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Background: In this randomized phase II study, we evaluated the efficacy and safety of sorafenib in combination with capecitabine and cisplatin (XP) as first‐line chemotherapy in advanced gastric cancer. Patients and Methods: Patients with metastatic gastric or gastroesophageal junction adenocarcinoma were randomized (1:1) to receive either sorafenib plus XP (S + XP) or XP alone. In cases of disease progression in the XP arm, crossover to sorafenib alone was allowed. The primary endpoint was progression‐free survival (PFS). The secondary endpoints included overall survival (OS), response rates, safety profiles, and biomarkers, and the response rates and PFS with secondline sorafenib alone after progression in the XP arm. Results: Between Jan 2011 and Feb 2013, a total of 195 patients were accrued (97 in the S + XP arm and 98 in the XP alone arm). The overall response rate was 54% with S + XP, and 52% with XP alone (p = 0.83). With a median follow‐up of 12.6 months (range, 0.1–29.2), the median PFS assessed by independent review was 5.6 months in the S + XP arm and 5.3 months in the XP arm (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.67–1.27, p = 0.61). Overall survival was not different between the two arms (median 11.7 vs. 10.8 months; HR 0.93, 95% CI 0.65–1.31, p = 0.66). Frequencies of grade 3/4 toxicities were similar between the S + XP and XP alone arms, except for neutropenia (21% vs. 37%), anorexia (0% vs. 5%), and hand‐foot skin reaction (7% vs. 1%). Among 51 patients who crossed over to sorafenib alone after disease progression in the XP arm, there was no objective response and their median PFS was 1.3 months (95% CI, 1.2–1.7). Conclusion: The addition of sorafenib to XP chemotherapy was safe but not more effective than XP alone for first‐line treatment of metastatic gastric cancer. [ABSTRACT FROM AUTHOR]

Objective To evaluate family-related stressors and resources associated with the depressive symptoms of military members and their spouses. Background Most deployment-related research has focused on deployment and reintegration, but there is a dearth of information about military families during the pre-deployment phase. Family stress theory provided a valuable lens from which to view family-related risk and protective factors associated with adaptation during times of stressful transition. Method Data were gathered using an online survey from 151 U.S. Army National Guard members and their spouses preparing for a scheduled deployment. Hierarchical regression was utilized to examine associations between the independent variables (e.g., stress pileup, informal and formal resources, deployment preparation) and participants' depressive symptoms. Results Results revealed that aspects of stress pileup were positively associated with depressive symptoms. Informal resources and deployment preparation, but not formal resources, had statistically significant negative associations with individuals' depressive symptoms. Findings were similar for military members and spouses. Conclusion Results indicated that logistical and instrumental preparation, in addition to informal resources such as effective family functioning and social support, are important for positive adaptation in times of stressful transition. Implications Family service professionals may want to assist families with identifying and strengthening their family support and improving family functioning, as well as guide families in a process of identifying the instrumental and logistical tasks that are necessary or helpful for an impending transition. [ABSTRACT FROM AUTHOR]

Purpose To examine the relationship between environmental ambience and psychological well-being of persons with dementia. Design A secondary analysis was conducted using observational data with repeated measures. A total of 1,857 observations from 177 persons with dementia in 17 nursing homes and 6 assisted living facilities were included. Methods Psychological well-being was measured by observed displays of positive and negative emotional expressions. The environmental ambience was assessed by two subscales of the Ambiance Scale: Engaging and Soothing. Multilevel modeling was used to account for hierarchical structures in the data. Findings An engaging environment was associated with more positive emotional expressions after controlling for covariates. However, a soothing environment was associated with neither positive nor negative emotional expressions. Conclusions Results suggest that the environment is an important consideration for administrators and clinicians as they respond to the mandate to actively plan and provide care to persons with dementia. Clinical Relevance An environment that is relevant and interesting may promote a sense of well-being and support resident-centered care. [ABSTRACT FROM AUTHOR]

