bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunohistochemical Detection Using the New Rabbit Monoclonal Antibody SP1 of Estrogen Receptor in Breast Cancer Is Superior to Mouse Monoclonal Antibody 1D5 in Predicting Survival
Authors: Cheang Maggie C.U. , Treaba Diana O. , Speers Caroline H. , Olivotto Ivo A. , Bajdik Chris D. , Chia Stephen K. , Goldstein Lynn C. , Gelmon Karen A. , Huntsman David , Gilks C. Blake , Nielsen Torsten O. , Gown Allen M.
Published: November 2006

Purpose

Estrogen receptor (ER) expression predicts improved breast cancer–specific survival and reduced risk of recurrence and is targeted in breast cancer therapy. A high-quality antibody to identify ER-positive patients plays an important role in clinical decision making for women with breast cancer. This study evaluates immunohistochemistry using two anti-ER antibodies, a new rabbit monoclonal antibody (SP1) and the mouse monoclonal antibody (1D5), in relation to biochemical ER assay results and clinical data on survival and adjuvant systemic therapy.

Patients and Methods

A population-based tissue microarray series of 4,150 invasive breast cancers was constructed. All patients had staging, pathology, treatment, and follow-up information. The median follow-up was 12.4 years and the median age at diagnosis 60 years. Survival analysis and log-rank tests were used to evaluate the prognostic value of ER status and correlations with clinical data.

Results

Among the 4,105 samples interpretable for both antibodies, SP1 detected ER positivity in 69.5% and 1D5 in 63.1% of cases. Both monoclonal antibodies are demonstrated to be good prognostic indictors for breast cancer–specific and relapse-free survival. In multivariate analysis, including age, tumor size, grade, and lymphovascular and nodal status, SP1 was a better independent prognostic factor than 1D5. Among patients with discrepant ER results, the 8% of patients who were SP1 positive/1D5 negative showed good outcomes, and the 2% SP1-negative/1D5 positive had poor outcomes. Maintaining the same 92% specificity and 98% positive predictive value, SP1 is 8% more sensitive than 1D5 using biochemical assay as gold standard.

Conclusion

SP1 represents an improved standard for ER immunohistochemistry assessment in breast cancer.
Polymorphisms inXRCC1,XRCC3, andCCND1and Survival After Treatment for Metastatic Breast Cancer
Authors: Bewick Mary A. , Conlon Michael S.C. , Lafrenie Robert M.
Published: November 2006

Purpose

Single nucleotide polymorphisms (SNPs) in DNA repair and cell cycle control genes may alter protein function and therefore the efficacy of DNA damaging chemotherapy. We retrospectively evaluated the association of SNPs in DNA repair genes, XRCC1-01 (Arg399Gln) and XRCC3-01 (Thr241Met), and a cell cycle control gene, CCND1-02 (A870G), with progression-free survival (PFS) and breast cancer specific survival (BCSS) in patients with metastatic breast cancer (MBC).

Patients and Methods

SNPs in 95 patients with MBC enrolled onto one of five prospective clinical trials of high-dose chemotherapy and autologous stem-cell transplantation were evaluated using genotyping assays.

Results

For XRCC1-01, the hazard ratio (HR) for BCSS was 2.8 (95% CI, 1.60 to 5.00) and the HR for PFS was 2.0 (95%CI, 1.12 to 3.43). For XRCC3-01, the HR for BCSS was 2.0 (95%CI, 1.12 to 3.70) and the HR for PFS was 2.0 (95%CI, 1.09 to 3.59). For CCND1-02, the HR for BCSS was 1.8 (95%CI, 1.12 to 2.78) and the HR for PFS was 1.8 (95%CI, 1.15 to 2.85). Patients carrying one variant genotype (HR, 1.7; 95%CI, 1.07 to 2.82) or combinations of any two variant genotypes (HR, 4.7; 95% CI, 2.41 to 8.94) had significantly poorer BCSS compared with patients carrying zero variants. In multivariable analysis, XRCC1-01, presence of liver metastases, and bone metastases independently predicted BCSS. Combinations of any two variant genotypes were stronger independent predictors of BCSS and PFS than the presence of liver or bone metastases.

Conclusion

XRCC1-01, XRCC3-01, and CCND1-01 may be predictive of survival outcome in patients with MBC treated with DNA damaging chemotherapy.
Sequential Adjuvant Epirubicin-Based and Docetaxel Chemotherapy for Node-Positive Breast Cancer Patients: The FNCLCC PACS 01 Trial
Authors: Roché Henri , Fumoleau Pierre , Spielmann Marc , Canon Jean-Luc , Delozier Thierry , Serin Daniel , Symann Michel , Kerbrat Pierre , Soulié Patrick , Eichler Françoise , Viens Patrice , Monnier Alain , Vindevoghel Anita , Campone Mario , Goudier Marie-Josèphe , Bonneterre Jacques , Ferrero Jean-Marc , Martin Anne-Laure , Genève Jean , Asselain Bernard
Published: November 2006

Purpose

The PACS 01 trial compared six cycles of fluorouracil, epirubicin, and cyclophosphamide (FEC) with a sequential regimen of three cycles of FEC followed by three cycles of docetaxel (FEC-D) as adjuvant treatment for women with node-positive early breast cancer.

