Preferences for Parenting Programs in Head Start: Using Conjoint Analysis to Understand Engagement in Parenting Health Promotion Programs

Prevention Science - The impact of evidence-based parenting health promotion programs is threatened by limited enrollment and attendance. We used a discrete choice experiment (DCE) to examine how...     

Das Pankreaskarzinom

Zum Thema In jüngster Zeit konnte mit Hilfe der Molekularbiologie Licht in die Pathogenese des Pankreaskarzinoms und seiner Vorl?uferl?sionen, der duktalen pankreatischen intraepithelialen Neoplasien gebracht werden. Die Detektion des K-ras-Onkogens, z. B. hat zu einer deutlichen Erh?hung der Sensitivit?t der Diagnostik in Kombination mit den etablierten Verfahren geführt. Interessanterweise lassen sich bei der famili?ren Pankreatitis und beim Pankreaskarzinom spezifische Gendefekte finden. Daher ist bereits abzusehen, dass auf der Grundlage tumorbiologischer Erkenntnisse neue Therapiestrategien für das Pankreaskarzinom entwickelt werden.     

Treatment of Failed Allograft Prosthesis Composites Used for Hip Arthroplasty in the Setting of Severe Proximal Femoral Bone Defects

This study assessed failures of allograft prosthesis composites (APC) and revisions with a new APC. Twenty-one patients with failed APC’s after revision hip arthroplasty with severe proximal femoral bone loss underwent revision with a new APC. Causes of failure were aseptic loosening (18 patients), infection (3 patients). Of these 21 APC revisions, two patients failed (after 60, 156 months). The 5 and 10 year survival rates were 83.5% (95% CI, 79–100%, number at risk 12 and 6 accordingly). In addition, two patients had non-union at the host-allograft bone junction and were augmented with bone autograft and plate. These results suggest that failed APCs may be revised to a new APC with a predictable outcome.     

The importance of distinguishing between the different eating disorders (sub)types when assessing emotion regulation strategies

People with eating disorders (ED) have difficulties regulating their emotions adaptively. Little is known about differences and similarities between different types of ED and how these regulation difficulties relate to other emotional problems. The present study examines maladaptive (suppression) and adaptive (cognitive reappraisal) emotion regulation strategies in women with different ED and relationships with anxiety and depression levels. In 32 women with AN restrictive subtype (ANR), 32 with AN binge-purge subtype (ANBP), 30 with bulimia nervosa (BN), 29 with binge eating disorder (BED), and 64 healthy women, the ERQ (emotion regulation) as well as STAI-T (anxiety), BDI-SF (depression), and EDDS (eating pathology) were administered. Women across different ED subtypes were inclined to suppress emotions and lacked the capacity to reappraise emotions (except women with ANBP). Correlational relations of suppression and reappraisal with anxiety and depression levels differed across ED groups. Emotion regulation problems were found across ED subtypes. However, the types of emotion regulation problems, and the effect of coexisting other emotional problems such as anxiety and depression may differ across ED subtypes. These findings illustrate the importance to of considering ED subtypes in emotion regulation research rather than consider ED as a whole.     

Identification of a localization factor for the polar positioning of bacterial structural and regulatory proteins

Polar pili biogenesis in Caulobacter involves the asymmetric localization of the CpaE and CpaC components of the pili-specific secretion apparatus to one pole of the predivisional cell followed by the biosynthesis of the pili filaments in the daughter swarmer cell. The histidine kinase signaling protein, PleC, that controls the temporal accumulation of the PilA pilin subunit is asymmetrically localized to the pole at which pili are assembled. Here we identify a protein, PodJ, that provides the positional information for the polar localization of both PleC and CpaE. The PodJ protein was found to exist in two forms, a truncated 90-kDa and a full-length 110-kDa form, each controlling a different aspect of polar development and each localizing to the cell poles at a specific time in the cell cycle. When active PleC is delocalized in a DeltapodJ mutant, the accumulation of PilA, the downstream target of PleC signaling, is impaired, providing evidence that the polar localization of this histidine kinase stimulates the response signaled by a two-component system.     

Sequence specificity of alternating hydroyprolyl/phosphono peptide nucleic acids against zebrafish embryo mRNAs

Morpholino phosphorodiamidate (MO) DNA mimics display excellent water solubility and hybridization properties toward DNA and RNA, and have been utilized in the model vertebrate zebrafish (Danio rerio) for genome-wide, sequence-based, reverse genetic screens during embryonic development. Peptide nucleic acids (PNAs) exhibit excellent mismatch discrimination, nuclease resistance, and protease resistance, but low solubility. Negatively charged DNA mimics composed of alternating residues of trans-4-hydroxy-L-proline peptide nucleic acid monomers and phosphono peptide nucleic acid monomers (HypNA-pPNA) combine all of the positive features of both MOs and PNAs. Thus, we evaluated PNA oligomers and HypNA-pPNA oligomers as an alternative to MOs for oligonucleotide inhibition of gene expression in zebrafish embryos. We observed that HypNA-pPNA 18-mers displayed comparable potency to MO 25-mers as knockdown agents against chordin, notail and uroD, with greater mismatch stringency. Furthermore, we observed that a specific HypNA-pPNA 18-mer elicited the dharma (bozozok)(-/-) phenotype in zebrafish embryos, which MO 25-mers do not. These observations validate HypNA-pPNAs as an alternative to MO oligomers for reverse genetic studies. The stronger hybridization and greater specificity of HypNA-pPNAs enable knockdown of mRNAs unaffected by MO oligomers.     

