bluuebunny/crossref_metadata_2025 huggingface dataset:
Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish Group report
Authors: Goenka N. , Turner B. , Vora J. ,   on behalf of the Diabetes UK Task and Finish group
Published: August 2011

Diabet. Med. 28, 1494–1500 (2011)

The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non‐specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled ‘Commissioning Diabetes Specialist Services for Adults with Diabetes’, which has been produced, as a ‘Task and Finish’ group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults.
Establishing an evidence base for frequency of monitoring glycated haemoglobin levels in patients with Type 2 diabetes: projections of effectiveness from a regression model
Authors: Oke J. L. , Stevens R. J. , Gaitskell K. , Farmer A. J.
Published: August 2011

Diabet. Med. 29, 266–271 (2012)

Aims  Glycated haemoglobin (HbA1c) is monitored to guide treatment decisions in relation to glycaemic goals over time. Changes between two consecutive HbA1c tests result not only from deterioration or improvement in glycaemic control, but also from biovariability and measurement error. We model how this short‐term variability impacts on HbA1c monitoring.

Methods  Using data from a randomized trial of non‐insulin treated patients with Type 2 diabetes we fitted a random‐effects model for progression and variability of HbA1c. We estimated how many tests where HbA1c ≥ 7.5% (58.5 mmol/mol) would be false‐positive (underlying HbA1c < 7.5% but test ≥ 7.5% owing to variability) vs. true‐positive, in people with initial HbA1c between 6.5% and 7.3% (48 mmol/mol and 56 mmol/mol).

Results  Participants (n = 320) had mean (SD) age 66 (10) years, BMI 31.3 (6.0) kg/m2 and median HbA1c was 7.1% (54 mmol/mol) with interquartile range 6.6% (49 mmol/mol) to 7.7% (61 mmol/mol). Mean (95% CI) change in HbA1c was 0.1% (1 mmol/mol) with 95% confidence interval 0.05% (0.5 mmol/mol) to 0.15% (2 mmol/mol) per 6 months. The minimum interval at which a true‐positive test is more likely than a false positive test is 270 days for a starting HbA1c of 6.9% (52 mmol/mol) and 360 days at a starting value of 6.5% (48 mmol/mol).

Conclusion  In patients with initial HbA1c close to treatment goal, retesting at 6 months would yield more true‐positive than false‐positive tests. For patients with lower initial HbA1c, retesting at 6 months would yield more false than true‐positive tests. In all patients, retesting at 12 months yields more true than false‐positive tests. In very few patients would retesting at 3 months be justified.
Assessing Key Competences across the Curriculum — and Europe
Authors: Pepper David
Published: August 2011

The development of key competences for lifelong learning has been an important policy imperative for EU Member States. The European Reference Framework of key competences (2006) built on previous developments by the OECD, UNESCO and Member States themselves. It defined key competences as knowledge, skills and attitudes applied appropriately to contexts. Now most Member States have incorporated key competences, or similarly broad learning outcomes, into their school curriculum frameworks. This is a necessary but insufficient step towards implementation; for the effective development of learners' key competences, assessment must also change. This article focuses on the challenge of assessing cross‐curricular key competences in primary and secondary education. It is based on a major study for the European Commission (Gordon, et al., 2009), which drew on information gathered and validated with the help of experts in each of the 27 EU Member States. The study's typology of assessment provides a basis for reviewing some recent developments in Member States. Present challenges and innovative responses are addressed, including ‘unpacking’ key competences, ‘mapping’ them to contexts and ‘accessment’ of their full scope and range. Policy developments are considered in the context of the author's work with the European Commission's Thematic Working Group on the assessment of key competences. The article concludes with considerations for policy and practice.
Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross‐sectional study in Greece
Authors: Brokalaki H. , Giakoumidakis K. , Fotos N.V. , Galanis P. , Patelarou E. , Siamaga E. , Elefsiniotis I.S.
Published: August 2011

BROKALAKI H., GIAKOUMIDAKIS K., FOTOS N.V., GALANIS P., PATELAROU E., SIAMAGA E. & ELEFSINIOTIS I.S. (2011) Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross‐sectional study in Greece. International Nursing Review58, 470–476

Background:  It is proven that early admission to hospital contributes significantly to the successful management of acute myocardial infarction (AMI).

Aim:  This study aimed to examine the factors associated with delayed hospital arrival among patients with AMI.

Methods:  A cross‐sectional study among 477 AMI patients was conducted during a 2‐year period in two large tertiary hospitals in Greece. Structured face‐to‐face interviews were conducted and information regarding their socio‐demographic characteristics, medical history and factors that might be correlated with delayed hospital arrival were collected.

Results:  The main factors that were found to be correlated with delayed hospital arrival among AMI patients were the absence of companion/attendant/escort present during the AMI [odds ratio (OR) 2.1, 95% confidence interval (CI) 0.98–4.4, P = 0.049], previous medical history of diabetes mellitus (OR 3.4, CI 1.6–7.2, P = 0.002), absence of dyspepsia (OR 9.2, CI 3.6–23.3, P < 0.001) and nausea/vomiting symptoms (OR 16.9, CI 4.1–69.1, P < 0.001), and also being at a distance of more than 10 km from the hospital (OR 19.6, CI 5.4–70.6, P < 0.001).

