bluuebunny/crossref_metadata_2025 huggingface dataset:
Underinsurance and Pediatric Immunization Delivery in the United States
Authors: Smith Philip J. , Molinari Noelle-Angelique , Rodewald Lance E.
Published: November 2009

BACKGROUND: Underinsured children are covered by private health insurance that does not cover the cost of vaccines, are not entitled to receive publicly purchased vaccines at no cost through the Vaccines for Children (VFC) Program unless they receive doses at a Federally Qualified Health Center (FQHC) or a Rural Health Center (RHC), may be referred by their primary care providers to health department clinics (HDCs) for vaccinations, and may have lower vaccination coverage for new and more expensive vaccines.

OBJECTIVES: To describe the estimated percentage of children in the U.S. who are underinsured, receive vaccine doses at HDCs, and are not VFC-entitled; and to evaluate the association between being underinsured, receiving vaccine doses at an HDC, and timely vaccination coverage.

METHODS: Subjects were 16621 19–35 month-old children sampled by the National Immunization Survey in 2007.

RESULTS: Of all 19–35 month-old children, an estimated 10.5% were underinsured; and an estimated 1.4% were underinsured, received doses at an HDC, and were not VFC-entitled. Compared to fully insured children, children who were underinsured and received doses at an HDC had significantly lower vaccination coverage for the varicella (81.5% vs. 87.7%, p < 0.05) and PCV7 (55.1% vs. 75.9%, p < 0.05) vaccines.

CONCLUSIONS: Children who were underinsured and received doses at HDCs were found to have lower estimated timely vaccination coverage for recently recommended vaccines and more expensive varicella and PCV7 vaccines. To adequately vaccinate these children at HDCs, states require stable funding to pay for vaccines as the number of new and more expensive vaccines grows.
Evaluation of a Simple Method to Classify the Thermal Characteristics of Streams Using a Nomogram of Daily Maximum Air and Water Temperatures
Authors: Chu Cindy , Jones Nicholas E. , Piggott Andrew R. , Buttle James M.
Published: November 2009

This study assessed the applicability of an existing methodology to classify different stream sites into coldwater, coolwater, or warmwater areas based on their maximum air and water temperatures in summer. Using this methodology, single measurements of daily maximum air temperatures (≥24.5°C) and water temperatures at 1600 hours between July 1 and September 7 can be plotted on a nomogram to approximate the thermal classification of a site. Data from 122 sites throughout the Great Lakes basin, Ontario, indicated that the existing methodology should be revised to include sampling days from July 1 to August 31 instead of July 1 to September 7 and daily sampling periods between 1600 and 1800 hours as opposed to 1600 hours to capture the warmest temperatures at the sites. Data from 80 of the 122 sites consistently fell into the coldwater, coolwater, or warmwater categories. Data from 5 sites overlapped the coldwater and coolwater categories, whereas data from 37 sites overlapped the coolwater and warmwater categories. Water temperatures at 11 of the coolwater–warmwater sites decreased as air temperatures increased. These sites had more groundwater discharge potential than either the coolwater and warmwater sites. This suggests that a higher proportion of groundwater (as opposed to surface runoff) in the summer caused the water temperatures to cool as air temperatures increased. A revised nomogram was developed that included five (cold, cold–cool, cool, cool–warm, and warm) rather than three (cold, cool, and warm) thermal classifications for sites in Ontario streams. We recommend the use of the revised nomogram to determine the thermal classification of stream sites, as the revised categories also correspond to the thermal preferences of 72 stream fish species commonly found in the Great Lakes basin.
Combination Systemic Therapy for Advanced Renal Cell Carcinoma
Authors: Miller Rowan E. , Larkin James M. G.
Published: November 2009

Outcomes for patients with advanced renal cell carcinoma (RCC) have improved significantly in recent years with the development of novel noncytotoxic systemic therapies. The multitargeted kinase inhibitors sunitinib and sorafenib have been approved for the treatment of advanced RCC, and bevacizumab, a monoclonal anti–vascular endothelial growth factor antibody, has shown significant clinical activity, both as a single agent and in combination with interferon-α. The mammalian target of rapamycin inhibitors temsirolimus and everolimus have led to longer overall survival times in poor-risk patients in the first-line setting and longer progression-free survival times in kinase inhibitor refractory patients in the second-line setting, respectively.

Despite these advances, almost all patients develop resistance to treatment and cure is rarely seen. There is therefore a need to overcome resistance, induce longer lasting remissions, and improve survival. A potential approach to this is to combine active agents, and the clinical data for combination therapy with novel targeted agents in advanced RCC are reviewed here.
Age at Diagnosis and Age at Death in Familial Prostate Cancer
Authors: Brandt Andreas , Bermejo Justo Lorenzo , Sundquist Jan , Hemminki Kari
Published: November 2009

Learning Objectives

After completing this course, the reader will be able to: Assess the relationship between the cumulative prostate cancer–specific mortality rate and the number, age at diagnosis, and degree of relatives affected by prostate cancer.Evaluate the difference in the age at onset and age at death in familial prostate cancer between men with and without a family history of prostate cancer.

This article is available for continuing medical education credit at CME.TheOncologist.com.

Objectives.

A family history of prostate cancer is associated with a higher risk for prostate cancer to first-degree relatives. If greater surveillance of men at familial risk is considered to be useful, population-based estimates of the differences in the age at diagnosis between familial and sporadic prostate cancer cases are needed.

