bluuebunny/crossref_metadata_2025 huggingface dataset:
Hired gardens and the question of transgression: lawns, food gardens and the business of ‘alternative’ food practice
Authors: Naylor Lindsay
Published: August 2012

As increased awareness of the industrial-capitalist food system draws consumers into ‘alternative’ food networks, a variety of approaches are being taken to access fresh, local foods. A growing trend within alternative food practice is the increasing number of people who are ripping out their lawns and creating sites of food production in neighborhood spaces. This challenge to the iconic lawn landscape has been viewed by some as both an alternative to the conventional marketplace and an act of transgression against neighborhood norms. This article explores a new strategy that has been used to access food, what I have termed the ‘hired garden’, to examine the contradictory implications of yard food production done for hire. Using the space of the yard as a vehicle for exploring transgression and resistance, this article considers the claim that accessing food through ‘alternative’ means is necessarily transgressive. I argue that such practices are not inherently transgressive or resistant and instead invite scholars to ask critical questions about transgression, resistance and landscapes of power. At the same time, this article suggests that the recent establishment of businesses that can be hired to install, maintain and harvest vegetables from their clients’ yards is a fundamental cultural contradiction, whereby consumers have competing desires to have easy access to fresh, local foods and to produce their own food. Finally, this analytical look at the hired garden addresses: who are the recipients of such services, and who has access to this type of food, drawing on critiques of the ‘alternative food movement,’ which characterize it as a white, middle-class phenomenon.
Referral to Health and Social Services for Intimate Partner Violence in Health Care Settings
Authors: Kirst Maritt , Zhang Yu Janice , Young Aynsley , Marshall Alena , O’Campo Patricia , Ahmad Farah
Published: August 2012

Efficient and coordinated health care responses to intimate partner violence (IPV) are essential, given that health care settings are a major entry point for abused women who seek professional services. However, there is a lack of evidence on how IPV referrals are effectively made within health care settings. In order to help program planners and providers across sectors to address the complex and chronic issue of IPV, a greater understanding of the post-IPV identification referral process is essential. A scoping review of the evidence on IPV referral programs and processes in health care settings was undertaken to provide an overview of the state of evidence and identify pertinent gaps in existing research. The scoping review identified 13 evaluative studies and 6 qualitative, primarily nonevaluative studies that examined IPV referral programs and processes. Evaluative studies involved a variety of designs and IPV referral outcomes. Rich descriptions of barriers and facilitators to seeking referrals by victims and making referrals by health care providers emerged from the evaluative and qualitative studies, but were explored more in depth in the qualitative studies. This scoping review provides guidance on what is currently known about IPV referral programs in health care settings and provides a starting point for further research on effectiveness of referral processes.
An Examination of Measures Related to Children’s Exposure to Violence for Use by Both Practitioners and Researchers
Authors: Acosta Joie , Barnes-Proby Dionne , Harris Racine , Francois Taria , Hickman Laura J. , Jaycox Lisa H. , Schultz Dana
Published: August 2012

Millions of children each year are exposed to violence in their homes, schools, and communities as both witnesses and victims. As a result, evidence-based programs for children and adolescents who have been exposed to traumatic events (CEV-EBPs) have been widely disseminated but rarely evaluated in their real-world applications. One crucial aspect of conducting such evaluations is finding appropriate measures that can be of use both to the practitioner and to the researcher. This review aims to provide guidance to the field by first identifying any gaps in the availability of psychometrically tested measures for certain outcome domains and age ranges and then recommending the measures that are most appropriate for use by both researchers and practitioners. Interviews with content experts in the measurement of trauma symptoms and parent–child relationships were conducted to identify the key outcome domains for measurement that are critical to the evaluation of CEV-EBPs and the criteria for dual-use measures, defined as measures that are useful to both researchers and practitioners. A database of 46 relevant measures was created by compiling measures from existing repositories and conducting a focused literature review. Our review of these measures found that existing repositories had few measures of depression, a major gap that should be addressed. Further, there were few measures for young children ages 0–3 years ( n = 15) and only a handful of measures ( n = 9) had both a child and parent version of the measure. Overall, although the different repositories that currently exist are helpful, researchers and practitioners would benefit from having a single reputable source (e.g., a centralized repository or item bank) to access when searching for measures to use in evaluating CEV-EBPs. Such a tool would hold promising to narrow the current gap between research and practice in the field of children’s exposure to violence.
The Consequences of Maltreatment on Children’s Lives
Authors: Fry Deborah , McCoy Amalee , Swales Diane
Published: August 2012

