bluuebunny/crossref_metadata_2025_split huggingface dataset:
“A Persistent Truth”—Reflections on Drought Risk Management in Southern Africa
Authors: Vogel Coleen , Koch Ingrid , Van Zyl Koos 
Published: November 2009

AbstractSevere droughts in southern Africa are associated with livelihood impacts, a strain on local economies, and other hardships. Extensive effort has been spent in the past trying to improve responses to periods of extensive drought. There have also been renewed calls for improvements to climate change adaptation by adopting more proactive governance and disaster risk reduction approaches. Few efforts, however, have been made to assess how to learn more from past drought efforts so as to enhance overall resilience to future drought risks. Few have examined the role and contributions of institutions and drought governance, either across spatial scales [from regional (i.e., Southern African Development Community) to national scales (e.g., South Africa) to the very local scale (e.g., Limpopo Province, South Africa)] or across temporal scales (over at least 100 yr). Despite calls for better risk management approaches at all levels, this paper illustrates two points. First, a failure to fully understand, integrate, and learn from past efforts may undermine current and future drought response. Second, state-led drought risk reduction, which remains focused on a financial “bail-out” mentality, with little follow-through on proactive rather than reactive drought responses, is also seriously contributing to the vulnerability of the region to future drought impacts.
Relative Cultural Distance and Public Understanding of Science
Authors: Raza Gauhar , Singh Surjit , Shukla Rajesh 
Published: November 2009

Public Understanding of Science is an area constituted by those scholars who essentially acquired expertise in various established academic disciplines and shifted their attention towards a few specific issues related to the science–society interface. The discipline though recognised as a legitimate area of research has not come out of all its teething problems associated with the formation of any new area. The mainstay, during the first phase of its development was the attitudinal surveys conducted in various countries. The objectives of these surveys were to measure the extent of scientific knowledge, probe public attitude towards science or scientists, and at times simply to explore the level of confidence or lack of confidence that a common citizen had in science. These surveys gradually turned into an important and regular activity in many countries. The debate that followed the first phase resulted in refinement of methodology, tools and the models of assessment of Public Understanding of Science. The PAUS group at NISTADS, India, has since 1989 worked on methodology suitable for carrying out surveys in developing countries. Subsequently, a culturally sensitive model for analysing the survey data was proposed by the group. The present article in the first section gives details of the model designated here as the ‘cultural model of Public Understanding of Science’. The following sections, in detail, deal with the application of the model on data sets collected by two different organisations in India. The conclusions drawn confirm that the method of measuring cultural distance could be successfully applied to various data sets to draw meaningful inferences.
Participation in High-Impact Sports Predicts Bone Mineral Density in Senior Olympic Athletes
Authors: Leigey Daniel , Irrgang James , Francis Kimberly , Cohen Peter , Wright Vonda 
Published: November 2009

Background: Loss of bone mineral density (BMD) and resultant fractures increase with age in both sexes. Participation in resistance or high-impact sports is a known contributor to bone health in young athletes; however, little is known about the effect of participation in impact sports on bone density as people age. Hypothesis: To test the hypothesis that high-impact sport participation will predict BMD in senior athletes, this study evaluated 560 athletes during the 2005 National Senior Games (the Senior Olympics). Study Design: Cross-sectional methods. The athletes completed a detailed health history questionnaire and underwent calcaneal quantitative ultrasound to measure BMD. Athletes were classified as participating in high impact sports (basketball, road race [running], track and field, triathalon, and volleyball) or non-high-impact sports. Stepwise linear regression was used to determine the influence of high-impact sports on BMD. Results: On average, participants were 65.9 years old (range, 50 to 93). There were 298 women (53.2%) and 289 men (51.6%) who participated in high-impact sports. Average body mass index was 25.6 ± 3.9. The quantitative ultrasound-generated T scores, a quantitative measure of BMD, averaged 0.4 ± 1.3 and −0.1 ± 1.4 for the high-impact and non-high-impact groups, respectively. After age, sex, obesity, and use of osteoporosis medication were controlled, participation in high-impact sports was a significant predictor of BMD ( R2 change 3.2%, P < .001). Conclusions: This study represents the largest sample of BMD data in senior athletes to date. Senior participation in high-impact sports positively influenced bone health, even in the oldest athletes. Clinical Relevance: These data imply that high-impact exercise is a vital tool to maintain healthy BMD with active aging.
Sports-Related Wrist Injuries in Adults
Authors: Chen Neal C. , Jupiter Jesse B. , Jebson Peter J. L. 
Published: November 2009

