bluuebunny/crossref_metadata_2025 huggingface dataset:
Flame-retardant fibrous materials in an aircraft
Authors: Uddin Faheem
Published: July 2014

An increasing number of flying hours requires an improved level of confidence in safety and comfort for crew staff, passengers, and valuables. Alternative or improved material utilization in interior furnishing and structure is perceived important in producing an aircraft. Fibrous material used in an aircraft may enhance the level of safety and the desired effects in producing the structural components. Aircraft accidents and loses to lives and valuable caused by fire are known in aviation history. Flammability in an aircraft as a leading cause or as a subcause may be prevented through an appropriate utilization of flame-retardant (FR) fibrous materials used in aircraft design and manufacturing and in interior furnishing. Improving the prevention of fire hazard through reduced flammability materials was a desired activity for achieving safer air travel. Important FR fibers (FR finished natural fibers and high-performance fibers including synthetic polyamides, carbon, and ceramic fibers), finishes (organophosphorus reagents), and fibrous structural components in aircraft are discussed. FR finishes including brominated FR with reference to recent environmental concerns are described. Standard testing of FR fibrous material based on the Federal Aviation Administration regulations are introduced for any flammability requirements. This study is particularly conducted to appreciate how fibrous materials are useful in improving the flame retardancy and any other performance factor including safety and reduced fuel consumption in an aircraft.
Cost-effectiveness of health research study participant recruitment strategies: A systematic review
Authors: Huynh Lynn , Johns Benjamin , Liu Su-Hsun , Vedula S Swaroop , Li Tianjing , Puhan Milo A
Published: July 2014

Background:

A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials.

Purpose:

To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies.

Methods:

We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies.

Results:

We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$—International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials.

Limitations:

We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis.

Conclusions:

Systematic and explicit reporting of cost and effectiveness of recruitment strategies from randomized comparisons is required to aid investigators to select cost-efficient strategies for recruiting participants to health research studies including clinical trials.
Tetramer‐visualized gluten‐specific CD4+ T cells in blood as a potential diagnostic marker for coeliac disease without oral gluten challenge
Authors: Christophersen Asbjørn , Ráki Melinda , Bergseng Elin , Lundin Knut EA , Jahnsen Jørgen , Sollid Ludvig M , Qiao Shuo-Wang
Published: July 2014

Background

Diagnosing coeliac disease (CD) can be challenging, despite highly specific autoantibodies and typical mucosal changes in the small intestine. The T‐cell response to gluten is a hallmark of the disease that has been hitherto unexploited in clinical work‐up.

Objectives

We aimed to develop a new method that directly visualizes and characterizes gluten‐reactive CD4+ T cells in blood, independently of gluten challenge, and to explore its diagnostic potential.

Methods

We performed bead‐enrichment of DQ2.5‐glia‐α1a and DQ2.5‐glia‐α2 tetramer+ cells in the blood of control individuals, treated (TCD) and untreated patients (UCD). We visualized these cells by flow cytometry, sorted them and cloned them. We assessed their specificity by antigen stimulation and re‐staining with tetramers.

Results

We detected significantly more gliadin‐tetramer+ CD4+ effector memory T cells (TEM) in UCD and TCD patients, compared to controls. Significantly more gliadin‐tetramer+ TEM in the CD patients than in controls expressed the gut‐homing marker integrin‐β7.

Conclusion

Quantification of gut‐homing, gluten‐specific TEM in peripheral blood, visualized with human leukocyte antigen (HLA) ‐tetramers, may be used to distinguish CD patients from healthy individuals. Easy access to gluten‐reactive blood T cells from diseased and healthy individuals may lead to new insights on the disease‐driving CD4+ T cells in CD.
Diagnostic impact of routine colonoscopy following acute diverticulitis: A multicenter study in 808 patients and controls
Authors: Lecleire Stéphane , Nahon Stéphane , Alatawi Abdullah , Antonietti Michel , Chaput Ulriikka , Di-Fiore Aude , Alhameedi Raied , Marteau Philippe , Ducrotté Philippe , Dray Xavier
Published: July 2014

Background

The diagnosis of acute diverticulitis is mainly based on clinical, biological and computed tomography (CT)‐scan findings. Elective colonoscopy is recommended after medical treatment, to rule out another diagnosis and to detect associated conditions; however, the relevance of this recommendation has been questioned.

Patients and methods

Between January 2005 and December 2011, we retrospectively identified in three referral centers the consecutive patients whom underwent a colonoscopy after the medical treatment of a CT scan‐proven acute diverticulitis episode. We excluded from the analysis patients with haematochezia or recent change in bowel habits. Sex and age‐matched asymptomatic patients undergoing a screening colonoscopy were chosen as a control group. We collected and compared the results of colonoscopy and histological findings in both groups.

Results

We matched 404 patients whom underwent a colonoscopy after an episode of acute diverticulitis with 404 control patients. Their mean age was 60.9 years, with 59% being women. Colorectal adenoma, advanced adenoma and cancer detection rates in acute diverticulitis patients were 12.1%, 2.7% and 0.25%, respectively; versus 14.6% (p  = 0.35), 6.7% (p  = 0.01) and 0.25% respectively, in control patients.

