bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech-Based Interaction in Multitask Conditions: Impact of Prompt Modality
Authors: Parush Avi
Published: November 2005

Speech-based interaction is often recognized as appropriate for hands-busy, eyes-busy multitask situations. The objective of this study was to explore prompt-guided speech-based interaction and the impact of prompt modality on overall performance in such situations. A dual-task paradigm was employed, with tracking as a primary task and speech-based data input as a secondary task. There were three tracking conditions: no tracking, basic, and difficult tracking. Two prompt modalities were used for the speech interaction: a dialogue with spoken prompts and a dialogue with visual prompts. Data entry duration was longer with the speech prompts than with the visual prompts, regardless of whether or not there was tracking or its level of difficulty. However, when tracking was difficult, data entry duration was similar for both spoken and visual prompts. Tracking performance was also affected by the prompt modality, with poorer performance obtained when the prompts were visual. The findings are discussed in terms of multiple resource theory and the possible implications for speech-based interactions in multitask situations. Actual or potential applications of this research include the design of speech-based dialogues for multitask situations such as driving and other hands-busy, eyes-busy situations.
Augmented, Pulsating Tactile Feedback Facilitates Simulator Training of Clinical Breast Examinations
Authors: Gerling Gregory J. , Thomas Geb W.
Published: November 2005

Haptic training devices can facilitate tactile skill development by providing repeatable exposures to rare stimuli. Extant haptic training simulator research primarily emphasizes realistic stimuli representation; however, the experiments reported herein suggest that providing augmented feedback can improve training effectiveness, even when the feedback is not natural. A novel clinical breast examination training device uses inflated balloons embedded in silicone to simulate breast lumps. Oscillating the balloon water pressure makes the lumps pulsate. The pulsating lumps are easier to detect than the static lumps used in current simulators, and this manipulation seems to effectively introduce trainees to small, deep lumps that are initially difficult to perceive. A study of 48 medical students indicates that training with the dynamic breast model increased the number of lumps detected, F(1, 47) = 9.34, p = .004, decreased the number of false positives, F(1, 47) = 5.78, p = .020, and improved intersimulator skill transfer, F(1, 47) = 26.56, p < .001. The results suggest that at least in this case, augmented, tactile feedback increases training effectiveness, despite the fact that the feedback does not attempt to mimic any physical phenomenon present in the natural stimulus. Applications of this research include training techniques and tools for improved detection of palpable cancers.
A Normative Database of Thumb Circumduction In Vivo: Center of Rotation and Range of Motion
Authors: Zhang Xudong , Braido Peter , Lee Sang-Wook , Hefner Robert , Redden Mark
Published: November 2005

This article reports a systematic research effort aimed at establishing a normative database of thumb circumduction range of motion (ROM) and related kinematic characteristics in vivo while examining the effects of anthropometry, gender, and direction of rotation. Twenty-eight (14 men, 14 women) anthropometrically diverse participants performed maximum voluntary thumb circumductions as the trajectories of the surface markers placed on their thumb landmarks were recorded by an optoelectronic motion capture system. A globographic representation method was employed to model the measured marker trajectories, determining the center of rotation and central reference axes for thumb circumduction. Thumb ROM was quantified using (a) the joint sinuses expressing the thumb orientation change with respect to the reference axes and (b) cone volumes circumscribed by the thumb at the distal phalangeal, interphalangeal, and metacarpophalangeal levels. Data analyses resulted in statistical summaries of the derived kinematic and ROM measures with significant effects identified and regression equations predicting the cone volumes. Potential applications of this research include ergonomic design of hand-operated controls or devices and evaluation of thumb impairments or disorders.
Assessing the Effects of Positive Feedback and Reinforcement in the Introduction Phase of an Ergonomic Intervention
Authors: Brandenburg David L. , Mirka Gary A.
Published: November 2005

Resistance to change is common in ergonomic interventions, often resulting in negative consequences when the intervention's effectiveness is studied. A lab-based study assessed the effects of positive reinforcement during the intervention process. On Day 1 all participants performed a simple screw-driving task that placed stress on the cervicobrachial region through static loading. On Day 2 a control group received basic information about ergonomics and then performed the task using an ergonomic intervention that has been shown to reduce loading on these muscle groups. The experimental group received the same basic information but also received positive reinforcement while performing the task with the ergonomic intervention. Subjective task assessment surveys and body-part discomfort surveys were administered, and these, along with speed of performance, were assessed in both groups. The results showed a significantly (p < .05) more positive subjective impression of the intervention for the feedback group than for the control group (29%-57% improvement) with no real changes in either the performance or discomfort levels. Applications of this research include improving workers' acceptance of ergonomic interventions in industrial and other settings. The reinforcement technique evaluated in this paper has yielded consistently positive effects in our ongoing ergonomic intervention research.
Team Task Analysis: Identifying Tasks and Jobs That Are Team Based
Authors: Arthur Winfred , Edwards Bryan D. , Bell Suzanne T. , Villado Anton J. , Bennett Winston
Published: November 2005

