bluuebunny/crossref_metadata_2025 huggingface dataset:
The Political Environment and Ballot Proposition Awareness
Authors: Nicholson Stephen P.
Published: June 2003

Studies that examine whether voters make informed decisions on direct legislation and whether direct legislation enhances civic engagement presume a basic awareness of ballot propositions, yet little is known about why some ballot propositions are more widely known than others. Despite the fact that research on awareness of ballot propositions and political awareness focus on individual factors, the political environment plays a vital role. This study seeks to advance our understanding of environmental factors in explaining awareness of ballot propositions. Using data on California ballot elections between the years 1956 and 2000, I find that the political environment has a substantial effect on voter awareness. Specifically, I find that the electoral cycle, media coverage, campaign spending, voter fatigue, the number of days before an election, and issues that concern morality, civil liberties, and civil rights contribute to ballot proposition awareness.
Congressional Response to Mandate Elections
Authors: Peterson David A. M. , Grossback Lawrence J. , Stimson James A. , Gangl Amy
Published: June 2003

Elections from time to time are widely believed to carry a mandate, to express a message about changed policy preferences of the electorate. Whatever the accuracy of such beliefs—a matter about which we are skeptical—perceptions of a mandate should affect the behavior of actors in government. Politicians lack the scholarly luxury of waiting for careful analyses. They must act in the months following elections. We postulate that many will act as if the mandate perceptions were true, veering away from their normal voting patterns. This is driven by election results and interpretations that undermine old calculations about what voters want. As the flow of information gradually changes these perceptions, and the election becomes more distant, members of Congress return to their normal position. We first ask, how would members observe an emerging consensus of mandate? And then we model the duration of the change in behavior in an event‐history framework. That permits a depiction of important movements of the median member and, from this, inferences about policy impact.
The Determinants and Consequences of Recall Error About Gulf War Preferences
Authors: Joslyn Mark R.
Published: June 2003

Memory plays a key role in many theories of politics, yet the determinants of inaccurate political memories have not been the subject of much investigation. Combining a dosage‐resistance theory of political communications with a theory of memory lapse and reconstruction, it is predicted that a clearly identifiable cluster of traits ought to render people vulnerable to inaccurate autobiographical memory. Testing this hypothesis with ANES 1990–1992 Gulf War panel data on postwar memories of prewar preferences, the theory receives considerable empirical support. Among other factors, media exposure and trust in government increase vulnerability to misremembering, while education increases resistance. Finally, it is established that inaccuracy in autobiographical memory can be tied to future political behavior: those respondents whose recall was inaccurate in 1991 were more likely to vote for the incumbent in 1992.
Value Conflict, Group Affect, and the Issue of Campaign Finance
Authors: Grant J. Tobin , Rudolph Thomas J.
Published: June 2003

The issue of campaign finance reform creates a potential conflict between the democratic values of expression and equality. Using a unique experiment embedded in a national survey of the American electorate, we examine the extent to which group affect influences citizens' commitment to these values and how it contributes to the resolution of value conflict. We find that citizens' commitment to the values of expression and equality in the campaign finance system is structured by their feelings toward those whose rights and influence are perceived to be at stake. Our analysis further shows that the effects of group affect are conditioned by issue frame. The effects of group affect are less pronounced when campaign finance is framed as an issue of political expression and rights than when it is framed in terms of political equality and influence. Finally, we find that affective information contributes to the resolution of value conflict by helping citizens to make tradeoffs between competing values in judgment situations.
Doing Rawls Justice: An Experimental Study of Income Distribution Norms
Authors: Michelbach Philip A. , Scott John T. , Matland Richard E. , Bornstein Brian H.
Published: June 2003

Distributive justice has been the focus of political theory with the postwar rise of the social welfare state, and Rawls' A Theory of Justice (1971) is arguably the most important work of political philosophy during that period. Parallel to this theoretical literature is a body of empirical research into distributive justice. We offer a synthesis of the theoretical and empirical approaches with an experimental study of how individuals use allocation principles in making judgments concerning income distribution under conditions of strict impartiality. Our experiment is designed in part to examine the extent to which they prioritize them consistent with Rawls' theory. We find that distributive justice judgments are complex but structured, with individuals tending to use several principles simultaneously and weighing them according to predictable factors, with sex and race being particularly important. We also find that individuals use several strategies in using competing allocation principles and that a considerable minority prioritize them consistent with a Rawlsian maximin strategy.
Voting May Be Habit‐Forming: Evidence from a Randomized Field Experiment
Authors: Gerber Alan S. , Green Donald P. , Shachar Ron
Published: June 2003

Habit is a frequently mentioned but understudied cause of political action. This article provides the first direct test of the hypothesis that casting a ballot in one election increases one's propensity to go to the polls in the future. A field experiment involving 25,200 registered voters was conducted prior to the November general election of 1998. Subjects were randomly assigned to treatment conditions in which they were urged to vote through direct mail or face‐to‐face canvassing. Compared to a control group that received no contact, the treatment groups were significantly more likely to vote in 1998. The treatment groups were also significantly more likely to vote in local elections held in November of 1999. After deriving a statistical estimator to isolate the effect of habit, we find that, ceteris paribus, voting in one election substantially increases the likelihood of voting in the future. Indeed, the influence of past voting exceeds the effects of age and education reported in previous studies.
When the State Takes Over a Life: The Public Guardian as Public Administrator
Authors: Teaster Pamela B.
Published: June 2003

