bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of education level on outcome of patients treated on Radiation Therapy Oncology Group Protocol 90‐03
Authors: Konski Andre , Berkey Brian A. , Kian Ang K. , Fu Karen K. 
Published: September 2003

AbstractBACKGROUNDIt has been hypothesized that people in lower socioeconomic groups have worse outcomes because they present with advanced‐stage cancers or receive inadequate treatment. The authors investigated this hypothesis by using education level as a proxy for socioeconomic status in patients treated on Radiation Therapy Oncology Group (RTOG) Protocol 90‐03.METHODSRTOG 90‐03 was a Phase III randomized trial investigating four different radiation fractionation schedules in the treatment of locally advanced head and neck carcinomas. Overall survival and locoregional control rates were analyzed by education level as measured by patient response on the demographic form at study entry.RESULTSA significant difference was observed in the distribution of patients by education level between the standard fractionated radiation treatment arm and the hyperfractionated radiation treatment arm. More patients in the standard fractionated treatment arm had a higher education level (P= 0.018). Patients attending college had highly and significantly better overall survival and locoregional control than the other groups combined (P= 0.0056 andP= 0.025, respectively: from Cox proportional hazards models stratified by assigned treatment with educational level, T classification, N classification, Karnofsky performance status, primary site, and race). Multivariate analysis revealed that education level was significant for predicting both overall survival and locoregional control when comparing attended college/technical school compared with all other education levels.CONCLUSIONSPatients attending college or technical school had improved overall survival and locoregional control. These differences cannot be explained by differences in tumor stage or treatment. Poorer overall health or lack of support systems contributing to these results needs to be investigated further. Cancer 2003;98:1497–503. © 2003 American Cancer Society.DOI 10.1002/cncr.11661
The biology and therapy of adult acute lymphoblastic leukemia
Authors: Faderl Stefan , Jeha Sima , Kantarjian Hagop M. 
Published: September 2003

AbstractBACKGROUNDMuch progress has been made in understanding the biology of acute lymphoblastic leukemia (ALL). This has translated into the recognition of several subgroups of ALL and the institution of risk‐adapted therapies. New therapies are emerging based on the definition of specific cytogenetic‐molecular abnormalities.METHODSA review from the English literature, including original articles and related reviews from Medline (Pubmed) and abstracts based on publication of meeting material, was performed.RESULTSChanges in the pathologic classification of ALL have led to therapeutic consequences. Adaptation of successful treatment strategies in children with ALL has resulted in similar complete response rates in adults. Prognosis has especially improved in mature–B‐cell and T‐lineage ALL. The role of tyrosine kinase inhibitors in Philadelphia chromosome–positive ALL was evaluated in the current study. However, regardless of the ALL subgroup, long‐term survival of adults is still inferior to that in children.CONCLUSIONSIntense clinical and laboratory research is attempting to close the gap in outcome between children and adults with ALL. Investigations are focusing on 1) refinement of the basic treatment stratagem of induction, consolidation, and maintenance; 2) expansion of risk‐based, subgroup‐oriented therapies; 3) assessment of minimal residual disease, its impact on disease recurrence, and its practical implications in clinical practice; 4) salvage strategies; 5) the role of stem cell transplantation in ALL; and 6) the development of new drugs based on a better understanding of disease biology. Cancer 2003;98:1337–54. © 2003 American Cancer Society.
Alternative decision modelling techniques for the evaluation of health care technologies: Markov processes versus discrete event simulation
Authors: Karnon Jonathan 
Published: September 2003

AbstractMarkov models have traditionally been used to evaluate the cost‐effectiveness of competing health care technologies that require the description of patient pathways over extended time horizons. Discrete event simulation (DES) is a more flexible, but more complicated decision modelling technique, that can also be used to model extended time horizons. Through the application of a Markov process and a DES model to an economic evaluation comparing alternative adjuvant therapies for early breast cancer, this paper compares the respective processes and outputs of these alternative modelling techniques. DES displays increased flexibility in two broad areas, though the outputs from the two modelling techniques were similar. These results indicate that the use of DES may be beneficial only when the available data demonstrates particular characteristics. Copyright © 2002 John Wiley & Sons, Ltd.
Conservative versus aggressive follow up of mildly abnormal Pap smears: Testing for process utility
Authors: Birch Stephen , Melnikow Joy , Kuppermann Miriam 
Published: September 2003