This study explores the consequences of child maltreatment in East Asia and the Pacific region based on the results of a systematic review of 16 English and non-English databases for journal articles and “gray” literature published between January 2001 and November 2010. This review shows that children in the region experiencing maltreatment are at increased risk of experiencing mental health consequences, physical health sequelae, high-risk sexual behaviors, and increased exposure to future violence including intimate partner violence (IPV) as an adult. Children who suffer from child sexual abuse have a median twofold increased risk of experiencing mental health disorders than those who have never experienced child maltreatment.  Similar findings were found for those who experience physical abuse.  Children who have been maltreated in the region are also at an increased risk of suicide ideation and attempts than those that have experienced child sexual or physical abuse being at a median fourfold increased risk. Children who have experienced physical abuse or those who have witnessed parental domestic abuse as a child are at median twofold increased risk of experiencing IPV as an adult, while children who have been sexually abused have a median threefold increase in risk of IPV later in life. There are still gaps in our understanding of the consequences of child maltreatment, but we do know that the consequences are profound and far-reaching. The findings indicate that there is an urgent need for governments, civil society organizations, development agencies, and academia to advocate for, invest in, and collaborate across sectors for the strengthening of child protection systems in the East Asia and Pacific Region, with a focus on evidence-based child maltreatment prevention policies and programs.
Promoting Successful Collaborations Between Domestic Violence and Substance Abuse Treatment Service Sectors
Authors: Macy Rebecca J. , Goodbourn Melissa
Published: August 2012

Women who experience intimate partner violence (IPV) victimization are more likely to struggle with substance abuse problems than are women who do not experience IPV. Given the connection between IPV victimization and substance abuse, recommended practices urge collaboration between domestic violence service agencies and substance abuse treatment agencies to provide comprehensive services for women with these co-occurring problems. However, domestic violence and substance abuse services have unique histories of development that have led to distinct ways of service delivery. To promote successful collaborations, service providers and researchers are developing strategies to foster relationships across the two service sectors. The authors conducted a review of this emerging body of knowledge with the aim of assembling recommendations for strategies to foster collaboration between domestic violence and substance abuse services. The authors identified 15 documents for review inclusion and our analysis established 5 categories of documents. Findings yield key collaboration strategies and recommended service models. In addition, the review determined the existence of considerable challenges to promoting collaborative relationships between domestic violence and substance abuse treatment service sectors.
Exports and Olympic Games
Authors: Maennig Wolfgang , Richter Felix
Published: August 2012

A recent study finds that Olympic Games host countries experience significant positive, lasting effects on exports. They interpret their results as an indication that countries use the hosting of such events to signal openness and competitiveness. The authors challenge these empirical findings on the grounds that a comparison of structurally different and nonmatching groups of countries might suffer from a selection bias. The authors demonstrate that with an appropriate matching and treatment methodology, the significant Olympic effect disappears.
Beyond Freedom of Movement
Authors: Searle Kristin A. , Kafai Yasmin B.
Published: August 2012

Few studies have examined gender and game play from the perspective of boys' participation. In this article we investigate boys' play in a tween-centric virtual world called Whyville.net, which had 1.5 million registered players at the time of study. Drawing primarily upon logfile data, we developed participation profiles and case studies of three boy players who ranged in engagement from casual to core players. In the case studies of boy players and their everyday activities in Whyville, we found that initial routines were remarkably similar but over time more nuanced differences emerged in players' identity and boundary play. Furthermore, Whyville provided the boys with relatively low consequence opportunities to experiment with different masculine identities. In comparing our findings with other work, we found that while virtual worlds offer space for the expression of boys' culture, they are qualitatively distinct from other gaming environments and thus need to be studied on their own terms.
Marketing Military Realism in Call of Duty 4
Authors: Payne Matthew Thomas
Published: August 2012

This essay investigates the challenges that video game marketing encounters when selling the pleasures of playing virtual war. While marketing paratexts are crucial to video games because of the vagaries of their industry, they are especially important for Call of Duty 4: Modern Warfare, as it is the first of the franchise to be set in the 21st century and immerse players in contemporary theaters of war. These marketing paratexts not only generate hype for the game and work to drive sales, but as importantly, they also suggest particular textual readings over others with the goal of insulating Call of Duty’s virtual war play from interpretations and criticisms that might link the violent play on-screen to the worldly violence unfolding in Iraq and Afghanistan.
Digital Elves as a Racial Other in Video Games
Authors: Poor Nathaniel
Published: August 2012

Elves are a long-standing cultural trope in the West, where they have often represented the other and fears associated with otherness. Elves continue to do the same cultural work today and are a fixture of fantasy settings. Fantasy-based video games portray elves in a variety of ways across a few types of elves (high elves, half-elves, and dark elves), but there are consistencies to their portrayal across such spaces. Given the dearth of work on elves in modern narratives, the cultural work of elves as the other in video games is analyzed here. World of Warcraft (WoW), EverQuest II, The Elder Scrolls series, and the Dragon Age series were studied, with Tolkien and Dungeons & Dragons (D&D) as background. Although WoW is somewhat exceptional in its portrayal of elves, digital elves are mostly portrayed similarly to a historically idealized real-world Western minority.
Radiofrequency ablation for the treatment of radiation proctitis: a case report and review of literature
Authors: Eddi Rodney , DePasquale Joseph R.
Published: August 2012

