bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainable Cities Programme: A Joint UN‐HABITAT‐UNEP Facility on the Urban Environment with Participation of the Dutch Government
Authors: GEBRE‐EGZIABHER AXUMITE
Published: July 2004

Abstract: The fundamental objective of the Sustainable Cities Programme is to promote environmentally sustainable local development to more fully realize the vital contributions that urban areas make to over‐all social and economic development by: (1) enhancing efficiency in the use of local environmental resources, reducing environmental risks, and strengthening application of environmental conventions and agreements with growing regard to the Climate Change Protocol; (2) reducing poverty by promoting more equitable access to resources and environmental services; (3) mobilizing and strengthening local capacities to plan, co‐ordinate, and manage sustainable local development in partnership; and (4) combining the complementary strengths of UN‐HABITAT, UNEP, and other partners in support of Agenda 21, and the Habitat Agenda sustainable development commitments including improved local environmental governance.
The Dynamics of Social‐Ecological Systems in Urban Landscapes: Stockholm and the National Urban Park, Sweden
Authors: ELMQVIST T , COLDING J , BARTHEL S , BORGSTRÖM S , DUIT A , LUNDBERG J , ANDERSSON E , AHRNé K , ERNSTSON H , FOLKE C , BENGTSSON J
Published: July 2004

Abstract: This study addresses social‐ecological dynamics in the greater metropolitan area of Stockholm County, Sweden, with special focus on the National Urban Park (NUP). It is part of the Millennium Ecosystem Assessment (MA) and has the following specific objectives: (1) to provide scientific information on biodiversity patterns, ecosystem dynamics, and ecosystem services generated; (2) to map interplay between actors and institutions involved in management of ecosystem services; and (3) to identify strategies for strengthening social‐ecological resilience. The green areas in Stockholm County deliver numerous ecosystem services, for example, air filtration, regulation of microclimate, noise reduction, surface water drainage, recreational and cultural values, nutrient retention, and pollination and seed dispersal. Recreation is among the most important services and NUP, for example, has more than 15 million visitors per year. More than 65 organizations representing 175,000 members are involved in management of ecosystem services. However, because of population increase and urban growth during the last three decades, the region displays a quite dramatic loss of green areas and biodiversity. An important future focus is how management may reduce increasing isolation of urban green areas and enhance connectivity. Comanagement should be considered where locally managed green space may function as buffer zones and for management of weak links that connect larger green areas; for example, there are three such areas around NUP identified. Preliminary results indicate that areas of informal management represent centers on which to base adaptive comanagement, with the potential to strengthen biodiversity management and resilience in the landscape.
The Changing Perception of the Wetlands in and around Kristianstad, Sweden: From Waterlogged Areas toward a Future Water Kingdom, Kristianstads Vattenrike Biosphere Reserve
Authors: MAGNUSSON SVEN‐ERIK
Published: July 2004

Abstract: Kristianstads Vattenrike (The Rich Wetlands of Kristianstad/Water Kingdom) is a 35‐km‐long wetland area surrounded by cultivated landscape in the south of Sweden. The project area covers some more than 100,000 hectares and includes the lower catchment areas of River Helge å and the coastal areas of the bay Hanöbukten, a part of the Baltic Sea. The River Helge å flows from upstream forests through agricultural land, lowland lakes, and wetlands and passes straight through the town of Kristianstad, which is the regional capital. An MAB candidate office is now in the process of completing the application form to become a biosphere reserve according to the UNESCO‐MAB concept, but in the past the wetlands often were seen as waterlogged areas, especially in the 19th century.
Sustainable Energy Planning with Efficient Office Buildings and Cogeneration Plants in Frankfurt am Main
Authors: FRIEDEL WENDELIN , NEUMANN WERNER
Published: July 2004

Abstract: Sustainable development of a city not only is determined through the amount of protected areas, but it is also an important task to integrate sustainable development in urban energy planning. In the last 10 years, many new areas for offices and residential buildings have been developed in Frankfurt am Main. In this context, the municipality has taken over a new role as organizer for the integrated energy planning. This article gives an overview of the achievements.
Regreening the Metropolis: Pathways to More Ecological Cities: Keynote Address
Authors: PLATT RUTHERFORD H.
Published: July 2004

Abstract: Eighty percent of the American population now lives in metropolitan regions whose geographic extent continues to expand even as many core cities and inner‐tier suburbs lose middle‐class populations, jobs, and tax base. Urban sprawl and the socioeconomic polarizing of metropolitan America have been fostered by public policies including (1) federal subsidies for new infrastructure on the urban fringe; (2) tax policies that favor home ownership over rental properties; (3) local zoning codes; and (4) federal and state neglect of older urban neighborhoods. In the face of diminished access to “nature” outside of metropolitan areas, locally based efforts to protect and restore greenspaces within urban areas seek to make older communities more habitable and more “ecological.” Some pathways to more ecological cities include the following: (1) the notion of rus in urbe (“the country in the city”); (2) the “usable outdoors”; (3) garden cities and eco‐villages; (4) green buildings and green roofs; (5) urban biodiversity; (6) ecological services; and (7) space, nature, and place.
Multi-Institutional Trial of Preoperative Chemoradiotherapy in Patients With Potentially Resectable Gastric Carcinoma
Authors: Ajani J.A. , Mansfield P.F. , Janjan N. , Morris J. , Pisters P.W. , Lynch P.M. , Feig B. , Myerson R. , Nivers R. , Cohen D.S. , Gunderson L.L.
Published: July 2004

Purpose

In the West, curative (R0) resection is achieved in approximately 50% of patients with localized gastric carcinoma, and more than 60% die of cancer following an R0 resection. A multi-institutional study of preoperative chemoradiotherapy was done to assess the R0 resection rate, pathologic complete response (pathCR) rate, safety, and survival in patients with resectable gastric carcinoma.

