The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging : results from an Australian multicentre cohort

Background Contrast enhanced echocardiography (CEE) is utilised when sub-optimal image quality results in non-diagnostic echocardiograms. However, there have been numerous safety notices issued by regulatory authorities regarding rare but potentially serious adverse reactions (AR). This multi-centre, retrospective analysis was performed to assess the short-term safety of CEE in a broad range of indications. Methods All CEE performed over 58 months at three institutions were assessed for AR within 30 min. Results A total of 5956 CEE were performed in 5576 patients. A total of 4903 were stress CEE and 1053 resting CCE.Bolus administration in 5719, infusion in 237 cases; 89.9% of CCE were outpatients. Commonest CEE indication was functional stress testing (82.3%). There were 16 AR related to CEE (0.27%). All AR were mild, transient and all patients made a full recovery. No cases of serious anaphylaxis or death within 30 min of contrast administration. Comparing those with and without an AR, there were no significant differences in age, gender, BMI, LVEF, patient location, exam type or RVSP. There was a slightly increased likelihood of an AR during infusion versus bolus dosing (p = 0.02). Conclusion CEE is a safe investigation in a broad range of indications and clinical scenarios. AR are very rare, mild and transient.

Toxicity profile of the immunomodulatory thalidomide analogue, lenalidomide : Phase I clinical trial of three dosing schedules in patients with solid malignancies

Thalidomide is an anti-angiogenic agent currently used to treat patients with malignant cachexia or multiple myeloma. Lenalidomide (CC-5013) is an immunomodulatory thalidomide analogue licensed in the United States of America (USA) for the treatment of a subtype of myelodysplastic syndrome. This two-centre, open-label phase I study evaluated dose-limiting toxicities in 55 patients with malignant solid tumours refractory to standard chemotherapies. Lenalidomide capsules were consumed once daily for 12 weeks according to one of the following three schedules: (I) 25 mg daily for the first 7 d, the daily dose increased by 25 mg each week up to a maximum daily dose of 150 mg; (II) 25 mg daily for 21 d followed by a 7-d rest period, the 4-week cycle repeated for 3 cycles; (III) 10 mg daily continuously. Twenty-six patients completed the study period. Two patients experienced a grade 3 hypersensitivity rash. Four patients in cohort I and 4 patients in cohort II suffered grade 3 or 4 neutropaenia. In 2 patients with predisposing medical factors, grade 3 cardiac dysrhythmia was recorded. Grade 1 neurotoxicity was detected in 6 patients. One complete and two partial radiological responses were measured by computed tomography scanning; 8 patients had stable disease after 12 weeks of treatment. Fifteen patients remained on treatment as named patients; 1 with metastatic melanoma remains in clinical remission 3.5 years from trial entry. This study indicates the tolerability and potential clinical efficacy of lenalidomide in patients with advanced solid tumours who have previously received multi-modality treatment. Depending on the extent of myelosuppressive pre-treatment, dose schedules (II) or (III) are advocated for large-scale trials of long-term administration. © 2006 Elsevier Ltd. All rights reserved.

Development of empirical equations for irradiance profile of a standard parabolic trough collector using Monte Carlo ray tracing technique

Irradiance profile around the receiver tube (RT) of a parabolic trough collector (PTC) is a key effect of optical performance that affects the overall energy performance of the collector. Thermal performance evaluation of the RT relies on the appropriate determination of the irradiance profile. This article explains a technique in which empirical equations were developed to calculate the local irradiance as a function of angular location of the RT of a standard PTC using a vigorously verified Monte Carlo ray tracing model. A large range of test conditions including daily normal insolation, spectral selective coatings and glass envelop conditions were selected from the published data by Dudley et al. [1] for the job. The R2 values of the equations are excellent that vary in between 0.9857 and 0.9999. Therefore, these equations can be used confidently to produce realistic non-uniform boundary heat flux profile around the RT at normal incidence for conjugate heat transfer analyses of the collector. Required values in the equations are daily normal insolation, and the spectral selective properties of the collector components. Since the equations are polynomial functions, data processing software can be employed to calculate the flux profile very easily and quickly. The ultimate goal of this research is to make the concentrating solar power technology cost competitive with conventional energy technology facilitating its ongoing research.

