bluuebunny/crossref_metadata_2025 huggingface dataset:
Ground water in the A baione Cove landslide, Palos Verdes Peninsula, southern California
Authors: Proffer Kathleen A.
Published: May 2013

The Abalone Cove landslide, in southern California, is an 80 acre (32 ha) landslide within an ~870 acre (348 ha) ancient landslide complex. The landslide has developed in seaward-dipping marine strata of the middle Miocene Monterey Formation. The lower part of the landslide began moving by February 1974; the upper part did not appear to start moving until the spring of 1978. Since 1980, landslide movement has been con-trolled by the removal of ground water from the landslide mass.

During years of nearly normal rainfall, subsurface inflow was the major source of ground water, contributing 55%. Percolation of rainfall and of delivered water were second and third, contributing 22% and 19%, respectively. During years of nearly twice normal rainfall, percolation of rainfall was the major source of ground water, contributing 56%. Subsurface inflow, percolation of delivered water, and surface inflow contributed 27%, 9%, and 8%, respectively.

Prior to the installation of seven dewatering wells, the major loss of ground water was discharge to the surface by seeps at the toe of the landslide. The seeps accounted for 81% of the ground-water disposal. During the last two years of the study when the dewatering system was fully operational, surface seeps accounted for 34% of the ground-water disposal and pumping accounted for 54%. Other sources of ground-water disposal were evapotranspiration and subsurface outflow.
Childhood bilateral limbal stem cell deficiency: long-term management and outcome
Authors: Jain Rajat , Sangwan Virender S
Published: May 2013

A 6-year-old boy presented in 1998 with a 1 month history of lime injury in both eyes. Grade 4 chemical injury (Roper-Hall classification) progressed to total limbal stem cell deficiency in both eyes. Between July 2000 and July 2009, he cumulatively underwent 11 limbal stem cell transplantation surgeries, either direct or cultivated from either his father or mother, and 3 corneal transplants in both eyes. Each of the procedures led to a transient clearing of his visual axis to give vision in the range of 20/60 to 20/100 for a period of 1–3 months after which it failed. He finally underwent Boston keratoprosthesis implantation and now enjoys 20/20 vision with stable optic disc and visual field at a follow-up of 41 months. Timely intervention in childhood helped in prevention of amblyopia in this patient. Perseverance by the patient, his relatives and treating ophthalmologist is very important.
Neonatal screening for the cystic fibrosis main mutation ΔF508 in Estonia
Authors: Klaassen T , Teder M , Viikmaa M , Metspalu A
Published: May 2013

In this pilot study the frequency of ΔF508 mutation carriers, their geographic distribution, and the prevalence of cystic fibrosis (CF) in Estonia were investigated. During the screening programme 7396 newborns were tested for ΔF508 mutation and 88 were found to carry this deletion. The mean frequency of ΔF508 mutation carriers in Estonia was thus estimated as 1 out of 84 live births. In eight separate districts of Estonia the heterozygote frequencies differed significantly (p=0.0369), with the highest incidence (1:36) on the Baltic Sea islands and western coastal region and with the lowest in south eastern parts of Estonia (1:129).
Development of the phenylketonuria screening programme in Estonia
Authors: Õunap K , Lilleväli H , Metspalu A , Lipping-Sitska M
Published: May 2013

Objective To develop the phenylketonuria (PKU) screening programme in Estonia.

Method All data about patients with PKU, born during 1980–92, were documented to establish its prevalence at birth in Estonia. Newborn screening for the diagnosis and treatment of PKU was started in Estonia in 1993 and the prevalence at birth established by screening. Phenylalanine was determined from filter paper blood by a modified fluorometric method based on enhancement of the fluorescence of a phenylalanine-ninhydrin reaction product by L-leucyl-L-alanine.

Results During three years (1993–5) 36 074 newborns (85% of the total) were screened for PKU. PKU was diagnosed in six cases during the first four to six weeks of life. All investigated cases could be classified as classical PKU. No cases of mild forms of hyperphenylalaninaemia were diagnosed. The retrospective study showed an average incidence of PKU of 1 in 8090, the prospective study identified a comparable incidence of 1 in 6010 live births.

Conclusion The prevalence at birth of classic PKU in Estonia is higher than the average in Europe and similar to that of some eastern and middle European countries.
A comparative study of routine versus selective fetal anomaly ultrasound scanning
Authors: Long G , Sprigg A
Published: May 2013

Objectives To evaluate the cost-benefit of changing from selective (high risk) to routine ultrasound screening for fetal anomaly.

Setting Women booked by general practitioners for primary antenatal care at their local hospital.

Methods Prospective study of the 12 months before and after introduction of routine second trimester ultrasound for fetal anomaly at our institution. All congenital abnormalities, mode of detection, and outcome were recorded and a cost analysis of the programme attempted.