Public guardians are appointed by the state to meet the needs of incapacitated citizens when no other willing or responsible surrogate decision maker exists. These public administrators, who live the decisional life of another citizen, need meaningful controls and accountability because of the great private and public authority that is entrusted to them. A review of program documents, interviews with public guardians and their program supervisors, and participant observations revealed complex roles for the public guardian: service monitor, service broker, client advocate, surrogate decision maker, and relationship architect. Because of the multiplicity of roles and few controls on their actions, public guardians' accountability should first be drawn from mechanical mechanisms (for instance, thorough audits and sanctions for infractions), but a second and necessary control is the principles of public administration, which are grounded in normative values and democratic governance.
Of Citizenship, Virtue, and the Administrative Imperative: Deconstructing Aristotelian Civic Republicanism
Authors: Kalu Kalu N.
Published: June 2003

Over the years, the public administration literature has generated many different strands in the definition and conceptualization of citizenship. In theory and in practice, our understanding of what it means to be a citizen is in danger of being muddled amid the diversity of perspectives and the epistemological confusion generated in the contemporary discourse on the subject. My aim in this article is to clarify and elaborate a common thread that runs through our contemporary understanding of citizenship and to advance the general thesis that our brand of theorizing reflects an earlier tradition that embodies the conservative ethos of Aristotelian republicanism. Can such a tradition survive in modern American society?
Understanding Cooperative Behavior in Labor Management Cooperation: A Theory‐Building Exercise
Authors: Ospina Sonia , Yaroni Allon
Published: June 2003

This article proposes a theory of how mandated institutional cooperation transforms into individual cooperative behavior. Using qualitative strategies, we draw insights about cooperation in three public‐sector efforts of labor‐management cooperation (LMC). We report an association between critical shifts in the roles of stakeholders and the change from adversarial to cooperative labor relations. While managers became team players along with their employees, labor representatives assumed managerial responsibilities. These changes were also associated with a service‐oriented perspective, better understanding of the other's experiences, and a view of cooperation as partnership. At the heart of these transformations, we found critical changes in communication patterns associated with incrementally growing levels of trust. We propose a model that depicts the links between collective and individual levels of organizational action related to LMC. We conclude that the positive shifts in mental models regarding work and the value of cooperation justify the promotion of LMC efforts.
Sexual Harassment in the Federal Workplace
Authors: Newman Meredith A. , Jackson Robert A. , Baker Douglas D.
Published: June 2003

What factors influence the likelihood that a federal worker will receive unwanted sexual attention? Who is most likely to be accused of sexual harassment? What factors influence federal workers' perceptions of the effectiveness of agency sexual harassment training? Using the raw data file of the U.S. Merit Systems Protection Board's most recent survey on sexual harassment, the authors find that worker characteristics are the principal influence on the likelihood that a worker will receive unwanted sexual attention and whether an agency's sexual harassment training is perceived favorably. Contextual factors demonstrate lesser influence. Their conclusions lead the authors to believe that a reevaluation of training programs is in order. A one‐size‐fits‐all training approach may no longer be tenable, if it ever was.
The Call to Public Service: Entrance, Learning, and Reflection
Authors: Kiel L. Douglas
Published: June 2003

Books reviewed in this article:

Richard P. Nathan, So You Want to Be in Government? Handbook for Appointed Officials in America's Governments

Kenneth H. Ashworth, Caught between the Dog and the Fireplug, or, How to Survive Public Service

O.C. McSwite, Invitation to Public Administration
Interaction of Rotaviruses with Hsc70 during Cell Entry Is Mediated by VP5
Authors: Zárate Selene , Cuadras Mariela A. , Espinosa Rafaela , Romero Pedro , Juárez Karla O. , Camacho-Nuez Minerva , Arias Carlos F. , López Susana
Published: June 2003

Rotavirus infection seems to be a multistep process in which the viruses are required to interact with several cell surface molecules to enter the cell. The virus spike protein VP4, which is cleaved by trypsin into two subunits, VP5 and VP8, is involved in some of these interactions. We have previously shown that the neuraminidase-sensitive rotavirus strain RRV initially attaches to a sialic acid-containing cell molecule through the VP8 subunit of VP4 and subsequently interacts with integrin α2β1 through VP5. After these initial contacts, the virus interacts with at least two additional proteins located at the cell surface, the integrin αvβ3 and the heat shock cognate protein Hsc70. In this work, we have shown that rotavirus RRV and its neuraminidase-resistant variant nar3 interact with Hsc70 through a VP5 domain located between amino acids 642 and 658 of the protein. This conclusion is based on the observation that a recombinant protein comprising the 300 carboxy-terminal amino acids of VP5 binds specifically to Hsc70 and a synthetic peptide containing amino acids 642 to 658 competes with the binding of the RRV and nar3 viruses to the heat shock protein. The VP5 peptide also competed with the binding to Hsc70 of the recombinant VP5 protein, and an antibody to Hsc70 reduced the binding of the recombinant protein to the surface of MA104 cells. The fact that the synthetic peptide blocks the infectivity of rotaviruses RRV and nar3 but not their binding to cells indicates that the interaction of VP5 with Hsc70 most probably occurs at a postattachment step during the virus entry process.
Ex Vivo Analysis of T-Cell Responses to Epstein-Barr Virus-Encoded Oncogene Latent Membrane Protein 1 Reveals Highly Conserved Epitope Sequences in Virus Isolates from Diverse Geographic Regions
Authors: Duraiswamy Jaikumar , Burrows Jacqueline M. , Bharadwaj Mandvi , Burrows Scott R. , Cooper Leanne , Pimtanothai Nattiya , Khanna Rajiv
Published: June 2003

