bluuebunny/crossref_metadata_2025 huggingface dataset:
What do people appreciate in physicians' communication? An international study with focus groups using videotaped medical consultations
Authors: Mazzi Maria A. , Rimondini Michela , Deveugele Myriam , Zimmermann Christa , Moretti Francesca , van Vliet Liesbeth , Deledda Giuseppe , Fletcher Ian , Bensing Jozien
Published: June 2013

Background

The literature shows that the quality of communication is usually determined from a professional perspective. Patients or lay people are seldom involved in the development of quality indicators or communication.

Objective

To give voice to the lay people perspective on what constitutes ‘good communication’ by evoking their reactions to variations in physician communication.

Design

Lay people from four different countries watched the same videotaped standardized medical encounters and discussed their preferences in gender‐specific focus groups who were balanced in age groups.

Setting and participants

Two hundred and fifty‐nine lay people (64 NL, 72 IT, 75 UK and 48 BE) distributed over 35 focus groups of 6–8 persons each.

Main variables studied

Comments on doctors' behaviours were classified by the GULiVer framework in terms of contents and preferences.

Results

Participants prevalently discussed ‘task‐oriented expressions’ (39%: competency, self‐confident, providing solutions), ‘affective oriented/emotional expressions' (25%: empathy, listening, reassuring) and ‘process‐oriented expressions' (23%: flexibility, summarizing, verifying). ‘Showing an affective attitude’ was most appreciated (positive percentage within category: 93%, particularly facilitations and inviting attitude), followed by ‘providing solution’ (85%). Among disfavoured behaviour, repetitions (88%), ‘writing and reading’ (54%) and asking permission (42%) were found.

Conclusions

Although an affective attitude is appreciated by nearly everybody, people may vary widely in their communication needs and preferences: what is ‘good communication’ for one person may be disliked or even a source of irritation for another. A physician should be flexible and capable of adapting the consultation to the different needs of different patients. This challenges the idea of general communication guidelines.
Influence of Maternal Social Communication on Ticklishness in Infants: A Comparison With Being Stroked
Authors: Ikeda Ayaka , Itakura Shoji
Published: June 2013

The tickle sensation is considered to arise from physiological and social factors. Previous research reports that although infants laugh in response to tactile stimulation in first 6 months of life, they cease laughing to this stimulation as they grow. Because older children often appear to laugh in response to tickling, the current study focused on relationships between infants’ response to tickling and social factors as they grow. Specifically, we examined effects of different maternal social interactions on infants’ reactions to tickling vs. stroking tactile stimulations. Results showed that a tickle stimulus, together with maternal communications, elicits positive reactions in infants. In contrast, a noncommunicative mother and stroking tends to elicit from the child a neutral response, whereas the combination of a noncommunicative mother with tickling evokes negative reactions in infants. These findings suggest that maternal social communication affects infants’ reactions to touch. In addition, the combination of tactile and social stimulations elicits laughter in infants over 6 months of age.
Factors Related to Thickness of Melanoma
Authors: KOPF ALFRED W. , RIGEL DARRELL , BART ROBERT S. , MINTZIS MEDWIN M. , HENNESSEY PATRICK , HARRIS MATTHEW N. , RAGAZ ANNA , TRAU HENRI , FRIEDMAN ROBERT J. , ESRIG BRUCE
Published: June 2013

Computer analyses to identify correlations between thickness of primary superficial spreading malignant melanoma and eighteen variables previously reported to be related to prognosis were performed on a series of malignant melanomas.

The variables that showed statistically significant (≤0.05) direct relationships to thickness were level (Clark), elevation of lesion, age of patient, least and greatest diameters of lesion, history of bleeding, ulceration, clinical and histologic stage, anatomic location, pedunculation, and satellitosis. The variables that did not correlate with thickness were clinical diagnosis of regional lymphadenopathy, in‐transit metastasis, duration of lesion, sex, history of a previous malignant melanoma, and history of a pre‐existing lesion at the site of the development of melanoma.

Multiple regression analysis of the factors that showed statistically significant correlation with thickness of the primary lesion revealed a subset of six dominant variables that were most predictive of thickness, namely, level, elevation, largest diameter of lesion, ulceration, histologic stage, and age of the patient.
Excision of a Malignant Lesion from the Forehead and Reconstruction by Bilateral Rotation Skin‐Muscle Flaps
Authors: PAGANI WILLY A. , CAPOZZI OLIVIA
Published: June 2013

Bilateral rotation skin‐muscle flaps were utilized for repair of a round defect resulting from excision of an invasive squamous‐cell carcinoma from the forehead. Functional and cosmetic results were found to be excellent from such a procedure.
The Use of Staples in Dermatologic Surgery
Authors: CAMPBELL JANIS P. , SWANSON NEIL A.
Published: June 2013

Staples are an excellent form of wound closure for certain types of cutaneous surgery, namely, scalp reductions, application of split‐thickness grafts, axillary vault resections, and truncal excisions. Various staplers currently in use, their advantages and disadvantages, are reviewed in the context of these aforementioned procedures.
Management of Lesions of the Helical Rim Using a Chondrocutaneous Advancement Flap
Authors: CAVANAUGH EDWARD B.
Published: June 2013

