bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive value of p53 and PCNA expression for occult neck metastases in patients with clinically node‐negative oral tongue cancer
Authors: Keum Ki Chang , Chung Eun Ji , Koom Woong Sub , Cho Jae Ho , Cho Sang Ho , Choi Eun Chang , Lee Chang Geol , Suh Chang Ok , Kim Gwi Eon
Published: November 2006

OBJECTIVE

In an attempt to identify molecular markers predictive of occult neck metastases, we investigated whether positive p53 or proliferating cell nuclear antigen (PCNA) immunoreactivities on deparaffinized sections of the primary tumor are correlated to the presence of occult neck node metastases in oral tongue cancer patients with clinically negative cervical nodes (N0).

STUDY DESIGN AND SETTING

Between 1986 and 1997, 37 clinically N0 patients who underwent neck dissection (25 male, 12 female; mean age 54 years) were selected for p53 and PCNA staining.

RESULTS

p53 and PCNA immunoreactivities were detected in 68% and 32%, respectively. There was no correlation between p53 or PCNA and other clinicopathological factors, such as tumor differentiation, tumor type, tumor size, and T‐stage. Although tumor differentiation (P = 0.03) and tumor size (P = 0.03) were significantly correlated with occult neck metastases of oral tongue cancer by univariate analysis, no correlation was found between p53 or PCNA and the presence of occult neck metastasis.

CONCLUSION

p53 and/or PCNA expression are unsuitable as biological markers predictive of lymph node metastases of oral tongue cancer.

SIGNIFICANCE

p53‐ or PCNA‐positive status are not a reliable parameter for selection of elective neck dissection in the management of N0 oral tongue cancer patients.
Crosslinked hydrogels for tympanic membrane repair
Authors: Park Albert H. , Hughes Casey W. , Jackson Adrienne , Hunter Lisa , McGill Lawrence , Simonsen Sara Ellis , Alder Stephen C. , Shu Xiao Zheng , Prestwich Glenn D.
Published: November 2006

PROBLEM

To provide a less expensive and more convenient protocol for the treatment of tympanic membrane perforations (TMPs).

METHODS

Several materials were prepared and compared for TMP repair including Carbylan‐SX, Gelatin‐DTPH‐PEGDA (GX), Carbylan‐S/Gelatin‐DTPH (Carbylan‐GSX) (injectable and sponge), Gelfoam, Epifilm, and crosslinked thiolated chondroitin sulfate (CS‐DTPH‐PEGDA [CS‐SX]). Hartley pigmented guinea pigs (Elm Hill) underwent bilateral myringotomy with 1 ear left as a control and the other treated with one of the previously mentioned materials.

RESULTS

Carbylan‐GSX (injectable and sponge), Gelfoam with saline, and CS‐SX had the shortest time for TMP closure. Epifilm, Carbylan, and gelatin preparations resulted in closure rates similar to controls. CS‐SX showed a marked inflammatory reaction compared with controls and other materials based on neutrophil, lymphocyte, epitheloid counts, and degree of fibrosis.

CONCLUSIONS

This study shows the validity of Carbylan‐GSX compared with Gelfoam as a material to promote TMP closure in an acute TMP guinea pig model.
Systematic facial nerve monitoring in middle ear and mastoid surgeries: “Surgical dehiscence” and “electrical dehiscence”
Authors: Choung Yun‐Hoon , Park Keehyun , Cho Min Jung , Choung Pill‐Hoon , Shin You Ree , Kahng Hison
Published: November 2006

OBJECTIVES

To evaluate and systemize intraoperative facial nerve monitoring (IOFNM) in middle ear and mastoid surgeries.

STUDY DESIGN AND SETTING

A prospective study.

METHODS

IOFNM was performed in 100 patients undergoing middle ear and mastoid surgeries. We checked “surgical dehiscence” under microscopes, and also estimated the minimal threshold of electric current needed to change the electromyography of facial muscles using Nerve Integrity Monitor (NIM)‐2 (Xomed, Minneapolis, MN, USA).

RESULTS

Forty‐three percent of cases showed “surgical dehiscence” and responded to electric stimulation of 0.7 mA or less. “Electrical dehiscence” (≤ 0.7 mA) was presented in 73 (73.0%) cases, and 82.2% of these cases responded to 0.4 mA or less. The mean threshold of minimal electrical stimulation was 0.29 mA for tympanic segments and 0.41 mA for mastoid segments.

CONCLUSIONS

We recommend an electrical stimulation of 0.7 mA for the first screening and 0.4 mA for the second exploration in order to define the facial nerve using intraoperative NIM‐2 monitoring in middle ear and mastoid surgeries.
Sunnybrook and House‐Brackmann Facial Grading Systems: Intrarater repeatability and interrater agreement
Authors: Kanerva Mervi , Poussa Tuija , Pitkäranta Anne
Published: November 2006

OBJECTIVE

To assess repeatability and agreement of the House‐Brackmann (H‐B FGS) and the Sunnybrook (SFGS) Facial Grading Systems.

STUDY DESIGN AND SETTING

Eight video‐recorded facial palsy patients were graded in 2 sittings by 28 doctors. Repeatability and agreement for SFGS were measured by intraclass correlation coefficient (ICC) and coefficient of repeatability (CR), and for H‐B FGS by agreement percentage and kappa coefficients.

