bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized Phase III Trial of Ixabepilone Plus Capecitabine Versus Capecitabine in Patients With Metastatic Breast Cancer Previously Treated With an Anthracycline and a Taxane
Authors: Sparano Joseph A. , Vrdoljak Eduard , Rixe Oliver , Xu Binghe , Manikhas Alexey , Medina Carlos , Ventilari Da Costa Susanne Crocamo , Ro Jungsil , Rubio Gonzalo , Rondinon Monica , Perez Manga Gumersindo , Peck Ronald , Poulart Valerie , Conte Pierfranco 
Published: June 2010

Purpose We sought to determine whether the combination of ixabepilone plus capecitabine improved overall survival (OS) compared with capecitabine alone in patients with metastatic breast cancer (MBC) previously treated with anthracyclines and taxanes. Patients and Methods A total of 1,221 patients with MBC previously treated with anthracycline and taxanes were randomly assigned to ixabepilone (40 mg/m2 intravenously on day 1) plus capecitabine (2,000 mg/m2 orally on days 1 through 14) or capecitabine alone (2,500 mg/m2 on the same schedule) given every 21 days. The trial was powered to detect a 20% reduction in the hazard ratio (HR) for death. Results There was no significant difference in OS between the combination and capecitabine monotherapy arm, the primary end point (median, 16.4 v 15.6 months; HR = 0.9; 95% CI, 078 to 1.03; P = .1162). The arms were well balanced with the exception of a higher prevalence of impaired performance status (Karnofsky performance status 70% to 80%) in the combination arm (32% v 25%). In a secondary Cox regression analysis adjusted for performance status and other prognostic factors, OS was improved for the combination (HR = 0.85; 95% CI, 0.75 to 0.98; P = .0231). In 79% of patients with measurable disease, the combination significantly improved progression-free survival (PFS; median, 6.2 v 4.2 months; HR = 0.79; P = .0005) and response rate (43% v 29%; P < .0001). Grade 3 to 4 neuropathy occurred in 24% treated with the combination, but was reversible. Conclusion This study confirmed a previous trial demonstrating improved PFS and response for the ixabepilone-capecitabine combination compared with capecitabine alone, although this did not result in improved survival.
Characteristics and Predictors of Missed Opportunities in Lung Cancer Diagnosis: An Electronic Health Record–Based Study
Authors: Singh Hardeep , Hirani Kamal , Kadiyala Himabindu , Rudomiotov Olga , Davis Traber , Khan Myrna M. , Wahls Terry L. 
Published: June 2010

Purpose Understanding delays in cancer diagnosis requires detailed information about timely recognition and follow-up of signs and symptoms. This information has been difficult to ascertain from paper-based records. We used an integrated electronic health record (EHR) to identify characteristics and predictors of missed opportunities for earlier diagnosis of lung cancer. Methods Using a retrospective cohort design, we evaluated 587 patients of primary lung cancer at two tertiary care facilities. Two physicians independently reviewed each case, and disagreements were resolved by consensus. Type I missed opportunities were defined as failure to recognize predefined clinical clues (ie, no documented follow-up) within 7 days. Type II missed opportunities were defined as failure to complete a requested follow-up action within 30 days. Results Reviewers identified missed opportunities in 222 (37.8%) of 587 patients. Median time to diagnosis in cases with and without missed opportunities was 132 days and 19 days, respectively (P < .001). Abnormal chest x-ray was the clue most frequently associated with type I missed opportunities (62%). Follow-up on abnormal chest x-ray (odds ratio [OR], 2.07; 95% CI, 1.04 to 4.13) and completion of first needle biopsy (OR, 3.02; 95% CI, 1.76 to 5.18) were associated with type II missed opportunities. Patient adherence contributed to 44% of patients with missed opportunities. Conclusion Preventable delays in lung cancer diagnosis arose mostly from failure to recognize documented abnormal imaging results and failure to complete key diagnostic procedures in a timely manner. Potential solutions include EHR-based strategies to improve recognition of abnormal imaging and track patients with suspected cancers.
Longer-Term Assessment of Trastuzumab-Related Cardiac Adverse Events in the Herceptin Adjuvant (HERA) Trial
Authors: Procter Marion , Suter Thomas M. , de Azambuja Evandro , Dafni Urania , van Dooren Veerle , Muehlbauer Susanne , Climent Miguel Angel , Rechberger Ernst , Liu Walter Tsang-Wu , Toi Mazakasu , Coombes R. Charles , Dodwell David , Pagani Olivia , Madrid Jorge , Hall Marcia , Chen Shin-Cheh , Focan Christian , Muschol Michael , van Veldhuisen Dirk J. , Piccart-Gebhart Martine J. 
Published: June 2010