This report describes and illustrates a method, believed heretofore unreported, for the surgical management of defects of the helical rim. There have been no complications or recurrence of tumors in 18 patients treated by this method, and cosmetic results are satisfactory.
The Surgical Management of “In Situ” Melanoma
Authors: ALPER JOSEPH C. , BOGAARS HENDRICK , SOBER ARTHUR J. , SCHOENFELD EUGENE
Published: June 2013

The concept of melanoma “in situ” is discussed pointing out that these lesions have the potential to become invasive tumors if not adequately treated. If such a pathologic diagnosis is made, each margin of the specimen should be carefully checked for the presence of atypical melanocytes. In our experience, with excision margins of 0.5–1 cm, local recurrence has not been a problem.
A Reappraisal of Melanoma In Situ
Authors: WEEDON DAVID
Published: June 2013

Sixty‐six cases of melanoma in situ were randomly selected from the files at the Royal Brisbane Hospital, Australia, and multiple deeper sections were cut from the paraffin blocks. An invasive component (Level II) was found in eight cases, with a thickness ranging from 0.19 to 0.45 mm. No recurrences or metastases have developed after at least five years. Focal areas of regression were present in the initial sections in all but one of these eight cases.
Surgical Treatment of Two Squamous‐Cell Carcinomas in the Same Lip: Case Report
Authors: MARTINS ORLANDO , AMARO JOÃO A.
Published: June 2013

We report one patient who developed two squamous‐cell carcinomas on different parts of the lower lip. The tumors were excised by the UV technique, a variation of the V‐shaped excision. We repaired the defect caused by excision of the first lesion by direct closure and that caused by extirpation of the second lesion by use of a transposition flap (Abbe‐Estlander technique).
Skin Metastases from Small‐Cell Carcinoma of the Lung
Authors: FOX JOSHUA L. , BERMAN BRIAN , PRIOLEAU PHILIP G.
Published: June 2013

Abstract. This paper reports the first case of skin metastases from small‐cell carcinoma of the lung with electron microscopic confirmation. The 2 to 3‐cm cutaneous lesions present on the chest and limbs were hard, nontender, smooth‐surfaced, freely moveable nodules with normal appearing overlying skin. Characteristic dense‐core granules 1562 123 Å (SEM) in diameter were detected by electron microscopy.

The detection by electron microscopy of dense‐core granules may assist in confirming the diagnosis of small‐cell carcinoma in cutaneous lesions with equivocal histologic findings.
Microcystic Adnexal Carcinoma Treated by Microscopically Controlled Excision
Authors: FLEISCHMANN HEIDI E. , ROTH ROBERT J. , WOOD COLIN , NICKOLOFF BRIAN J.
Published: June 2013

Abstract
Microcystic adnexal carcinoma is a distinct clinicopathologic entity with combined pilar and eccrine differentiation. Clinically it resembles other adnexal neoplasms, but it tends to be deeply invasive and locally aggressive. A 47‐year‐old man with microcystic adnexal carcinoma of the left cheek with deep dermal and subcutaneous invasion was successfully treated by microscopically controlled excision. The possible etiologic association with teenage radiation therapy is discussed.
Glucagonoma Syndrome: Case Report and Literature Review
Authors: PARKER COLLEEN M. , HANKE C. WILLIAM , MADURA JAMES A. , LISS EMANUEL C.
Published: June 2013

Abstract
The glucagonoma syndrome is characterized by dermatitis, glucose intolerance, hypoaminoacidemia, and hyperglucagonemia secondary to an α‐cell tumor of the pancreas. Other clinical features include anemia, glossitis, and weight loss. A 62‐year‐old woman with the syndrome sought medical attention for a chronic dermatitis. A skin biopsy was suggestive of necrolytic migratory erythema. A glucagonoma was surgically removed from the tail of the pancreas. Review of the literature indicates that 56 proven and 33 probable cases of glucagonoma syndrome have been reported.
Cutaneous Candidosis as a Complication of Facial Dermabrasion
Authors: SIEGLE RONALD J. , CHIARAMONTI ALEXANDER , KNOX DAVID W. , POLLACK SHELDON V.
Published: June 2013

Abstract
Cutaneous candidosis is a common skin condition. Facial candidosis is rare. Described herein are three cases of facial candidosis complicating dermabrasion, a previously undescribed condition. Why this may occur, why it is uncommon, and its differential diagnosis and therapy are discussed. The side effects and complications of dermabrasion in general are presented.
Management of Dermatitis Due to Surgical Gloves
Authors: FISHER ALEXANDER A.
Published: June 2013

Chronic hand dermatitis in surgeons may be produced or made worse by the use of certain rubber gloves. The allergens in rubber gloves are usually mercaptobenzothiazole or tetramethylthiuram. The Elastyren Glove, which is free of such rubber chemicals, is usually well tolerated by surgeons with hand dermatitis due to rubber.
How to Avoid the Principal Complication of Scalp Reduction in the Management of Extensive Alopecia
Authors: FRECHET PATRICK
Published: June 2013

Instead of risking the esthetic complication sometimes observed with the development of a vertical alopecic strip crossing the posterior aspect of the scalp, another method can be used to replace this. A small, round alopecic area similar to a small developing bald spot is created and eventually grafted later.
Use of Computed Tomography in the Preoperative Evaluation of Patients with Head and Neck Tumors
Authors: SCHMIDT JOHN J. , GRANDE DONALD J. , BANKOFF MARK S.
Published: June 2013

