bluuebunny/crossref_metadata_2025 huggingface dataset:
THE PAEDIATRIC OBSERVATION PRIORITY SCORE (POPS): A USEFUL TOOL TO PREDICT LIKELIHOOD OF ADMISSION FROM THE EMERGENCY DEPARTMENT
Authors: Kelly J , Rowland A G , Cotterill S , Lees H , Kamara M
Published: September 2013

Objectives & Background

No specific early warning score universally validated for use in all children presenting to the Emergency Department (ED) exists. POPS is a novel aggregate scoring system, designed for ED use.

Methods

Prospectively collected physiological and observational data were used to calculate POPS on 2068 patients aged under 16 presenting over one month to a UK District General Hospital Paediatric ED. Logistic regression was used to investigate the effect of POPS at first presentation on admission to hospital within the subsequent 72 hours.

Results

46% of patients were diagnosed with trauma and 54% with a medical condition. Mean age was 5.6 years (SD 4.6). 15.3% were admitted on first presentation. 76 re-presented within 72 hours of discharge from the ED and 19.7% were admitted. The mean POPS on first presentation was 0.87 (SD 1.58) overall (medical patients 1.03 (SD 1.70), trauma patients 0.68 (SD 1.41), p<0.001). POPS had a statistically significant positive effect on admission. A one point increase in POPS was associated with a 70% increase in the odds ratio (OR) of admission (p<0.001), with an area under the ROC of 0.72 (medical patients OR 1.67, area under ROC 0.73, p<0.001; trauma patients OR 1.77, area under ROC 0.69, p<0.001). The sensitivity and specificity of POPS to predict admission likelihood were: POPS≥2 (sensitivity 50%, specificity 85%), POPS≥3 (sensitivity 36%, specificity 93%).

Conclusion

POPS is a useful tool to predict the admission likelihood from the ED. POPS≥2 correctly predicts 50% of children who should be admitted and 85% of children who should be discharged. Multi-centre validation would help to refine POPS, increasing its sensitivity and specificity to admission likelihood, to improve the safety of discharge decisions and healthcare resource utilisation.
ESSENTIAL ETAT: ONE-DAY PAEDIATRIC RESUSCITATION TRAINING IN A RESOURCE-LIMITED SETTING
Authors: Dyer B , Pollock L , Morar N , Clarke E , Kampmann B , Anderson S
Published: September 2013

Objectives & Background

WHO ETAT training courses provide comprehensive training in paediatric emergency care over 3.5–5 days and have been shown to improve outcome in resource-limited settings. However, the logistics, cost and impact on local service delivery of a five-day course may limit training opportunities in some settings. In this context, we aimed to determine whether a shorter, more focused course would be feasible.

Methods

A one-day training course, ‘Essential ETAT’, was adapted from WHO ETAT training materials and included practical and lecture-based sessions on triage, cardiopulmonary resuscitation and recognition and management of key paediatric emergencies. Practical sessions in airway management, bag-valve-mask ventilation and intra-osseous needle insertion were included. A short manual summarizing ETAT guidelines was provided. Participants were all nurses or doctors working in primary or secondary care settings in The Gambia. The main outcome measure was participant knowledge, assessed by improvement in scores between pre and post-course multiple-choice tests. This was compared to similar data from a historical control group (n=76) who had completed standard 3.5 day ETAT training.

Results

57 participants completed the Essential ETAT one-day training course. Participants showed a significant improvement in post-course test scores; mean score pre-course 62.6% (95% CI 58.5–68.7%), post-course 78.4% (75.1–81.7%), p<0.0001. There was no significant difference in mean improvement in post-course test scores between Essential ETAT participants and the standard ETAT historical control (15.8% (12.1–19.5%) vs 14.7% (11.5–17.9%), p=0.67).

Conclusion

‘Essential ETAT’ was well received by participants and improvements in post-course test scores compared well to results from standard ETAT courses. Further evaluation is required to indicate whether knowledge is retained and changes clinical practice. Focused, short duration resuscitation training may offer a pragmatic and potentially cost-effective alternative to standard courses.
RESEARCH IN EMERGENCY CARE–THERE'S AN APP FOR THAT!
Authors: Crede A , Roland D , Alade J , Bryceland C , Lock R , Coats T
Published: September 2013

Objectives & Background

Many emergency medicine clinical trials have struggled to recruit to ‘time and target’ with investigators having to make a large additional effort or extend the time for recruitment. This study was performed to describe our experience in the use of a computer ‘app’ to facilitate the process of research subject identification and communication between the ED staff and the research team. Key questions were:

1) Does the introduction of an iPad ‘app’ result in a greater rate of patient notification to the research team?

2) Which type of notification method was most used?

Methods

An observational ‘before and after' study was performed where ED staff had the choice of using a telephone ‘research hotline', verbal notification, a sticky label on the clinical notes or an iPad app (in the second phase of the study). A ‘gold standard' was provided by a manual search of the notes of every patient who presented to the ED. We developed the specification for an ‘app’ that presented the trial entry criteria coupled with an easy embedded method of emailing the research team using only three ‘clicks'. The iPads were secured to walls in key locations (such as triage areas) and ED staff simply entered the patient's identification number and pressed ‘send' for a message to be emailed. We reviewed the method of patient notification for 3 months before and after the introduction of the iPad system.

