bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Prognostic Benefits of Radiotherapy as an Initial Treatment for Patients with Unresectable Advanced Hepatocellular Carcinoma with Invasion to Intrahepatic Large Vessels
Authors: Nakazawa Takahide , Adachi Shigeru , Kitano Masashi , Isobe Yoshinori , Kokubu Shigehiro , Hidaka Hisashi , Ono Koji , Okuwaki Yusuke , Watanabe Masaaki , Shibuya Akitaka , Saigenji Katsunori
Published: March 2008

Objectives: To examine the efficacy and prognostic benefits of radiotherapy (RT) in patients who have unresectable advanced hepatocellular carcinoma (HCC) with invasion to intrahepatic large vessels (IHLVs). Methods: Sixty-eight patients who had advanced HCC with invasion to IHLVs were studied. Thirty-two consecutive patients initially received 3-dimensional conformal RT for HCC invasion to IHLVs. Tumor response, prognostic factors, and survival were studied in the patients given RT. Prognostic factors and survival were assessed in the study group as a whole. Data were analyzed using the Kaplan-Meier method, univariate analysis, and a Cox model. Results: The rate of objective response to RT was 48%. Predictors of survival in the patients who received RT were a hepatic function of Child-Pugh class A (p = 0.0263) and a response to RT (p = 0.0121). In the study group as a whole, independent predictors of survival in a Cox model were multinodular HCC (p = 0.007), inferior vena caval invasion (p = 0.001), a serum α-fetoprotein level of >1,000 ng/ml (p = 0.032), and the performance of RT (p < 0.001). Notably, the median survival of the nonresponders to RT (n = 15) was significantly longer than that of the patients who received no treatment for HCC (n = 21; 7.0 vs. 3.4 months, p = 0.0014). Conclusion: RT is considered an effective initial treatment for HCC invasion to IHLVs, and may offer survival benefits, even in nonresponders, because of the induction of stable disease.
Prediction of Chemosensitivity Using Multigene Analysis in Head and Neck Squamous Cell Carcinoma
Authors: Hasegawa Yasuhisa , Goto Mitsuo , Hanai Nobuhiro , Ijichi Kei , Terada Akihiro , Hyodo Ikuo , Ogawa Tetsuya , Fukushima Masakazu
Published: March 2008

Aims: The main purpose of the current study was to find predictive biomarkers that can be routinely used for the response to chemotherapy in head and neck squamous cell carcinoma (HNSCC). Methods: From this standpoint, we selected the histoculture drug response assay (HDRA) to assess in vitro chemosensitivity, and real-time reverse transcription polymerase chain reaction to investigate the gene expression profile of individual tumors as available predictive biomarkers. Using both surgery and biopsy specimens, we analyzed their gene expression profiles using the 18 markers that we thought were likely predictors of the response to anti-cancer agents. Results: Statistically significant associations were found between 5-fluorouracil (5-FU) sensitivity in HDRA and HER-2 mRNA expression level (p = 0.0030). Moreover, HER-2 expression was significantly associated with cisplatin sensitivity (p = 0.0089). Cisplatin sensitivity in HDRA was also demonstrated to have a significant association with epidermal growth factor receptor (EGFR) expression in which the group with cisplatin resistance tended to have a higher expression level than the sensitive group (p = 0.0385). Conclusion: HER-2 and EGFR may be possible reliable predictive biomarkers for anti-cancer therapy, and might help in the decision-making process for individual patients with HNSCC.
Persistent Erythema Multiforme in a Patient with Extrahepatic Cholangiocarcinoma
Authors: Tzovaras Vasilios , Liberopoulos Evangelos N. , Zioga Aikaterini , Pavlidis Nikolas , Elisaf Moses
Published: March 2008

Presented in this report is a 66-year-old male with a widespread persistent erythema multiforme mostly atypical in appearance, which was detected well before the diagnosis of underlying extrahepatic cholangiocarcinoma. The lesions regressed in response to chemotherapy, but they appeared again in connection with tumor relapse. Clinicians should recognize persistent erythema multiforme as one of the paraneoplastic dermatoses and efforts should be made to detect internal malignancies in patients with these skin lesions.
Occurrence of Synchronous Invasive Lobular Breast Carcinoma and Poorly Differentiated Ovarian Carcinoma in a Single Peritoneal Deposit
Authors: Syed R. , Nazir S.A. , Lwin K.Y. , Bose P. , Evans P. , Choji K.
Published: March 2008

The synchronous occurrence of breast and ovarian cancers within individual omental metastases has not been reported in the available medical literature. We report such a finding in a patient with previously diagnosed invasive lobular carcinoma of the right breast. After 5 years of surveillance and disease-free interval, there was development of ovarian cancer, ascites and peritoneal metastases. Ultrasound-guided biopsy of a peritoneal metastasis confirmed dual histology from breast and ovarian carcinoma. Despite the presence of a prolonged disease-free survival from the primary breast cancer, the subsequent finding of advanced ovarian cancer highlights the potential diagnostic and therapeutic dilemmas which persist in the management of these patients.
Effects of Housing Characteristics and Home Environmental Factors on Respiratory Symptoms of 10,784 Elementary School Children from Northeast China
Authors: Dong Guang-Hui , Ma Ya-Nan , Ding Hai-Long , Jin Jing , Cao Ying , Zhao Ya-Dong , He Qin-Cheng
Published: March 2008

