bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods for reducing peak pressure in laparoscopic grasping
Authors: Bos Jasper , Doornebosch Ernst WLJ , Engbers Josco G , Nyhuis Ole , Dodou Dimitra
Published: September 2013

During tissue retraction with a laparoscopic grasper, tissue-damaging pressures can occur. Past research suggests that peak pressures can be considerably reduced by rounding the edges or covering the tip of the end effector with a silicon sleeve. To identify grasping methods that limit tissue damage, the effects of (a) Young’s modulus of the end effector, (b) curvature of the end effector, and (c) angle with which the tissue is pulled relative to the plane of the end effector, on the pressure generated on the tissue were investigated. Artificial skin was placed between two non-serrated jaws, a pressure-sensitive film was interposed between the skin and upper jaw, and the end effector was loaded with 13 N. End effectors with Young’s moduli of 0.09, 0.67, 1.49 MPa, and 69 GPa, and with non-rounded and 5 mm rounded edges were tested under pulling angles of 25°, 50°, and 75°. For non-rounded end effectors, the maximum pressure and the area across which pressure exceeded the safety threshold for tissue damage increased with Young’s modulus and pulling angle. For rounded end effectors, maximum pressure did not increase monotonically with Young’s modulus. Instead, the end effector with the second lowest Young’s modulus yielded significantly lower maximum pressure than the end effector with the lowest Young’s modulus. For rounded end effectors, pressures were below the safety threshold for all Young’s moduli. This indicates that to prevent tissue damage, soft graspers may not be needed; rounding the edges of metal graspers could suffice for preventing tissue damage.
A hotbed of medical innovation: George Kellie (1770–1829), his colleagues at Leith and the Monro–Kellie doctrine
Authors: Macintyre Iain
Published: September 2013

The Monro–Kellie doctrine is named after two Scottish doctors, the well-known Alexander Monro secundus and George Kellie, whose life and work has not previously been described in detail. After service as a naval surgeon, Kellie followed his father into a career as a surgeon in the port of Leith, near Edinburgh. His publications show him to be a compassionate and observant doctor, ready to question established concepts. He worked closely with surgical colleagues in the town, some of whom made important contributions in their own right. The paper which led to eponymous fame was based on post-mortem observations on the volume of blood in the cerebral blood vessels, which led him to conclude that a change in volume of one intracranial constituent must be compensated by a reciprocal change in the others. He collaborated with Monro in this work but the doctrine was disseminated by another colleague, John Abercrombie, in his widely read book on neuropathology. Kellie achieved recognition within the local medical community. The doctrine which bears his name remains fundamental to our understanding of pressure and volume relationships within the cranium.
Augustus Bozzi Granville (1783–1872): Pioneer obstetrician and gynaecological surgeon who performed the first scientific autopsy of a mummy
Authors: Harer W Benson , Tapp Eddie
Published: September 2013

AB Granville was a pioneer obstetrician and gynaecologic surgeon who performed the world’s first myomectomy and the first ovariotomy in England. He also performed the first scientific autopsy of an Egyptian mummy, discovering the oldest known ovarian tumour. He thought it was malignant and caused her death from ‘ovarian dropsy’. This study reveals the tumour to be a benign cystadenoma. Further analysis indicates she died from terminal pneumonia from tuberculosis.
Post-Green Revolution Agro-entrepreneurship among Capitalist Farmers in Indian Punjab and Andhra Pradesh
Authors: Singh Sukhpal
Published: September 2013

Indian agriculture has undergone substantial changes due to the phenomenon of Green Revolution of the 1960s and the 1970s resulting in accumulation of agrarian surpluses in many regions. This article examines the conversion of such surpluses into commercial and industrial capital in terms of agro-entrepreneurship and diversification among commercial farmers of the Green Revolution era within specific contexts of the states of Punjab and Andhra Pradesh. It compares and contrasts the nature of this agro-entrepreneurship between the two states in terms of patterns of mobility and social and cultural factors and their significance in understanding the rural social change from a business history perspective. The article infers, from this experience, implications for understanding processes and hurdles in transition from agriculture to agribusiness for such rural entrepreneurs.
A Study of Human Resource Development Climate in Government Health Centres in India
Authors: Purohit Bhaskar , Verma R.K.
Published: September 2013

While Human Resource Management (HRM) has gained significant importance in healthcare, very few studies have focused at assessing the Human Resource Development (HRD) climate at the organizational level in Public Healthcare Delivery Centres. The present study is aimed as assessing the HRD climate in Public Health Centres consisting of Primary Health Centres (PHCs), Community Health Centres (CHCs) and District Hospitals (DHs) in two districts of India.

The assessment is based on perception of 42 Medical Officers (MOs) about the overall importance given to various dimensions of the HRD climate. The study instrument measured 10 HRD dimensions. The instrument had 27 statements that were based on a 5-point Likert scale. Each statement represented one of the 10 HRD dimensions and higher averages/score indicated a better perception of the HRD climate for that particular dimension.

