bluuebunny/crossref_metadata_2025 huggingface dataset:
When Life Mattered
Authors: Hong Sun-ha
Published: November 2014

Games borrow ceaselessly from the past to constitute themselves. This locates the medium at the heart of our contemporary obsession with how to engage the past and the “real.” In tethering digital hyperreality to the horizon of history, myth, and ritual, games generate a disavowed and subjunctive engagement with a sense of “real enough.” They thus resemble Victor Turner’s liminoids: autotelic, bounded experiences of leisure that cultivate accepting yet playful attitudes against the “real enough” on offer. This commercialized bricolage is not dismissible as inauthentic simulacrum. Rather, such games demonstrate the ways in which new media are recalibrating our modes of engagement with the real. This article analyzes three key aspects of liminoid games: (1) techniques of reappropriation during production, (2) rules and expectations of engagement with the past and the “real” that games offer, and (3) emergent ways in which player communities, discourses, and productions recalibrate those politics of engagement.
Time, Space, and Motion in Braid
Authors: Stamenković Dušan , Jaćević Milan
Published: November 2014

This article (1) analyzes the computer game Braid with regard to the TIME IS SPACE/MOTION metaphor and the multimodal approach, (2) links the possibilities of such a study to the existing studies of temporality in video games, and (3) explores the link between the game’s narrative and its gameplay mechanics based on the TIME IS SPACE/MOTION metaphor. The theoretical section briefly overviews conceptual metaphor theory, the TIME IS SPACE/MOTION metaphor, multimodality, CMT in video games, time in video games, and several studies related to the game. The main section investigates Braid so as to evaluate the ways in which the TIME IS SPACE/MOTION metaphor operates within each of the game worlds and how this affects the narrative and the gameplay. The complex, unconventional relations existing among time, space, motion, and causality result in a unique coupling between the narrative and the use of the TIME IS SPACE/MOTION metaphor.
A Learning Activity to Introduce Undergraduate Students to Bioethics in Human Clinical Research
Authors: Segarra Ignacio , Gomez Manuel
Published: November 2014

We developed a pharmacology practicum assignment to introduce students to the research ethics and steps involved in a clinical trial. The assignment included literature review, critical analysis of bioethical situations, writing a study protocol and presenting it before a simulated ethics committee, a practice interview with a faculty member to obtain informed consent, and a student reflective assessment and self-evaluation. Students were assessed at various steps in the practicum; the learning efficiency of the activity was evaluated using an independent survey as well as students’ reflective feedback. Most of the domains of Bloom’s and Fink’s taxonomies of learning were itemized and covered in the practicum. Students highly valued the translatability of theoretical concepts into practice as well as the approach to mimic professional practice. This activity was within a pharmacy program, but may be easily transferable to other medical or health sciences courses.
Nedley Depression Hit Hypothesis
Authors: Nedley Neil , Ramirez Francisco E.
Published: November 2014

Depression is often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria. We propose how certain lifestyle choices and non-modifiable factors can predict the development of depression. We identified 10 cause categories (hits or “blows” to the brain) and theorize that four or more active hits could trigger a depression episode. Methods. A sample of 4271 participants from our community-based program (70% female; ages 17-94 years) was assessed at baseline and at the eighth week of the program using a custom test. Ten cause categories were examined as predictors of depression are (1) Genetic, (2)Developmental, (3)Lifestyle, (4)Circadian Rhythm, (5)Addiction, (6)Nutrition, (7)Toxic, (8)Social/Complicated Grief, (9)Medical Condition, and (10)Frontal Lobe. Results. The relationship between the DSM-5 score and a person having four hits categories in the first program week showed a sensitivity of 89.98 % (95% CI: 89.20 % - 90.73%), specificity 48.84% (CI 45.94-51.75) and Matthew Correlation Coefficient (MCC) .41 . For the eight-week test, the results showed a sensitivity 83.6% (CI 81.9-85.5), specificity 53.7% (CI 51.7-55.6) and MCC .38. Overall, the hits that improved the most from baseline after the eighth week were: Nutrition (47%), Frontal lobe (36%), Addiction (24%), Circadian rhythm (24%), Lifestyle (20%), Social (12%) and Medical (10%). Conclusions. The Nedley four-hit hypothesis seems to predict a depressive episode and correlates well with the DSM-5 criteria with good sensitivity and MCC but less specificity. Identifying these factors and applying lifestyle therapies could play an important role in the treatment of depressed individuals.
Distal third humeri fractures treated using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate: clinical, radiographic and patient outcome scores
Authors: Fawi Hassan , Lewis James , Rao Prasad , Parfitt Dan , Mohanty Khitish , Ghandour Adel
Published: November 2014

Background

Conventional management protocols for distal humeral extra-articular fractures (e.g. conservative, double columnar plating) are often associated with complications. We aimed to describe our experience of using the Synthes™ 3.5-mm extra-articular distal humeral locking compression plate for treatment of extra-articular distal humeral fractures.

Methods

We prospectively studied 23 consecutive patients who underwent fixation, in a tertiary trauma centre, over 2 years. Data, including patient demographics, duration of follow-up, patient satisfaction, visual analogue score (VAS), Oxford Elbow Score, and final outcome on discharge, were collected and analyzed.

