bluuebunny/crossref_metadata_2025 huggingface dataset:
The Marquis de Sade's Zimbabwe Adventure: A Contribution to the Critique of ‘African AIDS’
Authors: Epprecht Marc
Published: March 2007

This article examines a passage in a largely neglected 18th-century novel by the Marquis de Sade. The passage involves a culturally Africanized character who logically refutes homophobic Christian arguments against tolerance of sexual diversity. In that way it precociously anticipated heated debates that bedevil human rights and HIV/AIDS interventions to the present. Sade, by representing African sexualities as more complex than asserted or implied in the heterosexual African AIDS literature, makes a positive contribution to contemporary debates about sexuality and race in Africa today, with implications for anti-essentialist scholarship and AIDS activism globally.
Global Perspectives on Children’s Unpaid Caregiving in the Family
Authors: Becker Saul
Published: March 2007

This article provides the first cross-national review and synthesis of available statistical and research evidence from three developed countries, the UK, Australia and the USA, and from sub-Saharan Africa, on children who provide substantial, regular or significant unpaid care to other family members (‘young carers/caregivers’). It uses the issue of young carers as a window on the formulation and delivery of social policy in a global context. The article examines the extent of children’s informal caregiving in each country; how young carers differ from other children; and how children’s caring has been explained in research from both developed and developing countries. The article includes a review of the research, social policy and service developments for young carers in each country. National levels of awareness and policy response are characterized as ‘advanced’, ‘intermediate’, ‘preliminary’ or ‘emerging’. Explanations are provided for variations in national policy and practice drawing on themes from the globalization literature. Global opportunities and constraints to progress, particularly in Africa, are identified. The article suggests that children’s informal caring roles in both developed and developing nations can be located along a ‘caregiving continuum’ and that young carers, globally, have much in common irrespective of where they live or how developed are their national welfare systems. There is a need in all countries for young carers to be recognized, identified, analysed and supported as a distinct group of ‘vulnerable children’.
A Gendered Analysis of Labour Market Informalization and Access to Health in Chile
Authors: Gideon Jasmine
Published: March 2007

Health sector reforms across Latin America are replacing the concept of risk-sharing across the population with more individualized approaches to accessing health care, and health insurance schemes have been advocated by the World Bank as a means of helping poor people overcome the risk of ill health. Yet at the same time the lowering of labour standards and the growth of informal workers means that for an increased number of workers, contributing to a health insurance scheme is not feasible. Drawing on evidence from Chile this article examines the gendered dimensions of these processes and highlights the ways in which the gender division of labour means that women are more adversely affected than men.
Making Plans: Representation and Intention
Authors: Hoch Charles
Published: March 2007

Conceiving planning theory as a kind of practical reason shifts attention from making rational arguments justifying planning beliefs to the study of plan-making as a feature of practical reasoning. Adopting this viewpoint allows for the comparison of what rational planning theory keeps apart: theories about plan-making that focus on the representation of urban development (e.g. Lew Hopkins) and theories that study the intentional features of deliberative planning processes (e.g. Judith Innes). Analysis demonstrates that the seemingly incompatible viewpoints can offer complementary insights about plan-making without diminishing or distorting important differences. There need be no epistemic or theoretical gap separating the representation and intention of plan-making; no big difference between substance and process. The differences are practical.
Modalities of Urban Space
Authors: Lapintie Kimmo
Published: March 2007

Space is generally regarded as one of the key concepts in urban design and planning. Theoretical approaches in the field of design have, however, remained fragmentary, often concentrating on only one or two aspects of space (such as visual quality or functional requirements) and excluding others (such as social, cultural and political aspects of space). Within the fields of planning theory, geography and urban sociology, on the other hand, there is much more theorizing which, however, often remains too abstract to offer any real guidance to spatial practitioners. This article will work out a new theoretical approach to urban space informed by modal logic. In short, urban space is considered in terms of possibilities, that is, the activities that are opened up for the human agent and the possibilities of change, as well as the elements of trust and fear that will be perceived and conceived.
Re-Examining the Role of Knowledge Within Planning Theory
Authors: Rydin Yvonne
Published: March 2007

While modernist planning theory reifies knowledge as an object and makes it an inherent part of modernism's legitimacy, postmodern planning theory celebrates multiple epistemologies but fails to specify institutional arrangements for handling multiple knowledges in a way that recognizes the specificity of knowledge claims. An argument is made here for the limited variety of forms that such knowledge claims can take and the need to create spaces within planning processes for testing and recognizing these different knowledge claims.
Punishing ‘Poor Parents’: ‘Respect’, ‘Responsibility’ and Parenting Orders in Scotland
Authors: Walters Reece , Woodward Rona
Published: March 2007

This article critiques the rise of parenting orders in Scotland within New Labour’s self-styled model of ‘respect’ and ‘responsibility’. It examines the emergence of parenting orders in Scotland, which became available in April 2005, and argues that Scottish local authorities are sceptical of an approach they perceive as an ideological and legislative mix premised on punitive notions of individual responsibility and justice.
A canonical FtsZ protein in Verrucomicrobium spinosum, a member of the Bacterial phylum Verrucomicrobia that also includes tubulin-producing Prosthecobacter species
Authors: Yee Benjamin , Lafi Feras F , Oakley Brian , Staley James T , Fuerst John A
Published: March 2007