Results

There was a significant (Fisher's Exact Test. p<0.0001) increase in ‘real time' notification of patients to the research team from 18% to 33% after the introduction of the iPad app. The mode of notification also changed–with no use of the ‘research hotline' telephone number after the app system was introduced. The use of sticky labels and the number of verbal notifications was also greatly reduced (See table 1).

Conclusion

There was a significant increase in the immediacy of communication after the introduction of the iPad app. This occurred without a large amount of input from the research team, and seemed to be due to the staff knowing a specific location for the system and the ease of use, with the whole process taking less than 20 seconds. ED staff seemed to prefer using the ‘app', as after it was introduced there was very little use of the well publicised ‘research hotline' phone number. Information and communications technology can aid in the timely identification of potential research subjects in emergency care.
VALIDATING THE ICMED (INTERNATIONAL CROWDING MEASURE IN EMERGENCY DEPARTMENTS)
Authors: Boyle A , Coleman J , Sultan Y , Dhakshinamoorthy V , O'Keeffe J , Raut P , Beniuk K
Published: September 2013

Objectives & Background

Emergency department crowding is recognised as a major public health problem. While there is agreement that emergency department crowding harms patients, there is less agreement about the best way to measure emergency department crowding. We have previously derived an eight point measure of emergency department crowding by a formal consensus process, the International Crowding Measure in Emergency Departments (ICMED). We aimed to test the feasibility of collecting this measure in real time, and to partially validate this measure.

Methods

We conducted a cross-sectional study in four emergency departments in England. We conducted independent observations of the measure and compared this to senior clinician's perceptions of crowding and safety (see tables 1 and 2).

Results

We obtained 84 measurements, spread evenly across the four emergency departments. The measure was feasible to collect in real time, except for the ‘Left Before Being Seen’ variable. Increasing numbers of violations of the measure were associated with increasing clinician concerns. The Area under the Receiving Operator Curve was 0.80 (95% CI 0.72–0.90) for predicting crowding and 0.74 (95% CI 0.60–0.89) for predicting danger. The optimal number of violations for predicting crowding was three, with a sensitivity of 91.2 (95% CI 85.1–97.2) and a specificity of 100.0 (92.9–100). The measure predicted clinician concerns better than individual variables such as occupancy.

Abstract 007 Table 1BeforeAfterResearch ‘hotline'2 (3%)0Verbal10 (15%)3 (3%)Notes label21 (32%)14 (14%)iPad030 (30%)Not notified32 (49%)52 (52%)Total6599

Conclusion

The ICMED is easily to collect in multiple emergency departments with different IT systems. The ICMED seems to predict clinician's concerns about crowding and safety well, but future work is required to validate this before it can be advocated for widespread use.
CANCER INCIDENCE IN FIRST NATIONS AND MéTIS ADULTS IN CANADA: FOLLOW-UP OF THE 1991 CENSUS MORTALITY COHORT
Authors: Withrow Diana , Marrett Loraine , Tjepkema Michael , Pole Jason
Published: September 2013

Introduction

Cancer incidence amongst First Nations has historically been lower than that in the general population, but preliminary province-level evidence suggests it is rising to meet or exceed that in the general population.

Objectives

We aim to estimate incidence rates of lung, prostate, breast and colorectal cancers in First Nations and Métis (FN&M) and compare these to the rates in non-Aboriginal Canadians nationwide.

Methods

A cohort of 1991 Long Form Census respondents was probabilistically linked to the Canadian Cancer Registry (1992 to 2003) and the Canadian Mortality Database (1992 to 2006). Age-standardized, site-specific incidence rates and time trends will be generated over the next 4 months and results will be available for presentation. This will be the first national study of cancer incidence in FN&M. Further, this linked cohort provides a rare opportunity to include groups typically under-represented in health research (e.g. Métis and non-Status Indians) since FN&M will be identified based on self-report of Aboriginal ancestry, Registration and band membership in the Census.

Results

The cohort includes 2.7 million adults 25 and older on Census day in 1991, equivalent to a 15% sample of the population of that age at the time. Of these, approximately 62,000 reported either First Nations ancestry or are registered under the Indian Act of Canada. Preliminary analyses show that crudely, cancer incidence from 1992 to 2003 was higher in non-Aboriginals than in FN&M nationwide. FN&M have similar incidence of breast and colorectal cancers, both lower than the general population. The Métis have significantly lower incidence of prostate cancer than the general population, but significantly higher rates than First Nations. Incidence rates of lung cancer in Métis are comparable to those in the general population, while First Nations have lower lung cancer incidence.

Conclusions

Using an innovative approach, this study will provide much needed data to inform effective, culturally-appropriate cancer prevention and control activities for FN&M in Canada. New cancer incidence data will help justify and re-prioritize FN&M cancer programs by identifying issues that require the most attention.
AN ASSESSMENT OF HUMAN PAPILLOMAVIRUS (HPV) VACCINE SERIES COMPLETION AND ON-TIME DOSING IN ONTARIO'S GRADE 8 HPV VACCINATION PROGRAM
Authors: Lim W Ting , Sears Kim , Smith Leah M , Liu Guoyuan , Lévesque Linda E
Published: September 2013

Introduction

Proper administration of the human papillomavirus (HPV) vaccine (three doses at 0, 2, and 6 months) will likely influence the vaccine's effectiveness and the impact of provincial vaccination programs on adolescent health.

