Primary polyestradiol phosphate versus orchiectomy for advanced prostate cancer : Studies on the efficacy, cardiovascular complications and prognostic factors

Paikallisesti levinnyttä (T3-4 M0) ja luustoon levinnyttä (T1-4 M1) eturauhassyöpää sairastaneet potilaat satunnaistettiin kirurgiseen kastraatioon (orkiektomia) tai lääkkeelliseen kastraatioon lihaksensisäisellä polyestradiolifosfaatilla (PEP) annoksella 240 mg/kk. Verrattiin hoitojen kliinistä tehoa sekä sydän- ja verisuonikomplikaatioita (SV-komplikaatioita). Verrattiin myös hoitoa edeltäviä plasman testosteroni (T) ja estradioli (E2) pitoisuuksia T3-4 M0 ja T1-4 M1 potilaiden välillä sekä selvitettiin potilaiden yleistilan vaikutusta näihin hormonitasoihin. Lopuksi luotiin T1-4 M1 potilaille eturauhassyövän aiheuttaman kuoleman ennusteellinen riskiluokittelu kolmeen riskiryhmään käyttämällä hoitoa edeltäviä ennustetekijöitä. Kliinisessä tehossa ei orkiektomian ja PEP-hoidon välillä todettu tilastollisesti merkitsevää eroa. Odotetusti T1-4 M1 potilaiden ennuste oli huonompi kuin T3-4 M0 potilaiden. T1-4 M1 potilailla ei ollut SV-kuolemissa hoitoryhmien välillä tilastollista eroa, mutta ei-tappavia SV-komplikaatioita oli PEP ryhmässä (5.9%) enemmän kuin orkiektomia ryhmässä (2.0%). T3-4 M0 potilailla PEP-hoitoon liittyi tilastollisesti merkitsevä SV-kuolleisuus riski orkiektomiaan verrattuna (p = 0.001). PEP ryhmässä 67% kuolemista oli akuutteja sydäninfarkteja. Tämä PEP hoitoon liittyvä sydäninfarktiriski (mukaan lukien myös ei-tappavat sydäninfarktit) oli merkitsevästi pienempi potilailla, joiden hoitoa edeltävä E2 taso oli vähintään 93 pmol/l (p = 0.022). E2 taso oli merkitsevästi matalampi T1-4 M1 potilailla (74.7 pmol/l) kuin T3-4 M0 potilailla (87.9 pmol/l), mutta vastaavaa eroa ei ollut T tasoissa. Sekä T3-4 M0 että T1-4 M1 potilailla yleistilan lasku osittain selitti yksilöllisen T ja E2 tasojen laskun. Eturauhassyövän aiheuttaman kuoleman riskiryhmäluokittelu (Rg) kolmeen ryhmään luotiin käyttämällä alkalista fosfataasia (AFOS), prostata spesifistä antigeenia (PSA), laskoa (La) ja potilaan ikää. Yksi riskipiste annettiin, jos AFOS > 180 U/l (tällä hetkellä käytössä olevalla menetelmällä AFOS > 83 U/l), PSA > 35 µg/l, La > 80 mm/h ja ikä < 60 vuotta. Lopuksi pisteet laskettiin yhteen. Muodostettiin seuraavat ryhmät: Rg-a (0 -1 riskipistettä), Rg-b (2 riskipistettä) ja Rg-c (3 – 4 riskipistettä). Eturauhassyövän aiheuttama kuoleman riski lisääntyi merkitsevästi siirryttäessä riskiryhmästä seuraavaan (p < 0.001). Rg-luokittelu oli kliinisesti käytännöllinen ja hyvä havaitsemaan huonon ennusteen potilaat.

Eye movements and road hazard detection: Effects of blur and distractors

Purpose To examine the effects of optical blur, auditory distractors and age on eye movement patterns while performing a driving hazard perception test (HPT). Methods Twenty young (mean age 27.1 ± 4.6 years) and 20 older (73.3 ± 5.7 years) drivers with normal vision completed a HPT in a repeated-measures counterbalanced design while their eye movements were recorded. Testing was performed under two visual (best-corrected vision and with +2.00DS blur) and two distractor (with and without auditory distraction) conditions. Participants were required to respond to road hazards appearing in the HPT videos of real-world driving scenes and their hazard response times were recorded. Results Blur and distractors each significantly delayed hazard response time, by 0.42 and 0.76s respectively (p<0.05). A significant interaction between age and distractors indicated that older drivers were more affected by distractors than young drivers (response with distractors delayed by 0.96 and 0.60s respectively). There were no other two- or three-way interaction effect on response time. With blur, both groups fixated significantly longer on hazards before responding compared to best-corrected vision. In the presence of distractors, both groups exhibited delayed first fixation on the hazards and spent less time fixating on the hazards. There were also significant differences in eye movement characteristics between groups, where older drivers exhibited smaller saccades, delayed first fixation on hazards, and shorter fixation duration on hazards compared to the young drivers. Conclusions Collectively, the findings of delayed hazard response times and alterations in eye movement patterns with blur and distractors provide further evidence that visual impairment and distractors are independently detrimental to driving safety given that delayed hazard response times are linked to increased crash risk.

