bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpreting Trial Results in Light of Conflicting Evidence: A Bayesian Analysis of Adjuvant Chemotherapy for Non–Small-Cell Lung Cancer
Authors: Miksad Rebecca A. , Gönen Mithat , Lynch Thomas J. , Roberts Thomas G. 
Published: March 2009

PurposeWhen successive randomized trials contradict prior evidence, clinicians may be unsure how to evaluate them: Does accumulating evidence warrant changing practice? An increasingly popular solution, Bayesian statistics quantitatively evaluate new results in context. This study provides a clinically relevant example of Bayesian methods.MethodsThree recent non–small-cell lung cancer adjuvant chemotherapy trials were evaluated in light of prior conflicting data. Results were used from International Adjuvant Lung Trial (IALT), JBR.10, and Adjuvant Navelbine International Trialist Association (ANITA). Prior evidence was sequentially updated to calculate the probability of each survival benefit level (overall and by stage) and variance. Sensitivity analysis was performed using expert opinion and uninformed estimates of survival benefit prior probability.ResultsThe probability of a 4% survival benefit increased from 33% before IALT to 64% after IALT. After sequential updating with JBR.10 and ANITA, this probability was 82% (hazard ratio = 0.84; 95% CI, 0.77 to 0.91). IALT produced the largest decrease in variance (61%) and decreased the chance of survival decrement to 0%. Sensitivity analysis did not support a survival benefit after IALT. However, sequential updating substantiated a 4% survival benefit and, for stage II and III, more than 90% probability of a 6% benefit and 50% probability of a 12% benefit.ConclusionWhen evaluated in context with prior data, IALT did not support a 4% survival benefit. However, sequential updating with JBR.10 and ANITA did. A model for future assessments, this study demonstrates the unique ability of Bayesian analysis to evaluate results that contradict prior evidence.
Impact of the Duration of Adjuvant Hormonal Therapy in Patients With Locally Advanced Prostate Cancer Treated With Radiotherapy: A Secondary Analysis of RTOG 85-31
Authors: Souhami Luis , Bae Kyounghwa , Pilepich Miljenko , Sandler Howard 
Published: March 2009

PurposeRadiation Therapy Oncology Group 85-31 was a randomized trial of androgen suppression for life for patients with locally advanced prostate cancer. However, not all patients continued on the protocol-mandated long-term hormonal therapy despite no evidence of recurrence. We correlated duration of adjuvant hormonal therapy and outcomes among patients who prematurely discontinued hormonal therapy.Patients and MethodsThe protocol mandated pelvic radiotherapy followed by goserelin given indefinitely or until disease progression. There were 189 analyzable patients. Patients were divided in groups based on the tertile of hormonal therapy duration (HTD) as follows: ≤ 1 year, more than 1 year and ≤ 5 years, and more than 5 years. Overall survival (OS), disease-free survival (DFS), cause-specific mortality, local failure (LF), and distant metastasis (DM) were studied. Kaplan-Meier estimation and Cox proportional hazards regression model were used for OS and DFS, and Fine and Gray's regression model was used for the other outcomes.ResultsThe median follow-up for surviving patients is 9.6 years. The median duration of adjuvant hormonal therapy was 2.2 years. The HTD more than 5 years group is significantly associated with an improved survival and DFS and fewer DMs than other HTD groups. After adjustment for age, radical prostatectomy, nodal status, Gleason score, and stage variables, the HTD more than 5 years group remains significantly associated with better OS and DFS than other HTD groups.ConclusionIn this hypothesis-generating analysis, prolonged HTD of more than 5 years seems significantly associated with improvements in most outcomes. Given these data, decreasing HTD to ≤ 5 years may have a detrimental effect on patients with locally advanced prostate cancer. Only a randomized trial will conclusively clarify this issue.
Treatment Quality and Outcomes of African American Versus White Breast Cancer Patients: Retrospective Analysis of Southwest Oncology Studies S8814/S8897
Authors: Hershman Dawn L. , Unger Joseph M. , Barlow William E. , Hutchins Laura F. , Martino Silvana , Osborne C. Kent , Livingston Robert B. , Albain Kathy S. 
Published: March 2009