The study findings indicate that ‘Participation’ is given the least importance followed by ‘Succession Planning’. The study also found that ‘Rewards and Welfare’ was perceived to be given the highest importance. It can be concluded that the overall HRD climate from the viewpoint of MOs needs improvement. Such improvements are possible if there is a genuine focus in development of people and if there is a dedicated HRD Department in the Health System that treats various sub systems of HR like appraisal, counselling, rewards and welfare, etc., as interdependent rather than independent.
Development in Bihar: Predicaments and Prospects of Health Indices
Authors: Kumar Manish , Raj Aditya
Published: September 2013

The article aims at understanding the developmental process in Bihar and compares is the same with the national average. After a general comparison of developmental discourse, the focus in on health challenges. We look at the health indicators and delineate the sociological reasons for their poor accountability. We feel that lack of investment in health infrastructure and human resource; meagre program implementation and lack of monitoring and regulatory mechanisms; along with inertia for change from unhealthy social practices are the reasons for Bihar’s poor performance. Nevertheless, we feel that Bihar has huge potential and the province has in itself the potential to overcome all hurdles for a better tomorrow.
Investing in Company Wellness Programs: Does it make Financial Sense?
Authors: Kocakülâh Mehmet C. , Cherry Andrew , Morris Jan Taylor
Published: September 2013

Wellness programs have been adopted to impede the rising cost of providing employees with health benefits. Studies indicate that 50 per cent of corporate profits go for health care costs versus only 7 percent three decades ago. Though the spike was caused by just a handful of employees, management viewed the spike as a harbinger of future problems unless steps were taken to control the claims. Their case was not unique, nor was their solution. In response to the rising health care costs, companies responded with company wellness programs. To encourage employee participation in wellness based programs, companies have offered incentives to employees. With the current laws backing incentive-laden wellness programs, companies have the flexibility they need to implement and execute their wellness goals. The monetary benefit of participation acts as a carrot to lure people into the programme and it appears to be working. A study revealed that cost savings were greater when incentives were used to encourage participation.

In this study, we explore one company’s wellness program and analyze the investment it has made in the wellness of its employees. We make the assumption, based on western economic models, that companies are concerned with the cost of company expenditures and their future return on investment (ROI).
Exploring the Perspectives of Obese Adolescent Girls
Authors: Chung Richard J. , Sherman Laura , Goodman Elizabeth , Bickham David S. , Rich Michael
Published: September 2013

To understand obese adolescent girls’ perspectives regarding their weight and health we studied video intervention/prevention assessment audiovisual narratives created by 14 obese girls ages 12 to 20 years. The narratives included interviews, monologues, and daily activities. Themes included illness conceptualizations, health concerns, health misinformation, and distress regarding appearance deriving from both within and without. The predominant theme was ambivalence about obesity. Close examination of these themes revealed potential footholds for intervention. Sensitive exploration of issues such as appearance and psychosocial distress might strengthen the patient–clinician partnership in identifying a patient’s strengths and motivating weight loss.
Heterosexual Gender Relations In and Around Childhood Risk and Safety
Authors: Brussoni Mariana , Olsen Lise L. , Creighton Genevieve , Oliffe John L.
Published: September 2013

Injuries are a leading cause of child death, and safety interventions frequently target mothers. Fathers are largely ignored despite their increasing childcare involvement. In our qualitative study with 18 Canadian heterosexual couples parenting children 2 to 7 years old, we examined dyadic decision making and negotiations related to child safety and risk engagement in recreational activities. Parents viewed recreation as an important component of men’s childcare, but women remained burdened with mundane tasks. Most couples perceived men as being more comfortable with risk than women, and three negotiation patterns emerged: fathers as risk experts; mothers countering fathers’ risk; and fathers acknowledging mothers’ safety concerns but persisting in risk activities. Our findings suggest that contemporary involved fathering practices privilege men in the outdoors and can erode women’s control for protecting children from unintentional injury. We recommend promoting involved fathering that empowers both parents and developing injury-prevention strategies incorporating both fathers’ and mothers’ perspectives.
Narratives of Science Outreach in Elite Contexts of Academic Science
Authors: Johnson David R. , Ecklund Elaine Howard , Lincoln Anne E.
Published: September 2013

Using data from interviews with 133 physicists and biologists working at elite research universities in the United States, we analyze narratives of outreach. We identify discipline-specific barriers to outreach and gender-specific rationales for commitment. Physicists view outreach as outside of the scientific role and a possible threat to reputation. Biologists assign greater value to outreach, but their perceptions of the public inhibit commitment. Finally, women are more likely than men to participate in outreach, a commitment that often results in peer-based informal sanctions. The study reveals how the cultural properties of disciplines, including the status of women, shape the meaning and experience of science outreach.
A Microgenetic Analysis of Classroom Discussion Practices
Authors: Vogler Jane S. , Schallert Diane L. , Park Yangjoo , Song Kwangok , Chiang Yueh-hui Vanessa , Jordan Michelle E. , Lee SoonAh , Cheng An-Chih Janne , Lee Ji-Eun , Park Jeong-bin , Sanders Anke J. Z.
Published: September 2013

Unlike previous research on computer-mediated discussions that has focused analysis on the final conversation as a completed product, this study was focused on the process by which the conversation was created. Using screen-capturing software, the on-screen actions of the nine participants in an online classroom discussion were recorded and analyzed for evidence of reading, writing, and thinking processes. Retrospective interviews were conducted with three of the student participants for additional insights into these processes. A triangulation of data sources revealed participants engaged in at least three distinct patterns of reading, writing, and thinking, with some participants fluidly moving between these patterns throughout the conversation. The three patterns were described as follows: (a) a methodical reading of most messages, and composing of responses occurring as the reader/writer thinks of it; (b) a coordination of reading, thinking, and writing, with careful revisiting of messages already read and deliberate crafting of responses; and (c) a complex orchestration of processes, with several reading resources consulted in addition to the conversation’s unfolding messages as well as composing processes that were interleaved with thinking and reading. This study provides clear evidence that the experiences of individuals in the same online conversation can vary considerably even as they contribute to a co-constructed publicly shared conversation.
Failure of efficacy and adverse events associated with dose-intense diminazene diaceturate treatment of chronic Cytauxzoon felis infection in five cats
Authors: Lewis Kristin M , Cohn Leah A , Marr Henry S , Birkenheuer Adam J
Published: September 2013