Methods.

The men in the nationwide Swedish Family-Cancer Database were classified according to the number and type of affected first-degree relatives (father or brother) and according to the relative’s age at diagnosis. The cumulative incidence of prostate cancer and cumulative prostate cancer–specific mortality were estimated using a stratified Cox model.

Results.

The cumulative incidence was highest for men with multiple affected first-degree relatives, and it was higher for brothers than for sons of prostate cancer patients. The age to reach the same cumulative incidence as the general population at age 55 years decreased with decreasing age at diagnosis of the relative, ranging from 48.7 years (father diagnosed before 60 years of age) to 53.7 years (father diagnosed after 82 years of age). Prostate cancer–specific mortality was also related to the number and type of affected relatives but there was no clear evidence for a dependency on the age at diagnosis of the relative.

Conclusions.

Men with a father or a brother affected by prostate cancer are diagnosed and die at earlier ages than men without a family history of prostate cancer. This study should encourage further analysis in order to assess the risks and benefits of screening for prostate cancer in men at higher risk.
CXCR4 Expression in Early Breast Cancer and Risk of Distant Recurrence
Authors: Andre Fabrice , Xia Weiya , Conforti Rosa , Wei Yongkun , Boulet Thomas , Tomasic Gorana , Spielmann Marc , Zoubir Moustafa , Berrada Narjiss , Arriagada Rodrigo , Hortobagyi Gabriel N. , Hung Mien-Chie , Pusztai Lajos , Delaloge Suzette , Michiels Stefan , Cristofanilli Massimo
Published: November 2009

Learning Objectives

After completing this course, the reader will be able to: Assess CXCR4 expression in the primary tumor for use as an indicator of a higher risk for bone metastasis in early breast cancer.Evaluate the relationship between CXCR4 expression and the occurrence of metastases in other SDF-1–producing organs, including the liver and lung.Use CXCR4 in different ways in combination with other markers to identify patients to be screened for bony metastases and/or treated preventatively for bone metastasis.

This article is available for continuing medical education credit at CME.TheOncologist.com.

Background.

Chemokine receptor 4 (CXCR4) has been demonstrated to have a critical role in the early metastatic process. The aim of this study was to evaluate the prognostic value of CXCR4 expression in primary breast tumors and describe correlations with the occurrence of metastasis in organs expressing the CXCR4 ligand stromal cell–derived factor 1 (i.e., liver, lung, brain, and bone).

Patients and Methods.

CXCR4 expression in primary breast tumors was evaluated by immunohistochemistry in 823 patients included in two prospective clinical trials. CXCR4 expression was considered positive when >1% of tumor cells were stained. The prognostic value of CXCR4 expression was assessed by a Cox regression model adjusted for clinical characteristics. We assessed the association of CXCR4 expression with the rate of distant metastasis to specific organ sites.

Results.

CXCR4 was expressed in 92 of 794 primary tumors (12%). CXCR4 expression was not associated with clinical characteristics. CXCR4 was not prognostic for overall survival and showed a nonsignificant trend toward a higher risk for distant metastasis. CXCR4+ tumors showed a significantly higher risk for bone metastasis. The 10-year incidences of bone metastases were 23% (13.6%–32.6%) and 12% (9.7%–15%) in CXCR4+ and CXCR4− tumors, respectively.

Conclusion.

This study suggests that expression of CXCR4 in primary breast tumors is associated with a higher likelihood of developing bone metastases. This finding could open new avenues for the development of novel adjuvant strategies, including bone-targeting agents.
Plasmacytoid Dendritic Cell Leukemia: A Rapidly Evolving Disease Presenting with Skin Lesions Sensitive to Radiotherapy plus Hyperthermia
Authors: Tecchio Cristina , Colato Chiara , Bonifacio Massimiliano , Krampera Mauro , Maluta Sergio , Pizzolo Giovanni , Girolomoni Giampiero
Published: November 2009

Plasmacytoid dendritic cell leukemia (pDCL) is a rapidly evolving disease, which frequently presents with skin lesions, particularly nodules and plaques with a typical reddish-brown or brown color. Treatment of pDCL is based on multiagent chemotherapy followed by allogeneic hematopoietic stem cell transplant, but skin lesions may be refractory to therapy. Here, we report on a 61-year-old patient affected by pDCL who first presented with multiple cutaneous nodules and plaques on the trunk. Lesions showed an excellent response to radiotherapy plus hyperthermia. Although this treatment did not avoid the systemic evolution of disease, it resolved skin lesions and prevented their relapse, thus representing a therapeutic option to be used in combination with chemotherapy regimens. The case presentation is followed by a general discussion with an emphasis on the diagnosis and treatment of this rare malignancy.
The balance between gluco- and mineralo-corticoid action critically determines inflammatory adipocyte responses
Authors: Hoppmann J , Perwitz N , Meier B , Fasshauer M , Hadaschik D , Lehnert H , Klein J
Published: November 2009