Abstract. Computed tomography (CT) is a sensitive, noninvasive radiographic technique which can produce detailed cross‐sectional images of any anatomic region. The amount and accuracy of the information it provides far exceeds that produced by conventional radiographic techniques. The chemosurgeon can find CT scanning invaluable in his preoperative evaluation of patients with large, invasive head and neck tumors of cutaneous origin.
Nobecutane Spray as a Temporary Dressing of Skin Graft Donor Sites
Authors: BRODOVSKY SH. , DAGAN R. , BEN‐BASSATT M.
Published: June 2013

Abstract. Various methods have been used for managing split‐thickness skin graft donor sites. Open and closed techniques have been suggested by various authors with the purpose of achieving smooth and rapid healing of the wound. There is growing evidence to suggest that the site and quality of the healing is improved when the wound is protected from dehydration and further mechanical trauma. A recent method is the spraying of Nobecutane Spray on the donor site. Nobecutane sprayed on a wound forms a plastic film which serves as a dressing material. It contains specially modified acrylic resin in an organic solvent (ethyl acetate) and TMTD (tetramethylthiuram disulphide) which is strongly bactericidal and fungicidal.1 We employed this method on 50 patients and found it to be effective in achieving rapid and painless healing. The dressing is transparent, permits easy follow‐up of healing in the donor site, protects the wound against infection, and does not inconvenience the patient. The treatment is simple, economical, and does not require special skills. The dressing peels off spontaneously after epidermal regeneration of the wound is completed. No complications or allergic reaction were observed with this treatment.
Technical Aids for Dermabrasion
Authors: ALT THOMAS H.
Published: June 2013

Abstract. Since the introduction in the 1940s of an effective method for facial dermabrasion using the wire brush, there have been many ancillary procedures developed. Preoperative aids include scar elevation and punch grafting of deep scars prior to dermabrasion. Retinoic acid can prime the skin for more rapid healing. Gas sterilization of electrical equipment eliminates cross‐contamination between patients. Intraoperative improvements include regional block anesthesia of the face, staged narcotic administration and newer methods of facial prechilling, and criteria for the ambient air in the operatory. Gentian Violet staining of the face and use of microfoam tape to delineate the mandibular boundary of a dermabrasion are helpful. The use of a custom handle for the spray refrigerant, the safety of Turkish towels used for retraction, and the application of a sharp Buck's curette make the procedure simpler and more effective. Postoperative aids include the use of systemic steroids and the new biological dressings which simplify the postoperative recovery period.
Management of multicellular senescence and oxidative stress
Authors: Haines David D. , Juhasz Bela , Tosaki Arpad
Published: June 2013

Progressively sophisticated understanding of cellular and molecular processes that contribute to age‐related physical deterioration is being gained from ongoing research into cancer, chronic inflammatory syndromes and other serious disorders that increase with age. Particularly valuable insight has resulted from characterization of how senescent cells affect the tissues in which they form in ways that decrease an organism's overall viability. Increasingly, the underlying pathophysiology of ageing is recognized as a consequence of oxidative damage. This leads to hyperactivity of cell growth pathways, prominently including mTOR (mammalian target of rapamycin), that contribute to a build‐up in cells of toxic aggregates such as progerin (a mutant nuclear cytoskeletal protein), lipofuscin and other cellular debris, triggering formation of senescent cellular phenotypes, which interact destructively with surrounding tissue. Indeed, senescent cell ablation dramatically inhibits physical deterioration in progeroid (age‐accelerated) mice. This review explores ways in which oxidative stress creates ageing‐associated cellular damage and triggers induction of the cell death/survival programs’ apoptosis, necrosis, autophagy and ‘necroapoptophagy’. The concept of ‘necroapoptophagy’ is presented here as a strategy for varying tissue oxidative stress intensity in ways that induce differential activation of death versus survival programs, resulting in enhanced and sustained representation of healthy functional cells. These strategies are discussed in the context of specialized mesenchymal stromal cells with the potential to synergize with telocytes in stabilizing engrafted progenitor cells, thereby extending periods of healthy life. Information and concepts are summarized in a hypothetical approach to suppressing whole‐organism senescence, with methods drawn from emerging understandings of ageing, gained from Cnidarians (jellyfish, corals and anemones) that undergo a unique form of cellular regeneration, potentially conferring open‐ended lifespans.
Gravity loading induces adenosine triphosphate release and phosphorylation of extracellular signal‐regulated kinases in human periodontal ligament cells
Authors: Ito Mai , Arakawa Toshiya , Okayama Miki , Shitara Akiko , Mizoguchi Itaru , Takuma Taishin
Published: June 2013

Aim

The periodontal ligament (PDL) receives mechanical stress (MS) from dental occlusion or orthodontic tooth movement. Mechanical stress is thought to be a trigger for remodeling of the PDL and alveolar bone, although its signaling mechanism is still unclear. So we investigated the effect of MS on adenosine triphosphate (ATP) release and extracellular signal‐regulated kinases (ERK) phosphorylation in PDL cells.

Methods

Mechanical stress was applied to human PDL cells as centrifugation‐mediated gravity loading. Apyrase, Ca2+‐free medium and purinergic receptor agonists and antagonists were utilized to analyze the contribution of purinergic receptors to ERK phosphorylation.

Results

Gravity loading and ATP increased ERK phosphorylation by 5 and 2.5 times, respectively. Gravity loading induced ATP release from PDL cells by tenfold. Apyrase and suramin diminished ERK phosphorylation induced by both gravity loading and ATP. Under Ca2+‐free conditions the phosphorylation by gravity loading was partially decreased, whereas ATP‐induced phosphorylation was unaffected. Receptors P2Y4 and P2Y6 were prominently expressed in the PDL cells.