Cytauxzoon felis is a hemoprotozoan parasite of cats. While many infected cats die of acute illness, some enter a chronic carrier state. To date, no treatment has been documented to clear the chronic carrier state, leaving recovered cats to act as a potential indirect source of infection via a tick vector. Diminazene diaceturate is an anti-protozoal therapy that has been suggested for use in the treatment of acute cytauxzoonosis, but which failed to clear the carrier state at the dose used in acute illness. We hypothesized that a dose-intensified regimen of diminazene could reduce or eliminate parasitemia from five domestic cats naturally infected with C felis. Cats were administered 4 mg/kg of diminazene diaceturate intramuscularly for 5 consecutive days. Clearance of the organism was assessed via semi-quantitative polymerase chain reaction and light microscopy 1, 3, 6 and 10 weeks after starting treatment. Additionally, cats were monitored for adverse drug reactions by daily observation and examination. Complete blood count, biochemical profile and urinalysis were performed at 1, 3 and 10 weeks. Adverse events were common and included profuse salivation and nausea at the time of injection, monoparesis in the injected leg, proteinuria and potential hepatotoxicity. Severity of parasitemia was not reduced. Diminazene diaceturate cannot be recommended for elimination of the carrier state of C felis infection.
Aberrant expression of sLex and sLea as candidate prognostic factors for feline mammary gland tumour
Authors: Yoshida Saori , Yoshida Kota , Jaroensong Tassanee , Lee Soo-Jung , Kamida Ayako , Saeki Kohei , Fujita Naoki , Nishimura Ryohei , Sasaki Nobuo , Nakagawa Takayuki
Published: September 2013

Expression of the carbohydrate antigens sialyl Lewis x (sLex) and a (sLea) was evaluated in feline mammary gland tumours (FMGT). Immunohistochemical analysis of tissues from 21 FMGT patients and 11 healthy cats revealed significantly higher sLex and sLea antigen expression in adenocarcinoma tissues compared with that of normal mammary tissues ( P <0.01). Serum concentration of sLex was evaluated using an enzyme-linked immunosorbent assay and was significantly higher in the 11 FMGT patients (4.71 ± 10.1 U/ml) than the 22 patients with other disease (2.69 ± 1.59 U/ml) ( P = 0.03) and the 22 healthy cats (3.71 ± 1.10 U/ml), although the latter difference was not significant. Although the number of cases examined in this study was small, our findings suggest that aberrant expression of sLe antigens may be induced by tumourigenesis in FMGT and that sLe antigens are potential prognostic tumour markers for FMGT.
A Functional Single Nucleotide Polymorphism -1562C>T in the Matrix Metalloproteinase-9 Promoter Is Associated With Type 2 Diabetes and Diabetic Foot Ulcers
Authors: Singh Kanhaiya , Agrawal Neeraj K. , Gupta Sanjeev K. , Singh Kiran
Published: September 2013

Impaired neovascularization is the hallmark of type 2 diabetes, which results in various macro- and microvascular complications and the development of foot ulcerations later in life. Matrix metalloproteinases (MMPs) are the key enzymes which influence matrix remodeling. Here, we aim to investigate that whether single nucleotide polymorphism (SNP -1562C>T) (rs3918242) in the promoter region of MMP-9 gene, which alters the transcriptional activity of MMP-9 is associated with type 2 diabetes and diabetic foot ulcers (DFUs). This case–control study was composed of 730 individuals, out of which 463 patients were with type 2 diabetes mellitus (T2DM) and 267 were nondiabetic healthy controls (non-DM controls). T2DM patients were subclassified as 149 cases without any secondary complications (T2DMNSC), 110 with DFUs, 204 T2DM patients having one or the other secondary complications. Genotyping for -1562C>T SNP in MMP-9 gene was done by polymerase chain reaction–restriction fragment length polymorphism method and sequencing. SNP -1562C>T of MMP-9 gene showed a significant association with T2DM and DFU. The allele distribution differed significantly between patients and normal control group (odds ratio = 1.82, P = .00005, 95% confidence interval = 1.36-2.42 for T2DM vs control and odds ratio = 2.112, P = .00048, 95% confidence interval = 1.38-3.126 for DFU vs control) indicating strong association of SNP -1562C>T of MMP-9 gene with T2DM and DFU in an Indian population. SNP -1562C>T in the promoter of the MMP-9 gene results in increased expression at the level of the transcription. To the best of our knowledge, this is the first report that suggests that SNP -1562C>T in the promoter of the MMP-9 gene is associated with T2DM and DFU. An increased MMP-9 production from high expressing T allele may promote matrix degradation.
Unilateral Livedoid Vasculopathy Associated With Involutional Phase of Cutaneous Infantile Hemangioma
Authors: Criado Paulo Ricardo , Alavi Afsaneh , Halpern Ilana , Sotto Mirian Nacagami , Kirsner Robert S.
Published: September 2013

