bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Female Legislators Do It Differently? Sex Offender Lawmaking at the State Level
Authors: Meloy Michelle L.
Published: October 2014

This investigation explores sex offender bill sponsorship by male and female legislators from both political parties to determine if female policymakers legislate in a “different voice.” Quantitative results indicate that sex offender bill sponsorship often transcends differences of gender, race, or political affiliation. However, the in-depth qualitative findings revealed that female policymakers viewed sex crimes and sex offender laws more broadly than male legislators noting the multiple contexts in which sexual victimizations occur, and as connected with the larger social problem of violence against women. In comparison, male legislators focused on predatory child molestations as their motivation for sex offender bill sponsorship. Findings suggest that relying only on descriptive statistical analysis to study gender and policymaking, such as voting patterns, is likely to miss subtle, but significant, differences in women’s policymaking.
Expert Elicitation of Study Weights for Bayesian Analysis and Meta-Analysis
Authors: Rietbergen Charlotte , Groenwold Rolf H. H. , Hoijtink Herbert J. A. , Moons Karl G. M. , Klugkist Irene
Published: October 2014

Meta-analysis and Bayesian informative prior distributions are used for updating knowledge about treatment effects with new data. When the available data come from slightly different study populations, or from slightly different trials as compared with the new data, the researcher has to specify study weights to control the influence of the historical data on the current data. This research evaluates whether an internet Delphi technique is useful to elicit valid and reliable study weights from an expert panel. Weights were elicited for four historical studies by four experts. Despite some difficulties regarding the panel, such as respondent burden, the method seemed useful within this context. The authors advise to include sensitivity analyses to assess the required number of Delphi rounds.
Biological drugs for the treatment of rheumatoid arthritis by the subcutaneous route: interpreting efficacy data to assess statistical equivalence
Authors: Messori Andrea , Fadda Valeria , Maratea Dario , Trippoli Sabrina , Gatto Roberta , De Rosa Mauro , Marinai Claudio
Published: October 2014

Background:

No equivalence analysis has yet been conducted on the effectiveness of biologics in rheumatoid arthritis. Equivalence testing has a specific scientific interest, but can also be useful for deciding whether acquisition tenders are feasible for the pharmacological agents being compared.

Methods:

Our search covered the literature up to August 2014. Our methodology was a combination of standard pairwise meta-analysis, Bayesian network meta-analysis and equivalence testing. The agents examined for their potential equivalence were etanercept, adalimumab, golimumab, certolizumab, and tocilizumab, each in combination with methotrexate (MTX). The reference treatment was MTX monotherapy. The endpoint was ACR50 achievement at 12 months. Odds ratio was the outcome measure. The equivalence margins were established by analyzing the statistical power data of the trials.

Results:

Our search identified seven randomized controlled trials (2846 patients). No study was retrieved for tocilizumab, and so only four biologics were evaluable. The equivalence range was set at odds ratio from 0.56 to 1.78. There were 10 head-to-head comparisons (4 direct, 6 indirect). Bayesian network meta-analysis estimated the odds ratio (with 90% credible intervals) for each of these comparisons. Between-trial heterogeneity was marked. According to our results, all credible intervals of the 10 comparisons were wide and none of them satisfied the equivalence criterion. A superiority finding was confirmed for the treatment with MTX plus adalimumab or certolizumab in comparison with MTX monotherapy, but not for the other two biologics.

Conclusion:

Our results indicate that these four biologics improved the rates of ACR50 achievement, but there was an evident between-study heterogeneity. The head-to-head indirect comparisons between individual biologics showed no significant difference, but failed to demonstrate the proof of no difference (i.e. equivalence). This body of evidence presently precludes any option of undertaking competitive tenderings for the procurement of these agents.
Clozapine treatment of refractory schizophrenia during essential chemotherapy: a case study and mini review of a clinical dilemma
Authors: Usta Nazife Gamze , Poyraz Cana Aksoy , Aktan Melih , Duran Alaattin
Published: October 2014

Background:

Clozapine remains the antipsychotic of choice for refractory schizophrenia. Given the particular side effects of clozapine including neutropenia and myelosuppression, safety and efficacy of add-on chemotherapy for patients who are already under clozapine treatment remain unknown.

Objective:

We present evidence from a patient with a diagnosis of refractory schizophrenia on clozapine medication, who required essential chemotherapy for chronic lymphocytic leukemia (CLL). We have also reviewed literature regarding this challenging clinical dilemma.

Method:

We report details about a patient with treatment-resistant schizophrenia who was given chemotherapy (fludarabine, cyclophosphamide and rituximab) for CLL in the course of concomitant treatment with clozapine and granulocyte-colony stimulating factor (G-CSFs). In addition, we have reviewed literature using the PUBMED data base.

Results:

Current evidence remains insufficient to provide authoritative guide to clinicians regarding the efficacy and safety of the combined use of clozapine and chemotherapy. However, general conclusion from our case and of the published evidence is that a combination of clozapine use and chemotherapeutic agents do not cause additional hematological worsening with no decreasing efficacy concerns raised.

