EGFR expression : associations with outcome and clinicopathological variables in malignant pleural mesothelioma

Malignant mesothelioma (MM) is a fatal tumour of increasing incidence which is related to asbestos exposure. This work evaluated expression in MM of Epidermal Growth Factor Receptor (EGFR) by immunohistochemistry in 168 tumour sections and its correlations with clinicopathological and biological factors. The microvessel density (MVD) was derived from CD34 immunostained sections. Hematoxylin and eosin stained sections were examined for intratumoural necrosis. COX-2 protein expression was evaluated with semi-quantitative Western blotting of homogenised tumour supernatants (n = 45). EGFR expression was correlated with survival by Kaplan-Meier and log rank analysis. Univariate and multivariate Cox proportional hazards models were used to compare the effects of EGFR with clinicopathological and biological prognostic factors and prognostic scoring systems. EGFR expression was identified in 74 cases (44%) and correlated with epithelioid cell type (p < 0.0001), good performance status (p < 0.0001), the absence of chest pain (p < 0.0001) and the presence of TN (p = 0.004), but not MVD or COX-2. EGFR expression was a good prognostic factor in univariate analysis (p = 0.01). Independent indicators of poor prognosis in multivariate analysis were non-epithelioid cell type (p = 0.0001), weight loss, performance status and WBC > 8.3 × 10 9 L -1. EGFR status was not an independent prognostic factor. EGFR expression in MM correlates with epithelioid histology and TN. EGFR may be a target for selective therapies in MM. © 2006 Elsevier Ireland Ltd. All rights reserved.

Differential pathologic variables and outcomes across the spectrum of adenocarcinoma of the esophagogastric junction

Background Adenocarcinoma of the esophagogastric junction (AEG) as described by Siewert et al. is classified as one entity in the latest (7th Edition) American Joint Cancer Committee/International Union Against Cancer (AJCC/UICC) manual, compared with the previous mix of esophageal and gastric staging systems. The origin of AEG tumors, esophageal or gastric, and their biology remain controversial, particularly for AEG type II (cardia) tumors. Methods We adapted a large prospective database (n = 520: 180 type I, 182 type II, 158 type III) to compare AEG tumors under the new TNM system Pathological variables associated with prognosis were compared (pT, pN, stage, differentiation, R status, lymphovascular invasion, perineural involvement, number of positive nodes, percent of positive nodes, and tumor length), as well as overall survival. Results Compared with AEG type I tumors, type II and type III tumors had significantly (p\0.05) more advanced pN stages, greater number and percentage of positive nodes, poorer differentiation, more radial margin involvement, and more perineural invasion. In AEG type I, 14/180 patients (8%) had[6 involved nodes (pN3), compared with 16 and 30% of patients classified type II and III, respectively. Median survival was significantly (p = 0.03) improved for type I patients (38 months) compared with those with tumors classified as type II (28 months) and type III (24 months). In multivariate analysis node positivity and pN staging but not AEG site had an impact on survival. Conclusions In this series AEG type I is associated with more favorable pathologic features and improved outcomes compared with AEG type II and III. This may reflect earlier diagnosis, but an alternative possibility, that type I may be a unique paradigm with more favorable biology, requires further study. © Société Internationale de Chirurgie 2010.

Tumour necrosis is an independent prognostic marker in non-small cell lung cancer : correlation with biological variables

Background Tumour necrosis (TN) is recognized to be a consequence of chronic cellular hypoxia. TN and hypoxia correlate with poor prognosis in solid tumours. Methods In a retrospective study the prognostic implications of the extent of TN was evaluated in non-small cell lung cancer (NSCLC) and correlated with clinicopathological variables and expression of epidermal growth factor receptor, Bcl-2, p53 and matrix metalloproteinase-9 (MMP-9). Tissue specimens from 178 surgically resected cases of stage I-IIIA NSCLC with curative intent were studied. The specimens were routinely processed, formalin-fixed and paraffin-embedded. TN was graded as extensive or either limited or absent by two independent observers; disagreements were resolved using a double-headed microscope. The degree of reproducibility was estimated by re-interpreting 40 randomly selected cases after a 4 month interval. Results Reproducibility was attained in 36/40 cases, Kappa score=0.8 P<0.001. TN correlated with T-stage (P=0.001), platelet count (P=0.004) and p53 expression (P=0.031). Near significant associations of TN with N-stage (P=0.063) and MMP-9 expression (P=0.058) were seen. No association was found with angiogenesis (P=0.98). On univariate (P=0.0016) and multivariate analysis (P=0.023) TN was prognostic. Conclusion These results indicate that extensive TN reflects an aggressive tumour phenotype in NSCLC and may improve the predictive power of the TMN staging system. The lack of association between TN and angiogenesis may be important although these variables were not evaluated on serial sections. © 2002 Elsevier Science Ireland Ltd. All rights reserved.

