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Find video protocols related to scientific articles indexed in Pubmed.
K13-propeller polymorphisms in Plasmodium falciparum parasites from sub-Saharan Africa.
J. Infect. Dis.
PUBLISHED: 11-05-2014
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Mutations in the Plasmodium falciparum K13-propeller domain have recently been shown to be important determinants of artemisinin resistance in South-East Asia (SEA). This study investigated the prevalence of K13-propeller polymorphisms across sub-Saharan Africa. 1212 P. falciparum samples collected from twelve countries were sequenced. None of the K13-propeller mutations previously reported in SEA were found, but 22 unique mutations were detected, of which seven were non-synonymous. Allele frequencies ranged between 1-3%. Three mutations were observed in more than one country, and the A578S was present in parasites from five countries. This study provides baseline prevalence of K13-propeller mutations in sub-Saharan Africa.
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Tried and true: self-regulation theory as a guiding framework for teaching parents diabetes education using human patient simulation.
ANS Adv Nurs Sci
PUBLISHED: 11-04-2014
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Parents become emotionally upset when learning that their child has type 1 diabetes, yet they are expected to quickly learn functional diabetes management. The purpose of this article is to describe the application of self-regulation theory to guide a family-focused education intervention using human patient simulation to enhance the initial education of parents in diabetes management. A brief description is provided of the intervention framed by self-regulation theory. On the basis of the literature, we describe the educational vignettes used based on self-regulation in the randomized controlled trial entitled "Parent Education Through Simulation-Diabetes." Examples of theory-in-practice will be illustrated by parental learning responses to this alternative educational innovation.
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Predictors of Index Patient Acceptance of Expedited Partner Therapy for Chlamydia trachomatis Infection and Reasons for Refusal, Sexually Transmitted Disease Clinics, New York City, 2011 to 2012.
Sex Transm Dis
PUBLISHED: 10-10-2014
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Expedited partner therapy (EPT) for Chlamydia trachomatis (Ct) reduces repeat Ct infection and was legalized in New York State in 2009. It is a practice in which a Ct-infected index patient delivers medication or a prescription directly to sex partner(s), without those partners receiving medical evaluation. There have been few evaluations of EPT implementation assessing acceptance and uptake among index patients. We measured EPT acceptance among index patients, identified predictors of accepting EPT, and described reasons for declining EPT.
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Return of Results from Genomic Sequencing: A Policy Discussion of Secondary Findings for Cancer Predisposition.
J Cancer Policy
PUBLISHED: 09-18-2014
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Advances in DNA sequencing technology now allow for the rapid genome-wide identification of inherited and acquired genetic variants including those that have been identified as pathogenic alleles for a number of diseases including cancer. Whole genome and exome sequencing are increasingly becoming a part of both clinical practice and research studies. In 2013 the American College of Medical Genetics and Genomics (ACMG) recommended that results of pathogenic genetic variants in 56 genes, nearly half of which comprise cancer genes (including BRCA1, BRCA2, TP53, MLH1, MLH2, MSH6, PMS2, and APC),be returned to patients who have their genome sequenced independent of the purpose for the test. This recommendation has been highly controversial for several reasons, particularly the recommendation that individuals be returned secondary findings of disease causing variants for adult onset conditions regardless of age and without consideration of patient preferences. In addition, the policy regarding returning results of secondary findings from genomic sequencing studies in research settings is currently unclear. In response to these emerging ethical issues, the Washington University Brown School in St. Louis, MO, United Stateshosted a policy forum entitled "First do no harm: Genetic privacy in the age of genomic sequencing" on February 25(th), 2014. The forum included a panel of experts to discuss their views on ethical issues related to return of results in both the clinical and research settings. In this report, we highlight key issues related to return of results from genome sequencing tests that emerged during the forum.
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Monitoring parasite diversity for malaria elimination in sub-Saharan Africa.
Science
PUBLISHED: 09-13-2014
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The African continent continues to bear the greatest burden of malaria and the greatest diversity of parasites, mosquito vectors, and human victims. The evolutionary plasticity of malaria parasites and their vectors is a major obstacle to eliminating the disease. Of current concern is the recently reported emergence of resistance to the front-line drug, artemisinin, in South-East Asia in Plasmodium falciparum, which calls for preemptive surveillance of the African parasite population for genetic markers of emerging drug resistance. Here we describe the Plasmodium Diversity Network Africa (PDNA), which has been established across 11 countries in sub-Saharan Africa to ensure that African scientists are enabled to work together and to play a key role in the global effort for tracking and responding to this public health threat.
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Childhood Brain Tumor Epidemiology: A Brain Tumor Epidemiology Consortium Review.
Cancer Epidemiol. Biomarkers Prev.
PUBLISHED: 09-05-2014
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Childhood brain tumors are the most common pediatric solid tumor and include several histologic subtypes. Although progress has been made in improving survival rates for some subtypes, understanding of risk factors for childhood brain tumors remains limited to a few genetic syndromes and ionizing radiation to the head and neck. In this report, we review descriptive and analytical epidemiology childhood brain tumor studies from the past decade and highlight priority areas for future epidemiology investigations and methodological work that is needed to advance our understanding of childhood brain tumor causes. Specifically, we summarize the results of a review of studies published since 2004 that have analyzed incidence and survival in different international regions and that have examined potential genetic, immune system, developmental and birth characteristics, and environmental risk factors. Cancer Epidemiol Biomarkers Prev; 23(12); 1-21. ©2014 AACR.
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PIK3CA mutations in androgen receptor-positive triple negative breast cancer confer sensitivity to the combination of PI3K and androgen receptor inhibitors.
Breast Cancer Res.
PUBLISHED: 08-08-2014
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Triple negative breast cancer (TNBC) is a heterogeneous collection of biologically diverse cancers, which contributes to variable clinical outcomes. Previously, we identified a TNBC subtype that has a luminal phenotype and expresses the androgen receptor (AR+). TNBC cells derived from these luminal AR + tumors have high frequency phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutations. The purpose of this study was to determine if targeting phosphoinositide 3-kinase (PI3K) alone or in combination with an AR antagonist is effective in AR + TNBC.
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Associations Between Muscle-Related Cytokines and Selected Patient Outcomes in the ICU.
Biol Res Nurs
PUBLISHED: 05-31-2014
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Systemic cytokines produced by contracting skeletal muscles may affect the onset and severity of intensive care unit (ICU)-acquired weakness after critical illness.
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Age-related mutations associated with clonal hematopoietic expansion and malignancies.
Nat. Med.
PUBLISHED: 05-29-2014
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Several genetic alterations characteristic of leukemia and lymphoma have been detected in the blood of individuals without apparent hematological malignancies. The Cancer Genome Atlas (TCGA) provides a unique resource for comprehensive discovery of mutations and genes in blood that may contribute to the clonal expansion of hematopoietic stem/progenitor cells. Here, we analyzed blood-derived sequence data from 2,728 individuals from TCGA and discovered 77 blood-specific mutations in cancer-associated genes, the majority being associated with advanced age. Remarkably, 83% of these mutations were from 19 leukemia and/or lymphoma-associated genes, and nine were recurrently mutated (DNMT3A, TET2, JAK2, ASXL1, TP53, GNAS, PPM1D, BCORL1 and SF3B1). We identified 14 additional mutations in a very small fraction of blood cells, possibly representing the earliest stages of clonal expansion in hematopoietic stem cells. Comparison of these findings to mutations in hematological malignancies identified several recurrently mutated genes that may be disease initiators. Our analyses show that the blood cells of more than 2% of individuals (5-6% of people older than 70 years) contain mutations that may represent premalignant events that cause clonal hematopoietic expansion.