RESULTS

Repeatability for SFGS was from good to excellent and for H‐B FGS from fair to good. Agreement between doctors for SFGS was moderate by CR and nearly perfect by ICC. For H‐B FGS, the agreement percentage was 50%, and generalized kappa indicated only fair agreement.

CONCLUSIONS

SFGS was at least as good in repeatability as H‐B FGS and showed more reliable results in agreement between doctors.

SIGNIFICANCE

While waiting for an ideal scale for facial grading, the usage of SFGS can be encouraged over H‐B FGS.
Expression of cyclooxygenase‐2 and 5‐lipoxygenase in nasal polyps associated with interleukin‐4 promoter polymorphism ‐590
Authors: Kook Park Seong , Heo Kyung Wook , Jung Hyun , Yea Sung Su , Yang Young
Published: November 2006

OBJECTIVE:

To evaluate expression of cyclooxygenase (COX)‐2 and 5‐lipoxygenase (5‐LO) associated with interleukin (IL)‐4 promoter polymorphism ‐590 in nasal polyp tissues.

STUDY DESIGN AND SETTING:

A prospective controlled study. A venous blood sample was taken to determine the genotype in 61 nasal polyp subjects. The C‐590T variant was determined by the polymerase chain reaction‐restriction fragment length polymorphism method. The expression of 5‐LO and COX‐2 was determined with immunohistochemical staining in 37 nasal polyp tissues associated with genotype.

RESULTS:

The genotype frequencies at position ‐590 of the IL‐4 gene in the patients with nasal polyp were C/C (8.20%), C/T (40.98%), and T/T (50.82%). There was no significantly increased expression of COX‐2 among genotypes. The 5‐LO expression was significantly increased in C/C compared with C/T and T/T.

CONCLUSION:

We suggested that the IL‐4 promoter polymorphism ‐590 C/C is associated with the expression of 5‐LO in the patients with nasal polyp.
Primed fibroblasts and exogenous decorin: Potential treatments for subacute vocal fold scar
Authors: Krishna Priya , Rosen Clark A. , Branski Ryan C. , Wells Alan , Hebda Patricia A.
Published: November 2006

OBJECTIVE

To investigate hepatocyte growth factor (HGF) primed fibroblasts and decorin application on skin and vocal fold fibroblasts in vitro and in vivo in rabbit vocal fold scar model.

STUDY DESIGN AND SETTING:

Vocal fold and skin fibroblasts underwent five in vitro treatment conditions: control, epidermal growth factor, HGF, both decorin and HGF, and decorin alone. Hyaluronic acid and collagen enzyme‐linked immunosorbent assays were performed. In vivo, 12 rabbits underwent unilateral vocal fold stripping. Injured vocal folds were then injected with skin fibroblasts, HGF, HGF‐primed fibroblasts and decorin, or decorin. Outcomes included histologic and lamina propria height analyses.

RESULTS:

In vitro, HGF increased hyaluronic acid synthesis in vocal fold fibroblasts (P < 0.001). HGF and decorin treatment diminished collagen secretion (P < 0.01). In vivo, histologic findings indicated minimal difference in collagen amount between treatment groups.

CONCLUSION:

HGF and decorin together may decrease collagen production by skin and vocal fold fibroblasts. Fibroblast transplantation into scarred vocal folds has equivocal benefit.
Evaluation of Six Methods for Estimating Synonymous and Nonsynonymous Substitution Rates
Authors: Zhang Zhang , Yu Jun
Published: November 2006

Methods for estimating synonymous and nonsynonymous substitution rates among protein-coding sequences adopt different mutation (substitution) models with subtle yet significant differences, which lead to different estimates of evolutionary information. Little attention has been devoted to the comparison of methods for obtaining reliable estimates since the amount of sequence variations within targeted datasets is always unpredictable. To our knowledge, there is little information available in literature about evaluation of these different methods. In this study, we compared six widely used methods and provided with evaluation results using simulated sequences. The results indicate that incorporating sequence features (such as transition/transversion bias and nucleotide/codon frequency bias) into methods could yield better performance. We recommend that conclusions related to or derived from Ka and Ks analyses should not be readily drawn only according to results from one method.
Comparative Analysis of Transcription Start Sites Using Mutual Information
Authors: Reddy D. Ashok , Mitra Chanchal K.
Published: November 2006

The transcription start site (TSS) region shows greater variability compared with other promoter elements. We are interested to search for its variability by using information content as a measure. We note in this study that the variability is significant in the block of 5 nucleotides (nt) surrounding the TSS region compared with the block of 15 nt. This suggests that the actual region that may be involved is in the range of 5–10 nt in size. For Escherichia coli, we note that the information content from dinucleotide substitution matrices clearly shows a better discrimination, suggesting the presence of some correlations. However, for human this effect is much less, and for mouse it is practically absent. We can conclude that the presence of short-range correlations within the TSS region is species-dependent and is not universal. We further observe that there are other variable regions in the mitochondrial control element apart from TSS. It is also noted that effective comparisons can only be made on blocks, while single nucleotide comparisons do not give us any detectable signals.
Optimal Allocation of Replicates for Measurement Evaluation Studies
Authors: Zakharkin Stanislav O. , Kim Kyoungmi , Bartolucci Alfred A. , Page Grier P. , Allison David B.
Published: November 2006

