bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacokinetic modeling of carisoprodol and meprobamate disposition in adults
Authors: Lewandowski TA
Published: October 2016

Carisoprodol is a widely prescribed muscle relaxant and is also a drug known to be a subject to abuse. Despite the fact that carisoprodol has been available for prescription since 1959, a number of gaps in our knowledge of the toxicokinetics of this common drug exist. For example, the volume of distribution (Vd) for carisoprodol in humans has not been reported. A two-compartment pharmacokinetic model describing carisoprodol metabolism and that of the primary metabolite, meprobamate, was developed to better understand the pharmacokinetics of this drug. The model accounts for first pass metabolism of carisoprodol and was able to replicate the data from several previously reported data sets. Based on an analysis of four different data sets, the Vd for carisoprodol ranged from 0.93 to 1.3 L/kg, while that for meprobamate ranged from 1.4 to 1.6 L/kg. The model was also used to estimate the probable dose of this drug in an individual where questions concerning the drug’s role in her death had been posed. The model may, therefore, have significant utility for estimating doses of carisoprodol in medicolegal cases.
Responding to Richard: Celebrity and (mis)representation of science
Authors: Johnson David R. , Ecklund Elaine Howard , Di Di , Matthews Kirstin R.W.
Published: October 2016

Drawing on 48 in-depth interviews conducted with biologists and physicists at universities in the United Kingdom, this study examines scientists’ perceptions of the role celebrity scientists play in socially contentious public debates. We examine Richard Dawkins’ involvement in public debates related to the relationship between science and religion as a case to analyze scientists’ perceptions of the role celebrity scientists play in the public sphere and the implications of celebrity science for the practice of science communication. Findings show that Dawkins’ proponents view the celebrity scientist as a provocateur who asserts the cultural authority of science in the public sphere. Critics, who include both religious and nonreligious scientists, argue that Dawkins misrepresents science and scientists and reject his approach to public engagement. Scientists emphasize promotion of science over the scientist, diplomacy over derision, and dialogue over ideological extremism.
Open Innovation: Technology, Market and Complexity in South Korea
Authors: Yun Jinhyo Joseph
Published: October 2016

Open Innovation means that valuable ideas can come from inside or outside the company and can go to market from inside or outside the company as well (Chesbrough, 2006). This concept is a decade old and is still alive and thriving concept that we need to integrate it into the broader stream of innovation literature focusing on collaboration with external partners (Vanhaverbeke, Chesbrough, & West, 2014). Society of Open Innovation: Technology, Market, and Complexity (SOItmC) in conjunction with 8th Knowledge Cities World Summit (KCWS) organised a conference at Daegu Gyeongbuk Institute of Science and Technology (DGIST) in 2015. The theme of the conference was ‘open innovation, knowledge city, and creative economy’. The concrete meaning of this theme is twofold. The first leads us to motivate to make use of open innovation to build up knowledge city. The other motivates us to make creative economy, which is based on creative knowledge and technology through knowledge city. Most articles in this special issue were initially presented at this conference held at Daegu in South Korea. We triggered open innovation to motivate knowledge city and creative economy. Our conference made open innovation as the logical background of eight Korea creative economy centres.
Book Review: Andrew Small (2015). The China–Pakistan Axis: Asia’s New Geopolitics
Authors: Godbole Avinash
Published: October 2016

Andrew Small (2015). The China–Pakistan Axis: Asia’s New Geopolitics. New Delhi: Random House India, pp. 347, ₹399.
Developing crossmodal expression recognition based on a deep neural model
Authors: Barros Pablo , Wermter Stefan
Published: October 2016

A robot capable of understanding emotion expressions can increase its own capability of solving problems by using emotion expressions as part of its own decision-making, in a similar way to humans. Evidence shows that the perception of human interaction starts with an innate perception mechanism, where the interaction between different entities is perceived and categorized into two very clear directions: positive or negative. While the person is developing during childhood, the perception evolves and is shaped based on the observation of human interaction, creating the capability to learn different categories of expressions. In the context of human–robot interaction, we propose a model that simulates the innate perception of audio–visual emotion expressions with deep neural networks, that learns new expressions by categorizing them into emotional clusters with a self-organizing layer. The proposed model is evaluated with three different corpora: The Surrey Audio–Visual Expressed Emotion (SAVEE) database, the visual Bi-modal Face and Body benchmark (FABO) database, and the multimodal corpus of the Emotion Recognition in the Wild (EmotiW) challenge. We use these corpora to evaluate the performance of the model to recognize emotional expressions, and compare it to state-of-the-art research.
Can my robotic home cleaner be happy? Issues about emotional expression in non-bio-inspired robots
Authors: Bonarini Andrea
Published: October 2016

In many robotic applications, a robot body should have a functional shape that cannot include bio-inspired elements, but it would still be important that the robot can express emotions, moods, or a character, to make it acceptable, and to involve its users. Dynamic signals from movement can be exploited to provide this expression while the robot is acting to perform its task. A research effort has been started to find general emotion expression models for actions that could be applied to any kind of robot to obtain believable and easily detectable emotional expressions. The need for a unified representation of emotional expression emerged. A framework to define action characteristics that could be used to represent emotions is proposed in this paper. Guidelines are provided to identify quantitative models and numerical values for parameters, which can be used to design and engineer emotional robot actions. A set of robots having different shapes, movement possibilities, and goals have been implemented following these guidelines. Thanks to the proposed framework, different models to implement emotional expression can now be compared in a sound way. The question mentioned in the title can now be answered in a justified way.
Mid- to Long-term Results of Supramalleolar Osteotomy
Authors: Krähenbühl Nicola , Zwicky Lukas , Bolliger Lilianna , Schädelin Sabine , Hintermann Beat , Knupp Markus
Published: October 2016

Background:

Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery.