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Caregiver experience during advanced chronic illness and last year of life.
J Am Geriatr Soc
PUBLISHED: 05-06-2014
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To compare the prevalence and predictors of caregiver esteem and burden during two different stages of care recipients' illnesses-advanced chronic illness and the last year of life.
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Using the past to predict the future: latent class analysis of patterns of health service use of older adults in the emergency department.
J Am Geriatr Soc
PUBLISHED: 03-17-2014
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To classify older adults in the emergency department (ED) according to healthcare use and to examine associations between group membership and future ED visits and hospital admissions.
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Recruiting underrepresented minority and low-income high school students into dentistry while educating dental and dental hygiene students about academic careers.
J Dent Educ
PUBLISHED: 03-11-2014
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The objectives of this project were to create a program that would expose underrepresented minority (URM) and low income (LI) high school students to dental professions and provide an opportunity for dental and dental hygiene students from URM/LI groups to be engaged in teaching activities. Data were collected from participants during the school years 2009-10 (high school students: N=23, dental students: N=21, dental hygiene students: N=5) and 2010-11 (N=27, N=11, N=3, respectively). The students participated in fifteen Saturday sessions from October through March each year. The data showed that, from the beginning, mentees and mentors were very interested in participating in the program and getting to know each other. Lectures, general program activities, and patient-related events such as organizing a health fair and shadowing during two outreach clinics were evaluated positively by mentees and mentors. The end of program evaluations showed that the program and the mentee-mentor relationships were rated very positively and that the mentees had an increased interest in oral health-related careers. In conclusion, creating opportunities for URM/LI high school students to explore dental careers and for dental and dental hygiene students to engage in teaching resulted in positive experiences for both groups.
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Evaluation of participant recruitment methods to a rare disease online registry.
Am. J. Med. Genet. A
PUBLISHED: 02-14-2014
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Internet communication advances provide new opportunities to assemble individuals with rare diseases to online patient registries from wide geographic areas for research. However, there is little published information on the efficacy of different recruitment methods. Here we describe recruitment patterns and the characteristics of individuals with the self-identified autosomal dominant genetic disorder neurofibromatosis type 1 (NF1) who participated in an online patient registry during the 1-year period from 1/1/2012 to 12/31/2012. We employed four main mechanisms to alert potential participants to the registry: (1) Facebook and Google advertising, (2) government and academic websites, (3) patient advocacy groups, and (4) healthcare providers. Participants reported how they first heard about the registry through an online questionnaire. During the 1-year period, 880 individuals participated in the registry from all 50 U.S. States, the District of Columbia, Puerto Rico, and 39 countries. Facebook and Google were reported as referral sources by the highest number of participants (n=550, 72% Facebook), followed by healthcare providers (n=74), and government and academic websites (n=71). The mean participant age was 29±18 years and most participants reported White race (73%) and female sex (62%) irrespective of reported referral source. Internet advertising, especially through Facebook, resulted in efficient enrollment of large numbers of individuals with NF1. Our study demonstrates the potential utility of this approach to assemble individuals with a rare disease from across the world for research studies.
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Engaging teens and parents in collaborative practice: perspectives on diabetes self-management.
Diabetes Educ
PUBLISHED: 01-27-2014
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The purpose of this exploratory focus group study was to describe the perspectives of teens and their parents about self-management knowledge, behaviors (including division of labor associated with T1D management), and resources used to manage T1D. The overall goal is to use this information to develop a teen-family transition clinic.
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Integrated analysis of germline and somatic variants in ovarian cancer.
Nat Commun
PUBLISHED: 01-23-2014
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We report the first large-scale exome-wide analysis of the combined germline-somatic landscape in ovarian cancer. Here we analyse germline and somatic alterations in 429 ovarian carcinoma cases and 557 controls. We identify 3,635 high confidence, rare truncation and 22,953 missense variants with predicted functional impact. We find germline truncation variants and large deletions across Fanconi pathway genes in 20% of cases. Enrichment of rare truncations is shown in BRCA1, BRCA2 and PALB2. In addition, we observe germline truncation variants in genes not previously associated with ovarian cancer susceptibility (NF1, MAP3K4, CDKN2B and MLL3). Evidence for loss of heterozygosity was found in 100 and 76% of cases with germline BRCA1 and BRCA2 truncations, respectively. Germline-somatic interaction analysis combined with extensive bioinformatics annotation identifies 222 candidate functional germline truncation and missense variants, including two pathogenic BRCA1 and 1 TP53 deleterious variants. Finally, integrated analyses of germline and somatic variants identify significantly altered pathways, including the Fanconi, MAPK and MLL pathways.
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Neurofibromatosis type 1 and chronic neurological conditions in the United States: an administrative claims analysis.
Genet. Med.
PUBLISHED: 01-19-2014
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Purpose:Neurofibromatosis type 1 has been linked to several neurological conditions, including epilepsy, Parkinson disease, headache, multiple sclerosis, and sleep disturbances, predominantly through case reports and patient series that lack comparison groups. Our objective was to assess whether specific neurological conditions occur more frequently in individuals with neurofibromatosis type 1 versus those without neurofibromatosis type 1.Methods:We used the 2006-2010 MarketScan Commercial Claims and Encounters database to examine associations between neurological conditions and neurofibromatosis type 1. The neurofibromatosis type 1 group was identified through ?2 International Classification of Diseases, Ninth Revision, Clinical Modification neurofibromatosis codes (237.70, 237.71) occurring ?30 days apart or one inpatient neurofibromatosis code. A nonneurofibromatosis type 1 comparison group was frequency matched to the neurofibromatosis type 1 group on age and enrollment length at a 10:1 ratio. Unconditional logistic regression was employed to calculate adjusted odds ratios and 95% confidence intervals for associations between neurofibromatosis and neurological conditions.Results:Compared with the nonneurofibromatosis type 1 group (n = 85,790), the neurofibromatosis type 1 group (n = 8,579) had significantly higher odds of health insurance claims for epilepsy (odds ratio: 7.3; 95% confidence interval: 6.4-8.3), Parkinson disease (odds ratio: 3.1; 95% confidence interval: 1.3-7.5), headache (odds ratio: 2.9; 95% confidence interval: 2.6-3.1), multiple sclerosis (odds ratio: 1.9; 95% confidence interval: 1.2-2.9), and sleep disturbances/disorder (odds ratio: 1.4; 95% confidence interval: 1.2-3.6).Conclusion:This large study provides strong evidence for positive associations between several neurological conditions and neurofibromatosis type 1.Genet Med advance online publication 05 June 2014Genetics in Medicine (2014); doi:10.1038/gim.2014.70.
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Exploring the Frequency of Blood Pressure Documentation in Emergency Departments.
