bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of vehicle security devices and their role in the crime drop
Authors: Farrell Graham , Tseloni Andromachi , Tilley Nick
Published: March 2011

Car theft in the UK fell two-thirds from the mid-1990s as part of more widespread crime drops, and has been attributed to improved vehicle security. This study develops a Security Impact Assessment Tool (SIAT) to gauge the contribution of individual security devices and their combination. The metric of impact derived is termed the Security Protection Factor (SPF). Cars with central locking plus an electronic immobilizer, and often an alarm, are found to be ‘SPF 25’, that is, they were up to 25 times less likely to be stolen than those without security. That impact is greater than expected from the individual contributions of those devices, and is attributed to interaction effects. Tracking devices are found to be particularly effective but rarer. Protective effects were greater against theft of cars than against theft from cars or attempts, almost certainly reflecting the difficulty imposed on thieves by electronic immobilizers. It is suggested that this type of analysis could be usefully extended to other crime types and security combinations. The analysis also lends support to a ‘security hypothesis’ component of an explanation for the major national and international crime drops that is based in the criminologies of everyday life.
Maintenance therapy in advanced non-small cell lung cancer: evolution, tolerability and outcomes
Authors: Coate Linda E. , Shepherd Frances A.
Published: March 2011

Non-small cell lung cancer (NSCLC) is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage disease, survival rates for advanced disease remain low. Maintenance therapy is a treatment strategy that has been investigated extensively in NSCLC and has been the subject of considerable recent debate. Options for maintenance include continuing the initial combination chemotherapy regimen, continuing only single agent chemotherapy (‘continuation maintenance’) or introducing a new agent (‘switch’ maintenance therapy). Therapies that have been studied in this setting in randomized trials to date include chemotherapy, molecularly targeted agents and immunotherapy approaches. Following the development of multiple new agents that show activity in NSCLC, and have a tolerable side-effect profile, there has been increasing interest in utilizing them to maintain response to initial therapy after treatment with platinum-based doublets. Despite considerable controversy, it has become an acceptable treatment paradigm. Here, we briefly outline the evolution of this treatment paradigm and examine which subgroups of patients are most likely to benefit.
Thromboembolic Prophylaxis in Foot and Ankle Surgery What Should We Do?
Authors: Hardy Mark A.
Published: March 2011

The majority of orthopaedic venous thromboembolism (VTE) literature involves major orthopaedic surgery, which has distinct differences in comparison with foot and ankle surgery. Despite the current evidence-based medicine advocating against routine prophylaxis, confusion remains around who should be prophylaxed and with what modality. Clearly, larger prospective studies are needed to determine those individuals who require prophylaxis for the prevention of venous thromboembolic events following foot and ankle surgery.
Impact of Terrorism on Hospitality Stocks and the Role of Investor Sentiment
Authors: Chang Charles , Ying Ying Zeng
Published: March 2011

This study examines a comprehensive data set of all terrorist activities that directly affected Americans between 1973 and 2003, exploring the reaction of hospitality stocks to these events. Hospitality stocks’ returns following terrorist events are well in excess of those experienced by the rest of the stock market, beating the market by 10 to 15 percent per annum. These results persist despite controls for the type of event, number of casualties, location of the event, changes in market risk, and resulting impacts on room demand and average daily rates. The most severe one hundred events, after an initial negative reaction, are followed by returns nearly four times larger than those of the average event. Findings are consistent with sentiment playing a substantial role in hospitality stock returns.
Factors Encouraging Innovation in Spanish Hospitality Firms
Authors: López-Fernández Maria Concepción , Serrano-Bedia Ana Maria , Gómez-López Raquel
Published: March 2011

An analysis of data from 443 Spanish hospitality firms highlighted four factors that encourage innovation. This original analytic model considered the joint effect on innovation of both internal and external factors but did not find that external factors—including government assistance programs—had a significant effect on hospitality innovation. The results confirmed a significant and positive relationship between hospitality innovation and four internal factors, namely, large firm size, membership in a business group (that is, a franchise, management contract, or membership association), willingness to change, and a sufficiently strong bureaucratic framework to manage and institutionalize any innovations.
Inaccuracy of the “Naïve Table Mix” Calculations
Authors: Thompson Gary M.
Published: March 2011

This article extends the analysis of table mixes for restaurants, on the principle that table mix helps drive revenue. The article presents the results of a simulation experiment of more than forty-six thousand restaurant contexts to evaluate the accuracy of “naïve table mix” calculations. An earlier study presented a simple method of calculating a recommended mix of tables in a restaurant, and another found that those calculations provided table mixes yielding within about 1 percent of the revenue provided by the optimal table mix. While the earlier simulation studies assumed that the space required by a table was directly proportional to the number of seats it contained, that is not always the case. Thus, this article presents space-oriented versions of the existing naïve table mix methods. The article also presents the results of a test of two other forms of the naïve table mix calculations, which include party revenue (or contribution). The simplest of the naïve table mix models proved to be the best, on balance. It yielded table mixes that generated more than 98 percent of the revenue achievable by near-optimal table mixes. As a caveat, however, in more than 5 percent of the simulated scenarios, the best naïve table mix model yielded less than 95 percent of the revenue achievable by a near-optimal table mix. These findings suggest that the naïve table mix calculations be used with caution.
Effect of Patterned Electrical Neuromuscular Stimulation on Vertical Jump in Collegiate Athletes
Authors: Gulick Dawn T. , Castel John C. , Palermo Francis X. , Draper David O.
Published: March 2011

Background:

Patterned electrical neuromuscular stimulation (PENS) uses the electrical stimulation of sensory and motor nerves to achieve a skeletal muscle contraction using an electromyogram-derived functional pattern. PENS is used extensively for neuromuscular reeducation and treatment of muscle disuse atrophy.

