Trastuzumab use and risk of congestive heart failure in older breast cancer patients

Trastuzumab is a humanized-monoclonal antibody, developed specifically for HER2-neu over-expressed breast cancer patients. Although highly effective and well tolerated, it was reported associated with Congestive Heart Failure (CHF) in clinical trial settings (up to 27%). This leaves a gap where, Trastuzumab-related CHF rate in general population, especially older breast cancer patients with long term treatment of Trastuzumab remains unknown. This thesis examined the rates and risk factors associated with Trastuzumab-related CHF in a large population of older breast cancer patients. A retrospective cohort study using the existing Surveillance, Epidemiology and End Results (SEER) and Medicare linked de-identified database was performed. Breast cancer patients ≥ 66 years old, stage I-IV, diagnosed in 1998-2007, fully covered by Medicare but no HMO within 1-year before and after first diagnosis month, received 1st chemotherapy no earlier than 30 days prior to diagnosis were selected as study cohort. The primary outcome of this study is a diagnosis of CHF after starting chemotherapy but none CHF claims on or before cancer diagnosis date. ICD-9 and HCPCS codes were used to pool the claims for Trastuzumab use, chemotherapy, comorbidities and CHF claims. Statistical analysis including comparison of characteristics, Kaplan-Meier survival estimates of CHF rates for long term follow up, and Multivariable Cox regression model using Trastuzumab as a time-dependent variable were performed. Out of 17,684 selected cohort, 2,037 (12%) received Trastuzumab. Among them, 35% (714 out of 2037) were diagnosed with CHF, compared to 31% (4784 of 15647) of CHF rate in other chemotherapy recipients (p<.0001). After 10 years of follow-up, 65% of Trastuzumab users developed CHF, compared to 47% in their counterparts. After adjusting for patient demographic, tumor and clinical characteristics, older breast cancer patients who used Trastuzumab showed a significantly higher risk in developing CHF than other chemotherapy recipients (HR 1.69, 95% CI 1.54 - 1.85). And this risk is increased along with the increment of age (p-value < .0001). Among Trastuzumab users, these covariates also significantly increased the risk of CHF: older age, stage IV, Non-Hispanic black race, unmarried, comorbidities, Anthracyclin use, Taxane use, and lower educational level. It is concluded that, Trastuzumab users in older breast cancer patients had 69% higher risk in developing CHF than non-Trastuzumab users, much higher than the 27% increase reported in younger clinical trial patients. Older age, Non-Hispanic black race, unmarried, comorbidity, combined use with Anthracycline or Taxane also significantly increase the risk of CHF development in older patients treated with Trastuzumab. ^

Impact of Liquid Swine Manure Application and Cover Crops on Ground Water Quality

The primary objective of this project was to determine the impact of appropriate rates of swine manure applications to corn and soybeans based on nitrogen and phosphorus requirements of crops, soil phosphorus accumulation, and the potential of nitrate and phosphorus leaching to groundwater. Another purpose of this long-term experimental study was to develop and recommend appropriate manure and nutrient management practices to producers to minimize the water contamination potential and enhance the use of swine manure as inorganic fertilizer. A third component of this study was to determine the potential effects of rye as a cover crop to reduce nitrate loss to shallow ground water.

Retreat of top cliff of Kurungnakh Island, Lena Delta, Siberia, Russia, 2010-2014, with links to shapefiles

Thawing-induced cliff top retreat in permafrost landscapes is mainly due to thermo-erosion. Ground-ice-rich permafrost landscapes are specifically vulnerable to thermo-erosion and may show high degradation rates. Within the HGF Alliance Remote Sensing and the FP7 PAGE21 permafrost programs we investigated how SAR and optical remote sensing can contribute to the monitoring of erosion rates of ice-rich cliffs in Arctic Siberia (Lena Delta, Russia). We produced two different vector products: i) Intra-annual cliff top retreat based on TerraSAR-X (TSX) satellite data (2012-2014): High-temporal resolution time series of TSX satellite data allow the inter-annual and intra-annual monitoring of the upper cliff-line retreat also under bad weather conditions and continuous cloud coverage. This published SAR product contains the retreating upper cliff lines of a 1.5 km long part of eroding ice-rich coast of Kurungnakh Island in the central Lena Delta. The upper cliff line was mapped using a thresholding approach for images acquired in the years 2012, 2013 and 2014 for the months June (2013, 2014), July (2013, 2014), August (2012, 2013, 2014) and September (2013, 2014). The cliff top retreat vector product is called 'upper_cliff_TerraSAR-X'. While the 2014 cliff lines show a clear retreat of 2 to 3 m/month, the cliff top lines for 2012 and 2013 are not chronologically ordered. However, lines from the end of the season of a year are always close to the lines from the beginning of the next summer season, indicating low cliff retreat in winter. ii) 4-year cliff top retreat based on optical satellite data (2010-2014): Long-term cliff top retreat could be assessed with two high-spatial resolution optical satellite images (GeoEye-1, 2010-08-05 and Worldview-1, 2014-08-19). The cliff top retreat vector product is called 'upper_cliff_optical'. Results: The long-term cliff top retreat derived from optical satellite data are 35 m cliff retreat within 4 years. The higher-temporal resolution SAR data equivalently show long-term rates of 18 m within 2 years and nearly now degradation activities in winter but maximum erosion rates in summer months.The Intra-seasonal cliff top retreat lines from 2014 show a rate of 2 to 3 m per month.