Radiation proctitis is a frequent complication of pelvic radiation for cancer. This condition can present acutely within several weeks of radiation, or chronically many months or years after radiation, leading to rectal bleeding and transfusion-dependent anemia. Various medical and endoscopic therapies have been described to treat this condition; however, some patients fail to respond to the current standard therapies. Here we present a case of refractory radiation proctitis, with suboptimal response to other therapies, treated successfully with a novel method, radiofrequency ablation.
Dysmegakaryopoiesis of FPD/AML pedigrees with constitutional RUNX1 mutations is linked to myosin II deregulated expression
Authors: Bluteau Dominique , Glembotsky Ana C. , Raimbault Anna , Balayn Nathalie , Gilles Laure , Rameau Philippe , Nurden Paquita , Alessi Marie Christine , Debili Najet , Vainchenker William , Heller Paula G. , Favier Remi , Raslova Hana
Published: August 2012

FPD/AML is a familial platelet disorder characterized by platelet defects, predisposition to acute myelogenous leukemia (AML) and germ-line heterozygous RUNX1 alterations. Here we studied the in vitro megakaryopoiesis of 3 FPD/AML pedigrees. A 60% to 80% decrease in the output of megakaryocytes (MKs) from CD34+ was observed. MK ploidy level was low and mature MKs displayed a major defect in proplatelet formation. To explain these defects, we focused on myosin II expression as RUNX1 has been shown to regulate MYL9 and MYH10 in an inverse way. In FPD/AML MKs, expression of MYL9 and MYH9 was decreased, whereas MYH10 expression was increased and the MYH10 protein was still present in the cytoplasm of mature MKs. Myosin II activity inhibition by blebbistatin rescued the ploidy defect of FPD/AML MKs. Finally, we demonstrate that MYH9 is a direct target of RUNX1 by chromatin immunoprecipitation and luciferase assays and we identified new RUNX1 binding sites in the MYL9 promoter region. Together, these results demonstrate that the defects in megakaryopoiesis observed in FPD/AML are, in part, related to a deregulation of myosin IIA and IIB expression leading to both a defect in ploidization and proplatelet formation.
Targeting oncogenic Ras signaling in hematologic malignancies
Authors: Ward Ashley F. , Braun Benjamin S. , Shannon Kevin M.
Published: August 2012

Ras proteins are critical nodes in cellular signaling that integrate inputs from activated cell surface receptors and other stimuli to modulate cell fate through a complex network of effector pathways. Oncogenic RAS mutations are found in ∼ 25% of human cancers and are highly prevalent in hematopoietic malignancies. Because of their structural and biochemical properties, oncogenic Ras proteins are exceedingly difficult targets for rational drug discovery, and no mechanism-based therapies exist for cancers with RAS mutations. This article reviews the properties of normal and oncogenic Ras proteins, the prevalence and likely pathogenic role of NRAS, KRAS, and NF1 mutations in hematopoietic malignancies, relevant animal models of these cancers, and implications for drug discovery. Because hematologic malignancies are experimentally tractable, they are especially valuable platforms for addressing the fundamental question of how to reverse the adverse biochemical output of oncogenic Ras in cancer.
How we treat oral chronic graft-versus-host disease
Authors: Treister Nathaniel , Duncan Christine , Cutler Corey , Lehmann Leslie
Published: August 2012

Chronic graft-versus-host disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation that is associated with a diminished quality of life. The oral cavity is frequently affected, with a wide variety of signs and symptoms that can result in significant short- and long-term complications ranging from mucosal sensitivity and limited oral intake to secondary malignancy and early death. This article provides a comprehensive approach to the diagnosis and clinical management of patients with oral cGVHD, with particular attention to differential diagnosis, control of symptoms, and prevention of and screening for secondary complications. The clinical considerations and recommendations presented are intended to be practical and relevant for all clinicians involved in the care of patients with oral cGVHD, with the ultimate goal of improving care and outcomes.
JAK2V617F homozygosity arises commonly and recurrently in PV and ET, but PV is characterized by expansion of a dominant homozygous subclone
Authors: Godfrey Anna L. , Chen Edwin , Pagano Francesca , Ortmann Christina A. , Silber Yvonne , Bellosillo Beatriz , Guglielmelli Paola , Harrison Claire N. , Reilly John T. , Stegelmann Frank , Bijou Fontanet , Lippert Eric , McMullin Mary F. , Boiron Jean-Michel , Döhner Konstanze , Vannucchi Alessandro M. , Besses Carlos , Campbell Peter J. , Green Anthony R.
Published: August 2012