Results

Of the 23 patients (12 males, 11 females; mean age 47.5 years; range 18 years to 89 years), all fractures united radiologically and clinically after the index procedure, with a mean time to fracture union of 15.7 weeks (range 9 weeks to 34 weeks) and a mean time to discharge of 17.8 weeks (range 13 weeks to 34 weeks). Oxford Elbow Score was 36.5 (range 11 to 48) at 4.6 months postoperatively; at 20 months follow-up, it was 40 (range 14 to 48) and the VAS was 8.5 (range 5 to 10). One patient had radial nerve neuropraxia pre-operatively, and one postoperatively, and both recovered uneventfully 3 months postoperatively. Neither superficial, nor deep infections were observed in this cohort.

Conclusions

The present study reports satisfactory outcome with the usage of the Synthes plate for extra-articular fracture management. It has become the technique of choice in our centre because it provides excellent results.
Using Analytic Hierarchy Process for Exploring Prioritization of Functional Strategies in Auto Parts Manufacturing SMEs of Pakistan
Authors: Ahmad Yasir , Pirzada Danial Saeed
Published: November 2014

This article uses analytical hierarchy process (AHP) to find prioritization of functional strategies (manufacturing, marketing, human resource, and financial management) by small and medium enterprises (SMEs) operating in auto parts manufacturing sector of Pakistan. SMEs are major part of the industrial structure and have significant contribution toward generating jobs in Pakistan. These enterprises are generally family-owned businesses, and this study provides concrete insights into the mind-set of owners toward different functional strategies. The AHP implementation steps are performed using commercially available software “Expert Choice®.” Marketing strategy is considered to be the most important strategy, while manufacturing management strategy is the second most important strategy. There is little emphasis on the financial and human resource management which is a serious cause of concern. The study would help policy makers to understand the business behaviors of this sector and consequently formulate policies to enhance their performance.
Factors Associated With Service Use for Young Adolescents With Mental Health Problems
Authors: Ryan Siobhan M. , Toumbourou John W. , Jorm Anthony F.
Published: November 2014

The objective of the study wasto identify factors associated with use of services for adolescent mental health problems in an Australian community-based sample. Logistic regression analysis was conducted on data collected from 636 parents and their adolescent child to identify individual and family variables predicting parent report of service use for mental health problems in the adolescent 12 months later. The services most reported by parents to have been accessed were school-based ones. Multivariate analysis found that the following were associated with service use 12 months later: the adolescent being female, parent report of peer problems and hyperactivity, single-parent household, the parent being Australian born, and prior service use by the adolescent. Parental overcontrol was associated with reduced likelihood of service use at follow-up. No association was found between service use at follow-up and parent gender, socioeconomic status, number of siblings, parent psychopathology, family social connectedness, and prior service use by the parent. No association was also found for family environment factors, parental attachment, or for the adolescent’s emotional competence or use of social support. The results indicate that families provide a potential target for interventions aimed at increasing use of professional services for adolescent mental health problems.
A Constellation of Misfortune
Authors: Daker-White Gavin , Sanders Caroline , Rogers Anne , Vassliev Ivaylo , Blickem Christian , Cheraghi-Sohi Sudeh
Published: November 2014

Quantitative studies have drawn attention to the patterning of health inequalities in relation to subjective social status (SSS). There is currently little insight into the complexities of the social and biographical aspects that lie behind these findings. Narrative accounts were gathered in a mixed-methods study involving a population of people with coronary heart disease (CHD) and/or diabetes in a region of the United Kingdom with above average levels of socio-economic deprivation. The aim of this secondary qualitative analysis was to examine the accounts of interviewees with low socio-economic status (SES) who ranked themselves either low or high in terms of SSS. The results highlight the multiplicity of adverse circumstances leading to subjective assessments of low SSS. Loss of employment status contributed more to a feeling of being “at the bottom of the ladder” than the symptoms of chronic illness did, perhaps because having somewhere to go is central to the accrual of social, economic, and cultural capital. The narratives of those who ranked themselves highly (in spite of low SES) appeared to have more family and community connections. The findings contribute to theories of socio-economic biographies or trajectories, subjective social status, and engagement with the self-management aspects of chronic illness.
Meniscal Repair of Degenerative Horizontal Cleavage Tears Using Fibrin Clots
Authors: Kamimura Tamiko , Kimura Masashi
Published: November 2014

Background:

Presently, the treatment options available for patients with horizontal degenerative cleavage tears of the meniscus are limited. These tears are considered an indication for partial or subtotal meniscectomy because when the tear is located within an avascular area, it is difficult to induce healing. However, meniscectomy is not ideal because it disrupts the normal anatomical structure and function of the meniscus.

Purpose:

To examine the clinical and arthroscopic outcomes following meniscal repair of degenerative horizontal cleavage tears using fibrin clots.

Study Design:

Case series; Level of evidence, 4.

Methods:

Vertical sutures were placed in the meniscal tear, and the cleft was filled with fibrin clots before the sutures were tightened. We repaired 18 menisci in 18 consecutive eligible patients using a previously described technique. Three patients with anterior cruciate ligament (ACL) injury who underwent simultaneous ACL reconstruction and 5 patients who did not undergo follow-up arthroscopy within 12 months were excluded. The remaining 10 menisci in 10 patients were evaluated in this study. The mean age of the patients was 35.8 ± 16.5 years, and the mean postoperative follow-up time was 40.8 ± 5.4 months. Pre- and postoperative Lysholm scores, International Knee Documentation Committee (IKDC) subjective scores, and Tegner activity levels were compared. The arthroscopy findings were evaluated at a mean postoperative time of 6.7 ± 2.9 months.