Objectives

To assess HPV vaccine series completion and on-time dosing in Canada's largest publicly funded, school-based vaccination program.

Methods

Using Ontario's administrative health and immunization databases, we identified a population-based cohort of all girls eligible for Ontario's Grade 8 HPV vaccination program in the 2007/08-2009/10 program years who initiated the three-dose vaccination series. Vaccine exposure was ascertained for two relevant time windows: Grade 8 and Grades 8–9. To assess series completion, we determined the number of doses each girl received and calculated the percentage that received all three. To assess on-time dosing, the number of days between doses (1–2, 2–3, 1–3) was calculated and categorized (e.g., too short, on schedule, too long) based on the manufacturer's recommendations. Analyses were also stratified by program year.

Results

Based on the data available at the time of analysis (i.e., from 21 of Ontario's 36 health regions), we identified a cohort of 55,798 girls who initiated the vaccination series. Series completion in the Grade 8 window was high (81.8%) and increased approximately 6% in Grade 9. Series completion was similar across the three program years. 70.8%, 98.5%, and 86.1% of girls were classified as ‘on schedule’ for dosing intervals 1–2, 2–3, and 1–3, respectively; 70.0% of girls received all three doses in perfect accordance with dosing recommendations. Stratification by program year revealed that on-time dosing was high in the first two years of the program (85.6% and 80.6%), but dropped to 42.1% in the 2009/10 program year when H1N1 vaccination programs were prioritized.

Conclusions

Publicly funded, school-based HPV immunization programs overcome financial and accessibility barriers to healthcare, creating an ideal setting in which vaccine use be optimized. Indeed, our results indicate this approach to program delivery is enabling the vast majority of girls who initiate the vaccination series to successfully complete it as recommended.
DEVELOPMENTAL TRAJECTORIES OF BODY MASS INDEX THROUGHOUT ADULTHOOD: EVIDENCE FROM THE NATIONAL POPULATION HEALTH SURVEY
Authors: Wang Meng , Yi Yanqing
Published: September 2013

Background

There is little research that uses group-based trajectory modeling to capture adult body mass index (BMI) trajectories for the Canadian population.

Objectives

The aims of this study are 1) to identify and determine the number and features of mutually exclusive body mass trajectory groups throughout adulthood; 2) to examine the association between covariates and each BMI trajectory group; 3) to assess whether health consequences vary within different trajectory groups.

Methods

This study will apply group-based trajectory modeling to map adult body mass trajectories with an age axis spanning 18 to 64 years, based on the longitudinal data from Statistics Canada's National Population Health Survey 1994 (n=17276). Group-based trajectory modeling is a powerful semi-parametric statistical approach that captures information about inter-individual differences within a large population. Risk factors (time-instable covariates) including gender and age cohort, and time-varying covariates such as diet, daily activities, education level, income, lifestyle (sleep, smoking, and alcohol), stress, and mental health are identified and evaluated for group membership. To confirm that distinct trajectory groups are linked to different health consequences, Rao-Scott chi-square test and analysis of variance will be applied to handle categorical and continuous health outcome variables. The health outcomes include hypertension, diabetes, heart disease, stroke, asthma, arthritis, and back problems. Lastly, this study will compare group-based trajectory modeling to a standard statistical methodology (multilevel modeling) when modeling longitudinal data, and discuss possible benefits.
THE EFFECT OF TELEPHONE SUPPORT INTERVENTIONS ON CORONARY ARTERY DISEASE (CAD) PATIENT OUTCOMES DURING CARDIAC REHABILITATION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Kotb Ahmed , Wells George A. , Hsieh Shu-Ching
Published: September 2013

Background

Cardiac rehabilitation is offered to individuals after cardiac events to aid recovery and reduce the likelihood of further cardiac illness. However, patient participation remains suboptimal and the provision of high quality care to an expanding population of patients with chronic heart conditions is becoming increasingly difficult. As a result, the feasibility and effectiveness of using telehealth interventions to deliver care have recently been considered.

Objectives

To determine the effect of telephone support interventions compared with standard post-discharge care on coronary artery disease patient outcomes.

Methods

We searched The Cochrane Library, MEDLINE, EMBASE, and CINAHL. Reference lists of included studies were also checked. No language restrictions were applied. Selection criteria: We included randomized controlled trials that directly compared telephone interventions with standard post-discharge care in adults following a myocardial infarction, angina or a revascularization procedure.

Data collection and analysis

Studies were selected independently by two reviewers. Data were extracted by a single reviewer and checked by a second one. Where appropriate, outcome data were pooled and analyzed using a random effects model. For dichotomous variables, odds ratios (OR) and 95% confidence intervals (CI) were derived for each outcome. For continuous variables, standardized mean differences (SMD) and 95% CI were calculated for each outcome.