Purpose:

To explore the effectiveness of PENS as applied to the quadriceps muscles on the vertical jump of an athletic population.

Study Design:

Experimental with control and repeated measures over time.

Methods:

Healthy college athletes (54 women, 75 men) were divided into 3 groups (control, n = 30; jump, n = 33; and jump with PENS, n = 63). There was no difference among groups’ height and weight. Athletes performed a baseline standing vertical jump using a vertical jump system. The control group continued its normal daily activities with no jumping tasks included. The jump groups performed 3 sets of 12 repetitions with a 2-minute rest between sets at a frequency of 3 times per week. The PENS group did the jumping with the coordination of an electrical stimulation system. Vertical jump was retested after 6 weeks of intervention and 2 weeks after cessation.

Results:

A 3-way repeated measures analysis of variance for time (control, jump alone, jump with PENS) revealed a significant difference ( P < 0.05) for time and an interaction between time and treatment, as well as a significant difference for the PENS group from baseline to posttest and for the jump group from posttest to follow-up jump. There was no significant difference between groups for the baseline vertical jump.

Conclusions:

This study demonstrated that 6 weeks of vertical jump training coordinated with PENS resulted in a greater increase than jumping only or control. This pattern of stimulation with PENS in combination with jump training may positively affect jumping.
Testosterone and Self-Reported Dominance Interact to Influence Human Mating Behavior
Authors: Slatcher Richard B. , Mehta Pranjal H. , Josephs Robert A.
Published: March 2011

In this study, 76 men came into the lab in pairs and engaged in a 7-minute videotaped mate competition for the attention of an attractive female confederate. Pre-competition testosterone (T) levels were positively associated with men’s dominance behaviors and with how much the confederate indicated that she “clicked” with each participant. Dyadic analyses showed that self-reported dominance moderated the effects of T on one’s own dominance behaviors and on opponents' dominance behaviors. Specifically, among men high in self-reported dominance, there was a strong positive association between T and their own dominance behaviors and a strong negative association between T and opponents' dominance behaviors. However, among men low in self-reported dominance, there was no association between T and dominance behaviors. These findings provide novel evidence linking T with evolutionarily adaptive behaviors in humans and suggest that T interacts with people’s explicit dominance motives to regulate behaviors that enhance mating success.
A pilot randomized controlled trial of deprescribing
Authors: Beer Christopher , Loh Poh-kooi , Peng Yan Gee , Potter Kathleen , Millar Alasdair
Published: March 2011

Objective: Polypharmacy and adverse drug reactions are frequent and important among older people. Few clinical trials have evaluated systematic withdrawal of medications among older people. This small, open, study was conducted to determine the feasibility of a randomized controlled deprescribing trial.

Methods: Ten volunteers living in the community (recruited by media advertising) and 25 volunteers living in residential aged-care facilities (RCFs) were randomized to intervention or control groups. The intervention was gradual withdrawal of one target medication. The primary outcome was the number of intervention participants in whom medication withdrawal could be achieved. Other outcomes measures were quality of life, medication adherence, sleep quality, and cognitive impairment.

Results: Participants were aged 80 ± 11 years and were taking 9 ± 2 medications. Fifteen participants commenced medication withdrawal and all ceased or reduced the dose of their target medication. Two subjects withdrew; one was referred for clinical review, and one participant declined further dose reductions.

Conclusions: A randomized controlled trial of deprescribing was acceptable to participants. Recruitment in RCFs is feasible. Definitive trials of deprescribing are required.
A review of the safety of anticoagulants in older people using the medicines management pathway: weighing the benefits against the risks
Authors: Bajorek Beata
Published: March 2011

