bluuebunny/crossref_metadata_2025 huggingface dataset:
Environment and lupus-related diseases
Authors: Zandman-Goddard G , Solomon M , Rosman Z , Peeva E , Shoenfeld Y
Published: November 2011

Clinical manifestations of lupus are encountered in a variety of disease entities, including isolated cutaneous lupus, undifferentiated connective tissue disease, mixed connective tissue disease, drug-induced lupus, overlap syndrome, and systemic lupus erythematosus (SLE). While each entity has been recognized as a specific disease with its own diverse clinical and serological pattern, one could argue that many findings are common. Could it be that all of these entities actually represent a spectrum of one disease? Could it be that rather than the genetic predisposition and hence controlled factors that govern this spectrum of diseases, that environmental factors associated with SLE could also play a role in the different entities of this spectrum? The traditional environmental triggers in SLE include sunlight and ultraviolet (UV) light, infections, smoking, and medications including biologics such as tumor necrosis factor alpha (TNF-a) blockers. In this review, we update and further substantiate these traditional factors in the various lupus-related syndromes. We will also discuss the association with vaccine exposure, industrial estrogens, and other factors.
Disparate effects of depletion of CD1d-reactive T cells during early versus late stages of disease in a genetically susceptible model of lupus
Authors: Jacinto J , Kim PJ , Singh RR
Published: November 2011

Some T cells react with lipid antigens bound to antigen-presenting molecule CD1d. Numbers and functions of a subset of such lipid-reactive T cells are reduced in patients with systemic lupus erythematosus (SLE) and their relatives, as well as in genetically susceptible and chemically induced animal models of lupus-like disease. We have reported that the germline deletion of CD1d exacerbates lupus, suggesting a protective role of these cells in the development of lupus. The use of a knockout mouse model in this study, however, did not allow examination of the role of these cells at different stages of disease. Here, we describe an approach to deplete CD1d-dependent T cells, which allowed us to investigate the role of these cells at different stages of disease in genetically lupus-prone NZB/NZW F1 (BWF1) mice. Repeated intravenous injections of large numbers of CD1d-transfected cells resulted in ∼50–75% reduction in these cells, as defined by the expression of CD4, NK1.1 and CD122, and lack of expression of CD62 ligand. TCR γδ +NK1.1+ cells were also reduced in the recipients of CD1d-transfected cells as compared with control recipients. Such depletion of CD1d-reactive T cells in preclinical BWF1 mice resulted in disease acceleration with a significant increase in proteinuria and mortality. In older BWF1 mice having advanced nephritis, however, such depletion of CD1d-reactive T cells resulted in some disease improvement. Taken together, these data as well as our published studies suggest that CD1d-reactive T cells protect against the development of lupus in animal models. However, these cells appear to be unable to suppress established lupus nephritis in these animals, and might even play a disease aggravating role in late stages of disease.
The Seven Years War and Europe’s Ancien Régime
Authors: Scott Hamish
Published: November 2011

Recent decades have seen a welcome revival of scholarly interest in the Seven Years War (1756—63). This has not been accompanied, however, by sufficient appreciation of the burdens imposed by the fighting and the enormous impact of these upon the states which were at war. Drawing upon the abundant recent scholarship, this article argues that the adoption of an international and comparative perspective, together with an extension of the time frame within which consequences are assessed, makes clear that the Seven Years War was decisive for the European ancien régime. It drove governments to adopt new policies and to introduce fundamental reforms, and in some states stimulated opposition to established political authority.
Victorio’s Military and Political Leadership of the Warm Springs Apaches
Authors: Watt Robert N.
Published: November 2011

Victorio is widely acknowledged as being one of the best guerrilla leaders of the Apache Wars during the 1870s and 1880s. Yet previous accounts of Victorio make little or no effort to demonstrate why he was such an effective leader. This article combines a knowledge of Apache warfare techniques and primary sources to argue that not only did Victorio demonstrate a mastery of these principles of guerrilla warfare; he also displayed an ability to introduce new techniques to further confound his opponents. As a result Victorio, with a small number of warriors, was able to defeat the efforts of US and Mexican armed forces to destroy him for almost a year before being trapped and killed at Tres Castillos, Mexico, by Chihuahua state troops. The article will also show that Victorio’s military skills were augmented by a keen awareness of the political weaknesses of his enemies. This analysis of Victorio’s military and political skills concludes that his popular reputation as a great Apache leader is richly deserved and should be acknowledged.
Synergistic effect in magnetoelectrorheological fluids with a complex dispersed phase
Authors: Korobko E V , Novikova Z A , Zhurauski M A , Borin D , Odenbach S
Published: November 2011

In this article, the results of investigation of structural interactions, generated by simultaneous impact of electric and magnetic fields on fluids containing a two-component dispersed phase, are presented. Dielectric, magnetic, and rheological characteristics of these fluids are considered. The characteristic features of the formed structures depending on the filler type, deformation conditions, and intensity of application of external fields are discussed.
Sources of the Uncertainty Experienced by Women With HPV
Authors: Kosenko Kami A. , Hurley Ryan J. , Harvey Jacquelyn A.
Published: November 2011

