Design and physicochemical characterisation of a bioadhesive patch for dose-controlled topical delivery of imiquimod

Clinical use of the imidazoquinoline immunomodulator imiquimod for the topical treatment of dysplastic and neoplastic lesions has increased markedly in recent years. However, despite guidance from the manufacturer of the proprietary imiquimod cream, there seems to be little consensus between clinicians as to the topically applied dose. Given that patients often apply the cream themselves at home, further dosing variability is expected and, consequently, accurate comparison of the results of different published studies is dif?cult. This paper describes, for the ?rst time, the formulation and physicochemical characterisation of a bioadhesive patch for dose-controlled topical delivery of imiquimod as well as a new HPLC method for sensitive ?uorescence determination of imiquimod released from such systems. Patches containing imiquimod loadings of 4.75, 9.50 and 12.50 mg cm-2 all released signi?cantly more drug across a model membrane than the proprietary cream over a period of 6 h. Inclusion of imiquimod in patches did not adversely affect their physicochemical properties. Of major importance, patches contained de?ned drug loadings per unit area; therefore, their use could reduce inter-clinician variability. This would make critical comparison of clinical studies and determination of an appropriate imiquimod dose for successful treatment much simpler. Since bioadhesive formulations are capable of adhering to body tissues in moist environments, the use of a bioadhesive patch system may allow extension of the clinical uses of imiquimod to the treatment of neoplastic conditions of the oral cavity and cervix, as well as the vulva. © 2005 Elsevier B.V. All rights reserved.

Long-term ecology of native pinewood communities in East Glen Affric, Scotland

Fossil pollen, stomata and charcoal were examined from a lake sedimentary sequence in the Glen Affric National Nature Reserve, one of the largest areas of remnant native pine woodland in Scotland, in order to assess ecosystem dynamics over the last 11 000 years. Results reveal that pinewood communities have been continuously present in East Glen Affric for the last 8300 years. Pinus sylvestris fi rst arrived in the area around 9900 cal. BP, but occurred in only low abundance for the subsequent 1600 years. Pine populations expanded around 8300 cal. BP and remained in relatively constant abundance throughout the remainder of the Holocene. There is no evidence of a hypothesized regional mid-Holocene ‘ pine decline ’ at the site. Charcoal results reveal that pinewood communities in East Glen Affric do not appear to have been dependent on fire for either their establishment or their maintenance as has previously been suggested.

Impacts of climate change on species, populations and communities: palaeobiogeographical insights and frontiers

Understanding climate change and its potential impact on species, populations and communities is one of the most pressing questions of twenty-fi rst-century conservation planning. Palaeobiogeographers working on Cenozoic fossil records and other lines of evidence are producing important insights into the dynamic nature of climate and the equally dynamic response of species, populations and communities. Climatic variations ranging in length from multimillennia to decades run throughout the palaeo-records of the Quaternary and earlier Cenozoic and have been shown to have had impacts ranging from changes in the genetic structure and morphology of individual species, population sizes and distributions, community composition to large-scale bio-diversity gradients. The biogeographical impacts of climate change may be due directly to the effects of alterations in temperature and moisture on species, or they may arise due to changes in factors such as disturbance regimes. Much of the recent progress in the application of palaeobiogegraphy to issues of climate change and its impacts can be attributed to developments along a number of still advancing methodological frontiers. These include increasingly finely resolved chronological resolution, more refi ned atmosphere-biosphere modelling, new biological and chemical techniques in reconstructing past species distributions and past climates, the development of large and readily accessible geo-referenced databases of biogeographical and climatic information, and new approaches in fossil morphological analysis and new molecular DNA techniques.

