bluuebunny/crossref_metadata_2025 huggingface dataset:
Overweight and Obesity Are Increased in Childhood-Onset Cerebrovascular Disease
Authors: Pearson Virginia , Ruzas Chris , Krebs Nancy F. , Goldenberg Neil A. , Manco-Johnson Marilyn J. , Bernard Timothy J.
Published: May 2012

The objective of this work was to determine whether overweight/obesity is a risk factor for cerebrovascular disease in children. The study included 53 children with non–neonatal-onset cerebral sinovenous thrombosis or arterial ischemic stroke. The prevalence of overweight/obesity was compared between this cohort and healthy children from the National Health and Nutrition Examination Survey. In addition, cerebral sinovenous thrombosis patients were compared to a group of matched hospitalized controls. The prevalence of overweight/obesity was significantly higher in the cerebral sinovenous thrombosis cohort (55%), but not the arterial ischemic stroke cohort (36%), relative to national controls (32%; P = .04 and P = .81, respectively). Similarly, the prevalence of overweight/obesity was significantly higher in the cerebral sinovenous thrombosis cohort than in Colorado controls (25%; P = .02). In conclusion, the prevalence of overweight/obese was significantly increased in cerebral sinovenous thrombosis patients as compared to both national and local controls. Results should be evaluated in a larger multi-institutional cohort.
Poly(ethylene glycol) as a compatibilizer and plasticizer of poly(lactic acid)/clay nanocomposites
Authors: Rodríguez-Llamazares Saddys , Rivas Bernabé L. , Pérez Mónica , Perrin-Sarazin Florence
Published: May 2012

Nanocomposites of poly(lactic acid), PLA, and poly(lactic acid)/poly(ethylene glycol), PLA/PEG, with clay modified with methyl-bis(2-hydroxyethyl) tallow alkyl ammonium cations (Cloisite 30B) were prepared by melt-blending methods. The influence of PEG content on the structure and thermal properties of nanocomposites was investigated. Comparative samples of the PLA/PEG blends with different PEG content were also considered. X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and differential scanning calorimetric (DSC) were used to characterize the studied samples. From XRD, SEM and TEM results, it can be concluded that PEG molecules co-intercalate the silicate layers of Cloisite 30B, together with PLA, allowing better parallel stacking of the silicate layers and the interaction between them. The decrease in the glass transition temperature and crystallization temperature of PLA nanocomposites with an increase in the PEG content, showed the double role of PEG as a plasticizer and as a compatibilizer during the preparation of PLA nanocomposites.
Preparation and characterization of polyacrylonitrile doped PVDF/heteropoly acid composite membranes
Authors: Li Qiming , Guo Jing , Chen Yingbo , Kim Hern
Published: May 2012

A novel polyacrylonitrile (PAN)/phosphotungstic acid (PWA) doped PVDF composite membrane was successfully prepared by blending electrospinning. Impedance spectroscopy and scanning electron microscopy characterization showed that the electrospun composite membranes possess comparatively higher proton conductivity and well-defined microstructure. In particular, the addition of hydrophilic PAN can effectively improve the water uptake performance of composite membrane and simultaneously no obvious membrane swelling was found. The experimental results showed that excellent composite membranes can be obtained by 30% PAN doping, and more than 30% PAN doping will increase the diameter of composite nanofiber membrane and accelerate the loss of PWA. The production of high-quality composite membranes with optimized PAN and PWA compositions can be achieved, which are promising candidates for proton exchange electrolyte membranes.
Asymmetric-based novel poly(ether-imide)s: Preparation, properties, kinetics of thermal decomposition, and study electrochemical oxidation behavior by using nanocomposite paste of polymer and multi-walled carbon nanotube
Authors: Taghavi Mehdi , Ghaemy Mousa , Hassanzadeh Marjan
Published: May 2012

A series of novel fluorescent poly(ether-imide)s (PEIs) bearing ether linkage and diarylimidazole pendant in the backbone was successfully prepared by polycondensation reaction between a new unsymmetrical diamine and commercially available tetracarboxylic acid dianhydrides. The PEIs were characterized by Fourier transform infrared, 1H-NMR, UV-vis spectroscopy, fluorimetry, scanning electron microscopy and elemental analysis. The PEIs with inherent viscosities in the range of 0.47–0.63 dL g−1 showed excellent solubility in various aprotic solvents such as N-methylpyrrolidone, dimethyl sulfoxide, N, N-dimethylacetamide and N,N-dimethylformamide. Thermal properties of new PEIs were evaluated by differential scanning calorimetric and thermogravimetric analysis in N2 and air. These polymers showed glass transition temperatures ( Tg) in the range of 269–333 °C and 10% weight loss temperatures above 400 °C in air atmosphere. The data obtained from TGA experiments of these polymers have been applied in different kinetic equations such as Coats–Redfern, Kissinger and Criado methods, to determine the kinetic parameters ( E, ▵ S, ▵ G, ▵ H) and mechanism of thermal decomposition. Herein a method based on the adsorptive stripping cyclic voltammetry technique to investigate electrochemical oxidation of these polymers by using multi-walled carbon nano tubes modified glass electrode is also reported.
‘I want to say I may have seen my son die this morning’: Unintentional unreliable narration in digital fiction
Authors: Ensslin Astrid
Published: May 2012

