bluuebunny/crossref_metadata_2025 huggingface dataset:
Signature Profiling and Classification of Illicit Heroin by GC‐MS Analysis of Acidic and Neutral Manufacturing Impurities
Authors: Morello David R. , Cooper Sam D. , Panicker Sini , Casale John F.
Published: November 2009

Abstract:  The illicit manufacture of heroin results in the formation of trace level acidic and neutral impurities. These impurities are detectable in illicit heroin and provide valuable information about the manufacturing process used. The isolation, derivatization, and semiquantitative analysis of neutral and acidic heroin manufacturing impurities by programmed temperature vaporizing injector‐gas chromatography‐mass spectrometry (PTV‐GC‐MS) is described. Trace acidic and neutral heroin impurities were isolated from basic fractions using liquid–liquid extraction. Extracted impurities were treated with N‐Methyl‐N‐trimethylsilyltrifluoroacetamide followed by PTV‐GC‐MS analyses. Semiquantitative data were obtained using full scan mass spectrometry utilizing unique ions or ion combinations for 36 trace impurities found in crude and/or highly refined heroin samples. Minimum detection limits for acidic and neutral impurities were estimated to be at the 10−7 level relative to total morphine. Over 500 authentic heroin samples from South America, Mexico, Southwest Asia, and Southeast Asia were analyzed. Classification of illicit heroin based on the presence or absence and relative amounts of acidic and neutral impurities is presented.
Detection and Classification of Ignitable Liquid Residues Using a Fluorescence‐Based Vapor‐Sensitive Microsphere Array*
Authors: Aernecke Matthew J. , Walt David R.
Published: November 2009

Abstract:  This paper describes the application of microsphere vapor sensing arrays to the detection of ignitable liquid (IL) vapors as both pure vapors and as residues (ILRs) on simulated fire debris samples. The temporal fluorescence response profile of the microsphere array generated a reproducible pattern unique to each analyte that could be used to classify subsequent sensor responses. This system, together with a support vector machine pattern recognition algorithm, was used to address several different IL and ILR classification scenarios. High classification accuracy (98%) was maintained over more than 200 vapor responses and the array was able to identify ILs when presented to the pattern classification algorithm within a dataset containing 11 other volatile compounds. Both burned and unburned IL treated samples were classified correctly greater than 97% of the time. These results indicate that microsphere vapor sensing arrays may be useful for the rapid identification of ILs and ILRs.
Accidental Ligature Strangulation by an Ironing Machine: An Unusual Case*
Authors: Dogan Kamil Hakan , Demirci Serafettin , Gunaydin Gursel , Buken Bora
Published: November 2009

Abstract:  In this paper, we present a case of a 53‐year‐old woman who had her headscarf catch on the cylinder ironing machine in the laundry of the hospital where she worked. The hospital workers found the woman dead with her head stuck to the ironing machine. After the death scene investigation and autopsy were completed, it was determined that the death occurred as a result of accidental ligature strangulation. Accidental ligature strangulation in which an article of clothing is caught in such an electrical machine and strangles the wearer is very rare. This case highlights the fact that these kinds of machines can be hazardous to work around and that increased safety measures should be taken to insure worker safety; additionally, the people who use these machines should be educated on the potential hazards.
Leaf trichomes influence predatory mite densities through dispersal behavior
Authors: Loughner R. , Wentworth K. , Loeb G. , Nyrop J.
Published: November 2009

Habitat complexity can mediate interactions among predators and herbivores and influences arthropod population density and community structure. The abundance of many predatory mites (Acari: Phytoseiidae) is positively associated with abundance of non‐glandular trichomes. We hypothesized that (1) increasing the complexity (trichome density mimicked with cotton fiber patches) of the habitat that predatory mites encounter on leaves would reduce adult dispersal from plants, and (2) increasing habitat complexity would reduce the time that mites spend walking. Typhlodromus pyri Scheuten retention on plants increased linearly in the presence of trichome mimics; mites placed on plants lacking leaf trichomes showed a behavioral response that led to active dispersal. Phytoseiid retention increased with both fiber patch size and fiber density within patches. Moving fiber patches from the underside of the leaf to the upper leaf surface did not change phytoseiid retention but did alter egg distribution, suggesting trichomes do not exclusively influence phytoseiid behavior. Phytoseiid activity level as measured by the amount of time spent walking did not decrease with the addition of fibers. Overall, increasing habitat complexity in the form of non‐glandular trichomes strongly reduced T. pyri dispersal behavior; the predatory mites showed a consistent preference for complex trichome‐rich habitat that was manifest both rapidly and in absence of predators. Hence, the frequently observed pattern of population‐level accumulation of phytoseiids on trichome‐rich plants appears to be driven by a behavioral response to the presence and abundance of non‐glandular trichomes on the leaf surface manifested in the level of dispersal and/or retention. The primary implication of phytoseiid–habitat interactions for biocontrol programs is that where plants have no trichomes, T. pyri will not establish. Whether this behavioral response pattern is a general response of phytoseiids to leaf trichomes or varies with species is a question that remains unanswered.
Suppressive effect of exposure to Chenopodium album var. centrorubrum on the feeding response of the tortoise beetle, Cassida nebulosa, to spinach
Authors: Nagasawa Atsuhiko , Matsuda Kazuhiro
Published: November 2009