Coordinated control of grid connected photovoltaic reactive power and battery energy storage systems to improve the voltage profile of a residential distribution feeder

Increasing penetration of photovoltaic (PV) as well as increasing peak load demand has resulted in poor voltage profile for some residential distribution networks. This paper proposes coordinated use of PV and Battery Energy Storage (BES) to address voltage rise and/or dip problems. The reactive capability of PV inverter combined with droop based BES system is evaluated for rural and urban scenarios (having different R/X ratios). Results show that reactive compensation from PV inverters alone is sufficient to maintain acceptable voltage profile in an urban scenario (low resistance feeder), whereas, coordinated PV and BES support is required for the rural scenario (high resistance feeder). Constant as well as variable droop based BES schemes are analyzed. The required BES sizing and associated cost to maintain the acceptable voltage profile under both schemes is presented. Uncertainties in PV generation and load are considered, with probabilistic estimation of PV generation and randomness in load modeled to characterize the effective utilization of BES. Actual PV generation data and distribution system network data is used to verify the efficacy of the proposed method.

A profile of Australian travel journalists' professional views and ethical standards

Despite significant changes in mainstream journalism in recent decades, journalistic fields beyond the news have been little explored. In an attempt to contribute to a deeper understanding of such fields, this article examines the role perceptions of 85 Australian travel journalists. By viewing travel journalism as a distinct field of practice that is affected by a unique mix of influences, this study identifies five dimensions of practitioners’ role perceptions. These relate to travel journalists’ views of themselves as Cultural Mediators, Critics, Entertainers, Information Providers and Travellers. In addition, the study examines in some depth the ethical standards of travel journalists. Determinants of these views and standards are explored. The study argues that, in light of travel journalists’ increasingly important role in reporting about foreign places, more remains to be done to promote travel stories that show a deeper understanding of other cultures and which contain a more critical appraisal of destinations.

Profile of women detected drink driving via Roadside Breath Testing (RBT) in Queensland, Australia, between 2000 and 2011

Background Drink driving among women is a growing problem in many motorised countries. While research has shown that male and female drink drivers differ on a number of characteristics, few studies have addressed the circumstances surrounding women’s drink driving offences specifically. Aim To add to previous research by comparing apprehension characteristics among men and women and to extend the understanding of the female drink driving problem by investigating the drink driving characteristics that are unique to women. Results The sample consisted of the 248,173 (21.5% women) drink drivers apprehended between 2000 and 2011 in Queensland, Australia. Gender comparisons showed that women were older, had lower levels of reoffending, and were more likely to be apprehended in Major Cities compared to men. Comparisons of age group and reoffending and non-reoffending among female drink drivers only revealed that higher BAC readings were more common among younger women. Moreover, a substantial minority (13.7%) of women aged 24 years or younger were apprehended with a BAC below0.05%, reflecting a breach of the zero tolerance BAC for provisional licence holders in Australia. Older women were more likely to be charged with a ‘failure to provide a test’ offence as a result of refusing to provide a breath or blood sample, indicating that drink driving is associated high levels of stigma for this group. Reoffending occurred among 16.2% of the female drink drivers and these drivers were more likely than non-reoffending drivers to record a mid to high range BAC, to be aged 30-39 or below 21years, and to be apprehended in Inner Regional or Remote locations. Conclusion Findings highlight the unique circumstances and divergent needs of female drink drivers compared to male drivers and for different groups of female drivers.

Load profile based determination of distribution feeder configuration by dynamic programming

This paper presents a new method to determine feeder reconfiguration scheme considering variable load profile. The objective function consists of system losses, reliability costs and also switching costs. In order to achieve an optimal solution the proposed method compares these costs dynamically and determines when and how it is reasonable to have a switching operation. The proposed method divides a year into several equal time periods, then using particle swarm optimization (PSO), optimal candidate configurations for each period are obtained. System losses and customer interruption cost of each configuration during each period is also calculated. Then, considering switching cost from a configuration to another one, dynamic programming algorithm (DPA) is used to determine the annual reconfiguration scheme. Several test systems were used to validate the proposed method. The obtained results denote that to have an optimum solution it is necessary to compare operation costs dynamically.