Obesity is associated with chronic inflammation. Pro-inflammatory adipokines may promote metabolic disorders and cardiovascular morbidity. However, the key mechanisms leading to obesity-related inflammation are poorly understood. The corticosteroid metabolism in adipose tissue plays a crucial role in the pathogenesis of the metabolic syndrome. Both the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR) mediate corticosteroid action in adipose tissue. The significance of the interplay of these receptors in mediating an inflammatory adipokine response is virtually unexplored. In the present study, we investigated the differential roles of the GR and MR in controlling the key adipose tissue functions including inflammatory adipokine expression and adipogenesis using selective stimulation with receptor agonists, acute receptor knockdown via RNA interference and newly generated knockout adipose cell lines. Selective GR stimulation of white adipocytes with dexamethasone inhibited the expression of interleukin 6 (IL6), monocyte chemoattractant protein-1 (MCP1 or CCL2 as listed in the MGI Database), tumour necrosis factor-α, chemerin and leptin. By contrast, selective MR stimulation with aldosterone promoted the expression of IL6, plasminogen activator inhibitor 1, chemerin and leptin. Furthermore, in the presence of an acute GR knockdown as well as in GR knockout adipocytes, corticosterone increased the gene expression of the pro-inflammatory adipokines IL6 and MCP1. Whereas GR knockout adipocytes displayed a mildly impaired adipogenesis during early differentiation, MR knockout cells completely failed to accumulate lipids. Taken together, our data demonstrate a critical role for the balance between gluco- and mineralocorticoid action in determining adipocyte responses implicated in obesity-associated inflammation and cardiovascular complications.
The Course Content of APA-Accredited Doctoral Programs: If the Use of Psychiatric Drugs Is to Be Challenged, Then a Road to Better Psycho-Social Treatments Needs to Be Paved
Authors: Stein David B. , Foltz Robert
Published: December 2009

This article explores several issues surrounding the American Psychological Association’s accredited doctoral training of clinical psychologists. There is a movement to combat the use of psychiatric drugs with psycho-social treatments. However, as will be examined, such treatments seem to not work well. If there is to be a sincere challenge to the growing use of toxic psychiatric drugs then better psycho-social treatment efficacy rates are critical.
THE EFFECTS OF VARIED VERSUS CONSTANT HIGH‐, MEDIUM‐, AND LOW‐PREFERENCE STIMULI ON PERFORMANCE
Authors: Wine Byron , Wilder David A.
Published: December 2009

The purpose of the current study was to compare the delivery of varied versus constant high‐, medium‐, and low‐preference stimuli on performance of 2 adults on a computer‐based task in an analogue employment setting. For both participants, constant delivery of the high‐preference stimulus produced the greatest increases in performance over baseline; the varied presentation produced performance comparable to constant delivery of medium‐preference stimuli. Results are discussed in terms of their implications for the selection and delivery of stimuli as part of employee performance‐improvement programs in the field of organizational behavior management.
A PILOT STUDY OF NATURALLY OCCURRING HIGH‐PROBABILITY REQUEST SEQUENCES IN HOSTAGE NEGOTIATIONS
Authors: Hughes James
Published: December 2009

In the current study, the audiotapes from three hostage‐taking situations were analyzed. Hostage negotiator requests to the hostage taker were characterized as either high or low probability. The results suggested that hostage‐taker compliance to a hostage negotiator's low‐probability request was more likely when a series of complied‐with high‐probability requests preceded the low‐probability request. However, two of the three hostage‐taking situations ended violently; therefore, the implications of the high‐probability request sequence for hostage‐taking situations should be assessed in future research.
Investigation of Internal Pollutant Loading for a Tide‐Influenced Waterbody
Authors: Hua Wang , Yong Pang
Published: December 2009

Based on laboratory experiments and field investigations, the relationship between internal pollutant release intensity and water velocity was determined for Neijiang, a representative waterbody. A two‐dimension, unsteady hydrodynamic water quality model coupled with internal pollutant release was established and validated to assess Neijiang in different, typical years and at different tidal cycles. The internal‐to‐external pollutant loading ratio (IEPLR) was proposed in this paper for the first time to identify the temporal distribution of the effect induced by internal pollutant loading on the water environment. It was found that the annual internally released amounts of total nitrogen, total phosphorous, and chemical oxygen demand (COD) in the high‐water year (1998) was 484.0 Mg, 405.3 Mg, and 1928.3 Mg, respectively, which was 27% greater than levels found in the typical‐water year (2001) and the dry‐water year (2004). Internal pollutant loading in the three typical years showed marked temporal variation; the high‐water year displayed the most asymmetrical distribution. Internally released total nitrogen, total phosphorus, and COD during the tidal cycle of flood season was 1.374 Mg, 1.059 Mg, and 4.456 Mg, respectively, which was approximately 55.9% higher than dry season. External pollutant loading on Neijiang was the significant factor influencing water quality because the mean IEPLRs in the three typical years and the tidal cycles were less than one. However, because of the enhanced intensity of internal pollutant release, there were still 124 d in 1998, 22 d in 2001, and 38 d in 2004 when IEPLRs were greater than one; during these days a sudden algae bloom or water quality saltation might occur in Neijiang.
On the Scale-Up of Uneven DBD Reactor on Removal of Diesel Particulate Matter
Authors: Yao Shuiliang , Fushimi Chihiro , Kodama Satoshi , Yamamoto Shin , Mine Chieko , Fujioka Yuichi , Madokoro Kazuhiko , Naito Kazuya , Kim Yoon-Ho
Published: December 2009

The scale-up of an uneven type of dielectric barrier discharge (DBD) reactor driven by a positivenegative pulse power supply for the removal of particulate matter (PM) from a diesel engine has been carried out. The scale of the uneven DBD reactor was changed by using three kinds of reactors consisting of 20, 30, or 50 pairs of uneven alumina and stainless steel plates. In this study, relations of energy injection into the above DBD reactors, PM removals, PM removal efficiencies with pair numbers have been investigated. The parameters in the kinetic model used to describe the PM removal are given.
Synthesis of Carbon Nanotubes on Macroporous Kaolin Substrate via a New Simple CVD Method
Authors: Mohammadi Toraj , Ahmadzadeh Tofighy Maryam , Pak Afshin
Published: November 2009