Results In the 12 months of selective (high risk) ultrasound policy, detailed second trimester scans were performed in 1007 (26%) pregnancies. In the 12 months of routine ultrasound anomaly screening, scans were performed in 3529 (93%) pregnancies. Routine ultrasound was the sole method of detection for 11 major and 18 less severe congenital abnormalities found in low risk pregnancies which would not previously have qualified for high risk ultrasound. In seven of these cases the parents opted for termination of pregnancy, with estimated savings on treatment and long term care of £1 015 546. The financial cost of providing the ultrasound screening service at our hospital for 12 months was calculated at £57 573 and the resulting financial benefit for the year was estimated at £957 973.

Conclusion Although it is recognised that many of the emotional and psychological costs and benefits of the service are difficult to evaluate, routine fetal anomaly ultrasound would seem to be economically justifiable. The financial savings achieved at our hospital would translate into a potential annual saving for the National Health Service of nearly £170 million if screening were offered in all hospitals in England and Wales.
Calculation of roc curves in multidimensional likelihood ratio based screening with Down's syndrome as a special case
Authors: Larsen S O , Christiansen M , Nørgaard-Pedersen B
Published: May 2013

Objectives The development of algorithms and computer programs for the analysis of screening performance in situations with multiple normally (Gaussian) distributed selection markers and a priori risks depending on a stratification of the population.

Methods The S-PLUS programming language was used to construct programs producing distributions of log likelihood ratios based on the Monte Carlo simulation. These distributions were used to construct programs for the calculation of roc curves, including a possible stratification of the population.

Results S-PLUS programs for the analysis of screening performance are listed and described. The programs can be used without any special knowledge of S-PLUS. An example of the use of the programs is given.
Do the beliefs of Australian general practitioners about the effectiveness of cancer screening accord with the evidence?
Authors: Young J , Ward J , Sladden M
Published: May 2013

A national random sample of 855 Australian general practitioners was surveyed about their belief in the effectiveness of cancer screening tests in reducing premature mortality. Responses were then compared with scientific evidence of effectiveness for each test. 92% of respondents believed mammography to be effective compared with only 38% for faecal occult blood testing, despite comparable evidence of effectiveness from randomised controlled trials. Seven tests outranked their belief in faecal occult blood testing, despite weaker evidence. Further efforts are required to align general practitioners' beliefs better with the evidence.
Results from the Ontario breast screening program, 1990–1995
Authors: Libstug A R , Moravan V , Aitken S E
Published: May 2013

Objective The Ontario breast screening program (OBSP) is a provincial breast screening programme offering two view mammography, clinical breast examination, instruction in breast self examination, and systematic two year recall to Ontario women 50 years and older. This paper presents the results of the programme's intermediate outcomes from 1990 to 1995 and compares them with recommended standards and other published programmes.

Methods Programme data from a provincial screening programme in a large Canadian province were collated from 18 sites in operation between July 1990 and December 1995.

Results In its first five years of operation, 215 738 screens were performed on 142 173 women. The referral rates for initial and rescreens are 13.8% and 8.6% respectively. A total of 1718 women were diagnosed with cancer, 1325 at initial screens and 393 at rescreens, resulting in cancer detection rates of 9.3 and 5.3/1000. The cancer detection rates for invasive cancers were 8.3/1000 at initial screens and 4.5/1000 at rescreens. The benign to malignant biopsy ratio was 1.5:1 at initial screens and 1.3:1 at rescreens. Of the 1358 cancers diagnosed at initial screens, 11.6% were in situ and 50.3% of invasive cancers of known size were <15 mm. For women with invasive cancer where nodal status was known, 71.3% were node negative. The proportions at rescreens were 15.7%, 60.0%, and 76.0% respectively.

Conclusions While the OBSP has achieved the standards suggested by other studies and programmes during its first five years of operation, there is work to be done to increase participation and obtain more complete data on tumour size and nodal status.
Slippage in the NHS breast screening programme: an assessment of whether a three year screening round is being achieved
Authors: Faux A M , Lawrence G M , Wheaton M E , Wallis M G , Jeffery C L , Griffiths R K
Published: May 2013

Background The NHS breast screening programme (NHSBSP) was established in 1987 to screen women aged 50–64 every three years to achieve a significant reduction in breast cancer mortality. Ensuring that women are re-invited every three years (that is, a three year screening round is in operation) is becoming increasingly difficult as pressure on the service rises. Coverage measures the proportion of eligible women receiving a screen in the previous three years and is currently used as an NHS performance indicator, while uptake measures the proportion of invited women who attend for screening. Data for 1996/1997 for the West Midlands NHSBSP show that, although uptake among 50–64 year olds was in excess of the 70% target at 78%, coverage was 10% below this at 68%. The discrepancy between coverage and uptake is likely to in part reflect “round slippage” in which women are re-invited at three years or more from their previous screen. To investigate the extent to which slippage is occurring in the region a technique for assessing round length independently of coverage was developed.

Methods Records for women receiving routine recall (incident) screens between 1994 and 1997 in the West Midlands NHSBSP were examined and the time between the most recent screen and the previous screen measured in months.

Findings Of 73 785 women screened in 1996/1997, 46.3% had a round length of under three years, although 74.9% had been re-screened within 38 months of the previous screen. Overall the regional programme was estimated to have a round slippage of approximately two months.

