bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Screening Principles to the Reconstructed Breast
Authors: Zakhireh Jennifer , Fowble Barbara , Esserman Laura J.
Published: November 2009

A significant number of women choose mastectomy for the treatment of early and locally advanced breast cancer. Advances in reconstruction techniques and greater awareness of options have led to an increased use of immediate breast reconstruction, which has resulted in uncertainty for the management of surveillance for local recurrence. In this article, we review mastectomy and reconstruction trends and how these techniques affect the frequency and location of local recurrence. The data on surveillance imaging of the reconstructed breast are extremely limited. However, by assessing the potential role for imaging in this setting and applying the principles of screening, we have identified that there is a potential theoretic advantage of surveillance imaging in a very small subset of women: those with autologous tissue reconstructions and moderate to high risk of recurrence. A prospective registry study of surveillance imaging in this target population would be the appropriate way to determine its benefit and its impact on survival outcomes. In this review article, we will detail the reasons that should allow clinicians to forego routine surveillance imaging in the majority of women who undergo mastectomy and reconstruction.
Patients' Supportive Care Needs Beyond the End of Cancer Treatment: A Prospective, Longitudinal Survey
Authors: Armes Jo , Crowe Maggie , Colbourne Lynne , Morgan Helen , Murrells Trevor , Oakley Catherine , Palmer Nigel , Ream Emma , Young Annie , Richardson Alison
Published: November 2009

Purpose

To estimate prevalence and severity of patients' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need.

Patients and Methods

A multicenter, prospective, longitudinal survey was conducted. Sixty-six centers recruited patients for 12 weeks. Patients receiving treatment for the following cancers were recruited: breast, prostate, colorectal, and gynecologic cancer and non-Hodgkin's lymphoma. Measures of supportive care needs, anxiety and depression, fear of recurrence, and positive and negative affect were completed at the end of treatment (T0) and 6 months later (T1).

Results

Of 1,850 patients given questionnaire packs, 1,425 (79%) returned questionnaires at T0, and 1,152 (62%) returned questionnaires at T1. Mean age was 61 years; and most respondents were female (69%) and had breast cancer (57%). Most patients had no or few moderate or severe unmet supportive care needs. However, 30% reported more than five unmet needs at baseline, and for 60% of these patients, the situation did not improve. At both assessments, the most frequently endorsed unmet needs were psychological needs and fear of recurrence. Logistic regression revealed several statistically significant predictors of unmet need, including receipt of hormone treatment, negative affect, and experiencing an unrelated significant event between assessments.

Conclusion

Most patients do not express unmet needs for supportive care after treatment. Thirty percent reported more than five moderate or severe unmet needs at both assessments. Unmet needs were predicted by hormone treatment, negative mood, and experiencing a significant event. Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial resources.
Comparative Prognostic Value of HPV16 E6 mRNA Compared With In Situ Hybridization for Human Oropharyngeal Squamous Carcinoma
Authors: Shi Wei , Kato Hisayuki , Perez-Ordonez Bayardo , Pintilie Melania , Huang Shaohui , Hui Angela , O'Sullivan Brian , Waldron John , Cummings Bernard , Kim John , Ringash Jolie , Dawson Laura A. , Gullane Patrick , Siu Lillian , Gillison Maura , Liu Fei-Fei
Published: November 2009

Purpose

A significant proportion of oropharyngeal squamous cell carcinomas (OSCC) are associated with the human papilloma virus (HPV), particularly HPV16. The optimal method for HPV determination on archival materials however, remains unclear. We compared a quantitative real-time polymerase chain reaction (qRT-PCR) assay for HPV16 mRNA to a DNA in situ hybridization (ISH) method, and evaluated their significance for overall (OS) and disease-free (DFS) survival.

Patients and Methods

Matched, archival biopsies from 111 patients with OSCC were evaluated for HPV16 using a qRT-PCR for E6 mRNA and ISH for DNA. Immunohistochemistry for p16, p53, and epidermal growth factor receptor were also performed.

Results

HPV16 E6 mRNA was positive in 73 (66%) of 111 samples; ISH was positive in 62 of 106 samples (58%), with 86% concordance. P16 was overexpressed in 72 samples (65%), which was strongly associated with HPV16 status by either method. E6 mRNA presence or p16 overexpression were significantly associated with superior OS; E6 mRNA, HPV16 ISH, or p16 were all significantly associated with DFS. On multivariate analysis adjusted for age, stage, and treatment, positive E6 mRNA was the only independent predictor for superior OS; for DFS, p16 expression or HPV16 status determined by either method was significant.

Conclusion

The prevalence of HPV16 in OSCC ranges from 58% to 66%, in a recently treated Canadian cohort. Classification of HPV-positivity by HPV16 E6 mRNA, HPV16 ISH or p16 immunohistochemistry (IHC) is associated with improved DFS. However, the latter two assays are technically easier to perform; hence, HPV16 ISH or p16 IHC should become standard evaluations for all patients with OSCC.
High Risk of Recurrence for Patients With Breast Cancer Who Have Human Epidermal Growth Factor Receptor 2–Positive, Node-Negative Tumors 1 cm or Smaller
Authors: Gonzalez-Angulo Ana M. , Litton Jennifer K. , Broglio Kristine R. , Meric-Bernstam Funda , Rakkhit Ronjay , Cardoso Fatima , Peintinger Florentia , Hanrahan Emer O. , Sahin Aysegul , Guray Merih , Larsimont Denis , Feoli Francesco , Stranzl Heidi , Buchholz Thomas A. , Valero Vicente , Theriault Richard , Piccart-Gebhart Martine , Ravdin Peter M. , Berry Donald A. , Hortobagyi Gabriel N.
Published: November 2009

Purpose

To evaluate the risk of recurrence in women diagnosed with T1a and T1b, node-negative, human epidermal growth factor receptor 2 (HER2) –positive breast cancer.

