bluuebunny/crossref_metadata_2025 huggingface dataset:
Aggressive Mechanical Clot Disruption
Authors: Noser Elizabeth A. , Shaltoni Hashem M. , Hall Christiana E. , Alexandrov Andrei V. , Garami Zsolt , Cacayorin Edwin D. , Song Joon K. , Grotta James C. , Campbell Morgan S.
Published: December 2004

Background and Purpose—

This study evaluated the safety and efficacy of aggressive mechanical clot disruption (AMCD) in acute stroke patients with persisting middle cerebral artery (MCA) or internal carotid artery (ICA) occlusion after thrombolytic therapy.

Methods—

Retrospective case series were used from a prospectively collected stroke database on consecutive acute ischemic stroke patients treated with intra-arterial (IA) thrombolytics and mechanical clot disruption during a 5-year interval. Thrombolytic dosage, endovascular techniques, immediate and final recanalization rates, symptomatic hemorrhage, mortality, and outcome were determined.

Results—

Thirty-two patients received AMCD. Median baseline National Institutes of Health Stroke Scale (NIHSS) score was 18, and median time to initiation of IA treatment was 261 minutes from symptom onset. ICA occlusion was noted in 16 patients and MCA occlusion in 16 patients: 22 received combined IV/IA thrombolytics, 3 received IV thrombolytics, 6 received IA thrombolytics, and 1 patient received no thrombolytics before AMCD. No immediate periprocedural complications were noted. Immediate recanalization was achieved in 38% (50% MCA, 25% ICA) and final recanalization in 75% (88% MCA, 63% ICA) of patients. Favorable outcome occurred in 19 (59%) patients, symptomatic cerebral hemorrhage in 3 (9.4%) patients, and mortality in 4 (12.5%) patients.

Conclusion—

AMCD can be performed safely with comparable intracerebral hemorrhage and mortality rates to other IA therapies even after use of intravenous thrombolytics in selected patients. Early deployment of this technique leads to immediate recanalization in one third of patients. AMCD may potentially shorten the time to flow restoration and improve overall recanalization rates achieved with IA therapy.
River Discharge into the Mediterranean Sea: Climatology and Aspects of the Observed Variability
Authors: Struglia Maria Vittoria , Mariotti Annarita , Filograsso Angelo
Published: December 2004

River discharge across the Mediterranean catchment basin is investigated by means of an extensive dataset of historical monthly time series to represent at-best discharge into the sea. Results give an annual mean river discharge into the Mediterranean of 8.1 × 103 m3 s−1, or at most a value that should not exceed 10.4 × 103 m3 s−1. The seasonal cycle has an amplitude of 5 × 103 m3 s−1, with a dry season in midsummer and a peak flow in early spring. Dominant contributions are from Europe with a climatological annual mean of 5.7 × 103 m3 s−1. Discharge in the Adriatic Sea, the Gulf of Lion, and the Aegean Sea together account for 62% of Mediterranean discharge, which mostly occurs in the Adriatic (2.7 × 103 m3 s−1).

The North Atlantic Oscillation (NAO) impacts Mediterranean discharge primarily in winter, with most river discharges across the Mediterranean catchment being anticorrelated with the NAO. Related winter anomalies are about 10%–20% of the winter means. During the period 1960–90, Mediterranean winter discharge as a whole may have undergone year-to-year NAO-related variations of up to 26% of the seasonal mean, while about 17% on decadal time scales. These variations are expected to have occurred mostly in the Gulf of Lion and the Adriatic Sea, together with the Balearic Sea, where the impact of the NAO is greatest.
Asian Jet Waveguide and a Downstream Extension of the North Atlantic Oscillation
Authors: Watanabe Masahiro
Published: December 2004

Anomalous atmospheric fields associated with the North Atlantic Oscillation (NAO) are analyzed on interannual and intraseasonal time scales in order to examine the extent to which the NAO is a regional phenomenon.

Analyses on the interannual time scale reveal that the NAO signal is relatively confined to the Euro–Atlantic sector in December while it extends toward East Asia and the North Pacific in February. The difference is most clearly seen in the meridional wind anomaly, which shows a wave train along the Asian jet, collocated with an anomalous vorticity source near the jet entrance. Diagnoses using a linear barotropic model indicate that this wave train is interpreted as quasi-stationary Rossby waves trapped on the Asian jet waveguide, and effectively excited by the anomalous upper-level convergence over the Mediterranean Sea. It is found that, when the NAO accompanies the Mediterranean convergence (MC) anomaly, most frequently seen in February, the NAO indeed has a much wider horizontal structure than the classical picture, rather similar to the Arctic Oscillation. In such cases interannual variability of the NAO is tied to the East Asian climate variability such that the positive NAO tends to bring a surface warming over East Asia.

Similar results are obtained from an analysis of individual NAO events based on low-pass-filtered daily fields, which additionally identified that the downstream extension occurs at the decay stage of the NAO event and the MC anomaly appears to be induced by the Ekman pumping associated with the NAO. The signal of the MC anomaly can be detected even at 5 days before the peak of the NAO, suggesting that the NAO influence to East Asia is predictable to some extent; therefore, monitoring the developing NAO event is useful to the medium-range weather forecast in East Asian countries.
Downstream Weather Impacts Associated with Atmospheric Blocking over the Northeast Pacific
Authors: Carrera M. L. , Higgins R. W. , Kousky V. E.
Published: December 2004

Relationships between atmospheric blocking over the Alaskan region of the northeast Pacific, referred to as Alaskan blocking, and weather extremes over North America during boreal winter 1979–2000 are examined. A total of 37 atmospheric blocking events are identified with durations ranging from 8 to 25 days and a mean duration of 11.3 days. A total of 15.6% of the days during the boreal winter belonged to an Alaskan blocking event.