Conclusions The West Midlands NHSBSP operates to high standards in terms of uptake and cancer detection, but round slippage must be reduced. The lack of quantitative data with which to assess round length has hindered assessment in the past. The simple technique developed in this study will allow assessment of round length to be used routinely as the key quality assurance measure for the programme.
Planning for a possible national colorectal cancer screening programme
Authors: Garvican L
Published: May 2013

This report presents the planning, projected costs, and manpower requirements for a possible national colorectal cancer screening programme. Screening would be offered to all those aged 50–69, who comprise 20% of the United Kingdom population. The initial screening test would be faecal occult blood testing every two years. A local programme, administered by a screening centre serving a population of one million, would be responsible for inviting 100 000 subjects a year. The response rate in Nottingham, the UK trial centre, was below 60%. Good informed compliance would require the active support of primary care. The invitation and test kit would be sent by post, and completed tests returned to the screening centre, for reading and reporting. Those with a positive initial screen (about 2%) would be recalled for assessment. This would result in 60 000 investigations each year across England and Wales, given a screening uptake rate of 60%. Clearly any deviation from this predicted rate would have a major effect on resources. Assessment and any subsequent treatment would be by a multidisciplinary team working at the cancer unit, as recommended in recent NHS executive guidance. The best method for investigation is colonoscopy. When completed successfully this allows visualisation of the whole bowel. However, performance varies widely across the UK, and there is insufficient skilled manpower to undertake this additional workload. Most significantly the technique has a mortality rate of 0.02%, so the programme might expect 12 deaths a year, which would not be acceptable. Alternatively, assessment of screen positive cases could be by a combination of double contrast barium enema and flexible sigmoidoscopy, with a comparable sensitivity. Both procedures have much lower morbidity and mortality rates. Colonoscopy would then only be required for a smaller number of patients, with cancer or suspicious lesions, or after unsatisfactory investigations. Quality assurance should be an integ- ral part of the programme, as in the other NHS cancer screening programmes, involving all professional groups and coordinated by a regional quality assurance reference centre. Cost estimates are over £40 million a year, together with any allowance for general practitioners, with additional capital and training costs at the start of the programme. Given a 60% overall uptake rate, a test sensitivity of 60%, and a recall rate of 2%, about 35% of the cases of colorectal cancer in the eligible population—that is, about 5400 cases, could be detected each year. As this would also depend on maintaining good compliance, a continuing value of 4000 cases is more realistic. Appreciable savings on costs of treatment are unlikely as aggressive curative treatments would be expensive.
A comparison of cancer detection rates achieved by breast cancer screening programmes by number of readers, for one and two view mammography: results from the UK National Health Service breast screening programme
Authors: Blanks R G , Wallis M G , Moss S M
Published: May 2013

Objective To determine the increased cancer detection rate, if any, of programmes in the UK National Health Service breast screening programme (NHSBSP) using more than single reading of mammograms.

Design Information on the detection of cancers by individual screening programmes from annual (KC62) returns, supplemented by questionnaire information about the number of readers.

Setting The 87 NHSBSP programmes from England and Wales for the screening year 1 April 1996 to 31 March 1997. The study includes all programmes for prevalent screens where two views are mandatory, but excludes the four programmes using two view mammography for incident screening. Main outcome measuresCancer detection, invasive cancer detection, and small (<15 mm) invasive cancer detection by mammographic reading protocol using single reading as the reference level.

Results Programmes collectively using single reading detected the lowest rate of cancers at both prevalent (first) and incident (subsequent) screening. The highest rate of age standardised cancer detection was achieved by programmes using double reading with arbitration. At prevalent screens, where all programmes used two views, those programmes using double reading with arbitration detected 32% (95% confidence interval (CI) 3% to 69%) more small (<15 mm) invasive cancers than programmes using single reading. At incident screens, where all programmes analysed used one view this increased to 73% (95% CI 40% to 113%). Recall rates showed no obvious difference between single reading and the double reading protocols, being around 7% for prevalent screens and 3.5% for incident screens.

Discussion The results suggest that the increase in cancer detection resulting from increasing the number of readers depends on the number of views, and is higher for one view than two views. Single reading of one view results in a low detection rate of small invasive cancers for most individual programmes. It is, however, recognised that a small number of individual readers may achieve high detection rates with such a protocol. All groups of programmes using different reader/view protocols are on average close to or above target cancer detection rates, except those using single reading of one view (mediolateral oblique) at incident screens.
Newborn screening for haemoglobinopathies: the Brussels experience
Authors: Gulbis B. , Tshilolo L. , Cotton F. , Lin C. , Vertongen F.
Published: May 2013

Objectives To determine the prevalence of haemoglobinopathies and the need for neonatal screening for haemoglobinopathies in Brussels.

Methods Between December 1994 and June 1998 23 136 cord blood samples obtained in eight hospital nurseries of Brussels were systematically screened for haemoglobinopathies by isoelectric focusing.