Background

The origin and evolution of the homologous GTP-binding cytoskeletal proteins FtsZ typical of Bacteria and tubulin characteristic of eukaryotes is a major question in molecular evolutionary biology. Both FtsZ and tubulin are central to key cell biology processes – bacterial septation and cell division in the case of FtsZ and in the case of tubulins the function of microtubules necessary for mitosis and other key cytoskeleton-dependent processes in eukaryotes. The origin of tubulin in particular is of significance to models for eukaryote origins. Most members of domain Bacteria possess FtsZ, but bacteria in genus Prosthecobacter of the phylum Verrucomicrobia form a key exception, possessing tubulin homologs BtubA and BtubB. It is therefore of interest to know whether other members of phylum Verrucomicrobia possess FtsZ or tubulin as their FtsZ-tubulin gene family representative.

Results

Verrucomicrobium spinosum, a member of Phylum Verrucomicrobia of domain Bacteria, has been found to possess a gene for a protein homologous to the cytoskeletal protein FtsZ. The deduced amino acid sequence has sequence signatures and predicted secondary structure characteristic for FtsZ rather than tubulin, but phylogenetic trees and sequence analysis indicate that it is divergent from all other known FtsZ sequences in members of domain Bacteria. The FtsZ gene of V. spinosum is located within a dcw gene cluster exhibiting gene order conservation known to contribute to the divisome in other Bacteria and comparable to these clusters in other Bacteria, suggesting a similar functional role.

Conclusion

Verrucomicrobium spinosum has been found to possess a gene for a protein homologous to the cytoskeletal protein FtsZ. The results suggest the functional as well as structural homology of the V. spinosum FtsZ to the FtsZs of other Bacteria implying its involvement in cell septum formation during division. Thus, both bacteria-like FtsZ and eukaryote-like tubulin cytoskeletal homologs occur in different species of the phylum Verrucomicrobia of domain Bacteria, a result with potential major implications for understanding evolution of tubulin-like cytoskeletal proteins and the origin of eukaryote tubulins.
Genome analysis of DNA repair genes in the alpha proteobacterium Caulobacter crescentus
Authors: Martins-Pinheiro Marinalva , Marques Regina CP , Menck Carlos FM
Published: March 2007

Background

The integrity of DNA molecules is fundamental for maintaining life. The DNA repair proteins protect organisms against genetic damage, by removal of DNA lesions or helping to tolerate them. DNA repair genes are best known from the gamma-proteobacterium Escherichia coli, which is the most understood bacterial model. However, genome sequencing raises questions regarding uniformity and ubiquity of these DNA repair genes and pathways, reinforcing the need for identifying genes and proteins, which may respond to DNA damage in other bacteria.

Results

In this study, we employed a bioinformatic approach, to analyse and describe the open reading frames potentially related to DNA repair from the genome of the alpha-proteobacterium Caulobacter crescentus. This was performed by comparison with known DNA repair related genes found in public databases. As expected, although C. crescentus and E. coli bacteria belong to separate phylogenetic groups, many of their DNA repair genes are very similar. However, some important DNA repair genes are absent in the C. crescentus genome and other interesting functionally related gene duplications are present, which do not occur in E. coli. These include DNA ligases, exonuclease III (xthA), endonuclease III (nth), O6-methylguanine-DNA methyltransferase (ada gene), photolyase-like genes, and uracil-DNA-glycosylases. On the other hand, the genes imuA and imuB, which are involved in DNA damage induced mutagenesis, have recently been described in C. crescentus, but are absent in E. coli. Particularly interesting are the potential atypical phylogeny of one of the photolyase genes in alpha-proteobacteria, indicating an origin by horizontal transfer, and the duplication of the Ada orthologs, which have diverse structural configurations, including one that is still unique for C. crescentus.

Conclusion

The absence and the presence of certain genes are discussed and predictions are made considering the particular aspects of the C. crescentus among other known DNA repair pathways. The observed differences enlarge what is known for DNA repair in the Bacterial world, and provide a useful framework for further experimental studies in this organism.
Equity in health services use and intensity of use in Canada
Authors: Asada Yukiko , Kephart George
Published: March 2007

Background

The Canadian health care system has striven to remove financial or other barriers to access to medically necessary health care services since the establishment of the Canada Health Act 20 years ago. Evidence has been conflicting as to what extent the Canadian health care system has met this goal of equitable access. The objective of this study was to examine whether and where socioeconomic inequities in health care utilization occur in Canada.

Methods

We used a nationally representative cross-sectional survey, the 2000/01 Canadian Community Health Survey, which provides a large sample size (about 110,000) and permits more comprehensive adjustment for need indicators than previous studies. We separately examined general practitioner, specialist, and hospital services using two-part hurdle models: use versus non-use by logistic regression, and the intensity of use among users by zero-truncated negative binomial regression.

Results

We found that lower income was associated with less contact with general practitioners, but among those who had contact, lower income and education were associated with greater intensity of use of general practitioners. Both lower income and education were associated with less contact with specialists, but there was no statistically significant relationship between these socioeconomic variables and intensity of specialist use among the users. Neither income nor education was statistically significantly associated with use or intensity of use of hospitals.

