bluuebunny/crossref_metadata_2025 huggingface dataset:
Smoking Among Participants in the Childhood Cancer Survivors Cohort: The Partnership for Health Study
Authors: Emmons Karen M. , Butterfield Rita M. , Puleo Elaine , Park Elyse R. , Mertens Ann , Gritz Ellen R. , Lahti Maureen , Li Fredrick P.
Published: January 2003

Purpose: This article describes baseline data collection and the intervention design of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study. The purpose of this article is to evaluate demographic, psychosocial, and cancer-related factors that are associated with smoking behavior and mediators of smoking cessation.

Patients and Methods: This study includes 796 smokers from the Childhood Cancer Survivors Study database who were diagnosed with cancer before the age of 21, had survived at least 5 years, and were at least 18 years of age at the time of the baseline survey. Correlates of smoking behaviors included smoking rate, number of recent quit attempts, and nicotine dependence; two key mediators of smoking cessation, readiness to quit smoking and self-efficacy, were also assessed.

Results: Participants smoked, on average, 14 cigarettes/day; 53.2% were nicotine dependent, and 58% had made at least one quit attempt in the past year. Smoking behaviors were primarily associated with demographic variables; mediators of cessation were primarily associated with age at cancer diagnosis and perceived vulnerability to smoking-related illnesses. Severity of psychologic symptoms was associated with increased smoking rate, high nicotine dependence, and low self-efficacy. Support for quitting was related to smoking rate, number of quit attempts, readiness to quit smoking, and self-efficacy.

Conclusion: These findings indicate that many cancer survivors who smoke are receptive to smoking cessation interventions. Factors related to mediators of smoking cessation might be particularly good targets for intervention.
Metachronous Skeletal Osteosarcoma in Patients Treated with Adjuvant and Neoadjuvant Chemotherapy for Nonmetastatic Osteosarcoma
Authors: Aung LeLe , Gorlick Richard , Healey John H. , Shi Weiji , Thaler Howard T. , Shorter Nicholas A. , Huvos Andrew G. , Meyers Paul A.
Published: January 2003

Purpose: The prognosis for patients who develop metachronous skeletal osteosarcoma (OS) has been considered grave compared with that for patients with relapse limited to the lungs. We investigated the incidence and outcome of metachronous skeletal OS after initial treatment of the primary tumor.

Patients and Methods: Twenty-three (median age 18.7 years) of 426 patients with nonmetastatic, high-grade primary OS treated at Memorial Sloan-Kettering Cancer Center (New York, NY) between February 1973 and May 2000 developed metachronous skeletal OS. Initial therapy included combination chemotherapy and surgery. Treatment of subsequent relapses consisted of chemotherapy or radiation alone or surgery with or without additional individualized chemotherapy.

Results: The median time from the diagnosis of primary OS to the development of metachronous OS was 1.4 years (range, 0.2 to 11.3 years). Median survival was 1.5 years (95% confidence interval [CI], 0.8 to 6.9 years). Two- and 5-year postmetachronous overall survival was 43.5% (95% CI, 23.2% to 63.7%) and 33% (95% CI, 13% to 53%), respectively. At last follow-up (range, 0.1 to 12.8 years), five (30.4%) patients were alive with no evidence of disease (range, 1.7 to 12.8 years; median, 4.4 years). For 11 patients who developed metachronous OS 24 months or more from initial diagnosis, 5-year postmetachronous survival rate for patients receiving combined modality versus monotherapy was 83% (95% CI, 54% to 100%) and 40% (95% CI, 0% to 83%), respectively.

Conclusion: In a small subset of patients who developed late metachronous OS, combined-modality therapy with surgery and aggressive chemotherapy may result in long-term postmetachronous survival. This implies that principles used in treatment of primary OS may be applied to patients with late metachronous skeletal OS.
Survivin, bcl-2, bax, and bcl-X Gene Expression in Sentinel Lymph Nodes From Melanoma Patients
Authors: Gradilone Angela , Gazzaniga Paola , Ribuffo Diego , Scarpa Susanna , Cigna Emanuele , Vasaturo Fortunata , Bottoni Ugo , Innocenzi Daniele , Calvieri Stefano , Scuderi Nicolo’ , Frati Luigi , Aglianò Anna Maria
Published: January 2003

Purpose: The expression of apoptosis-related genes, such as survivin, bcl-2, bcl-X, and bax, has been evaluated by reverse transcriptase polymerase chain reaction (RT-PCR) and by immunohistochemistry in sentinel lymph nodes (SLNs) from melanoma patients and then correlated to the outcome of patients.

Patients and Methods: Thirty-six SLNs were examined. After RNA extraction, an RT-PCR followed by Southern blot hybridization was performed to detect survivin, bcl-2, bcl-X, and bax mRNA. bcl-2, survivin, and bax gene expression was evaluated, whenever possible, also by immunohistochemistry at the protein level.

Results: We found a significant correlation (P < .005) between survivin expression and outcome of patients; in fact, 61.5% of patients expressing survivin gene progressed or died because of the disease, whereas 38.5% are currently disease-free. Among patients negative for survivin expression, 100% are disease-free after a median follow-up time of 52.9 months. We did not find a significant correlation between bcl-2, bax, and bcl-X gene expression and outcome of patients. In fact, these genes were found equally expressed in patients with disease progression and in disease-free patients.