Epstein-Barr virus (EBV)-encoded oncogene latent membrane protein (LMP) 1, which is consistently expressed in multiple EBV-associated malignancies, has been proposed as a potential target antigen for any future vaccine designed to control these malignancies. However, the high degree of genetic variation in the LMP1 sequence has been considered a major impediment for its use as a potential immunotherapeutic target for the treatment of EBV-associated malignancies. In the present study, we have employed a highly efficient strategy, based on ex vivo functional assays, to conduct an extensive sequence-wide analysis of LMP1-specific T-cell responses in a large panel of healthy virus carriers of diverse ethnic origin and nasopharyngeal carcinoma patients. By comparing the frequencies of T cells specific for overlapping peptides spanning LMP1, we mapped a number of novel HLA class I- and class II-restricted LMP1 T-cell epitopes, including an epitope with dual HLA class I restriction. More importantly, extensive sequence analysis of LMP1 revealed that the majority of the T-cell epitopes were highly conserved in EBV isolates from Caucasian, Papua New Guinean, African, and Southeast Asian populations, while unique geographically constrained genetic variation was observed within one HLA A2 supertype-restricted epitope. These findings indicate that conserved LMP1 epitopes should be considered in designing epitope-based immunotherapeutic strategies against EBV-associated malignancies in different ethnic populations.
Lessons from the past: preventive medicine in early modern England
Authors: Hill Curth L
Published: June 2003

The history of English medicine used to consist of chronicles of medical progress and great ideas culminating in twentieth century biomedicine. Unlike earlier generations whose medical beliefs and practices were seen to be both futile and dangerous, modern medicine was thought to be able to eradicate illness with a “magic bullet”. During the later part of the 20th century, however, the general public began to have doubts about the efficacy and safety of modern medicine. In turn, both the institution of medicine and the biomedical model began to be challenged by the media. These events led to a spreading desire for people to take a greater responsibility for their own health. One of the areas of greatest interest and growth is that of preventive medicine which focuses on a good diet and exercise. Far from being a new concept, however, the idea of a daily health “regimen” goes back to the ancient Greece and was further developed during the Middle Ages, and by the early modern period (1500–1800).
Triumph of the light—isopathy and the rise of transcendental homeopathy, 1830–1920
Authors: Morrell P
Published: June 2003

Modern homeopathy dwells in a nebulous and metaphysical realm into which few non-homeopathic doctors would venture; a very different world and speaking a language virtually incomprehensible to science. Fundamentally incompatible systems, their highly sophisticated conceptions of “disease” and “cure” are sufficiently divergent to prevent their peaceful coexistence. Can the best of modern scientific medicine be reconciled with this recently resuscitated “medical Lazarus”? Could a creative dialogue be established? This article explores the development of modern homeopathic thinking between 1830 and 1920, charting a discourse within homeopathy initiated in the 1830s with reference to use of “higher potencies” and disease products (“nosodes”). Incorporation of disease products into the homeopathic mainstream killed off and supplanted the earlier allopathic version of homeopathy, encouraged the use of higher potencies, and legitimated a widespread adoption of metaphysical views within the movement, here termed “transcendental homeopathy”.

Long before the birth of bacteriotherapy ... homeopathic physicians carried out investigation in their own way, and discovered similar medicines, and effected numerous cures ... Hydrophobium was proved in 1833 ... 50 years before Pasteur ... many others followed.1
Medical Humanities: a vision and some cautionary notes
Authors: Pattison S
Published: June 2003

This article aims to engender discussion about the nature and future of medical humanities. First, a normative personal vision of medical humanities as an inclusive movement is outlined. Some of the problems that may emerge if medical humanities conceives itself too narrowly are then discussed. The case of the rise of the medical ethics movement is used to show what can happen to a movement that restricts itself too quickly and then the stages of the “death course of a discipline” are described and assayed. The article concludes with a plea for medical humanities to remain a “broad church”, exploratory, pluralistic movement rather than aiming to become a paramedical academic discipline.
Medical humanities: a vision and some cautionary notes
Authors: Downie R S
Published: June 2003

Stephen Pattison outlines his vision for medical humanities and then offers cautionary notes on what might go wrong with the movement. These notes are based on what he holds has already gone wrong with medical ethics, dramatically described as the “death course of a discipline”. I have a great deal of sympathy both with his anxieties about the future development of medical humanities and with his critique of medical ethics. My reasons in both cases are a little different from his, and indeed part of his vision for medical humanities constitutes part of my worries about its future! I shall begin with some comments on Pattison’s views on medical humanities, and then more briefly comment on his diagnosis of the ills of medical ethics.
“Attempting to say something without saying it …”: writing haiku in health care education
Authors: Biley F C , Champney-Smith J
Published: June 2003