Conclusion:  A number of factors that might delay hospital arrival among patients with AMI should be taken into account in healthcare service planning. Health policy actions that will improve the accessibility to healthcare services, the restructuring of the Greek primary healthcare system and the provision of effective patient education by nurses could reduce the pre‐hospital delay.

Limitations:  The study was conducted in two hospitals which limits the generalization of the findings. Also, the onset of AMI symptoms relied on self‐report by the patients.
Factors influencing midwifery migration from the United Kingdom to Australia
Authors: Sidebotham M. , Ahern K.
Published: August 2011

SIDEBOTHAM M. & AHERN K. (2011) Factors influencing midwifery migration from the United Kingdom to Australia. International Nursing Review58, 498–504

Background:  Within the current literature on the globalization of the healthcare workforce, it is difficult to separate the migration experience of nurses from that of midwives. As more countries are moving to offer direct entry educational programmes and provide separate registration for midwives, information specific to that professional group will be required to guide workforce planners and inform employment practice. This qualitative study tracks the migration experience of midwives moving between the UK and Australia.

Methods:  A purposeful sample of 18 midwives who had migrated from the UK to one state in Australia was interviewed within a descriptive phenomenological framework. Data were analysed using thematic coding within Nvivo (QSR International, Melbourne, Australia).

Results:  The strongest motivator for migration was to improve the family's lifestyle. Push factors included disillusionment with working conditions, standard of living in the UK and national politics. The majority of midwives had organized their own entry visa and employment. Most midwives had occupied senior positions in the UK but accepted employment initially within entry‐level positions in Australia.

Discussion:  Despite both countries offering similar standards of living, the majority of midwives expected to achieve an improvement in family lifestyle in Australia. Midwives indicated they were prepared to lose professional status and seniority of position to gain a better overall lifestyle for their family. To examine the long‐term sustainability of international recruitment processes, further research is indicated to examine the ongoing experience and integration of migrant midwives into the workforce in Australia.
Help‐seeking behaviours in childbearing women in Ghana, West Africa
Authors: Farnes C. , Beckstrand R.L. , Callister L.C.
Published: August 2011

FARNES C., BECKSTRAND R.L. & CALLISTER L.C. (2011) Help‐seeking behaviours in childbearing women in Ghana, West Africa. International Nursing Review58, 491–497

Aim:  The purpose of this ethnographic study was to examine the health‐seeking behaviours of Ghanaian childbearing women.

Background:  The Ashanti consider pregnancy to be a vulnerable time when risk increases that women may be affected by witchcraft and develop sunsumyare. Preparation for positive birth outcomes include biomedical, ethnomedical and faith‐based interventions.

Design:  A sample of 42 childbearing Ghanaian women participated in audiotaped interviews. Transcribed interviews were coded and categorized into themes.

Findings and discussion:  The overriding theme was health seeking to ensure positive pregnancy outcomes. Subthemes included accessing multiple sources of care simultaneously, feeling vulnerable to spiritual illness, seeking spiritual protection and disclosing multiple sources of care.

Conclusion:  Childbearing is an essential part of the gender identity of Ashanti women. Witchcraft mentality provides a way for a woman to manage her life challenges.

Implications for practice:  Cultural beliefs and practices have profound effects on health‐seeking behaviours. It is becoming increasingly important that healthcare providers perform cultural and spiritual assessments and inquire about complementary sources of health care.
“QUANTUM PHYSICS AND VEDANTA”: A PERSPECTIVE FROM BERNARD D'ESPAGNAT'S SCIENTIFIC REALISM
Authors: Duquette Jonathan
Published: August 2011

Abstract.  In the last decades, several rapprochements have been made between quantum physics and the Advaita Vedānta (AV) school of Hinduism. Theoretical issues such as the role of the observer in measurement and physical interconnectedness have been associated with tenets of AV, generating various critical responses. In this study, I propose to address this encounter in the light of recent works on philosophical implications of quantum physics by the physicist and philosopher of science Bernard d’Espagnat.
MICHAEL RUSE ON SCIENCE AND FAITH: SEEKING MUTUAL UNDERSTANDING
Authors: Wisdo David
Published: August 2011

Abstract. InScience and Spirituality, Michael Ruse attempts to reconcile traditional Christianity and modern science by arguing that Christianity addresses questions that lie beyond the domain of science. I argue that Ruse's solution raises a number of problems that render it unsatisfactory for both the scientist and believer. First, despite his objections to “God of the gaps” arguments, his own strategy for identifying those questions that are beyond the limits of science seems to raise the problem in a new form. Second, what Ruse offers as evidence for the limits of science is better construed as evidence for deep disagreements among scientists and as such does not support his claims about the limits of science. Third, in aiming to establish their independence, Ruse subordinates religion to science. Finally, his support of traditional theology as a mode of religious understanding might cause concern for those who believe that certain kinds of theological reflection are at odds with scientific thinking.
A Microfoundation for Production Functions: Assignment of Heterogeneous Workers to Heterogeneous Jobs
Authors: Dupuy Arnaud
Published: August 2011

This paper develops an assignment model of heterogeneous workers to heterogeneous tasks that provides a microeconomic foundation for aggregate production functions. The shape of the production function is shown to depend crucially on the distribution of tasks. Necessary and sufficient conditions are provided for the production function to be of the constant ratio of elasticities of substitution form, which nests the widely used constant elasticity of substitution (CES) form. For the CES production function, the elasticity of substitution between skill groups of workers is shown to depend only on the variance of tasks in the economy.
A study on the decontamination of insoles colonized by Trichophyton rubrum: effect of terbinafine spray powder 1% and terbinafine spray solution 1%
Authors: Feuilhade de Chauvin M.
Published: August 2011

Background  Shoes worn with bare feet function as a fungal reservoir and lead to persistent dermatophytosis.