Conclusions

Diagnosis rates for adenomas and for colorectal cancer during a colonoscopy scheduled after acute diverticulitis were similar than those of control patients undergoing a screening colonoscopy, while the detection rate of advanced adenomas was lower. We suggest that colonoscopy should be indicated only in selected patients, i.e. those presenting with reasonable doubt on initial CT‐scan, those with alarm symptoms, and those with identified risk factors for colorectal cancer.
Affective Neuroscience Strategies for Understanding and Treating Depression
Authors: Panksepp Jaak , Wright Jason S. , Döbrössy Máté D. , Schlaepfer Thomas E. , Coenen Volker A.
Published: July 2014

Mammalian brains contain seven primary-process affective substrates for primal emotional feelings and behaviors. Scientific labels for these interactive systems are SEEKING, RAGE, FEAR, LUST, CARE, PANIC, and PLAY. Understanding these brain substrates could lead to new treatments of emotional disturbances that accompany mental illnesses. We summarize how understanding of such emotional affects—especially those of separation distress (PANIC, promoting excessive sadness and grief), SEEKING (promoting enthusiasm), and PLAY (promoting social joy)—may regulate depressive affect through a focus on the following: (a) reducing PANIC, namely, “psychic pain” with “safe opioids” such as buprenorphine; (b) facilitating enthusiasm with deep brain stimulation of the transdiencephalic medial forebrain bundle–based SEEKING urges; and (c) how studies of brain neurochemical pathways that facilitate social joy (PLAY) in animals have yielded novel neurochemical interventions (e.g., GLYX-13, a partial agonist of glycine receptors) currently in successful human testing. Affective neuroscience principles that have led to these advances are summarized.
Unseen Affective Faces Influence Person Perception Judgments in Schizophrenia
Authors: Kring Ann M. , Siegel Erika H. , Barrett Lisa Feldman
Published: July 2014

To demonstrate the influence of unconscious affective processing on consciously processed information among people with and without schizophrenia, we used a continuous flash suppression (CFS) paradigm to examine whether early and rapid processing of affective information influences first impressions of structurally neutral faces. People with and without schizophrenia rated visible neutral faces as more or less trustworthy, warm, and competent when paired with unseen smiling or scowling faces compared to when paired with unseen neutral faces. Yet, people with schizophrenia also exhibited a deficit in explicit affect perception. These findings indicate that early processing of affective information is intact in schizophrenia but the integration of this information with semantic contexts is problematic. Furthermore, people with schizophrenia who were more influenced by smiling faces presented outside awareness reported experiencing more anticipatory pleasure, suggesting that the ability to rapidly process affective information is important for anticipation of future pleasurable events.
Nuclear and chloroplast diversity and phenotypic distribution of rice (Oryza sativa L.) germplasm from the democratic people’s republic of Korea (DPRK; North Korea)
Authors: Kim HyunJung , Jeong Eung Gi , Ahn Sang-Nag , Doyle Jeffrey , Singh Namrata , Greenberg Anthony J , Won Yong Jae , McCouch Susan R
Published: July 2014

Background

Rice accounts for 43% of staple food production in the Democratic People’s Republic of Korea (DPRK). The most widely planted rice varieties were developed from a limited number of ancestral lines that were repeatedly used as parents in breeding programs. However, detailed pedigrees are not publicly available and little is known about the genetic, phenotypic, and geographical variation of DPRK varieties.

Results

We evaluated 80 O. sativa accessions from the DPRK, consisting of 67 improved varieties and 13 landraces. Based on nuclear SSR analysis, we divide the varieties into two genetic groups: Group 1 corresponds to the temperate japonica subpopulation and represents 78.75% of the accessions, while Group 2 shares recent ancestry with indica varieties. Interestingly, members of Group 1 are less diverse than Group 2 at the nuclear level, but are more diverse at the chloroplast level. All Group 2 varieties share a single Japonica maternal-haplotype, while Group 1 varieties trace maternal ancestry to both Japonica and Indica. Phenotypically, members of Group 1 have shorter grains than Group 2, and varieties from breeding programs have thicker and wider grains than landraces. Improved varieties in Group 1 also show similar and/or better levels of cold tolerance for most traits, except for spikelet number per panicle. Finally, geographic analysis demonstrates that the majority of genetic variation is located within regions that have the most intensive rice cultivation, including the Western territories near the capital city Pyungyang. This is consistent with the conscious and highly centralized role of human selection in determining local dispersion patterns of rice in the DPRK.

Conclusions

Diversity studies of DPRK rice germplasm revealed two genetic groups. The most widely planted group has a narrow genetic base and would benefit from the introduction of new genetic variation from cold tolerant landraces, wild accessions, and/or cultivated gene pools to enhance yield potential and performance.
Evaluation of [11C]oseltamivir uptake into the brain during immune activation by systemic polyinosine-polycytidylic acid injection: a quantitative PET study using juvenile monkey models of viral infection
Authors: Seki Chie , Oh-Nishi Arata , Nagai Yuji , Minamimoto Takafumi , Obayashi Shigeru , Higuchi Makoto , Takei Makoto , Furutsuka Kenji , Ito Takehito , Zhang Ming-Rong , Ito Hiroshi , Ito Mototsugu , Ito Sumito , Kusuhara Hiroyuki , Sugiyama Yuichi , Suhara Tetsuya
Published: July 2014

Background

Abnormal behaviors of young patients after taking the anti-influenza agent oseltamivir (Tamiflu®, F. Hoffmann-La Roche, Ltd., Basel, Switzerland) have been suspected as neuropsychiatric adverse events (NPAEs). Immune response to viral infection is suspected to cause elevation of drug concentration in the brain of adolescents. In the present study, the effect of innate immune activation on the brain uptake of [11C]oseltamivir was quantitatively evaluated in juvenile monkeys.