Patients and Methods

Operable patients with localized gastric adenocarcinoma were eligible. Staging also included a laparoscopy and endoscopic ultrasonography (EUS). Patients received up to two 28-day cycles of induction chemotherapy of fluorouracil, leucovorin, and cisplatin, followed by 45 Gy of radiation plus concurrent fluorouracil. Patients were then staged and surgery was attempted.

Results

Thirty-four patients were registered at three institutions. One ineligible patient was excluded. Most patients had a promixal cancer and EUST3N1 designation. Twenty-eight (85%) of 33 patients underwent surgery. The R0 resection rate was 70% and pathCR rate was 30%. A pathologic partial response (< 10% residual carcinoma in the primary) occurred in eight patients (24%). EUS T plus N and postsurgery T plus N correlation showed significant downstaging (P = < .01). The median survival time for 33 patients was 33.7 months. Patients achieving a pathCR or pathPR had a significantly longer median survival time (63.9 months) than those achieving less than pathPR (12.6 months; P = .03). There were two treatment-related deaths.

Conclusion

Our data suggest that the three-step strategy of preoperative induction chemotherapy followed by chemoradiotherapy resulted in substantial pathologic response that resulted in durable survival time. This strategy is worthy of a direct comparison with postoperative adjuvant chemoradiotherapy.
Treatment of Metastatic Ewing's Sarcoma or Primitive Neuroectodermal Tumor of Bone: Evaluation of Combination Ifosfamide and Etoposide—A Children's Cancer Group and Pediatric Oncology Group Study
Authors: Miser James S. , Krailo Mark D. , Tarbell Nancy J. , Link Michael P. , Fryer Christopher J.H. , Pritchard Douglas J. , Gebhardt Mark C. , Dickman Paul S. , Perlman Elizabeth J. , Meyers Paul A. , Donaldson Sarah S. , Moore Sheila , Rausen Aaron R. , Vietti Teresa J. , Grier Holcolmbe E.
Published: July 2004

Purpose

One hundred twenty patients with metastatic Ewing's sarcoma or primitive neuroectodermal tumor (PNET) of bone were entered onto a randomized trial evaluating whether the addition of ifosfamide and etoposide to vincristine, doxorubicin, cyclophosphamide, and dactinomycin improved outcomes.

Methods

Thirty-two patients had metastases to lungs only, 12 patients had metastases to bone marrow or bones only, 64 patients had metastases in multiple sites, and five patients had metastases in other sites; seven patients could not be assessed precisely. Treatment comprised 9 weeks of chemotherapy before local control and 42 weeks of chemotherapy; thereafter, regimen A consisted of vincristine 2 mg/m2, cyclophosphamide 1,200 mg/m2, and either doxorubicin 75 mg/m2 or dactinomycin 1.25 mg/m2. Regimen B consisted of regimen A alternating every 3 weeks with ifosfamide 1,800 mg/m2/d for 5 days and etoposide 100 mg/m2/d for 5 days.

Results

Patients treated on regimen B did not have significantly better survival than those treated on regimen A. The event-free survival (EFS) and survival (S) at 8 years were 20% (SE, 5%) and 32% (SE, 6%), respectively, for those treated on regimen A and 20% (SE, 6%) and 29% (SE, 6%), respectively, for those treated on regimen B. Patients who had only lung metastases had EFS and S of 32% (SE, 8%) and 41% (SE, 9%), respectively, at 8 years. There were six toxic deaths (5%), four from cardiac toxicity and two from sepsis (four treated on regimen B and two treated on regimen A). Two had second malignant neoplasms.

Conclusion

Adding ifosfamide and etoposide to standard therapy does not improve outcomes of patients with Ewing's sarcoma or PNET of bone with metastases at diagnosis.
Autologous Dendritic Cell Vaccines for Non–Small-Cell Lung Cancer
Authors: Hirschowitz Edward A. , Foody Terry , Kryscio Richard , Dickson Larry , Sturgill Jamie , Yannelli John
Published: July 2004

Purpose

Therapeutic outcomes of definitively treated non–small-cell lung cancer (NSCLC) are unacceptably poor. A wealth of preclinical information, and a modest amount of clinical information indicate that dendritic cell (DC) vaccines have therapeutic potential. Only a handful of NSCLC patients have been included in DC clinical trials. We delivered autologous DC vaccines to 16 individuals with stage IA to IIIB NSCLC treated with surgery, chemoradiation, or multimodality therapy. The objectives of the study were to evaluate tolerability and measure immunologic responses to DC vaccines in a heterogeneous group of NSCLC patients.

Methods

DC vaccines were generated from CD14+ precursors, pulsed with apoptotic bodies of an allogeneic NSCLC cell line that overexpressed Her2/neu, CEA, WT1, Mage2, and survivin. DCs were partially matured with a factor that induced surface molecule expression but minimal cytokine production. Individuals were immunized intradermally two times, 1 month apart. Peripheral blood was drawn serially over 16 weeks, and immune responses were measured by interferon-gamma ELISPOT.