Objective  This study was designed to evaluate two formulations of terbinafine (1% spray powder or solution) to treat the insoles of shoes colonized by skin scales infected with Trichophyton rubrum and to determine the contact time necessary to achieve decontamination.

Methods  Infected skin scales weighing 0.5 g, taken from the feet of patients with confirmed T. rubrum infection, was dispersed onto insoles pre‐moistened with sterile saline solution (to mimic perspiration). Three types of insole were tested (felt, latex, leather). After inoculation, insoles were placed separately in new cardboard boxes at ambient temperature, and re‐humidified with sterile normal saline solution for 48 h before being treated; untreated insoles served as controls. Scales were scraped off at 48 h or 96 h, and dropped into tubes of Sabouraud agar, incubated at 27°C and examined at 3 and 6 weeks.

Results  Cultures from all control insoles showed numerous T. rubrum colonies. In contrast, cultures from all insoles treated with a single application of terbinafine 1% spray solution or powder, and taken after 48 h or 96 h contact with the product, remained sterile at 3 weeks and 6 weeks.

Conclusion  This study demonstrated the successful treatment of insoles colonized by T. rubrum‐infected skin scales. Terbinafine 1% spray solution and powder showed good efficacy; the dermatophyte could no longer be cultured 48 h after a single application of terbinafine.
An exploration of community learning disability nurses’ therapeutic role
Authors: Marsham Marian
Published: August 2011

Accessible summary

 Community Learning Disability Nurses were asked to talk about how they felt they had helped people in their care feel better.

 They talked about helping as a positive approach to problems, making the most of existing help, understanding what it means to have a Learning Disability, using time and communication, and teaching and learning.

 This is important because it can help people to understand the needs of people with learning disability and what help Community Learning Disabilities Nurses give.

This literature review and primary qualitative research explores therapeutic role from the perspective of Community Learning Disability Nurses. Semi‐structured interviews, based on Critical Incident Technique (Psychol Bull, 51, 1954, 327), and descriptive phenomenological methodology were adopted to elicit data amenable to systematic content analysis (Mayring 2000). This resulted in the identification of six inductive categories (therapeutic optimism, maximising support networks, time as a therapeutic tool, creative communication, understanding Learning Disability and initiating learning). Three deducted categories were derived from relevant literature (nature of the events, outcomes of therapeutic role, and therapeutic relationship). The sample consisted of seven practicing Community Learning Disability Nurses with two or more years experience managing an adult caseload, recruited via a professional networking forum. A conceptual model was developed indicating the multicomponent and interconnected nature of the therapeutic role.
Astrocytes treated by lysophosphatidic acid induce axonal outgrowth of cortical progenitors through extracellular matrix protein and epidermal growth factor signaling pathway
Authors: de Sampaio e Spohr Tania Cristina Leite , Dezonne Rômulo Sperduto , Rehen Stevens Kastrup , Gomes Flávia Carvalho Alcantara
Published: August 2011

J. Neurochem. (2011) 119, 113–123.

Lysophosphatidic acid (LPA) plays important roles in many biological processes, such as brain development, oncogenesis and immune functions, via its specific receptors. We previously demonstrated that LPA‐primed astrocytes induce neuronal commitment of cerebral cortical progenitors (Spohr et al. 2008). In the present study, we analyzed neurite outgrowth induced by LPA‐treated astrocytes and the molecular mechanism underlying this event. LPA‐primed astrocytes increase neuronal differentiation, arborization and neurite outgrowth of developing cortical neurons. Treatment of astrocytes with epidermal growth factor (EGF) ligands yielded similar results, suggesting that members of the EGF family might mediate LPA‐induced neuritogenesis. Furthermore, treatment of astrocytes with LPA or EGF ligands led to an increase in the levels of the extracellular matrix molecule, laminin (LN), thus enhancing astrocyte permissiveness to neurite outgrowth. This event was reversed by pharmacological inhibitors of the MAPK signaling pathway and of the EGF receptor. Our data reveal an important role of astrocytes and EGF receptor ligands pathway as mediators of bioactive lipids action in brain development, and implicate the LN and MAPK pathway in this process.
Insights into the pharmacological relevance of lysophospholipid receptors
Authors: Mutoh Tetsuji , Rivera Richard , Chun Jerold
Published: August 2011