Background: Wrist injuries are common in sports. Those who are involved in the care of athletes should be familiar with hand and wrist anatomy, common wrist injuries, and clinical examination; they should also know how to recognize emergent problems. Level of Evidence: Level V, expert opinion.
Cardiovascular Health, Part 1: Preparticipation Cardiovascular Screening
Authors: Gupta Sanjaya , Baman Timir , Day Sharlene M. 
Published: November 2009

Context: Identification of potentially fatal cardiac conditions in otherwise healthy athletes presents a major challenge to the sports medicine community. The requirements for preparticipation screening vary among countries and even from state to state within the United States. The mandated use of an electrocardiogram as a screening implement has provoked international controversy. Evidence acquisition: Part 1 of this review highlights the current guidelines and controversies surrounding cardiovascular screening, with a focus on the diagnostic challenges associated with identifying athletes with inheritable cardiomyopathies. Data sources were limited to peer-reviewed publications from 1984 to the present. Results: Preparticipation screening should include at least a history and a physical examination for all athletes, whereas use of an electrocardiogram is still controversial. Diagnosis of inherited cardiomyopathies presents unique challenges, particularly in hypertrophic cardiomyopathy, where many features can mimic those found in the “athlete’s heart.” Conclusions: Recognizing cardiac conditions in athletes that can predispose them to sudden cardiac death or other adverse outcomes is of vital importance, as is the appropriate exclusion of these athletes from competition. Further studies are needed to determine the most efficient and cost-effective means of screening and to increase the sensitivity and specificity of diagnostic testing for inheritable cardiovascular diseases.
Improved ability of biological and previous caries multimarkers to predict caries disease as revealed by multivariate PLS modelling
Authors: Nordlund Åke , Johansson Ingegerd , Källestål Carina , Ericson Thorild , Sjöström Michael , Strömberg Nicklas 
Published: November 2009

Abstract

Background
Dental caries is a chronic disease with plaque bacteria, diet and saliva modifying disease activity. Here we have used the PLS method to evaluate a multiplicity of such biological variables (n = 88) for ability to predict caries in a cross-sectional (baseline caries) and prospective (2-year caries development) setting.

Methods
Multivariate PLS modelling was used to associate the many biological variables with caries recorded in thirty 14-year-old children by measuring the numbers of incipient and manifest caries lesions at all surfaces.

Results
A wide but shallow gliding scale of one fifth caries promoting or protecting, and four fifths non-influential, variables occurred. The influential markers behaved in the order of plaque bacteria > diet > saliva, with previously known plaque bacteria/diet markers and a set of new protective diet markers. A differential variable patterning appeared for new versus progressing lesions. The influential biological multimarkers (n = 18) predicted baseline caries better (ROC area 0.96) than five markers (0.92) and a single lactobacilli marker (0.7) with sensitivity/specificity of 1.87, 1.78 and 1.13 at 1/3 of the subjects diagnosed sick, respectively. Moreover, biological multimarkers (n = 18) explained 2-year caries increment slightly better than reported before but predicted it poorly (ROC area 0.76). By contrast, multimarkers based on previous caries predicted alone (ROC area 0.88), or together with biological multimarkers (0.94), increment well with a sensitivity/specificity of 1.74 at 1/3 of the subjects diagnosed sick.

Conclusion
Multimarkers behave better than single-to-five markers but future multimarker strategies will require systematic searches for improved saliva and plaque bacteria markers.
Dual energy x-ray absorptiometry analysis contributes to the prediction of hip osteoarthritis progression
Authors: Castaño Betancourt Martha C , Van der Linden Jacqueline C , Rivadeneira Fernando , Rozendaal Rianne M , Bierma Zeinstra Sita M , Weinans Harrie , Waarsing Jan H 
Published: November 2009

Abstract
Introduction
To determine if structural bone parameters obtained from dual energy X-ray absorptiometry (DXA) contribute to the prediction of progression of hip osteoarthritis (OA) and to test if the difference between the most affected (OA) hip and the contralateral hip adds to this prediction.