The 1996 ‘Muslim holiday’ affair. Religious competition and state mediation in contemporary Mozambique

Political commentators often cast religious con? ict as the result of the numerical growth and political rise of a single faith. When Islam is involved, arguments about religious fundamentalism are quick to surface and often stand as an explanation in their own right. Yet, as useful as this type of explanation may be, it usually fails to address properly, if at all, two sets of important issues. It avoids, Ž rst, the question of the rise of other religions and their contribution to tensions and con? icts. Second, it reduces the role of the State to a reactive one. The State becomes an object of contest or conquest, or it is simply ignored. Adopting a different approach, this article investigates a controversy that took place in Mozambique in 1996 around the ‘ofŽ cialisation’ of two Islamic holidays. It looks at the role played by religious competition and state mediation. The article shows that the State’s abandonment of religious regulation – the establishment of a free ‘religious market’ – fostered religious competition that created tensions between faiths. It suggests that strife ensued because deregulation was almost absolute: the State did not take a clear stand in religious matters and faith organisations started to believe that the State was becoming, or could become, confessional. The conclusion discusses theoretical implications for the understanding of religious strife as well as Church and State relations. It also draws some implications for the case of Mozambique more speciŽ cally, implications which should have relevance for countries such as Malawi, Zambia and Zimbabwe where problems of a similar nature have arisen.

Influence of ABCB1 polymorphisms and haplotypes on tacrolimus nephrotoxicity and dosage requirements in children with liver transplant

AIMS
The aim of this study was to investigate the in?uence of genetic polymorphisms in ABCB1 on the incidence of nephrotoxicity and tacrolimus dosage-requirements in paediatric patients following liver transplantation.
METHODS
Fifty-one paediatric liver transplant recipients receiving tacrolimus were genotyped for ABCB1 C1236>T, G2677>T and C3435>T polymorphisms. Dose-adjusted tacrolimus trough concentrations and estimated glomerular ?ltration rates (EGFR) indicative of renal toxicity were determined and correlated with the corresponding genotypes.
RESULTS
The present study revealed a higher incidence of the ABCB1 variant-alleles examined among patients with renal dysfunction (30% reduction in EGFR) at 6 months post-transplantation (1236T allele: 63.3% vs 37.5% in controls,P = 0.019; 2677T allele: 63.3% vs. 35.9%, p = 0.012; 3435T allele: 60% vs. 39.1%,P = 0.057). Carriers of the G2677->T variant allele also had a signi?cant reduction (%) in EGFR at 12 months post-transplant (mean difference = 22.6%; P = 0.031). Haplotype analysis showed a signi?cant association between T-T-T haplotypes and an increased incidence of nephrotoxicity at 6 months post-transplantation (haplotype-frequency = 52.9% in nephrotoxic patients vs 29.4% in controls; P = 0.029). Furthermore, G2677->T and C3435->T polymorphisms and T-T-T haplotypes were signi?cantly correlated with higher tacrolimus dose-adjusted pre-dose concentrations at various time points examined long after drug initiation.
CONCLUSIONS
These ?ndings suggest that ABCB1 polymorphisms in the native intestine signi?cantly in?uence tacrolimus dosage-requirement in the stable phase after transplantation. In addition, ABCB1 polymorphisms in paediatric liver transplant recipients may predispose them to nephrotoxicity over the ?rst year posttransplantation. Genotyping future transplant recipients for ABCB1 polymorphisms, therefore, could have the potential to individualize better tacrolimus immunosuppressive therapy and enhance drug safety

BRCA1 and implications for response to chemotherapy in ovarian cancer

Objectives: Treatment of epithelial ovarian cancer (EOC) remains a challenge, despite advances in surgery and chemotherapy. Hereditary ovarian cancer is primarily due to germline mutations in the BRCA1 tumour suppressor gene. In addition, sporadic EOC tumours display signi?cant of loss of BRCA1 function due to epigenetic inactivation of the BRCA1 gene. This article reviews the preclinical and clinical evidence to support a role for BRCA1 as a potential predictive biomarker of response to both platinum and taxane based chemotherapy in EOC.

Methods: We conducted a Medline and Pubmed search for reports between 1990 and 2008 using the search terms: BRCA1 and hereditary ovarian cancer, BRCA1 and sporadic ovarian cancer, ovarian cancer and chemotherapy, ovarian cancer and taxanes, ovarian cancer and platinums, ovarian cancer and clinical response, BRCA1 and DNA damage, BRCA1 and DNA repair, BRCA1 and mitotic checkpoint. If reports identi?ed by these criteria referred to other papers not in the initial search, then these were also reviewed if relevant to BRCA1 and ovarian cancer.