Women with genital human papillomavirus (HPV) experience considerable stress and uncertainty as a result of the diagnosis; however, little is known about the sources of uncertainty in HPV. Given that uncertainty creates stress, which might be linked to the pathogenesis of cervical cancer, research on these sources of uncertainty is warranted. To this end, we completed semistructured interviews with 25 women living with HPV, and identified seven sources of uncertainty: The meaning of the diagnosis, the potential for disease progression, finances, the source of the infection, disclosure, sex and reproduction, and the HPV vaccine. In the discussion we articulate the relevance and importance of study findings to research, theory, and practice.
A History of Interpersonal Trauma and the Gynecological Exam
Authors: Ackerson Kelly
Published: November 2011

Cervical cancer is preventable, in part, by routine Papanicolaou (Pap) testing, but some women avoid routine screening. African American women have the greatest mortality among all groups of women in the United States. Personal reasons have been found to contribute to screening avoidance behavior, such as a history of sexual abuse and intimate partner violence. Fifteen African American women with a trauma history participated in personal interviews. The Interaction Model of Client Behavior was employed for exploring the women’s social influence, previous health care experience, cognitive appraisal, affective response, and motivation associated with routine Pap testing. Study findings suggest that providers need to assess and provide accurate information about Pap testing and cervical cancer to increase patients’ knowledge. Personally reflecting on one’s approach to conducting a woman’s gynecologic exam (and how it is performed) might prevent triggering unwanted memories, making that visit a positive experience and facilitating repeat screening behavior.
Young Women’s Perspectives on Cervical Cancer Prevention in Appalachian Kentucky
Authors: Head Katharine J. , Cohen Elisia L.
Published: November 2011

Human papillomavirus (HPV) vaccination coupled with routine Papanicolaou (Pap) tests can prevent pervasive HPV infections causing cervical cancer. However, both HPV vaccination rates and Pap testing rates in Appalachian Kentucky are lower among all age groups than the rest of the United States. We recruited 19 young women residing in Appalachian Kentucky from university-based and rural clinical settings for group and individual interviews. After considering an integrated behavioral framework, we illustrate these women’s perspectives by detailing five themes, including (a) experiential beliefs pose barriers to performing behaviors, (b) three vaccine doses complicate vaccination intention, (c) women have misunderstandings about HPV and the HPV vaccination function, (d) normative influences cue action (and inaction), and (e) specific environmental and contextual barriers exist to performing cervical cancer prevention behaviors in Appalachian Kentucky. These findings related to cervical cancer prevention in Appalachian Kentucky have implications for health-message design and clinical practice.
Thromboxane A2 Receptor
Authors: Ting Harold J. , Murad John P. , Espinosa Enma V. P. , Khasawneh Fadi T.
Published: November 2011

While blood platelets express several G-protein-coupled receptors (GPCRs) that play pivotal roles in their activation, several diseases, for example thrombotic disorders, may develop if these receptors are inappropriately activated. Thus, these receptors have been the subject of investigations to design therapeutic interventions for managing multiple thrombosis-based disease states. One such GPCR, the thromboxane A2 receptor (TPR), remains resistant to such interventions. The present review provides a critical examination of the binding, structural biology, and signaling of TPRs. The review also provides a rationale for using principles of “drug rediscovery” as an alternative/viable approach for the therapeutic targeting of TPRs. To this end, it is noteworthy that many US Food and Drug Administration (FDA)–approved drugs have been found to selectively (and nonselectively) block TPR-mediated functional responses, for example platelet aggregation, as described in this review. Therefore, while none of the antagonists, thus far developed for targeting TPRs, have made it into clinical use, this peculiar receptor can be antagonized by a large number of drugs used for indications unrelated to thrombosis.
Women and part-time employment
Authors: Rose Judy , Hewitt Belinda , Baxter Janeen
Published: November 2011

This article investigates satisfaction with time pressure for men and women with different hours of paid employment using data from the 2006 ‘Negotiating the Life Course’ project. In Australia, part-time employment is a common strategy adopted by women with dependent children to reconcile paid work and family responsibilities. However, women employed part-time are not a homogeneous group. This study differentiates between women employed for minimal part-time, half-time and reduced full-time hours, as well as women employed full-time and not in the labour force, to investigate differences in perceived time pressure. Three dimensions of time pressure are examined: overall time pressure, time pressure at home and time pressure at work. We find gender differences in time pressure at home and differences among women in overall and work time pressure. We conclude that being employed part-time does not alleviate time pressure for all women.
Development of a model-based transient calibration process for diesel engine electronic control module tables – Part 1: data requirements, processing, and analysis
Authors: Brahma I , Chi J N
Published: November 2011