Background: Only few studies have assessed the relative impact of housing characteristics and home environmental factors on asthma and asthma-related symptoms in Chinese children, and to our knowledge, few studies have elaborated respiratory symptoms and allergies in this context. Objective: It was the aim of this study to assess the effects of housing characteristics, pet keeping, home decorations and other indoor environmental factors on respiratory health of Chinese children. Methods: We studied 10,784 children (6–13 years old) from 12 districts in Liaoning province, Northeast China. Information on respiratory health, housing characteristics and environmental pollution was obtained by a standard questionnaire from the American Thoracic Society. Results: Prevalence of asthma-related symptoms was higher for those living along the main stem of traffic, and for those with a house nearby a pollution source. Lower prevalence rates of respiratory morbidity were associated with households with a bigger area of residence and more rooms. Pet keeping was associated with doctor-diagnosed asthma (OR = 1.52; 95% CI 1.25–1.84). Home decorations also increased the risk of doctor-diagnosed asthma (OR = 1.72; 95% CI 1.45–2.04) and current asthma (OR = 1.43; 95% CI 1.06–1.93). Environmental tobacco smoke, pests and visible mold on walls were associated with the occurrence of asthma symptoms. Conclusion: Home environmental factors are particularly important for the development of respiratory morbidity among children.
How New Is the “New” Social Study of Childhood? The Myth of a Paradigm Shift
Authors: Ryan Patrick J.
Published: March 2008

During the past two decades, a well-organized group of social scientists has proclaimed a new paradigm of childhood that views children as subjects and childhood as socially constructed. An explanation of why these claims are not new from a historical perspective requires a deep understanding of the landscape of modern childhood and its intellectual origins. The terms of modern childhood have long positioned children as subjects who know by making them objects of knowledge. This paradox cannot be circumvented without the introduction of an entirely new language of personhood.
Spike Train Probability Models for Stimulus-Driven Leaky Integrate-and-Fire Neurons
Authors: Koyama Shinsuke , Kass Robert E.
Published: March 2008

Mathematical models of neurons are widely used to improve understanding of neuronal spiking behavior. These models can produce artificial spike trains that resemble actual spike train data in important ways, but they are not very easy to apply to the analysis of spike train data. Instead, statistical methods based on point process models of spike trains provide a wide range of data-analytical techniques. Two simplified point process models have been introduced in the literature: the time-rescaled renewal process (TRRP) and the multiplicative inhomogeneous Markov interval (m-IMI) model. In this letter we investigate the extent to which the TRRP and m-IMI models are able to fit spike trains produced by stimulus-driven leaky integrate-and-fire (LIF) neurons.

With a constant stimulus, the LIF spike train is a renewal process, and the m-IMI and TRRP models will describe accurately the LIF spike train variability. With a time-varying stimulus, the probability of spiking under all three of these models depends on both the experimental clock time relative to the stimulus and the time since the previous spike, but it does so differently for the LIF, m-IMI, and TRRP models. We assessed the distance between the LIF model and each of the two empirical models in the presence of a time-varying stimulus. We found that while lack of fit of a Poisson model to LIF spike train data can be evident even in small samples, the m-IMI and TRRP models tend to fit well, and much larger samples are required before there is statistical evidence of lack of fit of the m-IMI or TRRP models. We also found that when the mean of the stimulus varies across time, the m-IMI model provides a better fit to the LIF data than the TRRP, and when the variance of the stimulus varies across time, the TRRP provides the better fit.
Women, Gender and Religion in Premodern China: A Brief Introduction
Authors: Grant Beata
Published: March 2008

This is an introduction to the eight essays included in this special two-issue volume of Nan Nü: Men, Women and Gender in China dedicated to the theme of women, gender and religion in premodern China. It is not intended as a comprehensive state-of-the-field overview. Rather, it seeks to address some of the issues and trends in this relatively under-represented area of scholarly research. It is for this reason that the discussion of the eight essays in this and the companion issue to follow is thematic rather than in order of appearance. The purpose is to show how these essays both provide, and illustrate the need for, a fuller understanding of the various ways in which Buddhist and Daoist religious practices and ideals in particular, were woven through the fabric of the lives of many women as well as men, not so much in opposition to, as in conjunction with, traditional Confucian norms.
Conversion to Chastity: A Buddhist Catalyst in Early Imperial China
Authors: Yuet Keung Lo
Published: March 2008

This paper traces the history of the notion of female chastity (zhen) in China from pre-Qin to the mid-imperial era and argues that, prior to the arrival of Buddhism in China, the idea of female “chastity” was concerned not so much with physical virginity as the dutiful fulfillment of wifely obligations as stipulated by the Confucian marriage rites. A woman's chastity was determined by her moral rectitude rather than by her biological condition. The understanding of the physical body as a sacrosanct entity that must be defended against defilement and violation emerged under the influence of Buddhist notions of the uncontaminated body, the pious observance of the Buddhist monastic code, and the performance of religious charity that became popular in early imperial China. Based on a critical analysis of a wide array of Confucian canonical texts, dynastic histories, Indian Buddhist scriptures, biographies of Chinese monks and nuns, the monastic code, and Chinese Buddhist encyclopedias, this paper delineates the gradual process by which the Buddhist concept of the “pure body” became fully assimilated into the indigenous Chinese notion of female “rectitude” and the notion of female chastity finally acquired an ontological identity around the end of the sixth century.
Ambiguous Visions of the Past: The Perception of History in Nineteenth-Century German Jewry
Authors: Gotzmann Andreas
Published: March 2008

