bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Ageing on Morphologic and Clinical Predictors of Prostate Cancer Progression
Authors: Stamey Thomas A. , Raimondo Marc , Yemoto Cheryl M. , McNeal John E. , Johnstone Iain M. 
Published: March 2003

ABSTRACTObjectives: Autopsy studies show that prostate cancer begins in the 4th and 5th decade of life. We sought to determine if increasing age at the time of diagnosis is related to morphologic and clinical predictors of cancer progression.Materials and Methods: We examined 7 morphologic variables known to impact progression of prostate cancer plus clinical stage and serum PSA in relation to increasing age. 981 untreated men undergoing radical prostatectomy were divided into 5 increasing age groups. Prostate size, which is known to increase with age, was used as a positive control. We compared the median and inter‐quartile range for each grouping.Results: Increase in prostate weight was highly significant at all age differences. The % Gleason grade 4/5 cancer and cancer volume showed the most statistically significant changes with ageing, followed by non‐organ confined cancer and capsular penetration both of which are highly correlated with cancer volume. Serum PSA was significant at 12, 17, and 22 years of age differences, but may be related more to prostate size than to increasing cancer volume. The presence of positive lymph nodes, seminal vesicle invasion, and palpable cancer were unrelated to increasing age.Conclusions: With the exception of increasing prostate size, % Gleason grade 4/5 cancer and cancer volume are the most significantly related variables to increasing age. Since % Gleason grade 4/5 cancer and cancer volume are also the primary determinants of failure to cure prostate cancer by radical prostatectomy, these age related changes suggest that detection of prostate cancer later in life will be accompanied by increased amounts of high grade cancer and larger tumor volumes. They also explain why, in so many younger men (age 45–60), the largest prostate cancer is often clinically insignificant (< 0.5 cc) at the time of radical prostatectomy.
Serum Prostate Specific Antigen as a Predictor of Survival in Prostate Cancer Patients Treated with Second‐Line Hormonal Therapy (CALGB 9181)
Authors: Halabi Susan , Conaway Mark R. , Small Eric J. , Vogelzang Nicholas J. , Dawson Nancy A. 
Published: March 2003

ABSTRACTObjectives: To explore whether serum prostate specific antigen (PSA) decline can be used as a prognostic factor for survival among patients with androgen‐independent prostate cancer (AIPC) who are treated with a secondary hormonal therapy, megestrol acetate.Materials and Methods: One hundred forty‐nine patients were randomized with equal probability to either low‐dose (160 mg/day) or high‐dose (640 mg/day) megestrol acetate. Patients were stratified on performance status (0–1, or 2) and on disease measurability (measurable, or evaluable disease).Results: Patients with high pretreatment PSA (≥95 ng/ml) had worse survival times than patients with low PSA (<95), with a hazard ratio of 1.6 (p = 0.003). The median survival times for patients with a ≥50% reduction in PSA at 8 weeks and those patients without a 50% reduction were 15 and 11 months, respectively (p = 0.763). A landmark analysis at 8 weeks showed that a PSA decline was significantly associated with survival. The survival time for patients whose PSA dropped below the pretreatment levels (median = 15 months) were significantly longer than for patients who did not have a decline in PSA (median = 9 months, p = 0.031). Similar significant results were observed between PSA reduction and survival when landmark analyses were performed at 12 and 16 weeks. PSA changes during the first 45 days after the initiation of therapy were significantly related to survival. The median survival time for patients whose PSA doubled during the first 45 days after treatment and for patients whose PSA did not double during the first 45 days were 10 and 14 months, respectively (p = 0.020).Conclusions: PSA decline is significantly associated with longer survival times in prostate patients treated with secondary hormonal manipulation. Longer survival time is observed among the following AIPC patients: 1) those whose pretreatment PSA were <95 ng/ml: 2) those whose PSA decline was >0% from baseline; and 3) those whose PSA did not double during the first 45 days of therapy. If these observations are generalizeable, PSA decline as a criterion of response could be used to rapidly approve new agents in patients treated with second‐line hormonal therapy.
What to Do When the End Is Near: Ethical Issues in Home Health Care Nursing
Authors: Ladd Rosalind Ekman , Pasquerella Lynn , Smith Sheri 
Published: March 2003