This is the first part of a study investigating a model-based transient calibration process for diesel engines. The motivation is to populate hundreds of parameters (which can be calibrated) in a methodical and optimum manner by using model-based optimization in conjunction with the manual process so that, relative to the manual process used by itself, a significant improvement in transient emissions and fuel consumption and a sizable reduction in calibration time and test cell requirements is achieved. Empirical transient modelling and optimization has been addressed in the second part of this work, while the required data for model training and generalization are the focus of the current work. Transient and steady-state data from a turbocharged multicylinder diesel engine have been examined from a model training perspective. A single-cylinder engine with external air-handling has been used to expand the steady-state data to encompass transient parameter space. Based on comparative model performance and differences in the non-parametric space, primarily driven by a high engine difference between exhaust and intake manifold pressures (Δ P) during transients, it has been recommended that transient emission models should be trained with transient training data. It has been shown that electronic control module (ECM) estimates of transient charge flow and the exhaust gas recirculation (EGR) fraction cannot be accurate at the high engine Δ P frequently encountered during transient operation, and that such estimates do not account for cylinder-to-cylinder variation. The effects of high engine Δ P must therefore be incorporated empirically by using transient data generated from a spectrum of transient calibrations. Specific recommendations on how to choose such calibrations, how many data to acquire, and how to specify transient segments for data acquisition have been made. Methods to process transient data to account for transport delays and sensor lags have been developed. The processed data have then been visualized using statistical means to understand transient emission formation. Two modes of transient opacity formation have been observed and described. The first mode is driven by high engine Δ P and low fresh air flowrates, while the second mode is driven by high engine Δ P and high EGR flowrates. The EGR fraction is inaccurately estimated at both modes, while EGR distribution has been shown to be present but unaccounted for by the ECM. The two modes and associated phenomena are essential to understanding why transient emission models are calibration dependent and furthermore how to choose training data that will result in good model generalization.
Culture Change in Addictions Treatment
Authors: Perka Edward J.
Published: November 2011

Targeted training and technical assistance can have a major impact on the attitudes and beliefs of addiction service providers with respect to the treatment of tobacco dependency. Major gains have been made with the general public since the mid-1960s with respect to the reduction of tobacco use behavior and tobacco-related diseases. Tobacco use continues to be a major public health problem, and tobacco control initiatives are significantly affecting public attitudes and norms regarding tobacco use. There is, however, a specific population that has not benefited from these gains and, in fact, has been encouraged to continue smoking rather than make an attempt to quit. Individuals with a substance use disorder and/or mental health disorder have a much higher percentage of tobacco use than the general population, resulting in major health disparities. The addiction treatment and recovery community has lagged behind the general public in addressing tobacco use. New York State’s project, “Integrating Tobacco Use Interventions Into Chemical Dependence Services,” is a model that demonstrates how innovative regulations, and training and technical assistance developed specifically for addiction service providers, can initiate culture change with respect to tobacco use within addiction treatment settings, resulting in improved treatment outcomes and longer term stable recovery.
State-Mandated School-Based BMI Screening and Parent Notification
Authors: Kaczmarski Jenna M. , DeBate Rita D. , Marhefka Stephanie L. , Daley Ellen M.
Published: November 2011

To address childhood obesity, several states and local school districts across the United States have adopted body mass index (BMI) measurement initiatives. This descriptive case study explored psychosocial, environmental, and behavioral factors among parents of sixth-grade students who received BMI Health Letters (BMIHLs) in one Florida County. A nonexperimental postintervention design was employed to gather quantitative data via self-report Likert-type questionnaire. Participants were parents/guardians of sixth-grade students attending one Hillsborough County public middle school ( n = 76). Results indicate three main findings: (a) most parents in this study (67.4%) who discussed the BMIHL with their child reported their child as “very” or “somewhat” uncomfortable with the discussion; (b) some parents of normal weight (NW) children responded by taking their child to a medical professional to control their weight; and (c) more parents of at risk of overweight/overweight (AR/OW) children (vs. NW) reported greater concern about their child’s weight, using food restriction and physical activity to control their child’s weight, and giving negative weight-related comments/behaviors. This case study illustrates the importance of adapting and tailoring state mandated BMIHLs for parents based on child’s BMI status.
The Use of Training and Technical Assistance to Drive and Improve Performance of California’s Tobacco Control Program
Authors: Roeseler April , Hagaman Tonia , Kurtz Caroline
Published: November 2011

The California Department of Public Health, California Tobacco Control Program uses a social norm–change strategy to reduce the uptake and continued use of tobacco products. The statewide media campaign frames the message, community-level projects implement advocacy campaigns, and statewide-funded projects build the capacity of community-level projects. The California Tobacco Control Program’s technical assistance (TA) system has evolved over time because of changing needs, evaluation findings, and budget considerations. However, TA services continue to strategically align with four statewide policy priorities: to eliminate secondhand smoke exposure, to counter protobacco influences, to reduce the availability of tobacco, and to promote cessation services. TA is the engine powering social change across California by playing a key role in the uptake of a single policy to facilitating the adoption of hundreds of tobacco control policies statewide. The inclusion of expert and peer-to-peer TA models broadly disseminates both evidence-based and tacit community-based knowledge. Comprehensive TA also levels the playing field for organizations and communities to effectively implement policy interventions. Together these approaches accelerate change throughout California communities.
Factors influencing enrollment of African Americans in the Look AHEAD trial
Authors: Mount David L , Davis Cralen , Kennedy Betty , Raatz Susan , Dotson Kathy , Gary-Webb Tiffany L , Thomas Sheikilya , Johnson Karen C , Espeland Mark A ,   and the Look AHEAD Research Group
Published: November 2011

Background Many factors have been identified that influence the recruitment of African Americans into clinical trials; however, the influence of eligibility criteria may not be widely appreciated. We used the experience from the Look AHEAD (Action for Health in Diabetes) trial screening process to examine the differential impact eligibility criteria had on the enrollment of African Americans compared to other volunteers.