Methods:

Two hundred ninety-four patients (298 ankles) underwent realignment surgery between December 1999 and June 2013. Kaplan-Meier survival analysis was performed with total ankle replacement and arthrodesis of the ankle joint as endpoints. A Cox proportional hazards model was performed to identify risk factors for failure. The mean time to follow-up was 5.0 ± 3.7 years.

Results:

The overall 5-year survival rate was 88%. Thirty-eight patients (12.9%) underwent either secondary total ankle replacement or ankle arthrodesis (30 total ankle replacements, 8 ankle arthrodesis). Risk factors for failure following realignment surgery were age at the time of surgery and a Takakura score of 3b preoperatively.

Conclusion:

Realignment surgery of the hindfoot was an excellent treatment option for young and physically active patients with early to mid-stage ankle OA.

Level of Evidence:

Level IV, prospective observational study.
HAMR: A dataflow-based real-time in-memory cluster computing engine
Authors: Wu Yao , Zheng Long , Heilig Brian , Gao Guang R
Published: October 2016

As the attention given to big data grows, cluster computing systems for distributed processing of large data sets become the mainstream and critical requirement in high performance distributed system research. One of the most successful systems is Hadoop, which uses MapReduce as a programming/execution model and takes disks as intermedia to process huge volumes of data. Spark, as an in-memory computing engine, can solve the iterative and interactive problems more efficiently. However, currently it is a consensus that they are not the final solutions to big data due to a MapReduce-like programming model, synchronous execution model and the constraint that only supports batch processing, and so on. A new solution, especially, a fundamental evolution is needed to bring big data solutions into a new era.

In this paper, we introduce a new cluster computing system called HAMR which supports both batch and streaming processing. To achieve better performance, HAMR integrates high performance computing approaches, i.e. dataflow fundamental into a big data solution. With more specifications, HAMR is fully designed based on in-memory computing to reduce the unnecessary disk access overhead; task scheduling and memory management are in fine-grain manner to explore more parallelism; asynchronous execution improves efficiency of computation resource usage, and also makes workload balance across the whole cluster better. The experimental results show that HAMR can outperform Hadoop MapReduce and Spark by up to 19x and 7x respectively, in the same cluster environment. Furthermore, HAMR can handle scaling data size well beyond the capabilities of Spark.
Effects of a randomized trial comparing standard and enhanced counseling for men at high risk of prostate cancer as a function of race and monitoring style
Authors: Roussi Pagona , Miller Suzanne M , Giri Veda N , Obeid Elias , Wen Kuang-Yi , Tagai Erin K , Scarpato John , Gross Laura , Roy Gem
Published: October 2016

Despite conflicting guidelines, a significant subset of high-risk men decide to undergo routine prostate cancer screening. Yet, there is a scarcity of available programs, and no studies evaluating interventions to support men in dealing with the psychosocial impact of screening. In this study, one of the first to explore the responses of high-risk men enrolling in a Prostate Cancer Risk Assessment Program ( N = 128), patients underwent a prostate cancer risk counseling visit immediately followed by either a cognitive–affective preparation session designed to help them process the information they received or a general health education session. All men in this self-selected sample chose to participate in prostate cancer screening. Men were assessed 3 weeks and 6 months post-counseling. The impact of the enhanced counseling condition on knowledge, perceived risk, expectancies, and intrusive ideation was a function of racial and coping style group. Implications for tailored interventions to maximize preparedness for risk and screening counseling are discussed.
The limits of justification: Critique, disclosure and reflexivity
Authors: McNay Lois
Published: October 2016

I argue that Forst’s justification paradigm is less radical than claimed in that it fails to establish an immanent connection between the role of justification as a transcendental principle and as a tool of disclosing, reflexive critique. I maintain that the construal of justification as a trans-historical principle, by definition, shields it from systematic criticism and consequently constrains critique’s capacity for reflexive self-scrutiny. Reflexivity is ignited by disclosure to the degree that it is reflection on the non-identical elements of social life that may prompt critical re-evaluation of a theory’s conceptual framework. Justification critique’s capacity for disclosure, and hence reflexivity, is crucially limited, however, by Forst’s reliance on a tendentious concept of noumenal power, which does not satisfactorily explain the complex, material dynamics through which structural inequalities are reproduced. It is further stymied by a disregard of the latent power dynamics often at work in actual conversations about justice that subvert formally equal relations of justification. In short, the lack of reflexivity is evident in Forst’s failure to adequately consider how entrenched asymmetries of power may require him to advance beyond an abstract, one-dimensional account of mutually owed justifications.
Changing assumptions and progressive change in theories of strategic organization
Authors: Foss Nicolai J , Hallberg Niklas L
Published: October 2016