This paper presents initial information on the development and validation of three team task analysis scales. These scales were designed to quantitatively assess the extent to which a group of tasks or a job is team based. During a 2-week period, 52 male students working in 4-person teams were trained to perform a complex highly interdependent computer-simulated combat mission consisting of both individual- and team-based tasks. Our results indicated that the scales demonstrated high levels of interrater agreement. In addition, the scales differentiated between tasks that were predetermined to be individual versus team based. Finally, the results indicated that job-level ratings of team workflow were more strongly related to team performance than were aggregated task-level ratings of team-relatedness or team workflow. These results suggest that the scales presented here are an effective means of quantifying the extent to which tasks or jobs are team based. A research and practical implication of our findings is that the team task analysis scales could serve as criterion measures in the evaluation of team training interventions or predictors of team performance.
An Attempt to Evaluate Mental Workload Using Wavelet Transform of EEG
Authors: Murata Atsuo
Published: November 2005

An attempt was made to evaluate mental workload using a wavelet transform of electroencephalographic (EEG) signals. Participants performed a continuous matching task at three levels of task difficulty. EEG signals during the task were recorded continuously from Fz, Cz, and Pz. The reaction time increased as the difficulty of the task increased. The percentage correct decreased as the task became more difficult. In accordance with this, the rating score on the NASA-Task Load Index tended to increase with increased task difficulty. The EEG signals were analyzed using wavelet transform to investigate time-frequency characteristics. The total power at θ, α, and β frequency bands and the time that the maximum power appeared for the three frequency bands were extracted from the scalogram. Increasing cognitive task difficulty seems to delay the time at which the central nervous system works most actively. These measures were found to be sensitive indicators of mental workload and could differentiate three cognitive task loads (low, moderate, and high) with high precision. Actual or potential applications of this research include a method that is relatively quick and accurate, compared with traditional methods, for the evaluation of mental workload.
Attentive Navigation for Viewpoint Control in Virtual Environments
Authors: Hughes Stephen , Lewis Michael
Published: November 2005

Three-dimensional virtual environments and teleoperation activities depend on the ability to position an egocentric viewpoint at meaningful locations. Evidence from foundational research has led to the development of control strategies that generally adopt an all-or-nothing approach to guiding the viewer to useful vistas. This work examines attentive navigation, a technique for partially automating viewpoint control to promote a supportive yet unscripted exploration of a virtual environment. A collection of three experiments was designed to assess the effectiveness of attentive navigation versus commonly used free navigation techniques. Results show that this approach has promising consequences for improving object recognition, developing an understanding of the configuration of objects, and searching for target objects. Actual or potential applications of this research include improved interaction techniques for extracting information from visual representations, virtual environments, and teleoperation experiences.
The Small GTPase Rab7 Controls the Endosomal Trafficking and Neuritogenic Signaling of the Nerve Growth Factor Receptor TrkA
Authors: Saxena Smita , Bucci Cecilia , Weis Joachim , Kruttgen Alex
Published: November 2005

Nerve growth factor (NGF) and its TrkA receptor exert important bioactivities on neuronal cells such as promoting survival and neurite outgrowth. Activated TrkA receptors are not only localized on the cell surface but also in signaling endosomes, and internalized TrkA receptors are important for the mediation of neurite outgrowth. The regulation of the endosomal trafficking of TrkA is so far unknown. Because the endosome-associated GTPase Rab7 coimmunoprecipitated with TrkA, we examined whether the endosomal trafficking of TrkA might be under the control of Rab7. Inhibiting Rab7 by expression of a green fluorescent protein-tagged, dominant-negative Rab7 variant resulted in endosomal accumulation of TrkA and pronounced enhancement of TrkA signaling in response to limited stimulations with NGF, such as increased activation of Erk1/2 (extracellular signal-regulated kinase 1/2), neurite outgrowth, and expression of GAP-43 (growth-associated protein 43). Our studies show that the endosomal GTPase Rab7 controls the endosomal trafficking and neurite outgrowth signaling of TrkA. Because mutations of Rab7 are found in patients suffering from hereditary polyneuropathies, dysfunction of Rab7 might contribute to neurodegenerative conditions by affecting the trafficking of neurotrophins. Moreover, strategies aimed at controlling Rab7 activity might be useful for the treatment of neurodegenerative diseases.
Phorbol Esters Target the Activity-Dependent Recycling Pool and Spare Spontaneous Vesicle Recycling
Authors: Virmani Tuhin , Ertunc Mert , Sara Yildirim , Mozhayeva Marina , Kavalali Ege T.
Published: November 2005