Results

There were no unanticipated or serious adverse events. Immunologic responses followed three distinct patterns of reactivity: (1) five of 16 patients showed no clear immunologic response, (2) five of 16 patients showed a tumor-antigen independent response, and (3) six of 16 show an antigen specific response. Immunologic responses were independent of stage and prior therapy. Favorable and unfavorable clinical outcomes were independent of measured immunologic responses.

Conclusion

Vaccines were well tolerated and had biologic activity in a variety of NSCLC patients. Establishing an optimal approach will require comparative studies in well-defined NSCLC patient groups.
Recommended Guidelines for the Treatment of Cancer Treatment-Induced Diarrhea
Authors: Benson Al B. , Ajani Jaffer A. , Catalano Robert B. , Engelking Constance , Kornblau Steven M. , Martenson James A. , McCallum Richard , Mitchell Edith P. , O'Dorisio Thomas M. , Vokes Everett E. , Wadler Scott
Published: July 2004

Purpose

To update and expand on previously published clinical practice guidelines for the treatment of cancer treatment-induced diarrhea.

Methods

An expert multidisciplinary panel was convened to review the recent literature and discuss recommendations for updating the practice guidelines previously published by this group in the Journal of Clinical Oncology in 1998. MEDLINE searches were performed and the relevant literature published since 1998 was reviewed by all panel members. The treatment recommendations and algorithm were revised by panel consensus.

Results

A recent review of early toxic deaths occurring in two National Cancer Institute-sponsored cooperative group trials of irinotecan plus high-dose fluorouracil and leucovorin for advanced colorectal cancer has led to the recognition of a life-threatening gastrointestinal syndrome and highlighted the need for vigilant monitoring and aggressive therapy for this serious complication. Loperamide remains the standard therapy for uncomplicated cases. However, the revised guidelines reflect the need for recognition of the early warning signs of complicated cases of diarrhea and the need for early and aggressive management, including the addition of antibiotics. Management of radiation-induced diarrhea is similar but may not require hospitalization, and chronic low- to intermediate-grade symptoms can be managed with continued loperamide.

Conclusion

With vigilant monitoring and aggressive therapy for cancer treatment-induced diarrhea, particularly in patients with early warning signs of severe complications, morbidity and mortality may be reduced.
Bone Imaging in Metastatic Breast Cancer
Authors: Hamaoka Tsuyoshi , Madewell John E. , Podoloff Donald A. , Hortobagyi Gabriel N. , Ueno Naoto T.
Published: July 2004

Bone is the most common site to which breast cancer metastasizes. Imaging—by skeletal scintigraphy, plain radiography, computed tomography, or magnetic resonance imaging—is an essential part, and positron emission tomography or single-photon emission computed tomography have a potential of evaluating bone metastases, but no consensus exists as to the best modality for diagnosing the lesion and for assessing its response to treatment. Imaging bone metastases is problematic because the lesions can be osteolytic, osteoblastic, or mixed, and imaging modalities are based on either direct anatomic visualization of the bone or tumor or indirect measurements of bone or tumor metabolism. Although bone metastases can be treated, their response to treatment is considered “unmeasurable” according to existing response criteria. Therefore, the process by which oncologists and radiologists diagnose and monitor the response of bone metastases needs revision, and the current inability to assess the response of bone metastases excludes patients with breast cancer and bone disease from participating in clinical trials of new treatments for breast cancer. In this review of the MEDLINE literature, we discuss the pros and cons of each modality for diagnosing bone metastases and for assessing their response to treatment and we present a practical approach for diagnosis and assessment of bone metastasis.
Treatment of Relapsed Wilms’ Tumor With High-Dose Therapy and Autologous Hematopoietic Stem-Cell Rescue: The Experience at Children’s Memorial Hospital
Authors: Campbell Andrew D. , Cohn Susan L. , Reynolds Marleta , Seshadri Roopa , Morgan Elaine , Geissler Grant , Rademaker Alfred , Marymount Maryann , Kalapurakal John , Haut Paul R. , Duerst Reggie , Kletzel Morris
Published: July 2004

Purpose

To investigate whether high-dose therapy with hematopoietic stem-cell rescue (HSCR) will improve survival for patients with relapsed Wilms’ tumor.

Patients and Methods

Thirteen children with relapsed Wilms’ tumor were treated with one or two cycles of high-dose chemotherapy (HDT) followed by autologous HSCR. Twelve of 13 patients received reinduction chemotherapy before HDT and HSCR. The median age at diagnosis was 4.8 years, and the median time to relapse was 12 months. The histology was favorable in 12 of 13 patients. The ablative regimens included: (1) thiotepa (TT)/cyclophosphamide (CTX)/carboplatin (CP; n = 2); (2) TT/CTX (n = 5); (3) TT/etoposide (ETP; n = 1); and (4) CP/ETP/CTX (n = 1). Four patients received two cycles of HDT and HSCR. Cycle 1 consisted of CP/ETP/CTX, and melphalan/CTX were used in cycle 2.

Results

Seven of 13 patients are alive without evidence of disease, with a median follow-up of 30 months. The 4-year estimated event-free survival (EFS) rate is 60% (95% CI, 0.40 to 6.88), and the overall survival (OS) at 4 years is 73% (95% CI, 0.40 to 6.86). There was no transplant-related mortality. All patients engrafted to an absolute neutrophil count 500/μL at a median of 13 days (range, 8 to 62 days) and had an unsustained platelet count > 20.0μ at a median of 16 days (range, 10 to 202 days).