AbstractEconomic evaluation generally limits outcome measurement to the valuation of health outcomes produced by interventions without considering the impact of processes on utility. We test for process utility by comparing utility measurements for alternative approaches to managing abnormal Pap smears in the context of a fixed outcome. The impact of health care interventions on individual well‐being was not confined to health outcomes. Aggressive and conservative follow‐up approaches were associated with statistically significant differences in utilities. We also found that relative preferences among different processes may depend on the particular circumstances or pathologies being considered. Copyright © 2003 John Wiley & Sons, Ltd.
Reflections on the optimal currency area (OCA) criteria in the light of EMU
Authors: Artis M.J. 
Published: September 2003

AbstractOptimal Currency Area (OCA) theory offers criteria for evaluating the optimality of monetary union arrangements. This paper reviews the use that has been made of these criteria in the specific context of European Monetary Union. It reviews the use of business cycle synchronization data and the data produced by SVAR analyses, which led to the ‘core–periphery’ distinction. It also reviews extensions of the criteria that have been proposed or generated in this context: in particular, the proposition that the criteria may be ‘endogenous’. It presents Taylor rule estimates to check for inhomogeneities in Euro Area performance. The paper concludes that OCA criteria provide a useful starting point for evaluating monetary union options. Copyright © 2003 John Wiley & Sons, Ltd.
The federal design of a central bank in a monetary union: The case of the European system of central banks
Authors: Eijffinger Sylvester C.W. 
Published: September 2003

AbstractIn this paper we analyse the ESCB as a federal central bank system. First, the degree of decentralization of the ESCB will be briefly compared with its predecessor, the Deutsche Bundesbank, and its counterweight in the US, the Federal Reserve System. Moreover, the development during the period 1990–99 of the total, economics and research staffing of the ECB and the national central banks in the EU will be investigated and also the staff ratios of the national central banks in 1999. Furthermore, the research activities of the central banks in the European Union over the period 1990–99 will be analysed both in terms of input (economics and research staff) and output (quality‐weighted number of articles in scientific journals). The share of economics research staff in total staff of the national central banks varies between 0.02 and 0.17. The ECB has the highest ratio between economists and researchers and other staff. A ranking of research performance based on the quality‐weighted number of scientific articles per economics and research employee reveals that the Bank of Finland has the best research performance of European central banks, followed by De Nederlandsche Bank, the Banco de Portugal and the Oesterreichische Nationalbank. There is only a weak relationship between the research performance and the share of research staff. The conclusion ‘small is beautiful’ also seems to hold for the economics and research departments of the European central banks. Copyright © 2003 John Wiley & Sons, Ltd.
Dollarization and economic performance: What do we really know?
Authors: Edwards Sebastian , Magendzo I. Igal 
Published: September 2003

AbstractIn this paper we analyse the macroeconomic record of dollarized economies. In particular, we investigate whether, as its supporters claim, dollarization is associated with lower inflation and faster growth. We analyse this issue by using a matching estimator technique developed in the training evaluation literature. Our findings suggest that inflation has been significantly lower in dollarized nations than in non‐dollarized ones. We also find that dollarized nations have had a lower rate of economic growth than non‐dollarized ones. Finally, we find that macroeconomic volatility is not significantly different across dollarized and non‐dollarized economies. We conjecture that the lower rate of economic growth in dollarized countries is due, at least in part, to these countries' difficulties in accommodating external disturbances, such as major terms of trade and capital flows shocks. Copyright © 2003 John Wiley & Sons, Ltd.
DNA‐binding characteristics of cnidarian Pax‐C and Pax‐B proteins in vivo and in vitro: No simple relationship with the Pax‐6 and Pax‐2/5/8 classes
Authors: Plaza Serge , De Jong Danielle M. , Gehring Walter J. , Miller David J. 
Published: September 2003