Using electrophysiology and styryl dye imaging, we studied the effect of phorbol 12-myristate 13-acetate (PMA) on activity-dependent and spontaneous vesicle recycling. In electrophysiological experiments, we found that the PMA effect depended on the maturational state of the synapses. Spontaneous neurotransmitter release from nascent synapses without a functional readily releasable pool (RRP) was unresponsive to PMA application. In contrast, mature synapses responded robustly to PMA application, consistent with previous studies. Using styryl dye imaging, we found that there was a PMA-dependent increase in the size of the RRP when PMA was present before, during, or after activity-dependent dye uptake, suggesting that this effect involves an increase in the population of the RRP by vesicles recruited from the reserve pool. Additionally, we found that when PMA was present during spontaneous dye uptake, there was an increase in dye labeling, and these additional dye-loaded vesicles showed rapid destaining in response to strong stimulation and were also releasable by hypertonic sucrose. In contrast, these observations were not reproducible when PMA treatment was performed after spontaneous dye uptake and extracellular dye washout. Together, these findings suggest that the increased spontaneous neurotransmission in the presence of PMA was attributable to release of vesicles from the RRP rather than an effect of PMA on the spontaneously recycling pool. Thus, the phorbol esters selectively regulate the activity-dependent pool of vesicles, indicating that priming mechanisms that prepare vesicles for fusion, which are targeted by phorbol esters, are different for the spontaneous and evoked forms of fusion.
Chinese Perceptions of American Power, 1991–2004
Authors: Zhang Biwu
Published: November 2005

This article presents Chinese perceptions of American power/capability in terms of economic, scientific and technological, military, and soft power, together with its perceived trajectory. This research suggests that in the foreseeable future, barring serious mistakes on its own part, the U.S. quite possibly will remain the dominant power in world politics.
Is There a Power Transition between the U.S. and China? The Different Faces of National Power
Authors: Chan Steve
Published: November 2005

Is China about to overtake the United States? Although China scores high on most traditional measures of national power, it continues to perform poorly in information technology and human capital, important assets that are necessary to promote productivity and sustain affluence in modern economies.
The Evolution of China's Engagement with International Governmental Organizations: Toward a Liberal Foreign Policy?
Authors: Hempson-Jones Justin S.
Published: November 2005

This article highlights China's interactions within intergovernmental organizations, a dynamic that has evolved in a liberal direction. The assertion is made that China's foreign policy behavior is no longer adequately explained solely by realist models and that, instead, we must look to neo-liberal institutionalism in order to describe and predict China's behavior.
China-Taiwan Tug of War in the WTO
Authors: Cho Hui-Wan
Published: November 2005

Although Taiwan expects interactions with China to occur under the WTO framework, China has developed a strategy of a WTO framework with one-China gestures. This is to make a statement that Taiwan customs territory is in fact China's separate customs territory and to avoid acquiescing in the view that Taiwan has a legal standing within the WTO.
Explaining Corruption at the Village and Individual Level in India: Findings from a Study of the Panchayati Raj Reforms
Authors: Widmalm Sten
Published: November 2005

This study of decentralization reforms in India challenges the assumption that corruption should be seen as a function of culture. At the individual level, the capacity to distinguish between public and private sectors is important for rejecting the use of bribes to public sector employees, while at the aggregate level social capital plays an important role for resisting corruption.
China's Moderate Middle Class: The Case of Homeowners' Resistance
Authors: Cai Yongshun
Published: November 2005

This paper considers how the middle class in China protects its interests against state and social actors by examining homeowners' defense of their rights. The study suggests that members of the Chinese middle class are largely moderate because of their intention to maintain the political order and limited ability to stage disruptive action.
Japan's Cabinet Secretariat and Its Emergence as Core Executive
Authors: Shinoda Tomohito
Published: November 2005

Since the 2001 administrative reform, the Cabinet Secretariat has played an increasingly important role as core executive in Japan's policy-making. With newly defined authority and expansion of the office, the Secretariat has dealt with politically difficult policies and demonstrated its ability to coordinate conflicting interests among various ministries.
The Post-English English
Authors: Greene Roland
Published: November 2005

The relation of english to other language-oriented departments, though dense with complexity, is rarely talked about in the open. One explanation for the lack of discussion may be the difficulty of framing a relation that is moving in two directions at once: while over the last generation or so English and the so-called foreign languages have come to resemble each other in substance, they have grown apart in material resources and institutional prestige. Many departments of English are more or less thriving, while departments of other languages and literatures in the same places are depleted and struggling. And yet, in the view of many of the people who determine our condition—administrators, legislators, and students—we are largely all of a piece; my problems will soon be yours, yours will be mine, and scholars and teachers of literature will find that they have far more joining than dividing them. To revive one of the rubrics of our New York University conference, we literary scholars are much better at collating the many ways we are different than identifying and leveraging the ways we are the same. How much does our declining influence in academy and society owe to an incapacity to come together and announce our identity when it matters? I take the position that we now have an ethical obligation to do what inclination and training have so badly prepared us for: to measure our sameness and difference on one scale and talk about what we can do together. How can people in English departments address this condition? What might those in other literature departments do? Having spent a career moving between these settings, I offer some reflections.
Cooperation between English and Foreign Languages in the Area of Multilingual Literature
Authors: Sollors Werner
Published: November 2005