Results

Thirty-two studies met the inclusion criteria. No difference was observed in mortality between the telephone group and the group receiving standard care (OR 1.02 (0.69, 1.62)). The intervention was however significantly associated with fewer hospitalizations than the comparison group (OR 0.62 (0.40, 0.97)). Significantly more participants in the telephone group stopped smoking (OR 1.40 (1.08, 1.82)); had lower LDL levels (SMD −0.19 (−0.39, −0.00)); lower SBP (SMD −0.22 (−0.36, −0.07)); and higher physical composite scores for quality of life (SMD 0.15 (0.01, 0.30)). However, no significant differences were observed for medication adherence (OR 0.78 (0.78, 1.28)); and the mental composite score for quality of life (SMD −0.00 (−0.19, 0.18)).

Conclusions

Regular telephone support interventions may help increase the uptake of secondary prevention and reduce further hospitalization.
IMPROVEMENT OF GLYCEMIC CONTROL IN PREDIABETIC AND TYPE 2 DIABETIC PATIENTS UNDERGOING LAPAROSCOPIC SLEEVE GASTRECTOMY (LSG) IN NEWFOUNDLAND AND LABRADOR
Authors: Lester Kendra , Twells Laurie , Gregory Deborah , Kovacs Christopher S. , Gamble J.M.
Published: September 2013

Introduction

Newfoundland and Labrador (NL) has the highest prevalence of diabetes in the country. In 2011, 11.1% of the population were identified as diabetic. LSG is a minimally invasive and irreversible procedure in which 80% of the stomach is removed, leaving a much smaller stomach or “sleeve”. It is a promising treatment option for obesity, and recent studies demonstrate that LSG may be effective in improving/resolving T2DM in obese patients.

Objectives

This study is evaluating LSG and its effectiveness in the improvement of glycemic control in prediabetes or type 2 diabetes mellitus (T2DM).

Methods

All patients (n=66) undergoing LSG in NL since May 2011 are followed prospectively. Patients are classified as having prediabetes (HbA1c: 5.7–6.4% or FPG: 6.1–6.9 mmol/L) or T2DM (HbA1c>6.5% or FPG≥7.0 mmol/L, self-reported, or antidiabetic medication use) at baseline. Glycemic control is evaluated at 3, 6, and 12 months. The primary outcome is the proportion of patients experiencing improved glycemic control.

Results

At baseline, 16 (24.2%) patients have prediabetes (average HbA1c 5.8% (SD 0.3), FPG 5.6 mmol/L (SD 0.7)) and 31 (47.0%) have T2DM (average HbA1c 7.6% (SD 1.4), FPG 8.1 mmol/L (SD 2.5)). Interim analysis within 6 months post-surgery: of the 11 prediabetic patients who've completed follow-up, 8 (72.7%) have HbA1c<5.7% (p=0.004) and 11 (100%) FPG<6.1 mmol/L; of T2DM patients who've completed follow-up, 12 of 19 (63.2%) have HbA1c<6.5% (p<0.001) and 14 of 17 (82.4%) have FPG<7.0 mmol/L (p=0.003). Prediabetes and T2DM groups show significant improvements in HbA1c (-0.6% and -1.5% respectively) and FPG (-1.0 mmol/L and -2.0 mmol/L respectively), p<0.001 for all. 9 of 21 T2DM patients (42.9%) who completed follow-up are no longer taking antidiabetic medications.

Conclusions

Interim analysis indicates better glucose control is achieved within 6 months following LSG.
Recording sympathetic nerve activity chronically in rats: surgery techniques, assessment of nerve activity, and quantification
Authors: Stocker Sean D. , Muntzel Martin S.
Published: September 2013

The sympathetic nervous system plays a pivotal role in homeostasis through its direct innervation and functional impact on a variety of end organs. In rats, a number of methods are available to assess sympathetic nervous system function. Traditionally, direct recording of sympathetic nerve activity (SNA) has been restricted to acute, anesthetized preparations or conscious animals within a few days after electrode implantation. However, these approaches provide short-term data in studies designed to investigate changes in SNA during chronic disease states. Over the last several years, chronic SNA recording has been pioneered in rabbits and more recently in rats. The purpose of this article is to provide insights and a “how to” guide for chronic SNA recordings in rats based on experiences from two independent laboratories. We will present common methodologies used to chronically record SNA, characteristics and methods to distinguish sympathetic bursts versus electrical artifacts (and provide corresponding audio clips when available), and provide suggestions for analysis and presentation of data. In many instances, these same guidelines are applicable to acute SNA recordings. Using the surgical approaches described herein, both laboratories have been able to chronically record SNA in >50% of rats for a duration >3 wk. The ability to record SNA over the time course of several weeks will, undoubtedly, greatly impact the field of autonomic and cardiovascular physiology.
Cyclooxygenase-1 inhibition attenuates angiotensin II-salt hypertension and neurogenic pressor activity in the rat
Authors: Asirvatham-Jeyaraj Ninitha , King Andrew J. , Northcott Carrie A. , Madan Shivanshu , Fink Gregory D.
Published: September 2013