Methods

We reviewed 965 T1a,bN0M0 breast cancers diagnosed at our institution between 1990 and 2002. Dedicated breast pathologists confirmed HER2 positivity if 3+ by immunohistochemistry or if it had a ratio of 2.0 or greater by fluorescence in situ hybridization (FISH). Patients who received adjuvant chemotherapy or trastuzumab were excluded. Kaplan-Meier product was used to calculate recurrence-free survival (RFS) and distant recurrence–free survival (DRFS). Cox proportional hazard models were fit to determine associations between HER2 status and survival after adjustment for patient and disease characteristics. Additionally, 350 breast cancers from two other institutions were used for validation.

Results

Ten percent of patients had HER2-positive tumors. At a median follow-up of 74 months, there were 72 recurrences. The 5-year RFS rates were 77.1% and 93.7% in patients with HER2-positive and HER2-negative tumors, respectively (P < .001). The 5-year DRFS rates were 86.4% and 97.2% in patients with HER2-positive and HER2-negative tumors, respectively (P < .001). In multivariate analysis, patients with HER2-positive tumors had higher risks of recurrence (hazard ratio [HR], 2.68; 95% CI, 1.44 to 5.0; P = .002) and distant recurrence (HR, 5.3; 95% CI, 2.23 to 12.62; P < .001) than those with HER2-negative tumors. Patients with HER2-positive tumors had 5.09 times (95% CI, 2.56 to 10.14; P < .0001) the rate of recurrences and 7.81 times (95% CI, 3.17 to 19.22; P < .0001) the rate of distant recurrences at 5 years compared with patients who had hormone receptor–positive tumors.

Conclusion

Patients with HER2-positive T1abN0M0 tumors have a significant risk of relapse and should be considered for systemic, anti-HER2, adjuvant therapy.
Comparison of Neurocognitive Functioning in Children Previously Randomly Assigned to Intrathecal Methotrexate Compared With Triple Intrathecal Therapy for the Treatment of Childhood Acute Lymphoblastic Leukemia
Authors: Kadan-Lottick Nina S. , Brouwers Pim , Breiger David , Kaleita Thomas , Dziura James , Northrup Veronika , Chen Lu , Nicoletti Megan , Bostrom Bruce , Stork Linda , Neglia Joseph P.
Published: November 2009

Purpose

For the majority of children with acute lymphoblastic leukemia (ALL), CNS prophylaxis consists of either intrathecal (IT) methotrexate or triple IT therapy (ie, methotrexate with both cytarabine and hydrocortisone). The long-term neurotoxicities of these two IT strategies have not yet been directly compared.

Patients and Methods

In this multisite study, 171 children with standard-risk ALL, age 1 to 9.99 years at diagnosis, previously randomly assigned to IT methotrexate (n = 82) or to triple IT therapy (n = 89) on CCG 1952, underwent neurocognitive evaluation by a licensed psychologist at a mean of 5.9 years after random assignment.

Results

Patients who received IT methotrexate had a mean Processing Speed Index that was 3.6 points lower, about one fourth of a standard deviation, than those who received triple IT therapy (P = .04) after analysis was adjusted for age, sex, and time since diagnosis. Likewise, 19.5% of children in the IT methotrexate group had a Processing Speed Index score in the below-average range compared with 6.9% in the triple IT therapy group (P = .02). Otherwise, the groups performed similarly on tests of full-scale intelligence quotient, academic achievement, attention/concentration, memory, and visual motor integration. The association of treatment with measures of cognitive functioning was not modified by sex or age at diagnosis. In the post-therapy period, there were no group differences in special education services, neurologic events, or use of psychotropic medications.

Conclusion

This study did not show any clinically meaningful differences in neurocognitive functioning between patients previously randomly assigned to IT methotrexate or triple IT therapy except for a small difference in processing speed in the IT methotrexate group.
Chronic Myeloid Leukemia: An Update of Concepts and Management Recommendations of European LeukemiaNet
Authors: Baccarani Michele , Cortes Jorge , Pane Fabrizio , Niederwieser Dietger , Saglio Giuseppe , Apperley Jane , Cervantes Francisco , Deininger Michael , Gratwohl Alois , Guilhot François , Hochhaus Andreas , Horowitz Mary , Hughes Timothy , Kantarjian Hagop , Larson Richard , Radich Jerald , Simonsson Bengt , Silver Richard T. , Goldman John , Hehlmann Rudiger
Published: November 2009

Purpose

To review and update the European LeukemiaNet (ELN) recommendations for the management of chronic myeloid leukemia with imatinib and second-generation tyrosine kinase inhibitors (TKIs), including monitoring, response definition, and first- and second-line therapy.

Methods

These recommendations are based on a critical and comprehensive review of the relevant papers up to February 2009 and the results of four consensus conferences held by the panel of experts appointed by ELN in 2008.