Conclusion

Our results suggest that HDT with HSCR is an effective treatment for patients with Wilms’ tumor who experience relapse.
Comparison of Pharmacokinetics and Pharmacodynamics of Docetaxel and Cisplatin in Elderly and Non-Elderly Patients: Why Is Toxicity Increased in Elderly Patients?
Authors: Minami Hironobu , Ohe Yuichi , Niho Seiji , Goto Koichi , Ohmatsu Hironobu , Kubota Kaoru , Kakinuma Ryutaro , Nishiwaki Yutaka , Nokihara Hiroshi , Sekine Ikuo , Saijo Nagahiro , Hanada Kazuhiko , Ogata Hiroyasu
Published: July 2004

Purpose

Following phase I studies of docetaxel and cisplatin in patients with non–small-cell lung cancer, the recommended doses of docetaxel were different for elderly (≥ 75 years) and non-elderly (< 75 years) patients. To elucidate the mechanism of the difference, the pharmacokinetics of docetaxel and cisplatin were investigated in two phase II studies separately conducted in elderly and non-elderly patients.

Patients and Methods

Twenty-seven elderly and 25 non-elderly patients were treated with three weekly administrations of docetaxel and cisplatin every 4 weeks. Doses of docetaxel were 20 and 35 mg/m2 for elderly and non-elderly patients, respectively. All patients received 25 mg/m2 of cisplatin. The pharmacokinetics and pharmacodynamics of docetaxel and cisplatin were compared in elderly and non-elderly patients.

Results

There were no differences in pharmacokinetics of docetaxel or cisplatin between elderly versus non-elderly patients with regard to clearance and volume of distribution. In the pharmacodynamic analysis, neutropenia was positively correlated with the area under the concentration-time curve for docetaxel but not for cisplatin. In evaluating the relationship between neutropenia and the area under the concentration-time curve of docetaxel, elderly patients experienced greater neutropenia than those predicted by a pharmacodynamic model developed in non-elderly patients; the residual for prediction of the percent change in neutrophil count was −11.2% (95% CI, −21.8 to −0.5%).

Conclusion

The pharmacokinetics of docetaxel and unchanged cisplatin were not different between elderly and non-elderly patients. The elderly patients were more sensitive to docetaxel exposure than the non-elderly patients, resulting in the different recommended doses for the phase II studies.
Allogeneic Vaccination With a B7.1 HLA-A Gene-Modified Adenocarcinoma Cell Line in Patients With Advanced Non–Small-Cell Lung Cancer
Authors: Raez Luis E. , Cassileth Peter A. , Schlesselman James J. , Sridhar Kasi , Padmanabhan Swaminathan , Fisher Eva Z. , Baldie Paulette A. , Podack Eckhard R.
Published: July 2004

Purpose

To determine the safety, immunogenicity, and clinical response to an allogeneic tumor vaccine for non–small-cell lung cancer, we conducted a phase I trial in patients with advanced metastatic disease.

Patients and Methods

We treated 19 patients with a vaccine based on an adenocarcinoma line (AD100) transfected with B7.1 (CD80) and HLA A1 or A2. Patients were vaccinated intradermally with 5 × 107 cells once every 2 weeks. Three vaccinations represented one course of treatment. If patients had complete response, partial response, or stable disease, they continued with the vaccinations for up to three courses (nine vaccinations). Immune response was assessed by a change between pre-study and postvaccination enzyme-linked immunospot frequency of purified CD8 T-cells secreting interferon-gamma in response to in vitro challenge with AD100.

Results

Four patients experienced serious adverse events that were unrelated to vaccine. Another four patients experienced only minimal skin erythema. All but one patient had a measurable CD8 response after three immunizations. The immune response of six surviving, clinically responding patients shows that CD8 titers continue to be elevated up to 150 weeks, even after cessation of vaccination. Overall, one patient had a partial response, and five had stable disease. Median survival for all patients is 18 months (90% CI, 7 to 23 months), with corresponding estimates of 1-year, 2-year, and 3-year survival of 52%, 30%, and 30%, respectively. HLA matching of vaccine, age, sex, race, and pathology did not bear a significant relation to response.

Conclusion

Minimal toxicity and good survival in this small population suggest clinical benefit from vaccination.
Preliminary Results of Radiation Therapy Oncology Group 97-03: A Randomized Phase II Trial of Concurrent Radiation and Chemotherapy for Advanced Squamous Cell Carcinomas of the Head and Neck
Authors: Garden A.S. , Harris J. , Vokes E.E. , Forastiere A.A. , Ridge J.A. , Jones C. , Horwitz E.M. , Glisson B.S. , Nabell L. , Cooper J.S. , Demas W. , Gore E.
Published: July 2004

Purpose

To define further the role of concurrent chemoradiotherapy for patients with advanced squamous carcinoma of the head and neck.