Anticoagulant drugs maintain a high potential for adverse events due to their inherent risk of haemorrhage and/or complex pharmacology. In addition, compromising the safety of these agents is the context in which they are principally used; that is, in the long-term prevention of thromboembolic diseases in an older patient population. These challenges are especially pronounced in the prevention of stroke in older persons with atrial fibrillation (AF), where the need for thromboprophylaxis is paramount and in whom the arrhythmia is most prevalent, but where the target population is simultaneously at high risk of adverse drug events. Essentially, this translates to the use of high-risk therapies on an indefinite basis, in persons who have multiple comorbidities, use polypharmacy, and who may have age-related functional and cognitive decline, culminating in a higher potential for medication misadventure. For this reason, anticoagulants mandate extra pharmacovigilance, and therefore the aim of this review is to address some of the key safety considerations in the use of anticoagulant drugs (warfarin, dabigatran, rivaroxaban), spanning the initiation of therapy to its ongoing management. Using the Medication Management Pathway (MMP) as a framework, in this review we canvas and highlight specific developments in practical strategies to facilitate the safe use of anticoagulants (particularly warfarin) in ‘at-risk' elderly patients including: comprehensive risk/benefit assessment using novel risk stratification tools; focused medicines review services; therapeutic drug monitoring services delivered in the primary care setting; and practical education strategies and resources targeting the older patient population. Until newer alternative anticoagulants become viable options for widespread use, clinicians will necessarily need to rely on specific resources and interventions to facilitate the safe use of currently available anticoagulants (i.e. warfarin) in ‘at-risk’ older people.
Magselectofection: an integrated method of nanomagnetic separation and genetic modification of target cells
Authors: Sanchez-Antequera Yolanda , Mykhaylyk Olga , van Til Niek P. , Cengizeroglu Arzu , de Jong J. Henk , Huston Marshall W. , Anton Martina , Johnston Ian C. D. , Pojda Zygmunt , Wagemaker Gerard , Plank Christian
Published: March 2011

Research applications and cell therapies involving genetically modified cells require reliable, standardized, and cost-effective methods for cell manipulation. We report a novel nanomagnetic method for integrated cell separation and gene delivery. Gene vectors associated with magnetic nanoparticles are used to transfect/transduce target cells while being passaged and separated through a high gradient magnetic field cell separation column. The integrated method yields excellent target cell purity and recovery. Nonviral and lentiviral magselectofection is efficient and highly specific for the target cell population as demonstrated with a K562/Jurkat T-cell mixture. Both mouse and human enriched hematopoietic stem cell pools were effectively transduced by lentiviral magselectofection, which did not affect the hematopoietic progenitor cell number determined by in vitro colony assays. Highly effective reconstitution of T and B lymphocytes was achieved by magselectofected murine wild-type lineage-negative Sca-1+ cells transplanted into Il2rg−/− mice, stably expressing GFP in erythroid, myeloid, T-, and B-cell lineages. Furthermore, nonviral, lentiviral, and adenoviral magselectofection yielded high transfection/transduction efficiency in human umbilical cord mesenchymal stem cells and was fully compatible with their differentiation potential. Upscaling to a clinically approved automated cell separation device was feasible. Hence, once optimized, validated, and approved, the method may greatly facilitate the generation of genetically engineered cells for cell therapies.
Insights into the regulatory mechanism controlling the inhibition of vaccine-induced seroconversion by maternal antibodies
Authors: Kim Dhohyung , Huey Devra , Oglesbee Michael , Niewiesk Stefan
Published: March 2011

The inhibition of vaccination by maternal antibodies is a widely observed phenomenon in human and veterinary medicine. Maternal antibodies are known to suppress the B-cell response. This is similar to antibody feedback mechanism studies where passively transferred antibody inhibits the B-cell response against particulate antigens because of epitope masking. In the absence of experimental data addressing the mechanism underlying inhibition by maternal antibodies, it has been suggested that epitope masking explains the inhibition by maternal antibodies, too. Here we report that in the cotton rat model of measles virus (MV) vaccination passively transferred MV-specific immunoglobulin G inhibit B-cell responses through cross-linking of the B-cell receptor with FcγRIIB. The extent of inhibition increases with the number of antibodies engaging FcγRIIB and depends on the Fc region of antibody and its isotype. This inhibition can be partially overcome by injection of MV-specific monoclonal IgM antibody. IgM stimulates the B-cell directly through cross-linking the B-cell receptor via complement protein 3d and antigen to the complement receptor 2 signaling complex. These data demonstrate that maternal antibodies inhibit B-cell responses by interaction with the inhibitory/regulatory FcγRIIB receptor and not through epitope masking.
Customising chemotherapy in advanced nonsmall cell lung cancer: daily practice and perspectives
Authors: Vilmar A.C. , Sorensen J.B.
Published: March 2011

Treating patients with advanced nonsmall cell lung cancer (NSCLC) is a daunting task but during recent years new options have emerged. By tailoring treatment using either information on histological subtypes of NSCLC or biomarkers it is now possible to improve outcome and maintain stable quality of life.

We conducted a literature search of tailored treatment already implemented in advanced NSCLC in order to highlight the information required to decide on the optimal oncological treatment for individual patients.

16 studies were identified by literature review. Significantly improved outcome was demonstrated in patients with nonsquamous NSCLC treated with cisplatin/pemetrexed in pre-planned, exploratory and retrospective analysis from large-scale, randomised trials. Level 1 evidence showed significantly better progression-free survival when patients carrying an epidermal growth factor receptor (EGFR) mutation were treated with gefitinib compared to standard chemotherapy. Retrospective, unplanned analysis of excision repair cross complementation group 1 (ERCC1) and betatubulin III upregulation demonstrated poorer outcome in NSCLC patients treated with platinum-doublets and vinorelbine-based chemotherapy, respectively.