In the present paper, a new simple chemical vapor deposition (CVD) method was investigated for synthesis of carbon nanotube (CNT) films on macroporous kaolin substrates (in mullite phase) using cyclohexanol and ferrocene as carbon source and catalyst, respectively. Effect of growth temperature on structure of the CNT films was also investigated by SEM images. Growth of a novel structure of the CNTs at 600°C on the macroporous kaolin substrate was succeeded. The novelty of these CNTs lies in their heart-like caps. At 650°C, CNTs were grown perpendicular on the macroporous surface of kaolin substrate. At higher temperatures (700, 750, 800°C), a quite different structure of CNT films was obtained. This interesting structure is composed of a continuous mat like thin film of long CNTs grown horizontally over the entire surface of macroporous kaolin substrate, and some casually overgrown humps. Various structures such as carbon fibers, helical CNTs and Y junction CNTs were observed in the overgrown humps. The results demonstrate ability of the proposed CVD method to perform growing of the CNT films with interesting structures on the macroporous kaolin substrates. We then perform a sensitivity analysis of the ignition time and ignition length to changes in the initial deposit thickness and gas flowrate under various conditions using the averaged model. We have found that the ignition time and ignition length are most sensitive to changes in deposit thickness when the deposit thickness and exhaust temperature is low. Also, the ignition time is relatively insensitive to changes in gas flow rate, but the ignition length is most sensitive to changes in gas flow rate at low exhaust temperatures. These studies are useful towards the ultimate development of a predictive particulate emissions control system for diesel-fueled vehicles.
An investigation into the suitability of a commercial real‐time PCR assay to screen for Taylorella equigenitalis in routine prebreeding equine genital swabs
Authors: OUSEY J. C. , PALMER L. , CASH R. S. G. , GRIMES K. J. , FLETCHER A. P. , BARRELET A. , FOOTE A. K. , MANNING F. M. , RICKETTS S. W.
Published: December 2009

Reasons for performing study: Standard bacteriological methods for identifying Taylorella equigenitalis in cervical smears are time consuming. Therefore, a more rapid real‐time PCR assay was evaluated for its suitability in screening swabs.

Objective: To compare the results of a commercially available real‐time PCR assay with routine microbiological culture for the identification of T. equigenitalis, the causative organism of contagious equine metritis, in equine genital swab samples, under ‘field trial’ conditions.

Materials and methods: Routine prebreeding genital swabs (n = 2072) collected from Thoroughbred mares and stallions during 2009 were examined together with stored T. equigenitalis positive material. Swabs were cultured for T. equigenitalis using standard microbiological techniques. Bacterial lysates were isolated from the swabs and examined for the presence of a 16S DNA fragment of T. equigenitalis, using a commercial multiplex real‐time PCR assay system.

Results: There was complete concordance between positive and negative results obtained by the 2 methods. Real‐time PCR also detected T. equigenitalis DNA from swabs that were negative using standard microbiological culture after 6 months' storage at +4°C but from which T. equigenitalis had been isolated following collection. The sensitivities of realtime PCR and bacterial culture were both 10−3 (equivalent to 3 colony‐forming units).

Conclusion and clinical relevance: Routine bacterial culture of T. equigenitalis requires an incubation period of not less than 7 days before a conclusive negative result can be obtained, whereas bacterial extraction and real‐time PCR assay can be completed in less than 6 h. The commercially‐available PCR assay tested provided a rapid and reliable method for the identification of T. equigenitalis from equine genital swabs and could be usefully employed for the screening of mares and stallions for preseason Horserace Betting Levy Board (HBLB) Code of Practice and in other situations such as for bloodstock sales screening requirements, overcoming the current delays imposed by bacterial culture requirements. Its use could be quality assured by the existing HBLB biannual testing scheme for designated laboratories.
A Danish national survey of women operated with mid‐urethral slings in 2001
Authors: AMMENDRUP ASTRID CECILIE , JØRGENSEN ANETTE , SANDER PIA , OTTESEN BENT , LOSE GUNNAR
Published: December 2009

Objective. To perform a national survey on self‐reported cure, satisfaction and complications four years after mid‐urethral sling (MUS) for urinary stress incontinence in Danish women operated in 2001. Design. A postal questionnaire survey. Population. All Danish women who received an MUS operation in 2001 extracted from the Danish National Patient Register. Methods. The women received a validated postal questionnaire in 2005. The questionnaire included questions about subjective cure, satisfaction, complications and a Danish version of International Consultation on Incontinence Questionnaire‐Short Form. The study was carried out in cooperation with the Danish National Board of Health. Results. A total of 335 (92%) women responded to the questionnaire, among whom 105 (32%) felt completely cured, 119 (36%) were much improved, 55 (17%) were improved and 48 (15%) unchanged or worse. Cure rate varied between departments from 0% to 67%. Low‐volume departments (<10 operations/year) had a significantly (p = 0.05) lower cure rate compared to the department with a higher volume. Altogether, 238 (73%) women were very satisfied with their operation. Self‐reported bladder emptying difficulties were reported by 103 (32%) and the need for clean intermittent catherization (CIC) at any stage was reported by 21 (7%). No woman was still performing CIC. Of the women, 126 (42%) had made contact with the healthcare system because of their operation after discharge from hospital. Conclusions. Long‐term outcome of MUS operations in Denmark in terms of cure, satisfaction and complication rates seems comparable to international results; however, the decentralized organization with many low‐volume departments seems inappropriate.
Miscarriage and risk of cardiovascular disease
Authors: KHARAZMI ELHAM , FALLAH MAHDI , LUOTO RIITTA
Published: November 2009