PurposeWomen of African ancestry (AA) have lower WBC counts and are more likely to have treatment delays and discontinue adjuvant breast cancer therapy early compared with white women. We assessed the association between race and treatment discontinuation/delay, WBC counts, and survival in women enrolled onto breast cancer clinical trials.Patients and MethodsAA and white women from Southwest Oncology Group adjuvant breast cancer trials (S8814/S8897) were matched by age and protocol. Only the treatment arms in which patients were scheduled to receive six cycles of chemotherapy were analyzed.ResultsA total of 317 pairs of patients (n = 634) were analyzed. At baseline, AA women had higher body-surface area (P < .0001) and lower WBC (P = .0009). AA women were more likely to have tumors that were ≥ 2 cm (P = .01) and hormone receptor negative (P < .0001). AA women, versus white women, were marginally more likely to discontinue treatment early (11% v 7%, respectively; P = .07) or have one or more treatment delays (85% v 79%, respectively; P = .07) and were significantly more likely to experience the combined end point (discontinuation/delay; 87% v 81%, respectively; P = .04). The mean relative dose-intensity (RDI) was similar for both groups (87% in AA women v 86% in white women); however, overall, 43% had an RDI of less than 85%. After adjusting for baseline WBC and prognostic factors in a multivariate model, AA women had worse disease-free survival (hazard ratio [HR] = 1.56; 95% CI, 1.15 to 2.11; P = .005) and overall survival (HR = 1.95; 95% CI, 1.36 to 2.78; P = .0002). The inclusion of RDI and treatment delivery/quality in the regression had little impact on the results.ConclusionOn cooperative group breast cancer trials, AA and white women had similar RDIs, but AA women were more likely to experience early discontinuation or treatment delay. Despite correcting for these factors and known predictors of outcome, AA women still had worse survival.
Suboptimal therapy and clinical management of gonorrhoea in an area with high-level antimicrobial resistance
Authors: Chen P-L , Hsieh Y-H , Lee H-C , Ko N-Y , Lee N-Y , Wu C-J , Chang C-M , Lee C-C , Ko W-C 
Published: March 2009

The choice of antimicrobial agents for the treatment of gonorrhoea is critical in areas where the prevalence of drug resistance is high. This study aimed to evaluate the antibiotic treatment of gonorrhoea in endemic areas. During 1999–2004, all Neisseria gonorrhoeae infections ( n = 90) were evaluated. Patients' medical records and antibiotic treatment regimens were retrospectively reviewed if their isolates were viable ( n = 65). In vitro antimicrobial susceptibility of N. gonorrhoeae isolates was performed. Urethritis (89%) and pelvic inflammatory disease (42%) were the most common presentations among men ( n = 53) and women ( n = 12), respectively. Of 54 patients with uncomplicated N. gonorrhoeae infection, 32 of them received appropriate antibiotics, including cefuroxime ( n = 20), ceftriaxone ( n = 10), ciprofloxacin ( n = 1) and azithromycin ( n = 1) during follow-ups. Among 65 patients, 53.8% were notified to the health authority. Check-ups of other sexually transmitted diseases were carried out in only 46% of patients. Not all isolates were susceptible to penicillin, 96.9% were resistant to tetracycline and 86% were resistant to ciprofloxacin. Ceftriaxone, cefixime, spectinomycin and azithromycin were active in vitro against all isolates. In conclusion, It is crucial to develop treatment guidelines according to regional antimicrobial resistances and educational programmes to improve clinical care for genital gonococcal diseases.
A delayed hypersensitivity reaction to enfuvirtide after rechallenge
Authors: Emerson C R , Post J J , Workman C 
Published: March 2009

