Characterization data of reference materials used for phase II of the priority program DFG SPP 2005 "Opus Fluidum Futurum - Rheology of reactive, multiscale, multiphase construction materials".

A thorough characterization of base materials is the prerequisite for further research. In this paper, the characterization data of the reference materials (CEM I 42.5 R, limestone powder, calcined clay and a mixture of these three components) used in the second funding phase of the priority program 2005 of the German Research Foundation (DFG SPP 2005) are presented under the aspects of chemical and mineralogical composition as well as physical and chemical properties. The data were collected based on tests performed by up to eleven research groups involved in this cooperative program.

Ultrafast melting of a charge-density wave in the Mott insulator 1T-TaS2.

Femtosecond time-resolved core-level photoemission spectroscopy with a free-electron laser is used to measure the atomic-site specific charge-order dynamics of the charge-density wave in the Mott insulator 1T-TaS2. After strong photoexcitation, a prompt loss of charge order and subsequent fast equilibration dynamics of the electron-lattice system are observed. On the time scale of electron-phonon thermalization, about 1 ps, the system is driven across a phase transition from a long-range charge ordered state to a quasiequilibrium state with domainlike short-range charge and lattice order. The experiment opens the way to study the nonequilibrium dynamics of condensed matter systems with full elemental, chemical, and atomic-site selectivity.

[The oculocardiac reflex in blepharoplasties]. / Der okulokardiale Reflex bei Blepharoplastiken.

The oculocardiac reflex (OCR) is a well-known phenomenon in ophthalmic surgery, but is rarely described in aesthetic blepharoplasty surgery. It was first mentioned in 1908 by Ascher and Dagnini. Since then, ophthalmologists and anaesthesiologists have regarded the onset of the oculocardiac reflex as a significant intraoperative problem, which is undermined by several case reports that describe dysrhythmias which have haved caused morbidity and death. Per definition the OCR is caused by ocular manipulation and involves intraoperative bradycardia by a change of 20 beats/minute compared to the preoperative heart rate or any dysrhythmia during the manipulation via a trigeminal-vagal-mediated reflex arc. Having operated on a 48-year-old, healthy woman in our clinic, who underwent a cardiac arrest during the blepharoplasty procedure, followed by a successful resuscitation, we investigated the onset of the OCR in our blepharoplasty patients within the last 3 years. The onset of the OCR was noted in 22 of 110 (20 %) blepharoplasty patients, mainly affecting younger, low-weighted patients operated under local anaesthesia. Awareness and treatment of this potentially life-threatening oculocardiac reflex are necessary. In most cases the onset of the reflex may be avoided by a gentle operation technique and by refraining from severe traction to the muscle or fat pad. The best treatment of a profound bradycardia caused by the OCR is to release tension to the muscle or fat pad in order to permit the heart rate to return to normal. Intraoperative monitoring is of utmost importance.

Self-amplified photo-induced gap quenching in a correlated electron material.

Capturing the dynamic electronic band structure of a correlated material presents a powerful capability for uncovering the complex couplings between the electronic and structural degrees of freedom. When combined with ultrafast laser excitation, new phases of matter can result, since far-from-equilibrium excited states are instantaneously populated. Here, we elucidate a general relation between ultrafast non-equilibrium electron dynamics and the size of the characteristic energy gap in a correlated electron material. We show that carrier multiplication via impact ionization can be one of the most important processes in a gapped material, and that the speed of carrier multiplication critically depends on the size of the energy gap. In the case of the charge-density wave material 1T-TiSe2, our data indicate that carrier multiplication and gap dynamics mutually amplify each other, which explains-on a microscopic level-the extremely fast response of this material to ultrafast optical excitation.

Paclitaxel activity in heavily pretreated breast cancer: a National Cancer Institute Treatment Referral Center trial.