Results

Cytogenetic monitoring was required at 3, 6, 12, and 18 months. Molecular monitoring was required every 3 months. On the basis of the degree and the timing of hematologic, cytogenetic, and molecular results, the response to first-line imatinib was defined as optimal, suboptimal, or failure, and the response to second-generation TKIs was defined as suboptimal or failure.

Conclusion

Initial treatment was confirmed as imatinib 400 mg daily. Imatinib should be continued indefinitely in optimal responders. Suboptimal responders may continue on imatinb, at the same or higher dose, or may be eligible for investigational therapy with second-generation TKIs. In instances of imatinib failure, second-generation TKIs are recommended, followed by allogeneic hematopoietic stem-cell transplantation only in instances of failure and, sometimes, suboptimal response, depending on transplantation risk.
In Vivo Targeting of the Growth Hormone Receptor (GHR) Box1 Sequence Demonstrates that the GHR Does Not Signal Exclusively through JAK2
Authors: Barclay Johanna L. , Kerr Linda M. , Arthur Leela , Rowland Jennifer E. , Nelson Caroline N. , Ishikawa Mayumi , d'Aniello Elisabetta M. , White Mary , Noakes Peter G. , Waters Michael J.
Published: November 2009

GH is generally believed to signal exclusively through Janus tyrosine kinases (JAK), particularly JAK2, leading to activation of signal transducers and activators of transcription (STAT), ERK and phosphatidylinositol 3-kinase pathways, resulting in transcriptional regulation of target genes. Here we report the creation of targeted knock-in mice wherein the Box1 motif required for JAK2 activation by the GH receptor (GHR) has been disabled by four Pro/Ala mutations. These mice are unable to activate hepatic JAK2, STAT3, STAT5, or Akt in response to GH injection but can activate Src and ERK1/2. Their phenotype is identical to that of the GHR−/− mouse, emphasizing the key role of JAK2 in postnatal growth and the minimization of obesity in older males. In particular, they show dysregulation of the IGF-I/IGF-binding protein axis at transcript and protein levels and decreased bone length. Because no gross phenotypic differences were evident between GHR−/− and Box1 mutants, we undertook transcript profiling in liver from 4-month-old males. We compared their transcript profiles with our 391-GHR truncated mice, which activate JAK2, ERK1/2, and STAT3 in response to GH but not STAT5a/b. This has allowed us for the first time to identify in vivo Src/ERK-regulated transcripts, JAK2-regulated transcripts, and those regulated by the distal part of the GHR, particularly by STAT5.
Peroxisome Proliferator-Activated Receptor γ Coactivator-1α Interacts with the Androgen Receptor (AR) and Promotes Prostate Cancer Cell Growth by Activating the AR
Authors: Shiota Masaki , Yokomizo Akira , Tada Yasuhiro , Inokuchi Junichi , Tatsugami Katsunori , Kuroiwa Kentaro , Uchiumi Takeshi , Fujimoto Naohiro , Seki Narihito , Naito Seiji
Published: November 2009

There are currently few successful therapies for castration-resistant prostate cancer (CRPC). CRPC is thought to result from augmented activation of the androgen/androgen receptor (AR) signaling pathway, which could be enhanced by AR cofactors. In this study, peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) was found to be an AR cofactor. PGC-1α interacted with the N-terminal domain of AR, was involved in the N- and C-terminal interaction of AR, and enhanced the DNA-binding ability of AR to androgen-responsive elements in the prostate-specific antigen enhancer and promoter regions to increase the transcription of AR target genes. Silencing of PGC-1α suppressed cell growth of AR-expressing prostate cancer (PCa) cells by inducing cell-cycle arrest at the G1 phase, similar to inhibition of androgen/AR signaling. Furthermore, PGC-1α knock-down also suppressed cell growth in the castration-resistant LNCaP-derivatives. These findings indicate that PGC-1α is involved in the proliferation of AR-expressing PCa cells by acting as an AR coactivator. Modulation of PGC-1α expression or function may offer a useful strategy for developing novel therapeutics for PCa, including CRPC, which depends on AR signaling by overexpressing AR and its coactivators.
Bios the Logosphere the Finite-Made Evolver Space
Authors: Rosenberg Jim
Published: November 2009

This piece is an essay describing my precompositional “semantic method” and placing my poetics in the context of prior poetries, such as Projective Verse. It was originally written for the conference “BIOS: The Poetics of Life in Digital Media,” held at the University of West Virginia, Morgantown, September 15-17, 2006. When I present this piece in a performance context, it is simultaneous with a kind of multimedia slide show illustrating some of the text materials and text operations discussed.
Docents of Discourse: The Logic of Dispersed Sites
Authors: Shaw Lytle
Published: November 2009

This essay proposes a revision of the dominant critical vocabulary for site-based practices in contemporary art and poetry through a critical engagement with the work of art historian Miwon Kwon. Focusing on recent art and poetry that sites itself not in relation to physical places but instead in relation to “discourses” (like anthropology or archaeology), the essay contests Kwon's arguments that artists like Mark Dion and Renée Green relativize artistic practice in relation to other disciplines and that their work breaks with the concerns of art history. Demonstrating instead how they recode disciplinary boundaries and modes of authority, I show how such new and expanded models of contextualization became central to the history of site-specific art since the 1960s, once the concept of site began to organize not only literal sculptural objects but the notion of an artistic context (both synchronic and diachronic) more generally. Without acknowledging the contingency inescapable in such modes of contextualization, art historians have presented the discursive site as a stable and authoritative frame. To address this problem, the essay then turns to a range of site-based contemporary poetries (Flarf, Rob Fitterman, Lisa Robertson) in which “discourses” (of Web commerce, nationalism, and urbanism, among others) function similarly as sites. But rather than merely assert such sites as stable frames of reference, contemporary poetry tends, often perversely and playfully, to anatomize the legibility of these very frames. They thus call our attention to what might count as the raw materials, scales, and intertextual logic or coherence of a discursive site.
Rakim's Performativity
Authors: Morris Tracie
Published: November 2009