Patients and Methods

Between June 1997 and March 2000, 1,999 patients with operable node-positive breast cancer were randomly assigned to either FEC every 21 days for six cycles, or three cycles of FEC followed by three cycles of docetaxel, both given every 21 days. Hormone-receptor–positive patients received tamoxifen for 5 years after chemotherapy. The primary end point was 5-year disease-free survival (DFS).

Results

Median follow-up was 60 months. Five-year DFS rates were 73.2% with FEC and 78.4% with FEC-D (unadjusted P = .011; adjusted P = .012). Multivariate analysis adjusted for prognostic factors showed an 18% reduction in the relative risk of relapse with FEC-D. Five-year overall survival rates were 86.7% with FEC and 90.7% with FEC-D, demonstrating a 27% reduction in the relative risk of death (unadjusted P = .014; adjusted P = .017). The incidence of grade 3 to 4 neutropenia, the need for hematopoietic growth factor, and incidence of nausea/vomiting were higher with FEC. Docetaxel was associated with more febrile neutropenia in the fourth cycle, stomatitis, edema, and nail disorders. Though rare overall, there were fewer cardiac events after FEC-D (P = .03), attributable mainly to the lower anthracycline cumulative dose.

Conclusion

Sequential adjuvant chemotherapy with FEC followed by docetaxel significantly improves disease-free and overall survival in node-positive breast cancer patients and has a favorable safety profile.
Allogeneic Marrow Stem-Cell Transplantation From Human Leukocyte Antigen–Identical Siblings Versus Human Leukocyte Antigen–Allelic–Matched Unrelated Donors (10/10) in Patients With Standard-Risk Hematologic Malignancy: A Prospective Study From the French Society of Bone Marrow Transplantation and Cell Therapy
Authors: Yakoub-Agha Ibrahim , Mesnil Florence , Kuentz Mathieu , Boiron Jean Michel , Ifrah Norbert , Milpied Noel , Chehata Sami , Esperou Helene , Vernant Jean-Paul , Michallet Mauricette , Buzyn Agnes , Gratecos Nicole , Cahn Jean Yves , Bourhis Jean Henri , Chir Zina , Raffoux Colette , Socié Gerard , Golmard Jean Louis , Jouet Jean-Pierre
Published: November 2006

Purpose

To investigate the influence of donor type (human leukocyte antigen [HLA] -identical sibling donor versus HLA-A–, HLA-B–, HLA-Cw–, HLA-DRB1–, and HLA-DQB1–identical unrelated donors, or so-called 10/10) on the outcome of patients who underwent allogeneic stem-cell transplantation (alloSCT), adjusting for other prognostic factors, in patients with standard-risk hematologic malignancy.

Patients and Methods

Between March 2000 and January 2003, we prospectively investigated the outcome of 236 consecutive patients with standard-risk malignancy from 12 French centers. Fifty-five patients underwent alloSCT from an unrelated HLA-identical donor at the allelic level, whereas 181 patients received an alloSCT from an HLA-identical sibling. Diagnoses included acute leukemia (n = 175), chronic myeloid leukemia (n = 43), and myelodysplastic syndrome (MDS; n = 18). All patients received unmodified marrow graft following myeloablative conditioning with cyclophosphamide and total-body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and short-course methotrexate in all patients.

Results

In multivariable analysis, overall survival and transplantation-related mortality were adversely influenced by recipient cytomegalovirus (CMV) -positive serology, age of donor older than 37 years, and the occurrence of acute grade ≥ II GVHD. Event-free survival rates were lower for patients with recipient CMV-positive serology. Acute grades II to IV GVHD rates were higher for patients with chronic myeloid leukemia (CML). No factor was found to influence either relapse or acute grades III to IV GVHD. The effect of donor type was nonsignificant for all criteria.

Conclusion

In patients with standard-risk malignancy, transplantation from unrelated HLA-allellically matched donors led to outcomes similar to those from HLA-identical sibling donors.
Is Cytarabine Useful in the Treatment of Acute Promyelocytic Leukemia? Results of a Randomized Trial From the European Acute Promyelocytic Leukemia Group
Authors: Adès Lionel , Chevret Sylvie , Raffoux Emmanuel , de Botton Stephane , Guerci Agnes , Pigneux Arnaud , Stoppa Anne Marie , Lamy Thierry , Rigal-Huguet Francoise , Vekhoff Anne , Meyer-Monard Sandrine , Maloisel Frederic , Deconinck Eric , Ferrant Augustin , Thomas Xavier , Fegueux Nathalie , Chomienne Christine , Dombret Herve , Degos Laurent , Fenaux Pierre
Published: November 2006

Purpose

Several phase II studies have suggested that cytarabine (AraC) was not required in the treatment of newly diagnosed acute promyelocytic leukemia (APL) patients receiving all-trans-retinoic acid (ATRA), an anthracycline, and maintenance therapy, and we aimed at confirming this finding in a randomized trial.

