bluuebunny/crossref_metadata_2025 huggingface dataset:
Korean Early Childhood Educators’ Perceptions of Importance and Implementation of Strategies to Address Young Children’s Social-Emotional Competence
Authors: Heo Kay H. , Cheatham Gregory A. , Hemmeter Mary Louise , Noh Jina
Published: November 2014

In South Korea, there has been a rapid increase in challenging behaviors and other social-emotional difficulties at the early childhood level. Korean early childhood educators’ perspectives and strategies to address young children’s social-emotional competencies and challenging behaviors were investigated. Overall, results suggest that many Korean early childhood educators recognize the importance of social-emotional teaching strategies but report low levels of implementation of specific social-emotional strategies. The study also examined the effect of the categorical predictors such as special education teaching experience, children’s classroom age level, and duration of early childhood teaching experience on participants’ implementation levels. Korean early childhood teachers’ importance perceptions, regardless of their categorical variables, were the most influential predictor of implementation. Results are discussed and implications are delineated.
Results of Operative Correction of Grade IIB Tibialis Posterior Tendon Dysfunction
Authors: Silva M. G. Amila N. , Tan Si Heng Sharon , Chong Hwei Chi , Su Hsien Ching David , Singh Inderjeet Rikhraj
Published: November 2014

Background:

The prevalence of tibialis posterior tendon dysfunction (PTTD) is estimated to be as high as 3% to 4% in Western populations, and it is one of the most commonly misdiagnosed conditions of the foot and ankle.

Methods:

Clinical and radiological outcomes were assessed in grade IIB PTTD treated with a medializing calcaneal osteotomy, lateral column lengthening, flexor digitorum longus transfer, and tendo-Achilles lengthening. The clinical and radiological findings recorded were the SF-36 score on physical function and mental health, midfoot and hindfoot American Orthopaedic Foot and Ankle Society (AOFAS) clinical scores, the midfoot and visual analog pain scores, as well as the radiological measurements of the hindfoot calcaneal pitch, talo-first metatarsal angle, and medial cuneiform height. The time points of assessment were preoperatively, 6 months postoperatively, and 24 months postoperatively by an examiner different from the operating surgeon.

Results:

The SF-36 score on physical function (mean difference of 8.7 and 8.2, respectively), AOFAS midfoot score (mean difference of 29.6 and 15.3, respectively), AOFAS ankle-hindfoot score (mean difference of 23.2 and 14.3, respectively), midfoot visual analog pain score (mean difference of 4.0 and 1.2), and the ankle and hindfoot visual analog score (mean difference of 3.6 and 1.6) all had significant reduction from the preoperative to the 24-month postoperative time point ( P < .001). Radiologically, there was also correction of the deformity associated with PTTD. The hindfoot calcaneal pitch was corrected from 8.4 degrees to 18.7 degrees. The talo-first metatarsal angle was corrected from 14.0 degrees to 1.3 degrees, and the medial cuneiform height was corrected from 10.3 mm to 20.4 mm at 24 months postoperatively.

Conclusion:

Grade IIB PTTD treated with a medializing calcaneal osteotomy, lateral column lengthening, flexor digitorum longus transfer, and tendo-Achilles lengthening demonstrated statistical significant improvement in hindfoot and midfoot AOFAS scores, SF-36 physical function scores, as well as visual analog scores. The complications were minimal. We advocate the combination of these procedures as being successful for the treatment of grade IIB PTTD. Longer term follow-up is needed to determine if these improvements plateau, improve, or deteriorate.

Level of Evidence:

Level IV, retrospective case series.
“What’s in it for Men?”
Authors: Holter Øystein Gullvåg
Published: November 2014

This article examines the question of what men win or lose by increased gender equality, in terms of well-being and health, combining a new macro data set with existing studies. A database was created for examining gender equality variables and potential health effects, using a sample of eighty-one European countries and the United States. The results indicate more positive effects for men than usually assumed. They also imply that men’s contribution to gender equality has been underestimated. Some patterns, like fertility, differ between Europe and the United States, and this article discusses different gender equality models. Also, the effects of gender equality differ for different groups of men, and this article discusses men who feel they “lose out.” Although the data concern associations, questions of causality are also raised, and the last part of this article presents a tentative explanatory model that includes structural factors as well as men and masculinity changes.
Combined numerical and experimental investigation of the micro-hydrodynamics of chevron-based textured patterns influencing conjunctional friction of sliding contacts
Authors: Morris N , Leighton M , De la Cruz M , Rahmani R , Rahnejat H , Howell-Smith S
Published: November 2014

Reciprocating and low-speed sliding contacts can experience increased friction because of solid boundary interactions. Use of surface texturing has been shown to mitigate undue boundary friction and improve energy efficiency. A combined numerical and experimental investigation is presented to ascertain the beneficial effect of pressure perturbation caused by micro-hydrodynamics of entrapped reservoirs of lubricant in cavities of textured forms as well as improved micro-wedge flow. The results show good agreement between numerical predictions and experimental measurements using a precision sliding rig with a floating bed-plate. Results show that the texture pattern and distribution can be optimised for given conditions, dependent on the intended application under laboratory conditions. The translation of the same into practical in-field applications must be carried out in conjunction with the cost of fabrication and perceived economic gain. This means that near optimal conditions may suffice for most application areas and in practice lesser benefits may accrue than that obtained under ideal laboratory conditions.
‘Standing on the periphery’
Authors: Young Ann-Marie , MacPhail Ann
Published: November 2014

