bluuebunny/crossref_metadata_2025_split huggingface dataset:
From ecological reservoir to disease: the nasopharynx, day-care centres and drug-resistant clones of Streptococcus pneumoniae
Authors: de Lencastre H. , Tomasz A. 
Published: January 2003

Abstract
Several lines of epidemiological and microbiological studies point to the multiple and critical roles of the nasopharynx of children—particularly those of pre-school age and attending day-care centres (DCCs)—in the emergence and spread of drug-resistant Streptococcus pneumoniae (DRP). A systematic yearly surveillance of the nasopharyngeal flora of children attending DCCs has been carried out in Lisbon since 1996. Molecular typing of several hundred DRP isolates showed that the great majority of DRP were represented by a relatively few clonal types that were frequently carried by many children in geographically distant DCCs and over several years of surveillance. The same epidemic DRP clones were also frequent among pneumococci causing both paediatric and adult disease worldwide. Penicillin-resistant pneumococci carry sequences of heterologous origin in their pbp genes and also in the recently identified murM : a gene essential for expression of penicillin resistance and for the unique cell wall structure of penicillin-resistant pneumococci. Virtually all DRP express only a limited number (five or six) of the very large genetic repertoire (up to 90) of serotypes available for this bacterial species and the serotypes of drug-resistant strains happens to be the same as the serotypes of drug-susceptible pneumococci that most frequently colonize pre-school age children. These observations strongly suggest that the nasopharynx of children is an important global ecological reservoir of DRP and may also play a critical role as the favoured anatomical site for the evolution of DRP.
Prognosis After Rectal Cancer in Blacks and Whites Participating in Adjuvant Therapy Randomized Trials
Authors: Dignam James J. , Ye Yunrong , Colangelo Linda , Smith Roy , Mamounas Eleftherios P. , Wieand H. Samuel , Wolmark Norman 
Published: January 2003

Purpose: National health statistics indicate that blacks have lower survival rates from colorectal cancer than do whites. This disparity has been attributed to differences in stage at diagnosis and other disease features, extent and quality of treatment, and socioeconomic factors. We evaluated outcomes for blacks and whites with rectal cancer who participated in randomized clinical trials of the National Surgical Adjuvant Breast and Bowel Project (NSABP). The randomized trial setting enhances uniformity in disease stage and treatment plan among all participants. Patients and Methods: The study included black (N = 104) or white (N = 1,070) patients from two serially conducted NSABP randomized trials for operable rectal cancer. Recurrence-free survival and survival were compared using statistical modeling to account for differences in patient and disease characteristics between the groups. Results: Blacks and whites had largely similar disease features at diagnosis. After adjustment for patient and tumor prognostic covariates, the black/white recurrence hazard ratio (HR) was 1.25 (95% confidence interval [CI], 0.94 to 1.66). The mortality HR was somewhat larger at 1.45 (95% CI = 1.09 to 1.93). Outcomes were improved for both groups in the more recent trial, which employed systemic adjuvant chemotherapy in all treatment arms. Conclusion: Recurrence-free survival was modestly less favorable for blacks, whereas overall survival was more disparate. Outcomes between groups were more comparable than those noted in national health statistics surveys and other studies. Adequate treatment access and the identification of new prognostic factors that can identify patients at high risk of recurrence are needed to ensure optimal outcomes for rectal cancer patients of all racial/ethnic backgrounds.
Renal Cell Carcinoma in Children: A Clinicopathologic Study
Authors: Indolfi Paolo , Terenziani Monica , Casale Fiorina , Carli Modesto , Bisogno Gianni , Schiavetti Amalia , Mancini Antonia , Rondelli Roberto , Pession Andrea , Jenkner Alessandro , Pierani Paolo , Tamaro Paolo , De Bernardi Bruno , Ferrari Andrea , Santoro Nicola , Giuliano Maria , Cecchetto Giovanni , Piva Luigi , Surico Gianmarco , Di Tullio M. Teresa 
Published: January 2003