Methods

Three 2-year-old monkeys underwent positron emission tomography (PET) scans at baseline and immune-activated conditions. Both scans were conducted under pre-dosing of clinically relevant oseltamivir. The immune activation condition was induced by the intravenous administration of polyinosine-polycytidylic acid (poly I:C). Dynamic [11C]oseltamivir PET scan and serial arterial blood sampling were performed to obtain [11C]oseltamivir kinetics. Brain uptake of [11C]oseltamivr was evaluated by its normalized brain concentration, brain-to-plasma concentration ratio, and plasma-to-brain transfer rate. Plasma pro-inflammatory cytokine levels were also measured.

Results

Plasma interleukin-6 was elevated after intravenous administration of poly I:C in all monkeys. Brain radioactivity was uniform both at baseline and under poly I:C treatment. The mean brain concentrations of [11C]oseltamivir were 0.0033 and 0.0035% ID/cm3 × kg, the mean brain-to-plasma concentration ratios were 0.58 and 0.65, and the plasma-to-brain transfer rates were 0.0047 and 0.0051 mL/min/cm3 for baseline and poly I:C treatment, respectively. Although these parameters were slightly changed by immune activation, the change was not notable.

Conclusions

The brain uptake of [11C]oseltamivir was unchanged by poly I:C treatment in juvenile monkeys. This study demonstrated that the innate immune response similar to the immune activation of influenza would not notably change the brain concentration of oseltamivir in juvenile monkeys.
G-CSF preferentially supports the generation of gut-homing Gr-1high macrophages in M-CSF-treated bone marrow cells
Authors: Meshkibaf Shahab , William Gower Mark , Dekaban Gregory A , Ouk Kim Sung
Published: July 2014

The G-CSF is best known for its activity in the generation and activation of neutrophils. In addition, studies on G-CSF−/− or G-CSFR−/− mice and BMC cultures suggested a role of G-CSF in macrophage generation. However, our understanding on the role of G-CSF in macrophage development is limited. Here, using in vitro BMC models, we demonstrated that G-CSF promoted the generation of Gr-1high/F4/80+ macrophage-like cells in M-BMCs, likely through suppressing cell death and enhancing generation of Gr-1high/F4/80+ macrophage-like cells. These Gr-1high macrophage-like cells produced “M2-like” cytokines and surface markers in response to LPS and IL-4/IL-13, respectively. Adoptive transfer of EGFP-expressing (EGFP+) M-BMCs showed a dominant, gut-homing phenotype. The small intestinal lamina propria of G-CSFR−/− mice also harbored significantly reduced numbers of Gr-1high/F4/80+ macrophages compared with those of WT mice, but levels of Gr-1+/F4/80− neutrophil-like cells were similar between these mice. Collectively, these results suggest a novel function of G-CSF in the generation of gut-homing, M2-like macrophages.
Anti-basal ganglia antibodies in primary obsessive–compulsive disorder: systematic review and meta-analysis
Authors: Pearlman Daniel M. , Vora Haily S. , Marquis Brian G. , Najjar Souhel , Dudley Lauren A.
Published: July 2014

Background

Autoimmune-mediated basal ganglia dysfunction is implicated in the pathophysiology of neuropsychiatric disorders commonly manifesting with obsessive–compulsive features (e.g. Sydenham chorea). The relationship between autoimmunity and primary obsessive–compulsive disorder (OCD), however, is less clear.

Aims

To pool data on serum and cerebrospinal fluid (CSF) anti-basal ganglia antibody (ABGA) positivity in primary OCD (without neurological or autoimmune comorbidity) relative to controls or neuropsychiatric disorders previously associated with increased odds of ABGA positivity.

Method

We performed electronic database and hand-searches for studies meeting pre-specified eligibility criteria from which we extracted data using a standardised form. We calculated pooled estimates of ABGA positivity using a random-effects model.

Results

Seven case–control studies totalling 844 participants met the eligibility criteria. Meta-analysis showed that a significantly greater proportion of those with primary OCD were ABGA seropositive compared with various controls (odds ratio (OR) = 4.97, 95% CI 2.88–8.55,P<0.00001). This effect was not associated with heterogeneity or publication bias, and remained significant after stratifying the analysis by age, gender, disease severity, illness duration, immunostaining methodology, study quality, publication type, kind of control group, and sample size. There were no significant differences in ABGA seropositivity for comparisons between primary OCD and Tourette syndrome, attention-deficit hyperactivity disorder or paediatric acute-onset neuropsychiatric syndrome. Results of one study testing CSF samples showed that a significantly greater proportion of participants with primary OCD were ABGA CSF-positive compared with healthy controls (OR = 5.60, 95% CI 1.04–30.20,P= 0.045).