Research has shown that teachers can derive substantial benefits from the role of cooperating teacher (CT) and many experienced teachers have made positive changes to their teaching as a result, often engaging as co-learners. The aim of this paper is to examine the intricacies of the trajectory of CTs in terms of the development of their understanding of what an effective supervisor entails. Lave and Wenger’s concept of legitimate peripheral participation is utilised to understand how teachers’ learning trajectories enhance or inhibit the move towards full participation in effective school placements. The findings indicated that within the school placement the role of the CT is very influential but poorly prepared for and supported by the Higher Education Institution (HEI). Results have indicated mechanisms to potentially enhance existing policy and practice, develop the role of the CT and create a systemic shift in school–university partnerships.
Exploring Alcohol Policy Approaches to Prevent Sexual Violence Perpetration
Authors: Lippy Caroline , DeGue Sarah
Published: November 2014

Sexual violence continues to be a significant public health problem worldwide with serious consequences for individuals and communities. The implementation of prevention strategies that address risk and protective factors for sexual violence at the community level are important components of a comprehensive approach, but few such strategies have been identified or evaluated. The current review explores one potential opportunity for preventing sexual violence perpetration at the community level: alcohol policy. Alcohol policy has the potential to impact sexual violence perpetration through the direct effects of excessive alcohol consumption on behavior or through the impact of alcohol and alcohol outlets on social organization within communities. Policies affecting alcohol pricing, sale time, outlet density, drinking environment, marketing, and college environment are reviewed to identify existing evidence of impact on rates of sexual violence or related outcomes, including risk factors and related health behaviors. Several policy areas with initial evidence of an association with sexual violence outcomes were identified, including policies affecting alcohol pricing, alcohol outlet density, barroom management, sexist content in alcohol marketing, and policies banning alcohol on campus and in substance-free dorms. We identify other policy areas with evidence of an impact on related outcomes and risk factors that may also hold potential as a preventative approach for sexual violence perpetration. Evidence from the current review suggests that alcohol policy may represent one promising avenue for the prevention of sexual violence perpetration at the community level, but additional research is needed to directly examine effects on sexual violence outcomes.
Candidate Age and Youth Voter Turnout
Authors: Pomante Michael J. , Schraufnagel Scot
Published: November 2014

The research addresses youth voter turnout in the United States and, specifically, tests the relationship between candidate age and a commitment to vote by young people in a controlled experiment. We learn that potential young voters are more willing to commit to vote when they view pictures of younger candidates running. This is the case after controlling for the age and partisanship of respondents. In a real-world test of our experimental results, we examine state-level variation in youth voter turnout in midterm governor and Senate races (1994-2010). In the state-level analysis, we find a larger candidate age gap in governor and Senate races associates with higher levels of youth mobilization. In all, the research affirms the value of candidate characteristics as a predictor of voting behavior.
The use of functional imaging in the diagnosis of carotid patch infection
Authors: Seager Matthew J , Dharmarajah Brahman , Davies Emma B , Davies Alun H , Franklin Ian J
Published: November 2014

Carotid patch infection following carotid patch angioplasty is a rare but serious complication. Accurate diagnosis is vital yet currently ill-defined. We present the use of computed tomography positron emission tomography and leucocyte radioisotope scintigraphy and highlight their potential role in the diagnosis of equivocal carotid patch infection.
Basal insulin combined incretin mimetic therapy with glucagon-like protein 1 receptor agonists as an upcoming option in the treatment of type 2 diabetes: a practical guide to decision making
Authors: Scholz Gerhard H. , Fleischmann Holger
Published: November 2014

The combination of basal insulin and glucagon-like protein 1 receptor agonists (GLP-1 RAs) is a new intriguing therapeutic option for patients with type 2 diabetes. In our daily practice we abbreviate this therapeutic concept with the term BIT (basal insulin combined incretin mimetic therapy) in a certain analogy to BOT (basal insulin supported oral therapy). In most cases BIT is indeed an extension of BOT, if fasting, prandial or postprandial blood glucose values have not reached the target range. In our paper we discuss special features of combinations of short- or prandial-acting and long- or continuous-acting GLP-1 RAs like exenatide, lixisenatide and liraglutide with basal insulin in relation to different glycemic targets. Overall it seems appropriate to use a short-acting GLP-1 RA if, after the near normalization of fasting blood glucose with BOT, the prandial or postprandial values are elevated. A long-acting GLP-1 RA might well be given, if fasting blood glucose values are the problem. Based on pathophysiological findings, recent clinical studies and our experience with BIT and BOT as well as BOTplus we developed chart-supported algorithms for decision making, including features and conditions of patients. The development of these practical tools was guided by the need for a more individualized antidiabetic therapy and the availability of the new BIT principle.
Keeping “critical” critical: A conversation from Culture on the Edge
Authors: Martin Craig , McCutcheon Russell , Miller Monica R. , Ramey Steven , Merinda Simmons K. , Dorrough Smith Leslie , Touna Vaia
Published: November 2014

In early March 2014, some of the members of Culture on the Edge—a scholarly research collaboration of seven scholars of religion, interested in more theoretically sophisticated studies of identity, and all of whom are at different career stages and at a variety of North American institutions—had a conversation online on the use of the terms “critique” and “critical,” terms widely used in the field today but employed in such a variety of ways that the members of the group thought it worthwhile to focus some attention on them. What follows is the transcript of their conversation.
Playing to Learn
Authors: Schlosser Linda K. , Balzano Betsy
Published: November 2014

