bluuebunny/crossref_metadata_2025_split huggingface dataset:
TH‐E‐137‐01: Status of ART in the Clinic
Authors: Li X , Mayr N , Yan D , Jaffray D 
Published: July 2013

Adaptive Radiation Therapy (ART) is state of the art radiotherapy approach which delivers individualized treatment based on treatment feedback via integrating most likely imaging and planning in the treatment delivery process. There are two major aspects: (1) adaptive treatment planning (i.e., design of the optimal plan adaptive to the best available morphological and biological changes during the treatment, and (2) robust and accurate delivery of the optimized plan to the patient. Strategies for ART include on‐line and off‐line approaches. Accumulated clinical data have demonstrated the need for ART in clinical settings, assisted by the wide application of IMRT and IGRT. The technology for ART has advanced significantly in the last few years and is moving into the clinic rapidly, and has drawn greater attention in the radiation oncology community. The purpose of this session is to review and update clinical physicists and dosimetrists on this exciting and rapidly developing area.Learning Objectives:1. Understanding rationale, indications and promise of ART2. Review of imaging, planning, and delivery technologies for ART3. Recent technology developments4. Clinical implementation, workflow, QA, cautions and initial clinical experience for using ART at several tumor sites.
A Combined Disk Test for Direct Differentiation of Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs
Authors: Pournaras Spyros , Zarkotou Olympia , Poulou Aggeliki , Kristo Ioulia , Vrioni Georgia , Themeli-Digalaki Katerina , Tsakris Athanassios 
Published: July 2013

ABSTRACT

Carbapenemase-producing
Enterobacteriaceae
(CPE) are rapidly spreading worldwide. Early detection of fecal CPE carriers is essential for effective infection control. Here, we evaluated the performance of a meropenem combined disk test (CDT) for rapidly differentiating CPE isolates directly from rectal swabs. The screening method was applied for 189 rectal swabs from hospitalized patients at high risk for CPE carriage. Swabs were suspended in 1 ml saline and cultured for confluent growth onto a MacConkey agar plate with a meropenem (MER) disk alone, a MER disk plus phenyl boronic acid (PBA), a MER disk plus EDTA, and a MER disk plus PBA and EDTA. An inhibition zone of ≤25 mm around the MER disk alone indicated carriage of carbapenem-resistant organisms. Furthermore, ≥5-mm differences in the inhibition zone between MER disks without and with the inhibitors (PBA, EDTA, or both) were considered positive results for detecting
Klebsiella pneumoniae
carbapenemase (KPC), metallo-β-lactamase (MBL), or both carbapenemases, respectively. For comparison, rectal suspensions were tested using MacConkey plates with ertapenem (MacERT) disks and PCR (PCR-S) for carbapenemase genes. Of the 189 samples, 97 were genotypically confirmed as CPE positive by one of the three protocols tested. The CDT, MacERT disks, and PCR-S assays exhibited sensitivities of 94.8%, 96.9%, and 94.8% and specificities of 100%, 98.9%, and 100%, respectively, for detecting CPE-positive swabs. Moreover, the CDT correctly differentiated the production of KPC, MBL, or both carbapenemases in 78 of the 97 (80.4%) CPE-positive rectal swabs. Our results demonstrate that the CDT may provide a simple and inexpensive method for detecting and differentiating the carbapenemase type within a single day without requiring further testing and additional delay, supporting the timely implementation of infection control measures.
Hsp90 Inhibitor 17-DMAG Decreases Expression of Conserved Herpesvirus Protein Kinases and Reduces Virus Production in Epstein-Barr Virus-Infected Cells
Authors: Sun Xiaoping , Bristol Jillian A. , Iwahori Satoko , Hagemeier Stacy R. , Meng Qiao , Barlow Elizabeth A. , Fingeroth Joyce D. , Tarakanova Vera L. , Kalejta Robert F. , Kenney Shannon C. 
Published: July 2013