J Nurs Scholarsh
PUBLISHED: 10-28-2013
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One of the most commonly performed task in the emergency department (ED) is reported as the monitoring of vital signs, yet there are no published standards of care that provide guidelines for the frequency of obtaining vital signs in the ED. The purpose of this exploratory study was to determine the frequency of documentation of vital signs recorded during ED visits across Veterans Health Administration (VHA) facilities.
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Racial and ethnic disparities in palliative care.
J Palliat Med
PUBLISHED: 09-27-2013
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Racial and ethnic disparities in health care access and quality are well documented for some minority groups. However, compared to other areas of health care, such as disease prevention, early detection, and curative care, research in disparities in palliative care is limited. Given the rapidly growing population of minority older adults, many of whom will face advanced serious illness, the availability of high-quality palliative care that meets the varied needs of older adults of all races and ethnicities is a priority. This paper reviews existing data on racial and ethnic disparities in use of and quality of palliative care and outlines priorities for future research.
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The Emergence of a Positive Gerontology: From Disengagement to Social Involvement.
Gerontologist
PUBLISHED: 09-05-2013
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The latter part of the 20th century was a period characterized by a fundamental transition in scholarship on activity and the aging process. Theory emphasizing the inevitable decline of human capacity was gradually replaced with concepts stressing positive, multidimensional views of aging. In this article, we highlight the key contributors and trace the origins and overlapping themes of successful aging, productive aging, and civic engagement in later life: 3 examples of scholarship representing a "positive" gerontology. Rowe and Kahns model of successful aging highlights the interplay between social engagement with life, health, and functioning for a positive aging experience. Productive aging, led by Robert Butler, recognizes the previously underappreciated participation of older adults in activities such as volunteering, paid work, and caregiving, and generates interest in the individual and societal barriers to and benefits of participation. Civic engagement in later life raises public awareness about the need to involve older adults in the community, creates opportunities for participation, and generates further interest in the mutual benefit of participation for community beneficiaries and participants. Successful aging, productive aging, and civic engagement represent important contributions to the field of gerontology through applications to policy, advocacy, and theory development.
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Parental tobacco and alcohol use and risk of hepatoblastoma in offspring: a report from the childrens oncology group.
Cancer Epidemiol. Biomarkers Prev.
PUBLISHED: 08-15-2013
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Hepatoblastoma is a rare pediatric liver tumor that has significantly increased in incidence over the last several decades. The International Agency for Research on Cancer (IARC) recently classified hepatoblastoma as a tobacco-related cancer. Parental alcohol use has shown no association. We examined associations between parental tobacco and alcohol use around the time of pregnancy and hepatoblastoma in a large case-control study.
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Effect of an enrichment program on DAT scores of potential dental students from disadvantaged backgrounds.
J Dent Educ
PUBLISHED: 08-10-2013
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The objectives of this study were to explore whether Dental Admission Test (DAT) training in an enrichment program for potential dental students increases the participants Perceptual Achievement Test (PAT) and academic average (AA) scores and whether the length of the program and personal factors such as the number of disadvantages correlate with the DAT scores. Data were collected from 361 students in the summer enrichment program at one dental school between 1994 and 2011. Their baseline, midpoint, and end of program PAT and AA DAT scores were collected. Seventy students self-reported official scores. These students PAT scores increased from 14.40 at baseline to 17.09 at midpoint to 17.84 at program end (p<0.001), and their AA scores increased from 13.53 to 14.09 to 15.12 (p<0.001). Their official scores were higher than the beginning scores (PAT: 14.42 vs. 16.15; p<0.001; AA: 13.61 vs. 16.23; p<0.001). The longer the program, the more the students improved their official scores (PAT: r=0.35; p=0.003; AA: r=0.24; p=0.044). The more disadvantages the students self-reported, the better their official test scores were (PAT: r=0.40; p<0.001; AA: r=0.43; p<0.001). This study found that the DAT training during summer enrichment programs for students from disadvantaged backgrounds led to significant improvements in their DAT scores. The longer the programs, the more the students improved; and the more disadvantages the students had, the more they benefitted.
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Using mobile phone technology to provide recovery support for women offenders.
Telemed J E Health
PUBLISHED: 08-09-2013
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Mobile technology holds promise as a recovery tool for people with substance use disorders. However, some populations who may benefit the most may not have access to or experience with mobile phones. Incarcerated women represent a group at high risk for recidivism and relapse to substance abuse. Cost-effective mechanisms must be in place to support their recovery upon release. This study explores using mobile technology as a recovery management tool for women offenders residing in the community following release from jail.
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Perigestational dietary folic acid deficiency protects against medulloblastoma formation in a mouse model of nevoid basal cell carcinoma syndrome.
Nutr Cancer
PUBLISHED: 08-06-2013
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Hereditary nevoid basal cell carcinoma syndrome (NBCCS) is caused by PTCH1 gene mutations that result in diverse neoplasms including medulloblastoma (MB). Epidemiological studies report reduced pediatric brain tumor risks associated with maternal intake of prenatal vitamins containing folic acid (FA) and FA supplements specifically. We hypothesized that low maternal FA intake during the perigestational period would increase MB incidence in a transgenic NBCCS mouse model, which carries an autosomal dominant mutation in the Ptch1 gene. Female wild-type C57BL/6 mice (n = 126) were randomized to 1 of 3 diets with differing FA amounts: 0.3 mg/kg (low), 2.0 mg/kg (control), and 8.0 mg/kg (high) 1 mo prior to mating with Ptch1 (+/-) C57BL/6 males. Females were maintained on the diet until pup weaning; the pups were then aged for tumor development. Compared to the control group, offspring MB incidence was significantly lower in the low FA group (Hazard Ratio = 0.47; 95% confidence interval 0.27-0.80) at 1 yr. No significant difference in incidence was observed between the control and high FA groups. Low maternal perigestational FA levels may decrease MB incidence in mice genetically predisposed to tumor development. Our results could have implications for prenatal FA intake recommendations in the presence of cancer syndromes.
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Update in hospital palliative care.
J Hosp Med
PUBLISHED: 07-25-2013
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Seriously ill patients frequently receive care in hospitals, and palliative care is a core competency for hospitalists. We aimed to summarize and critique recent research that has the potential to impact the clinical practice of palliative care in the hospital.
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Incidence of childhood and adolescent melanoma in the United States: 1973-2009.
Pediatrics
PUBLISHED: 04-15-2013
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Childhood and adolescent melanoma is rare but has been increasing. To gain insight into possible reasons underlying this observation, we analyzed trends in melanoma incidence diagnosed between the ages of 0 and 19 years among US whites by gender, stage, age at diagnosis, and primary site. We also investigated incidence trends by UV-B exposure levels.
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Race and residence: intercounty variation in black-white differences in hospice use.
J Pain Symptom Manage
PUBLISHED: 03-21-2013
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Although blacks use hospice at lower rates than whites in the U.S., racial differences in hospice use vary by geographic area.
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Kif11 dependent cell cycle progression in radial glial cells is required for proper neurogenesis in the zebrafish neural tube.
Dev. Biol.
