Perianal disease combined with NOD2 genotype predicts need for IBD-related surgery in Crohn’s Disease patients from a population-based cohort

Background: Patients with Crohn’s disease (CD) often require surgery at some stage of disease course. Prediction of CD outcome is influenced by clinical, environmental, serological, and genetic factors (eg, NOD2). Being able to identify CD patients at high risk of surgical intervention should assist clinicians to decide whether or not to prescribe early aggressive treatment with immunomodulators. Methods: We performed a retrospective analysis of selected clinical (age at diagnosis, perianal disease, active smoking) and genetic (NOD2 genotype) data obtained for a population-based CD cohort from the Canterbury Inflammatory Bowel Disease study. Logistic regression was used to identify predictors of complicated outcome in these CD patients (ie, need for inflammatory bowel disease-related surgery). Results: Perianal disease and the NOD2 genotype were the only independent factors associated with the need for surgery in this patient group (odds ratio=2.84 and 1.60, respectively). By combining the associated NOD2 genotype with perianal disease we generated a single “clinicogenetic” variable. This was strongly associated with increased risk of surgery (odds ratio=3.84, P=0.00, confidence interval, 2.28-6.46) and offered moderate predictive accuracy (positive predictive value=0.62). Approximately 1/3 of surgical outcomes in this population are attributable to the NOD2+PA variable (attributable risk=0.32). Conclusions: Knowledge of perianal disease and NOD2 genotype in patients presenting with CD may offer clinicians some decision-making utility for early diagnosis of complicated CD progression and initiating intensive treatment to avoid surgical intervention. Future studies should investigate combination effects of other genetic, clinical, and environmental factors when attempting to identify predictors of complicated CD outcomes.

Local plastic mechanisms in thin steel plates under in-plane compression

Thin-walled steel plates subjected to in-plane compression develop two types of local plastic mechanism, namely the roof-shaped mechanism and the so-called flip-disc mechanism, but the intriguing question of why two mechanisms should develop was not answered until recently. It was considered that the location of first yield point shifted from the centre of the plate to the midpoint of the longitudinal edge depending on the b/t ratio, imperfection level, and yield stress of steel, which then decided the type of mechanism. This paper has verified this hypothesis using analysis and laboratory experiments. An elastic analysis using Galerkin's method to solve Marguerre's equations was first used to determine the first yield point, based on which the local plastic mechanism/imperfection tolerance tables have been developed which give the type of mechanism as a function of b/t ratio, imperfection level and yield stress of steel. Laboratory experiments of thin-walled columns verified the imperfection tolerance tables and thus indirectly the hypothesis. Elastic and rigid-plastic curves were them used to predict the effect on the ultimate load due to the change of mechanism. A finite element analysis of selected cases also confirmed the results from simple analyses and experiments.

Curiosity to cupboard : self reported disengagement with energy use feedback over time

This paper discusses findings made during a study of energy use feedback in the home (eco-feedback), well after the novelty has worn off. Contributing towards four important knowledge gaps in the research, we explore eco-feedback over longer time scales, focusing on instances where the feedback was not of lasting benefit to users rather than when it was. Drawing from 23 semi-structured interviews with Australian householders, we found that an initially high level of engagement gave way over time to disinterest, neglect and in certain cases, technical malfunction. Additionally, preconceptions concerned with the “purpose” of the feedback were found to affect use. We propose expanding the scope of enquiry for eco-feedback in several ways, and describe how eco-feedback that better supports decision-making in the “maintenance phase”, i.e. once the initial novelty has worn off, may be key to longer term engagement.

Students' academic stress and welfare as perceived by the teachers

The objective of the present study was to understand the teachers' perception about students' academic stress and other welfare related issues. A group of 125 secondary and higher secondary school teachers (43 male and 82 female) from five schools located in Kolkata were covered in the study following convenience sampling technique. Data were collected by using a semi-structured questionnaire developed by the first author. Findings revealed that more than half of the teachers (55.8% male and 54.9% female) felt that today's students are not brought up in child friendly environment while an overwhelming number of teachers stated that students face some social problems (88.4% male and 96.3% female) which affects their mental health and causes stress (90.7% male and 92.7% female). However, majority of them (79.1% male and 78% female teachers), irrespective of gender, denied the fact that teaching method followed in schools could cause academic stress. Vast majority of the teachers felt that New Education System in India i.e., making Grade X examination (popularly known as secondary examination) optional will not be beneficial for students. So far as motivation of the students is concerned, introducing innovative teaching methods like project work, field visit, using audio-visual aids in the schools has been suggested by more than 95% of the teachers. This apart, most of the teachers suggested reward system in the schools in addition to taking classes seriously by the teachers and punctuality. Reduction of load of home work was also suggested by more than two-fifth teachers. Although corporal punishment has gone down, it is still practiced by some of the teachers' especially male teachers in Kolkata. Male and female teachers differed significantly with respect to two issues only (p < .05) i.e., applying corporal punishment and impact of sexual health education. Male teachers apply more corporal punishment compared to female teachers and secondly, male teachers do not forsee any negative influence of sexual health education.