Conclusion

Our study unveiled possible socioeconomic inequities in the use of health care services in Canada.
Identification of a human TFPI-2 splice variant that is upregulated in human tumor tissues
Authors: Kempaiah Prakasha , Chand Hitendra S , Kisiel Walter
Published: March 2007

Background

Previous studies have shown that the expression of tissue factor pathway inhibitor-2 (TFPI-2), a matrix-associated Kunitz-type serine proteinase inhibitor, is markedly down-regulated in several tumor cells through hypermethylation of the TFPI-2 gene promoter. In the present study, RT-PCR analysis of total RNA from both human normal and tumor cells revealed a novel 289 nucleotide splice variant of the TFPI-2 transcript designated as aberrantly-spliced TFPI-2 (asTFPI-2).

Results

Nucleotide sequence analyses indicated that asTFPI-2 consists of complete exons II and V, fused with several nucleotides derived from exons III and IV, as well as six nucleotides derived from intron C. 5'- and 3'-RACE analyses of total RNA amplified exclusively the wild-type TFPI-2 transcript, indicating that asTFPI-2 lacks either a 5'-untranslated region (UTR) or a 3'-poly (A)+ tail. Quantitative real-time RT-PCR analyses revealed that several human tumor cells contain 4 to 50-fold more copies of asTFPI-2 in comparison to normal cells. In spite of the absence of a 5'-UTR or poly (A)+ tail, the asTFPI-2 variant exhibited a half-life of ~16 h in tumor cells.

Conclusion

Our studies reveal the existence of a novel, aberrantly-spliced TFPI-2 transcript predominantly expressed in tumor cells and provides suggestive evidence for an additional mechanism for tumor cells to down-regulate TFPI-2 protein expression enhancing their ability to degrade the extracellular matrix.
Feeding oxidized fat during pregnancy up-regulates expression of PPARα-responsive genes in the liver of rat fetuses
Authors: Ringseis Robert , Gutgesell Anke , Dathe Corinna , Brandsch Corinna , Eder Klaus
Published: March 2007

Background

Feeding oxidized fats causes activation of peroxisome proliferator-activated receptor α (PPARα) in the liver of rats. However, whether feeding oxidized fat during pregnancy also results in activation of PPARα in fetal liver is unknown. Thus, this study aimed to explore whether feeding oxidized fat during pregnancy causes a PPARα response in fetal liver. Two experiments with pregnant rats which were administered three different diets (control; oxidized fat; clofibrate as positive control) in a controlled feeding regimen during either late pregnancy (first experiment) or whole pregnancy (second experiment) were performed.

Results

In both experiments pregnant rats treated with oxidized fat or clofibrate had higher relative mRNA concentrations of the PPARα-responsive genes acyl-CoA oxidase (ACO), cytochrome P450 4A1 (CYP4A1), L-type carnitin-palmitoyl transferase I (L-CPT I), medium-chain acyl-CoA dehydrogenase (MCAD), and long-chain acyl-CoA dehydrogenase (LCAD) in the liver than control rats (P < 0.05). In addition, in both experiments fetuses of the oxidized fat group and the clofibrate group also had markedly higher relative mRNA concentrations of ACO, CYP4A1, CPT I, MCAD, and LCAD in the liver than those of the control group (P < 0.05), whereas the relative mRNA concentrations of PPARα, SREBP-1c, and FAS did not differ between treatment groups. In the second experiment treatment with oxidized fat also reduced triacylglycerol concentrations in the livers of pregnant rats and fetuses (P < 0.05).

Conclusion

The present study demonstrates for the first time that components of oxidized fat with PPARα activating potential are able to induce a PPARα response in the liver of fetuses. Moreover, the present study shows that feeding oxidized fat during whole pregnancy, but not during late pregnancy, lowers triacylglycerol concentrations in fetal livers.
Behavioural and Morphological Evidence for the Involvement of Glial Cell Activation in Delta Opioid Receptor Function: Implications for the Development of Opioid Tolerance
Authors: Holdridge Sarah V , Armstrong Stacey A , Taylor Anna MW , Cahill Catherine M
Published: March 2007

Previous studies have demonstrated that prolonged morphine treatment in vivo induces the translocation of delta opioid receptors (δORs) from intracellular compartments to neuronal plasma membranes and this trafficking event is correlated with an increased functional competence of the receptor. The mechanism underlying this phenomenon is unknown; however chronic morphine treatment has been shown to involve the activation and hypertrophy of spinal glial cells. In the present study we have examined whether activated glia may be associated with the enhanced δOR-mediated antinociception observed following prolonged morphine treatment. Accordingly, animals were treated with morphine with or without concomitant administration of propentofylline, an inhibitor of glial activation that was previously shown to block the development of morphine antinociceptive tolerance. The morphine regimen previously demonstrated to initiate δOR trafficking induced the activation of both astrocytes and microglia in the dorsal spinal cord as indicated by a significant increase in cell volume and cell surface area. Consistent with previous data, morphine-treated rats displayed a significant augmentation in δOR-mediated antinociception. Concomitant spinal administration of propentofylline with morphine significantly attenuated the spinal immune response as well as the morphine-induced enhancement of δOR-mediated effects. These results complement previous reports that glial activation contributes to a state of opioid analgesic tolerance, and also suggest that neuro-glial communication is likely responsible in part for the altered functional competence in δOR-mediated effects following morphine treatment.
New genes in the evolution of the neural crest differentiation program
Authors: Martinez-Morales Juan-Ramon , Henrich Thorsten , Ramialison Mirana , Wittbrodt Joachim
Published: March 2007

Background

Development of the vertebrate head depends on the multipotency and migratory behavior of neural crest derivatives. This cell population is considered a vertebrate innovation and, accordingly, chordate ancestors lacked neural crest counterparts. The identification of neural crest specification genes expressed in the neural plate of basal chordates, in addition to the discovery of pigmented migratory cells in ascidians, has challenged this hypothesis. These new findings revive the debate on what is new and what is ancient in the genetic program that controls neural crest formation.