Methods Look AHEAD is a large randomized clinical trial to examine whether assignment to an intensive lifestyle intervention designed to produce and maintain weight loss reduces the long-term risk of major cardiovascular events in adults with type 2 diabetes. Differences in the screening, eligibility, and enrollment rates between African Americans and members of other racial/ethnic groups were examined to identify possible reasons.

Results Look AHEAD screened 28,735 individuals for enrollment, including 6226 (21.7%) who were self-identified African Americans. Of these volunteers, 12.9% of the African Americans compared to 19.3% of all other screenees ultimately enrolled ( p < 0.001). African Americans no more often than others were lost to follow-up or refused to attend clinic visits to establish eligibility. Furthermore, the enrollment rates of individuals with histories of cardiovascular disease and diabetes therapy did not markedly differ between the ethnic groups. Higher prevalence of adverse levels of blood pressure, heart rate, HbA1c, and serum creatinine among African American screenees accounted for the greater proportions excluded (all p < 0.001).

Conclusions Compared to non-African Americans, African American were more often ineligible for the Look AHEAD trial due to comorbid conditions. Monitoring trial eligibility criteria for differential impact, and modifying them when appropriate, may ensure greater enrollment yields.
Erlotinib in the treatment of advanced non-small cell lung cancer: an update for clinicians
Authors: Wang Yongsheng , Schmid-Bindert Gerald , Zhou Caicun
Published: November 2011

Inhibition of epidermal growth factor receptor (EGFR) has become an important target in the treatment of advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib, two small molecular agents that target the tyrosine kinase domain of the EGFR, were approved in many countries for the treatment of locally advanced or metastatic NSCLC as a second- or third-line regimen. Since then, randomized trials have evaluated the role of these two targeted agents alone or combined with chemotherapy in maintenance and first-line settings. This review summarizes the results of recent clinical trials with these tyrosine kinase inhibitors, with a focus on erlotinib, as first-line treatment towards a form of personalized medicine aimed at improving clinical outcome in advanced NSCLC.
Evaluation of bioactive sphingolipids in 4-HPR-resistant leukemia cells
Authors: Apraiz Aintzane , Idkowiak-Baldys Jolanta K , Boyano María Dolores , Pérez-Yarza Gorka , Hannun Yusuf A , Asumendi Aintzane
Published: November 2011

Background

N-(4-hydroxyphenyl)retinamide (4-HPR, fenretinide) is a synthetic retinoid with potent pro-apoptotic activity against several types of cancer, but little is known regarding mechanisms leading to chemoresistance. Ceramide and, more recently, other sphingolipid species (e.g., dihydroceramide and dihydrosphingosine) have been implicated in 4-HPR-mediated tumor cell death. Because sphingolipid metabolism has been reported to be altered in drug-resistant tumor cells, we studied the implication of sphingolipids in acquired resistance to 4-HPR based on an acute lymphoblastic leukemia model.

Methods

CCRF-CEM cell lines resistant to 4-HPR were obtained by gradual selection. Endogenous sphingolipid profiles and in situ enzymatic activities were determined by LC/MS, and resistance to 4-HPR or to alternative treatments was measured using the XTT viability assay and annexin V-FITC/propidium iodide labeling.

Results

No major crossresistance was observed against other antitumoral compounds (i.e. paclitaxel, cisplatin, doxorubicin hydrochloride) or agents (i.e. ultra violet C, hydrogen peroxide) also described as sphingolipid modulators. CCRF-CEM cell lines resistant to 4-HPR exhibited a distinctive endogenous sphingolipid profile that correlated with inhibition of dihydroceramide desaturase. Cells maintained acquired resistance to 4-HPR after the removal of 4-HPR though the sphingolipid profile returned to control levels. On the other hand, combined treatment with sphingosine kinase inhibitors (unnatural (dihydro)sphingosines ((dh)Sph)) and glucosylceramide synthase inhibitor (PPMP) in the presence or absence of 4-HPR increased cellular (dh)Sph (but not ceramide) levels and were highly toxic for both parental and resistant cells.

Conclusions

In the leukemia model, acquired resistance to 4-HPR is selective and persists in the absence of sphingolipid profile alteration. Therapeutically, the data demonstrate that alternative sphingolipid-modulating antitumoral strategies are suitable for both 4-HPR-resistant and sensitive leukemia cells. Thus, whereas sphingolipids may not be critical for maintaining resistance to 4-HPR, manipulation of cytotoxic sphingolipids should be considered a viable approach for overcoming resistance.
Mortality in an antiretroviral therapy programme in Jinja, south-east Uganda: a prospective cohort study
Authors: Amuron Barbara , Levin Jonathan , Birunghi Josephine , Namara Geoffrey , Coutinho Alex , Grosskurth Heiner , Jaffar Shabbar
Published: November 2011

Background

There have been few reports of long-term survival of HIV-infected patients on antiretroviral therapy (ART) in Africa managed under near normal health service conditions.