In conclusion, tailoring treatment according to either histological subtype or EGFR mutation status in advanced NSCLC should today be part of daily practice based on current evidence. Future biomarkers need optimisation of methodology and prospective validation before clinical implementation.
Lymphangioleiomyomatosis: what do we know and what are we looking for?
Authors: Harari S. , Torre O. , Moss J.
Published: March 2011

Lymphangioleiomyomatosis (LAM) is a rare disease characterised by proliferation of abnormal smooth muscle-like cells (LAM cells) leading to progressive cystic destruction of the lung, lymphatic abnormalities and abdominal tumours. It affects predominantly females and can occur sporadically or in patients with tuberous sclerosis complex.

This review describes the recent progress in our understanding of the molecular pathogenesis of the disease and LAM cell biology. It also summarises current therapeutic approaches and the most promising areas of research for future therapeutic strategies.
The rate sensitivity and plastic deformation of nanocrystalline tantalum films at nanoscale
Authors: Cao Zhenhua , She Qianwei , Huang Yongli , Meng Xiangkang
Published: March 2011

Nanoindentation creep and loading rate change tests were employed to examine the rate sensitivity (m) and hardness of nanocrystalline tetragonal Ta films. Experimental results suggested that the m increased with the decrease of feature scale, such as grain size and indent depth. The magnitude of m is much less than the corresponding grain boundary (GB) sliding deformation with m of 0.5. Hardness softening behavior was observed for smaller grain size, which supports the GB sliding mechanism. The rate-controlling deformation was interpreted by the GB-mediated processes involving atomic diffusion and the generation of dislocation at GB.
Investigation of Science Faculty with Education Specialties within the Largest University System in the United States
Authors: Bush Seth D. , Pelaez Nancy J. , Rudd James A. , Stevens Michael T. , Tanner Kimberly D. , Williams Kathy S.
Published: March 2011

Efforts to improve science education include university science departments hiring Science Faculty with Education Specialties (SFES), scientists who take on specialized roles in science education within their discipline. Although these positions have existed for decades and may be growing more common, few reports have investigated the SFES approach to improving science education. We present comprehensive data on the SFES in the California State University (CSU) system, the largest university system in the United States. We found that CSU SFES were engaged in three key arenas including K–12 science education, undergraduate science education, and discipline-based science education research. As such, CSU SFES appeared to be well-positioned to have an impact on science education from within science departments. However, there appeared to be a lack of clarity and agreement about the purpose of these SFES positions. In addition, formal training in science education among CSU SFES was limited. Although over 75% of CSU SFES were fulfilled by their teaching, scholarship, and service, our results revealed that almost 40% of CSU SFES were seriously considering leaving their positions. Our data suggest that science departments would likely benefit from explicit discussions about the role of SFES and strategies for supporting their professional activities.
Case-based discussion
Authors: Brown Nick , Holsgrove Gareth , Teeluckdharry Sadira
Published: March 2011

Case-based discussion has been a key element of the assessment programme for psychiatrists in training under the guidance of the Royal College of Psychiatrists since 2007. Its incorporation within systems for recertification and thus revalidation for psychiatrists in established practice has now been piloted. This article discusses the origins of the instrument in Canada and the USA before describing its use in the UK. Case-based discussion is placed within the context of contemporary postgraduate medical education and the curricula of the College, offering practical guidance on how best to use this method for the assessment of reasoning and judgement. Finally, some questions are posed regarding the potential use of case-based discussion in the proposals for revalidation.
A balanced approach to race in the treatment of personality disorder
Authors: Sen Piyal , Ramaswamy Dave
Published: March 2011

This case illustrates a clinical management problem in which a terminally ill psychiatric patient racially abuses the Black staff caring for him. The clinical team has to tread a fine line between supporting staff victimised by the patient and ensuring his quality of life and care. It is important that patients' (and staff's) sensitivities relating to race and ethnicity are openly discussed at an early stage, so that appropriate clinical management can be negotiated.
EEG in psychiatric practice: to do or not to do?
Authors: Badrakalimuthu Vellingiri Raja , Swamiraju Radhika , de Waal Hugo
Published: March 2011

Electroencephalography (EEG) is a non-invasive investigation that can aid the diagnosis of psychiatric and neuropsychiatric disorders. A good predictor of an abnormal EEG recording is the presence of an organic factor identified during the clinical assessment. The non-invasiveness and low cost of the procedure and its ability to measure spontaneous brain activity appear to attract clinicians to utilise this investigative tool. However, studies have reported that EEGs arising from psychiatric referrals have the lowest abnormality detection rate. The focus of this article is to improve this by highlighting the current pitfalls and providing recommendations for appropriate utilisation of EEG. We describe specific EEG changes associated with major psychiatric disorders. We conclude by offering pragmatic considerations when referring a patient for EEG, emphasising the fact that the information provided to the neurophysiologist plays a crucial role in interpreting the EEG recording in a diagnostically meaningful way.
Working with struggling teams
Authors: Undrill Guy , Gregory Nathan
Published: March 2011

Consultant psychiatrists are often called to work in teams that are functioning suboptimally. This is a major challenge, both professionally and personally. This article gives advice and strategies for working with struggling teams. It recommends combining objective-, data- and procedure-driven approaches to technical challenges with ‘softer’ person-centred and relational strategies matched to the learning needs of the team.
Teaching medical undergraduates: the psychiatrist as medical teacher
Authors: Eng Bennett
Published: March 2011