Results

To determine the origin of neural crest genes, we analyzed Phenotype Ontology annotations to select genes that control the development of this tissue. Using a sequential blast pipeline, we phylogenetically classified these genes, as well as those associated with other tissues, in order to define tissue-specific profiles of gene emergence. Of neural crest genes, 9% are vertebrate innovations. Our comparative analyses show that, among different tissues, the neural crest exhibits a particularly high rate of gene emergence during vertebrate evolution. A remarkable proportion of the new neural crest genes encode soluble ligands that control neural crest precursor specification into each cell lineage, including pigmented, neural, glial, and skeletal derivatives.

Conclusion

We propose that the evolution of the neural crest is linked not only to the recruitment of ancestral regulatory genes but also to the emergence of signaling peptides that control the increasingly complex lineage diversification of this plastic cell population.
Bortezomib Is Active in Patients With Untreated or Relapsed Waldenström's Macroglobulinemia: A Phase II Study of the National Cancer Institute of Canada Clinical Trials Group
Authors: Chen Christine I. , Kouroukis C. Tom , White Darrell , Voralia Michael , Stadtmauer Edward , Stewart A. Keith , Wright John J. , Powers Jean , Walsh Wendy , Eisenhauer Elizabeth
Published: March 2007

Purpose

To evaluate the efficacy and toxicity of single-agent bortezomib in Waldenström's macroglobulinemia (WM).

Patients and Methods

Symptomatic WM patients, untreated or previously treated, received bortezomib 1.3 mg/m2 intravenously days 1, 4, 8, and 11 on a 21-day cycle until two cycles past complete response (CR), stable disease (SD) attained, progression (PD), or unacceptable toxicity. Responses were based on both paraprotein levels and bidimensional disease measurements.

Results

Twenty-seven patients were enrolled. A median of six cycles (range, two to 39) of bortezomib were administered. Twenty-one patients had a decrease in immunoglobulin M (IgM) of at least 25%, with 12 patients (44%) reaching at least 50% IgM reduction. Using both IgM and bidimensional criteria, responses included seven partial responses (PRs; 26%), 19 SDs (70%), and one PD (4%). Total response rate was 26%. IgM reductions were prompt, with nodal responses lagging. Hemoglobin levels increased by at least 10 g/L in 18 patients (66%). Most nonhematologic toxicities were grade 1 to 2, but 20 patients (74%) developed new or worsening peripheral neuropathy (five patients with grade 3, no grade 4), a common cause for dose reduction. Onset of neuropathy was within two to four cycles and reversible in the majority. Hematologic toxicities included grade 3 to 4 thrombocytopenia in eight patients (29.6%) and neutropenia in five (19%). Toxicity led to treatment discontinuation in 12 patients (44%), most commonly because of neuropathy.

Conclusion

Bortezomib has efficacy in WM, but neurotoxicity can be dose limiting. The slower response in nodal disease may require prolonged therapy, perhaps with a less intensive dosing schedule to avoid early discontinuation because of toxicity. Future studies of bortezomib in combination with other agents are warranted.
Abdominal Computed Tomography Predicts Progression in Patients With Rai Stage 0 Chronic Lymphocytic Leukemia
Authors: Muntañola Ana , Bosch Francesc , Arguis Pedro , Arellano-Rodrigo Eduardo , Ayuso Carmen , Giné Eva , Crespo Marta , Abrisqueta Pau , Moreno Carol , Cobo Francesc , López-Guillermo Armando , Montserrat Emili
Published: March 2007

Purpose

Whether computed tomography (CT) should be routinely included in the diagnostic work-up in patients with chronic lymphocytic leukemia (CLL) has not yet been determined. The aim of this study was to analyze the prognostic significance of abdominal CT in patients with CLL in Rai clinical stage 0.

Patients and Methods

Abdominal CT was performed at diagnosis in 140 patients consecutively diagnosed with CLL in Rai stage 0 disease.

Results

An abnormal abdominal CT was found in 38 patients (27%). Abnormal CT correlated with increased bone marrow infiltration (P = .024), high lymphocyte count (P = .001), increased ZAP-70 expression (P = .003), and short lymphocyte doubling time (LDT; P = .007). Patients with abnormal CT progressed more frequently and had a shorter time to progression than those with normal CT (median, 3.5 years v not reached, respectively; P < .001) and required earlier treatment intervention. In a multivariate analysis, only high ZAP-70 expression (relative risk = 3.60) and an abnormal abdominal CT (RR = 2.71) correlated with disease progression.