Effectiveness of reactive power capability of photo voltaic inverters to maintain voltage profile in a residential distribution feeder

Large penetration of rooftop PVs has resulted in unacceptable voltage profile in many residential distribution feeders. Limiting real power injection from PVs to alleviate over voltage problem is not feasible due to loss of green power and hence corresponding revenue loss. Reactive capability of the PV inverter can be a solution to address over voltage and voltage dip problems to some extent. This paper proposes an algorithm to utilize reactive capability of PV inverters and investigate their effectiveness for voltage improvement based on R/X ratio of the feeder. The length and loading level of the feeder for a particular R/X ratio to have acceptable voltage profile is also investigated. This can be useful for suburban design and residential distribution planning. Furthermore, coordination among different PVs using residential smart meters via a substation based controller is also proposed.

Effectiveness of reactive power capability of photo voltaic inverters to maintain acceptable voltage profile in a residential distribution system

Integration of rooftop PVs and increasing peak demand in the residential distribution networks has resulted in unacceptable voltage profile. Curtailing PV generation to alleviate overvoltage problem and making regular network investment to cater peak demand is not always feasible. Reactive capability of the PV inverter can be a solution to address voltage dip and over voltage problems to some extent. This paper proposes an algorithm to utilize reactive capability of PV inverters and investigate their effectiveness on feeder length and R/X ratio of the line. Feeder loading level for a particular R/X ratio to have acceptable voltage profile is also investigated. Furthermore, the need of appropriate feeder distances and R/X ratio for acceptable voltage profile, which can be useful for suburban design and distribution planning, is explored.

Study on dynamic system optimum assignment to establish marginal time equilibrium

Several analytical methods for Dynamic System Optimum (DSO) assignment have been proposed but they are basically classified into two kinds. This chapter attempts to establish DSO by equilbrating the path dynamic marginal time (DMT). The authors analyze the path DMT for a single path with tandem bottlenecks and showed that the path DMT is not the simple summation of DMT associated with each bottleneck along the path. Next, the authors examined the DMT of several paths passing through a common bottleneck. It is shown that the externality at the bottleneck is shared by the paths in proportion to their demand from the current time until the queue vanishes. This share of the externality is caused by the departure rate shift under first in first out (FIFO) and the externality propagates to the downstream bottlenecks. However, the externalities propagates to the downstream are calculated out if downstream bottlenecks exist. Therefore, the authors concluded that the path DMT can be evaluated without considering the propagation of the externalities, but just as in the evaluation of the path DMT for a single path passing through a series of bottlenecks between the origin and destination. Based on the DMT analysis, the authors finally proposed a heuristic solution algorithm and verified it by comparing the numerical solution with the analytical one.

A visual profile of Queensland indigenous and non-indigenous school children, and the association between vision and reading

This research investigated the prevalence of vision disorders in Queensland Indigenous primary school children, creating the first comprehensive visual profile of Indigenous children. Findings showed reduced convergence ability and reduced visual information processing skills were more common in Indigenous compared to non-Indigenous children. Reduced visual information processing skills were also associated with reduced reading outcomes in both groups of children. As early detection of visual disorders is important, the research also reviewed the delivery of screening programs across Queensland and proposed a model for improved coordination and service delivery of vision screening to Queensland school children.

Exercise alters the profile of phospholipid molecular species in rat skeletal muscle

We have determined the effect of two exercise-training intensities on the phospholipid profile of both glycolytic and oxidative muscle fibers of female Sprague-Dawley rats using electrospray-ionization mass spectrometry. Animals were randomly divided into three training groups: control, which performed no exercise training; low-intensity (8 m/min) treadmill running; or high-intensity (28 m/min) treadmill running. All exercise-trained rats ran 1,000 m/session for 4 days/wk for 4 wk and were killed 48 h after the last training bout. Exercise training was found to produce no novel phospholipid species but was associated with significant alterations in the relative abundance of a number of phospholipid molecular species. These changes were more prominent in glycolytic (white vastus lateralis) than in oxidative (red vastus lateralis) muscle fibers. The largest observed change was a decrease of ∼20% in the abundance of 1-stearoyl-2-docosahexaenoyl-phosphatidylethanolamine [PE(18:0/22:6); P < 0.001] ions in both the low- and high-intensity training regimes in glycolytic fibers. Increases in the abundance of 1-oleoyl-2-linoleoyl phopshatidic acid [PA(18:1/18:2); P < 0.001] and 1-alkenylpalmitoyl-2-linoleoyl phosphatidylethanolamine [plasmenyl PE (16:0/18:2); P < 0.005] ions were also observed for both training regimes in glycolytic fibers. We conclude that exercise training results in a remodeling of phospholipids in rat skeletal muscle. Even though little is known about the physiological or pathophysiological role of specific phospholipid molecular species in skeletal muscle, it is likely that this remodeling will have an impact on a range of cellular functions.