This article is a brief review of the teaching role of psychiatrists and is directed at psychiatrists in the UK National Health Service who teach medical undergraduates. It reviews the responsibility of delivering teaching, the delineation of teaching duties, and the teaching roles of the psychiatrist in the changing environment of medical education. Application of good principles of clinical teaching and delivery of tomorrow's doctors in line with the General Medical Council's recommendations are discussed. The article also describes a recommended core curriculum in psychiatry for undergraduates, which lays out what should be taught.
Treatment of acute psychotic agitation: gaps in the evidence base
Authors: Brown Steve
Published: March 2011

Treatment of psychotic agitation is an area that is very poorly evidenced, principally because research evidence from patients with moderate agitation may not generalise to the more severely agitated patients. There is a significant gap between current treatment recommendations and what is seen in clinical practice. There are also big differences in clinical practice between different units treating seemingly similar patient groups. This commentary considers possible reasons for these findings and also discusses non-pharmacological interventions, which probably contribute more to the management of psychotic agitation than does the choice of one antipsychotic drug over another.
Hospital treatment and management in relapse of schizophrenia in the UK: associated costs
Authors: Munro Janet , Osborne Sarah , Dearden Lindsay , Pascoe Katie , Gauthier Aline , Price Martin
Published: March 2011

Aims and method

Relapse in schizophrenia carries a heavy burden. This study aimed to describe the characteristics of patients admitted to hospital for relapse and to explore the treatment, length of stay and associated in-patient costs. The sample comprised individuals discharged from a London National Health Service trust following a relapse of schizophrenia. The costs of hospital treatment were obtained by applying referenced unit costs.

Results

The cohort comprised 71 patients. Treatment non-adherence was implicated in 76% of relapses. Mean length of hospital stay was 138.9 days (range 1 week-1.8 years). Mean admission cost was £25 852 (range £1270-120 000). Over 97% of costs were hospital costs and less than 3% drug costs.

Clinical implications

Hospital treatment for relapse of schizophrenia carries a considerable economic burden, as shown in this study. Treatment non-adherence is a significant factor contributing to relapse.
The proportionality principle and what it means in practice
Authors: Curtice Martin , Bashir Fareed , Khurmi Sanjay , Crocombe Juli , Hawkins Tim , Exworthy Tim
Published: March 2011

The Mental Health Act 2007 and the Mental Capacity Act 2005 have been made compatible with the European Convention on Human Rights (as enacted in the UK by the Human Rights Act 1998). The respective Codes of Practice have now embedded within them a human rights-based approach. Central to this is the principle of proportionality, which is regarded as the dominant theme underlying the Convention. This article explores the legal basis of proportionality, specifically analysing its use in relation to the Mental Health Act and the Mental Capacity Act. In doing so, it considers the use of the principle of proportionality in clinical practice.
Prognostic Significance and Tumor Biology of Regional Lymph Node Disease in Patients With Rhabdomyosarcoma: A Report From the Children's Oncology Group
Authors: Rodeberg David A. , Garcia-Henriquez Norbert , Lyden Elizabeth R. , Davicioni Elai , Parham David M. , Skapek Stephen X. , Hayes-Jordan Andrea A. , Donaldson Sarah S. , Brown Kenneth L. , Triche Timothy J. , Meyer William H. , Hawkins Douglas S.
Published: March 2011

Purpose

Regional lymph node disease (RLND) is a component of the risk-based treatment stratification in rhabdomyosarcoma (RMS). The purpose of this study was to determine the contribution of RLND to prognosis for patients with RMS.

Patients and Methods

Patient characteristics and survival outcomes for patients enrolled onto Intergroup Rhabdomyosarcoma Study IV (N = 898, 1991 to 1997) were evaluated among the following three patient groups: nonmetastatic patients with clinical or pathologic negative nodes (N0, 696 patients); patients with clinical or pathologic positive nodes (N1, 125 patients); and patients with a single site of metastatic disease (77 patients).

Results

Outcomes for patients with nonmetastatic alveolar N0 RMS were significantly better than for patients with N1 RMS (5-year failure-free survival [FFS], 73% v 43%, respectively; 5-year overall survival [OS], 80% v 46%, respectively; P < .001). Patients with a single site of alveolar metastasis had even worse FFS and OS (23% FFS and OS, P = .01) when compared with patients with N1 RMS; however, the differences was not as large as the differences between patients with N0 RMS and N1 RMS. For embryonal RMS, there was no statistically significant difference in FFS or OS (P = .41 and P = .77, respectively) for patients with N1 versus N0 RMS. Gene array analysis of primary tumor specimens identified that genes associated with the immune system and antigen presentation were significantly increased in N1 versus N0 alveolar RMS.

