bluuebunny/crossref_metadata_2025 huggingface dataset:
Eight‐year median survival in multiple myeloma after total therapy 2: roles of thalidomide and consolidation chemotherapy in the context of total therapy 1
Authors: Zangari Maurizio , Van Rhee Frits , Anaissie Elias , Pineda‐Roman Mauricio , Haessler Jeff , Crowley John , Barlogie Bart
Published: March 2008

In comparison to total therapy 1 (TT1), the phase 3 trial total therapy 2 (TT2) evaluated the benefit of up‐front administration of thalidomide (THAL); TT2 also introduced post‐transplant consolidation chemotherapy. With median follow‐up times of 5 and 12 years, respectively, outcome comparisons were made of 668 patient’s enrolled on TT2 and 231 patients treated on TT1. Complete response (CR) rates were similar at 40% for TT1 and TT2 without THALversus60% on the THAL arm of TT2. CR durations were similar with either TT2 arm and both were superior to results of TT1. Event‐free and overall survivals were extended from 2·6 to 5·7 years, respectively, with TT1 to 4·8 and 8·0 years with TT2. TT2’s major advance vis‐à‐vis TT1 pertained to the subgroup without cytogenetic abnormalities (CA), supporting the role of post‐transplant consolidation therapy, whereas the improved survival of the CA subgroup on the experimentalversuscontrol arm of TT2 attests to the role of THAL in this setting. Adjusting for prognostic variables in multivariate and pair‐mate analyses, TT2 was superior to TT1 in terms of CR duration, event‐free and overall survival. These results provide a basis for the prospective evaluation of the consolidation strategy in a randomized clinical trial design.
Bone marrow trephine morphology and immunohistochemical findings in chronic myelomonocytic leukaemia
Authors: Ngo Nye‐Thane , Lampert Irvin A. , Naresh Kikkeri N.
Published: March 2008

Chronic myelomonocytic leukaemia (CMML) is a clonal disorder with myelodysplastic/myeloproliferative features. Its diagnosis is based on the presence of peripheral blood monocytosis and bone marrow aspirate findings, according to World Health Organization criteria. However, bone marrow trephine biopsy (BMTB) features characteristic of CMML have not been adequately investigated. We studied BMTB in 20 cases of CMML‐1 and three cases of CMML‐2 and compared with ten cases of polycythaemia vera, ten cases of chronic myeloid leukaemia (chronic phase) and ten cases of florid myeloid hyperplasia (MH). Furthermore, we evaluated the use of CD34, CD117 and CD68 (PGM‐1) antibodies in diagnosis and subtyping of CMML and in differentiating from other categories. Hypercellularity, high myeloid:erythroid ratio, increased proportion of ‘myelo/monocytic’ cells often seen as clusters and/or nodules, absence of eosinophilia, and presence of abnormal localisation of immature precursors (ALIP) and dysmegakaryopoiesis can aid in the diagnosis of CMML in BMTB. CD68 (PGM‐1) positive cells amounted to 20·7 ± 6·1% cells among CMML trephines. The proportion of CD34+ cells among cases of CMML‐1 was ≤5% and among CMML‐2 was ≥10% cells in two of three cases and 5% in the other case. Morphological and immunohistochemical features of BMTB samples are extremely helpful in the diagnosis of CMML.
Excellent survival following two courses of COPAD chemotherapy in children and adolescents with resected localized B‐cell non‐Hodgkin’s lymphoma: results of the FAB/LMB 96 international study*
Authors: Gerrard Mary , Cairo Mitchell S. , Weston Claire , Auperin Anne , Pinkerton Ross , Lambilliote Anne , Sposto Richard , McCarthy Keith , Lacombe Marie‐José T. , Perkins Sherrie L. , Patte Catherine ,   On Behalf of the FAB LMB96 International Study Committee
Published: March 2008

High cure rates are possible in children with localized mature B‐cell lymphoma (B NHL) using a variety of chemotherapeutic strategies. To reduce late sequelae, the duration and intensity of chemotherapy has been progressively reduced. The Lymphome Malins de Burkitt (LMB) 89 study reported long‐term survival in almost all children with localized resected disease treated with two courses of COPAD (cyclophosphamide, vincristine, prednisolone and doxorubicin). This study was designed to confirm the effectiveness of this approach in a larger number of patients in a multinational co‐operative study. The patient cohort was part of an international study (French‐American‐British LMB 96), which included all disease stages and involved three national groups. Patients in this part of the study had resected stage I or completely resected abdominal stage II disease. Following surgery, two courses of COPAD were given, without intrathecal (IT) chemotherapy. One hundred and thirty‐two children were evaluable. Two of 264 (0·9%) courses were associated with grade IV toxicity (one stomatitis and one infection). With a median follow up of 50·5 months, the 4 year event‐free survival is 98·3% and overall survival is 99·2%. Children with resected localized B‐NHL can be cured with minimal toxicity following two courses of low intensity treatment without IT chemotherapy.
Evaluating the potential effectiveness of harvest restrictions on riverine sunfish populations in Georgia, USA
Authors: SAMMONS S. M. , MACEINA M. J.
Published: March 2008