A threshold analysis of dengue transmission in terms of weather variables and imported dengue cases in Australia

Dengue virus (DENV) transmission in Australia is driven by weather factors and imported dengue fever (DF) cases. However, uncertainty remains regarding the threshold effects of high-order interactions among weather factors and imported DF cases and the impact of these factors on autochthonous DF. A time-series regression tree model was used to assess the threshold effects of natural temporal variations of weekly weather factors and weekly imported DF cases in relation to incidence of weekly autochthonous DF from 1 January 2000 to 31 December 2009 in Townsville and Cairns, Australia. In Cairns, mean weekly autochthonous DF incidence increased 16.3-fold when the 3-week lagged moving average maximum temperature was <32 °C, the 4-week lagged moving average minimum temperature was ≥24 °C and the sum of imported DF cases in the previous 2 weeks was >0. When the 3-week lagged moving average maximum temperature was ≥32 °C and the other two conditions mentioned above remained the same, mean weekly autochthonous DF incidence only increased 4.6-fold. In Townsville, the mean weekly incidence of autochthonous DF increased 10-fold when 3-week lagged moving average rainfall was ≥27 mm, but it only increased 1.8-fold when rainfall was <27 mm during January to June. Thus, we found different responses of autochthonous DF incidence to weather factors and imported DF cases in Townsville and Cairns. Imported DF cases may also trigger and enhance local outbreaks under favorable climate conditions.

Valuing those close to us : A comparison of German and Australian quality newspapers’ reporting of death in foreign news

A number of studies into the coverage of death have provided some evidence of journalists giving preference to events from certain regions and to certain types of death. This comprehensive evaluation of how two German and two Australian newspapers cover death specifically in foreign news finds clear evidence that journalists primarily look for events in countries which are culturally proximate to their own. The cultural proximity thesis here includes links such as cultural, political, economic or linguistic connections with a country. Some important national differences in how journalists at the Frankfurter Allgemeine Zeitung, Süddeutsche Zeitung, The Australian and The Sydney Morning Herald report on death were also identified. These could be traced to some important cultural differences between the two countries, underlining the need for more research which locates culture at the core of news analysis.

Never Tear Us Apart : the tabloid version of the INXS story

A review of the first episode of the miniseries "Never Tear Us Apart: The Untold Story of INXS" produced by Shine Australia and broadcast on the Seven Network.

Psychosocial and communication variables involved in mediating the individual experience of older adults following a severe weather event

The recent floods in south-east Queensland have focused policy, academic and community attention on the challenges associated with severe weather events (SWE), specifically pre-disaster preparation, disaster-response and post-disaster community resilience. Financially, the cost of SWE was $9 billion in the 2011 Australian Federal Budget (Swan 2011); psychologically and emotionally, the impact on individual mental health and community wellbeing is also significant but more difficult to quantify. However, recent estimates suggest that as many as one in five will subsequently experience major emotional distress (Bonanno et al. 2010). With climate change predicted to increase the frequency and intensity of a wide range of SWE in Australia (Garnaut 2011; The Climate Institute 2011), there is an urgent and critical need to ensure that the unique psychological and social needs of more vulnerable community members - such as older residents - are better understood and integrated into disaster preparedness and response policy, planning and protocols. Navigating the complex dynamics of SWE can be particularly challenging for older adults and their disaster experience is frequently magnified by a wide array of cumulative and interactive stressors, which intertwine to make them uniquely vulnerable to significant short and long-term adverse effects. This current article provides a brief introduction to the current literature in this area and highlights a gap in the research relating to communication tools during and after severe weather events.

Total energy shaping of a class of underactuated Port-Hamiltonian Systems using a new set of closed-loop potential shape variables

This paper proposes a method for designing set-point regulation controllers for a class of underactuated mechanical systems in Port-Hamiltonian System (PHS) form. A new set of potential shape variables in closed loop is proposed, which can replace the set of open loop shape variables-the configuration variables that appear in the kinetic energy. With this choice, the closed-loop potential energy contains free functions of the new variables. By expressing the regulation objective in terms of these new potential shape variables, the desired equilibrium can be assigned and there is freedom to reshape the potential energy to achieve performance whilst maintaining the PHS form in closed loop. This complements contemporary results in the literature, which preserve the open-loop shape variables. As a case study, we consider a robotic manipulator mounted on a flexible base and compensate for the motion of the base while positioning the end effector with respect to the ground reference. We compare the proposed control strategy with special cases that correspond to other energy shaping strategies previously proposed in the literature.

Clinical dyslipidaemia is associated with changes in the lipid composition and inflammatory properties of apolipoprotein-B-containing lipoproteins from women with type 2 diabetes

The aim of this study was to use lipidomics to determine if the lipid composition of apolipoprotein-B-containing lipoproteins is modified by dyslipidaemia in type 2 diabetes and if any of the identified changes potentially have biological relevance in the pathophysiology of type 2 diabetes. VLDL and LDL from normolipidaemic and dyslipidaemic type 2 diabetic women and controls were isolated and quantified with HPLC and mass spectrometry. A detailed molecular characterisation of VLDL triacylglycerols (TAG) was also performed using the novel ozone-induced dissociation method, which allowed us to distinguish vaccenic acid (C18:1 n-7) from oleic acid (C18:1 n-9) in specific TAG species. Lipid class composition was very similar in VLDL and LDL from normolipidaemic type 2 diabetic and control participants. By contrast, dyslipidaemia was associated with significant changes in both lipid classes (e.g. increased diacylglycerols) and lipid species (e.g. increased C16:1 and C20:3 in phosphatidylcholine and cholesteryl ester and increased C16:0 [palmitic acid] and vaccenic acid in TAG). Levels of palmitic acid in VLDL and LDL TAG correlated with insulin resistance, and VLDL TAG enriched in palmitic acid promoted increased secretion of proinflammatory mediators from human smooth muscle cells. We showed that dyslipidaemia is associated with major changes in both lipid class and lipid species composition in VLDL and LDL from women with type 2 diabetes. In addition, we identified specific molecular lipid species that both correlate with clinical variables and are proinflammatory. Our study thus shows the potential of advanced lipidomic methods to further understand the pathophysiology of type 2 diabetes.

Accelerometer data reduction : a comparison of four reduction algorithms on select outcome variables

Purpose Accelerometers are recognized as a valid and objective tool to assess free-living physical activity. Despite the widespread use of accelerometers, there is no standardized way to process and summarize data from them, which limits our ability to compare results across studies. This paper a) reviews decision rules researchers have used in the past, b) compares the impact of using different decision rules on a common data set, and c) identifies issues to consider for accelerometer data reduction. Methods The methods sections of studies published in 2003 and 2004 were reviewed to determine what decision rules previous researchers have used to identify wearing period, minimal wear requirement for a valid day, spurious data, number of days used to calculate the outcome variables, and extract bouts of moderate to vigorous physical activity (MVPA). For this study, four data reduction algorithms that employ different decision rules were used to analyze the same data set. Results The review showed that among studies that reported their decision rules, much variability was observed. Overall, the analyses suggested that using different algorithms impacted several important outcome variables. The most stringent algorithm yielded significantly lower wearing time, the lowest activity counts per minute and counts per day, and fewer minutes of MVPA per day. An exploratory sensitivity analysis revealed that the most stringent inclusion criterion had an impact on sample size and wearing time, which in turn affected many outcome variables. Conclusions These findings suggest that the decision rules employed to process accelerometer data have a significant impact on important outcome variables. Until guidelines are developed, it will remain difficult to compare findings across studies

Associations between physical activity and other health behaviors in a representative sample of US adolescents

OBJECTIVES This study examined the associations between physical activity and other health behaviors in a representative sample of US adolescents. METHODS In the 1990 Youth Risk Behavior Survey, 11631 high school students provided information on physical activity; diet; substance use; and other negative health behaviors. Logistic regression analyses examined associations between physical activity and other health behaviors in a subset of 2652 high-active and 1641 low-active students. RESULTS Low activity was associated with cigarette smoking, marijuana use, lower fruit and vegetable consumption, greater television watching, failure to wear a seat belt, and low perception of academic performance. For consumption of fruit, television watching, and alcohol consumption, significant interactions were found with race/ethnicity or sex, suggesting that sociocultural factors may affect the relationships between physical activity and some health behaviors. CONCLUSIONS Low physical activity was associated with several other negative health behaviors in teenagers. Future studies should examine whether interventions for increasing physical activity in youth can be effective in reducing negative health behaviors.