Over a number of years the authors have been running short haiku writing workshops and have been using haiku as an evaluation tool. This paper describes those experiences and uses the haiku generated in these workshops to illustrate how this poetic form can be used as—for example, part of the process of reflection, to explore emotional and practical issues related to clinical health care practice, to refine writing skills and precision and, it is hoped, to convey to others the essence of the experience of health care provision, education and, perhaps, health, illness, and disease.
Reflections on embodiment and vulnerability
Authors: Wainwright S P , Turner B S
Published: June 2003

Bodies matter as our experience of them is the basis both for social life and also for much medical and social research. There has been a spectacular increase in academic research on the body in the last twenty years or so. This paper—although a review of three ethnographic studies on the seemingly disparate and narrow fields of the embodiment of working class experience, boxing, and ballet—illuminates the broader relationships between the body, self, and society. Our paper works on three levels: firstly, as an account of the “lived experience” of embodied vulnerability; secondly, as an application of Bourdieu’s theoretical schema, and thirdly, as a philosophically grounded critique of radical social constructionist views of the body.
“The dark side of the spectrum …” a “day of suffering” for medical students
Authors: Lewis W , Grant A
Published: June 2003

The alleviation of suffering has been described as a central goal of medicine. A familiarity with this subject may have great practical benefit, while promoting reflection upon medicine more generally. This paper describes a study day for medical students that encourages them to think about suffering. A variety of texts in different media were used as the basis of group discussion. Sources reflected the range of suffering that may be encountered, including suffering from causes not normally considered to be “medical”. An evaluation of the study day was performed, using the nominal group technique, suggesting that the day was both popular and had achieved its goals.
What do Italian medical students read? A call for a library of good books on physicians for physicians
Authors: Piccoli G B , Mezza E , Soragna G , Burdese M , Bermond F , Grassi G , Jeantet A , Segoloni G P
Published: June 2003

Humanities are increasingly taught in medical schools based on the premise that sensitive and educated human beings may become better physicians. There have been few reports of what is offered in Italian medical schools and we have not been able to identify any published survey of student opinions.
Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients
Authors: Evans R G
Published: June 2003

The ideal of patient centred medicine remains only partially realised. Within modern Western society, the highly individualistic culture and religious decline linked with medicine's reluctance to relinquish an outmoded form of scientific rationalism can act as reductive influences, stifling conceptual development. Some examples of the recent literature on communication skills in medicine are analysed to discern the underlying philosophy. A rationalist stance invites an examination of the possible nature of rationality. Another example accepts the need to accommodate the emotional and the unconscious. Issues of human suffering with an inherent spiritual dimension seem to remain excluded. The need to move beyond a duality of reason and emotion to embrace the existential and spiritual is suggested as a theoretical prerequisite for developing a more inclusive concept of patient centred medicine, which only then may be realised. Some brief examples are considered of the sort of notions and types of discourse that might effectively inform “teaching” of communication skills.
Does Babbling Sound Native? Listener Responses to Vocalizations Produced by Swedish and American 12- and 18-Month-Olds
Authors: Engstrand Olle , Williams Karen , Lacerda Francisco
Published: June 2003

Previous studies of infants’ babbling have reported contradictory results as to the extent and timing of discernible phonetic influences of the ambient language. In the present experiment, five experienced phoneticians were asked to listen for ambient language effects on vocalizations produced by American and Swedish 12- and 18-month-olds (with 8 children in each language and age group), and to motivate their decisions in terms of word or phonetic cue perception. Group results indicated that listeners did not perceive effects of ambient language on pure babbles for either of the two age groups, whereas a clear effect appeared in both age groups given a more liberal definition of babbling. This is taken to suggest that results of ambient language listening tests may depend crucially on judgments of vocalizations’ word status. As compared to the group trends, listener responses to individual children’s vocalizations did not indicate that a majority of either 12- or 18-monthers were sufficiently native-sounding to be reliably identified on the basis of ambient language. A closer analysis of listeners’ use of phonetic cues indicated that one single phonetic property, the grave tonal word accent, was discerned by most listeners in vocalizations produced by the Swedish 18-monthers; this property was also discerned by one listener in vocalizations produced by Swedish 12-monthers. This result is consistent with the generally held belief in the primacy of tonal features in phonetic acquisition, and with experimental evidence indicating that Swedish mothers tend to enhance word accent contours in baby talk. In the final section of the paper, the results are discussed with a view to reconcile competing theories of babbling development, notably the ‘babbling drift’ and the ‘independence’ hypotheses.
Diet of a Free-Ranging Group of Squirrel Monkeys (Saimiri sciureus) in Eastern Brazilian Amazonia
Authors: Lima Eldianne M. , Ferrari Stephen F.
Published: June 2003