In a nationally representative sample (the Health 2000 Survey) comprising 3,937 Finnish women aged 30–99 years, we examined the association of miscarriage (assessed by questionnaire) with risk of cardiovascular disease (assessed by physician's examination and linkages to hospital discharge and drug reimbursement registers). We considered age, smoking, body mass index, waist/hip ratio, physical activity, education, number of previous pregnancies, blood pressure, and fasting blood glucose and cholesterol as potentially confounding factors in the analysis. In women 50–74 years of age who had experienced pregnancy, history of miscarriage tended to be associated with a higher risk of myocardial infarction (age‐adjusted odds ratio (OR): 2.1, 95% confidence interval (CI): 1.0–4.3), and the risk increased significantly with the number of miscarriages (age‐adjusted OR per miscarriage: 1.4, 95% CI: 1.1–1.8). These results suggest that women who experience repeated miscarriages may be at an increased risk of cardiovascular disease later in life.
An economic evaluation of alternative test‐intervention strategies to prevent spontaneous pre‐term birth in singleton pregnancies
Authors: TSOURAPAS ANGELOS , ROBERTS TRACY E. , BARTON PELHAM M. , HONEST HONEST , FORBES CAROL , HYDE CHRIS J. , KHAN KHALID S.
Published: November 2009

Objective. To investigate the potential cost‐effectiveness of alternative ‘test‐and‐treat’ strategies in the prevention of spontaneous pre‐term birth before 34 and 37 weeks' gestation.Design. Model‐based economic evaluation.Setting.Clinics, general practices, health centers or any setting delivering antenatal care.Population.Asymptomatic women in early pregnancy and symptomatic women with threatened pre‐term labor in later pregnancy.Methods. Data from systematic reviews of effectiveness and accuracy were combined into strategies and analyzed using a decision‐tree model. Full deterministic and probabilistic sensitivity analyses were carried out.Main outcome measures.Spontaneous pre‐term labor avoided for asymptomatic women and spontaneous pre‐term birth avoided for symptomatic women.Results. The systematic reviews identified evidence on the accuracy of 22 types of tests and on the effectiveness of 40 possible interventions. Cost data were based on secondary evidence, supplemented with primary data from local sources. Testing prior to intervention was not shown to be the most cost‐effective strategy in the main analyses for 34 and 37 weeks. Prophylactic fish oil in asymptomatic women, without prior testing, was highlighted as potentially cost‐effective in preventing threatened pre‐term labor before 34 weeks. In symptomatic women with a viable pregnancy, indomethacin without prior testing was a potentially cost‐effective strategy to prevent pre‐term birth occurring before 37 weeks.Conclusion.An effective, affordable and safe intervention applied to all mothers without prior testing is likely to be the most cost‐effective strategy in the prevention of spontaneous pre‐term labor and birth. The results reported in this paper are important for prioritizing future research, world‐wide.
Radiologic and clinical outcomes with special reference to tumor involvement pattern after stent placement for malignant bronchial obstructions
Authors: Shin Ji Hoon , Song Ho-Young , Kim Kyung-Rae , Kim Jin Hyoung , Kim Sang Wee , Lee Dae-Ho , Hong Sang-Beom
Published: December 2009

Background: Location of tumor within the tracheobronchial tree as well as its severity can affect the clinical outcome of patients who undergo airway stent placement.

Purpose: To evaluate radiologic and clinical outcome, including survival data, with special reference to proposed tumor involvement pattern, in patients with malignant bronchial strictures.

Material and Methods: A total of 35 patients who underwent stent placement for malignant bronchial strictures were enrolled over a 9-year period. Tumor involvement pattern was divided into three types based on computed tomography (CT) scans and selective bronchography. Type I was defined as tumor involving only the main stem bronchus; type II, tumor involving the bronchus intermedius and/or the lower lobar bronchus without involvement of the lower-lobe segmental bronchus; and type III, tumor involving the lower lobar bronchus with involvement of the lower-lobe segmental bronchus. Tumor stage, lung collapse/infiltration, radiologic improvement, clinical improvement, and survival were compared according to the tumor involvement pattern.

Results: Tumor involvement pattern was of type I, II, and III in 14, 13, and eight patients, respectively. When comparisons were made between types I/II and type III to evaluate the influence of lower-lobe segmental bronchial involvement, radiologic and clinical improvement was significantly lower in type III than in types I/II, while advanced stage, lung collapse/infiltration, and median overall survival were not significantly different between types I/II and type III.