Cyclooxygenase (COX)-derived prostanoids contribute to angiotensin II (ANG II) hypertension (HTN). However, the specific mechanisms by which prostanoids act are unclear. ANG II-induced HTN is caused partly by increased sympathetic nervous system activity, especially in a setting of high dietary salt intake. This study tested the hypothesis that COX-derived prostanoids cause ANG II-salt sympathoexcitation and HTN. Experiments were conducted in conscious rats. Infusion of ANG II (150 ng·kg−1·min−1 sc) caused a marked HTN in rats on 2% salt diet, but a much smaller increase in blood pressure in rats on 0.4% salt diet. The nonselective COX inhibitor ketoprofen (2 mg/kg sc) given throughout the ANG-II infusion period attenuated HTN development in rats on 2% NaCl diet, but not in rats on 0.4% NaCl diet. The acute depressor response to ganglion blockade was used to assess neurogenic pressor activity in rats on 2% NaCl diet. Ketoprofen-treated rats showed a smaller fall in arterial pressure in response to ganglion blockade during ANG-II infusion than did nontreated controls. In additional experiments, ketoprofen-treated rats exhibited smaller increases in plasma norepinephrine levels and whole body norepinephrine spillover than we previously reported in ANG II-salt HTN. Finally, the effects of the selective COX-1 inhibitor SC560 (10 mg·kg−1·day−1 ip) and the selective COX-2 inhibitor nimesulide (10 mg·kg−1·day−1 ip) were investigated. Treatment with SC560 but not nimesulide significantly reduced blood pressure and the depressor response to ganglion blockade in ANG II-salt HTN rats. The results suggest that COX-1 products are critical for sympathoexcitation and the full development of ANG II-salt HTN in rats.
Protein expression profile of rat type two alveolar epithelial cells during hyperoxic stress and recovery
Authors: Bhargava Maneesh , Dey Sanjoy , Becker Trisha , Steinbach Michael , Wu Baolin , Lee Sang Mee , Higgins LeeAnn , Kumar Vipin , Bitterman Peter B. , Ingbar David H. , Wendt Christine H.
Published: September 2013

In rodent model systems, the sequential changes in lung morphology resulting from hyperoxic injury are well characterized and are similar to changes in human acute respiratory distress syndrome. In the injured lung, alveolar type two (AT2) epithelial cells play a critical role in restoring the normal alveolar structure. Thus characterizing the changes in AT2 cells will provide insights into the mechanisms underpinning the recovery from lung injury. We applied an unbiased systems-level proteomics approach to elucidate molecular mechanisms contributing to lung repair in a rat hyperoxic lung injury model. AT2 cells were isolated from rat lungs at predetermined intervals during hyperoxic injury and recovery. Protein expression profiles were determined by using iTRAQ with tandem mass spectrometry. Of the 959 distinct proteins identified, 183 significantly changed in abundance during the injury-recovery cycle. Gene ontology enrichment analysis identified cell cycle, cell differentiation, cell metabolism, ion homeostasis, programmed cell death, ubiquitination, and cell migration to be significantly enriched by these proteins. Gene set enrichment analysis of data acquired during lung repair revealed differential expression of gene sets that control multicellular organismal development, systems development, organ development, and chemical homeostasis. More detailed analysis identified activity in two regulatory pathways, JNK and miR 374. A novel short time-series expression miner algorithm identified protein clusters with coherent changes during injury and repair. We concluded that coherent changes occur in the AT2 cell proteome in response to hyperoxic stress. These findings offer guidance regarding the specific molecular mechanisms governing repair of the injured lung.
TIG1 Promotes the Development and Progression of Inflammatory Breast Cancer through Activation of Axl Kinase
Authors: Wang Xiaoping , Saso Hitomi , Iwamoto Takayuki , Xia Weiya , Gong Yun , Pusztai Lajos , Woodward Wendy A. , Reuben James M. , Warner Steven L. , Bearss David J. , Hortobagyi Gabriel N. , Hung Mien-Chie , Ueno Naoto T.
Published: September 2013

Inflammatory breast cancer (IBC) is the most lethal form of breast cancer, but the basis for its aggressive properties are not fully understood. In this study, we report that high tumoral expression of TIG1 (RARRES1), a functionally undefined membrane protein, confers shorter survival in patients with IBC. TIG1 depletion decreased IBC cell proliferation, migration, and invasion in vitro and inhibited tumor growth of IBC cells in vivo. We identified the receptor tyrosine kinase, Axl, as a TIG1-binding protein. TIG1 interaction stablilized Axl by inhibiting its proteasome-dependent degradation. TIG1-depleted IBC cells exhibited reduced Axl expression, inactivation of NF-κB, and downregulation of matrix metalloproteinase-9, indicating that TIG1 regulates invasion of IBC cells by supporting the Axl signaling pathway in IBC cells. Consistent with these results, treatment of IBC cells with the Axl inhibitor SGI-7079 decreased their malignant properties in vitro. Finally, TIG1 expression correlated positively with Axl expression in primary human IBC specimens. Our findings establish that TIG1 positively modifies the malignant properties of IBC by supporting Axl function, advancing understanding of its development and rationalizing TIG1 and Axl as promising therapeutic targets in IBC treatment. Cancer Res; 73(21); 6516–25. ©2013 AACR.
Size Matters! Impact of Age, Sex, Height, and Weight on the Normal Heart Size
Authors: Pfaffenberger Stefan , Bartko Philipp , Graf Alexandra , Pernicka Elisabeth , Babayev Jamil , Lolic Emina , Bonderman Diana , Baumgartner Helmut , Maurer Gerald , Mascherbauer Julia
Published: September 2013

Background—

Therapeutic decisions in cardiology are determined frequently by cardiac chamber size. To decide whether cardiac dimensions are still in the normal range, reliable reference values are needed. However, published reference values mostly refer to historical cohorts using motion-mode measurements and have not been adjusted for sex or age. The impact of body size was only vaguely addressed. The importance of such adjustments is illustrated by studies, which show that smaller individuals and women are at risk of delayed treatment and impaired outcome when currently used reference values are applied. The aim of the present study was to assess the impact of body size, sex, and age on the normal heart size.