Results:

The mean Lysholm score improved significantly from 69.3 ± 16.3 points preoperatively to 95.4 ± 3.6 points postoperatively ( P < .005). The mean IKDC subjective score also improved significantly from 26.5% ± 19.0% preoperatively to 87.8% ± 7.5% postoperatively ( P < .001). The Tegner activity level recovered to the preinjury level in 6 patients and to 1 level below the preinjury level in 4 patients. The follow-up arthroscopies showed complete healing in 7 patients (70%) and incomplete healing in 3 patients (30%).

Conclusion:

Meniscal repair of degenerative horizontal cleavage tears using fibrin clots resulted in improved Lysholm and IKDC subjective scores, but the complete healing rate on follow-up arthroscopy was only 70%.

Clinical Relevance:

If we are to prevent osteoarthritis, we should minimize resection and restore the contact area of the meniscus to preserve the original shape.
Glenoid Rim Anatomy
Authors: Levy Yadin D. , Williamson Michael , Flores-Hernandez Cesar , D’Lima Darryl D. , Hoenecke Heinz R.
Published: November 2014

Background:

Injuries to the glenoid labrum frequently require repair with anchors. Placing anchor devices arthroscopically can be challenging, and anchor malpositioning can complicate surgical outcomes.

Purpose:

To determine the safe insertion range and optimal insertion angle of glenoid labral anchors at various positions on the glenoid rim and to establish surgical guidelines that minimize risk of anchor perforation.

Study Design:

Descriptive laboratory study.

Methods:

Three-dimensional computed tomography scans of 30 normal cadaveric specimens were obtained. A virtual model of a generic labral anchor was inserted into the rim of the glenoid at the clockface positions represented by 12:00, 1:30, 3:00, 4:30, 6:00, 7:30, 9:00, and 10:30. At each position, the safe insertion range was the maximal range measured, and the optimal insertion angle was identified as the angle between the bisector of the safe insertion range and the glenoid face.

Results:

Progressing in the clockwise direction, beginning at the 12:00 position, the safe insertion ranges (mean ± SD ) were 55.9° ± 10.6°, 63.6° ± 17.6°, 47.7° ± 9.1°, 46.1° ± 8°, 73.9° ± 9.7°, 40.9° ± 6.5°, 40.4° ± 7.4°, and 39.9° ± 7.1°, respectively. The optimal insertion angles were 47.9° ± 7.6°, 53.1° ± 10.9°, 35.0° ± 4.4°, 42.4° ± 4.9°, 60.9° ± 8.4°, 36.6° ± 5.9°, 31.2° ± 4.9°, 34.8° ± 4.6°, respectively.

Conclusion:

Optimal insertion angles and safe insertion ranges varied significantly with respect to the position on the glenoid face. The safe insertion range and optimal insertion angle were found to be wider at the anterior glenoid as compared with the posterior glenoid. A posterolateral insertion angle was safer than an anterior insertion angle at the 10:30 position.

Clinical Relevance:

Proper arthroscopic technique resulting in anchor insertion at the correct angle, depth, and location will prevent anchor-related glenohumeral complications such as glenoid perforation, cartilage damage, persistent pain, decreased range of motion, and failure of the reconstruction.
Probable Rare Case of Cholecystitis After Exposure to Supratherapeutic Doses of Hydralazine
Authors: Peng Alex , Reilly Timothy
Published: November 2014

Objective: To report a rare case of cholecystitis in a patient who received supratherapeutic doses of hydralazine for 1 month. Case Summary: A 79-year-old woman was admitted with severe right upper quadrant abdominal pain. Three weeks prior, she suffered a similar episode and was told she had a buildup of sludge in her gall bladder. For the past month, she had inadvertently received 400 mg of hydralazine per day instead of 150 mg; she was also prescribed fenofibrate 145 mg daily. Her workup was remarkable only for a slightly elevated white blood cell count and gall bladder sludge and distention without common duct obstruction. She was diagnosed with cholecystitis and underwent a laporoscopic cholecystectomy within 72 hours of admission. She was subsequently discharged a day later with the corrected hydralazine dose, and she has not been readmitted to the hospital. Discussion: Hydralazine is a direct acting vasodilator that may also potentiate the effects of nitric oxide. Nitric oxide has been linked to decreased gall bladder motility in in vivo and in vitro studies. The Naranjo algorithm indicates that this is a probable adverse event of fenofibrate and of hydralazine; the Drug Interaction Probability Scale indicates that this case of cholecystitis was a possible result of the interaction between hydralazine and fenofibrate. Based on the time course of the patient’s medication use and symptoms, hydralazine is more likely to be the cause of her cholecystitis than her other medications. Conclusion: Clinicians should be aware that high doses of hydralazine may inhibit gall bladder motility and contribute to the buildup of bile sludge.
Free breathing myocardial perfusion data sets for performance analysis of motion compensation algorithmss
Authors: Wollny Gert , Kellman Peter
Published: November 2014

Background

Perfusion quantification by using first-pass gadolinium-enhanced myocardial perfusion magnetic resonance imaging (MRI) has proved to be a reliable tool for the diagnosis of coronary artery disease that leads to reduced blood flow to the myocardium. The image series resulting from such acquisition usually exhibits a breathing motion that needs to be compensated for if a further automatic analysis of the perfusion is to be executed. Various algorithms have been presented to facilitate such a motion compensation, but the lack of publicly available data sets hinders a proper, reproducible comparison of these algorithms.

