bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation oncology in Australia: Workforce, workloads and equipment 1986–1999
Authors: Wigg David R , Morgan Graeme W 
Published: July 2002

SUMMARYRegular national surveys of all public and private radiation oncology facilities in Australia have been carried out between 1986 and 1999. Workforce data recorded were numbers of radiation oncologists and trainees, radiation therapists, medical physicists and physics technicians, nursing staff, data managers, social workers and clerical staff. Workloads included treatments with megavoltage beams (linear accelerators, cobalt‐60), orthovoltage/superficial X‐rays, brachytherapy, total body irradiation and stereotactic radiosurgery. Major equipment recorded included numbers of megavoltage and orthovoltage/superficial X‐ray machines, planning simulators, computerized dosimetry systems and brachytherapy equipment. The use of radiotherapy beds and the public–private mix of treatments were also documented. Data were assembled for Australia based on each individual state. Within Australia the number of public and private treatment facilities has increased by 44% from 18 in 1986 to 26 in 1999. The population has increased by 16.4%, cancer incidence by 51.8% and megavoltage workloads (fields) by 102%. The number of radiation therapists and physicists and the number of linear accelerators have, in general, increased with the growth in workloads. The number of radiation oncologists has increased by 60% from 4.5 full‐time equivalent (FTE) radiation oncologists per million population in 1986 to 7.2 per million in 1999. There is currently a deficit of at least 40 radiation oncologists to be able to treat the 50% of newly diagnosed cancer patients requiring radiotherapy. In addition, a significant deficiency exists in numbers of radiation therapists, nursing staff, data managers, social workers and clerical staff. Clearly the demands for medical physicists has increased but the data are insufficient to comment on deficiencies. Despite the increases in workloads the proportion of patients with cancer receiving radiotherapy remains below 40%. A positive correlation has been shown between the proportion of newly diagnosed cancer patients treated and the number of FTE radiation oncologists, the number of megavoltage machines and number of radiation therapists. This was shown for Australia as a whole, for each state and for the years 1986 to 1999. This was also the case when total megavoltage fields was used as the dependent variable. Multiple regression analysis using the same independent variables confirmed these positive correlations. It is concluded that the low treatment rate with radiation oncology for cancer patients in Australia is due mainly to the lack of resource allocation. The stated commitment of governments and health departments to a 50% treatment rate can only become a reality if there is a concerted effort to increase the numbers of radiation oncologists, radiation therapists, megavoltage machines and support staff. Otherwise at least one in every 10 newly diagnosed cancer patients will continue to be denied adequate and equitable access to radiotherapy – in 1999 that total figure was 9400 persons.
Breast radiotherapy: An Australasian survey of current treatment techniques
Authors: Delaney Geoff , Blakey David , Drummond Roslyn , Kenny Lizbeth , Centre Radiation Oncology Advisory Group to the National Breast Can 
Published: July 2002

SUMMARYPrior to the dissemination of evidence‐based quality assurance guidelines, the Australian National Breast Cancer Centre Radiation Oncology Group conducted a process survey of breast radiotherapy treatment delivery throughout Australia. A process survey was conducted in August/September 1998. This survey comprised questions enquiring about treatment positioning, immobilization devices used, planning strategies, simulation and dose computation methods, treatment prescribing and quality assurance. The survey was sent to 123 Australian fellows of the Royal Australian and New Zealand College of Radiologists (RANZCR) and to the six directors of New Zealand radiation oncology departments. Fifty‐eight questionnaires were returned of which 38 were received from individuals and 20 represented a reply from a department with a routine breast radiotherapy protocol (representing an average of 4.5 radiation oncologists per reply). The study identified great consistency between departments with respect to dose and fractionation for breast tangents. The study also identified some areas of treatment planning and delivery that varied between individuals or departments. These mainly reflected a lack of evidence in some areas of radiotherapy treatment delivery. The circulation of quality assurance guidelines will perhaps improve consistency of radiotherapy techniques in which studies have identified that technique changes improve outcome. This study identified that these areas include the taking of simulation and port films and the use of off‐axis dosimetry. Further studies are required for areas of radiotherapy treatment delivery that have little evidence for or against their implementation.
Breast conservation in BRCA1 or BRCA2 mutation carriers with early stage breast cancer
Authors: Phillips Kelly Anne , McKay Michael J 
Published: July 2002