Purpose: To identify the prognostic factors, treatment, and outcome of children affected by renal cell carcinoma (RCC). Patients and Methods: The series included 41 patients (18 males and 23 females) with a median age of 124 months observed at the 11 Italian Association for Pediatric Hematology and Oncology centers from January 1973 to January 2001. Clinical data, surgical notes, pathologic findings, and summaries of therapy were taken from the charts. Results: Seven (17%) of the 41 patients had a papillary histology, and 34 (82.4%) had nonpapillary histology. Eighteen patients (43.9%) had stage I, one patient (2.4%) had stage II, two patients (4.8%) had stage IIIA, 10 patients (24.3%) had stage IIIB, and nine patients (21.9%) had stage IV disease. One patient had a bilateral involvement at diagnosis. Seven patients experienced disease recurrence. Lung and liver were the most common distant lesions and usually were fatal. In this study, the major factor influencing the prognosis was the stage. Event-free survival at 20 years was 53.5% for all patients. Overall survival at 20 years was 54.9% for all patients. Conclusion: RCC is a rare disease in children and adolescents. This neoplasm has a different clinical presentation in children compared with adults but the same outcome. In our experience, patients with localized disease could be cured by nephrectomy alone. Prospective studies in a larger number of patients are needed to confirm radiation therapy and biologic response modifiers as effective adjunct therapy in RCC stage III. The alternative therapy seems warranted in patients with advanced disease.
Value of P-Glycoprotein and Clinicopathologic Factors as the Basis for New Treatment Strategies in High-Grade Osteosarcoma of the Extremities
Authors: Serra Massimo , Scotlandi Katia , Reverter-Branchat Gemma , Ferrari Stefano , Manara Maria C. , Benini Stefania , Incaprera Marina , Bertoni Franco , Mercuri Mario , Briccoli Antonio , Bacci Gaetano , Picci Piero 
Published: January 2003

Purpose: To evaluate the prognostic value of P-glycoprotein and clinicopathologic parameters in a large series of high-grade osteosarcoma (OS) patients treated at the Rizzoli Institute. Patients and Methods: With the use of immunohistochemistry, P-glycoprotein was assessed in 149 patients with primary, nonmetastatic, high-grade OS who were homogeneously treated with chemotherapy protocols based on doxorubicin, high-dose methotrexate, and cisplatin and the addition of ifosfamide in the postoperative phase. Results: P-glycoprotein positivity was found in 47 of 149 cases (32%) and was significantly associated with a higher incidence of relapse and a worse outcome, as was age younger than 12 years and tumor volume greater then 150 mL at diagnosis. Multivariate analysis further confirmed the prognostic value of these parameters, which all were independent adverse prognostic factors. Event-free survival and proportional hazards regression analyses confirmed that overexpression of P-glycoprotein at clinical onset is the most important adverse prognostic factor for high-grade OS patients treated with these chemotherapy protocols. Conclusion: Increased P-glycoprotein levels, together with tumor volume and age, should be taken into consideration to identify, at time of diagnosis, subgroups of OS patients with a higher risk of recurrence. This subgroup identification will constitute the basis for drawing individualized treatment protocols on the basis of risk evaluation, with the aim of using more aggressive chemotherapy, or combination chemotherapy with other adjuvants, only in those patients for which more aggressive regimens are strictly necessary and warranted.
Whole Body 18FDG-PET and the Response of Esophageal Cancer to Induction Therapy: Results of a Prospective Trial
Authors: Downey Robert J. , Akhurst Tim , Ilson David , Ginsberg Robert , Bains Manjit S. , Gonen Mithat , Koong Heng , Gollub Marc , Minsky Bruce D. , Zakowski Maureen , Turnbull Alan , Larson Steven M. , Rusch Valerie 
Published: January 2003