Patients and Methods

Newly diagnosed APL patients younger than age 60 years with a WBC count of less than 10,000/μL were randomly assigned to receive either ATRA combined with and followed by three daunorubicin (DNR) plus AraC courses and a 2-year maintenance regimen (AraC group) or the same treatment but without AraC (no AraC group). Patients older than age 60 years and patients with initial WBC count of more than 10,000/μL were not randomly assigned but received risk-adapted treatment, with higher dose of AraC and CNS prophylaxis in patients with WBC counts more than 10,000/μL.

Results

Overall, 328 (96.5%) of 340 patients achieved complete remission (CR). In the AraC and the no AraC groups, the CR rates were 99% and 94% (P = .12), the 2-year cumulative incidence of relapse (CIR) rates were 4.7% and 15.9% (P = .011), the event-free survival (EFS) rates were 93.3% and 77.2% (P = .0021), and survival rates were 97.9% and 89.6% (P = .0066), respectively. In patients younger than age 60 years with WBC counts more than 10,000/μL, the CR, 2-year CIR, EFS, and survival rates were 97.3%, 2.9%, 89%, and 91.9%, respectively.

Conclusion

These results support a role for AraC in addition to ATRA and anthracyclines in the treatment of newly diagnosed APL, at least using DNR at the cumulative dose we used and with the consolidation and maintenance regimens we used.
Primary Central Nervous System Lymphoma: The Memorial Sloan-Kettering Cancer Center Prognostic Model
Authors: Abrey Lauren E. , Ben-Porat Leah , Panageas Katherine S. , Yahalom Joachim , Berkey Brian , Curran Walter , Schultz Christopher , Leibel Steven , Nelson Diana , Mehta Minesh , DeAngelis Lisa M.
Published: November 2006

Purpose

The purpose of this study was to analyze prognostic factors for patients with newly diagnosed primary CNS lymphoma (PCNSL) in order to establish a predictive model that could be applied to the care of patients and the design of prospective clinical trials.

Patients and Methods

Three hundred thirty-eight consecutive patients with newly diagnosed PCNSL seen at Memorial Sloan-Kettering Cancer Center (MSKCC; New York, NY) between 1983 and 2003 were analyzed. Standard univariate and multivariate analyses were performed. In addition, a formal cut point analysis was used to determine the most statistically significant cut point for age. Recursive partitioning analysis (RPA) was used to create independent prognostic classes. An external validation set obtained from three prospective Radiation Therapy Oncology Group (RTOG) PCNSL clinical trials was used to test the RPA classification.

Results

Age and performance status were the only variables identified on standard multivariate analysis. Cut point analysis of age determined that patients age ≤ 50 years had significantly improved outcome compared with older patients. RPA of 282 patients identified three distinct prognostic classes: class 1 (patients < 50 years), class 2 (patients ≥50; Karnofsky performance score [KPS] ≥ 70) and class 3 (patients ≥ 50; KPS < 70). These three classes significantly distinguished outcome with regard to both overall and failure-free survival. Analysis of the RTOG data set confirmed the validity of this classification.

Conclusion

The MSKCC prognostic score is a simple, statistically powerful model with universal applicability to patients with newly diagnosed PCNSL. We recommend that it be adopted for the management of newly diagnosed patients and incorporated into the design of prospective clinical trials.
Errors of Omission in English‐Speaking Children's Production of Plurals and the Past Tense: The Effects of Frequency, Phonology, and Competition
Authors: Matthews Danielle E. , Theakston Anna L.
Published: November 2006

How do English‐speaking children inflect nouns for plurality and verbs for the past tense? We assess theoretical answers to this question by considering errors of omission, which occur when children produce a stem in place of its inflected counterpart (e.g., saying “dress” to refer to 5 dresses). A total of 307 children (aged 3;11–9;9) participated in 3 inflection studies. In Study 1, we show that errors of omission occur until the age of 7 and are more likely with both sibilant regular nouns (e.g., dress) and irregular nouns (e.g., man) than regular nouns (e.g., dog). Sibilant nouns are more likely to be inflected if they are high frequency. In Studies 2 and 3, we show that similar effects apply to the inflection of verbs and that there is an advantage for “regular‐like” irregulars whose inflected form, but not stem form, ends in d/t. The results imply that (a) stems and inflected forms compete for production and (b) children generalize both product‐oriented and source‐oriented schemas when learning about inflectional morphology.
Decision Making and Confidence Given Uncertain Advice
Authors: Lee Michael D. , Dry Matthew J.
Published: November 2006

We study human decision making in a simple forced‐choice task that manipulates the frequency and accuracy of available information. Empirically, we find that people make decisions consistent with the advice provided, but that their subjective confidence in their decisions shows 2 interesting properties. First, people's confidence does not depend solely on the accuracy of the advice. Rather, confidence seems to be influenced by both the frequency and accuracy of the advice. Second, people are less confident in their guessed decisions when they have to make relatively more of them. Theoretically, we develop and evaluate a type of sequential sampling process model—known as a self‐regulating accumulator—that accounts for both decision making and confidence. The model captures the regularities in people's behavior with interpretable parameter values, and we show its ability to fit the data is not due to excessive model complexity. Using the model, we draw conclusions about some properties of human reasoning under uncertainty.
Phonological Abstraction in the Mental Lexicon
Authors: McQueen James M. , Cutler Anne , Norris Dennis
Published: November 2006

