African-American and black British consumers of genetic genealogy testing, test-takers also adjudicate between sources of genealogical information and from these construct meaningful biographical narratives. Consumers engage in highly situated `objective' and `affiliative' self-fashioning, interpreting genetic test results in the context of their `genealogical aspirations'. I conclude that issues of site, scale, and subjectification must be attended to if scholars are to understand whether and to what extent social identities are being transformed by recent developments in genetic science.
The Rise of `Recruitmentology'
Authors: Epstein Steven
Published: October 2008

Recent debates concerning the biomedical meaning and significance of race have paid relatively little attention to the practical implications of new policies in the US mandating the inclusion of racial and ethnic minorities (along with other `underrepresented groups') as research subjects in clinical studies. I argue that pressures to enroll underrepresented groups have stimulated the development in the US of an auxiliary science I term `recruitmentology': an empirical body of studies scientifically evaluating the efficacy of various social, cultural, psychological, technological, and economic means of convincing people (especially members of `hard-to-recruit populations') that they want to become, and remain, human subjects. Via the filtering of social scientific frameworks into the clinical research domain, recruitmentology has promoted hybrid ways of thinking about race — awkward encounters in which depictions of race as a bounded, quasi-biological medical and administrative category sit uneasily alongside an interest in understanding racial identities and communities as sociocultural phenomena. I analyze how recruitmentologists, in addressing the mandate to recruit racially diverse subject populations, conceptualize race while simultaneously grappling with problems of trust, collective memory, and participation. I also examine how the increasingly transnational character of biomedical research is intensifying the exploitative dimensions of recruitment while further transforming the racialized character of human experimentation. This analysis highlights the tensions underlying projects to eliminate health disparities by race.
Effects of Fiber Orientation on Out-of-plane and In-plane Natural Frequencies of Angle-ply Laminated Composite Arches
Authors: Cevik Mehmet
Published: October 2008

Variation of natural frequencies of in-plane and out-of-plane vibrations of 4-layer angle-ply composite arch with respect to fiber angle is investigated by the finite element method. The arch has clamped-clamped boundary conditions. It is concluded that the fiber angle is particularly important for in-plane vibrations. For any certain value of radius/length ratio of the arch, the natural frequency can be either increased or decreased with respect to fiber angle; therefore, angle-ply lamination can be preferable to cross-ply lamination. On the other hand, the effect of fiber angle on the out-of-plane frequencies can be used as an advantage in the design of laminated composite arches.
Acoustic Based Structural Health Monitoring for Composites Using Optimal Sensor Placement: Analysis and Experiments
Authors: Das Santanu , Chattopadhyay Aditi , Xu Zhou
Published: October 2008

An acoustic based sensor network with optimal sensor placement is designed to characterize the existence of damage in composites. By incorporating the sensor certainty region and the sensing density, the developed optimal sensor set is able to provide an accurate description of the perturbations caused by the presence of damage. In the present study, piezoelectric sensors and actuators are used. A round-robin inspection is performed on the entire structure. Initially, the sensing region and the certainty region of a sensor-actuator pair are estimated, based on experimental data. The parameters of actuator position, excitation intensity, material properties of the host structure, the sensitivity property of the transducers, and detectable perturbations have been taken into account in the estimation. In multi-sensor applications, the placement of two neighboring sensors leads to an overlap between their certainty regions. Therefore, the overlap of the neighboring sensors is determined next and the minimum overlapping criteria is imposed in the design of sensor sets. This is further extended for each sensor member until certainty regions of the optimal number of sensors cover the entire structure, provided the minimum overlap criteria and additional geometric constraints are satisfied. Thus, the developed procedure is able to provide the optimal placement of the sensors. Parametric studies are conducted using composite laminates with seeded delaminations. Comparisons between healthy and delaminated structures are presented. The local effects of the sensors are identified. Both numerical and experimental results are presented for validation.
Effects of Filler Characteristics on the Acoustic Absorption of EPDM-based Highly Filled Particulate Composite
Authors: Hedayati A. , Arefazar A.
Published: October 2008

The acoustic properties of homogeneous isotropic viscoelastic materials are predicted by a new method for the composite materials. In this case, attenuation mechanisms of composite materials are separated in absorption and scattering mechanisms. Absorption of sound waves is obtained by using dynamic mechanical thermal analysis (DMTA) data at different temperatures in order to predict the sound loss in highly filled composites. Acoustic parameters, the attenuation coefficient (α), and sound velocity (c), are obtained in the shear and dilatation modes for different particulate composites. In order to study the effect of filler characteristics on the structural and intrinsic absorption mechanisms, different composites are prepared based on highly filled EPDM elastomer. Finally, based on residence time of sound waves in the material, a new absorption factor is introduced and variation of this parameter versus temperature is studied.