Methods

Participants starting ART between February 2005 and December 2006 in The AIDS Support (TASO) clinic in Jinja, Uganda, were enrolled into a cluster-randomised trial of home versus facility-based care and followed up to January 2009. The trial was integrated into normal service delivery with patients managed by TASO staff according to national guidelines. Rates of survival, virological failure, hospital admissions and CD4 count over time were similar between the two arms. Data for the present analysis were analysed using Cox regression analyses.

Results

1453 subjects were enrolled with baseline median count of 108 cells/μl. Over time, 119 (8%) withdrew and 34 (2%) were lost to follow-up. 197/1453 (14%) died. Mortality rates (95% CI) per 100 person-years were 11.8 (10.1, 13.8) deaths in the first year and 2.4 (1.8, 3.2) deaths thereafter. The one, two and three year survival probabilities (95% CI) were 0.89 (0.87 - 0.91), 0.86 (0.84 - 0.88) and 0.85 (0.83 - 0.87) respectively. Low baseline CD4 count, low body weight, advanced clinical condition (WHO stages III and IV), not being on cotrimoxazole prophylaxis and male gender were associated independently with increased mortality. Tuberculosis, cryptococcal meningitis and diarrhoeal disease were estimated to be major causes of death.

Conclusion

Practical and affordable interventions are needed to enable earlier initiation of ART and to reduce mortality risk among those who present late for treatment with advanced disease.
Survey of enterovirus infections from hand, foot and mouth disease outbreak in china, 2009
Authors: Yang Fan , Zhang Ting , Hu Yongfeng , Wang Xiaofang , Du Jiang , Li Yufen , Sun Shaoxia , Sun Xiuhua , Li Zhifang , Jin Qi
Published: November 2011

Background

In China, a rapid expansion of Hand, foot, and mouth disease (HFMD) outbreaks has occurred since 2004 and HFMD has become an important issue for China. However, people are still only concerned with human enterovirus 71(HEV-71) and coxsackie virus A16 (CV-A16). Much of what is known about the other enterovirus infections relies on fractional evidence and old epidemic data, with little knowledge concerning their distribution. To alert potential threatens of the other enteroviruses, our study genetically characterized specimens from different regions of China and yielded novel information concerning the circulating and phylogenetic characteristics of enteroviral strains from HFMD cases.

Findings

A total of 301 clinical throat swabs were randomly obtained from patients suffering from HFMD from the southern, northern and central regions of China during outbreaks in 2009. 266 of 301 (88.4%) HFMD cases were found positive for HEV and seven genotypes, HEV-71, CV-A16, -B5, -A4, -A6, -A10, and -A12, were detected.

Conclusions

The HFMD pathogen compositions in the different regions of China were significantly different. HFMD epidemics might persist for a long time in China due to the multiple pathogen compositions, the enteroviral characteristic of recombination and co-infection, the ever-increasing travel and migration and the deficiency of effective vaccine. Our study deserves the attention on HFMD control and vaccine development.
Expression and role of fibroblast activation protein-alpha in microinvasive breast carcinoma
Authors: Hua Xing , Yu Lina , Huang Xiaoxiao , Liao Zexiao , Xian Qi
Published: November 2011

Background

Diagnosis of ductal carcinoma in situ (DCIS) in breast cancer cases is challenging for pathologist due to a variety of in situ patterns and artefacts, which could be misinterpreted as stromal invasion. Microinvasion is detected by the presence of cytologically malignant cells outside the confines of the basement membrane and myoepithelium. When malignant cells invade the stroma, there is tissue remodeling induced by perturbed stromal-epithelial interactions. Carcinoma-associated fibroblasts (CAFs) are main cells in the microenvironment of the remodeled tumor-host interface. They are characterized by the expression of the specific fibroblast activation protein-alpha (FAP-α), and differ from that of normal fibroblasts exhibiting an immunophenotype of CD34. We hypothesized that staining for FAP-α may be helpful in determining whether DCIS has microinvasion.

Methods

349 excised breast specimens were immunostained for smooth muscle actin SMA, CD34, FAP-α, and Calponin. Study material was divided into 5 groups: group 1: normal mammary tissues of healthy women after plastic surgery; group 2: usual ductal hyperplasia (UDH); group 3: DCIS without microinvasion on H & E stain; group 4: DCIS with microinvasion on H & E stain (DCIS-MI), and group 5: invasive ductal carcinoma (IDC). A comparative evaluation of the four immunostains was conducted.

Results

Our results demonstrated that using FAP-α and Calponin adjunctively improved the sensitivity of pathological diagnosis of DCIS-MI by 11.29%, whereas the adjunctive use of FAP-α and Calponin improved the sensitivity of pathological diagnosis of DCIS by 13.6%.

Conclusions

This study provides the first evidence that immunostaining with FAP-α and Calponin can serve as a novel marker for pathologically diagnosing whether DCIS has microinvasion.
A survey of foot problems in community‐dwelling older Greek Australians
Authors: Kaoulla Patricia , Frescos Nicoletta , Menz Hylton B
Published: November 2011

Background

Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated.

Methods

One hundred and four community‐dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI) were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short‐Form 36 (SF‐36) questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment.