The feeding behaviour of free-ranging Saimiri sciureus was monitored over a 6-month period in eastern Brazilian Amazonia. Behavioural data were collected in scan samples (7–9 days per month), and fruit and arthropod availability were recorded monthly. A total of 3,546 feeding records were collected, divided between reproductive plant parts (55.1%) and arthropods (44.9%). The majority of identified prey were orthopterans and lepidopterans, and 10 of the 23 plant species exploited were Leguminosae and Sapotaceae. The diet varied progressively between August (20.0% plant, 80.0% animal) and January (79.7% plant, 20.3% animal). This shift accompanied an increase in the number of fruiting trees and evidence of declining arthropod availability. This included a marked reduction in foraging success and increasing consumption of immature prey. Overall, the data indicate that Amazonian squirrel monkeys may be relatively frugivorous during periods when prey is scarce.
Combined Treatment With Arsenic Trioxide and All-Trans-Retinoic Acid in Patients With Relapsed Acute Promyelocytic Leukemia
Authors: Raffoux Emmanuel , Rousselot Philippe , Poupon Joël , Daniel Marie-Thérèse , Cassinat Bruno , Delarue Richard , Taksin Anne-Laure , Réa Delphine , Buzyn Agnès , Tibi Annick , Lebbé Geneviève , Cimerman Patricia , Chomienne Christine , Fermand Jean-Paul , de Thé Hugues , Degos Laurent , Hermine Olivier , Dombret Hervé
Published: June 2003

Purpose: Arsenic trioxide (ATO) is capable of inducing a high hematologic response rate in patients with relapsed acute promyelocytic leukemia (APL). Preclinical observations have indicated that all-trans-retinoic acid (ATRA) may strongly enhance the response to ATO.

Patients and Methods: Between 1998 and 2001, we conducted a randomized study of ATO alone versus ATO plus ATRA in 20 patients with relapsed APL, all previously treated with ATRA-containing chemotherapy. The primary objective was to demonstrate a significant reduction in the time necessary to obtain a complete remission (CR) in the ATO/ATRA group compared with the ATO group. Secondary objectives were safety and molecular response.

Results: The CR rate after one ATO with or without ATRA induction cycle was 80%. Clinical and pharmacokinetic observations indicated that the main mechanism of action of ATO in vivo was the induction of APL cell differentiation. Hematologic and molecular response, time necessary to reach CR, and outcome were comparable in both treatment groups. Of 16 CR patients, three patients who reached a molecular remission after one induction cycle had all received chemotherapy for a treatment-induced hyperleukocytosis. Three additional patients who received further additional ATO with or without ATRA cycles converted later to molecular negativity.

Conclusion: ATRA did not seem to significantly improve the response to ATO in patients relapsing from APL. Other potential combinations, including ATO plus chemotherapy, have to be tested.
Randomized Trial of Adjuvant Chemotherapy With Mitomycin, Fluorouracil, and Cytosine Arabinoside Followed by Oral Fluorouracil in Serosa-Negative Gastric Cancer: Japan Clinical Oncology Group 9206–1
Authors: Nashimoto Atsushi , Nakajima Toshifusa , Furukawa Hiroshi , Kitamura Masatsugu , Kinoshita Taira , Yamamura Yoshitaka , Sasako Mitsuru , Kunii Yasuo , Motohashi Hisahiko , Yamamoto Seiichiro ,   the Gastric Cancer Surgical Study Group in the Japan Clinical Oncology Group
Published: June 2003

Purpose: To evaluate the survival benefit of adjuvant chemotherapy after curative resection in serosa-negative gastric cancer patients (excluding patients who were T1N0), we conducted a multicenter phase III clinical trial in which 13 cancer centers in Japan participated.

Patients and Methods: From January 1993 to December 1994, 252 patients were enrolled into the study and allocated randomly to adjuvant chemotherapy or surgery alone. The chemotherapy comprised intravenous mitomycin 1.33 mg/m2, fluorouracil (FU) 166.7 mg/m2, and cytarabine 13.3 mg/m2 twice weekly for the first 3 weeks after surgery, and oral FU 134 mg/m2 daily for the next 18 months for a total dose of 67 g/m2. The primary end point was relapse-free survival. Overall survival and the site of recurrence were secondary end points.

Results: Ninety-eight percent of patients underwent gastrectomy with D2 or greater lymph node dissection. There were no treatment-related deaths and few serious adverse events. There was no significant difference in relapse-free and overall survival between the arms (5-year relapse-free survival 88.8% chemotherapy v 83.7% surgery alone; P = .14 and 5-year survival 91.2% chemotherapy v 86.1% surgery alone; P = .13, respectively). Nine patients (7.1%) in the chemotherapy arm and 17 patients (13.8%) in the surgery-alone arm had cancer recurrence.

Conclusion: There was no statistically significant relapse-free or overall survival benefit with this adjuvant chemotherapy for patients with macroscopically serosa-negative gastric cancer after curative resection, and there was no statistical difference between the two arms relating to the types of cancer recurrence. We do not recommend adjuvant chemotherapy with this regimen for this population in clinical practice.
Long-Term Prospective Follow-Up Study of Cardiac Function After Cardiotoxic Therapy for Malignancy in Children
Authors: Poutanen Tuija , Tikanoja Tero , Riikonen Pekka , Silvast Annuli , Perkkiö Mikko
Published: June 2003

Purpose: To evaluate cardiac function by means of conventional and three-dimensional echocardiography (3DE) and measurement of natriuretic peptides in children and adolescents previously treated for childhood malignancy using individual follow-up data and matched control children as reference criteria.

Patients and Methods: Thirty-nine survivors of childhood malignancy were examined in 1994 and 1998. The mean time from the diagnosis was 8.6 (3.9 to 16.8) years and between cardiac evaluations was 4.1 (3.3 to 5.1) years. Patients were divided into two groups according to therapies given (group I (n = 30): no cardiac irradiation, median cumulative anthracycline dose 210 mg/m2; group II (n = 9): irradiation in the cardiac region, median cumulative anthracycline dose 180 mg/m2).