This article offers comparative close readings of two digital fictions that feature various types and degrees of unintentional unreliable narration. Its prime focus lies on the affordances and restraints provided by hypertextual, multilinear, multimodal, interactive and ludic new media with respect to the aesthetic representation and textual embedding of unreliability. To this end, I have chosen narratives from two ‘generations’ of digital fiction – a hyperfiction par excellence, and a hypermedia narrative, both of which are multilinear by definition yet deal with the ideas of closure and narrative framing in very different ways. In particular, I shall examine how unintentional, psycho-pathological unreliability in the sense of Riggan’s (1981; cf. Heyd, 2006; Jahn, 1998) ‘madman’ are represented in afternoon, a story (Joyce, 1987) and the German hypermedia novel Quadrego (Maskiewicz, 2001). My comparative analysis shows how manifestations of deviant yet not devious, in the sense of quietly deceptive narration, are aesthetically enriched by techniques afforded by the digital medium, such as hypertextual multilinearity, lack of or partial closure, multisensory experience, fluid transitions and boundaries and, most significantly, the play with reader agency, which may – in cases of radical multilinearity – even lead to readerly unreliability.
Narrated perception revisited: The case of Jane Austen’s Emma
Authors: Pallarés-García Elena
Published: May 2012

Jane Austen’s Emma (1816) is generally considered an ambiguous and unreliable narrative in terms of point of view (Morini, 2009: 53–57; Wallace, 1995: 77–97). These qualities are often attributed to the extensive use of free indirect discourse (Finch and Bowen, 1990: 5–6; Mezei, 1996: 72–75). This article aims to demonstrate that another narrative technique is also responsible for the ambiguity and unreliability of the novel. ‘Narrated perception’ (NP) portrays the sensory perceptions of a fictional character by describing events as they are experienced by that character (Fludernik, 1993: 305–309). NP has been pointed out by some critics to be a distinct narrative technique, but in general perception is included within the broader category of free indirect discourse (FID), and occasionally as an aspect of free indirect thought (FIT). This article suggests that there are some subtle differences between NP and FID/FIT, and thus it can be beneficial to examine NP separately. In fact, NP is frequently similar to pure narration in terms of form and function. As a case study, this article presents a stylistic analysis of a number of passages containing NP in Emma which do not typically feature in studies of FID/FIT. The analysis provides textual evidence of (1) the presence of Emma’s sensory perceptions within what looks like narration, (2) the close connection between perception, thought and emotion, and (3) the difficulty of distinguishing between perception and narration in some cases, which suggests the potential of NP to mislead the reader by presenting as a seemingly objective fact what later on turns out to be Emma’s mistaken assessment.
The Significance of Intramammary Lymph Nodes in Breast Cancer
Authors: AbdullGaffar Badr , Gopal Parthasarathi , Abdulrahim Manal , Ghazi Esaaf , Mohamed Eliza
Published: May 2012

Intramammary lymph nodes (IntraMLNs) are frequent mostly benign incidental findings. However, they are clinically important because they can be the primary sites of metastasis and sentinel lymph nodes. Literature data regarding the clinical significance of IntraMLNs metastasis, however, remains controversial. This study aimed to perform a systematic review and meta-analysis to better define the prognostic value of positive IntraMLNs in patients with breast cancer. A systematic review of the literature without date restrictions was conducted. Five electronic medical databases were searched, and a hand-search of the reference lists of the collected articles was also performed. Studies with sufficient and relevant pathologic and clinical survival data were included. Other studies with insufficient data or normal findings were excluded. This study found 18 studies eligible for systematic review, 3 of which were eligible for outcome meta-analysis. IntraMLNs metastases were strongly correlated with axillary lymph nodes involvement. Positive IntraMLNs are reliable predictors of axillary lymph node involvement and therefore a guide for further surgical management of the axillary nodes. Even though it could be concluded that IntraMLNs metastasis is an independent predictor of outcome, this meta-analysis was limited because of the scarcity of data and the inconsistencies and heterogeneity of the outcome studies.
State Electoral Institutions and Voter Turnout In Presidential Elections, 1920–2000
Authors: Springer Melanie J.
Published: May 2012

Expansiveandrestrictive state electoral institutions have been instrumental in structuring the vote throughout American history. Studies focused on a small number of reforms, years, or states lack the scope necessary to comprehensively evaluate the effects of institutional change over time. This work, however, places recent reforms in historical context and offers a long-term perspective. Using an original data set, it identifies the institutions that have generated the most substantial effects on state turnout rates during presidential elections from 1920 to 2000. Findings demonstrate that restrictive laws (those aiming to limit the vote or make voting more costly) produced large and consistently negative effects in the Southern and non-Southern states alike, but the effects associated with expansive reforms (those making participation more convenient or less costly) vary. Although a few expansive laws have increased turnout in the non-Southern states, they have had no effect in the Southern states where turnout rates are lowest.
Modification of a Bifurcated Stent Graft for Aortouniiliac Endovascular Aneurysm Repair in a Renal Transplant Patient
Authors: Poon Henrietta , Duddy Martin J. , Tiwari Alok , Hopkins Jonathan D.
Published: May 2012