Conclusion:

Continuing with clozapine in the course of chemotherapy may be relatively safer for patients who responded well to clozapine concomitant with G-CSF treatment.
Nutritional Aspects to Prevent Heart Diseases in Traditional Persian Medicine
Authors: Kordafshari Gholamreza , Kenari Hoorieh Mohammadi , Esfahani Mohammad Mehdi , Ardakani Mohammad Reza Shams , Keshavarz Mansoor , Nazem Esmaeil , Moghimi Maryam , Zargaran Arman
Published: October 2014

Cardiovascular diseases are major health complications currently in various societies. Management of heart diseases as a prevention step or as treatment with low-cost procedures like lifestyle modifications including nutrition are important current trends. Although the term nutrition dates back to 2 past centuries, Persian physicians contributed to this term at least from 1000 years ago. Rhazes (865-925 AD) was one of the pioneers in this field. He preferred using foods in treating illnesses. “Foods and drinks” were 1 subject from 6 principles ( Setteh Zarorieh) that Persian physicians believed can affect human health. In this review, we described some medieval Persian views on the role of nutrition in heart diseases and compare their prescriptions with current findings. Interestingly, current investigations mostly support Persian medicine principles. Historically, this work shows that the concept of nutrition in heart diseases has had a successful background at least from 1000 years ago in Persia.
The Importance of Cultivating Mindfulness for Cognitive and Emotional Well-Being in Late Life
Authors: Fiocco Alexandra J. , Mallya Sasha
Published: October 2014

The cultivation of mindfulness has received increasing attention over the past 2 decades because of its association with increased psychological well-being and reduced stress-related health disorders. Given the robust positive association between perceived stress and cognitive impairment in late life, the current study evaluated the association between trait mindfulness, psychological well-being, and cognitive function in 73 healthy community-dwelling older adults. Controlling for a priori covariates, multivariate regression analyses showed a significant association between trait mindfulness and measures of psychological well-being, including self-reported depressive symptoms, quality of life, and stress profile. Analyses further showed a significant association between trait mindfulness and executive function, namely set shifting. No association was found for declarative memory. Mediation analyses showed that the association between mindfulness and cognitive function is mediated by perceived stress. This research supports the importance of cultivating mindfulness in late life to ensure cognitive and emotional well-being.
STD Clinic Patients’ Awareness of Non-AIDS Complications of HIV Infection
Authors: Castro José Guillermo , Granovsky Inna , Jones Deborah , Weiss Stephen M.
Published: October 2014

Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection.
Leishmaniasis as a Manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV-Infected Patients
Authors: Badaró Roberto , Gonçalves Larissa O. , Gois Luana L. , Maia Zuinara Pereira Gusmão , Benson Constance , Grassi Maria Fernanda Rios
Published: October 2014

Introduction:

After the onset of highly active antiretroviral therapy (HAART), some HIV-infected patients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS.

Methods:

 A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases.

Results and Discussion:

The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 ± 77 cells/mm3, increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post–kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis.

Conclusions:

Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression.
Adherence among Rural HIV-Infected Patients in the Deep South
Authors: Tennant Sarah J. , Hester E. Kelly , Caulder Celeste R. , Lu Z. Kevin , Bookstaver P. Brandon
Published: October 2014

Background:

Once-daily (QD), combination antiretroviral therapy (ART) can impact the willingness and ability of patients to take medications as directed. The impact of antiretroviral (ARV) drug adherence influenced by single-tablet (STR) versus multi-tablet regimens (MTR) among patients enrolled in the AIDS Drug Assistance Program (ADAP) in a rural environment has not yet been assessed.

Material and Methods:

A retrospective chart review evaluated adherence and outcomes in adult HIV-infected patients enrolled in the ADAP at 2 ambulatory clinics in the Southeast, taking either a QD STR (efavirenz [EFV]/emtricitabine/tenofovir [TDF]) or a QD protease inhibitor (PI)-based, MTR (atazanavir [ATV], ritonavir [RTV], and emtricitabine/TDF) by evaluating pharmacy refill records, patient self-reported adherence, and virologic response.

Results:

A total of 389 patient records were analyzed (STR, n = 165 versus MTR, n = 224). There were more males, a higher percentage of treatment-naive patients, and more patients with a baseline CD4 count of >200 cells/mm3 in the MTR group. Based on refill records, more patients on MTR were >90% adherent (61.6% versus 51.5%, P = .047). In a multivariable analysis, being treatment experienced was a negative predictor (odds ratio [OR] = 0.48, 0.29-0.78) for adherence. Regimen choice was not associated with adherence. More patients taking MTR were virologically suppressed at the end of the observation period. Regardless of the regimen, being >90% adherent was a significant predictor of virologic suppression (OR = 3.51, 1.98-6.23).