Optimal experimental design is important for the efficient use of modern high-throughput technologies such as microarrays and proteomics. Multiple factors including the reliability of measurement system, which itself must be estimated from prior experimental work, could influence design decisions. In this study, we describe how the optimal number of replicate measures (technical replicates) for each biological sample (biological replicate) can be determined. Different allocations of biological and technical replicates were evaluated by minimizing the variance of the ratio of technical variance (measurement error) to the total variance (sum of sampling error and measurement error). We demonstrate that if the number of biological replicates and the number of technical replicates per biological sample are variable, while the total number of available measures is fixed, then the optimal allocation of replicates for measurement evaluation experiments requires two technical replicates for each biological replicate. Therefore, it is recommended to use two technical replicates for each biological replicate if the goal is to evaluate the reproducibility of measurements.
LIFE ASSURANCE AND CONSENSUAL DEATH: LAW MAKING FOR THE RATIONALLY SUICIDAL
Authors: Davey James , Coggon John
Published: November 2006

DIFFICULT questions of medical ethics are often made more complex in the real world by the intrusion of private law considerations. The end of life choices of a mentally competent but terminally ill patient may be influenced by the consequences for the financial well being of surviving dependants. In particular, attention is likely to be given to the effect on any life insurance cover in place. For many this will represent the greatest financial asset contingent on death. There has been considerable debate as to the proper response of public law to these issues, in both the criminal and regulatory fields. However, the prosecutorial, judicial and jury discretions that bound these rules limit their impact in practice. By contrast, the private law principles that govern the distribution of assets on death have been largely overlooked. This article redresses that imbalance.
IS ALL HARASSMENT EQUAL? THE CASE OF RELIGIOUS HARASSMENT
Authors: Vickers Lucy
Published: November 2006

IN 2000 the Employment Directive was enacted by the European Community, creating a framework for combating discrimination in employment on grounds not previously covered by Community law, namely religion or belief, disability, age and sexual orientation. To a large extent the definitions of discrimination are uniform in relation to the different grounds of discrimination. In accordance with the Directive, new Regulations have been introduced in the UK prohibiting discrimination on grounds of religion or belief (the Religion and Belief Regulations) and sexual orientation, and amendments have been made to some aspects of the law governing discrimination on grounds of race, sex and disability. Age discrimination is subject to regulations which came into force in October 2006. One common aspect of these new laws and amendments is that the concept of harassment is specifically defined, instead of being viewed as a form as discrimination.
PRIVACY IN PUBLIC PLACES
Authors: Moreham N.A.
Published: November 2006

ONE of the most difficult questions facing English courts as they develop the common law right to privacy recognised by the House of Lords in Campbell v. MGN Ltd. is whether and, if so, when a person might have a reasonable expectation of privacy in a public place. Should an individual have a cause of action if she is photographed as she leaves her mother’s funeral or as he receives medical attention after an accident? Or should there be an absolute rule which says that there is no privacy in a public space? Recent decisions in England and the European Court of Human Rights (ECtHR) suggest that it is no longer an answer (if it ever was) simply to say that the disclosure concerned something which took place in public. A more difficult question therefore remains: if the existence of a privacy interest does not depend on the nature of the space in which claimants find themselves, how do we determine whether a person does have a legitimate privacy interest?
Ossifying fibroma of the mandible with primary hyperparathyroidism due to non-familial parathyroid adenoma
Authors: Harimaya A , Tsubota H , Hoki K , Sato J , Kondo A , Yamada T , Seki N , Ikeda H , Himi T
Published: November 2006

Ossifying fibroma is an uncommon benign osteogenic neoplasm arising from cells of the periodontal ligament, typically with a slowly progressive enlargement of the affected bone. The neoplasm sometimes presents with hyperparathyroidism, most of which cases are due to familial parathyroid tumours. We report a rare case of ossifying fibroma of the mandible which showed very rapid growth and presented with primary hyperparathyroidism due to non-familial parathyroid adenoma. Despite improvement of parathyroid dysfunction after removal of the parathyroid adenoma, the tumour continued to grow very aggressively. The case required partial mandibular resection for complete resection of the tumour, and fixation of the remaining mandible with a titanium plate.
Rhinocerebral mucormycosis with orbital and intracranial extension: a case report and review of optimum management
Authors: Munir N , Jones N S
Published: November 2006

Rhinocerebral mucormycosis is a devastating, rapidly progressive and often fatal opportunistic fungal infection predominantly affecting individuals with underlying metabolic and/or immunological compromise. Intracranial extension of the disease has invariably been associated with mortality.

We present a review of optimum management of rhinocerebral mucormycosis and a case report of sinonasal mucormycosis with intracranial and orbital extension which was treated successfully with a combination of systemic liposomal amphotericin B therapy and wide surgical debridement.
Sphenochoanal polyp with heterotopic glial tissue
Authors: Nayak D R , Pujary K , Valiathan M , Parul P , Kamat A
Published: November 2006

An isolated polyp arising from the sphenoid sinus is rare. Due to the presence of important structures adjacent to the sphenoid sinus, a proper pre-operative radiological and nasal endoscopic evaluation is mandatory, along with a neurological and ophthalmological assessment. We report the case of a 23-year-old man with a sphenochoanal polyp with heterotopic glial tissue in the stroma. A Medline search did not reveal any previously reported cases of glial tissue in the sphenoid sinus presenting as a sphenochoanal polyp.
Topical antibiotic ototoxicity: does it influence our practice?
Authors: Ho E C , Alaani A , Irving R
Published: November 2006

Introduction: We hypothesised that general practitioners and ENT specialists manage discharging ears differently. This study was designed to investigate this further.