Radiographic imaging for traumatic ankle injuries : a demand profile and investigation of radiological reporting timeframes from an Australian tertiary facility

Background Radiographic examinations of the ankle are important in the clinical management of ankle injuries in hospital emergency departments. National (Australian) Emergency Access Targets (NEAT) stipulate that 90 percent of presentations should leave the emergency department within 4 hours. For a radiological report to have clinical usefulness and relevance to clinical teams treating patients with ankle injuries in emergency departments, the report would need to be prepared and available to the clinical team within the NEAT 4 hour timeframe; before the patient has left the emergency department. However, little is known about the demand profile of ankle injuries requiring radiographic examination or time until radiological reports are available for this clinical group in Australian public hospital emergency settings. Methods This study utilised a prospective cohort of consecutive cases of ankle examinations from patients (n=437) with suspected traumatic ankle injuries presenting to the emergency department of a tertiary hospital facility. Time stamps from the hospital Picture Archiving and Communication System were used to record the timing of three processing milestones for each patient's radiographic examination; the time of image acquisition, time of a provisional radiological report being made available for viewing by referring clinical teams, and time of final verification of radiological report. Results Radiological reports and all three time stamps were available for 431 (98.6%) cases and were included in analysis. The total time between image acquisition and final radiological report verification exceeded 4?hours for 404 (92.5%) cases. The peak demand for radiographic examination of ankles was on weekend days, and in the afternoon and evening. The majority of examinations were provisionally reported and verified during weekday daytime shift hours. Conclusions Provisional or final radiological reports were frequently not available within 4 hours of image acquisition among this sample. Effective and cost-efficient strategies to improve the support provided to referring clinical teams from medical imaging departments may enhance emergency care interventions for people presenting to emergency departments with ankle injuries; particularly those with imaging findings that may be challenging for junior clinical staff to interpret without a definitive radiological report.

Cisplatin treatment of primary and metastatic epithelial ovarian carcinomas generates residual cells with mesenchymal stem cell-like profile

Epithelial mesenchymal transition (EMT) and cancer stem cells (CSC) have been associated with resistance to chemotherapy. Eighty percent of ovarian cancer patients initially respond to platinum-based combination therapy but most return with recurrence and ultimate demise. To better understand such chemoresistance we have assessed the potential role of EMT in tumor cells collected from advanced-stage ovarian cancer patients and the ovarian cancer cell line OVCA 433 in response to cisplatin in vitro. We demonstrate that cisplatin-induced transition from epithelial to mesenchymal morphology in residual cancer cells correlated with reduced E-cadherin, and increased N-cadherin and vimentin expression. The mRNA expression of Snail, Slug, Twist, and MMP-2 were significantly enhanced in response to cisplatin and correlated with increased migration. This coincided with increased cell surface expression of CSC-like markers such as CD44, α2 integrin subunit, CD117, CD133, EpCAM, and the expression of stem cell factors Nanog and Oct-4. EMT and CSC-like changes in response to cisplatin correlated with enhanced activation of extracellular signal-regulated kinase (ERK)1/2. The selective MEK inhibitor U0126 inhibited ERK2 activation and partially suppressed cisplatin-induced EMT and CSC markers. In vivo xenotransplantation of cisplatin-treated OVCA 433 cells in zebrafish embryos demonstrated significantly enhanced migration of cells compared to control untreated cells. U0126 inhibited cisplatin-induced migration of cells in vivo, suggesting that ERK2 signaling is critical to cisplatin-induced EMT and CSC phenotypes, and that targeting ERK2 in the presence of cisplatin may reduce the burden of residual tumor, the ultimate cause of recurrence in ovarian cancer patients.

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