ABSTRACT
All eight human herpesviruses have a conserved herpesvirus protein kinase (CHPK) that is important for the lytic phase of the viral life cycle. In this study, we show that heat shock protein 90 (Hsp90) interacts directly with each of the eight CHPKs, and we demonstrate that an Hsp90 inhibitor drug, 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG), decreases expression of all eight CHPKs in transfected HeLa cells. 17-DMAG also decreases expression the of the endogenous Epstein-Barr virus protein kinase (EBV PK, encoded by the BGLF4 gene) in lytically infected EBV-positive cells and inhibits phosphorylation of several different known EBV PK target proteins. Furthermore, 17-DMAG treatment abrogates expression of the human cytomegalovirus (HCMV) kinase UL97 in HCMV-infected human fibroblasts. Importantly, 17-DMAG treatment decreased the EBV titer approximately 100-fold in lytically infected AGS-Akata cells without causing significant cellular toxicity during the same time frame. Increased EBV PK expression in 17-DMAG-treated AGS-Akata cells did not restore EBV titers, suggesting that 17-DMAG simultaneously targets multiple viral and/or cellular proteins required for efficient viral replication. These results suggest that Hsp90 inhibitors, including 17-DMAG, may be a promising group of drugs that could have profound antiviral effects on herpesviruses.
Child injury: using national emergency department monitoring systems to identify temporal and demographic risk factors
Authors: Hughes Karen , McHale Philip , Wyke Sacha , Lowey Helen , Bellis Mark A 
Published: July 2013

BackgroundInjury is a leading cause of death in children. Emergency department (ED) data offer a potentially rich source of data on child injury. This study uses an emerging national ED data collection system to examine sociodemographics and temporal trends in child injury attendances in England.MethodsCross sectional examination of ED attendances for key injury types made by children aged 0–14 years between April 2010 and March 2011 (road traffic injury (RTI) n=21 670; assault n=9529; deliberate self harm (DSH) n=3066; sports injury n=88 250; burns n=22 222; poisoning n=12 446). Multivariate analyses examined the impact of demographics (age, gender, residential deprivation) and temporal events (day, month, school and public holidays) on risk of attendance for different injury types.ResultsFor most injury types, attendance increased with deprivation. The attendance ratio between children from the poorest and richest deprivation quintiles was greatest for assaults (4.21:1). Conversely, sports injury attendance decreased with deprivation. Males made more attendances than females for all but DSH. Age and temporal profiles varied by injury type. Assault attendances reduced at weekends while burns attendances increased. RTI and sports injury attendances were increased during school term times.ConclusionsED data can provide a major epidemiological resource for examining both temporal and demographic risks of child injury. Emerging systems, such as the one analysed here, can already inform the targeting of prevention, and with improved data coding and use, their utility would be greatly strengthened.
Outcomes in patients with acute ischemic stroke from proximal intracranial vessel occlusion and NIHSS score below 8
Authors: Mokin Maxim , Masud Muhammad W , Dumont Travis M , Ahmad Ghasan , Kass-Hout Tareq , Snyder Kenneth V , Hopkins L Nelson , Siddiqui Adnan H , Levy Elad I 
Published: July 2013

ObjectiveAcute ischemic stroke due to proximal intracranial vessel occlusion is associated with poor prognosis and neurologic outcomes. Outcomes specifically in patients with stroke due to these occlusions and lower National Institutes of Health Stroke Scale (NIHSS) scores (0–7 range) have not been described previously.MethodsWe retrospectively reviewed discharge outcomes (reported in our ‘Get With the Guidelines-Stroke’ database) in patients with an admission NIHSS score of 0–7 due to proximal intracranial large vessel occlusion (based on CT angiography results) who were excluded from receiving intravenous (IV) thrombolysis with recombinant tissue plasminogen activator and endovascular intra-arterial (IA) stroke interventions.ResultsAmong the 204 patients included in our analysis, younger age and lower admission NIHSS score (0–4 range) were strong predictors of good outcome (defined as ability to ambulate independently) at discharge whereas female sex was a predictor of poor outcome. There was no significant difference between cerebrovascular risk factors, specific sites of occlusion, or presenting symptoms and outcomes at discharge. There was great variability in functional outcomes at discharge and discharge disposition (home versus acute or subacute facility or nursing home versus death/hospice) with a trend toward worse outcomes in patients with higher (5–7 range) NIHSS scores on admission.ConclusionsPatients with acute stroke due to large vessel occlusion and low admission NIHSS scores (0–7 range) may have poor functional outcomes at discharge. These patients, if not eligible for IV thrombolysis, might benefit from IA revascularization therapies.
The nocebo effect: patient expectations and medication side effects
Authors: Faasse Kate , Petrie Keith J 
Published: July 2013