SUMMARYThe role of breast conservation therapy (limited surgery and irradiation of the breast with/without axilla) in the approximately 5% of breast cancer patients who harbour a germline mutation in BRCA1 or BRCA2, is a largely unexplored area and is seen by some as controversial. The relatively high cumulative risk of second primary cancers in such patients and concern about a possible decreased ability of mutation carriers to repair DNA damage caused by radiation has fuelled this controversy. Published studies of breast conservation therapy in carriers of a mutation in BRCA1 or BRCA2 are reviewed, with particular attention to their methodology. These studies have not demonstrated any increase in radiation sensitivity of normal tissues in mutation carriers, either in terms of increased early or late toxicity or tumourigenesis. Likewise, tumour sensitivity to radiotherapy, which might be expected based on the known functions of the BRCA1 and BRCA2 genes, has not been documented to date in mutation carriers. Further, methodologically rigorous studies of large numbers of breast cancer patients who carry a mutation in BRCA1 or BRCA2 are required to fully elucidate these issues.
Prognostic factors in muscle‐invasive bladder cancer treated with radiotherapy: an immunohistochemical study
Authors: Osen  , FossÅ  , Majak  , RØtterud  , Berner  
Published: July 2002

Objective To determine the prognostic role of p53, Ki‐67 and p21 for patients with muscle‐invasive bladder cancer treated with curative intent by radiotherapy.Patients and methods The study included 131 patients (24 women and 107 men, median age 72 years, range 40–86) with transitional cell carcinoma (T2‐T4) treated with external definitive pelvic radiotherapy between 1985 and 1994. Paraffin‐embedded pretreatment biopsies from the patients were examined for the presence of p53, p21 and Ki‐67, detected by immunohistochemistry, and related to tumour stage, grade and patient survival.Results The expression of p53 protein correlated positively with the detection of Ki‐67 (P<0.05) but did not correlate with p21. None of the immunohistochemical variables (p53, p21 or Ki‐67) correlated with T category and only Ki‐67 correlated with histological grade. Patients with >5% p21 expression tended to live longer than those with <5% (P=0.09). In a multivariate analysis, the T category (T2/T3 vs. T4), histological grade (2 vs. 3) and p21 expression (≤5% vs. >5%) were independent prognostic factors for overall survival.Conclusion Further investigation is warranted in patients with muscle‐invasive bladder cancer undergoing different types of treatment. p21 seems to play an independent prognostic role in these patients, in addition to T category and grade.
Evaluation of an on‐call diabetes service in a large teaching hospital
Authors: Perros P. , Frier B. M. 
Published: July 2002

Summary Aims To assess prospectively the activity and effectiveness of a diabetes specialist on‐call service. Methods All requests for specialist advice received by the doctor on‐call for diabetes in a large teaching hospital were recorded and analysed over a period of 3 weeks. Results The total number of calls was 135 (mean 45 per week) of which 48.1% were outside normal working hours. Requests for advice from surgical and medical ward staff accounted for 43% of calls, the remainder were from staff in the maternity ward (12.6%), staff in other hospitals in the city (3.7%), general practitioners (13.3%) and patients (27.4%). The time spent by the on‐call doctor for diabetes responding to calls was a mean of 8.6 h per week. The number of acute admissions prevented by this service was estimated to be 11 (3.6 per week). Conclusions Open access to specialist advice provided by a doctor with expertise in diabetes is an effective adjunct to the delivery of diabetes care in the setting of a large teaching hospital.
Tinea barbae associated with erythema nodosum in an immunocompetent man
Authors: Foti C , Diaferio A , Daddabbo M , Angelini G 
Published: July 2002

AbstractWe describe the case of a 45‐year‐old man with atopy who developed marked inflammatory lesions on the bearded area of the face caused by Tricophyton rubrum, an anthropophilic fungus not frequently correlated with kerion of the face. After starting therapy with griseofulvin, he developed typical lesions of erythema nodosum on both legs. We discuss how these lesions could be correlated with the kerion of the face.
Improved computing scheme for measuring eye alignment with Purkinje images I and IV
Authors: Barry J. C. , Backes A. , Pongs U. M. , Kirschkamp T. , Dunne M. C. M. 
Published: July 2002