The number of blocked days over the Alaskan region was found to be sensitive to the phase of the ENSO cycle with a reduced (increased) number of blocked days during El Niño (La Niña/neutral) winters. The average number of blocked days during El Niño winters was 12, compared with 31.2 and 27 for neutral and La Niña winters, respectively. The mature Alaskan block possesses characteristics, which are typical of blocking episodes, including the equivalent barotropic structure of the blocking anticyclone, the meridional flow both upstream and downstream of the block, the equatorward shift of the Pacific storm track, downstream development of 500-hPa geopotential height, and sea level pressure anomalies over North America.

The surface temperature analysis revealed a significant shift in the daily mean surface temperature distribution during Alaskan blocking toward colder temperatures in the region extending from the Yukon southeastward to the southern plains of the United States, associated with a reduced variance of surface temperatures. Over extreme western Alaska there is a shift in the daily mean surface temperature distribution toward warmer temperatures. The shift toward colder (warmer) daily mean surface temperatures is also accompanied by a shift in the tails of the distribution toward more extreme cold (warm) days in these two regions. During Alaskan blocking, the regions of southern California, the Southwest, and the Intermountain West all possess a higher frequency of heavy precipitation days when compared with the long-term winter climatology. Over the eastern half of the United States, the Ohio Valley and the southeast regions experience a greater percentage of heavy precipitation days during Alaskan blocking.
Representing El Niño in Coupled Ocean–Atmosphere GCMs: The Dominant Role of the Atmospheric Component
Authors: Guilyardi E. , Gualdi S. , Slingo J. , Navarra A. , Delecluse P. , Cole J. , Madec G. , Roberts M. , Latif M. , Terray L.
Published: December 2004

A systematic modular approach to investigate the respective roles of the ocean and atmosphere in setting El Niño characteristics in coupled general circulation models is presented. Several state-of-the-art coupled models sharing either the same atmosphere or the same ocean are compared. Major results include 1) the dominant role of the atmosphere model in setting El Niño characteristics (periodicity and base amplitude) and errors (regularity) and 2) the considerable improvement of simulated El Niño power spectra—toward lower frequency—when the atmosphere resolution is significantly increased. Likely reasons for such behavior are briefly discussed. It is argued that this new modular strategy represents a generic approach to identifying the source of both coupled mechanisms and model error and will provide a methodology for guiding model improvement.
Minority Support for School Bonds in Charlotte-Mecklenburg
Authors: Priest Thomas B. , Fox Linette P.
Published: December 2004

This article examines support for school bonds among minority group members in Mecklenburg County, North Carolina, which includes the city of Charlotte. Asurveywas conducted shortly after a bitter court case and shortly before a proposed bond referendum. Support for bonds in the minority community was fairly moderate. Support was not related to self-interest. Rather, support for bonds was most closely associated with confidence in public officials.
Rethinking School Partnerships
Authors: Edens Retha , Gilsinan James F.
Published: December 2004

This article approaches educational partnerships from two perspectives not dominant in the current literature. First, it adopts an organizational perspective, analyzing the participants in a school, corporate foundation, university, and college partnership from the institutional dynamics of each agency. Focusing on preexistent organizational characteristics rather than on the group dynamics created by various forms of partnering may provide a more parsimonious way of conceptualizing what is a very complex phenomenon. Second, because partnerships are by definition the creation of networks, success is examined by looking at the potential to create social capital. Following Putnam, social capital refers to dense networks of reciprocal social relations.
Flexible Grouping and Student Learning in a High-Needs School
Authors: Castle Sharon , Deniz Carla Baker , Tortora Michael
Published: December 2004

The study focused on the impact of flexible grouping on student learning during a period of time in a high-needs school. The study tracked nontransient, below-goal elementary students on multiple literacy assessments during a 5-year flexible grouping implementation. Results showed that the percentage of students attaining mastery increased in 16 of 19 over-time comparisons. Increases in the percentage of students At Mastery ranged from 10% to 57%. The percentage of teachers using flexible grouping on a weekly basis increased from 25% to 95% during the same 5-year period. Teachers attributed the impact of flexible grouping to (a) focused instruction related to particular learning needs, (b) the ability to keep student attention focused on the instructional task, and (c) increased student confidence. The results support the use of flexible grouping to improve student learning for below-goal students without the potentially negative effects of ability grouping.
Losing Voice?
Authors: Bulkley Katrina
Published: December 2004

Charter schools are one form of decentralizing public education by shifting power into the hands of school stakeholders by providing them with more “voice” in day-to-day decisions. However, the increasing involvement of educational management organizations (EMOs) as managers of charter schools raises newquestions about the influence of school stakeholders. This exploratory study examines the experiences of three very different EMOs and two schools operated by each company. Specifically, the author describes the role of each company in the development of the educational programs in the schools it manages. The three companies varied in the extent to which they limited school stakeholder “voice.” The analysis builds toward a greater understanding of the impact of EMOs on decentralization, including an exploration of the power of charter schools in the EMO-school relationship that examines how “exit” from the EMO-school relationship may provide power in a way that “voice” does not.
“Who Shall be Educated?”
Authors: Richardson Jeanita W.
Published: December 2004