Abstract
Expectation of treatment side effects is consistently linked with those symptoms being realised. Patient expectations, including those generated by the informed consent process, can have a large influence on the side effects that patients feel after starting a new medical treatment. Such symptoms may be the result of the nocebo effect, whereby the expectation of side effects leads to them being experienced. Side effects may also be due to the misattribution of pre-existing or unrelated symptoms to the new medication. Medical professionals' own negative beliefs about a treatment, especially generic drugs, may further enhance patients' expectations of adverse effects. The news media may also influence expectations, particularly when media attention is directed towards a health or medication scare. This field of research has ethical and clinical implications for both medical professionals and the news media with respect to the level and type of information about treatment side effects that is provided to patients or members of the public.
Do differences in age between sexual partners affect sexual risk behaviour among Australian gay and bisexual men?
Authors: Prestage Garrett , Jin Fengyi , Bavinton Benjamin , Scott Stephen Andrew , Hurley Michael 
Published: July 2013

ObjectiveTo describe the relationships between HIV-negative Australian gay men's sexual behaviour and differences in age between them and their sex partners.DesignAnonymous computer-assisted internet survey was administered.MethodsWe used multinomial logistic regression to examine factors associated with reported differences in partners’ age (10 years older, within 10 years and 10 years younger) among 1476 men.ResultsTwo-thirds of the men reported their most recent casual sex partners were within 10 years of age to themselves, as were 79.3% of their regular partners. Neither men's own age nor relative differences in age with their partners was associated with the likelihood to engage in unprotected anal intercourse. Among men who reported sex with a regular partner, those with older partners tended to restrict themselves to the receptive position (adjusted ORs (AOR)=2.00; 95% CI 1.02 to 3.92; p=0.044). Among men who reported sex with a casual partner, those with younger partners tended to take the insertive position, both on occasions when a condom was used (AOR=2.42; 95% CI 1.39 to 4.20; p=0.002) and on occasions when a condom was not used (AOR=2.54; 95% CI 1.04 to 6.20; p=0.041).ConclusionsAge differences between gay men and their sex partners make little difference to the likelihood of engaging in sexual risk behaviour overall with either regular or casual partners. Those whose partners are substantially older than themselves are more likely, however, to take the receptive position during anal intercourse. Where risk of HIV infection among younger men is elevated this could be due to differences in sexual position, rather than differences in unprotected anal intercourse per se, during sex with men who are substantially older than themselves.
Treatment of fibroadenomatosis in 14 cats with aglepristone – changes in blood parameters and follow‐up
Authors: Jurka P. , Max A. 
Published: July 2013

Fourteen female cats with fibroadenomatosis were treated with aglepristone, and the effectiveness of the treatment and its effect on selected haematological and blood chemistry parameters were studied. The cats were monitored for 12 months after the end of the treatment. Complete remission of the clinical signs was achieved on average 3·9 weeks after the treatment began; the success of the treatment confirmed the clinical diagnosis of fibroadenomatosis. During the course of the treatment the cats’ haematological parameters returned to normal. In cats that had previously been treated with longacting medroxyprogesterone acetate, treatment with aglepristone for five weeks was recommended. Cases of fibroadenomatosis reappearing after a few months should be regarded as new disease rather than a relapse. Six cats were subsequently mated and four gave birth to one or more litters; all the pregnancies proceeded normally with no clinically evident fibroadenomatosis. The other eight cats underwent ovariohysterectomy soon after the aglepristone treatment was completed.
A 3-Plex Methylation Assay Combined with the FGFR3 Mutation Assay Sensitively Detects Recurrent Bladder Cancer in Voided Urine
Authors: Kandimalla Raju , Masius Roy , Beukers Willemien , Bangma Chris H. , Orntoft Torben F. , Dyrskjot Lars , van Leeuwen Nikki , Lingsma Hester , van Tilborg Angela A.G. , Zwarthoff Ellen C. 
Published: July 2013