Methods and materials: Postal questionnaires were sent to all general practitioners in the Birmingham area and all UK consultants on the British Association of Otolaryngology–Head and Neck Surgery address list.

Results and discussion: In the presence of an intact tympanic membrane, 99 per cent of consultants and 90 per cent of general practitioners would use topical antibiotics. In the presence of a perforated tympanic membrane, 97 per cent of consultants would continue to use topical antibiotics, compared with only 43 per cent of general practitioners. This was attributed to a fear of ototoxicity. If a topical non-ototoxic antibiotic of proven efficacy could be made available, 93 per cent of consultants and 88 per cent of general practitioners in this study would seriously consider using it as first line treatment.

Conclusion: The majority of general practitioners would not use topical antibiotics in the presence of a perforated tympanic membrane. Most doctors would consider using a non-ototoxic topical antibiotic as first line treatment should one be made available.
A multi-centre prospective case-control study of campylobacter infection in persons aged 5 years and older in Australia
Authors: STAFFORD R. J. , SCHLUTER P. , KIRK M. , WILSON A. , UNICOMB L. , ASHBOLT R. , GREGORY J. ,   the OzFoodNet Working Group
Published: November 2006

There are an estimated 277 000 cases of campylobacteriosis in Australia each year, most of which are thought to be sporadically acquired. To explore causes for these infections, we conducted a multi-centre case-control study of patients and community controls across five Australian States during 2001–2002. A total of 881 campylobacter cases and 833 controls aged ⩾5 years were recruited into the study. Crude logistic analyses were conducted within various food and non-food exposure groups. A final most parsimonious multivariable logistic regression model was developed and adjusted odds ratios (aOR), 95% confidence intervals (95% CI) were derived together with adjusted population attributable risks (PAR). Consumption of undercooked chicken (aOR 4·7, 95% CI 2·6–8·4) and offal (aOR 2·0, 95% CI 1·0–4·0), ownership of domestic chickens aged <6 months (aOR 12·4, 95% CI 2·6–59·3) and domestic dogs aged <6 months (aOR 2·1, 95% CI 1·1–4·2) were found to be independent risk factors for illness in the final model. The PAR proportions indicate that eating chicken meat, either cooked or undercooked may account for approximately 30% of campylobacter cases that occur each year in Australia. These results justify the continued need for education of consumers and foodhandlers about the risks associated with the handling of raw chicken and the potential for cross-contamination.
TWO NEW SPECIES OF ORMOSIA (LEGUMINOSAE – PAPILIONOIDEAE, SOPHOREAE) FROM MESOAMERICA
Authors: ZAMORA N. A.
Published: December 2006

Two new species of Ormosia (Leguminosae – Papilionoideae, Sophoreae) are described: Ormosia carinata N.Zamora and Ormosia intermedia N.Zamora.
THREE NEW SPECIES OF CHILOCARPUS (APOCYNACEAE – RAUVOLFIOIDEAE) FROM MALESIA
Authors: MIDDLETON D. J .
Published: December 2006

Three new species of Chilocarpus (Apocynaceae – Rauvolfioideae) from Malesia are described: Chilocarpus hirtus D.J.Middleton, Chilocarpus pubescens D.J.Middleton and Chilocarpus sarawakensis D.J.Middleton. Preliminary conservation assessments are proposed.
A SYNOPSIS OF THE GENUS BERLINIA (LEGUMINOSAE – CAESALPINIOIDEAE)
Authors: MACKINDER B. A. , HARRIS D. J.
Published: December 2006

Berlinia Sol. ex Hook.f. (Leguminosae – Caesalpinioideae) is under investigation with two main goals: (i) to delimit and describe the species, and (ii) to elucidate their relationships. Delimitation and description is now largely completed and is presented in this synopsis. The genus Berlinia is assessed as comprising 18 species. Keys to the species are presented and for each species a brief description, selected synonymy and specimen citations are given. A monograph of Berlinia including a full taxonomic treatment and the results of the phylogenetic investigation will be published later by the senior author.
NEW PROOF OF THE EXISTENCE OF EQUILIBRIUM IN A SINGLE-SECTOR GROWTH MODEL
Authors: ALIPRANTIS CHARALAMBOS D. , BORDER KIM C. , BURKINSHAW OWEN
Published: November 2006

We present a new simple and short proof of the existence of
equilibria in the classical single-sector growth model.
MONEY AS A MEDIUM OF EXCHANGE WHEN GOODS VARY BY SUPPLY AND DEMAND
Authors: CUADRAS-MORATÓ XAVIER , WRIGHT RANDALL
Published: November 2006

