Fidelio (Leonore); an opera in two acts, op. 72.

Ser. 20, no. 206 of Beethoven's Werke. Reprint Leipzig, Breitkopf & Hartel [1864-1890]

Randomized trial of 8 Gy in 1 versus 20 Gy in 5 fractions of radiotherapy for neuropathic pain due to bone metastases (Trans-Tasman Radiation Oncology Group, TROG 96.05)

Background and purpose: Despite numerous randomized trials investigating radiotherapy (RT) fractionation schedules for painful bone metastases, there are very few data on RT for bone metastases causing pain with a neuropathic component. The Trans-Tasman Radiation Oncology Group undertook a randomized trial comparing the efficacy of a single 8 Gy (8/1) with 20 Gy in 5 fractions (20/5) for this type of pain. Materials and methods: Eligible patients had radiological evidence of bone metastases from a known malignancy with no change in systemic therapy within 6 weeks before or anticipated within 4 weeks after RT, no other metastases along the distribution of the neuropathic pain and no clinical or radiological evidence of cord/cauda equina compression. All patients gave written informed consent. Primary endpoints were pain response within 2 months of commencement of RT and time to treatment failure (TTF). The hypothesis was that 8/1 is at least as effective as 20/5 and the planned sample size was 270 patients. Results: Between February 1996 and December 2002, 272 patients were randomized (8/1:20/5 = 137:135) from 15 centres (Australia 11, New Zealand 3, UK 1). The commonest primary cancers were lung (31%), prostate (29%) and breast (8%); index sites were spine (89%), rib (9%), other (2%); 72% of patients were males and the median age was 67 (range 2989). The median overall survival (95% CI) for all randomized patients was 4.8 mo (4.2-5.7 mo). The intention-to-treat overall response rates (95% Cl) for 8/1 vs 20/5 were 53% (45-62%) vs 61% (53-70%), P = 0.18. Corresponding figures for complete response were 26% (18-34%) vs 27% (19-35%), P = 0.89. The estimated median TTFs (95% CI) were 2.4 mo (2.0-3.3 mo) vs 3.7 mo (3.1-5.9 mo) respectively. The hazard ratio (95% Cl) for the comparison of TTF curves was 1.35 (0.99-1.85), log-rank P = 0.056. There were no statistically significant differences in the rates of re-treatment, cord compression or pathological fracture by arm. Conclusions: 8/1 was not shown to be as effective as 20/5, nor was it statistically significantly worse. Outcomes were generally poorer for 8/1, although the quantitative differences were relatively small. (c) 2004 Elsevier Ireland Ltd. All rights reserved.

A longitudinal controlled study of factors associated with mutans streptococci infection and caries lesion initiation in children 21 to 72 months old

Purpose: The purpose of this longitudinal study was to determine factors associated with mutans streptococci (MS) infection and development of caries lesions in a group of children 21 to 72 months old. Methods: The 63 caries-free children, recruited since birth, were divided into: (1) a study group of 24 children who were colonized with MS; and (2) a control group of 39 children without MS. The children were recalled every 3 months for approximately 24 months, and their social, medical, and dental histories were updated. At each recall, the teeth were checked for presence or absence of plaque, enamel hypoplasia, and caries lesions, and their MS status was assessed using a commercial test kit. Results: MS infection was associated with: (1) visible plaque (P < .01); (2) enamel hypoplasia (P < .05); (3) commencement of tooth-brushing after 12 months of age (P < .05); (4) lack of parental assistance with tooth-brushing (P < .025); and (5) increased hours of child care/school (P < .05). Four children (20%) were colonized at an age range of 21 to 36 months, 9 (45%) at 37 to 48 months, and 7 (35%) at 49 to 72 months (P < .001). Eight children who developed caries lesions: (1) had more hypoplastic teeth (P < .001); (2) ate sugar-containing snacks (P < .05); and (3) did not brush regularly with chlorhexidine gel (P < .01) compared to those who remained free of caries lesions. Conclusions: Lack of oral hygiene, consumption of sugar-containing snacks, and enamel hypoplasia are significant factors for both MS infection and caries lesion initiation.