This article not only provides a characterisation of the concept and meaning of historical thought—as a new concept—created by 19th century German Jewry. It also elaborates on the general nature of the newly developed historical approaches, showing the deeply ambivalent character of this major discourse on Jewish identity in modern times that included a general concept of self-perception that would soon overpower and characterize even religion. Although an amazingly unified perception of Jewish history can be found throughout the century, it remained janus-faced in many respects. Such ambivalences were the outcome of a modern historical approach and of 'minority history'. Its aim was to establish Jewish history within the wider frame of a national and evolutionary world history, at the same time defining it as a distinct and decisive one, central not only to Jewish identity, but to all of mankind through its purpose of upholding the quest for excellence, uniqueness, and power.
Forschungen Zur Judenfrage: A Notorious Journal and Some of its Contributors
Authors: Markner Reinhard
Published: March 2008

Among the many publishing ventures of the “Reichsinstitut für die Geschichte des neuen Deutschlands,” the journal Forschungen zur Judenfrage (1936–1944) has gained most notoriety. In its nine volumes, various aspects of the “Jewish question,” ranging from the Jews in antiquity to Albert Einstein's theory of relativity, were dealt with from a strictly National Socialist point of view. The ambitious project proved to be a failure even before the Third Reich collapsed. While some of the journal's contributors managed to pursue their academic careers in post-war West Germany, its founder, Walter Frank, committed suicide in 1945.
Development of the National Lightning Detection Network
Authors: Orville Richard E.
Published: March 2008

The development of the National Lightning Detection Network (NLDN) can be traced from the initial funding by the Electric Power Research Institute in June 1983. This support, when coupled with a small National Science Foundation-sponsored research program at the State University of New York at Albany, would lead in just six years to the coverage of 48 states by a network of lightning detectors providing the location and physical characteristics of nearly all cloud-to-ground lightning flashes in the continental United States. The generous sharing of data from existing federal lightning detection networks provided one-third of this national coverage. The measured lightning characteristics included stroke location to an accuracy of roughly 2 km, polarity and peak current estimates, and flash multiplicity or number of strokes within the flash. The development of satellite communications during this period ensured the receipt of data and the transmission of flash characteristics to consumers in the university, government, and private sectors. The history of the NLDN development is a story driven by technology with its roots in the 1970s. The future of lightning detection is embodied within the current satellite plans for a Geostationary Lightning Mapper to observe total lightning in the Western Hemisphere as part of the Geostationary Operational Environmental Satellite-R (GOESR) program, with launch dates as early as 2014.
A Sound Principle, but Not a Playbook
Authors: Steinberg James B.
Published: March 2008

Security First: For a Muscular, Moral Foreign Policy, by Amitai Etzioni, offers a promising effort to transcend the sterile debate between realism and idealism in U.S. foreign policy by arguing that the pursuit of security is a precondition to the longer-term objective of promoting democracy and human rights. Although conceptually appealing as a way to prioritize among potentially competing objectives, the book struggles with thorny problems of implementation that plague real world policy makers, including how to deal with the nuclear threats posed by North Korea and Iran, how to improve counterterrorism cooperation by ambivalent partners like Pakistan and when to intervene in the case of failed states.
Flexural Properties of Ridge Gourd/ Phenolic Composites and Glass/Ridge Gourd/Phenolic Hybrid Composites
Authors: Varada Rajulu A. , Devi R. Rama
Published: March 2008

Ridge gourd/phenolic and glass/ridge gourd/phenolic hybrid composites were prepared using resol resin PF-108 as the matrix and the bilayered vegetable fabric ridge gourd as the reinforcement without and with alkali treatment and glass fabric as a co-reinforcement. The natural bilayer fabric of ridge gourd vegetable belonging to the Cucurbitaceae family was treated with 2% aqueous NaOH solution. The flexural strength and modulus of untreated and alkali treated ridge gourd fabric reinforced resol type (PF-108) composites and glass, ridge gourd fabric reinforced resol type (PF-108) hybrid composites in the absence and presence of two coupling agents were also determined.
Schooling and the Construction of Identity Among Minority Students in Spain and the United States
Authors: Harry Beth , Arnaiz Pilar , Klingner Janette , Sturges Keith
Published: March 2008

Based on a study of the special education placement process in a large city in the United States and two studies in different regions of Spain, the authors offer a comparative analysis of the relationship between professional beliefs and practices and the achievement of culturally and linguistically diverse (CLD) students. The data focus on African American and Hispanic students in the United States and on Gitano (Gypsy) and Moroccan students in Spain. Although professional attitudes in both countries revealed deficit views of CLD students, a key concern in Spain was professionals' assumption that students' cultural assimilation was a requirement for success. In the United States, deficit views, entwined with the entrenched categorical approach to school-based disabilities, contributed to ethnic disproportionality in special education. The studies illustrate how the hegemony of mainstream culture and language in schooling contributes to inappropriate academic and social exclusion for students from historically oppressed minority groups.
Seeking `Legitimate' Great Power Status in Post-Cold War International Society: China's and Japan's Participation in UNPKO
Authors: Suzuki Shogo
Published: March 2008