Conclusion

In this series, an abnormal abdominal CT was a strong predictor of progression in patients with early-stage CLL. The inclusion of CT scans in the initial work-up of patients with early clinical stage on clinical grounds can, therefore, provide relevant clinical information.
Reclassification of 300 Primary Cutaneous B-Cell Lymphomas According to the New WHO–EORTC Classification for Cutaneous Lymphomas: Comparison With Previous Classifications and Identification of Prognostic Markers
Authors: Senff Nancy J. , Hoefnagel Juliette J. , Jansen Patty M. , Vermeer Maarten H. , van Baarlen Joop , Blokx Willeke A. , Canninga-van Dijk Marijke R. , Geerts Marie-Louise , Hebeda Konnie M. , Kluin Philip M. , Lam King H. , Meijer Chris J.L.M. , Willemze Rein
Published: March 2007

Purpose

In the new WHO–European Organisation for Research and Treatment of Cancer (WHO-EORTC) classification for cutaneous lymphomas three major groups of primary cutaneous B-cell lymphoma (CBCL) are distinguished: primary cutaneous marginal zone B-cell lymphoma (PCMZL) and primary cutaneous follicle center lymphoma (PCFCL) with a good prognosis, and primary cutaneous large B-cell lymphoma, leg type (PCLBCL-LT), with an intermediate-level prognosis. This study aimed to assess the clinical significance of the new classification compared with previous classification schemes (EORTC 1997; WHO 2001) and to define prognostic factors within the newly defined categories.

Patients and Methods

In the present study clinical data and histologic sections of 300 patients with CBCL, formerly classified according to the EORTC classification, were reviewed and reclassified according to the WHO and the new WHO-EORTC classification schemes.

Results

After reclassification, the study comprised 71 patients with PCMZL, 171 patients with PCFCL, and 58 patients with PCLBCL-LT, showing 5-year disease-specific survivals of 98%, 95%, and 50%, respectively. When compared with the EORTC and WHO schemes, 5.3% and 36.3% of patients with CBCL were reclassified into another prognostic category. Multivariate analysis of PCFCL revealed localization on the leg and expression of FOXP1 as independent parameters associated with a poor prognosis. Expression of Bcl-2 or MUM-1 had no significant effect on survival in this group. In PCLBCL-LT, no independent prognostic parameters were found.

Conclusion

These results emphasize the clinical significance of the WHO-EORTC classification, but suggest that within the group of PCFCL, distinction should be made between lymphomas presenting on the legs and lymphomas presenting at other sites.
Measuring Quality of Care in the Treatment of Colorectal Cancer: The Moffitt Quality Practice Initiative
Authors: Jacobsen Paul B. , Shibata David , Siegel Erin M. , Druta Mihaela , Lee Ji-Hyun , Marshburn Jan , Davenport Linda , Cruse Hugh , Levine Richard , Gondi Avantica , Brown Richard , Malafa Mokenge
Published: March 2007

Purpose

The Moffitt Quality Practice Initiative (MQPI) is a practice-based system of quality self-assessment, the ultimate goal of which is to improve the quality of cancer care at a statewide level. The initial phase of this project focused on developing procedures, determining feasibility, and evaluating utility for assessing quality of care for colorectal cancer within an existing affiliate network.

Patients and Methods

Representatives from four oncology groups selected quality measures consistent with evidence-, consensus-, and safety-based guidelines that could be abstracted from medical records. Trained abstractors then reviewed records of all eligible colorectal patients seen by each practice in 2004. Frequencies of responses for each indicator were tabulated for overall and practice-specific level of adherence and were compared among practices.

Results

Adherence was uniformly high for several indicators, including confirmatory pathology report, staging information, and chemotherapy discussion or recommendation. Lower adherence was evident across practices for performance of carcinoembryonic tests and complete colonoscopic evaluations. Significant variation among practices was evident only for consent for chemotherapy.

Conclusion

The initial phase of MQPI demonstrated the feasibility and utility of assessing quality indicators for colorectal cancer among members of an existing affiliate network. Findings identified areas where adherence to care was uniformly high, but also identified areas where both overall and practice-specific adherence were less than optimal. These efforts lay the groundwork for expanding MQPI in several directions that have in common the potential to improve the quality of cancer care on a statewide basis.
Future Supply and Demand for Oncologists : Challenges to Assuring Access to Oncology Services
Authors: Erikson Clese , Salsberg Edward , Forte Gaetano , Bruinooge Suanna , Goldstein Michael
Published: March 2007

Purpose

To conduct a comprehensive analysis of supply of and demand for oncology services through 2020. This study was commissioned by the Board of Directors of ASCO.

Methods

New data on physician supply gathered from surveys of practicing oncologists, oncology fellows, and fellowship program directors were analyzed, along with 2005 American Medical Association Masterfile data on practicing medical oncologists, hematologists/oncologists, and gynecologic oncologists, to determine the baseline capacity and to forecast visit capacity through 2020. Demand for visits was calculated by applying age-, sex-, and time-from-diagnosis-visit rate data from the National Cancer Institute's analysis of the 1998 to 2002 Surveillance, Epidemiology and End Results (SEER) database to the National Cancer Institute's cancer incidence and prevalence projections. The cancer incidence and prevalence projections were calculated by applying a 3-year average (2000–2002) of age- and sex-specific cancer rates from SEER to the US Census Bureau population projections released on March 2004. The baseline supply and demand forecasts assume no change in cancer care delivery and physician practice patterns. Alternate scenarios were constructed by changing assumptions in the baseline models.