Conclusion

Gravity loading induced ATP release and ERK phosphorylation in PDL fibroblasts, and ATP signaling via P2Y receptors was partially involved in this phosphorylation, which in turn would enhance gene expression for the remodeling of PDL tissue during orthodontic tooth movement.
Person‐centred reviews as a mechanism for planning the post‐school transition of young people with intellectual disability
Authors: Kaehne A. , Beyer S.
Published: June 2013

Background

Person‐centred planning has played a key role in the transformation of intellectual disabilities services for more than a decade. The literature has identified clear advantages for service users when service delivery is planned around the individual rather than the user is made to fit into service structures. Researchers however have pointed out that there is a lack of evidence that person‐centred planning positively influences outcomes for users.

Method

Our study examined the application of person‐centred planning during transition for young people with intellectual disabilities. We investigated the nature and content of 44 person‐centred reviews of transition planning for this population in a local authority in the UK. We carried out a documentary analysis of all person‐centred plans and conducted telephone interviews with all families participating in the programme. We focused on the issue of attendance at review meetings and what was discussed during the meetings.

Results

Analysis of the data shows an increase in the participation of young people and carers at review meetings and a significant shift in topics discussed during the transition planning process compared with previous programmes. However, some of these effects may dissipate once young people are actually leaving school as planning well is not synonymous with having an improved range of placement options.

Conclusions

The findings suggest that person‐centred planning can impact positively on some aspects of transition planning, while it may be too optimistic to expect radical improvement in other area. Key to further improvements is to complement person‐centred planning with consistent involvement of all relevant stakeholders in planning for individuals.
Causes and Consequences of Age‐Related Steroid Hormone Changes: Insights Gained from Nonhuman Primates
Authors: Sorwell K. G. , Urbanski H. F.
Published: June 2013

Similar to humans, rhesus macaques (Macaca mulatta) are large, long‐lived diurnal primates, and show similar age‐related changes in the secretion of many steroid hormones, including oestradiol, testosterone, cortisol and dehydroepiandrosterone (DHEA). Consequently, they represent a pragmatic animal model in which to examine the mechanisms by which these steroidal changes contribute to perturbed sleep–wake cycles and cognitive decline in the elderly. Using remote serial blood sampling, we have found the circulating levels of DHEA sulphate, as well as oestradiol and testosterone, decline markedly in old monkeys. Furthermore, using the real‐time polymerase chain reaction, we have shown that the genes for the enzymes associated with the conversion of DHEA to oestradiol and testosterone (3β‐hydroxysteroid dehydrogenase, 17β‐hydroxysteroid dehydrogenase, and aromatase) are highly expressed in brain areas associated with cognition and behaviour, including the hippocampus, prefrontal cortex and amygdala. Taken together, these findings suggest that the administration of supplementary DHEA in the elderly may have therapeutic potential for cognitive and behavioural disorders, although with fewer negative side effects outside of the central nervous system. To test this, we have developed a novel steroid supplementation paradigm for use in old animals; this involves the oral administration of DHEA and testosterone at physiologically relevant times of the day to mimic the circadian hormone patterns observed in young adults. We are currently evaluating the efficacy of this steroid supplementation paradigm with respect to reversing age‐associated disorders, including perturbed sleep–wake cycles and cognitive decline, as well as an impaired immune response.
The Implication of Neuroactive Steroids in Tourette's Syndrome Pathogenesis: A Role for 5α‐Reductase?
Authors: Bortolato M. , Frau R. , Godar S. C. , Mosher L. J. , Paba S. , Marrosu F. , Devoto P.
Published: June 2013

Tourette's syndrome (TS) is a neurodevelopmental disorder characterised by recurring motor and phonic tics. The pathogenesis ofTSis considered to reflect dysregulations in the signalling of dopamine (DA) and other neurotransmitters, which lead to excitation/inhibition imbalances in cortico‐striato‐thalamocortical circuits. The causes of these deficits may reflect complex gene × environment × sex (G × E × S) interactions; indeed, the disorder is markedly predominant in males, with a male‐to‐female prevalence ratio of approximately 4 : 1. Converging lines of evidence point to neuroactive steroids as being likely molecular candidates to account for G × E × S interactions inTS. Building on these premises, our group has begun examining the possibility that alterations in the steroid biosynthetic process may be directly implicated inTSpathophysiology; in particular, our research has focused on 5α‐reductase (5αR), the enzyme catalysing the key rate‐limiting step in the synthesis of pregnane and androstane neurosteroids. In clinical and preclinical studies, we found that 5αR inhibitors exerted marked anti‐DAergic and tic‐suppressing properties, suggesting a central role for this enzyme inTSpathogenesis. Based on these data, we hypothesise that enhancements in 5αR activity in early developmental stages may lead to an inappropriate activation of the ‘backdoor’ pathway for androgen synthesis from adrenarche until the end of puberty. We predict that the ensuing imbalances in steroid homeostasis may impair the signalling ofDAand other neurotransmitters, ultimately resulting in the facilitation of tics and other behavioural abnormalities inTS.
Advocacy of home telehealth care among consumers with chronic conditions
Authors: Lu Ju‐Fen , Chi Mei‐Ju , Chen Ching‐Min
Published: June 2013

Aims and objectives

To describe use of home telehealth care as an alternative for chronic disease management from users' perspective.