The purpose of the study was to uncover teachers’ emerging beliefs and perceptions about developmentally oriented instruction as they participated in professional development workshops and applied the strategies learned with students in after-school clubs. Twenty experienced, urban teachers volunteered to attend monthly workshops where they engaged in math games, simulations, and problem-solving activities based on the Common Core and modeled by college faculty. Teachers used the activities to offer 90-min weekly math clubs for sixth-and seventh-grade students at their schools. Twelve pre-service teachers enrolled in a college course on adolescent development acted as volunteers at the clubs. Data were collected through (a) questionnaires and rating scales, (b) informal group interviews, and (c) weekly electronic journals. Data collected revealed changes in teachers’ beliefs about and perceptions of effective instruction as they applied game-based activities in the after-school club settings. Eighty percent of the teachers reported high levels of student engagement and greater sustained interest in problem-solving, and connected their observations to beliefs about game-based learning as an effective and age-appropriate instructional strategy. Pre-service teacher volunteers reported similar observations: The majority of club members were actively engaged in solving complex problems during game-like activities, particularly when volunteers used scaffolding strategies to support students’ participation.
Cultural intelligence as a predictor of individuals’ adaptive performance: A study in a multicultural environment
Authors: Şahin Faruk , Gürbüz Sait
Published: November 2014

As the work environment is changing rapidly, organizations need more adaptable employees who can work creatively, learn new skills and adapt to diverse social contexts and novel environments. Individual differences such as prior experience and self-efficacy have been extensively examined as predictors of adaptive performance. In contrast, the role of cultural intelligence in promoting adaptive performance has been overlooked. The primary goal of this study was to examine cultural intelligence that may account for adaptive performance beyond prior experience and self-efficacy. Moreover, we examined the moderating role of self-efficacy in terms of the relationship between cultural intelligence and adaptive performance. We tested our hypothesis with multisource data in a sample of 132 military personnel assigned in a multinational military organization. Hierarchical regression analysis demonstrated that cultural intelligence, together with self-efficacy and prior experience, was important predictors of adaptive performance. Specifically, cultural intelligence explained additional variance in adaptive performance over and above that of prior experience and self-efficacy. These findings suggested the importance of cultural intelligence as a critical predictor of adaptive performance in multicultural contexts.
Farewell to leadership? Ideas of hegemony and counter-hegemony in the Americas
Authors: Muno Wolfgang , Brand Alexander
Published: November 2014

Mainstream International Relations and Foreign Policy Analysis have often concentrated on material factors and actors’ preferences, leaving out ideational dynamics. However, US–Latin American relations in general seem fraught with ideas, narratives and historical references re-articulated from time to time on both sides. In his campaign, Barack Obama announced a fresh start of US–Latin American relations, promising to “restore American leadership in Latin America”, at the same time creating “a new partnership for the Americas”, combining two narratives in US–Latin American policy. “Leadership”, enshrined in the Monroe Doctrine and the Roosevelt corollary, which declared Latin America the “backyard” of the USA, and “Partnership”, related to the Good Neighbor Policy declared by Franklin Delano Roosevelt, which aimed at establishing a more equal relation of partners. This discourse shows that inherited traditions and foreign policy narratives are subject to cycles of re-production, re-articulation and subtle change. In order to grasp the relevance of ideas in US–Latin American relations, we advocate a turn towards “ideational approaches” of discursive and constructivist providence. The article first situates “ideas” to key concepts of a more interpretive foreign policy analysis, which focuses on tradition and narratives. As a second step, US–Latin American relations are located within a specific, hegemony-oriented ideational account of foreign policy. Two analytical sketches of crucial cases of recent US–Latin American relations follow, the War on Drugs and the reactions towards the coup d’état in Honduras, showing how ideas were articulated on both the USA and the Latin American side and what role they played. The overall focus of the paper is thus on elucidating the ideational dynamics that underpin the political relations between the USA and Latin America.
Environmental Kuznets curve revisited with special reference to Eastern Europe and Central Asia
Authors: Oh Jinhwan , Yun ChiHyun
Published: November 2014

This study revisits the environmental Kuznets curve (EKC) hypothesis in order to find the inverted-U relationship between CO2 emissions and economic growth. It uses a comprehensive cross-national panel dataset containing 90 middle-income countries between 1981 and 2010. This study confirms that a quadratic relationship indeed exists. The turning points are determined at approximately US$8,300 and 9,100, which are consistent in all six models. Additionally, by classifying countries into different income levels or regional groups, this study attempts to find any group-wise discrepancies. Finally, individual countries are examined in order to find the gap between the actual data and their fitted values, which indicates that special attention is required in Eastern Europe and Central Asian countries in order to reduce CO2 emission problems.
Enhanced mechanical properties of 70/30 brass joint by multi-pass friction stir welding with rapid cooling
Authors: Xu N. , Ueji R. , Fujii H.
Published: November 2014