SummaryThis study introduces an improved computing scheme for determining eye rotation from Purkinje images I and IV. The original computing scheme systematically underestimated eye rotation. Paraxial raytracing calculations revealed that this error resulted from failure to account for the fact that Purkinje images I and IV fall al different distances behind the cornea. The error could be overcome with a correction factor derived from paraxial raytracing calculations. A series of experiments were carried out to test the validity of this correction factor; involving exact raytracing calculations as well as measurements on physical model eyes and human eyes. The influence on the correction factor of ocular surface asphericity, accommodation, age and ocular component variations were examined. The new method was also compared to Hirschberg's technique, which makes use of Purkinje image I alone, as a means of screening for strabismus.
THE CONNEXIN 32 NERVE‐SPECIFIC PROMOTER IS DIRECTLY ACTIVATED BY Egr2/Krox20 IN HeLa CELLS
Authors: Musso M. , Balestra P. , Bellone E. , Di Maria E. , Cassandrini D. , Ajmar F. , Mandich P. 
Published: July 2002

Connexin 32 (Cx32) belongs to a protein family that forms intercellular channels mediating the exchange of ions and chemical messengers. In the peripheral nervous system (PNS) Cx32 is expressed in Schwann cells and contributes to the homeostasis and structural integrity of myelin. Mutations of this gene determine X‐linked form of Charcot Marie‐Tooth (CMTX) disease. Cx 32 is transcriptionally regulated in a tissue‐specific manner by two different promoters termed P1 and P2. P2, active in Schwann cells, is located 5 kb downstream from the P1 promoter and at 500 bp from the exon 2 that contains the entire coding region.Previously, by Electrophoretical Mobility Shift Assay (EMSA) we have identified a sequence (‐101/‐93), within P2, specifically recognized by recombinant Egr2. In order to prove the direct involvement of Egr2 in the transcriptional control of the Cx32 gene, we have performed transfection experiments in HeLa cells with a luciferase driven by the P2 promoter in presence or not of a vector expressing Krox20, the mouse homologue of human Egr2. We have found that the construct in which the sequence ‐103/‐93 is mutated is not activated as well as the wild type sequence. Moreover we have detected another upstream sequence (‐236/‐213) recognized by recombinant Egr2 and other transcription factors present in HeLa nuclear extract like SP1. The construct, lacking this sequence and carrying the mutated downstream Egr2 recognition sequence, is not activated at all by Krox20. Taken together these findings strongly suggest the role of Egr2 in the transcriptional control of Connexin 32 through both sequences.The laboratory is a member of the European CMT Consortium; partially granted by Ministero della Sanit… to PM, MURST and Ateneo to FA.
INCREASED CSF PROTEINS IN CMT1A: ROLE OF ROOT HYPERTROPHY OR SUPERIMPOSED CIDP?
Authors: Pareyson D. , Erbetta A. , Taroni F. , Milani M. , Lauria G. , Ciano C. , Scaioli V. , Morbin M. , Sghirlanzoni A. , Testa D. 
Published: July 2002