“Rakim's Performativity” considers the influence and relevance of pioneering Rapper Rakim's influential track “Follow the Leader” through the lens of J. L. Austin's theory of performativity presented in his philosophical work How to Do Things with Words. The author reflects on Rakim's writing and performance as an MC by referencing performance studies theoretical frameworks from Erving Goffman, Martin Heidegger, and African American cultural iconography. Morris emphasizes Austin's constructed dichotomy in the first half of How to Do Things and his more expansive framing later in the book, and applies both overarching breakdowns to Rakim's work. This article not only praises one of Hip Hop's most important writers and utterers, it also seeks to affirm Austin's theoretical applicability through an unconventional lens. The twenty-page article is divided into four sections: a preface that outlines the context in which Rakim's work was heard by the author; section 1, “Follow Him into a Flow,” which contrasts Rakim's work with that of other Rappers at the time the track was released; section 2, “Austinian Performativity,” which diagrams Rakim's lyrics in the context of Austin's constative and performative distinctions, among other philosophical references; and section 3, which emphasizes the applicability of Rakim's work to Austin's three locutionary delineations. In addition to analyzing Rakim's iconic lyrics, Morris conveys a poetic and cultural nostalgia for the cultural time frame that epitomized Rakim's work (known as the “Golden Age of Hip Hop”) as well as a deep affection for J. L. Austin's theory as an infinitely applicable and a fundamentally democratic ethos.
Hypermnesia
Authors: Dworkin Craig
Published: November 2009

“Hypermnesia” sketches the historical, theoretical, and technological contexts for the Eclipse archive of radical poetry (http://english.utah.edu/eclipse). Engaging Jacques Derrida's argument in Mal d'archive, the essay posits the archive as a species of gift and teases out the contradiction at the heart of all digital archives: on the one hand, the dream of lossless reproduction; on the other hand, the distorting and degrading compression necessary for communicating between networked machines. Through close bibliographic readings of poems by Lyn Hejinian, Lorenzo Thomas, Tina Darragh, and Charles Bernstein, the essay further argues for the importance of material specificity to literary critical analyses, demonstrating that the material substrates of poetry and its modes of production—from typeface and ink type to binding and paper stock—are an inherent and inextricable aspect of the printed poem's meaning.
A Liquid Hand Blossoms
Authors: Rapaport Herman
Published: November 2009

This essay speaks to two New Critical taboos generally held by literary critics, whatever their training. The first concerns the poet's use of a preestablished referent that functions as a sentimental attachment that carries the poem along. This is usually considered a form of cheating, a loading of the dice. The second taboo concerns the poet's tossing “sweet nothings” into a poem, delicious turns of phrase that don't mean anything.

Again, critical readers generally take this to be a cheat. My article explores why readers of poetry should be more open to the sentimental attachment and the sweet nothing, given how central they are to poetry. This article is a short section from a book I'm working on that is composed of many short pieces on all manner of topics that concern contemporary poetry.
In Barry Bonds I See the Future of Poetry
Authors: Goldsmith Kenneth
Published: November 2009

Barry Bonds is not only the future of athletics, but he's also emblematic of the future of poetry. More machine than man, chemically enhanced, Bonds is our first mainstream posthuman public figure. Bonds's milestone signifies an end to the humanist discourse; he is a martyr for the future.
The '90s
Authors: Spahr Juliana
Published: November 2009

At a certain moment, a moment that extends from the late '80s to the turn of the twenty-first century, something interesting happens within literature in English: some of the more provocative literatures in English from various literary schools and various national traditions blatantly turn away from standard English in order to say something about English. This article argues that literature in English in the '90s is distinctive for the number of works that turn away from standard English by including other languages and/or are written mainly in the pidgins or creoles that resulted from English-language colonialism. The '90s are a unique moment when writers of disparate aesthetic, political, and philosophical concerns, writers from disparate nations that are united and separated by shared histories of imperialism, and writers with disparate relations to the English language do some really interesting thinking at the same time about what it means to be writing in the English language. This article reads these works in the context of the very public debates about the English language that happen in the '90s in the United States. It examines what this literature of the '90s has to say about globalization and indigenous and immigrant rights through its insistent turn against standard English. And it concludes by looking briefly beyond the '90s at the rise of lyric and plain speech poetries after the U.S. 9/11, which in turn are contested by the turn to appropriation-heavy writings such as Flarf and Conceptual writing.
The Stevens Wars
Authors: Filreis Al
Published: November 2009