Subclones homozygous for JAK2V617F are more common in polycythemia vera (PV) than essential thrombocythemia (ET), but their prevalence and significance remain unclear. The JAK2 mutation status of 6495 BFU-E, grown in low erythropoietin conditions, was determined in 77 patients with PV or ET. Homozygous-mutant colonies were common in patients with JAK2V617F-positive PV and were surprisingly prevalent in JAK2V617F-positive ET and JAK2 exon 12-mutated PV. Using microsatellite PCR to map loss-of-heterozygosity breakpoints within individual colonies, we demonstrate that recurrent acquisition of JAK2V617F homozygosity occurs frequently in both PV and ET. PV was distinguished from ET by expansion of a dominant homozygous subclone, the selective advantage of which is likely to reflect additional genetic or epigenetic lesions. Our results suggest a model in which development of a dominant JAK2V617F-homzygous subclone drives erythrocytosis in many PV patients, with alternative mechanisms operating in those with small or undetectable homozygous-mutant clones.
CaPSID: A bioinformatics platform for computational pathogen sequence identification in human genomes and transcriptomes
Authors: Borozan Ivan , Wilson Shane , Blanchette Paola , Laflamme Philippe , Watt Stuart N , Krzyzanowski Paul M , Sircoulomb Fabrice , Rottapel Robert , Branton Philip E , Ferretti Vincent
Published: August 2012

Background

It is now well established that nearly 20% of human cancers are caused by infectious agents, and the list of human oncogenic pathogens will grow in the future for a variety of cancer types. Whole tumor transcriptome and genome sequencing by next-generation sequencing technologies presents an unparalleled opportunity for pathogen detection and discovery in human tissues but requires development of new genome-wide bioinformatics tools.

Results

Here we present CaPSID (Computational Pathogen Sequence IDentification), a comprehensive bioinformatics platform for identifying, querying and visualizing both exogenous and endogenous pathogen nucleotide sequences in tumor genomes and transcriptomes. CaPSID includes a scalable, high performance database for data storage and a web application that integrates the genome browser JBrowse. CaPSID also provides useful metrics for sequence analysis of pre-aligned BAM files, such as gene and genome coverage, and is optimized to run efficiently on multiprocessor computers with low memory usage.

Conclusions

To demonstrate the usefulness and efficiency of CaPSID, we carried out a comprehensive analysis of both a simulated dataset and transcriptome samples from ovarian cancer. CaPSID correctly identified all of the human and pathogen sequences in the simulated dataset, while in the ovarian dataset CaPSID’s predictions were successfully validated in vitro.
Global changes in gene expression during compatible and incompatible interactions of cowpea (Vigna unguiculata L.) with the root parasitic angiosperm Striga gesnerioides
Authors: Huang Kan , Mellor Karolina E , Paul Shom N , Lawson Mark J , Mackey Aaron J , Timko Michael P
Published: August 2012

Background

Cowpea, Vigna unguiculata L. Walp., is one of the most important food and forage legumes in the semi-arid tropics. While most domesticated forms of cowpea are susceptible to the root parasitic weed Striga gesnerioides, several cultivars have been identified that show race-specific resistance. Cowpea cultivar B301 contains the RSG3-301 gene for resistance to S. gesnerioides race SG3, but is susceptible to race SG4z. When challenged by SG3, roots of cultivar B301 develop a strong resistance response characterized by a hypersensitive reaction and cell death at the site of parasite attachment. In contrast, no visible response occurs in B301 roots parasitized by SG4z.

Results

Gene expression in the roots of the cowpea cultivar B301 during compatible (susceptible) and incompatible (resistant) interactions with S. gesnerioides races SG4z and SG3, respectively, were investigated at the early (6 days post-inoculation (dpi)) and late (13 dpi) stages of the resistance response using a Nimblegen custom design cowpea microarray. A total of 111 genes were differentially expressed in B301 roots at 6 dpi; this number increased to 2102 genes at 13 dpi. At 13 dpi, a total of 1944 genes were differentially expressed during compatible (susceptible) interactions of B301 with SG4z. Genes and pathways involved in signal transduction, programmed cell death and apoptosis, and defense response to biotic and abiotic stress were differentially expressed in the early resistance response; at the later time point, enrichment was primarily for defense-related gene expression, and genes encoding components of lignifications and secondary wall formation. In compatible interactions (B301 – SG4z), multiple defense pathways were repressed, including those involved in lignin biosynthesis and secondary cell wall modifications, while cellular transport processes for nitrogen and sulfur were increased.

Conclusion

Distinct changes in global gene expression profiles occur in host roots following successful and unsuccessful attempted parasitism by Striga. Induction of specific defense related genes and pathways defines components of a unique resistance mechanism. Some genes and pathways up-regulated in the host resistance response to SG3 are repressed in the susceptible interactions, suggesting that the parasite is targeting specific components of the host’s defense. These results add to our understanding of plant-parasite interactions and the evolution of resistance to parasitic weeds.
Deciphering the complex leaf transcriptome of the allotetraploid species Nicotiana tabacum: a phylogenomic perspective
Authors: Bombarely Aureliano , Edwards Kieron D , Sanchez-Tamburrino Juan , Mueller Lukas A
Published: August 2012

Background

Polyploidization is an important mechanism in plant evolution. By analyzing the leaf transcriptomes taken from the allotetraploid Nicotiana tabacum (tobacco) and parental genome donors, N. sylvesteris (S-Genome) and N. tomentosiformis (T-Genome), a phylogenomic approach was taken to map the fate of homeologous gene pairs in this plant.