A 45‐year‐old male patient came to our observation with a clinical picture of slowly progressive wasting and weakness of distal limb muscles, mild distal sensory to all modalities, with pes cavus and hammer toes. His parents were consanguineous and both were affected by Charcot‐Marie‐Tooth disease (CMT). In the patient, disease onset occurred at age 11. Disease course was slowly progressive, but a somewhat sudden worsening had occurred three years before; muscle wasting and weakness were slightly asymmetrical. A previous spinal tap had demonstrated very high levels of CSF proteins (about 300 mg/dl). When admitted to our hospital, a repeat CSF examination revealed even higher protein content (380 mg/dl), raising the hypothesis of CIDP (chronic inflammatory demyelinating polyradiculoneuropathy) superimposed on CMT. Nerve conduction studies showed a diffuse and uniform nerve conduction slowing (10–12 m/s in limb nerves). Molecular analyses demonstrated the common 17p11.2 duplication of CMT1A. We performed nerve biopsy looking for signs of nerve inflammation, and MR scan of lumbar roots searching for evidence of blood‐root barrier disruption and root inflammation (root enhancement). We administered to the patient two courses of high dose intravenous immunoglobulin (IVIg), followed by steroid treatment for some weeks: there was a questionable clinical improvement and CSF protein content slightly decreased (288 mg/dl). Nerve biopsy showed the typical features of CMT1A with diffuse onion‐bulb formations, but neither focal abnormality nor inflammatory infiltrates were observed. MR scan demonstrated very mild enhancement of lumbar nerve roots after gadolinium administration, but the most impressive finding was a striking hypertrophy of the lumbar roots, which were overall much thicker than the cord itself and filled almost completely the spinal canal. Although superimposition of CIDP cannot be excluded, root hypertrophy causing leakage of the blood‐root barrier or even block of the CSF circulation appears the most likely explanation of the incredible rise of CSF protein content in this case.Partly supported by a grant from the Italian Ministry of Health.
Prompted Voiding for Nighttime Incontinence in Nursing Homes: Is it Effective?
Authors: Ouslander Joseph G. , Ai‐Samarrai Nahia , Schnelle John F. 
Published: July 2002

OBJECTIVES: To determine whether prompted voiding (PV) is effective for nighttime urinary incontinence in nursing home (NH) residents and whether residents who respond well to daytime PV also respond well at night.DESIGN: Prospective case series.SETTING: Four community NHs.PARTICIPANTS: Sixty‐one long‐stay incontinent NH residents of mean age 88 years, 75% female.MEASUREMENTS: The percentage of hourly checks for wetness and the appropriate toileting rate (continent voids divided by total voids) were measured during 3 days (7 a.m.–7 p.m.) of PV, and for an average of 5 nights (7 p.m.–7 a.m.), during which a modified PV protocol, designed to be minimally disruptive to sleep, was carried out.RESULTS: Fourteen residents (23%) responded well to daytime PV, with average wetness and appropriate toileting rates of 5% and 73%, respectively. In the group as a whole, nighttime PV was not effective, with wetness and appropriate toileting rates of 49% and 18%, respectively. Among those who responded well to daytime PV, wetness rates during nighttime PV remained significantly higher than during the day (24% vs 5%; P = .000), and nighttime appropriate toileting rates were significantly lower (39% vs 73%; P = .002). The poor response rate at night was primarily observed between 10 p.m. and 6 a.m.CONCLUSIONS: In this sample of incontinent NH residents, nighttime PV, even when carried out so as to minimize sleep disruption, was not an effective intervention. Although residents who responded well to daytime PV responded better to nighttime PV than those who did not respond to daytime PV, their wetness rates remained relatively high and their appropriate toileting rates were low. These data suggest that routine nighttime toileting programs should not be carried out for the majority of incontinent NH residents. Instead, individualized care based on resident's preferences, willingness to toilet at night, and sleep patterns should be emphasized. J Am Geriatr Soc 49:706–709, 2001.
Nonlinear optical properties of p-nitroaniline: An ab initio time-dependent coupled perturbed Hartree–Fock study
Authors: Karna Shashi P. , Prasad Paras N. , Dupuis Michel 
Published: July 2002