Femoral head density on CT scans of patients following hip fracture fixation by expandable proximal peg or dynamic screw

Computed tomography (CT) is currently considered to be an accurate method for evaluating bone density. We evaluated the CT measurements of bone density using the Hounsfield units (HUs) in 23 patients who had been operated in the past for an extra-capsular hip fracture. Twelve patients were treated with a dynamic hip screw and 11 with a proximal femoral expandable hip nail. All the CTs had been performed for non-orthopedic purposes. Bone density with a region of interest (ROI) could be assessed for both hips. We compared the bone density between the operated versus the non-operated sides as well as between the two surgical groups.Bone density was higher in the hip peg (the femoral component of the expandable nail) side 262.5 (range, 169-351) HU, compared to the opposite non-operated side and to the hip screw group 194 (range, 99-283) HU. The hip screw side had decreased bone density compared to the opposite non-operated side. We were able to define a density index and a difference index: both were higher in the hip peg group. These findings persisted over time. It would be interesting to speculate that increased bone density around an expandable peg provides better fracture stabilization and probably faster healing than a dynamic hip screw.     

‘Telangiectatic’ Transformation in Soft Tissue Sarcomas. A Clinicopathology Analysis of an Aggressive Feature of High-grade Sarcomas

Background ‘Telangiectatic’ change, which contains a large fluid hemorrhagic component, occurs in a variety of high-grade soft tissue sarcomas. Methods In a retrospective database review, we identified 20 consecutive patients (3%) with ‘telangiectatic’ change in soft tissue sarcomas. Results Tumors were located in the thigh (55%), shoulder (15%), calf (15%), upper arm (10%), and buttock in one patient. All 20 tumors were high grade. Histological diagnoses were MFH (40%), leiomyosarcoma (15%), synovial sarcoma (10%), and one each of seven other sarcomas (35%). Tumor size was often large—more than 10 cm (35%), between 5 and 10 cm (60%), and less than 5 cm in one case. A history of contusion to the tumor site followed by swelling was recorded in 30% of patients and 80% presented with a painful mass. On MRI imaging, 60% of tumors appeared to contain more than 50% blood, 50% had a hemosiderin-laden rim, and 55% had well-defined tumor nodules within the wall of the hematoma. Limb-sparing surgery was carried out in 90% of patients, the other 10% underwent primary amputation. The 5-year, event-free survival rate was 30%. Of the patients, 15% presented initially with metastatic disease; in 53%, it developed within 2 years of diagnosis. The overall local recurrence rate was 30%. Conclusions Telangiectatic transformation in soft tissue sarcomas is a rare feature of aggressive high-grade soft tissue sarcomas and is unique in its clinical presentation, MRI characteristics, pathological pattern, and a tendency for a worse-off prognosis. This investigation was performed at the Department of Orthopedic Oncology, Washington Cancer Institute, Washington Hospital Center, Washington DC.     

Porous metal revision shells for management of contained acetabular bone defects at a mean follow-up of six years: a comparison between up to 50% bleeding host bone contact and more than 50% contact

We report the use of porous metal acetabular revision shells in the treatment of contained bone loss. The outcomes of 53 patients with ≤ 50% acetabular bleeding host bone contact were compared with a control group of 49 patients with > 50% to 85% bleeding host bone contact. All patients were treated with the same type of trabecular metal acetabular revision shell. The mean age at revision was 62.4 years (42 to 80) and the mean follow-up of both groups was 72.4 months (60 to 102). Clinical, radiological and functional outcomes were assessed. There were four (7.5%) mechanical failures in the ≤ 50% host bone contact group and no failures in the > 50% host bone contact group (p = 0.068). Out of both groups combined there were four infections (3.9%) and five recurrent dislocations (4.9%) with a stable acetabular component construct that were revised to a constrained liner. Given the complexity of the reconstructive challenge, porous metal revision acetabular shells show acceptable failure rates at five to ten years' follow-up in the setting of significant contained bone defects. This favourable outcome might be due to the improved initial stability achieved by a high coefficient of friction between the acetabular implant and the host bone, and the high porosity, which affords good bone ingrowth.