70/30 (Cu/Zn) brass plates with a 2 mm thickness were jointed by repeated rapid cooling friction stir welding. The joints from each FSW cycle showed the typical construction of a microstructure which includes the stir zone and the thermo-mechanically affected zone, but the morphology and boundary characteristics in these zones changed with the different cycles. In the stir zone, the grain size decreased and the number fraction of the high angle boundaries increased with the increasing number of FSW cycles. The texture analysis suggested that the post-annealing effect, which frequently occurred after the FSW process, was remarkably restricted by the liquid CO2 cooling, which accelerated the refinement of the microstructure. As a result, a joint with an ultrafine grained structure (0·8 μm) and an excellent strength ductility matching (548 MPa and 34% respectively) can be achieved by multi-pass rapid cooling FSW process.
Novel postweld heat treatment method for improving mechanical properties of resistance spot weld
Authors: Duan R. , Luo Z. , Li Y. , Zhang Y. , Liu Z. M.
Published: November 2014

A novel postweld heat treatment method by applying cross-direction welding current (cross-current) was applied on the resistance spot weld. The effect of cross-current on the nugget shape, microstructure and mechanical properties was investigated. The results show that the cross-current postweld heat treatment enhances the efficiency of postweld heat treatment and improves the mechanical performance of nugget. The cross-current promotes the recrystallisation of nugget microstructure, which induced the transformation of microstructure from column crystal to quasi equiaxed grain. The quasiequiaxed grains of martensite in the weld nugget significantly increase the microhardness of weld nugget and the tensile shear force of weld joint.
Wettability and biomineralisation of laser cladded Si doped TiCN biocoating
Authors: Yang Y. L. , Yang Z. Y. , Dong D. Y. , Dahotre N. B. , Liu K. , Liu Y. X. , Niu J. J.
Published: November 2014

Surface textured Si doped TiCN coatings were synthesised on Ti–6Al–4V alloy by laser cladding technique. Phase constituent examination by X-ray diffraction revealed the formation of similar phases of TiC0.2N0.8 and Ti5Si4 within all coated samples. Laser coated samples presented much higher surface free energy compared to Ti–6Al–4V control due to the textured structure, which in turn demonstrated a better wettability and improved biomineralisation. Variation of silica content presented no significant influence on surface free energy, indicating that the silica content can be varied in a large range. The mineralised samples obtained after immersion in simulated body fluid were characterised to understand the mechanism and kinetics of Ca–P precipitation. The results confirmed that the precipitation kinetics of Ca–P was influenced by the substitution of silica.
Strontium ranelate effect on bone mineral density is modified by previous bisphosphonate treatment
Authors: Brun Lucas R , Galich Ana M , Vega Eduardo , Salerni Helena , Maffei Laura , Premrou Valeria , Costanzo Pablo R , Sarli Marcelo A , Rey Paula , Larroudé María S , Moggia María S , Brance María L , Sánchez Ariel ,   Grupo Argentino de Estudio del Ranelato de Estroncio (GAERE)
Published: November 2014

The aim of this study was to evaluate the effect of strontium ranelate (SrR) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of SrR in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 482 postmenopausal women treated with SrR (2 g/day) for 1 year in ten Argentine centers; 41 patients were excluded due to insufficient data, while 441 were included. Participants were divided according to previous bisphosphonate treatment in two groups: BP-naïve (n = 87) and BP-prior (n = 350). Data are expressed as mean ± SEM. After 1 year of treatment with SrR the bone formation markers total alkaline phosphatase and osteocalcin were increased (p < 0.0001), while the bone resorption marker s-CTX was decreased (p = 0.0579). Also increases in BMD at the lumbar spine (LS, 3.73%), femoral neck (FN, 2.00%) and total hip (TH, 1.54%) [p < 0.0001] were observed. These increments were significant (p < 0.0001) both among BP-naïve and BP-prior patients. Interestingly, the change in BMD after 1 year of SrR treatment was higher in BP-naïve patients: LS: BP-naïve = 4.58 ± 0.62%; BP-prior = 3.45 ± 0.28% (p = 0.078). FN: BP-naïve = 2.79 ± 0.56%; BP-prior = 2.13 ± 0.29% (p = 0.161). TH: BP-naïve = 3.01 ± 0.55%; BP-prior = 1.22 ± 0.27% (p = 0.0006). SrR treatment increased BMD and bone formation markers and decreased a bone resorption marker in the whole group, with better response in BP-naïve patients.
Impedance cardiography (electrical velocimetry) and transthoracic echocardiography for non-invasive cardiac output monitoring in pediatric intensive care patients: a prospective single-center observational study
Authors: Blohm Martin Ernst , Obrecht Denise , Hartwich Jana , Mueller Goetz Christoph , Kersten Jan Felix , Weil Jochen , Singer Dominique
Published: November 2014

Introduction

Electrical velocimetry (EV) is a type of impedance cardiography, and is a non-invasive and continuously applicable method of cardiac output monitoring. Transthoracic echocardiography (TTE) is non-invasive but discontinuous.

Methods

We compared EV with TTE in pediatric intensive care patients in a prospective single-center observational study. Simultaneous, coupled, left ventricular stroke volume measurements were performed by EV using an Aesculon® monitor and TTE (either via trans-aortic valve flow velocity time integral [EVVTI], or via M-mode [EVMM]). H0: bias was less than 10% and the mean percentage error (MPE) was less than 30% in Bland–Altman analysis between EV and TTE. If appropriate, data were logarithmically transformed prior to Bland–Altman analysis.