Conclusion:

Treatment-experienced patients enrolled in ADAP are less likely to be adherent. A QD PI-based MTR may result in comparable adherence to an STR in a rural HIV-infected population.
Managing the Personal Side of Health Care among Patients with HIV/AIDS
Authors: Mgbere Osaro , Khuwaja Salma , Bell Tanvir K. , Rodriguez-Barradas Maria C. , Arafat Raouf , Blair Janet M. , Essien Ekere James
Published: October 2014

The study describes the HIV care providers’ sociodemographic and medical practice characteristics and the health care services offered to patients during medical care encounters in Houston/Harris County, Texas. We used data from the pilot cycle of the Centers for Disease Control and Prevention Medical Monitoring Project Provider Survey conducted in June to September 2009. The average age and HIV care experience of the providers were 46.7 and 11.7 years, respectively, and they provided care to an average of 113 patients monthly. The average proportion of HIV-infected patients seen per month by race/ethnicity was 43.3% for blacks, 28.5% for whites, 26.6% for Hispanics, 1.3% for Asians, and 0.6% for other races. A total of 67% of providers offered HIV testing to all patients 13 to 64 years of age. Most HIV care providers (73.9%) reported that patients in their practices sought HIV care only after experiencing symptoms. Understanding the HIV care delivery system from providers’ perspectives may help enhance support services, patients’ ongoing care and retention, leading to improved health outcomes.
HIV-Associated Neurocysticercosis
Authors: Anand Kuljeet Singh , Wadhwa Ankur , Garg Jyoti , Mahajan Rakesh Kumar
Published: October 2014

Few cases of HIV and neurocysticercosis co-infection have been reported till date. The symptomatic manifestation of cysticercosis may be further reduced by interactions between the 2 disease processes. In patients with HIV, the diagnosis of neurocysticercosis is challenging and management must be individualized depending on the stage and the coexistent opportunistic conditions. We present 2 such cases. First was a 35-year-old driver seropositive for HIV-1 presented with complex partial seizures and a CD4 count of 530 cells/mm3. The second case was a 40-year-old businessman with a CD4 count of 350 cells/mm3. Both of them had multiple parenchymal lesions, with 1 being a large cystic lesion. Relatively high CD4 count and a positive enzyme-linked immunosorbent assay increased the likelihood for diagnosis and treatment. Both of our patients received cysticidal therapy, and none of them deteriorated with treatment.
Gq-mediated Akt translocation to the membrane: a novel PIP3-independent mechanism in platelets
Authors: Badolia Rachit , Manne Bhanu Kanth , Dangelmaier Carol , Chernoff Jonathan , Kunapuli Satya P.
Published: October 2014

Key Points

There is a novel PIP3-independent and Gq-dependent Akt translocation mechanism in the platelets. PAK constitutively associates with Akt, and possibly mediates its membrane translocation independently of PIP3.
Oscillation theorems for second order nonlinear neutral difference equations
Authors: Selvarangam Srinivasan , Thandapani Ethiraju , Pinelas Sandra
Published: October 2014

This paper deals with the oscillation of second order neutral difference equations of the form

△

(

a
n

(
△
(

x
n

+

p
n

x

τ
(
n
)

)
)

α

)

+

q
n

x

σ
(
n
)

β

=
0
.

The oscillation of all solutions of this equation is established via comparison theorems. Examples are provided to illustrate the main results.

MSC:39A10.
Dynamics of deterministic and stochastic multi-group MSIRS epidemic models with varying total population size
Authors: Wang Zhigang , Fan Xiaoming , Jiang Fuquan , Li Qiang
Published: October 2014

In this paper, we extend the deterministic single-group MSIRS epidemic model to a multi-group model, and we also extend the deterministic multi-group framework to a stochastic one and formulate it as a stochastic differential equation. In the deterministic multi-group model, the basic reproduction number

R
0

is a threshold that completely determines the persistence or extinction of the disease. By using Lyapunov function techniques, we show that if

R
0

>
1

, then the disease will prevail, the infective condition persists and the endemic state is asymptotically stable in a feasible region. If

R
0

⩽
1

, then the infective condition disappears and the disease dies out. For the stochastic version, we perform a detailed analysis on the asymptotic behavior of the stochastic model, which also depends on the value of

R
0

, when

R
0

>
1

, we determine the asymptotic stability of the endemic equilibrium by measuring the difference between the solution and the endemic equilibrium of the deterministic model in time-averaged data. Numerical methods are used to illustrate the dynamic behavior of the model and to solve the systems.
The potential of the energy cane as the main biomass crop for the cellulosic industry
Authors: Carvalho-Netto Osmar V , Bressiani Jose A , Soriano Hugo L , Fiori Celso S , Santos Joao M , Barbosa Geraldo VS , Xavier Mauro A , Landell Marcos GA , Pereira Goncalo AG
Published: October 2014

The last century was the scene of an extraordinary social and economic development of mankind. This development had the fossil energy as one of its pillars. The discovery of petrol led the society to shape a development model highly dependent on this source of energy, which has finite resources and also promotes a big increase on the greenhouse gases, with unforeseeable consequences for the human beings as well as the entire life. It is imperative that we change the pillars of energy from fossil to renewables that will be more sustainable and less aggressive to the environment. One of the sources of this new energy platform, probably the best, is biomass. Fibrous plants bring several advantages and fit well within the requirements deemed important to be elected as producers of biomass. Among these characteristics we have the high processing capacity of solar energy into biomass, fast growth, long-term canopy, possibility of large-scale production. Despite of that this plants are adapted to suboptimal environments that allows its production not compete with food production because it requires less energy input, bringing marginal lands into production with its all social-benefit consequences. Among the fibrous plants, SUGAR CANE or, better, ENERGY CANE has one of the biggest potential for biomass productions. Results from several breeding programs has showing the high biomass potential of energy cane over other biomass crops like sorghum, elephant grass and eucalyptus.
Southwest Oncology Group S0008: A Phase III Trial of High-Dose Interferon Alfa-2b Versus Cisplatin, Vinblastine, and Dacarbazine, Plus Interleukin-2 and Interferon in Patients With High-Risk Melanoma—An Intergroup Study of Cancer and Leukemia Group B, Children's Oncology Group, Eastern Cooperative Oncology Group, and Southwest Oncology Group
Authors: Flaherty Lawrence E. , Othus Megan , Atkins Michael B. , Tuthill Ralph J. , Thompson John A. , Vetto John T. , Haluska Frank G. , Pappo Alberto S. , Sosman Jeffrey A. , Redman Bruce G. , Moon James , Ribas Antoni , Kirkwood John M. , Sondak Vernon K.
Published: October 2014