Results 45% of the newborns were from regions at risk for haemoglobinopathies. Sickle cell disease was diagnosed for 11 neonates (0.048%) and β thalassaemia major for one neonate. Three hundred and fifty neonates (1.5%) were carriers for a haemoglobin variant, and Hb Bart's was found in 672 cases (2.9%). These prevalences are similar to those reported elsewhere in northern Europe.

Conclusions These results confirm the value of universal screening for haemoglobinopathies in Brussels.
The Scottish breast screening programme's experience of monitoring interval cancers
Authors: Everington D. , Gilbert F.J. , Tyack C. , Warner J.
Published: May 2013

Objectives To present the Scottish interval cancer data from 1991 to 1995, compare the Scottish experience with results published by other programmes and trials, and document appropriate methodologies to achieve maximum ascertainment of interval cancers.

Setting Scottish breast screening programme (part of the UK National Health Service breast screening programme).

Methods Interval cancers were identified by linking breast screening data with registrations of invasive breast cancers from the National Scottish Cancer Register. The main outcome measures were the numbers, rates, and proportionate incidence of interval cancers, and rates of total and small (<10 mm) screen detected invasive cancers diagnosed in this cohort of women.

Subjects Women who attended the Scottish breast screening programme (Scottish NHSBSP) from 1 April 1991 to 31 March 1995.

Results Interval cancer rates of 4.8, 12.1, and 12.1 per 10 000 women screened were calculated for the first, second, and third year after the last negative screen. Expressed as a proportion of the underlying incidence, the figures are 23%, 60%, and 59%.

Conclusions The Scottish data are comparable with those reported by other UK NHS breast screening programmes for the first and second years after the last negative screen. The interval cancer rate for the third year is appreciably lower. A longer follow up period would be of interest to provide greater evidence on which to base comparisons. Ascertainment of interval cancers depends vitally on the availability of complete, accurate, and timely national cancer registration data and highlights the value of national datasets.
Breast cancers missed in the prevalent screening round: effect upon the size distribution of incident round detected cancers
Authors: Maxwell A.J.
Published: May 2013

Objective To determine the effect of false negative screens (missed cancers) in the prevalent screening round on the relative size distribution of cancers detected at the first incident screen.

Setting The Bolton, Bury, and Rochdale breast screening programme.

Methods One hundred and three breast cancers detected in the first incident round of screening were analysed. The previous (prevalent round) screening films taken between two and four years earlier were subjected to blinded review and classified as either true negatives (no significant abnormality visible) or false negatives (a suspicious abnormality visible at the site of the subsequently detected cancer). The pathological size, type, and grade (where appropriate) of the cancers were recorded

Results Fifty one of the 103 cancers (49%) detected in the first incident round screen measured <15 mm in diameter. A total of 32 cases were classified as false negatives. Of these, 12 (38%) measured <15 mm in diameter. If all the false negative cancers had been detected at the prevalent screen, 39 (55%) of the remaining 71 cancers detected in the first incident round screen would have measured <15 mm. A relative excess of lobular carcinomas was found among the false negatives.

Conclusions The findings suggest that although false negative screens in the prevalent round increase the number of cancers available for detection at the first incident round screen, many of these cancers are still <15 mm in diameter at detection. Cancer detection performance in the prevalent screening round has only a minor influence on the relative proportion of small and large cancers detected at the first incident round screen.
Two models for radiological reviewing of interval cancers
Authors: Moberg K. , Grundström H. , Törnberg S. , Lundquist H. , Svane G. , Havervall L. , Muren C.
Published: May 2013

Objectives To compare two different review methods of examining how many of our interval cancers could be regarded as missed cases (overlooked and misinterpreted owing to observer's error).

Setting A mass screening programme in Stockholm 1989–91, performed at five independent screening units. 107 846 women attended for screening (70.6% of those invited), and 207 women with interval breast cancers were identified. Interval cancers from two of the units, 104 cases, are reviewed in this study.

Methods Screening examinations preceding the interval cancer diagnoses were reviewed both mixed with other screening images in a ratio 1:8 and non-mixed. Both internal reviewers (from the two units responsible for the screening mammograms) and external reviewers (from the other units) took part in the study.

Results The proportion regarded as missed cases varied between 7% and 34%, depending on what review method was used, and on the number of reviewers included to identify a case as missed. Mixed reviewing reduced the number identified as missed cases by 50% compared with non-mixed reviewing. Whether the reviewer was internal or external made no difference to the results.

Conclusions Comparing the rate of missed cases from different studies may be misleading unless the same review method is used. No difference in detection rate could be shown whether the radiologist reviewed images from his/her own screening unit or not. Most of our interval cancers were not regarded as missed cases by either of the two methods.
Attendance at cancer screening in the wake of widespread adverse publicity surrounding test results
Authors: Steadman L. , Field S. , Rutter D.
Published: May 2013

The largest error ever discovered in cervical smear test results was reported by an East Kent Hospitals' NHS Trust in 1996. To test whether the incident would have an impact on a separate NHS screening programme within the affected area, 1000 women who were due to be called for x ray mammography were asked how confident they would be about the accuracy of their mammogram result. Most women reported that they would be confident, but significantly fewer unconfident than confident women subsequently kept their appointment for breast screening. Attendance and non-attendance at breast screening in the area did not differ from previous screening rounds, suggesting that the error in the cervical cytology results had not adversely affected a separate screening programme.
Incidence among men of asymptomatic abdominal aortic aneurysms: estimates from 500 screen detected cases
Authors: Vardulaki K.A. , Prevost T.C. , Walker N.M. , Day N.E. , Wilmink A.B.M. , Quick C.R.G. , Ashton H.A. , Scott R.A.P.
Published: May 2013

Objectives To determine the incidence of asymptomatic abdominal aortic aneurysms and the implications for an ultrasound screening programme in England and Wales.