PUBLISHED: 03-08-2013
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Radial glia serve as the resident neural stem cells in the embryonic vertebrate nervous system, and their proliferation must be tightly regulated to generate the correct number of neuronal and glial cell progeny in the neural tube. During a forward genetic screen, we recently identified a zebrafish mutant in the kif11 loci that displayed a significant increase in radial glial cell bodies at the ventricular zone of the spinal cord. Kif11, also known as Eg5, is a kinesin-related, plus-end directed motor protein responsible for stabilizing and separating the bipolar mitotic spindle. We show here that Gfap+ radial glial cells express kif11 in the ventricular zone and floor plate. Loss of Kif11 by mutation or pharmacological inhibition with S-trityl-l-cysteine (STLC) results in monoastral spindle formation in radial glial cells, which is characteristic of mitotic arrest. We show that M-phase radial glia accumulate over time at the ventricular zone in kif11 mutants and STLC treated embryos. Mathematical modeling of the radial glial accumulation in kif11 mutants not only confirmed an ~226× delay in mitotic exit (likely a mitotic arrest), but also predicted two modes of increased cell death. These modeling predictions were supported by an increase in the apoptosis marker, anti-activated Caspase-3, which was also found to be inversely proportional to a decrease in cell proliferation. In addition, treatment with STLC at different stages of neural development uncovered two critical periods that most significantly require Kif11 function for stem cell progression through mitosis. We also show that loss of Kif11 function causes specific reductions in oligodendroglia and secondary interneurons and motorneurons, suggesting these later born populations require proper radial glia division. Despite these alterations to cell cycle dynamics, survival, and neurogenesis, we document unchanged cell densities within the neural tube in kif11 mutants, suggesting that a mechanism of compensatory regulation may exist to maintain overall proportions in the neural tube. We propose a model in which Kif11 normally functions during mitotic spindle formation to facilitate the progression of radial glia through mitosis, which leads to the maturation of progeny into specific secondary neuronal and glial lineages in the developing neural tube.
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Association of hospice patients income and care level with place of death.
JAMA Intern Med
PUBLISHED: 02-20-2013
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Terminally ill patients with lower incomes are less likely to die at home, even with hospice care.
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Causes and Occurrences of Interruptions During ED Triage.
J Emerg Nurs
PUBLISHED: 02-14-2013
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Introduction: Interruptions have been shown to cause errors and delays in the treatment of emergency patients and pose a real threat during the triage process. Missteps during the triage assessment can send a patient down the wrong treatment path and lead to delays. The purpose of this project was to identify the types and frequency of interruptions during the ED triage interview process. Methods: A focus group of emergency nurses was organized to identify the types of interruptions that commonly occur during the triage interview. These interruptions would be validated through observations in triage. A tally sheet was developed and implemented to determine how often each interruption occurred during an 8-hour shift. Triage nurses completed the tally sheets while working the first shift (7 am to 3 pm). This shift was selected because patient intake in the US Department of Veterans Affairs Emergency Department is highest during this time. Results: The categories of interruptions identified included provision of conveniences to visitors, coworker-related interruptions, patient care-related interruptions, locating of family members in the emergency department, and other miscellaneous interruptions. Tally sheets were completed by the triage nurses during 10 shifts. On average, triage nurses were interrupted 48.2 times during an 8-hour shift (7 interruptions per hour). After reviewing the data, we found that only 22% of interruptions were related to patient care. More frequently, the causes of interruptions were not related to patient care: opening the door (33%), providing conveniences to visitors (21%), waiting patients or family members asking "How much longer?" (14%), and other causes (10%). Discussion: Frequent interruptions can interfere with concentration and may affect patient care. Non-patient care-related interruptions not only can be frustrating to the triage nurse but also can be offensive to triage patients; they ultimately delay care and may even affect the quality of care. However, because scarce research is available regarding interruptions during ED triage, the effects on patient outcomes are unclear. Additional research needs to be conducted to explore the causes and effects of interruptions to the triage process.
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Its Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework?
J Prim Prev
PUBLISHED: 01-25-2013
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The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, Its Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.
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The Junior Faculty Laboratory: an innovative model of peer mentoring.
Acad Med
PUBLISHED: 10-28-2011
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Mentoring in academic medicine has been shown to contribute to the success of junior faculty, resulting in increased productivity, career satisfaction, and opportunities for networking. Although traditional dyadic mentoring, involving one senior faculty member and one junior protégé, is the dominant model for mentoring in the academic environment, there is increasing recognition that the sharing of knowledge, skills, and experiences among peers may also contribute to the career development of junior faculty. The authors describe the structure, activities, and outcomes of the Junior Faculty Laboratory (JFL), a self-organized, flexible, and dynamic peer-mentoring model within the Duke University Center for the Study of Aging and Human Development. As an innovative mentoring model, JFL is entirely peer driven, and its activities are determined by the real-time needs of members. In contrast to some other peer-mentoring models, JFL lacks senior faculty input or a structured curriculum, members are multidisciplinary, meeting times are project driven rather than preset, and participation in collaborative projects is optional based on the interests and needs of group members. Additionally, JFL was not formed as a substitute for, but as a complement to, the dyadic mentoring relationships enjoyed by its members. The model, now in its fifth year, has demonstrated success and sustainability. The authors present the JFL as an innovative, mentoring model that can be reproduced by other junior faculty seeking to foster collegial relationships with peers while simultaneously enhancing their career development.
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Potential roles for new communication technologies in treatment of addiction.
Curr Psychiatry Rep
PUBLISHED: 07-09-2011
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Information and communication technologies offer clinicians the opportunity to work with patients to manage chronic conditions, including addiction. The early research on the efficacy of electronic treatment and support tools is promising. Sensors have recently received increased attention as key components of electronic treatment and recovery management systems. Although results of the research are very promising, concerns at the clinical and policy level must be addressed before widespread adoption of these technologies can become practical. First, clinicians must adapt their practices to incorporate a continuing flow of patient information. Second, payment and regulatory systems must make adjustments far beyond what telemedicine and electronic medical records have required. This paper examines potential roles of information and communication technologies as well as process and regulatory challenges.
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Maternal exposure to household chemicals and risk of infant leukemia: a report from the Childrens Oncology Group.
Cancer Causes Control
PUBLISHED: 06-09-2011
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Utilizing data from the largest study to date, we examined associations between maternal preconception/prenatal exposure to household chemicals and infant acute leukemia.
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Black-white disparity in disability: the role of medical conditions.
J Am Geriatr Soc
PUBLISHED: 05-17-2011
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To describe the independent contributions of selected medical conditions to the disparity between black and white people in disability rates, controlling for demographic and socioeconomic factors.
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The effectiveness of nurses ability to interpret basic electrocardiogram strips accurately using different learning modalities.
J Contin Educ Nurs
PUBLISHED: 05-13-2011
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Historically, the instructional method of choice has been traditional lecture or face-to-face education; however, changes in the health care environment, including resource constraints, have necessitated examination of this practice.
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Industrial Ziegler-type hydrogenation catalysts made from Co(neodecanoate)2 or Ni(2-ethylhexanoate)2 and AlEt3: evidence for nanoclusters and sub-nanocluster or larger Ziegler-nanocluster based catalysis.
