Microarray-based comparative genomic hybridisation of breast cancer patients receiving neoadjuvant chemotherapy

We analysed the molecular genetic profiles of breast cancer samples before and after neoadjuvant chemotherapy with combination doxorubicin and cyclophosphamide (AC). DNA was obtained from microdissected frozen breast core biopsies from 44 patients before chemotherapy. Additional samples were obtained before the second course of chemotherapy (D21) and after the completion of the treatment (surgical specimens) in 17 and 21 patients, respectively. Microarray-based comparative genome hybridisation was performed using a platform containing approx5800 bacterial artificial chromosome clones (genome-wide resolution: 0.9 Mb). Analysis of the 44 pretreatment biopsies revealed that losses of 4p, 4q, 5q, 12q13.11–12q13.12, 17p11.2 and 17q11.2; and gains of 1p, 2p, 7q, 9p, 11q, 19p and 19q were significantly associated with oestrogen receptor negativity. 16q21–q22.1 losses were associated with lobular and 8q24 gains with ductal types. Losses of 5q33.3–q4 and 18p11.31 and gains of 6p25.1–p25.2 and Xp11.4 were associated with HER2 amplification. No correlations between DNA copy number changes and clinical response to AC were found. Microarray-based comparative genome hybridisation analysis of matched pretreatment and D21 biopsies failed to identify statistically significant differences, whereas a comparison between matched pretreatment and surgical samples revealed a statistically significant acquired copy number gain on 11p15.2–11p15.5. The modest chemotherapy-driven genomic changes, despite profound loss of cell numbers, suggest that there is little therapeutic selection of resistant non-modal cell lineages.

Dosing of gentamicin in patients with end-stage renal disease receiving hemodialysis

The aim of this study was to evaluate dosing schedules of gentamicin in patients with end-stage renal disease and receiving hemodialysis. Forty-six patients were recruited who received gentamicin while on hemodialysis. Each patient provided approximately 4 blood samples at various times before and after dialysis for analysis of plasma gentamicin concentrations. A population pharmacokinetic model was constructed using NONMEM (version 5). The clearance of gentamicin during dialysis was 4.69 L/h and between dialysis was 0.453 L/h. The clearance between dialysis was best described by residual creatinine clearance (as calculated using the Cockcroft and Gault equation), which probably reflects both lean mass and residual clearance mechanisms. Simulation from the final population model showed that predialysis dosing has a higher probability of achieving target maximum concentration (C-max) concentrations (> 8 mg/L) within acceptable exposure limits (area under the concentration-time curve [AUC] values > 70 and < 120 mg.h/L per 24 hours) than postdialysis dosing.

Application of Monte Carlo simulations to identify an appropriate dosage strategy for patients receiving a continuous intravenous infusion of enoxaparin

Aim: To identify an appropriate dosage strategy for patients receiving enoxaparin by continuous intravenous infusion (CII). Methods: Monte Carlo simulations were performed in NONMEM, (200 replicates of 1000 patients) to predict steady state anti-Xa concentrations (Css) for patients receiving a CII of enoxaparin. The covariate distribution model was simulated based on covariate demographics in the CII study population. The impact of patient weight, renal function (creatinine clearance (CrCL)) and patient location (intensive care unit (ICU)) were evaluated. A population pharmacokinetic model was used as the input-output model (1-compartment first order output model with mixed residual error structure). Success of a dosing regimen was based on the percent of Css that is between the therapeutic range of 0.5 IU/ml to 1.2 IU/ml. Results: The best dose for patients in the ICU was 4.2IU/kg/h (success mean 64.8% and 90% prediction interval (PI): 60.1–69.8%) if CrCL60ml/min, the best dose was 8.3IU/kg/h (success mean 65.4%, 90% PI: 58.5–73.2%). Simulations suggest that there was a 50% improvement in the success of the CII if the dose rate for ICU patients with CrCL

New product screening in fast moving consumer goods

Theory suggests that the dimensions that are incorporated in the new product screening decision will differ according to the stage of the development process. The outcome of the application of different screening dimensions would be quicker, realistic and more reliable screening decisions. This research project builds on existing new product development and screening literature by investigating new product screening in international fast moving consumer goods companies. It further builds on the existing literature by measuring decision-making relating to projects in 'real time', as managers' responses refer to projects they are currently working on. The introduction of branded consumer products allows us to evolve scales used in new product research by further developing variables relating to branding, promotion and retailer power. The project uncovers multiple dimensions of new product screening and evaluation within this branded product sector. These dimensions are found to differ in their ability to discriminate between two groups of accepted and rejected projects at each of four stages of the new product development process. This investigation provides the intelligence with which managers can determine the likelihood of project acceptance and rejection at different stages of the development process. It highlights the need for managers to apply stage-specific dimensions in the new product screening decision and advocates the redefinition of new product screening from both an academic and managerial perspective. The screening decision should not be viewed as a single, early decision in a product development process, but as a series of stage specific decisions regarding future project potential.

City branding:can goods and services branding models be used to brand cities?

A city's branding is investigated using generic product and services branding models. Two generic branding models and tourism segmentation models guide an investigation into city branding 'as it should be' and 'as it is' using Birmingham, England as a case study. The unique characteristics of city brands are identified and Keller's Brand Report Card provides a theoretical framework for building a picture of the brand-building activity taking place in the city. Four themes emerge and are discussed: 1) the impact of a network on brand models developed for organisations; 2) segmentation of brand elements; 3) corporate branding; and 4) the political dimension. A conclusion is that city branding would be more effective if the systems and structures of generic branding models were adopted.