As managed care shortens the length of hospital stays, home settings for the practice of nursing will become increasingly important. In spite of community health nursing's long tradition of family‐centered care delivered in the home, many discussions of the nurse/patient relationship in the medical ethics literature assume the hospital setting for the practice of nursing and seem to neglect the impact of family and significant others for the nurse/patient relationship. Through a case‐based analysis, this article highlights the special ethical and legal issues encountered in caring for patients who are dying at home.This analysis demonstrates that traditional frameworks for the nurse/patient relationship are inadequate for capturing the richness of the relationship the home health care nurse has with both patient and family. By developing a new framework for the nurse/patient/family relationship that (a) recognizes the patient's decision‐making authority and autonomy, (b) allows the exercise of the nurse's moral rights, and (c) recognizes the patient's relationships to significant others, the authors attempt to resolve some challenging legal and ethical questions concerning who should be allowed to decide what to do when the end is near. The discussion details the implications of this framework for nursing assessment in the home care setting.
Clinical Thermofiltration: Initial Application
Authors: Nosé Yukihiko , Usami Makoto , Malchesky Paul S. , Emura Muneo , Horiuchi Takashi , Sakamoto Hiroyuki , Smith James W. 
Published: March 2003

Guest Editor's Introduction: This paper was submitted for publication in June 1985 and published in the “Thought and Progress” section of Artificial Organs, Vol. 9, No. 4, 1985, pages 425–427. The first clinical thermofiltration procedures (plasma filtration near and above normal physiologic temperature) were performed on a secondary hypercholesterolemia patient. The intent of this filtration scheme is the selective removal of low density lipoprotins (LDL) and maintenance of high density limpoproteins (HDL) and other essential plasma proteins including albumin. The EVAL 4A filter, at a filtration temperature of 37°C, was selected for on‐line thermofiltration. The sieving coefficients of LDL + very low density lipoproteins (VLDL) cholesterol, HDL cholesterol, and albumin were 0.02, 0.75, and 0.78, respectively. These results were comparable to in vitro filtration tests using the plasma of the same patient. This system is simple to apply and does not require replacement solution. Compared with plasma exchange, a high return of HDL and other essential plasma solutes can be returned to the patient by this method.Abstract: The first clinical thermofiltration procedures (plasma filtration near or above normal physiologic temperature) were performed on a secondary hypercholesterolemia patient. The intent of this filtration scheme is the selective removal of low density lipoproteins (LDL) and maintenance of high density lipoproteins (HDL) and other essential plasma proteins including albumin. The EVAL 4A filter, at a filtration temperature of 37°C, was selected for on‐line thermofiltration. The sieving coefficients of LDL + very low density lipoproteins (VLDL) cholesterol, HDL cholesterol, and albumin were 0.02, 0.75, and 0.78, respectively. These results are comparable to in vitro filtration tests using the plasma of the same patient. This system is simple to apply and does not require replacement solution. Compared with plasma exchange, a high return of HDL and other essential plasma solutes can be returned to the patient by this method.
Vegetation Monitoring of Created Dune Swale Wetlands, Vandenberg Air Force Base, California
Authors: Parikh Anuja , Gale Nathan 
Published: March 2003

AbstractA monitoring program was established on San Antonio Terrace at Vandenberg Air Force Base to compare vegetation development at two created wetland sites and six nearby natural wetlands. The reference wetlands were chosen to represent a range of habitats in dune swale wetlands on the Terrace. Vegetation in the reference wetland plant communities varies from low‐growing herbaceous marsh species with open canopies to closed canopies dominated by shrub or tree species. Transects and plots for long‐term vegetation monitoring were established in all the wetlands, stratified by plant communities in the reference wetlands and by geomorphic location in the newly created wetlands. Quantitative vegetation and environmental data were collected at all the sites; measures included species distributions, species cover, and topographical elevations. Over the first three years of monitoring, variations in groundwater depth at different geomorphic locations in the created wetlands resulted in a variety of physical conditions for plant growth. In the first year, more than 100 plant species were observed, the majority being natives. During the next two years, species richness at the created wetland sites remained relatively stable and was higher than at the reference sites. Statistical comparisons of vegetation parameters by analysis of variance and hierarchical clustering exhibited patterns of increasing similarity between the created and reference wetlands. Long‐term monitoring will be continued to track the progress of vegetation at the created sites, and to assess their development relative to the reference wetlands.
Restoration and Rehabilitation of Species‐Rich Grassland Ecosystems in France: a Review
Authors: Muller S. , Dutoit T. , Alard D. , Grévilliot F. 
Published: March 2003