What reputation and influence has Wallace Stevens had in the years since 1975? The infamous Stevensean disaffection has tended to prohibit definitive legacy, and yet this, in the end, has been productive, forestalling closed arguments among poetics Lefts and Rights, keeping Stevens's work from theoretical alliances until past the point when such would fix its standing in contestations between, for example, theoretical as distinct from historical approaches. To the extent that Stevens can seem anything to anyone, the legacy is of little impact. The many imitations of Stevens's special rhetoric tend to riff on a single poem or idiomatic stance, quick-take attempts at posing in a particular ironic position, one abandoned as quickly as assumed. Among contemporary poets whose own writing contemplates Stevens's overall position, however, a larger pattern does emerge—two Stevenses. First, a meditative Stevens: unagonistic, verbally ruminative, romantic (but called “postromantic”), a repository of human responses, post-Christian yet lyric—a poet whose verse does not make truculent, discordant claims but rather “eke[s] out the mind,” forming “the particulars of sounds.” Secondly, a languaged Stevens: theoretical, serial, and nonnarrative, metapoetically radical, sometimes satirical (and antinarrative), always obsessive about the state of poetics and insisting on consciousness of the compositional mode as itself a pressure inducing the poem to be composed—a poet whose middle and late seriatic styles befit rather than reject the cyclonic modernist historical modes adopted early and briefly by Eliot, grandly and insistently by Pound, and later by Williams.
“The Rattle of Statistical Traffic”: Citation and Found Text in Susan Howe's The Midnight
Authors: Perloff Marjorie
Published: November 2009

This essay studies the particular conjunction of documentation (“hard facts”) and highly wrought lyric verse and prose in Susan Howe's book The Midnight, a collage text consisting of historical extracts, archival fragments, biographical information, photographs, drawings, cited poems, folk songs, letters, and the original lyrics of the “Bed Hangings” sequence—the whole designed to create an elegiac memoir of the poet's mother, Mary Manning Howe, that is also an autobiographical account of the poet's own discovery of her vocation and her place in her maternal family history. In Howe's text, various bits of documentary “evidence” jostle and contradict one another, providing a portrait of both mother and daughter as mysterious as it is complex. The seemingly unrelated items begin to coalesce even as the text foregrounds its “textile” production—its awareness of itself as an example of bookmaking. The Midnight is thus a new sort of poem—at once documentary and visionary—whose language play is everywhere charged with meaning.
Lyric Dissent
Authors: Willis Elizabeth
Published: November 2009

“Lyric Dissent” discusses the social structure and context of lyric address, particularly the lyric's propensity for multiple voicings beyond the personal. Reading the poems of William Carlos Williams in the context of modernism's evolving countertraditions and the violent backdrop of the First and Second World Wars, this essay reconsiders the pressures within lyric poetry to respond to—or reveal—the pressures of global politics on poetry in times of war. How can the labor of a poem be measured against the demands of paid labor and of political action? Can the treatment of such issues suggest a generational coherence within diverse and dissenting practices?
Numerical analysis of unsteady cavitating flow in an axial inducer
Authors: Campos-Amezcua R , Khelladi S , Bakir F , Mazur-Czerwiec Z , Sarraf C , Rey R
Published: November 2009

This article presents a numerical simulation of an unsteady cavitating flow. First, the analysis was carried out for a two-dimensional (2D) venturi-type geometry, and then for a 2D blade cascade simulating an axial inducer.

The main purpose of this work is to explore the local cavitation instabilities, such as alternate blade cavitation and rotating blade cavitation, which can appear in axial inducers.

The numerical simulation was performed using a commercial code based on a cell-centred finite-volume method. The cavitation model used for calculations assumes a thermal equilibrium between phases. It is based on the classical conservation equations of the vapour phase and the mixture phase, with mass transfer owing to the cavitation appearing as a source and a sink term in the vapour mass fraction equation. The mass transfer rate is derived from a simplified Rayleigh—Plesset model for bubble dynamics.
Oropharyngeal gonorrhoea: rate of co-infection with sexually transmitted infection, antibiotic susceptibility and treatment outcome
Authors: Manavi K , Zafar F , Shahid H
Published: November 2009

The aim of the present study is to investigate the rate of co-infections with other sexually transmitted infections (STIs), antibiotic susceptibility and management of oropharyngeal gonorrhoea diagnosed in a busy genitourinary medicine clinic. The method involved a retrospective study on consecutive patients diagnosed with oropharyngeal gonorrhoea. A total of 131 patients were diagnosed with oropharyngeal gonorrhoea over the study period. The median age of the infected patients was 28 (interquartile range: 22 to 35) years. Forty-one (31%) of patients were younger than 24 years. High rates of co-infection with urethral gonorrhoea (37%), rectal gonorrhoea (37%) or chlamydial infection (16%) were identified. Thirty patients (23%) had only oropharyngeal infection. Twenty-two (17%) patients' isolates showed resistance to at least one antibiotic. Antibiotic resistance among oropharyngeal gonococcal isolates was above 5% between 2000 and 2009. Test-of-cure (TOC) was carried out for only 63 (48%) of patients; none had positive culture. Among 46 isolates treated with cefixime 400 mg/stat, 27 (59%) had TOC; all were negative. Repeat TOC was not carried out for any of the patients. In conclusion, successful management of oropharyngeal gonorrhoea should comprise of counselling, partner notification and TOC after treatment with appropriate antibiotic regimen.
From supramolecular chemistry to nanotechnology: Assembly of 3D nanostructures
Authors: Ling Xing Yi , Reinhoudt David N. , Huskens Jurriaan
Published: November 2009