Methods First screen data were obtained from the Chichester and Huntingdon screening studies and used to estimate the prevalence of abdominal aortic aneurysms. The incidence of new, asymptomatic aneurysms was estimated from the prevalence rates observed in the Huntingdon screening study.

Setting Screening programmes in Huntingdon and Chichester using ultrasound to screen all men over the age of 50 and men over age 65 respectively.

Results The prevalence of abdominal aortic aneurysms ranged between 5.32% and 8.02% and between 6.18% and 9.88% of men aged between 65 and 79 in Chichester and Huntingdon respectively. Annual incidence rates, estimated by age, rose steadily reaching a peak of 0.67% of the Huntingdon population per year at age 65. Thereafter incidence falls. Estimates of the incidence of new asymptomatic abdominal aortic aneurysms, based on the observed prevalence data, were calculated and showed a peak at age 65.

Conclusions Hypotheses are offered to explain this unexpected early peak in incidence. This information should allow the definition of the optimum age for screening, and the relative benefits of screening at different intervals if widespread screening is adopted in the future.
Risk of cervical cancer after a negative Pap smear
Authors: Viikki M. , Pukkala E. , Hakama M.
Published: May 2013

Objective To evaluate whether five years is an appropriate screening interval for cervical cancer for the improvement of public health.

Setting Finland.

Methods 45 572 women with a cytological class I smear attending the mass screening programme organised every five years in Finland during 1971 to 1976 and followed up until the end of 1994. The data from the Nationwide Mass Screening Registry were linked to the Finnish Cancer Registry. Standardised incidence ratios of preinvasive and invasive cervical cancer with 95% confidence intervals (CI) were estimated, with rates for the total Finnish population as reference.

Results The standardised incidence ratio estimates were low initially after screening and then gradually increased up to the time of the next smear five years later. This pattern was repeated after each screening. The risk was persistently low for invasive cervical cancer even after 10 years of follow up, whereas the low risk for preinvasive lesions was of a shorter duration. The low risk associated with a negative smear became even lower with advancing age.

Conclusions Women who attend organised screening programmes and have a negative smear have a low risk of cervical cancer for over 10 years. Also, the relative risk of a preinvasive lesion after an initial negative smear is decreased for more than five years. Therefore, the five year screening interval in Finland is appropriate and effective in reducing the risk of invasive cervical cancer.
Combined α fetoprotein testing and ultrasonography as a screening test for primary liver cancer
Authors: Zhang B. , Yang B.
Published: May 2013

Objective To assess the validity and cost of a screening test for primary liver cancer using combined serum α fetoprotein testing and ultrasonography.

Setting An urban community in Shanghai, China.

Methods 9373 subjects aged 35 to 59 with positive hepatitis B surface antigen (HBsAg) or chronic hepatitis were studied. Outcome measures were detection rate, false positive rate, and positive predictive value, the cost for each primary liver cancer detected, and the average cost of detecting each additional primary liver cancer by the combined method. The number of small primary liver cancers detected was used for the economic evaluation.

Results 20 294 screening examinations were carried out. Primary liver cancer was detected in 51 subjects, 36 of whom had small primary liver cancer. When α fetoprotein and ultrasonography were used in parallel the detection rate, false positive rate, and positive predictive value were 92%, 7.5%, and 3.0%, respectively; the cost for each primary liver cancer detected was 30 206 RMB (Chinese currency, $3639). When ultrasonography was used alone the detection rate, false positive rate, and positive predictive value were 84%, 2.9%, and 6.6%, respectively; the cost for each primary liver cancer detected was 16 451 RMB ($1982). When the α fetoprotein test was used alone the detection rate, false positive rate, and positive predictive value were 69%, 5.0%, and 3.3%, respectively; the cost for each primary liver cancer detected was 25 139 RMB ($3029).

Conclusion The combination of both screening methods results in a relatively small increase in detection but a considerably higher false positive rate, increasing the costs. The combined test may be the best choice for primary liver cancer screening in developed areas of China, but otherwise, ultrasonography alone is the method of choice.
Issues in implementing prenatal screening for cystic fibrosis: results of a working conference
Authors: Haddow J.E. , Bradley L.A. , Palomaki G.E. , Doherty R.A.
Published: May 2013

Objective To summarise a conference convened to examine how cystic fibrosis screening might appropriately be introduced into routine prenatal practice.

Methods Participants included experts from various relevant disciplines. Systematic reviews and data from individual trials were presented; issues were identified and discussed.