Depending upon preceding dietary exposure, the tortoise beetle, Cassida nebulosa L. (Coleoptera: Chrysomelidae), exhibits various feeding responses to spinach, Spinacia oleracea L. (Chenopodiaceae). Adult tortoise beetles reared as adults on the main host Chenopodium album var. centrorubrum Makino (CAC) (Chenopodiaceae) eat little spinach, whereas those reared on spinach accept this plant as food. In this study, we investigated the suppressive effect of exposure to CAC on the feeding response of tortoise beetles to spinach. To investigate the effect of chemical factors in CAC, we provided beetles with Gomphrena globosa L. (Amaranthaceae) as the base food and exposed them to a CAC extract, because bioassays have indicated that exposure to G. globosa did not affect the feeding response of beetles to spinach. Adults reared on G. globosa treated with CAC extract consumed significantly less than adults reared on untreated G. globosa. Thus, we determined that exposure to CAC components is responsible for the suppressive effect on the feeding response to spinach observed in the beetles. In a choice feeding test with membrane filter discs, we found that adults reared on G. globosa treated with CAC extract exhibited a greater feeding deterrent response to the spinach deterrent than adults reared on untreated G. globosa leaves. Therefore, the suppression of spinach consumption due to exposure to CAC is probably caused by the development of a response to the feeding deterrents present in spinach.
Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients
Authors: Weigelt Nils , Metze Dieter , Ständer Sonja
Published: November 2009

Background: To date, there has been no systematic investigation of the detailed histological features of prurigo nodularis (PN) in a large cohort of patients.

Methods: This retrospective study includes skin biopsies of 136 patients (63 males, 73 females; mean age: 58.38 years) with PN.

Results: Highly characteristic for PN is the presence of thick compact orthohyperkeratosis; the hairy palm sign (folliculosebaceous units in nonvolar skin in conjunction with a thick and compact cornified layer, like that of volar skin); irregular epidermal hyperplasia or pseudoepitheliomatous hyperplasia; focal parakeratosis; hypergranulosis; fibrosis of the papillary dermis with vertically arranged collagen fibers; increased number of fibroblasts and capillaries; a superficial, perivascular and/or interstitial inflammatory infiltrate of lymphocytes, macrophages and, to a lesser extent, eosinophils and neutrophils. For comparison, histological findings in 45 patients (18 males, 27 females; mean, 55.64 years) with lichen simplex (LS) were studied. PN and LS, both of them scratch‐induced, had 50 of 58 (86.2%) histological features in common.

Conclusions: PN revealed a characteristic histological pattern. Absence of pseudoepitheliomatous hyperplasia or nerve fiber thickening, however, does not rule out the histological diagnosis of PN. A correlation of clinical and histological findings is necessary to reliably distinguish between PN and LS.

Weigelt N, Metze D, Ständer S. Prurigo nodularis: systematic analysis of 58 histological criteria in 136 patients.
Diagnostic challenges and recent advances in the early management of invasive fungal infections
Authors: Chandrasekar Pranatharthi
Published: November 2009

During the past 20 yr, the population of immunocompromized patients at risk of developing invasive fungal infections (IFIs) has increased, and there has been a shift in fungal epidemiology, with more infections caused by non‐Aspergillus molds and yeasts, which are often resistant to one or more antifungal drugs. Traditional diagnostic methods, such as culture and the histopathology of infected tissue, often fail to detect IFIs until the later stages. Furthermore, invasive diagnostic methods to obtain tissue may be contraindicated in severely ill patients; even when tissue is available, the morphology of several filamentous fungi is identical, or the cultures may fail to grow the pathogen. Recently developed non‐invasive diagnostic techniques, such as tests for serum markers and polymerase chain reaction assays, may allow for earlier and more accurate diagnoses – crucial in the effort to reduce morbidity and the risk of mortality. This article reviews current approaches to diagnosis and treatment, focusing on how an early and accurate diagnosis can guide treatment and improve outcomes. Strategies for improving the management of IFIs also are discussed.
Activating transcription factor 3 (ATF3) expression is increased in erythema multiforme and is regulated by IFN‐γ in human keratinocytes
Authors: Pollack Brian P. , Sapkota Bishu , Haun Paul L.
Published: November 2009

Please cite this paper as: Activating transcription factor 3 (ATF3) expression is increased in erythema multiforme and is regulated by IFN‐γ in human keratinocytes. Experimental Dermatology 2010; 19: e310–e313.