Aim We examined the relationship between cognitive impairment and dental care utilization among older adults in the USA. Methods A total of 329 older adults aged 70 years and older in West Virginia, USA, were included in the present analyses. We carried out multivariate ordinal regression analyses. Results Individuals with dementia were less likely to visit a dentist regularly, and more time had passed since their last dental visit compared with individuals with normal cognitive function. However, the pattern of dental care utilization for those with cognitive impairment, not dementia did not differ from individuals with normal cognition. A perceived greater social network and having dental insurance were associated with increased dental care utilization. Conclusions Less dental care utilization might contribute to the oral health problems often observed among individuals with dementia. Efforts to increase the use of dental care should include cost-effective options for dental insurance. In addition, educating formal and informal caregivers on the importance of dental care might be beneficial, as these individuals are in the best position to facilitate dental care for individuals with dementia. Geriatr Gerontol Int 2015; 15: 255-260. [ABSTRACT FROM AUTHOR]

Objective This study explored the relationship between observable emotional expression and wandering behaviors of people with dementia (PWD). Methods A secondary data analysis was conducted of a multi-site study that used a cross-sectional design with repeated measures nested within subjects. Participants included 142 PWD residing in 17 nursing homes and six assisted-living facilities in Michigan and Pennsylvania who were randomly assigned to six 20-min videotaped observation periods, conducted on two non-consecutive days. Poisson hierarchical linear modeling was used to examine associations between emotional expression and wandering. Results Participants exhibited an average of 13.5 (standard deviation [ SD] ± 12.4) episodes of positive emotional expression per observation; only 1.5 ( SD ± 2.3) episodes of negative emotional expression per observation were noted. The mean wandering rate was 2.9 episodes ( SD ± 6.9) per hour. Positive emotional expression was positively related to wandering rates, whereas negative emotional expression and higher cognitive status were negatively related to wandering rates after controlling for other predictors (age, education, gender, facility type, mobility, and time of day). Conclusions Both positive and negative emotional expressions, along with cognitive status, should be considered when developing interventions to improve wandering behaviors of PWD. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To examine the relationship between cognitive function and self-reported oral health-related quality of life ( HRQoL) in community-dwelling older adults. Design Cross-sectional. Setting Community in West Virginia. Participants Two hundred twenty-six community-dwelling older adults. Measurements Oral HRQoL was measured using the Geriatric Oral Health Assessment Index ( GOHAI) (range 12-60), and cognitive function was assessed using a comprehensive neuropsychological test battery. Dental professionals performed oral health examinations. Results Participants with normal cognitive function had higher GOHAI total scores (mean 55.1), indicating better oral HRQoL, than participants with cognitive impairment without dementia ( CIND) (mean 52.3) and mild dementia (mean 51.0). The difference remained significant after controlling for sociodemographic, health status, comorbidity, and clinical dental status covariates. Conclusion Oral HRQoL, as measured using the GOHAI, was better in participants with normal cognitive function than in those with CIND of mild dementia in the population studied. [ABSTRACT FROM AUTHOR]

Three Zn/ZSM-5 catalysts with Si/Al ratios of 17, 33, and 42 were treated with a weak base (Na2CO3) to create a hierarchical microporous-mesoporous system and to improve the catalyst stability in the aromatization of 2-methly-2-butene, a model compound that represented branched olefin byproducts that are produced from fluidized catalytic cracking. The Si/Al ratio of the parent ZSM-5 had a critical effect on the nature of the modified pore system. Thus, for Zn/ZSM-5 with a Si/Al ratio of 42, a hierarchical microporous-mesoporous system was formed in which intraparticle bimodal mesopores were in the form of cavities and cylinders, the latter of which connected internal micropores to the external surface of the catalyst. This pore structure was most suitable for enhancing the tolerance to coking and brought a dramatic increase in the catalyst stability in the aromatization of 2-methyl-2-butene. [ABSTRACT FROM AUTHOR]