Fabricating well-defined and stable nanoparticle crystals in a controlled fashion receives growing attention in nanotechnology. The order and packing symmetry within a nanoparticle crystal is of utmost importance for the development of materials with unique optical and electronic properties. To generate stable and ordered 3D nanoparticle structures, nanotechnology is combined with supramolecular chemistry to control the self-assembly of 2D and 3D receptor-functionalized nanoparticles. This review focuses on the use of molecular recognition chemistry to establish stable, ordered, and functional nanoparticle structures. The host–guest complexation of β-cyclodextrin (CD) and its guest molecules (e.g., adamantane and ferrocene) are applied to assist the nanoparticle assembly. Direct adsorption of supramolecular guest- and host-functionalized nanoparticles onto (patterned) CD self-assembled monolayers (SAMs) occurs via multivalent host–guest interactions and layer-by-layer (LbL) assembly. The reversibility and fine-tuning of the nanoparticle-surface binding strength in this supramolecular assembly scheme are the control parameters in the process. Furthermore, the supramolecular nanoparticle assembly has been integrated with top-down nanofabrication schemes to generate stable and ordered 3D nanoparticle structures, with controlled geometries and sizes, on surfaces, other interfaces, and as free-standing structures.
Prognostic Value of Emerging Neurohormones in Chronic Heart Failure during Optimization of Heart Failure–Specific Therapy
Authors: Neuhold Stephanie , Huelsmann Martin , Strunk Guido , Struck Joachim , Adlbrecht Christopher , Gouya Ghazaleh , Elhenicky Marie , Pacher Richard
Published: November 2009

Background: Serial measurements of neurohormones have been shown to improve prognostication in the setting of acute heart failure (HF) or chronic HF without therapeutic intervention. We investigated the prognostic role of serial measurements of emerging neurohormones and BNP in a cohort of chronic HF patients undergoing increases in HF-specific therapy.

Methods: In this prospective study we included 181 patients with chronic systolic HF after an episode of hospitalization for worsening HF. Subsequently, HF therapy was gradually increased in the outpatient setting until optimized. We measured copeptin, midregional proadrenomedullin, C-terminal endothelin-1 precursor fragment, midregional proatrial natriuretic peptide, and B-type natriuretic peptide before and after optimization of HF therapy. The primary endpoint was all-cause mortality at 24 months.

Results: Angiotensin-converting enzyme/angiotensin receptor blocker and β-blockers were increased significantly during the 3-month titration period (P < 0.0001 for both). In a stepwise Cox regression analysis adjusted for age, sex, glomerular filtration rate, diabetes mellitus, and ischemic HF, baseline and follow-up neurohormone concentrations were predictors of the primary endpoint as follows (baseline hazard ratios): copeptin 1.92, 95% CI 1.233–3.007, P = 0.004; midregional proadrenomedullin 2.79, 95% CI 1.297–5.995, P = 0.009; midregional proatrial natriuretic peptide 2.05, 95% CI 1.136–3.686, P = 0.017; C-terminal endothelin-1 precursor fragment 2.24, 95% CI 1.133–4.425, P = 0.025; B-type natriuretic peptide 1.46, 95% CI 1.039–2.050, P = 0.029.

Conclusions: In pharmacologically unstable chronic HF patients, baseline values and follow-up measures of copeptin, midregional proadrenomedullin, C-terminal endothelin-1 precursor fragment, midregional proatrial natriuretic peptide, and B-type natriuretic peptide were equally predictive of all-cause mortality. Relative change of neurohormone values was noncontributory.
The Clinical Plasma Proteome: A Survey of Clinical Assays for Proteins in Plasma and Serum
Authors: Anderson N Leigh
Published: November 2009

An analysis of all US Food and Drug Administration (FDA) approvals for protein-based assays through 2008 reveals 109 unique protein targets in plasma or serum, as well as 62 additional tests for peptides, protein posttranslational modifications, protein complexes, autoantibodies against endogenous proteins, and blood cell proteins. A further 96 unique protein targets are assayed in plasma by laboratory-developed tests available for clinical use in the US, yielding a total of 205 proteins that include products of approximately 211 genes (excluding immunoglobulins). These tests provide quantitative measurements for approximately 1% of the human protein gene products, defining a practical clinical plasma proteome. The rate of introduction of new protein analytes has remained essentially flat over the past 15 years, averaging 1.5 new proteins per year (median of 1 per year). This rate falls far short of that needed to support projected medical needs and indicates serious deficiencies in the protein biomarker pipeline, from which no proteomics-discovered analytes have yet emerged.
Detection of Increased Amounts of Cell-Free Fetal DNA with Short PCR Amplicons
Authors: Sikora Aleksandra , Zimmermann Bernhard G , Rusterholz Corinne , Birri Daniella , Kolla Varaprasad , Lapaire Olav , Hoesli Irene , Kiefer Vivian , Jackson Laird , Hahn Sinuhe
Published: November 2009

Aim: A digital PCR approach has recently been suggested to detect greater amounts of cell-free fetal DNA in maternal plasma than conventional real-time quantitative PCR (qPCR). Because the digital qPCR approach uses shorter PCR amplicons than the real-time qPCR assay, we investigated whether a real-time qPCR assay appropriately modified for such short amplicons would improve the detection of cell-free fetal DNA.

Method: We developed a novel universal-template (UT) real-time qPCR assay that was specific for the DYS14 sequence on Y chromosome and had a short amplicon size of 50 bp. We examined this “short” assay with 50 maternal plasma samples and compared the results with those for a conventional real-time qPCR assay of the same locus but with a longer amplicon (84 bp).

Results: Qualitatively, both assays detected male cell-free fetal DNA with the same specificity and detection capability. Quantitatively, however, the new UT real-time qPCR assay for shorter amplicons detected, on average, almost 1.6-fold more cell-free fetal DNA than the conventional real-time qPCR assay with longer amplicons.