Results

A total of 72 patients (age: 2 days to 17 years; weight: 0.8 to 86 kg) were analyzed. Patients were divided into subgroups: organ transplantation (OTX, n =28), sepsis or organ failure (SEPSIS, n =16), neurological patients (NEURO, n =9), and preterm infants (PREM, n =26); Bias/MPE for EVVTI was 7.81%/26.16%. In the EVVTI subgroup analysis for OTX, NEURO, and SEPSIS, bias and MPE were within the limits of H0, whereas the PREM subgroup had a bias/MPE of 39.00%/46.27%. Bias/MPE for EVMM was 8.07%/37.26% where the OTX and NEURO subgroups were within the range of H0, but the PREM and SEPSIS subgroups were outside the range. Mechanical ventilation, non-invasive continuous positive airway pressure ventilation, body weight, and secondary abdominal closure were factors that significantly affected comparison of the methods.

Conclusions

This study shows that EV is comparable with aortic flow-based TTE for pediatric patients.
Genetic variation in the tissue factor gene is associated with clinical outcome in severe sepsis patients
Authors: Shi Dongwei , Song Zhenju , Yin Jun , Xue Mingming , Yao Chenling , Sun Zhan , Shao Mian , Deng Zhi , Zhang Yaping , Tao Zhengang , Sun Si , Zhang Jin , Xing Lingyu , Dong Zhimin , Wang Yuxin , Tong Chaoyang
Published: November 2014

Introduction

Activation of inflammation and coagulation was closely related and mutually interdependent in sepsis. Tissue factor (TF) and its endogenous inhibitor, tissue factor pathway inhibitor (TFPI) was the main regulators of the initiation of coagulation process. Altered plasma levels of TF and TFPI have been related to worse outcome in sepsis. The objective of this study was to investigate whether single nucleotide polymorphisms (SNPs) in the TF and TFPI genes were associated with risk and outcome for patients with severe sepsis.

Methods

Seventeen SNPs in TF and TFPI were genotyped in samples of sepsis (n =577) and severe sepsis patients (n =476), and tested for association in this case–control collection. We then investigated correlation between the associated SNPs and the mRNA expression, and protein level of the corresponding gene. The mRNA levels of TF were determined using real-time quantitative reverse transcription-polymerase chain reaction and the soluble plasma levels of TF were measured using enzyme linked immunosorbent assay (ELISA) method.

Results

Association analysis revealed that three TF SNPs in perfect linkage disequilibrium, rs1361600, rs3917615 and rs958587, were significantly associated with outcome of severe sepsis. G allele frequency of rs1361600 in survivor patients was significantly higher than that in nonsurvivor severe sepsis patients (P =4.91 × 10-5, odds ratio (OR) =0.48, 95% confidence interval (CI) 0.33 to 0.69). The association remained significant after adjustment for covariates in multiple logistic regression analysis and for multiple comparisons. Lipopolysaccharide-induced TF-mRNA expression levels in peripheral blood mononuclear cells from subjects carrying rs1361600 AG and GG genotypes, were significantly lower than those subjects carrying AA genotype (P =0.0012). Moreover, severe sepsis patients of GG and GA genotypes showed lower serum levels of TF than patients with AA genotype (Padj =0.02). The plasma levels of TF were also associated with outcome of severe sepsis patients (Padj =0.01). However, genotype and allele analyses did not show any significant difference between sepsis and severe sepsis patients.

Conclusions

Our findings indicate that common genetic variation in TF was significantly associated with outcome of severe sepsis in Chinese Han population.
Increased plasma levels of endozepines, endogenous ligands of benzodiazepine receptors, during systemic inflammation: a prospective observational study
Authors: Clavier Thomas , Tonon Marie-Christine , Foutel Anne , Besnier Emmanuel , Lefevre-Scelles Antoine , Morin Fabrice , Gandolfo Pierrick , Tuech Jean-Jacques , Quillard Muriel , Veber Benoit , Dureuil Bertrand , Castel Hélène , Compère Vincent
Published: November 2014

Introduction

Recent work has shown that benzodiazepines interact with the immune system and exhibit anti-inflammatory effects. By using in vitro models, researchers in several studies have shown that the peptidergic endogenous ligands of benzodiazepine receptors, named endozepines, are involved in the immune response. All endozepines identified so far derive from diazepam-binding inhibitor (DBI), which generates several biologically active fragments. The aim of the present study was to measure plasma levels of DBI-like immunoreactivity (DBI-LI) in a rat model of sepsis and in patients with systemic inflammation from septic or non-septic origin.

Methods

Cecal ligation and puncture (CLP) or sham surgery was performed in rats. Blood samples were taken from animals, patients hospitalized for digestive surgery with inflammatory diseases, and healthy volunteers. Measurements of plasma DBI-related peptides were carried out by radioimmunoassay in animal and human samples.

Results

In the rats, CLP provoked an increase of plasma DBI-LI (+37%) 6 hours postsurgery. In humans, DBI-LI levels were significantly higher in the systemic inflammation group than in the healthy volunteer group (48.6 (32.7 to 77.7) pg/ml versus 11.1 (5.9 to 35.3) pg/ml, P < 0.001). We found a positive correlation between endozepine levels and Acute Physiology and Chronic Health Evaluation II score (rs = 0.33 (0.026 to 0.58), P < 0.05) and tumor necrosis factor α levels (rs = 0.43 (0.14 to 0.65), P < 0.01). The area under the receiver operating characteristic curve for endozepines was 0.842 (95% CI (0.717 to 0.966), P < 0.0001) for discriminating patients with inflammation from healthy volunteers.