A commonly held view is that strategic organization theories progress as a result of a Popperian process of bold conjectures and systematic refutations. However, our field also witnesses vibrant debates or disputes about the specific assumptions that our theories rely on, and although these debates are often decoupled from the results of empirical testing, changes in assumptions seem closely intertwined with theoretical progress. Using the case of the resource-based view, we suggest that progressive change in theories of strategic organization may come about as a result of scholarly debate and dispute over what constitutes proper assumptions—even in the absence of corroborating or falsifying empirical evidence. We also discuss how changing assumptions may drive future progress in the resource-based view.
The development of clinical ethics in Italy and the birth of the “Document of Trento”
Authors: Picozzi Mario , Nicoli Federico , Pegoraro Renzo
Published: October 2016

The Italian debate about the role of clinical ethics and ethics consultation has brought about the need to create a working group of Healthcare Ethics Consultation. The group began to take shape and to be organized in 2010; its activities are largely directed to share experiences, to analyze this field and to develop a professional profile of the clinical ethicist recognized throughout the nation. The working group of Clinical Ethics and Healthcare Ethics Consultation was born from some meetings and the group started to draft a Document about Clinical Ethics Consultation in Healthcare in Rome (June 2013). The Document was approved in Trento at the Kessler Foundation (October 2013) and undersigned by more than 200 people. The newborn document was called “The Document of Trento”: it is the first Italian document regarding clinical ethics consultation.
What is the value of conducting a trial of r-tPA for the treatment of mild stroke patients?
Authors: Guzauskas Gregory F , Chen Er , Lalla Deepa , Yu Elaine , Tayama Darren , Veenstra David L
Published: October 2016

Background

The Phase IIIb, Double-Blind, Multicenter Study to Evaluate the Efficacy and Safety of Alteplase in Patients With Mild Stroke: Rapidly Improving Symptoms and Minor Neurologic Deficits (PRISMS) trial will assess r-tPA in ischemic stroke patients who present with mild deficits (i.e. mild stroke).

Aims

To assess PRISMS’s societal value in clarifying the optimal care for patients with mild ischemic stroke.

Methods

A value of information (VOI) decision model was developed to compare the outcomes of mild stroke patients treated vs. not treated with r-tPA. Model inputs were derived from a subset of Third International Stroke Trial patients, a recent meta-analysis of r-tPA trials, expert opinion, and other published sources. VOI analyses were also used to assess the expected US societal value of the PRISMS trial and the expected value of reducing uncertainty in key trial estimates.

Results

The expected net societal value of the PRISMS trial was approximately $210 million ($160 m–$260 m), representing a six-fold return on investment. The value of reducing uncertainty in r-tPA efficacy was approximately $150 million ($100 m–$200 m), while reducing uncertainty in r-tPA safety (increased risk for symptomatic intracranial hemorrhage) did not add additional value in comparison.

Conclusions

Developing a better understanding of the outcomes of r-tPA treatment in patients with mild ischemic stroke will provide tremendous societal value by clarifying current uncertainty around treatment effectiveness. Enrollment in the PRISMS trial for patients presenting with mild ischemic stroke within 0–3 h of symptom onset should be highly encouraged.
Street talk and Bourdieusian criminology: Bringing narrative to field theory
Authors: Sandberg Sveinung , Fleetwood Jennifer
Published: October 2016

The work of Bourdieu has increasingly gained interest in criminology. His theoretical framework is rich and arguably the most sophisticated approach to social inequality and difference in sociology. It has however, been criticized for bias towards the structural aspects of social life, and for leaving little space for the constitutive, and creative role of language. We argue for the inclusion of narrative for understanding street fields. Based on qualitative interviews with 40 incarcerated drug dealers in Norway, we describe the narrative repertoire of the street field, including stories of crime business, violence, drugs and the ‘hard life’. The narrative repertoire is constituted by street capital, but also upholds and produces this form of capital. Street talk is embedded in objective social and economic structures and displayed in the actors’ habitus. Narratives bind the street field together: producing social practices and social structure.
Systematic review and meta-analysis: the effects of fermented milk with Bifidobacterium lactis CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population
Authors: Eales Jacqui , Gibson Peter , Whorwell Peter , Kellow John , Yellowlees Ann , Perry Richard H. J. , Edwards Mary , King Sarah , Wood Hannah , Glanville Julie
Published: October 2016

Background:

It has been suggested that probiotics may improve gastrointestinal discomfort. Not all probiotics exhibit the same effects and consequently meta-analyses on probiotics should be confined to well-defined strains or strain combinations. The aim of this study was to evaluate the effectiveness of a probiotic fermented milk (PFM) that includes Bifidobacterium lactis ( B. lactis) CNCM I-2494 and lactic acid bacteria on gastrointestinal discomfort in the general adult population.

Methods:

Double-blind randomized controlled trials in the general adult population comparing PFM with a control dairy product for at least 4 weeks were searched from multiple literature databases (up to February 2015). Meta-analyses using random-effects models, with individual participant data were undertaken to calculate an odds ratio (OR) or standard mean difference (SMD), with a 95% confidence interval (CI).