This article retrospectively examines the controversy surrounding the City University of New York’s (CUNY’s) Board of Trustees and the New York State Board of Regents’decision to phase out remedial coursework at all of the system’s senior colleges. Pivotal to this discussion are the ways in which this decision, although similar to many such initiatives across the country, places the historical mission of CUNY at odds with its current policy. In the wake of this policy, many students find themselves systematically barred from full participation in postsecondary pursuits, diminishing their hopes of upward mobility in the name of higher standards.
The Relationship between Resourcefulness and Persistence in Adult Autonomous Learning
Authors: Ponton Michael K. , Derrick M. Gail , Carr Paul B.
Published: December 2004

The purpose of this study was to investigate the tenability of a proposed path-analytic model relating resourcefulness and persistence in the context of adult autonomous learning. Data collected from a nonprobability sample of 492 American adults using valid and reliable measures for resourcefulness and persistence were analyzed. Results suggest that although adults intend to persist in valued learning activities, they often do not choose to engage in such activities. Methods are discussed that may help educators foster autonomous learning tendencies in their students, thereby supporting their development as lifelong learners.
Third-Space Practitioners: Women Educating for Justice in the Global South
Authors: English Leona M.
Published: December 2004

This article builds on qualitative research with 13 women (9 from Canada and 4 from Asia and Africa) doing international adult education in the Global South. The author examines the cases in light of the postcolonial literature of Bhabha, Spivak, and Khan, giving special attention to their theory of third space. The 13 participants are third-space practitioners who challenge the binaries of North/South, religion/development, and local/global. As development workers and educators, these women trouble existing categories of identity to practice progressive politics in the public sphere through third-space strategies of ritual, listening, negotiation, and subversion. This article’s main contribution is to show how these adult educators use and practice this radical position within the shifting (postfoundational) sands that are so often denounced as apolitical, noncommittal, or lost in linguistics.
A Blunt Instrument for Use By Low-Literate Participants in Summative and Formative Evaluations of Adult Education and Development Programs
Authors: Blunt Adrian
Published: December 2004

This article reports the development of an evaluation technique that uses adjective checklists as instruments for use by low-literate and marginally literate adults to provide assessments of their learning experiences in adult education and development programs. Vignettes of activities from three stages of the development process depict the range of groups and learning events used to refine the technique and to establish the reliability and validity of instrument scores. Recommended procedures are outlined for application of the technique, including the selection of adjectives, obtaining responses, summarizing results, and calculating scores and instrument statistics.
Ex-Offenders Need Not Apply
Authors: Harris Patricia M. , Keller Kimberly S.
Published: December 2004

Many legal barriers exist that prevent ex-offenders from obtaining lawful employment, a principle means for reintegration. This article explores the scope and utility of these laws, which aim ostensibly to reduce the prospective employee’s likelihood of engaging in workplace crime. Irrelevance of the provisions to the effective assessment of job applicants’ risks of offending, shortcomings of criminal background checks, lack of empirical evidence linking ex-offenders to workplace crime, and the availability of viable alternatives underscore the need to scale back these significant obstacles to ex-offender reentry. The article concludes with recommendations for reasonable uses of risk assessment in employment screening laws.
Collateral Consequences and Racial Inequality
Authors: Wheelock Darren
Published: December 2004

Studies of the collateral consequences of felony conviction have generally focused on single restrictions such as disenfranchisement or disqualification for welfare assistance. Although these studies have provided a wealth of valuable information, such an approach only provides a partial picture of the broader social context in which collateral sanctions operate and their implications for social stratification. Even after felons complete their sentences, they often find whole classes of key privileges revoked and opportunities blocked. Furthermore, because they are most likely to experience criminal justice sanctions, Black males are at far greater risk of also facing the social disadvantages that accompany criminal punishment. This article argues that collateral consequence provisions play a role in maintaining and exacerbating racial inequality.
Collateral Consequences of Sex Offender Registration
Authors: Tewksbury Richard
Published: December 2004

Sex offender registrationwas widely implemented in the 1990s as a means of enhancingcommunity awareness of sex offenders to promote community safety. This study is one of the first examinations of the collateral consequences of sex offender registration from the perspective of the offender. Drawing on data from 121 registered sex offenders in Kentucky, this research shows that social stigmatization, loss of relationships, employment, and housing, and both verbal and physical assaults are experienced by a significant minority of registered sex offenders.
Women’s Experience of Violence During Stalking by Former Romantic Partners
Authors: Roberts Karl A.
Published: December 2004

This study investigated female experiences of physical violence during stalking by a former romantic partner. It aimed to identify factors that were predictive of such stalking violence. Two hundred and twenty female undergraduates who defined themselves as victims of stalking following the dissolution of a romantic relationship completed a short questionnaire. From their responses, 11 predictor variables were considered. These were self-reported relationship experiences of physical and sexual violence, intentional damage to participant’s property, partner jealousy, isolation, monitoring, criticism and insults by the former partner, former partner’s drug and alcohol abuse, and specific threats of violence while being stalked. The dependent variable in the study was whether stalking violence occurred; 35.9% (79/220) of participants experienced stalking violence. Logistic regression analysis revealed that there were statistically significant independent associations between threats, partner jealousy, and former partner drug abuse and stalking violence.
Domestic Violence at the Intersections of Race, Class, and Gender
Authors: Sokoloff Natalie J. , Dupont Ida
Published: December 2004