Purpose We investigated the incidence of cardiac adverse events in patients with early breast cancer in the Herceptin Adjuvant (HERA) trial who were treated with 1 year of trastuzumab after completion of (neo)adjuvant chemotherapy. Patients and Methods The HERA trial is a three-group, randomized trial that compared 1 year or 2 years of trastuzumab with observation in women with human epidermal growth factor receptor-2 (HER2) –positive early breast cancer. Eligible patients had normal left ventricular ejection fraction (LVEF; ≥ 55%) after completion of (neo)adjuvant chemotherapy with or without radiotherapy. Cardiac function was monitored throughout the trial. This analysis considers patients randomly assigned to 1 year of trastuzumab treatment or observation. Results There were 1,698 patients randomly assigned to observation and 1,703 randomly assigned to 1 year of trastuzumab treatment; 94.1% of patients had been treated with anthracyclines. The incidence of discontinuation of trastuzumab because of cardiac disorders was low (5.1%). At a median follow-up of 3.6 years, the incidence of cardiac end points remained low, though it was higher in the trastuzumab group than in the observation group (severe CHF, 0.8% v 0.0%; confirmed significant LVEF decreases, 3.6% v 0.6%) In the trastuzumab group, 59 of 73 patients with a cardiac end point reached acute recovery; of these 59 patients, 52 were considered by the cardiac advisory board (CAB) to have a favorable outcome from the cardiac end point. Conclusion The incidence of cardiac end points remains low even after longer-term follow-up. The cumulative incidence of any type of cardiac end point increases during the scheduled treatment period of 1 year, but it remains relatively constant thereafter.
Report of a Multicenter Phase II Trial Testing a Combination of Biweekly Bevacizumab and Daily Erlotinib in Patients With Unresectable Biliary Cancer: A Phase II Consortium Study
Authors: Lubner Sam J. , Mahoney Michelle R. , Kolesar Jill L. , LoConte Noelle K. , Kim George P. , Pitot Henry C. , Philip Philip A. , Picus Joel , Yong Wei-Peng , Horvath Lisa , Van Hazel Guy , Erlichman Charles E. , Holen Kyle D. 
Published: June 2010

PurposeBiliary cancers overexpress epidermal growth factor receptor (EGFR), and angiogenesis has been correlated with poor outcome. Erlotinib, an EGFR tyrosine kinase inhibitor, and bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor have each been shown to have activity in biliary cancer. The primary objective of this study was to evaluate the response rate by Response Evaluation Criteria in Solid Tumors (RECIST). Secondary end points included overall survival (OS), time to progression (TTP), VEGF levels, and molecular studies of EGFR and k-ras.Patients and MethodsEligible patients had advanced cholangiocarcinoma or gallbladder cancer. Patients were treated with bevacizumab 5 mg/kg intravenously on days 1 and 15 and erlotinib 150 mg by mouth daily on days 1 through 28. Responses were evaluated by RECIST. VEGF levels were collected, and samples were analyzed for EGFR mutation by polymerase chain reaction.ResultsFifty-three eligible patients were enrolled at eight sites. Of 49 evaluable patients, six (12%; 95% CI, 6% to 27%) had a confirmed partial response. Stable disease was documented in another 25 patients (51%). Rash was the most common grade 3 toxicity. Four patients had grade 4 toxicities. Median OS was 9.9 months, and TTP was 4.4 months. Low repeats (< 16) in EGFR intron 1 polymorphism and G>G k-ras Q38 genotype (wild type) were associated with improved outcomes.ConclusionCombination chemotherapy with bevacizumab and erlotinib showed clinical activity with infrequent grade 3 and 4 adverse effects in patients with advanced biliary cancers. On the basis of preliminary molecular analysis, presence of a k-ras mutation may alter erlotinib efficacy. The combination of bevacizumab and erlotinib may be a therapeutic alternative in patients with advanced biliary cancer.
Development of an optimized chemical kinetic mechanism for homogeneous charge compression ignition combustion of a fuel blend of n-heptane and natural gas using a genetic algorithm
Authors: Rahimi A , Fatehifar E , Saray R Khoshbakhti 
Published: June 2010