Results

Demand for oncology services is expected to rise rapidly, driven by the aging and growth of the population and improvements in cancer survival rates, at the same time the oncology workforce is aging and retiring in increasing numbers. Demand is expected to rise 48% between 2005 and 2020. The supply of services provided by oncologists during this time is expected to grow more slowly, approximately 14%, based on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions. This translates into a shortage of 9.4 to 15.0 million visits, or 2,550 to 4,080 oncologists—roughly one-quarter to one-third of the 2005 supply. The baseline projections do not include any alterations based on changes in practice patterns, service use, or cancer treatments. Various alternate scenarios were also developed to show how supply and demand might change under different assumptions.

Conclusions

ASCO, policy makers, and the public have major challenges ahead of them to forestall likely shortages in the capacity to meet future demand for oncology services. A multifaceted strategy will be needed to ensure that Americans have access to oncology services in 2020, as no single action will fill the likely gap between supply and demand. Among the options to consider are increasing the number of oncology fellowship positions, increasing use of nonphysician clinicians, increasing the role of primary care physicians in the care of patients in remission, and redesigning service delivery.
Discrimination of Fish Bones from other Animal Bones in the Sedimented Fraction of Compound Feeds by near Infrared Microscopy
Authors: De la Haba M.J. , Pierna J.A. Fernández , Fumière O. , Garrido-Varo A. , Guerrero J.E. , Pérez-Marín D.C. , Dardenne P. , Baeten V.
Published: March 2007

Since the bovine spongiform encephalopathy (BSE) crisis, the use of animal proteins in animal feed has been prohibited. From October 2003, the European Union (EU) adopted Regulation (EC) no. 1774/2002 governing animal by-products (ABPs), which seeks to address the possible risks inherent in recycling potential infectivity due to the absence of barriers within species and to exclude the cannibalism which may be induced by intra-species recycling. There is an urgent need to develop fast and reliable methods for identification of low-level ABP origins. In this study, near infrared (NIR) microscopy was used to identify different classes of ABPs. Samples of fish meals ( n = 10) and meals of land-animal origin ( n = 50) were ground, sedimented and analysed using an Auto Image Microscope connected to a Fourier transform near infrared spectrometer (FT-NIR). Sediment fraction particles were spread on a Spectralon plate, presented to the NIR microscope and scanned in the 1112–2500 nm region. The support vector machine (SVM) algorithm was used to construct models to identify class origin. Models correctly classified 100% of the samples in the calibration set and between 95 and 95.5% in the validation set. The results demonstrated the potential of FT-NIR microscopy as a rapid method for distinguishing between fish and land-animal particles.
Temperature and Path Length Optimisation for near Infrared Measurement of Liquid Samples: An Alternative Approach
Authors: Sáiz-Abajo M.J. , González-Sáiz J.M. , Pizarro C.
Published: March 2007

Traditionally, when performing a spectroscopic measurement, temperature and path length are normally set by modifying one factor at a time. This fact means that spectroscopists can be unaware of some possible interaction between these factors and it supposes that a lot of experimental effort is required before inexperienced researchers understand the extent of the variation these may introduce. In this study, experimental design methodology and the subsequent evaluation of results were proposed and applied to this problem in order to make the selection of conditions easier and ensure that it is performed correctly. The present paper is a case study which focused on the selection of path length and temperature for near infrared measurements of vinegar samples from different origins. The main objective was to ensure repeatability between replicates and to make sure that absorbance values in the spectra fell within the linear absorbance range of 0.5–2 au. This paper reports the detection of possible interactions between the factors which can lead to erroneous interpretation of results.
Near Infrared Spectroscopy of Aurichalcite (Zn,Cu2+)5(CO3)2(OH)6
Authors: Reddy B. Jagannadha , Frost Ray L.
Published: March 2007

In this endeavour, near infrared spectroscopy studies show evidence of variable composition in aurichalcite minerals of zinc copper carbonate hydroxides. The observation of a broad feature in the electronic part of the spectrum around 11,500 cm−1 (870 nm) is a strong indication of Cu2+ substitution for Zn2+ in the mineral. Overtones of OH vibrations in the spectra from 7250 to 5400 cm−1 (1380–1850 nm) show strong hydrogen bonding in these carbonates. A band common to spectra of all carbonates appears near 5400 cm−1 (1850 nm) due to the combination of both OH-stretching and HOH-bending vibrations, which may be attributed to adsorbed water. Aurichalcite minerals display a spectral sequence of five absorption bands with variation of both band positions and intensities and this is the chief spectral feature observed in the range 5200–5100 cm−1 (1920–2380 nm) due to vibrational processes of the carbonate ion. The frequency shift of carbonate bands suggests the effect of divalent cations and/or variations of the Zn/Cu ratio in aurichalcite minerals.
A review of the quality of gastrointestinal investigations performed in UK laboratories
Authors: Duncan Andrew , Hill Peter G
Published: March 2007

Background: About 10 years ago, a survey showed significant deficiencies in the quality of gastrointestinal investigations performed by UK laboratories. Subsequently, several clinical guidelines have been developed and external quality assessment schemes introduced. This survey was performed to assess whether earlier deficiencies have been addressed.