Langmuir
PUBLISHED: 04-11-2011
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Ziegler-type hydrogenation catalysts are important for industrial processes, namely, the large-scale selective hydrogenation of styrenic block copolymers. Ziegler-type hydrogenation catalysts are composed of a group 8-10 transition metal precatalyst plus an alkylaluminum cocatalyst (and they are not the same as Ziegler-Natta polymerization catalysts). However, for ?50 years two unsettled issues central to Ziegler-type hydrogenation catalysis are the nature of the metal species present after catalyst synthesis, and whether the species primarily responsible for catalytic hydrogenation activity are homogeneous (e.g., monometallic complexes) or heterogeneous (e.g., Ziegler nanoclusters defined as metal nanoclusters made from combination of Ziegler-type hydrogenation catalyst precursors). A critical review of the existing literature (Alley et al. J. Mol. Catal. A: Chem. 2010, 315, 1-27) and a recently published study using an Ir model system (Alley et al. Inorg. Chem. 2010, 49, 8131-8147) help to guide the present investigation of Ziegler-type hydrogenation catalysts made from the industrially favored precursors Co(neodecanoate)(2) or Ni(2-ethylhexanoate)(2), plus AlEt(3). The approach and methods used herein parallel those used in the study of the Ir model system. Specifically, a combination of Z-contrast scanning transmission electron microscopy (STEM), matrix assisted laser desorption ionization mass spectrometry (MALDI MS), and X-ray absorption fine structure (XAFS) spectroscopy are used to characterize the transition metal species both before and after hydrogenation. Kinetic studies including Hg(0) poisoning experiments are utilized to test which species are the most active catalysts. The main findings are that, both before and after catalytic cyclohexene hydrogenation, the species present comprise a broad distribution of metal cluster sizes from subnanometer to nanometer scale particles, with estimated mean cluster diameters of about 1 nm for both Co and Ni. The XAFS results also imply that the catalyst solutions are a mixture of the metal clusters described above, plus unreduced metal ions. The kinetics-based Hg(0) poisoning evidence suggests that Co and Ni Ziegler nanoclusters (i.e., M(?4)) are the most active Ziegler-type hydrogenation catalysts in these industrial systems. Overall, the novelty and primary conclusions of this study are as follows: (i) this study examines Co- and Ni-based catalysts made from the actual industrial precursor materials, catalysts that are notoriously problematic regarding their characterization; (ii) the Z-contrast STEM results reported herein represent, to our knowledge, the best microscopic analysis of the industrial Co and Ni Ziegler-type hydrogenation catalysts; (iii) this study is the first explicit application of an established method, using multiple analytical methods and kinetics-based studies, for distinguishing homogeneous from heterogeneous catalysis in these Ziegler-type systems; and (iv) this study parallels the successful study of an Ir model Ziegler catalyst system, thereby benefiting from a comparison to those previously unavailable findings, although the greater M-M bond energy, and tendency to agglomerate, of Ir versus Ni or Co are important differences to be noted. Overall, the main result of this work is that it provides the leading hypothesis going forward to try to refute in future work, namely, that sub, M(?4) to larger, M(n) Ziegler nanoclusters are the dominant, industrial, Co- and Ni- plus AlR(3) catalysts in Ziegler-type hydrogenation systems.
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Racial differences in location before hospice enrollment and association with hospice length of stay.
J Am Geriatr Soc
PUBLISHED: 03-15-2011
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African Americans are less likely than Whites to enroll in hospice. In addition, patients are often referred to hospice very close to death, when they may not have time to take advantage of the full range of hospice services. Understanding how race and location before hospice enrollment are related to hospice length of stay (LOS) may inform the development of interventions to increase timely access to hospice care. Using data from a national hospice provider, African Americans and Whites admitted to routine home hospice care in a private residence between January 1, 2000, and December 31, 2003, were identified. Logistic regression was used to examine the association between race and hospice preadmission location (hospital vs other locations) and preadmission location and hospice LOS (?7 days vs >7 days) after adjusting for demographic and hospice use variables. Of 43,869 enrollees, 15.3% were African American. One to 2 days before hospice enrollment, African Americans were more likely than Whites to be in the hospital than in all other locations (48.6% vs 32.3%, P<.001; adjusted odds ratio=1.83, 95% confidence interval=1.73-1.95). Regardless of race, those whose preadmission location was the hospital were more likely than those from other locations to die 7 days or less after hospice enrollment. Initiatives to improve end-of-life care should focus on increasing timely access to hospice referrals in settings outside of the hospital. Future research should examine whether racial differences in hospice preadmission location reflect differences in preferences for care or disparities in timely access to hospice referrals in non-acute care settings.
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The effect of emergency department crowding on patient outcomes: a literature review.
Adv Emerg Nurs J
PUBLISHED: 02-15-2011
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The purpose of this review was to summarize the findings of published reports that investigated quality-related outcomes and emergency department (ED) crowding. Of 276 data-based articles, 23 reported associations between patient outcomes and crowding. These articles were grouped into 3 categories: delay in treatment, decreased satisfaction, and increased mortality. Although these studies suggest that crowding results in poor outcomes, it is possible that other factors such as nursing care contribute to these adverse outcomes. Nursing care has been shown to contribute to both positive and negative patient outcomes in other settings. Building an understanding of how ED crowding affects the practice of the emergency nurse is essential to examining how nursing care, surveillance, and communication impact outcomes of emergency patients. Investigation into nurse-sensitive quality indicators in the ED has potential to develop strategies that deliver high quality of care, regardless of crowded conditions.
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Which domains of spirituality are associated with anxiety and depression in patients with advanced illness?
J Gen Intern Med
PUBLISHED: 01-26-2011
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Anxiety and depression are common in seriously ill patients and may be associated with spiritual concerns. Little research has examined how concerns in different domains of spirituality are related to anxiety and depression.
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Effects of mean arterial pressure and needle size on arterial sampler filling time.
Respir Care
PUBLISHED: 01-21-2011
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Arterial blood sampling is subject to numerous pre-analytical errors, one of which is inadvertent venous blood sampling. Especially when assessing oxygenation and titrating ventilation, accidental venous blood sampling may lead to inappropriate respiratory care and repeated percutaneous punctures.
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Maternal dietary patterns during early pregnancy and the odds of childhood germ cell tumors: A Childrens Oncology Group study.
Am. J. Epidemiol.
PUBLISHED: 11-23-2010
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Maternal diet during pregnancy may be associated with cancer in offspring. Intake of individual foods, as well as dietary patterns, can be used when examining these relations. Here, the authors examined associations between maternal dietary intake patterns and pediatric germ cell tumors (GCTs) using principal components analysis and logistic regression. Mothers of 222 GCT cases aged less than 15 years who were diagnosed at a Childrens Oncology Group institution between 1993 and 2001 and those of 336 frequency-matched controls completed a self-administered food frequency questionnaire of diet during early pregnancy. Four dietary patterns were identified: "Western," "fruits and vegetables," "protein," and "healthful." With adjustment for birth weight, parity, and vitamin use, the fruits and vegetables pattern was significantly associated with a lower odds for GCTs (odds ratio (OR) = 0.83, 95% confidence interval (CI): 0.69, 0.99; 2 sided). Upon stratification, the fruits and vegetables pattern was significantly associated with a lower odds in males (OR = 0.66, 95% CI: 0.47, 0.92) but not females (OR = 0.91, 95% CI: 0.72, 1.14). A quantitative assessment of assumed nondifferential reporting error indicated no notable deviations from unadjusted odds ratio estimates. Results of this exploratory analysis suggest that maternal prenatal dietary patterns could be considered in future studies of GCTs in offspring.