Results:

The search strategy identified 12,439 documents. Overall, three trials with a total of 598 adults (female = 96.5%) met the inclusion criteria. Consumption of the PFM product was associated with a significant improvement in overall gastrointestinal discomfort compared with the control product (OR = 1.48; 95% CI 1.07–2.05), with a number needed to treat (NNT) of 10.24 (95% CI 5.64–55.93). PFM was also superior to the control in reducing digestive symptoms, as measured using a composite score (SMD = −0.21; 95% CI −0.37 to −0.05). Sensitivity analyses produced similar results, and the heterogeneity between studies was minimal.

Conclusions:

This meta-analysis shows that the consumption of PFM with B. lactis CNCM I-2494 and lactic acid bacteria is associated with a modest but consistent and significant improvement of outcomes related to gastrointestinal discomfort in healthy adults.
UroLift: a new minimally-invasive treatment for benign prostatic hyperplasia
Authors: Jones Patrick , Rai Bhavan P. , Aboumarzouk Omar , Somani Bhaskar K.
Published: October 2016

‘UroLift’ has emerged as a new minimally-invasive nonablative surgical technique for benign prostatic hyperplasia (BPH). We discuss the procedure, cost, evidence, advantages and disadvantages of this procedure. It is a novel technology suitable for a selected group of patients that allows for a bespoke treatment for men with BPH.
Analysis of the psychometric properties of the Multiple Sclerosis Impact Scale-29 (MSIS-29) in relapsing–remitting multiple sclerosis using classical and modern test theory
Authors: Bacci ED , Wyrwich KW , Phillips GA , Vollmer T , Guo S
Published: October 2016

Background

Investigations using classical test theory support the psychometric properties of the original version of the Multiple Sclerosis Impact Scale (MSIS-29v1), a disease-specific measure of multiple sclerosis (MS) impact (physical and psychological subscales). Later, assessments of the MSIS-29v1 in an MS community-based sample using Rasch analysis led to revisions of the instrument’s response options (MSIS-29v2).

Objective

The objective of this paper is to evaluate the psychometric properties of the MSIS-29v1 in a clinical trial cohort of relapsing–remitting MS patients (RRMS).

Methods

Data from 600 patients with RRMS enrolled in the SELECT clinical trial were used. Assessments were performed at baseline and at Weeks 12, 24, and 52. In addition to traditional psychometric analyses, Item Response Theory (IRT) and Rasch analysis were used to evaluate the measurement properties of the MSIS-29v1.

Results

Both MSIS-29v1 subscales demonstrated strong reliability, construct validity, and responsiveness. The IRT and Rasch analysis showed overall support for response category threshold ordering, person-item fit, and item fit for both subscales.

Conclusions

Both MSIS-29v1 subscales demonstrated robust measurement properties using classical, IRT, and Rasch techniques. Unlike previous research using a community-based sample, the MSIS-29v1 was found to be psychometrically sound to assess physical and psychological impairments in a clinical trial sample of patients with RRMS.
Haptics to improve task performance in people with disabilities: A review of previous studies and a guide to future research with children with disabilities
Authors: Jafari Nooshin , Adams Kim D , Tavakoli Mahdi
Published: October 2016

This review examines the studies most pertinent to the potential of haptics on the functionality of assistive robots in manipulation tasks for use by children with disabilities. Haptics is the fast-emerging science that studies the sense of touch concerning the interaction of a human and his/her environment; this paper particularly studies the human–machine interaction that happens through a haptic interface to enable touch feedback. Haptics-enabled user interfaces for assistive robots can potentially benefit children whose haptic exploration is impaired due to a disability in their infancy and throughout their childhood. A haptic interface can provide touch feedback and potentially contribute to an enhancement in perception of objects and overall ability to perform manipulation tasks. The intention of this paper is to review the research on the applications of haptics, exclusively focusing on attributes affecting task performance. A review of studies will give a retrospective insight into previous research with various disability populations, and inform potential limitations/challenges in research regarding haptic interfaces for assistive robots for use by children with disabilities.
A novel distractive and mobility-enabling lumbar spinal orthosis
Authors: DiAngelo Denis J , Hillyard Daniel C
Published: October 2016

Purpose

Lumbar spinal orthoses are often used as non-surgical treatment and serve to support the spine and alleviate low back pain. More recently, dynamic orthoses claiming to decompress the spine have been introduced. A previously developed prototype of dynamic mobility orthosis (DMO1) was designed that provided a distractive load across the lumbar spine but required higher sagittal bending moments and was unable to maintain spinal off-loading throughout extended ranges of movement. The objective was to design a new orthosis (DMO2) that reduced bending moment buildup and sustained spinal off-loading throughout daily living ranges of flexion and extension movement.

Methods

A mechanical analog upper torso model and programmable robotic testing platform were used to design features of DMO2: a mobility-enabling component and a distractive force component. Test conditions for DMO2 were 300  N of applied vertical torso load over a range of 25° flexion to 10° extension. Loads carried by the brace were determined throughout flexion and extension ranges. Applied moments to the upper torso model and transferred moments to the spine were measured. The difference in applied and transferred moments represented brace moment effects.