Models of the exchange process based on search theory can be used to
analyze the features of objects that make them more or less likely to
emerge as money in equilibrium. These models illustrate the
trade-off between endogenous acceptability (an equilibrium property)
and intrinsic characteristics of goods, such as storability or
recognizability. We look at how the relative
supply and demand for various goods affect their likelihood of
becoming money. Intuitively, goods in high demand and/or low supply
are more likely to appear as commodity money, subject to the
qualification that which object ends up circulating as a medium of
exchange depends at least partly on convention. Welfare properties
and fiat money are discussed.
VALUING THE FUTURES-MARKET PERFORMANCE GUARANTEE
Authors: CRAINE ROGER
Published: November 2006

Futures-market exchanges guarantee the performance of all contracts
to encourage active trading between anonymous partners. Traders buy
from or sell to the clearinghouse. The exchanges rely primarily on a
margin system — traders post a performance bond that they forfeit if
they default — to manage their risk exposure. The market
value of the performance guarantee is the amount a trader would have to pay to
insure his performance if there were no exchange guarantee. An
underpriced guarantee subsidizes high-risk traders and ultimately
undermines the credibility of the exchange's commitment to perform.
An adequate margin policy fairly prices the exchange performance
guarantee within an (economically insignificant)
varepsilon
neighborhood. I show that the value of a call (put) option with a
strike price equal to the futures price minus (plus) the margin is an
upper bound to the market value of the exchange's performance
guarantee. The probability that the futures price change exceeds the
margin is the probability that the option
expires “in the money.” I
estimate the value of the option on the December S&P 500 futures
contract during the market crash in October 1987 to illustrate the
technique. For the first half of the month the value of the
performance guarantee was fairly priced. On the day of the crash it
was underpriced by as much as 10% of the value of the futures
contract. Futures-market margin committees moved quickly; by the end
of the month the value of the performance
guarantee was fairly priced.
SELF-FULFILLING PROPHECIES AND THE BUSINESS CYCLE
Authors: FARMER ROGER E.A. , WOODFORD MICHAEL
Published: November 2006

We demonstrate that multiple stationary rational-expectations
equilibria exist in a version of Lucas's island economy. The
existence of these equilibria follows from the fact that there
is an indeterminate set of monetary equilibria in the two-period
overlapping-generations
model. We show how to construct stationary
rational-expectations equilibria by randomizing over the set of
nonstationary monetary equilibria. In some of our equilibria, a
positively sloped Phillips curve exists even though our economy
contains no signal-extraction problem as in the original Lucas paper.
Our equilibria are indexed by beliefs and are examples of the
existence of sunspot equilibria in which allocations may differ
across states of nature for which preferences, technology, and
endowments are identical. Our technique for constructing stationary
sunspot equilibria should prove useful in a wide class of models in
which an indeterminate stationary equilibrium exists.
COORDINATION, CREDIT, AND AN ELASTIC CURRENCY
Authors: BRYANT JOHN
Published: November 2006

The market economy is modeled as a decentralized joint production
system. Markets in such an economy require the use of money or credit
instruments to facilitate exchange. As a result, market economies are
at risk for monetary instability induced by real-side production
coordination failure. In particular, economies decentralized via
centralized wholesaling markets are subject to precipitous collapses.
The most stable monetary system is trade in specie. However, there
very likely is a scarcity of specie, which generates inefficiency and
discourages production. There is, then, a need for an elastic
currency. Bank-issued bills of exchange are a perfectly elastic
medium and eliminate the scarcity of specie and its attendant
inefficiency, but are a less stable monetary system than is trade in
specie. In the trade-off between elasticity and stability, fiduciary
currency (or fiduciary deposits) lies between specie and bank-issued
bills of exchange.
Implementation and experiences of an intraoperative radiotherapy service
Authors: Armoogum K. , Ackland C. , Gardner J.
Published: November 2006

Intraoperative radiotherapy (IORT) using a miniature X-ray source has the potential to impart the same clinical benefit as external beam radiotherapy (EBRT), in a single fraction. The patient benefits are significant, since IORT could replace several weeks of fractionated EBRT. We present our initial experiences of IORT using the Zeiss Intrabeam™ system for treating early stage breast cancer and intracranial malignancies. Implementing this treatment modality requires a multidisciplinary approach drawing on the expertise of surgeons, oncologists, medical physicists, anaesthesiologists, nursing staff and pathologists. Team coherence is facilitated by a nurse co-ordinator. We have treated 66 patients in 24 months. For breast tumours, the mean treatment time was 28.54 min and the applicator sizes ranged from 3.0 to 5.0cm (mode = 4.5cm). A dose of 5Gy is prescribed to spherical volume of 1cm from the applicator surface. For brain tumours, the mean treatment time was 19.70 min and the applicator sizes ranged from 1.5 to 3.5cm (mode = 2.5cm). Mean dose was 11.1Gy prescribed to a spherical volume of 0.5cm from the applicator surface.

A multidisciplinary team is essential for the successful implementation of IORT. This paper describes how, through reliance on an oncology nurse specialist to co-ordinate the programme, we have successfully set-up an IORT service.
A feasibility study of an internal control methodology using hydrocortisone cream for the management of skin reactions in patients receiving radical radiation therapy for cancers of the head and neck
Authors: Sperduti A. , Cashell A. , Rocca C. , Hirji A. , Billingsley S. , Waldron J. , Pond G.
Published: November 2006

Background: The literature on the evaluation of the management of radiation-induced dermatitis demonstrates the methodological difficulties of studying this subject. Therefore, the feasibility of a methodology whereby the patient acted as their own control was used to study acute cutaneous side effects for head and neck radiotherapy patients using 1% hydrocortisone cream (HC).