Abstract:  Activating transcription factor 3 (ATF3) is a member of the ATF/cyclic AMP responsive element‐binding protein (CREB) family of transcription factors and is involved in the regulation of immune responses, apoptosis, DNA repair and oncogenesis. The epidermal expression of ATF3 in the setting of cutaneous inflammation has not been well characterized. To examine the expression of ATF3 in the setting of inflammatory skin disease, ATF3 protein expression was analysed by immunohistochemistry (IHC). We found diffuse epidermal ATF3 protein expression in skin biopsies of erythema multiforme (EM). Given the role of interferon (IFN)‐γ in erythema multiforme, we sought to examine the impact of IFN‐γ on ATF3 expression in human keratinocytes. IFN‐γ induced ATF3 mRNA and protein in primary human keratinocytes and HaCaT cells. Thus, epidermal ATF3 expression can be increased in the setting of inflammatory skin diseases and is regulated by IFN‐γ in human keratinocytes.
Fruit–frugivore interactions in two southern hemisphere forests: allometry, phylogeny and body size
Authors: Burns Kevin C. , Lake Babs
Published: November 2009

The size of fleshy fruits spans several orders of magnitude. However, the evolution of fruit size diversity is poorly understood. Fruit size diversity is hypothesised to result from several potential processes. The frugivore hypothesis postulates that different‐sized animal fruit consumers select for different‐sized fruits. The correlated selection hypothesis postulates that fruit size is allometrically related to other plant traits (e.g. leaf size, plant height); therefore differences in fruit size result from correlated evolution with other plant traits. We tested the frugivore and correlated selection hypotheses as potential explanations for fruit size diversity in two New Zealand study sites. We observed birds foraging for fruits over two fruiting seasons at each site and measured fruit size, leaf size and plant height in a total of 32 plant species. Relationships between average fruit size, leaf size, plant size and the average size of birds consuming each fruit species were then evaluated using phylogenetically independent contrasts. Similar results were obtained in both study sites. Fruit size was correlated with the size of avian fruit consumers, but was unrelated to leaf size or plant height. Therefore, results falsified the correlated selection hypothesis but failed to falsify the frugivore hypothesis. Although results suggest that frugivores may have influenced the evolution of fruit size in New Zealand, further study is needed to generate a mechanistic understanding of how frugivores may have selected for interspecific variation in fruit size.
Performance enhancements and muscular adaptations of a 16‐week recreational football intervention for untrained women
Authors: Bangsbo J. , Nielsen J. J. , Mohr M. , Randers M. B. , Krustrup B. R. , Brito J. , Nybo L. , Krustrup P.
Published: November 2009

The present study investigated the performance effects and physiological adaptations over 16 weeks of recreational football training and continuous running for healthy untrained premenopausal women in comparison with an inactive control group [Football group (FG): n=21; running group (RG): n=18; CO: n=14]. Two weekly 1‐h training sessions were performed in FG and RG. After 4 and 16 weeks of training VO2max was elevated (P<0.05) by 7% and 15%, respectively, in FG, and by 6% and 10%, respectively, in RG. After 16 weeks, Yo‐Yo intermittent endurance level 2 performance was 33% and 19% better (P<0.05) for FG and 29% and 21% better (P<0.05) for RG than after 4 and 0 weeks, respectively. Peak sprinting speed was 12% higher (21.0 ± 0.6 vs 18.8 ± 0.7 km/h; P<0.05) for FG after the training period, whereas no difference was observed for RG. After 4 weeks citrate synthase (CS) and 3‐hydroxyacyl‐CoA dehydrogenase (HAD) activity was 9% and 8%, respectively, higher (P<0.05) than before training in FG with no further changes during the last 12 weeks. In RG, CS increased (P<0.05) by 12% after 4 weeks and no significant increase was observed for HAD. In FG, the number of capillaries per fiber was 18% higher (P<0.05) after 16 weeks (2.44 ± 0.15 vs 2.07 ± 0.05 cap/fiber), with no significant difference for RG. No differences were observed between 0 and 16 weeks for CO. In conclusion, recreational women's football leads to significant increases in VO2max, performance and muscular adaptations throughout a 16‐week training period. Thus, football can be used as an activity to elevate the physical capacity of untrained women.
Inventorying management status and plant species richness in semi‐natural grasslands using high spatial resolution imagery
Authors: Hall K. , Johansson L.J. , Sykes M.T. , Reitalu T. , Larsson K. , Prentice H.C.
Published: November 2009

Question: Can we reliably estimate grazing intensity, indicators of grazing intensity (i.e. field‐layer height and shrub‐cover), and vascular plant species richness in semi‐natural grasslands from high spatial resolution satellite data?

Location: The Baltic Island of Öland (Sweden).

Methods: Fieldwork included the on‐site description of grazed and ungrazed areas and shrub‐cover within 107 semi‐natural grassland sites. Field‐layer height and vascular plant species richness (total within‐site and mean small‐scale species richness) were recorded within the sites. Digital classification of QuickBird data was performed to identify grazed and ungrazed areas and shrub‐cover. Vegetation indices were generated to analyze the performance of satellite data for estimating field‐layer height, and the spectral heterogeneity was used to characterize the within‐site environmental heterogeneity.

Results: The proportion of digitally classified grazed area explained 45% of the variation in field‐layer height and 43% of the variation in shrub‐cover. Field‐layer height was significantly related to vegetation indices. A linear model with three explanatory variables (spectral richnessred, spectral richnessNIR, and shrub‐cover) explained 47% of the variation in total within‐site species richness.