Background

As the population ages, telehealth is increasingly being used to tackle problems related to the fast growing ageing population. Home telehealth care therefore poses challenges and offers opportunities for patients and healthcare providers.

Design

A qualitative approach was adopted with a purposeful sample of 20 patients residing in Taiwan.

Method

Patients who had received the service for three months and were willing to share their experiences were recruited. Data were collected by face‐to‐face interviews with semi‐structured interview guideline (n = 8) and a focus group discussion (n = 12) in 2010. A qualitative content analysis was used.

Results

Four key themes were identified: perceived support and security, enhanced disease self‐management, concerned with using the devices and worries about the cost by patients. Most users favoured using the service to control their chronic conditions because of its convenience and accessibility, and their condition could be measured daily to enhance their sense of security. Users could determine and understand changes in their condition and improve medical regimen compliance, and they were empowered to revise their lifestyles for better disease self‐management. However, users were concerned about the utility of the service, because they were unfamiliar with the operating procedures and doubted its quality. As the service is still in stage of pilot testing, users worried about possible cost and reimbursement policy changes in the future.

Conclusion

Most users perceived telehealth care was a convenient and useful model for healthcare‐delivery. It increased the availability of health care and improved the self‐care ability of patients.

Relevance to clinical practice

To advocate for home telehealth care, nurses must play an active role in providing consumers with proper training and support for any problems when adopting the system to foster patients' willingness to use this service.
Clinical Outcomes Following Percutaneous Coronary Intervention With Drug‐Eluting Stents Versus Bare Metal Stents in Patients on Chronic Hemodialysis
Authors: MELIGA EMANUELE , DE BENEDICTIS MAURO , GAGNOR ANDREA , CONROTTO FEDERICO , NOVARA MARCO , SCROCCA INNOCENZO , VARBELLA FERDINANDO , MARRA SEBASTIANO , CONTE MARIA ROSA
Published: June 2013

Background

Patients on chronic hemodialysis (HD) are recognized as a high‐risk group for adverse events after percutaneous coronary intervention, and whether drug‐eluting stents (DES) are associated with improved outcomes over bare metal stents (BMS) is still uncertain. The purpose of this study was to assess the efficacy of DES compared with BMS at short‐ and long‐term follow‐up (FU) in an unselected sample of HD patients.

Methods and Results

In the time period 2005–2010, consecutive patients on chronic HD treated with percutaneous coronary intervention (PCI) and stent implantation were retrospectively selected and analyzed. A total of 169 patients were selected, 77 treated exclusively with BMS and 92 exclusively with DES. Baseline clinical characteristics were similar in the 2 groups as well as the number of treated vessels, treated lesions, and the stent per patient ratio. At longest available FU, no difference between the 2 study groups was found in terms of cardiac death (18.2% vs 16.3%, P = 0.83), myocardial infarction (2.5% vs 8.6%, P = 0.09), cerebrovascular accidents (0% vs 1.1%, P = 0.98), and target vessel revascularization (TVR) (9.1% vs 16.3%, P = 0.17). Major adverse cardiac and cerebrovascular events‐free survival at 1,500 days in the BMS and DES groups was 57.6% and 50.9% (P = 0.11), respectively.

Conclusions

PCI in patients on chronic HD treatment is associated with a high incidence of adverse events at FU, mainly represented by death. In our study, the use of DES was not associated with a reduction of target lesion revascularization (TLR) and TVR.
Long‐term stimulation of areca nut components results in increased chemoresistance through elevated autophagic activity
Authors: Yen Ching‐Yu , Chiang Wei‐Fan , Liu Shyun‐Yeu , Cheng Pse‐Chou , Lee Sheng‐Yang , Hong Wen‐Zhai , Lin Pin‐Yen , Lin Mei‐Huei , Liu Young‐Chau
Published: June 2013

Background

We previously demonstrated the autophagy‐inducing activity in the crude extract of areca nut (ANE) and its 30–100 kDa fraction (ANE 30–100 K). This study aimed to analyze whether chronic ANE and ANE 30–100 K stimulations lead to higher stress resistance and autophagic activity in oral cells, and whether the resulting autophagic status in stimulated cells correlates with stress resistance.

Materials and Methods

Malignant cells from the mouth oral epidermoid carcinoma Meng‐1 (OECM‐1) and blood (Jurkat T) origins were stimulated with non‐cytotoxic ANE and ANE 30–100 K for 3 months. Sensitivity to anticancer drugs of and autophagy status in stimulated cells, analyzed respectively by XTT assay and calculating microtubule‐associated protein 1 light chain 3‐II LC3‐II/β‐actin ratios from Western blot, were compared to non‐treated cells. Autophagy inhibitors, 3‐methyladenine (3‐MA) and chloroquine (CQ), were used to assess whether autophagy inhibition interferes the altered chemoresistance.

Results

Areca nut extract‐stimulated (ANE‐s) and ANE 30–100 K‐stimulated (30–100 K‐s) OECM‐1 and Jurkat T cells generally exhibited higher cisplatin and 5‐fluorouracil (5‐FU) resistances, compared to non‐stimulated cells. Most stimulated cells expressed significantly higher levels of LC3‐II and Atg4B proteins. Interestingly, these cells also showed stronger tolerances against hypoxia environment and expressed higher LC3‐II levels under glucose‐deprived and hypoxia conditions. Finally, both 3‐MA and CQ alleviated, albeit to different degrees, the increased chemoresistance in ANE‐s and/or 30–100 K‐s cells.