This article joins the debates on hierarchies in international society. Drawing on the insights of the English School approach, it shows that the existence of socially legitimated great powers results in the emergence of `frustrated great powers', which are dissatisfied with their status in international society. By examining the participation of China and Japan in United Nations peacekeeping operations, it argues that `frustrated great powers' can play `recognition games' and attempt to persuade their peers that they are worthy of `legitimate great power' status. Rather than posing a threat to the international order, as is often assumed, I show that `frustrated great powers' can inadvertently strengthen the normative structures of international society by invoking the social discourses that surround `legitimate great power' status. The findings of this article also demonstrate that we need to pay greater attention to the intentions of `frustrated great powers', and put forward an alternative framework for examining these states.
Quantum mechanics, control theory and quantum control
Authors: Zhengtao Ding  , Zairong Xi  , Hong Wang
Published: March 2008

This paper provides a brief review of Rosenbrock's recent work on generating quantum mechanics using dynamic programming, some background knowledge of quantum mechanics and some general issues and problems in developing feedback quantum control.
Acceptance-Enhanced Behavior Therapy (AEBT) for Trichotillomania and Chronic Skin Picking
Authors: Flessner Christopher A. , Busch Andrew M. , Heideman Paul W. , Woods Douglas W.
Published: March 2008

This pilot study examined the utility of acceptance-enhanced behavior therapy (AEBT) for trichotillomania (TTM) and chronic skin picking (CSP) and the impact of altering treatment sequence on overall treatment efficacy. Participants referred to a TTM and CSP specialty clinic were assessed by an independent evaluator within separate, nonconcurrent, multiple-baseline designs across participants. The first group of three participants received habit-reversal training (HRT) followed by acceptance and commitment therapy (ACT), and the second group of two participants received ACT followed by HRT. Results indicated that AEBT greatly reduced pulling/picking for all five participants and that the order in which ACT and HRT were implemented made little or no difference in short-term treatment outcome. Conclusions, limitations, and future areas of research are discussed.
Recognizing Best Practice in Portuguese Higher Education Libraries
Authors: Baptista Melo Luiza , Pires Cesaltina , Taveira Ana
Published: March 2008

The purpose of this paper is to identify best practices in order to improve the quality of services in Portuguese academic libraries. This article describes an ongoing project to assess the performance of library services, resulting from a partnership of six Portuguese higher education libraries. The study has three main steps: (1) selection of criteria to be evaluated and selection of their corresponding performance indicators; (2) data collection and analysis; (3) identification of best practices. The selection of the criteria to be evaluated is based on a mixed model combining the Common Assessment Framework and the Balanced Scorecard. The associated performance indicators are in accordance with International Standards ISO 11620:1998 and ISO 2789:2006.
The Reflective Online Searching Skills (ROSS) Environment: embedding information literacy into student learning through an online environment
Authors: Partridge Helen , Edwards Sylvia , Baker Andrew , McAllister Lynn
Published: March 2008

The Reflective Online Searching Skills (ROSS) Environment is an e-learning tool that fosters the development of student skill and knowledge in online searching. It was developed with the support of Faculty of Information Technology and the Teaching and Learning Support Services at the Queensland University of Technology (QUT). In 2007 ROSS is being developed for use within the first year curriculum of other faculties within QUT. This paper will provide a demonstration of the ROSS environment and how it was embedded within the curriculum of two contrasting disciplines: IT and Science. Many online information literacy tools are static, modular, linear and heavily text based, and have failed to incorporate an interactive approach to the learning process. This paper will demonstrate that ROSS pushes the boundary of online information literacy programs by guiding learners to know, reflect, and practice information literacy concepts through the use of case studies or problem based learning.
Co-constructing a Group Narrative: One Group's Experience of `Translation' of the Unarticulated Symptom through the Narrative of the Film The Piano
Authors: Ritchie Sheila
Published: March 2008

This paper sets out to show how one group co-constructed a particular group narrative through the use of film. In so doing they attempted to develop a common narrative which individual members could use to find relief from their conflicts through the telling of their individual stories and find ways of managing difficult feelings in the group. Translation of the unarticulated symptom could take place. The paper examines the role of narrative in the social construction of identity. Clinical material highlights the construction of the narrative around the film The Piano. This narrative serves the function of helping group members find ways to make more palatable difficult feelings such as desire, anger and shame as they emerge in the group.
India's Border Trade with Its Neighbouring Countries with Special Reference to Myanmar
Authors: Singh Thiyam Bharat
Published: March 2008

Border trade between India and its neighbouring countries is largely determined by ethnic ties, affinity, long porous borders and low transaction costs. The inefficiencies and high transaction costs associated with formal trade have helped to promote informal trade, which traders find easier and more convenient. The feature that distinguishes cross-border trade between India and Myanmar from trade with other neighbouring countries is the adoption of a barter system. There is also a missing link between the border trade and production structure (both agriculture and industry) of the northeastern region of India, particularly Manipur, so that the larger gains from trade accrue to traders operating beyond the northeastern region.
Employment Preferences and Length of Job Queues in Pakistan
Authors: Hyder Asma
Published: March 2008