Results Judged by published criteria, prenatal cystic fibrosis screening is suitable for introduction. Screening can be performed cost effectively by identifying racial/ethnic groups at sufficient risk and then using either of two models for delivering laboratory services. Validated educational materials exist. Ethical issues are not unique.

Conclusions Once adequate facilities for patient and provider education, testing, counselling, quality control, and monitoring are in place, individual programmes can begin prenatal screening for cystic fibrosis.
Women with false positive screening mammograms: how do they cope?
Authors: Olsson P. , Armelius K. , Nordahl G. , Lenner P. , Westman G.
Published: May 2013

Objectives To assess the long term psychological impact on women who were recalled for further investigation after mammography screening and to find any factors that might predict coping ability in order to identify those subjects who require additional support at an earlier stage.

Setting Counties of Västerbotten and Västernorrland, Sweden.

Methods A prospective design was used in which 252 recalled women completed questionnaires twice—once within a week of having received the all-clear and again at follow up six months later. A group of 1104 randomly selected, screen negative women were followed up in the same way for comparison. The questionnaire included the Psychological Consequences Questionnaire (PCQ) and basic sociodemographic data. The main outcome measure was the total score on the PCQ at six months.

Results Of the 252 women, 235 (93%) completed both questionnaires. In the control group, 987 (89.4%) women responded. Six months after the all-clear, recalled women were still significantly more anxious (p<0.001) than those who had been screened but not recalled. The strongest predictor of psychological distress at six months was the PCQ score at the first measurement. Other predictors were a low level of education, living in high density urban areas, and having only one child or no children at all. Widows appeared to cope better than other women.

Conclusions It is possible to define a group of women with false positive results who are already at risk of coping less effectively at the time of recall. Offering these women counselling or other types of support should be considered.
Implementation of screening as a public health policy: issues in design and evaluation
Authors: Hakama M. , Pukkala E. , Söderman B. , Day N.
Published: May 2013

Objective To propose principles of design and measures of effect for cancer screening as a public health policy.

Material Finnish routine screening programme with mammography.

Design Evaluation of mortality from breast cancer by before-after time trends among Finnish women, by geographical (by municipalities) comparisons, and by intention to screen at an individual level with individual controls who were cluster randomised and matched for age.

Outcome measuresStandardised mortality ratios (SMRs) from breast cancer (total), SMRs from breast cancers diagnosed during the screening programme (refined), deaths prevented, prolongation of life for each breast cancer detected, for each death prevented, for each compliant woman, for each screen, and for each invitation. Relative prolongation of life—that is, time gained versus time spent.

Results SMRs only at an individual level with deaths from cancers diagnosed during the screening programme and individually selected controls showed 24% protection, whereas the other SMR measures were too crude or biased because of dilution and selection. Prolongation of life varied from 15 years for each death prevented to two days for each woman screened, with approximation for the prolongation relative to time spent of 3 to 1.

Conclusions A public health policy should be introduced gradually. Those not covered immediately by the policy serve as controls and they should be randomly allocated. The most relevant outcome measure is prolongation of life, and for public health purposes it should be given per unit of intervention, such as screen or invitation, and also related to the time spent for the intervention. Such gains are often small in a Western society, which implies that medicine, including research, should focus more on other aspects of life than length.
The adherence ofTrichomonas vaginalisto host ectocervical cells is influenced by lactobacilli
Authors: Phukan Niha , Parsamand Tina , Brooks Anna E S , Nguyen Tan N M , Simoes-Barbosa Augusto
Published: May 2013

Objectives

Trichomoniasis is a common sexually transmitted disease, and adhesion of the pathogenTrichomonas vaginalisto the host vaginal cells is the first step in establishing infection. For this to happen, the pathogen has to overcome a natural protective barrier composed mostly of lactobacilli. The objective of this study was to understand the role of lactobacilli in the adhesion ofT vaginalisto host cells.

Methods

Adhesion assays were carried out by incubating vaginal epithelial cells (VECs) withT vaginalisand lactobacilli together and compared with non-lactobacilli recipient controls. By varying incubation parameters and testing several microbial isolates, the number of pathogens that adhered to the VECs was determined by flow cytometry.

Results

Overall, but with few exceptions, lactobacilli caused inhibition ofT vaginalisadhesion to a variable degree.Lactobacillus gasseriATCC 9857 and CBI3 (ambiguousLactobacillus plantarumorLactobacillus pentosus) caused the highest level of parasite adhesion inhibition and enhancement, respectively. These isolates ofLactobacilluscan profoundly alter the adhesive properties of low-adherent and high-adherent strains ofT vaginalisin a dose-dependent manner. Additionally, the effects of lactobacilli onT vaginalisadhesion are strictly contact-dependent, and surface lipoglycans ofT vaginalisare most likely not involved in this modulation of adhesion mediated by the bacteria.