Conclusion: Our findings show a variable expression of apoptosis-related genes in SLNs of melanoma patients; more interestingly, we found that survivin expression correlates to outcome of patients in a statistically significant way, whereas the expression of other genes, such as bcl-2, bax, and bcl-X, did not seem to correlate to progression of disease. We suggest that the detection of survivin gene expression by RT-PCR in SLNs may be a useful prognostic indicator.
Humoral Immune Response to a Therapeutic Polyvalent Cancer Vaccine After Complete Resection of Thick Primary Melanoma and Sentinel Lymphadenectomy
Authors: Chung Mathew H. , Gupta Rishab K. , Hsueh Eddy , Essner Richard , Ye Wei , Yee Reynold , Morton Donald L.
Published: January 2003

Purpose: A therapeutic polyvalent cancer vaccine (Canvaxin vaccine; CancerVax Corp, Carlsbad, CA) induces antibodies to a glycoprotein tumor-associated antigen (TA90). However, endogenous immune responses to TA90 have also been reported. This study examined anti-TA90 antibody responses with respect to the survival of patients who received adjuvant vaccine immunotherapy after resection of thick (≥ 4 mm) primary cutaneous melanoma.

Patients and Methods: Serum specimens were obtained from 54 patients immediately before and then 1, 2, 4, and 6 months after wide local excision of thick primary cutaneous melanoma and sentinel lymphadenectomy. All patients were offered adjuvant therapies with the vaccine, high-dose interferon, or other agents. An enzyme-linked immunosorbent assay was used to determine serial serum titers of immunoglobulin G (IgG) and IgM antibodies against TA90. These titers were correlated with clinical course.

Results: Forty-three patients chose vaccine therapy, and 11 patients chose postoperative observation. Preoperative anti-TA90 IgG and IgM titers were similar for vaccine and observation groups (P = .184). At a median follow-up of 26 months, univariate analysis of Cox regression showed that disease-free survival and overall survival of vaccine patients were significantly correlated with maximal IgM response (P = .0006 and .006, respectively) but not with maximal IgG response (P = .73 and .95, respectively). Neither response predicted survival in the observation group.

Conclusion: Postoperative vaccine therapy may enhance IgG and IgM immune responses to TA90 after surgical resection, but only the IgM response is correlated with improved survival. These findings may become useful to guide selection of patients for postoperative adjuvant therapy of high-risk melanoma.
The prevalence and manifestations of hereditary hemorrhagic telangiectasia in the Afro‐Caribbean population of the Netherlands Antilles: A family screening
Authors: Westermann Cornelius J.J. , Rosina Ahlsen F. , de Vries Vanessa , Coteau Pamela A. de
Published: January 2003

Hereditary hemorrhagic telangiectasia (HHT) has been reported rarely in people of African descent. The prevalence in the Afro‐Caribbean population of the Netherlands Antilles is suspected to be high. A family screening in this population was done to arrive at a point prevalence and to identify patients with pulmonary involvement. By clinical history and physical examination, 219 persons over age twelve with a first‐degree relative with HHT were screened. The diagnosis was based on the new diagnostic criteria [Shovlin et al., 2000]. Chest‐roentgenogram and pulse‐oximetry or measurement of arterial oxygen pressure were used to detect pulmonary involvement. HHT was diagnosed in 112 individuals (51%), with at least a point prevalence of 1 in 1,331 inhabitants of Curaçao and Bonaire older than twelve years. The diagnosis was uncertain in 27; this was partly due to the new stringent criteria. Epistaxis was present in 98% and telangiectases in 99%. Facial telangiectases were relatively rare due to pigmented skin. Pulmonary involvement was found in 28% with serious—mainly neurological—complications in 48%. The point‐prevalence of HHT in the Afro‐Caribbean population of the Netherlands Antilles is the highest known in the world. Pulmonary involvement in this population is not rare and causes serious complications. © 2003 Wiley‐Liss, Inc.
Parental consanguinity and congenital heart malformations in a developing country
Authors: Nabulsi Mona M. , Tamim Hala , Sabbagh Maha , Obeid Mounir Y. , Yunis Khaled A. , Bitar Fadi F.
Published: January 2003

The association between isolated congenital heart defects and consanguinity was examined in 759 Lebanese patients with different types of congenital heart malformations. The subjects were patients of the Children's Cardiac Registry Center (CCRC) at the American University of Beirut Medical Center. The proportion of first‐cousin marriages among cardiac subjects was compared to that of the National Collaborative Perinatal Neonatal Network (NCPNN), after adjusting for the subjects' geographic distribution, and to the highest proportion reported by NCPNN. In general, the proportion of overall parental consanguinity and first‐cousin matings among CCRC subjects (34.7 and 20.2%, respectively) were significantly higher than the highest proportion of first‐cousin marriages reported by NCPNN (Bekaa subjects; 13.2%) (P < 0.0001). Comparison with the NCPNN‐adjusted first‐cousin mating proportion revealed a significantly increased rate of consanguinity in all categories of cardiac malformations except great vessel and coronary artery lesions (P < 0.05). The following lesions were significantly associated with increased parental consanguinity: aortic anomalies (aortic insufficiency, aortic stenosis, bicuspid aortic valve), atrial septal defect, double‐outlet right ventricle, pulmonary atresia, patent ductus arteriosus, pulmonic stenosis, tetralogy of Fallot, and ventricular septal defect (P < 0.05). Higher maternal education was the only variable that was negatively correlated with parental consanguinity (P = 0.037). Our study emphasizes the role of homozygous recessive genes in the causation of different types of isolated congenital heart malformations, known to follow a multifactorial pattern of inheritance. There is an urgent need for educating the public on the deleterious effects of inbreeding, especially in developing countries with high overall consanguinity rates and limited financial resources. © 2003 Wiley‐Liss, Inc.
Patient with Sotos syndrome, Wolff‐Parkinson‐White pattern on electrocardiogram, and two right‐sided accessory bypass tracts
Authors: Sharma Param P. , Vidaillet Humberto , Dietz Julie
Published: January 2003