Abstract  The effects of minimum length limits (MLLs) on bluegill, Lepomis macrochirus Rafinesque, redbreast sunfish, Lepomis auritus (Linnaeus), and redear sunfish, L. microlophus (Günther), fisheries in 13 river sections located across Georgia were evaluated. A Beverton–Holt equilibrium yield model was used to predict and compare the response of these fisheries to three MLL scenarios: 100 (i.e. no size limit), 125 and 150 mm. Model results indicated that natural mortality rates of all sunfish species examined in this study were low enough to allow harvest restrictions to be effective if growth was fast. If sunfish reached 203 mm in <4.0 years, then MLLs were generally effective in increasing size structure without decreasing yield or causing unacceptable declines in the number of fish available for anglers to harvest. Harvest restrictions resulted in minimal increases in size structure, declines in yield and a large decrease in the number of fish harvested by anglers if time to reach 203 mm was ≥ 8.0 years. Response to MLLs was more variable when fish grew to 203 mm in 4.0–6.5 years. Examination of mortality caps largely supported the results from the model, but there was indication that empirical rates of total annual mortality may have been biased high in some instances.
Bigeye tuna (Thunnus obesus) vertical movements in the Azores Islands determined with pop‐up satellite archival tags
Authors: ARRIZABALAGA H. , PEREIRA J. G. , ROYER F. , GALUARDI B. , GOÑI N. , ARTETXE I. , ARREGI I. , LUTCAVAGE M.
Published: March 2008

Movement patterns of 17 bigeye tuna (Thunnus obesus) near the Azores Islands were analyzed between April and May 2001 and 2002 using pop‐up satellite archival tags. Despite short attachment durations (1 to 21 days, 8.2 days on average), their vertical movements revealed much shallower distribution of bigeye tuna in comparison with previous studies in the tropical Pacific and tropical Atlantic. Depth and temperature histograms were unimodal, although overall depth distribution during the day was deeper than during the night due to daily incursions in deeper waters. Although generalized additive models showed significant non‐linear relationships with weight of the fish and sea level anomaly (as a proxy for variability of thermocline depth), the effect of these variables on bigeye depth appeared minor, suggesting that vertical movements of bigeye in the Azores during the spring migration may be influenced by food availability in upper water layers.
Remotely sensed spawning habitat of Pacific sardine (Sardinops sagax) and Northern anchovy (Engraulis mordax) within the California Current
Authors: REISS CHRISTIAN S. , CHECKLEY DAVID M. , BOGRAD STEVEN J.
Published: March 2008

We use trivariate kernel density estimation to define spawning habitat of northern anchovy (Engraulis mordax) and Pacific sardine (Sardinops sagax) in the California Current using satellite data and in situ egg samples from the Continuous Underway Fish Egg Sampler (CUFES) deployed during surveys in April by the California Cooperative Oceanic Fisheries Investigations (CalCOFI). Observed egg distributions were compared with monthly composite satellite sea surface temperature (SST) and surface chlorophyll a (chl a) data. Based on the preferred spawning habitat, as defined in SST and chl a space, the satellite data were used to predict potential spawning habitat along two areas of the west coast of North America. Data from the southern area (21.5 to 39°N) were compared to observations from the CUFES data for the period 1998–2005. Northern anchovy and Pacific sardine exhibited distinctly different spawning habitat distributions. A significant relationship was found between satellite‐based spawning area and that measured during surveys for sardine. CUFES area estimated for sardine was similar in magnitude to that estimated from satellite data (∼60 000 km2). In contrast, spawning habitat of anchovy averaged between 1000 and 200 000 km2 for the period 1998–2005, for CUFES and satellite estimates, respectively. Interannual variability in the area (km2) and duration (months) of estimates of suitable habitat varied between species and between the northern (39 to 50.5°N) and southern portions of the California Current. Long‐term monitoring of habitat variability using remote sensing data is possible in the southern portion of the California Current, and could be improved upon in the northern area with the addition of surveys better timed to describe relationships between observed and estimated spawning habitats.
Distribution and spawning dynamics of capelin (Mallotus villosus) in Glacier Bay, Alaska: a cold water refugium
Authors: ARIMITSU MAYUMI L. , PIATT JOHN F. , LITZOW MICHAEL A. , ABOOKIRE ALISA A. , ROMANO MARC D. , ROBARDS MARTIN D.
Published: March 2008

Pacific capelin (Mallotus villosus) populations declined dramatically in the Northeastern Pacific following ocean warming after the regime shift of 1977, but little is known about the cause of the decline or the functional relationships between capelin and their environment. We assessed the distribution and abundance of spawning, non‐spawning adult and larval capelin in Glacier Bay, an estuarine fjord system in southeastern Alaska. We used principal components analysis to analyze midwater trawl and beach seine data collected between 1999 and 2004 with respect to oceanographic data and other measures of physical habitat including proximity to tidewater glaciers and potential spawning habitat. Both spawning and non‐spawning adult Pacific capelin were more likely to occur in areas closest to tidewater glaciers, and those areas were distinguished by lower temperature, higher turbidity, higher dissolved oxygen and lower chlorophyll a levels when compared with other areas of the bay. The distribution of larval Pacific capelin was not sensitive to glacial influence. Pre‐spawning females collected farther from tidewater glaciers were at a lower maturity state than those sampled closer to tidewater glaciers, and the geographic variation in the onset of spawning is likely the result of differences in the marine habitat among sub‐areas of Glacier Bay. Proximity to cold water in Glacier Bay may have provided a refuge for capelin during the recent warm years in the Gulf of Alaska.
Migrations and hydrography determine the abundance fluctuations of blue whiting (Micromesistius poutassou) in the Barents Sea
Authors: HEINO MIKKO , ENGELHARD GEORG H. , GODØ OLAV RUNE
Published: March 2008