Livedoid vasculopathy is a bilateral painful and recurrent cutaneous ulcerative disorder of the legs that leads to atrophie blanche, atrophic white-porcelain scars, and is associated with disorders of fibrinolysis and/or coagulation. We present a young boy with an association between livedoid vasculopathy in the area of a previous involuted cutaneous hemangioma. We found 4 uncommon abnormalities associated with thrombo-occlusive events: heterozygous 20210 A→G genotype of prothrombin, reduced activity of anticoagulation proteins C and S, and elevated lipoprotein (a).
Current evidence for thoracic aorta type B dissection management
Authors: Capoccia Laura , Riambau Vicente
Published: September 2013

Aortic dissection is a devastating cardiovascular condition and represents the most common aortic emergency. Outcome is determined by the type and extent of dissection and the presence of associated complications requiring early diagnosis and treatment. Aortic dissection is defined as acute within 14 days from onset and chronic after that time period. The natural course of type B dissection is determined by 2 elements, early and chronic complications. An uncomplicated acute type B dissection is less frequently lethal but it is not totally benign. Some peculiar issues must be taken into account, such as the high probability of complications development in a dissected aorta and the poor long-term prognosis on medical treatment alone. Then, it would be helpful to identify which patients with uncomplicated type B dissection will have a poorest aortic prognosis over time in order to apply an early intervention.
Exposure to anti- and pro-tobacco advertising, promotions or sponsorships: Turkey, 2008
Authors: Erguder Toker , Bilir Nazmi , Özcebe Hilal , Irmak Hasan , Tasti Enver , İlter Hüseyin , Palipudi Krishna M. , Andes Linda J. , Asma Samira , Khoury Rula N. , Talley Brandon
Published: September 2013

Introduction:

In 2008, Turkey became one of 26 countries with a complete ban on all forms of direct and indirect tobacco marketing. We assessed the level of exposure to anti- and pro-cigarette advertising and to cigarette promotions and sponsorships among various demographic groups in Turkey.

Methods:

We used the data from the Global Adult Tobacco Survey (GATS), conducted in November 2008 in Turkey. The data consist of answers to GATS questions by 9030 respondents from a nationally representative, multistage probability sample of adults 15 years of age or older. To find differences in exposure to the advertising by sex, age, education level and smoking status, we analyzed responses to GATS questions about cigarette advertisements and anti-cigarette smoking information in various forms and through various advertising channels, during the 30 days before the survey, using bivariate analysis.

Results:

Overall, 13.3% of respondents aged 15 years or older noticed some type of cigarette marketing during the 30 days before the survey: 7.1% saw advertisements, 5.3% saw promotions and 3.3% saw sports sponsorships. Men were more likely than women to have seen cigarette promotions (7.8% versus 3.0%) and sports sponsorships (5.3% versus 1.4%). Respondents aged 15–24 years were more likely than those aged 25 years or older to have seen cigarette advertisements (10.2% versus 6.2%), promotions (8.7% versus 4.4%) and sponsorships (6.6% versus 2.3%), respectively. Respondents were most likely to have seen cigarette advertisements on television (3.4%) or in shops (2.7%). In addition, 2.8% of respondents reported seeing a clothing item with a brand name or logo, 2.5% reported that they received free samples of cigarettes and 0.3% received gifts along with the purchase of cigarettes. Almost 9 of 10 survey respondents (88.8%) reported having noticed some anti-cigarette information during the 30 days before the survey. Most anti-cigarette information was seen on television (85.5%). The anti-cigarette information was seen by slightly more cigarette smokers (91.6%) than nonsmokers (87.6%). Persons with less than a primary education were less likely to notice anti-cigarette information than those with a higher level of education, in all examined media channels.

Conclusions:

Our findings showed a low prevalence of noticing cigarette marketing, which indicates high compliance with the Turkish law banning such marketing. GATS data provide an in-depth understanding of the level of exposure to pro- and anti-cigarette information in 2008 and they are of practical assistance to those who implement policies to reduce the demand for tobacco. The challenge now is to maintain rigorous enforcement. To do so requires ongoing surveillance to produce data on the effectiveness of the enforcement efforts.
Recruiting and Retaining Black Teachers to Work in Urban Schools
Authors: Evans Brian R. , Leonard Jacqueline
Published: September 2013

The purpose of this article is to examine teacher preparation from the perspective of novice Black teachers. While all teachers, regardless of race, can be trained to be effective teachers of Black students, Black teachers can be more adept at motivating and engaging students of color. Six Black teachers were interviewed to determine their experiences during teacher preparation and induction. Findings revealed the teachers believed their programs were high quality and prepared them well to teach in urban spaces, but some expressed concern about the swift immersion into the classroom.
The potential impact on obesity of a 10% tax on sugar-sweetened beverages in Ireland, an effect assessment modelling study
Authors: Briggs Adam DM , Mytton Oliver T , Madden David , O’Shea Donal , Rayner Mike , Scarborough Peter
Published: September 2013

Background

Some governments have recently shown a willingness to introduce taxes on unhealthy foods and drinks. In 2011, the Irish Minister for Health proposed a 10% tax on sugar sweetened beverages (SSBs) as a measure to combat childhood obesity. Whilst this proposed tax received considerable support, the Irish Department of Finance requested a Health Impact Assessment of this measure. As part of this assessment we set out to model the impact on obesity.