Homogeneous charge compression ignition (HCCI) is a promising technique for advanced low-temperature combustion strategies that offers a high fuel conversion efficiency and low nitrogen oxide and soot emissions. One of the major problems associated with HCCI combustion engine application is the lack of direct control for combustion timing. A proposed solution for combustion timing control is to use a binary fuel blend in which two fuels with different autoignition characteristics are blended at various ratios on a cycle-by-cycle basis. Because dual-fuel diesel—natural-gas engines have already been used, a fuel blend of n-heptane (diesel-like fuel) and natural gas (mostly methane) is one of the best available options. The objective of this study is to optimize the chemical kinetic mechanisms available for n-heptane and natural gas to be used in a binary-fuel blend scenario. Using the genetic algorithm method, a combined mechanism was optimized and modelling results were verified against experimental results. The agreement between experimental and modelling results was found to be acceptable within the examined conditions. As a result, an optimized chemical kinetic mechanism for an n-heptane—natural-gas blend is presented.
Industrial Composting of Poly(Lactic Acid) Bottles
Authors: Danyluk Casey , Erickson Ryan , Burrows Samuel , Auras Rafael 
Published: June 2010

Abstract
In order to better understand the end of life scenario potential of poly(lactic acid) (PLA) packaging to reduce waste through composting when properly disposed, this study aimed to determine the rate at which 473 mL (16 oz) PLA bottles with and without associated high density polyethylene (HDPE) caps and polypropylene (PP) labels decomposed in an industrial compost pile. Temperature, moisture content, and pH levels of the compost pile were recorded throughout the study to determine their effects on the rate of decomposition and to ensure optimal conditions were met. Analyses performed at weeks 2, 4, and 8 showed that from week 2, a 94 % reduction of mass and weight average molecular weight occurred, along with a complete loss of structural integrity. PLA bottles without caps and labels were considered to be decomposed completely by week 4, while the bottles with the HDPE caps and PP labels showed plastic residues until week 8. The caps and labels acted as a barrier that slowed the rate of biodegradation. This study showed that PLA bottles can be composted in industrial composting facilities in 30–45 days, and it is recommended to remove all caps and labels. The results further indicated that if a proper infrastructure is put in place to allow large scale composting of PLA, this packaging polymer could have a significant impact on reducing municipal solid waste.
Fractures and Traumatic Brain Injuries: Abuse Versus Accidents in a US Database of Hospitalized Children
Authors: Leventhal John M. , Martin Kimberly D. , Asnes Andrea G. 
Published: June 2010

OBJECTIVE:
The goal was to use a national database to determine the incidence of abusive traumatic brain injuries (TBIs) and/or fractures and the frequency of abuse versus accidents among children &lt;36 months of age.

METHODS:
We used the 2006 Kids' Inpatient Database and classified cases into 3 types of injuries, that is, (1) TBI only, (2) TBI and fracture, or (3) fracture only. Groups 2 and 3 were divided into 3 patterns, that is, (1) skull fractures, (2) skull and nonskull fractures, or (3) nonskull fractures. For each type and pattern, we compared abuse, accidental falls, other accidents, and motor vehicle accidents.

RESULTS:
The incidence of TBIs and/or fractures attributable to abuse was 21.9 cases per 100 000 children &lt;36 months of age and 50.0 cases per 100 000 children &lt;12 months of age. In the abuse group, 29.9% of children had TBIs only, 28.3% TBIs and fractures, and 41.8% fractures only. Abused children were younger and were more likely to be enrolled in Medicaid. For TBI only, falls were more common than abuse in the first 2 months of life but abuse was more common from 2 to 7 months. For TBI and skull fracture, falls were more common during the first year of life. For skull fracture only, almost all injuries were attributable to falls.