The Barents Sea is the north‐eastern fringe of the distribution of blue whiting (Micromesistius poutassou). Fluctuations in distribution and abundance of blue whiting in the area have been marked. Two hypotheses are put forward to explain these fluctuations. First, rich year classes in the main Atlantic stock of blue whiting may contribute to increased abundance in the Barents Sea. Second, variations in hydrography, such as influx of warm Atlantic water, may be particularly important in this fringe area. We investigated these hypotheses using data from bottom trawl surveys conducted during the period 1981–2006. Variations in abundance (measured either as incidence or density) and distribution were correlated with recruitment in the Atlantic stock of blue whiting as well as hydrographic conditions. Regression analyses indicated that the abundance fluctuations are primarily determined by variations in recruitment of Atlantic blue whiting, a strong year class leading to high abundance in the Barents Sea the year after spawning. However, salinity anomaly in the Fugløya–Bear Island transect during the previous year, an indicator of high inflow of Atlantic water, had also a significant, positive effect. Thus, the data suggested a climatic modulation of dynamics that were primarily determined by recruitment of blue whiting in the main Atlantic stock. Analyses of size structure as well as earlier studies on population genetics supported this conclusion.
Hydrologic versus geomorphic limitation on CPOM storage in stream ecosystems
Authors: SMALL MELANIE J. , DOYLE MARTIN W. , FULLER RANDALL L. , MANNERS REBECCA B.
Published: March 2008

1. Stream ecosystems are the products of interactions between hydrology, geomorphology and ecology, but examining all three components simultaneously is difficult and rarely attempted. Frequently, either geomorphology or hydrology is treated as invariable or static.

2. To examine the validity of treating either hydrology or geomorphology as static, we studied the individual and combined effects of hydrology and channel geomorphology on coarse particulate organic matter (CPOM) storage. Using data from an experimental leaf release in a hydrologically regulated stream we created a simple numerical model. This allowed us to quantify the relative influence of CPOM trapping and CPOM retention on total long‐term CPOM storage under variable regimes of flood frequency and geomorphic structure.

3. CPOM storage is a function of supply, flood frequency and the type and frequency of in‐stream structures. In‐stream structures perform two distinct functions, trapping and retention, whose relative importance in leaf storage changes with stream hydrology. Trapping is more important for CPOM storage in streams with few floods, while retention is more important in streams with frequent floods. Different structures (e.g. boulders, large wood, small wood) perform these functions at different efficiencies. We found that large wood trapped two to three times more leaves than the bank, but that the bank retained leaves two to three times more efficiently.

4. A modelled channel with five times the amount of large wood as the study channel (a ‘wood restoration’) initially stored 14% more leaves than the modelled ‘natural’ channel. After six floods, however, the modelled wood restoration channel stored 50% less CPOM than the natural channel as the large wood had high trapping but poor retention. The modelled natural channel contained structures that could both trap and retain. Thus, as different structures performed different functions, the structural complexity buffered the stream allochthonous energy base against changes in hydrology through its balance of trapping and retention.

5. As the frequency of floods increased, the spatial distribution of CPOM became increasingly patchy as storage was driven entirely by structures with high retention. Thus, the coupling of flood frequency and geomorphic structure influenced CPOM availability, which in turn has ramifications for the entire stream food web.
Effects of throughfall manipulation on soil nutrient status: results of 12 years of sustained wet and dry treatments
Authors: JOHNSON D. W. , TODD D. E. , HANSON P. J.
Published: March 2008

To investigate the potential effects of changing precipitation on forest ecosystems, the Throughfall Displacement Experiment (TDE) was established on Walker Branch Watershed, Tennessee, in 1993. Three different throughfall amounts were tested: −33% (DRY); ambient (no change, AMB); and +33% (WET). Throughfall manipulations had no statistically significant effects on total C, N, exchangeable Ca2+, Mg2+, bicarbonate‐extractable P, or extractable SO42− in soils after 12 years of sustained treatments. Increased K+ inputs in the WET treatment resulted in relative increases in exchangeable K+compared with the AMB and DRY treatments. Soil C, N, and extractable P declined in all treatments over the 12‐year study, and the declines in N were inexplicably large. Field observations contrasted with earlier simulations from the Nutrient Cycling Model (NuCM), which predicted greater decreases in exchangeable K+, Ca2+, Mg2+, and extractable P in the order WET>AMB>DRY, and no change in C, N, and extractable SO42−. The failure of the NuCM model to accurately predict observed changes is attributed to the lack of mechanisms for deep rooting and the transfer of throughfall K+ from one plot to another in the model. Measurements of element availability using resin membranes during the final years showed higher values in wet and lower values in dry treatments compared with ambient conditions for mineral N, K, Mn, Zn, and Al, but the opposite for B, Ca, and Mg. In the cases of Ca and Mg, the patterns in resin values were similar to those at the soil exchange sites (greatest in the dry treatment) and appeared to reflect pretreatment differences. This study showed that while longer term changes in soil nutrients are likely to occur with changes in precipitation, potential changes over this 12‐year interval were buffered by ecosystem processes such as deep rooting.
GLOBE students, teachers, and scientists demonstrate variable differences between urban and rural leaf phenology
Authors: GAZAL RICO , WHITE MICHAEL A. , GILLIES ROBERT , RODEMAKER ELI , SPARROW ELENA , GORDON LESLIE
Published: March 2008