Introduction. We describe a case of aortouniiliac (AUI) endovascular aortic aneurysm repair (EVAR) using combined iliac limb and bifurcated body stent graft modular system. Case report. This technique is demonstrated in a 58-year-old man with a 6-cm abdominal aortic aneurysm suitable for EVAR. The patient has a functioning cadaveric renal transplant anastamosed to the mid right external iliac artery, an occluded left iliac system and stenosed right iliac system. The renal allograft was protected with minimal passage across the transplant artery origin using this modified approach. The patient was successfully treated with a bifurcated main body deployed within a contralateral limb endoprosthesis. Subsequent scans confirmed no endoleaks or stent migration. Conclusions. The AUI conversion from existing Gore excluder stent graft system is safe and should be considered when faced with challenging anatomy of a pelvic renal transplant, slender access, and contralateral iliac occlusion.
Relationship Between Motor Recovery and Independence After Sensorimotor-Complete Cervical Spinal Cord Injury
Authors: Kramer John L. K. , Lammertse Daniel P. , Schubert Martin , Curt Armin , Steeves John D.
Published: May 2012

Background. For therapeutics directed to the injured spinal cord, a change in neurological impairment has been proposed as a relevant acute clinical study end point. However, changes in neurological function, even if statistically significant, may not be associated with a functional impact, such as a meaningful improvement in items within the self-care subscore of the Spinal Cord Independence Measure (SCIM). Objective. The authors examined the functional significance associated with spontaneously recovering upper-extremity motor function after sensorimotor-complete cervical spinal cord injury (SCI). Methods. Using the European Multi-center Study about Spinal Cord Injury (EMSCI) data set, a retrospective analysis was undertaken of individuals with cervical sensorimotor-complete SCI (initial motor level, C4-C7). Specifically, changes in upper-extremity motor score (UEMS), motor level, and SCIM (total and self-care subscore) were assessed between approximately 1 and 48 weeks after injury (n = 74). Results. The initial motor level did not significantly influence the total UEMS recovered or number of motor levels recovered. SCIM self-care subscore recovery was significantly greater for those individuals regaining 2 motor levels compared with those recovering only 1 or no motor levels. However, the recovery in the SCIM self-care subscore was not significantly different between individuals recovering only 1 motor level and those individuals who showed no motor-level improvement. Conclusions. A 2 motor-level improvement indicates a clinically meaningful change and might be considered a primary outcome in acute and subacute interventional trials enrolling individuals with cervical sensorimotor-complete SCI.
Essential role of TAK1 in regulating mantle cell lymphoma survival
Authors: Buglio Daniela , Palakurthi Sangeetha , Byth Kate , Vega Francisco , Toader Dorin , Saeh Jamal , Neelapu Sattva S. , Younes Anas
Published: May 2012

TGF-β–activated kinase 1 (TAK1), a member of the MAPK kinase family, plays a key role in B-cell growth and development. In the present study, we examined the potential role of TAK1 as a therapeutic target for lymphoma. Here, we show that the active phosphorylated form of TAK1 is abundantly expressed in a panel of lymphoma cell lines, including mantle cell, anaplastic large cell, and Hodgkin lymphoma cell lines. Silencing TAK1 expression via the use of siRNA inhibited the activation of NF-κB and p38 and induced apoptosis in lymphoma cell lines. Moreover, submicromolar concentrations of AZ-TAK1, a novel ATP-competitive small molecule inhibitor of TAK1, dephosphorylated TAK1, p38, and IκB-α in lymphoma cell lines. These molecular events were associated with the release of cytochrome c into the cytosol, down-regulation of X-linked inhibitor of apoptosis, activation of caspase 9, and induction of apoptosis. We also demonstrate that primary lymphoma cells express TAK1 and pTAK1 and were sensitive to AZ-TAK1–mediated cell death. Collectively, our data demonstrate an essential role for TAK1 in regulating critical survival mechanisms in lymphoma and suggest that it may serve as a therapeutic target.
Residual disease detected by multidimensional flow cytometry signifies high relapse risk in patients with de novo acute myeloid leukemia: a report from Children's Oncology Group
Authors: Loken Michael R. , Alonzo Todd A. , Pardo Laura , Gerbing Robert B. , Raimondi Susana C. , Hirsch Betsy A. , Ho Phoenix A. , Franklin Janet , Cooper Todd M. , Gamis Alan S. , Meshinchi Soheil
Published: May 2012