Results

The DMO2 prototype improved spinal off-loading capacity from 172  N to 290  N at end-range flexion and from 247  N to 293  N at end range extension compared to the original DMO1 prototype. End-range applied moments (flexion-DMO1: 32.4 Nm/DMO2: 21.7 Nm; extension-DMO1: 15.0 Nm/DMO2: 10.9 Nm) and brace moments (flexion-DMO1: 18.6 Nm/DMO2: 6.6 Nm; extension-DMO1: 15.0 Nm/DMO2: 4.4 Nm) were also reduced.

Conclusions

A novel dynamic spinal orthosis was designed that maintained spinal off-loading throughout extended ranges of flexion and extension movement without buildup of adverse bending moments.
The American Association of Occupational Health Nurses’ Respiratory Protection Education Program and Resources Webkit for Occupational Health Professionals
Authors: Pompeii Lisa , Byrd Annette , Delclos George L. , Conway Sadie H.
Published: October 2016

Organizations are required to adhere to the Occupational Safety and Health Administration’s (OSHA) Respiratory Protection Standard (29 CFR 1910.134) if they have workers that wear a respirator on the job. They must also have an employee “suitably trained” to administer their program. The National Institute for Occupational Safety and Health and its National Personal Protective Technology Laboratory have worked to champion the occupational health nurse in this role by collaborating with the American Association of Occupational Health Nurses to develop free, online respiratory protection training and resources (RPP Webkit). This article describes the development, content, and success of this training. To date, 724 participants have completed the training, 32.6% of whom lead their organization’s respiratory protection program, 15.3% who indicated they will lead a program in the near future, and 52% who did not lead a program, but indicated that the training was relevant to their work. The majority “strongly agreed” the training was applicable to their work and it enhanced their professional expertise.
‘Persistent Centrism’ and Its Explanations
Authors: Singh Ujjwal Kumar , Roy Anupama
Published: October 2016

Susanne Rudolph and Lloyd Rudolph believed that ‘situated knowledge’ could be realized through area studies, which they argued was consonant with epistemic pluralism and comparative generalization. Their writings reflect a critical relationship with their field as well as the American Political Science academia particularly in the way they envisaged area studies of ‘a different kind’. The Rudolphs proposed that the Indian state and political process could be comprehended through analytical categories ‘adapted’ to capture its particularity. They found ‘a persistent centrism’ to be the most striking feature of Indian politics with the Indian National Congress crucial to the arrival at ‘centrism’. In their later writings, the Rudolphs addressed the contests that emerged in the domain of the state, particularly in the context of the diminished ‘interventionist state’, grappling with contests over political power, the institutional matrix of the state and constitutional design.
A Review of Journal of Indian Law Institute in Legal Education
Authors: Sharma Prakash
Published: October 2016

The aim of this review is to document a range of articles which were published by the esteemed institution established solely for the purpose of legal education (LE) and research—Indian Law Institute (ILI). So far, the experts and scholars have remained pessimistic about the direction of LE in India. The work acknowledges that though there were multiple understandings of various aspects pertaining to LE in India and abroad, the same were not found to be of any relevance. This review addresses how an ideal system of law must draw its postulates and legal justification from science. A particular focus was given on the prestige and the quality of institutions imparting LE. In addition to describing problems, efforts have been made to suggest some initiatives towards making an effective use of various available opportunities. The context of the review only adds to the relevance of this exercise. Apart from the dynamic character of our legal environment and the ambition to benefit from the developments in the technological world, which has contributed to social growth, we have discovered that this environment is more vulnerable than what most people had assumed.
Impact of Unplanned Care Interruption on CD4 Response Early After ART Initiation in a Nigerian Cohort
Authors: Ahonkhai Aimalohi A. , Adeola Juliet , Banigbe Bolanle , Onwuatuelo Ifeyinwa , Adegoke Abdulkabir B. , Bassett Ingrid V. , Losina Elena , Freedberg Kenneth A. , Okonkwo Prosper , Regan Susan
Published: October 2016

The authors conducted a retrospective cohort study of unplanned care interruption (UCI) among adults initiating antiretroviral therapy (ART) from 2009 to 2011 in a Nigerian clinic. The authors used repeated measures regression to model the impact of UCI on CD4 count upon return to care and rate of CD4 change on ART. Among 2496 patients, 83% had 0, 15% had 1, and 2% had ≥2 UCIs. Mean baseline CD4 for those with 0, 1, or ≥2 UCIs was 228/cells/mm3, 355/cells/mm3, and 392/cells/mm3 ( P < .0001), respectively. The UCI was associated with a 62 CD4 cells/mm3 decrease (95% confidence interval [CI]: −78 to −45) at next measurement. In months 1 to 6 on ART, patients with 0 UCI gained 10 cells/µL/mo (95% CI: 7-4). Those with 1 and ≥2 UCIs lost 2 and 5 cells/µL/mo (95% CI: −18 to 13 and −26 to 16). Patients with UCI did not recover from early CD4 losses associated with UCI. Preventing UCI is critical to maximize benefits of ART.
Cultural Fragmentation or Acquired Dispositions? A New Approach to Accounting for Patterns of Cultural Change
Authors: Vaisey Stephen , Lizardo Omar
Published: October 2016