Conclusions

Endozepines might be involved in the inflammatory response in patients with systemic inflammation.
Clinical relevance of procalcitonin and C-reactive protein as infection markers in renal impairment: a cross-sectional study
Authors: Park Ji Hyeon , Kim Do Hee , Jang Hye Ryoun , Kim Min-Ji , Jung Sin-Ho , Lee Jung Eun , Huh Wooseong , Kim Yoon-Goo , Kim Dae Joong , Oh Ha Young
Published: November 2014

Introduction

Although the clinical application of procalcitonin (PCT) as an infection marker in patients with impaired renal function (estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2) has been increasing recently, it is unclear whether PCT is more accurate than C-reactive protein (CRP). We investigated the clinical value of CRP and PCT based on renal function.

Methods

From November 2008 to July 2011, a total of 493 patients who simultaneously underwent CRP and PCT tests were enrolled. The area under the receiver operating characteristic (ROC) curve and characteristics of both markers were analyzed according to infection severity and renal function.

Results

In patients with impaired renal function, the area under the ROC curve was 0.876 for CRP and 0.876 for PCT. In patients with infection, CRP levels differed depending on whether the infection was localized, septic, or severely septic, whereas PCT levels were higher in patients with severe sepsis or septic shock. In patients without infection, CRP did not correlate with eGFR, while PCT was negatively correlated with eGFR.

Conclusion

This study demonstrates that CRP is accurate for predicting infection in patients with impaired renal function. The study suggests that in spite of its higher cost, PCT is not superior to CRP as an infection marker in terms of diagnostic value.
Prognosis and Conditional Disease-Free Survival Among Patients With Ovarian Cancer
Authors: Kurta Michelle L. , Edwards Robert P. , Moysich Kirsten B. , McDonough Kathleen , Bertolet Marnie , Weissfeld Joel L. , Catov Janet M. , Modugno Francesmary , Bunker Clareann H. , Ness Roberta B. , Diergaarde Brenda
Published: November 2014

Purpose

Traditional disease-free survival (DFS) does not reflect changes in prognosis over time. Conditional DFS accounts for elapsed time since achieving remission and may provide more relevant prognostic information for patients and clinicians. This study aimed to estimate conditional DFS among patients with ovarian cancer and to evaluate the impact of patient characteristics.

Patients and Methods

Patients were recruited as part of the Hormones and Ovarian Cancer Prediction case-control study and were included in the current study if they had achieved remission after a diagnosis of cancer of the ovary, fallopian tube, or peritoneum (N = 404). Demographic and lifestyle information was collected at enrollment; disease, treatment, and outcome information was abstracted from medical records. DFS was calculated using the Kaplan-Meier method. Conditional DFS estimates were computed using cumulative DFS estimates.

Results

Median DFS was 2.54 years (range, 0.03-9.96 years) and 3-year DFS was 48.2%. The probability of surviving an additional 3 years without recurrence, conditioned on having already survived 1, 2, 3, 4, and 5 years after remission, was 63.8%, 80.5%, 90.4%, 97.0%, and 97.7%, respectively. Initial differences in 3-year DFS at time of remission between age, stage, histology, and grade groups decreased over time.

Conclusion

DFS estimates for patients with ovarian cancer improved dramatically over time, in particular among those with poorer initial prognoses. Conditional DFS is a more relevant measure of prognosis for patients with ovarian cancer who have already achieved a period of remission, and time elapsed since remission should be taken into account when making follow-up care decisions.
Quality of Cancer Pain Management: An Update of a Systematic Review of Undertreatment of Patients With Cancer
Authors: Greco Maria Teresa , Roberto Anna , Corli Oscar , Deandrea Silvia , Bandieri Elena , Cavuto Silvio , Apolone Giovanni
Published: November 2014

Purpose

Pain is a frequent symptom in patients with cancer, with substantial impact. Despite the availability of opioids and updated guidelines from reliable leading societies, undertreatment is still frequent.

Methods

We updated a systematic review published in 2008, which showed that according to the Pain Management Index (PMI), 43.4% of patients with cancer were undertreated. This review included observational and experimental studies reporting negative PMI scores for adults with cancer and pain published from 2007 to 2013 and retrieved through MEDLINE, Embase, and Google Scholar. To detect any temporal trend and identify potential determinants of undertreatment, we compared articles published before and after 2007 with univariable, multivariable, and sensitivity analyses.

Results

In the new set of 20 articles published from 2007 to 2013, there was a decrease in undertreatment of approximately 25% (from 43.4 to 31.8%). In the whole sample, the proportion of undertreated patients fell from 2007 to 2013, and an association was confirmed between negative PMI score, economic level, and nonspecific setting for cancer pain. Sensitivity analysis confirmed the robustness of results.

Conclusion

Analysis of 46 articles published from 1994 to 2013 using the PMI to assess the adequacy of analgesic therapy suggests the quality of pharmacologic pain management has improved. However, approximately one third of patients still do not receive pain medication proportional to their pain intensity.
Impact of Spin in the Abstracts of Articles Reporting Results of Randomized Controlled Trials in the Field of Cancer: The SPIIN Randomized Controlled Trial
Authors: Boutron Isabelle , Altman Douglas G. , Hopewell Sally , Vera-Badillo Francisco , Tannock Ian , Ravaud Philippe
Published: November 2014

Purpose

We aimed to assess the impact of spin (ie, reporting to convince readers that the beneficial effect of the experimental treatment is greater than shown by the results) on the interpretation of results of abstracts of randomized controlled trials (RCTs) in the field of cancer.