Conclusions: High spatial resolution imagery may assist in the monitoring of the processes that follow the cessation of grazing, on the scale of individual grassland sites. Measures of spectral heterogeneity acquired by high spatial resolution imagery can be used in the assessment of total within‐site vascular plant species richness in semi‐natural grassland vegetation.
Photic and non‐photic entrainment on daily rhythm of locomotor activity in goats
Authors: GIANNETTO Claudia , CASELLA Stefania , CAOLA Giovanni , PICCIONE Giuseppe
Published: November 2009

We studied the photic (L/D cycle) and non‐photic (restricted feeding) entrainment on the patterns of daily rhythm of total locomotor activity in goats. Six female Maltese goats were subjected to three different artificial L/D cycles: 12/12 L/D, 12/12 D/L and constant light. During the 12/12 L/D and 12/12 D/L, food and water were available ad libitum. During constant light, animals were subjected to a restricted feeding treatment. Total activity was recorded by means of an actigraphy‐based data logger (Actiwatch‐Mini®). Our results showed that goats exhibited clear daily rhythms of activity in 12/12 L/D cycle, 12/12 D/L cycle and constant light, although they showed FAA prior the feeding time during the restricted feeding treatment. Goats were diurnal, with activity consistently beginning promptly following the onset of light. Even when the L/D cycle was delayed by 12 h on some days, to the daily rhythm was re‐established. During the constant light period, the onset of activity was linked to the time of food administration. Our study evidences two factors for the rhythm of total locomotor activity in goats: light stimuli (photic) and food access (non photic), strongly coupled to permit organisms the adaptive temporal coordination of behaviour with stable and unstable environmental periodicities.
The effect of frequent milk feeding on abomasal curd formation of Holstein calves
Authors: OKADA Keiji , KATO Junro , MIYAZAKI Tamako , SATO Shigeru , YASUDA Jun
Published: November 2009

In order to understand the effects of the automatic milk replacer feeding system on calf health, we examined the effect of frequent milk feeding on curd formation in the abomasum using ultrasonographic imaging. Eight male Holstein calves were divided into a milk‐replacer group and a fresh milk group. Calves were fed twice a day to 12 days after birth (Period A). From 13 days, calves were fed six times a day (Period B). The abomasal fluid was taken by paracentesis. In both periods A and B, the fresh milk group formed bigger curds faster than the milk replacer group. The curd score of the milk replacer group in period B at 2 h was significant lower than those of both groups in period A. The pH in the abomasum was lower in period B than in period A. We could not identify the location of the abomasum in the milk replacer group during period B at almost time points. Our experiment suggests the possibility that frequent feeding of milk replacer causes incomplete hydrolysis of κ‐casein as well as curd formation, thus reducing the digestibility compared to the feeding of the milk replacer twice per day or frequent feeding of fresh milk.
Neuropeptide Y expression and function during osteoblast differentiation – insights from transthyretin knockout mice
Authors: Nunes Ana F. , Liz Márcia A. , Franquinho Filipa , Teixeira Liliana , Sousa Vera , Chenu Chantal , Lamghari Meriem , Sousa Mónica M.
Published: November 2009

To better understand the role of neuropeptide Y (NPY) in bone homeostasis, as its function in the regulation of bone mass is unclear, we assessed its expression in this tissue. By immunohistochemistry, we demonstrated, both at embryonic stages and in the adult, that NPY is synthesized by osteoblasts, osteocytes, and chondrocytes. Moreover, peptidylglycine α‐amidating monooxygenase, the enzyme responsible for NPY activation by amidation, was also expressed in these cell types. Using transthyretin (TTR) KO mice as a model of augmented NPY levels, we showed that this strain has increased NPY content in the bone, further validating the expression of this neuropeptide by bone cells. Moreover, the higher amidated neuropeptide levels in TTR KO mice were related to increased bone mineral density and trabecular volume. Additionally, RT‐PCR analysis established that NPY is not only expressed in MC3T3‐E1 osteoblastic cells and bone marrow stromal cells (BMSCs), but is also detectable by RIA in BMSCs undergoing osteoblastic differentiation. In agreement with our in vivo observations, in vitro, TTR KO BMSCs differentiated in osteoblasts had increased NPY levels and exhibited enhanced competence in undergoing osteoblastic differentiation. In summary, this work contributes to a better understanding of the role of NPY in the regulation of bone formation by showing that this neuropeptide is expressed in bone cells and that increased amidated neuropeptide content is related to increased bone mass.
Is there a relationship between skin erythema and fatigue in women undergoing irradiation after breast conserving surgery for early breast cancer? A prospective study
Authors: GUPTA Sanjiv A , WRATTEN Chris R , KILMURRAY Janice , NASH Sharon , SELDON Michael , O'BRIEN Peter C , BELL Katy JL , DENHAM James W
Published: November 2009

Aim:  A prospective study was conducted to determine whether any relationship exits between skin erythema, fatigue and biological factors during and after adjuvant radiotherapy for early breast cancer.

Methods:  Breast erythema was assessed objectively using reflectance spectrophotometry. Fatigue was recorded utilising the functional assessment of cancer therapy fatigue subscale. A number of potential systemic indicators (biological factors) of the effects of radiotherapy was measured, including circulating cytokines, coagulation factors, peripheral blood indices and biochemistry. Measurements for erythema, fatigue and biological factors were taken at baseline and intervals during and following completion of radiotherapy.

