Rofecoxib and cardiovascular adverse events in adjuvant treatment of colorectal cancer

Background Selective cyclooxygenase inhibitors may retard the progression of cancer, but they have enhanced thrombotic potential. We report on cardiovascular adverse events in patients receiving rofecoxib to reduce rates of recurrence of colorectal cancer. Methods All serious adverse events that were cardiovascular thrombotic events were reviewed in 2434 patients with stage II or III colorectal cancer participating in a randomized, placebo-controlled trial of rofecoxib, 25 mg daily, started after potentially curative tumor resection and chemotherapy or radiotherapy as indicated. The trial was terminated prematurely owing to worldwide withdrawal of rofecoxib. To examine possible persistent risks, we examined cardiovascular thrombotic events reported up to 24 months after the trial was closed. Results The median duration of active treatment was 7.4 months. The 1167 patients receiving rofecoxib and the 1160 patients receiving placebo were well matched, with a median follow-up period of 33.0 months (interquartile range, 27.6 to 40.1) and 33.4 months (27.7 to 40.4), respectively. Of the 23 confirmed cardiovascular thrombotic events, 16 occurred in the rofecoxib group during or within 14 days after the treatment period, with an estimated relative risk of 2.66 (from the Cox proportional-hazards model; 95% confidence interval [CI], 1.03 to 6.86; P = 0.04). Analysis of the Antiplatelet Trialists’ Collaboration end point (the combined incidence of death from cardiovascular, hemorrhagic, and unknown causes; of nonfatal myocardial infarction; and of nonfatal ischemic and hemorrhagic stroke) gave an unadjusted relative risk of 1.60 (95% CI, 0.57 to 4.51; P = 0.37). Fourteen more cardiovascular thrombotic events, six in the rofecoxib group, were reported within the 2 years after trial closure, with an overall unadjusted relative risk of 1.50 (95% CI, 0.76 to 2.94; P = 0.24). Four patients in the rofecoxib group and two in the placebo group died from thrombotic causes during or within 14 days after the treatment period, and during the follow-up period, one patient in the rofecoxib group and five patients in the placebo group died from cardiovascular causes. Conclusions Rofecoxib therapy was associated with an increased frequency of adverse cardiovascular events among patients with a median study treatment of 7.4 months’ duration. (Current Controlled Trials number, ISRCTN98278138.

GONADOTROPHIN RESPONSES TO GnRH PULSES IN HYPOGONADOTROPHIC HYPOGONADISM: LH RESPONSIVENESS IS MAINTAINED IN THE PRESENCE OF LUTEAL PHASE CONCENTRATIONS OF OESTROGEN AND PROGESTERONE

LH pulse secretion changes during the menstrual cycle from a rapid regular pattern in the follicular phase to a slower and irregular pattern in the luteal phase. To determine whether the irregular LH pulse pattern in the luteal phase reflects altered GnRH secretion or altered pituitary responsiveness to GnRH, we gave low dose GnRH pulses (25 ng/kg i.v.) every 2 h or every hour for 10 or 12 d to three women with isolated GnRH deficiency. After 4 d of GnRH alone, oestradiol (E 2 ) was given and after 6 d progesterone (P) was added to mimic the hormonal milieu of the luteal phase. LH and FSH were measured every 4 h throughout and also every 20 min for 6 or 12 h, before and after GnRH alone (day 0 and day 4), after E 2 (day 6), and after E 2 + P (day 10 and day 12). Both GnRH pulse frequencies resulted in a rapid increase in plasma FSH to peaks on day 4 (every 2 h) and day 2 and 3 (every hour). FSH concentrations then declined as plasma E 2 rose to 50–80 pg/ml reflecting the selective inhibitory effect of E 2 on FSH release. Plasma LH was also increased after the hourly GnRH injections and this regimen was associated with a more rapid rise in E 2 reflecting follicular maturation. In contrast to the differences in mean hormone concentrations, administration of GnRH at both frequencies resulted in sustained one-on-one responsiveness of LH that was maintained in the presence of both oestrogen and progesterone at mid-luteal phase concentrations. We conclude that the slow frequency of LH pulses observed during the luteal phase reflects decreased GnRH pulse frequency rather than impaired pituitary responsiveness to GnRH.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74947/1/j.1365-2265.1987.tb00786.x.pd

Ice-cored moraine degradation mapped and quantified using an unmanned aerial vehicle: a case study from a polythermal glacier in Svalbard

Ice-cored lateral–frontal moraines are common at the margins of receding high-Arctic valley glaciers, but the preservation potential of these features within the landform record is unclear. Recent climatic amelioration provides an opportunity to study the morphological evolution of these landforms as they de-ice. This is important because high-Arctic glacial landsystems have been used as analogues for formerly glaciated areas in the mid-latitudes. This study uses SfM (Structure-from-Motion) photogrammetry and a combination of archive aerial and UAV (unmanned aerial vehicle) derived imagery to investigate the degradation of an ice-cored lateral–frontal moraine at Austre Lovénbreen, Svalbard. Across the study area as a whole, over an 11-year period, the average depth of surface lowering was − 1.75 ± 0.89 m. The frontal sections of the moraine showed low or undetectable rates of change. Spatially variable rates of surface lowering are associated with differences in the quantity of buried ice within the structure of the moraine. Morphological change was dominated by surface lowering, with limited field evidence of degradation via back-wastage. This permits the moraine a greater degree of stability than previously observed at other sites in Svalbard. It is unclear whether the end point will be a fully stabilised ice-cored moraine, in equilibrium with its environment, or an ice-free lateral–frontal moraine complex. Controls on geomorphological change (e.g. topography and climate) and the preservation potential of the lateral–frontal moraine are discussed. The methods used by this research also demonstrate the potential value of SfM photogrammetry and unmanned aerial vehicles for monitoring environmental change and are likely to have wider applications in other geoscientific sub-disciplines

IMG 305 - PEMBUNGKUSAN MAKANAN NOV.05.