Conclusion: In patients with malignant bronchial obstructions involving the lower-lobe segmental bronchus, clinicians must be aware of the possibility of less radiologic and clinical improvement following stent placement.
A Story and a Recommendation about the Principle of Maximum Entropy Production
Authors: Paltridge Garth  W.
Published: November 2009

The principle of maximum entropy production (MEP) is the subject of considerable academic study, but has yet to become remarkable for its practical applications. A tale is told of an instance in which a spin-off from consideration of an MEP-constrained climate model at least led to re-consideration of the very practical issue of water-vapour feedback in climate change. Further, and on a more-or-less unrelated matter, a recommendation is made for further research on whether there might exist a general "rule" whereby, for certain classes of complex non-linear systems, a state of maximum entropy production is equivalent to a state of minimum entropy.
“This Is Public Health: Recycling Counts!” Description of a Pilot Health Communications Campaign
Authors: Chase Nancy  L. , Dominick Gregory  M. , Trepal Amy , Bailey Leanne  S. , Friedman Daniela  B.
Published: November 2009

This paper describes the development, implementation, and evaluation of a pilot recycling campaign. The goal of the campaign was to increase people’s awareness and knowledge about recycling and the link between a healthy environment and the public’s health. A total of 258 individuals attended campaign week events and completed an initial survey. Results identified inconvenience of recycling facility locations as a key barrier to recycling. Post-campaign survey results revealed increased recycling of paper, plastic, glass, and cans (p < 0.05). The majority of participants “agreed” or “strongly agreed” that as a result of campaign messages they had greater awareness about recycling (88.4%) and their recycling efforts increased (61.6%).
Fracture Toughness of Polypropylene-Based Particulate Composites
Authors: Arencón David , Velasco José Ignacio
Published: November 2009

The fracture behaviour of polymers is strongly affected by the addition of rigid particles. Several features of the particles have a decisive influence on the values of the fracture toughness: shape and size, chemical nature, surface nature, concentration by volume, and orientation. Among those of thermoplastic matrix, polypropylene (PP) composites are the most industrially employed for many different application fields. Here, a review on the fracture behaviour of PP-based particulate composites is carried out, considering the basic topics and experimental techniques of Fracture Mechanics, the mechanisms of deformation and fracture, and values of fracture toughness for different PP composites prepared with different particle scale size, either micrometric or nanometric.
Pediatric Obesity: Looking into Treatment
Authors: Pietrobelli Angelo , Rugolotto Simone , De Cristofaro Paolo , Malavolti Marcella
Published: November 2009

Prevalence of pediatric obesity continues to rise worldwide. Increasing the number of health care practitioners as well as pediatricians with expertise in obesity treatment is necessary. Because many obese patients suffer obesity-associated cardiovascular, metabolic and other health complications that could increase the severity of obesity, it is fundamental not only to identify the child prone to obesity as early as possible, but to recognize, treat and monitor obesity-related diseases during adolescence. This short review outlines the treatment of pediatric obesity that may have applications in the primary care setting. It examines current information on eating behavior, sedentary behavior, and details studies of multidisciplinary, behavior-based, obesity treatment programs. We also report the less common and more aggressive forms of treatment, such as medication and bariatric surgery. We emphasize that health care providers have the potential to improve outcomes by performing early identification, helping families create the best possible home environment, and by providing structured guidance to obese children and their families.
A Water Balance Budget for Bung Boraphet—A Flood Plain Wetland-Reservoir Complex in Thailand
Authors: Sriwongsitanon Nutchanart , Surakit Kritsanat , Hawkins Peter R.
Published: November 2009

A water balance model was developed for Bung Boraphet reservoir, a large flood plain lake in Thailand, from daily measurements over three inflow outflow cycles between 2003 and 2006. Measurement error was 10% (as one standard deviation) of the total measured volume. The specific yield from the Bung Boraphet catchment was 3.9 m3/ha/yr and surface water inflow from the local catchment was the largest gain term and evaporation was the largest loss term in the water budget. Irrigation was the second largest loss term and dry season demand exceeded the storage supply. Uncontrolled extraction of water for irrigation is regarded as a threat to the reservoir fishery, although the increasing drawdown range may benefit wetland biodiversity. Sustainable management of the Bung Boraphet wetland will depend on careful management based on an informed understanding of the ecohydrological requirements of all wetland uses. Water balance models like this one are recommended as a tool to allocate water equitably and in ways which can be integrated across the Chao Phraya basin.
Coordination of foliar and wood anatomical traits contributes to tropical tree distributions and productivity along the Malay‐Thai Peninsula
Authors: Baltzer Jennifer L. , Grégoire Dorthea M. , Bunyavejchewin Sarayudh , Noor N. Supardi M. , Davies Stuart J.
Published: November 2009

Drought is a critical factor in plant species distributions. Much research points to its relevance even in moist tropical regions. Recent studies have begun to elucidate mechanisms underlying the distributions of tropical tree species with respect to drought; however, how such desiccation tolerance mechanisms correspond with the coordination of hydraulic and photosynthetic traits in determining species distributions with respect to rainfall seasonality deserves attention. In the present study, we used a common garden approach to quantify inherent differences in wood anatomical and foliar physiological traits in 21 tropical tree species with either widespread (occupying both seasonal and aseasonal climates) or southern (restricted to aseasonal forests) distributions with respect to rainfall seasonality. Use of congeneric species pairs and phylogenetically independent contrast analyses allowed examination of this question in a phylogenetic framework. Widespread species opted for wood traits that provide biomechanical support and prevent xylem cavitation and showed associated reductions in canopy productivity and consequently growth rates compared with southern species. These data support the hypothesis that species having broader distributions with respect to climatic variability will be characterized by traits conducive to abiotic stress tolerance. This study highlights the importance of the well‐established performance vs. stress tolerance trade‐off as a contributor to species distributions at larger scales.
A fruit and leaves of Rhamnaceous affinities from the late Cretaceous (Maastrichtian) of Colombia
Authors: Correa Edwin , Jaramillo Carlos , Manchester Steven , Gutierrez Mauricio
Published: November 2009