Conclusions

Odds of ABGA seropositivity are increased fivefold in primary OCD compared with controls, but are comparable to those associated with disorders previously associated with ABGA, providing circumstantial evidence of autoimmunity in a subset of those with primary OCD. Further experimental studies are needed to ascertain whether this relationship is causal.
A neurobiological hypothesis for the classification of schizophrenia: type a (hyperdopaminergic) and type B (normodopaminergic)
Authors: Howes Oliver D. , Kapur Shitij
Published: July 2014

Schizophrenia is usually classified based on clinical presentation. However, the conventional paranoid–disorganised–residual distinctions have had limited clinical utility. Here we draw on the evidence for differences in pathophysiology underlying treatment response to propose a subclassification based on neurobiology to guide diagnostic testing and treatment.
Recurrence and Survival Outcomes After Anatomic Segmentectomy Versus Lobectomy for Clinical Stage I Non–Small-Cell Lung Cancer: A Propensity-Matched Analysis
Authors: Landreneau Rodney J. , Normolle Daniel P. , Christie Neil A. , Awais Omar , Wizorek Joseph J. , Abbas Ghulam , Pennathur Arjun , Shende Manisha , Weksler Benny , Luketich James D. , Schuchert Matthew J.
Published: July 2014

Purpose

Although anatomic segmentectomy has been considered a compromised procedure by many surgeons, recent retrospective, single-institution series have demonstrated tumor recurrence and patient survival rates that approximate those achieved by lobectomy. The primary objective of this study was to use propensity score matching to compare outcomes after these anatomic resection approaches for stage I non–small-cell lung cancer.

Patients and Methods

A retrospective data set including 392 segmentectomy patients and 800 lobectomy patients was used to identify matched segmentectomy and lobectomy cohorts (n = 312 patients per group) using a propensity score matching algorithm that accounted for confounding effects of preoperative patient variables. Primary outcome variables included freedom from recurrence and overall survival. Factors affecting survival were assessed by Cox regression analysis and Kaplan-Meier estimates.

Results

Perioperative mortality was 1.2% in the segmentectomy group and 2.5% in the lobectomy group (P = .38). At a mean follow-up of 5.4 years, comparing segmentectomy with lobectomy, no differences were noted in locoregional (5.5% v 5.1%, respectively; P = 1.00), distant (14.8% v 11.6%, respectively; P = .29), or overall recurrence rates (20.2% v 16.7%, respectively; P = .30). Furthermore, when comparing segmentectomy with lobectomy, no significant differences were noted in 5-year freedom from recurrence (70% v 71%, respectively; P = .467) or 5-year survival (54% v 60%, respectively; P = .258). Segmentectomy was not found to be an independent predictor of recurrence (hazard ratio, 1.11; 95% CI, 0.87 to 1.40) or overall survival (hazard ratio, 1.17; 95% CI, 0.89 to 1.52).

Conclusion

In this large propensity-matched comparison, lobectomy was associated with modestly increased freedom from recurrence and overall survival, but the differences were not statistically significant. These results will need further validation by prospective, randomized trials (eg, Cancer and Leukemia Group B 140503 trial).
Long-Term Central Venous Catheter Use and Risk of Infection in Older Adults With Cancer
Authors: Lipitz-Snyderman Allison , Sepkowitz Kent A. , Elkin Elena B. , Pinheiro Laura C. , Sima Camelia S. , Son Crystal H. , Atoria Coral L. , Bach Peter B.
Published: July 2014

Purpose

Long-term central venous catheters (CVCs) are often used in patients with cancer to facilitate venous access to administer intravenous fluids and chemotherapy. CVCs can also be a source of bloodstream infections, although this risk is not well understood. We examined the impact of long-term CVC use on infection risk, independent of other risk factors such as chemotherapy, in a population-based cohort of patients with cancer.

Patients and Methods

We conducted a retrospective analysis using SEER-Medicare data for patients age > 65 years diagnosed from 2005 to 2007 with invasive colorectal, head and neck, lung, or pancreatic cancer, non-Hodgkin lymphoma, or invasive or noninvasive breast cancer. Cox proportional hazards regression was used to examine the relationship between CVC use and infections, with CVC exposure as a time-dependent predictor. We used multivariable analysis and propensity score methods to control for patient characteristics.

Results

CVC exposure was associated with a significantly elevated infection risk, adjusting for demographic and disease characteristics. For patients with pancreatic cancer, risk of infections during the exposure period was three-fold greater (adjusted hazard ratio [AHR], 2.93; 95% CI, 2.58 to 3.33); for those with breast cancer, it was six-fold greater (AHR, 6.19; 95% CI, 5.42 to 7.07). Findings were similar when we accounted for propensity to receive a CVC and limited the cohort to individuals at high risk of infections.