Results: Fractional shortening (FS) in 1994 was higher than in 1998 (32.5 ± 4.3 vs. 30.3% ± 3.3%, P = .009). 33% of patients in group I and 56% in group II in 1994 and 30% of patients in group I and 67% in group II in 1998 had N-terminal of the propeptide-atrial natriuretic peptide (NT-proANP) levels exceeding the 90th percentile of controls. In 1998, both groups (I and II) had lower ejection fraction (EF) measured by 3DE than their matched controls (52.9 ± 5.2 vs. 58.8% ± 3.1%, P < .001 and 50.0 ± 6.6 vs. 60.8% ± 3.2%, P = .024, respectively). Left atrial maximum volumes/body surface area were smaller in the patients than in controls. B-Type natriuretic peptide values did not differ significantly in either group.

Conclusion: Left ventricular contractility decreases slowly even years after cardiotoxic cancer therapy in children. 3DE and NT-proANP measurements are effective methods to evaluate the cardiac function in these patients.
Soluble E-Cadherin is an Independent Pretherapeutic Factor for Long-Term Survival in Gastric Cancer
Authors: Chan Annie On-On , Chu Kent-Man , Lam Shiu-Kum , Wong Benjamin Chun-Yu , Kwok Ka-Fai , Law Simon , Ko Samuel , Hui Wai-Mo , Yueng Yui-Hung , Wong John
Published: June 2003

Purpose: To evaluate whether pretherapeutic serum soluble E-cadherin is an independent factor predicting long-term survival in gastric cancer. Gastric cancer remains the second leading cause of cancer-related deaths in the world, but a satisfactory tumor marker is currently unavailable for gastric cancer. Soluble E-cadherin has recently been found to have prognostic value in gastric cancer.

Patients and Methods: One hundred sixteen patients with histologically proven gastric adenocarcinoma were included in the trial. Pretherapeutic serum was collected, and soluble E-cadherin was assayed using a commercially available enzyme-linked immunosorbent assay kit. The patients were followed up prospectively at the outpatient clinic.

Results: There were 75 men and 41 women, with a mean (± SD) age of 66 ± 14 years. Forty-eight percent of tumors were located in the gastric antrum. The median survival time was 11 months. The mean pretherapeutic value of soluble E-cadherin was 9,159 ng/mL (range, 6,002 to 10,025 ng/mL), and the mean pretherapeutic level of carcinoembryonic antigen was 11 ng/mL (range, 0.3 to 4,895 ng/mL). On multivariate analysis, soluble E-cadherin is an independent factor predicting long-term survival. Ninety percent of patients with a serum level of E-cadherin greater than 10,000 ng/mL had a survival time of less than 3 years (P = .009).

Conclusion: Soluble E-cadherin is a potentially valuable pretherapeutic prognostic factor in patients with gastric cancer.
Barriers to Clinical Trial Participation by Older Women With Breast Cancer
Authors: Kemeny M. Margaret , Peterson Bercedis L. , Kornblith Alice B. , Muss Hyman B. , Wheeler Judith , Levine Ellis , Bartlett Nancy , Fleming Gini , Cohen Harvey J.
Published: June 2003

Purpose: Although 48% of breast cancer patients are 65 years old or older, these older patients are severely underrepresented in breast cancer clinical trials. This study tested whether older patients were offered trials significantly less often than younger patients and whether older patients who were offered trials were more likely to refuse participation than younger patients.

Patients and Methods: In 10 Cancer and Leukemia Group B institutions, using a retrospective case-control design, breast cancer patients eligible for an open treatment trial were paired: less than 65 years old and ≥ 65 years old. Each of the 77 pairs were matched by disease stage and treating physician. Patients were interviewed as to their reasons for participating or refusing to participate in a trial. The treating physicians were also given questionnaires about their reasons for offering or not offering a trial.

Results: Sixty-eight percent of younger stage II patients were offered a trial compared with 34% of the older patients (P = .0004). In multivariate analyses, disease stage and age remained highly significant in predicting trial offering (P = .0008), when controlling for physical functioning and comorbidity. Of those offered a trial, there was no significant difference in participation between younger (56%) and older (50%) patients (P = .67).

Conclusion: In a multivariate analysis including comorbid conditions, age and stage were the only predictors of whether a patient was offered a trial. The greatest impediment to enrolling older women onto trials in the setting of this study was the physicians’ perceptions about age and tolerance of toxicity.
Repeated Intravesical Instillations of an Adenoviral Vector in Patients With Locally Advanced Bladder Cancer: A Phase I Study of p53 Gene Therapy
Authors: Pagliaro Lance C. , Keyhani Afsaneh , Williams Dallas , Woods Denise , Liu Baoshun , Perrotte Paul , Slaton Joel W. , Merritt James A. , Grossman H. Barton , Dinney Colin P.
Published: June 2003

Purpose: We investigated the feasibility, safety, and biologic activity of adenovirus-mediated p53 gene transfer in patients with locally advanced bladder cancer.