Enfuvirtide is beneficial in patients with limited treatment options. We report this case to highlight the possibility of a delayed hypersensitivity reaction as an important potential side-effect of enfuvirtide treatment. A highly antiretroviral treatment-experienced man was commenced on a new regimen containing enfuvirtide. Prophylaxis for Pneumocystis jirovecii pneumonia was started using trimethoprim/sulphamethoxazole (TMP-STX) simultaneously. Ten days later, he developed a maculopapular rash on the chest and abdomen without any systemic features. Both enfuvirtide and TMP-STX were discontinued. Re-introduction of enfuvirtide occurred in a hospital setting. Before re-challenge, haemodynamic observations were stable. The rash re-appeared involving the whole body 5 hours post-dose and was associated with fever (temperature 38.4), nausea and a presyncopal episode. Hypersensitivity to this drug occurred immediately post-dose in phase III trials. Enfuvirtide is a useful drug in those with reduced drug options. The possibility of delayed hypersensitivity has not been reported previously.
The Internet as a diagnostic aid: the patients' perspective
Authors: Schembri G , Schober P 
Published: March 2009

A questionnaire-based cross-sectional study was conducted in order to determine how frequently patients attending a genitourinary (GU) medicine clinic use the Internet to diagnose their own symptoms, and to assess the accuracy of their diagnosis. Out of 223 symptomatic patients attending a GU clinic, 101 (45.3%) looked up their symptoms on the Internet. The age difference between those who looked up their symptoms and those who did not was not statistically significant ( P = 0.77). Twenty (19.8%) out of 101 patients diagnosed their own symptoms, and 14 (13.9%) patients made the correct diagnosis. Ninety-one (90.1%) patients used the Google® search engine as the starting point for their search. Although the Internet plays an important role in providing health information, the variable quality of health information available limits its use as a diagnostic tool by patients.
Interpersonal complementarity in responses to auditory hallucinations in psychosis
Authors: Thomas Neil , McLeod Hamish J. , Brewin Chris R. 
Published: March 2009

Objectives. Models of interpersonal relating have proposed that people are drawn to respond to others according to a principle of complementarity, whereby perceived hostility elicits reciprocal hostility and perceived dominance elicits submission. This study examined interpersonal appraisals and responses to auditory hallucinations, to determine whether this principle predicts how patients respond to hallucinated voices.Design and methods. Thirty‐five participants with schizophrenia or schizoaffective disorder rated their internal ‘relationship’ with their auditory verbal hallucinations using the Structural Analysis of Social Behaviour, in addition to completing measures of voice‐related distress and depression.Results. Participants were able to ascribe almost the full range of interpersonal relating behaviours to their voices reliably, with some notable exceptions for voices' ‘responses’ to being directly addressed. Appraisals of voice hostility very strongly predicted reciprocal hostile responses, but perceptions of voice control were only weakly associated with submission to voices. Perceived voice hostility was also associated with voice‐related distress and perceived voice control was associated with depression.Conclusions. Individual differences in responses to auditory hallucinations appear to reflect normal interpersonal responses to appraisals of voice hostility and affiliation. However, voice hearers do not readily submit to voice control and other factors may be of importance in determining this response.
Elaborating the cry of pain model of suicidality: Testing a psychological model in a sample of first‐time and repeat self‐harm patients
Authors: Rasmussen Susan A. , Fraser Louisa , Gotz Michael , MacHale Siobhan , Mackie Rhona , Masterton George , McConachie Susan , O'Connor Rory C. 
Published: March 2009

Objectives. Few studies have specifically tested the Cry of Pain model (CoP model; Williams, 2001). This model conceptualizes suicidal behaviour as a behavioural response to a stressful situation which has three components: defeat, no escape potential, and no rescue. In addition, the model specifies a mediating role for entrapment on the defeat–suicidal ideation relationship, and a moderating role for rescue factors on the entrapment–suicidal ideation relationship. This is the first study to investigate the utility of this psychological model in a sample of first‐time and repeat self‐harm (SH) patients.Method. One hundred and thirteen patients who had been admitted to hospital following an episode of SH (36 first‐time, 67 repeat) and 37 hospital controls completed measures of defeat, entrapment/escape potential, rescue (social support and positive future thinking), as well as depression, anxiety, and suicidal ideation.Results. Analyses highlighted differences between the three participant groups on all of the CoP variables. Hierarchical regression analysis confirmed that total entrapment and internal entrapment mediated the relationship between defeat and suicidal ideation, whilst impaired ability to think positively about the future (but not social support) moderated the relationship between total and internal entrapment and suicidal ideation.Conclusions. The findings provide further empirical support for the CoP Model. The findings are discussed in relation to theory and practice and we recommend that the findings are replicated within a prospective design.
Association of the IGF1/pregnancy-associated plasma protein-A system and adipocytokine levels with the presence and the morphology of carotid plaques in type 2 diabetes mellitus patients with stable glycaemic control
Authors: Pellitero Silvia , Reverter Jordi L , Granada María Luisa , Pizarro Eduarda , Pastor M Cruz , Tàssies Dolors , Reverter Juan Carlos , Salinas Isabel , Sanmartí Anna 
Published: March 2009