Material

Free breathing perfusion MRI series of ten patients considered clinically to have a stress perfusion defect were acquired; for each patient a rest and a stress study was executed. Manual segmentations of the left ventricle myocardium and the right-left ventricle insertion point are provided for all images in order to make a unified validation of the motion compensation algorithms and the perfusion analysis possible. In addition, all the scripts and the software required to run the experiments are provided alongside the data, and to enable interested parties to directly run the experiments themselves, the test bed is also provided as a virtual hard disk.

Findings

To illustrate the utility of the data set two motion compensation algorithms with publicly available implementations were applied to the data and earlier reported results about the performance of these algorithms could be confirmed.

Conclusion

The data repository alongside the evaluation test bed provides the option to reliably compare motion compensation algorithms for myocardial perfusion MRI. In addition, we encourage that researchers add their own annotations to the data set, either to provide inter-observer comparisons of segmentations, or to make other applications possible, for example, the validation of segmentation algorithms.
Sensing the room: an integrated implementation process to visualize indoor temperature data on floor plans
Authors: Shin Minkyu , Lee Sang-ik , Lee Hyunsoo , Lee Jin-Kook
Published: November 2014

Background

Recently multi-use environmental sensors became affordable and easy to control. This improvement enabled us to measure the broad range of indoor environments by using low-priced and controllable sensor devices. As the data set acquired by widely installed environmental sensors increased significantly, the need for making effective use of the data has become of importance. We developed an integrated visualization mechanism to express larger amounts of sensor data.

Method

The mechanism for visualization on floor plan described in this paper consists of the following modules: 1) the sensor module; 2) the data collection module; 3) the data processing module; 4) the spatial data module; 5) the sensor location module; and 6) the data visualization module. A demonstration following the mechanism is introduced in this paper for evaluating the integrated visualization approach. We set up a test-purposed and versatile toolkit that is cheaper, smaller and more controllable than conventional tools. We collect indoor environmental data set composed of sequential numeric data so as to use them as parameters for visualization. We inspected three major issues in the process: 1) indoor temperature data of a specific room collected at a second interval; 2) such a data set can be varied by subdivided spots of interest using multiple toolkits; 3) as a result, the collection of data is regarded as one type of parameter for visualization on top of the room's floor plan, e.g. a sudden change of sequential numbers.

Results

Indoor environment such as temperature changes are shown as colors overlapped on the floor plan. In this way it may be easier to understand the state of indoor environment and factors which influence the environment. The floor plan based visualization of an indoor environmental element seems intuitive compared to just listing the numeric information.

Conclusion

This paper introduces and demonstrates an integrated approach for visualizing the indoor environment on a floor plan with an actual test case. Combined with the building model, the visualized data can be used for recognition of the factors affecting to the target environmental element. We expect floor plan-based visualization to be used for decision-making.
Programming the group behaviors of bacterial communities with synthetic cellular communication
Authors: Kong Wentao , Celik Venhar , Liao Chen , Hua Qiang , Lu Ting
Published: November 2014

Synthetic biology is a newly emerged research discipline that focuses on the engineering of novel cellular behaviors and functionalities through the creation of artificial gene circuits. One important class of synthetic circuits currently under active development concerns the programming of bacterial cellular communication and collective population-scale behaviors. Because of the ubiquity of cell-cell interactions within bacterial communities, having an ability of engineering these circuits is vital to programming robust cellular behaviors. Here, we highlight recent advances in communication-based synthetic gene circuits by first discussing natural communication systems and then surveying various functional engineered circuits, including those for population density control, temporal synchronization, spatial organization, and ecosystem formation. We conclude by summarizing recent advances, outlining existing challenges, and discussing potential applications and future opportunities.
Can Urinary PCA3 Supplement PSA in the Early Detection of Prostate Cancer?
Authors: Wei John T. , Feng Ziding , Partin Alan W. , Brown Elissa , Thompson Ian , Sokoll Lori , Chan Daniel W. , Lotan Yair , Kibel Adam S. , Busby J. Erik , Bidair Mohamed , Lin Daniel W. , Taneja Samir S. , Viterbo Rosalia , Joon Aron Y. , Dahlgren Jackie , Kagan Jacob , Srivastava Sudhir , Sanda Martin G.
Published: November 2014

Purpose

Given the limited sensitivity and specificity of prostate-specific antigen (PSA), its widespread use as a screening tool has raised concerns for the overdiagnosis of low-risk and the underdiagnosis of high-grade prostate cancer. To improve early-detection biopsy decisions, the National Cancer Institute conducted a prospective validation trial to assess the diagnostic performance of the prostate cancer antigen 3 (PCA3) urinary assay for the detection of prostate cancer among men screened with PSA.

Patients and Methods

In all, 859 men (mean age, 62 years) from 11 centers scheduled for a diagnostic prostate biopsy between December 2009 and June 2011 were enrolled. The primary outcomes were to assess whether PCA3 could improve the positive predictive value (PPV) for an initial biopsy (at a score > 60) and the negative predictive value (NPV) for a repeat biopsy (at a score < 20).

Results

For the detection of any cancer, PPV was 80% (95% CI, 72% to 86%) in the initial biopsy group, and NPV was 88% (95% CI, 81% to 93%) in the repeat biopsy group. The addition of PCA3 to individual risk estimation models (which included age, race/ethnicity, prior biopsy, PSA, and digital rectal examination) improved the stratification of cancer and of high-grade cancer.