Purpose

High-dose interferon (IFN) for 1 year (HDI) is the US Food and Drug Administration–approved adjuvant therapy for patients with high-risk melanoma. Efforts to modify IFN dose and schedule have not improved efficacy. We sought to determine whether a shorter course of biochemotherapy would be more effective.

Patients and Methods

S0008 (S0008: Chemotherapy Plus Biological Therapy in Treating Patients With Melanoma) was an Intergroup phase III trial that enrolled high-risk patients (stage IIIA-N2a through IIIC-N3), randomly assigning them to receive either HDI or biochemotherapy consisting of dacarbazine, cisplatin, vinblastine, interleukin-2, IFN alfa-2b (IFN-α-2b) and granulocyte colony-stimulating factor given every 21 days for three cycles. Coprimary end points were relapse-free survival (RFS) and overall survival (OS).

Results

In all, 432 patients were enrolled. Grade 3 and 4 adverse events occurred in 57% and 7% of HDI patients and 36% and 40% of biochemotherapy patients, respectively. At a median follow-up of 7.2 years, biochemotherapy improved RFS (hazard ratio [HR], 0.75; 95% CI, 0.58 to 0.97; P = .015), with a median RFS of 4.0 years (95% CI, 1.9 years to not reached [NR]) versus 1.9 years for HDI (95% CI, 1.2 to 2.8 years) and a 5-year RFS of 48% versus 39%. Median OS was not different (HR, 0.98; 95% CI, 0.74 to 1.31; P = .55), with a median OS of 9.9 years (95% CI, 4.62 years to NR) for biochemotherapy versus 6.7 years (95% CI, 4.5 years to NR) for HDI and a 5-year OS of 56% for both arms.

Conclusion

Biochemotherapy is a shorter, alternative adjuvant treatment for patients with high-risk melanoma that provides statistically significant improvement in RFS but no difference in OS and more toxicity compared with HDI.
Daily Aspirin Use and Prostate Cancer–Specific Mortality in a Large Cohort of Men with Nonmetastatic Prostate Cancer
Authors: Jacobs Eric J. , Newton Christina C. , Stevens Victoria L. , Campbell Peter T. , Freedland Stephen J. , Gapstur Susan M.
Published: October 2014

Purpose

In a recent analysis of a large clinical database, postdiagnosis aspirin use was associated with 57% lower prostate cancer–specific mortality (PCSM) among men diagnosed with nonmetastatic prostate cancer. However, information on this association remains limited. We assessed the association between daily aspirin use and PCSM in a large prospective cohort.

Patients and Methods

This analysis included men diagnosed with nonmetastatic prostate cancer between enrollment in the Cancer Prevention Study-II Nutrition Cohort in 1992 or 1993 and June 2009. Aspirin use was reported at enrollment, in 1997, and every 2 years thereafter. During follow-up through 2010, there were 441 prostate cancer deaths among 8,427 prostate cancer cases with information on prediagnosis aspirin use and 301 prostate cancer deaths among 7,118 prostate cancer cases with information on postdiagnosis aspirin use.

Results

Compared with no aspirin use, neither prediagnosis nor postdiagnosis daily aspirin use were statistically significantly associated with PCSM (prediagnosis use, multivariable-adjusted hazard ratio (HR) = 0.92, 95% CI 0.72 to 1.17, postdiagnosis use, HR = 0.98; 95% CI, 0.74 to 1.29). However, among men diagnosed with high-risk cancers (≥ T3 and/or Gleason score ≥ 8), postdiagnosis daily aspirin use was associated with lower PCSM (HR = 0.60; 95% CI, 0.37 to 0.97), with no clear difference by dose (low-dose, typically 81 mg per day, HR = 0.50; 95% CI, 0.27 to 0.92, higher dose, HR = 0.73; 95% CI, 0.40 to 1.34).