Patients and Methods: Patients with measurable, locally advanced transitional-cell carcinoma of the bladder who were not candidates for cystectomy were eligible. On a 28-day cycle, intravesical instillations of INGN 201 (Ad5CMV-p53) were administered on days 1 and 4 at three dose levels (1010 particles to 1012 particles) or on either 4 or 8 consecutive days at a single dose level (1012 particles).

Results: Thirteen patients received a total of 22 courses without dose-limiting toxicity. Specific transgene expression was detected by reverse transcriptase polymerase chain reaction in bladder biopsy tissue from two of seven assessable patients. There were no changes in p53, p21waf1/cip1, or bax protein levels in bladder epithelium evident from immunohistochemical analysis of 11 assessable patients. Outpatient administration of multiple courses was feasible and well tolerated. A patient with advanced superficial bladder cancer showed evidence of tumor response.

Conclusion: Intravesical instillation of Ad5CMV-p53 is safe, feasible, and biologically active when administered in multiple doses to patients with bladder cancer. Observations from this study indicate that this treatment has an antitumor effect in superficial transitional-cell carcinoma. Improvements in the efficiency of gene transfer and the levels of gene expression are required to develop more effective gene therapy for bladder cancer.
Phase II Evaluation of Temozolomide and 13-cis-Retinoic Acid for the Treatment of Recurrent and Progressive Malignant Glioma: A North American Brain Tumor Consortium Study
Authors: Jaeckle Kurt A. , Hess Kenneth R. , Yung W.K. Alfred , Greenberg Harry , Fine Howard , Schiff David , Pollack Ian F. , Kuhn John , Fink Karen , Mehta Minesh , Cloughesy Timothy , Nicholas M. Kelly , Chang Susan , Prados Michael
Published: June 2003

Purpose: Temozolomide (TMZ) and 13-cis-retinoic acid (cRA) have shown activity in prior single-agent trials of recurrent malignant gliomas (MG). This phase II trial evaluated efficacy and toxicity of combination temozolomide and cRA treatment in recurrent MG.

Patients and Methods: Adults with recurrent supratentorial MG for whom surgery, radiation, and/or chemotherapy failed were eligible. Treatment included oral TMZ 150 or 200 mg/m2/d, days 1 through 5, and cRA 100 mg/m2/d, days 1 to 21, every 28 days. Primary end point was progression-free survival at 6 months (PFS 6); secondary end points included response, survival, and PFS12.

Results: Eighty-eight eligible patients (glioblastoma multiforme [n = 40]; anaplastic gliomas [n = 48; astrocytoma, 28; oligodendroglioma, 14; mixed glioma, six]) received treatment. PFS 6 was 43% (95% confidence interval [CI], 33% to 54%) and PFS12 was 16% (95% CI, 10% to 26%). Median overall PFS was 19 weeks (95% CI, 16 to 27 weeks), and median overall survival (OS) was 47 weeks (95% CI, 36 to 58 weeks). OS was 46% (95% CI, 36% to 57%) at 52 weeks and 21% (95% CI, 13% to 31%) at 104 weeks. Of 84 assessable patients, there were two (3%) complete responses and eight (12%) partial responses (complete plus partial response, 15%). Among 499 treatment cycles, the most common grade 3/4 events included granulocytopenia (1.8%), thrombocytopenia (1.4%), and hypertriglyceridemia (1.2%).

Conclusion: TMZ and cRA were active, exceeding our 20% thresholds for PFS 6 success, assuming 20% improvement over our previously reported database (glioblastoma multiforme: expected, 30%; observed, 32%; anaplastic glioma: expected, 40%; observed, 50%).
Immunization With Melan-A Peptide-Pulsed Peripheral Blood Mononuclear Cells Plus Recombinant Human Interleukin-12 Induces Clinical Activity and T-Cell Responses in Advanced Melanoma
Authors: Peterson Amy C. , Harlin Helena , Gajewski Thomas F.
Published: June 2003

Purpose: Preclinical studies showed that immunization with peripheral blood mononuclear cells (PBMC) loaded with tumor antigen peptides plus interleukin-12 (IL-12) induced CD8+T-cell responses and tumor rejection. We recently determined that recombinant human (rh) IL-12 at 30 to 100 ng/kg is effective as a vaccine adjuvant in patients. A phase II study of immunization with Melan-A peptide-pulsed PBMC + rhIL-12 was conducted in 20 patients with advanced melanoma.

Patients and Methods: Patients were HLA-A2–positive and had documented Melan-A expression. Immunization was performed every 3 weeks with clinical re-evaluation every three cycles. Immune responses were measured by ELISpot assay before and after treatment and through the first three cycles, and were correlated with clinical outcome.

Results: Most patients had received prior therapy and had visceral metastases. Nonetheless, two patients achieved a complete response, five patients achieved a minor or mixed response, and four patients had stable disease. The median survival was 12.25 months for all patients and was not yet reached for those with a normal lactate dehydrogenase. There were no grade 3 or 4 toxicities. Measurement of specific CD8+T-cell responses by direct ex vivo ELISpot revealed a significant increase in interferon gamma–producing T cells against Melan-A (P = .015) after vaccination, but not against an Epstein-Barr virus control peptide (P = .86). There was a correlation between the magnitude of the increase in Melan-A–specific cells and clinical response (P = .046).