Conclusion

These data independently support the role of PCA3 in reducing the burden of prostate biopsies among men undergoing a repeat prostate biopsy. For biopsy-naive patients, a high PCA3 score (> 60) significantly increases the probability that an initial prostate biopsy will identify cancer.
Phase II Trial of the Anti-CD19 Bispecific T Cell–Engager Blinatumomab Shows Hematologic and Molecular Remissions in Patients With Relapsed or Refractory B-Precursor Acute Lymphoblastic Leukemia
Authors: Topp Max S. , Gökbuget Nicola , Zugmaier Gerhard , Klappers Petra , Stelljes Matthias , Neumann Svenja , Viardot Andreas , Marks Reinhard , Diedrich Helmut , Faul Christoph , Reichle Albrecht , Horst Heinz-August , Brüggemann Monika , Wessiepe Dorothea , Holland Chris , Alekar Shilpa , Mergen Noemi , Einsele Hermann , Hoelzer Dieter , Bargou Ralf C.
Published: November 2014

Purpose

Patients with relapsed or refractory acute lymphoblastic leukemia (ALL) have a dismal prognosis. CD19 is homogenously expressed in B-precursor ALL and can be targeted by the investigational bispecific T cell–engager antibody blinatumomab. A phase II trial was performed to determine clinical activity in this patient cohort.

Patients and Methods

Thirty-six patients with relapsed or refractory B-precursor ALL were treated with blinatumomab in cycles of 4-week continuous infusion followed by a 2-week treatment-free interval in a single-arm study with a dose-finding stage and an extension stage. The primary end point was complete remission (CR) or CR with partial hematologic recovery (CRh). Major secondary end points included minimal residual disease (MRD) response, rate of allogeneic hematopoietic stem-cell transplantation (HSCT) realization, relapse-free survival (RFS), overall survival (OS), and incidence of adverse events (AEs).

Results

Median age was 32 years (range, 18 to 77 years). Twenty-five patients (69%) achieved a CR or CRh, with 88% of the responders achieving an MRD response. Median OS was 9.8 months (95% CI, 8.5 to 14.9), and median RFS was 7.6 months (95% CI, 4.5 to 9.5). Thirteen responders (52%) underwent HSCT after achieving a CR or CRh. The most frequent AE during treatment was pyrexia (grade 1 or 2, 75%; grade 3, 6%). In six patients with nervous system or psychiatric disorder AEs and in two patients with cytokine release syndrome, treatment had to be interrupted or discontinued. These medical events were resolved clinically.

Conclusion

The data support further investigation of blinatumomab for the treatment of adult patients with relapsed or refractory ALL in a larger confirmatory study.
Inequalities in Premature Death From Colorectal Cancer by State
Authors: Jemal Ahmedin , Siegel Rebecca L. , Ma Jiemin , Islami Farhad , DeSantis Carol , Goding Sauer Ann , Simard Edgar P. , Ward Elizabeth M.
Published: November 2014

Purpose

Although disparities in colorectal cancer (CRC) with regard to race, socioeconomic status, and geography are well documented, the extent to which these factors contribute to premature death resulting from CRC nationwide and by state is unknown.

Patients and Methods

We calculated age-standardized CRC death rates for three broad educational categories as a marker of socioeconomic status by race/ethnicity and state among individuals age 25 to 64 years from 2008 through 2010. We also calculated the proportion of premature death resulting from CRC that could potentially be averted in each state by applying the average death rate for the five states with the lowest rates among the most educated whites (Connecticut, North Dakota, Utah, Vermont, and Wisconsin) to all populations.

Results

Compared with those with the most education, those with the least education had significantly higher CRC death rates in virtually all states for each racial/ethnic group. For example, rate ratios ranged from 1.15 (95% CI, 0.66 to 2.01) in Delaware to 3.18 (95% CI, 2.01 to 5.05) in New Mexico among whites. Overall, half the premature deaths resulting from CRC that occurred nationwide from 2008 through 2010, or 7,690 deaths annually, would have been avoided if everyone had experienced the lowest death rates of the most educated whites. More premature deaths could be averted in southern states (60% to 70%) than in northern and western states (30% to 40%). Restricting the analyses to persons age 50 to 64 years, for whom CRC screening is recommended, resulted in similar findings.

Conclusion

The majority of premature deaths from CRC in southern states and half these deaths nationwide are due to racial/ethnic, socioeconomic, and geographic inequalities.
Mitigating or Exacerbating Effects of Maternal-Fetal Programming of Female Mice Through the Food Choice Environment
Authors: Brenseke Bonnie , Bahamonde Javiera , Talanian Michael , Kornfeind Ellie , Daly Jacquiline , Cobb Grayson , Zhang Jinhua , Prater M. Renee , Davis George C. , Good Deborah J.
Published: November 2014

Humans live, eat, and become overweight/obese in complex surroundings where there are many available food choices. Prenatal exposure to poor food choices predisposes offspring to increased negative health risks, including obesity. Many animal experiments have analyzed intergenerational body weight parameters in an environment without food choices, which may not be directly translatable to the human food environment. In this study, offspring from mothers with a defined high-fat diet (HFD) or low-fat diet (LFD) were arbitrarily assigned to either an exclusively LFD or HFD or to a diet where they have a choice between LFD and HFD (choice diet). Offspring displayed negative outcomes of increased body weight, body fat, serum leptin, and blood glucose levels when given the choice diet compared with offspring on the LFD. Conversely, improved energy expenditure was found for offspring given the choice diet compared with offspring from HFD dams given LFD. In addition, maternal diet-specific influences on offspring metabolic parameters were identified, especially in offspring from HFD dams, including positive outcomes of reduced leptin in LFD offspring, reduced corticosterone and cholesterol levels in HFD offspring, and increased exercise levels in choice offspring, as well as the negative outcome of increased calorie intake in LFD offspring from HFD dams. This defined model can now be used as the basis for future studies to characterize the cycle of inter- and intragenerational obesity and whether more realistic diet environments, especially those including choice, can mitigate phenotype.
Relationship Between Insulin Resistance and β-Cell Dysfunction in Subphenotypes of Prediabetes and Type 2 Diabetes
Authors: Færch Kristine , Johansen Nanna B. , Witte Daniel R. , Lauritzen Torsten , Jørgensen Marit E. , Vistisen Dorte
Published: November 2014