Conclusion

A randomized trial of aspirin among men diagnosed with nonmetastatic prostate cancer was recently funded. Our results suggest any additional randomized trials addressing this question should prioritize enrolling men with high-risk cancers and need not use high doses.
Trastuzumab Plus Adjuvant Chemotherapy for Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: Planned Joint Analysis of Overall Survival From NSABP B-31 and NCCTG N9831
Authors: Perez Edith A. , Romond Edward H. , Suman Vera J. , Jeong Jong-Hyeon , Sledge George , Geyer Charles E. , Martino Silvana , Rastogi Priya , Gralow Julie , Swain Sandra M. , Winer Eric P. , Colon-Otero Gerardo , Davidson Nancy E. , Mamounas Eleftherios , Zujewski Jo Anne , Wolmark Norman
Published: October 2014

Purpose

Positive interim analysis findings from four large adjuvant trials evaluating trastuzumab in patients with early-stage human epidermal growth factor receptor 2 (HER2) –positive breast cancer were first reported in 2005. One of these reports, the joint analysis of North Central Cancer Treatment Group NCCTG N9831 (Combination Chemotherapy With or Without Trastuzumab in Treating Women With HER2-Overexpressing Breast Cancer) and the National Surgical Adjuvant Breast and Bowel Project NSABP B-31 (Doxorubicin and Cyclophosphamide Plus Paclitaxel With or Without Trastuzumab in Treating Women With Node-Positive Breast Cancer That Overexpresses HER2), was updated in 2011. We now report the planned definitive overall survival (OS) results from this joint analysis along with updates on the disease-free survival (DFS) end point.

Methods

In all, 4,046 patients with HER2-positive operable breast cancer were enrolled to receive doxorubicin and cyclophosphamide followed by paclitaxel with or without trastuzumab in both trials. The required number of events for the definitive statistical analysis for OS (710 events) was reached in September 2012. Updated analyses of overall DFS and related subgroups were also performed.

Results

Median time on study was 8.4 years. Adding trastuzumab to chemotherapy led to a 37% relative improvement in OS (hazard ratio [HR], 0.63; 95% CI, 0.54 to 0.73; P < .001) and an increase in 10-year OS rate from 75.2% to 84%. These results were accompanied by an improvement in DFS of 40% (HR, 0.60; 95% CI, 0.53 to 0.68; P < .001) and increase in 10-year DFS rate from 62.2% to 73.7%. All patient subgroups benefited from addition of this targeted anti-HER2 agent.

Conclusion

The addition of trastuzumab to paclitaxel after doxorubicin and cyclophosphamide in early-stage HER2-positive breast cancer results in a substantial and durable improvement in survival as a result of a sustained marked reduction in cancer recurrence.
Prediction of Late Distant Recurrence After 5 Years of Endocrine Treatment: A Combined Analysis of Patients From the Austrian Breast and Colorectal Cancer Study Group 8 and Arimidex, Tamoxifen Alone or in Combination Randomized Trials Using the PAM50 Risk of Recurrence Score
Authors: Sestak Ivana , Cuzick Jack , Dowsett Mitch , Lopez-Knowles Elena , Filipits Martin , Dubsky Peter , Cowens John Wayne , Ferree Sean , Schaper Carl , Fesl Christian , Gnant Michael
Published: October 2014

Purpose

We have previously shown that the PAM50-based risk of recurrence (ROR) score is significantly correlated with distant recurrence in both the translational research cohort within the Arimidex, Tamoxifen Alone or in Combination (ATAC) trial (TransATAC) and Austrian Breast and Colorectal Cancer Study Group 8 (ABCSG 8) randomized trials. Here, we focus on the ROR score for predicting distant recurrence after 5 years of follow-up in a combined analysis of these two randomized trials.

Methods

Long-term follow-up data and tissue samples were obtained from 2,137 postmenopausal women with hormone receptor–positive early-stage breast cancer from the ABCSG 8 and TransATAC trials. We used Cox proportional hazard regression models to determine the prognostic value of ROR for distant recurrence beyond 5 years in the combined data set.

Results

A total of 2,137 women who did not have a recurrence 5 years after diagnosis were included in the combined analyses. The Clinical Treatment Score (CTS) was the strongest prognostic factor 5 years after diagnosis (univariable: likelihood ratio [LR] χ2 = 94.12, bivariable: LR χ2 = 61.43). The ROR score was significantly prognostic by itself in years 5 to 10. In the node-negative/human epidermal growth factor receptor 2–negative subgroup, more prognostic value for late distant recurrence was added by the ROR score compared with the CTS.

Conclusion

The ROR score added clinically meaningful prognostic information to the CTS in all patients and all subgroups in the late follow-up period. These results suggest that the ROR score may be helpful for separating patients into risk groups who could be spared or potentially benefit from extended hormonal therapy beyond 5 years of treatment.
Preliminary Results of a Phase II Trial of Proton Radiotherapy for Pediatric Rhabdomyosarcoma
Authors: Ladra Matthew M. , Szymonifka Jackie D. , Mahajan Anita , Friedmann Alison M. , Yong Yeap Beow , Goebel Claire P. , MacDonald Shannon M. , Grosshans David R. , Rodriguez-Galindo Carlos , Marcus Karen J. , Tarbell Nancy J. , Yock Torunn I.
Published: October 2014

Purpose

This prospective phase II study was designed to assess disease control and to describe acute and late adverse effects of treatment with proton radiotherapy in children with rhabdomyosarcoma (RMS).