The authors argue that cultural fragmentation models predict that cultural change is driven primarily by period effects, whereas acquired dispositions models predict that cultural change is driven by cohort effects. To ascertain which model is on the right track, the authors develop a novel method to measure “cultural durability,” namely, the share of over-time variance that is due to either period or cohort effects for 164 variables from the 1972–2014 General Social Surveys. The authors find fairly strong levels of cultural durability across most items, especially those connected to values and morality, but less so for attitudes toward legal and political institutions.
“How Far Is Too Far?”
Authors: Parcel Toby L. , Hendrix Joshua A. , Taylor Andrew J.
Published: October 2016

The authors analyze how gender and other individual and family characteristics shape attitudes toward children’s school assignments. Using a mixed-methods approach, the authors analyze preferences for (1) diversity- and (2) neighborhood-based schools and three new dimensions of negative emotional capital: (3) parental challenge from student reassignments, (4) perceived dangers to children from reassignments, and (5) the uncertainty reassignment entails. Quantitative results indicate that emotional capital is highly gendered, with mothers perceiving more challenges, dangers, and uncertainty than fathers. We interpret these findings within the context of the division of household labor and how gendered work arrangements are reproduced at home.
Oral Bacterial Acid–Base Metabolism in Caries Screening: A Proof-Of-Concept Study
Authors: Morou-Bermudez E. , Loza-Herrero M.A. , Garcia-Rivas V. , Suarez-Perez E. , Billings R.J.
Published: October 2016

The objective of this cross-sectional study was to clinically validate an array of biochemical tests as caries screening tools for oral acid–alkali generation. Adult subjects ( n = 185; mean 33.6 ± 10.6 y) were examined clinically for dental caries using the International Caries Detection and Assessment System (ICDAS) criteria. Bitewing radiographs were used to confirm the interproximal surfaces of posterior teeth. For the purposes of this study, subjects were classified as “caries-active” if they had at least one untreated caries lesion with ICDAS 4 or higher. Pooled supragingival plaque and unstimulated saliva samples were collected and assayed for pH changes from sucrose and urea metabolism using colorimetric tests. The validity of each test to discriminate between “caries-inactive” and “caries-active” subjects was assessed and compared with a commercial bacteriological caries-screening test using roc regression and logistic regression models. The areas under the curve (AUCs) (95% CI) of the plaque-urea (PU, 0.59 (0.51 to 0.67)), plaque-urea-glucose (PUG: 0.59 (0.51 to 0.67)) and saliva-urea-glucose (SUG, 0.59 (0.51 to 0.67)) tests did not differ significantly from the bacteriological tests (CRT-mutans, 0.62 (0.54, 0.70); CRT-lactobacillus, 0.63 (0.56 to 0.71) ( P > 0.05), but the plaque-glucose (PG), saliva-glucose (SG), saliva-urea (SU) and saliva-plaque-glucose (SPG) tests had significantly smaller AUCs ( P < 0.05). The AUCs for PU, PUG, SUG, and the CRT-mutans tests were larger in subjects who had no existing dental restorations (PU, 0.90 (0.77 to 1.04); PUG, 0.90 (0.79 to 1.01); SUG, 0.89 (0.69 to 1.08); CRT-mutans, 0.90 (0.73 to 1.08)). The incorporation of the biochemical tests into a multidimensional bacteriological/psychosocial caries screening model significantly increased the diagnostic value (sensitivity and specificity, 160.6; AUC, 0.846). In conclusion, as a proof-of-concept, the results of this study indicate that measuring urea metabolism together with sugar metabolism by dental plaque and saliva may have a promising role in caries screening either independently or as part of a multidimensional biological test.

Knowledge Transfer Statement: The results of this study indicate that assessment of the oral acid/base balance may have a promising role in caries screening either independently, or as part of a multidimensional test.
Sharing housework between husbands and wives: how to improve marital satisfaction for working wives in Japan
Authors: Kobayashi Mayu , Kobayashi Miki , Okumura Tsunao , Usui Emiko
Published: October 2016

This paper examines whether and how the marital satisfaction of Japanese couples is related to the housework the spouse performs. For single-earner couples, both husbands and wives are more satisfied with the other spouse ifthe wifeperforms the greater share of the housework on weekdays. In dual-earner couples, both husbands and wives experience higher spousal satisfaction when theotherspouse performs more housework on weekdays. Japanese dual-earner couples are unable to spend more time on housework, because wives are already performing a significant share of housework on weekdays while husbands are working long hours.

JEL Classification:J12, J22
Naturalisation and on-the-job training: evidence from first-generation immigrants in Germany
Authors: von Haaren-Giebel Friederike , Sandner Malte
Published: October 2016

This paper empirically analyses the effect of naturalisation on on-the-job training (OJT) participation among first-generation immigrants in Germany. OJT is associated with improved labour market outcomes and provides therefore an indicator for labour market integration. Naturalisation is assumed to act as a signal of the employee’s commitment to the host country and may thus increase employers’ likelihood of offering OJT. Testing the theoretical link with multivariate estimations (based on the German Socio-Economic Panel) shows a positive and significant correlation. To reduce selection bias on observables, propensity score matching is applied, yielding a significant average treatment effect.