Conclusion

Long-term CVC use was associated with an increased risk of infections for older adults with cancer. Careful assessment of the need for long-term CVCs and targeted strategies for reducing infections are critical to improving cancer care quality.
Cyclophosphamide Compared With Ifosfamide in Consolidation Treatment of Standard-Risk Ewing Sarcoma: Results of the Randomized Noninferiority Euro-EWING99-R1 Trial
Authors: Le Deley Marie-Cécile , Paulussen Michael , Lewis Ian , Brennan Bernadette , Ranft Andreas , Whelan Jeremy , Le Teuff Gwénaël , Michon Jean , Ladenstein Ruth , Marec-Bérard Perrine , van den Berg Henk , Hjorth Lars , Wheatley Keith , Judson Ian , Juergens Heribert , Craft Alan , Oberlin Odile , Dirksen Uta
Published: July 2014

Purpose

Relative efficacy and toxicity of cyclophosphamide compared with ifosfamide are debatable. The Euro-EWING99-R1 trial asked whether cyclophosphamide may replace ifosfamide in combination with vincristine and dactinomycin (vincristine, dactinomycin, and cyclophosphamide [VAC] v vincristine, dactinomycin, and ifosfamide [VAI]) after an intensive induction chemotherapy containing vincristine, ifosfamide, doxorubicin, and etoposide (VIDE) in standard-risk localized disease (NCT00020566).

Methods

Standard-risk Ewing sarcomas were localized tumors with either a good histologic response to chemotherapy (< 10% cells) or small tumors (< 200 mL) resected at diagnosis or receiving radiotherapy alone as local treatment. Patients entered the trial after six VIDE+1 VAI courses. Allocated treatment was either 7 VAC courses with 1.5 g/m2 of cyclophosphamide or seven VAI-courses with 6 g/m2 ifosfamide. The limit of noninferiority was set at −8.5% for the 3-year event-free survival rate (EFS), equivalent to 1.43 in terms of the hazard ratio of event (HRevent).

Results

This large international trial recruited 856 patients between February 2000 and March 2010 (n = 431 receiving VAC and n = 425 receiving VAI). With a median follow-up of 5.9 years, the 3-year EFSs were 75.4% and 78.2%, respectively, the 3-year EFS difference was −2.8% (91.4% CI, −7.8 to 2.2%), the HRevent was 1.12 (91.4% CI, 0.89 to 1.41), and the HRdeath was 1.09 (91.4% CI, 0.84 to 1.42; intention-to-treat). The HRevent was 1.22 (91.4% CI, 0.96 to 1.54) on the per-protocol population. Major treatment modifications were significantly less frequent in the VAC arm (< 1%) than in the VAI arm (7%), mainly resulting from toxicity. Patients experienced more frequent thrombocytopenia in the VAC arm (45% v 35%) but fewer grade 2 to 4 acute tubular toxicities (16% v 31%).

Conclusion

Cyclophosphamide may be able to replace ifosfamide in consolidation treatment of standard-risk Ewing sarcoma. However, some uncertainty surrounding the noninferiority of VAC compared with VAI remains at this stage. The ongoing comparative evaluation of long-term renal and gonadal toxicity is crucial to decisions regarding future patients.
Cancer Treatment Disparities in HIV-Infected Individuals in the United States
Authors: Suneja Gita , Shiels Meredith S. , Angulo Rory , Copeland Glenn E. , Gonsalves Lou , Hakenewerth Anne M. , Macomber Kathryn E. , Melville Sharon K. , Engels Eric A.
Published: July 2014

Purpose

HIV-infected individuals with cancer have worse survival rates compared with their HIV-uninfected counterparts. One explanation may be differing cancer treatment; however, few studies have examined this.

Patients and Methods

We used HIV and cancer registry data from Connecticut, Michigan, and Texas to study adults diagnosed with non-Hodgkin's lymphoma, Hodgkin's lymphoma, or cervical, lung, anal, prostate, colorectal, or breast cancers from 1996 to 2010. We used logistic regression to examine associations between HIV status and cancer treatment, adjusted for cancer stage and demographic covariates. For a subset of local-stage cancers, we used logistic regression to assess the relationship between HIV status and standard treatment modality. We identified predictors of cancer treatment among individuals with both HIV and cancer.

Results

We evaluated 3,045 HIV-infected patients with cancer and 1,087,648 patients with cancer without HIV infection. A significantly higher proportion of HIV-infected individuals did not receive cancer treatment for diffuse large B-cell lymphoma (DLBCL; adjusted odds ratio [aOR], 1.67; 95% CI, 1.41 to 1.99), lung cancer (aOR, 2.18; 95% CI, 1.80 to 2.64), Hodgkin's lymphoma (aOR, 1.77; 95% CI, 1.33 to 2.37), prostate cancer (aOR, 1.79; 95% CI, 1.31 to 2.46), and colorectal cancer (aOR, 2.27; 95% CI, 1.38 to 3.72). HIV infection was associated with a lack of standard treatment modality for local-stage DLBCL (aOR, 2.02; 95% CI, 1.50 to 2.72), non–small-cell lung cancer (aOR, 2.43; 95% CI, 1.46 to 4.03), and colon cancer (aOR, 4.77; 95% CI, 1.76 to 12.96). Among HIV-infected individuals, factors independently associated with lack of cancer treatment included low CD4 count, male sex with injection drug use as mode of HIV exposure, age 45 to 64 years, black race, and distant or unknown cancer stage.

