Safety and efficacy of the combination of trastuzumab with docetaxel for HER2-positive women with advanced breast cancer : a review of the existing clinical trials and results of the expanded access programme in the UK

Trastuzumab is a humanised monoclonal antibody against the extracellular domain of HER2 (human epidermal growth factor receptor-2) that is overexpressed in about 25% of human breast cancers. It has shown clinical benefit in HER2-positive breast cancer cases when used alone or in combination with chemotherapy. Trastuzumab increases the response rate to chemotherapy and prolongs survival when used in combination with taxanes. In this article, we review the clinical trials where trastuzumab has been administered together with docetaxel, and we present the results of the trastuzumab expanded access programme (EAP) in the UK. Combination of trastuzumab with docetaxel results in similar response rates and time-to-progression with the trastuzumab/paclitaxel combinations. The toxicity of the combination and the risk of heart failure are low. The clinical data for the docetaxel/trastuzumab combination indicate a favourable profile from both the efficacy and the safety point of view and confirm the feasibility and safety of trastuzumab administration both as monotherapy and in combination with docetaxel. © 2004 Blackwell Publishing Ltd.

A vibrational spectroscopic study of the phosphate mineral whiteite CaMn++Mg2Al2(PO4)4(OH)2·8(H2O)

Vibrational spectroscopy enables subtle details of the molecular structure of whiteite to be determined. Single crystals of a pure phase from a Brazilian pegmatite were used. The infrared and Raman spectroscopy were applied to compare the molecular structure of whiteite with that of other phosphate minerals. The Raman spectrum of whiteite shows an intense band at 972 cm-1 assigned to the m1 PO3- 4 symmetric stretching vibrations. The low intensity Raman bands at 1076 and 1173 cm-1 are assigned to the m3 PO3- 4 antisymmetric stretching modes. The Raman bands at 1266, 1334 and 1368 cm-1 are assigned to AlOH deformation modes. The infrared band at 967 cm-1 is ascribed to the PO3- 4 m1 symmetric stretching vibrational mode. The infrared bands at 1024, 1072, 1089 and 1126 cm-1 are attributed to the PO3-4 m3 antisymmetric stretching vibrations. Raman bands at 553, 571 and 586 cm-1 are assigned to the m4 out of plane bending modes of the PO3- 4 unit. Raman bands at 432, 457, 479 and 500 cm-1 are attributed to the m2 PO4 and H2PO4 bending modes. In the 2600 to 3800 cm-1 spectral range, Raman bands for whiteite are found 3426, 3496 and 3552 cm-1 are assigned to AlOH stretching vibrations. Broad infrared bands are also found at 3186 cm-1. Raman bands at 2939 and 3220 cm-1 are assigned to water stretching vibrations. Raman spectroscopy complimented with infrared spectroscopy has enabled aspects of the structure of whiteite to be ascertained and compared with that of other phosphate minerals.

In vivo and in vitro models demonstrate a role for caveolin-1 in the pathogenesis of ischaemic acute renal failure

Caveolae and their proteins, the caveolins, transport macromolecules; compartmentalize signalling molecules; and are involved in various repair processes. There is little information regarding their role in the pathogenesis of significant renal syndromes such as acute renal failure (ARF). In this study, an in vivo rat model of 30 min bilateral renal ischaemia followed by reperfusion times from 4 h to 1 week was used to map the temporal and spatial association between caveolin-1 and tubular epithelial damage (desquamation, apoptosis, necrosis). An in vitro model of ischaemic ARF was also studied, where cultured renal tubular epithelial cells or arterial endothelial cells were subjected to injury initiators modelled on ischaemia-reperfusion (hypoxia, serum deprivation, free radical damage or hypoxia-hyperoxia). Expression of caveolin proteins was investigated using immunohistochemistry, immunoelectron microscopy, and immunoblots of whole cell, membrane or cytosol protein extracts. In vivo, healthy kidney had abundant caveolin-1 in vascular endothelial cells and also some expression in membrane surfaces of distal tubular epithelium. In the kidneys of ARF animals, punctate cytoplasmic localization of caveolin-1 was identified, with high intensity expression in injured proximal tubules that were losing basement membrane adhesion or were apoptotic, 24 h to 4 days after ischaemia-reperfusion. Western immunoblots indicated a marked increase in caveolin-1 expression in the cortex where some proximal tubular injury was located. In vitro, the main treatment-induced change in both cell types was translocation of caveolin-1 from the original plasma membrane site into membrane-associated sites in the cytoplasm. Overall, expression levels did not alter for whole cell extracts and the protein remained membrane-bound, as indicated by cell fractionation analyses. Caveolin-1 was also found to localize intensely within apoptotic cells. The results are indicative of a role for caveolin-1 in ARF-induced renal injury. Whether it functions for cell repair or death remains to be elucidated.