The urban heat island effect, classically associated with high impervious surface area (ISA), low vegetation fractional cover (Fr), and high land surface temperature (LST), has been linked to changing patterns of vegetation phenology, especially spring growth. In this study, a collaboration with the Global Learning and Observations to Benefit the Environment (GLOBE) program, we investigated the effect of the urban environment on the timing of leaf budburst of native deciduous trees in seven cities: Asia (Tokyo, Japan; Bangkok and Korat, Thailand), Europe (Jyväskylä, Finland; Bishkek, Kyrgyzstan), Africa (Dakar, Senegal), and North America (Fairbanks, Alaska). The cities differed not only in population size but also in climate and vegetation type. Using Landsat satellite imagery from each city, we calculated LST, Fr, and ISA, and classified sites within each study area as rural or urban. The timing of leaf flushing, measured by students using GLOBE budburst protocols, was statistically different within all cities, with absolute differences ranging from 1 to 23 days. We assessed the classic urban phenology paradigm, which proposes higher LST, lower Fr, and earlier budburst in urban areas of temperate cities. Of the four temperate cities, Tokyo followed the classic paradigm, but no other city demonstrated consistent support. Urban budburst was advanced in three of the four temperate cities, but in only one of the three tropical cities. Results suggest that while vegetation phenology is consistently different between urban and rural areas, a uniform paradigm based on the explanatory variables in this study did not emerge. Although not testable here, it is likely that alterations to chilling requirements in temperate climates and humidity in tropical climates may also influence observed budburst differences.
Spectrum of factor VIII mutations in Arab patients with severe haemophilia A
Authors: ABU‐AMERO K. K. , HELLANI A. , AL‐MAHED M. , AL‐SHEIKH I.
Published: March 2008

Summary.  Haemophilia A is an X‐linked recessive bleeding disorder caused by mutations in the factor VIII (FVIII) gene. The mutation spectrum is known in various populations, but not in Arabs. We selected 20 unrelated Arab patients with severe haemophilia A. Those patients underwent detailed clinical examination and their plasma FVIII:C activity was also measured. We extracted DNA from their blood samples and we looked for intron 22 inversion, deletions, insertions and base substitutions in the FVIII gene. Intron 22 inversion was common (detected in 11 patients, 55%), eight base substitutions (six of which are novel) were detected in nine patients (45%) and none had an insertion or deletion. Of eight base substitutions detected, six were potentially pathologic and this was correlated well with the severe clinical phenotype observed. Larger studies with more Arab patients from various Arab countries are needed in order to establish a solid conclusion about the prevalence of various mutations in this unique ethnic group. For the families included in this study, the results obtained can be helpful for carrier testing, prenatal diagnosis or pre‐implantation techniques for detection of unaffected embryos.
Desmoplasia in medullary thyroid carcinoma: a reliable indicator of metastatic potential
Authors: Koperek O , Scheuba C , Cherenko M , Neuhold N , De Micco C , Schmid K W , Niederle B , Kaserer K
Published: March 2008

Aims:  To evaluate the reliability of desmoplasia as a reproducible morphological parameter indicating the metastatic potential of medullary thyroid carcinoma (MTC).

Methods and results:  One hundred and twenty cases of MTC of the Medical University of Vienna, Austria and 76 cases from the School of Medicine of Marseille, France were analysed for the presence of desmoplastic stroma reaction by four endocrine pathologists. Intra‐ and interobserver concordance was assessed. The Austrian cases were also analysed for various morphological parameters. Intra‐ and interobserver concordance were highly significant with a κ value of 0.883 for intra‐observer reliability and 0.837, 0.79 and 0.758, respectively, when pathologists N.N., C.D.M. and K.W.S. reviewed the Austrian cases. The cases from France were reviewed by C.D.M. and K.K. with a κ value of 0.759. None of the cases that were categorized as desmoplasia negative by any of the investigators showed lymph node metastasis. No other distinct morphological characteristics could be assigned to the MTCs without desmoplasia.

Conclusions:  Our data indicate desmoplasia to be a reliable and highly reproducible parameter with regard to lymph node metastatic potential.
Conflict and identity shape shifting in an online financial community
Authors: Campbell John , Fletcher Gordon , Greenhill Anita
Published: March 2008

Abstract.  This paper challenges traditional explorations of online communities that have relied upon assumptions of trust and social cohesion. In the analysis presented here, conflict becomes more than just dysfunctional communication and provides an alternative set of unifying principles and rationales for understanding social interaction and identity shape shifting within an online community. A model is advanced that describes the systematic techniques of hostility and aggression in technologically enabled communities that take the form of contemporary tribalism. It is argued that this tribe‐like conflict embodies important rituals essential for maintaining and defining the contradictory social roles sometimes found in online environments. This research offers a critical interpretive perspective that focuses on the link between identity shape shifting behaviours and the power relations within an online financial community. The analysis reveals how conflict between positions of power can help to align the values and ideals of an online community. With this study we seek to motivate a re‐examination of the design and governance of online communities.
Unpacking the effect of IT capability on the performance of export‐focused SMEs: a report from China
Authors: Zhang Man , Sarker Saonee , Sarker Suprateek
Published: March 2008