Although Rhamnaceae are distributed worldwide today, the former hypothesis for its Laurasian origins may need to be reconsidered in view of recently discovered fossils from the Guaduas Formation of central Colombia (∼68 Ma), including fossil leaves (Berhamniphyllum)and a fruit (Archaeopaliurus boyacensis). Recent phylogenetic studies calibrate the stem of Rhamnaceae at 64 Ma and divide the family into three groups, rhamnoid, ampeloziziphoid, and ziziphoid. Although the fruit,Archaeopaliurus boyacensis, resembles that ofPaliurusand suggests a relationship to the Paliureae in the ziziphoid group, associated leaves ofBerhamniphyllumconform in architecture to those found today only in the Rhamneae tribe. The Maastrichtian age of these fossils predates the ages previously estimated for the Rhamneae tribe (28.5 Ma) and the Paliureae tribe (31.6 Ma) using a modified clock approach. Based on the new megafossil evidence, two alternative ideas are proposed: (1) that these fossils predate the extant tribes or (2) that the family diversified into modern tribes earlier than previously proposed.
Vessel grouping patterns in subfamilies Apocynoideae and Periplocoideae confirm phylogenetic value of wood structure within Apocynaceae
Authors: Lens Frederic , Endress Mary E. , Baas Pieter , Jansen Steven , Smets Erik
Published: November 2009

This study contributes to our understanding of the phylogenetic significance and major evolutionary trends in the wood of the dogbane family (Apocynaceae), one of the largest and economically most important angiosperm families. Based on LM and SEM observations of 56 Apocynoideae species—representing all currently recognized tribes—and eight Periplocoideae, we found striking differences in vessel grouping patterns (radial multiples vs. large clusters) between the mainly nonclimbing apocynoid tribes (Wrightieae, Malouetieae, Nerieae) and the climbing lineages (remaining Apocynoideae and Periplocoideae). The presence of large vessel clusters in combination with fibers in the ground tissue characterizing the climbing Apocynoideae and Periplocoideae clearly contrasts with the climbing anatomy of the rauvolfioids (solitary vessels plus tracheids in ground tissue), supporting the view that (1) the climbing habit has evolved more than once in Apocynaceae, (2) the three nonclimbing apocynoid tribes are basal compared to the climbing apocynoids, and (3) Periplocoideae belong to the crown clade. The wood anatomy within the nonclimbing and climbing lineages is rather homogeneous, although a combination of specific characters (e.g. presence of septate fibers, axial parenchyma distribution, abundance of uniseriate compared to multiseriate rays, and presence and location of prismatic crystals) may be used to identify several tribes.
The “sensational” power of movement in plants: A Darwinian system for studying the evolution of behavior
Authors: Whippo Craig W. , Hangarter Roger P.
Published: November 2009

Darwin's research on botany and plant physiology was a landmark attempt to integrate plant movements into a biological perspective of behavior. Since antiquity, people have sought to explain plant movements via mechanical or physiological forces, and yet they also constructed analogies between plant and animal behavior. During the Renaissance and Enlightenment, thinkers began to see that physiochemical explanations of plant movements could equally apply to animal behavior and even human thought. Darwin saw his research on plant movements as a strategic front against those who argued that his theory of evolution could not account for the acquisition of new behavioral traits. He believed that his research explained how the different forms of plant movement evolved as modified habits of circumnutation, and he presented evidence that plants might have a brain‐like organ, which could have acquired various types of plant sensitivity during evolution. Upon publication of The Power of Movement in Plants, his ideas were overwhelmingly rejected by plant physiologists. Subsequently, plant biologists came to view the work as an important contribution to plant physiology and biology, but its intended contribution to the field of evolution and behavior has been largely overlooked.
Signs and Symptoms of Heart Failure: Are You Asking the Right Questions?
Authors: Albert Nancy , Trochelman Kathleen , Li Jianbo , Lin Songhua
Published: November 2009

Background

Patients may not verbalize common and atypical signs and symptoms of heart failure and may not understand their association with worsening disease and treatments.

Objectives

To examine prevalence of signs and symptoms relative to demographics, care setting, and functional class.

Methods

A convenience sample of 276 patients (164 ambulatory, 112 hospitalized) with systolic heart failure completed a 1-page checklist of signs and symptoms experienced in the preceding 7 days (ambulatory) or in the 7 days before hospitalization. Demographic and medical history data were collected.

Results

Mean age was 61.6 (SD, 14.8) years, 65% were male, 58% were white, and 45% had ischemic cardiomyopathy. Hospitalized patients reported more sudden weight gain, weight loss, severe cough, low/orthostatic blood pressure, profound fatigue, decreased exercise, restlessness/confusion, irregular pulse, and palpitations (all P < .05). Patients in functional class IV reported more atypical signs and symptoms of heart failure (severe cough, nausea/vomiting, diarrhea or loss of appetite, and restlessness, confusion, or fainting, all P ≤ .001). Sudden weight gain increased from 5% in functional class I to 37.5% in functional class IV (P < .001). Dyspnea occurred in all functional classes (98%–100%) and both settings (92%–100%). Profound fatigue was associated with worsening functional class (P < .001) and hospital setting (P = .001); paroxysmal nocturnal dyspnea was associated with functional class IV (P = .02) and hospital setting (P < .001).