Abstract
Purpose: DNA methylation is associated with bladder cancer and these modifications could serve as useful biomarkers. FGFR3 mutations are present in 60% to 70% of non–muscle invasive bladder cancer (NMIBC). Low-grade bladder cancer recurs in more than 50% of patients. The aim of this study is to determine the sensitivity and specificity of a urine assay for the diagnosis of recurrences in patients with a previous primary NMIBC G1/G2 by using cystoscopy as the reference standard.
Experimental Design: We selected eight CpG islands (CGI) methylated in bladder cancer from our earlier genome-wide study. Sensitivity of the CGIs for recurrences detection was investigated on a test set of 101 preTUR urines. Specificity was determined on 70 urines from healthy males aged more than 50 years. A 3-plex assay for the best combination was developed and validated on an independent set of 95 preTUR, recurrence free, and nonmalignant urines (n = 130).
Results: The 3-plex assay identified recurrent bladder cancer in voided urine with a sensitivity of 74% in the validation set. In combination with the FGFR3 mutation assay, a sensitivity of 79% was reached (specificity of 77%). Sensitivity of FGFR3 and cytology was 52% and 57%, respectively.
Conclusion: The combination of methylation and FGFR3 assays efficiently detects recurrent bladder cancer without the need for stratification of patients regarding methylation/mutation status of the primary tumor. We conclude that the sensitivity of this combination is in the same range as cystoscopy and paves the way for a subsequent study that investigates a modified surveillance protocol consisting of the urine test followed by cystoscopy only when the urine test is positive. Clin Cancer Res; 19(17); 4760–9. ©2013 AACR.
Modulation of Circulating Angiogenic Factors and Tumor Biology by Aerobic Training in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy
Authors: Jones Lee W. , Fels Diane R. , West Miranda , Allen Jason D. , Broadwater Gloria , Barry William T. , Wilke Lee G. , Masko Elisabeth , Douglas Pamela S. , Dash Rajesh C. , Povsic Thomas J. , Peppercorn Jeffrey , Marcom P. Kelly , Blackwell Kimberly L. , Kimmick Gretchen , Turkington Timothy G. , Dewhirst Mark W. 
Published: July 2013

Abstract
Aerobic exercise training (AET) is an effective adjunct therapy to attenuate the adverse side-effects of adjuvant chemotherapy in women with early breast cancer. Whether AET interacts with the antitumor efficacy of chemotherapy has received scant attention. We carried out a pilot study to explore the effects of AET in combination with neoadjuvant doxorubicin–cyclophosphamide (AC+AET), relative to AC alone, on: (i) host physiology [exercise capacity (VO2 peak), brachial artery flow-mediated dilation (BA-FMD)], (ii) host-related circulating factors [circulating endothelial progenitor cells (CEP) cytokines and angiogenic factors (CAF)], and (iii) tumor phenotype [tumor blood flow (15O–water PET), tissue markers (hypoxia and proliferation), and gene expression] in 20 women with operable breast cancer. AET consisted of three supervised cycle ergometry sessions/week at 60% to 100% of VO2 peak, 30 to 45 min/session, for 12 weeks. There was significant time × group interactions for VO2 peak and BA-FMD, favoring the AC+AET group (P &lt; 0.001 and P = 0.07, respectively). These changes were accompanied by significant time × group interactions in CEPs and select CAFs [placenta growth factor, interleukin (IL)-1β, and IL-2], also favoring the AC+AET group (P &lt; 0.05). 15O–water positron emission tomography (PET) imaging revealed a 38% decrease in tumor blood flow in the AC+AET group. There were no differences in any tumor tissue markers (P &gt; 0.05). Whole-genome microarray tumor analysis revealed significant differential modulation of 57 pathways (P &lt; 0.01), including many that converge on NF-κB. Data from this exploratory study provide initial evidence that AET can modulate several host- and tumor-related pathways during standard chemotherapy. The biologic and clinical implications remain to be determined. Cancer Prev Res; 6(9); 925–37. ©2013 AACR.
Secularity, Religion and the Possibilities for Religious Citizenship
Authors: Parker Lyn , Hoon Chang-Yau 
Published: July 2013