Results:  A total of 52 eligible patients was included in the analysis. Breast erythema was shown to progressively increase during treatment, peaking on day 36 and returning to baseline by 4 months post‐irradiation. Fatigue also progressively increased during treatment, reaching a plateau between day 22 and 2 weeks post‐radiotherapy. A statistically significant association was demonstrated between total breast erythema and fatigue at days 4, 8, 22 and 29 of irradiation and 2 and 6 weeks post‐radiotherapy. When only the increase in erythema attributable to radiotherapy was considered, statistically significant associations remained for day 4 of irradiation and 2 and 6 weeks post‐radiotherapy. When multiple time points were considered together, an association between increased erythema and fatigue was present only post‐radiotherapy. No relationship was demonstrated between the biological factors and erythema or fatigue during radiotherapy.

Conclusion:  This study demonstrates a significant and consistent relationship between radiotherapy‐induced breast erythema and fatigue, particularly in the period immediately following breast irradiation.
Clinical and socio‐demographic profile of an Australian multi‐institutional prostate cancer cohort
Authors: BECKMANN Kerri , PINNOCK Carole B , TAMBLYN David J , KOPSAFTIS Tina , STAPLETON Alan MF , RODER David M
Published: November 2009

Aims:  To describe the clinical and socio‐demographic data from a South Australian prostate cancer cohort (PCCOD).

Methods:  Clinical data for 2329 prostate cancer patients treated at three South Australian teaching hospitals between 1998 and 2007 were analyzed by place of residence, time of diagnosis and socioeconomic status (SES). χ2 tests were used to investigate differences in stage, grade and prostate‐specific antigen (PSA) at diagnosis, among subgroups and over time. Logistic regression was used to examine predictors of treatment modalities. Five‐year survival was assessed using Kaplan–Meier methods.

Results:  The distributions of age, SES and place of residence of PCCOD patients closely reflected those of the state‐based prostate cancer population, with rural patients slightly underrepresented. Lower SES or rural residence was not associated with higher stage, grade, PSA level or disease‐specific survival. Treatment modalities varied with SES (for radical prostatectomy), rural residence (radical prostatectomy, radiotherapy and androgen ablation), age and clinical characteristics. There was a trend over time towards a younger age at diagnosis and more favorable clinical profiles, consistent with earlier diagnosis. However, the current risk profile for this cohort is similar to that reported approximately a decade earlier in a US series.

Conclusion:  PCCOD patients have a broadly similar socio‐demographic profile to prostate cancer patients statewide. Socioeconomic status is not associated with clinical characteristics at diagnosis, but does predict treatment type. The clinical characteristics of the cohort are consistent with a much later stage presentation than reported in current US case series.
Discussing sexuality in the clinical setting: The impact of a brief training program for oncology health professionals to enhance communication about sexuality
Authors: HORDERN Amanda , GRAINGER Michelle , HEGARTY Suzanne , JEFFORD Michael , WHITE Victoria , SUTHERLAND Georgina
Published: November 2009

Aim:  Cancer and its treatments can profoundly affect a person's sexuality and self‐image. However, oncology health professionals (OHP) are often reluctant to discuss these issues with patients. Cancer Council Victoria developed a short workshop to increase OHP's discussion of sexuality issues with cancer patients. We examined the immediate and longer term effect of workshop participation on perceived barriers to these discussions, their confidence in initiating the discussions, and changes in the frequency of their discussing sexuality issues with patients.

Method:  Twenty‐one workshops were conducted involving 155 OHP. The workshops were run by trained facilitators and incorporated cognitive, behavioral and experiential components. A major part of the workshop involved role‐playing with simulated patients (trained actors). Questionnaires assessing 20 perceived barriers, seven confidence items and seven practices concerning sexuality discussion were completed by the participants pre‐workshop, immediately post‐workshop, and 8‐weeks post‐workshop.

Results:  Overall 89 participants completed all three assessment phases. Data were analysed to assess change in perceived barriers, confidence and behavior across the three assessment points. Mean scores on 16 of the 20 barriers significantly decreased and scores on all seven confidence measures significantly increased between pre‐ and immediate post‐workshop. Most these changes were maintained 8 weeks later. The mean frequency of sexuality issue discussion in the previous 2 months increased significantly from 3.34 times at pre‐workshop to 3.82 times 8 weeks later (P = 0.003).

Conclusion:  This workshop appeared to reduce perceived barriers, increase confidence and increase actual practices around discussing sexuality issues with cancer patients.
Off label and unlicensed prescribing in a specialist oncology center in Australia
Authors: MELLOR James D , BENSTED Karen E , CHAN Pui Lam
Published: November 2009

Aim:  Oncology is an area with a high prevalence of off‐label and unlicensed prescribing. A previous audit conducted in 2001 at the Peter MacCallum Cancer Centre, a specialist oncology hospital, showed that 22% of all prescriptions were either off‐label or unlicensed. This study aimed to determine if the rates of off‐label and unlicensed prescribing in oncology had changed between 2001 and 2008.