Results

A comparison between the genes present in the leaf transcriptomes of N. tabacum and modern day representatives of its progenitor species demonstrated that only 33% of assembled transcripts could be distinguished based on their sequences. A large majority of the genes (83.6% of the non parent distinguishable and 87.2% of the phylogenetic topology analyzed clusters) expressed above background level (more than 5 reads) showed similar overall expression levels. Homeologous sequences could be identified for 968 gene clusters, and 90% (6% of all genes) of the set maintained expression of only one of the tobacco homeologs. When both homeologs were expressed, only 15% (0.5% of the total) showed evidence of differential expression, providing limited evidence of subfunctionalization. Comparing the rate of synonymous nucleotide substitution (Ks) and non-synonymous nucleotide substitution (Kn) provided limited evidence for positive selection during the evolution of tobacco since the polyploidization event took place.

Conclusions

Polyploidization is a powerful mechanism for plant speciation that can occur during one generation; however millions of generations may be necessary for duplicate genes to acquire a new function. Analysis of the tobacco leaf transcriptome reveals that polyploidization, even in a young tetraploid such as tobacco, can lead to complex changes in gene expression. Gene loss and gene silencing, or subfunctionalization may explain why both homeologs are not expressed by the associated genes. With Whole Genome Duplication (WGD) events, polyploid genomes usually maintain a high percentage of gene duplicates. The data provided little evidence of preferential maintenance of gene expression from either the T- or S-genome. Additionally there was little evidence of neofunctionalization in Nicotiana tabacum suggesting it occurs at a low frequency in young polyploidy.
Direct cost associated with acquired brain injury in Ontario
Authors: Chen Amy , Bushmeneva Ksenia , Zagorski Brandon , Colantonio Angela , Parsons Daria , Wodchis Walter P
Published: August 2012

Background

Acquired Brain Injury (ABI) from traumatic and non traumatic causes is a leading cause of disability worldwide yet there is limited research summarizing the health system economic burden associated with ABI. The objective of this study was to determine the direct cost of publicly funded health care services from the initial hospitalization to three years post-injury for individuals with traumatic (TBI) and non-traumatic brain injury (nTBI) in Ontario Canada.

Methods

A population-based cohort of patients discharged from acute hospital with an ABI code in any diagnosis position in 2004 through 2007 in Ontario was identified from administrative data. Publicly funded health care utilization was obtained from several Ontario administrative healthcare databases. Patients were stratified according to traumatic and non-traumatic causes of brain injury and whether or not they were discharged to an inpatient rehabilitation center. Health system costs were calculated across a continuum of institutional and community settings for up to three years after initial discharge. The continuum of settings included acute care emergency departments inpatient rehabilitation (IR) complex continuing care home care services and physician visits. All costs were calculated retrospectively assuming the government payer’s perspective.

Results

Direct medical costs in an ABI population are substantial with mean cost in the first year post-injury per TBI and nTBI patient being $32132 and $38018 respectively. Among both TBI and nTBI patients those discharged to IR had significantly higher treatment costs than those not discharged to IR across all institutional and community settings. This tendency remained during the entire three-year follow-up period. Annual medical costs of patients hospitalized with a brain injury in Ontario in the first follow-up year were approximately $120.7 million for TBI and $368.7 million for nTBI. Acute care cost accounted for 46-65% of the total treatment cost in the first year overwhelming all other cost components.

Conclusions

The main finding of this study is that direct medical costs in ABI population are substantial and vary considerably by the injury cause. Although most expenses occur in the first follow-up year ABI patients continue to use variety of medical services in the second and third year with emphasis shifting over time from acute care and inpatient rehabilitation towards homecare physician services and long-term institutional care. More research is needed to capture economic costs for ABI patients not admitted to acute care.
Mental health of asylum seekers: a cross-sectional study of psychiatric disorders
Authors: Heeren Martina , Mueller Julia , Ehlert Ulrike , Schnyder Ulrich , Copiery Nadia , Maier Thomas
Published: August 2012

Background

Asylum procedures are known to be protracted, stretching to over ten years in many host countries. International research shows high levels of distress for asylum seekers. Little is known about actual psychiatric morbidity in this population, especially during the first few years postmigration.

Methods

The mental health status of two groups of asylum seekers was assessed: Group 1 (n = 43) had arrived in Switzerland 2.9 (SD 1.1) months prior to assessment, while Group 2 (n = 43) had arrived 15.5 (SD 3.2) months prior to assessment. Psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Symptom severity of posttraumatic stress disorder (Posttraumatic Diagnostic Scale), anxiety (Hopkins Symptom Checklist), depression (Hopkins Symptom Checklist), and pain (Verbal Rating Scale) were assessed using self-report questionnaires. Postmigratory factors such as German language proficiency and social contacts were also assessed. Interviews were conducted with the assistance of trained interpreters.

Results

Four out of ten participants met diagnostic criteria for at least one DSM-IV disorder. Groups did not differ with respect to psychiatric morbidity or symptom levels. Major depression (31.4%) and PTSD (23.3%) were diagnosed most frequently. The number of experienced traumatic event types was highly correlated with psychiatric morbidity.