Patients and Methods

The Radiation Therapy Oncology Group developed this three-arm randomized phase II trial. Patients with stage III or IV squamous carcinoma of the oral cavity, oropharynx, or hypopharynx were eligible. Each of three arms proposed a radiation schedule of 70 Gy in 35 fractions. Patients on arm 1 were to receive cisplatin 10 mg/m2 daily and fluorouracil (FU) 400 mg/m2 continuous infusion (CI) daily for the final 10 days of treatment. Treatment on arm 2 consisted of hydroxyurea 1 g every 12 hours and FU 800 mg/m2/d CI delivered with each fraction of radiation. Arm 3 patients were to receive weekly paclitaxel 30 mg/m2 and cisplatin 20 mg/m2. Patients randomly assigned to arms 1 and 3 were to receive their treatments every week; patients on arm 2 were to receive their therapy every other week.

Results

Between 1997 and 1999, 241 patients were entered onto study; 231 were analyzable. Ninety-two percent, 79%, and 83% of patients on arms 1, 2, and 3, respectively, were able to complete their radiation as planned or with an acceptable variation. Fewer than 10% of patients had unacceptable deviations or incomplete chemotherapy in the three arms. Estimated 2-year disease-free and overall survival rates were 38.2% and 57.4% for arm 1, 48.6% and 69.4% for arm 2, and 51.3% and 66.6% for arm 3.

Conclusion

We have demonstrated that three different approaches of concurrent multiagent chemotherapy and radiation were feasible and could be delivered to patients in a multi-institutional setting with high compliance rates.
Prognostic Factors in Patients With Aggressive Non-Hodgkin's Lymphoma Treated by Front-Line Autotransplantation After Complete Remission: A Cohort Study by the Groupe d'Etude des Lymphomes de l'Adulte
Authors: Mounier N. , Gisselbrecht C. , Brière J. , Haioun C. , Feugier P. , Offner F. , Recher C. , Stamatoullas A. , Morschhauser F. , Macro M. , Thieblemont C. , Sonet A. , Fabiani B. , Reyes F.
Published: July 2004

Purpose

Improved survival has been observed in aggressive non-Hodgkin's lymphoma (NHL) patients with adverse prognostic factors when autotransplantation (ASCT) was performed after complete remission. However, there is no agreement on the prognostic factors for patients treated with ASCT. We aimed to estimate the prognostic effect of clinical and biologic variables on relapse and survival rates by pooling the data from two trials.

Patients and Methods

Of the patients treated in the LNH87 and LNH93 trials, 330 under age 60 years achieved complete remission after high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone, and received consolidative ASCT; 16% of patients had T-cell NHL. The International Prognostic Index (IPI) score was 0 for 11%, 1 for 23%, 2 for 51%, and 3 for 15%. Univariate and Cox multivariate survival analyses were retrospectively performed on this population.

Results

Overall survival was 75 ± 5% at 5 years and disease-free survival (DFS) 67 ± 5%. For T-cell NHL, these scores were 54% and 44%, respectively. The IPI score had no prognostic value and only the following parameters adversely affected overall survival and DFS (P < .05): marrow involvement; more than one extranodal site; histology (nonanaplastic T-cell v others); and type of anthracycline (mitoxantrone v doxorubicin, for DFS only).

Conclusion

These results suggest that ASCT can prevent relapse in patients with adverse IPI factors. However, patients presenting with a nonanaplastic T-cell phenotype, more than one extranodal site, or marrow involvement still have a higher risk of relapse. These factors should be taken into account when designing post-ASCT maintenance studies.
Pedagogical Aids: Learning Enhancers or Dangerous Detours?
Authors: Gurung Regan A. R.
Published: July 2004

I tested whether students' scores on the semester's first exam would change their reported use of textbook pedagogical aids during the course of the semester. I assessed 240 introductory psychology undergraduates early and late in the semester. The reported use of aids did not positively relate to student performance on any exams and showed only limited changes over the course of the semester. Poor scores on the first exam led only to small increases in the use of summary sections. Furthermore, the use of aids such as boldface terms decreased. Men and more able students used aids less, and women showed greater decreases in the perceived helpfulness of some aids over the semester.
Ethical Dilemmas Associated with Self-Disclosure in Student Writing
Authors: Haney Michelle R.
Published: July 2004

Personal and reflective writing assignments in psychology courses may prompt self-disclosure that presents ethical dilemmas. The literature discusses responsibilities of the psychologist in instances such as disclosure of suicidal ideation or threats of harming others within the context of the therapist–client relationship, but significantly less so within the professor–student relationship. I review relevant models of ethical decision making, ethics codes, case law, and related research and propose an ethical decision making guideline for addressing student self-disclosure. I offer additional suggestions for ethical decision making, based on the current American Psychological Association Code of Ethics (2002), and for future research endeavors in this area.
What is Postmodernism and How is it Relevant to Engaged Pedagogy?
Authors: Cosgrove Lisa
Published: July 2004

This article identifies some of the advantages of using a postmodern approach in the psychology classroom. A postmodern pedagogical stance has special relevance for faculty who teach abnormal psychology insofar as postmodernism encourages reflexivity and increases students' awareness of social justice issues. I provide specific ideas for classroom activities and assignments that enhance students' critical thinking skills and their engagement in the learning process. In addition to abnormal psychology, these suggestions and activities are appropriate for use in courses such as introductory psychology, personality theory, ethics, and cross-cultural psychology.
Employing Computer-Administered Exams in General Psychology: Student Anxiety and Expectations
Authors: Schult Carolyn A. , McIntosh John L.
Published: July 2004