Conclusions

Chronic stimulations of ANE or ANE 30–100 K may increase tolerance of oral cancer and leukemia T cells to anticancer drugs, as well as to glucose deprivation and hypoxia conditions, and cause an elevation of autophagy activity responsible for increased drug resistance.
Examining Primacy as an Identifier of Salience
Authors: Demorest Amy , Gleckel Jareb
Published: June 2013

This article examines whether the first things people report in narrative accounts represent themes of particular importance to them. In two studies, college students recounted autobiographical memories in an interview setting (Study 1:N = 56;Mage = 19.4; 29 male, 27 female; 48.2%Caucasian, 17.9%Asian, 14.3%AfricanAmerican, 10.7%Hispanic/Latino; Study 2:N = 40;Mage = 18.7; 27 female, 13 male; 57.5%Caucasian, 15%Asian, 12.5%Hispanic/Latino, 7.5%AfricanAmerican). Participants reported happy and sad memories (Study 1) or memories of any emotional type (Study 2), and narrative themes were identified from these memories using standard categories of emotion‐eliciting events. Study 2 included a follow‐up task one month later in which participants rated the importance of these themes. The themes from the first memories recurred in subsequent memories significantly more often than would be expected by chance, and this recurrence was not a function of the order of memories, the participant's gender, or the type of theme. Furthermore, the themes from the first memories were rated as significantly more important than other themes in the follow‐up task. These findings provide strong empirical evidence that primacy identifies important material in the context of narrative analysis.
Evaluation of child and parent outcomes after a pediatric cardiac camp experience
Authors: Bultas Margaret W. , Budhathoki Chakra , Balakas Karen
Published: June 2013

Purpose

This study evaluated the effects of a cardiac camp experience on children with heart disease and their parents.

Design and Methods

A repeated measures design was used with 49 parent–child dyads. Repeated measures evaluated the effects of camp on anxiety, attitude toward illness, and psychosocial functioning of the children. Parental anxiety was also evaluated.

Results

Results demonstrated decreases in parent anxiety, decreases in child trait anxiety, and positive psychosocial outcomes in the areas of self‐esteem, social, physical, and emotional functioning.

Practice Implications

Findings can be used to support decisions for those contemplating a camping experience for the child with heart disease.
Factors associated with the intention to recommend human papillomavirus vaccination among Korean school health teachers
Authors: Choi Keum Bong , Mo Hyun Suk , Kim Jin Sun
Published: June 2013

Purpose

The purposes were to examine Korean school health teachers' knowledge and attitudes toward human papillomavirus (HPV) and HPV vaccination, identify factors associated with their intention to recommend the HPV vaccine, and characterize school health teachers' communication with students or parents regarding the HPV vaccine.

Design and Methods

The online survey involved 119 school health teachers in Korea.

Results

Factors associated with an intention to recommend the HPV vaccine were perceived benefits, desiring more education regarding HPV and the HPV vaccine, and age of school health teachers.

Practice Implications

Findings suggest a need for more education to promote a greater understanding of HPV and HPV vaccination among Korean school health teachers.
Validation of a clinically useful measure of children's state anxiety before medical procedures
Authors: Ersig Anne L. , Kleiber Charmaine , McCarthy Ann Marie , Hanrahan Kirsten
Published: June 2013

Purpose

Assessment of children's anxiety in busy clinic settings is an important step in developing tailored interventions. This article describes the construct validation of the Children's Anxiety Meter‐State (CAM‐S), a brief measure of state anxiety.

Design and Methods

Existing data were used to investigate the associations between child self‐reports of anxiety, parent reports of child anxiety, and observed child distress during an intravenous procedure.

Results

Children's (n = 421) CAM‐S scores were significantly associated with all parent measures and observed distress ratings.

Practice Implications

Findings support the use of the CAM‐S for assessment of child anxiety in clinical settings.
Inosine triphosphatase deficiency helps predict anaemia, anaemia management and response in chronic hepatitis C therapy
Authors: Clark P. J. , Aghemo A. , Degasperi E. , Galmozzi E. , Urban T. J. , Vock D. M. , Patel K. , Thompson A. J. , Rumi M. G. , D'Ambrosio R. , Muir A. J. , Colombo M.
Published: June 2013