Abstract. Export‐focused small and medium‐sized enterprises (SMEs) in China face a number of barriers to success, two primary ones being the liability of foreignness and resource scarcity. In order to transcend these challenges and be able to survive/prosper in the hypercompetitive international market, where players include large resourceful multinational organizations with experience in varied national contexts, these firms need to develop different organizational capabilities. In this paper, we specifically examine the role of a key organizational capability – information technology (IT) capability – and its different dimensions, in determining performance of export‐focused SMEs in China. Our study reveals that IT capability has a positive impact on such firms' performance. This finding indicates the need for their owners/managers to invest in IT capability. Further, the study also highlights specific sub‐dimensions of IT capability that export‐focused Chinese SMEs should (or should not) develop, so as to derive maximum performance‐related gains for the minimum amount spent on IT.
Is knowledge a barrier to implementing low back pain guidelines? Assessing the knowledge of Israeli family doctors
Authors: Dahan Rachel , Reis Shmuel , Borkan Jeffry , Brown Judith‐Bell , Hermoni Doron , Mansor Nadia , Harris Stewart
Published: March 2008

Objectives  To measure knowledge of Israeli low back pain (LBP) clinical practice guidelines among different subgroups of primary care doctors, prior to designing an intervention programme to enhance guideline adherence in practice.

Study design  Confidential mailed survey questionnaire.

Setting  Family practices in the Haifa and western Galilee district, Israel.

Participants  Random sample of 163 primary care doctors. A total of 134 doctors (82%) completed the questionnaire.

Main outcome measures  A Multiple Choice Questionnaire measuring knowledge of the LBP guidelines. Instrument reliability and inter‐item reliability were tested in a pilot phase. Content validity was assured by having the Israeli LBP guideline authors involved in a consensus procedure.

Results  Distribution of test scores significantly differentiated professional levels and background variables, demonstrating the instrument reliability. Cronbach’s alpha was above 0.91. The average test score was 67.7 [standard deviation (SD) 16.2], family doctors had average scores of 75.2 (SD 9.8), general practitioners (GPs) 57.9 (SD 19) and family practice residents 67.4 (SD 13.2). The difference between the test average scores of family doctors, GPs and residents was significant (P < 0.001). Significant differences were also found for specific variables including the doctor’s age, country of medical training and self‐report familiarity with the LBP guidelines.

Conclusions  Striking differences exist between subgroups of primary care doctors regarding their knowledge of LBP guidelines. These differences will require the design of multiple interventions tailored to each subgroup.
Influence exerted on drug prescribing by patients’ attitudes and expectations and by doctors’ perception of such expectations: a cohort and nested case‐control study
Authors: Lado Eugenia , Vacariza Manuel , Fernández‐González Carlos , Gestal‐Otero Juan Jesús , Figueiras Adolfo
Published: March 2008

Rationale, aims and objectives  Although demand for medication is regarded as one of the most important factors in pharmaceutical expenditure, little is known about patients’ influence on drug prescribing. This study assesses the influence exerted on drug prescribing by patients’ attitudes and expectations, and by doctors’ perception of such expectations.

Method  We conducted a population‐based cohort study covering 937 subjects attending a health centre in the northwest of Spain. Prescription‐drug advertising directly targeted at patients is banned in Spain. We conducted home‐based interviews at the start of follow‐up to assess patients’ attitudes, and monthly telephone interviews during the 1‐year follow‐up period to assess consumption of medical drugs and medical visits. Using nested case‐control study covering 127 of the cohort subjects who attended the health centre, we assessed patients’ pre‐consultation expectations for prescriptions, doctors’ perception of such patients’ expectations, and the drugs actually prescribed.

Results  Of the total sample, 69.3% answered the home‐based questionnaire, 77.6% completed 11 or more months of follow‐up, and 100% of cohort subjects who attended the health centre responded to the pre‐consultation survey conducted in the waiting room. Patients’ attitudes, though not associated with prescription (P > 0.1), were, however, associated with demand for medical consultation (P < 0.01), self‐medication (P < 0.01) and prescription expectations (P < 0.01). Although doctors’ perception of patients’ expectations did indeed show an association with drug prescribing (P = 0.001), there was no association between patients’ expectations and doctors’ perception of such expectations (P > 0.1), as these tended to be overestimated by doctors.

Conclusion  We conclude that, although doctors prescribe in accordance with what they believe their patients expect, in practice patients exert no influence on drug prescribing because their prescription expectations are misconstrued by doctors, who overestimate them.
Combined bias suppression in single‐arm therapy studies
Authors: Hamre Harald J. , Glockmann Anja , Kienle Gunver S. , Kiene Helmut
Published: March 2008

Rationale, aims and objectives  For therapy evaluation studies, control groups are sometimes not feasible. In single‐arm studies, various bias factors apart from the test therapy can affect clinical outcomes. The objective of this analysis was to improve the methods to minimize bias in single‐arm studies.

Method  We present a procedure for combined suppression of several bias factors, using two methods: sample restriction to patients unaffected by bias, and score adjustment. The procedure was used for a secondary analysis of disease score (doctors’ global rating, 0–10) in a cohort of patients receiving anthroposophic therapies for chronic diseases. Four bias factors were suppressed stepwise: attrition bias (by replacing missing values with the baseline value carried forward), bias from natural recovery (by sample restriction to patients with disease duration of ≥12 months), regression to the mean due to symptom‐driven self‐selection (by replacing baseline scores with scores three months before enrolment) and bias from adjunctive therapies (by sample restriction to patients not using adjunctive therapies).