Early response to induction chemotherapy is a predictor of outcome in acute myeloid leukemia (AML). We determined the prevalence and significance of postinduction residual disease (RD) by multidimensional flow cytometry (MDF) in children treated on Children's Oncology Group AML protocol AAML03P1. Postinduction marrow specimens at the end of induction (EOI) 1 or 2 or at the end of therapy from 249 patients were prospectively evaluated by MDF for RD, and presence of RD was correlated with disease characteristics and clinical outcome. Of the 188 patients in morphologic complete remission at EOI1, 46 (24%) had MDF-detectable disease. Those with and without RD at the EOI1 had a 3-year relapse risk of 60% and 29%, respectively (P < .001); the corresponding relapse-free survival was 30% and 65% (P < .001). Presence of RD at the EOI2 and end of therapy was similarly predictive of poor outcome. RD was detected in 28% of standard-risk patients in complete remission and was highly associated with poor relapse-free survival (P = .008). In a multivariate analysis, including cytogenetic and molecular risk factors, RD was an independent predictor of relapse (P < .001). MDF identifies patients at risk of relapse and poor outcome and can be incorporated into clinical trials for risk-based therapy allocation. This study was registered at www.clinicaltrials.gov as NCT00070174.
Monoclonal antibodies against receptor-induced binding sites detect cell-bound plasminogen in blood
Authors: Félez Jordi , Jardí Mercè , Fàbregas Pere , Parmer Robert J. , Miles Lindsey A.
Published: May 2012

Binding of Glu-plasminogen (the native, circulating form of the zymogen) to cells results in enhancement of its activation. Cell-associated plasmin proteolytic activity is a key component of physiologic and pathologic processes requiring extracellular matrix degradation. Recently, we developed antiplasminogen mAbs that recognize receptor-induced binding sites (RIBS) in Glu-plasminogen and, therefore, preferentially react with cell-associated Glu-plasminogen in the presence of soluble Glu-plasminogen. Here we have used FACS with a representative antiplasminogen receptor-induced binding site mAb, mAb49, to examine whether plasminogen associates with peripheral blood cells in blood. Plasminogen binding to neutrophils, monocytes, B-lymphocytes, T-lymphocytes, and platelets was clearly detected. Treatment of whole blood with lipopolysaccharide or 12-0 tetradecanoylphorbol-13-acetate up-regulated plasminogen binding to neutrophils and in vivo treatment with all-trans retinoic acid decreased plasminogen binding to acute promyelocytic leukemia blasts. Our results demonstrate that mAb49 can be used to monitor cell-bound plasminogen in blood under both normal and pathologic conditions.
FCA: Forget Chemoimmunotherapy with Alemtuzumab?
Authors: Hallek Michael
Published: May 2012

A randomized phase 3 trial conducted in France and Belgium shows that a chemoimmunotherapy consisting of fludarabine, cyclophosphamide, and alemtuzumab (FCA) causes an excess mortality and is less efficient compared with fludarabine, cyclophosphamide, and rituximab (FCR), the current standard therapy for physically fit patients with chronic lymphocytic leukemia (CLL).1,2
Monocytes in HIT: an evolving story
Authors: McKenzie Steven E.
Published: May 2012

In this issue of Blood, Kasthuri and colleagues have examined the role of Fcγ receptors and signaling molecules in monocytes in HIT.1
CD20 antibodies: type II to tango?
Authors: van Oers Marinus H. J.
Published: May 2012

Although the chimeric anti-CD20 monoclonal antibody (mAb) rituximab has revolutionized the treatment of B-cell non-Hodgkin lymphoma (NHL), still many patients relapse and an increasing number become refractory to rituximab-containing therapy. This has initiated intense research to develop more potent anti-CD20 antibodies.
Phenytoin versus Leviteracetam for Seizure Prophylaxis after brain injury – a meta analysis
Authors: Zafar Syed Nabeel , Khan Abdul Ahad , Ghauri Asfar Ayaz , Shamim Muhammad Shahzad
Published: May 2012

Background

Current standard therapy for seizure prophylaxis in Neuro-surgical patients involves the use of Phenytoin (PHY). However, a new drug Levetiracetam (LEV) is emerging as an alternate treatment choice. We aimed to conduct a meta-analysis to compare these two drugs in patients with brain injury.

Methods

An electronic search was performed in using Pubmed, Embase, and CENTRAL. We included studies that compared the use of LEV vs. PHY for seizure prophylaxis for brain injured patients (Traumatic brain injury, intracranial hemorrhage, intracranial neoplasms, and craniotomy). Data of all eligible studies was extracted on to a standardized abstraction sheet. Data about baseline population characteristics, type of intervention, study design and outcome was extracted. Our primary outcome was seizures.

Results

The literature search identified 2489 unduplicated papers. Of these 2456 papers were excluded by reading the abstracts and titles. Another 25 papers were excluded after reading their complete text. We selected 8 papers which comprised of 2 RCTs and 6 observational studies. The pooled estimate’s Odds Ratio 1.12 (95% CI = 0.34, 3.64) demonstrated no superiority of either drug at preventing the occurrence of early seizures. In a subset analysis of studies in which follow up for seizures lasted either 3 or 7 days, the effect estimate remained insignificant with an odds ratio of 0.96 (95% CI = 0.34, 2.76). Similarly, 2 trials reporting seizure incidence at 6 months also had insignificant pooled results while comparing drug efficacy. The pooled odds ratio was 0.96 (95% CI = 0.24, 3.79).