Conclusions

Psychiatric morbidity in asylum seekers in the first two years after arrival is high, with no indication of a decrease in mental distress over time. Traumatic experiences seem to play a major role in morbidity during this time. Considering the magnitude of clinically relevant distress, a short psychological screening upon arrival with a focus on traumatic experiences may be warranted.
Study protocol for the 10 Top Tips (10TT) Trial: Randomised controlled trial of habit-based advice for weight control in general practice
Authors: Beeken Rebecca J , Croker Helen , Morris Stephen , Leurent Baptiste , Omar Rumana , Nazareth Irwin , Wardle Jane
Published: August 2012

Background

Primary care is the first port of call for advice about weight control. There is hence a need for simple, effective interventions that can be delivered without specialist skills. We have developed such an intervention; the 10 Top Tips (10TT). This intervention was effective with respect to weight loss in a volunteer population, but has yet to be tested in primary care. The aim of this trial is therefore to test the effectiveness of the 10TT intervention in primary care, incorporating clinical outcomes and health economic analyses.

Methods/Design

The trial is a two-arm, individually-randomised, controlled trial in obese (BMI ≥ 30) adults (n = 520) in primary care, comparing weight loss in patients receiving the 10TT intervention with weight loss in a control group of patients receiving usual care. The intervention is based on habit formation theory, using written materials to take people through a set of simple weight control behaviours with strategies to make them habitual; an approach that could make it more successful than others in establishing long-term behaviour change. Patients will be recruited from 14 General Practices across England. Randomisation will be through telephoning a central randomisation service using a computer-generated list of random numbers. Patients are followed up at 3, 6, 12, 18 and 24 months. The primary outcome is weight loss at 3 months, with assessment by a health professional who is blind to group allocation. Other follow-ups will be un-blinded. We will examine whether weight loss is maintained up to 24 months. We will also assess changes in the automaticity of the 10TT target behaviours and improvement in clinical markers for potential co-morbidities. Finally, we will undertake a full economic evaluation to establish cost-effectiveness in the NHS context.

Discussion

If proven to be effective when delivered through primary care, 10TT could make a highly cost-effective contribution to improvements in population health.

Trial Registration

ISRCTN16347068
Belief system, meaningfulness, and psychopathology associated with suicidality among Chinese college students: a cross-sectional survey
Authors: Zhao Jiubo , Yang Xueling , Xiao Rong , Zhang Xiaoyuan , Aguilera Diane , Zhao Jingbo
Published: August 2012

Background

Research suggests that Chinese religious believers are more likely to commit suicide than those identifying as non-religious among rural young adults, contrary to findings in Western countries. However, one cannot conclude that religiosity is associated with elevated suicide risk without examining the effect of political and religious beliefs in a generally atheist country like China where political belief plays a dominant role in the belief system of young adults. The present study investigated the effects of political and religious belief on suicidality with meaningfulness and psychopathology as potential mediators in a large representative sample of Chinese college students.

Methods

A cross-sectional survey was conducted among 1390 first-year college students randomly sampled from 10 colleges and universities in mainland China.

Results

A total of 1168 respondents (84.0%) provided complete data on all variables. Lifetime prevalence of suicidal ideation, plan, and attempt were 45.1%, 6.8%, and 1.9% respectively, with one-year suicidal ideation showing at 19.3%. Female gender was associated with elevated risk of suicidality. Political belief but not religious belief was associated with decreased suicide risk. A significant interactive effect of political belief and religious belief was found, indicating that for political believers, being religious was associated with decreased suicide risk; for non-political believers, being religious was associated with increased suicide risk. Multi-group structural equation modeling showed that meaningfulness completely mediated and psychopathology partially mediated the effect of belief system on suicidality. Gender differences were found in pathways of political belief by religious beliefs to suicidality and political belief to psychopathology. The coefficients were significant for males but not for females.

Conclusions

In less religious societies, political belief may serve as a means of integration as does religious affiliation in religious societies. Males were more likely to benefit from the protective effect of a belief system on suicidality than females.
Side chain modified peptide nucleic acids (PNA) for knock-down of six3in medaka embryos
Authors: Dorn Sebastian , Aghaallaei Narges , Jung Gerlinde , Bajoghli Baubak , Werner Birgit , Bock Holger , Lindhorst Thomas , Czerny Thomas
Published: August 2012

Background

Synthetic antisense molecules have an enormous potential for therapeutic applications in humans. The major aim of such strategies is to specifically interfere with gene function, thus modulating cellular pathways according to the therapeutic demands. Among the molecules which can block mRNA function in a sequence specific manner are peptide nucleic acids (PNA). They are highly stable and efficiently and selectively interact with RNA. However, some properties of non-modified aminoethyl glycine PNAs (aegPNA) hamper theirin vivoapplications.