It has long been recognised that public sector jobs are an attractive opportunity (because of job security, fringe benefits, and so on) in Pakistan's labour market. Since the early 1990s, Pakistan has been going through an economic restructuring plan, particularly in terms of privatisation. The aim of this paper is to examine the change in the phenomenon of ‘wait unemployment’ created due to preference for public sector jobs, using cross-section labour force surveys for 2001–02, 2003–04 and 2005–06. This hypothesis has been examined earlier only for 2001–02 (Hyder 2007). The evidence supported the view that unemployed people in Pakistan prefer public sector jobs, and due to this preference they remain unemployed for a particular period of time. However, the duration is uncompleted in nature. This study will provide an update on changing trends in job preferences among unemployed individuals based on two more recent nationwide Labour Force Surveys, for 2003–04 and 2005–06.
A fatal outcome in a patient with glioblastoma multiforme after receiving high-dose methotrexate
Authors: Price Samantha , Harless William , Rikhye Somi , Altaha Ramin
Published: March 2008

The most common adult primary brain tumor is glioblastoma multiforme (GBM). Current treatment is surgical resection, adjuvant radiation and chemotherapy, which can extend the median survival 20—36 weeks (Mansky et al. Central nervous system tumors. In Abraham J, Allegra CJ, Gulley J, eds. Bethesda Handbook of clinical oncology, 2nd edn. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins, 2000: 440—2; Knox S. Intracranial tumors. In Pillot G, Chantler M, Magiera H, Peles S, et al., eds. The Washington Manual Hematology and Oncology Subspecialty Consult. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins, 2004: 204—6.). But treatment efficacy is limited, mandating the exploration of more effective treatments. We report on a patient with GBM treated as per a clinical protocol with high-dose methotrexate (12 g/m2), who expired within hours after the initiation of treatment secondary to transtentorial herniation. Although it is not completely clear what caused the patient's herniation, we think that high-dose methotrexate therapy may have played a crucial role. We suggest that high-dose methotrexate should be used cautiously in patients with GBM. J Oncol Pharm Practice (2008) 14: 57—60.
Evolving roles of oncology pharmacists in Singapore: A survey on prescribing patterns of antiemetics for chemotherapy induced nausea and vomiting (CINV) at a cancer centre†
Authors: Chan Alexandre , Shih Vivianne , Chew Lita
Published: March 2008

Background. National Cancer Centre (NCC) is currently the largest ambulatory oncology treatment centre in Singapore that treats mainly solid tumors and lymphomas. Oncology pharmacists at NCC play an active role in the management of CINV. In order to improve the clinical services delivered by pharmacy, particularly in the utilization of antiemetics, pharmacy department conducted a survey that aimed to understand the prescribing patterns of antiemetics for CINV.

Objectives. ves. The primary aim of this study was to describe medical oncologists' perceptions of factors that can influence prescribing of antiemetics for acute and delayed nausea and vomiting associated with chemotherapy. A secondary aim was to assess medical oncologists' perception of antiemetic counseling by oncology pharmacists.

Methods. This was a single-centered, non-randomized survey conducted at NCC in Singapore. Twenty-seven oncologists in the Department of Medical Oncology (DMO) were invited to participate in this survey. Survey forms were distributed to the medical oncologists at weekly DMO and tumor board meetings in November 2006.

Results. Twenty oncologists returned surveys during the study period. Most oncologists closely adhered to the institution guideline on antiemetics utilization; however, results showed a trend of overprescribing acute antiemetics for low emetogenic chemotherapy regimens. Oncologists have identified anxiety, age and gender as the top three patient risk factors taken into consideration when they prescribe antiemetics. Majority of oncologists found pharmacists' counseling on antiemetics to be effective.

Conclusions. Through this survey, oncology pharmacists at NCC were able to identify areas of antiemetics utilization that needed refinement. Results from this survey provide opportunities for oncology pharmacists to collaborate with medical oncologists to further improve the management of chemotherapy induced nausea and vomiting. J Oncol Pharm Practice (2008) 14: 23—29.
Extreme Lamé Compliance in Anisotropic Crystals
Authors: Guo Cliff Y. , Wheeler Lewis
Published: March 2008

For a crystalline material, Poisson's ratio depends upon two orthogonal directions, one corresponding to the applied uniaxial stress and another for the resulting transverse strain. Interest in directions that yield a negative value leads to a consideration of extreme values and associated directions. Another indicator of a negative Poisson's ratio is the Lamé compliance, defined as the transverse strain response to a unit uniaxial stress. Where this quantity is positive, Poisson's ratio is negative and it is natural to associate a near minimum value of the ratio with a maximum of the Lamé compliance. Moreover, the stationary directions associated with the compliance bear a clearer relationship to the crystallographic directions than those of the ratio. Indeed, many of these directions are not dependent upon the elastic constants within a given crystal symmetry class. In the case of 1-cristobalite, the maximum value of the Lamé compliance is associated with such invariant stationary points. In the present work, we describe the invariant stationary directions and touch on a few of the simplest material-dependent stationary points.
The Divergence Theorem for Divergence Measure Vectorfields on Sets with Fractal Boundaries
Authors: Šilhavý M.
Published: March 2008