Methods

We performed a two-arm, parallel-group RCT. We selected a sample of published RCTs with statistically nonsignificant primary outcome and with spin in the abstract conclusion. Two versions of these abstracts were used—the original with spin and a rewritten version without spin. Participants were clinician corresponding authors of articles reporting RCTs, investigators of trials, and reviewers of French national grants. The primary outcome was clinicians' interpretation of the beneficial effect of the experimental treatment (0 to 10 scale). Participants were blinded to study hypothesis.

Results

Three hundred clinicians were randomly assigned using a Web-based system; 150 clinicians assessed an abstract with spin and 150 assessed an abstract without spin. For abstracts with spin, the experimental treatment was rated as being more beneficial (mean difference, 0.71; 95% CI, 0.07 to 1.35; P = .030), the trial was rated as being less rigorous (mean difference, −0.59; 95% CI, −1.13 to 0.05; P = .034), and clinicians were more interested in reading the full-text article (mean difference, 0.77; 95% CI, 0.08 to 1.47; P = .029). There was no statistically significant difference in the clinicians' rating of the importance of the study or the need to run another trial.

Conclusion

Spin in abstracts can have an impact on clinicians' interpretation of the trial results.
Comparing Standard Versus Prosocial Internet Support Groups for Patients With Breast Cancer: A Randomized Controlled Trial of the Helper Therapy Principle
Authors: Lepore Stephen J. , Buzaglo Joanne S. , Lieberman Morton A. , Golant Mitch , Greener Judith R. , Davey Adam
Published: November 2014

Purpose

Internet support group (ISG) members benefit from receiving social support and, according to the helper therapy principle, by providing support to others. To test the mental health benefits of providing support to others, this trial compared the efficacy of a standard ISG (S-ISG) and an enhanced prosocial ISG (P-ISG).

Methods

A two-armed randomized controlled trial with 1-month pretest and post-test assessments was conducted with women (N = 184) diagnosed in the past 36 months with nonmetastatic breast cancer who reported elevated anxiety or depression. Women were randomly assigned to either the S-ISG or P-ISG condition. Both conditions included six professionally facilitated live chat sessions (90-minute weekly sessions) and access to an asynchronous discussion board; P-ISG also included structured opportunities to help and encourage others.

Results

Relative to the S-ISG, participants in the P-ISG condition exhibited more supportive behaviors (emotional, informational, and companionate support), posted more messages that were other-focused and fewer that were self-focused, and expressed less negative emotion (P < .05). Relative to the S-ISG, participants in the P-ISG condition had a higher level of depression and anxiety symptoms after the intervention (P < .05).

Conclusion

Despite the successful manipulation of supportive behaviors, the P-ISG did not produce better mental health outcomes in distressed survivors of breast cancer relative to an S-ISG. The prosocial manipulation may have inadvertently constrained women from expressing their needs openly, and thus, they may not have had their needs fully met in the group. Helping others may not be beneficial as a treatment for distressed survivors of breast cancer.
Survival Among Patients With Pancreatic Cancer and Long-Standing or Recent-Onset Diabetes Mellitus
Authors: Yuan Chen , Rubinson Douglas A. , Qian Zhi Rong , Wu Chen , Kraft Peter , Bao Ying , Ogino Shuji , Ng Kimmie , Clancy Thomas E. , Swanson Richard S. , Gorman Megan J. , Brais Lauren K. , Li Tingting , Stampfer Meir J. , Hu Frank B. , Giovannucci Edward L. , Kulke Matthew H. , Fuchs Charles S. , Wolpin Brian M.
Published: November 2014

Purpose

Long-standing diabetes is a risk factor for pancreatic cancer, and recent-onset diabetes in the several years before diagnosis is a consequence of subclinical pancreatic malignancy. However, the impact of diabetes on survival is largely unknown.

Patients and Methods

We analyzed survival by diabetes status among 1,006 patients diagnosed from 1986 to 2010 from two prospective cohort studies: the Nurses' Health Study (NHS) and Health Professionals Follow-Up Study (HPFS). We validated our results among 386 patients diagnosed from 2004 to 2013 from a clinic-based case series at Dana-Farber Cancer Institute (DFCI). We estimated hazard ratios (HRs) for death using Cox proportional hazards models, with adjustment for age, sex, race/ethnicity, smoking, diagnosis year, and cancer stage.

Results

In NHS and HPFS, HR for death was 1.40 (95% CI, 1.15 to 1.69) for patients with long-term diabetes (> 4 years) compared with those without diabetes (P < .001), with median survival times of 3 months for long-term diabetics and 5 months for nondiabetics. Adjustment for a propensity score to reduce confounding by comorbidities did not change the results. Among DFCI patient cases, HR for death was 1.53 (95% CI, 1.07 to 2.20) for those with long-term diabetes compared with those without diabetes (P = .02), with median survival times of 9 months for long-term diabetics and 13 months for nondiabetics. Compared with nondiabetics, survival times were shorter for long-term diabetics who used oral hypoglycemics or insulin. We observed no statistically significant association of recent-onset diabetes (< 4 years) with survival.