Conclusions

Levetiracetam and Phenytoin demonstrate equal efficacy in seizure prevention after brain injury. However, very few randomized controlled trials (RCTs) on the subject were found. Further evidence through a high quality RCT is highly recommended.
Mifepristone prevents repopulation of ovarian cancer cells escaping cisplatin-paclitaxel therapy
Authors: Gamarra-Luques Carlos D , Goyeneche Alicia A , Hapon Maria B , Telleria Carlos M
Published: May 2012

Background

Advanced ovarian cancer is treated with cytoreductive surgery and combination platinum- and taxane-based chemotherapy. Although most patients have acute clinical response to this strategy, the disease ultimately recurs. In this work we questioned whether the synthetic steroid mifepristone, which as monotherapy inhibits the growth of ovarian cancer cells, is capable of preventing repopulation of ovarian cancer cells if given after a round of lethal cisplatin-paclitaxel combination treatment.

Methods

We established an in vitro approach wherein ovarian cancer cells with various sensitivities to cisplatin or paclitaxel were exposed to a round of lethal doses of cisplatin for 1 h plus paclitaxel for 3 h. Thereafter, cells were maintained in media with or without mifepristone, and short- and long-term cytotoxicity was assessed.

Results

Four days after treatment the lethality of cisplatin-paclitaxel was evidenced by reduced number of cells, increased hypodiploid DNA content, morphological features of apoptosis, DNA fragmentation, and cleavage of caspase-3, and of its downstream substrate PARP. Short-term presence of mifepristone either enhanced or did not modify such acute lethality. Seven days after receiving cisplatin-paclitaxel, cultures showed signs of relapse with escaping colonies that repopulated the plate in a time-dependent manner. Conversely, cultures exposed to cisplatin-paclitaxel followed by mifepristone not only did not display signs of repopulation following initial chemotherapy, but they also had their clonogenic capacity drastically reduced when compared to cells repopulating after cisplatin-paclitaxel.

Conclusions

Cytostatic concentrations of mifepristone after exposure to lethal doses of cisplatin and paclitaxel in combination blocks repopulation of remnant cells surviving and escaping the cytotoxic drugs.
Prevalence of chronic musculoskeletal disorders in elderly Brazilians: a systematic review of the literature
Authors: Miranda Vivian S , deCarvalho Vivielle BF , Machado Luciana AC , Dias João Marcos D
Published: May 2012

Background

Population ageing is a worldwide phenomenon that has recently challenged public healthcare systems. The knowledge of the burden of chronic musculoskeletal disorders in elders is still limited, particularly in the developing world. This systematic review aimed to investigate the prevalence of chronic musculoskeletal disorders in elderly Brazilians.

Methods

A comprehensive literature search was performed in five electronic databases (from inception to January 2012) and completed by additional searches in reference lists. Two review authors independently selected the eligible studies and extracted data on participants’ characteristics and rates of chronic musculoskeletal disorders. One review author extracted methodological quality data. We performed a critical synthesis of the results, which were grouped into the diagnoses “chronic musculoskeletal pain” or “specific musculoskeletal diagnoses”.

Results

Twenty five studies reporting on a total of 116,091 elderly Brazilians were included. Eight studies (32%) were of high methodological quality. There was a large variation in the measure of prevalence used by individual studies and in their definition of chronic pain. Prevalence estimates reached 86% for chronic musculoskeletal pain in any location. Studies investigating multiple pain sites found the lower limb and the spine to be the most prevalent complaints (50% each). Arthritis and rheumatism (including osteoarthritis) were the most prevalent specific musculoskeletal diagnoses (9% to 40%), followed by herniated disc (6% to 27%).

Conclusions

Despite the growth of the elderly population worldwide, high-quality research on the burden of chronic musculoskeletal disorders in the elderly is still scarce. Future healthcare research focusing on this age group should be a priority in developing countries since their public healthcare systems are not yet fully prepared to accommodate the needs of an aging population.
Comparative cross-sectional study of empathy among first year and final year medical students in Jimma University, Ethiopia: Steady state of the heart and opening of the eyes
Authors: Dehning Sandra , Girma Eshetu , Gasperi Sarah , Meyer Sebastian , Tesfaye Markos , Siebeck Matthias
Published: May 2012

Background

There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia.

Methods

A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES) was used for the detection of “heart-reading”, i.e. emotional empathy and the Reading the Mind in the Eyes test (RME-R test) to evaluate “mind-reading”, i.e. cognitive empathy. We performed t-test to compare the mean difference in empathy and RME-R scores between the two groups of students. A linear regression was computed to identify potential factors influencing the BEES and RME-R.

Results

Out of the total 237 students, 207 (87.3%) were males. The mean age of first year and final year students was 19.3 ± 1.1 and 24.0 ± 1.4 years respectively. First year students have scored 40.6 ± 23.8 while final year students scored 41.5 ± 20.8 mean in the BEES measuring emotional empathy score. However, this difference was not statistically significant (t = −0.30, df = 231, P-value >0.05). Final year students had significantly higher mean cognitive empathy score (17.8 ± 4.5) than first year students (14.4 ± 4.8) [β = 2.7, 95%CI (1.20, 4.13)]. Males had scored lower cognitive [β = −2.5, 95%CI (−4.37, −0.66)] and emotional empathy [β = −12.0, 95%CI (−21.66, −5.46)].