Methods

We used price elasticity estimates to calculate the effect of a 10% SSB tax on SSB consumption. SSBs were assumed to have an own-price elasticity of −0.9 and we assumed a tax pass-on rate to consumers of 90%. Baseline SSB consumption and obesity prevalence, by age, sex and income-group, for Ireland were taken from the 2007 Survey on Lifestyle and Attitude to Nutrition. A comparative risk assessment model was used to estimate the effect on obesity arising from the predicted change in calorie consumption, both for the whole population and for sub-groups (age, sex, income). Sensitivity analyses were conducted on price-elasticity estimates and tax pass-on rates.

Results

We estimate that a 10% tax on SSBs will result in a mean reduction in energy intake of 2.1 kcal/person/day. After adjustment for self-reported data, the 10% tax is predicted to reduce the percentage of the obese adult population (body mass index [BMI] ≥30 kg/m2) by 1.3%, equating to 9,900 adults (95% credible intervals: 7,750 to 12,940), and the overweight or obese population (BMI ≥ 25 kg/m2) by 0.7%, or 14,380 adults (9,790 to 17,820). Reductions in obesity are similar for men (1.2%) and women (1.3%), and similar for each income group (between 1.1% and 1.4% across income groups). Reductions in obesity are greater in young adults than older adults (e.g. 2.9% in adults aged 18–24 years vs 0.6% in adults aged 65 years and over).

Conclusions

This study suggests that a tax on SSBs in Ireland would have a small but meaningful effect on obesity. While such a tax would be perceived as affecting the whole population, from a health prospective the tax will predominantly affect younger adults who are the main consumers of SSBs.
A detailed phenotypic analysis of immune cell populations in the bronchoalveolar lavage fluid of atopic asthmatics after segmental allergen challenge
Authors: Boomer Jonathan S , Parulekar Amit D , Patterson Brenda M , Yin-Declue Huiqing , Deppong Christine M , Crockford Seth , Jarjour Nizar N , Castro Mario , Green Jonathan M
Published: September 2013

Background

Atopic asthma is characterized by intermittent exacerbations triggered by exposure to allergen. Exacerbations are characterized by an acute inflammatory reaction in the airways, with recruitment of both innate and adaptive immune cells. These cell populations as well as soluble factors are critical for initiating and controlling the inflammatory processes in allergic asthma. Detailed data on the numbers and types of cells recruited following allergen challenge is lacking. In this paper we present an extensive phenotypic analysis of the inflammatory cell infiltrate present in the bronchoalveolar lavage (BAL) fluid following bronchoscopically directed allergen challenge in mild atopic asthmatics.

Methods

A re-analysis of pooled data obtained prior to intervention in our randomized, placebo controlled, double blinded study (costimulation inhibition in asthma trial [CIA]) was performed. Twenty-four subjects underwent bronchoscopically directed segmental allergen challenge followed by BAL collection 48 hours later. The BAL fluid was analyzed by multi-color flow cytometry for immune cell populations and multi-plex ELISA for cytokine detection.

Results

Allergen instillation induced pro-inflammatory cytokines (IL-6) and immune modulating cytokines (IL-2, IFN-γ, and IL-10) along with an increase in lymphocytes and suppressor cells (Tregs and MDSC). Interestingly, membrane expression of CD30 was identified on lymphocytes, especially Tregs, but not eosinophils. Soluble CD30 was also detected in the BAL fluid after allergen challenge in adult atopic asthmatics.

Conclusions

After segmental allergen challenge of adult atopic asthmatics, cell types associated with a pro-inflammatory as well as an anti-inflammatory response are detected within the BAL fluid of the lung.
A 17 year old male with a testicular fibrothecoma: a case report
Authors: Sourial Michael-Wadih , Sabbagh Robert , Doueik Alexandre , Ponsot Yves
Published: September 2013

We herein report the case of a right-sided testicular fibrothecoma in a 17 year old male and review the pertinent literature relatable to this rare, benign lesion.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7738283021019280.
Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography
Authors: Gutekunst David J , Liu Lu , Ju Tao , Prior Fred W , Sinacore David R
Published: September 2013

Background

Surgical treatment and clinical management of foot pathology requires accurate, reliable assessment of foot deformities. Foot and ankle deformities are multi‐planar and therefore difficult to quantify by standard radiographs. Three‐dimensional (3D) imaging modalities have been used to define bone orientations using inertial axes based on bone shape, but these inertial axes can fail to mimic established bone angles used in orthopaedics and clinical biomechanics. To provide improved clinical relevance of 3D bone angles, we developed techniques to define bone axes using landmarks on quantitative computed tomography (QCT) bone surface meshes. We aimed to assess measurement precision of landmark‐based, 3D bone‐to‐bone orientations of hind foot and lesser tarsal bones for expert raters and a template‐based automated method.

Methods

Two raters completed two repetitions each for twenty feet (10 right, 10 left), placing anatomic landmarks on the surfaces of calcaneus, talus, cuboid, and navicular. Landmarks were also recorded using the automated, template‐based method. For each method, 3D bone axes were computed from landmark positions, and Cardan sequences produced sagittal, frontal, and transverse plane angles of bone‐to‐bone orientations. Angular reliability was assessed using intraclass correlation coefficients (ICCs) and the root mean square standard deviation (RMS‐SD) for intra‐rater and inter‐rater precision, and rater versus automated agreement.