This article provides a comprehensive review of the emerging domestic violence literature using a race, class, gender, sexual orientation intersectional analysis and structural framework fostered by women of color and their allies to understand the experiences and contexts of domestic violence for marginalized women in U.S. society. The first half of the article lays out a series of challenges that an intersectional analysis grounded in a structural framework provides for understanding the role of culture in domestic violence. The second half of the article points to major contributions of such an approach to feminist methods and practices in working with battered women on the margins of society.
The Shock of the Real
Authors: Jaguaribe Beatriz
Published: December 2004

The author discusses the aesthetic effects of the “shock of the real” and how it emerges in specific realist films and literature that portray urban experiences in contemporary Brazil. In the midst of the violence, image overflow, and uncertainty of many Brazilian cities, realist productions provide an interpretative pedagogy of the “real.” Although they attempt to forge a connection between lived experience and representation, contemporary realist registers not only rely on former depictions of Brazilian “reality” but also make use of genres that have become available through the global circulation of the media, such as the detective novel, the gangster film, and the dirty realism of the mean street narratives and visual images.
Indian Drama
Authors: Momen Mehnaaz
Published: December 2004

This article explores the relationship between the changing demands of nationhood and identity politics in India. The author analyzes the ideologies of nationalism and Hindutva through the lenses of space to understand how these concepts affect policies such as the Mandal Commission report, which triggered the usurpation of politics and eventually the government by communal political forces in India. As a policy, the Mandal report is a part of historic attempts to redefine the access and entry of the disadvantaged other in the educational and employment spheres. This article attempts to illuminate how the boundaries between political and religious spaces in India have become blurred in recent decades.
Poseidon’s Oar
Authors: Hosey Lance
Published: December 2004

The origins of colonial space may be traced to attitudes about the environment in ancient Greece. These attitudes evolved through three distinct stages that altered the relationship between culture and nature. The writing of Homer exposes a particular moment in history when these two categories began to split, causing a rift that defines conceptions of space and place even now.
Evaluation, a State of Mind
Authors: Swanson Richard A.
Published: December 2004

The problem and the solution. Many human resource development professionals do not have a predisposition toward measurement and evaluation. The overall state of measurement and evaluation practices in the profession is dismal. As an effort to clarify these conditions, this article explores the proposition that evaluation is not so much a purposeful process as it is a state of mind from both researcher and practitioner perspectives.
Holton's Evaluation Model: New Evidence and Construct Elaborations
Authors: Holton Elwood F.
Published: December 2004

The problem and the solution. Holton proposed the HRD Evaluation and Research Model as a comprehensive framework for diagnosing and understanding the causal influences of HRD intervention outcomes. Unfortunately, a full test of Holton's model has not been possible because tools to measure the constructs in the model did not exist. This article reviews recent studies relevant to the constructs in Holton’s model and updates it by delineating specific constructs that should be measured in each of the conceptual categories proposed.
In Search of the Holy Grail: Return on Investment Evaluation in Human Resource Development
Authors: Russ-Eft Darlene , Preskill Hallie
Published: December 2004

The problem and the solution. Much of the human resource development (HRD) evaluation literature focuses on the Kirkpatrick four-level approach and emphasizes the importance of measuring the return on investment (ROI) of HRD initiatives or programs. This article argues that, in many cases, ROI does not provide the kind of information needed by decision makers. What is needed is a systems model that examines the effect of organizational and environmental factors on the intended outcomes of an HRD initiative or program. Such a model can help to frame any evaluation, including one that focuses on ROI.
The Success Case Method: A Strategic Evaluation Approach to Increasing the Value and Effect of Training
Authors: Brinkerhoff Robert O.
Published: December 2004

The problem and the solution. Despite the fact that effective human resource development (HRD) operations are vital to overall organization success, most organizations fail to evaluate the impact and return on training investments that they could and should. Traditional evaluation models and methods, with their focus on simply assessing the scope of training’s effect, do little to help reap greater performance and organizational impact from HRD and, in fact, can even undermine this purpose. This article argues that it is performance, not HRD, that achieves (or does not achieve) results, and thus impact evaluation must inquire more broadly into the performance management context. Consequently, the Success Case Method (SCM) is presented and discussed. The final portion of the article presents a case study derived from a recent SCM evaluation project for a major business client that demonstrates and illustrates the working of the method.
Attendance at County Cricket
Authors: Paton David , Cooke Andrew
Published: December 2004

In this article, we use attendance data from the two main domestic cricket leagues in England and Wales to estimate the impact of a series of recent structural changes. We find that changes to the organization of cricket in England have had major impacts on attendance. Attendance is significantly higher when an international match is not scheduled at the same time, when the game is played in the evening under floodlights, and when the game is played at a “minor” or festival ground. Festival matches are estimated to increase average attendance at County Championship matches by over 1,400 and at National League matches by nearly 400. This finding provides strong evidence in support for of a move toward greater use of festival grounds around the counties. We also find evidence that the presence of players centrally contracted to the national side significantly boosts attendance, particularly at one-day games.
“We Got Game!”
Authors: McGoldrick KimMarie , Voeks Lisa
Published: December 2004