Methods
The study group involves a prospective cohort of 189 patients that met the American College of Rheumatology (ARC) classification criteria for hip osteoarthritis. Progression was defined as 20% joint space narrowing or total hip replacement within a two years follow up. Software was developed to calculate geometrical aspects and bone mineral density (BMD) in different regions of interest of the proximal femur. Logistic regression was used to test if Kellgren and Lawrence (K-L) scores and DXA parameters can predict progression of OA. Models were compared using -2log likelihood tests, R2 Nagelkerke and areas under the Receiver Operator Characteristic curves, assessed using 10-fold cross validation.

Results
The model that included the DXA variables was significantly better in predicting hip OA progression than the model with K-L score of the affected side alone (P < 0.01). The addition of the differences in DXA parameters between the most affected and contralateral hip in the superior part of the femoral head, trochanteric and intertrochanteric area further improved the prediction of progression (P < 0.05). K-L score of the affected side was still the most significant single variable in the models.

Conclusions
DXA parameters can significantly contribute to the prediction of progression in patients with hip osteoarthritis. The analysis of the DXA differences between the hips of the patient represents a small but significant contribution to this prediction. These analyses show the importance of bone density changes in the etiology of OA.
Analysis of PTEN, BRAF, and EGFR Status in Determining Benefit From Cetuximab Therapy in Wild-Type KRAS Metastatic Colon Cancer
Authors: Laurent-Puig Pierre , Cayre Anne , Manceau Gilles , Buc Emmanuel , Bachet Jean-Baptiste , Lecomte Thierry , Rougier Philippe , Lievre Astrid , Landi Bruno , Boige Valérie , Ducreux Michel , Ychou Marc , Bibeau Fréderic , Bouché Olivier , Reid Julia , Stone Steven , Penault-Llorca Frédérique 
Published: November 2009

Purpose The occurrence of KRAS mutation is predictive of nonresponse and shorter survival in patients treated by anti–epidermal growth factor receptor (anti-EGFR) antibody for metastatic colorectal cancer (mCRC), leading the European Medicine Agency to limit its use to patients with wild-type KRAS tumors. However, only half of these patients will benefit from treatment, suggesting the need to identify additional biomarkers for cetuximab-based treatment efficacy. Patients and Methods We retrospectively collected tumors from 173 patients with mCRC. All but one patient received a cetuximab-based regimen as second-line or greater therapy. KRAS and BRAF status were assessed by allelic discrimination. EGFR amplification was assessed by chromogenic in situ hybridization and fluorescent in situ hybridization, and the expression of PTEN was assessed by immunochemistry. Results In patients with KRAS wild-type tumors (n = 116), BRAF mutations (n = 5) were weakly associated with lack of response (P = .063) but were strongly associated with shorter progression-free survival (P < .001) and shorter overall survival (OS; P < .001). A high EGFR polysomy or an EGFR amplification was found in 17.7% of the patients and was associated with response (P = .015). PTEN null expression was found in 19.9% of the patients and was associated with shorter OS (P = .013). In multivariate analysis, BRAF mutation and PTEN expression status were associated with OS. Conclusion BRAF status, EGFR amplification, and cytoplasmic expression of PTEN were associated with outcome measures in KRAS wild-type patients treated with a cetuximab-based regimen. Subsequent studies in clinical trial cohorts will be required to confirm the clinical utility of these markers.
Randomized Phase III Trial of Gemcitabine-Based Chemotherapy With In Situ RRM1 and ERCC1 Protein Levels for Response Prediction in Non–Small-Cell Lung Cancer
Authors: Reynolds Craig , Obasaju Coleman , Schell Michael J. , Li Xueli , Zheng Zhong , Boulware David , Caton John R. , DeMarco Linda C. , O'Rourke Mark A. , Shaw Wright Gail , Boehm Kristi A. , Asmar Lina , Bromund Jane , Peng Guangbin , Monberg Matthew J. , Bepler Gerold 
Published: November 2009