Anaemia frequently complicates peginterferon/ribavirin therapy for chronic hepatitis C infection. Better prediction of anaemia, ribavirin dose reduction or erythropoietin (EPO) need, may enhance patient management. Inosine triphosphatase (ITPA) genetic variants are associated with ribavirin‐induced anaemia and dose reduction; however, their impact in real‐life clinic patient cohorts remains to be defined. We studied 193 clinic patients with chronic hepatitis C infection of mixed viral genotype (genotype 1/4 n = 123, genotype 2/3, n = 70) treated with peginterferon/ribavirin. Patients were genotyped for ITPA polymorphisms rs1127354 and rs7270101 using Taqman primers. Hardy–Weinberg equilibrium was present. Estimated ITPA deficiency was graded on severity (0–3, no deficiency/mild/moderate/severe, n = 126/40/24/3, respectively). Multivariable models tested the association with anaemia at 4 weeks of treatment [including decline in haemoglobin (g/dL); haemoglobin <10 g/dL and haemoglobin decline >3 g/dL]; ribavirin dose reduction and EPO use and explored sustained viral response (SVR) to peginterferon/ribavirin. More severe ITPA deficiency was associated with less reduction in haemoglobin level (P < 0.001; R2 = 0.34), less ribavirin dose reduction (OR 0.42; (95% CI = 0.23–0.77); P = 0.005) and less EPO use [OR 0.53; (0.30–0.94); P = 0.029]. ITPA deficiency was associated with SVR [OR: 1.70; (1.02–2.83); P = 0.041] independently of clinical covariates (adjusted R2 = 0.31). In this clinical cohort, ITPA deficiency helped predict the risk of on‐treatment anaemia, ribavirin dose reduction, need for EPO support and was associated with SVR. For patients on HCV regimens including peginterferon/ribavirin, testing for ITPA deficiency may have clinical utility.
Sexual reproduction of Hippospongia communis (Lamarck, 1814) (Dictyoceratida, Demospongiae): comparison of two populations living under contrasting environmental conditions
Authors: Zarrouk Souad , Ereskovsky Alexander V. , Mustapha Karim Ben , Abed Amor El , Pérez Thierry
Published: June 2013

The study of the reproductive processes of benthic invertebrates is essential to the understanding of their population dynamics and is also important in formulating conservation plans, especially for exploited species. The sexual reproduction of Hippospongia communis, the ‘honeycomb’ bath sponge, was studied at two locations in the Mediterranean Sea: the Kerkennah Islands (Tunisia, South Mediterranean), where the mean annual seawater temperature is 19 °C, and Marseille (France, Northwestern Mediterranean Sea), where the mean annual water temperature is 16 °C. The aim of this comparative study was to determine whether different environmental conditions could affect reproduction patterns. At both locations, H. communis was found to contain sexual reproductive elements year‐round. Oogenesis and embryogenesis occurred throughout the year, whereas spermatogenesis occurred during shorter periods between October and November, in both populations. While gametogenesis seemed to be synchronized, indicating that fertilization could occur at the same time at both locations, spawning was observed in late summer in Marseille, whereas it started in late spring for the Kerkennah population. Larval development of H. communis seems to take longer for sponges living at cooler locations such as Marseille. Reproductive effort calculated for both sexes showed significantly higher values for specimens from Kerkennah Islands. By comparing sexual reproductive patterns of populations living in two contrasted environments, we suggest that a change of thermal regime can affect H. communis phenology.
Can alteration experiments on impact melts from El'gygytgyn and volcanic glasses shed new light on the formation of the Martian surface?
Authors: Hellevang Helge , Dypvik Henning , Kalleson Elin , Pittarello Lidia , Koeberl Christian
Published: June 2013

This investigation involved three specimens: an altered felsic sample of impactite from the ICDP El'gygytgyn drill core D1c, and two reference volcanics from Iceland, namely a rhyolitic glass and a basaltic glass. The goal of this work was to better understand the alteration of impact melt and volcanic glass, and to apply the results to an investigation of alteration processes below the surface of Mars. Hydrothermal batch alteration experiments with the El'gygytgyn sample showed formation of various silica phases such as cristobalite, opal, and quartz. According to geochemical modeling, zeolites were also expected, but zeolite minerals already present in the impactite prior to the experiment may have masked possible experimental zeolite growth. Basaltic glass was altered to smectite, talc, and opal. The accompanying numerical modeling gave results that were similar or comparable to the laboratory experiments. Rhyolitic glass was kinetically more stable than basaltic glass, and showed only minor formation of calcite and feldspar during the 3‐week experiment. The study showed that closed‐system isochemical alteration of both siliceous and mafic glasses and melts results in the formation of smectites and zeolites. Therefore, to link alteration features on Mars to specific physical conditions, the exact identity of the mineral phases present in surface rocks must be known. Moreover, our simulations on closed‐system isochemical alteration showed that the fraction of zeolites and silica formed relative to smectite depends on the source mineral altered. Therefore, fractions of these mineral groups present in the Martian soil may be used to better predict source rock characteristics.
Petrography, geochemistry, and Hf‐Nd isotope evolution of drill core samples and target rocks from the El'gygytgyn impact crater, NE Chukotka, Arctic Russia
Authors: Pittarello Lidia , Schulz Toni , Koeberl Christian , Hoffmann J. Elis , Münker Carsten
Published: June 2013

El'gygytgyn in northeast Chukotka (Russia) is a 3.6 Ma, 18‐km‐diameter impact structure. The impact crater was recently drilled in the framework of a project sponsored by the International Continental Scientific Drilling Program (ICDP). Target rocks at the El'gygytgyn area are dominated by the felsic members of the Late Cretaceous Okhotsk‐Chukotka Volcanic Belt (OCVB). Such a target lithology is unique among terrestrial impact craters, thereby providing the opportunity to study shock metamorphism in siliceous volcanic rocks. Here, we present a petrographic, geochemical, and isotopic study of the section of the drill core underneath the lacustrine sediments, extending from ∼316 m to 517 m below the lake bottom (blb). The drill core stratigraphy includes ∼80 m of suevite and a cross section through a volcanic suite, which consists of (1) a middle section (∼390–423 mblb) with dominant felsic tuffs and a few mafic members, and (2) a welded rhyolitic‐dacitic ignimbrite (∼423–517 mblb). The melt fragments embedded in the suevite are interpreted as being impact‐related by comparison with impact glasses from the crater and in opposition to the target rock, which does not include similar melts. A suevitic dyke crosscuts the lower section of the core at the depth 471.40 mblb. Evidence for shock metamorphism is concentrated in the upper 10 m of the drill core and almost limited to the suevitic breccia. The geochemical and isotope (Nd and Hf) composition of samples from the target and the drill core reveals relationships to the “Berlozhya magmatic assemblage” (BMA) arguing for similar source magmas. The primitive upper mantle (PUM)‐normalized trace element plot of rocks investigated here confirms a subduction‐related signature, as previously proposed for rocks from both OCVB and BMA.
Using grounded theory methodology to conceptualize the mother–infant communication dynamic: Potential application to compliance with infant feeding recommendations
Authors: Waller Jennifer , Bower Katherine M. , Spence Marsha , Kavanagh Katherine F.
Published: June 2013