Selective dissemination of XML documents using GAs and SVM

XML has emerged as a medium for interoperability over the Internet. As the number of documents published in the form of XML is increasing there is a need for selective dissemination of XML documents based on user interests. In the proposed technique, a combination of Self Adaptive Migration Model Genetic Algorithm (SAMCA)[5] and multi class Support Vector Machine (SVM) are used to learn a user model. Based on the feedback from the users the system automatically adapts to the user's preference and interests. The user model and a similarity metric are used for selective dissemination of a continuous stream of XML documents. Experimental evaluations performed over a wide range of XML documents indicate that the proposed approach significantly improves the performance of the selective dissemination task, with respect to accuracy and efficiency.

The role of selected non-timber forest products for rural areas in Laos: Case studies in Ban Napo and Ban Kouay communities

Non-timber forest products (NTFPs) are one of the major income sources for the rural population of Laos. An exploratory study was conducted to determine the role of non-timber forest products for rural communities of the study area. The study was carried out in two villages viz. Ban Napo and Ban Kouay of Sangthong district between January and March 2010. A semi-structured questionnaire was used to gather data from the respondents. Twenty-five respondents from each village were chosen based on their involvement in NTFPs collection and marketing activities. Statistically significant NTFPs income differences were not found between the villages and age groups of the respondents, however, significant differences were found in the annual incomes between farms size of the respondents. This study also analyzed the value chain structure of the three (See khai’ ton, Bamboo mats and Incense sticks) important non-timber forest products and the interactions between the actors in the case study areas. Barriers to entry the market, governance and upgrading possibilities have been discussed for each of the value chains. Comparison of unit prices at different levels of the value chains indicated uneven income distribution in favour of the intermediaries, factories and foreign buyers. The lack of capital, marketing information and negotiation skills restricted the villagers to increase their income. However, all the respondents have shown their satisfaction with their income from NTFPs.

Health-related quality of life, symptoms and comorbidity in inflammatory bowel disease

Health-related quality of life (HRQoL) measurement has become an important outcome in treatment trials and in health policy decisions. HRQoL can be measured by using generic or disease-specific tools. Generic instruments can be used for comparing health status among patients in different health states and conditions but they do not focus specifically on the issues relevant in a particular disease. Disease-specific tools may be more responsive to changes within a specific condition. In earlier studies, impairment of HRQoL has been evident in patients with inflammatory bowel disease (IBD), especially when the disease is active. Data about the impact of comorbidity or demographic characteristics of the patients on HRQoL are partly controversial. This study, which comprised 2913 adult IBD patients, examined HRQoL using the disease-specific IBDQ and the general 15D instruments. The 15D scores of IBD patients were compared with scores of a gender and age matched general population sample. Frequency of IBD symptoms and arrangement of therapy were studied and compared with those of IBD patients in an earlier European study. Furthermore, data of other chronic diseases of the patients were obtained from the Social Insurance Institution s reimbursement register and comorbidity of IBD patients was compared with that of age and gender matched controls. --- Of the respondents, 37% reported that they suffered from disturbing IBD symptoms weekly. In 17% of the patients, the symptoms greatly affected the ability to enjoy leisure activities, and 14% stated that these symptoms greatly affected their capacity to work. Despite that, the great majority (93%) of patients expressed satisfaction with their current treatment, which exceeded the rate observed in the other European patients. The mean IBDQ score was 163, as the possible range is 32-224, and disease activity was strongly correlated with HRQoL. Older age, comorbid diseases, and female gender were also related to impairment of HRQoL. Lower HRQoL scores were seen also in newly-diagnosed patients and in those with a history of surgery, especially after stoma or ileal pouch-anal anastomosis (IPAA) operation. The range of 15D scores was 0.30-1.00, with mean of 0.87. As with the IBDQ, disease activity, older age and history of surgery were correlated with the score. Both the newly-diagnosed patients and patients with a long-lasting disease had lower scores than average even after adjusting for age. The 15D scores of IBD patients were significantly lower than those of the control group. A strong correlation was seen between the 15D and the IBDQ scores. Comorbidity with other chronic diseases was observed in 29% of IBD patients. Connective tissue diseases, chronic obstructive pulmonary diseases, pernicious anaemia, and coronary heart disease (CHD) were significantly increased in patients with IBD. Especially female IBD patients appeared to be at increased risk for CHD, and patients who reported weekly IBD symptoms had a higher risk for having other chronic diseases in addition to IBD. Comorbidity impaired HRQoL, as measured with both generic and disease-specific tools. In conclusion, HRQoL is impaired in IBD patients. An understanding of predictors of HRQoL will help to recognise patients who will need special support.