CONCLUSIONS:
There was overlap in TBIs and fractures attributable to abuse. Among &lt;12-month-old children, TBIs and/or fractures attributable to abuse occurred in 1 of 2000. Falls occurred more commonly than abuse, even among very young children.
US National Longitudinal Lesbian Family Study: Psychological Adjustment of 17-Year-Old Adolescents
Authors: Gartrell Nanette , Bos Henny 
Published: June 2010

OBJECTIVES:The objective of this study was to document the psychological adjustment of adolescents who were conceived through donor insemination by lesbian mothers who enrolled before these offspring were born in the largest, longest running, prospective, longitudinal study of same-sex–parented families.METHODS:Between 1986 and 1992, 154 prospective lesbian mothers volunteered for a study that was designed to follow planned lesbian families from the index children's conception until they reached adulthood. Data for the current report were gathered through interviews and questionnaires that were completed by 78 index offspring when they were 10 and 17 years old and through interviews and Child Behavior Checklists that were completed by their mothers at corresponding times. The study is ongoing, with a 93% retention rate to date.RESULTS:According to their mothers' reports, the 17-year-old daughters and sons of lesbian mothers were rated significantly higher in social, school/academic, and total competence and significantly lower in social problems, rule-breaking, aggressive, and externalizing problem behavior than their age-matched counterparts in Achenbach's normative sample of American youth. Within the lesbian family sample, no Child Behavior Checklist differences were found among adolescent offspring who were conceived by known, as-yet-unknown, and permanently unknown donors or between offspring whose mothers were still together and offspring whose mothers had separated.CONCLUSIONS:Adolescents who have been reared in lesbian-mother families since birth demonstrate healthy psychological adjustment. These findings have implications for the clinical care of adolescents and for pediatricians who are consulted on matters that pertain to same-sex parenting.
The Dialogical Self: Research and Applications
Authors: Batory Anna , Bąk Wacław , Oleś Piotr , Puchalska-Wasyl Małgorzata 
Published: June 2010

The Dialogical Self: Research and Applications
The paper presents dialogical self theory and its current theoretical and empirical status. We start with some inspirations from philosophy and literature and then describe the main thesis of the theory - self-multiplicity conceptualized in terms of I-positions and the dynamic relations between them. In the next section we present examples of empirical explorations of inner dialogical activity. Although dialogical self theory is generally perceived as a qualitative approach, there is a growing number of quantitative studies conducted both in correlational and experimental designs. Moreover, numerous interesting and promising topics are still open for further research - e.g. temporal dialogues, dialogical interpretations of personal identity, values and valuation, relations between self and culture. After reviewing these empirical results we try to explore the relations between the dialogical and the cognitive approach to self-multiplicity. We propose that those two approaches can be seen as complementary rather than competing. The last section discusses some practical implications of dialogical self theory for psychotherapy and counseling.
Environmental Responsibility: Teachers' Views
Authors: Manolas Evangelos , Tampakis Stilianos 
Published: June 2010

Environmental Responsibility: Teachers' ViewsThis research paper investigates the views of the teachers of elementary and secondary schools in Greece with regard to who bears the responsibility for the state of the environment, as well as who should bear the cost of its protection. The research was carried out at the Environmental Education Centre of Kissavos-Mavrovounio. The research subjects were 144 teachers undergoing training in environmental education. The teachers believe that today the quality of both the natural and the urban environments worsens with those most responsible, in order of importance, being the industrialists and businesses, public administration and control mechanisms, politicians and laws, the citizens as consumers, judges and the judicial system and the farmers as producers. According to the respondents, the parties less responsible are the journalists and the mass media, researchers and scientists and, finally, teachers and the educational system in general. With regard to who should bear the cost of environmental protection, the vast majority think that the government should be the one to pay. The ideas of indirect and direct taxation, the adoption of a lower standard of living are much less accepted.
Sustainable Leadership of Senior Students: The Case Study of Madeira
Authors: Bento António , Ribeiro Isabel 
Published: June 2010

Sustainable Leadership of Senior Students: The Case Study of MadeiraSecondary education plays a key role in developing sustainable leadership skills in students. This research analyses the characteristics of sustainable leadership of students at 2 secondary schools in Madeira Island (Portugal) in order to determine whether the type of school or gender of the students affect eight distinct domains: 1) self management; 2) interpersonal relations; 3) problem solving/decision making; 4) cognitive critical development/analysis; 5) organization and planning; 6) self-confidence; 7) diversity awareness; 8) technology. The Student Leadership Outcomes Inventory (SLOI) (Vann, 2000) was used to measure the leadership experiences of 158 senior students in these eight areas. Participants revealed moderate levels of sustainable leadership in the eight sub-scales. The findings show that students of Madeira Island who finish secondary education possess several well-developed sustainable leadership skills.
2010
Authors: Gedžūne Ginta , Gedžūne Inga 
Published: June 2010