Results

Intra‐ and inter‐rater ICCs were generally high (≥ 0.80), and the ICCs for each rater compared to the automated method were similarly high. RMS‐SD intra‐rater precision ranged from 1.4 to 3.6° and 2.4 to 6.1°, respectively, for the two raters, which compares favorably to uni‐planar radiographic precision. Greatest variability was in Navicular: Talus sagittal plane angle and Cuboid: Calcaneus frontal plane angle. Precision of the automated, atlas‐based template method versus the raters was comparable to each rater's internal precision.

Conclusions

Intra‐ and inter‐rater precision suggest that the landmark‐based methods have adequate test‐retest reliability for 3D assessment of foot deformities. Agreement of the automated, atlas‐based method with the expert raters suggests that the automated method is a valid, time‐saving technique for foot deformity assessment. These methods have the potential to improve diagnosis of foot and ankle pathologies by allowing multi‐planar quantification of deformities.
Breast cancer receptor status and stage at diagnosis in over 1,200 consecutive public hospital patients in Soweto, South Africa: a case series
Authors: McCormack Valerie A , Joffe Maureen , van den Berg Eunice , Broeze Nadine , dos Santos Silva Isabel , Romieu Isabelle , Jacobson Judith S , Neugut Alfred I , Schüz Joachim , Cubasch Herbert
Published: September 2013

Introduction

Estimates of the proportion of estrogen receptor negative (ERN) and triple-negative (TRN) breast cancer from sub-Saharan Africa are variable and include high values. Large studies of receptor status conducted on non-archival tissue are lacking from this region.

Methods

We identified 1218 consecutive women (91% black) diagnosed with invasive breast cancer from 2006–2012 at a public hospital in Soweto, South Africa. Immunohistochemistry based ER, progesterone receptor (PR) and human epidermal factor 2 (HER2) receptors were assessed at diagnosis on pre-treatment biopsy specimens. Mutually adjusted associations of receptor status with stage, age, and race were examined using risk ratios (RRs). ER status was compared with age-stratified US Surveillance Epidemiology and End Results program (SEER) data.

Results

35% (95% confidence interval (CI): 32–38) of tumors were ERN, 47% (45–52) PRN, 26% (23–29) HER2P and 21% (18–23) TRN. Later stage tumors were more likely to be ERN and PRN (RRs 1.9 (1.1-2.9) and 2.0 (1.3-3.1) for stage III vs. I) but were not strongly associated with HER2 status. Age was not strongly associated with ER or PR status, but older women were less likely to have HER2P tumors (RR, 0.95 (0.92-0.99) per 5 years). During the study, stage III + IV tumors decreased from 66% to 46%. In black women the percentage of ERN (37% (34–40)) and PRN tumors (48% (45–52)) was higher than in non-black patients (22% (14–31) and 34% (25–44), respectively, P = 0.004 and P = 0.02), which remained after age and stage adjustment. Age-specific ERN proportions in black South African women were similar to those of US black women, especially for women diagnosed over age 50.

Conclusion

Although a greater proportion of black than non-black South African women had ER-negative or TRN breast cancer, in all racial groups in this study breast cancer was predominantly ER-positive and was being diagnosed at earlier stages over time. These observations provide initial indications that late-stage aggressive breast cancers may not be an inherent feature of the breast cancer burden across Africa.
The non-coding snRNA 7SKcontrols transcriptional termination, poising, and bidirectionality in embryonic stem cells
Authors: Castelo-Branco Gonçalo , Amaral Paulo P , Engström Pär G , Robson Samuel C , Marques Sueli C , Bertone Paul , Kouzarides Tony
Published: September 2013

Background

Pluripotency is characterized by a unique transcriptional state, in which lineage-specification genes are poised for transcription upon exposure to appropriate stimuli, via a bivalency mechanism involving the simultaneous presence of activating and repressive methylation marks at promoter-associated histones. Recent evidence suggests that other mechanisms, such as RNA polymerase II pausing, might be operational in this process, but their regulation remains poorly understood.

Results

Here we identify the non-coding snRNA 7SK as a multifaceted regulator of transcription in embryonic stem cells. We find that 7SK represses a specific cohort of transcriptionally poised genes with bivalent or activating chromatin marks in these cells, suggesting a novel poising mechanism independent of Polycomb activity. Genome-wide analysis shows that 7SK also prevents transcription downstream of polyadenylation sites at several active genes, indicating that 7SK is required for normal transcriptional termination or control of 3′-UTR length. In addition, 7SK suppresses divergent upstream antisense transcription at more than 2,600 loci, including many that encode divergent long non-coding RNAs, a finding that implicates the 7SK snRNA in the control of transcriptional bidirectionality.

Conclusions

Our study indicates that a single non-coding RNA, the snRNA 7SK, is a gatekeeper of transcriptional termination and bidirectional transcription in embryonic stem cells and mediates transcriptional poising through a mechanism independent of chromatin bivalency.
Pleiotropic effects of cancer cells’ secreted factors on human stromal (mesenchymal) stem cells
Authors: Al-toub Mashael , Almusa Abdulaziz , Almajed Mohammed , Al-Nbaheen May , Kassem Moustapha , Aldahmash Abdullah , Alajez Nehad M
Published: September 2013

Introduction

Studying cancer tumors’ microenvironment may reveal a novel role in driving cancer progression and metastasis. The biological interaction between stromal (mesenchymal) stem cells (MSCs) and cancer cells remains incompletely understood. Herein, we investigated the effects of tumor cells’ secreted factors as represented by a panel of human cancer cell lines (breast (MCF7 and MDA-MB-231); prostate (PC-3); lung (NCI-H522); colon (HT-29) and head & neck (FaDu)) on the biological characteristics of MSCs.