To determine if nurse staffing predicts teamwork. A cross-sectional, descriptive design with a sample of nursing staff ( N= 2,545) on 52 patient care units in four hospitals was utilized. The Nursing Teamwork Survey was utilized to collect data on the level of perceived nursing teamwork on each of the study units. In addition, nursing staffing data were collected for each study unit. Higher levels of nurse staffing were related to better teamwork. Specifically, the greater the hours per patient day, the higher the level of overall teamwork on the unit (β= 0.417, p= .033). Also the greater the skill mix, the higher the level of overall teamwork on the unit (β= 0.436, p= .009). Adequate levels of staffing are needed to ensure nursing teamwork. The ability to provide quality and safe care is associated with teamwork, which in turn requires adequate staffing. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effectiveness of a media literacy‐based smoking prevention program based on Ajzen's theory of planned behavior in female adolescents. Methods: This quasi‐experimental study was conducted with female high school students aged 16–17 years in Seoul, Republic of Korea. The program provided eight sessions over 4 weeks. Quantitative data were collected before and after online surveys in an intervention (n = 21) and control (n = 21) groups, and analyzed using mixed analysis of variance. Qualitative data on participation experiences was collected by requesting the participants to answer open‐ended questions once a week during the intervention and performing co‐occurrence analysis of specific terms in the responses was conducted through text mining. Results: Although the program decreased smoking intention and increased smoking media literacy in the intervention group, there were no significant differences between the groups. Qualitative results obtained from the intervention group showed cognitive and behavioral changes in the perception of the harmfulness of e‐cigarettes in the media and the expression of a willingness to overcome the temptation to smoke. Conclusions: Our findings show that the enhancement of smoking media literacy, specifically by correcting misconceptions regarding e‐cigarettes promoted by the new media, contributes smoking prevention in female adolescents. It supports calls for an expanded role of public health professionals in health education at the school level. [ABSTRACT FROM AUTHOR]

We report two cases of pathologically proven pulmonary metastases presenting as pulmonary infarction with tumour emboli. In two cases, high-resolution CT showed multiple small subpleural consolidations in both lungs. The patients had breast cancer and uterine cervix cancer, respectively. Although various pulmonary diseases show subpleural consolidations on CT, pulmonary metastases by tumour emboli should be primarily considered in differential diagnosis especially when the patient has known malignancy. [ABSTRACT FROM AUTHOR]

Aims: The clinical use of brain stimulation is attractive for patients who have side effects or tolerance. However, studies on insular cortex (IC) stimulation are lacking in neuropathic pain. The present study aimed to investigate the effects of IC stimulation (ICS) on neuropathic pain and to determine how ICS modulates pain. Methods: Changes in pain behaviors were observed following ICS with various parameters in neuropathic rats. Western blotting was performed to assess molecular changes in the expression levels of phosphorylated extracellular signal‐regulated kinase (pERK), neurons, astrocytes, and microglia between experimental groups. Immunohistochemistry was performed to investigate the colocalization of pERK with different cell types. Results: The most effective pain‐relieving effect was induced at 50 Hz–120 μA in single trial of ICS and it maintained 4 days longer after the termination of repetitive ICS. The expression levels of pERK, astrocytes, and microglia were increased in neuropathic rats. However, after ICS, the expression levels of pERK were decreased, and colocalization of pERK and neurons was reduced in layers 2–3 of the IC. Conclusion: These results indicated that ICS attenuated neuropathic pain by the regulation of pERK in neurons located in layers 2–3 of the IC. This preclinical study may enhance the potential use of ICS and identify the therapeutic mechanisms of ICS in neuropathic pain. [ABSTRACT FROM AUTHOR]

Aim: To identify the factors associated with retention intention among Registered Nurses in South Korean nursing homes. Background: Although nurses are not mandatory personnel, Korean nursing homes employ Registered Nurses. Introduction: Determining the factors related to Registered Nurses' retention intention is important for their job stability and ensure provision of quality care. Methods: This mixed‐methods study employed a sequential explanatory design. A self‐reported questionnaire survey was conducted between May 1 and July 3, 2019, with 155 Registered Nurses providing direct care from 37 nursing homes. In‐depth qualitative interviews were conducted with 10 participants from August 1 to September 30, 2019. Data were analyzed using multilevel analysis for quantitative study and thematic analysis for qualitative study. Results: The participants' average age was 48.48 years. Personal factors related to retention intention were Registered Nurses' role, educational level, and job satisfaction. Institutional factors were ownership, number of beds, and working environment. The qualitative study revealed five themes: "Satisfaction with meaningful relationships," "Potential for professional growth," "Nursing service accompanied by emotional labor," "Poor working environments in nursing homes," and "Unprotected nursing expertise." Discussion: A nursing home's work environment is related to the Registered Nurses' retention intention. Most Registered Nurses in Korea received low wages, lacked access to career management programs, and experienced emotional labor. Conclusion: This study highlighted the personal and institutional factors related to retention intention among Registered Nurses in South Korean nursing homes. Implications for nursing and nursing policy: A law that designates Registered Nurses as an essential nursing home workforce is required. Further, nursing homes should increase the number of Registered Nurses to improve working conditions and thereby job satisfaction. It is also necessary to foster a working environment that facilitates professional development opportunities and job clarity. [ABSTRACT FROM AUTHOR]