2010This study explores pre-service teachers' views on the features and causes of social exclusion in the context of educational unsustainability. The data from expert questionnaires, assessment of research participants' personal experience with social exclusion in educational setting, their current understanding of the problem and individual suggestions for solving it were analysed qualitatively. The results indicate that, in teachers' opinion, social exclusion in education can be caused by subjective and objective factors – pupils' personal characteristics, school climate, parental influence and social causes. The research participants particularly emphasise teacher's role in reducing pupils' social exclusion by adhering to values, such as fairness, equality, empathy, cooperation and respect. The research results highlight the need for addressing the issue of social exclusion in teacher education programmes by raising future teachers' awareness of the problem and their responsibility to overcome it.
Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements
Authors: MSYAMBOZA KELIAS , SAVAGE EMMA , KALANDA GERTRUDE , KAZEMBE PETER , GIES SABINE , D'ALESSANDRO UMBERTO , BRABIN BERNARD J. 
Published: June 2010

AbstractObjective. To describe pregnancy outcomes of adolescent and adult primigravidae receiving antimalarials and hematinic supplementation and compare findings with a survey in this area a decade earlier. Design. Cross‐sectional surveys in intervention and control sites. Setting. Community, antenatal and delivery facilities in Chikwawa, Malawi. A rural area with year round malaria transmission. Methods. Data on antenatal attendance, uptake of intermittent preventive treatment with sulfadoxine‐pyrimethamine (IPTp‐SP), birthweight, malaria, anaemia, for 2,152 primigravidae. Outcome measures. Place of delivery, anaemia, malaria, birthweight. Results. Fewer adolescent than adult primigravidae received ≥2 IPTp‐SP doses (66 vs. 77.2%, p < 0.001), although more attended for two or more antenatal visits (92.0 vs. 76.7%, p < 0.001). Only 24.1% of adolescent primigravidae attended for hospital delivery. Women resident in intervention sites receiving IPTp‐SP community distribution were more likely to choose a community delivery (p < 0.01), and have higher uptake of IPTp‐SP (p = 0.036) than women not resident in these villages. Postnatal malaria prevalence was low and did not differ by age or place of delivery. Postnatal anaemia and low birthweight prevalence were higher in adolescents with community deliveries. Maternal anaemia and low birthweight prevalence were lower amongst adolescents in this study compared to estimates from the same population a decade previously. Conclusions. Adolescents had higher anaemia risk, lower IPTp‐SP uptake than adults and under a quarter had a hospital delivery. Pregnancy outcomes improved compared to the survey a decade earlier. Monitoring and surveillance is required to reinforce to policy makers the need to improve adolescent coverage for available interventions.
T Cell and APC Dynamics In Situ Control the Outcome of Vaccination
Authors: Khanna Kamal M. , Blair David A. , Vella Anthony T. , McSorley Stephen J. , Datta Sandip K. , Lefrançois Leo 
Published: June 2010

Abstract
The factors controlling the progression of an immune response to generation of protective memory are poorly understood. We compared the in situ and ex vivo characteristics of CD8 T cells responding to different forms of the same immunogen. Immunization with live Listeria monocytogenes, irradiated L. monocytogenes (IRL), or heat-killed L. monocytogenes (HKL) induced rapid activation of CD8 T cells. However, only IRL and live L. monocytogenes inoculation induced sustained proliferation and supported memory development. Gene and protein expression analysis revealed that the three forms of immunization led to three distinct transcriptional and translational programs. Prior to cell division, CD8 T cell–dendritic cell clusters formed in the spleen after live L. monocytogenes and IRL but not after HKL immunization. Furthermore, HKL immunization induced rapid remodeling of splenic architecture, including loss of marginal zone macrophages, which resulted in impaired bacterial clearance. These results identify initial characteristics of a protective T cell response that have implications for the development of more effective vaccination strategies.