ObjectivePregnancy-associated plasma protein-A (PAPP-A) has been implicated in the atherosclerotic process through regulation of local expression of IGF1. In type 2 diabetes mellitus, glycaemic control has been involved in PAPP-A expression. We compared PAPP-A, IGF1, inflammatory markers and adiponectin concentrations in type 2 diabetic patients with and without carotid plaques and evaluated the relationship between these serum parameters and ultrasound carotid markers of atherosclerosis.MethodsWe studied 125 consecutive type 2 diabetic patients. Clinical data, metabolic variables, hemostatic factors (plasma type-1 plasminogen activator inhibitor, fibrinogen), high-ultrasensitive C reactive protein (hsCRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6, adiponectin, IGF1 and PAPP-A were determined. Patients were classified into two groups according to the presence of carotid plaques on ultrasound. Carotid intima–media thickness (IMT) and morphology of carotid plaques were evaluated.ResultsThe mean age was 61.5±7.3 years and the mean glycated hemoglobin of 6.8±0.9%. A total of 60% presented carotid plaques. Both groups were homogeneous in anthropometric data, biochemical determinations and hemostatic factors. Adiponectin, hsCRP, TNF-α and IL-6 were similar in both groups. No differences were observed in serum PAPP-A (0.46 (0.22–0.86) vs 0.38 (0.18–0.66) mIU/l and in SDS IGF1 (−0.34±1.38 vs −0.67±1.35)) in patients with and without carotid plaques respectively. PAPP-A and IGF1 were not correlated with IMT.ConclusionsSerum PAPP-A and IGF1 do not appear to be useful serum biomarkers for carotid atherosclerosis in type 2 diabetic patients with stable glycemic control, despite scientific evidence of their local role in atherosclerosis.
Patterns of Intraspecific DNA Variation in the Daphnia Nuclear Genome
Authors: Omilian Angela R , Lynch Michael 
Published: March 2009

Abstract
Understanding nucleotide variation in natural populations has been a subject of great interest for decades. However, many taxonomic groups, especially those with atypical life history attributes remain unstudied, and Drosophila is the only arthropod genus for which DNA polymorphism data are presently abundant. As a result of the recent release of the complete genome sequence and a wide variety of new genomic resources, the Daphnia system is quickly becoming a promising new avenue for expanding our knowledge of nucleotide variation in natural populations. Here, we examine nucleotide variation in six protein-coding loci for Daphnia pulex and its congeners with particular emphasis on D. pulicaria, the closest extant relative of D. pulex. Levels of synonymous intraspecific variation, πs, averaged 0.0136 for species in the Daphnia genus, and are slightly lower than most prior estimates in invertebrates. Tests of neutrality indicated that segregating variation conforms to neutral model expectations for the loci that we examined in most species, while Ka/Ks ratios revealed strong purifying selection. Using a full maximum-likelihood coalescent-based method, the ratio of the recombination rate to the mutation rate (c/u), averaged 0.5255 for species of the Daphnia genus. Lastly, a divergence population-genetics approach was used to investigate gene flow and divergence between D. pulex and D. pulicaria.
The Challenge of Producing and Stimulating a Deep Sandstone-Carbonate Reservoir with Combined Organic and Inorganic Formation Damage
Authors: Mora José A. , Kondo Felix , Pinto Sandra González 
Published: March 2009