This article provides estimates of differences in game play between the WNBA and NBA. Game outcome measures that are absolute (win or loss) and relative (ratio of final points) both reveal differential impacts of relative characteristics of play (ratio of shooting percentages, rebounding, assists, turnovers, personal fouls, and differences in steals and blocked shots). A stochastic frontier model is estimated and used to generate (relative) efficiency measures of play that further reveal differences between the two leagues.
Tirapazamine, Cisplatin, and Radiation Versus Fluorouracil, Cisplatin, and Radiation in Patients With Locally Advanced Head and Neck Cancer: A Randomized Phase II Trial of the Trans-Tasman Radiation Oncology Group (TROG 98.02)
Authors: Rischin Danny , Peters Lester , Fisher Richard , Macann Andrew , Denham Jim , Poulsen Michael , Jackson Michael , Kenny Lizbeth , Penniment Michael , Corry June , Lamb David , McClure Bev
Published: December 2004

Purpose

To select one of two chemoradiotherapy regimens for locally advanced squamous cell carcinoma (SCC) of the head and neck as the experimental arm for the next Trans-Tasman Radiation Oncology Group phase III trial.

Patients and Methods

One hundred twenty-two previously untreated patients with stage III/IV SCC of the head and neck were randomized to receive definitive radiotherapy (70 Gy in 7 weeks) concurrently with either cisplatin (75 mg/m2) plus tirapazamine (290 mg/m2/d) on day 2 of weeks 1, 4, and 7, and tirapazamine alone (160 mg/m2/d) on days 1, 3, and 5 of weeks 2 and 3 (TPZ/CIS), or cisplatin (50 mg/m2) on day 1 and infusional fluorouracil (360 mg/m2/d) on days 1 through 5 of weeks 6 and 7 (chemoboost).

Results

Three-year failure-free survival rates were 55% with TPZ/CIS (95% CI, 39% to 70%) and 44% with chemoboost (95% CI, 30% to 60%; log-rank P = .16). Three-year locoregional failure-free rates were 84% in the TPZ/CIS arm (95% CI, 71% to 92%) and 66% in the chemoboost arm (95% CI, 51% to 79%; P = .069). More febrile neutropenia and grade 3 or 4 late mucous membrane toxicity were observed with TPZ/CIS, while acute skin radiation reaction was more severe and prolonged with chemoboost. Compliance with protocol treatment was satisfactory on both arms.

Conclusion

Both regimens are feasible and are associated with significant but acceptable toxicity profiles in the cooperative group setting. Based on the promising efficacy seen in this trial, TPZ/CIS is being evaluated in a large phase III trial.
Gemcitabine Plus Carboplatin Versus Mitomycin, Ifosfamide, and Cisplatin in Patients With Stage IIIB or IV Non-Small-Cell Lung Cancer: A Phase III Randomized Study of the London Lung Cancer Group
Authors: Rudd R.M. , Gower N.H. , Spiro S.G. , Eisen T.G. , Harper P.G. , Littler J.A.H. , Hatton M. , Johnson P.W.M. , Martin W.M.C. , Rankin E.M. , James L.E. , Gregory W.M. , Qian W. , Lee S.M.
Published: December 2004

Purpose

This phase III randomized trial compared two chemotherapy regimens, gemcitabine plus carboplatin and mitomycin, ifosfamide, and cisplatin, in chemotherapy-naive patients with advanced non-small-cell lung cancer (NSCLC). The regimens were compared with regard to effects on survival, response rates, toxicity, and quality of life.

Patients and Methods

Eligible patients had previously untreated stage IIIB or IV NSCLC suitable for cisplatin-based chemotherapy. Randomly assigned patients were to receive four cycles, each at 3-week intervals, of carboplatin area under the curve of 5 on day 1 plus gemcitabine 1,200 mg/m2 on days 1 and 8 (GCa) or mitomycin 6 mg/m2, ifosfamide 3g/m2, and cisplatin 50 mg/m2 on day 1 (MIC).

Results

Between February 1999 and August 2001, 422 patients (GCa, n = 212; MIC, n = 210) were randomly assigned in the United Kingdom. The majority of patients received the intended four cycles (GCa, 64%; MIC, 61%). There was a significant survival advantage for GCa compared with MIC (hazard ratio, 0.76; 95% CI, 0.61 to 0. 93; P = .008). Median survival was 10 months with GCa and 7.6 months with MIC (difference, 2.4 months; 95% CI, 1.0 to 4.0), and 1-year survival was 40% with GCa and 30% with MIC (difference, 10%; 95% CI, 3% to 18%). Overall response rates were similar (42% for GCa v 41% for MIC; P = .84). More thrombocytopenia occurred with GCa (P = .03), but this was not associated with increased hospital admission or fatality. GCa caused less nausea, vomiting, constipation, and alopecia and was associated with fewer admissions for administration and better quality of life.

Conclusion

In patients with advanced NSCLC, GCa chemotherapy was shown to be a better-tolerated treatment that conferred a survival advantage over MIC.
Invasive Lobular Carcinoma Classic Type: Response to Primary Chemotherapy and Survival Outcomes
Authors: Cristofanilli Massimo , Gonzalez-Angulo Ana , Sneige Nour , Kau Shu-Wan , Broglio Kristine , Theriault Richard L. , Valero Vicente , Buzdar Aman U. , Kuerer Henry , Buccholz Thomas A. , Hortobagyi Gabriel N.
Published: December 2004

Purpose

To investigate the impact of histologic type invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC) on response to primary chemotherapy (PC) and long-term outcome.