PURPOSE: To provide paclitaxel, an investigational drug at the inception of this study, to women with chemotherapy-refractory metastatic breast cancer and to evaluate response and toxicity in these patients. PATIENTS AND METHODS: Two hundred sixty-seven patients with progressive disease (PD) following at least two chemotherapy regimens for metastatic breast cancer and a contraindication to further doxorubicin treatment received paclitaxel either at 175 mg/m2 intravenously (IV) over 24 hours or at 135 mg/m2 if they had prior irradiation to 30% of marrow-bearing bone or a cumulative dose of mitomycin > or = 20 mg/m2. RESULTS: In a subgroup of patients (n = 172) with measurable disease, four complete responses (CRs) and 36 partial responses (PRs) occurred, for an overall response rate of 23% (95% confidence interval [CI], 17% to 30%). No differences in response rates were noted according either to the number of prior chemotherapy regimens received or to whether patients were considered refractory to doxorubicin. The dose and schedule used in this trial resulted in febrile neutropenia in 45% of patients and a hospitalization rate of 49%. CONCLUSION: Paclitaxel's activity in this multiinstitutional trial in heavily pretreated patients confirms the encouraging results attained in single-institution trials. Although at this dose and schedule paclitaxel may be considered too myelosuppressive for palliative care, supportive measures such as colony-stimulating factors and antibiotics were not used prophylactically. Current research efforts are focusing on whether paclitaxel's activity against breast cancer is dose- and/or schedule-dependent, and on what role it has in patients with less advanced disease.

Screening for cervical cancer--an evidence-based approach.

INTRODUCTION: The Papanicolau (Pap) smear is widely accepted by both the public and health authorities as a useful tool for detection of cervical cancer and its precursors. In Israel only opportunistic screening exists and still the incidence of invasive cervical cancer is among the lowest in the world. OBJECTIVES: To examine the existing evidence for the effectiveness of cervical cancer screening by Pap smears; to apply the findings to Israeli data, and to assess the implications for the current cervical cancer screening policy. METHODS: Search of Medline (1966-June 2003) and the Cochrane Library for relevant systematic reviews, controlled trials and cohort studies. RESULTS: There have been no trials of screening for cervical cancer and its precursors and therefore, no direct evidence that screening improves outcomes. A single retrospective cohort study estimated the age-adjusted RR for invasive cervical cancer in women with at least one Pap smear, whether normal or abnormal, compared to women with no smear at 0.4 (95% CI 0.2-0.9). In Israel some 27,800 (range: 20,800-167,000) women need to be screened in order to prevent one case of cervical cancer. The cost of preventing a single case of invasive cervical is approximately 1.288 million NIS (range: 1.643-13.193 million NIS). CONCLUSIONS: An evidence-based approach to the question of the effectiveness of cervical cancer screening using Pap smears has yielded weak evidence. Based on this weak evidence and rough estimations of the effectiveness and cost of mass screening for cervical cancer in Israel, we conclude that the current policy should be maintained.

The value of a clinical definition for epidemic KS in predicting HIV seropositivity in Africa.

Kaposi's sarcoma (KS) in African adults can present in endemic (non-HIV-related) and epidemic (HIV-related) forms. We evaluated the usefulness of a clinical case definition for epidemic KS in predicting HIV seropositivity. A total of 235 patients with KS presenting to the Uganda Cancer Institute from January 1, 1988 to March 31, 1990 were evaluated with history and physical examination. Symptomatic patients underwent chest radiography and upper gastrointestinal endoscopy. One hundred seventy-four patients (80%) underwent HIV ELISA testing with Western blot confirmation. The clinical case definition had a 91% sensitivity and a 95% specificity in predicting HIV seropositivity. Oral KS was the most sensitive specific site of involvement in predicting HIV seropositivity. The clinical case definition is useful in assessing patients to determine prognosis and likelihood of responding to aggressive therapy.

Phase II study of semisynthetic paclitaxel in metastatic breast cancer.

The aim of this phase II study was to characterise the efficacy and toxicity of semisynthetic paclitaxel in patients with metastatic breast cancer. Eligible patients had measurable disease and had been treated with one prior chemotherapy regimen either as adjuvant or for metastatic disease. Semisynthetic paclitaxel was given at a dose of 175 mg/m2 over 3 h every 21 days with dexamethasone, cimetidine and diphenhydramine premedications. 31 patients were entered. All were evaluable for toxicity. 30 patients were evaluable for response because 1 patient was lost to follow-up after receiving one cycle. One patient achieved a complete response and 10 patients achieved partial responses for an overall response rate (CR + PR) of 37% (95% confidence interval 20-56%). 17 patients (55%) experienced at least one episode of grade 3 or 4 neutropenia. There were two episodes of febrile neutropenia complicating 155 cycles of therapy. One of these resulted in a treatment-related death in a patient with pulmonary metastasis. 3 patients required dose reductions for grade 3 sensory neuropathy. Our study shows that the antitumour activity and toxic effects of semisynthetic paclitaxel appear to be identical to the naturally occurring product.