Conclusion

Profound fatigue is more reliable than dyspnea as an indicator of functional class. Nurses must recognize atypical signs and symptoms of worsening functional class to determine clinical status and facilitate patient care decisions.
APPARENT DDT TOLERANCE IN AN AQUATIC INSECT DISPROVED BY TEST
Authors: Sprague J. B.
Published: December 2009

Certain mayflies and stoneflies were present in a forest stream in New Brunswick after frequent yearly sprayings with DDT. Tests showed that a stonefly, Nemoura sp., apparently the most likely insect to have developed DDT tolerance, had not done so. Presence of mayflies and stoneflies in the stream was probably because they survived spraying while in the egg stage, or recovered quickly after spraying, or both.
THE PREDATION OF TENT CATERPILLARS, MALACOSOMA AMERICANA (LEPIDOPTERA: LASIOCAMPIDAE) BY ANTS (HYMENOPTERA: FORMICIDAE)
Authors: Ayre G. L. , Hitchon D. E.
Published: December 2009

First- and second-instar tent caterpillar larvae are acceptable prey for many native species of ants. The amount of predation which occurs is normally related to ambient temperature. A warm period in early spring allows ants to forage actively and often leads to destruction of the caterpillar colonies whereas a cool spring curtails ant activity and allows the caterpillars to develop beyond the vulnerable period free from predation by ants. In latter instars the caterpillars are protected completely against ants by their dense setae.
AGATHIS BINOMINATA (HYMENOPTERA: BRACONIDAE) PARASITIZING RHYACIONIA BUOLIANA (LEPIDOPTERA: OLETHREUTIDAE) IN CENTRAL ONTARIO
Authors: Syme Paul D.
Published: December 2009

Dissections of larvae from a routine collection of European pine shoot moth (Rhyacionia buoliana (Schiffermüller)) made on 12 October 1965 in a small red pine plantation in Con. VII, Mills Twp., Manitoulin Island, Ont., revealed the presence of larvae of an unrecognized parasite in approximately 44% of the 103 living shoot moth larvae obtained. This compares favourably with rates of approximately 40% found by the author for Orgilus obscurator Nees, the most effective internal parasite of shoot moth in southern Ontario. No adults of the unrecognized parasite were obtained at that time, and because of severe winter kill of the shoot moth, none were obtained in a sample made in the following spring from the same plantation. However, shoot moth larvae obtained in a sample taken on 4 October 1966 yielded similar larvae on dissection, and rearings produced adult parasites which were identified by Dr. W. R. M. Mason, Entomology Research Institute, Canada Department of Agriculture, Ottawa, Ont., as Agathis binominata Muesebeck. According to Muesebeck et al. (1951), Krombein et al. (1967), and Yates (1967), the following species are hosts of this parasite: Coleophora laricella (Hübner), Epiblema desertana (Zeller) , Epinotia nanana (Treitschke) , Petrova comstockiana (Fernald), Phalonia rutilana (Hübner) , Pulicalvaria coniferella (Kearfott) , P. piceaella (Kearfott) , and Rhyacionia frustrana (Comstock). Its association with Rhyacionia buoliana apparently has not been recorded previously.
CONTRIBUTIONS TO A STUDY OF THE PYRAUSTINAE (LEPIDOPTERA: PYRALIDAE) OF TEMPERATE EAST ASIA. VII
Authors: Munroe Eugene , Mutuura Akira
Published: December 2009

The following new species and subspecies of Circobotys are described: C. elegans n. sp., Taiwan; C. heterogenalis onumalis n. subsp., Hokkaido; C. heterogenalis pertinctalis n. subsp., Shantung, China; C. obscuralis ahyoui n. subsp., Yuennan, China; C. elongata n. sp., Taiwan; C. cryptica n. sp., Japan and China; C. plebeia n. sp., Tapaishan, S. Shensi, China.
CHEMOTAXONOMIC STUDIES OF ANTS: FREE AMINO ACIDS
Authors: Vick K. , Drew W. A. , Young J. , Eisenbraun E. J.
Published: December 2009

Extracts of free amino acids from six species of ants (Pogonomyrmex barbatus (F. Smith), P. occidentalis (Cresson), Tapinoma sessile (Say), Camponotus pennsylvanicus (DeGeer), Conomyrma pyramica (Roger), and Novomessor cockerelli (E. André) were analyzed by thin layer, one and two dimensional paper chromatography, and an automatic amino acid analyzer to determine the potential use of qualitative and (or) quantitative data of the free amino acid composition of ants in taxonomic studies. The results demonstrate that no significant qualitative differences exist, but that the automatic amino acid analyzer may be used to show significant quantitative differences in the free amino acid composition of the ants studied.
FLIGHT MUSCLE CHANGES IN BLACK HILLS BEETLES, DENDROCTONUS PONDEROSAE (COLEOPTERA: SCOLYTIDAE), DURING EMERGENCE AND EGG LAYING
Authors: McCambridge W. F. , Mata S. A.
Published: December 2009

The lateralis medius, an indirect flight muscle of Black Hills beetles, degenerated abruptly in females within 3 days after attack. Egg laying began at the end of the 3 days. Thickness of the muscle changed much more than width. Regeneration began in most ovipositing females about 10 days after attack. Steady development of the muscle to its maximum size, reached prior to beetle emergence, offers a method of forecasting emergence.