Faecal pellet production of copepoda collected in water depth up to 30 meters in the eastern Mediterranean Sea in Oktober 2008 during SES_GR2

Mesozooplankton is collected by vertical tows within the Black sea water body mass layer in the NE Aegean, using a WP-2 200 µm net equipped with a large non-filtering cod-end (10 l). Macrozooplankton organisms are removed using a 2000 µm net. A few unsorted animals (approximately 100) are placed inside several glass beaker of 250 ml filled with GF/F or 0.2 µm Nucleopore filtered seawater and with a 100 µm net placed 1 cm above the beaker bottom. Beakers are then placed in an incubator at natural light and maintaining the in situ temperature. After 1 hour pellets are separated from animals and placed in separated flasks and preserved with formalin. Pellets are counted and measured using an inverted microscope. Animals are scanned and counted using an image analysis system. Carbon- Specific faecal pellet production is calculated from a) faecal pellet production, b) individual carbon: Animals are scanned and their body area is measured using an image analysis system. Body volume is then calculated as an ellipsoid using the major and minor axis of an ellipse of same area as the body. Individual carbon is calculated from a carbon- total body volume of organisms (relationship obtained for the Mediterranean Sea by Alcaraz et al. (2003) divided by the total number of individuals scanned and c) faecal pellet carbon: Faecal pellet length and width is measured using an inverted microscope. Faecal pellet volume is calculated from length and width assuming cylindrical shape. Conversion of faecal pellet volume to carbon is done using values obtained in the Mediterranean from: a) faecal pellet density 1,29 g cm**3 (or pg µm**3) from Komar et al. (1981); b) faecal pellet DW/WW=0,23 from Elder and Fowler (1977) and c) faecal pellet C%DW=25,5 Marty et al. (1994).

Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days

BACKGROUND: From 2001 to March 2006, Planned Parenthood Federation of America (Planned Parenthood) health centers throughout the United States provided medical abortions principally by a regimen of oral mifepristone, followed 24-48 h later by vaginal misoprostol. In late March 2006, analyses of serious uterine infections following medical abortions led Planned Parenthood to change the route of misoprostol administration and to employ additional measures to minimize subsequent serious uterine infections. In August 2006, we conducted an extensive audit of medical abortions with the new buccal misoprostol regimen so that patients could be given accurate information about the success rate of the new regimen. OBJECTIVES: We sought to evaluate the effectiveness of the buccal medical abortion regimen and to examine correlates of its success during routine service delivery. METHODS: In 2006, audits were conducted in 10 large urban service points to estimate the success rates of the buccal regimen. Success was defined as medical abortion without vacuum aspiration. These audits also permitted estimates of success rates with oral misoprostol following mifepristone in a subset in which 98% of the subjects stemmed from two sites. RESULTS: The effectiveness of the buccal misoprostol-mifepristone regimen was 98.3% for women with gestational ages below 60 days. The oral misoprostol-mifepristone regimen, used by 278 women with a gestational age below 50 days, had a success rate of 96.8%. CONCLUSION: In conjunction with 200 mg of mifepristone, use of 800 mcg of buccal misoprostol up to 59 days of gestation is as effective as the use of 800 mcg of vaginal misoprostol up to 63 days of gestation.

Physical properties and accumulation rates in Dronning Maud Land, Antarctica

The European Programme for Ice Coring in Antarctica includes a comprehensive pre-site survey on the inland ice plateau of Dronning Maud Land, Antarctica. The German glaciological programme during the 1997/98 field season was carried out along a 1200 km traverse on Amundsenisen and involved sampling the snow cover in pits and by shallow firn cores. This paper focuses on the accumulation studies. The cores were dated by dielectric-profiling and continuous-flow analysis. Distinct volcanogenic peaks and seasonal signals in the profiles served to establish a depth time-scale. The eruptions of Krakatoa, Tambora, an unknown volcano, Kuwae and El Chichon are well-documented in the ice. Variations of the accumulation rates over different times were inferred from the depth time-scales. A composite record of accumulation rates for the last 200 years was produced by stacking 12 annually resolved records. According to this, accumulation rates decreased in the 19th century and increased in the 20th century. The recent values are by no means extraordinary, as they do not exceed the values at the beginning of the 19th century. Variations in accumulation rates are most probably linked to temperature variations indicated in d18O records from Amundsenisen.