Results: The BRCA1 pathway plays a signi?cant role in the development of both hereditary and sporadic EOC. Evidence suggests that BRCA1 is a potential biomarker of response to platinum chemotherapy in EOC with BRCA1 de?ciency predicting for enhanced response. In contrast, initial evidence suggests that loss of BRCA1 function results in reduced response to antimicrotubule-based chemotherapy. The ability of BRCA1 to differentially modulate response to these agents involves loss of BRCA1 mediated DNA repair and mitotic checkpoint control, respectively.

Conclusions: Standard ?rst line treatment of EOC consists of a combination of platinum and taxane chemotherapy, however clinically useful biomarkers for predicting response to these agents have yet to be established. BRCA1 may prove useful as a biomarker in EOC for assigning chemotherapy treatments based on the presence or absence of BRCA1 function.

Comparison of positron-impact vibrational excitation cross sections with the Born-dipole model

The development of cold trap-based positron beams and new scattering techniques has recently enabled the ?rst measurements of state-resolved positron-impact vibrational excitation cross sections. These measurements revealed a number of features worth further consideration, such as relatively sharp increases near threshold. This paper describes a comparison of the magnitudes and shapes of these cross sections with the predictions of the Born-dipole model. Agreement of the magnitudes of the cross sections varies widely, ranging from reasonable to excellent agreement for CO2 and CF4 to poor agreement for CO and CH4. In contrast, the energy dependence of these cross sections in all these cases is close to that predicted by the Born model.

On how structural model variability influence transonic aeroelasticity stability.

This paper considers the ways in which structural model parameter variability can in?uence aeroelastic stability. Previous work on formulating the stability calculation (with the Euler equations providing the aerodynamic predictions) is exploited to use Monte Carlo, Interval and Perturbation calculations to allow this question to be investigated. Three routes are identi?ed. The ?rst involves variable normal mode frequencies only. The second involves normal mode frequencies and mode shapes. Finally, the third, in addition to normal mode frequencies and mode shapes, also includes their in?uence on the static equilibrium. Previous work has suggested only considering route 1, which allows signi?cant gains in computational e?ciency if reduced order models can be built for the aerodynamics. However, results in the current paper show that neglecting route 2 can give misleading results for the ?utter onset prediction.

A Frequency Domain Algorithm for Wave Separation

We propose a frequency domain adaptive algorithm for
wave separation in wind instruments. Forward and backward travelling waves are obtained from the signals acquired by two microphones placed along the tube, while the
separation ?lter is adapted from the information given by a
third microphone. Working in the frequency domain has a
series of advantages, among which are the ease of design of
the propagation ?lter and its differentiation with respect to
its parameters.
Although the adaptive algorithm was developed as a ?rst
step for the estimation of playing parameters in wind instruments it can also be used, without any modi?cations, for
other applications such as in-air direction of arrival (DOA)
estimation. Preliminary results on these applications will
also be presented.

Estimation of Clarinet Reed Parameters by Inverse Modelling

Analysis of the acoustical functioning of musical instruments invariably involves the estimation of model parameters. The broad aim of this paper is to develop methods for estimation of clarinet reed parameters that are representative of actual playing conditions. This presents various challenges because of the di?culties of measuring the directly relevant variables without interfering with the control of the instrument. An inverse modelling approach is therefore proposed, in which the equations governing the sound generation mechanism of the clarinet
are employed in an optimisation procedure to determine the reed parameters from the mouthpiece pressure and volume ?ow signals. The underlying physical model captures most of the reed dynamics and is simple enough to be used in an inversion process. The optimisation procedure is ?rst tested by applying it to numerically synthesised signals, and then applied to mouthpiece signals acquired during notes blown by a human player. The proposed inverse modelling approach raises the possibility of revealing information about the way in which the embouchure-related reed parameters are controlled by the player, and also facilitates physics-based re-synthesis of clarinet sounds.

Informed consent and the requirement to ensure understanding

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood.Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken.When investigating what information is needed for consent to be informed we might be trying to determine what information a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the ?rst type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it.