Context:

There is little overlap between diabetes diagnosed by glycated hemoglobin (HbA1c) and blood glucose, and it is unclear which pathophysiological defects are captured when using HbA1c for diagnosis.

Objective:

We examined and compared the relationship between insulin sensitivity and β-cell function in different subphenotypes of prediabetes and type 2 diabetes (T2D).

Design, Setting, and Participants:

A cross-sectional analysis of the Danish ADDITION-PRO study was performed (n = 1713). Participants without known diabetes were classified into subgroups of prediabetes and T2D based on fasting or 2-hour glucose criteria or HbA1c. Insulin sensitivity and insulin release were determined from glucose and insulin concentrations during the oral glucose tolerance test, and disposition indices were calculated.

Results:

Individuals with prediabetes or T2D diagnosed by fasting glucose had lower absolute insulin release (P ≤ .01) and higher insulin sensitivity in response to glucose intake (P ≤ .01) but a similar disposition index (P ≥ .36), compared with individuals with elevated 2-hour glucose concentrations. Individuals with HbA1c-defined T2D or prediabetes had a mixture of the pathophysiological defects observed in the glucose-defined subgroups, and individuals with normoglycemia by HbA1c had worse pathophysiological abnormalities than individuals with normoglycemia by the glucose criteria.

Conclusions:

On average, the diagnostic HbA1c criteria for diabetes and prediabetes identified individuals with a mixture of the pathophysiological characteristics found when using the glucose criteria, but the diversity and pathophysiology captured by the oral glucose tolerance test cannot be captured when applying the more simple HbA1c criteria. Whether the disease progression and prognosis will differ in individuals diagnosed by fasting glucose, 2-hour glucose, or HbA1c should be examined in longitudinal studies.
“Janus-type” Ruthenium Complex Bearing Both Phosphonic Acids and Pyrene Groups for Functionalization of ITO and HOPG Surfaces
Authors: Yang Li , Ozawa Hiroaki , Koumoto Mayuko , Yoshikawa Kai , Matsunaga Mariko , Haga Masa-aki
Published: November 2014

A novel Janus-type ruthenium complex bearing both phosphonic acid and pyrene groups was tethered to both ITO and HOPG surfaces in different tethering modes. On the ITO surface, the phosphonic groups were selectively attached to the ITO, resulting in the hydrophobic surface because of the exposed pyrene groups on the top. On the other hand, on the HOPG surface, pyrene groups interacted with the HOPG surface through noncovalent interaction, resulting in a hydrophilic surface exposing phosphonic acid groups. This selectivity makes it possible to fabricate redox-active ruthenium complex and graphene composite by layer-by-layer growth of molecular units.
HER2 Heterogeneity Affects Trastuzumab Responses and Survival in Patients With HER2-Positive Metastatic Breast Cancer
Authors: Lee Hee Jin , Seo An Na , Kim Eun Joo , Jang Min Hye , Suh Koung Jin , Ryu Han Suk , Kim Yu Jung , Kim Jee Hyun , Im Seock-Ah , Gong Gyungyub , Jung Kyung Hae , Park In Ae , Park So Yeon
Published: November 2014

Objectives:

Heterogeneity of HER2 gene amplification is found in a subset of breast cancers. We investigated the impact of HER2 heterogeneity on trastuzumab responses and clinical outcomes in 112 patients with HER2-positive metastatic breast cancer.

Methods:

Regional and genetic heterogeneity of HER2 gene amplification was determined in three different areas of each tumor by immunohistochemistry and silver in situ hybridization. We also assessed the overall levels of HER2 amplification and the proportion of tumor cells with a HER2/CEP17 ratio of more than 2.2 or strong and complete membranous (3+) expression of HER2 protein.

Results:

HER2 regional and genetic heterogeneity based on the HER2/CEP17 ratio was confirmed in 8.7% and 2.7% of cases, respectively. Poor response to trastuzumab was associated with overall low-level or equivocal amplification, HER2 regional heterogeneity by the HER2/CEP17 ratio, the HER2/CEP17 ratio of more than 2.2 in less than 80% of tumor cells, and HER2 immunohistochemical expression of 3+ in less than 75% of tumor cells. In survival analyses, low-level or equivocal HER2 amplification, HER2 regional heterogeneity based on the HER2/CEP17 ratio, and the HER2/CEP17 ratio of more than 2.2 in less than 80% of tumor cells were associated with shorter time to progression and lower overall survival in univariate and multivariate analyses.