Nitrification rates in the NW Mediterranean Sea

During spring, ammonium oxidation and nitrite oxidation rates were measured in the NW basin of the Mediterranean Sea, from mesotrophic sites (Ligurian Sea and Gulf of Lions) to oligotrophic sites (Balearic Islands). Nitrification rates (average values for 37 measurements) ranged from 72 to 144 nmol of N oxidised/l/d, except in the Rhône River plume area where the rates increased to 264-504 nmol/l/d because of the riverine inputs of nitrogen. Maximal rates were located around the peak of nitrite within the nitracline at about 40 to 60 m and just above the phosphacline. At 1 station, relatively high values of nitrification (50 to 130 nmol/l/d) were also measured deep in the water column (240 m). Day-to-day variations were measured demonstrating the response within a few hours to hydrological stress (wind-induced mixing of the water column) and showing the role of hydrological characteristics on the distribution of nitrification rates. Because of the homogenous temperature (13°C) in the Mediterranean Sea, the spatial (geographical and vertical) fluctuations of nitrifying rates were linked to the presence of substrate due to mineralisation processes and/or Rhône River inputs. We estimate the contribution of nitrate produced by nitrification to the N demand of phytoplankton to range from 16% at mesotrophic to 61% at oligotrophic stations.

Middle Miocene to recent sedimentological record of ODP sites 177-1088 and 177-1092

During Leg 177 of the Ocean Drilling Program (ODP), well-preserved Middle Miocene to Pleistocene carbonate-rich sediment records were recovered on a north-south transect through the south-eastern Atlantic sector of the Southern Ocean at Site 1088 on the Agulhas Ridge and Site 1092 on Meteor Rise. Both sites were dominated by the deposition of calcareous nannofossil oozes through the Miocene, indicating low biological productivity in warm to temperate surface waters. A continuous increase in the proportions of foraminifera since the latest Miocene (6.5 Ma) points to enhanced nutrient supply, possibly related to the global 'biogenic bloom' event across the Miocene-Pliocene boundary. Since the Late Pliocene, different styles of biological productivity developed between the sites. Enhanced deposition of biosiliceous constituents at the southern Site 1092, particularly in the Early Pleistocene, is consistent with the formation of the Circum-Antarctic Opal Belt since 2.5 Ma in a setting near the Polar Front, whereas carbonate deposition still prevailed at the northern Site 1088 situated near the Subtropical Front. Clay-mineral tracers of water-mass advection together with the pattern of sedimentation rates and hiatuses reflect distinct pulses in the development of regional ocean circulation between 14 and 12 Ma, around 8 Ma and since 2.8 Ma. These pulses can be related to Antarctic ice-sheet extension that mediates the production and flow of southern source water, and stepwise increases in North Atlantic Deep Water production that drives global conveyor circulation. At Site 1088, illite chemistry and silt/clay ratios of the terrigenous sediment fraction reflect the history of terrestrial climate in southern Africa, with humid conditions prior to the Early Late Miocene (9.7 Ma), followed by a dry episode until 7.7 Ma. The latest Miocene and Early Pliocene were characterized by a humid episode until modern aridity was established in the Late Pliocene between 4.0 and 2.8 Ma. These climate changes were related to the latitudinal migration of climate belts in response to tectonically caused reorganizations in atmospheric and ocean circulation.

Organic matter in sediments of ODP Site 131-808

Microscopic studies reveal a predominance of terrestrial organic matter in sediments of Site 808. Terrestrial vitrinite and inertinite are more abundant (73% to 100%) than marine organic matter (alginite, 0% to 27%), which increases from open oceanic deposits of the Shikoku Basin sediments to sediments of the outer trench wedge. The abundance of terrestrial organic matter is also reflected through carbon isotope values of -23 per mil to -25.9 per mil. Mass accumulation rates of organic carbon are low in hemipelagic sediments of the Shikoku Basin (<0.2 g/cm**2/k.y.) but increase significantly in sediments of the Nankai Trench (0.2 to 1.7 g/cm**2/k.y.). Although the organic mass accumulation is high in sediments of the Nankai Trench, a comparison of sedimentation rates and total organic carbon suggests relative dilution of organic carbon through turbidite flows. Calculated marine paleoproductivity of organic carbon is low in sediments of the open ocean (Shikoku Basin) and increases closer to the shore (Nankai Trench). Thermal evolution of organic matter is obtained from vitrinite reflectance measurements. Two populations of vitrinites have been observed between 600 and 1234 mbsf. Reflectance values change with increasing depth and temperature in both groups of vitrinite (0.3% to 0.68% in group 1; 0.6% to 1% in group 2).