The discovery of lysophospholipid (LP) 7‐transmembrane, G protein‐coupled receptors (GPCRs) that began in the 1990s, together with research into the functional roles of the major LPs known as lysophosphatidic acid (LPA) and sphingosine 1‐phosphate (S1P), have opened new research avenues into their biological processes and mechanisms. Major examples of LP signalling effects include embryogenesis, nervous system development, vascular development, uterine implantation, immune cell trafficking, and inflammatory reactions. LP signalling also influences the pathophysiology of many diseases including cancer, autoimmune and inflammatory diseases, which indicate that LP receptors may be attractive targets for pharmacological therapies. A key example of such a therapeutic agent is the S1P receptor modulator FTY720, which upon phosphorylation and continued drug exposure, acts as an S1P receptor functional antagonist. This compound (also known as fingolimod or Gilenya) has recently been approved by the FDA for the treatment of relapsing forms of multiple sclerosis. Continued basic and translational research on LP signalling should provide novel insights into both basic biological mechanisms, as well as novel therapeutic approaches to combat a range of human diseases.
Dynamic monitoring of beating periodicity of stem cell‐derived cardiomyocytes as a predictive tool for preclinical safety assessment
Authors: Abassi Yama A , Xi Biao , Li Nan , Ouyang Wei , Seiler Alexander , Watzele Manfred , Kettenhofen Ralf , Bohlen Heribert , Ehlich Andreas , Kolossov Eugen , Wang Xiaobo , Xu Xiao
Published: August 2011

BACKGROUND AND PURPOSE Cardiac toxicity is a major concern in drug development and it is imperative that clinical candidates are thoroughly tested for adverse effects earlier in the drug discovery process. In this report, we investigate the utility of an impedance‐based microelectronic detection system in conjunction with mouse embryonic stem cell‐derived cardiomyocytes for assessment of compound risk in the drug discovery process.

EXPERIMENTAL APPROACH Beating of cardiomyocytes was measured by a recently developed microelectronic‐based system using impedance readouts. We used mouse stem cell‐derived cardiomyocytes to obtain dose‐response profiles for over 60 compounds, including ion channel modulators, chronotropic/ionotropic agents, hERG trafficking inhibitors and drugs known to induce Torsades de Pointes arrhythmias.

KEY RESULTS This system sensitively and quantitatively detected effects of modulators of cardiac function, including some compounds missed by electrophysiology. Pro‐arrhythmic compounds produced characteristic profiles reflecting arrhythmia, which can be used for identification of other pro‐arrhythmic compounds. The time series data can be used to identify compounds that induce arrhythmia by complex mechanisms such as inhibition of hERG channels trafficking. Furthermore, the time resolution allows for assessment of compounds that simultaneously affect both beating and viability of cardiomyocytes.

CONCLUSIONS AND IMPLICATIONS Microelectronic monitoring of stem cell‐derived cardiomyocyte beating provides a high throughput, quantitative and predictive assay system that can be used for assessment of cardiac liability earlier in the drug discovery process. The convergence of stem cell technology with microelectronic monitoring should facilitate cardiac safety assessment.
TASK1 (K2P3.1) K+ channel inhibition by endothelin‐1 is mediated through Rho kinase‐dependent phosphorylation
Authors: Seyler C , Duthil‐Straub E , Zitron E , Gierten J , Scholz EP , Fink RHA , Karle CA , Becker R , Katus HA , Thomas D
Published: August 2011

BACKGROUND AND PURPOSE TASK1 (K2P3.1) two‐pore‐domain K+ channels contribute substantially to the resting membrane potential in human pulmonary artery smooth muscle cells (hPASMC), modulating vascular tone and diameter. The endothelin‐1 (ET‐1) pathway mediates vasoconstriction and is an established target of pulmonary arterial hypertension (PAH) therapy. ET‐1‐mediated inhibition of TASK1 currents in hPASMC is implicated in the pathophysiology of PAH. This study was designed to elucidate molecular mechanisms underlying inhibition of TASK1 channels by ET‐1.

EXPERIMENTAL APPROACH Two‐electrode voltage clamp and whole‐cell patch clamp electrophysiology was used to record TASK1 currents from hPASMC and Xenopus oocytes.

KEY RESULTS ET‐1 inhibited TASK1‐mediated IKN currents in hPASMC, an effect attenuated by Rho kinase inhibition with Y‐27632. In Xenopus oocytes, TASK1 current reduction by ET‐1 was mediated by endothelin receptors ETA (IC50= 0.08 nM) and ETB (IC50= 0.23 nM) via Rho kinase signalling. TASK1 channels contain two putative Rho kinase phosphorylation sites, Ser336 and Ser393. Mutation of Ser393 rendered TASK1 channels insensitive to ETA‐ or ETB‐mediated current inhibition. In contrast, removal of Ser336 selectively attenuated ETA‐dependent TASK1 regulation without affecting the ETB pathway.