Patients and Methods

The study included 1,034 patients with stage II and III breast cancer who participated in six clinical trials of PC at our institution between 1985 and 2002. One hundred twenty-two patients (12%) had ILC and 912 (88%) had IDC. All patients received anthracycline-based PC, and 346 patients (33.5%) also received a taxane as part of PC. Pathologic complete response (pCR) was defined as no evidence of invasive disease in the breast and axillary lymph nodes.

Results

The median patient age was 48 years (range, 18 to 79 years). Patients with ILC tended to be older (median age, 53 years v 47 years for patients with IDC) and have more hormone-receptor–positive tumors (92% v 62%; P < .001), lower nuclear grade (nuclear grade 3, 16% v 56%; P < .001), and higher stage at diagnosis (10% v 0% with stage IIIB or IIIC disease; P < .001). Patients with ILC were less likely to have a pCR (3% v 15%; P < .001) and had a larger number of involved axillary lymph nodes (41% v 26% had > 3 involved nodes; P = .001). At a median follow-up time of 70 months, ILC patients tended to have longer recurrence-free survival (P = .004) and overall survival (P = .001).

Conclusion

ILC is characterized by lower rates of pathologic response to PC but better long-term outcomes compared to IDC. pCR might not be a prognostic indicator for this group of patients.
Randomized Phase III Trial of High-Dose Interleukin-2 Versus Subcutaneous Interleukin-2 and Interferon in Patients With Metastatic Renal Cell Carcinoma
Authors: McDermott David F. , Regan Meredith M. , Clark Joseph I. , Flaherty Lawrence E. , Weiss Geoffery R. , Logan Theodore F. , Kirkwood John M. , Gordon Michael S. , Sosman Jeffrey A. , Ernstoff Marc S. , Tretter Christopher P.G. , Urba Walter J. , Smith John W. , Margolin Kim A. , Mier James W. , Gollob Jared A. , Dutcher Janice P. , Atkins Michael B.
Published: December 2004

Purpose

The Cytokine Working Group conducted a randomized phase III trial to determine the value of outpatient interleukin-2 (IL-2) and interferon alfa-2b (IFN) relative to high-dose (HD) IL-2 in patients with metastatic renal cell carcinoma.

Patients and Methods

Patients were stratified for bone and liver metastases, primary tumor in place, and Eastern Cooperative Oncology Group performance status 0 or 1 and then randomly assigned to receive either IL-2 (5 MIU/m2 subcutaneously every 8 hours for three doses on day 1, then daily 5 days/wk for 4 weeks) and IFN (5 MIU/m2 subcutaneously three times per week for 4 weeks) every 6 weeks or HD IL-2 (600,000 U/kg/dose intravenously every 8 hours on days 1 through 5 and 15 to 19 [maximum 28 doses]) every 12 weeks.

Results

One hundred ninety-two patients were enrolled between April 1997 and July 2000. Toxicities were as anticipated for these regimens. The response rate was 23.2% (22 of 95 patients) for HD IL-2 versus 9.9% (nine of 91 patients) for IL-2/IFN (P = .018). Ten patients receiving HD IL-2 were progression-free at 3 years versus three patients receiving IL-2 and IFN (P = .082). The median response durations were 24 and 15 months (P = .18), and median survivals were 17.5 and 13 months (P = .24). For patients with bone or liver metastases (P = .001) or a primary tumor in place (P = .040), survival was superior with HD IL-2.

Conclusion

This randomized phase III trial provides additional evidence that HD IL-2 should remain the preferred therapy for selected patients with metastatic renal cell carcinoma.
Organ Preservation for Advanced Resectable Cancer of the Base of Tongue and Hypopharynx: A Southwest Oncology Group Trial
Authors: Urba Susan G. , Moon James , Giri P.G. Shankar , Adelstein David J. , Hanna Ehab , Yoo George H. , LeBlanc Michael , Ensley John F. , Schuller David E.
Published: December 2004

Purpose

The Southwest Oncology Group designed a phase II trial for patients with base of tongue or hypopharyngeal cancer to evaluate the complete histologic response rate at the primary site after induction chemotherapy followed by chemoradiotherapy for responders. Secondary end points were the rate of organ preservation and the need for salvage surgery.

Patients and Methods

Fifty-nine eligible patients were enrolled; 37 had base of tongue cancer, and 22 had hypopharynx cancer. Forty-two percent had stage III disease, and 58% had stage IV disease. Induction chemotherapy was two cycles of cisplatin 100 mg/m2 and fluorouracil 1,000 mg/m2/d for 5 days. Patients who had a greater than 50% response at the primary site were treated with radiation 72Gy and concurrent cisplatin 100 mg/m2 for three cycles. Patients with less than partial response at the primary had immediate salvage surgery.

Results

Forty-five patients (76%) had a greater than 50% response at the primary after induction chemotherapy; 43 went on to receive definitive chemoradiotherapy. Thirty-two patients (54%) achieved a histologic complete response at the primary site, and an additional nine patients had a complete clinical response, but biopsy was not done. Seventy-five percent of patients did not require surgery at the primary tumor site. The 3-year overall survival was 64%. The 3-year progression-free survival with organ preservation was 52%.