Computer-administered exams offer many advantages, but instructors may be reluctant to use them due to concerns that computer anxiety may increase student test anxiety. Introductory psychology students (N = 265) completed surveys prior to their first exam about their anxiety related to the upcoming exam, computers in general, and taking exams on the computer. One group of students took traditional paper-and-pencil exams and the other group took computer-administered exams. We found no differences between the groups for exam anxiety or general computer anxiety, but the traditional group reported more anxiety about taking an exam on computer. We recommend strategies for relieving students' anxiety, such as in-class demonstrations of the technology.
Modulation of acto-myosin contractility in skeletal muscle myoblasts uncouples growth arrest from differentiation
Authors: Dhawan Jyotsna , Helfman David M.
Published: July 2004

Cell-substratum interactions trigger key signaling pathways that modulate growth control and tissue-specific gene expression. We have previously shown that abolishing adhesive interactions by suspension culture results in G0 arrest of myoblasts. We report that blocking intracellular transmission of adhesion-dependent signals in adherent cells mimics the absence of adhesive contacts. We investigated the effects of pharmacological inhibitors of acto-myosin contractility on growth and differentiation of C2C12 myogenic cells. ML7 (5-iodonaphthalene-1-sulfonyl homopiperazine) and BDM (2,3, butanedione monoxime) are specific inhibitors of myosin light chain kinase, and myosin heavy chain ATPase, respectively. ML7 and BDM affected cell shape by reducing focal adhesions and stress fibers. Both inhibitors rapidly blocked DNA synthesis in a dose-dependent, reversible fashion. Furthermore, both ML7 and BDM suppressed expression of MyoD and myogenin, induced p27kip1 but not p21cip1, and inhibited differentiation. Thus, as with suspension-arrest, inhibition of acto-myosin contractility in adherent cells led to arrest uncoupled from differentiation. Over-expression of inhibitors of the small GTPase RhoA (dominant negative RhoA and C3 transferase) mimicked the effects of myosin inhibitors. By contrast, wild-type RhoA induced arrest, maintained MyoD and activated myogenin and p21 expression. The Rho effector kinase ROCK did not appear to mediate Rho's effects on MyoD. Thus, ROCK and MLCK play different roles in the myogenic program. Signals regulated by MLCK are critical, since inhibition of MLCK suppressed MyoD expression but inhibition of ROCK did not. Inhibition of contractility suppressed MyoD but did not reduce actin polymer levels. However, actin depolymerization with latrunculin B inhibited MyoD expression. Taken together, our observations indicate that actin polymer status and contractility regulate MyoD expression. We suggest that in myoblasts, the Rho pathway and regulation of acto-myosin contractility may define a control point for conditional uncoupling of differentiation and the cell cycle.
Glycine, GABA and their transporters in pancreatic islets of Langerhans: evidence for a paracrine transmitter interplay
Authors: Gammelsaeter Runhild , Frøyland Marianne , Aragón Carmen , Danbolt Niels Christian , Fortin Doris , Storm-Mathisen Jon , Davanger Svend , Gundersen Vidar
Published: July 2004

To elucidate the possible roles of the CNS neurotransmitters glycine and GABA in neuroendocrine paracrine signalling, we investigated their localizations, and those of their transport proteins, by confocal immunofluorescence and quantitative post-embedding immuno-electron microscopy in the pancreatic islets of Langerhans. We show that A-cells contain glycine in synaptic-like microvesicles as well as in secretory granules. A-cells express the macromolecules necessary to: (1) concentrate glycine within both organelle types before release (the vesicular GABA/glycine transporter VGAT=VIAAT); and to (2) take up the transmitter from the extracellular space (the plasma membrane glycine transporter GLYT2). Also B-cells have glycine in their microvesicles and granules, but the microvesicle/cytosol ratio is lower than in A-cells, consistent with the presence of GABA (which competes with glycine for vesicular uptake) in the cytosol at a much higher concentration in B-cells than in A-cells. Both A- and B-cells contain GABA in their microvesicles and secretory granules, and the membranes of the two organelle types contain VGAT in both cell types. A-cells as well as B-cells express a plasma membrane transporter GAT3 that mediates uptake of GABA. The localization of VGAT in the cores of A-cell secretory granules, and in the secretory granule membranes in both cell types, indicates novel aspects of the mechanisms for release of glycine and GABA. The discovery that both A- and B-cells possess the molecular machinery for the evoked release of both glycine and GABA from synaptic-like microvesicles suggests that both of the principal inhibitory transmitters in the brain participate in paracrine signalling in the pancreas.
cAMP-induced degradation of cyclin D3 through association with GSK-3β
Authors: Naderi Soheil , Gutzkow Kristine B. , Låhne Hege U. , Lefdal Siri , Ryves W. Johnathan , Harwood Adrian J. , Blomhoff Heidi K.
Published: July 2004

In this study we report a new mechanism whereby cyclic AMP (cAMP) regulates the cell-cycle machinery. We demonstrate that elevation of intracellular levels of cAMP promotes degradation of cyclin D3 in proteasomes, and that this occurs via glycogen synthase kinase-3β (GSK-3β)-mediated phosphorylation of cyclin D3 at Thr-283. Elevation of cAMP did not change the subcellular distribution of either cyclin D3 or GSK-3β. However, cAMP promoted the interaction between cyclin D3 and GSK-3β both in vitro and in vivo, indicating that GSK-3β-mediated phosphorylation of cyclin D3 might require the association between the two proteins. These results demonstrate how cAMP enhances degradation of cyclin D3. Furthermore, we provide evidence for a novel mechanism by which GSK-3β might phosphorylate unprimed substrates in vivo.
Visualization of unconstrained negative supercoils of DNA on polytene chromosomes ofDrosophila
Authors: Matsumoto Kuniharu , Hirose Susumu
Published: July 2004