Patients and Methods

Fifty-seven patients with localized RMS (age 21 years or younger) or metastatic embryonal RMS (age 2 to 10 years) were enrolled between February 2005 and August 2012. All patients were treated with chemotherapy based on either vincristine, actinomycin, and cyclophosphamide or vincristine, actinomycin, and ifosfamide–based chemotherapy and proton radiation. Surgical resection was based on tumor site and accessibility. Common Terminology Criteria for Adverse Events, Version 3.0, was used to assess and grade adverse effects of treatment. Concurrent enrollment onto Children's Oncology Group or European Pediatric Sarcoma Study Group protocols was allowed. All pathology and imaging were reviewed at the treating institution.

Results

Median follow-up was 47 months (range, 14 to 102 months) for survivors. Five-year event-free survival (EFS), overall survival (OS), and local control (LC) were 69%, 78%, and 81%, respectively, for the entire cohort. The 5-year LC by risk group was 93% for low-risk and 77% for intermediate-risk disease. There were 13 patients with grade 3 acute toxicity and three patients with grade 3 late toxicity. There were no acute or late toxicities higher than grade 3.

Conclusion

Five-year LC, EFS, and OS rates were similar to those observed in comparable trials that used photon radiation. Acute and late toxicity rates were favorable. Proton radiation appears to represent a safe and effective radiation modality for pediatric RMS.
Control of Hepatic Gluconeogenesis by the Promyelocytic Leukemia Zinc Finger Protein
Authors: Chen Siyu , Qian Jinchun , Shi Xiaoli , Gao Tingting , Liang Tingming , Liu Chang
Published: October 2014

The promyelocytic leukemia zinc finger (PLZF) protein is involved in major biological processes including energy metabolism, although its role remains unknown. In this study, we demonstrated that hepatic PLZF expression was induced in fasted or diabetic mice. PLZF promoted gluconeogenic gene expression and hepatic glucose output, leading to hyperglycemia. In contrast, hepatic PLZF knockdown improved glucose homeostasis in db/db mice. Mechanistically, peroxisome proliferator-activated receptor γ coactivator 1α and the glucocorticoid receptor synergistically activated PLZF expression. We conclude that PLZF is a critical regulator of hepatic gluconeogenesis. PLZF manipulation may benefit the treatment of metabolic diseases associated with gluconeogenesis.
Testicular fluorine-18 fludeoxyglucose uptake on positron emission tomography CT in patients with lymphoma: clinical significance and management impact
Authors: Sidhu P , Lin P , Son H , Rosenfeld D , Lin M
Published: October 2014

Objective:

This is the first case series examining the role of fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography-CT (PET-CT) in the diagnosis of lymphoma, and its impact on the clinical management of patients with secondary testicular involvement. This study explores the clinical significance of abnormal testicular uptake, maximum standardized uptake values and the diagnostic value of the CT component in PET-CT scans of these patients.

Methods:

The case notes and PET scans of 12 patients with diagnosis of lymphoma that were reported to have abnormal 18F-FDG uptake in the testes were examined. Case notes were reviewed for the underlying diagnosis, indication for the scan and its effect on the management decision.

Results:

12 patients demonstrated abnormal 18F-FDG uptake on the PET-CT scans (mean age, 63 years; range, 37–82 years). Seven patients were diagnosed with testicular lymphoma. Six out of the seven (86%) patients received additional intrathecal chemotherapy in addition to their systemic chemotherapy, and one patient had testicular radiotherapy.

Conclusion:

This study establishes the importance of identifying and reporting abnormal 18F-FDG uptake in the testes on PET-CT in patients with lymphoma. 18F-FDG PET-CT is superior to conventional imaging in identifying testicular lymphoma and has significant management impact. It also emphasizes the importance of incorporating the testes as part of the scan coverage.

Advances in knowledge:

The appearances of testicular lymphoma on 18F-FDG PET-CT can be variable and abnormal testicular uptake warrants further investigations and confirmation. FDG PET-CT is an important tool and can be used in addition to conventional imaging in the identification of testicular lymphoma.
Case Report: Paroxysmal nocturnal hemoglobinuria in a woman heterozygous for G6PD A-
Authors: Perdigones Nieves , Morales Mariela , Mason Philip , Bessler Monica
Published: October 2014

We describe a case of paroxysmal nocturnal hemoglobinuria (PNH) in a woman who is heterozygous for the glucose-6-phosphate dehydrogenase A-   (G6PDA-) allele. PNH is associated with one or more clones of cells that lack complement inhibition due to loss of function somatic mutations in thePIGAgene. PIGAencodes the enzyme phosphatidylinositol glycan anchor biosynthesis, class A, which catalyses the first step of glycosylphosphatidylinisotol (GPI)  anchor synthesis. Two GPI anchored red cell surface antigens regulate complement lysis. G6PD catalyses the first step of the pentose phosphate pathway and enzyme variants, frequent in some populations have been selected because they confer resistance to malaria, are associated with hemolysis in the presence of oxidizing agents including several drugs. The patient had suffered a hemolytic attack after taking co-trimoxazole, a drug that precipitates hemolysis in G6PD deficient individuals. Since bothG6PDandPIGAare X-linked we hypothesized that thePIGAmutation was on the X-chromosome carrying theG6PDA- allele. Investigations showed that in fact thePIGAmutation was on the X-chromosome carrying the normalG6PD Ballele. We speculate that complement activation onG6PD A- red cells exposed to Bactrim might have triggered complement activation inducing the lysis ofG6PD BPNH Type II red blood cells or that the patient may have had a PNH clone expressingG6PDA-at the time of the hemolytic episode.
Getting their oats
Authors: Chapman Ailsa
Published: October 2014