Methods

Morphological changes were assessed using fluorescence microscopy. Changes in gene expression were assessed using Agilent microarray and qRT-PCR. GeneSpring 12.1 and DAVID tools were used for bioinformatic and signaling pathway analyses. Cell migration was assessed using a transwell migration system. SB-431542, PF-573228 and PD98059 were used to inhibit transforming growth factor β (TGFβ), focal adhesion kinase (FAK), and mitogen activated protein kinase kinase (MAPKK) pathways, respectively. Interleukin-1β (IL1β) was measured using ELISA.

Results

MSCs exposed to secreted factors present in conditioned media (CM) from FaDu, MDA-MB-231, PC-3 and NCI-H522, but not from MCF7 and HT-29, developed an elongated, spindle-shaped morphology with bipolar processes. In association with phenotypic changes, genome-wide gene expression and bioinformatics analysis revealed an enhanced pro-inflammatory response of those MSCs. Pharmacological inhibitions of FAK and MAPKK severely impaired the pro-inflammatory response of MSCs to tumor CM (approximately 80% to 99%, and 55% to 88% inhibition, respectively), while inhibition of the TGFβ pathway was found to promote the pro-inflammatory response (approximately 3-fold increase). In addition, bioinformatics and pathway analysis of gene expression data from tumor cell lines combined with experimental validation revealed tumor-derived IL1β as one mediator of the pro-inflammatory phenotype observed in MSCs exposed to tumor CM.

MSCs exhibited significant tropism toward secreted factors from the aforementioned tumor cell lines, while both normal and MSCs exposed to tumor CM were capable of attracting human peripheral blood mononuclear cells (PBMCs).

Conclusions

Our data revealed tumor-derived IL1β as one mediator of the pro-inflammatory response in MSCs exposed to tumor CM, which was found to be positively regulated by FAK and MAPK signaling and negatively regulated by TGFβ signaling. Thus, our data support a model where MSCs could promote cancer progression through becoming pro-inflammatory cells within the cancer stroma.
Randomized Controlled Trial of Intensity-Modulated Radiotherapy for Early Breast Cancer: 5-Year Results Confirm Superior Overall Cosmesis
Authors: Mukesh Mukesh B. , Barnett Gillian C. , Wilkinson Jennifer S. , Moody Anne M. , Wilson Charles , Dorling Leila , Chan Wah Hak Charleen , Qian Wendi , Twyman Nicola , Burnet Neil G. , Wishart Gordon C. , Coles Charlotte E.
Published: September 2013

Purpose

There are few randomized controlled trial data to confirm that improved homogeneity with simple intensity-modulated radiotherapy (IMRT) decreases late breast tissue toxicity. The Cambridge Breast IMRT trial investigated this hypothesis, and the 5-year results are reported.

Patients and Methods

Standard tangential plans of 1,145 trial patients were analyzed; 815 patients had inhomogeneous plans (≥ 2 cm3 receiving 107% of prescribed dose: 40 Gy in 15 fractions over 3 weeks) and were randomly assigned to standard radiotherapy (RT) or replanned with simple IMRT; 330 patients with satisfactory dose homogeneity were treated with standard RT and underwent the same follow-up as the randomly assigned patients. Breast tissue toxicities were assessed at 5 years using validated methods: photographic assessment (overall cosmesis and breast shrinkage compared with baseline pre-RT photographs) and clinical assessment (telangiectasia, induration, edema, and pigmentation). Comparisons between different groups were analyzed using polychotomous logistic regression.

Results

On univariate analysis, compared with standard RT, fewer patients in the simple IMRT group developed suboptimal overall cosmesis (odds ratio [OR], 0.68; 95% CI, 0.48 to 0.96; P = .027) and skin telangiectasia (OR, 0.58; 95% CI, 0.36 to 0.92; P = .021). No evidence of difference was seen for breast shrinkage, breast edema, tumor bed induration, or pigmentation. The benefit of IMRT was maintained on multivariate analysis for both overall cosmesis (P = .038) and skin telangiectasia (P = .031).

Conclusion

Improved dose homogeneity with simple IMRT translates into superior overall cosmesis and reduces the risk of skin telangiectasia. These results are practice changing and should encourage centers still using two-dimensional RT to implement simple breast IMRT.
Hospital Management of Outpatient Oncology Treatment Decisions: A Survey to Identify Strategies and Concerns
Authors: Li Edward , Schleif Ron , Edelen Bruce
Published: September 2013

There is active control, management, and restriction of outpatient oncology drugs by hospitals, a majority of which use a multidisciplinary team with active involvement by an oncologist.
Study of Imatinib Treatment Patterns and Outcomes Among US Veteran Patients With Philadelphia Chromosome–Positive Chronic Myeloid Leukemia
Authors: Vander Velde Nancy , Chen Lei , Guo Amy , Sharma Hari , Marynchenko Maryna , Wu Eric Q. , Liu Jinan , Yang Heidi , Shi Lizheng
Published: September 2013