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Iridium Ziegler-type hydrogenation catalysts made from [(1,5-COD)Ir(mu-O2C8H15)](2) and AlEt3: spectroscopic and kinetic evidence for the Ir(n) species present and for nanoparticles as the fastest catalyst.
Inorg Chem
PUBLISHED: 08-05-2010
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Ziegler-type hydrogenation catalysts, those made from a group 8-10 transition metal precatalyst and an AlR(3) cocatalyst, are often used for large scale industrial polymer hydrogenation; note that Ziegler-type hydrogenation catalysts are not the same as Ziegler-Natta polymerization catalysts. A review of prior studies of Ziegler-type hydrogenation catalysts (Alley et al. J. Mol. Catal. A: Chem. 2010, 315, 1-27) reveals that a approximately 50 year old problem is identifying the metal species present before, during, and after Ziegler-type hydrogenation catalysis, and which species are the kinetically best, fastest catalysts--that is, which species are the true hydrogenation catalysts. Also of significant interest is whether what we have termed "Ziegler nanoclusters" are present and what their relative catalytic activity is. Reported herein is the characterization of an Ir Ziegler-type hydrogenation catalyst, a valuable model (vide infra) for the Co-based industrial Ziegler-type hydrogenation catalyst, made from the crystallographically characterized [(1,5-COD)Ir(mu-O(2)C(8)H(15))](2) precatalyst plus AlEt(3). Characterization of this Ir model system is accomplished before and after catalysis using a battery of physical methods including Z-contrast scanning transmission electron microscopy (STEM), high resolution (HR)TEM, and X-ray absorption fine structure (XAFS) spectroscopy. Kinetic studies plus Hg(0) poisoning experiments are then employed to probe which species are the fastest catalysts. The main findings herein are that (i) a combination of the catalyst precursors [(1,5-COD)Ir(mu-O(2)C(8)H(15))](2) and AlEt(3) gives catalytically active solutions containing a broad distribution of Ir(n) species ranging from monometallic Ir complexes to nanometer scale, noncrystalline Ir(n) nanoclusters (up to Ir(approximately 100) by Z-contrast STEM) with the estimated mean Ir species being 0.5-0.7 nm, Ir(approximately 4-15) clusters considering the similar, but not identical results from the different analytical methods; furthermore, (ii) the mean Ir(n) species are practically the same regardless of the Al/Ir ratio employed, suggesting that the observed changes in catalytic activity at different Al/Ir ratios are primarily the result of changes in the form or function of the Al-derived component (and not due to significant AlEt(3)-induced changes in initial Ir(n) nuclearity). However (iii), during hydrogenation, a shift in the population of Ir species toward roughly 1.0-1.6 nm, fcc Ir(0)(approximately 40-150), Ziegler nanoclusters occurs with, significantly, (iv) a concomitant increase in catalytic activity. Importantly, and although catalysis by discrete subnanometer Ir species is not ruled out by this study, (v) the increases in activity with increased nanocluster size, plus Hg(0) poisoning studies, provide the best evidence to date that the approximately 1.0-1.6 nm, fcc Ir(0)(approximately 40-150), heterogeneous Ziegler nanoclusters are the fastest catalysts in this industrially related catalytic hydrogenation system (and in the simplest, Ockhams Razor interpretation of the data). In addition, (vi) Ziegler nanoclusters are confirmed to be an unusual, hydrocarbon-soluble, highly coordinatively unsaturated, Lewis-acid containing, and highly catalytically active type of nanocluster for use in other catalytic applications and other areas.
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Characterization of the elemental composition of newborn blood spots using sector-field inductively coupled plasma-mass spectrometry.
J Expo Sci Environ Epidemiol
PUBLISHED: 06-30-2010
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We developed extraction and analysis protocols for element detection in neonatal blood spots (NBSs) using sector-field inductively coupled plasma-mass spectrometry (SF-ICP-MS). A 5% (v/v) nitric acid element extraction protocol was optimized and used to simultaneously measure 28 elements in NBS card filter paper and 150 NBSs. NBS element concentrations were corrected for filter paper background contributions estimated from measurements in samples obtained from either unspotted or spotted NBS cards. A lower 95% uncertainty limit (UL) that accounted for ICP-MS method, filter paper element concentration, and element recovery uncertainties was calculated by standard methods for each individuals NBS element concentration. Filter paper median element levels were highly variable within and between lots for most elements. After accounting for measurement uncertainties, 11 elements (Ca, Cs, Cu, Fe, K, Mg, Na, P, Rb, S, and Zn) had lower 95% ULs>0?ng/spot with estimated concentrations ranging from 0.05 to >50,000?ng/spot in ?50% of NBS samples in both correction methods. In a NBS sample minority, Li, Cd, Cs, Cr, Ni, Mo, and Pb had estimated concentrations ?20-fold higher than the respective median level. Taking measurement uncertainties into account, this assay could be used for semiquantitative newborn blood element measurement and for the detection of individuals exposed to supraphysiologic levels of some trace elements. Adequate control of filter paper element contributions remains the primary obstacle to fully quantitative element measurement in newborn blood using NBSs.
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Childhood cancer in relation to parental race and ethnicity: a 5-state pooled analysis.
Cancer
PUBLISHED: 06-22-2010
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Children of different racial/ethnic backgrounds have varying risks of cancer. However, to the authors knowledge, few studies to date have examined cancer occurrence in children of mixed ancestry.
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Infant leukemia and congenital abnormalities: a Childrens Oncology Group study.
Pediatr Blood Cancer
PUBLISHED: 05-21-2010
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Leukemia in infants is rare and has not been well studied apart from leukemia in older children. Differences in survival and the molecular characteristics of leukemia in infants versus older children suggest a distinct etiology, likely involving prenatal factors.
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Birth order and risk of childhood cancer: a pooled analysis from five US States.
Int. J. Cancer
PUBLISHED: 05-17-2010
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The causes of childhood cancers are largely unknown. Birth order has been used as a proxy for prenatal and postnatal exposures, such as frequency of infections and in utero hormone exposures. We investigated the association between birth order and childhood cancers in a pooled case-control dataset. The subjects were drawn from population-based registries of cancers and births in California, Minnesota, New York, Texas and Washington. We included 17,672 cases <15 years of age who were diagnosed from 1980 to 2004 and 57,966 randomly selected controls born 1970-2004, excluding children with Down syndrome. We calculated odds ratios and 95% confidence intervals using logistic regression, adjusted for sex, birth year, maternal race, maternal age, multiple birth, gestational age and birth weight. Overall, we found an inverse relationship between childhood cancer risk and birth order. For children in the fourth or higher birth order category compared to first-born children, the adjusted OR was 0.87 (95% CI: 0.81, 0.93) for all cancers combined. When we examined risks by cancer type, a decreasing risk with increasing birth order was seen in the central nervous system tumors, neuroblastoma, bilateral retinoblastoma, Wilms tumor and rhabdomyosarcoma. We observed increased risks with increasing birth order for acute myeloid leukemia but a slight decrease in risk for acute lymphoid leukemia. These risk estimates were based on a very large sample size, which allowed us to examine rare cancer types with greater statistical power than in most previous studies, however the biologic mechanisms remain to be elucidated.