Abstract
Scholarly predictions of the secularization of the world have proven premature. We see a heterogeneous world in which religion remains a significant and vital social and political force. This paper reflects critically upon secularization theory in order to see how scholars can productively respond to the, at least partly, religious condition of the world at the beginning of the twenty first century. We note that conventional multiculturalism theory and policy neglects religion, and argue the need for a reconceptualization of understanding of religion and secularity, particularly in a context of multicultural citizenship — such as in Australia and Indonesia. We consider the possibilities for religious pluralism in citizenship and for “religious citizenship”. Finally, we propose that religious citizenship education might be a site for fostering a tolerant and enquiring attitude towards religious diversity.
Conceptual-theoretical Re-orientation in Social Movement Discourse
Authors: Mukherji Partha Nath 
Published: July 2013

Abstract
Western ethnocentrism in the social movement discourse keeps cropping up now and again. An attempt is made to arrive at a theoretical orientation unconstrained by historical contingency, but at the same time, without being a-historical. Conceptually, a distinction is made between social mobilisations and social movements, and between social movements and quasi-social movements. Since social movements are inevitably linked with social changes, a classification of social movements by its intended changes is presented to distinguish between varieties of social movements. Finally, the use of means — institutional and non-institutional — is factored into the theoretical orientation.
What is a clinically relevant change on the HIT-6 questionnaire? An estimation in a primary-care population of migraine patients
Authors: Smelt Antonia FH , Assendelft Willem JJ , Terwee Caroline B , Ferrari Michel D , Blom Jeanet W 
Published: July 2013

Objective To interpret questionnaire scores, clinicians and researchers need to know what change in score reflects a meaningful change in the condition of an individual patient, and what difference reflects a meaningful difference between groups. These values differ between different populations. We determined the within-person minimally important change (MIC) and the between-group minimally important difference (MID) of the Headache Impact Test-6 (HIT-6) questionnaire in a primary-care population of migraine patients. Methods We included 490 patients who participated in a clinical trial on the treatment of migraine in primary care. We compared their change scores on the HIT-6 questionnaire between baseline and at three-months follow-up with the answers to two anchor questions according to the ‘mean change approach’ and the ‘ROC curve approach’. Results The within-person MIC was estimated to be between −2.5 points (mean change approach) and −6 points (ROC curve approach). The choice for the within-person MIC value depends on the consequences of false positives and false negatives in a particular setting. The between-group MID was estimated at −1.5 points. Conclusions We determined the within-person MIC and between-group MID for the HIT-6 in a primary-care population of migraine patients. We recommend the use of these values for clinical care and for research.
Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache
Authors: Guo Song , Shalchian Sarvnaz , Gérard Pascale , Küper Michael , Katsarava Zaza , Ashina Messoud , Schoenen Jean 
Published: July 2013

Background It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication-overuse headache (MOH), one may wonder if they have a more severe form of the disorder and more frequently a PFO. Objective The objective of this study is to determine the prevalence and grade of RLS in patients suffering from CM and MOH. Methods A cross-sectional multicenter study of air-contrast transcranial Doppler was conducted in 159 patients with CM ( n = 57) or MOH ( n = 102) attending a tertiary headache clinic. Results The prevalence of RLS in CM was 37% (11% large shunts) and in MOH patients 31% (13% large shunts). There was no difference between the two groups ( p = 0.49). Conclusion RLS prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches.