A natural oil-based emulsion containing allantoin versus aqueous cream for managing radiation-induced skin reactions in patients with cancer : a phase III double-blind randomised controlled trial

Purpose To investigate the effects of a natural oil-based emulsion containing allantoin versus aqueous cream for preventing and managing radiation induced skin reactions (RISR). Methods and Materials A total of 174 patients were randomised and participated in the study. Patients either received Cream 1 (the natural oil-based emulsion containing allantoin) or Cream 2 (aqueous cream). Skin toxicity, pain, itching and skin-related quality of life scores were collected for up to four weeks after radiation treatment. Results Patients who received Cream 1 had a significantly lower average level of Common Toxicity Criteria at week 3 (p<0.05), but had statistically higher average levels of skin toxicity at weeks 7, 8 and 9 (all p<0.001). Similar results were observed when skin toxicity was analysed by grades. With regards to pain, patients in the Cream 2 group had a significantly higher average level of worst pain (p<0.05) and itching (p=0.046) compared to the Cream 1 group at week 3, however these differences were not observed at other weeks. In addition, there was a strong trend for Cream 2 to reduce the incidence of grade 2 or more skin toxicity in comparison to Cream 1 (p=0.056). Overall, more participants in the Cream 1 group were required to use another topical treatment at weeks 8 (p=0.049) and 9 (p=0.01). Conclusion The natural oil-based emulsion containing allantoin appears to have similar effects for managing skin toxicity compared to aqueous cream up to week 5, however, it becomes significantly less effective at later weeks into the radiation treatment and beyond treatment completion (week 6 and beyond). There were no major differences in pain, itching and skin-related quality of life. In light of these results, clinicians and patients can base their decision on costs and preferences. Overall, aqueous cream appears to be a more preferred option.

Are alien fish a reliable indicator of river health?

1. The ability of many introduced fish species to thrive in degraded aquatic habitats and their potential to impact on aquatic ecosystem structure and function suggest that introduced fish may represent both a symptom and a cause of decline in river health and the integrity of native aquatic communities. 2. The varying sensitivities of many commonly introduced fish species to degraded stream conditions, the mechanism and reason for their introduction and the differential susceptibility of local stream habitats to invasion because of the environmental and biological characteristics of the receiving water body, are all confounding factors that may obscure the interpretation of patterns of introduced fish species distribution and abundance and therefore their reliability as indicators of river health. 3. In the present study, we address the question of whether alien fish (i.e. those species introduced from other countries) are a reliable indicator of the health of streams and rivers in south-eastern Queensland, Australia. We examine the relationships of alien fish species distributions and indices of abundance and biomass with the natural environmental features, the biotic characteristics of the local native fish assemblages and indicators of anthropogenic disturbance at a large number of sites subject to varying sources and intensities of human impact. 4. Alien fish species were found to be widespread and often abundant in south-eastern Queensland rivers and streams, and the five species collected were considered to be relatively tolerant to river degradation, making them good candidate indicators of river health. Variation in alien species indices was unrelated to the size of the study sites, the sampling effort expended or natural environmental gradients. The biological resistance of the native fish fauna was not concluded to be an important factor mediating invasion success by alien species. Variation in alien fish indices was, however, strongly related to indicators of disturbance intensity describing local in-stream habitat and riparian degradation, water quality and surrounding land use, particularly the amount of urban development in the catchment. 5. Potential confounding factors that may influence the likelihood of introduction and successful establishment of an alien species and the implications of these factors for river bioassessment are discussed. We conclude that the potentially strong impact that many alien fish species can have on the biological integrity of natural aquatic ecosystems, together with their potential to be used as an initial basis to find out other forms of human disturbance impacts, suggest that some alien species (particularly species from the family Poeciliidae) can represent a reliable 'first cut' indicator of river health.

Natural disasters and the responsibility to protect

The International Law Commission (ILC) study on the protection of persons in the event of disasters has been ongoing since 2006. During this period, there has been continuous debate in the literature and in consultations with States as to whether the study should explore the Responsibility to Protect (R2P) persons in the event of natural disasters. In this article, the rationale for this continuing argument is explored considering that the ILC has repeatedly stated since 2008 that the study’s topic – assistance in the event of natural disasters – has no legal relationship with the R2P principle. In the final section it is proposed that the real knowledge gap in the ILC discussion and study is the positive affirmation of the rights of those most affected by natural disasters – women.

'Not a Local Win': Rural Australian perceptions of the sustainable impacts of forest plantations

Australian forestry plantations have doubled in the past 15 years, with rural communities harbouring a diverse range of positive and negative of economic, environmental and social impacts – the so-called triple bottom line (TBL). Utilising two Australian rural communities in Eden/Gippsland and Tasmania as qualitative case studies, this research explores how 23 non-forestry affiliated rural residents perceived and experienced the TBL economic, environmental and social impacts of plantation forestry. Residents criticised the economic plantation forestry benefits because of lengthy periods of inactivity and limited local employment, explaining that their community was reliant on the industry yet the promised economic benefits had never fully materialised. There was a sense the industry ‘plant and walk away.’ Residents were concerned about the environment impact on water quality, water tables and fire hazards, although they praised plantation forestry for carbon sequestering, eradicating erosion and water run-off. Negative social impacts were described, specifically how the land-use change from farming to forestry had significantly reduced the local population, employment and need for services. Natural resource management and communication strategies are offered, derived from non-forestry affiliated rural resident perspectives on how best to ensure sustainable forest development in their community.

20 Years of pacifying responses to environmental management

Using a state, pressure, response framework, we provide an evidence-based reflection on environmental outcomes in Australia and New Zealand across the domains of climate change, biodiversity, freshwater and marine management, emphasising the role of Indigenous and business perspectives. Significant developments have occurred in the past 20 years through affirmation of Indigenous rights and responsibilities. Responses to climate change have tended to emphasise passive risk management with unclear outcomes. Despite meeting biodiversity protection targets, outcomes are worsening, suggesting a need to challenge the dualistic preservation/production land categorisations. In freshwater and marine management, a mix of collaborative and market-based responses has emerged, although their efficacy remains untested. A reliance on voluntary approaches by business makes critical assessment of progress difficult. Thus, despite strong progress in some areas, the adaptiveness of environmental management remains limited, and many indicators suggest continuing decline in environmental condition. Our responses have been largely pacifying in nature, leading to perverse outcomes and failure to acknowledge alternatives that might address deteriorating environmental conditions. A shift is needed towards deliberative policy experimentation that truly values the application of novel and diversified approaches and facilitates integrated learning across environmental domains.

Experimental investigation and design of lipped channel beams in shear

Cold-formed high strength steel members are increasingly used as primary load bearing components in low rise buildings. Lipped channel beam (LCB) is one of the most commonly used flexural members in these applications. In this research an experimental study was undertaken to investigate the shear behaviour and strengths of LCB sections. Simply supported test specimens of back to back LCBs with aspect ratios of 1.0 and 1.5 were loaded at mid-span until failure. Test specimens were chosen such that all three types of shear failure (shear yielding, inelastic and elastic shear buckling) occurred in the tests. The ultimate shear capacity results obtained from the tests were compared with the predictions from the current design rules in Australian/NewZealand and American cold-formed steel design standards. This comparison showed that these shear design rules are very conservative as they did not include the post-buckling strength observed in the shear tests and the higher shear buckling coefficient due to the additional fixity along the web-flange juncture. Improved shear design equations are proposed in this paper by including the above beneficial effects. Suitable lower bound design rules were also developed under the direct strength method format. This paper presents the details of this experimental study and the results including the improved design rules for the shear capacity of LCBs. It also includes the details of tests of LCBs subject to combined shear and flange distortion, and combined bending and shear actions, and proposes suitable design rules to predict the capacities in these cases.

Phage library screening for the rapid identification and in vivo testing of candidate genes for a DNA vaccine against Mycoplasma mycoides subsp. mycoides small colony biotype

A new strategy for rapidly selecting and testing genetic vaccines has been developed, in which a whole genome library is cloned into a bacteriophage λ ZAP Express vector which contains both prokaryotic (Plac) and eukaryotic (PCMV) promoters upstream of the insertion site. The phage library is plated on Escherichia coli cells, immunoblotted, and probed with hyperimmune and/or convalescent-phase antiserum to rapidly identify vaccine candidates. These are then plaque purified and grown as liquid lysates, and whole bacteriophage particles are then used directly to immunize the host, following which PCMV-driven expression of the candidate vaccine gene occurs. In the example given here, a semirandom genome library of the bovine pathogen Mycoplasma mycoides subsp. mycoides small colony (SC) biotype was cloned into λ ZAP Express, and two strongly immunodominant clones, λ-A8 and λ-B1, were identified and subsequently tested for vaccine potential against M. mycoides subsp. mycoides SC biotype-induced mycoplasmemia. Sequencing and immunoblotting indicated that clone λ-A8 expressed an isopropyl-β-d-thiogalactopyranoside (IPTG)-inducible M. mycoides subsp. mycoides SC biotype protein with a 28-kDa apparent molecular mass, identified as a previously uncharacterized putative lipoprotein (MSC_0397). Clone λ-B1 contained several full-length genes from the M. mycoides subsp. mycoides SC biotype pyruvate dehydrogenase region, and two IPTG-independent polypeptides, of 29 kDa and 57 kDa, were identified on immunoblots. Following vaccination, significant anti-M. mycoides subsp. mycoides SC biotype responses were observed in mice vaccinated with clones λ-A8 and λ-B1. A significant stimulation index was observed following incubation of splenocytes from mice vaccinated with clone λ-A8 with whole live M. mycoides subsp. mycoides SC biotype cells, indicating cellular proliferation. After challenge, mice vaccinated with clone λ-A8 also exhibited a reduced level of mycoplasmemia compared to controls, suggesting that the MSC_0397 lipoprotein has a protective effect in the mouse model when delivered as a bacteriophage DNA vaccine. Bacteriophage-mediated immunoscreening using an appropriate vector system offers a rapid and simple technique for the identification and immediate testing of putative candidate vaccines from a variety of pathogens.