Bulk DNA within the eukaryotic genome is torsionarily relaxed. However, unconstrained negative supercoils of DNA have been detected in few local domains of the genome through preferential binding of psoralen. To make a genome-wide survey for such domains, we introduced biotinylated psoralen into Drosophila salivary glands and visualized it on polytene chromosomes with fluorescent streptavidin. We observed bright psoralen signals on many transcriptionally active interbands and puffs. Upon heat shock, the signals appeared on heat-shock puffs. The signals were resistant to RNase treatment but disappeared or became faint by previous nicking of DNA or inhibition of transcription with α-amanitin. These data show that transcription-coupled, unconstrained negative supercoils of DNA exist in approximately 150 loci within the interphase genome.
Shiga toxin binding to globotriaosyl ceramide induces intracellular signals that mediate cytoskeleton remodeling in human renal carcinoma-derived cells
Authors: Takenouchi Hisami , Kiyokawa Nobutaka , Taguchi Tomoko , Matsui Jun , Katagiri Yohko U. , Okita Hajime , Okuda Kenji , Fujimoto Junichiro
Published: July 2004

Shiga toxin is a bacterial toxin consisting of A and B subunits. Generally, the essential cytotoxicity of the toxin is thought to be mediated by the A subunit, which possesses RNA cleavage activity and thus induces protein synthesis inhibition. We previously reported, however, that the binding of the Shiga toxin 1-B subunit to globotriaosyl ceramide, a functional receptor for Shiga toxin, induces intracellular signals in a manner that is dependent on glycolipid-enriched membrane domains, or lipid rafts. Although the precise role of this signaling mechanism is not known, here we report that Shiga-toxin-mediated intracellular signals induce cytoskeleton remodeling in ACHN cells derived from renal tubular epithelial carcinoma. Using confocal laser scanning microscopy, we observed that Shiga toxin 1-B treatment induces morphological changes in ACHN cells in a time-dependent manner. In addition, the morphological changes were accompanied by the redistribution of a number of proteins, including actin, ezrin, CD44, vimentin, cytokeratin, paxillin, FAK, and α- and γ-tubulins, all of which are involved in cytoskeletal organization. The transient phosphorylation of ezrin and paxillin was also observed during the course of protein redistribution. Experiments using inhibitors for a variety of kinases suggested the involvement of lipid rafts, Src family protein kinase, PI 3-kinase, and RHO-associated kinase in Shiga toxin 1-B-induced ezrin phosphorylation. Shiga toxin 1-B-induced cytoskeletal remodeling should provide an in vitro model that can be used to increase our understanding of the pathogenesis of Shiga-toxin-mediated cell injury and the role of lipid-raft-mediated cell signaling in cytoskeletal remodeling.
Integrin α3β1 directs the stabilization of a polarized lamellipodium in epithelial cells through activation of Rac1
Authors: Choma David P. , Pumiglia Kevin , DiPersio C. Michael
Published: July 2004

Epithelial cell migration is a crucial event in wound healing, yet little is known about mechanisms whereby integrins regulate epithelial cell polarization and migration. In the present work, we demonstrate the importance of adhesion through the α3β1 integrin in promoting the stabilization of leading lamellipodia in migrating keratinocytes. We demonstrate that this integrin is found at the leading edge of migrating keratinocytes and that inhibition of α3β1 binding to laminin-5 prevents the formation of stable leading lamellipodia. Consistent with this observation, keratinocytes derived from α3β1-deficient mice fail to form stable leading lamellipodia but retain the ability to form actin-containing protrusions that rapidly extend and retract from the cell membrane. Formation of a leading lamellipodium also requires α3β1-dependent activation of Rac1, because α3β1-deficient keratinocytes show decreased activation of Rac1 compared with α3β1-expressing cells, and formation of stable leading lamellipodia can be inhibited in the latter cells by expression of the dominant negative Rac1 mutant Rac1N17. Furthermore, α3β1-deficient keratinocytes expressing constitutively active Rac1L61 failed to form stable lamellipodia when plated onto laminin-5, demonstrating that α3β1 is required for Rac1-mediated formation of a stable lamellipodium. These observations identify a crucial role for integrin-mediated adhesion and signaling in the formation of large, polarized, stable lamellipodia by migrating epithelial cells. To our knowledge, this study is the first to demonstrate that signal transduction through a specific integrin is required to direct the development of a lamellipodium from an initial protrusion and promote persistent epithelial cell migration.
New Method for Preparing Monodispersed Nanocrystalline Silicalite via Hydrothermal Synthesis in Water/Surfactant/Oil Solution
Authors: Tago Teruoki , Nishi Mieko , Kouno Yousuke , Masuda Takao
Published: July 2004

Monodispersed silicalite nanocrystals with a diameter of 80–150 nm were successfully prepared in water–surfactant–oil solution. It was found that the ionicity of the surfactants used in preparation affected the crystallinity and structure of the silicalite, and that silicalite nanocrystals could be obtained when using a nonionic surfactant. Furthermore, silicalite nanocrystals with a diameter of approximately 80 nm could be obtained in even a high concentration region of Si source.
Time-selective Hydrothermal Synthesis of SnS Nanorods and Nanoparticles by Thiourea Hydrolysis
Authors: Rao M Mohan , Jayalakshmi M , Reddy R Sudarshan
Published: July 2004