CONCLUSIONS AND IMPLICATIONS ET‐1 regulated vascular TASK1 currents through ETA and ETB receptors mediated by downstream activation of Rho kinase and direct channel phosphorylation. The Rho kinase pathway in PASMC may provide a more specific therapeutic target in pulmonary arterial hypertension treatment.
Partial agonists for α4β2 nicotinic receptors stimulate dopaminergic neuron firing with relatively enhanced maximal effects
Authors: Chen Ying , Broad Lisa M , Phillips Keith G , Zwart Ruud
Published: August 2011

BACKGROUND AND PURPOSE Partial agonists selective for α4β2 nicotinic ACh receptors have been developed for smoking cessation as they induce weak activation of native α4β2* receptors and inhibit effect of nicotine. However, it is unclear whether at brain functions there is an existence of receptor reserve that allows weak receptor activation to induce maximum physiological effects. We assessed the extent of α4β2 partial agonist‐induced increase of firing rate in dopaminergic neurons and evaluated the influence of receptor reserve.

EXPERIMENTAL APPROACH The relative maximal effects and potencies of six nicotinic agonists were assessed on recombinant human α4β2 and α7 receptors expressed in mammalian cell lines by measuring calcium influx. Agonist‐induced increase of the spontaneous firing rate of dopaminergic neurons was recorded using microelectrodes in the ventral tegmental area of rat brain slices.

KEY RESULTS All α4β2 partial and full agonists increased the firing rate concentration‐dependently. Their sensitivity to subtype‐selective antagonists showed predominant activation of native α4β2* receptors. However, partial agonists with relative maximal effects as low as 33% on α4β2 receptors maximally increased the firing rate and induced additional depolarization block of firing, demonstrating that partial activation of receptors caused the maximum increase in firing rate in the presence of a receptor reserve.

CONCLUSIONS AND IMPLICATIONS Partial α4β2 agonists induced relatively enhanced effects on the firing rate of dopaminergic neurons, and the effect was mainly attributed to the existence of native α4β2* receptor reserve. The results have implications in the understanding of physiological effects and therapeutic efficacies of α4β2 partial agonists.
PLOD2 induced under hypoxia is a novel prognostic factor for hepatocellular carcinoma after curative resection
Authors: Noda Takehiro , Yamamoto Hirofumi , Takemasa Ichiro , Yamada Daisaku , Uemura Mamoru , Wada Hiroshi , Kobayashi Shogo , Marubashi Shigeru , Eguchi Hidetoshi , Tanemura Masahiro , Umeshita Koji , Doki Yuichro , Mori Masaki , Nagano Hiroaki
Published: August 2011

Background

Under hypoxia, tumour cells undergo genetic and adaptive changes that allow their survival. Previously, we reported that high expression of hypoxia‐inducible factor (HIF)‐1 was a significant predictive factor for recurrence in hepatocellular carcinoma (HCC). Hypoxia also stimulates expression of procollagen‐lysine, 2‐oxoglutarate 5‐dioxygenase (PLOD) genes via the HIF‐1 pathway.

Aims

The aim was to evaluate the relationship between hypoxia stress and expression of PLOD genes in HCC in vitro and to identify a new prognostic marker in HCC patients.

Methods

The PLOD2 expression was assessed under hypoxia in hepatoma cell lines and characterized in 139 HCC samples following hepatic resection using microarray experiments, quantitative RT‐PCR and immunohistochemistry. Prognostic factors in HCC patients were assessed using univariate and multivariate analyses.

Results

The PLOD2 expression was induced under the hypoxia in vitro. Disease‐free survival in the high PLOD2 expression group of HCC patients was significantly shorter when compared with the low‐expression group (P = 0.002). In a subset of HCCs, we found that the PLOD2 expression of microarray was correlated with data of quantitative RT‐PCR and immunohistochemistry. Of clinicopathological factors, PLOD2 expression was significantly correlated with tumour size (P = 0.022) and macroscopic intrahepatic metastasis (P = 0.049). In univariate analysis, six prognostic factors (tumour multiplicity, macroscopic intrahepatic metastasis, histological grade, microscopic portal invasion, microscopic intrahepatic metastasis and PLOD2 expression) were significant for disease‐free survival. PLOD2 expression was identified as a significant, independent factor of poor prognosis (P = 0.013).

Conclusions

PLOD2 is a potential novel prognostic factor for HCC patients following surgery.
Behavioral Economics and Regulatory Analysis
Authors: Robinson Lisa A. , Hammitt James K.
Published: August 2011

Behavioral economics has captured the interest of scholars and the general public by demonstrating ways in which individuals make decisions that appear irrational. While increasing attention is being focused on the implications of this research for the design of risk‐reducing policies, less attention has been paid to how it affects the economic valuation of policy consequences. This article considers the latter issue, reviewing the behavioral economics literature and discussing its implications for the conduct of benefit‐cost analysis, particularly in the context of environmental, health, and safety regulations. We explore three concerns: using estimates of willingness to pay or willingness to accept compensation for valuation, considering the psychological aspects of risk when valuing mortality‐risk reductions, and discounting future consequences. In each case, we take the perspective that analysts should avoid making judgments about whether values are “rational” or “irrational.” Instead, they should make every effort to rely on well‐designed studies, using ranges, sensitivity analysis, or probabilistic modeling to reflect uncertainty. More generally, behavioral research has led some to argue for a more paternalistic approach to policy analysis. We argue instead for continued focus on describing the preferences of those affected, while working to ensure that these preferences are based on knowledge and careful reflection.
Dynamic Logistic Regression and Dynamic Model Averaging for Binary Classification
Authors: McCormick Tyler H. , Raftery Adrian E. , Madigan David , Burd Randall S.
Published: August 2011