A divergence measure vectorfield is an ℝ n valued measure on an open subset U of ℝ n whose weak divergence in U is a (signed) measure. The paper uses the product rule for the product of the divergence measure by a function from W 1,∞ (U) 3 established in Šilhavý [Šilhavý, M., submitted, 2007] to prove the divergence theorem for the divergence measure vectorfields on bounded open sets U. It is shown that the surface integral of the normal component of the vectorfield occurring in the classical divergence theorem has to be replaced by a continuous linear functional on the space of Lipschitz functions on the boundary1 the volume integral contains the duality pairing occurring in the product rule. The boundary of U is arbitrary, it can be even fractal in the sense that the normal to ∂U cannot be defined.
Psychiatric Nurses' Attitudes Toward Consumer and Carer Participation in Care: Part 1—Exploring the Issues
Authors: Goodwin Val , Happell Brenda
Published: March 2008

Consumer and carer participation in mental health delivery is now enshrined in Australian Government policy. However, strategies assisting in implementing this vision have not been explored. Nurses are crucial to the mental health workforce, both in numbers and by virtue of the therapeutic relationship. The willingness of nurses to encourage consumer and carer participation is therefore essential for implementation of this policy. This article presents part 1 of the findings of a qualitative study exploring nurses' opinions regarding consumer and carer participation. Data were analyzed using a content-analysis approach, assisted by the software package NVivo. The themes explicated were as follows: Consumer and carer participation—a help or a hindrance? Encouragement—an important role for nurses; and communication—a gift of nursing. These findings highlight the unique and important role nurses can play in encouraging participation and explore some of the issues involved if that role is to become a reality.
Evaluating Nurse Staffing Regulation
Authors: Keepnews David M.
Published: March 2008

Ongoing research on the impact of nurse staffing regulation can yield important information that can guide continued staffing policy efforts. Understanding the impact of such efforts should include evaluating the outcomes of recent legislation in Oregon and Illinois as well as continued examination of staffing ratios in California. Successful efforts will need to transcend traditional boundaries between researchers, policy analysts, advocates, and organizations.
Targeting NF-κB in Waldenstrom macroglobulinemia
Authors: Leleu Xavier , Eeckhoute Jérôme , Jia Xiaoying , Roccaro Aldo M. , Moreau Anne-Sophie , Farag Mena , Sacco Antonio , Ngo Hai T. , Runnels Judith , Melhem Molly R. , Burwick Nicolas , Azab Abdelkareem , Azab Feda , Hunter Zachary , Hatjiharissi Evdoxia , Carrasco Daniel R. , Treon Steven P. , Witzig Thomas E. , Hideshima Teru , Brown Myles , Anderson Kenneth C. , Ghobrial Irene M.
Published: March 2008

The nuclear factor-κB (NF-κB) path-way has been implicated in tumor B-cell survival, growth, and resistance to therapy. Because tumor cells overcome single-agent antitumor activity, we hypothesized that combination of agents that target differentially NF-κB pathway will induce significant cytotoxicity. Therapeutic agents that target proteasome and Akt pathways should induce significant activity in B-cell malignancies as both pathways impact NF-κB activity. We demonstrated that perifosine and bortezomib both targeted NF-κB through its recruitment to the promoter of its target gene IκB using chromatin immunoprecipitation assay. This combination led to synergistic cytotoxicity in Waldenstrom macroglobulinemia (WM) cells that was mediated through a combined reduction of the PI3K/Akt and ERK signaling pathways, found to be critical for survival of WM cells. Moreover, a combination of these drugs with the CD20 monoclonal antibody rituximab further increased their cytotoxic activity. Thus, effective WM therapy may require combination regimens targeting the NF-κB pathway.
Keratinocyte growth factor and androgen blockade work in concert to protect against conditioning regimen-induced thymic epithelial damage and enhance T-cell reconstitution after murine bone marrow transplantation
Authors: Kelly Ryan M. , Highfill Steven L. , Panoskaltsis-Mortari Angela , Taylor Patricia A. , Boyd Richard L. , Holländer Georg A. , Blazar Bruce R.
Published: March 2008

Myeloablative conditioning results in thymic epithelial cell (TEC) injury, slow T-cell reconstitution, and a high risk of opportunistic infections. Keratinocyte growth factor (KGF) stimulates TEC proliferation and, when given preconditioning, reduces TEC injury. Thymocytes and TECs express androgen receptors, and exposure to androgen inhibits thymopoiesis. In this study, we have investigated whether TEC stimulation via preconditioning treatment with KGF and leuprolide acetate (Lupron), 2 clinically approved agents, given only before conditioning would circumvent the profound TEC and associated T-cell deficiency seen in allogeneic bone marrow transplant (BMT) recipients. Only combined treatment with KGF plus leuprolide acetate normalized TEC subset numbers and thymic architecture. Thymopoiesis and thymic output were supranormal, leading to the accelerated peripheral reconstitution of naive CD4 and CD8 T cells with a broad Vβ repertoire and decreased homeostatic T-cell proliferation. Combined therapy facilitated T:B cooperativity and enabled a B-cell humoral response to a CD4 T cell–dependent neoantigen challenge soon after BMT. In vivo antigen-specific CD8 T-cell responses and clearance of a live pathogen was superior with combined versus individual agent therapy. Thus, KGF combined with androgen blockade represents a novel approach to restore thymic function and facilitates the rapid recovery of peripheral T-cell function after allogeneic BMT.
TGF-β1 and IFN-γ stimulate mouse macrophages to express BAFF via different signaling pathways
Authors: Kim Hyun-A , Jeon Seong-Hyun , Seo Goo-Young , Park Jae-Bong , Kim Pyeung-Hyeun
Published: March 2008