Sotos syndrome is a growth regulation disorder. Accessory conduction pathways, the anatomical structures responsible for Wolff‐Parkinson‐White syndrome, are thought to result from developmental failure to eradicate the remnants of the atrioventricular connections during cardiogenesis. Although the reported prevalence of congenital heart disease in Sotos syndrome is 10 times higher than in the general population, there are no reported cases with ventricular pre‐excitation. We report a patient with Sotos syndrome with two distinct accessory atrioventricular bypass tracts documented by invasive electrophysiology testing and a curative catheter ablation procedure. © 2003 Wiley‐Liss, Inc.
Unknown diagnosis in two male cousins with facial abnormalities, optic atrophy, abnormal EEG, and severe psychomotor retardation
Authors: Mégarbané André
Published: January 2003

We report two male cousins with short stature, microcephaly, hypertelorism, optic atrophy, ptosis, absent ear lobes, high‐arched palates, abnormal EEG, and severe mental retardation. Both cousins have consanguineous parents. Differential diagnoses are discussed and the possibility that we might be reporting on a new syndrome is raised. © 2003 Wiley‐Liss, Inc.
Patient with terminal duplication 3q and terminal deletion 5q: comparison with the 3q duplication syndrome and distal 5q deletion syndrome
Authors: Angle Brad , Yen Frank , Hersh Joseph H. , Gowans Gordon
Published: January 2003

Partial duplication of chromosome 3q is a well‐described condition of multiple congenital anomalies and developmental delay that resembles the Brachmann‐de Lange syndrome. Similarly, an emerging phenotype of a distal 5q deletion syndrome has recently been described. The combination of both chromosome abnormalities has not been previously described. We report on a child with both a de novo duplication of distal 3q (q27 → qter) and terminal deletion of 5q (q35.2 → qter). The patient had facial anomalies, hypoplastic toenails, lymphedema of the dorsum of the feet, type I Chiari malformation, a seizure disorder, and moderate developmental delays. The phenotype is compared and contrasted to the few reports of patients with similar terminal 3q duplications and 5q deletions. Our patient did not have the characteristic phenotype of the 3q duplication syndrome, suggesting that the chromosome region responsible for this phenotype is more proximal than the terminal 3q27 region. In addition, comparison with three other reported cases of terminal 5q35 deletions suggests a possible association of terminal 5q deletions with central nervous system (CNS) structural abnormalities. © 2003 Wiley‐Liss, Inc.
Gaucher disease associated with parkinsonism: Four further case reports
Authors: Várkonyi Judit , Rosenbaum Hanna , Baumann Nicole , MacKenzie Jennifer J. , Simon Zsuzsa , Aharon‐Peretz Judith , Walker Jamie M. , Tayebi Nahid , Sidransky Ellen
Published: January 2003

Type 1 Gaucher disease is considered the non‐neuronopathic form of this autosomal recessively inherited lysosomal storage disease. We report the simultaneous occurrence of Gaucher disease with parkinsonian in four adult patients. The patients had a relatively early onset of parkinsonian manifestations, and their disease was rapidly progressive and refractory to therapy. Each had a different Gaucher genotype, although four alleles carried the common N370S mutation. No mutations were identified in the genes for parkin or α‐synuclein. The concurrence of these two phenotypes, both in this series of patients and in others in the literature, suggests a shared pathway, modifier, or other genetic etiology. Published 2003 Wiley‐Liss, Inc.
Speech characteristics in the Kabuki syndrome
Authors: Upton Sheila , Stadter Carmella S. , Landis Pat , Wulfsberg Eric A.
Published: January 2003

Six children with Kabuki syndrome were studied to investigate speech patterns associated with the syndrome. Each child's speech was characterized with regard to articulation (types of errors and intelligibility), pitch (high or low), loudness (volume of speech), and prosody (general quality of speech that combines rate and inflection). All six children had a history of delayed speech and language acquisition and were receiving speech services. All individuals had articulation errors and abnormal oral resonance, which appeared to be due to poor oral‐motor coordination and hypotonia and were not felt to be due to structural abnormalities such as velopharyngeal insufficiency, dental malocclusion, or cleft palate. An intriguing finding, noted in the two individuals followed from childhood into adolescence with serial speech evaluations, was that pitch, loudness, and prosody did not mature over time and what was age appropriate performance at younger ages became inappropriate in adolescence. This raises a challenge for speech services, as by adolescence, while articulation had improved, the pitch and loudness of these individuals' speech had not and so was noticeably different from peers. Distinctive speech characteristics with a lack of normal maturation during childhood can be added to the extensive list of clinical features associated with the Kabuki syndrome and hopefully will lead to improved speech/language treatment for individuals with this syndrome. © 2003 Wiley‐Liss, Inc.
Parents' and children's attitudes toward the enrollment of minors in genetic susceptibility research: Implications for informed consent
Authors: Bernhardt Barbara A. , Tambor Ellen S. , Fraser Gertrude , Wissow Lawrence S. , Geller Gail
Published: January 2003