Methods: Twenty patients were asked to apply Hyderm (1% hydrocortisone) cream twice daily to one side of the treatment area (either right or left) beginning on day one of radiation therapy and ending 2 weeks post-radiation therapy. The centres standard skin care protocol using mild soap and water and no creams was used on the other side of the neck. Once weekly the patients were assessed and scored using the Radiation-Induced Skin Reaction Scale and Radiotherapy and Oncology Group assessment scales and the patient completed a symptom scoring scale each week was a baseline assessment undertaken before they started treatment. To document compliance with study instructions, patients were asked to keep a calendar indicating when they applied the cream and to which side, and this was collected by clinical staff.

Results: At the conclusion of the study, 12 patients were enrolled. During the course of the study it became increasingly obvious that the side to which patients were applying the Hyderm scored higher on the assessment scale, indicating an increased skin reaction than the control side. This was confirmed with the photographs and patient symptom scale. As a result of these increased reactions, the study ceased accrual earlier than anticipated and all patients were advised to discontinue Hyderm use.

Conclusion: The increase in skin toxicity was unexpected, particularly as the institutional standard of care recommended the use of HC as treatment for radiation dermatitis. The number of patients in the study was too small to make conclusive statements about the efficacy of HC. We were able to confirm the feasibility of using an internal control methodology in these patients. Compliance results indicate the skin care instructions were clearly written and patients were able to follow them.
Dilemmas in gaining consent for radical radiotherapy from patients with early stage prostate cancer
Authors: Treeby J.
Published: November 2006

Prostate cancer is a common male cancer, and arguably the form of cancer with least certainties about most appropriate form of treatment, leading to a greater freedom of choice among patients as to which treatment they wish to undertake.

Department of Health guidelines state that to be valid, consent to treatment must be fully informed, and professional bodies demand that consent should be ongoing throughout a course of treatment. It is recognised that in spite of the wealth of information available, prostate cancer patients generally feel less well informed about their disease and treatment than those with any other form of cancer.

Information about treatment efficacy and outcome is available from a wide variety of sources, of varying reliability, and patients can as easily receive too much information as they can too little. Bias from those imparting information cannot be excluded, and patient choices could be made on the basis of inaccurate or misleading information.

Practitioners have a duty of care to ensure that patients receive a level of information appropriate to their level of understanding and ability to absorb knowledge, and longstanding legal precedents are established to ensure that risks as well as benefits of treatment are discussed with patients.
A critical evaluation of the clinical value of high-dose rate brachytherapy in the treatment of prostate cancer
Authors: Sharman E. C.
Published: November 2006

Prostate cancer has been treated with low-dose rate (LDR) brachytherapy for early localised disease in the form of permanent seed implants, with all its inherent problems in terms of dosimetry and seed migration. High-dose rate (HDR) brachytherapy has mainly been utilised as a boost to external beam radiotherapy (EBRT) in patients with locally advanced disease. However, limited studies investigating HDR as a monotherapy for early local disease are yielding promising results in terms of biochemical control and reduced toxicity. With the ability to optimise the plan and conform the dose, dose escalation can be achieved whilst sparing normal tissue. Recent studies to assess the α/β ratio of prostate cancer have shown this to be low, making this tumour sensitive to large fractions or hypofractionation. The HDR delivery and large fraction sizes may be advantageous in tumours sensitive to radiation fraction size making HDR brachytherapy the treatment of choice over LDR brachytherapy and EBRT.
Molecular mimicry and horror autotoxicus: do chlamydial infections elicit autoimmunity?
Authors: Swanborg Robert H. , Boros Dov L. , Whittum-Hudson Judith A. , Hudson Alan P.
Published: November 2006

All species of the order Chlamydiales are obligate intracellular eubacterial pathogens of their various hosts. Two chlamydial species, Chlamydia trachomatis and Chlamydia pneumoniae, are primarily human pathogens, and each is known to cause important diseases. Some strains of C. trachomatis are sexually transmitted and frequently cause severe reproductive problems, primarily in women. Other strains of the organism serve as the aetiological agents for blinding trachoma, still the leading cause of preventable blindness in underdeveloped nations. C. pneumoniae is a respiratory pathogen known to cause community-acquired pneumonia. Importantly, both organisms engender an immunopathogenic response in the human host, and both have been associated with widely diverse, relatively common and currently idiopathic chronic diseases, most of which include an important autoimmune component. In this article, we explore the available experimental data regarding the possible elicitation of autoimmunity in various contexts by chlamydial infection, and we suggest several avenues for research to explore this potentially important issue further.
The Role of a Right Fronto-Parietal Network in Cognitive Control
Authors: Fassbender C. , Simoes-Franklin C. , Murphy K. , Hester R. , Meaney J. , Robertson I.H. , Garavan H.
Published: December 2006