B cell-activating factor belonging to the TNF family (BAFF) is primarily expressed by macrophages and dendritic cells and stimulates the proliferation, differentiation, and survival of B cells and their Ig production. In the present study, we examined the pathways by which TGF-β1 and IFN-γ induce BAFF expression to see if TGF-β1 and IFN-γ regulate B cell differentiation via macrophages. We found that TGF-β1 stimulated mouse macrophages to express BAFF and that a typical TGF-β signaling pathway was involved. Thus, Smad3 and Smad4 promoted BAFF promoter activity, and Smad7 inhibited it, and the BAFF promoter was shown to contain three Smad-binding elements. Importantly, TGF-β1 enhanced the expression of membrane-bound and soluble forms of BAFF. IFN-γ further augmented TGF-β1-induced BAFF expression. IFN-γ caused phosphorylation of CREB, and overexpression of CREB increased IFN-γ-induced BAFF promoter activity. Furthermore, H89, a protein kinase A (PKA) inhibitor, abrogated the promoter activity. Neither Stat1α (a well-known transducing molecule of IFN-γ) nor AG490 (a JAK inhibitor) affected BAFF expression in response to IFN-γ. Taken together, these results demonstrate that TGF-β1 and IFN-γ up-regulate BAFF expression through independent mechanisms, i.e., mainly Smad3/4 and PKA/CREB, respectively.
Survival and function of human thymic dendritic cells are dependent on autocrine Hedgehog signaling
Authors: Varas Alberto , Hernández-López Carmen , Valencia Jaris , Mattavelli Silvia , Martínez Victor G , Hidalgo Laura , Gutiérrez-Frías Cruz , Zapata Agustín G , Sacedón Rosa , Vicente Angeles
Published: March 2008

The Hedgehog (Hh) family of signaling molecules functions in the development of numerous tissues during embryogenesis and has also been involved in adult self-renewing tissues. Recent results have demonstrated that the different components of the Hh signaling pathway are expressed in the human thymus. In this study, we investigate whether thymic dendritic cells (DCs) are cell targets for Hh signaling. Both components of the Hh receptor, Patched and Smoothened, as well as other Hh-binding proteins with modulating functions, are expressed by human thymic DCs. The expression of Gli1, Gli2, and Gli3 transcription factors suggests that the Hh signaling pathway is active in thymic DCs, and approximately one-half of thymic DCs produces Sonic Hh (Shh). The culture of thymic DCs with Shh protects them from apoptosis [similarly to CD40 ligand (CD40L)], and these antiapoptotic effects are related to an up-regulation of Bcl-2 and Bcl-XL protein expression. The addition of the Hh pathway inhibitor, cyclopamine, decreases DC viability and impairs their allostimulatory function in vitro. In addition, the blockade of the Hh signaling pathway by cyclopamine treatment abrogates the up-regulation of HLA-DR, CD86, CD80, and CD83 expression induced by CD40L on thymic DCs. Finally, we also show that after activation with CD40L thymic DCs down-regulate the expression of Hh receptor components as well as Shh production. Taken together, these results suggest that the survival and function of thymic DCs are regulated by an autocrine Hh signaling.
Adipokine Protein Expression Pattern in Growth Hormone Deficiency Predisposes to the Increased Fat Cell Size and the Whole Body Metabolic Derangements
Authors: Ukropec Jozef , Penesová Adela , Škopková Martina , Pura Mikuláš , Vlček Miroslav , Rádiková Žofia , Imrich Richard , Ukropcová Barbara , Tajtáková Mária , Koška Juraj , Zórad Štefan , Belan Vítazoslav , Vaňuga Peter , Payer Juraj , Eckel Juergen , Klimeš Iwar , Gašperíková Daniela
Published: March 2008

Context: GH deficiency (GHD) in adults is associated with central adiposity, dyslipidemia, and insulin resistance.

Objective: The objective of the study was to test the hypothesis that GHD might change the spectrum of adipokines and thus influence the adipose tissue and the whole-body metabolic and inflammatory status leading to development of insulin resistance.

Design: This was a single-center observational study with a cross-sectional design.

Participants and Methods: Protein arrays were used to characterize adipokines expressed in the sc adipose tissue obtained from young GHD adults and compared with age-, gender-, and body mass index (BMI)-matched group of healthy individuals. All subjects underwent an oral glucose tolerance test, euglycemic hyperinsulinemic clamp, and magnetic resonance imaging examination.

Results: Presence of abdominal obesity, enlarged adipocytes, increased circulating high-sensitivity C-reactive protein, impaired glucose tolerance, and decreased insulin action were found in GHD. Changes in adipokine protein expression due to GHD were highly dependent on the obesity phenotype. Lean GHD individuals (BMI ∼23 kg/m2) had decreased protein levels for stem cell factor and epithelial growth factor, indicating a possible defect in adipocyte differentiation and proliferation. Decrease of vascular endothelial growth factor, stromal cell-derived factor, angiopoietin-2, and brain-derived neurotrophic factor advocated for attenuated angiogenesis and neurogenesis. Presence of obesity (BMI ∼31 kg/m2) eliminated these inhibitory effects. However, adipose tissue expansion in GHD individuals was paralleled by an elevation of adipose tissue proinflammatory cytokines (IL-1β, interferon-γ) and chemoattractants (interferon-inducible T cell α-chemoattractant, monocyte chemotactic protein-2, monocyte chemotactic protein-3, eotaxin).