Conclusion

Patients with base of tongue or hypopharyngeal cancer treated with this regimen of induction chemotherapy followed by definitive chemoradiotherapy have a good rate of organ preservation without compromise of survival.
Randomized Phase II Evaluation of 6 g/m2 of Ifosfamide Plus Doxorubicin and Granulocyte Colony-Stimulating Factor (G-CSF) Compared With 12 g/m2 of Ifosfamide Plus Doxorubicin and G-CSF in the Treatment of Poor-Prognosis Soft Tissue Sarcoma
Authors: Worden Francis P. , Taylor Jeremy M.G. , Biermann Janet S. , Sondak Vernon K. , Leu Kirstin M. , Chugh Rashmi , McGinn Cornelius J. , Zalupski Mark M. , Baker Laurence H.
Published: December 2004

Purpose

The relative value of increasing ifosfamide dose in combination chemotherapy for patients with soft tissue sarcoma (STS) is unclear. The purpose of this study was to compare the efficacy and toxicity of doxorubicin with high-dose (HD) ifosfamide or standard-dose (SD) ifosfamide in patients with STS.

Patients and Methods

Chemotherapy-naive patients with STS were randomly assigned to receive doxorubicin 60 mg/m2 and either SD ifosfamide (1.5 g/m2/d, days 1 through 4) or HD ifosfamide (3.0 g/m2, days 1 through 4) every 21 days. Patients were stratified by the presence or absence of metastatic disease. End points were overall survival (OS), 1-year disease-free survival (DFS), and toxicity.

Results

The study group consisted of 79 patients (52 patients with localized disease and 27 patients with metastases). Both groups were well-balanced with respect to known prognostic factors. There was no significant difference in 1-year DFS comparing SD ifosfamide with HD ifosfamide (55% v 52%; P = .81). For SD ifosfamide, 2- and 3-year OS were 73% and 52% versus 57% and 49% for HD ifosfamide (P = .34). The incidence of grade 3/4 neutropenia, anemia, and thrombocytopenia were 49%, 23%, and 10%, respectively, on the SD ifosfamide arm, compared with 88%, 58%, and 63%, respectively, on the HD ifosfamide arm. There were five early deaths, all on the HD ifosfamide arm.

Conclusion

When combined with doxorubicin, HD ifosfamide did not improve 1-year DFS and OS. Toxicity was clearly greater with the HD ifosfamide arm, and lack of outcome differences might be explained by toxicities with HD ifosfamide. These results suggest that HD ifosfamide combination regimens should not be used as first-line therapy for patients with STS.
Single-Agent Versus Combination Chemotherapy in Advanced Non–Small-Cell Lung Cancer: The Cancer and Leukemia Group B (study 9730)
Authors: Lilenbaum Rogerio C. , Herndon James E. , List Marcy A. , Desch Chris , Watson Dorothy M. , Miller Antonius A. , Graziano Stephen L. , Perry Michael C. , Saville Wayne , Chahinian Philippe , Weeks Jane C. , Holland Jimmie C. , Green Mark R.
Published: December 2004

Purpose

We compared the efficacy of combination chemotherapy versus single-agent therapy in patients with advanced non–small-cell lung cancer.

Patients and Methods

A total of 561 eligible patients were randomly assigned to receive paclitaxel alone or in combination with carboplatin.

Results

The response rate was 17% in the paclitaxel arm and 30% in the carboplatin-paclitaxel arm (P < .0001). Median failure-free survival was 2.5 months in the paclitaxel arm and 4.6 months in the carboplatin-paclitaxel arm (P = .0002). Median survival times were 6.7 months (95% CI, 5.8 to 7.8) and 8.8 months (95% CI, 8.0 to 9.9), and 1-year survival rates were 32% (95% CI, 27% to 38%), and 37% (95% CI, 32% to 43%), respectively. The overall survival distributions were not statistically different: hazard ratio = 0.91 (95% CI, 0.77 to 1.17; P = .25). Hematological toxicity and nausea were more frequent in the combination arm, but febrile neutropenia and toxic deaths were equally low in both arms. There was no significant survival difference in elderly patients. Performance status 2 patients treated with combination chemotherapy had a better survival rate than those treated with single-agent therapy (P = .019).

Conclusion

Combination chemotherapy improves response rate and failure-free survival compared with single-agent therapy, but there was no statistically significant difference in the primary end point of overall survival. The results in elderly patients were similar to younger patients. Performance status 2 patients had a superior outcome when treated with combination chemotherapy.
Detection and Identification of Fish-Pathogenic Aphanomyces piscicida Using Polymerase Chain Reaction (PCR) with Species-Specific Primers
Authors: Phadee Panarat , Kurata Osamu , Hatai Kishio , Hirono Ikuo , Aoki Takashi
Published: December 2004

Aphanomyces piscicida is an important pathogen that plays a role in the morbidity and mortality of various fish species around the world. The poor quality of current identification techniques for this fungus led to the development of highly sensitive and specific polymerase chain reaction (PCR) techniques. Primers derived from the ITS1 and ITS2 regions of A. piscicida NJM 0204 were designed for the detection and identification of fish-pathogenic A. piscicida, with the potential for the diagnosis of mycotic granulomatosis (MG). Polymerase chain reaction amplification showed that the primer set was specific only to fish-pathogenic A. piscicida, not to non-fish-pathogenic Aphanomyces, Saprolegnia spp., Achlya spp., Dictyuchus spp., and Lagenidium spp. In addition, PCR revealed an improved sensitivity sufficient to detect A. piscicida in artificially infected goldfish Carassius auratus. Results demonstrated that the PCR method established in this study is effective for the detection and identification of A. piscicida with MG.
Histological Analysis of an Outbreak of QPX Disease in Wild Hard Clams Mercenaria mercenaria in New York
Authors: Dove Alistair D. M. , Bowser Paul R. , Cerrato Robert M.
Published: December 2004