Results  In the cohort analysed, these four bias factors could together explain a maximum of 37% of the 0‐ to 6‐month improvement of disease score.

Conclusion  Combined bias suppression, using sample restriction and score adjustment, is a transparent procedure to minimize bias in single‐arm therapy studies. Further applicability of the procedure should be tested in future studies.
Proteinase‐activated receptor‐1 (PAR1) and PAR2 but not PAR4 mediate contraction in human and guinea‐pig gallbladders
Authors: Lee M.‐c. , Huang S.‐c.
Published: March 2008

Abstract  Proteinase‐activated receptor‐1 (PAR1) and PAR2 mediate contraction in the guinea‐pig gallbladder. To investigate and compare the effects mediated by PARs in the human gallbladder with those in the guinea‐pig gallbladder, we measured contractions of isolated human and guinea‐pig gallbladder strips caused by PAR agonists. Results in human were similar to those in guinea‐pig gallbladder. The PAR1 agonists, thrombin, TFLLR‐NH2 and SFLLRN‐NH2, as well as the PAR2 agonists, trypsin, SLIGKV‐NH2 and SLIGRL‐NH2, caused contraction in both human and guinea‐pig gallbladders. These indicate the existence of PAR1 and PAR2 mediating gallbladder contraction. Furthermore, the existence of PAR1 and PAR2 in the human gallbladder was confirmed by reverse transcription‐polymerase chain reaction. In contrast, FSLLR‐NH2, a PAR1 control peptide, and VKGILS‐NH2, a PAR2 control peptide, as well as three PAR4 agonists, GYPGKF‐NH2, GYPGQV‐NH2 and AYPGKF‐NH2, did not cause any contraction or relaxation. The contractile responses to TFLLR‐NH2, SFLLRN‐NH2 and trypsin in both human and guinea‐pig gallbladders were insensitive to atropine and tetrodotoxin, suggesting direct effects. These results demonstrate that, similar to the guinea‐pig gallbladder, both PAR1 and PAR2 but not PAR4 mediate muscle contraction in the human gallbladder. PAR1 and PAR2 may play important roles in the control of both human and guinea‐pig gallbladder motility.
Enteric neurodegeneration in ageing
Authors: Camilleri M. , Cowen T. , Koch T. R.
Published: March 2008

Abstract  The objective of this article is to review the clinical presentation and neurobiology of degeneration of the enteric nervous system with emphasis on human data where available. Constipation, incontinence and evacuation disorders are frequently encountered in the ageing population. Healthy lower gastrointestinal function is essential for successful ageing as it is critical to maintaining independence and autonomy to pursue further activity. One clinical expression of enteric neurodegeneration is constipation. However, the aetiology may be multifactorial as disturbances of epithelial, muscle or neural function may all result from neurodegeneration. There is evidence of loss of excitatory (e.g. cholinergic) enteric neurons and interstitial cells of Cajal, whereas inhibitory (including nitrergic) neurons appear unaffected. Understanding neurodegeneration in the enteric nervous system is key to developing treatments to reverse it. Neurotrophins have been shown to accelerate colonic transit and relieve constipation in the medium term; they are also implicated in maintenance programmes in adult enteric neurons through a role in antioxidant defence. However, their effects in ageing colon require further study. There is evidence that 5‐HT2 and 5‐HT4 mechanisms are involved in development, maintenance and survival of enteric neurons. Further research is needed to understand and potentially reverse enteric neurodegeneration.
Three parameters comprehensively describe the temperature response of respiratory oxygen reduction
Authors: KRUSE JÖRG , ADAMS MARK A.
Published: March 2008

Using an exponential model that relies on Arrhenius kinetics, we explored Type I, Type II and dynamic (e.g. decliningQ10with increasing temperature) responses of respiration to temperature. Our Arrhenius model provides three parameters:RREF(the base of the exponential model, nmol g−1 s−1),E0(the overall activation energy of oxygen reduction that dominates its temperature sensitivity, kJ mol−1) andδ(that describes dynamic responses ofE0to measurement temperature, 103 K2). Two parameters,E0andδ, are tightly linked. Increases in overall activation energy at a reference temperature were inversely related to changes inδ. At anE0of ca. 45 kJ mol−1,δapproached zero, and respiratory temperature response was strictly Arrhenius‐like. Physiologically, these observations suggest that as contributions of AOX to combined oxygen reduction increase,E0(REF) decreases because of different temperature sensitivities forVmax, andδincreases because of different temperature sensitivities forK1/2of AOX and COX. The balance between COX and AOX activity helps regulate plant metabolism by adjusting the demand for ATP to that for reducing power and carbon skeleton intermediates. Our approach enables determination of respiratory capacityin vivoand opens a path to development of process‐based models of plant respiration.
SsTypA1, a chloroplast‐specific TypA/BipA‐type GTPase from the halophytic plant Suaeda salsa, plays a role in oxidative stress tolerance
Authors: WANG FANG , ZHONG NAI‐QIN , GAO PENG , WANG GUI‐LING , WANG HAI‐YUN , XIA GUI‐XIAN
Published: March 2008