Long-term outcomes following neoadjuvant chemoradiotherapy for esophageal cancer

OBJECTIVE: We present and analyze long-term outcomes following multimodal therapy for esophageal cancer, in particular the relative impact of histomorphologic tumor regression and nodal status. PATIENTS AND METHODS: A total of 243 patients [(adenocarcinoma (n = 170) and squamous cell carcinoma (n = 73)] treated with neoadjuvant chemoradiotherapy in the period 1990 to 2004 were followed prospectively with a median follow-up of 60 months. Pathologic stage and tumor regression grade (TRG) were documented, the site of first failure was recorded, and Kaplan-Meier survival curves were plotted. RESULTS: Thirty patients (12%) did not undergo surgery due to disease progression or deteriorated performance status. Forty-one patients (19%) had a complete pathologic response (pCR), and there were 31(15%) stage I, 69 (32%) stage II, and 72 (34%) stage III cases. The overall median survival was 18 months, and the 5-year survival was 27%. The 5-year survival of patients achieving a pCR was 50% compared with 37% in non-pCR patients who were node-negative (P = 0.86). Histomorphologic tumor regression was not associated with pre-CRT cTN stage but was significantly (P < 0.05) associated with ypN stage. By multivariate analysis, ypN status (P = 0.002) was more predictive of overall survival than TRG (P = 0.06) or ypT stage (P = 0.39). CONCLUSION: Achieving a node-negative status is the major determinant of outcome following neoadjuvant chemoradiotherapy. Histomorphologic tumor regression is less predictive of outcome than pathologic nodal status (ypN), and the need to include a primary site regression score in a new staging classification is unclear. © 2007 Lippincott Williams & Wilkins, Inc.

How international entrepreneurship characteristics influence Internet capabilities for the international business processes of the firm

This research explores the relationship between international entrepreneurship characteristics and the use of Internet capabilities for the international business processes of the firm. It has been suggested, that the accumulation of a firms Internet capability can assist international operations, especially when operating in fast changing dynamic Internet environments. However, international entrepreneurship characteristics which are seen as a precursor to leveraging Internet capabilities are still vague. Given this finding, eight case studies of small and medium sized travel and tourism firms were selected to investigate the influence of international entrepreneurship characteristics, and Internet capabilities for international business processes. Based on the eight in-depth case studies, the results signify that successful international entrepreneurial firms which encompass high levels of international innovativeness and proactiveness behaviour integrate Internet capabilities to a greater degree. Our findings also indicate that the prior international business experience, international risk-taking propensity and international networking characteristics are not necessarily precursors to successful integration of Internet capabilities for international business processes. On the contrary, international business experience and international networks actually lead to a reliance on traditional mechanisms of internationalisation and can dilute the development of Internet capabilities for international business processes.

Treatment rationale study design for the MetLung trial : a randomized, double-blind phase III study of onartuzumab (MetMAb) in combination with erlotinib versus erlotinib alone in patients who have received standard chemotherapy for stage IIIB or IV met-positive non-small-cell lung cancer

We present the treatment rationale and study design of the MetLung phase III study. This study will investigate onartuzumab (MetMAb) in combination with erlotinib compared with erlotinib alone, as second- or third-line treatment, in patients with advanced non-small-cell lung cancer (NSCLC) who are Met-positive by immunohistochemistry. Approximately 490 patients (245 per treatment arm) will receive erlotinib (150 mg oral daily) plus onartuzumab or placebo (15 mg/kg intravenous every 3 weeks) until disease progression, unacceptable toxicity, patient or physician decision to discontinue, or death. The efficacy objectives of this study are to compare overall survival (OS) (primary endpoint), progression-free survival, and response rates between the 2 treatment arms. In addition, safety, quality of life, pharmacokinetics, and translational research will be investigated across treatment arms. If the primary objective (OS) is achieved, this study will provide robust results toward an alternative treatment option for patients with Met-positive second- or third-line NSCLC. © 2012 Elsevier Inc. All Rights Reserved.