Use of outpatient clinics as a health indicator for communities around a coal-fired power plant.

The permit to operate the first coal fired power plant in Israel was issued with the condition that a comprehensive network to monitor its effects on the environment, health, and agriculture must be installed and operated around the plant. The health monitoring system consists of four studies, which started 1 year prior to the operation of the plant and were carried out for 10 years. In the framework of the health monitoring system, a study of requests for health services was carried out. In this survey, 8 clinics of the Sick Fund, served by 16 physicians, were followed up. The clinics were located as near as possible to air pollution monitoring stations and represent expected different levels of pollution. A health recorder summarized each day's visits to each physician and tabulated the total visits for each day and the visits due to respiratory tract complaints. Multivariate stepwise regressions on total as well as on respiratory complaints were carried out. The independent variables in the regressions were sulfur dioxide, meteorological parameters (such as temperature and humidity), and flu epidemics. Temperature was almost always significantly correlated with respiratory complaints, but less correlated with total visits among, adults and children. Sulfur dioxide, most meterological parameters and flu epidemics were not meaningful explanatory factor in the regressions. Ambient air pollution levels did not exceed the Israeli air quality or the more stringent local air quality standards, the monthly and annual average sulfur dioxide and nitrogen oxides values were very low.

Follow-up of schoolchildren in the vicinity of a coal-fired power plant in Israel.

This study was carried out in the framework of a health monitoring system set up in the vicinity of a 1400 megawatt coal-fired power plant in Israel. Second- and fifth-grade school children were followed up every 3 years; they performed pulmonary function tests (PFT), and their parents filled out American Thoracic Society-National Heart and Lung Institute health questionnaires. Among the cohort of second graders (in 1983) living in the area expected to be most polluted, a significant increase in the prevalence of part of the respiratory symptoms (such as cough and sputum, wheezing with and without cold and wheezing accompanied by shortness of breath) was evident in 1986. The prevalence of asthma among fifth graders in this area doubled (p = 0.0273) compared with prevalence when they were second graders. Among the children from the older cohort (fifth graders in 1983) living in this community, a similar although milder trend could be observed, especially in regard to an increased prevalence of asthma in 1986 compared with 1983 (13.9% versus 8.1%). Annual increases in PFT in the four groups of children (boys and girls from both cohorts) were found to be higher in the community expected to be polluted (especially in the younger cohort) compared with the two other communities. The discrepancy between the increased prevalence of respiratory symptoms and diseases and the higher annual increase in PFT among children from the expected more polluted community may be partly attributable to differential annual increase in height and to different distribution of background variables (such as socioeconomic status, passive smoking, heating, and respiratory diseases among parents) in the three communities.

Has the prevalence of asthma increased in children? Evidence from a long term study in Israel.

BACKGROUND: The permit to build and operate the first 1400 megawatt coal fired power plant in Israel was given provided that three monitoring systems-environmental, agricultural, and health monitoring-be set up near the plant. This study was carried out in the framework of a health monitoring system which included a mortality survey, requests for health services, a schoolchildren's health survey, and an adult panel study. METHODS: 2nd, 5th, and 8th grade school-children living in three communities with different expected levels of air pollution were followed up every three years. They performed pulmonary function tests (PFT), and their parents filled out American Thoracic Society-National Heart and Lung Institute (ATS-NHLI) health questionnaires. A follow up of the prevalence of respiratory conditions among the studied schoolchildren in four rounds of tests was carried out. This report deals with the changes in the prevalence of asthma, related respiratory conditions, and PFT in the data sets gathered among 5th grade schoolchildren. RESULTS: A significant (p = 0.0024) increase in the prevalence of asthma could be observed among 5th grade children in all three communities studied between 1980 and 1989. At the same time a significant (p = 0.0172) rise in the prevalence of wheezing accompanied by shortness of breath could be observed. A similar trend could not be found for the prevalence of bronchitis and other respiratory conditions among the studied children. PFT (FEV1, FEV1/FVC) of children suffering from asthma or from wheeze accompanied by shortness of breath were lower than those of healthy children. Changes in the prevalence of background variables over time could not explain the significant rise in the prevalence of asthma among the children. CONCLUSIONS: The significant rise in asthma and related respiratory conditions coupled with reduced PFT observed in this study suggest that the increase over time in the prevalence of asthma is a true increase in morbidity and not due to reporting bias. The increased prevalence of asthma could be observed in all the communities studied and does not seem to be connected with the operation of the power plant.