The cytochrome P-450 isoenzyme CYP2E1 in the biological processing of industrial chemicals : consequences for occupational and environmental medicine

The importance of the isoform CYP2E1 of the human cytochrome P-450 superfamily of enzymes for occupational and environmental medicine is derived from its unique substrate spectrum that includes a number of highly important high-production chemicals, such as aliphatic and aromatic hydrocarbons, solvents and industrial monomers (i.a. alkanes, alkenes, aromatic and halogenated hydrocarbons). Many polymorphic genes, such as CYP2E1, show considerable differences in allelic distribution between different human populations. The polymorphic nature of the human CYP2E1 gene is significant for inter-individual differences in toxicity of its substrates. Since the substrate spectrum of CYP2E1 includes many compounds of basic relevance to industrial toxicology, a rationale for metabolic interactions of different CYP2E1 substrates is provided. In-depth research into the inter-individual phenotypic differences of human CYP2E1 enzyme activities was enabled by the recognition that the 6-hydroxylation of the drug chlorzoxazone is mediated by CYP2E1. Studies on CYP2E1 phenotyping have pointed to inter-individual variations in enzyme activities. There are consistent ethnic differences in CYP2E1 enzyme expression, mostly demonstrated between European and Japanese populations, which point to a major impact of genetic factors. The most frequently studied genetic polymorphisms are the restriction fragment length polymorphisms PstI/RsaI (mutant allele: CYP2E1*5B) located in the 5′-flanking region of the gene, as well as the DraI polymorphism (mutant allele: CYP2E1*6) located in intron 6. These polymorphisms are partly related, as they form the common allele designated CYP2E1*5A. Striking inter-ethnic differences between Europeans and Asians appear with respect to the frequencies of the CYP2E1*5A allele (only approximately 5% of Europeans are heterozygous, but 37% of Asians are, whilst 6% of Asians are homozygous). Available studies indicate a wide variation in human CYP2E1 expression, which are very likely based on complex gene-environment interactions. Major inter-ethnic differences are apparent on the genotyping and the phenotyping levels. Selected cases are presented where inter-ethnic variations of CYP2E1 may provide likely explanations for unexplained findings concerning industrial chemicals that are CYP2E1 substrates. Possible consequences of differential inter-individual and inter-ethnic susceptibilities are related to individual expressions of clinical symptoms of chemical toxicity, to results of biological monitoring of exposed workers, and to the interpretation of results of epidemiological or molecular-epidemiological studies.

Brief interventions to reduce ecstasy use : a multi-site randomized controlled trial

Studies examining the ability of motivational enhancement therapy (MET) to augment education provision among ecstasy users have produced mixed results and none have examined whether treatment fidelity was related to ecstasy use outcomes. The primary objectives of this multi-site, parallel, two-group randomized controlled trial were to determine if a single-session of MET could instill greater commitment to change and reduce ecstasy use and related problems more so than an education-only intervention and whether MET sessions delivered with higher treatment fidelity are associated with better outcomes. The secondary objective was to assess participants’ satisfaction with their assigned interventions. Participants (N = 174; Mage = 23.62) at two Australian universities were allocated randomly to receive a 15-minute educational session on ecstasy use (n = 85) or a 50-minute session of MET that included an educational component (n = 89). Primary outcomes were assessed at baseline, and then at 4-, 16-, and 24-weeks post-baseline, while the secondary outcome measure was assessed 4-weeks post-baseline by researchers blind to treatment allocation. Overall, the treatment fidelity was acceptable to good in the MET condition. There were no statistical differences at follow-up between the groups on the primary outcomes of ecstasy use, ecstasy-related problems, and commitment to change. Both interventions groups reported a 50% reduction in their ecstasy use and a 20% reduction in the severity of their ecstasy-related problems at the 24-week follow up. Commitment to change slightly improved for both groups (9% - 17%). Despite the lack of between-group statistical differences on primary outcomes, participants who received a single session of MET were slightly more satisfied with their intervention than those who received education only. MI fidelity was not associated with ecstasy use outcomes. Given these findings, future research should focus on examining mechanisms of change. Such work may suggest new methods for enhancing outcomes.