Conclusions: The use of short PCR amplicons improves the detection of cell-free fetal DNA. This feature may prove useful in attempts to detect cell-free fetal DNA under conditions in which the amount of template is low, such as in samples obtained early in pregnancy.
Microphytobenthic biomass along gradients of physical conditions in Arctic Kongsfjorden, Svalbard
Authors: Woelfel Jana , Schumann Rhena , Leopold Peter , Wiencke Christian , Karsten Ulf
Published: November 2009

In contrast to numerous studies on the biomass of marine microphytobenthos from temperate coastal ecosystems, little is known from polar regions. Therefore, microphytobenthos biomass was measured at several coastal sites in Arctic Kongsfjorden (Spitsbergen) during the polar summer (June–August 2006). On sandy sediments, chla varied between 8 and 200 mg m-2 and was related to water depth, current/wave exposure and geographical location. Biomass was rather independent of abiotic parameters such as sediment properties, salinity, temperature or light availability. At three stations, sediments at water depths of 3–4, 10, 15, 20 and 30 m were investigated to evaluate the effect of light availability on microalgae. Significant differences in distribution patterns of biomass in relation to deeper waters >10 m were found. The productive periods were not as distinct as phytoplankton blooms. Only at 3–4 m water depth at all three stations were two- to threefold increases of biomass measured during the investigation period. Hydrodynamic conditions seemed to be the driving force for differences in sediment colonisation by benthic microalgae. In spite of the extreme Arctic environmental conditions for algal growth, microphytobenthos biomass was comparable to marine temperate waters.
Morphological non-blocking in Dutch plural allomorphy: a contrastive approach
Authors: Kürschner Sebastian
Published: November 2009

Dutch simplex nouns ending in schwa have two regular plural forms, e.g. bode-s/bode-n ‘messengers’. This means that neither of the two allomorphs -s and -n is blocked. Such regular non-blocking is non-existent in the closely related languages German and Afrikaans. To identify the reasons for this divergence, the history of plural marking in the three languages is compared. Based on the historical observations it is argued that the doublets in Dutch are retained due to the output principle of plurals ending in a trochaic foot, according to which both -s and -n may apply without preference on stems with non-final stress.
Semantic markedness in gender opposition, blocking and fossilization
Authors: Zwarts Joost , Hogeweg Lotte , Lestrade Sander , Malchukov Andrej
Published: November 2009

The semantics of natural gender in animate nouns is modeled in the framework of bidirectional Optimality Theory (OT). This allows for the interaction of lexical, conceptual and contextual constraints and for a straightforward treatment of the effect of blocking in this domain. Two versions of bidirectional OT are discussed and related to each other in terms of Blutner’s (2007) notion of fossilization.
No recurrence of sporadic primary hyperparathyroidism when cure is established 6 months after parathyroidectomy
Authors: Witteveen Janneke E , Kievit Job , Morreau Hans , Romijn Johannes A , Hamdy Neveen A T
Published: November 2009

Objective

Cure rate for primary hyperparathyroidism (PHPT) is reported to be 94–100% 1 year after surgery, but recent data suggest recurrence in 4% of the patients 1–5 years post-operatively. The aim of our study was to establish the cure rate and its maintenance in the long-term after parathyroidectomy (PTx) in patients with sporadic PHPT.

Design

Evaluation of recurrence in patients with sporadic hyperparathyroidism who underwent PTx 1–24 years prior to the study.

Patients and methods

We identified 111 patients who underwent initial PTx between 1984 and 2008, and had no MEN-1, MEN-2, or CaR mutation; parathyroid carcinoma; a history of lithium use; or renal failure. Thirty-eight patients were lost to follow-up or were unwilling or unable to participate in the study. Cure was defined as maintenance of normal serum calcium and parathyroid hormone concentrations 6 months after PTx.

Results

Cure was achieved in 68 of 73 patients studied (93%) and was sustained in all for 6±5 years.

Conclusion

The cure rate of sporadic PHPT after initial surgery is 93%. When cure is achieved, this is sustained in 100% of the patients for up to 24 years post-operatively. Our data suggest that closer early follow-up is advocated in all patients undergoing PTx to definitively establish cure and to provide a safety net for those with residual gland pathology. The data do not support the need for long-term follow-up when cure is established 6 months after PTx.
Human Triallelic Sites: Evidence for a New Mutational Mechanism?
Authors: Hodgkinson Alan , Eyre-Walker Adam
Published: November 2009

Most SNPs in the human genome are biallelic; however, there are some sites that are triallelic. We show here that there are approximately twice as many triallelic sites as we would expect by chance. This excess does not appear to be caused by natural selection or mutational hotspots. Instead we propose that a new mutation can induce another mutation either within the same individual or subsequently during recombination. We provide evidence for this model by showing that the rarer two alleles at triallelic sites tend to cluster on phylogenetic trees of human haplotypes. However, we find no association between the density of triallelic sites and the rate of recombination, which leads us to suggest that triallelic sites might be generated by the simultaneous production of two new mutations within the same individual on the same genetic background. Under this model we estimate that simultaneous mutation contributes ∼3% of all distinct SNPs. We also show that there is a twofold excess of adjacent SNPs. Approximately half of these seem to be generated simultaneously since they have identical minor allele frequencies. We estimate that the mutation of adjacent nucleotides accounts for a little less than 1% of all SNPs.
Association Between Adherence and Glycemic Control in Pediatric Type 1 Diabetes: A Meta-analysis
Authors: Hood Korey K. , Peterson Claire M. , Rohan Jennifer M. , Drotar Dennis
Published: November 2009

CONTEXT: Although adherence has been identified in practice guidelines for youth with type 1 diabetes to promote optimal glycemic control, there has been no systematic integration of studies investigating the adherence-glycemic control link. This recommendation partly stemmed from the Diabetes Control and Complications Trial (DCCT); however, this trial did not comprehensively measure adherence and had only 195 adolescents.