Phonological Mean Length of Utterance as an indicator of typical and impaired phonological development in children acquiring Finnish

The aim of this study was to examine the applicability of the Phonological Mean Length of Utterance (pMLU) method to the data of children acquiring Finnish, for both typically developing children and children with a Specific Language Impairment (SLI). Study I examined typically developing children at the end of the one-word stage (N=17, mean age 1;8), and Study II analysed children s (N=5) productions in a follow-up study with four assessment points (ages 2;0, 2;6, 3;0, 3;6). Study III was carried out in the form of a review article that examined recent research on the phonological development of children acquiring Finnish and compared the results with general trends and cross-linguistic findings in phonological development. Study IV included children with SLI (N=4, mean age 4;10) and age-matched peers. The analyses in Studies I, II and IV were made using the quantitative pMLU method. In the pMLU method, pMLU values are counted for both the words that the children targeted (so-called target words) and the words produced by the children. When the child s average pMLU value was divided with the average target word pMLU value, it is possible to examine that child s accuracy in producing the words with the Whole-Word Proximity (PWP) value. In addition, the number of entirely correctly produced words is counted to obtain the Whole-Word Correctness (PWC) value. Qualitative analyses were carried out in order to examine how the children s phoneme inventories and deficiencies in phonotactics would explain the observed pMLU, PWP and PWC values. The results showed that the pMLU values for children acquiring Finnish were relatively high already at the end of the one-word stage (Study I). The values were found to reflect the characteristics of the ambient language. Typological features that lead to cross-linguistic differences in pMLU values were also observed in the review article (Study III), which noted that in the course of phonological acquisition there are a large number of language-specific phenomena and processes. Study II indicated that overall the children s phonological development during the follow-up period was reflected in the pMLU, PWP and PWC values, although the method showed limitations in detecting qualitative differences between the children. Correct vowels were not scored in the pMLU counts, which led to some misleadingly high pMLU and PWP results: vowel errors were only reflected in the PWC values. Typically developing children in Study II reached the highest possible pMLU results already around age 3;6. At the same time, the differences between the children with SLI and age-matched peers in the pMLU values were very prominent (Study IV). The values for the children with SLI were similar to the ones reported for two-year-old children. Qualitative analyses revealed that the phonologies of the children with SLI largely resembled the ones of younger, typically developing children. However, unusual errors were also witnessed (e.g., vowel errors, omissions of word-initial stops, consonants added to the initial position in words beginning with a vowel). This dissertation provides an application of a new tool for quantitative phonological assessment and analysis in children acquiring Finnish. The preliminary results suggest that, with some modifications, the pMLU method can be used to assess children s phonological development and that it has some advantages compared to the earlier, segment-oriented approaches. Qualitative analyses complemented the pMLU s observations on the children s phonologies. More research is needed in order to verify the levels of the pMLU, PWP and PWC values in children acquiring Finnish.

Male-biased adult sex ratios and their significance for cooperative breeding in dhole, Cuon alpinus, packs

Two free-ranging packs of dholes (Asiatic wild dog, Cuon alpinus) were monitored for a period of 6 yr (Sep. 1990-Sep. 1996) in the Mudumalai sanctuary, southern India. Demographic data on age structure, litter-size, sex ratio and age and sex specific dispersal were collected. Behavioural data on social interactions and reproductive behaviour among pack members were obtained to determine the frequencies of dominant and subordinate behaviours shown by malt: and female pack members and a measure of each male's reproductive access to females. Behaviours displayed by pack members at dens were recorded to determine whether any age- or sex-specific role specialization existed during pup care. Tenures for dominant males and females within the pack were calculated to ascertain the rate of breeding vacancies occurring within packs. Approximate levels of genetic relatedness within packs were determined by studying pedigrees. In most years one study pack had a male-biased adult sex ratio. This was caused by almost twofold higher dispersal of adult females over adult males. A considerable variance existed in the percentage of sub-adults dispersing from the two packs. Differences existed in the frequencies of dominant and subordinate behaviours shown by males. For males, dominance ranks and ranks based on submissive behaviours were not correlated with frequencies of reproductive behaviours. Subordinate males also displayed reproductive behaviours. In packs, dominant males had lower tenures than dominant females indicating that among males breeding vacancies arose more quickly. The litter size was found to be negatively correlated with the age of the breeding female. There were no significant differences across individuals of varying age or sex classes in the display of pup care behaviours. Significant differences did exist among individual adults. Genetic relatedness among packs tended to vary temporally as a consequence of possible mating by subordinate animals and immigration of new males into the pack. In conclusion, it appears that males delay dispersal and cooperate within their natal packs because of the variety of reproductive strategies they could pursue within. A combination of ecological constraints and the difficulties of achieving breeding status within non-natal packs may make early dispersal and independent breeding less beneficial.