Methods and Results—

We prospectively studied 622 individuals (52.7% women; 17–91 years; 143–200 cm; 32–240 kg) without cardiac disease by standard transthoracic echocardiography. Multivariable linear regression analyses of the impact of sex, age, height, and weight on cardiac chamber size were performed. By multivariable regression analysis (n=500), all 4 variables independently influenced cardiac chamber size. The validity of cardiac dimensions predicted by the regression model was tested prospectively in a validation cohort (n=122). A calculator is proposed that estimates cardiac dimensions on the basis of the regression analysis.

Conclusions—

Sex, height, weight, and age significantly affect the normal heart size. These parameters need to be considered when cutoff values indicating the need for treatment or even surgery are established.
Brain Angiotensin-Converting Enzyme Type 2 Shedding Contributes to the Development of Neurogenic Hypertension
Authors: Xia Huijing , Sriramula Srinivas , Chhabra Kavaljit H. , Lazartigues Eric
Published: September 2013

Rationale
:

Overactivity of the brain renin–angiotensin system is a major contributor to neurogenic hypertension. Although overexpression of angiotensin-converting enzyme type 2 (ACE2) has been shown to be beneficial in reducing hypertension by transforming angiotensin II into angiotensin-(1–7), several groups have reported decreased brain ACE2 expression and activity during the development of hypertension.

Objective
:

We hypothesized that ADAM17-mediated ACE2 shedding results in decreased membrane-bound ACE2 in the brain, thus promoting the development of neurogenic hypertension.

Methods and Results
:

To test this hypothesis, we used the deoxycorticosterone acetate–salt model of neurogenic hypertension in nontransgenic and syn-hACE2 mice overexpressing ACE2 in neurons. Deoxycorticosterone acetate–salt treatment in nontransgenic mice led to significant increases in blood pressure, hypothalamic angiotensin II levels, inflammation, impaired baroreflex sensitivity, and autonomic dysfunction, as well as decreased hypothalamic ACE2 activity and expression, although these changes were blunted or prevented in syn-hACE2 mice. In addition, reduction of ACE2 expression and activity in the brain paralleled an increase in ACE2 activity in the cerebrospinal fluid of nontransgenic mice after deoxycorticosterone acetate–salt treatment and were accompanied by enhanced ADAM17 expression and activity in the hypothalamus. Chronic knockdown of ADAM17 in the brain blunted the development of hypertension and restored ACE2 activity and baroreflex function.

Conclusions
:

Our data provide the first evidence that ADAM17-mediated shedding impairs brain ACE2 compensatory activity, thus contributing to the development of neurogenic hypertension.
Effect of the Proprotein Convertase Subtilisin/Kexin 9 Monoclonal Antibody, AMG 145, in Homozygous Familial Hypercholesterolemia
Authors: Stein Evan A. , Honarpour Narimon , Wasserman Scott M. , Xu Feng , Scott Rob , Raal Frederick J.
Published: September 2013

Background—

Homozygous familial hypercholesterolemia is a rare, serious disorder with a substantial reduction in low-density lipoprotein (LDL) receptor function, severely elevated LDL cholesterol, cardiovascular disease, and often death in childhood. Response to conventional drug therapies is modest. Monoclonal antibodies to proprotein convertase subtilisin/kexin 9 (PCSK9) reduce LDL cholesterol in heterozygous familial hypercholesterolemia. The effect in homozygous familial hypercholesterolemia is unknown and uncertain. We evaluated the efficacy and safety of AMG 145 in an open-label, single-arm, multicenter, dose-scheduling pilot study in patients with homozygous familial hypercholesterolemia.

Methods and Results—

Eight patients with LDL receptor–negative or –defective homozygous familial hypercholesterolemia on stable drug therapy were treated with subcutaneous 420 mg AMG 145 every 4 weeks for ≥12 weeks, followed by 420 mg AMG 145 every 2 weeks for an additional 12 weeks. All patients completed both treatment periods. Mean change from baseline in LDL cholesterol at week 12 was −16.5% (range, 5.2% to −43.6%;
P
=0.0781) and −13.9% (range, 39.9% to −43.3%;
P
=0.1484) with 4- and 2-week dosing, respectively. No reduction was seen in the 2 receptor-negative patients. Over the treatment periods, mean±SD LDL cholesterol reductions in the 6 LDL receptor–defective patients were 19.3±16% and 26.3±20% with 4- and 2-week dosing, respectively (
P
=0.0313 for both values), ranging from 4% to 48% with 2-week dosing. No serious side effects were reported.