Purpose: Whole-body 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) imaging before and after induction therapy was prospectively evaluated in patients with esophageal cancer to determine whether changes in PET images could measure response to therapy. Patients and Methods: Between April 1997 and April 1999, 39 patients (34 men and five women; median age, 59 years; range, 36 to 76 years) with esophageal cancer were prospectively enrolled in a single-institution clinical trial of staging, including PET, induction therapy, restaging including PET, and esophagectomy. All patients undergoing esophagectomy after induction therapy (n = 17) were followed either to recurrence, to death, or through a disease-free interval of at least 24 months. Results: PET after standard staging studies and before therapy imaged undetected sites of metastatic disease in six patients (15%). Restaging (including PET) after induction therapy did not identify any patients with disease progression or any patients with loco-regionally unresectable disease at exploration. The median decrease in the standardized uptake value (SUV) during induction therapy was 59%. After R0 esophagectomy, the 2-year disease-free and overall survival was 38% and 63%, respectively, among patients who had a less than 60% decrease in SUV, and 67% and 89%, respectively, among patients who had a greater than 60% decrease in SUV (P = .055 and P = .088, respectively). Conclusion: Compared with conventional imaging, PET detects additional sites of metastatic disease at initial evaluation. After induction therapy, PET did not add to the estimation of loco-regional resectability and did not detect new distant metastases. However, changes in [18F]FDG PET may predict disease-free and overall survival after induction therapy and resection in patients with esophageal cancer. Further evaluation in larger trials is warranted.
Role of Surgeon Volume in Radical Prostatectomy Outcomes
Authors: Hu Jim C. , Gold Karen F. , Pashos Chris L. , Mehta Shilpa S. , Litwin Mark S. 
Published: January 2003

Purpose: To examine the effect of hospital and surgeon volume on postoperative outcomes and to determine whether hospital or surgeon volume is the stronger predictor. Patients and Methods: Using 1997 to 1998 claims data from a national 5% random sample of Medicare beneficiaries, we identified 2,292 men who underwent radical prostatectomy at 1,210 hospitals by 1,788 surgeons. Hospitals were classified as high (≥ 60 per year) or low (< 60 per year) volume according to radical prostatectomy experience over the 2-year period. Surgeons were classified as high (≥ 40 per year) or low (< 40 per year) volume. Multivariate logistic regression was performed to control for patient demographics and comorbidities when assessing the association of hospital and surgeon volume with in-hospital complications, length of stay, and anastomotic stricture rates. In-hospital complications included cardiac, respiratory, vascular, wound, genitourinary, and miscellaneous surgical and medical conditions. Results: High-volume surgeons had half the complication risk (odds ratio [OR] = 0.53; 95% confidence interval [CI], 0.32 to 0.89) and shorter lengths of stay (4.1 v 5.2 days, P = .03) compared with low-volume surgeons. High-volume hospital patients tended to have fewer anastomotic strictures (OR = 0.72; 95% CI, 0.49 to 1.04). Patient age (≥ 75 years) was associated with more complications (OR = 1.9; 95% CI, 1.39 to 2.70), more anastomotic strictures (OR = 2.2; 95% CI, 1.54 to 3.15), and longer hospital stays (parameter estimate = 2.26; 95% CI, 1.75 to 2.77). Conclusion: Surgeon volume is inversely related to in-hospital complications and length of stay in men undergoing radical prostatectomy. Hospital volume is not significantly associated with outcomes after adjusting for physician volume. Further study is necessary to elucidate the mechanism of the volume-outcome effect.
Estrogen Receptor Classification for Hepatocellular Carcinoma: Comparison With Clinical Staging Systems
Authors: Villa Erica , Colantoni Alessandra , Cammà Calogero , Grottola Antonella , Buttafoco Paola , Gelmini Roberta , Ferretti Ilva , Manenti Federico 
Published: January 2003

Purpose: Several scoring systems to evaluate patients with hepatocellular carcinoma (HCC) exist. A good scoring system should provide information on prognosis and guide therapeutic decisions. The presence of variant liver estrogen receptor (ER) transcripts in the tumor has been shown to be the strongest negative predictor of survival in HCC. The aim of this study was to compare the predictive value of the commonly applied clinical scoring systems for survival of patients with HCC with that of the evaluation of ER in patients with HCC (molecular scoring system). Materials and Methods: HCC was staged according to the Okuda classification, Barcelona Clinic Liver Cancer classification, Italian classification system (CLIP), French classification, and ER status in 96 patients. Analysis of survival was performed according to the Kaplan-Maier test and was made for each classification system and ER. A comparison between classifications was made by univariate and multivariate analysis. Results: Among the clinical classification systems, only the CLIP was able to identify patient populations with good, intermediate, and poor prognosis. On multivariate analysis, ER classification was shown to be the best predictive classification for survival of patients with HCC (P <.0001). This difference was the result of a better allocation of patients with ominous prognosis (variant ER) having nevertheless good clinical score. Conclusion: The evaluation of the presence of wild-type or variant ER transcripts in the tumor is the best predictor of survival in patients with HCC. Its accuracy in discriminating patients with good or unfavorable prognosis is significantly greater than that of the commonly used scoring systems for the staging of HCC.
Diminished Survival in Patients With Inner Versus Outer Quadrant Breast Cancers
Authors: Gaffney David K. , Tsodikov Alexander , Wiggins Charles L. 
Published: January 2003