Over 600 hard clams Mercenaria mercenaria from a wild population in Raritan Bay, New York, were examined histologically to assess the extent and intensity of quahog parasite X (QPX) disease in the fishery area. The overall rate of positive samples was 5.8%. A further 5.1% of clams had inflamed lesions suggestive of QPX infection but no QPX organisms were observed. In over half of the QPX-positive cases, infections of the viscera were involved. The significant proportion of visceral infections and the appearance of the pathogen in the gonads of clams are previously unreported presentations of QPX disease. Visceral infections are of concern for fisheries because they involve significantly larger numbers of parasites and higher biomass than mantle-only infections.
Experimental Transmission of the Fungus Phoma herbarum to Chinook Salmon
Authors: Burton Tamara O. , Meyers Theodore R. , Starkey Norman S. , Follett Jill E.
Published: December 2004

The fungus Phoma herbarum is an incidental pathogen for salmonid fish, and experimental studies were conducted to determine whether it could be transmitted to juvenile Chinook salmon Oncorhynchus tshawytscha by oral and airborne exposures. Phoma herbarum that had been isolated from juvenile Chinook salmon sustaining a low-level mortality in a hatchery was grown in the laboratory and quantified using a hemocytometer. The quantified inoculum of fungal conidia was mixed with dry fish food for the feeding studies, sprayed on the surface of the water for the airborne study, and injected into fish to verify the pathogenicity of the fungus. Histological examination revealed no mortality or internal fungal infection in either the oral or airborne exposures. Average cumulative mortality in the replicate groups injected with fungal conidia was 65% in the fingerlings and 56% in the fry, both groups showing clinical signs of hemorrhage and invasion of tissues by visible fungus. Histological examination of injected fish indicated hyphal invasion of tissues with necrosis and inflammatory exudate. The 100% survival of the fish in the oral and airborne exposures and the surprisingly high survival of fish inoculated with fungal conidia indicated that Phoma herbarum is not easily transmissible to juvenile Chinook salmon under optimal environmental conditions.
First Report of Spring Viremia of Carp Virus (SVCV) in Wild Common Carp in North America
Authors: Dikkeboom Audrey L. , Radi Craig , Toohey-Kurth Kathy , Marcquenski Susan , Engel Marty , Goodwin Andrew E. , Way Keith , Stone David M. , Longshaw Clare
Published: December 2004

In spring 2002, an estimated 1,500 common carp Cyprinus carpio in Cedar Lake, northwestern Wisconsin, died over a 6-week period from late April through the first week in June. Three moribund carp were necropsied and had signs consistent with spring viremia of carp (SVC) disease, including petechiae and ecchymotic hemorrhages on the skin, ascites, and edematous kidney and spleen. A virus was isolated on fathead minnow cells and shown to be a rhabdovirus by electron microscopy. Immunoassay results indicated a close serological relationship with spring viremia of carp virus (SVCV). This was confirmed by a reverse transcriptase–polymerase chain reaction assay and subsequent analysis of a subsection glycoprotein gene. Immunocytochemistry and serum neutralization tests indicated that the Cedar Lake isolate did not share complete antigenic identity with the European reference SVCV. Also, the isolate showed an inhibition of cytopathic effect after repeated subculture in epithelioma papulosum cyprini and bluegill fibroblast cells when compared with other SVCV isolates. In virus transmission studies the isolate was shown to be of low virulence for juvenile carp. Sequence analysis showed that the Cedar Lake SVCV isolate was more closely related to a recently isolated North Carolina strain of SVCV (98.6% nucleotide identity) and to strains of Asian origin rather than the European reference strain of SVCV. This is the first report of an SVC epizootic in a wild common carp population in North America.
Distribution of Tubifex tubifex Lineages and Myxobolus cerebralis Infection in the Tailwater of the San Juan River, New Mexico
Authors: DuBey Robert , Caldwell Colleen
Published: December 2004

We chose a hypolimnetic-release tailwater of the San Juan River, New Mexico, to characterize the etiology of whirling disease, a parasitic infection of salmonids. We sampled a 2-km reach of the tailwater in August and December 2001 and June 2002 to characterize environmental factors influencing the distribution and density of Tubifex tubifex lineages and Myxobolus cerebralis infection rates. Shortly after the scouring flow, organic matter in sediments and T. tubifex densities increased within deep habitats. In contrast, no differences were observed in T. tubifex densities and organic matter collected from shallow habitats throughout the three sampling dates. Within this study area, we found three sympatric lineages of T. tubifex (lineages I, III, and VI). Lineage VI dominated riffle reaches, whereas lineages I, III, and VI were observed in pool habitats. Myxobolus cerebralis infection rates were higher in T. tubifex collected in pool habitats (3.01%) than in those collected in riffle habitats (0.51%). Only lineage III exhibited infection with M. cerebralis. We suggest that the habitat and genotype of T. tubifex are important in characterizing prevalence of disease within the San Juan River tailwater. Scouring flow may have a beneficial effect on disease severity in salmonid hosts by reducing organic loading and hence T. tubifex abundance in deep habitats.