Conclusion: Our data demonstrate that GHD modulates adipokine and cytokine protein expression pattern, which might influence the adipose tissue growth and differentiation and predispose to tissue hypoxia, inflammation, and a defect in the whole-body insulin action.
Plasma Osteopontin Increases After Bariatric Surgery and Correlates with Markers of Bone Turnover But Not with Insulin Resistance
Authors: Riedl Michaela , Vila Greisa , Maier Christina , Handisurya Ammon , Shakeri-Manesch Soheila , Prager Gerhard , Wagner Oswald , Kautzky-Willer Alexandra , Ludvik Bernhard , Clodi Martin , Luger Anton
Published: March 2008

Context: Osteopontin (OPN) is a multifunctional protein involved in bone metabolism, cardiovascular disease, diabetes, and obesity. OPN levels are elevated in the plasma and adipose tissue of obese subjects, and are decreased with diet-induced weight loss.

Objective: We investigated the effect of bariatric surgery on plasma OPN concentrations in morbidly obese patients.

Setting: The study was performed at a university hospital.

Subjects: We investigated 40 obese patients aged 43.1 ± 1.8 yr, scheduled to undergo bariatric surgery. Roux-en-Y gastric bypass (RYGB) was performed in 30 subjects (27 females, three males), and laparoscopic adjustable gastric banding (LAGB) in 10 subjects (eight females, two males).

Study Design: All patients were studied before and 1 yr (10.3–14.8 months) after the intervention.

Main Outcome Measures: OPN, leptin, C-reactive protein, insulin, the homeostatic model assessment insulin resistance index, calcium, 25-hydroxyvitamin D, C telopeptide, and osteocalcin were determined.

Results: Both bariatric procedures significantly reduced body weight, body mass index, insulin, leptin, and C-reactive protein 1 yr after surgery. Plasma OPN increased from 31.4 ± 3.8 to 52.8 ± 3.7 ng/ml after RYGB (P < 0.001) and from 29.8 ± 6.9 to 46.4 ± 10.6 ng/ml after LAGB (P = 0.042). Preoperative OPN correlated with age, insulin, the homeostatic model assessment insulin resistance index, and postoperative OPN. Postoperative OPN correlated with C telopeptide and osteocalcin.

Conclusions: One year after RYGB and LAGB, plasma OPN levels significantly increased and correlated with biomarkers of bone turnover. Unlike other proinflammatory cytokines, OPN does not normalize but increases further after bariatric surgery.
Effect of Low-Dose Oral Contraceptives on Metabolic Risk Factors in African-American Women
Authors: Frempong Barbara A. , Ricks Madia , Sen Sabyasachi , Sumner Anne E.
Published: March 2008

Context: The effect of oral contraceptive pill (OCP) use on cardiovascular risk in African-American women is unknown.

Objective: Our objective was to examine in African-American women the effect of OCP use on insulin resistance, glucose intolerance, and triglycerides (TGs).

Design: This was a cross-sectional study.

Setting: The study was conducted at the National Institutes of Health Clinical Research Center.

Participants: A total of 104 healthy nondiabetic African-American women [21 OCP users, 83 controls, age mean ± sd, 34.7 ± 7.6 yr, body mass index (BMI) 31 ± 8.4 kg/m2] was included in the study.

Interventions: Subjects had oral glucose tolerance tests, insulin-modified frequently sampled iv glucose tolerance tests, and fasting lipid profiles. Insulin resistance was determined by the insulin sensitivity index (SI).

Main Outcome Measures: Insulin resistance, glucose tolerance status, and TG levels were determined.

Results: Fasting glucose did not differ between OCP users and controls (P = 0.27). In contrast, compared with controls, 2-h glucose (135 ± 23 vs.120 ± 25 mg/dl; P = 0.01) and fasting TGs (73 ± 31 vs.57 ± 27 mg/dl; P = 0.02) were higher in OCP users. OCP users tended to be more insulin resistant than controls (SI: 2.51 ± 2.01 vs. 3.46 ± 2.09; P = 0.09). Multiple regression analysis revealed that BMI, age, and OCP use were significant determinants of 2-h glucose (adjusted R2 = 0.37; P < 0.001) and TG levels (adjusted R2 = 0.21; P < 0.001). As BMI was a determinant of both 2-h glucose and TGs, participants were divided into nonobese and obese groups, and the analyses repeated. Among the nonobese women, the OCP users were more insulin resistant (SI: 2.91 ± 1.58 vs. 4.35 ± 1.88; P = 0.03) and had a higher prevalence of glucose intolerance than controls (odds ratio 5.7; 95% confidence interval 1.4–24; P = 0.01).

Conclusion: In African-American women, OCP use is associated with an increase in markers of cardiovascular risk manifested by increased insulin resistance, glucose intolerance, and elevated TGs.