Sports participation and health-related behaviors among US youth

Objective To examine the relationship between sports participation and health-related behaviors among high school students. Design Cross-sectional design using data from the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey. Participants A nationally representative sample of 14221 US high school students. Main Outcome Measures Prevalence of sports participation among males and females from 3 ethnic groups and its associations with other health behaviors, including diet, tobacco use, alcohol and illegal drug use, sexual activity, violence, and weight loss practices. Results Approximately 70% of male students and 53% of female students reported participating on 1 or more spores teams in school and/or nonschool settings; rates varied substantially by age, sex, and ethnicity. Male sports participants were more likely than male nonparticipants to report fruit and vegetable consumption on the previous day and less likely to report cigarette smelting, cocaine and other illegal drug use, and trying to lose weight. Compared with female nonparticipants, female sports participants were more likely to report consumption of vegetables on the previous day and less likely to report having sexual intercourse in the past 3 months. Among white males and females, several other beneficial health behaviors were associated with sports participation. A few associations with. negative health behaviors were observed in African American and Hispanic subgroups. Conclusion Sports participation is highly prevalent among US high school students, and is associated with numerous positive health behaviors and few negative health behaviors.

Identifying the spatial scale of land use that most strongly influences overall river ecosystem health score

Catchment and riparian degradation has resulted in declining ecosystem health of streams worldwide. With restoration a priority in many regions, there is an increasing interest in the scale at which land use influences stream ecosystem health. Our goal was to use a substantial data set collected as part of a monitoring program (the Southeast Queensland, Australia, Ecological Health Monitoring Program data set, collected at 116 sites over six years) to identify the spatial scale of land use, or the combination of spatial scales, that most strongly influences overall ecosystem health. In addition, we aimed to determine whether the most influential scale differed for different aspects of ecosystem health. We used linear-mixed models and a Bayesian model-averaging approach to generate models for the overall aggregated ecosystem health score and for each of the five component indicators (fish, macroinvertebrates, water quality, nutrients, and ecosystem processes) that make up the score. Dense forest close to the survey site, mid-dense forest in the hydrologically active nearstream areas of the catchment, urbanization in the riparian buffer, and tree cover at the reach scale were all significant in explaining ecosystem health, suggesting an overriding influence of forest cover, particularly close to the stream. Season and antecedent rainfall were also important explanatory variables, with some land-use variables showing significant seasonal interactions. There were also differential influences of land use for each of the component indicators. Our approach is useful given that restoring general ecosystem health is the focus of many stream restoration projects; it allowed us to predict the scale and catchment position of restoration that would result in the greatest improvement of ecosystem health in the regions streams and rivers. The models we generated suggested that good ecosystem health can be maintained in catchments where 80% of hydrologically active areas in close proximity to the stream have mid-dense forest cover and moderate health can be obtained with 60% cover.

Improving US airport taxicab services through governance arrangements

Most airports internationally have implemented customer satisfaction programs into their operations to increase non-aeronautical revenues. In the US, taxicabs are an essential airport transport mode given the limited public transport options available. Effective airport taxicab planning can increase airport customer satisfaction levels, as well as facilitate handling increased airport passenger volumes. However, little is known on how US airports have adapted their governance practices from a traditional hierarchical to a network approach in their efforts to undertake airport taxicab planning initiatives since the deregulation of the transportation industry. Data acquired from 51 US hub airports is used to examine their existing taxicab planning practices. The findings offer how US airports can modify governance processes in their airport taxicab planning processes to better support increases in the customer satisfaction levels of airport taxicab patrons.

Duty in the time of epidemics : what China and Zimbabwe teach us

In November 2002, a man with ‘atypical pneumonia’ treated in Foshan hospital, Guangdong Province, in the People's Republic of China, was the first known case of Severe Acute Respiratory Syndrome (SARS). However, it was not until April 2003 that the Chinese government admitted to the full scale of ‘atypical pneumonia’ cases infected with SARS, two months after the disease had rapidly spread across the world with initial infections in Hong Kong and Vietnam sourced to Guangdong. In 2008, Zimbabwe experienced one of the biggest outbreaks of cholera ever recorded. By February 2009, the disease had spread across all of Zimbabwe's 10 provinces and to neighbouring countries—Botswana, South Africa, Zambia and Mozambique—causing thousands of infections amongst their populations. This article seeks to examine what duties the Chinese and Zimbabwe states had to protect their citizens and the international community from these outbreaks. The article refers to the findings of the International Law Commission's study into the role of states and international organisations in protecting persons in the event of a disaster to consider whether there is an international duty to protect persons from epidemics. The article concludes that both cases reveal a growing concept of protection that entails an international duty to assist individuals when an affected state proves unwilling or unable to assist its own population in the event of a disease outbreak.