Modeling conditional correlations of asset returns : a smooth transition approach

In this paper we propose a new multivariate GARCH model with time-varying conditional correlation structure. The time-varying conditional correlations change smoothly between two extreme states of constant correlations according to a predetermined or exogenous transition variable. An LM–test is derived to test the constancy of correlations and LM- and Wald tests to test the hypothesis of partially constant correlations. Analytical expressions for the test statistics and the required derivatives are provided to make computations feasible. An empirical example based on daily return series of five frequently traded stocks in the S&P 500 stock index completes the paper.

Evaluation of features for leaf classification in challenging conditions

Fine-grained leaf classification has concentrated on the use of traditional shape and statistical features to classify ideal images. In this paper we evaluate the effectiveness of traditional hand-crafted features and propose the use of deep convolutional neural network (ConvNet) features. We introduce a range of condition variations to explore the robustness of these features, including: translation, scaling, rotation, shading and occlusion. Evaluations on the Flavia dataset demonstrate that in ideal imaging conditions, combining traditional and ConvNet features yields state-of-theart performance with an average accuracy of 97:3%�0:6% compared to traditional features which obtain an average accuracy of 91:2%�1:6%. Further experiments show that this combined classification approach consistently outperforms the best set of traditional features by an average of 5:7% for all of the evaluated condition variations.

Use of physical activity self-management strategies by high school students

Teaching adolescents to use self-management strategies (SMS's) may be an effective approach to promoting lifelong physical activity (PA). However, the extent to which adolescents use SMS's and their impact on current PA have not been studied previously. The aims of this study were: 1) describe the prevalence of SMS use in adolescents; and 2) determine relationships between SMS use, PA self-efficacy, and PA participation. 197 students completed questionnaires measuring use of SMS's, self-efficacy, and PA behavior. The most prevalent SMS's (>30%) were thinking about the benefits of PA, making PA more enjoyable, choosing activities that are convenient, setting aside time to do PA, and setting goals to do PA. Less than 10% reported rewarding oneself for PA, writing planned activities in a book or calendar, and keeping charts of PA. SMS use was associated with increased self-efficacy (r = 0.47, P < .001) and higher levels of PA (r = 0.34 P < .001). A one unit difference in SMS scores was associated with a ~ 4-fold increase in the probability of being active (OR = 3.7, 95% CI = 1.8-7.4). Although strongly associated with PA, a relatively small percentage of adolescents routinely use SMS's.

A Likelihood-Maximizing Framework for Enhanced In-Car Speech Recognition Based on Speech Dialog System Interaction

Speech recognition in car environments has been identified as a valuable means for reducing driver distraction when operating noncritical in-car systems. Under such conditions, however, speech recognition accuracy degrades significantly, and techniques such as speech enhancement are required to improve these accuracies. Likelihood-maximizing (LIMA) frameworks optimize speech enhancement algorithms based on recognized state sequences rather than traditional signal-level criteria such as maximizing signal-to-noise ratio. LIMA frameworks typically require calibration utterances to generate optimized enhancement parameters that are used for all subsequent utterances. Under such a scheme, suboptimal recognition performance occurs in noise conditions that are significantly different from that present during the calibration session – a serious problem in rapidly changing noise environments out on the open road. In this chapter, we propose a dialog-based design that allows regular optimization iterations in order to track the ever-changing noise conditions. Experiments using Mel-filterbank noise subtraction (MFNS) are performed to determine the optimization requirements for vehicular environments and show that minimal optimization is required to improve speech recognition, avoid over-optimization, and ultimately assist with semireal-time operation. It is also shown that the proposed design is able to provide improved recognition performance over frameworks incorporating a calibration session only.

Supporting the needs of public health decision-makers and review authors in the UK

Introduction Systematic reviews, through the synthesis of multiple primary research studies, can be powerful tools in enabling evidence-informed public health policy debate, development and action. In seeking to optimize the utility of these reviews, it is important to understand the needs of those using them. Previous work has emphasized that researchers should adopt methods that are appropriate to the problems that public health decision-makers are grappling with, as well as to the policy context in which they operate.1,2 Meeting these demands poses significant methodological challenges for review authors and prompts a reconsideration of the resources, training and support structures available to facilitate the efficient and timely production of useful, comprehensive reviews. The Cochrane Public Health Group (CPHG) was formed in 2008 to support reviews of complex, upstream public health topics. The majority of CPHG authors are from the UK, which has historically been at the forefront of efforts to promote the production and use of systematic reviews of research relevant to public health decision-makers. The UK therefore provides a suitably mature national context in which to examine (i) the current and future demands of decision-makers to increase the use, value and impact of evidence syntheses; (ii) the implications this has for the scope and methods of reviews and (iii) the required action to build and support capacity to conduct such reviews.