Methods:  All prescriptions at the Peter MacCallum Cancer Centre were reviewed on a single day in March 2008. Each prescription was classified as licensed, off‐label or unlicensed by comparing to the Approved Product Information (API).

Results:  The medications of 132 patients were assessed. Among the 1094 prescriptions, 382 (35%) were off‐label and 44 (4%) were unlicensed. 112 (85%) patients received at least one off‐label or unlicensed drug.

Conclusion:  The results of the audit suggest that the level of off‐label prescribing increased by 17% since 2001. This study confirmed the extensive off‐label and unlicensed drug usage as suggested by the literature and demonstrated a higher rate of off‐label prescribing than the previous audit in 2001. The results demonstrate that 85% of all cancer patients in the study were prescribed at least one drug that had not been fully tested by the regulatory approval process.
Role of videofluorography in assessing functional abnormalities in patients of head and neck cancer treated with chemoradiotherapy
Authors: LAL Punita , TIWARI Anu , VERMA Ashish , MARIA DAS Koilpillai Joseph , BAIJAL Sanjay Sharan , BAJPAI Ranjeet , KUMAR Pavan , SRIVASTAVA Anurita , KUMAR Shaleen
Published: November 2009

Aim:  The major toxicity following treatment for head neck cancer is swallowing dysfunction which can be easily assessed by videofluorography (VFG), allowing documentation of the site and extent of abnormality thereby facilitating directed management.

Methods:  Between October 2003 and January 2007, 56 patients with locally advanced head and neck cancer were treated by an accelerated radiotherapy schedule with concurrent weekly cisplatin chemotherapy. Three months following treatment, these patients were locally disease free clinically, but complained of varying degrees of dysphagia and were subjected to a VFG evaluation.

Results:  This group comprised 52 men and four women with a median age of 56 years. The primary site distribution was: oral cavity (9), oropharynx (22), larynx (19), hypopharynx (5) and unknown primary (1). Swallowing function abnormalities in the form of structural displacement and temporal delays were documented and recorded as weakness of the tongue musculature (n = 6), palatal kink (n = 8), premature leak into the oropharynx (n = 20), impaired hyoid elevation (n = 23), impaired epiglottic tilt (n = 26), unilateral pharyngeal wall impairment (n = 16), residuum in vallecula or pyriform fossa (n = 30), aspiration in trachea (n = 29) and loss of nasopharyngeal seal (n = 7). Multiple abnormalities of different sub‐sites were seen in each patient.

Conclusion:  VFG can document dysmotility disorders of upper aero‐digestive tract like dysfunction of the base of tongue, larynx and pharyngeal musculature leading to stasis of the bolus and vallecular residuum, epiglottis dysmotility resulting in silent aspirations, and inadequate nasopharyngeal seal leading to nasal regurgitation. A clinical correlation alongwith quantification of VFG findings is required.
HER2 and tau expression as potential markers for response and survival to first line taxane plus cisplatin therapy in non‐small cell lung cancer
Authors: SHIM Byoung Yong , KIM Chi Hong , AHN Myeong Im , KIM Sung Whan , CHO Deog Gon , CHO Kyo Do , YOO Jinyoung , KIM Hoon‐Kyo
Published: November 2009

Aim:  The aim of this study was to assess the role of various HER2, tau and bcl2 as prognostic markers of responsiveness to taxane and cisplatin therapy in patients with advanced NSCLC.

Methods:  Amplification of HER2 gene determined by chromogenic in situ hybridization (CISH) and HER2, tau and bcl2 protein expression determined by immunohistochemistry were assessed in 49 patients with NSCLC enrolled in our four clinical trials of taxane plus cisplatin chemotherapy.

Results:  The patients were classified as responders or non‐responders, a negative tau expression was associated with a significantly higher rate of response compared to a positive tau expression (OR 3.33, 95% CI 1.01–10.97, P = 0.043). Patients with more than stable disease compared to those with progressive disease showed that negative amplification of the HER2 gene was associated with a significantly higher rate of disease control compared to positive amplification (OR 7.35, 95% CI 0.83–65.21, P = 0.048). Furthermore, HER2 gene amplification was strongly associated with the overall survival: 20 months (95% CI 9.007–30.993) in patients with negative amplification of the HER2 gene versus 12 months (95% CI 6.584–17.416) in patients with positive amplification of the HER2 gene (P = 0.040). A multivariate analysis with the Cox proportional hazards model confirmed that HER2 gene amplification was a significant independent prognostic factor with a hazard ratio of 2.334 (95% CI 1.060–5.142, P = 0.035).