Conclusion—

This study demonstrates significant and dose-related LDL cholesterol lowering with a PCSK9 monoclonal antibody in homozygous familial hypercholesterolemia patients with defective LDL receptor activity but no reduction in those who were receptor negative.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT01588496 and NCT01624142.
Putting the Bias in Skill-Biased Technological Change? A Relational Perspective on White-Collar Automation at General Electric
Authors: Hanley Caroline
Published: September 2013

The skill-biased technological change (SBTC) theory of rising inequality rests on assumptions that are challenged by a relational perspective. This article develops a historical case study of the design and implementation of technologies to automate white-collar work at the General Electric Company (GE) starting in the 1950s in order to interrogate the assumptions on which the SBTC thesis rests. Executives at GE resisted framing computer technologies as automation and sought to neutralize the class-based implications of the term. Yet they actively pursued white-collar automation technologies designed to prevent the industrial relations of the heavily unionized manufacturing sector from being replicated in the growing service sector. A new conception of productivity that locates managers as the core productive workers of the firm is embedded in the company’s internal definition of white-collar automation as information handling, lending legitimacy to the changing distribution of earnings in the following decades. By embedding the history of white-collar workplace computers in an analysis of the labor relations and other business administration problems the technologies were designed to address, this article lends a critical perspective to the SBTC theory of rising inequality.
A Pre-PREA Survey of Inmate and Correctional Staff Opinions on How to Prevent Prison Sexual Assault
Authors: Struckman-Johnson David , Struckman-Johnson Cindy , Kruse Justin D. , Gross Pamela M. , Sumners Brady J.
Published: September 2013

This study is a content analysis of inmate and staff free responses to a question about good ways to prevent prison sexual assault. Data from 1,094 inmates and 373 correctional staff were abstracted from a 1998 survey of Midwestern prisons. A total of 2,689 distinctive ideas (1,830 from inmates and 859 from staff) were distributed across 12 prevention categories. Inmates’ top solutions were classification of inmates and increased sexual outlets. Staff’s top choices were increasing security and hiring more and better staff. Similarities and disparities in inmate and staff solutions are discussed in light of Prison Rape Elimination Act–based policies.
Shame-Focused Attitudes Toward Mental Health Problems
Authors: Hampton Nan Zhang , Sharp Seneca E.
Published: September 2013

The purpose of this study was to examine the effects of gender and culture on shame-focused attitudes toward mental health problems. Two hundred and ninety-three university students from Asian, Latino, and Caucasian American cultural backgrounds participated in the study. The Attitudes Toward Mental Health Problems Scale was used to measure shame-focused attitudes. A 2 (gender) × 3 (culture) multivariate analyses of variance was performed. Results indicated that there was no significant gender difference in shame-focused attitudes toward mental health problems. Of the three ethnic cultural groups, Latino American students had the highest mean score on how shameful they would feel if they had mental health problems. Asian American students had the lowest mean score on how negative their families would view themselves if they had mental health problems. Implications of the results for rehabilitation research and practice are discussed.
Doctoral Dissertation Research in Rehabilitation Counseling
Authors: Zanskas Stephen A. , Phillips Brian N. , Tansey Timothy N. , Smith Ben N.
Published: September 2013

This article begins a series of planned annual reviews of rehabilitation doctoral dissertation research. Twenty doctoral dissertations completed in 2011 from recognized doctoral programs in rehabilitation were identified and analyzed. Dissertations were indexed according to their research topic, methodology employed, model, and statistical analysis, and an annotated bibliography was developed. Institutional productivity and employment trends of doctoral graduates were added as baseline data points for future analysis. Results of the current analysis reflect that a majority of the studies consisted of quantitative descriptive research designs. Unlike prior analyses, advanced and basic statistics were utilized equitably. Dissertations focusing on attitudes toward persons with a disability were higher than any of the prior reporting periods. Predictive outcome studies and clinical population research also remain prevalent. Implications for the practice of rehabilitation counseling, education, and future research are discussed.
Attitudes Toward Adoption in Singapore
Authors: Mohanty Jayashree
Published: September 2013

This study aimed to understand the factors that influence attitudes toward adoption in Singapore. Using a multistage, quota sampling method, 1,200 Singaporean citizens and permanent residents were interviewed. The results indicate that the majority of the respondents approved adoption as a family form. Logistic regression analysis showed that individual characteristics (women and income) and factors such as the importance of blood ties, adoption-related altruistic values, and familiarity with adoption were related to adoption approval. The factors that influenced intention to adopt were women, familiarity with adoption, and approval of adoption. Individuals who perceived the importance of blood ties in familial relationships and had concerns about the outcomes of adopted children (adjustment problems, behavioral problems, medical problems, etc.) were less likely to have considered adopting. The findings point to the need to increase awareness among the public and to promote adoption as a rewarding and responsible choice for family formation.
When the Saints Went Marching In
Authors: Burns Elizabeth Booksh
Published: September 2013