Seemingly distinct cognitive tasks often activate similar anatomical networks. For example, the right fronto-parietal cortex is active across a wide variety of paradigms suggesting that these regions may subserve a general cognitive function. We utilized fMRI and a GO/NOGO task consisting of two conditions, one with intermittent unpredictive “cues-to-attend” and the other without any “cues-to-attend,” in order to investigate areas involved in inhibition of a prepotent response and top-down attentional control. Sixteen subjects (5 male, ages ranging from 20 to 30 years) responded to an alternating sequence of the letters X and Y and withheld responding when the alternating sequence was broken (e.g., when X followed an X). Cues were rare stimulus font-color changes, which were linked to a simple instruction to attend to the task at hand. We hypothesized that inhibitions and cues, despite requiring quite different responses from subjects, might engage similar top-down attentional control processes and would thus share a common network of anatomical substrates. Although inhibitions and cues activated a number of distinct brain regions, a similar network of right dorsolateral prefrontal and inferior parietal regions was active for both. These results suggest that this network, commonly activated for response inhibition, may subserve a more general cognitive control process involved in allocating top-down attentional resources.
Item Response Theory Models and Testing Practices: Current International Status and Future Directions ٭ ٭Invited paper presented at the 23rd International Congress of Applied Psychology, Madrid, Spain. ٭Laboratory of Psychometric and Evaluative Research Report No.229. Amherst, MA: University of Massachusetts, School of Education.
Authors: Hambleton Ronald K. , Slater Sharon C.
Published: November 2006

Psychological testing has been undergoing major changes. One of the main changes is the transition from the use of classical to modern test models and methods in test development. The purposes of this paper are to describe the shortcomings of classical test models which are overcome with modern test theory, i.e., item response theory, to introduce the basic concepts of item response theory, to describe several important international applications of item response theory models, and finally, to describe some likely IRT directions in the next century.
Towards an Integrated Analysis of Bias in Cross-Cultural Assessment
Authors: van de Vijver Fons J. R. , Poortinga Ype H.
Published: November 2006

A central methodological aspect of cross-cultural assessment is the interpretability of intergroup differences: Do scores obtained by subjects from different cultural groups have the same psychological meaning? Equivalence (or the absence of bias) is required in making valid cross-cultural comparisons. As cross-cultural comparisons are becoming increasingly popular and important, the problem of bias and its detection is receiving increased attention from researchers. Three kinds of bias are discussed and illustrated, namely construct bias, method bias, and item bias (or differential item functioning). Methods to identify bias are reviewed. An overview is given of common sources of each kind of bias. It is argued that an integrated treatment of all forms of bias is needed to enhance the validity of cross-cultural comparisons. The predominant focus on item bias techniques has the unfortunate implication that construct and method bias are examined insufficiently.
Energy release and heat generation during the 1999 Ms7.6 Chi‐Chi, Taiwan, earthquake
Authors: Wang Jeen‐Hwa
Published: November 2006

On 20 September 1999, the Ms7.6 Chi‐Chi earthquake ruptured the Chelungpu fault in central Taiwan. Integrating observed and inversed results of source parameters, the fracture energy, Eg, and frictional energy, Ef, on the fault and its northern and southern segments are estimated. Together with given values of strain energy, ΔE, and seismic radiation energy, Es, the seismic efficiency, i.e., η = Es/ΔE, and the radiation efficiency, i.e., ηR = Es/(Es + Eg), are evaluated. The average fracture energy per unit area, G, is also calculated from Eg. The frictional heat caused by dynamic frictional stress is calculated from Ef. Results show a marked difference in source properties between the two segments. The average frictional and ambient stress levels on the two segments are estimated. The total energy budget of and heat generated by the earthquake are elucidated based on a two‐dimensional faulting model with frictional heat. Both observed and calculated results suggest the possible existence of fluids, which produced suprahydrostatic gradients, on the fault during faulting. Lubrication and thermal fluid pressurization might play a significant role on rupture.
Regional P wave velocity structure of the Northern Cascadia Subduction Zone
Authors: Ramachandran K. , Hyndman R. D. , Brocher T. M.
Published: November 2006

This paper presents the first regional three‐dimensional P wave velocity model for the Northern Cascadia Subduction Zone (SW British Columbia and NW Washington State) constructed through tomographic inversion of first‐arrival traveltime data from active source experiments together with earthquake traveltime data recorded at permanent stations. The velocity model images the structure of the subducting Juan de Fuca plate, megathrust, and the fore‐arc crust and upper mantle. Beneath southern Vancouver Island the megathrust above the Juan de Fuca plate is characterized by a broad zone (25–35 km depth) having relatively low velocities of 6.4–6.6 km/s. This relative low velocity zone coincides with the location of most of the episodic tremors recently mapped beneath Vancouver Island, and its low velocity may also partially reflect the presence of trapped fluids and sheared lower crustal rocks. The rocks of the Olympic Subduction Complex are inferred to deform aseismically as evidenced by the lack of earthquakes within the low‐velocity rocks. The fore‐arc upper mantle beneath the Strait of Georgia and Puget Sound is characterized by velocities of 7.2–7.6 km/s. Such low velocities represent regional serpentinization of the upper fore‐arc mantle and provide evidence for slab dewatering and densification. Tertiary sedimentary basins in the Strait of Georgia and Puget Lowland imaged by the velocity model lie above the inferred region of slab dewatering and densification and may therefore partly result from a higher rate of slab sinking. In contrast, sedimentary basins in the Strait of Juan de Fuca lie in a synclinal depression in the Crescent Terrane. The correlation of in‐slab earthquake hypocenters M > 4 with P wave velocities greater than 7.8 km/s at the hypocenters suggests that they originate near the oceanic Moho of the subducting Juan de Fuca plate.
A note on the angular correction applied to fracture intensity profiles along drill core
Authors: Davy P. , Darcel C. , Bour O. , Munier R. , de Dreuzy J. R.
Published: November 2006