Purpose: Children at high risk of future disease may be recruited for participation in disease susceptibility research involving genetic testing. This study was aimed at assessing parents' and children's reactions to such research, and their perceptions of risks and benefits of participating. Methods: Parents and children (ages 10–17) from families at increased risk for breast cancer (n = 16 dyads) and heart disease (n = 21 dyads) participated in separate audiotaped interviews and a follow‐up family interview one year later. We asked about reactions, risks and benefits, and informational needs regarding participation in hypothetical research involving genetic testing on a saliva sample. Audiotape transcripts were analyzed qualitatively. Results: All children would initially participate because they viewed the research as low risk. When thinking about learning their test result and sharing it with others, or the uncertainties of testing, many children became hesitant about participating. Many parents thought their child might worry about a positive result, making them unlikely to enroll their child, or to choose not to tell the child test results. Both children and parents thought the benefits of participating included early detection or treatment (breast cancer families), prevention (heart disease families) and helping others. Children's questions about research participation centered on details of the study design and purpose, while parents' questions related to the genetic test itself. Conclusions: Children's first reaction to participating in research involving genetic susceptibility testing research may not indicate an adequate appreciation of risks and benefits; if encouraged to personalize the impact of genetic testing, children are able to engage in a more informed decision‐making process. © 2003 Wiley‐Liss, Inc.
An angel with Down syndrome in a sixteenth century Flemish Nativity painting
Authors: Levitas Andrew S. , Reid Cheryl S.
Published: January 2003

Artistic representation of malformation syndromes has been of ongoing interest, often as a point of departure for discussion of medical history. We have identified a 16th‐century Flemish Nativity painting in which one angelic figure appears distinctly different from other individuals in the painting with an appearance of Down syndrome. Several prior observers have identified Down syndrome in premodern art, sometimes stimulating ongoing discussions concerning its history, its prevalence, and its relationship to hypothyroidism. This may be one of the earliest European representations of Down syndrome. The depiction of an individual with Down syndrome as an angel raises several questions regarding the status of such an individual in late medieval times and societal recognition of minor anomalies, as contrasted with major malformations, in their predictive value for disabilities. In contrast, Langdon Down's description of the condition occurred only after evolution of concepts regarding the clinical significance of physical appearance and measurement. © 2003 Wiley‐Liss, Inc.
Double supernumerary isodicentric chromosomes derived from 15 resulting in partial hexasomy
Authors: Qumsiyeh Mazin B. , Rafi Syed K. , Sarri Catherine , Grigoriadou Maria , Gyftodimou Jolanda , Pandelia Effie , Laskari Hara , Petersen Michael B.
Published: January 2003

We report two unrelated patients each with two supernumerary marker chromosomes (SMCs) derived from chromosome 15, and thus resulting in partial hexasomy. Hexasomy in the one case (family 1) was diagnosed at prenatal diagnosis and did not include the Prader–Willi/Angelman critical region (PWACR). The double SMCs were also found in the mother, the pregnancy continued to term, and an apparently phenotypically normal child was born. This represents the first report of transmission of double SMCs from mother to child. In the second case (family 2), the hexasomy did include the PWACR and was de novo in origin. This patient manifested severe psychomotor retardation, clefting of the soft palate, hypotonia, seizure‐like episodes, and other phenotypic features. The aberrant phenotype is attributable to the hexasomy for the PWACR gene loci. The normal homologs of chromosome 15 proved to be biparental in origin while the two SMCs appeared maternal. © 2003 Wiley‐Liss, Inc.
Clinical variability of type II sialidosis by C808T mutation
Authors: Rodríguez Criado G. , Pshezhetsky A.V. , Rodríguez Becerra A. , Gómez de Terreros I.
Published: January 2003

Sialidosis (McKusick 256550) is an autosomal recessive disorder resulting from mutations in the NEU gene, located in 6p21.3, which leads to deficiency of alpha‐N‐acetyl neuraminidase (sialidase) activity, causing an accumulation of its substrates, oligosaccharides, in the lysosomes of various organs and tissues and an increased presence in urine and other organic fluids. We present a clinical report of three patients diagnosed for type II sialidosis. The first patient is a 12‐year‐old boy with the classic infantile form. His sister had a congenital form of sialidosis and died at 20 months of age. The third, nonrelated patient presented shortly after 1 year of age and had borderline cognitive delay at 9 years. All three patients were homozygous for the C808T mutation of the NEU gene. Their ancestors originated from a small area to the east of the city of Seville (Spain), suggesting the existence of a Seville founder mutation. © 2002 Wiley‐Liss, Inc.
Apparent encephalocele in twin fetus papyraceus with twin‐reversal arterial perfusion
Authors: Gilbert‐Barness Enid , Opitz John M. , Chamyan Gabriel , Debich‐Spicer Diane
Published: January 2003