JEL Classification:J15, J24, M53
Prediagnosis Body Mass Index and Risk of Secondary Primary Cancer in Male Cancer Survivors: A Large Cohort Study
Authors: Park Sang Min , Yun Young Ho , Kim Young Ae , Jo Minkyung , Won Young-Joo , Back Joung Hwan , Lee Eun-Sook
Published: October 2016

Purpose

Male cancer survivors have a higher risk of cancer than the general population, which might be caused by an increased prevalence of obesity or susceptibility to obesity-related carcinogenesis. We assessed the effects of obesity before the diagnosis of a first cancer on the development of secondary primary cancers (SPCs).

Methods

The study population consisted of 239,615 Korean male cancer survivors between January 2003 and December 2010. Incident SPCs were assessed throughout follow-up until December 2011. Cox proportional hazards models were used to calculate the hazard ratios of SPCs associated with prediagnosis body mass index (BMI), which were compared with those of first cancers in all cohort participants.

Results

After 1,614,583 person-years of follow-up, we observed 4,799 patients with SPC. The age-standardized incidence rate of cancer in cancer survivors was 1.1 times higher than that of the general population. We found positive linear trends between prediagnosis BMI and risk of all-combined, colorectal, liver, lymphoma, biliary tract, kidney, and obesity-related SPCs. The magnitude of the BMI-SPC risk association in male cancer survivors was stronger than that for first cancers in the general population, whereas the mean BMI was similar in both groups. In the severely obese category (BMI ≥ 30 kg/m2), the adjusted hazard ratios for SPCs among cancer survivors (1.41; 95% CI, 1.15 to 1.74) were significantly higher than those for first cancers among all cohort participants (1.12; 95% CI, 1.09 to 1.16; Pheterogeneity< .01).

Conclusion

Prediagnosis obesity is a risk factor for overall and individual SPCs, and the strength of the BMI-cancer association is slightly stronger in male cancer survivors than in the general population.
Programmed Death-Ligand 1 Expression and Response to the Anti–Programmed Death 1 Antibody Pembrolizumab in Melanoma
Authors: Daud Adil I. , Wolchok Jedd D. , Robert Caroline , Hwu Wen-Jen , Weber Jeffrey S. , Ribas Antoni , Hodi F. Stephen , Joshua Anthony M. , Kefford Richard , Hersey Peter , Joseph Richard , Gangadhar Tara C. , Dronca Roxana , Patnaik Amita , Zarour Hassane , Roach Charlotte , Toland Grant , Lunceford Jared K. , Li Xiaoyun Nicole , Emancipator Kenneth , Dolled-Filhart Marisa , Kang S. Peter , Ebbinghaus Scot , Hamid Omid
Published: October 2016

Purpose

Expression of programmed death-ligand 1 (PD-L1) is a potential predictive marker for response and outcome after treatment with anti–programmed death 1 (PD-1). This study explored the relationship between anti–PD-1 activity and PD-L1 expression in patients with advanced melanoma who were treated with pembrolizumab in the phase Ib KEYNOTE-001 study (clinical trial information: NCT01295827).

Patients and Methods

Six hundred fifty-five patients received pembrolizumab10 mg/kg once every 2 weeks or once every 3 weeks, or 2 mg/kg once every 3 weeks. Tumor response was assessed every 12 weeks per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 by independent central review. Primary outcome was objective response rate. Secondary outcomes included progression-free survival (PFS) and overall survival (OS). Membranous PD-L1 expression in tumor and tumor-associated immune cells was assessed by a clinical trial immunohistochemistry assay (22C3 antibody) and scored on a unique melanoma (MEL) scale of 0 to 5 by one of three pathologists who were blinded to clinical outcome; a score ≥ 2 (membranous staining in ≥ 1% of cells) was considered positive.

Results

Of 451 patients with evaluable PD-L1 expression, 344 (76%) had PD-L1–positive tumors. Demographic and staging variables were equally distributed among PD-L1–positive and –negative patients. An association between higher MEL score and higher response rate and longer PFS (hazard ratio, 0.76; 95% CI, 0.71 to 0.82) and OS (hazard ratio, 0.76; 95% CI, 0.69 to 0.83) was observed ( P < .001 for each). Objective response rate was 8%, 12%, 22%, 43%, 57%, and 53% for MEL 0, 1, 2, 3, 4, and 5, respectively.

Conclusion

PD-L1 expression in pretreatment tumor biopsy samples was correlated with response rate, PFS, and OS; however, patients with PD-L1–negative tumors may also achieve durable responses.
Prevalence and Risk Factors of Early Endocrine Disorders in Childhood Brain Tumor Survivors: A Nationwide, Multicenter Study
Authors: Clement Sarah C. , Schouten-van Meeteren Antoinette Y.N. , Boot Annemieke M. , Claahsen-van der Grinten Hedy L. , Granzen Bernd , Sen Han K. , Janssens Geert O. , Michiels Erna M. , van Trotsenburg A.S. Paul , Vandertop W. Peter , van Vuurden Dannis G. , Kremer Leontien C.M. , Caron Hubert N. , van Santen Hanneke M.
Published: October 2016

Purpose

To evaluate the prevalence of, and risk factors for, early endocrine disorders in childhood brain tumor survivors (CBTS).