Methods: The repertoire of gastrointestinal investigations in UK departments of clinical biochemistry was obtained by questionnaire. Nominees were sent further questionnaires to assess various aspects of the service. Analytical performance was determined by sending samples for analysis and by reviewing external quality assessment (EQA) programmes.

Results: The survey showed that in many instances no internal quality control (IQC) is used, analytical performance is poor, reference ranges are inaccurate, protocols are inappropriate, EQA is not adopted, some useful tests are not widely available and interpretation for some tests is inadequate.

Conclusions: Much of the responsibility for this scenario lies with individual laboratories. Although participation in available EQA schemes is mandatory for accreditation, many laboratories are failing to participate in such schemes, and IQC is inadequate for many gastrointestinal tests. One reason for the poor performance is likely to be the low numbers of tests performed: laboratories receiving infrequent requests may be less able to produce reliable results and develop interpretive expertise. The survey highlights areas requiring the development of consensus guidelines by the Association for Clinical Biochemistry and British Society of Gastroenterology, so that appropriate tests are available and a reliable analytical service provided for laboratory-based and point-of-care gastrointestinal investigations in the UK.
Rapid detection of R90H mutations in the human urate transporter 1 gene
Authors: Inazu Tetsuya , Kawahara Tetsuya , Ishikawa Isao
Published: March 2007

Background: Hypouricaemia is a relatively common disorder in the general population. Since the discovery of the human urate transporter 1 (hURAT1) gene, the number of patients diagnosed with renal hypouricaemia caused by hURAT1 gene mutation(s) has increased. A rapid method for detecting such a mutation(s) for diagnostic aid is described herein.

Methods: A rapid method for detecting G269A (R90H) mutations by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was developed.

Results: The patient had compound heterozygous mutations in the hURAT1 gene (R90H and W258X), but showed no clinical manifestations such as urolithiasis or exercise-induced acute renal failure. The G269A (R90H) mutation was detected by PCR-RFLP using the Notl restriction enzyme.

Conclusions: PCR-RFLP is useful for detecting G269A (R90H) mutations in the hURAT1 gene.
Dehydroepiandrostenedione sulphate interferes in many direct immunoassays for testosterone
Authors: Middle Jonathan G
Published: March 2007

Background: In response to a report that the Abbott Architect direct testosterone immunoassay was affected by dehydroepiandrostenedione sulphate (DHEAS) cross-reactivity, this study investigated the effect of DHEAS on other testosterone methods using a UK National External Quality Assessment Scheme (UK NEQAS) for steroid hormones special distribution.

Methods: Separate male and female matrix pools of normal human serum were prepared and divided into three portions. Two portions from each matrix were spiked with 10.07 and 20.14. μmol/L DHEAS, respectively. Aliquots of these pools were distributed to participants in UK NEQAS for male and female testosterone at distribution 319 (July 2006). Median testosterone results for each method group were examined for an increase in testosterone concentration.

Results: In the female matrix, the effect on Abbott Architect was confirmed and shown also for Roche Elecsys, Roche E170 Modular and Beckman Access (includes some Beckman DxI users). In the male matrix, the effect on Abbott Architect, Roche Elecsys and Roche E170 Modular was similar in magnitude to that in the female matrix, but was smaller for Beckman Access/DxI. However, the effect on Immulite 2000 (includes some Immulite 2500 users) was greater in the male matrix. Indications of interference in other methods, used by only a few laboratories (notably Tosoh AIA and Wallac Delfia), were also observed.

Conclusions: DHEAS interference in testosterone assays is a feature of many routine testosterone methods, and occurs in both male and female matrices.
Evidence-based laboratory medicine - a guide for critical evaluation of in vitro laboratory testing
Authors: Christenson Robert H ,   Committee on Evidence Based Laboratory Medicine of the International Federation for Clinical Chemistry Laboratory Medicine
Published: March 2007

Evidence-based laboratory medicine (EBLM) is an essential part of modern laboratory medicine practice. This review presents a guide for better understanding and implementing the EBLM process. The process of EBLM begins with development of a clinically relevant question. Tools for assisting in question formulation include the Patient Intervention Comparator and Outcome (PICO) or Case Assay Predicate and Outcome (CAPO) strategies. Locating evidence that addresses the question is performed using resources available on the internet. Systematic reviews that have objectively collated evidence addressing the question can be particularly useful. The evidence collected must be critically appraised using checklists developed for this purpose. Diagnostic performance of tests is frequently stated in terms of sensitivity, specificity, negative and positive predictive values, and the diagnostic odds ratio. Evaluating 95% confidence limits is important for interpretation. Likelihood ratios for tests in disease states are also important for converting pre-test probabilities to post-test probabilities using Bayes Theorem. Tools such as Receiver Operator Characteristic curves and Fagan's diagram are important analytical and visual aids. Laboratorians must give thoughtful consideration into conveying information to clinicians in a useful format. Evidence-based guidelines and collaboration with clinicians are important for development of local care paths. Auditing the effectiveness of implemented care paths is an important part of quality management. In conclusion, effective use of EBLM can benefit patients by helping laboratorians provide the best-available information in the clinically relevant time frame. Presenting the information appropriately maximizes clinical application of the best evidence.
A rare case of metabolic bone disease
Authors: Srivastava Rajeev , Jenkinson Fiona , Murphy Michael J
Published: March 2007