An apparently iniencephalic or exencephalic monoamniotic monochorionic female twin fetus, delivered as a fetus papyraceus at 28 weeks of gestation, had severe anomalies of the central nervous system and spine, including occipital encephalocele with a defect of the occipital bone. The encephalocele contained a spherical mass of autolyzed brain tissue without identifiable cerebellum or vermis. The cervical canal was widely patent dorsally, there were severe bony anomalies, including agenesis and fusion of vertebrae in the cervicothoracic spine. The upper limbs were absent. All organs were hypoplastic and autolyzed. The hypoplastic heart had three chambers. The placenta was monochorionic and monoamniotic; barium injection showed a twin‐reversal arterial perfusion and entanglement of the umbilical cords. © 2002 Wiley‐Liss, Inc.
Griscelli syndrome without hemophagocytosis in an eleven‐year‐old girl: Expanding the phenotypic spectrum of Rab27A mutations in humans
Authors: Aksu Güzide , Kütükçüler Necil , Genel Ferah , Vergin Canan , Omowaire Benjamin
Published: January 2003

We present an eleven‐year‐old female patient who was referred to us with silvery hair, hepatosplenomegaly, neutropenia‐thrombocytopenia, hypogammaglobulinemia and degenerative white matter disease, with a family history of a female sibling dying at the age of five and two living male cousins, ages 10 and 11. She had been followed up for her cytopenia the last three years and had totally recovered from a hemiplegic episode before admission. The family was of Arabic origin, and a second‐degree consanguinity was reported between the parents. Microscopic analysis of her hair shafts revealed irregularly distributed small and large clumps of melanin, and skin biopsy findings were consistent with partial albinism. Bone marrow aspiration and biopsy did not detect any evidence of hemophagocytosis. Genetic analysis identified a homozygous two‐base‐pair deletion (51 del CT leading to S18X) in the Rab27A gene of the patient. She suffered from febrile neutropenic episodes. Her persistent cytopenia could not be corrected with immunoglobulin, thrombocyte infusions, or a short course of growth factor treatment. Splenectomy was planned due to her progressive splenic enlargement. She was also considered for bone marrow transplantation. She unfortunately died from an intracranial hemorrhage. Her clinical presentation was remarkable, mostly resembling partial albinism immunodeficiency/Elejalde syndrome due to her older age and absence of hemophagocytosis, but with molecular findings confirming Griscelli syndrome. © 2002 Wiley‐Liss, Inc.
Familial lateral semicircular canal malformation with external and middle ear abnormalities
Authors: Matsunaga Tatsuo , Hirota Eiko
Published: January 2003

We report a family with inner ear lateral semicircular canal (LSC) malformation and external and middle ear abnormalities. The family had no history of known syndromes or toxic exposures. Distinct phenotypic manifestations were found in three family members. A young girl exhibited bilateral LSC malformation with a right‐sided preauricular tag, a mildly deformed auricle, a stenotic external auditory canal, and a constricted middle ear cavity. She had moderate conductive hearing loss in the right ear but normal hearing in the left ear. Her younger brother exhibited right‐sided LSC malformation, microtia, external auditory canal atresia, a malformed middle ear cavity, and abnormal auditory ossicles. He had severe mixed hearing loss in his right ear. Their mother exhibited left‐sided LSC malformation without external and middle ear abnormalities, and the hearing was normal in her left ear. None of the three cases had vestibular symptoms, and their results of balance tests were appropriate for the corresponding ages. In contrast, significantly decreased LSC function was revealed by caloric tests in an ear with LSC malformation. Previously, LSC malformation may have been underdiagnosed in patients presenting with external and middle ear abnormalities and their relatives, since this malformation is frequently associated with normal hearing and balance or conductive hearing loss only. To our knowledge, this condition has not been described previously. This condition supports a genetic basis for the combination of LSC malformation and external and middle ear abnormalities and may represent an autosomal dominant condition with variable expressivity. © 2002 Wiley‐Liss, Inc.
Dynamic ecosystem models and the evaluation of ecosystem effects of fishing: can we make meaningful predictions?
Authors: Robinson L.A. , Frid C.L.J.
Published: January 2003

Fishing is one of the most widespread anthropogenic impacts on marine ecosystems. In recent times, the development of measurable metrics of the resultant ecosystem effects, has become an important aspect of fisheries management. Ecosystem models are often advocated as tools for the evaluation of system effects, but the extent to which models are able to make meaningful predictions, has not yet been fully addressed.

In order to assess the suitability of models, to evaluate ecosystem effects of fisheries, the direct and indirect effects were catalogued.

From the literature, 33 applications of marine ecosystem models were identified for analysis of their ability to fully assess these catalogued effects. Analysis was possible for only 24 of the models due to poor documentation of the other 9.

Each model was examined for their inclusion of nine functional groups, deemed essential for the assessment of impacts of fishing on the whole ecosystem (e.g. detritus, marine mammals). The models were also assessed for their inclusion of several additional factors, either fundamental in the regulation of marine ecosystems (e.g. environmental forcing), or important in the classification of their role as a predictor of changes in ecological processes (e.g. simulation, spatial properties).