International technology transfer and development of capabilities in Chinese state-owned manufacturing enterprises:lessons from 20 years of case research

Technological capabilities in Chinese manufacturing have been transformed in the last three decades. However, the extent to which domestic market oriented state owned enterprises (SOEs) have developed their capabilities is not clear. Six SOEs in the automotive, steel and machine tools sectors in Beijing and Tianjin have been studied since the mid-1990s to assess the capability levels attained and the role of external sources and internal efforts in developing them. Aided by government policies, acquisition of technology and their own efforts, the case study companies appear to be broadly following the East Asian late industrialisation model. All six enterprises demonstrate competences in operating established technology, managing investment and making product and process improvements. The evidence suggests that companies without foreign joint venture (JV) collaborations have made more progress in this respect.

Oxygen and carbon isotopic compositions of foraminifers at DSDP Hole 72-517

Oxygen and carbon isotope analyses were performed on monospecific or mixed-species samples of benthic foraminifers, as well as on the planktonic species Globigerinoides ruber from a 24-m hydraulic piston core raised on the western flank of the Rio Grande Rise, at DSDP Site 517 (30°56.81'S and 38°02.47'W, water depth 2963 m) in the southwestern Atlantic. This site is presently located in the core of North Atlantic Deep Water (NADW). This is the first long isotopic record of Quaternary benthic foraminifers; it displays at least 30 isotopic stages, 25 of them readily correlated with the standard sequence of Pacific Core V28-239. The depths of both the Bruhnes/Matuyama boundary and the Jaramillo Event based on oxygen isotope stratigraphy agree well with paleomagnetic results. Quaternary faunal data from this part of the Atlantic are dated through isotopic stratigraphy and partially contradict data previously published by Williams and Ledbetter (1979). There was a substantial increase in the size of the earth's major ice sheets culminating at Stage 22 and corresponding to a l per mil progressive increase of d18O maximal values. Further, ice volume-induced isotopic changes were not identical for different glacial cycles. Oxygen and carbon isotope analyses of benthic foraminifers show that during Pleistocene glacial episodes, NADW was cooler than today and that Mediterranean outflow might still have contributed to the NADW sources. The comparison of coiling ratio changes of Globorotalia truncatulinoides with planktonic and benthic oxygen isotope records shows that there might have been southward excursions of the Brazil Current during the Pleistocene, perhaps related to Antarctic surface water surges. The question of the location of NADW sources during glacial maxima remains open.

Annotated record of the detailed examination of Mn deposits from DSDP Site 20, Leg 3 (Holes 3-20, 3-20A and 3-20C)

Prior to arrival on this site, the only survey data available was from the Vema-20 crossing of the area. The recommended site location was over a relatively smooth valley in the bottom topography at about 4750 meters (15,580 feet) depth (uncorrected), about 10 kilometers wide E-W between peaks (or ridges) on either side. Sediment thickness was unknown. The center of the valley is near the peak of a wide (40 to 50 kilometers) positive magnetic anomaly, identified as Magnetic Anomaly 30 in the hypothesized geomagnetic time scale with an age of 72 million years.

El autocuidado y apoyo social de mujeres de un proyecto de seguimiento mamográfico en Porto Alegre/Brasil

Objective: Identify preventive self-care practices and analyze the configurations of the network support for women with and without breast cancer registered in a mammography-monitoring project from Porto Alegre/Brazil.Method: a mixed sequential delimitation was performed, which expanded the results of the quantitative step (cross and correlation section) in a qualitative step (narrative interviews). 37 women diagnosed with breast cancer (group 1) and 72 without this diagnosis (group 2 – monitoring) participated. The following instruments were used: Assessment Questionnaire Self-care Ability (ASA-A) and Assessment Questionnaire Perceived Social Support and Community. There were performed descriptive analysis and comparison of means (t test and ANOVA) between the two groups. To deepen the understanding of the data, we selected four women with breast cancer with extreme levels on the scale of Social Support to participate in the biographical narrative interviews.Results: the analysis indicate that women who had breast cancer have better self-care practices than the women from the monitoring project (t = 1.791, P = 0.027). As for the analysis of social support, there were no statistically significant differences between the two groups. All participants have an average level of perceived social and community support. It was highlighted by the qualitative data that it was after the diagnosis of breast cancer that women lived self-care aspects they had not previously experienced.Conclusions: the self-care was significantly bigger in the group of women with breast cancer, where the cancer diagnosis was a trigger to increase self-care.