OBJECTIVE: Our goal was to determine the magnitude of the adherence-glycemic control link in pediatric type 1 diabetes and evaluate its correlates.

METHODS: Our data sources were PubMed (1950–2008), Scopus (1950–2008), and references from reviews in pediatric type 1 diabetes. Studies that included youth under age 19 with type 1 diabetes and a reported association between adherence and glycemic control were eligible for inclusion. Articles were not included if they contained youth with type 2 diabetes, had study samples that overlapped with other studies, or the results came from intervention studies. Of the eligible 26 studies, 21 had sufficient statistical data. Two authors independently extracted information by using a standardized protocol. Agreement between coders was high.

RESULTS: The mean effect size across 21 studies, including 2492 youth with type 1 diabetes, was −0.28 (95% confidence interval: −0.32 to −0.24). As adherence increases, A1c values decrease. No sample or disease characteristics were correlates of the adherence-glycemic control link. Pre-DCCT studies had a mean effect size of −0.32 (8 studies; 1169 participants) compared with −0.25 in post-DCCT studies (13 studies; 1323 participants).

CONCLUSIONS: This meta-analysis supports the adherence-glycemic control link in pediatric type 1 diabetes. The weaker post-DCCT association suggests that the approach to intensive diabetes management has shortcomings. We conclude that this is because of a mismatch between what scientists and clinicians know is the best way to manage pediatric type 1 diabetes and the capabilities of youth and their families.
Controlling Structural Evolution by VHF Power Profiling Technique for High-efficiency Microcrystalline Silicon Solar Cells at High Deposition Rate
Authors: Hou Guofu , Han Xiaoyan , Wei Changchun , Zhang Xiaodan , Li Guijun , Dai Zhihua , Chen Xinliang , Zhang Jianjun , Zhao Ying , Geng Xinhua
Published: November 2009

High rate deposition of hydrogenated microcrystalline silicon (μc-Si:H) films and solar cells were prepared by very high frequency plasma enhanced chemical vapor deposition (VHF-PECVD) process in a high power and high pressure regime. The experiment results demonstrate that in high-rate deposited μc-Si:H films, the structural evolution is much more dramatic than that in low-rate deposited μc-Si:H films. A novel VHF power profiling technique, which was designed by dynamically decreasing the VHF power step by step during the deposition of μc-Si:H intrinsic layers, has been developed to control the structural evolution along the growth direction. Another advantage of this VHF power profiling technique is the reduced ion bombardments on growth surface because of decreasing the VHF power. Using this method, a significant improvement in the solar cell performance has been achieved. A high conversion efficiency of 9.36% (Voc=542mV, Jsc=25.4mA/cm2, FF=68%) was obtained for a single junction μc-Si:H p-i-n solar cell with i-layer deposited at deposition rate over 10 �/s.
Nanocrystalline Superlattice Solar Cells
Authors: Madhavan Atul , Chakravarty Nayan , Dalal Vikram L.
Published: November 2009

We report on the growth and properties of nanocrystalline Si superlattice solar cells. The solar cells consisted of a stack of alternating layers of amorphous and nanocrystalline Si. The thickness of each of the two layers in the superlattice structure was varied independently. It was found that when the nanocrystalline layer thickness was low, increasing the thickness of the amorphous layer in the superlattice systematically reduced the <220> grain size, while the <111> grain size remained essentially invariant. This fact shows that by interposing an amorphous layer between two nanocrystalline layers forces the nano grains to renucleate and regrow. It was also found that when the amorphous Si layer was too thick, there were significant problems with hole transport through the device. Measurements of defect densities and effective diffusion lengths showed that there was an optimum thickness of the amorphous layer (about 10 nm) for which the defect density was the lowest and the diffusion length was the highest. We also show that the absorption coefficient in nano Si depends upon the grain size and can be increased significantly by increasing the grain size.
Latent Patterned Surface Metallization of Silver Ion-Doped Polyimide Films
Authors: Davis Luke M. , Stukenbroeker Tyler S. , Abelt Christopher J. , Scott Joseph L. , Orlova Evguenia , Thompson David Wallace
Published: November 2009

A straightforward ambient temperature route to the fabrication of surface silver-metallized polyimide films is described. Silver(I) trifluoromethane sulfonate and a polyimide, derived from 2,2-bis(3,4-dicarboxyphenyl)hexafluoropropane dianhydride (6FDA) and an equimolar amount of 4,4'-oxydianiline (ODA) and 3,5-diaminobenzoic acid (DABA), were dissolved together in dimethylacetamide. Silver(I)-doped films were prepared at thicknesses of 25-50 microns and depleted of solvent by evaporation. The silver(I)-containing films were then treated with aqueous reducing agents, which brought forth silvered films exhibiting conductivity on the order of bulk polycrystalline silver and good specular reflectivity.