Respiratory conditions among schoolchildren and their relationship to environmental tobacco smoke and other combustion products.

The purpose of this study was to examine possible links between respiratory conditions among schoolchildren and exposure to environmental tobacco smoke and other home and community exposures. More than 8,000 second- and fifth-grade schoolchildren who lived in three towns along the Israeli coast were administered pulmonary function tests, and their parents completed standardized health questionnaires. The prevalence of the most reported respiratory conditions was found to be higher, some of them significantly so, among children whose fathers or mothers were smokers, compared with children of non-smoking parents. Most respiratory conditions were reported significantly more often for children who were growing up in medium- and highly polluted communities than for children from low-polluted areas. House heating with kerosene or gas was seldom associated with higher prevalence of respiratory conditions among children. No consistent r trend of reduced pulmonary function tests was associated with exposure to environmental tobacco smoke, with community pollution, or with house heating pollution. In conclusion, exposure of schoolchildren to their parents' cigarette smoke and to community air pollution is associated with higher prevalence of respiratory conditions, whereas house heating does not appear to be a public health problem in Israel.

Respiratory problems associated with exposure to airborne particles in the community.

During the spring of 1995, schoolchildren aged 7-13 y who lived in a rural area in Israel were studied. These children lived in two communities: in one community, the population was exposed to pollution from a cement factory and quarries; the population of the second community was not exposed to pollution from these sources. The children from participating schools performed forced vital capacity, forced expiratory volume in 1 s, peak expiratory flow, forced expiratory flow at 50%, and forced expiratory flow at 25%. Parents completed an American Thoracic Society-National Heart and Lung Institute health questionnaire, which included information about respiratory symptoms and diseases of the children and information about background variables. A trend of higher prevalence of most respiratory symptoms occurred in 638 children who were growing up in the community that bordered the industrial zone, compared with 338 children from the unexposed community. Cough without cold, sputum without cold, and cough accompanied by sputum were the most prevalent symptoms. Asthma diagnosed by a physician was reported more frequently for children who lived near the polluting sources. No consistent trend of reduced pulmonary function tests was observed among children who lived in the polluted community; however, peak expiratory flow was significantly lower among these children. Odds ratio values, calculated from logistic regressions in which we controlled for respiratory problems among parents, mothers who smoked, crowding index, education of mothers, and residential heating, were 3.6 (p value for model = .244) for cough without cold, 4.0 (p value for model = .333) for asthma, and 2.2 (p value for model = .753) for asthma and/or bronchitis in the polluted area, compared with 1.0 in the low-pollution community. Total suspended particulate matter and levels of airborne particles less than 10 microns, measured in the community bordering the industrial zone, very often violated the relevant 24-h Israeli standards of 200 microg/m3 and 150 microg/m3, respectively.

Time-domain classification of charge-density-wave insulators.

Distinguishing insulators by the dominant type of interaction is a central problem in condensed matter physics. Basic models include the Bloch-Wilson and the Peierls insulator due to electron-lattice interactions, the Mott and the excitonic insulator caused by electron-electron interactions, and the Anderson insulator arising from electron-impurity interactions. In real materials, however, all the interactions are simultaneously present so that classification is often not straightforward. Here, we show that time- and angle-resolved photoemission spectroscopy can directly measure the melting times of electronic order parameters and thus identify-via systematic temporal discrimination of elementary electronic and structural processes-the dominant interaction. Specifically, we resolve the debates about the nature of two peculiar charge-density-wave states in the family of transition-metal dichalcogenides, and show that Rb intercalated 1T-TaS(2) is a Peierls insulator and that the ultrafast response of 1T-TiSe(2) is highly suggestive of an excitonic insulator.

Prevalence of respiratory symptoms and diseases in schoolchildren living in a polluted and in a low polluted area in Israel.