Conclusion:  Tau protein expression and HER2 gene amplification are the prognostic factors in NSCLC patients treated with a taxane and cisplatin combination.
Mining the Galactic halo for very metal-poor stars
Authors: Salvadori S. , Ferrara A. , Schneider R. , Scannapieco E. , Kawata D.
Published: November 2009

We study the age and metallicity distribution function (MDF) of metal-poor stars in the Milky Way halo as a function of galactocentric radius by combining N-body simulations and semi-analytical methods. We find that the oldest stars populate the innermost region, while extremely metal-poor stars are more concentrated within r < 60 kpc. The MDF of [Fe/H]≤−2 stars varies only very weakly within the central 50 kpc, while the relative contribution of [Fe/H]≤−2 stars strongly increases with r, varying from 16 per cent within 7 < r < 20 kpc up to ≥40 per cent for r > 20 kpc. This is due to the faster descent of the spatial distribution (as seen from Earth) of the more enriched population. This implies that the outer halo < 40 kpc is the best region to search for very metal-poor stars. Beyond ∼60 kpc the density of [Fe/H]≤−2 stars is maximum within dwarf galaxies. All these features are imprinted by a combination of (i) the virialization epoch of the star-forming haloes, and (ii) the metal enrichment history of the Milky Way environment.
A New Mixture Design‐Based Approach to Graphical Screening of Potential Interconnections and Variability Processes in Metabolic Systems
Authors: Semmar Nabil
Published: November 2009

The flexibility of metabolic systems implies a high variability of metabolic profiles linked to different regulation ratios between metabolites. Such regulations are controlled by several interactive metabolic pathways resulting in multidirectional continuums of metabolic profiles. This article presents a new metabolomic approach helping to graphically analyse the flexibility of metabolic regulation systems. Its principle consists in extracting a metabolic backbone from iterative combinations of metabolic profiles representing different metabolic trends. The iterated combinations were performed on the basis of Scheffe matrix then averaged to calculate a response matrix of smoothed metabolic profiles. From such a smoothed matrix, a graphical analysis of relationships between metabolites highlighted different scale‐dependent variation paths responsible for the observed metabolic trends. Such a flexibility favouring some metabolites at the expense of others was indirectly checked by a single kinetic approach by considering both the variation of maximal concentrations and the metabolic trends in time. This kinetic approach highlighted a succession of metabolic trends linked to the variation of maximal concentrations in time. Finally, a delayed regulation of a metabolite was highlighted both by the kinetic approach and by a dynamic application of the metabolomic approach. This new approach was illustrated on a dataset of blood concentrations of levodopa and its metabolites analysed in 34 patients at different times.
Explaining Partisan Change among Northeastern Whites
Authors: KNUCKEY JONATHAN
Published: November 2009

This article focuses on partisan change in a region that has become a Democratic stronghold: the Northeast. Using data from the American National Election Studies, the article conceptualizes realignment as changes in the social group composition and ideological and issue bases of party support. Findings suggest that an ideological realignment has transformed the party coalitions in the Northeast in a way that suggests a widespread and durable Democratic advantage. Furthermore, this realignment was produced by both party conversion and generational replacement of the electorate. The article finds little signs that a competitive Republican electoral coalition can be forged, and that a solid Democratic Northeast will likely be a feature of American politics and a regional pillar of any emerging national Democratic majority.

Este artículo se enfoca en el cambio partidista en una región que se ha convertido en un bastión Demócrata: el Noreste. Utilizando información de los Estudios Americanos Nacionales de Elecciones (ANES, por sus siglas en inglés), este artículo conceptualiza la realineación como cambios en la composición de los grupos sociales y sus bases ideológicas y de las bases de apoyo partidista por asunto. Los resultados sugieren que una realineación ideológica ha transformado las coaliciones partidistas en el Noreste de una forma que sugiere una ventaja Demócrata extendida y durable. Además, esta realineación fue producida tanto por la transformación del partido como por un remplazo generacional del electorado. El artículo encuentra pocas señales que una coalición electoral competitiva Republicana pueda ser forjada, y que un sólido Noreste Demócrata será probablemente un rasgo de la política Americana y un pilar regional emergente de cualquier mayoría nacional Demócrata.
Improving the health of populations – evidence for policy and practice action
Authors: Ramírez Gilbert
Published: November 2009

The evidence‐based movement has greatly improved how health scientists review literature. It has also resulted in improvements in the conduct and reporting of primary studies. Its impact in the practice of clinical medicine has been greater than in public health, both in terms of practice and policy decisions. In order to substantially improve population health, there needs to be a paradigm shift in academia – evidence should be guided by the needs of practitioners and policymakers in terms of relevance and timeliness.
Analysis of rehabilitation needs, measures taken, and their effectiveness for the wounded following the Wenchuan Earthquake
Authors: Li Yuanfeng , Pan Fuqiong , Li Yufeng
Published: November 2009

Objective To investigate the recovery status of people wounded in the Wenchuan earthquake.

Method Data were retrospectively collected from administrative documents in the Bureau of Medical Affairs, Sichuan Provincial Health Department. The severity of injury was assessed by Injury Severity Score (ISS). The data were recorded by EXCEL software and descriptive analysis was conducted.

Results Our analysis results of rehabilitation treatment through Feb. 5, 2009 shows that 27,080 of the 28,008 patients had been treated and discharged, for a discharge rate of 97.8%. There were 928 patients still in hospitals at that time, including 55 cases of traumatic brain injury, 163 cases of paraplegia, 260 amputees, and 449 cases of severe spine, pelvis and other fractures. Some amputees needed to receive replacement of artificial limbs or stump dressing operation and rehabilitation; most patients who were installed internal fixation needed to removal and post‐rehabilitation.