Effect of leachate recirculation and extent of degradation on the stability of bioreactor landfill slopes

The stability of a bioreactor landfill slope is influenced by the quantity and method of leachate recirculation as well as on the degree of decomposition. Other factors include properties variation of waste material and geometrical configurations, i.e., height and slope of landfills. Conventionally, the stability of slopes is evaluated using factor of safety approach, in which the variability in the engineering properties of MSW is not considered directly and stability issues are resolved from past experiences and good engineering judgments. On the other hand, probabilistic approach considers variability in mathematical framework and provides stability in a rational manner that helps in decision making. The objective of the present study is to perform a parametric study on the stability of a bioreactor landfill slope in probabilistic framework considering important influencing factors, such as, variation in MSW properties, amount of leachate recirculation, and age of degradation, in a systematic manner. The results are discussed in the light of existing relevant regulations, design and operation issues.

Unemployment rates and population changes in Spain

Published as an article in: Journal of Applied Economics, 2004, vol. VII, pages 47-76.

The Use of Herbicides to Control Hydrilla and the Effects on Young Largemouth Bass Population Characteristics and Aquatic Vegetation in Lake Seminole, Georgia

From 1997 to 2003, we examined the impacts of two aquatic herbicides, fluridone (Sonar; 1-methyl-3-phenyl-5-[3-(trifluromethl) phenyl]-4(1H)-pyridinone), and dipotassium salt of endothall (Aquathol K; 7-oxabicyclo[2.2.1]heptane-2,3-dicarboxylic acid), used to control dense hydrilla (Hydrilla verticillata L. f. Royle), on population characteristics of juvenile largemouth bass (Micropterus salmoides Lacepede) in small coves (<10 ha) in Lake Seminole, Georgia. In addition, we estimated areal coverage and species composition of submersed aquatic vegetation (SAV) communities in each cove. Fish and plants were sampled in both control (hydrilla infested)and herbicide treated coves in November and March- April each year. Electrofishing catch-per-effort for both number and weight of age-0 and age-1 fish for the 1997 to 2002 year classes was either the same or higher (p < 0.05) in herbicide treated than in control coves. Age-0 fish were larger (p <0.05) in treated, than in control coves in November, but at age-1 in the following spring, fish were slightly longer (p <0.05) in the control coves. Higher age-0 catches were associated with greater percent reductions in numeric catch between age-0 and age-1 and reduced lengths of fish in November indicating density-dependent effects. Age-0 fish lengths were also negatively correlated to percent cover of both total and native SAV. Total or native SAV coverages were not associated with catch-per-unit effort for number and weight, but nearly all control and herbicide treated coves had total SAV coverage greater than 40%. Applications of both Sonar and Aquathol K reduced total SAV coverage and hydrilla, permitted the establishment of native SAVs, and had either neutral or positive impacts on young largemouth bass in small coves in Lake Seminole. (PDF contains 7 pages.)