Suaeda salsa is a leaf‐succulent euhalophytic plant capable of surviving under seawater salinity. Here, we report the isolation and functional analysis of a novel Suaeda gene (designated as SsTypA1) encoding a member of the TypA/BipA GTPase gene family. The steady‐state transcript level of SsTypA1 in S. salsa was up‐regulated in response to various external stressors. Expression of SsTypA1 was restricted to the epidermal layers of the leaf and stem in S. salsa, and SsTypA1–green fluorescence protein (GFP) fusion proteins were targeted to the chloroplasts of tobacco leaves. Ectopic over‐expression of SsTypA1 rendered the transgenic tobacco plants with significantly increased tolerance to oxidative stress, and this was accompanied by a reduction in H2O2 content. Enzymatic and Western blot analyses revealed that the activity and amount of the thylakoid‐bound NAD(P)H dehydrogenase (NDH) complex in the chloroplasts of leaf cells were enhanced. Additionally, an in vitro assay demonstrated that SsTypA1 bound to GTP and possessed GTPase activity that was stimulated by the presence of chloroplast 70S ribosomes. Together, these results suggest that SsTypA1 may play a critical role in the development of oxidative stress tolerance, perhaps as a translational regulator of the stress‐responsive proteins involved in reactive oxygen species (ROS) suppression in chloroplast.
Truncated flame structures within a deposit of the Indian Ocean Tsunami: evidence of syn‐sedimentary deformation
Authors: MATSUMOTO DAN , NARUSE HAJIME , FUJINO SHIGEHIRO , SURPHAWAJRUKSAKUL APICHART , JARUPONGSAKUL THANAWAT , SAKAKURA NORIHIKO , MURAYAMA MASAFUMI
Published: March 2008

This study reveals the three‐dimensional morphology and syn‐sedimentary formation processes of a deformation structure termed ‘truncated flame structures’ which is found in a terrestrial tsunami deposit in southern Thailand that formed during the 2004 Indian Ocean Tsunami. The structure was found at the boundary between a lower fine‐grained layer and an upper coarse‐grained layer that are related to two runup events. In order to confirm the morphology of the structure, the authors excavated two trenches and an opencast pit. When viewed in a cross‐section oriented parallel to the direction of the runup current, the deformed boundary has an irregularly bulging profile, similar to that observed in flame structures. The protruding structures are inclined towards the downstream direction of the runup current, and are truncated horizontally along their upper surface by parallel laminations in the overlying layer. When viewed in a cross‐section oriented perpendicular to the current direction, it appears that parts of the upper layer descend into the lower layer as lobate masses. In places, these masses are completely detached from the main part of the upper layer, forming circular or elliptical shapes. The contact between the lower layer and the main part of the upper layer is a planar truncation surface. Opencast excavation of the contact surface revealed that the deformed structures have flat, sinuous horseshoe crests that open in a downstream direction. It is possible for the runup current to generate shear stress such that it deforms the boundary into a truncated flame structure. Moreover, the observations made in this study indicate the syn‐sedimentary development of the structure: deformation and truncation occurred simultaneously in association with the runup current that formed the upper layer. Truncated flame structures can be used as a criterion in identifying the syn‐sedimentary deformation of substrate: the structures are indicative of unidirectional flow with sufficiently high shear velocity to deform unconsolidated substrate. As in the present case, the truncated flame structures may be characteristic of tsunami events that involve strong unidirectional currents on land due to the extraordinarily long wave period of tsunamis, rather than other events such as storm surges or flooding.
Widespread unidirectional transfer of mitochondrial DNA: a case in western Palaearctic water frogs
Authors: PLÖTNER J. , UZZELL T. , BEERLI P. , SPOLSKY C. , OHST T. , LITVINCHUK S. N. , GUEX G.‐D. , REYER H.‐U. , HOTZ H.
Published: March 2008

Interspecies transfer of mitochondrial (mt) DNA is a common phenomenon in plants, invertebrates and vertebrates, normally linked with hybridization of closely related species in zones of sympatry or parapatry. In central Europe, in an area north of 48°N latitude and between 8° and 22°E longitude, western Palaearctic water frogs show massive unidirectional introgression of mtDNA: 33.7% of 407 Rana ridibunda possessed mtDNA specific for Rana lessonae. By contrast, no R. lessonae with R. ridibunda mtDNA was observed. That R. ridibunda with introgressed mitochondrial genomes were found exclusively within the range of the hybrid Rana esculenta and that most hybrids had lessonae mtDNA (90.4% of 335 individuals investigated) is evidence that R. esculenta serves as a vehicle for transfer of lessonae mtDNA into R. ridibunda. Such introgression has occurred several times independently. The abundance and wide distribution of individuals with introgressed mitochondrial genomes show that R. lessonae mt genomes work successfully in a R. ridibunda chromosomal background despite their high sequence divergence from R. ridibunda mtDNAs (14.2–15.2% in the ND2/ND3 genes). Greater effectiveness of enzymes encoded by R. lessonae mtDNA may be advantageous to individuals of R. ridibunda and probably R. esculenta in the northern parts of their ranges.
RADIOLOGICAL CRITERIA OF THE RESPONSE OF BONE TUMOURS TO RADIOTHERAPY*
Authors: DEANS B. L.
Published: March 2008

The generally accepted signs of satisfactory response of a bone tumour to radiotherapy are described. The opinion is expressed that diminution of blood supply is a result of tumour atrophy and not a primary cause of it, and that where a tumour diminishes in bulk after irradiation corresponding reduction of its blood supply is to be inferred. Arteriography has proved unreliable as an index of response to radiotherapy.