Conclusion: This immunization approach may be more straightforward than dendritic cell strategies and seems to have clinical activity that can be correlated to a biologic end point.
Activation energy and curing behavior of resol‐ and novolac‐type phenolic resins by differential scanning calorimetry and thermogravimetric analysis
Authors: Lee Young‐Kyu , Kim Dae‐Jun , Kim Hyun‐Joong , Hwang Teak‐Sung , Rafailovich Miriam , Sokolov Jonathan
Published: June 2003

The thermal behavior, thermal degradation kinetics, and pyrolysis of resol and novolac phenolic resins with different curing conditions, as a function of the formaldehyde/phenol (F/P) molar ratio (1.3, 1.9, and 2.5 for the resol resins and 0.5, 0.7, and 0.9 for the novolac resins) were investigated. The activation energy of the thermal reaction was studied with differential scanning calorimetry at five different heating rates (2, 5, 10, 20, and 40°C/min) between 50 and 300°C. The activation energy of the thermal decomposition was investigated with thermogravimetric analysis at five different heating rates (2, 5, 10, 20, and 40°C/min) from 30 to 800°C. The low molar ratio resins exhibited a higher activation energy than the high molar ratio resins in the curing process. This meant that less heat was needed to cure the high molar ratio resins. Therefore, the higher the molar ratio was, the lower the activation energy was of the reaction. As the thermal decomposition of the resol resins proceeded, the activation energy sharply decreased at first and then remained almost constant. The activation energy of the thermal decomposition for novolac resins with F/P = 0.5 or F/P = 0.7 was almost identical in all regions, whereas that for novolac resins with F/P = 0.9 gradually decreased as the reaction proceeded. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2589–2596, 2003
Thermotropic liquid‐crystalline copolyester/thermoplastic elastomer in situ composites. I. Rheology, morphology, and mechanical properties of extruded strands
Authors: Saikrasun S. , Bualek‐Limcharoen S. , Kohjiya S. , Urayama K.
Published: June 2003

A thermotropic liquid‐crystalline polymer (TLCP), a copolyester with a 60/40 molar ratio of p‐hydroxy benzoic acid and poly(ethylene terephthalate), was blended with a styrene/ethylene butylene/styrene thermoplastic elastomer with a twin‐screw extruder. The rheological behavior, morphology, and mechanical properties of the extruded strands of the blends were investigated. The rheological measurements were performed on a capillary rheometer in the shear rate range of 5–2000 s−1 and on a plate‐and‐plate rheometer in the frequency range of 0.6–200 rad s−1. All the neat components and blends exhibited shear thinning behavior. Both the shear and complex viscosities of all the blends decreased with increasing TLCP contents, but the decrease in the shear viscosity was more pronounced. The best fibrillar morphology was observed in the extruded strands of a blend containing 30 wt % TLCP, and a lamellar structure started to form at 40 wt % TLCP. With an increasing concentration of TLCP, the tensile modulus of the blends was greatly enhanced, whereas the tensile strength was almost unchanged. The elongation at break of the blends first slightly decreased with the addition of TLCP and then sharply dropped at 40 wt % TLCP. The tension set measured at 200% deformation slightly increased with increasing TLCP contents up to 30 wt %, over which the set value was unacceptable for a thermoplastic elastomer. A remarkable improvement in the dynamic mechanical properties of the extruded strands was observed in the blends with increasing amounts of TLCP. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2676–2685, 2003
Biodegradation of starch and acrylic‐grafted starch by Aspergillus niger
Authors: Moreno‐Chulim M. V. , Barahona‐Perez F. , Canche‐Escamilla G.
Published: June 2003

The biodegradation of starch and grafted starch by Aspergillus niger was examined. The grafted polymers were poly(methyl methacrylate) (PMMA) and poly(butyl acrylate) (PBA). Thermogravimetric analysis, Fourier transform infrared, and scanning electron microscopy were used to determine the morphology and degradation degree of each material. The temperature of maximum decomposition for starch decreased as enzymatic degradation proceeded, and it was completed on the 8th day of culturing in a liquid medium. Grafted samples with PMMA and PBA achieved degradation of their starch moiety. PBA in starch‐g‐PBA samples hindered the accessibility of the enzymes to the degradable material, and this resulted in a longer degradation time. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2764–2770, 2003
Morphology, crystallinity, and electrochemical properties of in situ formed poly(ethylene oxide)/TiO2 nanocomposite polymer electrolytes
Authors: Liu Y. , Lee Jim Y. , Hong L.
Published: June 2003

A method to produce nanocomposite polymer electrolytes consisting of poly(ethylene oxide) (PEO) as the polymer matrix, lithium tetrafluoroborate (LiBF4) as the lithium salt, and TiO2 as the inert ceramic filler is described. The ceramic filler, TiO2, was synthesized in situ by a sol–gel process. The morphology and crystallinity of the nanocomposite polymer electrolytes were examined by scanning electron microscopy and differential scanning calorimetry, respectively. The electrochemical properties of interest to battery applications, such as ionic conductivity, Li+ transference number, and stability window were investigated. The room‐temperature ionic conductivity of these polymer electrolytes was an order of magnitude higher than that of the TiO2 free sample. A high Li+ transference number of 0.51 was recorded, and the nanocomposite electrolyte was found to be electrochemically stable up to 4.5 V versus Li+/Li. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2815–2822, 2003