Conclusion

HIV-infected individuals are less likely to receive treatment for some cancers than uninfected people, which may affect survival rates.
Moving Beyond the Hazard Ratio in Quantifying the Between-Group Difference in Survival Analysis
Authors: Uno Hajime , Claggett Brian , Tian Lu , Inoue Eisuke , Gallo Paul , Miyata Toshio , Schrag Deborah , Takeuchi Masahiro , Uyama Yoshiaki , Zhao Lihui , Skali Hicham , Solomon Scott , Jacobus Susanna , Hughes Michael , Packer Milton , Wei Lee-Jen
Published: July 2014

In a longitudinal clinical study to compare two groups, the primary end point is often the time to a specific event (eg, disease progression, death). The hazard ratio estimate is routinely used to empirically quantify the between-group difference under the assumption that the ratio of the two hazard functions is approximately constant over time. When this assumption is plausible, such a ratio estimate may capture the relative difference between two survival curves. However, the clinical meaning of such a ratio estimate is difficult, if not impossible, to interpret when the underlying proportional hazards assumption is violated (ie, the hazard ratio is not constant over time). Although this issue has been studied extensively and various alternatives to the hazard ratio estimator have been discussed in the statistical literature, such crucial information does not seem to have reached the broader community of health science researchers. In this article, we summarize several critical concerns regarding this conventional practice and discuss various well-known alternatives for quantifying the underlying differences between groups with respect to a time-to-event end point. The data from three recent cancer clinical trials, which reflect a variety of scenarios, are used throughout to illustrate our discussions. When there is not sufficient information about the profile of the between-group difference at the design stage of the study, we encourage practitioners to consider a prespecified, clinically meaningful, model-free measure for quantifying the difference and to use robust estimation procedures to draw primary inferences.
Liprin-α1, ERC1 and LL5 identify a polarized, dynamic compartment implicated in cell migration
Authors: Astro Veronica , Chiaretti Sara , Magistrati Elisa , Fivaz Marc , de Curtis Ivan
Published: July 2014

Cell migration during development and metastatic invasion requires the coordination of actin and adhesion dynamics to promote the protrusive activity at the cell front. The knowledge of the molecular mechanisms required to achieve such coordination is fragmentary. Here we identify a new functional complex that drives cell motility. The adaptor proteins ERC1a and LL5 are required with liprin-α1 for effective migration and tumor cell invasion, and do so by stabilizing the protrusive activity at the cell front. Depletion of either protein negatively affects invasion, migration on extracellular matrix, lamellipodial persistence, as well as the internalization of active integrin β1 receptors needed for adhesion turnover at the cell front. Liprin-α1, ERC1a and LL5 also define new highly polarized and dynamic cytoplasmic structures uniquely localized near the protruding cell edge. Our results indicate that the functional complex and the associated structures described here represent an important mechanism to drive tumor cell migration.
Synthesis of Curved Hexa-peri-hexabenzocoronenes
Authors: Yamaguchi Ryuichi , Hiroto Satoru , Shinokubo Hiroshi
Published: July 2014

Halogenation and phenylthiolation of hexabenzocoronenetetraone were performed. We found that introduction of substituents at the fjord regions induced substantial curvature of the hexabenzocoronene (HBC) plane through steric repulsion between the substituents and proximal hydrogen atoms. This method allows construction of curved HBC derivatives, which would allow formation of novel supramolecular structures.
Enrichment Map – a Cytoscape app to visualize and explore OMICs pathway enrichment results
Authors: Isserlin Ruth , Merico Daniele , Voisin Veronique , Bader Gary D.
Published: July 2014

High-throughput OMICs experiments generate signals for millions of entities (i.e. genes, proteins, metabolites or any measurable biological entity) in the cell. In an effort to summarize and explore these signals, expression results are examined in the context of known pathways and processes, through enrichment analysis to generate a set of pathways and processes that is significantly enriched. Due to the high redundancy in annotation resources this often results in hundreds of sets. To facilitate the analysis of these results, we have developed the Enrichment Map app to visualize enrichments as a network. We have updated Enrichment Map to support Cytoscape 3, and have added additional features including new data formats and command line access.
The Cytoscape app article collection
Authors: Pico Alexander R , Bader Gary D , Demchak Barry , Guitart Pla Oriol , Hull Timothy , Longabaugh William , Lopes Christian , Lotia Samad , Molenaar Piet , Montojo Jason , Morris John H , Ono Keiichiro , Schwikowski Benno , Welker David , Ideker Trey
Published: July 2014

As a network visualization and analysis platform, Cytoscape relies on apps to provide domain-specific features and functions. There are many resources available to support Cytoscape app development and distribution, including the Cytoscape App Store and an online “cookbook” for app developers. This article collection is another resource to help researchers find out more about relevant Cytoscape apps and to provide app developers with useful implementation tips. The collection will grow over time as new Cytoscape apps are developed and published.
The Central Role of Engagement in Online Communities
Authors: Ray Soumya , Kim Sung S. , Morris James G.
Published: July 2014