Conclusions

Lactobacilli can modulate adhesion ofT vaginalisby significantly modifying the natural adhesive properties of variousT vaginalisstrains. This study highlights the importance of considering the role of the vaginal microbiota in the pathogenesis of trichomoniasis.
Trichomycetes associated with insects in lotic habitats (streams) within the Halifax Regional Municipality, Nova Scotia, Canada
Authors: William R.T. , Strongman D.B.
Published: May 2013

Reported from marine, freshwater, and terrestrial habitats, trichomycetes are an ecological group of both fungi and protists that colonize the guts of insects, crustaceans, and millipedes. Lotic sites (streams, rivers) are a rich source of hosts and their trichomycetes. As part of a larger study of trichomycetes from different aquatic habitats within the Halifax Regional Municipality in Nova Scotia, Canada, one stream from each of three separate watersheds was sampled for aquatic insects, and their guts were dissected and examined for microscopic trichomycetes. Over the course of 17 months, 24 species of trichomycetes were collected including the following four new species: Glotzia gemina sp. nov. R.T. William and Strongman from a mayfly (Baetidae); Stachylina tanysoma sp. nov. R.T. William and Strongman; Smittium ampliboja sp. nov. R.T. William and Strongman; and Smittium insolitum sp. nov. R.T. William and Strongman, all recovered from dipteran (Chironomidae) hosts. New continental records were established for three species including Smittium pusillum Manier & Coste and Stachylina euthena Manier & Coste, both originally described from France, and Smittium nodifixum Strongman & Shengquan Xu previously known only from China. A new regional geographical record for Pennella arctica Lichtw. & M.C. Williams is reported and 17 other species previously known from eastern Canada were recorded. Pteromaktron timberleaense R.T. William & Strongman was described by us from Timberlea, Nova Scotia, but at the time no sexual spores (zygospores) were seen. In the collections reported in this paper, zygospores were found so the original description is emended to include the zygospore features for this species. This report adds to the published data on trichomycetes from Nova Scotia that have appeared over the last 10 years and highlights the significance of long-term sampling in cataloguing the diversity of this group of insect associated microorganisms. We also present some data on seasonal variation in trichomycete occurrence and comment on site specificity in the trichomycetes we collected.
Improvement of capture efficacy of immunomagnetic beads forCampylobacter jejuniusing reagents that alter its motility
Authors: Huang Hongsheng , Phipps-Todd Beverley
Published: May 2013

Previous studies using the immunomagnetic beads separation (IMS) technique have shown high detection limits of live campylobacters but low detection limits of formalin-killed campylobacters. The present study investigated if the addition of various concentrations of reagents that alter the motility of live Campylobacter jejuni could enhance the recovery of the organisms by IMS. The addition of 5% glycerol, 0.001% formalin, 10% polyethylene glycol, or 0.001% agarose in a buffer slowed down the movement of C. jejuni and increased the recovery of live C. jejuni, using beads coated with specific monoclonal antibodies (mAbs). The highest recovery yielded was 5.2- ± 3.3-fold with 5% glycerol at 105colony-forming units (CFU)·mL−1. The addition of 5% glycerol also improved isolation at lower concentrations of C. jejuni (102to 104CFU·mL−1) in buffer. The recovery by IMS of C. jejuni killed by 1% formalin was increased up to as high as 17-fold compared with the recovery of live organisms, as detected using a real-time polymerase chain reaction assay. The reagents investigated did not enhance the immunological reactivity of the mAbs to this organism. These results indicate that the addition of several reagents enhanced the capture of C. jejuni by IMS, which could be partially due to the slowing down of the movement or the altering of the motility of C. jejuni and to the increasing of the contact time between C. jejuni and immunomagnetic beads.
QUANTUM NONLOCAL BOXES EXHIBIT STRONGER DISTILLABILITY
Authors: HØYER PETER , RASHID JIBRAN
Published: May 2013

The hypothetical nonlocal box (NLB) proposed by Popescu and Rohrlich allows two spatially separated parties, Alice and Bob, to exhibit stronger than quantum correlations. If the generated correlations are weak, they can sometimes be distilled into a stronger correlation by repeated applications of the NLB. Motivated by the limited distillability of NLBs, we initiate here a study of the distillation of correlations for nonlocal boxes that output quantum states rather than classical bits (qNLBs). We propose a new protocol for distillation and show that it asymptotically distills a class of correlated quantum nonlocal boxes to the value [Formula: see text], whereas in contrast, the optimal non-adaptive parity protocol for classical nonlocal boxes asymptotically distills only to the value 3.0. We show that our protocol is an optimal non-adaptive protocol for 1, 2 and 3 qNLB copies by constructing a matching dual solution for the associated primal semidefinite program (SDP). We conclude that qNLBs are a stronger resource for nonlocality than NLBs. The main premise that develops from this conclusion is that the NLB model is not the strongest resource to investigate the fundamental principles that limit quantum nonlocality. As such, our work provides strong motivation to reconsider the status quo of the principles that are known to limit nonlocal correlations under the framework of qNLBs rather than NLBs.
HIDDEN SUPERSYMMETRY IN DIRAC FERMION QUASINORMAL MODES OF BLACK HOLES
Authors: OIKONOMOU V. K.
Published: May 2013