We discuss the use of Agent-based Modelling for the development and testing of theories about emergent social phenomena in marketing and the social sciences in general. We address both theoretical aspects about the types of phenomena that are suitably addressed with this approach and practical guidelines to help plan and structure the development of a theory about the causes of such a phenomenon in conjunction with a matching ABM. We argue that research about complex social phenomena is still largely fundamental research and therefore an iterative and cyclical development process of both theory and model is to be expected. To better anticipate and manage this process, we provide theoretical and practical guidelines. These may help to identify and structure the domain of candidate explanations for a social phenomenon, and furthermore assist the process of model implementation and subsequent development. The main goal of this paper was to make research on complex social systems more accessible and help anticipate and structure the research process

Live fast, die young: Estimating size-age relations and mortality pattern of shrubs species in the semi-arid Karoo, South Africa

We present a technique for estimating size-age relations and size-dependent mortality patterns of long-lived plants. The technique requires two sets of size data of individual (non-marked) plants that should be collected with a time-lag of several years in the same area of a study site. The basic idea of our technique is to assume general (three parameter) families of size-dependent functions which describe growth and mortality that occurred between the two data gathering events. We apply these growth and mortality functions to the size data of the early data set and construct predicted size-class distributions to compare it, in a systematic way, to the size-class distribution of the later data set. In a next step we calculate the size-age relations from the resulting growth functions, which yield the smallest difference between observed and predicted size-class distribution. Applying this technique to size data of five dominant shrub species at the Tierberg study site in the semiarid Karoo, South Africa produced new insight into the biology of these species which otherwise cannot be obtained without frequent measurements of marked plants. We could relate characteristics of growth behavior and mortality, for certain subgroups of the five species, to the life-history attributes evergreen vs. deciduous, succulent vs. woody, and early reproductive vs. late reproductive. The results of our pilot-study suggest a broad applicability of our technique to other shrublands of the world. This requires at least one older record of (individual) shrub-size data and performance of resampling.Conference Pape

Live fast, die young: Estimating size-age relations and mortality pattern of shrubs species in the semi-arid Karoo, South Africa

We present a technique for estimating size-age relations and size-dependent mortality patterns of long-lived plants. The technique requires two sets of size data of individual (non-marked) plants that should be collected with a time-lag of several years in the same area of a study site. The basic idea of our technique is to assume general (three parameter) families of size-dependent functions which describe growth and mortality that occurred between the two data gathering events. We apply these growth and mortality functions to the size data of the early data set and construct predicted size-class distributions to compare it, in a systematic way, to the size-class distribution of the later data set. In a next step we calculate the size-age relations from the resulting growth functions, which yield the smallest difference between observed and predicted size-class distribution. Applying this technique to size data of five dominant shrub species at the Tierberg study site in the semiarid Karoo, South Africa produced new insight into the biology of these species which otherwise cannot be obtained without frequent measurements of marked plants. We could relate characteristics of growth behavior and mortality, for certain subgroups of the five species, to the life-history attributes evergreen vs. deciduous, succulent vs. woody, and early reproductive vs. late reproductive. The results of our pilot-study suggest a broad applicability of our technique to other shrublands of the world. This requires at least one older record of (individual) shrub-size data and performance of resampling.Conference Pape

Do plants need passport?: a socio-economic study of the role of exotic tree and other plants species in Quang Tri province, Vietnam

A multidisciplinary team evaluated the role and use of exotic and indigenous trees in household livelihood systems in four villages, typical of three distinctly different ecosystems in Quang Tri Province, central Viet Nam. While in each case farmers used a great variety of trees and plants to meet their diverse subsistence and cash needs, this study reveals the crucial contribution of exotic trees. Where land tenure is clear and ownership of the trees is unambiguous, there was widespread enthusiasm for tree planting in all four areas studied. The use of casuarinas on sand dune areas as a coastal protection belt, for farm windbreaks and agroforestry, seems entirely positive on all social, ecological and economic criteria. Likewise the use of acacias provided significant economic and environmental benefits as an essential windbreak around (exotic) coffee and pepper plantations in the highlands near the Laos border, and in mixed plantations on farms in the low hills as a component of a mosaic landscape. Small-scale eucalyptus planting for local fuelwood and construction materials in the foothills has no discernible social or ecological ill-effects, offers one of the few economically viable land use options for both women and men, and creates a low-cost alternative to collection of wood from the few remaining natural forests. Through consultation between local villagers, government forestry extension workers, NGO assistance programmes, and other land users, appropriate species and silvicultural systems are being developed to significantly enhance social and economic welfare with minimal adverse environmental impact. The farmers concluded that provided the trees meet their needs, they do not care about the country of origin of that species