Second and fifth grade schoolchildren living in two communities with different levels of air pollution were studied. The parents of these children filled out ATS-NHLI health questionnaires. The prevalence of reported respiratory symptoms and pulmonary diseases was found to be significantly higher among children growing up in the polluted community (Ashdod) as compared with the low-pollution area (Hadera). Logistic models fitted for the respiratory conditions which differed significantly between both areas of residence also included background variables that could be responsible for these differences. Relative risk values, which were calculated from the logistic models, were in the range of 1.47 for cough without cold to 2.66 for asthma for children from Ashdod, as compared with 1.00 for children from Hadera.

The necessity of building population specific prediction equations for clinical assessment of pulmonary function tests.

UNLABELLED: Fitting adequate prediction equations for pulmonary function test (PFT) parameters is crucial in the analysis of lung function tests and their interpretation. Our work aimed at studying the necessity of building population specific prediction equations, rather than using prediction equations built-in in commercial equipment. We used as an example results of studies carried out among Israeli schoolchildren. Second to sixth grade children (7-13 years old), 1064 boys and 1211 girls, were studied in Tel-Aviv. PFT (forced vital capacity, forced expiratory volume in 1st second, peak expiratory flow, forced expiratory flow in 50% volume, forced expiratory flow in 75% volume) performed by these children were adjusted for height, weight and age, for each sex separately, by a multiple regression procedure. Predicted PFT parameters of 300 boys and 301 girls aged 7-13 years, living along the southern shore of Israel, were calculated using the equations built for the same aged Tel-Aviv children as well as the prediction equations built-in in the spirometer used. The ratios between the observed PFT parameters in the southern children and their expected values, using the Israeli population specific equations, were around 1.00. Using the built-in equations resulted in ratios around 0.90. CONCLUSION: The development of population specific prediction equations for PFT parameters is necessary. Such equations should be used both in clinical assessment to minimize misclassification (healthy/sick child) and in epidemiological studies.

Changing prevalence of asthma among schoolchildren in Israel.

This survey was part of a health monitoring system operated in the vicinity of a new power plant in Israel. The aim of this analysis was to determine whether a temporal trend of increased prevalence of asthma can be observed among cohorts of same-aged children, between 1980 and 1989. Schoolchildren were followed up between 1980 and 1989. They performed pulmonary function tests (PFTs), and their parents filled out American Thoracic Society-National Heart and Lung Institute (ATS-NHLI) health questionnaires. This report deals with the changes in the prevalence of asthma, related respiratory conditions and PFT in four cross-sectional data sets gathered among eighth-grade schoolchildren (aged 13-14 yrs). A highly significant (p=0.0005) increase in the prevalence of asthma (from 5.6% in 1980 to 11.2% in 1989), and of wheezing accompanied by shortness of breath (p=0.0009) could be observed. A similar trend could not be found for the prevalence of bronchitis among these children. PFTs of children suffering from asthma or from wheeze accompanied by shortness of breath were lower than those of healthy children. Changes in prevalence of background variables over time could not explain these findings. The significant rise in the prevalence of asthma coupled with reduced pulmonary function test results among asthmatic children, seems to reflect a true increase in morbidity. Temporal changes in the prevalence of background variables as well as proximity to the power plant could not explain this trend.

Cross-sectional health study in polluted and nonpolluted agricultural settlements in Israel.

During the summer of 1984 a health survey was carried out among the population of six rural settlements, three in a polluted and three in a low polluted area. Residents of these settlements between 6 and 65 years of age filled out an ATS-NHLI health questionnaire and performed the following pulmonary function tests (PFT): FVC, FEV1, FEV1/FVC, PEF, FEF50, and FEF75. A trend of higher prevalence of reported respiratory symptoms and diseases characterizes children growing up in a polluted rural as compared with a low polluted rural area. The relative risks (calculated from logistic models) for children from the polluted area to have sputum with cold is 2.13, cough accompanied by sputum 3.89, and for their siblings to have respiratory diseases 3.02, as compared with 1.00 in the low polluted area. A trend of lower PFT characterizes children from the polluted area, with significantly reduced PEF (P = 0.054). The trends for adults in the two areas were similar to those for the children. The relative risks for adults from the polluted area to have sputum is 1.7 and cough accompanied by sputum 2.6, as compared with 1.0 in the low polluted area. PEF is significantly lower (P = 0.002) among adults from the polluted area, while FEF50 and FEF75 are lower (not significantly) among adults from the low polluted area.