Abstract
Gigante-1A (G-1A) is a well that is located in Upper Magdalena Valley in Colombia, South America. It has been producing for almost 10 years today. There are several wells in this area that have been producing from sandstone and carbonate/dolomite reservoirs at different depths for more than 30 years and are still drawing interest from producers. There is a high interest in new well construction based on experiences from G-1A related to drilling, completion, production stages, reservoir analysis with stimulation techniques, and response-related identification of formation damage. A second well at the same depth is currently in progress.
The specific condition of water, oil, and gas flowing commingled to surface from the same zone, covering sandstone and carbonate formations with significant petro-physical differences and reservoir fluids has allowed for the establishment of best practices and identified areas of research to get improved responses.
A continuous learning curve focused on improving operational procedures and placement techniques has been built according to the mechanical status of the well before each intervention. Periodical interventions focused on organic deposition, emulsion blockage damages, and scaling related problems have helped to establish operational and treatment design procedures which contribute to effective stimulation results.
Continuous improvements related to chemical treatment designs, based on adjustments of formulations, radius of penetration, and placement techniques, have helped to ensure effectiveness. Chemical treatments have focused on organic, nature-related problems since the beginning. In particular, asphaltenes flocculation, have generated pore throat blockage because of asphaltenes deposition and emulsion blockage. Water cut increase over time has brought inorganic scaling problems. Corresponding solutions have been combined with organic stimulation treatments for removal and damage inhibition overtime. There is also a clear learning curve over the last seven years on well lifting in optimizing well production in conjunction with chemical treatments to maximize oil production.
Oil Shale ICP - Colorado Field Pilots
Authors: Fowler Thomas D. , Vinegar Harold J. 
Published: March 2009

Abstract
The massive size of the oil shale resource in the Western USA, particularly in the Green River Basin, has attracted numerous commercialization attempts from industry over the last 100 years. Although great sums of money have been invested and many professional careers have been devoted to the challenge, efforts thus far have not resulted in a commercial oil shale industry.
For more than 40 years, Shell has been active in the Green River oil shale seeking a process that could develop the 800 billion bbls of oil resource (RAND Corporation). Since 1980 Shell has focused on the In-situ Conversion Process (ICP) in which oil shale is heated by thermal conduction from a closely spaced array of electric resistance heaters. At approximately 650oF, the kerogen present in the oil shale is converted to oil, gas and water that can be produced by conventional means. Although the process is subject to mining statutes and regulations in the State of Colorado, no traditional mining is required.
This paper provides a brief history of attempts to commercialize oil shale in the United States and an overview of Shell's ICP technology, including its 1940s Swedish oil shale roots. It focuses on Shell's seven field pilots conducted in Colorado that address ICP recovery, heater testing, and freeze wall construction and performance.
Hydraulic Stimulation Techniques Applied to Injection Wells at the Salak Geothermal Field, Indonesia
Authors: Yoshioka Keita , Pasikki Riza , Suryata Indra , Riedel Kenneth L. 
Published: March 2009

Abstract
The Salak field is the largest developed geothermal resource in Indonesia. Steam production levels have been maintained at or above the rated power plant capacity for 15 years through periodic infill drilling and injection realignment. The reservoir management strategy for Salak involves injecting separated brine into deep wells on the margins of the reservoir where permeability is known to be low. A technique that has been used to enhance permeability in new injection wells combines hydraulic and thermal fracturing. This involves complex rock/fluid interactions and heat transfer relationships that must be considered in order to design appropriate injection rates, pumping times, and injection temperatures.
This paper describes the techniques used to characterize candidate wells and interpret surveillance data collected during long-term cold water injection experiments. Analyzing continuous measurements of well injectivity along with pressure transient data taken periodically shows the evolution of enhanced permeability during stimulation. A high degree of success has been achieved using these techniques at Salak, with significant improvements in well injection capacity. These results provide additional alternatives for managing injection to increase the ultimate heat recovery from the reservoir.