Ailsa Chapman helps children to cook Goldilock's favourite biscuits made with porridge oats and golden syrup.
Laboratory Evaluation of Pheochromocytoma and Paraganglioma
Authors: Eisenhofer Graeme , Peitzsch Mirko
Published: October 2014

BACKGROUND

Pheochromocytomas and paragangliomas (PPGLs) are potentially lethal yet usually surgically curable causes of endocrine hypertension; therefore, once clinical suspicion is aroused it is imperative that clinicians choose the most appropriate laboratory tests to identify the tumors.

CONTENT

Compelling evidence now indicates that initial screening for PPGLs should include measurements of plasma free metanephrines or urine fractionated metanephrines. LC-MS/MS offers numerous advantages over other analytical methods and is the method of choice when measurements include methoxytyramine, the O-methylated metabolite of dopamine. The plasma test offers advantages over the urine test, although it is rarely implemented correctly, rendering the urine test preferable for mainstream use. To ensure optimum diagnostic sensitivity for the plasma test, reference intervals must be established for blood samples collected after 30 min of supine rest and after an overnight fast when measurements include methoxytyramine. Similarly collected blood samples during screening, together with use of age-adjusted reference intervals, further minimize false-positive results. Extents and patterns of increases in plasma normetanephrine, metanephrine, and methoxytyramine can additionally help predict size and adrenal vs extraadrenal locations of tumors, as well as presence of metastases and underlying germline mutations of tumor susceptibility genes.

Carried out correctly at specialist endocrine centers, collection of blood for measurements of plasma normetanephrine, metanephrine, and methoxytyramine not only provides high accuracy for diagnosis of PPGLs, but can also guide clinical decision-making about follow-up imaging strategies, genetic testing, and therapeutic options. At other centers, measurements of urine fractionated metanephrines will identify most PPGLs.
The participatory installation – Forming the evidence of experience
Authors: Fenner Patricia , Allen Jan
Published: October 2014

This article reports on an enquiry designed to explore the impact of the arts on health though a participatory arts installation during the Evidence in a Different Form Conference. Delegates were invited to contribute to the installation with small, personally meaningful objects related to the arts, health and evidence. The process and content of the installation are discussed, focusing on dynamic interactions, conversations and meaningful associations that evolved. Implications identified relate to the arts, place-making and restorative environments, how personal meanings attached to art can change over time and how the direction of projects using arts-based processes can sometimes develop unpredictably. This installation project demonstrates how being open to the natural evolution of a project can reap meaningful results for communities.
Learning from experience: Building the evidence base for arts and health in a community health service
Authors: Nikolas Helen
Published: October 2014

Well-planned and evaluated work that produces measurable repeatable outcomes will add to the evidence base for arts and health. Two participatory artworks were created over consecutive years to promote a welcoming ambience in reception areas on two sites of a community health service (CHS) in Victoria. The model used consultation and achieved maximum participation. A range of evaluation methods allowed for triangulation of the results. In addition to the improved ambience, qualitative thematic analysis identified outcomes for participants in both projects of connectedness, relaxation, reminiscence, enjoyment and beauty. By repeating a successful model and finding similar outcomes, we can develop the evidence base.
Art as evidence: Ethical considerations when using client artworks in exhibitions
Authors: Leenstra San , Goldstraw Sally , Rumbold Bruce
Published: October 2014

Exhibitions are frequently used to illustrate outcomes of arts therapy programmes, showcase community arts projects, and to gather research data. In this article we review some of the ethical dilemmas that arise in exhibiting client or participant artwork, and argue that attention to shared decision-making within an ethics of care framework is needed to ensure constructive ethical practice.
Palliative care for the planet
Authors: Horsfall Debbie , Linnell Sheridan , Latham Robyne , Rumbold Jean
Published: October 2014

This article weaves together our responses, as three visitors and one Indigenous owner of this land, to the impending end of life, at least human life, on this planet. What we make of this almost impossible theme and what it makes of us are enacted through art, poetry, reverie, analysis and storytelling. We write in ways that are personal, lateral and yet collective, experimenting with how the tensions and connections between different art forms, methodologies and theories might contribute to an emergent ethic of ‘palliative care for the planet’.
Face-to-face and distance teaching and learning in higher education: Lessons from the preparation of professional musicians
Authors: Jorgensen Estelle R.
Published: October 2014

In this article, it is suggested that academic programmes in higher education can benefit from focusing on procedural (or practical and phenomenal) and propositional (or theoretical and abstract) knowledge. The preparation of professional musicians is particularly relevant to this issue because musicians’ focus is often on procedural knowledge gained through making music. Accordingly, two approaches to preparing professional musicians are contrasted – face-to-face and distance education – and these illustrate how the transmission and acquisition of procedural knowledge works. The first, face-to-face teaching and learning, is thought about figuratively in terms of an artist who apprentices pupils or disciples and leads them to become exponents of particular musical practices. The second, distance teaching and learning in music as practiced worldwide, is informed particularly by metaphors of the web, factory and boutique that invoke, respectively, notions of connectivity, production and consumption in music education. The role of technology in mediating the process of teacher and student interaction in distance education is explored. Implications of the analysis for distance teaching and learning in higher education are sketched, with particular reference to the practical case of a hypothetical music school.
Reviews
Authors: Mitchell Helen , Thomas Niall
Published: October 2014