A perceptual learning experiment provides evidence that the mental lexicon cannot consist solely of detailed acoustic traces of recognition episodes. In a training lexical decision phase, listeners heard an ambiguous [f–s] fricative sound, replacing either [f] or [s] in words. In a test phase, listeners then made lexical decisions to visual targets following auditory primes. Critical materials were minimal pairs that could be a word with either [f] or [s] (cf. English knife–nice), none of which had been heard in training. Listeners interpreted the minimal pair words differently in the second phase according to the training received in the first phase. Therefore, lexically mediated retuning of phoneme perception not only influences categorical decisions about fricatives (Norris, McQueen, & Cutler, 2003), but also benefits recognition of words outside the training set. The observed generalization across words suggests that this retuning occurs prelexically. Therefore, lexical processing involves sublexical phonological abstraction, not only accumulation of acoustic episodes.
Pictures and Spoken Descriptions Elicit Similar Eye Movements During Mental Imagery, Both in Light and in Complete Darkness
Authors: Johansson Roger , Holsanova Jana , Holmqvist Kenneth
Published: November 2006

This study provides evidence that eye movements reflect the positions of objects while participants listen to a spoken description, retell a previously heard spoken description, and describe a previously seen picture. This effect is equally strong in retelling from memory, irrespective of whether the original elicitation was spoken or visual. In addition, this effect occurs both while watching a blank white board and while sitting in complete darkness. This study includes 4 experiments. The first 2 experiments measured eye movements of participants looking at a blank white board. Experiment 1 monitors eye movements of participants on 2 occasions: first, when participants listened to a prerecorded spoken scene description; second, when participants were later retelling it from memory. Experiment 2 first monitored eye movements of participants as they studied a complex picture visually, and then later as they described it from memory. The second pair of experiments (Experiments 3 and 4) replicated Experiments 1 and 2 with the only difference being that they were executed in complete darkness. This method of analysis differentiated between eye movements that are categorically correct relative to the positions of the whole eye gaze pattern (global correspondence) and eye movements that are only locally correct (local correspondence). The discussion relates the findings to the current debate on mental imagery.
LDL-receptor-related protein 4 is crucial for formation of the neuromuscular junction
Authors: Weatherbee Scott D. , Anderson Kathryn V. , Niswander Lee A.
Published: November 2006

Low-density lipoprotein receptor-related protein 4 (Lrp4) is a member of a family of structurally related, single-pass transmembrane proteins that carry out a variety of functions in development and physiology, including signal transduction and receptor-mediated endocytosis. Lrp4 is expressed in multiple tissues in the mouse, and is important for the proper development and morphogenesis of limbs, ectodermal organs, lungs and kidneys. We show that Lrp4 is also expressed in the post-synaptic endplate region of muscles and is required to form neuromuscular synapses. Lrp4-mutant mice die at birth with defects in both presynaptic and postsynaptic differentiation, including aberrant motor axon growth and branching, a lack of acetylcholine receptor and postsynaptic protein clustering, and a failure to express postsynaptic genes selectively by myofiber synaptic nuclei. Our data show that Lrp4 is required during the earliest events in postsynaptic neuromuscular junction (NMJ) formation and suggest that it acts in the early,nerveindependent steps of NMJ assembly. The identification of Lrp4 as a crucial factor for NMJ formation may have implications for human neuromuscular diseases such as myasthenia syndromes.
STEPS: A probabilistic precipitation forecasting scheme which merges an extrapolation nowcast with downscaled NWP
Authors: Bowler Neill E. , Pierce Clive E. , Seed Alan W.
Published: November 2006

An ensemble‐based probabilistic precipitation forecasting scheme has been developed that blends an extrapolation nowcast with a downscaled NWP forecast, known as STEPS: Short‐Term Ensemble Prediction System. The uncertainties in the motion and evolution of radar‐inferred precipitation fields are quantified, and the uncertainty in the evolution of the precipitation pattern is shown to be the more important. The use of ensembles allows the scheme to be used for applications that require forecasts of the probability density function of areal and temporal averages of precipitation, such as fluvial flood forecasting—a capability that has not been provided by previous probabilistic precipitation nowcast schemes. The output from a NWP forecast model is downscaled so that the small scales not represented accurately by the model are injected into the forecast using stochastic noise. This allows the scheme to better represent the distribution of precipitation rate at spatial scales finer than those adequately resolved by operational NWP. The performance of the scheme has been assessed over the month of March 2003. Performance evaluation statistics show that the scheme possesses predictive skill at lead times in excess of six hours. © Crown copyright, 2006.
Observed mass transports accompanying upstream orographic blocking during MAP IOP8
Authors: Bousquet Olivier , Smull Bradley F.
Published: November 2006