AbstractCnidarians are the simplest animals in which distinct eyes are present. We have previously suggested that cnidarian Pax‐Cam might represent a precursor of the Pax‐6 class. Here we show that when expressed in Drosophila imaginal discs, Pax‐Cam chimeric proteins containing the C‐terminal region of EY were capable of eye induction and driving expression of a reporter gene under the control of a known EY target (the sine oculis gene). Whilst these results are consistent with a Pax‐6‐like function for Pax‐Cam, in band shift experiments we were unable to distinguish the DNA‐binding behaviour of the Pax‐Cam Paired domain from that of a second Acropora Pax protein, Pax‐Bam. The ability of a Pax‐Bam/EY chimera to also induce eye formation in leg imaginal discs, together with the in vitro data, cast doubt on previously assumed direct relationships between cnidarian Pax genes and the Pax‐6 and Pax‐2/5/8 classes of bilateral animals. J. Exp. Zool. (Mol. Dev. Evol.) 299B:26–35, 2003. © 2003 Wiley‐Liss, Inc.
Breath‐hold signal‐loss sequence for the qualitative assessment of flow disturbances in cardiovascular MR
Authors: Keegan Jennifer , Gatehouse Peter D. , John Anna S. , Mohiaddin Raad H. , Firmin David N. 
Published: September 2003

AbstractPurposeTo develop a breath‐hold segmented sequence which generates similar patterns of signal loss to a non–breath‐hold, relatively long echo time, conventional gradient echo sequence for the qualitative assessment of valvular heart disease.Materials and MethodsBoth velocity‐sensitized and acceleration‐sensitized segmented sequences were developed. The sensitivities were empirically adjusted to give similar degrees of signal loss to a conventional sequence. These sequences were compared with a conventional sequence in eight patients with flow disturbances and in four healthy subjects.ResultsThere was no significant difference in the extent of signal loss observed when using the breath‐hold velocity‐ and acceleration‐sensitized sequences developed and the conventional sequence (1862 mm2, 1831 mm2, and 1782 mm2, respectively; P = ns). However, the image quality obtained was significantly better with the breath‐hold sequences (both P < 0.01). Furthermore, the image quality achieved with the acceleration‐sensitized sequence was significantly better than that achieved with the velocity‐sensitized sequence (P < 0.01) where artifacts from beat‐to‐beat variations in blood‐flow velocities were a frequent problem.ConclusionSignal loss in complex flow is best demonstrated using the breath‐hold acceleration‐sensitized sequence where the signal from both stationary and constant velocity material is rephased at the echo time.
Soil restorative effects of mulching on aggregation and carbon sequestration in a Miamian soil in central Ohio
Authors: Saroa G. S. , Lal R. 
Published: September 2003

AbstractSoils play a key role in the global carbon cycle, and can be a source or a sink of atmospheric carbon (C). Thus, the effect of land use and management on soil C dynamics needs to be quantified. This study was conducted to assess: (1) the role of aggregation in enhancing soil organic carbon (SOC) and total soil nitrogen (TSN) concentrations for different mulch rates, (2) the association of SOC and TSN with different particle size fractions, and (3) the temporal changes in the SOC concentration within aggregate and particle size fractions with duration of mulching. Two experiments were initiated, one each in 1989 and 1996, on a Crosby silt loam (Aeric Ochraqualf or Stagnic Luvisol) in central Ohio. Mulch treatments were 0, 8, and 16 Mg ha−1 yr−1 without crop cultivation. Soil samples from 0–5 cm and 5–10 cm depths were obtained in November 2000; 4 and 11 years after initiating the experiments. Mulch rate significantly increased SOC and TSN concentrations in the 0–5 cm soil layer only. The variation in the SOC concentration attributed to the mulch rate was 41 per cent after 4 years of mulching and 52 per cent after 11 years of mulching. There were also differences in SOC and TSN concentrations among large aggregate size fractions, up to 2 mm size after 4 years and up to 0ċ5 mm after 11 years of mulching. There were also differences in SOC and TSN concentrations among particle size fractions. Variation in the SOC concentration in relation to particle size was attributed to clay by 45–51 per cent, silt by 34–36 per cent, and to sand fraction by 15–19 per cent. Bulk of the TSN (62–67 per cent) was associated with clay fraction and the rest was equally distributed between silt and sand fractions. The enrichment of SOC and TSN concentrations in the clay fraction increased with depth. The C:N ratio was not affected by the mulch rate, but differed significantly among particle size fractions; being in the order of sand >silt >clay. Copyright © 2003 John Wiley & Sons, Ltd.
Surgery for early stage non‐small cell lung cancer
Authors: Chang Michael Y. , Sugarbaker David J. 
Published: September 2003