The Oxford Handbook of Film Music Studies, David Neumeyer (ed.) (2014) New York: Oxford University Press, 683 pp., ISBN: 9780195328493, h/bk, £100

The Art of Music Production: The Theory and Practice, Richard James Burgess (2013) Oxford University Press, 329 pp., ISBN: 9780199921744, p/bk, £19.99
The politics of place in two early films by Borau
Authors: D’Lugo Marvin
Published: October 2014

Borau’s refusal to accept the ghettoization of Spanish film through the imposition of ‘national’ cinema is one of the hallmarks of his career. He is the first in his generation of Spanish directors to develop an aesthetic strategy to reframe Spanish cultural identity through a series of international co-productions. This article looks at two films and two decisive moments in Borau’s career when that transnational aesthetic first emerges. Hay que matar a B/B Must Die (1974) and La Sabina (1979) elaborate counter-narratives of the nation that interrogate the relationship between place and power and the identity shaped by the politics of location.
Border-crossing with Borau: At home, abroad
Authors: D’Lugo Marvin , Kinder Marsha
Published: October 2014

This special issue pays tribute to José Luis Borau’s unique and innovative career in Spanish film spanning more than four decades. It assesses his influence on the larger development of a modern Spanish cinema in national and transnational contexts. Throughout his multifaceted career, Borau was instrumental in shaping a modern cinematic language that helped bring Spanish cinema international acclaim. His unique contributions to Spanish and international cinema include landmark films like the Oscar-nominated black comedy My Dear Señorita (1971), co-scripted with director Jaime de Armiñán; B Must Die (1974); Furtivos (1975); La Sabina (1979); and On the Line (1984). Borau’s collaborations on films with his former students from the National Film School (Iván Zuelueta, Antonio Drove, Manuel Gutiérrez Aragón) would assure his influence on future generations of Spanish audiences. His more recent television series Celia (1991) and Goya award-winning film Leo (2001) confirm Borau’s range as a uniquely gifted film author.
Recuerdos De Un Testigo Exiliado
Authors: Gubern Román
Published: October 2014

In November 1975, José Luis Borau initiated a strategy to promote the American distribution of his award-winning film Furtivos/Poachers by enlisting the support of noted Spanish film historian Román Gubern to present the film in Los Angeles to a gathering of members of the Hollywood press. By chance, the screening on 20 November coincided with the death of Francisco Franco, which gave a symbolic aura to the screening. The momentous date marked the beginning of a long friendship and scholarly dialogue between the two men. As a witness to Borau’s American career, Gubern brings to light the film-maker’s multifaceted efforts to realize his ambition of becoming part of the Hollywood film industry, including his plan for a remake of his Oscar-nominated film, My Dear Señorita (1971). Gubern recounts Borau’s scholarly efforts to document the presence of other Spaniards in the Hollywood industry, which would eventually culminate in the publication of his Diccionariodel Cine Español (1998).
José Luis Borau, un cineasta furtivo
Authors: Vergés Rosa
Published: October 2014

The objective of this article is to demonstrate that under the deceptive appearance of realism, Borau’s cinema reveals a rich layer of symbolism rooted in intellectual depth. The article begins by reviewing Borau’s unique contributions promoting film culture in Spain through his activities as president of the Spanish Film Academy (AACC). It then focusses on Borau’s most emblematic film Furtivos (Poachers, 1975), which, among its other qualities, also inscribes the features of the multifaceted personality of the famed Aragonese film-maker.
When we put ourselves ‘on the line’
Authors: Kovacs Steven
Published: October 2014

An eye-witness account of the preparation, production, post-production and release of José Luis Borau’s On the Line (Río abajo, 1984) by the American producer of the film, Steven Kovacs. This article details the relationship between Borau and Kovacs and the evolution of the production from screenplay to finished film, including the way decisions were made and the problems that plagued the production. In telling the narrative, the author attempts to evaluate Borau’s intention, vision, and directorial style.
‘Niña somebody’: Bringing Elena Fortún’s Celia to Spanish television
Authors: Vernon Kathleen M.
Published: October 2014

In much of his varied career, José Luis Borau vowed he would never work on television, undertake the adaptation of a literary work or direct a historical film. Yet, in 1991, in collaboration with his long-time friend and novelist Carmen Martín Gaite, Borau took on the task of producing and directing a television series based on the popular children’s books of Republican-era writer Elena Fortún. Told from the perspective of the precocious 7-year-old protagonist Celia Gálvez, the series offers a glimpse into the world of the pre–Civil War Madrileñan bourgeoisie. Although the child of privilege, Celia insistently questions accepted hierarchies, from gender roles and class divisions to the dominant role of religion. Born from Borau’s conviction that children deserve the best in cultural offerings, the series also marked an opportunity to revisit their own childhoods and childhood readings for the director and his co-scriptwriter Martín Gaite.