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ISG20L1 is a p53 family target gene that modulates genotoxic stress-induced autophagy.
Mol. Cancer
PUBLISHED: 04-29-2010
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Autophagy is characterized by the sequestration of cytoplasm and organelles into multimembrane vesicles and subsequent degradation by the cells lysosomal system. It is linked to many physiological functions in human cells including stress response, protein degradation, organelle turnover, caspase-independent cell death and tumor suppression. Malignant transformation is frequently associated with deregulation of autophagy and several tumor suppressors can modulate autophagic processes. The tumor suppressor p53 can induce autophagy after metabolic or genotoxic stress through transcriptionally-dependent and -independent mechanisms. In this study we expand on the former mechanism by functionally characterizing a p53 family target gene, ISG20L1 under conditions of genotoxic stress.
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Evaluation of p63 and p73 antibodies for cross-reactivity.
Cell Cycle
PUBLISHED: 11-09-2009
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The tumor suppressor p53 is commonly mutated in human cancers. However, two homologs of p53, p63 and p73, are frequently overexpressed in tumors and are associated with tumor subtypes, clinical outcomes, and responses to therapy. There are many isoforms of p53, p63 and p73 (the p53 family). Proper detection of and discrimination between the members of this tumor suppressor family in human tissues is of critical importance to cancer research and clinical care. In this study, we assessed the specificity of several commercially available and newly generated p73 antibodies, focusing on antibodies that distinguish between the TA p73 and DeltaNp73 isoforms by western analysis, immunohistochemistry, and immunofluorescence. In addition, we found that the pan-p63 and pan-p73 antibodies tested cross-react with p73 and p63 respectively. The results of this study have important implications for analysis of p63 and p73 expression and co-expression in human tumors, and for potential use of these reagents in molecular diagnostics and therapeutic decision-making.
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Smoking cessation toolbox for allergists.
Ann. Allergy Asthma Immunol.
PUBLISHED: 10-27-2009
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To review nicotine addiction, to examine how tobacco use has a direct negative impact on common disorders seen in allergy practice, and to provide a summary of the national guidelines for treating tobacco use and dependence.
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Racial differences in self-reported exposure to information about hospice care.
J Palliat Med
PUBLISHED: 10-08-2009
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Previous research suggests that lack of knowledge of hospice is a barrier to the use of hospice care by African Americans. However, there is little data examining racial differences in exposure to hospice information.
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Pediatric germ cell tumors and maternal vitamin supplementation: a Childrens Oncology Group study.
Cancer Epidemiol. Biomarkers Prev.
PUBLISHED: 09-15-2009
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Maternal vitamin supplementation has been linked to a reduced risk of several pediatric malignancies. We examined this relationship in a study of childhood germ cell tumors (GCT). Subjects included 278 GCT cases diagnosed <15 years during 1993 to 2001 at a United States or Canadian Childrens Oncology Group Institution and 423 controls that were ascertained through random digit dialing matched to cases on sex, and age within 1 year. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between GCTs and maternal vitamin use at several time points during and around pregnancy. In models controlling for the childs age, sex, household income, and maternal education, any maternal vitamin use during the 6 months before conception through nursing was associated with a nonsignificant reduced risk of GCTs (OR, 0.7; 95% CI, 0.4-1.2). Inverse associations were observed for both extragonadal (OR, 0.8; 95% CI, 0.4-1.6) and gonadal (OR, 0.6; 95% CI, 0.3-1.1) tumors, and for dysgerminoma/seminoma (OR, 0.6; 95% CI, 0.2-1.3) and teratoma (OR, 0.5; 95% CI, 0.2-0.9) but not yolk sac tumors (OR, 1.1; 95% CI, 0.5-2.3). No consistent patterns were found with respect to vitamin use during the periconceptional period (6 months before pregnancy and first trimester) or first trimester specifically. In conclusion, although our study suggests that maternal vitamin supplementation may reduce the risk or pediatric GCTs in the offspring, the small study size and limitations inherent to observational studies must be considered when interpreting these results.
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Emergency department discharge diagnosis and adverse health outcomes in older adults.
J Am Geriatr Soc
PUBLISHED: 08-20-2009
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To determine the relationship between the reason for an emergency department (ED) visit and subsequent risk of adverse health outcomes in older adults discharged from the ED.
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Cancer risk among children with very low birth weights.
Pediatrics
PUBLISHED: 07-01-2009
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The risk of hepatoblastoma is strongly increased among children with very low birth weight (<1500 g). Because data on very low birth weight and other childhood cancers are sparse, we examined the risk of malignancy with very low birth weight in a large data set.
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Selective activity against proliferating tumor endothelial cells by CVX-22, a thrombospondin-1 mimetic CovX-Body.
Anticancer Res.
PUBLISHED: 06-17-2009
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CVX-22 is a CovX-Body, produced by covalently attaching a thrombospondin-1 (TSP-1) type 1 repeat peptide mimetic to a humanized IgG1 molecule. To dissect the antiangiogenic mechanism of CVX-22, the numbers and proliferative status of defined tumor endothelial cell (TEC) subsets from the B16 and C32 melanoma models were examined. CVX-22 treatment reduced the numbers of activated, vascular endothelial growth factor receptor 2 (VEGFR2)-positive TECs. Because the vast majority of mitotically active TECs reside in the VEGFR2 subset, a reduction in numbers of this compartment resulted in an 82% overall decrease in BrdU labeling of TEC. However, the rate of proliferation and VEGFR2 receptor density of this VEGFR2-positive subpopulation were unaffected. Instead, CVX-22 induced endothelial cell apoptosis both in vitro and in vivo, indicating that CVX-22 acts by selective deletion of activated, VEGFR2-positive TEC. The overrepresentation of activated cells in sites of tumor angiogenesis may confer a unique specificity of CVX-22 for tumor vasculature.
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Parental age and risk of childhood cancer: a pooled analysis.
Epidemiology
PUBLISHED: 04-18-2009
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Few risk factors for childhood cancer are well-established. We investigated whether advancing parental age increases childhood cancer risk.
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DeltaNp63 antagonizes p53 to regulate mesoderm induction in Xenopus laevis.
Dev. Biol.
PUBLISHED: 02-25-2009
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p63, a homolog of the tumor suppressor p53, is critical for the development and maintenance of complex epithelia. The developmentally regulated p63 isoform, DeltaNp63, can act as a transcriptional repressor, but the link between the transcriptional functions of p63 and its biological roles is unclear. Based on our initial finding that the mesoderm-inducing factor activin A is suppressed by DeltaNp63 in human keratinocytes, we investigated the role of DeltaNp63 in regulating mesoderm induction during early Xenopus laevis development. We find that down-regulation of DeltaNp63 by morpholino injection in the early Xenopus embryo potentiates mesoderm formation whereas ectopic expression of DeltaNp63 inhibits mesoderm formation. Furthermore, we show that mesodermal induction after down-regulation of DeltaNp63 is dependent on p53. We propose that a key function for p63 in defining a squamous epithelial phenotype is to actively suppress mesodermal cell fates during early development. Collectively, we show that there is a distinct requirement for different p53 family members during the development of both mesodermal and ectodermal tissues. These findings have implications for the role of p63 and p53 in both development and tumorigenesis of human epithelia.