The regional lymph node‐positive bladder cancer was classified as stage IV in the AJCC 7th edition but was changed to stage IIIB in the 8th edition, revised in 2018. Among the various studies involving immune checkpoint inhibitors, groups that had only lymph node metastasis showed better outcomes than those with distant metastasis. Therefore, it is necessary to rethink the treatment strategy for lymph node‐positive bladder cancer. The aim of this study was to compare the treatment outcomes of chemotherapy, surgery, and combination therapy in patients with lymph node‐positive bladder cancer. From 1 January 2010 to 31 December 2015, patients with bladder cancer presenting local lymph node metastasis at the time of diagnosis were treated with a single treatment strategy, with either radical cystectomy or chemotherapy or with a combined strategy using both. Treatment outcomes were retrospectively analyzed on the basis of clinical indices and survival time. Out of 230 patients with bladder cancer, 44 (19.1%) were treated with palliative chemotherapy, 30 (13.0%) with neoadjuvant chemotherapy followed by cystectomy, 129 (56.1%) with cystectomy followed by adjuvant chemotherapy, and 27 (11.7%) with cystectomy alone. Median survival among all groups was 30.4 months. For each group, median overall survival was 19.3, 49.1, 42.6, and 11.2 months, respectively. This study represents an advancement in understanding the impact of clinical treatment patterns of lymph node‐positive bladder cancer through comparison of survival data of patients treated with different therapeutic strategies. Combined treatment resulted in better outcomes than did single treatments. [ABSTRACT FROM AUTHOR]

Aim The vascular endothelial growth factor ( VEGF) or its family might play role in tumor-related angiogenesis in gastrointestinal stromal tumors ( GIST), thereby affecting the prognosis. Accordingly, the present study analyzed the impact of VEGF and VEGF receptor-2 ( VEGFR-2) gene polymorphisms on the prognosis for GIST patients. Methods In all, 213 consecutive patients with GIST from five medical centers were enrolled in the present study. The genomic DNA was extracted from paraffin-embedded tumor tissue, and four VEGF (−2578 C/ A, −1498 C/ T, −634 G/ C, and +936 C/ T) and one VEGFR-2 (+1416 A/ T) gene polymorphisms were determined using a Sequenom MassARRAY system. Results With a median follow up of 18.4 months, the estimated 5-year relapse-free survival and overall survival rates were 70 and 87%, respectively. In a multivariate analysis including age, sex, primary site of disease, pathology and risk stratification, no significant association was observed between the polymorphism of the VEGF and VEGFR-2 genes and survival. Conclusion None of the five VEGF and VEGFR-2 gene polymorphisms investigated in this study was found to be an independent prognostic marker for Korean patients with surgically resected GIST. However, further studies on a larger scale are warranted to clarify the role of VEGF and VEGFR gene polymorphisms as a prognostic biomarker for GIST patients. [ABSTRACT FROM AUTHOR]

The method allows an efficient access to a wide range of 1,4-disubstituted triazoles. [ABSTRACT FROM AUTHOR]

CCL15 is a novel human CC chemokine and exerts its biological activities on immune cells through CCR1 and CCR3. Because a number of chemokines induce angiogenesis and endothelial cells express CCR1 and CCR3, we investigated the angiogenic activity of CCL15. Both CCL15(1-92) and N-terminal truncated CCL15(25-92) stimulate the chemotactic endothelial cell migration and differentiation, but CCL15(25-92) is at least 100-fold more potent than CCL15(1-92). Treatment with pertussis toxin (PTX), with anti-CCR1, or with anti-CCR3 antibody inhibits the CCL15(25-92)-induced endothelial cell migration. CCL15(25-92) also stimulates sprouting of vessels from aortic rings and mediates angiogenesis in the chick chorioallantoic membrane assay. Our findings demonstrate that CCL15(25-92) has in vitro and in vivo angiogenic activity, and suggest roles of the chemokine in angiogenesis. [Copyright &y& Elsevier]