The changes in the bone which may follow irradiation of a bone tumour are reviewed, particularly with respect to “dead tumour space”. Causes of incomplete repair, and the significance of diminished resistance to effects of ordinary “wear and tear” are discussed. Radiological appreciation of the changes which may occur involves the distinction of repair bone from neoplastic bone. A suggestion as to how this distinction may be made is offered. Tomography is of value and importance in showing changes both before and after radiotherapy.
LEIOMYOMA OF THE CARDIO ‐ OESOPHAGEAL JUNCTION WITH OVERLYING SQUAMOUS CELL CARCINOMA OF THE OESOPHAGUS IN ASSOCIATION WITH A HIATAL HERNIA
Authors: WALD M. , WALTERS M. N. I.
Published: March 2008

The case history of a 72 year old woman with a leiomyoma of the cardio‐oesophageal junction associated with an overlying squamous cell carcinoma, the combined tumour lying in a hiatal hernia, is presented. The treatment was by resection, alimentary continuity being restored by oesophagogastrostomy.

The importance of oesophagoscopy in all suspected cases of oesophageal neoplasia including leiomyoma is stressed. Where the mucosa overlying an extramucosal tumour is normal, biopsy is contraindicated because of interference with subsequent surgical enucleation. When, however, the mucosa is in any way abnormal biopsy is mandatory, as in the case described an early squamous cell carcinoma was revealed.

A brief review of the literature with particular reference to the symptomatology and radiological findings is included.
Traumatic Meningoceles
Authors: Perrett Lanze V.
Published: March 2008

Traction lesions of the brachial plexus may result in avulsion of nerve roots within the spine or peripheral lesions outside the spine. The avulsion lesions carry the more serious prognosis and may be diagnosed by the myelographic demonstration of traumatic meningoceles. Other suggestive, but less specific myelographic findings are elongation of root pouches or obliteration of these structures. Accurate diagnosis of the site of the lesion saves unnecessary surgical exploration and helps in management and prognosis.
Oesophageal Dyskinesia
Authors: Wright J. T.
Published: March 2008

Various types of abnormal movements of the oesophagus have been discussed. It has been shown that there is a gentle gradation between tertiary wave formation, idiopathic diffuse spasm and achalasia, such that it becomes difficult at times to put each case into its proper compartment. The question of lower oesophageal rings has been discussed, and an attempt made to sort out some confusions which have arisen.
The Calcaneo‐Navicular Bar
Authors: Beale G.
Published: March 2008

The calcaneo‐navicular bar is discussed and illustrative cases of some of its forms are presented.
The Acute Radiation Syndrome
Authors: Gurner Colonel C. M.
Published: March 2008

Summary

Whole body radiation in doses greater than 100 rem produces the acute radiation syndrome, which may be fatal.

The final assessment of the degree of radiation damage sustained by a casualty will be made on the clinical findings, supported by serial blood examinations, and perhaps by biochemical and physical estimations, but the early assessment can only be made by knowledge of the physical circumstances of the accident and by the rapidity of appearance of the symptoms and their severity.
Radiology in Respiratory Distress of the Newborn
Authors: Howie R. N. , Stewart J. H. , Campbell THE LATE B. L.
Published: March 2008

This paper reviews the experience of an obstetric hospital in neonatal chest radiology during a twelve‐month period in which 178 babies with a variety of respiratory disorders were X‐rayed. Radiological patterns were correlated with pathological findings in 39 babies dying. Changes in early X‐rays of 68 babies with the idiopathic respiratory distress syndrome were studied and were found to be of some, although rather limited, value in prognosis. The value and some limitations of radiology in neonatal respiratory disorders are discussed.
Some Radiological Aspects of Acromegaly
Authors: Glancy J. J.
Published: March 2008

A radiological review of 15 cases of acromegaly with bone and joint involvement is presented, particular attention being paid to the constellation of changes appearing in relation to the major and minor joints of all types. A single explanation is offered for the various radiological expressions of this disease as it influences articular and related tissue.
Cavitating Pulmonary Metastases
Authors: Lowen W.
Published: March 2008

Cavitation of the primary tumors of the lung is a well known phenomenon, but it is rare in the pulmonary metastases. Three cases of cavitating pulmonary metastases are presented. The pathogenesis of the cavitation, and the radiological principles on which the demonstration of a “ring” shadow in the lung depends, are discussed. Clinical features and the differential diagnosis are briefly outlined.
Double Contrast Barium Meal Technique
Authors: Kaiokerinos James
Published: March 2008

A modified form of barium meal examination is described using a small quantity of barium and introducing gas into the stomach to produce double contrast mucosal films of the whole of the stomach.
Arterial Embolism of the Lower Limbs
Authors: WESTON T. S.
Published: March 2008

Twenty‐nine cases of arterial embolus of the lower limbs over an eight‐year period are reviewed from the case records of this hospital. Of these, 18 patients were in atrial fibrillation and 19 finally died. Of the total, five were subjected to arteriography. All five presented an appearance of block in the arterial tree, a block which in each case presented a crescentic upper margin, with convexity proximal which it is considered may be characteristic of embolus. The sites of block were in four the popliteal artery and in one the external iliac artery. Of the five patients, three underwent embolectomy and in the other two there was little clinical doubt that the obstruction was in fact due to embolus. It is suggested that this arterio‐graphic picture may in some cases be useful in differentiating embolic from thrombotic arterial obstruction.