Conclusions:

These results suggest that accurate assessment of HER2 status, including HER2 heterogeneity, is important in predicting trastuzumab responses and outcomes in patients with HER2-positive metastatic breast cancer.
Prognostic Stratification of Ulcerated Melanoma
Authors: Bønnelykke-Behrndtz Marie L. , Schmidt Henrik , Christensen Ib J. , Damsgaard Tine E. , Møller Holger J. , Bastholt Lars , Nørgaard Peter H. , Steiniche Torben
Published: November 2014

Objectives:

For patients with melanoma, ulceration is an important prognostic marker and interestingly also a predictive marker for the response of adjuvant interferon. A consensual definition and accurate assessment of ulceration are therefore crucial for proper staging and clinical management. We evaluated the prognostic impact of the extent and type of ulceration and the epidermal involvement theoretically preceding it (consumption of epidermis and cleft formation) or seen subsequent to the inflammation (reepithelialization and reactive epidermal hyperplasia), aiming for better prognostic stratification of ulcerated lesions.

Methods:

From H&E-stained sections, the status (presence vs absence), extent (percentage of the total tumor length), and type (infiltrative vs attenuative) of ulceration and epidermal involvement were evaluated from 385 patients with cutaneous melanoma.

Results:

The presence of ulceration (hazard ratio [HR], 1.83), an attenuative type of ulceration (HR, 3.02), and excessive ulceration (HR, 3.57) were independent predictors of poor melanoma-specific survival. Further subdivision of minimal/moderate ulceration showed independent prognostic value only for lesions with epidermal involvement of the surrounding epidermis (HR, 1.78).

Conclusion:

The extent and type of ulceration and involvement of the surrounding epidermis provided more accurate prognostic information than the mere absence or presence and may be useful markers allowing better stratification of ulcerated lesions.
‘Round and round’: Metatheatre, illusion, and reality in The Fantasticks
Authors: Stephenson Bradley
Published: November 2014

The Fantasticks by Tom Jones and Harvey Schmidt is one of the most beloved and well-known musicals in the world. However, it is often dismissed as frivolous entertainment or church basement fluff. The concept of metatheatre, coined by Lionel Abel to describe plays about life seen as already theatricalized, is a potent analytical tool that can reveal a more sophisticated edge to the longest running musical in the world. Throughout the musical, The Fantasticks plays with truth and illusion, blending them and merging them in complex whirligigs that stir up the theatricalized and theatricalizing forces permeating the show, while touching the metaphysical imaginations of its audiences. This article explores some of the metatheatrical elements of the play (role playing within the role, the play within the play, self-reference) to illuminate the complex metatheatrical interplay of truth and illusion in relation to the audiences’ imaginations.
Decisão de carreira: processo, desafios e soluções
Authors: Silva José Manuel Tomás da
Published: November 2014

O ser humano no decurso do desenvolvimento ao longo da vida toma um incontável número de decisões. A maioria das decisões envolvem escolhas triviais, enquanto outras, porém, são percebidas como mais importantes e requerem uma maior atenção. As decisões relacionadas com a carreira profissional pertencem a este último grupo, porque têm implicações significativas para o estilo de vida das pessoas, o tipo de amigos com quem socializam, as actividades de tempos livres a que se dedicam, e, em última análise, para a sua qualidade de vida e de bem-estar. Neste trabalho propomo-nos, em primeiro lugar, reflectir sobre o que é uma “boa” escolha ou decisão de carreira, tendo por base alguns modelos de decisão de carreira. De seguida, procuraremos ilustrar com base no modelo PIC [Prescreening, In-depth exploration, & Choice] (Gati & Asher, 2001a) uma abordagem que pode ser usada para facilitar o processo de tomada de decisão de carreira de jovens e adultos.
Avaliação da Inteligência Pré-Mórbida: Desenvolvimento da versão experimental do Teste de Leitura de Palavras Irregulares (TeLPI) para a população portuguesa
Authors: Alves Lara , Martins Cristina , Simões Mário R.
Published: November 2014

Na ausência de informação objectiva sobre o nível de funcionamento cognitivo anterior, é essencial uma estimação fiel da inteligência pré-mórbida (IPM) quando se pretende avaliar a existência, natureza e grau de lesões com potencial declínio cognitivo. Trabalhos recentes nesta área interligam a presente capacidade de leitura de palavras irregulares com índices de inteligência actuais e variáveis demográficas, utilizando fórmulas de regressão. A utilidade e uso frequente de testes de estimação da IPM em protocolos de avaliação neuropsicológica justificam a construção de um teste análogo para a população portuguesa. Deste modo, com o propósito de criar um instrumento objectivo de estimação da IPM, foi desenvolvida a primeira versão experimental do TeLPI, constituída por 121 palavras portuguesas que ostentam casos de irregularidade na relação grafema-fone (palavras irregulares), 105 das quais infrequentes e 16 frequentes. O presente estudo apresenta a metodologia de construção do TeLPI, o processo de selecção de itens e os desafios futuros para a concretização da sua versão final.
Bateria de avaliação do temperamento infantil – forma revista
Authors: Almeida Maria Margarida , Seabra-Santos Maria João , Major Sofia
Published: November 2014