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Childhood cancer among twins and higher order multiples.
Cancer Epidemiol. Biomarkers Prev.
PUBLISHED: 01-07-2009
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Although several studies have found no change or a decreased risk of childhood cancer in twins, few have controlled for potential confounders such as birth weight. We examined the association of birth plurality and childhood cancer in pooled data from five U.S. states (California, Minnesota, New York, Texas, and Washington) using linked birth-cancer registry data. The data, excluding children with Down syndrome or who died before 28 days of life, included 17,672 cases diagnosed from 1980 to 2004 at ages 28 days to 14 years and 57,966 controls with all cases and controls born from 1970 to 2004. Analyses were restricted to children weighing
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Development of an international internet-based neurofibromatosis Type 1 patient registry.
Contemp Clin Trials
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Internet technology provides unprecedented opportunities to assemble large numbers of individuals with rare diseases from across the world to conduct clinical research studies. One such rare disease is Neurofibromatosis Type 1 (NF1), a cancer predisposition syndrome affecting ~1/3000-4000 individuals worldwide. To enable large epidemiological research studies on NF1, we developed an online NF1 Patient Registry Initiative (NPRI) (https://nf1registry.wustl.edu/). Our objective is to describe the methods for registry development and implementation as well as the characteristics of participants during the first year of registry operation. Following electronic consent, participants completed a 30-45 minute questionnaire with 11 sections that asked about demographic, health, and social information. During the first year, 308 individuals from 44 U.S. states, the District of Columbia, and 19 countries participated. Of these, 98% provided demographic information and ~85% completed all questionnaire sections, of which 95% reported the presence of at least two NF1 diagnostic criteria. Most participants who completed the questionnaire indicated willingness for future contact (99%) and for providing biological samples (94%). Based on this first year of experience, we conclude that online registries provide a valuable tool for assembling individuals with a rare disease from across the world for research studies.
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The Factors that Affect the Frequency of Vital Sign Monitoring in the Emergency Department.
J Emerg Nurs
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Vital signs are an important component of the nursing assessment and are used as early warning signs of changes in a patients condition; however, little research has been conducted to determine how often vital signs are monitored in the emergency department. Additionally, it has not been determined what personal, social, and environmental factors affect the frequency of vital sign monitoring. The purpose of this study was to examine what factors may influence the time between recording vital signs in the emergency department.
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Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review.
Neuro-oncology
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Although exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for brain and CNS tumors, it is not clear whether this relationship differs across tumor subtypes, by sex or age at exposure, or at the low-to-moderate range of exposure. This systematic review summarizes the epidemiologic evidence on the association between ionizing radiation exposure and risk of brain/CNS tumors. Articles included in this review estimated radiation exposure doses to the brain and reported excess relative risk (ERR) estimates for brain/CNS tumors. Eight cohorts were eligible for inclusion in the analysis. Average age at exposure ranged from 8 months to 26 years. Mean dose to the brain ranged from 0.07 to 10 Gy. Elevated risks for brain/CNS tumors were consistently observed in relation to ionizing radiation exposure, but the strength of this association varied across cohorts. Generally, ionizing radiation was more strongly associated with risk for meningioma compared with glioma. The positive association between ionizing radiation exposure and risk for glioma was stronger for younger vs older ages at exposure. We did not observe an effect modification on the risk for meningioma by sex, age at exposure, time since exposure, or attained age. The etiologic role of ionizing radiation in the development of brain/CNS tumors needs to be clarified further through additional studies that quantify the association between ionizing radiation and risk for brain/CNS tumors at low-to-moderate doses, examine risks across tumor subtypes, and account for potential effect modifiers.
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Characteristics and outcomes of hospice enrollees with dementia discharged alive.
J Am Geriatr Soc
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To examine the characteristics of hospice enrollees with dementia who were discharged alive because their condition stabilized or improved and predictors of death in the year after discharge.
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Drawbacks and benefits associated with inter-organizational collaboration along the discovery-development-delivery continuum: a cancer research network case study.
Implement Sci
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The scientific process around cancer research begins with scientific discovery, followed by development of interventions, and finally delivery of needed interventions to people with cancer. Numerous studies have identified substantial gaps between discovery and delivery in health research. Team science has been identified as a possible solution for closing the discovery to delivery gap; however, little is known about effective ways of collaborating within teams and across organizations. The purpose of this study was to determine benefits and drawbacks associated with organizational collaboration across the discovery-development-delivery research continuum.
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Promoting new practices to increase access to and retention in addiction treatment: an analysis of five communication channels.
Addict Behav
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Addiction treatment programs adopt evidence-based practices slowly, in part because adopting a new practice is a process, not an event. Using different communication channels may have a different effect at different points in the process. This paper reports the effectiveness of five communication channels in getting substance abuse treatment programs to adopt new business practices. In this study, national trade media coverage produced the greatest interest among programs and the greatest number of decisions to adopt. Conference presentations produced fewer decisions to adopt than national media, but were the most effective channel when compared to the number of programs they reached. Peers were the greatest influence in moving clinic staff from the decision to adopt to implementation. These findings give preliminary evidence for using different communication channels at different times during an effort to promote the adoption of best practices.
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Racial differences in hospice use and patterns of care after enrollment in hospice among Medicare beneficiaries with heart failure.
Am. Heart J.
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We examined racial differences in patterns of care and resource use among Medicare beneficiaries with heart failure after enrollment in hospice.
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Extrafollicular dermal melanocyte stem cells and melanoma.
Stem Cells Int
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Recent studies suggest that extrafollicular dermal melanocyte stem cells (MSCs) persist after birth in the superficial nerve sheath of peripheral nerves and give rise to migratory melanocyte precursors when replacements for epidermal melanocytes are needed on the basal epidermal layer of the skin. If a damaged MSC or melanocyte precursor can be shown to be the primary origin of melanoma, targeted identification and eradication of it by antibody-based therapies will be the best method to treat melanoma and a very effective way to prevent its recurrence. Transcription factors and signaling pathways involved in MSC self-renewal, expansion and differentiation are reviewed. A model is presented to show how the detrimental effects of long-term UVA/UVB radiation on DNA and repair mechanisms in MSCs convert them to melanoma stem cells. Zebrafish have many advantages for investigating the role of MSCs in the development of melanoma. The signaling pathways regulating the development of MSCs in zebrafish are very similar to those found in humans and mice. The ability to easily manipulate the MSC population makes zebrafish an excellent model for studying how damage to MSCs may lead to melanoma.
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What is your understanding of your illness? A communication tool to explore patients perspectives of living with advanced illness.
J Gen Intern Med
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Provider communication courses and guidelines stress the use of open-ended questions, such as "what is your understanding of your illness?," to explore patients perceptions of their illness severity, yet descriptions of patients responses are largely absent from the current literature. These questions are most often used by clinicians as they deliver bad news to cancer patients or address code status at the end of life, but have not been well studied in other diseases or earlier in the disease course.
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Childhood cancer incidence trends in association with US folic acid fortification (1986-2008).
Pediatrics
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Epidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.