Conclusions

Low emotional (BEES) and cognitive empathy sores were found in first year and final year students of Jimma University could have implications on the medical education curricula. Medical education targeted at enhancing emotional empathy and increasing cognitive empathy is required by segmenting with gender for effective physician-patient interaction. The influence of empathy on clinical competence should be studied using more rigorous design.
The impact of decision aids to enhance shared decision making for diabetes (the DAD study): protocol of a cluster randomized trial
Authors: LeBlanc Annie , Ruud Kari L , Branda Megan E , Tiedje Kristina , Boehmer Kasey R , Pencille Laurie J , Van Houten Holly , Matthews Marc , Shah Nilay D , May Carl R , Yawn Barbara P , Montori Victor M
Published: May 2012

Background

Shared decision making contributes to high quality healthcare by promoting a patient-centered approach. Patient involvement in selecting the components of a diabetes medication program that best match the patient’s values and preferences may also enhance medication adherence and improve outcomes. Decision aids are tools designed to involve patients in shared decision making, but their adoption in practice has been limited. In this study, we propose to obtain a preliminary estimate of the impact of patient decision aids vs. usual care on measures of patient involvement in decision making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and resource utilization. In addition, we propose to identify, describe, and explain factors that promote or inhibit the routine embedding of decision aids in practice.

Methods/Design

We will be conducting a mixed-methods study comprised of a cluster-randomized, practical, multicentered trial enrolling clinicians and their patients (n = 240) with type 2 diabetes from rural and suburban primary care practices (n = 8), with an embedded qualitative study to examine factors that influence the incorporation of decision aids into routine practice. The intervention will consist of the use of a decision aid (Statin Choice and Aspirin Choice, or Diabetes Medication Choice) during the clinical encounter. The qualitative study will include analysis of video recordings of clinical encounters and in-depth, semi-structured interviews with participating patients, clinicians, and clinic support staff, in both trial arms.

Discussion

Upon completion of this trial, we will have new knowledge about the effectiveness of diabetes decision aids in these practices. We will also better understand the factors that promote or inhibit the successful implementation and normalization of medication choice decision aids in the care of chronic patients in primary care practices.

Trial registration

NCT00388050
β3 integrin modulates transforming growth factor beta induced (TGFBI) function and paclitaxel response in ovarian cancer cells
Authors: Tumbarello David A , Temple Jillian , Brenton James D
Published: May 2012

Background

The extracellular matrix (ECM) has a key role in facilitating the progression of ovarian cancer and we have shown recently that the secreted ECM protein TGFBI modulates the response of ovarian cancer to paclitaxel-induced cell death.

Results

We have determined TGFBI signaling from the extracellular environment is preferential for the cell surface αvβ3 integrin heterodimer, in contrast to periostin, a TGFBI paralogue, which signals primarily via a β1 integrin-mediated pathway. We demonstrate that suppression of β1 integrin expression, in β3 integrin-expressing ovarian cancer cells, increases adhesion to rTGFBI. In addition, Syndecan-1 and −4 expression is dispensable for adhesion to rTGFBI and loss of Syndecan-1 cooperates with the loss of β1 integrin to further enhance adhesion to rTGFBI. The RGD motif present in the carboxy-terminus of TGFBI is necessary, but not sufficient, for SKOV3 cell adhesion and is dispensable for adhesion of ovarian cancer cells lacking β3 integrin expression. In contrast to TGFBI, the carboxy-terminus of periostin, lacking a RGD motif, is unable to support adhesion of ovarian cancer cells. Suppression of β3 integrin in SKOV3 cells increases resistance to paclitaxel-induced cell death while suppression of β1 integrin has no effect. Furthermore, suppression of TGFBI expression stimulates a paclitaxel resistant phenotype while suppression of fibronectin expression, which primarily signals through a β1 integrin-mediated pathway, increases paclitaxel sensitivity.

Conclusions

Therefore, different ECM components use distinct signaling mechanisms in ovarian cancer cells and in particular, TGFBI preferentially interacts through a β3 integrin receptor mediated mechanism to regulate the response of cells to paclitaxel-induced cell death.
Clinical proteomics and OMICS clues useful in translational medicine research
Authors: López Elena , Madero Luis , López-Pascual Juan , Latterich Martin
Published: May 2012

Since the advent of the new proteomics era more than a decade ago, large-scale studies of protein profiling have been used to identify distinctive molecular signatures in a wide array of biological systems, spanning areas of basic biological research, clinical diagnostics, and biomarker discovery directed toward therapeutic applications. Recent advances in protein separation and identification techniques have significantly improved proteomic approaches, leading to enhancement of the depth and breadth of proteome coverage.