Results

We generated new backbone modifications of PNAs, which exhibit more hydrophilic properties. When we examined the activity and specificity of these novel phosphonic ester PNAs (pePNA) molecules in medaka (Oryzias latipes) embryos, high solubility and selective binding to mRNA was observed. In particular, mixing of the novel components with aegPNA components resulted in mixed PNAs with superior properties. Injection of mixed PNAs directed against the medakasix3gene, which is important for eye and brain development, resulted in specificsix3phenotypes.

Conclusions

PNAs are well established as powerful antisense molecules. Modification of the backbone with phosphonic ester side chains further improves their properties and allows the efficient knock down of a single gene in fish embryos.
Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review
Authors: Wu Helen W , Davis Paul K , Bell Douglas S
Published: August 2012

Background

Greater use of computerized decision support (DS) systems could address continuing safety and quality problems in healthcare, but the healthcare field has struggled to implement DS technology. This study surveys DS experience across multiple non-healthcare disciplines for new insights that are generalizable to healthcare provider decisions. In particular, it sought design principles and lessons learned from the other disciplines that could inform efforts to accelerate the adoption of clinical decision support (CDS).

Methods

Our systematic review drew broadly from non-healthcare databases in the basic sciences, social sciences, humanities, engineering, business, and defense: PsychINFO, BusinessSource Premier, Social Sciences Abstracts, Web of Science, and Defense Technical Information Center. Because our interest was in DS that could apply to clinical decisions, we selected articles that (1) provided a review, overview, discussion of lessons learned, or an evaluation of design or implementation aspects of DS within a non-healthcare discipline and (2) involved an element of human judgment at the individual level, as opposed to decisions that can be fully automated or that are made at the organizational level.

Results

Clinical decisions share some similarities with decisions made by military commanders, business managers, and other leaders: they involve assessing new situations and choosing courses of action with major consequences, under time pressure, and with incomplete information. We identified seven high-level DS system design features from the non-healthcare literature that could be applied to CDS: providing broad, system-level perspectives; customizing interfaces to specific users and roles; making the DS reasoning transparent; presenting data effectively; generating multiple scenarios covering disparate outcomes (e.g., effective; effective with side effects; ineffective); allowing for contingent adaptations; and facilitating collaboration. The article provides examples of each feature. The DS literature also emphasizes the importance of organizational culture and training in implementation success. The literature contrasts “rational-analytic” vs. “naturalistic-intuitive” decision-making styles, but the best approach is often a balanced approach that combines both styles. It is also important for DS systems to enable exploration of multiple assumptions, and incorporation of new information in response to changing circumstances.

Conclusions

Complex, high-level decision-making has common features across disciplines as seemingly disparate as defense, business, and healthcare. National efforts to advance the health information technology agenda through broader CDS adoption could benefit by applying the DS principles identified in this review.
Primaquine radical cure of Plasmodium vivax: a critical review of the literature
Authors: John George K , Douglas Nicholas M , von Seidlein Lorenz , Nosten Francois , Baird J Kevin , White Nicholas J , Price Ric N
Published: August 2012

Background

Primaquine has been the only widely available hypnozoitocidal anti-malarial drug for half a century. Despite this its clinical efficacy is poorly characterized resulting in a lack of consensus over the optimal regimen for the radical cure of Plasmodium vivax.

Methods

Published studies since 1950 of the use of primaquine regimens for preventing P. vivax relapse were reviewed. Data were extracted systematically from available papers. Primaquine regimens were categorized according to the total dose administered: very low (≤2.5 mg/kg), low (>2.5 mg/kg- < 5.0 mg/kg) and high (≥ 5.0 mg/kg). The risk of recurrent infection were summarized across geographical regions and the odds ratios between treatment regimens calculated after stratifying by total treatment dose and duration of study follow up.

Results

Data could be retrieved from 87 clinical trials presenting data in 59,735 patients enrolled into 156 treatment arms, conducted in 20 countries. There was marked heterogeneity in study design, particularly primaquine dosing and duration of follow up. The median rate of recurrence following very low dose of primaquine (n = 44) was 25% (range 0-90%) at 4–6 months, compared to 6.7 % (range 0-59%) following low dose primaquine (n = 82). High dose primaquine regimens were assessed in 28 treatment arms, and were associated with a median recurrence rate of 0% (Range: 0-15%) at one month. In 18 studies with control arms, the effectiveness of a very low dose primaquine regimen was no different from patients who did not receive primaquine (OR = 0.60, 95%CI 0.33-1.09, p = 0.09), whereas for the low dose regimens a significant difference was reported in 50% (6/12) of studies (overall OR = 0.14, 95%CI: 0.06-0.35, p < 0.001). Two studies enrolling 171 patients demonstrated high effectiveness of high dose primaquine compared to a control arm (OR = 0.03 (95%CI: 0.01-0.13); p < 0.0001).