There are approximately six billion people living in the world today, of whom roughly one billion are well off (living at or near Western standards) while three billion live on less than two dollars a day; two billion are in between, though even the most fortunate among them are at least fifty percent below the standards of the top one billion (Summers). The trend, unfortunately, is toward more wealth at the top, more poverty at the bottom, and the population is growing fastest where needs are greatest (estimates for population growth by 2050 range from about eight to nearly twelve billion). The United Nations Population Fund report from which these facts are taken furthermore points out that the

world's richest countries, with 20 per cent of global population, account for 86 per cent of total private consumption, whereas the poorest 20 per cent of the world's people account for just 1.3 per cent. A child born today in an industrialized country will add more to consumption and pollution over his or her lifetime than 30 to 50 children born in developing countries. The ecological “footprint” of the more affluent is far deeper than that of the poor and, in many cases, exceeds the regenerative capacity of the earth.

(“Chapter 1”)

One does not have to be a prophet to predict large global crises—military, political, migratory, environmental, health-related, concerning international law, and so forth—that will affect if not us, then surely our students' generation.
Why Major in Literature—–What Do We Tell Our Students?
Authors: Crosby Christina
Published: November 2005

If the value of the study of literature were self-evident, there would be no need to pose this question. That such is not the case is clear from the virulence of the debates about higher education in the humanities that have roiled the profession and areas beyond. Professors of literature have had a lot to say to one another about this question but not, perhaps, as much to say to their students. Yet faculty members implicitly answer this question all the time, in the courses they teach, especially in introductory, or “gateway,” courses. I will address the question, then, as concretely as possible, by way of the introductory course for the English major my colleagues and I have designed together and discussed repeatedly over the past two decades at Wesleyan University. In so doing, I will argue that the value of studying literature is precisely that it poses value as a question, not an answer.
Why Major in Literature—–What Do We Tell Our Students?
Authors: Seyhan Azade
Published: November 2005

It is precisely because of the elusive character of real life that we need the help of fiction to organize life retrospectively, after the fact, prepared to take as provisional and open to revision any figure of emplotment borrowed from fiction or from history.

–Paul Ricoeur

In the aftermath of what has come to be known as Nine One One, literary texts became the last resort of consolation in a vast desert of mindless media commentary and aggressive but ultimately futile political rhetoric. The Philadelphia Inquirer promptly published email messages exchanged by four University of Pennsylvania students trying to grapple with the tragic enormity of the historical moment. For these students “[t]he old world died on Tuesday [11 Sept. 2001],” and they had to learn to live in a new reality. To make sense of this not-so-brave new world, they sought for answers in “books and literature” (“Facing”). Mass-circulated email carried messages of consolation in literary format across the cyber globe. W. H. Auden's “September 1, 1939” was reprinted in all the major newspapers and forwarded to countless e-mail accounts. The conservative columnist George F. Will quoted liberally from the closing lines of Albert Camus's The Plague. “Today's president, his rhetorical rheostat turned way up, vows that the current military campaign 'will rid the world of evil,'” observed Will with undisguised sarcasm. He countered the president's naiveté by citing Camus's allegory of the plague as the permanence of evil in the world. In the final paragraph of the novel, Camus's narrator, Dr. Rieux, muses that the plague bacillus never dies but lies dormant until its time comes to unleash its terror on an unsuspecting world once again. By invoking The Plague, Will wanted to remind his fellow Americans “who are mild in temperament and amnesiac in tendency” that for America “there are only two kinds of years, the war years and the interwar years.” The banality of this conclusion contrasts sharply with the profundity of Camus's final lines.
Why Major in Literature?—–What We Say to Our Students
Authors: Ward Patricia A.
Published: November 2005

What better time could there be to major in literature than now? The corpus of texts available, thanks to translation, is that of the world. The boundaries of the literary are allinclusive, embracing high and low culture. Reading lists are always a surprise. You can be a literature major and work with film, with computer-generated texts and hypertexts. You can cross over into creative writing and communications. The skills you will learn are easily transferable and will enable you to be a candidate in a variety of areas when you enter the job market, especially if you have had an internship. Humanities majors are more likely to attain leadership positions during their careers than are students in narrow technical fields. A literature major can even be combined with premed and prelaw if you are thinking about graduate school.
“Lycidas”: The Pastoral Elegy as Same-Sex Epithalamium
Authors: Boehrer Bruce
Published: November 2005

Milton's “Lycidas” deploys a variety of matrimonial references—classical and Christian—within an elegiac context that simultaneously manifests anxiety over feminine sexuality. The result is a poem whose erotic investments, coexisting as they do with a general preference for masculine over feminine companionship, tend to settle into patterns of same-sex attachment. These culminate in the “unexpressive nuptial song” of the poem's conclusion, which figures spiritual consummation in matrimonial terms while implicitly positioning Lycidas in the role of bride.
Holocaust and Hiroshima: American Ethnic Prose Writers Face the Extreme
Authors: Sollors Werner
Published: November 2005