Summary We propose an online binary classification procedure for cases when there is uncertainty about the model to use and parameters within a model change over time. We account for model uncertainty through dynamic model averaging, a dynamic extension of Bayesian model averaging in which posterior model probabilities may also change with time. We apply a state‐space model to the parameters of each model and we allow the data‐generating model to change over time according to a Markov chain. Calibrating a “forgetting” factor accommodates different levels of change in the data‐generating mechanism. We propose an algorithm that adjusts the level of forgetting in an online fashion using the posterior predictive distribution, and so accommodates various levels of change at different times. We apply our method to data from children with appendicitis who receive either a traditional (open) appendectomy or a laparoscopic procedure. Factors associated with which children receive a particular type of procedure changed substantially over the 7 years of data collection, a feature that is not captured using standard regression modeling. Because our procedure can be implemented completely online, future data collection for similar studies would require storing sensitive patient information only temporarily, reducing the risk of a breach of confidentiality.
Constructing Normalcy and Discrepancy Indexes for Birth Weight and Gestational Age Using a Threshold Regression Mixture Model
Authors: Whitmore G. A. , Zhang Guangyu , Lee Mei‐Ling Ting
Published: August 2011

Summary Birth weight and gestational age are important measures of a newborn’s intrinsic health, serving both as outcome measures and explanatory variables in health studies. The measures are highly correlated but occasionally inconsistent. We anticipate that health researchers and other scientists would be helped by summary indexes of birth weight and gestational age that give more precise indications of whether the birth outcome is healthy or not. We propose a pair of indexes that we refer to as the birth normalcy index or BNI and birth discrepancy index or BDI. Both indexes are simple functions of birth weight and gestational age and in logarithmic form are orthogonal by construction. The BNI gauges whether the birth weight and gestational age combination are in a normal range. The BDI gauges whether birth weight and gestational age are consistent. We present a three‐component mixture model for BNI, with the components representing premature, at‐risk, and healthy births. The BNI distribution is derived from a stochastic model of fetal development proposed by Whitmore and Su (2007, Lifetime Data Analysis 13, 161–190) and takes the form of a mixture of inverse Gaussian distributions. We present a noncentral t‐distribution as a model for BDI. BNI and BDI are also well suited for making comparisons of birth outcomes in different reference populations. A simple z‐score and t‐score are proposed for such comparisons. The BNI and BDI distributions can be estimated for births in any reference population of interest using threshold regression.
A Composite Likelihood Approach to Latent Multivariate Gaussian Modeling of SNP Data with Application to Genetic Association Testing
Authors: Han Fang , Pan Wei
Published: August 2011

Summary Many statistical tests have been proposed for case–control data to detect disease association with multiple single nucleotide polymorphisms (SNPs) in linkage disequilibrium. The main reason for the existence of so many tests is that each test aims to detect one or two aspects of many possible distributional differences between cases and controls, largely due to the lack of a general and yet simple model for discrete genotype data. Here we propose a latent variable model to represent SNP data: the observed SNP data are assumed to be obtained by discretizing a latent multivariate Gaussian variate. Because the latent variate is multivariate Gaussian, its distribution is completely characterized by its mean vector and covariance matrix, in contrast to much more complex forms of a general distribution for discrete multivariate SNP data. We propose a composite likelihood approach for parameter estimation. A direct application of this latent variable model is to association testing with multiple SNPs in a candidate gene or region. In contrast to many existing tests that aim to detect only one or two aspects of many possible distributional differences of discrete SNP data, we can exclusively focus on testing the mean and covariance parameters of the latent Gaussian distributions for cases and controls. Our simulation results demonstrate potential power gains of the proposed approach over some existing methods.
Identifiability of Causal Effects for Binary Variables with Baseline Data Missing Due to Death
Authors: Yan Wei , Hu Yaqin , Geng Zhi
Published: August 2011

Summary We discuss identifiability and estimation of causal effects of a treatment in subgroups defined by a covariate that is sometimes missing due to death, which is different from a problem with outcomes censored by death. Frangakis et al. (2007, Biometrics 63, 641–662) proposed an approach for estimating the causal effects under a strong monotonicity (SM) assumption. In this article, we focus on identifiability of the joint distribution of the covariate, treatment and potential outcomes, show sufficient conditions for identifiability, and relax the SM assumption to monotonicity (M) and no‐interaction (NI) assumptions. We derive expectation–maximization algorithms for finding the maximum likelihood estimates of parameters of the joint distribution under different assumptions. Further we remove the M and NI assumptions, and prove that signs of the causal effects of a treatment in the subgroups are identifiable, which means that their bounds do not cover zero. We perform simulations and a sensitivity analysis to evaluate our approaches. Finally, we apply the approaches to the National Study on the Costs and Outcomes of Trauma Centers data, which are also analyzed by Frangakis et al. (2007) and Xie and Murphy (2007, Biometrics 63, 655–658).
Does online hemodiafiltration lead to reduction in trace elements and vitamins?
Authors: CROSS Jennifer , DAVENPORT Andrew
Published: August 2011