Purpose We evaluated the efficacy of gemcitabine versus gemcitabine and carboplatin in patients with advanced non–small-cell lung cancer (NSCLC) and a performance status (PS) of 2 and assessed if tumoral RRM1 and ERCC1 protein levels are predictive of response to therapy. Patients and Methods A randomized phase III trial was conducted in community-based oncology practices. Tumor specimens were collected a priori and shipped to a single laboratory for blinded determination of in situ RRM1 and ERCC1 protein expression levels by an automated quantitative immunofluorescent-based technology. Results One hundred seventy patients were randomly assigned. Overall median survival was 5.1 months for gemcitabine and 6.7 months for gemcitabine and carboplatin (P = .24). RRM1 (range, 5.3 to 105.6; median, 34.1) and ERCC1 (range, 5.2 to 131.3; median, 34.7) values were significantly and inversely correlated with disease response (r = −0.41; P = .001 for RRM1; r = −0.39; P = .003 for ERCC1; ie, response was better for patients with low levels of expression). A model for response prediction that included RRM1, ERCC1, and treatment arm, was highly predictive of the treatment response observed (P = .0005). We did not find statistically significant associations between survival and RRM1 or ERCC1 levels. Conclusion Single-agent chemotherapy remains the standard of care for patients with advanced NSCLC and poor PS. Quantitative analysis of RRM1 and ERCC1 protein expression in routinely collected tumor specimens in community oncology practices is predictive of response to gemcitabine and gemcitabine and carboplatin therapy. Oncologists should consider including in situ expression analysis for these proteins into their therapeutic decisions.
Phase II Study of Preoperative Gefitinib in Clinical Stage I Non–Small-Cell Lung Cancer
Authors: Lara-Guerra Humberto , Waddell Thomas K. , Salvarrey Maria A. , Joshua Anthony M. , Chung Catherine T. , Paul Narinder , Boerner Scott , Sakurada Akira , Ludkovski Olga , Ma Clement , Squire Jeremy , Liu Geoffrey , Shepherd Frances A. , Tsao Ming-Sound , Leighl Natasha B. 
Published: November 2009

Purpose Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have proven efficacy in advanced non–small-cell lung cancer (NSCLC). Their role in early-stage NSCLC has not been established. Our purpose was to explore the use of preoperative gefitinib in clinical stage I NSCLC to assess tumor response, toxicity, and clinical and molecular predictors of response. Patients and Methods Patients received gefitinib 250 mg/d for up to 28 days, followed by mediastinoscopy and surgical resection in an open-label, single-arm study. Tumor response was evaluated by Response Evaluation Criteria in Solid Tumors. Blood samples and tumor biopsies were collected and analyzed for transforming growth factor α level, EGFR protein expression, EGFR gene copy number, and EGFR (exon 19 to 21) and KRAS mutations. Results Thirty-six patients completed preoperative treatment (median duration, 28 days; range, 27 to 30 days). Median follow-up time is 2.1 years (range, 0.86 to 3.46 years). Three patients experienced grade 3 toxicities (rash, diarrhea, and elevated ALT). Tumors demonstrated EGFR-positive protein expression in 83%, high gene copy number in 59%, EGFR mutations in 17%, and KRAS mutations in 17%. Tumor shrinkage was more frequent among women and nonsmokers. Partial response was seen in four patients (11%), and disease progression was seen in three patients (9%). The strongest predictor of response was EGFR mutation. Conclusion Preoperative window therapy with gefitinib is a safe and feasible regimen in early NSCLC and provides a trial design that may better inform predictors of treatment response or sensitivity.
Effect of Epoetin Alfa on Survival and Cancer Treatment–Related Anemia and Fatigue in Patients Receiving Radical Radiotherapy With Curative Intent for Head and Neck Cancer
Authors: Hoskin Peter J. , Robinson Martin , Slevin Nicholas , Morgan David , Harrington Kevin , Gaffney Christopher 
Published: November 2009