For p-nitroaniline the ab initio method with a double-zeta basis set which includes semidiffuse polarization functions has been used to calculate the dipole moment μ, frequency-dependent linear polarizability α, and nonlinear hyperpolarizabilities β and γ using the time-dependent coupled perturbed Hartree–Fock approach. The computation procedure used here yields information on the dispersion behavior of all the tensor components of polarizability and various hyperpolarizability terms. The largest dispersion effect is observed for the diagonal components of the polarizability and hyperpolarizability tensors along the long in-plane axis. The magnitudes of the various hyperpolarizability terms which describe the various second-order nonlinear processes show the following trend: β(−2ω;ω,ω) ≳β(0;ω,−ω)=β(−ω;0,ω) ≳β(0;0,0), with β(−2ω;ω,ω) exhibiting the largest frequency dispersion. The various second hyperpolarizability terms which describe the various third-order nonlinear optical processes show the following trend: γ(−3ω;ω,ω,ω) ≳γ(−2ω;0,ω,ω) ≳γ(−ω;ω,−ω,ω) ≳γ(−ω;0,0,ω) ≊ γ(0;0,ω,−ω) ≳γ(0;0,0,0). Again γ(−3ω;ω,ω,ω) shows the largest dispersion effect.
The results of existing semiempirical calculations on p-nitroaniline are compared with that of the present ab initio calculation, and the problem due to the arbitrary parametrization procedure adopted in the past for semiempirical calculation is discussed. The computed values of the first resonance energy, the dipole moment, and the polarizability are in good agreement with the respective values experimentally observed, within the spread of the existing experimental data. In contrast, the computed β and γ values are considerably smaller than the respective experimentally determined values. We attribute this discrepancy to two sources. First, in the theoretical calculation electron correlation has been neglected, and the basis set used, although large, may not still be adequate. Second, there is a considerable spread in the reported experimental values for a given nonlinear coefficient making any comparison between the theory and the experiment difficult.
Meeting New Challenges in Educational Research Training: The Signposts for Educational Research CD‐ROM
Authors: Barrett Elizabeth , Lally Vic 
Published: July 2002

ABSTRACTThis article suggests that the professional educational research community is facing new challenges in the development of educational research training. In particular it argues that as the learning needs of the student population become more differentiated, there is a strong pressure to develop and evaluate the use of information and communications technologies (ICTs) to support research training in education. The article describes one response to this pressure: the development and evaluation of an interactive multimedia (IMM) resource, the Signposts for Educational Research CD‐ROM. The CD‐ROM is designed to be used by postgraduate students on a wide range of courses but is particularly aimed at those enrolled on part‐time and distance education programmes. Typically, part‐time students studying at a distance from their providing institution use print‐based materials in combination with occasional attendance at residential study schools; such residential schools frequently represent the only occasions on which tutors and students come together. Many distance learners therefore have limited contact with their tutors and peers, and only limited access to site‐based resources. At the same time, because of their different prior experiences of formal academic study, there is considerable diversity in the individual needs of students registered on part‐time and distance education programmes. This distinctive student profile indicates highly differentiated training requirements and thus the need for personal and customised support for research training. One of the reasons for producing the Signposts CD‐ROM was the perceived need to offer such students alternative modes of learning support. It is argued that the flexible structure of IMM materials may be effective in meeting the individual needs of students while the use of affective material (in the form of a ‘peer voice’) may help to build the confidence, and lessen the isolation, of the distance learner. The article concludes with a discussion of the impact on learning of IMM resources. In particular, it asks whether research students can ‘become critical’ in a multimedia environment, and attempts to assess some of the methodological difficulties involved in evaluating the use of IMM to support learning in this context.
Screening for fetal alcohol syndrome: is it feasible and necessary?
Authors: Burd Larry , Cox Chaun , Fjelstad Kari , McCulloch Kimberly 
Published: July 2002

AbstractThe potential to utilize screening strategies to improve the identification and outcome of persons with fetal alcohol syndrome (FAS) is reviewed. FAS is a condition where screening and surveillance activities would be appropriate. Development of FAS screening and surveillance programs is encouraged because the disorder is expensive. People with FAS have poor outcomes as adults with less than 10% living independently. Several useful tools and models are available. Screening would improve ascertainment and prevalence estimates. Early identification could improve access to services and long term outcome, secondary disabilities and, by extension, excess disability in affected children could be decreased. Lastly, mothers who are at the highest risk to have additional children with FAS could be identified and offered treatment. While both screening and surveillance activities are discussed, the principle focus of this article is a review of the screening process. Two screening tools and several screening methodologies for FAS are available. Since no test will be appropriate in all settings, screening tests need to be selected depending on the setting and population of interest. Screening for FAS should be conducted in a variety of settings and in populations of both high and moderate risk. The results would also provide important data to influence public policy development and resource allocation. Appropriate evaluation of the efficacy, efficiency and effectiveness of FAS screening tools and methodologies would be important before utilization in screening programs.