Who do we treat when resources are scarce?

In a health service with limited resources we must make decisions about who to treat ?rst. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don’t know in a particular case that the illness is self-in?icted, that it seems that all illness is self-in?icted in the sense used in my argument, and ?nally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like ?re-?ghters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections.

Bright Laser-Driven Neutron Source Based on the Relativistic Transparency of Solids

Neutrons are unique particles to probe samples in many ?elds of research ranging from biology to material sciences to engineering and security applications. Access to bright, pulsed sources is currently
limited to large accelerator facilities and there has been a growing need for compact sources over the recent years. Short pulse laser driven neutron sources could be a compact and relatively cheap way to
produce neutrons with energies in excess of 10 MeV. For more than a decade experiments have tried to obtain neutron numbers suf?cient for applications. Our recent experiments demonstrated an ion acceleration mechanism based on the concept of relativistic transparency. Using this new mechanism, we produced an intense beam of high energy (up to 170 MeV) deuterons directed into a Be converter to
produce a forward peaked neutron ?ux with a record yield, on the order of 1010 n=sr. We present results comparing the two acceleration mechanisms and the ?rst short pulse laser generated neutron radiograph.

A Comparison of Programming Models for Multiprocessors with Explicitly Managed Memory Hierarchies

On multiprocessors with explicitly managed memory hierarchies (EMM), software has the responsibility of moving data in and out of fast local memories. This task can be complex and error-prone even for expert programmers. Before we can allow compilers to handle the complexity for us, we must identify the abstractions that are general enough to allow us to write applications with reasonable effort, yet speci?c enough to exploit the vast on-chip memory bandwidth of EMM multi-processors. To this end, we compare two programming models against hand-tuned codes on the STI Cell, paying attention to programmability and performance. The ?rst programming model, Sequoia, abstracts the memory hierarchy as private address spaces, each corresponding to a parallel task. The second, Cellgen, is a new framework which provides OpenMP-like semantics and the abstraction of a shared address spaces divided into private and shared data. We compare three applications programmed using these models against their hand-optimized counterparts in terms of abstractions, programming complexity, and performance.

The Source of 3 Minute Magnetoacoustic Oscillations in Coronal Fans

We use images of high spatial, spectral, and temporal resolution, obtained using both ground- and space-based instrumentation, to investigate the coupling between wave phenomena observed at numerous heights in the solar atmosphere. Analysis of 4170 Å continuum images reveals small-scale umbral intensity enhancements, with diameters ~0."6, lasting in excess of 30 minutes. Intensity oscillations of ˜3 minutes are observed to encompass these photospheric structures, with power at least three orders of magnitude higher than the surrounding umbra. Simultaneous chromospheric velocity and intensity time series reveal an 87?±8? out-of-phase behavior, implying the presence of standing modes created as a result of partial wave re?ection at the transition region boundary. We ?nd a maximum waveguide inclination angle of˜40? between photospheric and chromospheric heights, combined with a radial expansion factor of <76%. An average blueshifted Doppler velocity of ˜1.5 km s-1, in addition to a time lag between photospheric and chromospheric oscillatory phenomena, con?rms the presence of upwardly propagating slow-mode waves in the lower solar atmosphere. Propagating oscillations in EUV intensity are detected in simultaneous coronal fan structures, with a periodicity of 172±17 s and a propagation velocity of 45±7 km s-1. Numerical simulations reveal that the damping of the magnetoacoustic wave trains is dominated by thermal conduction. The coronal fans are seen to anchor into the photosphere in locations where large-amplitude umbral dot (UD) oscillations manifest. Derived kinetic temperature and emission measure time series display prominent outof-phase characteristics, and when combined with the previously established sub-sonic wave speeds, we conclude that the observed EUV waves are the coronal counterparts of the upwardly propagating magnetoacoustic slow modes detected in the lower solar atmosphere. Thus, for the ?rst time, we reveal how the propagation of 3 minute magnetoacoustic waves in solar coronal structures is a direct result of amplitude enhancements occurring in photospheric UDs.photospheric UDs.