In her last essay, “House of the One Father” (1941), Mary Antin, most famous for her immigrant autobiography, The Promised Land (1912), questioned her “divorcement” from Jewish life and found herself

pulled by the old forgotten ties, through the violent projection of an immensely magnified Jewish problem. It is one thing to go your separate way, leaving your friends and comrades behind in peace and prosperity; it is another thing to fail to remember them when the world is casting them out. […] The least I can do, in my need to share the sufferings of my people, is declare that I am as one of them. (41)
Transnationalism and Classic American Literature
Authors: Giles Paul
Published: November 2005

Taking issue with associations between American literature and identity politics, this essay argues that to remap the culture of the United States in global terms is to problematize its exemplary and exceptionalist qualities and recognize inherent transnational frictions. As an example of this, the writings of Emerson and Thoreau in the 1840s are situated in relation to conflicts over the Oregon Territory, so that their textual designs come to seem less abstract or Neoplatonic than aggressively nationalistic. To restore a sense of the spatial problematic to American literature is to interrogate its more traditional integration within a temporal dimension of prophetic destiny. The essay concludes by suggesting that reexamining American allegories of interiority through pre-Romantic theories of spatial formation effectively produces a different perspective on texts that have become naturalized as examples of liberal self-reliance and institutionalized as types of classic American literature.
“Islanded in the World”: Cultural Memory and Human Mobility inThe Last Man
Authors: Sussman Charlotte
Published: November 2005

The Last Man, Mary Shelley's novel of 1826, describes the extinction of humanity by a plague that leaves only one man alive. The plague exerts pressure on the idea of national community by forcing a reevaluation of the number of people needed to continue a nation. It also increases human mobility, severing all local attachments as its survivors seek safety. By considering these issues,The Last Manengages with contemporary sociopolitical debates, reflects on the consequences of those debates for literary production and readership, and meditates on the possibilities for cultural memory in a peripatetic world. This essay introduces a neglected historical context for the novel: the debates over emigration, especially state-aided emigration, during the first three decades of the nineteenth century. Shelley's novel aligns itself, in a strikingly pessimistic way, with those who opposed any encouragement of emigration.
Berlin's Architectural Citations: Reconstruction, Simulation, and the Problem of Historical Authenticity
Authors: Goebel Rolf J.
Published: November 2005

Reunified Berlin's ubiquitous examples of architectural citation—such as the Reichstag, the plans for the Stadtschloß, the Sony Center at Potsdamer Platz, the new Hotel Adlon, and the FriedrichstadtPassagen—variously inscribe contemporary architectural styles with allusive reinventions of previous forms and cultural discourses, incorporate remnants of older edifices, or use partial reconstructions for new social purposes. In the process, these projects problematize conventional principles of architectural restoration by dramatizing a productive tension between past and present, between authenticity and simulation, between genuine nostalgia and the sometimes cynical manipulation of historical memory. Relying on the synchronicity of (seemingly) nonsynchronous styles, architectural citation goes beyond postmodern pastiche; such citation signifies Berlin's renegotiation of its identity as the new-old capital by recycling half-obliterated and yet irrepressible traces of urban history within the parameters of international capitalism, Europe-directed national politics, and the rampant tourist industry.
The Library and Material Texts
Authors: Stallybrass Peter
Published: November 2005

For the last three years, roger chartier and i have taught an undergraduate seminar called the history of print Culture in Early Modern Europe and America. Although the content of the course has changed, one feature has been persistent: at least half our classes met in the rare-book libraries of Philadelphia. While we have often held the seminar in Special Collections at the University of Pennsylvania, we have also gone to the Library Company of Philadelphia, the Free Library, and the Rosenbach Museum and Library. This would not have been possible without the extraordinary openness and generosity of the Philadelphia libraries and librarians. But the work of those librarians has not only provided an infrastructure for the course; it has also reshaped what we've worked on and how we teach it.
Science Fiction in South Africa
Authors: Byrne Deirdre C.
Published: November 2005

As has been said many times before, South Africa is a land of contrasts: Between races, landscapes, economic strata, political viewpoints, and lifestyles. A complex contrast, but one that is relevant to science fiction, is the disparity between levels of technological literacy. Some of the country's population have access to advanced technology, such as Internet connections and cell phones, but most citizens have a monthly income well below the comfort level. Illiteracy is extremely high, despite the efforts of a large number of educational organizations. The HIV/AIDS pandemic has reached crisis proportions; by 2010, approximately sixty-five percent of the country's adult population will have died of the disease if the current rate of infection continues unchecked. In this context, one cannot expect an advanced awareness of technological or scientific developments; neither can one assume even a basic acquaintance with published literature.
Controversies in the Therapy of Early Stage Breast Cancer
Authors: Cianfrocca Mary , Gradishar William J.
Published: November 2005

Learning Objectives

After completing this course, the reader will be able to: Select appropriate adjuvant therapies for patients with early stage breast cancer.Describe the evolving role of taxanes in the adjuvant therapy of early stage breast cancer.Discuss the evolving role of aromatase inhibitors in the adjuvant therapy of early stage breast cancer.Discuss the controversies that remain in the treatment of early stage breast cancer.Interpret the recent data supporting the use of trastuzumab in the adjuvant setting for patients with HER-2–positive, early stage breast cancer.

Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com

Breast cancer is the most common malignancy among U.S. women, with more than 200,000 new cases diagnosed annually. In the U.S., mortality from breast cancer has declined in recent years as a result of more widespread screening, leading to earlier detection, as well as advances in the adjuvant treatment of early-stage disease. It is widely accepted that the appropriate use of adjuvant chemotherapy and endocrine therapy improves the disease-free and overall survival of patients with early-stage breast cancer. It is, therefore, standard clinical practice to administer adjuvant systemic therapy to patients with node-positive and high-risk, node-negative breast cancer. There remain, however, many controversies in the primary systemic therapy of breast cancer, which are discussed in this review.
Using Single-Agent Therapy in Adult Patients with Advanced Soft Tissue Sarcoma Can Still Be Considered Standard Care
Authors: Sleijfer Stefan , Seynaeve Caroline , Verweij Jaap
Published: November 2005

Learning Objectives

After completing this course, the reader will be able to: Discuss the current status of the chemotherapeutic treatment of advanced soft tissue sarcomas in adult patients.Explain the pitfalls in trial design when reading published papers on performed clinical studies.Discuss the importance of identifying the several subtypes comprising the group of soft tissue sarcomas.Describe new strategies to improve future research in adult soft tissue sarcomas.

Access and take the CME test online and receive 1 AMA PRA category 1 credit at CME.TheOncologist.com

The group of soft tissue sarcomas in adult patients is a heterogeneous group with more than 40 different subtypes. While local treatment remains the mainstay for localized disease, systemic chemotherapy can importantly contribute in the treatment of advanced soft tissue sarcoma. For patients with metastatic disease, chemotherapy is a palliative treatment in the vast majority of the cases. In this setting, toxicity should not outweigh the potential benefits resulting from chemotherapy. In patients with locally advanced disease too extensive for local treatment, systemic chemotherapy can contribute to cure, provided that tumor shrinkage renders subsequent optimal local treatment possible. In these cases, chemotherapeutic regimens yielding the highest response rates achievable should be used. In the last decades, several randomized studies have aimed to determine whether combination regimens yield benefit over single-agent treatment in terms of response rate and overall survival. This review addresses the current available data on chemotherapy for adult patients with soft tissue sarcoma, excluding gastrointestinal stromal tumor, the Ewing-like sarcomas, and other small blue round cell tumors. In addition, it is increasingly recognized that future research in soft tissue sarcoma should focus on the identification of tumor factors that can serve as targets for treatment and that the diverse tumor subtypes should be analyzed separately for their sensitivity to systemic treatment. This review also focuses on these and other strategies that will hopefully lead to better out comes in this disease entity in the near future.
Trace metals, stable isotope ratios, and trophic relations in seabirds from the North Pacific Ocean
Authors: Elliott John E.
Published: November 2005

Trace elements including mercury, cadmium, selenium, and stable nitrogen isotope ratios (δ15N) were measured in tissues of Pacific seabirds. Two species of albatross (Diomedea immutabilis, Diomedea nigripes), four species of shearwaters (Puffinus bulleri, Puffinus carneipes, Puffinus griseus, Puffinus tenuirostris), northern fulmar (Fulmarus glacialis), and horned puffin (Fratercula corniculata) were collected opportunistically by an experimental fishery in the North Pacific Ocean. Two species each of petrels (Oceanodroma leucorhoa, Oceanodroma furcata) and auklets (Ptychoramphus aleuticus, Cerorhinca monocerata) were collected at breeding colonies on the north coast of British Columbia, Canada. Concentrations of toxic trace metals varied considerably among the pelagic nonbreeders; highest concentrations consistently were in D. nigripes (e.g., Hg), 70-fold greater than F. corniculata (e.g., Cd), eightfold greater than P. tenuirostris (e.g., Se), and fourfold greater than F. corniculata. Most essential trace elements varied little among species, consistent with physiological regulation. Values for δ15N correlated positively with hepatic Se (r = 0.771, p = 0.025) and negatively with Co (r = 0.817, p = 0.013). Among the four breeding species, there were significant positive associations for δ15N in muscle and hepatic Se (r = 0.822, p = 0.002), Hg (r = 0.744, p = 0.0001), and Cd (r = 0.589, p = 0.003). Differences in time scales integrated by δ15N versus trace metals in tissues probably reduced the apparent associations between trace-metal exposure and diet.
Effect of temperature on toxicity of a natural pyrethrin pesticide to green anole lizards (Anolis carolinensis)
Authors: Talent Larry G.
Published: November 2005