Conclusion

RLND alters prognosis for alveolar but not embryonal RMS. For patients with N1 disease and alveolar histology, outcomes were more similar to distant metastatic disease rather than local disease. Current data suggest that more aggressive therapy for patients with alveolar N1 RMS may be warranted.
Late Recurrence of Childhood T-Cell Acute Lymphoblastic Leukemia Frequently Represents a Second Leukemia Rather Than a Relapse: First Evidence for Genetic Predisposition
Authors: Szczepański Tomasz , van der Velden Vincent H.J. , Waanders Esmé , Kuiper Roland P. , Van Vlierberghe Pieter , Gruhn Bernd , Eckert Cornelia , Panzer-Grümayer Renate , Basso Giuseppe , Cavé Hélène , Stadt Udo zur , Campana Dario , Schrauder André , Sutton Rosemary , van Wering Elisabeth , Meijerink Jules P.P. , van Dongen Jacques J.M.
Published: March 2011

Purpose

Relapse of childhood T-cell acute lymphoblastic leukemia (T-ALL) often occurs during treatment, but in some cases, leukemia re-emerges off therapy. On the basis of previous analyses of T-cell receptor (TCR) gene rearrangement patterns, we hypothesized that some late recurrences of T-ALL might in fact represent second leukemias.

Patients and Methods

In 22 patients with T-ALL who had late relapses (at least 2.5 years from diagnosis), we studied TCR gene rearrangement status at first and second presentation, NOTCH1 gene mutations, and the presence of the SIL-TAL1 gene fusion. We performed genome-wide copy number and homozygosity analysis by using oligonucleotide- and single nucleotide polymorphism (SNP) –based arrays.

Results

We found evidence of a common clonal origin between diagnosis and relapse in 14 patients (64%). This was based on concordant TCR gene rearrangements (12 patients) or concordant genetic aberrations, as revealed by genome-wide copy number analysis (two patients). In the remaining eight patients (36%), TCR gene rearrangement sequences had completely changed between diagnosis and relapse, and gene copy number analysis showed markedly different patterns of genomic aberrations, suggesting a second T-ALL rather than a resurgence of the original clone. Moreover, NOTCH1 mutation patterns were different at diagnosis and relapse in five of these eight patients. In one patient with a second T-ALL, SNP analysis revealed a germline del(11)(p12;p13), a known recurrent aberration in T-ALL.

Conclusion

More than one third of late T-ALL recurrences are, in fact, second leukemias. Germline genetic abnormalities might contribute to the susceptibility of some patients to develop T-ALL.
Implementing a Geriatric Assessment in Cooperative Group Clinical Cancer Trials: CALGB 360401
Authors: Hurria Arti , Cirrincione Constance T. , Muss Hyman B. , Kornblith Alice B. , Barry William , Artz Andrew S. , Schmieder Linda , Ansari Rafat , Tew William P. , Weckstein Douglas , Kirshner Jeffrey , Togawa Kayo , Hansen Kurt , Katheria Vani , Stone Richard , Galinsky Ilene , Postiglione John , Cohen Harvey Jay
Published: March 2011

Purpose

Factors captured in a geriatric assessment can predict morbidity and mortality in older adults, but are not routinely measured in cancer clinical trials. This study evaluated the implementation of a geriatric assessment tool in the cooperative group setting.

Patients and Methods

Patients age ≥ 65 with cancer, who enrolled on cooperative group cancer trials, were eligible to enroll on Cancer and Leukemia Group B (CALGB) 360401. They completed a geriatric assessment tool before initiation of protocol therapy, consisting of valid and reliable geriatric assessment measures which are primarily self-administered and require minimal resources and time by healthcare providers. The assessment measures functional status, comorbidity, cognitive function, psychological state, social support, and nutritional status. The protocol specified criteria for incorporation of the tool in future cooperative group trials was based on the time to completion and percent of patients who could complete their portion without assistance. Patient satisfaction with the tool was captured.

Results

Of the 93 patients who enrolled in this study, five (5%) met criteria for cognitive impairment and three did not complete the cognitive screen, leaving 85 assessable patients (median age, 72 years). The median time to complete the geriatric assessment tool was 22 minutes, 87% of patients (n = 74) completed their portion without assistance, 92% (n = 78) were satisfied with the questionnaire length, 95% (n = 81) reported no difficult questions, and 96% (n = 82) reported no upsetting questions. One hundred percent of health care professionals completed their portion.

Conclusion

This brief, primarily self-administered geriatric assessment tool met the protocol specified criteria for inclusion in future cooperative group clinical trials.
Prognostic Factors After Relapse in Nonmetastatic Rhabdomyosarcoma: A Nomogram to Better Define Patients Who Can Be Salvaged With Further Therapy
Authors: Chisholm Julia C. , Marandet Julien , Rey Annie , Scopinaro Marcelo , de Toledo Jose Sánchez , Merks Johannes H.M. , O‘Meara Anne , Stevens Michael C.G. , Oberlin Odile
Published: March 2011

Purpose

Previous studies suggest poor outcome in children with relapsed rhabdomyosarcoma (RMS). A better understanding is needed of which patients can be salvaged after first relapse.

Patients and Methods

The analysis included children with nonmetastatic RMS and embryonal sarcoma enrolled onto the International Society of Paediatric Oncology (SIOP) Malignant Mesenchymal Tumor (MMT) 84, 89, and 95 studies who relapsed after achieving complete local control with primary therapy. All patients included in the analysis had follow-up for ≥ 3.0 years after the last event. The clinical features, initial treatment characteristics, and features of the relapse were correlated with survival in univariate and multivariate analyses.