Purpose To evaluate the effect of epoetin alfa on local disease-free survival (DFS), overall survival (OS), and cancer treatment–related anemia and fatigue in patients with head and neck cancer receiving radical radiotherapy with curative intent. Patients and Methods Patients (N = 301) with hemoglobin (Hb) less than 15 g/dL were randomly assigned in a ratio of 1:1 to receive radiotherapy plus epoetin alfa (10,000 U subcutaneously [SC] three times weekly if baseline Hb was < 12.5 g/dL; 4,000 U SC three times weekly if baseline Hb ≥ 12.5 g/dL) or radiotherapy alone. Hb levels were monitored weekly. The primary end point was local DFS, defined as the time from random assignment to local disease recurrence or death. Secondary efficacy end points included OS, local tumor response, and local tumor control. Patients were followed at 1, 4, 8, and 12 weeks postradiotherapy and annually for 5 years. Cancer treatment–related anemia and fatigue were evaluated with the Functional Assessment of Cancer Therapy-Anemia and Functional Assessment of Cancer Therapy-Head and Neck. Adverse events were recorded up to 12 weeks postradiotherapy. Results Hb levels increased from baseline with epoetin alfa. The median duration of local DFS was not statistically different between groups (observation, 35.42 months; epoetin alfa, 31.47 months; hazard ratio, 1.04; 95% CI, 0.77 to 1.41). Groups did not significantly differ in DFS, OS, tumor outcomes, or cancer treatment–related anemia or fatigue. No new or unexpected adverse events were observed. Conclusion Addition of epoetin alfa to radical radiotherapy did not affect survival, tumor outcomes, anemia, or fatigue positively or negatively in patients with head and neck cancer.
KRAS and BRAF Mutations in Advanced Colorectal Cancer Are Associated With Poor Prognosis but Do Not Preclude Benefit From Oxaliplatin or Irinotecan: Results From the MRC FOCUS Trial
Authors: Richman Susan D. , Seymour Matthew T. , Chambers Philip , Elliott Faye , Daly Catherine L. , Meade Angela M. , Taylor Graham , Barrett Jennifer H. , Quirke Philip 
Published: November 2009

Purpose Activating mutation of the KRAS oncogene is an established predictive biomarker for resistance to anti–epidermal growth factor receptor (anti-EGFR) therapies in advanced colorectal cancer (aCRC). We wanted to determine whether KRAS and/or BRAF mutation is also a predictive biomarker for other aCRC therapies. Patients and Methods The Medical Research Council Fluorouracil, Oxaliplatin and Irinotecan: Use and Sequencing (MRC FOCUS) trial compared treatment sequences including first-line fluorouracil (FU), FU/irinotecan or FU/oxaliplatin in aCRC. Tumor blocks were obtained from 711 consenting patients. DNA was extracted and KRAS codons 12, 13, and 61 and BRAF codon 600 were assessed by pyrosequencing. Mutation (mut) status was assessed first as a prognostic factor and then as a predictive biomarker for the benefit of adding irinotecan or oxaliplatin to FU. The association of BRAF-mut with loss of MLH1 was assessed by immunohistochemistry. Results Three hundred eight (43.3%) of 711 patients had KRAS-mut and 56 (7.9%) of 711 had BRAF-mut. Mutation of KRAS, BRAF, or both was present in 360 (50.6%) of 711 patients. Mutation in either KRAS or BRAF was a poor prognostic factor for overall survival (OS; hazard ratio [HR], 1.40; 95% CI, 1.20 to 1.65; P < .0001) but had minimal impact on progression-free survival (PFS; HR, 1.16; 95% CI, 1.00 to 1.36; P = .05). Mutation status did not affect the impact of irinotecan or oxaliplatin on PFS or OS. BRAF-mut was weakly associated with loss of MLH1 staining (P = .012). Conclusion KRAS/BRAF mutation is associated with poor prognosis but is not a predictive biomarker for irinotecan or oxaliplatin. There is no evidence that patients with KRAS/BRAF mutated tumors are less likely to benefit from these standard chemotherapy agents.