Numerosos estudos sugerem que o temperamento pode ser considerado uma variável particularmente útil na compreensão das interacções entre as crianças e o seu ambiente social. É neste sentido que a avaliação do temperamento tem vindo a ser destacada como um componente importante da avaliação psicológica de crianças. Neste artigo é apresentado o questionário Temperament Assessment Battery for Children – Revised (TABC-R, Martin & Bridger, 1999), versões para pais e para professores, aplicável a crianças com 2 a 7 anos, quanto à composição, fundamentação teórica, procedimentos de aplicação e correcção e interpretação dos resultados. Em seguida expõem-se os estudos sobre a TABC-R conduzidos no nosso país (N=138), com especial destaque para investigações no âmbito da respectiva precisão e validade. Em geral, os resultados apontam para boas características psicométricas, animadoras quanto ao potencial de utilização do questionário em Portugal, tanto mais que não existem no nosso país instrumentos alternativos para avaliar o temperamento nesta faixa etária. Finalmente é feita uma avaliação crítica da TABC-R incidindo sobre as suas principais potencialidades e limitações e são apontadas pistas para estudos futuros.
Estudo das propriedades psicométricas da Perceived Stress Scale (PSS) na população portuguesa
Authors: Trigo Miguel , Canudo Noélia , Branco Fernando , Silva Danilo
Published: November 2014

Objectivo: Estudar as propriedades psicométricas da versão portuguesa da Perceived Stress Scale-10 (PSS-10). Amostra: Cinco amostras da população geral (n = 762) e cinco amostras de pessoas com doença física ou perturbação ansiosa (n = 201). Medidas: Dados socio-demográficos, hábito tabágico, Beck Depression Inventory® (BDI®), PSS-10, State-Trait Anxiety Inventory® (STAI®-Y2) e Smoking Abstinence Self-Efficacy (SASE-12). Resultados: Pela análise em componentes principais, reteve-se um factor que explica 47,4% da variância. O alfa de Cronbach foi de 0,874 e encontraram-se diferenças significativas na percepção do stresse, em diversos estratos da população. Existem correlações moderadas entre a PSS-10, o BDI® e o STAI®-Y2 e ausência de associação com o SASE-12. Consideram-se indicador de patologia pontuações brutas acima do percentil 80. Conclusões: A PSS-10 apresenta boas qualidades psicométricas. A sua aplicação e cotação é simples, constituindo um instrumento válido para avaliar o stresse, em contextos de doença física ou condições psicopatológicas.
Vinculação a Pais, Pares e Professores – estudos com o IPPA-R para crianças do ensino básico
Authors: Machado Teresa Sousa , Figueiredo Tânia
Published: November 2014

O período do meio da infância – período de latência – tem sido menos investido no âmbito dos estudos da vinculação. Todavia, tarefas normativas como a adaptação escolar são essenciais para o desenvolvimento nestas idades e parecem exigir competências psicossociais que são influenciadas pela vinculação aos cuidadores principais. Na escola, pares e professores podem também assumir papéis significativos – complementares aos pais – funcionando aí como ponto de referência ou apoio. O presente trabalho apresenta dados preliminares da adaptação e validação de três versões – Pais, Pares e Professores – do IPPA-R (Inventory of Parent and Peer Attachment, de Armsden & Greenberg), a crianças entre os 9 e 11 anos. Os três instrumentos de auto-relato – cada um com 25 itens – passados a uma amostra de 254 crianças do ensino Público e Privado/cooperativo, apresentam estrutura factorial semelhante entre si, composta por três sub-escalas. As qualidades psicométricas encontradas e a facilidade de aplicação sugerem que se tratam de instrumentos
adequados para avaliar a segurança da relação a figuras significativas nestas idades.
Estudo Psicométrico preliminar da Mental Health Continuum – Short Form – for youth numa amostra de adolescentes portugueses
Authors: Matos Ana Paula , André Raquel Simão , Cherpe Sónia , Rodrigues Daniela , Figueira Célia , Pinto Alexandra Marques
Published: November 2014

A definição e avaliação da saúde mental pressupõem não só a ausência de doença mental, como, também, a existência de bem-estar subjectivo (WHO, 2004). Keyes (2002) propôs uma escala de auto-resposta, a Mental Health Continuum – Short Form – for youth (MHC-SF), com o objectivo de avaliar num continuum a saúde mental e de identificar diagnósticos categoriais (flourishing, saúde mental moderada e languishing). Neste estudo, traduzimos e adaptámos a referida escala para uma amostra de adolescentes Portugueses. Foi desenvolvido um estudo psicométrico da MHC-SF através da exploração da sua estrutura factorial, da análise da consistência interna, da validade convergente e divergente. Esta escala revelou boas propriedades psicométricas, parecendo indicada para detectar categorias de saúde mental nos adolescentes. Poderá ainda ser utilizada na identificação de dimensões do bem-estar (psicológico, emocional e social) as quais são importantes na prevenção e tratamento da doença mental, assim como na protecção e promoção da saúde mental.
Funções na família multigeracional: Contributo para a caracterização funcional do sistema familiar multigeracional
Authors: Vicente Henrique Testa , Sousa Liliana
Published: November 2014

Esta pesquisa procura contribuir para a compreensão do sistema familiar multigeracional, centrando-se na análise das funções desempenhadas no seu seio e das características de quem as desempenha. Para tal, definiu-se um conjunto de funções a partir das características idiossincráticas da família multigeracional e aplicou-se uma entrevista de genograma a elementos das gerações intermédias de 25 famílias com elementos vivos de quatro gerações. Os papéis definidos em consonância com as funções identificadas são: “guardião das memórias familiares”, “elo de ligação familiar” e “pronto-socorro familiar”. Os dados apontam para um contributo mais equitativo das diferentes gerações para a dinâmica familiar multigeracional, ou seja, o funcionamento deste sistema parece depender da participação das suas várias gerações. Para além disso, os dados fornecem pistas para a intervenção familiar e facultam um contributo teórico para o tópico das famílias envelhecidas.