No model formulation provided coverage in all the areas necessary to cover the identified effects of fisheries. Eight models provided good coverage, nutrient dynamics and benthos were the least well represented aspects of the ecosystem.

The ECOPATH with Ecosim family of models, the European Regional Seas Ecosystem Model (ERSEM) and the Anderson & Ursin multispecies extension to the Beverton & Holt model all seem likely to yield good insights.

In further developing these models, however, consideration must be given to explicitly incorporate spatial factors and extrinsic forcing functions, such as climate.

Copyright © 2002 John Wiley & Sons, Ltd.
Effects of seasonal variation in salinity on a population ofEnochrus bicolor Fabricius 1792 (Coleoptera: Hydrophilidae)and implications for other beetles of conservation interest
Authors: Greenwood M.T. , Wood P.J.
Published: January 2003

A population ofEnochrus bicolor(Fabricius) was monitored over a 4‐year period (March 1997–March 2001) from a coastal brackish pool in S.E. Essex. This water beetle, together withOchthebius marinus(Payk.), O. viridisPeyrhiff,O. punctatusSteph.,Hygrotus parallelogrammus(Ahrens),Berosus affinisBrulle,Agabus conspersus, (Marsham),Rhantus frontalis(Marsham),R. suturalis(MacLeay),Paracymus aeneus(Germar), andHaliplus apicalisThompson, are all taxa of conservation interest.

Enochrus bicolorwas present in most months, with greatest adult abundances being recorded in August and September each year.

During the study period salinity values ranged from 4.7 ppt (parts per thousand) to 62.6 ppt.

Correlation analysis and the development of regression models indicated that the highest abundances ofE. bicolorcoincided with maximum water temperature in the late summer–early autumn. However, when the natural seasonal signal was removed by standardizing the series, a relatively weak association with the relative abundance ofE. bicolorand conductivity was observed.

The conservation ofE. bicolorand other organisms associated with brackish water habitats subject to irregular marine inundation is considered.

Copyright © 2002 John Wiley & Sons, Ltd.
Landscape‐level constraints on recruitment of chinook salmon (Oncorhynchus tshawytscha) in the Columbia River basin, USA
Authors: Regetz James
Published: January 2003

The decline of salmonid populations in the Pacific Northwest has been well‐documented. It is unclear, however, which threats to salmonid persistence are the most serious, and how best to prioritize recovery efforts intended to ameliorate these threats.

It has been argued previously that one possible cause of salmon endangerment is degradation of spawning grounds. In order to explore this hypothesis, this study examines the relationships between chinook salmon (Oncorhynchus tshawytscha) productivity and landscape‐level characteristics of spawning grounds in the interior Columbia River Basin.

Population productivity is expressed as the mean and maximum recruitment rates for different stocks, measured from 1980 to 1990; habitat conditions are calculated using sub‐watershed scale data on land cover, land use, water quality and watershed hydrology.

Significant linear regression results were obtained for three environmental variables: percentage of land classified as urban, proportion of stream length failing to meet water quality standards, and an index of the ability of streams to recover from sediment flow events. A multiple regression with all three variables accounts for over 60% of the variation in mean salmon recruitment.

It further appears that these landscape attributes may limit the maximum recruitment rates of salmon, with a magnitude of difference in productivity large enough to be relevant to recovery planners. Additional study will be necessary to identify cause‐and‐effect linkages between habitat quality and salmon recruitment success, and to determine the ultimate impact of changes in recruitment rates on short‐ and long‐term salmon population trajectories.

Copyright © 2002 John Wiley & Sons, Ltd.
Geophysical approaches to the classification, delineation and monitoring of marine habitats and their communities
Authors: Roff John C. , Taylor Mark E. , Laughren Josh
Published: January 2003

If marine environments are to be systematically protected from the adverse effects of human activities, then identification of the types of marine habitats and the communities they contain, and delineation of their boundaries utilizing a consistent classification is required. Human impacts on defined communities can then be assessed, the ‘health’ of these communities can be monitored, and marine protected areas can be designated as appropriate.

Schemes to classify habitats at local and regional scales, according to their geophysical properties, may identify different factors as determinants, and/or use them in different sequences in a hierarchical classification. We examined the reasons for these differences in local and regional applications of a global concept, and argue that a common set of factors could be applied in a defined and defensible sequence to produce a common hierarchy of habitat types among geographic regions.

We show how simple mapping and GIS techniques, based on readily available data, can lead to the identification of representative habitat types over broad geographic regions. We applied a geophysical framework first to the entire Canadian coastline and second to the Scotian Shelf of Atlantic Canada to establish broad scale marine natural regions and ‘seascapes’, respectively. This ecosystem level approach — which defines representative habitat types — is a fundamental prerequisite for many purposes. It can form the basis for further analyses including: definition of community types from habitat — community relationships; evaluation of the potential roles of focal species in marine conservation; evaluation of candidate marine protected areas; definition of unaffected reference areas against which the effects of human activities can be gauged; guidance for water quality monitoring studies; management of marine resources.