Purpose: To evaluate the role of breast tumor location on survival in patients with breast cancer. Patients and Methods: We evaluated tumor location within the breast on breast cancer–specific survival (BCSS) and overall survival (OS) in patients with invasive breast cancer using the Surveillance, Epidemiology, and End-Results (SEER) registries in the United States. Effects on survival were evaluated according to age, stage, tumor site, tumor size, grade, axillary lymph node status, extent of surgery, and radiotherapy (RT). A multivariate model was used with complete data on 45,880 patients. The median follow-up was 59 months. Results: Patients with outer tumor location demonstrated superior BCSS on Kaplan-Meier analysis for both local stage (node-negative, P < .001) and regional stage disease (node-positive, P = .0002). For BCSS, the hazard ratio (HR) for inner quadrant location compared with outer quadrant was 1.31 (95% confidence interval [CI], 1.19 to 1.37; P < .001); and for OS, the HR was 1.12 (95% CI, 1.05 to 1.17; P < .001). When ER and PR status were included in the model, the HR for inner quadrant location compared with outer quadrant was 1.27 for BCSS (95% CI, 1.16 to 1.40; P < .001) and 1.11 for OS (95% CI, 1.03 to 1.19; P = .004). Patients treated by lumpectomy that received RT had a superior OS compared with patients that did not receive RT in both local (HR, 0.52; 95% CI, 0.48 to 0.61; P < .001) and regional (HR, 0.63; 95% CI, 0.56 to 0.72; P < .001) stage disease. Mastectomy patients with local stage disease that received RT had a diminished OS (HR, 1.24; 95% CI, 1.02 to 1.50; P = .033). Conclusion: On multivariate analysis, incorporating data on age, stage, tumor site, tumor size, grade, ER and PR status, axillary lymph node status, extent of surgery, and RT, this SEER registry–based study demonstrates that medial tumor location adversely impacts BCSS and OS.
The role of small‐scale orographic features in the spatial distribution of precipitation
Authors: Cosma S. , Richard E. , Miniscloux F. 
Published: January 2003

AbstractRadar images from the Cévennes experiment, which took place during the autumns of 1986–88 on the southeastern flank of the Massif Central in France, reveal a characteristic and repetitive structure of the precipitation distribution. In southerly Mediterranean flows, which are frequent there in autumn, precipitation is often organized into narrow bands or plumes, oriented south–north.The period 14 and 15 November 1986 has been selected as an example on which to perform numerical simulations and analyse the mechanism yielding this specific precipitation organization. The numerical model correctly reproduces the bands, especially at high horizontal resolution (1 km). These rainfall bands are focused on the small‐scale topography, oriented east–west, composed of a succession of ridges and penetrating valleys. The bands are generated upstream of these ridges and enhanced on the lee side by convergence created by deflection around the obstacle and penetration of the flow into the valleys.Idealized simulations and sensitivity experiments have been carried out to verify these hypotheses. These simulations suggest that small‐scale orography plays a decisive role in forcing the precipitation into bands, while upstream moisture conditions mainly affect the precipitation intensity and its south–north extent. Copyright © 2002 Royal Meteorological Society.
Relationship between cloud‐to‐ground lightning flashes over the Iberian Peninsula and sea surface temperature
Authors: Pablo Fernando De , Soriano Luis Rivas 
Published: January 2003

AbstractThe correlation between cloud‐to‐ground (CG) lightning anomalies over the Iberian peninsula and sea surface temperature (SST) anomalies in its bordering seas has been calculated. The results disclosed a significant link between them. The warmer SSTs in the Atlantic north‐west of the Iberian Peninsula and in the Cantabrian Sea are related to increased CG lightning activity over the Iberian Peninsula. The warmer SSTs in the Atlantic south of the Iberian Peninsula are related to increased CG lightning over the northern half of the Iberian Peninsula and to decreased CG lightning over the southern half. The Mediterranean Sea does not show significant links with CG lightning. The way these links work seems to involve changes in the advection of moisture from the Atlantic Ocean and the Cantabrian Sea as well as changes in static instability. It was also observed that there is no significant link between CG lightning anomalies and land surface temperature anomalies over the Iberian Peninsula. Copyright © 2002 Royal Meteorological Society.
Influence of added observations on analysis and forecast errors: Results from idealized systems
Authors: Morss R. E. , Emanuel K. A. 
Published: January 2003