A mass budget within a domain of 200 km×300 km encompassing the western end of the Po river valley in northern Italy is performed to examine the relative contributions of the multiple sources of moist airflow in the formation of precipitation for a case of strong upstream blocking observed during Intensive Observing Period eight (IOP8) of the Mesoscale Alpine Programme (MAP). Results of this mass budget, made possible by horizontally extensive Doppler radar observations covering this upstream region, reveal that the bulk of the blocked easterly flow undergoes widespread (i.e. mesoscale) slow ascent over a region of relatively flat terrain, and is ultimately lifted to a level at which it can apparently be entrained into the overriding (unblocked) southerly component flow. As a result, the occurrence of profound orographic blocking did not preclude a portion of this low‐level air from ultimately surmounting the high Alpine crest. The contribution to this broad mesoscale circulation of smaller‐scale downslope flows observed within multiple deep Alpine river drainages is also investigated, by computing observed mass transports emerging from the mouths of several valleys surrounding the Lago Maggiore region. Overall, the down‐valley flow is shown to be a relatively minor contributor to the low‐level mesoscale transports within the Po basin, but, nonetheless, one which is important to obtain mass balance in these budget computations. Copyright © 2006 Royal Meteorological Society
Stratiform precipitation production over sub‐Saharan Africa and the tropical East Atlantic as observed by TRMM
Authors: Schumacher Courtney , Houze Robert A.
Published: November 2006

Convective systems over sub‐Saharan Africa and the tropical East Atlantic have distinct geographical and seasonal variations in convective intensity and stratiform precipitation production as observed by the Tropical Rainfall Measuring Mission (TRMM) Precipitation Radar. Over the East Atlantic, convective rain rates are lower and the percentage of total rain that is stratiform is higher compared to over West Africa. In addition, the East Atlantic has more shallow precipitating convection and less non‐precipitating anvil than sub‐Saharan Africa. During the monsoon season, convective rain rates and the percentage of area covered by anvil decrease while the stratiform rain fraction and number of shallow convective cells increase in both regions compared to the pre‐monsoon season. These observations suggest that convective sustainability, i.e. the ability of a region to continually support convection, helps determine whether a robust stratiform rain area or non‐precipitating anvil forms.

In addition to convective sustainability, wind shear and the Saharan Air Layer appear to play important roles in the formation and extent of the stratiform components of convective cloud systems. Strong winds associated with the African Easterly Jet and dry intrusions from the Sahara Desert may increase sublimation and evaporation at mid levels, resulting in less stratiform rain. Strong upper‐level shear associated with the African Easterly Jet may further hinder stratiform rain production by displacing hydrometeors that form in the convective cells beyond the area of mesoscale rain formation. When the upper‐level Tropical Easterly Jet strengthens during the monsoon season, upper‐level shear is reduced dramatically and stratiform rain areas form in preference to non‐raining anvil. Copyright © 2006 Royal Meteorological Society
A fast radiative‐transfer model for the assimilation of MIPAS limb radiances: Accounting for horizontal gradients
Authors: Bormann N. , Healy S. B.
Published: November 2006

We investigate the influence of horizontal structure in the atmosphere on the simulation of emitted infrared limb radiances from the Envisat‐MIPAS instrument, and examine a pragmatic extension of the regression‐based RTMIPAS fast radiative‐transfer model to deal with horizontal atmospheric structure. The extension of RTMIPAS takes into account the horizontal structure at the ray‐tracing step which is used to determine scene temperatures, path lengths, and other conditions along the ray. But the transmittance parametrization used in the extension is based on regression models previously derived from a set of horizontally homogeneous atmospheres. This reduces the computational effort required for the derivation of the regression models. The effects of horizontal gradients in the atmosphere on MIPAS radiances are examined by comparing radiance spectra simulated with RTMIPAS to line‐by‐line equivalents and to real MIPAS observations.

It is shown that neglecting horizontal structure in the atmosphere can introduce errors in the radiance simulation that exceed by far the instrument noise, particularly for lower tangent heights and for strongly absorbing spectral regions. The extension of the fast radiative‐transfer model can substantially reduce this error, and for tangent pressures less than 350 hPa (tangent heights greater than about 8 km) almost all error due to horizontal gradients is eliminated. In agreement with this, fast‐model radiances simulated from cross‐sections of the European Centre for Medium‐Range Weather Forecasts model compare significantly better to observed MIPAS limb radiances than radiances simulated under the assumption of horizontal homogeneity. This further confirms a considerable reduction in forward‐model error when horizontal atmospheric structure is taken into account. Copyright © 2006 Royal Meteorological Society
Implementation of 1D+4D‐Var assimilation of precipitation‐affected microwave radiances at ECMWF. I: 1D‐Var
Authors: Bauer Peter , Lopez Philippe , Benedetti Angela , Salmond Deborah , Moreau Emmanuel
Published: November 2006

This paper presents the operational implementation of a 1D+4D‐Var assimilation system of rain‐affected satellite observations at the European Centre for Medium‐Range Weather Forecasts. The first part describes the methodology and performance analysis of the 1D‐Var retrieval scheme in clouds and precipitation that uses Special Sensor Microwave/Imager microwave radiance observations for the estimation of total‐column water vapour. The second part shows the global and long‐term impact of these observations on both model 4D‐Var analyses and medium‐range forecasts.