The authors found that in this population, a substantial number of imatinib-treated patients, including those with disease progression, either discontinued or interrupted imatinib use without switching to other therapies.
Prevalence of Pain and Analgesic Use in Men With Metastatic Prostate Cancer Using a Patient-Reported Outcome Measure
Authors: Autio Karen A. , Bennett Antonia V. , Jia Xiaoyu , Fruscione Michael , Beer Tomasz M. , George Daniel J. , Carducci Michael A. , Logothetis Christopher J. , Kane Robert C. , Sit Laura , Rogak Lauren , Morris Michael J. , Scher Howard I. , Basch Ethan M.
Published: September 2013

The authors' results provide a method for estimating accruals along the disease continuum, and for enabling design of trials appropriately powered to assess pain.
“Stop Smoking!” Do We Say It Enough?
Authors: Hildebrand Jessica R. , Sastry Sangeeta
Published: September 2013

In spite of evidence that smoking cessation is beneficial even after the diagnosis of bronchogenic carcinoma, physicians are not counseling their patients sufficiently.
Hemogenic endothelium specification and hematopoietic stem cell maintenance employ distinct Scl isoforms
Authors: Zhen Fenghua , Lan Yahui , Yan Bo , Zhang Wenqing , Wen Zilong
Published: September 2013

Recent studies have shown that nascent hematopoietic stem cells (HSCs) derive directly from the ventral aortic endothelium (VAE) via endothelial to hematopoietic transition (EHT). However, whether EHT initiates from a random or predetermined subpopulation of VAE, as well as the molecular mechanism underlying this process, remain unclear. We previously reported that different zebrafish stem cell leukemia (scl) isoforms are differentially required for HSC formation in the ventral wall of the dorsal aorta. However, the exact stage at which these isoforms impact HSC development was not defined. Here, using in vivo time-lapse imaging of scl isoform-specific reporter transgenic zebrafish lines, we show that prior to EHT scl-β is selectively expressed in hemogenic endothelial cells, a unique subset of VAE cells possessing hemogenic potential, whereas scl-α is expressed later in nascent HSCs as they egress from VAE cells. In accordance with their expression, loss-of-function studies coupled with in vivo imaging analysis reveal that scl-β acts earlier to specify hemogenic endothelium, which is later transformed by runx1 into HSCs. Our results also reveal a previously unexpected role of scl-α in maintaining newly born HSCs in the aorta-gonads-mesonephros. Thus, our data suggest that a defined hemogenic endothelial population preset by scl-β supports the deterministic emergence of HSCs, and unravel the cellular mechanisms by which scl isoforms regulate HSC development.
Nonplanar and Dynamic Structures of 1,8-Anthrylene–Ethenylene Cyclic Dimers
Authors: Inoue Masataka , Iwanaga Tetsuo , Toyota Shinji
Published: September 2013

The title cyclic compounds, synthesized by cross-coupling reactions, have nonplanar frameworks, as revealed by X-ray analysis and DFT calculations. The barrier to exchange between the nonplanar structures of the mesityl derivative was determined to be 34 kJ mol−1 by a dynamic NMR method.
Trends in biological joint resurfacing
Authors: Myers K. R. , Sgaglione N. A. , Grande D. A.
Published: September 2013

The treatment of osteochondral lesions and osteoarthritis remains an ongoing clinical challenge in orthopaedics. This review examines the current research in the fields of cartilage regeneration, osteochondral defect treatment, and biological joint resurfacing, and reports on the results of clinical and pre-clinical studies. We also report on novel treatment strategies and discuss their potential promise or pitfalls. Current focus involves the use of a scaffold providing mechanical support with the addition of chondrocytes or mesenchymal stem cells (MSCs), or the use of cell homing to differentiate the organism’s own endogenous cell sources into cartilage. This method is usually performed with scaffolds that have been coated with a chemotactic agent or with structures that support the sustained release of growth factors or other chondroinductive agents. We also discuss unique methods and designs for cell homing and scaffold production, and improvements in biological joint resurfacing. There have been a number of exciting new studies and techniques developed that aim to repair or restore osteochondral lesions and to treat larger defects or the entire articular surface. The concept of a biological total joint replacement appears to have much potential.

Cite this article: Bone Joint Res 2013;2:193–9.
Software-Automated Counting of Ki-67 Proliferation Index Correlates With Pathologic Grade and Disease Progression of Follicular Lymphomas
Authors: Samols Mark A. , Smith Nathan E. , Gerber Jonathan M. , Vuica-Ross Milena , Gocke Christopher D. , Burns Kathleen H. , Borowitz Michael J. , Cornish Toby C. , Duffield Amy S.
Published: September 2013

Objectives:

To examine the accuracy of software-assisted measurement of the Ki-67 proliferation index (PI) and its correlation with the grade and clinical progression of follicular lymphoma (FL).

Methods:

High-power field equivalents were extracted from H&E- and Ki-67–immunostained slides of FL, and a nuclear quantitation algorithm was used to calculate a PI. Representative fields were manually counted for validation with close agreement.

Results:

The PI was significantly higher in World Health Organization grade 3 FL than grade 1 to 2 FL. Disease progression, as defined by subsequent treatment with radiation or cytotoxic chemotherapy, was also significantly associated with elevated PI but not pathologic grade.

Conclusions:

These data show that software-automated quantitation of Ki-67 can provide both a useful adjunct to pathologic grade in FL and improved prognostic information for patients.