AbstractIn France the alteration of species‐rich grasslands is due mainly to agriculture and civil engineering projects (roadways, dams, ski resorts, etc.). The restoration of such ecosystems has been tested in many regions and after many sorts of degradation. According to the level of initial degradation, different responses can be envisioned. Some variations are presented of a general model of restoration and rehabilitation: (1) rejuvenation of fallow land by grazing with rustic animal breeds in wetlands or chalk grasslands in south and northwestern France, (2) restoration by recovery of extensive agricultural management in intensive agricultural areas such as the Rhône or Meuse Valleys, and (3) rehabilitation by appropriate ecological engineering carried out in grasslands degraded by intensification, ski‐track, or civil engineering installations. Despite some positive results, these undertakings have not always had the expected effects and therefore should not provide alibis for the destruction of natural grasslands. In general, the success of such undertakings depends on the maintenance in the surrounding areas of protected seed source reservoirs and on the persistence of a diversified landscape pattern permitting connectivity between these seed sources and the restoration or rehabilitation sites.
Nitrogen Addition Could Shift Plant Community Composition in a Restored California Salt Marsh
Authors: Boyer Katharyn E. , Zedler Joy B. 
Published: March 2003

AbstractAt a salt marsh restoration site, fertilizer trials to improve height growth of Spartina foliosa (a C4 perennial grass that can reach 140 cm) appeared to favor Salicornia bigelovii (an annual C3 succulent under 40 cm tall) where the two species co‐occurred on the marsh plain. This observation prompted a field experiment to examine the potential for nitrogen (N) addition to shift community composition. Without N addition, total stem length and stem density of S. foliosa did not respond to the presence or absence of S. bigelovii. But where N was added, S. foliosa growth increased only where S. bigelovii was removed from plots. S. bigelovii responded strongly to fertilizer, with mean heights matching those of S. foliosa and 600% increases in biomass, branching, and seed production (to more than 1 million seeds/m2). Soil N also increased seasonally where S. bigelovii was present, suggesting that this species may aid accumulation of N at restoration sites with poor soils. S. foliosa growth is greatest at lower elevations along tidal creeks where it occurs alone. Beyond creek edges, where S. bigelovii and other potential competitors occur, S. foliosa is unlikely to grow tall even with N addition. Thus, there is little point in trying to force mixed‐species stands to provide tall S. foliosa for nesting by an endangered bird, Rallus longirostris levipes (the Light‐footed Clapper Rail). A marsh construction design that maximizes tidal creek edges is thus recommended when restoration goals include providing habitat for clapper rails.
Comparative Study of Ant Communities of Rehabilitated Mineral Sand Mines and Heathland, Western Australia
Authors: Bisevac L. , Majer J. D. 
Published: March 2003

AbstractWe conducted a survey of ants in April 1997 in seven rehabilitated (2‐ to 20‐year‐old) and three native heathland reference sites of the Renison Goldfields Corporation (RGC) Mineral Sands operations at Eneabba, Western Australia. We employed a variety of collecting methods, including pitfall trapping, litter and soil sampling, sweeping and beating of vegetation, and collecting by hand in the day and after dark, replicating those used by previous researchers in a similar study conducted in the same area in 1980. We found a total of 96 ant species representing 30 genera in 1997, compared with 46 species from 18 genera in 1980. Ant species richness increased with age of rehabilitation and exceeded that of heath controls by the time it reached 11 years. Ant species richness related to rehabilitation age was represented by a logarithmic curve, and the slope for current rehabilitation was steeper than that for the earlier rehabilitation studied in 1980. This probably reflects improved rehabilitation practices. Ordination of the sites in terms of ant species composition indicated differences between ant species in the rehabilitated sites studied in 1980 and 1997, and also between all rehabilitated sites and heath controls. Classification of the sites in terms of the distribution of ants across functional groups also indicated differences between rehabilitation and heath control sites. According to species composition and functional group profiles from rehabilitated and control sites, we concluded that although the current rehabilitation allows for a rapid return of ant species, even after 20 years the fauna still had not attained the composition of the original heath fauna.
The Role of White Clover in the Loss of Diversity in Grassland Habitat Restoration
Authors: Warren John M. 
Published: March 2003

AbstractA field experiment was designed to recreate a species‐rich mesotrophic grassland community of conservation worth. Trifolium repens (white clover) was observed to increase significantly in both frequency and abundance in sown plots grazed by cattle, but not in plots cut in June and subsequently grazed by cattle. In both these treatments permanent quadrats containing clover patches were found to be lower in species richness than were quadrats without clover. In both treatments botanical diversity was seen to decline over time. In the grazed‐only treatment the loss of diversity may be linked to the increase in clover. In the cut and grazed plots, T. repens did not become so abundant but diversity was still seen to decline, possibly due to the loss of low growing species from the taller sward. A pot experiment which varied the sowing density of a mix of seven wild flower species in full factorial combination with cutting frequency was established on soils from an arable field also sown with a single density of clover. T. repens was seen to decline from initial high cover estimates in infrequently cut and uncut treatments. In the pot experiment where a grass component to the vegetation was absent, clover was seen to have less impact on the other forbs than it did in the field. It is suggested that, being a nitrogen fixer, T. repens may have a competitive edge in ex‐arable soils low in available nitrogen. The observed reduction in botanical diversity may be a result of this increase in available nitrogen, facilitating the spread of the sown grasses and preventing the recovery of the sown forbs that were excluded by the invasion of T. repens. It is suggested that reducing the proportion of grass in the seed mixtures during grassland habitat creation on these soils may help reduce or delay this effect.
Logs and Fern Patches as Recruitment Sites in a Tropical Pasture
Authors: Slocum Matthew G. 
Published: March 2003