We connect the quasinormal modes corresponding to Dirac fermions in various curved space–time backgrounds to an N = 2 supersymmetric quantum mechanics algebra, which can be constructed from the radial part of the fermionic solutions of the Dirac equation. In the massless fermion case, the quasinormal modes are in bijective correspondence with the zero modes of the fermionic system and this results to unbroken supersymmetry. The massive case is more complicated, but as we demonstrate, supersymmetry remains unbroken even in this case.
SUPPORTING SUCCESSFUL STANDARDIZATION PROCESSES IN COMPLEX EMERGING FIELDS THROUGH QUANTITATIVE ANALYSIS — THE CASE OF NANOTECHNOLOGY
Authors: GOLUCHOWICZ KERSTIN , GAUCH STEPHAN , BLIND KNUT
Published: May 2013

The field of nanotechnology is characterized by its rapid development and a multitude of participating communities and different subareas of scientific and technical activities, challenges regarding the understanding, coordination and implementation of new technologies. By reviewing some of the main challenges for successful knowledge-based standardization in complex emerging and heterogeneous fields this paper will present a range of quantitative methods, applied to publication data, that will provide a blueprint for further foresight activities in complex R&D fields. It addresses the issue of identification and integration of topics and researchers in such research fields that can be decomposed into thematic subfields and present solutions for an integration of this plurality into standardization processes.
Morphometric analysis of gastrocnemius muscle biopsies from patients with peripheral arterial disease: objective grading of muscle degeneration
Authors: Cluff Kim , Miserlis Dimitrios , Naganathan Govindarajan Konda , Pipinos Iraklis I. , Koutakis Panagiotis , Samal Ashok , McComb Rodney D. , Subbiah Jeyamkondan , Casale George P.
Published: May 2013

Peripheral arterial disease (PAD), which affects ∼10 million Americans, is characterized by atherosclerosis of the noncoronary arteries. PAD produces a progressive accumulation of ischemic injury to the legs, manifested as a gradual degradation of gastrocnemius histology. In this study, we evaluated the hypothesis that quantitative morphological parameters of gastrocnemius myofibers change in a consistent manner during the progression of PAD, provide an objective grading of muscle degeneration in the ischemic limb, and correlate to a clinical stage of PAD. Biopsies were collected with a Bergström needle from PAD patients with claudication ( n = 18) and critical limb ischemia (CLI; n = 19) and control patients ( n = 19). Myofiber sarcolemmas and myosin heavy chains were labeled for fluorescence detection and quantitative analysis of morphometric variables, including area, roundness, perimeter, equivalent diameter, major and minor axes, solidity, and fiber density. The muscle specimens were separated into training and validation data sets for development of a discriminant model for categorizing muscle samples on the basis of disease severity. The parameters for this model included standard deviation of roundness, standard deviation of solidity of myofibers, and fiber density. For the validation data set, the discriminant model accurately identified control (80.0% accuracy), claudicating (77.7% accuracy), and CLI (88.8% accuracy) patients, with an overall classification accuracy of 82.1%. Myofiber morphometry provided a discriminant model that establishes a correlation between PAD progression and advancing muscle degeneration. This model effectively separated PAD and control patients and provided a grading of muscle degeneration within clinical stages of PAD.
Knockdown of parathyroid hormone related protein in smooth muscle cells alters renal hemodynamics but not blood pressure
Authors: Raison Denis , Coquard Catherine , Hochane Mazène , Steger Jacques , Massfelder Thierry , Moulin Bruno , Karaplis Andrew C. , Metzger Daniel , Chambon Pierre , Helwig Jean-Jacques , Barthelmebs Mariette
Published: May 2013

Parathyroid hormone-related protein (PTHrP) belongs to vasoactive factors that regulate blood pressure and renal hemodynamics both by reducing vascular tone and raising renin release. PTHrP is expressed in systemic and renal vasculature. Here, we wanted to assess the contribution of vascular smooth muscle cell endogenous PTHrP to the regulation of cardiovascular and renal functions. We generated a mouse strain ( SMA-CreERT2/ PTHrPL2/L2or premutant PTHrPSM−/−), which allows temporally controlled, smooth muscle-targeted PTHrP knockdown in adult mice. Tamoxifen treatment induced efficient recombination of PTHrP-floxed alleles and decreased PTHrP expression in vascular and visceral smooth muscle cells of PTHrPSM−/−mice. Blood pressure remained unchanged in PTHrPSM−/−mice, but plasma renin concentration and creatinine clearance were reduced. Renal hemodynamics were further analyzed during clearance measurements in anesthetized mice. Conditional knockdown of PTHrP decreased renal plasma flow and glomerular filtration rate with concomitant reduction in filtration fraction. Similar measurements were repeated during acute saline volume expansion. Saline volume expansion induced a rise in renal plasma flow and reduced filtration fraction; both were blunted in PTHrPSM−/−mice leading to impaired diuresis. These findings show that endogenous vascular smooth muscle PTHrP controls renal hemodynamics under basal conditions, and it is an essential factor in renal vasodilation elicited by saline volume expansion.