Conclusions

Low dose regimens retain adequate efficacy in some areas, but this is not uniform. The efficacy and safety of pragmatic high dose primaquine regimens needs to be assessed in a range of endemic and geographical locations. Such studies will require a prolonged period of follow up and comparison with control arms to account for confounding factors.
The tumor suppressive role of miRNA-370 by targeting FoxM1 in acute myeloid leukemia
Authors: Zhang Xiaolu , Zeng Jiping , Zhou Minran , Li Bingnan , Zhang Yuanyuan , Huang Tao , Wang Lixiang , Jia Jihui , Chen Chunyan
Published: August 2012

Background

Recent evidence has accumulated that MicroRNA (miRNA) dysregulation occurs in the majority of human malignancies including acute myeloid leukemia (AML) and may contribute to onco-/leukemo-genesis.

Methods

The expression levels of miR-370 and FoxM1 were assessed in 48 newly diagnosed AML patients, 40 AML patients in 1stcomplete remission (CR) and 21 healthy controls. Quantitative real-time PCR, western blots, colony formation assay, and β-Galactosidase ( SA-β-Gal) staining were used to characterize the changes induced by overexpression or inhibition of miR-370 or FoxM1.

Results

We found that the down-regulation of miR-370 expression was a frequent event in both leukemia cell lines and primary leukemic cells from patients with de novo AML. Lower levels of miR-370 expression were found in 37 of 48 leukemic samples from AML patients compared to those in bone marrow cells derived from healthy adult individuals. Ectopic expression of miR-370 in HL60 and K562 cells led to cell growth arrest and senescence. In contrast, depletion of miR-370 expression using RNA interference enhanced the proliferation of those leukemic cells. Mechanistically, miR-370 targets the transcription factor FoxM1, a well established oncogenic factor promoting cell cycle progression. Moreover, when HL60 and K562 cells were treated with 5-aza-2′-deoxycytidine, a DNA methylation inhibitor, miR-370 expression was up-regulated, which indicates epigenetic silencing of miR-370 in leukemic cells.

Conclusions

Taken together, miR-370 may function as a tumor suppressor by targeting FoxM1, and the epigenetic silence of miR-370 thus leads to derepression of FoxM1 expression and consequently contributes to AML development and progression.
A modified regimen of extracorporeal cardiac shock wave therapy for treatment of coronary artery disease
Authors: Wang Yu , Guo Tao , Ma Tie-kun , Cai Hong-yan , Tao Si-ming , Peng Yun-zhu , Yang Ping , Chen Ming-qing , Gu Yun
Published: August 2012

Background

Cardiac shock wave therapy (CSWT) improves cardiac function in patients with severe coronary artery disease (CAD). We aimed to evaluate the clinical outcomes of a new CSWT treatment regimen.

Methods

The 55 patients with severe CAD were randomly divided into 3 treatment groups. The control group (n = 14) received only medical therapy. In group A ( n = 20), CSWT was performed 3 times within 3 months. In group B ( n = 21), patients underwent 3 CSWT sessions/week, and 9 treatment sessions were completed within 1 month. Primary outcome measurement was 6-minute walk test (6MWT). Other measurements were also evaluated.

Results

The 6MWT, CCS grading of angina, dosage of nitroglycerin, NYHA classification, and SAQ scores were improved in group A and B compared to control group.

Conclusions

A CSWT protocol with 1 month treatment duration showed similar therapeutic efficacy compared to a protocol of 3 months duration.

Clinical trial registry

We have registered on ClinicalTrials.gov, the protocol ID is CSWT IN CHINA.
Cutaneous squamous cell carcinoma metastatic to parotid - analysis of prognostic factors and treatment outcome
Authors: Goh Robin Yeong Hong , Bova Ron , Fogarty Gerald B
Published: August 2012

Background

Cutaneous squamous cell carcinoma (cSCC) comprises 20% of all skin cancer of the head and neck. A minority will metastasize to regional parotid lymph nodes. This study evaluates the St Vincent’s Hospital, Sydney experience between 1996 and 2006.

Methods

A retrospective review was performed of patients who were evaluated in our multidisciplinary head and neck clinic with metastatic cSCC to parotid, and all treatment and pathologic details were reviewed. Statistical analysis, including univariate and multivariate analyses, were performed using Cox proportional hazards regression mode, overall and disease-specific survival were estimated by the Kaplan-Meier method.

Results

Sixty-seven patients were identified. Some 90 % were male, and with a mean age of 72.8 years. One died on the first postoperative day. The remaining 66 patients received radiotherapy. For these 66 patients, the two-year and five-year overall survival rate was 0.83 and 0.72, respectively. The two-year and five-year disease-free survival rate was 0.91 and 0.83 respectively. Overall survival was only significantly correlated to the extent of parotidectomy (superficial versus total; P = 0.0256). Margin status was available in 59 patients. The only parameter that significantly correlated with disease-free survival was margin status (close/negative versus positive P = 0.0348). Other parameters of immune suppression, perineural invasion, extra capsular extension, degree of tumour differentiation, number of positive nodes, extent of neck dissection and radiotherapy dosage delivered did not confer prognostic significance.

Conclusions

This study confirmed the association of adverse prognostic implication of positive margins on disease-free survival. Immune compromise was not a significant factor in this small group. Further studies are warranted in this population.