AbstractLung cancer accounts for 28.2% of all cancer‐related deaths in the United States. Most patients present with advanced‐stage disease, with only 15% having disease confined to the lung. Surgical resection is the optimal treatment for Stage I and II non‐small cell lung cancer. Pre‐resection staging includes various radiographic modalities, including PET scan and mediastinoscopy. Survival and local recurrence statistics favor full anatomic lobar resection over sublobar resection, although cases must be judged individually. Lobectomy via thoracoscopic approach appears to have equivalent outcome as lobectomy via thoracotomy. Characteristics of the counseling physician and the hospital volume at which the surgery is performed can also influence outcome. After surgical resection, stage IA patients have about 70% 5‐year survival, but this falls below 50% for stage IIB patients. Methods that identify early‐stage lung cancer patients at greatest risk for recurrence are needed to identify patients who may benefit from additional therapies. Semin. Surg. Oncol. 21:74–84, 2003. © 2003 Wiley‐Liss, Inc.
Surgery for locally advanced non‐small cell lung cancer
Authors: Grunenwald Dominique H. 
Published: September 2003

AbstractAdvanced stage non‐small lung cancers are currently considered unresectable. However numerous series on patients with locally advanced disease treated by surgery have been published. Surgery alone or induction treatments followed by surgery achieve long‐term outcomes in an encouraging proportion of selected patients with T4 disease, despite the high rate of morbidity associated with technically demanding procedures. Semin. Surg. Oncol. 21:85–90, 2003. © 2003 Wiley‐Liss, Inc.
Induction chemotherapy followed by radical local therapy for locally advanced non‐small cell lung cancer
Authors: Wendland Merideth M. M. , Sause William T. 
Published: September 2003

AbstractMany patients who receive a diagnosis of non‐small cell lung cancer (NSCLC) have locally advanced disease at initial presentation. Historically, these patients were treated with primary thoracic radiation therapy and had poor long‐term survival rates, secondary to both progression of local disease and development of distant metastases. With the goal of improving clinical outcomes, multiple concepts of combined‐modality therapy for locally advanced NSCLC have been investigated. The rationale for using chemotherapy in the induction regimen is to eliminate subclinical metastatic disease while improving local control. The optimal treatment of locally advanced NSCLC continues to evolve, but combined‐modality therapy has led to improved survival rates compared to treatment with radiation alone and has become the new standard of care. This report reviews the major trials that have investigated various combinations of surgery, radiation therapy, and chemotherapy in the treatment of locally advanced NSCLC. Semin. Surg. Oncol. 21:111–121, 2003. © 2003 Wiley‐Liss, Inc.
Limited‐disease small‐cell lung cancer
Authors: Zimmermann Frank B. , Bamberg Michael , Molls Michael , Jeremic Branislav 
Published: September 2003

AbstractSubstantial improvements in treatment outcome for limited‐disease small‐cell lung cancer (LD SCLC) have been achieved in the last two decades owing to the introduction of chemotherapy (CHT) consisting of cisplatin and etoposide (PE), and the understanding that thoracic radiation therapy (TRT) is an essential component in improving treatment outcome. In addition, a recent metaanalysis confirmed the importance of prophylactic cranial irradiation (PCI) in general treatment plans for patients who show a complete response to treatment. However, numerous questions remain unanswered regarding this disease. While TRT/PE/PCI is considered to be the standard treatment in the majority of centers worldwide, the emergence of new and effective drugs (e.g., topoisomerase I inhibitors and paclitaxel) for the treatment of LD SCLC will likely affect therapy strategies in the near future. Important issues regarding optimal doses and fractionation regimens, as well as the timing of TRT, remain to be resolved. While most centers currently use b.i.d. fractionation as a result of the Intergroup findings, high‐dose standard TRT may also be beneficial. TRT volumes are also considered an important issue, since they likely relate to the incidence of both local failure and toxicity. Finally, the optimization of PCI (total dose, fractionation regimen, and timing) is already under way. The value of surgery is limited to peripheral tumors and poorly responding cancer, and to confirm histology or improve local control and survival. Semin. Surg. Oncol. 21:156–163, 2003. © 2003 Wiley‐Liss, Inc.
Extensive‐stage small‐cell lung cancer
Authors: Spira Alexander , Ettinger David S. 
Published: September 2003