Comparison of accelerometer cut points for predicting activity intensity in youth

The absence of comparative validity studies has prevented researchers from reaching consensus regarding the application of intensity-related accelerometer cut points for children and adolescents. PURPOSE This study aimed to evaluate the classification accuracy of five sets of independently developed ActiGraph cut points using energy expenditure, measured by indirect calorimetry, as a criterion reference standard. METHODS A total of 206 participants between the ages of 5 and 15 yr completed 12 standardized activity trials. Trials consisted of sedentary activities (lying down, writing, computer game), lifestyle activities (sweeping, laundry, throw and catch, aerobics, basketball), and ambulatory activities (comfortable walk, brisk walk, brisk treadmill walk, running). During each trial, participants wore an ActiGraph GT1M, and VO 2 was measured breath-by-breath using the Oxycon Mobile portable metabolic system. Physical activity intensity was estimated using five independently developed cut points: Freedson/Trost (FT), Puyau (PU), Treuth (TR), Mattocks (MT), and Evenson (EV). Classification accuracy was evaluated via weighted κ statistics and area under the receiver operating characteristic curve (ROC-AUC). RESULTS Across all four intensity levels, the EV (κ = 0.68) and FT (κ = 0.66) cut points exhibited significantly better agreement than TR (κ = 0.62), MT (κ = 0.54), and PU (κ = 0.36). The EV and FT cut points exhibited significantly better classification accuracy for moderate-to vigorous-intensity physical activity (ROC-AUC = 0.90) than TR, PU, or MT cut points (ROC-AUC = 0.77-0.85). Only the EV cut points provided acceptable classification accuracy for all four levels of physical activity intensity and performed well among children of all ages. The widely applied sedentary cut point of 100 counts per minute exhibited excellent classification accuracy (ROC-AUC = 0.90). CONCLUSIONS On the basis of these findings, we recommend that researchers use the EV ActiGraph cut points to estimate time spent in sedentary, light-, moderate-, and vigorous-intensity activity in children and adolescents. Copyright © 2011 by the American College of Sports Medicine.

Artemisinin induced dormancy in Plasmodium falciparum : duration, recovery rates and implications in treatment failure

Background Despite the remarkable activity of artemisinin and its derivatives, monotherapy with these agents has been associated with high rates of recrudescence. The temporary arrest of the growth of ring-stage parasites (dormancy) after exposure to artemisinin drugs provides a plausible explanation for this phenomenon. Methods Ring-stage parasites of several Plasmodium falciparum lines were exposed to different doses of dihydroartemisinin (DHA) alone or in combination with mefloquine. For each regime, the proportion of recovering parasites was determined daily for 20 days. Results Parasite development was abruptly arrested after a single exposure to DHA, with some parasites being dormant for up to 20 days. Approximately 50% of dormant parasites recovered to resume growth within the first 9 days. The overall proportion of parasites recovering was dose dependent, with recovery rates ranging from 0.044% to 1.313%. Repeated treatment with DHA or with DHA in combination with mefloquine led to a delay in recovery and an ∼10-fold reduction in total recovery. Strains with different genetic backgrounds appeared to vary in their capacity to recover. Conclusions These results imply that artemisinin-induced arrest of growth occurs readily in laboratory-treated parasites and may be a key factor in P. falciparum malaria treatment failure.