Social identity theory is used to explain behaviors, thoughts, and feelings associated with group membership. This study focuses on the New Orleans Saints National Football League (NFL) team and its effect on citizens of its host city as well as fans from the surrounding region. While a large body of research shows little evidence that new stadiums and professional sports teams make a significant economic impact on the region, some findings have shown that sports teams can provide intangible benefits. These intangible benefits are often related to the positive associations fans of the team have by considering themselves a part of that particular in-group. This study applies social identity theory to the New Orleans Saints’ fan base and discusses the reactions of the team’s fans during the 2009 Super Bowl–winning season as reported in national, regional, and local publications.
Good News from Africa, Community Transformation Through the Church
Authors: Woolnough Brian E.
Published: September 2013

We live in a world of gross inequality. While a minority live in unprecedented wealth, the majority live in considerable poverty. Though much money has been given in aid by the rich countries to the poor, both by secular and Christian institutions, there has been much criticism that much of that aid has been wasted, indeed much of it has been actually harmful. But while there is truth in some of these criticisms, there is also increasing evidence of where community development has been effective, and sustainable. This article considers the strengths and limitations, and examples, of such a church-based, bottom-up, approach to transforming the physical and spiritual needs of the individuals and their communities. We will see that it is, arguably, the only way that truly holistic transformation can be delivered, and consider some of the implications for Western Christians and Christian NGOs.
A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study
Authors: Peirone Eliana , Goria Paolo Filiberto , Anselmino Arianna
Published: September 2013

Objective:

To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury.

Design:

Single-blind, randomized controlled pilot study.

Setting:

Single rehabilitation centre.

Subjects:

Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score <10 seconds on the One-Leg Stance Test (eyes open).

Intervention:

All participants received 50-minutes individualised traditional physiotherapy sessions three times a week for seven weeks. In addition, the intervention group ( N = 8) performed an individualised dual-task home-based programme six days a week for seven weeks.

Main outcome measures:

The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling.

Results:

At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63).

Conclusions:

This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.
Prevalence and Risk Factors for Self-Reported Violence of Osaka and Seattle Male Youths
Authors: Bui Laura , Farrington David P. , Ueda Mitsuaki , Hill Karl G.
Published: September 2013

Traditionally, Japan has been regarded as a country with low crime. Comparative research has given insights into the extent of similarities and differences in crime between America and Japan. The importance of these studies is the examination of whether Western-established criminological knowledge is applicable to non-Western societies like Japan. Unfortunately, comparative self-report studies involving Japan and investigating youth offending are scarce. The current study investigates risk factors and self-reports of violence from Osaka and Seattle male youths. The findings reveal that Japanese male youths self-report a higher prevalence of violence than Seattle male youths. Risk factors for violence, issues of comparability, and prevalence versus strength of relationships of risk factors are examined. It is concluded that the higher prevalence of violence in Osaka is primarily a function of the higher prevalence of troubled peers and risk taking. The findings call for replication of this type of comparative research.
Criminality and the 2D:4D Ratio
Authors: Ellis Lee , Hoskin Anthony W.
Published: September 2013

A decade old theory hypothesizes that brain exposure to androgens promotes involvement in criminal behavior. General support for this hypothesis has been provided by studies of postpubertal circulating levels of testosterone, at least among males. However, the theory also predicts that for both genders, prenatal androgens will be positively correlated with persistent offending, an idea for which no evidence currently exists. The present study used an indirect measure of prenatal androgen exposure—the relative length of the second and fourth fingers of the right hand (r2D:4D)—to test the hypothesis that elevated prenatal androgens promote criminal tendencies later in life for males and females. Questionnaires were administered to 2,059 college students in Malaysia and 1,291 college students in the United States. Respondents reported their r2D:4D relative finger lengths along with involvement in 13 categories of delinquent and criminal acts. Statistically significant correlations between the commission of most types of offenses and r2D:4D ratios were found for males and females even after controlling for age. It is concluded that high exposure to androgens during prenatal development contributes to most forms of offending following the onset of puberty.
Biphasic calcium phosphate loading on polycaprolactone/poly(lacto-co-glycolic acid) membranes for improved tensile strength, in vitro biocompatibility, and in vivo tissue regeneration
Authors: Franco Rose Ann , Sadiasa Alexander , Seo Hyung Seok , Lee Byong-Taek
Published: September 2013

Electrospun polycaprolactone and poly(lacto- co-glycolide) membranes were loaded with biphasic calcium phosphate powder to facilitate osteoconductivity. Different concentrations of biphasic calcium phosphate powder were added to the polymer solution, and successful loading was confirmed by X-ray diffraction analysis, transmission electron microscope, and scanning electron microscope with energy-dispersive spectroscopy visualization. The effect of the added biphasic calcium phosphate on the polymer membrane was investigated in terms of the material’s tensile strength and strain, in vitro cytocompatibility, and in vivo tissue regeneration. It was observed that the tensile strength of the membranes increased with the addition of the biphasic calcium phosphate powder. Immersion in simulated body fluid solution for seven days leads to the formation of apatite-like deposits in the fibers, which further improved the mechanical stability. Moreover, proliferation and adhesion of osteoblast-like cells were more apparent upon the addition of the biphasic calcium phosphate powder as seen with the increasing cell density from (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and micrographs from scanning electron microscope and confocal microscopy. Sample membranes were also implanted to investigate the membrane’s ability to regenerate bone in a rat calvarium. Histological staining and micro-CT histomorphometric analyses showed neo-bone formation in the implanted rat skull.