The effect of extent of local resection on patterns of disease progression in malignant pleural mesothelioma

Background We sought to determine whether or not there are differences in disease progression after radical or nonradical (debulking) surgical procedures for malignant pleural mesothelioma. Methods Over a 49-month period, 132 patients with malignant pleural mesothelioma underwent surgery. Fifty-three underwent extrapleural pneumonectomy and 79 underwent nonradical procedures. Time to evidence of clinical disease progression was recorded, as was the site(s) of that disease. Results One-hundred nineteen patients were evaluable, of which 59% (22 radical; 48 nonradical) had disease progression. Overall 30-day mortality was 8.5% (7.5% radical; 9% nonradical). The median time to overall disease progression was considerably longer after extrapleural pneumonectomy than debulking surgery (319 days vs 197 days, p = 0.019), as was the time to local disease progression (631 days vs 218 days, p = 0.0018). There was no preponderance of earlier stage disease in the radical surgery group. There was a trend toward prolonged survival in those undergoing radical surgery, but no significant difference between the groups (497 days vs 324 days, p = 0.079). In those who had extrapleural pneumonectomy, time-to-disease progression significantly decreased with N2 disease compared with N0/1 involvement (197 days vs 358 days, p = 0.02). Conclusions Extrapleural pneumonectomy may be preferable to debulking surgery in malignant pleural mesothelioma to delay disease progression and give greater control of local disease. Involvement of N2 nodes is associated with accelerated disease progression and is therefore a contraindication to extrapleural pneumonectomy. © 2004 by The Society of Thoracic Surgeons.

Networked masculinities and social networking sites : a call for the analysis of men and contemporary digital media

It is of course recognised that technology can be gendered and implicated in gender relations. However, it continues to be the case that men’s experiences with technology are underexplored and the situation is even more problematic where digital media is concerned. Over the past 30 years we have witnessed a dramatic rise in the pervasiveness of digital media across many parts of the world and as associated with wide ranging aspects of our lives. This rise has been fuelled over the last decade by the emergence of Web 2.0 and particularly Social Networking Sites (SNS). Given this context, I believe it is necessary for us to undertake more work to understand men’s engagements with digital media, the implications this might have for masculinities and the analysis of gender relations more generally. To begin to unpack this area, I engage theorizations of the properties of digital media networks and integrate this with the masculinity studies field. Using this framework, I suggest we need to consider the rise in what I call networked masculinities – those masculinities (co)produced and reproduced with digitally networked publics. Through this analysis I discuss themes related to digital mediators, relationships, play and leisure, work and commerce, and ethics. I conclude that as masculinities can be, and are being, complicated and given agency by advancing notions and practices of connectivity, mobility, classification and convergence, those engaged with masculinity studies and digital media have much to contribute.

Psychological determinants and outcomes of sedentary and physical activity behaviours

There is now a large body of literature that supports the protective role of physical activity for both physical and psychological health. Sedentary behaviour was previously considered the functional opposite of physical activity, but 10 years ago, Owen and colleagues highlighted the need to study physical activity and sedentary behaviour as two distinct modes of behaviour that can independently influence health [1]. Since then, there has been growing evidence that participation in sedentary behaviours such as television viewing, computer use and sitting at work are associated with higher risk of chronic disease outcomes (type 2 diabetes, obesity), and leisure-time sitting has recently been associated with increased mortality [2]. Growing research points to the possible synergistic effects of physical activity and sedentary behaviours in contributing to health outcomes

Rough set based approach to text classification

Textual document set has become an important and rapidly growing information source in the web. Text classification is one of the crucial technologies for information organisation and management. Text classification has become more and more important and attracted wide attention of researchers from different research fields. In this paper, many feature selection methods, the implement algorithms and applications of text classification are introduced firstly. However, because there are much noise in the knowledge extracted by current data-mining techniques for text classification, it leads to much uncertainty in the process of text classification which is produced from both the knowledge extraction and knowledge usage, therefore, more innovative techniques and methods are needed to improve the performance of text classification. It has been a critical step with great challenge to further improve the process of knowledge extraction and effectively utilization of the extracted knowledge. Rough Set decision making approach is proposed to use Rough Set decision techniques to more precisely classify the textual documents which are difficult to separate by the classic text classification methods. The purpose of this paper is to give an overview of existing text classification technologies, to demonstrate the Rough Set concepts and the decision making approach based on Rough Set theory for building more reliable and effective text classification framework with higher precision, to set up an innovative evaluation metric named CEI which is very effective for the performance assessment of the similar research, and to propose a promising research direction for addressing the challenging problems in text classification, text mining and other relative fields.