Metabolic rates of reptiles vary with body temperature; therefore, the sensitivity of reptiles to a particular dose level of a pesticide might be expected to vary as well. The purpose of the present study was twofold: To evaluate the effects of temperature on the toxicity to green anole lizards (Anolis carolinensis) of a single concentration of a natural pyrethrin pesticide via percutaneous exposure, and to compare the effects of temperature (20 vs 35°C) on the toxicity of different concentrations of pyrethrins to green anoles. When lizards were exposed to a solution that contained 300 mg/L of pyrethrins, the mortality of lizards maintained at 15 and 20°C was significantly higher (p < 0.01) than the mortality of lizards maintained at 35 and 38°C. In addition, the median lethal concentrations of pyrethrins for lizards maintained at 20 and 35°C were 77.6 and greater than 300 mg/L, respectively. Therefore, temperature clearly influenced the sensitivity of lizards to pyrethrin pesticides.
Biochemical responses of the aquatic higher plant Lemna gibba to a mixture of copper and 1,2-dihydroxyanthraquinone: Synergistic toxicity via reactive oxygen species
Authors: Babu T. Sudhakar , Tripuranthakam Sridevi , Greenberg Bruce M.
Published: November 2005

Metals and polycyclic aromatic hydrocarbons (PAHs) are known to be toxic to plants. Because metals and PAHs often are cocontaminants in the environment, plants can be subjected to damage caused by their combined effects. We recently found that copper and an oxygenated PAH (1,2-dihydroxyanthraquinone [1,2-dhATQ]) synergistically are toxic to plants. This synergistic toxicity was linked indirectly to production of reactive oxygen species (ROS). In this study, plant growth, chlorophyll pigments, protein accumulation, and ROS production were chosen as endpoints to assess the mechanism of toxicity of copper and 1,2-dhATQ to Lemna gibba in more detail. Because copper and PAHs can generate ROS, we assayed for specific antioxidant enzymes: Superoxide dismutase (SOD), glutathione reductase (GR), and ascorbate peroxidase (APX). Copper treatment at a concentration that did not cause growth inhibition resulted in upregulation of Mn SOD, Cu—Zn SOD, and APX. At a level that moderately was toxic to plants, 1,2-dhATQ did not alter significantly the levels of these antioxidant enzymes. However, a synergistically toxic mixture of copper plus 1,2-dhATQ upregulated Cu—Zn SOD, Mn SOD, and GR, although APX activity was downregulated. When plants were treated with the ROS scavenger dimethyl thiourea (DMTU), enhanced toxicity and formation of ROS caused by the mixture both were diminished substantially. However, 1,2-dhATQ toxicity was not affected significantly by DMTU. Based on this study, the toxicity caused by the mixture of copper plus 1,2-dhATQ directly can be connected to elevated levels of ROS.
Gene expression in caged fish as a first-tier indicator of contaminant exposure in streams
Authors: Roberts Aaron P. , Oris James T. , Burton G. Allen , Clements William H.
Published: November 2005

The development of sensitive, biologically based indicators of contaminant exposure (i.e., biomarkers) is an ongoing topic of research. These indicators have been proposed as a first-tier method of identifying contaminant exposure. The primary objective of this research was to implement a biomarker-based method of exposure assessment using caged fish and real-time reverse-transcriptase polymerase chain reaction (rtRT-PCR) measurements of gene expression. Primers were developed for the CYPIA, metallothionein, and vitellogenin genes in rainbow trout (Oncorhynchyus mykiss), cutbow trout (Oncorhynchyus clarkii × mykiss), and Atlantic salmon (Salmo salar). Each of these genes has been shown to respond specifically to planar aromatic compounds, heavy metals, and environmental estrogens, respectively. Juvenile fish were placed in cages and exposed in situ at reference and contaminated sites on the Cache la Poudre River (CO, USA), the Arkansas River (CO, USA), the St. John River (NB, Canada), and two urban creeks near Dayton (OH, USA). Quantitative gene expression was determined using rtRT-PCR. Biomarker expression profiles were obtained that demonstrated differences in CYP1A, metallothionein, and vitellogenin mRNA production unique to each site, indicating that specific types of compounds were bioavailable and present in sufficient concentrations to elicit transcriptional responses in the organism. These findings support the use of a biomarker-based approach to exposure identification and assessment.
A universal assay for vitellogenin in fish mucus and plasma
Authors: Van Veld Peter A. , Rutan Barbara J. , Sullivan Constance A. , Johnston L. Danielle , Rice Charles D. , Fisher Daniel F. , Yonkos Lance T.
Published: November 2005

Expression of vitellogenin (VTG) in male fish has become a widely used biomarker of exposure to environmental estrogens. Vitellogenin is usually measured in blood by immunoassays that require species-specific antibodies. In this paper, we describe a universal assay that is based on the high—molecular weight and extensive phosphoserine content of all VTGs. Plasma and mucosal proteins from Pimephales promelas and Fundulus heteroclitus and mucosal proteins from Gambusia holbrooki were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, stained with a commercially available fluropore dye (Pro-Q Diamond), and visualized by ultraviolet transillumination. The method allowed sensitive detection of VTG in females and estradiol-treated males in all species tested. Quantitative analysis indicated that the phosphoprotein assay is at least as sensitive as antibody-based methods but is universal, offering the advantage of VTG measurement in multiple species.
The cost effectiveness of occupational health interventions: Preventing occupational back pain
Authors: Lahiri Supriya , Markkanen Pia , Levenstein Charles
Published: November 2005

Background

Occupational back pain exacts a toll on society with concomitant economic losses; it is imperative to evaluate the cost‐effectiveness of interventions to reduce the relevant ergonomic stressors at work. This study estimates and evaluates the average and incremental cost‐effectiveness ratios (CERs) of specific interventions for the prevention of occupationally induced back pain for the World Health Organization (WHO) defined subregions of the world.