Copyright © 2003 John Wiley & Sons, Ltd.
The Yangtze River dolphin or baiji (Lipotes vexillifer): population status and conservation issues in the Yangtze River, China
Authors: ZHANG X. , WANG D. , LIU R. , WEI Z. , HUA Y. , WANG Y. , CHEN Z. , WANG L.
Published: January 2003

Baiji were sighted 17 times during three recent simultaneous multi‐vessel surveys in the Yangtze River, China (November 4–10, 1997; December 4–9, 1998; October 31–November 5, 1999). There were 11 sightings in 1997 (consisting of 17 animals), five in 1998 (seven animals), and two in 1999 (four animals). It was concluded that 13 individuals could be considered as a minimum number of the baiji currently in the Yangtze River.

An annual rate of population decrease was roughly estimated as 10%. From the body sizes observed, the proportions of old, adult and immature individuals were approximately estimated at 57, 26, and 17% respectively.

Baiji showed a significant attraction to confluences and sand bars with large eddies. The present distribution range of the baiji is less than 1400 km in length in the Yangtze main river. Distances between the two nearest groups of baiji appear to be increasing.

Two typical sightings are described, in which surfacing and movements of baiji were recorded. Baiji were often found swimming together with finless porpoise. In the surveys they occurred in the same group in 63% of occurrences. Interactions between baiji and finless porpoise are described and discussed.

Human activities are the main threats to the baiji. Illegal electrical fishing accounted for 40% of known mortalities during the 1990s. Engineering explosions for maintaining navigation channels have become another main cause of baiji deaths. The last hope of saving the species may be to translocate the remaining baiji into a semi‐captive reserve, known as the ‘Baiji Semi‐natural Reserve’.

Copyright © 2003 John Wiley & Sons, Ltd.
Range and diet of Eurasian otters Lutra lutra (L.) in the catchment of the River Lee (south‐east England) since re‐introduction
Authors: Copp Gordon H. , Roche Kevin
Published: January 2003

After re‐introduction in 1991 of Eurasian otters Lutra lutra (L.) to the River Lee catchment (England), changes in range were assessed from spraint collections in the periods 1991–1994, 1995–1997 and 1998–2000. Diet, assessed from concerted spraint sampling within the first two periods, was compared between 1992–1994 and 1996–1997, with dietary preferences assessed for the initial phase using available fish stock data for that period.

In 1991–1994, range encompassed much of the catchment, but reduced in 1995–1997 to a small area around the initial release site, when the otters were joined/replaced by natural immigrants presumed to come from a contiguous catchment. Range expanded in 1998–2000 to upper reaches of the catchment's major tributaries.

Fish, mainly cyprinids, were the major prey taken in 1992–1994 and 1996–1997. In 1996–1997, fish abundant near the initial release site became more prominent, in particular chub Leuciscus cephalus, and (upstream) species characteristic of the initial range decreased in importance.

Despite confirmed and unconfirmed sightings of females with cubs, it remains unclear whether the presence and apparent expansion of otters in the Lee catchment is the result of the re‐introduction or of natural immigration/recolonization.

Copyright © 2003 John Wiley & Sons, Ltd.
Hip fracture patients are not treated for osteoporosis: A call to action
Authors: Harrington J. Timothy , Broy Susan B. , Derosa Angela M. , Licata Angelo A. , Shewmon David A.
Published: January 2003

Objective

To determine whether hip fracture patients, a group at very high risk for additional fragility fractures, are being evaluated and treated effectively for osteoporosis.

Methods

Clinical and bone densitometry (dual x‐ray absorptiometry [DXA]) records were reviewed in hip fracture patients at 4 Midwestern US health systems to determine the frequency of DXA use, calcium and vitamin D supplementation, and antiresorptive drug treatment.

Results

DXA was performed at the 4 study sites in only 12%, 12%, 13%, and 24% of patients, respectively. Calcium and vitamin D supplements were prescribed in 27%, 1%, 3%, and 25% of the patients at the 4 study sites. Antiresorptive drugs were prescribed in 26%, 12%, 7%, and 37% of the patients with only 2–10% receiving a bisphosphonate.

Conclusion

Reducing osteoporotic fractures will require more effective approaches to managing hip fracture patients and other high‐risk populations.
Trajectory of assistive device usage and user and non‐user characteristics: Long‐handled bath sponge
Authors: Rogers Joan C. , Holm Margo B. , Perkins Lynette
Published: January 2003

Objectives

To examine use of an assistive device, a long‐handled bath sponge (LHBS) in patients with rheumatoid arthritis and osteoarthritis to describe use from the time of in‐hospital prescription to the 2‐ and 12‐month followups, and to describe the characteristics of those who became device users and non‐users.

Methods

Patients (n = 102) who were prescribed a LHBS during hospitalization were followed prospectively. The clinical and psychosocial assessment included disease, physical and psychosocial factors, and disability.

Results

The overall usage rate for the LHBS was 86%. When compared with users, non‐users had fewer arthritic joints, perceived greater control over their disability and pain, and had less favorable perceptions of the LHBS. Characteristics that did not differentiate non‐users from users were sociodemographic variables, disease duration, movement capability, level of disability and pain, and general perceptions of assistive devices.

Conclusion

The results support the early identification of patients who are likely to become non‐users so that acceptable alternative interventions can be planned.
Measuring exercise‐induced mood changes in fibromyalgia: A comparison of several measures
Authors: Gowans S. E. , deHueck A. , Abbey S. E.
Published: January 2003

Objective

To compare scales measuring exercise‐induced changes in mood.