Patients and Methods

This nationwide study cohort consisted of 718 CBTS who were diagnosed between 2002 and 2012, and who survived ≥ 2 years after diagnosis. Patients with craniopharyngeoma or a pituitary gland tumor were excluded. Results of all endocrine investigations, which were performed at diagnosis and during follow-up, were collected from patient charts. Multivariable logistic regression was used to study associations between demographic and tumor- and treatment-related variables and the prevalence of early endocrine disorders.

Results

After a median follow-up of 6.6 years, 178 CBTS (24.8%) were diagnosed with an endocrine disorder. A total of 159 CBTS (22.1%) presented with at least one endocrine disorder within the first 5 years after diagnosis. The most common endocrine disorders were growth hormone deficiency (12.5%), precocious puberty (12.2%), thyroid-stimulating hormone deficiency (9.2%), and thyroidal hypothyroidism (5.8%). The risk of hypothalamic-pituitary dysfunction (n = 138) was associated with radiotherapy (odds ratio [OR], 15.74; 95% CI, 8.72 to 28.42), younger age at diagnosis (OR, 1.09; 95% CI, 1.04 to 1.14), advanced follow-up time (OR, 1.10; 95% CI, 1.02 to 1.18), hydrocephalus at diagnosis (OR, 1.77; 95% CI, 1.09 to 2.88), and suprasellar (OR, 34.18; 95% CI, 14.74 to 79.29) and infratentorial (OR, 2.65; 95% CI, 1.48 to 4.74) tumor site.

Conclusion

The prevalence of early endocrine disorders among CBTS is high. The observation that 22.1% of CBTS developed at least one endocrine disorder within the first 5 years after diagnosis stresses the importance of early and regular assessment of endocrine function in CBTS who are at risk for endocrine damage.
Multidisciplinary Optimization of Oral Chemotherapy Delivery at the University of Wisconsin Carbone Cancer Center
Authors: Mulkerin Daniel L. , Bergsbaken Jason J. , Fischer Jessica A. , Mulkerin Mary J. , Bohler Aaron M. , Mably Mary S.
Published: October 2016

Purpose:

Use of oral chemotherapy is expanding and offers advantages while posing unique safety challenges. ASCO and the Oncology Nursing Society jointly published safety standards for administering chemotherapy that offer a framework for improving oral chemotherapy practice at the University of Wisconsin Carbone Cancer Center.

Methods:

With the goal of improving safety, quality, and uniformity within our oral chemotherapy practice, we conducted a gap analysis comparing our practice against ASCO/Oncology Nursing Society guidelines. Areas for improvement were addressed by multidisciplinary workgroups that focused on education, workflows, and information technology. Recommendations and process changes included defining chemotherapy, standardizing patient and caregiver education, mandating the use of comprehensive electronic order sets, and standardizing documentation for dose modification. Revised processes allow pharmacists to review all orders for oral chemotherapy, and they support monitoring adherence and toxicity by using a library of scripted materials.

Results:

Between August 2015 and January 2016, revised processes were implemented across the University of Wisconsin Carbone Cancer Center clinics. The following are key performance indicators: 92.5% of oral chemotherapy orders (n = 1,216) were initiated within comprehensive electronic order sets (N = 1,315), 89.2% compliance with informed consent was achieved, 14.7% of orders (n = 193) required an average of 4.4 minutes review time by the pharmacist, and 100% compliance with first-cycle monitoring of adherence and toxicity was achieved.

Conclusion:

We closed significant gaps between institutional practice and published standards for our oral chemotherapy practice and experienced steady improvement and sustainable performance in key metrics. We created an electronic definition of oral chemotherapies that allowed us to leverage our electronic health records. We believe our tools are broadly applicable.
Ovarian Sex Cord-Stromal Tumors
Authors: Schultz Kris Ann P. , Harris Anne K. , Schneider Dominik T. , Young Robert H. , Brown Jubilee , Gershenson David M. , Dehner Louis P. , Hill D. Ashley , Messinger Yoav H. , Frazier A. Lindsay
Published: October 2016

Ovarian sex cord-stromal tumors are clinically significant heterogeneous tumors that include several pathologic types. These tumors are often found in adolescents and young adults and can present with hormonal manifestations as well as signs and symptoms of a pelvic mass. Serum tumor markers may assist in preoperative diagnosis and surveillance. Several subtypes are associated with genetic predisposition, including those observed in patients with Peutz-Jegher syndrome. Recent studies have elucidated the relationship between Sertoli-Leydig cell tumors and DICER1 mutations. When classified as International Federation of Gynecology and Obstetrics stage Ia, most subtypes may be treated with surgery alone. Higher stage or recurrent tumors have variable prognoses that range from a usually rapid course in poorly differentiated Sertoli-Leydig cell tumor to an often prolonged course in adult granulosa cell tumors. New understanding of the molecular pathogenesis of these tumors may pave the way for novel therapeutics.