Results

The MFPDI score ranged from 1 to 30 (median 14), out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF‐36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%), and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%). Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back.

Conclusions

Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health‐related quality of life. These findings are broadly similar to previous studies in English‐speaking older people in Australia. However, only a small proportion of this sample was currently receiving podiatry treatment, and a substantial number stated that they required more help looking after their feet. To address this issue, steps need to be taken to increase awareness of podiatry services among older Greek Australians.
Survival following a vertical free fall from 300 feet: The crucial role of body position to impact surface
Authors: Weckbach Sebastian , Flierl Michael A , Blei Michael , Burlew Clay Cothren , Moore Ernest E , Stahel Philip F
Published: November 2011

We report the case of a 28-year old rock climber who survived an "unsurvivable" injury consisting of a vertical free fall from 300 feet onto a solid rock surface. The trauma mechanism and injury kinetics are analyzed, with a particular focus on the relevance of body positioning to ground surface at the time of impact. The role of early patient transfer to a level 1 trauma center, and "damage control" management protocols for avoiding delayed morbidity and mortality in this critically injured patient are discussed.
ARTEMIN synergizes with TWIST1 to promote metastasis and poor survival outcome in patients with ER negative mammary carcinoma
Authors: Banerjee Arindam , Wu Zheng-Sheng , Qian PengXu , Kang Jian , Pandey Vijay , Liu Dong-Xu , Zhu Tao , Lobie Peter E
Published: November 2011

Introduction

ARTEMIN (ARTN) is an estrogen regulated growth factor, the expression of which promotes resistance to antiestrogen therapies and predicts poorer survival outcome of patients with estrogen receptor (ER) positive mammary carcinoma (ER+MC) treated with tamoxifen. ARTN is also expressed in ER negative mammary carcinoma (ER-MC). Herein, we determined the role of ARTN in ER-MC and defined the mechanism of action producing poor patient prognosis.

Methods

We modulated the expression of ARTN in two ER- (mesenchymal/claudin-low) mammary carcinoma cell lines (BT549 and MDA-MB-231) by forced expression or small interfering RNA (siRNA) mediated depletion. The effects of modulation of ARTN expression were examined by various in vitro measures of oncogenicity, including the expression of TWIST1 messenger RNA (mRNA) and protein. In vitro results were correlated to xenograft studies in immunodeficient mice. Co-expression of ARTN and TWIST1 and their association to poor survival outcome were examined in a cohort of patients with ER-MC. Pathway analysis was performed by pharmacological inhibition of phosphorylation of AKT (pAKT-Ser 473) or modulation of TWIST1 expression.

Results

ARTN expression resulted in ER-MC cells with enhanced mesenchymal characteristics, including increased invasion and a gene expression profile consistent with enhanced mesenchymal phenotype. ARTN stimulated ER-MC cell anchorage independent and 3D matrigel growth, endothelial cell adhesion and transmigration of ER-MC cells through an endothelial cell barrier. Forced expression of ARTN produced a larger, locally invasive tumour mass with tumour emboli that produced distant metastasis. ARTN regulated TWIST1 expression in ER-MC cells and ARTN expression was significantly correlated to TWIST1 expression in a panel of mammary carcinoma cell lines and in a cohort of patients with ER-MC. Low expression of both ARTN and TWIST1 predicted 100% relapse free and overall survival in patients with ER-MC, whereas high expression of both ARTN and TWIST1 was associated with a poor survival outcome. ARTN stimulated an increase in TWIST1 expression via increased AKT activity. siRNA mediated depletion of TWIST1 abrogated ARTN stimulated cellular behaviour associated with metastasis, and forced expression of TWIST1 abrogated the functional effects of ARTN depletion.

Conclusions

ARTN and TWIST1 synergize to produce a worse outcome in ER-MC and combined inhibition of ARTN and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) may therefore provide a novel therapeutic strategy in this subtype of mammary carcinoma.
Development and Independent Validation of a Prognostic Assay for Stage II Colon Cancer Using Formalin-Fixed Paraffin-Embedded Tissue
Authors: Kennedy Richard D. , Bylesjo Max , Kerr Peter , Davison Timothy , Black Julie M. , Kay Elaine W. , Holt Robert J. , Proutski Vitali , Ahdesmaki Miika , Farztdinov Vadim , Goffard Nicolas , Hey Peter , McDyer Fionnuala , Mulligan Karl , Mussen Julie , O'Brien Eamonn , Oliver Gavin , Walker Steven M. , Mulligan Jude M. , Wilson Claire , Winter Andreas , O'Donoghue Diarmuid , Mulcahy Hugh , O'Sullivan Jacintha , Sheahan Kieran , Hyland John , Dhir Rajiv , Bathe Oliver F. , Winqvist Ola , Manne Upender , Shanmugam Chandrakumar , Ramaswamy Sridhar , Leon Eduardo J. , Smith William I. , McDermott Ultan , Wilson Richard H. , Longley Daniel , Marshall John , Cummins Robert , Sargent Daniel J. , Johnston Patrick G. , Harkin D. Paul
Published: November 2011

Purpose

Current prognostic factors are poor at identifying patients at risk of disease recurrence after surgery for stage II colon cancer. Here we describe a DNA microarray–based prognostic assay using clinically relevant formalin-fixed paraffin-embedded (FFPE) samples.