Conclusions The effectiveness of rehabilitation is significant. Our work in the next stage should focus on (1) continuing to improve the establishment of province's rehabilitation capabilities and increasing capital investment; (2) enhancing training for medical rehabilitation practitioners in order to improve operational standards and service capabilities; (3) developing the wounded rehabilitation standards in later stages, conducting follow‐up and functional training in order to maximize recovery and return to society; (4) increasing employment opportunities for disabled persons.
Family stigma and care burden of schizophrenia patients: Comparison between Japan and Korea
Authors: Hanzawa Setsuko , Bae Jeong‐Kyu , Tanaka Hideki , Tanaka Goro , Bae Yong Jun , Goto Masahiro , Inadomi Hiroyuki , Ohta Yasuyuki , Nakane Hideyuki , Nakane Yoshibumi
Published: November 2009

Introduction: In the present study, we compared the care burden and stigma experienced by families of patients with schizophrenia in Japan (Niigata) and Korea (Seoul and Daegu) to elucidate similarities and differences in the sociocultural factors that affect the care experience of families in East Asia.

Methods: Factors such as care burden (evaluated using the eight‐item short version of the Zarit Caregiver Burden Interview [ZBI‐8]), stigma, and social distance were evaluated in members of support groups for families of mentally ill individuals in Japan (n=47) and Korea (n=92) using an interview questionnaire. Interviewees reported their personal attitudes (personal stigma and social distance) and perceptions of the attitudes of others in the community (perceived stigma) with respect to a case vignette. These vignettes described a person with chronic schizophrenia.

Results: The data analysis revealed the following: (i) feelings of care burden (according to ZBI‐8), perceived stigma, and social distance were significantly stronger in Japan compared to Korea, and (ii) feelings of personal stigma were significantly stronger in Korea than in Japan.

Discussion: The care burden and stigma experienced by families of patients with schizophrenia differed between Japan and Korea. The present findings suggest that to provide effective support for reducing family stigma and care burden, the necessity of such support must be emphasized in both countries.
Cardiac Troponin I Is Associated with Severity of Myxomatous Mitral Valve Disease, Age, and C‐Reactive Protein in Dogs
Authors: Ljungvall I. , Höglund K. , Tidholm A. , Olsen L.H. , Borgarelli M. , Venge P. , Häggström J.
Published: November 2009

Background:Concentrations of cardiac troponin I (cTnI) and C‐reactive protein (CRP) might be associated with cardiac remodeling in dogs with myxomatous mitral valve disease (MMVD). Age‐ and sex‐dependent variations in cTnI concentration have been described.

Objective:To investigate whether plasma concentrations of cTnI and CRP are associated with severity of MMVD, and investigate potential associations of dog characteristics on cTnI and CRP concentrations.

Animals:Eighty‐one client‐owned dogs with MMVD of varying severity.

Methods:Dogs were prospectively recruited for the study. Dogs were classified according to severity of MMVD. Plasma cTnI was analyzed by a high sensitivity cTnI assay with a lower limit of detection of 0.001 ng/mL, and plasma CRP was analyzed by a canine‐specific CRP ELISA.

Results:Higher cTnI concentrations were detected in dogs with moderate (0.014 [interquartile range 0.008–0.029] ng/mL,P= .0011) and severe (0.043 [0.031–0.087] ng/mL,P< .0001) MMVD, compared with healthy dogs (0.001 [0.001–0.004] ng/mL). Dogs with severe MMVD also had higher cTnI concentrations than dogs with mild (0.003 [0.001–0.024] ng/mL,P< .0001) and moderate (P= .0019) MMVD. There were significant associations of age, CRP, heart rate, and left ventricular end‐diastolic diameter, on cTnI concentration C‐reactive protein did not differ among severity groups, but was significantly associated with cTnI, breed, and systolic blood pressure on CRP concentration.

Conclusions and Clinical Importance:Analysis of cTnI concentration has potential to increase knowledge of overall cardiac remodeling in dogs with MMVD. However, effect of age on cTnI needs consideration when assessing cTnI.
Effect of Tissue Processing on Assessment of Endoscopic Intestinal Biopsies in Dogs and Cats
Authors: Willard M.D. , Moore G.E. , Denton B.D. , Day M.J. , Mansell J. , Bilzer T. , Wilcock B. , Gualtieri M. , Olivero D. , Lecoindre P. , Twedt D.C. , Collett M.G. , Hall E.J. , Jergens A.E. , Simpson J.W. , Else R.W. , Washabau R.J.
Published: November 2009

Background: Prior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions.

Hypothesis: Use of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia.

Animals: Tissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries.

Methods: Retrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2‐ and 4‐point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while κ statistics determined agreement between pathologists on histologic lesions.

Results: There was poor agreement (κ=−0.013 to 0.3) between pathologists, and institution of origin of slides had effect (κ= 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4‐point grading scale increased agreement between pathologists (maximum κ= 0.69 using 4‐point scale versus maximum κ= 1.0 using 2‐point scale). Significant association (P= .019– .04; 95% OR = 3.14–10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists.

Conclusions and Clinical Importance: Substantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.