Spatial database of canopy plant densities created from satellite images over Galapagos in 2011, with intent to manage invasive species

Mapping is an important tool for the management of plant invasions. If landscapes are mapped in an appropriate way, results can help managers decide when and where to prioritize their efforts. We mapped vegetation with the aim of providing key information for managers on the extent, density and rates of spread of multiple invasive species across the landscape. Our case study focused on an area of Galapagos National Park that is faced with the challenge of managing multiple plant invasions. We used satellite imagery to produce a spatially-explicit database of plant species densities in the canopy, finding that 92% of the humid highlands had some degree of invasion and 41% of the canopy was comprised of invasive plants. We also calculated the rate of spread of eight invasive species using known introduction dates, finding that species with the most limited dispersal ability had the slowest spread rates while those able to disperse long distances had a range of spread rates. Our results on spread rate fall at the lower end of the range of published spread rates of invasive plants. This is probably because most studies are based on the entire geographic extent, whereas our estimates took plant density into account. A spatial database of plant species densities, such as the one developed in our case study, can be used by managers to decide where to apply management actions and thereby help curtail the spread of current plant invasions. For example, it can be used to identify sites containing several invasive plant species, to find the density of a particular species across the landscape or to locate where native species make up the majority of the canopy. Similar databases could be developed elsewhere to help inform the management of multiple plant invasions over the landscape.

Accumulation, velocities, fluxes and mass balance of glacial tributaries to the Lambert Glacier-Amery Ice Shelf system, Antarctica

By incorporating recently available remote sensing data, we investigated the mass balance for all individual tributary glacial basins of the Lambert Glacier-Amery Ice Shelf system, East Antarctica. On the basis of the ice flow information derived from SAR interferometry and ICESat laser altimetry, we have determined the spatial configuration of eight tributary drainage basins of the Lambert-Amery glacial system. By combining the coherence information from SAR interferometry and the texture information from SAR and MODIS images, we have interpreted and refined the grounding line position. We calculated ice volume flux of each tributary glacial basin based on the ice velocity field derived from Radarsat three-pass interferometry together with ice thickness data interpolated from Australian and Russian airborne radio echo sounding (RES) surveys and inferred from ICESat laser altimetry data. Our analysis reveals that three tributary basins have a significant net positive imbalance, while five other subbasins are slightly positive or close to zero balance. Overall, in contrast to previous studies, we find that the grounded ice in Lambert Glacier-Amery Ice Shelf system has a positive mass imbalance of 22.9 ± 4.4 Gt/a. The net basal melting for the entire Amery Ice Shelf is estimated to be 27.0 ± 7.0 Gt/a. The melting rate decreases rapidly from the grounding zone to the ice shelf front. Significant basal refreezing is detected in the downstream section of the ice shelf. The mass balance estimates for both the grounded ice sheet and the ice shelf mass differ substantially from other recent estimates.

Effects of endophyte colonization of Vicia faba (Fabaceae) plants on the life

The effects of fungal endophytes Beauveria bassiana isolates ICIPE 279, G1LU3, S4SU1 and Hypocrea lixii isolate F3ST1 on the life-history of Phaedrotoma scabriventris and Diglyphus isaea, parasitoids of the pea leafminer Liriomyza huidobrensis, were studied in the laboratory. Parasitoids were allowed to parasitize 2nd-3rd L. huidobrensis larvae reared on endophytically-inoculated Vicia faba. In the control, parasitoids were reared on non-inoculated host plants. Parasitism, pupation, adult emergence and survival were recorded. No significant difference was observed between the control and the endophyte-inoculated plants in terms of parasitism rates of P. scabriventris (p = 0.68) and D. isaea (p = 0.45) and adult' survival times (p = 0.06). The survival period of the F1 progeny of P. scabriventris was reduced (p < 0.0001) in B. bassiana S4SU1 to 28 days as compared to more than 40 days for B. bassiana G1LU3, ICIPE 279 and H. lixii F3ST1. However, no significant difference (p = 0.54) was observed in the survival times of the F1 progeny of D. isaea. This study has therefore demonstrated the beneficial effects of both endophytes and parasitoids in L. huidobrensis population suppression.