We derive the angular correction that has to be applied to borehole fracture intensities to recover the actual three‐dimensional distribution when the fracture networks have a length distribution. We assume that the fracture intensity is calculated from the fractures that fully transect the core. Because of the length distribution, the classical Terzaghi correction, which involves the cosine of fracture dip, is no longer valid. Solutions have been calculated in the specific case of fractal fracture networks with power law length distribution. We show that the Terzaghi correction may significantly overestimate the frequency of fractures subparallel to the borehole. The correction procedure proposed here was tested on a fracture database recorded at a study site for a repository of spent nuclear fuel located in SE Sweden, with three outcrop maps and three boreholes. A consistency between the dip distributions of outcrops and boreholes was achieved when applying the angular correcting term calculated with the power law length distribution deduced from outcrop maps.
Potential for carbon dioxide sequestration in flood basalts
Authors: McGrail B. Peter , Schaef H. Todd , Ho Anita M. , Chien Yi‐Ju , Dooley James J. , Davidson Casie L.
Published: December 2006

Flood basalts are a potentially important host medium for geologic sequestration of anthropogenic CO2. Most lava flows have flow tops that are porous and permeable and have enormous capacity for storage of CO2. Interbedded sediment layers and dense low‐permeability basalt rock overlying sequential flows may act as effective seals allowing time for mineralization reactions to occur. Laboratory experiments confirm relatively rapid chemical reaction of CO2‐saturated pore water with basalts to form stable carbonate minerals. Calculations suggest a sufficiently short time frame for onset of carbonate precipitation after CO2 injection that verification of in situ mineralization rates appears feasible in field pilot studies. If proven viable, major flood basalts in the United States and India would provide significant additional CO2 storage capacity and additional geologic sequestration options in certain regions where more conventional storage options are limited.
Teleconnections between the tropical Pacific and the Amundsen‐Bellinghausens Sea: Role of the El Niño/Southern Oscillation
Authors: Lachlan‐Cope Tom , Connolley William
Published: December 2006

Tropical Pacific–high southern latitude teleconnections are shown to be caused by Rossby wave dynamics and are sensitive to the exact pattern of sea surface temperature (SST) anomalies forcing anomalous ascent. Further, the signal becomes obscured by local natural variability at higher southern latitudes. Here it is shown that a Rossby wave with a source in the tropical Pacific can explain the general pattern of teleconnection found during the southern winter. Upper level divergence associated with deep convection in the tropical Pacific plays a major role in the generation of these Rossby waves. SST anomalies associated with El Niño/Southern Oscillation force the tropical deep convection. However, the relationship between deep convection and SST anomalies is complex and modeling experiments show that in areas of large‐scale subsidence positive SST anomalies would have to be larger than any observed anomalies (>4°C) before they have any effect on the vertical motion. Large variations are observed between the high‐latitude response to El Niño with apparently similar tropical forcings. This makes accurate prediction of the high‐latitude response to tropical change difficult. Ensemble GCM runs show that variations due to the natural variation of the zonal flow in the Southern Hemisphere can swamp the signal resulting from changes in the Rossby wave source region.
Ozone decrease outside Arctic polar vortex due to polar vortex processing in 1997
Authors: Akiyoshi H. , Sugata S. , Yoshiki M. , Sugita T.
Published: November 2006

We examine the effect of polar vortex processing on ozone concentrations outside the 1997 Arctic polar vortex. The Arctic vortex in this year was well isolated, cold, and circumpolar, and it broke up unusually late. However, time threshold diagnostics (TTD) analysis using a middle vortex boundary defined by the first derivative of the equivalent latitude gradient of potential vorticity and calculations using the nudging chemical transport model (CTM) of the Center for Climate System Research/National Institute for Environmental Studies (CCSR/NIES) show that there were intermittently several relatively large transport events from the vortex to the outside region in the lower stratosphere, with timescales and spatial scales that can be resolved at T42 CTM horizontal resolution (2.8° by 2.8° grid). These intermittent outflow events of polar air are also identified in TTD analysis using an outer vortex boundary defined by the second derivative of potential vorticity and a boundary defined by the N2O concentration. These intermittent events had a significant effect on the ozone concentration outside the vortex near the boundary in this year. A CTM calculation with a polar chemical ozone tracer shows that the effect on the ozone concentration outside the polar vortex near the vortex boundary in the equivalent latitude band of 55°–65°N and 450 K is 0.3 ppmv (15–20% of the ozone concentration at this height) and that on the total ozone is 12–15 Dobson units (1 DU = 0.001 atm cm) (3–4% of the total ozone) by the end of April just before the final vortex breakup. The effect in the equivalent latitude band of 30°–60°N is much smaller, with a reduction of 2 DU at the end of March and 4 DU by the end of April (less than 1% of the total ozone). The effect is about the half if we use the inner boundary or a boundary of 73°N equivalent latitude for the polar tracer calculations. The CTM calculations also show that these polar vortex processing effects might be masked at midlatitudes by the local gas phase chemical ozone production/loss reactions after mid‐April at 450 K and earlier than those at 500 K.