AbstractExtensive‐stage small‐cell lung cancer (ES‐SCLC) continues to be a difficult management issue. While response rates to therapy are relatively high, durable responses are rare, and long‐term survival rates are dismal. Although many attempts have been made to develop new therapies, cisplatin‐based combination chemotherapy remains the mainstay in the management of these patients. In this review we highlight recent developments in the treatment and management of this malignancy, and discuss future prospects in treatment. Semin. Surg. Oncol. 21:164–175, 2003. © 2003 Wiley‐Liss, Inc.
Curative approaches to lung cancer in the elderly
Authors: Weinmann Martin , Zimmermann Frank , Bamberg Michael , Jeremic Branislav 
Published: September 2003

AbstractLung cancer is a common disease in elderly patients, and the increase in the size of the elderly population will lead to an increased proportion of elderly among lung cancer patients in the future. The prognosis of lung cancer is still poor, but curative approaches are feasible for patients with local stage NSCLC and for some patients with limited disease (LD) SCLC. The evidence for these curatively‐intended approaches is derived from studies that are usually performed with highly selected patients. Elderly patients are underrepresented, and in daily clinical practice elderly patients are less likely to be treated with full standard approaches. We used the data from studies that focused particularly on the elderly, or provided subgroup information on age, to analyze the feasibility of applying current standard approaches to the elderly. We also discuss alternative approaches. Age alone is a very uncertain prognostic criterion for outcome or tolerability of treatment. It is much more important to obtain a comprehensive geriatric assessment of each individual patient. When adequate patient selection is provided, standard treatment approaches appear to be feasible for elderly (>70 years) patients with good performance status. Semin. Surg. Oncol. 21:182–189, 2003. © 2003 Wiley‐Liss, Inc.
New radiotherapy technologies
Authors: Rosenzweig Kenneth E. , Amols Howard , Ling C.C. 
Published: September 2003

AbstractConventional radiation therapy has had limited success in curing inoperable lung cancer due to poor local control. There is evidence to suggest that higher doses of radiation will improve local control. In order to safely deliver higher doses of thoracic radiation, advanced treatment techniques are required. Different biologic indices have been utilized to determine whether dose escalation can be safely accomplished, and the results have been reported from many institutions. Tumor motion control aids in treatment since it allows radiation oncologists to more accurately target tumors and therefore to spare more normal tissue from the radiation field. The imaging information from 18‐FDG‐PET scans also improves target delineation. Advanced treatment delivery techniques, such as three‐dimensional conformal radiation therapy, intensity modulated radiation therapy, and stereotactic radiosurgery are also being used to safely escalate the radiation dose. This article explores the current literature on these issues and other advanced radiation therapy techniques. Semin. Surg. Oncol. 21:190–195, 2003. © 2003 Wiley‐Liss, Inc.
Impaired disengagement from threatening cues of impending pain in a crossmodal cueing paradigm
Authors: Van Damme Stefaan , Crombez Geert , Eccleston Chris , Goubert Liesbet 
Published: September 2003

AbstractThis paper reports an experimental investigation of attentional engagement to and disengagement from cues of impending pain. Pain‐free volunteers performed a cueing task in which they were instructed to detect somatosensory and tone targets. Target stimuli were preceded by visual cues informing participants of the modality of the impending stimuli. Participants were randomly assigned to a pain group (n=54) or to a control group (n=53). Somatosensory targets consisted of painful electrocutaneous stimuli in the pain group and non‐painful vibrotactile targets in the control group. Analyses revealed a similar amount of attentional engagement to both cues signalling somatosensory targets, irrespective of their threat value. However, participants had significantly more difficulty in disengaging attention from a threatening cue of impending pain compared to a cue signalling the non‐painful vibrotactile target. Our findings provide further evidence that pain cues demand attention, particularly resulting in impaired disengagement.