Methods

Four back‐pain interventions were selected from the literature: training (T), engineering controls (EC), engineering controls and training (EC&T), and a comprehensive full ergonomics program (EP) for evaluation. A simulation model for a 100‐year time horizon, developed by the WHO CHOICE initiative project was used to estimate the effectiveness of the interventions in healthy year equivalents. The intervention costs were adjusted for all WHO subregions.

Results

In all of the subregions, training was the most cost‐effective with CERs varying from $74 per healthy life years gained in the subregion comprising of Egypt, Iraq, Morocco, Yemen (EMROD) to approximately $567 in the subregion covering Canada and the United States (AMROA). Training is considered to be very cost‐effective and would be the first choice option where resources are scarce. However, the overall effectiveness of training is low. Although other interventions such as engineering controls and total ergonomic interventions are relatively more expensive, the addition to health outcome through these interventions is much higher. The difference in the CERs for training and other engineering controls and full ergonomic interventions is relatively small for most of the industrialized regions of the world. It is clear from the ranked CERs and incremental CERs over the different subregions that in most of the industrialized regions of the world additional resources, if they become available, should go straight to the full ergonomics program.

Conclusions

The model results based on CERs show that worker training is a low cost, feasible first step toward reducing back pain/injury incidence. However, all of the average CERs for the different interventions, for each of the regions, fall well within their GDP per capita estimates [World Bank, 2001]. According to the WHO Commission on Macroeconomics and Health any intervention that costs less than three times GDP per capita for saving a healthy year equivalent should be considered worthwhile and good value for money [WHO, 2002]. Given this criterion, the engineering controls interventions as well as the full ergonomics program look very cost effective for all of the WHO subregions. Am. J. Ind. Med. 48:515–529, 2005. © 2005 Wiley‐Liss, Inc.
The global burden of disease due to occupational carcinogens
Authors: Driscoll Timothy , Nelson Deborah Imel , Steenland Kyle , Leigh James , Concha‐Barrientos Marisol , Fingerhut Marilyn , Prüss‐Üstün Annette
Published: November 2005

Background

The worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures to carcinogens are described. Cases reported in the year 2000 that resulted from relevant past and current exposures are assessed.

Methods

The proportions of workers exposed to the carcinogens of interest, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for lung cancer and leukemia) or absolute risk measures (for malignant mesothelioma) to develop estimates of deaths, disability‐adjusted life years (DALYs) and attributable fraction (for lung cancer and leukemia).

Results

There were an estimated 152,000 deaths (lung cancer: 102,000; leukemia: 7,000; and malignant mesothelioma: 43,000) and nearly 1.6 million DALYS (lung cancer: 969,000; leukemia: 101,000; and malignant mesothelioma: 564,000) due to exposure to occupational carcinogens.

Conclusions

Occupational carcinogens are an important cause of death and disability worldwide. Am. J. Ind. Med. 48:419–431, 2005. © 2005 Wiley‐Liss, Inc.
The global burden of occupational noise‐induced hearing loss
Authors: Nelson Deborah Imel , Nelson Robert Y. , Concha‐Barrientos Marisol , Fingerhut Marilyn
Published: November 2005

Background

Excessive noise is a global occupational health hazard with considerable social and physiological impacts, including noise‐induced hearing loss (NIHL). This paper describes the worldwide morbidity of occupational NIHL in the year 2000.

Methods

The proportion of the population exposed to occupational noise was estimated using noise exposure data from the US National Institute for Occupational Safety and Health (NIOSH), adjusted by data on the distribution of the work force by occupational category and economic sector, and economic activity rates in each WHO subregion. These values for the exposed population and risk measures for NIHL were used to develop estimates of the attributable fraction (AF) of adult‐onset hearing loss resulting from occupational noise exposure. The AFs were applied to WHO estimates of total disability‐adjusted life years (DALYs) from adult‐onset hearing loss to estimate the DALYs due to occupational noise.

Results

Worldwide, 16% of the disabling hearing loss in adults (over 4 million DALYs) is attributed to occupational noise, ranging from 7% to 21% in the various subregions. The effects of the exposure to occupational noise are larger for males than females in all subregions and higher in the developing regions.

Conclusions

Occupational noise is a significant cause of adult‐onset hearing loss. The majority of this NIHL burden can be minimized by the use of engineering controls to reduce the generation of noise at its source. Am. J. Ind. Med. 48:446–458, 2005. © 2005 Wiley‐Liss, Inc.