Hemodiafiltration (HDF) has been reported to improve nutritional intake, but as it increases convective losses, it could also increase micronutrient loss. We prospectively audited the effect of HDF on vitamin B12, zinc and selenium. Thirty‐four patients dialyzing (T/Th/Sa) switched to HDF, and 44 dialyzing (M/W/F) remained on high‐flux hemodialysis (HD) and were followed for 12 months. Dialysis adequacy, weight, hemoglobin, and serum albumin did not differ between the groups and did not change over 12 months’ follow up. Similarly, vitamin B12 did not differ: HDF, 443 (325–682) ng/mL HD vs. 478 (327–690) ng/mL HDF; 6 months, 513 (351–664) ng/mL vs. 460 (379–647) ng/mL; or 12 months, 444 (317–617) ng/mL vs. 492 (323–644) ng/mL. And no patient had subnormal values. Folate levels, in those not taking supplements, were also stable (start, 6.2 ± 0.7 μg/L HD vs. 7.2 ± 1.0 μg/L HDF; 12 months, 6.5 ± 0.9 μg/L vs. 10.9 ± 2.4 μg/L). Serum zinc was subnormal in 50% prior to switching to HDF, 10.4 ± 0.4 μmol/L, but did not fall with HDF 10.2 ± 0.3 μmol/L; similarly, selenium was low in 49% prior to switching to HDF, 0.77 ± 0.06 μmol/L, but remained stable on HDF, 0.82 ± 0.06 μmol/L. Although HDF adds convective clearance to standard hemodialysis, it does not lead to a reduction in vitamin B12, folate, zinc, or selenium. However, half of this dialysis cohort had low levels of both zinc and selenium.
Massive, painful tumoral calcinosis in a long‐term hemodialysis patient
Authors: CARVALHO Mauricio , de MENEZES Igor Alexandre Côrtes , RIELLA Miguel Carlos
Published: August 2011

In chronic dialysis patients, ectopic, extraosseous calcifications can cause significant morbidity. Uremic tumoral calcinosis is an uncommon and severe complication of dialysis therapy. It is defined as deposition of dense nodular calcium‐containing masses surrounding the large joints of the body, generally associated with the presence of high serum calcium‐and‐phosphorus product. We describe a 69‐year‐old woman submitted to long‐term chronic hemodialysis that developed painful, bilateral hip tumors. Radiographic investigation showed extensive periarticular calcifications, and a bone biopsy was suggestive of adynamic bone disease and contained substantial amounts of aluminum. The lesions were surgically excised, and the histological analysis demonstrated amorphous, calcified material associated with densely collagenized connective tissue.
Hemodialysis catheter infection with unusual presentation and grave outcome
Authors: GABALDON Darlene , XU Zhi , SUN Yijuan , SERVILLA Karen S. , HARTSHORNE Michael F. , TZAMALOUKAS Antonios H.
Published: August 2011

Bacteremia from central venous catheter (CVC) infection causes morbidity and mortality in patients on hemodialysis (HD). Diagnosis of the infection can be difficult and may require special imaging. A 70‐year‐old man with diabetic nephropathy was on HD for 11 months through a permanent CVC. Because of symptomatic osteoporosis, he had kyphoplasty in three lumbar vertebrae (L2, L3, L4) 6 months after starting HD. Severe back pain persisted after kyphoplasty. Throughout the HD period, the exit site of the CVC had a clean appearance, there was no fever, and blood leukocyte counts were normal. During the 11th month of HD, he complained of subjective fever at home. Blood count revealed normal leukocyte count with neutrophilic predominance and blood cultures grew methicillin‐resistant Staphylococcus aureus (MRSA). Echocardiogram revealed no heart valve vegetations, but irregular thickening of the CVC wall. Fluorodeoxyglucose positron‐emission tomography‐computed tomography (FDG‐PET‐CT) revealed severe inflammation of the CVC wall and a picture consistent with osteomyelitis and severe destruction of the body of the 11th thoracic vertebra. He was treated with intravenous vancomycin and removal of the CVC, the wall of which was grossly inflamed and grew in culture MRSA. Three weeks later, he discontinued HD because of persistent severe back pain. CVC infection with bacteremia and remote infectious foci having grave sequelae can develop in HD patients with paucity of clinical manifestations. FDG‐PET‐CT is a useful imaging tool in establishing the presence and extent of both the CVC infection and remote metastatic infectious foci.
Linking Procedural Justice to Turnover Intentions: A Longitudinal Study of the Mediating Effects of Perceived Job Characteristics
Authors: LI ANDREW , BAGGER JESSICA
Published: August 2011

The present study examined the mediating role of perceived job characteristics on the relationship between procedural justice and turnover intentions. The results of a longitudinal field study (N = 82) indicate that the relationship between procedural justice and turnover intentions was partially mediated by perceived job characteristics. Additionally, it was found that the mediating effects remained significant, even when controlling for negative affectivity. The implications of the findings for research and practice are discussed.
Psychiatric diagnosis in late adolescence and long‐term risk of suicide and suicide attempt
Authors: Lundin A. , Lundberg I. , Allebeck P. , Hemmingsson T.
Published: August 2011

Lundin A, Lundberg I, Allebeck P, Hemmingsson T. Psychiatric diagnosis in late adolescence and long‐term risk of suicide and suicide attempt.