Online communities are new social structures dependent on modern information technology, and they face equally modern challenges. Although satisfied members regularly consume content, it is considerably harder to coax them to contribute new content and help recruit others because they face unprecedented social comparison and criticism. We propose that engagement—a concept only abstractly alluded to in information systems research—is the key to active participation in these unique sociotechnical environments. We constructed and tested a framework that demonstrates what engagement is, where it comes from, and how it powerfully explains both knowledge contribution and word of mouth. Our results show that members primarily contribute to and revisit an online community from a sense of engagement. Nonetheless, word of mouth is partly influenced by prior satisfaction. Therefore, engagement and satisfaction appear to be parallel mediating forces at work in online communities. Both mediators arise from a sense of communal identity and knowledge self-efficacy, but engagement also emerges from validation of self-identity. Nevertheless, we also found signs that the contributions of the most knowledgeable users are not purely from engagement, but also from a competing sense of self-efficacy. Our findings significantly contribute to the area of information systems by highlighting that engagement is a concrete phenomenon on its own, and it can be directly modeled and must be carefully managed.
Meeting individual cultural and religious needs in a multiracial society
Authors: Schott Judith , Henley Alix
Published: July 2014

Faced with diverse needs many health professionals want ‘facts’ about different cultural and religious groups. But such ‘facts’ ignore the tremendous diversity among individuals within any group. A useful approach is to consider the wide spectrum of possible needs and attitudes in relation to each component of care, and then to discuss with each woman what is important to her.
Haemoglobinopathies, antenatal screening and the midwife
Authors: Dyson Simon , Fielder Anna , Kirkham Mavis
Published: July 2014

In the absence of mandatory guidelines on antenatal screening for haemoglobinopathies, this article considers the responsibilities of midwives in antenatal clinics, the educational prerequisites of an effective service and the implications of identified areas of deficit in haemoglobinopathy knowledge.
The challenge of negotiating the maze of woman-centred care in Scotland
Authors: Reid Lindsay , Hillan Edith , McGuire Margaret
Published: July 2014

This article, the second in a two-part series, looks at changes in practice that might be encountered by midwives in Scotland, as the term ‘woman-centred care’ and the attendant new schemes of care are tried and tested. The challenges are examined, good points come to light but problems too, emerge. While being ready to look forward and embrace change for good, midwives should be sure that the changes are initiated by those in whom they have full confidence.
Redesigning postnatal care: physical and psychological needs
Authors: Bick Debra , MacArthur Christine , Winter Heather , Fortune Helena , Henderson Christine , Lilford Richard , Gillies Anne , Gee Harry , Belfield Clive
Published: July 2014

This trial to assess a new model of postnatal care has been funded by the NHS Research and Development, Health Technology Assessment Programme. The authors, who are also the trial management team, represent a range of disciplines relevant to the evaluation of postpartum care.
Letters
Authors: Gaskell Catherine , Peattie Siobhan , Murphy Stell , Jaiyesimi RAK , Siddiqi Ferzana
Published: July 2014

I was recently asked by a large multinational baby milk manufacturer if they could attend the unit I manage and speak to the mothers directly about techniques of bottle feeding and bottle care, etc. I had reservations about this idea based on the free advertising angle, product placement and appearing to endorse milk products by having them demonstrated in an NHS environment. However, the article by Dykes — ‘Return to breastfeeding: a global priority’ (Vol. 5(6) 1997, p.344) summed up the issue more succinctly and firmly for me, particularly after reading the WHO's International Code of Marketing of Breast milk Substitutes.
The costs to the NHS of maternity care: midwife-managed vs shared
Authors: Young Denise , Twaddle Sara , Lees Ann
Published: July 2014

The objectives of this article are to compare the costs to the NHS of midwife-managed care and shared care. A randomized controlled trial was used. Women who were randomized to receive midwife-managed care but did not complete the care programme remained in the midwife-managed group for the purpose of analysis. The study took place in the Glasgow Royal Maternity Hospital, a major urban teaching hospital providing an integrated maternity service. A total of 1299 women experiencing normal healthy pregnancy took part in the study — 648 women were randomized to midwife-managed care and 651 to shared care. The main outcome measures were the costs to the NHS of providing the two alternative types of maternity care. Assuming a median caseload of 29 women per midwife in the midwife-managed group, there were no significant differences in the median costs of antenatal (midwife-managed=£287.60, shared care=£295.91, p=0.48) and intrapartum (midwife-managed=£240.90, shared care= £241.17, p=0.4) care. However, midwife-managed care was associated with significantly higher costs than shared care in the postnatal period (midwife-managed=£470.84, shared care=£352.03, p<0.001). When sensitivity analysis was performed to examine the effect of increased caseload on costs, shared care was associated with higher costs antenatally (midwife-managed=£274.94, shared care=£295.91, p=0.05). However, midwife-managed postnatal care remained significantly more expensive than shared care (midwife-managed=£404.17, shared care=£352.03, p<0.001). The costs of intrapartum care were not affected by this change in assumption. Differences in costs to the NHS largely reflected organizational differences between the two styles of care. Decisions concerning the provision of maternity services should not be based on costing information alone; information about clinical outcomes and women's satisfaction with care should also be considered. In the postnatal period, service providers would ultimately need to consider whether the increased costs of midwife-managed care were worth the enhanced levels of women's satisfaction measured in the randomized controlled trial.
Do birth plans adversely affect the outcome of labour?
Authors: Jones MH , Barik S , Mangune HH , Jones P , Gregory SJ , Spring JE
Published: July 2014