The 1D‐Var scheme employs a complex observation operator that consists of linearized moist physics parametrization schemes and a multiple‐scattering radiative‐transfer model. The observation operator shows rather linear behaviour in most situations except in the presence of very intense precipitation suggesting a possible use even for a direct assimilation of radiances in 4D‐Var. A bias correction and observation‐error estimation method were implemented and indicate stable error behaviour. The 1D‐Var algorithm quality control shows the largest failure number in areas with mostly frozen precipitation where the Special Sensor Microwave/Imager channels have little sensitivity to changes in hydrometeor contents. From test analyses on a global scale, a small moisture increase was computed that was greatest in dry subtropical areas. Large‐scale and convective precipitation were increased similarly but showed a significantly different geographical distribution. The large‐scale precipitation scheme has a stronger sensitivity to moisture changes and therefore moisture increments mainly affect stratiform precipitation distributions. While the global mean moisture fields are only weakly affected by the assimilation of rain‐affected observations, the impact on local systems may be quite large. The forecast of synoptic system development through the 4D‐Var analysis can be significant. Copyright © 2006 Royal Meteorological Society
A linear model of gravity wave drag for hydrostatic sheared flow over elliptical mountains
Authors: Teixeira M. A. C. , Miranda P. M. A.
Published: November 2006

An analytical model of orographic gravity wave drag due to sheared flow past elliptical mountains is developed. The model extends the domain of applicability of the well‐known Phillips model to wind profiles that vary relatively slowly in the vertical, so that they may be treated using a WKB approximation. The model illustrates how linear processes associated with wind profile shear and curvature affect the drag force exerted by the airflow on mountains, and how it is crucial to extend the WKB approximation to second order in the small perturbation parameter for these effects to be taken into account. For the simplest wind profiles, the normalized drag depends only on the Richardson number, Ri, of the flow at the surface and on the aspect ratio, γ, of the mountain. For a linear wind profile, the drag decreases as Ri decreases, and this variation is faster when the wind is across the mountain than when it is along the mountain. For a wind that rotates with height maintaining its magnitude, the drag generally increases as Ri decreases, by an amount depending on γ and on the incidence angle. The results from WKB theory are compared with exact linear results and also with results from a non‐hydrostatic nonlinear numerical model, showing in general encouraging agreement, down to values of Ri of order one. Copyright © 2006 Royal Meteorological Society
A consistent vertical Bowen ratio profile in the planetary boundary layer
Authors: Hantel M. , Steinheimer M.
Published: November 2006

It has recently been suggested that the integrandb=−α′ω′of the subgrid‐scale conversion rate between available and kinetic energy has a measurable impact upon the Lorenz energy cycle. Here we discuss a technique to estimate this quantity within the lower part of an atmospheric column by relatingbto the subgrid‐scale fluxes of sensible and latent heat in form of their sum (thetotal convective heat flux, c, to be diagnosed from the pertinent energy law) and their ratio (a generalizedBowen ratio, β, to be specified a priori). We focus on the frequently observed case thatcvanishes at or above the top of the boundary layer, which implies that β must be minus unity at the same level (referred to as ‘critical pressure’). β at the earth's surface is taken as measured. Observations suggest that the vertical curvature of the β profile is negative in the boundary layer. We specify an analytic vertical profile β(ζ) that interpolates these pieces of information; ζ is a non‐dimensional vertical coordinate.

The pertinent thermodynamic energy law from which the column profilec(ζ) is gained (referred to here asconvection equation) is driven by the (observed)grid‐scale budget; the solutioncis over most of the boundary layer quite insensitive to β. It is only in the immediate vicinity of the critical pressure thatc(ζ) becomes sensitively dependent upon β(ζ); it actually turns infinite at this level (a ‘pole’ of the convection equation). We remove the pole through adjusting the critical pressure by a uniquely determined (and actually quite small) amount. This makes the β profile consistent with the convection equation and with the other convective flux profiles, across the entire boundary layer. The remaining open parameter that cannot be fixed by our method is the curvature of the Bowen ratio profile.

This exercise has implications for about a third of all atmospheric columns over the globe and thus may be relevant for the quantification of the global energy cycle. Copyright © 2006 Royal Meteorological Society
Shallow mesoscale flows at the north‐eastern Adriatic coast
Authors: Prtenjak Maja Telišman , Grisogono Branko , Nitis Theodoros
Published: November 2006

A summertime anticyclonic situation over the northern part of the eastern Adriatic coast is studied using a three‐dimensional nonhydrostatic mesoscale model. The aim is to evaluate small‐scale variability, such as mesoscale eddies, sea‐breeze convergence zones (CZs) and the coastal jet‐like flow in the thermally driven mesoscale circulations over very complex terrain. The results show that the model reproduces main known features of the diurnal flow with certain local specific characteristics, in addition to some new ones, previously only somewhat qualitatively known. After comparisons with measurements, further analyses are performed by sensitivity tests in which topography and synoptic input are varied.