AbstractRecent tests of adding observations to improve individual forecasts have shown a mix of positive, negative, and neutral results. In this study, the influence of added observations on analysis and forecast errors is explored in idealized systems. The primary system studied is a three‐dimensional simulated observing and forecasting system that includes a quasi‐geostrophic forecast model and a three‐dimensional variational data‐assimilation system. In this simulated system, adding observations generally improves analyses and often improves 12‐hour forecasts. Even with perfect observational data and a perfect forecast model, however, there is a non‐negligible risk that adding observations will degrade analyses, and a significant risk that assimilated added observations will degrade forecasts on a time‐scale of one or several days. To illustrate several general principles that help interpret the results, several experiments are performed with low‐dimensional data‐assimilation systems; the results demonstrate that the risk of analysis degradation is inherent in statistical data assimilation. Experiments are also performed with a low‐dimensional forecast model, demonstrating that the risk of forecast degradation is inherent in prediction systems with sensitivity to small errors in initial conditions. Although degradations cannot be avoided, several circumstances are identified in which adding observations is less likely to degrade analyses and forecasts and on average improves analyses and forecasts by a larger amount. Copyright © 2002 Royal Meteorological Society.
Lagrangian description of airflows using Eulerian passive tracers
Authors: Gheusi François , Stein Joël 
Published: January 2003

AbstractA method of tracking coherent Lagrangian airmasses is presented. It is not based on the computation of individual trajectories, but rather on three Eulerian passive tracers initialized with the coordinates of each grid cell. This ‘initial coordinates’ method allows the later unambiguous identification of each Lagrangian air parcel by referring to its initial position. Further, the physical history of each parcel can be retrieved. The advantages of this method in the framework of mesoscale numerical modelling are discussed with respect to trajectory‐based methods. Preliminary examples are given by studying idealized airflows: (i) a two‐dimensional stratified flow past an isolated obstacle generating gravity‐wave breaking; (ii) a deep convective squall line. Then the method is applied to a heavy‐rain situation over the Alps during the Mesoscale Alpine Programme (MAP) field phase. A coherent mesoscale pool of dry air is identified over the Mediterranean and tracked with the aid of the initial‐coordinates method. Its influence on the rain distribution over the Ligurian Alps and Apennines is demonstrated. Copyright © 2002 Royal Meteorological Society.
Cross‐reactivity with myelin basic protein and human herpesvirus‐6 in multiple sclerosis
Authors: Tejada‐Simon Maria V. , Zang Ying C. Q. , Hong Jian , Rivera Victor M. , Zhang Jingwu Z. 
Published: January 2003

AbstractViral infections are though to play an important role in the pathogenesis of multiple sclerosis (MS) potentially through molecular mimicry. An identical sequence was found in both myelin basic protein (MBP, residues 96–102), a candidate autoantigen for MS, and human herpesvirus‐6 (HHV‐6 U24, residues 4–10) that is a suspected viral agent associated with MS. In this study, we showed that greater than 50% of T cells recognizing MBP93‐105 cross‐reacted with and could be activated by a synthetic peptide corresponding to residues 1 to 13 of HHV‐6 U24 in MS patients. The estimated precursor frequency of these cross‐reactive T cells recognizing both peptides, MBP93‐105 and HHV‐6 (U24)1‐13, was significantly elevated in MS patients compared with that in healthy controls. These cross‐reactive CD4+ T cells represented the same Th1 phenotype as that of monospecific T cells recognizing MBP93‐105. There were increased antibody titers for both peptide HHV‐6 (U24)1‐13 and peptide MBP93‐105 in the same patients with MS compared with those in healthy controls, suggesting B‐cell sensitization to the antigens in MS patients. The study provides important evidence in the understanding of the potential role of HHV‐6 infection/reactivation in the activation of autoimmune reactivity to MBP and its implication in the pathogenesis of MS. Ann Neurol 2003