Results

In all, 474 eligible patients were identified for the study. At ≥ 3.0 years from the last event, 176 (37%) were alive (“cured”). In a full-model multivariate analysis, the factors identified at first relapse that most strongly associated with poor outcome were metastatic relapse (odds ratio [OR], 4.19; 95% CI, 2.0 to 8.5), prior radiotherapy treatment (OR, 3.64; 95% CI, 2.1 to 6.4), initial tumor size > 5 cm (OR, 2.53; 95% CI, 1.5 to 4.1), and time of relapse < 18 months from diagnosis (OR, 2.20; 95% CI, 1.3 to 3.6). Unfavorable primary disease site, nodal involvement at diagnosis, alveolar histology, and previous three- or six-drug chemotherapy were also independently associated with poor outcome. To estimate chance of cure for individual patients, a nomogram was developed, which allowed for weighting of these significant factors.

Conclusion

Some children with relapsed RMS remain curable. It is now possible to estimate the chance of salvage for individual children to direct therapy appropriately toward cure, use of experimental therapies, and/or palliation.
Prevalence and Predictors of Cognitive Dysfunction in Opioid-Treated Patients With Cancer: A Multinational Study
Authors: Kurita Geana P. , Sjøgren Per , Ekholm Ola , Kaasa Stein , Loge Jon H. , Poviloniene Irena , Klepstad Pål
Published: March 2011

Purpose

To identify prevalence and associated factors of cognitive dysfunction in opioid-treated patients with cancer.

Patients and Methods

EPOS (European Pharmacogenetic Opioid Study) is a prospective cross-sectional multicenter study in which adult patients with cancer who received treatment with opioids for moderate or severe pain for at least 3 days were included. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). MMSE scores were categorized into definite cognitive dysfunction (scores < 24), possible cognitive dysfunction (scores 24-26), and no cognitive dysfunction (scores > 26). Factors potentially associated with cognitive dysfunction were assessed. Associations between MMSE and explanatory variables were analyzed by ordinal logistic regression models.

Results

We included 1,915 patients with cancer from 17 centers. MMSE scores less than 27 were observed in 32.9% of patients. Patients with lung cancer had higher odds (adjusted odds ratio, 1.46; 95% CI, 1.09 to 1.95) for having lower MMSE scores compared with patients with other cancer diagnoses. Patients receiving daily opioid doses of 400 mg or more (oral morphine equivalents) had 1.75 (95% CI, 1.25 to 2.46) times higher odds of having lower MMSE scores compared with those receiving daily doses less than 80 mg. Other risk factors for cognitive dysfunction were older age, low Karnofsky performance status (KPS), time since diagnosis (< 15 months), and absence of breakthrough pain (BTP).

Conclusion

One third of opioid-treated patients with cancer had possible or definite cognitive dysfunction. Lung cancer, daily opioid doses of 400 mg or more (oral morphine equivalents), older age, low KPS, shorter time since cancer diagnosis, and absence of BTP were predictors for cognitive dysfunction.
The Collapse of Interwar Vienna: Oskar Morgenstern's Community, 1925–50
Authors: Leonard Robert
Published: March 2011

Using as a window the life and career of one of its members, Oskar Morgenstern, this essay explores the development and demise of the economics community of interwar Vienna. As product of the Austrian school of economics, director of the Austrian Institute for Business Cycle Research, and promoter of the mathematical economics of Karl Menger and Abraham Wald, Morgenstern played a central role in Viennese economic life. His involvements cast light on the community's constituent groups, on the tensions that pervaded them, and on the ultimate demise of Viennese intellectual life with the annexation of Austria by Germany in 1938.
Translating metabolic biochemistry into the clinic: an interview with Steve O’Rahilly
Authors: Weston Kathy
Published: March 2011

Professor Steve O’Rahilly is one of the UK’s most renowned clinical researchers. He made his reputation by combining clinical practice with scientific and clinical studies focused on understanding the causes and consequences of obesity and insulin resistance. Here, he talks about his research philosophy, and his wider role as a spokesman for obesity research.
Synthesis of Structurally Diverse 2-Azetidinones via Staudinger Reaction on a Solid Support
Authors: Jarrahpour Aliasghar , Fadavi Abdolhamid , Zarei Maaroof
Published: March 2011

Trimellitic anhydride was attached to Merrifield resin and a ketene was generated from polymer-bound phthaloylglycine. Then this polymer reacted with imines in the presence of Vilsmeier reagent and triethylamine to afford the solid-phase-tethered β-lactam products. Selective cleavage of supported β-lactams by trifluoroacetic acid and methylhydrazine gave 4-carboxyphthalimido- and 3-amino-β-lactams, respectively. The trans-stereochemistry was found in all products.
Hybridized Organic Nanocrystals for Optically Functional Materials
Authors: Oikawa Hidetoshi
Published: March 2011