The simulations show a development of two diurnal intensive mesoscale eddies inside Kvarner Bay (∼20 km×20 km). The night‐time deeper eddies exhibit anticlockwise rotation, while the late afternoon shallow one shows the opposite rotation. Their appearance and dynamics are connected primarily to the coastline shape and topography; meanwhile, the large‐scale flow in the anticyclonic weather type, as addressed here, has small influence. Moreover, a CZ develops over Istria and the island of Krk as a result of merged sea breezes. The intensity, speed, position and configuration of the sea‐breeze cells are examined. The results also show that the topography is more important for the formation of the CZ over the island of Krk and for the coastal jet‐like flow between the island and mainland than for the Istrian CZ. Copyright © 2006 Royal Meteorological Society
Instability of finite‐amplitude lower‐neutral Eady waves
Authors: Fantini M.
Published: November 2006

The problem of the stability of the two‐dimensional neutral Eady wave, studied numerically by Fantini and Davolio (2001) as a possible mechanism leading to strong orographic cyclogenesis, is re‐examined. An approximate analytic solution is found, and a simple condition for the appearance of meridionally structured unstable secondary modes is proposed, based on the relative vorticity of the primary wave. The approximate analytic solution compares well with the numerical simulations and extends previous results. Copyright © 2006 Royal Meteorological Society
Teaching Internal Medicine Resident Physicians about Alcoholics Anonymous
Authors: Rose Adam J. , Stein Melissa R. , Arnsten Julia H. , Saitz Richard
Published: November 2006

Greater physician confidence in treating alcoholism is associated with a higher frequency of referring alcoholic patients for treatment, but many physicians have limited experience with Alcoholics Anonymous. We implemented a brief, didactic and experiential educational intervention about AA and evaluated its effect on knowledge and attitudes, using a before-after repeated measures study design. Thirty-six first-year internal medicine resident physicians received an educational intervention, which consisted of a 45-minute lecture about AA, a visit to an AA meeting, and a 30-minute debriefing session the next day. Residents’ knowledge and attitudes were assessed by a brief written anonymous survey before and after the educational intervention. Residents reported increases in self-perceived knowledge about AA and had more favorable attitudes towards AA after the intervention. Our pilot study shows that a brief, didactic and experiential course can improve physician knowledge and attitudes about AA, and holds promise for improving physician interface with this commonly used intervention.
Training HIV Physicians to Prescribe Buprenorphine for Opioid Dependence
Authors: Sullivan Lynn E. , Tetrault Jeanette , Bangalore Deepa , Fiellin David A.
Published: November 2006

Few HIV physicians are trained to provide buprenorphine treatment. We conducted a cross-sectional survey to assess the impact of an eight-hour course on the treatment of opioid dependence on HIV physicians’ preparedness to prescribe buprenorphine. One hundred thirteen of 257 trained physicians (44%) provided HIV care. Post-course, the majority of both HIV physicians and non-HIV physicians (66% vs. 67%, P =.8) planned to pursue a registration to prescribe buprenorphine. The most common reason for not planning to do so was lack of experience (9% vs. 15%, P =.19). Fifty-two of the 113 (46%) HIV physicians had concerns about prescribing buprenorphine. Thirty of the 52 (58%) indicated that interactions between buprenorphine and HAART was their primary concern. Following training, most physicians feel prepared and plan to obtain a registration to prescribe buprenorphine. HIV physicians’ concerns regarding interactions between buprenorphine and HAART need to be addressed in future training efforts.
Technology-Based Training in Cognitive Behavioral Therapy for Substance Abuse Counselors
Authors: Weingardt Kenneth R. , Villafranca Steven W. , Levin Cindy
Published: November 2006

This study compared the learning outcomes achieved by 166 practicing substance abuse counselors who were randomized to one of three conditions: (1) a Web-Based Training (WBT) module designed to familiarize practitioners with the “Coping with Craving” module from the NIDA treatment manual, “A Cognitive-Behavioral Approach: Treating Cocaine Addiction” ( www.nidatoolbox.org ), (2) a face-to-face training workshop covering the identical content, or (3) a delayed training control condition. Participants in all three conditions completed an identical test of knowledge before and after the session. Results indicated that participants in both the WBT and face-to-face workshop conditions showed improvement in mean test scores, while participants in the delayed training control condition did not. Improvements in test scores for participants in both the WBT and face-to-face conditions were statistically significant and equally modest in magnitude. The finding of equivalent rates of knowledge transfer across these two delivery mechanisms highlight one function for which WBT may be particularly well-suited, and suggest that the most effective clinical training applications may use a “blended delivery” format that leverages the strengths of both WBT and face-to-face training.
Assessment of Alcohol and Other Drug Use Behaviors in Health Professions Students
Authors: Baldwin Jeffrey N. , Scott David M. , Agrawal Sangeeta , Bartek Jean K. , Davis-Hall R. Ellen , Reardon Thomas P. , DeSimone Edward M.
Published: November 2006

Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by surveying both university-based HPS and other nursing programs in a Midwestern state in 1999. Response was 2,646 (56.4%) of surveyed students. Family history of alcohol-related and drug-related problems were reported by 39.8% and 13.9%, respectively, with 42.6% of respondents reporting one or both. Among nursing respondents, 48.1%, 19.2%, and 51.1%, respectively, reported family problems with alcohol, drugs, or one or both. Past-year alcohol use was comparable to undergraduate college students (UCS) nationally (83%); heavy drinking, tobacco, and recreational drug use by HPS were lower. Past year drug use was highest among medical students. Marijuana was the predominant illicit drug; medical students and males most often reported use. Health professions educational systems should proactively address student AOD prevention, education, and assistance needs.
Duration of Nonmethadone Outpatient Treatment
Authors: Friedmann Peter D. , Alexander Jeffrey A. , Yey Yining , Nahra Tammie , Soliman Soheil , Pollack Harold A.
Published: November 2006

Objectives

This study examined organizational trends from 1990 to 2000 and unit characteristics associated with the duration of nonmethadone outpatient addiction treatment.