A 26-year-old female overseas student was admitted to hospital with a fracture of her left humerus following minimal trauma. Biochemical abnormalities included hypercalcaemia, hypophosphataemia, raised alkaline phosphatase, raised parathyroid hormone and undetectable 25-hydroxy-vitamin D. Skeletal X-rays revealed multiple osteolytic lesions in the humerus as well as similar lesions in the femora and pelvis. Magnetic resonance imaging of her left shoulder showed a large soft tissue mass in the proximal humerus. Bone biopsy was reported as consistent with a brown tumour of primary hyperparathyroidism and a sestamibi scan confirmed the presence of a parathyroid adenoma. However, the isotope bone scan was reported as showing features typical of fibrous dysplasia involving multiple sites. The patient subsequently fractured her right femoral shaft, and a femoral nail was inserted. Parathyroidectomy was performed at the same time. Postoperatively she exhibited increased calcium and vitamin D requirements. Coexistence of primary hyperparathyroidism and polyostotic fibrous dysplasia is very rare.
The assessment of interpretation in clinical biochemistry: a personal view
Authors: Challand G S , Vasikaran S D
Published: March 2007

In many laboratories, clinical biochemists add interpretative comments to laboratory reports. There is, however, little evidence base to support this activity. Interpretative comments attached to reports are quite complex, usually consisting of several components that may suggest possible diagnoses and additional tests. Every comment is different, and assessment of interpretation is difficult. We illustrate different approaches which can be used: assessing whole comments or comment components or key phrases; and using independent assessors or a pooled panel of experts. No approach has yet been optimized: assessment is a guide to and not a definition of exact solutions. Although External Quality Assurance Schemes examining interpretation provide information to individual participants on how their comments compare with others, a more important role of these Schemes is to enable us to pool knowledge, and their primary purpose is educational.
Development of a denaturing high-performance liquid chromatography screening method for SMAD4 in juvenile polyposis syndrome
Authors: Hatch Sarah L , Trewick Anne L , Payne Stewart J
Published: March 2007

Background: Juvenile polyposis syndrome is an inherited condition associated with the development of gastrointestinal polyps and subsequent cancer. An efficient denaturing high-performance liquid chromatography (DHPLC) screening method has been developed to detect mutations in SMAD4, which account for around 20% of reported cases.

Methods: The nucleotide sequences of polymerase chain reaction (PCR)amplified SMAD4 exons were examined using WAVEMAKERTM software to determine suitable DHPLC conditions. Multiple wild-type controls were characterized by DHPLC, and known mutations analysed where available.

Results: DHPLC elution profiles for wild-type and variant SMAD4 alleles were successfully characterized across a range of column oven temperatures.

Conclusions: DHPLC analysis of SMAD4 has been refined to an efficient screening protocol that uses the minimal number of column oven temperatures for reliable mutation detection.
Effect of vitamin C on fracture healing in elderly Osteogenic Disorder Shionogi rats
Authors: Alcantara-Martos T. , Delgado-Martinez A. D. , Vega M. V. , Carrascal M. T. , Munuera-Martinez L.
Published: March 2007

We studied the effect of vitamin C on fracture healing in the elderly. A total of 80 elderly Osteogenic Disorder Shionogi rats were divided into four groups with different rates of vitamin C intake. A closed bilateral fracture was made in the middle third of the femur of each rat. Five weeks after fracture the femora were analysed by mechanical and histological testing. The groups with the lower vitamin C intake demonstrated a lower mechanical resistance of the healing callus and a lower histological grade. The vitamin C levels in blood during healing correlated with the torque resistance of the callus formed (r = 0.525). Therefore, the supplementary vitamin C improved the mechanical resistance of the fracture callus in elderly rats. If these results are similar in humans, vitamin C supplementation should be recommended during fracture healing in the elderly.
The Avon patellofemoral arthroplasty
Authors: Ackroyd C. E. , Newman J. H. , Evans R. , Eldridge J. D. J. , Joslin C. C.
Published: March 2007

We report the mid-term results of a new patellofemoral arthroplasty for established isolated patellofemoral arthritis. We have reviewed the experience of 109 consecutive patellofemoral resurfacing arthroplasties in 85 patients who were followed up for at least five years.

The five-year survival rate, with revision as the endpoint, was 95.8% (95% confidence interval 91.8% to 99.8%). There were no cases of loosening of the prosthesis. At five years the median Bristol pain score improved from 15 of 40 points (interquartile range 5 to 20) pre-operatively, to 35 (interquartile range 20 to 40), the median Melbourne score from 10 of 30 points (interquartile range 6 to 15) to 25 (interquartile range 20 to 29), and the median Oxford score from 18 of 48 points (interquartile range 13 to 24) to 39 (interquartile range 24 to 45). Successful results, judged on a Bristol pain score of at least 20 at five years, occurred in 80% (66) of knees. The main complication was radiological progression of arthritis, which occurred in 25 patients (28%) and emphasises the importance of the careful selection of patients. These results give increased confidence in the use of patellofemoral arthroplasty.