Patients and Methods

A gene signature was developed from a balanced set of 73 patients with recurrent disease (high risk) and 142 patients with no recurrence (low risk) within 5 years of surgery.

Results

The 634–probe set signature identified high-risk patients with a hazard ratio (HR) of 2.62 (P < .001) during cross validation of the training set. In an independent validation set of 144 samples, the signature identified high-risk patients with an HR of 2.53 (P < .001) for recurrence and an HR of 2.21 (P = .0084) for cancer-related death. Additionally, the signature was shown to perform independently from known prognostic factors (P < .001).

Conclusion

This gene signature represents a novel prognostic biomarker for patients with stage II colon cancer that can be applied to FFPE tumor samples.
Esophageal Cancer: A Critical Evaluation of Systemic Second-Line Therapy
Authors: Thallinger Christiane Maria Rosina , Raderer Markus , Hejna Michael
Published: November 2011

The objective of this article was to review clinical trials that used antineoplastic second-line chemotherapy and/or targeted therapies in patients with esophageal cancer after first-line therapy. Computerized (MEDLINE) and manual searches were performed to identify articles published on this topic between 1996 and 2011. Twenty-five published trials and four abstracts presented at scientific meetings were identified. A total of 10 trials included only patients with squamous cell carcinomas (SCCs), four focused exclusively on adenocarcinoma (AC), the remaining 15 studies included both SCC and AC. The majority of trials (17 of 29) used docetaxel in combination with platinum analogs, eight used single-agent cytotoxic chemotherapy, and six evaluated targeted therapies. The numbers of patients were relatively small, ranging from eight to 55 patients. The response rates were generally low (between 0% and 39%), with only two small studies reporting objective responses of 50% and 63%, respectively. Time to progression ranged from 1.4 to 6.2 months, and the overall survival was disappointing at 4.0 to 11.4 months. Approximately 40% of patients who experience progressive disease after first-line chemotherapy are able to undergo second-line treatment. On the basis of data published so far, no standard second-line therapy has emerged. Future research will need to focus on individual therapy strategies such as genetic receptor mutations to increase the therapeutic outcome.
Epistolary Propaganda: Forgery and Revolution in the Atlantic World
Authors: Castronovo Russ
Published: November 2011

How was public opinion forged in the Atlantic world during the age of the American, French, and Haitian Revolutions? This essay takes up this question by looking at the vexed role of propaganda in manufacturing democratic consent. In particular, it examines a counterfeit set of letters attributed to George Washington. The strange career of these forged communiqués reveals how epistolary propaganda widened public opinion so that it intersected with currents of radical republicanism associated with hemispheric revolution. In contrast to contemporary views of propaganda as unified around the state and the corporate interests that it supports, this late eighteenth-century forgery opens a window onto a moment when propaganda appears less villainous, less the tool of public relations practiced by governments and corporations spreading misinformation or outright lies, and more a set of practices for disseminating heterodox truths. By considering the Washington counterfeit amid meditations on revolution and writing from Edmund Burke and William Godwin, a volatile and unstable print culture comes into focus. The argument is not that print is inherently revolutionary but rather that it is the circulation of print that poses a threat to ideals of unified public consent. In this context, unofficial documents such as private letters and secret histories became sources of alternative communication.
And All the Ceremonies to Come: Of High Modernism and Visionary Violence
Authors: O'Hara Daniel T.
Published: November 2011

A review of Michael Wood's Yeats and Violence (2010) and Alain Badiou's Five Lessons on Wagner (2010), this article argues that Wood, by not taking the occult seriously in Yeats, mistakes his general imaginative project, which, as Badiou argues concerning Wagner, is to discover a viable modern form of public ceremony that incorporates the transcendental and supernatural into fully immanent forms that are never pro forma but ever disruptive of habit and complacency. The truth of violence for Yeats, as for Wagner or Badiou, is thus not any supernatural transcendence but immortal beauty of and in the flesh.
Modellbasierte Regelung pneumatisch betriebener Herzunterstützungssysteme
Authors: Sievert Alexander , Drewelow Wolfgang , Lampe Bernhard P. , Arndt Andreas , Simanski Olaf
Published: November 2011

Dieser Beitrag stellt neue Ansätze für die Regelung eines extrakorporalen Herzunterstützungssystems vor. Die Grundlage ist eine kaskadierte Regelung von zwei Teilsystemen. Im ersten Teilsystem finden nichtlineare modellbasierte Regelungsansätze Anwendung. Im äußeren Regelkreis erfolgt die Regelung auf Basis einer Modellprädiktion der Regelgröße, da keine Messwerte zur Verfügung stehen. Die vorgestellte Regelung des Pumpvolumens adaptiert sich an zeitvariante, nicht direkt messbare Patientenparameter.
Paternal Depressive Symptoms and Child Behavioral or Emotional Problems in the United States
Authors: Weitzman Michael , Rosenthal David G. , Liu Ying-Hua
Published: November 2011

BACKGROUND:

The negative effects of maternal mental health problems on child health are well documented. In contrast, there is a profound paucity of information about paternal mental health's association with child health.