Proteomic signatures, specific for multiple diseases, including cancer and pre-invasive lesions, are emerging. This article combines, in a simple manner, relevant proteomic and OMICS clues used in the discovery and development of diagnostic and prognostic biomarkers that are applicable to all clinical fields, thus helping to improve applications of clinical proteomic strategies for translational medicine research.
SITC 26th annual meeting – summary
Authors: Romano Emanuela , Nardelli-Haefliger Denise , Donda Alena , Corgnac Stephanie , Romero Pedro
Published: May 2012

The 26th annual meeting of the Society for Immunotherapy of Cancer took place in Bethesda on November 4 to 6, 2011 and was organized by Charles G. Drake (Johns Hopkins University) Dolores J. Schendel (Helmholtz Zentrum Muenchen – German Research Center for Environmental Health Institute of Molecular Immunology), Jeffrey Schlom (National Cancer Institute, National Institutes of Health), and Jedd D. Wolchok (Memorial Sloan-Kettering Cancer Center). It was an event marked by a number of extraordinary circumstances: it attracted a record attendance of 805 participants from 24 different countries. The gathering came in the wake of great as well as very sad news for the tumor immunology community. Good news included the approval of anti-CTLA-4 as a therapy for metastatic melanoma in April and the announcement in early October of the Nobel Prize in Physiology and Medicine awarded to pioneering studies in the field of immunology. Indeed, one part of the prize went to Dr. Bruce Beutler, Scripps Research Institute, La Jolla, USA and Dr. Jules Hoffman, Institute for Molecular Cell Biology, Strasbourg, France, for their discoveries in innate immunity and the other part to Dr. Ralph Steinman, The Rockfeller University, New York, for his discovery of dendritic cells. Sad news was the losses of two giants in the field. Jürg Tschopp of the University of Lausanne in March and Ralph Steinman, who passed away just three days before his Nobel Prize announcement. The loss of these two charismatic scientific leaders was particularly sad for the Annual Meeting as both J. Tschopp and R. Steinman were confirmed speakers at this meeting: the former to deliver the keynote lecture and the latter as recipient of the Richard V. Smalley prize.
Workshop on immunotherapy combinations. Society for immunotherapy of cancer annual meeting Bethesda, November 3, 2011
Authors: Forero Ivan Martinez , Okada Hideho , Topalian Suzanne L , Gajewski Thomas F , Korman Alan J , Melero Ignacio
Published: May 2012

Although recent FDA approvals on ipilimumab and sipuleucel-T represent major milestones, the ultimate success of immunotherapy approaches will likely benefit from appropriate combinations with other immunotherapeutic and/or non-immunotherapeutic approaches. However, implementation of ideal combinations in the clinic may still face formidable challenges in regulatory, drug-availability and intellectual property aspects. The 2011 SITC annual meeting hosted a workshop on combination immunotherapy to discuss: 1) the most promising combinations found in the laboratory; 2) early success of combination immunotherapy in clinical trials; 3) industry perspectives on combination approaches, and 4) relevant regulatory issues. The integrated theme was how to accelerate the implementation of efficacious combined immunotherapies for cancer patients. Rodent animal models are providing many examples of synergistic combinations that typically include more than two agents. However, mouse and human immunology differ in a significant number of mechanisms and hence we might be missing opportunities peculiar to humans. Nonetheless, incisive animal experimentation with deep mechanistic insight remains the best compass that we can use to guide our paths in combinatorial immunotherapy. Combination immunotherapy clinical trials are already in progress and preliminary results are extremely promising. As a key to translate promising combinations into clinic, real and “perceived” business and regulatory hurdles were debated. A formidable step forward would be to be able to test combinations of investigational agents prior to individual approval. Taking together the FDA and the industrial perspective on combinatorial immunotherapy, the audience was left with the clear message that this is by no means an impossible task. The general perception is that the road ahead of us is full of combination clinical trials which hopefully will bring clinical benefit to our cancer patients at a fast pace.
Monoaminergic modulation of photoreception in ascidian: evidence for a proto-hypothalamo-retinal territory
Authors: Razy-Krajka Florian , Brown Euan R , Horie Takeo , Callebert Jacques , Sasakura Yasunori , Joly Jean-Stéphane , Kusakabe Takehiro G , Vernier Philippe
Published: May 2012

Background

The retina of craniates/vertebrates has been proposed to derive from a photoreceptor prosencephalic territory in ancestral chordates, but the evolutionary origin of the different cell types making the retina is disputed. Except for photoreceptors, the existence of homologs of retinal cells remains uncertain outside vertebrates.

Methods

The expression of genes expressed in the sensory vesicle of the ascidian Ciona intestinalis including those encoding components of the monoaminergic neurotransmission systems, was analyzed by in situ hybridization or in vivo transfection of the corresponding regulatory elements driving fluorescent reporters. Modulation of photic responses by monoamines was studied by electrophysiology combined with pharmacological treatments.

Results

We show that many molecular characteristics of dopamine-synthesizing cells located in the vicinity of photoreceptors in the sensory vesicle of the ascidian Ciona intestinalis are similar to those of amacrine dopamine cells of the vertebrate retina. The ascidian dopamine cells share with vertebrate amacrine cells the expression of the key-transcription factor Ptf1a, as well as that of dopamine-synthesizing enzymes. Surprisingly, the ascidian dopamine cells accumulate serotonin via a functional serotonin transporter, as some amacrine cells also do. Moreover, dopamine cells located in the vicinity of the photoreceptors modulate the light-off induced swimming behavior of ascidian larvae by acting on alpha2-like receptors, instead of dopamine receptors, supporting a role in the modulation of the photic response. These cells are located in a territory of the ascidian sensory vesicle expressing genes found both in the retina and the hypothalamus of vertebrates (six3/6, Rx, meis, pax6, visual cycle proteins).