AbstractForest recovery in degraded pastures is often highly variable, possibly due to variation in the availability of adequate recruitment sites. In an actively grazed pasture in northeastern Costa Rica, this study examines how recruitment of woody species in patches of the fern Nephrolepsis sp. and near logs compares with recruitment in grassy areas. Fern patches and logs had five and eight times higher densities of woody recruits, respectively, as grassy areas. They also had more than twice the species richness and growth as grassy areas. Grass apparently presents a competitive barrier against invading woody recruits, and also attracts cattle that may trample and/or consume recruits. Both logs and patches of fern appeared to provide superior conditions for establishment and growth of woody species, and they did not attract cattle. This study suggests that fern patches and logs can be managed to accelerate forest succession.
Seed Availability as a Limiting Factor in Forest Recovery Processes in Costa Rica
Authors: Wijdeven Sander M. J. , Kuzee Mirjam E. 
Published: March 2003

AbstractAbandoned pastures and secondary forests are increasingly prominent features of tropical landscapes. Forest regrowth on abandoned pastures is generally slow and virtually limited to regeneration from seeds from external sources, since agricultural activities alter site conditions. We hypothesize that seed availability is a major limiting factor in forest recovery on abandoned pastures. This hypothesis was tested by studying the seed bank, seed rain, and seed predation in a small pasture (1 ha) situated in a forest‐pasture mosaic in northwestern Costa Rica. The tree seed density in the pasture seed bank was much lower (21/m2) than the density in the seed bank of a neighboring secondary forest (402/m2). Within a period of five weeks, 23 tree seeds entered the pasture by seed rain. This number is low compared to densities found in closed forests but higher than densities reported in other studies where virtually no seeds were found beyond 20 m from the forest edge. Possibly the small size of the pasture with seed sources nearby and the small‐scale landscape mosaic enhance seed dispersal. Predation limits the seed density in pastures, with 42% of the woody species consumed by predators. The low seed density in the seed bank, and hampered recruitment combined with significant losses, pose severe restrictions to forest recovery on abandoned pastures. Moderate land use, and small sized clearings with seed sources nearby may increase the pace of recovery. Nevertheless, forest establishment may still take a considerable time. Thus, enlarging the available pool of species may be a worthwhile management strategy.
Determining the Pattern of Oak Woodland Regeneration for a Cleared Watershed in Northwest California: A Necessary First Step for Restoration
Authors: Brooks Colin N. , Merenlender Adina M. 
Published: March 2003

AbstractHistorically, oak woodlands of northern California have been subject to intensive tree and brush removal efforts to improve land for livestock grazing. As a result of this tree removal, these watersheds are susceptible to soil erosion and stream degradation. Therefore, planting woody vegetation is often required to restore watershed function. Prior to such actions, a thorough understanding of natural vegetation regeneration patterns is essential. The physical and biological attributes of natural vegetation regeneration in a cleared watershed were characterized using remote sensing, a Geographic Information System, and field surveys. A 79‐ha watershed at the University of California's Hopland Research and Extension Center was examined because the clearing of vegetation was part of a well‐documented experiment in the early 1960s, providing essential baseline data. The results of this study reveal that significantly more oak regeneration, consisting mostly of evergreen oaks, occurred on moister and steeper northerly slopes. Deciduous oaks, located primarily on drier and less steep southerly slopes, have not regenerated. Hardwood regeneration was associated with Josephine, Los Gatos, and Maymen soils. The distribution of hardwood regeneration is clustered, suggesting that the presence of other trees may promote regeneration. These results also suggest that without active restoration efforts such as tree planting and seedling protection, southerly slopes will most likely remain barren and erosion will continue, while northerly slopes and riparian areas will recover under the current land management practices. Despite some woody plant regeneration, the once densely forested watershed is now predominantly grassland, emphasizing the need to minimize clearing of California oak woodlands.