Objective:  To investigate the associations between psychiatric diagnosis in late adolescence in an unselected population and subsequent suicide attempt and suicide during 36‐year follow‐up.

Method:  A total of 49 321 Swedish men conscripted for compulsory military training in 1969/1970, born 1949–1951, were screened for psychiatric disorder and, if detected, diagnosed by a psychiatrist according to ICD‐8. Data on suicides and suicide attempts 1971–2006 were collected in national registers.

Results:  At conscription examination, 11.7% of the cohort received a psychiatric diagnosis. Among those, increased risks of suicide 1971–2006 [HR = 2.7 (2.2–3.2), 624 cases] and suicide attempt 1973–2006 [HR = 3.5 (3.1–4.0), 1170 cases] were found. The increased relative risks persisted during the follow‐up period 19–36 years after examination [1989–2006 suicide HR = 2.1 (1.6–2.7), 308 cases, and 1989–2006 suicide attempt HR = 2.6 (2.1–3.1), 484 cases]. The dominant diagnostic groups, neurosis and personality disorder, were significantly associated with suicide and suicide attempt in the early as well as the late follow‐up period.

Conclusion:  Psychiatric diagnoses made in late adolescence predicted subsequent suicide and suicide attempt over a 36‐year follow‐up period. The increased relative risks were not limited to young adulthood but were also evident 18–36 years after conscription examination.
The oral microbiome in health and disease and the potential impact on personalized dental medicine
Authors: Zarco MF , Vess TJ , Ginsburg GS
Published: August 2011

Oral Diseases (2012) 18, 109–120

Every human body contains a personalized microbiome that is essential to maintaining health but capable of eliciting disease. The oral microbiome is particularly imperative to health because it can cause both oral and systemic disease. The oral microbiome rests within biofilms throughout the oral cavity, forming an ecosystem that maintains health when in equilibrium. However, certain ecological shifts in the microbiome allow pathogens to manifest and cause disease. Severe forms of oral disease may result in systemic disease at different body sites. Microbiomics and metagenomics are two fields of research that have emerged to identify the presence of specific microbes in the body and understand the nature of the microbiome activity during both health and disease. The analysis of the microbiome and its genomes will pave the way for more effective therapeutic and diagnostic techniques and, ultimately, contribute to the development of personalized medicine and personalized dental medicine.
Is Peripheral Blood Cell Balanced Altered by the Use of Fresh Frozen Bone Block Allografts in Lateral Maxillary Ridge Augmentation?
Authors: Spin Neto Rubens , Felipe Leite Coletti , Pereira Luis Antonio Violin Dias , Marcantonio Elcio , Marcantonio Jr Elcio
Published: August 2011

Background: The relationship between the immune response and red and white blood cell homeostasis is cited in literature, but no studies regarding the balance of these cell populations following maxillary bone‐graft surgeries can be found.

Aim: The aim of this study was to evaluate the possible impairments in the blood cell balance following fresh–frozen allogeneic bone‐graft augmentation procedures in patients who needed maxillary reconstruction prior to implants.

Material and Methods: From 33 patients elected to onlay bone grafting procedures, 20 were treated with fresh–frozen bone allografts and 13 with autologous bone grafts. Five blood samples were collected from each patient in a 6‐month period (baseline: 14, 30, 90, and 180 days postsurgery), and the hematological parameters (erythrogram, leukogram, and platelets count) were accessed.

Results: All evaluated parameters were within the reference values accepted as normal, and significant differences were found for the eosinophils count when comparing the treatments (30 days, p = .035) and when comparing different periods of evaluation (allograft‐treated group, baseline × 180 days, p ≤ .05 and 90 × 180 days, p ≤ .01; autograft‐treated group, 30 × 90 days, p ≤ .05 and 30 × 180 days, p ≤ .05).

Conclusions: Both autologous and fresh–frozen allogeneic bone grafts did not cause any impairment in the red and white blood cell balance, based on quantitative hemogram analysis, in patients subjected to maxillary reconstruction.
Localized amyloids important in diseases outside the brain – lessons from the islets of Langerhans and the thoracic aorta
Authors: Westermark Gunilla T. , Westermark Per
Published: August 2011

It has long been understood that amyloids can be lethal in systemic diseases. More recently, it has been accepted that local cerebral aggregation of the small peptide Aβ is involved in the pathogenesis of Alzheimer’s disease. Protein aggregation, with the generation of small amyloid deposits in specific organs, also occurs outside the central nervous system and often is associated with increased cell death. In this review, we discuss two lesser known but common localized amyloid fibril‐forming proteins: the polypeptide hormone islet amyloid polypeptide (IAPP) and the lactadherin‐derived peptide medin. IAPP aggregates and induces the depletion of islet β‐cells in type 2 diabetes and in islets transplanted into type 1 diabetic subjects. Initial amyloid deposition occurs intracellularly and parts of this amyloid consist of proIAPP. Medin derived from lactadherin expressed by smooth muscle cells aggregates into amyloid in certain arteries, particularly the thoracic aortic media layer, and may have a role in the generation of the potentially lethal conditions of thoracic aortic aneurysm and dissection.