Organic nanocrystals (NCs) are in the mesoscopic phase between a single molecule and the corresponding bulk crystals, and are expected to exhibit peculiar optical properties, depending on crystal size and shape. In the present Award Accounts, recent progress on hybridized organic NCs and ordered array structure of encapsulated organic NCs will be introduced in detail for optically functional materials toward next-generation organic device application. Hybrid material (or hybridization) is an important area in current material science. Our attention is now focused on core–shell type hybridized organic NCs, which seem to be the best suited nanostructure for providing novel optoelectronic properties and photonic function induced by core–shell interface interaction. On the other hand, it may be necessary to arrange and integrate organic NCs, including hybridized materials, on a substrate so as to receive and transmit input and output signals by electronically and/or optically accessing organic devices. Hence, encapsulations of organic NCs, patterned substrates, and tapered cell method have been employed suitably to fabricate and control ordered array structure of organic NCs on a substrate. Finally, the future scope in the relevant fields of optoelectronics and photonics will be discussed in brief.
Reaction of Benzyne with Formamides and Acetylimidazole
Authors: Okuma Kentaro , Nojima Akiko , Nakamura Yuki , Matsunaga Nahoko , Nagahora Noriyoshi , Shioji Kosei
Published: March 2011

The reaction of DMF with o-trimethylsilylphenyl triflate in the presence of CsF afforded dimethyldiphenylammonium triflate, xanthene, and xanthone in 62%, 16%, and 24% yields, respectively. On the other hand, the reaction of dimethylthioformamide with triflate and CsF resulted in diphenyl sulfide, xanthene, and xanthone in 62%, 10%, and 12% yields, respectively. The reaction of acetylimidazole with benzyne gave 9-N,N-diphenylaminoanthracene in 85% yield.
Synthesis, Characterization, and Chiral Assembly Structure of a Self-Complementary Iron(III) Complex, [FeIII(H2L5-Me)(HL5-Me)](ClO4)2·EtOH (H2L5-Me: N-[(5-Methylimidazol-4-yl)methylidene]histamine)
Authors: Hagiwara Hiroaki , Nishi Koshiro , Matsumoto Naohide , Sunatsuki Yukinari , Kojima Masaaki , Iijima Seiichiro
Published: March 2011

A low-spin FeIII complex, [FeIII(H2L5-Me)(HL5-Me)](ClO4)2·EtOH, was prepared by the reaction of FeII(ClO4)2·6H2O and H2L5-Me in ethanol with 1:2 molar ratio and in air, where H2L5-Me: N-[(5-methylimidazol-4-yl)methylidene]histamine. Each complex molecule of [Fe(H2L5-Me)(HL5-Me)]2+ has both fully protonated ligand and mono-deprotonated ligand and acts as a chiral self-complementary building block to produce the homochiral imidazole–imidazolate-bridged zigzag-chain structure. The X-ray analysis confirmed that the adjacent chains with the same chirality are stacked in a crystal lattice to give a chiral crystal (conglomerate). Low-spin FeIII was revealed by the magnetic susceptibility and Mössbauer measurements.
The history and evolution of sutures in pelvic surgery
Authors: Muffly Tyler M , Tizzano Anthony P , Walters Mark D
Published: March 2011

Summary

The purpose of the study is to review the history and innovations of sutures used in pelvic surgery. Based on a review of the literature using electronic- and hand-searched databases we identified appropriate articles and gynaecology surgical textbooks regarding suture for wound closure. The first documented uses of suture are explored and then the article focuses on the use of knotted materials in pelvic surgery. The development of suture of natural materials is followed chronologically until the present time where synthetic suture is implanted during countless surgeries every day. This millennial history of suture contains an appreciation of the early work of Susruta, Celsus, Paré and Lister, including a survey of some significant developments of suture methods over the last 100 years. Most surgeons know little about the history and science of sutures. A retrospective view of suture is critical to the appreciation of the current work and development of this common tool.
A new technique for feeding dogs with a congenital cleft palate for surgical research
Authors: Martínez-Sanz Elena , Casado-Gómez Inmaculada , Martín Concepción , López-Gordillo Yamila , González Pablo , Rodríguez-Bobada Cruz , Paradas Irene , González-Meli Beatriz , Maldonado Estela , Maestro Carmen , Prados Juan Carlos , Martínez-Álvarez Concepción
Published: March 2011

In humans, cleft palate (CP) is one of the most common malformations. Although surgeons use palatoplasty to close CP defects in children, its consequences for subsequent facial growth have prompted investigations into other novel surgical alternatives. The animal models of CP used to evaluate new surgical treatments are frequently obtained by creating surgically induced clefts in adult dogs. This procedure has been ethically criticized due to its severity and questionable value as an animal model for human CP. Dogs born with a congenital CP would be much better for this purpose, provided they developed CP at a sufficient rate and could be fed. Up until now, feeding these pups carried the risk of aspiration pneumonia, while impeding normal suckling and chewing, and thus compromising orofacial growth. We developed a technique for feeding dog pups with CP from birth to the time of surgery using two old Spanish pointer dog pups bearing a complete CP. This dog strain develops CP in 15–20% of the offspring spontaneously. Custom-made feeding teats and palatal prostheses adapted to the pups' palates were made from thermoplastic plates. This feeding technique allowed lactation, eating and drinking in the pups with CP, with only sporadic rhinitis. To determine whether the use of this palatal prosthesis interferes with palatal growth, the palates of three littermate German shorthaired pointer pups without CP, either wearing or not wearing (controls) the prosthesis, were measured. The results showed that the permanent use of this prosthesis does not impede palatal growth in the pups.