Accounting for individual variability in the von Bertalanffy growth model

Estimation of von Bertalanffy growth parameters has received considerable attention in fisheries research. Since Sainsbury (1980, Can. J. Fish. Aquat. Sci. 37: 241-247) much of this research effort has centered on accounting for individual variability in the growth parameters. In this paper we demonstrate that, in analysis of tagging data, Sainsbury's method and its derivatives do not, in general, satisfactorily account for individual variability in growth, leading to inconsistent parameter estimates (the bias does not tend to zero as sample size increases to infinity). The bias arises because these methods do not use appropriate conditional expectations as a basis for estimation. This bias is found to be similar to that of the Fabens method. Such methods would be appropriate only under the assumption that the individual growth parameters that generate the growth increment were independent of the growth parameters that generated the initial length. However, such an assumption would be unrealistic. The results are derived analytically, and illustrated with a simulation study. Until techniques that take full account of the appropriate conditioning have been developed, the effect of individual variability on growth has yet to be fully understood.

Resistivity Maxima in Lithium Fast-Ion Conductors at High Pressure

The resistivity of two types of lithium fast-ion conductors, Li16-2xZnx(GeO4)4 (x=1,2) and Li3+xGexV1-xO4 (x=0.25,0.6,0.72), showed pronounced maxima as a function of pressure. For the first type, ln(ρ / ρ0) peaked at values of 0.12 (x=1) and 0.35 (x=2) near 20 kbar and decreased thereafter up to 80 kbar. Thermal activation energies and prefactors also showed corresponding maxima. For the second type, ln(ρ / ρ0) increased to 3-4 between 20 and 32 kbar. Near 80 kbar, ρ decreased (for x=0.25) by a factor of 250. The results are interpreted in terms of negative activation volumes.

Exploring profit - Sustainability trade-offs in cropping systems using evolutionary algorithms

Models that implement the bio-physical components of agro-ecosystems are ideally suited for exploring sustainability issues in cropping systems. Sustainability may be represented as a number of objectives to be maximised or minimised. However, the full decision space of these objectives is usually very large and simplifications are necessary to safeguard computational feasibility. Different optimisation approaches have been proposed in the literature, usually based on mathematical programming techniques. Here, we present a search approach based on a multiobjective evaluation technique within an evolutionary algorithm (EA), linked to the APSIM cropping systems model. A simple case study addressing crop choice and sowing rules in North-East Australian cropping systems is used to illustrate the methodology. Sustainability of these systems is evaluated in terms of economic performance and resource use. Due to the limited size of this sample problem, the quality of the EA optimisation can be assessed by comparison to the full problem domain. Results demonstrate that the EA procedure, parameterised with generic parameters from the literature, converges to a useable solution set within a reasonable amount of time. Frontier ‘‘peels’’ or Pareto-optimal solutions as described by the multiobjective evaluation procedure provide useful information for discussion on trade-offs between conflicting objectives.

Serum immunoreactive cationic trypsinogen: A useful indicator of severe exocrine dysfunction in the paediatric patient without cystic fibrosis