Interleukin-1β stimulates human renal fibroblast proliferation and matrix protein production by means of a transforming growth factor-β-dependent mechanism

One of the hallmarks of progressive renal disease is the development of tubulointerstitial fibrosis. This is frequently preceded by macrophage infiltration, raising the possibility that macrophages relay fibrogenic signals to resident tubulointerstitial cells. The aim of this study was to investigate the potentially fibrogenic role of interleukin-1beta (IL-1beta), a macrophage-derived inflammatory cytokine, on cortical fibroblasts (CFs). Primary cultures of human renal CFs were established and incubated for 24 hours in the presence or absence of IL-1beta. We found that IL-1beta significantly stimulated DNA synthesis (356.7% +/- 39% of control, P <.003), fibronectin secretion (261.8 +/- 11% of control, P <.005), collagen type 1 production, (release of procollagen type 1 C-terminal-peptide, 152.4% +/- 26% of control, P <.005), transforming growth factor-beta (TGF-beta) secretion (211% +/- 37% of control, P <.01), and nitric oxide (NO) production (342.8% +/- 69% of control, P <.002). TGF-beta (1 ng/mL) and the phorbol ester phorbol 12-myristate 13-acetate (PMA, 25 nmol/L) produced fibrogenic effects similar to those of IL-1beta. Neither a NO synthase inhibitor (N(G)-methyl-l-arginine, 1 mmol/L) nor a protein kinase C (PKC) inhibitor (bis-indolylmaleimide 1, 1 micromol/L) altered the enhanced level of fibronectin secretion or DNA synthesis seen in response to IL-1beta treatment. However, addition of a TGF-beta-neutralizing antibody significantly reduced IL-1beta-induced fibronectin secretion (IL-1beta + IgG, 262% +/- 72% vs IL-1beta + alphaTGF-beta 156% +/- 14%, P <.02), collagen type 1 production (IL-1beta + IgG, 176% +/- 28% vs IL-1beta + alphaTGF-beta, 120% +/- 14%, P <.005) and abrogated IL-1beta-induced DNA synthesis (245% +/- 49% vs 105% +/- 21%, P <.005). IL-1beta significantly stimulated CF DNA synthesis and production of fibronectin, collagen type 1, TGFbeta, and NO. The fibrogenic and proliferative action of IL-1beta on CF appears not to involve activation of PKC or production of NO but is at least partly TGFbeta-dependent.

Retailer-driven agricultural restructuring - Australia, the UK and Norway in comparison

In recent decades, the governance of food safety, food quality, on-farm environmental management and animal welfare has been shifting from the realm of 'the government' to that of the private sector. Corporate entities, especially the large supermarkets, have responded to neoliberal forms of governance and the resultant 'hollowed-out' state by instituting private standards for food, backed by processes of certification and policed through systems of third party auditing. Today's food regime is one in which supermarkets impose 'private standards' along the food supply chain to ensure compliance with a range of food safety goals-often above and beyond those prescribed by government. By examining regulatory governance in Australia, Norway and the United Kingdom we highlight emerging trajectories of food governance. We argue that the imposition of the new private forms of monitoring and compliance continue the project of agricultural restructuring that began with government support for structural adjustment schemes in agriculture and that these are most evident in the UK and Australia where neoliberalism is an entrenched philosophy. However, despite Norway's identity as a social democracy, we also identify neoliberal 'creep' into the system of food governance. Small-scale producers in all three nations are finding themselves increasingly subject to governance through private, market-based mechanisms that, to varying degrees, are dominated by major supermarket chains. The result is agricultural restructuring not through the traditional avenues of elected governments, but via non-elected market operatives.

Expression and in vitro functions of the ghrelin axis in endometrial cancer

Ghrelin is a peptide hormone produced in the stomach and a range of other tissues, where it has endocrine, paracrine and autocrine roles in both normal and disease states. Ghrelin has been shown to be an important growth factor for a number of tumours, including prostate and breast cancers. In this study, we examined the expression of the ghrelin axis (ghrelin and its receptor, the growth hormone secretagogue receptor, GHSR) in endometrial cancer. Ghrelin is expressed in a range of endometrial cancer tissues, while its cognate receptor, GHSR1a, is expressed in a small subset of normal and cancer tissues. Low to moderately invasive endometrial cancer cell lines were examined by RT-PCR and immunoblotting, demonstrating that ghrelin axis mRNA and protein expression correlate with differentiation status of Ishikawa, HEC1B and KLE endometrial cancer cell lines. Moreover, treatment with ghrelin potently stimulated cell proliferation and inhibited cell death. Taken together, these data indicate that ghrelin promotes the progression of endometrial cancer cells in vitro, and may contribute to endometrial cancer pathogenesis and represent a novel treatment target.

The ‘feminine revolution in mining’ : a critique

This paper presents an analysis of media reports of Australian women in mine management. It argues that a dominant storyline in the texts is one of gender change; in fact, a ‘feminine revolution’ is said to have occurred in the mining industry and corporate Australia more generally. Despite this celebratory and transformative discourse the female mine managers interviewed in the media texts seek to distance themselves from women/female identity/femininity and take up a script of gender neutrality. It is demonstrated, however, that this script is saturated with the assumptions and definitions of managerial masculinity.