Conclusion

Long-standing diabetes was associated with statistically significantly decreased survival among patients with pancreatic cancer enrolled onto three longitudinal studies.
Germline Mutations in SUFU Cause Gorlin Syndrome–Associated Childhood Medulloblastoma and Redefine the Risk Associated With PTCH1 Mutations
Authors: Smith Miriam J. , Beetz Christian , Williams Simon G. , Bhaskar Sanjeev S. , O'Sullivan James , Anderson Beverley , Daly Sarah B. , Urquhart Jill E. , Bholah Zaynab , Oudit Deemesh , Cheesman Edmund , Kelsey Anna , McCabe Martin G. , Newman William G. , Evans D. Gareth R.
Published: November 2014

Purpose

Heterozygous germline PTCH1 mutations are causative of Gorlin syndrome (naevoid basal cell carcinoma), but detection rates > 70% have rarely been reported. We aimed to define the causative mutations in individuals with Gorlin syndrome without PTCH1 mutations.

Methods

We undertook exome sequencing on lymphocyte DNA from four unrelated individuals from families with Gorlin syndrome with no PTCH1 mutations found by Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), or RNA analysis.

Results

A germline heterozygous nonsense mutation in SUFU was identified in one of four exomes. Sanger sequencing of SUFU in 23 additional PTCH1-negative Gorlin syndrome families identified a SUFU mutation in a second family. Copy-number analysis of SUFU by MLPA revealed a large heterozygous deletion in a third family. All three SUFU-positive families fulfilled diagnostic criteria for Gorlin syndrome, although none had odontogenic jaw keratocysts. Each SUFU-positive family included a single case of medulloblastoma, whereas only two (1.7%) of 115 individuals with Gorlin syndrome and a PTCH1 mutation developed medulloblastoma.

Conclusion

We demonstrate convincing evidence that SUFU mutations can cause classical Gorlin syndrome. Our study redefines the risk of medulloblastoma in Gorlin syndrome, dependent on the underlying causative gene. Previous reports have found a 5% risk of medulloblastoma in Gorlin syndrome. We found a < 2% risk in PTCH1 mutation–positive individuals, with a risk up to 20× higher in SUFU mutation–positive individuals. Our data suggest childhood brain magnetic resonance imaging surveillance is justified in SUFU-related, but not PTCH1-related, Gorlin syndrome.
The kiss/kissr Systems Are Dispensable for Zebrafish Reproduction: Evidence From Gene Knockout Studies
Authors: Tang Haipei , Liu Yun , Luo Daji , Ogawa Satoshi , Yin Yike , Li Shuisheng , Zhang Yong , Hu Wei , Parhar Ishwar S. , Lin Haoran , Liu Xiaochun , Cheng Christopher H. K.
Published: November 2014

The kiss1/gpr54 signaling system is considered to be a critical regulator of reproduction in most vertebrates. However, this presumption has not been tested vigorously in nonmammalian vertebrates. Distinct from mammals, multiple kiss1/gpr54 paralogous genes (kiss/kissr) have been identified in nonmammalian vertebrates, raising the possibility of functional redundancy among these genes. In this study, we have systematically generated the zebrafish kiss1−/−, kiss2−/−, and kiss1−/−;kiss2−/− mutant lines as well as the kissr1−/−, kissr2−/−, and kissr1−/−;kissr2−/− mutant lines using transcription activator-like effector nucleases. We have demonstrated that spermatogenesis and folliculogenesis as well as reproductive capability are not impaired in all of these 6 mutant lines. Collectively, our results indicate that kiss/kissr signaling is not absolutely required for zebrafish reproduction, suggesting that the kiss/kissr systems play nonessential roles for reproduction in certain nonmammalian vertebrates. These findings also demonstrated that fish and mammals have evolved different strategies for neuroendocrine control of reproduction.
Sex-Specific Effects of Relaxin-3 on Food Intake and Brain Expression of Corticotropin-Releasing Factor in Rats
Authors: Lenglos Christophe , Calvez Juliane , Timofeeva Elena
Published: November 2014

This study compared the effects of relaxin-3 (RLN3) on food intake, plasma corticosterone, and the expression of corticotropin-releasing factor (CRF) in male and female rats. RLN3 was injected into the lateral ventricle at 25, 200, and 800 pmol concentrations. RLN3 at 25 pmol increased food intake (grams) at 30 and 60 minutes after injection in female but not male rats. Female rats also showed higher increase in relative to body weight (BW) food intake (mg/g BW) for all RLN3 concentrations at 30 minutes and for 800 pmol of RLN3 at 60 minutes. Moreover, RLN3 at 800 pmol significantly increased 24-hour BW gain in female but not male rats. At 60 minutes after administration, 800 pmol of RLN3 produced a significant increase in plasma corticosterone and in the expression of CRF and c-fos mRNAs in the parvocellular paraventricular hypothalamic nucleus (PVN) in male but not female rats. The levels of c-fos mRNA in the magnocellular PVN were increased by RLN3 but did not differ between the sexes. Conversely, expression of CRF mRNA in the medial preoptic area was increased in female rats but was not sensitive to 800 pmol of RLN3. In the bed nucleus of the stria terminalis, 800 pmol of RLN3 significantly increased CRF mRNA expression in female but not male rats. Therefore, female rats showed more sensitivity and stronger food intake increase in response to RLN3. The differential effects of RLN3 on CRF expression in the PVN and bed nucleus of the stria terminalis may contribute to the sex-specific difference in the behavioral response.