OBJECTIVE:

To investigate the association of paternal mental health problems and depressive symptoms and children's emotional or behavioral problems.

METHODS:

We analyzed Medical Expenditure Panel Survey data, which included a representative sample of US children (N = 21 993) aged 5 to 17 years and their mothers and fathers. The main outcome measure was child emotional or behavioral problems assessed by using the Columbia Impairment Scale.

RESULTS:

Paternal depressive symptoms, as assessed using the Patient Health Questionnaire–2, and mental health problems, more generally, assessed by using the Short-Form 12 Scale, were independently associated with increased rates of child emotional or behavioral problems even after controlling for numerous potential confounders including maternal depressive symptoms and other mental health problems. The adjusted odds ratio (aOR) for emotional or behavioral problems among children of fathers with depressive symptoms was 1.72 (95% confidence interval [CI]: 1.33–2.23) and the aOR associated with abnormal paternal scores on the mental component scale of the Short-Form 12 was 1.33 (95% CI: 1.10–1.62) for those within 1 SD below average and 1.48 (95% CI: 1.20–1.84) for those >1 SD below average.

CONCLUSIONS:

To the best of our knowledge, this is the first study to use a representative US sample to demonstrate that living with fathers with depressive symptoms and other mental health problems is independently associated with increased rates of emotional or behavioral problems of children.
Effect of Antihypotensive Treatment on Cerebral Oxygenation of Preterm Infants Without PDA
Authors: Bonestroo Hilde J. C. , Lemmers Petra M. A. , Baerts Wim , van Bel Frank
Published: November 2011

BACKGROUND:

Preterm infants with hypotension (mean arterial blood pressure [MABP] < gestational age [GA]) are treated with volume expansion and/or dopamine to ensure adequate cerebral perfusion/oxygenation. We used near-infrared spectroscopy to analyze the effects of volume expansion and dopamine on cerebral oxygenation in hypotensive preterm infants without patent ductus arteriosus (PDA).

PATIENTS AND METHODS:

Among 390 infants, 71 (GA < 32 weeks) were hypotensive and eligible for inclusion. Thirty-three infants received volume expansion only (NaCl 0.9%; 20 mL/kg), and 38 received additional dopamine (5 μg/kg per minute). Nine and 11 infants initially treated with dopamine subsequently needed 7.5 and 10 μg/kg per minute, respectively. Seventy-one infants without hypotension were individually matched to serve as controls. MABP, regional cerebral oxygen saturation (rSco2), fractional tissue oxygen extraction (cFTOE), and arterial saturation (Sao2) were monitored 15 minutes before and 30 and 60 minutes after volume or dopamine and at comparable postnatal ages in controls.

RESULTS:

No changes in MABP, rSco2, or cFTOE were found 30 minutes after volume expansion. MABP increased 60 minutes after 5 μg/kg per minute dopamine (median [range]: 28 [19–32] vs 33 [23–46] mm Hg; P < .001). There was a small increase and decrease, respectively, in rSco2 (63 [43–84] vs 66 [46–87]%; P < .05) and cFTOE (0.33 [0.14–0.56] vs 0.31 [0.07–0.54]1/1; P < .05). However, no differences were found at any time point between controls and infants treated with volume or additional dopamine (5, 7.5, and 10 μg/kg per minute) for rSco2 or cFTOE.

CONCLUSIONS:

Volume expansion and additional dopamine do not cause any significant change in rSco2 or cFTOE in hypotensive preterm infants without PDA. We speculate that very preterm infants with hypotension but without signs of a compromised cerebral oxygenation and systemic perfusion might not be in need of antihypotensive therapy.
Effect of Maxillary Sinus Floor Augmentation on Sinus Membrane Thickness in Computed Tomography
Authors: Pommer Bernhard , Dvorak Gabriella , Jesch Philip , Palmer Richard M. , Watzek Georg , Gahleitner André
Published: November 2011

Background: Little is known about maxillary sinus compliance, i.e., the intrinsic potential of the sinus membrane to resume its homeostatic status after the surgical trauma caused by sinus floor elevation. The aim of the present study is to investigate the effect of maxillary sinus floor augmentation on sinus membrane thickness.

Methods: Within‐patient comparison of computed tomographic scans before bone grafting versus 4 to 6 months after bone grafting was performed. Changes in membrane thickness were evaluated in 65 maxillary sinus floor augmentation procedures via a lateral approach in 35 patients without clinical signs of sinus pathology at any time.

Results: Sinus membrane thickness differed significantly before (0.8 ± 1.2 mm) versus after (1.5 ± 1.3 mm) augmentation surgery (P <0.001), with a mean increase of 0.8 ± 1.6 mm (maximum: 4.4 mm). Only 28% of augmented sinuses did not show membrane thickening. In non‐augmented control sinuses, there was no evidence of membrane thickness increase.

Conclusions: The results indicate that the maxillary sinus membrane, even in healthy clinical conditions, undergoes morphologic modifications after sinus floor elevation, yet membrane reactions demonstrate significant variability. Future research on the effect of augmentation surgery on maxillary sinus physiology is recommended.