Methods

Program directors and clinical supervisors from a nationally representative panel of nonmethadone outpatient units in the United States were surveyed in 1990, 1995, and 2000. Treatment duration was measured from clinical supervisors’ reports of the average length of stay. Negative binominal regression models controlled for multivariate effects.

Results

Treatment duration modestly declined between 1990 and 2000 while addiction severity increased. Affiliation with a mental health center, older program age, JCAHO accreditation-ostensibly a marker for structural quality-and serving more clients with prior authorization requirements-a measure of managed care stringency-were associated with shorter treatment durations.

Conclusions

These findings suggest that treatment duration did not increase between 1990 and 2000 despite clients’ worsening addiction severity and growing evidence that longer duration of formal treatment improves treatment outcome. In addition, programs with JCAHO accreditation and stronger managed care oversight appeared to seek efficiencies through reductions in treatment duration.
Advances in the Study of Spirit Experience: Drawing Together Many Threads
Authors: Turner Edith
Published: November 2006

This article traces some important changes in anthropology during the last 100 years, especially with regard to the study of consciousness. Vignettes of the field material of a number of scholars given here exemplify that the philosophy under which we have studied in the past is now no longer limiting itself but is extending its provenance all the way to the study of spirituality. Earlier, the concept of liminality broke through social anthropology and loosened the power of Durkheim, while the study of what the old consciousness scholars called psi proved ineradicable from researchers' reports and keeps coming back. Arising from whatever causes, there has been a literature explosion on spirituality and shamanism in the last fifteen years. This article draws the following conclusion from the vivid field examples given: that a thing variously called spirit‐energy is everywhere and is commonly accepted at the heart of the ritual of all the different societies.
Shamanism: An Inquiry into the History of the Scholarly Use of the Term in English‐Speaking North America
Authors: Jones Peter N.
Published: November 2006

In this paper, I discuss the results of a large‐scale archival and data base research project that investigated the history of the scholarly use of the terms shamanism and shaman in English‐speaking North America. This was done to provide a historical grounding in the hope of arriving at an operationally sound definition of the term. Twomajor findings emerged from the data: first, current uses of the terms shamanism and shaman are inadequate for any discussion of the phenomenon from a historical perspective; second, the terms shamanism and shaman have been widely used in English‐speaking North America by researchers, scholars, scientists, and lay people for more than a 100 years, and the use of the term has changed greatly in this time, complicating any possibility of arriving at an agreed‐upon operational definition. I discuss these two research findings and how they fit into contemporary uses of the terms, concluding that current definitions and understandings of this phenomenon are unduly circumscribed, largely the result of historical research orientations. I then suggest future research questions and call for a concise, workable understanding of the phenomenon of shamanism.
Toward a Theory of Divinatory Practice
Authors: Tedlock Barbara
Published: November 2006

Divination has been practiced as a way of knowing and communicating for millennia. Diviners are experts who embrace the notion of moving from a boundless to a bounded realm of existence in their practice. They excel in insight, imagination, fluency in language, and knowledge of cultural traditions and human psychology. During a divination, they construct usable knowledge from oracular messages of various sorts. To do so, they link diverse domains of representational information and symbolism with emotional or presentational experience. Their divinatory acts involve complementary modes of cognition associated with these rather different symbolic forms. In representational symbolism, intentional reference, within a relatively controlled inductive reality, is paramount, while in presentational symbolism, implicit experiential immersion, within a free‐flowing context, is grasped intuitively. Wherever a theory of divination has been elicited from diviners, there is a clear recognition of the overlapping of inductive, intuitive, and interpretive techniques and ways of knowing. In order to arrive at a theory of practice for divination, as a form of practical consciousness or knowledge within different modes of cognition, one must take what diviners say and do seriously. Recent scientific studies reveal that consciousness is connected both to electrical information in the brain and nervous system and to electronic semi‐conduction in body tissues. Brain consciousness is embedded in body consciousness and coupled to it. This validates the experience of mind‐body consciousness diviners have used for millennia in their performances.
Genetic Counseling for Sex Chromosome Anomalies (SCAs) in Israel and Germany: Assessing Medical Risks According to the Importance of Fertility in Two Cultures
Authors: Hashiloni‐Dolev Yael
Published: November 2006

In this article, I report findings from a comparative study of Israeli and German genetic counselors. Specifically, it concerns counselors' attitudes and risk assessments relating to prenatal diagnosis of sex chromosome anomalies (SCAs) such as Klinefelter and Turner syndromes. Data collected through in‐depth interviews with counselors in both countries (N = 32) are presented, and the types of claims experts deploy in their personal and professional estimation of the risks involved in SCAs are analyzed. The article concludes by suggesting that the counselors rhetoric concerning SCAs, whose major manifestation is the future infertility of the unborn child as well as their estimations of the related risks, should be situated in a broader cultural context, that of local Israeli and German understandings of the importance of fertility, and not in their professional nondirective ethos. Hence, to understand the practice of genetic counselors in two late‐modern societies, one must understand the unique relationship between the individual bodies of pregnant women and the body politics of their nations, a relationship mediated by the counselors, who are the bearers of knowledge and expertise in this field.