Methods

Mood changes in a randomized, 23‐week controlled trial of exercise were assessed using the Beck Depression Inventory (BDI), Center for Epidemiologic Studies Depression Scale (CES‐D), State Trait Anxiety Inventory (STAI), Fibromyalgia Impact Questionnaire, and the Mental Health Inventory (MHI). Effect sizes and t‐tests were computed on 23‐week change scores. Scales were deemed to be confounded if items addressed sleep disturbances, fatigue, or effort (symptoms of both mood disturbances and fibromyalgia).

Results

Efficacy (15 exercise subjects) and intent‐to‐treat analyses (27 exercise subjects) generated medium effects for BDI (total, cognitive), MHI depression (efficacy only), and CES‐D (intent‐to‐treat only) scales. BDI (total, cognitive), MHI (depression, positive affect, total [MHI‐5]), and STAI scales distinguished exercise from control subjects at 23 weeks in all analyses. BDI somatic and CES‐D scales were deemed to be confounded.

Conclusion

We recommend the BDI cognitive, STAI, and MHI‐5 scales to measure depression, anxiety, and general mood, respectively, in patients with fibromyalgia.
Barriers to treatment adherence among African American and white women with systemic lupus erythematosus
Authors: Mosley‐Williams Angelia , Lumley Mark A. , Gillis Mazy , Leisen James , Guice Deena
Published: January 2003

Objective

To determine whether African Americans with systemic lupus erythematosus (SLE) have poorer treatment adherence than whites, and to determine ethnic group differences in barriers to adherence, and how barriers affect adherence.

Methods

We compared 68 African American and 54 white women with SLE on 19 potential barriers, on 2 adherence behaviors during the past year, and on how the potential barriers relate to each nonadherence behavior.

Results

African Americans and whites were similar on most barriers, although African Americans were more likely to rely on religion and were more concerned about long‐term medication effects. The 2 ethnic groups were comparable on medication nonadherence, but whites tended to have poorer clinic appointment adherence than African Americans. Finally, we found that barriers related to negative affect (depression, medication concerns, physical symptoms) as well as short‐term memory problems and the need for child or elder care were associated with nonadherence among African Americans, whereas perceived treatment inefficacy and lacking trust in physicians were associated with nonadherence among whites.

Conclusion

Relationships between adherence barriers and nonadherence may be ethnicity specific, suggesting that interventions to address barriers should be targeted to specific groups.
Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997
Authors: Hootman Jennifer M. , Helmick Charles G. , Schappert Susan M.
Published: January 2003

Objective

To describe ambulatory medical care utilization, defined to exclude injury‐related visits, for persons with arthritis and other rheumatic conditions.

Methods

National estimates, rates, and other characteristics of ambulatory care visits were calculated from a national sample of patient visits to physician offices and acute care hospital outpatient and emergency departments.

Results

An estimated 36.5 million ambulatory care visits were related to arthritis and other rheumatic conditions. Visit rates increased with age and, overall, were twice as high among women as men. Rates of visits by race varied by ambulatory care setting. Soft tissue disorders (9.3 million), osteoarthritis (7.1 million), nonspecific joint pain/effusion (7.0 million), and rheumatoid arthritis (3.9 million) were the most common diagnoses.

Conclusions

Arthritis and other rheumatic conditions account for about as many ambulatory care visits as cardiovascular disease or essential hypertension. These visits serve as excellent opportunities to counsel patients regarding prevention messages for arthritis.
Renal underexcretion of uric acid is present in patients with apparent high urinary uric acid output
Authors: Perez‐Ruiz F. , Calabozo M. , Erauskin G. García , Ruibal A. , Herrero‐Beites A. M.
Published: January 2003

Objective

To compare renal handling of uric acid in patients with primary gout with that of a control group.

Methods

A case–control study of 100 patients with primary gout and 72 healthy controls was undertaken. Creatinine clearance, uric acid clearance, 24‐hour uric acid urinary excretion, fractional excretion of uric acid, excretion of uric acid per volume of glomerular filtration, urinary uric acid to creatinine ratio, and glomerular uric acid filtered load were calculated using 24‐hour urine samples. After treatment with allopurinol to achieve similar glomerular filtered load of uric acid, patients were again compared with controls.

Results

Patients with gout showed lower uric acid clearance, fractional excretion of uric acid, excretion of uric acid per volume of glomerular filtration, and urinary uric acid to creatinine ratio than controls at baseline, when patients showed hyperuricemia. Although the glomerular uric acid filtered load was much higher in patients with gout than controls, 24‐hour uric acid excretion was not statistically different. After treatment with allopurinol, and achieving similar uric acid filtered loads, patients still showed lower figures than controls. When patients with 24‐hour urinary uric acids levels >700 mg/day were compared with controls, they had lower uric acid clearance and fractional excretion of uric acid than controls, both at baseline and after achieving similar filtered loads with allopurinol therapy.

Conclusions

Renal underexcretion is the main mechanism for the development of primary hyperuricemia in gout, but even patients showing apparent high 24‐hour uric acid output show lower uric acid clearance than controls, indicating that relative, low‐grade underexcretion of uric acid is at work.