Excessive, rapid weight gain in early infancy has been linked to risk of later overweight and obesity. Inappropriate infant feeding practices associated with this rapid weight gain are currently of great interest. Understanding the origin of these practices may increase the effectiveness of interventions. Low‐income populations in the Southeastern United States are at increased risk for development of inappropriate infant feeding practices, secondary to the relatively low rates of breastfeeding reported from this region. The objective was to use grounded theory methodology (GTM) to explore interactions between mothers and infants that may influence development of feeding practices, and to do so among low‐income, primiparous, Southeastern United States mothers. Analysis of 15 in‐depth phone interviews resulted in development of a theoretical model in which Mother–Infant Communication Dynamic emerged as the central concept. The central concept suggests a communication pattern developed over the first year of life, based on a positive feedback loop, which is harmonious and results in the maternal perception of mother and infant now speaking the same language. Importantly, though harmonious, this dynamic may result from inaccurate maternal interpretation of infant cues and behaviours, subsequently leading to inappropriate infant feeding practices. Future research should test this theoretical model using direct observation of mother–infant communication, to increase the understanding of maternal interpretation of infant cues. Subsequently, interventions targeting accurate maternal interpretation of and response to infant cues, and impact on rate of infant weight gain could be tested. If effective, health care providers could potentially use these concepts to attenuate excess rapid infant weight gain.
A rat model for orthodontic translational expansive tooth movement
Authors: Danz J. C. , Dalstra M. , Bosshardt D. D. , Katsaros C. , Stavropoulos A.
Published: June 2013

Structured Abstract

Objectives

To present the development of an experimental model in rats for translational expansive tooth movement.

Setting and Sample

Section of Periodontology at Department of Dentistry Aarhus University. Twenty male Wistar rats in two pilot experimental settings plus seven animals without any intervention serving as controls.

Material and Methods

The second molar (group P1) or the second and third molar (group P2) in the maxillae of the animals were moved buccally using transpalatal β‐titanium springs. In the group P2, two spring types (high force and low force) and two preangulations (0° passive or 30° torsion moment) were tested. The amount and type of tooth movement achieved and the resulting skeletal effect were assessed on microCT images, histological analysis was performed on few selected specimens.

Results

Expansive translational root movement amounting half a tooth width was achieved. Comparison of the amount of tooth movement at the right and left side of the maxilla showed that the expansion was rather symmetrical in the P2 group. Skeletal widening of the maxilla contributed in the P2 group to approximately one‐third of the total root movement, whereas two‐thirds were dental movement.

Conclusion

With the model used in the P2 group, further research on translational expansive tooth movement and its effect on the periodontium can be pursued. In models for orthodontic expansion, it is strongly recommended to separately evaluate skeletal and dental effects.
Clinical significance of aberrant vimentin expression in oral premalignant lesions and carcinomas
Authors: Sawant SS , Vaidya MM , Chaukar DA , Alam H , Dmello C , Gangadaran P , Kannan S , Kane S , Dange PP , Dey N , Ranganathan K , D'Cruz AK
Published: June 2013

Objective

To investigate the clinical significance of vimentin expression at early and late events of tobacco/areca nut–associated oral tumorigenesis.

Materials and Methods

Immunohistochemistry (IHC) was carried out on paraffin‐embedded tissues of oral mucosa normal (n = 10), inflammatory lesions (n = 19), leukoplakia (n = 52), submucous fibrosis (n = 71) and tumours/cut margins (n = 227 each), using anti‐vimentin antibody, and the expression profile was correlated with patients' clinical parameters. Immunofluorescence, Western blot and RT‐PCR analysis were also carried out wherever adequate and fresh tissues were available.

Results

Aberrant vimentin expression was seen in hyperplastic, dysplastic and fibrotic tissues, which showed statistically significant correlation with the histopathological grade of dysplasia (P = 0.001) and fibrosis (P = 0.009). Vimentin expression also showed statistically significant correlation with tumour size (P = 0.048), clinical stage (P = 0.013), regional lymph node metastases (P = 0.001), local recurrence (P = 0.001) and survival (P = 0.021) of patients with oral squamous cell carcinoma (OSCC). Its expression in invasive fronts statistically correlated with development of nodal metastasis and local recurrence.

Conclusions

Our results suggest possible role of vimentin in early events of tobacco/areca nut–associated oral tumorigenesis, which may prove useful to predict the malignant potential of high‐risk oral lesions. Further, association between vimentin expression in invasive fronts and aggressive phenotype of tumours may help clinicians to choose the appropriate treatment modality for OSCC management.