SnS nanorods and nanoparticles were synthesized by thiourea hydrolysis in an autoclave at 180 °C within a time window of 2 and 8 h, respectively. In the absence of added structure-directing agent, the nanorods formation was attributed to templating characteristic of ammonium ion produced in situ during hydrolysis.
A p-tert-Butyldithiacalix[4]arene-Copper(II) Complex Having Double-cone Shape of Unique Heteroditopic Inclusion Behavior
Authors: Kon Noriyoshi , Iki Nobuhiko , Kajiwara Takashi , Ito Tasuku , Miyano Sotaro
Published: July 2004

X-ray diffraction revealed a single crystal of a Cu(II) complex of p-tert-butyldithiacalix[4]arene 5 (H4L) to be [Cu3(HL)(H2L)(AcO)], in which three Cu(II) ions are sandwiched by two calixarene ligands including different guest molecules, CHCl3 and hexane, in each cone-shaped cavity.
Amplified Electrochemical Detection Based on Redox Cycle at a Liquid/Liquid Interface Formed in a Microchannel
Authors: Torimura Masaki , Ichieda Nobuyuki , Ito Takeshi , Ohya Seishiro , Tao Hiroaki
Published: July 2004

An electrochemical detector chip with a Y-shaped microchannel was fabricated, and an amplification of the detection current based on the redox cycle at the liquid/liquid interface formed in the microchannel was demonstrated. The dependence of the amplification factor on the flow rate of the solutions was studied.
Interdisciplinarity in health services research: dreams and nightmares, maladies and remedies
Authors: Giacomini Mita
Published: July 2004

Interdisciplinarity has become popular in health services research. Advocates suggest that interdisciplinary approaches may produce more accessible, applicable, exciting and realistic knowledge than traditional disciplinary approaches. To date, there has been surprisingly little analysis of the institutional and intellectual demands of interdisciplinarity as a methodology or practice. This paper (1) identifies some basic intellectual and institutional features of interdisciplinary research, (2) describes typical interdisciplinary 'dreams' and corresponding 'nightmares' that researchers might encounter in practice, (3) highlights maladies of interdisciplinary research careers and suggests practical remedies, and (4) discusses implications for health research policy. Individual researchers can avoid pitfalls of interdisciplinarity through strategies that include selective collaboration, cross-training, sustained relationships, good humour, participation in peer review, declaring the place of one's work, and balancing dissemination of research between peer and other audiences. Interdisciplinary activities span institutional boundaries and make novel demands on academic resources and allegiances. Research organizations can improve their hospitality to interdisciplinary work by encouraging straightforward communication, recognising interdisciplinary productivity, making allowances for the higher time and energy costs of interdisciplinary liaisons, and providing the necessary institutional support and stability to cultivate projects to fruition. Alongside the creation of large new interdisciplinary networks and organizations, we should invest in the highly valuable contributions of small and enduring interdisciplinary teams, modest interdisciplinary stretches and evolving interdisciplinary creatures.
In the absence of evidence, who chooses? A qualitative study of patients' needs after treatment for colorectal cancer
Authors: Rozmovits Linda , Rose Peter , Ziebland Sue
Published: July 2004

Objectives: To identify the range of patient pathways following surgery for colorectal cancer and explore patients' needs and preferences for follow-up.

Methods: A survey of hospitals within the UK Colorectal Cancer Services Collaborative and qualitative thematic analysis of 39 in-depth narrative interviews with colorectal cancer patients. Participants volunteered or were contacted through hospital consultants, support groups and general practitioners (GPs). Most of the interviews were collected in respondents' homes, throughout the UK.

Results: Thirty-five (70%) hospitals supplied details of their follow-up regime. There was a wide variation: only three hospitals specifically stated that patients were given a choice about the type of follow-up. The patients' interviews highlighted their need for a responsive GP and realistic information about recovery, resources and diet. Choice is particularly important because patients differ in their views of the benefits of hospital follow-up.

Conclusions: The absence of evidence about what constitutes ideal clinical follow-up for colorectal cancer is reflected in current hospital practice. In such circumstances, the preferences of individual patients are particularly important. Not all patients want repeated specialist investigations but those without stomas, and therefore no access to a stoma nurse, need another source of advice about recovery and long-term practical help. Follow-up care organised by GPs may be acceptable to many patients. We suggest a list of topics for GPs to discuss with their patients about follow-up. The needs described by patients are not extensive and could often be met by existing resources.
Issues arising from the use of qualitative methods in health economics
Authors: Coast Joanna , McDonald Ruth , Baker Rachel
Published: July 2004

As health economists begin to embrace qualitative methodology they inevitably face a number of issues. This paper explores these, distinguishing between those associated with the conflict between quantitative and qualitative methodologies (that has already been faced in a number of other research areas) and those associated with the potential for challenges to the discipline of mainstream economics. The former include both the acceptability of the methods (because of issues such as generalisability and reflexivity) and the acceptability of presentation. The latter appear to be essentially concerned with identity within economics. The paper concludes by noting the positive aspects of conducting qualitative research in health economics: the interesting and motivating nature of the research and, particularly, the possibilities for increasing the relevance associated with economic theory in the context of health and health services.