More women are now presenting for antenatal with their own personal requirements and expectations regarding labour and delivery. This study assesses whetner women with birth plans are as likely to achieve spontaneous vaginal delivery as women without birth plans.
Male power: a challenge to normal childbirth?
Authors: Stephens Liz
Published: July 2014

In the UK, recent government papers have attempted to give choice, continuity and control over childbirth choices to women. Maternity care has been dominated by the medical establishment, which in turn is dominated by men with midwives and women seen in the traditional female powerless role of the caring nurturing woman. Midwives and women will need education at a more fundamental level to effect attitude changes if women are to be empowered through childbirth.
Athletic activity after lower limb arthroplasty
Authors: Jassim S. S. , Douglas S. L. , Haddad F. S.
Published: July 2014

In this systematic review, our aim was to explore whether or not patients are able to return to athletic activity following lower limb joint replacement. We also investigated any evidence as to whether participation in athletic activity post-joint replacement increases complications and reduces implant survival.

A PubMed, Embase and Sports Discus search was performed using the MeSH terms ‘Sport’, ‘Athletic’, ‘Athlete’, ‘Physical’, ‘Activity’, ‘Arthroplasty’, ‘Total Hip Replacement’, ‘Hip Resurfacing’, ‘Total Knee Replacement’, ‘Unicompartmental Knee Replacement’ and ‘Unicondylar Knee Replacement’. From this search, duplications were excluded, the remaining abstracts were reviewed and any unrelated to the search terms were excluded. The remaining abstracts had their full papers reviewed.

Following joint replacement, participation in sporting activity is common principally determined by pre-operative patient activity levels, BMI and patient age. The type of joint replaced is of less significance. Total time spent performing activity does not change but tends to be at a lower intensity. There is little evidence in the literature of an association between high activity levels and early implant failure.

Cite this article: Bone Joint J 2014;96-B:923–7.
Pelvic position and movement during hip replacement
Authors: Grammatopoulos G. , Pandit H. G. , da Assunção R. , Taylor A. , McLardy-Smith P. , De Smet K. A. , Murray D. W. , Gill H. S.
Published: July 2014

The orientation of the acetabular component is influenced not only by the orientation at which the surgeon implants the component, but also the orientation of the pelvis at the time of implantation. Hence, the orientation of the pelvis at set-up and its movement during the operation, are important. During 67 hip replacements, using a validated photogrammetric technique, we measured how three surgeons orientated the patient’s pelvis, how much the pelvis moved during surgery, and what effect these had on the final orientation of the acetabular component. Pelvic orientation at set-up, varied widely (mean (± 2, standard deviation (sd))): tilt 8° (2sd ±32), obliquity –4° (2sd ±12), rotation –8° (2sd ±14). Significant differences in pelvic positioning were detected between surgeons (p < 0.001). The mean angular movement of the pelvis between set-up and component implantation was 9° (sd 6). Factors influencing pelvic movement included surgeon, approach (posterior >  lateral), procedure (hip resurfacing > total hip replacement) and type of support (p < 0.001). Although, on average, surgeons achieved their desired acetabular component orientation, there was considerable variability (2sd ±16) in component orientation. We conclude that inconsistency in positioning the patient at set-up and movement of the pelvis during the operation account for much of the variation in acetabular component orientation. Improved methods of positioning and holding the pelvis are required.

Cite this article: Bone Joint J 2014; 96-B:876–83.
Cortical comminution in distal radial fractures can predict the radiological outcome
Authors: Wadsten M. Å. , Sayed-Noor A. S. , Englund E. , Buttazzoni G. G. , Sjödén G. O.
Published: July 2014

This paper investigates whether cortical comminution and intra-articular involvement can predict displacement in distal radius fractures by using a classification that includes volar comminution as a separate parameter.

A prospective multicentre study involving non-operative treatment of distal radius fractures in 387 patients aged between 15 and 74 years (398 fractures) was conducted. The presence of cortical comminution and intra-articular involvement according to the Buttazzoni classification is described. Minimally displaced fractures were treated with immobilisation in a cast while displaced fractures underwent closed reduction with subsequent immobilisation. Radiographs were obtained after reduction, at 10 to 14 days and after union. The outcome measure was re-displacement or union.

In fractures with volar comminution (Buttazzoni type 4), 96% (53 of 55) displaced. In intra-articular fractures without volar comminution (Buttazzoni 3), 72% (84 of 117) displaced. In extra-articular fractures with isolated dorsal comminution (Buttazzoni 2), 73% (106 of 145) displaced while in non-comminuted fractures (Buttazzoni 1), 16 % (13 of 81 ) displaced.

A total of 32% (53 of 165) of initially minimally displaced fractures later displaced. All of the initially displaced volarly comminuted fractures re-displaced. Displacement occurred in 31% (63 of 205) of fractures that were still in good alignment after 10 to 14 days.

Regression analysis showed that volar and dorsal comminution predicted later displacement, while intra-articular involvement did not predict displacement. Volar comminution was the strongest predictor of displacement.

Cite this article: Bone Joint J 2014;96-B:978–83.