Assessment of Atlantic Red Drum for 1999: Northern and southern regions

An assessment of the status of the Atlantic stock of red drum is conducted using recreational and commercial data from 1986 through 1998. This assessment updates data and analyses from the 1989, 1991, 1992 and 1995 stock assessments on Atlantic coast red drum (Vaughan and Helser, 1990; Vaughan 1992; 1993; 1996). Since 1981, coastwide recreational catches ranged between 762,300 pounds in 1980 and 2,623,900 pounds in 1984, while commercial landings ranged between 60,900 pounds in 1997 and 422,500 pounds in 1984. In weight of fish caught, Atlantic red drum constitute predominantly a recreational fishery (ranging between 85 and 95% during the 1990s). Commercially, red drum continue to be harvested as part of mixed species fisheries. Using available length-frequency distributions and age-length keys, recreational and commercial catches are converted to catch in numbers at age. Separable and tuned virtual population analyses are conducted on the catch in numbers at age to obtain estimates of fishing mortality rates and population size (including recruitment to age 1). In tum, these estimates of fishing mortality rates combined with estimates of growth (length and weight), sex ratios, sexual maturity and fecundity are used to estimate yield per recruit, escapement to age 4, and static (or equilibrium) spawning potential ratio (static SPR, based on both female biomass and egg production). Three virtual analysis approaches (separable, spreadsheet, and FADAPT) were applied to catch matrices for two time periods (early: 1986-1991, and late: 1992-1998) and two regions (Northern: North Carolina and north, and Southern: South Carolina through east coast of Florida). Additional catch matrices were developed based on different treatments for the catch-and-release recreationally-caught red drum (B2-type). These approaches included assuming 0% mortality (BASEO) versus 10% mortality for B2 fish. For the 10% mortality on B2 fish, sizes were assumed the same as caught fish (BASEl), or positive difference in size distribution between the early period and the later period (DELTA), or intermediate (PROP). Hence, a total of 8 catch matrices were developed (2 regions, and 4 B2 assumptions for 1986-1998) to which the three VPA approaches were applied. The question of when offshore emigration or reduced availability begins (during or after age 3) continues to be a source of bias that tends to result in overestimates of fishing mortality. Additionally, the continued assumption (Vaughan and Helser, 1990; Vaughan 1992; 1993; 1996) of no fishing mortality on adults (ages 6 and older), causes a bias that results in underestimates of fishing mortality for adult ages (0 versus some positive value). Because of emigration and the effect of the slot limit for the later period, a range in relative exploitations of age 3 to age 2 red drum was considered. Tuning indices were developed from the MRFSS, and state indices for use in the spreadsheet and FADAPT VPAs. The SAFMC Red Drum Assessment Group (Appendix A) favored the FADAPT approach with catch matrix based on DELTA and a selectivity for age 3 relative to age 2 of 0.70 for the northern region and 0.87 for the southern region. In the northern region, estimates of static SPR increased from about 1.3% for the period 1987-1991 to approximately 18% (15% and 20%) for the period 1992-1998. For the southern region, estimates of static SPR increased from about 0.5% for the period 1988-1991 to approximately 15% for the period 1992-1998. Population models used in this assessment (specifically yield per recruit and static spawning potential ratio) are based on equilibrium assumptions: because no direct estimates are available as to the current status of the adult stock, model results imply potential longer term, equilibrium effects. Because current status of the adult stock is unknown, a specific rebuilding schedule cannot be determined. However, the duration of a rebuilding schedule should reflect, in part, a measure of the generation time of the fish species under consideration. For a long-lived, but relatively early spawning, species as red drum, mean generation time would be on the order of 15 to 20 years based on age-specific egg production. Maximum age is 50 to 60 years for the northern region, and about 40 years for the southern region. The ASMFC Red Drum Board's first phase recovery goal of increasing %SPR to at least 10% appears to have been met. (PDF contains 79 pages)

Bag and size limit analyses for red drum in Northern and Southern Regions of the U.S. Atlantic

Assessments of the Atlantic red drum for the northern (North Carolina and north) and southern (South Carolina through east coast of Florida) regions along the U. S. Atlantic coast were recently completed. The joint Red Drum Technical Committee (SAFMC/ASMFC) selected the most appropriate catch matrix (incorporating an assumption on size of recreationally-released fish), selectivity of age 3 relative to age 2, and virtual population analysis (FADAPT). Given gear- and age-specific estimates of fishing mortality (F) for the 1992-1998 period, analyses were made of potential gains in escapement through age 4 and static spawning potential ratio (SPR) from further reductions in fishing mortality due to changes in slot and bag limits. Savings from bag limits were calculated given a particular slot size for the recreational fishery, with no savings for the commercial fisheries in the northern region due to their being managed primarily through a quota. Relative changes in catch-at-age estimates were used to adjust age-specific F and hence calculated escapement through age 4 and static SPR. Adjustment was made with the recreational savings to account for release mortality (10%, as in the stock assessment). Alternate runs for the northern region commercial fishery considered 25% release mortality for lengths outside the slot (instead of 0% for the base run), and 0% vs. 10% gain or loss across legal sizes in F. These results are summarized for ranges of bag limits with increasing minimum size limit (for fixed maximum size), and with decreasing maximum size limit (for fixed minimum size limit). For the southern region, a bag limit of one-fish per angler trip would be required to attain the stated target of 40% static SPR if the current slot limit were not changed. However, for the northern region, a bag limit of one-fish per angler trip appears to be insufficient to attain the stated target of 40% static SPR while maintaining the current slot limit. (PDF contains 41 pages)