Conclusion

We propose that the dopamine cells of the ascidian larva derive from an ancestral multifunctional cell population located in the periventricular, photoreceptive field of the anterior neural tube of chordates, which also gives rise to both anterior hypothalamus and the retina in craniates/vertebrates. It also shows that the existence of multiple cell types associated with photic responses predates the formation of the vertebrate retina.
The new temperature-sensitive mutation PA-F35S for developing recombinant avian live attenuated H5N1 influenza vaccine
Authors: Zhang Wenting , Tu Jiagang , Zhao Zongzheng , Chen Huanchun , Jin Meilin
Published: May 2012

Background

H5N1 highly pathogenic avian influenza virus (HPAIV) is continuously circulating in many Asian countries and threatening poultry industry and human population. Vaccination is the best strategy to control H5N1 HPAIV infection in poultry and transmission to human population. The aim of this study is to identify new temperature-sensitive (ts) mutations for developing recombinant avian live attenuated H5N1 influenza vaccine.

Findings

A “6 + 2” recombinant virus C4/W1 that contained NA gene and modified HA gene from virus A/chicken/Hubei/327/2004 (H5N1) (C4), and six internal genes from virus A/duck/Hubei/W1/2004 (H9N2) (W1) was generated using reverse genetics and subsequently passaged in chicken eggs at progressively lower temperatures (32°C, 28°C and 25°C). The resulting virus acquired ts phenotype and one of its amino acid mutations, PA (F35S), was identified as ts mutation. Furthermore, when used as live attenuated vaccine, the recombinant virus with this ts mutation PA (F35S) provided efficient protection for chickens against H5N1 HPAIV infection.

Conclusions

These findings highlight the potential of the new ts mutation PA (F35S) in developing recombinant avian live attenuated H5N1 influenza vaccine.
Are perceived stress, depressive symptoms and religiosity associated with alcohol consumption? A survey of freshmen university students across five European countries
Authors: Sebena Rene , El Ansari Walid , Stock Christiane , Orosova Olga , Mikolajczyk Rafael T
Published: May 2012

Background

The aim of this study was to investigate the association of perceived stress, depressive symptoms and religiosity with frequent alcohol consumption and problem drinking among freshmen university students from five European countries.

Methods

2529 university freshmen (mean age 20.37, 64.9% females) from Germany (n = 654), Poland (n = 561), Bulgaria (n = 688), the UK (n = 311) and Slovakia (n = 315) completed a questionnaire containing the modified Beck Depression Inventory for measuring depressive symptoms, the Cohen’s perceived stress scale for measuring perceived stress, the CAGE-questionnaire for measuring problem drinking and questions concerning frequency of alcohol use and the personal importance of religious faith.

Results

Neither perceived stress nor depressive symptoms were associated with a high frequency of drinking (several times per week), but were associated with problem drinking. Religiosity (personal importance of faith) was associated with a lower risk for both alcohol-related variables among females. There were also country differences in the relationship between perceived stress and problem drinking.

Conclusion

The association between perceived stress and depressive symptoms on the one side and problem drinking on the other demonstrates the importance of intervention programs to improve the coping with stress.
3-methylcrotonyl-CoA carboxylase deficiency: Clinical, biochemical, enzymatic and molecular studies in 88 individuals
Authors: Grünert Sarah C , Stucki Martin , Morscher Raphael J , Suormala Terttu , Bürer Celine , Burda Patricie , Christensen Ernst , Ficicioglu Can , Herwig Jürgen , Kölker Stefan , Möslinger Dorothea , Pasquini Elisabetta , Santer René , Schwab K Otfried , Wilcken Bridget , Fowler Brian , Yue Wyatt W , Baumgartner Matthias R
Published: May 2012

Background

Isolated 3-methylcrotonyl-CoA carboxylase (MCC) deficiency is an autosomal recessive disorder of leucine metabolism caused by mutations in MCCC1 or MCCC2 encoding the α and β subunit of MCC, respectively. The phenotype is highly variable ranging from acute neonatal onset with fatal outcome to asymptomatic adults.

Methods

We report clinical, biochemical, enzymatic and mutation data of 88 MCC deficient individuals, 53 identified by newborn screening, 26 diagnosed due to clinical symptoms or positive family history and 9 mothers, identified following the positive newborn screening result of their baby.

Results

Fifty-seven percent of patients were asymptomatic while 43% showed clinical symptoms, many of which were probably not related to MCC deficiency but due to ascertainment bias. However, 12 patients (5 of 53 identified by newborn screening) presented with acute metabolic decompensations. We identified 15 novel MCCC1 and 16 novel MCCC2 mutant alleles. Additionally, we report expression studies on 3 MCCC1 and 8 MCCC2 mutations and show an overview of all 132 MCCC1 and MCCC2 variants known to date.

Conclusions

Our data confirm that MCC deficiency, despite low penetrance, may lead to a severe clinical phenotype resembling classical organic acidurias. However, neither the genotype nor the biochemical phenotype is helpful in predicting the clinical course.