We evaluated serum cationic trypsinogen as a marker of exocrine pancreatic function in children without cystic fibrosis. The ability of this test to determine steatorrhoea of pancreatic origin, and its relationship to a wide range of exocrine pancreatic function were assessed. Serum trypsinogen was measured in 32 children with steatorrhoea, 10 with pancreatic and 22 with non-pancreatic causes. In patients with pancreatic steatorrhoea, serum cationic trypsinogen was 4·9±4·9 μg/l (mean ±SD), significantly below values in patients with non-pancreatic steatorrhoea (47·0±22·1 μg/l, p<0·001) and 50 control subjects (31·4±7·4 μg/l, p<0·001). Serum cationic trypsinogen values in patients with pancreatic steatorrhoea all fell below the lower limit of our control range and below all values for patients with non-pancreatic steatorrhoea. Serum cationic trypsinogen was also evaluated against pancreatic trypsin output in 47 patients (range 0·2-17·0 yr) who underwent a hormonal pancreatic stimulation test. In 17 patients, serum cationic trypsinogen was low (<-2SD or 16·6 μg/l), and associated with greatly impaired pancreatic trypsin output, ranging from 0-8% of mean normal trypsin output. Five of these 17 patients did not have steatorrhoea. In 30 patients with normal or raised serum cationic trypsinogen (≥16·6 μg/l), pancreatic trypsin output ranged from 15-183% of mean normal values. In conclusion, low serum cationic trypsinogen suggests severely impaired exocrine pancreatic function, with sensitivity extending above the steatorrhoeic threshold. In the presence of steatorrhoea, low serum cationic trypsinogen indicates a pancreatic aetiology. Normal serum cationic trypsinogen, however, does not exclude impaired pancreatic function, above the steatorrhoeic threshold.

Spontaneous fermentation of traditional sago starch in Papua New Guinea

Sago starch is an important dietary carbohydrate in lowland Papua New Guinea (PNG). An investigation was conducted to determine whether microbes play a role in its preservation using traditional methods. In 12 stored sago samples collected from PNG villages, lactic acid bacteria (LAB) were present (>= 3.6 x 10(4) cfu/g) and pH ranged from 6.8 to 4.2. Acetic and propionic acids were detected in all samples, while butyric, lactic and valeric acids were present in six or more. In freshly prepared sago, held in sealed containers in the laboratory at 30 degrees C, spontaneous fermentation by endogenous microflora of sago starch was observed. This was evident by increasing concentrations of acetic, butyric and lactic acids over 4 weeks, and pH reducing from 4.9 to 3.1: both LAB and yeasts were involved. Survival of potential bacterial pathogens was monitored by seeding sago starch with similar to 10(4)/g of selected organisms. Numbers of Bacillus cereus, Listeria monocytogenes and Staphylococcus aureus fell to <30/g within 7 days. Salmonella sp. was present only in low numbers after 7 days (<36/g), but Escherichia coli was still detectable after three weeks (>10(2)/g). Fermentation appeared to increase the storability and safety of the product.

A TEM study on TiB2-20%MoSi2 composite: Microstructure development and densification mechanism

We report the results of transmission electron microscopy (TEM) study, carried out on a hot-pressed TiB2-20 wt.%MoSi2 composite. One of the important microstructural observations includes the detection of crystalline TiSi2 at triple grain junctions. The densification mechanism is discussed, based on experimental observations and thermodynamic analysis

Polyquinanes from (R)-(+)-limonene. Enantioselective total synthesis of the novel tricyclic sesquiterpene (-)-ceratopicanol

The first total synthesis of the biogenetically important and structurally novel triquinane sesquiterpene (-)-ceratopicanol has been accomplished.

The Indian Ocean forecast system

In order to meet the ever growing demand for the prediction of oceanographic parametres in the Indian Ocean for a variety of applications, the Indian National Centre for Ocean Information Services (INCOIS) has recently set-up an operational ocean forecast system, viz. the Indian Ocean Forecast System (INDOFOS). This fully automated system, based on a state-of-the-art ocean general circulation model issues six-hourly forecasts of the sea-surface temperature, surface currents and depths of the mixed layer and the thermocline up to five-days of lead time. A brief account of INDOFOS and a statistical validation of the forecasts of these parametres using in situ and remote sensing data are presented in this article. The accuracy of the sea-surface temperature forecasts by the system is high in the Bay of Bengal and the Arabian Sea, whereas it is moderate in the equatorial Indian Ocean. On the other hand, the accuracy of the depth of the thermocline and the isothermal layers and surface current forecasts are higher near the equatorial region, while it is relatively lower in the Bay of Bengal.